Discourse on the Characteristics of Diseases
The Yellow Emperor asked: “When someone suffers from a gastric abscess, how should it be diagnosed?” Qi Bo replied: “To diagnose this condition, the gastric pulse should be examined; its pulse image ought to be deep and thin. Deep and thin indicates counterflow of qi; counterflow of qi makes the Renying pulse excessively large, and excessive largeness indicates the presence of heat pathogen. The Renying pulse belongs to the stomach channel. When qi is in counterflow and exuberant, it causes heat pathogen to accumulate at the stomach opening and cannot move, hence an abscess forms in the gastric cavity.”
The Yellow Emperor said: “Good. Some people cannot sleep peacefully—why is this?” Qi Bo said: “The five viscera can be damaged, and only when essence and qi have a place to lodge can one rest peacefully. Thus, a person cannot simply rid themselves of disease without cause.”
The Yellow Emperor said: “Some people cannot lie supine—why is this?” Qi Bo said: “The lung is the canopy of the five viscera. When lung qi is exuberant, it makes the pulse large; when the pulse is large, one cannot lie supine. This theory is recorded in Qi Heng Yin Yang.”
The Yellow Emperor said: “There is a person suffering from reversal disorder. The right pulse is deep and tight, the left pulse is floating and slow. I do not know where the disease is primarily located.” Qi Bo said: “When examined in winter, the right pulse should originally be deep and tight—this conforms to the four seasons; the left pulse being floating and slow violates the four seasons. The abnormality of the left pulse should indicate disease primarily in the kidney, and it is also related to the lung; there should be a symptom of lower back pain.” The Yellow Emperor said: “Why is this said?” Qi Bo said: “The Shaoyin channel traverses the kidney and connects with the lung. Now, when the lung pulse (floating and slow) is diagnosed, the kidney thereby becomes diseased. Thus, kidney disease leads to lower back pain.”
The Yellow Emperor said: “Good. Some people suffer from neck abscesses; some are treated with stone needles, others with acupuncture and moxibustion, yet both can cure it. What is the true principle behind this?” Qi Bo said: “This is a case where the disease name is the same but the type differs. When the abscess qi accumulates but does not disperse, it should be opened and drained by needling; when qi is exuberant and blood accumulates, it should be bled with a stone needle. This is what is meant by treating the same disease with different methods.”
The Yellow Emperor said: “Some people suffer from anger and mania. How does this disease arise?” Qi Bo said: “It arises from yang qi.” The Yellow Emperor said: “How can yang qi cause a person to become manic?” Qi Bo said: “Because yang qi is suddenly thwarted and difficult to disperse, the person easily becomes angry; the disease is called yang reversal.” The Yellow Emperor said: “How is it known?” Qi Bo said: “The Yangming channel often pulses; the Taiyang and Shaoyang channels do not often pulse. When these rarely-pulsing channels suddenly pulse very vigorously, that is the sign.” The Yellow Emperor said: “How is it treated?” Qi Bo said: “Restricting his diet can cure it. Because food enters the yin aspect and assists qi in the yang aspect, restricting the diet allows it to be cured. Let him take sheng tie luo yin [raw iron filings decoction], because raw iron filings can quickly descend qi.”
The Yellow Emperor said: “Good. Some people have a hot body, fatigue and weakness, sweat pouring like a wash, fear of wind, and shortness of breath. What disease is this?” Qi Bo said: “The disease is called jiu feng [wine wind].” The Yellow Emperor said: “How is it treated?” Qi Bo said: “Use ze xie [Alisma orientale] and bai zhu [Atractylodes macrocephala], each ten parts, mi xian [herb of Siegesbeckia orientalis] five parts. Mix them together, take three finger-pinches before a meal.”
What is meant by “deep palpation with fine pulse” is that it feels like a needle under the fingers; when pressing and palpating, if the pulse gathers together, it is a firm pulse; if the pulse strikes the fingers forcefully, it is a large pulse. The Shang Jing [Upper Canon] discusses qi being connected to heaven; the Xia Jing [Lower Canon] discusses the changes of disease; the Jin Kui [Golden Repository] discusses deciding life and death; the Kui Du [Measuring and Estimating] discusses palpation and diagnosis; the Qi Heng [Extraordinary and Constant] discusses strange diseases. What is called “qi” [extraordinary] refers to strange diseases that do not cause death due to changes of the four seasons; “heng” [constant] refers to ordinary diseases that cause death due to changes of the four seasons. What is called “kui” [measuring] means precisely seeking the pattern of the pulse—that is, palpating to seek the principle of the pulse; “du” [estimating] means finding the location of the disease and measuring it according to the four seasons.