Nan Jing
Hoang Ti Ba Shi Yi Nan Jing (Tratado de las ochenta y una dificultades, del Emperador Amarillo)
(Traducción Bob Flaws)
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Prefacio Este libro es una traducción del Hoang Ti Ba Shi Yi Nan Jing (Tratado de las ochenta y una dificultades, del Emperador Amarillo), conocido, por lo general, simplemente como El Nan Jing o Tratado de las dificultades. Se trata de una colección de ochenta y una preguntas y sus respuestas correspondientes, que pretenden El aclarar pasajes o conceptos difíciles del Hoang Ti Nei Jing ( El Tratado interior del emperador Amarillo ). Los que se dedican al estudio de la medicina china creen que este libro se escribió o compiló algún tiempo después de la dinastía Han, durante el siglo I o el II de la Era China. La tradición atribuye la autoría del Nan Jing a Bian Que, el primer y legendario acupuntor de la antigüedad. Sin embargo, esto es históricamente imposible y no es nada más que una ficción piadosa. Este libro es importante para la historia y el desarrollo de la medicina china y especialmente para la acupuntura, por tres razones: la primera es que presenta un sistema relativamente coherente de la diagnosis por el pulso. Fijándose en las tres posiciones y los diversos niveles del cun kou o arteria radial, que se encuentra en la arteria radial del proceso estiloides de las muñecas. Aunque en el Nei Jing o Tratado interior se hace referencia a muchos sistemas diferentes de reconocimiento por el pulso, ninguno de ellos se explica lo suficiente para ponerlo en práctica con garantías en una clínica. Fue el Nan Jing el que centró la atención de los doctores chinos en el pulso de la arteria radial y describió un sistema coherente de reconocimiento y correspondencia que se utiliza todavía en algunos países de Asia y Europa. En segundo lugar, este libro presenta y aclara la aplicación clínica de la teoría de las cinco fases, que es una evolución avanzada de la del yin y el yang, según la cual, todo lo que hay en el universo de lo manifestable corresponde a una o varias combinaciones de las cinco
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occidental, se les puso en principio el nombre erróneo de cinco elementos. Sin embargo, no son entidades estáticas o elementos, sino, más bien, cinco etapas de la evolución de las cosas que existen de forma manifestable, que se engendran y se eliminan unas a otras, de una forma constantemente mutante y dinámica. Aunque los taoístas y confucionistas chinos siguen discutiendo hasta ahora sobre si la teoría de las cinco fases y la medicina de correspondencias sistemáticas a que dio lugar son una creación taoísta o confucionista, es este sistema de correspondencia sistemática el que sirve de base para casi todas las demás teorías y prácticas de la medicina china. Y, en tercer lugar, es el Nan Jing el que codifica el uso de los llamados puntos de transporte que hay entre los codos y las puntas de los dedos de las manos, y las rodillas y las puntas de los dedos de los pies. Algunas veces se les llama “puntos antiguos” o “puntos de mando”, y forman un conjunto de 60 puntos muy importantes para
la práctica de la acupuntura. Como explica el texto, cada uno de los 12 canales tiene un total de cinco puntos que corresponden a las cinco fases. Como cada una de las cinco fases corresponde a uno o más órganos y entrañas, canales y vasos, direcciones, estaciones, colores, aromas, olores, sonidos, fluidos, tejidos, emociones, etc., y como cada canal tiene un punto que corresponde a cada una de las cinco fases, al llenar y vaciar diferentes combinaciones de estos puntos de cinco fases, podemos restablecer el equilibrio dinámico de estas cinco fases en el cuerpo humano y entre el cuerpo humano y el macrocosmos exterior. Por tanto, El Nan Jing es un tratado básico importante para todo el que A) esté interesado por el diagnóstico chino del pulso, B) esté interesado por la medicina china de las correspondencias sistemáticas, en general, y la teoría de las de las cinco fases, en particular, y C) esté interesado por la acupuntura china en particular. Aunque este libro no describe el uso de las medicinas chinas, su teoría de la diagnosis y tratamiento se aplicó a la medicina interna en las dinastías Jin-Yuang. Desde entonces, el Nan Jing ha tenido un impacto amplio y duradero en la medicina china de todos los países a los que se ha extendido. Concretamente, el Nan Jing ha influido
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acupuntura europeos y americanos. Por eso creo que todo profesional de la medicina y la acupuntura chinas debe estar familiarizado con este tratado básico. Cada una de las preguntas y respuestas que figuran en este libro no abarca más que un párrafo o dos. Este libro resulta muy denso y conciso, incluso más de lo normal nor mal de la medicina china. En la China antigua, no se limitaban a leer este tratado, sino que lo memorizaban. Incluso se pretendía darle al escribirlo un estilo que facilitase la memorización. Por tanto, he pretendido mantener el carácter de resumen del original, dentro de lo posible. Donde he tenido que añadir palabras distintas de preposiciones y conjunciones que no estaban en el texto original, lo he hecho entre corchetes. Cuando he pensado que se necesitaba una explicación para que tuviese sentido una palabra, frase o pasaje, he puesto una nota a pie de página como comentario. En China hay muchos comentarios que analizan línea a línea el Nan Jing. Muchos de éstos figuran en la cuidada traducción que ha hecho de este texto Paul Unschuld: Medicine in China: Nan-ching, The Classic of Difficult Issues
(University of California Press, Berkeley, 1986) y yo remito a los lectores a esta fuente tan excelente para que puedan profundizar en este texto. Hay que decir que el Dr. Unschuld no es un profesional de la medicina china ni de la acupuntura y muchos profesionales occidentales se han quejado de que las palabras de que se sirve hacen que resulte difícil utilizar en una clínica su traducción de este tratado tan importante. Por ejemplo, Unschuld traduce qi como influencias y órganos y entrañas, como depósitos y palacios. Yo tampoco creo que el Dr. Unschuld, que no es nativo de habla inglesa, haya elegido siempre la palabra más directa ni la idónea para traducir al inglés. Su traducción tiene muchas más palabras que la mía. Es más, creo que el Dr. Unschuld ha insertado en el texto muchas anotaciones entre corchetes, con lo que impone ciertas interpretaciones. El tratado chino es ambiguo por naturaleza y, cuando traducimos tales textos de una forma demasiado minuciosa, perdemos muchos detalles de los significados que quiere sugerirnos el autor. Si leemos los diversos comentarios que figuran en el libro del Dr. Unschuld, veremos que se han debatido apasionadamente el
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Dentro de lo posible, he utilizado la terminología de las traducciones de Nigel Wiseman, tal como aparece en English-Chinese Chinese English Dictionary of Chinese Medicine , Hunan Science & Technology Press, Changsha, 1995. Cuando no estoy de acuerdo con la palabra elegida por el Dr. Wiseman, la marco y explico la razón de mi discrepancia con una nota a pie de página. Ésta va seguida después por una transliteración del nombre en Pinyin y la identificación del canal y el número entre paréntesis. Estas identificaciones de canal y número se basan en la nomenclatura normal de los puntos de acupuntura recomendada por la Organización Mundial de la Salud, con las excepciones siguientes: P significa pulmones; B significa bazo; C, corazón; V, vejiga; R, riñones; MC, maestro del corazón; TC, triple calentador; H, hígado, VC, vaso concepción; VG, vaso gobernador. Los textos originales de esta traducción se tomaron del ya mencionado libro de Unschuld, en el que figuran completos los textos chinos, el Nan Jing publicado por Sciencie & Technology Publishing Co., Beijing, 1996, y Knan Jing Jing Shi (An Elucidation of the Classic of Difficulties) de Xu da-chun, publicado por el Jiangsu Science & Technology Publishing Co., 1985. El Nan Jing es uno de los cuatro textos básicos de la medicina china, siendo los demás el Nei Jing, el Shang Han Lun (Tratado sobre el daño [producido por el] frío y el Shen Nong Ben Cao (Materia médica del Granjero Divino) . Cabe esperar que esta edición de este clásico original impulse a más escuelas occidentales de acupuntura para incluir su estudio en su currículo básico de nivel inicial.
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Indice
Las dificultades 1-22 .............................. ............................................. .............................. ........................6 .........6 Tratan del reconocimiento reconocimiento por el pulso. ........................................... .............................. ..................... ...... 37 Las dificultades 23-29 ............................
Tratan de los canales y vasos de la red. ........................................... .............................. ..................... ...... 47 Las dificultades 30-47 ............................
Tratan de la anatomía y la fisiología. Las dificultades 48-61 ............................ ........................................... .............................. ..................... ...... 67
Tratan de las enfermedades, en sus causas, mecanismos y diagnósticos. Las dificultades 62-68 ............................ ........................................... .............................. ..................... ...... 85
Tratan de los 60 puntos de transporte. ........................................... .............................. ..................... ...... 92 Las dificultades 69-81 ............................ Tratan del modo modo de ll
y vaciar con
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Uno De los doce canales, todos tienen vasos agitados. Pero se elige sólo el cun kou o arteria radial de la muñeca para determinar la muerte y la vida, los auspicios buenos y los malos de los cinco órganos y las seis entrañas. ¿Qué significa esto? La dificultad Uno dice: 1
La arteria radial es la gran confluencia de todos los vasos que están situados en el vaso agitado del tai yin de la mano. Cada vez que exhala una persona, [el contenido de] los vasos se desplaza tres pulgadas. [Una] exhalación y [una] inhalación forman [una] respiración, [durante la cual] los vasos se desplazan seis pulgadas. En los seres humanos se produce 13.500 respiración en un ciclo completo de día y noche [durante el cual, el contenido de] los vasos recorre cincuenta circuitos por el cuerpo [en el tiempo que se necesita para que] el agua gotee cien marcas del reloj de agua]. Lo constructivo y defensivo recorre veinticinco circuitos [durante] el yang, del mismo modo que también recorren 25 circuitos [durante] el yin. Esto completa un ciclo. Por tanto, [después de] cincuenta circuitos [el contenido de los vasos] vuelve a encontrarse en el tai yin de la mano. [Según esto], la arteria radial es el principio y el fin de los cinco órganos y las seis entrañas y, por consiguiente, el método consiste en elegir la arteria radial. Respuesta:
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Dos La dificultad dos dice:
El pulso tiene un codo y una pulgada. 2
¿Qué significa esto? Respuesta: El codo y la pulgada son los grandes e importantes puntos de encuentro de los vasos. Desde la barra al Cúbito [Marsh, i.e., Chi Ze, H11] hay un codo en la [parte interior del antebrazo]. Desde la barra hasta el Pez [Vientre, i.e., el lado más próximo de la
eminencia tenar] está la arteria radial. Es el sitio donde se trata el yin. Por tanto, [la barra] separa la pulgada para hacer el codo, [del mismo modo que] separa el codo para formar la pulgada. Así se obtiene el yin, en una pulgada del cúbito, [mientras que] el yang se obtiene dentro de los nueve fen de la pulgada. El codo y la pulgada [desde] el principio hasta el final, es una pulgada, nueve fen. Por eso se le llama el codo y la pulgada.
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Tres Los pulsos pueden ser exageradamente excesivos o insuficientes. Se puede tener el yin y el yang dominando uno sobre otro, decaído o derramado, atascado o bloqueado. ¿Qué significa esto? La dificultad tres dice:
Enfrente de la barra es donde se agita el yang. El pulso que encontramos en estos nueve fen es flotante. [Si se extiende] por encima de [estos nueve fen] , , se dice que se exageradamente excesivo. Si está vacío, se dice que no llega. Si sigue subiendo por el Pez [Vientre], se derrama. Esto se produce por un atasco externo o un bloqueo interno. Esto significa que es el yin el que predomina en los vasos. Detrás del atasco es donde se agita el yin. El pulso que se toma dentro de esta pulgada está hundido. Si [se pasa] más allá [de esta zona], se considera muy excesivo. Si está vacío, se considera insuficiente. Si se extiende hacia el cúbito, se considera volcado. Se produce por un atasco interno y un bloqueo externo. Esto significa que es el yang el que predomina en los vasos. Por tanto, se habla de volcado y derramado. Existen los [llamados] pulsos viscerales verdaderos. [Aunque] la persona afectada no se encuentre enferma, esto es [significa] la muerte. Respuesta:
3
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Cuatro La dificultad cuatro dice:
Los pulsos tienen el método del yin y el
yang. ¿Qué significa esto? La exhalación sale del corazón y los pulmones, mientras que la inhalación entra a los riñones y el hígado. Entre la inhalación y la exhalación, el bazo recibe granos y aromas. Su pulso está situado en el centro. El que flota es el yang y el que se hunde, el yin. Esto es lo que se llama yin y yang. Respuesta:
Los [pulsos] del corazón y los pulmones están flotando los dos. ¿Cómo podemos distinguirlos? Respuesta: El que flota y está muy disperso [corresponde al] cora-
zón. El flotante, corto y astringente [corresponde a] los pulmones.
4
Si, tanto los riñones como el hígado, están hundidos, ¿cómo podremos distinguirlos? Lo estrecho y alargado [corresponde al] hígado. Si presionas humedeciendo y, al levantar los dedos, se llena, [corresponde] a los riñones. El bazo es la isleta central. Por tanto, su pulso está situado en el centro. Éste es el método del yin y el yang. Respuesta:
El pulso puede tener un yin y un yang, un yin y dos yang [o] un yin y tres yang. [También] puede tener un yang y un yin, un yang y dos
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Esta sentencia no [significa] que estén agitados los seis pulsos [mismo tiempo]. Esto indica [o significa] [pulsos] flotantes y hundidos, largos, cortos, escurridizos y cortados. El flotante es yang, el escurridizo es yang y el largo es yang. El hundido es yin, el corto es yin y el cortado es yin. Por eso, cuando se habla de un yin y un yang, se quiere decir que el pulso se hace hundido y escurridizo. Un yin y dos yang significa que el pulso se hace hundido, escurridizo y largo. Un yin y tres yang significa que el pulso se hace flotante, escurridizo y largo [pero también] hundido de vez en cuando. Lo que decimos que es un yang y un yin significa que el pulso se hace flotante y cortado. Un yang y dos yin significa que el pulso se hace largo, hundido y cortado. Un yang y tres yin significa que el pulso se hace hundido, cortado y corto [y también] flotante, de vez en cuando. En cada [caso] dependiendo del canal en que se esté, se sabe [si] la enfermedad [se desplaza] correctamente o en contra del flujo. Respuesta:
5
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Cinco La dificultad cinco dice:
Los pulsos tienen ligero y pesado. ¿Qué
significa esto? Respuesta: Para empezar, toma el pulso. Si es tan pesado como tres
udías y se ha tomado en la piel y el pelo, se trata de la sección de los pulmones. Si es tan pesado como seis judías y se ha tomado en los vasos sanguíneos, se trata de la sección del corazón. Si pesa como nueve judías y se ha tomado en los músculos y la carne, es la sección del bazo. Si pesa como doce judías y se ha tomado en los tendones, es la sección del hígado. [Si se] presiona un rato contra el hueso y se sueltan los dedos [hasta notar] [de nuevo un flujo] rápido, es la sección de los riñones. Así es como se habla de ligero y pesado, [refiriéndose al pulso]. 6
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Seis Los pulsos tienen exuberancia yin y vacío yang y exuberancia yang y vacío yin. ¿Qué significa esto? La dificultad seis dice:
Respuesta: Si el flotante [el nivel superficial de pulso] disminuye y
es pequeño, cuando está hundido [o el nivel profundo del pulso] está repleto y es grande, es lo que se llama exuberancia yin y vacuidad yang. Si el hundido disminuye y es pequeño y el flotante está repleto y es grande, es lo que se conoce como exuberancia yang y vacuidad yin. Esto es lo que se quiere dar a entender con vacuidad y plenitud yin y yang.
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Siete La dificultad siete dice: El [ Nei Nei] Jing (Tratado interior ) dice que la llegada del shao yang puede ser grande o pequeña, corta o larga. La llegada del yang ming es flotante, grande y corta. La llegada del tai yang es surgente, grande y larga. La llegada del tai yin es estrecha, grande y larga. La llegada del shao yin es estrecha, fina y débil, y la llegada del jue yin es hundida, corta y pesada. ¿Son todos los 7
seis pulsos de este nivel [normales] o son enfermos? Respuesta:
Todos ellos son pulsos reyes. 8
¿Durante qué meses y en qué días es rey su qi? Respuesta: Después del solsticio de invierno, [durante el primer] jia zi [siguiente] shao yang es el rey. A partir del jia zi siguiente, el rey es yang ming. En el tercero, el rey es tai yang. En el que viene después, el rey es tai ying. En el otro jai zi, el rey es shao yin. Al siguiente jia zi, es jue yin. Cada uno es rey durante 60 días. Seis 9
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Ocho El pulso de arteria radial [puede estar] nivelado [normal] y, sin embargo, puede haber muerte. ¿Qué significa esto? La dificultad ocho dice:
El pulso de todos los 12 canales está vinculado con el origen del qi vivo, por lo que se dice que el origen del qi vivo es la raíz de los 12 canales. Es el qi que se mueve entre los riñones. Es la raíz de los cinco órganos y las seis entrañas, la raíz de los 12 canales y sus pulsos, la puerta de inhalación y exhalación y el origen de los tres calentadores. Otro de sus nombres es el espíritu que guarda contra los males. Por tanto, el qi es la raíz de una persona. Si se corta la raíz, se marchitan el tallo y las hojas. Si el pulso de la arteria radial está nivelado y hay muerte, sólo puede ser porque el qi vivo está interrumpido [o cortado] por dentro. Respuesta:
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Nueve ¿Cómo se puede distinguir las enfermedades de los órganos y las entrañas? La dificultad nueve dice:
Rápido, [y la enfermedad] está en las entrañas. Lento, [y la enfermedad] está en los órganos. La rapidez se debe al calor. La lentitud se debe al frío. Todas las [condiciones] yang se producen con el calor. Todas las [condiciones] yin se producen con el frío. Así es como se distinguen las enfermedades de los órganos y las de las entrañas. Respuesta:
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Diez La dificultad diez dice:
Cada pulso tiene 10 cambios. ¿Qué
significa esto? Respuesta: Esto tiene que ver con los conceptos de los cinco males,
la dureza y la blandura, y la influencia mutua. Por ejemplo, si el pulso del corazón es muy tenso, los males del hígado han entrado en el corazón. Si el pulso del corazón está un poco tenso, los males de la vesícula biliar han entrado en el intestino. Si el pulso del corazón es demasiado grande, los males del corazón han entrado en el propio corazón. Si el pulso del corazón es ligeramente grande, los
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Once dice que, si el pulso no da 50 latidos y se para alguna vez, una víscera está sin qi. ¿Qué significa esto? La dificultad once dice: El tratado
Respuesta: La inhalación de una persona sigue al yin y entra, mien-
tras que la exhalación se debe al yang y sale. Si la inhalación no es capaz de llegar a los riñones, sino que se vuelve al llegar al hígado, sabemos que hay una víscera sin qi y que es el qi de los riñones el primero que se agota.
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Doce dice que, si los cinco pulsos viscerales están ya interrumpidos por dentro, es contraproducente [erróneo] utilizar agujas para llenar lo externo. Si los cinco pulsos viscerales están ya interrumpidos por fuera, es contraproducente utilizar agujas para llenar lo interno. ¿Cómo podemos distinguir entre interrupción interna y externa? La dificultad doce dice: El tratado
Si los cinco pulsos viscerales están ya interrumpidos por dentro, [esto significa que] los vasos de los riñones y del hígado están interrumpidos por dentro. [En tal caso], el médico [actúa] de Respuesta:
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Trece dice: si uno ve el color [complexión facial de una persona] y no puede tomar el pulso [correspondiente], sino que, por el contrario, encuentra un pulso [que indica] que hay una confrontación mutua, [está persona] morirá. En cambio, si se encuentra un pulso de generación mutua, la enfermedad se cura por sí sola. [Por tanto], el color y el pulso [de una persona] pueden compararse en su correspondencia mutua; pero ¿cómo se hace esto? Respuesta: Los cinco órganos tienen cinco colores y cada uno de ellos puede verse en la cara. Estos pueden corresponder también al La dificultad trece dice: El Tratado
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color es negro, el pulso debe ser hundido, húmedo y escurridizo. Esto es lo que se quiere dar a entender al decir que el color y el pulso deben corresponderse mutuamente. 13
Si el pulso es rápido, la piel del lado interior del cúbito debe ser también rápida. Si el pulso es tenso, la piel del cúbito debe ser también tensa. Si el pulso es moderado, la piel del cúbito debe ser también moderada. Si el pulso es cortado, la piel del cúbito debe 14
15
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Catorce La dificultad catorce dice:
llegada. ¿Qué significa esto?
El pulso puede tener detrimento y
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insuficientes y no pueden construir los cinco órganos y las seis entrañas. El tercer detrimento es el de los músculos y la carne. Los músculos y la carne están dispersos y agotados. La comida y la bebida no son capaces de hacer los músculos y la piel. El cuarto detrimento es el de los tendones. Los tendones están relajados [flojos] y no pueden contraerse y mantenerse. El quinto detrimento es el de los huesos. Los huesos están marchitos y uno no es capaz de levantarse de la cama. Lo contrario [lo opuesto a esto] es la
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exhalación y tres llegadas en una inhalación, está precisamente [al principio de] contraer una enfermedad. Si el pulso es grande por delante y pequeño por detrás, hay dolor de cabeza y vértigo. Si [el pulso] es pequeño por delante y grande por detrás, hay plenitud en el pecho y deficiencia de qi [respiración corta]. Si hay cuatro llegadas en una exhalación y cuatro llegadas en una inhalación, la enfermedad sigue adelante o está agravándose. Si el pulso es surgente y grande, hay amargura, vejación y plenitud. Si está 21
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Quince dice que, en primavera, el pulso es [como] cuerda de arco. En verano, el pulso es [como] un gancho. En otoño, en pulso es [como] el cabello, mientras que, en invierno, es [como] una piedra. ¿Son éstos pulsos regios o pulsos de La dificultad quince dice: El Tratado
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estación corresponde a] los riñones, el norte y el agua. [Durante esta
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está curvado por detrás, es continuo [tal como debe ser, y, por tanto,
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en el estómago, se llama muerte. En invierno, el qi del estómago es
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Cuarenta y dos ¿Qué es lo largo y lo corto [ Ej. Ej. Contiene] Longitud] de las entrañas y el estómago y cuál recibe [ Ej. más agua y granos La dificultad cuarenta y dos dice:
Respuesta: El estómago tiene un codo y cinco pulgadas de ancho y
su diámetro es de cinco pulgadas. Su longitud es de dos codos y seis pulgadas. Está enrollado de forma horizontal y recibe tres dou y cinco sheng de agua y granos. Suele retener en su interior dos dou de granos y un dou y cinco sheng de agua. El intestino delgado tiene dos pulgadas y media de ancho. Su diámetro es de ocho fen y [un poco] menos de medio fen. Su longitud es de tres chang y dos codos. Recibe dos dou y cuatro sheng de grano y seis sheng y tres y [un poco] menos de medio he de agua. El intestino de retorno tiene cuatro pulgadas de ancho. Su diámetro es de pulgada y media. Su longitud es de dos chang y un codo. Recibe un dou de grano y siete sheng y medio de agua. El intestino grueso tiene ocho pulgadas de ancho y su diámetro es de dos pulgadas y media. Tiene dos codos y ocho pulgadas de largo. Recibe nueve sheng y tres he y un octavo de grano. Por tanto, la longitud de las entrañas y el estómago es de cinco chang ocho codos y cuatro pulgadas. La combinación de grano y agua que admite es de ocho dou, siete sheng y un octavo de he. Esto es lo largo y lo corto de las entrañas y el estómago y los números del agua y el grano que admiten. El hígado pesa dos jin y cuatro liang. Al lado izquierdo tiene tres hojas [o lóbulos] y, al derecho, cuatro lóbulos, lo que hace un total de siete lóbulos. Alberga principalmente el hun [o alma etérea]. El corazón pesa 123 liang. Tiene siete agujeros y tres capilares. Es Ej. Se llena con] tres he de jugo de esencia. Almacena exuberante [ Ej. principalmente el espíritu. El bazo pesa dos jin y tres liang. Su
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Contiene la sangre, calienta los cinco órganos y, sobre todo, almacena la mente. Los pulmones pesan tres jin y tres liang. Tiene seis lóbulos y dos orejas, lo que hace ocho lóbulos. Almacenan principalmente el po [o alma corpórea]. Los riñones tienen dos entidades. Pesan un jin y dos liang. Principalmente, almacenan la voluntad. La vesícula biliar está situada entre los lóbulos cortos del hígado. Pesa tres liang y tres chu. Es exuberante [o está llena con] tres he de jugo de esencia. El estómago pesa dos jin y 14 liang. Se curva, doblándose y extendiéndose. Tiene dos codos y seis pulgadas de largo; un codo y cinco pulgadas, de ancho, y su diámetro es de cinco pulgadas. Está exuberante [se llena con] dos dou de grano y un dou y cinco sheng de agua. El intestino delgado pesa dos jin y 14 liang. Tiene tres chang y dos codos de largo; dos pulgadas y media, de ancho, y un diámetro de ocho fen y [un poco menos] de medio. Está plegado y se envuelve hacia la izquierda, con 16 vueltas. Está exuberante [se llena con] dos dou y cuatro sheng de grano y seis sheng y tres he y algo más de medio de agua. El intestino grueso pesa tres jin y 12 liang, tiene una longitud de dos chang y un codo, una anchura de cuatro pulgadas y un diámetro de una pulgada. Está situado exactamente en el ombligo y se envuelve hacia la derecha con 16 vueltas. Está exuberante [se llena con] un dou de grano y siete sheng y medio de agua. La vejiga urinaria pesa nueve liang y dos chu. Dilatada, tiene una anchura de nueve pulgadas. Está exuberante [se llena con] nueve sheng y nueve he de orina. La boca tiene dos pulgadas y media de ancho. De los labios a los dientes hay una distancia de nueve fen. Desde los dientes hacia atrás, a la epiglotis, hay una profundidad de tres pulgadas y media. [La cavidad oral] contiene, como mucho, cinco he. La lengua pesa 10 liang. Tiene siete pulgadas de largo y dos y media, de ancho. La puerta de la garganta [o esófago] pesa 12 liang. Tiene dos pulgadas y media de ancho. [Desde allí] hasta el estómago hay un codo y seos pulgadas de longitud. La tráquea pesa 12 liang, tiene dos pulgadas de ancho y un codo y dos pulgadas de largo, con nueve articulaciones. La puerta anal pesa 12 liang, tiene ocho fen de ancho y poco más de dos pulgadas y media de diámetro. Tiene dos codos y ocho pulgadas de longitud. Recibe nueve sheng y tres he y un octavo de grano.
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Cuarenta y tres Si una persona no come ni bebe durante siete días, muere. ¿Por qué ocurre esto? La dificultad cuarenta y tres dice:
Respuesta: El estómago de una persona retiene dos dou de grano y un dou y cinco sheng de agua. Por tanto, una persona que tenga un
nivel [de salud normal] irá a la letrina dos veces al día y en cada movimiento [de entrañas evacuará] dos sheng y medio, lo que hace cinco sheng al día. En siete días, [tiene que evacuar] cinco [veces] siete[o] tres dou y cinco sheng. Con eso terminan toda su agua y sus granos. Por tanto, si una persona sana no come ni bebe durante siete días y muere, su muerte se debe a que su agua, granos, fluidos y humores se han terminado [o utilizado] todos.
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Cuarenta y cuatro La dificultad cuarenta y cuatro dice:
siete puertas de paso?
¿Dónde están situadas las
43
Respuesta: Los labios son la puerta rápida. Los dientes son la puer-
ta de entrada. La epiglotis es la puerta de inhalación. El estómago es la puerta de aceleración. La boca [o abertura] inferior del gran granero es la puerta más baja. El lugar donde se encuentran el intestino delgado y el grueso es la puerta de balaustrada. El final más bajo [el ano] es la puerta del po [o alma corpórea]. Por tanto, hay siete puertas de paso.
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Cuarenta y cinco La dificultad cuarenta y cinco dice: El tratado
dice que hay ocho
encuentros. ¿Cuáles son? Respuesta: Las entrañas se encuentran en el Gran Granero ( Tai CNAG, VC12). Los órganos se encuentran en la Costilla Flotante ( Ji Xie, H13). Los tendones se juntan en el manantial del Montículo Yang (Yang Ling Quan, VB34). La médula se encuentra en el Jue Gu, VB39). La sangre se encuentra en el Hueso Roto ( Jue Transporte del Diafragma ( Ge Shu, V17). Los huesos se encuentran Da Shu, V10). Los vasos se encuentran en el Gran Transbordador ( Da en el Gran Abismo ( Tai Yuan, P9). El qi se encuentra en el triple
calentador, por fuera, [en el punto localizado en] un tendón directamente entre los dos pechos. Si se sitúa por dentro una enfermedad de calor, elige el orificio qi del punto de encuentro [de la entidad afectada].
44
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Cuarenta y seis Las personas de edad avanzada se acuestan; pero no duermen. La gente joven y fuerte se duerme y no se levanta. ¿Por qué es eso? La dificultad cuarenta y seis dice:
dice que la gente joven y fuerte [tiene] exuberancia de sangre y de qi. Sus músculos y su carne están brillantes [o suaves], sus pasos de qi fluyen libremente y el movimiento de lo que tienen de constructivo y defensivo no pierde su constancia [o regularidad]. Por tanto, durante el día están atentos, y, por la noche, no se despiertan. La sangre y el qi de la gente de edad están debilitados, sus músculos y su carne no tienen brillo y sus pasos constructivos y defensivos están cortados [o rugosos]. Por tanto, no pueden estar atentos y, por la noche, no duermen. Así podemos comprender [por qué] las personas de edad no consiguen dormir. Respuesta: El Tratado
45
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Cuarenta y siete La dificultad cuarenta y siete dice:
Sólo el rostro de las personas
puede resistir el frío. ¿Por qué es eso? La cabeza de una persona es el punto de encuentro de todo el yang.. Todos los vasos yin llegan al cuello, al pecho, al centro, y regresan después. Todos los vasos yang son los únicos que ascienden hasta llegar a la cabeza y a los oídos. Por eso es por lo que el rostro puede soportar el frío. Respuesta:
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Cuarenta y ocho La dificultad cuarenta y ocho dice:
La gente tiene tres vacuidades
y tres plenitudes. ¿Qué significa esto? Uno puede tener vacuidad o plenitud de los pulsos, vacuidad o plenitud de enfermedades o plenitud y vacuidad de los Ej. Signos y síntomas. Hablando de] vacuidad y reconocimientos [ Ej. plenitud de los pulsos, el mojado indica vacuidad, mientras que el tenso y breve indica plenitud. [Si hablamos de] vacuidad y plenitud de enfermedades, si sale [honradez], indica vacuidad, mientras que si, entran [males], indica plenitud. Hablar indica vacuidad, mientras que no hablar [estar taciturno y despistado] indica plenitud. La relajación indica vacuidad, mientras que la tensión indica plenitud. [Hablando de] vacuidad y plenitud de los reconocimientos, la humedad [o suavidad] indica vacuidad y confinamiento [y la dureza] indica plenitud. El picor indica vacuidad, mientras que el dolor indica plenitud. El dolor externo con placer [o alivio] indica plenitud externa y vacuidad interna. El dolor interno con placer externo indica plenitud interna y vacuidad externa. Eso es lo que se dice de la vacuidad y la plenitud. Respuesta:
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Cuarenta y nueve ¿Cuál es la diferencia que hay entre [cuando] los canales regulares enferman por sí mismos y [cuando] los perjudican los cinco males? La dificultad cuarenta y nueve dice:
dice que el sufrimiento y la ansiedad, las obsesiones y la tristeza dañan el corazón. El frío corporal y las bebidas frías dañan los pulmones. El contraflujo colérico del qi y la ascensión sin descenso dañan el hígado. Comer y beber y el exceso de esfuerzo y la fatiga dañan el bazo. Estar mucho tiempo sentado sobre tierra húmeda o meterse al agua después de un ejercicio fuerte daña los riñones. Así es como pueden enfermar los canales regulares por sí mismos. Respuesta: El Tratado
¿Qué quiere decir con los cinco males? Haber sido golpeado por el viento, haber sufrido daños por el calor del verano o por la comida y la bebida y haber hecho un ejercicio [demasiado] fuerte o estar fatigado, haber sufrido daños por frío, haber soportado humedad, todo esto se llama los cinco males. Fíjate, por ejemplo en la enfermedad del corazón. ¿Cómo puede saber uno si se debe a que se ha recibido un golpe de viento? Respuesta:
Ej. El de la complexión del rostro] debe ser Su color [ Ej. rojo. ¿Por qué digo esto? El hígado rige los colores. Si la
Respuesta:
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Deben tener un olor maligno [o malo]. ¿Por qué digo esto? El corazón rige los olores o aromas. Si entra la enfermedad por sí misma, se produce un olor a requemado. Si entran [los males] en el bazo, se produce un olor aromático. Si entran en el hígado, huele a tostado. Si es en los riñones, es pútrido. En los pulmones, el olor es repugnante [a pescado]. Por tanto, se sabe que, si el corazón está enfermo porque se ha recibido daño por el calor del verano, [el paciente] debe tener un olor maligno. Su enfermedad [tiene también] calor corporal y vejación y dolor de corazón. Su pulso es flotante, amplio y cortado. Respuesta:
¿Cómo se puede saber si se debe la enfermedad a la comida, la bebida, [exceso de] ejercicio o fatiga? Deben tener predilección por el sabor amargo. La vacuidad hace que no se tengan ganas de comer. La plenitud hace que se tengan ganas de comer. ¿Por qué digo esto? El bazo rige los sabores. [Los males] que entran en el hígado producen sabor agrio. Si están en el corazón, producen sabor amargo. Si entran en los pulmones, producen acritud. Si entran en los riñones, producen sabor salado. Si la enfermedad entra por sí misma produce sabor dulce. Por eso se sabe que esos males del bazo han entrado en el corazón y esto produce sabor amargo. Su enfermedad [tiene también] calor corporal y pesadez de cuerpo, ganas de acostarse y falta de contracción de las cuatro extremidades. El pulso es flotante, amplio y moderado o relajado. Respuesta:
¿Cómo se puede saber si se debe [su enfermedad] a daños producidos por el frío?
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hable frenéticamente. Su enfermedad [tiene también] calor Ej. temblores] y aversión al frío. Si es grave, corporal, con rociado [ Ej. hay jadeo y tos. El pulso es flotante, amplio y cortado. ¿Cómo se puede saber si [su enfermedad] se debe a humedad? Respuesta: El enfermo debe tener predilección por el sudor, que no
puede detenerse. ¿Por qué digo esto? Los riñones producen humedad. Los males que entran en el hígado producen lágrimas. Los que entran por el corazón producen sudor. Los que entran por el bazo, babeo. Los que entran por los pulmones, llanto. Cuando se produce por sí misma, saliva. Así es como se sabe que los males del riñón han entrado en el corazón, produciendo un sudor que no se puede detener. Esta enfermedad [tiene también] calor corporal, dolor del bajo vientre, frío en los pies y las espinillas y flujo contrario. Su pulso es hundido, húmedo y amplio. Éste es el método para [conocer] los cinco males. 46
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Cincuenta Las enfermedades pueden tener males de vacuidad y males de plenitud. Pueden tener males ladrones, pueden tener males marchitos [o leves] y pueden tener males regulares. ¿Cómo se distinguen? La dificultad cincuenta dice:
Respuesta: [Las que] vienen de la parte de atrás producen males de
vacuidad. Las que vienen de la parte de delante producen males de plenitud. Las que vienen de lo que no se ha superado producen males ladrones. Las que vienen de lo que se ha superado producen males marchitos y la enfermedad que surge por sí misma producen males regulares. ¿Por qué digo esto? Toma, por ejemplo, una enfermedad del corazón. Si se ha adquirido por un golpe de viento, produce males de vacuidad. Si se ha adquirido por recibir daños del calor del verano, produce males regulares. Si se debe a la comida, la bebida y el exceso de ejercicio o la fatiga, produce males de plenitud. Si se debe a daños recibidos por frío, produce males marchitos. Si se debe a que se ha cogido humedad, produce males
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Cincuenta y uno Las enfermedades pueden dar ganas de tener calor o de recibir frío. Puede apetecer estar con la gente o que no lo vean a uno. Cada una es distinta. ¿Cómo [se puede saber si] la enfermedad está localizada en los órganos o en las entrañas? La dificultad cincuenta y uno dice:
Si al enfermo le apetece el frío y quiere ver a la gente, la enfermedad está en las entrañas. Si prefiere el calor y no quiere ver a la gente, está en los órganos. ¿Qué quiere decir esto? Las entrañas son yang. Con las enfermedades yang se prefiere el frío y ver a la gente. Los órganos son yin. Con las enfermedades yin se quiere calor y estar sólo con la puerta cerrada. Se siente aversión a oír las voces de la gente. En eso se pueden distinguir y conocer las enfermedades de los órganos y las entrañas. Respuesta:
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Cincuenta y dos La dificultad cincuenta y dos dice: Cuando los órganos y las entrañas emiten malestar [ Ej. Se ponen enfermos], ¿son, en la raíz, lo
mismo o algo diferente? Respuesta: No son lo mismo.
¿Por qué no son lo mismo? Ej. EsLas enfermedades de los órganos son paradas [ Ej. táticas] y no son variables. Esas enfermedades no se mueven de su sitio. Las enfermedades de las entrañas dañan el Buddha y dan vueltas haciendo ruido. Ascienden y descienden, fluyen y se mueven sin constancia hacia su morada. Así, pues, por esto se conoce que las raíces [de la enfermedad] de los órganos y de los riñones no son las mismas.
Respuesta:
47
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Cincuenta y tres dice que siete transmisiones es muerte. La intertransmisión es vida. ¿Qué significa esto? La dificultad cincuenta y tres dice: El Tratado
Siete transmisiones [de víscera a víscera, significa] transmisión hacia donde[o lo que] superan [según la teoría de las cinco fases Inter-transmisión [significa] transmitir al niño. ¿Por qué digo esto? Pongamos como ejemplo una enfermedad del corazón transmitida a los pulmones. Los pulmones la transmiten al hígado, [mediante el ciclo de control]. El hígado la transmite al bazo. El bazo la transmite a los riñones. Los riñones la transmiten al corazón. Una víscera no se puede dañar dos veces. Por eso se dice que siete transmisiones es muerte. [Si una enfermedad] intertransmite se transmite al lugar donde se ha generado. Pongamos, como ejemplo, una enfermedad del corazón transmitida al bazo. El bazo la transmite a los pulmones; los pulmones, a los riñones; los riñones, al hígado, y el hígado, al corazón. Es la Respuesta:
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Cincuenta y cuatro Las enfermedades viscerales son difíciles de tratar, mientras que las de las entrañas son fáciles de tratar. ¿Qué significa esto? La dificultad cincuenta y cuatro dice:
Las enfermedades viscerales son difíciles de tratar, [porque] transmiten hacia lo que superan. Las enfermedades de las entrañas son fáciles de tratar, [porque] transmite hacia su hijo. Es el mismo método [o principio] de las siete transmisiones y sus intertransmisiones [analizadas antes]. Respuesta:
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Cincuenta y cinco Las enfermedades pueden tener acumulaciones y congregaciones. ¿Cómo se distinguen? La dificultad cincuenta y cinco dice:
Las acumulaciones son qi yin. Las congregaciones [son] qi yang. Por tanto, el yin se hunde y está profundo [u oculto], mientras que el yang flota y se agita. El lugar donde se acumula el qi se llama acumulación. El lugar donde se congrega el qi se llama congregación. Según esto, las acumulaciones se generan en los cinco órganos, mientras que las congregaciones se producen en las seis entrañas. Las acumulaciones [son] qi yin. [Por eso], empiezan y Respuesta:
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Cincuenta y seis ¿Tiene cada una de las acumulaciones de los cinco órganos su propio nombre? ¿En qué mes y en qué día se presentan o contraen? La dificultad cincuenta y seis dice:
La acumulación del hígado se llama qi graso. Está situada en el hipocondrio izquierdo. Es como una copa puesta boca abajo. Tiene cabeza y pies. Tarda [mucho tiempo] en curar y el enfermo emite [o desarrolla] contraflujo de tos, tétanos y [síntomas] parecidos a los de la malaria. No termina a lo largo del año. Se ha contraído el verano anterior, en días wu y ji. ¿Por qué digo esto? La Respuesta:
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amarillenta. La comida y la bebida no hacen músculos ni piel. Se contrae en invierno, en días ren y gui. ¿Por qué digo esto? La enfermedad del hígado se transmite al bazo. El bazo tiene que transmitirla a los riñones. Los riñones son el único rey del invierno y el rey no acepta males. [Después], el bazo trata de reciclar [estos males] y mandarlos al hígado de nuevo; pero el hígado se niega a aceptarlos. Entonces, se retienen y sujetan, formando una acumulación. Por esto podemos saber que el qi sombrío se contrae en invierno, en días ren y gui. La acumulación de los pulmones se llama respiración acelerada. Está situado en el hipocondrio derecho. Es varias veces mayor que una copa. Tarda [mucho tiempo] en curar y el enfermo tirita, [alternando] frío y calor, y tiene jadeos y tos y congestión pulmonar. Se contrae en primavera, en días jia o yi. ¿Por qué digo esto? La enfermedad del corazón se transmite a los pulmones. Los 48
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Cincuenta y siete La dificultad cincuenta y siete dice:
¿Cuántos tipos de descarga o
diarrea hay? Respuesta: Hay cinco tipos de descarga [o diarrea] y su nombre no
es el mismo. Está la descarga del estómago, la descarga del bazo, la descarga del intestino grueso, la descarga del intestino delgado, y la descarga de gran aglomeración. [También hay algo] llamado pesadez [o tenesmo. En] la descarga del estómago, la comida y la bebida no se transforman y el color [de
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Cincuenta y ocho ¿Cuántos son los tipos de daños producidos por el frío y cambian los pulsos [con ellos o] no? La dificultad cincuenta y ocho dice:
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enfermedad no es estable [ Ej. no descansa] en ningún sitio. El sudor no deja de manar y las raíces de los dientes están secas y doloridas.
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Cincuenta y nueve La dificultad cincuenta y nueve dice:
manías y las epilepsias?
¿Cómo se distinguen las
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Sesenta La dificultad sesenta dice: [Entre] las enfermedades de la cabeza y
el corazón, hay dolor de inversión y dolor verdadero. ¿Qué significa
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Sesenta y uno dice que el que mira y conoce [el diagnóstico del paciente] se llama [como]-espíritu [o divino]. El que oye y conoce se llama [como]-sabio. El que La dificultad sesenta y uno dice: El Tratado
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