夫疮疡者。乃气血凝滞而生。岂有定位。内经云。营气不从。逆于肉理。乃生痈肿。
因营气凝滞于五脏六腑之内。则为五脏六腑内痈疽。如凝之于皮肤之外。脑背肢腹之间。
随处而名之。然又有不因凝滞而生者。所谓坠仆打跌金刀箭伤。汤火炙烙。及虫兽爪牙伤
害而成疮者。亦无定位。故以此鸣之于观者味之。
疮疡者。因气血不和。感受六淫七情而生。或浓味房
劳过度。致令肌体空虚。染不正之气。所有经云诸痈肿筋挛骨痛者。此寒气之肿。八风之
变也。当诊其脉浮紧洪缓。在何经部位。再辨之以色。是何经所苦。假令疮生在胁肋。即
知肝胆二经部位受邪所生。其人面色当青。其脉左关浮紧弦数。其症寒热呕逆。胁痛多怒
者。此正经自病也。故云能合色脉。可保万全。如得肺脉浮涩而短。面白色。在秋月是金
克木也。脉诀云。秋得肝而亦何宜。举此一隅而象脏何知也。医当精此。
夫人之体者五也。皮肉脉筋骨共则成形。五体悉具。外有部位。中有经络。内应脏腑
是也。假令疮在头顶者。即足太阳经也。面部阳明经。颈项肝经。肋胆经。手足心内应心
经。背为诸阳。腹为诸阴。臂膊即手之三阴三阳经所行。股胫即足之三阴三阳经所属。七
窍者目肝耳肾鼻肺舌心口脾。是五脏之窍也。如有疮疡。可以即知经络所属脏腑也。
疮疡,是由于气血凝滞而形成的,哪里有固定的部位呢?《内经》说:营气运行不畅,逆乱于肌肉纹理之间,就会发生痈肿。
如果营气凝滞于五脏六腑内部,就会形成五脏六腑的内痈疽;如果凝滞于皮肤之外、脑背四肢腹部之间,就根据发生的部位来命名。然而,又有并非因凝滞而生疮的情况,所谓跌打坠仆、金刃箭伤、汤火烫伤灼烙,以及虫兽爪牙伤害而成的疮疡,也没有固定的部位。因此将这些道理阐明,供观察者品味研究。
疮疡,是因为气血不和,感受六淫(风、寒、暑、湿、燥、火)和七情(喜、怒、忧、思、悲、恐、惊)邪气而产生。或者因为饮食厚味、房劳过度,导致肌体空虚,感染不正之气。所有经典所说“各种痈肿、筋脉拘挛、骨节疼痛”,这是寒气引起的肿胀,是八风变化的结果。应当诊察其脉象浮紧洪缓,确定在何经部位,再辨别面色,判断是何经受病。假如疮生在胁肋部,就知道是肝胆二经部位受邪所生。此人面色应当发青,左关脉浮紧弦数,症状表现为寒热往来、呕吐逆气、胁痛、易怒等,这是本经自病。所以说能结合面色与脉象诊断,可以保证万无一失。如果诊得肺脉浮涩而短,面色白,在秋季出现,这是金克木的相克关系。《脉诀》说:“秋季见到肝脉又适宜什么呢?”举此一角为例,即可推知脏腑病变。医生应当精通此道。
人的形体由皮、肉、脉、筋、骨五者构成,共同形成身体形态,五体具备。外部有体表部位,中间有经络分布,内部对应脏腑。假如疮生在头顶,属于足太阳膀胱经;面部属于阳明经;颈项属于肝经;胁肋属于胆经;手足心内应心经;背部为诸阳经汇聚之处,腹部为诸阴经汇聚之处;手臂膊肘属于手三阴三阳经循行部位;大腿小腿属于足三阴三阳经所属区域。七窍中,目通肝,耳通肾,鼻通肺,舌通心,口通脾,这是五脏开窍于七窍的道理。如果有疮疡发生,就可以据此知道其所属的经络和脏腑。
Chuangyang (sores and ulcers) arise from the stagnation of Qi and Blood; they do not have a fixed location. The *Neijing* states: "When Ying Qi (Nutritive Qi) does not flow smoothly and reverses into the muscle tissue, abscesses and swellings occur."
If Ying Qi stagnates within the Zang-Fu organs, it results in internal carbuncles and sores of the Zang-Fu organs. If it stagnates outside the skin, between the head, back, limbs, and abdomen, it is named according to its location. However, there are also sores not caused by stagnation, such as those resulting from falls, blows, cuts from metal weapons or arrows, scalds from boiling water, burns from fire, or injuries from insect and animal claws and teeth. These also have no fixed location. Therefore, these principles are elucidated for observers to study and understand.
Chuangyang arises from disharmony of Qi and Blood, exposure to the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Overthinking, Sorrow, Fear, Fright). It may also result from excessive consumption of rich foods or sexual indulgence, leading to emptiness in the body tissues and infection by pathogenic factors. As stated in classics: "Various abscesses, spasms of sinews, and bone pain" are swellings caused by Cold Qi and changes due to the Eight Winds. One should diagnose the pulse (floating, tight, surging, or slow), determine the meridian and location, and further distinguish the condition by facial color to identify which meridian is suffering. For example, if a sore appears on the hypochondrium, it indicates pathogenic invasion of the Liver and Gallbladder meridians. The patient's complexion would likely be greenish, the left Guan pulse floating, tight, wiry, and rapid, with symptoms of alternating chills and fever, vomiting, rib pain, and irritability. This is a disease originating from the proper meridian itself. Thus, it is said that combining color and pulse diagnosis ensures complete safety. If the Lung pulse is found to be floating, choppy, and short, accompanied by a white complexion in autumn, this represents Metal overcoming Wood. The *Mai Jue* asks: "What is appropriate about finding a Liver pulse in autumn?" Taking this one instance as an analogy, one can infer the state of the Zang organs. Physicians must master this knowledge.
The human body consists of five structures: skin, flesh, vessels, tendons, and bones, which together form the physical shape. Externally, there are surface regions; internally, there are meridians connecting to the Zang-Fu organs. For instance, sores on the crown of the head belong to the Foot-Taiyang Bladder Meridian; the face belongs to the Yangming Meridian; the neck and nape belong to the Liver Meridian; the hypochondrium belongs to the Gallbladder Meridian; the palms and soles correspond internally to the Heart Meridian; the back is the gathering place of all Yang meridians; the abdomen is the gathering place of all Yin meridians; the arms and elbows are traversed by the Hand-Yin and Hand-Yang meridians; the thighs and calves belong to the Foot-Yin and Foot-Yang meridians. The seven orifices connect to the Zang organs: eyes to the Liver, ears to the Kidneys, nose to the Lungs, tongue to the Heart, and mouth to the Spleen. These are the openings of the five Zang organs. When sores occur, one can thereby identify their associated meridians and Zang-Fu organs.