《离合真邪论》曰∶天地温和,则经水安静;天寒地冻,则经水凝涩;天暑地热,则经水沸溢;
卒风暴起,则经水波涌而陇起。夫邪之入于脉也,寒则血脉凝涩,暑则气淖译,虚邪因而入客,亦如
经水之得风也。
诛伐无过,命曰大惑,反乳大经,真不可复,用实为虚,以邪为真,用针无义,反为气贼,夺
人正气。以从为逆,荣卫散乱,真气已失,邪独内着,绝人长命,子人夭殃。不知三部九候,故不能长久。
(识非精辨,学未该明,且乱大经,又为气贼,动为残害,安可久乎!)因不知合之四时五行,因加
相胜,释邪攻正。绝人长命。(非惟昧三部九候之为弊,若不知四时五行之气序,亦足殒绝其生灵也。)
邪之所客来也,未有定处,推之则前,引之则止,逢而泻之,其病立已。(此亦解《针经》补泻法也。)
《通评虚实论》曰∶何谓虚实?邪气盛则实,精气夺则虚。(夺,谓精气减少,如夺去也。)
乳子而病、热,脉悬小者,何如?(悬,谓如悬物之动也。)手足温则生,寒则死。乳子
中风热,喘鸣肩息者,脉何如?喘鸣肩息者,脉实大也。缓则生急则死。(此言乳子脉与病反者,复
有他证可验,病症俱甚者,复有脉体可据。而决其死生也。乳子而病热,阳证也。脉悬小,是阳证见阴
脉也。然手足温和,正气犹存,脉虽悬小,甚未大耳,故可以得生。否则,手足寒而死矣。又乳子中风发
热,喘鸣肩息者,阳证也。脉当实大,惟实大中而缓,则邪气渐退,可以得生,若实大中而急,则邪热愈
增其病当死矣。)肠 便血何如?身热则死,寒则生。(热为血败,故死;寒为荣气在,故生。)肠
下白沫何如?脉沉则生,脉浮则死。(阴病而见阳脉,与证相反故死。)肠 下脓血何如?脉悬绝则死,
滑大则生。肠 之属,身不热脉不悬绝,何如?滑大者曰生,悬涩者曰死。以脏期之。(肝见庚辛
死,心见壬癸死,肺见丙丁死,肾见戊己死,脾见甲乙死,是谓以脏期之,此言肠 之属,有便血者,
有下白沫者,有下浓血者,随证随脉而可以决其死生也。)巅疾何如?脉搏大滑,久自已;脉小坚急,死不
治。(脉小坚急,为阳病而见阴脉,故死不治。)巅疾之脉虚买何如?虚则可治,实则死。(言巅疾之
脉,得阳脉虚脉而生也,巅疾者,阳证也,故搏大滑,则阳证得阳脉,所以病久自己若脉小坚急,则
得阴脉,故死不治,然巅疾之脉,当有取于虚也。必搏大滑中带虚可治,若带实则邪气有余,乃死候
也。)消瘅虚实何如?脉实大,病可久治∶脉悬小坚,病久不可治。(久病血气衰,脉不当实大,
故不可治。)黄胆暴痛,癫疾浊狂,久逆之所生也。五脏不平,六腑闭塞之所生也。头痛耳鸣,九
窍不利,肠胃之所生也。(此言病有所生者,皆从内而起也。)
《离合真邪论》说:天地气候温和,人体的经脉气血就平静安宁;天气寒冷、大地冻结,经脉气血就会凝滞不畅;天气酷热、地气蒸腾,经脉气血就像沸腾溢出一样;突然狂风大作,经脉气血就像水面波涛汹涌、隆起波浪。外邪侵入血脉,寒邪会使血脉凝涩,暑邪会使气机濡润散乱,虚邪趁机侵入人体,也如同经水遇到风一样(产生波动)。
如果误治没有过错的正气,称之为极大的迷惑,反而损伤了大的经脉,导致真气无法恢复,将实证误作虚证,将邪气误作真气,使用针刺没有法度,反而成为伤害正气的贼寇,剥夺人的正气。把顺证当作逆证处理,导致营卫之气散乱,真气已经丧失,只有邪气独自内着,断绝人的长寿,给人带来早夭的灾祸。因为不懂得三部九候诊法,所以不能长久生存。(如果见识不精微辨析,学问不够广博明确,就会扰乱大经,又成为伤害正气的贼寇,动不动就造成残害,怎么能长久呢!)因为不懂得结合四时五行来辨证,反而利用相克的关系,在驱除邪气的同时攻伐正气,断绝人的寿命。(不仅仅是昏昧于三部九候诊法的弊端,如果不知道四时五行的气序规律,也足以导致生灵灭绝。)
邪气客居在体内,没有固定的位置,推按它它就向前移动,牵引它它就停止,遇到邪气所在之处就用泻法,病立刻就能痊愈。(这也是解释《针经》中补泻方法的内容。)
《通评虚实论》说:什么是虚和实?邪气盛实就是实证,精气亏损就是虚证。(“夺”,是指精气减少,就像被剥夺一样。)
妇女哺乳期患病发热,脉象悬小,会怎样?(“悬”,是指像悬挂物体那样动摇不定。)如果手足温暖就能生,手足寒冷就会死。哺乳期妇女感受风热,出现喘息有声、耸肩呼吸的症状,脉象会怎样?出现喘息有声、耸肩呼吸症状的,脉象是实大的。脉缓则生,脉急则死。(这里说的是哺乳期妇女脉象与病症相反的情况,还有其他的证候可以验证,如果病症都很严重,又有脉象特征可以依据,从而判断其生死。哺乳期妇女患热病,属于阳证。脉象悬小,是阳证见到阴脉。但是手足温和,说明正气尚存,脉象虽然悬小,但还不算太弱,所以可以得生。否则,手足寒冷就会死亡。另外,哺乳期妇女中风发热,喘息有声、耸肩呼吸,也是阳证。脉象应当实大,只有在实大中带有缓和之象,说明邪气逐渐消退,可以得生;如果实大中带有紧急之象,说明邪热更加增加,病情加重就会死亡。)
肠道便血会怎样?身体发热就会死,身体不热就能生。(发热是因为血液败坏,所以死;不热是因为营气还在,所以生。)
肠道下白沫会怎样?脉沉就能生,脉浮就会死。(阴病见到阳脉,与证候相反,所以死。)
肠道下脓血会怎样?脉象悬绝就会死,脉滑大就能生。
肠道疾病这类情况,身体不发热、脉象不悬绝,会怎样?脉滑大的是生,脉象悬涩的是死。根据脏腑旺衰日期来预测。(肝脏病见于庚辛日死,心脏病见于壬癸日死,肺脏病见于丙丁日死,肾脏病见于戊己日死,脾脏病见于甲乙日死,这叫做根据脏腑日期预测。这里说的是肠道疾病这类情况,有便血的,有下白沫的,有下脓血的,随证候和脉象就可以判断生死。)
巅顶部的疾病(如癫痫等)会怎样?脉搏大而滑,时间久了自己会好;脉搏小而坚急,死,不可治。(脉小坚急,是阳病见到阴脉,所以死且不可治。)
巅顶疾病的脉象虚弱会怎样?脉虚就可以治,脉实就会死。(意思是巅顶疾病的脉象,得到阳脉中的虚脉就能生。巅顶疾病属于阳证,所以脉搏大而滑,是阳证得阳脉,所以病久自愈;如果脉小坚急,则是得阴脉,所以死且不可治。然而巅顶疾病的脉象,应当以取决于“虚”为吉。必须是大而滑中带虚才能治,如果带实则邪气有余,乃是死候。)
消瘅(糖尿病类疾病)的虚实会怎样?脉实大,病可以久治;脉悬小坚,病久不可治。(久病血气衰弱,脉象不应当实大,所以不可治。)
黄疸突发疼痛,癫疾浊狂,是由于长期气机逆乱所产生的。五脏功能不平,是由于六腑闭塞所产生的。头痛耳鸣,九窍不利,是由于肠胃病变所产生的。(这里说的是疾病有所产生,都是从内部发起的。)
*Lihé Zhenxie Lun* (Treatise on the Separation and Union of True and Pathogenic Qi) states: When heaven and earth are mild and warm, the Jing water (meridian qi/blood) remains quiet; when heaven is cold and earth frozen, the Jing water becomes congealed and sluggish; when heaven is hot and earth warm, the Jing water boils and overflows; when sudden storms arise, the Jing water surges like waves. When pathogenic factors enter the vessels, cold causes blood vessels to become congealed and sluggish, while heat causes qi to become moist and scattered. Deficient pathogens take this opportunity to invade, just as Jing water reacts to wind.
If one punishes that which has committed no fault (i.e., attacks healthy Zheng Qi instead of Xie Qi), it is called great confusion. One reverses the major meridians, making the True Qi irrecoverable. Treating excess as deficiency, and pathogen as truth, using acupuncture without principle, one becomes a thief of Qi, depriving people of their righteous Qi. Treating compliance as rebellion causes Ying and Wei (Nutritive and Defensive Qi) to scatter and disarray. The True Qi is lost, only the pathogen remains internally lodged, cutting off long life and bringing premature disaster upon humans. Not knowing the Three Regions and Nine Pulses prevents longevity. (If insight is not precise and learning not comprehensive, one will disrupt the major meridians and become a thief of Qi, causing harm at every turn; how can one survive long?) Because one does not combine these with the Four Seasons and Five Elements, one adds mutual overcoming [pathology], releasing the pathogen while attacking the righteous Qi, thus cutting off human longevity. (It is not only the ignorance of the Three Regions and Nine Pulses that causes harm; if one does not know the sequence of Qi in the Four Seasons and Five Elements, it is sufficient to cause the extinction of living beings.)
Wherever the pathogen lodges, there is no fixed location. Pushing it moves it forward; pulling it stops it. Encountering it and applying draining methods, the disease is immediately cured. (This also explains the tonifying and draining methods from the *Zhenjing* / Classic of Acupuncture.)
*Tongping Xushi Lun* (General Discussion on Excess and Deficiency) states: What are excess and deficiency? When pathogenic Qi is flourishing, it is excess; when Essence and Qi are depleted, it is deficiency. ("Depletion" refers to the reduction of Essence and Qi, as if taken away.)
If a nursing woman falls ill with fever and the pulse is suspended and small, what happens? ("Suspended" means moving like a hanging object.) If the hands and feet are warm, she lives; if cold, she dies. If a nursing woman contracts wind-heat, with wheezing and shoulder breathing, what is the pulse? For those with wheezing and shoulder breathing, the pulse is excess and large. If slow, she lives; if rapid/tight, she dies. (This discusses cases where the pulse contradicts the illness in nursing women. There are other signs to verify; if both symptoms and pulse are severe, they provide basis for determining life or death. Nursing women with fever have Yang syndromes. A suspended-small pulse indicates a Yin pulse appearing in a Yang syndrome. However, if hands and feet are warm, Righteous Qi still exists. Although the pulse is suspended-small, it is not extremely weak, so survival is possible. Otherwise, cold hands and feet lead to death. Furthermore, nursing women with wind-heat, wheezing, and shoulder breathing have Yang syndromes. The pulse should be excess and large. Only if it is excess-large yet slow does it indicate the pathogen receding and survival possible. If it is excess-large yet rapid/tight, pathogenic heat increases, leading to death.)
What about intestinal bleeding? If the body is hot, death ensues; if cool, survival occurs. (Heat indicates blood corruption, hence death; coolness indicates Ying Qi remains, hence survival.)
What about passing white mucus from the intestines? If the pulse is deep, survival; if floating, death. (Yin disease showing Yang pulse contradicts the syndrome, hence death.)
What about passing pus and blood from the intestines? If the pulse is suspended and severed, death; if slippery and large, survival.
For intestinal conditions, if the body is not hot and the pulse is not suspended-severed, what happens? Slippery and large indicates survival; suspended and choppy indicates death. Prediction is made based on organ cycles. (Liver diseases die on Geng/Xin days; Heart diseases die on Ren/Gui days; Lung diseases die on Bing/Ding days; Kidney diseases die on Wu/Ji days; Spleen diseases die on Jia/Yi days. This is called predicting by organ timing. This refers to intestinal conditions involving bleeding, white mucus, or pus/blood, where life or death can be decided according to syndrome and pulse.)
What about Dian diseases (epilepsy/head disorders)? If the pulse is large and slippery, it resolves itself after a long time; if small, firm, and rapid, it is untreatable death. (Small, firm, and rapid pulse indicates Yang disease showing Yin pulse, hence untreatable death.)
What if the Dian disease pulse is deficient? Deficient is treatable; excess is fatal. (This means Dian disease, being a Yang syndrome, survives if the pulse shows Yang characteristics but is deficient. Large and slippery pulses represent Yang syndrome matching Yang pulse, allowing self-resolution. Small, firm, and rapid pulses represent Yin pulse, leading to death. Thus, the Dian pulse should ideally show deficiency. It must be large, slippery, yet contain deficiency to be treatable. If it contains excess, pathogenic Qi is surplus, indicating a fatal prognosis.)
What about the excess/deficiency of Xiao Dan (wasting-thirst diabetes-like conditions)? Pulse excess and large allows prolonged treatment; pulse suspended, small, and firm indicates untreatable chronic disease. (In chronic disease, Blood and Qi decline; the pulse should not be excess-large, hence untreatable.)
Jaundice with sudden pain, Dian disease, turbid mania, arise from long-term reversal of Qi. Imbalance of the Five Zang organs arises from obstruction of the Six Fu organs. Headache, tinnitus, and dysfunction of the nine orifices arise from the stomach and intestines. (This states that diseases originate internally.)