切 脈 而 知 死 生 存 亡 pulse correspondence to death, life, dying or birth
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十 七 難 論 切 脈 而 知 死 生 存 亡
十 七 難 曰 ： 經 言 ： 「 病 或 有 死 ， 或 有 不 治 自 愈 ， 或 連 年月 不 已 。 」 其 死 生 存 亡 ， 可 切 脈 而 知 之 耶 ？ 然 ： 可 盡 知也 。 診 病 若 閉 目 不 欲 見 人 者 ， 脈 當 得 肝 脈 ， 強 急 而 長 ， 而反 得 肺 脈 ， 浮 短 而 濇 者 ， 死 也 。 病 若 開 目 而 渴 ， 心 下 牢 者 ， 脈 當 得 緊 實 而 數 ， 反 得 沉濇 而 微 者 ， 死 也 。 病 若 吐 血 ， 復 鼽 衄 血 者 ， 脈 當 沉 細 ， 而 反 浮 大 而 牢 者， 死 也 。 病 若 譫 言 妄 語 ， 身 當 有 熱 ， 脈 當 洪 大 ， 而 反 手 足 厥 逆， 脈 沉 細 而 微 者 ， 死 也 。 病 若 大 腹 而 洩 者 ， 脈 當 微 細 而 濇 ， 反 緊 大 而 滑 者 ， 死也 。 |
17th difficult issue is linked to the 4th, 10th and 13th difficult issues. It explains change of the signs and pulse during different development of diseases
1 For example it states in the first example if observed patient closes eyes and doesn’t want to see people
so pulse will be same as pulse of the liver strong rapid and long. In opposite case when lung pulse is presented
superficial, short and grating so it means death. This example shows signs of the liver with liver pulse will produce recovery. In opposite case when signs are of liver but pulse is of lung it is death.
2 In second case it says that if patient has his eyes open but is thirsty so there will be sensation of pressure under the heart so pulse will be hard, full and fast. In contrary case when pulse is deep, grating and microscopic so it is death. This case shows signs and pulse is yang so it is beneficial. If signs are yang but pulse is yin, so it is death.
3 In third case it says that if patient vomits the blood
and has nose congestion and nasal bleeding so his pulse will be deep and fine. But if it opposite superficial, large and firm so it is death. Here signs of affected interior shows pulse of interior. In case that signs of interior change to exterior pulse, so it indicates death.
4 In fourth case it says that if patient has delirium and speaks absurd speeches and his body has fever so pulse is vast and large. In opposite case hands and legs have opposite qi flow and pulse is deep, fine and microscopic
so it is death. This difficulty explains that during hot signs pulse shows heat. If Hot signs are presented with pulse of cold, it is death.
5 Fifth case explains that if patient has large belly and diarrhea so pulse is microscopic, thin and grating. In contrary case pulse is tight/ hard, large and slippery so it is death. In this cases difficult issue explains that with empty symptoms there are empty pulse. In case of empty signs and full pulse it indicates death.
This issue is linked with difficulty 21 where pulse is primary diagnosis and signs and symptoms are secondary.
1 For example it states in the first example if observed patient closes eyes and doesn’t want to see people
so pulse will be same as pulse of the liver strong rapid and long. In opposite case when lung pulse is presented
superficial, short and grating so it means death. This example shows signs of the liver with liver pulse will produce recovery. In opposite case when signs are of liver but pulse is of lung it is death.
2 In second case it says that if patient has his eyes open but is thirsty so there will be sensation of pressure under the heart so pulse will be hard, full and fast. In contrary case when pulse is deep, grating and microscopic so it is death. This case shows signs and pulse is yang so it is beneficial. If signs are yang but pulse is yin, so it is death.
3 In third case it says that if patient vomits the blood
and has nose congestion and nasal bleeding so his pulse will be deep and fine. But if it opposite superficial, large and firm so it is death. Here signs of affected interior shows pulse of interior. In case that signs of interior change to exterior pulse, so it indicates death.
4 In fourth case it says that if patient has delirium and speaks absurd speeches and his body has fever so pulse is vast and large. In opposite case hands and legs have opposite qi flow and pulse is deep, fine and microscopic
so it is death. This difficulty explains that during hot signs pulse shows heat. If Hot signs are presented with pulse of cold, it is death.
5 Fifth case explains that if patient has large belly and diarrhea so pulse is microscopic, thin and grating. In contrary case pulse is tight/ hard, large and slippery so it is death. In this cases difficult issue explains that with empty symptoms there are empty pulse. In case of empty signs and full pulse it indicates death.
This issue is linked with difficulty 21 where pulse is primary diagnosis and signs and symptoms are secondary.
