黄帝问于少师曰。余闻人之生也。有刚有柔。有弱有强。有短有长。有阴有阳。愿闻其方。少师答曰。阴中有阴。
阳中有阳。审知阴阳。刺之有方。得病所始。刺之有理。谨度病端。与时相应。内合于五脏六腑。外合于筋骨皮肤。是
故内有阴阳外亦有阴阳。在内者。五脏为阴六腑为阳在外者筋骨为阴皮肤为阳。故曰病在阴之阴者。刺阴之荥输。病在
阳之阳者。刺阳之合。病在阳之阴者。刺阴之经。病在阴之阳者。刺络脉。故曰病在阳者。命曰风。病在阴者。命曰痹。
阴阳俱病。命曰风痹。病有形而不痛者阳之类也。无形而痛者阴之类也。无形而痛者其阳完而阴伤之也急治其阴无攻其
阳。有形而不痛者。其阴完而阳伤之也。急治其阳无攻其阴。阴阳俱动。乍有形。乍无形。加以烦心。命曰阴胜其阳。
此谓不表不里。其形不久。黄帝问于伯高曰。余闻形气。病之先后。外内之应。奈何。伯高答曰。风寒伤形。忧恐忿怒
伤气。气伤脏。乃病脏。寒伤形。乃应形。风伤筋脉。筋脉乃应。此形气外内之相应也。黄帝曰。刺之奈何。伯高答曰。
病九日者。三刺而已。病一月者。十刺而已。多少远近。以此衰之久痹不去身者。视其血脉。尽出其血。黄帝曰外内之
病。难易之治。奈何。伯高答曰。形先病而未入脏者。刺之半其日。脏先病而形乃应者刺之倍其日。此外内难易之应也。
黄帝问于伯高曰。余闻形有缓急。气有盛衰。骨有大小。肉有坚脆。皮有浓薄其以立寿夭。奈何。伯高曰。形与气相任
则寿不相任则夭。皮与肉相果则寿。不相果则夭。血气经络胜形则寿。不胜形则夭。黄帝曰。何谓形之缓急。伯高答曰。
形充而皮肤缓者则寿。形充而皮肤急者则夭。形充而脉坚大者顺也。形充而脉小以弱者气衰。衰则危矣。若形充而颧不
起者骨小。骨小而夭矣。形充而大肉 坚而有分者肉坚。肉坚则寿矣。形充而大肉无分理不坚者肉脆。肉脆则夭矣。此
天之生命。所以立形定气而视寿夭者。必明乎此。立形定气。而后以临病患。决死生。黄帝曰。余闻寿夭。无以度之。
伯高答曰。墙基卑高。不及其地者。不满三十而死。其有因加疾者。不及二十而死也。黄帝曰。形气之相胜。以立寿夭
奈何。伯高答曰。平人而气胜形者寿。病而形肉脱。气胜形者死。形胜气者危矣。黄帝曰。余闻刺有三变。何谓三变。
伯高曰。有刺营者。有刺卫者。有刺寒痹之留经者。黄帝曰。刺三变者奈何。伯高答曰。刺营者出血。刺卫者出气。刺
寒痹者内热。黄帝曰。营卫寒痹之为病奈何。伯高答曰。营之生病也。寒热少气。血上下行。卫之生病也。气通时来时
去。怫忾贲响。风寒客于肠胃之中。寒痹之为病也。留而不去时痛而皮不仁。黄帝曰。刺寒痹内热奈何。伯高答曰。刺
布衣者。以火 之。刺大人者。以药熨之。黄帝曰。药熨奈何。伯高答曰。用 酒二十斤。蜀椒一升。干姜一斤。桂心
一斤。凡四种。皆 咀。渍酒中。用绵絮一斤。细白布四丈。并内酒中。置酒马矢 中。盖封涂。勿使泄。五日五夜。
出布绵絮。曝干之。干复渍。以尽其汁。每渍。必 其日。乃出干。干并用滓与绵絮。复布为复巾。长六七尺为六七巾。
则用之。生桑炭炙巾以熨寒痹所刺之处。令热入至于病所寒。复炙巾以熨之。三十遍而止。汗出。以巾拭身。亦三十遍。
止起步内中。无见风。每刺。必熨。如此。病已矣。此所谓内热也。
通篇以风痹立论。苦无条理层次。其接缝斗 之处。亦无意义可寻。不得以文法求之矣。而事理自为学人所宜究。
黄帝向少师问道:我听说人的体质,有的刚强,有的柔和;有的虚弱,有的强壮;有的矮小,有的高大;有的偏阴,有的偏阳。我想了解判断这些差异的方法。
少师回答说:阴中有阴,阳中有阳。若能审察清楚阴阳的归属,施刺就有法度。若知晓疾病发生的起始部位,施刺就有条理。谨慎地考察病情的开端,使其与四时气候相应,内部对应五脏六腑,外部对应筋骨皮肤。因此,体内有阴阳,体外也有阴阳。在体内,五脏属阴,六腑属阳;在体外,筋骨属阴,皮肤属阳。所以说,病在“阴中之阴”(指五脏),应针刺阴经的荥穴和输穴;病在“阳中之阳”(指皮肤),应针刺阳经的合穴;病在“阳中之阴”(指筋),应针刺阴经的经穴;病在“阴中之阳”(指络脉),应针刺络脉。所以说,病在阳分的,称为风;病在阴分的,称为痹;阴阳俱病的,称为风痹。
病症表现为有形质但无痛感的,属于阳类;无形质但有痛感的,属于阴类。无形质而痛的,说明阳气完好而阴气受损,应当急治其阴,不要攻伐其阳。有形质但不痛的,说明阴气完好而阳气受损,应当急治其阳,不要攻伐其阴。如果阴阳都出现异常,时而见有形质,时而无形质,并伴有心烦,这叫做阴胜其阳,称为不表不里之证,这种病人寿命不会长久。
黄帝向伯高问道:我听说形体与元气的盛衰、疾病的先后以及内外相应的关系,是怎么回事呢?
伯高回答说:风寒邪气伤害形体,忧恐忿怒等情志损伤元气。元气受伤则累及脏腑,这就成为脏病;寒邪伤害形体,就应验在形体上;风邪伤害筋脉,就应验在筋脉上。这就是形、气、外、内相互对应的道理。
伯高回答说:患病九天的,针刺三次即可痊愈;患病一个月的,针刺十次即可痊愈。针刺次数的多少和疗程的远近,都以此类推递减。对于久痹不去身的情况,要观察其血脉,将其瘀血全部放出。
黄帝问:内外疾病的难易治疗原则是怎样的?
伯高回答说:形体先病而未入脏腑的,针刺所需天数减半;脏腑先病而后反映到形体的,针刺所需天数加倍。这就是内外疾病难易对应的规律。
黄帝向伯高问道:我听说人的形体有缓急之分,元气有盛衰之别,骨骼有大小的不同,肌肉有坚脆的差异,皮肤有厚薄的区别,如何据此判断寿夭呢?
伯高说:形体与元气相称则长寿,不相称则短命。皮肤与肌肉紧密贴合则长寿,不紧密贴合则短命。血气经络胜过形体表现则长寿,不胜过则短命。
黄帝问:什么叫形体的缓急?
伯高回答说:形体充实而皮肤松弛柔缓的长寿;形体充实而皮肤紧绷拘急的短命。形体充实而脉象坚实粗大的为顺证;形体充实而脉象细小虚弱的为气衰,气衰则有危险。如果形体充实但颧骨不高起,说明骨骼小,骨骼小则短命。形体充实且大腿肌肉坚实且有纹理分界的,说明肌肉坚实,肌肉坚实则长寿。形体充实但大腿肌肉无纹理且不坚实的,说明肌肉脆弱,肌肉脆弱则短命。这是天生的生命规律,通过确立形体、定察元气来判断寿夭,必须明白这些道理。确立了形体、定察了元气之后,才能面对病患,决断生死。
伯高回答说:如果面部四周如墙基般低矮,不及面部中央地面的高度,这种人不满三十岁就会死亡;如果再加上患有疾病,不到二十岁就会死亡。
伯高回答说:普通人元气胜过形体表现的长寿;生病后形体肌肉脱失,若元气仍胜过形体表现的必死;若形体胜过元气表现的则处于危重状态。
伯高回答说:刺营血要使其出血,刺卫气要使其出气(疏泄卫气),刺寒痹要使其内部产生热感。
伯高回答说:营气生病,会出现寒热往来、气短、血液上下妄行的症状;卫气生病,会出现气机通行时来时去、胸膈痞闷、肠鸣有声,这是因为风寒客居于肠胃之中;寒痹生病,邪气留滞不去,时常疼痛且皮肤麻木不仁。
伯高回答说:用酒二十斤,蜀椒一升,干姜一斤,桂心一斤,共四种药材,都切碎,浸泡在酒中。再用绵絮一斤,细白布四丈,一同放入酒中。将容器放置在马粪火中加热,加盖封口并涂抹密封,不要让酒气泄漏。经过五天五夜,取出布和绵絮,晒干后再浸渍,直到吸尽药汁为止。每次浸渍,都必须等到干燥的日子进行,然后取出晒干。将药渣与绵絮混合,再用布包裹成复巾,每六七尺为一巾,共做六七条。使用时,用桑木炭火烘烤复巾,以熨烫寒痹针刺的部位,使热力深入病所。待冷却后,再次烘烤复巾进行熨烫,如此重复三十遍停止。患者出汗时,用巾擦拭身体,也擦拭三十遍。擦完后在室内行走,不要吹风。每次针刺后,必须配合药熨。像这样,病就好了。这就叫作“内热”。
通篇以风痹立论,苦于缺乏条理层次,其衔接转折之处,也无意义可寻,不能仅从文法角度去寻求解释。然而其中的事理自然是学者应当探究的。
Huangdi asked Shaoshi, saying: I have heard that human constitution varies; some are rigid and some are flexible; some are weak and some are strong; some are short and some are tall; some are Yin-predominant and some are Yang-predominant. I wish to hear the methods for distinguishing them.
Shaoshi replied: Within Yin there is Yin, and within Yang there is Yang. If one carefully discerns the Yin-Yang nature, acupuncture will have a method. If one knows the origin of the disease, acupuncture will have principles. One must cautiously assess the onset of the illness, ensuring it corresponds with the seasons. Internally, it correlates with the Zang-Fu organs (Zang organs are Yin, Fu organs are Yang); externally, it correlates with sinews, bones, skin, and flesh. Therefore, there is Yin and Yang internally, and also Yin and Yang externally. Internally, the Five Zang Organs are Yin and the Six Fu Organs are Yang; externally, sinews and bones are Yin and skin is Yang. Thus it is said: For diseases located in "Yin within Yin" (referring to the Zang organs), one should puncture the Ying-Spring and Shu-Acups of the Yin meridians. For diseases located in "Yang within Yang" (referring to the skin), one should puncture the He-Sea Acupoints of the Yang meridians. For diseases located in "Yang within Yin" (referring to sinews), one should puncture the Jing-River Acupoints of the Yin meridians. For diseases located in "Yin within Yang" (referring to collateral vessels), one should puncture the Luo-Collaterals. It is said that diseases in the Yang aspect are termed Wind; diseases in the Yin aspect are termed Bi (Obstruction syndrome); when both Yin and Yang are diseased, it is termed Feng-Bi (Wind-Bi).
If a disease presents with visible form but no pain, it belongs to the category of Yang. If it presents with no visible form but with pain, it belongs to the category of Yin. In cases of no form but pain, Yang integrity is preserved while Yin is injured; one should urgently treat the Yin and not attack the Yang. In cases of visible form but no pain, Yin integrity is preserved while Yang is injured; one should urgently treat the Yang and not attack the Yin. If both Yin and Yang show abnormal movements, alternating between having form and lacking form, accompanied by vexation and heart distress, this is termed "Yin overcoming Yang." This is called neither exterior nor interior, and such patients will not live long.
Huangdi asked Bogao, saying: I have heard about the relationship between Form and Qi, the sequence of disease, and the correspondence between interior and exterior. How does this work?
Bogao replied: Wind and Cold pathogens injure the Form; sorrow, fear, anger, and resentment injure Qi. When Qi is injured, it affects the Zang organs, resulting in Zang disease. When Cold injures the Form, it manifests in the Form. When Wind injures the sinews and vessels, it manifests in the sinews and vessels. This is the correspondence among Form, Qi, exterior, and interior.
Huangdi asked: How should acupuncture be applied?
Bogao replied: For a disease lasting nine days, three needle insertions will suffice. For a disease lasting one month, ten needle insertions will suffice. The number of insertions and the duration of treatment decrease proportionally based on this standard. For chronic Bi syndrome that persists in the body, observe the blood vessels and drain all the stagnant blood.
Huangdi asked: What are the principles of difficulty and ease in treating interior and exterior diseases?
Bogao replied: If the Form is diseased first but has not yet entered the Zang organs, the number of treatment days required should be halved. If the Zang organs are diseased first and then the Form responds, the number of treatment days required should be doubled. This is the correspondence regarding the difficulty and ease of interior and exterior diseases.
Huangdi asked Bogao, saying: I have heard that Form has variations in slackness and tension, Qi has variations in excess and deficiency, bones have variations in size, muscles have variations in firmness and fragility, and skin has variations in thickness. How can these be used to determine longevity and early death?
Bogao said: When Form and Qi are in balance, the person lives long; when they are not in balance, the person dies young. When skin and muscle adhere closely, the person lives long; when they do not adhere closely, the person dies young. When Blood, Qi, and meridians exceed the manifestation of Form, the person lives long; when they do not exceed Form, the person dies young.
Huangdi asked: What is meant by the slackness and tension of Form?
Bogao replied: When the body is full and robust but the skin is loose and relaxed, the person lives long. When the body is full and robust but the skin is tight and tense, the person dies young. When the body is full and robust but the pulse is firm and large, it indicates smooth health. When the body is full and robust but the pulse is small and weak, it indicates Qi deficiency, which is dangerous. If the body is full but the cheekbones do not protrude, it indicates small bones; small bones imply early death. If the body is full and the large muscles are firm with clear texture divisions, it indicates firm muscles; firm muscles imply longevity. If the body is full but the large muscles lack texture and are not firm, it indicates fragile muscles; fragile muscles imply early death. These are the natural laws of life. To establish Form and ascertain Qi in order to judge longevity or early death, one must understand these principles clearly. Only after establishing Form and ascertaining Qi can one face patients and determine life and death.
Huangdi said: I have heard that there is no standard measure for determining longevity and early death.
Bogao replied: If the facial foundation (the bone structure around the eyes and cheeks) is low and does not reach the level of the central facial plane, the person will die before thirty. If additional illness occurs, they will die before twenty.
Huangdi asked: How do the supremacy of Form and Qi determine longevity and early death?
Bogao replied: In healthy individuals, if Qi exceeds Form, they live long. In sick individuals, if the flesh and muscles have wasted away but Qi still exceeds Form, they will die. If Form exceeds Qi, the condition is critical.
Huangdi said: I have heard that acupuncture has three transformations. What are these three transformations?
Bogao said: There is acupuncture for Ying (Nutrient) blood, acupuncture for Wei (Defensive) Qi, and acupuncture for Cold-Bi remaining in the meridians.
Huangdi asked: How are these three transformations performed?
Bogao replied: Acupuncture for Ying involves bleeding; acupuncture for Wei involves releasing Qi; acupuncture for Cold-Bi involves generating internal heat.
Huangdi asked: What are the pathological manifestations of Ying, Wei, and Cold-Bi?
Bogao replied: Disease of Ying manifests as alternating cold and fever, shortness of breath, and blood moving up and down abnormally. Disease of Wei manifests as Qi flowing intermittently, chest oppression, and borborygmus (intestinal rumbling), caused by Wind and Cold lodging in the stomach and intestines. Disease of Cold-Bi manifests as pathogenic factors lingering without departing, causing intermittent pain and numbness of the skin.
Huangdi asked: How is internal heat generated when acupuncture is used for Cold-Bi?
Bogao replied: For commoners, fire moxibustion is used. For nobles, medicinal hot compresses are used.
Huangdi asked: How is the medicinal hot compress prepared?
Bogao replied: Take twenty jin of wine, one sheng of Shu pepper (Sichuan peppercorn), one jin of dried ginger, and one jin of cinnamon bark. These four ingredients are all chopped and soaked in the wine. Take one jin of cotton wadding and four zhang of fine white cloth, and put them into the wine. Place the container in horse manure fire, cover and seal tightly with mud to prevent leakage. After five days and nights, remove the cloth and cotton wadding, dry them in the sun, and soak them again until all the juice is extracted. Each soaking must wait for a dry day before drying out. Mix the dregs with the cotton wadding, wrap them in cloth to make multiple layers of towels, each six or seven chi long, making six or seven towels. Use mulberry charcoal to heat the towels and apply them to the acupunctured sites of the Cold-Bi, allowing the heat to penetrate to the disease site. When cool, reheat the towel and apply again. Repeat this thirty times and stop. When the patient sweats, wipe the body with the towel, also thirty times. Then walk inside the room and avoid exposure to wind. Every time acupuncture is performed, it must be followed by hot compress. In this way, the disease will be cured. This is what is meant by "generating internal heat."
The entire passage argues from the perspective of Wind-Bi, but unfortunately lacks logical structure and coherence. Its transitions and connections are meaningless and cannot be understood merely through literary analysis. However, the underlying medical principles are certainly worthy of scholarly investigation.