风。八风。得其正则无邪。唯不得其正。则为邪气。而能中于人。然其中者。要各以四时之胜气袭之。故春胜长夏。
长夏胜冬。而于所胜之入。则又必随脏随时而为病。以内气不守。外疾得入也。故春气病在头。夏气病在脏。在脏者心
通夏气。为诸脏之主。故病在脏。秋气病在肩背。冬气病在四肢。唯病在头。故春善鼽衄。夏邪通心。故善病胸胁。长
夏犯脾。土气动扰。积风为寒。故善病洞泄。寒中。秋暑汗不出而风袭肤腠。故善病风疟。冬寒邪犯四肢。故善病痹厥。
原其然者。人身之精。真阴也。为元气之本。唯冬能藏精。则根本内实。而邪不易犯。虽夏之暑邪。亦得汗出而邪不入
矣。若冬不藏精。与夏暑汗不出。则两失其疏泄闭藏之道。故春当病温。秋必风疟。所以随时随脏而病也。此则风邪所
犯之由也。
风善行而数变。苟一袭于人。则所伤为病。变态不一。是以或为寒热。或为热中。或为寒中。或为疠风。或为偏枯。
病虽异名。皆风之变。为寒热者。风藏皮层之间。内不得通。外不得泄。又善行数变。俟腠理开则卫失守。而洒然寒。
玄府 则阳内壅而热烦闷。此所以为寒热也。其寒则能衰饮食。其热则能消肌肉。至使 HT 不食。此寒热交作之剧也。
其为寒中热中者。风与阳明入胃。胃居中焦。其脉上行至目 内。其人肥则邪不得出。留为热中。而目黄。其人瘦则外
泄而寒。为寒中。而泣出也。风气与太阳俱入。行诸脉俞。散行分肉之间。与卫相干。故能使肌肉愤 而有疡。若气凝
不行。则又能能使肉有不仁也。至夫疠者。营气热 。其气不清。故能使鼻柱坏而色败。皮肤疡溃。风寒客于脉而不去。
名曰疠风。则风之入深矣。若风中五脏六腑之俞。则亦各入其门户。故随俞之左右。而偏中之则为偏风。循风府而上入
脑户。则为脑风入于眼系则为目风。酒饮后玄府易开而中之。汗漏不止则为漏风。入房汗出。内耗春精。而中之则为内
风。新沐而中之则为首风。风不外散。传变而入。则为肠风。热则下血。寒则飧泄。在腠理而汗泄不止。亦为泄风自循
风府。至此凡七种。所以明其成为风也。
风入五脏。变为诸症。其受病形状各有不同。肺受风之状。多汗恶风而色 然白。凡伤风必恶风其多汗者。风开腠
理。凡风入而伤。皆 然微白貌。肺色也。肺变动为咳。为风所迫。必短气。昼日差。暮则甚。昼犹与卫气相和。暮则
与阴入内。故甚也。其诊在眉上色白。心受风状。则多汗恶风。焦绝善怒。赤色。盖风木心火相薄。木与火交炽。神志
溃乱。故或为善怒。赫赤甚。则言不可快。心病则舌本强也。心和则能知味。故诊在口。肝受风状。则多汗恶风。善悲。
色微苍。嗌干。善怒。肝为风而风反胜之。则内气不胜。故善悲。动其本气。故又善怒。时憎女子者阴器强则好色。病
则妒。阴也。目乃为肝之官。故诊在目下。脾受风状。则多汗恶风。身体怠惰。四肢不欲动。脾为风木所克也。色微黄。
黄为土也。不嗜食。风胜则土疏不能化也。鼻为面主。故以此诊之。肾受风状。则多汗恶风。面庞然浮肿。脊痛不能正
立。盖邪入则肾挟水气上升。故面浮肿。在其部故脊痛不能正立。色 。肾枯也。隐曲不利。肾气伤也。诊在肌上。水
挟风行。又乘土也。此五脏受风不同。而病由以异也。而诸症又有异焉者。首风之状。头面多汗。恶风。先风一日则病
甚。头痛不可以出。内至其次日则少愈。盖因沐中风者。则中于头面。故多汗恶风。首风止作无时。故凡于风气将发先
一日而必甚。头痛以阳性先而且速也。先至必先衰。故次日则少愈。漏风之状。常多汗。不可单衣。食则汗出。盖风邪
挟酒则阳气散越故多汗。阳胜则身热恶寒。故不可单衣。食长阳气。故食则多汗。甚则阳独盛于上。故喘息汗出不止。
故衣濡。阳盛阴虚。故口干善渴。身不能劳也。泄风之状。多汗泄衣。口干不能劳事。身体尽痛。则寒。盖表既不固。而
汗出如溃。则津涸故口干液涸。血虚故不能劳事而身尽痛。且汗多亡阳。故令人寒也。此风之所部。而受病不同也。
风为百病之长。其中于人也。治必当早。迟则传入不已以至于死。盖其所以传者。皆不早治者也。当风寒客于人。
使人毫毛毕直。皮肤闭而为热。是时当以汗发之而已。即或痹不仁肿痛。亦可汤熨及火灸刺而去之。弗治。病遂入舍于
肺。以风寒自表入里。必先于肺也。风寒闭于此而不行。名肺痹。发咳。上气者。变之为咳而喘急也。此尚在可发之时。
弗治。即传之于肝。从所克也。亦曰肝痹。以肝气厥而上逆。故胁痛且厥。而犯胃故出食。可按若刺。是可治也。弗治。
再传之脾。为肝木乘土。风热入脾。病名脾痹。其在内则中热烦心。在外则肌体出黄。然尚可按可药可浴。以解表与里
之风热也。弗治。脾又传之肾。名曰疝瘕。疝瘕聚气而痛之。名少腹冤热而痛出白。冤热。烦热也。邪聚下焦。溲出白
浊。以热结不散。亏蚀真阴。如虫之吸血。故名曰蛊。然此犹可及治也。弗治。肾传之心则筋脉相引而急。病名曰螈。
心主血脉。心病则血燥。故筋脉相引。手足挛掣。是以螈名。邪气至心。其病已极。使天千一周。则五脏之气皆息。故
死。此病之次也。
有病 然如有水状。切其脉大紧。身无痛者。形不瘦。不能食。食少。此病在肾。名为肾风。如有水状。谓 然浮
肿。似水而非也。脉大者。阴虚也。脉紧者。寒气也。身无痛。形不瘦者。邪气不藏。不在表也。肾邪反克于脾。故不
能食。肾既克脾。势必至犯心。犯心则神气失守。故善惊。惊而心气痿弱。不能复。是水火俱困矣。故死也。
有内伤而适与风邪会。因加而发者。不离屏蔽而病。此皆常有所伤也。或伤湿而留于分肉血脉。或堕恐恶血。留而
不去。或卒然喜怒不节。则气有所逆。或饮食失宜。则内有所伤。或寒温不时。致腠理闭而卫气不通。其开而冒露于风
寒。则邪在前。风寒继之。二者相值。则血气凝结。故为寒痹。其或有因热而汗出受风者。虽非外感之贼风。而邪气因
加而发。亦所谓合邪也。
邪气伤人。各有所入。要归于三部。三部之风。各不同。或起于阴。或起于阳。喜怒不节则伤脏。脏伤则病起于阴。
清湿袭虚则病起于下。风雨袭虚则病起于上。至于淫佚不可胜数。然受病之始。只此三部。故风雨寒暑。不得虚邪。不
能独伤人。两虚相得。乃客其形。是以气有定舍。因处为名。上下中分为三员。
寒 按内经风门所述病机。委曲详尽。理宜复有寒门以悉病源。今书止存热病一章。且以为热病者。皆伤寒之类。
以为类伤寒。则知前此有正伤寒可知。缘其所失三卷。与奇恒六十首者。并失之。后人见仲景法与热病不合。而所以治
寒者。亦不止传经。盖仲景时必见全书。而叔和不察。遂以热病条冠仲景伤寒之首。而以传经之法。混乱诸条。由今于
本经散见者。有曰气盛身寒。得之伤寒。风邪篇曰。中于面。则下阳明。中于项。则下太阳。中于颊。则下少阳。此岂
在传经之例。宁谓风然而寒独不然欤。仲景曰。太阳病或已发热。或未发热。必恶寒体痛呕逆。脉亦阴阳俱紧者。名曰
伤寒。此与气盛身寒。得之伤寒合符。寒为阴邪。故不能即热。寒令气逆。故体痛呕吐以营中寒。故脉阴阳俱紧也。又
曰。一日太阳受之。脉若静者为不传。二三日阳明少阳证不见者。为不传也。观此则奈何以热病一条冠伤寒哉。叔和不
能述仲景而以己意乱其文。引此条以压之。使后人不知内经之文亡。而仲景补之之妙。岂非千载之罪人乎。
热 热病一门。帝问以为伤寒之类。其非谓伤寒止于热病。特帝以热起见而问伤寒之变热者耳。盖六日遍六经者。
热之势盛而易于入经者也。热病不止伤寒。而以伤寒为重。故首举六经传变之条。然伤寒变热为有阳气。热虽盛不死。
此见伤寒之未变热者。阴寒惨毒不可言无事。况两感于寒则表里阴阳俱受哉。后人又有言两感不死而可以有治法者。以
此人内伤极重。适与外感寒会故如是耳。然亦危矣。若真两感则必无治法也。
有热胜而阴虚。正气虚不能胜热者。病亦死。内经曰。有病温。汗出辄复热。而脉躁疾。不为汗衰。狂言不能食。
病名阴阳交。交者死也。阴气不守而阳邪入之。则阴已散越。故曰阴阳交。又有汗出复热不能食。脉躁盛狂言。此亦死。
盖汗生于精。精生于谷。令邪气争而得汗。是精胜也。精胜当能食而不复热。乃辄复热者。邪胜也。邪胜不能食。是精
无裨也。如是而脉躁盛。狂言。脉不胜病。故躁盛。失言故狂言。所谓见三死而不见一生。何以生耶。
热病其脉色相胜。见真阴不守。病若两感者亦必死。为其无内也。太阳之脉。色荣颧骨。热病也。荣未交。其荣颧
者。太阳热。赤色当见于颧。而荣未交。以伤卫而未及于营。其时若与厥阴脉争见者。死期不过三日。盖其所以然者。
太阳之脉浮。厥阴之脉弦而细。以病言。太阳为头痛腰脊强。厥阴为烦满囊缩。今以太阳热病。与厥阴争见。此为阴阳
俱病。夫六经热病之序。始太阳。终厥阴。今始终争见。故当不及期而死。
热病。内连肾。外见少阳之脉色。少阳之脉色。荣颧颊前。此热病也。荣未交。可得汗而已。若与少阴脉争见者。
死期不过三日。热病连肾。本经连肾也。其热之脉色荣颊前。是少阳外见。汗之可已。而独与少阴脉争见。夫少阳之脉
弦。少阴之脉沉微。与上条皆所谓阳病见阴脉也。厥阴作晦明。少阴主里。二阴为阴之根柢。两阴脉见于热病。则真阴
绝矣。真阴绝则不待行其经尽之三日者。半期也。
五脏热病。在经不已而犯及脏。则脏病见。脏病见遂有死期。如肝热病。小便先黄腹痛多卧身热。厥阴之热。起于
下焦。故小便先黄。上逆于腹。故必致腹痛筋弛。故多卧。火生于木。故身热。此厥阴之在经者也。不已则邪入于脏。
于是邪正相胜而争。气争于肝则肝气乱。故狂言而惊。以肝病主惊骇也。肝脉布胁。故胁满痛。热极阳胜而淫于四末。
故手足躁扰。其邪乘土犯胃。则胃不和而卧不安。此则肝病甚矣。庚辛死者。邪进而胜正败于克也。
心热病。则下脉厥而上。上则下脉虚。虚生脉痿。枢折挈胫纵而不任地。夫心主血脉。心为血养则不热。不热则心
脉恬和而得下交于足三阴。今心气热则火独上炎。其下行于阴之脉皆逆而上。故下虚而生脉痿。凡四肢关节之处。其枢
折而不能提挈。足胫纵缓而不能任地也。
脾热病者。先头重颊痛。烦心。颜青。欲呕。身热。脾热。热必上行。令阳明经之在头面者必先病。此头重颊痛也。
烦心者。脾热及胃及心也。颜青者。木邪胜而见侵于阳明之部也。脾燥不运。则胃亦不和。故欲呕。身热者。一身之肌
肉热也。热至此。则热淫所胜而乘肾。故热争则腰痛不可俯仰。腹满泄者。土壅故满。协热故泄。两颔痛者。阳明络也。
若逆甚。甲乙死。
肺热病者。先淅然厥。起毫毛。恶风寒。舌上黄。身热。肺主皮毛。热则畏寒。故起毫毛。恶风寒。肺络胃。中焦
热入胃。故舌黄。身热。至热甚而与脏气争。则气逆喘咳。痛走膺背。且不得太息。头痛不堪。盖喘逆在肺。则肺气不
得下行。而三阳俱壅于上。故痛苦不堪也。又汗出而寒者。以热邪在肺。皮毛不敛也。
肾热病者。先腰痛 。苦渴欲饮。身热。热至于肾。其热深矣。水失其职。必先见其部。腰与 。肾部也。无水
故腰痛 。热而虚则必引水自救。故苦渴欲饮。身热阴铄而营热也。热争则项痛而强。 寒且 。足下热。不欲言。
其逆则头痛员员澹澹然。戊己死。盖热争则外及于表之太阳。故项强痛。内甚于里之少阴。故 寒且 。此 复加以寒
者。阴无气以充也。足下热者。热起涌泉。水空之候也。不欲言者。丹田之气不赡也。员员澹澹。无所根据薄之貌。阴虚
无气。伤及心神也。
风。八风。得其正则无邪。唯不得其正。则为邪气。而能中于人。然其中者。要各以四时之胜气袭之。故春胜长夏。
长夏胜冬。而于所胜之入。则又必随脏随时而为病。以内气不守。外疾得入也。故春气病在头。夏气病在脏。在脏者心
通夏气。为诸脏之主。故病在脏。秋气病在肩背。冬气病在四肢。唯病在头。故春善鼽衄。夏邪通心。故善病胸胁。长
夏犯脾。土气动扰。积风为寒。故善病洞泄。寒中。秋暑汗不出而风袭肤腠。故善病风疟。冬寒邪犯四肢。故善病痹厥。
原其然者。人身之精。真阴也。为元气之本。唯冬能藏精。则根本内实。而邪不易犯。虽夏之暑邪。亦得汗出而邪不入
矣。若冬不藏精。与夏暑汗不出。则两失其疏泄闭藏之道。故春当病温。秋必风疟。所以随时随脏而病也。此则风邪所
犯之由也。
风善行而数变。苟一袭于人。则所伤为病。变态不一。是以或为寒热。或为热中。或为寒中。或为疠风。或为偏枯。
病虽异名。皆风之变。为寒热者。风藏皮层之间。内不得通。外不得泄。又善行数变。俟腠理开则卫失守。而洒然寒。
玄府 则阳内壅而热烦闷。此所以为寒热也。其寒则能衰饮食。其热则能消肌肉。至使 HT 不食。此寒热交作之剧也。
其为寒中热中者。风与阳明入胃。胃居中焦。其脉上行至目 内。其人肥则邪不得出。留为热中。而目黄。其人瘦则外
泄而寒。为寒中。而泣出也。风气与太阳俱入。行诸脉俞。散行分肉之间。与卫相干。故能使肌肉愤 而有疡。若气凝
不行。则又能能使肉有不仁也。至夫疠者。营气热 。其气不清。故能使鼻柱坏而色败。皮肤疡溃。风寒客于脉而不去。
名曰疠风。则风之入深矣。若风中五脏六腑之俞。则亦各入其门户。故随俞之左右。而偏中之则为偏风。循风府而上入
脑户。则为脑风入于眼系则为目风。酒饮后玄府易开而中之。汗漏不止则为漏风。入房汗出。内耗春精。而中之则为内
风。新沐而中之则为首风。风不外散。传变而入。则为肠风。热则下血。寒则飧泄。在腠理而汗泄不止。亦为泄风自循
风府。至此凡七种。所以明其成为风也。
风入五脏。变为诸症。其受病形状各有不同。肺受风之状。多汗恶风而色 然白。凡伤风必恶风其多汗者。风开腠
理。凡风入而伤。皆 然微白貌。肺色也。肺变动为咳。为风所迫。必短气。昼日差。暮则甚。昼犹与卫气相和。暮则
与阴入内。故甚也。其诊在眉上色白。心受风状。则多汗恶风。焦绝善怒。赤色。盖风木心火相薄。木与火交炽。神志
溃乱。故或为善怒。赫赤甚。则言不可快。心病则舌本强也。心和则能知味。故诊在口。肝受风状。则多汗恶风。善悲。
色微苍。嗌干。善怒。肝为风而风反胜之。则内气不胜。故善悲。动其本气。故又善怒。时憎女子者阴器强则好色。病
则妒。阴也。目乃为肝之官。故诊在目下。脾受风状。则多汗恶风。身体怠惰。四肢不欲动。脾为风木所克也。色微黄。
黄为土也。不嗜食。风胜则土疏不能化也。鼻为面主。故以此诊之。肾受风状。则多汗恶风。面庞然浮肿。脊痛不能正
立。盖邪入则肾挟水气上升。故面浮肿。在其部故脊痛不能正立。色 。肾枯也。隐曲不利。肾气伤也。诊在肌上。水
挟风行。又乘土也。此五脏受风不同。而病由以异也。而诸症又有异焉者。首风之状。头面多汗。恶风。先风一日则病
甚。头痛不可以出。内至其次日则少愈。盖因沐中风者。则中于头面。故多汗恶风。首风止作无时。故凡于风气将发先
一日而必甚。头痛以阳性先而且速也。先至必先衰。故次日则少愈。漏风之状。常多汗。不可单衣。食则汗出。盖风邪
挟酒则阳气散越故多汗。阳胜则身热恶寒。故不可单衣。食长阳气。故食则多汗。甚则阳独盛于上。故喘息汗出不止。
故衣濡。阳盛阴虚。故口干善渴。身不能劳也。泄风之状。多汗泄衣。口干不能劳事。身体尽痛。则寒。盖表既不固。而
汗出如溃。则津涸故口干液涸。血虚故不能劳事而身尽痛。且汗多亡阳。故令人寒也。此风之所部。而受病不同也。
风为百病之长。其中于人也。治必当早。迟则传入不已以至于死。盖其所以传者。皆不早治者也。当风寒客于人。
使人毫毛毕直。皮肤闭而为热。是时当以汗发之而已。即或痹不仁肿痛。亦可汤熨及火灸刺而去之。弗治。病遂入舍于
肺。以风寒自表入里。必先于肺也。风寒闭于此而不行。名肺痹。发咳。上气者。变之为咳而喘急也。此尚在可发之时。
弗治。即传之于肝。从所克也。亦曰肝痹。以肝气厥而上逆。故胁痛且厥。而犯胃故出食。可按若刺。是可治也。弗治。
再传之脾。为肝木乘土。风热入脾。病名脾痹。其在内则中热烦心。在外则肌体出黄。然尚可按可药可浴。以解表与里
之风热也。弗治。脾又传之肾。名曰疝瘕。疝瘕聚气而痛之。名少腹冤热而痛出白。冤热。烦热也。邪聚下焦。溲出白
浊。以热结不散。亏蚀真阴。如虫之吸血。故名曰蛊。然此犹可及治也。弗治。肾传之心则筋脉相引而急。病名曰螈。
心主血脉。心病则血燥。故筋脉相引。手足挛掣。是以螈名。邪气至心。其病已极。使天千一周。则五脏之气皆息。故
死。此病之次也。
有病 然如有水状。切其脉大紧。身无痛者。形不瘦。不能食。食少。此病在肾。名为肾风。如有水状。谓 然浮
肿。似水而非也。脉大者。阴虚也。脉紧者。寒气也。身无痛。形不瘦者。邪气不藏。不在表也。肾邪反克于脾。故不
能食。肾既克脾。势必至犯心。犯心则神气失守。故善惊。惊而心气痿弱。不能复。是水火俱困矣。故死也。
有内伤而适与风邪会。因加而发者。不离屏蔽而病。此皆常有所伤也。或伤湿而留于分肉血脉。或堕恐恶血。留而
不去。或卒然喜怒不节。则气有所逆。或饮食失宜。则内有所伤。或寒温不时。致腠理闭而卫气不通。其开而冒露于风
寒。则邪在前。风寒继之。二者相值。则血气凝结。故为寒痹。其或有因热而汗出受风者。虽非外感之贼风。而邪气因
加而发。亦所谓合邪也。
邪气伤人。各有所入。要归于三部。三部之风。各不同。或起于阴。或起于阳。喜怒不节则伤脏。脏伤则病起于阴。
清湿袭虚则病起于下。风雨袭虚则病起于上。至于淫佚不可胜数。然受病之始。只此三部。故风雨寒暑。不得虚邪。不
能独伤人。两虚相得。乃客其形。是以气有定舍。因处为名。上下中分为三员。
寒 按内经风门所述病机。委曲详尽。理宜复有寒门以悉病源。今书止存热病一章。且以为热病者。皆伤寒之类。
以为类伤寒。则知前此有正伤寒可知。缘其所失三卷。与奇恒六十首者。并失之。后人见仲景法与热病不合。而所以治
寒者。亦不止传经。盖仲景时必见全书。而叔和不察。遂以热病条冠仲景伤寒之首。而以传经之法。混乱诸条。由今于
本经散见者。有曰气盛身寒。得之伤寒。风邪篇曰。中于面。则下阳明。中于项。则下太阳。中于颊。则下少阳。此岂
在传经之例。宁谓风然而寒独不然欤。仲景曰。太阳病或已发热。或未发热。必恶寒体痛呕逆。脉亦阴阳俱紧者。名曰
伤寒。此与气盛身寒。得之伤寒合符。寒为阴邪。故不能即热。寒令气逆。故体痛呕吐以营中寒。故脉阴阳俱紧也。又
曰。一日太阳受之。脉若静者为不传。二三日阳明少阳证不见者。为不传也。观此则奈何以热病一条冠伤寒哉。叔和不
能述仲景而以己意乱其文。引此条以压之。使后人不知内经之文亡。而仲景补之之妙。岂非千载之罪人乎。
热 热病一门。帝问以为伤寒之类。其非谓伤寒止于热病。特帝以热起见而问伤寒之变热者耳。盖六日遍六经者。
热之势盛而易于入经者也。热病不止伤寒。而以伤寒为重。故首举六经传变之条。然伤寒变热为有阳气。热虽盛不死。
此见伤寒之未变热者。阴寒惨毒不可言无事。况两感于寒则表里阴阳俱受哉。后人又有言两感不死而可以有治法者。以
此人内伤极重。适与外感寒会故如是耳。然亦危矣。若真两感则必无治法也。
有热胜而阴虚。正气虚不能胜热者。病亦死。内经曰。有病温。汗出辄复热。而脉躁疾。不为汗衰。狂言不能食。
病名阴阳交。交者死也。阴气不守而阳邪入之。则阴已散越。故曰阴阳交。又有汗出复热不能食。脉躁盛狂言。此亦死。
盖汗生于精。精生于谷。令邪气争而得汗。是精胜也。精胜当能食而不复热。乃辄复热者。邪胜也。邪胜不能食。是精
无裨也。如是而脉躁盛。狂言。脉不胜病。故躁盛。失言故狂言。所谓见三死而不见一生。何以生耶。
热病其脉色相胜。见真阴不守。病若两感者亦必死。为其无内也。太阳之脉。色荣颧骨。热病也。荣未交。其荣颧
者。太阳热。赤色当见于颧。而荣未交。以伤卫而未及于营。其时若与厥阴脉争见者。死期不过三日。盖其所以然者。
太阳之脉浮。厥阴之脉弦而细。以病言。太阳为头痛腰脊强。厥阴为烦满囊缩。今以太阳热病。与厥阴争见。此为阴阳
俱病。夫六经热病之序。始太阳。终厥阴。今始终争见。故当不及期而死。
热病。内连肾。外见少阳之脉色。少阳之脉色。荣颧颊前。此热病也。荣未交。可得汗而已。若与少阴脉争见者。
死期不过三日。热病连肾。本经连肾也。其热之脉色荣颊前。是少阳外见。汗之可已。而独与少阴脉争见。夫少阳之脉
弦。少阴之脉沉微。与上条皆所谓阳病见阴脉也。厥阴作晦明。少阴主里。二阴为阴之根柢。两阴脉见于热病。则真阴
绝矣。真阴绝则不待行其经尽之三日者。半期也。
五脏热病。在经不已而犯及脏。则脏病见。脏病见遂有死期。如肝热病。小便先黄腹痛多卧身热。厥阴之热。起于
下焦。故小便先黄。上逆于腹。故必致腹痛筋弛。故多卧。火生于木。故身热。此厥阴之在经者也。不已则邪入于脏。
于是邪正相胜而争。气争于肝则肝气乱。故狂言而惊。以肝病主惊骇也。肝脉布胁。故胁满痛。热极阳胜而淫于四末。
故手足躁扰。其邪乘土犯胃。则胃不和而卧不安。此则肝病甚矣。庚辛死者。邪进而胜正败于克也。
心热病。则下脉厥而上。上则下脉虚。虚生脉痿。枢折挈胫纵而不任地。夫心主血脉。心为血养则不热。不热则心
脉恬和而得下交于足三阴。今心气热则火独上炎。其下行于阴之脉皆逆而上。故下虚而生脉痿。凡四肢关节之处。其枢
折而不能提挈。足胫纵缓而不能任地也。
脾热病者。先头重颊痛。烦心。颜青。欲呕。身热。脾热。热必上行。令阳明经之在头面者必先病。此头重颊痛也。
烦心者。脾热及胃及心也。颜青者。木邪胜而见侵于阳明之部也。脾燥不运。则胃亦不和。故欲呕。身热者。一身之肌
肉热也。热至此。则热淫所胜而乘肾。故热争则腰痛不可俯仰。腹满泄者。土壅故满。协热故泄。两颔痛者。阳明络也。
若逆甚。甲乙死。
肺热病者。先淅然厥。起毫毛。恶风寒。舌上黄。身热。肺主皮毛。热则畏寒。故起毫毛。恶风寒。肺络胃。中焦
热入胃。故舌黄。身热。至热甚而与脏气争。则气逆喘咳。痛走膺背。且不得太息。头痛不堪。盖喘逆在肺。则肺气不
得下行。而三阳俱壅于上。故痛苦不堪也。又汗出而寒者。以热邪在肺。皮毛不敛也。
肾热病者。先腰痛 。苦渴欲饮。身热。热至于肾。其热深矣。水失其职。必先见其部。腰与 。肾部也。无水
故腰痛 。热而虚则必引水自救。故苦渴欲饮。身热阴铄而营热也。热争则项痛而强。 寒且 。足下热。不欲言。
其逆则头痛员员澹澹然。戊己死。盖热争则外及于表之太阳。故项强痛。内甚于里之少阴。故 寒且 。此 复加以寒
者。阴无气以充也。足下热者。热起涌泉。水空之候也。不欲言者。丹田之气不赡也。员员澹澹。无所根据薄之貌。阴虚
无气。伤及心神也。
Wind. The Eight Winds (Ba Feng, winds from eight directions). When they follow their proper seasonal patterns, there is no pathogenic factor; only when they deviate from the norm do they become pathogenic factors capable of invading humans. However, those that invade must attack according to the overcoming Qi (Sheng Qi) of the four seasons. Thus, Spring overcomes Late Summer; Late Summer overcomes Winter. In the season being overcome, illness must arise in accordance with the corresponding Zang organ and time, because internal Qi fails to guard, allowing external pathogens to enter. Therefore, Spring Qi causes illness in the head; Summer Qi causes illness in the Zang organs. Among the Zang organs, the Heart corresponds to Summer Qi and is the master of all Zang organs; thus, illness occurs in the Zang organs. Autumn Qi causes illness in the shoulders and back; Winter Qi causes illness in the four limbs. Because illness occurs in the head, Spring is prone to nasal congestion and epistaxis (Jiu Nu). Because Summer pathogens connect with the Heart, illness often affects the chest and hypochondrium. Because Late Summer pathogens invade the Spleen, Earth Qi becomes disturbed, accumulating wind into cold, so illness often manifests as severe diarrhea (Dong Xie) and cold invasion in the middle (Han Zhong). Because Autumn heat prevents sweating while wind attacks the skin and interstices, illness often manifests as wind-malaria (Feng Nue). Because Winter cold pathogens invade the four limbs, illness often manifests as bi-syndrome (Bi) and cold extremities (Jue). Tracing the origin: the essence of the human body is True Yin (Zhen Yin), which is the root of Yuan Qi (Primordial Qi). Only in Winter can essence be stored; then the root is internally solid, and pathogens find it difficult to invade. Even if Summer heat pathogens exist, one can sweat out the pathogens, preventing them from entering. If one does not store essence in Winter, and in Summer heat prevents sweating, both the mechanisms of excretion and storage are lost. Thus, in Spring one should suffer from warm diseases (Wen Bing), and in Autumn wind-malaria is inevitable. This is how illness arises according to time and Zang organ. This is the cause of Wind Pathogen invasion.
Wind moves swiftly and changes frequently. Once it invades a person, the resulting injury manifests as various diseases with diverse transformations. Thus, it may manifest as alternating chills and fever (Han Re), or heat in the middle (Re Zhong), or cold in the middle (Han Zhong), or leprosy/wind disease (Li Feng), or hemiplegia/paralysis (Pian Ku). Although these diseases have different names, they are all variations of Wind. For alternating chills and fever: Wind hides between the skin layers, unable to communicate internally or excrete externally. Since it moves swiftly and changes frequently, when the pores (Cou Li) open, Wei Qi (Defensive Qi) loses its guard, causing sudden chills. When the sweat pores (Xuan Fu) close, Yang Qi becomes obstructed internally, causing heat, irritability, and stifling sensation. This is why it manifests as alternating chills and fever. The cold aspect weakens appetite; the heat aspect consumes muscle tissue, leading to inability to eat. This is the severity of alternating chills and fever. Regarding cold in the middle and heat in the middle: Wind and the Yangming channel enter the Stomach. The Stomach is located in the Middle Jiao, and its channel ascends to the inner canthus. In obese individuals, pathogens cannot exit and remain as heat in the middle, causing yellow eyes. In thin individuals, pathogens leak outward causing cold, manifesting as cold in the middle with tearing. Wind Qi enters together with the Taiyang channel, traveling through various acupoints and dispersing between muscle intervals, interfering with Wei Qi. Thus, it can cause muscle swelling and ulcers. If Qi stagnates and does not flow, it can also cause numbness in the flesh. As for Leprosy (Li): Ying Qi (Nutritive Qi) is hot, and its Qi is impure, causing destruction of the nasal bridge and deterioration of complexion, with skin ulcers and溃烂. When Wind-Cold lodges in the channels and does not depart, it is called Leprosy/Wind Disease (Li Feng), indicating deep penetration of Wind. If Wind strikes the Shu points of the Five Zang and Six Fu organs, it enters each gateway. Thus, depending on the left or right Shu point struck, it becomes Hemiplegic Wind (Pian Feng). Following Fengfu (GV16) upward into Naohu (DU17), it becomes Brain Wind (Nao Feng). Entering the eye system, it becomes Eye Wind (Mu Feng). After drinking alcohol, Xuan Fu opens easily, and invasion leads to Dripping Wind (Lou Feng) with continuous sweating. Intercourse with sweating depletes Spring Essence internally, and invasion leads to Internal Wind (Nei Feng). Washing hair recently and being invaded leads to Head Wind (Shou Feng). Wind failing to scatter externally and transmitting inward leads to Intestinal Wind (Chang Feng). Heat causes lower bleeding; cold causes undigested food diarrhea (Sun Xie). Lodging in the interstices with continuous sweating is also called Leakage Wind (Xie Feng). Following Fengfu, these constitute seven types, clarifying how they become Wind.
Wind entering the Five Zang organs transforms into various symptoms, each having different manifestations. Lung affected by Wind: profuse sweating, aversion to wind, and pale white complexion. All wind injuries involve aversion to wind; those with profuse sweating result from Wind opening the interstices. Any Wind invasion presents with a slightly pale white appearance, which is the color of the Lung. Lung movement manifests as cough; forced by Wind, there must be shortness of breath, improving during the day and worsening at night. During the day, it harmonizes with Wei Qi; at night, it enters with Yin, hence worsening. Diagnosis is indicated by white color above the eyebrows. Heart affected by Wind: profuse sweating, aversion to wind, dryness, irritability, and red complexion. Wind Wood and Heart Fire clash; Wood and Fire intertwine fiercely, confusing spirit and mind, causing irritability. Severe redness makes speech difficult; Heart disease causes stiffness of the tongue base. When Heart is harmonious, taste is perceived; thus, diagnosis is via the mouth. Liver affected by Wind: profuse sweating, aversion to wind, sadness, slightly bluish complexion, dry throat, and irritability. Liver governs Wind, but if Wind overcomes it, internal Qi is insufficient, causing sadness. Stirring its original Qi causes irritability. Sometimes hating women: strong genitalia indicate lust; disease indicates jealousy (Yin). Eyes are the orifice of the Liver; thus, diagnosis is below the eyes. Spleen affected by Wind: profuse sweating, aversion to wind, lethargy, unwillingness to move limbs. Spleen is overcome by Wind-Wood. Slightly yellow complexion (Yellow is Earth). Lack of appetite; Wind dominance causes Earth to loosen, failing to transform. Nose is the master of the face; thus, diagnosis is via the nose. Kidney affected by Wind: profuse sweating, aversion to wind, facial edema, back pain unable to stand upright. Pathogen entry causes Kidney to carry Water Qi upward, causing facial edema. Located in this region, back pain prevents standing. Complexion is [missing character], indicating Kidney exhaustion. Difficulty in urination/defecation indicates Kidney Qi injury. Diagnosis is on the muscles. Water carries Wind, attacking Earth. These are the differences in Wind affecting the Five Zang, leading to varied illnesses. Furthermore, among these symptoms, there are distinctions: Head Wind: head and face sweat profusely, aversion to wind. Illness worsens one day before the wind arrives; headache prevents going out. By the next day, it improves slightly. Because washing hair invites Wind, it strikes the head and face, causing sweating and aversion to wind. Head Wind comes and goes unpredictably; whenever wind is about to arise, it worsens one day prior. Headache, being Yang, arrives first and quickly. First arrival means decline, so it improves the next day. Dripping Wind: constant profuse sweating, cannot wear single clothes. Sweating upon eating. Because Wind Pathogen combines with alcohol, Yang Qi scatters, causing sweating. Yang dominance causes body heat and aversion to cold, hence cannot wear single clothes. Food generates Yang Qi, so sweating occurs upon eating. Severely, Yang alone dominates upper body, causing panting and continuous sweating, soaking clothes. Yang excess and Yin deficiency cause dry mouth and thirst. Body cannot endure labor. Leakage Wind: profuse sweating soaking clothes, dry mouth, inability to work, whole body pain, then chills. Because exterior is not secure, and sweating is like an ulcer, fluids dry up, causing dry mouth. Blood deficiency causes inability to work and whole body pain. Moreover, profuse sweating loses Yang, causing chills. These are the parts of Wind, yet illnesses differ.
Wind is the chief of a hundred diseases. When it invades humans, treatment must be early. Delay allows transmission until death. Those who transmit do so because they were not treated early. When Wind-Cold lodges in humans, making all hairs stand erect and skin close, causing heat, at this time it should be released via sweating. If there is numbness, pain, or swelling, herbal compresses, moxibustion, or acupuncture can remove it. If untreated, the disease enters the Lungs. Because Wind-Cold enters from exterior to interior, it must first affect the Lungs. Wind-Cold closed here without moving is named Lung Bi (Obstruction), causing cough and rebellious Qi, transforming into cough and wheezing. This is still a time for releasing via sweating. If untreated, it transmits to the Liver, following the overcoming cycle. Also called Liver Bi. Because Liver Qi rebels and rises upward, there is hypochondriac pain and cold extremities. Invading the Stomach causes vomiting. Can be treated with massage or acupuncture. If untreated, it transmits to the Spleen. Liver Wood overcomes Earth. Wind-Heat enters the Spleen, named Spleen Bi. Internally, there is middle heat and vexation; externally, the body turns yellow. Yet it can still be treated with massage, herbs, or bathing to resolve exterior and interior Wind-Heat. If untreated, the Spleen transmits to the Kidney, named Shan Jia (Hernia/Mass). Shan Jia gathers Qi and causes pain, named Lower Abdomen Oppressive Heat Pain with White Discharge. Oppressive heat means vexatious heat. Pathogens gather in Lower Jiao, urine becomes turbid white. Due to heat accumulation not dissipating, depleting True Yin like insects sucking blood, it is named Gu (Poison/Insect). Yet this is still treatable. If untreated, Kidney transmits to the Heart, causing sinews and vessels to contract and spasm, named Chou (Convulsion). Heart governs blood vessels. Heart disease causes blood dryness, so sinews and vessels contract. Hands and feet spasm, hence named Chou. Pathogen reaching the Heart, the disease is extreme. If a Heavenly Cycle completes, Qi of all Five Zang ceases, hence death. This is the sequence of disease transmission.
There is a disease presenting with edema resembling water. Pulse is large and tight. Body has no pain, form is not emaciated, cannot eat, eats little. This disease is in the Kidney, named Kidney Wind. Resembling water means edematous swelling, similar to water but not true water retention. Large pulse indicates Yin deficiency. Tight pulse indicates Cold Qi. No pain and non-emaciated form indicate pathogen is not lodging in the exterior. Kidney Pathogen counter-overcomes Spleen, hence inability to eat. Since Kidney overcomes Spleen, it inevitably attacks the Heart. Attacking the Heart causes Spirit Qi to lose its guard, causing fright. Fright causes Heart Qi to wither and weaken, unable to recover. Water and Fire are both trapped, hence death.
There is internal injury coinciding with Wind Pathogen, exacerbating and manifesting due to addition. Illness persists without leaving shelter. These are all chronic injuries. Or injury from Dampness lingering in muscle intervals and blood vessels. Or falling/fright causing bad blood to linger and not disperse. Or sudden unregulated joy/anger causing Qi rebellion. Or improper diet causing internal injury. Or irregular cold/warmth causing interstitial closure and Wei Qi blockage. When opening and exposed to Wind-Cold, pathogen is in front, Wind-Cold follows. Both meeting causes Blood and Qi coagulation, hence Cold Bi. Or those who receive Wind after sweating from heat. Although not external thieving Wind, pathogen adds and manifests, also called Combined Pathogen (He Xie).
Pathogens injuring humans each have entry points, ultimately returning to Three Regions. Wind of the three regions differs. Some originate from Yin, some from Yang. Unregulated joy/anger injures Zang organs; Zang injury means disease originates from Yin. Clear/Dampness attacks deficiency, disease originates from below. Wind/Rain attacks deficiency, disease originates from above. Licentiousness is countless. But initial illness only involves these three regions. Thus, Wind/Rain/Cold/Summer Heat cannot injure alone without Deficient Pathogen (Xu Xie). Two deficiencies meeting, then they lodge in the form. Thus, Qi has fixed abodes, named by location. Upper, Middle, Lower divided into three sections.
Cold: According to Neijing's Wind section describing pathogenesis, it is detailed and thorough. Ideally, there should be a Cold section to complete the source of disease. Now the book only preserves the Warm Disease chapter, considering Warm Diseases as a category of Shang Han (Cold Damage). Considering them as similar to Shang Han, one can know there was proper Shang Han before. Because the lost three volumes and sixty chapters of Qi Heng (Extraordinary) are also lost. Later generations saw Zhang Zhongjing's methods did not match Warm Diseases, and treating Cold was not just about channel transmission. Presumably Zhang Zhongjing saw the complete book, but Wang Shuhe did not examine it carefully, thus placing the Warm Disease clause at the head of Zhang Zhongjing's Shang Han, and using channel transmission methods to confuse various clauses. From what is scattered in this classic, there is "Qi abundance, body cold, obtained from Shang Han." The Wind Pathogen section says: "Striking the face descends to Yangming; striking the neck descends to Taiyang; striking the cheek descends to Shaoyang." How can this be in the example of channel transmission? Could it be that Wind is so, but Cold is not? Zhang Zhongjing said: "Taiyang disease, whether fever has appeared or not, must have aversion to cold, body pain, vomiting/reversal, and pulse both Yin and Yang are tight, named Shang Han." This matches "Qi abundance, body cold, obtained from Shang Han." Cold is Yin Pathogen, hence cannot immediately cause heat. Cold causes Qi rebellion, hence body pain and vomiting. Because Ying has cold, pulse Yin and Yang are both tight. He also said: "On the first day, Taiyang receives it; if pulse is quiet, it does not transmit. On the second or third day, if Yangming and Shaoyang signs do not appear, it does not transmit." Seeing this, how can one place Warm Disease clause at the head of Shang Han? Wang Shuhe could not narrate Zhang Zhongjing but confused the text with his own ideas, citing this clause to suppress it, making later generations unaware that Neijing text is lost and Zhang Zhongjing's supplementation is wonderful. Is he not a sinner of a thousand years?
Warm: The Warm Disease section, the Emperor asked regarding Shang Han as a category. It does not mean Shang Han stops at Warm Disease. Specifically, the Emperor asked about Shang Han changing to Warm based on heat. Presumably, six days covering six channels, Heat trend is abundant and easily enters channels. Warm Disease is not only Shang Han, but Shang Han is heavy. Thus, first listing six-channel transmission clauses. However, Shang Han changing to Warm has Yang Qi. Even if Heat is abundant, one does not die. This shows that Shang Han not yet changed to Warm, Yin Cold is cruel and toxic, impossible to say nothing happens. Especially if contracting Cold on both Exterior and Interior (Liang Gan), then Exterior/Interior and Yin/Yang are both affected. Later generations again said Liang Gan does not die and can have treatment methods. Because this person has severe internal injury, coinciding with external Cold, thus such. Yet it is also critical. If true Liang Gan, there must be no treatment method.
If Heat dominates and Yin is deficient, Zheng Qi is weak and cannot overcome Heat, disease also dies. Neijing said: "Having Warm Disease, sweating then fever returns, pulse is restless and rapid, does not decrease with sweating, delirious speech, inability to eat. Disease name is Yin-Yang Intersection (Yin Yang Jiao). Intersection means death. Yin Qi does not guard and Yang Pathogen enters, then Yin has already scattered. Hence named Yin-Yang Intersection." There is also sweating then fever returns, inability to eat, pulse restless and abundant, delirious speech. This also means death. Sweat is born from Essence; Essence is born from Grain. Letting Pathogen contend and obtain sweat is Essence victory. Essence victory should be able to eat and not fever return. But fever returns, meaning Pathogen victory. Pathogen victory means inability to eat, meaning Essence provides no benefit. Like this, pulse restless and abundant, delirious speech. Pulse cannot overcome disease, hence restless. Lost words hence delirium. So-called seeing three deaths and not seeing one life, how can one live?
Warm Disease, its pulse and color overcome each other, showing True Yin does not guard. If disease is Liang Gan, also must die. Because there is no interior. Taiyang pulse, color shines on cheekbones, Warm Disease. Ying has not intersected. Its shining on cheekbones: Taiyang Heat. Red color should appear on cheeks, but Ying has not intersected, because damaging Wei but not reaching Ying. At this time, if contending with Jueyin pulse appearing, death period will not exceed three days. The reason: Taiyang pulse is floating; Jueyin pulse is string-like and fine. Regarding disease: Taiyang is headache and stiff waist/spine; Jueyin is vexation/fullness and testicular retraction. Now Taiyang Warm Disease contends with Jueyin appearing. This is Yin and Yang both diseased. The order of Six Channel Warm Disease starts with Taiyang, ends with Jueyin. Now beginning and end contend appearing, hence should die before period ends.
Warm Disease, internally connects to Kidney, externally shows Shaoyang pulse/color. Shaoyang pulse/color, shines on cheek/jaw front. This is Warm Disease. Ying has not intersected, can obtain sweat and be cured. If contending with Shaoyin pulse appearing, death period will not exceed three days. Warm Disease connects to Kidney, this channel connects to Kidney. Its Heat pulse/color shines on jaw front, is Shaoyang external appearance. Sweating it can be cured. But alone contends with Shaoyin pulse appearing. Shaoyang pulse is string-like; Shaoyin pulse is deep and faint. With previous clause, all are so-called Yang disease seeing Yin pulse. Jueyin makes dark/bright; Shaoyin governs interior. Two Yins are root of Yin. Two Yin pulses seen in Warm Disease, then True Yin is exhausted. True Yin exhausted, then does not wait for completing three days of channel travel. Half period.
Five Zang Warm Diseases: If in channels not resolved and invade Zang, then Zang disease appears. Zang disease appearing then has death period. Such as Liver Warm Disease: urine first yellow, abdominal pain, much lying down, body heat. Jueyin Heat starts from Lower Jiao, hence urine first yellow. Rebelling upward to abdomen, hence must cause abdominal pain and sinew relaxation, hence much lying down. Fire born from Wood, hence body heat. This is Jueyin in channels. Not resolving, pathogen enters Zang. Then Pathogen and Zheng contend and fight. Qi contends in Liver, then Liver Qi is chaotic, hence delirious speech and fright. Because Liver disease governs fright/terror. Liver channel spreads to hypochondrium, hence hypochondriac fullness/pain. Heat extreme, Yang dominates and floods four extremities, hence hands/feet restless. Pathogen overcomes Earth attacking Stomach, then Stomach not harmonious and sleep uneasy. This is Liver disease severe. Geng/Xin days death: Pathogen advances and defeats Zheng in overcoming.
Heart Warm Disease: then lower pulses rebel upward. Upward then lower pulses empty. Empty generates Mai Wei (Vessel Flaccidity). Pivot breaks, lifting shank relaxes and cannot bear ground. Heart governs blood vessels. Heart nourished by blood then not hot. Not hot then Heart pulse is peaceful and can descend to interact with Foot Three Yin. Now Heart Qi hot then Fire alone flares upward. Its descending to Yin pulses all rebel upward. Hence lower empty generating Mai Wei. Wherever four limbs joints are, pivot breaks cannot lift. Shank relaxes cannot bear ground.
Spleen Warm Disease: first heavy head, cheek pain, vexation, green face, desire to vomit, body heat. Spleen Heat, Heat must ascend. Making Yangming channel in head/face first diseased. This is heavy head cheek pain. Vexation: Spleen Heat reaches Stomach and Heart. Green face: Wood Pathogen dominates and invades Yangming region. Spleen dry not transporting, then Stomach also not harmonious, hence desire to vomit. Body heat: whole body muscle heat. Heat to this, then Heat flood dominates and overcomes Kidney. Hence Heat contest then waist pain cannot bend/extend. Abdominal fullness/diarrhea: Earth obstruction hence full. Cooperating with Heat hence diarrhea. Bilateral mandible pain: Yangming collaterals. If rebellion severe, Jia/Yi days death.
Lung Warm Disease: first chilly trembling, raising hairs, aversion to Wind-Cold, yellow tongue coating, body heat. Lung governs skin/hairs. Heat then fears cold, hence raising hairs, aversion to Wind-Cold. Lung connects to Stomach. Middle Jiao Heat enters Stomach, hence yellow tongue. Body heat. To Heat extreme and contends with Zang Qi, then Qi rebels panting/coughing, pain travels to chest/back, and cannot take deep breath. Headache unbearable. Because panting/rebellion in Lung, then Lung Qi cannot descend, and Three Yang all obstruct upward, hence pain unbearable. Also sweating then chills: because Heat Pathogen in Lung, skin/hairs not closing.
Kidney Warm Disease: first waist pain, bitter thirst desiring drink, body heat. Heat to Kidney, its Heat is deep. Water loses its function, must first show in its region. Waist and [missing character] are Kidney region. No Water hence waist pain [missing]. Heat and empty then must draw water to save self, hence bitter thirst desiring drink. Body heat Yin melts and Ying Heat. Heat contest then neck pain and stiffness. [Missing] cold and [missing]. Feet bottom heat, do not want to speak. Its rebellion then headache dizzy/swaying. Wu/Ji days death. Because Heat contest then externally reaches Exterior Taiyang, hence neck stiff pain. Internally severe in Interior Shaoyin, hence [missing] cold and [missing]. This [missing] adding Cold: Yin has no Qi to fill. Feet bottom heat: Heat rises from Yongquan, sign of Water empty. Do not want to speak: Dantian Qi does not suffice. Dizzy/swaying: form of no foundation. Yin empty no Qi, injuring Spirit Mind.