（《素问·着至教论》全）
黄帝坐明堂，召雷公而问之曰∶子知医之道乎？（明堂，天子布政之所，圣人向明而治，故曰明堂。）雷公对曰∶诵
而颇能解，解而未能别，别而未能明，明而未能彰，（颇能解，粗解其义耳。别者别其条理，明者明其精微，彰则利于用
矣。杨上善曰∶习道有五∶一诵，二解，三别，四明，五彰。）足以治群僚，不足至侯王。（群僚之情易通，侯王之意难
测，所以有不同也。然则膏粱藜藿，其为难易亦然。）愿得受树天之度，四时阴阳合之，别星辰与日月光，以彰经术，后
世益明，上通神农，着至教拟于二皇。（树，立也。天度立则四时阴阳之序可以合，星辰日月之光可以别，用以彰经术，
令后世益明，是上通神农之道，着为至教，则拟德于二皇矣。二皇，伏羲、神农也。）帝曰∶善。无失之，此皆阴阳表里、
上下雌雄相输应也，而道上知天文，下知地理，中知人事，可以长久，以教众庶，亦不疑殆，医道论篇，可传后世，可
以为宝。（阴阳表里上下雌雄相输应者，即指上文天度四时阴阳星辰日月光言，所以医道合于三才，必尽知之，斯可以垂
教后世，不致疑殆，永传为宝矣。而道上知天文等四句，与《气交变大论》同，详运气类十。）雷公曰∶请受道，讽诵用
解。帝曰∶子不闻阴阳传乎？曰∶不知。曰∶夫三阳天为业，（阴阳传，古经也。此三阳者，统手足六阳为言。三阳在上，
应天之气而卫乎周身，故曰天为业者，谓业同乎天也。）上下无帝，合而病至，偏害阴阳。（三阳主表，而虚邪中之，则
应变不定，故其气上下无常。若三阳相合而病至，阳胜伤阴，则自外而内，偏害阴阳矣。《禁服篇》曰∶审察卫气，为百
病母。盖亦此义。）雷公曰∶三阳莫当，请闻其解。（此必古经语也。言三阳并至，则邪变之多，气有莫可当者。）帝曰∶
三阳独至者，是三阳并至，并至如风雨，上为巅疾，下为漏病。（此三阳独至者，虽兼手足太阳为言，而尤以足太阳为之
主，故曰独至。盖足太阳为三阳之纲领，故凡太阳之邪独至者，则三阳气会，皆得随而并至也。阳邪之至，疾速无期，
故如风雨。且足太阳之脉，上从巅入络脑，下络肾属膀胱；手太阳之脉，上循颈颊，下抵胃属小肠。故上为顶巅之疾，
下为漏病。漏病者，二阴不禁，凡水谷精血之类皆是也。）外无期，内无正，不中经纪，诊无上下以书别。（三阳并至，
倏如风雨，故外无证据可期，内无名目可正，病变之至，不中于经常纲纪。故其诊也，亦无上下一定之法及可以书记先
别之者。）雷公曰∶臣治疏愈，说意而已。（言臣之治病鲜愈者，正如帝之所教，然愿言其意而已。）帝曰∶三阳者，至阳
也，积并则为惊，病起疾风，至如 砺，九窍皆塞，阳气滂溢，干嗌喉塞。（太阳为至盛之阳，故曰至阳。若诸阳更为积
并，则阳盛之极，必伤阴气。手太阳之阴心也，足太阳之阴肾也，心伤其神，肾伤其志，则为惊骇。疾风 砺，皆速暴
之谓。其为九窍嗌喉之干塞者，以手太阳手足少阴之脉，皆循咽喉也。 砺，霹雳同。）并于阴则上下无常，薄为肠 。
（阴，脏也。阳邪自表入脏，并聚于阴，则或上或下，亦无定诊。若留薄下焦，则为肠 而下利。）此谓三阳直心，坐不
得起卧者，便身全三阳之病。（直心，谓邪气直冲心膈也。手太阳之脉，循臂外廉出绕肩胛交肩上，入缺盆络心；足太阳
之脉，夹脊贯臀入 中，其别者散之肾，循膂当心入散，故凡病邪气直心，及坐不得起，起不得卧者，便身全三阳之病
也。愚按∶三阳之邪多自外入，故伤寒家多有直心不得起卧之证。凡诊外感者，不可不察此节之义。）且以知天下，何以
别阴阳、应四时，合之五行，（且，犹将也。谓欲知天下之要道，尤当别阴阳、应四时，以合之五行之理也。）雷公曰∶
阳言不别，阴言不理，请起受解，以为至道。（不别不理，言未明也。公因帝问，故自歉而复请。）帝曰∶子若受传，不
知合至道以惑师教，语子至道之要。（受传于师而未明其道，适足以惑师之教，故语以其要也。）病伤五脏，筋骨以消，
子言不明不别，是世主学尽矣。（邪并于阳则阳病，并于阴则阴病，阴阳俱病，故伤五脏。脏伤于内，则筋骨消于外也。
医道司人之命，为天下之所赖，故曰世主。不明不别，于道何有，是使圣人之学泯矣。）肾且绝，惋惋日暮，从容不出，
人事不殷。（肾与足太阳为表里，至阴之脏也。《上古天真论》曰∶肾者主水，受五脏六腑之精而藏之。今如上文所云，
三阳并至而病伤五脏，则精虚气竭，筋骨以消矣。且太阳传里，必至少阴，是以肾气受伤，真阴且绝，故惋惋不已，忧
疑终日，宜其窘窘乎从容之不出，岌岌乎人事之不殷也。然则阳邪之至，害必归阴，五脏之伤，穷必及肾，此所谓阴阳
表里上下雌雄相输应也，即所谓至道之要也。学人于此知救其原，则回天之手矣。故论名《着至教》者，夫岂徒然也哉。
惋，乌贯切。）
《素问·着至教论》（全文）
黄帝坐在明堂，召见雷公并问他道：“你懂得医学的道理吗？”雷公回答说：“能够诵读并且大致能理解其含义，理解了但还不能辨别条理，辨别了但还不能阐明精微，阐明了但还不能彰显于应用。”（注：明堂是天子颁布政令的地方，圣人面向光明而治理天下，所以称为明堂。）（注：大致能理解，只是粗略地理解其义理。辨别是指分辨其条理，阐明是指明白其精微之处，彰显则是利于实际应用了。杨上善说：学习医道有五个阶段：一为诵读，二为理解，三为辨别，四为阐明，五为彰显。）“足以治疗群臣僚属，却不足以应对侯王。”（注：群臣僚属的情况容易沟通，侯王的意图难以揣测，所以有所不同。然而，无论是富贵人家还是贫贱百姓，对待他们的难易程度也是如此。）“希望我能确立天的度数，与四季阴阳相合，辨别星辰与日月的光芒，以彰显经典医术，使后世更加明晰，上通神农之道，著成至教，比拟于二皇的德行。”（注：树，即立的意思。确立天的度数，则四季阴阳的顺序可以相合，星辰日月之光可以辨别，用以彰显经典医术，让后世更加明晰，这是上通神农之道，著为至高教诲，那么德行就比拟于二皇了。二皇，指伏羲和神农。）黄帝说：“好。不要失传，这些都是阴阳、表里、上下、雌雄相互输注对应的道理，向上通晓天文，向下通晓地理，中间通晓人事，可以长久传承，用来教导大众，也不会产生疑惑危险。这篇医道论述，可以流传后世，可以作为珍宝。”（注：阴阳表里上下雌雄相互输注对应，就是指上文所说的天度、四时阴阳、星辰日月之光，所以医道符合天地人三才之道，必须完全知晓，这样才能垂教后世，不致产生疑惑危险，永远流传成为珍宝。而上文‘向上通晓天文’等四句，与《气交变大论》相同，详见运气类第十部分。）雷公说：“请让我接受这道法，通过讽诵来理解和运用。”黄帝说：“你没听说过《阴阳传》吗？”雷公说：“不知道。”黄帝说：“三阳以天为事业，”（注：《阴阳传》是古经。这里的三阳，统指手六阳经和足六阳经。三阳在上，顺应天之阳气而护卫周身，所以说‘以天为事业’，意思是其事业同乎天道。）“上下没有固定的主宰，如果合并发病，就会偏害阴阳。”（注：三阳主表，若虚邪侵入，则应变不定，所以其气上下无常。如果三阳合并而发病，阳胜伤阴，则病邪自外入内，偏害阴阳。《禁服篇》说：审察卫气，它是百病的母源。大概也是这个意思。）雷公说：“三阳气势莫当，请听我解释。”（注：这一定是古经中的话语。意思是三阳并至，则邪变繁多，气机有不可抵挡之势。）黄帝说：“三阳单独到来，就是三阳并至，并至时如同风雨，上是巅顶之疾，下是漏泄之病。”（注：这里说的三阳单独到来，虽然兼指手足太阳经，但尤其以足太阳为主，所以叫独至。因为足太阳是三阳的纲领，所以凡是太阳的病邪单独到来，三阳之气会聚，都会随之并至。阳邪的到来，疾速无期，所以像风雨一样。而且足太阳经脉，上行从巅顶入络脑，下行联络肾脏属于膀胱；手太阳经脉，上行沿颈部脸颊，下行抵胃属于小肠。所以上部导致头顶的疾病，下部导致漏泄之病。漏泄之病，指二阴不能固摄，凡是水谷精血之类流失都是。）“外部没有确切的征候可期待，内部没有确定的名称可指正，病变不符合常规纲纪，诊断没有上下一定的法则及可以用书记预先辨别的。”（注：三阳并至，忽然如风雨般急骤，所以外部没有证据可期待，内部没有名目可确定，病变的发生，不符合经常的纲纪。所以诊断时，也没有上下一定的方法以及可以用文字记录预先区分的办法。）雷公说：“臣治病很少痊愈，只是说说心意罢了。”（注：意思是臣治病鲜少痊愈，正如皇帝所教导的那样，但希望陈述一下其中的意旨。）黄帝说：“三阳，是至盛的阳，积聚兼并就会导致惊骇，病起如疾风，迅猛如霹雳，九窍都闭塞，阳气滂溢，咽喉干塞。”（注：太阳是至盛之阳，所以叫至阳。如果诸阳互相积聚兼并，则阳盛至极，必然损伤阴气。手太阳的阴脏是心，足太阳的阴脏是肾，心受伤则神乱，肾受伤则志伤，就会发生惊骇。疾风和霹雳，都是形容迅速暴烈。之所以出现九窍和咽喉的干燥闭塞，是因为手太阳和手足少阴的经脉，都循行经过咽喉。）“如果并入阴分，则上下无常，迫近下焦则为肠澼。”（注：阴，指内脏。阳邪从表入脏，并聚于阴，则或上或下，也没有固定的诊断。如果留滞迫近下焦，就会形成肠澼而下利。）“这叫作三阳直冲心膈，坐不起来躺不下去的人，全身都患了三阳的病。”（注：直心，指邪气直冲心膈部位。手太阳经脉，循行手臂外侧外出绕过肩胛，交会于肩上，进入缺盆联络心脏；足太阳经脉，夹脊柱贯穿臀部进入腘中，其分支散于肾脏，循行脊背当心而入散，所以凡是病邪气直冲心膈，以及坐不得起、起不得卧的人，就是全身都患了三阳的病。我认为：三阳的病邪多从外侵入，所以伤寒患者多有直心不得起卧的症状。凡诊治外感病，不可不考察这一节的意义。）“并且以此来知晓天下，如何辨别阴阳、顺应四时，结合五行，”（注：且，犹将也。意思是想要知晓天下的要道，尤其应当辨别阴阳、顺应四时，以结合五行的道理。）雷公说：“阳言不能辨别，阴言不能理清，请起身接受解说，将其作为至高之道。”（注：不别不理，意思是尚未明白。雷公因黄帝的提问，所以自谦后又请求讲解。）黄帝说：“你若接受了传授，却不知道结合至高之道来迷惑老师的教导，我就告诉你至高之道的要点。”（注：从老师那里接受传授却不明其道，只足以迷惑老师的教导，所以告诉他其中的要点。）“疾病损伤五脏，筋骨消瘦，你言语不明不辨，这是世俗君主学问的尽头了。”（注：邪气并于阳则阳病，并于阴则阴病，阴阳俱病，所以损伤五脏。内脏受伤于内，则筋骨消瘦于外。医道掌管人的性命，被天下人所依赖，所以称世主。如果不明不辨，对道有什么帮助呢？这是使圣人之学泯灭了。）“肾气将要断绝，终日忧疑不安，从容不出，人事不殷实。”（注：肾与足太阳互为表里，是至阴之脏。《上古天真论》说：肾主水，受五脏六腑之精而藏之。现在像上文所说，三阳并至而病伤五脏，则精虚气竭，筋骨消瘦。而且太阳传里，必至少阴，所以肾气受伤，真阴几乎断绝，因此终日忧疑不安，显得窘迫不敢从容出门，岌岌乎人事不殷实。然而，阳邪的到来，危害必然归于阴，五脏的损伤，穷尽必然波及肾脏，这就是所谓的阴阳表里上下雌雄相互输注对应，也就是所谓的至高之道的要点。学者在这里知道救治本源，就有回天之力了。所以这篇论著名为《着至教》，难道不是徒有其名吗。惋，音乌贯切。）
*Suwen: Zhuo Zhi Jiao Lun* (Full Text)
Huangdi sat in the Mingtang and summoned Leigong, asking him, "Do you understand the principles of medicine?" Leigong replied, "I can recite it and roughly comprehend its meaning; having comprehended it, I cannot yet distinguish its details; having distinguished them, I cannot yet clarify their subtleties; having clarified them, I cannot yet manifest them for practical application." (Note: The Mingtang is the place where the Son of Heaven promulgates policies. Since sages govern facing the light, it is called the Mingtang.) (Note: 'Roughly comprehend' means merely grasping the general sense. 'Distinguish' refers to differentiating its logical structure; 'clarify' means understanding its essence; 'manifest' implies facilitating practical use. Yang Shangshan stated: There are five stages in learning the Dao: 1. Recitation, 2. Comprehension, 3. Distinction, 4. Clarification, 5. Manifestation.) "This is sufficient to treat officials, but insufficient to attend to feudal lords." (Note: The conditions of officials are easy to communicate with, whereas the intentions of feudal lords are difficult to fathom, hence the difference. Similarly, treating the rich and the poor presents varying degrees of difficulty.) "I wish to establish the measures of Heaven, harmonize them with the Yin and Yang of the four seasons, distinguish the light of stars from that of the sun and moon, thereby illuminating the classic medical arts, making them clearer for future generations, connecting upwards with the Way of Shennong, and establishing the highest teachings comparable to the Two Sovereigns." (Note: 'Shu' means to establish. Once the measures of Heaven are established, the order of Yin and Yang in the four seasons can be harmonized, and the light of stars, sun, and moon can be distinguished. This serves to illuminate the classic arts, making them clearer for posterity, thus connecting upwards with the Way of Shennong and establishing the highest teachings, thereby matching the virtue of the Two Sovereigns. The Two Sovereigns refer to Fuxi and Shennong.) Huangdi said, "Good. Do not lose this. All these involve the mutual transmission and correspondence of Yin and Yang, exterior and interior, upper and lower, and male and female. By knowing astronomy above, geography below, and human affairs in the middle, one can maintain longevity. Teaching the masses with this will prevent doubt and danger. This discourse on medical principles can be passed down to future generations and treasured as a jewel." (Note: The mutual transmission and correspondence of Yin/Yang, exterior/interior, etc., refers to the aforementioned measures of Heaven, seasonal Yin/Yang, and celestial lights. Thus, medical principles align with the Three Powers (Heaven, Earth, Human), requiring complete knowledge to teach posterity without causing doubt or danger, ensuring eternal preservation. The phrase 'knowing astronomy above...' is identical to that in *Qi Jiao Bian Da Lun*; see detailed discussion in the Yunqi category, Part 10.) Leigong said, "Please let me receive this Dao, reciting it to understand and apply it." Huangdi said, "Have you not heard of the *Yin Yang Zhuan*?" Leigong said, "No." Huangdi said, "The Three Yang channels take Heaven as their function," (Note: *Yin Yang Zhuan* is an ancient classic. Here, 'Three Yang' collectively refers to the six Yang channels of the hands and feet. Positioned superiorly, they correspond to Heavenly Qi and protect the body, hence 'taking Heaven as function,' meaning their operation mirrors Heaven.) "There is no fixed ruler above and below. If they combine to cause disease, they will disproportionately harm Yin and Yang." (Note: Three Yang govern the exterior. If deficient evil invades, responses become unpredictable, so their Qi moves irregularly up and down. If Three Yang combine to cause disease, excess Yang damages Yin, leading pathology from exterior to interior and disproportionately harming Yin and Yang. *Jinfu Pian* states: Examine Wei Qi, for it is the mother of all diseases. This likely shares the same meaning.) Leigong said, "The Three Yang are irresistible; please explain this." (Note: This must be a quote from an ancient classic. It means when Three Yang converge, pathogenic changes are numerous, and the Qi becomes unstoppable.) Huangdi said, "When Three Yang arrive alone, it is the convergence of Three Yang. Such convergence is like wind and rain: superiorly it causes disorders of the vertex, inferiorly it causes leakage diseases." (Note: 'Arriving alone' here, while including both hand and foot Taiyang, particularly emphasizes Foot Taiyang as the primary channel, hence 'alone.' Since Foot Taiyang is the commander of the Three Yang, whenever Taiyang pathogenic factors arrive exclusively, the Qi of all Three Yang converges and arrives together. Pathogenic Yang arrives swiftly and unpredictably, like wind and rain. Furthermore, Foot Taiyang meridians ascend from the vertex to connect with the brain and descend to link with the Kidney and belong to the Bladder; Hand Taiyang meridians ascend along the neck and cheek, descend to the stomach, and belong to the Small Intestine. Thus, superiorly it causes vertex disorders, and inferiorly it causes leakage diseases. Leakage diseases refer to the inability of the two Yin orifices to retain, involving the loss of fluids, grain essence, and blood.) "Externally there are no predictable signs, internally there are no definitive names to identify, the changes do not conform to standard principles, and diagnosis lacks fixed upper/lower methods or written precedents for differentiation." (Note: The convergence of Three Yang is sudden like wind and rain; thus, external signs are unpredictable, and internal nomenclature is indeterminate. Pathological changes do not follow regular patterns. Therefore, diagnosis lacks fixed upper/lower protocols or written records for prior differentiation.) Leigong said, "My treatments rarely result in recovery; I merely express my thoughts." (Note: Meaning that his cures are rare, as taught by the Emperor, but he wishes to articulate the underlying intent.) Huangdi said, "Three Yang represents Supreme Yang. Accumulation and confluence lead to fright. The disease arises like a gale, swift as thunder, blocking all nine orifices. Yang Qi overflows, causing dryness and obstruction in the throat." (Note: Taiyang is the most vigorous Yang, hence 'Supreme Yang.' If various Yang energies accumulate and confluence, extreme Yang excess inevitably damages Yin. The Yin organ of Hand Taiyang is the Heart; the Yin organ of Foot Taiyang is the Kidney. Damage to the Heart disturbs the Shen (Spirit); damage to the Kidney injures the Zhi (Will), resulting in fright. 'Gale' and 'thunder' denote speed and violence. The dryness and blockage of the nine orifices and throat occur because the meridians of Hand Taiyang and Hand/Foot Shaoyin all traverse the throat.) "If it merges into Yin, movement becomes erratic up and down, pressing upon the intestines leads to dysentery." (Note: 'Yin' refers to the Zang organs. When Yang pathogens enter from the exterior into the Zang and gather in Yin, symptoms may appear anywhere without fixed diagnosis. If stagnation presses upon the Lower Jiao, it results in intestinal dysentery with diarrhea.) "This is called Three Yang striking directly at the heart and diaphragm. Those who sit unable to rise or lie down fully suffer from Three Yang diseases." (Note: 'Direct strike to the heart' means pathogenic Qi rushes directly to the heart and diaphragm region. Hand Taiyang meridians run along the lateral arm, exit around the scapula, intersect at the shoulder, enter the supraclavicular fossa, and connect to the Heart; Foot Taiyang meridians flank the spine, pass through the buttocks into the popliteal fossa, with branches dispersing to the Kidneys, running along the back towards the heart. Thus, anyone suffering from direct pathogenic impact on the heart/diaphragm, or inability to sit/rise or lie down, suffers from full-blown Three Yang disease. In my view: Three Yang pathogens mostly enter from the exterior; thus, many cold-strike patients exhibit direct heart strikes with inability to sit/rise. In diagnosing exogenous diseases, one must not neglect this principle.) "And thereby to understand the world, how to distinguish Yin and Yang, respond to the four seasons, and integrate with the Five Elements," (Note: 'Qie' means 'furthermore' or 'intend to'. To understand the essential Dao of the world, one must distinguish Yin/Yang, align with the four seasons, and integrate with the logic of the Five Elements.) Leigong said, "I cannot distinguish statements on Yang, nor reason out statements on Yin. Please rise and grant explanation, so I may regard it as the Highest Dao." (Note: 'Cannot distinguish/reason' means lack of clarity. Responding to Huangdi's query, Leigong humbly requests further instruction.) Huangdi said, "If you accept transmission without integrating it with the Highest Dao, you will only confuse your teacher's teachings. I will tell you the essence of the Highest Dao." (Note: Receiving transmission without understanding the Dao only confuses the teacher's intent; thus, I impart its core essence.) "Disease damages the Five Zang organs, causing muscles and bones to waste away. Your unclear and undifferentiated speech indicates the limit of worldly rulers' scholarship." (Note: Pathogens merging with Yang cause Yang disease; merging with Yin cause Yin disease; affecting both damages the Five Zang. Internal Zang injury leads to external wasting of muscles and bones. Medicine governs life and is relied upon by the world, hence 'worldly ruler.' Lack of clarity and differentiation hinders the Dao, causing the extinction of sage learning.) "Kidney Qi is near exhaustion. You worry throughout the day until dusk, remaining withdrawn, and social affairs become neglected." (Note: The Kidney and Foot Taiyang are exterior-interior partners; the Kidney is the organ of Extreme Yin. *Shanggu Tianzhen Lun* states: The Kidney governs water and stores the essence of all Five Zang and Six Fu organs. As described above, convergence of Three Yang damages the Five Zang, leading to depletion of essence and Qi, and wasting of muscles/bones. Transmission from Taiyang to interior necessarily reaches Shaoyin, injuring Kidney Qi and nearly depleting True Yin. Hence, constant worry and anxiety, appearing too distressed to act calmly or go out, and social affairs becoming neglected. However, when Yang pathogens arrive, harm inevitably returns to Yin; when Five Zang are damaged, the decline ultimately reaches the Kidney. This is the aforementioned mutual transmission and correspondence of Yin/Yang, exterior/interior, upper/lower, male/female—the essence of the Highest Dao. Scholars who understand how to treat the root here possess the power to reverse heaven's decree. Thus, this treatise is named *Zhuo Zhi Jiao* (Establishing the Highest Teaching), surely not in vain. 'Wan' is pronounced 'guan'.)