此谓人触冒于寒气而成病。冬时严寒,摄卫周密者,则寒不能伤人。若卒苦劳役,汗出
触冒寒气,即发成病,谓之伤寒也。其轻者,微咳嗽鼻塞,啬啬小寒,吸吸微热,
数日而歇。重者,头痛体疼,恶寒壮热。而膏腴之人,肌肤脆弱,虽不大触冒,其居处小有
失宜,则易伤于寒也。自有四时节内,忽有暴寒,伤于人成病者,亦名伤寒,谓之时行伤寒
,非触冒所致,言此时通行此气,故为时行也。
此谓四时之间,忽有非节之气,伤人而成病也。如春时应暖而反寒,夏时应热而反冷,
秋时应凉而反热,冬时应寒而反温。言此四时通行此气,一气之至,无问少长,病皆相似,
故名为时气也。但言其病,若风寒所伤则轻,状犹如伤寒,小头痛,壮热也。若挟毒厉之气
则重,壮热烦毒,或心腹胀满,多死也。
夫疟病者,由夏伤于暑,客在皮肤,至秋因劳动血气,腠理虚而风邪乘之,动前暑热,
正邪相击,阴阳交争,阳盛则热,阴盛则寒,阴阳更虚更盛,故发寒热;阴阳相离,则寒热
俱歇。若邪动气至,交争复发,故疟休作有时。
其发时节渐晏者,此由邪客于风府,循膂而下,卫气一日一夜常大会于风府,其明日日
下一节,故其作日晏。其发日早者,卫气之行风府,日下一节,二十一日下至尾 ,二十二
日入脊内,上注于伏冲之脉,其气上行九日,出于缺盆之内,其气既上,故其病发更早。
其间日发者,由邪气内薄五脏,横连募原,其道远,其气深,其行迟,不能日作,故间
日蓄积乃发。
凡病疟多渴引饮,饮不消,乃变为癖。大肠虚引饮,水入肠胃,则变为利也。
这说的是人因接触冒犯寒气而致病。冬季严寒,如果保养护卫周密,那么寒气就不能伤害人体。如果突然遭受劳役之苦,出汗后接触冒犯寒气,就会立即发病,这就叫做伤寒。病情轻的,表现为轻微咳嗽、鼻塞,怕冷瑟瑟发抖,微微发热,几天后症状缓解。病情重的,表现为头痛、身体疼痛,恶寒且高热。那些肥胖的人,肌肤脆弱,即使没有明显地接触冒犯寒气,只要居住环境的起居稍有不当,就容易受寒邪侵袭。在四季正常节令中,如果有突如其来的暴寒,伤人致病,也称为伤寒,称为时行伤寒,这不是由个人触冒所致,而是说此时流行这种邪气,所以叫时行。
这说的是在四季之中,突然出现不合时令的气候,伤人致病。比如春季本该温暖却反而寒冷,夏季本该炎热却反而凉爽,秋季本该凉快却反而炎热,冬季本该寒冷却反而温暖。说的是此时流行这种气候,一旦这种气候到来,无论老少,患病症状都相似,所以称为时气。仅从病症来说,如果是风寒所伤则较轻,症状如同伤寒,只是轻微头痛、高热。如果夹杂毒厉之气则较重,表现为高热烦躁、毒邪内盛,或者心腹胀满,死亡率很高。
疟病,是由于夏季感受暑邪,邪气潜伏在皮肤之间,到了秋季因为劳动导致血气耗损,腠理空虚,风邪乘虚而入,触动之前潜伏的暑热,正气与邪气相互搏击,阴阳交争,阳气盛则发热,阴气盛则发冷,阴阳交替虚实盛衰,所以出现寒热往来;当阴阳分离(正邪暂时休战),寒热症状就停止。如果邪气再次发动,正气随之而至,再次交争,所以疟疾发作有定时。
发作时间逐渐推迟的,这是因为邪气客居在风府穴,沿着脊柱向下移动,卫气一天一夜常在风府穴大会,第二天卫气下行一节,所以发作时间一天天推迟。发作时间逐渐提前的,是因为卫气运行经过风府,每天下行一节,二十一天下行至尾骶部,第二十二天进入脊内,向上注入伏冲脉,其气上行九天,出于缺盆穴内部,既然气已上行,所以发病时间更早。
隔日发作的,是因为邪气向内迫近五脏,横向连及募原,路径遥远,邪气深藏,运行缓慢,不能每日发作,所以积聚到一定程度才发作。
This refers to illness caused by exposure to cold pathogenic factors. During the severe cold of winter, those who carefully maintain their defensive qi (Wei Qi) will not be harmed by the cold. However, if one suddenly suffers from overexertion and labor, sweats, and then is exposed to cold air, illness will immediately manifest; this is called Cold Damage (Shanghan). In mild cases, symptoms include slight coughing, nasal congestion, shivering chills, and low-grade fever, which resolve after a few days. In severe cases, symptoms include headache, body aches, aversion to cold, and high fever. Plump individuals with fragile skin and muscles are prone to cold injury even without obvious exposure, provided there is any minor impropriety in their living environment or daily routine. When sudden violent cold occurs during normal seasonal transitions, causing illness upon exposure, it is also named Cold Damage, specifically referred to as Epidemic Cold Damage (Shixing Shanghan). This is not caused by personal exposure but indicates that this specific pathogenic factor is prevalent at that time, hence the term "Epidemic" (Shixing).
This refers to illness caused by abnormal climatic conditions appearing suddenly during the four seasons. For instance, spring should be warm but turns cold; summer should be hot but turns cool; autumn should be cool but turns hot; winter should be cold but turns warm. It signifies that this abnormal climate prevails during these periods. Once such climate arrives, regardless of age, the resulting illnesses present similar symptoms, thus termed Seasonal Qi (Shiqi) disease. Regarding the severity: if caused by wind-cold, the condition is milder, resembling Cold Damage with slight headache and high fever. If complicated by toxic and pestilential qi, the condition is severe, presenting with high fever, restlessness, toxicity, abdominal distension and fullness, often leading to death.
Malaria (Nue Bing) arises from summerheat injury in summer, where the pathogen resides in the skin. In autumn, due to physical exertion depleting blood and qi, the interstices (Cou Li) become deficient, allowing wind pathogen to invade. This triggers the latent summerheat, causing righteous qi and pathogenic factors to clash. Yin and Yang engage in conflict: excess Yang leads to heat, excess Yin leads to cold. As Yin and Yang alternate between deficiency and excess, chills and fever ensue. When Yin and Yang separate (the struggle ceases temporarily), both chills and fever subside. If the pathogen reactivates and righteous qi responds again, the clash recurs, causing malaria to have periodic intervals of onset and remission.
When the onset time gradually delays, it is because the pathogen lodges in the Fengfu acupoint (GV16) and moves downward along the spine. Defensive Qi (Wei Qi) gathers at Fengfu once every day and night. The next day, it descends one vertebral level, causing the onset time to delay daily. When the onset time advances earlier, it is because Defensive Qi travels past Fengfu, descending one level daily. After twenty-one days, it reaches the coccyx; on the twenty-second day, it enters the interior of the spine, ascends into the Fu Chong vessel, travels upward for nine days, and emerges within the Quepen area (LI15 region). Since the qi has ascended, the disease manifests earlier.
For intermittent malaria occurring every other day, the pathogen presses inward toward the five zang organs and extends laterally to the Mu Yuan (sea of origin). The pathway is distant, the pathogen is deep, and its movement is slow, preventing daily attacks. Thus, it accumulates until sufficient force builds up before manifesting.
Generally, patients with malaria experience thirst and desire to drink. If the ingested water fails to transform and dissipate, it may form phlegm-stagnation masses (Pi). If large intestine deficiency leads to thirst and drinking, the water entering the stomach and intestines transforms into diarrhea.