平按∶此篇见《素问》卷十三第四十九《脉解》篇。又按∶《素问》新校正云∶详此篇所解，
多《甲乙经》是动所生之病，虽复少有异处，大概则不殊矣。
太阳所谓肿、腰 痛者，正月大阳寅。寅，大阳也。（ ，尻也，音谁也。十一月一阳生，十
二月二阳生，正月三阳生。三阳生寅之时，其阳已大，故曰大阳也。）正月阳气出在上，（一阳
在地下，深牙初发也；二阳在地中，浅牙出也；三阳在地上出，故曰正月阳气出在上也。平按∶注
二牙字，袁刻均误作少。）而阴气盛，阳未得自次也，故肿、腰 痛。（三阴犹在地上未没，故
阴气盛也。以阴气盛隔，阳气未得次第专用，故发肿于肤肉、生痛于腰也。）偏虚为跛者，正月
阳冻解地气而出也。所谓偏虚者，冬寒颇有不足者，故偏
虚，故跛。（正月已有三阳，故冻解，阳气出于地也。先有三阴，故犹有冬寒，阳气不足也。人身
亦尔，半阳不足，故偏虚。跛，谓左脚偏跛也。平按∶《素问》偏虚为跛者上有病字，冻上有气字，
故跛作为跛也。颇有下袁刻脱不足者三字。注故冻解三字，袁刻在出于地也下。）所谓强上者，阳
气大上而争，故强上。（三阳向盛，与三阴战，得大得上，而阴犹争也。平按∶《素问》所谓强
上四字下，有引背二字。注得上，得字袁刻作德。）所谓耳鸣者，阳气万物上而跃，故耳鸣。（正
月阳气令万物勇跃鸣上，故生病气上冲耳鸣也。平按∶上而跃《素问》作盛上而跃。）所谓甚则
狂癫疾者，阳尽在上而阴气从下，下虚上实，故癫疾。（二阳爻与三阴争，而三阳俱胜，尽在于
头，为上实；三阴从下，即为下虚。于是发病，脱衣登上，驰走妄言，即谓之狂；僵仆而倒，遂
谓之颠也。平按∶《素问》故癫疾作故狂巅疾也。）所谓浮为聋者，皆在气也。（诊人迎之脉，
得三阳浮者，皆是太阳之气为聋也。）所谓人中为喑者，阳气已衰，故为喑。（太阳之气中伤人
者，即阳大盛，盛已顿衰，故为喑也。喑，不能言也。平按∶人中《素问》作入中。）内夺而厥，
则为喑痱，此肾虚也，（阳气外衰，故但为喑也；左肾气内虚夺而厥者，则为喑痱，音肥，风病
不能言也。谓四肢不用，喑不能言，心无所知，甚者死，轻者生可疗也。平按∶痱《素问》作俳。
注左肾左字袁刻作有。）少阴不至，少阴不至者厥也。（少阴，肾脉也。足少阴脉不通，则血气
不资于肾，故厥为喑痱也。平按∶少阴不至四字《素问》不重。）少阳所谓心胁痛者，言少阳戌
也，戌者心之所表也，（手少阳脉络心包，足少阳脉循胁里，故少阳病心胁痛也。戌为九月，九
月阳少，故曰少阳也。戌少阳脉，散络心包，故为心之所表。平按∶二戌字《素问》均作盛。）
九月阳尽而阴气盛，故心胁痛。（阴气已
盛，阳气将尽，少阳为病，故心胁痛也。平按∶阳尽《素问》作阳气尽。）所谓不可反侧者，阴气
藏物也，物藏则不动，故曰不可反侧。（九月物藏，静而不动，阴之盛也，故病不能反侧也。）
所谓甚则跃者，九月万物尽衰，草木毕落而堕也，则气去阳而之阴，（跃，勇动也。甚谓九月阴
气外盛，故万物之气极毕堕落，则万物之气去阳之阴也。平按∶注九月下袁刻脱阴气二字。）而
阳之下长也，故曰跃。（阴气盛于地上，阳气在于地下，勇动万物之根，令其内长也。平按∶而
阳上《素问》有气盛二字，袁刻有气盛灸三字。）阳明所谓洒洒振寒者，（阳明，三阳之长也。
午为五月，阳之盛也。在于广明，故曰阳明。平按∶洒洒《素问》作洒洒，下同，不再举。）阳
明者午也，五月盛阳之阴也，（五月盛阳，一阴爻生，即是阳中之阴也。）阳盛而阴气加之，故
洒洒振寒。（一阴始生，劲猛加阳，故洒洒振寒也。）所谓胫肿而股不收者，五月盛阳之阴也，
阳者衰于五月，而阴气一下，与阳始争，故胫肿而股不收。（腰以上为阳，腰以下为阴，五月有
一阴气在下始生，与阳交争，阳强实于上，阴弱虚于下，故胫肿，股不收也。平按∶阴气一下
《素问》作一阴气上。）所谓上喘为水者，曰阴气下，下复上，上则邪客于脏腑间，故为水。（五
月阳明，一阴为病，谓上喘咳水病者也。一阴上下胸腹之中，不根据常度，遂邪随阴气，客于腑脏
之间，故为水病也。平按∶阴气下下复上《素问》作阴气下而复上。注常度，度字袁刻作处。）
所谓胸痛少气者，水在脏腑也，水者阴气也，阴气在中故少气。（火为阳气，水为阴气，水在脏
腑之间，故阳气少也。平按∶《素问》水在脏腑作水气在脏腑，故少气作故胸痛少气也。）所谓甚
则厥、恶人与火、闻木音惕然而惊者，阳与阴气相薄，水火相恶，故惕然而惊。（阳明脉气与阴
气
俱盛，水火相恶，故惕然惊也。木胜土，故闻木音惕然惊也。）所谓志欲独闭户牖而处者，阴阳
相薄也，阳尽而阴盛也，故欲独闭户牖居。（阴阳相争更胜，阳盛已衰，次阴气盛，故好闭户牖
独居暗处也。平按∶志欲，志字《素问》无。）所谓病重至则欲乘高而歌、弃衣而走者，阴阳复
争而外并于阳也，故使之弃衣而走。（阴阳相争，阴少阳多，阴并外阳，故欲弃衣走也。平按∶
病重至，重字《素问》无。）所谓客孙脉则头痛鼻鼽腹肿者，阳明并于上，上者则其孙脉太阴也，
故头痛鼻鼽腹肿。（太阴经脉，至于舌下，太阴孙络，络于头鼻，故阳明并于太阴孙络，至鼻鼽
腹肿也。平按∶则其孙脉，《素问》脉作络。）太阴所谓病胀者，曰太阴者子也，十一月万物气
皆藏于中，故曰病胀。（以十一月阴气大，故曰太阴。阴气内聚，阳气外通；十一月阴气内聚，
虽有一阳始生，气微未能外通，故内病为胀也。）所谓上走心为噫者，曰阴气盛而上走阳，阳者
阳明络属心，故曰上走心为噫。（十一月有五阴爻，故阴气盛也。太阴在内，所以为下也；阳明
居外，所以为上也。阳明之正，上入腹里，属胃散之脾，上通于心，故阳明络属心者也。寒气先客
胃中，复有厥气从胃上散，其厥气复出胃之中上口，胃以连心，故曰上走心为噫也。平按∶阴气
盛，《素问》无气字，袁刻脱盛字。而上走阳阳者《素问》作而上走于阳明。）所谓食则呕者，
曰物盛满而上溢，故呕。（胃中食满，阳气消之。今十一月，一阳力弱，未能熟消，故胃满而溢
谓之欧。此呕，吐也。平按∶注食满袁刻误作气满。一阳，一字袁刻脱。）所谓得后与气则快然
而衰者，曰十一月阴气下衰，而阳气且出，故曰得后与气则快然而衰。（阳气未大，故腹满为胀。
阴气向下，一阳引之，故得后便及泄气，快然腹减。平按∶而衰，两而字《素问》均作如。
十一月《素问》作十二月。）少阴所谓腰痛者，曰少阴者肾也，七月万物阳气背伤，故腰痛。
（七月秋气始至，故曰少阴。十一月少阴之气大，三月少阴已厥，故少阴至肾七月之时，三阴已
起，万物之阳已衰，太阳行腰，太阳既衰，腰痛也。平按∶七月《素问》作十月，背伤作皆伤。
注故少阴至肾，袁刻脱阴字。）所谓上气咳、上气喘者，曰阴气在下，阳气在上，诸气浮无所根据
从，故呕咳、上气喘也。（此肾咳也。阴阳二气不和，各在上下，故诸阳气浮无所根据，好为呕咳、
上气喘也。平按∶《素问》上气咳作呕咳，诸气浮作诸阳气浮。）所谓邑邑不能久立、坐起则目
KTKT 无所见者，万物阴阳不定，未有主也，秋气始至，微霜始下，而方杀万物，阴阳内夺，
故曰目KT KT 无所见也。（七月阴阳气均未有定主，秋气始至，阳气初夺，故邑然怅望，不能
久立。又阴阳内各不足，故从坐起，目KT 无所见也。有本作露，但白露即霜之微也。十月已降甚
霜，即知有本作十月者，非也。平按∶邑邑《素问》作色色，新校正云∶色色二字疑误。坐上《素
问》有久字，KT KT 作KT KT 。注怅望，怅字袁刻误作胀。）所谓少气喜怒者，阳气热不治，
阳气不得出，肝气当治而未得也，故喜怒者，名曰前厥。（少阴气用也，则阳气热而不用，故不
得出也。肝以主怒，少阴用时，肝气未得有用，故喜怒也。喜怒之病，名曰前厥者也。平按∶阳
气热不治，《素问》无热字，作阳气不治二句。故喜怒者作善怒善怒者。前厥作煎厥。注肝以主
怒，肝字袁刻误作所。）所谓恐如人将捕之者，秋气万物未得毕去，阴气少，阳气入，阴阳相薄，
故恐。（七月万物少衰，未至枯落，故未得毕去也。始凉未寒，故阴气少也。其时犹热，故阳气
入也。然
则二气相薄不足，进退莫定，故有恐也。平按∶阳气入，原抄脱入字，谨根据《素问》及本注补入。）
所谓恶闻食臭者，胃无气，故恶闻食臭也。（七月阳衰，胃无多气，故恶闻食气也。）所谓面黑
地色者，秋气内夺，故变于色也。（七月三阳已衰，三阴已起，然阳去阴来不已，则阴强阳弱，
故夺色而变。平按∶注而变袁刻误作而起。）所谓咳则有血者，阳脉伤也，阳气未盛于上，腹满
则咳，故血见于鼻也。（七月金主肺也，肺主咳也，不咳则已，咳则伤阳，阳伤血脉，故腹满、
见血于鼻中也。平按∶腹满则咳《素问》作而脉满满则咳六字。）厥阴所谓颓疝、妇人少腹肿者，
曰厥阴者辰也，三月阳中之阴也，邪在中，故曰颓疝少腹肿。（三月阴气将尽，故曰厥阴。三月为
阳，厥阴脉在中，故曰阳中之阴。邪客厥阴之脉，遂为颓疝。颓，谓丈夫少腹寒气成，积阴器之中
而痛也。疝，谓寒积气上，入少腹而痛也。病在少腹痛，不得大小便，病名曰疝也。平按∶颓《素
问》作 。注上入小腹，袁刻脱上字。）所谓腰脊痛不可以俯仰者，三月一振荣华，而万物一俯
而不仰也。（振，动也。三月三阳合动而为春，万物荣华，低枝垂叶，俯而不仰，故邪因客厥阴，
腰脊痛，俯不仰也。）所谓钉 肤胀者，曰阴一盛而胀，阴胀不通，故曰颓 。（毒热客于厥阴，
故为钉肿。邪客于阴器，遂为 病，小便难也。客于皮肤中，因为肤胀。三月为阳，阴气一在而
盛，故阴器肿胀。阴器肿胀不通，故为颓 也。平按∶《素问》钉作 ，肤上有疝字，一盛作亦
盛，而胀阴胀不通作而脉胀不通，故曰 作故曰 疝也。）所谓甚则嗌干热中者，阴阳相薄
而热则干，故曰嗌干也。（甚，谓厥阴邪气盛也。厥阴之脉，挟胃属肝络胆，上入颃颡，故阴阳
相薄，热中而嗌干也。平按∶《素问》无则干二字。）
平按：此篇见于《素问》卷十三第四十九《脉解》篇。又按：《素问》新校正说：详细考察此篇所解释的内容，大多出自《甲乙经》中“是动”和“所生”的病证，虽然略有不同之处，但大体上没有差异。
太阳经所说的肿胀、腰脊痛，对应正月寅月。寅，代表大阳。（ ，指尾骨，读音为“谁”。十一月一阳生，十二月二阳生，正月三阳生。在三阳生于寅月之时，其阳气已经盛大，所以称为大阳。）正月阳气出于上方，（一阳在地下，像深埋的牙芽刚刚发出；二阳在地中，像浅出的牙芽；三阳在地上出现，所以说正月阳气出于上方。平按：注中的“二牙”字，袁刻本均误作“少”。）而阴气旺盛，阳气未能独自按次序运行，所以出现肿胀、腰脊痛。（三阴还在地上未完全消退，所以阴气旺盛。因为阴气旺盛阻隔，阳气未能依次单独发挥作用，所以在肌肤肌肉间发生肿胀，在腰部产生疼痛。）偏侧虚弱导致跛行，是因为正月阳气解冻，地气外出。所谓偏虚，是因为冬季寒冷颇有不足，所以偏侧虚弱，因此跛行。（正月已有三阳，所以冰冻解除，阳气出于地面。先前有三阴，所以仍有冬寒，阳气不足。人体也是如此，半侧阳气不足，所以偏侧虚弱。跛，指左脚偏侧跛行。平按：《素问》在“偏虚为跛者”上有“病”字，“冻”上有“气”字，“故跛”作“故跛也”。 “颇有”下袁刻本脱漏“不足者”三字。注中“故冻解”三字，袁刻本在“出于地也”之下。）所谓头项强直，是因为阳气大上而争斗，所以头项强直。（三阳趋向旺盛，与三阴交战，得以大胜而上行，但阴气仍在争斗。平按：《素问》“所谓强上”四字下，有“引背”二字。注中“得上”，“得”字袁刻本作“德”。）所谓耳鸣，是因为阳气如万物向上跳跃，所以耳鸣。（正月阳气令万物勇跃鸣叫向上，所以生病时气上冲导致耳鸣。平按：“上而跃”在《素问》中作“盛上而跃”。）所谓严重时发为狂癫疾，是因为阳气全部在上而阴气从下跟随，下虚上实，所以发癫疾。（二阳爻与三阴争斗，而三阳俱胜，全部在于头部，造成上实；三阴从下跟随，造成下虚。于是发病，脱衣登上高处，奔跑胡言乱语，这就叫做狂；僵仆倒地，这就叫做颠。平按：《素问》“故癫疾”作“故狂巅疾”。）所谓脉浮导致耳聋，都是气的问题。（诊察人迎脉，得到三阳脉浮的，都是太阳之气导致耳聋。）所谓邪入中导致失音，是因为阳气已衰，所以失音。（太阳之气中伤人者，即阳气大盛，盛极后突然衰退，所以失音。喑，不能说话。平按：“人中”在《素问》中作“入中”。）内里精气被夺且厥逆，就会失音并足废不用，这是肾虚，（阳气外衰，所以只是失音；左肾气内虚被夺且厥逆，就会失音并足废不用，音同“肥”，风病不能说话。指四肢不能用，失音不能说话，心神无知，严重的死亡，轻的可以治疗。平按：“痱”在《素问》中作“俳”。注中“左肾”的“左”字袁刻本作“有”。）少阴脉不至，少阴脉不至就是厥逆。（少阴，是肾脉。足少阴脉不通，则血气不资助于肾，所以厥逆导致失音和足废不用。平按：“少阴不至”四字在《素问》中不重复。）少阳经所说的心胁痛，是指少阳戌月，戌是心的表象所在，（手少阳脉络心包，足少阳脉循行胁里，所以少阳病有心胁痛。戌为九月，九月阳气少，所以叫少阳。戌少阳脉，散络心包，所以是心的表象。平按：两个“戌”字在《素问》中均作“盛”。）九月阳气尽而阴气盛，所以心胁痛。（阴气已盛，阳气将尽，少阳生病，所以心胁痛。平按：“阳尽”在《素问》中作“阳气尽”。）所谓不能反侧，是因为阴气收藏万物，物藏则不动，所以叫不能反侧。（九月万物收藏，静止不动，是阴气盛的表现，所以病不能反侧。）所谓严重时跳跃，是因为九月万物尽衰，草木全部落叶坠落，气离开阳转向阴，（跃，勇动。甚指九月阴气外盛，所以万物之气极毕堕落，那么万物的气就离开阳进入阴。平按：注中“九月”下袁刻本脱漏“阴气”二字。）而阳气在下生长，所以叫跃。（阴气盛于地上，阳气在于地下，勇动万物的根，让它们内部生长。平按：“而阳上”在《素问》中有“气盛”二字，袁刻本有“气盛灸”三字。）阳明经所说的洒洒振寒，（阳明，是三阳之长。午为五月，是阳气的盛期。在于广明，所以叫阳明。平按：“洒洒”在《素问》中作“洒洒”，下同，不再列举。）阳明就是午，五月是盛阳中的阴，（五月盛阳，一阴爻生，就是阳中之阴。）阳盛而阴气加之，所以洒洒振寒。（一阴始生，劲猛加于阳，所以洒洒振寒。）所谓小腿肿而大腿不收，是因为五月盛阳中的阴，阳气在五月衰退，而阴气一下来，与阳气开始争斗，所以小腿肿而大腿不收。（腰以上为阳，腰以下为阴，五月有一阴气在下始生，与阳交争，阳强实于上，阴弱虚于下，所以小腿肿，大腿不收。平按：“阴气一下”在《素问》中作“一阴气上”。）所谓上喘为水肿，是说阴气下行，下行后又上行，上行则邪气客于脏腑之间，所以为水病。（五月阳明，一阴为病，指上喘咳水病。一阴上下胸腹之中，不根据常度，于是邪随阴气，客于脏腑之间，所以为水病。平按：“阴气下下复上”在《素问》中作“阴气下而复上”。注中“常度”，“度”字袁刻本作“处”。）所谓胸痛少气，是因为水在脏腑，水是阴气，阴气在中所以少气。（火为阳气，水为阴气，水在脏腑之间，所以阳气少。平按：《素问》“水在脏腑”作“水气在脏腑”，“故少气”作“故胸痛少气”。）所谓严重时厥逆、怕人怕火、听到木声惊恐，是因为阳与阴气相薄，水火相恶，所以惊恐。（阳明脉气与阴气俱盛，水火相恶，所以惊恐。木克土，所以听到木声惊恐。）所谓病情重时想独自关窗闭门居住，是因为阴阳相薄，阳气尽而阴气盛，所以想独自关窗闭门居住。（阴阳相争更胜，阳盛已衰，次阴气盛，所以喜欢闭户牖独居暗处。平按：“志欲”，“志”字在《素问》中没有。）所谓病重发作时想登高唱歌、脱衣奔跑，是因为阴阳再次争斗而外并于阳，所以让他脱衣奔跑。（阴阳相争，阴少阳多，阴并外阳，所以想脱衣走。平按：“病重至”，“重”字在《素问》中没有。）所谓邪客孙脉则头痛鼻流清涕腹肿，是因为阳明并于上，上则其孙脉太阴，所以头痛鼻流清涕腹肿。（太阴经脉，至于舌下，太阴孙络，络于头鼻，所以阳明并于太阴孙络，至鼻流清涕腹肿。平按：“则其孙脉”，《素问》“脉”作“络”。）太阴经所说的病胀，是指太阴子月，十一月万物气皆藏于中，所以叫病胀。（以十一月阴气大，所以叫太阴。阴气内聚，阳气外通；十一月阴气内聚，虽有一阳始生，气微未能外通，所以内病为胀。）所谓气上走心为嗳气，是指阴气盛而上走阳，阳者阳明络属心，所以叫上走心为嗳气。（十一月有五阴爻，所以阴气盛。太阴在内，所以为下；阳明居外，所以为上。阳明之正，上入腹里，属胃散之脾，上通于心，所以阳明络属心。寒气先客胃中，复有厥气从胃上散，其厥气复出胃之中上口，胃以连心，所以叫上走心为嗳气。平按：“阴气盛”，《素问》无“气”字，袁刻本脱“盛”字。“而上走阳阳者”在《素问》中作“而上走于阳明”。）所谓食则呕吐，是指物盛满而上溢，所以呕。（胃中食满，阳气消之。今十一月，一阳力弱，未能熟消，所以胃满而溢谓之欧。此呕，吐也。平按：注中“食满”袁刻本误作“气满”。一阳，“一”字袁刻本脱漏。）所谓得后与气则快然而衰，是指十一月阴气下衰，而阳气且出，所以叫得后与气则快然而衰。（阳气未大，所以腹满为胀。阴气向下，一阳引之，所以得后便及泄气，快然腹减。平按：“而衰”，两个“而”字在《素问》中均作“如”。“十一月”在《素问》中作“十二月”。）少阴经所说的腰痛，是指少阴肾，七月万物阳气背伤，所以腰痛。（七月秋气始至，所以叫少阴。十一月少阴之气大，三月少阴已厥，所以少阴至肾七月之时，三阴已起，万物之阳已衰，太阳行腰，太阳既衰，腰痛。平按：“七月”在《素问》中作“十月”，“背伤”作“皆伤”。注中“故少阴至肾”，袁刻本脱“阴”字。）所谓上气咳、上气喘，是指阴气在下，阳气在上，诸气浮无所根据从，所以呕咳、上气喘。（此肾咳。阴阳二气不和，各在上下，所以诸阳气浮无所根据，好为呕咳、上气喘。平按：《素问》“上气咳”作“呕咳”，“诸气浮”作“诸阳气浮”。）所谓抑郁不能久立、坐起则目视不明，是因为万物阴阳不定，未有主，秋气始至，微霜始下，而方杀万物，阴阳内夺，所以叫目视不明。（七月阴阳气均未有定主，秋气始至，阳气初夺，所以怅望，不能久立。又阴阳内各不足，所以从坐起，目视不明。有本作“露”，但白露即霜之微也。十月已降甚霜，即知有本作十月者，非也。平按：“邑邑”在《素问》中作“色色”，新校正说：色色二字疑误。“坐上”在《素问》中有“久”字，“KT KT”作“KT KT”。注中“怅望”，“怅”字袁刻本误作“胀”。）所谓少气喜怒，是因为阳气热不治，阳气不得出，肝气当治而未得，所以喜怒，名叫前厥。（少阴气用，则阳气热而不用，所以不得出。肝以主怒，少阴用时，肝气未得有用，所以喜怒。喜怒之病，名叫前厥。平按：“阳气热不治”，《素问》无“热”字，作“阳气不治”二句。“故喜怒者”作“善怒善怒者”。“前厥”作“煎厥”。注中“肝以主怒”，“肝”字袁刻本误作“所”。）所谓恐惧像被人抓捕，是因为秋气万物未得毕去，阴气少，阳气入，阴阳相薄，所以恐。（七月万物少衰，未至枯落，所以未得毕去。始凉未寒，所以阴气少。其时犹热，所以阳气入。然而二气相薄不足，进退莫定，所以有恐。平按：“阳气入”，原抄本脱“入”字，谨根据《素问》及本注补入。）所谓厌恶闻食物气味，是因为胃无气，所以厌恶闻食物气味。（七月阳衰，胃无多气，所以厌恶闻食气。）所谓面色黑如地色，是因为秋气内夺，所以变色。（七月三阳已衰，三阴已起，然阳去阴来不已，则阴强阳弱，所以夺色而变。平按：注中“而变”袁刻本误作“而起”。）所谓咳则有血，是因为阳脉伤，阳气未盛于上，腹满则咳，所以血见于鼻。（七月金主肺，肺主咳，不咳则已，咳则伤阳，阳伤血脉，所以腹满、见血于鼻中。平按：“腹满则咳”在《素问》中作“而脉满满则咳”六字。）厥阴经所说的颓疝、妇人少腹肿，是指厥阴辰月，三月阳中之阴，邪在中，所以叫颓疝少腹肿。（三月阴气将尽，所以叫厥阴。三月为阳，厥阴脉在中，所以叫阳中之阴。邪客厥阴之脉，遂为颓疝。颓，指丈夫少腹寒气成，积阴器之中而痛。疝，指寒积气上，入少腹而痛。病在少腹痛，不得大小便，病名叫疝。平按：“颓”在《素问》中作“ ”。注中“上入小腹”，袁刻本脱“上”字。）所谓腰脊痛不可以俯仰，是因为三月一振荣华，而万物一俯而不仰。（振，动。三月三阳合动而为春，万物荣华，低枝垂叶，俯而不仰，所以邪因客厥阴，腰脊痛，俯不仰。）所谓钉肤胀，是指阴一盛而胀，阴胀不通，所以叫颓 。（毒热客于厥阴，所以为钉肿。邪客于阴器，遂为 病，小便难。客于皮肤中，因为肤胀。三月为阳，阴气一在而盛，所以阴器肿胀。阴器肿胀不通，所以为颓 也。平按：《素问》“钉”作“ ”，“肤”上有“疝”字，“一盛”作“亦盛”，“而胀阴胀不通”作“而脉胀不通”，“故曰 ”作“故曰 疝”。）所谓严重时咽干热中，是因为阴阳相薄而热则干，所以叫咽干。（甚，指厥阴邪气盛。厥阴之脉，挟胃属肝络胆，上入颃颡，所以阴阳相薄，热中而咽干。平按：《素问》无“则干”二字。）
Ping An: This chapter appears in the "Mai Jie" (Explanation of Pulse Changes) chapter, Volume 13, Chapter 49 of the *Su Wen* (Basic Questions). Furthermore, according to: The New Corrections of the *Su Wen* state: Upon detailed examination, the diseases explained in this chapter are mostly those of "Shi Dong" (Diseases of Movement) and "Suo Sheng" (Diseases Generated) from the *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion). Although there are slight differences, generally speaking, they are not distinct.
The swelling and lower back pain mentioned by the Taiyang (Greater Yang) meridian correspond to the first lunar month, Yin month. Yin represents Great Yang. ( , refers to the coccyx, pronounced "shui". In the eleventh month, one Yang is born; in the twelfth month, two Yangs are born; in the first month, three Yangs are born. At the time when three Yangs are born in Yin month, their Yang Qi is already grand, hence it is called Great Yang.) In the first month, Yang Qi emerges upwards. (One Yang is underground, like a deep tooth-like sprout just emerging; two Yangs are in the earth, like shallow sprouts emerging; three Yangs emerge on the ground, thus it is said that in the first month Yang Qi emerges upwards. Ping An: In the notes, the characters "two teeth" were misprinted as "shao" (few) in Yuan's edition.) And Yin Qi is abundant, while Yang Qi cannot act independently in sequence, resulting in swelling and lower back pain. (Three Yin are still above ground and have not fully subsided, so Yin Qi is abundant. Because Yin Qi blocks and isolates, Yang Qi cannot function sequentially on its own, thus causing swelling in the skin and muscles, and pain in the waist.) Unilateral deficiency leading to limping occurs because in the first month, frozen ice thaws and Earth Qi exits. The term "unilateral deficiency" implies that winter cold was somewhat insufficient, leading to unilateral weakness and thus limping. (In the first month, there are already three Yangs, so the ice thaws, and Yang Qi emerges from the ground. Previously there were three Yin, so winter cold remains, and Yang Qi is insufficient. The human body is similar; half-Yang is insufficient, leading to unilateral deficiency. Limping refers to limping on the left foot. Ping An: The *Su Wen* has the character "bing" (disease) before "pian xu wei bo zhe"; it has the character "qi" before "dong"; and "gu bo" is written as "gu bo ye". The phrase "po you" lacks the three characters "bu zu zhe" (lack of sufficiency) in Yuan's edition. The three characters "gu dong jie" in the note appear after "chu yu di ye" in Yuan's edition.) The term "strong upper body" (stiff neck/head) occurs because Yang Qi rises greatly and contends, causing stiffness in the head and neck. (Three Yang tend to prosper and battle with Three Yin, achieving great victory and rising up, yet Yin still contends. Ping An: After the four characters "suo wei qiang shang" in the *Su Wen*, the characters "yin bei" (pulling the back) appear. In the note, the character "de" in "de shang" is written as "de" (virtue) in Yuan's edition.) The term "tinnitus" occurs because Yang Qi leaps upward like all things, causing tinnitus. (In the first month, Yang Qi causes all things to leap and cry out upward; thus, when illness arises, Qi rushes upward causing tinnitus. Ping An: "Shang er yue" is written as "Sheng shang er yue" in the *Su Wen*.) When severe, it becomes mania and epilepsy because Yang Qi is entirely above and Yin Qi follows from below, creating a condition of deficiency below and excess above, thus leading to epilepsy. (Two Yang lines contend with Three Yin, but Three Yang prevail entirely in the head, causing excess above; Three Yin follow from below, causing deficiency below. Thus disease manifests: stripping clothes, climbing high, running wildly and speaking nonsense is called Mania (Kuang); stiffening and falling is called Epilepsy (Dian). Ping An: "Gu dian ji" in the *Su Wen* is written as "Gu kuang dian ji".) The term "floating pulse leads to deafness" refers to issues of Qi. (Diagnosing the Renying pulse, if the Three Yang pulse is floating, it is all due to Taiyang Qi causing deafness.) The term "entering middle leads to aphonia" occurs because Yang Qi has declined, thus causing aphonia. (When Taiyang Qi attacks humans, i.e., Yang Qi is extremely abundant, and then suddenly declines, aphonia results. Yin means inability to speak. Ping An: "Ren zhong" is written as "Ru zhong" in the *Su Wen*.) Internal depletion and reversal lead to aphonia and flaccidity, which is Kidney Deficiency. (Yang Qi declines externally, thus only causing aphonia; if Left Kidney Qi is internally depleted and reverses, it leads to aphonia and flaccidity, pronounced "fei", a wind disease causing inability to speak. It refers to limbs being unusable, aphonia, lack of mental awareness; severe cases die, mild cases can be treated. Ping An: "Fei" is written as "Pai" in the *Su Wen*. In the note, the character "Zuo" (Left) in "Zuo Shen" is written as "You" (Have) in Yuan's edition.) Shaoyin (Lesser Yin) pulse not arriving indicates Reversal. (Shaoyin is the Kidney pulse. If the Foot Shaoyin meridian is blocked, Blood and Qi do not nourish the Kidney, thus Reversal leads to aphonia and flaccidity. Ping An: The four characters "Shaoyin bu zhi" are not repeated in the *Su Wen*.)*
The Heart and hypochondriac pain mentioned by the Shaoyang (Lesser Yang) meridian refers to the Shaoyang Xu month. Xu is the exterior manifestation of the Heart. (Hand Shaoyang connects to the Pericardium; Foot Shaoyang follows the hypochondrium interior, so Shaoyang disease involves Heart and hypochondriac pain. Xu is the ninth month; Yang Qi is scarce in the ninth month, hence called Shaoyang. The Xu Shaoyang meridian scatters and connects to the Pericardium, thus it is the exterior of the Heart. Ping An: Both "Xu" characters in the *Su Wen* are written as "Sheng" (Abundant).) In the ninth month, Yang Qi ends and Yin Qi abounds, causing Heart and hypochondriac pain. (Yin Qi is already abundant, Yang Qi is about to end, Shaoyang disease arises, thus Heart and hypochondriac pain. Ping An: "Yang jin" is written as "Yang Qi jin" in the *Su Wen*.) The term "unable to turn or side" occurs because Yin Qi stores all things; when things are stored, they do not move, hence "unable to turn or side". (In the ninth month, all things are stored, quiet and unmoving, indicating abundance of Yin Qi, thus illness prevents turning or side-bending.) When severe, jumping occurs because in the ninth month all things decline, grass and trees fall completely, Qi leaves Yang and turns to Yin. (Yue means vigorous movement. Severe refers to the ninth month where Yin Qi is abundant externally, so the Qi of all things falls completely; thus the Qi of all things leaves Yang for Yin. Ping An: Yuan's edition omits the two characters "Yin Qi" after "September" in the note.) And Yang grows downward, hence called "jumping". (Yin Qi is abundant on the ground, Yang Qi is underground, vigorously moving the roots of all things to grow internally. Ping An: "Er Yang Shang" has the two characters "Qi Sheng" in the *Su Wen*, and Yuan's edition has "Qi Sheng Jiu".)*
The chills and trembling described by the Yangming (Bright Yang) meridian. (Yangming is the chief of the Three Yangs. Wu is the fifth month, the peak of Yang. Located in Guangming, hence called Yangming. Ping An: "Sa Sa" is written as "Sa Sa" in the *Su Wen*, same below, not repeated.)* Yangming corresponds to Wu. The fifth month is Yin within abundant Yang. (In the fifth month of abundant Yang, one Yin line is born, which is Yin within Yang.) Yang is abundant and Yin Qi adds to it, causing chills and trembling. (One Yin begins to generate, fierce and strong adding to Yang, thus chills and trembling.) The term "swollen calves and relaxed thighs" occurs because of Yin within abundant Yang in the fifth month. Yang declines in the fifth month, and Yin Qi descends, beginning to contend with Yang, thus swollen calves and relaxed thighs. (Waist above is Yang, waist below is Yin. In the fifth month, one Yin Qi begins to generate below, contending with Yang. Yang is strong and solid above, Yin is weak and deficient below, thus swollen calves and relaxed thighs. Ping An: "Yin Qi Yi Xia" is written as "Yi Yin Qi Shang" in the *Su Wen*.)* The term "upper wheezing indicates water retention" says that Yin Qi descends, descends again and ascends; ascending allows pathogenic factors to lodge between Zang and Fu organs, thus causing water disease. (In the fifth month Yangming, One Yin causes disease, referring to upper wheezing and coughing with water disease. One Yin moves up and down in the chest and abdomen without following normal rules, so pathogens follow Yin Qi and lodge between Fu and Zang organs, thus causing water disease. Ping An: "Yin Qi Xia Xia Fu Shang" is written as "Yin Qi Xia Er Fu Shang" in the *Su Wen*. In the note, "Du" is written as "Chu" in Yuan's edition.)* The term "chest pain and shortness of breath" occurs because water is in the Zang and Fu organs. Water is Yin Qi; Yin Qi in the middle causes shortness of breath. (Fire is Yang Qi, Water is Yin Qi. Water between Zang and Fu organs means Yang Qi is scarce. Ping An: In the *Su Wen*, "Shui Zai Zang Fu" is written as "Shui Qi Zai Zang Fu", and "Gu Shao Qi" is written as "Gu Xiong Tong Shao Qi".)* When severe, there is Reversal, fear of people and fire, and startle at the sound of wood, because Yang and Yin Qi contend, and Water and Fire are hostile, thus startling. (Yangming Meridian Qi and Yin Qi are both abundant, Water and Fire are hostile, thus startling. Wood overcomes Earth, thus startling at the sound of wood.)* The desire to close doors and windows and stay alone during severe illness occurs because Yin and Yang contend, Yang ends and Yin abounds, thus desiring to close doors and windows and live alone. (Yin and Yang contend and alternate in victory. Yang abundance has declined, next Yin Qi abounds, thus preferring to close doors and windows and live alone in the dark. Ping An: The character "Zhi" in "Zhi Yu" is absent in the *Su Wen*.)* When disease is severe and arrives, wanting to climb high and sing, discard clothes and run, occurs because Yin and Yang contend again and merge outwardly into Yang, thus causing discarding clothes and running. (Yin and Yang contend, Yin is few and Yang is many, Yin merges outwardly into Yang, thus wanting to discard clothes and run. Ping An: The character "Zhong" in "Bing Zhong Zhi" is absent in the *Su Wen*.)* When external pathogens affect Sun meridians, causing headache, nasal discharge, and abdominal swelling, it is because Yangming merges upward. Upward merging affects the Sun meridians of Taiyin, thus headache, nasal discharge, and abdominal swelling. (Taiyin Meridian reaches under the tongue; Taiyin Sun collateral networks the head and nose. Thus Yangming merging into Taiyin Sun collaterals leads to nasal discharge and abdominal swelling. Ping An: "Ze Qi Sun Mai", the character "Mai" is written as "Luo" in the *Su Wen*.)*
The bloating described by the Taiyin (Greater Yin) meridian refers to the Taiyin Zi month. In the eleventh month, the Qi of all things is stored within, hence called bloating. (Because Yin Qi is great in the eleventh month, it is called Taiyin. Yin Qi gathers internally, Yang Qi communicates externally. In the eleventh month, Yin Qi gathers internally; although one Yang begins to generate, its Qi is slight and cannot communicate externally, thus internal illness causes bloating.) The term "Qi moving upward to the heart causing belching" refers to Yin Qi being abundant and moving upward to Yang. Yang refers to Yangming connecting to the Heart, hence "moving upward to the heart causing belching". (In the eleventh month, there are five Yin lines, so Yin Qi is abundant. Taiyin is inside, thus considered lower; Yangming is outside, thus considered upper. The proper Qi of Yangming enters the abdomen interior, belongs to the Stomach, scatters to the Spleen, and communicates upward to the Heart, thus Yangming connects to the Heart. Cold pathogen first lodges in the Stomach, then Jue Qi disperses upward from the Stomach. This Jue Qi re-enters the upper opening of the Stomach. The Stomach connects to the Heart, thus "moving upward to the heart causing belching". Ping An: "Yin Qi Sheng" lacks the character "Qi" in the *Su Wen*, and Yuan's edition omits "Sheng". "Er Shang Zou Yang Yang Zhe" is written as "Er Shang Zou Yu Yang Ming" in the *Su Wen*.)* The term "vomiting after eating" occurs because food is full and overflows upward, thus vomiting. (Stomach contains full food, digested by Yang Qi. Now in the eleventh month, one Yang is weak and cannot fully digest, thus stomach fullness overflows, called Ou. This Ou is vomiting. Ping An: Note "Shi Man" is misprinted as "Qi Man" in Yuan's edition. The character "Yi" in "Yi Yang" is omitted in Yuan's edition.)* The term "relief after defecation and passing gas" refers to the eleventh month where Yin Qi declines downward and Yang Qi is about to emerge, hence relief after defecation and passing gas. (Yang Qi is not yet great, thus abdominal fullness causes bloating. Yin Qi moves downward, guided by one Yang, thus after defecation and passing gas, the abdomen feels relieved and reduced. Ping An: The two characters "Er" in "Er Shuai" are both written as "Ru" in the *Su Wen*. "November" is written as "December" in the *Su Wen*.)*
The lower back pain described by the Shaoyin (Lesser Yin) meridian refers to Shaoyin Kidney. In the seventh month, the Yang Qi of all things is injured on the back, thus lower back pain. (Autumn Qi begins in the seventh month, hence called Shaoyin. Shaoyin Qi is great in November, Jue occurred in March. Thus when Shaoyin reaches the Kidney in July, Three Yin have risen, and the Yang Qi of all things has declined. Taiyang governs the waist; since Taiyang declines, lower back pain occurs. Ping An: "July" is written as "October" in the *Su Wen*, "Bei Shang" is written as "Jie Shang". In the note, the character "Yin" in "Gu Shaoyin Zhi Shen" is omitted in Yuan's edition.)* The term "rising Qi, cough, and panting" refers to Yin Qi below and Yang Qi above. All Qi floats without foundation or direction, thus vomiting, coughing, and panting. (This is Kidney Cough. Yin and Yang Qi are discordant, each located above and below, thus all Yang Qi floats without foundation, prone to vomiting, coughing, and panting. Ping An: In the *Su Wen*, "Shang Qi Ke" is written as "Ou Ke", and "Zhu Qi Fu" is written as "Zhu Yang Qi Fu".)* The term "depressed, unable to stand long, and blurred vision upon sitting and standing" occurs because Yin and Yang of all things are undetermined, having no master. Autumn Qi begins, light frost descends, and all things are killed. Yin and Yang are internally depleted, hence blurred vision. (In July, Yin and Yang Qi are equal with no fixed master. Autumn Qi begins, Yang Qi is initially depleted, thus gazing sadly and unable to stand long. Also, Yin and Yang are internally insufficient, thus upon rising from sitting, vision is blurred. Some editions use "Lu", but White Dew is slight frost. Since heavy frost falls in October, editions using October are incorrect. Ping An: "Yi Yi" is written as "Se Se" in the *Su Wen*; New Corrections say "Se Se" is likely erroneous. "Zuo Shang" has the character "Jiu" in the *Su Wen*. "KT KT" is written as "KT KT". In the note, "Chang Wang" is misprinted as "Zhang" in Yuan's edition.)* The term "shortness of breath and mood swings" occurs because Yang Qi heat is unregulated, Yang Qi cannot exit, Liver Qi should regulate but fails, thus mood swings, named Qian Jue. (When Shaoyin Qi functions, Yang Qi heat does not function, thus cannot exit. Liver governs anger. When Shaoyin is in use, Liver Qi has not gained utility, thus mood swings. Diseases of mood swings are named Qian Jue. Ping An: "Yang Qi Re Bu Zhi" lacks the character "Re" in the *Su Wen*, written as "Yang Qi Bu Zhi" two sentences. "Gu Hu Nu Zhe" is written as "Shan Nu Shan Nu Zhe". "Qian Jue" is written as "Jian Jue". In the note, "Gan Yi Zhu Nu", the character "Gan" is misprinted as "Suo" in Yuan's edition.)* The term "fear as if being caught" occurs because in autumn, all things have not completely departed, Yin Qi is little, Yang Qi enters, Yin and Yang contend, thus fear. (In July, all things slightly decline, not yet withered, thus not completely departed. Just cool, not cold, thus Yin Qi is little. It is still hot, thus Yang Qi enters. However, the two Qi contend and are insufficient, advancing and retreating uncertainly, thus fear. Ping An: "Yang Qi Ru", the character "Ru" is omitted in the original manuscript, added here based on the *Su Wen* and this note.)* The term "aversion to the smell of food" occurs because the Stomach has no Qi, thus aversion to the smell of food. (In July, Yang declines, Stomach has little Qi, thus aversion to food smell.)* The term "face black like earth color" occurs because Autumn Qi depletes internally, thus changing color. (In July, Three Yang have declined, Three Yin have risen. However, Yang departs and Yin comes continuously, making Yin strong and Yang weak, thus depleting color and changing. Ping An: Note "Er Bian" is misprinted as "Er Qi" in Yuan's edition.)* The term "coughing with blood" occurs because Yang meridians are injured. Yang Qi is not yet abundant above; abdominal fullness causes cough, thus blood appears in the nose. (In July, Metal governs Lung. Lung governs cough. If not coughing, fine; if coughing, Yang is injured. Yang injury damages blood vessels, thus abdominal fullness and blood appearing in the nose. Ping An: "Fu Man Ze Ke" is written as "Er Mai Man Man Ze Ke" six characters in the *Su Wen*.)*
The Tui Shan (flaccid hernia) and lower abdominal swelling in women described by the Jueyin (Terminal Yin) meridian refer to the Jueyin Chen month. Chen is Yin within Yang. Pathogens in the middle, hence Tui Shan and lower abdominal swelling. (In March, Yin Qi is about to end, hence Jueyin. March is Yang, Jueyin meridian is in the middle, hence Yin within Yang. Pathogens lodge in the Jueyin meridian, thus Tui Shan. Tui refers to men where cold qi forms in the lower abdomen, accumulating in the genitalia causing pain. Shan refers to cold accumulated Qi rising, entering the lower abdomen causing pain. Disease in lower abdomen pain, inability to urinate or defecate, is named Shan. Ping An: "Tui" is written as " " in the *Su Wen*. In the note, "Shang Ru Xiao Fu", the character "Shang" is omitted in Yuan's edition.)* The term "lower back and spine pain unable to bend or extend" occurs because in March, all things shake and flourish, and all things bow down but do not look up. (Zhen means movement. In March, Three Yang combine to move for Spring. All things flourish, low branches and drooping leaves, bowing down but not looking up. Thus pathogens lodge in Jueyin, causing lower back and spine pain, unable to bend or extend.)* The term "Ning skin bloating" occurs because Yin is abundant and causes bloating. Yin bloaging is blocked, hence Tui . (Toxic heat lodges in Jueyin, thus Ning swelling. Pathogens lodge in genitalia, thus disease, difficult urination. Lodging in skin, thus skin bloating. March is Yang, Yin Qi is present and abundant, thus genitalia swelling. Genitalia swelling and blockage, thus Tui . Ping An: In the *Su Wen*, "Ning" is written as " ", "Fu" has "Shan" above, "Yi Sheng" is written as "Yi Sheng", "Er Zhang Yin Zhang Bu Tong" is written as "Er Mai Zhang Bu Tong", "Gu Yue " is written as "Gu Yue Shan".)* When severe, throat dryness and internal heat occur because Yin and Yang contend and heat causes dryness, hence throat dryness. (Severe refers to abundant Jueyin pathogenic Qi. The Jueyin meridian夹胃 belongs to Liver, connects to Gallbladder, and enters the Ying-Sang. Thus Yin and Yang contend, internal heat causes throat dryness. Ping An: The *Su Wen* lacks the two characters "Ze Gan".)*