用上述的涵义来比喻人，有的人经常毛病不断，今天这不舒服，明天那不舒服，可是这样的人却不容易害大病，而且往往都比较长寿。而有的人平常一点毛病也没有，可一害起病来就不是小病，甚至是要命的病。为什么呢？我想就与这个识别系统的灵敏度有关。不是没有疾病，而是你没有识别出来，反映出来。所以，我们对平素很健康的人，就应该懂得区别他的真假。真健康当然好，要是假健康，那就很危险。因为你的识别系统出了问题，识别系统麻痹了，碰上昏君了，潜在的隐患没有办法揭露，你说危不危险呢？从上面的讨论，我想大家对《素问·灵兰秘典论》的重要性会有更充分的认识。大家现在接触得更多的是社会，《素问·灵兰秘典论》实际上就是用社会观去看待人体。人就是在君主之官的号令下，分工合作，各司其职。这一点很重要。我们讲五行也好，讲藏象也好，都是讲这个各司其职。少阴的藏义，我们重点谈了心肾。可以说，心肾这对关系在人身再怎么强调也不过分。肾心是什么关系呢？用两个字来形容，是水火，是阴阳，是男女，也是精神。我们天天都在用精神这个词，可精神是什么呢？实际上就是心肾。《素问·六节藏象论》云：“心者，生之本，神之变也……肾者，主蛰，封藏之本，精之处也。”一个精之处，一个是神之变。一个主藏精，一个主藏神。这就是精神。所以，从一个人的精神状态，就完全可以看出心肾的状态。当然也就可以看出水火、阴阳的状态。心属火、属离，肾属水、属坎。正常情况下，水火要既济，心肾要相交。心火下降的目的是温暖肾水，也就是温暖坎中之阳。肾水上升的目的是济养心阴，也就是离中之阴。坎离相交，各得其所。
4.少阴运气义
下面讨论第四个问题，就是少阴的运气问题。少阴在运气方面属什么呢？属君火。君火以明，相火以位。君相的明和位在少阳篇中已经讨论过，这里不再重复。刚才谈心的时候，曾多次提到《素问·灵兰秘典论》，论云：主明则下安，主不明则十二官皆危。所以，少阴很大程度上是在讲主，由于主不明，而致十二官皆危。为什么少阴这一篇有很多的危证出现，可见这一篇主要就是探讨这个“主不明”的问题。那么，君主为什么能明呢？它凭什么明？我们在讨论火的自然性用时曾经谈到，火的一个很重要的性用就是明。能明物者，无非阳火。因此，君主要明，关键就是要阳火充足。为什么心属火而又主神明？为什么“君火以明”？很显然，就是要强调火与明的关系。所以，只有阳火用事，君主才能神明。现在为什么主不明呢？很显然就是阳火虚衰了。我们看少阴篇中的危证和死证，也就知道它无一不是由阳火虚衰引起的。少阴病总体上可分为寒化证和热化证。热化证里，危证死证都没有。危证和死证全都集中在寒化证里。寒化证也就是阳火虚衰之证。从整个《伤寒论》来看，亦是如此。因热化，也就是因阳火过盛而危而死者，所占甚少，仅阳明篇中有数条。而绝大多数之危证死证存于少阴、厥阴篇中，皆由阳火虚衰所致。由此便知，不管西医是什么疾病，心血管疾病也好，肿瘤也好，肺心病也好，最后导致险情出现，甚至死亡的，其主要原因大都属阳火不及。所以，从宏观上看，不但是东汉末的建安年间，其死亡者伤寒十居其七，就是现在的死亡者中，伤寒亦占大多数，阳火虚衰亦占大多数。为什么呢？因为阳火虚衰，则君主不明，主不明，则十二官皆危矣。回过头，我们再看十九病机。十九病机中，火热病机占九条，而风、寒、湿病机仅各占一条。什么道理呢？就是强调火热与诸多疾病的关系。而这个关系并不是说火热一定亢盛。有火热会产生这些疾病，无火热也会产生这些疾病；火热盛会产生这些疾病，火热虚也会产生这些疾病。有关这一点，岐伯在紧接十九病后的一段文字中说得十分清楚。而后世的许多医家，仅看到病机十九条，却忽略了这段将病机落向实处的至关重要的文字。故尔认为天下疾病火热盛者多，危证死证亦多属阳火亢盛。只知阳火亢盛，热盛能致神昏，却全然不知阳火虚衰则君主不明，主不明则十二官皆危，更何况神昏之证。所以到了后世，对于危证险证医家但知以三宝来救逆，却不知四逆才是救逆的正法。宋·窦材撰有一本《扁鹊心书》，这本书虽然多谈灸刺，但是它的一个主干思想却非常值得我们借鉴。窦氏认为，人身的疾病阳证比较容易解决，为什么呢？因为阳证易于发觉。阳火太过就像纸包火一样，包得住吗？包不住的。所以阳证它潜伏不了，能够得到及时的治疗。而阴证则不然，阴证易伏易藏，我们不易发觉它。所以，到最后能酿成大患，造成危证险证的，往往就是这个阴证。为什么阴证易伏藏而不易发觉呢？根本的原因就是阳火虚衰了，识别系统麻木了，对任何异常都反应不出来。一句话，就是主不明了。窦氏提出的这个思想，很值得我们结合现实来进行思考。总的来说，君火在上，肾水在下。《老子》云：高以下为基，贵以贱为本。君火高高在上，贵为君主，可是它的基、它的本在哪里呢？在下，在肾水。所以，君火与肾水又是这样的一种关系。病至少阴，往往高高在上和低低在下的都不行了。没有在下的这个基和本，在上的君主也就难以发挥作用。因此，疾病发展到少阴，就到了一个很棘手的阶段。二、少阴病提纲少阴病提纲以原文 281 条之“少阴之为病，脉微细，但欲寐”为依据。为与病机相合，我们仍可将其改为：“诸脉微细，但欲寐，皆属于少阴。”有关少阴病提纲，我们拟从三方面来讨论。1.微妙在脉由六经篇题皆云“辨某某病脉证并治”，可知仲景对脉是非常强调的。但是，具体地落实到六经提纲条文里，却非皆有脉。如阳明提纲条文云：“阳明之为病，胃家实是也。”而未云：“阳明之为病，脉大，胃家实。”同样，少阳之提纲条文云：“少阳之为病，口苦，咽干，目眩。”而未云：“少阳之为病，脉弦细，口苦，咽干，目眩。”可见六经虽皆重脉，然直接将脉落实于提纲条文里的，则仅有太阳少阴两经。故知脉与太阳少阴具有特殊的意义。脉的意义很微妙，正如《素问·脉要精微论》所云：“微妙在脉，不可不察，察之有纪，从阴阳始。”所以，察脉关键的是看阴阳。前面我们讲过，阳加于阴谓之脉。从物理学的角度看，心脏不停地搏动，致血液在脉管里流动，并形成脉压差，这就有像潮水一样起伏涨落的脉搏出现。血属阴本静，为什么会在血管里流动，并形成起伏的变化呢？这就是阳的作用。因此，我们将脉形容为阳加于阴，是十分恰当的。这样一来，我们诊脉其实就是察阴阳，察水火，从而也就是察心肾。心肾水火阴阳者，皆属少阴。以少阴为心肾水火之藏。所以，脉与少阴的关系就很特别。而少阴与太阳又是标本、对待、表里的关系，因此，在整个六经的提纲条文里，就只有太阳少阴谈到脉。太阳少阴为表里，太阳是在外一层谈阴阳，谈水火。太阳为什么与寒水相连？就是要强调这个阴阳水火。火升则水升，火降则水降，这才有水的循环。而少阴呢？少阴则是在内一层讲阴阳、讲水火。在外的太阳言阴阳水火之用，在内的少阴言阴阳水火之体。因此，太阳与少阴实际上就是体与用的关系。病到了少阴，显然体用都衰微了。用不行了，脉势就显得很微弱；体不足了，脉当然就细起来。因此，“脉微细”实际上讲的是体用都不行了。“脉微细”的情况在《伤寒论》中有两处，一处在少阴篇里（少阴篇不只一条），另一处在哪里呢？就在太阳篇。太阳篇 60条云：“下之后，复发汗，必振寒，脉微细。所以然者，以内外俱虚故也。”太阳篇的这一条讲得非常形象，刚好将我们以上讨论的内容作了一个总结。太阳病，经汗下之后，出现振寒，脉微细。为什么会脉微细呢？以内外俱虚故也。内则言少阴言体，外则言太阳言用。用虚则脉微，体虚则脉细。故一个“脉微细”，已然将水火、心肾、内外、体用的病变揭露无遗。你说这个脉微不微妙呢？2.但欲寐（1）人之寤寐我们首先来看人的寤寐情况。人的睡眠和觉醒是什么因素造成的呢？这在前面已经多次谈到过。我们曾作过一个很形象的比喻，人的清醒与睡眠，就像白天的光明与夜晚的黑暗一样。故《内经》云：天有昼夜，人有起卧。中医理论的一大特色就是天人相应，天人合一。而这个“天有昼夜，人有起卧”，我想就是最大的相应，最大的合一。如果我们从天之昼夜及人之寤寐中，仍参不出这个合一，仍以为中医这个理念是虚玄的，那就只好“道不同不相为谋”了。既然天之昼夜即是人之寤寐，那当然人之寤寐就要与昼夜相应。现代几乎大多数人都不明这个道理，以为只要睡够八小时就行了，而这个睡觉的时间并不重要。其实不然，天地白昼了，你醒了，你寤了；天地黑夜了，你睡了，你寐了，这个才叫相应，这个才叫合一。如果反过来，那就不是相应、不是合一了。相应、合一又叫得道，得什么道呢？得天之道。得道多助。不相应、不合一又叫失道，失道寡助。因此要想养生保健，把握好寤寐的时间，其实就是很大的一个方面。昼何以明呢？以日出地则明也。夜何以暗？以日入地则暗。由此亦知，人之寤寐也是因为这个日出地和日入地的关系。日出地则明，于易卦则为晋。晋者上离下坤，离在坤上为晋（?）。离为火为日，坤为地。日火出地，阳光普照，何得不明？故《说文》云：“晋，进也，日出万物进也。”《杂卦》云：“晋，昼也”。《彖》曰：“晋，进也。明出地上，顺而丽乎大明。”日入地则暗，于易卦则为明夷（脁）。明夷正好是晋的一个相反卦。把晋卦倒过来，变成坤上离下，就成为明夷。明是光明，夷呢？夷者伤也。明伤故晦。日出地上，其明乃光。此则为晋，为昼，亦为寤矣。至其入地，明则伤矣。此则为明夷，为夜，亦为寐也。《易·系辞》曰：“古者包牺氏之王天下也，仰则观象于天，俯则观法于地。观鸟兽之文，与地之宜。近取诸身，远取诸物。于是始作八卦，以通神明之德，以类万物之情。”晋与明夷二卦，远则以类天地，以类昼夜；近则以类寤寐。远类昼夜，经中已有明训。近类寤寐呢？我们略观双目即能知晓。双目外覆眼睑，上睑属脾，下睑属胃，合之共由脾胃所主。故其属土也，属地也，属坤也。双睑打开，则目外露而能视物，此则为明也。《说卦》云：“离为目。”睑开而目露，这与什么相类呢？正与日出于地相类。日出于地为晋，而人之由寐至寤，所干的第一件事是什么呢？就是睁开双目进入晋的状态。可见晋之与寤确为一类。日入地为明夷，亦为寐。我们睡眠的时候，首先需要的就是合上双睑，闭上双目。让双目覆于睑下，此非明夷为何？故寐之与明夷亦确为一类。从人之寤寐，与易卦之晋与明夷，我们看到了医易之间的关系是非常实在的。本来寤寐的过程好像很玄，可是透过易象，透过晋与明夷，就变得很直观、很清楚。由此我们会联想到什么呢？第一，睡眠的过程对于人的身心健康都非常重要，而从目前的情况看，处于不良睡眠状态的人越来越多。西医解决这个问题主要靠镇静安眠，这显然不是一个很好的方法。而作为中医，我们如何去解决这个问题呢？我想就要从晋与明夷去考虑。认识到睡眠就是由晋进入明夷，从而帮助实现明夷的状态，就能够很好地解决上述问题。明夷的状态何以实现？就是要坤土上而离火下。所以，要实现明夷，无非就是解决这两个问题。依照这样一个思路，多年来以太阳篇半夏泻心汤化裁治疗失眠，取得了良好的效果。半夏泻心汤在前面已经讨论过，它主要针对痞证而设，多用于现代的肠胃病。这样一个方子为什么可以治疗失眠呢？关键就在于它能够帮助解决上述两个问题。方中的主药半夏功善开结，能够打开上下交通的道路。上下的道路打开了，交通起来就比方便。黄连、黄芩用于帮助离火的下降，人参、干姜、炙甘草、大枣用于帮助坤土的上升。离火降于下，坤土升于上，明夷的格局便自然地形成，良好的睡眠状态亦自然地形成。是不治寐而寐自治，不安神而神自安也。这便显出知易与不知易的差别。第二，研究易学确实不能脱离象。故古称易乃象辞之学、象数之学、象占之学。理数象占，四者不可缺一。如果离开象，那易的辞理就很难落到实处。单就这个晋与明夷，我们也很难把它们说清楚。而一旦结合象，易理是很通透的，而医理亦在象中得到很清楚地表露。（3）日入地者，太阴也；日出地者，厥阴也日入地靠什么呢？从明夷卦可以看到，它靠太阴。太阴开，日才能入。从理论上至少可以这样来看。当然，太阴开的这个过程还需要阳明来配合。那么，日出地靠什么呢？这就要靠厥阴。而这个过程同样需要太阳的配合。太阴与厥阴，一个开一个合。这个开合把握好了，晋与明夷便没有问题。而这个开合靠什么来把握呢？靠少阴枢来把握。所以，在少阴病的提纲条文里，谈“但欲寐”的问题，其涵义是十分深刻的。但欲寐是什么意思呢？但是只的意思，仅的意思；欲是想；寐是睡觉。合起来，就是一天到晚想睡觉。
用上述的含义来比喻人，有的人经常小毛病不断，今天这里不舒服，明天那里不舒服，但是这样的人却不容易患大病，而且往往比较长寿。而有的人平时一点毛病也没有，可是一旦生病就不是小病，甚至是要命的病。为什么呢？我想这与这个识别系统的灵敏度有关。不是没有疾病，而是你没有识别出来，反映出来。所以，对于平时很健康的人，我们就应该懂得辨别他的真假。真健康当然好，如果是假健康，那就很危险。因为你的识别系统出了问题，识别系统麻痹了，碰上昏庸的君主（指心阳不足），潜在的隐患没有办法揭露，你说危不危险呢？从上面的讨论，我想大家对《素问·灵兰秘典论》的重要性会有更充分的认识。大家现在接触得更多的是社会，《素问·灵兰秘典论》实际上就是用社会观去看待人体。人就是在君主之官（心）的号令下，分工合作，各司其职。这一点很重要。我们讲五行也好，讲藏象（脏腑生理功能及相互关系的理论）也好，都是讲这个各司其职。少阴的藏义，我们重点谈了心和肾。可以说，心肾这对关系在人身再怎么强调也不过分。心肾是什么关系呢？用两个字来形容，是水火，是阴阳，是男女，也是精神。我们天天都在用精神这个词，可精神是什么呢？实际上就是心肾。《素问·六节藏象论》说：“心者，生之本，神之变也……肾者，主蛰，封藏之本，精之处也。”一个是精之处，一个是神之变。一个主藏精，一个主藏神。这就是精神。所以，从一个人的精神状态，就完全可以看出心肾的状态。当然也就可以看出水火、阴阳的状态。心属火、属离卦，肾属水、属坎卦。正常情况下，水火要既济（相交），心肾要相交。心火下降的目的是温暖肾水，也就是温暖坎中之阳。肾水上升的目的是济养心阴，也就是离中之阴。坎离相交，各得其所。
4. 少阴运气义
下面讨论第四个问题，就是少阴的运气问题。少阴在运气方面属什么呢？属君火。君火以明，相火以位。君相的明和位在少阳篇中已经讨论过，这里不再重复。刚才谈心的时候，曾多次提到《素问·灵兰秘典论》，论云：主明则下安，主不明则十二官皆危。所以，少阴很大程度上是在讲主，由于主不明，而致十二官皆危。为什么少阴这一篇有很多的危证出现，可见这一篇主要就是探讨这个“主不明”的问题。那么，君主为什么能明呢？它凭什么明？我们在讨论火的自然性用时曾经谈到，火的一个很重要的性用就是明。能明物者，无非阳火。因此，君主要明，关键就是要阳火充足。为什么心属火而又主神明？为什么“君火以明”？很显然，就是要强调火与明的关系。所以，只有阳火用事，君主才能神明。现在为什么主不明呢？很显然就是阳火虚衰了。我们看少阴篇中的危证和死证，也就知道它无一不是由阳火虚衰引起的。少阴病总体上可分为寒化证和热化证。热化证里，危证死证都没有。危证和死证全都集中在寒化证里。寒化证也就是阳火虚衰之证。从整个《伤寒论》来看，亦是如此。因热化，也就是因阳火过盛而危而死者，所占甚少，仅阳明篇中有数条。而绝大多数之危证死证存于少阴、厥阴篇中，皆由阳火虚衰所致。由此便知，不管西医是什么疾病，心血管疾病也好，肿瘤也好，肺心病也好，最后导致险情出现，甚至死亡的，其主要原因大都属阳火不及。所以，从宏观上看，不但是东汉末的建安年间，其死亡者伤寒十居其七，就是现在的死亡者中，伤寒亦占大多数，阳火虚衰亦占大多数。为什么呢？因为阳火虚衰，则君主不明，主不明，则十二官皆危矣。回过头，我们再看十九病机。十九病机中，火热病机占九条，而风、寒、湿病机仅各占一条。什么道理呢？就是强调火热与诸多疾病的关系。而这个关系并不是说火热一定亢盛。有火热会产生这些疾病，无火热也会产生这些疾病；火热盛会产生这些疾病，火热虚也会产生这些疾病。有关这一点，岐伯在紧接十九病后的一段文字中说得十分清楚。而后世的许多医家，仅看到病机十九条，却忽略了这段将病机落向实处的至关重要的文字。故尔认为天下疾病火热盛者多，危证死证亦多属阳火亢盛。只知阳火亢盛，热盛能致神昏，却全然不知阳火虚衰则君主不明，主不明则十二官皆危，更何况神昏之证。所以到了后世，对于危证险证医家但知以三宝（安宫牛黄丸、紫雪丹、至宝丹）来救逆，却不知四逆才是救逆的正法。宋·窦材撰有一本《扁鹊心书》，这本书虽然多谈灸刺，但是它的一个主干思想却非常值得我们借鉴。窦氏认为，人身的疾病阳证比较容易解决，为什么呢？因为阳证易于发觉。阳火太过就像纸包火一样，包得住吗？包不住的。所以阳证它潜伏不了，能够得到及时的治疗。而阴证则不然，阴证易伏易藏，我们不易发觉它。所以，到最后能酿成大患，造成危证险证的，往往就是这个阴证。为什么阴证易伏藏而不易发觉呢？根本的原因就是阳火虚衰了，识别系统麻木了，对任何异常都反应不出来。一句话，就是主不明了。窦氏提出的这个思想，很值得我们结合现实来进行思考。总的来说，君火在上，肾水在下。《老子》云：高以下为基，贵以贱为本。君火高高在上，贵为君主，可是它的基、它的本在哪里呢？在下，在肾水。所以，君火与肾水又是这样的一种关系。病至少阴，往往高高在上和低低在下的都不行了。没有在下的这个基和本，在上的君主也就难以发挥作用。因此，疾病发展到少阴，就到了一个很棘手的阶段。二、少阴病提纲少阴病提纲以原文 281 条之“少阴之为病，脉微细，但欲寐”为依据。为与病机相合，我们仍可将其改为：“诸脉微细，但欲寐，皆属于少阴。”有关少阴病提纲，我们拟从三方面来讨论。1.微妙在脉由六经篇题皆云“辨某某病脉证并治”，可知仲景对脉是非常强调的。但是，具体地落实到六经提纲条文里，却非皆有脉。如阳明提纲条文云：“阳明之为病，胃家实是也。”而未云：“阳明之为病，脉大，胃家实。”同样，少阳之提纲条文云：“少阳之为病，口苦，咽干，目眩。”而未云：“少阳之为病，脉弦细，口苦，咽干，目眩。”可见六经虽皆重脉，然直接将脉落实于提纲条文里的，则仅有太阳少阴两经。故知脉与太阳少阴具有特殊的意义。脉的意义很微妙，正如《素问·脉要精微论》所云：“微妙在脉，不可不察，察之有纪，从阴阳始。”所以，察脉关键的是看阴阳。前面我们讲过，阳加于阴谓之脉。从物理学的角度看，心脏不停地搏动，致血液在脉管里流动，并形成脉压差，这就有像潮水一样起伏涨落的脉搏出现。血属阴本静，为什么会在血管里流动，并形成起伏的变化呢？这就是阳的作用。因此，我们将脉形容为阳加于阴，是十分恰当的。这样一来，我们诊脉其实就是察阴阳，察水火，从而也就是察心肾。心肾水火阴阳者，皆属少阴。以少阴为心肾水火之藏。所以，脉与少阴的关系就很特别。而少阴与太阳又是标本、对待、表里的关系，因此，在整个六经的提纲条文里，就只有太阳少阴谈到脉。太阳少阴为表里，太阳是在外一层谈阴阳，谈水火。太阳为什么与寒水相连？就是要强调这个阴阳水火。火升则水升，火降则水降，这才有水的循环。而少阴呢？少阴则是在内一层讲阴阳、讲水火。在外的太阳言阴阳水火之用，在内的少阴言阴阳水火之体。因此，太阳与少阴实际上就是体与用的关系。病到了少阴，显然体用都衰微了。用不行了，脉势就显得很微弱；体不足了，脉当然就细起来。因此，“脉微细”实际上讲的是体用都不行了。“脉微细”的情况在《伤寒论》中有两处，一处在少阴篇里（少阴篇不只一条），另一处在哪里呢？就在太阳篇。太阳篇 60条云：“下之后，复发汗，必振寒，脉微细。所以然者，以内外俱虚故也。”太阳篇的这一条讲得非常形象，刚好将我们以上讨论的内容作了一个总结。太阳病，经汗下之后，出现振寒，脉微细。为什么会脉微细呢？以内外俱虚故也。内则言少阴言体，外则言太阳言用。用虚则脉微，体虚则脉细。故一个“脉微细”，已然将水火、心肾、内外、体用的病变揭露无遗。你说这个脉微不微妙呢？2.但欲寐（1）人之寤寐我们首先来看人的寤寐情况。人的睡眠和觉醒是什么因素造成的呢？这在前面已经多次谈到过。我们曾作过一个很形象的比喻，人的清醒与睡眠，就像白天的光明与夜晚的黑暗一样。故《内经》云：天有昼夜，人有起卧。中医理论的一大特色就是天人相应，天人合一。而这个“天有昼夜，人有起卧”，我想就是最大的相应，最大的合一。如果我们从天之昼夜及人之寤寐中，仍参不出这个合一，仍以为中医这个理念是虚玄的，那就只好“道不同不相为谋”了。既然天之昼夜即是人之寤寐，那当然人之寤寐就要与昼夜相应。现代几乎大多数人都不明这个道理，以为只要睡够八小时就行了，而这个睡觉的时间并不重要。其实不然，天地白昼了，你醒了，你寤了；天地黑夜了，你睡了，你寐了，这个才叫相应，这个才叫合一。如果反过来，那就不是相应、不是合一了。相应、合一又叫得道，得什么道呢？得天之道。得道多助。不相应、不合一又叫失道，失道寡助。因此要想养生保健，把握好寤寐的时间，其实就是很大的一个方面。昼何以明呢？以日出地则明也。夜何以暗？以日入地则暗。由此亦知，人之寤寐也是因为这个日出地和日入地的关系。日出地则明，于易卦则为晋。晋者上离下坤，离在坤上为晋（?）。离为火为日，坤为地。日火出地，阳光普照，何得不明？故《说文》云：“晋，进也，日出万物进也。”《杂卦》云：“晋，昼也”。《彖》曰：“晋，进也。明出地上，顺而丽乎大明。”日入地则暗，于易卦则为明夷（脁）。明夷正好是晋的一个相反卦。把晋卦倒过来，变成坤上离下，就成为明夷。明是光明，夷呢？夷者伤也。明伤故晦。日出地上，其明乃光。此则为晋，为昼，亦为寤矣。至其入地，明则伤矣。此则为明夷，为夜，亦为寐也。《易·系辞》曰：“古者包牺氏之王天下也，仰则观象于天，俯则观法于地。观鸟兽之文，与地之宜。近取诸身，远取诸物。于是始作八卦，以通神明之德，以类万物之情。”晋与明夷二卦，远则以类天地，以类昼夜；近则以类寤寐。远类昼夜，经中已有明训。近类寤寐呢？我们略观双目即能知晓。双目外覆眼睑，上睑属脾，下睑属胃，合之共由脾胃所主。故其属土也，属地也，属坤也。双睑打开，则目外露而能视物，此则为明也。《说卦》云：“离为目。”睑开而目露，这与什么相类呢？正与日出于地相类。日出于地为晋，而人之由寐至寤，所干的第一件事是什么呢？就是睁开双目进入晋的状态。可见晋之与寤确为一类。日入地为明夷，亦为寐。我们睡眠的时候，首先需要的就是合上双睑，闭上双目。让双目覆于睑下，此非明夷为何？故寐之与明夷亦确为一类。从人之寤寐，与易卦之晋与明夷，我们看到了医易之间的关系是非常实在的。本来寤寐的过程好像很玄，可是透过易象，透过晋与明夷，就变得很直观、很清楚。由此我们会联想到什么呢？第一，睡眠的过程对于人的身心健康都非常重要，而从目前的情况看，处于不良睡眠状态的人越来越多。西医解决这个问题主要靠镇静安眠，这显然不是一个很好的方法。而作为中医，我们如何去解决这个问题呢？我想就要从晋与明夷去考虑。认识到睡眠就是由晋进入明夷，从而帮助实现明夷的状态，就能够很好地解决上述问题。明夷的状态何以实现？就是要坤土上而离火下。所以，要实现明夷，无非就是解决这两个问题。依照这样一个思路，多年来以太阳篇半夏泻心汤化裁治疗失眠，取得了良好的效果。半夏泻心汤在前面已经讨论过，它主要针对痞证而设，多用于现代的肠胃病。这样一个方子为什么可以治疗失眠呢？关键就在于它能够帮助解决上述两个问题。方中的主药半夏功善开结，能够打开上下交通的道路。上下的道路打开了，交通起来就比方便。黄连、黄芩用于帮助离火的下降，人参、干姜、炙甘草、大枣用于帮助坤土的上升。离火降于下，坤土升于上，明夷的格局便自然地形成，良好的睡眠状态亦自然地形成。是不治寐而寐自治，不安神而神自安也。这便显出知易与不知易的差别。第二，研究易学确实不能脱离象。故古称易乃象辞之学、象数之学、象占之学。理数象占，四者不可缺一。如果离开象，那易的辞理就很难落到实处。单就这个晋与明夷，我们也很难把它们说清楚。而一旦结合象，易理是很通透的，而医理亦在象中得到很清楚地表露。（3）日入地者，太阴也；日出地者，厥阴也日入地靠什么呢？从明夷卦可以看到，它靠太阴。太阴开，日才能入。从理论上至少可以这样来看。当然，太阴开的这个过程还需要阳明来配合。那么，日出地靠什么呢？这就要靠厥阴。而这个过程同样需要太阳的配合。太阴与厥阴，一个开一个合。这个开合把握好了，晋与明夷便没有问题。而这个开合靠什么来把握呢？靠少阴枢来把握。所以，在少阴病的提纲条文里，谈“但欲寐”的问题，其涵义是十分深刻的。但欲寐是什么意思呢？但是只的意思，仅的意思；欲是想；寐是睡觉。合起来，就是一天到晚想睡觉。
Using the above meaning to metaphorically describe human beings, some people frequently suffer from minor ailments; today they feel uncomfortable here, tomorrow they feel uncomfortable there. However, such people are unlikely to contract serious diseases and often enjoy longevity. In contrast, some people have no minor ailments at all, but when they do fall ill, it is not a minor disease, but even a life-threatening one. Why? I believe this is related to the sensitivity of their recognition system. It is not that there is no disease, but rather that you have not recognized or manifested it. Therefore, for those who appear very healthy in daily life, we must understand how to distinguish between true and false health. True health is naturally good, but if it is false health, it is very dangerous. Because your recognition system has malfunctioned, becoming numb, and encountering a "dim ruler" (referring to insufficient Heart Yang), potential hidden dangers cannot be exposed. Is this not dangerous? From the above discussion, I think everyone will have a fuller understanding of the importance of *Suwen: Linglan Midian Lun* (Treatise on the Secret Canon of the Spiritual Pivot). What people encounter nowadays is mostly society. *Suwen: Linglan Midian Lun* actually uses a social perspective to view the human body. Humans operate under the command of the "Ruler Official" (Heart), with division of labor, cooperation, and each performing its own duties. This point is crucial. Whether we discuss the Five Phases (Wu Xing) or Zang-Xiang (the theory of physiological functions and interrelationships of the Zang-Fu organs), we are all discussing this principle of performing respective duties. Regarding the Zang meaning of Shaoyin, we focused on the Heart and Kidney. It can be said that the relationship between the Heart and Kidney cannot be overemphasized in the human body. What is the relationship between the Heart and Kidney? Described in two words, it is Water and Fire, Yin and Yang, Male and Female, and also Spirit and Essence (Jing-Shen). We use the word "spirit" every day, but what is spirit? Actually, it is the Heart and Kidney. *Suwen: Liujie Zangxiang Lun* states: "The Heart is the root of life, the residence of the Shen... The Kidney governs hibernation, is the root of sealing and storing, and the abode of Jing." One is the abode of Jing, the other is the transformation of Shen. One governs storing Jing, the other governs storing Shen. This is what constitutes spirit. Therefore, from a person's mental state, one can completely discern the state of the Heart and Kidney. Naturally, one can also discern the state of Water and Fire, Yin and Yang. The Heart belongs to Fire and the Li trigram; the Kidney belongs to Water and the Kan trigram. Under normal circumstances, Water and Fire must achieve Ji Ji (mutual intersection), and the Heart and Kidney must interact. The purpose of Heart Fire descending is to warm Kidney Water, which is to warm the Yang within Kan. The purpose of Kidney Water ascending is to nourish Heart Yin, which is the Yin within Li. When Kan and Li intersect, each finds its proper place.
4. The Meaning of Shaoyin in Yunqi (Luck and Qi)
Next, let us discuss the fourth issue, which is the Yunqi aspect of Shaoyin. What does Shaoyin belong to in terms of Yunqi? It belongs to Sovereign Fire (Jun Huo). Sovereign fire illuminates, while Minister fire maintains its position. The illumination and positioning of Sovereign and Minister fire were discussed in the Shaoyang chapter, so they will not be repeated here. When discussing the Heart earlier, *Suwen: Linglan Midian Lun* was mentioned multiple times. The treatise says: "If the Ruler is clear, the subordinates are peaceful; if the Ruler is unclear, the Twelve Officials are all in danger." Thus, Shaoyin largely discusses the "Ruler." Due to the Ruler being unclear, the Twelve Officials become endangered. Why are there so many critical conditions appearing in the Shaoyin chapter? It is evident that this chapter primarily explores the problem of "Ruler Unclearness." So, why can the Ruler be clear? On what basis is it clear? When we discussed the natural properties and functions of Fire, we mentioned that an important function of Fire is illumination. That which illuminates things is none other than Yang Fire. Therefore, for the Ruler to be clear, the key is to have sufficient Yang Fire. Why does the Heart belong to Fire and yet govern Shen Ming (Spiritual Clarity)? Why is it said that "Sovereign Fire illuminates"? Clearly, this emphasizes the relationship between Fire and Illumination. Thus, only when Yang Fire is active can the Ruler possess spiritual clarity. Why is the Ruler unclear now? Clearly, it is because Yang Fire is deficient and declining. Looking at the critical and fatal cases in the Shaoyin chapter, we know that none are not caused by the deficiency of Yang Fire. Shaoyin disease is generally divided into Cold Transformation Syndrome and Heat Transformation Syndrome. There are no critical or fatal cases in the Heat Transformation Syndrome. All critical and fatal cases are concentrated in the Cold Transformation Syndrome. Cold Transformation Syndrome is essentially a syndrome of Yang Fire deficiency. Looking at the entire *Shanghan Lun*, this is also the case. Those who die due to heat transformation, i.e., excessive Yang Fire, account for very few, with only a few entries in the Yangming chapter. The vast majority of critical and fatal cases exist in the Shaoyin and Jueyin chapters, all caused by Yang Fire deficiency. From this, we can see that regardless of what Western medicine diagnoses—whether cardiovascular disease, tumors, or cor pulmonale—the main cause leading to critical situations or even death is mostly due to insufficient Yang Fire. Therefore, macroscopically speaking, not only during the Jian'an era of the late Eastern Han Dynasty, where seven out of ten deaths were due to Shanghan (Cold Damage), but also among current deaths, Shanghan accounts for the majority, and Yang Fire deficiency accounts for the majority. Why? Because Yang Fire deficiency leads to the Ruler being unclear; if the Ruler is unclear, the Twelve Officials are all in danger. Turning back, let us look at the Nineteen Pathogenesis Mechanisms. Among the nineteen mechanisms, nine relate to Fire-Heat, while Wind, Cold, and Dampness each account for only one. What is the reason? It emphasizes the relationship between Fire-Heat and various diseases. This relationship does not mean that Fire-Heat must be hyperactive. Diseases can arise with Fire-Heat, and without Fire-Heat; diseases can arise with excess Fire-Heat, and with deficient Fire-Heat. Qibo explains this clearly in the text immediately following the nineteen pathogenesis mechanisms. However, many later physicians only saw the Nineteen Pathogenesis Mechanisms and ignored this crucial text that grounds the pathogenesis in reality. Consequently, they believed that most diseases in the world are due to excess Fire-Heat, and that critical and fatal cases also mostly belong to Yang Fire hyperactivity. They only knew that Yang Fire hyperactivity and heat excess can lead to coma, but completely failed to realize that Yang Fire deficiency causes the Ruler to be unclear; if the Ruler is unclear, the Twelve Officials are all in danger, let alone coma. Thus, in later generations, for critical and dangerous cases, physicians only knew to use the "Three Treasures" (An Gong Niu Huang Wan, Zi Xue Dan, Zhi Bao Dan) to rescue deviation, but did not know that Si Ni Tang (Frigid Extremities Decoction) is the correct method for rescuing deviation. Dou Cai of the Song Dynasty wrote a book called *Bianque Xinshu* (Heart Mirror of Bian Que). Although this book focuses heavily on moxibustion and acupuncture, its core ideology is very worthy of our reference. Dou believed that Yang syndromes in the human body are relatively easy to resolve. Why? Because Yang syndromes are easy to detect. Excessive Yang Fire is like paper wrapping fire; can it be contained? No. Therefore, Yang syndromes cannot remain latent and can receive timely treatment. Yin syndromes are different; Yin syndromes are prone to concealment and hiding, making them difficult for us to detect. Therefore, the ones that eventually brew into major disasters, causing critical and dangerous conditions, are often these Yin syndromes. Why are Yin syndromes prone to concealment and difficult to detect? The fundamental reason is that Yang Fire is deficient, the recognition system is numb, and it fails to react to any abnormalities. In short, the Ruler is unclear. This idea proposed by Dou is very worth considering in conjunction with reality. Generally speaking, Sovereign Fire is above, and Kidney Water is below. *Laozi* states: "High takes low as its foundation; noble takes humble as its root." Sovereign Fire is high above, noble as the Ruler, but where is its foundation and root? It is below, in Kidney Water. Thus, this is the relationship between Sovereign Fire and Kidney Water. When disease reaches Shaoyin, often both the high and the low fail. Without the foundation and root below, the Ruler above cannot function effectively. Therefore, when disease develops to Shaoyin, it reaches a very tricky stage. II. Outline of Shaoyin Disease The outline of Shaoyin disease is based on Article 281: "Shaoyin disease manifests as a faint and thin pulse, and merely desiring sleep." To align with the pathogenesis, we may still revise it to: "All faint and thin pulses, and merely desiring sleep, belong to Shaoyin." Regarding the outline of Shaoyin disease, we intend to discuss it from three aspects. 1. Subtlety in the Pulse Since the titles of the Six Meridian chapters all say "Distinguishing [Name] Disease Pulse, Symptoms, and Treatment," it is known that Zhongjing emphasized the pulse highly. However, specifically applied to the outline articles of the Six Meridians, not all contain the pulse. For example, the Yangming outline article says: "Yangming disease manifests as stomach fullness and hardness," without saying: "Yangming disease manifests as a large pulse and stomach fullness." Similarly, the Shaoyang outline article says: "Shaoyang disease manifests as bitter taste in the mouth, dry throat, and dizziness," without saying: "Shaoyang disease manifests as a string-taut and thin pulse, bitter taste in the mouth, dry throat, and dizziness." It is evident that although the Six Meridians all value the pulse, only the Taiyang and Shaoyin meridians directly incorporate the pulse into their outline articles. Thus, we know that the pulse has a special significance with Taiyang and Shaoyin. The significance of the pulse is very subtle, just as *Suwen: Maiyao Jingwei Lun* states: "Subtlety lies in the pulse; it must not be neglected. Examination has its principles, starting from Yin and Yang." Therefore, the key to examining the pulse is to observe Yin and Yang. As we stated earlier, "Yang added to Yin is called the pulse." From a physics perspective, the heart beats continuously, causing blood to flow in the vessels and forming a pressure difference, resulting in a pulse that rises and falls like tides. Blood belongs to Yin and is inherently static. Why does it flow in the vessels and form undulating changes? This is the action of Yang. Therefore, describing the pulse as "Yang added to Yin" is very appropriate. In this way, taking the pulse is actually observing Yin and Yang, observing Water and Fire, and thus observing the Heart and Kidney. Heart, Kidney, Water, Fire, Yin, and Yang all belong to Shaoyin. Taking Shaoyin as the storehouse of Heart-Kidney Water-Fire makes the relationship between the pulse and Shaoyin particularly special. Furthermore, Shaoyin and Taiyang have a Biao-Ben (Branch-Root), mutual opposition, and exterior-interior relationship. Therefore, among all the outline articles of the Six Meridians, only Taiyang and Shaoyin mention the pulse. Taiyang and Shaoyin are exterior and interior. Taiyang discusses Yin-Yang and Water-Fire at the outer layer. Why is Taiyang connected with Cold Water? To emphasize this Yin-Yang and Water-Fire. When Fire ascends, Water ascends; when Fire descends, Water descends, allowing for the circulation of water. And Shaoyin? Shaoyin discusses Yin-Yang and Water-Fire at the inner layer. Taiyang, the exterior, speaks of the function (Yong) of Yin-Yang and Water-Fire; Shaoyin, the interior, speaks of the substance (Ti) of Yin-Yang and Water-Fire. Therefore, Taiyang and Shaoyin are essentially the relationship between Substance and Function. When disease reaches Shaoyin, obviously both Substance and Function are declining. When Function fails, the pulse momentum appears very faint; when Substance is insufficient, the pulse naturally becomes thin. Therefore, "faint and thin pulse" actually means that both Substance and Function are failing. The situation of "faint and thin pulse" appears twice in *Shanghan Lun*: once in the Shaoyin chapter (not just one entry), and where is the other? It is in the Taiyang chapter. Article 60 of the Taiyang chapter states: "After purgation and subsequent sweating, chills and a faint, thin pulse are inevitable. The reason is internal and external deficiency." This entry in the Taiyang chapter describes things very vividly, summarizing the content we discussed above. After sweating and purgation in Taiyang disease, chills and a faint, thin pulse appear. Why is the pulse faint and thin? Because of internal and external deficiency. Internally refers to Shaoyin and Substance; externally refers to Taiyang and Function. Deficiency of Function leads to a faint pulse; deficiency of Substance leads to a thin pulse. Thus, a single "faint and thin pulse" fully reveals the pathological changes of Water-Fire, Heart-Kidney, Internal-External, and Substance-Function. Isn't this pulse subtle? 2. Merely Desiring Sleep (1) Human Wakefulness and Sleep Let us first look at human wakefulness and sleep. What factors cause human sleep and wakefulness? This has been mentioned many times before. We made a vivid metaphor: human wakefulness and sleep are like daylight and darkness. Thus, *Neijing* states: Heaven has day and night; humans have rising and lying down. A major characteristic of TCM theory is the correspondence between Heaven and Humanity, and the unity of Heaven and Humanity. This "Heaven has day and night, humans have rising and lying down" is, I think, the greatest correspondence and unity. If we cannot perceive this unity from the day/night of Heaven and wake/sleep of humans, and still consider this TCM concept to be illusory, then we must say "those with different paths cannot plan together." Since heaven's day and night correspond to human wakefulness and sleep, naturally human wakefulness and sleep must correspond to day and night. Almost everyone nowadays does not understand this principle, thinking that getting eight hours of sleep is enough, and the timing of sleep is unimportant. This is not the case. When heaven and earth are bright, you wake up (Wu); when heaven and earth are dark, you sleep (Mei). This is called correspondence, this is called unity. If reversed, it is neither correspondence nor unity. Correspondence and unity are also called obtaining the Dao. Obtaining what Dao? Obtaining the Dao of Heaven. He who obtains the Dao has much support. Non-correspondence and non-unity are called losing the Dao. He who loses the Dao has little support. Therefore, to maintain health and well-being, grasping the time of wakefulness and sleep is indeed a significant aspect. How does the day become bright? By the sun emerging from the earth, it becomes bright. How does the night become dark? By the sun entering the earth, it becomes dark. From this, we also know that human wakefulness and sleep are due to this relationship of the sun emerging from and entering the earth. When the sun emerges from the earth, it is bright, corresponding to the Yi Jing hexagram Jin (Progress). Jin consists of Li (Fire/Sun) above and Kun (Earth) below. Li above Kun is Jin. Li represents Fire and Sun; Kun represents Earth. Sun and Fire emerging from the earth, sunlight shining everywhere, how could it not be bright? Thus, *Shuowen* states: "Jin means advance; when the sun rises, all things advance." *Zagua* states: "Jin is day." *Tuazhuan* states: "Jin is advance. Brightness emerges from the earth, following and attaching to the Great Brightness." When the sun enters the earth, it becomes dark, corresponding to the Yi Jing hexagram Mingyi (Darkening of the Light). Mingyi is exactly the opposite hexagram of Jin. Reversing the Jin hexagram to put Kun above and Li below results in Mingyi. Ming means brightness; Yi means injury/wounding. Brightness injured implies obscurity. When the sun emerges from the earth, its brightness shines. This is Jin, Day, and also Wakefulness. When it enters the earth, brightness is injured. This is Mingyi, Night, and also Sleep. *Yi: Xici* states: "In ancient times, when Fuxi ruled the world, he looked up to observe images in Heaven, looked down to observe laws on Earth. He observed the patterns of birds and beasts, and the suitability of the land. He took examples near from his own body, and far from other objects. Thus he created the Eight Trigrams to communicate the virtue of Divine Brightness, and to categorize the feelings of all things." The two hexagrams Jin and Mingyi, far away, categorize Heaven and Earth, Day and Night; close by, they categorize Wakefulness and Sleep. Categorizing Day and Night far away is already clearly instructed in the classics. What about categorizing Wakefulness and Sleep close by? We can know by briefly observing the eyes. The eyes are covered by eyelids externally; the upper eyelid belongs to the Spleen, the lower eyelid belongs to the Stomach, together governed by the Spleen and Stomach. Thus, they belong to Earth, to the ground, to Kun. When both eyelids open, the eyes are exposed and can see objects; this is brightness. *Shuagua* states: "Li is the Eye." Eyelids opening and eyes exposed, what is this similar to? It is precisely similar to the sun emerging from the earth. Sun emerging from earth is Jin, and the first thing humans do when transitioning from sleep to wakefulness is to open their eyes and enter the state of Jin. Thus, Jin and Wakefulness are indeed of the same category. Sun entering earth is Mingyi, also Sleep. When we sleep, the first requirement is to close both eyelids and shut the eyes. Letting the eyes be covered under the eyelids, what else is this but Mingyi? Thus, Sleep and Mingyi are indeed of the same category. From human wakefulness and sleep, and the Yi Jing hexagrams Jin and Mingyi, we see that the relationship between Medicine and Yi is very substantial. Originally, the process of wakefulness and sleep seems mysterious, but through Yi symbols, through Jin and Mingyi, it becomes very intuitive and clear. What does this remind us of? First, the process of sleep is very important for physical and mental health, and currently, more and more people are in poor sleep states. Western medicine mainly solves this problem with sedatives and hypnotics, which is obviously not a very good method. As TCM practitioners, how should we solve this problem? I think we should consider Jin and Mingyi. Recognizing that sleep is the transition from Jin to Mingyi, thereby helping to achieve the state of Mingyi, can well solve the above problems. How can the state of Mingyi be achieved? It requires Kun Earth to ascend and Li Fire to descend. Therefore, to achieve Mingyi, there are无非 (nothing but) solving these two issues. Following this line of thought, for many years, I have used a modified Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) from the Taiyang chapter to treat insomnia, achieving good results. Banxia Xiexin Tang was discussed earlier; it is mainly designed for Pi Syndrome (epigastric stuffiness) and is often used for modern gastrointestinal diseases. Why can such a formula treat insomnia? The key lies in its ability to help solve the aforementioned two issues. The main herb Banxia excels at opening knots, able to open the pathways of communication between upper and lower. Once the pathways between upper and lower are opened, communication becomes convenient. Huanglian and Huangqin are used to help Li Fire descend; Renshen, Ganjiang, Zhigancao, and Dazao are used to help Kun Earth ascend. When Li Fire descends to the lower and Kun Earth ascends to the upper, the pattern of Mingyi naturally forms, and a good sleep state naturally arises. This is treating sleeplessness without directly treating sleep, and calming the Shen without directly calming the Shen. This shows the difference between knowing Yi and not knowing Yi. Second, studying Yi indeed cannot detach from Xiang (Images/Symbols). Thus, ancient times called Yi the study of Image-Rhetoric, Image-Number, and Image-Divination. Principle, Number, Image, and Divination are four aspects, none of which can be omitted. If one detaches from Image, the rhetoric and principles of Yi are hard to ground in reality. Just with Jin and Mingyi alone, it is difficult to explain them clearly. But once combined with Image, Yi principles are very transparent, and medical principles are also clearly revealed in the Image. (3) What enters the earth is Taiyin; what emerges from the earth is Jueyin. What does the sun entering the earth rely on? From the Mingyi hexagram, we can see it relies on Taiyin. Only when Taiyin opens can the sun enter. At least theoretically, it can be viewed this way. Of course, the process of Taiyin opening also requires coordination with Yangming. Then, what does the sun emerging from the earth rely on? This relies on Jueyin. And this process similarly requires coordination with Taiyang. Taiyin and Jueyin, one opens and one closes. If this opening and closing is grasped well, there will be no problem with Jin and Mingyi. And what grasps this opening and closing? It is grasped by the Shaoyin pivot. Therefore, in the outline article of Shaoyin disease, discussing the issue of "merely desiring sleep" has profound implications. What does "merely desiring sleep" mean? "Dan" means only; "Yu" means desire; "Mei" means sleep. Together, it means wanting to sleep all day long.