黄帝问于岐伯曰。夫百病之始生也。皆生于风雨寒暑清湿喜怒。喜怒不节则伤脏。风雨则伤上。清湿则伤下。三部
之气。所伤异类。愿闻其会。岐伯曰。三部之气各不同。或起于阴。或起于阳。请言其方。喜怒不节。则伤脏。脏伤则
病起于阴也。清湿袭虚。则病起于下。风雨袭虚。则病起于上。是谓三部。至于其淫 。不可胜数。黄帝曰。余固不能
数。故问先师。愿卒闻其道。岐伯曰。风雨寒热。不得虚邪。不能独伤人。卒然逢疾风豪雨而不病者。盖无虚。故邪不
能独伤人也。此必因虚邪之风。与其身形两虚相得。乃客其形两实相逢。众人肉坚其中。于虚邪也。因于天时与其身形
参以虚实。大病乃成。气有定舍。因处为名。上下中外分为三员。（以上为第一节是叙病之源统冒全篇）是故虚邪之中人
也。始于皮肤。皮肤缓则腠理开。开则邪从毛发入。入则抵深。深则毛发立。毛发立则淅然。故皮肤痛。留而不去。则
传舍于络脉。在络之时。痛于肌肉。其痛之时息。大经乃代。（息长久也代气弱不振也岁露论曰经气结代）留而不去。传
舍于经。在经之时。洒淅喜惊。留而不去。传舍于输。在输之时。六经不通四肢。则肢节痛。腰脊乃强。留而不去。传
舍于伏冲之脉。在伏冲之时。体重身痛。留而不去。传舍于肠胃。在肠胃之时。贲响腹胀。多寒则肠鸣飧泄。食不化。
多热则溏。出麋。留而不去传舍于肠胃之外。募原之间。留着于脉。稽留而不去息而成积。或着孙脉。或着络脉。或着
经脉。或着输脉。或着于伏冲之脉。或着于膂筋。或着于肠胃之募原。上连于缓筋。（募原夹膜之中空者也缓筋脏腑之系
络也西书谓之网油）邪气淫 。不可胜论。（以上为第二节叙邪之由浅渐深是叙病之舍也）黄帝曰。愿尽闻其所由然。岐
伯曰。其着孙络之脉而成积者。其积往来上下。臂手。孙络之居也。浮而缓。不能句积而止之。故往来移行。肠胃之间。
水凑渗注灌。濯濯有音。有寒则 满雷引。故时切痛其着于阳明之经。则挟脐而居。饱食则益大。饥则益小。其着于缓
筋也。似阳明之积。饱食则痛。饥则安。其着于肠胃之募原也。痛而外连于缓筋。饱食则安。饥则痛。其着于伏冲之脉
者。揣之应手而动。发手则热气下于两股。如汤沃之状。其着于膂筋。在肠后右。饥则积见。饱则积不见。按之不得。
其着于输之脉者。闭塞不通。津液不下。孔窍干壅。此邪气之从外入内。从上下也。（以上为第三节叙病之症也大义已晰
下文乃补叙病机也病机者病源与病舍病证之交际也前叙病源是叙其所由生下叙病机是叙其所由成）黄帝曰。积之始生至
其已成。奈何。岐伯曰。积之始生得寒。乃生厥。乃成积也。黄帝曰。其成积奈何。岐伯曰。厥气生足 。 生胫寒。
胫寒则血脉凝涩。血脉凝涩则寒气上入于肠胃。入于肠胃则 胀。 胀则肠外之汁沫迫聚不得散。日以成积卒然多食饮
则肠满。起居不节。用力过度。则络脉伤阳。络伤则血外溢。血外溢则衄血。阴络伤则血内溢。血内溢则后血肠胃之络
伤。则血溢于肠外。肠外有寒。汁沫与血相搏。则并合凝聚。不得散而积成矣。卒然外中于寒。若内伤于忧怒。则气上
逆。气上逆。则六输不通。温气不行。凝血蕴里而不散津液。涩渗着而不去而积皆成矣。（此病机之自外而内也是生于阳）
黄帝曰。其生于阴者奈何。岐伯曰。忧思伤心。重寒伤肺。忿怒伤肝。醉以入房。汗出当风。伤脾。用力过度。若入房
汗出。浴则伤肾。（此病机之自内而成也是生于阴）此内外三部之所生病者也。（以上第四五节是叙内外之病机当作一节
读）黄帝曰。善。治之奈何。岐伯答曰。察其所痛。以知其应。有余不足。当补则补。当泻则泻。毋逆天时。是谓至治。
通篇论积也。来踪去迹层次井井。其笔坚凝。其气浩瀚。三部之事。或分或合。操纵屈伸。无不如志。可称理达词
举。
黄帝向岐伯问道：各种疾病的发生，都是由于风雨寒暑、清湿以及喜怒情绪引起的。喜怒情绪没有节制就会损伤内脏；风雨之邪容易伤害人体上部；清湿之邪容易伤害人体下部。这三种来源的气（指风雨、清湿、喜怒），所伤害的部位各不相同。我希望听听它们是如何汇聚并导致疾病的。
岐伯回答说：这三种来源的气性质各不相同，有的起于阴分，有的起于阳分。请让我说明其中的道理。喜怒情绪没有节制，就会损伤内脏，内脏受伤则疾病起于阴分。清湿之气侵袭虚弱之处，则疾病起于下部；风雨之邪侵袭虚弱之处，则疾病起于上部。这就称为“三部”。至于病邪的蔓延传变，多得数不过来。
黄帝说：我确实无法列举完，所以询问先师，希望您能详尽地讲述这个道理。
岐伯说：风雨寒热等外邪，如果不是乘虚而入的“虚邪”，就不能单独伤人。突然遭遇狂风暴雨却不生病的人，是因为体内没有虚弱之处，所以邪气不能单独伤害人。这一定是因为外界的虚邪之风与人体内部的虚弱状态两者相遇，邪气才得以客居在人体内。如果外界气候正常（实）与人身体质强健（实）相逢，众人肌肉坚实，面对虚邪也无能为力。因此，必须结合天时气候与人体虚实状况来判断，大病才会形成。气有固定的居留之所，根据停留部位来命名，上下内外分为三类。（以上为第一节，叙述疾病的总源头，统领全篇）
因此，虚邪侵入人体时，始于皮肤。如果皮肤松弛，腠理（汗孔及纹理）就会张开，张开后邪气就从毛发进入。进入后逐渐深入，深入则使毛发竖立，毛发竖立则使人感到寒冷战栗（淅然），所以皮肤疼痛。如果邪气停留不去，就会传舍到络脉。在络脉阶段，肌肉会有疼痛感，这种疼痛有时缓解，随后大经（十二正经）就会受累。（“息”指长久，“代”指气弱不振。《岁露论》说：经气结代）。如果邪气继续停留不去，就会传舍到大经。在大经阶段，会出现洒淅恶寒、容易惊悸的症状。如果邪气继续停留不去，就会传舍到输脉（转输气血的经脉）。在输脉阶段，六经之气不通达四肢，就会出现关节疼痛，腰脊僵硬强直。如果邪气继续停留不去，就会传舍到伏冲之脉（冲脉深伏于脊柱内的部分）。在伏冲之脉阶段，会出现身体沉重、全身疼痛的症状。如果邪气继续停留不去，就会传舍到肠胃。在肠胃阶段，会出现肠鸣腹胀。寒气多则肠鸣飧泄（完谷不化的腹泻），食物不消化；热气多则大便溏薄，排泄物如糜粥状。如果邪气继续停留不去，就会传舍到肠胃之外、募原（腹腔内脂肪组织或膜原）之间，留着在脉络中，稽留不去，逐渐形成积聚。或者附着在孙脉（最细小的分支脉络），或者附着在络脉，或者附着在经脉，或者附着在输脉，或者附着在伏冲之脉，或者附着在膂筋（夹脊两旁的筋肉），或者附着在肠胃的募原，向上连接于缓筋。（募原是夹膜中间中空的地方，缓筋是脏腑的系络，西医称之为网油）。邪气的淫溢变化，多得无法尽述。（以上为第二节，叙述邪气由浅入深的过程，即叙述疾病的居留之所）。
黄帝说：我希望听您详尽地讲述其产生的原因。
岐伯说：那些附着在孙络并形成积聚的，其积块往来上下移动，涉及手臂和手部。因为孙络分布浅表且松弛，不能拘束积块使其停止，所以积块会往来移行。这是肠胃间水液凑集渗透灌注，发出濯濯的声音。如果有寒气，则腹部胀满，雷鸣般牵引作痛，所以时常剧烈疼痛。那些附着在阳明经的，积块挟持脐部而居，吃饱饭后积块变大，饥饿时积块变小。那些附着在缓筋的，症状类似阳明经的积聚，吃饱饭后疼痛，饥饿时则安适。那些附着在肠胃募原的，疼痛并向外牵连到缓筋，吃饱饭后安适，饥饿时则疼痛。那些附着在伏冲之脉的，用手按压感觉应手而动，松手后热气下行至大腿两侧，像热水浇淋一样的感觉。那些附着在膂筋的，位于肠道后方右侧，饥饿时积块显现，吃饱后积块隐藏，按压也摸不到。那些附着在输脉的，会导致闭塞不通，津液不能下行，孔窍干燥壅塞。这就是邪气从外部进入内部、从上向下传变的规律。（以上为第三节，叙述疾病的症状，大义已经清晰，下文则是补充叙述病机。病机是病源、病舍与病证之间的交汇点。前文叙述病源是讲其由来，下文叙述病机是讲其形成）。
岐伯说：积聚的开始产生，是由于感受寒气，导致厥气（逆乱之气）产生，从而形成积聚。
岐伯说：厥气产生于足部，进而导致小腿寒冷。小腿寒冷则血脉凝滞涩滞，血脉凝滞则寒气上行进入肠胃。进入肠胃则导致腹部胀满，腹部胀满则迫使肠胃外面的汁沫聚集而不能消散，日久便形成积聚。突然大量饮食则肠道充满；起居没有节制，用力过度，则损伤络脉。阳络受伤则血液向外溢出，表现为鼻衄（流鼻血）；阴络受伤则血液向内溢出，表现为便血。如果肠胃的络脉受伤，血液就会溢出到肠外。如果肠外有寒气，溢出的汁沫与血液相互搏结，则凝结在一起，不能消散，于是积聚就形成了。如果突然外感寒气，或者内伤于忧怒，则气机上逆。气机上逆，则六输之气不通畅，温煦之气不能运行，凝血蕴积在内而不能消散，津液涩滞渗出附着而不能去除，于是积聚就都形成了。（这是病机由外而内的过程，属于生于阳）。
岐伯说：忧愁思虑伤心，双重寒邪伤肺，忿怒伤肝，醉酒后行房事、出汗时当风，伤脾；用力过度，或者房事后出汗洗澡，伤肾。（这是病机由内而成的过程，属于生于阴）。这就是内外三部所发生的疾病。（以上第四、五节叙述内外的病机，应当作为一节阅读）。
黄帝说：好。如何治疗呢？
岐伯回答说：观察患者疼痛的部位，以推断病变的反应所在。判断有余还是不足，该补的就补，该泻的就泻，不要违背自然时序，这就叫做最高的治疗境界。
全篇论述的是积聚病。来龙去脉层次井然，笔法坚凝，气势浩瀚。关于三部的论述，或分或合，操纵自如，无不如愿，可称得上道理通达、言辞精举。
Huangdi asked Qibo: "The onset of all diseases arises from wind, rain, cold, heat, clear dampness, and emotions of joy and anger. Unregulated joy and anger damage the Zang organs; wind and rain damage the upper body; clear dampness damages the lower body. The Qi of these three sectors (wind/rain, clear dampness, emotions) damages different parts. I wish to hear how they converge."
Qibo replied: "The Qi of the three sectors differs in nature. Some originate from the Yin, some from the Yang. Let me explain their directions. Unregulated joy and anger damage the Zang organs; when Zang organs are damaged, disease originates from the Yin. Clear dampness attacks deficiency, so disease originates from below; wind and rain attack deficiency, so disease originates from above. This is called the 'Three Sectors.' As for their spreading and transforming, there are too many to count."
Huangdi said: "I indeed cannot enumerate them all, so I ask my former teachers. I wish you to exhaustively explain this principle."
Qibo said: "Wind, rain, cold, and heat, if they are not 'deficient pathogenic factors' (Xu Xie, pathogenic factors that take advantage of deficiency), cannot harm people alone. Those who suddenly encounter fierce winds and heavy rains without getting sick do so because there is no internal deficiency; thus, pathogens cannot harm people alone. This must be due to the convergence of external deficient pathogenic wind and internal bodily deficiency. When two deficiencies meet, the pathogen enters the body. If two realities (normal climate and strong constitution) meet, with solid flesh and muscles, even deficient pathogenic factors have no effect. Therefore, one must consider both the heavenly timing (climate) and the bodily state, combining reality and deficiency, before major diseases are formed. Qi has fixed abodes; names are given according to location. Upper, lower, interior, and exterior are divided into three sectors. (This is the first section, narrating the general source of disease, covering the whole chapter.)
Therefore, when deficient pathogenic factors enter humans, they start at the skin. If the skin is lax, the Couli (pores and tissue spaces) open. When open, pathogens enter through the hair. Upon entering, they reach depth. At depth, the hair stands erect. When hair stands erect, one feels shivering (Xi Ran), hence skin pain. If it stays and does not leave, it transmits to the Luo vessels. During its stay in the Luo vessels, there is pain in the muscles. The pain comes and goes, and then the main meridians (Da Jing) take over. ('Xi' means long-lasting; 'Dai' means weak and unvigorous Qi. The *Sui Lu Lun* states: 'Meridian Qi becomes knotted and intermittent.') If it stays and does not leave, it transmits to the Jing meridians. During its stay in the Jing meridians, there is shivering aversion to cold and frequent fright. If it stays and does not leave, it transmits to the Shu vessels. During its stay in the Shu vessels, the Qi of the Six Meridians fails to flow to the four limbs, resulting in joint pain and stiffness in the waist and spine. If it stays and does not leave, it transmits to the Fu Chong Mai (Deeply seated Chong vessel). During its stay in the Fu Chong Mai, there is heaviness of the body and pain throughout. If it stays and does not leave, it transmits to the stomach and intestines. During its stay in the stomach and intestines, there is rumbling and abdominal distension. With excess cold, there is borborygmus and undigested stool diarrhea (Sun Xie); food is not transformed. With excess heat, there is loose stool resembling millet gruel. If it stays and does not leave, it transmits outside the stomach and intestines, between the Mu Yuan (epigastric membrane/origin of peritoneum), lingering in the vessels. Staying and not leaving, it gradually forms accumulations (Ji). It may attach to Sun vessels (finest branches), or Luo vessels, or Jing meridians, or Shu vessels, or the Fu Chong Mai, or the Lv Jin (muscles alongside the spine), or the Mu Yuan of the stomach and intestines, connecting upwards to the Huan Jin. (Mu Yuan refers to the hollow spaces within the membranes; Huan Jin refers to the ligaments connecting organs; Western medicine calls this omentum.) The proliferation of pathogenic Qi is indescribable. (This is the second section, narrating the progression of pathogens from shallow to deep, i.e., the abodes of disease.)
Huangdi said: "I wish to hear exhaustively how this happens."
Qibo said: "For those attaching to Sun vessels forming accumulations, the accumulation moves up and down, involving the arms and hands. Because Sun vessels are superficial and lax, they cannot confine the accumulation to stop it; thus, it migrates back and forth. Between the stomach and intestines, water gathers and渗注 (seeps and pours), making a gurgling sound. With cold, there is fullness and thunder-like traction pain, causing sharp pain intermittently. For those attaching to the Yangming Meridian, the accumulation resides flanking the navel. After eating, it enlarges; when hungry, it shrinks. For those attaching to the Huan Jin, it resembles an accumulation of the Yangming Meridian. After eating, there is pain; when hungry, there is relief. For those attaching to the Mu Yuan of the stomach and intestines, there is pain extending externally to the Huan Jin. After eating, there is relief; when hungry, there is pain. For those attaching to the Fu Chong Mai, palpation reveals movement under the hand. Upon releasing pressure, hot qi flows down to both thighs, like boiling water being poured. For those attaching to the Lv Jin, located posterior to the intestines on the right, the accumulation appears when hungry and disappears when full; it cannot be felt by pressing. For those attaching to the Shu vessels, there is blockage and obstruction, fluids fail to descend, and orifices become dry and congested. This is the pathogenic Qi entering internally from externally, descending from above. (This is the third section, narrating disease symptoms; the main meaning is clear. The following text supplements the pathogenesis. Pathogenesis is the intersection of disease origin, abode, and manifestation. The previous section narrated the origin; this section narrates the formation.)
Huangdi said: "How does an accumulation begin and eventually form?"
Qibo said: "Accumulations begin with the acquisition of cold, which generates Jue Qi (rebellious Qi), leading to the formation of accumulation."
Huangdi said: "How is the accumulation formed?"
Qibo said: "Jue Qi originates in the feet, generating cold in the calves. Cold in the calves causes blood vessels to coagulate and become stagnant. Coagulated blood vessels allow cold Qi to ascend into the stomach and intestines. Entering the stomach and intestines causes distension. Distension forces the fluid foam outside the intestines to gather and condense, unable to disperse, forming accumulation day by day. Sudden excessive eating fills the intestines. Irregular living habits and excessive physical effort injure the Luo vessels. Injury to Yang Luo vessels causes blood to overflow externally, manifesting as epistaxis. Injury to Yin Luo vessels causes blood to overflow internally, manifesting as hematochezia. If the Luo vessels of the stomach and intestines are injured, blood overflows outside the intestines. If there is cold outside the intestines, the fluid foam and blood contend and combine, coagulating and unable to disperse, thus forming accumulation. Sudden external invasion by cold, or internal injury by sorrow and anger, causes Qi to rebel upward. Upward rebellion of Qi blocks the Six Shu points, preventing the circulation of warming Qi. Coagulated blood remains trapped inside without dispersing; fluid seeps and adheres without clearing, thus all accumulations are formed. (This is the pathogenesis from external to internal, arising from Yang.)
Huangdi said: "What about those arising from Yin?"
Qibo said: "Worry and thought damage the Heart; double cold damages the Lungs; resentment and anger damage the Liver; sexual intercourse while drunk with sweating exposed to wind damages the Spleen; excessive physical effort, or sexual intercourse followed by sweating and bathing, damages the Kidneys. (This is the pathogenesis formed internally, arising from Yin.) These are the diseases generated by the internal and external three sectors. (Sections 4 and 5 narrate internal and external pathogenesis and should be read as one section.)
Huangdi said: "Excellent. How should they be treated?"
Qibo answered: "Observe the site of pain to know the corresponding reaction. Assess excess and deficiency. Tonify when appropriate, drain when appropriate. Do not go against the timing of Heaven. This is called supreme treatment."
The entire passage discusses accumulations. The cause and effect are orderly. The writing is firm and condensed, the aura vast. The discussion of the three sectors is either separated or combined, manipulated with flexibility and ease, achieving perfect expression. It can be praised for clear reasoning and precise diction.