《脏气法时论》曰∶夫邪气之客于身也。以胜相加,(邪者,不正之目。风寒暑湿饥饱劳逸是也。)
至其所生而愈,(谓至己所生也。)至其所不胜而甚,(谓至克己之气也。)至于所生而持,(谓至生己之
气也。)自得其位而起。(居所生处,谓自得其位也。)肝病者,两胁下痛引少腹,令人善怒,(肝厥
阴脉,自足而上,环阴器,抵少腹,又上贯肝膈布胁助,故两胁下痛,引少腹,其气实,则善怒。)
虚则目 无所见,耳无所闻,善恐如人将捕之。(肝厥阴脉,自胁助、肘,循喉咙,入颃颡,连目系。胆少阳
脉,其支者,从耳后入耳中,出走耳前,至目锐 后,故病如是也。恐,谓恐惧,魂不安也。)心病者,胸中痛,胁支满,胁下痛,背肩甲间痛,两臂内
痛,(心少阴脉,支别者,循胸出胁。又手心主厥阴之脉,起于胸中∶其支别者,亦循胸中,出胁
下腋三寸,上抵腋下,下循 内,行太阴少阴之间,入肘中,下循臂,行两筋之间。又心少阴之脉,
直行者,复从心系却上肺,上出腋下,下循 内后廉。行太阴心主之后,下肘内,循臂内后廉,抵掌
后锐骨之端,又小肠太阳之脉,自臂 上绕肩甲,交肩上,故病如是。)虚则胸腹大,胁下与腰
相引而痛。(手心主厥阴之脉,从胸中,出属心胞,下膈,历络三焦;其支别者,循胸出胁,心少阴
之脉,自心系下膈络小肠。故病如是。)脾病者,身重善肌肉痿,足不收行,善 脚下痛,( ,
小儿病。脾象
土而主肉,故身重肉痿也。脾太阴之脉起于足大指之端,循指内侧上内踝前廉,上 内。肾少阴之脉,
起于足小指之下,斜趋足心,上 内,出 内廉,故病则足不收行,善 ,脚下痛也。)虚则腹胀满,
肠鸣,飧泄,食不化。(脾太阴脉,从股内前廉入腹,属脾络胃,故病如是。《灵枢经》曰∶中气不足则
腹内为之善满,肠为之善鸣。肺病者,喘咳逆气,肩背痛,汗出尻阴,股膝髀 足皆痛,肺藏气而
主喘息,在变动为咳,故病则喘咳逆气也。背为胸中之府,肩接近之,故肩背痛也。肺养皮毛,邪盛则
心液外泄,故汗出也。肾为少阴之脉,从足下上循 ,内出 内廉,上股内后廉,贯脊,属肾络膀胱。
今肺病则肾脉受邪,故尻阴股膝髀 足皆痛。)虚则少气不能报息,耳聋咽干。(气虚少,故不足
以报息也。肺太阴之络,会于耳中,故聋也。肾少阴之脉,从肾上贯肝膈,入肺中,循喉咙夹
舌本,今肺虚,则肾气不足以上润于咽,故咽干也。)肾病者,腹大胫肿,喘咳身重,寝汗出憎风,
肾少阴脉,起于足,而上循 ,复从横骨中,侠脐循腹里,上行而入肺,故腹大胫肿而喘咳也。肾病
则骨不能用,故身重也。肾邪入肺,心气内微,心液为汗,故寝汗出也。胫既肿矣。汗复津泄,阴
凝玄府,阳灼下焦,内热外寒,故憎风也。)虚则胸中痛,大腹小腹痛,清厥意不乐。(肾少阴脉,
从肺出络心注胸中。肾气既虚,心无所制,心气灼肺,故痛聚胸中也。足太阳脉,从项下行而至足,
肾虚则太阳之气不能盛行于足,故足冷而气逆也。清,谓清冷。厥、谓厥逆。以清冷气逆,故大腹
小腹痛,志不足,则神燥扰,故不乐也。)
《脏气法时论》说:邪气侵犯人体,是按照五行相克的规律相加害的。(所谓“邪”,是指不正之气,如风、寒、暑、湿、饥饱、劳、逸等。)
当病情发展到其所生(即我生者)之时则痊愈,(指到了由本脏所生的脏腑气旺之时。)当病情发展到其所不胜(即克我者)之时则加重,(指到了克制本脏的气旺之时。)当病情发展到所生(即生我者)之时则维持现状,(指到了生养本脏的气旺之时。)当处于本脏自得其位(即本脏气旺)之时则发作或起病。(指处于本脏所主的时令或部位,称为自得其位。)
肝脏发生病变时,两侧胁肋下疼痛并牵引至小腹,使人容易发怒。(足厥阴肝经,从足部向上,环绕生殖器,抵达小腹,又向上贯穿肝膈,分布于胁肋,所以两胁下痛,牵引少腹。若肝气实证,则容易发怒。)
肝虚时,眼睛看不见东西,耳朵听不见声音,容易恐惧,好像有人要抓捕自己一样。(足厥阴肝经,从胁肋、肘部,沿着喉咙,进入颃颡,连接目系。足少阳胆经,其支脉,从耳后进入耳中,走出耳前,到达目外角后方,所以出现上述病症。“恐”,指恐惧,魂不安定。)
心脏发生病变时,胸中疼痛,胁肋支撑胀满,胁下疼痛,背部肩胛间疼痛,双臂内侧疼痛。(手少阴心经,其分支,沿胸部出于胁部。另外手厥阴心包经,起于胸中;其分支,也沿胸中,出于胁下腋前三寸,向上抵腋下,向下沿臂内,行于手太阴、手少阴之间,入肘中,向下沿臂,行于两筋之间。另外手少阴心经,直行的经脉,又从心系上行至肺,出腋下,向下沿臂内后廉,行于手太阴、手厥阴之后,下肘内,循臂内后廉,抵掌后锐骨之端。另外手太阳小肠经,从臂上绕肩甲,交于肩上,所以出现上述病症。)
心虚时,胸腹部胀大,胁下与腰部相互牵引而痛。(手厥阴心包经,从胸中,出来属于心包,向下穿过膈肌,联络三焦;其分支,沿胸出于胁。手少阴心经,从心系向下穿过膈肌,联络小肠。所以出现上述病症。)
脾脏发生病变时,身体沉重,容易肌肉痿软无力,脚不能收持行走,容易足底痛,(“ ”,指小儿疳积病。脾象土而主肌肉,所以身体沉重、肌肉痿软。足太阴脾经,起于足大趾末端,沿趾内侧上行至内踝前缘,上行至小腿内侧。足少阴肾经,起于足小趾之下,斜趋足心,上行至小腿内侧,出于内踝前缘,所以生病时脚不能收持行走,容易足底痛。)
脾虚时,腹胀满,肠鸣,完谷不化的泄泻,食物不消化。(足太阴脾经,从大腿内侧前缘进入腹部,属于脾,联络胃,所以出现上述病症。《灵枢经》说:“中气不足,则腹内经常胀满,肠道经常鸣响。”)
肺脏发生病变时,气喘咳嗽,气逆,肩背疼痛,出汗,尻骨、阴部、大腿、膝盖、髀部、小腿及足部都疼痛,肺藏气而主呼吸喘息,在变动时为咳嗽,所以生病时气喘咳嗽气逆。背部是胸中之府,肩部接近胸部,所以肩背痛。肺滋养皮毛,邪气盛则心液外泄,所以出汗。足少阴肾经,从足下向上沿小腿内侧,出内踝前缘,上行至大腿内侧后缘,贯穿脊柱,属于肾,联络膀胱。现在肺病则肾脉受邪,所以尻骨、阴部、大腿、膝盖、髀部、小腿及足部都疼痛。)
肺虚时,气短不足以接续呼吸,耳聋,咽干。(气虚少,所以不足以接续呼吸。足太阴肺经的络脉,会合于耳中,所以耳聋。足少阴肾经,从肾脏向上贯穿肝膈,进入肺中,沿喉咙夹舌根,现在肺虚,则肾气不足以上润咽喉,所以咽干。)
肾脏发生病变时,腹部肿大,小腿浮肿,气喘咳嗽,身体沉重,睡着出汗,怕风。(足少阴肾经,起于足部,向上沿小腿内侧,再从横骨中,挟脐沿腹里,上行而入肺,所以腹部肿大、小腿浮肿且气喘咳嗽。肾病则骨骼不能用,所以身体沉重。肾邪入肺,心气内微,心液化为汗,所以睡着出汗。小腿既已肿胀,汗又津液外泄,阴凝玄府,阳灼下焦,内热外寒,所以怕风。)
肾虚时,胸中疼痛,大腹和小腹疼痛,四肢清冷厥逆,意志消沉不乐。(足少阴肾经,从肺出来联络心注入胸中。肾气既虚,心无所制约,心气灼肺,所以疼痛聚集在胸中。足太阳膀胱经,从项下行至足,肾虚则太阳之气不能盛行于足,所以脚冷且气逆。“清”,指清冷。“厥”,指厥逆。因清冷气逆,所以大腹和小腹疼痛,志气不足,则神燥扰,所以不快乐。)
The *Zangqi Fashi Lun* (Treatise on the Laws of Zang Organ Times) states: When pathogenic factors invade the body, they inflict harm according to the principle of mutual overcoming. (By "pathogenic factors" is meant abnormal qi, such as wind, cold, summer-heat, dampness, overeating or hunger, fatigue, and inactivity.)
The condition improves when it reaches the time of its offspring (i.e., when the qi of the organ it generates is prosperous). (Referring to the time when the qi generated by the affected zang organ becomes strong.) The condition worsens when it reaches the time of its conqueror (i.e., when the qi that overcomes it is prosperous). (Referring to the time when the qi that controls the affected zang organ becomes strong.) The condition stabilizes when it reaches the time of its mother (i.e., when the qi that generates it is prosperous). (Referring to the time when the qi that nourishes the affected zang organ becomes strong.) The condition arises or peaks when it attains its own position (i.e., when its own qi is prosperous). (Referring to the season or location governed by the affected zang organ, termed "attaining its own position".)
When the Liver is diseased, there is pain in both hypochondriac regions radiating to the lower abdomen, causing irritability. (The Foot Jueyin Liver Meridian ascends from the foot, circles the genitalia, reaches the lower abdomen, pierces through the liver and diaphragm, and distributes along the hypochondrium; hence the pain in the hypochondrium radiating to the lower abdomen. If Liver Qi is Excess, irritability occurs.)
When Liver Qi is Deficient, vision is impaired, hearing is diminished, and there is excessive fear, as if being pursued. (The Foot Jueyin Liver Meridian travels from the hypochondrium and elbow, follows the throat, enters the pharynx, and connects with the eye system. The Foot Shaoyang Gallbladder Meridian has a branch entering the ear from behind, emerging anterior to the ear, and reaching the lateral canthus; thus these symptoms arise. "Fear" refers to fright and unsettled Hun [Soul].)
When the Heart is diseased, there is pain in the chest, distension and fullness in the hypochondrium, pain below the hypochondrium, pain between the back and scapula, and pain in the medial aspect of both arms. (The Hand Shaoyin Heart Meridian has a branch following the chest to emerge at the hypochondrium. Additionally, the Hand Jueyin Pericardium Meridian originates in the chest; its branch also follows the chest, emerges below the hypochondrium three cun lateral to the axilla, ascends to the axilla, descends along the medial arm, running between the Hand Taiyin and Hand Shaoyin meridians, entering the elbow, and descending along the forearm between two tendons. Furthermore, the direct pathway of the Hand Shaoyin Heart Meridian rises from the heart connection to the lung, emerges from the axilla, descends along the posterior-medial aspect of the arm, posterior to the Hand Taiyin and Hand Jueyin, passes the medial elbow, follows the posterior-medial forearm, and reaches the tip of the radial styloid process. Additionally, the Hand Taiyang Small Intestine Meridian ascends from the arm, winds around the scapula, and crosses the shoulder; thus these symptoms occur.)
When Heart Qi is Deficient, the chest and abdomen become distended, and there is pulling pain between the hypochondrium and the waist. (The Hand Jueyin Pericardium Meridian originates in the chest, belongs to the Pericardium, descends through the diaphragm, and interconnects with the Sanjiao; its branch follows the chest to emerge at the hypochondrium. The Hand Shaoyin Heart Meridian descends from the heart connection through the diaphragm to connect with the Small Intestine. Thus these symptoms arise.)
When the Spleen is diseased, the body feels heavy, muscles may atrophy, the feet cannot support walking, and there is frequent pain in the soles of the feet. ("Kui" refers to pediatric malnutrition syndrome. The Spleen corresponds to Earth and governs muscles, hence heaviness and muscle atrophy. The Foot Taiyin Spleen Meridian originates at the tip of the great toe, ascends along the medial aspect of the toe to the anterior edge of the medial malleolus, and continues up the medial leg. The Foot Shaoyin Kidney Meridian originates below the little toe,斜趋es the sole, ascends the medial leg, emerges anterior to the medial malleolus; thus disease manifests as inability to support the feet, frequent Kui, and pain in the soles.)
When Spleen Qi is Deficient, there is abdominal distension and fullness, borborygmus, undigested stool diarrhea, and food stagnation. (The Foot Taiyin Spleen Meridian enters the abdomen from the anterior medial thigh, belongs to the Spleen, and connects with the Stomach, hence these symptoms. The *Ling Shu* states: "Deficiency of Middle Qi causes frequent abdominal fullness and borborygmus.")
When the Lung is diseased, there is wheezing, coughing, rebellious Qi, shoulder and back pain, sweating, and pain in the sacrum, yin region, thighs, knees, hips, calves, and feet. The Lung stores Qi and governs respiration; its pathological change manifests as coughing, hence wheezing, coughing, and rebellious Qi. The back is the mansion of the chest, and the shoulder is proximate to it, hence shoulder and back pain. The Lung nourishes skin and hair; when pathogenic factors are excess, Heart fluids leak outward, hence sweating. The Foot Shaoyin Kidney Meridian ascends from the foot along the medial calf, emerges anterior to the medial malleolus, ascends the posterior-medial thigh, penetrates the spine, belongs to the Kidney, and connects with the Bladder. Now, Lung disease affects the Kidney meridian, hence pain in the sacrum, yin region, thighs, knees, hips, calves, and feet.)
When Lung Qi is Deficient, there is shortness of breath with inability to complete inhalation, deafness, and dry throat. (Qi deficiency leads to insufficient breath completion. The Luo-connecting vessel of the Foot Taiyin Lung Meridian converges in the ear, hence deafness. The Foot Shaoyin Kidney Meridian ascends from the Kidney through the Liver and Diaphragm, enters the Lung, and follows the throat flanking the tongue root. Now, Lung deficiency causes insufficient Kidney Qi to moisten the throat upward, hence dry throat.)
When the Kidney is diseased, there is abdominal distension, swelling of the calves, wheezing and coughing, body heaviness, nocturnal sweating, and aversion to wind. (The Foot Shaoyin Kidney Meridian originates at the foot, ascends the medial calf, passes through the transverse bone, runs alongside the umbilicus within the abdomen, ascends into the Lung; hence abdominal distension, calf swelling, and wheezing/coughing. Kidney disease impairs bone function, hence body heaviness. Kidney pathogens enter the Lung, weakening Heart Qi; Heart fluid becomes sweat, hence nocturnal sweating. With calf swelling and sweat leaking fluids, Yin congeals at the Xuanfu pores, Yang scorches the Lower Jiao, creating internal heat and external cold, hence aversion to wind.)
When Kidney Qi is Deficient, there is pain in the chest, pain in the greater and lesser abdomen, cold extremities with reversal cold, and low spirits/unhappiness. (The Foot Shaoyin Kidney Meridian exits the Lung, connects with the Heart, and pours into the chest. With Kidney Qi deficient, the Heart lacks control; Heart Qi scorches the Lung, hence pain gathering in the chest. The Foot Taiyang Bladder Meridian descends from the nape to the foot. Kidney deficiency prevents Taiyang Qi from prospering in the feet, hence cold feet and rebellious Qi. "Qing" means cold/chilly. "Jue" means reversal cold. Due to cold Qi rebellion, there is pain in the greater and lesser abdomen. Insufficient willpower leads to restless spirit, hence unhappiness.)