万物之在天地间也。咸以气而生。及其病也。莫不以气而得。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。而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。怒喜悲恐寒暑惊劳思也。其言曰怒则气逆。甚则呕血及飧泄。故气逆上。王注曰。怒则
阳气逆上而肝木乘脾。故甚则呕血及飧泄也。喜则气如志达。营卫通利。故气缓。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。恐则精却。却则上焦闭。闭则气还。还则下焦胀。故气不行。王注云。恐则使精却上而
不下流。下焦阴气亦回环而不散。故聚而胀也。然上焦固禁。下焦气还。故气不行也。寒则腠理闭。气不行。故气收。
王注云。身凉则卫气沉。故皮肤之理及渗泄之处皆闭密。而气不流行。卫气收敛于中而不散也。暑则腠理开。营卫通。
汗大出。故气泄。王注云。人在阳则舒。在阴则惨。故热则肤腠开发。营卫大通。津泄而汗大出也。惊则心无所根据。神
无所归。虑无所定。故气乱。劳则喘息汗出。内外皆越。故气耗。王注云。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。王注云。系心不散。故
气亦停留。素问论九气甚明。其论所感之疾则甚略。惟灵枢论思虑悲哀喜乐愁忧盛怒恐惧而言其病。其言曰。心怵惕思
虑则伤神。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 乱。四肢不举。毛瘁色夭。
死于春。肝悲哀动中则伤魂。魂伤则狂妄不精。不精则不正。当人阴缩而挛筋。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。人皮萃焦。毛瘁色夭死于夏。肾盛怒而不止则伤志。志伤则善忘其前。腰脊不可
仰屈伸。毛瘁色夭。死于季夏。肾恐惧不解则伤精。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。然无寒暑惊劳四症。余以是推而广之。怒气所至。
为呕血。为飧泄。为煎厥薄厥阳厥。为胸满胁痛。食则气逆不下。为喘陷烦心。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。为伤气不收。甚则为狂。悲气所至。为阴缩筋挛。为
肌痹脉痿。男为数便血。女为血崩。为酸鼻为辛额目昏。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。为暴下汗水。为面热肤急。为阴痿。为惧。而脱颐。惊气所至。为潮涎目HT 口 。为痴痫不省人僵仆。
久则为痛痹。劳气所至。为咽嚏。为病促促。为嗽血。为腰痛骨痿。为肺鸣。为高骨坏。为阴痿。为唾血。为冥视耳闭。
男为少精。女为不月。衰甚则渍渍乎若坏都。汨汨乎不可止。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。为胆脾呕苦。为筋痿。为白淫。为得后与气则快然如衰。为不嗜食。寒气所至。为上下所出水液澄澈清冷
下利清白。吐利腥秽。食已不饥。坚痞腹满。急痛 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。甚则瞀螈目不明。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。跗肿酸疼。
暴喑暴死。暴病暴注。凡此九者。内经有治法。但以五行相胜之理治之。夫怒伤肝。肝为木。怒则气并于肝。而脾土受
邪。木太过。则肝亦自病。喜伤心。心为火。喜则气并于心。而肺金受邪。火太过则心亦自病。悲伤肺。肺为金。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。以谑浪狎亵之言娱之。恐可以治喜。以迫遽死亡之言怖之。怒可以治思。以污辱欺罔之言触之。思可以治
恐。以虑彼忘此之言夺之。此凡五者。必诡诈谲怪。无所不至。然后可以动人耳目。易人视听。若非有材有识之人。亦
不能用此五法也。炅可以治寒。寒在外者。以 针熨灸汗之。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。乃清利汗之。热在内者。以寒饮寒剂平之。唯逸可以治劳。经曰。劳者温之。温谓温存而养之。若以为
温药误矣。岐伯曰。以平为期。亦谓休息之也。唯习可以治惊。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。内经自有是理。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。故凡见喜怒悲恐思之症。皆以平心火为主。至于劳者伤于动。动便为阳。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。遂起寒凉之谤过矣。
天地间的所有万物，都是凭借气而生存的。当它们生病时，没有不是因为气的问题而产生的。天地的正常运行之气，人体会感到安宁；如果发生异常变化，人就会生病。何况人禀受了天地之气，外部有五行运气交替侵袭，内部有七情相互交战。因此，圣人像对待最珍贵的宝物一样爱惜自己的气。轩辕黄帝和岐伯之所以论述各种疼痛都因气而起，百病都生于气，于是就有了“九气”不同的说法。气本质上是同一个，因为所接触的刺激不同而分为九种。所谓九种，就是怒、喜、悲、恐、寒、暑、惊、劳、思。
经文说：愤怒会使气机逆乱上冲，严重时会导致呕血或完谷不化的腹泻，这是因为气逆向上。王冰注解说：愤怒会使阳气逆乱上行，导致肝木克制脾土，所以严重时会出现呕血和完谷不化的腹泻。喜悦会使心志舒畅，营卫之气通畅流利，所以使气机缓和。悲伤会使心脉拘急，肺叶张举，导致上焦不通畅，营卫之气不能布散，热气郁结在体内，所以使气机消损。恐惧会使精气下退，精气下退则上焦闭塞，上焦闭塞则气机还返于下，气还返于下则下焦胀满，所以使气机不行。王冰注解说：恐惧会使精气下退而不能向下流注，下焦的阴气也会回环聚集而不消散，所以产生胀满。然而由于上焦固闭，下焦气机还返，所以气机运行不畅。寒冷会使腠理闭塞，气机运行受阻，所以使气机收敛。王冰注解说：身体发凉则卫气沉潜，所以皮肤的纹理及汗孔都闭合紧密，气机不流行，卫气收敛于体内而不外散。暑热会使腠理开泄，营卫之气通畅，大汗淋漓，所以使气机外泄。王冰注解说：人在阳热环境中则舒展，在阴冷环境中则凄惨，所以受热则皮肤腠理开发，营卫之气大通，津液外泄而大汗出。惊恐会使心神无所依托，神气无所归依，思虑无所定夺，所以使气机紊乱。过劳会使喘息出汗，体内的正气和体表的卫气都向外耗散，所以使气机耗损。王冰注解说：疲劳过度则气机奔涌急促，所以喘息气促，气机急促则阳气外发，所以出汗。体内的正气和体表的卫气都超越了正常的节度，所以气机耗损。思虑会使心神有所存留，神气有所归依，正气停留而不运行，所以使气机郁结。王冰注解说：心系精神不散乱，所以气机也停留积聚。
《素问》对九气的论述非常明确，但对所感受的具体疾病论述得较为简略。只有《灵枢》论述了思虑、悲哀、喜乐、愁忧、盛怒、恐惧等情绪引发的病症。经文说：心中惊惧思虑会损伤神，神受损则会恐惧且自我丧失控制，肌肉消瘦脱肉，毛发枯槁面色夭折，死于冬季。脾脏忧愁不解会损伤意，意受损则思维混乱，四肢不能举动，毛发枯槁面色夭折，死于春季。肝脏悲哀触动内心会损伤魂，魂受损则会狂妄且不精明，不精明则行为不正，此时会出现阴器收缩、筋脉拘挛、两胁不能抬举，毛发枯槁面色夭折，死于秋季。肺脏喜乐无节制会损伤魄，魄受损则会发狂，狂者意念不存在，皮肤干枯焦裂，毛发枯槁面色夭折，死于夏季。肾脏大怒不止会损伤志，志受损则会忘记过去的事情，腰脊不能仰身屈伸，毛发枯槁面色夭折，死于长夏。肾脏恐惧不解会损伤精，精受损则骨骼痿软厥冷，精液自行滑泄。因此五脏是主藏精的器官，不可损伤。一旦损伤就会失守而导致阴虚，阴虚则无气，无气就会死亡。
《灵枢》论述了神、意、魂、魄、志、精所主的病症，但没有涉及寒、暑、惊、劳四种情况。我据此推演并扩展它：怒气所致，会导致呕血、完谷不化的腹泻、煎厥、薄厥、阳厥，导致胸满胁痛，进食后气逆不下，喘息、下陷、心烦，消瘅（糖尿病类疾病），肥气（腹部肿块），突然失明、突然耳聋，筋脉弛缓发散于外，疽痈（化脓性感染）。喜气所致，会导致笑个不停，毛发焦枯，内脏病变，伤气不收摄，严重时会导致发狂。悲气所致，会导致阴器收缩、筋脉拘挛，肌痹、脉痿，男子多次便血，女子血崩，酸鼻、辛额、目昏，少气不足以呼吸，哭泣时手臂麻木。恐气所致，会导致肌肉消瘦脱肉，骨酸、痿软厥冷，突然腹泻冷汗，面部发热皮肤紧绷，阳痿，恐惧且下颌脱落。惊气所致，会导致潮涎、眼睛斜视、口角歪斜，痴痫不省人事、僵仆倒地，时间久了会导致痛痹。劳气所致，会导致咽部不适、打喷嚏，病情急促，咳嗽带血，腰痛、骨骼痿软，肺鸣音，高骨坏死，阳痿，唾血，视力模糊、耳聋，男子精少，女子闭经，衰败严重时就像堤坝崩溃，水流滔滔不可止住。思气所致，会导致失眠，嗜睡，头昏眼花，中脘痞塞，三焦闭塞，咽喉不利，胆脾呕吐苦水，筋痿，白淫（白带过多或尿浊），排便排气后感觉轻松症状减轻，食欲不振。寒气所致，会导致上下排泄的水液清澈寒冷，下利清白，呕吐物带有腥味秽臭，吃完东西不觉得饿，坚硬的痞块、腹部胀满，急痛、疝气，屈伸不便，厥逆、肢体拘禁固定。热气所致，会导致喘息、呕吐酸水，急性腹泻伴里急后重，转筋，小便混浊，腹部胀大如鼓，敲击有声，疮疽疡疹，瘤气结核，吐泻霍乱，郁闷肿胀，鼻塞、流涕、鼻出血，血液溢出或泄漏，淋证、闭证，身体发热恶寒，严重时神志昏迷、抽搐、眼睛不明亮，耳鸣或耳聋，烦躁扰乱、狂妄越轨，骂人、惊骇，战栗如同失去了神志的主宰，气逆冲上，打喷嚏伴有腥臭涌溢，饮食不下，足背浮肿酸痛，突然失声、突然死亡，突发疾病、急性腹泻。
以上这九种情况，《内经》中有治疗方法，只是用五行相克的原理来治疗。例如：怒伤肝，肝属木，愤怒会使气机汇聚于肝，从而脾土受邪，木气太过，肝自身也会生病。喜伤心，心属火，喜悦会使气机汇聚于心，从而肺金受邪，火气太过，心自身也会生病。悲伤肺，肺属金，悲伤会使气机汇聚于肺，从而肝木受邪，金气太过，肺自身也会生病。恐伤肾，肾属水，恐惧会使气机汇聚于肾，从而心火受邪，水气太过，肾自身也会生病。思伤脾，脾属土，思虑会使气机汇聚于脾，从而肾水受邪，土气太过，脾自身也会生病。寒伤形，形属阴，寒胜热则阳气受病，寒气太过，阴气自身也会生病。热伤气，气属阳，热胜寒则阴气受病，热气太过，阳气自身也会生病。这七种情况，可以互相治疗。所以，可以用悲伤来治疗愤怒，用凄凉痛苦的话语去感动他；可以用喜悦来治疗悲伤，用戏谑轻浮的话语去娱乐他；可以用恐惧来治疗喜悦，用紧迫死亡的话语去恐吓他；可以用愤怒来治疗思虑，用污辱欺骗的话语去触犯他；可以用思虑来治疗恐惧，用考虑其他事情的话语去转移他的注意力。这五种方法，必须使用诡诈奇特、无所不至的手段，然后才能打动人的耳目，改变人的视听。如果不是有才华见识的人，也不能使用这五种方法。
温热可以治疗寒冷。寒邪在外的，用针刺、熨法、艾灸、发汗的方法治疗；寒邪在内的，用热食和温性药物平复它。寒冷可以治疗热邪。热邪在外的，用清凉的房间、凉席、薄衣，以及清利发汗的方法治疗；热邪在内的，用冷饮和寒性药物平复它。唯有安逸可以治疗过劳。经文说：“劳者温之。”这里的“温”是指温存养护，如果理解为温补药物就错了。岐伯说：“以平为期。”这也是指休息的意思。唯有习惯可以治疗惊恐。经文说：“惊者平之。”这里的“平”是指平常。惊恐是因为突然遇到意外引起的，如果让患者习惯于见到、听到这些事物，就不会惊恐了。这九种情况，《内经》中本来就有这些道理，但平庸的医生废弃不用。当代的刘河间在治疗五志方面独得言外之意，认为五志的产生，都是从心造作出来的。所以凡是见到喜怒悲恐思的症状，都以平抑心火为主。至于过劳是由于活动过度引起的，活动就属于阳；惊恐是惊吓了心脏，心脏就属于火。这两种情况也以平抑心火为主。现在的医生，不理解这个旨意，于是发起了对寒凉药物的诽谤，这就错了。
All things in the heaven and earth are born of Qi (vital energy). When they become ill, none do so without being caused by Qi. The normal Qi of heaven and earth brings peace; changes bring disease. How much more so for humans who inherit the Qi of heaven and earth? Externally, the Five Movements (Wu Yun) invade alternately; internally, the Seven Emotions (Qi Qing) clash with each other. Therefore, sages cherish Qi as if it were a supreme treasure. Xuanyuan Huangdi and Qibo discussed that all pains arise from Qi and all diseases originate from Qi, leading to 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, Fatigue, and Overthinking.
The text states: Anger causes Qi to rebel upwards; severely, it leads to hematemesis (vomiting blood) or undigested stool diarrhea, because Qi rebels upward. Wang Bing's commentary notes: Anger causes Yang Qi to rebel upward, causing Liver Wood to overact on Spleen Earth, hence severe cases present with hematemesis and undigested stool diarrhea. Joy makes the mind relaxed, Ying (Nutritive) and Wei (Defensive) Qi flow smoothly, thus relaxing Qi. Sorrow makes the Heart vessel tense, Lung leaves elevate, blocking the Upper Jiao, preventing Ying and Wei Qi from dispersing, trapping heat in the center, thus consuming Qi. Fear causes Essence (Jing) to retreat downward; this blocks the Upper Jiao, causing Qi to return downward, filling the Lower Jiao, thus stagnating Qi. Wang Bing's commentary notes: Fear causes Essence to retreat without flowing down; Yin Qi in the Lower Jiao circles and gathers without dispersing, causing distension. Thus, with Upper Jiao blocked and Lower Jiao Qi returning, Qi movement is obstructed. Cold closes the Cou Li (pores/skin texture), obstructing Qi, thus contracting Qi. Wang Bing's commentary notes: Body cooling causes Wei Qi to sink; skin pores close tightly, Qi does not circulate, and Wei Qi converges inward without dispersing. Heat opens the Cou Li, unblocks Ying and Wei Qi, causes profuse sweating, thus leaking Qi. Wang Bing's commentary notes: In Yang/heat, one feels comfortable; in Yin/cold, one feels miserable. Heat opens skin and pores, unblocks Ying and Wei Qi, leaks fluids via profuse sweat. Fright leaves the Heart without support, Shen (Spirit) without refuge, thoughts without certainty, thus disordering Qi. Fatigue causes panting and sweating, internal and external Qi escape, thus depleting Qi. Wang Bing's commentary notes: Physical exhaustion causes Qi to rush rapidly, leading to panting. Rapid Qi release causes Yang to emit outward, leading to sweating. Internal and external Qi exceed normal limits, thus depleting Qi. Overthinking retains the mind and Shen, causing Zheng Qi (Upright Qi) to stay and not move, thus knotting Qi. Wang Bing's commentary notes: The Heart's focus remains scattered/not released, so Qi also stays accumulated.
Su Wen discusses Nine Qi clearly but briefly mentions the resulting diseases. Ling Shu discusses diseases caused by overthinking, sorrow, joy, worry, excessive anger, and fear. It states: Heart fright and overthinking damage Shen; damaged Shen leads to fear and loss of self-control, muscle wasting, brittle hair, pale complexion, dying in Winter. Spleen worry unresolved damages Yi (Intellect); damaged Yi leads to confusion, inability to move limbs, brittle hair, pale complexion, dying in Spring. Liver sorrow moving internally damages Hun (Ethereal Soul); damaged Hun leads to madness and lack of clarity, improper behavior, retracted genitals, contracted sinews, immobile ribs, brittle hair, pale complexion, dying in Autumn. Lung excessive joy damages Po (Corporeal Soul); damaged Po leads to madness, lack of intent, dry/scorched skin, brittle hair, pale complexion, dying in Summer. Kidney excessive anger damages Zhi (Willpower); damaged Zhi leads to forgetfulness, immovable waist/spine, brittle hair, pale complexion, dying in Late Summer. Kidney fear unresolved damages Jing (Essence); damaged Jing leads to bone weakness and cold extremities, spontaneous seminal emission. Thus, the Five Zang organs store Essence and must not be damaged. 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 governed by Shen, Yi, Hun, Po, Zhi, and Jing, but omits Cold, Heat, Fright, and Fatigue. I deduce and expand upon this:
Anger-induced diseases include: hematemesis, undigested stool diarrhea, Jian Jue (Frying Collapse), Bo Jue (Thin Collapse), Yang Jue, chest fullness, hypochondriac pain, postprandial Qi rebellion, panting, sinking, vexation, Xiao Dan (Wasting-Thirst), Fei Qi (Abdominal Mass), sudden blindness, sudden deafness, sinew relaxation/discharge, Ju Yong (Carbuncles), and abscesses.
Joy-induced diseases include: incessant laughter, scorched hair, internal illness, unrestrained Qi, and severe madness.
Sorrow-induced diseases include: retracted genitals, contracted sinews, Ji Bi (Muscle Bi), Mai Wei (Vessel Flaccidity), frequent bloody stools in men, metrorrhagia in women, sour nose, pungent forehead, blurred vision, shortness of breath, arm numbness when weeping.
Fear-induced diseases include: muscle wasting, bone soreness/flaccidity/cold, sudden diarrhea with cold sweat, hot face/tight skin, impotence, terror, and mandibular dislocation.
Fright-induced diseases include: tidal salivation, strabismus, deviation of mouth, dementia/seizures/unconsciousness, stiff collapse, and long-term Tong Bi (Painful Bi).
Fatigue-induced diseases include: throat discomfort/sneezing, rapid pulse/disease, hemoptysis, lower back pain, bone flaccidity, lung sounds, high bone necrosis, impotence, hematemesis, dim vision/deafness, scant semen in men, amenorrhea in women. Severe depletion resembles a breached dam, unstoppable.
Overthinking-induced diseases include: insomnia, lethargy, dizziness/blindness, epigastric fullness, closure of San Jiao, throat obstruction, bitter vomiting from Gallbladder/Spleen, sinew flaccidity, Bai Yin (White Turbidity), relief after defecation/qi passage, and anorexia.
Cold-induced diseases include: clear/cold urine/stool, clear diarrhea, foul-smelling vomit, postprandial satiety without hunger, hard masses, abdominal distension, acute pain, hernia, immobility, cold extremities, and rigidity.
Heat-induced diseases include: panting, acid regurgitation, acute diarrhea with tenesmus, tetany, turbid urine, drum-like abdominal distension, sores/rashes/nodules, tumor qi/lumps, cholera/vomiting-diarrhea, depression/swelling, nasal obstruction/epistaxis, hemorrhage, stranguria/retention, fever/chills, coma/tremors/blurred vision, tinnitus/deafness, restlessness/madness/insults/fear, tremors losing spiritual control, rebellious Qi, sneezing with foul discharge, dysphagia, dorsal edema/soreness, sudden aphonia/death, acute onset/diarrhea.
For these nine, Neijing provides treatments based on the Five Elements overcoming principle. Anger injures Liver (Wood); Qi gathers in Liver, injuring Spleen Earth; excess Wood injures Liver itself. Joy injures Heart (Fire); Qi gathers in Heart, injuring Lung Metal; excess Fire injures Heart itself. Sorrow injures Lung (Metal); Qi gathers in Lung, injuring Liver Wood; excess Metal injures Lung itself. Fear injures Kidney (Water); Qi gathers in Kidney, injuring Heart Fire; excess Water injures Kidney itself. Overthinking injures Spleen (Earth); Qi gathers in Spleen, injuring Kidney Water; excess Earth injures Spleen itself. Cold injures Form (Yin); Cold defeats Heat, injuring Yang; excess Cold injures Yin itself. Heat injures Qi (Yang); Heat defeats Cold, injuring Yin; excess Heat injures Yang itself. These seven can treat each other. Thus: Sorrow treats Anger via tragic words; Joy treats Sorrow via playful words; Fear treats Joy via threats of death; Anger treats Overthinking via insulting words; Overthinking treats Fear via distracting thoughts. These five methods require cunning and novelty to affect senses and perception, usable only by talented individuals.
Heat treats Cold: External cold uses acupuncture, moxibustion, warming therapy, sweating. Internal cold uses hot food/warm herbs. Cold treats Heat: External heat uses cool rooms/sheets/clothes, clearing/sweating. Internal heat uses cold drinks/cold herbs. Rest treats Fatigue: "Treat fatigue with warmth" means nurturing/resting, not warm herbs. Qibo says "aim for balance," meaning rest. Habituation treats Fright: "Treat fright with normalization." Normalization means making it common. Fright arises from suddenness; habituation removes fear.
Neijing contains these principles, but mediocre doctors ignore them. Liu Hejian of the current dynasty understood the deeper meaning of treating the Five Emotions, stating they originate from the Heart. Thus, symptoms of joy, anger, sorrow, fear, and overthinking should primarily regulate Heart Fire. Fatigue involves movement (Yang); Fright shocks the Heart (Fire). Both also prioritize regulating the Heart. Modern doctors fail to understand this, leading to unjust criticism of cold-cooling therapies.