黄帝问曰∶治民治身,可得闻乎?岐伯对曰∶治民与自治,治彼与治此,治小与治大,
治国与治家,未有逆而能治者,夫唯顺而已矣。故入国问其俗,临病患问所便。曰∶便病奈
何?曰∶中热消瘅则便寒,寒中之属则便热。胃中热则消谷,令人悬心善饥,脐以上皮
热。肠中热,则出黄如糜色,脐以下皮寒。胃中寒则 胀。肠中寒则肠鸣飧泄。胃中
寒,肠中热,则胀且泄。胃中热,肠中寒,则疾饥,少腹痛胀。曰∶胃欲寒饮,肠欲热饮,
两者相逆,治之奈何?曰∶春夏先治其标,后治其本;秋冬先治其本,后治其标。曰∶便
其相逆者奈何?曰∶便此者,食饮衣服,欲适寒温。寒无凄怆,暑无出汗。食饮者,热无灼
灼,寒无沧沧。寒温中适,故气搏持,乃不致邪僻。先病而后逆者治其本,先逆而后病者
治其本,先寒而后生病者治其本,先病而后生寒者治其本,先热而后生病者治其本
,先病而后生热者治其本,先病而后生中满者治其标,先病而后泄者治其本。先泄而
后生他病者治其本,必先调之,乃治其他病。先病而后中满者治其标,先中满而后烦心
者治其本。人有客气同(同一作固)气,小大不利治其标。小大便利治其本。病发而有
余,本而标之,先治其本,后治其标;病发而不足,标而本之,先治其标,后治其本。谨察
间甚而调之,间者并行,甚者独行。小大不利而后生他病者,治其本。
东方滨海傍水,其民食鱼嗜咸。鱼者使人热中,咸者胜血。其民皆黑色疏理,其病多
壅肿,其治宜砭石。
西方水土刚强,其民华食而脂肥,故邪不能伤其形体,其病生于内,其治宜毒药。
北方风寒冰冽,其民乐野处而乳食,脏寒生满病,其治宜灸 。
南方其地下,水土弱,雾露之所聚也。其民嗜酸而食臊,故致理而赤色,其病挛痹,
其治宜微针。
中央其地平以湿,天地所生物者众,其民食杂而不劳。故其病多痿厥寒热,其治宜导引
按跷。故圣人离合以治,各得其宜。
形乐志苦,病生于脉,治之以灸刺。形苦志乐,病生于筋,治之以熨引。形乐志乐,病
生于肉,治之以针石。形苦志苦,病生于困竭(一作咽喝),治之以甘药。形数惊恐,经
络不通,病生于不仁,治之以按摩醪醴。是谓五形。故志曰刺阳明出血气,刺太阳出血恶气,
刺少阳出气恶血,刺太阴出气恶血,刺少阴出血恶血,刺厥阴出血恶气。
黄帝问道:治理百姓和修养自身,可以讲给我听吗?岐伯回答说:治理百姓与自我修养,治理他人与自己,治理小事与治理大事,治理国家与治理家庭,没有违背规律而能治理好的,只有顺应规律罢了。所以进入一个国家要询问当地的风俗,面对病患要询问其适宜之处。问:对于适宜之处该如何处理?答:体内有热邪导致消渴病证的,适宜用寒凉之法;属于中焦虚寒的,适宜用温热之法。胃中有热则消化食物过快,使人心中空虚、容易饥饿,肚脐以上的皮肤发热。肠中有热,则排出黄色如粥状的粪便,肚脐以下的皮肤发冷。胃中有寒则腹部胀满。肠中有寒则肠鸣并发生完谷不化的泄泻。胃中有寒而肠中有热,则既胀满又泄泻。胃中有热而肠中有寒,则容易饥饿且小腹痛胀。问:胃喜欢寒凉饮食,肠喜欢温热饮食,两者相互矛盾,治疗该怎么办?答:春夏季节先治疗标症,后治疗本因;秋冬季节先治疗本因,后治疗标症。问:如何顺应这种相互矛盾的情况?答:顺应这种情况,在饮食衣服方面,要追求寒温适中。寒冷时不要感到凄惨刺骨,暑热时不要大汗淋漓。饮食方面,热的不要过烫,冷的不要过凉。寒温适中,正气就能固守,从而不致产生邪僻之病。先患病而后出现气机逆乱的,治疗其本;先气机逆乱而后患病的,治疗其本;先受寒而后患病的,治疗其本;先患病而后出现寒象的,治疗其本;先发热而后患病的,治疗其本;先患病而后出现热象的,治疗其本;先患病而后出现胸腹胀满的,治疗其标;先患病而后发生泄泻的,治疗其本。先发生泄泻而后产生其他疾病的,治疗其本,必须先调理好泄泻,然后才能治疗其他疾病。先患病而后出现胸腹胀满的,治疗其标;先出现胸腹胀满而后心烦意乱的,治疗其本。人有外感客气与内伤真气相搏的情况,若大小便不通利,治疗其标;若大小便通利,治疗其本。发病表现为邪气有余的,先治其本后治其标,即先治本后治标;发病表现为正气不足的,先治其标后治其本,即先治标后治本。仔细察看病情的轻重缓急来调治,病情轻缓的标本兼治,病情严重的单独治标或治本。先大小便不通利而后产生其他疾病的,治疗其本。
东方靠近海边,民众吃鱼并嗜好咸味。吃鱼会使人体内有积热,吃咸会损伤血液。那里的民众肤色多黑且皮肤纹理疏松,他们的疾病多为壅滞肿胀,治疗适宜用砭石。
西方水土性质刚强,民众以精美食物为主且脂肪丰厚,所以邪气不能伤害他们的形体,他们的疾病多生于内脏,治疗适宜用药物(毒药)。
北方风寒冰冽,民众喜欢住在野外并以乳制品为食,内脏虚寒而产生胀满病,治疗适宜用艾灸。
南方地势低洼,水土柔弱,是雾露聚集的地方。那里的民众嗜好酸味并食用膻腥食物,所以皮肤纹理致密且面色发红,他们的疾病多为筋脉拘挛和痹证,治疗适宜用微针。
中央地区地势平坦且潮湿,天地所生的物产丰富,民众饮食杂而不从事体力劳动。所以他们的疾病多为痿证、厥证以及寒热往来,治疗适宜用导引按跷。所以圣人根据地域不同分别施治,各得其宜。
形体安逸但精神痛苦,疾病生于血脉,治疗用灸法和针刺。形体劳苦但精神愉快,疾病生于筋脉,治疗用热敷和导引。形体安逸且精神愉快,疾病生于肌肉,治疗用针石。形体劳苦且精神痛苦,疾病生于精气耗竭,治疗用甘缓的药物。形体经常惊恐,导致经络不通,疾病表现为麻木不仁,治疗用按摩和药酒。这称为五种身形情况。所以古书说:刺阳明经可排出血和气,刺太阳经可排出血和恶气,刺少阳经可排出气而避免出血,刺太阴经可排出气而避免出血,刺少阴经可排出血而避免出气,刺厥阴经可排出血而避免出气。
Huangdi asked, saying: May I hear about governing the people and cultivating oneself? Qibo replied, saying: Governing the people and self-cultivation, governing others and governing oneself, governing small matters and governing great matters, governing a state and governing a household—there has never been one who could govern by going against (the natural order); it is only through following (Shun, 顺) that success is achieved. Therefore, when entering a country, inquire about its customs; when facing patients, inquire about their preferences. One asks: How to handle these preferences? The answer is: For those with internal heat leading to Xiao-dao (Wasting-thirst syndrome), cold methods are suitable; for those belonging to middle-jiao deficiency-cold, warm methods are suitable. Heat in the Stomach leads to rapid digestion of food, causing a sensation of emptiness in the heart, frequent hunger, and heat in the skin above the umbilicus. Heat in the Intestines leads to the discharge of yellow stool resembling porridge, and coldness in the skin below the umbilicus. Cold in the Stomach leads to abdominal distension. Cold in the Intestines leads to borborygmus and Sund-xie (Diarrhea with undigested food). If there is cold in the Stomach and heat in the Intestines, there will be both distension and diarrhea. If there is heat in the Stomach and cold in the Intestines, there will be rapid hunger and pain and distension in the lower abdomen. One asks: The Stomach desires cold drinks, while the Intestines desire hot drinks; the two are contradictory, how should this be treated? The answer is: In Spring and Summer, treat the Biao (Manifestation/Symptom) first, then the Ben (Root/Cause); in Autumn and Winter, treat the Ben first, then the Biao. One asks: How to accommodate these contradictions? The answer is: To accommodate this, diet, clothing, and shelter should aim for moderate temperature. In cold weather, avoid shivering from chill; in summer heat, avoid profuse sweating. Regarding diet and drink, avoid scalding heat and freezing cold. When cold and heat are moderate, Qi can maintain balance, thus preventing pathogenic deviations. If disease occurs first and then Qi rebellion follows, treat the Ben; if Qi rebellion occurs first and then disease follows, treat the Ben; if cold occurs first and then disease follows, treat the Ben; if disease occurs first and then cold symptoms follow, treat the Ben; if heat occurs first and then disease follows, treat the Ben; if disease occurs first and then heat symptoms follow, treat the Ben; if disease occurs first and then Zhong-man (Abdominal fullness/distension) follows, treat the Biao; if disease occurs first and then Xie (Diarrhea) follows, treat the Ben. If Xie occurs first and then other diseases follow, treat the Ben; one must first regulate the Xie before treating other diseases. If disease occurs first and then Zhong-man follows, treat the Biao; if Zhong-man occurs first and then Fanxin (Vexation in the heart) follows, treat the Ben. If a person has conflict between Keqi (Exogenous Qi/Pathogen) and Zhengqi (Upright Qi), and there is difficulty in urination and defecation, treat the Biao; if urination and defecation are smooth, treat the Ben. If the onset of disease shows excess (Yuxu), treat the Ben first and then the Biao (i.e., treat Ben then Biao); if the onset shows deficiency (Buzu), treat the Biao first and then the Ben (i.e., treat Biao then Ben). Carefully observe the severity and modulate accordingly: for mild cases, treat both Ben and Biao simultaneously; for severe cases, treat either Ben or Biao exclusively. If difficulty in urination and defecation occurs first and then other diseases follow, treat the Ben.
In the East, near the sea and waters, the people eat fish and love salt. Fish causes heat accumulation in the interior; salt damages Blood. Their people generally have dark skin and loose texture, and their diseases are mostly Yong-zhong (Obstruction and swelling); treatment is suitable with Bian-shi (Stone needles).
In the West, the water and soil are strong and rigid. The people eat refined foods and are fat; thus, pathogens cannot damage their形体 (Body/Form). Their diseases arise internally; treatment is suitable with Du-yao (Medicines/Poisons).
In the North, wind and cold are biting and icy. The people enjoy living in the open and consume dairy products. Internal cold generates Man-bing (Fullness/Distension diseases); treatment is suitable with Jiu-lio (Moxibustion).
In the South, the land is low, the water and soil are weak, and it is where fog and dew gather. The people love sour flavors and eat game/meat with strong odors. Thus, their skin texture is dense and their complexion is red. Their diseases are Luan-bi (Cramping and Bi-syndrome/Obstruction); treatment is suitable with Wei-zhen (Fine needles).
In the Central region, the land is flat and damp. The things produced by Heaven and Earth are abundant. The people eat a varied diet and do not labor. Thus, their diseases are mostly Wei-jue (Wei-paralysis and Jue-reversal) and Han-re (Cold and Heat alternations). Treatment is suitable for Dao-yin An-qiao (Qigong exercises and Tuina massage). Therefore, the Sages separate and combine treatments according to circumstances, each finding its appropriateness.
If the Form is comfortable but the Zhi (Spirit/Mind) is suffering, disease arises in the Mai (Vessels); treat with Jiu-ci (Moxibustion and Acupuncture). If the Form is arduous but the Zhi is happy, disease arises in the Jin (Sinews/Tendons); treat with Yi-yin (Hot compresses and Guided exercises). If the Form is comfortable and the Zhi is happy, disease arises in the Rou (Muscle/Flesh); treat with Zhen-shi (Needles and Stone tools). If the Form is arduous and the Zhi is suffering, disease arises from exhaustion (Kun-jie); treat with Gan-yao (Sweet-tonifying medicines). If the Form frequently experiences fright and terror, causing Jing-luo (Meridians and Collaterals) obstruction, and disease manifests as Bu-ren (Numbness/Loss of sensation), treat with An-mo (Massage) and Lao-li (Medicated wine). This is called the Five Forms. Thus, the ancient texts state: Needling Yangming releases Blood and Qi; needling Taiyang releases Blood and avoids releasing Evil Qi; needling Shaoyang releases Qi and avoids releasing Blood; needling Taiyin releases Qi and avoids releasing Blood; needling Shaoyin releases Blood and avoids releasing Qi; needling Jueyin releases Blood and avoids releasing Evil Qi.