(《素问·方盛衰论》)
雷公请问∶气之多少,何者为逆?何者为从?黄帝答曰∶阳从左,阴从右,(多少,言盛衰也。阳气主升,故从乎左。
阴气主降,故从乎右。从者为顺,反者为逆。)老从上,少从下。(老人之气,先衰于下,故从上者为顺。少壮之气,先
盛于下,故从下者为顺。盖天之生气,必自下而升,而人气亦然也。故凡以老人而衰于上者,其终可知,少壮而衰于下
者,其始可知,皆逆候也。)是以春夏归阳为生,归秋冬为死;(春夏以阳盛之时,或证或脉皆当归阳为生。若得阴候如
秋冬者,为逆为死。)反之,则归秋冬为生。(反之,谓秋冬也。秋冬以阴盛阳衰之时,故归阴为顺曰生。然不曰归春夏
为死者,可见阴中有阳,未必至害,而阳为阴贼,乃不免矣。)是以气多少,逆皆为厥。(气有多少,则阴阳不和,不和
则逆,故为厥也。)问曰∶有余者厥耶?(有其少,必有其多,故以阳厥多阳,阴厥多阴,皆疑其为有余也。)答曰∶一
上不下,寒厥到膝,少者秋冬死,老者秋冬生。(阳逆于上而不下,则寒厥到膝。老人阳气从上,膝寒犹可;少年阳气从
下,膝寒为逆。少年之阳不当衰而衰者,故最畏阴胜之时。老人阳气本衰,是其常也,故于秋冬无虑焉。)气上不下,头
痛巅疾。(巅,顶巅也。上实下虚,故病如此。)求阳不得,求阴不审,五部隔无征,若居旷野,若伏空
室,HT HT 绵乎属
不满日。(厥之在人也,谓其为阳,则本非阳盛,谓其为阴,则又非阴盛,故皆不可得。盖以五脏隔绝,无征可验,若居
圹野无所闻,若伏空室无所见。乃病则HT HT
不解,势甚雕敝,若弗能终其日者,岂真阴阳之有余者耶?HT ,古绵字)是
以少阴之厥,令人妄梦,其极至迷。(手少阴,心也。心主阳,其藏神。足少阴,肾也,肾主阴,其藏精。是以少阴厥逆,
则心肾不交而精神散越,故为妄梦。若其至极,乃令人迷乱昏昧也。)三阳绝,三阴微,是为少气。(三阳隔绝则阴亏于
上,三阴微弱则阳亏于下,阴阳不相生化,故少气不足以息。)是以肺气虚,则使人梦见白物,见人斩血籍籍;(此下言
五脏阴虚之梦兆也。肺虚者梦白物,金色白也,斩者,金之用也。虚者必怯,故见人斩血籍籍,多惊惕也。)得其时,则
梦见兵战。(得金王之时也。)肾气虚,则使人梦见舟船溺人;(肾合水,故梦应之。)得其时,则梦伏水中,若有畏恐。(得
水王之时也。)肝气虚,则梦见菌香生草;(肝合木也。菌,区允切。)得其时,则梦伏树下不敢起。(虽得木王之时,而
肝气本虚,故梦伏而不敢起。)心气虚,则梦救火阳物;(心合火也。阳物,即属火之类。)得其时则梦燔灼。(得火王之
时也。燔音凡。)脾气虚,则梦饮食不足;(仓廪空虚,故欲得饮食。)得其时,则梦筑垣盖屋。(得土王之时也。)此皆五
脏气虚,阳气有余,阴气不足。(五脏气虚,即阴不足也。阴气不足则虚阳独浮,故云阳气有余。无根之阳,其虚可知,
所以为厥为梦者,皆阳不附阴之所致。)合之五诊,调之阴阳,以在经脉。(合之五诊,则五脏可察。调之阴阳,则六经
可和。以在经脉,谓义如灵枢之经脉篇也。)
(出自《素问·方盛衰论》)
雷公请问:气的多少,什么叫做逆?什么叫做从?
黄帝回答说:阳气从左升发,阴气从右沉降。(“多少”,指的是盛衰。阳气主升,所以顺应左;阴气主降,所以顺应右。顺应者为顺,违背者为逆。)老年人之气从上起调摄,年轻人之气从下起调摄。(老年人的气,先在下面衰退,所以气从上起调摄为顺。年轻壮年人的气,先在下面旺盛,所以气从下起调摄为顺。大概天的生气,必定是从下向上升发,而人的气也是如此。所以凡是老年人如果在上面衰退的,其结局可以预知;年轻壮年人如果在下面衰退的,其起始原因可以知晓,这都是逆证的征象。)因此,春夏季节归于阳为生,归于秋冬为死;(春夏是阳气旺盛的时候,无论是证候还是脉象都应当归属于阳才为生。如果得到像秋冬那样的阴证候,就是逆证,主死。)反之,则归于秋冬为生。(所谓“反之”,是指秋冬季节。秋冬是阴气旺盛、阳气衰退的时候,所以归属于阴为顺,称为生。这里没有说归属于春夏为死,可以看出阴中蕴含阳,未必会造成危害,而阳被阴所克制伤害,这才难免致死。)因此,气的多少,凡是逆乱的都会导致厥证。(气有盛衰,就会导致阴阳不和,不和就会逆乱,所以产生厥证。)
雷公问:是邪气有余导致的厥吗?(有少必有多的情况,所以阳厥多因阳盛,阴厥多因阴盛,都让人怀疑是有余之邪。)
黄帝回答:阳气上逆而不下行,寒厥会到达膝盖,年轻人会在秋冬季节死亡,老年人则在秋冬季节生存。(阳气逆乱在上而不能下行,寒厥就会到达膝盖。老人的阳气本应从上,膝盖寒冷尚可忍受;少年的阳气本应从下,膝盖寒冷则是逆乱。少年人的阳气不应当衰退却衰退了,所以最畏惧阴气胜时的秋冬季节。老人阳气本来就衰弱,这是常态,所以在秋冬季节无需担忧。)气上逆而不下降,会导致头痛和头顶部的疾病。(巅,指头顶。上实下虚,所以出现这样的病症。)
想要探求阳气却得不到,想要审察阴气却不明确,五脏之间隔绝而没有征象,就像居住在旷野之中,又像伏在空室之内,茫然无依,似乎连一天都难以支撑。(厥证发生在人身上,如果说它是阳盛,其实并非阳盛;如果说它是阴盛,其实也并非阴盛,所以都无法确切得知。大概是因为五脏隔绝,没有证据可以验证,就像居住在旷野听不到声音,伏在空室看不到东西。然而病情缠绵不解,气势非常衰败,好像不能度过一整天的人,难道真的是阴阳有余吗?“HT”即古文的“绵”字。)
因此,少阴经气逆乱,使人做荒诞的梦,严重时甚至神志迷乱。(手少阴经对应心脏,心主阳,藏神。足少阴经对应肾脏,肾主阴,藏精。所以少阴经气逆乱,心肾不交,精神散乱,因此做荒诞的梦。如果严重到极点,就会让人迷乱昏昧。)三阳经气隔绝,三阴经气微弱,这叫做少气。(三阳经隔绝则阴气亏虚于上,三阴经微弱则阳气亏虚于下,阴阳不能相互化生,所以气少不足以呼吸。)
因此,肺气虚弱,会使人梦见白色的物体,梦见别人杀人流血遍地;(以下讲述五脏阴虚的梦兆。肺虚的人梦见白色物体,因为金色白,且白色属金。杀戮是金的功用。虚损的人必然胆怯,所以梦见别人杀人流血遍地,多有惊恐警惕。)如果遇到金气旺盛的时节,就会梦见战争。(遇到金王之时。)
肾气虚弱,会使人梦见舟船和人溺水;(肾合水,所以梦境与之相应。)如果遇到水气旺盛的时节,就会梦见趴在水中,好像充满恐惧。(遇到水王之时。)
肝气虚弱,会梦见菌类香草和生长的草木;(肝合木。菌,读音同“区允”。)如果遇到木气旺盛的时节,就会梦见趴在树下不敢起来。(虽然遇到木王之时,但肝气本来虚弱,所以梦见趴着不敢起来。)
心气虚弱,会梦见救火和阳刚之物;(心合火。阳物,即属于火的一类。)如果遇到火气旺盛的时节,就会梦见焚烧灼热。(遇到火王之时。燔,音凡。)
脾气虚弱,会梦见饮食不足;(仓库空虚,所以想要得到饮食。)如果遇到土气旺盛的时节,就会梦见修筑墙壁和盖房子。(遇到土王之时。)
这些都是五脏气虚,阳气有余,阴气不足。(五脏气虚,就是阴不足。阴气不足则虚阳独自浮越,所以说阳气有余。无根之阳,其虚可知,所以产生厥证和做梦,都是阳不能依附于阴所致。)结合五诊法,调和阴阳,依据经脉理论进行诊治。(结合五诊法,就能察知五脏状况。调和阴阳,就能使六经和谐。依据经脉,意思是如同《灵枢·经脉》篇所述那样。)
(From *Suwen: Fang Sheng Shuai Lun*)
Leigong asked: Regarding the abundance and deficiency of Qi, what constitutes "Ni" (Rebellion/Counterflow) and what constitutes "Cong" (Following/Compliance)?
Huangdi answered: Yang Qi ascends from the left, Yin Qi descends from the right. ("Abundance and deficiency" refers to excess and decline. Yang Qi governs ascent, thus it follows the left. Yin Qi governs descent, thus it follows the right. Following is considered "Shun" (Smooth/Obedient), while opposing is considered "Ni" (Rebellious).) For the elderly, regulation starts from above; for the young, regulation starts from below. (The Qi of the elderly declines first in the lower part, so regulating from above is "Shun". The Qi of the vigorous youth is abundant first in the lower part, so regulating from below is "Shun". Generally, the vital Qi of Heaven must ascend from below, and human Qi operates similarly. Therefore, if an elderly person declines in the upper part, their end can be foreseen; if a young person declines in the lower part, the cause can be known at the beginning. Both are signs of "Ni".) Thus, in Spring and Summer, returning to Yang indicates life, while returning to Autumn and Winter indicates death. (Spring and Summer are times when Yang is abundant; whether in symptoms or pulse, one should return to Yang for life. If one presents with Yin signs like those of Autumn and Winter, it is "Ni" and indicates death.) Conversely, returning to Autumn and Winter indicates life. (By "conversely", we refer to Autumn and Winter. These are times when Yin is abundant and Yang is declining, so returning to Yin is "Shun" and called life. The reason it does not say returning to Spring and Summer causes death is that Yin contains Yang, which may not necessarily be harmful, whereas Yang being harmed by Yin inevitably leads to death.) Therefore, regarding the abundance and deficiency of Qi, any "Ni" results in Jue syndrome. (When Qi has varying degrees of abundance and deficiency, Yin and Yang become disharmonious. Disharmony leads to rebellion, thus causing Jue syndrome.)
Leigong asked: Is Jue caused by excess? (Where there is deficiency, there must be relative excess; thus, Yang Jue involves excessive Yang, and Yin Jue involves excessive Yin, leading one to suspect they are caused by excess pathogens.)
Huangdi answered: When Yang rebels upward and does not descend, Cold Jue reaches the knees. The young will die in Autumn and Winter, while the elderly will survive in Autumn and Winter. (When Yang rebels upward and fails to descend, Cold Jue reaches the knees. For the elderly, whose Yang naturally resides higher, coldness in the knees is tolerable; for the youth, whose Yang naturally resides lower, coldness in the knees is rebellious. The Yang of the youth should not decline; if it does, they fear the time of Yin dominance most. The Yang of the elderly is inherently weak, which is normal, so they need not worry during Autumn and Winter.) When Qi rebels upward and does not descend, it causes headache and disorders of the vertex. ("Vertex" refers to the top of the head. Excess above and deficiency below cause such symptoms.)
Seeking Yang yields nothing; examining Yin remains unclear. The five Zang organs are isolated without evidence, as if dwelling in a vast wilderness or lying in an empty room, feeling lost and unsupported, seemingly unable to last even a full day. (Jue syndrome in humans: if considered Yang excess, it is not truly Yang excess; if considered Yin excess, it is not truly Yin excess, hence neither can be confirmed. This is because the five Zang organs are isolated, lacking verifiable signs, similar to hearing nothing in a wilderness or seeing nothing in an empty room. Yet the illness persists, the condition is severely depleted, as if unable to endure a whole day. Could this truly be due to Yin and Yang excess? "HT" is the ancient character for "Mian" [continuous/lingering].)
Therefore, Jue of the Shaoyin channel causes people to have delusional dreams; at its extreme, it causes confusion. (Hand-Shaoyin corresponds to the Heart, which governs Yang and houses the Shen [Spirit]. Foot-Shaoyin corresponds to the Kidney, which governs Yin and stores Jing [Essence]. Thus, when Shaoyin Qi rebels, Heart and Kidney do not interact, causing the Spirit and Essence to scatter, leading to delusional dreams. At its extreme, it causes mental confusion and stupor.) When the three Yang channels are severed and the three Yin channels are weak, this is called "Shao Qi" [Deficient Qi]. (Severance of the three Yang channels leads to Yin deficiency above; weakness of the three Yin channels leads to Yang deficiency below. Yin and Yang fail to generate each other, resulting in insufficient Qi and shortness of breath.)
Therefore, when Lung Qi is deficient, one dreams of white objects or sees people being slaughtered with blood spilling everywhere. (This section describes dream omens of Yin deficiency in the five Zang organs. Lung deficiency leads to dreaming of white objects, as Metal is white and slaughter is the function of Metal. Deficiency implies timidity, hence dreaming of slaughter and blood, indicating much fright and vigilance.) When encountering the time of Metal's dominance, one dreams of war. (Encountering the time when Metal is king.)
When Kidney Qi is deficient, one dreams of boats capsizing or people drowning. (Kidney corresponds to Water, so the dream reflects this.) When encountering the time of Water's dominance, one dreams of lying submerged in water, filled with fear. (Encountering the time when Water is king.)
When Liver Qi is deficient, one dreams of mushrooms, fragrant herbs, and growing grass. (Liver corresponds to Wood. "Jun" [mushroom] is pronounced "Qu Yun".) When encountering the time of Wood's dominance, one dreams of hiding under trees, afraid to rise. (Even when encountering the time when Wood is king, since Liver Qi is inherently deficient, one dreams of hiding and fearing to rise.)
When Heart Qi is deficient, one dreams of extinguishing fires and yang objects. (Heart corresponds to Fire. "Yang wu" [yang object] belongs to the category of Fire.) When encountering the time of Fire's dominance, one dreams of burning and scorching. (Encountering the time when Fire is king. "Fan" is pronounced "Fan".)
When Spleen Qi is deficient, one dreams of insufficient food and drink. (The granaries are empty, so there is a desire for food and drink.) When encountering the time of Earth's dominance, one dreams of building walls and roofs. (Encountering the time when Earth is king.)
These are all cases where the five Zang organs' Qi is deficient, Yang is in excess, and Yin is insufficient. (Five Zang Qi deficiency means Yin insufficiency. When Yin is insufficient, deficient Yang floats alone, hence it is said that Yang is in excess. The rootless nature of this Yang reveals its deficiency. Thus, the occurrence of Jue and dreams is caused by Yang failing to attach to Yin.) Combine these with the Five Diagnostic Methods, regulate Yin and Yang, and base treatment on the Meridians. (Combining the Five Diagnostic Methods allows observation of the five Zang organs. Regulating Yin and Yang harmonizes the six channels. Basing on the meridians refers to principles such as those in the *Lingshu: Jingmai* chapter.)