《素问·经脉别论》帝曰∶人之居处、动静、勇怯,脉亦为之变乎?岐伯曰∶凡人之惊恐、恚劳、动
静,皆为变也。是以夜行则喘出于肾,淫气病肺;有所堕恐,喘出于肝,淫气害脾;有所惊恐,喘出于肺,
淫气伤心;度水跌仆,喘出于肾与骨,当是之时,勇者气行则已,怯者则着而为病。故曰∶诊病之道,观人勇
怯、骨肉、皮肤,能知其情,以为诊法也。
此言七情劳力,皆扰动身心,其禀强者,气血流行,旋即安和无患,怯者因而气血滞着成病。故凡临证,
当观其形气强弱,察其病由,以为延医要法也。
故饮食饱甚,汗出于胃;惊而夺精,汗出于心;持重远行,汗出于肾;疾走恐惧,汗出于肝;摇体劳苦,
汗出于脾。故春夏秋冬,四时阴阳生病,起于过用,此为常也。
经言夺血者无汗,夺汗者无血,是汗与血,同由水谷精气所化,而出于一源者。有所劳伤,以动五脏精气,
即与胃中水谷之精,随气上注于肺,遂化汗由皮腠而外泄也。是故春夏秋冬之四时,阴阳气血之生病,起于过
用心力,劳伤所致,此为常也。
《灵枢·大惑论》帝曰∶人之善忘者,何气使然?岐伯曰∶上气不足,下气有余,肠胃实而心肺虚,虚则营
卫留于下,久之不以时上,故善忘也。
善忘者,后世名健忘,以心肺清阳气虚,故神不精明而善忘。清阳上虚,则浊阴不降,故肠胃实,腑不转
动,而营卫之气因之不得旋运,留滞于下而不升,心主营,肺主卫,其气不以时上,故心肺虚而善忘也。
黄帝问道:人的居住环境、活动状态以及性格的勇敢或怯懦,是否也会使脉象发生变化?岐伯回答说:凡是人们的惊恐、愤怒和疲劳,以及动静状态的变化,都会引起脉象的改变。因此,夜间行走则气喘出自肾经,邪气淫溢而伤害肺脏;从高处坠落或受到惊吓,气喘出自肝经,邪气淫溢而损害脾脏;突然受惊或恐惧,气喘出自肺经,邪气淫溢而损伤心脏;渡水或跌倒受伤,气喘出自肾与骨骼。在这个时候,体质强健的人,正气运行通畅,病邪随即消散;体质虚弱的人,邪气就会停留并导致疾病。所以说:诊断疾病的道理,在于观察病人的勇敢或怯懦、骨肉强弱、皮肤状况,从而了解其病情,作为诊断的方法。
这段话讲的是七情(喜、怒、忧、思、悲、恐、惊)和劳力过度,都会扰动身心。禀赋强壮的人,气血流行顺畅,很快就能恢复安和而没有祸患;禀赋怯弱的人,因此导致气血停滞而形成疾病。所以凡是在临证时,应当观察病人的形体和元气强弱,考察疾病的由来,这是延请医生诊治的重要法则。
因此,饮食过饱,汗液出于胃;受惊导致精气耗夺,汗液出于心;负重远行,汗液出于肾;快速奔跑且恐惧,汗液出于肝;身体摇动且劳作辛苦,汗液出于脾。所以春夏秋冬四季,因阴阳失调而产生的疾病,都起于过度使用,这是常理。
经文说:失血的人不宜发汗,大汗淋漓的人不宜放血,这说明汗与血,都是由水谷的精微之气所化生,而出自同一源头。如果有劳伤,动摇了五脏的精气,就会与胃中水谷的精微一起,随着气机上注于肺,进而化为汗液,从皮毛腠理向外泄出。因此,春夏秋冬四季,因阴阳气血失调而产生的疾病,都起于过度用心力和劳伤所致,这是常理。
《灵枢·大惑论》记载:黄帝问道:人容易健忘,是什么气造成的?岐伯回答说:上部的气不足,下部的气有余,肠胃充实而心肺虚弱。虚弱则营气和卫气滞留于下部,久而久之不能按时上行,所以容易健忘。
所谓善忘,后世称为健忘。因为心肺的清阳之气虚弱,所以神志不能清明而容易健忘。清阳在上部虚弱,则浊阴不能下降,所以肠胃充实,腑气不转动,而营卫之气因此不能旋转运化,留滞于下部而不能上升。心主司营气,肺主司卫气,它们的气不能按时上行,所以心肺虚弱而导致健忘。
Huangdi asked: Do a person's living environment, activity level, and courage or timidity also cause changes in the pulse? Qibo replied: All instances of fright, anger, fatigue, movement, and stillness among people result in such changes. Therefore, walking at night causes panting originating from the Kidney channel, with pathogenic qi overflowing to damage the Lung; falling from a height or experiencing fright causes panting originating from the Liver channel, with pathogenic qi overflowing to harm the Spleen; sudden fright or terror causes panting originating from the Lung channel, with pathogenic qi overflowing to injure the Heart; wading through water or suffering falls causes panting originating from the Kidney and bones. At such times, those who are courageous have smooth Qi circulation and recover quickly, while those who are timid suffer from lingering pathogens that cause disease. Thus it is said: The way to diagnose disease lies in observing a patient's courage or timidity, the strength of their sinews and bones, and the condition of their skin, thereby understanding their condition as a diagnostic method.
This passage states that the Seven Emotions (Joy, Anger, Worry, Thought, Sadness, Fear, Fright) and physical overexertion all disturb the mind and body. Those with strong constitution have smooth Qi and Blood circulation and soon return to harmony without illness; those with weak constitution suffer from stagnant Qi and Blood, leading to disease. Therefore, in clinical practice, one must observe the strength of the patient's form and Yuan Qi (Original Qi), investigate the origin of the disease, which is a crucial method for seeking medical treatment.
Thus, excessive fullness from eating causes sweat to emerge from the Stomach; fright causing depletion of Jing (Essence) causes sweat to emerge from the Heart; carrying heavy loads and traveling far causes sweat to emerge from the Kidney; running fast and feeling fear causes sweat to emerge from the Liver; bodily shaking and arduous labor causes sweat to emerge from the Spleen. Therefore, diseases arising from Yin-Yang imbalance across the four seasons of Spring, Summer, Autumn, and Winter all stem from overuse, which is the normal pattern.
The Classics state: "Those who have lost blood should not be sweated; those who have suffered excessive sweating should not have blood let." This indicates that Sweat and Blood are both transformed from the essence of water and grain, originating from the same source. When labor or injury disturbs the essence of the Five Zang Organs, it combines with the essence of water and grain in the Stomach, ascends with Qi to the Lung, transforms into sweat, and leaks out through the skin and interstices. Hence, diseases of Yin-Yang and Qi-Blood arising in the four seasons all result from mental and physical overexertion, which is the normal pattern.
In *Ling Shu: Da Huo Lun*, Huangdi asked: What causes a person to be prone to forgetfulness? Qibo answered: Insufficiency of Upper Qi, excess of Lower Qi, fullness of the Intestines and Stomach, and deficiency of the Heart and Lungs. Due to this deficiency, Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) remain stagnant in the lower part, and after a long time fail to ascend when they should, thus causing forgetfulness.
Forgetfulness, known in later generations as Jian Wang (Impaired Memory), occurs because the Clear Yang Qi of the Heart and Lung is deficient, causing the Shen (Spirit) to lack clarity and resulting in forgetfulness. When Clear Yang is deficient in the upper part, Turbid Yin fails to descend, leading to fullness in the Intestines and Stomach. The Fu organs fail to transform and move, causing Ying and Wei Qi to stagnate in the lower part and fail to ascend. Since the Heart governs Ying Qi and the Lung governs Wei Qi, their Qi fails to ascend on time, resulting in deficiency of the Heart and Lung and consequently forgetfulness.