黄帝问于岐伯曰。凡刺之法。先必本于神。血脉营气精神。此五脏之所藏也。至其淫 。离脏则精失。魂魄飞扬。
志意恍乱。智虑去身者。何因而然乎。天之罪与人之过乎。何谓德气生精神魂魄心意志思智虑。请问其故。(以上用淡笔
以统冒全篇大意)岐伯答曰。天之在我者。德也。地之在我者。气也。德流气薄而生者也。(流充溢也薄鼓舞也)故生之
来谓之精。两精相搏谓之神。随神往来者。谓之魂。并精而出入者。谓之魄。所以任物者谓之心。心有所忆谓之意。意
之所存谓之志。因志而存变。谓之思。因思而远慕。谓之虑。因虑而处物。谓之智。故智者之养生也。必顺四时。而适
寒暑和喜怒。而安居处节阴阳。而调刚柔如是则邪僻不至。长生久视是故怵惕思虑者。则伤神。神伤则恐惧流淫而不止。
因悲哀动中者。竭绝而失生喜乐者。神惮散而不藏愁忧者。气闭塞而不行。盛怒者。迷惑而不治。恐惧者。神荡惮而不
收。(此节凡三段源流俱备云垂海立气象万千是通篇之上游精神结聚之处也)心怵惕思虑。则伤神。神伤则恐惧自失。破
脱肉。毛悴色夭。死于冬。脾忧愁而不解则伤意。意伤则 乱。四肢不举。毛悴色夭。死于春。肝悲哀动中则伤魂。
魂伤则狂忘不精。不精则不敢正当人。阴缩而挛筋。两胁骨不举。毛悴色夭。死于秋。肺喜乐无极则伤魄。伤魄则狂。
狂者意不存人。皮革焦。毛悴色夭。死于夏。肾盛怒而不止则伤志。志伤则喜忘。其前言腰脊不可以俯仰屈伸。毛悴色
夭。死于季夏。恐惧而不解则伤精。精伤则骨 痿厥。精时自下。是故五脏主藏精者也。不可伤。伤则失守。而阴虚。
阴虚则无气。无气则死矣。是故用针者察观病患之态。以知精神魂魄之存亡。得失之意五者以伤针不可以治之也。(此节
接论五脏之伤而不可治者)肝藏血。血舍魄。肝气虚则恐实则怒。脾藏营。营舍意。脾气虚则四肢不用。五脏不安。实
则腹胀。经溲不利。心藏脉。脉舍神心气虚则悲。实则笑不休。肺藏气。气舍魄。肺气虚则鼻塞不利。少气。实则喘喝。
胸盈仰息。肾藏精。精舍志。肾气虚则厥。实则胀。五脏不安。必审五脏之病形以知其气之虚实谨而调之也。(此节接论
五脏之虚实而宜调者)
以神字为主。以五脏为骨。以伤字虚实字为次第。从源头说起。层递而下浩然沛然之中。铸词仍自精湛。非惟才大。
实由理熟。是极正大光明文本。此篇言五脏之神不可伤。伤之者。其死各有期。其神未伤而气有虚实者可审而调之也。
黄帝向岐伯问道:大凡针刺的方法,必须以“神”为根本。血脉、营气、精神,这五者是五脏所藏纳的。如果这些精气淫溢妄动,脱离脏腑,就会导致精气的丧失,魂魄飞扬,志意恍惚混乱,智虑离开身体,这是什么原因造成的呢?是上天的罪过还是人的过错呢?什么是德、气、生、精神、魂、魄、心、意、志、思、智、虑?请问它们的缘由。(以上用淡笔统摄全篇大意)
岐伯回答说:天赋予我们的叫作“德”,地赋予我们的叫作“气”。德与气交融流动而产生了生命。(注:流指充溢,薄指鼓舞)所以生命的本源称为“精”,两精结合搏动产生“神”,伴随神往来活动的称为“魂”,依附于精而出入的称为“魄”,用来承担外物感应的称为“心”,心中有所回忆称为“意”,意念中保存下来的称为“志”,依据志而进行存变思考的称为“思”,依据思而进行长远谋划的称为“虑”,依据虑而处理事物的称为“智”。所以明智的人养生,必然顺应四季变化,适应寒暑交替,调和喜怒情绪,安顿起居生活,节制阴阳,调节刚柔。像这样,邪僻之气就不会到来,从而长生久视。因此,惊恐思虑会损伤神,神受损就会恐惧不安、精气滑脱不止;因为悲哀触动内脏的,会导致精气枯竭绝灭而失去生机;喜乐过度的,会使神气涣散而不能内守;忧愁的,会使气机闭塞而不运行;大怒的,会使人迷惑而神志不清;恐惧的,会使神气荡散而不能收敛。(此节分三段,源流完备,气象万千,是通篇精神凝聚之处)
心脏惊恐思虑,就会损伤神,神受损就会恐惧自我失守,肌肉破裂消瘦,毛发枯悴,面色夭折,死于冬季。脾脏忧愁不解就会损伤意,意受损就会思维混乱,四肢不能举动,毛发枯悴,面色夭折,死于春季。肝脏悲哀触动内脏就会损伤魂,魂受损就会狂妄健忘而不精明,不精明就不敢正视他人,阴器收缩且筋脉拘挛,两胁骨骼不能抬举,毛发枯悴,面色夭折,死于秋季。肺脏喜乐无极就会损伤魄,魄受损就会狂妄,狂妄的人心中没有他人,皮肤皮革焦枯,毛发枯悴,面色夭折,死于夏季。肾脏盛怒不止就会损伤志,志受损就会喜欢遗忘,正如前面所说的腰脊不能俯仰屈伸,毛发枯悴,面色夭折,死于长夏(季夏)。恐惧不解就会损伤精,精受损就会骨痿厥冷,精气自行滑脱下泄。所以五脏是主藏精气的器官,不可损伤。一旦损伤就会失守,导致阴虚。阴虚就没有气,没有气就会死亡。所以使用针法的人,要观察病患的状态,以此知道精神魂魄的存亡得失。如果这五种精神要素已经受伤,针法就不能治疗了。(此节承接论述五脏之伤且不可治的情况)
肝藏血,血舍魄。肝气虚则恐惧,肝气实则易怒。脾藏营气,营气舍意。脾气虚则四肢不能用,五脏不安宁,脾气实则腹部胀满,大小便不利。心藏脉,脉舍神。心气虚则悲伤,心气实则笑个不停。肺藏气,气舍魄(注:原文此处似有误,通常肺藏气,气舍魄或肺藏魄,依《内经》原文多为“肺藏气,气舍魄”或“肺藏魄”,此处依原文翻译)。肺气虚则鼻塞不通利,少气,肺气实则喘喝,胸部胀满需仰面呼吸。肾藏精,精舍志。肾气虚则厥冷,肾气实则腹胀,五脏不安。必须详细审查五脏病变的表现,以判断其气的虚实,谨慎地进行调理。(此节承接论述五脏之虚实及适宜调理的情况)
本篇以“神”字为主旨,以五脏为骨架,以“伤”字和“虚实”字为次第,从源头说起,层层递进,气势浩然充沛。遣词造句依然精湛,不仅才华横溢,更是因为道理熟稔。这是极其正大光明的文本。此篇讲述五脏之神不可损伤,损伤者,其死亡各有期限;其神未伤而气有虚实者,可以审察并调理。
Huangdi asked Qibo: In all acupuncture methods, one must first base oneself on Shen (Spirit). The blood vessels, Ying-Qi (Nutritive Qi), and Jing-Shen (Essence-Spirit) are what the Five Zang Organs store. When these become excessive and erratic, leaving the organs, the Essence is lost, Hun (Ethereal Soul) and Po (Corporeal Soul) fly about restlessly, Zhi (Will) and Yi (Intent) become confused and chaotic, and Zhi-Lv (Wisdom and Deliberation) depart from the body. What causes this? Is it the fault of Heaven or the error of man? What are De (Virtue/Heavenly Qi), Qi (Earthly Qi), Sheng (Life), Jing-Shen, Hun, Po, Xin (Heart/Mind), Yi, Zhi, Si (Thought), Lv (Deliberation), and Zhi (Wisdom)? Please explain their origins. (The above uses a light touch to summarize the main idea of the entire chapter.)
Qibo replied: What Heaven gives us is called De (Virtue/Heavenly Qi); what Earth gives us is called Qi (Earthly Qi). Life is generated by the flow and interaction of De and Qi. (Note: Liu means overflowing/spreading; Bo means stimulating/agitating.) Therefore, the origin of life is called Jing (Essence). The interaction and fusion of two Jings is called Shen (Spirit). That which accompanies Shen and comes and goes is called Hun (Ethereal Soul). That which emerges and enters along with Jing is called Po (Corporeal Soul). That which assumes responsibility for external objects is called Xin (Heart/Mind). Memory within the Xin is called Yi (Intent). What is retained in Yi is called Zhi (Will). Based on Zhi, engaging in preservation and transformation is called Si (Thought). Based on Si, engaging in far-reaching contemplation is called Lv (Deliberation). Based on Lv, handling matters appropriately is called Zhi (Wisdom). Therefore, those who are wise in nurturing life must conform to the four seasons, adapt to cold and heat, harmonize joy and anger, regulate dwelling and movement, restrain Yin and Yang, and adjust rigidity and softness. By doing so, deviant pathogens will not arrive, allowing for long life and clear vision.
Thus, being startled and overthinking injures Shen. If Shen is injured, fear arises, leading to uncontrolled leakage and loss of essence. Sorrow that moves the interior exhausts and destroys life-giving energy. Unrestrained joy scatters Shen, preventing it from storing itself. Worry and grief cause Qi to block and fail to circulate. Excessive anger leads to confusion and lack of control. Fear causes Shen to be agitated and unable to gather. (This section consists of three paragraphs, complete in origin and flow, majestic in imagery, representing the gathering point of spirit in the whole text.)
If the Heart is startled and overthinks, Shen is injured. If Shen is injured, there is fear and self-loss; muscles break down and flesh wastes away, hair becomes brittle, complexion fades, and death occurs in Winter. If the Spleen is worried and unresolved, Yi is injured. If Yi is injured, thinking becomes chaotic, the four limbs cannot move, hair becomes brittle, complexion fades, and death occurs in Spring. If the Liver is sorrowful and moved internally, Hun is injured. If Hun is injured, madness and forgetfulness occur, lacking clarity; one dares not face others directly; the genitals shrink and sinews contract, the two hypochondriac regions feel rigid and cannot lift, hair becomes brittle, complexion fades, and death occurs in Autumn. If the Lungs experience boundless joy, Po is injured. If Po is injured, madness ensues; the mad person has no regard for others; skin and leather become scorched, hair becomes brittle, complexion fades, and death occurs in Summer. If the Kidneys are excessively angry without relief, Zhi is injured. If Zhi is injured, there is frequent forgetting; as mentioned before, the waist and spine cannot bend or extend, hair becomes brittle, complexion fades, and death occurs in Late Summer (Ji Xia). Unresolved fear injures Jing. If Jing is injured, bone萎 (Wei - atrophy/flaccidity) and Jue (Cold extremities/reversal) occur, and Jing leaks spontaneously.
Therefore, the Five Zang Organs are responsible for storing Jing (Essence) and must not be injured. Injury leads to loss of control and Yin deficiency. Yin deficiency leads to a lack of Qi. Lack of Qi leads to death. Thus, practitioners of acupuncture must observe the patient's condition to know the existence or loss of Jing-Shen, Hun, and Po, and the gain or loss of Yi and Zhi. If these five spiritual aspects are injured, acupuncture cannot cure them. (This section follows up on discussing injuries to the Five Zang Organs that are incurable.)
The Liver stores Blood, and Blood houses Po. Liver Qi deficiency leads to fear; excess leads to anger. The Spleen stores Ying-Qi (Nutritive Qi), and Ying-Qi houses Yi. Spleen Qi deficiency leads to inability to use the four limbs and disharmony of the Five Zang Organs; excess leads to abdominal distension and difficult urination and defecation. The Heart stores Mai (Vessels/Pulse), and Mai houses Shen. Heart Qi deficiency leads to sadness; excess leads to incessant laughter. The Lungs store Qi, and Qi houses Po. Lung Qi deficiency leads to nasal congestion and obstruction, shortness of breath; excess leads to wheezing and drinking sounds, chest fullness requiring supine breathing. The Kidneys store Jing, and Jing houses Zhi. Kidney Qi deficiency leads to Jue (Cold extremities/reversal); excess leads to abdominal distension and disharmony of the Five Zang Organs. One must carefully examine the pathological manifestations of the Five Zang Organs to determine the deficiency or excess of their Qi, and then cautiously regulate them. (This section follows up on discussing the deficiency/excess of the Five Zang Organs and those suitable for regulation.)
This passage centers on "Shen," uses the Five Zang Organs as its framework, and follows the sequence of "injury" and "deficiency/excess." It starts from the source and proceeds layer by layer, with a vast and vigorous momentum. The wording remains exquisite, reflecting not only great talent but also profound familiarity with the principles. This is an extremely upright and luminous text. This chapter states that the Spirit of the Five Zang Organs must not be injured; if injured, death has its specific timing. If the Spirit is not injured but the Qi exhibits deficiency or excess, it can be examined and regulated.