凡痹之客五脏者∶肺痹者,烦满喘而呕;心痹者,脉不通,烦则心下鼓,暴上气而喘,嗌干善噫,厥气上
则恐;肝痹者,夜卧则惊,多饮数小便,上为引如怀;
肾痹者,善胀,尻以代踵,脊以代头;脾痹者,四肢解堕,发咳呕汁,上为大塞。
邪客于脏则病重,为难治矣。肺痹者,遏其心火而多烦,肺主气而居胸,气痹,故胸满而喘,肺胃相连,
故胃气亦逆,则呕也;心主血脉,痹则脉不通而烦,烦则气动,故心下鼓,暴逆犯肺则喘,心火上灼则嗌干,
脘滞则善噫,阳上亢而下虚则厥,厥则伤肾而恐也;肝藏魂,气痹而魂不安,故夜卧则惊,肝火郁,故多饮,
数小便者,肝木主疏泄也,肝阳本上升,痹不得达,故上引如有物在怀中也;三焦通主升降,而肾司下焦,
肾气痹而下焦不宣,则中上两焦皆不通利,故善胀也,督脉通肾,肾痹而督脉阳气不通,跷维之脉皆不用,
而两足不举,以尻代踵,尻音考,平声,尾骨也,督伤则天柱骨痿,头垂背曲,故脊以代头也;脾主四肢,
气痹不得充于四肢,故懈堕无力,脾为肺母,母病必及于子而发咳,有痰名嗽,无痰有声名咳也,脾不运,
不能为胃行其津液,而汁上泛,则呕出,浊壅不降,上焦大塞也。病至如此,不可治矣,故下文言入脏者死。
凡是痹邪侵犯五脏的情况:肺痹,表现为烦闷胀满、气喘和呕吐;心痹,表现为血脉不通,心烦时感到心下悸动,突然气逆上冲而喘,咽喉干燥且容易嗳气,厥逆之气上冲则产生恐惧感;肝痹,表现为夜间睡眠时易受惊扰,口渴多饮且小便频数,气机上逆牵引胸胁如有物阻塞在怀中;肾痹,表现为容易腹胀,臀部代替脚跟站立(形容足部萎缩无法行走),脊背弯曲高耸代替头部(形容头项低垂);脾痹,表现为四肢懈怠无力,引发咳嗽、呕吐涎沫,上部出现严重的痞塞不通。
邪气侵入内脏则病情严重,难以治疗。肺痹是因为心火被遏制而烦躁,肺主气且位于胸部,气机痹阻,所以胸中胀满而气喘,肺与胃相连,胃气也随之上逆,因此发生呕吐;心主管血脉,痹阻则血脉不通而烦躁,烦躁导致气机扰动,所以心下悸动,气逆突然犯肺则气喘,心火上炎灼伤咽喉则口干,脘腹滞涩则容易嗳气,阳气亢盛于上而下焦虚损则发生厥逆,厥逆损伤肾脏而产生恐惧感;肝藏魂,气机痹阻则魂不安定,所以夜间睡眠时易惊,肝火郁结,所以口渴多饮,小便频数是因为肝木主疏泄功能失常,肝阳本应上升,因痹阻而不能通达,所以上部牵引感觉如同有物在胸中;三焦主管升降通行,而肾管辖下焦,肾气痹阻导致下焦宣发不利,则中焦和上焦都不通利,所以容易腹胀,督脉连通肾脏,肾痹导致督脉阳气不通,跷脉和维脉都失去作用,导致双腿不能抬起,用臀部代替脚跟(尻音考,平声,指尾骨),督脉受伤则天柱骨痿软,头垂背曲,所以脊背代替了头部;脾主管四肢,气机痹阻不能充养四肢,所以懈怠无力,脾为肺之母脏,母病必波及子脏而引发咳嗽,有痰称为嗽,无痰仅有声音称为咳,脾运化功能失职,不能为胃输送津液,导致津液上泛,从而呕吐出汁液,浊气壅滞不降,导致上焦严重痞塞。病情发展到这种地步,就无法治疗了,所以下文说邪气入脏者死。
In cases where Bi syndrome (Obstruction Syndrome) affects the five Zang organs: In Lung Bi, there is vexation, chest fullness, panting, and vomiting; in Heart Bi, the vessels are obstructed, with palpitations under the heart when vexed, sudden upward rushing of Qi causing panting, dry throat, frequent belching, and fear when rebellious Qi ascends; in Liver Bi, there is fright during sleep at night, excessive thirst with frequent urination, and upward pulling sensation as if something were lodged in the chest; in Kidney Bi, there is frequent abdominal distension, the buttocks replace the heels (indicating inability to walk due to leg atrophy), and the spine replaces the head (indicating head drooping); in Spleen Bi, there is flaccidity and weakness of the four limbs, coughing, vomiting of saliva/fluid, and severe obstruction in the upper Jiao.
When pathogenic factors invade the Zang organs, the disease becomes severe and difficult to treat. Lung Bi occurs because Heart Fire is suppressed, leading to vexation; since the Lung governs Qi and resides in the chest, Qi obstruction causes chest fullness and panting. As the Lung and Stomach are connected, Stomach Qi also rebels, causing vomiting. The Heart governs blood vessels; obstruction leads to vessel blockage and vexation. Vexation agitates Qi, causing palpitations under the heart. Sudden rebellion attacking the Lung causes panting. Heart Fire scorching upwards causes a dry throat. Stagnation in the epigastrium causes frequent belching. Hyperactivity of Yang above and deficiency below leads to Jue (rebellious cold/heat), which injures the Kidney and causes fear. The Liver stores the Hun (Ethereal Soul); Qi obstruction makes the Hun unsettled, causing fright during sleep. Liver Fire stagnation causes excessive thirst. Frequent urination results from the Liver Wood's failure in its function of dispersion and descent. Liver Yang naturally tends to ascend, but obstruction prevents it from reaching the upper body, causing an upward pulling sensation as if something were in the chest. The Sanjiao (Triple Burner) governs ascending and descending; the Kidney controls the Lower Jiao. When Kidney Qi is obstructed and the Lower Jiao fails to diffuse, the Middle and Upper Jiao become blocked, causing frequent distension. The Du Mai (Governing Vessel) connects to the Kidney; Kidney Bi blocks Du Mai Yang Qi, rendering the Qiao Mai (Heel Vessels) and Wei Mai (Stabilizing Vessels) ineffective, so the legs cannot lift, and the buttocks replace the heels (Kao, flat tone, refers to the coccyx). Injury to the Du Mai causes the Tian Zhu Bone (neck vertebrae) to wither, head droops, and back curves, so the spine replaces the head. The Spleen governs the four limbs; Qi obstruction prevents nourishment of the limbs, causing flaccidity and weakness. The Spleen is the Mother of the Lung; maternal illness affects the child organ, causing cough. Phlegm indicates Sou (cough with phlegm), while sound alone indicates Ke (dry cough). Spleen dysfunction fails to transport fluids for the Stomach, causing fluid to reflux upwards and be vomited. Turbid Qi stagnates and fails to descend, causing severe upper Jiao obstruction. When the disease reaches this stage, it is incurable, hence the following text states that invasion into the Zang organs leads to death.