经言东西南北中五方人土产浓薄。居处高下。风寒暑湿。各地不同。日用谷 颇异。所以黄帝举
五方之问。岐伯进五治之功。针砭 淋灸之法。乃五方得宜之用。而今年力衰壮。五土之别。学人当
详察之。不可不备矣。
夫 妓者乃烟花路柳。人人可折。逐日交欢。罕于间隔。鸨妪易老。是精华作丧于早年。虽受男
子阳精补益。自己岂无泄漏。故云爽口。物多终作疾。快心事过易为殃。嫖客亦然。凡此之人。有疮
难愈者何也。盖精血不足。难溃难敛。必须大托大补。先禁房色。非百日不痊。岂但疮疡诸疾可忌。
养生之源。莫出于此矣。
夫肥人多湿多痰。多气虚。形体外实者多肉。内虚者属气虚。故气虚之人生疮疡故多痈。痈者壅
也。属阳在表。气虚即表虚。故多浮肿于外。皮薄色赤。宜内托之。使邪不内陷则易溃而易完。丹溪
云。肥人宜二陈汤加人参 归术金银花连翘等类治之。无出于此。学人察之。
夫瘦人多火多血虚。血虚即阴虚。阴虚即火盛。火盛即发热。筋骨瘦而不胜于寒。盖皮宽肉缓。
如生疮疡则多疽。疽者阻也。属阴。因荣血受凝注不从。正是阴滞于阳。血滞于气。则为疽也。又云疽乃五脏
之毒。痈为六腑之毒。故疽多附于骨。肉色不变。故难溃。溃而难完。治宜八珍汤中加金银花连翘附
子之类加减。妙在于不执其方。斯为上工。学人味之。
The classics state that the richness or scarcity of local products varies among people in the five directions: East, West, South, North, and Center. The elevation or depression of dwellings, as well as the wind, cold, summer heat, and dampness, differ from place to place. The daily consumption of grains also varies considerably. Therefore, Huangdi raised questions regarding the five directions, and Qibo presented the merits of treatments tailored to the five regions. Methods such as acupuncture (Zhenjiu), Bian stone therapy, washing, and moxibustion are applications suited to the conditions of the five directions. Nowadays, individuals vary in physical strength, being either weak or robust; given the differences in the five soils, students of medicine should examine these factors in detail and must not neglect them.
Prostitutes belong to the trade of flowers and willows, accessible to all. They engage in sexual intercourse daily with little interval. Pimps age easily because their essence is depleted in their early years. Although they receive nourishment from men's yang essence, do they not leak their own? Thus it is said: "Things that taste good, if eaten too much, eventually cause disease; matters that bring pleasure, if indulged excessively, easily lead to disaster." Clients are the same. Why do sores in such people often fail to heal? It is likely due to insufficiency of essence and blood, making it difficult for sores to suppurate and difficult for wounds to close. Large doses of supporting methods (Tuo Fa) and tonifying methods must be used, and sexual activity must be prohibited first; recovery takes at least a hundred days. This taboo applies not only to various sores but is also the source of health preservation.
Obese people tend to have excessive dampness and phlegm, and Qi deficiency. Those who appear solid externally have excess flesh, while those who are deficient internally suffer from Qi deficiency. Therefore, when people with Qi deficiency develop sores, they often suffer from carbuncles (Yong). A carbuncle implies obstruction. It belongs to Yang and is located on the exterior. Qi deficiency equates to exterior deficiency, leading to external edema. The skin is thin and red. Internal support (Nei Tuo) is appropriate to prevent the pathogenic factor from sinking inward, facilitating both suppuration and healing. Zhu Danxi stated that obese people should be treated with Erchen Tang (Two-Cured Decoction) added with Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Jin Yin Hua (Lonicerae Japonicae Flos), Lian Qiao (Forsythiae Fructus), etc. There is no deviation from this principle. Students should observe this carefully.
Emaciated people tend to have excessive fire and blood deficiency. Blood deficiency constitutes Yin deficiency; Yin deficiency leads to hyperactive fire; hyperactive fire causes fever. Their sinews and bones are thin and cannot withstand cold. Generally, their skin is loose and muscles flaccid. If they develop sores, they often suffer from deep abscesses (Ju). A deep abscess implies blockage. It belongs to Yin. Because Ying (Nutritive) blood becomes stagnant and does not flow smoothly, there is Yin stagnation obstructing Yang, and blood stagnation obstructing Qi, resulting in a Ju. It is further said that Ju represents toxicity of the Five Zang organs, while Yong represents toxicity of the Six Fu organs. Therefore, Ju often attaches to the bone, with unchanged muscle color, making it difficult to suppurate. Even after suppuration, it is difficult to heal. Treatment should involve Bajzhen Tang (Eight-Treasure Decoction) modified with Jin Yin Hua, Lian Qiao, Fu Zi (Aconiti Lateralis Radix Praeparata), etc. The subtlety lies in not adhering rigidly to a fixed formula; this characterizes a skilled physician. Students should ponder this.