\r天地六位脏象图\ps6a1.bmp\r
注云∶肝、心、脾、肺、肾,皆属阴,五脏也。胆、胃、三焦、膀胱、大肠、小
肠,皆属阳,六腑也。分而言之,手足皆有三阴三阳是也。
肺寅燥金手太阴,大肠卯燥金手阳明;心午君心手少阴,小肠未君火手太
〔阳〕;包络戌相火手厥阴,三焦〔亥〕相火手少阳。
胃辰湿土足阳明,脾巳湿土足太阴;膀胱申寒水足太阳,肾酉寒
水足少阴;胆子风木足少阳,肝丑风木足厥阴。
歌曰
手经太阳属小肠,膀胱经属足太阳;
肝足厥阴手包络,胃足阳明手〔大肠〕;
胆属少阳足经寻,三焦手内少阳临;
脾足太阴手经肺,肾足少阴手是心。
夫人有五脏六腑,虚实寒热,生死逆顺,皆见形证脉气,若非诊(切),无由识
也。虚则补之,实则泻之,寒则温之,热则凉之,不虚不实,以经调之,此乃良医之大法也。
经曰∶肝与胆为表里,足厥阴(少〔阳〕)也。其经旺于春,乃万物之始生也。其
气软而弱,软则不可汗,弱则不可下。其脉弦长曰平,反此曰病。脉实而弦,此为
太过,病在外,令人忘忽眩运;虚而微,则为不及,病在内,令人胸胁胀满。凡肝
〔实〕则两胁下引痛,喜怒,虚〔则〕如人将捕之。其气逆则头痛、耳聋、颊赤,其脉沉而急,浮之
亦然,主胁〔支〕满,小便难,头痛眼眩。脉急〔甚〕主恶言,微急气在〔胸胁下〕。缓甚则呕逆,
微缓水痹。大甚内痈吐血,微大筋痹。〔小甚多饮〕,微小痹。滑甚 疝,微滑遗尿。涩甚流饮,
微涩 挛。肝之积气在左胁
下,久而不去,发为咳逆,或为〔 〕疟也。虚梦花草茸茸,实梦山林茂盛。肝病旦
〔慧、晚〕甚、夜静。肝病头痛目眩,胁满囊缩,小便不通,十日死。又身〔热〕
恶寒,四肢不举,其脉当弦而急;反短涩者,乃金克木也,死不治。又肝中寒,则
两臂不举,舌燥,多太息,胸中痛,不能转侧,其脉左关上迟而涩者是也。肝中热,
则喘满多嗔,目痛,腹胀不嗜食,所作不定,梦中惊悸,眼赤,视物不明,〔其〕
脉左关阳实者是也。肝虚冷,则胁下坚痛,目〔盲〕臂痛,发寒〔热〕如疟状,不
欲食,妇人则月水不来,气急,其脉左关上沉而弱者是也。此寒热虚实,生
死逆顺之法也。
《主治备要》云∶是动则病腰痛,甚则不可俯仰,丈夫〔 〕疝,妇人小腹肿,甚
则嗌干,面尘脱色,主肝所生病者,胸中呕逆,飧泄狐疝,遗溺闭癃病。肝苦急,急食
甘以缓之,甘草。肝欲散者,急食辛以散之,川芎。补以细辛之辛,泻以白芍药之
酸。肝虚,以陈皮、生姜之类补之。经曰∶虚则补其母。水能生〔木〕,水乃
肝之母也。苦以补肾,熟地黄、黄柏是也。如无他证,惟不足,钱氏地黄丸补之。实则
芍药泻之,如无他证,钱氏泻青丸主之,实则泻其子,心乃肝之子,以甘草泻之。
[Diagram of the Six Positions of Heaven and Earth and Visceral Manifestations]
The annotation states: The Liver, Heart, Spleen, Lung, and Kidney all belong to Yin and are the Five Zang Organs. The Gallbladder, Stomach, Sanjiao (Triple Burner), Bladder, Large Intestine, and Small Intestine all belong to Yang and are the Six Fu Organs. Speaking separately, both the Hand meridians and Foot meridians have three Yin and three Yang.
The Lung corresponds to the Yin hour, belongs to Dry Metal, and is the Hand Taiyin Meridian; the Large Intestine corresponds to the Mao hour, belongs to Dry Metal, and is the Hand Yangming Meridian; the Heart corresponds to the Wu hour, belongs to Sovereign Fire (Heart Fire), and is the Hand Shaoyin Meridian; the Small Intestine corresponds to the Wei hour, belongs to Sovereign Fire, and is the Hand Taiyang Meridian; the Pericardium corresponds to the Xu hour, belongs to Ministerial Fire, and is the Hand Jueyin Meridian; the Sanjiao corresponds to the Hai hour, belongs to Ministerial Fire, and is the Hand Shaoyang Meridian.
The Stomach corresponds to the Chen hour, belongs to Damp Earth, and is the Foot Yangming Meridian; the Spleen corresponds to the Si hour, belongs to Damp Earth, and is the Foot Taiyin Meridian; the Bladder corresponds to the Shen hour, belongs to Cold Water, and is the Foot Taiyang Meridian; the Kidney corresponds to the You hour, belongs to Cold Water, and is the Foot Shaoyin Meridian; the Gallbladder corresponds to the Chou hour, belongs to Wind Wood, and is the Foot Shaoyang Meridian; the Liver corresponds to the Chou hour, belongs to Wind Wood, and is the Foot Jueyin Meridian.
The Song says:
Among the Hand meridians, the Taiyang meridian belongs to the Small Intestine; the Bladder meridian belongs to the Foot Taiyang;
The Liver belongs to the Foot Jueyin meridian, and in the Hand meridians is the Pericardium;
The Stomach belongs to the Foot Yangming meridian, and in the Hand meridians is the Large Intestine;
The Gallbladder belongs to the Shaoyang meridian, sought from the Foot meridian; the Sanjiao in the Hand meridians is Shaoyang;
The Spleen belongs to the Foot Taiyin meridian, and in the Hand meridians is the Lung;
The Kidney belongs to the Foot Shaoyin meridian, and in the Hand meridians is the Heart.
Humans possess five Zang organs and six Fu organs. Their deficiency or excess, cold or heat, life or death, and reversal or smoothness are all manifested through physical symptoms and pulse qi. If one does not perform palpation (pulse diagnosis), there is no way to recognize them. For deficiency, tonify it; for excess, drain it; for cold, warm it; for heat, cool it; for neither deficiency nor excess, regulate it through the meridians. This is the great principle of a good physician.
The Classics state: The Liver and Gallbladder are exterior-interior pairs, corresponding to the Foot Jueyin [note: text error, should be Foot Shaoyang]. Its qi prospers in Spring, which is the beginning of the generation of all things. Its qi is soft and weak; because it is soft, sweating is contraindicated; because it is weak, purgation is contraindicated. A string-like and long pulse is called a normal pulse; the opposite is a pathological pulse. A pulse that is full and string-like indicates excess, with disease located externally, causing forgetfulness and dizziness. A pulse that is deficient and faint indicates insufficiency, with disease located internally, causing distension and fullness in the chest and hypochondrium. Generally, Liver excess causes pulling pain under both hypochondria, irritability, or laughter; Liver deficiency causes a sensation of being pursued by someone. When Liver qi rebels upward, it causes headache, deafness, and red cheeks; the pulse is deep and rapid, and superficial palpation reveals the same; this governs rib-side distension, difficulty in urination, headache, and dizziness. An extremely rapid pulse governs malicious speech; a slightly rapid pulse indicates Qi stagnation in the chest and hypochondrium. An extremely slow pulse governs vomiting and rebellion of Qi; a slightly slow pulse indicates water-dampness bi-syndrome. An extremely large pulse governs internal abscesses and hematemesis; a slightly large pulse indicates sinew bi-syndrome. An extremely small pulse governs excessive drinking; a slightly small pulse indicates bi-syndrome. An extremely slippery pulse governs hernia; a slightly slippery pulse governs enuresis. An extremely choppy pulse governs flowing fluid retention; a slightly choppy pulse indicates spasms. The accumulated Qi of the Liver is located under the left hypochondrium; if it persists for a long time, it develops into coughing and rebellious Qi, or may develop into malaria. Liver deficiency dreams of lush flowers and grass; Liver excess dreams of lush mountains and forests. In Liver disease, clarity occurs in the morning, aggravation in the evening, and stillness at night. Liver disease presenting with headache, dizziness, hypochondriac fullness, scrotal retraction, and urinary obstruction leads to death within ten days. Furthermore, if there is fever with aversion to cold, and the limbs cannot move, the pulse should be string-like and rapid; if it is instead short and choppy, this is Metal overcoming Wood, a fatal condition that is incurable. Additionally, if the Liver is invaded by Cold, the two arms cannot be raised, the tongue is dry, there is frequent sighing, pain in the chest, inability to turn over, and the pulse at the left Guan position is slow and choppy. If the Liver is invaded by Heat, there is wheezing and fullness, much anger, eye pain, abdominal distension, loss of appetite, indecisive actions, nightmares with palpitations, red eyes, and blurred vision; the pulse at the left Guan position is Yang-excess. If the Liver is deficient and cold, there is hardness and pain under the hypochondria, blindness, arm pain, chills and fever resembling malaria, loss of appetite, and in women, amenorrhea and急促 breathing; the pulse at the left Guan position is deep and weak. These are the principles of cold, heat, deficiency, excess, life, death, reversal, and smoothness.
*Zhu Zhi Bei Yao* states: When the meridian Qi moves abnormally, it causes disease: lower back pain, severe cases unable to bend or straighten, men's hernia, women's lower abdominal swelling, severe cases with dry throat, dusty complexion, and loss of luster. It governs diseases generated by the Liver: vomiting and rebellious Qi in the chest, undigested diarrhea, fox hernia, enuresis, and stranguria. The Liver suffers from tension; urgently eat sweet flavors to relax it, such as Gancao (Licorice). The Liver desires dispersion; urgently eat pungent flavors to disperse it, such as Chuanxiong (Sichuan Lovage Rhizome). Tonify with the pungency of Xixin (Asarum); drain with the acidity of Baishao (White Peony Root). For Liver deficiency, tonify with Chenpi (Aged Tangerine Peel), Shengjiang (Fresh Ginger), etc. The Classics say: Deficiency tonifies its mother. Water generates Wood; Water is the mother of the Liver. Use bitter flavors to tonify the Kidney, such as Shudihuang (Prepared Rehmannia Root) and Huangbai (Phellodendron Bark). If there are no other syndromes, only insufficiency, use Qian Shi Dihuang Wan (Childhood Doctor's Rehmannia Pill) to tonify. For Liver excess, drain with Shaoyao (Peony); if there are no other syndromes, use Qian Shi Xie Qing Wan (Childhood Doctor's Draining Green Pill) as the primary treatment. Excess drains its child; the Heart is the child of the Liver, drain it with Gancao (Licorice).