Question: "What is meant by 'disaster and anomaly in the pulse'?" The master replied: "Suppose a person is ill, and the pulse indicates taiyang, which corresponds to the symptoms. Therefore, a decoction is prepared and administered. Shortly after taking the decoction, the patient experiences severe vomiting or diarrhea with abdominal pain." The master said: "I did not observe these symptoms before, but now they have changed. This is called disaster and anomaly." Another question was asked: "Why does this vomiting and diarrhea occur?" The answer was: "Perhaps it is due to medication taken in the past, which is now causing a reaction. Hence, it is called disaster and anomaly."

bubble_chart Note

Disaster and anomaly in the pulse refers to changes caused by medication. For example, if a person has taiyang disease and the pulse indicates taiyang, which corresponds to the symptoms, a taiyang disease decoction is prepared and administered. Shortly after taking the decoction, the patient experiences severe vomiting, diarrhea, and abdominal pain. The master asked: "I did not observe these symptoms before, but now they have changed. Why does this vomiting and diarrhea occur?" The patient replied: "Perhaps it is due to medication taken in the past, which is now causing a reaction. Hence, it is called disaster and anomaly." It is the duty of the physician to inquire, but the patient must also be completely honest to allow the physician to do their best. Zhang Zhongjing included this passage to warn against patients taking medication without informing the physician, and physicians failing to ask about previously taken medication.

bubble_chart Collected Annotations

• Cheng Wuji said: "When the physician matches the pulse and symptoms with the medication, but the condition changes unexpectedly, it is called disaster and anomaly."
• Zhang Zhicong said: "When the pulse indicates taiyang and corresponds to the symptoms, such as in taiyang disease where the pulse is floating, there is stiffness and pain in the neck, and aversion to cold, the pulse and symptoms correspond. If the patient has taken medication in the past, it may now cause a reaction. Shortly after taking the decoction, the medication has not yet circulated through the meridians, indicating that it is due to medication taken in the past."