上古天真论曰∶女子之数七,丈夫之数八。女子七七四十九,任脉虚,冲脉衰,天癸竭,
地道不通。丈夫八八六十四,五脏皆衰,筋骨解堕,精气尽,脉弱形枯。女子过六十之期,丈
夫逾七十之年,越天常数。上寿
之人,若衣食丰备,子孙勤养,承顺慈亲,恭行孝道,能调其饮食,适其寒温,上合神灵,
下契人理。此顺天之道也。高年之人形羸气弱,理自当然。其丈夫、女子年逾七十,面色红润,
形气康强,饮食不退,尚多秘热者,此常理哉?且年老之人,痿瘁为常,今反此者,非真阳血
海气壮也,但诊左右手脉,须大紧数,此老人延永之兆也。老人真气已衰,此得虚阳气盛充于
肌体,则两手脉大,饮食倍进,双脸常红,精神强健,此皆虚阳气所助也。虽时有烦躁膈热,
大腑秘结,但随时以常平汤药微微消解,三五日间自然平复。常得虚阳气存,自然饮食得进,
此天假其寿也,切不得为有小热频用转泻通利苦冷之药疏解。若虚阳气退,复归真体,则形气
虺羸,脏腑衰弱,多生冷疾,无由补复。若是从来无虚阳之气,一向惫乏之人,全在斟酌汤
剂,常加温补调停, 粥以为养治,此养老之先也。
凡人衰晚之年,心力倦怠,精神耗短,百事懒于施为。盖气血筋力之使然也,全藉子孙
孝养,竭力将护,以免非横之虞。凡行住坐卧,宴处起居,皆须巧立制度,以助娱乐。栖息之
室必常雅洁,夏则虚敞,冬则温密。其寝寐床榻不须高广,比常之制三分减一,低则易于升
降,狭则不容漫风。 褥浓藉务在软平,三面设屏以防风冷。其枕宜用夹熟色帛为之,实以
菊花,制在低长,低则寝无隙风,长则转不落枕。其所在坐之椅,宜作矮卑床样,坐可垂
足履地,易于兴居。左右置栏,面前设几。缘老人多困,坐则成眠,有所栏围,免闪侧之伤。
其衣服制度不须宽长,长则多有蹴绊,宽则衣不着身。缘老人骨肉疏冷,风寒易中,若窄衣
贴身,暖气着体,自然气血流利,四肢和畅。虽遇盛夏亦不可令袒露,其颈后连项,常用紫软
夹帛,自颈后巾帻垂下着肉,入衣领中至背脊间,以护腠理。老年人肌瘦,腠理开疏,若风
伤腠理,便成大患,深宜慎之。
《上古天真论》中说:女子的生理节律以七为基数,男子的生理节律以八为基数。女子到了四十九岁(七七),任脉气血虚弱,冲脉衰退,天癸(促进生殖机能成熟的物质)枯竭,月经停止。男子到了六十四岁(八八),五脏功能衰退,筋骨松弛无力,精气耗尽,脉象微弱,形体枯槁。
女子过了六十岁,男子过了七十岁,就超越了正常的寿数极限。那些高寿的人,如果衣食充足完备,子孙勤劳奉养,顺承并孝顺父母,能够调节饮食,适应寒温变化,上合天道神灵,下契人间伦理,这就是顺应自然规律。年老之人形体消瘦、气息虚弱,本是理所当然的事。那些男子和女子年过七十,面色红润,形体气力康强,饮食不减,且常有便秘内热的情况,这难道是正常现象吗?况且年老之人,身体衰弱是常态,现在反而出现这种情况,并不是因为真阳、血海、真气真正强壮,而是诊察左右手脉象,必须是大而紧数的脉象,这是老人延长寿命的征兆。老人的真气已经衰退,这是因为虚阳之气旺盛充盛于肌体,所以两手脉象大,饮食加倍增加,双颊常红,精神强健,这些都是虚阳之气助长的结果。虽然偶尔有烦躁、胸膈发热、大便干结的情况,但只需随时用常平汤药微微消解,三五天后自然平复。只要虚阳之气尚存,自然饮食能进,这是上天假借其延长寿命,切记不要因为有一点小热就频繁使用泻下通利、苦寒的药物来疏解。如果虚阳之气消退,回归到真实的本体状态,那么形体气力就会更加羸弱,脏腑衰弱,多生冷病,无法再补益恢复。如果是从来就没有虚阳之气,一直疲惫乏力的人,完全在于斟酌汤剂,经常加入温补调停的药物,以粥作为调养治疗的基础,这是养老的首要原则。
凡是人到了衰老晚年,心力倦怠,精神短少,百事懒得去做。这是气血筋力使然,全依赖子孙孝顺奉养,竭力将护,以避免意外横祸的忧患。凡是行走、站立、坐着、躺着,日常起居生活,都必须巧妙制定制度,以帮助娱乐。休息的房间必须保持高雅洁净,夏天要通风敞亮,冬天要温暖密闭。睡觉的床榻不需要高大宽敞,比常规尺寸减少三分之一,低则容易上下,窄则不会让风随意吹入。褥垫被褥务必柔软平整,三面设置屏风以防风冷。枕头宜用夹层的熟色丝绸制成,里面填充菊花,制作成低长形状,低则睡觉时没有缝隙进风,长则翻身时头不会滑落。坐的椅子,宜做成矮床样式,坐着可以垂足踩地,便于起坐。左右设置栏杆,面前设几案。因为老人多困倦,坐着容易睡着,有栏杆围护,避免闪跌侧翻受伤。衣服制度不需要宽大过长,长则多有绊倒之患,宽则衣服不贴身。因为老人骨肉疏松怕冷,风寒容易侵袭,如果窄衣贴身,暖气附着身体,自然气血流利,四肢和畅。即使遇到盛夏也不可以让身体袒露,颈后连项部,常用紫色柔软的夹层丝绸,从颈后巾帻垂下贴着肉,进入衣领中至背脊间,以保护腠理(皮肤纹理及汗孔)。老年人肌肉消瘦,腠理开疏,如果风邪损伤腠理,就会酿成大患,深宜谨慎对待。
The *Lingshu: Shanggu Tianzhen Lun* (Treatise on the Natural Truth of Antiquity) states: The physiological cycle for women is based on the number seven, and for men, on the number eight. When a woman reaches forty-nine years old (7 x 7), the Ren Mai (Conception Vessel) becomes deficient, the Chong Mai (Penetrating Vessel) declines, Tian Gui (the substance promoting reproductive maturity) is exhausted, and menstruation ceases. When a man reaches sixty-four years old (8 x 8), the Zang-Fu organs (internal organs) all decline, sinews and bones become loose and weak, Jing Qi (Essence and Qi) is depleted, the pulse is weak, and the body form withers.
When women pass the age of sixty, or men exceed seventy, they have surpassed their natural lifespan limits. Those who reach high longevity, provided their food and clothing are abundant and complete, their descendants diligently support them, and they receive filial piety and obedience from their children; if they can regulate their diet, adapt to cold and warmth, harmonize with the heavens and spirits, and conform to human ethics, this is following the Way of Heaven. It is naturally expected that elderly people will have emaciated forms and weak Qi. Is it normal for men and women over seventy to have ruddy complexions, strong physical constitution and Qi, unimpaired appetite, and yet suffer from constipation and internal heat? Moreover, physical frailty is the norm for the elderly. If one presents contrary to this, it is not because of robust True Yang (True Vital Fire), Blood Sea (Liver storing blood), or True Qi. Instead, upon palpating the pulses at both left and right positions, they must be large, tight, and rapid; this is a sign of extended life in the elderly. Since the True Qi of the elderly has already declined, this condition arises from Deficient Yang Qi (floating false fire) being excessively abundant in the body tissues, resulting in large pulses in both hands, doubled food intake, persistently red cheeks, and vigorous spirit—all aided by Deficient Yang Qi. Although there may occasionally be irritability, chest diaphragm heat, and dry stool, one should simply use mild resolving decoctions like Changping Tang (Constant Peace Decoction) as needed; within three to five days, the condition will naturally resolve. As long as Deficient Yang Qi remains, food intake continues naturally, which is Heaven granting extended life. One must strictly avoid frequently using bitter, cold purgative or draining medications to resolve minor heat symptoms. If Deficient Yang Qi recedes and returns to the True Body, the form and Qi will become extremely emaciated, Zang-Fu organs will weaken, cold diseases will multiply, and recovery through tonification will be impossible. For those who never had Deficient Yang Qi and have always been exhausted, treatment relies entirely on carefully斟酌 (deliberating) decoctions, frequently adding warming and tonifying agents, using congee as the foundation for nourishment and treatment; this is the primary principle of elder care.
In the late years of aging, mental energy is fatigued, spirit is diminished, and one is reluctant to engage in any affairs. This is caused by the state of Qi, Blood, sinews, and strength. It fully depends on the filial support of descendants, who must exert themselves in nursing and protection to avoid unexpected mishaps. Whether walking, standing, sitting, or lying down, daily living arrangements must be cleverly designed to aid comfort and entertainment. The resting room must always be elegant and clean; in summer, it should be airy and open, while in winter, warm and enclosed. The sleeping bed need not be high or wide; it should be reduced by one-third compared to standard sizes. A lower height facilitates getting up and down, and a narrower width prevents drafts from blowing freely. Mattresses and bedding must be soft and flat, with screens set up on three sides to prevent wind and cold. Pillows should be made of double-layered dyed silk, stuffed with chrysanthemum flowers, and crafted to be low and long. A low profile prevents wind entering gaps during sleep, while a long shape prevents the head from slipping off when turning. Sitting chairs should be designed like low beds, allowing the feet to touch the ground when seated, facilitating ease of rising and sitting. Railings should be placed on both sides, and a table in front. Since the elderly often feel drowsy and may fall asleep while sitting, railings prevent injuries from falling sideways. Clothing should not be overly wide or long; excessive length causes tripping hazards, and excessive width fails to keep the body warm. Because elderly people have loose bones and muscles and fear cold, wind and cold easily invade. Tight-fitting clothes retain body warmth, ensuring smooth flow of Qi and Blood and harmony in the four limbs. Even in midsummer, one should not expose the body. The area behind the neck and extending to the nape should be covered with soft purple double-layered silk, hanging from a head covering behind the neck, touching the skin, and tucked into the collar down to the spine, to protect the Cou Li (skin texture and pores). Elderly people have thin muscles and open Cou Li; if wind pathogen damages the Cou Li, it can lead to serious complications, so great caution is required.