魚者使人熱中,鹽者勝血,故其民皆黑色疏理,其病皆爲癰瘍,其治宜砭石。
鱼者使人热中,盐者胜血,故其民皆黑色疏理,其病皆为痈疡,其治宜砭石。
yú zhě shǐ rén rè zhōng, yán zhě shèng xuè, gù qí mín jiē hēi sè shū lǐ, qí bìng jiē wéi yōng yáng, qí zhì yí biān shí.
Fish causes heat within a person; salt gets the better of the blood. Therefore its people are all dark of complexion and loose of grain, and their illnesses are abscesses and sores. Their treatment is suited to the stone needle.
「魚者使人熱中,鹽者勝血。」王冰:「魚發瘡,則熱中之信;鹽發渴,則勝血之徵。」張志聰:「魚性屬火,故使人熱中。」按:王注別本又訓「多飲數溲,謂之熱中」,乃消渴一類,與本篇異義,讀者宜別。
麤大者,陰不足,陽有餘,爲熱中也。來疾去徐,上實下虚,爲厥巔疾;來徐去疾,上虚下實,爲惡風也。故中惡風者,陽氣受也。
粗大者,阴不足,阳有余,为热中也。来疾去徐,上实下虚,为厥巅疾;来徐去疾,上虚下实,为恶风也。故中恶风者,阳气受也。
cū dà zhě, yīn bù zú, yáng yǒu yú, wéi rè zhōng yě. lái jí qù xú, shàng shí xià xū, wéi jué diān jí; lái xú qù jí, shàng xū xià shí, wéi wù fēng yě. gù zhòng wù fēng zhě, yáng qì shòu yě.
A pulse that is coarse and large means yin insufficient and yang in excess: this is heat in the interior. If it comes swift and goes slow, the upper is replete and the lower empty, and this becomes counterflow disease of the crown. If it comes slow and goes swift, the upper is empty and the lower replete, and this is aversion to wind. Therefore one who is struck by wind aversion has yang qi receiving it.
「麤大者,陰不足,陽有餘,爲熱中也」:麤音 cū,同「粗」。與第十二篇「熱中」同條:第十二篇以熱中為一方之地勢所致之病,本篇則以脈之麤大為熱中之診——脈形粗大者陰不足而陽有餘,陽盛於內故為熱中。下文「來疾去徐,上實下虚,爲厥巔疾;來徐去疾,上虚下實,爲惡風也」亦以脈之來去之勢辨上下虛實。
尺寒脉細,謂之後泄。脉尺麤常熱者,謂之熱中。
尺寒脉细,谓之后泄。脉尺粗常热者,谓之热中。
chǐ hán mài xì, wèi zhī hòu xiè. mài chǐ cū cháng rè zhě, wèi zhī rè zhōng.
A cold cubit skin with a fine pulse indicates discharge behind, diarrhoea. A cubit skin that is coarse and constantly hot indicates heat in the centre.
「脉尺麤常熱者,謂之熱中」:麤音 cū,同「粗」。本篇熱中之診有二:一見於脈(緩而滑曰熱中),一見於尺(脉尺麤常熱者謂之熱中)。與第十二篇「熱中」、第十七篇「熱中」同條而義進:第十二篇以熱中為一方之地勢所致,第十七篇以脈之麤大為熱中,本篇則兼脈與尺膚二者言之——尺膚粗而常熱者,陽盛於內之候。
是故寒熱病者,以平旦死。熱中及熱病者,以日中死。病風者,以日夕死。病水者,以夜半死。其脉乍疏乍數,乍遲乍疾者,日乘四季死。
是故寒热病者,以平旦死。热中及热病者,以日中死。病风者,以日夕死。病水者,以夜半死。其脉乍疏乍数,乍迟乍疾者,日乘四季死。
Shì gù hán rè bìng zhě, yǐ píng dàn sǐ. Rè zhōng jí rè bìng zhě, yǐ rì zhōng sǐ. Bìng fēng zhě, yǐ rì xī sǐ. Bìng shuǐ zhě, yǐ yè bàn sǐ. Qí mài zhà shū zhà shuò, zhà chí zhà jí zhě, rì chéng sì jì sǐ.
Thus cold-heat disease kills at daybreak; internal heat and heat disease kill at noon; wind disease kills at sunset; water disease kills at midnight. One whose pulse is now scattered, now rapid, now slow, now hurried dies on a day that mounts the four quarters of the year.
「熱中及熱病者,以日中死」:本篇熱中之義,在與熱病同屬陽而同歸於日中——日中者,陽之極,陽病極於其時而死。與第十八篇「緩而滑曰熱中」「脉尺麤常熱者,謂之熱中」同條而義別:第十八篇以熱中為脈診所得之病(脈緩而滑、尺麤常熱),本篇則以熱中為陽病之一而配其死時;下文「病風者,以日夕死。病水者,以夜半死」,皆以病性配死時之一例。
帝曰:夫子數言熱中、消中,不可服高梁、芳草、石藥,石藥發瘨,芳草發狂。
帝曰:夫子数言热中、消中,不可服高梁、芳草、石药,石药发癫,芳草发狂。
Dì yuē: fū zǐ shuò yán rè zhōng, xiāo zhōng, bù kě fú gāo liáng, fāng cǎo, shí yào, shí yào fā diān, fāng cǎo fā kuáng.
The Emperor says: you have said several times, my master, that in heat-within and wasting-within one must not take rich grain, aromatic herbs or mineral drugs; mineral drugs bring on derangement, aromatic herbs bring on madness.
**「夫子數言熱中、消中,不可服高梁、芳草、石藥」**,**是全篇引子最長之一問,亦熱中、消中二名在《素問》中最關治禁之一處**。**本篇「熱中」2見、「消中」2見**,**二字連稱者二、分見者二**;「數」讀 shuò**讀 shuò**(屢也);「夫」讀 fū**「夫子」讀 fū**,**本篇「夫」5見,惟此一見讀 fū**;「言」讀 yán;「熱」讀 rè、**本篇5見**;「中」讀 zhōng**熱中、消中之「中」皆讀 zhōng**。**「皆富貴人也」五字,是本篇對熱中、消中最切之一筆**:**病由口腹,而口腹之病必富貴者得之**——**與第三十三篇「脾癉」之「數食甘美而多肥」同一病源**。**禁高梁則不合其心,禁芳草石藥則病不愈,兩難之局由此而成**。
風氣與陽明入胃,循脉而上,至目内眥,其人肥則風氣不得外泄,則爲熱中而目黄;人瘦則外泄而寒,則爲寒中而泣出。
风气与阳明入胃,循脉而上,至目内眦,其人肥则风气不得外泄,则为热中而目黄;人瘦则外泄而寒,则为寒中而泣出。
Fēng qì yǔ yáng míng rù wèi, xún mài ér shàng, zhì mù nèi zì, qí rén féi zé fēng qì bù dé wài xiè, zé wéi rè zhōng ér mù huáng; rén shòu zé wài xiè ér hán, zé wéi hán zhōng ér qì chū.
When wind qi enters the stomach together with yang brightness and follows the vessel upward to the inner canthus: if the person is fat, the wind qi cannot drain outward and there is heat in the interior with yellowing of the eyes; if the person is thin, it drains outward and there is cold, and so cold in the interior with tears.
「其人肥則風氣不得外泄,則爲熱中而目黄」——**本篇「熱中」2見**(**「或爲熱中」「則爲熱中而目黄」**),**「寒中」2見**;**肥者腠理密緻,風不得外泄,故熱中而目黄;瘦者腠理開疏,風得外泄,故寒中而泣出**——**同一風邪,異體而異病**。「黄」讀 huáng;「泣」讀 qì**「泣出」讀 qì,淚也,不讀 sè**;「泄」讀 xiè**「外泄」讀 xiè**。
所謂甚則嗌乾熱中者,陰陽相薄而熱,故嗌乾也。
所谓甚则嗌干热中者,阴阳相薄而热,故嗌干也。
Suǒ wèi shèn zé yì gān rè zhōng zhě, yīn yáng xiāng bó ér rè, gù yì gān yě.
What is called dry throat and heat in the centre in severe cases: yin and yang press against each other and heat is generated; hence the dry throat.
「「嗌」讀 yì乾「熱」讀 rè中者」——**本篇「熱中」1見**;**「嗌」讀 yì——「嗌」讀 yì,本篇2見**;「乾」讀 gān、**本篇2見**;**陰陽相薄而熱故嗌乾,此熱在中之「熱中」,非王冰別注消渴之「熱中」**。