黄帝问曰∶余闻皮有分部,脉有经纪,筋有结络,骨有度量,其所生病各异,别其分部,左右上下,阴阳
所在,病之始终,愿闻其道。岐伯对曰∶欲知皮部以经脉为纪者,诸经皆然。阳明之阳,名曰害蜚,上下同法,
视其部中有浮络者,皆阳明之络也,其色多青则痛,多黑则痹,黄赤则热,多白则寒,五色皆见,则寒热也,
络盛则入客于经,阳主外,阴主内。少阳之阳,名曰枢持,上下同法,视其部中有浮络者,皆少阳之络也,络
盛则入客于经,故在阳者主内,在阴者主出,以渗于内,诸经皆然。太阳之阳,名曰关枢,上
下同法,视其部中有浮络者,皆太阳之络也,络盛则入客于经。少阴之阴,名曰枢儒,上下同法,视其部中
有浮络者,皆少阴之络也,络盛则入客于经,其入经也,从阳部注于经,其出者,从阴内注于骨。心主之
阴,名曰害肩,上下同法,视其部中有浮络者,皆心主之络也,络盛则入客于经。太阴之阴,名曰关蛰,
上下同法,视其部中有浮络者,皆太阴之络也,络盛则入客于经。凡十二经络脉者,皮之部也。是故百病之始
生也,必先于皮毛,邪中之则腠理开,开则入客于络脉,留而不去,传入于经,留而不去,传入于腑,廪于肠
胃。邪之始入于皮也, 然起毫毛,开腠理;其入于络也,则络脉盛色变;其入客于经也,则感虚乃陷下;其
留于筋骨之间,寒多则筋挛骨痛,热多则筋弛骨消,肉烁 破,毛直而败。帝曰∶夫子言
皮之十二部,其生病皆何如?岐伯曰∶皮者脉之部也,邪客于皮则腠理开,开则邪入客于络脉,络脉满则注于
经脉,经脉满则入舍于腑脏也,故皮者有分部,不与而生大病也。帝曰∶善。
黄帝问道:我听说皮肤有分属的部类,经脉有运行的纲纪,筋脉有结聚联络,骨骼有长短度量,它们所发生的疾病各不相同。辨别它们的分部,以及左右上下、阴阳所在之处,还有疾病的起始与终结,我想听听其中的道理。
岐伯回答说:想要了解皮肤的部类,应以经脉作为纲纪,各条经脉都是如此。阳明经的阳气部分,名叫“害蜚”,上下部位遵循同样的诊法。观察该部中浮现的络脉,都是阳明经的络脉。如果颜色多青,则主痛;多黑,则主痹证;黄赤,则主热;多白,则主寒;五色都出现,则主寒热错杂。络脉充盛,邪气就会侵入并客居于经脉。阳主外,阴主内。
少阳经的阳气部分,名叫“枢持”,上下部位遵循同样的诊法。观察该部中浮现的络脉,都是少阳经的络脉。络脉充盛,邪气就会侵入并客居于经脉。所以在阳分的络脉主要向内传入,在阴分的络脉主要向外渗出,从而渗透入体内,各条经脉都是如此。
太阳经的阳气部分,名叫“关枢”,上下部位遵循同样的诊法。观察该部中浮现的络脉,都是太阳经的络脉。络脉充盛,邪气就会侵入并客居于经脉。
少阴经的阴气部分,名叫“枢儒”,上下部位遵循同样的诊法。观察该部中浮现的络脉,都是少阴经的络脉。络脉充盛,邪气就会侵入并客居于经脉。邪气进入经脉时,是从阳部的络脉注入到经脉中;邪气外出时,是从阴内部注入到骨骼中。
心包络的阴气部分,名叫“害肩”,上下部位遵循同样的诊法。观察该部中浮现的络脉,都是心包络的络脉。络脉充盛,邪气就会侵入并客居于经脉。
太阴经的阴气部分,名叫“关蛰”,上下部位遵循同样的诊法。观察该部中浮现的络脉,都是太阴经的络脉。络脉充盛,邪气就会侵入并客居于经脉。
以上十二条经络脉,是皮肤的分属部类。因此,各种疾病的发生,必定先从皮毛开始。邪气侵袭人体,腠理(皮肤纹理及汗孔)便开放,开放后邪气便侵入络脉;若停留不去,便传入经脉;若再停留不去,便传入腑;最终廪积于肠胃。
邪气刚开始侵入皮肤时,毫毛竖起,腠理开张;当它侵入络脉时,络脉充盛且颜色发生改变;当它客居于经脉时,必须遇到正气虚衰才会深陷下去;当它停留在筋骨之间时,寒气多则导致筋脉拘挛、骨骼疼痛;热气多则导致筋脉松弛、骨骼消损、肌肉消瘦枯槁、皮肤破裂、毫毛枯败。
黄帝说:先生所说的皮肤十二分部,它们发生的疾病情况是怎样的呢?
岐伯说:皮肤是脉络所属的部位。邪气客居在皮肤,则腠理开放,开放后邪气便侵入络脉;络脉充满后,便注入经脉;经脉充满后,便深入留舍于脏腑。所以皮肤有特定的分部,如果不加以辨别而任其发展,就会生大病。
黄帝说:讲得好。
Huangdi asked, saying: I have heard that the skin has its specific regions, the meridians have their governing pathways, the sinews have their knots and connections, and the bones have their measurements. The diseases they produce are different from one another. I wish to hear about the principles of distinguishing their regions, their locations in the left and right, upper and lower, yin and yang, as well as the beginning and end of diseases.
Qibo replied: To understand the regions of the skin, one should take the meridians as the guiding principle; this applies to all meridians. The yang aspect of the Yangming Meridian is named Haifei (Harmful Flying). The methods for the upper and lower parts are the same. Observe the superficial collaterals within these regions; all such superficial collaterals belong to the Yangming Meridian. If the color is predominantly blue-green, it indicates pain; if predominantly black, it indicates Bi syndrome (obstruction); if yellow-red, it indicates heat; if predominantly white, it indicates cold; if all five colors appear, it indicates alternating cold and heat. When the collaterals are full, the pathogenic factor enters and lodges in the main meridian. Yang governs the exterior, and Yin governs the interior.
The yang aspect of the Shaoyang Meridian is named Chuchi (Pivot Holding). The methods for the upper and lower parts are the same. Observe the superficial collaterals within these regions; all such superficial collaterals belong to the Shaoyang Meridian. When the collaterals are full, the pathogenic factor enters and lodges in the main meridian. Therefore, what is in the yang aspect tends to move inward, and what is in the yin aspect tends to move outward, permeating into the interior. This applies to all meridians.
The yang aspect of the Taiyang Meridian is named Guanshu (Gate Pivot). The methods for the upper and lower parts are the same. Observe the superficial collaterals within these regions; all such superficial collaterals belong to the Taiyang Meridian. When the collaterals are full, the pathogenic factor enters and lodges in the main meridian.
The yin aspect of the Shaoyin Meridian is named Shuru (Pivot Confucian). The methods for the upper and lower parts are the same. Observe the superficial collaterals within these regions; all such superficial collaterals belong to the Shaoyin Meridian. When the collaterals are full, the pathogenic factor enters and lodges in the main meridian. Upon entering the meridian, it flows from the yang region into the meridian; upon exiting, it flows from the yin interior into the bones.
The yin aspect of the Pericardium (Heart Protector) is named Haijian (Harmful Shoulder). The methods for the upper and lower parts are the same. Observe the superficial collaterals within these regions; all such superficial collaterals belong to the Pericardium. When the collaterals are full, the pathogenic factor enters and lodges in the main meridian.
The yin aspect of the Taiyin Meridian is named Guanzhe (Gate Hibernation). The methods for the upper and lower parts are the same. Observe the superficial collaterals within these regions; all such superficial collaterals belong to the Taiyin Meridian. When the collaterals are full, the pathogenic factor enters and lodges in the main meridian.
These twelve meridian collateral systems constitute the regions of the skin. Therefore, the onset of all diseases must first occur at the hair follicles and skin surface. When a pathogenic factor attacks, the interstices (pores and skin texture) open. Once open, the pathogen enters the collaterals. If it remains there without being expelled, it transmits to the meridians. If it remains in the meridians without being expelled, it transmits to the fu organs, eventually accumulating in the intestines and stomach.
When the pathogen initially enters the skin, the body hair stands erect, and the interstices open. When it enters the collaterals, the collaterals become full and the color changes. When it lodges in the meridians, it sinks deeper only when encountering deficiency. When it stays between the sinews and bones, excessive cold causes sinew spasms and bone pain; excessive heat causes sinew flaccidity, bone wasting, muscle emaciation, skin cracking, and the failure of body hair.
The Emperor said: You spoke of the twelve regions of the skin. How do the diseases arising from them present?
Qibo said: The skin is the domain of the vessels. When a pathogenic factor lodges in the skin, the interstices open. Once open, the pathogen enters the collaterals. When the collaterals are full, it pours into the meridians. When the meridians are full, it enters and resides in the zang-fu organs. Thus, the skin has specific regions. If one does not attend to these distinctions, serious diseases will arise.
The Emperor said: Excellent.