帝曰∶人之不得偃卧者，何也？岐伯白∶肺者，脏之盖也，肺气盛则脉大，脉大则不得偃卧，论在《奇恒
阴阳》中。
偃卧者，平身而卧也。肺为华盖，其气下降，肺气偏盛则逆而不降，故寸口脉大，不得偃卧也。《奇恒阴
阳》古经篇名，奇者，异也，恒者，常也，谓所论皆异常之病也。
《素问·逆调论》帝曰∶人有逆气不得卧而息有
音者，有不得卧而息无音者，有起居如故而息有音者，有得卧行而喘者，有不得卧不能行而喘者，有不得卧卧
而喘者，皆何脏使然？愿闻其故。岐伯曰∶不得卧而息有音者，是阳明之逆也，足三阳者下行，今逆而上行，
故息有音也。阳明者，胃脉也，胃者，六腑之海，其气亦下行，阳明逆，不得从其道，故不得卧也。《下经》
曰∶胃不和则卧不安。此之谓也。夫起居如故而息有音者，此肺之络脉逆也，络脉不得随经上下，故留经而不
行，络脉之病患也微，故起居如故而息有音也。夫不得卧卧则喘者，是水气之客也，夫水者，循津液而流也，
肾者水脏，主津液，主卧与喘也。
脾胃统一身阴阳之气，脾主升，胃主降，阳明行气于三阳，而足三阳经皆下行也，故胃气逆，则三阳经皆
逆而不得从其道，故不得卧，而出入之息有音也。若起居如故，则眠食安而胃气和也，而息有音，是肺之络
脉气逆，不得随经上下流行，而肺最高，其络脉浅在皮肤，故病患也微，虽息有音，而起居如故也。若坐则气
定，卧则喘者，是水气客于三焦，盖三焦为决渎之官而出水道，气不宣化而水客之，故坐则水气下行，卧则水
壅气喘，此但喘而息无音，故病不在肺胃，而在下焦肾脏，以肾为寒水之脏，其阳虚则下焦之气不化津液，
水壅为患，卧则肺气归肾，以水壅逆肺，则喘不得卧，是故阳气化而津液流行，则水道通而气顺喘定，所以言
津液与卧与喘，皆肾脏主之，当治其主病者也。帝所问六证，岐伯止答其三。盖帝问虽有六证，不出肺、胃、
肾三者之病，岐伯已详明之，其余不过浅深虚实之异，可以类推而知。如帝所云得卧而行则喘者，肺虚也，故
静则气定得卧，行则劳动即喘也。如云不得卧，不能行而喘者，却有虚实两
证∶一者肺肾俱虚，以肾虚不能纳气，肺虚气不收降，故喘不得卧，不能行也；一者风痰闭结于肺，肺主一身
之气，一身气壅不行，故喘不得卧，不能行，此为邪实也。然邪闭者，其声粗而脉实；若脏虚者，其声低而脉
弱，气既不顺，亦必有痰而易吐也。如云不得卧而息无音者，其气平而不喘，但胃不和而卧不安，是上文半夏
汤证也，故所问虽有六证，总不外肺、胃、肾之病也。
黄帝问道：人不能仰卧，是什么原因呢？岐伯回答说：肺是五脏的华盖，肺气偏盛则脉象变大，脉象变大就不能仰卧，这一论述记载在《奇恒阴阳》篇中。
所谓仰卧，就是身体平躺而卧。肺为华盖，其气应当下降，如果肺气偏盛，就会逆乱而不能下降，所以寸口脉大，导致不能仰卧。《奇恒阴阳》是古代的一篇经名，“奇”意为异常，“恒”意为平常，意思是所论述的都是异常的病证。
《素问·逆调论》中黄帝问道：有的人气机逆乱不能仰卧且呼吸有声，有的人不能仰卧但呼吸无声，有的人起居如常但呼吸有声，有的人能仰卧行走却喘息，有的人不能仰卧也不能行走却喘息，有的人不能仰卧一躺下就喘息，这些都是哪些脏腑引起的呢？希望听听其中的缘故。岐伯说：不能仰卧且呼吸有声的，是阳明经气逆乱所致。足三阳经的气本应下行，现在反而上行，所以呼吸有声。阳明经即胃脉，胃为六腑之海，其气也应当下行，阳明经气逆乱，不能顺从其正常通道，所以不能仰卧。《下经》说：“胃不和则卧不安。”说的就是这个道理。至于起居如常但呼吸有声的，这是肺的络脉气逆所致。络脉之气不能随经脉上下运行，所以滞留于经脉而不行，这是络脉的轻微病患，所以起居如常只是呼吸有声。至于不能仰卧、一躺下就喘息的，是水气客犯所致。水液是跟随津液流动的，肾是水脏，主管津液，所以睡眠和喘息都与肾有关。
脾胃统管一身阴阳之气，脾主升清，胃主降浊，阳明经在三阳经中运行气机，而足三阳经的气皆向下行，所以胃气逆乱，则三阳经之气都逆乱而不能顺从其通道，因此不能仰卧，且呼吸出入有声。如果起居如常，说明睡眠饮食安适且胃气和顺，此时若呼吸有声，则是肺的络脉气逆，不能随经脉上下流行。因为肺位置最高，其络脉浅在于皮肤，所以病情轻微，虽然呼吸有声，但起居如常。如果坐位时气息平稳，仰卧时则喘息，这是水气客犯于三焦。三焦是决渎之官，负责疏通水道，气机不宣通化生而导致水气客犯，所以坐位时水气下行，仰卧时水气壅滞导致气喘。这种情况只是喘息而呼吸无声，所以病不在肺胃，而在下焦肾脏。因为肾是寒水之脏，阳气虚则下焦之气不能气化津液，水气壅滞为患。仰卧时肺气归于肾，因水气壅逆犯肺，所以喘息不能仰卧。因此，阳气气化则津液流通，水道通畅则气顺喘定，所以说津液、睡眠与喘息，都由肾脏主宰，应当治疗其主病的脏腑。黄帝所问六种证候，岐伯只回答了三种。大概黄帝所问虽有六种证候，但不外乎肺、胃、肾三者的病变，岐伯已经详细阐明，其余不过是深浅虚实不同，可以类推而知。如黄帝所说的“能仰卧行走却喘息”，是肺虚所致，所以静则气定能仰卧，动则劳动即喘息。如所说的“不能仰卧、不能行走且喘息”，却有虚实两种证候：一是肺肾俱虚，因肾虚不能纳气，肺虚气不收降，所以喘息不能仰卧、不能行走；一是风痰闭结于肺，肺主一身之气，一身气机壅滞不行，所以喘息不能仰卧、不能行走，此为邪实。然而邪气闭阻者，声音粗重且脉象实；若是脏腑虚损者，声音低微且脉象弱，气既不顺，也必有痰且容易咳出。如所说的“不能仰卧且呼吸无声”，其气息平和且不喘息，只是胃不和导致卧不安，这就是上文半夏汤证的范畴，所以所问虽有六种证候，总不外乎肺、胃、肾的病变。
Huangdi asked: Why is it that some people cannot lie on their backs? Qibo replied: The Lung is the canopy of the zang organs. When Lung Qi is excessive, the pulse becomes large; when the pulse is large, one cannot lie on their back. This discussion is recorded in the chapter "Qi Heng Yin Yang" (Odd and Constant Yin-Yang).
"Lying on the back" refers to lying flat. The Lung serves as the floral canopy, and its Qi should descend. If Lung Qi is excessively abundant, it rebels and fails to descend, resulting in a large pulse at the Cun Kou position and an inability to lie on one's back. "Qi Heng Yin Yang" is the title of an ancient classic chapter; "Qi" means abnormal or odd, and "Heng" means constant or normal, indicating that the diseases discussed are all abnormal conditions.
In *Su Wen: Ni Diao Lun* (Treatise on Counterflow Regulation), Huangdi asked: There are cases where people have counterflow Qi, cannot lie down, and breathe with sound; there are cases where they cannot lie down but breathe without sound; there are cases where daily activities remain normal but breathing has sound; there are cases where they can lie down and walk but pant; there are cases where they cannot lie down, cannot walk, yet pant; and there are cases where they cannot lie down and pant immediately upon lying down. Which zang organs cause these conditions? I wish to hear the reasons. Qibo said: Those who cannot lie down and breathe with sound suffer from counterflow in the Yangming channel. The Foot Three Yang channels normally descend; now they rebel and ascend, causing sound in respiration. The Yangming channel corresponds to the Stomach meridian. The Stomach is the sea of the six fu organs, and its Qi also descends. When Yangming Qi rebels and cannot follow its proper pathway, one cannot lie down. The *Xia Jing* (Lower Classic) states: "When the Stomach is not harmonious, sleep is uneasy." This refers to such cases.
As for those whose daily activities remain normal but breathe with sound, this is due to counterflow in the collateral vessels of the Lung. Collateral Qi cannot move up and down with the main meridians, so it stagnates within the meridians and does not circulate freely. This is a minor disorder of the collateral vessels; hence, daily activities remain normal despite respiratory sounds.
Regarding those who cannot lie down and pant immediately upon lying down, this is caused by Water Qi invading. Water follows the flow of Jin Ye (Body Fluids). The Kidney is the Water Zang organ, governing Jin Ye; thus, sleep and panting are both governed by the Kidney.
The Spleen and Stomach regulate the Yin and Yang Qi of the entire body. The Spleen governs ascending, while the Stomach governs descending. The Yangming channel circulates Qi among the Three Yang channels, and the Qi of the Foot Three Yang channels all descends. Therefore, if Stomach Qi rebels, the Qi of the Three Yang channels all rebels and cannot follow its proper pathway, leading to an inability to lie down and audible respiration. If daily activities remain normal, it indicates that sleep and digestion are comfortable and Stomach Qi is harmonious. If respiratory sound occurs under these conditions, it is due to counterflow in the collateral vessels of the Lung, which cannot circulate up and down with the meridians. Since the Lung is located highest and its collateral vessels are superficial in the skin, the pathology is mild; thus, although there is respiratory sound, daily activities remain normal.
If one is calm when sitting but pants when lying down, this is because Water Qi has invaded the San Jiao (Triple Burner). The San Jiao is the official responsible for irrigation and water passage. When Qi fails to diffuse and transform, Water Qi invades. Thus, when sitting, Water Qi flows downward; when lying down, Water Qi stagnates, causing panting. In this case, there is only panting without respiratory sound, so the disease is not in the Lung or Stomach, but in the Lower Jiao Kidney. The Kidney is the Cold Water Zang organ. When Yang Qi is deficient, Qi in the Lower Jiao fails to transform Jin Ye, leading to Water stagnation. When lying down, Lung Qi returns to the Kidney; obstructed by stagnant Water, it rebels against the Lung, causing panting and inability to lie down. Therefore, when Yang Qi transforms and Jin Ye circulates, water passages open, Qi flows smoothly, and panting subsides. Hence, it is said that Jin Ye, sleep, and panting are all governed by the Kidney, and treatment should target the primary diseased organ.
Although Huangdi asked about six conditions, Qibo answered only three. Although there were six questions, they did not exceed the pathologies of the Lung, Stomach, and Kidney, which Qibo had already explained in detail. The others merely differ in depth and deficiency/excess, allowing them to be inferred by analogy. For example, regarding "can lie down and walk but pant," this is due to Lung Deficiency. Thus, stillness allows Qi to settle and enables lying down, while movement causes labor-induced panting.
Regarding "cannot lie down, cannot walk, and pants," there are two patterns: deficiency and excess. One is combined Lung and Kidney Deficiency: Kidney Deficiency fails to grasp Qi, and Lung Deficiency fails to receive and descend Qi, causing panting, inability to lie down, and inability to walk. The other is Wind-Phlegm blocking the Lung. The Lung governs the Qi of the whole body; when systemic Qi stagnates and fails to move, panting, inability to lie down, and inability to walk occur. This is an Excess pattern due to pathogenic factors. However, in cases of pathogenic closure, the voice is coarse and the pulse is excess/forceful; in cases of organ deficiency, the voice is low and the pulse is weak. Since Qi is not smooth, Phlegm is likely present and easily expectorated.
Regarding "cannot lie down and breathes without sound," the Qi is calm and there is no panting; only Stomach disharmony leads to uneasy sleep. This corresponds to the Ban Xia Tang (Pinellia Decoction) syndrome mentioned earlier. Thus, although six conditions were asked, they ultimately do not go beyond the pathologies of the Lung, Stomach, and Kidney.