Human beings are endowed with the Five Constants and grow in accordance with the Qi of nature. Though natural Qi can give life to all things, it can also harm them — just as water can keep a boat afloat, it can also capsize it. If the Yuan Zhen (original Qi) of the five Zang organs flows freely, a person remains peaceful and healthy. But when pathogenic Qi and evil winds strike, most who are afflicted perish. Of the thousand possible ailments, none exceed three categories:
First, when pathogenic factors enter the meridians and penetrate the Zang-Fu organs — this is disease caused from within. Second, when the four limbs and nine orifices are affected, with pathological changes transmitted through the blood vessels causing stagnation and obstruction — this is disease caused by external attack on the skin. Third, injury caused by sexual excess, metal blades, insects, or wild beasts.
By analyzing disease through these three, all causes are accounted for.
If a person cultivates careful living and prevents evil winds from invading the meridians, or if pathogenic factors have just entered the meridians but have not yet spread to the Zang-Fu organs, treatment should be applied immediately. As soon as heaviness and sluggishness are felt in the limbs, one should practice Daoyin (guiding and stretching), Tuna (breathing exercises), acupuncture, and acupressure with herbal ointments — do not allow the nine orifices to become blocked. Furthermore, one should avoid violating the law, prevent injury from beasts, and not deplete oneself through sexual excess. In diet, moderate the intake of cold, hot, bitter, sour, pungent, and sweet foods. By not allowing the body to decline, disease will find no way to enter the Cou Li.
(Cou refers to the place where the San Jiao communicates and gathers Yuan Zhen, where Qi and blood converge. Li refers to the texture of the skin and Zang-Fu organs.)
This passage primarily addresses Zhang Zhongjing’s views on why people fall ill and how to prevent and treat disease. When I first studied this text, there was one character I kept mispronouncing: 疢 (chèn).
疢 primarily refers to heat diseases — specifically, what we would call cold-induced febrile diseases (Shanghan). The Shuowen Jiezi explains: “疢 means heat disease; it is also written as 疹.” Therefore, using this passage to summarize the Jingui Yaolue is inappropriate. I personally believe this section should be placed in the Shanghan Lun portion, or at least acknowledged as encompassing both works, rather than claiming it only explains miscellaneous diseases of the Jingui. This is an important distinction — many students of the Jingui tend to forget about the Six Meridian diseases, which is inexcusable and undermines genuine understanding.
Overall, this passage is remarkably information-dense, touching upon numerous causes of disease, theoretical frameworks, and treatment methods. The theoretical foundation clearly derives from the Neijing and Nan Jing — that much is certain. However, the mention of “Daoyin, Tuna, acupuncture, and herbal ointment massage” reflects the medical character of that era. What we now consider wellness practices were, in those times, legitimate medical interventions. This passage also reveals that Zhongjing was not particularly skilled in acupuncture — or rather, acupuncture in that era was not accorded the same importance as decoctions, existing on a different tier altogether. In my view, studying pre-Tang dynasty acupuncture does not require understanding the underlying rationale; in most cases, it is simply a collection of empirical practices without theoretical guidance, remaining quite rudimentary.
“When upright Qi resides within, pathogenic factors cannot invade” — this ancient principle holds as true today as ever. The ancients, much like modern people, tended toward excess, neglected prevention, and were reluctant to exercise. For a normal, healthy person, maintaining abundant upright Qi and unobstructed meridians is sufficient for good health.
Nourish life while you still can — wait until you are frail and old, and it will be too late.
中文原文 / Chinese Original
夫人禀五常，因风气而生长，风气虽能生万物，亦能害万物，如水能浮舟，亦能覆舟。若五藏元真通畅，人即安和。客气邪风，中人多死。千般疢难，不越三条；一者，经络受邪，入藏府，为内所因也；二者，四肢九窍，血脉相传，壅塞不通，为外皮肤所中也；三者，房室、金刃、虫兽所伤。以此详之，病由都尽。
若人能养慎，不令邪风干杵经络，适中经络，未流传藏府，即医治之，四肢才觉重滞，即导引、吐纳、针灸、膏摩，勿令九窍闭塞；更能无犯王法、禽兽灾伤，房室勿令竭乏，服食节其冷、热、苦、酸、辛、甘，不遗形体有衰，病则无由入其腠理。（腠者，是三焦通会元真之处，为血气所注；理者，是皮肤藏府之纹理也）
这一段主要讲了仲景对于人为什么会得病以及如何防病治病的看法，我刚学习的时候，有一个字始终念不对，那就是”疢”。
疢（chen）主要指热病，应该特指伤寒，《说文》中解释”疢,热病也。亦作疹”，所以我们拿这条来概括金匮是不合适的，个人觉得这一段应该放到伤寒论部分，或者至少包含了伤寒论部分，而不能说是只解释了杂病或是金匮的病，这个很重要，很多学生学习金匮的时候往往都忘了六经病，这是不应该的，会影响理解。
这段总体来说信息量很大，提到了很多内容，很多病因，很多理论，还有很多治疗方法。总的来看，理论源于内难是没跑的了，但”导引、吐纳、针灸、膏摩”代表了那个时代的医学特征，我们现在讲究的养生方法，在那个时代是一种医疗手段。这里更能看得出来，仲景是不擅长针灸的，或者说针灸在那个年代并没有得到重视，与汤液不在一个等级上，所以我个人觉得学习唐以前的针灸学问，不需要知其所以然，绝大部分情况下都是经验的集合，并没有理论的指导，还是很朴素的。
正气存内，邪不可干，自古的道理至今仍然通用，古人跟今人一样，都过于放纵，疏于防范，又懒得动弹，对于正常人来说，只要保持体内正气充足，经络通畅，就能够拥有健康。
养生要趁早，颓颓老矣就来不及了。
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