《素问·奇病论》帝曰∶人生而有病癫疾者,病名曰何?安所得之?岐伯曰∶病名为胎病,此得之在母腹
中时,其母有所大惊,气上而不下,精气并居,故令子发为癫疾也。
此言初生时即有癫疾,近时所名癫痫者也。忽然暴仆,昏不知人,手足抽掣,少顷痰涌而吐,吐出痰涎,
则渐苏。此在胎时,母受大惊而动肝风,儿禀其气,与精气并居,如油入面矣。每遇风气动,则鼓其痰涎,上
蒙心窍,即神昏暴仆,风动而手足抽掣也。因其气闭不通而作猪羊声,故有羊癫、猪癫之名。其病得之胎元,
故难治也。
《灵枢·邪客篇》帝曰∶邪气之客人也,或令人
目不瞑,不卧出者,何气使然?伯高曰∶五谷入于胃也,其糟粕、津液、宗气,分为三隧。故宗气积于胸中,
出于喉咙,以贯心脉,而行呼吸焉;营气者,泌其津液,注之于脉,化以为血,以荣四末,内注五脏六腑,以
应刻数焉;卫气者,出其悍气之 疾,而先行于四末、分肉、皮肤之间,而不休者也,昼日行于阳,夜行于阴,
常从足少阴之分间,行于五脏六腑。今厥气客于五脏六腑,则卫气独卫其外,行于阳,不得入于阴,行于阳则
阳气盛,阳气盛则阳跷陷,不得入于阴,阴虚,故目不瞑。
营卫流行,义理已详营卫经络门。卫气昼行于阳,如日行天,夜行于阴,如日入地,此人身阴阳应天地之
阴阳而流行也。今厥逆之气客于脏腑,与卫气格拒,卫气不得入阴,则阴阳不交,而阳独盛于外,阴分之气虚,
阴虚阳盛,故目不瞑也。厥气者,或因外邪,或因内伤,致阴阳厥逆不和,通名厥气。故凡内伤、外感之病,
皆有不寐者,必审其因而治之,方能见效也。
帝曰∶治之奈何?伯高曰∶补其不足,泻其有余,调其虚实,以通其道,而去其邪。饮以半夏汤一剂,阴
阳已通,其卧立至。帝曰∶此所谓决渎壅塞,经络大通,阴阳和得者也。愿闻其方。伯高曰∶以流水千里以
外者八升,扬之万遍,取其清五升,煮之,炊以苇薪,火沸,置秫米一升,治半夏五合,徐炊,令竭为一升半,
去其滓,饮汁一小杯,日三,稍益,以知为度。故其病新发者,覆杯则卧,汗出则已矣;久者,三
饮而已也。
脾胃为中土,阴阳升降之道路也。阳根于阴而主升,脾为阴而气升也,升者,由内而行外;阴根于阳而主
降,胃为阳而气降也,降者,由外而内联。卫气不得入于阴,是外气不能行于内者,由胃气不得通降故也。饮
以半夏汤,通降胃气,则阴阳交通,其卧立至。取长流水而又扬之万遍,取其清,炊以苇薪猛火者,用其轻
扬滑利而流走,以通壅滞也。半夏通胃生津,秫米和脾生液,一举两得,故虽久者,三饮可已也。此交通阴阳
之法,而从脾胃主治者,以脾胃统一身之阴阳也。
《素问·病能论》帝曰∶人有卧而有所不安者,何也?岐伯曰∶脏有所伤,及精有所之,寄则安,故人
不能悬其病也。
此言卧有所不安,即不成寐也。以思虑情欲而伤脏,其精神有所之之处,执着不释,故卧不得安。如将执
着之心寄放,则自安矣。但未知其所执何事,所伤何脏,如思则气结而伤脾、怒则气逆而伤肝之类,故人不能
悬揣其病,必问其所因而治之也。
《素问·奇病论》中黄帝问道:人生下来就患有癫疾的,这病名叫什么?是从哪里得来的?岐伯回答说:这种病名为胎病,这是在母亲腹中时获得的。当时母亲受到极大的惊吓,导致气机上逆而不能下行,精气并聚于上,因此使孩子出生后发作癫疾。
这里说的是出生时就有的癫疾,也就是近代所说的癫痫。突然昏倒仆地,神志昏迷不知人事,手足抽搐掣动,过了一会儿痰涌上来并呕吐,吐出痰涎后,逐渐苏醒。这是因为在胎儿时期,母亲遭受大惊而动摇了肝风,胎儿禀受了这种风气,与精气并聚体内,就像油渗入面粉一样难以分离。每当遇到风气触动,就会鼓动体内的痰涎,向上蒙蔽心窍,于是出现神志昏迷、突然仆倒;风气扰动则导致手足抽搐。因为气机闭塞不通而发出类似猪羊的叫声,所以有羊癫疯、猪癫疯的名称。这种病源于胎元,所以难以治愈。
《灵枢·邪客篇》中黄帝问道:邪气侵入人体,有的人使人眼睛闭不上,无法入睡,是什么气造成的呢?伯高回答说:五谷进入胃中,其糟粕、津液、宗气分为三条通道运行。所以宗气积聚在胸中,出于喉咙,贯通心脉,以推动呼吸;营气,分泌津液,注入脉中,化生为血液,以滋养四肢末端,向内灌注五脏六腑,以应合昼夜刻漏的时间节律;卫气,发出其剽悍滑疾之气,先行运行于四肢末端、肌肉纹理和皮肤之间,不停息。白天行于阳分,夜晚行于阴分,经常从足少阴肾经的分野间,运行于五脏六腑。现在厥逆之气客居于五脏六腑,那么卫气只能独自护卫于外,行于阳分,不能进入阴分。行于阳分则阳气盛,阳气盛则阳跷脉陷滞(此处指阳跷脉气盛或功能异常,原文“陷”通“限”或指阳气被阻,结合上下文意为阳气偏盛不得入阴),不能进入阴分,导致阴虚,所以眼睛闭不上。
营卫之气的流行,义理已在“营卫经络门”中详述。卫气白天行于阳分,如同太阳行于天空;夜晚行于阴分,如同太阳落入地下,这是人身阴阳顺应天地阴阳而运行的规律。现在厥逆之气客居于脏腑,与卫气格拒,卫气不能进入阴分,导致阴阳不交,而阳气独盛于外,阴分之气虚弱,阴虚阳盛,所以眼睛闭不上无法入睡。所谓厥气,可能是因为外邪,也可能是因为内伤,导致阴阳厥逆不和,统称为厥气。所以凡是内伤、外感引起的疾病,都有可能出现不寐,必须审察病因进行治疗,才能见效。
黄帝问道:怎么治疗呢?伯高回答说:补其不足,泻其有余,调和虚实,疏通其道,去除邪气。服用半夏汤一剂,阴阳得以通畅,睡眠立刻就能恢复。黄帝说:这就是所说的疏通水道壅塞,经络大通,阴阳和谐的方法。希望听听这个方子。伯高回答说:取千里之外的流水八升,反复扬洒一万遍,取其清澈部分五升,用芦苇做燃料煮水,火沸后,放入秫米一升,制半夏五合,慢慢煎煮,直到药液浓缩为一升半,去掉药渣,每次饮用一小杯,每天三次,逐渐增加剂量,以见效为度。所以如果是新发的病,喝完药碗底朝上放置片刻就能入睡,出汗就好了;如果是久病,喝三次就能痊愈。
脾胃属于中土,是阴阳升降的道路。阳根植于阴而主升,脾属阴但气机主升,升是指由内向外运行;阴根植于阳而主降,胃属阳但气机主降,降是指由外向内联络。卫气不能进入阴分,是因为外部的气不能行于内部,这是由于胃气不能通降的缘故。服用半夏汤,通降胃气,则阴阳交通,睡眠立刻就能恢复。取长流水又扬洒万遍,取其清轻部分,用芦苇薪柴猛火煮,是利用其轻扬滑利且流动的特性,来疏通壅滞。半夏能通胃生津,秫米能和脾生液,一举两得,所以即使是久病,喝三次也可以痊愈。这是交通阴阳的方法,而从脾胃主治,是因为脾胃统一全身的阴阳。
《素问·病能论》中黄帝问道:有人睡觉时感到不安宁,为什么呢?岐伯回答说:脏腑有所损伤,以及精神有所执着寄托之处,如果寄托了就能安宁,所以人不能凭空猜测他的病情。
这里说的睡觉不安宁,就是不能入睡。因为思虑情欲而损伤脏腑,其精神有所执着的地方,执着不放,所以睡觉不得安宁。如果把执着的心寄放出去,自然就安宁了。只是不知道所执着的是什么事情,所损伤的是哪个脏腑,比如思虑过度则气结而伤脾、愤怒则气逆而伤肝之类,所以人不能凭空揣测病情,必须询问病因然后进行治疗。
In the *Suwen: Qibing Lun* (Treatise on Rare Diseases), the Yellow Emperor asked: Those who are born with Dianji (epilepsy/seizure disorder), what is this disease called? How is it acquired? Qibo replied: This disease is named Taibing (fetal disease). It is acquired while in the mother's womb. At that time, the mother suffered a great fright, causing Qi to ascend and fail to descend. Jingqi (Essence-Qi) gathered together, thus causing the child to develop Dianji after birth.
This refers to Dianji present at birth, which is what is near-termly called Dianxian (epilepsy). Suddenly collapsing unconscious, not knowing people or surroundings, with convulsions of the hands and feet; after a short while, phlegm surges and vomiting occurs. After the phlegm-drool is vomited out, consciousness gradually returns. This is because during the fetal stage, the mother's great fright stirred up Liver Wind (Liver Wind). The fetus inherited this Qi, which combined with Essence-Qi within the body, like oil penetrating into flour. Whenever Wind Qi moves, it stirs up Phlegm-Drool, which rises to cloud the Heart Orifices, resulting in unconsciousness and sudden collapse; Wind movement causes convulsions of the hands and feet. Because Qi closure prevents normal sound production, pig-like or sheep-like sounds are made, hence the names Yangdian (Sheep Epilepsy) and Zhudian (Pig Epilepsy). Since this disease originates from the Fetal Origin (Ta Yuan), it is difficult to treat.
In the *Lingshu: Xieke Pian* (Chapter on Evil Qi Invasion), the Yellow Emperor asked: When Evil Qi invades the person, sometimes it causes inability to close the eyes and insomnia. What Qi causes this? Bo Gao replied: When five grains enter the stomach, their dregs, Jin Ye (Body Fluids), and Zong Qi (Gathering Qi) are divided into three pathways. Thus, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart vessels, and governs respiration; Ying Qi (Nutritive Qi) secretes Jin Ye, injects them into the vessels, transforms them into Blood, to nourish the four extremities, and internally irrigates the Zang-Fu organs, corresponding to the time markers of the day and night; Wei Qi (Defensive Qi) emits its fierce, swift, and slippery Qi, proceeding first among the four extremities, interstices of muscles, and skin, without rest. During the day, it travels in the Yang aspects; at night, it travels in the Yin aspects. It often passes through the divisions of Foot-Shaoyin (Kidney Meridian) and travels through the Zang-Fu organs. Now, if Jue Qi (Rebellious Qi) lodges in the Zang-Fu organs, then Wei Qi can only guard the exterior, traveling in the Yang, and cannot enter the Yin. Traveling in the Yang leads to excess Yang; excess Yang leads to stagnation/excess in the Yang Qiao Mai (Yang Heel Vessel), preventing entry into Yin, resulting in Yin deficiency, thus causing inability to close the eyes.
The circulation of Ying and Wei Qi has been detailed in the "Ying Wei Jing Luo Men" (Gate of Nutritive and Defensive Qi and Collaterals). Wei Qi travels in Yang during the day, like the sun traversing the sky; it travels in Yin at night, like the sun setting into the earth. This is how human Yin and Yang circulate in correspondence with the Yin and Yang of Heaven and Earth. Now, Jue Qi lodges in the Zang-Fu organs, conflicting with Wei Qi. Wei Qi cannot enter Yin, leading to a failure of Yin-Yang interaction, with Yang exclusively excessive on the exterior and Qi in the Yin aspect deficient. Yin deficiency and Yang excess cause inability to close the eyes (insomnia). Jue Qi may be due to external pathogens or internal injury, causing Yin-Yang rebellion and disharmony, collectively termed Jue Qi. Therefore, in all diseases caused by internal injury or external contraction, insomnia may occur. One must examine the etiology to treat it for efficacy.
The Yellow Emperor asked: How should it be treated? Bo Gao replied: Tonify the deficiency, drain the excess, regulate emptiness and fullness, unblock the pathways, and eliminate the evil. Administer one dose of Banxia Tang (Pinellia Decoction); once Yin and Yang are unblocked, sleep will follow immediately. The Yellow Emperor said: This is what is meant by dredging waterways blocked by obstruction, allowing collaterals to flow freely, and harmonizing Yin and Yang. I wish to hear the prescription. Bo Gao replied: Take eight sheng of running water from over a thousand li away, toss it ten thousand times, take five sheng of the clear part, boil it using reed firewood. When the fire boils, add one sheng of Shumi (Sorghum) and five he of processed Banxia (Pinellia Rhizome). Simmer slowly until reduced to one and a half sheng. Remove the dregs. Drink one small cup, three times a day, gradually increasing the dose until therapeutic effect is achieved. For newly onset cases, sleep comes as soon as the cup is set down; sweating indicates recovery. For chronic cases, three doses are sufficient for cure.
Spleen and Stomach belong to Central Earth and are the pathways for the ascent and descent of Yin and Yang. Yang roots in Yin and governs ascent; Spleen is Yin but its Qi ascends. Ascent means moving from interior to exterior. Yin roots in Yang and governs descent; Stomach is Yang but its Qi descends. Descent means connecting from exterior to interior. Wei Qi failing to enter Yin is because external Qi cannot move inward, due to the failure of Stomach Qi to descend and unblock. Drinking Banxia Tang descends Stomach Qi, allowing Yin-Yang communication, so sleep follows immediately. Taking long-flowing water and tossing it ten thousand times, taking the clear part, and boiling with reed firewood on strong heat utilizes its light, ascending, slippery, and flowing nature to unblock stagnation. Banxia unblocks Stomach and generates fluids; Shumi harmonizes Spleen and generates fluids. This achieves two goals with one action, so even for chronic cases, three doses suffice. This is a method to communicate Yin and Yang, treating primarily from the Spleen and Stomach, because Spleen and Stomach unify the Yin and Yang of the whole body.
In the *Suwen: Bingneng Lun* (Treatise on Disease Capabilities), the Yellow Emperor asked: Why do some people feel uneasy when lying down? Qibo replied: If Zang organs are injured, and the Spirit (Shen) has something to cling to or lodge upon, it finds peace there. Therefore, one cannot arbitrarily guess the disease.
This refers to uneasiness during sleep, i.e., inability to fall asleep. Due to excessive thinking and desires injuring the Zang organs, the Spirit lingers on certain obsessions and cannot let go, thus preventing peaceful sleep. If the obsessive mind is released/lodged elsewhere, it will naturally become peaceful. However, since we do not know what the obsession is or which Zang organ is injured—for example, excessive thought knots Qi and injures the Spleen, anger causes Qi rebellion and injures the Liver—one cannot speculate on the disease. One must inquire about the etiology to treat accordingly.