黄帝问曰∶有病温者,汗出辄复热,而脉躁疾不为汗衰,狂言不能食,病名为何?岐伯对曰∶病名阴阳交,
交者死也。帝曰∶愿闻其说。岐伯曰∶人所以汗出者,皆生于谷,谷生于精,今邪气交争于骨肉而得汗者,是
邪却而精胜也,精胜则当能食而不复热。复热者邪气也,汗者精气也,今汗出而辄复热者,是邪胜也,不能食
者,精无俾也,病而留者,其寿
可立而倾也。且夫《热论》曰∶汗出而脉尚躁盛者死。今脉不与汗相应,此不胜其病也,其死明矣。狂言者
是失志,失志者死。今见三死,不见一生,虽愈必死也。帝曰∶有病身热汗出烦满,烦满不为汗解,此为何病?
岐伯曰∶汗出而身热者风也,汗出而烦满不解者厥也,病名曰风厥。帝曰∶愿卒闻之。岐伯曰∶巨阳主气,故
先受邪,少阴与其为表里也,得热则上从之,从之则厥也。帝曰∶治之奈何?岐伯曰∶表里刺之,饮之服汤。
帝曰∶劳风为病何如?岐伯曰∶劳风法在肺下,其为病也,使人强上冥视,唾出若涕,恶风而振寒,此为劳
风之病。帝曰∶
治之奈何?岐伯曰∶以救俯仰。巨阳引精者三日,中年者五日,不精者七日,咳出青黄涕,其状如脓,大如
弹丸,从口中若鼻中出,不出则伤肺,伤肺则死也。帝曰∶有病肾风者,面 然壅,害于言,可刺不?岐
伯曰∶虚不当刺,不当刺而刺,后五日其气必至。帝曰∶其至何如?岐伯曰∶至必少气时热,时热从胸背上至
头,汗出手热,口干苦渴,小便黄,目下肿,腹中鸣,身重难以行,月事不来,烦而不能食,不能正偃,正偃
则咳甚,病名曰风水,论在《刺法》中。帝曰∶愿闻
其说。岐伯曰∶邪之所凑,其气必虚,阴虚者阳必凑之,故少气时热而汗出也。小便黄者,少腹中有热也。
不能正偃者,胃中不和也。正偃则咳甚,上迫肺也。诸有水气者,微肿先见于目下也。帝曰∶何以言?岐伯曰∶
水者阴也,目下亦阴也,腹者至阴之所居,故水在腹者,必使目下肿也。真气上逆,故口苦舌干,卧不得正偃,
正偃则咳出清水也。诸水病者,故不得卧,卧则惊,惊则咳甚也。腹中鸣者,病本于胃也。薄脾则烦不能食,
食不下者,胃脘隔也。身重难以行者,胃脉在足也。月事不来者,胞脉闭也,胞脉者属心而络于胞中,今气上
迫肺,心气不得下通,故月事不来也。帝曰∶善。
黄帝问道:有一种患温病的人,出汗后随即又发热,脉搏躁动急速并不因出汗而减弱,出现胡言乱语且不能进食,这种病叫什么名字?岐伯回答说:这种病名叫阴阳交,阴阳交是死证。黄帝说:我想听听其中的道理。岐伯说:人之所以出汗,都是因为水谷精微化生的,水谷精微又源于先天之精。现在邪气与正气在骨肉之间交争而得出汗的,这是邪气退却而精气胜利的表现,精气胜利就应当能够进食并且不再发热。再次发热的,说明邪气仍在;出汗的,是精气外泄;现在出汗后随即又发热,这是邪气胜过了精气;不能进食,说明精气得不到补充。病情这样滞留下去,寿命就会立刻终结。况且《热论》中说:出汗后脉搏仍然躁动旺盛的,主死。现在脉搏不与出汗的情况相应(即汗出脉不静),这说明正气不能战胜疾病,死亡是显而易见的。胡言乱语是神志丧失的表现,神志丧失就会死亡。现在出现了这三种死证征象,却看不到一丝生机,即使暂时看似痊愈,最终也必定死亡。
黄帝问:有一种病人身热、出汗、心中烦闷胀满,出汗后烦闷胀满并不解除,这是什么病?岐伯说:出汗而身热的,是风邪所致;出汗后烦闷胀满不解的,是厥逆,这种病名叫风厥。黄帝说:我想详细听听。岐伯说:太阳经主一身之气,所以先受邪气侵袭;少阴经与太阳经互为表里,受到热邪影响就会向上从属于太阳经的热势,顺从了就会导致厥逆。黄帝说:怎么治疗呢?岐伯说:对表里两经进行针刺治疗,并服用汤药。
黄帝问:劳风病怎么样?岐伯说:劳风病通常在肺下发生,它引起的病症,使人项背强直、视物不清,咳吐像鼻涕一样的痰液,怕风且战栗发冷,这就是劳风病。黄帝说:怎么治疗呢?岐伯说:以挽救呼吸俯仰困难为首要任务。精气充沛者三日可愈,中年人五日可愈,精气不足者七日可愈,咳出青黄色的痰涕,形状像脓一样,大小如弹丸,从口中或鼻中排出,如果不排出来就会损伤肺部,损伤肺部就会死亡。
黄帝问:患有肾风病的人,面部浮肿,言语不利,可以针刺吗?岐伯说:虚证不应当针刺,不应当针刺而误刺了,五天后邪气必然到来。黄帝问:邪气到来会怎样?岐伯说:到来时一定会有气短、定时发热,发热从胸背向上至头部,手心发热,口干口苦且渴,小便黄,眼睑下方肿胀,腹中肠鸣,身体沉重难以行走,月经停止,心烦且不能进食,不能仰卧,如果仰卧咳嗽就会加重,这种病名叫风水,论述在《刺法》篇中。黄帝说:我想听听其中的道理。岐伯说:邪气聚集的地方,正气必定虚弱,阴虚则阳邪必凑集于此,所以会出现气短、定时发热和出汗。小便黄,是因为小腹中有热。不能仰卧,是因为胃中不和。仰卧则咳嗽加重,是因为邪气上迫于肺。所有有水气病的患者,轻微肿胀首先出现在眼睑下方。黄帝问:为什么这样说?岐伯说:水属阴,眼睑下方也属阴,腹部是至阴之所居,所以水湿停留在腹部,必然导致眼睑下方肿胀。真气上逆,所以口苦舌干,卧不得正仰卧,仰卧则会咳出清水。所有的水病患者,所以不能平卧,平卧则惊悸,惊悸则咳嗽加重。腹中肠鸣,是因为病根在胃。邪气薄侵脾脏则心烦不能进食,食物不下咽,是因为胃脘部阻隔。身体沉重难以行走,是因为胃经的经脉循行于足部。月经不来,是因为胞脉闭塞,胞脉属于心并联络于子宫,现在气机上迫于肺,心气不能向下通达,所以月经不来。黄帝说:好。
Huangdi asked: There is a person suffering from a warm disease (Wen Bing, 温病). After sweating, fever returns immediately, the pulse is rapid and restless without subsiding due to sweating, accompanied by delirious speech and inability to eat. What is the name of this disease? Qibo replied: This disease is called Yin-Jiao (Yin-Yang Intersection, 阴阳交), which is a fatal condition. Huangdi said: I wish to hear the explanation. Qibo said: The reason humans sweat is that it originates from grain (nutritive essence derived from food), and grain essence is generated from Jing (Essence, 精). Now, when pathogenic factors contend with healthy Qi in the muscles and bones resulting in sweating, it indicates that the pathogen is retreating and Essence has prevailed. If Essence prevails, one should be able to eat and not have recurrent fever. Recurrent fever indicates the presence of pathogenic factors; sweating represents the loss of Essence. Now, sweating followed immediately by fever indicates that the pathogen has prevailed over the Essence. Inability to eat means that Essence receives no assistance (from dietary intake). With the disease lingering in this state, life can be lost instantly. Furthermore, the *Treatise on Cold Damage* (*Shanghan Lun*, 《热论》) states: "If sweating occurs but the pulse remains rapid and vigorous, death ensues." Now, the pulse does not correspond with the sweating, indicating that the body cannot overcome the disease; death is evident. Delirious speech indicates the loss of Zhi (Will/Spirit, 志); loss of Zhi leads to death. Currently, three signs of death are present, while no sign of life is seen. Even if there is temporary recovery, death is inevitable.
Huangdi asked: There is a patient with body heat, sweating, and vexation/fullness. The vexation and fullness do not resolve after sweating. What disease is this? Qibo said: Sweating accompanied by body heat is caused by Wind (Feng, 风). Sweating accompanied by unresolved vexation and fullness is Jue (Jue Ni, 厥逆). This disease is named Feng-Jue (Wind-Jue, 风厥). Huangdi said: I wish to hear the details. Qibo said: The Taiyang (Greater Yang, 巨阳) channel governs the Qi of the exterior and thus is the first to receive pathogenic invasion. Shaoyin (Lesser Yin, 少阴) is interior-exteriorly related to Taiyang. When affected by heat, Shaoyin follows the heat upwards; following it leads to Jue. Huangdi asked: How should it be treated? Qibo said: Needle both the exterior and interior channels, and administer herbal decoctions.
Huangdi asked: What about Lao-Feng (Labor-induced Wind, 劳风)? Qibo said: Lao-Feng typically resides below the lungs. Its symptoms include stiffness of the neck and upper back, blurred vision, expectoration of thick sputum resembling mucus, aversion to wind, and chills. This constitutes Lao-Feng disease. Huangdi asked: How should it be treated? Qibo said: The primary goal is to rescue breathing difficulties (restoring ability to bend and extend). For those with abundant Jing (Essence, 精), recovery takes three days; for middle-aged individuals, five days; for those with deficient Jing, seven days. They will cough up greenish-yellow phlegm resembling pus, shaped like a pellet. It must be expelled from the mouth or nose. If not expelled, it will damage the Lungs; damaging the Lungs leads to death.
Huangdi asked: A patient suffers from Shen-Feng (Kidney-Wind, 肾风), presenting with facial edema and difficulty speaking. Can acupuncture be used? Qibo said: Deficiency patterns should not be needled. If needled inappropriately, the pathogenic Qi will arrive within five days. Huangdi asked: How will it manifest upon arrival? Qibo said: Upon arrival, there will be shortness of breath and intermittent fever. The fever spreads from the chest and back to the head. There will be hot palms, dry mouth, bitter taste, thirst, yellow urine, periorbital edema, borborygmus (abdominal rumbling), heavy body making movement difficult, amenorrhea, vexation, inability to eat, inability to lie flat on the back. Lying flat exacerbates coughing. This disease is named Feng-Shui (Wind-Water, 风水). The discussion is found in the *Ci Fa* (Methods of Needling, 《刺法》) chapter. Huangdi said: I wish to hear the explanation. Qibo said: Wherever pathogenic factors gather, Healthy Qi is necessarily deficient. When Yin is deficient, Yang pathogenic factors inevitably converge. Thus, there is shortness of breath, intermittent fever, and sweating. Yellow urine indicates heat in the lower abdomen. Inability to lie flat indicates disharmony in the Stomach. Lying flat exacerbates coughing because the pathogen presses upward against the Lungs. In all cases of fluid retention (Water Qi, 水气), slight edema first appears under the eyes. Huangdi asked: Why say this? Qibo said: Water belongs to Yin; the area under the eyes also belongs to Yin; the abdomen is the residence of Supreme Yin (Zhi Yin, 至阴). Therefore, when water accumulates in the abdomen, it causes swelling under the eyes. Rebellious True Qi (Zhen Qi, 真气) moves upward, causing bitter taste and dry tongue. One cannot lie flat; lying flat causes coughing up of clear fluid. All patients with water diseases cannot lie flat; lying flat causes fright, and fright exacerbates coughing. Borborygmus indicates that the root of the disease lies in the Stomach. Pathogenic pressure on the Spleen causes vexation and anorexia; inability to swallow food is due to obstruction in the epigastrium. Heavy body and difficulty walking occur because the Stomach Meridian runs along the feet. Amenorrhea occurs because the Bao Mai (Uterine Vessels, 胞脉) are blocked. The Bao Mai connects to the Heart and links to the Uterus. Now, Qi rebels upward pressing on the Lungs, preventing Heart Qi from descending smoothly, hence amenorrhea. Huangdi said: Excellent.