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Yibian
 Shen Yaozi 
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titleWei Changchun's Medical Notes
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Fan Wenfu treated a male patient named Lin, who had a fever for nine days, was unable to speak, see, or move, and had cold limbs. All the doctors believed it to be a case of pudendal coldness. Fan checked his pulse and found no pulse in both hands. When he pressed the patient's abdomen, the patient protected it with his hands, frowning in pain. Fan then checked the anterior tibial pulse on both feet, which were strong, and concluded that there was dry stool in the abdomen. He administered a heavy formula, Major Purgative Decoction, via oral administration. After taking the medicine, the patient passed five or six pieces of dry stool, regained consciousness, and his condition improved. Fan mentioned that he usually did not pay much attention to the pulse, but since this patient had no pulse in both hands, he checked the feet. He realized that the ancients paid great attention to the pulse, and the pulse should not be overlooked. If he had not checked the feet, how could he have saved this critically ill patient? In the preface of "Treatise on Cold Damage Diseases," Zhang Zhongjing said: "If the inch pulse is deficient, check the foot pulse; if the hand pulse is deficient, check the foot pulse. Renying (ST9), Fuyang, and the three regions should be considered together. If the pulse is rapid and the breath count is less than fifty, it is difficult to make a diagnosis. Even after nine pulse-takings, there is no clear indication. The nose and the space between the eyebrows are not observed. This is like looking through a tube. To distinguish between life and death is indeed difficult." Fan usually did not pay much attention to the pulse, but in severe and critical cases, he checked the hands and feet to determine life and death. This is what Xu Lingtai meant when he said that the pulse can be relied upon, but it can also be unreliable. Fan relied on what could be trusted and conducted a detailed examination; for what was usually unreliable, he used observation, listening, questioning, and palpation to compensate for the shortcomings of pulse diagnosis, showing that he respected ancient methods but was not bound by them.

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