制水,而水反侮脾,是谓辟阴。辟者,放僻也)。
结阳者,肿四肢(阳,六阳也,四肢为诸阳之本,故云);结阴者,便血一升,再结二升,三结三升(
阴,六阴也。阴主血,邪结阴分,故当便血。病浅者,一升即愈。若不愈而再结,邪甚于前矣,故便血二升。
更不愈为尤甚,故便血三升)。阴阳结斜,多阴少阳,曰石水,少腹肿(斜。当作邪。六阴六阳诸经皆能结聚水
邪,若多在阴经,少在阳经,病生石水。沉坚在下,症则少腹肿也);二阳结谓之消(胃与大肠经也,阳邪结
于肠胃,则成三消之症,多饮而渴不止为上消,多食而饥不止为中消。多溲而膏浊不止为下消);三阳结谓之
隔(膀胱、小肠二经也。邪结膀胱,则气化不行,津液阻绝。小肠居大肠之上、胃之下,盛水谷而厘清浊者也。邪
乘之则水液不前,糟粕不后,二者
皆痞隔之象也),三阴结谓之水(脾肺二经也。脾土制水,土受邪则水反侮之,肺金生水,金气病则水不能输,
故寒结三阴而水胀之症作矣);一阴一阳结谓之喉痹(一阴,肝与心主也,一阳,胆与三焦也。肝胆属木,心
主三焦属火,四经皆亢上,其脉并络于喉,阳邪内结,痹症乃生。痹者,闭也)。
《灵枢·经脉》篇曰∶〔肺,手太阴也〕是动则病肺胀满膨膨而喘咳(动者,变也,变常而病也。肺脉起中
焦,循胃上膈属肺,故病如此),缺盆中痛,甚则交两手而瞀,此谓臂厥(缺盆近肺,肺病则痛。瞀,麻木也。
肺脉出腋下行肘臂,故臂厥)。是主肺所生病者,咳,上气喘渴,烦心胸满, 臂内前廉痛厥,掌中热(喘者,
气上而声粗息急也。渴者,金令燥也。太阴之别,直入掌中。故为痛厥掌热)。气盛有余,则肩背痛,风寒,
汗出中风,小便数而欠(肺之筋结于肩背,故气盛则痛。肺主皮毛,风寒在表,故汗出中风。母病传子,故肾
病而小便数且欠也)。气虚则肩背痛寒,少气不足以息,溺色变(肩背处上焦为阳分,气虚则阳病,故为痛为
寒为少气。金衰则水涸,故溺色变为黄赤)。
〔大肠,手阳明也〕是动则病齿痛颈肿(阳明支脉从缺盆上颈贯颊,入下齿中)。是主津液所生病者(大
肠或泄或闭,皆津液病也)。目黄口干,鼽衄喉痹,肩前 痛,大指次指痛不用(皆本经之脉所过,故如此)。
气有余则当脉所过者热肿,虚则寒栗不复(不复,不易温也)。
〔胃,足阳明也〕是动则病洒洒振寒,善伸数欠,颜黑(振寒者,肝风胜也。伸者,胃之郁也。欠与颜黑,肾象
也,土虚水侮,故肾之象见),病至则恶人与火,闻
木音则惕然而惊,心欲动,独闭户塞牖而处,甚则欲上高而歌,弃衣而走(阳明热甚,则恶人与火。惊闻木音
者,土畏木也。欲闭户者,火动则畏光明也。上高而歌者,火性上越且阳盛,则四肢实也。弃衣而走者,中外
皆热也)。贲响腹胀,是为 厥(贲响者,腹如雷鸣也。 ,足胫也。阳明之脉,自膝下胫,故胫 厥逆)。是
主血所生病者(阳明为受谷而多血之经),狂疟温淫汗出,鼽衄,口 唇胗,颈肿喉痹(热甚则狂,风甚则疟,
且汗出衄血、口 唇疮等症,皆本经经脉之所过也),大腹水肿,膝膑肿痛,循膺、乳、气街、股、伏兔、 外
廉、足跗上皆痛,中指不用(阳明脉从缺盆下乳挟脐腹、前阴,由股下足,以入中指,故病状如上)。气盛则身
以前皆热,其有余于胃,则消谷善饥,溺色黄(此阳明实热,在经在脏之辨也)。气不足则身以前寒栗,胃中
寒则胀满(此阳明虚寒在经在脏之辨也)。
〔脾,足太阴也〕是动则病舌本强,食则呕(脉连舌本故强,脾虚不运故呕),胃脘痛,腹胀善噫(脾
脉入腹络胃,故为痛为胀。阴盛而上走阳明,故气滞为噫),得后与气则快然如衰(后,大便也。气,转失气
也,气通故快),身体皆重(脾主肌肉,脾主湿,湿伤则体重)。是主脾所生病者,舌本痛,体不能动摇,食
不下,烦心,心下急痛,溏、瘕泄,水闭,黄胆,不能卧,强立股膝内肿厥,足大指不用(支者,上膈注心,
故为烦心与痛。溏者,水泄也。瘕者,痢疾也。水闭者,土病不能治水也,水闭则湿热壅而为疸,为不卧。脾
脉起于足拇,以上膝股,肿与厥之所由生也)。
〔心,手少阴也〕是动则病嗌干心痛,渴而欲饮,是为臂厥。是主心所生病者(支者,从心系上咽,故嗌
干心痛,火炎故渴,脉循臂内,故为臂厥),目黄胁痛, 臂内后廉痛厥,掌中热痛(脉系目系,故目黄。出
腋下,故胁痛。循臂入掌,故有热痛等症)。
〔小肠,手太阳也〕是动则病嗌痛颔肿,不可以顾,肩似拔, 似折(经脉循咽下膈,支者循颈上颊,循
绕肩,故为病如上)。是主液所生病者(小肠分水谷,故主液),耳聋目黄颊肿,颈颔肩 肘臂外后廉痛(皆
经脉所及也)。
〔膀胱,足太阳也〕是动则病冲头痛(本经脉上额入脑,故邪气冲而头痛)。目似脱,项如拔,脊痛腰似
折,髀不可以曲, 如结, 如裂,是为踝厥(皆经脉所及之病也)。是主筋所生病者(周身之筋,惟足太阳至
多至大,故凡筋症,皆足太阳水亏也),痔疟狂癫疾(脉入肛,故为痔。经属表,故为疟。邪入太阳,故为狂
癫),头囱项痛,目黄泪出鼽衄,项背腰尻 脚皆痛,小指不用。(皆本经所过之症)。
〔肾,足少阴也〕是动则病饥不欲食(水中有火,为脾之母。真火不生土则脾虚,虽饥不能食矣),面如漆
柴,咳唾则有血,喝喝而喘(肾之本色见者,精衰故也,吐血与喘,水虚而火刑金也)。坐而欲起,目 如无
所见(坐而欲起,阴虚则不能静也,肾虚则瞳神昏眩,故无所见也),心如悬若饥状(相火不宁,君主亦不自
安也。如悬若饥,心肾不交也),气不足则善恐,心惕惕如人将捕之,是为骨厥(肾志恐,故如捕也,肾主骨,
故为骨厥)。是主肾所生病者,口热舌干,咽肿上气,嗌干及痛,烦心心痛(经脉之病也),黄胆肠 (黄胆肠
,咎由湿热,水虚者多有之),脊股内后廉痛,痿厥嗜卧,足下热而痛(皆经脉所及之病,精竭者神疲,故嗜卧,身半
以下,肾所主也,故足痛)。
〔心主,手厥阴心包络也〕是动则病手心热,臂肘挛急,腋肿,甚则胸胁支满,心中 大动(皆经脉之
所及),面赤目黄,喜笑不休(心之华在面,在声为笑,故见症如此)。是主脉所生病者(心主血脉),烦心
心痛,掌中热(经脉病也)。
〔三焦,手少阳也〕是动则病耳聋,浑浑 ,嗌肿喉痹(经脉所过之病)。是主气所生病者(三焦为水府,
水病必由于气),汗出,目锐 痛,颊痛,耳后肩 肘臂外皆痛,小指次指不用(三焦出气,以温肌肉,充皮
肤,故为汗出诸病,皆经脉所过也)。
〔胆,足少阳也〕是动则病口苦,善太息(胆病汁溢,故口苦。胆郁则太息),心胁痛不能转侧(别脉贯心
循胁),甚则面微有尘,体无膏泽(别脉散于面,胆受金残,则燥症见矣),足外反热,是为阳厥(本经脉出外踝
之前,故足外反热,热上逆,名阳厥)。是主骨所生病者(胆而主骨病者,乙癸同元也),头痛颔痛,目锐
痛,缺盆中肿痛,腋下肿,马刀侠瘿(马刀,瘰 也。侠瘿,侠颈之瘤也),汗出振寒,疟(少阳居三阳之中,
半表半里,故阳胜则汗出,风胜则振寒而为疟也),胸胁肋髀膝外至胫绝骨外踝前及诸节皆痛,小指次指不
用(皆经脉所过之病)。
〔肝,足厥阴也〕是动则病腰痛不可以俯仰(支别者,与太阴、少阳之脉同结腰踝,故腰痛),丈夫 疝,妇
人少腹肿(脉绕阴器,故控睾而痛为疝症。妇人少腹肿,亦疝也),甚则嗌干,面尘脱色(脉循喉上额,支者
从目系下颊,故其病如此)。是肝所生病者,胸满呕逆飧泄,狐疝遗溺闭癃(上行者挟胃贯膈,下行者过阴器,
故为是诸病)。
《通评虚实论》曰∶邪气盛则实,精气夺则虚(此二语为医宗之纲领,万世之准绳。其言若浅而易明,其旨实深而
难究。夫邪气者,风、寒、暑,湿,燥,火。精气,即正气,
乃谷气所化之精微。盛则实者,邪气方张名为实症,三候有力名为实脉。实者泻之,重则汗吐下,轻则清火降
气是也。夺则虚者,亡精失血,用力劳神,名为内夺;汗之下之,吐之清之,名为外夺。气怯神疲名为虚症,
三候无力名为虚脉。虚者补之,轻则温补,重则热补是也。无奈尚子和、丹溪之说者,辄曰泻实,尚东垣、立斋
之说者,辄曰补虚,各成偏执,鲜获圆通,此皆赖病合法耳,岂所为法治病乎?精于法者,止辨虚实二字而已。
其中大实大虚,小实小虚,似实似虚,更贵精详。大虚者,补之宜峻宜温,缓则无功也。大实者,攻之宜急宜
猛,迟则生变也。小虚者,七分补而三分攻,开其一面也。小实者,七分攻而三分补,防其不测也。至于似虚
似实,举世淆讹,故曰至虚有盛候,反泻衔冤;大实有羸状,误补益疾,辨之不可不精,治之不可不审也,或
攻邪而正始复,或养正而邪自除,千万法门,只图全其正气耳。嗟乎?实而误补,固必增邪,尚可解救,其祸
犹小;虚而误攻,真气立尽,莫可挽回,其祸至大。生死关头,良非渺小,司命者其慎之哉)。
《调经论》∶帝曰∶阳虚则外寒,阴虚则内热,阳盛则外热,阴盛则内寒……不知其所由然也,岐伯曰∶阳
受气于上焦,以温皮肤分肉之间,令寒气在外,则上焦不通,上焦不通,则寒气独留于外,故寒栗(阳气者,
卫外而为固者也。阳虚则无气以温皮肤,命曰无火。上焦所以不通,独有寒气而已矣)。帝曰∶阴虚生内热奈
何?岐伯曰∶有所劳倦,形气衰少,谷气不盛,上焦不行,下脘不通,胃气热,热气熏胸中,故内热(阴气营
于内者也。有所劳倦,则脾胃受伤。脾主肌肉,亦主运化,谷气以生真气,土衰则形肉与中气俱衰,谷气减少,脾
虚下陷则上焦不行,下脘不通矣。脾阴不足则胃热,肺居胸中,热上熏肺则内热也。此言劳倦伤脾,故见症如上。
若色欲所伤,真水耗竭,火无所畏,亢而刑金,此之内热,尤为难疗)。帝曰∶阳盛生外热奈何?岐伯曰∶上焦不
通利,则皮肤致密,腠理闭塞,玄府不通,卫气不得泄越,故外热(阳主在上,又主在表,故阳亢则上壅而表热,
此伤寒之候也)。帝曰∶阴盛生内寒奈何?岐伯曰∶厥气上逆,寒气积于胸中而不泻,不泻则温气去,寒独留,则
血凝泣,凝则脉不通,其脉盛大以涩,故中寒(寒气入脏,则阳气去矣。寒独留者,如冬令严寒,万物闭蛰之象,
故脉不通而涩。此内伤之候也)。
《调经篇》云∶因饮食劳倦,损伤脾胃,始受热中,末传寒中(始受者,病初起也。末传者,久而不愈
也。初起病时,元气未虚,邪气方实,实者多热,及病之久,邪气日退,正气日虚,虚者多寒。古人立法,于始
受热中者,实则泻其子。夫肺金为脾土之子而实主气,气有余便是火,故凡破气清火之剂皆所以泻其子也,于
末传寒中者,虚则补其母。夫少火为脾土之母而实主营运三焦,熟腐五谷,故凡温中益火之剂皆所以补其母也。
每见近世不辨虚实,一遇脾病,如胀满、如停滞,如作痛、如发热之类,概以清火疏气之药投之,虚虚之祸可
胜数哉)。
《玉机真藏论》曰∶脉盛,皮热,腹胀,前后不通,闷瞀,此谓五实(实者,邪气实也。心受邪则脉盛,
肺受邪则皮热,脾受邪则腹胀,肾受邪则前后不通,肝受邪则闷瞀。肝脉贯膈,气逆上也);脉细,皮寒,气少,泄利前
后,饮食不入,此谓五虚(虚者,正气虚也。心虚则脉细,肺虚则皮寒,肝虚则气少,肾虚则泄
利前后,脾虚则饮食不入。五实五虚,皆死候也)。
浆粥入胃,泄注止,则虚者活(治虚之法,先扶根本。浆粥入胃则脾土将复,泄注既止则肾水渐固,虽犯虚死,
自可回生也),身汗得后利,则实者活(治实之法,汗下为要,身既得汗则表邪解,后既得利则里邪去,虽犯实死
之条,邪退则活矣)。
《举痛论》∶帝曰∶余知百病生于气也,怒则气上,喜则气缓,悲则气消,恐则气下,寒则气收,热则气泄,
惊则气乱,劳则气耗,思则气结,九气不同,何病之生?岐伯曰∶怒则气逆,甚则呕血及飧泄,故气上矣(肝木
主春升之令,怒伤之,如雷奋九天,故气逆也。血属阴,主静定而润下,肝逆而上。且为血海,则阴血不得安
其静定之常,故呕逆也。木旺侮脾,脾伤则不化谷而飧泄,是以气逆而上也)。喜则气和志达,荣卫通利,故
气缓矣(和达通利,若不为病矣。不知大喜则气散而不收,缓慢不能摄持,故《本神》篇曰喜乐者神惮散而
不藏是也)。悲则心系急,肺布叶举,而上焦不通,荣卫不散,热气在中,故气消矣(悲生于心,故心系急。
并于肺则肺叶举,不通不散则气壅而为火,火主刑金,金主气,故气消也)。恐则精却,却则上焦闭,闭则气
制约水液代谢,但水气反而反侮脾土,这称为“辟阴”。辟,意为放纵乖僻。
阳气郁结在四肢,会导致四肢肿胀(阳,指六条阳经;四肢是诸阳经的根本,所以这样说);阴气郁结,会导致便血,初结时出血一升,再次郁结出血二升,三次郁结出血三升(阴,指六条阴经。阴主司血液,邪气郁结在阴分,所以应当出现便血。病势浅的,出一升血就会痊愈。如果不止血而再次郁结,说明邪气比之前更盛了,所以便血二升。如果再不好转,病情就更严重了,所以便血三升)。阴阳之气郁结且偏斜,表现为阴多阳少,这种病叫做石水,症状是小腹部肿胀(“斜”字应作“邪”解。六阴六阳各条经脉都能郁结水邪,如果多在阴经,少在阳经,就会生出石水。病邪沉伏坚硬在下部,症状就是小腹部肿胀);阳明经(胃与大肠)郁结,称为消渴症(指胃经和大肠经。阳邪郁结在肠胃,就会形成三消的症状:口渴多饮、饮水不止为上消;多食易饥、饥饿不止为中消;多尿且尿液浑浊如膏脂不止为下消);太阳经(膀胱与小肠)郁结,称为膈证(指膀胱经和小肠经。邪气郁结在膀胱,导致气化功能不行,津液阻隔断绝。小肠位于大肠之上、胃之下,负责容纳水谷并分清泌浊。邪气侵犯它,就会导致水液不能下行,糟粕不能后出,这两种情况都是痞塞隔阻的现象),太阴经(脾与肺)郁结,称为水胀病(指脾经和肺经。脾土本应制约水液,但脾受邪气侵袭则水气反而反侮脾土;肺金本应生水,但肺气生病则水液无法输布,所以寒邪郁结在三阴经,导致水胀的病证发作);厥阴经(肝与心包)与少阳经(胆与三焦)郁结,称为喉痹(一阴,指肝和心包;一阳,指胆和三焦。肝胆属木,心包和三焦属火,这四条经脉的气机都亢盛向上,其脉络都联系于咽喉,阳邪在内郁结,痹症就产生了。痹,就是闭塞的意思)。
《灵枢·经脉》篇说:“肺,属于手太阴经。”这条经脉发生变动,就会病发肺胀满,膨膨胀满而气喘咳嗽(动,指变化,即违背常态而生病。肺脉起于中焦,沿着胃上行穿过膈肌归属于肺,所以病状如此),缺盆中间疼痛,严重时双手交叉按在胸前而视物模糊,这叫臂厥(缺盆靠近肺,肺生病就会痛。瞀,指麻木。肺脉从腋下出来下行经过肘部到手臂,所以叫臂厥)。这条经脉主治肺所生的疾病,包括咳嗽,上气喘促口渴,心烦胸中胀满,手臂内侧前缘疼痛厥冷,手掌中心发热(喘,指气向上逆而声音粗重呼吸急促。渴,是因为肺金主令燥热。手太阴肺经的别支,直接进入掌中。所以会出现疼痛、厥冷和掌中发热)。肺气盛有余,就会肩背疼痛,怕风寒,出汗后容易中风,小便频数且量少(肺的筋脉结聚在肩背部,所以气盛就会疼痛。肺主管皮毛,风寒在体表,所以出汗后易感中风。母病传子,所以肾生病而小便频数且量少)。肺气虚,就会肩背疼痛怕冷,气短不足以呼吸,尿液颜色改变(肩背部位于上焦,属于阳分,气虚则阳分生病,所以出现疼痛、怕冷和气短。肺金衰弱则肾水枯竭,所以尿液颜色变为黄赤)。
“大肠,属于手阳明经。”这条经脉发生变动,就会病发牙痛颈部肿胀(阳明经的分支脉从缺盆上行至颈部贯穿面颊,进入下齿中)。这条经脉主治津液所生的疾病(大肠或者腹泻或者便秘,都属于津液病变)。眼睛发黄,口干,鼻塞流涕或鼻出血,喉痹,肩前部疼痛,食指和拇指连接处疼痛且活动不便(这些都是本经经脉所经过的地方,所以出现这些症状)。气有余,则在经脉所经过的地方出现红肿热痛;气虚,则出现寒战且不易回暖(不复,指不容易温暖)。
“胃,属于足阳明经。”这条经脉发生变动,就会病发瑟瑟发抖怕冷,喜欢伸展身体频繁打哈欠,面色发黑(振寒,指肝风胜克所致。伸,指胃气郁结。打哈欠和面色发黑,是肾的征象,因为脾土虚弱被肾水反侮,所以显现出肾的征象)。病发时则厌恶人和火,听到木头敲击的声音就会惊恐心动,心中悸动不安,独自关上门窗居住,严重时想要登上高处唱歌,脱掉衣服奔跑(阳明经热势很盛,所以厌恶人和火。听到木头声音惊恐,是因为土畏木。想要关门,是因为火动则畏惧光明。登上高处唱歌,是因为火性炎上且阳气盛,导致四肢充实有力。脱衣奔跑,是因为体内体外都热)。腹中雷鸣作响且腹胀,这叫厥逆(贲响,指腹部像雷声一样鸣响。胻,指小腿。阳明经的脉,从膝盖下方沿小腿下行,所以小腿出现厥逆)。这条经脉主治血所生的疾病(阳明经是接受水谷且多血的经脉),狂躁、疟疾、温热病出汗,鼻塞流涕或鼻出血,口唇生疮,颈部肿胀喉痹(热盛则狂躁,风盛则疟疾,且出汗、鼻血、口唇疮等症状,都是本经经脉所经过的地方),大腹部水肿,膝盖髌骨肿痛,沿着胸部、乳房、气街、大腿、伏兔穴、小腿外侧前缘、足背都会疼痛,中指活动不便(阳明经脉从缺盆下行经过乳房挟脐腹、前阴,由大腿下到足,进入中指,所以病状如上所述)。气盛则身体前面都发热,如果在胃方面有余,就会消化食物快且容易饥饿,尿液颜色黄(这是辨别阳明实热是在经还是在脏)。气不足则身体前面寒冷战栗,胃中有寒就会腹胀满(这是辨别阳明虚寒是在经还是在脏)。
“脾,属于足太阴经。”这条经脉发生变动,就会病发舌根僵硬,进食则呕吐(脉连舌根所以僵硬,脾虚不能运化所以呕吐),胃脘疼痛,腹胀喜欢嗳气(脾脉进入腹腔联络胃,所以产生疼痛和胀满。阴气盛而上行走向阳明经,所以气滞而产生嗳气),大便通畅或排气后感觉轻松舒服(后,指大便。气,指放屁,气通了所以感觉爽快),身体沉重(脾主管肌肉,脾主管湿气,湿气受伤则身体沉重)。这条经脉主治脾所生的疾病,包括舌根疼痛,身体不能动摇,饮食不下,心烦,心窝部急痛,腹泻、痢疾、小便不通、黄疸,不能平卧,强行站立则大腿膝盖内侧肿胀厥冷,足大趾活动不便(分支脉,上行穿过膈肌注入心脏,所以出现心烦和疼痛。溏,指水样泄泻。瘕,指痢疾。水闭,指脾土生病不能制约水液,水液闭阻则湿热壅盛而形成黄疸,导致不能安卧。脾脉起于足大趾,上行经过膝盖和大腿,这是肿胀和厥冷产生的原因)。
“心,属于手少阴经。”这条经脉发生变动,就会病发咽喉干燥心痛,口渴想喝水,这叫臂厥。这条经脉主治心所生的疾病(分支脉,从心系上行至咽喉,所以咽喉干燥心痛,火炎上所以口渴,脉循行于手臂内侧,所以出现臂厥),眼睛发黄胁肋疼痛,手臂内侧后缘疼痛厥冷,手掌中心发热疼痛(脉系连目系,所以眼睛发黄。从腋下出来,所以胁肋疼痛。循行手臂进入手掌,所以有发热疼痛等症状)。
“小肠,属于手太阳经。”这条经脉发生变动,就会病发咽喉疼痛下巴肿胀,不能回头看,肩膀像被拔除一样,胳膊像折断一样(经脉循行咽喉向下穿过膈肌,分支脉循行颈部上面颊,环绕肩膀,所以病状如上所述)。这条经脉主治液所生的疾病(小肠分别水谷,所以主管液),耳聋眼睛发黄脸颊肿胀,颈部下巴肩膀肘部手臂外侧后缘疼痛(都是经脉所到达的地方)。
“膀胱,属于足太阳经。”这条经脉发生变动,就会病发冲头痛(本经脉上行至额头入脑,所以邪气冲击而头痛)。眼睛像要脱出一样,脖子像被拔除一样,脊背疼痛腰部像折断一样,大腿不能弯曲,小腿肚像被捆绑一样,脚跟像被撕裂一样,这叫踝厥(都是经脉所到达地方的病症)。这条经脉主治筋所生的疾病(全身的筋,只有足太阳经最多最大,所以凡是筋的病,都是足太阳经肾水亏虚),痔疮、疟疾、狂癫疾(脉进入肛门,所以患痔疮。经属表,所以患疟疾。邪气侵入太阳经,所以患狂癫),头囟项部疼痛,眼睛发黄流泪鼻塞流涕或鼻出血,颈背腰骶部脚部都疼痛,小脚趾活动不便。(都是本经所经过部位的病症)。
“肾,属于足少阴经。”这条经脉发生变动,就会病发肚子饿不想吃东西(水中有火,是脾的母脏。真火不生脾土则脾虚,虽然肚子饿但不能吃东西),面色像漆柴一样枯黑,咳嗽吐痰带血,喘息有声(肾的本色显现,是因为精气衰竭,吐血和喘息,是水虚而火刑克肺金)。坐着想要起来,眼睛好像看不见东西(坐着想要起来,是因为阴虚所以不能安静,肾虚则瞳孔昏花眩晕,所以看不见东西),心里像悬空一样像饥饿的感觉(相火不宁静,君主之官也不安宁。像悬空像饥饿,是心肾不交的表现),气不足就容易恐惧,心里惕惕不安好像有人要抓捕自己,这叫骨厥(肾志为恐,所以像被人追捕,肾主骨,所以叫骨厥)。这条经脉主治肾所生的疾病,包括口热舌干,咽喉肿痛气逆,咽喉干燥及疼痛,心烦心痛(这是经脉的病),黄疸、肠澼(黄疸和肠澼,罪过在于湿热,肾水虚的人多有此病),脊股内侧后缘疼痛,痿证厥冷嗜睡,足底发热而疼痛(都是经脉所到达部位的病症,精竭则神疲,所以嗜睡,身体下半部分由肾所主,所以足部疼痛)。
“心主(心包络),属于手厥阴经。”这条经脉发生变动,就会病发手心发热,手臂肘部拘挛紧急,腋窝肿胀,严重时胸胁支撑胀满,心中悸动不安(都是经脉所到达的部位),面色红眼睛黄,喜欢笑个不停(心的荣华表现在面部,在声音方面表现为笑,所以出现这些症状)。这条经脉主治脉所生的疾病(心主血脉),心烦心痛,手掌中心发热(这是经脉的病)。
“三焦,属于手少阳经。”这条经脉发生变动,就会病发耳聋,听力模糊不清,咽喉肿胀喉痹(这是经脉所经过部位的病)。这条经脉主治气所生的疾病(三焦是水府,水病必然由于气病),出汗,眼角疼痛,脸颊疼痛,耳后肩膀肘部手臂外侧都疼痛,食指和中指活动不便(三焦发出气,以温养肌肉,充实皮肤,所以出现出汗等病,都是经脉所经过的部位)。
“胆,属于足少阳经。”这条经脉发生变动,就会病发口苦,喜欢叹气(胆病胆汁溢出,所以口苦。胆气郁结所以叹气),心胁部疼痛不能翻身(别脉贯穿心脏循行胁肋),严重时面色微显尘垢,身体没有光泽(别脉散布于面部,胆受金气残害,则燥症显现),足外侧反常发热,这叫阳厥(本经脉出于外踝之前,所以足外侧反常发热,热邪上逆,名叫阳厥)。这条经脉主治骨所生的疾病(胆之所以主管骨病,是因为乙癸同源),头痛下巴痛,眼角痛,缺盆中间肿痛,腋窝肿胀,马刀侠瘿(马刀,指瘰疬。侠瘿,指夹在脖子两侧的瘤子),出汗战栗,疟疾(少阳居于三阳之中,半表半里,所以阳胜则出汗,风胜则战栗而为疟疾),胸胁肋部大腿膝盖外侧直到小腿绝骨、外踝前以及各个关节都疼痛,食指和中指活动不便(都是经脉所经过部位的病)。
“肝,属于足厥阴经。”这条经脉发生变动,就会病发腰痛不能前后俯仰(分支别脉,与太阴、少阳的脉同结于腰踝,所以腰痛),男子疝气,妇女小腹部肿胀(脉环绕阴器,所以牵引睾丸疼痛为疝症。妇女小腹部肿胀,也是疝症),严重时咽喉干燥,面色如尘失去血色(脉循行喉咙上额,分支脉从目系下行至面颊,所以病状如此)。这是肝所生的疾病,包括胸满呕吐逆气、完谷不化的泄泻、狐疝、遗尿或小便不通(上行者挟胃穿过膈肌,下行者经过阴器,所以产生这些病)。
《通评虚实论》说:“邪气盛实就是实证,精气亏损就是虚证”(这两句话是医学的宗旨纲领,万世的准则。这些话看起来浅显易懂,但其旨意实际上深奥难究。所谓邪气,指风、寒、暑、湿、燥、火。精气,即正气,是由谷气转化而来的精微物质。盛则实,指邪气正旺盛称为实证,三部脉有力称为实脉。实证用泻法,重的用汗、吐、下法,轻的用清火降气法。夺则虚,指出血失精、用力劳神,称为内夺;汗、下、吐、清等治法不当,称为外夺。气怯神疲称为虚证,三部脉无力称为虚脉。虚证用补法,轻的用温补,重的用热补。无奈那些信奉张子和、朱丹溪学说的人,动不动就说泻实;信奉李东垣、薛立斋学说的人,动不动就说补虚,各自形成偏执,很少能圆融通达,这都是碰巧病证符合治法罢了,哪里算是真正的法治病呢?精通医法的人,只分辨虚实两个字而已。其中有大实大虚,小实小虚,似实似虚,更要精细详察。大虚证,补益应该峻猛温和,缓慢则无效。大实证,攻伐应该急切猛烈,迟缓则会产生变证。小虚证,七分补益三分攻伐,留有余地。小实证,七分攻伐三分补益,防止意外。至于似虚似实,举世混淆错误,所以说至虚有盛候,误用泻法会含冤受害;大实有羸状,误用补法会加重疾病,辨别不可不精细,治疗不可不审慎。或者攻邪而正气始复,或者扶正而邪气自除,千万种法门,只求保全正气罢了。唉!实证误用补法,固然会增加邪气,还可以解救,祸害还小;虚证误用攻法,真气立刻耗尽,无可挽回,祸害极大。生死关头,关系非比寻常,掌握人命者一定要谨慎啊)。
《调经论》:黄帝说:“阳虚则外部寒冷,阴虚则内部发热,阳盛则外部发热,阴盛则内部寒冷……不知道其中的原因。”岐伯说:“阳气从上焦受气,用来温养皮肤肌肉之间。如果寒气在外,则上焦不通畅,上焦不通畅,则寒气单独留在外面,所以寒战(阳气,是护卫体表而固密的。阳虚就没有气来温养皮肤,叫做无火。上焦之所以不通畅,只有寒气停留罢了)。”黄帝说:“阴虚产生内热怎么办?”岐伯说:“如果有劳累疲倦,形体和气衰少,谷气不盛,上焦不通行,下脘不通畅,胃气热,热气熏蒸胸中,所以内热(阴气在体内营卫。如果有劳累疲倦,则脾胃受伤。脾主管肌肉,也主管运化,谷气产生真气,土衰则形体肌肉和中气都衰败,谷气减少,脾虚下陷则上焦不通行,下脘不通畅了。脾阴不足则胃热,肺位于胸中,热气上熏肺则内热。这是说劳累疲倦伤脾,所以见到上述症状。如果是房事过度所伤,真水耗竭,火无所畏惧,亢盛而刑克肺金,这样的内热,尤为难治)。”黄帝说:“阳盛产生外热怎么办?”岐伯说:“上焦不通利,则皮肤致密,腠理闭塞,玄府不通,卫气不得宣泄越出,所以外热(阳主要在上,又主要在表,所以阳亢则上壅而表热,这是伤寒的证候)。”黄帝说:“阴盛产生内寒怎么办?”岐伯说:“厥气上逆,寒气积聚在胸中而不消散,不消散则温气离去,寒气单独留下,则血液凝涩,凝涩则脉道不通,脉象盛大而涩,所以中寒(寒气入脏,则阳气离去。寒气单独留下,就像冬天严寒,万物闭藏蛰伏的景象,所以脉不通而涩。这是内伤的证候)”。
《调经篇》说:“因为饮食劳倦,损伤脾胃,开始受热中证,最后传变为寒中证”(始受,指病初起。末传,指久而不愈。初起病时,元气未虚,邪气方实,实证多热,等到病久,邪气日渐消退,正气日渐虚弱,虚证多寒。古人立法,对于开始受热证的,实则泻其子。肺金是脾土之子且主司气,气有余便是火,所以凡是破气清火的药剂都是用来泻其子的;对于最后传变寒证的,虚则补其母。少火是脾土之母且主营运三焦,熟腐五谷,所以凡是温中益火的药剂都是用来补其母的。常见近代人不辨别虚实,一遇到脾病,如胀满、如停滞、如作痛、如发热之类,一概用清火疏气的药投治,造成虚虚的祸害,岂能数得尽呢)。
《玉机真藏论》说:“脉象盛大,皮肤发热,腹部胀满,大小便不通,烦闷视物模糊,这叫五实”(实,指邪气实。心受邪则脉盛,肺受邪则皮热,脾受邪则腹胀,肾受邪则前后不通,肝受邪则闷瞀。肝脉贯穿膈肌,气逆向上);“脉象细弱,皮肤寒冷,气短,大小便泄利,饮食不进,这叫五虚”(虚,指正气虚。心虚则脉细,肺虚则皮寒,肝虚则气少,肾虚则泄利前后,脾虚则饮食不入。五实五虚,都是死候)。
“浆粥进入胃中,泄泻停止,则虚证者可活”(治疗虚证的方法,先扶助根本。浆粥入胃则脾土将要恢复,泄泻既止则肾水逐渐稳固,虽然犯了虚死的禁忌,自然可以回生),“身体出汗且大小便通畅,则实证者可活”(治疗实证的方法,汗法和下法是关键的,身体既然出汗则表邪解除,大小便既然得利则里邪去除,虽然犯了实死的条款,邪气退去则活了)。
《举痛论》:黄帝说:“我知道百病都生于气,怒则气上,喜则气缓,悲则气消,恐则气下,寒则气收,热则气泄,惊则气乱,劳则气耗,思则气结,九气不同,会产生什么病?”岐伯说:“怒则气逆,严重时呕血及完谷不化的泄泻,所以气上”(肝木主管春天升发的命令,怒伤肝,如同雷霆震动九天,所以气逆。血属阴,主静定而润下,肝气逆而上行。且肝为血海,则阴血不能安守其静定的常态,所以呕逆。木旺反侮脾土,脾受伤则不能消化谷物而完谷不化泄泻,因此气逆而上行)。喜则气和志达,营卫通利,所以气缓”(和达通利,如果不生病就好了。不知道大喜则气散而不收敛,缓慢不能摄持,所以《本神》篇说喜乐者神惮散而不藏是也)。悲则心系急,肺布叶举,而上焦不通,荣卫不散,热气在中,所以气消”(悲生于心,所以心系急。并于肺则肺叶举,不通不散则气壅而为火,火主刑金,金主气,所以气消也)。恐则精却,却则上焦闭,闭则气
Regulating water metabolism, yet water qi counteracts and insults the Spleen, this is called "Pi Yin" (Deviant Yin). "Pi" means deviant or perverse.
Yang Qi stagnating in the limbs leads to swelling of the four limbs (Yang refers to the six Yang meridians; the four limbs are the root of all Yang meridians, hence this statement); Yin Qi stagnating leads to hematochezia (blood in stool), with one sheng [approx. 200ml] upon first stagnation, two sheng upon second stagnation, and three sheng upon third stagnation (Yin refers to the six Yin meridians. Yin governs blood; pathogenic factors stagnating in the Yin aspect lead to hematochezia. In mild cases, bleeding one sheng results in recovery. If it persists and stagnates again, the pathogen is stronger than before, hence two sheng of blood. If it still does not heal and becomes even more severe, hence three sheng of blood). Stagnation of both Yin and Yang Qi with deviation, characterized by excess Yin and deficient Yang, is called "Shi Shui" (Stone Water), presenting with swelling of the lower abdomen ("Xie" should be read as "Xie" meaning pathogen. Pathogenic water-dampness can stagnate in any of the twelve meridians; if it predominantly affects the Yin meridians and sparsely affects the Yang meridians, Shi Shui arises. The pathogen sinks and hardens in the lower part, manifesting as lower abdominal swelling); Stagnation of the Yang Ming Meridian (Stomach and Large Intestine) is called "Xiao Ke" (Wasting and Thirsting Syndrome) (The Stomach and Large Intestine belong to the Yang aspect. Yang-heat pathogenic factors stagnating in the stomach and intestines form the Three Xiao syndromes: excessive thirst and drinking without relief is Upper Xiao; excessive hunger and eating without relief is Middle Xiao; excessive urination with turbid, paste-like urine is Lower Xiao); Stagnation of the Tai Yang Meridian (Bladder and Small Intestine) is called "Ge Zheng" (Obstruction Syndrome) (The Bladder and Small Intestine meridians. Pathogens stagnating in the Bladder impair Qi transformation, blocking and severing body fluids. The Small Intestine sits above the Large Intestine and below the Stomach, responsible for receiving food and fluids and separating the clear from the turbid. When pathogens invade, fluids fail to descend and waste fails to exit posteriorly, both presenting as signs of obstruction and blockage); Stagnation of the Tai Yin Meridian (Spleen and Lung) is called "Shui Zhong" (Edema/Water Swelling) (The Spleen and Lung meridians. Spleen Earth normally controls Water, but when Spleen Earth is diseased, Water counterattacks and insults it; Lung Metal generates Water, and when Lung Qi is diseased, Water cannot be distributed. Thus, cold stagnating in the Three Yin meridians triggers water swelling syndromes); Stagnation of the Jue Yin Meridian (Liver and Pericardium) and Shao Yang Meridian (Gallbladder and San Jiao) is called "Hou Bi" (Throat Bi/Obstruction) (One Yin refers to the Liver and Pericardium; One Yang refers to the Gallbladder and San Jiao. Liver and Gallbladder belong to Wood; Pericardium and San Jiao belong to Fire. The Qi of these four meridians tends to hyperactive upward, and their channels connect to the throat. Internal stagnation of Yang-heat pathogens generates Bi syndrome. Bi means closure/blockage).
The *Ling Shu · Jing Mai* chapter states: "The Lung belongs to the Hand Tai Yin Meridian." When this meridian undergoes change, disease manifests as lung distension, fullness, panting, and coughing (Dong [change/movement] refers to alteration, i.e., deviating from normal state causing disease. The Lung channel originates in the middle jiao, follows the stomach, passes through the diaphragm, and connects to the Lung, hence these symptoms); pain in the supraclavicular fossa (Que Pen); in severe cases, crossing both hands over the chest and experiencing visual blurring or numbness, which is called Arm Jue (The supraclavicular fossa is near the Lung; Lung disease causes pain. Mu refers to numbness. The Lung channel emerges from the axilla, descends along the elbow and arm, hence Arm Jue). This meridian governs diseases generated by the Lung, including cough, upper asthma with panting and thirst, vexation, chest fullness, pain and Jue-cold in the anterior medial aspect of the arm, and heat in the palm (Panting refers to Qi rushing upward with coarse, rapid breathing. Thirst occurs because the Metal phase governs dryness. The collateral of the Hand Tai Yin enters the palm directly. Hence pain, Jue-cold, and palm heat occur). When Lung Qi is excessive and surplus, shoulder and back pain, aversion to wind-cold, sweating with susceptibility to wind-stroke, frequent urination with incomplete emptying occur (The sinews of the Lung knot at the shoulder and back; thus excess Qi causes pain. The Lung governs skin and hair; wind-cold on the exterior causes sweating and susceptibility to wind-stroke. Mother disease transmitting to Child leads to Kidney disease causing frequent urination and incomplete emptying). When Lung Qi is deficient, shoulder and back pain with cold sensation, shortness of breath insufficient for respiration, and changes in urine color occur (The shoulder and back are in the Upper Jiao, belonging to the Yang aspect; Qi deficiency leads to Yang pathology, causing pain, cold, and shortness of breath. Decline of Metal leads to exhaustion of Water, hence urine turns yellow-red).
"The Large Intestine belongs to the Hand Yang Ming Meridian." When this meridian undergoes change, toothache and neck swelling occur (The Yang Ming branch rises from the supraclavicular fossa, passes through the neck, penetrates the cheek, and enters the lower teeth). This meridian governs diseases generated by fluids (Diarrhea or constipation in the Large Intestine are both fluid disorders). Yellow eyes, dry mouth, rhinorrhea or epistaxis, throat Bi, pain in the anterior shoulder, and pain with dysfunction of the index finger and thumb (All are areas traversed by this meridian, hence these symptoms). When Qi is in excess, heat and swelling occur along the meridian pathway; when deficient, chills occur that do not easily resolve (Bu Fu means not easily warming up).
"The Stomach belongs to the Foot Yang Ming Meridian." When this meridian undergoes change, shivering and aversion to cold occur, with a tendency to stretch and frequent yawning, and darkening of the face (Zhen Han [shivering cold] is due to Liver Wind overcoming; stretching is due to Stomach Qi stagnation; yawning and dark face are Kidney signs, indicating Earth deficiency allowing Water to insult, hence Kidney signs appear). Upon onset, there is aversion to people and fire, startle upon hearing wooden sounds, palpitations, desire to close doors and windows and stay indoors; in severe cases, climbing high to sing and discarding clothes to run (Excessive Yang Ming heat causes aversion to people and fire. Startle at wood sound indicates Earth fears Wood. Desire to close doors indicates Fire agitation fears light. Climbing high to singing indicates Fire nature rising and Yang excess leading to solid extremities. Discarding clothes to run indicates heat inside and outside). Borborygmus and abdominal distension constitute Jue (Ben Xiang refers to borborygmus like thunder. Ting refers to the lower leg. The Yang Ming channel descends from the knee along the tibia, hence tibial Jue-ni). This meridian governs diseases generated by Blood (Yang Ming is the meridian receiving grain and abundant in blood). Mania, malaria, warm pathogen sweating, epistaxis, sores on lips and cheeks, neck swelling, and throat Bi (Severe heat causes mania; severe wind causes malaria; sweating, epistaxis, lip/cheek sores etc. are all along the meridian pathway). Massive abdominal edema, swelling and pain of the knee patella, pain along the chest, breast, Qi Street, thigh, Fu Tu point, lateral anterior leg, and dorsum of foot, with dysfunction of the middle finger (The Yang Ming channel descends from the supraclavicular fossa, passes the breast, flanks the navel and abdomen, passes the genitals, goes down the thigh to the foot, entering the middle finger, hence symptoms as above). Excess Qi causes heat in the anterior body; if excess in the Stomach, rapid digestion and easy hunger, yellow urine (This distinguishes Yang Ming excess-heat in the meridian vs. zang-fu). Deficient Qi causes cold chills in the anterior body; cold in the Stomach causes distension (This distinguishes Yang Ming deficiency-cold in the meridian vs. zang-fu).
"The Spleen belongs to the Foot Tai Yin Meridian." When this meridian undergoes change, tongue stiffness, vomiting after eating occur (Channel connects to tongue root causing stiffness; Spleen deficiency failing to transport causes vomiting), epigastric pain, abdominal distension with frequent belching (Spleen channel enters abdomen and links to Stomach, causing pain and distension. Yin excess moves upward to Yang Ming, causing Qi stagnation and belching). Relief comes after defecation or passing gas (Hou means stool; Qi means passing gas; Qi flow brings relief). Heaviness of the body (Spleen governs muscles and dampness; injury to dampness causes heaviness). This meridian governs diseases generated by the Spleen: tongue pain, immobility, inability to eat, vexation, urgent epigastric pain, loose stools, dysentery, urinary retention, jaundice, inability to lie flat, swelling and Jue-cold in inner thigh/knee when standing forcibly, dysfunction of the big toe (Branch ascends through diaphragm to Heart, causing vexation and pain. Tang refers to watery diarrhea. Jia refers to dysentery. Shui Bi refers to Spleen Earth disease failing to control Water; water retention leads to damp-heat congestion causing jaundice and insomnia. Spleen channel starts at big toe, ascends knee/thigh, causing swelling and Jue).
"The Heart belongs to the Hand Shao Yin Meridian." When this meridian undergoes change, dry throat, heart pain, thirst with desire to drink occur, constituting Arm Jue. This meridian governs diseases generated by the Heart (Branch from Heart system ascends to throat, causing dry throat and heart pain; Fire flaming upward causes thirst; channel runs along medial arm, causing Arm Jue), yellow eyes, hypochondriac pain, pain and Jue-cold in posterior medial arm, heat and pain in palm (Channel connects to eye system, causing yellow eyes; emerges from axilla, causing hypochondriac pain; runs to palm, causing heat/pain).
"The Small Intestine belongs to the Hand Tai Yang Meridian." When this meridian undergoes change, sore throat, submandibular swelling, inability to turn head, shoulder feeling pulled, arm feeling broken occur (Channel follows throat, descends through diaphragm; branch follows neck to cheek, circles shoulder, hence symptoms). This meridian governs diseases generated by fluids (Small Intestine separates clear and turbid, hence governs fluids), deafness, yellow eyes, facial swelling, pain in neck, jaw, shoulder, elbow, and posterior-lateral arm (All areas reached by the channel).
"The Bladder belongs to the Foot Tai Yang Meridian." When this meridian undergoes change, headache with sensation of rushing upward occurs (Channel ascends forehead into brain, hence pathogen rushes causing headache). Eyes feel like popping out, neck feels pulled, back pain, waist feels broken, thighs unable to bend, calves feel bound, heels feel torn, constituting Ankle Jue (All symptoms along the channel). This meridian governs diseases generated by sinews (Whole body sinews are most numerous/largest in Foot Tai Yang; hence all sinew diseases relate to Foot Tai Yang/Kidney Water deficiency), hemorrhoids, malaria, mania, epilepsy (Channel enters anus, causing hemorrhoids; channel belongs to Exterior, causing malaria; pathogen enters Tai Yang, causing mania/epilepsy), vertex/neck/back pain, yellow eyes, tearing, rhinorrhea/epistaxis, pain in neck, back, loin, buttocks, heels, dysfunction of little toe (All symptoms along the channel).
"The Kidney belongs to the Foot Shao Yin Meridian." When this meridian undergoes change, hunger without desire to eat occurs (Water contains Fire, mother of Spleen. True Fire failing to generate Earth causes Spleen deficiency; though hungry, cannot eat). Face looks like lacquered charcoal, coughing/spitting blood, panting with audible sounds (Kidney's true color appears due to essence depletion; hemoptysis and panting result from Water deficiency failing to control Fire insulting Lung Metal). Desire to sit up, vision obscured/blurred (Desire to sit up indicates Yin deficiency unable to calm; Kidney deficiency causes pupil dizziness/blurriness). Heart feels suspended like hunger (Minister Fire unsettled, Sovereign Fire uneasy; suspended/hunger feeling indicates Heart-Kidney non-interaction). Qi deficiency leads to fearfulness, palpitations as if being hunted, constituting Bone Jue (Kidney emotion is Fear, hence feeling hunted; Kidney governs bones, hence Bone Jue). This meridian governs diseases generated by the Kidney: oral heat, dry tongue, swollen throat, rebellious Qi, dry/painful throat, vexation, heart pain (Meridian diseases). Jaundice, Chang Pi (Intestinal Dysentery) (Caused by damp-heat, common in Water deficiency). Pain in posterior-medial spine/thigh, Wei Jue (limp/cold limbs), lethargy, heat/pain in soles (All meridian diseases; essence exhaustion causes spirit fatigue/lethargy; lower body governed by Kidney, hence foot pain).
"The Master of Heart (Pericardium) belongs to the Hand Jue Yin Meridian." When this meridian undergoes change, heat in palms, spasms/tightness in arms/elbows, axillary swelling, severe chest/hypochondriac fullness, violent heart palpitations occur (All along the channel). Red face, yellow eyes, excessive laughing (Heart's brilliance shows in face; voice manifests as laughter, hence these symptoms). This meridian governs diseases generated by vessels (Heart governs blood vessels), vexation, heart pain, heat in palms (Meridian diseases).
"The San Jiao belongs to the Hand Shao Yang Meridian." When this meridian undergoes change, deafness, muffled hearing, swollen throat, throat Bi occur (Meridian diseases). This meridian governs diseases generated by Qi (San Jiao is the water mansion; water diseases stem from Qi disorders), sweating, pain in outer canthus, cheek pain, pain in post-auricular area, shoulder, elbow, arm lateral aspects, dysfunction of ring finger (San Jiao emits Qi to warm muscles/skin, hence sweating etc.; all along the channel).
"The Gallbladder belongs to the Foot Shao Yang Meridian." When this meridian undergoes change, bitter taste, frequent sighing occur (Gallbladder disease causes bile overflow/bitter taste; Gallbladder depression causes sighing). Hypochondriac pain preventing turning (Branch passes Heart/follows hypochondrium). Severe case: dusty complexion, lack of luster (Branch scatters on face; Gallbladder affected by Metal residue, causing dryness). Heat on lateral foot, constituting Yang Jue (Channel exits anterior to lateral malleolus, hence lateral foot heat; heat reverses upward, named Yang Jue). This meridian governs diseases generated by bones (Gallbladder governs bone disease due to Yi-Gui same source), headache, jaw pain, outer canthus pain, supraclavicular swelling, axillary swelling, Ma Dao Xia Ying (Ma Dao refers to scrofula; Xia Ying refers to neck tumors). Sweating with chills, malaria (Shao Yang is between Interior/Exterior; Yang excess causes sweating, Wind excess causes chills/malaria). Pain in chest, hypochondrium, ribs, thigh, lateral knee to fibula, lateral malleolus, joints, dysfunction of ring finger (All along the channel).
"The Liver belongs to the Foot Jue Yin Meridian." When this meridian undergoes change, low back pain preventing bending/straightening (Branch joins Tai Yin/Shao Yang at waist/ankle, causing back pain). Hernia in men, lower abdominal swelling in women (Channel wraps genitalia,牵引ing testicular pain constitutes hernia; female lower abdominal swelling is also hernia). Severe case: dry throat, dusty/dull complexion (Channel follows throat to vertex; branch from eye system to cheek, hence symptoms). Diseases generated by Liver: chest fullness, vomiting/reversal, undigested diarrhea, fox hernia, enuresis, strangury (Ascending branch passes Stomach/diaphragm; descending branch passes genitalia, hence these diseases).
*Tong Ping Xu Shi Lun* states: Excess of pathogenic Qi constitutes Excess Syndrome; Depletion of Essence-Qi constitutes Deficiency Syndrome (These two phrases are the guideline of medicine, standard for generations. Words seem simple but meaning is profound. Pathogenic Qi refers to Wind, Cold, Summer-heat, Dampness, Dryness, Fire. Essence-Qi is Righteous Qi, refined from Grain Qi. Excess means pathogen flourishing, pulse strong in three positions; treat by draining, heavy cases use sweating/vomiting/purging, light cases use clearing heat/descending Qi. Depletion means loss of essence/blood, labor/stress (internal depletion); improper sweating/purging/vomiting/clearing (external depletion). Qi timidity/spirit fatigue is Deficiency Syndrome, pulse weak in three positions; treat by tonifying, light cases use warm-tonification, heavy cases use hot-tonification. Unfortunately, followers of Zhang Hezi/Zhu Danxi insist on draining excess; followers of Li Donggan/Xue Lijia insist on tonifying deficiency, forming biases, lacking flexibility, relying only on coincidence of disease and method. Experts distinguish only Excess/Deficiency. There are great/small excess/deficiency, apparent excess/deficiency requiring precision. Great deficiency requires峻猛 (strong/warm) tonification, slow yields no effect. Great excess requires urgent/fierce attack, delay causes changes. Minor deficiency: 70% tonify, 30% attack, leaving room. Minor excess: 70% attack, 30% tonify, preventing unpredictability. Apparent deficiency/excess is confused globally: Extreme deficiency has excess symptoms, mistaken draining brings injustice; Extreme excess has debility symptoms, mistaken tonification worsens disease. Differentiation must be precise, treatment cautious. Attack pathogen to restore Zheng Qi, or nourish Zheng Qi to eliminate pathogen. Thousands of methods aim only to preserve Zheng Qi. Alas! Mistaken tonification in excess increases pathogen, but can be rescued, harm is small; Mistaken attack in deficiency depletes True Qi instantly, irrecoverable, harm is huge. Life/death threshold, vital for physicians to be cautious).
*Tiao Jing Lun*: Emperor said: Yang deficiency causes external cold, Yin deficiency causes internal heat, Yang excess causes external heat, Yin excess causes internal cold... don't know why. Qibo said: Yang receives Qi from Upper Jiao to warm skin/flesh. If cold pathogen is external, Upper Jiao blocks; Upper Jiao blockage leaves cold externally, causing chills (Yang Qi guards exterior. Yang deficiency lacks Qi to warm skin, called "No Fire". Upper Jiao blockage leaves only cold). Emperor asked: How does Yin deficiency generate internal heat? Qibo said: Fatigue/labor deforms Qi, Grain Qi fails to flourish, Upper Jiao doesn't move, Lower Wan doesn't open, Stomach Qi heats, heat steams chest, causing internal heat (Yin Qi nourishes interior. Labor injures Spleen/Stomach. Spleen governs muscles/transportation, Grain Qi generates True Qi. Earth decline deforms flesh/Middle Qi, Grain Qi reduces. Spleen deficiency sinks, Upper Jiao stops, Lower Wan blocks. Spleen Yin deficiency causes Stomach heat; Lung in chest, heat steams Lung causing internal heat. This describes labor injuring Spleen. If sexual excess depletes True Water, Fire uncontrolled insults Metal, such internal heat is hard to treat). Emperor asked: How does Yang excess generate external heat? Qibo said: Upper Jiao blockage makes skin dense, pores closed, Xuan Fu blocked, Wei Qi cannot vent, causing external heat (Yang governs Upper/Exterior. Yang hyperactivity causes upper congestion/exterior heat, pattern of Shang Han). Emperor asked: How does Yin excess generate internal cold? Qibo said: Jue Qi rebels upward, cold accumulates in chest without dispersing, warmth leaves, cold remains, blood coagulates/stagnates, pulse becomes large and choppy, causing internal cold (Cold enters Zang, Yang departs. Cold remaining resembles winter freezing, pulse blocked/choppy. Pattern of Nei Shang).
*Tiao Jing Pian* says: Due to diet/labor damaging Spleen/Stomach, initially receiving Re Zhong (Heat in Middle), finally transmitting to Han Zhong (Cold in Middle) (Initial: disease onset. Final: chronic persistence. Onset: Zheng Qi not deficient, pathogen excess, excess tends heat. Late: pathogen retreats, Zheng Qi deficient, deficiency tends cold. Ancient law: For initial Re Zhong, excess drains its Son. Lung Metal is Spleen Earth's Son, governs Qi; excess Qi is Fire, so Qi-breaking/heat-clearing formulas drain the Son. For final Han Zhong, deficiency tonifies its Mother. Lesser Fire is Spleen Earth's Mother, manages San Jiao/grain digestion, so warming/tonifying-fire formulas tonify the Mother. Modern doctors fail to distinguish excess/deficiency, treating Spleen diseases like distension, stagnation, pain, fever indiscriminately with heat-clearing/Qi-moving drugs, causing "deficientizing deficiency" disasters countless times).
*Yu Ji Zhen Zang Lun* states: Pulse surging, skin hot, abdominal distension, blockage of front/back (urination/defecation), oppression/blurring, this is Five Excesses (Excess means pathogen excess. Heart pathogen -> surging pulse; Lung pathogen -> hot skin; Spleen pathogen -> abdominal distension; Kidney pathogen -> front/back blockage; Liver pathogen -> oppression/blurring. Liver channel pierces diaphragm, Qi rebels upward). Pulse fine, skin cold, short Qi, diarrhea/front-back leakage, inability to eat, this is Five Deficiencies (Deficiency means Zheng Qi deficiency. Heart deficiency -> fine pulse; Lung deficiency -> cold skin; Liver deficiency -> short Qi; Kidney deficiency -> leakage; Spleen deficiency -> inability to eat). Five Excess/Five Deficiency are death omens).
If gruel enters Stomach, diarrhea stops, deficiency patients live (Treating deficiency supports root. Gruel entering Stomach restores Spleen Earth; diarrhea stopping stabilizes Kidney Water. Though violating deficiency death rules, recovery is possible). If sweating occurs and bowels open, excess patients live (Treating excess relies on sweating/purging. Sweating resolves exterior pathogen; opening bowels removes interior pathogen. Though violating excess death rules, pathogen retreat allows survival).
*Ju Tong Lun*: Emperor said: I know hundred diseases arise from Qi. Anger raises Qi, Joy slows Qi, Grief dissipates Qi, Fear lowers Qi, Cold gathers Qi, Heat vents Qi, Fright scrambles Qi, Labor耗 (consumes) Qi, Thought knots Qi. Nine Qi differ, what diseases arise? Qibo said: Anger causes Qi rebellion, severe cases hematemesis and undigested diarrhea, hence Qi rises (Liver Wood governs Spring ascending. Anger injures it like thunder, causing rebellion. Blood is Yin, static/downward; Liver rebels upward. Liver is Sea of Blood, Yin blood loses static nature, causing vomiting/rebellion. Wood insults Spleen, Spleen injured fails to digest, causing diarrhea, hence Qi rebels upward). Joy harmonizes Qi, reaches Will, unblocks Ying/Wei, hence Qi slows (Harmony/unblocking is healthy. But extreme Joy scatters Qi, slowing prevents holding, hence *Ben Shen* says joy scatters Spirit). Grief tightens Heart Tie, lifts Lung Leaves, blocks Upper Jiao, Ying/Wei don't disperse, heat stays in middle, hence Qi dissipates (Grief originates in Heart, tightening Heart Tie. Merging with Lung lifts Lung Leaves. Blockage/dispersion failure causes Qi congestion turning to Fire. Fire insults Metal; Metal governs Qi, hence Qi dissipates). Fear causes Essence to recede, receding closes Upper Jiao, closing blocks Qi