(素问至真要大论)
帝曰∶六气标本,所从不同奈何?(六气者,风寒暑湿火燥,天之令也。标,末也。本,原也。犹树木之有根枝也。
分言之则根枝异形,合言之则标出乎本。此篇当与六微旨大论,少阳之上,火气治之,中见厥阴之义参看,详运气类第
六。)岐伯曰∶气有从本者,有从标本者,有不从标本者也。帝曰∶愿卒闻之。(不从标本者,从中气也。)岐伯曰∶少阳
太阴,从本;(六气少阳为相火,是少阳从火而化,故火为本,少阳为标。太阴为湿土,是太阴从湿而化,故湿为本,太
阴为标。二气之标本同,故经病之化皆从乎本。)少阴太阳,从本从标;(少阴为君火,从热而化,故热为本,少阴为标,
是阴从乎阳也。太阳为寒水,从寒而化,故寒为本,太阳为标,是阳从乎阴也。二气之标本异,故经病之化,或从乎标,
或从乎本。)阳明厥阴,不从标本,从乎中也。(阳明为燥金,从燥而化,故燥为本,阳明为标。厥阴为风木,从风而化,
故风为本,厥阴为标。但阳明与太阴为表里,故以太阴为中气,而金从湿土之化。厥阴与少阳为表里,故以少阳为中气,
而木从相火之化。是皆从乎中也。详义见图翼三卷,上中下本标中气图解。)故从本者,化生于本;从标本者,有标本之
化;从中者,以中气为化也。(六气之太过不及皆能为病,病之化生必有所因,故或从乎本,或从乎标,或从乎中气,知
其所从,则治无失矣。)帝曰∶脉从而病反者,其诊何如?(谓脉之阴阳必从乎病,其有脉病不应而相反者,诊当何如也。)
岐伯曰∶脉至而从,按之不鼓,诸阳皆然。(阳病见阳脉,脉至而从也。若浮洪滑大之类,本皆阳脉,但按之不鼓,指下
无力,便非真阳之候,不可误认为阳。凡诸阳证得此者,似阳非阳皆然也。故有为假热、有为格阳等证,此脉病之为反
也。)帝曰∶诸阴之反,其脉何如?岐伯曰∶脉至而从,按之鼓甚而盛也。(阴病见阴脉,脉至而从矣。若虽细小而按之
鼓甚有力者,此则似阴非阴也。凡诸阴病而得此,有为假寒,有为格阴,表里异形,所以为反。凡此相反者,皆标本不
同也。如阴脉而阳证,本阴标阳也。阳脉而阴证,本阳标阴也。故治病当必求其本。)
黄帝问道:六气的标本,为什么有的相同、有的不同呢?(六气,指风、寒、暑、湿、火、燥,是自然界气候变化的规律。标,指末端;本,指根源。就像树木有根和枝叶一样。分开来说,根和枝叶形态各异;合起来说,枝叶是从根部生发出来的。这一篇应当与《六微旨大论》中“少阳之上,火气治之,中见厥阴”的含义参看,详见运气类第六部分。)
岐伯回答说:六气之中,有的从本化,有的既从本又从标,有的既不从本也不从标。(所谓不从标本的,是指从中气转化。)
岐伯继续说道:少阳和太阴,从本化。(六气中的少阳属相火,因此少阳随火而化,所以火为本,少阳为标。太阴属湿土,因此太阴随湿而化,所以湿为本,太阴为标。这两气的标本属性相同,所以其经络病变的变化都取决于本。)
少阴和太阳,既从本也从标。(少阴属相火,随热而化,所以热为本,少阴为标,这是阴随阳化。太阳属寒水,随寒而化,所以寒为本,太阳为标,这是阳随阴化。这两气的标本属性不同,所以其经络病变的变化,有时取决于标,有时取决于本。)
阳明和厥阴,既不从本也不从标,而是从中气转化。(阳明属燥金,随燥而化,所以燥为本,阳明为标。厥阴属风木,随风而化,所以风为本,厥阴为标。但是阳明与太阴互为表里,所以以太阴为中气,金随湿土之气而化。厥阴与少阳互为表里,所以以少阳为中气,木随相火之气而化。这些都是从中气转化的。详细含义参见《图翼》第三卷中的上、中、下本标中气图解。)
所以说,从本化的,变化产生于本;从标本的,具有本和标的两种变化;从中气转化的,以中气作为变化的依据。(六气的太过或不及都能导致疾病,疾病的变化生成必然有其成因,所以有的从本,有的从标,有的从中气。知道它们所从属的关系,治疗就不会出现失误了。)
黄帝问道:脉象顺从病情但症状相反的情况,诊断是怎样的?(意思是脉象的阴阳必须顺从疾病,如果有脉象与病情不相符合且相反的情况,诊断应当如何处理?)
岐伯回答说:脉象看似顺从,但重按之下不鼓动有力,所有的阳证都是这样。(阳病见到阳脉,脉象看似顺从。如果是浮、洪、滑、大之类的脉,本来都是阳脉,但如果重按之下不鼓动,指下感觉无力,这就不是真正的阳证表现,不能误认为是阳证。凡是各种阳证出现这种情况的,看似阳证实则非阳证都是如此。所以有的表现为假热,有的表现为格阳等证,这就是脉与病的相反情况。)
黄帝问道:各种阴证的反常情况,其脉象是怎样的?
岐伯回答说:脉象看似顺从,但重按之下鼓动非常有力且盛大。(阴病见到阴脉,脉象看似顺从。如果脉象虽然细小,但重按之下鼓动有力,这则是看似阴证实则非阴证。凡是各种阴病出现这种情况的,有的表现为假寒,有的表现为格阴,表里表现形态不同,所以称为反常。凡是这种相反的情况,都是因为标本不同所致。如阴脉却见阳证,是本阴标阳;阳脉却见阴证,是本阳标阴。所以治病一定要探求疾病的根本。)
The Yellow Emperor asked: Why do the Biao (Branch) and Ben (Root) of the Six Qi differ in their origins? (The Six Qi refer to Wind, Cold, Summer Heat, Dampness, Fire, and Dryness, which are the commands of Heaven. Biao means the extremity or branch; Ben means the origin or root. It is like a tree having roots and branches. When discussed separately, the roots and branches have different forms; when discussed together, the branches emerge from the root. This chapter should be read in conjunction with the concept in "Liu Wei Zhi Da Lun" that "Above Shaoyang, Fire Qi governs, and Jueyin is seen in the Middle," as detailed in the sixth part of the Luck and Qi category.)
Qibo replied: Among the Qi, some transform according to the Ben, some transform according to both the Ben and the Biao, and some transform neither according to the Ben nor the Biao. (Those that do not transform according to the Ben or Biao transform according to the Zhong Qi [Middle Qi].)
Qibo continued: Shaoyang and Taiyin transform according to the Ben. (In the Six Qi, Shaoyang belongs to Ministerial Fire; thus, Shaoyang transforms following Fire. Therefore, Fire is the Ben, and Shaoyang is the Biao. Taiyin belongs to Damp Earth; thus, Taiyin transforms following Dampness. Therefore, Dampness is the Ben, and Taiyin is the Biao. Since the Ben and Biao of these two Qi are identical, the transformations of their meridian diseases all follow the Ben.)
Shaoyin and Taiyang transform according to both the Ben and the Biao. (Shaoyin belongs to Sovereign Fire and transforms following Heat; therefore, Heat is the Ben, and Shaoyin is the Biao. This is Yin transforming according to Yang. Taiyang belongs to Cold Water and transforms following Cold; therefore, Cold is the Ben, and Taiyang is the Biao. This is Yang transforming according to Yin. Since the Ben and Biao of these two Qi are different, the transformations of their meridian diseases may follow either the Biao or the Ben.)
Yangming and Jueyin transform neither according to the Ben nor the Biao, but rather according to the Zhong Qi. (Yangming belongs to Dry Metal and transforms following Dryness; therefore, Dryness is the Ben, and Yangming is the Biao. Jueyin belongs to Wind Wood and transforms following Wind; therefore, Wind is the Ben, and Jueyin is the Biao. However, Yangming and Taiyin are exterior-interior pairs, so Taiyin serves as the Zhong Qi, and Metal transforms following the Damp Earth Qi. Jueyin and Shaoyang are exterior-interior pairs, so Shaoyang serves as the Zhong Qi, and Wood transforms following the Ministerial Fire Qi. These all transform according to the Zhong Qi. For detailed meanings, see the diagrams of Upper, Middle, and Lower Ben, Biao, and Zhong Qi in Volume Three of Tu Yi.)
Therefore, those that transform according to the Ben generate transformation from the Ben; those that transform according to the Ben and Biao possess transformations of both Ben and Biao; those that transform according to the Zhong Qi take the Zhong Qi as the basis for transformation. (Excess or deficiency of the Six Qi can all cause disease. The generation of disease transformation must have a cause. Thus, one must know whether it follows the Ben, the Biao, or the Zhong Qi. Knowing this ensures that treatment will not fail.)
The Yellow Emperor asked: In cases where the pulse conforms to the disease but the symptoms are contrary, how should the diagnosis be made? (This refers to situations where the Yin-Yang nature of the pulse should conform to the disease, but there are instances where the pulse and disease do not correspond and are contradictory. How should such cases be diagnosed?)
Qibo replied: The pulse appears to conform, but upon deep pressure, it does not throb vigorously. This applies to all Yang conditions. (When a Yang disease presents with a Yang pulse, the pulse appears to conform. Pulses such as Floating, Surging, Slippery, and Large are inherently Yang pulses. However, if they do not throb vigorously upon deep pressure and feel weak under the fingers, they are not true signs of Yang. They should not be mistaken for Yang patterns. Whenever any Yang pattern presents with this type of pulse, what appears to be Yang is actually non-Yang. Thus, some manifest as False Heat, while others manifest as Ge Yang [Rejecting Yang], representing the contradiction between pulse and disease.)
The Yellow Emperor asked: What is the pulse like in various contrary Yin conditions?
Qibo replied: The pulse appears to conform, but upon deep pressure, it throbs very strongly and abundantly. (When a Yin disease presents with a Yin pulse, the pulse appears to conform. If the pulse is fine and small but throbs strongly and forcefully upon deep pressure, it appears to be Yin but is actually non-Yin. Whenever any Yin pattern presents with this, it may manifest as False Cold or Ge Yin [Rejecting Yin], where the interior and exterior present different forms, hence termed "contrary." All such contradictions arise because the Ben and Biao differ. For example, a Yin pulse with Yang symptoms indicates Ben-Yin and Biao-Yang; a Yang pulse with Yin symptoms indicates Ben-Yang and Biao-Yin. Therefore, in treating disease, one must necessarily seek the Ben [Root].)