人之为病，顺与逆而已，顺者或可勿药，逆则所当急治者也。逆调论者，盖论调逆之法。凡六段。然人之
逆证，实不止于如此也。
黄帝问曰∶人身非常温也，非常热也，为之热而烦满者，何也？岐伯对曰∶阴气少而阳气胜故热而
烦满也。（按∶阴虚于内则阳浮于外，故热而烦满，阳之胜也，阴少故也。）
帝曰∶人身非衣寒也，中非有寒气也，寒从中生者何？岐伯曰∶是人多痹气也，阳气少，阴气多，故身
寒如从水中出。（按∶经络论曰∶“阳虚生外寒。”刺志论曰∶“气虚者，寒也。”阳者火也，阳虚则无火而
水独治，故一身内外皆寒也。痹者，顽木不仁之谓。盖气生于火，无火则气凝泣而痹矣。气痹身寒，似属阴多，
实则由于阳少之故也。）
帝曰∶人有四肢热，逢风寒，如炙于火者，何也？（按∶王本如炙如火，太素作如炙于火，义更通，从之。）
岐伯曰∶是人者，阴气虚，阳气盛，四肢者阳也，两阳相得而阴气虚少，少水不能灭盛火而阳独治，独治者不
能生长也，独胜而止耳。逢风而如炙于火者，是人当肉烁也。（按∶内阳已盛，又逢外热，故云两阳相得。相
得者，以火济火也。纯阳无阴，岂能生长。火愈盛则水益枯而肢体干槁，其肉必消烁也。）
帝曰∶人有身寒，汤火不能热，浓衣不能温，然不冻栗，是为何病？岐伯曰∶是人者，素肾气胜，以水为
事，太阳气衰，肾脂枯不长。……肾者水也，而生于骨，肾不生则髓不能满，故寒甚至骨也。所以不能冻栗者，
肝一阳也，心二阳也，肾孤脏也，一水不能胜二火，故不能冻栗，病曰骨痹，是人当挛节也。（按∶肾气素胜，
则恃其强而纵欲矣，故云以水为事。然恃而不已，则肾髓必且枯竭，以至寒彻于骨也。肝本属阴，然主木而能
生火，又与胆为表里，故亦云一阳。肝心二脏，在五脏之中为木火相资，故能以热胜寒也。挛节，注云∶“肾
不生则髓不满，髓不满则筋干缩，故节挛拘。”是也。）
帝曰∶人之肉苛者，虽近衣絮，犹尚苛也，是谓何
疾？（苛谓 重。）岐伯曰∶荣气虚，卫气实也。（按∶言肉之 重，由于荣血不足，故不知痛痒。然荣之所
以致虚者，由于卫气偏盛，阳盛阴虚而血少故也。）荣气虚则不仁，卫气虚则不用，荣卫俱虚，则不仁且不用，
肉如故也，人身与志不相有，曰死。（按∶此又因论荣虚而并及于卫虚，以明不用不仁之所以为病也。）
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。帝曰∶善！（寻经所解之旨，不得卧而息无音者，
有得卧行而喘，有不得卧不能行而喘，此三义悉阙未对，亦脱简也。按∶络脉在皮毛之内，经脉之外，尚属浮
浅，非如脏腑之深而重也，故邪虽客之而病微。息有音，如鼻塞气粗咳嗽吐痰之类，不过肺经感冒之轻者。）
人的疾病，无非是顺证与逆证两种。顺证或许可以不用药物治疗，逆证则是应当紧急治疗的。《逆调论》这篇，大概是论述调理逆乱之气的法则。全文共分为六段。然而，人体出现的逆证，实际上并不止于此。
黄帝问道：人的身体并不是因为外界气温高而发热，也不是因为外界气候热而发烫，却出现发热且心中烦闷胀满的症状，这是为什么呢？岐伯回答说：这是因为体内阴气不足而阳气偏盛，所以出现发热和烦闷胀满。（按语：阴虚于内则阳气浮越于外，所以发热且烦闷胀满，这是阳胜的表现，根本原因在于阴气少。）
黄帝说：人的身体并不是因为穿衣少受寒，体内也没有寒气侵入，却感觉寒气从体内产生，这是为什么呢？岐伯说：这种人往往多有痹气阻滞，阳气少而阴气多，所以身体寒冷，就像刚从水中出来一样。（按语：《经络论》说：“阳虚生外寒。”《刺志论》说：“气虚者，寒也。”阳对应火，阳虚则无火，导致水湿独盛，所以全身内外都感到寒冷。痹，是指肢体顽麻、不知痛痒的感觉。气生于火，没有火则气凝结滞涩而形成痹症。气痹身寒，看似阴气多，实则由于阳气少的缘故。）
黄帝说：有的人四肢发热，遇到风寒，感觉像被火烤一样，这是为什么呢？（按语：王冰注本写作“如炙如火”，《太素》写作“如炙于火”，意义更通顺，采用此说法。）岐伯说：这种人，阴气虚弱，阳气旺盛。四肢属于阳，两阳相合而阴气虚少，少量的水不能扑灭旺盛的火，导致阳气独亢。独亢的阳气不能正常生长化育，只是单纯的偏胜罢了。遇到风邪而感到像被火烤一样，这种人肌肉必然消瘦干枯。（按语：体内阳气已经旺盛，又遭遇外来的热邪，所以说两阳相合。所谓相合，是以火助火。纯阳而无阴，怎么能维持生长。火越盛则水越枯，肢体干槁，肌肉必然消烁。）
黄帝说：有的人身体寒冷，喝热水或靠近火源都不能使其温暖，穿厚衣服也不能使其暖和，但是却不发抖战栗，这是什么病？岐伯说：这种人，平时肾气偏胜，纵欲过度，导致太阳经气衰弱，肾精枯竭无法滋养骨骼。……肾属水，主骨生髓，肾气不生则骨髓不能充盈，所以寒冷直达骨髓。之所以不冻得发抖战栗，是因为肝为一阳，心为二阳，而肾为孤脏（仅有一水），一水不能胜过二火，所以不会冻得发抖战栗。这种病叫做骨痹，这种人关节必然拘挛。（按语：肾气原本偏胜，便倚仗其强盛而放纵欲望，所以说“以水为事”。然而倚仗而不节制，肾中精髓必然枯竭，以至于寒气彻骨。肝本属阴，但主木而生火，又与胆互为表里，所以也称一阳。肝心二脏，在五脏中属于木火相生，所以能以热能战胜寒邪。挛节，注释说：“肾不生则髓不满，髓不满则筋干缩，所以关节拘挛。”正是这个意思。）
黄帝说：有的人肌肉沉重麻木，即使靠近棉絮等保暖物品，仍然感觉沉重麻木，这叫什么病？（苛，意为沉重。）岐伯说：这是营气虚弱，卫气实盛。（按语：说肌肉沉重，是由于营血不足，所以不知痛痒。然而营气之所以致虚，是由于卫气偏盛，阳盛阴虚而血少所致。）营气虚弱则感觉迟钝麻木，卫气虚弱则肢体不能运动，如果营卫都虚弱，则既麻木又不能运动，肌肉依然如故，人身与意志不相联系，这就预示死亡。（按语：这里又因讨论营气虚而连带提到卫气虚，以说明肢体不用和感觉麻木的病理原因。）
黄帝说：有的人气逆不能平卧，呼吸时有声音；有的人不能平卧，呼吸时没有声音；有的人起居如常，但呼吸时有声音；有的人能躺下但不能行走，并且气喘；有的人不能躺下，也不能行走，并且气喘；有的人不能躺下，躺下就气喘。这些都是哪个脏腑出了问题？希望听听其中的道理。岐伯说：不能平卧且呼吸有声音的，是阳明经气逆乱。足三阳经的气本该下行，现在逆而上行，所以呼吸有声音。阳明经是胃脉，胃是六腑之海，其气也应当下行。阳明气逆，不能顺着其道而行，所以不能平卧。《下经》说：“胃不和则卧不安。”说的就是这种情况。至于起居如常但呼吸有声音的，这是肺的络脉气逆。络脉不能随着经脉上下运行，所以留滞在经脉中而不能正常运行，这是络脉病变，病情较轻，所以起居如常但呼吸有声音。至于不能平卧，躺下就气喘的，是水气客犯所致。水液是沿着津液流动的，肾是水脏，主管津液，所以涉及睡眠和气喘的问题。黄帝说：讲得好！（寻究经文解释的宗旨，关于“不得卧而息无音”、“有得卧行而喘”、“有不得卧不能行而喘”这三种情况，文中都没有回答，应该是简牍脱漏了。按语：络脉在皮毛之内，经脉之外，位置尚属浮浅，不像脏腑那样深重。所以邪气虽然侵犯它，但病情轻微。呼吸有声音，像鼻塞气粗、咳嗽吐痰之类，不过是肺经感冒的轻症。）
Human diseases are categorized merely as favorable (Shun) or unfavorable (Ni). Favorable conditions may sometimes require no medication, whereas unfavorable conditions demand urgent treatment. The *Treatise on Reversal and Regulation* discusses the methods for regulating reversal. It consists of six sections. However, the unfavorable conditions in humans actually extend beyond what is described here.
Huangdi asked: "The human body is not constantly warm, nor constantly hot, yet there are cases where heat arises accompanied by vexation and fullness. What is the cause?" Qibo replied: "This occurs because Yin Qi is deficient while Yang Qi is excessive, resulting in heat, vexation, and fullness." [Note: Internal Yin deficiency leads to external floating of Yang, causing heat and vexation/fullness due to Yang excess, which stems from insufficient Yin.]
Huangdi said: "The body is not cold due to lack of clothing, nor is there internal cold invasion, yet cold arises from within. Why?" Qibo said: "Such individuals often have Bi Qi (obstructive pathogenic factors) stagnation, with little Yang Qi and much Yin Qi, causing the body to feel cold as if emerging from water." [Note: The *Treatise on Meridians* states: 'Yang deficiency generates external cold.' The *Treatise on Acupuncture Techniques* states: 'Qi deficiency results in cold.' Yang corresponds to Fire; Yang deficiency means lack of Fire, allowing Water to dominate exclusively, leading to cold throughout the interior and exterior. 'Bi' refers to numbness and insensitivity. Qi originates from Fire; without Fire, Qi coagulates and stagnates, forming Bi. Although Bi and cold seem indicative of excess Yin, they are actually caused by Yang deficiency.]
Huangdi asked: "Some people experience heat in their four limbs that feels like being roasted by fire when exposed to wind and cold. What is the cause?" [Note: Wang Bing's commentary reads 'like roasting and like fire,' while *Tai Su* reads 'like being roasted by fire,' which is more coherent; this version is adopted.] Qibo said: "In such individuals, Yin Qi is deficient and Yang Qi is abundant. The four limbs belong to Yang; thus, two Yangs combine while Yin Qi becomes scarce. A small amount of water cannot extinguish a raging fire, leading to exclusive dominance of Yang. This exclusive dominance cannot sustain growth and life, representing only unchecked excess. When encountering wind, feeling like being roasted indicates that the muscles will eventually waste away." [Note: Internal Yang is already strong, and encountering external heat creates a combination of two Yangs. Combining fire with fire implies pure Yang without Yin, which cannot sustain growth. As Fire intensifies, Water dries up further, limbs become dry and shriveled, and muscles must emaciate.]
Huangdi asked: "Some people feel cold in their bodies; hot drinks and fires cannot warm them, and thick clothes cannot provide warmth, yet they do not shiver or tremble. What disease is this?" Qibo said: "Such individuals typically have an inherent excess of Kidney Qi and engage excessively in sexual activity ('water affairs'), leading to decline of Taiyang Qi and desiccation of Kidney essence/jelly, preventing nourishment of the bones... The Kidney belongs to Water and generates bone; if the Kidney does not generate, Marrow cannot fill the bones, so cold penetrates to the bone. The reason they do not shiver is that the Liver represents one Yang, the Heart represents two Yangs, while the Kidney is a solitary Zang organ (Water). One unit of Water cannot overcome two units of Fire, hence no shivering. This disease is called Bone Bi, and such individuals will likely suffer from joint contracture." [Note: Inherent Kidney excess leads to indulgence due to perceived strength, termed 'engaging in water affairs.' Unchecked indulgence causes Kidney Marrow to deplete, leading to bone-chilling cold. Although the Liver belongs to Yin, it governs Wood and generates Fire, and is externally-interiorly related to the Gallbladder, thus also referred to as one Yang. The Liver and Heart, governing Wood and Fire respectively, support each other among the Five Zang organs, allowing Heat to overcome Cold. Contracture of joints is explained as: 'If Kidney does not generate, Marrow is insufficient; insufficient Marrow leads to dry tendons, causing joint contracture.']
Huangdi asked: "Some people have heavy, numb flesh; even near cotton wadding, they still feel heavy and numb. What disease is this?" [Ke means heavy.] Qibo said: "This is due to deficient Ying Qi (Nutritive Qi) and solid/excess Wei Qi (Defensive Qi)." [Note: Muscle heaviness results from insufficient Ying Blood, leading to loss of pain/temperature sensation. Ying Qi becomes deficient due to Wei Qi excess; Yang excess and Yin deficiency lead to blood scarcity. Deficient Ying Qi causes numbness (Bu Ren); deficient Wei Qi causes immobility (Bu Yong). If both Ying and Wei are deficient, there is both numbness and immobility, muscles remain unchanged, the body disconnects from consciousness, indicating death.] [Note: This extends the discussion of Ying deficiency to include Wei deficiency to explain the pathology of immobility and numbness.]
Huangdi asked: "Some people have rebellious Qi, cannot lie down, and breathe with sound; some cannot lie down but breathe silently; some function normally but breathe with sound; some can lie down but wheeze when walking; some cannot lie down, cannot walk, and wheeze; some cannot lie down and wheeze immediately upon lying down. Which Zang organs cause these? I wish to hear the explanation." Qibo said: "Those who cannot lie down and breathe with sound have rebellious Yangming Qi. The Foot Three Yang meridians should descend; now they rebel and ascend, causing noisy breathing. Yangming is the Stomach meridian; the Stomach is the sea of the Six Fu organs, and its Qi should also descend. Yangming rebellion prevents following the proper pathway, causing inability to lie down. The *Classic of Lower Methods* says: 'When the Stomach is disharmonious, sleep is restless.' This refers to that case. Those who function normally but breathe with sound have rebellious collateral vessels of the Lung. Collaterals cannot follow the main meridians up and down, so they stagnate in the meridians. Disease in collaterals is minor, hence normal function despite noisy breathing. Those who cannot lie down and wheeze upon lying down are affected by Water Qi invasion. Water flows along fluids; the Kidney is the Water organ, governing fluids, and controls sleep and wheezing." Huangdi said: "Excellent!" [Investigating the intent of the classic explanations, the three cases of 'cannot lie down but silent breathing,' 'can lie down and wheeze when walking,' and 'cannot lie down, cannot walk, and wheeze' are missing answers, suggesting lost bamboo slips. Note: Collaterals are inside the skin/hair and outside the main meridians, relatively superficial, not deep/heavy like Zang-Fu. Thus, even if invaded by pathogens, the disease is mild. Noisy breathing, such as nasal congestion, coarse breathing, coughing, or expectoration, are merely mild lung colds.]