(《素问·阳明脉解篇》全)
黄帝问曰∶足阳明之脉病,恶人与火,闻木音则惕然而惊,钟鼓不为动,闻木音而惊何也?愿闻其故。(脉,即经也。
本篇之义,大略皆出《灵枢·经脉篇》,详前二章。)岐伯对曰∶阳明者胃脉也,胃者土也,故闻木音而惊者,土恶木也。
(木能克土,故恶之。)帝曰∶善。其恶火何也?岐伯曰∶阳明主肉,其脉血气盛,邪客之则热,热甚则恶火。(阳明经
多气多血,邪客之则血气壅而易为热,热则恶火也。)帝曰∶其恶人何也?岐伯曰∶阳明厥则喘而惋,惋则恶人。(阳明
气逆而厥,则为喘惋。惋,忧惊也。故恶人之烦扰。惋,乌贯切。)帝曰∶或喘而死者,或喘而生者,何也?岐伯曰∶厥
逆连脏则死,连经则生。(连脏者败及三阴,故死。连经则肌表之疾耳,故生。)帝曰善。病甚则弃衣而走,登高而歌,
或至不食数日,逾垣上屋,所上之处,皆非其素所能也,病反能何也?(凡癫狂伤寒家多有此证。)岐伯曰∶四肢者诸阳
之本也,阳盛则四肢实,实则能登高也。(阳受气于四末,故四肢为诸阳之本。阳邪刚盛,故步履变常也。)帝曰∶其弃
衣而走者何也?岐伯曰∶热盛于身,故弃衣欲走也。(阳明主肌肉,故热盛于身。)帝曰∶其妄言骂詈、不避亲疏而歌者
何也?岐伯曰∶阳盛则使人妄言骂詈、不避亲疏而不欲食,不欲食故妄走也。(阳盛者,阳邪盛也。阳明为多气多血之经
而阳邪实之,阳之极也。阳气者静则神藏,躁则消亡,故神明乱而病如是。詈音利。)
(《素问·阳明脉解篇》全文)
黄帝问道:足阳明经发生病变,患者厌恶人和火光,听到木器的声音就惊恐不安,但听到钟鼓的声音却不为所动。为什么听到木器的声音就会惊恐呢?我想听听其中的道理。(这里的“脉”,指的就是“经”。本篇的大意主要出自《灵枢·经脉篇》,详见前两章。)
岐伯回答说:阳明经是胃的经脉,胃在五行中属土,所以听到木器的声音而惊恐,是因为土畏惧木。(因为木能克土,所以对此感到厌恶。)
岐伯说:阳明经主管肌肉,它的经脉气血旺盛,邪气侵入就会发热,热势严重就会厌恶火光。(阳明经是多气多血的经脉,邪气侵入会导致气血壅滞而容易发热,热盛则厌恶火。)
岐伯说:阳明经的气机逆乱就会导致气喘和心中烦闷惊惧,心中烦闷惊惧就会厌恶人。(阳明之气上逆而发生厥逆,就会出现气喘和烦闷。惋,是指忧愁惊惧。所以厌恶人的烦扰。惋,读音为乌贯切。)
黄帝说:有的病人气喘而死,有的气喘却存活下来,这是为什么呢?
岐伯说:如果厥逆之气连及内脏就会死亡,只连及经脉就能存活。(连及内脏意味着病败坏了三阴经,所以死亡。只连及经脉只是肌表的疾病,所以存活。)
黄帝说:讲得好。病情严重时,病人会扔掉衣服到处跑,登上高处唱歌,甚至几天不吃饭,翻越墙垣、爬上屋顶,他们爬到的地方,都是他们平时做不到的,为什么生病后反而能做到呢?(凡是癫狂病或伤寒病患者,多有这种症状。)
岐伯说:四肢是诸阳经的根本,阳气旺盛则四肢充实有力,充实有力就能登高。(阳气受纳于四肢末端,所以四肢是诸阳的根本。阳邪刚强旺盛,所以步态举止变得反常。)
黄帝说:那为什么扔掉衣服到处跑呢?
岐伯说:因为热气充斥全身,所以扔掉衣服想要奔跑。(阳明经主管肌肉,所以热气充斥全身。)
黄帝说:那为什么胡言乱语、骂人、不分亲疏地唱歌呢?
岐伯说:阳气过盛会使人胡言乱语、骂人、不分亲疏并且不想吃东西,不想吃东西所以胡乱奔走。(所谓阳盛,是指阳邪亢盛。阳明经是多气多血的经脉,被阳邪实邪占据,是阳气的极盛状态。阳气本性安静则神志内守,躁动则神志消亡,所以神志错乱而出现上述病症。詈,读音为利。)
(Full text of "Explanation of the Yangming Meridian" from *Suwen*)
The Yellow Emperor asked: When the Foot-Yangming meridian is diseased, the patient dislikes people and fire. Upon hearing the sound of wood, they are startled and frightened; however, the sounds of bells and drums do not move them. Why does hearing the sound of wood cause fright? I wish to hear the reason behind this. (Here, "meridian" refers to the "channel." The general meaning of this chapter is largely derived from the "Meridian Channel Chapter" in *Lingshu*; see the previous two chapters for details.)
Qibo replied: The Yangming is the stomach meridian. The stomach belongs to Earth in the Five Elements. Therefore, the fright caused by hearing the sound of wood occurs because Earth fears Wood. (Since Wood overcomes Earth, it is disliked.)
The Yellow Emperor said: Well said. Why do they dislike fire?
Qibo said: Yangming governs the flesh. Its meridians are abundant in Qi and Blood. When pathogenic factors invade, heat arises; when the heat is severe, the patient dislikes fire. (The Yangming meridian has abundant Qi and Blood. Pathogenic invasion leads to stagnation of Qi and Blood, making it prone to heat. Heat severity causes aversion to fire.)
The Yellow Emperor said: Why do they dislike people?
Qibo said: When Yangming Qi rebels, it causes panting and mental distress/fright. Mental distress leads to disliking people. (Yangming Qi rebellion results in counterflow and panting/distress. "Wan" refers to sorrow and fright. Thus, they dislike the disturbance caused by others. "Wan" is pronounced as 'wuguan'.)
The Yellow Emperor said: Some patients die from panting, while others survive with panting. Why is this?
Qibo said: If the counterflow connects to the Zang organs, death ensues; if it connects only to the Jing meridians, survival is possible. (Connection to Zang organs implies deterioration affecting the Three Yin, leading to death. Connection to meridians indicates a disease limited to the muscle and surface, allowing survival.)
The Yellow Emperor said: Well said. In severe cases, patients discard their clothes and run around, climb high places and sing. They may go without food for several days, jump over walls and roofs. They reach places they could never access before. Why can they perform these actions when ill? (Patients with mania or cold damage often exhibit such symptoms.)
Qibo said: The four limbs are the root of all Yang meridians. When Yang is excessive, the four limbs become solid and strong, enabling one to climb high. (Yang Qi receives nourishment at the extremities, so the four limbs are the root of all Yang. Excessive Yang pathogens are rigid and vigorous, causing abnormal gait and behavior.)
The Yellow Emperor said: Why do they discard their clothes and run?
Qibo said: Because heat is abundant throughout the body, they discard clothes and wish to run. (Yangming governs the muscles, so heat fills the body.)
The Yellow Emperor said: Why do they speak nonsense, curse, ignore kinship distinctions, and sing?
Qibo said: Excessive Yang causes people to speak nonsense, curse, disregard kinship ties, and lose their appetite. Due to loss of appetite, they wander aimlessly. (Excessive Yang means an abundance of Yang pathogens. Yangming is a meridian abundant in Qi and Blood; when filled with Yang excess, it represents the extreme of Yang. Yang Qi is naturally quiet, preserving the Spirit; when agitated, the Spirit dissipates. Thus, the Spirit becomes chaotic, resulting in such illnesses. "Li" is pronounced as 'li'.)