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Shang Han Lun · Treatise on Cold Damage
15. Contraindications to Sweating · Pulses, Signs and Treatment
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Illness may become extremely urgent, and in a sudden emergency the essential material is difficult to find by searching the text. Therefore the formulas and treatments that may or may not be used are collected again here. Compared with searching the three yin and three yang chapters, this makes them easier to see. Some material is not confined to those chapters and appears only among these indications and contraindications.
The pulse is yielding and weak: weakness is instead at the guan, yielding at the uppermost position, faintness above and roughness below. Faintness means insufficient yang qi; roughness means absence of blood. Yang qi is unexpectedly faint, and wind-strike with sweating instead produces restlessness and agitation. Roughness means absence of blood, with reversal cold and chill. Inducing sweating when yang is faint causes restlessness and inability to sleep.
Stirring qi on the right forbids sweating. Inducing it causes nosebleeding, thirst and distressing vexation; drinking water immediately causes it to be vomited.
Stirring qi on the left forbids sweating. Inducing it causes dizziness, unceasing sweat, twitching sinews and quivering flesh.
Stirring qi above forbids sweating. Inducing it makes qi surge upward directly to the tip of the Heart.
Stirring qi below forbids sweating. Induction produces no sweat but great vexation, distressing pain of bones and joints, spinning vision, aversion to cold and vomiting after eating. Grain cannot proceed onward.
Blockage of the throat forbids sweating. Inducing it causes vomiting of blood, qi on the verge of expiring, reversal cold of hands and feet, a wish to lie curled up and inability to become warm.
Rapid, stirring, faint and weak pulse findings forbid sweating. Inducing it causes difficult defecation, dryness in the abdomen and a dry Stomach with agitation. Outward forms may resemble one another while their roots have different origins.
The pulse is faint and weak: weakness is instead at the guan, yielding at the uppermost position, wiriness above and faintness below. Wiriness signifies yang movement, faintness yin cold. There is repletion above and deficiency below, with a wish for warmth. Faintness and wiriness indicate deficiency, forbidding sweating. Inducing it causes cold trembling from which the person cannot recover unaided.
Cough makes the condition worse, with frequent vomiting of thin saliva and foam, a throat that must become dry, difficult urination and hungry agitation in the Heart region. Attacks occur in full-day cycles and resemble nüe fever, but with cold and no heat. Deficiency produces cold trembling; cough and sweating occur, with a curled posture, distressing fullness and renewed hardness in the abdomen.
Reversal cold with a tight pulse forbids sweating. Inducing it disorders the voice, makes the throat hoarse and tongue wilted, and prevents the voice from coming forth.
After the various contrary applications of sweating, mild illness becomes difficult to resolve. In severe illness, disordered speech and dizzy vision mean death; life will be difficult to preserve.
Cough with free urination or urinary incontinence forbids sweating. Sweat causes reversal counterflow cold of all four limbs.
Cold damage with headache, gently rising fever, a form resembling wind-strike, persistent slight sweating and spontaneous vomiting becomes more agitated after purging, with distressing vexation in the Heart region resembling hunger. Induced sweating causes jing spasm disorder, a rigid body and difficulty flexing and extending. Fumigation produces yellowing and inability to urinate; moxibustion produces cough and expectoration.
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