《移精变气论》曰∶变化相移,以观其妙,以知其要,故欲知其要,则色脉是矣。
言所以知四时五行之气,变化相移之要妙者何?以色脉故也。色以应日,脉以应月,常求其要,则其
要也。(言脉应月,色应日者,故候之则准也。常求色脉之差忒,则是平人之诊要也。)粗工凶凶
以为可攻,故病未已,新病复起,(谓粗工,不料事宜,非病妄治,则其害反增矣。)治之要极,无
失色脉,用之不惑,治之大则。(惑,为惑乱,则为法则也。言色脉之应,昭然不欺,但顺用而不乱
纪纲,则治病审当之大法也。)得神则昌,失神则亡。(此详言治法,以色脉为要之极,而其要之一,
惟在于得审而已。神者,病者之神气也。)
《汤液醪醴论》曰∶精神不进,志意不治,故病不可愈。(动离于道,耗散天真故尔。)精
坏神去,营卫不可复收,何者?嗜欲无穷,而忧患不止,精气弛坏,营涩卫除,故神去
之而病不愈也。(精神者,生之源;营卫者,气之主。气主不辅,生源复消,神不内居,病何能愈。)
其有不从毫毛生,而五脏阳以竭也。津液充廓,其魄独居,孤精于内,气耗于外,形不可与衣
相保,此四极急而动中,是气拒于内,而形
施于外,治之奈何?(不从毫毛,言行于内也。阴气内盛,阳气竭绝。不得入于腹中,故言五脏
阳以竭也。津液者,水也。充,满也,廓,皮也。阴蓄于中,水气胀满,上攻于肺,肺气孤危。魄者,
肺神,肾为水害,子不救母,故云其魄独居也。夫阴精损削于内,阳气耗减于外,则三焦闭溢,
水道不能通,水满皮肤身体痞肿。故云∶形不可与衣相保也。凡此之类,皆四肢脉数急而内鼓
动于脉中也。肺动者,谓气急而咳也。言如是者,皆水气格拒于腹膜之内,浮肿施张,于身形之外,
欲穷标本,其可得乎?四极言四末,则四肢也。)
平治于权衡,去宛陈 ,是以微动四极,温衣缪刺其处,以复其形。开鬼门,洁净腑,精以时服,
五阳已布,疏涤五脏,故精自生,形自盛,骨肉相保,巨气乃平。(平治权衡,察脉之轻重浮沉。宛,
积也。陈 ,陈草也。邪气之在人身,犹草 之陈积,五脏五阳皆有阳气。巨气,大气也。正气也。
脉浮在表宜汗,沉在里宜泄,如去宛积之陈草,又微动四肢,以导引之。温暖其衣,以流通之。缪刺
其处,以复其形体,盖经脉满则络脉溢,缪刺之以调其经脉。开鬼门,以发其汗。洁净腑,以利其水,使
五脏之精渐以时复,五脏之阳渐以宣布,疏涤五脏,邪气去,而精自生,形自盛,骨肉相保,巨气乃平。)
《移精变气论》说:观察阴阳五行之气的变化相互推移,以洞察其奥妙,从而掌握其关键。因此想要掌握关键,就要通过望色和切脉来进行判断。
为什么说能够了解四时五行之气变化推移的关键奥妙呢?是因为可以通过面色和脉象来判断。面色对应太阳(阳),脉象对应月亮(阴),经常探求其中的关键要点,就能把握诊断的要领。(所谓脉象对应月亮、面色对应太阳,是因为这样候诊才准确。经常探求面色与脉象的偏差,就是诊断正常人的要领。)庸医慌张失措,认为可以使用攻下法,所以旧病未愈,新病又起。(所谓庸医,是不考虑病情适宜与否,对非实证妄用攻伐,这样危害反而增加了。)治疗的最高准则,没有比不忽视面色和脉象更重要的了,运用它们而不迷惑,这是治疗的大法则。(“惑”指迷惑混乱,这里指遵循法则而言。意思是面色和脉象的反应,清晰明确且不欺骗人,只要顺应使用而不扰乱纲纪,就是诊治疾病审慎得当的大法。)得到神气则生机昌盛,失去神气则生命灭亡。(这里详细阐述治法,以面色和脉象为最关键的要领,而其中关键的一点,只在于审察清楚而已。“神”,是指病人的神气。)
《汤液醪醴论》说:如果精神不能振奋,意志不能调摄,那么疾病就不能痊愈。(因为活动背离了正道,耗散了先天真元所致。)精气败坏,神气离去,营气和卫气无法再恢复,为什么呢?因为嗜欲没有穷尽,而忧患不停止,导致精气松弛败坏,营气涩滞,卫气消散,所以神气离去而疾病不能痊愈。(精神和神气是生命的源泉;营气和卫气是气的主宰。气的主宰不能辅助,生命的源泉再次消亡,神气不能内守,疾病怎么能痊愈呢?)有的疾病不是从皮毛开始发生的,而是五脏的阳气已经衰竭了。津液充满胸廓,只有肺神(魄)独自存在,精气孤立于内,气耗散于外,形体消瘦以至于衣服都显得宽大不合身,这是四肢拘急且内脏受到扰动,这是因为气机格拒于体内,而形体浮肿施张于体外,该怎么治疗呢?(“不从毫毛生”,是说病邪行于体内。阴气在体内盛极,阳气衰竭断绝。津液不能进入腹中,所以说五脏阳气衰竭。津液就是水。“充”是满,“廓”是皮。阴邪蓄积于中,水气胀满,上攻于肺,导致肺气孤立危险。魄是肺的神志,肾为水害,子不救母,所以说“魄独居”。阴精在内受损削减,阳气在外耗减,导致三焦闭塞溢泄,水道不通畅,水湿充满皮肤身体痞肿。所以说“形不可与衣相保”。大凡此类情况,都是四肢脉搏数急,且内部鼓动于脉中。肺动,是指气急而咳嗽。意思是像这样的情况,都是水气格拒于腹膜之内,浮肿施张于身形之外,想要穷究标本,怎么可能呢?“四极”指四肢末端,即四肢。)
通过权衡轻重来平复病情,去除积聚的陈腐之物,因此轻微活动四肢,穿着温暖衣物,采用缪刺法针刺相应部位,以恢复形体。开发汗孔(鬼门),清洁六腑,精气按时服用(或理解为精气按时恢复),五脏阳气得以布散,疏通涤荡五脏,所以精气自然产生,形体自然强盛,骨肉相互保护,正气于是平和。(“平治权衡”,指诊察脉象的轻重浮沉。“宛”是积聚。“陈莝”是陈旧的草。邪气在人体内,就像陈旧的杂草堆积一样,五脏的五阳都有阳气。“巨气”指大气,即正气。脉浮在表适宜发汗,脉沉在里适宜泄下,如同去除陈旧杂草般的积聚;又轻微活动四肢,以导引气血;穿温暖衣物,以流通气血;缪刺相应部位,以恢复形体,因为经脉满则络脉溢,缪刺是为了调节经脉。开鬼门,是为了发汗;洁净腑,是为了利水,使五脏的精气逐渐按时恢复,五脏的阳气逐渐宣布布散,疏通涤荡五脏,邪气去除,精气自然产生,形体自然强盛,骨肉相互保护,正气于是平和。)
*Yi Jing Bian Qi Lun* (Treatise on Shifting Essence and Transforming Qi) states: By observing the mutual shifting of changes, one can perceive their subtleties and grasp their essentials. Therefore, to grasp the essentials, one must rely on inspection of the complexion (Se, facial color) and palpation of the pulse (Mai, pulse).
Why is it that one can understand the subtleties and essentials of the shifting changes of the Qi of the four seasons and five elements? It is because of the complexion and pulse. The complexion corresponds to the Sun (Yang), and the pulse corresponds to the Moon (Yin). Constantly seeking the essential principles allows one to master the diagnostic key. (The reason why the pulse corresponds to the Moon and the complexion to the Sun is that diagnosis becomes accurate in this manner. Constantly examining discrepancies between the complexion and pulse constitutes the essential method for diagnosing healthy individuals.) Crude practitioners, acting with panic and agitation, assume that purgative methods should be applied; consequently, the original disease remains unresolved, and new diseases arise. (By "crude practitioners," we refer to those who fail to consider the appropriateness of the condition and apply incorrect treatments to non-excess patterns, thereby increasing harm.) The ultimate principle of treatment lies in not neglecting the complexion and pulse. Utilizing them without confusion constitutes the great rule of treatment. ("Confusion" refers to being misled or chaotic; here it implies adhering to rules. The indications from the complexion and pulse are clear and unerring. As long as one follows them without disrupting the fundamental principles, this constitutes the great method for accurately treating diseases.) Possessing Shen (Spirit/Shen Qi) leads to prosperity; losing Shen leads to demise. (This elaborates on treatment methods, emphasizing that the utmost importance lies in the complexion and pulse, and the core of this lies solely in careful examination. "Shen" refers to the patient's Spirit or Shen Qi.)
*Tang Ye Lao Li Lun* (Treatise on Medicinal Grains and Fermented Liquids) states: If the Jing (Essence) and Shen do not advance, and the Zhi (Will/Intent) is not regulated, then the disease cannot be cured. (This occurs because movement deviates from the Dao, dissipating Tian Zhen [Innate True Qi].) When Jing is ruined and Shen departs, Ying (Nutritive Qi) and Wei (Defensive Qi) cannot be recovered. Why is this? Because desires are endless, and worries and anxieties are unceasing, causing Jing Qi to become lax and ruined, Ying Qi to become stagnant, and Wei Qi to dissipate. Thus, Shen departs, and the disease does not heal. (Jing and Shen are the source of life; Ying and Wei are the masters of Qi. If the master of Qi fails to assist, the source of life diminishes again, Shen cannot reside within, and how can the disease heal?) There are cases where the disease does not originate from the hair and skin but arises because the Yang Qi of the Five Zang Organs has been exhausted. Jin Ye (Body Fluids) fill the chest cavity, while Po (Corporeal Soul/Lung Spirit) exists alone. Jing is isolated within, while Qi is depleted externally. The body becomes so emaciated that clothes no longer fit. This presents as urgency and internal disturbance in the four extremities. This indicates that Qi is rejected within, while edema manifests externally. How should this be treated? ("Not originating from hair and skin" means the pathogen acts internally. Yin Qi is excessive internally, and Yang Qi is exhausted. Jin Ye cannot enter the abdomen, hence it is said that the Yang Qi of the Five Zang Organs is exhausted. Jin Ye refers to water. "Chong" means full; "Kuo" refers to the skin/subcutaneous tissue. Yin accumulates internally, causing water-Qi distension and attacking the Lung, leaving the Lung Qi in a precarious state of isolation. Po is the spirit of the Lung; Kidney pathology involving water harms the mother organ, and since the child does not rescue the mother, it is said that "Po exists alone." When Yin-Jing is damaged internally and Yang-Qi is depleted externally, the San Jiao (Triple Burner) becomes blocked and overflow occurs, preventing the smooth flow of water pathways. Water fills the skin and body, causing swelling and stagnation. Hence, it is said that "the body cannot be maintained by clothes." In all such cases, the pulses in the four extremities are rapid and urgent, with internal pulsation within the vessels. Lung involvement manifests as急促 breathing and coughing. Such cases indicate that water-Qi is obstructed within the peritoneum, causing edema to manifest externally on the body shape. Can one fully investigate the root and branch in such situations? "Si Ji" refers to the four extremities, i.e., the arms and legs.)
Treatment involves balancing through weighing and measuring, removing accumulated stagnation (Wan Chen). Therefore, one should slightly move the four extremities, wear warm clothing, and apply Mi Ci (Mistaken/Piercing Needling) at specific locations to restore the form. Open the Gui Men (Ghost Gates/Sweat Pores) to induce sweating, and cleanse the Six Fu Organs to promote urination. Jing will be restored in due time, the Yang Qi of the Five Zang Organs will be distributed, and the Five Zang Organs will be dredged and cleansed. Consequently, Jing generates spontaneously, the form becomes robust, bones and flesh protect each other, and Ju Qi (Great Qi/Vital Energy) becomes balanced. ("Ping Zhi Heng Quan" refers to assessing the weight, floating, and sinking of the pulse. "Wan" means accumulation. "Chen Cuo" refers to old grass. Pathogenic Qi in the human body is like accumulated old grass; the Five Zang Organs possess Yang Qi. "Ju Qi" refers to Great Qi, i.e., Zheng Qi [Upright Qi]. If the pulse is floating and superficial, sweating is appropriate; if sunken and interior, purging is appropriate, similar to removing accumulated old grass. Slightly moving the four extremities guides the Qi. Wearing warm clothing promotes circulation. Mi Ci at specific locations restores the form; when meridians are full, collaterals overflow, and Mi Ci regulates the meridians. Opening Gui Men induces sweating; cleansing the Fu Organs promotes diuresis, allowing the Jing of the Five Zang Organs to gradually recover in time, and their Yang Qi to be disseminated. Dredging and cleansing the Five Zang Organs expels pathogenic Qi, leading to spontaneous generation of Jing, robustness of the form, protection between bones and flesh, and balance of Ju Qi.)