(《素问·经脉别论》)
黄帝问曰∶人之居处动静勇怯,脉亦为之变乎?岐伯对曰∶凡人之惊恐恚劳动静皆为变也。(脉以经脉血气统言之也。
恚,怒也。恚,慧、畏二音。)是以夜行则喘出于肾,淫气病肺。(此下四条言喘者,喘属气,病在阳也。肾者至阴也,
阴受气于夜,夜行则劳骨伤阴,故喘出于肾。淫气者,阴伤则阳胜,气逆为患也。肺肾为母子之脏,而少阴之脉上入肺
中,故喘出于肾则病苦于肺。)有所堕恐,喘出于肝,淫气害脾。(有所堕坠而恐者,伤筋损血,故喘出于肝。肝气淫则
害于脾,木乘土也。)有所惊恐,喘出于肺,淫气伤心。(惊恐则神气散乱,肺藏气,故喘出于肺。心藏神,故淫气伤之。)
度水跌仆,喘出于肾与骨。(水气通于肾,跌仆伤于骨,故喘出焉。仆音付。)当是之时,勇者气行则已,怯者则着而为
病也。(此结上文而言有病有不病者,因气有强弱不同也。)故曰∶诊病之道,观人勇怯骨肉皮肤,能知其情,以为诊法
也。(勇可察其有余,怯可察其不足,骨可以察肾,肉可以察脾,皮肤可以察肺,望而知其情,即善诊者也。)
故饮食饱甚,汗出于胃。(此下五条言汗者,汗属精,病在阴也。饮食饱甚,则胃气满而液泄,故汗出于胃。)惊而
夺精,汗出于心。(惊则神散,神散则夺其精气,故汗出于心。)持重远行,汗出于肾。(持重远行则伤骨,肾主骨,故汗
出于肾。)疾走恐惧,汗出于肝。(肝主筋而藏魂,疾走则伤筋,恐惧则伤魂,故汗出于肝。)摇体劳苦,汗出于脾。(摇
体劳苦,则肌肉四肢皆动,脾所主也,故汗出于脾。《本病论》曰∶醉饱行房,汗出于脾。)故春秋冬夏,四时阴阳,生
病起于过用,此为常也。(五脏受气,强弱各有常度,若勉强过用,必损其真,则病之所由起也。)
(出自《素问·经脉别论》)
黄帝问道:人的居住环境、活动状态以及性格的勇敢与怯弱,是否也会导致脉象发生变化呢?岐伯回答说:凡是人的惊恐、愤怒、劳累以及动静状态,都会引起变化。(这里的“脉”是从经脉和气血的整体角度来论述的。“恚”,意为愤怒。读音同“慧”或“畏”。)因此,夜间行走会导致气喘从肾发出,邪气蔓延会伤害肺脏。(以下四条论述气喘,气喘属于气机病变,病位在阳分。肾是至阴之脏,夜间属阴,夜间行走则劳损骨骼、损伤阴精,所以气喘源于肾。所谓“淫气”,是指阴精受损导致阳气偏胜,气机上逆为患。肺与肾是母子关系的脏腑,且足少阴肾经上行进入肺中,所以气喘源于肾就会痛苦地波及肺脏。)如果有坠落受惊的情况,气喘从肝发出,邪气蔓延会损害脾脏。(因坠落而恐惧的人,会损伤筋脉和血液,所以气喘源于肝。肝气过盛会伤害脾脏,这是木克土的关系。)如果有受到惊吓的情况,气喘从肺发出,邪气蔓延会伤害心脏。(惊恐会使神气散乱,肺主藏气,所以气喘源于肺。心主藏神,所以邪气会伤害心神。)如果涉水或跌倒受伤,气喘从肾和骨骼发出。(水气通应于肾,跌仆损伤骨骼,所以气喘由此产生。“仆”音同“付”。)在这个时候,勇敢的人气机运行通畅则病愈,怯弱的人气机郁滞则会形成疾病。(这是对上文的小结,说明有病和不病的区别,是因为人的气有强弱不同。)所以说:诊断疾病的道理,在于观察人的勇敢与怯弱、骨骼肌肉和皮肤状况,能够了解其内在情况,这就是诊法。(勇敢可以察知正气有余,怯弱可以察知正气不足,骨骼可以察知肾的状态,肌肉可以察知脾的状态,皮肤可以察知肺的状态,通过望诊就能了解病情,这就是善于诊病的人。)
因此,饮食过饱,汗液从胃发出。(以下五条论述汗出,汗液属于精微物质,病位在阴分。饮食过饱,则胃气充盈而津液外泄,所以汗出于胃。)受惊导致精气耗夺,汗液从心发出。(惊则神气散失,神气散失则导致精气被夺,所以汗出于心。)负重远行,汗液从肾发出。(负重远行则损伤骨骼,肾主骨,所以汗出于肾。)急速奔跑且恐惧,汗液从肝发出。(肝主筋并藏魂,急速奔跑则损伤筋,恐惧则损伤魂,所以汗出于肝。)身体摇动劳作辛苦,汗液从脾发出。(身体摇动劳作辛苦,则肌肉四肢都运动,这是脾所主管的,所以汗出于脾。《本病论》说:醉酒后行房事,汗出于脾。)所以春夏秋冬四季阴阳的变化,疾病产生于过度使用(劳逸不当),这是常理。(五脏接受的气血,强弱各有常规限度,如果勉强过度使用,必然损伤真元,这就是疾病产生的原因。)
(From *Suwen: Treatise on the Distinctive Characteristics of the Meridians*)
The Yellow Emperor asked, "Do a person's living environment, activity levels, and inherent courage or timidity also cause variations in the pulse?" Qibo replied, "All conditions such as fright, anger, labor, and rest can induce changes. (Here, 'pulse' refers generally to the meridians and the integration of Qi and Blood. 'Hui' means anger; pronounced like 'hui' or 'wei'.) Therefore, walking at night causes panting originating from the Kidney, with pathogenic Qi spreading to damage the Lung. (The following four points discuss panting; panting is related to Qi disorders and belongs to the Yang aspect. The Kidney is the organ of extreme Yin. Nighttime corresponds to Yin. Walking at night labors the bones and injures Yin essence, thus causing panting from the Kidney. 'Yin Qi' refers to the condition where Yin injury leads to Yang excess, resulting in rebellious Qi. The Lung and Kidney are mother-son organs, and the Foot-Shaoyin Kidney meridian ascends into the Lung. Thus, panting originating from the Kidney will distress the Lung.) If there is a fall accompanied by fear, panting originates from the Liver, with pathogenic Qi harming the Spleen. (Falls and fear injure tendons and blood, so panting originates from the Liver. Excessive Liver Qi harms the Spleen, representing Wood overacting on Earth.) If there is sudden fright, panting originates from the Lung, with pathogenic Qi damaging the Heart. (Fright scatters Shen spirit; the Lung stores Qi, so panting originates from the Lung. The Heart stores Shen, so pathogenic Qi damages it.) Wading through water or suffering falls causes panting originating from the Kidney and bones. (Water Qi communicates with the Kidney, and falls injure bones, hence the panting. 'Pu' is pronounced 'fu'.) At such times, those who are courageous have smooth Qi flow and recover, while those who are timid have stagnant Qi that manifests as disease. (This concludes the above discussion, indicating that some get sick and others do not, due to differences in Qi strength.) Therefore, it is said: The way to diagnose disease is to observe a person's courage or timidity, bones, muscles, and skin, thereby understanding their condition, which constitutes the diagnostic method. (Courage indicates excess [of Zheng Qi], timidity indicates deficiency; bones reflect the Kidney, muscles reflect the Spleen, and skin reflects the Lung. Observing these allows one to know the condition, which is the skill of an excellent diagnostician.)
Therefore, excessive fullness from food and drink causes sweating from the Stomach. (The following five points discuss sweating; sweat belongs to Essence and the disorder is in the Yin aspect. Excessive eating fills Stomach Qi and causes fluids to leak out, so sweat comes from the Stomach.) Fright that depletes Jing causes sweating from the Heart. (Fright scatters Shen; scattered Shen leads to depletion of Jing-Qi, so sweat comes from the Heart.) Carrying heavy loads and traveling long distances causes sweating from the Kidney. (Carrying heavy loads and traveling far injures bones; the Kidney governs bones, so sweat comes from the Kidney.) Running fast while fearful causes sweating from the Liver. (The Liver governs tendons and houses Hun; running fast injures tendons, and fear injures Hun, so sweat comes from the Liver.) Physical exertion and toil cause sweating from the Spleen. (Physical movement and toil involve the muscles and four limbs, which are governed by the Spleen, so sweat comes from the Spleen. *Benbing Lun* states: Sexual intercourse after drunkenness and fullness causes sweating from the Spleen.) Thus, the Yin-Yang of the four seasons—Spring, Summer, Autumn, and Winter—diseases arise from overuse, which is the constant principle. (The Qi received by the Five Zang organs has its own normal limits of strength; if forced beyond use, it inevitably damages True Yuan, which is how diseases originate.)