(《素问·至真要大论》)
帝曰∶六气相胜奈何?相胜者,(六气互有强弱,而乘虚相胜也。)岐伯曰∶厥阴之胜,耳鸣头眩,愦愦欲吐,胃膈
如寒,大风数举, 虫不滋, 胁气并,化而为热,小便黄赤,胃脘当心而痛,上支两胁,肠鸣飧泄,少腹痛,注下赤
白,甚则呕吐,膈咽不通。(厥阴之胜,风邪盛也。耳鸣头眩,肝脉会于顶巅而风主动也。愦愦欲吐,胃膈如寒,以木邪
伤胃,胃虚生于寒也。 虫不滋,土气衰也。 胁气并,肝邪聚也。化热而小便黄赤,邪侵小肠也。其在上则胃脘当心
而痛,上支两胁、为呕吐,为膈咽不通,在下则飧泄少腹痛,注下赤白,皆肝经脉气所及,而木邪乘于肠胃也。愦音贵,
心乱也。 音区。)少阴之胜,心下热善饥,齐下反痛,气游三焦,炎暑至,木乃津,草乃萎,呕逆躁烦,腹满痛溏泄,
传为赤沃。(少阴之胜,君火盛也。少阴之脉起心中,出属心系,故心下热而善饥。少阴之脉络小肠,而热乘之,故齐下
反痛。心火盛则热及心包络,包络之脉历络三焦,故气游三焦。其在天则炎暑至,在物则木乃津,草乃萎。火在上焦则
呕逆躁烦,在中焦则腹满痛,在下焦则溏泄传为赤沃。赤沃者,利血尿赤也。齐,脐同。)太阴之胜, 火气内郁,疮疡
于中,流散于外,病在 胁,甚则心痛,热格,头痛喉痹项强,独胜则湿气内郁,寒迫下焦,痛留顶,互引眉间,胃满,
雨数至,燥(当作湿。)化乃见,少腹满,腰 重强,内不便,善注泄,足下温,头重足胫 肿,饮发于中。 肿于上。
(太阴之胜,湿邪盛也。寒湿外盛,则心火内郁,故疮疡先发于中,而后流散于外。心脉起心中,出腋下,故病在 胁,
甚则心痛。热格于上,则为头痛喉痹项强。若无热而湿独胜,则湿气内郁,寒迫下焦,故痛留巅顶,互引眉间。胃属土,
不能制湿则为胀满。其在天则雨数至,在物则湿化见。湿下流则少腹满,腰 重强。内湿不便则清浊不分。故善注泄。
湿郁于下则热生,故足温。湿滞于上,故头重。脾胃不能胜湿,则足胫 肿,故饮发于中,浮肿于上也。)少阳之胜,热
客于胃,烦心心痛,目赤欲呕,呕酸善饥,耳痛溺赤,善惊谵妄,暴热消烁,草萎水涸,介虫乃屈,少腹痛,下沃赤白。
(少阳之胜,相火盛也。热客于胃而上行,则为烦心心痛、目赤欲呕、呕酸善饥耳痛等病,下行则为溺赤。火盛则伤阴,
故善惊谵妄,暴热消烁。热极则害物,故草萎水涸。介虫属金,故遇火而屈。热陷下焦,故少腹为痛。下沃赤白者,热
在血分则赤,气分则白,大便曰利,小便曰浊也。)阳明之胜,清发于中,左 胁痛溏泄,内为嗌塞,外发 疝,大凉肃
杀,华英改容,毛虫乃殃,胸中不便,嗌塞而咳。(阳明之胜,金邪盛也,金气寒肃,故清发于中。木受其制,故左 胁
痛。清气在下则为溏泄,在上则为嗌塞,在少腹则为 疝,在天则大凉肃杀,在物则华英改容。毛虫,木虫也,故受其
殃。胸中,肺所居也,燥胜则肺气敛而失其治节,故有不便而嗌塞为咳也。)太阳之胜,凝栗且至,非时水冰,羽乃后化,
痔疟发,寒厥入胃则内生心痛,阴中乃疡,隐曲不利,互引阴股,筋肉拘苛,血脉凝泣,络满色变,或为血泄,皮肤痞
肿,腹满食减,热反上行,头项囟顶脑户中痛,目如脱,寒入下焦,传为濡泻。(太阳之胜,水邪盛也,故为凝栗水冰。
羽虫属火,故后化。太阳经挟脊贯臀。故痔发。寒胜则邪正分争。故为疟。寒气入胃,厥逆于中,上侵君火,故内生心
痛。太阳之脉络肾属膀胱,故为阴疡,为隐曲不利而互引阴股,筋肉得寒则为急为痹 ,故筋急肉苛。血脉得寒则营卫凝
涩,经脉不行,故络满色变。血滞于经则妄行,故或为血泄。表寒不行,故皮肤痞肿。里寒为滞,故腹满食减。阴寒在
下,则戴阳于上,故热反上行。头项囟顶脑户目内 ,皆太阳经也,寒气居之,故为痛如脱。寒入下焦,则命门阳衰,
故传为大便濡泻。囟音信。)帝曰∶治之奈何?(治六气相胜。)岐伯曰∶厥阴之胜,治以甘清,佐以苦辛,以酸泻之。(木
胜土败,治以甘清,甘益土,清平木也。佐以苦辛,散风邪也。以酸泻之,木之正味,其泻以酸也。)少阴之胜,治以辛
寒,佐以苦咸,以甘泻之。(热胜则乘金 ,治以辛寒,散火也。佐以苦咸,泄热也。以甘泻之,火之正味,其泻以甘也。)
太阴之胜,治以咸热,佐以辛甘,以苦泻之。(土胜则湿淫,治以咸热,咸能润下,热能燥湿也。湿胜则土寒,佐以辛甘,
辛能温土,甘能补土也。以苦泻之,土之正味,其泻以苦也。)少阳之胜,治以辛寒 ,佐以甘咸,以甘泻之。(此与上少
阴治同,但佐有少异,盖甘能泻火也。)阳明之胜,治以酸温,佐以辛甘,以苦泄之。(燥金之胜,病在肺肝,治以酸温,
润燥暖肺也。佐以辛甘,泻肺补肝也。以苦泄之,苦从火化,能泄燥邪之实也。)太阳之胜,治以甘热,佐以辛酸,以咸
泻之。(水胜则火衰,治以甘热,甘益土以制水,热扶阳以逐寒也。佐以辛酸,辛散寒邪之实,酸收心气之伤也。以咸泻
之,水之正味,其泻以咸也。)
(出自《素问·至真要大论》)
黄帝问道:六气相互克制是怎样的情况?所谓相胜,是指六气之间互有强弱,乘虚而相互克制的现象。岐伯回答说:厥阴风木之气偏胜,会出现耳鸣、头晕目眩、心中烦乱欲吐、胃脘及膈部感觉寒冷、大风频繁刮起、昆虫不能滋生、胁肋部位气机郁结,进而化热,导致小便黄赤;胃脘当心处疼痛,向上支撑两侧胁肋,肠鸣且完谷不化的泄泻,少腹疼痛,痢下赤白脓血,严重时呕吐,膈部和咽喉不通畅。(厥阴之胜,即风邪亢盛。耳鸣头眩,是因为肝经经脉会于头顶,且风性主动。心中烦乱欲吐、胃膈如寒,是因为木邪伤害胃土,胃气虚弱而生寒。昆虫不能滋生,是脾土之气衰弱的表现。胁肋气机郁结,是肝邪聚积所致。化热而小便黄赤,是邪气侵入小肠的表现。病在上焦则胃脘当心而痛,向上支撑两胁,出现呕吐、膈咽不通;病在下焦则肠鸣飧泄、少腹痛、痢下赤白,这些都是肝经脉气所影响的范围,属于木邪侵犯肠胃所致。“愦”音贵,意为心乱。“蝝”音区,指幼虫。)
少阴君火之气偏胜,会出现心下部发热、容易饥饿、脐下反而疼痛,热气游走于三焦;天气炎热暑气到来,树木汁液枯竭,草木枯萎;出现呕吐逆气、烦躁不安、腹部胀满疼痛、溏泄,进而发展为便血或尿赤。(少阴之胜,即君火亢盛。少阴经脉起于心中,归属于心系,所以心下部发热且易饥。少阴经脉联络小肠,热邪侵袭,所以脐下反而疼痛。心火亢盛会波及心包络,心包络的经脉依次联络三焦,所以热气游走于三焦。在天为炎暑,在物为树木干枯、草木萎谢。火在上焦则呕吐逆气、烦躁;在中焦则腹部胀满疼痛;在下焦则溏泄并发展为赤沃。赤沃,指的是便血或尿赤。“齐”通“脐”。)
太阴湿土之气偏胜,火热之气内郁,体内发生疮疡,流散于体表,病变在胁肋,严重时心痛,热邪格拒于上,出现头痛、喉痹、项强;若湿气独胜,则湿气内郁,寒气逼迫下焦,疼痛停留于头顶,牵引眉间,胃部胀满;雨水频繁降下,湿气显现,少腹胀满,腰部沉重僵硬,大便不畅,容易腹泻,足底温热,头部沉重,足胫浮肿,水饮发于中焦,浮肿见于上部。(太阴之胜,即湿邪亢盛。寒湿外盛,则心火内郁,所以疮疡先发于体内,后流散于体表。心脉起于心中,出于腋下,所以病变在胁肋,严重时心痛。热邪格拒于上,则头痛、喉痹、项强。若无热而湿独胜,则湿气内郁,寒气逼迫下焦,所以疼痛停留于巅顶,牵引眉间。胃属土,不能制约湿气则产生胀满。在天为雨水频降,在物为湿气显现。湿气下流则少腹胀满,腰部沉重僵硬。内湿阻滞则清浊不分,所以容易腹泻。湿气郁滞于下则生热,所以足温。湿气停滞于上,所以头重。脾胃不能胜湿,则足胫浮肿,所以水饮发于中焦,浮肿见于上部。)
少阳相火之气偏胜,热邪客居胃中,出现心烦、心痛、眼睛发红、想呕吐、呕酸水、易饥、耳痛、小便黄赤、容易惊恐、胡言乱语;暴热消烁万物,草木枯萎,水流干涸,甲壳类昆虫受屈,少腹疼痛,下利赤白脓血。(少阳之胜,即相火亢盛。热邪客居胃中上行,则出现心烦、心痛、目赤、欲呕、呕酸、易饥、耳痛等病;下行则导致小便黄赤。火盛伤阴,所以容易惊恐、胡言乱语;暴热消烁,说明热极害物,所以草木枯萎、水流干涸。介虫属金,遇到火则受屈。热陷下焦,所以少腹疼痛。下利赤白,热在血分则色赤,在气分则色白,大便称为利,小便称为浊。)
阳明燥金之气偏胜,清凉之气发于体内,左侧胁肋疼痛、溏泄,内部表现为咽喉阻塞,外部发为疝气;大凉肃杀之气盛行,花卉花朵改变容颜,毛虫遭受灾殃;胸中不便,咽喉阻塞且咳嗽。(阳明之胜,即金邪亢盛。金气寒凉肃杀,所以清凉之气发于体内。木受金制,所以左侧胁肋疼痛。清气在下则为溏泄,在上则为咽喉阻塞,在少腹则为疝气。在天为大凉肃杀,在物为花卉改容。毛虫属木,所以受其灾殃。胸中是肺脏所在,燥胜则肺气收敛而失去治节功能,所以出现胸中不便、咽喉阻塞和咳嗽。)
太阳寒水之气偏胜,凝结寒冷之气到来,非时令之水结冰,羽虫延后化生,痔疮疟疾发作;寒气进入胃中,厥逆于内则内生心痛,阴部生疮,隐曲之事不利,牵引大腿内侧,筋肉拘急苛恶,血脉凝涩,络脉充盈颜色改变,或者出现便血,皮肤痞块肿胀,腹部胀满食欲减退;寒气反向上行,导致头项、囟门、脑户疼痛,眼睛像要脱出;寒气进入下焦,传变为濡泻。(太阳之胜,即水邪亢盛,所以出现凝结寒冷、非时水冰。羽虫属火,所以化生延后。太阳经脉挟脊贯臀,所以痔疮发作。寒胜则邪正分争,所以发生疟疾。寒气入胃,厥逆于中,上侵君火,所以内生心痛。太阳经脉联络肾脏属膀胱,所以阴部生疮,隐曲不利并牵引大腿内侧。筋肉得寒则拘急痹痛,所以筋急肉苛。血脉得寒则营卫凝涩,经脉不行,所以络脉充盈颜色改变。血滞于经则妄行,所以有时便血。表寒不行,所以皮肤痞肿。里寒阻滞,所以腹部胀满食欲减退。阴寒在下,则阳气戴于上,所以热气反向上行。头项、囟门、脑户、目内眦,都是太阳经脉所过之处,寒气占据这些部位,所以疼痛剧烈如脱出。寒气进入下焦,命门阳气衰弱,所以传变为大便濡泻。“囟”音信。)
黄帝问道:如何治疗?(治疗六气相胜的病证。)岐伯回答说:厥阴之胜,用甘清之药为主治疗,佐以苦辛之药,用酸味药来泻之。(木胜土败,用甘清之药,甘味补益脾土,清味平抑肝木。佐以苦辛,以疏散风邪。用酸味泻之,因为酸是木的正味,用酸味来泻木邪。)少阴之胜,用辛寒之药为主治疗,佐以苦咸之药,用甘味药来泻之。(热胜则乘金,用辛寒之药,辛能散火。佐以苦咸,苦能泄热。用甘味泻之,因为甘是火的正味,用甘味来泻火邪。)太阴之胜,用咸热之药为主治疗,佐以辛甘之药,用苦味药来泻之。(土胜则湿淫,用咸热之药,咸能润下,热能燥湿。湿胜则土寒,佐以辛甘,辛能温土,甘能补土。用苦味泻之,因为苦是土的正味,用苦味来泻土邪。)少阳之胜,用辛寒之药为主治疗,佐以甘咸之药,用甘味药来泻之。(这与上面少阴的治法相同,只是佐药略有不同,因为甘味也能泻火。)阳明之胜,用酸温之药为主治疗,佐以辛甘之药,用苦味药来泄之。(燥金之胜,病在肺肝,用酸温之药,酸能润燥暖肺。佐以辛甘,辛能泻肺,甘能补肝。用苦味泄之,苦从火化,能泄燥邪之实。)太阳之胜,用甘热之药为主治疗,佐以辛酸之药,用咸味药来泻之。(水胜则火衰,用甘热之药,甘味补益脾土以制水,热性扶助阳气以逐寒。佐以辛酸,辛能散寒邪之实,酸能收敛心气之伤。用咸味泻之,因为咸是水之正味,用咸味来泻水邪。)
(Sourced from *Suwen: Zhizhen Yao Dalun*)
The Yellow Emperor asked: How does the mutual overcoming among the Six Qi manifest? Mutual overcoming refers to the phenomenon where the Six Qi vary in strength and overcome each other by taking advantage of weakness. Qibo replied: When Jueyin (Liver/Gallbladder) Wind-Wood Qi prevails, symptoms include tinnitus, dizziness, a sense of mental confusion with nausea, a cold sensation in the stomach and diaphragm, frequent strong winds, inability of insects to thrive, Qi stagnation in the hypochondrium transforming into heat, yellow and red urine, pain in the epigastrium at the heart's location radiating to both hypochondria, borborygmus with undigested stool diarrhea, lower abdominal pain, dysentery with red and white discharge, and in severe cases, vomiting and obstruction of the diaphragm and pharynx. (Jueyin prevalence indicates excessive Wind pathogen. Tinnitus and dizziness occur because the Liver meridian connects to the vertex and Wind is active. Mental confusion and nausea arise because Wood pathogen damages Stomach Earth, leading to Stomach deficiency and cold generation. Insects failing to thrive indicates Spleen Earth Qi decline. Hypochondriac Qi stagnation reflects Liver pathogen accumulation. Transformation into heat and yellow-red urine indicate pathogen invading the Small Intestine. Upper manifestations include epigastric pain radiating to hypochondria, vomiting, and pharyngeal obstruction; lower manifestations include borborygmus, undigested stool diarrhea, lower abdominal pain, and dysentery. These are all areas influenced by the Liver meridian, representing Wood pathogen attacking the intestines and stomach. "Kui" [confusion] sounds like 'gui'. "Yuan" [insect larvae] sounds like 'qu'.)
When Shaoyin (Heart/Small Intestine) Minister-Fire Qi prevails, symptoms include heat in the epigastrium, easy hunger, pain below the umbilicus, heat wandering through the Sanjiao (Triple Burner), hot summer weather causing trees to exude sap and grasses to wither, regurgitation, irritability, abdominal fullness and pain, loose stools, progressing to bloody discharges or red urine. (Shaoyin prevalence indicates excessive Monarch Fire. The Shaoyin meridian originates in the heart and connects to the heart system, causing epigastric heat and hunger. It links to the Small Intestine; heat invading it causes pain below the umbilicus. Excessive Heart fire affects the Pericardium meridian, which traverses the Sanjiao, causing heat to wander there. In nature, this manifests as hot summers and withering vegetation. Fire in the Upper Jiao causes regurgitation and irritability; in the Middle Jiao, abdominal fullness and pain; in the Lower Jiao, loose stools progressing to Chiwo (bloody discharge/red urine). "Qi" is synonymous with "Umbilicus".)
When Taiyin (Spleen/Stomach) Damp-Earth Qi prevails, internal depression of Fire Qi leads to sores within, spreading externally, with pathology in the hypochondrium, potentially progressing to heart pain, heat rejection, headache, throat obstruction, and neck stiffness. If Dampness alone prevails, internal dampness stagnates, Cold presses the Lower Jiao, pain remains at the vertex and radiates between the eyebrows, gastric fullness occurs, frequent rains fall, and damp transformation becomes visible, causing lower abdominal fullness, heavy and stiff waist, internal difficulty in defecation, profuse diarrhea, warm soles, heavy head, swollen calves, water retention originating internally, and edema appearing superiorly. (Taiyin prevalence indicates excessive Damp pathogen. External excess of Cold-Damp causes internal Fire depression, leading to initial internal sores spreading outward. The Heart meridian originates in the heart and exits the axilla, causing hypochondriac pathology and potential heart pain. Heat rejection upward causes headache, throat obstruction, and neck stiffness. Without heat, if Dampness prevails, internal dampness stagnates and Cold presses the Lower Jiao, causing vertex pain radiating to the glabella. The Stomach belongs to Earth; inability to control dampness causes distension. In nature, frequent rains and visible damp transformation occur. Downward flowing dampness causes lower abdominal fullness and heavy waist. Internal dampness obstruction leads to unclear separation of clear and turbid, causing profuse diarrhea. Dampness stagnating below generates heat, warming the feet. Dampness stagnating above heavies the head. Spleen and Stomach failing to overcome dampness cause calf swelling, leading to internal water retention and upper edema.)
When Shaoyang (Gallbladder/Triple Burner) Minister-Fire Qi prevails, heat guests the Stomach, causing vexation, heart pain, red eyes, desire to vomit, sour regurgitation, easy hunger, ear pain, red urine, fright, delirium, sudden heat consuming vitality, withering grasses, drying waters, and subjugation of shelled creatures. Symptoms include lower abdominal pain and downward discharge of red and white matter. (Shaoyang prevalence indicates excessive Minister Fire. Heat guesting the Stomach and moving upward causes vexation, heart pain, red eyes, nausea, sour regurgitation, hunger, and ear pain; moving downward causes red urine. Fire excess injures Yin, causing fright and delirium. Extreme heat harms objects, withering grasses and drying waters. Shelled creatures belong to Metal and are subdued by Fire. Heat sinking to the Lower Jiao causes lower abdominal pain. Downward discharge of red and white indicates heat in the Blood level (red) or Qi level (white); bowel movements are termed "Li", urination "Zhuo".)
When Yangming (Large Intestine/Lung) Dry-Metal Qi prevails, coolness emerges internally, causing left-sided hypochondriac pain and loose stools, internal throat obstruction, external hernia manifestation, severe cool and austere killing energy, changing appearance of flowers, and disaster to hairy creatures. Symptoms include chest discomfort, throat obstruction, and cough. (Yangming prevalence indicates excessive Metal pathogen. Metal Qi is cold and austere, so coolness emerges internally. Wood being controlled by Metal causes left hypochondriac pain. Cool Qi descending causes loose stools; ascending causes throat obstruction; in the lower abdomen, hernia. In nature, severe coolness kills; in objects, flowers change appearance. Hairy creatures belong to Wood and suffer disaster. The chest is the residence of the Lung; dryness excess causes Lung Qi to contract and lose its regulating function, resulting in chest discomfort, throat obstruction, and cough.)
When Taiyang (Bladder/Kidney) Cold-Water Qi prevails, condensation and chill arrive, water freezes out of season, feathered creatures delay metamorphosis, hemorrhoids and malaria appear. Cold entering the Stomach causes jue-ni (cold reversal) internally and heart pain. Ulcers form in the yin region, difficulty in sexual/urinary functions occurs, pain radiates to the inner thighs, muscles and tendons become rigid and numb, blood vessels coagulate and stagnate, collaterals fill and change color, possibly leading to bloody discharge, skin induration and swelling, abdominal fullness, and reduced appetite. Heat reverses to move upward, causing pain in the head, nape, fontanelle, and brain, eyes feeling as if protruding. Cold entering the Lower Jiao transmits into soft diarrhea. (Taiyang prevalence indicates excessive Water pathogen, causing condensation and freezing. Feathered creatures belong to Fire and delay metamorphosis. The Taiyang meridian runs along the spine and buttocks, causing hemorrhoids. Cold excess leads to struggle between pathogen and righteous Qi, causing malaria. Cold entering the Stomach causes jue-ni and internal heart pain via invasion of Monarch Fire. The Taiyang meridian connects to the Kidney and Bladder, causing yin ulcers, functional difficulty, and thigh radiation. Cold in muscles/tendons causes rigidity and bi-syndrome. Cold in blood vessels causes Ying-Wei stagnation and meridian blockage, filling collaterals and changing color. Blood stasis in meridians causes erratic flow and bloody discharge. Exterior cold failure causes skin induration/swelling. Interior cold stagnation causes abdominal fullness/appetite loss. Yin-cold below causes Yang to float above, reversing heat upward. Head, nape, fontanelle, brain, and eye corners are Taiyang pathways; cold occupying them causes severe pain. Cold entering the Lower Jiao depletes Mingmen Yang, transmitting into soft diarrhea. "Xin" [fontanelle] sounds like 'xin'.)
The Yellow Emperor asked: How should these be treated? (Treating Six Qi mutual overcoming.) Qibo replied: For Jueyin prevalence, treat with Sweet-Clear herbs, assist with Bitter-Acrid herbs, and drain with Sour herbs. (Wood excess damages Earth; Sweet clears Earth, Clear calms Wood. Assist with Bitter-Acrid to disperse Wind. Drain with Sour, as Sour is the true flavor of Wood.) For Shaoyin prevalence, treat with Acrid-Cold herbs, assist with Bitter-Salty herbs, and drain with Sweet herbs. (Heat excess attacks Metal; Acrid-Cold disperses Fire. Assist with Bitter-Salty to drain heat. Drain with Sweet, as Sweet is the true flavor of Fire.) For Taiyin prevalence, treat with Salty-Hot herbs, assist with Acrid-Sweet herbs, and drain with Bitter herbs. (Earth excess causes Dampness; Salty-Hot moistens downward and dries damp. Damp excess chills Earth; Acrid-Sweet warms and tonifies Earth. Drain with Bitter, as Bitter is the true flavor of Earth.) For Shaoyang prevalence, treat with Acrid-Cold herbs, assist with Sweet-Salty herbs, and drain with Sweet herbs. (This matches Shaoyin treatment but differs slightly in assisting herbs, as Sweet can also drain Fire.) For Yangming prevalence, treat with Acid-Warm herbs, assist with Acrid-Sweet herbs, and drain with Bitter herbs. (Dry-Metal excess affects Lung and Liver; Acid-Warm moistens dryness and warms Lung. Assist with Acrid-Sweet to drain Lung and tonify Liver. Drain with Bitter, as Bitter transforms via Fire and drains Dryness excess.) For Taiyang prevalence, treat with Sweet-Hot herbs, assist with Acrid-Sour herbs, and drain with Salty herbs. (Water excess weakens Fire; Sweet-Hot tonifies Earth to control Water and supports Yang to expel Cold. Assist with Acrid-Sour to disperse Cold excess and astringe Heart Qi injury. Drain with Salty, as Salty is the true flavor of Water.)