肝象木,旺于春;其脉弦,其神魂,其华在爪,其充在筋,其声呼,其臭臊,
其味酸,其液泣,其色青,其藏血;足厥阴其经也。与胆合,胆为腑而主表,肝为脏而主里
。
肝气盛,为血有余,则病目赤,两胁下痛引小腹,善怒。气逆则头眩,耳聋不聪,颊肿
,是肝气之实也,则宜泻之。肝气不足,则病目不明,两胁拘急,筋挛,不得太息,爪甲枯
,面青,善悲恐,如人将捕之,是肝气之虚也,则宜补之。
于四时∶病在肝,愈于夏;夏不愈,甚于秋;秋不死,待于冬;起于春。于日∶愈在丙
丁;丙丁不愈,加于庚辛;庚辛不死,待于壬癸;起于甲乙。于时∶平旦慧,下哺甚,夜半
静。禁当风。
肝部,左手关上是也。平肝脉来,绰绰如按琴瑟之弦,如揭长竿末梢,曰肝平。春以胃
气为本。春,肝木王,其脉弦细而长,是平脉也。反得微涩而短者,是肺之乘肝,金之克木
,大逆,十死不治;反得浮大而洪者,是心乘肝,子之扶母,虽病当愈;反得沉濡滑者,是
肾乘肝,母之归子,虽病当愈;反得大而缓者,是脾之乘肝,为土之陵木,土之畏木,虽病
不死。病肝脉来,盛实而滑,如循长竿,曰肝病;死肝脉来,急益劲,如新张弓弦,曰肝死
;真肝脉至,中外急,如循刀刃赜赜然,如新张弓弦。色青白不泽,毛折乃死。
《养生方》云∶春三月,此谓发陈,天地俱生,万物以荣。夜卧早起,阔步于庭。被发
缓形,以使春志生。生而勿杀,与而勿夺,赏而勿罚,此春气之应也;养生之道也。逆之则
伤于肝,夏变为寒,则奉长生者少。
《养生方·导引法》云∶肝脏病者,愁忧不乐,悲思嗔怒,头旋眼痛,呵气出而愈。
肝脏在五行中对应木,在春季最为旺盛;其脉象表现为弦脉,主宰神魂,荣华表现于指甲,充养组织在于筋脉,声音表现为呼号,气味表现为臊味,味道表现为酸味,体液表现为泪液,颜色表现为青色,功能是贮藏血液;足厥阴肝经是其所属经脉。肝脏与胆腑相表里配合,胆为腑而主表,肝为脏而主里。
肝气过盛,意味着血分有余,则会出现眼睛发红、两侧胁肋下疼痛并牵引至小腹、容易发怒的症状。若肝气上逆,则会出现头晕目眩、耳聋听力不灵敏、面颊肿胀,这是肝气实证的表现,治疗应当采用泻法。肝气不足,则会出现视物不明、两侧胁肋拘急挛缩、筋脉抽搐、不能深长呼吸、指甲干枯、面色青暗、容易悲伤恐惧,感觉像被人追捕一样,这是肝气虚证的表现,治疗应当采用补法。
在四季变化方面:肝病在夏季痊愈;如果夏季未愈,病情会在秋季加重;如果在秋季没有死亡,会等到冬季好转;并在春季开始恢复。在日干方面:痊愈多在丙、丁日;如果丙、丁日未愈,病情会在庚、辛日加重;如果庚、辛日没有死亡,会等到壬、癸日好转;并在甲、乙日开始恢复。在一天的时辰方面:清晨时症状减轻(神志清醒),傍晚时分症状加重,半夜时症状安静。应当避免直接吹受风邪。
肝部的脉诊位置,在左手关部是相应的。正常的肝脉,来势柔和有力,如同按压琴瑟之弦,又像提起长竹竿的末梢,这称为肝平脉。春季脉象以胃气为本底。春季是肝木当令之时,其脉象弦细而长,这是正常的平脉。如果反而出现微涩而短的脉象,这是肺金乘袭肝木,即金克木,属于大逆之证,十死无救;如果反而出现浮大而洪大的脉象,这是心火乘袭肝木,即子扶母,虽然生病但应当痊愈;如果反而出现沉濡滑的脉象,这是肾水乘袭肝木,即母归子,虽然生病但应当痊愈;如果反而出现大而缓的脉象,这是脾土乘袭肝木,即土陵木,虽然土畏木,但即使生病也不会死亡。患肝病时的脉象,盛大坚实且滑利,如同抚摸长竹竿,称为肝病脉;死亡的肝脉,急促且强劲,如同刚拉开的弓弦,称为肝死脉;真肝脉到来时,脉象内外紧急,如同触摸刀刃般锋利锐利,又像刚拉开的弓弦。面色青白而无光泽,毛发枯折者将会死亡。
《养生方》说:春季三个月,这叫做推陈出新,天地生机共同萌发,万物因此繁荣。晚上睡觉早上起床,在庭院中阔步慢行。披散头发,放松形体,以使春日的生发之气得以舒展。顺应生发之气而不杀戮,给予而不剥夺,奖赏而不惩罚,这是顺应春气的做法;也是养生的道理。违背它则会损伤肝脏,到了夏季可能会变为寒性疾病,那么奉养长生之气的力量就少了。
《养生方·导引法》说:患有肝脏疾病的人,往往忧愁不乐,悲伤思虑或愤怒,出现头晕眼花眼痛等症状,通过呵气吐故纳新即可痊愈。
The Liver corresponds to Wood in the Five Elements and is most vigorous in Spring; its pulse is Xian (Wiry), it governs Hun (Ethereal Soul), its luster manifests in the nails, it nourishes the sinews, its sound is shouting, its odor is fishy, its taste is sour, its fluid is tears, its color is green, and its function is storing Blood; the Foot-Jueyin Liver Meridian is its associated channel. It pairs with the Gallbladder; the Gallbladder is a Fu-organ and governs the exterior, while the Liver is a Zang-organ and governs the interior.
When Liver Qi is excessive, indicating an excess of Blood, symptoms include red eyes, pain in the hypochondriac regions radiating to the lower abdomen, and irritability. If Liver Qi rebels upward, symptoms include dizziness, deafness and poor hearing, and swelling of the cheeks; this is an Excess pattern of Liver Qi, which should be treated with draining methods. When Liver Qi is deficient, symptoms include blurred vision, stiffness and spasm in the hypochondriac regions, tendon cramping, inability to take deep sighs, dry and brittle nails, a bluish complexion, and frequent sadness or fear, feeling as if being pursued; this is a Deficiency pattern of Liver Qi, which should be treated with tonifying methods.
Regarding the four seasons: Liver diseases tend to heal in Summer; if they do not heal in Summer, they worsen in Autumn; if death does not occur in Autumn, recovery awaits in Winter; and improvement begins in Spring. Regarding Heavenly Stems: healing occurs on Bing and Ding days; if not healed on these days, worsening occurs on Geng and Xin days; if death does not occur on these days, recovery awaits on Ren and Gui days; and improvement begins on Jia and Yi days. Regarding times of day: symptoms are mild at dawn, severe in the late afternoon, and quiet at midnight. One must avoid exposure to wind.
The Liver pulse position corresponds to the Guan position on the left hand. A normal Liver pulse arrives soft and forceful, like pressing the strings of a qin or se, or like holding the tip of a long bamboo pole; this is called a Normal Liver Pulse. In Spring, the pulse is rooted in Stomach Qi. In Spring, when Liver Wood is dominant, the pulse is wiry, fine, and long, which is a Normal Pulse. If instead a faint, choppy, and short pulse is obtained, this indicates Lung Metal overacting on Liver Wood (Metal overcoming Wood), representing a great reversal; such cases are ten out of ten fatal and incurable. If instead a floating, large, and surging pulse is obtained, this indicates Heart Fire overacting on Liver Wood (the child supporting the mother); although sick, recovery is expected. If instead a deep, soft, and slippery pulse is obtained, this indicates Kidney Water overacting on Liver Wood (the mother returning to the child); although sick, recovery is expected. If instead a large and moderate pulse is obtained, this indicates Spleen Earth overacting on Liver Wood (Earth encroaching on Wood); although Earth fears Wood, death will not occur even if sick. In Liver disease, the pulse arrives abundant, solid, and slippery, like stroking a long pole; this is called a Liver Disease Pulse. The dying Liver pulse arrives rapid and tense, like a newly drawn bowstring; this is called a Dying Liver Pulse. When the True Liver pulse arrives, it is urgent inside and out, like touching the edge of a blade, sharp and cutting, like a newly drawn bowstring. If the complexion is greenish-white without luster and hair breaks off, death ensues.
The *Yangsheng Fang* states: The three months of Spring are called "promoting renewal"; Heaven and Earth generate together, and all things flourish. Sleep late and rise early, walk broadly in the courtyard. Let down your hair and relax your body to allow the Spring spirit to arise. Promote growth and do not kill; give and do not deprive; reward and do not punish; this is responding to Spring Qi; it is the way of health preservation. Violating this injures the Liver, potentially transforming into cold syndromes in Summer, thereby reducing the capacity to support life generation.
The *Yangsheng Fang · Daoyin Fa* states: Patients with Liver diseases often experience sorrow, unhappiness,悲伤思虑 (sadness and rumination), or anger, accompanied by dizziness and eye pain; exhaling deeply can lead to recovery.