黄帝问曰∶人身非常温也,非常热也,为之热而烦满者何也?岐伯对曰∶阴气少而阳气胜,故热而
烦满也。帝曰∶人身非衣寒也,中非有寒气也,寒从中生者何?岐伯曰∶是人多痹气也,阳气少,阴气
多,故身寒如从水中出。帝曰∶人有四肢热,逢风寒如炙如火者何也?岐伯曰∶是人者阴气虚,阳气盛,
四肢者阳也,两阳相得而阴气虚少,少水不能灭盛火,而阳独治,独治者不能生长也,独胜而止耳,逢风而如
炙如火者,是人当肉烁也。帝曰∶人有身寒,汤火不能热,浓衣不能温,然不冻栗,是为何病?岐伯曰∶是人
者,素肾气胜,以水为事,太阳气衰,肾脂枯不长,一水不能胜两火,肾者水也,而生于骨,肾不生则髓不能
满,故寒甚至骨也。所以不能冻栗者,肝一阳也,心二阳也,肾孤脏也,一水不能胜二火,故不能冻栗,病名
曰骨痹,是人当挛节也。帝曰∶人之肉苛者,虽近衣絮,犹尚苛也,是谓何疾?岐伯曰∶荣气虚,卫气实也,
荣气虚则不仁,卫气虚则不用,荣
卫俱虚,则不仁且不用,肉如故也,人身与志不相有,曰死。帝曰∶人有逆气不得卧而息有音者,有不得
卧而息无音者,有起居如故而息有音者,有得卧行而喘者,有不得卧不能行而喘者,有不得卧卧而喘者,皆
何脏使然?愿闻其故。岐伯曰∶不得卧而息有音者,是阳明之逆也,足三阳者下行,今逆而上行,故息有音
也。阳明者胃脉也,胃者六腑之海,其气亦下行,阳明逆不得从其道,故不得卧也。《下经》曰∶胃不和
则卧不安。此之谓也。夫起居如故而息有音者,此肺之络脉逆也,络脉不得随经上下,故留经而不行,络
脉之病患也微,故起居如故而息有音也。夫不得卧卧则喘者,是水气之客也,夫水者循津液而流也,肾者水
脏,主津液,主卧与喘也。帝曰∶善。
热论∶怫(音弗)谵(之阎切,多言也)
刺热论∶颔(胡感切)洒淅(上先礼切,下先历切) (音酸)跟(音根) (音氐)
评热病论∶ (下莫江切) (音博)
逆调论∶苛(胡歌切)
黄帝问道:人的身体并不像外界那样持续发热,也不像外界那样持续寒冷,但体内却出现发热并伴有烦闷的症状,这是什么原因呢?岐伯回答说:这是因为阴气不足而阳气偏盛,所以会出现发热和烦闷的症状。
黄帝又问:人的身体并不是因为穿衣太少感到寒冷,体内也没有外来的寒气侵袭,但寒气却从体内产生,这是为什么呢?岐伯说:这是因为此人多痹阻之气,阳气虚弱,阴气偏盛,所以身体感觉寒冷,就像刚从水中出来一样。
黄帝问:有的人四肢发热,遇到风寒时,感觉像被火烤、被火烧一样,这是什么原因呢?岐伯说:这样的人阴气虚弱,阳气偏盛。四肢属于阳,阳气与四肢之阳相结合,导致阴气更加虚少。这就好比少量的水无法扑灭旺盛的火焰,阳气独自亢盛。阳气独自亢盛就不能正常生长化育,只是单纯的偏胜而已。遇到风邪就感觉像被火烤一样,这样的人肌肉将会消烁干枯。
黄帝问:有的人身体寒冷,喝热水、用热水烫或靠近火源都不能使其温暖,穿厚衣服也不能使其暖和,但是却不发生寒战发抖,这是什么病呢?岐伯说:这样的人素来肾气偏盛,从事涉水湿冷的劳作,导致太阳膀胱经之气衰弱,肾精枯竭不能滋养骨骼。肾属水,主骨生髓,一水不能克制两火(肝心二脏之火),肾气不生则骨髓不能充盈,所以寒冷感直达骨髓。之所以不发生寒战发抖,是因为肝为一阳,心为二阳,肾为孤脏(独阴)。一水不能战胜二火,所以不寒战发抖。这种病名叫骨痹,这样的人关节将会拘挛收缩。
黄帝问:有的人肌肉麻木沉重,即使靠近棉絮等保暖物品,仍然感觉麻木沉重,这叫什么病呢?岐伯说:这是因为营气虚弱,卫气实盛。营气虚弱则感觉迟钝麻木,卫气虚弱则肢体不能随意运动。如果营气和卫气都虚弱,就会既麻木又不能运动,肌肉依然如故。如果人身形体与神志不相维系,预后不良,会导致死亡。
黄帝问:有的人气逆不能平卧且呼吸有声音,有的人不能平卧但呼吸没有声音,有的人起居如常但呼吸有声音,有的人能躺着但不能行走且喘息,有的人不能平卧不能行走且喘息,有的人不能平卧但躺下就喘息,这些都是哪些脏腑病变引起的?我想听听其中的缘故。岐伯说:不能平卧且呼吸有声音的,是阳明经气逆乱所致。足三阳经的气本应下行,现在反而上行,所以呼吸有声音。阳明经是胃的经脉,胃是六腑之海,其气也应当下行。阳明经气逆乱,不能顺从其正常的通道,所以不能平卧。《下经》说:“胃不和则卧不安。”说的就是这种情况。至于起居如常但呼吸有声音的,这是肺的络脉气逆所致。络脉之气不能随经脉上下运行,所以滞留于经脉中而不能正常运行。络脉病变轻微,所以起居如常但呼吸有声音。至于不能平卧,躺下就喘息的,是水气客居体内所致。水液循行于津液之中,肾是水脏,主管津液,同时也主宰睡眠和喘息。
黄帝说:讲得好。
热论篇中提到:怫(音弗)谵(之阎切,意为多言)
刺热论篇中提到:颔(胡感切)洒淅(上先礼切,下先历切) (音酸)跟(音根) (音氐)
评热病论篇中提到: (下莫江切) (音博)
逆调论篇中提到:苛(胡歌切)
Huangdi asked, "The human body is not constantly warm like the external environment, nor constantly cold. Yet, why does internal heat arise accompanied by vexation and fullness?" Qibo replied, "This occurs when Yin Qi is deficient and Yang Qi is excessive; thus, heat and vexation/fullness manifest."
Huangdi said, "The body is not cold due to insufficient clothing, nor is there an invasion of external cold Qi within. Why does cold arise from within?" Qibo said, "This person suffers from Bi obstruction (blockage of Qi and blood). Yang Qi is deficient, and Yin Qi is excessive; therefore, the body feels cold as if emerging from water."
Huangdi asked, "Why do some people experience heat in the four limbs, feeling as if roasted or burned by fire when exposed to wind and cold?" Qibo said, "In such individuals, Yin Qi is deficient, and Yang Qi is excessive. The four limbs belong to Yang. When pathogenic Yang combines with the Yang of the limbs, Yin Qi becomes even more deficient. This is akin to a small amount of water failing to extinguish a raging fire, leaving Yang Qi to dominate independently. Independent dominance prevents normal growth and transformation, resulting only in excess. When exposed to wind, the sensation of being roasted occurs because the flesh will eventually waste away."
Huangdi asked, "Some people feel cold in their bodies; hot drinks, hot compresses, or thick clothing cannot warm them, yet they do not shiver or tremble. What disease is this?" Qibo said, "Such individuals typically have excessive Kidney Qi and engage in work involving water or dampness. This leads to a decline in Taiyang (Bladder) Qi, causing Kidney essence to dry up and fail to nourish the bones. The Kidney belongs to Water and governs the bones; if Kidney Qi fails to generate, Marrow will not fill, leading to cold penetrating to the bone. The reason for no shivering is that the Liver is One-Yang, the Heart is Two-Yang, and the Kidney is a solitary Zang organ. One Water cannot overcome Two Fires; thus, there is no shivering. This disease is named Bone Bi (Bone Arthralgia), and such individuals are prone to joint contracture."
Huangdi asked, "Some people suffer from numb and heavy muscles; even near cotton wadding, they still feel numb and heavy. What disease is this?" Qibo said, "This is due to deficient Ying Qi (Nutritive Qi) and robust Wei Qi (Defensive Qi). Deficient Ying Qi leads to insensibility (numbness); deficient Wei Qi leads to immobility. If both Ying and Wei Qi are deficient, there is both insensibility and immobility, and the muscles remain unchanged. If the physical form and the Shen (Spirit/Mind) lose their connection, death ensues."
Huangdi asked, "Some people have rebellious Qi preventing them from lying flat and have audible breathing sounds; others cannot lie flat but have silent breathing; others have normal daily activities but audible breathing; some can lie down but cannot walk and wheeze; some cannot lie flat, cannot walk, and wheeze; some cannot lie flat but wheeze immediately upon lying down. Which Zang organs cause these conditions? I wish to hear the reasons." Qibo said, "Those who cannot lie flat and have audible breathing suffer from reversal of Yangming Qi. The Foot Three Yang meridians normally descend; now they reverse and ascend, causing audible breathing. The Yangming meridian is the Stomach meridian; the Stomach is the Sea of the Six Fu organs, and its Qi also descends. When Yangming Qi reverses and cannot follow its proper pathway, one cannot lie flat. The *Xia Jing* states: 'If the Stomach is not harmonious, sleep is restless.' This refers to that situation. As for those with normal activities but audible breathing, this is due to reversal of the collateral vessels of the Lung. Collateral Qi cannot move up and down with the main meridians, so it stagnates in the meridians. Since collateral diseases are minor, activities remain normal despite audible breathing. Regarding those who cannot lie flat and wheeze upon lying down, this is caused by Water Qi invading. Water flows along with Jin-Ye (Body Fluids). The Kidney is the Water Organ, governing Jin-Ye, and also governs sleep and wheezing."
Huangdi said, "Excellent."
*Re Lun* mentions: Fu (pronounced Fu) Zhan (Zhi Yan qie, meaning talking excessively)
*Ci Re Lun* mentions: Han (Hu Gan qie) Sa Xi (Shang Xian Li qie, Xia Xian Li qie) Suan (pronounced Suan) Gen (pronounced Gen) Di (pronounced Di)
*Ping Re Bing Lun* mentions: Bo (Xia Mo Jiang qie) Bo (pronounced Bo)
*Ni Diao Lun* mentions: Ke (Hu Ge qie)