帝曰∶有病怒狂者,此病安生?岐伯曰∶生于阳也。阳气者,因暴折而难决,故善怒也。病名阳厥。帝
曰∶何以知之?岐伯曰∶阳明者常动,巨阳、少阳不动,不动而动大疾,此其候也。帝曰∶治之奈何?岐伯
曰∶夺其食即已。夫食入于阴,长气于阳,故夺其食即已。使之服以生铁落饮。夫生铁落者,下气疾也。
此言怒狂之病,因阳气暴折难决,暴折者,过激而致郁逆也,难决者,如水之壅遏,不能决之使流也,故
病怒狂而名阳厥也。所以然者,阳明人迎之脉,本常动不休,若太阳、少阳经脉,本来不动,不动而动,且
大且疾,此三阳之气亢极,而逆可见矣。治之当夺其食而使气衰,服以生铁落饮,铁落者,打铁飞落之屑,煎
汤饮之,下气最疾也。盖怒狂由阳亢,阳由肝胆而升,木邪炽盛,铁落以金制木也。然此怒狂与上条之狂,其
虚实相反也。
《素问·奇病论》帝曰∶人有病头痛,数岁不已,此安得之?名为何病?岐伯曰∶当有所犯大寒,内至骨
髓,髓者,以脑为主,脑逆,故令头痛,齿亦痛,病名厥逆。
大寒深入骨髓,脑为髓海,邪气上逆至脑,其病深,故头痛数岁不已;齿为骨之余,其根属肾,故齿亦痛,
此因寒邪而肾气厥逆也。后贤制玉真丸方,治肾厥头痛,内有硫黄,以去骨髓之寒邪。凡头痛之因,甚多不同,
必须详辨。
黄帝问道:有的人患发怒发狂的病,这种病是怎么产生的?岐伯回答说:产生于阳分。人体的阳气,因为突然受到挫折而难以疏泄,所以容易发怒。这种病叫做阳厥。
黄帝问:怎么知道是这种情况呢?岐伯说:足阳明胃经的动脉通常是搏动的,而足太阳膀胱经和足少阳胆经的动脉通常是不搏动的。如果不该搏动的地方反而搏动得特别剧烈快速,这就是它的征象。
黄帝问:治疗它该怎么办?岐伯说:限制病人的饮食就可以痊愈。因为食物进入体内属于阴,会助长体内的阳气,所以限制饮食就能使亢盛的阳气衰减从而痊愈。还可以让病人服用生铁落饮。生铁落具有迅速降气的作用。
这里所说的怒狂病,是因为阳气突然受挫、难以疏泄所致。“暴折”是指过度激惹导致气机郁结逆乱;“难决”是指像水流被堵塞一样,不能疏通使其流畅,所以表现为发怒发狂,命名为阳厥。之所以这样,是因为足阳明胃经的人迎脉本来经常跳动不止,而足太阳、足少阳经脉本来是不跳动的。如果不该跳动却跳动,而且幅度大、速度快,这说明三阳之气亢盛到了极点,其气上逆的情况就显而易见了。治疗时应当通过限制饮食来使气机衰退,并服用生铁落饮。铁落是打铁时飞落的铁屑,煎汤饮用,降气作用最快。大概怒狂是由于阳气亢盛引起的,阳气由肝胆升发,木邪炽盛,铁落属金,以金来克制木。然而这种怒狂与上一条所述的狂证,虚实性质是相反的。
《素问·奇病论》中记载:黄帝问道:有人患头痛病,多年不愈,这是怎么得的?叫什么病?岐伯回答说:这应该是遭受了严重寒邪侵袭,寒气深入骨髓。髓以脑为主,脑气上逆,所以导致头痛,牙齿也痛,这种病名叫厥逆。
大寒深入骨髓,脑为髓海,邪气上逆至脑,病情深重,所以头痛多年不愈;牙齿是骨之余,齿根属于肾,所以牙齿也痛,这是由于寒邪导致肾气厥逆所致。后世医家制定了玉真丸方剂,用于治疗肾厥头痛,方中含有硫黄,用以祛除骨髓中的寒邪。凡是引起头痛的原因很多,各不相同,必须详细辨别。
Yellow Emperor asked: There are patients suffering from anger and mania. How does this disease arise? Qibo replied: It arises from Yang. The Yang Qi, due to sudden frustration and difficulty in resolution, tends to cause frequent anger. This disease is named Yang Jue (Yang Reversal).
Yellow Emperor asked: How can one know this? Qibo replied: The Yangming channel usually has a palpable pulse, whereas the Taiyang and Shaoyang channels do not normally have a palpable pulse. If the latter exhibit a strong and rapid pulse where none should be, this is the sign.
Yellow Emperor asked: How should it be treated? Qibo replied: Depriving the patient of food will cure it. Food enters the Yin aspect and generates Qi in the Yang aspect; therefore, restricting food intake will resolve the condition. Additionally, administer Shengtie Luo Yin (Raw Iron Filings Decoction). Raw iron filings possess a rapid qi-descending property.
The mania described here arises because Yang Qi is suddenly frustrated and difficult to resolve. "Sudden frustration" refers to excessive stimulation leading to qi stagnation and rebellion; "difficulty in resolution" implies an obstruction like blocked water that cannot flow freely. Thus, the patient manifests anger and mania, named Yang Jue. Specifically, the Renying acupoint on the Yangming channel naturally pulsates continuously, while the Taiyang and Shaoyang channels do not. If these non-pulsating channels exhibit strong and rapid pulsations, it indicates that the Qi of the three Yang channels is hyperactive to an extreme degree, making their rebellious nature evident. Treatment should involve restricting food to subdue the qi and administering Shengtie Luo Yin (Raw Iron Filings Decoction). Iron filings are the flakes produced when forging iron; decocting them for drinking has the fastest qi-descending effect. Generally, mania stems from Yang hyperactivity. Yang rises via the Liver and Gallbladder; when Wood pathogenic factors are vigorous, Iron (Metal) is used to control Wood. However, this type of mania is opposite in terms of excess and deficiency compared to the mania described in the previous section.
In *Suwen: Qibing Lun* (Plain Questions: Treatise on Rare Diseases), the Yellow Emperor asked: A person suffers from headache that persists for several years without relief. How did this occur? What is the name of this disease? Qibo replied: It must be due to exposure to severe cold, which penetrated inward to the bone marrow. Marrow is dominated by the brain. When Brain Qi rebels upward, it causes headache, and the teeth also hurt. This disease is named Jue Ni (Reversal Counterflow).
Severe cold penetrates deep into the bone marrow. The brain is the Sea of Marrow. Pathogenic Qi rebels upward to the brain, resulting in a deep-seated condition, hence the persistent headache for years. Teeth are the surplus of bones, and their roots belong to the Kidney; therefore, the teeth also hurt. This is caused by Kidney Qi reversal due to Cold pathogenic factors. Later scholars formulated the Yuzhen Wan (True Jade Pill) to treat Kidney Jue Headache. This formula contains Liu Huang (Sulfur) to dispel Cold pathogenic factors from the bone marrow. The causes of headache are numerous and varied; they must be carefully differentiated.