(癃、溺血、鬲肠、口糜、伏瘕、食亦、鼻渊、衄 瞑目)
胞移热于膀胱,则癃,溺血;膀胱移热于小肠,鬲肠
不便,上为口糜;小肠移热于大肠,为 瘕为沉;大肠移热于胃,善食而瘦,又谓之食亦;胃移热于胆,亦曰
食亦;胆移热于脑,则辛 鼻渊,鼻渊者,浊涕下不止也;传为衄 瞑目,故得之气厥也。
脏为阴,寒邪入之而不化,故有移寒之病。如其由经腑而传脏者,其邪先已化热也。腑为阳,寒邪入之,
即化为热,故有热邪而无寒邪;其有寒者,是内伤之病,如生冷冻饮料食伤胃之类,又如脏寒则腑冷之虚证也。
《难经》曰∶命门者,男子以藏精,女子以系胞。胞脉在冲任间,上通心气,下通膀胱,是胞者,为女子受孕、
男子藏精之所。胞中邪热,多由欲火蕴酿,若移热于膀胱,是内出外也,膀胱热结气分,则小便癃闭,热伤血
分,则溺血,闭则痛,名淋也;小肠为受盛之官,化水谷而厘清浊,浊者下传大肠,清者渗入膀胱,故膀胱亦
能移热于小肠,因而与大肠阻隔,而便不通利,浊既不下,热蒸胃中水气,上熏于口而糜烂,兼舌亦有腐蚀者,
以舌为心之苗,小肠为心之腑也;小肠下接大肠,如移热于大肠,则滓浊结聚不行而成 瘕, ,音义同伏,
瘕者,假物结成形质,沉着难去,如宿积燥屎之类也;大肠经脉络肺,肺胃相连,故大肠亦能移热于胃,胃受
邪热而善食,热烁肌肉而反瘦,以脾胃主肌肉也,此即中消之病,古名食亦也;胃移热于胆,仍在中焦,故病
不变,或兼口苦,是胆热也;胆经之脉,上头通脑,邪热入脑,脑髓被灼,化为浊涕,下注不止,以其由脑而
出,似有辛辣气味触动,涕即下注,名为辛 鼻渊, 音曷,两目中间鼻柱之内,以在鼻之深处,而出涕腥臭,
故名渊,久则传为衄 瞑目者,浊涕挟污血而下,以气逆眩晕,故瞑目,而得之气厥者,其病为深重也。
(癃闭、尿血、膈肠、口舌生疮、伏瘕、食亦、鼻渊、衄血、闭目)
胞宫的热邪转移至膀胱,就会导致癃闭和尿血;膀胱的热邪转移至小肠,会导致肠道阻隔、大便不通,热邪上熏则引起口舌生疮;小肠的热邪转移至大肠,会形成伏瘕和沉积;大肠的热邪转移至胃,患者容易饥饿但身体消瘦,这也被称为“食亦”病;胃的热邪转移至胆,同样称为“食亦”;胆的热邪转移至脑,则出现辛辣感并引发鼻渊。所谓鼻渊,是指浑浊的鼻涕不断流出。若病情传变导致衄血和闭目,这是由气机逆乱所致。
五脏属阴,寒邪侵入后难以转化,因此会有移寒的疾病。如果是从经络、腑脏传入脏器的,其邪气通常已经转化为热邪。六腑属阳,寒邪侵入后会立即转化为热邪,所以六腑只有热邪而没有寒邪;所谓的寒证,属于内伤疾病,例如生冷饮料食物损伤胃气之类,又比如脏器虚寒导致腑脏寒冷等虚证。
《难经》说:命门,男子用来藏精,女子用来系胞。胞脉位于冲脉和任脉之间,向上连通心气,向下连通膀胱,所以胞宫是女子受孕、男子藏精的场所。胞中的邪热,多由情欲之火蕴酿而成。如果热邪转移至膀胱,这是由内向外传变;膀胱热结于气分,就会导致小便癃闭;热邪损伤血分,就会导致尿血;闭塞则疼痛,名为淋证。
小肠是受盛之官,负责消化水谷并分清别浊,浊物向下传给大肠,清液渗入膀胱,所以膀胱也能将热邪转移至小肠,进而与大肠阻隔,导致大便不通利。浊气既不能下行,热邪蒸腾胃中的水气,向上熏蒸口腔导致糜烂,兼有舌头也有腐蚀现象,因为舌为心之苗窍,小肠为心之腑。
小肠下接大肠,如果热邪转移至大肠,则渣滓浊物结聚不行而成为伏瘕。“伏”音义同“伏”,瘕是指假借物结成形质,沉着难去,如同宿积的燥屎之类。
大肠经脉联络肺,肺与胃相连,所以大肠也能将热邪转移至胃。胃受到邪热侵袭而食欲旺盛,热邪灼烁肌肉反而导致消瘦,因为脾胃主司肌肉,这就是中消病,古名食亦。
胃将热邪转移至胆,病位仍在中焦,所以病症没有本质变化,或者兼见口苦,这是胆热的表现。
胆经的脉络上头通脑,邪热入脑,脑髓被灼烧,化为浊涕,向下灌注不止。因为是从脑部出来,似乎带有辛辣气味触动,鼻涕随即下注,名为辛𦟌鼻渊。“𦟌”音曷,在两目中间鼻柱之内,因为在鼻子深处而出涕腥臭,所以名叫渊。日久则传变为衄血和闭目,这是因为浊涕挟带污血而下,因气逆眩晕,所以闭目。这种情况得之于气厥,说明病情深重。
(Lin syndrome [dysuria], hematuria, Ge Chang [intestinal obstruction], oral ulcers, Fu Jia [latent mass], Shi Yi [polyphagia with emaciation], Bi Yuan [nasal sinusitis], epistaxis, closing of eyes)
When heat from the Bao (uterus/womb) transfers to the Bladder, it results in Lin syndrome (dysuria) and hematuria; when heat from the Bladder transfers to the Small Intestine, it causes Ge Chang (intestinal obstruction with difficulty in defecation), and upward transmission leads to oral ulcers; when heat from the Small Intestine transfers to the Large Intestine, it forms Fu Jia (latent masses) and sinking accumulations; when heat from the Large Intestine transfers to the Stomach, the patient experiences polyphagia but remains emaciated, a condition also known as Shi Yi disease; when heat from the Stomach transfers to the Gallbladder, it is likewise called Shi Yi; when heat from the Gallbladder transfers to the Brain, it causes a pungent sensation and Bi Yuan (nasal sinusitis). Bi Yuan refers to the continuous flow of turbid nasal discharge. If the condition progresses to cause epistaxis and closing of the eyes, it is due to Qi reversal (Qi Jue).
The Zang organs are Yin; when Cold pathogenic factors enter, they do not transform easily, thus giving rise to diseases of transferred Cold. However, if pathogens transmit from the meridians and Fu organs to the Zang organs, the pathogenic factors have usually already transformed into Heat. The Fu organs are Yang; when Cold enters, it immediately transforms into Heat, so there are only Heat pathogens in the Fu organs, not Cold. Any Cold conditions are internal injuries, such as damage to the Stomach by raw, cold drinks or food, or deficiency patterns where Zang Cold leads to Fu Cold.
The *Nan Jing* states: Mingmen (Gate of Life) stores Essence in men and connects to the Bao (uterus/womb) in women. The Bao Mai (Bao vessels) lie between the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel), connecting upwards to the Heart Qi and downwards to the Bladder. Thus, the Bao is the site for conception in women and storing Essence in men. Pathogenic Heat within the Bao often arises from the brewing of desire/fire. If this Heat transfers to the Bladder, it moves from interior to exterior. If Bladder Heat stagnates in the Qi aspect, it causes urinary retention (Lin syndrome); if it injures the Blood aspect, it causes hematuria. Obstruction leads to pain, named Lin syndrome.
The Small Intestine is the official responsible for receiving and containing, transforming water and grain, and separating the clear from the turbid. The turbid descends to the Large Intestine, while the clear seeps into the Bladder. Therefore, the Bladder can also transfer Heat to the Small Intestine, causing obstruction with the Large Intestine and leading to difficult defecation. Since the turbid cannot descend, Heat steams the water vapor in the Stomach, ascending to scorch the mouth causing ulceration, and may also corrode the tongue, because the tongue is the sprout of the Heart, and the Small Intestine is the Interior-Exterior paired organ of the Heart.
The Small Intestine connects below to the Large Intestine. If Heat transfers to the Large Intestine, dregs and turbidity accumulate and fail to move, forming Fu Jia. "Fu" has the same pronunciation and meaning as "Fu". Jia refers to masses formed artificially that are fixed and difficult to remove, similar to accumulated dry feces.
The Large Intestine meridian links to the Lung, and the Lung and Stomach are connected; thus, the Large Intestine can transfer Heat to the Stomach. When the Stomach receives pathogenic Heat, appetite increases, but Heat scorches the muscles, leading to emaciation, because the Spleen and Stomach govern the muscles. This is Zhong Xiao (Middle Jiao Wasting-Thirst disease), anciently named Shi Yi.
When the Stomach transfers Heat to the Gallbladder, the pathology remains in the Middle Jiao, so the disease nature does not change significantly, though bitter taste in the mouth may occur, indicating Gallbladder Heat.
The Gallbladder meridian ascends to the head and connects to the Brain. When pathogenic Heat enters the Brain, it scorches the brain marrow, transforming it into turbid nasal discharge that flows down continuously. Because it originates from the Brain, it seems to have a pungent odor that triggers the flow of mucus, named Xin He Bi Yuan. "He" is pronounced 'he'. It is located inside the nasal bridge between the two eyes. Because it is deep in the nose and discharges foul-smelling mucus, it is named Yuan. Over time, it transmits to cause epistaxis and closing of the eyes. This occurs because turbid mucus mixed with dirty blood flows downward, causing dizziness due to Qi reversal, hence the eyes close. This condition arises from Qi Jue (Qi Reversal), indicating a severe and deep pathology.