《病能论》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。(言有卧而不安者,以脏
气伤而精气耗也。盖五脏为阴,各藏其精,脏有所伤而精耗也,卧不安也。必精有所寄,各在本脏而无失,则
卧斯安矣。寄者,藏也。如肝藏魂,肺藏魄之类。凡卧有不安者,血不归肝,卫气不能入于阴,此人之所以不
能悬其病者也。悬者,绝也。)人之不得偃卧者何也?(谓不得仰卧也。)肺者脏之盖也,居高布叶,四
脏下之,故言肺者,脏之盖也。)肺气盛则脉大,脉大则不得偃卧,(肺之邪气盛满,则气促喘奔,故不
得偃卧。)有病怒狂者,此病安生?生于阳也。(怒不虑祸,故谓之狂。)阳气者,因暴折而难决,
故善怒也,病名曰阳厥。(言阳气被折郁不散,或曾因暴折而心不舒畅者,皆阳逆躁极所生,病名阳厥。)
治之奈何?夺其食即已。夫食入于阴,长气于阳,故夺其食即已。(食少则气衰,故节去其
食,即病自已。)使之服以生铁落为饮。夫生铁落者,下气疾也。(取金平肝也。)
《奇病论》曰∶人有重身,九月而喑,此为何也?(重身,谓身中有身,则怀妊者也。喑,谓
不言语也。妊娠九月,足少阴脉养胎。)胞之络脉绝也。(绝,谓脉断绝不流通,而不能言,非天真之气断绝
也。)胞络者系于肾,少阴之脉,贯肾系舌本,故不能言。(少阴,肾脉也。气不营养,故舌不能言。)
无治也,当十月复。(十月胎去,胞络复通,肾脉上营,故复旧而言也。)无损不足,益有余,以成其
疹。(疹,谓久病,反法而治,则胎死不去,遂成久固之疹病。)人有病头痛以数岁不已,此安得之,名
为何病?(头痛之病,不当逾月,数年不愈,故怪而问之。)当有所犯大寒,内至骨髓,髓者以脑为
主,脑逆故令头痛,齿亦痛,(脑为髓主,齿是骨余,脑逆犯寒,骨亦寒,故令头痛齿亦痛。)病名曰
厥逆。(人先生脑,有脑则有骨髓。齿者,骨之本也。)有病口甘者,病名为何?何以得之?此五气
之溢也,名曰脾瘅。(瘅,热也。脾热则四脏同禀,故五脏上溢也。甘因脾热,故曰脾瘅。)夫五味入口,
藏于胃,脾为之行其精气,津液在脾,故令人口甘也。(脾热内渗,津液在脾,胃谷化余,精
气随溢,口通脾气,故口甘。津液在脾,是脾之湿。)此
肥美之所发也,此人必数食甘美而多肥也。肥者令人内热,甘者令人中满,故其气上
溢,转为消渴。(食肥则腠理密,阳气不得外泄,故肥令人内热。甘者性气和缓而发散逆,故令人中满。然
内热则阳气炎上,炎上则欲饮而嗌干,中满则陈气有余,有余则脾气上溢,故曰其气上溢则转为消渴也。)治之
以兰,除陈气也。(兰,兰草也。言兰除陈久甘肥不化之气者,以辛能发散也。)有病口苦,取阳陵泉,
口苦者病名为何?何以得之?病名曰胆瘅。(亦谓热也。胆汁味苦,故口苦。)夫肝者,中之将也,
取决于胆,咽为之使。(肝者,将军之官,谋虑出焉。胆者,中正之官,决断出焉。肝与胆合,气性相通,
故诸谋虑取决于胆。咽胆相应,故咽为使焉。)此人者,数谋虑不决,故胆虚气上溢而口为之苦,治
之以胆募俞。(胸腹曰募,背脊曰俞,胆募在乳下二肋外,期门下同身寸之五分。俞在脊第十椎下两旁,相
去各同身寸之一寸半。)有癃者,一日数十溲,此不足也。身热如炭,颈膺如格,人迎躁盛,
喘息气逆,此有余也。(是阳气太盛于外,阴气不足,故有余也。)太阴脉细微如发者,此不足也。
其病安在?名为何病?(癃,小便不得也。溲,小便也。颈膺如格,言颈与胸膺,如相格拒,不顺应也。人
迎躁盛,谓结喉两旁脉动,盛满急数,非常躁速也,胃脉也。太阴脉细缕如发者,谓手大指后同身寸之一寸骨
高脉动处脉,则肺脉也。此正手太阴脉气之所流,可以候于五脏也。)病在太阴,其盛在胃,颇在肺,
病名曰厥,死不治,(病癃数溲,身热如炭,颈膺如格,息气逆者,皆手太阴脉当洪大而数,今太阴脉反微
细如发者,是病与脉相反也。何以致之?肺气逆陵于胃,上使人迎躁盛,故曰病在太阴,其盛在胃也。以喘息气
逆,故云颇亦在肺也。病因气逆,证不相应,故病名曰厥,死不治也。)此所谓得五有余二不足也。所
谓五有余者,五病之气有余也。二不足者,亦病气之不足也。今外得五有余,内得二不足,此其身不表
不里,亦正死明矣。(外有五余者,一身热如炭,二颈膺如格,三人迎躁盛,四喘息,五气逆也。内二
不足者,一病癃日数十溲,二太阴脉微细如发。在表则内有二不足,在里则外得五有余,表
里既不足凭,补泻固难为法,故曰此其身不表不里,亦正死明矣。)人生而有病颠疾者,病名曰何?安
所得之?(百病皆生于风雨寒暑,阴阳喜怒,然始生未犯邪气,已有颠疾,岂邪气素伤。巅,谓上巅,则头首
也。)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
子发为巅疾也。(精气,谓阳之精气也。言人初生有顶巅之疾者,胎中之病也。在腹之时,母有大惊,气上
而不下,精气并居于上,令子发为巅疾。)
《病能论》说:有人睡觉时感到不安稳,这是为什么呢?岐伯回答说:内脏受到损伤,精气有所耗散,所以不能安稳(意思是:有睡觉不安稳的,是因为脏气受伤而精气耗损。五脏属阴,各自藏纳精气,如果脏腑受伤导致精气耗散,就会睡眠不安。必须精气有所归藏,各守其本脏而不流失,才能安睡。所谓“寄”,就是“藏”的意思。比如肝藏魂,肺藏魄等。凡是睡觉不安稳的,都是血不归肝,卫气不能入于阴分,这就是人之所以不能安稳患病的原因。“悬”意为断绝、隔绝)。
人不能仰卧是怎么回事呢?(指不能仰面躺卧。)肺是五脏的华盖,位置最高,像树叶一样布散,覆盖在其余四脏之下,所以说肺是五脏的华盖。肺气盛满则脉象变大,脉象变大就不能仰卧。(肺中邪气盛满,就会导致气促喘急,所以不能仰卧。)
有的人发怒发狂,这种病是怎么产生的?产生于阳分。(发怒不顾祸患,所以称为狂。)阳气因为突然受挫而难以疏泄,所以容易发怒,这种病名叫阳厥。(意思是阳气被郁结阻滞而不能发散,或者曾经因突然受挫而心情不畅,这些都是阳气逆乱躁动至极所生,病名叫做阳厥。)
怎么治疗呢?限制他的饮食即可痊愈。食物进入体内转化为阴精,助长阳气,所以限制饮食就能痊愈。(吃得少则气衰,所以节制饮食,病自然就好了。)让他服用生铁落煎成的汤剂。生铁落具有迅速降气的作用。(取金克木以平抑肝气之意。)
《奇病论》说:孕妇怀孕到第九个月时失音,这是什么原因呢?(重身,指身中有身,即怀孕。喑,指不能说话。妊娠九月,足少阴肾经滋养胎儿。)胞宫的络脉阻滞不通。(绝,指脉络断绝不流通,导致不能说话,并非先天真气断绝。)胞络连接着肾脏,足少阴肾经贯穿肾脏并联系舌根,所以不能说话。(少阴,即肾脉。气不能营养舌体,所以舌头不能言语。)不需要治疗,等到第十个月分娩后自然会恢复。(十月胎去,胞络重新通畅,肾脉上荣,所以恢复旧状并能说话。)不要对不足者再施泻法,对有余者再施补法,以免形成久治不愈的痼疾。(疹,指久病。如果用反常的方法治疗,会导致胎死腹中不去,从而形成顽固难愈的疾病。)
有的人头痛几年都不愈,这是怎么得的?叫什么病?(头痛的病,不应超过一个月,数年不愈,所以奇怪地询问它。)一定是遭受了大寒之邪,寒气深入骨髓。髓由脑所主,脑气上逆所以引起头痛,牙齿也痛,(脑为髓之主,齿为骨之余,脑气上逆犯寒,骨骼也受寒,所以引起头痛和牙痛。)这种病名叫厥逆。(人先生成脑,有脑则有骨髓。齿是骨的根本。)
有的人口甜,这叫什么病?怎么得的?这是五气溢出的表现,名叫脾瘅。(瘅,指热。脾热则四脏同受其害,所以五脏之气上溢。甘味因脾热而生,所以叫脾瘅。)五味入口,储藏于胃,脾为之运化精气。津液滞留于脾,所以使人感觉口甜。(脾热内渗,津液滞留于脾,胃中谷物化生的余气,精气随之溢出,口通脾气,所以口甜。津液滞留于脾,即是脾湿。)
这是由于肥甘厚味引起的,这个人一定经常食用甜美且多脂肪的食物。肥腻的食物使人内生热气,甘甜的食物使人中焦痞满,所以气机上溢,进而转变为消渴病。(吃肥肉则腠理致密,阳气不能外泄,所以肥腻令人内热。甘味性气和缓但易导致气机发散受阻,所以令人中焦痞满。然而内热则阳气炎上,炎上则想喝水且咽喉干燥;中焦痞满则陈积之气有余,有余则脾气上溢,所以说气机上溢就转变为消渴病。)用兰草治疗,以去除陈久的积滞之气。(兰,即兰草。意思是兰草能消除长久以来甘肥不化的积气,因为辛味能发散。)
有的人口苦,取阳陵泉穴治疗。口苦这叫什么病?怎么得的?病名叫胆瘅。(也是指热。胆汁味苦,所以口苦。)肝是中军的将领,取决于胆的决断,咽部是胆气的通道。(肝是将军之官,谋虑由此发出。胆是中正之官,决断由此发出。肝与胆相合,气性相通,所以各种谋虑取决于胆。咽与胆相应,所以咽作为通道。)这种人常常谋虑不决,导致胆虚气上溢而口苦,治疗应取胆的募穴和俞穴。(胸腹部穴位叫募,背部脊柱旁穴位叫俞。胆募穴在乳下第二肋外,期门穴下同身寸五分处。胆俞穴在背部第十椎下两旁,距离中线各同身寸一寸半处。)
有的人小便不利,一天几十次排尿,这是正气不足的表现。身体发热像火炭一样,颈部和胸膺部感觉像被格拒一样不适,人迎脉搏动躁动旺盛,喘息气逆,这是邪气有余的表现。(这是阳气太盛于外,阴气不足,所以表现为有余。)手太阴肺脉细微如头发丝一样,这是正气不足的表现。病在哪里?叫什么病?(癃,指小便不通。溲,指小便。颈膺如格,指颈部和胸膺部,像相互格拒,不顺应。人迎躁盛,指喉结两旁脉搏跳动,盛满急数,非常躁速,这是胃脉。太阴脉细缕如发,指手大拇指后方同身寸一寸高骨处脉搏跳动的位置,即肺脉。这正是手太阴脉气流动之处,可以以此候察五脏之气。)
病在太阴,其盛实在胃,同时也涉及肺,病名叫厥,属于死证,不可治愈,(患癃闭且频繁排尿,身体热如炭火,颈胸如格拒,呼吸气逆,这些症状本该是手太阴脉洪大而数,现在太阴脉反而细微如发,这是病证与脉象相反。为什么会这样?肺气逆乱侵犯胃,向上导致人迎脉躁动旺盛,所以说病在太阴,其盛在胃。因为喘息气逆,所以说也涉及肺。病因是气逆,证候与脉象不相符合,所以病名叫厥,属于死证不可治愈。)这就是所谓的“五有余二不足”。所谓五有余,是指五种病气有余。二不足,也是指病气不足。现在外面表现出五有余,里面表现出二不足,这说明病情表里俱败,也是明确的死证。(外在的五有余,是一身热如炭火,二是颈胸如格拒,三是人迎脉躁盛,四是喘息,五是气逆。内在的二不足,一是患癃闭每天几十次排尿,二是太阴脉微细如发。在表则有内在的二不足,在里则有外在的五有余,表里既无法凭据,补泻之法也难以施行,所以说这种情况表里俱败,确实是死证无疑。)
人生下来就有癫疾,这叫什么病?怎么得的?(百病都生于风雨寒暑、阴阳喜怒,但在出生之初未犯邪气时,就已经有癫疾,难道不是邪气素来伤害吗?巅,指头顶,即头部。)这种病名叫胎病,这是在母腹中时获得的。当时母亲受到极大的惊吓,气机上逆而不能下行,精气并聚于上,所以导致孩子发生巅疾。(精气,指阳之精气。意思是人生下来就有头顶部的疾病,是胎中的病。在腹中时,母亲有大惊,气上逆不下行,精气并聚于上部,导致孩子发生巅疾。)
*Yi Neng Lun* (Treatise on Disease Manifestations) states: Why do some people feel uneasy when sleeping? Qibo replied: When the internal organs are injured and the essence (*Jing*) is dissipated, one cannot sleep peacefully. (This means that those who sleep uneasily do so because their organ qi is damaged and their essence is depleted. The five zang organs belong to Yin and each stores its own essence; if the zang organs are injured and the essence is depleted, sleep will be restless. Only when the essence has a place to reside—stored in its respective zang organ without loss—can one sleep peacefully. "Reside" here means "to store." For example, the Liver stores the Hun [ethereal soul], and the Lung stores the Po [corporeal soul]. In all cases of restless sleep, blood does not return to the Liver, and the Wei [defensive] Qi fails to enter the Yin. This is why people suffer from such disturbances. "Xuan" implies severance or isolation.)
Why can some people not lie supine? (This refers to the inability to lie on one's back.) The Lung is the canopy of the five zang organs; it occupies the highest position and spreads out like leaves, covering the other four zang organs below it. Therefore, the Lung is called the canopy of the zang organs. When Lung Qi is excessive, the pulse becomes large; when the pulse is large, one cannot lie supine. (When pathogenic Qi in the Lung is full and excessive, it causes shortness of breath and panting, thus preventing supine positioning.)
Some people suffer from anger and mania. How does this disease arise? It arises from Yang. (Anger disregards disaster, hence it is called mania.) The Yang Qi, having suffered sudden frustration and difficult resolution, leads to frequent anger. This disease is named Yang Jue [Yang Reversal]. (This means that Yang Qi is constrained and stagnant, unable to disperse, or previously caused by sudden frustration leading to emotional stagnation. These are all generated by extreme rebellion and agitation of Yang Qi, and the disease is named Yang Jue.)
How should it be treated? Restricting their food intake will cure it. Food enters and transforms into Yin, thereby nourishing Yang; therefore, restricting food intake cures the condition. (Eating less reduces Qi generation; thus, dietary restriction allows the disease to resolve itself.) Administer them a decoction made from *Sheng Tie Luo* (Fallen Pig Iron). *Sheng Tie Luo* has a rapid descending effect on Qi. (This utilizes the Metal element to subdue Wood/Liver.)
*Qi Bing Lun* (Treatise on Strange Diseases) states: A pregnant woman loses her voice in the ninth month. What is the reason for this? ("Chong Shen" [Double Body] refers to being pregnant. "Yin" refers to aphonia. In the ninth month of pregnancy, the Foot-Shaoyin Kidney Meridian nourishes the fetus.) The collateral vessels of the uterus are obstructed. ("Jue" here means obstruction of the vessels, preventing speech, not the severance of innate vital Qi.) The uterine collaterals connect to the Kidney. The Foot-Shaoyin Kidney Meridian passes through the Kidney and connects to the root of the tongue; therefore, the patient cannot speak. (Shaoyin refers to the Kidney meridian. If Qi fails to nourish the tongue, speech is impaired.) No treatment is needed; speech will recover after the tenth month. (After delivery in the tenth month, the uterine collaterals reopen, the Kidney meridian ascends to nourish, and normal function returns.) Do not treat deficiency with draining methods, nor treat excess with tonifying methods, lest you create a chronic, entrenched disease. ("Zhen" here refers to chronic illness. Using contrary treatment methods may cause fetal death and retention, leading to stubborn, long-standing pathology.)
Some people suffer from headache for several years without relief. How did they acquire this? What is the disease name? (Headache should not persist beyond a month; since it lasts for years, we inquire curiously about it.) It must be due to exposure to severe Cold, which penetrated inward to the bone marrow. Marrow is governed by the Brain. When Brain Qi rebels upward, it causes headache, and the teeth also hurt. (The Brain is the master of Marrow; teeth are the surplus of Bone. When Brain Qi rebels against Cold, the bones also become cold, causing both headache and toothache.) This disease is named Jue Ni [Reversal Counterflow]. (Humans form the Brain first; where there is Brain, there is bone marrow. Teeth are the root of Bone.)
Some people have a sweet taste in their mouths. What is this disease called? How is it acquired? This is an overflow of the Five Qi, named Pi Dan [Spleen Heat/Dysentery]. ("Dan" means heat. Spleen heat affects the other four zang organs, causing an overflow of Qi from all five zang organs. Sweetness arises from Spleen heat, hence it is called Pi Dan.) The five flavors enter the mouth and are stored in the Stomach. The Spleen transports their essence and qi. When fluid-dampness remains in the Spleen, it causes a sweet sensation in the mouth. (Spleen heat seeps inward, fluid-dampness stays in the Spleen, and the residual essence from grain digestion overflows. Since the mouth communicates with Spleen Qi, a sweet taste results. Fluid-dampness remaining in the Spleen indicates Spleen dampness.)
This arises from rich and fatty foods. Such individuals must frequently consume sweet and fatty foods. Fatty foods generate internal heat, and sweet foods cause middle-jiao fullness. Consequently, Qi overflows upward, transforming into Xiao Ke [Wasting-Thirst Syndrome]. (Consuming fat makes the pores tight, preventing Yang Qi from dissipating outward, thus causing internal heat. Sweet flavors are mild but can obstruct Qi dispersion, causing middle-jiao fullness. Internal heat causes Yang Qi to flare upward, leading to thirst and dry throat. Middle-jiao fullness implies an excess of stale Qi; this excess causes Spleen Qi to overflow upward. Thus, Qi overflow transforms into Wasting-Thirst.) Treat it with Lan Cao [Coix Seed/Orchid Grass] to remove stale Qi. (Lan refers to Orchid Grass. It eliminates the stale Qi accumulated from long-term consumption of sweet and fatty foods, as pungent flavors promote dispersion.)
Some people have a bitter taste in their mouths. Acquire Yanglingquan (GB34) for treatment. What is the disease name for bitter taste? How is it acquired? The disease is named Dan Dan [Gallbladder Heat]. (Also referring to heat. Bile tastes bitter, hence the bitter taste.) The Liver is the general of the interior, relying on the Gallbladder for decision-making. The pharynx serves as its conduit. (The Liver is the official of the General, originating strategic planning. The Gallbladder is the official of Equilibrium, originating decisiveness. The Liver and Gallbladder are internally-externally related and share similar natures; thus, all planning depends on the Gallbladder. The pharynx corresponds to the Gallbladder, serving as the passage.) Such individuals often deliberate without deciding, causing Gallbladder deficiency and Qi reflux, resulting in a bitter taste. Treatment involves the Front-Mu and Back-Shu points of the Gallbladder. (Mu points are located on the chest and abdomen; Shu points are on the back. The Gallbladder Mu point is at Qimen (LR14), 0.5 cun below the nipple in the second intercostal space. The Gallbladder Shu point is at Dajiao (BL19), 1.5 cun lateral to the lower border of the spinous process of the 10th thoracic vertebra.)
Some patients experience Lin [Dysuria/Obstruction], urinating dozens of times a day. This indicates deficiency. Their body feels hot like a charcoal brazier, the neck and chest feel obstructed or rejected, the Renying (ST9) pulse is agitated and vigorous, accompanied by panting and rebellious Qi. This indicates excess. (This signifies excessive Yang Qi on the exterior and insufficient Yin Qi internally, presenting as excess.) The Taiyin (Lung) pulse is fine and thread-like, resembling hair. This indicates deficiency. Where is the disease located? What is the disease name? (Lin refers to urinary difficulty. Sou refers to urine. "Neck and chest like rejection" means the neck and chest feel stiff and unyielding. "Renying agitated and vigorous" refers to the pulsation at the sides of the larynx being full, rapid, and unusually agitated, indicating the Stomach meridian. "Taiyin pulse fine as hair" refers to the pulse at the radial artery near the thumb, indicating the Lung meridian. This is where Hand-Taiyin Qi flows and can be used to observe the five zang organs.)
The disease is in Taiyin, but the excess is in the Stomach, and it significantly involves the Lung. The disease is named Jue [Reversal], and it is a fatal, untreatable condition. (Symptoms of Lin with frequent urination, body heat like charcoal, neck/chest obstruction, and rebellious Qi should present with a洪大 (surging-large) and rapid Taiyin pulse. However, the Taiyin pulse is instead fine and thread-like. This contradiction arises because Lung Qi rebels and invades the Stomach, causing the Renying pulse to become agitated. Hence, the disease is in Taiyin, with excess in the Stomach. Due to panting and rebellious Qi, it also involves the Lung. Because the etiology is Qi rebellion and the symptoms contradict the pulse, it is named Jue and is considered fatal.) This is referred to as "Five Excesses and Two Deficiencies." The "Five Excesses" refer to excess in five pathological aspects. The "Two Deficiencies" refer to insufficiency in two pathological aspects. Currently, there are five excesses externally and two deficiencies internally. This indicates a collapse of both exterior and interior, confirming a fatal prognosis. (The external five excesses are: 1. Body heat like charcoal, 2. Neck/chest obstruction, 3. Agitated Renying pulse, 4. Panting, 5. Rebellious Qi. The internal two deficiencies are: 1. Lin syndrome with frequent urination, 2. Fine/thread-like Taiyin pulse. If viewed from the exterior, there are internal deficiencies; if viewed from the interior, there are external excesses. With both exterior and interior compromised, tonification and drainage methods are ineffective, confirming this as a clear case of death.)
Some people are born with Dian Ji [Epilepsy/Convulsive Disorder]. What is this disease called? How is it acquired? (All diseases arise from wind, rain, cold, heat, yin-yang imbalances, and emotions. However, if Dian Ji exists before any pathogenic invasion, it suggests prenatal factors. "Dian" refers to the vertex of the head.) This disease is named Tai Bing [Prenatal Disease]. It is acquired while in the mother's womb. At that time, the mother experienced severe fright. The Qi rushed upward and failed to descend, causing essence and Qi to congregate above, leading the child to develop Dian Ji. (Essence and Qi here refer to Yang essence. Individuals born with vertex disorders have prenatal conditions. During gestation, maternal severe fright causes Qi to rebel upward, congregating essence and Qi in the upper body, inducing Dian Ji in the fetus.)