黄帝间居。辟左右而问于岐伯曰。余已闻九针之经。论阴阳逆顺。六经已毕。愿得口问。岐伯避
席再拜曰。善乎哉问也。此先师之所口传也。黄帝曰。愿闻口传。岐伯答曰。夫百病之始生也。皆生
于风雨寒暑。阴阳喜怒。饮食居处。大惊卒恐。则血气分离。阴阳破散。经络厥绝。脉道不通。阴阳
相逆。卫气稽留。经脉虚空。血气不次。乃失其常。论不在经者。请道其方。
九针之经。谓上古之针经。帝欲于经传之外。而有口传心受者。阴阳六经之外。有别走其道者。
外因内因之外。有奇邪之为病者。故设此问。辟左右者。此上帝之所贵。非其人勿传也。伯言百病
之生。不出外内二因。外因者。因于风雨寒暑。内因者。因于喜怒惊恐。饮食居处。皆伤营卫血气。阴
阳经脉。若不在经者。请言其所在之病。
黄帝曰。人之欠者。何气使然。岐伯答曰。卫气昼日行于阳。夜半则行于阴。阴者主夜。夜者卧。
阳者主上。阴者主
下。故阴气积于下。阳气未尽。阳引而上。阴引而下。阴阳相引。故数欠。阳气尽。阴气盛。则目
瞑。阴气尽而阳气盛则寤矣。泻足少阴。补足太阳。(数叶朔欠江左谓之呵欠)
此论阴阳之气。上下出入。阳者天气也。主外主上。阴者地气也。主内主下。然又有升降出入
之机。而人亦应之。人之卫气。日行于阳。夜行于阴。行于阴则阳气在内。阴气在外。阳气在下。阴
气在上。夜半一阳初升。至天明卫行于阳而寤。然在下之阳气。未尽行于上。阳欲引而上。阴欲引
而下。阴阳相引。故数欠。此阴阳之上下也。日暮在外之阳气将尽。而阴气渐盛。则目瞑而卧。平旦
在外之阴气将尽。而阳气渐盛则寤矣。此阴阳之外内也。当补足太阳以助阳引而上。泻足少阴以引
阴气而下。少阴太阳。标本相合。为阴阳之主宰。
黄帝曰。人之哕者。何气使然。岐伯曰。谷入于胃。胃气上注于肺。今有故寒气与新谷气。俱
还入于胃。新故相乱。真邪相攻。气并相逆。复出于胃。故为哕。补手太阴。泻足少阴。
此言人之所受谷气。由胃气之布散于天下者也。胃为水谷之海。肺属天而外主皮毛。谷入于胃。
乃传之肺。肺朝百脉。输精于皮毛。毛脉合精。行气于腑。五脏六腑。皆以受气。是入胃之水谷。
藉肺气转输于皮毛。行于脏腑。如肺有故寒气。而不能输布。寒气与新谷气。俱还入于胃。新故相
乱。真邪相攻。气并相逆于胃。而胃腑不受。复出于胃。故呃逆也。夫肾者。至阴也。至阴者。盛
水也。肺者。太阴也。少阴者。冬脉也。故其本在肾。其末在肺。皆积水也。是在下之寒水。上通
于天者也。故当补手太阴。以助天之阳气。泻足少阴以下肺之寒邪。肺之寒者。乃肾水之寒气也。此
篇论人身之应天地阴阳。奇邪之走空窍。非外因之形寒。亦非饮冷之寒气也。
姚士因曰。按金匮玉函云。哕逆者。橘皮竹茹汤主之。盖橘之色黄臭香。味甘而辛。乃中土之品
也。辛兼走肺。皮性走皮。是助胃气走肺而外出于皮毛者也。竹性寒而凌冬不凋。得冬令寒水之气。
用茹者。助水气之营运于肤表。不凝聚于肺中。配人参甘草生姜大枣。以助中土之气。先圣立方之
法。咸从经义得之。学人引而伸之。天下之能事毕矣。
黄帝曰。人之唏者。何气使然。岐伯曰。此阴气盛而阳气虚。阴气疾而阳气徐。阴气盛而阳气
绝。故为唏。补足太阳。泻足少阴。
此论阴阳之不相和也。太阳少阴。乃水火阴阳之本。雌雄相合。标本互交。若阴气盛而阳气虚。
则阴气疾而阳气徐矣。阴气疾而阳气徐。则阴气不能相将。而阴与阳绝矣。故当补足太阳之阳。泻
足少阴之阴。以和其阴阳焉。唏者。欷 悲咽也。盖阳气盛则多喜笑。阴气盛则多悲哀。
黄帝曰。人之振寒者。何气使然。岐伯曰。寒气客于皮肤。阴气盛。阳气虚。故为振寒寒栗。
补诸阳。
此言阳气之在外也。诸阳之气。主于肌表。故寒气客于皮肤。藉阳气以化热。若阴气盛而阳气
虚。则为振寒战栗。当补诸阳。诸阳者。三阳也。吴懋先曰。寒气即太阳寒水之气。故当补诸阳。
黄帝曰。人之噫者。何气使然。岐伯曰。寒气客于胃。厥逆从下上散。复出于胃。故为噫。补
足太阴阳明。一曰补眉本也。
此言土位中央。而气出于上下也。寒气客于胃。厥逆之气。上走心为噫。得后气则快然如衰。
是厥气出于胃。
从脾气而上下散。故当补足太阴阳明。以助其分散焉。眉本乃足太阳之经。寒气客于胃者。乃太阳寒
水之气也。一曰补太阳之阳气于上。而客中之寒气可散矣。姚士因曰。肾为水脏。太阳之上。寒气
主之。哕者。寒气在于肺。噫者。寒气在胃中。一泻少阴之寒。一补太阳之阳。补泻虽别。其义则
同。
黄帝曰。人之嚏者。何气使然。岐伯曰。阳气和利。满于心。出于鼻。故为嚏。补足太阳荣眉
本。一曰眉上也。
此言太阳之气。与心气之相和也。太阳之上。寒水主之。少阴之上。君火主之。阴阳互交。标
本相合。故心为阳中之太阳。太阳与心气之相合也。是以阳气和利。则上满于心。出于鼻而为嚏。
鼻乃肺之窍。肺乃心之盖也。太阳之气。生于膀胱。膀胱乃津液之府。阳气和利。上满于心。则阳
气盛矣。故当取足太阳之荣于眉本。使津液上资。则阴阳相平矣。夫太阳之气。主于肤表。一曰补
眉上以取太阳之气。使气行于外。则不满于心矣。
黄帝曰。人之 者。何气使然。岐伯曰。胃不实。则诸脉虚。诸脉虚。则筋脉懈惰。筋脉懈惰。
则行阴用力。气不能复。故为 。因其所在。补行肉间。( 音朵)
此言筋脉皆本于胃腑之所生者。 者垂首斜倾。懈惰之态。筋脉皆本于水谷之所资养。故胃不
实则诸脉虚。诸脉虚则筋脉懈惰。盖经脉者。所以濡筋骨而利关节者也。夫阳明主润宗筋。阳明虚
则宗节纵。是以筋脉懈惰。则阳明之气。行于宗筋。而用力于阴器矣。行阴用力。则阳明之气。不能
复养于筋脉。故为 。因其所在行阴。故补分肉间。以取阳明之气外出。
黄帝曰。人之哀而泣涕出者。何气使然。岐伯曰。心者。五脏六腑之主也。目者。宗脉之所聚也。
上液之道也。口鼻
者。气之门户也。故悲哀愁忧则心动。心动则五脏六腑皆摇。摇则宗脉感。宗脉感则液道开。液道
开故泣涕出焉。液者。所以灌精濡空窍者也。故上液之道开则泣。泣不止则液竭。液竭则精不灌。
精不灌则目无所见矣。故命曰夺精。补天柱经挟颈。
此言五脏之液。内濡百脉。膀胱之津外濡空窍。夫水谷入胃。津液各走其道。酸先入肝。苦先
入心。甘先入脾。辛先入肺。咸先入肾。五脏主藏水谷之津者也。膀胱者。州都之官。津液藏焉。
复还入胃中。以资脏腑。是脏腑膀胱之津。交相资益者也。是故泣不止则液竭。液竭则精不灌。盖
液者。又所以灌精濡空窍者也。宗脉者。上液之道也。液道开而泣不止。则液竭。而濡空窍之精。
不能灌于目。而目不明矣。故命曰夺精。谓夺其外濡空窍之精也。当补膀胱经之天柱于挟颈间。以资
津液上灌。盖液随气行者也。夫口鼻耳目。皆为空窍。故曰口鼻者。气之门户也。谓津液随气而上
濡空窍。故精不灌则目不明。
黄帝曰。人之太息者。何气使然。岐伯曰。忧思则心系急。心系急则气道约。约则不利。故太
息以伸出之。补手少阴心主。足少阳留之也。
此言上焦之宗气。与下焦之生气相通。而行呼吸者也。夫宗气积于胸中。出于喉咙。以贯心脉
而行呼吸。忧思则心系急。心系急则气道敛约。约则不利。故太息以伸出之。当补手少阴心主。足
少阳留之。留之者。候气之至也。盖肾为生气之原。少阳属肾。乃肾中所生之初阳。上通于心主包络。
故补手少阴心主。以通上焦之气。补足少阳留之。以候下焦之生气以上交。王芳侯曰。本经凡曰
手少阴心主。乃包络之经。以相而代行
君令者也。凡曰足少阳。乃兼手少阳而言。盖六腑皆出于足之三阳。上合于手者也。
黄帝曰。人之涎下者。何气使然。岐伯曰。饮食者。皆入于胃。胃中有热则虫动。虫动则胃缓。
胃缓则廉泉开。故涎下。补足少阴。
此言足少阴之气。上与阳明相合。而主化水谷者也。虫者。阴类也。阴类动。则肾气不交于阳
明。而胃气缓矣。气不上交。则水邪反从任脉而上出于廉泉。故涎下。当补足少阴以助下焦之生气
上升。而水邪自下矣。
姚士因曰。少阴阳明。戊癸相合。而后能化水谷之精微。故曰饮食者。皆入于胃。谓不合则胃
缓。缓则不能化饮食矣。不合则热。热则虫动矣。上节论少阴之气。上与宗气相合以行呼吸。此论
与阳明相合。以化饮食之精微。下节论与宗脉相合。而通会于百脉。盖营卫血气。本于后天水谷之
所资生。然必藉下焦先天之气以合化。
黄帝曰。人之耳中鸣者。何气使然。岐伯曰。耳中宗脉之所聚也。故胃中空则宗脉虚。虚则下溜。
脉有所竭者。故耳鸣。补客主人。手大指爪甲上与肉交者也。
此言经脉之血气。资生于胃。而资始于肾也。夫肺朝百脉。宗脉者。百脉一宗。肺所主也。耳者。
宗脉之所聚也。百脉之血气。水谷之所生也。故胃中空则宗脉虚。虚则脉气下溜矣。脉中之血气有
所竭。故耳鸣也。当补客主人与手太阴之少商。客主人乃足少阳之脉。补之以引下溜之脉气上行。
王芳侯曰。客主人者。谓经脉为客。脉中之主人在肾。下溜者。下陷于肾中也。故取在上之脉以引
启之。
黄帝曰。人之自啮舌者。何气使然。(缺岐伯曰)此厥逆走上。脉气辈至也。少阴气至则啮舌。
少阳气至则啮颊。阳明气至则啮唇矣。视主病者则补之。(啮音业)
此总结脉气生于中焦后天之水谷。本于下焦先天之阴阳。中下之气。相合而行者也。齿者。肾气
之所生也。少阴之脉挟舌本。少阳之脉循于颊。阳明之脉。挟口环唇下。如肾脏之生气。厥逆走上。
与中焦所生之脉气。相辈而至。则舌在齿之内。而反向外矣。唇在齿之外。而反向内矣。颊在齿之
旁。而反向中矣。此处假啮舌啮唇。以明阳明所生之血脉。本于先天之生气。相合而偕行者也。
凡此十二邪者。皆奇邪之走空窍者也。故邪之所在。皆为不足。故上气不足。脑为之不满。耳为
之苦鸣。头为之苦倾。目为之眩。中气不足。溲便为之变。肠为之苦鸣。下气不足。则乃为痿厥心
。补足外踝下留之。
此总结十二邪者。皆缘膀胱所藏之津液。不能灌精濡空窍故也。所谓奇邪者。外不因于风雨寒
暑。内不因于阴阳喜怒。饮食居处。皆缘津液不足。而空窍虚无。故邪之所在。皆为之不足。盖因
正气不足。而生奇邪之证也。故上气不足者。脑为之不满。耳为之苦鸣。头为之苦倾。目为之眩。
中气不足者。溲便为之变。肠为之苦鸣。下气不足者。则为痿厥心 。盖不足于下。则为痿厥。不
得上交于心。则心 矣。补足外踝下留之。乃取太阳之昆仑穴。候太阳之气至也。盖太阳者。三阳
也。三阳者。天之业。膀胱之津水。随气营运。以濡空窍。故取之昆仑。昆仑乃津水之发原。上通于
天者也。
黄帝曰。治之奈何。岐伯曰。肾主为欠。取足少阴。肺主为哕。取手太阴足少阴。唏者阴与阳
绝。故补足太阳。泻足
少阴。振寒者补诸阳。噫者补足太阴阳明。嚏者补足太阳眉本。 因其所在。补分肉间。泣出补天
柱经挟颈。挟颈者。头中分也。太息补手少阴心主。足少阳留之。涎下补足少阴。耳鸣补客主人。
手大指爪甲上与肉交者。自啮舌视主病者则补之。
上节总论膀胱之津液。不能灌濡空窍。以致上中下气。皆为之不足。此复分论十二邪者。各有补
泻阴阳之法。盖膀胱者。津液之府。受脏腑之津而藏之。复还入胃中以资益脏腑。互相交通者也。
故各因其邪之所在而补泻之。
目眩头倾。补足外踝下留之。痿厥心 。刺足大趾间上二寸留之。一曰足外踝下留之。
足大趾间上二寸。乃足太阴之太白。脾脏之上俞也。此篇论太阳之津水。随气而营运于肤表。
复从中土而上交于心。应司天在泉之气。营运于地之外。复贯通于地中。是以上气不足。补足太阳
之昆仑。下气不足。不得从中而上通于心者。刺足太阴之俞以通土气。然本于足太阳之津气贯通。
故一曰足外踝下留之。乃取太阳之津气也。姚士因曰。欠者。足太阳少阴之气。相引而上下也。
哕者。少阴寒水之气。客于肺也。唏者。太阳与少阴之气不和也。振寒者。寒水之气客于皮肤。而
太阳之阳气虚于表也。噫者。太阳寒水之气客于胃也。嚏者。太阳之阳气满于心也。 者。筋脉之
气。行阴用力。前阴者。足少阴太阳之会也。哀泣者。太阳之津液竭也。太息者。下焦之生气不交
于上也。涎下者。膀胱之水邪上溢也。耳鸣者。宗脉之气。溜陷于下焦也。自啮者。下焦之气。厥
黄帝闲居,屏退左右侍从,向岐伯问道:“我已经学习了《九针》的经典,论述了阴阳的逆顺和六经的规律,现在希望听听关于‘口问’的内容。”岐伯离开座位,拜了两拜说:“这个问题问得好啊!这是先师口头传授的知识。”黄帝说:“我希望听听这些口头传授的知识。”岐伯回答说:“各种疾病的产生,都源于风雨寒暑、喜怒情绪、饮食起居以及大惊大恐。这些因素会导致血气分离、阴阳破散、经络断绝、脉道不通、阴阳相逆、卫气滞留、经脉空虚、血气运行无序,从而失去常态。那些不在经典中记载的,请允许我说明其道理。”
《九针》的经典,指的是上古时期的《针经》,黄帝希望在经文之外,能有口传心授的内容。在阴阳六经之外,还有其他的致病途径;在外因和内因之外,还有奇邪导致的疾病。所以提出这个问题。屏退左右侍从,是因为这是上天所重视的知识,不是合适的人不能传授。岐伯说百病的产生,不外乎外因和内因。外因是感受风雨寒暑,内因是喜怒惊恐、饮食起居不当,这些都损伤营卫血气、阴阳经脉。如果不在经典中的,请让我说说它们所在的病症。
黄帝说:“人打哈欠,是什么气引起的?”岐伯回答说:“卫气白天行于阳分,半夜行于阴分。阴分主夜间,夜间需要睡眠。阳分主上,阴分主下。所以阴气积聚在下部,阳气未尽,阳气牵引向上,阴气牵引向下,阴阳相互牵引,所以频繁打哈欠。当阳气耗尽,阴气旺盛时,眼睛就闭上了(入睡);当阴气耗尽而阳气旺盛时,人就醒来了。治疗应泻足少阴经,补足太阳经。(数叶朔欠江左谓之呵欠:意为频繁打哈欠,江浙一带称为呵欠)”
这里论述的是阴阳之气的上下出入。阳分如同天气,主外主上;阴分如同地气,主内主下。然而又有升降出入的机制,人也顺应这一规律。人的卫气,白天行于阳分,夜晚行于阴分。行于阴分时,阳气在内,阴气在外,阳气在下,阴气在上。半夜一阳初升,到天亮卫气行于阳分人就醒来。但是下部尚未完全上行到上部的阳气,阳气想要引而上行,阴气想要引而下陷,阴阳相互牵引,所以频繁打哈欠。这是阴阳的上下关系。傍晚时,体表的阳气将尽,阴气渐盛,所以眼睛闭上睡觉。清晨时,体表的阴气将尽,阳气渐盛,人就醒来了。这是阴阳的外内关系。应当补足太阳经以助阳气引而上行,泻足少阴经以引阴气下行。少阴和太阳,标本相合,是阴阳的主宰。
黄帝说:“人呃逆,是什么气引起的?”岐伯说:“食物进入胃中,胃气上注于肺。现在如果有旧的寒气与新进入的食物之气,一起回到胃中,新旧之气相互扰乱,真气与邪气相互冲突,气机并逆,再次从胃中出来,所以发生呃逆。治疗应补手太阴经,泻足少阴经。”
这里说的是人所摄入的谷气,通过胃气的布散遍布全身。胃是水谷之海,肺属天且外部主管皮毛。食物进入胃中,然后传输给肺。肺朝会百脉,将精微输布到皮毛。皮毛与血脉结合精气,将气运行于脏腑。五脏六腑都接受这种气。所以进入胃的水谷,借助肺气的转输到达皮毛,运行于脏腑。如果肺中有旧的寒气,不能输布,寒气与新进入的食物之气一起回到胃中,新旧之气相互扰乱,真气与邪气相互冲突,气机并在胃中逆乱,胃腑无法承受,再次从胃中出来,所以发生呃逆。肾是至阴之脏,至阴意味着水气旺盛。肺是太阴之脏,少阴是冬脉。所以病根在肾,表现在肺,都是积水所致。这是在下部的寒水上通于天的表现。所以应当补手太阴经以助天之阳气,泻足少阴经以下降肺中的寒邪。肺中的寒气,其实是肾水的寒气。本篇论述人身应合天地阴阳,奇邪走窜空窍,不是外因的形寒,也不是饮冷的寒气。
姚士因说:按《金匮玉函》记载,呃逆用橘皮竹茹汤主治。大概橘子的颜色黄气味香,味道甘辛,是中土的药物。辛味兼走肺,橘皮性走皮肤,这是帮助胃气走向肺并外出于皮毛。竹子性寒且在冬天不凋谢,得到冬季寒水之气。使用竹茹,是帮助水气运送到肤表,不凝聚在肺中。配合人参、甘草、生姜、大枣,以助中土之气。先圣制定方剂的方法,都从经义得来。学习者引申它,天下的医术就能完备了。
黄帝说:“人叹息,是什么气引起的?”岐伯说:“这是阴气盛而阳气虚,阴气运行快而阳气运行慢,阴气盛而阳气绝,所以发生叹息。治疗应补足太阳经,泻足少阴经。”
这里论述的是阴阳不相调和。太阳和少阴,是水火阴阳的根本,雌雄相合,标本互交。如果阴气盛而阳气虚,那么阴气运行快而阳气运行慢。阴气运行快而阳气运行慢,阴气就不能相随,阴与阳就会隔绝。所以应当补足太阳的阳气,泻足少阴的阴气,来调和阴阳。叹息,是指欷歔悲咽。大概阳气盛则多喜笑,阴气盛则多悲哀。
黄帝说:“人战栗发冷,是什么气引起的?”岐伯说:“寒气客居于皮肤,阴气盛,阳气虚,所以发生战栗发冷。治疗应补诸阳经。”
这里说的是阳气在体表的情况。诸阳之气,主管肌表。所以寒气客居于皮肤,依靠阳气来化热。如果阴气盛而阳气虚,就会发生战栗发冷。应当补诸阳经。诸阳,指三阳经。吴懋先说:寒气就是太阳寒水之气,所以应当补诸阳经。
黄帝说:“人嗳气,是什么气引起的?”岐伯说:“寒气客居于胃,厥逆之气从下向上散发,再次从胃中出来,所以发生嗳气。治疗应补足太阴经和足阳明经。另一种说法是补眉本穴。”
这里说的是土位居中,气出于上下。寒气客居于胃,厥逆之气上走于心表现为嗳气,得到排气后感觉轻松减轻。这说明厥气出于胃,随着脾气上下散发。所以应当补足太阴经和足阳明经,以帮助其分散。眉本是足太阳经的穴位。寒气客居于胃,是太阳寒水之气。另一种说法是在上部补足太阳的阳气,客居的寒气就可以消散了。姚士因说:肾是水脏,太阳之上,寒气主之。呃逆,寒气在于肺;嗳气,寒气在胃中。一个泻少阴的寒,一个补太阳的阳。补泻虽然不同,但意义相同。
黄帝说:“人打喷嚏,是什么气引起的?”岐伯说:“阳气和谐通畅,充满于心,出于鼻,所以发生喷嚏。治疗应补足太阳经的荥穴眉本穴。另一种说法是补眉上穴。”
这里说的是太阳之气与心气相和。太阳之上,寒水主之;少阴之上,君火主之。阴阳互交,标本相合。所以心为阳中之太阳,太阳与心气相合。因此阳气和谐通畅,就向上充满于心,出于鼻而发生喷嚏。鼻是肺的窍,肺是心的盖。太阳之气生于膀胱,膀胱是津液的府库。阳气和谐通畅,向上充满于心,阳气就旺盛了。所以应当取足太阳经的荥穴眉本,使津液上资,这样阴阳就平衡了。太阳之气,主管肤表。另一种说法是补眉上来获取太阳之气,使气行于外,就不会充满于心了。
黄帝说:“人垂首斜倾,是什么气引起的?”岐伯说:“胃不实,则诸脉虚。诸脉虚,则筋脉懈惰。筋脉懈惰,则行房用力,气不能恢复,所以发生垂首斜倾。根据其所在部位,补分肉间。( 音朵:指垂首斜倾的样子)”
这里说的是筋脉都本于胃腑所生。 是指垂首斜倾,懈惰的状态。筋脉都本于水谷的滋养。所以胃不实则诸脉虚,诸脉虚则筋脉懈惰。经脉是用来濡养筋骨滑利关节的。阳明经主润宗筋,阳明虚则宗筋松弛。所以筋脉懈惰,阳明之气行于宗筋,而在阴器用力。行房用力,则阳明之气不能恢复滋养筋脉,所以发生垂首斜倾。因其所在行房,所以补分肉间,以获取阳明之气外出。
黄帝说:“人悲哀哭泣流泪,是什么气引起的?”岐伯说:“心是五脏六腑的主宰。目是宗脉汇聚的地方,也是上液之道。口鼻是气的门户。所以悲哀愁忧则心动,心动则五脏六腑都摇动。摇动则宗脉感应,宗脉感应则液道打开,液道打开所以哭泣流泪。液,是用来灌注精髓濡养空窍的。所以上液之道打开就哭泣。哭泣不止则液竭,液竭则精不灌,精不灌则目无所见,所以命名为夺精。治疗应补天柱经,位于颈部两侧。”
这里说的是五脏的液,内部濡养百脉;膀胱的津,外部濡养空窍。水谷进入胃中,津液各走其道。酸先入肝,苦先入心,甘先入脾,辛先入肺,咸先入肾。五脏主藏水谷的津液。膀胱是州都之官,津液藏焉,又返回胃中,以资助脏腑。这是脏腑与膀胱的津液互相资助的关系。所以哭泣不止则液竭,液竭则精不灌。液,又是用来灌注精髓濡养空窍的。宗脉,是上液之道。液道打开而哭泣不止,则液竭,而濡养空窍的精,不能灌注于目,而目不明。所以命名为夺精,意思是剥夺了外部濡养空窍的精。应当补膀胱经的天柱穴,位于颈部两侧,以资助津液上灌。因为液随气运行。口鼻耳目,都是空窍,所以说口鼻是气的门户。意思是津液随气而上濡养空窍,所以精不灌则目不明。
黄帝说:“人长叹气,是什么气引起的?”岐伯说:“忧思则心系紧急,心系紧急则气道约束,约束则不利,所以长叹气以伸展它。治疗应补手少阴心包经,足少阳经留针。”
这里说的是上焦的宗气,与下焦的生气相通,而行呼吸。宗气积于胸中,出于喉咙,贯通心脉而行呼吸。忧思则心系紧急,心系紧急则气道收敛约束,约束则不利,所以长叹气以伸展它。应当补手少阴心包经,足少阳经留针。留针,是等待气至。肾是生气的源头,少阳属肾,是肾中所生的初阳,上通于心包络。所以补手少阴心包经,以通上焦之气;补足少阳经留针,以等待下焦的生气上交。王芳侯说:本经凡是说手少阴心包,是指心包络的经脉,代替君主行使命令。凡是说足少阳,是兼指手少阳而言。大概六腑都出于足的三阳经,上合于手的经脉。
黄帝说:“人流涎,是什么气引起的?”岐伯说:“饮食都进入胃中。胃中有热则虫动,虫动则胃缓,胃缓则廉泉开,所以流涎。治疗应补足少阴经。”
这里说的是足少阴之气,上与阳明相合,而主化水谷。虫,是阴类。阴类动,则肾气不交于阳明,而胃气缓了。气不上交,则水邪反从任脉而上出于廉泉,所以流涎。应当补足少阴经以助下焦的生气上升,而水邪自然下降。
姚士因说:少阴与阳明,戊癸相合,而后能化水谷的精微。所以说饮食者,皆入于胃。如果不合则胃缓,缓则不能化饮食。不合则热,热则虫动。上一节论少阴之气,上与宗气相合以行呼吸;此节论与阳明相合,以化饮食的精微;下一节论与宗脉相合,而通会于百脉。大概营卫血气,本于后天水谷的滋生,但必须借助下焦先天之气来合化。
黄帝说:“人耳中鸣响,是什么气引起的?”岐伯说:“耳中是宗脉汇聚的地方。所以胃中空虚则宗脉虚,虚则下溜,脉有所竭者,所以耳鸣。治疗应补客主人穴,以及手大拇指指甲角与肉交接处(少商穴)。”
这里说的是经脉的血气,资生于胃,而资始于肾。肺朝会百脉,宗脉是百脉的一宗,由肺所主。耳是宗脉汇聚的地方。百脉的血气,是水谷所生。所以胃中空虚则宗脉虚,虚则脉气下溜。脉中的血气有所枯竭,所以耳鸣。应当补客主人穴和手太阴经的少商穴。客主人穴是足少阳经的脉,补它以引下溜的脉气上行。
王芳侯说:客主人,是说经脉为客,脉中的主人在肾。下溜,是下陷于肾中。所以取在上部的脉以引导开启它。
黄帝说:“人自己咬舌头,是什么气引起的?(缺岐伯曰)这是厥逆之气走上,脉气辈至。少阴气至则咬舌,少阳气至则咬颊,阳明气至则咬唇。视主病者则补之。(啮音业:咬的意思)”
这里总结脉气生于中焦后天的水谷,本于下焦先天的阴阳,中下的气,相合而行。齿,是肾气所生。少阴的脉挟持舌本,少阳的脉循行于颊,阳明的脉挟口环唇下。如果肾脏的生气厥逆走上,与中焦所生的脉气,相辈而至,则舌在齿之内,而反向外;唇在齿之外,而反向内;颊在齿之旁,而反向中。此处假借咬舌咬唇,来说明阳明所生的血脉,本于先天的生气,相合而偕行。
这十二种邪气,都是奇邪走窜空窍的缘故。所以邪气所在的地方,都是因为不足。所以上气不足,脑为之不满,耳为之苦鸣,头为之苦倾,目为之眩。中气不足,大小便为之改变,肠为之苦鸣。下气不足,则为痿厥心悸。治疗应补足外踝下留针。
这里总结十二种邪气,都是因为膀胱所藏的津液,不能灌注精髓濡养空窍的缘故。所谓的奇邪,外不因于风雨寒暑,内不因于阴阳喜怒、饮食起居,都是因为津液不足,而空窍虚无。所以邪气所在的地方,都是因为不足。大概是因为正气不足,而生奇邪之证。所以上气不足,脑为之不满,耳为之苦鸣,头为之苦倾,目为之眩。中气不足,大小便为之改变,肠为之苦鸣。下气不足,则为痿厥心悸。大概不足于下,则为痿厥;不得上交于心,则心悸。补足外踝下留针,是取太阳经的昆仑穴,等待太阳之气至。太阳是三阳,三阳是天之业。膀胱的津水,随气营运,以濡养空窍。所以取昆仑穴,昆仑是津水的发源,上通于天。
黄帝说:“如何治疗?”岐伯说:“肾主为哈欠,取足少阴经。肺主为呃逆,取手太阴经和足少阴经。叹息是阴与阳绝,所以补足太阳经,泻足少阴经。战栗发冷者补诸阳经。嗳气者补足太阴经和足阳明经。打喷嚏者补足太阳经眉本穴。垂首斜倾者,根据其所在,补分肉间。哭泣流泪者补天柱经位于颈部两侧。颈部两侧,是头的中间部分。长叹气者补手少阴心包经,足少阳经留针。流涎者补足少阴经。耳鸣者补客主人穴,以及手大拇指指甲角与肉交接处。自己咬舌者,视主病者则补之。”
上一节总论膀胱的津液,不能濡养空窍,导致上中下气,都为不足。这一节分别论述十二种邪气,各有补泻阴阳的方法。大概膀胱是津液的府库,受脏腑的津而藏之,又返回胃中以资助脏腑,互相交通。所以各因其邪气所在而补泻。
目眩头倾,补足外踝下留针。痿厥心悸,刺足大趾间上二寸留针。另一种说法是补足外踝下留针。
足大趾间上二寸,是足太阴经的太白穴,脾脏的上俞。本篇论述太阳的津水,随气而营运于肤表,复从中土而上交于心,应司天在泉之气,营运于地之外,复贯通于地中。所以上气不足,补足太阳经的昆仑穴;下气不足,不得从中而上通于心者,刺足太阴经的俞穴以通土气。然本于足太阳的津气贯通,所以另一种说法是补足外踝下留针,是取太阳的津气。姚士因说:哈欠,是足太阳少阴之气,相引而上下。呃逆,是少阴寒水之气,客于肺。叹息,是太阳与少阴之气不和。战栗发冷,是寒水之气客于皮肤,而太阳的阳气虚于表。嗳气,是太阳寒水之气客于胃。打喷嚏,是太阳的阳气满于心。垂首斜倾,是筋脉之气,行房用力,前阴是足少阴太阳的交会。悲哀哭泣,是太阳的津液竭。长叹气,是下焦的生气不交于上。流涎,是膀胱的水邪上溢。耳鸣,是宗脉之气,溜陷于下焦。自己咬舌,是下焦之气,厥...
Huangdi, in his leisure residence, dismissed the attendants and asked Qibo: "I have already studied the classics of the Nine Needles, discussing the reversal and smoothness of Yin and Yang, and the completion of the Six Meridians. I now wish to hear about 'Oral Questions' (Kouwen). Qibo stepped down from his seat, bowed twice, and said: "What a good question! This is knowledge orally transmitted by our former masters." Huangdi said: "I wish to hear this oral transmission." Qibo replied: "The onset of all diseases arises from wind, rain, cold, heat, Yin and Yang emotions (anger and joy), diet and living conditions, as well as sudden fright and terror. These factors cause the separation of blood and Qi, the disintegration of Yin and Yang, the severance of collaterals, the blockage of vessel pathways, the reversal of Yin and Yang, the stagnation of Defensive Qi (Wei Qi), the emptiness of meridians, and the disorder of blood and Qi, thereby losing their normal state. For those not recorded in the classics, please allow me to explain their principles."
The "classics of the Nine Needles" refers to the ancient *Zhenjing* (Classic of Acupuncture). Huangdi sought knowledge beyond the written texts through oral transmission and mental reception. Beyond the Yin-Yang and Six Meridians, there are other pathological pathways; beyond external and internal causes, there are diseases caused by "strange pathogens" (Qi Xie). Hence, this question was posed. Dismissing the attendants signifies that this is precious knowledge valued by Heaven, not to be transmitted to the unworthy. Qibo stated that the origin of all diseases lies in neither external nor internal causes alone. External causes include exposure to wind, rain, cold, and heat; internal causes include emotional disturbances (anger, joy, fear, terror) and improper diet and lifestyle. All these damage Ying (Nutritive) and Wei (Defensive) Qi, as well as Yin and Yang meridians. For those not covered in the classics, let me describe their specific manifestations.
Huangdi asked: "What causes yawning?" Qibo answered: "Defensive Qi (Wei Qi) travels in the Yang aspects during the day and in the Yin aspects at midnight. Yin governs the night, and the night requires sleep. Yang governs the upper part, and Yin governs the lower part. Thus, Yin Qi accumulates in the lower body while Yang Qi has not yet fully exhausted. Yang pulls upward, and Yin pulls downward; the mutual attraction of Yin and Yang results in frequent yawning. When Yang Qi is exhausted and Yin Qi is abundant, the eyes close (sleep). When Yin Qi is exhausted and Yang Qi becomes abundant, one awakens. Treatment involves reducing the Foot Shaoyin meridian and supplementing the Foot Taiyang meridian. (Note: Frequent yawning is referred to as 'heqian' in the Jiangzuo region.)"
This passage discusses the ascending and descending movement of Yin and Yang Qi. Yang is like Heavenly Qi, governing the exterior and the upper; Yin is like Earthly Qi, governing the interior and the lower. However, there is a mechanism of ascending, descending, entering, and exiting, which humans also follow. Human Defensive Qi (Wei Qi) travels in the Yang aspects during the day and in the Yin aspects at night. When traveling in the Yin aspects, Yang Qi is inside, Yin Qi is outside, Yang Qi is below, and Yin Qi is above. At midnight, the first Yang Qi begins to rise. By dawn, when Defensive Qi travels in the Yang aspects, one awakens. However, the Yang Qi remaining in the lower body has not yet fully ascended; Yang desires to pull upward, and Yin desires to pull downward, causing mutual attraction and frequent yawning. This describes the vertical relationship of Yin and Yang. In the evening, when the Yang Qi on the exterior is nearly exhausted and Yin Qi gradually increases, the eyes close for sleep. At dawn, when the Yin Qi on the exterior is nearly exhausted and Yang Qi gradually increases, one awakens. This describes the internal-external relationship of Yin and Yang. Treatment should involve supplementing the Foot Taiyang meridian to assist Yang in pulling upward, and reducing the Foot Shaoyin meridian to guide Yin downward. Shaoyin and Taiyang, combining their root and branch, serve as the masters of Yin and Yang.
Huangdi asked: "What causes hiccups?" Qibo said: "Food enters the stomach, and Stomach Qi flows upward into the Lungs. If old cold pathogen and new food Qi both return to the stomach, the new and old Qi interfere with each other, true Qi and evil Qi attack each other, Qi merges and reverses, and re-emerges from the stomach, causing hiccups. Treatment involves supplementing the Hand Taiyin meridian and reducing the Foot Shaoyin meridian."
This explains that the Qi derived from grain ingested by humans is distributed throughout the body via Stomach Qi. The Stomach is the sea of water and grain. The Lung belongs to Heaven and externally governs the skin and hair. Food enters the stomach and is then transmitted to the Lung. The Lung receives all vessels and transmits essence to the skin and hair. The skin and vessels combine their essence, circulating Qi through the zang-fu organs. All five zang and six fu organs receive this Qi. Thus, water and grain entering the stomach rely on Lung Qi for transport to the skin and hair, and circulation within the zang-fu. If the Lung contains old cold pathogen and cannot distribute it, the cold pathogen and new food Qi both return to the stomach. The new and old Qi interfere, true and evil Qi conflict, Qi reverses in the stomach, the stomach cannot accept it, and it re-emerges, causing hiccups. The Kidney is the organ of extreme Yin, meaning it holds abundant water. The Lung is the organ of Great Yin, and Shaoyin is the pulse of winter. Therefore, the root of the disease is in the Kidney, and the manifestation is in the Lung, both involving fluid accumulation. This represents cold water from the lower body connecting to Heaven. Thus, one should supplement the Hand Taiyin meridian to assist Heavenly Yang Qi, and reduce the Foot Shaoyin meridian to descend cold evil from the Lung. The cold in the Lung is actually the cold qi of Kidney water. This chapter discusses how the human body corresponds to Heaven and Earth's Yin and Yang, and how strange pathogens travel through orifices. It is not due to external physical cold nor cold from drinking cold beverages.
Yao Shiyin stated: According to the *Jinkui Yufan*, hiccups are treated with Jupi Zhuru Tang (Tangerine Peel and Bamboo She Decoction). Tangerine peel is yellow and fragrant, sweet and pungent, belonging to the Earth element. Its pungency travels to the Lung, and its nature travels to the skin. This helps Stomach Qi move to the Lung and emerge through the skin. Bamboo is cold and remains green in winter, obtaining the cold water energy of winter. Using bamboo she (Ruzhu) helps circulate water energy to the body surface without condensing in the Lung. Combined with Ginseng, Licorice, Ginger, and Jujube, it assists Earth Qi. The methods of the sages in formulating prescriptions are all derived from canonical principles. Students who extend these principles will master medical arts.
Huangdi asked: "What causes sighing?" Qibo said: "This occurs when Yin Qi is abundant and Yang Qi is deficient, Yin Qi moves rapidly while Yang Qi moves slowly, and Yin Qi is excessive while Yang Qi is depleted. Thus, sighing occurs. Treatment involves supplementing the Foot Taiyang meridian and reducing the Foot Shaoyin meridian."
This discusses the disharmony of Yin and Yang. Taiyang and Shaoyin are the roots of Water-Fire and Yin-Yang. They combine like male and female, interacting between root and branch. If Yin Qi is abundant and Yang Qi is deficient, Yin Qi moves rapidly while Yang Qi moves slowly. Rapid Yin and slow Yang prevent them from accompanying each other, leading to a separation of Yin and Yang. Therefore, one should supplement the Yang of Taiyang and reduce the Yin of Shaoyin to harmonize Yin and Yang. Sighing refers to sobbing and choking with grief. Generally, abundant Yang leads to laughter, while abundant Yin leads to sorrow.
Huangdi asked: "What causes shivering and chills?" Qibo said: "Cold pathogen lodges in the skin, Yin Qi is abundant, and Yang Qi is deficient, resulting in shivering and chills. Treatment involves supplementing all Yang meridians."
This describes Yang Qi on the exterior. The Qi of all Yang meridians governs the muscle and surface. Thus, when cold pathogen lodges in the skin, it relies on Yang Qi to transform into heat. If Yin Qi is abundant and Yang Qi is deficient, shivering and chills occur. One should supplement all Yang meridians. "All Yang" refers to the Three Yang meridians. Wu Maoxian stated: Cold pathogen is the cold water Qi of Taiyang, so one should supplement all Yang meridians.
Huangdi asked: "What causes belching?" Qibo said: "Cold pathogen lodges in the stomach, rebellious Qi rises from below and scatters upward, then re-emerges from the stomach, causing belching. Treatment involves supplementing the Foot Taiyin and Foot Yangming meridians. Alternatively, supplement the Meiben point."
This describes Earth positioned centrally, with Qi emerging from above and below. Cold pathogen lodges in the stomach, and rebellious Qi moves upward to the Heart, manifesting as belching. Relief is felt after passing gas, indicating the rebellious Qi originates from the stomach and scatters up and down following Spleen Qi. Therefore, one should supplement the Foot Taiyin and Foot Yangming meridians to aid dispersion. Meiben is an acupoint on the Foot Taiyang meridian. Cold pathogen lodging in the stomach is the cold water Qi of Taiyang. Alternatively, supplementing the Yang Qi of Taiyang above can dissipate the lodged cold pathogen. Yao Shiyin stated: The Kidney is the Water organ, governed by cold above Taiyang. Hiccups involve cold in the Lung; belching involves cold in the stomach. One reduces the cold of Shaoyin, the other supplements the Yang of Taiyang. Although supplementation and reduction differ, the principle is the same.
Huangdi asked: "What causes sneezing?" Qibo said: "When Yang Qi is harmonious and smooth, filling the Heart, and emerging from the nose, sneezing occurs. Treatment involves supplementing the Ying (Spring) point of the Foot Taiyang meridian, Meiben. Alternatively, supplement the point above the eyebrow."
This describes the harmony between Taiyang Qi and Heart Qi. Above Taiyang, cold water governs; above Shaoyin, Sovereign Fire governs. Yin and Yang interact, combining root and branch. Thus, the Heart is the Sun among Yang organs, harmonizing with Taiyang. When Yang Qi is harmonious and smooth, it fills the Heart upward and emerges from the nose, causing sneezing. The nose is the orifice of the Lung, and the Lung is the cover of the Heart. Taiyang Qi originates from the Bladder, which is the reservoir of fluids. When Yang Qi is harmonious and smooth, filling the Heart upward, Yang Qi becomes abundant. Therefore, one should select the Ying point of the Foot Taiyang meridian at Meiben to nourish fluids from above, balancing Yin and Yang. Taiyang Qi governs the skin surface. Alternatively, supplementing above the eyebrow retrieves Taiyang Qi, allowing it to circulate outward, preventing it from filling the Heart excessively.
Huangdi asked: "What causes drooping head and slanting posture?" Qibo said: "If the Stomach is not solid, all vessels become deficient. If all vessels are deficient, sinews and vessels become lax. If sinews and vessels are lax, exertion in sexual activity depletes Qi, which cannot recover, resulting in drooping head and slanting posture. Treatment involves supplementing the space between muscles at the affected site. (Pronunciation: duo)"
This explains that sinews and vessels originate from the Stomach. Drooping head and slanting posture indicate a state of laxity. Sinews and vessels are nourished by water and grain. Thus, if the Stomach is not solid, vessels become deficient; if vessels are deficient, sinews and vessels become lax. Meridians moisten bones and tendons and facilitate joint movement. Yangming moistens Zongjin (major sinews). If Yangming is deficient, Zongjin relaxes. Thus, when sinews and vessels are lax, Yangming Qi acts on Zongjin and exerts force on the genitalia. Exertion in sexual activity prevents Yangming Qi from recovering to nourish sinews and vessels, causing drooping head and slanting posture. Since the condition relates to sexual exertion, one should supplement the intermuscular spaces to retrieve Yangming Qi moving outward.
Huangdi asked: "What causes crying and tearing when grieving?" Qibo said: "The Heart is the master of the five zang and six fu organs. The eyes are the gathering place of Zongmai (Major Vessels) and the pathway for upper fluids. The mouth and nose are the gates of Qi. Thus, grief and sorrow move the Heart; when the Heart moves, all five zang and six fu organs tremble. Trembling stimulates Zongmai, opening the fluid pathways. Once opened, tears and mucus flow. Fluids are used to nourish essence and moisten orifices. Therefore, when the upper fluid pathway opens, one cries. If crying does not stop, fluids are exhausted. If fluids are exhausted, essence is not nourished. If essence is not nourished, vision fails. This is called 'Loss of Essence'. Treatment involves supplementing the Tianzhu meridian along the neck."
This explains that the fluids of the five zang internally nourish hundred vessels, while the fluids of the Bladder externally nourish orifices. After food and drink enter the stomach, fluids follow different paths. Sour enters the Liver first, bitter enters the Heart first, sweet enters the Spleen first, pungent enters the Lung first, and salty enters the Kidney first. The five zang store the fluids of water and grain. The Bladder is the official of the capital, storing fluids, which return to the stomach to nourish the zang-fu. Thus, fluids of zang-fu and Bladder mutually benefit each other. Therefore, if crying does not stop, fluids are exhausted; if fluids are exhausted, essence is not nourished. Fluids nourish essence and moisten orifices. Zongmai is the pathway for upper fluids. If fluid pathways open and crying continues, fluids are exhausted, and the essence moistening orifices cannot nourish the eyes, leading to blurred vision. This is called 'Loss of Essence', meaning the loss of essence that externally moistens orifices. One should supplement the Tianzhu point of the Bladder meridian on both sides of the neck to assist fluids in flowing upward. Fluids follow Qi. The mouth, nose, eyes, and ears are all orifices, hence "mouth and nose are the gates of Qi." This means fluids follow Qi upward to moisten orifices. Thus, if essence is not nourished, vision is unclear.
Huangdi asked: "What causes deep sighing (Tai Xi)?" Qibo said: "Worry and thought tighten the Heart ties. Tightened Heart ties constrict the Qi pathway. Constriction causes obstruction, so deep sighing occurs to release it. Treatment involves supplementing the Hand Shaoyin Pericardium meridian and retaining needle insertion in the Foot Shaoyang meridian."
This explains that the Zong Qi (Gathering Qi) of the Upper Jiao connects with the Sheng Qi (Generating Qi) of the Lower Jiao to govern respiration. Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart vessels, and governs breathing. Worry and thought tighten the Heart ties, constricting the Qi pathway, causing obstruction. Deep sighing releases this. One should supplement the Hand Shaoyin Pericardium meridian and retain needles in the Foot Shaoyang meridian. "Retaining" means waiting for Qi arrival. The Kidney is the source of Generating Qi. Shaoyang belongs to the Kidney and is the initial Yang generated from the Kidney, connecting upward to the Pericardium. Thus, supplementing the Hand Shaoyin Pericardium meridian unblocks Upper Jiao Qi; retaining needles in the Foot Shaoyang meridian waits for Lower Jiao Generating Qi to ascend and connect. Wang Fanghou stated: Whenever the classic mentions "Hand Shaoyin Pericardium," it refers to the Pericardium meridian, which acts on behalf of the Sovereign. Whenever it mentions "Foot Shaoyang," it includes Hand Shaoyang. Generally, the six fu organs originate from the three Yang meridians of the foot and connect upward to the hand meridians.
Huangdi asked: "What causes salivation?" Qibo said: "Food and drink enter the stomach. Heat in the stomach causes worms to move. Worm movement relaxes the stomach. Stomach relaxation opens Lianquan, causing salivation. Treatment involves supplementing the Foot Shaoyin meridian."
This explains that Foot Shaoyin Qi combines with Yangming to govern the transformation of water and grain. "Worms" belong to Yin. When Yin moves, Kidney Qi does not connect with Yangming, causing stomach relaxation. Without upward connection, water evil rises via the Ren Mai to emerge at Lianquan, causing salivation. One should supplement the Foot Shaoyin meridian to assist Lower Jiao Generating Qi in ascending, causing water evil to descend.
Yao Shiyin stated: Shaoyin and Yangming combine (Wu-Gui combination) to transform the essence of water and grain. Thus, "food and drink enter the stomach." If they do not combine, the stomach relaxes and cannot digest food. Lack of combination generates heat, causing worm movement. The previous section discussed Shaoyin Qi combining with Zong Qi for respiration; this section discusses combining with Yangming to transform food essence; the next section discusses combining with Zongmai to connect with hundred vessels. Ying, Wei, Blood, and Qi originate from postnatal water and grain but require prenatal Qi from the Lower Jiao for transformation.
Huangdi asked: "What causes tinnitus?" Qibo said: "The ear is the gathering place of Zongmai. Thus, if the stomach is empty, Zongmai becomes deficient. Deficiency causes downward slipping, and exhaustion of vessels leads to tinnitus. Treatment involves supplementing Keyrenman and the point where the nail meets flesh on the thumb."
This explains that vessel blood and Qi are nourished by the stomach and initiated by the Kidney. The Lung receives all vessels; Zongmai is the unity of hundred vessels, governed by the Lung. The ear is the gathering place of Zongmai. Blood and Qi of hundred vessels are produced by water and grain. Thus, if the stomach is empty, Zongmai becomes deficient; deficiency causes Qi to slip downward. Exhaustion of blood and Qi in vessels causes tinnitus. One should supplement Keyrenman and Shaoshang (Hand Taiyin). Keyrenman is a Foot Shaoyang vessel; supplementing it guides downward-slipping Qi upward.
Wang Fanghou stated: Keyrenman implies vessels are guests, while the host in the vessels is the Kidney. Downward slipping means sinking into the Kidney. Thus, selecting upper vessels guides and opens them.
Huangdi asked: "What causes self-biting of the tongue? (Qibo's answer missing) This is due to rebellious Qi rising, with vessel Qi arriving in succession. Arrival of Shaoyin Qi causes biting of the tongue; arrival of Shaoyang Qi causes biting of the cheek; arrival of Yangming Qi causes biting of the lip. Supplement based on the primary diseased meridian. (Nye: bite)"
This summarizes that vessel Qi originates from postnatal water and grain in the Middle Jiao and is rooted in prenatal Yin and Yang in the Lower Jiao. Qi of Middle and Lower Jiao combines and moves together. Teeth are generated by Kidney Qi. Shaoyin meridians flank the base of the tongue; Shaoyang meridians circle the cheeks; Yangming meridians flank the mouth and encircle the lips. If Kidney Generating Qi rebels upward and arrives simultaneously with Middle Jiao vessel Qi, the tongue (inside teeth) turns outward; lips (outside teeth) turn inward; cheeks (beside teeth) turn inward. Self-biting illustrates that Yangming vessels are rooted in Prenatal Generating Qi and move in harmony.
These twelve pathogens are all strange pathogens traveling through orifices. Therefore, wherever pathology exists, there is deficiency. If Upper Qi is deficient, the brain feels empty, ears ring painfully, head tilts painfully, and eyes dazzle. If Middle Qi is deficient, urination and defecation change, and intestines rumble painfully. If Lower Qi is deficient, there is flaccidity, cold extremities, and palpitations. Treatment involves supplementing below the outer ankle and retaining needle insertion.
This summarizes that the twelve pathogens arise because fluids stored in the Bladder cannot nourish essence and moisten orifices. Strange pathogens are not caused by external wind/rain/cold/heat or internal emotions/diet, but by fluid deficiency and empty orifices. Thus, pathology indicates deficiency. Generally, righteous Qi deficiency generates strange pathogen syndromes. Upper Qi deficiency causes brain emptiness, ear ringing, head tilting, and eye dizziness. Middle Qi deficiency causes urinary/fecal changes and intestinal rumbling. Lower Qi deficiency causes flaccidity, cold extremities, and palpitations. Deficiency below causes flaccidity and cold; failure to connect upward to the Heart causes palpitations. Supplementing below the outer ankle and retaining needle insertion selects Kunlun (Foot Taiyang), waiting for Taiyang Qi arrival. Taiyang is the Three Yang, representing Heavenly work. Bladder fluids circulate with Qi to moisten orifices. Kunlun is the source of fluids, connecting to Heaven.
Huangdi asked: "How to treat?" Qibo said: "Kidney governs yawning; select Foot Shaoyin. Lung governs hiccups; select Hand Taiyin and Foot Shaoyin. Sighing is Yin-Yang separation; supplement Foot Taiyang, reduce Foot Shaoyin. Chills supplement all Yang. Belching supplements Foot Taiyin and Yangming. Sneezing supplements Foot Taiyang Meiben. Drooping posture supplements intermuscular spaces based on location. Crying supplements Tianzhu along the neck. Neck sides refer to the midline of the head. Deep sighing supplements Hand Shaoyin Pericardium and retains Foot Shaoyang. Salivation supplements Foot Shaoyin. Tinnitus supplements Keyrenman and the thumb nail corner. Self-biting supplements based on the primary diseased meridian."
The previous section summarized that Bladder fluids failing to moisten orifices cause Upper, Middle, and Lower Qi deficiency. This section details supplementation and reduction methods for Yin and Yang for each of the twelve pathogens. The Bladder is the reservoir of fluids, receiving fluids from zang-fu, storing them, returning them to the stomach to nourish zang-fu, and communicating mutually. Thus, treatment depends on the location of the pathogen.
Eye dizziness and head tilting: supplement below the outer ankle and retain. Flaccidity, cold extremities, and palpitations: prick two cun above the web between the big toe and retain. Alternatively, supplement below the outer ankle and retain.
Two cun above the web between the big toe is Taibai (Foot Taiyin), the Shu-stream point of the Spleen. This chapter discusses Taiyang fluids circulating on the skin surface, connecting upward to the Heart via Earth, responding to Si Tian and Zai Quan energies, circulating outside the earth, and penetrating through the earth. Thus, Upper Qi deficiency is treated by supplementing Taiyang Kunlun. If Lower Qi deficiency cannot connect upward to the Heart via Earth, prick the Shu point of Foot Taiyin to unblock Earth Qi. However, this is rooted in the continuous flow of Taiyang fluid and Qi. Hence, alternatively, supplement below the outer ankle and retain, retrieving Taiyang fluid and Qi. Yao Shiyin stated: Yawning is the mutual attraction and vertical movement of Foot Taiyang and Shaoyin Qi. Hiccups are Shaoyin cold water pathogen lodging in the Lung. Sighing is disharmony between Taiyang and Shaoyin Qi. Chills are cold water pathogen lodging in the skin with deficient Taiyang Yang on the exterior. Belching is Taiyang cold water pathogen lodging in the stomach. Sneezing is Taiyang Yang filling the Heart. Drooping posture is sinew-vessel Qi exerting force during sexual activity; the anterior yin is the convergence of Foot Shaoyin and Taiyang. Crying is exhaustion of Taiyang fluids. Deep sighing is Lower Jiao Generating Qi failing to connect upward. Salivation is water evil overflowing from the Bladder. Tinnitus is Zongmai Qi sinking into the Lower Jiao. Self-biting is Lower Jiao Qi rebelling...