《脏气法时论》曰∶夫邪气之客于身也,以胜相加,(邪者,不正之目,风寒暑湿饥饱劳逸是也。)
至其所生而愈,(谓至己所生也。)至其所不胜而甚,(谓至克己之气也。)至于所生而持,(谓至生己之
气也。)自得其位而起。(居所主处,谓自得其位也。)肝病者,两胁下痛引少腹,令人善怒,(肝厥
阴脉,自足而上,环阴器,抵少腹,又上贯肝鬲,布于胁肋,故两胁下痛引少腹,其气实则善怒。)虚则目KT
KT无所见,耳无所闻,善恐如人将捕之。(肝厥阴脉,自胁肋循喉咙入颃颡连目系。胆少阳脉,其支
者,从耳后耳中出走耳前至目锐 后。故病如是也。恐,谓恐惧,魂不安也。)心病者,胸中痛,胁支满,
胁下痛,膺背肩甲间痛,两臂内痛,(心少阴脉,支别者,循胸出胁。又手心主厥阴之脉,起于胸中;
其支别者,亦循胸出胁,下腋三寸,上抵腋下,下循 内,行太阴少阴之间,入肘中,下循臂行两筋之间。又
心少阴之脉,直行者,复从心系却上肺,上出腋下,下循 内后廉,行太阴心主之后,下肘内,循臂后内廉抵
掌后锐骨之端。又小肠太阳之脉,自臂 上绕肩甲,交肩上。故病如是。)虚则胸腹大,胁下与腰相引
而痛。(手心主厥阴之脉,从胸中出属心包,下鬲历络三焦;其支别者,循胸出胁。心少阴之脉,自心系下鬲
络小肠。故病如是。)脾病者,身重善肌肉痿,足不收行,善 脚下痛,( ,小儿病。脾象土而主
肉,故身重肉痿也。脾太阴之脉,起于足大指之端,循指内侧上内踝前廉,上 内。肾少阴之脉,起于足小指
之下,斜趋足心,上 内,出 内廉。故病如是,则足不收行,善 ,脚下痛也。)虚则腹满肠鸣,飧泄
食不化。(脾太阴脉,从股内前廉入腹属脾络胃,故病如是。《灵枢经》曰∶中气不足,则腹为之善满,肠为之
善鸣。)肺病者,喘咳逆气,肩背痛,汗出尻阴股膝髀 足皆痛,(肺藏气而主喘息,在变动
为咳,故病则喘咳逆气也。背为胸中之府,肩接近之,故肩背痛也。肺养皮毛,邪盛则心液外泄,故汗出也。肾
少阴之脉,从足下上循 内出 内廉,上股内后廉,贯脊属肾络膀胱。今肺病则肾脉受邪,故尻阴股膝髀
足皆痛。)虚则少气不能报息,耳聋嗌干。(气虚少,故不足以报息也。肺太阴之络会于耳中,故聋也。肾
少阴之脉,从肾上贯肝鬲入肺中,循喉咙侠舌本。今肺虚则肾气不足,不能上润于咽,故以嗌干也。)肾病者,
腹大胫肿,喘咳身重,寝汗出憎风,(肾少阴
脉,起于足面上循 ,复从横骨中侠脐循腹里上行而入肺,故腹大胫肿而喘咳也。肾病则骨不能用,故身重也。
肾邪攻肺,心气内微,心液为汗,故寝汗出也。胫既肿矣,汗复津泄,阴凝玄府,阳灼上焦,内热外寒,故汗
出憎风也。)虚则胸中痛,大腹小腹痛,清厥意不乐。(肾少阴脉,从肺出络心,注胸中。肾气既虚,心
无所制,心气灼肺,故痛聚胸中也。足太阳脉,从项下行而至足,肾虚则太阳之气不能盛行于足,故足冷而气
逆也。清,谓气冷。厥,谓气逆也。以清冷气逆,故大腹小腹痛。志不足则神躁扰,故不乐也。)
《脏气法时论》说:邪气侵犯人体,遵循五行相克的规律相互作用。(所谓“邪”,是指不正之气,包括风、寒、暑、湿、饥饱、劳、逸等。)当病情发展到其所生(即我生者)的时辰或阶段则痊愈,(指到了由本脏所生的脏腑气旺之时。)当病情发展到其所不胜(即克我者)的时辰或阶段则加重,(指到了克制本脏的气旺之时。)当病情发展到所生(即生我者)的时辰或阶段则维持现状,(指到了生助本脏的气旺之时。)当处于本脏所主的时辰或阶段则发作或起病。(指处于本脏气旺的主位之时。)
肝脏发生病变时,两侧胁肋下疼痛并牵引至小腹,使人容易发怒。(足厥阴肝经,从足部向上,环绕生殖器,抵达小腹,又向上穿过膈肌,分布于胁肋,所以两胁下疼痛牵引小腹;肝气实则容易发怒。)肝气虚弱时,眼睛昏花看不清东西,耳朵听不见声音,容易恐惧,好像有人要抓捕自己一样。(足厥阴肝经,从胁肋沿喉咙上行,进入颃颡,连接目系。足少阳胆经,其分支从耳后入耳中,出走耳前,至目外角后方。所以出现上述病症。恐,指恐惧,神魂不安。)
心脏发生病变时,胸中疼痛,胁肋支撑胀满,胁下疼痛,胸部、背部、肩胛间疼痛,双臂内侧疼痛。(手少阴心经,其分支从胸部出于胁部。另外手厥阴心包经,起于胸中;其分支也循行胸部出于胁部,向下腋下三寸,向上抵腋下,向下沿上臂内侧,行在手太阴肺经和手少阴心经之间,进入肘中,向下沿前臂行于两筋之间。另外手少阴心经直行者,又从心系向上返肺,出于腋下,向下沿上臂内侧后缘,行在手太阴肺经和手厥阴心包经之后,向下进入肘内,沿前臂后内侧,抵掌后高骨端。另外手太阳小肠经,自手臂上绕肩胛,交会于肩上。所以出现上述病症。)心气虚弱时,胸腹部胀大,胁下与腰部相互牵引而痛。(手厥阴心包经,从胸中出来属于心包,向下穿过膈肌,依次联络三焦;其分支循行胸部出于胁部。手少阴心经,从心系向下穿过膈肌,联络小肠。所以出现上述病症。)
脾脏发生病变时,身体沉重,容易肌肉萎缩无力,脚不能收持行走,容易足底疼痛,( ,指小儿疳积病。脾象土而主肌肉,所以身体沉重、肌肉萎缩。足太阴脾经,起于足大趾末端,沿足趾内侧上行至内踝前缘,向上沿小腿内侧。足少阴肾经,起于足小趾之下,斜趋足心,向上沿小腿内侧,出内踝前缘。所以出现上述病症,导致脚不能收持行走,容易患 病,足底疼痛。)脾气虚弱时,腹部胀满,肠鸣,完谷不化的泄泻。(足太阴脾经,从大腿内侧前缘进入腹部,属于脾,联络胃,所以出现上述病症。《灵枢经》说:中气不足,则腹部容易胀满,肠道容易鸣响。)
肺脏发生病变时,气喘咳嗽,气逆,肩背疼痛,出汗,尻骨、阴部、大腿、膝盖、髀部、小腿及足部都疼痛,(肺藏气而主管喘息,在变动时为咳嗽,所以生病时会出现气喘咳嗽气逆。背部是胸中之府,肩部接近之,所以肩背疼痛。肺滋养皮毛,邪气盛则心液外泄为汗,所以出汗。足少阴肾经,从足底向上沿小腿内侧,出内踝前缘,向上沿大腿内侧后缘,贯穿脊柱,属于肾,联络膀胱。现在肺病则肾脉受邪,所以尻骨、阴部、大腿、膝盖、髀部、足部都疼痛。)肺气虚弱时,气短不足以接续呼吸,耳聋,咽喉干燥。(气虚少,所以不足以接续呼吸。手太阴肺经的络脉会合于耳中,所以耳聋。足少阴肾经,从肾脏向上穿过肝膈进入肺中,沿喉咙夹舌根。现在肺虚则肾气不足,不能向上滋润咽喉,所以咽喉干燥。)
肾脏发生病变时,腹部肿大,小腿肿胀,气喘咳嗽,身体沉重,睡中出汗,怕风,(足少阴肾经,起于足面,沿小腿上行,再从横骨中夹脐沿腹里上行进入肺,所以腹部肿大、小腿肿胀且气喘咳嗽。肾病则骨骼不能用,所以身体沉重。肾邪攻肺,心气内微,心液化为汗,所以睡中出汗。小腿既已肿胀,汗又津液外泄,阴凝玄府,阳灼上焦,内热外寒,所以出汗且怕风。)肾气虚弱时,胸中疼痛,大腹和小腹疼痛,四肢清冷厥逆,意志消沉不乐。(足少阴肾经,从肺出来联络心,注入胸中。肾气既虚,心无所制,心气灼肺,所以疼痛聚集于胸中。足太阳膀胱经,从项部下行至足,肾虚则太阳之气不能在足部盛行,所以足冷且气逆。清,指气冷;厥,指气逆。因为清冷气逆,所以大腹和小腹疼痛。志不足则神躁扰,所以不快乐。)
The *Zangqi Fashi Lun* (Treatise on the Viscera and Their Correspondence to Time) states: When pathogenic factors invade the body, they interact according to the principle of mutual overcoming. (By "pathogenic factors" is meant improper influences, such as wind, cold, summer-heat, dampness, irregular diet, fatigue, and inactivity.) The condition improves when it reaches the phase generated by the affected organ (i.e., when the qi of the organ generated by the diseased viscus becomes prosperous). The condition worsens when it reaches the phase that overcomes the affected organ (i.e., when the qi that overcomes the diseased viscus becomes prosperous). The condition persists when it reaches the phase that generates the affected organ (i.e., when the qi that generates the diseased viscus becomes prosperous). The condition arises or exacerbates when it occupies its own dominant position (i.e., when the qi of the diseased viscus itself becomes prosperous).
In liver disease, there is pain in both hypochondriac regions radiating to the lower abdomen, causing irritability. (The Foot-Jueyin Liver Meridian ascends from the foot, circles the external genitalia, reaches the lower abdomen, pierces through the diaphragm, and distributes along the hypochondriac and costal regions; hence, pain in the hypochondriac region radiates to the lower abdomen. Excess liver qi leads to irritability.) In liver deficiency, vision becomes blurred and unclear, hearing diminishes, and there is excessive fear, as if being pursued by someone. (The Foot-Jueyin Liver Meridian runs from the hypochondriac region along the throat, enters the pharynx, and connects with the eye system. The Foot-Shaoyang Gallbladder Meridian has a branch that enters the ear from behind, emerges anterior to the ear, and reaches the lateral canthus. Thus, these symptoms occur. Fear refers to fright and unsettled soul.)
In heart disease, there is pain in the chest, distending fullness in the hypochondriac region, pain below the ribs, pain in the chest, back, and between the shoulder blades, and pain in the medial aspect of both arms. (The Hand-Shaoyin Heart Meridian has a branch emerging from the chest to the hypochondriac region. Additionally, the Hand-Jueyin Pericardium Meridian originates in the chest; its branch also follows the chest to emerge at the hypochondriac region, descends three cun below the axilla, ascends to the axilla, descends along the medial upper arm, running between the Hand-Taiyin Lung Meridian and the Hand-Shaoyin Heart Meridian, entering the elbow, and descending along the forearm between two tendons. Furthermore, the direct course of the Hand-Shaoyin Heart Meridian returns from the heart connection to ascend into the lung, emerges from the axilla, descends along the posterior-medial aspect of the upper arm, running posterior to the Hand-Taiyin Lung and Hand-Jueyin Pericardium meridians, enters the elbow, and follows the posterior-medial aspect of the forearm to the tip of the styloid process of the ulna. Also, the Hand-Taiyang Small Intestine Meridian winds around the scapula from the arm and intersects above the shoulders. Thus, these symptoms arise.) In heart deficiency, there is abdominal and thoracic distension, and pain linking the hypochondriac region and the waist. (The Hand-Jueyin Pericardium Meridian emerges from the chest, belongs to the pericardium, descends through the diaphragm, and sequentially connects with the Triple Burner; its branch follows the chest to emerge at the hypochondriac region. The Hand-Shaoyin Heart Meridian descends from the heart connection through the diaphragm to connect with the small intestine. Thus, these symptoms occur.)
In spleen disease, the body feels heavy, muscles may atrophy or become weak, the feet cannot support walking, and there is frequent pain in the soles of the feet. (Refers to pediatric malnutrition syndrome. The spleen corresponds to earth and governs the muscles; hence, heaviness and muscle atrophy. The Foot-Taiyin Spleen Meridian originates at the tip of the great toe, ascends along the medial aspect of the toe to the anterior margin of the medial malleolus, and continues up the medial leg. The Foot-Shaoyin Kidney Meridian originates below the little toe,斜趋 (diagonally approaches) the sole, ascends along the medial leg, and emerges at the anterior margin of the medial malleolus. Thus, these symptoms lead to inability to support the feet, susceptibility to malnutrition syndrome, and plantar pain.) In spleen deficiency, there is abdominal fullness, borborygmus, and diarrhea with undigested food. (The Foot-Taiyin Spleen Meridian enters the abdomen from the anterior medial thigh, belongs to the spleen, and connects with the stomach; thus, these symptoms occur. The *Ling Shu* states: Insufficiency of middle qi leads to frequent abdominal fullness and borborygmus.)
In lung disease, there is wheezing, coughing, and rebellious qi, shoulder and back pain, sweating, and pain in the sacrum, yin region, thighs, knees, thighs (hip), calves, and feet. (The lung stores qi and governs respiration; its movement manifests as coughing; thus, disease presents with wheezing, coughing, and rebellious qi. The back is the mansion of the chest, and the shoulder is close to it; hence, shoulder and back pain. The lung nourishes the skin and hair; when pathogens are excess, heart fluids leak externally as sweat; hence, sweating. The Foot-Shaoyin Kidney Meridian ascends from the sole along the medial leg, emerges at the anterior margin of the medial malleolus, continues up the posterior-medial thigh, penetrates the spine, belongs to the kidney, and connects with the bladder. Now, lung disease causes the kidney meridian to be affected by pathogens; hence, pain in the sacrum, yin region, thighs, knees, hips, and feet.) In lung deficiency, there is shortness of breath with inability to complete inhalation, deafness, and dry throat. (Qi insufficiency means insufficient breath to complete inhalation. The collateral of the Hand-Taiyin Lung Meridian converges in the ear; hence, deafness. The Foot-Shaoyin Kidney Meridian ascends from the kidney through the liver and diaphragm into the lung, following the throat alongside the root of the tongue. Now, lung deficiency leads to kidney qi insufficiency, which cannot moisten the throat upward; hence, dry throat.)
In kidney disease, there is abdominal distension, swelling of the calves, wheezing and coughing, heaviness of the body, night sweats, and aversion to wind. (The Foot-Shaoyin Kidney Meridian originates on the dorsum of the foot, ascends along the leg, passes through the transverse bone, runs alongside the umbilicus within the abdomen, and ascends into the lung; hence, abdominal distension, calf swelling, wheezing, and coughing. Kidney disease impairs bone function, leading to bodily heaviness. Kidney pathogens attack the lung, weakening heart qi internally; heart fluid becomes sweat, hence night sweats. With calf swelling and sweat leaking fluids, yin congeals in the xuanku (pores), while yang scorches the upper jiao, creating internal heat and external cold; hence, sweating and aversion to wind.) In kidney deficiency, there is pain in the chest, pain in the greater and lesser abdomen, cold extremities with reversal (Jue), and low spirits/unhappiness. (The Foot-Shaoyin Kidney Meridian emerges from the lung, connects with the heart, and pours into the chest. With kidney qi deficient, the heart lacks control; heart qi scorches the lung, causing pain to gather in the chest. The Foot-Taiyang Bladder Meridian descends from the nape to the feet; kidney deficiency prevents Taiyang qi from flourishing in the feet, leading to cold feet and rebellious qi. Qing refers to cold qi; Jue refers to rebellious qi. Due to cold rebellious qi, there is pain in the greater and lesser abdomen. Insufficiency of will leads to restless spirit and unhappiness.)