平按∶此篇见《素问》卷十一第三十九《举痛论》篇，又见《甲乙经》卷一第一。
黄帝曰∶余闻百病生于气也，怒则气上，喜则气缓，悲则气消，恐则气下，寒则气收聚，炅则
腠理开气泄，忧则气乱，劳则气耗，思则气结，九气不同，何病之生？（炅音桂，热也。人之生病，
莫不内因怒喜思忧恐等五志，外因阴阳寒暑，以发于气而生百病。所以善摄生者，内除喜怒，外避
寒暑，故无道夭，遂得长生久视者也。若纵志放情，怒以气上伤魂，魂伤肝伤也。若喜气缓伤神，
神伤心伤也。若忧悲气消亦伤于魂，魂伤肝伤也。恐以气下则伤志，志伤肾伤也。若多寒则气收聚，
内伤于肺也。若多热腠理开泄，内伤于心也。忧则气乱伤魄，魄伤则肺伤也。若多劳气耗，则伤于
肾。思以气结伤意，意伤则脾伤也。五脏既伤，各至不胜时则致死也，皆由九邪生于九气，所生之
病也。平按∶《素问》余闻作余知，气收下无聚字，气泄上无腠理开三字，忧作惊。新校正云∶按
《太素》惊作忧。与此正合。又注伤魄魄伤二魄字，原抄作魂，原校作魄。按经文云∶肺藏气，气舍
魄。又云∶肺在志为忧。作伤魄亦合。）岐伯曰∶怒则气逆，甚则欧血及食而气逆上也。（因引气
而上，故气逆。怒甚气逆，则致欧血及食气逆上也。平按∶食而气逆《素问》作飧泄。按新校正云∶
按《甲乙经》、《太素》作食而气逆。与此正合。）喜则气和志达，营卫行通利，故气缓焉。（喜则
气和志达，营卫行利，故气缓为病也。平按∶通上《素问》《甲乙经》均无行字。）悲则心系急，
肺布叶举，两焦不通，营卫不散，热气在中，故
气消。（肝脉上入颃颡，连目系；支者，从肝别贯膈，上注肺。肺以主悲，中上两焦在于心肺，悲
气聚于肺，叶举心系急，营卫之气在心肺，聚而不散，神归不移，所以热而气消虚也。平按∶《素问》
两焦不通作而上焦不通。新校正云∶按《甲乙经》、《太素》作两焦不通。与此正合。又王注释布
叶谓布盖之大叶，新校正疑非是，复引全元起云∶悲则损于心，心系急则动于肺，肺气系诸经，逆
故肺布而叶举。安得谓肺布为肺布盖之大叶。据此，则全注与本注意合。）恐则精却，却则上焦闭，
闭则气还，还则下焦胀，故气不行。（虽命门藏精，通名为肾，脉起肾，上贯肝膈，入肺中；支者，
从肺络心，注胸中。故人惊恐，其精却缩。上焦起胃口上，上焦既闭不通，则气不得上，还于下焦，
下焦胀满，气不得行。平按∶精却《甲乙经》作神却。又《素问》新校正云∶气不行当作气下行。玩
本注，仍当作气不行。）热则腠理开，营卫通，故汗大泄。（气不得行，或因热而腠理开，营卫外
通，汗大泄也。平按∶《素问》、《甲乙经》热作炅。《素问》故汗大泄作汗大泄故气泄。）寒则腠
理闭，气不行，故气收聚。（因营卫不通，遇寒则腠理闭塞，则气聚为病也。平按∶寒则腠理闭，
《甲乙经》无此三句，《素问》在炅则腠理开三句之前。聚《素问》作矣。）忧则心无所寄，神无
所归，虑无所定，故气乱。（心，神之用。人之忧也，忘于众事，虽有心情，无所任物，故曰无所寄。
气营之处，神必归之，今既忧繁，气聚不行，故神无归也。虑，亦神用也，所以忧也不能逆虑于事，
以气无主守，故气乱也。平按∶《素问》、《甲乙经》忧均作惊。新校正云∶《太素》惊作忧。寄
《素问》、《甲乙经》均作倚。注心情别本作心精。）劳则喘喝汗出，内外皆越，故气耗。（人之
用力劳乏，则气并喘喝，皮腠及五内腑皆汗，以汗即是气，故汗出内外气衰耗也。平按∶喘喝顾本
《素问》作喘息，赵府本
作喘且，《甲乙》同。内外《素问》作外内。）思则身心有所存，神有所止，气留而不行，故气结矣。
（专思一事，则心气驻一物。所以神务一物之中，心神引气而聚，故结而为病也。平按∶身《素问》、
《甲乙经》均无。《甲乙经》存作伤。《素问》止作归正，新校正云∶按《甲乙经》归正二字作止字。
气留《甲乙经》作气流。）
平按：此篇见于《素问》卷十一第三十九《举痛论》篇，又见于《甲乙经》卷一第一。
黄帝说：我听说各种疾病都产生于气的异常，发怒则气机上逆，喜悦则气机舒缓，悲伤则气机消减，恐惧则气机下陷，寒冷则气机收敛聚结，炎热则腠理（皮肤毛孔）开张而气机外泄，忧愁则气机紊乱，劳倦则气机耗损，思虑则气机郁结。这九种气机变化各不相同，它们分别会导致什么样的疾病呢？（炅音同“桂”，意为热。人之所以生病，无不内因怒、喜、思、忧、恐等五志失调，外因阴阳寒暑侵袭，从而引发气机病变而产生百病。所以善于养生的人，内心消除喜怒情绪，外部避开寒暑邪气，因此不会遭遇非正常死亡，得以长寿。如果放纵情志，愤怒导致气机上逆损伤魂，魂伤则肝受损；喜悦导致气机舒缓损伤神，神伤则心受损；忧愁悲伤导致气机消减也损伤魂，魂伤则肝受损；恐惧导致气机下陷损伤志，志伤则肾受损；若受寒过多则气机收敛聚结，内部损伤肺脏；若受热过多则腠理开泄，内部损伤心脏；忧愁导致气机紊乱损伤魄，魄伤则肺脏受损；若过度劳累导致气机耗损，则损伤肾脏；思虑导致气机郁结损伤意，意伤则脾脏受损。五脏既然受损，到了各自不胜任的时令就会致死，这都是由九种邪气生于九种气机变化所导致的疾病。（平按：《素问》中“余闻”作“余知”，“气收”下无“聚”字，“气泄”上无“腠理开”三字，“忧”作“惊”。新校正云：按《太素》“惊”作“忧”。这与本文正相符合。另外注释中“伤魄”、“魄伤”两个“魄”字，原抄本写作“魂”，原校注改为“魄”。按经文说：“肺藏气，气舍魄。”又说：“肺在志为忧。”写作“伤魄”也是合理的。）
岐伯说：发怒则气机上逆，严重时会出现呕血以及进食后气逆向上。（因为引动气机向上，所以气机逆乱。愤怒严重导致气机逆乱，就会导致呕血及饮食之气逆向上冲。（平按：“食而气逆”在《素问》中作“飧泄”。按新校正云：按《甲乙经》、《太素》作“食而气逆”。这与本文正相符合。）
喜悦则气和顺、意志通达，营卫之气运行通畅流利，所以气机舒缓。（喜悦使气和顺意志通达，营卫运行流利，所以气缓成为病症。（平按：“通”字上，《素问》、《甲乙经》均无“行”字。）
悲伤则心脉拘急，肺叶扩张上举，上焦与中焦不通畅，营卫之气不能布散，热气郁结在中焦，所以气机消减。（肝脉上行进入颃颡，连接目系；分支从肝脏别出贯穿膈肌，向上注入肺中。肺主司悲伤，上焦和中焦位于心和肺之间，悲伤之气聚积于肺，导致肺叶上举、心脉拘急，营卫之气在心肺聚集而不能散开，神气回归而不移动，所以产生热象而气虚消减。（平按：《素问》中“两焦不通”作“而上焦不通”。新校正云：按《甲乙经》、《太素》作“两焦不通”。这与本文正相符合。另外王注解释“布叶”为像盖子一样大的叶子，新校正怀疑不是这个意思，又引用全元起的说法：悲伤损伤于心，心脉拘急则触动肺，肺气联系诸经，气机逆乱所以肺叶扩张而上举。怎么能说肺布是指肺像盖子一样的大叶子呢？根据这些，全元起注与本文注疏的意思相合。）
恐惧则精气退缩，精气退缩则上焦闭塞，上焦闭塞则气机返还，气机返还则下焦胀满，所以气机运行不畅。（虽然命门藏精，统称为肾，经脉起于肾，向上贯穿肝膈，进入肺中；分支从肺联络心脏，注入胸中。人受到惊恐时，精气退缩。上焦起于胃口之上，上焦既然闭塞不通，则气机不得上行，返还于下焦，导致下焦胀满，气机不得运行。（平按：“精却”在《甲乙经》中作“神却”。另外《素问》新校正云：“气不行”应当作“气下行”。玩味本文注疏，仍然应当作“气不行”。）
炎热则腠理开张，营卫之气通行，所以大汗淋漓。（气机不得运行，或者因为炎热导致腠理开张，营卫之气向外通畅，导致大汗淋漓。（平按：《素问》、《甲乙经》中“热”作“炅”。《素问》中“故汗大泄”作“汗大泄故气泄”。）
寒冷则腠理闭塞，气机运行不畅，所以气机收敛聚结。（因为营卫之气不通畅，遇到寒冷则腠理闭塞，导致气机聚结成为病症。（平按：“寒则腠理闭”三句，《甲乙经》没有，《素问》放在“炅则腠理开”三句之前。“聚”字在《素问》中作“矣”。）
忧愁则心神无所寄托，神气无所归依，思虑无法安定，所以气机紊乱。（心是神的作用表现。人的忧愁，忘记众多事务，虽然有心情，却无法处理事物，所以说无所寄托。气是营卫所在之处，神气必然归依于此，现在既然忧愁繁杂，气机聚集而不能运行，所以神气无归依。虑，也是神的作用，所以忧愁不能逆向应对事务，因为气没有主宰守护，所以气机紊乱。（平按：《素问》、《甲乙经》中“忧”均作“惊”。新校正云：《太素》中“惊”作“忧”。“寄”字在《素问》、《甲乙经》中均作“倚”。注疏中“心情”其他版本作“心精”。）
劳倦则喘息粗重、出汗，内外之气皆外越，所以气机耗损。（人用力劳动疲劳，则气机并集导致喘息粗重，皮肤腠理及五脏六腑都出汗，因为汗即是气，所以出汗导致内外气机衰耗。（平按：“喘喝”顾校本《素问》作“喘息”，赵府本作“喘且”，《甲乙经》相同。“内外”在《素问》中作“外内”。）
思虑则身心有所专注，神气有所止息，气机停留而不能运行，所以气机郁结。（专门思考一件事，则心气驻留在一物上。所以神务专注于这一物之中，心神引动气机聚结，所以郁结成为病症。（平按：“身”字在《素问》、《甲乙经》中均无。《甲乙经》中“存”作“伤”。《素问》中“止”作“归正”，新校正云：按《甲乙经》“归正”二字作“止”字。“气留”在《甲乙经》中作“气流”。）
Ping An: This chapter appears in Volume 11, Chapter 39 "Ju Tong Lun" (Discourse on the Causes of Pain) of the *Su Wen* (Basic Questions), and also in Volume 1, Chapter 1 of the *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion).
The Yellow Emperor said: I have heard that all diseases arise from Qi abnormalities. Anger causes Qi to ascend; joy causes Qi to slacken; grief causes Qi to dissipate; fear causes Qi to sink; cold causes Qi to contract and gather; heat causes the Cou Li (skin pores) to open and Qi to leak out; worry causes Qi to become disordered; exertion causes Qi to be depleted; and contemplation causes Qi to knot. These nine types of Qi changes differ from one another; what diseases do they generate? (Jiong sounds like "gui," meaning heat. The reason people become ill is invariably due to internal imbalances of the Five Emotions—anger, joy, worry, pensiveness, and fear—and external invasions by Yin-Yang, cold, and heat, which disturb Qi and give rise to myriad diseases. Therefore, those who are skilled in preserving health eliminate internal emotional excesses and avoid external climatic evils, thus avoiding premature death and achieving longevity. If one indulges in emotions, anger causes Qi to ascend and damage Hun (Ethereal Soul); damage to Hun results in Liver injury. Joy causes Qi to slacken and damage Shen (Spirit); damage to Shen results in Heart injury. Worry and grief cause Qi to dissipate and also damage Hun; damage to Hun results in Liver injury. Fear causes Qi to sink and damage Zhi (Willpower); damage to Zhi results in Kidney injury. Excessive cold causes Qi to contract and gather, internally injuring the Lung. Excessive heat causes Cou Li to open and leak, internally injuring the Heart. Worry causes Qi to become disordered and damage Po (Corporeal Soul); damage to Po results in Lung injury. Excessive exertion causes Qi to deplete, injuring the Kidney. Contemplation causes Qi to knot and damage Yi (Intellect); damage to Yi results in Spleen injury. Once the Five Zang Organs are injured, death occurs when the time comes when each organ is overcome by its controlling element. All these illnesses arise from the Nine Evils generated by the Nine Qi changes. (Ping An: In the *Su Wen*, "I have heard" is written as "I know"; under "Qi contracts," the character "gather" is absent; above "Qi leaks," the three characters "Cou Li open" are absent; "worry" is written as "fright." Xin Zheng Xiao Yun: According to the *Tai Su*, "fright" is written as "worry." This aligns perfectly with this text. Furthermore, in the annotations, the two instances of "Po" in "injure Po" and "Po injured" were originally copied as "Hun" and corrected by the original annotator to "Po." As the classic states: "The Lung stores Qi, and Qi houses Po." It also states: "In the emotions, the Lung corresponds to worry." Writing "injure Po" is also consistent.)
Qi Bo said: Anger causes Qi to rebel; in severe cases, it leads to vomiting blood and regurgitation of food with rebellious Qi ascending. (Because it draws Qi upward, Qi rebels. Severe anger causes Qi rebellion, leading to vomiting blood and the upward reversal of food and Qi. (Ping An: "Food and Qi reversing" in the *Su Wen* is written as "undigested stool diarrhea." According to Xin Zheng Xiao Yun: According to the *Jia Yi Jing* and *Tai Su*, it is written as "food and Qi reversing." This aligns perfectly with this text.)
Joy causes Qi to harmonize and the will to be unobstructed, allowing Ying and Wei Qi to flow freely and smoothly, thus causing Qi to slacken. (Joy harmonizes Qi and opens the will, making Ying and Wei Qi flow smoothly, thus causing Qi slackness as a pathology. (Ping An: Above the character "flow," both the *Su Wen* and *Jia Yi Jing* lack the character "xing" (walk/run).)
Grief causes the Heart vessels to contract, the Lung lobes to expand and elevate, blocking communication between the Upper and Middle Jiao, preventing the dispersion of Ying and Wei Qi, trapping heat in the center, thus causing Qi to dissipate. (The Liver channel ascends into the pharynx and connects to the eye system; a branch diverges from the Liver, pierces the diaphragm, and ascends to inject into the Lung. The Lung governs grief. The Upper and Middle Jiao are located in the Heart and Lung. Grief Qi gathers in the Lung, causing the lung lobes to elevate and the Heart vessels to contract. Ying and Wei Qi gather in the Heart and Lung without dispersing, and Shen returns and does not move, resulting in heat and Qi deficiency/dissipation. (Ping An: In the *Su Wen*, "blockage of two Jiaos" is written as "and Upper Jiao blockage." Xin Zheng Xiao Yun: According to the *Jia Yi Jing* and *Tai Su*, it is written as "blockage of two Jiaos." This aligns perfectly with this text. Additionally, Wang Zhu interprets "bu ye" (spreading leaves) as large leaves like a cover. Xin Zheng Xiao Yun doubts this interpretation and quotes Quan Yuanqi: "Grief injures the Heart; contraction of the Heart vessels moves the Lung. Lung Qi connects to all channels; due to rebellion, Lung spreads and leaves elevate. How can one say 'Lung bu' refers to large leaves like a cover?" Based on this, Quan's annotation aligns with the intent of this commentary.)
Fear causes Essence to retreat; retreat causes Upper Jiao closure; closure causes Qi to return; return causes Lower Jiao distension, thus causing Qi to fail to circulate. (Although the Ming Men stores Essence, collectively referred to as the Kidney, the channel originates in the Kidney, passes up through the Liver and Diaphragm, enters the Lung; a branch connects from the Lung to the Heart and injects into the chest. When humans experience fright, Essence retreats. The Upper Jiao begins above the stomach opening. Since the Upper Jiao is closed and blocked, Qi cannot ascend but returns to the Lower Jiao, causing Lower Jiao distension and preventing Qi circulation. (Ping An: "Essence retreats" in the *Jia Yi Jing* is written as "Shen retreats." Additionally, Xin Zheng Xiao Yun in the *Su Wen* states: "Qi fails to circulate" should be read as "Qi descends." Examining the original annotation, it still should be read as "Qi fails to circulate.")
Heat causes Cou Li to open and Ying and Wei Qi to circulate, thus causing profuse sweating. (Qi fails to circulate, or due to heat, Cou Li open and Ying and Wei Qi circulate externally, causing profuse sweating. (Ping An: In the *Su Wen* and *Jia Yi Jing*, "heat" is written as "jiong." In the *Su Wen*, "thus causing profuse sweating" is written as "profuse sweating thus Qi leaks.")
Cold causes Cou Li to close and Qi to fail to circulate, thus causing Qi to contract and gather. (Because Ying and Wei Qi do not circulate, encountering cold causes Cou Li to close, leading to Qi gathering as a pathology. (Ping An: The three sentences "Cold causes Cou Li to close" are absent in the *Jia Yi Jing*; in the *Su Wen*, they appear before the three sentences about "Jiong causes Cou Li to open." The character "gather" in the *Su Wen* is written as "yi".)
Worry causes the Heart to have no place to rest, Shen to have no place to return, and thoughts to have no stability, thus causing Qi to become disordered. (The Heart is the function of Shen. In human worry, one forgets various matters; although there is mental state, there is nothing to attend to, hence "no place to rest." Qi is where Ying resides, and Shen must return to it. Now, since worry is complex, Qi gathers and does not move, so Shen has no return. Lu (deliberation) is also a function of Shen. Thus, worry cannot counteract affairs because Qi lacks a master to guard it, so Qi becomes disordered. (Ping An: In the *Su Wen* and *Jia Yi Jing*, "worry" is written as "fright." Xin Zheng Xiao Yun: In the *Tai Su*, "fright" is written as "worry." The character "ji" (rest/place) in the *Su Wen* and *Jia Yi Jing* is written as "yi" (lean on). In the annotation, "xin qing" (mental state) in other versions is written as "xin jing" (heart essence).)
Exertion causes panting, heavy breathing, and sweating, with internal and external Qi both escaping, thus causing Qi depletion. (When humans exert force and become fatigued, Qi converges, causing panting and heavy breathing. Skin, Cou Li, and the Five Internal Organs all sweat. Since sweat is Qi, sweating causes internal and external Qi to deplete. (Ping An: "Chuan he" (panting and drinking/heavy breath) in Gu Ben edition of *Su Wen* is written as "chuan xi" (panting), Zhao Fu edition writes "chuan qie", same as *Jia Yi Jing*. "Internal and external" in the *Su Wen* is written as "external and internal".)
Contemplation causes body and mind to focus, Shen to settle, Qi to remain and not move, thus causing Qi to knot. (Focusing on one matter causes Heart Qi to reside on one object. Thus, Shen focuses within one object, and Heart Qi draws Qi to gather, thus knotting and becoming pathology. (Ping An: The character "shen" (body) is absent in the *Su Wen* and *Jia Yi Jing*. In the *Jia Yi Jing*, "cun" (exist/reside) is written as "shang" (injure). In the *Su Wen*, "zhi" (stop) is written as "gui zheng" (return to correct); Xin Zheng Xiao Yun states: According to the *Jia Yi Jing*, the two characters "gui zheng" are written as the single character "zhi". "Qi liu" (Qi remains) in the *Jia Yi Jing* is written as "Qi liu" (Qi flows).)