(《素问·金匮真言论》)
黄帝问曰∶天有八风,经有五风,何谓?(经,经脉也。八风,八方之风也,出《九宫八风篇》。五风,五脏之风也,
出《风论》。)岐伯对曰∶八风发邪,以为经风,触五脏,邪气发病。(八风不得其正,则发为邪气,其中于人,则入为五
经之风,特以所伤之异,故名亦异耳。风自外入,则循经而触于五脏,故发病也。)所谓得四时之胜者,春胜长夏,长夏
胜冬,冬胜夏,夏胜秋,秋胜春,所谓四时之胜也。(春木,夏火,长夏土,秋金,冬水,五时五气,互有克胜。所胜为
邪,则不胜者受之。天之运气,人之藏气,无不皆然。此节义与《六节藏象论》同,详运气类二。)东风生于春,病在肝,
俞在颈项。(上文言四时之胜者能为病,此下言邪气随时之为病也。东风生于春,木气也,故病在肝。春气发荣于上,故
俞应于颈项。)南风生于夏,病在心,俞在胸胁。(火气应于心。心脉循胸出胁,而南方之气主于前,故俞在胸胁。)西风
生于秋,病在肺,俞在肩背。(金之气也,故病在肺。肺居上焦,附近肩背,故俞应焉。)北风生于冬,病在肾,俞在腰
股。(水之气也,故病在肾。腰为肾之府,与股接近,故俞应焉。)中央为土,病在脾,俞在脊。(脊居体中,故应土也。)
故春气者病在头,(阳气上升也。)夏气者病在藏,(在藏言心,心通夏气,为诸藏之主也。)秋气者病在肩背,(肺之应也。)
冬气者病在四肢。(上文北方言在腰股,此言在四肢者,盖腰股属阴,四肢气薄,皆易于受寒者也。)故春善病鼽衄,(风
邪在头也。鼽音求。衄,女六切。)仲夏善病胸胁,(胸胁近心也。)长夏善病洞泄寒中,(风寒犯脾也。)秋善病风疟,(暑
汗不出,风寒袭于肤腠也。)冬善病痹厥。(寒邪在四肢也。)故冬不按跷,春不鼽衄,(按跷,谓按摩肢节以行导引也。
三冬元气伏藏在阴,当伏藏之时而扰动筋骨,则精气泄越,以致春夏秋冬各生其病。故冬宜养藏,则春时阳气虽升,阴
精自固,何有鼽衄及如下文之患?按跷且不可,则冒寒妄劳益可知矣。跷音乔,又极虐切。)春不病颈项,仲夏不病胸胁,
长夏不病洞泄寒中,秋不病风疟,冬不病痹厥飧泄而汗出也。(此节五句亦皆由冬不按跷所致,盖水王则生春木,木王则
生夏火,火王则生长夏土,土王则生秋金,金王则生冬水,故可免四时之病。飧音孙。)夫精者身之本也,故藏于精者,
春不病温。(人身之精,真阴也,为元气之本。精耗则阴虚,阴虚则阳邪易犯,故善病温。此正谓冬不按跷则精气伏藏,
阳不妄升则春无温病,又何虑乎鼽衄颈项等病?)夏暑汗不出者,秋成风疟。此平人脉法也。(夏月伏暑而汗不出,则暑
邪内蓄,以至秋凉凄切之时,寒热相争,乃病风疟。故《热论篇》曰∶暑当与汗皆出勿止也。以上二节,一言冬宜闭藏,
一言夏宜疏泄。冬不藏精则病温,夏不汗泄则病疟。阴阳启闭,时气宜然。此举冬夏言,则春秋在其中矣。凡四时之气,
顺之则安,逆之则病,是即平人之脉法。脉法者,言经脉受邪之由然也。)
(出自《素问·金匮真言论》)
黄帝问道:天有八方之风,经脉受邪可形成五脏之风,这是什么意思?(注:经,指经脉。八风,指来自八个方向的风,出自《九宫八风篇》。五风,指侵犯五脏的风,出自《风论》。)
岐伯回答说:八方之风引发邪气,成为侵袭经脉的风邪,触动五脏,导致邪气发病。(注:如果八方之风不顺应时令正气,就会发为邪气,侵入人体,就成为五脏经脉之风,只是由于伤害的部位不同,所以名称也各异。风从外而入,便顺着经脉触动五脏,因此发病。)
所谓符合四时相克规律而致病的情况是:春胜长夏,长夏胜冬,冬胜夏,夏胜秋,秋胜春,这叫做四时之胜。(注:春属木,夏属火,长夏属土,秋属金,冬属水,五个时节和五种气候相互克制。被克的一方产生邪气,则不胜者受病。天的运气与人的脏气,无不如此。这一节的含义与《六节藏象论》相同,详见运气类第二。)
东风生于春季,病变在肝,输注部位在颈项。(注:上文讲四时相胜能致病,下文讲邪气随季节变化而致病。东风生于春,属木气,所以病变在肝。春气生发向上,所以输注反应在颈项。)
南风生于夏季,病变在心,输注部位在胸胁。(注:火气应于心。心脉循行经过胸部出于胁部,且南方之气主于前方,所以输注反应在胸胁。)
西风生于秋季,病变在肺,输注部位在肩背。(注:这是金之气,所以病变在肺。肺位于上焦,靠近肩背,所以输注反应在此。)
北风生于冬季,病变在肾,输注部位在腰股。(注:这是水之气,所以病变在肾。腰是肾的府邸,与大腿根部接近,所以输注反应在此。)
中央属土,病变在脾,输注部位在脊。(注:脊柱位于身体中部,所以对应土。)
所以,春气致病多在头部,(注:因为阳气上升。)夏气致病多在脏腑,(注:这里“在藏”主要指心,因为心通应夏气,是各脏的主宰。)秋气致病多在肩背,(注:这是肺的对应部位。)冬气致病多在四肢。(注:上文北方提到在腰股,这里说在四肢,是因为腰股属阴,四肢阳气较薄,都容易受寒邪侵袭。)
所以,春季容易患鼻渊(鼽)和鼻出血(衄),(注:风邪在头部。鼽音qiú,指鼻塞流涕;衄音nǜ,指出血。)仲夏容易患胸胁病,(注:胸胁靠近心脏。)长夏容易患洞泄和寒中症,(注:风寒侵犯脾脏。)秋季容易患风疟,(注:暑热出汗不畅,风寒侵袭皮肤腠理。)冬季容易患痹证和厥证。(注:寒邪在四肢。)
所以,冬季不进行按跷(按摩导引),春季就不会发生鼻渊和鼻出血,(注:按跷,指按摩肢体关节以施行导引术。冬季元气潜伏收藏于阴分,如果在应当潜伏收藏的时候扰动筋骨,就会导致精气泄漏耗散,从而引起春夏秋冬四季各自产生疾病。所以冬季宜于养藏,这样春季阳气虽然升发,但阴精自然固密,怎么会有鼻渊、鼻出血以及下文提到的各种病患呢?连按跷尚且不可做,那么冒犯寒冷、妄自劳累就更不用说了。跷音qiáo,又音jīo。)春季就不会患颈项病,仲夏不会患胸胁病,长夏不会患洞泄寒中症,秋季不会患风疟,冬季不会患痹证、厥证、完谷不化的飧泄以及汗出症。(注:这五句也都是由冬季不按跷所导致的。因为水旺则生春木,木旺则生夏火,火旺则生长夏土,土旺则生秋金,金旺则生冬水,所以可以避免四季的疾病。飧音sūn。)
精气是身体的根本,所以善于保养精气的人,春季不会患温病。(注:人体的精,是真阴,是元气的根本。精耗损则阴虚,阴虚则阳邪容易侵犯,所以容易患温病。这正是说冬季不按跷则精气潜伏收藏,阳气不妄动升发,则春季没有温病,又何须担心鼻渊、颈项等病患呢?)
夏季感受暑邪而不出汗的,到了秋天会发展成风疟。这是平和之人正常的脉法规律。(注:夏季伏留暑邪而不出汗,则暑邪内蓄,直到秋季凉意肃杀之时,寒热相争,于是患上风疟。所以《热论篇》说:暑邪应当随着汗液一起排出,不要制止。以上两节,一节讲冬季宜闭藏,一节讲夏季宜疏泄。冬季不藏精则患温病,夏季不汗泄则患疟疾。阴阳的开合,顺应时气自然是这样的。这里举冬季和夏季为例,则春季和秋季的情况就在其中了。凡是四时的气候,顺应它则平安,违背它则生病,这就是平和之人的脉法。脉法,是指经脉受邪的原因。)
(From *Suwen: Jin Gui Zhenyan Lun*)
Huangdi asked: "The heaven has Eight Winds (Bafeng, winds from eight directions), and the meridians have Five Winds (Wufeng, wind pathogens affecting the five zang organs). What does this mean?"
Qibo replied: "The Eight Winds generate pathogenic factors, becoming wind pathogens that invade the meridians, touching the five zang organs, causing disease due to pathogenic qi."
Regarding the concept of 'overcoming' among the four seasons leading to disease: Spring overcomes Late Summer; Late Summer overcomes Winter; Winter overcomes Summer; Summer overcomes Autumn; Autumn overcomes Spring. This is called the overcoming relationship among the four seasons. [Spring corresponds to Wood, Summer to Fire, Late Summer to Earth, Autumn to Metal, and Winter to Water. The five seasons and their corresponding climates mutually overcome each other. The overcome side generates pathology, and the side that cannot overcome suffers. This applies to both the heavenly luck (Yunqi) and human organ qi.]
East Wind arises in Spring, causing disease in the Liver, with its transport points located at the neck and nape. [East Wind belongs to Wood Qi, thus affecting the Liver. Spring Qi rises and flourishes upward, so the response is at the neck and nape.]
South Wind arises in Summer, causing disease in the Heart, with its transport points located at the chest and hypochondrium. [Fire Qi corresponds to the Heart. The Heart meridian passes through the chest and emerges at the hypochondrium, and Southern Qi governs the anterior aspect, so the response is at the chest and hypochondrium.]
West Wind arises in Autumn, causing disease in the Lungs, with its transport points located at the shoulders and back. [This is Metal Qi, thus affecting the Lungs. The Lungs reside in the Upper Jiao, near the shoulders and back, so the response is there.]
North Wind arises in Winter, causing disease in the Kidneys, with its transport points located at the waist and thighs. [This is Water Qi, thus affecting the Kidneys. The waist is the mansion of the Kidneys, close to the thighs, so the response is there.]
The Center corresponds to Earth, causing disease in the Spleen, with its transport points located at the spine. [The spine is in the center of the body, thus corresponding to Earth.]
Therefore, diseases caused by Spring Qi often affect the head, [because Yang Qi ascends.] Diseases caused by Summer Qi often affect the zang organs, [specifically the Heart, which corresponds to Summer and is the master of all zang organs.] Diseases caused by Autumn Qi often affect the shoulders and back, [corresponding to the Lungs.] Diseases caused by Winter Qi often affect the four limbs. [The previous section mentioned the waist and thighs for the North; here mentioning the four limbs is because the waist and thighs belong to Yin, while the four limbs have thinner Qi and are prone to cold invasion.]
Thus, in Spring, one is prone to rhinorrhea (Qiu) and epistaxis (Nu); [Wind pathogen in the head.] In Mid-Summer, one is prone to chest and hypochondriac disorders; [Chest and hypochondrium are near the Heart.] In Late Summer, one is prone to severe diarrhea (Dongxie) and cold injury in the middle jiao; [Cold and dampness invading the Spleen.] In Autumn, one is prone to wind-malaria (Fengnüe); [Summer heat sweat fails to discharge, allowing cold and wind to invade the skin and interstices.] In Winter, one is prone to Bi syndrome (painful obstruction) and Jue syndrome (cold extremities/reversal); [Cold pathogen in the four limbs.]
Therefore, if one does not perform Anqiao (massage and guided movement) in Winter, one will not suffer from rhinorrhea or epistaxis in Spring. [Anqiao refers to massaging joints and limbs to promote circulation and guided exercises. During the three winter months, Yuan Qi (Original Qi) is hidden within Yin. Disturbing bones and muscles during this time of hiding leads to leakage and depletion of essence and qi, causing diseases in all four seasons. Thus, Winter should be used for nurturing storage. If Spring Yang Qi rises but Yin Essence remains secure, there will be no rhinorrhea or subsequent ailments. If even massage is inadvisable, then exposing oneself to cold and overexertion is certainly worse.] Consequently, one will not suffer from neck and nape disorders in Spring, chest and hypochondriac disorders in Mid-Summer, severe diarrhea and cold injury in Late Summer, wind-malaria in Autumn, or Bi syndrome, Jue syndrome, undigested stool diarrhea (Sunxie), and sweating in Winter. [These five conditions are also caused by failing to hide in Winter. When Water is prosperous, it generates Spring Wood; when Wood is prosperous, it generates Summer Fire; when Fire is prosperous, it generates Late Summer Earth; when Earth is prosperous, it generates Autumn Metal; when Metal is prosperous, it generates Winter Water. Thus, seasonal diseases can be avoided.]
Essence (Jing) is the root of the body. Therefore, those who preserve their essence will not suffer from Warm diseases (Wenbing) in Spring. [Human essence is True Yin, the root of Original Qi. Depletion of essence leads to Yin deficiency, making Yang pathogens easy to invade, hence prone to Warm diseases. This implies that if one hides essence in Winter by avoiding excessive activity, Yang Qi will not rise recklessly, preventing Spring Warm diseases and concerns about rhinorrhea or neck disorders.]
If summer heat is retained without sweating in Summer, it will develop into wind-malaria in Autumn. This is the normal pattern of pulse and disease prevention. [If summer heat is retained internally due to lack of sweating in Summer, when autumn coolness arrives, cold and heat contend, resulting in wind-malaria. As stated in *Re Lun*: "Summer heat should be expelled with sweat; do not stop it." These two sections discuss Winter storage and Summer dispersion. Failure to store essence in Winter leads to Warm diseases; failure to disperse heat via sweating in Summer leads to malaria. The opening and closing of Yin and Yang follow the seasonal climate. By citing Winter and Summer, Spring and Autumn are implied. For all seasonal climates, following them ensures peace, while opposing them causes disease. This is the method of maintaining health. 'Pulse method' here refers to understanding how meridians receive pathogens.]