暴死,乃真死也。皆死于片晌半日,或一日二日。如非卒中,可再醒也。
〔《灵》〕黄帝曰∶其有卒然暴死暴病者,何也?少师答曰∶三虚者,其死暴疾也。得三实者,
邪不能伤人也。黄帝曰∶愿闻三虚?少师曰∶乘年之衰,逢月之空,失时之和,因为贼风所伤,
是为三虚。故论不知三虚,工反为粗。帝曰∶愿闻三实?少师曰∶逢年之盛,遇月之满,得时之和,
虽有贼风邪气,不能危之。(岁露篇)
三虚相搏,则为暴病卒死。(全文见诊岁为病。)
运气暴死暴病有四∶
一曰虚。经云∶六位之气盈何如?岐伯曰∶大少异也。大者之至徐而常,少者之至暴而亡
是也。盖暴虽谓所至之气,然病气皆在其中也。
二曰火。经曰∶火郁之发,甚则闷,懊 ,善暴死。又云∶少阴所至为暴死。又云∶少阳司
天之政,三之气,炎暑至,民病暴死。又云∶阳明司天之政,二之气,荣厉大至,民善暴死。又
云∶少阳所至,为暴病是也。
三曰风火。经云∶少阳司天,火气下临,风行于地,其主暴速。又云∶厥阴司天,风气下临,其
发机速,主所谓变化卒急,其为疾病,速在发机是也。
四曰金。经云∶金太过曰坚成,坚成之纪,其动暴折疡疰是也。此金兼火化之气,金主折,
火主暴也。
〔《灵》〕雷公曰∶人不病而卒死,何以知之?黄帝曰∶火气入于脏腑者,不病而卒死矣。
雷公曰∶病小愈而卒死者,何以知之?黄帝曰∶赤色出两颧,大如拇指者,病虽小愈,必卒死。黑
色出于庭,大如拇指,必不病而卒死。(赤色出两颧,即脉诀所谓暴病如妆不久居者是也。
五色篇)
太阳根于至阴,结于命门。命门者,目也。太阳为开。开折则肉节渎而暴病起矣。故暴病者,
取之太阳,视有余不足。渎者,皮肉宛 而弱也。(根结篇)
暴死,是指真正的死亡。通常发生在片刻、半天或一两天之内。如果不是中风暴厥,还有可能再次苏醒。
《灵枢》记载:黄帝问:那些突然暴死或突发急病的人,是什么原因造成的?少师回答:遇到“三虚”的情况,就会发生暴死的急症。如果得到“三实”,邪气就不能伤害人体。黄帝说:我想听听什么是“三虚”。少师说:趁着年份的衰退(运气不及),逢上月亮亏空的时候(月廓空),又违背了四时气候的和谐(失时之和),因此被贼风所伤,这就叫做“三虚”。所以,医工如果不了解“三虚”,反而显得粗疏。黄帝说:我想听听什么是“三实”。少师说:逢上年份的旺盛(运气太过),遇上月亮圆满的时候(月郭满),得到四时气候的调和,即使有贼风邪气,也不能危害人体。(出自《素问·岁露论》)
“三虚”相互搏结,就会导致暴病和猝死。(全文详见《诊要经终论》相关部分。)
第一种是虚。经文说:六步主气的盛衰如何?岐伯说:大(太过)与小(不及)是不同的。大(太过之气)到来缓慢而持久,小(不及之气)到来暴急而短暂,说的就是这种情况。虽然“暴”指的是所至之气的特性,但病气都包含在其中。
第二种是火。经文说:火郁发之时,严重时会出现胸闷、烦闷懊恼,容易突然死亡。又说:少阴君火所至,会导致暴死。又说:少阳相火司天执政时,第三步气(三之气),炎热暑气到来,民众易患暴死之病。又说:阳明燥金司天执政时,第二步气(二之气),温热厉气大行,民众容易暴死。又说:少阳所至,表现为暴病,说的就是这种情况。
第三种是风火。经文说:少阳司天,火气下临,风气行于地,其发病暴急迅速。又说:厥阴风木司天,风气下临,其发作如机括触发般迅速,主要体现为变化猝急,其所引发的疾病,发病速度极快,说的就是这种情况。
第四种是金。经文说:金气太过称为“坚成”,在坚成之年,其变动表现为突然折损、疮疡和注病(传染性或流注性疾病)。这是金兼带火化的气,金主折损,火主暴烈。
《灵枢》记载:雷公问:人没有明显病症却突然死亡,怎么知道原因呢?黄帝说:火气侵入脏腑的,会在无明显外症的情况下突然死亡。雷公问:病情轻微好转后却突然死亡的,怎么知道原因呢?黄帝说:如果两颧出现赤色,大小如拇指,虽然病情看似稍有好转,但必定会突然死亡。黑色出现在天庭(前额中央),大小如拇指,必定是无病而突然死亡。(两颧出现赤色,即《脉诀》所说的“暴病如妆,不久居”,指假神现象。出自《素问·五色篇》)
足太阳膀胱经根于至阴穴,结于命门。命门,指的是眼睛。太阳经主“开”。如果“开”的功能衰竭,则肌肉关节疏松弛缓,暴病就会发生。所以治疗暴病,应取太阳经穴位,根据有余或不足进行补泻。所谓“渎”,是指皮肉松弛萎弱无力。(出自《灵枢·根结篇》)
Sudden death refers to true death. It typically occurs within moments, half a day, or one to two days. If it is not due to stroke or syncope (Zhong Feng), revival may be possible.
The *Ling Shu* records: The Yellow Emperor asked, "What causes sudden death or acute illness?" Master Shao answered, "When the 'Three Deficiencies' (San Xu) are present, death occurs suddenly and rapidly. When the 'Three Excesses/Realities' (San Shi) are encountered, pathogenic factors cannot harm the human body." The Yellow Emperor said, "I wish to hear about the Three Deficiencies." Master Shao said, "When the year's qi is deficient (Cheng Nian Zhi Shuai), coinciding with the waning moon (Feng Yue Zhi Kong), and failing to harmonize with the seasonal climate (Shi Shi Zhi He), one is then injured by thieving wind (Zeifeng). This is called the Three Deficiencies. Therefore, if physicians do not understand the Three Deficiencies, they remain crude in their practice." The Yellow Emperor said, "I wish to hear about the Three Excesses." Master Shao said, "When the year's qi is abundant (Feng Nian Zhi Sheng), coinciding with the full moon (Yu Yue Zhi Man), and obtaining the harmony of seasons (De Shi Zhi He), even if thieving wind and pathogenic factors exist, they cannot endanger life." (From *Su Wen: Sui Lu Pian*)
When the Three Deficiencies combine, they lead to acute illness and sudden death. (The full text is found in discussions on diagnosing illnesses based on annual patterns.)
There are four types of sudden death and acute illness caused by Five Movements and Six Qi (Yunqi):
First is Deficiency (Xu). The classic states: "How are the six positions of qi盈 (full/excessive) and empty?" Qibo answered, "They differ greatly between excess and deficiency. The arrival of excess (Da) is slow and constant; the arrival of deficiency (Shao) is violent and fleeting." Although 'sudden' refers to the nature of the arriving qi, the pathological qi is contained within it.
Second is Fire (Huo). The classic states: "When fire depression erupts (Huo Yu Zhi Fa), severe cases involve chest oppression and restlessness (Ao Nu), leading to sudden death." It also states: "Where Shaoyin (Lesser Yin) arrives, sudden death occurs." Furthermore: "When Shaoyang (Lesser Yang) governs the Heavenly Qi (Si Tian), during the third phase (San Zhi Qi), intense heat and summer heat arrive, causing the people to suffer from sudden death." Also: "When Yangming (Greater Yang) governs the Heavenly Qi, during the second phase (Er Zhi Qi), warm and pestilential qi prevails, and the people are prone to sudden death." Additionally: "Where Shaoyang arrives, it manifests as acute illness."
Third is Wind-Fire (Feng Huo). The classic states: "When Shaoyang governs the Heavenly Qi, fire qi descends, and wind moves on the earth; its onset is sudden and rapid." It also states: "When Jueyin (Terminal Yin) governs the Heavenly Qi, wind qi descends; its eruption is swift like a trigger mechanism, characterized by sudden changes and urgency. The diseases arising from this occur with extreme speed."
Fourth is Metal (Jin). The classic states: "Excessive Metal is called 'Solid Formation' (Jian Cheng). In years of Solid Formation, the movement involves sudden fracture/breakage (Bao Zhe), sores, and infectious diseases (Zhu Zhu)." This represents Metal combined with Fire transformation. Metal governs breaking/fracturing, while Fire governs suddenness/violence.
The *Ling Shu* records: Lei Gong asked, "How can we know why a person dies suddenly without prior illness?" The Yellow Emperor answered, "When Fire Qi enters the Zang-Fu organs, death occurs suddenly without preceding symptoms." Lei Gong asked, "How can we know why a person dies suddenly after a minor illness has seemingly improved?" The Yellow Emperor answered, "If red color appears on both cheekbones (Liang Quan), the size of a thumb, although the illness seems slightly better, sudden death is inevitable. If black color appears on the forehead center (Ting), the size of a thumb, death will occur suddenly without prior illness." (Red appearing on the cheekbones corresponds to the pulse manual's description of 'acute illness presenting with makeup-like flush, indicating life is short,' referring to false spirit phenomena. From *Su Wen: Wu Se Pian*)
The Foot-Taiyang Bladder Meridian originates at Zhiyin (BL67) and terminates at Mingmen. Mingmen refers to the eyes. The Taiyang meridian governs 'Opening'. If the Opening function collapses, muscle joints become lax and disordered, leading to the onset of acute illness. Therefore, for treating acute illness, one should select points from the Taiyang meridian and assess whether there is excess or deficiency. 'Du' refers to the flaccidity and weakness of skin and flesh. (From *Ling Shu: Gen Jie Pian*)