肾主欠嚏。经云∶肾为欠为嚏是也。
运气 欠嚏有三∶
一曰寒。经云∶太阳司天,寒气下临,心气上从,寒清时举,鼽嚏喜悲数欠是也。
二曰火。经云∶少阳司天之政,三之气,炎暑至,民病嚏欠是也。
三曰湿郁其火。经云∶阳明司天之政,初之气,阴始凝,民病中热嚏欠是也。
二阳一阴发病,主惊骇背痛,善噫善欠。(全文见诊病传变 王注云∶气郁于胃,故欠生焉。)
运气 欠伸皆属风。经云∶厥阴在泉,风淫所胜,病善伸数欠,治以辛是也。
〔仲〕中寒家善欠。
〔《灵》〕黄帝曰∶人之欠者,何气使然?岐伯曰∶卫气昼日行于阳,夜半则行于阴,阴者主夜,夜
者卧,阳者主上,阴者主下,故阴气积于下,阳气未尽,阳引而上,阴引而下,阴阳相引,故数欠。阳气尽,
阴气盛,则目瞑;阴气尽,阳气盛,则寤矣。泻足少阴,补足太阳。(口问篇)
针灸 欠伸有二法,此篇经文取足少阴太阳,是其一也。其二取胃,经云∶胃足阳明之脉,是动则病振寒,
善伸数欠,视盛虚实寒陷下调之也。
〔河〕嚏,鼻中因痒而气喷作于声也。鼻为肺窍,痒为火化,心火邪热干于阳明,发于鼻而痒则嚏也。或
故以物扰之,痒而嚏者,扰痒属火故也。或视日而嚏者,由目为五脏神华,太阳真火晃曜于目,心
神躁乱而热发于上,则鼻中痒而嚏也。
运气 嚏有三∶
一曰热火。经云∶少阴司天之政,热病生于上,民病血溢鼽嚏。又云∶少阴司天,热气下临,肺气上从,
病嚏鼽衄。又云∶少阴之复,燠热内作,烦躁鼽嚏。又云∶少阳所至为鼽嚏。又云∶少阳司天,火气下临,肺
气上从,咳嚏鼽衄,治以诸寒是也。
二曰金不及火乘之。经曰∶金不及曰从革,从革之纪,其病嚏咳鼽衄,从火化者是也。
三曰燥金。经云∶阳明所至,为鼽嚏是也。
〔《灵》〕黄帝曰∶人之嚏者,何气使然?岐伯曰∶阳气和利,满于心,出于鼻,故为嚏,补足太阳荣眉本,
一曰眉上也。(口问篇 眉本,恐攒竹穴。)
〔《撮》〕腠理不密,喷嚏不已∶风门(一分,沿皮向后一寸半,补一呼。)
〔仲〕其人清涕出,发热色和者善嚏。
肾脏主管呵欠和打喷嚏。《内经》说:“肾表现为呵欠和打喷嚏”,正是这个意思。
从五运六气的角度分析,呵欠和打喷嚏有三种成因:
一是寒邪。《内经》说:“当太阳司天之时,寒气下行临照,心气随之上应,寒冷清肃之气时常兴起,出现鼻塞、打喷嚏、易悲伤、频繁呵欠等症状。”
二是火邪。《内经》说:“当少阳司天之政令时,在三之气阶段,炎热暑气到来,民众患病出现打喷嚏、呵欠等症状。”
三是湿气郁结导致内火。《内经》说:“当阳明司天之政令时,在初之气阶段,阴气开始凝结,民众患病出现心中烦热、打喷嚏、呵欠等症状。”
足阳明胃经与足厥阴肝经发病时,主要表现为惊恐、骇异、背痛,容易嗳气和呵欠。(全文详见“诊病传变”章节。王冰注解说:“气机郁滞于胃,所以产生呵欠。”)
从五运六气的角度分析,呵欠和伸懒腰都归属于风邪。《内经》说:“当厥阴在泉之时,风邪过盛,病症表现为喜欢伸展、频繁呵欠,治疗应用辛味药物。”
〔《灵枢》〕黄帝问:“人为什么会打呵欠?是什么气导致的?”岐伯回答:“卫气白天运行于阳分,半夜则运行于阴分。阴分主夜间,夜间主睡眠;阳分主上部,阴分主下部。因此阴气积聚在下部,阳气尚未耗尽,阳气牵引向上,阴气牵引向下,阴阳相互牵引,所以频繁打呵欠。当阳气耗尽,阴气旺盛,眼睛就闭合(入睡);当阴气耗尽,阳气旺盛,人就醒来。”治疗可泻足少阴肾经,补足太阳膀胱经。(出自《口问篇》)
针灸治疗呵欠和伸懒腰有两种方法,本篇经文选取足少阴和足太阳经,这是其中一种。第二种方法是选取胃经,《内经》说:“足阳明胃经发生病变时,会出现战栗恶寒,喜欢伸展、频繁呵欠,需根据脉象的盛衰、虚实、寒热及陷下等情况进行调理。”
〔李东垣〕打喷嚏,是因为鼻中发痒,气息喷出而发出声音。鼻子是肺的窍道,发痒是由火邪转化所致。当心火邪热侵犯阳明经,反映在鼻部引起发痒,就会打喷嚏。或者是故意用物体刺激鼻腔,因痒而打喷嚏,这种由刺激引起的痒属于火邪。或者是看太阳时打喷嚏,这是因为眼睛是五脏神气的精华所在,太阳真火的光辉照耀眼睛,导致心神躁动混乱,热气上行,从而鼻中发痒而打喷嚏。
从五运六气的角度分析,打喷嚏有三种成因:
一是热火。《内经》说:“当少阴司天之政令时,热病生于上部,民众患病出现血溢、鼻塞、打喷嚏。”又说:“少阴司天,热气下行临照,肺气随之上应,病症表现为打喷嚏、鼻塞、鼻出血。”又说:“少阴之复气发作,内部产生燠热,烦躁不安,鼻塞、打喷嚏。”又说:“少阳之气所至,表现为鼻塞、打喷嚏。”又说:“少阳司天,火气下行临照,肺气随之上应,咳嗽、打喷嚏、鼻塞、鼻出血,治疗应用各种寒性药物。”
二是金气不足,被火气乘袭。《内经》说:“金气不足称为‘从革’,在从革之年,病症表现为打喷嚏、咳嗽、鼻塞、鼻出血,这是由于从火化生所致。”
三是燥金之气。《内经》说:“阳明之气所至,表现为鼻塞、打喷嚏。”
〔《灵枢》〕黄帝问:“人为什么会打喷嚏?是什么气导致的?”岐伯回答:“阳气调和顺畅,充满于心,出于鼻,所以形成喷嚏。治疗应补足太阳经的荥穴眉本,也就是眉毛上方。(出自《口问篇》,眉本,推测是攒竹穴。)”
〔《医学入门》或相关针灸著作〕腠理不致密,导致喷嚏不止:取风门穴(进针一分,沿皮向后斜刺一寸半,采用补法,配合一次呼吸的时间)。
The Kidney governs yawning and sneezing. The Classics state: "The Kidney manifests as yawning and sneezing," which is precisely this meaning.
From the perspective of Five Movements and Six Qi (Wu Yun Liu Qi), there are three causes for yawning and sneezing:
First, Cold pathogen. The Classics state: "When Taiyang governs the year, Cold qi descends and临 (shines upon) from above, Heart qi responds upwards; when cold and clear qi frequently arises, symptoms include rhinorrhea, sneezing, frequent sadness, and numerous yawns."
Second, Fire pathogen. The Classics state: "When Shaoyang governs the administration of the year, during the third Qi phase, scorching heat arrives, and the people suffer from diseases involving sneezing and yawning."
Third, Dampness stagnating and trapping internal Fire. The Classics state: "When Yangming governs the administration of the year, during the first Qi phase, Yin qi begins to congeal, and the people suffer from diseases involving central heat, sneezing, and yawning."
When the Foot-Yangming Stomach channel and the Foot-Jueyin Liver channel are affected, the main manifestations are fright, terror, back pain, frequent belching, and frequent yawning. (For the full text, see the section on "Transmission and Variation of Diseases". Wang Bing's commentary states: "Qi stagnates in the Stomach, thus yawning arises.")
From the perspective of Five Movements and Six Qi, yawning and stretching belong to Wind pathogen. The Classics state: "When Jueyin is at the bottom (Zai Quan), excessive Wind invasion causes diseases characterized by a preference for stretching and frequent yawning; treatment should employ acrid substances."
[Zhang Zhongjing] Individuals suffering from Cold injury frequently yawn.
[Su Wen / Ling Shu] Huangdi asked: "Why do people yawn? What qi causes this?" Qibo replied: "Wei Qi (Defensive Qi) travels through the Yang aspects during the day and through the Yin aspects at midnight. Yin governs the night, and the night governs sleep; Yang governs the upper body, and Yin governs the lower body. Therefore, Yin qi accumulates in the lower part, while Yang qi has not yet exhausted. Yang pulls upward, and Yin pulls downward; the mutual attraction of Yin and Yang results in frequent yawning. When Yang qi is exhausted and Yin qi is abundant, the eyes close (sleep); when Yin qi is exhausted and Yang qi is abundant, one awakens." Treatment involves draining the Foot-Shaoyin Kidney channel and tonifying the Foot-Taiyang Bladder channel. (From *Kouwen* Chapter)
There are two acupuncture methods for treating yawning and stretching. This chapter's scripture selects the Foot-Shaoyin and Foot-Taiyang channels, which is one method. The second method selects the Stomach channel. The Classics state: "When the Foot-Yangming Stomach channel is disturbed, it causes trembling chills, a preference for stretching, and frequent yawning; it should be regulated according to whether the pulse is excess or deficiency, cold or heat, or sinking."
[Li Dongyuan] Sneezing occurs because itching in the nose causes air to spray out with sound. The nose is the orifice of the Lung. Itching is transformed by Fire. When Heart Fire and evil heat invade the Yangming channel, manifesting as itching in the nose, sneezing occurs. Or, if one deliberately disturbs the nose with an object, causing itching and sneezing, this disturbance-induced itching belongs to Fire. Or, if one sneezes while looking at the sun, it is because the eyes are the splendor of the Spirit of the Five Zang organs. The true Fire of Taiyang shines brightly into the eyes, causing the Heart Spirit to become restless and chaotic, with heat rising upward, leading to itching in the nose and subsequent sneezing.
From the perspective of Five Movements and Six Qi, there are three causes for sneezing:
First, Hot Fire. The Classics state: "When Shaoyin governs the administration of the year, Heat diseases arise in the upper part, and the people suffer from blood overflow, rhinorrhea, and sneezing." It also says: "When Shaoyin governs the year, Heat qi descends and临 from above, Lung qi responds upwards, causing diseases of sneezing, rhinorrhea, and epistaxis." It also says: "In the recurrence of Shaoyin, internal warmth and heat arise, accompanied by irritability, rhinorrhea, and sneezing." It also says: "Wherever Shaoyang reaches, it manifests as rhinorrhea and sneezing." It also says: "When Shaoyang governs the year, Fire qi descends and临 from above, Lung qi responds upwards, causing cough, sneezing, rhinorrhea, and epistaxis; treatment employs various Cold medicines."
Second, Metal qi is insufficient and is overcome by Fire. The Classics say: "When Metal qi is insufficient, it is called 'Cong Ge' (following transformation). In years of Cong Ge, the diseases involve sneezing, cough, rhinorrhea, and epistaxis, which follow the transformation of Fire."
Third, Dry Metal qi. The Classics state: "Wherever Yangming reaches, it manifests as rhinorrhea and sneezing."
[Su Wen / Ling Shu] Huangdi asked: "Why do people sneeze? What qi causes this?" Qibo replied: "When Yang Qi is harmonious and smooth, it fills the Heart and emerges from the Nose, thus forming a sneeze. Treatment should tonify the Ying-Spring point Meiben of the Foot-Taiyang channel, also known as the point above the eyebrow." (From *Kouwen* Chapter; Meiben is likely the Cuanzhu acupoint.)
[Medical Entry / Acupuncture Texts] If the interstices (Cou Li) are not dense, leading to incessant sneezing: Select Fengmen (Depth 1 cun, oblique insertion backward 1.5 cun, tonification method synchronized with one respiration).
[Zhang Zhongjing] If a person has clear nasal discharge, fever, but a normal complexion, they will frequently sneeze.