论曰五脏设位,肺独居上,故内经曰,天气通于肺,又曰肺主皮毛,为五脏之华盖,在
五脏为魄,魄则并精而出入者也,在五性为义,义则胜物而断制者也,开窍于鼻,故其液为
涕,涕者继泣而先泗也,在声为哭,故其志为忧,忧者阴肃而情惨也。其色白者,入金故也
,其味辛者,物成故也,以至在天为燥,在地为金,在音为商,在臭为腥,无非时数气类之
所系然也,尝以经脉表里论之,手太阴肺之经也,手阳明、大肠之经也,二者之经,为脏腑
表里之合,手太阴之经,起于中焦,下络大肠,环循胃口,上膈属肺,从肺系横出腋下,下
循内,行少阴心主之前,下肘中,循臂内上骨下廉,入寸口上循鱼际,出大指之端,其支
者,从腕后直出次指内廉出其端,阴阳适平,经络和顺,盈虚消息,莫睹偏胜,一失其平,
病所由生,过为有余,有余病也,不及为不足,不足亦病也,有余之病,是谓肺实;不足之
病,是谓肺虚,肺实之证,喘嗽上气肩背痛汗出,阴股膝胫皆痛是也,肺虚之证,肩背寒痛
,少气不能太息,胸满嗌干是也,病之所生,凡以其经络流行之处而见证焉,治法之施,实
者宜泻,虚者宜补,有余则损之,不足则益之,此其大略也,至于论脉,则手太阴脉之来,
浮涩而短为平脉,若见他脉,皆失其平,故肺与脾肾子母也,与心肝夫妇也,脉得洪大而缓
,则为母所克,得沉濡则滑,则为子所克,得弦而长,则为妇所克,得浮大而洪,则为夫所
克,若母克子者为虚邪,虽病易治,子克母者为实邪,虽病自愈,妇克夫者为微邪,虽病即
瘥,夫克妇者为贼邪,大逆不治,当察其虚实以补以泻,审治之法,此其大概也。
论述说:五脏各有其位置,唯独肺居于上部。所以《内经》说:“天气通于肺”,又说“肺主皮毛”,是五脏的华盖(覆盖保护五脏的脏器)。在五脏中对应“魄”,魄是伴随精气出入的东西;在五性中对应“义”,义是能战胜外物并加以决断的品质;开窍于鼻,所以它的体液是涕,涕是继眼泪之后先流出的液体;在声音中对应哭,所以它的情志是忧,忧是一种阴气肃杀且情感凄惨的状态。它的颜色是白色,是因为归属于金;它的味道是辛味,是因为万物成熟的结果;至于在天为燥,在地为金,在五音为商,在五臭为腥,无不是与时令、数理、气类相关联的。
我曾经从经脉表里关系来论述:手太阴肺经和手阳明大肠经,这两条经脉构成了脏腑表里的配合。手太阴肺经,起始于中焦,向下联络大肠,环绕胃的上口,穿过膈肌,属于肺脏;从肺系(气管、喉咙等与肺相连的组织)横向出于腋下,向下沿上臂内侧前行,走在手少阴心经和手厥阴心包经的前面,下行至肘中,沿前臂内侧桡骨下缘,进入寸口,向上行至鱼际,出大拇指尖端;它的支脉,从腕后直出食指内侧边缘,出于指尖。阴阳平衡,经络和顺,气血盈虚适度,看不到偏盛的情况;一旦失去平衡,疾病就由此产生。太过就是有余,有余即为病;不及就是不足,不足也是病。有余的病,称为肺实;不足的病,称为肺虚。肺实的证候,表现为气喘咳嗽、气逆、肩背痛、出汗,大腿内侧、膝盖、小腿胫骨都痛;肺虚的证候,表现为肩背寒冷疼痛、气短不能深长呼吸、胸闷咽喉干燥。疾病的产生,凡是根据经络流行的部位而出现相应的症状。治疗方法的施行,实证适宜用泻法,虚证适宜用补法,有余则损害它(指攻邪),不足则补充它,这是大概的原则。
至于论述脉象,手太阴肺经的脉象,浮涩而短是平脉(正常脉象),如果见到其他脉象,都是失去了平衡。所以肺与脾肾是子母关系,与心肝是夫妇关系。脉象若见洪大而缓,则是被母脏所克;若见沉濡而滑,则是被子脏所克;若见弦而长,则是被妻脏所克;若见浮大而洪,则是被夫脏所克。如果母脏克制子脏,称为虚邪,虽然生病但容易治愈;子脏克制母脏,称为实邪,虽然生病但能自愈;妻脏克制夫脏,称为微邪,虽然生病很快就能痊愈;夫脏克制妻脏,称为贼邪,大逆不道难以治愈。应当察辨虚实以决定补泻,审察治疗的法则,这是大概的情况。
It is stated that the five Zang organs have their respective positions, with the Lung alone residing in the upper region. Therefore, the *Neijing* (Classic of Internal Medicine) states: "The Qi of Heaven communicates with the Lung," and further says: "The Lung governs the skin and hair." It serves as the Huagai (Canopy of the Five Zang Organs). Among the five Zang organs, it corresponds to Po (Corporeal Soul), which enters and exits together with Jing (Essence). In the five moral dispositions, it corresponds to Yi (Righteousness), which overcomes external things and makes decisions. Its orifice opens into the nose; thus, its fluid is Ti (Nasal Discharge), which flows out before saliva follows tears. In vocal sounds, it corresponds to Ku (Crying); thus, its emotion is You (Sorrow/Grief), which is characterized by Yin austerity and a desolate sentiment. Its color is white because it belongs to Metal; its taste is Xin (Pungent) because it signifies the completion of things. As for its correspondence to Dryness in Heaven, Metal in Earth, Shang (Metal Note) in musical tones, and Xing (Fishy Odor) in smells, all are related to seasons, numbers, Qi, and categories.
I shall discuss it from the perspective of meridians and interior-exterior relationships: The Hand-Taiyin Lung Meridian and the Hand-Yangming Large Intestine Meridian constitute the interior-exterior pairing of these Zang-Fu organs. The Hand-Taiyin Meridian originates in the Middle Jiao (Middle Burner), descends to connect with the Large Intestine, circles around the stomach opening, passes through the diaphragm, and attaches to the Lung. From the Fei Xi (Lung System, including trachea and larynx), it emerges horizontally under the axilla, descends along the medial aspect of the arm, running anterior to the Hand-Shaoyin Heart Meridian and Hand-Jueyin Pericardium Meridian, reaches the elbow center, follows the medial forearm along the lower border of the radius, enters the Cun Kou (Radial Pulse site), ascends to Yu Ji (LU10), and exits at the tip of the thumb. Its branch diverges from behind the wrist, goes straight to the medial side of the index finger, and exits at its tip. When Yin and Yang are balanced, meridians are harmonious, and Qi and Blood fluctuate moderately without excess or deficiency, no bias is observed. Once balance is lost, diseases arise. Excess constitutes "Youyu" (Surplus), which is pathological; deficiency constitutes "Bují" (Insufficiency), which is also pathological. Pathologies of surplus are termed Fei Shi (Lung Excess); pathologies of insufficiency are termed Fei Xu (Lung Deficiency). Symptoms of Lung Excess include panting, cough, rebellious Qi, shoulder and back pain, sweating, and pain in the medial thigh, knee, and tibial region. Symptoms of Lung Deficiency include cold pain in the shoulder and back, shortness of breath with inability to sigh deeply, chest fullness, and dry throat. Diseases manifest according to the locations where meridian Qi circulates. Therapeutic principles dictate that Excess patterns should be treated with Draining methods, while Deficiency patterns should be treated with Tonifying methods; Surplus should be reduced, and Insufficiency should be supplemented. This is the general principle.
Regarding pulse diagnosis, the normal pulse of the Hand-Taiyin Meridian is Floating, Choppy, and Short. If other pulses appear, balance is lost. Thus, the Lung has a Mother-Child relationship with the Spleen and Kidney, and a Husband-Wife relationship with the Heart and Liver. If the pulse is Hong (Surging) and large yet Huan (Moderate), it indicates being overcome by the Mother organ. If it is Chen (Deep) and Ru (Soft) yet Hua (Slippery), it indicates being overcome by the Child organ. If it is Xian (Wiry) and Chang (Long), it indicates being overcome by the Wife organ. If it is Fu (Floating) and Da (Large) yet Hong (Surging), it indicates being overcome by the Husband organ. If the Mother overcomes the Child, it is called Xu Xie (Deficient Evil); although diseased, it is easy to treat. If the Child overcomes the Mother, it is called Shi Xie (Excess Evil); although diseased, it will heal spontaneously. If the Wife overcomes the Husband, it is called Wei Xie (Minor Evil); although diseased, it will recover quickly. If the Husband overcomes the Wife, it is called Zei Xie (Robber Evil); this is a great reversal and is difficult to cure. One must examine Deficiency and Excess to apply Tonification or Draining. Examining treatment methods represents the general overview.