(次刺腰痛论之后)
风者善行而数变。腠理开则洒然寒。闭则热而闷。其寒也则衰食饮(寒则胃气凝滞)其热
也则
消肌肉(热则津液燥涸)故使人 (音突)栗而不能食。名曰寒热( 栗。犹战栗也)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(风内郁故热中)人瘦则外
泄而寒。则为寒中而泣出(腠理疏故寒中)风气与太阳俱入。行诸脉俞。散于分肉之间。与卫
气相干。其道不利。故使肌肉愤 而有疡(愤 。肿起也。疡痈毒也)卫气有所凝而不行。故
其肉有不仁也(顽痹不知痛痒)疠者。有荣气热 。(腐同)其气不清。故使鼻柱坏而色败。皮
肤疡溃。风寒客于脉而不去。名曰疠风(溃破也)风中五脏六腑之俞。亦为脏腑之风。各入其
门户。所中则为偏风(即偏枯也)风气循风府而上。则为脑风风入系头(眼系在脑后)则为目风
眼寒。饮酒中风。则为漏风(或多汗。常不可单衣。食则汗出。甚则身汗喘息。恶风衣常濡
口干善渴。不能劳事)入房汗。出中风。则为内风(风乘虚犯。令人遗精咳血。寝汗骨蒸)新
沐中风。则为首风(头面多汗恶风当先风一日则病甚。头痛不可以出纳。至其风日则病少愈)
久风人中。则为肠风飧泄(传入肠胃。热则下血。寒则泄泻)外在腠理。则为泄风(多汗。汗
出泄衣上。口中干。上渍其风。不能劳事。身体尽痛则寒)故风者百病之长也。至其变化。
乃为他病。无常方(所也)然致有风气也。肺风之状。多汗恶风。色 然白。时咳短气昼日则
差。(瘥同)暮则甚。诊在眉上其色白( 。音烹上声)心风之状。多汗恶风焦绝。善怒吓。赤
色。病甚则言不可快。诊在口。其色赤(焦。喉舌燥也。绝唇口裂也。心脉侠咽喉而主舌。
故见此诸症)肝风之状。多汗恶风。善悲。色微苍。嗌干善怒。时憎女子(肝衰则恶色)诊在
目下。其色青。脾风之状。多汗。恶风。身体怠堕(惰同)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。面疣然浮肿。脊痛不能正立(骨衰)其色 (音壹)隐曲
不
胀。食寒则泄。诊形瘦而腹大。
(紧接在论述腰痛针刺之后的章节)
风邪善于游走且变化迅速。腠理(皮肤毛孔及间隙)开放时,会感到一阵寒意;腠理闭塞时,则会发热且胸闷。当表现为寒象时,食欲饮食就会减退(因为寒气导致胃气凝滞);当表现为热象时,肌肉就会消瘦(因为热邪使津液干燥枯竭),因此使人战栗(音突,即发抖)而不能进食。这种病症被称为“寒热”(栗,即战栗之意)。
风邪侵入阳明经并进入胃中,沿着经脉上行至目内眦。如果患者体型肥胖,风邪无法向外宣泄,就会形成“热中”证,出现眼睛发黄的症状(因风邪内郁导致体内生热);如果患者体型瘦弱,风邪容易外泄,就会形成“寒中”证,出现流泪的症状(因腠理疏松导致体内受寒)。
风邪与太阳经一同侵入人体,运行于各条经脉的腧穴之间,散布在分肉(肌肉间隙)之中,与卫气相互干扰。由于运行通道不畅,会导致肌肉肿胀并发生疮疡(愤,指肿起的样子;疡,指痈毒)。卫气有所凝滞而不能正常运行,因此肌肉会出现麻木不仁的现象(即顽痹,不知痛痒)。
疠风(麻风病),是由于营气热盛(腐,同“腐”意,指腐败),气血不清所致,因此会导致鼻梁塌陷、面色败坏、皮肤溃疡溃烂。风寒之邪客居在经脉中而不离去,称为“疠风”(溃破之意)。
风邪侵入五脏六腑的背俞穴,也会形成脏腑之风。风邪各自进入其门户,所侵犯的部位不同则形成偏风(即半身不遂)。
风邪顺着风府穴向上侵入,则形成脑风;风邪侵入连系眼球的脉络(眼系位于脑后),则形成目风、眼寒。饮酒后感受风邪,则形成漏风(症状包括多汗,常不能穿单衣,进食时出汗,严重时全身出汗喘息,厌恶穿衣,衣服常被汗水浸湿,口干喜欢喝水,不能从事劳累事务)。
房事后出汗又感受风邪,则形成内风(风邪乘虚而入,导致遗精、咳血、盗汗、骨蒸潮热)。刚洗完头感受风邪,则形成首风(头面部多汗恶风,通常在刮风前一天病情加重,头痛剧烈无法洗头洗脸,到了刮风那天病情稍减轻)。
风邪久留人体内,则形成肠风、飧泄(传入肠胃,热邪则便血,寒邪则泄泻)。风邪停留在体表的腠理,则形成泄风(多汗,汗水流出浸湿衣服,口中干燥,风气上渍,不能从事劳累事务,身体疼痛则怕冷)。
所以,风邪是百病的先导。至于它的变化,会成为其他疾病,没有固定的规律,但都是由风邪引起的。
肺风的症状:多汗、恶风,面色苍白,时常咳嗽、气短,白天症状较轻(瘥,同“差”,指好转),晚上加重。诊断部位在眉毛上方,颜色发白(烹,音pēng,上声)。
心风的症状:多汗、恶风,咽喉干燥,嘴唇裂开,容易愤怒惊吓,面色发红。病情严重时说话不流利。诊断部位在口部,颜色发红(焦,指喉舌干燥;绝,指唇口裂开;心脉夹持咽喉而主司舌头,所以出现这些症状)。
肝风的症状:多汗、恶风,容易悲伤,面色微青,咽喉干燥,容易愤怒,有时厌恶女性(肝气衰败则厌恶美色)。诊断部位在眼下,颜色发青。
脾风的症状:多汗、恶风,身体倦怠无力(惰,同“堕”),四肢不想活动,面色淡黄,食欲不振。诊断部位在鼻头,颜色发黄。
肾风的症状:多汗、恶风,面部浮肿像疣状,脊背疼痛不能直立(因骨骼衰败),面色晦暗(壹,音yī),小便不利或隐曲不畅,腹部不胀。吃寒凉食物则腹泻。诊断时形体消瘦而腹部膨大。
(Following the discussion on acupuncture for lumbar pain)
Wind is agile in its movement and prone to frequent changes. When the couli (pores and interstices of the skin) are open, one feels a sudden chill; when they are closed, one experiences heat and chest oppression. When cold predominates, food and drink intake decline (as cold causes stagnation of Stomach Qi); when heat predominates, muscles waste away (as heat dries up body fluids). Thus, it causes shivering (sound 'tu', meaning trembling) and inability to eat. This condition is named "Chills and Fever" (Li refers to trembling).
When wind pathogen enters the Yangming channel and the Stomach, it follows the meridian upwards to the inner canthus of the eye. If the person is obese, the wind cannot diffuse outward, leading to "Heat in the Middle" (Jiao Re Zhong), characterized by yellow eyes (due to internal stagnation of wind generating heat). If the person is emaciated, the wind diffuses outward easily, leading to "Cold in the Middle" (Han Zhong), characterized by tearing (due to loose couli allowing cold to invade internally).
When wind enters together with the Taiyang channel, it travels through the Shu points of various meridians and scatters between the muscle layers (fen rou), interfering with Wei Qi (Defensive Qi). Due to obstructed pathways, this causes muscle swelling and sores (Fen means swelling; Yang refers to carbuncles and toxins). If Wei Qi coagulates and fails to circulate, the flesh becomes insensible (numbness and loss of pain/itch sensation).
Leprosy (Li Feng) arises from hot Ying Qi (Nutritive Qi) causing corruption, resulting in turbid Qi. This leads to the collapse of the nasal bridge, deterioration of complexion, and ulceration of the skin. When Wind-Cold lodges in the meridians and does not depart, it is called Leprosy (referring to ulceration).
If wind invades the Back-Shu points of the Zang-Fu organs, it becomes Wind of the Zang-Fu. Entering through their respective gates, it causes Pi Feng (Hemiplegia).
If wind ascends along the Fengfu point (GV16), it becomes Brain Wind. If wind enters the ocular system (located at the back of the head), it becomes Eye Wind and Cold Eyes. If wind strikes after drinking alcohol, it becomes Leaking Wind (symptoms include excessive sweating, intolerance to thin clothing, sweating upon eating, severe cases involving whole-body sweating and panting, aversion to wearing clothes, wet garments, dry mouth, thirst, and inability to perform labor).
If wind strikes after sweating following sexual intercourse, it becomes Internal Wind (wind exploits deficiency, causing seminal emission, hemoptysis, night sweats, and bone-steaming fever).
If wind strikes after washing hair, it becomes Head Wind (excessive sweating and aversion to wind on the head and face; symptoms worsen one day before windy weather with severe headache preventing washing or combing, improving on the day of the wind).
If wind remains in the body for a long time, it becomes Intestinal Wind and Undigested Food Diarrhea (entering the intestines and stomach; heat causes bloody stool, cold causes diarrhea).
If wind stays at the couli externally, it becomes Leaking Wind (excessive sweating soaking clothes, dry mouth, wind rising upward, inability to labor, body ache with chills).
Therefore, wind is the chief of all diseases. Its transformations lead to other illnesses without fixed patterns, yet all stem from wind pathogen.
The presentation of Lung Wind includes: excessive sweating, aversion to wind, pale white complexion, occasional cough and shortness of breath, milder during the day and worse at evening. Diagnosis is located above the eyebrows, showing a white color.
The presentation of Heart Wind includes: excessive sweating, aversion to wind, dry throat and lips, irritability and fright, red complexion. In severe cases, speech is slurred. Diagnosis is located at the mouth, showing a red color (Jiao refers to dry throat/tongue; Jue refers to cracked lips; the Heart meridian flanks the throat and governs the tongue, hence these symptoms).
The presentation of Liver Wind includes: excessive sweating, aversion to wind, propensity to sadness, slightly blue-green complexion, dry throat, irritability, and sometimes aversion to women (Liver deficiency leads to aversion to beauty). Diagnosis is located below the eyes, showing a green color.
The presentation of Spleen Wind includes: excessive sweating, aversion to wind, lethargic body, limbs unwilling to move, pale yellow complexion, and poor appetite. Diagnosis is located on the nose tip, showing a yellow color.
The presentation of Kidney Wind includes: excessive sweating, aversion to wind, puffy facial edema resembling warts, back pain preventing standing upright (due to bone weakness), dark/dull complexion, difficult urination, and abdominal distension. Eating cold foods causes diarrhea. Diagnosis shows a thin body with a distended abdomen.