大哉医乎。其来远矣。粤自混沌既判。洪荒始分。太阳之轻清者。以气而上浮者为天。
之重浊者。以形而下凝者为地。天确然而位乎上。地焕然而位乎下。于是阳之精者为日。东
升而西坠。阴之精者为月。夜见而昼阴。两仪立矣。二曜行焉。于是玄气凝空。水始生也。
赤气炫空。火始生也。苍气浮空。木始生也。素气横空。金始生也。黄气际空。土始生也。
五行备。万物生。三才之道着矣。是以人之生也。禀天地之阴阳。假父母之精血。交感凝结
。以为胞胎也。干道成男。坤道成女。始自襁褓。以至龆龄。迨其成童。与夫壮年。岂易然
哉。故一月之原。有白露之称。三月之胚。有干桃花之譬。及其三月。则先生右肾而为男。
阴包阳也。先生左肾而为女。阳包阴也。其次肾生脾。脾生肝。肝生肺。肺生心。以生其胜
己者。肾属水。故五脏由是为阴。其次心生小肠。小肠生大肠。大肠生胆。胆生胃。胃生膀
胱。膀胱生三焦。以生其己胜也。小肠属火。六腑由是为阳。其次三焦生八脉。八脉生十二
经。十二经生十二络。十二络生一百八十丝络。一百八十丝络生一百八十缠络。一百八十缠
络生三万四千经络。三万四千经络生三百六十五骨节。生三百六十五大穴。三百六十五大穴。
生八万四千毛窍。则耳目口鼻四肢百骸之身皆备矣。所谓四月形像具。五月筋骨成。六月毛发
生。七月则游其魂儿能动其左手。八月游其魄。儿能动其右手。九月三转身。十月满足母子
分。其中有延月生者。必生贵子。不足日月生者。必生贫贱之人。诞生之后,有变蒸之热。
长其精神。壮其筋骨。生其意志。变蒸已毕。一岁期焉。齿生发长。神志有异于前也。故曰
。齿者肾之余也。爪者筋之余也。神者气之余也。吁。人身之难得也如此哉。方其幼也。有
如水面之泡。草头之露。气血未定。易寒易热。肠胃软脆,易饥易饱。为母者调摄不得其宜
。必不免吐泻惊疳之病矣。及其长也。嗜欲既开。不能修养。是以六气逆侵于其外。七情交
战于其中。百忧累其心。万事劳其神。一融之气,安能无病焉。小儿之疮疹。大人之伤寒。
尤其甚也。是故圣人不治已病治未病。不治已乱治未乱。大病已成而后药之。乱已成而后治
之。亦犹渴而穿井。斗而铸兵。不亦晚乎。
医学之道,真是伟大啊!它的渊源非常久远。自从混沌分开,洪荒初定以来,太阳中轻清的部分,凭借气的性质向上漂浮而成为天;重浊的部分,凭借形的性质向下凝结而成为地。天稳固地位于上方,大地光辉地位于下方。于是,阳的精华化为太阳,从东方升起而在西方落下;阴的精华化为月亮,夜间显现而白天隐没(注:原文“昼阴”此处指月亮在白天不可见或属阴的特性,结合语境译为白天隐没/不显)。天地两仪确立,日月二曜运行。于是玄色的气凝聚于空中,水开始生成;赤色的气闪耀于空中,火开始生成;苍色的气浮游于空中,木开始生成;素色的气横亘于空中,金开始生成;黄色的气弥漫于空中,土开始生成。五行具备,万物由此产生,天、地、人三才的道理也就彰显出来了。
因此,人的出生,是禀受了天地的阴阳之气,借助父母的精血,通过交感凝结,形成了胞胎。乾道成就男性,坤道成就女性。从婴儿期到儿童期,再到成童期和壮年期,这一过程难道容易吗?所以,怀孕一个月时,胚胎被称为“白露”;三个月时的胎胚,被比喻为“干桃花”。到了第三个月,如果是男孩,先生右肾,因为阴包裹着阳;如果是女孩,先生左肾,因为阳包裹着阴。接着,肾生脾,脾生肝,肝生肺,肺生心,这是相生关系中克制自己的那一环(注:中医五行相生顺序为水生木、木生火、火生土、土生金、金生水,此处原文逻辑稍显特殊,通常认为肾水生肝木,肝木生心火等,原文“以生其胜己者”可能指相生链条中的下一环节,或者特定流派观点,此处依字面意译并保留原意结构,即按照五行相生次序生成)。肾属水,所以五脏由此确定为阴。接着,心生小肠,小肠生大肠,大肠生胆,胆生胃,胃生膀胱,膀胱生三焦,这是相生关系中自己所克的那一环(注:此处原文逻辑亦较独特,通常脏腑表里相合,此处描述生成次序)。小肠属火,所以六腑由此确定为阳。
接着,三焦生八脉,八脉生十二经脉,十二经脉生十二络脉,十二络脉生一百八十丝络,一百八十丝络生一百八十缠络,一百八十缠络生三万四千经络,三万四千经络生三百六十五个骨节,生三百六十五个大穴,三百六十五个大穴生八万四千毛窍。这样,耳、目、口、鼻、四肢及全身骨骼都具备了。这就是所谓的:四个月时形体像貌完备,五个月时筋骨长成,六个月时毛发生出,七个月时魂游动,胎儿能活动左手,八个月时魄游动,胎儿能活动右手,九个月时身体转动三次,十个月时足月成熟,母子分离。其中有超过十月出生的,必定生下贵子;不足十月出生的,必定生下贫贱之人。出生后,会有“变蒸”的热象,以此长养精神,强壮筋骨,生发意志。变蒸结束后,满一周岁,牙齿生长,头发长长,神志与之前有所不同。所以说:牙齿是肾的余气所化,指甲是筋的余气所化,神气是气的余气所化。唉,人身体的难得竟然如此啊!
当孩子幼小时,就像水面上的泡沫,草头上的露水,气血尚未稳定,容易受寒也容易受热;肠胃柔软脆弱,容易饥饿也容易饱胀。如果母亲调摄护理不得当,就难免患上呕吐、腹泻、惊风、疳积等疾病。等到孩子长大,嗜欲开启,不能修养身心,导致六淫邪气逆侵于外,七情内伤交战于中,百种忧虑累及其心,万事劳损其神,一身的气机,怎么能没有病呢?小儿的疮疹,大人的伤寒,尤其严重。所以圣人不是治疗已经发生的疾病,而是预防未发生的疾病;不是治理已经发生的混乱,而是预防未发生的混乱。大病已经形成再去用药,混乱已经造成再去治理,这就像口渴了才去挖井,要打仗了才去铸造兵器,不也太晚了吗?
The Way of Medicine is truly great! Its origins are far-reaching. Since the separation of chaos and the beginning of the primordial age, the light and pure aspects of Taiyang (Supreme Ultimate) floated upward by virtue of Qi to become Heaven; the heavy and turbid aspects condensed downward by virtue of Form to become Earth. Heaven stands firmly in the upper position, and Earth shines brightly in the lower position. Thus, the essence of Yang became the Sun, rising in the East and setting in the West; the essence of Yin became the Moon, appearing at night and hidden during the day. The Two Modes (Liangyi, i.e., Yin and Yang) were established, and the Two Luminaries (Sun and Moon) moved. Thus, the dark Qi condensed in the void, and Water began to generate; the red Qi dazzled in the void, and Fire began to generate; the blue/green Qi floated in the void, and Wood began to generate; the white Qi stretched across the void, and Metal began to generate; the yellow Qi permeated the void, and Earth began to generate. With the Five Elements (Wuxing) complete, all things were born, and the Dao of the Three Powers (Heaven, Earth, and Humanity) was revealed.
Therefore, human birth involves inheriting the Yin and Yang of Heaven and Earth, borrowing the essence and blood of parents, undergoing interaction and condensation to form the fetal sac. The Dao of Qian (Heaven/Yang) forms the male, and the Dao of Kun (Earth/Yin) forms the female. From infancy to childhood, then to pre-adolescence and adulthood, is this process easy? Hence, at one month of gestation, the embryo is called "White Dew"; at three months, the fetal mass is likened to "Dried Peach Blossom". By the third month, if it is a boy, the right Kidney generates first, as Yin envelops Yang; if it is a girl, the left Kidney generates first, as Yang envelops Yin. Subsequently, the Kidney generates the Spleen, the Spleen generates the Liver, the Liver generates the Lung, and the Lung generates the Heart, following the generative sequence. The Kidney belongs to Water, thus the Zang Organs (Five Viscera) are determined as Yin. Subsequently, the Heart generates the Small Intestine, the Small Intestine generates the Large Intestine, the Large Intestine generates the Gallbladder, the Gallbladder generates the Stomach, the Stomach generates the Bladder, and the Bladder generates the Sanjiao (Triple Burner), following another generative sequence. The Small Intestine belongs to Fire, thus the Fu Organs (Six Bowels) are determined as Yang.
Subsequently, the Sanjiao generates the Eight Extraordinary Vessels, the Eight Extraordinary Vessels generate the Twelve Primary Meridians, the Twelve Primary Meridians generate the Twelve Collaterals, the Twelve Collaterals generate 180 Silk-like Collaterals, the 180 Silk-like Collaterals generate 180 Coiled Collaterals, the 180 Coiled Collaterals generate 34,000 Meridian Channels, the 34,000 Meridian Channels generate 365 Bone Joints, the 365 Bone Joints generate 365 Major Acupoints, and the 365 Major Acupoints generate 84,000 Hair Pores. Thus, the ears, eyes, mouth, nose, limbs, and entire skeletal structure are complete. This is what is meant by: at four months, the physical form is complete; at five months, sinews and bones are formed; at six months, hair grows; at seven months, the Hun (Ethereal Soul) moves, and the fetus can move its left hand; at eight months, the Po (Corporeal Soul) moves, and the fetus can move its right hand; at nine months, the body turns three times; at ten months, full term is reached, and mother and child separate. Those born after exceeding ten months will surely be noble children; those born before full term will surely be people of low status. After birth, there is the heat of Bianzheng (Metamorphosis and Steaming), which nourishes the spirit, strengthens the sinews and bones, and develops the will. Once Bianzheng is complete, the child reaches one year of age, teeth grow, hair lengthens, and the mind and consciousness differ from before. It is said: Teeth are the surplus of the Kidney; Nails are the surplus of the Sinews; Spirit (Shen) is the surplus of Qi. Alas, how precious is the human body!
In early childhood, one is like bubbles on water or dew on grass; Qi and Blood are not yet settled, prone to both cold and heat; the intestines and stomach are soft and fragile, prone to both hunger and satiety. If the mother fails to provide proper care and regulation, diseases such as vomiting, diarrhea, convulsions, and malnutrition (Gan syndrome) are inevitable. As the child grows, desires open up, and self-cultivation is neglected. Consequently, the Six Evils (pathogenic factors) invade from outside, and the Seven Emotions clash within. A hundred worries burden the heart, and ten thousand tasks exhaust the spirit. How can the Qi of the body remain free of disease? The rashes and sores of children and the Shanghan (Cold Damage) of adults are particularly severe. Therefore, the sages do not treat disease that has already occurred but prevent disease that has not yet occurred; they do not govern chaos that has already arisen but prevent chaos that has not yet arisen. To use medicine only after a major illness has formed, or to govern only after chaos has erupted, is like digging a well only when thirsty or forging weapons only when battle begins. Is this not too late?