《灵枢·百病始生篇》帝曰∶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。
此总举外感、内伤之病，而分三部以辨之也。喜怒该七情而言，七情伤脏，脏为阴，则病起于阴也∶风雨
之邪上受，上为阳部，则病起于阳也；清湿即寒湿，其邪下受，下属足经，有阴有阳，则病或起于阴，或起于
阳，当随证辨之也。至于病之淫 ，犹水之泛滥，故其变化不可胜数也。
帝曰∶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，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。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，毛发立则洒然，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；留而不去，传舍于经，在经之时，洒
淅喜惊；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，多热则溏出糜；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。或着孙络，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，邪气淫 ，不可胜论。
寻常风雨寒热，不能伤人，必因虚邪之风，与身形之虚，两虚相遇，邪乃客之。盖太乙所居之宫，风从后
来者为虚邪，从前来者为实邪，义详前卷《灵枢·九宫八风篇》。若身形实而邪实，两实相逢，则肉坚不能伤
也。若天时身形，虚实相参，而中其邪，大病乃成。邪客于身而有定舍，因其邪在之所而立病名，分上下中外
三部，以其直则有上中下三焦，横则有表里中三层。虚邪中人，初在皮肤，留而不去，则渐入渐深，各有现证
可验，而不随证治之，则病根深痼难去。当邪之初入，其流传亦无定所，或浅或深，留着为病，以至久着不去，
则息而成积，乃不复流传，以其与气血胶结而成瘀积也。故邪气之淫 蔓延，何可胜论哉！
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
拘积而止之，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；
其着于膂筋在肠后者，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，孔窍干塞。
此邪气之从外入内，从上下也。
浮在皮里之细络，名孙络，稍深而粗者，名大络，大络内通
于经，阳经则通腑，阴经则通脏，故阴经又深于阳经，经有阴阳，故络亦有阴阳也。气血周内联外，无处不到，
其邪客之，则气血瘀滞，久乃结而成积矣。积在孙络，往来上下者，以臂手乃孙络所居之处，其气浮浅而缓，
不能拘止其积，故积往来移行，以至肠胃之间，肠胃为水饮灌注旁渗之地，而邪从旁凑之，故濯濯有音，如系
寒积，则 满雷鸣相引，时时切痛，因其络阻，气不流通也；其或着于阳明胃经，则挟脐而居，以经气聚于此
也，饱食则胃气充溢于经，故积形益大，饥则气消，而仍小矣，经居于肉而不贴胃，无形质触碍，故积不痛；
其着于缓筋者，缓筋贴胃，故似阳明之积，以其贴胃，饱则胃胀触动，故痛，饥则安矣；其着于肠胃之膜原，
膜原，遮蔽胃中浊气者，饥则虚火冲动，故痛，饱则火息，故安，其痛连缓筋者，缓筋乃募原之枝也；其着于
伏冲之脉者，脉在脊背肉内，是营气所流行者，被积壅阻，故揣之应手而动，发手则气流散，故觉热气下于两
股，如汤沃之状也∶积着于膂筋，其在肠胃之后，饥则肠胃空虚，故积现，饱则气漫，故积不现，以其在肠胃
之后，躯体之里，故按之不可得也；积着于输之脉者，脉闭不通，则津液不能下输，故便窍干窒。此皆言其邪
气之从外入内，从上而下之成积也。
《灵枢·百病始生篇》中，黄帝问道：各种疾病的产生，都源于风雨寒暑、清湿以及喜怒情绪。如果喜怒情绪没有节制，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。这三种部位的气（指致病因素），所伤害的部位各不相同，我希望听听它们是如何交汇影响的。岐伯回答说：这三种部位的气各不相同，有的起于阴分，有的起于阳分，请允许我说明其中的道理。喜怒情绪没有节制会损伤内脏，内脏受伤则疾病起于阴分；清湿侵袭虚弱之处则疾病起于下部；风雨侵袭虚弱之处则疾病起于上部，这就称为三部。至于这些邪气蔓延变化，多得数不胜数。
这段文字总括了外感病和内伤病，并分为三部来辨别。喜怒涵盖了七情（喜、怒、忧、思、悲、恐、惊），七情损伤内脏，脏属阴，所以疾病起于阴分；风雨之邪从上部受纳，上部为阳部，所以疾病起于阳分；清湿即寒湿，其邪气从下部受纳，下属足经，有阴有阳，所以疾病或起于阴分，或起于阳分，应当根据证候来辨别。至于病的蔓延变化，就像水泛滥一样，所以其变化不可胜数。
黄帝说：希望详尽地听您讲述其中的道理。岐伯说：风雨寒热，如果不是虚邪贼风，不能单独伤人。突然遭遇狂风暴雨却不生病的人，是因为身体不虚，所以邪气不能单独伤人，这必定是因为遇到了虚邪之风，并与身体的虚弱相结合，两虚相合，邪气才能客居在体内；如果是两实相逢（身体实且邪气实），众人的肌肉就会坚固。其中于虚邪的情况，是由于天时与身体状态相结合，参酌虚实，大病才形成。邪气在体内有一定的居留之所，根据其所在部位命名，上下中外分为三部。因此，虚邪侵入人体，始于皮肤，如果皮肤松弛则腠理开泄，腠理开泄则邪气从毛发进入，进入后则深入，深入则毛发竖立，毛发竖立则感到洒然恶寒，所以皮肤疼痛；邪气停留不去，则传舍于络脉，在络脉之时，肌肉疼痛，这种疼痛有时停止，大经脉就会代偿出现症状；邪气停留不去，传舍于经脉，在经脉之时，感到洒淅恶寒且喜欢惊恐；邪气停留不去，传舍于伏冲之脉，在伏冲之脉之时，身体沉重且疼痛；邪气停留不去，传舍于肠胃，在肠胃之时，腹部奔响且腹胀，寒气多则肠鸣飧泄，食物不消化，热气多则大便稀薄如糜；邪气停留不去，传舍于肠胃之外，募原之间，留着于脉中，稽留不去，逐渐形成积块。或者附着于孙络，或者附着于络脉，或者附着于经脉，或者附着于输脉，或者附着于伏冲之脉，或者附着于膂筋，或者附着于肠胃的募原，向上连接于缓筋，邪气蔓延变化，多得无法尽述。
寻常的风雨寒热，不能伤人，必定因为遇到虚邪之风，加上身体虚弱，两虚相遇，邪气才客居体内。大概太乙（指天体运行规律）所居之宫，风从后面吹来的是虚邪，从前面吹来的是实邪，详细义理见前卷《灵枢·九宫八风篇》。如果身体充实而邪气也实，两实相逢，则肌肉坚固不能受伤。如果天时与身体状态虚实参半，从而中邪，大病就形成了。邪气客居在身体上有固定的居留处，根据邪气所在的部位确立病名，分为上下中外三部，纵向则有上中下三焦，横向则有表里中三层。虚邪中人，初在皮肤，停留不去，则逐渐深入，各有现证可以验证，如果不随证治疗，则病根深痼难去。当邪气刚入时，其流传也没有定所，或浅或深，留着为病，以至久着不去，则逐渐形成积块，不再流传，因为它与气血胶结而成瘀积。所以邪气的蔓延变化，怎么能说得完呢！
黄帝说：希望详尽地听您讲述其形成的原因。岐伯说：那些附着于孙络而形成积块的，其积块往来上下移动，因为臂手是孙络居住的地方，孙络浮浅而松弛，不能拘束积块使其停止，所以积块往来移行于肠胃之间，水饮凑聚渗透灌注，发出濯濯的声音，如果有寒气，则胀满雷鸣牵引，所以时常剧烈疼痛；那些附着于阳明经的，则挟持脐部而居住，饱食后积块变大，饥饿时积块变小；那些附着于缓筋的，类似阳明经的积块，饱食后疼痛，饥饿时安宁；那些附着于肠胃的募原的，疼痛并向外牵连到缓筋，饱食后安宁，饥饿时疼痛；那些附着于伏冲之脉的，触摸它应手而动，抬手后感觉热气向下流注到大腿，像热水浇淋的样子；那些附着于膂筋且在肠胃后面的，饥饿时积块显现，饱食时积块不显现，按压也摸不到；那些附着于输脉的，闭塞不通，津液不能下行，孔窍干燥阻塞。这是邪气从外入内、从上往下的情况。
浮在皮里的细络，名叫孙络，稍深而粗的，名叫大络，大络内部通达于经脉，阳经则通腑，阴经则通脏，所以阴经又深于阳经，经脉有阴阳，所以络脉也有阴阳。气血周流于体内联络于体表，无处不到，邪气客居其中，则气血瘀滞，久而久之结而成积。积在孙络，往来移动的，因为臂手是孙络所居之处，其气浮浅而缓，不能拘止其积，所以积往来移行，以至于肠胃之间，肠胃是水饮灌注旁渗之地，邪气从旁边凑聚，所以发出濯濯的声音，如果系寒积，则胀满雷鸣相互牵引，时时剧烈疼痛，因为络脉阻滞，气不流通；或者附着于阳明胃经，则挟持脐部而居住，因为经气聚集于此，饱食后胃气充溢于经，所以积形变大，饥饿时气消，因而仍然变小，经脉居于肉中而不贴附胃壁，没有有形质触碍，所以积不痛；附着于缓筋的，缓筋贴附于胃，所以类似阳明经的积块，因为贴附于胃，饱食时胃胀触动，所以疼痛，饥饿时安宁；附着于肠胃的膜原的，膜原是遮蔽胃中浊气的地方，饥饿时虚火冲动，所以疼痛，饱食时火息，所以安宁，其疼痛连及缓筋的，缓筋是募原的分支；附着于伏冲之脉的，脉在脊背肉内，是营气流行的地方，被积块壅阻，所以触摸它应手而动，抬手后气流散开，所以感觉热气向下流注到大腿，像热水浇淋的样子；积附着于膂筋，其在肠胃之后，饥饿时肠胃空虚，所以积显现，饱食时气漫，所以积不显现，因为它在肠胃之后，躯体的里面，所以按压也摸不到；积附着于输脉的，脉闭不通，则津液不能下输，所以便窍干窒。这些都是说邪气从外入内、从上而下形成积块的情况。
In the "Bai Bing Shi Sheng Pian" (Chapter on the Origin of Hundred Diseases) of the *Ling Shu* (Spiritual Pivot), the Yellow Emperor asked: The origin of all diseases arises from wind, rain, cold, and heat, clear dampness, and joy and anger. If joy and anger are not regulated, they damage the Zang organs; wind and rain damage the upper part; clear dampness damages the lower part. The Qi of these three parts differs in what it damages. I wish to hear how they intersect. Qibo replied: The Qi of the three parts is different; some originate from Yin, some from Yang. Please allow me to explain the principles. Unregulated joy and anger damage the Zang organs; since Zang organs belong to Yin, disease originates from Yin. Clear dampness invading deficiency causes disease to originate from below; wind and rain invading deficiency cause disease to originate from above. This is called the Three Parts. As for their spreading and transformation, there are countless variations.
This passage generally categorizes exogenous and endogenous diseases, distinguishing them by dividing into three parts. Joy and anger encompass the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). The Seven Emotions damage the Zang organs; since Zang organs are Yin, disease originates from Yin. Wind and rain pathogens are received from above; the upper part is Yang, so disease originates from Yang. Clear dampness refers to cold-dampness; its pathogen is received from below. The lower part corresponds to the Foot meridians, which contain both Yin and Yang, so disease may originate from Yin or Yang, and must be differentiated according to the syndrome. As for the spreading of disease, like flooding water, its changes are countless.
The Yellow Emperor said: I wish to hear this principle in detail. Qibo said: Wind, rain, cold, and heat, if not acting as Empty Pathogens (Xu Xie, pathogenic factors taking advantage of bodily weakness), cannot injure people alone. Those who suddenly encounter fierce winds and heavy rains without getting sick do so because they lack deficiency; thus, pathogens cannot injure alone. It is necessary for an Empty Pathogen wind to meet with bodily deficiency. When two deficiencies meet, the pathogen resides in the body. When two realities meet (robust constitution and strong pathogen?), the flesh remains firm. Contracting empty pathogens depends on heavenly timing and bodily condition, combined with assessment of deficiency and excess, leading to major illness. Qi has fixed abodes; names are given based on location, divided into Upper, Middle, and Lower sections. Therefore, when empty pathogens enter humans, they start at the skin. If the skin is lax, the Cou Li (pores/clefts) open; when open, pathogens enter via hair follicles. Upon entering, they reach depth; at depth, hair stands erect. Erect hair causes a sensation of chilliness (Sa Ran), hence skin pain. If lingering and not expelled, they transmit to the Luo vessels (Collaterals). At the stage of the Luo vessels, muscle pain occurs; this pain may cease intermittently, while the larger meridians take over symptoms. If lingering further, they transmit to the Jing meridians (Main Meridians). At this stage, one feels chilly and prone to fright. If lingering further, they transmit to the Fu Chong Mai (Hidden Rush Vessels). At this stage, the body feels heavy and painful. If lingering further, they transmit to the intestines and stomach. At this stage, there is rushing sounds and abdominal distension; excessive cold leads to borborygmus and undigested stool diarrhea; excessive heat leads to loose, mushy stools. If lingering further, they reside outside the intestines and stomach, between the Mu Yuan (Moyuan/Roots of the Peritoneum), staying within the vessels. Lingeringly remaining, they gradually form Jis (Accumulations/Masses). They may attach to Sun Luo vessels (Branch Collaterals), Luo vessels, Jing meridians, Shu vessels, Fu Chong Mai, Lv Jin (Spinal Muscles/Tendons), or the Mu Yuan of the intestines and stomach, connecting upwards to Huan Jin (Relaxing Tendons). The spreading of pathogens is incalculable.
Ordinary wind, rain, cold, and heat cannot injure people; it requires the meeting of Empty Pathogen winds and bodily deficiency. When two deficiencies meet, the pathogen resides. Generally, wind coming from behind the Tai Yi palace (referring to celestial directions) is an Empty Pathogen; wind coming from the front is a Real Pathogen (Shi Xie). Detailed meanings are found in the previous volume, *Ling Shu*, "Jiu Gong Ba Feng Pian". If the body is solid and the pathogen is real, their meeting results in firm flesh that resists injury. If heavenly timing and bodily condition involve mixed deficiency and excess, contracting the pathogen leads to major illness. Pathogens residing in the body have fixed abodes; disease names are established based on the pathogen's location, divided into Upper, Middle, and Lower parts. Vertically, there are the Triple Burner (San Jiao); horizontally, there are Exterior, Interior, and Middle layers. Empty pathogens entering humans start at the skin. Lingering and not expelled, they gradually deepen, each stage having observable signs. If not treated according to the syndrome, the disease root becomes deep and stubborn. Initially, the pathogen's transmission is不定 (uncertain), shallow or deep, lingering to cause disease. Prolonged lingering leads to the formation of Jis (Accumulations), ceasing transmission as it binds with Qi and Blood to form stasis. Thus, the spreading of pathogens is incalculable.
The Yellow Emperor said: I wish to hear the reasons for their formation in full. Qibo said: For Jis formed by attachment to Sun Luo vessels, the accumulation moves up and down. Since the arms and hands are where Sun Luo vessels reside, and these vessels are superficial and lax, they cannot confine the accumulation, causing it to migrate between the intestines and stomach. Fluids gather and permeate, making a gurgling sound (Zhuo Zhuo). With cold, there is fullness, rumbling, and traction, causing sharp pain. For those attaching to the Yangming Meridian, the accumulation resides flanking the navel; it enlarges after eating and shrinks when hungry. For those attaching to Huan Jin, it resembles Yangming accumulations; it hurts after eating but is comfortable when hungry. For those attaching to the Mu Yuan of the intestines and stomach, pain radiates outward to the Huan Jin; it is comfortable after eating but hurts when hungry. For those attaching to the Fu Chong Mai, palpation reveals pulsation under the fingers; upon releasing pressure, heat flows down to the thighs, resembling hot water pouring. For those attaching to Lv Jin behind the intestines and stomach, the accumulation appears when hungry and disappears when full; it cannot be felt by pressing. For those attaching to Shu vessels, blockage prevents fluids from descending, causing dryness and obstruction of orifices. These describe pathogens entering from outside to inside, from top to bottom.
Fine collaterals floating in the skin are called Sun Luo vessels. Slightly deeper and thicker ones are called Da Luo vessels. Da Luo vessels connect internally to Jing meridians; Yang meridians connect to Fu organs, Yin meridians to Zang organs. Thus, Yin meridians are deeper than Yang meridians. Since meridians have Yin and Yang, collaterals also have Yin and Yang. Qi and Blood circulate internally and externally, reaching everywhere. When pathogens reside, Qi and Blood stagnate, eventually knotting into Jis. Accumulations in Sun Luo vessels move up and down because the arms and hands are their residence; their Qi is superficial and lax, unable to stop the accumulation, so it migrates to the intestines and stomach. The intestines and stomach are places where fluids pour and seep; pathogens gather from the side, causing gurgling sounds. If cold accumulation, fullness and rumbling occur, causing sharp pain due to collateral blockage and stagnant Qi. If attaching to the Stomach Meridian of Yangming, it resides flanking the navel because Qi gathers there. After eating, Stomach Qi overflows into the meridian, enlarging the mass; when hungry, Qi dissipates, shrinking it. The meridian lies in flesh without touching the stomach wall directly, lacking tangible obstruction, so no pain. Attaching to Huan Jin, which adheres to the stomach, resembles Yangming accumulation. Because it adheres to the stomach, fullness causes swelling and stimulation, leading to pain; hunger brings relief. Attaching to the Membrane Source (Mu Yuan) of the intestines and stomach, which shields turbid Qi in the stomach, hunger triggers deficient fire causing pain; fullness extinguishes fire, bringing relief. Pain connecting to Huan Jin occurs because Huan Jin is a branch of the Mu Yuan. Attaching to Fu Chong Mai, located in the back muscles where Ying Qi circulates, blockage by the accumulation causes pulsation on palpation. Releasing pressure disperses Qi flow, causing heat to rush down to the thighs like hot water. Accumulation on Lv Jin, behind the intestines and stomach, appears when the intestines/stomach are empty (hungry) and disappears when Qi fills them (full). Being deep in the body behind the viscera, it cannot be palpated. Accumulation on Shu vessels causes blockage, preventing fluid descent, leading to dryness in the bowels. These all describe the formation of Jis from external-to-internal and superior-to-inferior pathogen entry.