诸本无篇字。甲乙名四时贼风邪气大论篇。
贼风邪气（止）其故何也 张云。贼者伤害之名。凡四时不正之气。皆谓之贼风邪气。详岁露篇。室穴
者。古人多穴居也。非不离贼风邪气。言虽避风邪。而亦有病者何也。张氏医通云。按痛风一证。灵枢谓之贼
风。素问谓之痹。金匮
名曰历节。后世更名白虎历节。多由风寒湿气。乘虚袭于经络。气血凝滞所致。近世邪说盛行。而名之曰箭风。
风毒肿溃。乃谓之曰箭袋。禁绝一切汤药。恣行艾熨针挑。此虽灵枢刺布衣之法。而药熨之方。世绝不闻。使
既病之肌肉。复受无辜之痛楚。奈何懵憧无知。甘受其惑。良可概夫。
此皆尝（止）闭而不通 张云。凡此五者。皆如下文之所谓故邪也。
其开而（止）为寒痹 甲乙无其开二字。遇上有适字。马云。及其腠理开。而或遇风寒。则血气凝结。
与湿气恶血等之故邪相袭。（如春秋齐师袭莒之袭）则为寒痹。即痹论之所谓寒气胜者。为痛痹也。张云。其
开者。谓冒露于风寒也。故邪在前。风寒继之。二者相值。则血气凝结。故为寒痹。简案、据甲乙考之。马注为是。
其有热（止）有因加而发焉 张云。其或有因热汗出而受风者。虽非贼风邪气。亦为外感。必有因加而
发者。谓因于故而加以新也。新故合邪。故病发矣。
此亦有故邪（止）故似鬼神 甲乙。搏、作薄。马云。人有湿气恶血等之故邪。留而未发。因病患素
所不知。因而偶有所触。或好或恶。则血气内乱。故邪与新志相搏。遂尔为病。此其所从来者甚微。非见闻之
所能及。故人不知其故。而以鬼神为疑。乃似鬼神而非鬼神也。志云。此病气而不病形。故视之不见。听之勿
闻。若有似乎鬼神。
其祝而已者（止）可祝而已也 甲乙。祝下并有由字。病之以从生。病上有百字。张云。祝者巫咒之
属。即祝由也。胜者。凡百病五行之道。必有所以胜之者。然必先知其病所从生之由。而后以胜法胜之。则可
移精变气。祛其邪矣。病有药石所不及。非此不可者。惟先巫知之。故可祝而已也。
然则先巫用祝之妙。正不在祝。其机在胜之而已。王弘义云。上古有十三科。祝由乃其一也。先巫者。言上古
之能祝由而愈病者。谓之巫医。故古之 字从巫。非与师巫之贱役比也。南人有言曰。人而无恒。不可以作巫
医。即上古祝而已病之医。非医巫之有二也。简案、十三科。 于元。言上古者误。
介按、吴鞠通曰。按祝由二字。出自素问。祝、告也。由、病之所从出也。近时以巫家为祝由科。并列于
十三科之中。内经谓信巫不信医不治。巫岂可列之医科中哉。吾谓凡治内伤者。必先祝由详告。以病之所由来。
使病患知之。而不敢再犯。又必细体变风变雅。曲察劳人思妇之隐情。婉言以开导之。庄言以振惊之。危言以
悚惧之。必使之心悦诚服。而后可以奏效如神。
各版本均无“篇”字。《甲乙经》将其命名为《四时贼风邪气大论篇》。
问：贼风邪气（指不正之气侵袭人体所致的病证）为何会导致疾病？张景岳注：所谓“贼”，是伤害的意思。凡是四季中不合时令的异常气候，都称为贼风邪气。详见《岁露篇》。所谓“室穴”，是指古人多居住在洞穴之中。并非说他们不躲避贼风邪气，而是说即使避开了风邪，依然有人患病，这是为什么呢？《张氏医通》记载：按照痛风这一病症，《灵枢》称之为贼风，《素问》称之为痹，《金匮要略》名为历节，后世改称为白虎历节。这多是由于风寒湿气乘虚侵入经络，导致气血凝滞所致。近代邪说盛行，将此类病症称为箭风。若出现风毒肿胀溃烂，便称之为箭袋。禁止使用一切汤药，肆意施行艾灸、熨烫和针挑。这虽然是《灵枢》中针对平民百姓的治疗法则，但关于药物熨烫的方剂，世间已完全失传。使得已经患病的肌肉，再次遭受无辜的痛苦，真是令人无奈，愚昧无知，甘愿受其迷惑，实在可悲啊。
这些都是曾经（止）闭阻而不通畅。张景岳注：以上五种情况，都像下文所说的“故邪”（旧有的病邪）。
当腠理开泄时（止）则形成寒痹。《甲乙经》中没有“其开”二字，“遇”字在“上”字之上。马莳注：等到腠理开泄时，如果遇到风寒，那么血气就会凝结，与湿气、恶血等故邪相互侵袭。（如同春秋时期齐国军队袭击莒国的“袭”字含义）就会形成寒痹。即《痹论》中所说的寒气偏胜者，称为痛痹。张景岳注：“其开”，是指暴露在风寒之中。故邪先存在，风寒随后侵袭，两者相遇，导致血气凝结，所以形成寒痹。简案：根据《甲乙经》考证，马莳的注解是正确的。
如果有热（止）有因加而发焉。张景岳注：如果因为天热出汗后受风，虽然不一定是贼风邪气，但也属于外感。一定有因为旧疾加上新的诱因而发作的情况，意思是因于旧病再加上新的致病因素。新邪与故邪结合，所以疾病发作了。
这里也有故邪（止）所以看起来像鬼神。《甲乙经》中，“搏”字写作“薄”。马莳注：人有湿气、恶血等故邪，停留体内而未发作，因为病人平时不知道，于是偶然有所触动，无论是喜好还是厌恶的情绪波动，都会导致血气内部紊乱。故邪与新产生的情志相搏结，从而生病。这种病的来源非常细微，不是见闻所能达到的，所以人们不知道原因，怀疑是鬼神作祟，看起来像鬼神但实际上并不是鬼神。张志聪注：这是病在气而不在形，所以看不见，听不到，好像有鬼神一样。
那些可以通过祝由治愈的（止）可以用祝由来治愈。《甲乙经》中，“祝”字下都有“由”字。“病之”上有“百”字。张景岳注：祝，属于巫咒一类，即祝由术。胜，指五行相克的道理，所有疾病都有能够克制它的原理。但是必须先知道疾病产生的根源，然后用克制的疗法去治疗，才可以转移精神、改变气机，祛除邪气。有些疾病是药物和砭石所不能及的，非此法不可，只有以前的巫师知道这些，所以可以用祝由来治愈。
然而，古代巫师使用祝由的奥妙，重点不在于咒语本身，关键在于运用相克原理。王弘义说：上古时期有十三科，祝由就是其中之一。所谓的“先巫”，是指上古时期能够通过祝由治愈疾病的医生，称为巫医。所以古文中“医”字从“巫”，并不是指地位低下的师巫役卒。南方人有话说：“人如果没有恒心，不可以做巫医。”这就是上古时期用祝由治病医生的说法，并不是说医和巫是两回事。简案：十三科的分类始于元代，说上古就有是错误的。
介按：吴鞠通说：按“祝由”二字，出自《素问》。祝，是告述的意思；由，是疾病产生的缘由。近代将巫术之家列为祝由科，并列在十三科之中。《内经》说相信巫术不相信医学的人不治，巫术怎么能列入医科之中呢？我认为凡是治疗内伤疾病，必须先通过祝由详细告知患者疾病产生的由来，使患者知道并不敢再犯。又必须细致体会《诗经》中变风变雅所反映的社会现实，委婉地洞察劳苦人和思妇的隐情，用温和的话语开导他们，用严肃的话语振惊他们，用危言耸听的话使他们恐惧。一定要让他们心悦诚服，然后才能奏效如神。
All versions lack the character "Pian" (Chapter). The *Jia Yi Jing* names it "Da Lun Pian on Wind and Evil Qi of Four Seasons."
Question: Why do Zefeng Xieqi (pathogenic factors from irregular winds) cause disease? Zhang Yun's commentary: The term "Zei" (Thief/Bandit) refers to harm. All abnormal climatic conditions that do not conform to the four seasons are called Zefeng Xieqi. See the "Sui Lu Pian" for details. The term "Shixue" (Cave dwelling) refers to the fact that ancient people often lived in caves. It is not that they did not avoid wind and evil qi, but rather, even if one avoids wind and evil qi, some still fall ill. Why is this? *Zhang Shi Yi Tong* records: Regarding the condition known as Gout (Tongfeng), *Ling Shu* calls it Zefeng, *Su Wen* calls it Bi (Obstruction Syndrome), and *Jin Gui Yao Lue* names it Lijie (Migratory Joint Pain), later renamed Baihu Lijie (White Tiger Migratory Joint Pain). This is mostly caused by wind-cold-dampness invading the meridians when the body is deficient, leading to stagnation of blood and qi. In recent times, heretical theories have prevailed, calling this condition Jianfeng (Arrow Wind). If wind-toxin causes swelling and ulceration, it is called Jiandai (Arrow Quiver). All decoctions are forbidden, while moxibustion, hot compresses, and needle pricking are practiced indiscriminately. Although this follows the method for commoners in *Ling Shu*, the formulas for herbal hot compresses are completely lost in the world. Thus, muscles already diseased suffer innocent pain again. How can people be so ignorant, willingly falling for such confusion? It is truly lamentable.
These are all cases where [pathogens] were previously (stop) blocked and not circulating freely. Zhang Yun's commentary: All these five situations are similar to what is described below as Gu Xie (latent pathogenic factors).
When the pores open (stop) it becomes Hanbi (Cold Bi Syndrome). *Jia Yi Jing* lacks the characters "Qi Kai". The character "Yu" appears above "Shang". Ma Shi's commentary: When the couli (pores/skin texture) open, and one encounters wind-cold, then blood and qi coagulate. This interacts with latent pathogens like dampness and bad blood. (Like the military ambush of the State of Qi attacking the State of Ju in the Spring and Autumn period) resulting in Hanbi. This corresponds to what *Bi Lun* calls Tongbi (Painful Bi), which occurs when cold qi prevails. Zhang Yun's commentary: "Qi Kai" means being exposed to wind and cold. The Gu Xie is present first, followed by wind-cold. When these two meet, blood and qi coagulate, thus forming Hanbi. Brief Note: Based on *Jia Yi Jing*, Ma Shi's annotation is correct.
If there is heat (stop) it may arise from an addition. Zhang Yun's commentary: If one contracts wind after sweating due to heat, although it may not be Zefeng Xieqi, it is still an external contraction. There must be cases where the disease arises from an "addition," meaning adding a new factor to an old condition. New and old pathogens combine, causing the disease to manifest.
Here too there are Gu Xie (stop) hence it seems like ghosts and spirits. *Jia Yi Jing*: "Bo" is written as "Bo" (approach). Ma Shi's commentary: People have latent pathogens like dampness and bad blood remaining without manifesting. Because the patient is unaware of them, an accidental trigger occurs. Whether through pleasant or unpleasant emotions, internal blood and qi become chaotic. The Gu Xie contends with the new emotional state, leading to illness. The origin of this disease is very subtle, beyond the reach of ordinary observation and hearing. Therefore, people do not know the cause and suspect ghosts and spirits, appearing like them but not actually being them. Zhang Zhicong's commentary: This is a disease of Qi rather than Form, so it cannot be seen or heard, resembling ghosts and spirits.
Those who can be cured by Zhu You (stop) can be cured by Zhu You. *Jia Yi Jing*: Adds "You" after "Zhu". Adds "Bai" before "Bing". Zhang Yun's commentary: Zhu belongs to witchcraft incantations, i.e., Zhu You therapy. "Sheng" refers to the principle of overcoming; for all diseases governed by the Five Elements, there is always something that overcomes them. However, one must first know the origin of the disease, then use the overcoming method to treat it, thereby shifting spirit and changing qi to dispel evil. Some diseases are beyond the reach of herbs and needles, requiring this method alone. Only ancient shamans knew this, so it can be cured by Zhu You.
However, the subtlety of the ancient shamans using Zhu You lies not in the incantation itself, but in the mechanism of overcoming. Wang Hongyi said: In ancient times, there were thirteen departments, and Zhu You was one of them. "Xian Wu" refers to doctors in ancient times who could cure diseases through Zhu You, called Wu Yi (Shaman Doctors). Hence, the ancient character for "Yi" (Doctor) contains the radical "Wu" (Shaman), not comparing them to lowly servant shamans. A southern saying goes: "One without constancy cannot practice Shaman Medicine." This refers to the doctors of ancient times who used Zhu You to cure diseases, indicating that medicine and shamanism were not two separate things. Brief Note: The classification into thirteen departments began in the Yuan Dynasty; claiming it existed in ancient times is incorrect.
Jie An (Editor's Note): Wu Jutong stated: According to *Su Wen*, "Zhu" means to inform/tell, and "You" means the source/origin of the disease. Recently, families practicing witchcraft have been listed as the Zhu You Department among the thirteen departments. *Nei Jing* states that those who believe in witches and not in doctors shall not be treated. How can witchcraft be listed within medical departments? I believe that whenever treating internal injuries, one must first use Zhu You to detail the origin of the disease to the patient, making them aware so they dare not repeat the mistake. One must also carefully empathize with the social realities reflected in the "Bian Feng" and "Bian Ya" poems of the *Shi Jing*, gently observe the hidden feelings of laborers and longing women, guide them with gentle words, shock them with solemn words, and alarm them with dire warnings. Only when they are sincerely convinced and satisfied can the treatment achieve miraculous effects.