黄帝问曰∶厥之寒热者何也?岐伯对曰∶阳气衰于下,则为寒厥;阴气衰于下,则为热厥。帝曰∶热
厥之为热也,必起于足下者何也?岐伯曰∶阳气起于足五指之表,阴脉者集于足下而聚于足心,故阳气胜则
足下热也。帝曰∶寒厥之为寒也,必从五指而上于膝者何也?岐伯曰∶阴气起于五指之里,集于膝下而聚于膝
上,故阴气胜则从五指至膝上寒,其寒也,不从外,皆从内也。帝曰∶寒厥何失而然也?岐伯曰∶前阴者,
宗筋之所聚,太阴阳明之所合也。春夏则阳气多而阴气少,秋冬则阴气盛而阳气
衰。此人者质壮,以秋冬夺于所用,下气上争,不能复,精气溢下,邪气因从之而上也,气因于中,
阳气衰,不能渗营其经络,阳气日损,阴气独在,故手足为之寒也。帝曰∶热厥何如而然也?岐伯曰∶酒入于
胃,则络脉满而经脉虚,脾主为胃行其津液者也,阴气虚则阳气入,阳气入则胃不和,胃不和则精气竭,精气
竭则不营其四肢也。此人必数醉若饱以入房,气聚于脾中不得散,酒气与谷气相薄,热盛于中,故热遍于身内
热而溺赤也。夫酒气盛而 悍,肾气有衰,阳气独胜,故手足为之热也。帝曰∶厥或令人腹满,或令人暴不
知人,或至半日远至一日乃知人者何也?岐伯曰∶阴气盛于上则下虚,下虚则腹胀满,阳气盛于上则下气重上
而邪气逆,逆则阳气乱,阳气乱则不知人也。帝曰∶善。愿闻六经脉之厥状病能
也。岐伯曰∶巨阳之厥,则肿首头重,足不能行,发为 仆。阳明之厥,则癫疾欲走呼,腹满不得卧,面
赤而热,妄见而妄言。少阳之厥,则暴聋颊肿而热,胁痛, 不可以运。太阴之厥,则腹满 胀,后不
利,不欲食,食则呕,不得卧。少阴之厥,则口干溺赤,腹满心痛。厥阴之厥,则少腹肿痛,腹胀泾溲不
利,好卧屈膝,阴缩肿, 内热。盛则泻之,虚则补之,不盛不虚,以经取之。太阴厥逆, 急挛,心痛
引腹,治主病者。少阴厥逆,虚满呕变,下泄清,治主病者。厥阴厥逆,挛腰痛,虚满前闭谵言,治主
病者。三阴俱逆,不得前后,使人手足寒,三日死。太阳厥逆,僵仆呕血善衄,治主病者。少阳厥逆,机关不
利,机关不利者,腰不可以行,项不可以顾,发肠痈不可治,惊者死。阳明厥逆,喘咳身热,善惊衄呕血。手
太阴厥逆,虚满而咳,善呕沫,治主病者。手心主少阴厥逆,心痛引喉,身热。死不可治。手太阳厥逆,耳聋
泣出,项不可以顾,腰不可以俯仰,治主病者。手阳明少阳厥逆,发喉痹,嗌肿, ,治主病者。
风论∶疠(音利)溃(胡对切)脑(奴皓切)
痹论∶肓(音荒)
痿论∶ (必亦切)髋(音宽)尻(枯熬切) (音总)膑(音牝)
厥论∶谵(音詹)僵(居良切)仆(音赴)髦(音毛)
黄帝问道:厥证出现寒象或热象的原因是什么?岐伯回答说:阳气在下部衰少,就会发生寒厥;阴气在下部衰少,就会发生热厥。黄帝说:热厥的热感,为什么一定从足底开始?岐伯说:阳气起于足五指的外侧,阴脉汇聚于足下并聚集在足心,所以阳气偏胜时,足底就会发热。黄帝说:寒厥的寒冷感,为什么一定从足五指向上蔓延到膝盖?岐伯说:阴气起于足五指的内侧,汇聚于膝下并聚集在膝上,所以阴气偏胜时,就会从足五指至膝上感到寒冷。这种寒冷并非来自体外,而是都发自体内。黄帝说:寒厥是因为什么失调而发生的呢?岐伯说:前阴部位,是宗筋(众多筋脉)汇聚之处,也是太阴脾经与阳明胃经会合的地方。春夏季节阳气多而阴气少,秋冬季节阴气盛而阳气衰。如果这个人身体壮实,却在秋冬季节过度使用肾精(如纵欲),导致下部之气上争而不能恢复,精气向下漏泄,邪气便趁机随之上逆,气机郁结在中焦,阳气因此衰败,不能渗透濡养其经络,阳气日渐损耗,阴气独存,所以手足会出现寒冷。黄帝说:热厥又是如何发生的呢?岐伯说:酒进入胃中,络脉充盈而经脉空虚,脾脏的功能是为胃传输津液,阴气虚弱则阳气内入,阳气内入则胃气不和,胃气不和则精气枯竭,精气枯竭就不能濡养四肢。这种人一定是经常醉酒或饱食后行房事,导致气聚积在脾中不得疏散,酒气与谷气相互搏结,热气盛于中焦,所以热感遍布全身,内部发热且小便颜色深赤。酒的性质刚烈迅猛,若肾气已有衰退,阳气就会单独偏胜,所以手足会出现发热。黄帝说:有的厥证使人腹部胀满,有的使人突然昏倒不省人事,有的甚至半天或一天后才苏醒,这是为什么呢?岐伯说:阴气在上部偏盛则下部虚损,下部虚损则腹部胀满;阳气在上部偏盛则下部之气重并于上部,导致邪气上逆,气逆则阳气紊乱,阳气紊乱就会使人神志不清。黄帝说:好。我想听听六经脉发生厥证时的症状和病态表现。岐伯说:太阳经发生厥逆,就会出现头部肿胀、头重脚轻,脚不能行走,甚至突然跌倒。阳明经发生厥逆,就会患癫狂病,想奔跑呼喊,腹部胀满不能安卧,面色发红发热,胡言乱语,看见不存在的东西。少阳经发生厥逆,就会突然耳聋,脸颊肿胀发热,胁肋疼痛,关节活动不利。太阴经发生厥逆,就会腹部胀满,大便不通畅,不想吃东西,吃了就呕吐,不能安卧。少阴经发生厥逆,就会口干,小便色赤,腹部胀满,心痛。厥阴经发生厥逆,就会小腹部肿痛,腹部胀满,大小便不通利,喜欢躺着并弯曲膝盖,生殖器收缩肿胀,阴股内侧发热。治疗原则是:实证用泻法,虚证用补法,不盛不虚的,直接取本经穴位治疗。太阴经气厥逆,出现小腿拘急挛缩,心痛牵引腹部,治疗应针对主要病症。少阴经气厥逆,出现虚性胀满、呕吐变症、下利清谷,治疗应针对主要病症。厥阴经气厥逆,出现拘挛腰痛,虚性胀满、小便闭塞、胡言乱语,治疗应针对主要病症。三阴经气全部厥逆,导致大小便不通,使人手足寒冷,三天后死亡。太阳经气厥逆,出现身体僵硬跌倒、呕血、容易鼻出血,治疗应针对主要病症。少阳经气厥逆,出现关节活动不利,关节活动不利的人,腰部不能行走,颈部不能回顾,若并发肠痈则不可治,若受惊则死。阳明经气厥逆,出现气喘咳嗽、身体发热、易受惊吓、鼻出血、呕血。手太阴经气厥逆,出现虚性胀满而咳,容易呕吐涎沫,治疗应针对主要病症。手厥阴心包经与手少阴心经气厥逆,出现心痛牵引咽喉,身体发热,属死证,不可治。手太阳经气厥逆,出现耳聋、流泪,颈部不能回顾,腰部不能俯仰,治疗应针对主要病症。手阳明经与手少阳经气厥逆,出现喉痹、咽喉肿胀,治疗应针对主要病症。
风论篇:疠(音利)溃(胡对切)脑(奴皓切)
痹论篇:肓(音荒)
痿论篇:髋(音宽)尻(枯熬切)膑(音牝)
厥论篇:谵(音詹)僵(居良切)仆(音赴)髦(音毛)
Huangdi asked: What is the reason for cold and heat manifestations in Jue syndrome? Qibo replied: When Yang Qi (Vital Energy) declines at the lower part of the body, it results in Cold Jue; when Yin Qi (Substantial Energy) declines at the lower part of the body, it results in Heat Jue. The Emperor said: Why does the heat sensation in Heat Jue always originate from the sole of the foot? Qibo said: Yang Qi originates from the dorsal aspect of the five toes of the foot, while Yin meridians converge at the sole and gather at the center of the foot. Therefore, when Yang Qi prevails, the sole becomes hot. The Emperor said: Why does the cold sensation in Cold Jue always extend from the five toes upward to the knee? Qibo said: Yin Qi originates from the plantar aspect of the five toes, converges below the knee, and gathers above the knee. Thus, when Yin Qi prevails, coldness extends from the five toes to above the knee. This coldness does not come from the exterior but arises entirely from within. The Emperor said: What imbalance causes Cold Jue? Qibo said: The anterior yin region is where the Zongjin (Major Sinews) gather and where the Taiyin Spleen Meridian and Yangming Stomach Meridian intersect. In spring and summer, Yang Qi is abundant and Yin Qi is scarce; in autumn and winter, Yin Qi is abundant and Yang Qi declines. If a person with a robust constitution overexerts themselves during autumn and winter, depleting their essence, the Qi from the lower body struggles upward but cannot recover. Essence leaks downward, and pathogenic factors follow this Qi upward. The Qi becomes stagnant in the middle jiao, causing Yang Qi to decline so that it cannot permeate and nourish the meridians. As Yang Qi diminishes day by day, only Yin Qi remains, resulting in cold hands and feet. The Emperor said: How does Heat Jue occur? Qibo said: When wine enters the stomach, the collateral vessels become full while the main meridians become empty. The Spleen is responsible for transporting fluids for the Stomach. When Yin Qi is deficient, Yang Qi enters inward; when Yang Qi enters inward, the Stomach loses harmony; when the Stomach lacks harmony, essential Qi is exhausted; when essential Qi is exhausted, it fails to nourish the four limbs. Such individuals likely engage in sexual intercourse after frequent intoxication or heavy meals. Qi accumulates in the Spleen and cannot disperse. The Qi of wine and the Qi of food contend with each other, generating intense heat in the middle jiao. Consequently, heat pervades the entire body, causing internal heat and dark red urine. Wine possesses a vigorous and fierce nature; if Kidney Qi is already declining, Yang Qi will prevail alone, resulting in hot hands and feet. The Emperor said: Some cases of Jue cause abdominal fullness, others cause sudden unconsciousness, and some take half a day to a full day to regain consciousness. Why is this? Qibo said: When Yin Qi is excessive in the upper part, the lower part becomes deficient. Lower deficiency leads to abdominal distension. When Yang Qi is excessive in the upper part, Qi from the lower part rises heavily, causing pathogenic Qi to reverse its flow. Reversal leads to chaos in Yang Qi, and chaotic Yang Qi results in loss of consciousness. The Emperor said: Excellent. I wish to hear about the symptoms and pathological states of Jue affecting the six meridian systems. Qibo said: When the Jueyang (Taiyang) Meridian experiences Jue reversal, there is swelling of the head, heaviness of the head, inability to walk, and sudden collapse. When the Yangming Meridian experiences Jue reversal, there is manic epilepsy, desire to run and shout, abdominal fullness preventing sleep, red and hot face, hallucinations, and delirious speech. When the Shaoyang Meridian experiences Jue reversal, there is sudden deafness, swollen and hot cheeks, flank pain, and immobility of the joints. When the Taiyin Meridian experiences Jue reversal, there is abdominal fullness and distension, difficulty with defecation, anorexia, vomiting after eating, and inability to sleep. When the Shaoyin Meridian experiences Jue reversal, there is dry mouth, dark red urine, abdominal fullness, and heart pain. When the Jueyin Meridian experiences Jue reversal, there is swelling and pain in the lower abdomen, abdominal distension, difficulty with urination and defecation, preference for lying down with knees flexed, contraction and swelling of the genitals, and heat in the medial thigh. The treatment principle is: excess conditions are treated with draining methods, deficiency conditions with tonifying methods, and neither-excess-nor-deficiency conditions by selecting points from the affected meridian directly. When the Taiyin Meridian experiences Qi Jue reversal, there is calf cramping and spasm, and heart pain radiating to the abdomen; treatment should target the primary disease. When the Shaoyin Meridian experiences Qi Jue reversal, there is vacuous fullness, vomiting with altered symptoms, and passage of clear diarrhea; treatment should target the primary disease. When the Jueyin Meridian experiences Qi Jue reversal, there is cramping and lower back pain, vacuous fullness, urinary retention, and delirious speech; treatment should target the primary disease. When all three Yin meridians experience Jue reversal, leading to obstruction of both urination and defecation, causing cold hands and feet, death occurs within three days. When the Taiyang Meridian experiences Qi Jue reversal, there is stiffness and collapse, hematemesis, and frequent epistaxis; treatment should target the primary disease. When the Shaoyang Meridian experiences Qi Jue reversal, there is joint dysfunction. Joint dysfunction manifests as inability to walk due to waist stiffness and inability to look back due to neck rigidity. If intestinal abscess develops, it is incurable; if accompanied by fright, it is fatal. When the Yangming Meridian experiences Qi Jue reversal, there is wheezing and coughing, fever, susceptibility to fright, epistaxis, and hematemesis. When the Hand-Taiyin Meridian experiences Qi Jue reversal, there is vacuous fullness with coughing and frequent vomiting of frothy saliva; treatment should target the primary disease. When the Hand-Jueyin Pericardium Meridian and Hand-Shaoyin Heart Meridian experience Qi Jue reversal, there is heart pain radiating to the throat and fever; this is a fatal condition and cannot be treated. When the Hand-Taiyang Meridian experiences Qi Jue reversal, there is deafness, tearing, inability to look back, and inability to bend or extend the waist; treatment should target the primary disease. When the Hand-Yangming and Hand-Shaoyang meridians experience Qi Jue reversal, there is Bi syndrome of the throat (throat obstruction) and swelling of the pharynx; treatment should target the primary disease.
Wind Chapter: Li (pronounced li) Kui (hu dui qie) Nao (nu hao qie)
Bi Syndrome Chapter: Huang (pronounced huang)
Flaccidity Chapter: Kuan (pronounced kuan) Kao (ku ao qie) Bin (pin)
Jue Chapter: Zhan (pronounced zhan) Jiang (ju liang qie) Pu (pronounced fu) Mao (pronounced mao)