灵枢·周痹
Miraculous Pivot · Generalized Obstruction Syndrome
黄帝问于岐伯曰：”周痹之在身也，上下移徒随脉，其上下左右相应，间不容空，愿闻此痛，在血脉之中邪？将在分肉之间乎？何以致是？The Yellow Emperor asked Qi Bo, "When the generalized obstruction syndrome occurs in the body, it migrates up and down along the vessels, and the corresponding parts above and below, on the left and on the right are so closely related that there is hardly any gap. I'd like to know whether this pain is in the blood vessels or between the muscles? What causes this situation?
黄帝问岐伯说：周痹这个病，病邪在人的身体中随着血脉上下移动，疼痛的部位左右对称，随时在转移，又连续不断，我想知道这种疼痛是发生在血脉之中呢？还是在分肉之间呢？又是怎样形成这种病痛的呢？
其痛之移也，间不及下针，其慉痛之时，不及定治，而痛已止矣。何道使然？愿闻其故。“When the pain migrates, there isn't even enough time to insert the needle, and when the pain intensifies, there isn't enough time to determine the treatment method, but the pain has already stopped. What is the reason for this? I'd like to hear the cause."
这种疼痛部位转移得如此之快，快到来不及在疼痛的部位下针，当某一个部位的蓄积的疼痛很明显的时候，还没有来得及决定怎样治疗，疼痛就已经停止了。这是什么样的机制呢？请你告诉我其中的缘故。
岐伯答曰：此众痹也，非周痹也。Qi Bo replied, "This is multiple obstruction syndrome, not generalized obstruction syndrome."
岐伯回答说：这是众痹病，而不是周痹病。
黄帝曰：愿闻众痹。The Yellow Emperor said, "I'd like to hear about multiple obstruction syndrome."
黄帝说：我也很想听你说一说众痹这个病。
岐伯对曰：此各在其处，更发更止，更居更起，以右应左，以左应右，非能周也，更发更休也。Qi Bo replied, "Each of these occurs in its specific location, starts and stops alternately, appears and disappears alternately, responds on the right corresponding to the left, and responds on the left corresponding to the right. It isn't able to spread all over but starts and stops alternately."
岐伯回答说：众痹的痛点分布在身体的各个部位，可以随时发作，随时停止，随时转移，随时兴起，左侧会影响到右侧，右侧会影响到左侧，往往是左右对称的，连续不断的，但不是周遍全身都疼痛，而是集中在身体的某个区域，有时发作有时休止。
黄帝曰：善。刺之奈何？The Yellow Emperor said, "Good. How should it be needled?"
黄帝说：说得好！针刺治疗用什么方法呢？
岐伯对曰：刺此者，痛虽已止，必刺其处，勿令复起。Qi Bo replied, "When needling this, although the pain has already stopped, the affected area must be needled to prevent it from recurring."
岐伯回答说：要针刺疼痛发作的那个部位，即使疼痛暂时停止了，也还要准确的针刺疼痛发作的那个部位，以防止邪气流窜使疼痛复发。
帝曰：善。愿闻周痹何如？The Emperor said, "Good. I'd like to hear about generalized obstruction syndrome."
黄帝说：好极了。我还希望您再讲一讲周痹这个病是怎样的呢？
岐伯对曰：周痹者，在于血脉之中，随脉以上，随脉以下，不能左右，各当其所。Qi Bo replied, "The generalized obstruction syndrome is in the blood vessels. It moves up along the vessels and moves down along the vessels. It doesn't spread to the left and right but stays in its respective place."
岐伯回答说：周痹的病邪存在于血脉之中，能随着血脉在身体中上下游移而遍及全身，但是，在发病的时候，不像众痹那样是左右对称的疼痛，而是随着血液的流动，停在什么地方就在什么地方发病。
黄帝曰：刺之奈何？The Yellow Emperor said, "How should it be needled?"
黄帝说：那么针刺治疗又如何呢？
岐伯对曰：痛从上下者，先刺其下以过（别本作遏）之，后刺其上以脱之。痛从下上者，先刺其上以过（别本作遏）之，后刺其下以脱之。Qi Bo replied, "For pain that moves from above to below, first needle the lower part to block it, and then needle the upper part to relieve it. For pain that moves from below to above, first needle the upper part to block it, and then needle the lower part to relieve it."
岐伯回答说：疼痛是从上至下传递的，就先针刺疼痛部位之下的穴位，使邪气不再继续下传，再针刺其上部疼痛的部位，以祛除病邪本身。如果疼痛是从下至上传递的，就先针刺疼痛部位之上的穴位，使邪气不再继续上行，再针其下部疼痛的部位，以祛除病邪本身。
黄帝曰：善。此痛安生？何因而有名？The Yellow Emperor said, "Good. How does this pain occur? Why is it named like this?"
黄帝说：好的。那么这种疼痛是怎样产生的呢？又为什么将这种疼痛称作周痹呢？
岐伯对曰：“风寒湿气，客于外分肉之间，迫切而为沫，沫得寒则聚，聚则排分肉而分裂也。Qi Bo replied, "The pathogenic factors of wind, cold, and dampness invade the space between the external muscles. They compress and form froth. When the froth encounters cold, it aggregates. When it aggregates, it pushes aside the muscles and causes separation.
岐伯回答说：风寒湿的邪气，从外至内逐渐侵入人体的分肉之间，将肌肉之间的津液挤压为汁沫，汁沫因寒冷而凝聚，凝聚为有形之物后就更加排挤分肉而使之分裂。
分裂则痛，痛则神归之，神归之则热，热则痛解，痛解则厥，厥则他痹发，发则如是。”When there is separation, there is pain. When there is pain, the spirit converges there. When the spirit converges, there is heat. When there is heat, the pain is relieved. When the pain is relieved, there is reversal. When there is reversal, other types of obstruction syndrome occur, and it happens like this."
分裂就会产生疼痛，疼痛发生之后，人的注意力就会集中在那个疼痛的部位上，心神集中在这个地方，就会使阳气聚敛，阳气聚而热生，热生就会散寒而缓解疼痛，疼痛缓解就会使厥气上逆，厥气上逆则导致其他痹痛发作，于是疼痛也就随之转移了，因此疼痛就会这样此起彼落。
帝曰：善。余已得其意矣。The Emperor said, "Good. I've understood the meaning."
黄帝说：好的，我已经明白这其中的道理了。
此内不在臓，而外未发于皮，独居分肉之间，真气不能周，故名曰周痹。This condition is neither inside the internal organs nor has it manifested on the skin outside. It exists alone between the muscles. The genuine qi cannot circulate all around, so it is named generalized obstruction syndrome.
（岐伯接着说：）这种病邪在内并没有深入脏腑之中，在外也没有通过皮表发散出来，而是独留于分肉之间，致使人身的真气不能流畅地在周身贯通，因此叫做周痹。
故刺痹者，必先切循其下之六经，视其虚实，及大络之血结而不通，及虚而脉陷空者而调之，熨而通之。其瘈坚，转引而行之。Therefore, when needling for obstruction syndrome, one must first palpate and examine the six meridians below, observe their deficiency and excess, as well as the blood stasis and blockage in the large collaterals, and adjust those with deficiency and sunken and empty pulses. Use moxibustion to make them unblocked. For those that are rigid and spasmodic, guide and move them by rotation.
在针刺治疗时，首先要沿着发病的经络，用手指按切诊察，以判断其病是虚是实，以及大络的血脉是不是有瘀结不通，以及经脉中有没有下陷空虚的情况，根据证候进行调治，或用熨蒸的方法通其经络。如果筋脉拘紧，就用按摩导引等方法行其气血。
黄帝曰：善。余已得其意矣，亦得其事也。九者，经巽之理，十二经脉阴阳之病也。The Yellow Emperor said, "Good. I have already grasped the meaning of it and also understood the relevant treatment methods. The 'nine' refers to the principle of the meridians being in harmony with the natural order, and it can be used to treat the diseases of yin and yang imbalance in the twelve meridians."
黄帝说：对。我明白这个病的机制了，也知道了治疗的方法。原来使用九针除了能使经气顺达流畅之外，还能治疗十二经脉阴阳不调的各种疾病。
