积者,五脏所生;聚者,六腑所成。五脏之气积,名曰积;六腑之气聚,名曰聚也。积
者,其痛不离其部;聚者,其痛无有常处。皆由阴阳不和,风冷搏于脏腑而生积聚也。妇人
病积经久,则令无子,亦令月水不通。所以然者,积聚起于冷气,结入子脏,故令无子;若
冷气入于胞络,冷搏于血,血冷则涩结,故令月水不通。
癖病者,由冷气结聚,饮食不消,停积于胁下,则成癖病。其状,弦急刺痛,得冷则发
作也。
疝瘕之病,由饮食不节,寒温不调,气血劳伤,脏腑虚弱,受于风冷,冷入腹内,与血
气相结所生。疝者,痛也;瘕者,假也。其结聚浮假而痛,推移而动。妇人病之有异于丈夫
者,或因产后脏虚受寒,或因经水往来,取冷过度,非独关饮食失节,多挟有血气所成也。
诊妇人疝瘕,其脉弦急者生,虚弱小者死。又尺脉涩而牢,为血实气虚也。其发腹痛逆
满,气上行,此为妇人胞中绝伤,有恶血,久成结瘕。得病以冬时,黍 赤而死。
症痞者,由冷热不调,饮食不节,积在腹内,或肠胃之间,与脏相结搏。其牢强,
推之不移,名曰症,言其病形征可验也;气壅塞为痞,言其气痞涩不宣畅也。皆得冷则
发动刺痛。症痞之病,其形冷结,若冷气入于子脏,则使无子;若冷气入于胞络,搏于
血气,血得冷则涩,令月水不通也。
积聚,是由五脏产生的;聚证,是由六腑形成的。五脏之气郁结,称为积;六腑之气聚散无常,称为聚。积证的疼痛位置固定,不离其所在部位;聚证的疼痛位置不固定,没有常处。这两种病证都是由于阴阳失调,风冷之邪搏结于脏腑而形成的。妇女患有积聚病日久,会导致不孕,也会使月经不通畅。之所以这样,是因为积聚起于冷气,结入子宫(子脏),所以导致不孕;如果冷气进入胞络,与血液搏结,血液因寒而凝涩结聚,所以导致月经不通。
癖病,是由于冷气结聚,饮食不能消化,停滞积聚在胁下,从而形成癖病。其症状表现为胁肋部弦急刺痛,遇冷则发作。
疝瘕病,是由于饮食不节制,寒温不调,气血劳损受伤,脏腑虚弱,感受风冷之邪,冷气进入腹内,与气血相互搏结所产生。疝,意思是痛;瘕,意思是假(指包块时聚时散)。其特点是结聚物浮泛不实且疼痛,推之可移动。妇女患此病与男子不同,有的因为产后脏腑虚弱受寒,有的因为月经期间贪凉过度,不仅与饮食失节有关,多还夹杂血气病变而形成。诊断妇女疝瘕病,脉象弦急的预后良好,脉象虚弱细小的预后不良。另外,尺脉涩而坚牢,表示血实而气虚。如果发病时腹痛胀满,气逆上行,这是妇女胞宫受损,有瘀血,日久形成结瘕。如果在冬季得病,出现黍米赤色(指面色或舌色等异常,此处原文可能有脱字或特定指代,通常指危重征象)则死亡。
症痞病,是由于冷热不调,饮食不节制,积滞在腹内,或在肠胃之间,与脏腑相互搏结。其质地坚硬牢固,推之不移,称为“症”,是说其病形征象可以验证;气机壅塞不通称为“痞”,是说其气机痞塞涩滞,宣畅不利。这两种病遇到寒冷都会引发刺痛。症痞病,其形态为冷结,如果冷气进入子宫,会导致不孕;如果冷气进入胞络,与血气搏结,血液遇冷则凝涩,导致月经不通。
Accumulation (Ji) arises from the five Zang organs; gathering (Ju) is formed by the six Fu organs. When the Qi of the five Zang organs stagnates, it is called Accumulation (Ji); when the Qi of the six Fu organs gathers and disperses irregularly, it is called Gathering (Ju). The pain in Accumulation (Ji) remains fixed in its location; the pain in Gathering (Ju) has no constant place. Both conditions arise from the disharmony of Yin and Yang, where Wind-Cold pathogens contend with the Zang-Fu organs to produce these accumulations and gatherings. In women, if an Accumulation (Ji) condition persists for a long time, it leads to infertility and also causes amenorrhea (absence of menstruation). This is because the accumulation originates from Cold Qi, which knots into the uterus (Zi Zang), thus causing infertility; if Cold Qi enters the uterine collaterals (Bao Luo) and contends with Blood, the Blood becomes cold, stagnant, and knotted, thus causing amenorrhea.
Pi disease (Pi Bing) results from the knotting of Cold Qi and undigested food, which stagnates and accumulates under the hypochondrium, thereby forming Pi disease. Its manifestations include tight, stabbing pain in the hypochondrium, which is triggered or exacerbated by exposure to Cold.
Shan-Jia disease (Shan Jia zhi Bing) arises from irregular diet, imbalance of Cold and Warmth, labor and injury to Qi and Blood, weakness of the Zang-Fu organs, and invasion by Wind-Cold. When Cold Qi enters the abdomen and contends with Qi and Blood, this condition is generated. "Shan" refers to pain; "Jia" implies falsity (referring to masses that appear and disappear). The knotted mass is superficial and false, accompanied by pain, and can be moved upon pushing. Women suffer from this differently than men; some cases result from postpartum organ weakness and Cold invasion, while others stem from excessive exposure to Cold during menstrual cycles. It is not solely related to dietary irregularities but often involves complications with Qi and Blood disorders. In diagnosing Shan-Jia in women, a wiry and tense pulse indicates survival, whereas a weak and thready pulse indicates death. Furthermore, a choppy and firm pulse at the Chi position indicates Excess of Blood and Deficiency of Qi. If abdominal pain and distension occur with rebellious Qi moving upward, this signifies injury to the uterus (Bao Zhong) in women, presence of malignant Blood (stasis), and the formation of a fixed mass (Jia) over time. If contracted during winter, the appearance of redness resembling millet grains (indicating severe pathological signs) portends death.
Zheng-Pi disease (Zheng Pi zhi Bing) results from imbalance of Cold and Warmth and irregular diet, leading to accumulation within the abdomen or between the intestines and stomach, contending with the Zang organs. When the mass is hard, solid, and immovable upon pushing, it is called Zheng, indicating that the pathological form is verifiable. When Qi is obstructed and blocked, it is called Pi, signifying that Qi is stagnant, choppy, and fails to circulate freely. Both conditions are triggered by Cold, causing stabbing pain. In Zheng-Pi disease, the morphology is characterized by Cold knotting. If Cold Qi enters the uterus, it causes infertility; if Cold Qi enters the uterine collaterals and contends with Qi and Blood, the Blood becomes stagnant due to Cold, resulting in amenorrhea.