黄帝问曰∶风之伤人也,或为寒热,或为热中,或为寒中,或为厉风,或为偏枯。其为
风也,其病各异,其名不同,或内至五脏六腑,不知其解,愿闻其说?岐伯对曰∶风气藏于
皮肤之间,内不得通,外不得泄,风气者,善行而数变,腠理开则凄(《素问》作洒)然寒
,闭则热而闷,其寒也则衰食饮,其热也则消肌肉,使人解 (《素问》作 栗
)。闷而不能食,名曰寒热。风气与阳明入胃,循脉而上至目内 ,其人肥则风气不得外泄
,则为热中而目黄;人瘦则外泄而寒,则为寒中而泣出。风气与太阳俱入,行诸脉俞,散
分肉间。卫气悍,邪时与卫气相干(《素问》无卫气悍邪时五字),其道不利,故使肌肉
胀而有疡;卫气凝而有所不行,故其肉有不仁。厉者,有荣气热浮,其气不清,故使鼻
柱坏而色败,皮肤疡以溃。风寒客于脉而不去,名曰厉风,或曰寒热。
以春甲乙伤于风者,为肝风,以夏丙丁伤于风者,为心风。以季夏戊己伤于风者,为脾
风。以秋庚辛伤于风者,为肺风。以冬壬癸伤于风者,为肾风。风气中五脏六腑之俞,亦为
脏腑之风,各入其门户。风之所中则为偏风。风气循风府而上,则为脑风。入系头则为目风
眼寒,饮酒中风,则为漏风。入房汗出中风,则为内风。新沐中风,则为首风。久风入中,
则为肠风飧泄;而外在腠理,则为泄风。故风者,百病之长也,至其变化乃为他病,无常方
,然故有风气也。
肺风之状,多汗恶风,色 (音平)然白,时咳短气,昼日则差,暮则甚,诊在眉
上,其色白。
心风之状,多汗恶风,焦绝善怒,色赤,病甚则言不快,诊在口,其色赤。
肝风之状,多汗恶风,善悲,色微苍,嗌干善怒,时憎女子,诊在目下,其色青。
脾风之状,多汗恶风,身体怠惰,四肢不欲动,色薄微黄,不嗜食,诊在鼻上,其色黄
肾风之状,多汗恶风,面庞然浮肿,腰脊痛,不能正立,色 ,隐曲不利,
诊在肌上,其色黑。
胃风之状,颈多汗恶风,食饮不下,鬲塞不通,腹善满,失衣则 胀,食寒则泄,
诊形瘦而腹大。
首风之状,头痛面多汗恶风,先当风一日,则病甚,头痛不可以出内,至其风日,则
病少愈。
漏风之状,或多汗,常不可单衣,食则汗,甚则身汗,喘息恶风,衣常濡,口干善
渴,不能劳事。
泄风之状,多汗,汗出泄衣上,咽(《素问》作口中)干,上渍其风,不能劳事,身体尽
痛则寒。
曰∶邪之在经也,其病患何如,取之奈何?曰∶天有宿度,地有经水,人有经脉。天地
温
(《素问》作涌)而陇起。夫邪之入于脉中,寒则血凝泣,暑则气淖泽,虚邪因而入客也。亦
如经水之得风也,经之动脉,其至也亦时陇起,于脉中循循然。其至寸口中手也,时大时小
,大则邪至,小则平。其行无常处,在阴与阳不可为度。循而察之,三部九候。卒然逢之,
早遏其路。吸则内针,无令气忤。静以久留,无令邪布。吸则转针,以得气为故。候呼引针
,呼尽乃去。大气皆出,故名曰泻。曰∶不足者补之奈何?曰∶必先扪而循之,切而散之,
推而按之,弹而怒之,抓而下之,通而散之,外引其门,以闭其神。呼尽内针,静以久留,
以气至为故。知待所贵,不知日暮。其气已至,适以自护。候吸引针,气不得出,各在其外
推阖其门,令真气(《素问》作神气)存。大气留止,故名曰补。曰∶候气奈何?曰∶夫邪
去络,入于经,舍于血脉之中,其寒温未相得,如涌波之起也,时来时去,故不常在。故曰
方其来也,必按而止之,止而取之,无迎(《素问》作逢)其冲而泻之。真气者经气也,经
气大虚,故曰其气(《素问》作其来)不可逢,此之谓也。故曰候邪不审,大气已过,泻之则
真气脱,脱则不复,邪气益至而病益畜。故曰其往不可追,此之谓也,不可挂以发者,待邪
之至时而发针泻焉。若先若后者,血气已尽,其病不下。故曰知其可取如发机,不知其
取如叩椎。故曰知机道者不可挂以发,不知机者叩之不发,此之谓也,曰∶真邪以合
,波陇不起,候之奈何?曰∶审扪循三部九候之盛虚而调之。不知三部者,阴阳不别,天地
不分。地以候地,天以候天,人以候人,调之中府,以定三部。故曰刺不知三部九候病脉之
处,虽有大过,且至工不得(《素问》作能)禁也。诛罚无过,命曰大惑。反乱大经,真不
可复。用实为虚,以邪为正(《素问》作真)。用针无义,反为气贼,夺人正气,以顺为逆,
营卫散乱。真气已失,邪独内着,绝人长命,予人夭殃。不知三部九候,故不能久长。固
(《素问》作因)不知合之四时五行,因加相胜,释邪攻正,绝人长命。邪之新客来也,未有
定处,推之则前,引之则上,逢而泻之,其病立已。曰∶人之善病风,洒洒汗出者,何以候
之?曰∶肉不坚、腠理疏者,善病风。曰∶何以候肉之不坚也?曰∶ 肉不坚而无分理者
,肉不坚;肤粗而皮不致者,腠理疏也。
黄帝问道:风邪侵袭人体,有的表现为寒热症状,有的表现为热中症,有的表现为寒中症,有的表现为厉风(一种严重的皮肤病,如麻风),有的表现为偏枯(半身不遂)。同样是风邪致病,病情各不相同,病名也不同,有的深入五脏六腑,对此我不明白其中的道理,希望听听您的解释?岐伯回答说:风邪潜伏在皮肤之间,向内不能通达,向外不能宣泄。风性善于游走且变化迅速,腠理(皮肤纹理及汗孔)开泄时,人会感到凄冷畏寒;腠理闭塞时,则发热且胸闷。出现寒象时,食欲减退;出现热象时,肌肉消耗消瘦,使人战栗发抖。胸闷且无法进食,这种病称为寒热。
风邪随阳明经进入胃中,沿着经脉上行至目内眦。如果患者体型肥胖,风邪难以从体表宣泄,就会形成热中症,表现为眼睛发黄;如果患者体型瘦弱,风邪容易外泄而兼夹寒气,就会形成寒中症,表现为流泪。风邪与太阳经一同侵入,运行于各经脉的俞穴,散布在分肉(肌肉间隙)之间。卫气(行于脉外、具有防御作用的气)剽悍滑利,若邪气与卫气相互干扰,导致经络运行不畅,就会使肌肉肿胀并生疮疡;若卫气凝滞而不能正常运行,就会导致肌肉麻木不仁。所谓厉风,是因为营气(行于脉中、具有营养作用的气)热盛浮越,气血不清,从而导致鼻梁塌陷、面色败坏,皮肤溃疡溃烂。风寒之邪客居在经脉中不去除,就称为厉风,也有人称之为寒热。
在春季甲乙日受风邪伤害的,称为肝风;在夏季丙丁日受风邪伤害的,称为心风。在长夏戊己日受风邪伤害的,称为脾风。在秋季庚辛日受风邪伤害的,称为肺风。在冬季壬癸日受风邪伤害的,称为肾风。风邪侵袭五脏六腑的俞穴,也会形成脏腑之风,各自进入其相应的门户。风邪所中的部位不同,则称为偏风。风邪顺着风府穴上行,则称为脑风。风邪侵入头部系连眼目的经络,则称为目风、眼寒;饮酒后中风,则称为漏风;房事后出汗又受风,则称为内风;刚洗完头受风,则称为首风。久风入里,则称为肠风飧泄(大便中含有未消化食物);若风邪停留在体表的腠理,则称为泄风。所以说,风是百病的先导,到了它发生变化的时候就成为其他疾病,没有固定的规律,但都是因为存在风邪的缘故。
肺风的症状,是多汗、怕风,面色苍白,时常咳嗽、气短,白天症状减轻,傍晚加重,诊断部位在眉毛上方,其色白。
心风的症状,是多汗、怕风,口舌干燥、易怒,面色发红,病情严重时言语不利,诊断部位在口部,其色赤。
肝风的症状,是多汗、怕风,容易悲伤,面色微青,咽喉干燥、易怒,有时厌恶女性,诊断部位在眼下,其色青。
脾风的症状,是多汗、怕风,身体倦怠懒惰,四肢不想活动,面色淡黄,食欲不振,诊断部位在鼻上,其色黄。
肾风的症状,是多汗、怕风,面部浮肿,腰脊疼痛,不能直立,面色黑,小便不利,诊断部位在肌肉表面,其色黑。
胃风的症状,是颈部多汗、怕风,饮食难下,胸膈阻塞不通,腹部容易胀满,受凉则腹胀,吃生冷食物则腹泻,诊断特征是形体消瘦而腹部膨大。
首风的症状,是头痛、面部多汗、怕风,在当风前一天,病情加重,头痛剧烈以至于不敢出门或进入室内,到了当风的日子,病情稍微好转。
漏风的症状,是多汗,常常不能穿单衣,吃饭时出汗,严重时全身出汗,喘息、怕风,衣服经常湿透,口干善渴,不能从事劳累的工作。
泄风的症状,是多汗,汗水流出浸湿衣服,口中干燥,风邪浸渍上部,不能从事劳累工作,全身疼痛且伴有寒冷感。
(黄帝)问:邪气在经脉中,病人的表现如何?针刺治疗应当怎样进行?(岐伯)答:天有星辰运行的度数,地有江河流水的通道,人有经脉的运行。天地之气温暖而涌动起伏。邪气进入脉中,遇寒则血液凝涩,遇暑则气机淖泽(滋润流动),虚邪因此侵入体内。这也如同河水遇到风一样,经脉中的动脉搏动,其到来时也时而涌动起伏,在脉中缓缓流动。诊察寸口脉搏时,有时大有时小,大表示邪气已至,小表示平和。邪气的运行没有固定位置,在阴分和阳分之间变化,不可用固定标准衡量。必须循经仔细诊察三部九候(古代切脉法,将手腕分为寸、关、尺三部,每部又分天、地、人三候,共九候)。突然遇到邪气,要尽早阻断其路径。吸气时进针,不要让正气逆乱。安静地长时间留针,不让邪气扩散。吸气时转针,以得气为度。呼气时引针,呼尽时拔针。大邪之气随之排出,所以称为泻法。
(黄帝)问:正气不足该如何补益?(岐伯)答:必须先用手扪摸并循按穴位,切压并散结,推按穴位,弹击使血脉充盈,抓捏向下导引,疏通并消散郁滞,向外牵引毛孔,以闭合神气。呼气尽时进针,安静地长时间留针,以气至为度。知道等待时机的重要性,不要等到日暮才施治。气已到达,适当保护正气。吸气时拔针,使气不得外出,在针孔处推按闭合,令真气留存。大气(此处指正气)停留止息,所以称为补法。
(黄帝)问:如何候气?(岐伯)答:邪气由络脉进入经脉,停留在血脉之中,其寒温性质尚未与人体相适应,就像波浪兴起一样,时来时去,所以不常固定。所以说,当邪气来的时候,必须按压以阻止它,阻止后随即取穴针刺,不要迎着邪气的冲势去泻它。真气就是经气,经气大虚,所以说邪气来时不可迎而泻之,说的就是这个道理。所以说,候邪如果不审慎,邪气的大波已经过去,此时若用泻法,会导致真气脱失,脱失后就不能恢复,邪气反而更盛,病情更加积聚。所以说,邪气已去不可追,说的就是这个道理。针刺时机不可差之毫厘,要等待邪气到达时发针泻之。若先于邪气或未等邪气而刺,血气已尽,病邪不会消退。所以说,知道可取的时机像扣动机关一样灵敏,不知道可取的时机就像敲击木椎一样迟钝。所以说,懂得机道的人不可差之毫厘,不懂机道的人敲击也不会有反应,说的就是这个道理。
(黄帝)问:真邪相合,波浪不起,如何候气?(岐伯)答:仔细审察三部九候脉象的盛衰虚实来调治。不懂得三部九候,就无法分辨阴阳,区分天地。地候对应下部,天候对应上部,人候对应中部,通过调和中焦脾胃之气,来确定三部。所以说,针刺不懂得三部九候病脉所在之处,即使有过人的技术,也不能禁止误治。诛罚无过,称为大惑。反而扰乱大的经络,使真气无法恢复。将实证误作虚证,将邪气误作真气。用针没有义理,反而成为气的贼害,夺取人的正气,以顺为逆,导致营卫散乱。真气已经丧失,邪气独自内着,断绝人的寿命,给人带来夭折的灾殃。不懂得三部九候,所以不能长寿。本来就不结合四时五行,因加相胜(五行相克),放弃攻邪而攻击正气,断绝人的寿命。邪气新近入侵,还没有定处,推之则向前,引之则向上,逢其未定而泻之,病立刻就好。
(黄帝)问:人容易患风病,洒洒然汗出的,如何诊察?(岐伯)答:肌肉不坚实、腠理疏松的人,容易患风病。(黄帝)问:如何诊察肌肉不坚实呢?(岐伯)答:肌肉松软而没有纹理的,是肌肉不坚实;皮肤粗糙而皮理不致密的,是腠理疏松。
Yellow Emperor asked: When wind pathogen invades the human body, it may manifest as chills and fever (Hanre), heat in the middle jiao (Rezhong), cold in the middle jiao (Hanzhong), severe wind (Lifeng, a severe skin disease such as leprosy), or hemiplegia (Piangu). Although caused by wind, the diseases differ, and their names vary. Some penetrate deeply into the five zang organs and six fu organs. I do not understand the explanation; I wish to hear your theory?
Qibo replied: Wind pathogen hides between the skin and hair follicles. It cannot communicate internally nor be excreted externally. Wind is characterized by its ability to move rapidly and change frequently. When the interstices (Couli, referring to skin pores and tissue spaces) open, one feels chilly and cold; when they close, one experiences fever and chest fullness. In cases of cold, appetite decreases; in cases of heat, muscles emaciate, causing shivering. With chest fullness and inability to eat, this condition is named Chills and Fever (Hanre).
When wind pathogen enters the stomach along the Yangming meridian and ascends via the vessel to the inner canthus of the eye: if the person is obese, wind cannot be excreted externally, leading to Heat in the Middle Jiao (Rezhong) with yellow eyes; if the person is thin, wind escapes externally combined with cold, leading to Cold in the Middle Jiao (Hanzhong) with tearing. When wind pathogen enters together with the Taiyang meridian, it travels through the Shu points of various vessels and scatters between the muscle layers (Fenrou). Wei Qi (Defensive Qi) is fierce and agile. If evil interferes with Wei Qi, obstructing the pathway, it causes muscle swelling and sores; if Wei Qi stagnates and fails to circulate, it results in insensitivity of the flesh (Ren). Lifeng occurs when Ying Qi (Nutritive Qi) is hot and floating, and the qi is turbid, causing collapse of the nasal bridge, deterioration of complexion, and ulceration of the skin. When wind-cold lodges in the vessels and does not depart, it is called Lifeng, also known as Hanre.
Wind contracted on Jia-Yi days in spring affects the Liver Wind (Gan Feng); on Bing-Ding days in summer, it affects the Heart Wind (Xin Feng); on Wu-Ji days in late summer, it affects the Spleen Wind (Pi Feng); on Geng-Xin days in autumn, it affects the Lung Wind (Fei Feng); on Ren-Gui days in winter, it affects the Kidney Wind (Shen Feng). Wind invading the Shu points of the five zang and six fu organs also creates Zang-Fu Wind, entering their respective gates. Wind striking different parts is called Pian Feng. Wind ascending via the Fengfu point (GV16) is called Brain Wind (Nao Feng). Entering the connections of the head, it is Eye Wind (Mu Feng) with cold eyes. Wind after drinking alcohol is Leakage Wind (Lou Feng). Wind during sweating from sexual intercourse is Internal Wind (Nei Feng). Wind after washing hair is Head Wind (Shou Feng). Long-standing wind entering inward is Intestinal Wind (Chang Feng) with undigested stool; wind remaining at the surface interstices is Leakage Wind (Xie Feng). Thus, wind is the chief of all diseases. Its changes lead to other illnesses without fixed patterns, yet always involve wind pathogen.
Lung Wind presents with excessive sweating, aversion to wind, pale complexion, frequent coughing, shortness of breath, symptoms improving during the day and worsening at night. Diagnosis is at the supraorbital region, with white color.
Heart Wind presents with excessive sweating, aversion to wind, dryness, irritability, red complexion. Severe cases involve slurred speech. Diagnosis is at the mouth, with red color.
Liver Wind presents with excessive sweating, aversion to wind, sadness, slightly blue-green complexion, dry throat, irritability, occasional aversion to women. Diagnosis is below the eyes, with green color.
Spleen Wind presents with excessive sweating, aversion to wind, lethargy, desire to remain inactive, pale yellow complexion, loss of appetite. Diagnosis is on the nose, with yellow color.
Kidney Wind presents with excessive sweating, aversion to wind, facial edema, lower back and spine pain, inability to stand upright, black complexion, difficulty in urination. Diagnosis is on the muscle surface, with black color.
Stomach Wind presents with excessive sweating on the neck, aversion to wind, dysphagia, chest obstruction, abdominal distension, worsening upon exposure to cold, diarrhea from cold food. Diagnosis shows emaciated body with large abdomen.
Head Wind presents with headache, facial sweating, aversion to wind. Symptoms worsen one day before the windy day, making it impossible to go out or enter rooms. On the windy day, symptoms improve slightly.
Leakage Wind presents with excessive sweating, inability to wear single clothes, sweating while eating, severe whole-body sweating, panting, aversion to wind, wet clothes, dry mouth with thirst, inability to perform labor.
Exudative Wind (Xie Feng) presents with excessive sweating soaking clothes, dry mouth, wind infiltration above, inability to labor, whole-body pain with cold sensation.
(Huangdi) asked: How do pathogens in the meridians present, and how should acupuncture be applied? (Qibo) answered: Heaven has stellar degrees, Earth has river waters, and humans have meridians. Heaven and Earth's warmth rises like waves. When pathogens enter the vessels, cold causes blood stasis, heat causes fluid abundance, and deficient evil enters. Similarly, water ripples in wind, arterial pulses rise intermittently, moving steadily within vessels. At the Cun Kou pulse, size varies: large indicates pathogen arrival, small indicates peace. Movement is irregular, Yin and Yang shifting, defying fixed measures. Observe carefully via Three Parts and Nine Hopes (Sanbu Jiuhou). Intercept early. Insert needle during inhalation, avoid Qi rebellion. Retain quietly to prevent pathogen spread. Rotate needle during inhalation until Deqi (arrival of Qi) is achieved. Withdraw during exhalation, removing excess Qi, termed Expelling (Xie).
(Huangdi) asked: How to tonify deficiency? (Qibo) answered: Palpate and stroke, press and disperse, push and press, flick to engorge, grasp and descend, unblock and scatter, draw open the gate to seal Shen (Spirit). Insert at end of exhalation, retain until Deqi. Know the value of timing, do not wait till dusk. Protect Qi once arrived. Withdraw during inhalation to keep Qi inside, press the pore to store True Qi (Zhen Qi). Retained Qi is Tonification (Bu).
(Huangdi) asked: How to await Qi? (Qibo) answered: Pathogens move from collaterals to meridians, lodging in blood vessels. Their temperature is unsettled, rising like waves, coming and going. Thus, when approaching, press to stop, then treat. Do not attack the surge directly. True Qi is Meridian Qi. If Meridian Qi is greatly deficient, do not attack incoming Qi. If awaiting evil is imprecise, and the main wave passes, expelling will deplete True Qi, which cannot recover, allowing evil to accumulate. Once gone, it cannot be chased. Timing must be precise. Wait for evil's arrival to expel. Premature or delayed needling exhausts Qi and fails to cure. Knowing the moment is like a trigger; ignorance is like striking a mallet. One who knows the mechanism acts instantly; one who does not strikes futilely.
(Huangdi) asked: When true and evil merge without wave formation, how to await? (Qibo) answered: Examine the fullness or emptiness of Sanbu Jiuhou to regulate. Not knowing Sanbu means failing to distinguish Yin/Yang and Heaven/Earth. Earth corresponds to lower, Heaven to upper, Human to middle. Regulate Central Fu organs to define three parts. Ignorance of Sanbu Jiuhou locations leads to error even for skilled practitioners. Punishing the innocent is great confusion. Disrupting major meridians makes True Qi irrecoverable. Mistaking excess for deficiency, or evil for truth, using needles without principle becomes a thief of Qi, dispersing Ying and Wei. Loss of True Qi allows evil to lodge, shortening life. Not combining with Four Seasons and Five Elements leads to attacking Zheng (Righteous Qi) instead of Xie (Evil), causing death. New pathogens have no fixed location; pushing moves them forward, pulling moves them up. Expelling upon encounter cures immediately.
(Huangdi) asked: How to diagnose those prone to wind with chilliness and sweating? (Qibo) answered: Those with weak muscles and loose interstices are prone to wind. (Huangdi) asked: How to diagnose weak muscles? (Qibo) answered: Soft muscles without distinct texture indicate weakness; rough skin with loose texture indicates loose interstices.