寒淫所胜,水气胜也,燥火能治之,故平以燥气之辛,火气之热。辛热不及,则佐以甘苦,甘生金
而苦助火也。辛热太过,则以咸泻之。凡此佐平之法,味各不同,理无不合,学人当随其所宜,以为佐平可也。
帝曰∶善。邪气反胜,治之奈何?
上文治之平之,是以所胜气味,治平淫胜,倘气味太过,则邪
气反胜,故承上文之意而复问之。
岐伯曰∶风司于地,清反胜之,治以酸温,佐以苦甘,以辛平之。
先举在泉之胜气以明之。上文云∶风淫于内,治以辛凉,是风司于地,清反胜之。清气反胜,今当治
以酸温,酸生火,温胜清也。酸温不及,清气犹胜,则佐以苦,苦助温也。酸温太过,金气过虚,则佐以
甘,甘生金也。凡此治佐,以金之清气反胜,味属于辛,乃以辛而如是以平之。上文在泉气胜则曰治,司
天气胜则曰平,今论在泉亦曰平,以明治之,即所以平之,平之即所以治之,故
于此复言平之。下文司天邪胜,并不言平也。
热司于地,寒反胜之,治以甘热,佐以苦辛,以咸平之。
上文云∶热淫于内,治以咸寒。是热司于地反胜之,寒气反胜,今当治以甘热,甘胜水,热胜寒
也。甘热不及,寒气犹胜,则佐以苦,苦生甘也。甘热太过,水气过虚,则佐以辛,辛生水也。
凡此治佐,以水之寒气反胜,味属于咸,乃以咸而如是以平之。
湿司于地,热反胜之,治以苦冷,佐以咸甘,以苦平之。
上文云∶湿淫于内,治以苦热。是湿司于地,热反胜之,热气反胜,今当治以苦冷,苦性寒而冷胜
热也。苦冷不及,热气犹胜,则佐以咸,咸助冷也。苦冷不过,热气过虚,则佐以甘,甘胜水
也,凡此治佐,以火之热气反胜,味属于苦,乃以苦而如是以平
之。
火司于地,寒反胜之,治以甘热,佐以苦辛,以咸平之。
上文云∶火淫于内,治以咸冷。是火司于地,寒反胜之,寒气反胜,今当治以甘热,甘胜水而热温
寒也。甘热不及,寒气犹胜,则佐以苦,苦助热也。甘热太过,寒气过虚,则佐以辛,辛生水
也。凡此治佐,以水之寒气反胜,味属于咸,乃以咸而如是以平之。
燥司于地,热反胜之,治以辛寒,佐以苦甘,以辛平之,以和为利。
辛寒,旧本讹平寒;辛平,旧本讹酸平,今改。上文云∶燥淫于内,治以苦寒。是燥司于地,热反胜之,
热气反胜,今当治以辛寒,辛生水,而寒胜热也。热反胜而金气犹盛,则佐以苦,苦胜金也。热反胜,而金
气过虚,则佐以甘,甘生金也。凡此治佐,以燥司于地,味属于辛,乃以辛,而如是以平之。上文所佐之味,
皆因反胜之味,有太过不及而佐之,此所佐之味,不因辛寒之太过不及,仍因燥金之太过不及,是佐司地之
味,不佐所胜之味也。至以辛平之,亦言司地之味,不言所胜之味,是佐虽不同,大要以和为利
尔。盖治所胜之味,未得其平,佐之得宜,则司地之气自和。司地之气,未得其平,佐之得宜,则所胜之
气亦和。凡此乃以和为利,贵学人之能善悟也。
寒司于地,热反胜之,治以咸冷,佐以甘辛,以苦平之。
上文云∶寒淫于内,治以甘热。是寒司于地,热反胜之,热气反胜,今当治以咸冷,咸助水而冷胜热
也。咸冷太过,则佐以甘,甘胜水也。咸冷不及,则佐以辛,辛生水也。凡此治佐,以火之热
气反胜,味属于苦,乃以苦而如是以平之。
帝曰∶其司天邪胜何如?
其司天邪胜,治之何如?
岐伯曰∶风化于天,清反胜之,治以酸温,佐以甘苦。
上文云∶风淫所胜,平以辛凉。是风化于天,清反胜之,清气
反胜,今当治以酸温,佐以甘苦,与司地邪胜同一义也。
热化于天,寒反胜之,治以甘温,佐以苦酸辛。
上文云∶热淫所胜,平以咸寒。是热化于天,寒反胜之,寒气反胜,今当治以甘温。甘温不及,
则佐以苦酸,苦生甘而酸生热也。甘温太过,则佐以辛,辛生水也。
湿化于天,热反胜之,治以苦寒,佐以苦酸。
上文云∶湿淫所胜,平以苦热。是湿化于天,热反胜之,热气
反胜,今当治以苦寒。苦寒不及,则佐以苦,助其寒也。苦寒太过,则佐以酸,酸生火也。
火化于天,寒反胜之,治以甘热,佐以苦辛。
上文云∶火淫所胜,平以咸冷。是火化于天,寒反胜之,寒气反胜,今当治以甘热,佐以苦辛,
与司地邪胜,同一义也。
燥化于天,热反胜之,治以辛寒,佐以苦甘。
上文云∶燥淫所胜,平以苦温。是燥化于天,热反胜之,热气
反胜,今当治以辛寒,佐以苦甘,与司地邪胜,同一义也。
寒化于天,热反胜之,治以咸冷,佐以苦辛。
上文云∶寒淫所胜,平以辛热。是寒化于天,热反胜之,热气
反胜,今当治以咸冷,佐以苦辛。上文司地,佐以甘辛,盖苦能生甘,其义一也。
帝曰∶六气相胜奈何?
上文邪胜,乃气味太过,故复有六气相胜之问。
岐伯曰∶厥阴之胜,耳鸣头眩,愦愦欲吐,胃膈如寒,大风数
举, 虫不滋, 胁气并,化而为热,小便黄赤,胃脘当心而痛,
上支两胁,肠鸣飧泄,少腹痛,注下赤白,甚则呕吐,膈咽不通。
厥阴之胜,风气胜也。风胜则耳鸣头眩,鸣眩无定,则愦愦欲吐,欲吐不吐,则胃膈如寒,凡此鸣眩
欲吐如寒,皆火风数举之所致也。风者木也,木克其土,则 虫不滋。不滋,燥而不润也。木
气内逆,不能枢转从外,则 胁气并,化而为热,热郁于下,则小便黄赤;热郁于上;则胃脘当心而痛,
上支两胁;热滋于下,不和
于中,则肠鸣飧泄,少腹痛,注下赤白;热郁于上,不和于中,甚则呕吐,膈咽不通。
少阴之胜,心下热,善饥,齐下反动,气游三焦,炎暑至,木
乃津,草乃萎,呕逆躁烦,腹满痛溏泄,传为赤沃。
“齐”,脐同。少阴之胜,热气胜也。热胜则心下热而善饥,热胜于上,不足于下,则脐下反动。
脐下,相火之所居也。脐下反动,则气游三焦。三焦,少阳也。少阴少阳,两火相合,气如炎暑,
故炎暑至。至,极也。炎暑已极,则木乃流津,草乃焦萎。少阳三焦不和则呕逆,少阳心肾不交则躁烦,君
相二火,逆于中土,不能外出,则腹满痛溏泄,甚则传为赤沃。赤沃,血液也。
太阴之胜,火气内郁,疮疡于中,流散于外,病在 胁,甚则
心痛热格,头痛喉痹项强独胜,则湿气内郁,寒迫下焦,痛留顶,
互引眉间,胃满,雨数至,燥化乃息,少腹满,腰 重强,内不便,
善注泄,足下温,头重,足胫 肿,饮发于中, 肿于上。
息,旧本讹见,今改。太阴之胜,湿气胜也。湿胜,则火郁,故火气内郁。火郁,则疮疡于中,从中而
流散于皮肤之外,其疮疡在 胁之皮肤,故曰病在 胁。若疮疡于中,不能流散于外,甚则
心痛而热格矣。热格于上,则头痛喉痹项强。此火气内郁而有如是之病也。若非火气内郁,而太阴之气独胜,
则湿气内郁。湿气为寒,故寒迫下焦。太阴主湿,太阳主寒,寒迫下焦,则太阳之气,不能从经脉而开于外,
故痛留巅顶,而互引眉间。盖太阳之脉,起于目内 ,从眉间而上额交巅也。湿气内郁,则太阴之气,不能从
经脉而开于内,故胃满。雨湿之气数至,而燥化乃息。盖太阴之脉,属脾络胃,此脾胃不和,燥湿之气不相
交济而然也。少腹满,腰 重强,内不小便,善注泄,此太阳寒水之为病也。足下温,头
重,足胫与 皆肿,饮发于中,而 肿于上,此太阴湿土之为病也。
少阳之胜,热客于胃,烦心心痛,目赤欲呕,呕酸善饥,耳痛
溺赤,善惊谵妄,暴热消烁,草萎水涸,介虫乃屈,少腹痛,下沃
赤白。
少阳之胜,火气胜也。火胜,故热客于胃。胃络通心,故烦心痛。火热上炎,则目赤。火热在中,
则欲呕,呕酸善饥。水阴不濡空窍,则耳痛。火热之气,下行水府,则溺赤。水火阴阳,不相交济,则善惊谵
妄。暴热而消烁万物,则草萎水涸,金类之介虫乃屈。火热之气,伤其血液,则少腹痛,下沃赤白。
阳明之胜,清发于中,左 胁痛,溏泄,内为嗌塞,外发
疝,大凉肃杀,华英改容,毛虫乃殃,胸中不便,嗌塞而咳。
便,平声,下同。阳明之胜,金气胜也。金胜,故清发于中。金胜木虚,故左 胁痛。清发于中,故
大便溏泄。塞,干塞也。 疝,犹 疝也。《经脉》论云∶肝是动病,丈夫 疝,甚则嗌干,此
肝木受病,故内为嗌塞,外发 疝。金气胜,故大凉肃杀,则草之华英改容,木类之毛虫
乃殃经脉,不能从肝贯膈,上注于肺,故胸中不便,嗌塞而咳。
太阳之胜,凝栗且至,非时水冰,羽乃后化,痔疟发,寒厥入
胃,则内生心痛,阴中乃疡,隐曲不利,互引阴股,筋肉拘苛,血
脉凝泣络满色变,或为血泄,皮肤痞肿,腹满食减,热反上行,头
项囟顶脑户中痛,目如脱,寒入下焦,传为濡泻。
泣,音涩。痞,批,上声。下同。囟, ,同,音信。太阳之胜,寒气胜也。寒胜则凝栗且至,
有非时之水冰。水寒气胜,火热受制,故火类之羽虫,后时生化。寒胜火郁,则痔疟乃发。痔与
疟,皆寒胜火郁之病也。寒胜厥逆而入于胃,则内生心痛。心痛。胃脘当心声痛也。寒入阴中,则阴中乃
疡。阴中乃疡,则隐曲不利,从阴中而互引阴股,则筋肉拘苛。筋挛急曰拘,肉暴痛曰苛,
内则血脉凝泣,外则络满色变。《通评虚实论》,帝有经虚络满之问。或为血泄,血脉凝涩而下泄也。皮
肤痞肿,络脉色变,而外浮也。皮肤痞肿,则腹满食减。或为血泄,则热反上行,则头顶,囟顶,
脑户中皆痛。甚则目如脱。《经脉》论云,足太阳之脉,病冲头痛,目似脱,痔疟,头囟项痛,若寒入
下焦,决渎有乖,则传为濡泻。
帝曰∶治之奈何?
六气相胜,治之奈何?
岐伯曰∶厥阴之胜,治以甘清,佐以苦辛,以酸泻之。
甘者,土之味,清者,金之气。土金相生,以治厥阴风本之胜。佐以苦辛者,苦为火味以生土,辛为金味
以制木。所以助其甘清也。木性条达,酸主收敛,反其性而敛之则泻,故以酸泻之。
少阴之胜,治以辛寒,佐以苦咸,以甘泻之。
辛者金之味,寒者水之气。金水相生,以治少阴火热之胜。佐以苦咸者,苦虽火味,其气则寒,咸为
水味,所以助其辛寒也。火性急速,反其性而缓之则泻,故以甘泻之。
太阴之胜,治以咸热,佐以辛甘,以苦泻之。
咸者水之味,热者火之气。太阴土燥,咸以治之。太阴土湿,热以治之。佐以辛甘者,土气有余,辛
以散之,土气不足,甘以资之。土性喜温,反其性而寒之则泻;土性喜润,反其性而燥之则泻,苦为火味,
性燥而寒,故以苦泻之。土位中央,灌溉四旁,气贵和平,故其治佐如此。下文阳明之胜,亦言以苦泻之,其义
一也。
少阳之胜,治以辛寒,佐以甘咸,以甘泻之。
少阳之治,与少阴同。苦为火味,故不曰佐以苦咸,而曰佐以
甘咸。甘为土味,以生金。所以助其辛寒也。
阳明之胜,治以酸温,佐以辛甘,以苦泄之。
酸为木味,温为火气,木火相生,以治阳明金气之胜。阳明有燥金之气,有清金之气。燥气有余,故佐辛
以散之。清气不足,故佐甘以滋之。以苦泄之,而同于太阴也。不曰泻而曰泄者,以明泻
之乃所以泄也。
太阳之胜,治以甘热,佐以苦酸,以咸泻之。
苦,旧本讹辛,今改。甘为土味,热为火气。火土相生,以治太阳寒水之胜。佐以苦酸者,木火相生,
所以助其甘热也。水性善下,反其性而凝之则泻,故以咸泻之。
帝曰∶六气之复,何如?
有六气之胜,即为六气之复,故复问之。
岐伯曰∶悉乎哉问也!厥阴之复,少腹坚满,里急暴痛,偃木
飞沙, 虫不荣,厥心痛,汗发呕吐,饮食不入,入而复出,筋骨
掉眩,清厥,甚则入脾,食痹而吐,冲阳绝,死不治。
始焉受制,既乃复也。其气虽复,经脉未和,故厥阴之复,少腹坚满,里急暴痛。风气盛,故偃木飞
沙。木盛土衰,故 虫不荣。厥心痛者,《灵枢·厥论》篇云∶厥心痛,色苍如死状,终日不得太
息,肝心痛也。汗发,风伤肌腠也。呕吐,肝气逆也,肝气逆,故饮食不入,入而复出也。筋骨掉眩,风
气盛也。清厥,手足清冷厥逆也,甚则木克其土,病入于脾,故食痹而吐。痹,闭也,上闭不
达,故吐也。若木盛土衰,至胃脉之冲阳绝,则死不治。
少阴之复,懊热内作,烦躁鼽嚏,少腹绞痛,火见燔 ,嗌燥,分
注时止,气动于左,上行于右,咳,皮肤痛,暴喑,心痛,郁冒不
知人,乃洒淅恶寒,振栗 妄,寒已而热,渴而欲饮,少气骨痿,
膈肠不便,外为浮肿,哕噫,赤气后化,流水不冰,热气大行,介
虫不复,病痱疹疮疡,痈疽痤痔,甚则入肺,咳而鼻渊,天府绝,死不治。
便如字。受制而复,经脉未和。故少阴之复,懊热内作,烦躁鼽嚏。少阴从下而上,故少腹绞痛,上
寒邪过盛,是水气克制太过,应当用燥气和火气来治疗,所以用辛味的燥气、热性的火气来平抑。如果辛热之力不足,就辅以甘味和苦味,因为甘味能生金(肺),苦味能助火。如果辛热之力太强,就用咸味来泻之。以上这些辅助和平抑的方法,虽然药味各不相同,但道理无不契合,学习者应当根据具体情况,灵活选用作为辅助和平抑的手段即可。
黄帝说:好。如果邪气反向克制胜气,该怎么治疗呢?
上文讲的是用胜气的性味来平抑淫胜之气,假如气味使用太过,就会导致邪气反向克制(即反胜),所以承接上文的意思再次发问。
岐伯说:风气主司于地,清气反而克制它,治疗用酸温的药,辅以苦甘的药,再用辛味的药来平复它。
先列举在泉之气的胜气来说明。上文说:“风淫于内,治以辛凉”,这是指风气主司于地,清气反而克制它。既然清气反胜,现在应当用酸温的药来治疗,酸味能生火,温性能胜清。如果酸温之力不足,清气仍然占优势,就辅以苦味,苦味能助温。如果酸温之力太强,导致金气过于虚弱,就辅以甘味,甘味能生金。以上这些治疗和辅助手段,是因为金的清气反胜,其味属于辛,所以用辛味来如此平复它。上文讲在泉之气胜时说“治”,讲司天之气胜时说“平”,现在讨论在泉之气也说“平”,是因为所谓“治”也就是“平”,所谓“平”也就是“治”,所以在这里再次说“平”。下文讲司天邪胜时,并不说“平”。
热气主司于地,寒气反而克制它,治疗用甘热的药,辅以苦辛的药,再用咸味的药来平复它。
上文说:“热淫于内,治以咸寒”。这是指热气主司于地,寒气反而克制它。既然寒气反胜,现在应当用甘热的药来治疗,甘味能胜水,热能胜寒。如果甘热之力不足,寒气仍然占优势,就辅以苦味,苦味能生甘。如果甘热之力太强,导致水气过于虚弱,就辅以辛味,辛味能生水。以上这些治疗和辅助手段,是因为水的寒气反胜,其味属于咸,所以用咸味来如此平复它。
湿气主司于地,热气反而克制它,治疗用苦冷的药,辅以咸甘的药,再用苦味的药来平复它。
上文说:“湿淫于内,治以苦热”。这是指湿气主司于地,热气反而克制它。既然热气反胜,现在应当用苦冷的药来治疗,苦性寒而冷性能胜热。如果苦冷之力不足,热气仍然占优势,就辅以咸味,咸味能助冷。如果苦冷之力不过强,热气导致过虚,就辅以甘味,甘味能胜水。以上这些治疗和辅助手段,是因为火的热气反胜,其味属于苦,所以用苦味来如此平复它。
火气主司于地,寒气反而克制它,治疗用甘热的药,辅以苦辛的药,再用咸味的药来平复它。
上文说:“火淫于内,治以咸冷”。这是指火气主司于地,寒气反而克制它。既然寒气反胜,现在应当用甘热的药来治疗,甘味能胜水而热能温寒。如果甘热之力不足,寒气仍然占优势,就辅以苦味,苦味能助热。如果甘热之力太强,导致寒气过虚,就辅以辛味,辛味能生水。以上这些治疗和辅助手段,是因为水的寒气反胜,其味属于咸,所以用咸味来如此平复它。
燥气主司于地,热气反而克制它,治疗用辛寒的药,辅以苦甘的药,再用辛味的药来平复它,以调和为有利。
“辛寒”,旧本误作“平寒”;“辛平”,旧本误作“酸平”,现已改正。上文说:“燥淫于内,治以苦寒”。这是指燥气主司于地,热气反而克制它。既然热气反胜,现在应当用辛寒的药来治疗,辛味能生水,而寒性能胜热。如果热反胜而金气仍然旺盛,就辅以苦味,苦味能胜金。如果热反胜而金气过虚,就辅以甘味,甘味能生金。以上这些治疗和辅助手段,是因为燥气主司于地,其味属于辛,所以用辛味来如此平复它。上文所佐助的药味,都是针对反胜之味有过剩或不足而加的,这里所佐助的药味,不是针对辛寒的过剩或不足,而是仍针对燥金的过剩或不足,这是佐助主司地气的药味,而不是佐助被胜之气的药味。至于用辛味来平复,也是指主司地气的药味,不涉及被胜之气的药味,虽然佐助不同,大体上都是以调和为有利罢了。大概治疗被胜之味,若未得其平,佐助得当,则主司地气自然调和;主司地气若未得其平,佐助得当,则被胜之气也会调和。凡此种种,都是以调和为利,贵在学者善于领悟。
寒气主司于地,热气反而克制它,治疗用咸冷的药,辅以甘辛的药,再用苦味的药来平复它。
上文说:“寒淫于内,治以甘热”。这是指寒气主司于地,热气反而克制它。既然热气反胜,现在应当用咸冷的药来治疗,咸味能助水而冷性能胜热。如果咸冷之力太强,就辅以甘味,甘味能胜水。如果咸冷之力不足,就辅以辛味,辛味能生水。以上这些治疗和辅助手段,是因为火的热气反胜,其味属于苦,所以用苦味来如此平复它。
岐伯说:风化于天,清气反而克制它,治疗用酸温的药,辅以甘苦的药。
上文说:“风淫所胜,平以辛凉”。这是指风化于天,清气反而克制它。既然清气反胜,现在应当用酸温的药来治疗,辅以甘苦的药,这与在泉邪胜的道理是一样的。
热气化于天,寒气反而克制它,治疗用甘温的药,辅以苦酸辛的药。
上文说:“热淫所胜,平以咸寒”。这是指热气化于天,寒气反而克制它。既然寒气反胜,现在应当用甘温的药来治疗。如果甘温之力不足,就辅以苦酸,苦味能生甘而酸味能生热。如果甘温之力太强,就辅以辛味,辛味能生水。
上文说:“湿淫所胜,平以苦热”。这是指湿气化于天,热气反而克制它。既然热气反胜,现在应当用苦寒的药来治疗。如果苦寒之力不足,就辅以苦味,助其寒性。如果苦寒之力太强,就辅以酸味,酸味能生火。
上文说:“火淫所胜,平以咸冷”。这是指火气化于天,寒气反而克制它。既然寒气反胜,现在应当用甘热的药来治疗,辅以苦辛的药,这与在泉邪胜的道理是一样的。
上文说:“燥淫所胜,平以苦温”。这是指燥气化于天,热气反而克制它。既然热气反胜,现在应当用辛寒的药来治疗,辅以苦甘的药,这与在泉邪胜的道理是一样的。
上文说:“寒淫所胜,平以辛热”。这是指寒气化于天,热气反而克制它。既然热气反胜,现在应当用咸冷的药来治疗,辅以苦辛的药。上文讲在泉时,佐药用甘辛,大概苦能生甘,其义理是一样的。
上文讲的邪胜,是气味太过所致,所以现在又有六气相互克制的提问。
岐伯说:厥阴风木之气偏胜,会出现耳鸣头晕,心中烦闷欲吐,胃膈部感觉像受寒一样,大风频繁刮起,昆虫不能滋生,胁肋部气机郁结,郁久化热,小便黄赤,胃脘当心处疼痛,向上支撑两胁,肠鸣飧泄,少腹疼痛,腹泻下痢赤白,严重时呕吐,胸膈咽喉不通畅。
厥阴之胜,是风气偏胜。风胜则耳鸣头晕,鸣眩无定,所以心中烦闷欲吐,想吐又吐不出,导致胃膈部感觉像受寒一样。凡此鸣眩、欲吐、如寒等症状,都是风火数举所致。风属木,木克土,所以昆虫不能滋生。“不滋”是指干燥而不润泽。木气内逆,不能枢转从外,所以胁肋部气机郁结,郁久化热。热郁于下,则小便黄赤;热郁于上,则胃脘当心处疼痛,向上支撑两胁;热滋于下,不和于中,则肠鸣飧泄,少腹疼痛,腹泻下痢赤白;热郁于上,不和于中,严重时呕吐,胸膈咽喉不通畅。
少阴君火之气偏胜,心下部发热,容易饥饿,脐下跳动不安,气游走于三焦,炎暑到来,树木流汁,草木枯萎,呕吐逆乱,烦躁不安,腹部胀满疼痛,溏泄,进而发展为便血。
“齐”同“脐”。少阴之胜,是热气偏胜。热胜则心下部发热且容易饥饿,热胜于上,下部不足,所以脐下跳动不安。脐下是相火所在之处。脐下跳动不安,则气游走于三焦。三焦属少阳。少阴与少阳,两火相合,气如炎暑,所以炎暑至极。炎暑已极,则树木流汁,草木焦萎。少阳三焦不和则呕吐逆乱,少阴心肾不交则烦躁,君相二火逆于中土,不能外出,则腹部胀满疼痛溏泄,严重时发展为便血。赤沃,即血液。
太阴湿土之气偏胜,火气内郁,体内生疮疡,流散于体表,病变在胁部的皮肤,严重时心痛且格拒不通,头痛、喉痹、项强。如果是太阴独胜,则湿气内郁,寒气逼迫下焦,疼痛留在头顶,互相牵引至眉间,胃脘胀满,雨水频繁降临,燥化之气乃止,少腹胀满,腰部沉重僵硬,内部小便不利,容易腹泻,足下温暖,头部沉重,足胫及面部浮肿,体内有水饮发作,面部浮肿。
“息”,旧本误作“见”,现已改正。太阴之胜,是湿气偏胜。湿胜,则火郁,所以火气内郁。火郁,则体内生疮疡,从中流散到皮肤之外,其疮疡在胁部的皮肤,所以说病变在胁部的皮肤。如果疮疡在体内,不能流散于体表,严重时就会心痛且格拒不通。热格于上,则头痛、喉痹、项强。这是火气内郁而有这样的病症。如果不是火气内郁,而是太阴之气独胜,则湿气内郁。湿气属寒,所以寒气逼迫下焦。太阴主湿,太阳主寒,寒气逼迫下焦,则太阳之气,不能从经脉开泄于外,所以疼痛留在巅顶,互相牵引至眉间。大概太阳之脉,起于目内眦,从眉间而上额交会于巅顶。湿气内郁,则太阴之气,不能从经脉开泄于内,所以胃脘胀满。雨湿之气频繁降临,而燥化之气乃止。大概太阴之脉,属脾络胃,这是脾胃不和,燥湿之气不相交济所致。少腹胀满,腰部沉重僵硬,内部小便不利,容易腹泻,这是太阳寒水的病症。足下温暖,头部沉重,足胫及面部浮肿,体内有水饮发作,面部浮肿,这是太阴湿土的病症。
少阳相火之气偏胜,热气客居胃中,心烦心痛,眼睛发红欲呕,呕吐酸水,容易饥饿,耳朵痛,小便黄赤,容易惊恐谵妄,暴热消烁万物,草木枯萎,水干涸,甲壳类昆虫萎缩,少腹疼痛,下痢赤白。
少阳之胜,是火气偏胜。火胜,所以热气客居胃中。胃络通心,所以心烦心痛。火热上炎,则眼睛发红。火热在中,则欲呕,呕吐酸水且容易饥饿。水阴不能濡润空窍,则耳朵痛。火热之气下行至水府,则小便黄赤。水火阴阳,不相交济,则容易惊恐谵妄。暴热消烁万物,则草木枯萎,水干涸,甲壳类昆虫萎缩。火热之气,损伤血液,则少腹疼痛,下痢赤白。
阳明燥金之气偏胜,清凉之气发于中,左侧胁肋疼痛,大便溏泄,内部咽喉堵塞,外部发生疝气,大凉肃杀,花叶改变颜色,毛虫受灾,胸部不便,咽喉堵塞且咳嗽。
“便”,读平声,下同。阳明之胜,是金气偏胜。金胜,所以清凉之气发于中。金胜木虚,所以左侧胁肋疼痛。清凉之气发于中,所以大便溏泄。“塞”,指干塞。“疝”,犹言狐疝。《经脉》篇说:“肝是动病,丈夫狐疝,甚则咽干”,这是肝木受病,所以内部咽喉堵塞,外部发生狐疝。金气胜,所以大凉肃杀,则草木的花叶改变颜色,毛虫受灾。经脉不能从肝贯膈,上注于肺,所以胸部不便,咽喉堵塞且咳嗽。
太阳寒水之气偏胜,凝结寒冷将至,非时令之水结冰,羽虫延后化生,痔疮疟疾发作,寒厥入胃,则内生心痛,阴部生溃疡,隐曲之事不利,互相牵引至大腿内侧,筋肉拘挛苛急,血脉凝涩,络脉充盈色变,或者便血,皮肤痞肿,腹部胀满食欲减退,热气反而上行,头项囟顶脑户中疼痛,眼睛像要脱出,寒气入下焦,传变为濡泻。
“泣”,音涩。“痞”,批,上声,下同。“囟”,同“信”,音信。太阳之胜,是寒气偏胜。寒胜则凝结寒冷将至,有非时令之水冰。水寒气胜,火热受制,所以火类的羽虫,延后生化。寒胜火郁,则痔疮疟疾发作。痔与疟,都是寒胜火郁的病。寒胜厥逆而入于胃,则内生心痛。心痛,指胃脘当心处的疼痛。寒入阴中,则阴部生溃疡。阴部生溃疡,则隐曲之事不利,从阴中互相牵引至大腿内侧,则筋肉拘挛苛急。筋挛急叫拘,肉暴痛叫苛。内则血脉凝涩,外则络脉充盈色变。《通评虚实论》中,黄帝有经虚络满的提问。或者便血,是血脉凝涩而下泄。皮肤痞肿,是络脉色变而外浮。皮肤痞肿,则腹部胀满食欲减退。或者便血,则热气反而上行,则头顶、囟顶、脑户中都痛。严重时眼睛像要脱出。《经脉》篇说,足太阳之脉,病冲头痛,眼睛像要脱出,痔疮疟疾,头囟项痛。如果寒气入下焦,决渎功能失常,则传变为濡泻。
黄帝说:该怎么治疗呢?
六气相胜,该怎么治疗呢?
岐伯说:厥阴之胜,治疗用甘清的药,辅以苦辛的药,用酸味来泻之。
甘是土的味道,清是金的气。土金相生,用来治疗厥阴风木之本的偏胜。辅以苦辛,苦是火味以生土,辛是金味以制木。以此来帮助甘清。木性条达,酸主收敛,违背其本性而收敛就是泻,所以用酸味来泻之。
辛是金的味道,寒是水的气。金水相生,用来治疗少阴火热的偏胜。辅以苦咸,苦虽是火味,但其气则寒,咸是水味,以此来帮助辛寒。火性急速,违背其本性而缓之就是泻,所以用甘味来泻之。
咸是水味道,热是火的气。太阴土燥,用咸来治之。太阴土湿,用热来治之。辅以辛甘,土气有余,用辛来散之,土气不足,用甘来资助之。土性喜温,违背其本性而寒之就是泻;土性喜润,违背其本性而燥之就是泻,苦为火味,性燥而寒,所以用苦味来泻之。土位中央,灌溉四旁,气贵和平,所以其治疗辅助如此。下文阳明之胜,也说用苦味来泻之,其义理是一样的。
少阳的治疗,与少阴相同。苦为火味,所以不说辅以苦咸,而说辅以甘咸。甘为土味,以生金。以此来帮助辛寒。
酸为木味,温为火气,木火相生,用来治疗阳明金气的偏胜。阳明有燥金之气,有清金之气。燥气有余,所以辅以辛来散之。清气不足,所以辅以甘来滋之。用苦味来泄之,与太阴相同。不说“泻”而说“泄”,是为了说明泻之也就是泄之。
“苦”,旧本误作“辛”,现已改正。甘为土味,热为火气。火土相生,用来治疗太阳寒水的偏胜。辅以苦酸,木火相生,以此来帮助甘热。水性善下,违背其本性而凝之就是泻,所以用咸味来泻之。
岐伯说:问得真详细啊!厥阴之复,少腹坚硬胀满,里急暴痛,偃木飞沙,昆虫不荣,厥心痛,汗出呕吐,饮食不入,入而复出,筋骨震颤眩晕,清厥,严重时入脾,食痹而吐,冲阳脉绝,死不治。
开始受制,随后报复。其气虽复,经脉未和,所以厥阴之复,少腹坚硬胀满,里急暴痛。风气盛,所以偃木飞沙。木盛土衰,所以昆虫不荣。厥心痛者,《灵枢·厥论》篇说:“厥心痛,色苍如死状,终日不得太息,肝心痛也。”汗出,是风伤肌腠。呕吐,是肝气逆,肝气逆,所以饮食不入,入而复出。筋骨震颤眩晕,是风气盛。清厥,手足清冷厥逆也,严重时木克其土,病入于脾,所以食痹而吐。痹,闭也,上闭不达,所以吐。如果木盛土衰,至胃脉的冲阳绝,则死不治。
少阴之复,懊热内作,烦躁鼽嚏,少腹绞痛,火见燔焫,咽燥,分注时止,气动于左,上行于右,咳,皮肤痛,暴喑,心痛,郁冒不知人,乃洒淅恶寒,振栗谵妄,寒已而热,渴而欲饮,少气骨痿,膈肠不便,外为浮肿,哕噫,赤气后化,流水不冰,热气大行,介虫不复,病痱疹疮疡,痈疽痤痔,严重时入肺,咳而鼻渊,天府脉绝,死不治。
When Cold excess prevails, it is Water Qi overcoming excessively. Dryness and Fire can treat it; therefore, it is levelled with the acridity of Dryness Qi and the heat of Fire Qi. If acrid-heat is insufficient, then sweet and bitter are assisted; sweet generates Metal (Lung) and bitter assists Fire. If acrid-heat is excessive, then salty is used to drain it. All these methods of assistance and leveling differ in flavor but conform to principle. Students should follow what is appropriate and use them for assistance and leveling.
The Yellow Emperor said: Excellent. What if pathogenic Qi counter-overcomes?
The above text discusses treating and leveling by using the flavors and qi of the prevailing Qi to treat and level the excess. If the flavors and qi are excessive, then Pathogenic Qi counter-overcomes. Thus, following the meaning of the above text, the question is repeated.
Qi Bo said: When Wind governs at the Earthly Position (Zai Quan), and Clearness (Cold/Dryness) counter-overcomes it, treat with sour-warm, assist with bitter-sweet, and level with acrid.
First, the winning Qi of Zai Quan is cited to clarify. The above text says: "Wind excess within, treat with acrid-cool." This means Wind governs at the Earthly Position, and Clearness counter-overcomes it. Since Clearness counter-overcomes, now treat with sour-warm. Sour generates Fire, and Warm overcomes Clearness. If sour-warm is insufficient and Clearness still prevails, then assist with bitter; bitter assists Warm. If sour-warm is excessive and Metal Qi becomes too deficient, then assist with sweet; sweet generates Metal. In all these treatments and assists, because Metal's Clearness Qi counter-overcomes, and its flavor belongs to Acrid, it is leveled with Acrid as described. The above text says "treat" when Zai Quan Qi wins, and "level" when Si Tian (Heavenly Position) Qi wins. Now discussing Zai Quan also uses "level," because treating is leveling, and leveling is treating, hence "level" is mentioned again here. The following text on Si Tian pathogenic excess does not mention "level."
When Heat governs at the Earthly Position, and Cold counter-overcomes it, treat with sweet-hot, assist with bitter-acrid, and level with salty.
The above text says: "Heat excess within, treat with salty-cold." This means Heat governs at the Earthly Position, and Cold counter-overcomes it. Since Cold counter-overcomes, now treat with sweet-hot. Sweet overcomes Water, and Heat overcomes Cold. If sweet-hot is insufficient and Cold still prevails, then assist with bitter; bitter generates sweet. If sweet-hot is excessive and Water Qi becomes too deficient, then assist with acrid; acrid generates Water. In all these treatments and assists, because Water's Cold Qi counter-overcomes, and its flavor belongs to Salty, it is leveled with Salty as described.
When Dampness governs at the Earthly Position, and Heat counter-overcomes it, treat with bitter-cold, assist with salty-sweet, and level with bitter.
The above text says: "Dampness excess within, treat with bitter-hot." This means Dampness governs at the Earthly Position, and Heat counter-overcomes it. Since Heat counter-overcomes, now treat with bitter-cold. Bitter is cold-natured, and Cold overcomes Heat. If bitter-cold is insufficient and Heat still prevails, then assist with salty; salty assists Cold. If bitter-cold is not excessive and Heat causes deficiency, then assist with sweet; sweet overcomes Water. In all these treatments and assists, because Fire's Heat Qi counter-overcomes, and its flavor belongs to Bitter, it is leveled with Bitter as described.
When Fire governs at the Earthly Position, and Cold counter-overcomes it, treat with sweet-hot, assist with bitter-acrid, and level with salty.
The above text says: "Fire excess within, treat with salty-cold." This means Fire governs at the Earthly Position, and Cold counter-overcomes it. Since Cold counter-overcomes, now treat with sweet-hot. Sweet overcomes Water and Heat warms Cold. If sweet-hot is insufficient and Cold still prevails, then assist with bitter; bitter assists Heat. If sweet-hot is excessive and Cold causes deficiency, then assist with acrid; acrid generates Water. In all these treatments and assists, because Water's Cold Qi counter-overcomes, and its flavor belongs to Salty, it is leveled with Salty as described.
When Dryness governs at the Earthly Position, and Heat counter-overcomes it, treat with acrid-cold, assist with bitter-sweet, and level with acrid, taking harmony as beneficial.
"Acrid-cold" was erroneously printed as "Ping-cold" in old editions; "Acrid-level" was erroneously printed as "Sour-level," now corrected. The above text says: "Dryness excess within, treat with bitter-cold." This means Dryness governs at the Earthly Position, and Heat counter-overcomes it. Since Heat counter-overcomes, now treat with acrid-cold. Acrid generates Water, and Cold overcomes Heat. If Heat counter-overcomes and Metal Qi is still strong, then assist with bitter; bitter overcomes Metal. If Heat counter-overcomes and Metal Qi is too deficient, then assist with sweet; sweet generates Metal. In all these treatments and assists, because Dryness governs at the Earthly Position, and its flavor belongs to Acrid, it is leveled with Acrid as described. The flavors assisted in the above text were added due to the excess or deficiency of the counter-overcoming flavor. Here, the assisted flavors are not due to the excess or deficiency of Acrid-Cold, but still due to the excess or deficiency of Dryness-Metal. This assists the flavor governing the Earthly Position, not the flavor being overcome. As for leveling with Acrid, it refers to the flavor governing the Earthly Position, not the flavor being overcome. Although the assistance differs, the general principle is that harmony is beneficial. Generally, if the treatment of the overcome flavor is not balanced, proper assistance will harmonize the governing Earthly Qi. If the governing Earthly Qi is not balanced, proper assistance will harmonize the overcome Qi. All this emphasizes harmony as beneficial, relying on the student's ability to comprehend well.
When Cold governs at the Earthly Position, and Heat counter-overcomes it, treat with salty-cold, assist with sweet-acrid, and level with bitter.
The above text says: "Cold excess within, treat with sweet-hot." This means Cold governs at the Earthly Position, and Heat counter-overcomes it. Since Heat counter-overcomes, now treat with salty-cold. Salty assists Water and Cold overcomes Heat. If salty-cold is excessive, then assist with sweet; sweet overcomes Water. If salty-cold is insufficient, then assist with acrid; acrid generates Water. In all these treatments and assists, because Fire's Heat Qi counter-overcomes, and its flavor belongs to Bitter, it is leveled with Bitter as described.
The Yellow Emperor said: What about Si Tian pathogenic excess?
What about Si Tian pathogenic excess and how to treat it?
Qi Bo said: When Wind transforms at Heaven, and Clearness counter-overcomes it, treat with sour-warm, assist with sweet-bitter.
The above text says: "Wind excess prevailing, level with acrid-cool." This means Wind transforms at Heaven, and Clearness counter-overcomes it. Since Clearness counter-overcomes, now treat with sour-warm, assist with sweet-bitter. This has the same meaning as Zai Quan pathogenic excess.
When Heat transforms at Heaven, and Cold counter-overcomes it, treat with sweet-warm, assist with bitter-sour-acrid.
The above text says: "Heat excess prevailing, level with salty-cold." This means Heat transforms at Heaven, and Cold counter-overcomes it. Since Cold counter-overcomes, now treat with sweet-warm. If sweet-warm is insufficient, then assist with bitter-sour; bitter generates sweet and sour generates Heat. If sweet-warm is excessive, then assist with acrid; acrid generates Water.
When Dampness transforms at Heaven, and Heat counter-overcomes it, treat with bitter-cold, assist with bitter-sour.
The above text says: "Dampness excess prevailing, level with bitter-hot." This means Dampness transforms at Heaven, and Heat counter-overcomes it. Since Heat counter-overcomes, now treat with bitter-cold. If bitter-cold is insufficient, then assist with bitter; assisting its coldness. If bitter-cold is excessive, then assist with sour; sour generates Fire.
When Fire transforms at Heaven, and Cold counter-overcomes it, treat with sweet-hot, assist with bitter-acrid.
The above text says: "Fire excess prevailing, level with salty-cold." This means Fire transforms at Heaven, and Cold counter-overcomes it. Since Cold counter-overcomes, now treat with sweet-hot, assist with bitter-acrid. This has the same meaning as Zai Quan pathogenic excess.
When Dryness transforms at Heaven, and Heat counter-overcomes it, treat with acrid-cold, assist with bitter-sweet.
The above text says: "Dryness excess prevailing, level with bitter-warm." This means Dryness transforms at Heaven, and Heat counter-overcomes it. Since Heat counter-overcomes, now treat with acrid-cold, assist with bitter-sweet. This has the same meaning as Zai Quan pathogenic excess.
When Cold transforms at Heaven, and Heat counter-overcomes it, treat with salty-cold, assist with bitter-acrid.
The above text says: "Cold excess prevailing, level with acrid-hot." This means Cold transforms at Heaven, and Heat counter-overcomes it. Since Heat counter-overcomes, now treat with salty-cold, assist with bitter-acrid. In the above text regarding Zai Quan, assistance was with sweet-acrid, because bitter can generate sweet; their principles are identical.
The Yellow Emperor said: What about the six Qi overcoming each other?
The above pathogenic excess was due to excessive flavors and qi, so there is a further question about the six Qi overcoming each other.
Qi Bo said: When Jueyin prevails, there is tinnitus and dizziness, confusion and desire to vomit, the stomach and diaphragm feel cold, strong winds blow frequently, insects do not thrive, Qi gathers in the hypochondrium, transforms into heat, urine is yellow and red, epigastric pain at the heart's region, extending upwards to support both hypochondria, borborygmus and undigested stool diarrhea, lower abdominal pain, dysentery with red and white discharge, severe cases involve vomiting, and obstruction of the chest, diaphragm, and throat.
Jueyin prevalence is Wind prevalence. Wind prevalence causes tinnitus and dizziness; fluctuating tinnitus and dizziness lead to confusion and desire to vomit. Desire to vomit without success leads to the stomach and diaphragm feeling cold. All these symptoms—tinnitus, dizziness, desire to vomit, and feeling cold—are caused by frequent occurrences of Wind and Fire. Wind is Wood; Wood controls Earth, so insects do not thrive. "Not thriving" means dry and unmoistened. Wood Qi reverses internally and cannot pivot outward, so Qi gathers in the hypochondrium and transforms into heat. Heat stagnating below causes yellow-red urine; Heat stagnating above causes epigastric pain at the heart's region, extending upwards to support both hypochondria. Heat nourishing below and not harmonizing in the middle causes borborygmus and undigested stool diarrhea, lower abdominal pain, and dysentery with red and white discharge. Heat stagnating above and not harmonizing in the middle causes severe vomiting and obstruction of the chest, diaphragm, and throat.
When Shaoyin prevails, there is heat in the epigastrium, frequent hunger, pulsation below the navel, Qi wandering through the Sanjiao, arrival of sultry heat, trees exuding sap, grass withering, vomiting and reversal, restlessness and irritability, abdominal fullness and pain, loose stools, progressing to bloody discharge.
"Qi" is synonymous with "Navel." Shaoyin prevalence is Heat prevalence. Heat prevalence causes heat in the epigastrium and frequent hunger. Heat prevailing above and lacking below causes pulsation below the navel. The area below the navel is where Ministerial Fire resides. Pulsation below the navel causes Qi to wander through the Sanjiao. Sanjiao is Shaoyang. Shaoyin and Shaoyang, two Fires combining, create Qi like sultry heat, so sultry heat arrives. "Arrives" means reaches extremity. When sultry heat reaches extremity, trees exude sap and grass withers. Shaoyang Sanjiao disharmony causes vomiting and reversal; Shaoyin Heart-Kidney non-interaction causes restlessness and irritability. Sovereign and Ministerial Fires reversing in the Middle Earth, unable to exit outward, cause abdominal fullness, pain, and loose stools. Severe cases progress to bloody discharge. "Chi Wo" refers to blood.
When Taiyin prevails, Fire Qi stagnates internally, sores and ulcers arise within and scatter externally, disease is in the skin of the hypochondrium, severe cases involve heart pain and heat rejection, headache, throat bi, and neck stiffness. If Taiyin alone prevails, Dampness stagnates internally, Cold forces the Lower Jiao, pain remains at the vertex, radiating to the glabella, stomach fullness, frequent rain, Dryness transformation ceases, lower abdominal fullness, heavy and stiff waist, internal difficulty urinating, frequent watery diarrhea, warm soles, heavy head, swollen calves and face, fluid retention internally, and swelling above.
"Xi" was erroneously printed as "Jian" in old editions, now corrected. Taiyin prevalence is Dampness prevalence. Dampness prevalence causes Fire stagnation, so Fire Qi stagnates internally. Fire stagnation causes sores and ulcers within, scattering from the center to the skin outside. The sores are in the skin of the hypochondrium, hence "disease in the skin of the hypochondrium." If sores are internal and cannot scatter externally, severe cases involve heart pain and heat rejection. Heat rejection above causes headache, throat bi, and neck stiffness. These diseases result from internal Fire stagnation. If not Fire stagnation, but Taiyin Qi alone prevails, then Dampness stagnates internally. Dampness is Cold, so Cold forces the Lower Jiao. Taiyin governs Dampness, Taiyang governs Cold. Cold forcing the Lower Jiao means Taiyang Qi cannot open outward through the meridians, so pain remains at the vertex and radiates to the glabella. Taiyang meridian starts at the inner canthus, goes up from the glabella to the forehead and meets at the vertex. Dampness stagnating internally means Taiyin Qi cannot open inward through the meridians, so the stomach is full. Frequent arrival of Rain-Damp Qi causes Dryness transformation to cease. Taiyin meridian belongs to Spleen and connects to Stomach; this is due to Spleen-Stomach disharmony and lack of interaction between Dryness and Dampness Qi. Lower abdominal fullness, heavy and stiff waist, internal difficulty urinating, and frequent watery diarrhea are diseases of Taiyang Cold Water. Warm soles, heavy head, swollen calves and face, internal fluid retention, and facial swelling are diseases of Taiyin Wet Earth.
When Shaoyang prevails, Heat lodges in the Stomach, causing vexation and heart pain, red eyes and desire to vomit, vomiting acid and frequent hunger, ear pain and red urine, frequent fright and delirium, sudden heat consuming things, grass withering and water drying, shell insects shrinking, lower abdominal pain, and bloody dysentery.
Shaoyang prevalence is Fire prevalence. Fire prevalence causes Heat to lodge in the Stomach. Stomach meridian connects to Heart, causing vexation and heart pain. Fire-Heat flares upward, causing red eyes. Fire-Heat in the middle causes desire to vomit, vomiting acid, and frequent hunger. Yin-Water fails to moisten hollow organs, causing ear pain. Fire-Heat Qi descends to the Water Palace, causing red urine. Water-Fire Yin-Yang fail to interact, causing frequent fright and delirium. Sudden heat consumes all things, causing grass to wither, water to dry, and shell insects to shrink. Fire-Heat Qi damages Blood, causing lower abdominal pain and bloody dysentery.
When Yangming prevails, Clearness emerges from the middle, causing left hypochondriac pain, loose stools, internal pharyngeal obstruction, external development of hernia, great coolness and killing frost, flowers and leaves changing appearance, hair insects suffering, chest discomfort, pharyngeal obstruction, and cough.
"Bian" is read as flat tone, same below. Yangming prevalence is Metal prevalence. Metal prevalence causes Clearness to emerge from the middle. Metal prevalence and Wood deficiency cause left hypochondriac pain. Clearness emerging from the middle causes loose stools. "Se" means dry obstruction. "Hernia" refers to Fox Hernia. The *Meridians* chapter says: "Liver moving disease, men have Fox Hernia, severe cases have dry throat." This is Liver Wood disease, hence internal pharyngeal obstruction and external Fox Hernia. Metal Qi prevalence causes great coolness and killing frost, so flower leaves change appearance and hair insects suffer. Meridians cannot pass from Liver through Diaphragm to Lung, causing chest discomfort, pharyngeal obstruction, and cough.
When Taiyang prevails, condensation and chill arrive, ice forms out of season, feathered insects develop late, hemorrhoids and malaria appear, Cold-Jue enters Stomach causing internal heart pain, ulcers in the yin region, difficulty with private matters, radiation to inner thighs, muscle cramps and spasms, coagulation of blood vessels, fullness of collaterals with color changes, hematochezia, skin induration and swelling, abdominal fullness and reduced appetite, Heat reversing upward causing pain in head, neck, fontanelle, and brain house, eyes protruding, Cold entering Lower Jiao transmitting to damp diarrhea.
"Qi" sounds like "Se." "Pi" is pronounced "Pi," upper tone, same below. "Xin" is same as "Xin," sound "Xin." Taiyang prevalence is Cold prevalence. Cold prevalence brings condensation and chill, with ice forming out of season. Water-Cold Qi prevails, restricting Fire-Heat, so Fire-class feathered insects develop late. Cold prevalence and Fire stagnation cause hemorrhoids and malaria. Hemorrhoids and Malaria are diseases of Cold prevalence and Fire stagnation. Cold prevalence and Jue-Ni enter Stomach, causing internal heart pain. Heart pain refers to pain in the epigastrium at the heart's region. Cold entering Yin causes ulcers in the yin region. Ulcers in the yin region cause difficulty with private matters, radiating from Yin to inner thighs, causing muscle cramps and spasms. Cramping tendons is Ju, sudden muscle pain is Ke. Internally, blood vessels coagulate; externally, collaterals fill with color changes. In *Tong Ping Xu Shi Lun*, the Emperor asked about Empty Meridians and Full Collaterals. Or hematochezia, due to coagulated blood vessels bleeding downward. Skin induration and swelling, due to collateral color changes floating outward. Skin induration causes abdominal fullness and reduced appetite. Or hematochezia, Heat reverses upward, causing pain in vertex, fontanelle, and brain house. Severe cases, eyes protrude. *Meridians* chapter says: Foot Taiyang meridian disease causes rushing headache, eyes like protruding, hemorrhoids and malaria, head/vertex/neck pain. If Cold enters Lower Jiao, Du Shu function is abnormal, transmitting to damp diarrhea.
The Yellow Emperor said: How to treat it?
How to treat the six Qi overcoming each other?
Qi Bo said: For Jueyin prevalence, treat with sweet-cool, assist with bitter-acrid, drain with sour.
Sweet is the flavor of Earth, Cool is the Qi of Metal. Earth and Metal generate each other, treating the prevalence of Jueyin Wind origin. Assisting with bitter-acrid: Bitter is Fire flavor to generate Earth, Acrid is Metal flavor to control Wood. This assists sweet-cool. Wood nature is flexible; Sour governs convergence. Reversing its nature to converge is draining, hence drain with sour.
For Shaoyin prevalence, treat with acrid-cold, assist with bitter-salty, drain with sweet.
Acrid is the flavor of Metal, Cold is the Qi of Water. Metal and Water generate each other, treating the prevalence of Shaoyin Fire-Heat. Assisting with bitter-salty: Bitter is Fire flavor but its Qi is Cold, Salty is Water flavor, assisting acrid-cold. Fire nature is rapid; reversing its nature to slow is draining, hence drain with sweet.
For Taiyin prevalence, treat with salty-hot, assist with sweet-acrid, drain with bitter.
Salty is the flavor of Water, Hot is the Qi of Fire. Taiyin Earth is dry, treated with Salty. Taiyin Earth is damp, treated with Hot. Assisting with sweet-acrid: Earth Qi excess, Acrid disperses it; Earth Qi deficiency, Sweet nourishes it. Earth nature likes warmth; reversing its nature to cold is draining. Earth nature likes moisture; reversing its nature to dryness is draining. Bitter is Fire flavor, nature is dry and cold, hence drain with bitter. Earth occupies the center, irrigating four directions, Qi values harmony, hence treatment and assistance are thus. The following text on Yangming prevalence also says drain with bitter, same principle.
For Shaoyang prevalence, treat with acrid-cold, assist with sweet-salty, drain with sweet.
Shaoyang treatment is same as Shaoyin. Bitter is Fire flavor, so not assist with bitter-salty, but sweet-salty. Sweet is Earth flavor, generating Metal. This assists acrid-cold.
For Yangming prevalence, treat with sour-warm, assist with sweet-acrid, drain with bitter.
Sour is Wood flavor, Warm is Fire Qi. Wood and Fire generate each other, treating Yangming Metal Qi prevalence. Yangming has Dry Metal Qi and Clear Metal Qi. Dry Qi excess, assist Acrid to disperse. Clear Qi deficiency, assist Sweet to nourish. Drain with bitter, same as Taiyin. Not saying "drain" but "drain off" clarifies that draining is draining off.
For Taiyang prevalence, treat with sweet-hot, assist with bitter-sour, drain with salty.
"Bitter" was erroneously printed as "Acrid" in old editions, now corrected. Sweet is Earth flavor, Hot is Fire Qi. Fire and Earth generate each other, treating Taiyang Cold Water prevalence. Assisting with bitter-sour: Wood and Fire generate each other, assisting sweet-hot. Water nature flows down; reversing its nature to coagulate is draining, hence drain with salty.
The Yellow Emperor said: What about the six Qi rebounding?
There is six Qi prevalence, which is six Qi rebounding, hence the question.
Qi Bo said: You ask thoroughly! For Jueyin rebounding, lower abdomen firm and full, interior urgency and sudden pain, trees bending and sand flying, insects not flourishing, Juexin pain, sweating and vomiting, food not entering or entering and immediately coming out, sinews and bones trembling and dizziness, clear Jue, severe cases enter Spleen, food obstruction and vomiting, Chongyang pulse extinct, death untreatable.
Initially restrained, then rebounds. Its Qi rebounds but meridians are not harmonized. Hence Jueyin rebounding: lower abdomen firm and full, interior urgency and sudden pain. Wind Qi prevails, so trees bend and sand flies. Wood prevails, Earth declines, so insects do not flourish. Juexin pain: *Ling Shu · Jue Lun* chapter says: "Juexin pain, complexion pale like dead state, unable to sigh deeply all day, Liver Xin pain." Sweating, Wind damaging muscle-coupling. Vomiting, Liver Qi reversing. Liver Qi reversing, so food does not enter, or enters and comes out. Sinews and bones trembling and dizziness, Wind Qi prevails. Clear Jue, hands and feet cold and Jue-Ni. Severe cases Wood controls Earth, disease enters Spleen, hence food obstruction and vomiting. Bi means obstruction, upper obstruction not reaching, hence vomiting. If Wood prevails and Earth declines, until Stomach meridian Chongyang pulse extinct, then death untreatable.
For Shaoyin rebounding, internal stifling heat, restlessness, sneezing, lower abdominal colic, Fire appearing burning, throat dry, profuse discharge stopping intermittently, Qi moving on left, ascending on right, cough, skin pain, sudden aphonia, heart pain, depression and fainting losing consciousness, then shivering with chills, tremors and delirium, after cold then heat, thirst wanting drink, shortness of breath and bone weakness, diaphragm and intestine obstruction, external edema, belching, Red Qi develops late, flowing water not freezing, Heat Qi greatly prevailing, shell insects not recovering, disease febrile rashes sores ulcers, carbuncles malignant sores acne hemorrhoids, severe cases enter Lung, cough and nasal sinusitis, Tianfu pulse extinct, death untreatable.
"Bian" as written. Restrained then rebounding, meridians not harmonized. Hence Shaoyin rebounding: internal stifling heat, restlessness, sneezing. Shaoyin ascends from below, hence lower abdominal colic, up