会通十二类,惟疾病一类浩繁难悉,今所采者,或摘其要,或总其题,观者仍当于各类细求之。)
阳者,天气也,主外;阴者,地气也,主内。故阳道实,阴道虚。故犯贼风虚邪者,阳受之;饮食不节、起居不时
者,阴受之。阳受之则入六腑,阴受之则入五脏。阳受风气,阴受湿气。阳病者上行极而下,阴病者下行极而上。(见疾
病类十三。)
天不足西北,故西北方阴也,而人右耳目不如左明也;地不满东南,故东南方阳也,而人左手足不如右强也。故俱
感于邪,其在上则右甚,在下则左甚,此天地阴阳所不能全也,故邪居之。(阴阳三。)
帝曰∶法阴阳奈何?岐伯曰∶阳胜则身热,腠理闭,喘粗为之俯仰,汗不出而热,齿干以烦冤腹满死,能冬不能夏。
阴胜则身寒汗出,身常清,数栗而寒,寒则厥,厥则腹满死,能夏不能冬。此阴阳更胜之变,病之形能也。帝曰∶调此
二者奈何?岐伯曰∶能知七损八益,则二者可调,不知用此,则早衰之节也。年四十而阴气自半也,起居衰矣。年五十,
体重,耳目不聪明矣。年六十,阴萎,气大衰,九窍不利,下虚上实,涕泣俱出矣。(阴阳二。)
病在阳者命曰风,病在阴者命曰痹,阴阳俱病命曰风痹。病有形而不痛者,阳之类也;无形而痛者,阴之类也。无
形而痛者,其阳完而阴伤之也,急治其阴,无攻其阳;有形而不痛者,其阴完而阳伤之也,急治其阳,无攻其阴。阴阳
俱动,乍有形,乍无形,加以烦心,命曰阴胜其阳,此为不表不里,其形不久。(针刺三十一。)
阴病发于骨,阳病发于血,阴病发于肉,阳病发于冬,阴病发于夏,是谓五发。邪入于阳则狂,邪入于阴则痹,搏
阳则为巅疾,搏阴则为喑,阳入之阴则静,阴出之阳则怒,是谓五乱。(疾病二十五。)
阳虚则外寒,阴虚则内热;阳盛则外热,阴盛则内寒。(疾病二十。)
阳并于阴,则阴实而阳虚。阳盛则外热,阴虚则内热。(疾病四十八。)
清阳出上窍,浊阴出下窍;清阳发腠理,浊阴走五脏;清阳实四肢,浊阴归六腑。(阴阳一。)
邪之生于阳者,得之风雨寒暑;生于阴者,得之饮食居处,阴阳喜怒。(疾病十九。)
阳气者,烦劳则张。阳气者,精则养神,柔则养筋。开阖不得,寒气从之,乃生大偻。(疾病五。)
阴气者,静则神藏,躁则消亡,饮食自倍,肠胃乃伤。(疾病六十七。)
阴胜则阳病,阳胜则阴病。阳胜则热,阴胜则寒。(阴阳一。)
重阴必阳,重阳必阴。(阴阳一。脉色三十三。)
别于阳者,知病从来;别于阴者,知死生之期。(藏象二十四。脉色二十六。)
阴气太盛,则阳气不能荣也,故曰关。阳气太盛,则阴气弗能荣也,故曰格。阴阳俱盛,不得相荣,故曰关格。(经
络二十二。)
阴阳不相应,病名曰关格。(脉色二十二。)
粗大者,阴不足,阳有余,为热中也。诸浮不躁者皆在阳,则为热;其有躁者在手。诸细而沉者皆在阴,则为骨痛;
其有静者在足。阳气有余,为身热无汗;阴气有余,为多汗身寒;阴阳有余,则无汗而寒。(脉色二十一。)
阴气少而阳气胜,故热而烦满也。阳气少,阴气多,故身寒如从水中出。四肢者阳也,两阳相得而阴气虚少,少水
不能灭盛火,而阳独治,独治者不能生长也。(疾病四十五。)
阴阳如一者,病难治。(针刺二十三。)
阴气在下,阳气在上,诸阳气浮,无所根据从,故呕咳上气喘也。(疾病十一。)
阴虚者阳必凑之,故少气时热而汗出也。(疾病三十一。)
阴阳虚,肠辟死。阳加于阴谓之汗。阴虚阳搏谓之崩。(脉色二十九。)
阳急则反折,阴急则俯不伸。(疾病六十九。)
病痛者阴也,痛而以手按之不得者阴也,深刺之。病在上者阳也,病在下者阴也。痒者阳也,浅刺之。(针刺五十三。)
刚与刚,阳气破散,阴气乃消亡。死阴之属,不过三日而死;生阳之属,不过四日而已。结阳者,肿四肢。结阴者,
便血一升。(疾病六。)
阴虚则无气,无气则死矣。(藏象九。)
阳重脱者易狂,阴阳皆脱者,暴死不知人也。(藏象三十。)
阳气有余,阴气不足,则热中善饥;阳气不足,阴气有余,则寒中肠鸣腹痛。(针刺二十五。)
(将十二类内容融会贯通,唯有“疾病”这一类浩繁复杂难以详尽列举,现在所选取的,或是摘录其要点,或是概括其主题,读者仍应当在各类别中仔细探求。)
阳,代表天气,主要主管体表;阴,代表地气,主要主管体内。所以阳气的运行规律多表现为充实,阴气的运行规律多表现为虚损。因此,遭受贼风虚邪等外邪侵袭的,由阳经接受;饮食不节制、起居作息不规律的,由阴经接受。病邪由阳经受纳则传入六腑,由阴经受纳则传入五脏。阳经容易感受风气,阴经容易感受湿气。阳经发病,病势向上发展到极点则向下传变;阴经发病,病势向下发展到极点则向上反逆。(参见疾病类第十三篇)
天的阳气在西北方不足,所以西北方属阴,人的右耳目不如左耳目光亮敏锐;地的阴气在东南方不满,所以东南方属阳,人的左手足不如右手足强壮有力。因此,如果人体上下都受到邪气侵袭,在上部的病症右侧严重,在下部的病症左侧严重,这是天地阴阳之气不能完备的缘故,所以邪气便居于这些薄弱之处。(参见阴阳第三篇)
黄帝问道:如何运用阴阳的道理来指导诊疗?岐伯回答:阳气偏胜则身体发热,腠理闭塞,呼吸喘促粗重,甚至因呼吸困难而俯仰不定,汗不出而身热,牙齿干燥并伴有烦闷不安,腹部胀满而死,这种病能耐受冬天而不能耐受夏天。阴气偏胜则身体寒冷,出汗,身体经常清冷,频繁战栗发冷,寒冷至极则出现四肢厥逆,厥逆则腹部胀满而死,这种病能耐受夏天而不能耐受冬天。这是阴阳相互偏胜的变化,也是疾病的形态表现。黄帝问道:调理这两者该怎么办?岐伯回答:如果能懂得“七损八益”的道理,那么阴阳二者就可以调和;如果不了解运用这个原则,就是早衰的征兆。人到四十岁,阴气自然减半,起居能力开始衰退。五十岁时,身体沉重,耳目不够灵敏。六十岁时,阳痿,元气大衰,九窍不通利,下部虚损上部实盛,鼻涕和眼泪都会流出。(参见阴阳第二篇)
病在阳分的称为风,病在阴分的称为痹,阴阳都患病称为风痹。病有形体表现但不疼痛的,属于阳的类别;没有形体表现但疼痛的,属于阴的类别。没有形体表现但疼痛的,是阳气完好而阴气受伤,应当紧急治疗阴气,不要攻伐阳气;有形体表现但不疼痛的,是阴气完好而阳气受伤,应当紧急治疗阳气,不要攻伐阴气。如果阴阳都受动,时而显现形体,时而无形体,再加上心烦,称为阴胜过阳,这属于既不在表也不在里的病证,病情不会长久维持。(参见针刺第三十一篇)
阴病发作于骨骼,阳病发作于血液,阴病发作于肌肉,阳病发作于冬季,阴病发作于夏季,这称为“五发”。邪气侵入阳分则导致狂症,邪气侵入阴分则导致痹症,邪气搏结于阳分则导致头顶部疾病,邪气搏结于阴分则导致失音,阳气入于阴分则安静,阴气出于阳分则愤怒,这称为“五乱”。(参见疾病第二十五篇)
阳气虚弱则体表寒冷,阴液亏虚则体内发热;阳气亢盛则体表发热,阴气亢盛则体内寒冷。(参见疾病第二十篇)
阳气并入阴分,则阴实而阳虚。阳气亢盛则体表发热,阴液亏虚则体内发热。(参见疾病第四十八篇)
清阳之气出于上窍(眼耳鼻口),浊阴之气出于下窍(前后二阴);清阳之气发散于腠理,浊阴之气走注于五脏;清阳之气充实于四肢,浊阴之气归聚于六腑。(参见阴阳第一篇)
邪气产生于阳分的,是由于风雨寒暑等外感因素;产生于阴分的,是由于饮食起居失调以及情绪喜怒等内伤因素。(参见疾病第十九篇)
人体的阳气,若因烦劳过度则亢张外越。人体的阳气,精微部分能滋养精神,柔和部分能滋养筋脉。如果开阖功能失常,寒气随之侵入,就会发生严重的驼背弯曲。(参见疾病第五篇)
人体的阴气,静止时神志得以潜藏,躁动时神志就会消亡,饮食过量一倍,肠胃就会受损。(参见疾病第六十七篇)
阴气偏胜则损伤阳气,阳气偏胜则损伤阴气。阳气偏胜则发热,阴气偏胜则发冷。(参见阴阳第一篇)
阴气过重必转化为阳证,阳气过重必转化为阴证。(参见阴阳第一篇、脉色第三十三篇)
辨别阳分的病变,可以知道疾病的来源;辨别阴分的病变,可以判断死生的期限。(参见藏象第二十四篇、脉色第二十六篇)
阴气太盛,则阳气不能通达荣养,所以称为“关”。阳气太盛,则阴气不能通达荣养,所以称为“格”。阴阳都亢盛,彼此不能相互荣养交通,所以称为“关格”。(参见经络第二十二篇)
脉象粗大的,是阴不足而阳有余,属于热中病。各种浮脉而不躁动的,病都在阳分,则为热证;其中伴有躁动的,病在手部经脉。各种细脉而沉伏的,病都在阴分,则为骨痛;其中伴有静象的,病在足部经脉。阳气有余,表现为身体发热无汗;阴气有余,表现为多汗身寒;阴阳都有余,则无汗且身体寒冷。(参见脉色第二十一篇)
阴气少而阳气胜,所以发热且烦闷。阳气少,阴气多,所以身体寒冷如同从水中出来一样。四肢属于阳,两阳相合而阴气虚少,少量的水不能扑灭旺盛的火,导致阳气独治,独治的状态不能正常生长化育。(参见疾病第四十五篇)
阴阳分离如一(指阴阳离决),病难治愈。(参见针刺第二十三篇)
阴气在下,阳气在上,诸阳之气浮越,无所依附遵循,所以出现呕吐、咳嗽、上气喘急。(参见疾病第十一篇)
阴虚则阳邪必然凑集,所以出现少气、时时发热且出汗。(参见疾病第三十一篇)
阴阳俱虚,患肠辟病则死。阳加于阴谓之汗。阴虚而阳脉搏击有力谓之崩漏。(参见脉色第二十九篇)
阳筋拘急则身体反折,阴筋拘急则身体俯曲不能伸展。(参见疾病第六十九篇)
病痛属于阴,用手按压疼痛处不得缓解的也属于阴,应当深刺。病在上部的属于阳,病在下部的属于阴。瘙痒属于阳,应当浅刺。(参见针刺第五十三篇)
刚与刚相加(指纯阳无阴),阳气破散,阴气乃消亡。属于死阴的类别,不超过三天就会死亡;属于生阳的类别,不超过四天而已。阳气结滞于四肢,则四肢肿胀。阴气结滞于内脏,则便血一升。(参见疾病第六篇)
(Integrating the twelve categories, only the category of "Diseases" is vast and complex, difficult to exhaustively list. What is selected here are either excerpts of key points or summaries of themes; readers should still seek detailed understanding within each respective category.)
Yang represents the Qi of Heaven and primarily governs the exterior; Yin represents the Qi of Earth and primarily governs the interior. Therefore, the pathway of Yang tends toward fullness (Shi), while the pathway of Yin tends toward emptiness (Xu). Consequently, those who contract pathogenic factors such as thieving winds and empty evils are affected via Yang; those affected by irregular diet and improper daily routines are affected via Yin. When contracted via Yang, the pathogen enters the Six Fu Organs (Six Bowels); when contracted via Yin, it enters the Five Zang Organs (Five Viscera). Yang channels are susceptible to Wind Qi, while Yin channels are susceptible to Dampness Qi. Diseases in Yang ascend to their extreme and then descend; diseases in Yin descend to their extreme and then ascend. (See Diseases Category 13)
The Heaven's Yang is insufficient in the Northwest, so the Northwest belongs to Yin; consequently, a person's right ear and eye are less acute than the left. The Earth's Yin is incomplete in the Southeast, so the Southeast belongs to Yang; consequently, a person's left hand and foot are not as strong as the right. Thus, if both upper and lower parts are affected by pathogens, the condition is more severe on the right when located above, and more severe on the left when located below. This is because the Yin and Yang of Heaven and Earth cannot be complete, so pathogens reside in these deficient areas. (See Yin-Yang 3)
The Yellow Emperor asked: How should one apply the principles of Yin and Yang? Qibo replied: If Yang is excessive, the body becomes hot, pores close, breathing becomes coarse and labored causing difficulty in bending and stretching, sweat does not come out yet heat persists, teeth become dry accompanied by vexation and oppression, abdominal fullness occurs leading to death; such patients can tolerate Winter but not Summer. If Yin is excessive, the body becomes cold with sweating, the body feels constantly chilly, frequent shivering and coldness occur, cold leads to cold extremities (Jue), and cold extremities lead to abdominal fullness causing death; such patients can tolerate Summer but not Winter. These are the changes of alternating excess of Yin and Yang, representing the forms of disease. The Yellow Emperor asked: How to regulate these two? Qibo replied: If one understands the principles of "Seven Damages and Eight Benefits," then Yin and Yang can be regulated; failing to use this principle leads to signs of premature aging. At forty years old, Yin Qi naturally halves, and daily activities decline. At fifty, the body feels heavy, and hearing and vision become less acute. At sixty, impotence occurs, Qi severely declines, the Nine Orifices become obstructed, deficiency in the lower part and excess in the upper part manifest, and tears and nasal discharge appear. (See Yin-Yang 2)
Disease in Yang is called Feng (Wind); disease in Yin is called Bi (Obstruction); disease involving both Yin and Yang is called Feng-Bi. Disease presenting with physical form but no pain belongs to the category of Yang; disease presenting with no physical form but pain belongs to the category of Yin. For no form but pain, Yang is intact but Yin is injured; urgently treat Yin, do not attack Yang. For form present but no pain, Yin is intact but Yang is injured; urgently treat Yang, do not attack Yin. If both Yin and Yang are disturbed, alternately showing form and formlessness, compounded by vexation, it is called Yin exceeding Yang. This is neither in the Exterior nor the Interior, and the condition will not last long. (See Acupuncture 31)
Yin diseases manifest in bones, Yang diseases manifest in blood, Yin diseases manifest in flesh, Yang diseases manifest in Winter, Yin diseases manifest in Summer; this is called the "Five Manifestations." Pathogens entering Yang cause Mania (Kuang); pathogens entering Yin cause Bi syndrome; pathogens clashing with Yang cause Cephalic Diseases (Dian Ji); pathogens clashing with Yin cause Aphonia (Yin); Yang entering Yin results in quietness; Yin exiting Yang results in anger; this is called the "Five Disorders." (See Diseases 25)
Yang deficiency causes exterior cold; Yin deficiency causes interior heat; Yang excess causes exterior heat; Yin excess causes interior cold. (See Diseases 20)
Yang merging into Yin results in Yin excess and Yang deficiency. Yang excess causes exterior heat; Yin deficiency causes interior heat. (See Diseases 48)
Clear Yang exits through the Upper Orifices; Turbid Yin exits through the Lower Orifices. Clear Yang disperses through the Couli (pores/skin interstices); Turbid Yin travels to the Zang Organs. Clear Yang fills the Four Limbs; Turbid Yin returns to the Fu Organs. (See Yin-Yang 1)
Pathogens generated in Yang arise from wind, rain, cold, and summer heat; those generated in Yin arise from diet, dwelling, and emotional joys and angers. (See Diseases 19)
Human Yang Qi, when subjected to fatigue and overexertion, becomes hyperactive and expansive. Human Yang Qi, in its refined state, nourishes the Spirit (Shen); in its soft state, it nourishes the Sinews (Jin). If opening and closing functions fail, Cold Qi follows and enters, resulting in severe kyphosis (Lou). (See Diseases 5)
Human Yin Qi, when quiet, stores the Spirit; when restless, the Spirit dissipates. If food intake doubles, the Intestines and Stomach are damaged. (See Diseases 67)
Yin excess injures Yang; Yang excess injures Yin. Yang excess causes Heat; Yin excess causes Cold. (See Yin-Yang 1)
Extreme Yin transforms into Yang; Extreme Yang transforms into Yin. (See Yin-Yang 1; Pulse and Color 33)
Differentiating Yang allows one to know the origin of the disease; differentiating Yin allows one to know the time of death or survival. (See Zang-Xiang 24; Pulse and Color 26)
If Yin Qi is too excessive, Yang Qi cannot circulate and nourish, thus it is called Guan (Obstruction). If Yang Qi is too excessive, Yin Qi cannot circulate and nourish, thus it is called Ge (Rebellion). If both Yin and Yang are excessive and cannot mutually nourish, it is called Guan-Ge. (See Meridians 22)
When Yin and Yang do not correspond, the disease is named Guan-Ge. (See Pulse and Color 22)
A coarse pulse indicates Yin insufficiency and Yang excess, constituting Heat in the Middle. All floating pulses without agitation belong to Yang, indicating Heat; if agitation is present, it is in the Hand meridians. All fine and deep pulses belong to Yin, indicating Bone Pain; if stillness is present, it is in the Foot meridians. Yang excess manifests as body heat without sweat; Yin excess manifests as profuse sweating and cold body; excess in both Yin and Yang manifests as no sweat and cold body. (See Pulse and Color 21)
When Yin Qi is scant and Yang Qi prevails, there is heat and vexation/fullness. When Yang Qi is scant and Yin Qi is abundant, the body feels cold as if emerging from water. The Four Limbs belong to Yang. When two Yangs combine and Yin Qi becomes deficient, little water cannot extinguish flourishing fire, leading to Yang acting alone. Acting alone prevents growth and development. (See Diseases 45)
When Yin and Yang are separated like distinct entities, the disease is difficult to treat. (See Acupuncture 23)
With Yin Qi below and Yang Qi above, all Yang Qi floats without foundation or guidance, causing vomiting, coughing, and upper body wheezing/asthma. (See Diseases 11)
Yin deficiency allows Yang pathogens to converge, causing shortness of breath, intermittent fever, and sweating. (See Diseases 31)
Deficiency in both Yin and Yang with Chang Pi (dysentery/blood in stool) leads to death. Yang added to Yin is called Sweat. Yin deficiency with pounding Yang pulse is called Beng (Metrorrhagia/Metrorrhesis). (See Pulse and Color 29)
Yang spasm causes opisthotonos (body arching backward); Yin spasm causes flexion inability (bending forward without extension). (See Diseases 69)
Pain is Yin; pain that cannot be relieved by pressure is also Yin, requiring deep needling. Disease in the upper part is Yang; disease in the lower part is Yin. Itching is Yang, requiring shallow needling. (See Acupuncture 53)
Yang combining with Yang causes Yang Qi to scatter and Yin Qi to perish. Those belonging to Dead Yin die within three days; those belonging to Living Yang die within four days. Yang stagnation causes swelling of the four limbs. Yin stagnation causes hematochezia (blood in stool) of one sheng. (See Diseases 6)
Yin deficiency leads to lack of Qi; lack of Qi leads to death. (See Zang-Xiang 9)
Severe depletion of Yang Qi easily leads to mania; depletion of both Yin and Yang leads to sudden death and unconsciousness. (See Zang-Xiang 30)
Yang excess and Yin deficiency cause Heat in the Middle and frequent hunger; Yang deficiency and Yin excess cause Cold in the Middle, borborygmus, and abdominal pain. (See Acupuncture 25)