丹溪曰∶西北之地多风寒,故患外感者居多;东南之地本卑湿,故患湿热者众。盖北方高阜,
天不足西北而多风;南方卑下,地不满东南而多湿。所以方土之候,各有不齐,而所生之病,多
随土着。医者必须因时处治,随地判宜。治北人之病,宜以攻伐外邪为多;治南方之疾,宜以保
养内气为本。何则?北方风气浑浓,禀赋雄壮,兼之饮食倍常,居室俭素,殊少戕贼元气之患,
一有疾病,辄以疏利之,其病如脱而快意通神矣。若夫东南之人,体质柔脆,腠理不密,而饮食
色欲之过侈,与西北之人迥异,概以峻剂攻之,不几操刃而杀人乎?虽然,北方禀气固浓,安能
人人皆实?南方禀气虽薄,安得人人皆虚?当观其人,因其证而施药之,斯无一偏之弊矣。
皇甫谧《黄帝世纪》曰∶黄帝命雷公岐伯教别九针,着《内外经》、《素问》,书咸出焉。
《黄帝内传》曰∶帝升为天子,《针经》、《脉诀》无不备也,故《金匮》、《甲乙》之书皆祖《内经》。
黄帝御极,坐明堂之上,临观八极,考建五常,以谓人生负阴而抱阳,食味而被色,寒暑相
荡,喜怒交伤,乃与岐伯上穷天纪,下极地理,远取诸物,近取诸身,更相问难。雷公之伦,授
业传之,而《内经》作矣。
苍周之兴,秦和述六气之论,具于左史。厥后越人得其一二,演述《难经》,西汉仓公传其旧业,
东汉仲景撰其遗论,晋皇甫谧刺为《甲乙》,隋杨上善纂为《太素》,唐王冰笃好之,大为次注。
(林亿《素问序》)
《内经素问》,世称黄帝岐伯问答之书,及观其旨意,殆非一时之言,其所撰述,亦非一人
之手。刘向指为诸韩公子所着,程子谓出于战国之末。而其大略,正如《礼记》之萃于汉儒,而
与孔子子思之言并传也。盖灵兰秘典、五常政、六元正纪等篇,无非阐明阴阳五行生制之理,配
象合德,实切于人身。其诸色脉、病名、针刺、治要,皆推是理以广之。皇甫谧之《甲乙》,杨
上善之《太素》,亦皆本之于此。按西汉《艺文志》有《内经》十八卷之目,至隋《经籍志》始
有《素问》之名,而不指为《内经》。唐王冰乃以《灵枢》九卷率合《汉志》之数,而为之注释,
后以《阴阳大论》托其为师张公所藏,以补其亡逸,其用心亦勤矣。惜乎朱墨混淆,玉石相乱,
训诂失之于迂疏,援引或至于未切。至宋林亿、高若讷等正其误文而精其缺义,颇于冰为有功。(《医史》)
朱丹溪说:西北地区的土地多风寒之气,所以患外感病的人很多;东南地区的土地本来低洼潮湿,所以患湿热病的人众多。大概北方地势高亢,天阳之气在西北方有所不足而多风;南方地势低洼,地阴之气在东南方有所不满而多湿。因此各地的气候环境,各有不同,所发生的疾病,也多随着当地的风土习惯而定。医生必须根据时节来制定治疗方案,依据地域来判断适宜的方法。治疗北方人的疾病,宜以攻伐外邪为主;治疗南方人的疾病,宜以保养内气为根本。为什么呢?北方风气浓厚,人们先天禀赋雄壮,加上饮食量超过常人,居室生活俭朴节约,很少有过度消耗元气的祸患,一旦有了疾病,就用疏通利导的方法治疗,病情就像摆脱束缚一样迅速好转,让人畅快通神。至于东南地区的人,体质柔弱脆嫩,腠理(皮肤纹理及汗孔)不致密,而且饮食和色欲过度奢侈,这与西北人截然不同,如果一概用猛烈的药剂去攻伐,岂不是拿着刀杀人吗?虽然如此,北方人禀受的气血固然浓厚,难道人人都身体结实吗?南方人禀受的气血虽然薄弱,难道人人都身体虚弱吗?应当观察具体的人,根据其证候来施用药物,这样就没有偏颇的弊病了。
皇甫谧在《黄帝世纪》中说:黄帝命令雷公、岐伯教导辨别九针,撰写了《内外经》、《素问》,书籍都出自于此。
《黄帝内传》说:黄帝升格为天子后,《针经》、《脉诀》无不具备,所以《金匮要略》、《针灸甲乙经》等书都以《内经》为祖源。
黄帝登上帝位,坐在明堂之上,俯瞰八方极远之地,考察建立五常(仁义礼智信),认为人生背负阴而怀抱阳,品尝五味而接触美色,寒暑相互激荡,喜怒交替伤人,于是与岐伯向上穷尽天道的纪纲,向下穷尽地理的变化,向远处取法万物,向近处取法自身,互相问答疑难。雷公这一类人,接受学业并传承下去,于是《内经》就产生了。
苍周兴起时,秦越人(扁鹊)阐述了六气(风、寒、暑、湿、燥、火)的理论,详细记载在左史官的记录中。此后秦越人得到其中一二要点,演绎阐述成《难经》,西汉的仓公(淳于意)传承了他的旧业,东汉的张仲景撰写了他遗留的论述,晋代的皇甫谧删节编纂为《针灸甲乙经》,隋代的杨上善汇编为《黄帝内经太素》,唐代的王冰非常喜爱它,大大地进行了编次和注释。(林亿《素问序》)
《内经素问》,世人称为黄帝与岐伯问答的书,但观看它的旨意,大概不是某一时刻的话,它所撰述,也不是一个人的手笔。刘向指出是各个韩国的公子所著,程子说是出于战国末期。而它的大致情况,正如《礼记》汇聚于汉代儒生之手,而与孔子、子思的话一同流传一样。大概像《灵兰秘典论》、《五常政大论》、《六元正纪大论》等篇章,无非是阐明阴阳五行生克制化的道理,配合象数符合德行,确实切近人身。其中的各种望色、脉诊、病名、针刺、治疗要点,都是推演这个道理来扩充它。皇甫谧的《针灸甲乙经》,杨上善的《黄帝内经太素》,也都是基于此。按照西汉《艺文志》有《内经》十八卷的名目,到了隋代《经籍志》才有《素问》的名称,而不指称为《内经》。唐代王冰于是将《灵枢》九卷合并计算《汉书·艺文志》的数量,并为它作注释,后来把《阴阳大论》托名为他的老师张公所收藏,用来补充其亡佚的内容,他的用心也算勤勉了。可惜墨迹朱批混淆,玉石混杂,训诂解释失之于迂腐疏阔,引用或许未能贴切。到了宋代林亿、高若讷等人纠正其中的误文并精审缺失的含义,对王冰来说颇有功劳。(《医史》)
Zhu Danxi said: In the northwest regions, the climate is predominantly cold and windy; therefore, exogenous diseases (diseases caused by external pathogenic factors) are common. In the southeast regions, the land is naturally low and damp; consequently, damp-heat (a pathological condition characterized by dampness and heat pathogens) disorders are prevalent. Generally speaking, the north features high terrain where heavenly yang energy is deficient in the northwest, leading to much wind; the south features low terrain where earthly yin energy is insufficient in the southeast, leading to much dampness. Thus, climatic conditions vary by locality, and diseases arising there tend to follow local environmental habits. Physicians must formulate treatments according to the season and judge appropriateness based on the region. When treating patients from the north, it is appropriate to focus more on attacking and dispelling exogenous pathogens; when treating illnesses in the south, it is appropriate to prioritize preserving and nourishing internal qi (vital energy). Why? The northern atmosphere is dense, and people possess robust constitutions due to their innate endowment. Coupled with diets exceeding normal quantities and frugal living conditions, they rarely suffer from damage to their yuan qi (original vital energy). Once illness occurs, using methods of unblocking and purging often leads to rapid recovery, bringing relief and mental clarity. Conversely, people from the southeast have fragile constitutions and loose cou li (skin texture and interstices/pores). Their indulgence in diet and sexual desire differs vastly from those in the northwest. If one were to uniformly apply harsh or drastic formulas to attack pathogens, would it not be akin to killing someone with a blade? Nevertheless, although northerners generally possess strong innate qi, can everyone be considered solid/excess? Although southerners generally possess thin/weak innate qi, can everyone be considered deficient? One must observe the individual patient and administer medicine according to their specific syndrome differentiation (pattern identification), thereby avoiding the弊端 of bias.
Huangfu Mi, in *The Century of the Yellow Emperor*, stated: The Yellow Emperor ordered Leigong and Qibo to teach the distinction of the Nine Needles, composing the *Nei Wai Jing* (Classic of Internal and External Medicine) and *Su Wen* (Basic Questions); these texts originated from this instruction.
*The Inner Biography of the Yellow Emperor* states: After ascending the throne as Son of Heaven, the *Jing Jing* (Classic of Acupuncture) and *Mai Jue* (Pulse Secrets) were all complete. Therefore, works such as *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) and *Zhen Jiu Jia Yi Jing* (Acupuncture and Moxibustion: A Systematic Classic) trace their ancestry back to the *Nei Jing* (Inner Canon).
When the Yellow Emperor assumed imperial power, he sat in the Bright Hall, observing the eight extreme directions, investigating and establishing the Five Constants (benevolence, righteousness, propriety, wisdom, and trustworthiness). He reasoned that human life carries yin and embraces yang, tastes flavors, and encounters beauty, while cold and heat interact and anger and joy alternately cause harm. Thus, he engaged in mutual questioning and difficulty resolution with Qibo, exploring heaven's laws to the utmost extent above, earth's geography to the utmost extent below, taking examples from distant objects, and taking references from the body itself. Disciples like Leigong received this teaching and transmitted it, resulting in the creation of the *Nei Jing*.
During the rise of the Zhou dynasty, Qin Yueren (Bian Que) expounded on the theory of the Six Qi (wind, cold, summer heat, dampness, dryness, fire), which was recorded in detail by left historians. Later, Yueren grasped some of its principles and elaborated upon them in the *Nan Jing* (Classic of Difficult Issues). Cang Gong (Chunyu Yi) of the Western Han inherited this tradition. Zhang Zhongjing of the Eastern Han compiled his remaining theories into writings. Huangfu Mi of the Jin Dynasty edited these into the *Zhen Jiu Jia Yi Jing*. Yang Shangshan of the Sui Dynasty compiled them into the *Huang Di Nei Jing Tai Su*. Wang Bing of the Tang Dynasty held a deep affection for these texts and extensively revised and annotated them. (From Lin Yi's Preface to *Su Wen*)
The *Su Wen* section of the *Nei Jing* is widely known as a book of dialogues between the Yellow Emperor and Qibo. However, examining its intent, it seems unlikely that it consists of words spoken at a single time, nor was it written by a single hand. Liu Xiang pointed out that it was authored by princes of various states of Han. Cheng Zi (Cheng Hao or Cheng Yi) suggested it originated from the late Warring States period. Its general nature is similar to how the *Li Ji* (Book of Rites) was compiled by Han Confucians, yet transmitted alongside the words of Confucius and Zisi. Chapters such as *Ling Lan Mi Dian Lun*, *Wu Chang Zheng Da Lun*, and *Liu Yuan Zheng Ji Da Lun* essentially elucidate the principles of generation and restriction among Yin-Yang and the Five Elements, aligning images with virtues, and are indeed pertinent to the human body. Various aspects regarding complexion observation, pulse diagnosis, disease names, acupuncture, and treatment essentials all expand upon these principles. Huangfu Mi’s *Zhen Jiu Jia Yi Jing* and Yang Shangshan’s *Tai Su* are also based on this foundation. According to the *Yi Wen Zhi* (Treatise on Literature) of the Western Han, there was a title for *Nei Jing* comprising eighteen volumes. It was not until the *Jing Ji Zhi* (Treatise on Books and Records) of the Sui Dynasty that the name *Su Wen* appeared, without being explicitly identified as the *Nei Jing*. Wang Bing of the Tang Dynasty then combined the nine volumes of *Ling Shu* (Spiritual Pivot) to match the count in the *Han Zhi*, providing annotations for them. Later, he attributed the *Yin Yang Da Lun* to his teacher Master Zhang’s collection to supplement lost content, showing considerable diligence. Unfortunately, red and black ink marks became confused, jade and stones were mixed, glosses were pedantic and loose, and citations were sometimes imprecise. It was not until the Song Dynasty, when Lin Yi, Gao Ruone, and others corrected erroneous texts and refined missing meanings, that merit was truly achieved relative to Wang Bing. (From *History of Medicine*)