黄帝内经 - 黄帝内经原文: https://www.huangdineijing.org/docs/ - 素问·重广补注黄帝内经素问序: https://www.huangdineijing.org/docs/su_wen/zhong-guang-bu-zhu-huang-di-nei-jing-su-wen-xu/ - 素问·上古天真论篇第一: https://www.huangdineijing.org/docs/su_wen/shang-gu-tian-zhen-lun/ - 素问·四气调神大论篇第二: https://www.huangdineijing.org/docs/su_wen/si-qi-tiao-shen-da-lun/ - 素问·生气通天论篇第三: https://www.huangdineijing.org/docs/su_wen/sheng-qi-tong-tian-lun/ - 素问·金匮真言论篇第四: https://www.huangdineijing.org/docs/su_wen/jin-kui-zhen-yan-lun/ - 素问·阴阳应象大论篇第五: https://www.huangdineijing.org/docs/su_wen/yin-yang-ying-xiang-da-lun/ - 素问·阴阳离合篇第六: https://www.huangdineijing.org/docs/su_wen/yin-yang-li-he/ - 素问·六节藏象论篇第九: https://www.huangdineijing.org/docs/su_wen/liu-jie-cang-xiang-lun/ - 素问·五藏生成篇第十: https://www.huangdineijing.org/docs/su_wen/wu-cang-sheng-cheng/ - 素问·五藏别论篇第十一: https://www.huangdineijing.org/docs/su_wen/wu-cang-bie-lun/ - 素问·异法方宜论篇第十二: https://www.huangdineijing.org/docs/su_wen/yi-fa-fang-yi-lun/ - 素问·移精变气论篇第十三: https://www.huangdineijing.org/docs/su_wen/yi-jing-bian-qi-lun/ - 素问·汤液醪醴论篇第十四: https://www.huangdineijing.org/docs/su_wen/tang-ye-lao-li-lun/ - 素问·玉版论要篇第十五: https://www.huangdineijing.org/docs/su_wen/yu-ban-lun-yao/ - 素问·脉要精微论篇第十七: https://www.huangdineijing.org/docs/su_wen/mai-yao-jing-wei-lun/ - 素问·诊要经终论篇第十六: https://www.huangdineijing.org/docs/su_wen/zhen-yao-jing-zhong-lun/ - 素问·平人气象论篇第十八: https://www.huangdineijing.org/docs/su_wen/ping-ren-qi-xiang-lun/ - 素问·玉机真藏论篇第十九: https://www.huangdineijing.org/docs/su_wen/yu-ji-zhen-cang-lun/ - 素问·三部九候论篇第二十: https://www.huangdineijing.org/docs/su_wen/san-bu-jiu-hou-lun/ - 素问·经脉别论篇第二十一: https://www.huangdineijing.org/docs/su_wen/jing-mai-bie-lun/ - 素问·藏气法时论篇第二十二: https://www.huangdineijing.org/docs/su_wen/cang-qi-fa-shi-lun/ - 素问·宣明五气篇第二十三: https://www.huangdineijing.org/docs/su_wen/xuan-ming-wu-qi/ - 素问·血气形志篇第二十四: https://www.huangdineijing.org/docs/su_wen/xue-qi-xing-zhi/ - 素问·宝命全角论篇第二十五: https://www.huangdineijing.org/docs/su_wen/bao-ming-quan-jiao-lun/ - 素问·八正神明论篇第二十六: https://www.huangdineijing.org/docs/su_wen/ba-zheng-shen-ming-lun/ - 素问·离合真邪论篇第二十七: https://www.huangdineijing.org/docs/su_wen/li-he-zhen-xie-lun/ - 素问·通评虚实论篇第二十八: https://www.huangdineijing.org/docs/su_wen/tong-ping-xu-shi-lun/ - 素问·太阴阳明论篇第二十九: https://www.huangdineijing.org/docs/su_wen/tai-yin-yang-ming-lun/ - 素问·阳明脉解篇第三十: https://www.huangdineijing.org/docs/su_wen/yang-ming-mai-jie/ - 素问·热论篇第三十一: https://www.huangdineijing.org/docs/su_wen/re-lun/ - 素问·刺热篇第三十二: https://www.huangdineijing.org/docs/su_wen/ci-re/ - 素问·评热病论篇第三十三: https://www.huangdineijing.org/docs/su_wen/ping-re-bing-lun/ - 素问·逆调论篇第三十四: https://www.huangdineijing.org/docs/su_wen/ni-tiao-lun/ - 素问·疟论篇第三十五: https://www.huangdineijing.org/docs/su_wen/nue-lun/ - 素问·刺疟篇第三十六: https://www.huangdineijing.org/docs/su_wen/ci-nue/ - 素问·气厥论篇第三十七: https://www.huangdineijing.org/docs/su_wen/qi-jue-lun/ - 素问·咳论篇第三十八: https://www.huangdineijing.org/docs/su_wen/ke-lun/ - 素问·举痛论篇第三十九: https://www.huangdineijing.org/docs/su_wen/ju-tong-lun/ - 素问·腹中论篇第四十: https://www.huangdineijing.org/docs/su_wen/fu-zhong-lun/ - 素问·刺腰痛篇第四十一: https://www.huangdineijing.org/docs/su_wen/ci-yao-tong/ - 素问·风论篇第四十二: https://www.huangdineijing.org/docs/su_wen/feng-lun/ - 素问·痹论篇第四十三: https://www.huangdineijing.org/docs/su_wen/bi-lun/ - 素问·痿论篇第四十四: https://www.huangdineijing.org/docs/su_wen/wei-lun/ - 素问·厥论篇第四十五: https://www.huangdineijing.org/docs/su_wen/jue-lun/ - 素问·病能论篇第四十六: https://www.huangdineijing.org/docs/su_wen/bing-neng-lun/ - 素问·奇病论篇第四十七: https://www.huangdineijing.org/docs/su_wen/qi-bing-lun/ - 素问·大奇论篇第四十八: https://www.huangdineijing.org/docs/su_wen/da-qi-lun/ - 素问·脉解篇第四十九: https://www.huangdineijing.org/docs/su_wen/mai-jie/ - 素问·刺要论篇第五十: https://www.huangdineijing.org/docs/su_wen/ci-yao-lun/ - 素问·刺齐论篇第五十一: https://www.huangdineijing.org/docs/su_wen/ci-qi-lun-pian/ - 素问·刺禁论篇第五十二: https://www.huangdineijing.org/docs/su_wen/ci-jin-lun-pian/ - 素问·刺志论篇第五十三: https://www.huangdineijing.org/docs/su_wen/ci-zhi-lun-pian/ - 素问·针解篇第五十四: https://www.huangdineijing.org/docs/su_wen/zhen-jie-pian/ - 素问·长刺节论篇第五十五: https://www.huangdineijing.org/docs/su_wen/zhang-ci-jie-lun-pian/ - 素问·皮部论篇第五十六: https://www.huangdineijing.org/docs/su_wen/pi-bu-lun-pian/ - 素问·经络论篇第五十七: https://www.huangdineijing.org/docs/su_wen/jing-luo-lun-pian/ - 素问·气穴论篇第五十八: https://www.huangdineijing.org/docs/su_wen/qi-xue-lun-pian/ - 素问·气府论篇第五十九: https://www.huangdineijing.org/docs/su_wen/qi-fu-lun-pian/ - 素问·骨空论篇第六十: https://www.huangdineijing.org/docs/su_wen/gu-kong-lun-pian/ - 素问·水热穴论篇第六十一: https://www.huangdineijing.org/docs/su_wen/shui-re-xue-lun-pian/ - 素问·调经论篇第六十二: https://www.huangdineijing.org/docs/su_wen/diao-jing-lun-pian/ - 素问·缪刺论篇第六十三: https://www.huangdineijing.org/docs/su_wen/miu-ci-lun-pian/ - 素问·四时刺逆从论篇第六十四: https://www.huangdineijing.org/docs/su_wen/si-shi-ci-ni-cong-lun/ - 素问·标本病传论篇第六十五: https://www.huangdineijing.org/docs/su_wen/biao-ben-bing-chuan-lun-pian/ - 素问·天元纪大论篇第六十六: https://www.huangdineijing.org/docs/su_wen/tian-yuan-ji-da-lun-pian/ - 素问·五运行大论篇第六十七: https://www.huangdineijing.org/docs/su_wen/wu-yun-xing-da-lun-pian/ - 素问·六微旨大论篇第六十八: https://www.huangdineijing.org/docs/su_wen/liu-wei-zhi-da-lun-pian/ - 素问·气交变大论篇第六十九: https://www.huangdineijing.org/docs/su_wen/qi-jiao-bian-da-lun-pian/ - 素问·五常政大论篇第七十: https://www.huangdineijing.org/docs/su_wen/wu-chang-zheng-da-lun-pian/ - 素问·六元正纪大论篇第七十一: https://www.huangdineijing.org/docs/su_wen/liu-yuan-zheng-ji-da-lun-pian/ - 素问·刺法论篇第七十二: https://www.huangdineijing.org/docs/su_wen/ci-fa-lun-pian/ - 素问·本病论篇第七十三: https://www.huangdineijing.org/docs/su_wen/ben-bing-lun-pian/ - 素问·至真要大论篇第七十四: https://www.huangdineijing.org/docs/su_wen/zhi-zhen-yao-da-lun-pian/ - 素问·着至教论篇第七十五: https://www.huangdineijing.org/docs/su_wen/zhe-zhi-jiao-lun-pian/ - 素问·示从容论第七十六: https://www.huangdineijing.org/docs/su_wen/shi-cong-rong-lun/ - 素问·疏五过论篇第七十七: https://www.huangdineijing.org/docs/su_wen/shu-wu-guo-lun/ - 素问·征四失论篇第七十八: https://www.huangdineijing.org/docs/su_wen/zheng-si-shi-lun-pian/ - 素问·阴阳类论篇第七十九: https://www.huangdineijing.org/docs/su_wen/yin-yang-lei-lun-pian/ - 素问·方盛衰论篇第八十: https://www.huangdineijing.org/docs/su_wen/fang-sheng-shuai-lun-pian/ - 素问·解精微论篇第八十一: https://www.huangdineijing.org/docs/su_wen/jie-jing-wei-lun-pian/ - 灵枢/序: https://www.huangdineijing.org/docs/ling_shu/ling-shu-xu/ - 灵枢/九针十二原第一: https://www.huangdineijing.org/docs/ling_shu/jiu-zhen-shi-er-yuan-di-yi/ - 灵枢/本输第二: https://www.huangdineijing.org/docs/ling_shu/ben-shu-di-er/ - 灵枢/小针解第三: https://www.huangdineijing.org/docs/ling_shu/xiao-zhen-jie-di-san/ - 邪气藏府病形第四: https://www.huangdineijing.org/docs/ling_shu/xie-qi-cang-fu-bing-xing-di-si/ - 灵枢/根结第五: https://www.huangdineijing.org/docs/ling_shu/gen-jie-di-wu/ - 灵枢/寿夭刚柔第六: https://www.huangdineijing.org/docs/ling_shu/shou-yao-gang-rou-di-liu/ - 灵枢/官针第七: https://www.huangdineijing.org/docs/ling_shu/guan-zhen-di-qi/ - 灵枢/本神第八: https://www.huangdineijing.org/docs/ling_shu/ben-shen-di-ba/ - 灵枢/终始第九: https://www.huangdineijing.org/docs/ling_shu/zhong-shi-di-jiu/ - 灵枢/经脉第十: https://www.huangdineijing.org/docs/ling_shu/ling-shu-di-shi/ - 灵枢/经别第十一: https://www.huangdineijing.org/docs/ling_shu/jing-bie-di-shi-yi/ - 灵枢/经水第十二: https://www.huangdineijing.org/docs/ling_shu/jing-shui-di-shi-er/ - 灵枢/经筋第十三: https://www.huangdineijing.org/docs/ling_shu/jing-jin-di-shi-san/ - 灵枢/骨度第十四: https://www.huangdineijing.org/docs/ling_shu/gu-du-di-shi-si/ - 灵枢/五十营第十五: https://www.huangdineijing.org/docs/ling_shu/wu-shi-ying-di-shi-wu/ - 灵枢/营气第十六: https://www.huangdineijing.org/docs/ling_shu/ying-qi-di-shi-liu/ - 灵枢/脉度第十七: https://www.huangdineijing.org/docs/ling_shu/mai-du-di-shi-qi/ - 灵枢/营卫生会第十八: https://www.huangdineijing.org/docs/ling_shu/ying-wei-sheng-hui-di-shi-ba/ - 灵枢/四时气第十九: https://www.huangdineijing.org/docs/ling_shu/si-shi-qi-di-shi-jiu/ - 灵枢/五邪第二十: https://www.huangdineijing.org/docs/ling_shu/wu-xie-di-er-shi/ - 灵枢/寒热病第二十一: https://www.huangdineijing.org/docs/ling_shu/han-re-bing-di-er-shi-yi/ - 灵枢/癫狂病第二十二: https://www.huangdineijing.org/docs/ling_shu/dian-kuang-bing-di-er-shi-er/ - 灵枢/热病第二十三: https://www.huangdineijing.org/docs/ling_shu/re-bing-di-er-shi-san/ - 灵枢/厥病第二十四: https://www.huangdineijing.org/docs/ling_shu/jue-bing-di-er-shi-si/ - 灵枢/病本第二十五: https://www.huangdineijing.org/docs/ling_shu/bing-ben-di-er-shi-wu/ - 灵枢/杂病第二十六: https://www.huangdineijing.org/docs/ling_shu/za-bing-di-er-shi-liu/ - 灵枢/周痹第二十七: https://www.huangdineijing.org/docs/ling_shu/zhou-bi-di-er-shi-qi/ - 灵枢/口问第二十八: https://www.huangdineijing.org/docs/ling_shu/kou-wen-di-er-shi-ba/ - 灵枢/师传第二十九: https://www.huangdineijing.org/docs/ling_shu/shi-chuan-di-er-shi-jiu/ - 灵枢/决气第三十: https://www.huangdineijing.org/docs/ling_shu/jue-qi-di-san-shi/ - 灵枢/肠胃第三十一: https://www.huangdineijing.org/docs/ling_shu/chang-wei-di-san-shi-yi/ - 灵枢/平人绝谷第三十二: https://www.huangdineijing.org/docs/ling_shu/ping-ren-jue-gu-di-san-shi-er/ - 灵枢/海论第三十三: https://www.huangdineijing.org/docs/ling_shu/hai-lun-di-san-shi-san/ - 灵枢/五乱第三十四: https://www.huangdineijing.org/docs/ling_shu/wu-luan-di-san-shi-si/ - 灵枢/胀论第三十五: https://www.huangdineijing.org/docs/ling_shu/zhang-lun-di-san-shi-wu/ - 灵枢/五癃津液别第三十六: https://www.huangdineijing.org/docs/ling_shu/wu-long-jin-ye-bie-di-san-shi-liu/ - 灵枢/五阅五使第三十七: https://www.huangdineijing.org/docs/ling_shu/wu-yue-wu-shi-di-san-shi-qi/ - 灵枢/逆顺肥瘦第三十八: https://www.huangdineijing.org/docs/ling_shu/ni-shun-fei-shou-di-san-shi-ba/ - 灵枢/血络论第三十九: https://www.huangdineijing.org/docs/ling_shu/xue-luo-lun-di-san-shi-jiu/ - 灵枢/阴阳清浊第四十: https://www.huangdineijing.org/docs/ling_shu/yin-yang-qing-zhuo-di-si-shi/ - 灵枢/阴阳系日月第四十一: https://www.huangdineijing.org/docs/ling_shu/yin-yang-xi-ri-yue-di-si-shi-yi/ - 灵枢/病传第四十二: https://www.huangdineijing.org/docs/ling_shu/bing-chuan-di-si-shi-er/ - 灵枢/淫邪发梦第四十三: https://www.huangdineijing.org/docs/ling_shu/yin-xie-fa-meng-di-si-shi-san/ - 灵枢/顺气一日分为四时第四十四: https://www.huangdineijing.org/docs/ling_shu/shun-qi-yi-ri-fen-wei-si-shi-di-si-shi-si/ - 灵枢/外揣第四十五: https://www.huangdineijing.org/docs/ling_shu/wai-chuai-di-si-shi-wu/ - 灵枢/五变第四十六: https://www.huangdineijing.org/docs/ling_shu/wu-bian-di-si-shi-liu/ - 灵枢/本藏第四十七: https://www.huangdineijing.org/docs/ling_shu/ben-cang-di-si-shi-qi/ - 灵枢/禁服第四十八: https://www.huangdineijing.org/docs/ling_shu/jin-fu-di-si-shi-ba/ - 灵枢/五色第四十九: https://www.huangdineijing.org/docs/ling_shu/wu-se-di-si-shi-jiu/ - 灵枢/论勇第五十: https://www.huangdineijing.org/docs/ling_shu/lun-yong-di-wu-shi/ - 灵枢/背腧第五十一: https://www.huangdineijing.org/docs/ling_shu/bei-shu-di-wu-shi-yi/ - 灵枢/卫气第五十二: https://www.huangdineijing.org/docs/ling_shu/wei-qi-di-wu-shi-er/ - 灵枢/论痛第五十三: https://www.huangdineijing.org/docs/ling_shu/lun-tong-di-wu-shi-san/ - 灵枢/天年第五十四: https://www.huangdineijing.org/docs/ling_shu/tian-nian-di-wu-shi-si/ - 灵枢/逆顺第五十五: https://www.huangdineijing.org/docs/ling_shu/ni-shun-di-wu-shi-wu/ - 灵枢/五味第五十六: https://www.huangdineijing.org/docs/ling_shu/wu-wei-di-wu-shi-liu/ - 灵枢/水胀第五十七: https://www.huangdineijing.org/docs/ling_shu/shui-zhang-di-wu-shi-qi/ - 灵枢/贼风第五十八: https://www.huangdineijing.org/docs/ling_shu/zei-feng-di-wu-shi-ba/ - 灵枢/卫气失常第五十九: https://www.huangdineijing.org/docs/ling_shu/wei-qi-shi-chang-di-wu-shi-jiu/ - 灵枢/玉版第六十: https://www.huangdineijing.org/docs/ling_shu/yu-ban-di-liu-shi/ - 灵枢/五禁第六十一: https://www.huangdineijing.org/docs/ling_shu/wu-jin-di-liu-shi-yi/ - 灵枢/动输第六十二: https://www.huangdineijing.org/docs/ling_shu/dong-shu-di-liu-shi-er/ - 灵枢/五味论第六十三: https://www.huangdineijing.org/docs/ling_shu/wu-wei-lun-di-liu-shi-san/ - 灵枢/阴阳二十五人第六十四: https://www.huangdineijing.org/docs/ling_shu/yin-yang-er-shi-wu-ren-di-liu-shi-si/ - 灵枢/五音五味第六十五: https://www.huangdineijing.org/docs/ling_shu/wu-yin-wu-wei-di-liu-shi-wu/ - 灵枢/百病始生第六十六: https://www.huangdineijing.org/docs/ling_shu/bai-bing-shi-sheng-di-liu-shi-liu/ - 灵枢/行针第六十七: https://www.huangdineijing.org/docs/ling_shu/hang-zhen-di-liu-shi-qi/ - 灵枢/上膈第六十八: https://www.huangdineijing.org/docs/ling_shu/shang-ge-di-liu-shi-ba/ - 灵枢/忧恚无言第六十九: https://www.huangdineijing.org/docs/ling_shu/you-hui-wu-yan-di-liu-shi-jiu/ - 灵枢/寒热第七十: https://www.huangdineijing.org/docs/ling_shu/han-re-di-qi-shi/ - 灵枢/邪客第七十一: https://www.huangdineijing.org/docs/ling_shu/xie-ke-di-qi-shi-yi/ - 灵枢/通天第七十二: https://www.huangdineijing.org/docs/ling_shu/tong-tian-di-qi-shi-er/ - 灵枢/官能第七十三: https://www.huangdineijing.org/docs/ling_shu/guan-neng-di-qi-shi-san/ - 灵枢/论疾诊尺第七十四: https://www.huangdineijing.org/docs/ling_shu/lun-ji-zhen-chi-di-qi-shi-si/ - 灵枢/刺节真邪第七十五: https://www.huangdineijing.org/docs/ling_shu/ci-jie-zhen-xie-di-qi-shi-wu/ - 灵枢/卫气行第七十六: https://www.huangdineijing.org/docs/ling_shu/wei-qi-hang-di-qi-shi-liu/ - 灵枢/九宫八风第七十七: https://www.huangdineijing.org/docs/ling_shu/jiu-gong-ba-feng-di-qi-shi-qi/ - 灵枢/九针论第七十八: https://www.huangdineijing.org/docs/ling_shu/jiu-zhen-lun-di-qi-shi-ba/ - 灵枢/岁露论第七十九: https://www.huangdineijing.org/docs/ling_shu/sui-lu-lun-di-qi-shi-jiu/ - 灵枢/大惑论第八十: https://www.huangdineijing.org/docs/ling_shu/da-huo-lun-di-ba-shi/ - 灵枢/痈疽第八十一: https://www.huangdineijing.org/docs/ling_shu/yong-ju-di-ba-shi-yi/ - 素问·灵兰秘典论篇第八: https://www.huangdineijing.org/docs/su_wen/ling-lan-mi-dian-lun/ - 素问·阴阳别论篇第七: https://www.huangdineijing.org/docs/su_wen/yin-yang-bie-lun/ # 痿论篇第四十四 黄帝问曰:五脏使人痿何也? 岐伯对曰:肺主身之皮毛,心主身之血脉,肝主身之筋膜,脾主身之肌肉,肾主身之骨髓。 故肺热叶焦,则皮毛虚弱,急薄,着则生痿躄也。 心气热,则下脉厥而上,上则下脉虚,虚则生脉痿,枢析挈,胫纵而不任地也。 肝气热,则胆泄口苦,筋膜干,筋膜干则筋急而挛,发为筋痿。 脾气热,则胃干而渴,肌肉不仁,发为肉痿。 肾气热,则腰脊不举,骨枯而髓减,发为骨痿。 帝曰:何以得之? 岐伯曰:肺者脏之长也,为心之盖也,有所失亡,所求不得,则发肺呜,呜则肺热叶焦,故曰:五脏因肺热叶焦,发为痿躄,此之谓也。 悲哀太甚,则胞络绝,胞络绝,则阳气内动,发则心下崩数溲血也。故本病曰:大经空虚,发为肌痹,传为脉痿。 思想无穷,所愿不得,意淫于外,入房太甚,宗筋弛纵,发为筋痿,及为白淫。故下经曰:筋痿者生于肝使内也。 有渐于湿,以水为事,若有所留,居处相湿,肌肉濡渍,痹而不仁,发为肉痿。故下经曰:肉痿者,得之湿地也。 有所远行劳倦,逢大热而渴,渴则阳气内伐,内伐则热合于肾,肾者水脏也;今水不胜火,则骨枯而髓虚。故足不任身,发为骨痿。故下经曰:骨痿者,生于大热也。 帝曰:何以别之? 岐伯曰:肺热者色白而毛败;心热者色赤而络脉溢;肝热者色苍而爪枯;脾热者色黄而肉蠕动;肾热者色黑而齿槁。 帝曰:如夫子言可矣。论言治痿者,独取阳明何也? 岐伯曰:阳明者五脏六腑之海,主润宗筋,宗筋主束骨而利机关也。冲脉者,经脉之海也,主渗灌溪谷,与阳明合于宗筋,阴阳?宗筋之会,合于气街,而阳明为之长,皆属于带脉,而络于督脉。故阳明虚,则宗筋纵,带脉不引,故足痿不用也。 帝曰:治之奈何? 岐伯曰:各补其荥而通其俞,调其虚实,和其逆顺,筋脉骨肉,各以其时受月,则病已矣。 帝曰:善。 ## 痿论篇第四十四注释 ①肺热叶焦:形容肺叶受热灼伤,津液损伤的一种病理状态。 ②痿躄:指四肢萎废,不能行走,包括下文的各种痿病。 ③枢折挈:枢,指关节;折,指断;挈,提举的意思;枢折挈,形容关节迟缓,不能做提举活动,像是枢轴折断不能活动的样子。 ④白淫:指男子滑精,女子带下的一类疾病。 ⑤络脉溢:指表浅部位的脉络出血。 ⑥肉蠕动:肌肉萎软无力的意思。 ⑦宗筋:指全身众多筋会聚地。泛指全身的筋膜。 ⑧各以其时受月:都各在其当旺的月份进行治疗。按张志聪说法,正月、二月,人气在肝;三月、四月,人气在脾;五月、六月,人气在头;七月、八月,人气在肺;九月、十月,人气在心;十一月、十二月,人气在肾。 ## 痿论篇第四十四参考白话译文 黄帝问道:五脏都能使人发生痿病,是什么道理呢?岐伯回答说:肺主全身皮毛,心主全身血脉,肝主全身筋膜,脾主全身肌肉,肾主全身骨髓。所以肺脏有热,灼伤津液,则枯焦,皮毛也呈虚弱、干枯不润的状态,热邪不去,则变生痿躄;心脏有热,可使气血上逆,气血上逆就会引起在下的血脉空虚,血脉空虚就会变生脉痿,使关节如折而不能提举,足胫弛缓而不能着地行路;肝脏有热,可使胆汁外溢而口苦,筋膜失养而干枯,以至筋脉挛缩拘急,变生筋痿;脾有邪热,则灼耗胃津而口渴,肌肉失养而麻木不仁,变生不知痛痒的肉痿;肾有邪热,热灼精枯,致使髓减骨枯,腰脊不能举动,变生骨痿。 黄帝问道:痿症是怎样引起的?岐伯说:肺是诸脏之长,又是心脏的华盖。遇有失意的事情,或个人要求得不到满足,则使肺气郁而不畅,于是出现喘息有声,进而则气郁化热,使肺叶枯焦,精气因此而不能敷布于周身,五脏都是因肺热叶焦得不到营养而发生痿躄的,说的就是这个道理。如果悲哀过度,就会因气机郁结而使心包络隔绝不通,心包络隔绝不通则导致阳气在内妄动,逼迫心血下崩,于是屡次小便出血。所以《本病》中说:“大经脉空虚,发生肌痹,进一步传变为脉痿。”如果无穷尽地胡思乱想而欲望又不能达到,或意念受外界影响而惑乱,房事不加节制,这些都可致使宗筋弛缓,形成筋痿或白浊、白带之类疾患。所以《下经》中说:筋痿之病发生于肝,是由于房事太过内伤精气所致。有的人日渐感受湿邪,如从事于水湿环境中的工作,水湿滞留体内,或居处潮湿,肌肉受湿邪浸渍,导致了湿邪痹阻而肌肉麻木不仁,最终则发展为肉痿。所以《下经》中说:“肉痿是久居湿地引起的。”如果长途跋涉,劳累太甚,又逢炎热天气而口渴,于是阳气化热内扰,内扰的邪热侵入肾脏,肾为水脏,如水不胜火,灼耗阴精,就会骨枯髓空,致使两足不能支持身体,形成骨痿。所以《下经》中说:“骨痿是由于大热所致。” 黄帝问道:用什么办法鉴别五种痿症呢?岐伯说:肺有热的痿,面色白而毛发衰败;心有热的痿,面色红而浅表血络充盈显现;肝有热的痿,面色青而爪甲枯槁;脾有热的痿,面色黄而肌肉蠕动;肾有热的痿,面色黑而牙齿枯槁。 黄帝道:先生以上所说是合宜的。医书中说:治痿应独取阳明,这是什么道理呢?岐伯说:阳明是五脏六腑营养的源泉,能濡养宗筋,宗筋主管约束骨节,使关节运动灵活。冲脉为十二经气血会聚之处,输送气血以渗透灌溉分肉肌腠,与足阳明经会合于宗筋,阴经阳经都总会于宗筋,再会合于足阳明经的气衔穴,故阳明经是它们的统领,诸经又都连属于带脉,系络于督脉。所以阳明经气血不足则宗筋失养而弛缓,带脉也不能收引诸脉,就使两足痿弱不用了。 黄帝问道:怎样治疗呢?岐伯说:调补各经的荥穴,疏通各经的输穴,以调机体之虚实和气血之逆顺;无论筋脉骨肉的病变,只要在其所合之脏当旺的月份进行治疗,病就会痊愈。黄帝道:很对!