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医理真传

Yi Li Zhen Chuan

原著       ·  郑钦安

Author; Zhen Qin-An (Qing dynasty, China)

 

太阴经证解

The significance of the Taiyin meridian/stage

按太阴一经,以湿为本(太阴之上,湿气主之,故也),阳明为中气(胃与脾为表里),太阴为标(主外,是本经之标、本、中三气也)。有经症,有五饮症,有着痹、行痹症,有阳黄、阴黄症(本经恒有之病),不可不知也。

The Taiyin meridian/stage dominates the Wetness (The Wetness Qi dominates the Taiyin). Yangming is its middle Qi (the Stomach and the Spleen is the surface and inside couple relationship. The Stomach belongs to the Yangming). Taiyin is its surface layer. The disease can be in its meridian layer. There is also the Five-Water condition, moving Bi syndrome, zhe Bi syndrome, Yin jaundice syndrome and Yang jaundice syndrome too.

(以下承接少阳经)如少阳之邪未罢,势必传入太阴,则治太阴,必兼治少阳。若全不见少阳之经腑证,则专治太阴,方为合法。

If the disease in the Shaoyang is not solved, it will move into the Taiyin. In this case, the Taiyin and the Shaoyang should be treated the same time. If there is only the evidence for the Taiyin, only treat the disease in the Taiyin.

经症者何?腹满而吐,食不下,时腹自痛,自利益甚,手足自温是也。夫太阴主湿而恶湿(太阴为阴经,与阳经有别。寒邪由太阳、阳明、少阳,此际寒邪全化为热,并无寒邪之形,即有寒者,皆由太阳误下,而寒陷于内者有之。务要知得少阳火邪,传至太阴,即从太阴湿而化为湿邪,为传经病机主脑),少阳之热邪入而附之,即从湿化,湿气太甚,阻滞中脘。邪乘于上,则腹满而吐;邪乘于下,则腹痛自利。四肢察气于胃,邪犯脾未犯胃,故虽有吐利,而手足尚温也。主以理中汤,直守其中,上下自定,乃握要之道也。若桂枝倍芍药汤,是太阳经症误下,而寒邪陷入太阴之内也(三阴症,原不在发汗之例,不应用桂枝。若此方而用桂枝者,仍是复还太阳之表也,须知)。

What is the disease in the meridian/stage of the Taiyin? The patient has fullness in the abdomen, hard to eat the food, pain in the abdomen from time to time, self-diarrhea, but the hands and feet is warm. The Taiyin dominates the Wetness but also hates the Wetness (the Taiyin belongs to the Yin meridian/stage/layer. It is different from the Yang meridians. The Cold Xie Qi, through the Taiyang, the Yangming, and the Shaoyang, transforms into the hot. Upon in the Taiyin stage, it will follow the dominating Wetness Qi in the Taiyin as a Wetness Qi.). The Wetness Qi is overwhelming in the middle abdomen, block the Qi movement to cuase the fullness and vomiting. The Xie Qi moves down, to cause abdomen pain and diarrhea. The extreme of the body reflects the Stomach Qi, but not the Spleen Qi. The Xie Qi attacks the Spleen Qi, but not the Stomach Qi, so the hands and feet are still warm. In such condition, the herb formula needed is the Lizhong Tang. If the condition is due to the improper treatment of a Taiyang stage with over-sweat therapy, which makes the Xie Qi shrinks down to the Taiyin stage, the herb Guizhi Tang with double the amount of Shaoyao will be needed. (When in the three Yin stages, the sweat therapy is not recommended in principle. In this condition, when the Guizhi Tang is used, it is to bring and to transport the Xie Qi back to the surface Taiyang).

至于五饮症者何?夫饮者,水之别名也,即以一水字括之,不必另分名目。名目愈多,旨归即晦,学者更无从下手,故仲景列于太阴。太阴主湿,湿即水也(本经是水,复得外来之客水),水盛则土衰,土衰即不能制水,以致寒水泛溢,或流于左,或流于右,或犯心下,或直下趋,或化为痰,种种不一,故有五饮之说焉。经云:"脾无湿不生痰。"即此一语,便得治五饮之提纲也。治法总不外健脾、温中、除湿、行水、燥脾为主,因其势,随其机而导之利之,即得步步立法之道也。

What is the Five-Water condition? The Water here is listed by Master Zhang Zhongjing in the Taiyin stage. The Taiyin dominates the wetness, and the Wetness is kind of Water. If the Water is overwhelming, it will damage, depress, suppress the Soil. The Soil is weak, it can not control, to prevent, to buffer the Water, so that the Cold-Water flood over, to flow to the left, or to the right side, to the heart, or to the bladder or to the large intestine, or transform and to condensed into phlegm, with largely various transforms. For this reason, it is called Five-Water. The medical bible, the <<Huang Di Nei Jing>> said: “If there is no the Wetness in the Spleen, the Spleen will not produce phlegm”. This implies the treatment principle for the water.  

所谓着痹行痹者何?夫痹者,不通之谓也。经云:"风寒湿三气,合而为痹。"风胜为行痹,寒胜为着痹(行痹流走作痛,着痹痛在一处),风为阳而主动,风行而寒湿随之,故流走作痛;寒为阴而主静,寒停不行,风湿附之,故痛处有定。风寒湿三气,闭寒经络,往往从本经中气化为热邪,热盛则阴亏而火旺,湿热薰蒸,结于经隧,往往赤热肿痛,手不可近,法宜清热润燥。

What’s the Wind Bi syndrome? The Bi here in Chinese means not go-through or blockage syndrome.[1] The medical bible said: “The Wind, the Cold and the Wetness, all three come together to cause the Bi syndrome.” If the Wind is overwhelming, the Bi is the Wind Bi. If the Cold is overwhelming in the Bi syndrome, it is the heavy Bi syndrome (In the Wind Bi syndrome, the pain moving from place to place. In the Cold Bi, the pain localized in one place). The Wind belongs to Yang Xie, which dominates moving. When the Wind is moving, the Cold and the Wetness follows, so that the pain is moving too. The Cold belongs to the Yin Xie, dominates stay quiet. If the Cold Xie is overwhelming, the Cold stays in a local area, the Wind and the Wetness have to attach to it, so that the painful area is fixed to a fixed area. The Wind, the Cold and the Wetness, the three Xie Qi can block the energy flow in the meridian. It usually follows the middle Qi of the Taiyin (e.g. follow the Stomach Qi) and turns to the Hot Xie. When the Hot is overwhelming, it will burns down the Yin, causing the steam of the Hot and Wetness. The steam blocks in the meridian, so as to cause the affected area hot, swelling and pain. The painful area tends not be touched. For the treatment, it is needed to clear the Fire and wet the Dry.

若忽突起,不赤不痛,则为溢饮所致,又当温中除湿,不可不知也。

If the swelling mass comes soon, no red color on its surface and not pain either, it is Spilling Water. The principle for the treatment is to warm the middle and clear the Wetness.

所谓阳黄阴黄者何?夫黄者,土之色也,今为湿热蒸动,土象外呈,故周身皮肤尽黄。阳者,邪从中化(中者,胃也。少阳之热,不从太阴之湿化,而从中化,胃火与湿合,薰蒸而色黄);阴者,邪从湿化。阳主有余,阴主不足,阳者主以茵陈五苓散,阴者主以附子理中汤加茵陈。立法总在湿热、阴阳二字分途,外验看病人之有神无神、脉之有力无力、声之微厉,则二症之盛衰立决矣。

What is the Yang jaundice and the Yin jaundice? The yellow is the color of the Soil. The steam of the Hot and Wetness in the Soil, and the Soil color shows in the skin, so the body skin shows yellow in color. For the Yang jaundice, the Xie Qi transforms following the middle Qi (the middle Qi means the Stomach Qi. The Hot of the Shaoyang does not transform to the Taiyin Wetness, but to the Stomach Hot. The Hot and the Wetness mixes up and steams to cause the jaundice. For the Yin jaundice, the Xie Qi transforms into the Wetness mostly. For the Yang jaundice, the herb Yinchen Wuling San is needed to be used. For the Yin jaundice, the herb Fuzi Lizhong Tang jia Yinchen should be used. The herbal formula is set according to the amount of the Hot or the Wetness, the Yin or the Yang. Furthermore, it is also needed to be considered the patient’s Shen, the strength of the pulse, the loud or weak of the voice, to determine the overwhelming or the weakness status of the condition.

附解:夫人身立命,全赖这一团真气流行于六步耳(真气乃人立命之根,先天种子也,如天日之流行,起于子宫。子为一,乃数之首也。六步即三阳经、三阴经也)。以六步合而观之,即乾坤两卦也(三阳即乾卦,三阴即坤卦)。真气初生,行于太阳经,五日而一阳气足(五日为一候,又为一元),真气行于阳明经,又五日而二阳气足(此际真气渐甚),真气行于少阳经,又五日而三阳气足(合之三五得十五日,阳气盈,月亦圆满。月本无光,借日之光以为光,三阳气足,故月亦圆也),此际真气旺极,极则生一阴,真气行于太阴经,五日而真气衰一分,阴气便旺一分也。真气行于少阴经,又五日而真气衰二分,阴气便旺二分也。真气行于厥阴经,又五日而真气衰极,阴气旺极也(三阳十五日,三阴十五日,合之共三十日,为一月。一月为一小周天,一岁为一大周天。一日为一小候。古人积日成月,积月成岁,乃不易之至理。一岁之中,上半岁属三阳,下半岁属三阴;一月之内,上半月属三阳,下半月属三阴;一日之内,上半日属三阳,下半日属三阴。一年之气机,即在一月尽之;一月之气机,又可以一日括之。三五而盈,三五而缩,盛衰循环不已,人身气机亦然)。阴极复生一阳,真气由盛而衰,由衰而复盛,乃人身一付全龙也(人活一口气,即此真气也)。须知天地以日月往来为功用,人身以气血往来为功用(气即火也、日也,血即水也、月也)。

(This paragraph is not to be translated)

人活天地之气,天道有恒,故不朽;人心无恒,损伤真气,故病故死。

惟仲景一人,明得阴阳这点真机,指出三阴三阳界限,提纲挈领,开创渡世法门,为群生司命之主。后代注家,专在病形上论三阴三阳固是,究未领悟气机,指出所以然之故,以致后学无从下手,虽记得三阳三阴,而终莫明其妙也。余故不惮烦,特为指出。

(This paragraph is not to be translated)



[1] Only the “Bi” in Chinese may mean many different meaning. It is the pinyin (the pronounce) of the Chinese, not the characters of Chinese, e.g. the word per se in Chinese. This is why we have to indicated the pinyin “Bi” HERE means the not go-through.