(《素问·脉要精微论》)
帝曰∶病成而变何谓?(成言病之本,变言病之标,标本不同,是谓之变。)岐伯曰∶风成为寒热,(风,阳邪也,
善行而数变。或并于里则阳虚,阳虚则外寒;或并于表则阳实,阳实生外热。故《生气通天论》曰∶因于露风,乃生寒
热。是风成而变为寒热也。)瘅成为消中,(瘅,热邪也。热积于内,当病为消中,善食易饥也。)厥成为巅疾,(厥,逆
气也。气逆于上,则或为疼痛,或为眩仆,而成顶巅之疾也。一曰气逆则神乱,而病为癫狂者,亦通。)久风为飧泄,(风
从木化,久风不已则脾土受伤,病为飧泄而下利清谷也。飧音孙。)脉风成为疠,(风寒客于血脉,久而不去则肤肉败坏,
其病为疠。疠,赖、利二音,癞也。)病之变化,不可胜数。(此举风热之邪,以见致病之概,其他变化百出,有不可以
数计者,亦犹此也。)
(《素问·通评虚实论》)
黄帝曰∶凡治消瘅仆击,偏枯痿厥,气满发逆,肥贵人,则高粱之疾也。(消瘅,热消也。仆击,暴仆如击也。偏枯,
半身不随也。痿,痿弱无力也。厥,四肢厥逆也。高梁,膏梁也。肥贵之人,每多浓味,夫肥者令人热中,甘者令人中
满,热蓄于内,多伤其阴,故为此诸病。瘅音丹,又上、去二声。仆音付。)隔则闭绝,上下不通,则暴忧之病也。(愁
忧者,气闭塞而不行,故或上或下,致为痞隔,而水谷有不通也。)暴厥而聋,偏塞闭不通,内气暴薄也。(暴厥,气暴
逆也。此以内气之逆,暴有所薄而然。薄,侵迫之谓。)不从内,外中风之病,故瘦留着也。(有病不从内,而外中风寒,
藏蓄不去,则伏而为热,故致燔烁消瘦,此以表邪留薄,而着于肌肉筋骨之间也。) 跛,寒风湿之病也。足不可行谓之
,一足偏废谓之跛,此在下者,必风寒湿气之病也。 音只。跛,波上声。)黄胆暴痛,癫疾厥狂,久逆之所生也。(此
以气逆之久,而阴阳营卫有所不调,然后成此诸证,皆非一朝所致也。疸音旦。)五脏不平,六腑闭塞之所生也。(六腑
闭塞,则水谷无以化,津液无以行,精气失所养,故五脏有不平矣。)头痛耳鸣,九窍不利,肠胃之所生也。(头耳九窍,
皆手足阳明经脉所及,故病由肠胃之所生。然肠胃二字,实兼六腑为言,盖六腑俱属三阳,三阳遍于九窍也。)
(出自《素问·脉要精微论》)
黄帝问道:疾病形成后发生的变化是指什么?(“成”指疾病的根本,“变”指疾病的表现,根本与表现不同,这就叫做变化。)岐伯回答说:风邪久留可转化为寒热病证,(风属于阳邪,善于游走且变化多端。如果风邪并入体内,则导致阳气虚弱,阳气虚弱则体表感到寒冷;如果风邪并入体表,则导致阳气亢盛,阳气亢盛则体表产生发热。所以《生气通天论》中说:因为暴露于风中,从而产生寒热。这就是风邪停留而转化为寒热病证的意思。)瘅热内积可转化为消中病证,(瘅是热邪。热邪积聚在体内,就会引发消中病证,表现为食欲旺盛、容易饥饿。)气机上逆可转化为巅顶部位的疾病,(厥是指气机逆乱。气逆冲于上部,就会导致或疼痛、或眩晕跌倒,从而形成头顶部的疾病。另一种说法认为,气逆会导致神志紊乱,从而引发癫狂病,这种解释也是通顺的。)风邪久留可转化为飧泄病证,(风从木化,风邪久治不愈则会损伤脾土,引发飧泄病证,表现为大便中含有未消化的食物残渣。飧音同孙。)风邪侵入血脉可转化为疠风病证,(风寒之邪客居于血脉之中,长久不去则导致皮肤肌肉败坏,其病症为疠风。疠音同赖、利二音,即癞疮。)疾病的变化,多得数不过来。(这里列举风热之邪,是为了展示致病的大致规律,其他各种层出不穷的变化,多得无法计算,也与此类似。)
(出自《素问·通评虚实论》)
黄帝说:凡是治疗消瘅、仆击、偏枯、痿厥、气满发逆这些病证,如果是肥胖显贵的人得的,那就是由于过食膏粱厚味引起的疾病。(消瘅,指热性消渴病。仆击,指突然昏倒如同被打击一样。偏枯,指半身不遂。痿,指肢体痿弱无力。厥,指四肢厥冷。高梁,即膏粱,指肥甘厚味的食物。肥胖尊贵的人,往往多吃浓味食物,肥腻的食物使人热蕴于中,甘甜的食物使人中焦胀满,热邪蓄积在体内,多会损伤阴液,因此产生这些疾病。瘅音同丹,又读上声和去声。仆音同付。)膈塞不通、闭绝,上下气机不相交通,这是由突然遭受忧怒引起的疾病。(忧愁的人,气机闭塞而不能运行,所以上下部位出现痞塞隔阂,导致水谷饮食不能通畅下行。)突然昏厥并伴有耳聋,身体一侧或双侧闭塞不通,这是由于体内气机突然迫逆所致。(暴厥,指气机突然逆乱。这是因为体内气机逆乱,突然受到邪气侵迫而造成的。薄,意为侵迫。)不是由内伤引起,而是外感风邪的疾病,是因为形体消瘦且病邪留恋不去。(有的疾病并非源于内脏,而是外感风寒,邪气藏伏不去,郁而化热,导致身体燔灼消瘦,这是由于表邪留恋侵迫,附着在肌肉筋骨之间造成的。)跛行,是寒风湿邪引起的疾病。脚不能行走称为跛,一只脚偏废不用也称为跛,这种发生在下肢的病,必定是风寒湿气引起的。只音同支。跛音同波的上声。)黄疸、突发剧痛、癫疾、厥狂,都是由气机长期逆乱所产生的。(这是由于气机逆乱日久,导致阴阳、营卫失调,然后才形成这些证候,都不是短时间内造成的。疸音同旦。)五脏功能失调,是由六腑闭塞不通所引发的。(六腑闭塞,则水谷无法消化,津液无法运行,精气失去滋养,所以五脏就会出现功能失调。)头痛耳鸣,九窍不利,是由肠胃病变所引发的。(头、耳及九窍,都是手足阳明经脉所覆盖的区域,所以病症源于肠胃。然而“肠胃”二字,实际上兼指六腑而言,因为六腑都属于三阳经,三阳经遍布于九窍。)
(From *Suwen: Treatise on the Essential Subtleties of Pulse Diagnosis*)
The Yellow Emperor asked: What is meant by changes occurring after a disease has formed? ("Cheng" refers to the root of the disease, while "Bian" refers to its manifestations; when the root and manifestation differ, this is called change." Qibo replied: Wind pathogen remaining for a long time can transform into cold-heat disorders. (Wind is a Yang pathogenic factor that moves freely and changes frequently. If wind merges into the interior, it causes Yang deficiency, leading to exterior cold; if wind merges into the exterior, it causes Yang excess, generating exterior heat. Thus, the *Treatise on the Vitality and Heaven-Human Resonance* states: Exposure to wind leads to cold and heat. This illustrates how wind transforms into cold-heat disorders.) Dan-heat accumulation can transform into Xiaozhong (Xiaozhong, excessive eating with easy hunger). (Dan refers to heat pathogen. Heat accumulating internally causes Xiaozhong, characterized by voracious appetite and easy hunger.) Qi rebellion can transform into diseases of the vertex. (Jue refers to rebellious Qi. When Qi rebels upward, it may cause pain or dizziness and collapse, resulting in diseases of the vertex. Another view holds that Qi rebellion disturbs the spirit, causing Diankuang (epilepsy and mania), which is also valid.) Long-standing wind can transform into Sundxie (Sundxie, diarrhea with undigested food). (Wind transforms according to Wood; prolonged wind injures Spleen Earth, causing Sundxie with clear, undigested stool in the feces. 'Sun' is pronounced as 'sun'.) Wind entering the blood vessels can transform into Lifeng (Lifeng, leprosy-like disease). (Cold and wind pathogens lodge in the blood vessels; if they remain for a long time, skin and flesh deteriorate, resulting in Lifeng. 'Li' is pronounced as 'lai' or 'li', referring to leprosy/sores.) The changes of diseases are countless. (This cites wind and heat pathogens to illustrate the general principles of disease causation; other myriad changes are incalculable, similar to this case.)
(From *Suwen: Treatise on Evaluating Deficiency and Excess*)
The Yellow Emperor said: In treating Xiao-dan (heat-type wasting-thirst), Pujie (sudden collapse), Pianku (hemiplegia), Weijue (flaccidity and cold limbs), and Qi-man fani (chest fullness with rebellious Qi), if these occur in obese, noble individuals, they are diseases caused by rich food and drink. (Xiao-dan refers to heat-type wasting-thirst. Pujie means sudden collapse as if struck. Pianku refers to hemiplegia. Wei refers to flaccidity and weakness. Jue refers to cold extremities. Gao-liang refers to rich, fatty, and sweet foods. Obese and noble people often consume strong-flavored foods; fatty foods cause heat in the middle, and sweet foods cause fullness in the middle. Heat accumulated internally damages Yin, thus causing these diseases. 'Dan' is pronounced as 'dan', also with rising and departing tones. 'Pu' is pronounced as 'fu'.) Ge (diaphragmatic obstruction) with closure and lack of communication between upper and lower parts is a disease caused by sudden sorrow and anger. (Those who worry have blocked Qi that cannot flow, leading to痞隔 (stagnation and obstruction) where water and grain cannot pass smoothly.) Sudden Jue with deafness, and unilateral or bilateral blockage, is caused by sudden internal Qi invasion. (Baovie refers to sudden Qi rebellion. This occurs due to internal Qi rebellion suddenly being invaded by pathogenic factors. 'Bo' means invasion or pressure.) Diseases not originating from internal injury but from external wind strike result in emaciation and lingering pathogens. (Some diseases do not arise from internal organs but from external wind-cold; if pathogens accumulate and do not depart, they stagnate and generate heat, causing burning and emaciation. This is due to exterior pathogens lingering and attaching to muscles, sinews, bones, and joints.) Bo (limping) is a disease of cold, wind, and dampness. Inability to walk is called Bo; paralysis of one leg is also called Bo. These lower limb conditions are definitely caused by cold, wind, and dampness. 'Zhi' is pronounced as 'zhi'. 'Bo' is pronounced with the rising tone of 'bo'. Huangdan (jaundice), sudden severe pain, Dianji (epilepsy), Juekuang (rebellious mania) are generated by long-term Qi rebellion. (This is because prolonged Qi rebellion leads to disharmony of Yin-Yang, Ying, and Wei, eventually forming these syndromes, which are not caused overnight. 'Dan' is pronounced as 'dan'). Disharmony of the Five Zang organs is generated by obstruction of the Six Fu organs. (Obstruction of the Six Fu organs prevents digestion of water and grain and movement of Jin-Ye, depriving Jing-Qi of nourishment, thus causing disharmony in the Five Zang organs). Headache, tinnitus, and dysfunction of the nine orifices are generated by stomach and intestinal diseases. (The head, ears, and nine orifices are covered by the Hand and Foot Yangming meridians, so diseases originate from the stomach and intestines. However, the term "stomach and intestines" actually encompasses all Six Fu organs, as all Six Fu belong to the Three Yang channels, which pervade the nine orifices.)