厥阴之为病。消渴。气上撞心。心中疼热。饥而不欲食。食则吐蛔。下之利不止。
厥阴者。至阴也。阴气至此而极。故谓之厥阴。太少两阴交尽之经。为阴极阳回之处。草木得阳气而
勾萌于至阴坤土之中。在卦为泰。在十二辰为寅。阳气将出而未出。为尚未透地之木。故在人为厥阴肝木。
至阳气透地而草木发生。在卦为大壮。在十二辰为卯。乃已出土而抽条发叶之木。在人则为少阳而属胆
经矣。前太阴为阴气之纯全。有阴无阳。故专以温经为治。少阴则阳气初生于盛阴之中。右属三焦相火。左
属膀胱肾水。水火相须。若寒邪犯脏。则
以温经复阳为治。阳邪入里。则以滋阴清降为治。厥阴虽属至阴。而阳气已长。阴阳相半矣。然终是阴中之阳。其气
犹未透达。故通篇以热多厥少为病之退。热少厥多为病之进。先厥后热。热后不厥者愈。热后厥逆下利
烦躁者死也。寒邪固多败证。而热气有余者必发痈脓。有热在里。必圊脓血。然虽发热不死。终不似有阴无阳。
下利厥冷烦躁。及厥不还者死之为甚。毕竟阴。经以阳气为重也。夫足厥阴之脉。起于足大趾。上循足 。上
踝。交出太阴之后。上 循股阴。入毛中。过阴器。抵小腹。挟胃属肝络胆。上贯膈。布胁肋。循喉咙之之后。
上入颃颡。连目系。上出额。与督脉会于巅。其支者复从肝贯膈。上注肺。邪入其经。则阴邪自下迫阳于上。故气上
撞心。心中疼热而消渴也。消渴者。饮水多而渴不止也。阴中之阳。受迫而在上。故消渴而胃觉饥。然终是阴
邪。所以不欲食。客热尚不杀谷。况阴邪乎。即使强食。阴邪不能腐化。湿热郁蒸。顷刻化而为蛔。随阴气之
上逆。故吐蛔也。若不知而以苦寒误下之。则胃阳败绝。真阳下脱。故利不止也。
厥阴病的主要症状表现为:口渴多饮,气逆上冲至心窝部,心中感觉疼痛且灼热,虽有饥饿感却不想进食,若勉强进食则会吐出蛔虫,若误用攻下法治疗,则会导致腹泻不止。
厥阴,是极致的阴。阴气运行到这里达到极点,所以称为“厥阴”。它是太阴和少阴两经阴气终结的经脉,也是阴极阳回(阴气极盛而阳气开始回复)的关键部位。就像草木在至阴的坤土之中,得到阳气而萌芽一样;在卦象上对应泰卦,在十二地支中对应寅时。此时阳气即将发出但尚未完全透出,如同还没有穿透地面的树木。所以在人体中对应厥阴肝木。等到阳气穿透地面,草木开始生长,在卦象上对应大壮卦,在十二地支中对应卯时,这是已经出土并抽条长叶的树木。在人体则转化为少阳,属于胆经。
之前的太阴经是纯粹的阴气,有阴无阳,所以专门以温通经脉为治疗方法。少阴经则是阳气初生于盛阴之中,右边归属于三焦相火,左边归属于膀胱肾水,水火相互依存。如果寒邪侵犯脏腑,则以温经复阳为治疗方法;如果阳邪入里,则以滋阴清降为治疗方法。厥阴虽然属于极阴,但阳气已经开始增长,阴阳各占一半。然而终究还是阴中之阳,其气尚不能完全透达。因此全篇以“热多厥少”作为病情好转的标志,以“热少厥多”作为病情加重的标志。先出现四肢厥冷后出现发热,发热后不再厥冷的可以痊愈;发热后再次出现厥逆、下利、烦躁的则预后不良致死。寒邪固然容易导致败证,但热气有余者必然引发痈脓;热邪在体内,必然导致排出脓血。虽然发热不一定致死,但终究不像那种有阴无阳、下利厥冷烦躁以及厥冷不回的情况那样致命。归根结底,阴经是以阳气为重心的。足厥阴肝经的脉路,起始于足大趾,沿足背向上,经过内踝,交出于足太阴脾经之后,沿大腿内侧上行,进入阴毛区域,环绕生殖器,抵达小腹,夹行于胃旁,归属于肝,联络胆,向上穿过膈肌,分布于胁肋部,沿喉咙后方,向上进入鼻咽部(颃颡),连接目系,向上出于前额,与督脉交会于头顶。其分支又从肝贯穿膈肌,向上注入肺中。邪气侵入该经,则阴邪自下向上逼迫阳气,所以出现气上撞心、心中疼痛灼热以及消渴的症状。所谓消渴,是指喝水很多但口渴不止。阴中之阳受迫而上浮,所以感到消渴且胃中觉饥。但这终究是阴邪,所以不想进食。客居的热邪尚且不能消化食物,何况是阴邪呢?即使强行进食,阴邪也不能腐熟消化,湿热郁蒸,短时间内化为蛔虫,随着阴气上逆,所以吐出蛔虫。如果不知此理而误用苦寒药物攻下,就会导致胃阳败绝,真阳下脱,所以腹泻不止。
The manifestations of Jueyin disease include: excessive thirst (Xiao Ke), sensation of Qi rushing up to the heart, pain and burning heat in the heart region, hunger without desire to eat, vomiting of roundworms (Hui) after eating, and intractable diarrhea if purgatives are mistakenly administered.
Jueyin represents the ultimate Yin. When Yin Qi reaches this stage, it is at its extreme, hence named "Jueyin." It is the meridian where the Yin of Shaoyin and Taiyin converge and terminate, serving as the juncture where extreme Yin transforms into returning Yang. Just as plants sprout in the Kun earth (representing pure Yin) upon receiving Yang Qi; in the I Ching hexagrams, it corresponds to Tai (Peace); in the twelve Earthly Branches, it corresponds to Yin. At this time, Yang Qi is about to emerge but has not yet fully penetrated, resembling wood that has not yet broken through the soil. Thus, in the human body, it corresponds to the Jueyin Liver Wood. When Yang Qi penetrates the soil and plants begin to grow, it corresponds to the Dazhuang (Great Strength) hexagram and the Mao branch. This represents wood that has emerged from the ground, sprouting branches and leaves. In the human body, it transforms into Shaoyang, belonging to the Gallbladder Meridian.
Previously, the Taiyin meridian was characterized by pure Yin, possessing Yin without Yang, so treatment focused exclusively on warming the meridians. Shaoyin is where Yang Qi initially arises amidst abundant Yin; its right side belongs to the Sanjiao Ministerial Fire, and its left side belongs to the Bladder and Kidney Water. Water and Fire support each other. If Cold Evil invades the zang organs, treatment involves warming the meridians and restoring Yang. If Yang Evil enters inward, treatment involves nourishing Yin and clearing/descending. Although Jueyin belongs to extreme Yin, Yang Qi has already begun to grow, with Yin and Yang being equal. However, it remains ultimately Yin containing Yang, and its Qi has not yet fully permeated. Therefore, throughout the text, "more heat and less cold extremities" indicates the regression of the disease, while "less heat and more cold extremities" indicates the progression of the disease. If cold extremities appear first followed by fever, and no further cold extremities occur after the fever, recovery ensues. If after fever, cold extremities, diarrhea, and irritability reappear, death results. Cold Evil often leads to deteriorating conditions, but excess Heat will inevitably cause carbuncles and suppuration. Heat within the interior will inevitably lead to the passage of pus and blood. Although fever does not necessarily mean death, it is not as severe as cases of pure Yin without Yang, featuring intractable diarrhea, cold extremities, irritability, and irreversible cold extremities. Ultimately, the Jueyin meridian emphasizes the importance of Yang Qi. The Foot Jueyin Meridian originates at the tip of the great toe, ascends along the foot, passes the ankle, crosses behind the Taiyin meridian, ascends along the medial aspect of the thigh, enters the pubic region, circles the external genitalia, reaches the lower abdomen, flanks the stomach, connects with the Liver, and links with the Gallbladder. It ascends through the diaphragm, spreads over the hypochondrium, follows the posterior aspect of the throat, enters the nasopharynx (Hangsang), connects with the eye system, emerges above the forehead, and meets the Du Meridian at the vertex. A branch returns from the Liver, pierces the diaphragm, and flows upward into the Lungs. When pathogenic factors enter this meridian, Yin pathogens force Yang upward from below. Hence, there is a sensation of Qi rushing to the heart, pain and burning heat in the heart region, and excessive thirst. Excessive thirst refers to drinking large amounts of water yet remaining unquenched. The Yang within Yin is forced upward, causing thirst and a sensation of gastric hunger. However, since it is ultimately Yin pathology, there is no desire to eat. Even exogenous Heat cannot digest food, let alone Yin pathology. Even if one forces food intake, Yin pathology cannot rot and transform it. Damp-Heat stagnates and steams, transforming into roundworms in an instant. Following the counterflow of Yin Qi, roundworms are vomited. If one fails to recognize this and mistakenly uses bitter-cold purgatives, Stomach Yang will be ruined, and True Yang will sink and escape, resulting in intractable diarrhea.