(1)大饱伤脾∶因脾主运化饮食,饮食太饱,脾之运化力不足以胜之,是以受伤。其作噫者,因脾
不运化,气郁中焦,其气郁极欲通,故噫以通之;其欲卧者,因脾主四肢,脾伤四肢酸懒,是以欲卧;其色黄
者,因脾属土。凡人之五脏,何脏有病,即现何脏所属之本色。此四诊之中,所以望居首也。
(2)大怒气逆伤肝∶因肝属木,木之条上达,木之根下达。为肝气能上达,故能助心气之宣通(肝系下
连气海,上连心,故能接引气海中元气上达于心)。为肝气能下达,故能助肾气之疏泄(肾主闭藏,有肝气以疏
泄之,二便始能通顺)。大怒,其气有升无降,甚而至于横行,其中所藏之相火,亦遂因之暴动
(相火生于命门,寄于肝胆,游行于三焦),耗其血液,所以伤肝而血即少。肝开窍于
目,目得血而能视,肝伤血少,所以其目暗也。
(3)形寒饮冷伤肺∶因肺为娇脏,冷热皆足以伤之也。盖肺主皮毛,形寒则皮毛闭塞,肺气不能
宣通,遂郁而生热,此肺之因热而伤也。饮冷则胃有寒饮留滞,变为饮邪,上逆于肺而为
悬饮,此肺之因冷而伤也。肺主气,开窍于鼻,有病则咳,肺伤,所以气少、咳嗽、鼻鸣也。
(4)忧愁思虑伤心∶因人之神明藏于脑,故脑为精明之府(《内经》脉要精微论),而发出在心,
故心为君主之官(《内经》灵兰秘典),神明属阳,阳者主热。忧愁思虑者,神明常常由心发露,心血必因
热而耗,是以伤心也。心伤,上之不能充量输血于脑,下之不能充量输血于肝,脑中之神失其凭借,故苦惊
喜忘,肝中之魂,失其护卫,故夜不能寐,且肝中血少,必生燥热,故又多怒也。
(5)强力入房久坐湿地伤肾∶因肾有两枚,皆属于水,中藏相火,为真阴中之真阳,以统摄下
焦真阴真阳之气。强力入房则伤阴,久坐湿地则伤阳,肾之真阴真阳俱伤,所以伤肾。肾伤则呼吸之时,不能纳
气归根,所以短气。腰者肾之腑,肾伤所以腰疼。骨者肾所主,肾伤所以脚骨作疼。至于厥逆下冷,亦肾中水
火之气,不能敷布之故也。
(6)风雨寒暑伤形∶因风雨寒暑,原天地之气化,虽非若疠疫不正之气,而当其来时或过于猛烈,即
与人身之气化有不宜。乃有时为时势所迫,或自不经意,被风雨寒暑之气侵,其身体气弱,不能捍御,则
伤形矣。形伤则发落,肌肤枯槁,此犹木伤其本,而害及枝叶也。
(7)大恐惧不节伤志∶因志者为心之所之,必以中正之官辅之,此志始百折不回。中正之官者,胆也,
若过恐惧,则胆失其司,即不能辅心以成志,所以伤志。志伤,则心有所图而畏首畏尾,所以恍惚不乐也。
(1)暴饮暴食损伤脾脏:因为脾脏主管饮食的运化,如果吃得过饱,脾脏的运化功能不足以消化这些食物,因此导致受伤。出现打嗝的症状,是因为脾脏不能正常运化,气机郁结在中焦,这股郁结之气极欲疏通,所以通过打嗝来宣泄它;想要躺卧,是因为脾脏主管四肢,脾脏受伤后四肢酸软懒惰,所以想要躺卧;面色发黄,是因为脾脏在五行中属土。凡是人的五脏中哪一脏有病,就会显现出该脏所属的五行的本色。这就是在望、闻、问、切四诊之中,望诊排在首位的原因。
(2)大怒导致气机上逆而损伤肝脏:因为肝脏在五行中属木,木的特性是枝条向上生长,根系向下延伸。因为肝气能够上达,所以能辅助心气的宣通(肝系下端连接气海,上端连接心脏,因此能引导气海中的元气上达于心)。因为肝气能够下达,所以能辅助肾气的疏泄(肾脏主闭藏,有肝气来疏泄它,大小便才能通畅)。大怒时,气机只有上升没有下降,甚至横行乱窜,其中所藏的相火(相火生于命门,寄居于肝胆,游行于三焦),也随之暴动,耗伤血液,所以损伤肝脏且血液减少。肝脏开窍于眼睛,眼睛得到血液滋养才能视物,肝脏受伤且血液减少,所以视力昏暗。
(3)身体受寒和饮用冷饮损伤肺脏:因为肺脏是娇嫩的脏器,冷和热都足以伤害它。肺脏主管皮毛,身体受寒则皮毛闭塞,肺气不能宣通,于是郁结而生热,这是肺脏因热而受伤。饮用冷饮则胃中有寒饮停留停滞,变为饮邪,向上逆犯肺脏而形成悬饮(指水饮停聚胸胁之间的病证),这是肺脏因冷而受伤。肺脏主管气,开窍于鼻子,有病时会咳嗽,肺脏受伤,所以会出现气短、咳嗽、鼻鸣等症状。
(4)忧愁思虑损伤心脏:因为人的神明(精神意识思维活动)藏于脑,所以脑是精明之府(出自《内经·脉要精微论》),而神明的发出在于心,所以心是君主之官(出自《内经·灵兰秘典》)。神明属于阳,阳主热。忧愁思虑时,神明常常由心中发露,心血必然因热而耗损,因此损伤心脏。心脏受伤,向上不能充足地输血给脑,向下不能充足地输血给肝,脑中的神失去了凭借,所以容易惊恐、健忘;肝中的魂失去了护卫,所以夜晚不能入睡,而且肝中血液少,必然产生燥热,所以也容易发怒。
(5)强力行房和久坐湿地损伤肾脏:因为肾脏有两个,都归属于水,中间藏着相火,是真阴之中的真阳,用来统摄下焦的真阴和真阳之气。强力行房会损伤阴液,久坐湿地会损伤阳气,肾脏的真阴和真阳都受到损伤,所以称为损伤肾脏。肾脏受伤,则在呼吸时不能纳气归根,所以气短。腰部是肾脏的外腑,肾脏受伤所以腰痛。骨骼是肾脏所主的,肾脏受伤所以脚骨疼痛。至于手足厥冷、下肢寒冷,也是肾中水火之气不能敷布到全身的缘故。
(6)风雨寒暑损伤形体:因为风雨寒暑原本是天地的气化现象,虽然不像疠疫那样的不正之气,但当它们来临时如果过于猛烈,就与人身的气化不相适宜。有时被时势所迫,或者自己不经意,被风雨寒暑之气侵袭,身体气弱,不能抵御,就会损伤形体。形体受伤则头发脱落,肌肤枯槁,这就像树木损伤了根本,从而危害到枝叶一样。
(7)过度恐惧且不节制损伤意志:因为志是由心所指向的,必须有中正之官(胆)来辅助它,这个志才能百折不回。中正之官就是胆,如果过度恐惧,则胆失去其职能,就不能辅助心来完成意志的形成,所以损伤志。志受伤,则心里有所图谋却畏首畏尾,所以神情恍惚、不快乐。
(1) Excessive eating damages the Spleen: This is because the Spleen governs the transportation and transformation of food and drink. If one eats too much, the Spleen's transformative power is insufficient to handle it, resulting in injury. The occurrence of belching is due to the Spleen's failure to transform and transport, causing Qi stagnation in the Middle Jiao (Middle Burner); this stagnant Qi desperately seeks release, hence belching occurs to vent it. The desire to lie down arises because the Spleen governs the four limbs; when the Spleen is injured, the limbs become sore and lazy, leading to a desire to rest. The yellowish complexion occurs because the Spleen corresponds to the Earth element. In cases of disease in any of the five Zang organs, the characteristic color associated with that organ's elemental nature appears. This is why inspection (Wang) is prioritized among the four diagnostic methods (Inspection, Auscultation-Olfaction, Inquiry, Palpation).
(2) Great anger causes Qi to rebel upward, damaging the Liver: The Liver corresponds to the Wood element. Wood branches grow upward while roots extend downward. Because Liver Qi can ascend, it assists the Heart Qi in dissemination and unblocking (the Liver system connects inferiorly to the Qi Sea and superiorly to the Heart, thereby guiding the Yuan Qi from the Qi Sea up to the Heart). Because Liver Qi can descend, it assists the Kidney Qi in diffusing and draining (the Kidney governs storage and retention; with the assisting diffusion of Liver Qi, urination and defecation remain smooth). During great anger, Qi rises without descending, and may even move horizontally. The Minister Fire (Minister Fire originates from the Gate of Vitality, resides in the Liver and Gallbladder, and circulates through the Three Jiao) stored within also becomes violently agitated, consuming Blood. Thus, the Liver is damaged and Blood becomes deficient. The Liver opens into the eyes; the eyes require Blood nourishment to see. When the Liver is injured and Blood is scarce, vision becomes dim.
(3) Physical cold exposure and drinking cold beverages damage the Lungs: The Lung is a delicate organ, susceptible to both cold and heat. The Lung governs the skin and hair. Physical cold causes the pores to close, preventing Lung Qi from disseminating and unblocking, leading to stagnation and subsequent heat generation; this constitutes Lung injury due to heat. Drinking cold beverages causes cold fluids to stagnate in the Stomach, transforming into fluid retention pathogen that rebels upward to the Lung, forming Xuan Yin (fluid retention between the chest and hypochondrium); this constitutes Lung injury due to cold. The Lung governs Qi and opens into the nose. When diseased, coughing occurs. Lung injury results in shortness of breath, cough, and nasal congestion sounds.
(4) Worry and overthinking damage the Heart: The Shen (Spirit/Mind) resides in the Brain, making the Brain the "Palace of Clarity" (as stated in *Nei Jing: Mai Yao Jing Wei Lun*), but its expression emanates from the Heart, making the Heart the "Monarch Official" (as stated in *Nei Jing: Ling Lan Mi Dian*). Shen belongs to Yang, and Yang is associated with Heat. Worry and overthinking cause the Shen to frequently manifest from the Heart, depleting Heart Blood due to heat, thereby damaging the Heart. When the Heart is injured, it cannot sufficiently transfuse blood to the Brain above or to the Liver below. The Spirit in the Brain loses its support, resulting in fright and forgetfulness. The Hun (Ethereal Soul) in the Liver loses its protection, resulting in insomnia at night. Furthermore, since Liver Blood is scant, dryness-heat inevitably generates, leading to irritability and anger.
(5) Forceful sexual activity and prolonged sitting on damp ground damage the Kidneys: There are two Kidneys, both belonging to Water, containing Minister Fire within. They represent the True Yang within True Yin and govern the True Yin and True Yang Qi of the Lower Jiao. Forceful sexual activity damages Yin, while prolonged sitting on damp ground damages Yang. Since both True Yin and True Yang of the Kidneys are injured, the Kidneys are damaged. Kidney injury impairs the ability to grasp Qi and return it to its root during respiration, causing shortness of breath. The waist is the external mansion of the Kidney; Kidney injury causes lower back pain. Bones are governed by the Kidney; Kidney injury causes pain in the foot bones. Cold extremities and lower limb coldness result from the inability of the Water and Fire Qi within the Kidneys to distribute throughout the body.
(6) Wind, rain, cold, and heat damage the Form: Wind, rain, cold, and heat are originally transformations of Heaven and Earth. Although they are not like the noxious Qi of epidemics, if they arrive too violently, they become incompatible with the human body's Qi transformations. Sometimes forced by circumstances or due to inadvertence, one is invaded by these atmospheric factors. If the body's Qi is weak and unable to defend against them, the Form is damaged. Damage to the Form leads to hair loss and withered skin and muscles, analogous to a tree whose root is damaged, thereby harming its branches and leaves.
(7) Excessive fear and lack of moderation damage Zhi (Willpower): Zhi is directed by the Heart and requires the assistance of the "Official of Justice" (the Gallbladder) to remain steadfast despite setbacks. The "Official of Justice" refers to the Gallbladder. If fear is excessive, the Gallbladder loses its function and cannot assist the Heart in forming Zhi, thus damaging Zhi. When Zhi is injured, the mind hesitates and fears taking action despite having intentions, resulting in mental confusion and unhappiness.