(《素问·至真要大论》)
帝曰∶六气之胜,何以候之?(候者,候其气之应见也。)岐伯曰∶乘其至也。(乘其气至而察之也。)清气大来,燥
之胜也,风木受邪,肝病生焉。(金气克木,故肝木受邪,肝病则并及于胆。)热气大来,火之胜也,金燥受邪,肺病生
焉。(火气克金,故肺金受邪,肺病则并及于大肠。)寒气大来,水之胜也,火热受邪,心病生焉。(水气克火,故心火受
邪,心病则并及小肠、包络、三焦。)湿气大来,土之胜也,寒水受邪,肾病生焉。(土气克水,故肾水受邪,肾病则并
及膀胱。)风气大来,木之胜也,土湿受邪,脾病生焉。(木气克土,故脾土受邪,脾病则并及于胃。)所谓感邪而生病也。
(不当至而至者,谓之邪气,有所感触,则病生矣。)乘年之虚,则邪甚也;(凡岁气不及,邪胜必甚,如乙丁己辛癸年
是也。)失时之和,亦邪甚也;(客主不和,四时失序,感而为病,则随所不胜而与脏气相应也,其邪亦甚。)遇月之空,
亦邪甚也。(《八正神明论》曰∶月始生,则血气始精,卫气始行;月廓满,则血气实,肌肉坚;月廓空,则肌肉减,经
络虚,卫气去,形独居。是即月空之义,亦邪之所以甚也。以上三节,曰乘、曰失、曰遇,皆以人事为言,是谓三虚。
详义见后三十六。)重感于邪,则病危矣。(如《岁露论》云∶冬至之日,中于虚风而不发,至立春之日,又皆中于虚风,
此两邪相搏。即重感之谓,义详后三十六。)有胜之气,其必来复也。(天地之气,不能相过也,有胜则有复也。)帝曰∶
其脉至何如?(言六气胜至之脉体。)岐伯曰∶厥阴之至其脉弦。(厥阴之至,风木气也。木体端直以长,故脉弦。弦者,
长直有力,如弓弦也。)少阴之至其脉钩,(少阴之至,君火气也,火性升浮,故脉钩。钩者,来盛去衰,外实内虚。如
带之钩也。)太阴之至其脉沉,(太阴之至,湿土气也,土体重实,故脉沉。沉者,行于肌肉之下也。)少阳之至大而浮,
(少阳之至,相火气也。火热盛长于外,故脉来洪大而浮于肌肤之上也。)阳明之至短而涩,(阳明之至,燥金气也。金
性收敛,故脉来短而涩也。)太阳之至大而长。(太阳之至,寒水气也。水源长而生意广,故其脉至,大而且长。)至而和
则平,(以上六脉之至,各无太过不及,是为和平之脉,不平则为病矣。)至而甚则病,(甚,谓过甚而失其中和之气,如
但弦无胃之类是也。)至而反者病,(反者,反见胜己之脉,如应弦反涩,应大反小之类是也。)至而不至者病,(时已至
而脉不应,来气不足也,故病。)未至而至者病,(时未至而脉先至,来气太过也,故病。凡南北政之岁,脉象变易皆然。)
阴阳明易者危。(阴阳易,即《五营运大论》阴阳交之义,阴阳错乱,故谓之危。详见本类前五。)
黄帝问道:六气偏胜,如何诊察?(所谓“候”,是观察其气候变化的相应表现。)岐伯回答说:在其气至之时进行诊察。(即在客气到达时加以观察。)
如果清气大至,这是燥金偏胜的表现,风木受邪,肝病由此产生。(因为金气克制木气,所以肝木受邪,肝病发生并波及胆腑。)
如果热气大至,这是火气偏胜的表现,金燥受邪,肺病由此产生。(因为火气克制金气,所以肺金受邪,肺病发生并波及大肠。)
如果寒气大至,这是水气偏胜的表现,火热受邪,心病由此产生。(因为水气克制火气,所以心火受邪,心病发生并波及小肠、心包络和三焦。)
如果湿气大至,这是土气偏胜的表现,寒水受邪,肾病由此产生。(因为土气克制水气,所以肾水受邪,肾病发生并波及膀胱。)
如果风气大至,这是木气偏胜的表现,土湿受邪,脾病由此产生。(因为木气克制土气,所以脾土受邪,脾病发生并波及胃腑。)
这就是所谓的感受邪气而生病。(不该出现的时候出现,称为邪气,一旦有所感触,疾病就会发生。)
如果遇到岁运虚衰之年,则邪气更盛;(凡是岁气不及的年份,邪气必然强盛,如乙、丁、己、辛、癸年等即是。)
如果违背了四时的和谐规律,邪气也甚盛;(客气与主气不相协调,四季时序错乱,因感邪而发病,则随其所不胜之气而与脏腑之气相应,其邪气也很严重。)
如果遇到月廓空虚之时,邪气也甚盛。(《八正神明论》说:月亮初生时,血气开始精微,卫气开始运行;月亮圆满时,血气充实,肌肉坚实;月亮亏空时,肌肉减损,经络虚弱,卫气离去,形体独存。这就是月空的含义,也是邪气之所以猖獗的原因。以上三节,分别用“乘”、“失”、“遇”来描述,都是指人事方面的因素,这被称为“三虚”。详细义理见后文第三十六篇。)
如果再次感受邪气,病情就危险了。(如《岁露论》所说:冬至之日,中于虚风而未发病,到了立春之日,又再次中于虚风,这是两种邪气相互搏结。这就是“重感”的意思,义理详见后文第三十六篇。)
有偏胜之气,必然会有复气产生。(天地之气,不会超过限度,有偏胜就有报复之气。)
黄帝问道:这些脉象到来时是怎样的?(这是在问六气偏胜到来时的脉象特征。)岐伯回答说:厥阴之气到来,其脉象弦。(厥阴之气到来,对应风木之气。木性端直而长,所以脉象弦。弦脉,是指脉来长直有力,像弓弦一样。)
少阴之气到来,其脉象钩。(少阴之气到来,对应君火之气。火性升浮,所以脉象钩。钩脉,是指脉来势盛而去势衰,外实内虚,像衣带上的钩子一样。)
太阴之气到来,其脉象沉。(太阴之气到来,对应湿土之气。土性重实,所以脉象沉。沉脉,是指脉行于肌肉之下。)
少阳之气到来,其脉象大而浮。(少阳之气到来,对应相火之气。火热之气盛长于外,所以脉来洪大而浮于肌肤之上。)
阳明之气到来,其脉象短而涩。(阳明之气到来,对应燥金之气。金性收敛,所以脉来短而涩。)
太阳之气到来,其脉象大而长。(太阳之气到来,对应寒水之气。水源长远且生意广博,所以其脉到来时,既大且长。)
脉至而平和,则为正常。(以上六种脉象到来时,若无太过或不及,就是和平之脉,不平则为病态。)
脉至而过甚,则为病态。(“甚”,指过于亢盛而失去了中和之气,例如只有弦象而没有胃气的情况。)
脉至而相反,则为病态。(“反”,指出现了克制自己的脉象,例如应当见弦脉却反见涩脉,应当见大脉却反见小脉等情况。)
脉至而不应期,则为病态。(时令已到而脉象未应,说明来气不足,所以生病。)
脉至而先于时令,则为病态。(时令未到而脉象先到,说明来气太过,所以生病。凡南北政的不同年份,脉象的变化都是如此。)
阴阳脉象互换错乱者,病情危重。(“阴阳易”,即《五营运大论》中阴阳交错的含义,阴阳错乱,所以称为危重。详见本类前五篇。)
The Yellow Emperor asked: How can one observe the excess of the Six Qi? (To "observe" means to monitor the manifestation of the corresponding Qi.) Qibo replied: Observe when the Qi arrives. (Observe it when the Qi reaches its peak.)
If clear Qi arrives in abundance, this indicates an excess of Dryness (Metal). The Wind-Wood element is affected, and Liver disease arises. (Since Metal overcomes Wood, the Liver-Wood is affected; thus, Liver disease extends to the Gallbladder.)
If hot Qi arrives in abundance, this indicates an excess of Fire. The Metal-Dryness is affected, and Lung disease arises. (Since Fire overcomes Metal, the Lung-Metal is affected; thus, Lung disease extends to the Large Intestine.)
If cold Qi arrives in abundance, this indicates an excess of Water. The Fire-Heat is affected, and Heart disease arises. (Since Water overcomes Fire, the Heart-Fire is affected; thus, Heart disease extends to the Small Intestine, Pericardium, and Sanjiao.)
If damp Qi arrives in abundance, this indicates an excess of Earth. The Cold-Water is affected, and Kidney disease arises. (Since Earth overcomes Water, the Kidney-Water is affected; thus, Kidney disease extends to the Bladder.)
If wind Qi arrives in abundance, this indicates an excess of Wood. The Earth-Dampness is affected, and Spleen disease arises. (Since Wood overcomes Earth, the Spleen-Earth is affected; thus, Spleen disease extends to the Stomach.)
This is what is meant by contracting pathogenic factors and becoming ill. (When Qi appears when it should not, it is called pathogenic Qi. Once contacted, illness ensues.)
If one encounters a year of deficient annual Qi, the pathogenic factor becomes severe. (In years where the annual Qi is insufficient, the overcoming pathogen is necessarily severe, such as in Yi, Ding, Ji, Xin, and Gui years.)
If one loses harmony with the seasons, the pathogenic factor also becomes severe. (When the Guest Qi and Host Qi are discordant, and the four seasons lose their order, contracting pathogens leads to illness corresponding to the element that overcomes the Zang organ; the pathogen is also severe.)
If one encounters the time of the empty moon, the pathogenic factor also becomes severe. (As stated in the *Ba Zheng Shen Ming Lun*: When the moon begins to wax, blood and Qi begin to refine, and Wei Qi begins to circulate; when the moon is full, blood and Qi are substantial, and muscles are firm; when the moon wanes (is empty), muscles diminish, meridians become deficient, Wei Qi departs, and only the form remains. This is the meaning of the "empty moon," which explains why pathogens become severe. The above three sections, described as "encountering deficiency," "losing harmony," and "meeting emptiness," all refer to human circumstances, known as the "Three Deficiencies." Detailed meanings are found in Chapter 36 below.)
If re-infected by pathogens, the condition becomes critical. (As stated in the *Sui Lu Lun*: On the day of Winter Solstice, one may be struck by Empty Wind but not fall ill immediately; on the day of Start of Spring, if one is again struck by Empty Wind, these two pathogens contend with each other. This is referred to as "re-infection"; detailed meanings are found in Chapter 36 below.)
Where there is an excess Qi, there must be a repelling Qi. (The Qi of Heaven and Earth does not exceed limits; where there is excess, there is retaliation/rebound.)
The Yellow Emperor asked: What are the pulses like when they arrive? (This asks about the pulse characteristics of the arrival of the Six Excess Qi.) Qibo replied: When Jueyin arrives, the pulse is Xian (Wiry). (Jueyin arrival corresponds to Wind-Wood Qi. Wood is straight and long, hence the pulse is Wiry. A Wiry pulse is long, straight, and forceful, like a bowstring.)
When Shaoyin arrives, the pulse is Gou (Hooked). (Shaoyin arrival corresponds to Ministerial Fire Qi. Fire rises and floats, hence the pulse is Hooked. A Hooked pulse comes strongly and leaves weakly, being solid externally and deficient internally, like a hook.)
When Taiyin arrives, the pulse is Chen (Deep). (Taiyin arrival corresponds to Damp-Earth Qi. Earth is heavy and solid, hence the pulse is Deep. A Deep pulse travels beneath the muscles.)
When Shaoyang arrives, the pulse is Da (Large) and Fu (Floating). (Shaoyang arrival corresponds to Ministerial Fire Qi. Fire-heat grows vigorously outward, hence the pulse comes large and floats on the surface of the skin.)
When Yangming arrives, the pulse is Duan (Short) and Se (Rough). (Yangming arrival corresponds to Dryness-Metal Qi. Metal has a contracting nature, hence the pulse comes short and rough.)
When Taiyang arrives, the pulse is Da (Large) and Chang (Long). (Taiyang arrival corresponds to Cold-Water Qi. The source of water is long and its generative power is broad, hence its pulse arrives both large and long.)
When the pulse arrives in harmony, it is normal. (For the six pulses mentioned above, if there is neither excess nor deficiency, it is a harmonious pulse; disharmony indicates disease.)
When the pulse arrives excessively, it indicates disease. ("Excessive" means overly vigorous and losing the middle-harmonious Qi, such as a pulse that is purely Wiry without the Stomach Qi.)
When the pulse arrives contrary to expectation, it indicates disease. ("Contrary" means appearing opposite to the controlling element's pulse, such as expecting a Wiry pulse but finding a Rough one, or expecting a Large pulse but finding a Small one.)
When the pulse arrives but does not correspond to the season, it indicates disease. (The season has arrived, but the pulse does not respond, indicating insufficient incoming Qi, hence disease.)
When the pulse arrives before the season, it indicates disease. (The season has not yet arrived, but the pulse appears first, indicating excessive incoming Qi, hence disease. In years of North and South Polarity, changes in pulse images occur similarly.)
When Yin and Yang pulses exchange places, the condition is critical. ("Yin-Yang Exchange" refers to the concept of Yin-Yang intersection in the *Wu Yun Liu Qi Da Lun*; Yin and Yang are disordered, hence termed critical. See details in the first five chapters of this category.)