天以气而焘，地以气而持。万物盈乎天地之间，咸以气而生。及其病也，莫不以
气而得。且风之气，和平而HT 启；热之气，暄而舒荣；火之气，炎暑而出行，湿之气，埃溽
而盈，燥之气，清劲而凄怆；寒之气，寒雾而归藏。此六气时化，司化之常也。
及其变，风之气，飘怒而反大凉；热之气，大暄而反寒；火之气，飘风燔燎而反霜凝；湿之气，雷霆骤
注而反烈风；燥之气，散落而反湿；寒之气，寒雪霜雹而反白埃。此六气之变也。故天久寒
则治之以暑；天久凉则治之以暄；天久晦则治之以明；天久晴则治之以雨。夫天地之气，常
则安，变则病。而况人禀天地之气，五运迭侵于其外，七情交战于其中。是以圣人啬气，如
持至宝；庸人役物，而反伤大和。此轩岐所以论诸痛，皆因于气，百病皆生于气。遂有九气不同之说。
气，本一也，因所触而为九。所谓九者，怒、喜、悲、恐、寒、暑、惊、思、劳也。其言曰∶怒则
气逆，甚则呕血及飧泄，故气逆上矣。王太仆曰∶怒则阳气逆上，而肝木乘脾，故甚则呕血
及飧泄也。喜则气和志达，荣卫通利，故气缓矣。悲则心系急，肺布叶举而上焦不通，荣卫
不散，热气在中，故气消矣。恐则精却，却则上焦闭，闭则气还，还则下焦胀，故气不行矣
。王太仆云∶恐则阳精却上而不下流，下焦阴气，亦还回而不散，故聚而胀也。然上焦固禁
，下焦气还，故气不行也。
《新校正》云∶不行当作下行。寒则腠理闭，气不行，故气收矣。王
太仆云∶身寒则卫气沉，故皮肤文理，及渗泄之处，皆闭密而气不流行，卫气收敛于中而不
散也。炅则腠理开，荣卫通，汗大出，故气泄矣。王太仆云∶人在阳则舒，在阴则惨。故热
则肤腠开发，荣卫大通，津液外渗，汗大泄。惊则心无所根据，神无所归，虑无所定，故气乱
矣。劳则喘息汗出，内外皆越，故气耗矣。王太仆云∶疲劳役则气奔速，故喘息。气奔速，
则阳外发，故汗出。内外皆逾越于常纪，故气耗损也。思则心有所存，神有所归，正气留而不
行，故气结矣。王太仆云∶系心不散，故气亦停留。此《素问》之论九气，其变甚详，其理甚明。
然论九气所感之疾则略，惟论呕血及飧泄，余皆不言。惟《灵枢》论思虑、悲哀、喜乐、愁忧、盛怒、恐
惧而言其病。其言曰∶知者知养生也，必顺四时而适寒暑，和喜怒而安居处，节阴阳而和刚
柔。如是则辟邪不至，而长生久视。是故怵惕思虑则伤神，神伤则恐惧流淫而不止。因悲哀
动中者，竭绝而失生；喜乐者，神惮散而不藏；愁忧者，气闭塞而不行；盛怒者，神迷惑而
不治；恐惧者，神荡惮而不收。怵惕思虑而伤神，神伤则恐惧自失，破 脱肉，毛瘁色夭
，死于冬；脾忧愁而不解则伤意，意伤则恍乱，四肢不举，毛瘁色夭，死于春；肝悲哀动中
则伤魂，魂伤则狂忘不精不正，当人阴缩挛筋，两胁不举，毛瘁色夭，死于秋；肺喜乐无极则
伤魄，魄伤则狂，狂者意不存人，皮革焦，毛瘁色夭，死于季夏；肾盛怒而不止则伤志，志伤
则喜忘其前言，腰脊不可俯仰屈伸，毛瘁色夭，死于季夏；恐惧不解则伤精，精伤则骨痿厥
，精时自下。是故五脏主藏精者也，不可伤，伤则失守而阴虚，虚则无气，无气则死矣。
《灵枢》论神、意、魂、魄、志、精所主之病，然无寒暑惊劳四证。余以是推而广之。怒气所
至，为呕血，为飧泄，为煎厥，为薄厥，为阳厥，为胸满胁痛；食则气逆而不下，为喘渴烦心，为消瘅，为
肥气，为目暴盲，耳暴闭，筋解，发于外为疽痈；喜气所至，为笑不休，为毛发焦，为内病
，为阳气不收，甚则为狂；悲气所至，为阴缩，为筋挛，为肌痹，为脉痿，男为数溲血，女
为血崩，为酸鼻辛 ，为目昏，为少气不足以息，为泣
则臂麻；恐气所至，为破 脱肉，为
骨酸痿厥，为暴下绿水，为面热肤急，为阴痿，为惧而脱颐；惊气所至，为潮涎，为目
HT，为口 ，为痴痫，为不省人，为僵仆，久则为痛痹；劳
气所至，为咽噎病，为喘促，为嗽血，为腰痛、骨痿，为肺鸣，为高骨坏，为阴痿，为唾血，为瞑视
，为耳闭，男为少精，女为不月，衰甚则溃溃乎若环都， 乎不可止；思气所至，为不眠，
为嗜卧，为昏瞀，为中痞三焦闭塞，为咽嗌不利，为胆瘅呕苦，为筋痿，为白淫，为得后
与气快然如衰，为不嗜食；寒气所至，为上下所出水液澄沏清冷，下痢清白，吐痢腥秽，食已
不饥，坚痞腹满急痛，症瘕颓疝，屈伸不便，厥逆禁固，热气所至，为喘呕吐酸，暴注下迫
，转筋，小便混浊，腹胀大而鼓之有声如鼓，疮疽疡疹，瘤气结核，吐下霍乱，瞀郁肿胀，
鼻窒鼽衄，血溢血泄淋闭，身热恶寒，甚则瞀 ，目昧不明，耳鸣或聋，躁扰狂越，骂詈惊
骇，禁栗，如丧神守，气逆冲上，嚏腥涌溢，食不下，跗肿疼酸，暴喑暴注，暴病暴死。
凡此九者，《内经》有治法，但以五行相胜之理治之。夫怒伤肝，肝属木，怒则气并于肝，而脾土受
邪；木太过，则肝亦自病。喜伤心，心属火，喜则气并于心，而肺金受邪；火太过，则心亦
自病。悲伤肺，肺属金，悲则气并于肺，而肝木受邪；金太过，则肺亦自病。恐伤肾，肾属
水，恐则气并于肾，而心火受邪；水太过，则肾亦自病。思伤脾，脾属土，思则气并于脾，
而肾水受邪；土太过，则脾亦自病。寒伤形，形属阴，寒胜热，则阳受病；寒太过，则阴亦
自病。热伤气，气属阳，热胜寒，则阴受病；热太过，则阳亦自病。凡此七者，更相为治。
故悲可以治怒，以怆恻苦楚之言感之；喜可以治悲，以谑浪亵狎之言娱之；恐可以治喜，以恐惧死
亡之言怖之；怒可以治思，以污辱欺罔之言触之；思可以治恐，以虑彼志此之言夺之。凡此
五者，必诡诈谲怪，无所不至，然后可以动人耳目，易人听视。若胸中无材器之人，亦不能
用此五法也。热可以治寒，寒在外者，以淬针、HT 熨
汤而汗之；寒在内者，以热食温剂平之。寒可以治热，热在外者，以清房、凉榻、薄衣，以
清剂汗之；热在内者，以寒饮、寒剂平之。惟逸可以治劳，《经》曰∶劳者温之。温，谓温存而养
之。今之医者，以温为温之药，差之久矣！岐伯曰∶“以平为期”。亦谓休息之也，惟习可以治惊。
《经》曰∶惊者平之。平，谓平常也。夫惊以其忽然而遇之也，使习见习闻则不惊矣。此九者，《内
经》自有至理，庸工废而不行。
今代刘河间治五志，独得言外之意。谓五志所发，皆从心造。故凡见
喜、怒、悲、惊、思之证，皆以平心火为主。至于劳者伤于动，动便属阳；惊者骇于心，心便属火，
二者亦以平心为主。
今之医者，不达此旨，遂有寒凉之谤。群而聚HT 之，士大夫又从而惑之，公议何时而定耶？
昔余治一书生，劳苦太过，大便结燥，咳逆上气，时喝喝然有音，唾呕
鲜血。余以苦剂，解毒黄连汤加木香、汉防己，煎服，时时啜之；复以木香槟榔丸，泄其逆
气，不月余而痊。
余又尝以巫跃妓抵，以治人之悲结者。余又尝以针下之时便杂舞，忽笛鼓应之，以
治人之忧而心痛者。余尝击拍门窗，使其声不绝，以治因惊而畏响，魂气飞扬者。余又尝治
一妇人，久思而不眠，余假醉而不问，妇果呵怒，是夜困睡。又尝以酸枣仁丸，治人多忧。
以白虎汤，不计四时，调理人之暑。余又以无忧散，泻人冬月得水中之寒痹，次以麻黄汤，
数两作一剂，煎之枣姜，热服汗出而愈。如未愈者，以瓜蒂散涌之，以火助其汗，治寒厥亦然
。余尝治大暑之病，诸药无效，余从其头，数刺其 ，出血立愈。余治此数者，如探囊。然
惟劳而气耗，恐而气夺者，为难治。喜者少病，百脉舒和故也。昔闻山东杨先生，治府主洞
泄不已。杨初未对病患，与众人谈日月星辰缠度，及风云雷雨之变，自辰至未，而病者听之，
而忘其圊。杨尝曰∶治洞泄不已之人，先问其所好之事。好棋者，与之棋；好乐者，与之笙
笛，勿辍。又闻庄先生者，治以喜乐之极而病者。庄切其脉，为之失声，佯曰∶吾取药去。数
日更不来，病者悲泣，辞其亲友曰∶吾不久矣。庄知其将愈，慰之。诘其故，庄引《素问》曰∶
惧胜喜。此二人可谓得玄关者也。然华元化以怒郡守而几见杀；文挚以怒齐王而竟杀之。千万
人中，仅得一两人，而反招暴祸。若乃医，本至精至微之术，不能自保，果贱技也哉？悲夫！
天地以气覆盖、承载万物。万物充盈于天地之间，皆因气而生成。当人患病时，没有不是因为气机失调而导致的。风的气化特性，平和则开启生机；热的气化特性，温暖则使草木舒展繁荣；火的气化特性，炎热暑气而运行发散；湿的气化特性，潮湿闷热而充盈弥漫；燥的气化特性，清劲肃杀而令人凄怆；寒的气化特性，寒冷雾气而归藏收敛。这六气的正常时令变化，是主持气化运行的常规规律。
到了异常变化时，风的气化，飘动暴怒反而变得大凉；热的气化，极度炎热反而反常变寒；火的气化，狂风燃烧反而反常霜凝；湿的气化，雷霆暴雨骤降反而反常烈风大作；燥的气化，散落凋零反而反常湿润；寒的气化，寒冷雪霜冰雹反而反常出现白埃（尘土）。这是六气的变异现象。所以天气长久寒冷就用暑热之气来治疗；天气长久凉爽就用温暖之气来治疗；天气长久昏暗就用光明之气来治疗；天气长久晴朗就用雨水之气来治疗。天地的正气，常态下使人安宁，变异时则导致疾病。何况人禀受天地之气，外有五行运气交替侵袭，内有七情相互交战。因此圣人爱惜元气，如同持有至宝；庸人役使外物，反而损伤了身体的大和谐。这就是黄帝、岐伯论述各种疼痛都因气而起，百病都生于气的缘故。于是有了九气不同的说法。
气，本质上是同一的，因为所接触的情志或环境不同而分为九种。所谓九种，就是怒、喜、悲、恐、寒、暑、惊、思、劳。经文说：怒则气机上逆，严重时会呕血及完谷不化的泄泻，这是因为气逆上了。王太仆说：怒则阳气逆上，肝木乘克脾土，所以严重时呕血及完谷不化的泄泻。喜则气和顺、意志通达，营卫通畅流利，所以气机舒缓。悲则心脉拘急，肺叶张举而上焦不通畅，营卫不能布散，热气郁结在中焦，所以气机消损。恐则精气退缩，退缩则上焦闭塞，闭塞则气还留于下，还留则下焦胀满，所以气机不行。王太仆说：恐则阳精退缩于上而不向下流注，下焦阴气也回返而不散失，所以聚积而胀满。然而上焦固闭，下焦气还，所以气机不行。《新校正》说：“不行”应当作“下行”。寒则腠理闭塞，气机不行，所以气机收敛。王太仆说：身体寒冷则卫气沉潜，所以皮肤纹理及汗孔排泄之处，都闭合紧密而气不流行，卫气收敛于体内而不散失。热（炅）则腠理开泄，营卫通畅，大汗流出，所以气机外泄。王太仆说：人在阳热环境中则舒适，在阴寒环境中则凄惨。所以热则皮肤腠理开发，营卫大通，津液外渗，大汗泄出。惊则心神无所依托，神志无所归依，思虑无所定夺，所以气机紊乱。劳则喘息出汗，内外之气都越出耗散，所以气机耗损。王太仆说：疲劳役作则气奔行急速，所以喘息。气奔行急速，则阳气外发，所以汗出。内外都逾越了正常的节度，所以气机耗损。思则心有所存留，神有所归着，正气停留而不运行，所以气机结滞。王太仆说：心系念不散，所以气也停留。这是《素问》关于九气的论述，其变化非常详细，其道理非常明确。
然而论述九气所感之疾却简略，只论及呕血及完谷不化的泄泻，其余都不言说。只有《灵枢》论述了思虑、悲哀、喜乐、愁忧、盛怒、恐惧而言及其病症。经文说：明智的人懂得养生，必须顺应四时而适应寒暑，调和喜怒而安居处所，节制阴阳而调和刚柔。像这样邪气就不会到来，从而长生久视。所以惊恐思虑会伤神，神受伤则恐惧流淫不止。因悲哀触动内脏的，精气竭绝而失去生命；喜乐的，神志惮散而不能内藏；愁忧的，气机闭塞而不行；盛怒的，神志迷惑而不能治理；恐惧的，神志动荡惊惧而不能收摄。惊恐思虑伤神，神伤则恐惧自失，肌肉破败消瘦，毛发枯槁面色夭折，死于冬季；脾脏忧愁不解则伤意，意伤则恍惚混乱，四肢不能举动，毛发枯槁面色夭折，死于春季；肝脏悲哀触动内脏则伤魂，魂伤则狂妄健忘精神不精不正，应当出现阴部收缩筋脉拘挛，两胁不能抬举，毛发枯槁面色夭折，死于秋季；肺脏喜乐无极则伤魄，魄伤则狂，狂者心中无人，皮毛干枯，毛发枯槁面色夭折，死于长夏；肾脏盛怒不止则伤志，志伤则喜欢忘记前言，腰脊不能俯仰屈伸，毛发枯槁面色夭折，死于长夏；恐惧不解则伤精，精伤则骨痿厥冷，精液时常自行滑出。所以五脏是主藏精的器官，不可受伤，受伤则失守而阴虚，虚则无气，无气则死。
《灵枢》论述了神、意、魂、魄、志、精所主的病症，但没有寒、暑、惊、劳四种证候。我据此推演并扩充它。怒气所致，表现为呕血，表现为完谷不化的泄泻，表现为煎厥，表现为薄厥，表现为阳厥，表现为胸满胁痛；进食则气逆不下，表现为喘渴烦心，表现为消瘅，表现为肥气，表现为目突然失明，耳突然闭塞，筋脉松弛，发于体表为疽痈；喜气所致，表现为笑个不停，表现为毛发焦枯，表现为内病，表现为阳气不收，严重时则为狂症；悲气所致，表现为阴部收缩，表现为筋脉拘挛，表现为肌痹，表现为脉痿，男子多次尿血，女子血崩，表现为酸鼻辛痒，表现为目昏，表现为气少不足以呼吸，表现为哭泣时手臂麻木；恐气所致，表现为肌肉破败消瘦，表现为骨酸痿厥，表现为突然拉下绿水样便，表现为面部发热皮肤紧绷，表现为阳痿，表现为恐惧而下巴脱臼；惊气所致，表现为潮涌之痰涎，表现为眼睛瞪视，表现为口角歪斜，表现为痴呆癫痫，表现为不省人事，表现为僵倒，日久则变为痛痹；劳气所致，表现为咽噎病，表现为喘促，表现为咳血，表现为腰痛、骨痿，表现为肺鸣，表现为高骨坏损，表现为阳痿，表现为唾血，表现为视物昏花，表现为耳闭，男子表现为精少，女子表现为闭经，衰败严重时则溃烂如环都之水，淋漓不可止；思气所致，表现为不眠，表现为嗜卧，表现为头昏眼花，表现为中痞三焦闭塞，表现为咽喉不利，表现为胆热呕吐苦水，表现为筋痿，表现为白淫，表现为排便排气后感觉轻松如病减，表现为不想进食；寒气所致，表现为上下排出的水液清澈冷冽，下痢清白，呕吐下痢腥秽，食后不知饥饿，腹部坚硬痞满急痛，症瘕颓疝，屈伸不便，厥逆禁固；热气所致，表现为喘呕吐酸，突然腹泻里急后重，转筋，小便混浊，腹胀大叩之有声如鼓，疮疽疡疹，瘤气结核，吐下霍乱，郁闷肿胀，鼻塞鼻渊鼻衄，出血淋闭，身热恶寒，严重时则神志昏蒙，视力不明，耳鸣或聋，烦躁扰乱狂越，骂詈惊骇，战栗，如丧神守，气逆冲上，喷嚏腥臭涌溢，饮食不下，足背肿痛酸痛，突然失音突然腹泻，突发重病突然死亡。
以上这九种情况，《内经》有治疗方法，只是用五行相胜的道理来治疗。怒伤肝，肝属木，怒则气并于肝，而脾土受邪；木太过，则肝亦自病。喜伤心，心属火，喜则气并于心，而肺金受邪；火太过，则心亦自病。悲伤肺，肺属金，悲则气并于肺，而肝木受邪；金太过，则肺亦自病。恐伤肾，肾属水，恐则气并于肾，而心火受邪；水太过，则肾亦自病。思伤脾，脾属土，思则气并于脾，而肾水受邪；土太过，则脾亦自病。寒伤形，形属阴，寒胜热，则阳受病；寒太过，则阴亦自病。热伤气，气属阳，热胜寒，则阴受病；热太过，则阳亦自病。以上这七种情况，互相制约来治疗。所以悲可以治怒，用凄凉痛苦的语言感动他；喜可以治悲，用戏谑轻慢的语言娱乐他；恐可以治喜，用恐惧死亡的语言恐吓他；怒可以治思，用污辱欺骗的语言触犯他；思可以治恐，用考虑彼处此处的心思来夺取他的注意力。以上这五种方法，必须诡诈怪异，无所不用其极，然后才能动人耳目，改变人的视听。如果胸中没有才器的人，也不能运用这五种方法。热可以治寒，寒在体表的，用淬针、热敷汤药使其发汗；寒在体内的，用热食温剂平复它。寒可以治热，热在体表的，用清凉房间、凉席、薄衣，用清剂发汗；热在体内的，用冷饮、寒剂平复它。只有逸可以治劳，《经》说：劳者温之。温，是指温存调养。现在的医生，把温当作温补的药，差得远了！岐伯说：“以平为期”。也是指休息的意思。只有习可以治惊。《经》说：惊者平之。平，是指平常。惊是因为忽然遇到，如果习惯见到听到就不惊了。这九种情况，《内经》自有至理，庸医废弃而不施行。
当代刘河间治疗五志，独得言外之意。认为五志所发，都从心造。所以凡是见到喜、怒、悲、惊、思的证候，都以平抑心火为主。至于劳者伤于动，动便属阳；惊者骇于心，心便属火，这两者也以平抑心火为主。
现在的医生，不理解这个宗旨，于是招致寒凉派的诽谤。众人聚集非议他，士大夫又跟着迷惑他，公议何时才能定呢？
过去我治疗一个书生，劳苦太过，大便结燥，咳逆上气，时时发出喝喝的声音，唾呕鲜血。我用苦剂，解毒黄连汤加木香、汉防己，煎服，时时饮用；再用木香槟榔丸，泄其逆气，不到一个月就好了。
我又曾用让巫女跳舞妓女抵债的方法，来治疗人的悲结症。我又曾用针灸时让人杂舞，忽然笛鼓应和，来治疗人的忧而心痛症。我曾敲击门窗，使声音不绝，来治疗因惊而畏响、魂气飞扬的人。我又曾治疗一个妇人，久思而不眠，我假装醉酒不过问，妇人果然呵斥愤怒，当晚困睡。又曾用酸枣仁丸，治疗人多忧。用白虎汤，不计较四季，调理人的暑病。我又用无忧散，泻除人冬天得水中之寒痹，随后用麻黄汤，数两作一剂，加枣姜煎煮，热服汗出而愈。如果未愈，用瓜蒂散涌吐，用火助其汗，治疗寒厥也是这样。我曾治疗大暑之病，诸药无效，我从他头部多次针刺放血，立即痊愈。我治疗这几例，如探囊取物。然而只有劳而气耗，恐而气夺的，为难治。喜者少病，因为百脉舒和的缘故。过去听说山东杨先生，治疗府主洞泄不止。杨起初不对病人说话，与众人谈论日月星辰度数，及风云雷雨的变化，从辰时至未时，病人听之，忘记了上厕所。杨曾说：治疗洞泄不止的人，先问他所好的事。好棋的，给他下棋；好音乐的，给他笙笛，不要停。又听说庄先生，治疗因喜乐至极而生病的人。庄切其脉，为之失声，假装说：我去取药。几天不再来，病人悲泣，辞别亲友说：我不久了。庄知道他将要痊愈，安慰他。追问原因，庄引用《素问》说：惧胜喜。这两个人可以说是得了玄关妙旨的人了。然而华元化因激怒郡守而几乎被杀；文挚因激怒齐王而竟然被杀。千万人中，仅得一两人，反而招致暴祸。如果是医道，本是至精至微的技术，不能自保，果真是贱技吗？可悲啊！
Heaven covers with Qi, and Earth supports with Qi. All things fill the space between Heaven and Earth, all born of Qi. When illness occurs, none arises except through Qi. The Qi of Wind is peaceful and opens life; the Qi of Heat is warm and promotes flourishing; the Qi of Fire is hot and summer-like in its movement; the Qi of Dampness is humid and muggy, filling the air; the Qi of Dryness is clear and biting, causing desolation; the Qi of Cold is cold and misty, leading to storage. These six Qi transformations are the normal governance of seasonal changes.
When they change abnormally: the Qi of Wind becomes turbulent and angry, turning excessively cold; the Qi of Heat becomes extremely hot but turns cold; the Qi of Fire brings fierce winds and burning flames but turns to frost; the Qi of Dampness brings thunder and sudden rain but turns to fierce wind; the Qi of Dryness scatters and falls but turns damp; the Qi of Cold brings snow, frost, and hail but turns to white dust. These are the variations of the Six Qi. Thus, if Heaven is cold for a long time, treat it with heat; if cool, treat with warmth; if dark, treat with brightness; if dry/clear, treat with rain. The Qi of Heaven and Earth is stable in normalcy, causing disease in variation. How much more so for humans who receive the Qi of Heaven and Earth, with the Five Movements (Wu Yun) invading externally and the Seven Emotions clashing internally? Therefore, sages cherish Qi as a supreme treasure; fools serve external things and damage their Great Harmony. This is why Huangdi and Qibo stated that all pain stems from Qi, and all diseases arise from Qi. Hence, the theory of Nine Qi differences.
Qi is fundamentally one, but becomes nine due to different triggers. These nine are: Anger, Joy, Sorrow, Fear, Cold, Heat, Fright, Thought, and Overexertion. It is said: Anger causes Qi to rebel upwards; severely, it leads to vomiting blood or undigested stool diarrhea, because Qi rebels upward. Wang Taipu said: Anger causes Yang Qi to rebel upward, and Liver Wood overacts on Spleen Earth, hence vomiting blood and undigested stool diarrhea. Joy causes Qi to harmonize and will to reach, Ying and Wei to flow freely, hence Qi relaxes. Sorrow causes the Heart vessel to contract, Lung leaves to expand and rise, Upper Jiao to block, Ying and Wei not to disperse, Heat to stay in the middle, hence Qi dissipates. Fear causes Essence to retreat; retreating blocks the Upper Jiao; blocking causes Qi to return; returning distends the Lower Jiao, hence Qi does not move downward. Wang Taipu said: Fear causes Yang Essence to retreat upward without flowing down, and Lower Jiao Yin Qi returns without dispersing, hence gathering and distending. Although Upper Jiao is closed and Lower Jiao Qi returns, Qi does not move downward. *Xin Zheng* notes: "does not move" should be "does not move downward." Cold closes the Cou Li (pores/skin texture), Qi does not move, hence Qi contracts. Wang Taipu said: Body cold makes Wei Qi sink, so skin texture and sweat pores close tightly, Qi does not circulate, Wei Qi gathers inside without dispersing. Heat (Jiong) opens Cou Li, Ying and Wei flow, sweat pours out, hence Qi leaks. Wang Taipu said: Humans are comfortable in Yang, miserable in Yin. So heat opens skin and Cou Li, Ying and Wei flow greatly, fluids seep out, sweat pours. Fright causes Heart to have no foundation, Spirit to have no home, thoughts to have no certainty, hence Qi becomes chaotic. Overexertion causes panting and sweating, internal and external Qi both escape, hence Qi is consumed. Wang Taipu said: Fatigue and labor make Qi rush fast, hence panting. Fast-rushing Qi sends Yang outward, hence sweating. Internal and external both exceed normal limits, hence Qi is consumed. Thought causes Heart to retain focus, Spirit to settle, Zheng Qi to stay and not move, hence Qi knots. Wang Taipu said: Heart tied and not scattered, so Qi also stays. This is the discussion of Nine Qi in *Su Wen*, very detailed in changes, clear in principles.
However, the discussion of diseases caused by Nine Qi is brief, only mentioning vomiting blood and undigested stool diarrhea, ignoring others. Only *Ling Shu* discusses diseases from thought, sorrow, joy/anger, worry/grief, extreme anger, fear. It says: Those who know health must follow the four seasons and adapt to cold/heat, harmonize joy/anger and live peacefully, regulate Yin/Yang and harmonize Gang/Rou. Thus evil Qi cannot enter, ensuring long life. So fright/thought damages Shen (Spirit); damaged Shen leads to endless fear and leakage. Sorrow moving internally exhausts Essence, losing life; Joy makes Shen scatter and not store; Worry/Grief blocks Qi; Extreme Anger confuses Shen and loses control; Fear agitates Shen and prevents gathering. Fright/thought damages Shen; damaged Shen leads to self-loss of fear, muscle wasting, brittle hair, premature death in Winter; Spleen worry damages Yi (Intellect); damaged Yi leads to confusion, limbs unable to lift, brittle hair, premature death in Spring; Liver sorrow damages Hun (Ethereal Soul); damaged Hun leads to madness, forgetfulness, improper spirit, yin contraction, tendon spasm, inability to raise ribs, brittle hair, premature death in Autumn; Lung excessive joy damages Po (Corporeal Soul); damaged Po leads to madness, disregard for others, scorched skin/hair, brittle hair, premature death in Late Summer; Kidney extreme anger damages Zhi (Will); damaged Zhi leads to forgetting words, stiff waist/spine, brittle hair, premature death in Late Summer; Unresolved fear damages Jing (Essence); damaged Jing leads to bone萎 (atrophy/cold) and spontaneous seminal emission. Thus, the Five Zang store Jing; do not damage them. Damage leads to loss of control and Yin deficiency; deficiency leads to lack of Qi; lack of Qi leads to death.
*Ling Shu* discusses diseases of Shen, Yi, Hun, Po, Zhi, Jing, but lacks Cold, Heat, Fright, Overexertion. I deduce and expand upon this. Anger leads to: vomiting blood, undigested stool diarrhea, Jian Jue (Frying Syncope), Bo Jue (Thin Syncope), Yang Jue, chest fullness/hypochondriac pain; food rebellion without descent, panting/thirst/irritability, Xiao Dan (Consumption Diabetes), Fei Qi (Mass in Hypochondrium), sudden blindness, sudden deafness, tendon relaxation, carbuncles/sores externally. Joy leads to: unceasing laughter, scorched hair, internal disease, Yang Qi not gathering, severe cases become Mania. Sorrow leads to: yin contraction, tendon spasm, Muscle Bi, Mai Wei (Vessel Atrophy), frequent hematuria in men, metrorrhagia in women, sour nose/itching, blurred vision, shortness of breath, arm numbness when crying. Fear leads to: muscle wasting, bone soreness/atrophy/cold, sudden green watery diarrhea, facial heat/tight skin, impotence, jaw dislocation from fear. Fright leads to: tidal phlegm, staring eyes, mouth deviation, dementia/epilepsy, unconsciousness, stiff collapse, chronic Pain Bi. Overexertion leads to: dysphagia, panting, hemoptysis, lower back pain/bone atrophy, lung sounds, high bone destruction, impotence, hematemesis, blurred vision, deafness, scant semen in men, amenorrhea in women; severe cases lead to溃溃 (ulceration/discharge) like water rings, unstoppable. Thought leads to: insomnia, lethargy, dizziness, Middle Jiao痞 (fullness/blockage), throat obstruction, Dan Dan (Biliary Heat) with bitter vomiting, tendon atrophy, Bai Yin (White Discharge), relief after defecation/gas passage, anorexia. Cold leads to: clear/cold fluids excreted, clear/white dysentery, foul vomiting/dysentery, postprandial anorexia, hard/full painful abdomen, masses/hernias, stiffness, cold reversal/stiffness. Heat leads to: panting/vomiting acid, sudden diarrhea with tenesmus, tetany, turbid urine, drum-like abdominal distension, sores/rashes/nodules, Huo Luan (Cholera-like), depression/swelling, nasal obstruction/epistaxis, bleeding/stranguria, fever/chills, severe cases: coma/blindness, tinnitus/deafness, restlessness/madness, cursing/fear, trembling, loss of spirit control, Qi rebelling upward, sneezing/foul discharge, inability to eat, foot swelling/pain, sudden aphasia/diarrhea, sudden severe illness/death.
For these nine, *Nei Jing* has treatments based on the Five Elements overcoming each other. Anger damages Liver (Wood); Qi gathers in Liver, damaging Spleen Earth; excess Wood damages Liver itself. Joy damages Heart (Fire); Qi gathers in Heart, damaging Lung Metal; excess Fire damages Heart itself. Sorrow damages Lung (Metal); Qi gathers in Lung, damaging Liver Wood; excess Metal damages Lung itself. Fear damages Kidney (Water); Qi gathers in Kidney, damaging Heart Fire; excess Water damages Kidney itself. Thought damages Spleen (Earth); Qi gathers in Spleen, damaging Kidney Water; excess Earth damages Spleen itself. Cold damages Form (Yin); Cold defeats Heat, damaging Yang; excess Cold damages Yin itself. Heat damages Qi (Yang); Heat defeats Cold, damaging Yin; excess Heat damages Yang itself. These seven treat each other. Thus, Sorrow treats Anger (using tragic words); Joy treats Sorrow (using playful words); Fear treats Joy (using threats of death); Anger treats Thought (using insulting words); Thought treats Fear (using distracting worries). These five methods must be bizarre/unconventional to affect senses/hearing. Only those with talent can use them. Heat treats Cold: external cold uses acupuncture/quenching/warm baths to sweat; internal cold uses hot food/warm medicine. Cold treats Heat: external heat uses cool rooms/clothes/clear medicine to sweat; internal heat uses cold drinks/cold medicine. Rest treats Overexertion (*Jing*: "Overexertion requires warming"). Warm means nurturing/restoring. Modern doctors mistake "warm" for warm-tonic herbs, a great error! Qibo said: "Aim for balance." Means rest. Habituation treats Fright (*Jing*: "Fright requires leveling"). Ping means ordinary/common. Fright comes from suddenness; habituation removes fear. *Nei Jing* has profound logic here, ignored by mediocre doctors.
Modern Liu Hejian treated Five Emotions, grasping the implicit meaning: Five Emotions originate from the Heart. Thus, treat Joy/Anger/Sorrow/Fright/Thought by calming Heart Fire. Overexertion involves movement (Yang); Fright shocks the Heart (Fire); both require calming the Heart.
Modern doctors miss this, inviting criticism of cold-cool therapies. Critics gather, scholars confuse, when will public opinion settle?
Once I treated a scholar, overworked, constipated, coughing/rebellious Qi, noisy breathing, hemoptysis. I used Bitter agents: Jiedu Huanglian Tang + Muxiang, Han Fangji, decocted and sipped frequently; then Muxing Binglang Wan to drain rebellious Qi. Recovered in less than a month.
I once used a dancing prostitute to treat emotional stagnation from sorrow. I once used acupuncture accompanied by dance/flute/drums to treat heart pain from worry. I once banged doors/windows continuously to treat fear/noise sensitivity and flying Hun. I once treated a woman with insomnia from prolonged thought; I feigned drunkenness and ignored her; she got angry and slept soundly that night. I used Suanzaoren Wan for excessive worry. I used Baihu Tang regardless of season to treat summerheat. I used Wuyou San to drain winter cold-damp Bi, followed by Mahuang Tang (several taels per dose) with dates/ginger, taken hot to sweat and cure. If unresolved, use Gengti San to induce vomiting, assist sweat with fire; same for cold reversal. I treated severe summerheat where all drugs failed; I pricked his head repeatedly to bleed, curing immediately. My treatments were like taking from a bag. However, Overexertion with Qi consumption and Fear with Qi depletion are difficult to treat. Joyful people rarely get sick because meridians are relaxed.
I heard of Mr. Yang from Shandong treating a governor with persistent profuse diarrhea. Yang did not speak to the patient initially, but discussed astronomy/weather with others from Chen to Wei hours. The patient listened and forgot to defecate. Yang said: Ask what the patient likes. If they like chess, play chess; if music, provide instruments, ceaselessly. I heard of Mr. Zhuang treating someone ill from excessive joy. Zhuang felt the pulse, feigned shock, said he would fetch medicine, and didn't return for days. The patient wept, said goodbye to friends, expecting death. Zhuang knew he would recover and comforted him. Asked why, Zhuang cited *Su Wen*: "Fear overcomes Joy." These two understood the hidden gate. However, Hua Yuanhua nearly died angering a prefect; Wen Zhi was killed angering the King of Qi. In thousands, only one or two succeed, often bringing disaster. Medicine is a subtle art; if it cannot protect itself, is it truly a low skill? Alas!