厥，逆也。人之营运一身者，气也。气顺则治，气逆则病。此篇所言，皆气逆行之为病，故云气厥也。气
之所以逆而为病者，由于寒热之所致，移寒移热者，盛极而逆行也。然同一寒热之为病，乃移寒者仅止
于五脏，而移热则遍及于六腑，何也？盖寒为水化，其性阴，其气静，故病止及于五脏。热为火化，其性阳，
其气动，故由脏而并及于腑也。
黄帝问曰∶五脏六腑，寒热相移者何？岐伯曰∶肾移寒于脾，痈肿少气。（按∶王本移寒于肝，详文义应
作移寒于脾。按全元起本云∶“肾移寒于脾。”注云∶“肾伤于寒而传于脾，脾主肉，寒生于肉则结为坚，坚
化为脓，故为痈也。血伤气少，故曰少气。”甲乙亦作移寒于脾。王本作移寒于肝，或传写误也。今改正。）
脾移寒于肝，痈肿筋挛。（脾脏主肉，肝脏主筋，肉温则筋舒，肉冷则筋急，故筋挛也。按∶脾寒则气滞，肝
寒则血凝，气血凝滞，则结为痈肿。注言肉冷，辞不达意。）肝移寒于心，狂隔中。（按∶木火内盛则病狂，
狂者热病，寒亦何以致狂也？六元正纪大论曰∶“木郁达之，火郁发之。”木火之性，喜发达而恶抑郁。肝受
寒而传于心，木火之气，郁而不能遂其发达之性，于是神明乱而为狂矣。是其狂也，实由于火气闭隔于中而然
也。）心移寒于肺，肺消。肺消者，饮一溲二，死不治。（按∶消者，火盛烁水，亦热病也。心受寒气，何能
消肺？盖心者火也，克金者也；肺者金也，畏火者也。火性得热则外散，得寒则内闭。心既受寒，火为寒抑，
外为寒包，内实藏火，移而之肺，火气内攻，金不胜刑，故消散而令溲倍于饮也。饮少溲多，精气竭矣，谁能
治之。）肺移寒于肾，为涌水。涌水者，按腹不坚，水气客于大肠，疾行则鸣濯濯，如囊裹浆，水之病也。
（按∶气者水之母，肺主诸气，降下之令操焉。是故气利则水行，气闭则水滞。然气之或利或闭者，热则利，
寒则闭。今肺寒而移于肾，是气闭而不下达，故水涌溢于大肠，而令濯濯有声也。大肠者肺之合，气闭水逆，
肺病以从其合也。）
脾移热于肝，则为惊衄。（肝藏血，又主惊，故热薄之，则惊而鼻中出血。）肝移热于心，则死。（按∶心
本火脏，更受木燔，以火益火，阳而亢矣，焉得不死。王注误引强解，冒昧极矣。）心移
热于肺，传为膈消。（按∶心火刑金，金不胜热，故致消渴。膈者，上膈也。火上冲肺，病止膈上，所以别于
中下，上消是也。）肺移热于肾，传为柔 。（按∶柔 解，注不明确。窃意 者，筋脉抽掣，木之病也。木
养于水，今肾受肺热，水枯不能养筋，故令搐搦不已。但比刚痉少缓，故曰柔也。 音翅。）肾移热于脾，传
为虚，肠 ，死不可治。（脾土制水，肾反移热以与之，是脾土不能制水而受病，故久久传为虚损也。肠 死
者，肾主下焦，象水而冷，今乃移热，是精气内消，下焦无主以守持，故肠 除而气不禁止。按∶肠 ，痢疾
也。痢之为病，似止属脾，而不知其为受肾传热之所致。欲去肾热，必用滋阴。世之治痢，止于治脾者非也。）
胞移热于膀胱，则癃，溺血。（按∶膀胱者，水道也。胞者，盛溺之所，俗名尿胞是也。胞与膀胱，相连而近，
亦言移者，沿前文也。二者皆热，水为火灼，故小便闭而溺血也。）膀胱移热于小肠，膈肠不便，上为口糜。
（糜谓烂也。按∶小肠受化物，膀胱藏津液，膀胱居小肠之下。今受热而移于小肠，则反自下而上矣。火性炎
上，胸膈肠胃俱为之不便，而口且糜烂。不便，不安也。）小肠移热于大肠，为 瘕，为沉。（按∶小肠者，心
之腑，丙火也。大肠者，肺之腑，庚金也。小肠属火而更受他热，移入大肠，火气凌金，金不能胜，其气伏匿
而成瘕。瘕者，假也，气所聚也。其病如是，其脉则沉，金畏火刑，如盛夏之时，庚伏是也。注以瘕为血溢，
以沉为月闭，不辨金火之义，误矣。 与伏同。）大肠移热于胃，善食而瘦人，谓之食亦。（食亦者，食移易
而过，不生肌肤也。亦，易也。按∶胃主受纳，大肠主变化，饮食二者，是其职也。二腑既热，阳明火炽，内
消水谷，外铄肌肉，故食虽多，而人愈瘦。食亦之解，诚如注云。瘦人王本作瘦入，义既难通；甲乙经入作又，
读连下文，上无所谓，何得言又，理亦不合。余谓入者人字之讹，读作瘦人，较通。今厘正之。）胃移热于胆，
亦曰食亦。（按∶胆者肝之腑，阳木也。木本有火，更受胃热，木火相燔，故其为病，如同二阳，故亦
曰食亦也。）胆移热于脑，则辛 鼻渊。鼻渊者浊涕下不止也，传为衄蔑，瞑目。（脑液下渗，则为浊涕，
涕下不止，如彼水泉，故曰鼻渊也。 ，鼻额也。热盛则阳络溢，阳络溢则衄出汗血。 ，汗血也。血出甚，
阳明太阳脉衰，不能荣养于目，故目瞑。瞑，暗也。按∶胆属木而生火，复受多火，移入于脑，木火上冲，故
病皆在上。辛者辣也，火之气也。注作酸痛，误矣。传者，以次而及之谓，言先鼻渊而后衄 瞑目也。 音遏，
鼻梁也。）
故得之气厥也。（厥者，气逆也，皆由气逆而得之。按∶此总结上文之旨也。注意是矣，然逆之为解，虽
自下而上之称，亦不正而乱之意。盖气顺则治，逆则乱，移寒移热，实气逆乱而然也。）
厥，就是逆乱。人体运行周身的是气。气机顺调则健康，气机逆乱则生病。本篇所论述的，都是气机逆行导致的疾病，所以称为“气厥”。气之所以逆乱而致病，是由于寒邪或热邪的影响；寒热之邪相互转移，是因为邪气盛极而逆行所致。然而同样是寒热致病，寒邪转移仅局限于五脏，而热邪转移却遍及六腑，为什么呢？大概因为寒属于水化生，其性质属阴，其气机沉静，所以病变只波及五脏。热属于火化生，其性质属阳，其气机躁动，所以病由脏传及于腑。
黄帝问道：五脏六腑之间，寒热邪气相互转移是怎么回事？岐伯回答：肾将寒邪转移给脾，会导致痈肿、少气。（按语：王冰注本写作“移寒于肝”，根据文义分析应作“移寒于脾”。全元起本记载：“肾移寒于脾。”注释说：“肾受寒邪而传于脾，脾主肌肉，寒邪生于肌肉则凝结成坚硬，坚硬化为脓液，所以形成痈肿。血液受损、气虚，所以称为少气。”《甲乙经》也作“移寒于脾”。王本作“移寒于肝”，可能是传抄错误。现予以改正。）脾将寒邪转移给肝，会导致痈肿、筋脉拘挛。（脾脏主肌肉，肝脏主筋，肌肉温暖则筋脉舒展，肌肉寒冷则筋脉紧急，所以出现筋脉拘挛。按语：脾寒则气机阻滞，肝寒则血液凝滞，气血凝滞，就会结聚成痈肿。注释中说“肉冷”，词不达意。）肝将寒邪转移给心，会导致发狂、胸膈痞闷。（按语：木火内盛会引发狂症，狂症属于热病，寒邪怎么能导致发狂呢？《素问·六元正纪大论》说：“木郁达之，火郁发之。”木和火的特性，喜欢发散通达而厌恶抑郁。肝受寒邪传于心，木火之气被郁遏而不能发挥其发散通达的特性，于是神明紊乱而发狂。这所谓的“狂”，实际上是由于火气闭隔在体内所致。）心将寒邪转移给肺，会导致肺消。所谓肺消，是指喝一份水排两份尿，属于死证，无法治疗。（按语：“消”是指火盛灼烧津液，也是热病。心脏受寒气，怎么能消烁肺金呢？盖因心属火，是克制肺金的；肺属金，畏惧火克。火性遇热则向外散发，遇寒则向内闭藏。心脏既受寒邪，火被寒邪抑制，外为寒邪包裹，内里实藏火气，火热内攻于肺，肺金不能承受刑克，所以消散而导致小便量多于饮水量。饮水少而排尿多，精气枯竭，谁能治愈呢？）肺将寒邪转移给肾，会导致涌水。所谓涌水，是按腹部不坚硬，水气客居在大肠，快速行走时腹部鸣响濯濯有声，像囊袋裹着浆液一样，这是水病的表现。（按语：气是水之母，肺主管全身之气，气的降下功能由肺掌握。因此气行通畅则水行，气机闭塞则水停滞。然而气机的通畅或闭塞，受热则通畅，受寒则闭塞。现在肺受寒邪并转移至肾，这是气机闭塞而不能下达，所以水气涌溢于大肠，发出濯濯声响。大肠是肺的相合之腑，气闭水逆，肺病通过其相合之腑表现出来。）
脾将热邪转移给肝，会导致惊悸、鼻出血。（肝藏血，又主惊骇，所以热邪迫近肝，就会导致惊悸和鼻出血。）肝将热邪转移给心，会导致死亡。（按语：心本是火脏，再受到肝木燔灼的热邪，是以火助火，阳气亢盛至极，怎么能不死。王冰的注释错误地引用并强行解释，非常冒昧荒谬。）心将热邪转移给肺，传变为膈消。（按语：心火刑克肺金，肺金不能耐受热邪，所以导致消渴。膈指上膈。火气上冲于肺，病位仅在膈上，以此区别于中焦和下焦，这就是上消。）肺将热邪转移给肾，传变为柔痉。（按语：对“柔痉”的解释，注释不明确。我推测“痉”是指筋脉抽掣，这是木的病态。木依赖水滋养，现在肾受肺热，肾水枯涸不能滋养筋脉，所以导致抽搐不止。但比刚痉症状稍缓，所以称为“柔”。痉音翅。）肾将热邪转移给脾，传变为虚损、肠澼，属于死证不可治。（脾土本应制约水湿，肾反而将热邪转移给它，导致脾土不能制水而受病，久而久之传变为虚损。肠澼致死的原因在于：肾主下焦，象水而性冷，现在反而移入热邪，这是精气在内消亡，下焦失去主宰而无法固摄，所以肠澼发作而气机无法禁止。按语：肠澼即痢疾。痢疾这种病，看似只属于脾，却不知道它是由于接受肾转移来的热邪所致。想要去除肾热，必须使用滋阴之法。世间治疗痢疾，只从治脾入手是错误的。）胞（子宫/精室）将热邪转移给膀胱，会导致癃闭、尿血。（按语：膀胱是水液排泄的通道。胞是储存尿液的地方，俗称尿胞。胞与膀胱相连且位置相近，这里说“移”，是沿袭前文的说法。两者都受热邪，水液被火邪灼烧，所以小便闭塞且尿血。）膀胱将热邪转移给小肠，会导致胸膈肠胃不适、大便不通，向上发展为口舌糜烂。（糜指腐烂。按语：小肠负责受纳化物，膀胱储藏津液，膀胱位于小肠之下。现在受热邪并转移至小肠，则病势反自下而上。火性炎上，导致胸膈肠胃都不适，并且口舌糜烂。“不便”指不安宁、不通畅。）小肠将热邪转移给大肠，会导致瘕积、脉沉。（按语：小肠是心的腑，属丙火。大肠是肺的腑，属庚金。小肠属火而又接受其他热邪，移入大肠，火气凌犯肺金，肺金不能胜任，气机伏匿而成瘕积。瘕，意为假，是气聚集的地方。病情如此，脉象则沉，金畏惧火刑，如同盛夏之时庚金伏藏一样。注释将瘕解释为血溢，将沉解释为月经闭止，不分辨金火之义，是错误的。瘕与伏同义。）大肠将热邪转移给胃，表现为食欲旺盛但身体消瘦，称为食亦。（食亦的意思是，食物虽然吃下去却像经过一样，不能转化为肌肤营养。亦，通易。按语：胃主受纳，大肠主变化，饮食消化是它们的职责。两腑都有热邪，阳明火炽盛，内部消烁水谷，外部烤灼肌肉，所以吃得虽多，人却越来越瘦。关于食亦的解释，确实如注释所说。王本将“瘦人”写作“瘦入”，意义难通；《甲乙经》将“入”写作“又”，读起来连接下文，上文没有对应，为何说“又”，道理也不合。我认为“入”是“人”字的讹误，读作“瘦人”更通顺。现予以厘正。）胃将热邪转移给胆，也称为食亦。（按语：胆是肝的腑，属阳木。木本含有火性，再接受胃的热邪，木火相互燔灼，所以其病症，如同两阳合病，因此也称为食亦。）胆将热邪转移给脑，会导致鼻辛、鼻渊。鼻渊是指浊涕不断流出，进而传变为衄蔑、瞑目。（脑液下渗，就成为浊涕，涕下不止，像泉水一样，所以叫鼻渊。辛，指鼻梁。热盛则阳络溢出，阳络溢出则发生衄血、汗血。瞑目，指眼睛闭合或失明。血出过多，阳明太阳经脉衰败，不能荣养眼睛，所以眼睛闭合或视物昏暗。瞑，指昏暗。按语：胆属木而生火，又受到多火之邪，移入于脑，木火上冲，所以病症都在上部。辛是辣的意思，是火的气味。注释解释为酸痛，是错误的。传，指依次波及，意思是先发生鼻渊，然后发生衄血、瞑目。音遏，指鼻梁。）
这些都是由于气厥导致的。（厥，就是气逆，都是由气逆而产生的。按语：这是对上文主旨的总结。注释的理解是正确的，然而对于“逆”的解释，虽然是从下到上的称呼，也有不正、混乱的意思。气顺则治理有序，气逆则混乱，寒热邪气的相互转移，实际上是气机逆乱所致。）
Jue (Reversal) refers to reversal. The qi that circulates throughout the human body is vital energy. When qi is smooth, health is maintained; when qi is reversed, disease occurs. This chapter discusses diseases caused by the reversal of qi, hence it is called "Qi Jue" (Vital Energy Reversal). The reason why qi becomes reversed and causes disease is due to the influence of cold or heat pathogens. The transfer of cold and heat occurs because the pathogens become excessive and reverse their flow. However, although both cold and heat cause disease, the transfer of cold is limited only to the Five Zang Organs, whereas the transfer of heat extends to all Six Fu Organs. Why is this? Generally, cold originates from water transformation; its nature is Yin, and its movement is quiet, so the pathology remains confined to the Five Zang Organs. Heat originates from fire transformation; its nature is Yang, and its movement is active, so the pathology spreads from the Zang to the Fu Organs.
The Yellow Emperor asked: What is the mechanism behind the mutual transfer of cold and heat between the Five Zang and Six Fu Organs? Qibo replied: When Kidney transfers cold to Spleen, it results in carbuncles/swellings and shortness of breath. (Note: Wang Bing's edition writes "transfers cold to Liver," but based on textual context, it should be "transfers cold to Spleen." Quan Yuanqi's edition states: "Kidney transfers cold to Spleen." The annotation explains: "When Kidney is injured by cold and transmits it to Spleen, since Spleen governs flesh, cold generated in the flesh condenses into hardness, which turns into pus, thus forming a carbuncle. Blood is damaged and Qi is deficient, hence 'shortness of breath.' " The *Jia Yi Jing* also records "transfers cold to Spleen." Wang's version writing "Liver" is likely a copying error. It has been corrected here.) When Spleen transfers cold to Liver, it results in carbuncles/swellings and tendon spasms. (Spleen governs flesh, Liver governs tendons. Warm flesh allows tendons to relax; cold flesh causes tendons to tighten, leading to spasms. Note: Spleen cold causes Qi stagnation, Liver cold causes blood coagulation. Stagnant Qi and congealed blood form carbuncles/swellings. The annotation mentioning "cold flesh" fails to convey the meaning accurately.) When Liver transfers cold to Heart, it results in mania and chest obstruction. (Note: Excessive internal Wood and Fire lead to mania. Mania is a heat condition; how can cold cause mania? The *Su Wen · Liu Yuan Zheng Ji Da Lun* states: "For Wood depression, promote its spread; for Fire depression, vent it." The nature of Wood and Fire prefers expansion and detests depression. When Liver receives cold and transmits it to Heart, the Wood and Fire Qi are depressed and cannot expand freely, causing the Spirit to become chaotic and resulting in mania. Thus, this "mania" is actually caused by Fire Qi being blocked internally.) When Heart transfers cold to Lung, it results in Lung Xiao (Wasting-Thirst of the Lung). Lung Xiao is characterized by drinking one part fluid and urinating two parts; it is a fatal condition and untreatable. (Note: "Xiao" refers to Fire excess scorching Water, which is also a heat disease. How can Heart receiving Cold damage Lung Metal? Heart belongs to Fire and controls Lung Metal; Lung belongs to Metal and fears Fire control. Fire nature disperses outward when hot but closes inward when cold. Having received cold, the Fire in Heart is suppressed by cold, wrapped externally by cold while harboring Fire internally. This Fire attacks the Lung internally. Lung Metal cannot withstand the penalty, leading to dissipation and urine volume exceeding intake. With little intake and excessive output, Essence and Qi are exhausted; who can cure it?) When Lung transfers cold to Kidney, it results in Yong Shui (Surging Water). Yong Shui is characterized by a non-tender abdomen when pressed. Water Qi resides in the Large Intestine, making a gurgling sound when moving quickly, like a bag wrapping paste; this is a water disease. (Note: Qi is the mother of Water. Lung governs all Qi and controls the descending function. Therefore, smooth Qi leads to flowing Water, while closed Qi leads to stagnant Water. Qi flows when hot and closes when cold. Now, Lung cold transfers to Kidney, meaning Qi is closed and cannot descend, causing Water to surge into the Large Intestine and produce gurgling sounds. Large Intestine is the interior-exterior pair of Lung; Qi closure and Water reversal manifest as Lung disease through its paired organ.)
When Spleen transfers heat to Liver, it results in fright and epistaxis. (Liver stores Blood and governs fright. When heat approaches, it causes fright and bleeding from the nose.) When Liver transfers heat to Heart, death ensues. (Note: Heart is inherently a Fire organ. Receiving burning heat from Wood makes it Fire adding to Fire, leading to extreme Yang hyperactivity. How can one not die? Wang Bing's annotation incorrectly cites and forces an explanation, which is extremely presumptuous and erroneous.) When Heart transfers heat to Lung, it transmits to Ge Xiao (Diaphragm Wasting-Thirst). (Note: Heart Fire penalizes Lung Metal. Since Metal cannot withstand heat, Wasting-Thirst results. "Ge" refers to the upper diaphragm. Fire Qi rushes up to the Lung, and the pathology stays above the diaphragm, distinguishing it from middle and lower levels; this is Upper Xiao.) When Lung transfers heat to Kidney, it transmits to Rou Jing (Soft Spasm). (Note: The annotation for "Rou Jing" is unclear. I speculate that "Jing" refers to muscle twitching/spasms, a disorder of Wood. Wood is nourished by Water. Now Kidney receives Lung heat, causing Water depletion and inability to nourish tendons, leading to continuous convulsions. Compared to Gang Jing (Stiff Spasm), it is milder, hence called "Rou" (Soft). Jing sounds like 'chi'.) When Kidney transfers heat to Spleen, it transmits to Xu Sun (Deficiency Damage) and Chang Pi (Intestinal Dysentery), which is fatal and untreatable. (Spleen Earth normally controls Water. If Kidney transfers heat to it, Spleen Earth fails to control Water and becomes diseased, eventually transmitting to deficiency. The reason Chang Pi leads to death is: Kidney governs the Lower Jiao, resembles Water, and is cold. Transferring heat means Essence and Qi are consumed internally, and the Lower Jiao loses its master to guard and hold, causing Chang Pi to occur with uncontrolled Qi. Note: Chang Pi is dysentery. Although dysentery seems related only to Spleen, it is actually caused by receiving transferred heat from Kidney. To remove Kidney heat, Yin-nourishing methods must be used. Treating dysentery solely by addressing Spleen, as done in the world today, is incorrect.) When Bao (Uterus/Essence Chamber) transfers heat to Bladder, it results in Long Bi (Dysuria) and hematuria. (Note: Bladder is the pathway for water metabolism. Bao is where urine is stored, commonly known as the urinary bladder. Bao and Bladder are connected and close. Saying "transfer" follows the previous text. Both are heated; water is scorched by fire, causing urinary retention and hematuria.) When Bladder transfers heat to Small Intestine, it results in obstruction of the diaphragm and intestines, difficulty in defecation, and upward progression to oral ulcers. (Mi means rotting. Note: Small Intestine receives and transforms substances; Bladder stores fluids. Bladder is below Small Intestine. Now receiving heat and transferring to Small Intestine, the pathogen moves upward from below. Fire nature flares upward, causing discomfort in the chest, diaphragm, and intestines, and oral ulcers. "Bu Bian" means unrest/obstruction.) When Small Intestine transfers heat to Large Intestine, it results in Jia Masses and deep pulse. (Note: Small Intestine is the Fu organ of Heart, belonging to Bing Fire. Large Intestine is the Fu organ of Lung, belonging to Geng Metal. Small Intestine belongs to Fire and receives other heat, transferring to Large Intestine. Fire Qi harasses Metal. Metal cannot overcome it, so Qi hides and forms Jia masses. Jia means false; it is the gathering of Qi. In such cases, the pulse is deep. Metal fears Fire penalty, similar to Geng Metal hiding in midsummer. The annotation interpreting Jia as blood overflow and Shen as amenorrhea ignores the meaning of Metal and Fire and is erroneous. Jia is synonymous with Fu.) When Large Intestine transfers heat to Stomach, it manifests as polyphagia with emaciation, called Shi Yi. (Shi Yi means food passes through without nourishing the body. Yi means change. Note: Stomach governs reception; Large Intestine governs transformation. Digestion is their duty. With heat in both Fu organs, Yangming Fire blazes, consuming grain internally and scorching muscles externally. Thus, despite eating much, the person becomes thinner. The interpretation of Shi Yi aligns with the annotation. Wang's edition writes "Shou Ru" instead of "Shou Ren," which is hard to understand. *Jia Yi Jing* writes "Ru" as "You," connecting to the next sentence, which lacks context and logic. I believe "Ru" is a typo for "Ren." Reading it as "Shou Ren" (emaciated person) is smoother. It has been corrected here.) When Stomach transfers heat to Gallbladder, it is also called Shi Yi. (Note: Gallbladder is the Fu organ of Liver, belonging to Yang Wood. Wood inherently contains Fire. Receiving Stomach heat, Wood and Fire burn each other. Thus, the disease is similar to the combination of Two Yangs, hence also called Shi Yi.) When Gallbladder transfers heat to Brain, it results in Xin Bi (Nasal Pain) and Bi Yuan (Nasal Sinusitis). Bi Yuan is characterized by continuous discharge of turbid nasal mucus, which may transmit to Nu Mie (Epistaxis/Hemorrhage) and Ming Mu (Blindness/Closed Eyes). (Brain fluid seeps down to become turbid mucus. Continuous discharge like a spring is called Bi Yuan. Xin refers to the nose and forehead. Heat excess causes Yang collaterals to overflow, leading to epistaxis and sweat-blood. Ming Mu refers to closing eyes/blindness. Severe blood loss weakens Yangming and Taiyang meridians, failing to nourish the eyes, causing them to close or vision to dim. Ming means dark. Note: Gallbladder belongs to Wood and generates Fire. Receiving multiple Fire pathogens and transferring to Brain, Wood-Fire Qi rushes upward, so symptoms are in the upper body. Xin means pungent/spicy, the quality of Fire. Annotation interpreting it as soreness/pain is wrong. Chuan means sequential involvement, implying Bi Yuan precedes epistaxis and blindness. E sounds like 'he', referring to the nasal bridge.)
These conditions all arise from Qi Jue. (Jue means Qi reversal; all result from Qi reversing. Note: This summarizes the main point of the preceding text. The annotation is correct. However, the explanation of "reversal" implies not only upward movement but also disorder and chaos. Smooth Qi brings order; reversed Qi brings chaos. The transfer of cold and heat is indeed due to Qi reversal and disorder.)