(首节)
身半以上者。邪中之也。(阳受风气)身半以下者。湿中之也。(阴受湿气)诸阳之会。皆
在于
阳。中于颊则下少阳。其中于膺背两胁。亦中其经(即三阳之经)中于阴者。常从臂 始。夫
臂。其阴皮薄。其肉淖(音闹)泽。故俱受于风独伤于阴(臂 内廉曰阴。手足三阴之所行
也)故邪入于阴经。则其脏气实。邪气入而不能客。故还之于腑。故中阳则溜于经。中阴则
溜于腑。(如心之及。小肠此邪中三阴。亦有表症也)
愁忧恐惧则伤心。形寒寒饮则伤肺。(肺合皮毛而畏寒。)以其两寒相感中外皆伤。故气
逆而上行。(形寒伤外。饮寒伤内)有所堕坠恶血留内。若有所大怒。气上而不下。积于胁下则伤
肝。有所击仆。若醉入房。汗出当风则伤脾有所用力举重若入房过度。汗出浴水则伤肾。(
此言邪中五脏)
(次官针篇之后)
天之在我者德也。地之在我者气也。德流气薄而生者也。初(一作故)生之来谓之精。(
精者
者谓之魄。(魂为阳。魄为阴)所以任物者谓之心。心有所忆谓之意。(忆。思念也。心有所
向而未定者曰意)意之所存谓之志。(专在于是曰志)因志而存变谓之思。(图谋以成此志曰思
)
惕思虑者则伤神。神伤则恐惧流淫而不止(怵恐。惕惊也。流淫。谓流泄淫溢)因悲哀动中者
。竭绝而失生(悲哀甚则胞络绝。故致失生。竭者。绝之渐)喜乐者神惮散而不藏(神不能持
而流荡)愁忧者。气闭塞而不行。盛怒者。迷惑而不治(怒则气逆。故昏迷惶惑而乱也)恐惧
者神荡惮而不收(神为恐惧而散失)心怵惕思虑则伤神。神伤则恐惧自失。破 脱肉。毛悴色
夭。死于冬。脾愁忧而不解则伤意。意伤则 乱。四肢不举。毛悴。色夭。死于春( 。音
瞒。闷也。)肝悲哀动中则伤魂。魂伤则狂妄(马注作忘)不精。不精则不正。(精明失则。邪
妄不正。)当人阴缩而挛筋。两胁骨不举。毛悴色夭。死于秋。肺喜乐。无极则伤魄。魄伤
则狂。狂者意不存人。皮革焦。毛悴色夭。死于夏。肾盛怒而不止则伤志。志伤则喜忘其前
言。腰脊不可以俯仰屈伸。毛悴色夭。死于季夏(怒。本肝志。而亦伤肾者。肝肾为子母。
气相通也)恐惧而不解则伤精。精伤则骨酸痿厥。精时自下(此亦言心肾受伤也)是故。五脏
主藏精者也。不可伤。伤则失守而阴虚。阴虚则无气。无气则死矣。
肝藏血。血舍魂。肝气虚则恐。实则怒。脾藏营。营舍意。脾气虚则四肢不用。五脏不
安。实
则腹胀经溲不利(调经论。形有余。泾溲不利。同此)心藏脉。脉舍神。心气虚则悲。实则笑
不休。肺藏气。气舍魄。肺气虚则鼻塞不利少气。实则喘喝(气促声粗)胸盈仰息(胀满也)肾
藏精。精舍志。肾气虚则厥。实则胀。
(首节)
身体上半部分,邪气容易侵袭它。(因为阳经受风气)身体下半部分,湿邪容易侵袭它。(因为阴经受湿气)所有阳经的交会处,都在身体的上部。邪气中于面颊,则下行侵犯少阳经;邪气中于胸膺、背部和两侧胁肋,也是侵犯其所属的经脉(即三阳经)。邪气中于阴经,通常从手臂开始。手臂内侧皮肤薄,肌肉滋润滑利,所以容易受风邪侵袭而独伤于阴(手臂内侧称为阴,是手足三阴经循行的部位)。因此,邪气侵入阴经时,如果脏气充实,邪气进入后不能留驻,就会返还到腑。所以,中于阳经的邪气流注于经,中于阴经的邪气流注于腑。(例如心与小肠相表里,此邪气中于三阴经,也有表证的表现)
愁苦忧虑恐惧会伤心。形体受寒或饮用冷食会伤肺。(肺与皮毛相合,畏惧寒冷。)因为外寒和内寒相互感应,内外都受到损伤,所以气逆而上行。(形寒损伤体表,饮寒损伤体内)如果有跌坠受伤,恶血留滞体内,或者有大怒,气上逆而不能下行,积聚在胁下,就会伤肝。如果有击打跌倒,或者醉酒后行房事,出汗时当风,就会伤脾。如果有用力举重,或者行房过度,出汗后洗冷水澡,就会伤肾。(这里讲的是邪气中伤五脏)
(次官针篇之后)
天赋于我们的叫“德”,地赋予我们的叫“气”。德流布、气交迫而生命产生。初生时的本源叫做“精”。(精的基础层面叫做“魄”。魂属阳,魄属阴)用来接受和处理外界事物的叫“心”。心中有所记忆叫做“意”。(忆,指思念。心中有所指向但尚未确定的状态叫意)意念所存留的目标叫做“志”。(专一于此叫志)依据志向而进行谋划变化叫做“思”。(图谋以实现这个志向叫思)
惊恐思虑会伤神。神受伤则恐惧不安,精气滑泄不止(怵恐,指惊惧。流淫,指流泄淫溢)。因悲哀触动内心的,会导致精气竭绝而失去生机(悲哀过甚则胞络断绝,故导致失生。竭,是绝的渐进过程)。喜乐过度会使神气涣散而不能内守(神不能持守而流荡)。愁忧会使气机闭塞而不运行。盛怒会使神志迷惑而紊乱(怒则气逆,所以昏迷惶惑而乱)。恐惧会使神气动荡惊慌而不能收敛(神因恐惧而散失)。
心受惊恐思虑则伤神。神受伤则恐惧自失,肌肉破溃消瘦,毛发枯悴,面色枯槁,死于冬季。脾愁忧不解则伤意。意受伤则神志昏乱,四肢不能举动,毛发枯悴,面色枯槁,死于春季(瞒,音mán,指闷乱)。肝悲哀触动内心则伤魂。魂受伤则狂妄不精明,不精明则行为不正(精明丧失准则,邪妄不正)。会出现阴茎收缩、筋脉拘挛,两胁骨骼不能抬举,毛发枯悴,面色枯槁,死于秋季。肺喜乐无度则伤魄。魄受伤则发狂,狂者目中无人,皮肤皮革焦枯,毛发枯悴,面色枯槁,死于夏季。肾盛怒不止则伤志。志受伤则喜欢忘记以前的话,腰脊不能俯仰屈伸,毛发枯悴,面色枯槁,死于长夏(怒本是肝之志,但也伤肾,因为肝肾为子母关系,气相通)。
恐惧不解则伤精。精受伤则骨酸、痿软、厥冷,精液时常自行滑出(这也是讲心和肾受伤的情况)。因此,五脏是主藏精气的器官,不可损伤。损伤则精气失守而阴虚,阴虚则无气,无气则死亡。
肝藏血,血舍魂。肝气虚则恐惧,实则易怒。脾藏营气,营气舍意。脾气虚则四肢不能用,五脏不安,实则腹胀、大小便不利(参考《调经论》,形有余,泾溲不利,与此相同)。心藏脉,脉舍神。心气虚则悲伤,实则笑不休。肺藏气,气舍魄。肺气虚则鼻塞不利、少气,实则喘促(气促声粗)、胸满仰息(胀满也)。肾藏精,精舍志。肾气虚则厥冷,实则腹胀。
(First Section)
The upper half of the body is susceptible to pathogenic factors. (Yang meridians receive wind and qi.) The lower half of the body is susceptible to dampness. (Yin meridians receive dampness.) All gatherings of Yang meridians are located in the upper part of the body. If struck by pathogens on the cheeks, the pathogen descends to invade the Shaoyang meridian. If struck on the chest, back, or lateral costal regions, it also invades their respective meridians (i.e., the three Yang meridians). Pathogens invading Yin meridians usually start from the arms. The skin on the inner aspect of the arms is thin, and the flesh is moist and lustrous; therefore, they are easily affected by wind and uniquely injured by Yin pathogens (the inner aspect of the arm is called Yin, where the three Yin meridities of the hand and foot travel). Thus, when pathogens enter Yin meridians, if the Zang organ qi is substantial, the pathogen cannot lodge there and returns to the Fu organs. Therefore, invasion of Yang meridians causes the pathogen to flow into the meridians, while invasion of Yin meridians causes the pathogen to flow into the Fu organs. (For example, regarding the Heart and Small Intestine, this pathogen invading the three Yin meridians may also present with exterior syndrome symptoms.)
Sorrow, worry, and fear injure the Heart. External cold exposure and consumption of cold drinks injure the Lungs. (The Lung harmonizes with the skin and hair and fears cold.) Because external cold and internal cold interact, both the interior and exterior are injured, causing Qi to rebel and move upward. (External cold injures the exterior, while cold drinks injure the interior.) Falling or bruising leads to evil blood remaining inside. Great anger causes Qi to rise but not descend, accumulating under the hypochondrium, thereby injuring the Liver. Blows, falls, sexual intercourse after drunkenness, sweating exposed to wind, heavy lifting, excessive sexual activity, or bathing in water while sweating all injure the Spleen and Kidney respectively. (This section discusses pathogens injuring the five Zang organs.)
(After the Chapter on Official Needles)
What Heaven endows us with is called "De" (Virtue/Nature), and what Earth provides us with is called "Qi". Life arises from the flow of De and the interaction of Qi. The origin at birth is called "Jing" (Essence). (The foundational aspect of Jing is called "Po" (Corporeal Soul). Hun is Yang, Po is Yin.) That which receives and processes external objects is called the "Heart". Memory within the heart is called "Yi" (Intention/Thought). (Yi refers to reflection. A mental direction that is not yet fixed is called Yi.) What is retained by intention is called "Zhi" (Will). (Focus on a specific object is called Zhi.) Planning changes based on will is called "Si" (Reflection/Deliberation). (Plotting to realize this will is called Si.)
Fear and anxiety injure Shen (Spirit). When Shen is injured, fear ensues, leading to uncontrolled leakage and discharge (Chu Kong refers to fright; Liu Yin refers to leakage and overflow). Profound sorrow moving the interior leads to exhaustion and loss of life (Excessive sorrow severs the Bao Luo [Pericardium Collateral], causing loss of life. Jie is the gradual process of Jue [severance]). Excessive joy scatters Shen, preventing it from being stored (Shen cannot hold its course and wanders). Sorrow and worry cause Qi to block and stagnate. Extreme anger confuses and disorders the mind (Anger causes Qi rebellion, leading to confusion and chaos). Fear agitates and dissipates Shen, preventing its gathering (Shen scatters due to fear).
If the Heart is subjected to fright and anxiety, Shen is injured. Injury to Shen causes fear and self-loss, muscle wasting, withered hair, and sallow complexion, leading to death in Winter. If the Spleen is burdened with unresolved sorrow and worry, Yi is injured. Injury to Yi causes mental confusion, inability to move the four limbs, withered hair, and sallow complexion, leading to death in Spring. (Man sounds like 'man', meaning stifled/confused.) If the Liver is moved by profound sorrow, Hun is injured. Injury to Hun causes madness and lack of clarity; lack of clarity leads to impropriety (Loss of spiritual clarity leads to wickedness and impropriety). Symptoms include retraction of the genitals and tendon contraction, inability to lift the ribs, withered hair, and sallow complexion, leading to death in Autumn. If the Lungs experience boundless joy, Po is injured. Injury to Po causes madness; the mad person disregards others, skin and leather become scorched, hair withers, complexion becomes sallow, leading to death in Summer. If the Kidneys suffer unceasing anger, Zhi is injured. Injury to Zhi causes forgetfulness of past words, inability to bend or extend the waist and spine, withered hair, and sallow complexion, leading to death in Late Summer (Anger is primarily the emotion of the Liver but also injures the Kidney because Liver and Kidney have a mother-son relationship and their Qi connects).
Unresolved fear injures Jing. Injury to Jing causes bone soreness, flaccidity, and cold extremities, with spontaneous leakage of essence. (This also describes injury to the Heart and Kidney.) Therefore, the five Zang organs store Jing (Essence) and must not be injured. Injury leads to loss of control and Yin deficiency. Yin deficiency leads to lack of Qi. Lack of Qi leads to death.
The Liver stores Blood, and Blood houses Hun. Liver Qi deficiency causes fear; excess causes anger. The Spleen stores Ying (Nutritive Qi), and Ying houses Yi. Spleen Qi deficiency causes inability to use the four limbs and instability of the five Zang organs; excess causes abdominal distension and difficult urination and defecation (Referencing *Tiao Jing Lun*, excess form presents with difficult urination and defecation, similar to this). The Heart stores Mai (Vessels/Pulse), and Vessels house Shen. Heart Qi deficiency causes sadness; excess causes incessant laughter. The Lungs store Qi, and Qi houses Po. Lung Qi deficiency causes nasal congestion, difficulty breathing, and shortness of breath; excess causes panting (rapid breathing and coarse voice) and chest fullness requiring仰息 (breathing with raised chest). The Kidneys store Jing, and Jing houses Zhi. Kidney Qi deficiency causes cold extremities; excess causes abdominal distension.