Suwen · On How Illness Appears

The text

The Yellow Emperor asked: When a person is ill with an abscess at the stomach duct, how should one examine it? Qi Bo answered: In examining this, one should wait on the stomach pulse. That pulse should be sunken and fine. Sunken and fine means the qi is reversed. When it is reversed, the person's greeting pulse is very full; when very full, there is heat. The greeting pulse is the stomach pulse. Reversed and full, heat gathers at the mouth of the stomach and does not travel; thus the stomach duct becomes an abscess. The Emperor said: Good. There are those who lie down and are not at rest. How is that? Qi Bo said: A zang has been wounded, and only when jing has a place to lodge is there rest. Thus a person cannot hang an illness in midair. The Emperor said: There are those who cannot lie on the back. How is that? Qi Bo said: The lung is the cover of the zang. When lung qi is full the vessels are large; when the vessels are large one cannot lie on the back. The discourse is in Strange and Constant, Yin and Yang. The Emperor said: There is one ill with reversal: the right pulse is sunken and tight, the left pulse floating and slow. If this is not so — where does the illness dwell? Qi Bo said: Examined in winter, the right pulse should indeed be sunken and tight; this answers the four seasons. The left pulse floating and slow — this goes against the four seasons. On the left it should mean the illness is in the kidney, and somewhat concerns the lung; there should be lumbar pain. The Emperor said: How do you say this? Qi Bo said: The Shaoyin vessel threads the kidney and networks the lung. Now one has gotten a lung pulse, and the kidney is ill from it. Thus the kidney is the illness of lumbar pain. The Emperor said: Good. There are those ill with an abscess of the neck; some are treated with the stone, some with needle and moxa, and all are finished. Where is the true in this? Qi Bo said: These are the same name and different ranks. When the qi of the abscess is at rest, it is right to open it with the needle and take it away. When qi is full and blood has gathered, it is right to drain it with the stone. This is what is called the same illness, different treatment. The Emperor said: There are those ill with rage and mania. How is this illness born? Qi Bo said: It is born from yang. The Emperor said: How does yang make a person manic? Qi Bo said: Yang qi, because it is suddenly broken and cannot be decided, is given to anger. The illness is called yang reversal. The Emperor said: How does one know it? Qi Bo said: The Yangming is always moving; the Great Yang and the Shaoyang do not move. What should not move, moving in great haste — this is the sign. The Emperor said: How does one treat it? Qi Bo said: Take away the food and it is at once done. Food enters into yin and grows qi in yang; thus take away the food and it is done. Have the person drink raw iron leavings as a decoction. Raw iron leavings send qi down in haste. The Emperor said: Good. There is one ill with a hot body, slack and fallen, sweat coming out as if from a bath, aversion to wind, little qi. What illness is this? Qi Bo said: The illness is called wine wind. The Emperor said: How does one treat it? Qi Bo said: Ze-xie and zhu, ten parts each, and mi-xian five parts; mix a three-finger pinch, and take it after the meal. What is called deep and fine: it meets the hand like a needle. Rub it, press it: what gathers is hard; what is broad is large. The Upper Classic speaks of qi communicating with heaven. The Lower Classic speaks of the changes of illness. The Golden Casket decides death and life. Measuring and gauging is to press and to gauge. Strange and Constant speaks of strange illness. What is called strange: it makes a strange illness not die by the four seasons. What is constant dies by the four seasons. What is called measuring: just then one presses and seeks it — it means pressing and seeking the pattern of the pulse. Gauging is getting the seat of the illness, and gauging it by the four seasons.

The line

Qi Bo answered: In examining this, one should wait on the stomach pulse. That pulse should be sunken and fine. Sunken and fine means the qi is reversed. When it is reversed, the person's greeting pulse is very full; when very full, there is heat. The greeting pulse is the stomach pulse. Reversed and full, heat gathers at the mouth of the stomach and does not travel; thus the stomach duct becomes an abscess.

The note

How it appears — that is what this chapter means by neng. For an abscess at the stomach duct, first wait on the stomach pulse. Form is on the outside; the appearing is in the pulse. First see how it appears; then see the form.