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Capítulo 77 de 78
黄帝内经·素问
Overall Paraphrase
This chapter discusses the ebb and flow of vital Qi, the concepts of "contrary" (adverse) and "compliant" (favorable) motion, and diagnostic methods. Lei Gong asks: Human Qi varies in abundance or deficiency — what constitutes "contrary" and what constitutes "compliant"? The Yellow Emperor replies: Yang Qi ascends from the left; Yin Qi descends from the right. In the elderly, the flow of Qi tends to be upward; in the young, it tends to be downward. Therefore, in spring and summer, when Qi returns to Yang, it governs life; if it reverts to the Yin of autumn and winter, it governs death. In autumn and winter, the opposite holds: when Qi returns to Yin, it governs life; when it reverts to the Yang of spring and summer, it governs death. Thus, whether Qi is abundant or deficient, if its movement is disordered and contrary, it can give rise to Jue (reversal or syncopal disorders).
Lei Gong further asks: Can Jue also arise when Qi is in excess? The Yellow Emperor answers: When Qi rises without descending, it can cause a cold Jue extending to the knees. If a young person encounters this condition in autumn or winter, death is likely; if an elderly person encounters it in autumn or winter, survival is possible instead. When Qi surges upward without descending, it can trigger headaches and disorders of the vertex. At such times, seeking from the Yang aspect yields nothing, and examining from the Yin aspect reveals no clear distinctions; the five viscera are separated and blocked with no conspicuous signs. The patient feels as if standing in an open wilderness or lying hidden in an empty room, with breath feeble and lingering — one fears they will not survive the day.
Therefore, Jue caused by Qi deficiency incites chaotic dreams, and in severe cases, mental confusion. When the Three Yang channels' Qi is exhausted and the Three Yin channels' Qi is faint, this constitutes Qi deficiency.
Thus, when Lung Qi is vacuous, one dreams of white objects or sees people covered in blood from killings; if encountered during the time when Lung Metal is ascendant, one dreams of warfare. When Kidney Qi is vacuous, one dreams of boats capsizing or people drowning in water; if encountered during the time when Kidney Water is ascendant, one dreams of being submerged in water, accompanied by fear. When Liver Qi is vacuous, one dreams of mushrooms, fragrant herbs, and flourishing vegetation; if encountered during the time when Liver Wood is ascendant, one dreams of hiding under trees without daring to rise. When Heart Qi is vacuous, one dreams of rescuing from fire; if encountered during the time when Heart Fire is ascendant, one dreams of great conflagrations. When Spleen Qi is vacuous, one dreams of insufficient food and drink; if encountered during the time when Spleen Earth is ascendant, one dreams of building walls or roofing houses. These all arise from vacuity of the five viscera's Qi, with Yang Qi relatively in excess and Yin Qi insufficient. One should integrate the Five Diagnoses and regulate Yin and Yang, grounding the treatment in the channel network.
🩺 Diagnosis employs ten measuring methods: pulse measure, viscera measure, flesh measure, sinew measure, and Shu (transport point) measure. When the transformation of Yin and Yang Qi reaches its extreme, illness naturally manifests. The pulsation lacks fixed regularity; Yin Qi scatters, Yang Qi predominates, the pulse pattern appears detached and incomplete, and no fixed diagnostic procedure exists. Examination must attend to both upper and lower, and also weigh the differing constitutions and lifestyles of commoners, rulers, and high officials.
If one studies medicine without completing the training, the art remains unclear, and failing to examine the compliant and the contrary constitutes reckless practice. Grasping only one side while losing the other, discarding Yin and clinging solely to Yang, ignorance of synthesis leads to unclear diagnosis. Transmitting such theories to later generations only magnifies their errors.
When Zhiyin (the extreme Yin at the foot, Kidney channel) is vacuous, Heavenly Qi loses its attachment and is severed. When Zhiyang (the extreme Yang, governing heat and movement) is excessive, Earthly Qi falls into deficiency. The harmonious convergence of Yin and Yang denotes the pattern followed by the highest Shengren (sage). At the union of Yin and Yang, Yang arrives first, Yin follows afterward. Therefore, the sage, mastering diagnosis, first distinguishes the sequence of Yin and Yang. Qiheng zhi shi — "Strange-Constant Potentialities" — comprises sixty treatises, synthesizing subtle manifestations, tracing the transformations of Yin and Yang, and illuminating the inner conditions of the five viscera. Among them, if one seizes the essentials of vacuity and repletion and stabilizes the Five Measures, only then is one sufficiently equipped to diagnose illness.
So, if one examines Yin but fails to understand Yang, the diagnostic information remains incomplete. Understanding Yang without understanding Yin means the learning is not profound. Knowing only the left and not the right, only the right and not the left, only the upper and not the lower, only the prior and not the posterior — then regulation and treatment cannot endure. If one knows the ugly, also knows the good; knows illness, also knows pre-illness; knows the high, also knows the low; knows sitting, also knows arising; knows moving, also knows stillness — then the application has discipline, the diagnostic Way is complete, and it remains efficacious for ten thousand generations without peril. From surplus one infers deficiency, measuring upper and lower, and then the pulse can be fully appreciated. Thus, when the physique is weak and Qi is also vacuous, the prognosis is poor. When physical Qi is surplus but pulse Qi is deficient, the prognosis is poor. When pulse Qi is surplus but physical Qi is slightly deficient, the prognosis is favorable.
Thus, diagnostics has great rules: sitting, standing, rising, and moving follow standard patterns; entry and exit observe proper measure. Turn and concentrate the spirit, maintaining a serene and celar mind. Look up to observe the celestial seasons; look down to observe terrestrial principles; wait upon the Eight Cardinal Evils (external pathogenic factors of the four seasons and eight winds); differentiate the inner workings of the five viscera. Appraise the dynamics of the pulse and the condition of the skin, distinguishing the moistness or dryness of muscle, the rising and settling nature of coming and leaving, as well as clinical observation of all conditions. Inspect the sliding quality, relative determination of character as to medium, etc.
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本内容基于中医经典古籍，仅供传统文化学习与研读，不构成任何医疗诊断、用药或治疗建议；如有不适请立即获取翻译。y the — End natural close in language accordingly be expected full disclosure = placed above*
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