五脏皆禀气于肺,肺感微寒则咳嗽也。寒搏于气,气聚还肺,而邪有动息。邪动则气奔
逆上,气上则五脏伤动,动于胃气者,则胃气逆而呕吐也。此是肺咳连滞,气动于胃而呕吐
者也。
又有季夏脾王之时,而脾气虚不能王,有寒气伤之而咳嗽,谓之脾咳。其状,咳则右胁
下痛,喑喑引膊背,甚则不可动,动则咳发。脾与胃合,脾咳不已,则胃受之。其状,
咳嗽而呕,呕甚则长虫出是也。
凡诸咳嗽,甚则呕吐,各随证候,知其腑脏也。
肺虚为微寒所伤,则咳嗽。嗽则气还于肺间,则肺胀;肺胀则气逆。而肺本虚,气为不
足,复为邪所乘,壅痞不能宣畅,故咳逆短气也。
诸淋者,由肾虚膀胱热故也。膀胱与肾为表里,俱主水。水入小肠,下于胞,行于阴,
为溲便也。肾气通于阴,阴,津液下流之道也。若饮食不节,喜怒不时,虚实不调,则腑脏
不和,致肾虚而膀胱热也。膀胱,津液之府,热则津液内溢而流于睾,水道不通,水不上不
下,停积于胞,肾虚则小便数,膀胱热则水下涩。数而且涩,则淋沥不宣,故谓之为淋。其
状,小便出少起数,小腹弦急,痛引于齐。
又有石淋、劳淋、血淋、气淋、膏淋。诸淋形证,各随名具说于后章,而以一方治之者
,故谓之诸淋也。其汤熨针石,别有正方,补养宣导,今附于后。
《养生方·导引法》云∶偃卧,令两手布膝头,邪踵置尻下,口纳气,振腹自极,鼻出
气七息。去淋、数小便。
又云∶蹲踞,高一尺许,以两手从外屈膝内入,至足趺上,急手握足五指,极力一通,
令内曲入,利腰髋,治淋。
五脏的气血都禀受于肺,如果肺受到轻微寒邪的侵袭,就会发生咳嗽。寒邪与正气相搏结,气机郁聚并反逆于肺,而邪气的盛衰有波动起伏。当邪气发动时,气机便奔涌上逆;气机上逆则损伤五脏,若扰动到胃气,就会导致胃气上逆而发生呕吐。这就是肺部的咳嗽迁延不愈,气机变动波及胃部从而引起呕吐的情况。
又有在夏末秋初(季夏)脾气当令之时,如果脾气虚弱不能正常发挥其功能,被寒气所伤而导致咳嗽,这被称为脾咳。其症状表现为:咳嗽时右侧胁肋下疼痛,牵连肩背发出隐隐作痛的声音,严重时身体不能活动,一旦活动就会引发咳嗽。脾与胃互为表里,脾咳久治不愈,病邪会传移至胃。其症状表现为:咳嗽并伴有呕吐,呕吐剧烈时甚至会吐出蛔虫(长虫)。
大凡各种咳嗽,严重的都会导致呕吐,应当根据具体的证候表现,来判断病变所在的脏腑。
肺气虚弱,被轻微的寒邪所伤,就会发生咳嗽。咳嗽时气机返还于肺中,导致肺胀满;肺胀满则气机上逆。由于肺本身虚损,气机不足,又遭受邪气乘虚而入,导致气机壅塞痞滞,不能宣通畅达,所以出现咳嗽、气逆和呼吸短促的症状。
各种淋证,是由于肾虚兼有膀胱热所致。膀胱与肾互为表里,共同主管水液代谢。水液进入小肠后,下行至膀胱,流经前阴,形成尿液排出。肾气通达于前阴,前阴是津液向下流注的通道。如果饮食没有节制,喜怒情绪不加调节,导致虚实失调,就会造成脏腑不和,致使肾气虚弱而膀胱生热。膀胱是贮存津液的府库,若有热邪,则津液内溢并流入睾丸部位,导致水道不通,水液既不能向上输布也不能顺利向下排出,停滞积聚在膀胱中。肾虚则小便频数,膀胱有热则排尿涩滞不畅。既频数又涩滞,导致尿意急迫但排尿淋漓不尽,所以称为“淋”。其症状表现为:小便量少且次数频繁,小腹部拘急紧绷,疼痛牵引至肚脐周围。
又有石淋、劳淋、血淋、气淋、膏淋五种类型。各种淋证的形态和证候,将在后面的章节中分别详细叙述,这里因为用一方来概括论述,所以统称为“诸淋”。对于汤药外敷、熨烫、针刺、砭石等治疗方法,另有专门的方剂,补益调养和导引锻炼的方法,现在附在后面。
《养生方·导引法》中说:仰卧,将两手分开置于膝盖处,脚跟斜放于臀部下方,口吸气,震动腹部直至极限,鼻呼气,共进行七次呼吸。这种方法可以去除淋证和小便频数。
又说:蹲踞姿势,高度约一尺左右,双手从外侧弯曲膝盖向内插入,直到脚背上,用力握住脚趾,极力伸展一次,使体内气机向内收敛屈曲,有利于腰部和髋关节,治疗淋证。
The Qi of the five Zang organs is derived from the Lung. If the Lung is affected by slight cold, coughing occurs. Cold combats with Qi, causing Qi to gather and reverse into the Lung, while the pathogen fluctuates in intensity. When the pathogen moves, Qi rushes upward; when Qi ascends, it injures the five Zang organs. If it disturbs the Stomach Qi, the Stomach Qi rebels, leading to vomiting. This is a case where lung cough lingers, and the movement of Qi affects the Stomach, causing vomiting.
Furthermore, during the late summer when the Spleen governs, if the Spleen Qi is deficient and fails to function properly, injury by cold Qi causes coughing, known as Spleen Cough (Pi Ke). The presentation involves pain under the right hypochondrium upon coughing, radiating to the shoulder and back with a humming sound; in severe cases, movement is impossible, and any movement triggers coughing. Since the Spleen and Stomach are exterior-interiorly related, persistent Spleen Cough transmits to the Stomach. The presentation involves coughing and vomiting; if vomiting is severe, roundworms (Ascaris) may be expelled.
In general, various coughs that lead to vomiting should be diagnosed according to their specific manifestations to identify the affected Zang or Fu organ.
When Lung Qi is deficient and injured by slight cold, coughing occurs. Coughing causes Qi to return to the Lung, resulting in Lung distension; Lung distension leads to rebellious Qi. Because the Lung is originally deficient and Qi is insufficient, and further invaded by pathogens, obstruction and stagnation prevent smooth circulation, thus causing coughing, rebellious Qi, and shortness of breath (Duan Qi).
Various types of Lin syndrome (Strangury) arise from Kidney deficiency combined with Bladder heat. The Bladder and Kidney are exterior-interiorly related and both govern water metabolism. Water enters the Small Intestine, descends to the Bladder, flows through the genitalia, and is excreted as urine. Kidney Qi connects to the genitalia, which serve as the pathway for fluids to flow downward. If diet is irregular, emotions such as joy and anger are unregulated, and deficiency/excess are unbalanced, internal-external harmony is lost, leading to Kidney deficiency and Bladder heat. The Bladder is the mansion of fluids; heat causes fluids to overflow internally and flow into the testes, obstructing the water pathways. Water cannot ascend or descend, accumulating in the Bladder. Kidney deficiency causes frequent urination, while Bladder heat causes difficult, scanty urination. Frequent yet difficult urination results in dribbling and incomplete emptying, hence termed "Lin." The presentation includes small amounts of urine passed frequently, tension and urgency in the lower abdomen, and pain radiating to the umbilicus.
There are also five subtypes: Stone Lin (Shi Lin), Exhaustion Lin (Lao Lin), Blood Lin (Xue Lin), Qi Lin (Qi Lin), and Turbid Lin (Gao Lin). The morphological and clinical presentations of these Lin syndromes are detailed separately in subsequent chapters; here they are collectively referred to as "Various Lin Syndromes" because they are discussed under one general approach. Treatments involving decoctions, external applications, moxibustion/ironing, acupuncture, and stone therapy have separate specific formulas. Methods for nourishing, supporting, and guiding Qi are appended below.
The *Yangsheng Fang* (Prescriptions for Nourishing Life) · *Daoyin Fa* (Guiding and Pulling Methods) states: Lie supine, spread hands on the knees, place heels obliquely under the buttocks, inhale through the mouth, vibrate the abdomen to its limit, and exhale through the nose for seven breaths. This removes Lin syndrome and frequent urination.
It also states: Assume a squatting position, approximately one chi high. Insert hands from outside bending the knees inward until reaching the dorsum of the foot. Firmly grasp the five toes with great effort, extending fully once, allowing internal Qi to curve inward. This benefits the waist and hips and treats Lin syndrome.