形數驚恐,經絡不通,病生於不仁,治之以按摩醪藥。是謂五形志也。
形数惊恐,经络不通,病生于不仁,治之以按摩醪药。是谓五形志也。
Xíng shuò jīng kǒng, jīng luò bù tōng, bìng shēng yú bù rén, zhì zhī yǐ àn mó láo yào. Shì wèi wǔ xíng zhì yě.
Form given repeatedly to fright and fear: the channels and networks do not pass through, and the disease arises in insensitivity; treat it with pressing, rubbing and medicated wine. These are the five forms and wills.
本篇「經絡」一見,而不作解剖言之,乃作致病之由言之:形體屢受驚恐,則經絡不通,不通則病生於不仁。「經」為直行,「絡」為橫而相維者;《說文》以經為織(經線),以絡為絮(未漚之麻),醫家取其一縱一橫之義。本篇通例:病生於何,即治於何——病在脉者灸刺、在肉者鍼石、在筋者熨引、在咽嗌者百藥,而病在經絡者則按摩醪藥,以其不可用針藥直入,故治自外。本站第二十篇「孫絡」條(id 661)、第十六篇「經終」條(id 555)可與本條互參。
歧伯曰:夫邪去絡入於經也,舍於血脉之中,其寒温未相得,如涌波之起也,時來時去,故不常在。
歧伯曰:夫邪去络入于经也,舍于血脉之中,其寒温未相得,如涌波之起也,时来时去,故不常在。
Qí bó yuē: fú xié qù luò rù yú jīng yě, shè yú xuè mài zhī zhōng, qí hán wēn wèi xiāng dé, rú yǒng bō zhī qǐ yě, shí lái shí qù, gù bù cháng zài.
Qibo says: When an evil leaves the network vessels and enters the channels, it lodges in the midst of the blood and vessels. Its cold and its warmth have not yet come to accord, and it rises like a surging wave — now coming, now going, so it does not stay constantly in one place.
「夫邪去絡入於經也,舍於血脉之中」——邪由絡入經,是由淺入深之序,故本站經絡條於此掛引文。**「舍」讀 shè**,留舍、止息之義,不讀 shě;「絡」讀 luò;「脉」讀 mài,本篇六見,底本作脉不作「脈」;「於」讀 yú。下文「其寒温未相得,如涌波之起也,時來時去,故不常在」,正是邪在絡與經之間、往來未定之狀——與上文「經之動脉,其至也亦時隴起」同一機括。
帝曰:經絡俱實何如?何以治之?歧伯曰:經絡皆實,是寸脉急而尺緩也,皆當治之。
帝曰:经络俱实何如?何以治之?歧伯曰:经络皆实,是寸脉急而尺缓也,皆当治之。
Dì yuē: jīng luò jù shí hé rú? hé yǐ zhì zhī?Qí bó yuē: jīng luò jiē shí, shì cùn mài jí ér chǐ huǎn yě, jiē dāng zhì zhī.
The Emperor says: what if the channels and the network vessels are both replete? How is it treated? Qibo says: when channels and network vessels are both replete, the pulse at the inch is tight and the pulse at the cubit is slack. Both are to be treated.
本篇辨析虛實之部位,以經與絡為綱:經絡俱實(此節)、絡氣不足而經氣有餘(下文)、經虚而絡滿(又下文)三者對舉,為全篇最整齊之一組。經深而絡淺,故治法有「灸陰剌陽」「剌陰灸陽」之分。**「經」讀 jīng,本篇十五見**;**「絡」讀 luò,本篇十二見**,底本皆作絡,不作簡體「络」;「俱」讀 jù;「皆」讀 jiē。「是寸脉急而尺緩也」一句,**底本「脉」下有空闕一格**,疑傳寫時誤分,今連讀,已著於本篇校勘。寸主上、尺主下,寸急尺緩者陽盛於上而陰不足於下。
三陽經絡皆受其病,而未入於藏者,故可汗而已。
三阳经络皆受其病,而未入于藏者,故可汗而已。
Sān yáng jīng luò jiē shòu qí bìng, ér wèi rù yú zàng zhě, gù kě hàn ér yǐ.
When all three yang channels and network vessels have received the disease but it has not yet entered the depots, it can be resolved by sweating.
「經絡」之目於本站已立(id 767),本篇用之為汗下之分界:「三陽經絡皆受其病,而未入於藏者,故可汗而已」。「三」讀 sān;「陽」讀 yáng;**「經」讀 jīng,本篇二見**;**「絡」讀 luò,本篇六見**;「皆」讀 jiē;「受」讀 shòu;「其」讀 qí;「病」讀 bìng;「而」讀 ér;「未」讀 wèi;「入」讀 rù,本篇二見;「於」讀 yú;**「藏」讀 zàng**;「者」讀 zhě;「故」讀 gù;「可」讀 kě;「汗」讀 hàn;「已」讀 yǐ。**「未入於藏」是汗下之分界**:三陽受病而未入藏者可汗,入藏者不可汗,此即下文「未滿三日者可汗,滿三日者可泄」之義。**本篇之「經絡」與他篇異**:他篇多言經與絡之別(經為幹、絡為支),本篇則「經絡」連言,統指三陽之脉,以其所重在病之淺深(在經絡者可汗、入藏者死),而不在經與絡之分。與本站「經絡」條他篇之義可互注。
歧伯曰:風氣留其處,故常在,瘧氣隨經絡,沈以内薄,故衛氣應乃作。
歧伯曰:风气留其处,故常在,疟气随经络,沉以内薄,故卫气应乃作。
Qí bó yuē: fēng qì liú qí chù, gù cháng zài, nüè qì suí jīng luò, chén yǐ nèi bó, gù wèi qì yìng nǎi zuò.
Qi Bo says: the wind qi stays in its place, and so is constant; the malarial qi follows the channels and networks, sinking to press inward, and so it breaks out only when the defensive qi answers it.
「經絡」之目於本站已立(id 767),所收四條,本站之釋以第二十四篇「經絡不通,病生於不仁」為其要——經絡之阻。**本篇「經絡」二字惟此一見,而言其通:「瘧氣隨經絡,沈以内薄」**——**彼言經絡之不通,此言瘧氣之循經絡而行,為一阻一行**。「風」讀 fēng;「氣」讀 qì;「留」讀 liú,本篇惟此一見;「其」讀 qí;「處」讀 chǔ,本篇 2 見,不作「处」(「处」);「故」讀 gù;「常」讀 cháng;「在」讀 zài;「瘧」讀 nüè;「隨」讀 suí,本篇惟此一見,不作「随」(「随」);「經」讀 jīng,本篇 4 見,不作「经」(「经」);「絡」讀 luò,不作「络」(「络」);「沈」讀 chén,本篇惟此一見,讀 chén,**底本作「沈」不作「沉」(「沉」)**;「以」讀 yǐ;「内」讀 nèi;「薄」讀 bó;「衛」讀 wèi;「應」讀 yìng;「乃」讀 nǎi;「作」讀 zuò。**「風氣留其處,故常在;瘧氣隨經絡,沈以内薄,故衛氣應乃作」二十四字,是本篇第五答之全,亦是全篇「風與瘧之別」之定論**:**留與行二字,即常在與有休之別**——風留而不行故常在,瘧行而不留故有時。**與本站「經絡」條所收第二十四篇「形數驚恐,經絡不通」之以不通為病者,為一行一阻**:**本篇之瘧氣正賴經絡之通而後能行**,**是經絡之通亦可以為病,非獨其阻也**。
其不痛不仁者,病久入深,榮衛之行濇,經絡時疏,故不通,皮膚不營,故爲不仁。
其不痛不仁者,病久入深,荣卫之行涩,经络时疏,故不通,皮肤不营,故为不仁。
Qí bù tòng bù rén zhě, bìng jiǔ rù shēn, róng wèi zhī xíng sè, jīng luò shí shū, gù bù tōng, pí fū bù yíng, gù wéi bù rén.
The ones that are not painful but numb are long-standing and deeply entered: the movement of construction and defensive qi is rough, the channels and network vessels are at times empty, and so there is no pain; the skin is not nourished, and so there is numbness.
「經絡時疏,故不通」——**本篇「經絡」1見**;「絡」讀 luò,**本篇「絡」2見**(經絡1、絡六府1)。**榮衛之行既濇,則經絡時時空疏而氣不通**——**本篇言經絡惟此一見**。
氣因於中,陽氣衰,不能滲營其經絡,陽氣日損,陰氣獨在,故手足爲之寒也。
气因于中,阳气衰,不能渗营其经络,阳气日损,阴气独在,故手足为之寒也。
Qì yīn yú zhōng, yáng qì shuāi, bù néng shèn yíng qí jīng luò, yáng qì rì sǔn, yīn qì dú zài, gù shǒu zú wéi zhī hán yě.
The qi lodges in the centre; yang qi weakens and can no longer percolate into and nourish the conduits and network vessels. Day by day yang qi is depleted and yin qi is left alone — hence the hands and feet are cold.
「不能滲營其經絡」——**本篇「經」四見、「絡」二見,「經絡」連言惟此一見**;**下文「絡脉滿而經脉虚」,絡脉、經脉對舉,絡在外而經在内**;**「滲營」之營為動詞,滋養灌溉之義**。
凡十二經絡脉者,皮之部也。
凡十二经络脉者,皮之部也。
Fán shí èr jīng luò mài zhě, pí zhī bù yě.
All the channels and network vessels of the twelve, taken together, are the regions of the skin.
「凡十二「經」讀 jīng「絡」讀 luò脉者,皮之部也」——**本篇「經絡」1見,讀 jīng luò**;**一見,在全篇總束之句:十二經與其絡脉,即皮之部**;**同一句中「絡脉」連讀,又挂 id 1033;二目同條而分挂,猶第五十五篇「背俞」與「俞」之例:一釋十二之全,一釋分部之細**;「凡」讀 fán、**「凡」讀 fán,總括之辭,本篇1見**
歧伯曰:五藏者,故得六府與爲表裏,經絡支節,各生虚實。
歧伯曰:五藏者,故得六府与为表里,经络支节,各生虚实。
Qí bó yuē: wǔ zàng zhě, gù dé liù fǔ yǔ wéi biǎo lǐ, jīng luò zhī jié, gè shēng xū shí.
Qi Bo says: the five depots have the six palaces for their outer and inner from of old; the channels, network vessels, limbs and joints each give rise to their own deficiency and excess.
「五藏者,故得六府與爲表裏,經絡支節,各生虚實」——**「經絡」本篇2見**:**「未入於經絡也」一見(神之微,邪在毫毛而未入)**;**「經絡支節,各生虚實」一見(答十二經脉何以合於五藏)**;**「經」本篇25見、「絡」13見**;**本篇經與絡分言者多:無中其大經、冩其小絡之血、視其虚絡、視其血絡、冩其陽經、𥙷其陽絡——絡淺而經深,是其別**
長夏者,經絡皆盛,内溢肌中。
长夏者,经络皆盛,内溢肌中。
Zhǎng xià zhě, jīng luò jiē shèng, nèi yì jī zhōng.
In late summer the channels and the network vessels are both exuberant, and the overflow goes inward into the flesh.
「長夏者,經絡皆盛,内溢肌中」——**「經絡」本篇1見**;**長夏為經與絡皆盛之時,故其氣內溢於肌肉之中**;**「溢」讀 yì,「盛」讀 shèng**
火不及,夏有炳明光顯之化,則冬有嚴肅霜寒之政。夏有慘淒凝冽之勝,則不時有埃昏大雨之復。其眚南,其藏心,其病内舍膺脅,外在經絡。
火不及,夏有炳明光显之化,则冬有严肃霜寒之政。夏有惨凄凝冽之胜,则不时有埃昏大雨之复。其眚南,其藏心,其病内舍膺胁,外在经络。
Huǒ bù jí, xià yǒu bǐng míng guāng xiǎn zhī huà, zé dōng yǒu yán sù shuāng hán zhī zhèng. Xià yǒu cǎn qī níng liè zhī shèng, zé bù shí yǒu āi hūn dà yǔ zhī fù. Qí shěng nán, qí zàng xīn, qí bìng nèi shè yīng xié, wài zài jīng luò.
When fire falls short, if summer has the transformation of shining brightness and manifest light, then winter has the governance of severity, frost and cold; if summer has the prevalence of the bleak and the congealing, then out of season there comes the revenge of dust and darkness and great rain. Its calamity is in the south, its viscus is the heart, and its illness lodges within in the breast and flanks and shows without in the channels and network vessels.
「其眚南,其藏心,其病内舍膺脅,外在經絡」——**「經絡」本篇1見,止此一見**;**本篇五方之病分内外:内舍五藏之部,外在關節、經絡、肌肉四支、皮毛、谿谷踹膝,經絡其一**;**「經」讀 jīng、「絡」讀 luò**
必審問其所始病,與今之所方病,而後各切循其脉,視其經絡浮沈,以上下逆從循之。
必审问其所始病,与今之所方病,而后各切循其脉,视其经络浮沉,以上下逆从循之。
Bì shěn wèn qí suǒ shǐ bìng, yǔ jīn zhī suǒ fāng bìng, ér hòu gè qiè xún qí mài, shì qí jīng luò fú chén, yǐ shàng xià nì cóng xún zhī.
One must ask carefully about the disease as it began and about what is presently afflicting, and only then feel and follow each pulse, watching whether channels and networks are floating or sunken, and tracing them by upward and downward, by counterflow and compliance.
「視其經絡浮沈」——經與絡分言而浮與沈異候,診者循之以上下逆從;篇末「治其經絡」同此;**「經絡」本篇2見**
帝曰:其久病者,有氣從不康,病去而瘠,柰何?歧伯曰:昭乎哉,聖人之問也!化不可代,時不可違。夫經絡以通,血氣以從,復其不足,與衆齊同,養之和之,靜以待時,謹守其氣,無使傾移,其形乃彰,生氣以長,命曰聖王。故大要曰:無代化,無違時,必養必和,待其來復,此之謂也。帝曰:善。
帝曰:其久病者,有气从不康,病去而瘠,奈何?歧伯曰:昭乎哉,圣人之问也!化不可代,时不可违。夫经络以通,血气以从,复其不足,与众齐同,养之和之,静以待时,谨守其气,无使倾移,其形乃彰,生气以长,命曰圣王。故大要曰:无代化,无违时,必养必和,待其来复,此之谓也。帝曰:善。
Dì yuē: qí jiǔ bìng zhě, yǒu qì cóng bù kāng, bìng qù ér jí, nài hé? Qí bó yuē: zhāo hū zāi, shèng rén zhī wèn yě! Huà bù kě dài, shí bù kě wéi. Fú jīng luò yǐ tōng, xuè qì yǐ cóng, fù qí bù zú, yǔ zhòng qí tóng, yǎng zhī hé zhī, jìng yǐ dài shí, jǐn shǒu qí qì, wú shǐ qīng yí, qí xíng nǎi zhāng, shēng qì yǐ zhǎng, mìng yuē shèng wáng. Gù dà yào yuē: wú dài huà, wú wéi shí, bì yǎng bì hé, dài qí lái fù, cǐ zhī wèi yě. Dì yuē: shàn.
Huang Di said: of those long ill, some have the qi following yet are not at ease, and when the illness has gone they are thin — what then? Qi Bo said: how bright the sage’s question is! Transformation cannot be replaced, the season cannot be opposed. When the channels and networks are freed and blood and qi follow, restore what was lacking and make it equal to the rest; nourish it and harmonise it, wait quietly for the season, guard its qi with care and do not let it lean and shift; then the form is displayed and the qi of growth grows, and this is called the sage king. Therefore the Great Compendium says: do not replace transformation, do not oppose the season; nourish and harmonise and wait for its return. This is what it means. Huang Di said: good.
**「經絡」本篇1見,止在「夫經絡以通,血氣以從」**;**此段論久病去而瘠者,當養之和之,靜以待時**