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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 48 · Great Anomalies
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Fullness in Liver, Kidney and Lung, when all are replete, produces swelling. Lung obstruction brings panting and fullness beneath both flanks. Liver obstruction fills both flanks, brings startlement when lying down and prevents urination. Kidney obstruction brings fullness from beneath the feet to the lower abdomen. The shins differ in size; hips and lower legs enlarge. Lameness readily changes into one-sided withering.
A full, large Heart pulse brings convulsive seizures and contracted sinews. A small, urgent Liver pulse likewise brings convulsive seizures and contraction. A Liver pulse rushing suddenly occurs after fright or alarm; the pulse may fail to arrive, with something like loss of voice, yet recover without treatment.
Small, urgent Kidney, Liver or Heart pulses that do not beat forcefully all indicate masses. Kidney and Liver pulses both sinking mean stone Water; both floating, Wind Water; both deficient, death; both small and stringlike, impending startlement.
A large, urgent, sinking Kidney pulse and a large, urgent, sinking Liver pulse both indicate hernia. A beating, slippery, urgent Heart pulse means Heart hernia. A sinking, beating Lung pulse means Lung hernia. Urgency in Three Yang means masses; in Three Yin hernia; in Two Yin convulsive counterflow; in Two Yang startlement.
A Spleen pulse beating outward and sinking means intestinal flux that ends of itself after a long time. A small, relaxed Liver pulse means intestinal flux easily treated. A small, beating and sinking Kidney pulse means intestinal flux with blood below; warm blood and a hot body mean death.
Flux involving Heart and Liver also discharges blood. Illness of these two zang organs together can be treated. A small, sinking and rough pulse means intestinal flux; bodily heat means death. Death comes seven days after heat appears.
A Stomach pulse sinking, beating and rough, a Stomach pulse beating outward and large, and a Heart pulse small, firm and urgent all indicate obstruction with one-sided withering. It begins on the left in men and the right in women. If the person is not mute and the tongue moves, it can be treated and recovery begins in thirty days.
In cases described as following the course, there is muteness and recovery begins in three years. Those under twenty die in three years.
Reading note: The supplied thirty-day, three-year and under-twenty distinctions remain; the three-year periods are not changed to days.
A pulse arriving with forceful beating, nosebleed and bodily heat means death. A pulse arriving suspended, hooklike and floating is a normal pulse.
A pulse arriving like panting is called sudden counterflow, in which the person does not know to speak with others. Arrival as though rapid makes a person suddenly startled; it ends of itself in three or four days.
A pulse arriving with floating convergence, as though rapid, ten or more arrivals within one breath, means channel qi is insufficient. From its first slight appearance, death comes in ninety days.
Arrival like kindling on fire means Heart essence has been taken away: death when grasses dry. Arrival like scattered leaves means Liver qi is deficient: death when tree leaves fall. Arrival like a visiting guest means the pulse is blocked yet beats: Kidney qi is insufficient. It turns and departs; death comes at jujube flowering.
Arrival like a ball of mud means Stomach essence is insufficient: death when elm pods fall. Arrival like a transverse barrier means Gallbladder qi is insufficient: death when grain ripens. Arrival like a string or thread means the receiving sac’s essence is insufficient. The illness brings frequent speech; death comes with falling frost. Without speech it can be treated.
Arrival like interlacing lacquer means arrival from both sides. From its first slight appearance, death comes in thirty days. Arrival like a surging spring, floating and beating within flesh, means Taiyang qi is insufficient, with scant qi and taste: death when chives flower.
Arrival like collapsing earth, unobtainable on pressure, means flesh is insufficient. Black appears first among the five colors; death comes when bai lei, the white clusters, appear.
Arrival like a suspended form, xuan yong, means it floats under palpation and grows larger when pressed. The twelve transport sites are insufficient: death when water freezes.
Arrival like a laid-down knife means small and urgent at a floating level, but firm, large and urgent under pressure. The five zang organs are congested and heated; cold and heat gather in Kidney alone. Such a person cannot sit; death comes at the Beginning of Spring.
Arrival like a slippery ball that does not meet the hand means it cannot be obtained on pressure. Large Intestine qi is insufficient: death when jujube leaves emerge. Arrival like a blossom makes the person fearful, unwilling to sit or lie, constantly listening while walking or standing. Small Intestine qi is insufficient: death in late autumn.
Reading note: The supplied normal-pulse clause, breath counts, ninety/thirty-day periods and seasonal markers are preserved. The turning-and-departing phrase 懸去 follows a classical reading of repeated withdrawal. Scant qi and taste retains the disputed 少氣味 wording. Bai lei and xuan yong keep uncertain historical images; no modern species, rash diagnosis or exact calendar date is imposed. The receiving sac retains 胞 without replacing it with a single modern anatomical identification.
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