灵枢·逆顺肥瘦
Miraculous Pivot ·Reversal, Obedience, Fatness and Thinness
黄帝问于岐伯曰：余闻针道于夫子，众多毕悉矣。夫子之道，应若失而据未有坚然者也。夫子之问学熟乎？将审察于物而心生之乎？The Yellow Emperor asked Qi Bo, saying: "I have heard about the principles of acupuncture from you, sir, and have learned many things thoroughly. Your teachings seem to lack a firm foundation as if they are lost without a hold. Are you well-versed in the inquiries and studies? Or do you generate them by carefully observing things?"
黄帝问岐伯说：我从先生这里听到了针刺治疗的道理，许多内容都已理解了。先生讲的道理与实际情况相符得如箭之中的，但根据却是不固定的，先生的学问是继承谁的呢？还是经过仔细观察事物而后心中思考琢磨出来的呢？
岐伯曰：“圣人之为道者，上合于天，下合于地，中合于人事，必有明法以起度数，法式检押，乃后可传焉。Qi Bo said: "When sages expound on the Way, it conforms to the heavens above, to the earth below, and to human affairs in the middle. There must be clear methods to establish standards and regulations, and only then can it be passed on.
岐伯说：圣人创立的理论，上合于天，下合于地，中与人事相符，一定要有明确的法规，来确立度量标准、模式规矩，然后才能传于后世。
故匠人不能释尺寸而意短长，废绳墨而起平水也，工人不能置规而为圆，去矩而为方。知用此者，固自然之物，易用之教，逆顺之常也。”Therefore, a craftsman cannot abandon the use of measurements to estimate lengths and widths, nor can he discard the plumb line and water level to achieve flatness. A worker cannot set aside the compass to draw a circle or abandon the square to make a square. Those who know how to use these tools understand the natural things, the easy-to-apply teachings, and the normal principles of reversal and obedience."
所以，工匠不能丢掉尺寸而随意定长短，不能放弃绳墨而求平直，不能不用圆规而画圆，也不能抛开矩尺而画方形。知道运用这些法则，就可以顺应自然，用简单易懂的方法，掌握顺逆的常规。
黄帝曰：愿闻自然奈何？The Yellow Emperor said: "I would like to hear about what is meant by 'natural'."
黄帝说：我想知道顺应自然是怎样的。
岐伯曰：临深决水，不用功力，而水可竭也。循拙（别本作掘）决冲，而经可通也。此言气之滑涩，血水清浊，行之逆顺也。Qi Bo said: "When draining water from a deep place, one doesn't need to exert much effort and the water can be drained dry. When dredging a blocked channel, the meridians can be unblocked. This refers to the smoothness or roughness of qi, the clearness or turbidity of blood and fluids, and the order of their movement, whether it is in reverse or in obedience."
岐伯说：从深处决堤放水，不用很大的气力就能把水放尽。循着地下的孔洞挖地道，就可以开通地下通路。同样对于人体来说，气有滑涩的不同，血有清浊的区别，经脉运行有逆顺的变化，所以应当掌握其特点，因势利导地治疗。
黄帝曰：愿闻人之白黑、肥瘦、小长，各有数乎？The Yellow Emperor said: "I would like to hear if there are specific rules for people's skin color, whether they are fat or thin, short or tall?"
黄帝说：我想知道人有皮肤黑白、形体胖瘦、年龄长幼的不同，那在针刺的深浅和次数方面有一定的标准吗？
岐伯曰：年质壮大，血气充盈，肤革坚固，因加以邪，刺此者，深而留之，此肥人也。广肩腋项，肉薄厚皮而黑色，唇临临然，其血黑以浊，其气涩以迟。其为人也，贪于取与，刺此者，深而留之，多益其数也。Qi Bo said: "For those who are in the prime of life, with abundant qi and blood, and firm skin and muscles, if affected by pathogenic factors, when needling such people, insert the needle deeply and retain it for a longer time. These are fat people. They have broad shoulders, axillae, and necks, with thick flesh, thin but tough skin, and black in color. Their lips are thick. Their blood is black and turbid, and their qi is rough and slow. Such people are often greedy in taking and giving. When needling them, insert the needle deeply and retain it for a longer time, and increase the number of times if necessary."
岐伯说：身体强壮的壮年人，气血充盛，皮肤坚固，感受外邪时，应采取深刺的方法，而且留针时间要长，这个方法也适宜于肥壮的人。如果是宽肩、腋下厚实、粗项、肉薄皮厚且肤色发黑、嘴唇厚大的人，他们的血液发黑而稠浊，气行滞涩缓慢，性格争强好胜，针刺时应当刺得更深而留针时间更长，并增加针刺的次数。
黄帝曰：刺瘦人奈何？The Yellow Emperor said: "How should one needle thin people?"
黄帝说：针刺瘦人的方法又是怎样的呢？
岐伯曰：瘦人者，皮薄色少，肉廉廉然，薄唇轻言，其血清气滑，易脱于气，易损于血，刺此者，浅而疾之。Qi Bo said: "Thin people have thin skin with less color, scanty flesh, thin lips, and speak softly. Their blood is clear and qi is smooth. They are prone to losing qi and suffering damage to their blood. When needling them, insert the needle shallowly and withdraw it quickly."
岐伯说：瘦人的皮肤薄，血色浅淡，肌肉消瘦，口唇薄，说话声音小，这种人血液清稀而气行滑利，气容易散失，血容易消耗，针刺的方法应是浅刺而出针快。
黄帝曰：刺常人奈何？The Yellow Emperor said: "How should one needle ordinary people?"
黄帝说：针刺不胖不瘦的平常人其方法是怎样的呢？
岐伯曰：视其白黑，各为调之。其端正敦厚者，其血气和调，刺此者，无失常数也。Qi Bo said: "Observe their skin color, whether white or black, and adjust the needling accordingly. For those who are well-proportioned and honest-looking, their qi and blood are in harmony. When needling them, do not deviate from the normal parameters."
岐伯说：这要辨别他肤色的黑白，并据此分别进行调治。对于端正敦厚的人，因血气调和，针刺时的方法不要违背一般常规的刺法。
黄帝曰：刺壮士真骨者奈何？The Yellow Emperor said: "How should one needle strong men with solid bones?"
黄帝说：针刺身体强壮、骨骼坚硬的人是怎样的呢？
岐伯曰：刺壮士真骨，坚肉缓节监监然。此人，重则气涩血浊，刺此者，深而留之，多益其数；劲则气滑血清，刺此者，浅而疾之。Qi Bo said: "When needling strong men with solid bones, they have firm muscles and loose joints. For such people, if they are of a heavy build, their qi is rough and blood is turbid. When needling them, insert the needle deeply and retain it for a longer time, and increase the number of times if necessary. If they are of a vigorous build, their qi is smooth and blood is clear. When needling them, insert the needle shallowly and withdraw it quickly."
岐伯说：身体强壮的人、骨骼坚硬，肌肉结实，关节运转自如有力。这样的人，如果是稳重不好动的，多属气行滞涩而血液稠浊，针刺的方法应当深刺而留针时间长，并增加针刺的次数；如果是轻劲好动的，气行滑利而血液清稀，针刺的方法应当浅刺而迅速出针。
黄帝曰：刺婴儿奈何？The Yellow Emperor said: "How should one needle infants?"
黄帝说：针刺婴儿是怎样的呢？
岐伯曰：婴儿者，其肉脆、血少、气弱，刺此者，以毫针浅刺而疾发（别本作拔）针，日再可也。Qi Bo said: "Infants have tender flesh, little blood, and weak qi. When needling them, use a fine needle to make a shallow insertion and quickly withdraw the needle. It can be done twice a day."
岐伯说：婴儿的肌肉脆薄而血少气弱，针刺的方法，应当选用毫针浅刺而且快速进针，一天可以针刺两次。
黄帝曰：临深决水奈何？The Yellow Emperor said: "What does it mean to 'drain water from a deep place'?"
黄帝说：前面所比喻的“临深决水”情况，在针刺上应当怎么处置呢？
岐伯曰：血清气浊，疾泻之则气竭焉。Qi Bo said: "If the blood is clear and qi is turbid, rapid purging will cause the qi to be exhausted."
岐伯说：血液清稀而气行滑利的人，如果采用疾泻法，就会使其真气耗竭。
黄帝曰：循掘决冲奈何？The Yellow Emperor said: "What does it mean to 'dredge a blocked channel'?"
黄帝说：前面所比喻的“循掘决冲”情况，又应当怎么处置呢？
岐伯曰：血浊气涩，疾泻之，则经可通也。Qi Bo said: "If the blood is turbid and qi is rough, rapid purging will make the meridians unblocked."
岐伯说：血液稠浊而气行迟涩的人，采用疾泻法，经脉可通。
黄帝曰：脉行之逆顺，奈何？The Yellow Emperor said: "What is the order of the movement of the meridians, whether in reverse or in obedience?"
黄帝说：经脉循行的逆顺是怎样的呢？
岐伯曰：手之三阴，从臓走手；手之三阳，从手走头；足之三阳，从头走足；足之三阴，从足走腹。Qi Bo said: "The three yin meridians of the hand run from the internal organs to the hand; the three yang meridians of the hand run from the hand to the head; the three yang meridians of the foot run from the head to the foot; the three yin meridians of the foot run from the foot to the abdomen."
岐伯说：手三阴经都是从胸部经上肢走向手指；手三阳经都是从手指向上经肩部走向头部；足三阳经都是从头部经躯干和下肢走向足部；足三阴经都是从足部经下肢走向腹部。
黄帝曰：少阴之脉独下行，何也？The Yellow Emperor said: "Why does the Shaoyin meridian run downward alone?"
黄帝说：足三阴经都是上行到腹的，为什么惟独足少阴经向下行呢？
岐伯曰：“不然。夫冲脉者，五脏六腑之海也，五脏六腑皆禀焉。Qi Bo said: "That's not the case. The Chong meridian is the sea of the five zang-organs and six fu-organs. All the five zang-organs and six fu-organs are nourished by it.
岐伯说：不像您说的那样，那不是足少阴经而是冲脉。冲脉是五脏六腑经脉所汇聚的地方，五脏六腑都禀受冲脉气血的濡养。
其上者，出于颃颡，渗诸阳，灌诸精。Its upper part emerges from the pharynx, permeates the yang meridians, and irrigates the essence.
冲脉上行的部分，在咽部上面的后鼻道附近出于体表，然后渗入阳经，向其灌注精气。
其下者，注少阴之大络，出于气街，循阴股内廉入腘中，伏行骭骨内，下至内踝之后，属而别。Its lower part injects into the large collateral of the Shaoyin meridian, emerges from the Qi Street, follows the inner side of the thigh along the Yin femoral line into the popliteal fossa, travels hiddenly within the tibia, descends to the back of the inner ankle, connects and then branches.
冲脉下行的部分，注入足少阴肾经的大络，在气街（气冲穴）出于体表，沿着大腿内侧下行，进入膝腘窝中，伏行于胫骨之内，再向下行到内踝后的跟骨上缘而分为两支：
其下者，并于少阴之经，渗三阴；其前者，伏行出跗属，下循跗入大趾间，渗诸络而温肌肉。Its lower part combines with the Shaoyin meridian, permeates the three yin meridians; its front part travels hiddenly and emerges from the tarsus, descends along the tarsus into the space between the big toe, permeates the collaterals and warms the muscles.
向下行的分支，与足少阴经相并行，同时将精气灌注于三阴经；其前行的分支，从内踝后的深部出于跟骨结节上缘，向下沿着足背进入足大趾间，将精气渗注到络脉中而温养肌肉。
故别络结则跗上不动，不动则厥，厥则寒矣。”Therefore, if the collateral is knotted, there will be no movement on the tarsus. If there is no movement, there will be coldness due to reversed qi."
所以，当冲脉下行支脉瘀结不通时，足背上的冲阳脉搏动就会消失，冲阳脉搏动消失就会导致卫气不行而成厥逆，出现厥逆就会感到下肢寒冷。
黄帝曰：何以明之？The Yellow Emperor said: "How can we prove this?"
黄帝说：怎样查明经脉气血的顺逆呢？
岐伯曰：以言导之，切而验之，其非必动，然后仍可明逆顺之行也。Qi Bo said: "Guide with words, examine by palpation. If it doesn't move as expected, then we can still clarify the order of movement, whether in reverse or in obedience."
岐伯说：在给病人检查的时候，首先要用言语问清症状，然后切按脉搏查验脉动情况。如果脉动正常就不是经气厥逆，这样就可以明确经脉气血循行逆顺的情况了。
黄帝曰：窘乎哉！圣人之为道也。明于日月，微于毫厘，其非夫子，孰能道之也。The Yellow Emperor said: "How profound is the Way of the sages! It is as clear as the sun and the moon, yet as subtle as a hair's breadth. If it weren't for you, sir, who could expound on it?"
黄帝说：这些问题真难解答啊！圣人所归纳的这些道理真是重要。这些道理，比日月的光辉还明亮，比毫厘之物还细微，若不是先生，谁能阐明清楚这些道理呢。
