(《素问·评热病论》)
帝曰∶有病身热汗出烦满,烦满不为汗解,此为何病?(不为汗解,谓汗后热烦不散也。)岐伯曰∶汗出而身热者风
也,汗出而烦满不解者厥也,病名曰风厥。帝曰∶愿卒闻之。岐伯曰∶巨阳主气,故先受邪,少阴与其为表里也,得热
则上从之,从之则厥也。(风为阳邪,故汗虽出而身仍热也。巨阳主气,气言表也。表病则里应,故少阴得热,则阴分之
气亦从阳而上逆,逆则厥矣,故名风厥。按∶风厥之义不一,如本篇者,言太阳少阴病也。其在《阴阳别论》者,云二
阳一阴发病名曰风厥,言胃与肝也。详本类前六。在《五变篇》者,曰人之善病风厥漉汗者,肉不坚,腠理疏也。详本
类后七十六。俱当参辨其义。)帝曰∶治之奈何?岐伯曰∶表里刺之,饮之服汤。(阳邪盛者阴必虚,故当泻太阳之热,
补少阴之气,合表里而刺之也。饮之服汤,即《脉度篇》所谓虚者饮药以补之之意。)
帝曰∶劳风为病何如?岐伯曰∶劳风法在肺下,(劳风者,因劳伤风也。肺下者,在内则胸膈之间,在外则四椎五椎
之间也。风受于外则病应于内,凡人之因于劳者必气喘,此劳能动肺可知。按∶王氏曰∶劳,谓肾劳也。肾脉从肾上贯
肝膈入肺中,故肾劳风生,上居肺下也。此固一说,第劳之为病,所涉者多,恐不止于肾经耳。)其为病也,使人强上冥
视,(邪在肺下,则为喘逆,故令人强上不能 首。风热上壅,则畏风羞明,故令人冥目而视。)唾出若涕,恶风而振寒,
此为劳风之病。(风热伤阴,则津液稠浊,故唾出若涕。肺主皮毛,卫气受伤,故恶风振寒。)帝曰∶治之奈何?岐伯曰∶
以救 仰。(风之微甚,证在 仰之间也,故当先救之。然救此者必先温肺,温肺则风散,风散则 仰安矣。若温散不愈,
郁久成热,然后可以清解。温清失宜,病必延甚。 ,俯同。)巨阳引精者三日,中年者五日,不精者七日,(风邪之病
肺者,必由足太阳膀胱经风门、肺俞等穴,内入于藏。太阳者水之府,三阳之表也,故当引精上行,则风从咳散。若巨
阳气盛,引精速者,应在三日。中年精衰者,应在五日。衰年不精者,应在七日。当咳出青黄痰涕而愈如下文者,是即
引精之谓。)咳出青黄涕,其状如脓,大如弹丸,从口中若鼻中出,不出则伤肺,伤肺则死也。(咳涕不出者,即今人所
谓干咳嗽也,甚至金水亏竭,虚劳之候,故死。王氏曰∶平调咳者,从咽而上出于口。暴卒咳者,气冲突于蓄门而出于
鼻。夫如是者,皆肾气劳竭,肺气内虚,阳气奔迫之所为,故不出则伤肺而死也。按王氏所谓蓄门者,义出《营气篇》,
详经络类二十四。)
(出自《素问·评热病论》)
黄帝问道:有一种病症,身体发热,出汗后烦闷胀满,但汗出之后烦闷并不缓解,这是什么病?(所谓“不为汗解”,是指出汗后热象和烦闷感依然不散。)岐伯回答说:出汗而身体发热的,是风邪所致;出汗而烦闷胀满不解除的,是厥逆所致,这种病名叫风厥。黄帝说:我想详细听听其中的道理。岐伯说:足太阳膀胱经主司一身之表气,所以最先受到邪气侵袭;足少阴肾经与足太阳膀胱经互为表里,当受到热邪时,少阴之气就会随之向上从属于阳邪,气机上逆就会导致厥逆。(风邪属于阳邪,所以虽然出汗但身体仍然发热。足太阳膀胱经主司体表之气,表有病则里相应,所以少阴受到热邪影响,阴分之气也会随阳气而上逆,上逆则形成厥逆,因此称为风厥。按:风厥的含义不止一种,如本篇所说,是指太阳经和少阴经同病的证候。在《阴阳别论》中提到的,是二阳(胃)和一阴(肝)发病名为风厥,指的是胃和肝。详见本类前第六节。在《五变篇》中提到的,是说人容易患风厥且淋漓出汗的,是因为肌肉不坚实,腠理疏松。详见本类后第七十六节。这些都应当参考辨析其含义。)黄帝问:如何治疗?岐伯说:对表里两经进行针刺治疗,并服用汤药。(阳邪盛则阴必虚,所以应当泻足太阳膀胱经的热邪,补足少阴肾经的气,结合表里两经一起针刺。饮用汤药,就是《脉度篇》所说的对于虚证用药物来补益的意思。)
黄帝问:劳风病是怎样的?岐伯说:劳风病通常发生在肺下部位,(劳风,是因为劳累后感受风邪所致。肺下,在内指胸膈之间,在外指第四、第五胸椎之间。风邪从外侵入则病应于内,凡是因劳累致病的人必然气喘,由此可知劳倦会伤肺。按:王冰说:劳,指的是肾劳。肾脉从肾脏上行穿过肝脏和膈肌进入肺部,所以肾劳生风,风邪上行居于肺下。这固然是一种说法,但劳倦作为病因,涉及的方面很多,恐怕不仅仅局限于肾经。)这种病使人项背强直,视物不清,(邪气在肺下,会导致喘逆,所以使人项背强直不能低头。风热上壅,导致畏风羞明,所以使人闭目视物。)咳吐黏稠如鼻涕样的痰液,怕风且伴有寒战,这就是劳风病。(风热损伤阴液,导致津液变得稠浊,所以咳出的痰像鼻涕一样。肺主皮毛,卫气受伤,所以怕风且寒战。)黄帝问:如何治疗?岐伯说:先救治项背强直的症状。(风的轻重,症状体现在项背强直之间,所以应当先救治这一症状。然而救治此症必须先温补肺气,肺气温暖则风邪消散,风邪消散则项背强直得以安宁。如果温散法无效,郁久化热,然后才可以清热解表。温法和清法使用不当,病情必定加重。俯,同“俯”。)足太阳膀胱经精气充足的人,三天可愈;中年人五天可愈;精气衰退的人七天可愈,(风邪侵犯肺脏的病,必然通过足太阳膀胱经的风门、肺俞等穴位,向内传入脏腑。太阳经是水液代谢的府库,也是三阳经的表象,所以应当引导精气上行,风邪就能随着咳嗽排出。如果太阳经气旺盛,引导精气迅速上行,应该在三天内痊愈。中年精气开始衰退的人,应该在五天内痊愈。老年精气严重衰退的人,应该在七天内痊愈。应当咳出青黄色的痰涕而痊愈,如下文所述,这就是引导精气的意思。)咳出青黄色的鼻涕样痰,形状像脓,大小如弹丸,从口中或鼻中排出,如果不排出则会损伤肺脏,损伤肺脏就会死亡。(咳不出痰涕,就是现在人们所说的干咳,甚至导致金水(肺肾)亏竭,出现虚劳的征候,所以死亡。王冰说:平稳发作的咳嗽,是从咽喉向上出于口。突然爆发的咳嗽,是气冲击蓄门而出于鼻。像这样的情况,都是肾气劳竭,肺气内虚,阳气奔迫所造成的,所以痰涕不出就会损伤肺脏而死。按:王冰所说的蓄门,意义出自《营气篇》,详见经络类第二十四节。)
(From *Suwen: Ping Re Bing Lun*)
The Yellow Emperor asked: There is a disease characterized by fever, sweating, and vexation with fullness. The vexation and fullness do not resolve after sweating. What kind of disease is this? (The phrase "does not resolve after sweating" means that the heat and vexation remain unchanged after perspiration.) Qibo replied: Sweating accompanied by fever indicates Wind pathogen; sweating accompanied by unresolved vexation and fullness indicates Jue (reversal) pathology. This disease is named Feng Jue (Wind Jue). The Yellow Emperor said: I wish to hear the details. Qibo said: The Foot-Taiyang Bladder Meridian governs the exterior Qi, so it is the first to be invaded by pathogens. The Foot-Shaoin Kidney Meridian forms an interior-exterior relationship with it. When heat is received, the Shaoyin Qi follows the Yang upward; following upward leads to Jue. (Wind is a Yang pathogen, so although sweat is produced, the body remains hot. The Foot-Taiyang Meridian governs the exterior Qi. Exterior illness elicits an interior response; thus, when Shaoyin receives heat, the Yin Qi also follows the Yang and rebels upward. Rebellion constitutes Jue, hence the name Feng Jue. Note: The meaning of Feng Jue varies. As described in this chapter, it refers to concurrent Taiyang and Shaoyin diseases. In *Yinyang Bie Lun*, it states that onset involving Er Yang (Stomach) and Yi Yin (Liver) is named Feng Jue, referring to the Stomach and Liver. See Section 6 of this category for details. In *Wu Bian Pian*, it says those prone to Feng Jue with profuse sweating have insecure flesh and loose cou li [pores]. See Section 76 of this category for details. All these should be cross-referenced to clarify their meanings.) The Yellow Emperor asked: How should it be treated? Qibo said: Acupuncture both the exterior and interior meridians, and administer decoctions. (When Yang pathogens are excessive, Yin must be deficient. Therefore, one should drain the heat of the Foot-Taiyang Meridian and tonify the Qi of the Foot-Shaoyin Meridian, needling both exterior and interior meridians together. Administering decoctions aligns with the principle in *Maidu Pian* that deficiency conditions are treated with medicinal drinks to tonify.)
The Yellow Emperor asked: What is the nature of Lao Feng (Labor-induced Wind) disease? Qibo said: Lao Feng typically manifests below the Lungs. (Lao Feng results from wind invasion due to overexertion. "Below the lungs" refers internally to the region between the chest and diaphragm, and externally to the area between the fourth and fifth thoracic vertebrae. Wind invading from the exterior affects the interior. Anyone suffering from overexertion will experience asthma/dyspnea, indicating that labor injures the Lungs. Note: Wang Bing stated that "Lao" refers to Kidney exhaustion. The Kidney meridian ascends from the Kidneys, passes through the Liver and diaphragm, and enters the Lungs; thus, wind generated by Kidney exhaustion rises to reside below the Lungs. This is one interpretation, but since "labor" as a cause involves many aspects, it likely extends beyond just the Kidney meridian.) The symptoms include stiffness and rigidity of the neck and upper back, and blurred vision. (Pathogens located below the Lungs cause rebellious Qi and asthma, leading to neck stiffness preventing bowing of the head. Wind-heat obstructing upwards causes aversion to wind and photophobia, leading to squinting or closed-eye vision.) The patient expectorates sputum resembling mucus, experiences aversion to wind, and chills. This constitutes Lao Feng disease. (Wind-heat damages Yin, causing body fluids to become thick and turbid, resulting in expectoration resembling mucus. The Lungs govern the skin and hair; injury to Wei Qi [Defensive Qi] causes aversion to wind and chills.) The Yellow Emperor asked: How should it be treated? Qibo said: First rescue the condition of neck stiffness and rigidity. (The severity of the wind is manifested in the neck stiffness; therefore, this symptom must be addressed first. However, treating this requires warming the Lungs first. Warming the Lungs disperses the wind; once the wind is dispersed, the neck stiffness resolves. If warming and dispersing methods fail, stagnation may transform into heat, after which clearing and resolving methods can be used. Improper use of warming versus clearing methods will worsen the disease. "Fu" [bending forward] is synonymous with "Fu".) If the Foot-Taiyang Jing's essence is robust, recovery occurs in three days; if middle-aged, in five days; if essence is depleted, in seven days. (Wind pathogens attacking the Lungs enter the Zang organs via acupoints such as Fengmen and Feishu on the Foot-Taiyang Bladder Meridian. The Taiyang is the residence of water and the exterior of the Three Yang meridians. Thus, guiding essence upward allows wind to be coughed out. If Taiyang Qi is strong and guides essence rapidly, recovery should occur within three days. Middle-aged individuals with declining essence should recover within five days. Elderly individuals with depleted essence should recover within seven days. Recovery is marked by the expectoration of green-yellow phlegm and nasal discharge, as described below, which constitutes the guiding of essence.) The patient expects green-yellow phlegm resembling pus, sized like a pill, expelled from the mouth or nose. If not expelled, it injures the Lungs; injuring the Lungs leads to death. (Inability to cough up phlegm corresponds to modern dry cough. It may lead to depletion of Metal and Water [Lung and Kidney], presenting as consumptive disease, hence fatal. Wang Bing stated: Chronic cough exits from the throat to the mouth. Sudden acute cough results from Qi rushing against the Xumen [accumulation gate] and exiting through the nose. Such cases result from exhausted Kidney Qi, empty Lung Qi, and surging Yang Qi. Thus, failure to expel phlegm injures the Lungs and causes death. Note: Wang Bing's term "Xumen" originates from *Yingqi Pian*; see Category 24 on Meridians for details.)