平按∶此篇自篇首至末,见《灵枢》卷九第五十八《贼风》篇,又见《甲乙经》卷
六第五。
黄帝曰∶夫子言贼风邪气之伤人也,令人病焉;今有其不离屏蔽,不出室内之中,
卒然病者,非必离贼风邪气,其故何也?(贼风者,风从冲上所胜处来,贼邪风也。离,
历也。贼邪之风夜来,人皆卧,虽是昼日,不离屏蔽室内,不历贼风邪气,仍有病者,
其故何也?平按∶室内《灵枢》、《甲乙》作室穴。非必
《灵枢》作非不。袁刻脱必字。)岐伯曰∶此皆尝有所伤于湿气,藏于血脉之中,分肉
之间,久留而不去,若有所堕坠,恶血在内而不去,卒然喜怒不节,饮食不适,寒温不
时,腠理闭而不通,其开而遇风寒时,血气 结,与故邪相袭,则为寒痹。其有热则汗
出,汗出则受风,虽不遇贼风邪气,必有因加而发焉。(人虽不离屏室之中,伤于寒湿,
又因坠有恶血,寒湿恶血等邪,藏于血脉中,又因喜怒饮食寒温失理,遂令腠理闭塞,
壅而不通。若当腠开,遇于风寒,则血凝结,与先寒湿故邪相因,遂为寒痹。虽在屏蔽
之中,因热汗出,腠开受风,斯乃屏内之中加此诸病,不因贼风者。平按∶其开而遇风
寒,《甲乙》无其开二字,遇上有适字。时血气 结《素问》、《甲乙》作则血气凝结。)
黄帝曰∶今夫子之所言者,皆病患之所自知也;其无所遇邪气,又无怵惕之志,卒然而
病者,其故何也?唯有鬼神之事乎?(因内邪得病,病患并能自知;仍有自知不遇寒湿
之邪,又无喜怒怵惕之志,有卒然为病,当是鬼神为之乎?平按∶其无所遇邪气,《甲
乙》无所字。之志《灵枢》作之所志。鬼神上《灵枢》、《甲乙》有因字。注仍有袁刻
作因有有。)岐伯曰∶此亦有故邪留而未发也,因而志有所恶,及有所梦慕,血气内乱,
两气相薄,其所从来者微,视之不见,听而不闻,故似鬼神。(以下答意,非无故邪在
内,亦非无怵惕之志。故有所恶,即为怒也;梦有所乐,即为喜也。因此两者相薄,故血
气乱而生病。所来微细,视听难知,众人谓如鬼神,非鬼神也。平按∶《灵枢》、《甲
乙》无梦字。薄《灵枢》作搏。)黄帝曰∶其祝而已者,其故何也?岐伯曰∶先巫者固
知百病之胜,先知其病之所从生者,可祝而已。黄帝曰∶善。(先巫知者,巫先于人,
因于鬼神,前
知事也。知于百病从胜克生,有从内外邪生。生病者,用针药疗之,非鬼神能生病也,
鬼神但可先知而已。由祝去其巫知之病,非祝巫之鬼也。平按∶祝下《甲乙》有由字。
固知《灵枢》、《甲乙》作因知。其病之所从生者《甲乙》作百病之所从者。)
平按:本篇从开头到结尾,见于《灵枢》卷九第五十八篇《贼风》篇,又见于《甲乙经》卷六第五篇。
黄帝说:先生您谈到贼风邪气伤害人体,使人患病;现在有的人虽然不离开遮蔽物,也不走出室内,却突然生病,这并非一定是因为接触了贼风邪气,其中的原因是什么呢?(所谓贼风,是指从冲要方向吹来的、具有克制作用的风,即贼邪之风。离,意为经历。贼邪之风在夜间袭来,人们都在睡觉,即使是白天,不离开遮蔽物和室内,不经历贼风邪气,却依然生病,这是什么原因呢?平按:室内,《灵枢》和《甲乙经》作“室穴”。非必,《灵枢》作“非不”。袁刻本脱漏了“必”字。)
岐伯回答说:这都是曾经被湿气所伤,湿气藏在血脉之中、分肉之间,长久停留而不消散;或者曾经有跌坠损伤,恶血留在体内而不消散;再加上突然喜怒情绪失控,饮食不适,寒温调节不当,导致腠理闭塞而不通畅。当腠理开放时遇到风寒,血气凝结,与原有的邪气相互侵袭,就会形成寒痹。如果有热象则出汗,出汗后容易受风,即使没有遇到贼风邪气,也必定会因为这些因素叠加而发病。(人虽然不离开屏蔽的室内,但已受到寒湿伤害,又因坠落而有恶血滞留,寒湿、恶血等邪气藏在血脉中;再加上因喜怒、饮食、寒温调理失当,致使腠理闭塞,壅滞不通。如果在腠理开放时,遇到风寒,则血气凝结,与先前的寒湿旧邪相合,遂成为寒痹。虽然身在屏蔽之中,但因热出汗,腠理开放而受风,这是在屏蔽之内叠加了这些病症,并非因为贼风所致。平按:“其开而遇风寒”,《甲乙经》无“其开”二字,“遇”上有“适”字。“时血气结”,《素问》和《甲乙经》作“则血气凝结”。)
黄帝说:如今先生所说的,都是病人自己知道的情况;那些没有遇到邪气,又没有惊恐忧虑的情绪,却突然生病的人,是什么原因呢?难道只有鬼神的事情吗?(因为内邪而得病,病人能够自知;仍然有人自知没有遇到寒湿之邪,又没有喜怒惊恐的情绪,却突然生病,难道是鬼神造成的吗?平按:“其无所遇邪气”,《甲乙经》无“所”字。“之志”,《灵枢》作“之所志”。鬼神之上,《灵枢》和《甲乙经》有“因”字。注文中“仍有”,袁刻本作“因有有”。)
岐伯回答说:这也是因为有旧的邪气留存在体内而未发作,加上志向有所厌恶,以及梦中有所思慕,导致血气内部紊乱,两种气机相互搏结。它们到来的方式很细微,肉眼看不见,耳听不到,所以看起来像鬼神一样。(以下是回答的意思,并非没有故邪在内,也并非没有惊恐的情绪。所谓的“志有所恶”,就是怒;“梦有所乐”,就是喜。因此这两种情绪相互搏结,所以血气混乱而生病。来源微细,视听难以察觉,众人认为像鬼神,其实不是鬼神。平按:《灵枢》和《甲乙经》无“梦”字。“薄”,《灵枢》作“搏”。)
黄帝说:那些通过祝由疗法就能治愈的疾病,其原因是什么呢?
岐伯回答说:以前的巫医确实知道百病的克制规律,预先知道疾病产生的根源,可以通过祝由疗法来治愈。
黄帝说:好。(所谓的“先巫知者”,是指巫医先于常人知晓,依托鬼神,预知事情。知道百病从胜克关系产生,有的从内外邪气产生。生病时,应用针药治疗,并不是鬼神能让人生病,鬼神只能预先知晓而已。通过祝由去除那些依赖巫医认知的疾病,而不是依靠祝由中的鬼神。平按:祝之下,《甲乙经》有“由”字。“固知”,《灵枢》和《甲乙经》作“因知”。“其病之所从生者”,《甲乙经》作“百病之所从者”。)
Ping An: This section, from the beginning to the end of the chapter, is found in Chapter 58, Volume 9, "Zei Feng" (Robbing Wind) of *Ling Shu* (Spiritual Pivot), and also in Chapter 5, Volume 6 of *Jia Yi Jing* (The Classic of Jia Yi).
Huang Di said: You have spoken of how Zei Feng (Robbing Wind) and pathogenic factors injure the human body, causing disease. Now, there are those who do not leave their shelters or exit their rooms, yet suddenly fall ill. This is not necessarily due to exposure to Zei Feng or pathogenic factors. What is the reason for this? (Zei Feng refers to wind coming from a dominant direction that overcomes others, i.e., treacherous pathogenic wind. "Li" means to experience. Treacherous pathogenic wind arrives at night when people are sleeping. Even during the day, if one does not leave shelter or indoor spaces and does not experience such wind, yet still falls ill, what is the cause? Ping An: "Indoor space" (*Shi nei*) is written as "Room hole" (*Shi xue*) in *Ling Shu* and *Jia Yi Jing*. "Not necessarily" (*Fei bi*) is written as "Not not" (*Fei bu*) in *Ling Shu*. The character "bi" is omitted in the Yuan edition.)
Qi Bo replied: These cases all involve prior injury by dampness, which has been stored within the blood vessels and between the muscle layers, remaining there for a long time without dissipating. Or, there may have been a previous fall or trauma, leaving bad blood (stasis) inside that has not been expelled. Additionally, sudden unregulated emotions of joy or anger, improper diet, and untimely regulation of cold and warmth can cause the couli (pores/skin texture) to close and become obstructed. When the couli open and encounter wind and cold, the blood and qi congeal. This interacts with the pre-existing pathogenic factors, resulting in Cold Bi syndrome (painful obstruction due to cold). If there is heat, sweating occurs; after sweating, one becomes susceptible to wind. Even without encountering Zei Feng, illness will inevitably manifest due to these accumulated factors. (Although one remains within shelter, having been injured by cold and dampness, and possessing stasis from falls, the pathogens of cold, dampness, and stasis reside in the blood vessels. Furthermore, imbalances in emotions, diet, and temperature regulation cause the couli to close and become congested. If the couli open and encounter wind and cold, blood and qi congeal, combining with the prior cold-damp pathogens to form Cold Bi. Even within shelter, heat-induced sweating opens the couli, allowing wind invasion. Thus, diseases arise from internal accumulation rather than external Zei Feng. Ping An: "When it opens and encounters wind and cold" (*Qi kai er yu feng han*) lacks the characters "qi kai" in *Jia Yi Jing*, and has the character "shi" before "yu". "At that time, blood and qi congeal" (*Shi xue qi jie*) is written as "then blood and qi coagulate" (*Ze xue qi ning jie*) in *Su Wen* and *Jia Yi Jing*.)
Huang Di said: What you have described so far pertains to conditions known to the patient. For those who have not encountered pathogenic factors and have no feelings of fear or alarm, yet suddenly fall ill, what is the reason? Is it solely due to matters of ghosts and spirits? (Illness caused by internal pathogens is known to the patient. However, some know they have not encountered cold-damp pathogens and have no emotional disturbances like joy, anger, fear, or alarm, yet suddenly fall ill. Could this be the work of ghosts and spirits? Ping An: "Those who have not encountered pathogenic factors" (*Qi wu suo yu xie qi*) lacks the character "suo" in *Jia Yi Jing*. "Of will" (*Zhi zhi*) is written as "of that will" (*Zhi suo zhi*) in *Ling Shu*. Before "ghosts and spirits", the character "yin" (because) appears in *Ling Shu* and *Jia Yi Jing*. In the commentary, "still have" (*Reng you*) is written as "due to have have" (*Yin you you*) in the Yuan edition.)
Qi Bo replied: This is also because old pathogenic factors remain latent within the body. Triggered by aversion in the mind or longing in dreams, the blood and qi become internally chaotic, and two types of qi clash. Their origin is subtle; they cannot be seen or heard, which makes them appear like ghosts and spirits. (This answers the intent: it is not that there is no latent pathogen, nor that there is no feeling of alarm. "Aversion in the mind" corresponds to anger; "longing in dreams" corresponds to joy. The interaction of these two causes blood and qi chaos and disease. The origin is minute and difficult to perceive through sight or hearing, leading the masses to believe it is ghosts and spirits, but it is not. Ping An: *Ling Shu* and *Jia Yi Jing* lack the character "meng" (dream). "Bo" is written as "bo" (clash/fight) in *Ling Shu*.)
Huang Di said: For those cured by Zhuyou (incantation therapy), what is the reason?
Qi Bo replied: Ancient shamans indeed understood the overcoming relationships among the hundred diseases and knew beforehand the origins of the illnesses, allowing them to be cured through Zhuyou.
Huang Di said: Excellent. (The term "ancient shaman knows" implies that shamans, relying on ghosts and spirits, possess foreknowledge. They understand that diseases arise from the cycle of overcoming and from internal or external pathogens. Illnesses should be treated with acupuncture and herbs, not caused by ghosts and spirits themselves; ghosts and spirits only provide foreknowledge. Zhuyou removes diseases dependent on shamanistic cognition, not those caused by ghosts in Zhuyou rituals. Ping An: After "Zhuj", the character "you" appears in *Jia Yi Jing*. "Gu zhi" (indeed knows) is written as "yin zhi" (because knows) in *Ling Shu* and *Jia Yi Jing*. "The source from which the disease arises" (*Qi bing zhi suo cong sheng zhe*) is written as "the source from which the hundred diseases arise" (*Bai bing zhi suo cong zhe*) in *Jia Yi Jing*.)