平按∶此篇自篇首至则不得偃卧，见《素问》卷十三第四十六《病能论》篇。自问
曰人有逆气至末，见《素问》卷九第三十四《逆调论》篇。又自篇首至末，见《甲乙经》
卷十二第三。
黄帝问于岐伯曰∶人有卧而有所不安者何也？岐伯曰∶脏有所伤，及精有所乏，倚
则不安，故人不能注悬其病。（人之病有卧不安者，五脏内伤，入房太甚，泄精过多，
有所不足，故倚卧不安，不能悬
定病处，数起动也。平按∶及精所有乏倚则不安，别本乏作之，《素问》作及精有所之
寄则安，《甲乙》作及情有所倚则卧不安，《素问》新校正云∶“《太素》作精所有倚
则不安。”均无乏字。本书原抄作及精有所乏倚则不安，与杨注“泄精过多，有所不足，
故倚卧不安”正合。袁刻无乏字。《素问》、《甲乙》悬上无注字。注太甚袁刻作太盛。）
黄帝曰∶人之不得偃卧者何也？岐伯曰∶肺者脏之盖也，肺气盛则脉大，大则不得偃卧。
（肺居五脏之上主气，气之有余，则手太阳脉盛，故不得偃卧也。）问曰∶人有逆气不
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，
有不能得卧、卧而喘者，皆何脏使然？愿闻其故。（此五皆是人之起居，卧之与喘，不
安之病，皆由脏内不和，故请示也。）答曰∶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。（阳明为三阳之长，故气下行，顺而息调，失和上
行，逆而有音，此解息有音也。）阳明者胃脉也，胃者六腑之海也，其气亦下行，阳明
逆，不得从其道，故不得卧，上经曰，胃不和则卧不安，此之谓也。（阳明循道逆行，
息便有音，今不根据其道逆行，故不得卧。上经，前所说经也。平按∶上经《素问》、《甲
乙》作下经，王注∶《下经》，上古经也。）夫起居如故息有音者，此脾之络脉逆，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。（夫络脉循
脉经上下而行，络脉受邪，注留于经，病患也甚，故起居不安，息亦有声。今络脉气逆，
不循于经，其病也微，所以起居如故，息有音也。平按∶脾之络脉《素问》、《甲乙》
作肺之络
脉。）夫不得卧，卧则喘者，是水气之客也，夫水者循津液而流者也，肾者水脏，主津
液，津液主卧与喘。（肾为水脏，主于胃中津液。今有水气客于津液，循之而流，津液
主卧主喘，故津液受邪，不能得卧，卧即喘也。平按∶《甲乙》而流作而留。《素问》、
《甲乙》津液二字不重。）
【平按】：本篇从篇首到“则不得偃卧”的内容，见于《素问》卷十三第四十六《病能论》篇。从提问“人有逆气”开始直到结尾，见于《素问》卷九第三十四《逆调论》篇。另外，从篇首到结尾的全部内容，见于《甲乙经》卷十二第三。
黄帝向岐伯问道：有人睡觉时感到不安稳，这是为什么呢？岐伯回答说：内脏受到损伤，以及精气有所匮乏，身体倚靠时就感到不安稳，所以人不能确定地指出病痛所在。（人的疾病中有睡眠不安的，是因为五脏内部受伤，房事过度，泄精过多，导致精气不足，所以倚靠卧床时不安稳，不能固定病痛之处，多次起身活动。平按：及精有所乏倚则不安，其他版本中“乏”作“之”，《素问》作“及精有所之寄则安”，《甲乙经》作“及情有所倚则卧不安”，《素问》新校正说：“《太素》作‘精所有倚则不安’。”都没有“乏”字。本书原抄本作“及精有所乏倚则不安”，与杨上善注文中“泄精过多，有所不足，故倚卧不安”正相符合。袁刻本没有“乏”字。《素问》、《甲乙经》在“悬”字上没有“注”字。注文中的“太甚”袁刻本作“太盛”。）
黄帝说：人不能仰卧（偃卧）是怎么回事呢？岐伯说：肺是五脏的盖子，肺气旺盛则脉象盛大，脉象盛大就不能仰卧。（肺位于五脏之上，主司气，气有余，则手太阳经脉盛实，所以不能仰卧。）又问：有人气逆不能仰卧且呼吸有声，有人起居如常但呼吸有声，有人能行走但喘息，有人不能仰卧、不能行走且喘息，有人不能仰卧、一躺下就喘息，这些都是哪个脏腑导致的呢？希望听听其中的原因。（这五种情况都是关于人的起居、睡眠和喘息的病症，不安稳的病，都是由内脏不和引起的，所以请示说明。）回答：不能仰卧且呼吸有声的，是阳明经之气逆乱所致。足三阳经的气本是下行的，现在逆乱而上行，所以呼吸有声。（阳明经是三阳经之长，所以气下行，顺则呼吸调和，失和则上行，逆乱则有声音，这是对呼吸有声的解释。）阳明经是胃脉，胃是六腑的海，其气也是下行的，阳明经气逆乱，不能遵循其道，所以不能仰卧。《上经》说，胃不和则卧不安，说的就是这个意思。（阳明经循行之道逆行，呼吸就有声音，现在不根据其道逆行，所以不能仰卧。《上经》，指前面所说的经典。平按：《上经》在《素问》、《甲乙经》中作《下经》，王冰注：《下经》，是上古的经典。）至于起居如常但呼吸有声的，这是脾的络脉气逆，络脉不能随经脉上下运行，所以留滞在经脉中而不通行，这是络脉病变，病情较轻，所以起居如常而呼吸有声。（络脉沿经脉上下而行，络脉受邪，注留于经，病情严重，所以起居不安，呼吸也有声音。现在络脉气逆，不循行于经，病情轻微，所以起居如常，呼吸有声。平按：脾之络脉在《素问》、《甲乙经》中作肺之络脉。）至于不能仰卧，一躺下就喘息的，是水气侵犯所致。水，是顺着津液流动的。肾是水脏，主司津液，津液主管睡眠和喘息。（肾为水脏，主司胃中的津液。现在有客邪水气侵入津液，顺着津液流动，津液主管睡眠和喘息，所以津液受邪，不能安卧，躺下就喘息。平按：《甲乙经》中“而流”作“而留”。《素问》、《甲乙经》中“津液”二字不重复。）
[Ping An]: The content from the beginning of this chapter to "then cannot lie flat" is found in Chapter 46, "Lun Bing Neng" (Discussion on Disease Capabilities), Volume 13 of *Su Wen* (Plain Questions). From the question "If a person has rebellious Qi" to the end, it is found in Chapter 34, "Lun Ni Diao" (Discussion on Abnormal Regulation), Volume 9 of *Su Wen*. Furthermore, the entire content from the beginning to the end is found in Volume 12, Section 3 of *Jia Yi Jing* (The Classic of Jia Yi).
Huang Di asked Qi Bo: Why do some people feel uneasy when lying down? Qi Bo replied: When the internal organs are injured and the essence and spirit are deficient, leaning or resting causes unease; therefore, one cannot pinpoint the location of the disease. (Among human diseases, those with sleep disturbance are due to internal injury of the five Zang organs, excessive sexual activity, excessive loss of semen, leading to insufficiency. Thus, leaning on the bed causes unease, and one cannot fix the location of the illness, frequently getting up and moving. Ping An: In other editions, "fa" (lack) in "ji jing you suo fa yi ze bu an" is written as "zhi". *Su Wen* reads "ji jing you suo zhi ji ze an", while *Jia Yi Jing* reads "ji qing you suo yi ze wo bu an". The New Correction of *Su Wen* states: "*Tai Su* reads 'jing suo you yi ze bu an'." None contain the character "fa". The original manuscript of this book reads "ji jing you suo fa yi ze bu an", which aligns with Yang Shangshan's annotation "excessive loss of semen, resulting in insufficiency, thus leaning on the bed causes unease". Yuan's printed edition lacks the character "fa". *Su Wen* and *Jia Yi Jing* do not have the character "zhu" (annotation) above "xuan". In the annotation, "tai shen" is written as "tai sheng" in Yuan's edition.)
Huang Di said: Why can some people not lie flat (on their backs)? Qi Bo answered: The Lung is the cover of the five Zang organs. When Lung Qi is abundant, the pulse becomes large. When the pulse is large, one cannot lie flat. (The Lung resides above the five Zang organs and governs Qi. Excess Qi leads to fullness in the Hand Taiyang meridian, hence the inability to lie flat.) Another question arises: Some people have rebellious Qi preventing them from lying flat and have noisy breathing; some have normal daily activities but noisy breathing; some can walk but wheeze; some cannot lie flat, cannot walk, and wheeze; some cannot lie flat and wheeze immediately upon lying down. Which Zang organ causes these conditions? I wish to hear the reason. (These five cases all concern disturbances in daily life, sleep, and wheezing. These ailments of unease are caused by disharmony within the Zang organs, hence the request for explanation.) The answer is: Those who cannot lie flat and have noisy breathing suffer from rebellion of Yangming Qi. The Qi of the Foot Three Yang meridians normally descends; now it rebels and ascends, causing noisy breathing. (Yangming is the head of the Three Yang meridians, so its Qi descends. Harmony results in regulated breathing; disharmony leads to ascending rebellion, causing noise. This explains the noisy breathing.) The Yangming meridian is 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 path, one cannot lie flat. The *Shang Jing* (Upper Classic) states: "When the Stomach is not harmonious, sleep is disturbed." This refers to such cases. (When Yangming Qi rebels against its pathway, breathing becomes noisy. If it does not rebel according to its pathway, one cannot lie flat. *Shang Jing* refers to the classics mentioned earlier. Ping An: *Shang Jing* is written as *Xia Jing* (Lower Classic) in *Su Wen* and *Jia Yi Jing*. Wang Bing's annotation says: "*Xia Jing* is the ancient classic.") As for those whose daily activities remain normal but have noisy breathing, this is due to rebellion of the collateral vessels of the Spleen. The collateral vessels cannot move up and down with the main meridians, so they stagnate in the meridians and do not circulate. This is a mild disease of the collateral vessels; thus, daily activities remain normal while breathing is noisy. (Collateral vessels run along the meridians. If collaterals are invaded by pathogens and stagnate in the meridians, the condition is severe, causing restlessness and noisy breathing. Now, if collateral Qi rebels without following the meridians, the condition is mild, so daily activities are normal, but breathing is noisy. Ping An: "Spleen collateral vessels" is written as "Lung collateral vessels" in *Su Wen* and *Jia Yi Jing*.) As for those who cannot lie flat and wheeze immediately upon lying down, this is caused by the invasion of Water Qi. Water flows following the Jin Ye (Body Fluids). The Kidney is the Water Organ and governs Jin Ye. Jin Ye governs sleep and wheezing. (The Kidney is the Water Organ, governing the Jin Ye in the Stomach. Now, pathogenic Water Qi invades the Jin Ye and flows with it. Since Jin Ye governs sleep and wheezing, when Jin Ye is affected by pathogens, one cannot lie peacefully and wheezes upon lying down. Ping An: In *Jia Yi Jing*, "er liu" (flows) is written as "er liu" (stays/lingers). In *Su Wen* and *Jia Yi Jing*, the term "Jin Ye" is not repeated.)