《望診遵經(jīng)》 腠理望法提綱

聞之津液滲泄之所曰腠．紋理縫會(huì)之中曰理．腠者是三焦通會(huì)元真之處．理者是皮膚臟腑之紋理也．字書(shū)謂膚肉之間為腠理．以其有脈理焉．三說(shuō)合觀．體用備矣．考之內(nèi)經(jīng)．則曰開(kāi)、曰闔、曰粗、曰細(xì)．曰疏、曰密．有因天者．有因人者．有因腑而異者．有因病而異者．因天者何．熱則人氣在外．皮膚緩．腠理開(kāi)．汗大泄．血?dú)鉁p．皮淖澤．寒則人氣在中．皮膚致．腠理閉．汗不出．血?dú)鈴?qiáng)．肉堅(jiān)澀．此腠理之開(kāi)閉．因天之寒暑也．因人者何．膏者其肉淖．而粗理者身寒．細(xì)理者身熱．脂者其肉堅(jiān)．細(xì)理者熱．粗理者寒．此腠理之粗細(xì)．因人之脂膏也．何謂因腑而異．三焦膀胱者．腠理毫毛其應(yīng)．密理濃皮者．三焦膀胱濃．粗理薄皮者．三焦膀胱薄．疏腠理者．三焦膀胱緩．皮急而無(wú)毫毛者．三焦膀胱急．毫毛美而疏者．三焦膀胱直．稀毫毛者．三焦膀胱結(jié)．此腠理之疏密．因腑而異者也．何謂因病而異．陽(yáng)勝則身熱．腠理閉．喘粗為之俯仰．汗不出而熱．齒干以煩冤．腹?jié)M死．能冬不能夏．陰勝則身寒．汗出身常清．?dāng)?shù)栗而寒．寒則厥．厥則腹?jié)M死．能夏不能冬．此陰陽(yáng)更勝之變．病之形能也．然陽(yáng)病亦有汗出者．陰病亦有不汗出者．其開(kāi)也衛(wèi)氣虛．其閉也衛(wèi)氣實(shí)．是又因證而異．可與診汗之法參觀也．要之．開(kāi)則有汗．閉則無(wú)汗．察腠理之開(kāi)閉．視汗液之有無(wú)一也．此腠理之開(kāi)閉．因病而異者也．蓋觀粗細(xì)與疏密者．欲明其體．而觀開(kāi)闔之常變者．欲達(dá)其用也．且夫腠理之開(kāi)闔．非腠理之自為開(kāi)闔也．有溫分肉．充皮膚．肥腠理．司開(kāi)闔者焉．蓋衛(wèi)氣也．衛(wèi)氣者．下焦之所出．太陰主其內(nèi)．太陽(yáng)主其外者也．陰平陽(yáng)秘．衛(wèi)氣和矣．衛(wèi)氣和．則分肉解利．皮膚調(diào)柔．腠理致密矣．如是而云開(kāi)闔．則似開(kāi)非開(kāi)．似闔非闔．然非不開(kāi)也．非不闔也．有時(shí)而開(kāi)．有時(shí)而闔．或因寒暑．或因冷暖．或因動(dòng)靜．非病也．常也．時(shí)開(kāi)則開(kāi)．時(shí)闔則闔者也．設(shè)或不當(dāng)開(kāi)而開(kāi)．不當(dāng)闔而闔．豈得謂之無(wú)病哉．合汗而診之．因時(shí)而驗(yàn)之．參證而辨之．知其開(kāi)闔之常．即知其開(kāi)闔之變矣．經(jīng)曰．謹(jǐn)察衛(wèi)氣．為百病母．腠理之開(kāi)闔．衛(wèi)氣之虛實(shí)也．開(kāi)闔虛實(shí)．蓋可以忽乎哉．