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《neijing》4

已有 858 次阅读2015-3-10 21:54 |个人分类:中医

Chapter 4

Xie Qi Zang Fu Bing Xing

Huang Di asked Qi Bo: what is the condition about the sick Qi attack human body?

Qi Bo answered: the wind heat or wind cold will attack upper part of human body.

Huang Di said: is there certain location the sick Qi attack human body?

Qi Bo said: upper part body will be attacked by wind heat or wind cold Qi, lower part body will be attacked by damp cold Qi. Hence, the sick Qi attack human body is not on certain location, the sick Qi attack yin Zang and then will transfer to yang Fu; the sick Qi attack yang Fu and then will transfer by meridians.

Huang Di said: the meridians has yin and yang, and yin and yang meridians all connected to internal Zang Fu, and connected to external muscle and skin, they also connected up and down, left and right like circle around never begin or end. The meridians named yin or yang, but in fact they all the same connected as one united. But the exterior sick Qi attack body, sometime on yin meridians, sometimes on yang meridians, sometimes attack up or down, sometimes attack left or right, there is not a certainly location, why?

Qi Bo said: hand three yang meridians and foot three yang meridians, all connected to head, so the head is the location assemble the yang meridians. The exterior sick Qi attack body, usually during the meridian Qi weak time, or after body work feel tired time, or irregular diet and sweating cause the muscle skin spaces open time, or the body Qi deficiency can not hold body Jing Qi time, those times are very easy be attacked by exterior sick Qi. If the exterior sick Qi attack front of face, the sick Qi will transfer down by the Yang Ming meridians. If the exterior sick Qi attack to the neck, the sick Qi will transfer down by the Tai Yang meridians. If the sick Qi attack the cheek, the sick Qi will transfer down by the Shao Yang meridians. If the exterior sick Qi attack chest, back or ribs, the sick Qi will transfer down by Yang Ming, Tai Yang or Shao Yang meridians and sick syndromes will happen on those meridians locations.

Huang Di asked: what is the condition if the wind sick Qi attack body yin meridians?

Qi Bo said: the wind sick Qi attack body yin meridians, usually through yin side of arms or legs begin to go up to body. Because the yin side of arms and legs’ skin very thin, muscle very soft, these locations will more easy get hurt by wind sick Qi than other part of body locations.

Huang Di asked: during this condition, the wind sick Qi will first transfer to hurt five Zang?

Qi Bo answered: the wind sick Qi attack body may not hurt five Zang first, during the sick Qi attack body yin meridians, if the five Zang Jing Qi is strong, the sick Qi will not stay in five Zang, but will transfer to six Fu. So wind sick Qi attack yang meridians will sick syndromes on yang meridian locations; wind sick Qi attack yin meridians, if Zang Qi is strong, the sick Qi will not transfer inside body, but transfer to six Fu which is exterior-interior relationship to the yin Zang to get sick syndromes.

Huang Di said: the sick Qi attack body, also hurt five Zang, why?

Qi Bo said: because the five Zang Jing Qi injury inside first, so the exterior sick Qi can attack five Zang during the deficiency condition, for example, heart store shen, if the patient has anxiety with scared emotion problems, this will injury shen, at the same time get sick Qi from exterior, and then it will injury the heart. Lung control the skin and fur, if body get wind cold Qi, at the same time drink a lot of cold water, both cold energy from inside and outside meet together, this will injury lung, lung loose the function of sink down Qi, the Qi will go upward cause cough. Liver store blood, its meridians go along under the ribs, if the body fall down cause blood stasis in the ribs area, at the same time the patient has big angry and stimulate emotions, and then the liver Qi go upward cause vomit, and Qi and blood stagnation under the ribs, the sick Qi will injury liver. Spleen control the muscle absorb nutrition and digestion functions, if the patient after fighting or drunk and go sex with someone and sweating during wind condition, and this will injury spleen. Kidney store Jing and support bones, if the patient after lift heavy things feel very tired, and too much sex life with someone or sweating during bath, this will injury the bone’s jing Qi and injury kidney.

Huang Di said: what is the condition of wind hurt five Zang?

Qi Bo said: it must be the five Zang get injury first, and then the body get wind attack, under the condition of internal hurt with external wind attack the yin and yang Qi and blood both deficiency, the wind Qi will attack five Zang.

Huang Di said: your speech is very good!

Huang Di asked: the head face and whole body other parts are the same connect with tendons and bones Qi and blood circulation, but when the season is cold at winter ice weather, the hands and feet feel numb and stiff, but the face not feel cold and not need clothes to cover to get warm, why?

Qi Bo answered: human body twelve meridians, three hundred sixty five luo meridians’ Qi and blood, all gather to the face at seven orifices. The front essence yang Qi all go up to eyes can seeing, the side essence yang Qi all go up to ears can listening, the lung’s Zong Qi go up to nose can smelling, the stomach food Qi go up to mouth tongue can tasting. The different of body jing liquid will steam become Qi gather to face, and the skin of face is very thick, muscle of face is very strong, this is why in the winter cold weather, the face can adapt.

Huang Di said: what is the syndromes condition during the wind sick Qi attack human body?

Qi Bo said: there are two kind of wind sick Qi, upright face attack wind sick Qi, steal attack wind sick Qi. the steal attack wind sick Qi is during the four season connection time, it will make body more serious syndromes, the patient will fear of cold and body shaking. The upright face attack wind sick Qi is during the four season time, it will make body less syndromes, patient can not feel it happens, or just very light syndromes, not clear and easy be ignored.

Huang Di said: very good!

Huang Di asked: I heard some doctors can check the patient’s face five colors and then know the sick condition, we call this “Ming”; some doctor can check the patient’s pulse and then know the sick condition, we call this “Shen”; some doctor can ask patient questions and then know the sick condition, we call this “Gong”. I want know your opinion of the three kind of doctors, why they can check color, pulse and ask question to know the sick condition?

Qi Bo answered: the color, pulse and body local condition all connect each other, their relationship like drum and drumstick coordinate each other, never separate each other, this is like the tree’s root and tree’s leafs, if root die, the leafs will die too. The face color, pulse and body local condition are the same, so, the doctor know the questions called “Gong”, the doctor know the pulse called “Shen”, the doctor know the color and pulse called “Shen Ming”.

Huang Di said: I want hear more detail about your theory.

Qi Bo answered: blue color, its pulse is wiry; red color, its pulse is surging; yellow color, its pulse is regularly intermittent; white color, its pulse is floating; black color, its pulse is deep soft and rolling; This is color and pulse relationship. If only see the color without the relate pulse or shows the restriction pulse, this means very serious condition or death condition; if shows the generation pulse, this means the patient’s condition will getting better.

Huang Di asked: what is the condition shows about five Zang illness?

Qi Bo answered: first figure out the five color and five pulse relate to five Zang, and then we can figure out the five Zang illness condition.

Huang Di said: if we known the color and pulse, how to figure out the five Zang condition?

Qi Bo said: we need find out from the pulse’s fast or slow, strong or weak, slippery or hesitant and then figure out five Zang’s illness condition.

Huang Di said: how the check the pulse and local sick area condition?

Qi Bo said: if the pulse is fast, the local skin area also tight; if the pulse slow, the local skin area also relax; if the pulse weak, the local skin area will thin; if the pulse strong, the local skin area will thick; if the pulse slippery, the local skin area will smooth; if the pulse hesitant, the local skin will dry and un-smooth. But these six conditions will be vary but different situations. So if the doctor good to check the local skin condition, will know the illness without check the pulse; if the doctor good to check the pulse, will know the illness without check the local color condition. If the doctor can check color, pulse and local skin condition together, this is the very high level diagnosis doctor, and the treatment correct rate can reach to 90%; if the doctor can use two ways in diagnosis, is the middle level doctor, the treatment correct rate can reach to 70%, if the doctor only can use one way in diagnosis, is the lower level doctor, the treatment correct rate can reach to 60%.

Huang Di said: what conditions shown by the fast, slow, strong, weak, slippery and hesitant pulse?

Qi Bo said: let me talk about the five Zang sick conditions shown by the six pulses first. The heart pulse very fast, means meridian tendons cramp; heart pulse little fast, means heart pain connect to back pain, even can not eat food. Heart pulse very slow, the patient will like laugh loudly; Heart pulse slightly slow the patient is food stasis in stomach, the Qi go upset on chest, even vomit blood. Heart pulse very strong, the patient is heart fire up to throat, feel something block the throat; heart pulse slightly strong shows the heart impediment pain connect to back, and easy dacryorrhea. Heart pulse very weak, the patient easy hiccup; heart pulse slightly weak, the patient will be hyperorexia. Heart pulse very slippery, the patient is diabetes; heart pulse slightly slippery, the patient is umbilical hernia and lower abdomen noisy. Heart pulse very hesitant, the patient can not speak by mouth; heart pulse slightly hesitant, the patient will hematemesis and nose bleeding with limbs cold extremity, also ear ringing with epilepsy. Lung pulse very fast shows the patient has epilepsy; lung pulse slightly fast shows the patient has cold or heat in lung, and feel fatigue and lack of strength and cough or cough blood, during cough the pain will from chest connect to back and lower back pain together, also the nose has polyp block the breath channel. Lung pulse very slow shows the patient sweat too much; lung pulse slightly slow shows the patient has lung atrophy and limbs atrophy, neck and under shoulder ulcer, body sweating or head sweating no end. Lung pulse very strong shows the patient has swollen on tibia; lung pulse slightly strong shows patient’s lung channel obstructed, pain at chest and back, and fear of sun light. Lung pulse very weak shows the patient has diarrhea; lung pulse slightly weak shows the patient has diabetes. Lung pulse very slippery shows the patient has phlegm stasis in lung and asthma; lung pulse slightly slippery shows the patient has heat hurt blood vessel cause nose bleeding or bowel movement bleeding. Lung pulse very hesitant shows the patient vomit blood; lung pulse slightly hesitant shows the patient’s neck or under shoulder has ulcer, legs stiff, weak and lack of strength, can not stand body weight. Liver pulse very fast shows the patient emotion easy to angry and speak bad words; liver pulse slightly fast shows the patient liver Qi stagnation on the ribs area swell like cup big. Liver pulse very slow shows the patient easy vomit; liver pulse slightly slow shows the patient body liquid stasis on the chest and ribs area and difficult urination, body liquid mass illness. Liver pulse very strong shows the patient has tumor disease and often vomit and nose bleeding; liver pulse slightly strong shows the patient has liver impediment, genital shrink and cough cause lower abdomen pain. Liver pulse very weak shows the patient has blood deficiency and feel very thirsty want drink lot of water and upper jiao diabetes; pulse slightly weak shows the patient easy hungry and middle jiao diabetes. Liver pulse very slippery shows the patient genital swell has hernia; liver pulse slightly slippery shows the patient has enuresis. Liver pulse very hesitant shows the patient has water edema at limbs and subcutaneous fluid retention; liver pulse slightly hesitant shows the patient has tendons cramp not sooth and tendons impediment. Spleen pulse very fast shows the patient has limbs cold syndromes; spleen pulse slightly fast shows the patient easy vomit during eat food even can not swallow food, and cold diarrhea. Spleen pulse very slow shows patient limbs cold stiff and weak without power; spleen pulse slightly slow shows the patient has wind atrophy-flaccidity, limbs can not move, because the wind Qi is on the meridians not on the internal organ of heart, so the patient’s mind is clear like normal. Spleen pulse very strong shows the patient suddenly fall down sick; spleen pulse slightly strong shows the patient has Qi stasis in spleen, or blood mass inside abdomen, outside the intestine and stomach. Spleen pulse very weak shows the patient has cold or heat illness; spleen pulse slightly weak shows the patient internal heat diabetes. Spleen pulse very slippery shows the patient genital swell, fatigue and hernia; spleen pulse slightly slippery shows the patient has malnutrition due consumption or parasite in intestines cause heat inside abdomen. Spleen pulse very hesitant shows the patient has anal prolapse; spleen pulse slightly hesitant shows the patient has bleeding in bowel movement. Kidney pulse very fast shows the sick Qi deep inside patient’s bone and has bone atrophy-flaccidity; kidney pulse slightly fast shows the patient has kidney meridian cold Qi up-rushing, leg can not bend, bowel movement and urination not go through. Kidney pulse very slow shows the patient has break spine pain; kidney pulse slightly slow shows the patient has spleen kidney yang deficiency and diarrhea, undigested food in stools and vomit food during swallowing. Kidney pulse very strong shows the patient has genital flaccid without power; kidney pulse slightly strong shows the patient has fluid mass disease, water stasis in abdomen, from belly button down to lower abdomen, and up to stomach epigastric swell hard like stone, this is dead syndromes, can not be treated. Kidney pulse very weak shows the patient kidney yang deficiency diarrhea; kidney pulse slightly weak shows the patient has lower jiao diabetes. Kidney pulse very slippery shows the patient urination not smooth or genital hernia; kidney pulse slightly slippery shows the patient has bone atrophy, can not stand up from sitting, stand up will blurred vision. Kidney pulse very hesitant shows the patient has Qi and blood stasis with big abscess on body; kidney pulse slightly hesitant shows the patient Qi and blood stagnation, patient will menstruation stop, or internal hemorrhoids.

Huang Di said: what is the needling way for the six sick pulse different condition?

Qi Bo said: mostly pulse cramp fast means cold Qi attack body, mostly the pulse floating slow means heat Qi attack body; mostly pulse strong means Qi excess and blood deficiency; mostly pulse weak means Qi and blood deficiency; mostly pulse slippery means yang excess heat; mostly pulse hesitant means Qi stagnation with blood deficiency, and slightly cold Qi inside body. Hence, during the needling, for cramp fast pulse need deep needling, and long time retaining of needle to born yang Qi. For floating slow pulse need shallow needling and fast pull out needle to sedate heat Qi. For strong pulse need slightly sedate way to needling to slightly sedate the Qi but should not bleeding to balance Qi and blood. For slippery pulse need shallow needling and fast pull out needle way, to sedate the strong yang Qi and heat energy. For hesitant pulse is very difficult “De Qi” during needling, so need focus on the meridian to needling and based on the syndromes favorable or deterioration to long time retaining needle and massage the local muscle to sooth the local wei Qi, pull out needle then cover the hole to balance and mix the Qi and blood. For weak pulse should not needling during Qi and blood deficiency condition, just use sweet herbs to tonify body.

Huang Di said: I heard the Qi of five Zang and six Fu all come from Jing well points, and pass through Ying spring point and Shu stream point final go to He sea point, I want to know how the meridians lead the Qi and blood go into internal organs? and what organs they connect to?

Qi Bo said: for example, the yang ming meridians’ branches connect to internal organs, belong to Fu.

Huang Di said: Ying spring points and Shu stream points with He sea points have different way in treatment?

Qi Bo answered: Ying spring and Shu stream points is for external meridians illness conditions treatments. He sea points is for internal Fu illness conditions treatments.

Huang Di said: How to treat the internal Fu illness?

Qi Bo said: use He sea points to treat the internal Fu illness.

Huang Di said: are there any different names for the He sea points?

Qi Bo answered: stomach He sea point is St36, Large intestine He sea point is St37, Small intestine He sea point is St39, San Jiao He sea point is Ub39, Urination bladder He sea point is Ub40, Gall bladder He sea point is Gb34.

Huang Di said: how to needling them?

Qi Bo answered: to needling the St36, the patient should lower down legs and flat feet. To needling the St37, 39, the patient should lift higher feet. To needling the Ub39, the patient should during bend and straight the legs movement to find out the points. To needling the Ub40 should bend the knee to needling. To needling the Gb34, the patient should sit down flat knee to find out the point. For external meridians illness of Ying spring and Shu stream points, should stretch the limbs to find out the points.

Huang Di said: I want listen you talk about six Fu illness conditions.

Qi Bo answered: if the patient feel heat on face, means foot yang ming stomach illness; if the patient has blue color stagnant on Thenar location, means hand yang ming large intestine illness; if the patient has hard or sink down condition on feet St42 pulse area, means feet yang ming stomach illness; The large intestine illness mostly pain at abdomen intestine area, and borborygmus like water movements, if in the winter weather patient get cold energy will diarrhea and belly button pain, can not stand up for long time, in digesting system, the stomach is connect to the large intestine, so to treat the large intestine illness must use St37. The stomach illness will distending pain at abdomen, pain at epigastric and even pain hypochondriac, diaphragm and throat be blocked not smooth through, difficult to swallow food down, use St36 for treatment. The small intestine illness will pain at lower abdomen, also pain connect to lower back spine and genital, patient has the feeling want go urine and stool, also has the Si meridian heat or cold at front of ear, or shoulder very heat, or very heat between small finger and index finger, or the Si meridian deficiency sink down on the skin, those syndromes all are small intestine illness, use St39 for treatment. Sanjiao illness, the abdomen will distending swelling, lower abdomen more swell hard, patient can not urine feel impatient, so the water stay under skin become edema, water stay in abdomen become distending swelling, the Sanjiao illness is on the foot Tai Yang big luo meridian which is between foot Tai Yang and Shao Yang meridians, the color in this area shows redness, use Ub39 for treatment. Urine Bladder illness, the lower abdomen distention pain, use hand press it, the patient will has urine feeling but can not make out, the Ub channel on shoulder area will heat and deficiency sink down on skin, the Ub channel on legs and feet area all feel heat and deficiency sink down on skin, use Ub40 for treatment. Gall bladder illness patient, often sighing, bitter taste in mouth, vomit bitter juice from mouth, heart beat fast like scare to be caught by someone, throat seems be blocked by something always want spit it out of mouth, patient’s Gb channel deficiency sink down on skin, it can use moxa to treatment, needling for cold or heat syndrome, use Gb34 for treatment.

Huang Di asked: are there any rules for needling those points?

Qi Bo said: to needling those points must needling the points’ Qi, should not needling the muscle, because needling the Qi which is the points space can sooth meridian Qi, if mistake needling on the muscle will hurt the muscle, the patient only feel pain on skin and can not make any treatment effective. And the the tonify and sedate ways should use in correct ways, if deficiency use sedate way, excess use tonify way, because deficiency should tonify, excess should sedate, so the wrong way will make illness more heavy. If mistake needling on the tendons and tendons become weak without power, the sick Qi can not be push out of body, so the body Qi will fighting with the sick Qi into a more complicated condition, this will effect body normal Qi movements, even can make the illness Qi sink down more deep in body and stay inside body, the illness will more serious develop on body. These are mistake needling ways cause bad affections.

邪 氣 藏 府 病 形 第 四

    黃 帝 問 於 岐 伯 曰 : 邪 氣 之 中 人 也 奈 何 ? 岐 伯 答 曰 :邪 氣 之 中 人 高 也 。

    黃 帝 曰 : 高 下 有 度 乎 ? 岐 伯 曰 : 身 半 以 上 者 , 邪中 之 也 。 身 半 已 下 者 , 濕 中 之 也 。 故 曰 : 邪 之 中 人 也 。無 有 常 , 中 於 陰 則 溜 於 腑 , 中 於 陽 則 溜 於 經 。

    黃 帝 曰 : 陰 之 與 陽 也 , 異 名 同 類 , 上 下 相 會 , 經絡 之 相 貫 , 如 環 無 端 。 邪 之 中 人 , 或 中 於 陰 , 或 中 於 陽, 上 下 左 右 , 無 有 恆 常 , 其 故 何 也 ?

    岐 伯 曰 : 諸 陽 之 會 , 皆 在 於 面 。 中 人 也 , 方 乘 虛時 及 新 用 力 , 若 飲 食 汗 出 , 腠 理 開 而 中 於 邪 。 中 於 面 ,則 下 陽 明 。 中 於 項 , 則 下 太 陽 。 中 於 頰 , 則 下 少 陽 。 其中 於 膺 背 兩 脅 , 亦 中 其 經 。

    黃 帝 曰 : 其 中 於 陰 , 奈 何 ? 岐 伯 答 曰 : 中 於 陰 者, 常 從 臂 胻 始 。 夫 臂 與 胻 , 其 陰 皮 薄 , 其 肉 淖 澤 , 故 俱受 於 風 , 獨 傷 其 陰 。

    黃 帝 曰 : 此 故 傷 其 藏 乎 ? 岐 伯 答 曰 : 身 之 中 於 風也 , 不 必 動 藏 。 故 邪 入 於 陰 經 , 則 其 藏 氣 實 , 邪 氣 入 而不 能 客 , 故 還 之 於 腑 。 故 中 陽 則 溜 於 經 , 中 陰 則 溜 於 府。

    黃 帝 曰 : 邪 之 中 人 臟 奈 何 ? 岐 伯 曰 : 愁 憂 恐 懼 則傷 心 。 形 寒 寒 飲 則 傷 肺 , 以 其 兩 寒 相 感 , 中 外 皆 傷 , 故氣 逆 而 上 行 。 有 所 墮 墜 , 惡 血 留 內 ; 若 有 所 大 怒 , 氣 上而 不 下 , 積 於 脅 下 , 則 傷 肝 。 有 所 擊 仆 , 若 醉 入 房 , 汗出 當 風 , 則 傷 脾 。 有 所 用 力 舉 重 , 若 入 房 過 度 , 汗 出 浴水 , 則 傷 腎 。

    黃 帝 曰 : 五 臟 之 中 風 , 奈 何 ? 岐 伯 曰 : 陰 陽 俱 感, 邪 乃 得 往 。 黃 帝 曰 : 善 哉 。

    黃 帝 問 於 岐 伯 曰 : 首 面 與 身 形 也 , 屬 骨 連 筋 , 同血 合 於 氣 耳 。 天 寒 則 裂 地 凌 冰 , 其 卒 寒 , 或 手 足 懈 ● ,然 而 其 面 不 衣 , 何 也 ? 岐 伯 答 曰 : 十 二 經 脈 , 三 百 六 十五 絡 , 其 血 氣 皆 上 於 面 而 走 空 竅 。 其 精 陽 氣 上 走 於 目 而為 睛 。 其 別 氣 走 於 耳 而 為 聽 。 其 宗 氣 上 出 於 鼻 而 為 臭 。其 濁 氣 出 於 胃 , 走 唇 舌 而 為 味 。 其 氣 之 津 液 , 皆 上 熏 於面 , 而 皮 又 厚 , 其 肉 堅 , 故 天 氣 甚 寒 , 不 能 勝 之 也 。

    黃 帝 曰 : 邪 之 中 人 , 其 病 形 何 如 ? 岐 伯 曰 : 虛 邪之 中 身 也 , 洒 淅 動 形 。 正 邪 之 中 人 也 , 微 , 先 見 於 色 ,不 知 於 身 , 若 有 若 無 , 若 亡 若 存 , 有 形 無 形 , 莫 知 其 情。 黃 帝 曰 : 善 哉 。

    黃 帝 問 於 岐 伯 曰 : 余 聞 之 , 見 其 色 , 知 其 病 , 命曰 明 。 按 其 脈 , 知 其 病 , 命 曰 神 。 問 其 病 , 知 其 處 , 命曰 工 。 余 願 聞 見 而 知 之 , 按 而 得 之 , 問 而 極 之 , 為 之 奈何 ?

    岐 伯 答 曰 : 夫 色 脈 與 尺 之 相 應 也 , 如 桴 鼓 影 響 之相 應 也 , 不 得 相 失 也 , 此 亦 本 末 根 葉 之 出 候 也 , 故 根 死則 葉 枯 矣 。 色 脈 形 肉 , 不 得 相 失 也 。 故 知 一 則 為 工 , 知二 則 為 神 , 知 三 則 神 且 明 矣 。

    黃 帝 曰 : 願 卒 聞 之 。 岐 伯 答 曰 : 色 青 者 , 其 脈 弦也 , 赤 者 , 其 脈 鉤 也 , 黃 者 , 其 脈 代 也 , 白 者 , 其 脈 毛, 黑 者 , 其 脈 石 。 見 其 色 而 不 得 其 脈 , 反 得 其 相 勝 之 脈, 則 死 矣 ; 得 其 相 生 之 脈 , 則 病 已 矣 。

    黃 帝 問 於 岐 伯 曰 : 五 臟 之 所 生 , 變 化 之 病 形 何 如?

    岐 伯 答 曰 : 先 定 其 五 色 五 脈 之 應 , 其 病 乃 可 別 也。

    黃 帝 曰 : 色 脈 已 定 , 別 之 奈 何 ?

    岐 伯 說 : 調 其 脈 之 緩 、 急 、 小 、 大 、 滑 、 澀 , 而病 變 定 矣 。

    黃 帝 曰 : 調 之 奈 何 ? 岐 伯 答 曰 : 脈 急 者 , 尺 之 皮膚 亦 急 ; 脈 緩 者 , 尺 之 膚 亦 緩 ; 脈 小 者 , 尺 之 皮 膚 亦 減而 少 氣 ; 脈 大 者 , 尺 之 皮 膚 亦 賁 而 起 ; 脈 滑 者 , 尺 之 皮膚 亦 滑 ; 脈 澀 者 , 尺 之 皮 膚 亦 澀 。 凡 此 變 者 , 有 微 有 甚。 故 善 調 尺 者 , 不 待 於 寸 , 善 調 脈 者 , 不 待 於 色 。 能 參合 而 行 之 者 , 可 以 為 上 工 , 上 工 十 全 九 。 行 二 者 , 為 中工 , 中 工 十 全 七 。 行 一 者 , 為 下 工 , 下 工 十 全 六 。

    黃 帝 曰 : 請 問 脈 之 緩 、 急 , 小 、 大 , 滑 、 澀 之 病形 何 如 ?

    岐 伯 曰 : 臣 請 言 五 藏 之 病 變 也 。 心 脈 急 甚 者 為 瘈瘲 ; 徵 急 , 為 心 痛 引 背 , 食 不 下 。 緩 甚 , 為 狂 笑 ; 微 緩, 為 伏 梁 , 在 心 下 , 上 下 行 , 時 唾 血 。 大 甚 , 為 喉 吤 ;微 大 , 為 心 痺 引 背 , 善 淚 出 。 小 甚 為 善 噦 ; 微 小 為 消 病。 滑 甚 為 善 渴 ; 微 滑 為 心 疝 , 引 臍 , 小 腹 鳴 。 澀 為 為 瘖; 微 澀 為 血 溢 , 維 厥 耳 鳴 , 顛 疾 。

    肺 脈 急 甚 , 為 癲 疾 ; 微 急 , 為 肺 寒 熱 , 怠 惰 , 咳唾 血 , 引 腰 背 胸 , 若 鼻 息 肉 不 通 。 緩 甚 , 為 多 汗 ; 微 緩, 為 痿 , 痿 , 偏 風 , 頭 以 下 汗 出 不 可 止 。 大 甚 , 為 脛 腫; 微 大 , 為 肺 痺 , 引 胸 背 , 起 惡 見 日 光 。 小 甚 , 為 泄 ;微 小 , 為 消 痺 。 滑 甚 , 為 息 賁 上 氣 ; 微 滑 , 為 上 下 出 血。 澀 甚 , 為 嘔 血 ; 微 澀 , 為 鼠 瘘 , 在 頸 支 腋 之 間 , 下 不勝 其 上 , 其 應 善 痠 矣 。

    肝 脈 急 甚 者 為 惡 言 ; 微 急 為 肥 氣 在 脅 下 , 若 復 杯。 緩 甚 為 善 嘔 , 微 緩 為 水 瘕 痺 也 。 大 甚 為 內 癰 , 善 嘔 衄; 微 大 為 肝 痺 , 陰 縮 , 咳 引 小 腹 。 小 甚 為 多 飲 ; 微 小 為消 癉 。 滑 甚 為 ● 疝 ; 微 滑 為 遺 溺 。 澀 甚 為 溢 飲 ; 微 澀 為瘈 攣 筋 痺 。

    脾 脈 急 甚 為 瘈 瘲 ; 微 急 為 膈 中 , 食 飲 入 而 還 出 ,後 沃 沫 。 緩 甚 為 痿 厥 ; 微 緩 為 風 痿 , 四 肢 不 用 , 心 慧 然若 無 病 。 大 甚 為 擊 仆 ; 微 大 為 疝 氣 , 腹 裏 大 膿 血 在 腸 胃之 外 。 小 甚 為 寒 熱 ; 微 小 為 消 癉 。 滑 甚 為 ● 癃 ; 微 滑 為蟲 毒 ● 蝎 腹 熱 。 澀 甚 為 腸 ● ; 微 澀 為 內 溃 , 多 下 膿 血 。

    腎 脈 急 甚 為 骨 癲 疾 ; 微 急 為 沉 厥 奔 豚 , 足 不 收 ,不 得 前 後 。 緩 甚 為 折 脊 ; 微 緩 為 洞 , 洞 者 , 食 不 化 , 下嗌 逐 出 。 大 甚 為 陰 痿 ; 微 大 為 石 水 , 起 臍 已 下 至 小 腹 睡睡 然 , 上 至 胃 脘 , 死 不 治 。 小 甚 為 洞 泄 ; 微 小 為 消 癉 。滑 甚 為 癃 ● ; 微 滑 為 骨 痿 , 坐 不 能 起 , 起 則 目 無 所 見 。澀 甚 為 大 癰 ; 微 澀 為 不 月 , 沉 痔 。

    黃 帝 曰 : 病 之 六 變 者 , 刺 之 奈 何 ? 岐 伯 曰 : 諸 急者 多 寒 ; 緩 者 多 熱 ; 大 者 多 氣 少 血 ; 小 者 血 氣 皆 少 ; 滑者 陽 氣 盛 , 微 有 熱 ; 澀 者 多 血 、 少 氣 , 微 有 寒 。 是 故 刺急 者 , 深 內 而 久 留 之 ; 刺 緩 者 , 淺 內 而 疾 發 針 , 以 去 其熱 ; 刺 大 者 , 微 瀉 其 氣 , 無 出 其 血 ; 刺 滑 者 , 疾 發 針 而淺 內 之 , 以 瀉 其 陽 氣 而 去 其 熱 ; 刺 澀 者 , 必 中 其 脈 , 隨其 逆 順 而 久 留 之 , 必 先 按 而 循 之 , 已 發 針 , 已 按 其 疝 ,無 令 其 血 出 , 以 和 其 脈 ; 諸 小 者 , 陰 陽 形 氣 俱 不 足 , 勿取 以 針 而 調 以 甘 藥 也 。

    黃 帝 曰 : 余 聞 五 臟 六 府 之 氣 , 滎 、 俞 所 入 為 合 ,令 何 道 從 入 , 入 安 連 過 , 願 聞 其 故 。 岐 伯 答 曰 : 此 陽 脈之 別 入 於 內 , 屬 於 府 者 也 。

    黃 帝 曰 : 滎 俞 與 合 , 各 有 名 乎 ? 岐 伯 曰 : 滎 俞 治外 經 , 合 治 內 府 。

    黃 帝 曰 : 治 內 府 奈 何 ? 岐 伯 曰 : 取 之 於 合 。

    黃 帝 曰 : 合 各 有 名 乎 ? 岐 伯 答 曰 : 胃 合 於 三 里 ,大 腸 合 入 於 巨 虛 上 廉 , 小 腸 合 入 於 巨 虛 下 廉 , 三 焦 合 入於 委 陽 , 膀 胱 合 入 於 委 中 央 , 膽 合 入 於 陽 陵 泉 。

    黃 帝 曰 : 取 之 奈 何 ? 岐 伯 答 曰 : 取 之 三 里 者 , 低跗 取 之 ; 巨 虛 者 , 舉 足 取 之 ; 委 陽 者 , 屈 伸 而 索 之 ; 委中 者 , 屈 而 取 之 ; 陽 陵 泉 者 , 正 豎 膝 予 之 齊 下 , 至 委 陽之 陽 取 之 ; 取 諸 外 經 者 , 揄 申 而 從 之 。

    黃 帝 曰 : 願 聞 六 府 之 病 。 岐 伯 答 曰 : 面 熱 者 足 陽明 病 , 魚 絡 血 者 手 陽 明 病 , 兩 跗 之 上 脈 豎 陷 者 , 足 陽 明病 , 此 胃 脈 也 。

    大 腸 病 者 , 腸 中 切 痛 , 而 鳴 濯 濯 。 冬 日 重 感 於 寒即 泄 , 當 臍 而 痛 , 不 能 久 立 , 與 胃 同 候 , 取 巨 虛 上 廉 。

    胃 病 者 , 腹 (月真) 脹 , 胃 脘 當 心 而 痛 , 上 肢 兩 脅 , 膈咽 不 通 , 食 飲 不 下 , 取 之 三 里 也 。

    小 腸 病 者 , 小 腹 痛 , 腰 脊 控 睪 而 痛 , 時 窘 之 後 ,當 耳 前 熱 , 若 寒 甚 , 若 獨 肩 上 熱 甚 , 及 手 小 指 次 指 之 間熱 , 若 脈 陷 者 , 此 其 候 也 。 手 太 陽 病 也 , 取 之 巨 虛 下 廉。

    三 焦 病 者 , 腹 氣 滿 , 小 腹 尤 堅 , 不 得 小 便 , 窘 急, 溢 則 水 留 , 即 為 脹 。 候 在 足 太 陽 之 外 大 絡 , 大 絡 在 太陽 少 陽 之 間 , 亦 見 於 脈 , 取 委 陽 。

    膀 胱 病 者 , 小 腹 偏 腫 而 痛 , 以 手 按 之 , 即 欲 小 便而 不 得 , 肩 上 熱 , 若 脈 陷 , 及 足 小 趾 外 廉 及 脛 踝 後 皆 熱, 若 脈 陷 , 取 委 中 央 。

    膽 病 者 , 善 太 息 , 口 苦 , 嘔 宿 汁 , 心 下 淡 淡 , 恐人 將 捕 之 , 嗌 中 吤 吤 然 數 唾 。 在 足 少 陽 之 本 末 , 亦 視 其脈 之 陷 下 者 灸 之 ; 其 寒 熱 者 取 陽 陵 泉 。

    黃 帝 曰 : 刺 之 有 道 乎 ? 岐 伯 答 曰 : 刺 此 者 , 必 中氣 穴 , 無 中 肉 節 。 中 氣 穴 , 則 針 游 於 巷 ; 中 肉 節 , 即 皮膚 痛 ; 補 瀉 反 , 則 病 益 篤 。 中 筋 則 筋 緩 , 邪 氣 不 出 , 與其 真 相 搏 亂 而 不 去 , 反 還 內 著 。 用 針 不 審 , 以 順 為 逆 也。


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