《素问·奇病论》帝曰∶病胁下满,气逆,二三岁不已,是为何病?岐伯曰∶病名息积,此不妨于食,
不可灸刺,积为导引服药,药不能独治也。
一呼一吸名一息,息根于脐中,与胁下相近,其有涎沫郁而成痰,随息积于络脉经膜之间,以致胁满气逆,
病名息积也。其腑气通利转动,故不妨于食。以积僻处肉内膜间,故久不愈而不可针灸。针灸止能通经气,不
能去积,须叠为按摩导引之法,而兼服药,药亦不能独治也。
帝曰∶人有身体髀股 皆肿,环脐而痛,是为何病?岐伯曰∶病名伏梁,此风根也。其气溢于大肠,而
着于肓,肓之原在脐下,故环脐而痛也。不可动之,动之为水溺涩之病也。
有形之邪,内伏横亘如梁,故名伏梁。盖一身皆肿为风,风邪与气血胶结成形而内伏,为风肿之根也。因
其邪气溢于大肠,滞着于肓,肓之原在脐下,故环脐而痛也。动之者,谓用针以动经气,不能抉其根,反使
邪气溢于膀胱,以成蓄水溺涩之病,则当用药内治可知。然所谓病入膏肓,其危重亦可想见矣。
《素问·腹中论》帝曰∶病有少腹盛,上下左右皆有根,此为何病?岐伯曰∶病名伏梁。帝曰∶何以得
之?岐伯曰∶裹大脓血,居肠胃之外,不可治,治之每切按之致死。帝曰∶何以然?岐伯曰∶此下则因阴,必
下脓血;上则迫胃脘生膈,挟胃脘内痈。此久病也,难治。居齐上为逆,居齐下为从,勿动亟夺。论在《刺法》中。
此亦名伏梁者,以其同前证之形状,而病邪有异,但少腹盛而身不肿也。然其邪积裹大脓血,成肠胃痈,
病已危害,故不可切按治之,每切按致死也。此在下因近二阴,必有脓血下出,若居脐上,迫胃脘而生于膈,则
近心肺,而脓血不得下出,故为逆,居脐下为从也。治之勿可妄动而亟攻夺,亦可设法导其脓血下行而已。考
《刺法论》并无伏梁证,未知其故。《灵枢·经筋篇》曰∶手少阴之筋,其病内急,心承伏梁。其成伏梁,吐脓
血者,死不治。其义大同。
黄帝问道:有人胁下胀满,气机上逆,持续两三年不愈,这是什么病?岐伯回答说:这种病名叫息积。此病不影响饮食,不能用灸法和针刺治疗,积聚之邪需要通过导引术配合服药来调理,单靠药物无法单独治愈。
一呼一吸称为一息,息的根源在脐中,与胁下部位相近。如果有涎沫郁结而成痰,随着呼吸积聚在络脉和经膜之间,导致胁下胀满、气机上逆,这种病就叫做息积。因为腑气通畅流利,所以不影响进食。由于积滞僻处于肌肉内膜之间,所以久治不愈且不宜使用针灸。针灸只能疏通经络之气,不能消除积滞,必须叠加使用按摩和导引的方法,并兼用药物治疗,但药物也不能单独起效。
黄帝问道:有人身体大腿和小腿都肿胀,环绕肚脐疼痛,这是什么病?岐伯回答说:这种病名叫伏梁,这是风邪留下的病根。风气溢于大肠,附着于肓膜,肓膜的根源在脐下,所以会出现环绕肚脐疼痛的症状。不可用攻伐之法治疗,如果强行攻动,会导致小便涩滞不通的病症。
有形之邪,内伏横亘如梁状,所以叫作伏梁。大概全身肿胀属于风邪,风邪与气血胶结形成有形之邪而内伏,成为风肿的病根。因为邪气溢于大肠,滞着于肓膜,肓膜的根源在脐下,所以环绕肚脐疼痛。所谓“动之”,是指用针法扰动经气,这不仅不能拔除病根,反而会使邪气溢入膀胱,形成蓄水、小便涩滞的病症,由此可见应当采用药物进行内治。然而所谓病入膏肓,其危重程度也可以想见了。
《素问·腹中论》记载:黄帝问道:有病证表现为少腹部胀满坚硬,上下左右都有根基,这是什么病?岐伯回答说:这种病名叫伏梁。黄帝问道:是怎么得的呢?岐伯回答说:包裹着大量的脓血,居住在肠胃之外,难以治疗,如果治疗时每次用力按压,会导致死亡。黄帝问道:为什么这样呢?岐伯回答说:病位在下则因阴分受累,必然出现便下脓血;病位在上则压迫胃脘产生膈塞,挟持胃脘内部发生痈肿。这是久病,难以治疗。病位在脐上为逆证,病位在脐下为顺证,不要急于攻夺。相关论述在《刺法》篇中。
这里所说的伏梁,是因为它具备前面所述证候的形状,但病邪有所不同,仅表现为少腹胀满而身体不肿胀。然而其邪气积聚包裹大量脓血,形成肠胃痈肿,病情已经危害生命,所以不可用力按压治疗,每次按压都会致死。此病位于下部因靠近二阴(前后阴),必然有脓血从下排出;若位于脐上,压迫胃脘而生于膈,则接近心肺,脓血不得下行排出,所以称为逆证;位于脐下则为顺证。治疗时不可妄动而急于攻夺,只可设法引导脓血下行而已。考证《刺法论》中并没有关于伏梁证的记载,不知是何缘故。《灵枢·经筋篇》说:手少阴心经的筋,发病时内部拘急,心脏支撑着伏梁。如果形成伏梁并吐出脓血的,属于死证,难以治愈。其含义大致相同。
Yellow Emperor asked: There is a condition where the hypochondrium is full and distended, with rebellious Qi, persisting for two or three years without resolution. What disease is this? Qibo replied: This disease is named Xi Ji (Breath Accumulation). It does not interfere with eating. Moxibustion and acupuncture are contraindicated. The accumulation must be treated with Daoyin (guided breathing and physical exercises) combined with herbal medicine; herbs alone cannot cure it independently.
One exhalation and one inhalation constitute one "Xi" (breath cycle). The root of breath is in the umbilicus, which is close to the hypochondrium. If saliva and foam stagnate and transform into phlegm, accumulating along with the breath in the collaterals and between the meridians and membranes, it leads to hypochondriac fullness and rebellious Qi. This disease is named Xi Ji. Since the Fu organs' Qi is smooth and flowing, it does not affect food intake. Because the accumulation resides in the secluded space between muscle layers and membranes, it persists for a long time and is unsuitable for acupuncture. Acupuncture can only unblock Meridian Qi but cannot eliminate the accumulation. One must repeatedly apply massage and Daoyin methods, accompanied by herbal medication, yet herbs also cannot act alone.
Yellow Emperor asked: There is a person whose thighs and calves are all swollen, with pain circling the umbilicus. What disease is this? Qibo replied: This disease is named Fu Liang (Hidden Beam). It is the root of Wind pathogen. Its Qi overflows into the Large Intestine and adheres to the Huang (Blind/Meng) membrane. The source of the Huang is below the umbilicus; therefore, there is pain circling the umbilicus. It must not be subjected to aggressive treatment (Dong Zhi). Aggressive treatment will lead to difficulty in urination (Shui Niao Se).
A tangible pathogen lies hidden within, crossing horizontally like a beam, hence the name Fu Liang. Generally, swelling of the whole body is due to Wind. Wind pathogen combines with Qi and Blood to form a tangible structure that lies hidden internally, becoming the root of Wind swelling. Because the pathogen overflows into the Large Intestine and stagnates in the Huang, and the source of the Huang is below the umbilicus, pain circles the umbilicus. "Aggressive treatment" refers to using needles to disturb Meridian Qi. This cannot extract the root but instead causes the pathogen to overflow into the Bladder, resulting in water retention and dysuria. Thus, internal treatment with herbs is indicated. However, as the saying goes, when the disease enters the Gao Huang (Heart Fat and Diaphragm), its critical severity can be imagined.
In *Suwen: Fuzhong Lun*, Yellow Emperor asked: There is a condition where the lower abdomen is full and hard, with roots extending up, down, left, and right. What disease is this? Qibo replied: This disease is named Fu Liang. Yellow Emperor asked: How is it acquired? Qibo replied: It wraps large amounts of pus and blood, residing outside the stomach and intestines. It is difficult to treat; if treated, each forceful pressing may cause death. Yellow Emperor asked: Why is this so? Qibo replied: If located below, it affects the Yin, inevitably leading to the passage of pus and blood in stool; if located above, it presses on the epigastrium causing obstruction, and harbors an internal abscess near the epigastrium. This is a chronic disease and difficult to treat. Located above the umbilicus is considered "Ni" (Rebellious/Adverse); located below the umbilicus is "Cong" (Compliant/Favorable). Do not move it hastily or attack it vigorously. The discussion is in the *Cifa* chapter.
This case is also named Fu Liang because it shares the shape of the previous symptoms, but the pathogen differs; here, only the lower abdomen is full while the body is not swollen. However, the pathogen accumulates, wrapping large amounts of pus and blood, forming an intestinal abscess. The disease is already life-threatening, so forceful pressing for treatment is contraindicated, as each press may cause death. Located in the lower part near the Two Yins (anterior and posterior orifices), pus and blood must exit downwards. If located above the umbilicus, pressing on the epigastrium and arising in the diaphragm, it is close to the Heart and Lungs, and pus and blood cannot drain downwards, hence it is called "Ni". Located below the umbilicus is "Cong". Treatment should avoid reckless movement and hasty attack; rather, measures should be taken to guide the pus and blood downward. Examining the *Cifa Lun*, there is no mention of Fu Liang syndrome, the reason for which is unknown. *Lingshu: Jingjin Pian* states: The sinews of the Hand Shaoyin [Heart] channel, when diseased, cause internal urgency, with the Heart supporting the Fu Liang. If Fu Liang forms and pus and blood are vomited, it is a fatal and untreatable condition. The meaning is largely the same.