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Chapter 1 of 29
伤寒杂病论
Someone asks: How can we know the disorders of qi and blood (the material and energetic foundations of human life) and the internal organs through the pulse?
The teacher replies: The pulse is where the state of qi and blood first manifests. Qi and blood have states of excess and deficiency, and the functions of the internal organs likewise have tendencies toward excess and deficiency. When both qi and blood are abundant, both the inch and cubit positions of the pulse are full; when both are deficient, both positions are weak. When qi alone is in relative excess, the pulse is forceful; when blood alone is in relative excess, the pulse is slippery; when qi is deficient, the pulse is faint; when blood is deficient, the pulse is rough. When qi and blood are harmonious, the pulse is relaxed; when they are calm, the pulse is even; when they are chaotic, the pulse is disordered; when they are depleted, the pulse cannot be felt. Yang heat forces qi and blood to move rapidly, and the pulse becomes rapid (fast); yin cold obstructs the movement of qi and blood, and the pulse becomes slow.
If external pathogens are contracted, qi and blood are disturbed, and the pulse changes accordingly. The changes are endless, but their root lies in qi and blood; the manifestations of disease are diverse, but one must distinguish them from the fundamental basis. To know the source of disease, one should rely on the changes of the pulse; to know the transformations of disease, one must first investigate the root. The difference in root lies in the person themselves; examining in light of the individual constitution, disease cannot remain hidden.
Someone asks: The pulse has three regions, and yin and yang influence each other. Nutritive and defensive qi (nutritive qi and defensive qi, the body's nourishing and protective energies) together with qi and blood move within the body, ascending and descending with inhalation and exhalation, spreading upward and downward, with fluids flowing through. The pulse moves with the seasons, and its manifestations are: wiry in spring, floating in autumn, sunken in winter, surging in summer. Observing the complexion and examining the pulse, the sizes differ; within the same period, changes follow no fixed pattern. The inch and cubit positions are irregular, now short, now long; the upper and lower are disordered, sometimes present, sometimes absent. As illness changes with time, the pulse also advances, retreats, rises, and falls. If the mind is confused, diagnosis loses its guiding principles. I hope you will explain in detail.
The teacher replies: What you ask is the root source of the pulse way. The pulse has three regions, namely inch, bar, and cubit. Nutritive and defensive qi flows in circulation without losing its balance. The kidney pulse is sunken, the heart pulse is surging, the lung pulse is floating, the liver pulse is wiry—these are the normal states, differing not by a hair's breadth. The ascent and descent of qi is like the timing of a water clock, revolving in cycles: when the water has descended two marks, the pulse qi completes one full circuit. Returning again to the inch opening, deficiency and excess become manifest. The changes of the pulse influence one another, and yin and yang interfere with each other.
Wind pathogen makes the pulse floating and deficient; cold pathogen makes it firm and hard; retained fluid within makes the pulse sunken; prescribed fluid makes it wiry and tense; the moving pulse indicates pain; the rapid pulse indicates heat and vexation. If there are departures from these patterns, one must know the reason for the change. The three regions of the pulse differ, and the diseases likewise differ accordingly. A pulse that is excessively full is suspicious, and one that is excessively insufficient is equally suspicious. Pathogenic qi does not arise without cause—there must be an underlying internal problem. Examine the exterior and interior, distinguish the three burners (upper, middle, and lower burners—the three functional regions of the body as conceived by the ancients), know where the pathogen resides, investigate carefully through inspection, and infer the condition of the organs—then one may see with clarity like a spirit. I will record this for you item by item and pass it on to later worthy scholars.
The teacher says: The great method of even pulse diagnosis is to divide the pulse into three regions. Light palpation examines the qi of the skin and channels; deep palpation examines the qi of the five solid organs; medium palpation examines the qi of the six hollow organs.
The pulse is divided into inch, bar, and cubit. The inch pulse examines yang, and yang is the commander of qi; the cubit pulse examines yin, and yin is the gathering place of blood, hence they are called yin and yang. The bar position is the boundary between yin and yang, corresponding to the ascent and descent of qi and blood, and by division examines the qi of the spleen and stomach in the middle burner.
Someone asks: The classics say the pulse has "three beans" and "six beans" of weight—what does this mean?
The teacher replies: When palpating the pulse, pressure like the weight of three beans examines the qi of the lungs; pressure like six beans examines the qi of the heart; pressure like nine beans examines the qi of the spleen; pressure like twelve beans examines the qi of the liver; pressing down to the bone examines the qi of the kidneys.
Suppose a patient has diarrhea, and the pulse cannot be felt at the inch, bar, or cubit positions, but at the cubit position there is occasional slight movement, and the pulse barely responds to the finger—this is the kidney qi. If "atrophy-extreme pulses" appear (extremely slow or extremely rapid pulses), the condition is difficult to treat.
Eastern liver pulse: The liver belongs to wood and is named Jueyin. Its normal pulse is slightly wiry, soft, and long—this is the liver pulse. If liver disease manifests a soft pulse of its own, recovery will follow; if a purely wiry pulse appears, straight like a bowstring, the liver is injured, and the prognosis is known to be poor.
Southern heart pulse: The heart belongs to fire and is named Shaoyin. Its normal pulse is surging, large, and long—this is the heart pulse. If heart disease manifests a surging and large pulse of its own, recovery will follow; if the pulse comes faint and goes large, this is called "reversal," and the disease is in the interior; if the pulse has a small head and a large root, this is called "return," and the disease is in the exterior. If the upper part is faint with a small head, then sweating will occur; if the lower part is faint with a large root, then there will be blockage and obstruction with inability to urinate. If there is no sweating from the head, the condition is treatable; if there is sweating, the prognosis is poor.
Western lung pulse: The lung belongs to metal and is named Taiyin. Its normal pulse is floating and downy like a feather. If lung disease manifests this pulse of its own, recovery follows. If a slow and relaxed pulse is obtained, recovery will also occur; if a rapid pulse is obtained, the condition worsens. This is because the rapid pulse belongs to southern fire, and fire overcomes western metal—abscesses and swellings may develop, and the condition is difficult to treat.
Northern kidney pulse: The kidney belongs to water. Its normal pulse is sunken and stony. If kidney disease manifests this pulse of its own, recovery follows; if a full and large pulse is obtained, the condition worsens. This is because the full and large pulse belongs to the long summer period when earth is dominant, and earth overcomes water—the kidney water will rapidly dry up.
The teacher says: Renying pulse (the pulsation at the carotid artery) being large and Fuyang pulse (the pulsation at the dorsalis pedis artery) being small is the normal state. If the Renying and Fuyang pulses are equal, this is a reversed pattern; if the Renying pulse is weaker than the Fuyang pulse, this is a great reversal, and death may result. This is because stomach qi rises to stir the Renying pulse, and stomach qi descends to stir the Fuyang pulse. When the ascending force is strong, the Renying pulse is large; when the descending force is weak, the Fuyang pulse is small. Opposing this is reversal, and great reversal leads to death.
The teacher says: The six qi (wind, cold, summer heat, dampness, dryness, and fire) injure humans according to certain patterns. Each attacks specific regions and manifests with a sequence of onset. Wind injures the front, cold injures the back; dampness injures the lower body, fog injures the upper body; fog attacks the skin and interstices, dampness flows into the joints; extreme cold injures the channels, extreme heat injures the collaterals. Wind makes the pulse floating, cold makes it tight and tense; summer heat makes it floating and deficient, dampness makes it soft and rough; dryness makes it short and abrupt, fire makes it agitated and rapid. Wind and cold first attack the Taiyang channel; summer heat and heat injure the lung metal; dampness is born in the long summer and enters the spleen and stomach; dryness first injures the large intestine and the lung; excessive fire consumes qi, and disease arises internally, with the heart and small intestine first affected. The six qi combine and transform, transmitting between exterior and interior; when the qi of an organ is in relative excess, it may transfer to or encroach upon other organs. The manifestations of disease are too many to fully describe; when one can combine color inspection with pulse diagnosis, complete success is possible.
Someone asks: Superior physicians know the disease by inspecting the complexion, middling physicians know the disease by questioning, and inferior physicians know the disease by pulse taking. We wish to hear your explanation.
The teacher replies: Complexion and pulse correspond. Complexion governs the external appearance, pulse governs the internal condition; complexion reveals the state of the organs, and it also has its internal and external aspects. The subtlety of examining complexion lies in the bright hall (the nose) and the gate palace (between the eyebrows and the forehead). The method of examining complexion is to press with the thumb and push. To examine the bright hall, push downward; to examine the gate palace, push upward. The five colors correspond to the five organs: the liver is green, the spleen is yellow, the lungs are white, the heart is red, and the kidneys are black—clearly discernible and easy to know. The matter of life and death in complexion lies in the carefulness of the mind; if the mind is confused and the intentions unclear, it is difficult to discuss this with such a person.
Pulse colors of the gate palace:
If the color of the bright hall and gate palace is not distinct, and upon pushing the color appears green-purple—the disease is in the middle burner with accumulations; if upon pushing it is bright like water—the disease is in the upper burner with retained fluids; if upon pushing it is black-red and uneven—the disease is in the lower burner with cold and heat.
Someone asks: Complexion has internal and external aspects—how are they distinguished?
The teacher replies: That which is seen at first glance is external; that which is seen only after pressing and pushing on the bright hall and gate palace is internal. If disease arises suddenly, it first manifests in the complexion, not in the pulse; if disease develops over a long period, it first manifests in the pulse, not in the complexion; if disease has entered the organs without other symptoms, it manifests in the pulse, not in the complexion; in chronic, stubborn diseases, it also manifests in the pulse, not in the complexion.
Someone asks: Complexion has indications of life and death—what does this mean?
The teacher replies: For example, a yellow complexion like the belly of a crab indicates life; one like a bitter orange indicates death. If there is luster and vitality, there is life; if there is no luster, death follows. The other colors follow the same principle.
The teacher says: Humans receive the five constants (norms), and have five organs; the five organs produce five tones, namely gong, shang, jue, zhi, and yu. Each of the five tones is embodied in each person. Suppose a person's original tone is jue (liver), and it changes to the shang (lung) tone—this is metal overcoming wood, and death should occur in autumn; changing to gong, zhi, or yu all indicate disease, because one's original tone should not change.
If a person's original tone is gong (spleen), and it changes to the jue (liver) tone—this is wood overcoming earth, and death should occur in spring; changing to shang, zhi, or yu all indicate disease. If a person's original tone is shang (lung), and it changes to the zhi (heart) tone—this is fire overcoming metal, and death should occur in summer; changing to gong, jue, or yu all indicate disease. If a person's original tone is zhi (heart), and it changes to the yu (kidney) tone—this is water overcoming fire, and death should occur in winter; changing to jue, gong, or shang all indicate disease. If a person's original tone is yu (kidney), and it changes to the gong (spleen) tone—this is earth overcoming water, and death should occur in long summer; changing to jue, shang, or zhi all indicate disease.
All these are cases where the voice changes before the person has visibly fallen ill. Initial changes are treatable; established changes are difficult to cure. The discrimination of tones differs by subtleties of a hair's breadth and is not easily understood; if the voice changes after the disease has already manifested, it is comparatively easier to recognize.
The teacher says: While taking the pulse, if the patient yawns, this mostly indicates no disease; if he groans, it mostly indicates disease. Slurred speech indicates wind; shaking the head while speaking indicates interior pain; slow walking indicates stiffness of the exterior; sitting bent forward indicates shortness of breath; sitting with one leg extended indicates lumbar pain; guarding the abdomen with the hands as if holding an egg indicates heart pain. When the patient sighs with a long breath: if the sound of exhaling is high and inhaling is low, the disease is in the upper burner; if the sound of exhaling is low and inhaling is high, the disease is in the lower burner; if breathing in and out is rapid and hurried, there is pain in the middle burner; if the voice is small and cricking with sighs, the body is in pain; if when questioned the patient does not want to speak, and tears come before speech, there must be grief; if when questioned the patient does not respond, and tears flow incessantly, there must be hidden distress; if when questioned the patient remains silent, but after repeated questioning smiles, there must be a hidden ailment.
In excess conditions there is delirious speech (zhan yu); in deficiency conditions the voice is faint and repetitions are weak (zheng sheng). Faint, low speech indicates qi deficiency; loud, forceful speech indicates qi excess. Wanting to speak while pressing the chest with the hand indicates fullness and pain in the chest; pressing the abdomen with the hand indicates fullness and pain in the abdomen. Wanting to speak but unable to produce sound indicates swelling and pain in the throat.
The teacher says: When the pulse is diseased but the person shows no obvious signs of illness, this is called a "walking corpse"—because there is no normal organ qi, the person may suddenly become dizzy and collapse, lose consciousness, and may die prematurely. When the person is diseased but the pulse is not, this is called "internal deficiency"—because the qi of grain and the spirit qi are insufficient; although afflicted, there is no great suffering.
The teacher says: Regarding the pulse, in fat people one should examine the reason it is floating; in thin people one should examine the reason it is sunken. A fat person should normally have a sunken pulse but instead has a floating one; a thin person should normally have a floating pulse but instead has a sunken one—thus examination is required.
The teacher says: Respiration is the head of the pulse. When at the initial touch of the pulse, it comes rapid and leaves slow, this is called "exiting fast, entering slow," named "internal deficiency with external excess." When at the initial touch the pulse comes slow and leaves fast, this is called "exiting slow, entering fast," named "internal excess with external deficiency."
Inch opening (the radial artery pulsation at the wrist, the commonly used pulse-taking site) defensive qi being exuberant is called "elevated" (gao); nutritive qi being exuberant is called "manifest" (zhang); when elevated and manifest combine, it is called "guiding" (gang). Defensive qi being weak is called "timid" (die); nutritive qi being weak is called "lowly" (bei); when timid and lowly combine, it is called "diminishing" (sun). Defensive qi being harmonious is called "relaxed" (huan); nutritive qi being harmonious is called "slow" (chi); when relaxed and slow combine, it is called "sunken" (chen). If the yang pulse (inch) is floating, large, and soft, and the yin pulse (cubit) is floating, large, and soft, and the yin and yang pulses are equal, this is called the "relaxed" pulse.
Someone asks: If in the second month a downy floating pulse is obtained, why is it said that death will occur in autumn?
The teacher replies: In the second month, the pulse should be soft and weak; if instead a downy floating pulse is obtained, it is known that death will occur in autumn. In the second month, the liver is in charge; the liver belongs to wood, and its pulse should be soft and weak. Obtaining instead a downy floating pulse is the lung pulse. The lung belongs to metal, and metal overcomes wood—therefore death occurs in autumn. All other cases follow this pattern.
The teacher says: At the beginning of summer, obtaining a surging and large pulse is the seasonal pulse of summer. If the patient suffers from body pain and heaviness, sweating should be induced. If the next day there is no more pain or heaviness, sweating is not needed. If sweat comes out naturally, then the next day there will be resolution. Why? At the beginning of summer, the pulse being surging and large is the seasonal pulse—this is how it is. The four seasons follow the same pattern.
Someone asks: In any disease, to know when it arose and when it will resolve, how can this be determined?
The teacher replies: For example, if disease arises at midnight, resolution will come at noon the next day; if disease arises at noon, resolution will come at midnight. If disease arises at noon and resolves at midnight, this is because yang encountering yin brings resolution; if disease arises at midnight and resolves at noon the next day, this is because yin encountering yang brings resolution.
Someone asks: In the presence of pulse and disease, to know whether there will be recovery, how is this distinguished? Reply: If at the inch opening, bar, and cubit—all three positions—the size, floating and sunken quality, and slow or rapid nature are all equal, then although cold and heat have not yet resolved, the yin and yang of the pulse are in harmony, and although the symptoms are severe, recovery should occur.
The teacher says: If the inch pulse does not reach the bar, this is yang exhaustion; if the cubit pulse does not reach the bar, this is yin exhaustion. Both of these are untreatable and death is certain. If calculating the remaining years of life and the time of death, determine it through the cycle of months and seasons. When the pulse is floating in the fore part, the disease is in the exterior; when it floats in the hind part, the disease is in the interior. If it is soft and flows upward to the fish region, it indicates leakage of the ancestral qi; if it is solitary and sinks below the cubit, it indicates failure to store the essence; if it rises high and low without pattern, suddenly ascending and suddenly descending, treatment becomes difficult.
When the inch opening pulse is relaxed and slow: being relaxed means yang qi grows, the complexion becomes moist and fresh, the face becomes glossy, the voice becomes clear, and the hair grows long; being slow means yin qi flourishes, the marrow is generated, blood is full, and the muscles become firm and compact. When yin and yang embrace each other, nutritive and defensive qi move together, and the firm and soft complement one another—this is named "strength."
An inch opening pulse that is floating indicates the exterior; sunken indicates the interior; rapid indicates the hollow organs; slow indicates the solid organs. If the pulse is slow, this indicates disease in the solid organs.
When the inch opening pulse is floating and tight: floating indicates wind, and tight indicates cold. Wind injures the defensive, cold injures the nutritive. When both nutritive and defensive are diseased, there is aching and pain in the bones and joints, and sweating should be induced. When the inch opening pulse is floating and rapid: floating indicates wind, and rapid indicates heat. Wind being a deficiency, and deficiency leads to cold; when wind and deficiency combat each other, there is a shivering sensation with aversion to cold.
Someone asks: There are diseases with a shivering aversion to cold conjoined with fever—why is this?
The teacher replies: When yin pulse is insufficient, yang follows from above; when yang pulse is insufficient, yin rides upon it from below. What is meant by yang pulse insufficiency? When the inch opening pulse is faint, this is named yang insufficiency—yin qi ascends into the yang region, and shivering aversion to cold results. What is meant by yin insufficiency? When the cubit pulse is weak, this is named yin insufficiency—yang qi sinks and descends into the yin region, and fever results. When the yin pulse is weak, the blood is deficient; when the blood is deficient, the sinews become tense. A rough pulse indicates that nutritive qi is faint. If the pulse is floating and sweating flows like pearls, defensive qi is failing. In those with faint nutritive qi, applying moxibustion or hot needles causes the blood to congeal and cease moving, with further fever and agitation.
When the inch opening pulse at both yin and yang positions is tight, as a rule clear pathogen attacks the upper burner and turbid pathogen the lower burner. Clear pathogen attacking above is named "pure"; turbid pathogen attacking below is named "impure." When yin is attacked by pathogen, there must be internal cold with shivering; the exterior qi is slightly deficient and interior qi fails to hold, so the pathogen attacks yin. When yang is attacked by pathogen, there must be fever, headache, stiff neck, neck contracture, lumbar pain, and aching calves—this is what is meant by yang being attacked by mist and dew qi, hence it is called clear pathogen attacking the upper. When turbid pathogen attacks the lower, the yin qi shivers, the feet and knees become cold and reversed, urine and stool pass involuntarily, the exterior qi is slightly deficient and the interior qi is slightly constrained. The three burners become intermingled and chaotic, the interior and exterior do not communicate; the upper burner becomes obstructed and stifled, the organ qi fumigates one another, and the mouth ulcerates with erosion at the gums. When the middle burner fails in its governance, the stomach qi rushes upward, the spleen qi fails to turn and transport, the stomach becomes turbid, nutritive and defensive do not flow, and blood coagulates and does not circulate. If stomach qi passes forward, the urine becomes red and yellow, and abiding with heat in combat, being driven by heat, it travels through the channels and collaterals, entering and leaving the organs; where the heat passes, abscesses and purulent swellings develop. If yin qi passes forward instead, yang qi becomes exhausted and faint, yin qi loses its mandate, foreign qi enters from within, and is ejected by sneezing; the voice becomes muffled and the throat blocked, cold and reversal pursue each other and are trapped by heat, the blood congeals and discharges from below, looking like pig's liver. When both yin and yang are exhausted, the spleen qi becomes solitary and weak, the five fluids pour downward, the lower burner cannot close, the clear stools press downward with heaviness, causing frequent and difficult urination and defecation, with pain and cramping at the navel—survival will be difficult.
When the inch opening pulse at both yin and yang positions is tight, with breath exiting from the mouth, the lips and mouth dry, the patient curling up in sleep with cold feet, dribbling nose discharge, and a slippery coating on the tongue—do not treat recklessly. If by the seventh day the person has slight fever and warm hands and feet, resolution is impending; or if beyond the eighth day there is instead great fever, the condition is difficult to treat. If there is aversion to cold, vomiting will ensue; if there is pain in the abdomen, diarrhea will follow.
At the inch-opening pulse, both yin and yang are tight. As for vomiting and diarrhea, if the pulse alone does not resolve, and once the tightness departs the person becomes calm, this indicates impending recovery. If the pulse becomes slow and lasts for six to seven days, with no desire for food, this is a late-onset condition caused by water retention, and has not yet resolved; if eating proceeds normally, recovery is imminent.
At the inch-opening pulse, if it is floating and large, with heat present, and the region below the heart is actually rigid, when it pertains to the viscera, attack it; do not induce sweating. When it pertains to the bowels, do not cause frequent urination. Frequent urination will lead to hard stools, and profuse sweating will aggravate the heat. If the pulse is slow, it is not yet time to attack.
Someone asks: There are diseases where shivering occurs followed by sweating, and thereby resolution is attained—why is this?
The teacher answers: When the pulse is floating and tight, but upon pressing it becomes hollow instead, this indicates a fundamental deficiency, and thus shivering with sweating should occur. The person is fundamentally deficient, therefore shivering develops; because the pulse is floating and tight, sweating should occur and bring resolution. If the pulse is floating and rapid, and upon pressing it is not hollow, this person is not fundamentally deficient; if spontaneous resolution is approaching, mere sweating will occur, without shivering.
Someone asks: There are diseases that resolve by sweating without shivering—why? The teacher answers: When the pulse is large, floating, and rapid, there is no shivering and resolution is achieved through sweating.
Someone asks: There are diseases that resolve without shivering and without sweating—why? Answer: If the pulse is spontaneously faint, this is because there has been previous sweating, or vomiting, or purging, or blood loss, leaving the body without fluids. Here yin and yang harmonize on their own, and recovery will surely follow, hence resolution occurs without shivering or sweating.
Someone asks: In cold damage of three days, when the pulse is floating, rapid, and faint, and the patient's body feels cool and comfortable—why is this?
The teacher answers: This indicates impending resolution, occurring at midnight. When resolution comes through floating, there will be gentle sweating; When resolution comes through rapidity, the person will surely be able to eat; When resolution comes through faintness, there will surely be profuse sweating.
When the pulse is floating and slow, the face is hot and flushed with trembling and fear, sweating should occur around six to seven days bringing resolution. If fever returns instead, recovery is delayed. Slowness indicates absence of yang, inability to produce sweat, and the body will necessarily itch.
When disease lasts six to seven days, and the pulse at the three parts of the hands and feet all arrives, with great vexation and lockjaw preventing speech, and the person is restless and agitated, resolution is not yet approaching. If the pulse becomes harmonious, the person is not vexed, the eyes are heavy, and the inner margins of the eyelids appear yellow, this indicates impending resolution.
The teacher says: For diseases of latent qi, discern them by intention. Within the present month, one wishes to know latent qi. Suppose there is old latent qi, the pulse should be examined. If the pulse is weak and faint, there should be throat pain resembling an injury, not throat obstruction. If the patient says there is indeed pain in the throat, even so, purging should now be applied.
The teacher says: The patient's family comes to invite saying the patient suffers from fever and body pain, and the patient lies down on their own. After the teacher arrives and examines the pulse, if it is deep and slow, he knows the disease has healed. How does he know this? Whenever exterior disease is present, the pulse should be floating and large; now it is instead deep and slow, therefore he knows recovery has occurred. Suppose the patient says there is sudden abdominal pain, and the patient sits on their own. After the teacher arrives and examines the pulse, if it is floating and large, he knows the disease has healed. Whenever interior disease is present, the pulse should be deep and fine; now it is instead floating and large, therefore he knows recovery has occurred.
The teacher says: The patient's family comes to invite saying the patient has fever and extreme vexation. The next day the teacher arrives, and the patient lies facing the wall—this indicates the heat has already departed. If the pulse is not harmonious, one may say recovery has already occurred. If the patient lies facing the wall, and upon hearing the teacher arrive, neither startles nor rises to look, and if speech comes in threes and stops in threes, and swallows saliva during pulse-taking, this is feigned illness. If the pulse is spontaneously harmonious, one may say this disease is very severe and requires taking emetic and purgative medicines, with acupuncture and moxibustion at several tens to hundreds of points, before recovery will occur. (This is an ancient method of recognizing feigned illness by "countering deception with deception," not a genuine treatment recommendation.)
Someone asks: What is meant by extraordinary aberration in the pulse?
The teacher answers: Suppose a person falls ill, and the pulse presents with Greater Yang, corresponding to the body's manifestations, and therefore a decoction is prepared. After administering the decoction for about the time of one meal, the patient vomits profusely, has diarrhea, and abdominal pain. The teacher says: I have not previously seen this presentation—now an anomaly appears, and this is called extraordinary aberration.
Again asking: What causes this vomiting and diarrhea?
The teacher answers: It may be that old medications taken previously are now manifesting their effect, hence it is called extraordinary aberration.
Bu Gua note: This content is based on classical Chinese medicine texts and is provided solely for traditional cultural study and research. It does not constitute any medical diagnosis, medication, or treatment advice; if unwell, please seek medical attention promptly.