《灵·水胀篇》肠覃者，寒气客于肠外，与卫气相搏，气不得荣，因有所系，癖而内着
，恶
气乃起，息肉内生。其始生也，大如鸡子，稍以益大，至其成，如怀子之状，久者离岁，按
之则坚，推之则移，月事以时下，此其候也。泉案∶肠覃既生息肉，则有形矣。但覃乃延长
之义，于病状何取？当为蕈之省文。《韵》、《篇》并云∶蕈，之荏反，地上菌也。病之蕈
名者，盖取肠外息肉生如蕈状，后世咽菌、阴菌等名准此。读当寻上声，不当如字读。古蕈
、蕈二字多相通，故五经文本云诗葛，覃字亦作蕈。但彼蕈仍当训延，而此蕈则当训菌。二
字之诂虽异，二字之通则同。此类甚多，不可不正。
《灵·热病》男子如蛊，女子如 ，身体腰脊如解，不欲饮食。杨注《太素》以为男女
相悦
之病。女惑男为蛊，男惑女为 。泉案∶杨说盖据《左传》而对参得之，于名义最合。今为
引申之。蛊者，坏也。《素·生气通天》注谓煎厥由房劳来，而至耳目溃溃乎若坏都，正以
女惑男而坏也。 者，阻也。《史记·仓公传》韩女欲男子不可得，病寒热，月不下，正以
男惑女而阻也。曰煎厥，曰寒热，则身必发热，故经列于热病。此热必发于肾，肾热则侮脾
，故身体腰脊如解，不欲饮食。肾中之热既淫于脾，则必脾肾同治，故下文云刺涌泉及跗上
。经文莫着于此，由刺法推药法，其方可知。《千金》无比山药丸可以治蛊，《本事方》抑
阴煎可以治 。若更中于虚邪，必皆致羸瘦、咳嗽、沉默、 ，为风虚劳、传尸劳等症，
当各随宜治之矣。或据《玉篇》 ，骄也。《广韵》 ， 也。而通 于狙，释为诈病亦得
。盖此症变幻，不的知所苦，朝凉即如平人，暮热辄至大剧，有似诈也。然以狙虚拟其神，
不若以阻实征诸病。《千金》直作“阻”字，阻者，经阻。
《灵枢·水胀篇》中提到的肠覃，是寒气侵袭于肠道外部，与卫气相互搏结，导致气机不能正常濡养，因而有所羁绊，癖积内着，邪气由此产生，息肉在内部生成。它刚开始形成时，大小如鸡蛋，逐渐增大，直到成熟时，状似怀孕，病程长的可达一年以上，按压时感觉坚硬，推动时可移动，月经仍能按时来潮，这是它的征候。
泉按：肠覃既然生成了息肉，就已经是有形的病证了。但“覃”字有延长之意，这与病症表现有何关联？应当认为是“蕈”字的省写。《韵书》和《篇海》都记载：“蕈”，读音为之荏反，指地面上的菌类。病名之所以叫“蕈”，大概是取肠外息肉生长形状像菌类的意思，后世所说的咽菌、阴菌等名称都是依据这个逻辑。读音应当寻究上声，不应当像普通字那样直接读。古文中“覃”、“蕈”二字大多通用，所以五经文本中说“诗葛覃”，“覃”字也写作“蕈”。但是那里的“覃”仍然应当解释为延长，而这里的“覃”则应当解释为菌类。这两个字的训诂虽然不同，但通假的原则是一样的。这类情况很多，不可不加以辨正。
《灵枢·热病》中提到：男子表现为类似蛊病的症状，女子表现为类似阻病的症状，身体腰脊感觉像要散架一样，不想吃东西。杨上善注释《太素》时认为这是男女互相倾慕导致的疾病。女迷惑男称为蛊，男迷惑女称为阻。
泉按：杨氏的说法大概是根据《左传》的内容参悟得出的，在名义上最为契合。现在我为其引申解释。“蛊”，意思是败坏。《素问·生气通天论》的注解说煎厥是由于房劳过度引起的，以至于耳目昏乱好像城池崩坏，正是由于女色惑乱而导致身体败坏。“阻”，意思是阻隔。《史记·仓公传》记载韩女想嫁男子却不可得，患病寒热往来，月经不通，正是由于男色阻隔而导致病情。提到煎厥、寒热，说明身体必然发热，所以经文将其列在热病篇中。这种热必然发源于肾，肾热则会克制脾土，所以身体腰脊感觉像要散架，不想吃东西。肾中的热邪既已浸淫到脾，那么就必须脾肾同治，所以下文说针刺涌泉穴及足背上的穴位。经文在此处没有明确写出药方，由刺法可以推知药法，其方剂是可以知道的。《千金方》中的无比山药丸可以治疗蛊病，《本事方》中的抑阴煎可以治疗阻病。如果再受到虚邪的侵袭，必定会导致消瘦、咳嗽、沉默寡言、精神恍惚，成为风虚劳、传尸劳等症状，应当各自根据适宜的方法治疗。或者依据《玉篇》，解释为骄纵；《广韵》解释为欺诈。并且通假于“狙”，解释为诈病也是可以的。因为这个病症变幻莫测，不知道病人真正的痛苦所在，早晨凉爽时就像正常人，傍晚发热时就很严重，有点像装病。然而用“狙”来虚拟形容其神志不定，不如用“阻”来实证描述其病理阻滞。《千金方》直接作“阻”字，阻者，经络阻隔。
In the *Ling Shu: Water Swelling Chapter* (Lingshu, Shuizhang Pian), "Changqin" (Intestinal Polyp/Tumor) refers to cold pathogenic factors invading outside the intestines, struggling with Wei Qi (Defensive Qi), causing Qi to fail in nourishing properly. Due to this obstruction, a fixed mass forms internally, evil Qi arises, and polyps grow inside. Initially, it is as large as a chicken egg, gradually increasing in size until maturity, resembling pregnancy. The duration may exceed a year. Upon palpation, it feels firm; upon pushing, it moves. Menstruation still occurs on time. This is its clinical presentation.
Quan's Commentary: Since Changqin has formed polyps, it is already a tangible pathology. However, "Qin" implies extension or lengthening, which seems unrelated to the disease manifestation. It should be considered an abbreviated form of "Xun" (Mushroom/Fungus). Both the *Yunshu* (Rhyme Books) and *Pianhai* state: "Xun," pronounced as Zhi Ren fan, refers to fungi growing on the ground. The disease is named "Xun" likely because the polyps growing outside the intestine resemble the shape of mushrooms. Later terms such as "Yan Jun" (Throat Fungus) and "Yin Jun" (Genital Fungus) follow this logic. The pronunciation should be traced to the rising tone, not read as the character appears. In ancient texts, "Qin" and "Xun" were often interchangeable. For instance, in the Five Classics text regarding the poem "Ge Qin," the character "Qin" is also written as "Xun." However, in that context, "Qin" still means extension, whereas here it means fungus. Although the exegesis differs, the principle of interchangeability is the same. There are many such cases, which must be clarified.
The *Ling Shu: Heat Disease Chapter* states: Men present with symptoms similar to "Gu" (Gu Syndrome/Parasitic Disease), women present with symptoms similar to "Zu" (Obstruction Syndrome); the body, waist, and spine feel as if dislocated; there is a lack of appetite. Yang Shangshan, in his commentary on the *Tai Su*, believed this referred to diseases caused by mutual attraction between men and women. When a woman bewitches a man, it is called "Gu"; when a man bewitches a woman, it is called "Zu."
Quan's Commentary: Yang's theory seems derived from references to the *Zuo Zhuan*, fitting the nomenclature best. I will now elaborate. "Gu" means ruin or decay. The commentary on *Su Wen: Sheng Qi Tong Tian Lun* states that Jian Jue (Frying Decoction Collapse) results from sexual exhaustion, leading to blurred vision and hearing, like a collapsing city wall; this is precisely due to being bewitched by women, leading to bodily decay. "Zu" means obstruction. The *Shi Ji: Cang Gong Biography* records that Han Nu, unable to marry the man she desired, suffered from alternating chills and fever and amenorrhea; this was precisely due to male obstruction causing illness. Mentioning Jian Jue and alternating chills and fever indicates that the body must have heat; thus, the classic categorizes it under Heat Diseases. This heat originates in the Kidney. Kidney Heat overacts on Spleen Earth, causing the sensation of the waist and spine dislocating and loss of appetite. Since Kidney Heat invades the Spleen, both organs must be treated simultaneously. Hence, the text later mentions needling Yongquan (KI 1) and points on the dorsum of the foot. The text does not explicitly list herbal formulas here, but one can deduce them from the acupuncture methods. The Wubi Shanyao Wan (Peerless Yam Pill) from *Qian Jin Fang* can treat Gu syndrome; the Yiyin Jian (Yin-Subduing Decoction) from *Benshi Fang* can treat Zu syndrome. If further invaded by deficient pathogens, emaciation, cough, silence, and mental confusion may occur, resulting in Wind Deficiency Consumption or Transmitted Corpse Consumption. Treatment should be tailored accordingly. Alternatively, based on the *Yu Pian*, it can be interpreted as arrogance; the *Guang Yun* interprets it as deceit. It can also be interchanged with "Ju" (Monkey/Ape), interpreted as malingering. Given the变幻 (changing/unpredictable) nature of these symptoms, where the patient's true suffering is unknown, appearing normal in the morning with coolness but severely febrile in the evening, it resembles malingering. However, using "Ju" to metaphorically describe mental instability is less accurate than using "Zu" to empirically describe pathological obstruction. *Qian Jin Fang* directly uses the character "Zu," meaning meridian obstruction.