诸风掉眩皆属于肝,诸寒收引皆属于肾,诸气 郁皆属于肺,诸湿肿满皆属于脾,诸热瞀螈皆属于火,
诸痛痒疮皆属于心,诸厥固泄皆属于下,诸痿喘呕皆属于上,诸禁鼓栗如丧神守皆属于火,诸痉项强皆属于
湿,诸逆冲上皆属于火,诸胀腹大皆属于热,诸躁狂越皆属于火,诸病有声鼓之如鼓皆属于热,诸病 肿疼酸
惊骇皆属于火,诸转反戾水液混浊皆属于热,诸病水液澄澈清冷皆属于寒,诸呕吐酸暴注下迫皆属于热。故
大要曰∶谨守病机,各司其属,有者求之,无者求之,盛者责之,虚者责之,必先五胜,(五行之胜,
即六气之胜复也。)疏其气血,令其调达,而致和平,此之谓也。
东方生风,风生木,木生酸,酸生肝,肝生筋,筋生心。(其在天为玄,在人为道,在地为化。化生五
味,道生智,玄生神,化生气。)神在天为风,在地为木,在体为筋,在气为柔,在脏为肝。其性为暄,其
德为和,其用为动,其色为苍,其化为荣,其虫毛,其政为散,其令宣发,其变摧拉,其眚为陨,其味
为酸,其志为怒。怒伤肝,悲胜怒,风伤肝,燥胜风,酸伤筋,辛胜酸。(阴阳应象有在音为角,在声为呼,
在变动为握,在窍为目。)
南方生热,热生火,火生苦,苦生心,心生血,血生脾。其在天为热,在地为火,在体为脉,在气为息,
在脏为心。其性为暑,其德为显,其用为躁,其色为赤,其化为茂,其
虫羽,其政为明,其令郁蒸,其变炎烁,其眚燔 ,其味为
苦,其志为喜。喜伤心,恐胜喜,热伤气,寒胜热,苦伤气,咸胜苦。(阴阳应象有在音为征,在声为笑,
在变动为忧,在窍为舌。)
中央生湿,湿生土,土生甘,甘生脾,脾生肉,肉生肺。其在天为湿,在地为土,在体为肉,在气为充
,在脏为脾。其性静兼,其德为濡,其用为化,其色为黄,其化为盈,其
虫,其政为谧,其令云雨,其变动注,其眚淫溃,其味为甘,其志为思。思伤脾,怒胜思,湿伤肉,风
胜湿,甘伤脾,酸胜甘。(阴阳应象有在音为宫,在声为歌,在变动为哕,在窍为口。)
西方生燥,燥生金,金生辛,辛生肺,肺生皮毛,皮毛生肾。其在天为燥,在地为金,在体为皮毛,在
气为成,在脏为肺。其性为凉,其德为清,其用为固,其色为白,其化为敛,其虫介,其政为劲,其令雾露,
其变肃杀,其眚苍落,其味为辛,其志为忧。忧伤肺,喜胜忧,热伤皮毛,寒胜热,辛伤皮毛,苦胜辛。(
阴阳应象有在音为商,在声为哭,在变动为咳,在窍为鼻。)
北方生寒,寒生水,水生咸,咸生肾,肾生骨髓,髓生肝。其在天为寒,在地为水,在体为骨,在气
为坚,在脏为肾。其性为凛。其德为寒,其用为(阙),其色为黑,其化为肃,其虫鳞,其政为静,其令(本阙
),其变凝冽,其眚冰雹,其味为咸,其志为恐。恐伤肾,思胜恐,寒伤血,燥胜寒,
咸伤血,甘胜咸。(阴阳应象有在音为羽,在声为呻,在变动为栗,在窍为耳。又按∶以例推之,中央热伤皮
毛,寒胜热,当作燥伤皮毛,热胜燥。北方寒伤血,燥胜寒,当作寒伤骨,湿胜寒。盖湿热二气相合,热胜
燥,是热而湿也。湿胜寒,是湿而热也。此五节字字精切,果能参透,万病机括,无不贯澈。上《素问》。)
假令得肝脉,其外证,善洁,面青,善怒。其内证,脐
左有动气,按之牢若痛。其病,四肢满闭,淋溲便难,转筋。有是者肝也,无是者非也。(满闭,即满痹也。旧
以闭淋二字句,误。)
假令得心脉,其外证,面赤,口干,喜笑。其内证,脐上有动气,按之牢若痛。其病,烦心,心痛,
掌中热而 。有是者心也,无是者非也。
假令得脾脉,其外证,面黄,善噫,善思,善味。其内证,当脐有动气,按之牢若痛。其病,腹胀满,食
不消,体重节痛,怠堕嗜卧,四肢不收。有是者脾也,无是者非也。
假令得肺脉,其外证,面白,善嚏,悲愁不乐,欲哭。其内证,脐右有动气,按之牢若痛。其病,喘
咳,洒淅寒热。有是者肺也,无是者非也。
假令得肾脉,其外证,面黑,善恐欠。其内证,脐下有动气,按之牢若痛。其病,逆气,小
腹急痛,泄而下重,足胫寒而逆。有是者肾也,无是者非也。(上《难经》。)
凡是风邪引起的肢体震颤、头晕目眩,都归属于肝脏;凡是寒邪引起的筋脉收缩牵引,都归属于肾脏;凡是气机郁滞不畅,都归属于肺脏;凡是湿邪引起的浮肿、胀满,都归属于脾脏;凡是热邪引起的神志昏蒙、抽搐,都归属于火(六淫中的火热之邪);凡是疼痛、瘙痒、疮疡,都归属于心脏;凡是厥逆、二便不通或失禁,都归属于下焦;凡是痿证、气喘、呕吐,都归属于上焦;凡是口噤不开、鼓颔战栗、如同失去神志控制的症状,都归属于火;凡是痉挛、项背强直,都归属于湿;凡是气机上逆冲撞,都归属于火;凡是腹部胀大,都归属于热;凡是烦躁、狂乱、行为越常度,都归属于火;凡是病证中有声响,叩击腹部如鼓声者,都归属于热;凡是肿胀、疼痛、酸楚、惊骇等症状,都归属于火;凡是身体扭转、角弓反张、小便浑浊,都归属于热;凡是排泄物清澈寒冷,都归属于寒;凡是呕吐酸水、突然暴泻且伴有肛门急迫感,都归属于热。所以医经大要说:谨慎地把握病机,分别审查其所属的脏腑经络,有是症就求其因,无是症也要探究其理,实证则责备其邪气盛,虚证则责备其正气虚,必须首先明辨五行相克的胜复关系,疏通气血,使其调和通达,从而达到阴阳平衡的状态,说的就是这个道理。
东方生风,风气滋生木行,木行滋生酸味,酸味滋养肝脏,肝脏滋养筋脉,筋脉滋养心脏。(风在天体现为玄妙之道,在人体现为生命规律,在地体现为生化作用。生化产生五味,规律产生智慧,玄妙产生神灵,生化产生元气。)神灵在天表现为风,在地表现为木,在人体组织表现为筋,在气候表现为柔和,在五脏表现为肝。风的性质是温暖,其德性是平和,其作用是运动,其颜色是苍青,其化育作用是繁荣,其对应的虫类是有毛的动物,其政令是疏散,其时令主宣发,其变异是摧折拉断,其灾害是陨落,其味道是酸,其情志是怒。怒伤肝,悲能胜怒,风伤肝,燥能胜风,酸伤筋,辛能胜酸。(《阴阳应象大论》中还有:在五音对应角,在五声对应呼,在变动对应握,在开窍对应目。)
南方生热,热气滋生火行,火行滋生苦味,苦味滋养心脏,心脏滋养血液,血液滋养脾脏。热在天体现为炎热,在地体现为火,在人体组织表现为血脉,在气候表现为气息流动,在五脏表现为心。热的性质是暑热,其德性是显扬,其作用是躁动,其颜色是赤红,其化育作用是茂盛,其对应的虫类是有羽的动物,其政令是光明,其时令主郁蒸闷热,其变异是炎烤灼烧,其灾害是焚烧,其味道是苦,其情志是喜。喜伤心,恐能胜喜,热伤气,寒能胜热,苦伤气,咸能胜苦。(《阴阳应象大论》中还有:在五音对应徵,在五声对应笑,在变动对应忧,在开窍对应舌。)
中央生湿,湿气滋生土行,土行滋生甘味,甘味滋养脾脏,脾脏滋养肌肉,肌肉滋养肺脏。湿在天体现为湿润,在地体现为土,在人体组织表现为肉,在气候表现为充盛,在五脏表现为脾。湿的性质是安静兼蓄,其德性是濡润,其作用是化生,其颜色是黄色,其化育作用是充盈,其对应的虫类是无足之虫(如蚯蚓等),其政令是静谧,其时令主云雨,其变异是暴雨倾注,其灾害是泛滥溃决,其味道是甘,其情志是思。思伤脾,怒能胜思,湿伤肉,风能胜湿,甘伤脾,酸能胜甘。(《阴阳应象大论》中还有:在五音对应宫,在五声对应歌,在变动对应哕,在开窍对应口。)
西方生燥,燥气滋生金行,金行滋生辛味,辛味滋养肺脏,肺脏滋养皮毛,皮毛滋养肾脏。燥在天体现为干燥,在地体现为金,在人体组织表现为皮毛,在气候表现为收敛成熟,在五脏表现为肺。燥的性质是清凉,其德性是清洁,其作用是固摄,其颜色是白色,其化育作用是收敛,其对应的虫类是有甲壳的动物,其政令是强劲,其时令主雾露,其变异是肃杀凋零,其灾害是草木苍白凋落,其味道是辛,其情志是忧。忧伤肺,喜能胜忧,热伤皮毛,寒能胜热,辛伤皮毛,苦能胜辛。(《阴阳应象大论》中还有:在五音对应商,在五声对应哭,在变动对应咳,在开窍对应鼻。)
北方生寒,寒气滋生水行,水行滋生咸味,咸味滋养肾脏,肾脏滋养骨髓,骨髓滋养肝脏。寒在天体现为寒冷,在地体现为水,在人体组织表现为骨,在气候表现为坚固,在五脏表现为肾。寒的性质是凛冽。其德性是寒冷,其作用是(原文缺字),其颜色是黑色,其化育作用是肃杀,其对应的虫类是有鳞的动物,其政令是静止,其时令(原文缺字),其变异是凝结严寒,其灾害是冰雹,其味道是咸,其情志是恐。恐伤肾,思能胜恐,寒伤血,燥能胜寒,咸伤血,甘能胜咸。(《阴阳应象大论》中还有:在五音对应羽,在五声对应呻,在变动对应战栗,在开窍对应耳。另外按语:以此类推,中央一节中“热伤皮毛,寒胜热”应当作“燥伤皮毛,热胜燥”。北方一节中“寒伤血,燥胜寒”应当作“寒伤骨,湿胜寒”。因为湿热二气相合,热胜燥,这是热而兼湿;湿胜寒,这是湿而兼热。这五节的文字字字精当切要,如果能参透其中道理,万病的机理没有不能贯通的。以上引自《素问》。)
假如诊得肝脉,其外在证候,表现为爱洁净,面色发青,容易发怒。其内在证候,脐左方有搏动感,按压时坚实且疼痛。其病症,表现为四肢胀满闭塞,小便淋漓困难,大便艰难,筋脉拘挛抽搐。具备这些症状的是肝病,不具备的不是肝病。(注:“满闭”即“满痹”。旧时将“闭淋”二字连读为句,是错误的。)
假如诊得心脉,其外在证候,表现为面色发红,口干,喜欢笑。其内在证候,脐上方有搏动感,按压时坚实且疼痛。其病症,表现为心烦,心痛,手掌心发热且伴有某种不适(原文此处似有脱漏,通常指烦闷或特定感觉)。具备这些症状的是心病,不具备的不是心病。
假如诊得脾脉,其外在证候,表现为面色发黄,经常嗳气,多思虑,口味异常敏感。其内在证候,正脐部有搏动感,按压时坚实且疼痛。其病症,表现为腹部胀满,食物不消化,身体沉重关节疼痛,倦怠懒卧嗜睡,四肢无力收持。具备这些症状的是脾病,不具备的不是脾病。
假如诊得肺脉,其外在证候,表现为面色苍白,经常打喷嚏,悲伤忧愁不快乐,想要哭泣。其内在证候,脐右方有搏动感,按压时坚实且疼痛。其病症,表现为气喘咳嗽,洒淅恶寒发热。具备这些症状的是肺病,不具备的不是肺病。
假如诊得肾脉,其外在证候,表现为面色发黑,容易惊恐呵欠。其内在证候,脐下方有搏动感,按压时坚实且疼痛。其病症,表现为气逆,小腹急痛,腹泻且伴有肛门重坠感,足胫寒冷且逆冷。具备这些症状的是肾病,不具备的不是肾病。(以上引自《难经》。)
All wind-induced tremors and vertigo belong to the Liver; all cold-induced contraction and pulling belong to the Kidney; all qi stagnation and depression belong to the Lung; all dampness-induced edema and fullness belong to the Spleen; all heat-induced mental clouding and convulsions belong to Fire (the pathogenic factor of Heat/Fire); all pain, itching, and sores belong to the Heart; all jue (reversal cold/heat) and retention or incontinence belong to the Lower Jiao; all wei (wasting-thirst syndrome), asthma, and vomiting belong to the Upper Jiao; all cases of locked jaws, shivering chills, and loss of spiritual control belong to Fire; all spasms and neck stiffness belong to Dampness; all rebellious qi rushing upward belong to Fire; all abdominal distension and enlargement belong to Heat; all restlessness, mania, and transgression of normal behavior belong to Fire; all diseases with sounds, where percussion of the abdomen yields a drum-like sound, belong to Heat; all swelling, pain, soreness, and fright belong to Fire; all torsion, opisthotonos, and turbid urine belong to Heat; all clear and cold excretions belong to Cold; all vomiting of sour fluid, sudden violent diarrhea with tenesmus belong to Heat. Therefore, the great principle states: Carefully observe the disease mechanism, assign each to its respective category; investigate those that are present, investigate those that are absent; hold accountable for excess conditions, hold accountable for deficiency conditions; first determine the mutual overcoming relationships of the Five Phases (i.e., the勝復 [shèng fù] cycles of the Six Qi), unblock the qi and blood, ensure their smooth flow and distribution, thereby achieving harmony. This is what is meant.
The East generates Wind; Wind generates Wood; Wood generates Sour taste; Sour taste nourishes the Liver; Liver nourishes the Sinews; Sinews nourish the Heart. (In Heaven it is profound mystery; in Humanity it is the Way; on Earth it is transformation. Transformation generates the Five Flavors; the Way generates Wisdom; Mystery generates Spirit; Transformation generates Vital Qi.) Spirit manifests as Wind in Heaven, as Wood on Earth, as Sinews in the body, as Flexibility in the qi, and as the Liver among the Zang organs. Its nature is warm; its virtue is harmonious; its function is movement; its color is green/cyan; its transformation is flourishing; its associated insects are hairy ones; its administration is dispersing; its command is dissemination; its alteration is destruction and tearing; its disaster is falling; its flavor is Sour; its emotion is Anger. Anger injures the Liver; Grief overcomes Anger; Wind injures the Liver; Dryness overcomes Wind; Sour injures the Sinews; Pungent overcomes Sour. (In *Yin Yang Ying Xiang Da Lun*, it is stated: In musical tones corresponds to Jue; in vocal sounds corresponds to Hu; in movement corresponds to grasping; in orifices corresponds to the Eyes.)
The South generates Heat; Heat generates Fire; Fire generates Bitter taste; Bitter taste nourishes the Heart; Heart nourishes Blood; Blood nourishes the Spleen. Heat manifests as Heat in Heaven, as Fire on Earth, as Vessels in the body, as Respiration in the qi, and as the Heart among the Zang organs. Its nature is summer-heat; its virtue is illumination; its function is agitation; its color is red; its transformation is luxuriance; its associated insects are feathered ones; its administration is clarity; its command is muggy oppression; its alteration is scorching fire; its disaster is burning; its flavor is Bitter; its emotion is Joy. Joy injures the Heart; Fear overcomes Joy; Heat injures Qi; Cold overcomes Heat; Bitter injures Qi; Salty overcomes Bitter. (In *Yin Yang Ying Xiang Da Lun*, it is stated: In musical tones corresponds to Zhi; in vocal sounds corresponds to Xiao; in movement corresponds to sorrow/worry; in orifices corresponds to the Tongue.)
The Center generates Dampness; Dampness generates Earth; Earth generates Sweet taste; Sweet taste nourishes the Spleen; Spleen nourishes Flesh/Muscles; Flesh/Muscles nourish the Lungs. Dampness manifests as Dampness in Heaven, as Earth on Earth, as Flesh in the body, as Fullness in the qi, and as the Spleen among the Zang organs. Its nature is quiet and inclusive; its virtue is moistening; its function is transformation; its color is yellow; its transformation is abundance; its associated insects are legless ones; its administration is tranquility; its command is clouds and rain; its alteration is torrential rain; its disaster is flooding and ulceration; its flavor is Sweet; its emotion is Pensiveness. Pensiveness injures the Spleen; Anger overcomes Pensiveness; Dampness injures Flesh; Wind overcomes Dampness; Sweet injures the Spleen; Sour overcomes Sweet. (In *Yin Yang Ying Xiang Da Lun*, it is stated: In musical tones corresponds to Gong; in vocal sounds corresponds to Ge; in movement corresponds to hiccup; in orifices corresponds to the Mouth.)
The West generates Dryness; Dryness generates Metal; Metal generates Pungent taste; Pungent taste nourishes the Lungs; Lungs nourish Skin and Hair; Skin and Hair nourish the Kidneys. Dryness manifests as Dryness in Heaven, as Metal on Earth, as Skin and Hair in the body, as Completion in the qi, and as the Lungs among the Zang organs. Its nature is cool; its virtue is pure; its function is consolidation; its color is white; its transformation is gathering/restraining; its associated insects are shelled ones; its administration is vigorous; its command is fog and dew; its alteration is austere killing/falling; its disaster is pale withering; its flavor is Pungent; its emotion is Sorrow/Grief. Sorrow injures the Lungs; Joy overcomes Sorrow; Heat injures Skin and Hair; Cold overcomes Heat; Pungent injures Skin and Hair; Bitter overcomes Pungent. (In *Yin Yang Ying Xiang Da Lun*, it is stated: In musical tones corresponds to Shang; in vocal sounds corresponds to Ku; in movement corresponds to cough; in orifices corresponds to the Nose.)
The North generates Cold; Cold generates Water; Water generates Salty taste; Salty taste nourishes the Kidneys; Kidneys nourish Marrow/Bone; Marrow/Bone nourishes the Liver. Cold manifests as Cold in Heaven, as Water on Earth, as Bones in the body, as Hardness in the qi, and as the Kidneys among the Zang organs. Its nature is biting cold; its virtue is chilling; its function is (lacuna); its color is black; its transformation is solemnity/restriction; its associated insects are scaled ones; its administration is stillness; its command is (lacuna); its alteration is freezing condensation; its disaster is hail; its flavor is Salty; its emotion is Fear. Fear injures the Kidneys; Pensiveness overcomes Fear; Cold injures Blood; Dryness overcomes Cold; Salty injures Blood; Sweet overcomes Salty. (In *Yin Yang Ying Xiang Da Lun*, it is stated: In musical tones corresponds to Yu; in vocal sounds corresponds to Shen; in movement corresponds to shivering; in orifices corresponds to the Ears. Note: By analogy, in the Central section, "Heat injures Skin and Hair, Cold overcomes Heat" should read "Dryness injures Skin and Hair, Heat overcomes Dryness." In the Northern section, "Cold injures Blood, Dryness overcomes Cold" should read "Cold injures Bones, Dampness overcomes Cold." For when Heat and Dampness combine, if Heat overcomes Dryness, it is Heat with Dampness; if Dampness overcomes Cold, it is Dampness with Heat. These five sections are precise and incisive word by word; if one can penetrate their meaning, the mechanisms of all diseases will be thoroughly understood. The above is from *Su Wen*.)
Suppose the Liver pulse is obtained: Its external signs include cleanliness obsession, greenish complexion, and irritability. Its internal signs include pulsation at the left side of the umbilicus, which feels firm and painful upon pressure. Its diseases include fullness and obstruction of the four limbs, dysuria and difficult defecation, and tendon cramping. If these signs are present, it is Liver disease; if absent, it is not. (Note: "Man Bi" refers to "Man Bi" [fullness and bi-syndrome]. Old interpretations incorrectly punctuated "Bi Lin" as a phrase.)
Suppose the Heart pulse is obtained: Its external signs include reddish complexion, dry mouth, and excessive laughter. Its internal signs include pulsation above the umbilicus, which feels firm and painful upon pressure. Its diseases include vexation, heart pain, and heat in the palms accompanied by [lacuna/discomfort]. If these signs are present, it is Heart disease; if absent, it is not.
Suppose the Spleen pulse is obtained: Its external signs include yellowish complexion, frequent belching, excessive thinking, and heightened sensitivity to taste. Its internal signs include pulsation at the center of the umbilicus, which feels firm and painful upon pressure. Its diseases include abdominal distension, indigestion, heavy body and joint pain, lethargy and desire to lie down, and weakness of the four limbs. If these signs are present, it is Spleen disease; if absent, it is not.
Suppose the Lung pulse is obtained: Its external signs include pale complexion, frequent sneezing, sadness and melancholy, and desire to cry. Its internal signs include pulsation at the right side of the umbilicus, which feels firm and painful upon pressure. Its diseases include asthma and cough, and aversion to wind with fever/chills. If these signs are present, it is Lung disease; if absent, it is not.
Suppose the Kidney pulse is obtained: Its external signs include dark complexion, frequent fearfulness, and yawning. Its internal signs include pulsation below the umbilicus, which feels firm and painful upon pressure. Its diseases include rebellious qi, acute pain in the lower abdomen, diarrhea with a sensation of heaviness/tenesmus, and coldness with reversal in the feet and calves. If these signs are present, it is Kidney disease; if absent, it is not. (The above is from *Nan Jing*.)