四时首春,五行首木,六气首厥阴,厥阴之上,风气主之,故风为百病长。《金匮真言论》云,“天
有八风,经有五风”,人与天地相参,天有此风气,人亦有此风气,人身经脉内虚,则生风,因风
传变,则其病各异,内病五脏,则形状不同,举而论之,故曰风论。
黄帝问曰∶风之伤人也,或为寒热,或为热中,或为寒中,或
为疠风,或为偏枯,或为风也,其疾各异,其名不同,或内至五脏六腑,不如其解,愿闻其说。
因风而有寒热之病,因风而有热中寒中之病,或为疠风,或为偏枯,或为风病之无常,或内至五脏
六腑,同是风也,而病名不同,故以为问。
岐伯对曰∶风气藏于皮肤之间,内不得通,外不得泄。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,其热也则消肌肉,故使人 栗而不能食;名曰寒热。
藏,为字。数,音朔。 ,音突。风之伤人,或为寒热者,乃风气藏于皮肤之间,内不得通于
经脉,外不得泄于毫毛。风者,其性鼓动,善行而数变,风气藏于皮肤,则腠理开,开则洒然寒,腠
理开而复闭,闭则热而闷。其寒也,阳气虚微,则衰食饮。其热也,火气过盛,则消肌肉,邪之所凑,其
正必虚。正气虚,故使人外 栗而内不能食,申明风之伤人,或为寒热者如此。
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。人瘦则外泄而寒,则为寒中而泣出。
风之伤人,或为热中,或为寒中者,乃风气与阳明之经脉而入于胃,循阳明胃脉而上,旁约太阳之
脉,至目内 ,肌肉丰浓,则其人肥,肥则风气不得外泄,不得外泄则为热中,而目色黄,肌肉
消减,则其人瘦,瘦则风气外泄而寒,则为寒中,而泣出。申明风之伤人,或为热中,或为寒中者如此。
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,
卫气有所凝而不行,故其肉有不仁也。疠者,有荣气热 ,其气不清,故使其鼻柱坏而色败,皮肤疡
溃,风寒客于脉而不者,名曰疠风,或名曰寒热。
风之伤人,或为疠风者,乃风气与太阳俱入,行诸太阳之脉俞。脉,经脉也。俞,俞穴也。太阳之气主
通体,今行诸脉俞,而散于通体分肉之间。分肉,分腠之肌肉也。散于分肉,更与周身之
卫气相干,风气行于脉俞,散于分肉,干于卫气,则正气不能通贯,其道不利。其道不利,故使肌肉愤然
胀而有疡。疡,疠疡也。此肌肉有疡,因脉外之卫气,有所凝而不行,故其肌肉疠疡而
亦有不仁也。申明疠者,经脉之气,不和于荣,风气相搏,搏而为热,致有荣气之热,在于 肉之间,
其经脉之气不清,故使面王之鼻柱坏而周身之毛色败,以致皮肤疡 ,而为疠风。由此观之,是
风寒客于太阳三经脉而不者,皮肤疡溃,而名曰疠风也。夫风为阳邪而主热,寒为阴邪而主寒,今风寒客
于脉中,不但名疠风,而或名曰寒热也。此申明风之伤人,或为疠风者如此。
以春甲乙伤于风者,为肝风,以夏丙丁伤于风者,为心风。以
季夏戊己伤于邪者,为脾风。以秋庚辛中于邪者,为肺风。以冬壬
癸中于邪者,为肾风。风中五脏六腑之俞,亦为脏腑之风。
中,去声,下同。风之伤人也,或内至五脏六腑者,五脏合四时,四时合五行,春夏秋冬,四时之
五行也。甲乙丙丁戊己庚辛壬癸,十日之五行也。肝心脾肺肾,五脏之五行也,各以五行之时日
受邪,而五脏之气应之,则为五脏之风。若风中五脏六腑之俞穴,伤其经脉,亦为脏腑之风,既曰伤于风,
复曰伤于邪,以明风者,邪气也。既曰伤于邪,复曰中于邪,以明伤者,中之谓也。此申明
或内至五脏六腑,而为脏腑之风者如此。
各入其门户所中,则为偏风,风气循风府而上,则为脑风,风入系头,则为目风眼寒,饮
酒中风,则为漏风,入房汗出中风,则为内风,新沐中风,则为首风,久风入中,则
为肠风飧泄,外在腠理,则为泄风。
系、旧本讹系,今改,末中为字。风之伤人,或为偏枯者,或上或下,或外或内,各入其门户所中,
则为偏枯之风,为风气循风府而上,则入脑之门户,而为脑风。风入目系而至于头,则入目之门
户,而为目风眼寒。酒气充于络脉,饮酒中风则入络脉之门户,而为漏风。入房汗出,则肾精竭而腠理疏,
复中于风,则入肾脏之门户,而为内风。以水灌顶曰沐,沐则发窍开,新沐中风,则入顶之
门户,而为首风。久风入中,内伤中土,则入肠之门户,而为肠风飧泄。久风外在腠理,则入腠理之门户,
而为隐疹之泄风。此申明风之伤人,或为偏枯之偏风者如此。
故风者,百病之长也。至其变化,乃为他病也,无常方然,致有风气也。
长,上声。承上文而总结之。申明风之为病,其病各异,其名不同也。六气主时,厥阴为首,厥阴
之上,风气主之,故风者百病之长也。风无定体,至其变化,乃为他病也,在气在经,或上或
下,或外或内,无常方然,致有上文诸风气之病也。此申明或为风也,其病各异,其名不同者如此。此一
节,言风之伤人,有经气上下内外之病,承帝问而一一以对也。
帝曰∶五脏风之形状不同者何?愿闻其诊及其病能。
风病五脏,则有五脏之形状病能,何以诊其不同。
岐伯曰∶肺风之状,多汗,恶风,色 然白,时咳短气,昼日则差,暮则甚,诊在眉上,其色白。
恶,去声,下同。骈,音骈。差,瘥同。状,形状也。风性鼓动,开发毛窍,故多汗。正邪不合,故
恶风。不特肺风为然,下文心风肝风脾风肾风胃风皆多汗恶风,血不充于皮毛,故色骈然白。
肺受风邪,故时咳,肺气不足,故短气,昼则阳气盛,故昼日则差,暮则阳气衰,故暮夜则甚,此肺风之
形状病能,其诊视之部,在眉上阙庭之间,其色骈然白者是也。
心风之状,多汗恶风,焦绝,善怒吓,赤色,病甚则言不可快,诊在舌,其色赤。
舌,旧本讹口,今改。心者火也。风动火炎,故唇舌焦而津绝。风者木也。木火相生,故善以怒而吓
人,火气有余,故面色赤,病甚则舌本强,而言不可快,此心风之形状病能,其诊视之部,在
舌,其色赤,而并见于舌也。
肝风之状,多汗恶风,善悲色微苍嗌干,善怒,时憎女子,诊在目下,其色青。
悲,悲泣也,肝开窍于目,故善悲,苍者,肝之色,故色微苍。风木合而火热盛,故嗌于。《
经脉》论云,肝是动病,甚则嗌干,肝主怒,故善怒,善怒则时见憎于女子,此肝风之形状病能,其诊
视之部,在目下之承泣,其色青,即微苍,而见于目下也。
脾风之状,多汗恶风,身体怠惰,四肢不欲动,色薄微黄,不嗜食,诊在鼻上,其色黄。
脾主身体,脾属四肢。风气伤脾,故身体怠惰,四肢不欲动,土主肌肉,脾受风而土虚,故面皮
色薄微黄,脾不消谷,故不嗜食,此脾风之形状病能,其诊视之部,在鼻上之明堂,其色微黄,而见于鼻也。
肾风之状,多汗恶风,面庞然浮肿,脊痛不能正立,其色 。隐曲不利,诊在HT 上,其色黑。
HT ,旧本讹肌,今改。肾者水也,风动水涣,故面庞然浮肿,肾藏精,上贯脊,故脊痛不能正立。 ,
黑也。其色,面如烟尘之黑色也。肾虚不能为隐曲之事,故隐曲不利,此肾风之形状病能。其
诊视之部在HT 上之颧。HT ,两颊肉也。HT 上,颧也。颧,肾所主也。其色黑者,即 色而见于HT 上也。
胃风之状,颈多汗,恶风,食饮不下,膈塞不通,腹善满,失
衣,则 胀,食寒则泄,诊形瘦而腹大。
此举胃风所以该六腑也。颈多汗者,汗出于头而聚于颈,以明五脏之脉,不至于头,故但言多汗恶
风;六腑之脉,皆循颈至头,或从头至颈,故曰颈多汗恶风,胃气不和于上,不能纳谷,故食饮
不下,胃气不和于下,大便不利,故膈塞不通,胃气不和于中,脾胃不相运,故腹善满,外失衣,则胃气
不充于外而 胀,里食寒则胃气不温于内而飧泄,此胃风之形状病能,其诊视之色在形,而诊
视之部在腹,故诊形瘦而腹大,犹言诊其形色则瘦,诊其腹上则大,以明五脏诊色,六腑诊形之义。
首风之状,头面多汗恶风,当先风一日,则病甚,头痛不可以
出内,至其风日则病少愈。
上文新沐中风,则为首风。首风之状,其头面多汗恶风,风入于头,伤其骨空,一日之中,经脉
之气未行于头,谓之当先风一日,正气未至,风邪猖獗,故病甚。病甚者,头痛不可以出户内
也,即此一日之中,经脉之气上行于头,谓之至其风日,正气已至,则痛病少愈。
漏风之状,或多汗,常不可单衣,食则汗出,甚则自汗喘息恶
风,衣常濡,口干善渴,不能劳事。
自汗,旧本讹身汗,今改。上文饮酒中风,则为漏风。漏风之状,酒气外充则身无汗,酒行风动,
或多汗矣。多汗表虚,欲着复衣,故常不可单衣也。食则汗出者,言身若无汗,食入则汗出也,
甚则自汗者,言身或多汗,甚则自汗也。甚,犹多也。饮酒中风,络脉空疏,故喘息恶风,汗出而衣常濡。
濡,濡湿也。津液泄,故口干善渴。气血皆虚,故不能劳事。
泄风之状,多汗,汗出泄衣上。口中干,上渍其风,不能劳事,身体尽痛,则寒。
上文腠理久风,则为泄风。泄风之状,腠理虚,故多汗也。汗出泄衣上,犹言身湿沾衣也。汗出,故
口中干。泄衣上,则身湿。既湿且冷,一如水渍而有风,故曰上渍其风也。腠理久风,气血皆
虚,故不能劳事。血虚,故身体尽痛。气虚,则身寒。凡此承上文各入门户之风。而明其状。
帝曰∶善。
上文各入门户之偏风,有脑风、目风,言首风,而脑风、目风在其中。有内风、肠风,内风属脏,
肠风属胃,故不复言。帝默会其意而善之。此一节,因五脏而并论各入门户之风,形状不同,病能各异也。
四季之中,春季为首;五行之中,木行为首;六气之中,厥阴气为首。厥阴之上,由风气所主,所以风是百病之首。《金匮真言论》说:“天有八风,经有五风。”人与天地相应,天有此风气,人也有此风气。如果人身经脉内部虚弱,就会产生内风,因风邪传变,疾病就各不相同。如果内伤五脏,症状表现也就不同。这里列举风邪进行论述,所以称为“风论”。
黄帝问道:风邪伤人,有的表现为寒热症,有的表现为热中证,有的表现为寒中证,有的表现为疠风(麻风),有的表现为偏枯(半身不遂),有的表现为各种无常的风病。这些疾病虽然不同,名称也不同,有的甚至深入五脏六腑,我不明白其中的道理,希望听听您的解释。
因为风邪而有寒热病症,因为风邪而有热中、寒中病症,或者成为疠风,或者成为偏枯,或者成为变化无常的风病,或者内传至五脏六腑。同样是风邪致病,但病名不同,所以提出这个问题。
岐伯回答说:风邪潜伏在皮肤之间,向内不能通达经脉,向外不能发泄于体表。风性善于游走且变化多端,腠理(汗孔)开放时,人会感到洒然寒冷;腠理闭合时,则会发热且胸闷。这种寒冷会导致食欲减退,这种发热会消耗肌肉,因此使人战栗而不能进食;这叫做寒热症。
“藏”字意为潜伏。“数”读作“朔”,意为频繁。“栗”读作“突”,意为战栗。风邪伤人,有的表现为寒热症,是因为风邪潜伏在皮肤之间,向内不能通达经脉,向外不能发泄于毫毛。风的性质具有鼓动作用,善于游走且变化多端。风邪潜伏在皮肤,导致腠理开放,开放则感到寒冷;腠理开后又闭合,闭合则发热且胸闷。出现寒冷症状,是因为阳气虚微,导致饮食减少;出现发热症状,是因为火气过盛,导致肌肉消瘦。邪气聚集的地方,正气必然虚弱。正气虚弱,所以使人外见战栗而内不能进食。这就说明了风邪伤人,有的表现为寒热症的道理。
风邪与阳明胃经之气一起进入胃中,沿着经脉向上运行,到达目内眦(眼角)。如果这个人形体肥胖,风邪就不能向外发泄,就会形成热中证,并且眼睛发黄。如果这个人形体消瘦,风邪就会向外发泄并伴有寒象,就会形成寒中证,并且流泪。
风邪伤人,有的表现为热中证,有的表现为寒中证,是因为风邪伴随阳明经脉进入胃中,沿着阳明胃脉向上,旁约太阳经脉,到达目内眦。如果肌肉丰厚,人就肥胖,肥胖则风邪不得外泄,不得外泄则形成热中证,眼色发黄;如果肌肉消减,人就消瘦,消瘦则风邪外泄而现寒象,形成寒中证,并且流泪。这就说明了风邪伤人,有的表现为热中或寒中的道理。
风邪与太阳经之气一起进入人体,行走在各经脉的俞穴,散布在分肉(肌肉间隙)之间,与卫气相干扰,导致运行通道不畅,所以使肌肉肿胀并形成疡疮。卫气有所凝滞而不能运行,所以肌肉会出现麻木不仁。疠风,是由于营气有热,其气不清净,所以导致鼻梁塌陷、面色败坏、皮肤溃疡。风寒客居于脉中而不散者,名叫疠风,也有的名叫寒热。
风邪伤人,有的表现为疠风,是因为风邪与太阳经一起进入,行走在各太阳经脉的俞穴。脉,指经脉。俞,指俞穴。太阳之气主管全身,现在行走在各经脉俞穴,散布在全身的分肉之间。分肉,指分腠之间的肌肉。散布在分肉间,又与全身的卫气相干扰。风气行于脉俞,散布在分肉,干扰卫气,导致正气不能贯通,运行通道不畅。通道不畅,所以使肌肉肿胀而形成疡疮。疡,指疠疡。这是因为脉外的卫气凝滞不行,所以肌肉发生疠疡并且出现麻木不仁。这就说明了疠风的成因:经脉之气与营气不和,风气与之搏结,搏结化为热,导致营气有热,存在于肌肉之间,经脉之气不清净,所以导致面部鼻柱塌陷、周身毛发色泽败坏,以致皮肤溃疡,成为疠风。由此可见,这是风寒客居太阳三经脉而不散,导致皮肤溃疡,名叫疠风。风为阳邪主热,寒为阴邪主寒,如今风寒客居脉中,不仅名叫疠风,有时也名叫寒热。这就说明了风邪伤人,有的表现为疠风的道理。
如果在春季甲乙日受风邪,就成为肝风;在夏季丙丁日受风邪,就成为心风;在长夏戊己日受邪气,就成为脾风;在秋季庚辛日受邪气,就成为肺风;在冬季壬癸日受邪气,就成为肾风。风邪侵入五脏六腑的俞穴,也会成为脏腑之风。
“中”读去声,以下同。风邪伤人,有的内传至五脏六腑,是因为五脏对应四时,四时对应五行。春夏秋冬是四时的五行。甲乙丙丁戊己庚辛壬癸是十日的五行。肝心脾肺肾是五脏的五行。各自在对应的五行时日受邪,五脏之气与之相应,就形成五脏之风。如果风邪侵入五脏六腑的俞穴,损伤经脉,也成为脏腑之风。前面说“伤于风”,后面又说“伤于邪”,是为了说明风就是邪气。前面说“伤于邪”,后面又说“中于邪”,是为了说明“伤”就是“中”的意思。这就说明了风邪内传至五脏六腑,成为脏腑之风的道理。
风邪各入其门户而中伤,就成为偏风。风邪顺着风府穴向上,就成为脑风。风邪侵入头部系络,就成为目风眼寒。饮酒后中风,就成为漏风。房事后出汗再中风,就成为内风。刚洗头后中风,就成为首风。久风入里,就成为肠风和飧泄(完谷不化的腹泻)。风邪外在腠理,就成为泄风。
“系”字,旧本误作“系”,今改正。“末”字为衍文。风邪伤人,有的表现为偏枯,或上或下,或外或内,各入其门户而中伤,就成为偏枯之风。风邪顺着风府穴向上,就进入头脑的门户,成为脑风。风邪侵入目系至于头,就进入眼的门户,成为目风眼寒。酒气充满络脉,饮酒后中风,就进入络脉的门户,成为漏风。房事后出汗,肾精枯竭且腠理疏松,再受风邪,就进入肾脏的门户,成为内风。用水浇头顶叫沐,沐则发窍打开,刚洗头后中风,就进入头顶的门户,成为首风。久风入里,内伤脾胃(中土),就进入肠道的门户,成为肠风飧泄。久风外在腠理,就进入腠理的门户,成为隐疹类的泄风。这就说明了风邪伤人,有的表现为偏枯及偏风的道理。
所以说,风是百病之长。到了它变化莫测的时候,就变成其他疾病了,没有固定的规律,但都是由风气引起的。
“长”读上声。承接上文总结。说明风邪致病,病情各异,名称不同。六气主时,厥阴为首,厥阴之上,风气主之,所以风是百病之长。风没有固定形态,它的变化导致其他疾病,或在气或在经,或上或下,或外或内,没有固定规律,从而导致了上文所说的各种风病。这就说明了风邪致病,病情各异,名称不同的道理。这一节,讲述风邪伤人,有经气上下内外不同的病症,承接黄帝的提问一一回答。
黄帝说:五脏受风邪后的形状表现为什么不同?希望听听如何诊断以及它们的病理特征。
风病涉及五脏,就有五脏不同的形状和病理特征,如何诊断它们的不同呢?
岐伯说:肺风的症状,是多汗,怕风,面色白而苍白无华,时常咳嗽、气短,白天症状减轻,傍晚加重,诊察部位在眉上,颜色发白。
“恶”读去声,以下同。“骈”读骈音。“差”同“瘥”,意为好转。风性鼓动,开发毛窍,所以多汗。正邪不合,所以怕风。不仅是肺风如此,下文的心风、肝风、脾风、肾风也都多汗怕风。血不充盈皮毛,所以面色苍白无华。肺受风邪,所以时常咳嗽;肺气不足,所以气短。白天阳气盛,所以白天症状减轻;傍晚阳气衰,所以夜晚症状加重。这就是肺风的形状和病理特征,其诊察部位在眉上阙庭之间,面色苍白无华的就是肺风。
心风的症状,是多汗,怕风,唇舌焦干枯绝,容易发怒吓人,面色红赤,病情严重时说话不流利,诊察部位在舌,颜色红赤。
“舌”字,旧本误作“口”,今改正。心属火。风动火炎,所以唇舌焦干枯绝。风属木。木火相生,所以容易发怒吓唬人。火气有余,所以面色红赤。病情严重时舌根僵硬,说话不流利。这就是心风的形状和病理特征,其诊察部位在舌,颜色红赤,并体现在舌头上。
肝风的症状,是多汗,怕风,容易悲伤,面色微青,咽喉干燥,容易发怒,时常厌恶女子,诊察部位在目下,颜色发青。
“悲”指悲泣。肝开窍于目,所以容易悲伤。“苍”是肝的颜色,所以面色微青。风木合化火热旺盛,所以咽喉干燥。《经脉》篇说,肝经病变严重时,会咽喉干燥。肝主怒,所以容易发怒。容易发怒,所以时常厌恶女子。这就是肝风的形状和病理特征,其诊察部位在目下的承泣穴,颜色发青,即微青色,体现在目下。
脾风的症状,是多汗,怕风,身体怠惰,四肢不想活动,面色淡黄,食欲不振,诊察部位在鼻上,颜色发黄。
脾主身体,脾属四肢。风邪伤脾,所以身体怠惰,四肢不想活动。土主肌肉,脾受风邪而土虚,所以面皮颜色淡黄。脾不消化谷物,所以食欲不振。这就是脾风的形状和病理特征,其诊察部位在鼻上的明堂,颜色微黄,体现在鼻部。
肾风的症状,是多汗,怕风,面部浮肿,脊痛不能直立,面色黑如烟尘,小便不利,诊察部位在颧骨上,颜色发黑。
“HT”指脸颊肉,旧本误作“肌”,今改正。肾属水。风动水涣,所以面部浮肿。肾藏精,上贯脊柱,所以脊痛不能直立。“ ”指黑色。其色黑,指面色如烟尘般的黑色。肾虚不能完成隐蔽之事(指性生活或排尿等),所以小便不利。这就是肾风的形状和病理特征。其诊察部位在脸颊肉上的颧骨。颧骨,由肾所主。其色黑,即黑色体现在颧骨上。
胃风的症状,颈部多汗,怕风,饮食不下,胸膈堵塞不通,腹部常感胀满,衣服穿少了就腹胀,吃冷的食物就腹泻,诊察时形体消瘦但腹部膨大。
这里举胃风来概括六腑的情况。颈部多汗,是因为汗出于头而聚于颈,以说明五脏的经脉不到达头部,所以只说多汗怕风;六腑的经脉,都循行颈部至头,或从头至颈,所以说颈部多汗怕风。胃气不和于上,不能纳谷,所以饮食不下;胃气不和于下,大便不利,所以胸膈堵塞不通;胃气不和于中,脾胃运化不相协调,所以腹部常感胀满。外失衣保暖,胃气不能充实于外而腹胀;内食寒凉,胃气不能温煦于内而腹泻。这就是胃风的形状和病理特征,其诊察之色在形体,诊察之部在腹部,所以诊察时形体消瘦而腹部膨大,意思是诊察其形色则瘦,诊察其腹部则大,以说明五脏诊色、六腑诊形的意义。
首风的症状,头面多汗,怕风,在刮风前一天病情加重,头痛得不能出门或进屋,到了刮风那天病情稍好。
上文提到新洗头后中风,就成为首风。首风的症状,头面多汗怕风。风邪侵入头部,损伤骨空。一天之中,经脉之气未运行到头部,称为“当先风一日”。此时正气未到,风邪猖獗,所以病情加重。病情加重时,头痛得不能出户进屋。在这一天之中,经脉之气上行至头部,称为“至其风日”。此时正气已至,所以头痛等症状稍好。
漏风的症状,或多汗,常常不能穿单衣,吃饭时就出汗,严重时自汗、喘息、怕风,衣服经常湿透,口干善渴,不能从事劳累的工作。
“自汗”,旧本误作“身汗”,今改正。上文提到饮酒后中风,就成为漏风。漏风的症状,酒气外充时身上无汗,酒行风动后,就多汗了。多汗导致表虚,想穿厚衣,所以常常不能穿单衣。吃饭就出汗,是说身上若无汗,进食后就出汗。严重时自汗,是说身上或多汗,严重时变为自汗。“甚”意为多。饮酒中风,络脉空虚疏松,所以喘息怕风,出汗导致衣服经常湿透。“濡”意为濡湿。津液流失,所以口干善渴。气血皆虚,所以不能从事劳累工作。
泄风的症状,多汗,汗水流出浸湿衣服。口中干燥,风邪上渍,不能从事劳累工作,身体全部疼痛,并且怕冷。
上文提到腠理久风,就成为泄风。泄风的症状,腠理虚弱,所以多汗。汗水流出浸湿衣服,就是说身体湿沾衣服。出汗,所以口中干燥。汗水浸湿衣服,身体就湿冷。既湿且冷,就像被水浸泡又有风邪侵袭,所以叫“上渍其风”。腠理久受风邪,气血皆虚,所以不能从事劳累工作。血虚,所以身体全部疼痛。气虚,所以身体怕冷。以上承接上文各入门户的风,来说明它们的症状。
黄帝说:讲得好。
上文提到的各入门户的偏风,有脑风、目风,说到首风,脑风、目风就在其中。有内风、肠风,内风属于脏,肠风属于胃,所以不再重复提及。黄帝默会其意而称赞他说得好。这一节,因五脏而一并论述各入门户的风,形状不同,病理特征各异。
In the four seasons, spring is primary; among the Five Phases (Wu Xing), Wood is primary; among the Six Qi (Liu Qi), Jue Yin is primary. Above Jue Yin, Wind Qi governs, therefore Wind is the chief of a hundred diseases. The *Jin Gui Zhen Yan Lun* states: "Heaven has eight winds, and the meridians have five winds." Humans correspond with Heaven and Earth; as Heaven possesses this Wind Qi, humans also possess it. If the meridians within the human body are internally deficient, internal wind is generated. Due to the transmission and variation of Wind, the diseases differ. If the interior organs (Zang-Fu) are affected internally, the manifestations vary. Here, Wind is discussed comprehensively, hence it is called "Treatise on Wind" (Feng Lun).
The Yellow Emperor asked: When Wind pathogen injures the human body, some manifest as Chills and Fever (Han Re), some as Heat in the Middle (Re Zhong), some as Cold in the Middle (Han Zhong), some as Leprosy (Li Feng), some as Hemiplegia (Pian Ku), and some as unpredictable Wind diseases. Although these diseases are different and have different names, some even penetrate deeply into the Zang-Fu organs. I do not understand the rationale behind this and wish to hear your explanation.
Because of Wind, there are Chills and Fever diseases; because of Wind, there are Heat in the Middle and Cold in the Middle diseases; or it becomes Leprosy, or Hemiplegia, or an unpredictable Wind disease, or penetrates internally to the Zang-Fu. It is all Wind pathogen causing disease, yet the names differ. Hence, this question is raised.
Qibo replied: Wind pathogen lodges between the skin and flesh, unable to communicate inwardly with the meridians, nor be excreted outwardly through the hair follicles. Wind is agile in its movement and prone to frequent changes. When the interstices (Cou Li, pores) open, one feels chilly; when they close, one feels feverish and stifled. The coldness leads to a decline in appetite; the heat consumes muscle tissue, thus causing shivering and inability to eat; this is named Chills and Fever (Han Re).
"Lodge" means to hide. "Shuo" refers to frequency. "Tu" refers to shivering. Wind injuring the body, manifesting as Chills and Fever, occurs because Wind lodges between the skin, unable to connect inwardly with meridians or excrete outwardly via hair follicles. Wind's nature is stirring, agile in movement, and prone to change. Wind lodging in the skin causes the interstices to open; opening leads to chills. When the interstices open and then close, closing leads to fever and stifling. The coldness indicates deficiency and weakness of Yang Qi, leading to reduced food intake. The heat indicates excessive Fire Qi, leading to muscle wasting. Where pathogens gather, Zheng Qi (Upright Qi) must be deficient. Due to Zheng Qi deficiency, one exhibits external shivering and internal inability to eat. This explains why Wind injuring the body may manifest as Chills and Fever.
Wind pathogen enters the Stomach along with the Yangming Meridian Qi, travels upward along the meridian, reaching the inner canthus of the eye. If the person is obese, Wind cannot be excreted outwardly, resulting in Heat in the Middle (Re Zhong) and yellow eyes. If the person is thin, Wind is excreted outwardly accompanied by cold, resulting in Cold in the Middle (Han Zhong) and tearing.
Wind injuring the body, manifesting as Heat in the Middle or Cold in the Middle, occurs because Wind enters the Stomach with the Yangming Meridian, traveling upward along the Yangming Stomach Meridian, bordering the Taiyang Meridian, reaching the inner canthus. If muscles are thick, the person is obese; obesity prevents Wind from excreting outwardly, leading to Heat in the Middle and yellow eye color. If muscles waste away, the person is thin; thinness allows Wind to excrete outwardly with cold, leading to Cold in the Middle and tearing. This explains why Wind injuring the body may manifest as Heat in the Middle or Cold in the Middle.
Wind pathogen enters together with the Taiyang Meridian Qi, traverses the Shu points of various meridians, and disperses between the muscle layers (Fen Rou), interfering with Wei Qi (Defensive Qi). The pathway becomes obstructed, causing muscle swelling and sores. Wei Qi stagnates and fails to circulate, resulting in numbness of the flesh. Leprosy (Li Feng) involves hot Ying Qi (Nutritive Qi) and turbid Qi, causing collapse of the nasal bridge, deterioration of complexion, and ulceration of the skin. When Cold and Wind lodge in the meridians and fail to disperse, it is named Leprosy (Li Feng), or sometimes Chills and Fever.
Wind injuring the body, manifesting as Leprosy, occurs because Wind enters with the Taiyang Meridian, traversing the Shu points of the Taiyang meridians. "Meridian" refers to the main channels. "Shu point" refers to the transport points. Taiyang Qi governs the whole body. Now traversing the Shu points and dispersing in the Fen Rou of the entire body. Fen Rou refers to the muscles between the interstices. Dispersing in the Fen Rou, it interferes with the body-wide Wei Qi. Wind moving through the meridian Shu points, dispersing in the Fen Rou, and interfering with Wei Qi prevents Zheng Qi from flowing smoothly, obstructing the pathway. Obstruction causes muscle swelling and sores. "Sore" refers to leprous sores. This muscle soreness arises because Wei Qi outside the meridines stagnates and fails to move, causing leprous sores and numbness. This explains Leprosy: the Qi of the meridians does not harmonize with Ying Qi; Wind combats it, generating heat, causing heat in Ying Qi within the muscle layers. The meridian Qi becomes turbid, leading to collapse of the nasal bridge and deterioration of hair color, resulting in skin ulcers, becoming Leprosy. Thus, Cold and Wind lodging in the Taiyang three-meridian system without dispersing cause skin ulcers, named Leprosy. Wind is a Yang pathogen governing heat; Cold is a Yin pathogen governing cold. Now that Cold and Wind lodge in the meridians, it is not only named Leprosy but also sometimes Chills and Fever. This explains why Wind injuring the body may manifest as Leprosy.
If injured by Wind on Jia/Yi days in Spring, it becomes Liver Wind (Gan Feng); if injured on Bing/Ding days in Summer, it becomes Heart Wind (Xin Feng); if injured by evil on Wu/Ji days in Late Summer, it becomes Spleen Wind (Pi Feng); if injured by evil on Geng/Xin days in Autumn, it becomes Lung Wind (Fei Feng); if injured by evil on Ren/Gui days in Winter, it becomes Kidney Wind (Shen Feng). If Wind invades the Shu points of the Zang-Fu organs, it also becomes Zang-Fu Wind.
"Zhong" is pronounced with the falling tone, same below. Wind injuring the body, penetrating internally to the Zang-Fu, occurs because the Five Zang correspond to the Four Seasons, which correspond to the Five Phases. Spring, Summer, Late Summer, Autumn, and Winter are the Five Phases of the four seasons. Jia, Yi, Bing, Ding, Wu, Ji, Geng, Xin, Ren, Gui are the Five Phases of the ten Heavenly Stems. Liver, Heart, Spleen, Lung, Kidney are the Five Phases of the Five Zang. Each receives evil in its corresponding time and day, and the Qi of the Five Zang responds, forming Wind of the Five Zang. If Wind invades the Shu points of the Zang-Fu, damaging the meridians, it also becomes Zang-Fu Wind. Previously saying "injured by Wind," now saying "injured by evil," clarifies that Wind is an evil pathogen. Previously saying "injured by evil," now saying "struck by evil," clarifies that "injury" implies being struck. This explains how Wind penetrates internally to the Zang-Fu, becoming Zang-Fu Wind.
Wind entering each door where it strikes becomes Biased Wind (Pian Feng). If Wind follows the Fengfu GV16 acupoint upward, it becomes Brain Wind (Nao Feng). If Wind enters the head connections, it becomes Eye Wind (Mu Feng) with cold eyes. If Wind strikes after drinking alcohol, it becomes Leaking Wind (Lou Feng). If Wind strikes after sweating from sexual intercourse, it becomes Internal Wind (Nei Feng). If Wind strikes after newly washing hair, it becomes Head Wind (Shou Feng). If long-standing Wind enters the interior, it becomes Intestinal Wind (Chang Feng) with undigested stool diarrhea (Sun Xie). If Wind remains externally in the interstices, it becomes Draining Wind (Xie Feng).
"Xi" was erroneously printed as "xi" in old editions, corrected here. "Mo" is a superfluous character. Wind injuring the body, manifesting as hemiplegia, whether up or down, out or in, enters each door where it strikes, becoming Biased Hemiplegia Wind. Wind following the Fengfu GV16 acupoint upward enters the door of the brain, becoming Brain Wind. Wind entering the eye connections to the head enters the door of the eye, becoming Eye Wind with cold eyes. Alcohol qi fills the collaterals; striking Wind after drinking enters the door of the collaterals, becoming Leaking Wind. After intercourse, sweat ensues, kidney essence is depleted, and interstices are loose; striking Wind again enters the door of the Kidney, becoming Internal Wind. Pouring water on the head is called "washing hair"; washing opens the hair pores. Striking Wind after newly washing hair enters the door of the vertex, becoming Head Wind. Long-standing Wind entering the interior damages the Central Earth (Spleen/Stomach), entering the door of the intestines, becoming Intestinal Wind with undigested stool diarrhea. Long-standing Wind remaining externally in the interstices enters the door of the interstices, becoming Draining Wind characterized by hidden rashes. This explains why Wind injuring the body may manifest as Biased Hemiplegia and Biased Wind.
Therefore, Wind is the chief of a hundred diseases. When it changes, it becomes other diseases, without fixed patterns, yet caused by Wind Qi.
"Zhang" is pronounced with the rising tone. Concluding the above text. It clarifies that Wind diseases vary in condition and name. The Six Qi govern the times, with Jue Yin as primary; above Jue Yin, Wind Qi governs, so Wind is the chief of a hundred diseases. Wind has no fixed form; its changes lead to other diseases, affecting Qi or meridians, up or down, out or in, without fixed patterns, causing the various Wind diseases mentioned above. This explains why Wind diseases vary in condition and name. This section discusses Wind injuring the body, presenting diseases of the meridian Qi in terms of up/down and out/in, answering the Emperor's questions one by one.
The Yellow Emperor said: Why do the shapes of Wind affecting the Five Zang differ? I wish to hear about their diagnosis and pathological characteristics.
Wind diseases involving the Five Zang have different shapes and pathological characteristics for each Zang. How can we diagnose their differences?
Qibo said: The signs of Lung Wind include profuse sweating, aversion to wind, pale white complexion, intermittent cough, shortness of breath, improvement during the day, and worsening at night. Diagnosis is observed above the eyebrows, showing a white color.
"E" is pronounced with the falling tone, same below. "Pian" sounds like "pian". "Cha" is the same as "Cai", meaning recovery. Wind's nature is stirring and opens the hair follicles, causing profuse sweating. Conflict between righteous and evil causes aversion to wind. Not only Lung Wind, but Heart, Liver, Spleen, and Kidney Winds also exhibit profuse sweating and aversion to wind. Blood failing to nourish the skin and hair results in a pale white complexion. Lung receiving Wind pathogen causes intermittent cough; Lung Qi deficiency causes shortness of breath. Yang Qi is abundant during the day, so symptoms improve; Yang Qi declines at night, so symptoms worsen. These are the signs and pathological characteristics of Lung Wind. The diagnostic area is above the eyebrows between the glabella and forehead, where the complexion is pale white.
The signs of Heart Wind include profuse sweating, aversion to wind, dryness and depletion of lips and tongue, irritability and frightening anger, red complexion. In severe cases, speech is sluggish. Diagnosis is observed on the tongue, showing a red color.
"Tongue" was erroneously printed as "mouth" in old editions, corrected here. Heart belongs to Fire. Wind stirring and Fire flaming cause dryness and depletion of lips and tongue. Wind belongs to Wood. Wood and Fire generate each other, causing irritability and frightening anger. Excess Fire Qi causes a red facial complexion. In severe cases, the root of the tongue stiffens, causing sluggish speech. These are the signs and pathological characteristics of Heart Wind. The diagnostic area is the tongue, where the red color appears.
The signs of Liver Wind include profuse sweating, aversion to wind, propensity to sadness, slightly bluish complexion, dry throat, irritability, and occasional aversion to women. Diagnosis is observed below the eyes, showing a green color.
"Bei" refers to weeping. The Liver opens into the eyes, hence propensity to sadness. "Cang" is the color of the Liver, hence the slightly bluish complexion. Wind-Wood combining with flourishing Fire-Heat causes dry throat. The *Jing Mai* Treatise states that Liver meridian disorders severely manifest as dry throat. The Liver governs anger, hence irritability. Irritability leads to occasional aversion to women. These are the signs and pathological characteristics of Liver Wind. The diagnostic area is Chengqi ST1 below the eyes, where the green color, i.e., bluish hue, appears.
The signs of Spleen Wind include profuse sweating, aversion to wind, bodily lethargy, reluctance to move the limbs, pale yellow complexion, and lack of appetite. Diagnosis is observed on the nose, showing a yellow color.
The Spleen governs the body and belongs to the limbs. Wind injuring the Spleen causes bodily lethargy and reluctance to move the limbs. Earth governs muscles; Spleen receiving Wind causes Earth deficiency, resulting in a pale yellow facial complexion. The Spleen fails to digest grain, causing lack of appetite. These are the signs and pathological characteristics of Spleen Wind. The diagnostic area is Mingtang on the nose, where the slightly yellow color appears.
The signs of Kidney Wind include profuse sweating, aversion to wind, puffy facial edema, back pain preventing upright standing, and a dark complexion resembling smoke. There is difficulty with urination and defecation. Diagnosis is observed on the zygomatic bone, showing a black color.
"Cheek flesh" was erroneously printed as "muscle" in old editions, corrected here. Kidney belongs to Water. Wind stirring causes Water dispersion, leading to puffy facial edema. The Kidney stores Essence and connects to the spine, causing back pain preventing upright standing. "Hei" means black. The dark complexion resembles smoke. Kidney deficiency prevents proper function of concealed activities (urination/defecation), causing difficulty. These are the signs and pathological characteristics of Kidney Wind. The diagnostic area is the zygomatic bone on the cheek flesh. The zygomatic bone is governed by the Kidney. The black color appears on the zygomatic bone.
The signs of Stomach Wind include profuse sweating on the neck, aversion to wind, inability to swallow food and drink, chest diaphragm obstruction, abdominal fullness, abdominal distension when clothes are insufficient, and diarrhea when eating cold food. Diagnosis shows emaciated body but enlarged abdomen.
This example of Stomach Wind covers the Six Fu organs. Profuse sweating on the neck occurs because sweat originates from the head and gathers at the neck, illustrating that Zang meridians do not reach the head, hence only mentioning profuse sweating and aversion to wind; Fu organ meridians all traverse the neck to the head or vice versa, hence mentioning neck sweating and aversion to wind. Stomach Qi disharmony above prevents grain acceptance, causing inability to swallow; Stomach Qi disharmony below causes constipation, leading to chest diaphragm obstruction; Stomach Qi disharmony in the middle causes Spleen-Stomach transport failure, leading to abdominal fullness. External loss of clothing warmth causes Stomach Qi to fail to fill the exterior, leading to distension; internal consumption of cold food causes Stomach Qi to fail to warm the interior, leading to undigested stool diarrhea. These are the signs and pathological characteristics of Stomach Wind. Diagnostic color relates to the form, and diagnostic area relates to the abdomen. Thus, diagnosis shows emaciation in form but enlargement in the abdomen, meaning diagnosing form/color reveals emaciation, while diagnosing the abdomen reveals enlargement, illustrating the principle of diagnosing colors for Zang and forms for Fu.
The signs of Head Wind include profuse sweating on the head and face, aversion to wind. Symptoms worsen one day before the wind blows; headache is severe enough to prevent going out or coming in. Symptoms improve slightly on the day the wind blows.
Previously, striking Wind after newly washing hair becomes Head Wind. Signs of Head Wind include profuse sweating on the head and face, aversion to wind. Wind invading the head damages the bone cavities. Within a day, before meridian Qi reaches the head, it is called "one day before the wind." At this time, Zheng Qi has not arrived, and Wind pathogen is rampant, so symptoms worsen. Severe symptoms mean headache preventing exiting or entering. Within this day, as meridian Qi ascends to the head, it is called "the day of the wind." At this time, Zheng Qi has arrived, so headache improves slightly.
The signs of Leaking Wind include profuse sweating, often inability to wear single garments, sweating upon eating. In severe cases, spontaneous sweating, panting, aversion to wind, constantly wet clothes, dry mouth, thirst, and inability to perform labor.
"Spontaneous sweating" was erroneously printed as "body sweating" in old editions, corrected here. Previously, striking Wind after drinking alcohol becomes Leaking Wind. Signs of Leaking Wind: when alcohol qi fills the exterior, there is no sweat; as alcohol moves and Wind stirs, profuse sweating occurs. Profuse sweating indicates exterior deficiency, desire for layered clothing, hence inability to wear single garments. Sweating upon eating means if there is no sweat normally, sweating occurs after eating. Severe spontaneous sweating means normal profuse sweating worsens to spontaneous sweating. "Severe" implies abundance. Striking Wind after drinking empties the collaterals, causing panting and aversion to wind, with constantly wet clothes due to sweating. "Ru" means dampness. Loss of body fluids causes dry mouth and thirst. Deficiency of both Qi and Blood causes inability to perform labor.
The signs of Draining Wind include profuse sweating, with sweat leaking onto clothes. Dry mouth, Wind infiltrating upwards, inability to perform labor, whole-body pain, and aversion to cold.
Previously, long-standing Wind in the interstices becomes Draining Wind. Signs of Draining Wind: interstitial deficiency causes profuse sweating. Sweat leaking onto clothes means body wetness staining clothes. Sweating causes dry mouth. Wet clothes mean body dampness. Dampness and cold resemble water immersion with Wind, hence "Wind infiltrating upwards." Long-standing Wind in interstices causes Qi and Blood deficiency, leading to inability to perform labor. Blood deficiency causes whole-body pain. Qi deficiency causes body cold. This concludes the discussion of Wind entering various doors and clarifies their signs.
The Yellow Emperor said: Excellent.
The previously mentioned Biased Winds entering various doors include Brain Wind and Eye Wind; mentioning Head Wind includes them. Internal Wind and Intestinal Wind are mentioned; Internal Wind belongs to Zang, Intestinal Wind belongs to Stomach, so they are not repeated. The Yellow Emperor silently understood the meaning and praised it. This section discusses the Winds entering various doors alongside the Five Zang, noting their different shapes and varying pathological characteristics.