黄帝曰:经脉者常不可见也,其虚实也,以气口知之,脉之见者,皆络脉也。
雷公曰:细子无以明其然也。
黄帝曰:诸络脉皆不能经大节之间,必行绝道而出,人复合于皮中,其会皆见于外。故诸刺络脉者,必刺其结上。甚血者虽无结,急取之以泻其邪而出其血,留之发为痹也。凡诊络脉,脉色青则寒且痛,赤则有热。胃中寒,手鱼之络多青矣;胃中有热鱼际络赤;其暴黑者,留久痹也;其有赤有黑有青者,寒热气也;其青短者,少气也。凡刺寒热者皆多血络,必间日而一取之,血尽而止,乃调其虚实;其小而短者少气,甚泻之则闷,闷甚则仆,不得言。闷则急坐之也。
翻译:雷公问:怎样才能知道经脉或是络脉之中发生了病变呢?
黄帝说:经脉隐伏在内,因此即使其发生了病变,在体表常常也是看不到的,其虚实的变化情况只能从气口部位的脉象变化来测知。而在体表可以看到的那些经脉的病变,其实都是络脉的病变。
雷公说:我还是不能明白这样做的道理。
黄帝说:所有的络脉都不能通过大关节所在的部位,因此在走行到大关节的部位时,络脉都要经过经脉所不到的地方,出于皮表,越过大关节后,再入里而与经脉象合于皮中,此外,它们相合的部位还都会在皮表部显现出来。因此,凡是针刺络脉的病变,都必须刺中其有淤血结聚的地方,才能取得良好的疗效。而对于血气郁积的病症,虽然它还没有出现淤血结聚的现象,但也应该尽快采用刺络的方法去进行治疗,以泻除其病邪而放出其恶血;如果把恶血留在体内,就会导致血络凝滞、闭塞不通的痹证。在诊察络脉病变的时候,如果络脉所在的部位呈现青色,那就表明它是寒邪凝滞于内气血不通而痛的病症;如果络脉所在的部位呈现红色,那就表明它是体内有热的病症。例如,胃中有寒的病人,其手鱼部的络脉大多都会呈现出青色;而胃中有热的病人,其鱼际部的络脉就会呈现出红色。络脉所在部位突然呈现出黑色的,那就说明它是留滞已久的痹病。络脉所在部位的颜色时而发红、时而发黑又时而发青的,那就说明它是寒热相兼的病症。颜色发青且脉络短小的,那是元气衰少的征象。一般在针刺邪在浅表以致寒热并作的病症时,因为病邪尚未深入于经,所以就应该多刺浅表的血络,同时还必须隔日一刺,直到把恶血完全泻尽才能停止,然后才可以再根据病症的虚实来进行调治。络脉色青且脉形短小的,是属于元气衰少的病症。如果对元气衰少很严重的病人使用了泻法,就会使他感到心胸烦闷,烦闷至极就会出现昏厥倒地、不能言语等症状;此,对于这种病人,在他已有烦闷感而尚未昏仆的时候,就应该立即将他扶起,成半坐半卧位,再施以急救。
英语翻译：
Lei Gong asked: how can we know that there is pathological
change in meridians or collaterals?
Huangdi said: the meridians are concealed inside, so even if they have pathological changes, they are often invisible on the body surface, and the changes of the deficiency and the excess can only be measured from the changes of the pulse at the Qikou site. And the lesions of those meridians that can be seen on the body surface are actually the lesions of collaterals.
Lei Gong said: I still can't understand the reason for this. Huang Di said: all collaterals can't pass through the part where the big joint is located. Therefore, when walking to the part where the big joint is located, the collaterals must pass through the place where the meridians are not. They come from the skin surface, cross the big joint, and then enter into the skin to match the meridians. In addition, the parts where they meet will appear on the skin surface. Therefore, in order to achieve good curative effect, it is necessary to stab the lesions of the collaterals where there is congestion and aggregation. But for the disease of blood gas stasis, although it has not appeared the phenomenon of congestion and aggregation, we should also use the method of pricking collaterals to treat it as soon as possible, so as to eliminate its pathogenic factors and release its evil blood; if the evil blood is left in the body, it will lead to the Bi syndrome of blood stasis and occlusion. When examining the pathological changes of the collaterals, if the location of the collaterals is cyan, it indicates that it is a disease of cold pathogenic stagnation and pain due to the blockage of internal Qi and blood; if the location of the collaterals is red, it indicates that it is a disease of heat in the body. For example, for patients with cold stomach, the collaterals of hand and fish will mostly appear cyan; for patients with heat stomach, the collaterals of thenar will appear red. The location of collaterals suddenly appears black, which means that it is a long-standing Bi disease. The color of collaterals is sometimes red, sometimes black and sometimes blue, which means that they are both cold and hot. If the color is blue and the vein is short, it is a sign of less vitality. Generally, when acupuncture is superficial and cold and hot, because the pathogenic factors are not deep into the meridians, we should prick the superficial more often
At the same time, a stab must be made every other day until the evil blood is drained completely, and then it can b
e treated according to the deficiency and excess of the disease. The blood vessels are blue and short in shape, which belong to the disease of low vitality. If the cathartic method is used for the patient with low vital energy, he will feel upset. If he is extremely upset, he will faint and fall to the ground, unable to speak and other symptoms will appear. Therefore, for this kind of patient, when he is already upset and has not fainted, he should be immediately lifted up, sitting in a half lying position, and then given first
aid.
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