黄帝问曰∶病有标本,刺有逆从奈何?岐伯对曰∶凡刺之方,必别阴阳,前后相应,逆从得施,标本相移,
故曰有其在标而求之于标,有其在本而求之于本,有其在本而求之于标,有其在标而求之于本。故治有取标而
得者,有取本而得者,有逆取而得者;有从取而得者。故知逆与从,正行无问,知标本者,万举万当,不知
标本,是谓妄行。夫阴阳逆从标本之为道也,小而大,言一而知百病之害,少而多,浅而博,可以言一而知百
也。以浅而知深,察近而知远,言标与本,易而勿及。治反为逆,治得为从。先病而后逆者治其本,先逆而后
病者治其本,先寒而后生病
者治其本,先病而后生寒者治其本,先热而后生病者治其本,先热而后生中满者治其标,先病而后泄者治其本,
先泄而后生他病者治其本,必且调之,乃治其他病,先病而后生中满者治其标,先中满而后烦心者治其本。人
有客气有同气。小大不利治其标,小大利治其本。病发而有余,本而标之,先治其本,后治其标。病发而
不足,标而本之,先治其标,后治其本。谨察间甚,以意调之,间者并行,甚者独行。先小大不利而后生病者
治其本。夫病传者,心病先心痛,一日而咳,三日胁支痛,五日闭塞不通,身痛体重,
三日不已死,冬夜半,夏日中。肺病喘咳,三日而胁支满痛,一日身重体痛,五日而胀,十日不已死,
冬日入,夏日出。肝病头目眩胁支满,三日体重身痛,五日而胀,三日腰脊少腹痛胫 ,三日不已死,冬日入,
夏早食。脾病身痛体重,一
日而胀,二日少腹腰脊痛胫 ,三日背KT 筋痛小便闭,十日不已死,冬人定,夏晏食。肾病少腹腰脊痛 ,
三日背KT 筋痛小便闭,三日腹胀,三日两胁支痛,三日不已死,冬大晨,夏晏晡。胃病胀满,五日少腹
腰脊痛 ,三日背KT 筋痛小便闭,五日身体重,六日不已死,冬夜半后,夏日 。膀胱病小便闭,五日
少腹胀腰脊痛 ,一
日腹胀,一日身体痛,二日不已死,冬鸡鸣,夏下晡。诸病以次相传,如是者,皆有死期,不可刺。间
一脏止,及至三四脏者,乃可刺也。
黄帝问道:疾病有标和本之分,针刺治疗有逆治和从治的区别,这是为什么呢?岐伯回答说:凡是针刺的方法,必须辨别阴阳,使前后穴位相互呼应,逆治和从治的原则得以正确施用,标和本的关系能够灵活转换。所以说,病邪在标而求治于标,病邪在本而求治于本;病邪在本却求治于标,病邪在标却求治于本。因此,治疗中有通过治标而获效的,有通过治本而获效的,有通过逆治而获效的,有通过从治而获效的。所以,懂得逆治与从治的道理,正治之法便可毫无疑问地施行;懂得标与本的关系,就能万举万当;不懂得标与本的关系,就称为妄行。关于阴阳、逆从、标本的道理,看似微小实则宏大,说一个道理就能知晓百种疾病的危害;看似少实则多,看似浅显实则广博,可以通过一个道理推知其他众多情况。以浅显的知识推知深奥的道理,观察近处而知晓远处,谈论标与本,虽然容易理解但往往被忽视。治疗违背原则即为逆治,治疗符合原则即为从治。先患病而后出现气机逆乱的,治疗其本;先气机逆乱而后患病的,治疗其本;先受寒而后患病的,治疗其本;先患病而后出现寒象的,治疗其本;先发热而后患病的,治疗其本;先发热而后出现中满(胸腹胀满)的,治疗其标;先患病而后泄泻的,治疗其本;先泄泻而后产生其他疾病的,治疗其本,必须先调理好泄泻,然后才能治疗其他疾病;先患病而后出现中满的,治疗其标;先出现中满而后出现心烦的,治疗其本。人体既有外来的客气,也有内在的同气。大小便不通利的,先治其标;大小便通利的,治其本。疾病发作时表现为邪气有余的,先治其本后治其标;疾病发作时表现为正气不足的,先治其标后治其本。仔细察看病情的轻重缓急,用心加以调治,病情轻缓的可以标本同治,病情严重的则单独治标或治本。先出现大小便不利而后患病的,治疗其本。
关于疾病的传变规律:心病先发心痛,一天后传至肺引起咳嗽,三天后传至肝引起胁肋支撑疼痛,五天后传至肾引起闭塞不通、身体疼痛沉重,如果三天后病仍未愈就会死亡,死于冬季夜半时分,夏季日中时分。肺病先发喘咳,三天后传至肝引起胁肋支撑胀满疼痛,一天后传至肾引起身体沉重疼痛,五天后传至脾引起腹部胀满,十天后病仍未愈就会死亡,死于冬季日落时分,夏季日出时分。肝病先发头晕目眩、胁肋支撑胀满,三天后传至脾引起身体沉重疼痛,五天后传至肾引起腹部胀满,三天后传至心引起腰脊和小腹痛、小腿酸痛,三天后病仍未愈就会死亡,死于冬季日落时分,夏季早饭时分。脾病先发身体疼痛沉重,一天后传至肾引起腹部胀满,两天后传至心引起小腹、腰脊痛及小腿酸痛,三天后传至肝引起背部筋脉疼痛、小便闭阻,十天后病仍未愈就会死亡,死于冬季人定时分,夏季晏食时分。肾病发小腹部、腰脊疼痛,三天后传至肝引起背部筋脉疼痛、小便闭阻,三天后传至脾引起腹部胀满,三天后传至心引起两胁肋支撑疼痛,三天后病仍未愈就会死亡,死于冬季大晨时分,夏季晏晡时分。胃病先发腹部胀满,五天后传至肾引起小腹部、腰脊疼痛,三天后传至肝引起背部筋脉疼痛、小便闭阻,五天后传至心引起身体沉重,六天后病仍未愈就会死亡,死于冬季夜半之后,夏季特定时辰。膀胱病发小便闭阻,五天后传至肾引起小腹部胀满、腰脊疼痛,一天后传至脾引起腹部胀满,一天后传至心引起身体疼痛,二天后病仍未愈就会死亡,死于冬季鸡鸣时分,夏季下晡时分。各种疾病依次相传,像这样都有死亡的期限,不可进行针刺治疗。如果间隔一脏不传,或者传到三四脏就停止的,才可以进行针刺治疗。
Huangdi asked: Diseases have the concepts of Biao (Branch/Symptom) and Ben (Root/Cause), and acupuncture treatment involves Ni (Counter/Reverse) and Cong (Following/Compliant) approaches. What is the rationale behind this? Qibo replied: In all acupuncture methods, one must distinguish between Yin and Yang, ensure that anterior and posterior points correspond to each other, apply the principles of Ni and Cong correctly, and flexibly shift the focus between Biao and Ben. Therefore, it is said that if the pathogen is at the Biao, treat the Biao; if the pathogen is at the Ben, treat the Ben; if the pathogen is at the Ben but treated via the Biao, or if the pathogen is at the Biao but treated via the Ben. Thus, in treatment, some are cured by addressing the Biao, some by addressing the Ben, some by using Ni methods, and some by using Cong methods. Therefore, those who understand Ni and Cong can practice Zheng (Correct/Standard) therapy without doubt; those who understand Biao and Ben will succeed in every attempt; those who do not understand Biao and Ben are called acting recklessly. The Dao of Yin-Yang, Ni-Cong, and Biao-Ben appears small yet is great; stating one principle allows one to know the harm of a hundred diseases; appearing few yet is many; appearing shallow yet is profound. One can know the deep through the shallow, and know the distant by observing the near. Discussing Biao and Ben is easy to understand but often neglected. Treatment contrary to principles is Ni; treatment conforming to principles is Cong. If illness occurs first and then Qi reversal follows, treat the Ben; if Qi reversal occurs first and then illness follows, treat the Ben; if cold exposure occurs first and then illness follows, treat the Ben; if illness occurs first and then cold symptoms follow, treat the Ben; if heat occurs first and then illness follows, treat the Ben; if heat occurs first and then Zhongman (chest and abdominal fullness/distension) follows, treat the Biao; if illness occurs first and then diarrhea follows, treat the Ben; if diarrhea occurs first and then other illnesses follow, treat the Ben, but one must first regulate the diarrhea before treating other illnesses; if illness occurs first and then Zhongman follows, treat the Biao; if Zhongman occurs first and then vexation of the heart follows, treat the Ben. The human body has Keqi (External Pathogenic Qi) and Tongqi (Internal Matching Qi). If urination and defecation are obstructed, treat the Biao; if they are unobstructed, treat the Ben. If the disease onset manifests as Excess (Yu), treat the Ben first and then the Biao. If the disease onset manifests as Deficiency (Bu Zu), treat the Biao first and then the Ben. Carefully observe the severity and remission of the condition and adjust accordingly: for mild conditions, treat both Biao and Ben simultaneously; for severe conditions, treat either Biao or Ben exclusively. If obstruction of urination and defecation occurs first and then illness follows, treat the Ben.
Regarding the transmission of diseases: Heart disease begins with chest pain; after one day, it transmits to the Lung causing cough; after three days, it transmits to the Liver causing distending pain in the hypochondrium; after five days, it transmits to the Kidney causing obstruction and blockage, body pain, and heaviness. If the disease persists for three more days without improvement, death ensues, occurring at midnight in winter and at noon in summer. Lung disease begins with wheezing and cough; after three days, it transmits to the Liver causing distending pain in the hypochondrium; after one day, it transmits to the Kidney causing body heaviness and pain; after five days, it transmits to the Spleen causing abdominal distension. If the disease persists for ten more days without improvement, death ensues, occurring at sunset in winter and at sunrise in summer. Liver disease begins with dizziness and blurred vision, and distending fullness in the hypochondrium; after three days, it transmits to the Spleen causing body heaviness and pain; after five days, it transmits to the Kidney causing abdominal distension; after three days, it transmits to the Heart causing lower back, spine, and abdominal pain, and shin soreness. If the disease persists for three more days without improvement, death ensues, occurring at sunset in winter and at breakfast time in summer. Spleen disease begins with body pain and heaviness; after one day, it transmits to the Kidney causing abdominal distension; after two days, it transmits to the Heart causing lower abdominal, lower back, spine, and shin pain; after three days, it transmits to the Liver causing back meridian pain and urinary retention. If the disease persists for ten more days without improvement, death ensues, occurring at Rending (9-11 PM) in winter and at Yan Shi (late morning meal) in summer. Kidney disease begins with lower abdominal and lower back/spine pain; after three days, it transmits to the Liver causing back meridian pain and urinary retention; after three days, it transmits to the Spleen causing abdominal distension; after three days, it transmits to the Heart causing distending pain in both hypochondria. If the disease persists for three more days without improvement, death ensues, occurring at Da Chen (early dawn) in winter and at Yan Bu (late afternoon) in summer. Stomach disease begins with abdominal distension; after five days, it transmits to the Kidney causing lower abdominal and lower back/spine pain; after three days, it transmits to the Liver causing back meridian pain and urinary retention; after five days, it transmits to the Heart causing body heaviness. If the disease persists for six more days without improvement, death ensues, occurring after midnight in winter and at a specific hour in summer. Bladder disease begins with urinary retention; after five days, it transmits to the Kidney causing lower abdominal distension and lower back/spine pain; after one day, it transmits to the Spleen causing abdominal distension; after one day, it transmits to the Heart causing body pain. If the disease persists for two more days without improvement, death ensues, occurring at Ji Ming (3-5 AM) in winter and at Xia Bu (late afternoon) in summer. When various diseases transmit sequentially in this manner, there is a fixed time for death, and acupuncture should not be performed. However, if the transmission skips one Zang organ, or stops after reaching three or four Zang organs, acupuncture may be applied.