黄帝曰。夫子言贼风邪气之伤人也。令人病焉。今有其不离屏蔽。不出室穴之中。卒然病者。非
不离贼风邪气。其故何也。岐伯曰。此皆尝有所伤于湿。气藏于血脉之中。分肉之间。久留而不去。
若有所堕坠。恶血在内而不去。卒然喜怒不节。饮食不适。寒温不时。腠理闭而不通。其开而遇风
寒。则血气凝结。与故邪相袭。则为寒痹。其有热。则汗出。汗出则受风。虽不遇贼风邪气。必有因
加而发焉。
此篇论病形而伤其精气神也。三邪杂至。合而为痹。在内而伤其精气神者。有似乎鬼神。可祝由
而已也。篇名贼风者。言往古之人。恬 虚无。精神内守。邪不能深入。故可移精祝由而已。当今之世
不然。忧患缘其内。
苦形伤其外。贼风数至。虚邪朝夕。内至五脏骨髓。外伤空窍肌肤。故祝由不能已也。夫心主脉。
诸血者皆属于心。尝有所伤于湿。气藏于血脉之中。则伤心藏之神矣。分肉者。三焦通会元真之处。
留于分肉之间。则伤其气矣。若有所堕坠。则有伤于筋骨。筋即为肝。骨即为肾。血即为心。恶血
在内。则伤心藏之神。有伤于筋。则伤肝藏之魂。有伤于骨。则伤肾藏之精。卒然喜怒不节。则更伤
所藏之神魂。饮食不适。则更伤水谷之精液。寒温不时。则伤在外之形气。形气伤则腠理闭而不通。
其开而遇风寒。则血气凝结。与故之湿邪相袭。则风寒湿三气杂合而为痹矣。其开而遇风者。以有热
则汗出。盖热乃火之气。汗乃精血之液。因伤其精神。是以热则气弛。汗出而开也。汗出则受风。虽
不遇贼风邪气。必有因加于风寒而发焉。任谷庵曰。贼风邪气。不正之邪气也。风寒。天之正气也。
因有故邪。开而汗出。故因加而合为邪病焉。王子方曰。风伤气。寒伤神。湿伤精。盖风伤卫。
寒伤营。而寒水之气。又伤心火也。湿乃土之邪气。故伤肾藏之精。是以伤于湿者则为痿厥。痿者。
骨痿。厥者。肾脏之生气厥逆。而四肢清冷也。
黄帝曰。夫子之所言者。皆病患之所自知也。其毋所遇邪气。又无怵惕之所志。卒然而病者。其
故何也。惟有因鬼神之事乎。岐伯曰。此亦有故邪。留而未发。因而志有所恶。及有所慕。血气内
乱。两气相搏。其所从来者微。视之不见。听而不闻。故似鬼神。(毋无同恶去声)
此言病在内而伤其精气神也。故邪留而未发者。留于脏腑募原之间。则有伤于气矣。水之精为志。
火之精为神。志有所恶。则伤肾藏之精。心有所慕。则伤心藏之神。血气内乱。真邪相搏。其所由
来者渐矣。此病气而
不病形。故视之不见。听而不闻。若有似乎鬼神。夫魂游为神。魄降为鬼。随神往来谓之魂。并精
而出谓之魄。精神内伤。则魂魄飞扬。而有似乎鬼神也。
黄帝曰。其祝而已者。其故何也。岐伯曰。先巫者。因知百病之胜。先知其病之所从生者。可
祝而已也。
知百病之胜者。知精气神三者。能胜其百病也。知其病之所从生者。知先伤其精气神。而病之所
由生也。可祝而已者。先巫之能移精变气而通神明也。王子方曰。上古有十三科。祝由乃其一也。
先巫者。言上古之能祝由而愈病者。谓之巫医。故古之医字从巫。非与师巫之贱役比也。南人有言曰。
人而无恒。不可以作巫医。即上古祝而已病之医。非医巫之有二也。
黄帝说:先生谈论贼风邪气伤害人体,使人患病。现在有的人从不离开遮蔽物,不出居室之中,却突然生病,这并非因为不远离贼风邪气,其中的原因是什么呢?岐伯回答说:这都是曾经被湿气所伤,湿气潜伏在血脉之中、分肉之间,长久停留而不消散。或者曾经跌坠受伤,恶血留在体内未能排出。如果突然喜怒无常、饮食不当、寒温失调,导致腠理闭塞不通;当腠理开泄时又遇到风寒,就会使血气凝结,与原有的邪气相合,从而形成寒痹。如果有热象,就会出汗,出汗后容易受风侵袭。即使没有遇到贼风邪气,也必定会因为诱因而发作。
这一篇论述病形并损伤精气神的情况。三种邪气混杂而至,结合而成痹证。在内损伤精气神的,看起来好像鬼神作祟,可以通过祝由疗法来治愈。篇名叫做“贼风”,是说古代的人心境恬淡虚无,精神内守,邪气不能深入,所以可以通过移精变气、祝由疗法来治愈。当今的时代就不是这样了,忧患从内部产生,苦累形体从外部损伤,贼风频繁到来,虚邪早晚侵袭,向内深入五脏骨髓,向外损伤空窍肌肤,所以祝由疗法不能治愈了。心主脉,所有的血液都归属于心。曾经被湿气所伤,湿气潜伏在血脉之中,就会损伤心藏的神志。分肉是三焦通会元真之气(元气)的地方,邪气留存在分肉之间,就会损伤气。如果有跌坠受伤,就会损伤筋骨。筋属于肝,骨属于肾,血属于心。恶血留在体内,就会损伤心藏的神;损伤筋,就会损伤肝藏魂;损伤骨,就会损伤肾藏的精。突然喜怒不节制,就会进一步损伤所藏的神和魂;饮食不当,就会进一步损伤水谷化生的精液;寒温不调,就会损伤体表的形气。形气受损则腠理闭塞不通,当腠理开泄遇到风寒时,血气凝结,与原有的湿邪相合,风寒湿三气混杂结合就形成了痹证。当腠理开泄遇到风时,因为有热所以出汗。热是火的气化表现,汗是精血的液体。因为损伤了精神和血,所以热时气机弛缓,汗出而腠理开泄。汗出后就容易受风侵袭,即使没有遇到贼风邪气,也必定会因为加上风寒的因素而发作。任谷庵说:贼风邪气是不正之气,风寒是天的正气。因为体内有旧邪,腠理开泄且出汗,所以因加而结合成为邪病。王子方说:风伤气,寒伤神,湿伤精。大概风伤卫气,寒伤营血,而寒水之气又伤心火。湿是土的邪气,所以损伤肾藏的精。因此被湿邪所伤就会形成痿厥。痿是指骨痿,厥是指肾脏的生气厥逆,导致四肢清冷。
黄帝说:先生所说的,都是病人自己知道的情况。如果没有遇到邪气,也没有惊恐忧虑的情志刺激,却突然生病,其中的原因是什么呢?难道是因为鬼神的事情吗?岐伯回答说:这也是因为有旧邪留存而未发作,因为情志上有所厌恶,以及有所贪慕,导致血气内部紊乱,新旧两气相互搏结。它来的根源很细微,看也看不见,听也听不到,所以看起来像鬼神。(“毋”同“无”,读音为去声)
这里说的是病在内而损伤精气神。故邪留存而未发作,停留在脏腑募原之间,就会损伤气。水的精华是志,火的精华是神。志有所厌恶,就会损伤肾藏的精;心有所贪慕,就会损伤心藏的神。血气内部紊乱,真气与邪气相互搏结,它的由来是逐渐积累的。这是病在气而不在形,所以看也看不见,听也听不到,好像有鬼神一样。魂游动称为神,魄下降称为鬼。随神往来的是魂,伴随精而出的是魄。精神内伤,魂魄飞扬,所以看起来像鬼神。
黄帝说:那些通过祝由就能治愈的病,原因是什么呢?岐伯回答说:以前的巫医,因为知道百病的克制之法,先知道疾病产生的根源,就可以通过祝由来治愈。
知道百病的克制之法,就是知道精气神三者能够战胜百病。知道疾病产生的根源,就是知道先损伤了精气神,然后疾病才由此产生。可以通过祝由治愈,是因为古代巫医能够移精变气并通达神明。王子方说:上古时期有十三科,祝由是其中之一。所谓的“先巫”,是指上古时期能够通过祝由治愈疾病的人,称之为巫医。所以古时候的“医”字是从“巫”演变而来的,并不是与师巫那种低贱的职业相比。南方人有句话说:“人如果没有恒心,不可以做巫医。”指的就是上古时期通过祝由治愈疾病的医生,并不是说医和巫是两种不同的东西。
Huangdi said: You have discussed how the wind of thieves (Zefeng, sudden and unexpected pathogenic winds) and other evil qi damage the human body, causing illness. Now, there are those who never leave their shelters or exit their rooms, yet suddenly fall ill. This is not because they fail to avoid the wind of thieves and evil qi; what is the reason? Qibo replied: This is all due to previous injuries from dampness. The damp qi hides within the blood vessels and between the muscle layers, lingering for a long time without dispersing. Or perhaps there was a previous fall or injury, leaving bad blood (stasis) inside that has not been expelled. If one experiences sudden emotional fluctuations such as anger or joy without moderation, improper diet, or irregular exposure to cold and heat, the interstices (Couli) become closed and obstructed. When the interstices open and encounter wind and cold, the blood and qi coagulate and combine with the old pathogen, resulting in Cold Bi syndrome. If there is heat, sweat will be produced. After sweating, one becomes susceptible to wind invasion. Even if the wind of thieves and evil qi are not encountered, an attack will inevitably occur due to these aggravating factors.
This chapter discusses disease manifestations that injure the Jing (Essence), Qi, and Shen (Spirit). When three types of pathogens mix and combine to form Bi syndrome, and internally injure the Jing, Qi, and Shen, it may appear as if caused by ghosts or spirits, and can be treated through Zhuyou (incantation therapy). The chapter is named "Wind of Thieves" to indicate that in ancient times, people were tranquil and empty of desires, keeping their spirits inwardly guarded, so pathogens could not penetrate deeply; thus, shifting the spirit and using Zhuyou was sufficient. In today's world, this is no longer the case. Worries arise internally, and physical toil damages the exterior. The wind of thieves arrives frequently, and empty evils (Xuexie, vacuous pathogens) invade morning and night, penetrating inward to the five zang organs and bone marrow, and outwardly damaging the orifices, skin, and muscles. Therefore, Zhuyou cannot cure them. The Heart governs the vessels, and all blood belongs to the Heart. Previous injury from dampness causes damp qi to hide in the blood vessels, thereby injuring the Shen stored in the Heart. The space between muscles is where the Sanjiao (Triple Burner) connects and distributes Yuanzhen (Original True Qi). If pathogenic qi lingers between the muscles, it injures the Qi. If there is a fall or injury, the sinews and bones are damaged. Sinews belong to the Liver, bones to the Kidney, and blood to the Heart. Bad blood remaining inside injures the Shen of the Heart; injury to sinews injures the Hun (Ethereal Soul) of the Liver; injury to bones injures the Jing (Essence) of the Kidney. Sudden lack of moderation in anger and joy further injures the stored Shen and Hun. Improper diet further injures the fluids derived from food and water. Irregular cold and heat damage the exterior form and qi. When form and qi are damaged, the interstices close and obstruct. Upon opening and encountering wind and cold, blood and qi coagulate and combine with the original damp pathogen. The three pathogens—wind, cold, and damp—mix and combine to form Bi syndrome. When the interstices open and encounter wind, heat causes sweating. Heat is the manifestation of Fire qi, and sweat is the fluid of Jing and blood. Because Jing and Spirit are injured, heat causes Qi to relax, and sweating opens the interstices. After sweating, one is susceptible to wind. Even without encountering the wind of thieves, an attack will inevitably occur due to the addition of wind and cold. Ren Gu'an stated: The wind of thieves and evil qi are incorrect pathogens, whereas wind and cold are the correct qi of Heaven. Because there is an old pathogen inside, and the interstices open with sweating, the new and old combine to form a pathological condition. Wang Zifang stated: Wind injures Qi, Cold injures Shen, and Damp injures Jing. Generally, Wind injures Wei (Defensive) Qi, and Cold injures Ying (Nutritive) Blood, while the cold-water qi also injures Heart Fire. Damp is the pathogen of Earth, so it injures the Jing stored in the Kidney. Therefore, injury from dampness leads to Wei Jue (Flaccidity and Reversal). Wei refers to bone flaccidity, and Jue refers to the reversal of the generating Qi of the Kidney, resulting in cold limbs.
Huangdi said: What you have described are conditions known to the patients themselves. If they have not encountered any pathogenic qi, nor experienced fright or anxiety, yet suddenly fall ill, what is the reason? Is it solely due to matters involving ghosts and spirits? Qibo replied: There is also an old pathogen retained but not yet manifesting. Due to mental aversion or excessive longing, the blood and qi become chaotic internally, and the two types of qi (pathogenic and healthy) contend with each other. Its origin is subtle; it cannot be seen, nor heard, so it appears like ghosts and spirits. ("Wu" is identical to "Wu" [no/without], pronounced with the departing tone.)
This passage discusses disease occurring internally and injuring the Jing, Qi, and Shen. When the old pathogen remains latent, residing between the zang-fu organs and the Mu-Yuan (marginal areas), it injures the Qi. Water's essence is Zhi (Will), and Fire's essence is Shen (Spirit). Aversion injures the Jing stored in the Kidney; longing injures the Shen stored in the Heart. Internal chaos of blood and qi, and the struggle between true qi and pathogenic qi, accumulate gradually. This disease affects Qi rather than Form, so it cannot be seen or heard, appearing as if caused by ghosts and spirits. The wandering of Hun is called Shen; the descent of Po is called Ghost. Following Shen's movement is Hun; exiting with Jing is Po. When internal injury occurs to the Spirit, Hun and Po fly erratically, appearing like ghosts and spirits.
Huangdi asked: For those cured by Zhuyou, what is the reason? Qibo replied: The ancient shamans knew the overcoming principles of the hundred diseases. By first knowing the origin of the disease, it could be cured by Zhuyou.
Knowing the overcoming principles of the hundred diseases means understanding that the Jing, Qi, and Shen can overcome the hundred diseases. Knowing the origin of the disease means understanding that the Jing, Qi, and Shen are first injured, leading to the generation of disease. Being curable by Zhuyou implies that the ancient shamans could shift the spirit, change the qi, and communicate with the divine. Wang Zifang stated: In ancient times, there were thirteen medical departments, and Zhuyou was one of them. The term "ancient shaman" refers to those in antiquity who could cure diseases through Zhuyou, called Wu-Yi (Shaman-Doctors). Thus, the ancient character for "Doctor" (Yi) was derived from "Shaman" (Wu), and was not comparable to the lowly status of later fortune-tellers or exorcists. People in the South say, "If a person lacks constancy, they cannot serve as a Shaman-Doctor." This refers to the doctors of ancient times who cured diseases through Zhuyou, indicating that Medicine and Shamanism were not originally two separate entities.