两经无内风之名,始见于《史》一百零五卷《仓公传》“脉来滑者为内风也”一语。盖
指外
风之入内者,不谓其自内出也。《千金方》亦颇言内风,细绎其指,与仓公同。惟王太仆《
素·大奇》肾风注云,劳气内蓄,化而为风,始以自内出者解经风字,然究不言此风宜补也
。且《素·水热穴》原肾风明言汗出逢风,是肾风何尝非外入之风,不必如王注所云矣。近
世内风之说盛行东南,尝以意别之,乃中风、痹、痱及肝气、肾气等症,但本各有主名,何
庸易以混号。且古人惟以中风诸症为外风入内,故制诸续命汤加减之方以治之;惟以肝气诸
症为脏气之厥,故制诸七气汤加减之方以治之。若概目为内风,专为补计,则续命不嫌于发
散
,七气不嫌于走泄乎?夫古人立法,每症皆有百世不易之准,何独风、厥两门,乃至与后世
大相刺谬如此耶?噫!异矣。
《灵》、《素》动以人迎、气口对说,而于终始篇专着“太阴”二字于脉口上(太阴谓
手太
阴。脉口即气口),其言曰∶人迎与太阴脉口俱盛四倍以上,命曰关格。此一语,正以别人
迎于气口也。王注知人迎之不属太阴,因以结喉旁脉当之。盖本《素·阴阳别》三阳在头、
三阴在手之论最的。后人不知其所本,粗读古经,转驳王注为谬,而创左人迎、右气口之说
,以为本之《脉经》。岂知《脉经》“关前一分,人命之主,左为人迎,右为气口”四句,
一气贯下,与神门诀断两在关后相对,则专谓关前一分之在左者为人迎,故与关后一分之神
门并论,非统左三部言也。平人迎条云,左手寸口人迎以前脉实者,阳实也,等语,与《灵
》、《素》所言迥殊,细玩“以前”两字自明。《脉经》本不误,后人自误会耳!前人辨此
者多,兹不备引,要惟杨上善《太素》注为独胜焉。
《灵枢》和《素问》中并没有“内风”这一名称,该词最早见于《史记》第一百零五卷《仓公传》中的“脉来滑者为内风也”这句话。这里指的是外风侵入体内,并非指从体内产生的风邪。《千金方》中也较多谈论内风,仔细推敲其含义,与仓公的观点相同。只有王冰(王太仆)在注释《素问·大奇论》时提到:“劳气内蓄,化而为风”,才开始将“自内而出”作为解释经文“风”字的依据,然而终究没有说这种风应当用补法治疗。况且《素问·水热穴论》中原文明确指出肾风是“汗出逢风”,可见肾风何尝不是外来的风邪侵入,不必像王冰注解说的那样。近代以来,“内风”的说法在东南地区盛行,我曾尝试加以辨析,发现所谓的内风,不过是中风、痹证、痱病以及肝气、肾气等病症,但这些病症原本各有专名,何必改用混淆的称号?况且古人只将中风诸症视为外风入内,因此制定各种续命汤的加减方来治疗;只将肝气诸症视为脏气之厥逆,因此制定各种七气汤的加减方来治疗。如果一概称之为内风,专门采用补益之法,那么续命汤难道不嫌发散太过,七气汤难道不嫌走泄正气吗?古人确立治法,每种病症都有百世不变的准则,为何唯独风病和厥逆两门,竟与后世理论如此大相径庭呢?唉!真是奇怪啊。
《灵枢》和《素问》经常将人迎脉和气口脉对举论述,而在《终始》篇中特别在脉口上方着重强调“太阴”二字(太阴指手太阴肺经。脉口即气口),文中说:“人迎与太阴脉口俱盛四倍以上,命曰关格。”这一句话,正是用来区分人迎脉和气口脉的。王冰注解说人迎脉不属于太阴经,因此以喉结旁的动脉来对应。这大概是依据《素问·阴阳别论》中“三阳在头、三阴在手”的理论,最为确切。后人不知道其来源,粗读古经,反而驳斥王冰的注解为错误,并创立了“左为人迎、右为气口”的说法,认为这是源自《脉经》。哪里知道《脉经》中“关前一分,人命之主,左为人迎,右为气口”这四句话,是一气贯通下来的,与神门诀断中“两在关后相对”相呼应,则是专指关前一寸部位左侧的人迎脉,因此与关后一寸的神门脉并论,并不是统指左手三部脉而言。《脉经》平人迎条中说:“左手寸口人迎以前脉实者,阳实也”等语,这与《灵枢》、《素问》所说的截然不同,仔细玩味“以前”这两个字自然明了。《脉经》本身没有错误,是后人自己误解罢了!前人对此进行辨正的很多,此处不再一一引用,总之杨上善在《太素》中的注解最为出色。
Neither the *Ling Shu* (Spiritual Pivot) nor the *Su Wen* (Basic Questions) contains the term "Nei Feng" (Internal Wind). This term first appears in Volume 105 of the *Shi Ji* (Records of the Grand Historian), specifically in the "Biography of Cang Gong," with the phrase: "A slippery pulse indicates Nei Feng." Here, it refers to external wind pathogens invading the interior, not wind generated from within. The *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) also discusses Nei Feng extensively; upon careful analysis, its meaning aligns with that of Cang Gong. Only Wang Bing (Wang Taipu), in his commentary on the *Su Wen · Da Qi Lun*, stated, "Laborious qi accumulates internally and transforms into wind," thereby interpreting the character "wind" in the classic texts as originating from within. However, he ultimately did not suggest that this type of wind should be treated with tonification methods. Moreover, the original text in the *Su Wen · Shui Re Xue Lun* explicitly states that Shen Feng (Kidney Wind) occurs when one sweats and is exposed to wind. Thus, Shen Feng is undoubtedly an externally acquired pathogen, contrary to Wang Bing's interpretation. In recent times, the theory of Internal Wind has become prevalent in the southeastern regions. I have attempted to differentiate these conditions, finding that what is called Internal Wind actually comprises symptoms such as Zhong Feng (Wind Stroke), Bi Syndrome (Obstruction Syndrome), Fei Disease (Flaccidity Disorder), and disorders of Gan Qi (Liver Qi) and Shen Qi (Kidney Qi). Since these conditions already have specific names, why replace them with confusing general terms? Furthermore, ancient physicians only regarded Zhong Feng syndromes as external wind invading the interior, formulating various modified versions of Xu Ming Tang (Continuing Life Decoction) to treat them. They regarded Gan Qi disorders as Jue Ni (Rebellious Qi of Zang Organs), formulating various modified versions of Qi Qi Tang (Seven Qi Decoction) for treatment. If all are broadly categorized as Internal Wind and treated exclusively with tonification, would Xu Ming Tang not be considered too dispersing, and Qi Qi Tang too draining? Ancient physicians established treatments for each syndrome based on eternal principles. Why do the categories of Wind and Jue Ni differ so drastically from later theories? Alas, how strange!
The *Ling Shu* and *Su Wen* frequently discuss Ren Ying (Human Welcome Pulse) and Qi Kou (Qi Gate Pulse) in contrast. In the *Zhong Shi* chapter, special emphasis is placed on the character "Tai Yin" (Hand Tai Yin Lung Meridian) above the Mai Kou (Pulse Gate, which is synonymous with Qi Kou). It states: "When both Ren Ying and the Hand Tai Yin Mai Kou are four times or more than normal, it is termed Guan Ge (Closed and Blocked)." This statement serves precisely to distinguish Ren Ying from Qi Kou. Wang Bing noted that Ren Ying does not belong to the Tai Yin meridian, thus identifying it with the artery beside the larynx. This likely stems from the theory in the *Su Wen · Yin Yang Bie Lun*: "Three Yang meridians are at the head, Three Yin meridians are at the hands," which is highly accurate. Later scholars, unaware of its origin, hastily read the ancient classics and erroneously rejected Wang Bing’s commentary, creating the theory of "Left Ren Ying, Right Qi Kou," claiming it originated from the *Mai Jing* (Pulse Classic). However, they failed to realize that the four sentences in the *Mai Jing*—"One fen before the cun guan is the master of life; the left is Ren Ying, the right is Qi Kou"—flow continuously and correspond to the "two points opposite behind the guan" in the Shen Men formula. This specifically refers to the Ren Ying point on the left side of the one fen anterior to the guan, discussed alongside the Shen Men point posterior to the guan, rather than referring collectively to the three positions of the left hand. The Ping Ren Ying section of the *Mai Jing* states: "If the pulse anterior to Ren Ying at the Cun Kou position of the left hand is excess, it indicates Yang Excess." This differs significantly from the descriptions in the *Ling Shu* and *Su Wen*; careful examination of the word "anterior" clarifies this. The *Mai Jing* itself is correct; the error lies in later misinterpretations. Many predecessors have debated this issue, but I will not cite them all here. Ultimately, Yang Shangshan’s commentary in the *Tai Su* (Grand Simplicity) stands out as superior.