30.五运六气之为病, 名异情同气质分, 今将二病归为一, 免使医工
枉费心.
【注】五运六气之为病, 虽其名有木, 火, 土, 金, 水, 风, 火, 湿
,燥, 寒之异, 而其实为病之情状则同也. 今将木运之病, 风气之病
,火运之病, 暑气之病, 土运之病, 湿气之病, 金运之病, 燥气之病
,水运之病, 寒气之病, 总归为一病. 不使初学医工, 枉费心思而不
得其头绪也.
31.诸风掉眩属肝木, 诸暴强直风所因, 支痛软戾难转侧, 里急筋缩
两胁疼.
【注】在天为风, 在地为木, 在人为肝, 在体为筋. 风气通于肝, 故
诸风为病, 皆属于肝木也. 掉, 摇动也, 眩, 昏运也. 风主动旋, 故
病则头身摇动目昏眩运也. 暴, 猝也, 强直, 筋病, 强急不柔也. 风
性劲急, 风入于筋, 故病则猝然筋急强直也. 其四肢拘急疼痛, 筋软
短缩, 乖戾失常, 难于转侧, 里急胁痛, 亦皆风伤其筋, 转入里病也
.
32.诸痛痒疮属心火, 诸热昏瘖躁谵狂, 暴注下迫呕酸苦, 膺背彻痛
血家殃.
【注】在天为热, 在地为火, 在人为心, 在体为脉. 热气通于心, 故
诸火痛痒疮之病, 皆属于心火也. 热微则燥, 皮作痒. 热甚则灼, 肤
作痛. 热入经脉与血凝结, 浅则为痈, 深则为疽, 更深入之, 则伤脏
腑.心脏神, 热乘于心, 则神不明, 故昏冒不省人事也. 心主言, 热
乘于心, 则神不辨, 故瘖而不能言, 或妄言而谵语也. 火主动, 热乘
于身 , 则身动而不宁, 故身躁扰, 动甚则发狂也. 暴注者, 猝暴水
泻,火与水为病也. 下迫者, 后重里急, 火与气为病也. 呕吐酸苦,
火病胃也. 膺背彻痛, 火伤胸也. 血家殃者, 热入于脉, 则血满腾,
不上溢则下泻, 而为一切失血之病也.
33.诸湿肿满属脾土, 霍乱积饮痞闭疼, 食少体重肢不举, 腹满肠鸣
飧泄频.
【注】在天为湿, 在地为土, 在人为脾, 在体为肉. 湿气通于脾, 故
诸湿为病, 皆属于脾土也. 湿蓄内外, 故肉肿腹满也. 饮乱于中, 故
病霍乱也. 脾失健运, 故病积饮也. 脾气凝结, 故病痞硬、便闭而痛
也.脾主化谷, 病则食少也. 脾主肌肉, 湿胜故身重也. 脾主四肢,
四肢不举, 亦由湿使然也. 脾主腹, 湿淫腹疾, 故腹满、肠呜、飧泄
也.
34.诸气膹郁痿肺金, 喘咳痰血气逆生, 诸燥涩枯涸干劲, 皴揭皮肤
肩臂疼.
【注】在天为燥, 在地为金, 在人为肺, 在体为皮. 燥气通于肺, 故
诸燥气为病, 皆属于肺金也. 膹郁, 谓气逆胸满, 膹郁不舒也. 痿 ,
谓肺痿咳嗽, 唾浊痰涎不巳也. 喘咳气逆、唾痰涎血, 皆肺病也. 凡
涩枯涸干劲, 皆燥之化也. 干劲似乎强直, 皆筋劲病也. 故猝然者,
多风入而筋劲也. 久之者, 多枯燥而筋劲也. 皴, 肤皴涩也. 揭, 皮
揭起也, 此燥之病乎外也. 臂痛肩痛也, 亦燥之病于经也.
35. 诸寒收引属肾水, 吐下腥秽彻清寒, 厥逆禁固骨节痛, 症瘕??
疝腹急坚.
【注】在天为寒, 在地为水, 在人为肾, 在体为骨. 寒气通于肾, 故
诸寒气为病, 皆属于肾水也. 收、敛也, 引, 急也. 肾属水, 其化寒
,敛缩拘急, 寒之化也. 热之化, 吐下酸苦, 故寒之化, 吐下腥秽也
.热之化, 水液浑浊, 故寒之化, 澄彻清冷也. 厥逆, 四肢冷也. 禁
固,收引坚劲. 寒伤于外, 则骨节痛也. 寒伤于内, 则症瘕,?? 疝,
腹急坚痛也.
30. 五运六气所致的疾病,虽然名称不同但病情相似,因体质禀赋有所区别。现在将这两类疾病归为一类讨论,以免让医生徒劳耗费心思。
【注】五运六气所致的疾病,虽然其名称有木、火、土、金、水、风、暑、湿、燥、寒的区别,但其实疾病的实际表现状况是相同的。现在将木运的病、风气的病、火运的病、暑气的病、土运的病、湿气的病、金运的病、燥气的病、水运的病、寒气的病,总括归为一种病。不让初学医的人,徒费心思而不得要领。
31. 各种风病引起的震颤眩晕归属于肝木,各种突然发生的强直拘急由风邪引起,肢体支节疼痛、筋脉软弱扭曲难以转侧,腹中拘急、筋脉短缩以及两胁疼痛。
【注】在天为风,在地为木,在人为肝,在体为筋。风气通于肝,所以各种风病,都归属于肝木。掉,指摇动;眩,指昏晕。风主动旋,所以发病时头身摇动、目昏眩晕。暴,指猝然;强直,指筋病,强急不柔和。风性劲急,风邪侵入筋脉,所以发病时突然筋脉紧急强直。四肢拘急疼痛,筋脉软弱短缩,乖戾失常,难以转侧,腹中拘急胁痛,也都是风邪损伤筋脉,转入里部病变所致。
32. 各种疼痛、瘙痒、疮疡归属于心火,各种热病引起的昏厥失音、烦躁谵语发狂,突然腹泻且肛门重坠、呕吐酸苦之物,胸背彻痛以及血证患者的灾殃。
【注】在天为热,在地为火,在人为心,在体为脉。热气通于心,所以各种火邪引起的疼痛、瘙痒、疮疡之病,都归属于心火。热轻微则干燥,皮肤作痒。热严重则灼烧,肌肤作痛。热邪侵入经脉与血液凝结,浅表则为痈,深部则为疽,更深入则损伤脏腑。心脏藏神,热邪乘袭于心,则神明不清,所以昏冒不省人事。心主言语,热邪乘袭于心,则神志不能辨别,所以失音不能说话,或胡言乱语。火性主动,热邪侵袭身体,则身体躁动不安宁,所以身体烦躁扰动,动得厉害则发狂。暴注,指猝然水样腹泻,是火与水相搏为病。下迫,指后重里急,是火与气相搏为病。呕吐酸苦,是火邪犯胃。胸背彻痛,是火邪损伤胸部。血家殃者,热邪入于脉中,则血液满溢沸腾,不上溢则下泻,从而成为一切失血性疾病。
33. 各种湿邪引起的肿胀胀满归属于脾土,霍乱、停饮、痞塞闭结疼痛,食欲减少、身体沉重、四肢不能抬举,腹部胀满、肠鸣、完谷不化的泄泻频繁。
【注】在天为湿,在地为土,在人为脾,在体为肉。湿气通于脾,所以各种湿邪为病,都归属于脾土。湿邪蓄积于内外,所以肌肉肿胀、腹部胀满。水饮扰乱于中焦,所以患霍乱病。脾失去健运功能,所以患停饮病。脾气凝结,所以患痞硬、便秘而疼痛。脾主消化谷物,患病则食欲不振。脾主肌肉,湿邪偏胜所以身体沉重。脾主四肢,四肢不能抬举,也是由湿邪所致。脾主腹部,湿邪淫溢导致腹部疾病,所以出现腹部胀满、肠鸣、完谷不化的泄泻。
34. 各种气机壅滞郁结、痿证归属于肺金,气喘咳嗽、痰中带血、气逆而生,各种干燥涩滞、枯涸、干劲、皮肤皴裂脱屑以及肩臂疼痛。
【注】在天为燥,在地为金,在人为肺,在体为皮。燥气通于肺,所以各种燥气为病,都归属于肺金。膹郁,指气逆胸满,膹郁不舒展。痿,指肺痿咳嗽,吐出浊痰涎沫不止。气喘咳嗽、气逆、唾出痰涎血液,都是肺病。凡是涩、枯、涸、干、劲,都是燥的化生表现。干劲似乎像强直,都是筋脉劲急的病证。所以猝然发作的,多是风邪入内导致筋脉劲急。病程长久的,多是枯燥导致筋脉劲急。皴,指皮肤皴裂涩滞。揭,指皮肤掀起脱落,这是燥邪致病于体表。臂痛肩痛,也是燥邪致病于经络。
35. 各种寒邪引起的收缩牵引归属于肾水,呕吐下利腥秽清冷,四肢厥逆、关节僵硬疼痛,症瘕积聚、疝气、腹部拘急坚硬。
【注】在天为寒,在地为水,在人为肾,在体为骨。寒气通于肾,所以各种寒气为病,都归属于肾水。收,即收敛;引,即紧急。肾属水,其化气为寒,收敛缩急,是寒的化生表现。热的化生,呕吐下利物酸苦,所以寒的化生,呕吐下利物腥秽。热的化生,水液浑浊,所以寒的化生,澄澈清冷。厥逆,指四肢寒冷。禁固,指收缩牵引、坚劲。寒邪伤于外,则骨节疼痛。寒邪伤于内,则形成症瘕、疝气,腹部拘急坚硬疼痛。
30. Diseases caused by the Five Movements and Six Qi, though differing in name, share similar pathological conditions but vary according to constitutional endowment. Now, these two types of diseases are categorized together to prevent physicians from expending effort in vain.
[Note] Diseases caused by the Five Movements and Six Qi, although named differently as Wood, Fire, Earth, Metal, Water, Wind, Summer-heat, Dampness, Dryness, and Cold, actually present with similar clinical manifestations. Here, diseases associated with Wood Movement, Wind Qi, Fire Movement, Summer-heat Qi, Earth Movement, Dampness Qi, Metal Movement, Dryness Qi, Water Movement, and Cold Qi are collectively grouped into one category. This is done so that novice practitioners do not waste their mental energy without finding the underlying principles.
31. Various wind-induced tremors and vertigo belong to Liver Wood; sudden stiffness and rigidity are caused by Wind. Pain in limbs and joints, flaccidity and twisting of sinews making turning difficult, abdominal tension, tendon shortening, and pain in both hypochondria are all involved.
[Note] In Heaven it is Wind, in Earth it is Wood, in Humans it is the Liver, and in the body it is the Sinews. Wind Qi connects with the Liver; therefore, all wind-related diseases belong to Liver Wood. "Diao" refers to shaking or trembling; "Xuan" refers to dizziness or vertigo. Wind governs movement and rotation; thus, when diseased, the head and body shake, and vision becomes dizzy. "Bao" means sudden; "Qiangzhi" refers to a sinew disease characterized by stiffness and lack of flexibility. The nature of Wind is vigorous and urgent; when Wind enters the sinews, sudden stiffness and rigidity occur. Cramping and pain in the four limbs, softness and shortening of sinews, abnormal dysfunction making turning difficult, abdominal tension, and hypochondriac pain are also due to Wind damaging the sinews and transitioning into interior pathology.
32. Various pains, itching, and sores belong to Heart Fire; various heat-induced coma, aphonia, restlessness, delirium, and mania; sudden diarrhea with tenesmus; vomiting of sour and bitter fluids; penetrating pain in the chest and back; and calamities for those with blood disorders.
[Note] In Heaven it is Heat, in Earth it is Fire, in Humans it is the Heart, and in the body it is the Vessels (Mai). Heat Qi connects with the Heart; therefore, all fire-induced diseases such as pain, itching, and sores belong to Heart Fire. Mild heat causes dryness and skin itching. Severe heat causes burning and skin pain. When Heat enters the vessels and coagulates with Blood, superficial involvement results in carbuncles (Yong), while deep involvement results in ulcers (Ju); further penetration damages the Zang-Fu organs. The Heart houses the Spirit (Shen); when Heat attacks the Heart, the Spirit becomes unclear, leading to coma and loss of consciousness. The Heart governs speech; when Heat attacks the Heart, the Spirit cannot discern, leading to aphonia and inability to speak, or delirious speech. Fire governs movement; when Heat invades the body, the body moves restlessly, causing agitation, which may progress to mania if severe. "Baozhu" refers to sudden watery diarrhea, caused by the interaction of Fire and Water. "Xiapo" refers to tenesmus and abdominal urgency, caused by the interaction of Fire and Qi. Vomiting sour and bitter fluids indicates Fire affecting the Stomach. Penetrating pain in the chest and back indicates Fire injuring the Chest. Calamity for blood patients occurs because Heat entering the vessels causes blood to overflow; if it does not flow upward, it flows downward, resulting in all kinds of hemorrhagic diseases.
33. Various dampness-induced swelling and fullness belong to Spleen Earth; cholera, retained fluid, stagnation, obstruction, and pain; decreased appetite, heavy body, and inability to lift the limbs; abdominal distension, borborygmus, and frequent incomplete digestion diarrhea.
[Note] In Heaven it is Dampness, in Earth it is Earth, in Humans it is the Spleen, and in the body it is Flesh/Muscle. Dampness Qi connects with the Spleen; therefore, all dampness-related diseases belong to Spleen Earth. Accumulation of Dampness internally and externally leads to flesh swelling and abdominal fullness. Disturbance of fluids in the middle jiao leads to Cholera. Loss of Spleen's transportive function leads to retained fluid. Congestion of Spleen Qi leads to stagnation, hardness, constipation, and pain. The Spleen governs the transformation of food; when diseased, appetite decreases. The Spleen governs muscles; excessive Dampness leads to heaviness of the body. The Spleen governs the four limbs; inability to lift the limbs is also caused by Dampness. The Spleen governs the abdomen; Dampness invading the abdomen leads to abdominal fullness, borborygmus, and diarrhea with undigested food.
34. Various qi stagnation, depression, and flaccidity belong to Lung Metal; wheezing, coughing, phlegm with blood, and rising qi; various dryness, astringency, withering, dehydration, stiffness, skin cracking and peeling, and shoulder-arm pain.
[Note] In Heaven it is Dryness, in Earth it is Metal, in Humans it is the Lung, and in the body it is Skin. Dryness Qi connects with the Lung; therefore, all dryness-related diseases belong to Lung Metal. "Fenyu" refers to rebellious qi, chest fullness, and stifling sensation without relief. "Wei" refers to Lung Wei with coughing and continuous expectoration of turbid phlegm and saliva. Wheezing, coughing, rebellious qi, and expectoration of phlegm and blood are all Lung diseases. Astringency, withering, dehydration, dryness, and stiffness are all transformations of Dryness. Stiffness resembles rigidity and involves stiff sinews. Sudden onset is often due to Wind entering and stiffening the sinews. Long-standing cases are often due to dryness causing stiff sinews. "Cun" refers to rough and astringent skin. "Jie" refers to peeling skin, indicating Dryness disease on the exterior. Shoulder and arm pain indicate Dryness disease in the meridians.
35. Various cold-induced contraction and pulling belong to Kidney Water; vomiting and purging of foul-smelling and clear-cold fluids; cold extremities, rigid joints, and pain; masses, hernias, and urgent, hard abdominal pain.
[Note] In Heaven it is Cold, in Earth it is Water, in Humans it is the Kidney, and in the body it is Bones. Cold Qi connects with the Kidney; therefore, all cold-related diseases belong to Kidney Water. "Shou" means contraction; "Yin" means urgency/tightness. The Kidney belongs to Water, its transformation is Cold, leading to contraction and cramping, which is the manifestation of Cold. The transformation of Heat involves vomiting and purging of sour/bitter fluids; thus, the transformation of Cold involves vomiting and purging of foul-smelling fluids. The transformation of Heat involves turbid fluids; thus, the transformation of Cold involves clear and cold fluids. "Jueni" refers to cold extremities. "Jingu" refers to contraction, pulling, and stiffness. Cold injuring the exterior causes joint pain. Cold injuring the interior leads to masses (Zhengjia), hernias, and urgent, hard abdominal pain.