黄帝问于岐伯曰∶水谷入于口,输于肠胃,其液别为五。天寒衣薄,则为溺与气;天热衣浓,则为汗;
悲哀气并,则为泣;中热胃缓,则为唾∶邪气内逆,则气为之闭塞而不行,不行则为水胀。余知其然也,不
知其何由生?愿闻其道。岐伯曰∶水谷皆入于口,其味有五,各注其海,津液各走其道。故三焦出气,以
温肌肉,充皮肤,为其津;其流而不行者为液。天暑衣浓,则腠理开,故汗出。寒留于分肉之间,聚沫则
为痛。天寒则腠理闭,气湿不行,水下留于膀胱,则为溺与气。五脏六腑,心为之主,耳为之听,目为之
候,肺为之相,肝为之将,脾为之卫,肾为之主外。故五脏六腑之津液,尽上渗于目,心悲气并,则心系
急,心系急则肺举,肺举则液上溢。夫心系与肺,不能常举,乍上乍下,故咳而泣出矣。中热则胃中消谷,
消谷则虫上下作,肠胃充郭,故胃缓,胃缓则气逆,故唾出。五谷之津液,和合而为膏者,内渗入于骨空,
补益脑髓,而下流于阴股,阴阳不和,则使液溢而下流于阴,髓液皆减而下,下过度则虚,虚故腰背痛而胫
酸,阴阳气道不通,四海闭塞,三焦不泻,津液不化,水谷并行肠胃之中,别于回肠,留于下焦,不得渗膀
胱,则下焦胀,水溢则为水胀。此津液五别之逆顺也。
黄帝向岐伯问道:饮食水谷进入口中,输送到肠胃,其中的津液分为五种情况。天气寒冷且衣着单薄时,就转化为尿液和放屁;天气炎热且衣着厚重时,就转化为汗液;情绪悲哀导致气机郁结时,就转化为眼泪;体内有热且胃壁松弛时,就转化为唾液。如果邪气在体内逆乱,就会导致气机闭塞不通,气机不通畅就会形成水肿胀满。我知道这些现象是这样发生的,但不知道它们具体是如何产生的?希望听听其中的道理。
岐伯回答说:饮食水谷都从口进入,其味道分为五味,各自注入相应的“海”(指气血汇聚之处),津液各自沿着不同的路径运行。所以三焦发出气,用来温煦肌肉,充实皮肤,这称为“津”;其中流动缓慢、质地稠厚而不轻易外泄的称为“液”。天气暑热且衣着厚重时,腠理(皮肤毛孔)张开,所以出汗。寒气停留在分肉(肌肉间隙)之间,凝聚成沫,就会引起疼痛。天气寒冷时,腠理闭合,气与湿气不能正常输布,水液向下流注并停留在膀胱,就形成尿液和气体。
五脏六腑中,心是主宰,耳是听觉器官,目是观察外界反应的窗口,肺是辅佐之官,肝是将帅之官,脾是卫护之官,肾是主管体表的官职。因此,五脏六腑的津液,都向上渗透于眼睛。当人心悲气机郁结时,心系(连接心脏的组织)拘急,心系拘急则牵引肺脏上举,肺脏上举则津液向上溢出。因为心系和肺脏不能经常处于上举状态,而是忽上忽下,所以会出现咳嗽和流泪的现象。体内有热则胃中消化食物过快,消化过快则肠道内的虫类上下活动,导致肠胃充满扩张,所以胃壁松弛,胃壁松弛则气机上逆,所以吐出唾液。
五谷产生的津液,调和融合成为膏脂样的物质,向内渗透入骨空,补益脑髓,并向下流注到大腿内侧。如果阴阳不和,就会使津液外溢并向下流注于阴部,骨髓和津液都减少并下行,如果下行过度则导致虚损,虚损所以出现腰背痛和小腿酸软。如果阴阳之气运行通道不通畅,四海(指髓海、血海、气海、水谷之海)闭塞,三焦排泄功能失常,津液无法化生,水谷并行于肠胃之中,在回肠处被分别,停留于下焦,不能渗入膀胱,就会导致下焦胀满,水液泛滥则形成水肿胀满。这就是津液五种分流情况的顺逆规律。
Huangdi asked Qibo: When food and drink enter the mouth, they are transported to the stomach and intestines. Their fluids differentiate into five types. In cold weather with thin clothing, they become urine and flatus; in hot weather with thick clothing, they become sweat; when sorrow causes Qi stagnation, they become tears; when internal heat relaxes the stomach, they become saliva. If pathogenic factors reverse internally, Qi becomes obstructed and fails to circulate; failure of circulation leads to water distension (edema). I know that this is how it happens, but I do not know by what mechanism it arises. I wish to hear the principle.
Qibo replied: Food and drink all enter through the mouth. Their flavors belong to the Five Flavors, each pouring into its respective "Sea" (a term for areas where Qi and Blood gather), and the Jingye (body fluids) each follow their own pathways. Thus, the Sanjiao (Triple Burner) emits Qi to warm the muscles and fill the skin; this is called Jin (thin fluid). That which flows slowly and does not easily disperse is called Ye (thick fluid). When the weather is hot and clothing is thick, the Couli (pores) open, so sweat is excreted. When cold remains between the Fenrou (muscle intervals), condensed foam forms pain. When the weather is cold, the Couli close, Qi and dampness do not circulate, water descends and stays in the Bladder, thus becoming urine and flatus.
Among the Zang and Fu organs, the Heart is the ruler, the Ear is the listener, the Eye is the observer, the Lung is the minister, the Liver is the general, the Spleen is the guard, and the Kidney is the manager of the exterior. Therefore, the Jingye of the Zang and Fu organs all seep upward into the eyes. When the Heart is sorrowful and Qi merges, the Xinxi (heart connection/tissue) becomes tense. When the Xinxi is tense, the Lung rises. When the Lung rises, fluids overflow upward. Since the Xinxi and Lung cannot remain constantly elevated, but rise and fall alternately, coughing and tearing occur. Internal heat causes the stomach to digest grain rapidly; rapid digestion causes worms in the intestines to move up and down, filling and expanding the stomach and intestines, thus causing gastric relaxation. Gastric relaxation leads to rebellious Qi, thus causing spitting of saliva.
The Jingye from the Five Grains harmonize and combine to form a paste-like substance. This penetrates inward into the bone cavities to nourish the brain marrow, and flows downward into the inner thighs. If Yin and Yang are not in harmony, fluids overflow and flow downward into the yin region. Marrow and fluids both decrease and descend; if descent is excessive, deficiency results. Deficiency causes lower back pain and shin soreness. If the Qi channels of Yin and Yang are blocked, the Four Seas are closed, the Sanjiao fails to drain, and Jingye fails to transform, water and grain travel together within the stomach and intestines. They are separated at the Hui Chang (returning intestine), stay in the Lower Jiao, and fail to渗 (seep) into the Bladder. This causes distension in the Lower Jiao; overflowing water leads to water distension (edema). This describes the normal and abnormal patterns of the five differentiations of Jingye.