按厥阴本气。为风为木。在岁序为十一月。冬至一阳生之后。于时则两阴交尽于上。于气则风木升动于下。是以风
木为本。厥阴为标。标属沉阴。本乃少阳。少阳方起于沉阴而未着。故不曰少阳。而曰厥阴。于时风木而未胜乎阴。而
厥阴用事。是以凡厥阴时气。及岁气司天在泉所至。虽属风木。而标之所在。皆风木不足。阴寒有余。在人应之。外动
于风。内感于肝。而恒起于阴。故其病在筋。所至为里急。阴乘木而木郁也。为支痛胁痛。阴乘本经络。而木不伸也。
为缓戾。风动筋而筋转也。为呕泄。风木上达下克也。此皆所至而病也。然司天恒气。从六元天气司之。若己亥岁。虽
厥阴司天。乃风气在上。厥阴下奉之。则风宣而动。风行地上。必脾土受克。势必病脾。是以病胃脘。当心而痛。上支
两胁鬲咽不通。食饮不下。舌本强。食则呕。此时脾之部位经络。两为所乘。故病如是。至若胃膈如塞。腹胀。溏冷泄
水闭瘕之反见者。则又风兼阴寒。阴寒动脾。而厥阴之标见也。然而风气在上。又中见少阳。则风与少阳摇动。当其淫
胜。又必本肝先病。故耳鸣头眩。愦愦欲吐。 胁气并化而为热。小便黄赤。胃脘当心而痛。肠鸣飧泄。少腹痛。注下
赤白。皆风与热并。而摇动肝脾之间也。风木之动必兼寒热二者。是以寒热二症。亦出于肝也。若当不运不及。则恒从
金气所化。而为摇动注恐。摇动者筋病。注恐者肝胆俱病。又其病为支废。且壅肿疮疡。木被金刑。清燥伤荣。而壅溪
谷关节。故支废且壅肿疮疡也。然以在天之气。岂容尽克。于是有郁。郁与燥伤异。燥伤为乘所胜。郁则为内不伸。盖
其气将发而伏也。惟伏而不发。则郁特甚。所以民病亦胃脘当心而痛。上支两胁鬲咽不通。饮食不下。症与风胜同。彼
以木逆。此以木伏也。抑久而伏。必将上拒于鬲。故遂支两胁而鬲咽不通也。甚则耳鸣目眩。转不识人。善暴僵仆。不
郁生火。而相煽于心肾之间。使神魂不守。而卒中暴厥也。故所谓郁者。非不及也。受制而莫之发。则怒而自相乘也。
此其治必发而伸之乃快耳。病机曰。诸风掉眩。皆属于肝。诸暴强直。皆属于风。诸风掉眩。皆兼火与寒。诸暴强直。
皆兼胜与郁。总之皆厥阴风木外淫之为也。内气不足。而与之逢合者有之。时气太过。而脏气不能御者有之。是以有主
客之分治。客以急治。主以缓治。主胜逆。客胜缓。从此治六气之权衡也。
按厥阴的本气,表现为风,归属于木。在岁序中对应十一月。冬至一阳初生之后,此时在上则两阴(太阴、少阴)交尽,在下则风木之气升动。因此,风木为本气,厥阴为标气。标气属于沉阴,本气乃属少阳。少阳气机刚刚从沉阴中兴起而尚未显着,所以不称为少阳,而称为厥阴。此时风木之气尚未胜过阴寒,但厥阴主事。因此,凡是厥阴时气,以及岁气司天、在泉所至的情况,虽然属于风木,但其标气所在之处,往往表现为风木不足,阴寒有余。人体感应于此,外受风邪扰动,内感于肝,病证多起于阴分。所以其病变在筋脉,症状表现为里急拘挛,这是阴寒乘袭木气导致木气郁结所致;表现为胁肋支痛,这是阴寒乘袭厥阴本经络,导致木气不能舒展所致;表现为肢体缓曲畸形,这是风动筋脉导致筋脉转侧不利所致;表现为呕吐泄泻,这是风木之气上达并下克脾土所致。这些都是岁气所至引发的病证。
然而,司天恒常之气,遵循六元天气的规律。例如己亥年,虽然是厥阴司天,风气位于上部,厥阴在下顺应之,则风气宣通而动,风行地上,必然克制脾土,势必导致脾病。因此出现胃脘部疼痛,当心而痛,向上牵引至两胁及膈咽部位不通畅,饮食难以下咽,舌根强硬,进食后呕吐。这是此时脾土的脏腑部位和经络,同时受到风木与阴寒的乘袭,所以出现上述病症。至于出现胃膈如堵塞感、腹胀、溏泄冷利、水闭、瘕积等反常症状的,则是风邪兼夹阴寒,阴寒扰动脾土,表现出厥阴的标气特征。
然而,风气位于上部,又中见少阳相火,则风与少阳相火共同摇动。当其淫胜之时,必定是本脏肝脏先发病。因此出现耳鸣、头眩、心中烦闷欲吐的症状。胁肋之气郁结化热,小便黄赤,胃脘当心而痛,肠鸣飧泄,少腹疼痛,下痢赤白。这都是风邪与热邪并见,摇动肝脾之间所致。风木之动必然兼夹寒热两种性质,所以寒热二症,也出于肝脏。
如果当年运气不及,则往往从金气所化,表现为动摇不安和恐惧。动摇是筋脉的病证,恐惧是肝胆俱病的表现。另外其病证还有肢体废用、壅肿、疮疡。这是因为木被金刑,清燥之气损伤营血,导致溪谷关节壅滞,所以出现肢体废用且伴有壅肿疮疡。
然而,在天之气,岂能完全克制?于是产生郁结。郁结与燥伤不同,燥伤是乘袭所胜之气,郁结则是内部气机不得伸展。盖因该气将发而潜伏。只有伏而不发,郁结才特别严重。所以民众患病也出现胃脘当心而痛,向上牵引至两胁及膈咽不通,饮食不下,症状与风邪偏胜相同。彼处是因为木气上逆,此处是因为木气伏留。压抑久了且伏留,必将向上抗拒于膈膜,所以遂致牵引两胁而膈咽不通。严重时出现耳鸣目眩,转头不识人,善于突然僵仆倒地。这是因为郁久化火,与心肾之间的相火相互煽动,使神魂不能守舍,从而发生卒中和暴厥。
所以所谓的“郁”,并非运气不及,而是受制而不能发泄,于是愤怒而自相乘袭。对此的治疗,必须发散而舒展其气,才能畅快。《病机十九条》说:诸风掉眩,皆属于肝;诸暴强直,皆属于风。诸风掉眩,都兼夹火与寒;诸暴强直,都兼夹胜气与郁结。总之,这都是厥阴风木外淫所致。内有正气不足而与之外气逢合的,有时也有时气太过而脏气不能抵御的。因此有主气与客气的区分治疗。客气致病需急治,主气致病需缓治。主气胜则为逆,客气胜则为顺。从此把握六气治疗的权衡原则。
According to the fundamental qi of Jueyin (Jueyin Meridian), it manifests as Wind and belongs to Wood. In the annual cycle, it corresponds to the eleventh month. After the generation of one Yang at Winter Solstice, the two Yin meridians (Taiyin and Shaoyin) are exhausted above, while the Wind-Wood qi rises below. Therefore, Wind-Wood is the root (Ben), and Jueyin is the marking (Biao). The marking belongs to deep Yin, while the root belongs to Shaoyang. Since Shaoyang qi has just risen from deep Yin but is not yet prominent, it is called Jueyin rather than Shaoyang. At this time, Wind-Wood has not yet overcome Yin, but Jueyin governs. Thus, for all Jueyin seasonal qi, as well as the influences of the ruling Qi of Heaven and Earth in a given year, although they belong to Wind-Wood, where the marking resides, there is often insufficient Wind-Wood and an excess of Cold-Yin. When humans respond to this, external Wind disturbs, and internally the Liver is affected, so diseases invariably arise from the Yin aspect. Consequently, the pathology involves the sinews, presenting with internal tension and cramping, which is due to Yin attacking Wood causing Wood stagnation; presenting with distending pain in the hypochondrium, due to Yin attacking the Jueyin collaterals causing Wood to fail to extend; presenting with flaccidity and deformity, due to Wind moving the sinews causing them to twist; presenting with vomiting and diarrhea, due to Wind-Wood reaching upward and overcoming Spleen Earth downward. These are all diseases arising from the influence of the seasonal qi.
However, the constant Qi of the Ruling Heaven follows the laws of the Six Yuan Heavenly Qi. For example, in the Ji-Hai year, although Jueyin rules Heaven, with Wind Qi above and Jueyin below complying, the Wind disperses and moves, blowing upon the earth, inevitably overcoming Spleen Earth, thus inevitably causing Spleen disease. Therefore, epigastric pain occurs, painful in the region of the heart, radiating upward to both hypochondria and obstruction in the diaphragm and throat, inability to swallow food and drink, stiffness of the tongue root, and vomiting after eating. This is because the location and collaterals of the Spleen are simultaneously attacked by both Wind-Wood and Yin-Cold, hence such symptoms occur. As for the counter-occurrence of sensations like blockage in the stomach and diaphragm, abdominal distension, loose cold diarrhea, water retention, and masses, these indicate Wind combined with Yin-Cold, where Yin-Cold agitates the Spleen, manifesting the marking aspect of Jueyin.
Nevertheless, since Wind Qi is above and it internally corresponds to Shaoyang (Ministerial Fire), Wind and Shaoyang shake together. When their excessive influence prevails, it must be that the Liver organ is first diseased. Thus, tinnitus, dizziness, mental confusion with a desire to vomit occur. Qi in the hypochondrium transforms into Heat, urine becomes yellow and red, epigastric pain centered behind the heart, borborygmus with undigested stool in diarrhea, lower abdominal pain, and dysentery with red and white discharge all result from Wind and Heat combining to agitate between the Liver and Spleen. The movement of Wind-Wood must involve both Cold and Heat; therefore, both Cold and Heat syndromes also originate from the Liver.
If the annual fortune is deficient (Bu Ji), it tends to transform according to Metal Qi, resulting in tremors and fear. Tremors indicate Sinew disease, while fear indicates simultaneous disease of the Liver and Gallbladder. Additionally, its pathologies include limb paralysis, swelling, and sores/ulcers. This is because Wood is punished by Metal, Clear-Dryness damages the Ying (Nutritive) Blood, causing stagnation in the溪谷 (valleys/collaterals) and joints, hence limb paralysis accompanied by swelling and sores/ulcers.
However, how can the Qi in Heaven completely overcome? Thus, stagnation (Yu) arises. Stagnation differs from Dryness injury; Dryness injury is overcoming the conquered element, whereas stagnation is internal failure to extend. Because the Qi is about to emerge but remains latent. Only when it lies latent without emerging does stagnation become particularly severe. Therefore, the people suffer from epigastric pain centered behind the heart, radiating upward to both hypochondria and obstruction in the diaphragm and throat, inability to eat and drink. The symptoms are the same as those caused by Wind excess. In the former case, it is due to Wood rebelling upward; in this case, it is due to Wood being suppressed. If suppressed for a long time, it will eventually resist upward against the diaphragm, leading to distending pain in the hypochondria and obstruction in the diaphragm and throat. In severe cases, tinnitus, dizziness, inability to recognize people upon turning the head, sudden stiff collapse, and fainting occur. This is because stagnation generates Fire over time, which fans the Ministerial Fire between the Heart and Kidney, causing the Soul and Spirit to lose their residence, resulting in stroke and sudden syncope.
Therefore, what is meant by "Stagnation" is not deficiency, but being constrained and unable to emit, leading to anger and self-overcoming. The treatment for this must involve dispersing and extending the Qi to achieve relief. The Pathogenesis says: "All wind-induced tremors and dizziness belong to the Liver"; "All sudden rigidity and straightening belong to Wind." All wind-induced tremors and dizziness involve Fire and Cold; all sudden rigidity and straightening involve Overcoming (Sheng) and Stagnation (Yu). In summary, these are all caused by the external invasion of Jueyin Wind-Wood. There are instances where internal Qi is insufficient and meets with external Qi, and instances where seasonal Qi is excessive and the Zang Qi cannot defend against it. Therefore, there is a distinction between Primary (Zhu) and Guest (Ke) treatments. Guest pathogens require urgent treatment, while Primary pathogens require slow treatment. Primary victory is contrary (Ni), Guest victory is compliant (Huan). From this, the balance of treating the Six Qi is determined.