(素问血气形志篇)
形乐志苦,病生于脉,治之以灸刺。(形乐者,身无劳也。志苦者,心多虑也。心主脉,深思过虑则脉病矣。脉病者
当治经络,故当随其宜而灸刺之。)形乐志乐,病生于肉,治之以针石。(形乐者逸,志乐者闲。饱食终日,无所运用,
多伤于脾,脾主肌肉,故病生焉。肉病者,或为卫气留,或为脓血聚,故当用针石以取之。石,砭石也。)形苦志乐,病
生于筋,治之以熨引。(形苦者,身多劳。志乐者,心无虑。劳则伤筋,故病生于筋。熨,以药熨。引,谓导引。熨音郁。)
形苦志苦,病生于咽嗌,治之以甘药。(形苦志苦,必多忧思,忧则伤肺,思则伤脾,脾肺气伤,则虚而不行,气必滞矣。
脾肺之脉,上循咽嗌,故病生于咽嗌。如人之悲忧过度,则喉咙哽咽,食饮难进;思虑过度则上焦痞隔,咽中核塞,即
其征也。通评虚实论曰∶隔则闭绝,上下不通,则暴忧之病也。亦此之谓。病在嗌者,因损于脏,故当以甘药调补之。
甘,旧作百,灵枢九针论作甘药者是,今改从之。嗌音益。)形数惊恐,经络不通,病生于不仁,治之以按摩醪药。(惊
者气乱,恐者气下,数有惊恐,则气血散乱而经络不通,故病不仁。不仁者,顽痹 弱也,故治宜按摩以导气行血,醪
药以养正除邪。醪药,药酒也。经络二字,九针论作筋脉,义亦同。醪音劳)是谓五形志也。(结上文。按∶灵枢九针论
文有与此同者,俱不重载。)
(《素问·血气形志篇》)
形体安逸而精神苦闷,疾病产生于脉,治疗用灸法和刺法。(所谓形体安逸,是指身体没有劳累。所谓精神苦闷,是指心中思虑过多。心主司脉,深思熟虑且过度忧虑会导致脉病。既然属于脉病,就应当治疗经络,因此要根据具体情况采用灸法或刺法。)
形体安逸且精神快乐,疾病产生于肌肉,治疗用针和砭石。(所谓形体安逸是指身体闲逸,精神快乐是指心境悠闲。整天吃饱了饭却无所活动,多会损伤脾脏,脾主肌肉,所以疾病产生于此。肌肉生病,要么是卫气滞留,要么是脓血积聚,因此应当用针或砭石来治疗。这里的“石”,指的是砭石。)
形体劳苦但精神快乐,疾病产生于筋,治疗用热敷和导引。(所谓形体劳苦,是指身体经常劳作。精神快乐是指心中没有忧虑。劳作会损伤筋,所以疾病产生于筋。“熨”,是用药物进行热敷。“引”,是指导引术。熨读作yù。)
形体劳苦且精神苦闷,疾病产生于咽喉,治疗用甘味药物。(形体劳苦且精神苦闷,必然多有忧愁和思虑。忧愁会伤肺,思虑会伤脾,脾肺之气受损,就会虚弱而不能正常运行,气必然停滞。脾肺的经脉向上循行经过咽喉,所以疾病产生于咽喉。比如人悲伤忧虑过度,喉咙就会哽咽,饮食难进;思虑过度则上焦痞塞阻隔,咽中如有物堵塞,这就是征象。《通评虚实论》说:“隔阂则闭塞断绝,上下不通,这是突然遭受忧怒所致。”也是这个意思。病在咽喉,是因为脏腑受损,所以应当用甘味药物来调补。甘味,古本误作“百”,《灵枢·九针论》作“甘药”是正确的,现在改正依从它。嗌读作yì。)
频繁惊恐,经络不通,疾病产生于麻木不仁,治疗用按摩和药酒。(惊则气乱,恐则气下,频繁出现惊恐,气血就会散乱而导致经络不通,所以产生麻木不仁的症状。不仁,是指皮肤顽痹、肢体软弱无力,所以治疗适宜用按摩来引导气机、运行血液,用药酒来扶助正气、祛除邪气。醪药,就是药酒。其中的“经络”二字,《九针论》作“筋脉”,意义也相同。醪读作láo。)
这被称为五种形志情况。
(总结上文。按:《灵枢·九针论》中有与此相同的内容,这里不再重复记载。)
(Su Wen, Chapter on Blood, Qi, Form, and Will)
When the body is at ease but the mind is distressed, disease arises in the vessels (Mai, pulse/vessels), and treatment involves moxibustion and acupuncture. (Body at ease means the physical body is not overworked. Mind distressed means the heart is burdened with excessive thinking. The Heart governs the vessels; deep reflection and excessive worry lead to vessel pathology. Since it is a vessel disease, one should treat the meridians and collaterals; therefore, moxibustion or acupuncture should be applied according to suitability.)
When both the body is at ease and the mind is joyful, disease arises in the muscles, and treatment involves needles and bian stones. (Body at ease implies physical leisure; mind joyful implies mental relaxation. Consuming full meals all day without exertion often damages the Spleen. The Spleen governs the muscles, hence disease arises here. Muscle diseases may involve stagnation of Wei Qi (Defensive Qi) or accumulation of pus and blood; thus, needles or bian stones should be used for treatment. "Stone" refers to bian stones.)
When the body is laborious but the mind is joyful, disease arises in the sinews, and treatment involves hot compresses and daoyin exercises. (Laborious body means frequent physical exertion. Joyful mind means absence of mental worry. Exertion damages the sinews, hence disease arises in the sinews. "Wen" refers to herbal hot compresses. "Yin" refers to daoyin (guiding and pulling exercises). Wen is pronounced yù.)
When both the body is laborious and the mind is distressed, disease arises in the pharynx, and treatment involves sweet-flavored medicines. (Laborious body and distressed mind inevitably involve much sorrow and rumination. Sorrow damages the Lung; rumination damages the Spleen. When Qi of the Spleen and Lung is damaged, it becomes deficient and fails to circulate, leading to Qi stagnation. The meridians of the Spleen and Lung ascend along the pharynx, hence disease arises in the pharynx. For instance, excessive grief causes choking in the throat and difficulty swallowing; excessive rumination causes obstruction in the Upper Jiao and a sensation of a lump in the throat, which are typical signs. Tong Ping Xu Shi Lun states: "Obstruction leads to closure and severance, with no communication between upper and lower, this is a disease caused by sudden anger or grief." This is also what is meant. Disease in the pharynx stems from internal organ damage, so sweet-flavored medicines should be used to regulate and tonify. "Sweet" was erroneously written as "Hundred" in old texts; Ling Shu, Jiu Zhen Lun writes "sweet-flavored medicine," which is correct, and we now adopt this correction. Yi is pronounced yì.)
Frequent fright and fear cause blockage of meridians and collaterals, and disease arises as insensibility (Bu Ren), treated with massage and medicinal wine. (Fright causes Qi to become chaotic; fear causes Qi to sink. Frequent fright and fear scatter and disorder Qi and Blood, blocking the meridians and collaterals, thus causing insensibility. Insensibility refers to numbness, bi syndrome, and weakness. Therefore, treatment should employ massage to guide Qi and move Blood, and medicinal wine to nourish Zheng Qi (Upright Qi) and eliminate pathogens. Lao Yao refers to medicinal wine. The term "meridians and collaterals" appears as "sinews and vessels" in Jiu Zhen Lun, with similar meaning. Lao is pronounced láo.)
These are referred to as the five conditions of form and will.
(Summarizing the above. Note: Ling Shu, Jiu Zhen Lun contains identical content; it is not repeated here.)