(素问汤液醪醴论 全)
黄帝问曰∶为五谷汤液及醪醴奈何?(汤液醪醴,皆酒之属。韵义云∶醅酒浊酒日醪。诗诂云∶酒之甘浊而不 者
日醴。然则汤液者,其即清酒之类欤。醪音劳。醴音礼。 音济。)岐伯对曰∶必以稻米,炊之稻薪,稻米者完,稻薪者
坚。(完者其味全。坚者其气锐。)帝曰∶何以然?岐伯曰∶此得天地之和,高下之宜,故能至完;伐取得时,故能至坚
也。(谷之性味中正,功用周全,以其得天地之和,高下之宜,故能至完。完,全也。)帝曰∶上古圣人作汤液醪醴,为
而不用何也?岐伯曰∶自古圣人之作汤液醪醴者,以为备耳,夫上古作汤液,故为而弗服也。(圣人之作汤液者,先事预
防,所以备不虞耳。盖上古之世,道全德盛,性不嗜酒,邪亦弗能害,故但为而弗服也。)中古之世,道德稍衰,邪气时
至,服之万全。(道德稍衰,天真或损,则邪能侵之;然犹不失于道,故但服汤液醪醴而可万全矣。)帝曰∶今之世不必
已何也?(谓治以汤液醪醴,而不能必其病之已也。)岐伯曰∶当今之世,必齐毒药攻其中, 石针艾治其外也。(齐毒
药,以毒药为剂也。 ,针也。九针论∶一曰 针。今世道德已衰,疾病已甚,故非毒药不能攻其中,非针艾不能治其
外。齐,剂同。 音惭,锐也。)帝曰∶形弊血尽而功不立者何?(此承上文而言治之如法,以至于形弊血尽,而病犹不
愈者何也?)岐伯曰∶神不使也。(凡治病之道,攻邪在乎针药,行药在乎神气,故治施于外,则神应于中,使之升则升,
使之降则降,是其神之可使也。若以药剂治其内而脏气不应,针艾治其外而经气不应,此其神气已去,而无可使矣。虽
竭力治之,终成虚废已尔,是即所谓不使也。)帝曰∶何谓神不使?岐伯曰∶针石道也,精神不进,志意不治,故病不可
愈。(道,治病之道也。不进不治者,欲其进而不进,欲其治而不治也,故病不可愈。)今精坏神去,荣卫不可复收。何
者?嗜欲无穷而忧患不止,精气弛坏,荣泣卫除,故神去之而病不愈也。(肾藏精,精为阴,心藏神,神为阳,精坏神去
则阴阳俱败,表里俱伤,荣卫不可收拾矣。此其故,以今人嗜欲忧患不节,失其所养,故致精气弛坏,荣泣卫除,而无
能为力也。荣,营同。泣,涩同。)帝曰∶夫病之始生也,极微极精,必先入结于皮肤。今良工皆称曰∶病成名曰逆,则
针石不能治,良药不能及也。今良工皆得其法,守其数,亲戚兄弟远近音声日闻于耳,五色日见于目,而病不愈者,亦
何暇不早乎?(极微者,言轻浅未深。极精者,言专一未乱。斯时也,治之极易,及其病成,则良工称为逆矣。然良工
之治,既云得法而至数弗失,亲戚之闻见极熟而声色无差,宜乎无不速愈者,而顾使其直至于精坏神去而病不能愈,亦
何暇治之不早乎?暇,言慢事也。)岐伯曰∶病为本,工为标,标本不得,邪气不服,此之谓也。(病必得医而后愈,故
病为本,工为标。然必病与医相得,则情能相浃,才能胜任,庶乎得济而病无不愈。惟是用者未必良,良者未必用,是
为标本不相得,不相得则邪气不能平服,而病之不愈者以此也。又如五脏别论曰∶拘于鬼神者,不可与言至德。恶于针
石者,不可与言至巧。病不许治者,病必不治,治之无功矣。又如脉色类不失人情详按,皆标本不得之谓。)帝曰∶其有
不从毫毛生,而五脏阳已竭也,津液充郭,其魄独居,孤精于内,气耗于外,形不可与衣相保,此四极急而动中,是气
拒于内而形施于外,治之奈何?(不从毫皮生,病生于内也。五脏阳已竭,有阴无阳也。津液,水也。郭,形体胸腹也。
胀论曰∶夫胸腹,脏腑之郭也。凡阴阳之要,阴无阳不行,水无气不化,故灵兰秘典论曰∶气化则能出矣。今阳气既竭,
不能通调水道,故津液妄行,充于郭也。魄者阴之属,形虽充而气则去,故其魄独居也。精中无气,则孤精于内。阴内
无阳,则气耗于外。三焦闭塞,水道不通,皮肤胀满,身体羸败,故形不可与衣相保也。四肢者诸阳之本,阳气不行,
故四极多阴而胀急也。胀由阴滞,以胃中阳气不能制水,而肺肾俱病,喘咳继之,故动中也。此以阴气格拒于内,故水
胀形施于外而为是病。)岐伯曰∶平治于权衡。(平治之法当如权衡者,欲得其平也。且水胀一证,其本在肾,其标在肺。
如五脏阳已竭、魄独居者,其主在肺,肺主气,气须何法以化之?津液充郭,孤精于内,其主在肾,肾主水,水须何法
以平之?然肺金生于脾,肾水制于土,故治肿胀者,必求脾肺肾三脏,随盛衰而治得其平,是为权衡之道也。)去宛陈 ,
是以微动四极,温衣,缪刺其处,以复其形。开鬼门,洁净府,精以时服,五阳已布,疏涤五脏,故精自生,形自盛,
骨肉相保,巨气乃平。帝曰∶善。(宛,积也。陈,久也。 ,斩草也。谓去其水气之陈积,欲如斩草而渐除之也。四极,
四肢也。微动之,欲其流通而气易行也。温衣,欲助其肌表之阳而阴凝易散也。然后缪刺之,以左取右,以右取左,而
去其大络之留滞也。鬼门,汗空也,肺主皮毛,其藏魄,阴之属也,故曰鬼门。净府,膀胱也,上无入孔而下有出窍,
滓秽所不能入,故曰净府。邪在表者散之,在里者化之,故曰开鬼门、洁净府也。水气去则真精服。服,行也。阴邪除
则五阳布。五阳,五脏之胃气也。由是精生形盛,骨肉相保,而巨气可平矣。宛,郁同。 音 。)
《素问·汤液醪醴论》(全文)
黄帝问道:制作五谷的汤液和醪醴,应当怎么做?(汤液和醪醴,都属于酒类。韵义说:浑浊的酒叫醪。诗诂说:甘甜浑浊而不清的酒叫醴。那么汤液,大概就是清酒之类吧。醪音劳。醴音礼。 音济。)岐伯回答说:必须用稻米做原料,用稻秆做燃料。因为稻米的性质完备,稻秆的性质坚实。(“完”是指它的味道纯正。“坚”是指它的气味锐利。)黄帝说:为什么这样说呢?岐伯说:这是因为稻米得到了天地阴阳的和谐之气,适应了高下不同的地理环境,所以性质极其完备;砍伐采集的时间恰当,所以质地极其坚实。(谷物的性味中正,功用周全,因为它得天地之和、高下之宜,所以能达到极致的完备。完,就是全的意思。)黄帝说:上古的圣人制作了汤液醪醴,只是预备着却不使用,这是为什么呢?岐伯说:自古圣人制作汤液醪醴,是为了防备疾病之用。上古时代制作汤液,所以只是预备着而不服用。(圣人的制作汤液,是事先预防,用来防备意外情况。大概上古时代,道德完备,德性昌盛,本性不嗜好饮酒,邪气也不能侵害人体,所以只是制作出来而不服用。)中古时代,道德稍微衰退,邪气时常侵袭,服用汤液醪醴就能万无一失。(道德稍衰,天真之气或有损伤,则邪气能够侵入;然而还不至于违背大道,所以只要服用汤液醪醴就可以保证痊愈。)黄帝说:现在的时代,即使使用了汤液醪醴,也不一定能使病愈,这是为什么呢?(意思是治疗使用汤液醪醴,而不能必定使疾病痊愈。)岐伯说:当今时代,必须使用毒药来攻治体内的病变,使用砭石、针具和艾灸来治疗体表的病变。(齐毒药,即以毒药作为药剂。 ,指针。九针论说:第一种是 针。现在道德已经衰退,疾病已经很严重,所以不用毒药不能攻治体内,不用针艾不能治疗体表。齐,通“剂”。 音惭,意为锐利。)黄帝说:形体败坏、血液耗尽,而治疗效果却建立不起来,这是为什么呢?(这是承接上文所说的,虽然治疗方法合乎法度,以至于形体败坏、血液耗尽,但病仍然不愈,这是为什么呢?)岐伯说:这是因为神气不再发挥作用了。(大凡治病的方法,攻逐邪气在于针药,发挥药效在于神气,所以治疗施于体外,神气就会在体内响应,让它上升它就上升,让它下降它就下降,这就是神气可以被驱使。如果用药剂治疗内部而脏气不响应,用针艾治疗外部而经气不响应,这说明神气已经离去,无法再被驱使了。虽然竭尽全力治疗,最终也只能成为虚废之人罢了,这就是所谓的“不使”。)黄帝说:什么叫神不使?岐伯说:针石是治病的手段,如果精神不能进复,意志不能调治,所以病不能痊愈。(道,指治病之道。不进不治,是想让它恢复却不能恢复,想让它调治却不能调治,所以病不能痊愈。)现在精气败坏、神气离去,营气和卫气都无法再收摄。为什么呢?因为嗜欲没有穷尽而忧患不停止,精气松弛败坏,营血凝涩、卫气消散,所以神气离去而病不能痊愈。(肾藏精,精属阴;心藏神,神属阳。精坏神去则阴阳俱败,表里俱伤,营卫就无法收拾了。这其中的原因,是因为现代人嗜欲忧患不加节制,失去了对精气的滋养,导致精气松弛败坏,营血凝涩、卫气消散,从而无能为力。荣,同“营”。泣,同“涩”。)黄帝说:疾病刚产生的时候,极其细微精微,必然先结聚在皮肤。现在优秀的医生都说:疾病形成后称为“逆证”,那么针石不能治疗,良药也达不到作用了。现在的优秀医生都掌握了方法,遵守了法则,亲戚兄弟远近的人声音天天在耳边听到,五色天天在眼前看到,而病仍不愈,这难道不是治疗得太晚了吗?(极微,是说病情轻浅未深。极精,是说精神专一未乱。这个时候,治疗极易;等到疾病形成,就连优秀的医生也称其为“逆证”了。然而优秀医生的治疗,既然声称得法且不失度数,亲戚的见闻极其熟悉且声色无误,按理说应该无不迅速痊愈的,却反而让病情发展到精气败坏、神气离去而病不能愈,这难道不是治疗太慢、太晚了吗?暇,指怠慢、疏忽。)岐伯说:疾病是本,医生是标,标本不相契合,邪气就不能被制服,说的就是这个道理。(疾病必须得到医生的诊治才能痊愈,所以病为本,医为标。但是必须病人和医生相互配合,才能使情意相通,才能胜任治疗,这样才有望治愈且病无不好。只是使用的人未必是良医,良医未必被使用,这就是标本不相契合。不相契合则邪气不能平服,而病不愈的原因就在这里。又如《五脏别论》说:拘泥于鬼神的人,不可与他谈论高深的医德。厌恶针石的人,不可与他谈论高超的技巧。病人不允许治疗,病一定治不好,治疗也不会有效果。又如《脉色类》中关于不失人情的详细分析,都是说的标本不得的情况。)黄帝说:如果有不从皮毛开始发生,而是五脏阳气已经衰竭的疾病,津液充满胸腹,只有魄(阴形)独存,孤立的精气在内,耗散的气在外,形体消瘦到衣服都穿不住,四肢紧急并伴有内脏躁动,这是气拒于内而形体衰败于外,治疗该怎么办?(不从毫毛皮肤生发,说明病生于内部。五脏阳气已竭,是有阴无阳。津液,指水湿。郭,指形体胸腹。《胀论》说:胸腹是脏腑的外廓。大凡阴阳的关键,阴没有阳就不能运行,水没有气就不能气化,所以《灵兰秘典论》说:气化后才能排出。现在阳气既已衰竭,不能通调水道,所以津液妄行,充满胸腹。魄属于阴,形体虽然充盛但气已离去,所以魄独存。精中没有气,就是孤精在内。阴中没有阳,就是气耗于外。三焦闭塞,水道不通,皮肤胀满,身体羸弱败坏,所以形体瘦削到衣服都穿不住。四肢是诸阳之本,阳气不行,所以四肢多阴而胀急。胀由阴气阻滞,因胃中阳气不能制水,而肺肾俱病,喘息咳嗽随之而来,所以动及内脏。这是以阴气格拒于内,所以水胀、形体衰败于外而成为这种病。)岐伯说:要像权衡一样平治其阴阳。(平治的方法应当像权衡那样,以求得其平衡。况且水胀这一病症,其本在肾,其标在肺。如五脏阳气已竭、魄独存者,其主治在肺,肺主气,气需要用何种方法来化生?津液充满胸腹,孤精在内,其主治在肾,肾主水,水需要用何种方法来平调?然而肺金生于脾,肾水受制于土,所以治疗肿胀,必须求之于脾、肺、肾三脏,根据它们的盛衰情况进行治疗以求得平衡,这就是权衡之道。)去除积聚的陈腐之物,轻微活动四肢,穿着温暖衣物,采用缪刺法针刺患处,以恢复形体。开泄汗孔,通利小便,精气按时行使,五脏阳气得以布散,疏通涤荡五脏,所以精气自然产生,形体自然强盛,骨肉相互保护,元气得以平和。黄帝说:好。(宛,积聚。陈,久远。 ,斩草。指去除水气的陈积,想要像斩草一样逐渐清除。四极,指四肢。轻微活动它们,是为了使气血流通而气容易运行。温衣,是为了帮助肌表的阳气而使阴凝容易消散。然后进行缪刺,即左病取右,右病取左,以去除大络中的留滞。鬼门,指汗孔,肺主皮毛,其脏为魄,属于阴,所以叫鬼门。净府,指膀胱,上无入孔而下有出窍,污秽不能进入,所以叫净府。邪在表则发散之,在里则化解之,所以说开鬼门、洁净府。水气去除则真精运行。服,指运行。阴邪去除则五阳布散。五阳,指五脏的胃气。由此精气生成,形体强盛,骨肉相保,而元气可以平和了。宛,同“郁”。 音 。)
*Suwen: Treatise on Decoctions and Fermented Liquors* (Full Text)
The Yellow Emperor asked, saying: How should one prepare decoctions of the five grains and fermented liquors? (Decoctions and fermented liquors both belong to the category of wine. *Yunyi* states: Turbid wine is called Lao. *Shigu* states: Sweet, turbid, but not clear wine is called Li. Thus, decoctions are likely similar to clear wine. Lao is pronounced "lao". Li is pronounced "li". [Character] is pronounced "ji".) Qibo replied, saying: One must use rice as the raw material and burn rice straw as fuel. Rice is perfect in nature, and rice straw is firm in quality. ("Perfect" refers to its complete flavor. "Firm" refers to its sharp qi.) The Emperor asked, saying: Why is this so? Qibo said: This is because they obtain the harmony of heaven and earth and the suitability of high and low places, thus achieving perfection; they are harvested at the appropriate time, thus achieving firmness. (The nature and flavor of grains are central and correct, and their functions are comprehensive. Because they obtain the harmony of heaven and earth and the suitability of terrain, they achieve ultimate perfection. "Perfect" means complete.) The Emperor asked, saying: In ancient times, sages prepared decoctions and fermented liquors but did not use them. Why was this? Qibo said: Since ancient times, when sages prepared decoctions and fermented liquors, it was for preparation purposes. In ancient times, decoctions were prepared but not consumed. (Sages prepared decoctions to prevent disease beforehand, thereby preparing for unforeseen circumstances. In ancient times, the Dao was complete and virtue was abundant; people's natures did not crave alcohol, and pathogenic factors could not harm them. Therefore, they only prepared them without consuming them.) In middle antiquity, virtue declined slightly, and pathogenic factors frequently invaded. Consuming these preparations ensured complete recovery. (With slight decline in virtue, innate truth might be damaged, allowing pathogens to invade; however, since the Dao was still largely maintained, consuming decoctions and fermented liquors could ensure safety.) The Emperor asked, saying: In the present era, even if decoctions and fermented liquors are used, why is it not certain that the disease will cease? (This implies that treating with decoctions and fermented liquors does not guarantee the cessation of disease.) Qibo said: In the current era, one must necessarily use toxic medicines to attack internal pathology and employ bian stones, needles, and moxibustion to treat external pathology. ("Qi du yao" means using toxic medicines as agents. [Character] refers to needles. *Jiuzhen Lun* states: The first type is the [Character] needle. Now that virtue has declined and diseases are severe, non-toxic medicines cannot attack internally, and non-needle/moxa treatments cannot cure externally. "Qi" is synonymous with "ji" (agent/dose). [Character] is pronounced "can", meaning sharp.) The Emperor asked, saying: When the physique is debilitated and blood is exhausted, yet therapeutic efficacy fails to manifest, why is this? (This follows from the previous discussion: although treatment methods are correct, leading to physical debilitation and blood exhaustion, why does the disease persist?) Qibo said: It is because the Shen (Spirit) no longer responds. (In general, the method of curing disease involves attacking pathogens with needles and medicines, while the execution of medicinal effects relies on Shen Qi. Thus, when treatment is applied externally, Shen responds internally; if directed to rise, it rises; if directed to descend, it descends. This shows that Shen can be directed. However, if internal medication fails to elicit a response from Zang organs, or external needle/moxa treatment fails to elicit a response from Jing meridians, it indicates that Shen Qi has departed and cannot be directed. Even with utmost effort in treatment, the patient ultimately becomes wasted and useless. This is what is meant by "not responding".) The Emperor asked, saying: What is meant by "Shen not responding"? Qibo said: Needles and stones are the way of treatment. If Jing Spirit does not advance and Zhi Yi (Will/Intent) is not regulated, the disease cannot be cured. ("Dao" refers to the way of treatment. "Not advancing/not regulating" means desiring advancement but failing to advance, desiring regulation but failing to regulate, hence the disease cannot be cured.) Now, Jing Essence is ruined and Shen departs, making Ying (Nutritive) and Wei (Defensive) Qi irretrievable. Why? Because desires are endless and worries are unceasing, causing Jing Qi to slacken and deteriorate, Ying Blood to become stagnant, and Wei Qi to dissipate. Thus, Shen departs, and the disease cannot be cured. (The Kidneys store Jing Essence, which is Yin; the Heart stores Shen, which is Yang. Ruin of Jing and departure of Shen lead to the collapse of both Yin and Yang, and injury to both interior and exterior, making Ying and Qi unmanageable. The reason lies in modern people's lack of moderation in desires and worries, losing nourishment for their essence, leading to slackening Jing Qi, stagnant Ying Blood, and dissipated Wei Qi, rendering them powerless. "Rong" is synonymous with "Ying". "Qi" is synonymous with "Se" (stagnant)). The Emperor asked, saying: When a disease first arises, it is extremely subtle and refined, initially binding in the skin and hair. Now, skilled physicians say: Once a disease takes form, it is called an "adverse condition," where needles and stones cannot treat it, and good medicines cannot reach it. Skilled physicians today possess the correct methods and adhere to the proper numbers. Relatives and friends are constantly heard and seen, yet the disease does not heal. Is this not due to treatment being too late? (Extremely subtle means light and shallow, not deep. Extremely refined means focused spirit, not chaotic. At this stage, treatment is very easy. Once the disease forms, even skilled physicians call it "adverse." However, skilled physicians claim to have mastered the methods and lost no degrees of precision. Relatives' observations are thorough, and auditory/visual inputs are accurate. Logically, rapid recovery should occur. Yet, the condition progresses to ruin of Jing and departure of Shen, making cure impossible. Is this not due to negligence or delay in early treatment? "Xia" refers to slowness/negligence.) Qibo said: The disease is the root (Ben), and the physician is the branch (Biao). If root and branch do not match, pathogenic Qi cannot be subdued. This is what is meant. (Disease requires a physician to heal, so disease is Ben, physician is Biao. However, there must be compatibility between patient and physician for mutual understanding and effective treatment. Often, those who need care are not served by good physicians, and good physicians are not utilized by those who need care. This mismatch prevents subduing pathogenic Qi, leading to non-healing. As stated in *Wu Zang Bie Lun*: One bound by ghosts/spirits cannot be spoken to regarding profound virtue. One who dislikes needles/stones cannot be spoken to regarding skill. If the patient refuses treatment, the disease will not heal, and treatment will be ineffective. Similarly, analyses in *Mai Se Lei* regarding human relations all refer to the mismatch of root and branch.) The Emperor asked, saying: What if the disease does not originate from the skin/hair, but rather the Yang Qi of the Five Zang Organs is exhausted? Fluids fill the body cavity (Guo), only the Po (Corporeal Soul/Yin Form) remains alone, isolated Jing Essence is inside, Qi is exhausted outside, the body is so emaciated it cannot retain clothing, the four extremities are tight and internal organs are agitated. This is Qi rejecting internally and the form suffering externally. How should this be treated? (Not originating from skin/hair means the disease arises internally. Exhaustion of Five Zang Yang Qi means presence of Yin without Yang. "Fluids" refer to water/dampness. "Guo" refers to the body cavity/chest and abdomen. *Zhang Lun* states: Chest and abdomen are the outer walls of the Zang organs. The key to Yin and Yang is that Yin cannot move without Yang, and water cannot transform without Qi. Thus, *Linglan Midian Lun* states: Transformation allows for excretion. Now, with exhausted Yang Qi, water passages cannot be regulated, causing fluids to wander and fill the cavity. Po belongs to Yin. Although the form is full, Qi has left, so Po remains alone. Jing without Qi is isolated Jing inside. Yin without Yang is Qi exhausted outside. San Jiao is blocked, water passages are obstructed, skin is distended, body is wasted, so the form cannot retain clothing. Extremities are the root of all Yang. With non-moving Yang, extremities are Yin-heavy and tense. Distension is caused by Yin stagnation; stomach Yang cannot control water, affecting Lung and Kidney, leading to wheezing/coughing, thus affecting internal organs. This is Yin rejecting internally, causing water distension and external form deterioration.) Qibo said: Balance and treat according to the scale (Quan Heng). (The method of balancing treatment should be like a scale, seeking equilibrium. Regarding water distension, the root is in the Kidney, and the branch is in the Lung. For cases of exhausted Five Zang Yang and solitary Po, the focus is the Lung, which governs Qi. How should Qi be transformed? For fluids filling the cavity and isolated Jing, the focus is the Kidney, which governs Water. How should Water be balanced? Lung Metal is born from Spleen Earth, and Kidney Water is controlled by Earth. Therefore, treating swelling requires addressing the Spleen, Lung, and Kidney, adjusting based on their excess or deficiency to achieve balance. This is the way of the scale.) Remove accumulated stale matter, gently move the four extremities, wear warm clothes, apply Miu Ci (lateral puncture) at the affected sites to restore the form. Open the "Ghost Gates" (sweat pores), purify the "Clean Mansion" (bladder), allow Jing Essence to function regularly, distribute the Five Yang Qi, and dredge/cleanse the Five Zang Organs. Thus, Jing Essence generates naturally, the form strengthens, bones and flesh protect each other, and the Great Qi becomes peaceful. The Emperor said: Excellent. ("Wan" means accumulation. "Chen" means old/stale. [Character] means cutting grass. This refers to removing stale water accumulation, gradually eliminating it like cutting grass. "Si Ji" refers to the four extremities. Gently moving them promotes circulation and ease of Qi flow. Warm clothes assist surface Yang to disperse Yin coagulation. Then, apply Miu Ci—treating left with right, right with left—to remove stagnation in large collaterals. "Gui Men" (Ghost Gate) refers to sweat pores. The Lung governs skin/hair and houses the Po, belonging to Yin, hence "Ghost Gate". "Jing Fu" (Clean Mansion) refers to the bladder. It has no upper opening but has an outlet below, preventing filth from entering, hence "Clean Mansion". Pathogens in the exterior are dispersed; pathogens in the interior are resolved. Hence, "Open Ghost Gates, Purify Clean Mansion". Removal of water Qi allows true Jing to circulate. "Fu" means to circulate/function. Removal of Yin pathogens allows Five Yang to distribute. "Five Yang" refers to the Stomach Qi of the Five Zang Organs. From this, Jing generates, form strengthens, bones/flesh are protected, and Great Qi is pacified. "Wan" is synonymous with "Yu" (depression/stagnation). [Character] is pronounced "chan".)