平按∶此篇自篇首至是谓至治，见《灵枢》卷十第六十六《百病始生》篇，又见
《甲乙经》卷八第二。自
五邪入至末，见《素问》卷七第二十三《宣明五气》篇。
黄帝问于岐伯曰∶夫百病之始生也，皆生于风雨寒暑，清湿喜怒。（湿从地起，雨
从上下，其性虽同，生病有异。寒生于外，清发于内，性是一物，起有内外，所病亦有
不同。喜者，阳也。怒者，阴也。此病之起也。）喜怒不节则伤脏，（心主于喜，肝主
于怒，二者起之过分即伤神，伤神即内伤五脏，即中内之部也。）风雨则伤上，清湿
则伤下，三部之气所伤异类，愿闻其会。（风雨从头背而下，故为上部之气。清湿从尻
脚而上，故为下部之气。所伤之类不同，望请会通之也。）岐伯对曰∶三部之气各不同，
或起于阴，或起于阳，请言其方。（或起于阴，谓臂 及尻。或起于阳，谓面与项膺背
及胁。请具申之也。）喜怒不节则伤于脏，脏伤则病起于阴；（阴，谓内也。）清湿袭
虚，则病起于下；风雨袭虚，则病起于上，（足阳并于阴，阴虚即清湿袭之，故曰病起
于下也。人之面项阴并于阳，气虚即风雨袭之，故曰病在于上也。）是谓三部。至其淫
佚，不可胜数。（是谓三部之气，生病不同，更随所因，变而生病，漫衍过多，不可量
度也。平按∶佚《灵枢》、《甲乙》作 ，下同。）黄帝问曰∶余固不能数，故问于天
师，愿卒闻其道。（诸邪相传，变化为病，余知不可数量，天师所知，固应穷其至数，
余请卒闻其道。天师，尊之号也。平按∶《灵枢》天师作先师。）岐伯对曰∶风雨寒热，
不得虚邪，不能独伤人。卒然逢疾风豪雨而不病者，亦无虚邪，不能独伤人。必因虚邪
之风，与其身形，两虚相得，乃客其形。（虚邪，即风从虚乡来，故曰虚邪。风雨寒热，
四时正气也。四时正气，不得虚邪之气，亦不能伤人。卒风豪雨，虽非正气，不得虚邪
之气，亦不能伤人。独有虚邪之气，亦不能伤人。必因虚
邪之风，及身形虚相感，故得邪客于形。平按∶亦无虚邪，《甲乙》亦作盖，《灵枢》
同，惟邪上有故字。相得《甲乙》作相搏。）两实相逢，众人肉坚。其中于虚邪也，因
于天时，与其躬身，参以虚实，大病乃成，（风雨寒暑，四时正气，为实风也。众人肉
坚，为实形也。两实相逢，无邪客病也。故虚邪中人，必因天时虚风，并身形虚，合以
虚实也。参，合也。虚者，形虚也。实者，邪气盛实也。两者相合，故大病成也。平按∶
《甲乙》众人肉坚作中人肉间，因于天时作因其天时。躬身《灵枢》作身形。）气有定
舍，因处为名，（邪气舍定之处，即因处以施病名。如邪舍形头，即为头眩等头病也；
若舍于腹，即为腹痛泄利等病也；若舍于足，则为足 不仁之病也。）上下中外，分
为三贞。（上，谓头面也。下，谓尻足也。中，谓腹。三部各有其外也。贞，正也。三
部各有分别，故名三贞也。平按∶贞《灵枢》作员，《甲乙》作真。）是故虚邪之中人
也，始于皮肤，皮肤缓则腠理开，从毛发入，入则柩深，深则毛发立淅然，皮肤痛。
（皮肤缓者，皮肤为邪所中，无力不能收，故缓也。人毛发中虚，故邪从虚中入也。柩，
久也。邪气逆入久深腠理之时，振寒也。平按∶从毛发入《灵枢》作开则邪从毛发入。
柩《灵枢》作抵，《甲乙》作稍。）留而不去，则传舍于络脉，在络脉之时，痛于肌肉，
其痛之时，大经乃代。（去，散邪也。孙络大络，皆称络脉也。十二经脉行皆代息，以大
经在肌肉中，今肌肉痛，故大经代息也。平按∶《甲乙》则传舍于络脉作则舍于络，痛
于肌肉作通于肌肉，其痛之时作其病时痛时息，《灵枢》时下有息字。）
留而不去，传舍于经，在经之时，洫 善惊。（经脉连于五脏，五脏为邪气所动，故其
善惊，惊即洫 振寒也。 音诉。平按∶洫 《灵枢》作洒淅，《甲乙》同。善《灵枢》
作喜。）留而不去，传舍于输，在输之时，六经不通，四肢节痛，腰脊乃强。（输，谓
五脏二十五输，六腑三十六输。大经，谓三阴三阳也。输在四肢，故四肢痛也。足太阳
及督脉在腰脊，邪气循之，故急强也。平按∶输《素问》、《甲乙》作俞。四肢节痛《灵
枢》作四肢则肢节痛，《甲乙》作四节即痛。）留而不去，传舍于伏冲，在伏冲之时，
体重身痛。（冲脉为经络之海，故邪居体重。平按∶传舍《甲乙》作伏舍。伏冲下《灵
枢》、《甲乙》有之脉二字。体重身痛《甲乙》作身体重痛。）留而不去，传舍于肠胃，
舍于肠胃之时，贲向腹胀，多寒则肠鸣飧泄，食不化，多热则溏出糜。（贲向，虚起貌。
多寒则邪为飧泄，多热则邪为溏糜。糜，黄如糜也。平按∶向《灵枢》作响，《甲乙》
作向，袁刻作响。《甲乙》不化上无食字。注貌袁刻误作也。）留而不去，传舍于肠胃之
外，募原之间。（肠胃之腑，外有募原，邪传肠胃之外，溢至募原之间也。）留着于脉，
稽而不去，息而成积。（脉，谓经脉及络脉也。谓邪着于经络之脉，传入肠胃之间，长
息成于积病，此句是总也。平按∶《灵枢》、《甲乙》稽下有留字。）或着孙络，或着
络脉，或着经脉，或着输脉，或着于伏冲之脉，或着于膂筋，或着于肠胃之募原，上连
于缓筋，邪气淫佚，不可胜论。（以下言邪着成积，略言七处，变化滋章，不可复论也。
输脉者，足太阳脉，以管五脏六腑之输，故曰输脉。膂筋，谓肠后脊膂之筋也。缓筋，
谓足阳明筋，以阳明之气主缓。平
按∶孙络《灵枢》作孙脉。注滋章袁刻作滋蔓。）黄帝曰∶愿尽闻其所由然。（愿尽
闻者，愿尽闻于成积所由。）岐伯曰∶其着孙络之脉而成积者，其积往来上下，臂手孙
络之居也，浮而缓，不能勾积而止之，故往来移行，肠间之水，凑渗注灌，濯濯有音，
（居，着也。邪气着于臂手孙络，随络往来上下，其孙络浮缓，不能勾止积气，臂手之
络行在肠间，故邪随络脉往来，令肠间之水凑渗有声也。濯濯，水声也。平按∶《甲乙》
臂手作擘乎，注∶擘音拍，破尽也。勾作 ，肠间之水作肠胃之外，《灵枢》作肠胃之
间水。）有寒则脉 满雷引，故时切痛。（邪循于络，在肠间时，有寒则孙络 满，引
肠而作雷声，时有切痛。平按∶《灵枢》无脉字，《甲乙》脉作腹。）其着于阳明之经，
则侠脐而居，饱食则益大，饥则益小。（胃脉足阳明之经，直者下乳内廉，下侠脐入气
街中，故邪气着之，饱食则其脉粗大，饥少谷气则脉细小，今人称此病两 也。平按∶
《灵枢》侠作挟。）其着于缓筋也，似阳明之积，饱食则痛，饥则安。（缓筋，足阳明
之筋也。邪客缓筋，是足阳明筋从上下腹，侠脐而布，似足阳明经脉之积。饱则大而痛，
饥小而安，亦邪挟经之大小也。平按∶似袁刻作以，注同，《灵枢》亦作似。）其着于
肠胃之募原也，痛而外连于缓筋，饱食则安，饥则痛。（募，谓肠胃腑之募也。原，谓
肠胃腑之原也。募原之气外来连足阳明筋，故邪使饱安饥痛也。平按∶注足阳明筋，袁
刻筋误作经。）其着于伏冲之脉者，揣揣应手而动，发手则热气下于两股，如汤沃之状。
（冲脉下者，注少阴之大络，出于气街，循阴股内廉入 中，伏行 骨内，下至内踝之
属而别，前者伏行出跗属下，循跗入大趾间，以其伏行，故曰伏冲。揣，动也。以手按
之，应手而动，发手则热气下于两股如汤沃，邪之盛也。平按∶揣揣《灵枢》、《甲乙》作揣之。）
其着于膂筋在肠后者，饥则积见，饱则积不见，按之弗得。（膂筋，足少阴筋，循脊内
挟膂，在小肠后附脊。因饥则见，按之可得，饱则不见，按之难得也。平按∶《甲乙》
弗得作伏得。）其着于输之脉者，闭塞不通，津液不下，空窍干壅。（输脉，足太阳脉也。
以管诸输，络肾属膀胱，故邪着之，津液不通，大便干壅，不得下于大小便之窍也。平
按∶空《灵枢》作孔，《甲乙》作而空窍干。）此邪气之从外入内，从上下者。（结邪
行处也。）黄帝曰∶积之始生，至其已成奈何？岐伯曰∶积之始生，得寒乃生，厥上乃
成积也。（夫聚者阳邪，积者阴邪也，此言病成；若言从生，阴阳生也。故积之始生，
邪得寒气，入舍于足，以为积始也，故曰得寒乃生也。寒厥邪气上行，入于肠胃，以成
于积也。平按∶《灵枢》厥下无上字，《甲乙》上作止。）黄帝曰∶成积奈何？岐伯曰∶
厥气生足 ，足 生胫寒，胫寒则血脉 泣，寒气上入肠胃，入于肠胃则 胀， 胀则
肠外之汁沫迫聚不散，日以成积。（以上言成积所由三别。外邪厥逆之气客之，则阳脉
虚，故胫寒。胫脉皮薄，故血寒而 泣。 ，凝也。寒血循于络脉上行，入于肠胃。寒
血入于肠胃，则肠胃之内 胀，肠胃之外冷汁沫聚不得消散，故渐成积也。此为生积所
由一也。平按∶足 《甲乙》作足溢，注云∶《灵枢》作足 。 泣《灵枢》作凝涩，
《甲乙》作凝泣。寒气上《甲乙》作寒热上下。）卒然盛食多饮则脉满，起居不节，用
力过度，则络脉伤，阳络伤则血外溢，外溢则衄血，阴络伤则血内溢，内溢则便血，肠
外之络伤，则血溢于肠外，肠外有寒，汁沫与血相薄，则并合 聚不得散，积成矣。（盛
饮多食无节，遂令脉满，起居用力过度，内络脉伤。若伤肠内阳络，则便衄血；若伤肠
内阴络，遂则便血；若伤肠外之络，则血与寒
汁凝聚为积。此则生积所由二也。平按∶《灵枢》盛食多饮作多食饮，脉满作肠满。
聚《灵枢》、《甲乙》作凝聚，散下有而字。）卒然外中于寒，若内伤于忧怒，则气上
逆。气上逆则六输不通，温气不行， 血蕴裹而不散，津液泣澡，着而不去，而积皆成
矣。（人之卒然外中于寒，以入于内，内伤忧怒，以应于外，内外相搏，厥气逆上，阴
气既盛，遂令六腑阳经六输皆不得通，卫气不行，寒血凝泣，蕴裹不散，着而成积，所
由三也。平按∶忧怒《甲乙》作忧恐，六输作穴俞， 血蕴裹作凝血 裹，泣澡作凝涩，
《灵枢》作涩渗。）黄帝曰∶其生于阴者奈何？岐伯曰∶忧思伤心；（前言积成于阳，
以下言积成于阴。忧思劳神，故伤心也。）重寒伤肺；（饮食外寒，形冷内寒，故曰重
寒。肺以恶寒，故重寒伤肺。）忿怒伤肝；（肝主于怒，故多怒伤肝也。）醉以入房，
汗出当风，则伤脾；（因醉入房，汗出当风，则脾汗得风，故伤脾也。平按∶醉以《甲
乙》作醉饱。）用力过度若入房，汗出浴水，则伤肾。（肾与命门，主于入房，故用
力及入房，汗出浴水，故伤于肾也。平按∶《灵枢》无水字。）此外内三部之所生病者
也。黄帝曰∶善。（忧思为内，重寒为外，入房当风以为内外，故合前三部所生病。平
按∶《灵枢》、《甲乙》外内作内外。）治之奈何？岐伯曰∶察其所痛，以知其应，
有余不足，当补则补，当泻则泻，毋逆天时，是谓至治。（凡积之病，皆有痛也，故察
其痛以候其积。既得其病，顺于四时以行补泻，可得其妙也。）
五邪入∶邪入于阳则为狂；邪入于阴则为血痹；邪入于阳，搏则为癫疾；邪入于阴，
搏则为喑；阳入之于阴，病静；阴出之于阳，病善怒。（热气入于阳脉，重阳故为狂病。
寒邪入于阴
脉，重阴故为血痹。阳邪入于阳脉，聚为癫疾。阳邪入于阴脉，聚为喑不能言。阳邪入
阴者，则为病好静。阴邪出之于阳，阳动故多生怒也。平按∶《素问》五邪入作五邪所
乱，则为血痹作则痹，邪入于阳搏作搏阳二字，邪入于阴搏作搏阴二字，怒上无善字。
新校正云∶“《难经》云∶重阳者狂，重阴者癫。巢元方云∶邪入于阴则为癫。《脉经》
云∶阴附阳则狂，阳附阴则癫。孙思邈云∶邪入于阳则为狂，邪入于阴则为血痹。邪入
于阳，传则为癫痉；邪入于阴，传则为痛喑。全元起云∶邪已入阴，复传于阳，邪气盛，
腑脏受邪，使其气不朝，荣气不复周身，邪与正气相击，发动为癫疾。邪已入阳，阳今
复传于阴，脏腑受邪，故不能言，是胜正也。诸家之说不同，故俱载。”又引全元起云∶
阳入阴则为静，出则为恐。《千金方》云∶阳入于阴病静，阴出于阳病怒。）五发∶阴
病发于骨，阳病发于血，以味病发于气，阳病发于冬，阴病发于夏。（阴之为病，发骨
疼等。阳之为病，发于血痹等。五味为病，发于气不调等。冬阳在内，故病发冬。夏阳
在外，故病发夏也。平按∶《素问》五发作五病所发，以味病发于气作阴病发于肉。）
【平按】：本篇从篇首至“是谓至治”，见于《灵枢》卷十第六十六《百病始生》篇，又见于《甲乙经》卷八第二。从“五邪入”至末尾，见于《素问》卷七第二十三《宣明五气》篇。
黄帝向岐伯问道：各种疾病的产生，都源于风雨寒暑、清湿以及喜怒。（湿气从地而起，雨水从天而降，虽然性质相同，但引发的疾病有所不同。寒气生于外部，清气发于内部，本质是一回事，但起因有内外之分，所导致的疾病也不同。喜属于阳，怒属于阴。这是疾病产生的原因。）喜怒没有节制就会损伤内脏，（心主管喜，肝主管怒，这两者如果发作过度就会损伤神志，损伤神志就是内伤五脏，即中于内部的病部。）风雨会伤害上部，清湿会伤害下部，这三类邪气所伤害的部位各不相同，我希望听听它们汇聚的道理。（风雨从头背部向下侵袭，所以称为上部的邪气。清湿从尾骶脚部向上侵袭，所以称为下部的邪气。所伤害的类型不同，希望请您融会贯通地讲解。）岐伯回答说：三类邪气各不相同，有的起于阴分，有的起于阳分，请允许我说明其规律。（有的起于阴分，指手臂和尾骶部位。有的起于阳分，指面部、项部、胸膺部和背部胁肋。请详细陈述。）喜怒没有节制就会损伤内脏，内脏受损则疾病起于阴分；（阴，指体内。）清湿侵袭虚弱之处，则疾病起于下部；风雨侵袭虚弱之处，则疾病起于上部，（足阳脉并合于阴分，阴虚则清湿侵袭它，所以说疾病起于下部。人的面项阴脉并合于阳分，气虚则风雨侵袭它，所以说疾病在于上部。）这叫做三部。至于邪气淫乱逸散，变化无穷，不可胜数。（这就是说三部的邪气，生病情况不同，更随着病因的变化而产生疾病，蔓延过多，不可计量。平按：佚，《灵枢》、《甲乙经》作“溢”，下同。）黄帝问道：我本来就不能列举尽数，所以向天师请教，希望您能详尽地告诉我其中的道理。（各种邪气相传变，化为疾病，我知道不可数量穷尽，天师您所知，应当穷尽至极的数理，我请求听您说完这个道理。天师，是对您的尊称。平按：《灵枢》中天师作先师。）岐伯回答说：风雨寒热，如果不是虚邪贼风，不能单独伤人。突然遇到疾风暴雨而不生病的人，也是因为如果没有虚邪之气，就不能单独伤人。必须因为虚邪之风，加上人体自身的虚弱，两虚相感，邪气才能客居在形体之中。（虚邪，就是风从虚乡吹来，所以叫虚邪。风雨寒热，是四时的正气。四时正气，如果没有虚邪之气，也不能伤人。卒来的狂风暴雨，虽然不是正气，如果没有虚邪之气，也不能伤人。只有虚邪之气，也不能伤人。必须因为虚邪之风，以及人体形体的虚弱相互感应，所以邪气得以客居于形体。平按：亦无虚邪，《甲乙经》也作盖，《灵枢》相同，只是邪字上有故字。相得，《甲乙经》作相搏。）两实相逢，众人肌肉坚实。（其中被虚邪所伤，是因为天时因素，加上自身身体，参合虚实，大病才形成，（风雨寒暑，是四时正气，为实风。众人肌肉坚实，为实形。两实相逢，就没有邪气客居致病。所以虚邪中人，必须因为天时的虚风，并身形虚弱，合以虚实。参，合的意思。虚者，形体虚弱。实者，邪气盛实。两者相合，所以大病形成。平按：《甲乙经》众人肉坚作中人肉间，因于天时作因其天时。躬身，《灵枢》作身形。）气有固定的居所，根据所在部位命名，（邪气停留的固定处所，就根据该处所施以病名。比如邪气停留在头部，就是头眩等头部疾病；如果停留在腹部，就是腹痛泄利等疾病；如果停留在足部，就是足部麻木不仁的疾病。）上下中外，分为三正。（上，指头面。下，指尾骶足部。中，指腹部。三部各有其外。贞，正的意思。三部各有分别，所以叫三正。平按：贞，《灵枢》作员，《甲乙经》作真。）所以虚邪侵入人体，始于皮肤，皮肤松弛则腠理开泄，从毛发进入，进入则逐渐深入，深入则毛发竖立感到寒冷战栗，皮肤疼痛。（皮肤松弛，是因为皮肤被邪气所中，无力收敛，所以松弛。人毛发中空虚，所以邪气从虚处进入。柩，久的意思。邪气逆入久深腠理之时，出现振寒。平按：从毛发入，《灵枢》作开则邪从毛发入。柩，《灵枢》作抵，《甲乙经》作稍。）停留不去，则传舍于络脉，在络脉的时候，肌肉疼痛，当疼痛的时候，大经脉随之受影响。（去，消散邪气。孙络大络，都称为络脉。十二经脉运行都交替呼吸，因为大经脉在肌肉中，现在肌肉痛，所以大经交替呼吸。平按：《甲乙经》则传舍于络脉作则舍于络，痛于肌肉作通于肌肉，其痛之时作其病时痛时息，《灵枢》时下有息字。）
停留不去，传舍于经，在经的时候，容易惊惧。（经脉连于五脏，五脏被邪气所动，所以容易惊惧，惊惧就是洒淅振寒。 音诉。平按：洫 ，《灵枢》作洒淅，《甲乙经》同。善，《灵枢》作喜。）
停留不去，传舍于输，在输的时候，六经不通，四肢关节疼痛，腰脊僵硬。（输，指五脏二十五输穴，六腑三十六输穴。大经，指三阴三阳。输在四肢，所以四肢痛。足太阳及督脉在腰脊，邪气循行于此，所以急强。平按：输，《素问》、《甲乙经》作俞。四肢节痛，《灵枢》作四肢则肢节痛，《甲乙经》作四节即痛。）
停留不去，传舍于伏冲之脉，在伏冲的时候，身体沉重疼痛。（冲脉是经络之海，所以邪气居留导致体重。平按：传舍，《甲乙经》作伏舍。伏冲下，《灵枢》、《甲乙经》有之脉二字。体重身痛，《甲乙经》作身体重痛。）
停留不去，传舍于肠胃，舍于肠胃的时候，腹胀满，多寒则肠鸣飧泄，食物不消化，多热则大便溏薄如糜。（贲向，虚起的样子。多寒则邪致飧泄，多热则邪致溏糜。糜，黄如粥泥。平按：向，《灵枢》作响，《甲乙经》作向，袁刻作响。《甲乙经》不化上无食字。注貌袁刻误作也。）
停留不去，传舍于肠胃之外，募原之间。（肠胃之腑，外有募原，邪气传至肠胃之外，溢至募原之间。）留着于脉，稽留不去，喘息而成积。（脉，指经脉及络脉。指邪着于经络之脉，传入肠胃之间，长久喘息成于积病，此句是总括。平按：《灵枢》、《甲乙经》稽下有留字。）或者着于孙络，或者着于络脉，或者着于经脉，或者着于输脉，或者着于伏冲之脉，或者着于膂筋，或者着于肠胃之募原，上连于缓筋，邪气淫乱逸散，不可胜论。（以下言邪着成积，略言七处，变化滋章，不可复论也。输脉者，足太阳脉，以管五脏六腑之输，故曰输脉。膂筋，谓肠后脊膂之筋也。缓筋，谓足阳明筋，以阳明之气主缓。平按：孙络，《灵枢》作孙脉。注滋章袁刻作滋蔓。）黄帝说：希望能详尽听闻其成因。（愿尽闻者，愿尽闻于成积所由。）岐伯说：那些着于孙络而成积的，其积往来上下，位于臂手孙络所在，浮而缓，不能勾住积气而止住它，所以往来移行，肠间的水液，凑渗注灌，发出濯濯的声音，（居，着的意思。邪气着于臂手孙络，随络往来上下，其孙络浮缓，不能勾止积气，臂手之络行在肠间，所以邪随络脉往来，令肠间之水凑渗有声。濯濯，水声。平按：《甲乙经》臂手作擘乎，注：擘音拍，破尽也。勾作 ，肠间之水作肠胃之外，《灵枢》作肠胃之间水。）有寒则脉满雷引，所以时常切痛。（邪循于络，在肠间时，有寒则孙络满，引肠而作雷声，时有切痛。平按：《灵枢》无脉字，《甲乙经》脉作腹。）那些着于阳明经的，则夹脐而居，饱食则更大，饥饿则更小。（胃脉足阳明经，直行者下乳内廉，下夹脐入气街中，所以邪气着之，饱食则其脉粗大，饥少谷气则脉细小，今人称此病两 。平按：《灵枢》侠作挟。）那些着于缓筋的，似阳明之积，饱食则痛，饥饿则安。（缓筋，足阳明之筋。邪客缓筋，是足阳明筋从上下腹，夹脐而布，似足阳明经脉之积。饱则大而痛，饥小而安，也是邪挟经的大小。平按：似袁刻作以，注同，《灵枢》亦作似。）那些着于肠胃之募原的，痛而外连于缓筋，饱食则安，饥饿则痛。（募，谓肠胃腑之募。原，谓肠胃腑之原。募原之气外来连足阳明筋，所以邪使饱安饥痛。平按：注足阳明筋，袁刻筋误作经。）那些着于伏冲之脉的，揣揣应手而动，放手则热气下于两股，像热水浇淋的样子。（冲脉下者，注少阴之大络，出于气街，循阴股内廉入 中，伏行 骨内，下至内踝之属而别，前者伏行出跗属下，循跗入大趾间，以其伏行，故曰伏冲。揣，动。以手按之，应手而动，发手则热气下于两股如汤沃，邪之盛。平按：揣揣，《灵枢》、《甲乙经》作揣之。）那些着于膂筋在肠后的，饥饿则积见，饱食则积不见，按之不得。（膂筋，足少阴筋，循脊内挟膂，在小肠后附脊。因饥则见，按之可得，饱则不见，按之难得。平按：《甲乙经》弗得作伏得。）那些着于输之脉的，闭塞不通，津液不下，空窍干壅。（输脉，足太阳脉。以管诸输，络肾属膀胱，所以邪着之，津液不通，大便干壅，不得下于大小便之窍。平按：空，《灵枢》作孔，《甲乙经》作而空窍干。）这是邪气从外入内，从上下的。（结邪行处。）黄帝说：积的开始生成，到它已经形成怎么办？岐伯说：积的开始生成，得到寒气才生成，厥气上行才成为积。（夫聚者阳邪，积者阴邪，此言病成；若言从生，阴阳生。故积之始生，邪得寒气，入舍于足，以为积始，故曰得寒乃生。寒厥邪气上行，入于肠胃，以成于积。平按：《灵枢》厥下无上字，《甲乙经》上作止。）黄帝说：如何形成积？岐伯说：厥气生足 ，足 生胫寒，胫寒则血脉凝涩，寒气上入肠胃，入于肠胃则胀，胀则肠外之汁沫迫聚不散，日以成积。（以上言成积所由三别。外邪厥逆之气客之，则阳脉虚，故胫寒。胫脉皮薄，故血寒而凝涩。 ，凝。寒血循于络脉上行，入于肠胃。寒血入于肠胃，则肠胃之内胀，肠胃之外冷汁沫聚不得消散，故渐成积。此为生积所由一。平按：足 ，《甲乙经》作足溢，注云：《灵枢》作足 。泣，《灵枢》作凝涩，《甲乙经》作凝泣。寒气上，《甲乙经》作寒热上下。）突然暴饮暴食则脉满，起居不节，用力过度，则络脉伤，阳络伤则血外溢，外溢则衄血，阴络伤则血内溢，内溢则便血，肠外之络伤，则血溢于肠外，肠外有寒，汁沫与血相薄，则并合凝聚不得散，积成矣。（盛饮多食无节，遂令脉满，起居用力过度，内络脉伤。若伤肠内阳络，则便衄血；若伤肠内阴络，遂则便血；若伤肠外之络，则血与寒汁凝聚为积。此则生积所由二。平按：《灵枢》盛食多饮作多食饮，脉满作肠满。聚，《灵枢》、《甲乙经》作凝聚，散下有而字。）突然外中于寒，若内伤于忧怒，则气上逆。气上逆则六输不通，温气不行，凝血蕴裹而不散，津液凝涩，着而不去，而积皆成矣。（人之卒然外中于寒，以入于内，内伤忧怒，以应于外，内外相搏，厥气逆上，阴气既盛，遂令六腑阳经六输皆不得通，卫气不行，寒血凝涩，蕴裹不散，着而成积，所由三。平按：忧怒，《甲乙经》作忧恐，六输作穴俞， 血蕴裹作凝血 裹，泣澡作凝涩，《灵枢》作涩渗。）黄帝说：那些生于阴分的怎么样？岐伯说：忧思伤心；（前言积成于阳，以下言积成于阴。忧思劳神，故伤心。）重寒伤肺；（饮食外寒，形冷内寒，故曰重寒。肺以恶寒，故重寒伤肺。）忿怒伤肝；（肝主于怒，故多怒伤肝。）醉以入房，汗出当风，则伤脾；（因醉入房，汗出当风，则脾汗得风，故伤脾。平按：醉以，《甲乙经》作醉饱。）用力过度若入房，汗出浴水，则伤肾。（肾与命门，主于入房，故用力及入房，汗出浴水，故伤于肾。平按：《灵枢》无水字。）这是外内三部所生的疾病。黄帝说：好。（忧思为内，重寒为外，入房当风以为内外，故合前三部所生病。平按：《灵枢》、《甲乙经》外内作内外。）治疗怎么样？岐伯说：察其所痛，以知其应，有余不足，当补则补，当泻则泻，毋逆天时，是谓至治。（凡积之病，皆有痛，故察其痛以候其积。既得其病，顺于四时以行补泻，可得其妙。）
五邪入：邪入于阳则为狂；邪入于阴则为血痹；邪入于阳，搏则为癫疾；邪入于阴，搏则为喑；阳入之于阴，病静；阴出之于阳，病善怒。（热气入于阳脉，重阳故为狂病。寒邪入于阴脉，重阴故为血痹。阳邪入于阳脉，聚为癫疾。阳邪入于阴脉，聚为喑不能言。阳邪入阴者，则为病好静。阴邪出之于阳，阳动故多生怒。平按：《素问》五邪入作五邪所乱，则为血痹作则痹，邪入于阳搏作搏阳二字，邪入于阴搏作搏阴二字，怒上无善字。新校正云：“《难经》云：重阳者狂，重阴者癫。巢元方云：邪入于阴则为癫。《脉经》云：阴附阳则狂，阳附阴则癫。孙思邈云：邪入于阳则为狂，邪入于阴则为血痹。邪入于阳，传则为癫痉；邪入于阴，传则为痛喑。全元起云：邪已入阴，复传于阳，邪气盛，腑脏受邪，使其气不朝，荣气不复周身，邪与正气相击，发动为癫疾。邪已入阳，阳今复传于阴，脏腑受邪，故不能言，是胜正也。诸家之说不同，故俱载。”又引全元起云：阳入阴则为静，出则为恐。《千金方》云：阳入于阴病静，阴出于阳病怒。）五发：阴病发于骨，阳病发于血，以味病发于气，阳病发于冬，阴病发于夏。（阴之为病，发骨疼等。阳之为病，发于血痹等。五味为病，发于气不调等。冬阳在内，故病发冬。夏阳在外，故病发夏。平按：《素问》五发作五病所发，以味病发于气作阴病发于肉。）
[Ping An]: This section, from the beginning of the chapter to "is called the highest treatment," is found in *Ling Shu* (Spiritual Pivot), Volume 10, Chapter 66, "The Origin of Hundred Diseases," and also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 8, Section 2. From "Five Evils Enter" to the end, it is found in *Su Wen* (Basic Questions), Volume 7, Chapter 23, "The Manifestation of Five Qi."
Yellow Emperor asked Qibo: The onset of various diseases all arises from wind, rain, cold, heat, clear dampness, and emotions of joy and anger. (Dampness arises from the earth, rain falls from above; although their nature is similar, the diseases they cause differ. Cold originates externally, clear qi emerges internally; though essentially one thing, their origins are internal or external, leading to different diseases. Joy belongs to Yang, anger belongs to Yin. These are the causes of disease.) Unregulated joy and anger will damage the Zang organs. (The Heart governs joy, the Liver governs anger. If these two emotions arise excessively, they damage Shen (Spirit). Damaging Shen constitutes internal injury to the five Zang organs, which is the internal sector of disease.) Wind and rain damage the upper part, while clear dampness damages the lower part. The three types of pathogenic factors damage different areas; I wish to hear how they converge. (Wind and rain descend from the head and back, thus constituting upper pathogenic factors. Clear dampness ascends from the sacrum and feet, thus constituting lower pathogenic factors. Since the types of damage differ, I hope you will explain them comprehensively.) Qibo replied: The three types of pathogenic factors are different; some originate in the Yin, and some in the Yang. Please allow me to explain their principles. (Some originate in Yin, referring to the arms and sacrum. Some originate in Yang, referring to the face, neck, chest, back, and flanks. I will elaborate fully.) Unregulated joy and anger damage the Zang organs; when Zang organs are damaged, disease originates in Yin. (Yin refers to the interior.) Clear dampness attacks deficiency, so disease originates in the lower part; wind and rain attack deficiency, so disease originates in the upper part. (When Foot Yang meridians merge with Yin, Yin deficiency allows clear dampness to attack, hence disease originates in the lower part. When facial and neck Yin meridians merge with Yang, Qi deficiency allows wind and rain to attack, hence disease resides in the upper part.) This is called the Three Parts. As for the rampant dispersion of pathogens, changes are countless. (This means that the three parts of pathogenic factors cause different diseases, varying with the cause, spreading extensively beyond measure. Ping An: Yi in *Ling Shu* and *Jia Yi Jing* is written as Yi [overflow], same below.) Yellow Emperor asked: I cannot enumerate them all, so I ask the Heavenly Master; please tell me this principle completely. (Various evils transmit and transform into disease; I know they cannot be counted. What the Heavenly Master knows should reach the ultimate numbers; I request to hear your complete explanation. Heavenly Master is a title of respect. Ping An: In *Ling Shu*, Heavenly Master is written as Former Master.) Qibo replied: Wind, rain, cold, and heat, if not empty evil (Xu Xie), cannot harm people alone. Those who suddenly encounter fierce winds and heavy rains without getting sick do so because, without empty evil, they cannot be harmed alone. It must be due to the wind of empty evil combined with the body's own deficiency; when two deficiencies meet, the pathogen can reside in the form. (Empty evil refers to wind coming from an empty direction, hence called empty evil. Wind, rain, cold, and heat are the correct Qi of the four seasons. Correct Qi of the four seasons, without the Qi of empty evil, cannot harm people. Sudden fierce winds and heavy rains, though not correct Qi, cannot harm people without the Qi of empty evil. Only the Qi of empty evil cannot harm people either. It requires the wind of empty evil and the body's deficiency to resonate, allowing the pathogen to reside in the form. Ping An: "Also no empty evil" in *Jia Yi Jing* is written as Gai; *Ling Shu* is the same, only with the character Gu before Xi. "Xiang De" in *Jia Yi Jing* is written as Xiang Bo.) When two realities meet, the masses have firm flesh. (Being attacked by empty evil depends on heavenly timing and one's own body, combining emptiness and fullness, leading to major illness. (Wind, rain, cold, and heat are the four seasons' correct Qi, constituting Real Wind. Firm flesh of the masses constitutes Real Form. When two realities meet, no pathogen resides to cause disease. Thus, when empty evil enters humans, it must be due to heavenly timing's empty wind and bodily deficiency, combining emptiness and fullness. Can means combine. Emptiness refers to bodily deficiency. Fullness refers to abundant pathogenic Qi. The combination of the two leads to major illness. Ping An: "Zhong Ren Rou Jian" in *Jia Yi Jing* is written as Zhong Ren Rou Jian; "Yin Yu Tian Shi" as Yin Yu Tian Shi. Gong Shen in *Ling Shu* is written as Shen Xing.) Qi has fixed abodes, named according to location. (The fixed place where pathogenic Qi resides determines the disease name based on that location. For example, if pathogenic Qi resides in the head, it causes head diseases like dizziness; if in the abdomen, abdominal pain and diarrhea; if in the feet, numbness in the feet.) Upper, lower, middle, and exterior are divided into three Zheng. (Upper refers to the face and head. Lower refers to the sacrum and feet. Middle refers to the abdomen. Each of the three parts has its exterior. Zhen means correct. Each of the three parts has distinctions, hence called Three Zheng. Ping An: Zhen in *Ling Shu* is written as Yuan; in *Jia Yi Jing* as Zhen.) Therefore, when empty evil enters humans, it starts at the skin. If the skin is lax, pores open, entering through hair follicles. Once entered, it goes deeper; once deep, hair stands erect causing chills, and the skin hurts. (Skin laxity occurs because the skin is struck by pathogenic Qi, losing tension, hence lax. Human hair follicles are hollow, so pathogenic Qi enters through this void. Jiu means long. When pathogenic Qi reverses and penetrates deeply into the interstices over time, chills occur. Ping An: "Cong Mao Fa Ru" in *Ling Shu* is written as Kai Ze Xie Cong Mao Fa Ru. Jiu in *Ling Shu* is written as Di; in *Jia Yi Jing* as Shao.) If it stays and does not leave, it transits to the Luo vessels. At this stage, there is muscle pain, and when painful, the large meridians are affected. (Qu means dissipating pathogenic Qi. Sun Luo and Da Luo are both called Luo vessels. The twelve main meridians circulate alternately; since the large meridians are in the muscles, current muscle pain affects the large meridians' circulation. Ping An: "Ze Chuan She Yu Luo Mai" in *Jia Yi Jing* is written as Ze She Yu Luo; "Tong Yu Ji Rou" as Tong Yu Ji Rou; "Qi Bing Shi" as Qi Bing Shi Tong Shi Xi; *Ling Shu* has Xi character after Xia.)
If it stays and does not leave, it transits to the Jing meridians. At this stage, there is frequent fright. (Meridians connect to the five Zang organs; when Zang organs are moved by pathogenic Qi, fright occurs. Fright is synonymous with Sa Xi chills. Su sound. Ping An: Xu , in *Ling Shu* is written as Sa Xi; same in *Jia Yi Jing*. Shan in *Ling Shu* is written as Xi.)
If it stays and does not leave, it transits to the Shu points. At this stage, the six meridians are blocked, limbs and joints ache, and the waist and spine become stiff. (Shu refers to the twenty-five Shu points of the five Zang organs and thirty-six Shu points of the six Fu organs. Large meridians refer to the Three Yin and Three Yang. Shu points are in the limbs, hence limb pain. Foot Taiyang and Du Meridian are in the waist and spine; pathogenic Qi follows them, causing stiffness. Ping An: Shu in *Su Wen* and *Jia Yi Jing* is written as Yu. "Si Zhi Jie Tong" in *Ling Shu* is written as Si Zhi Ze Zhi Jie Tong; in *Jia Yi Jing* as Si Jie Ji Tong.)
If it stays and does not leave, it transits to the Fu Chong vessel. At this stage, the body feels heavy and painful. (Chong Meridian is the sea of meridians; thus, pathogenic residence causes heaviness. Ping An: "Chuan She" in *Jia Yi Jing* is written as Fu She. After Fu Chong, *Ling Shu* and *Jia Yi Jing* have Zhi Mai two characters. "Ti Zhong Shen Tong" in *Jia Yi Jing* is written as Shen Ti Zhong Tong.)
If it stays and does not leave, it transits to the stomach and intestines. Residing in the stomach and intestines, there is distension and fullness. With much cold, there is borborygmus and undigested stool diarrhea; with much heat, there is loose, mushy stool. (Ben Xiang describes a vacuous rising appearance. Much cold leads to pathogenic undigested stool diarrhea; much heat leads to pathogenic loose mush. Mi means yellow like porridge. Ping An: Xiang in *Ling Shu* is written as Xiang; in *Jia Yi Jing* as Xiang; Yuan edition writes Xiang. *Jia Yi Jing* lacks Shi character before Bu Hua. Note: Mao in Yuan edition is mistakenly written as Ye.)
If it stays and does not leave, it transits outside the stomach and intestines, between the Mu Yuan. (Outside the stomach and intestines fu organs, there is Mu Yuan; pathogenic Qi transmits outside the stomach and intestines, overflowing to the space between Mu Yuan.) If it lingers in the vessels, detaining and not leaving, breathing accumulates into a mass. (Mai refers to Jing meridians and Luo vessels. Pathogenic Qi adheres to the meridians and vessels, transmitting into the stomach and intestines, accumulating into a mass disease over time; this sentence is a summary. Ping An: *Ling Shu* and *Jia Yi Jing* have Liu character after Qi.) It may adhere to Sun Luo, or to Luo vessels, or to Jing meridians, or to Shu vessels, or to Fu Chong vessels, or to Lv Jin, or to Mu Yuan of the stomach and intestines, connecting upwards to Huan Jin. The rampant dispersion of pathogenic Qi is indescribable. (Below discusses pathogenic adherence forming masses, briefly mentioning seven locations; changes are complex and cannot be fully discussed. Shu vessel refers to Foot Taiyang meridian, managing Shu points of five Zang and six Fu organs, hence called Shu vessel. Lv Jin refers to the tendons behind the spine. Huan Jin refers to Foot Yangming tendons, as Yangming Qi governs relaxation. Ping An: Sun Luo in *Ling Shu* is written as Sun Mai. Note: Zi Zhang in Yuan edition is written as Zi Man.) Yellow Emperor said: I wish to hear completely how it happens. (Wishing to hear completely means wishing to hear completely how masses form.) Qibo said: For those adhering to Sun Luo vessels forming masses, the mass moves up and down. Located in the arm and hand Sun Luo, which are floating and lax, unable to detain the mass Qi, it moves back and forth. Water in the intestines gathers and seeps, making a Zhuo Zhuo sound. (Ju means adhering. Pathogenic Qi adheres to arm and hand Sun Luo, moving up and down with the vessels. The Sun Luo is floating and lax, unable to detain mass Qi. Arm and hand vessels run through the intestinal area, so pathogenic Qi follows the vessels, causing water in the intestines to gather and make sound. Zhuo Zhuo is the sound of water. Ping An: *Jia Yi Jing* writes Bi Shou as Bo Hu; note: Bo sounds like Pai, meaning broken completely. Gou is written as ; Chang Jian Zhi Shui is written as Chang Wei Zhi Wai; *Ling Shu* writes Chang Jian Zhi Jian Shui.) With cold, the vessels fill and thunder pulls, causing occasional sharp pain. (Pathogenic Qi follows the vessels; when in the intestinal area, with cold, Sun Luo fills, pulling the intestines to make thunderous sounds, causing occasional sharp pain. Ping An: *Ling Shu* lacks Mai character; *Jia Yi Jing* writes Mai as Fu.) For those adhering to the Yangming Meridian, the mass resides beside the navel. After a full meal, it becomes larger; when hungry, it becomes smaller. (Stomach meridian, Foot Yangming Meridian, straight branch descends along the inner breast, beside the navel, entering Qi Street. Thus, when pathogenic Qi adheres, after a full meal the vessel is coarse and large; when hungry with less grain Qi, the vessel is fine and small. People today call this disease Liang . Ping An: Xia in *Ling Shu* is written as Jia.) For those adhering to Huan Jin, it resembles Yangming mass. After a full meal, it hurts; when hungry, it is comfortable. (Huan Jin is Foot Yangming tendon. Pathogenic Qi residing in Huan Jin means Foot Yangming tendon runs from upper and lower abdomen, beside the navel, resembling Foot Yangming Meridian mass. Full makes it large and painful; hungry makes it small and comfortable, also reflecting the size change of pathogenic Qi in the meridian. Ping An: Si in Yuan edition is written as Yi, note same; *Ling Shu* also writes Si.) For those adhering to Mu Yuan of the stomach and intestines, it hurts and connects externally to Huan Jin. After a full meal, it is comfortable; when hungry, it hurts. (Mu refers to the Mu of stomach and intestines fu organs. Yuan refers to the Yuan of stomach and intestines fu organs. Mu Yuan Qi connects externally to Foot Yangming tendon, so pathogenic Qi causes comfort when full and pain when hungry. Ping An: Note Foot Yangming Jin, Yuan edition mistakenly writes Jing.) For those adhering to Fu Chong vessel, it throbs and responds to touch. Upon releasing hand, hot air descends to both thighs, like boiling water pouring. (Lower Chong Meridian injects into large Luo of Shaoyin, exits Qi Street, follows inner thigh, enters Zhong, lies hidden inside bone, descends to ankle junction then branches; former lies hidden exiting dorsum descending, follows dorsum entering big toe gap. Because it lies hidden, it is called Fu Chong. Chuai means move. Pressing with hand, it moves responding to touch; releasing hand, hot air descends to both thighs like boiling water, indicating severe pathogenic Qi. Ping An: Chuai Chuai in *Ling Shu* and *Jia Yi Jing* is written as Chuai Zhi.) For those adhering to Lv Jin behind the intestines, the mass appears when hungry, disappears when full, and cannot be felt upon pressing. (Lv Jin is Foot Shaoyin tendon, following spine internally clamping Lv, attaching to spine behind small intestine. Appears when hungry, palpable when pressed; disappears when full, hard to feel when pressed. Ping An: *Jia Yi Jing* writes Fu De as Fu De.) For those adhering to Shu vessels, blockage occurs, fluids do not descend, orifices become dry and obstructed. (Shu vessel is Foot Taiyang meridian. Managing all Shu points, connecting to Kidney and belonging to Bladder, thus when pathogenic Qi adheres, fluids do not flow, stool becomes dry and obstructed, unable to exit via urination and defecation orifices. Ping An: Kong in *Ling Shu* is written as Kong; in *Jia Yi Jing* as Er Kong Qian Gan.) This is pathogenic Qi entering from exterior to interior, from upper to lower. (Location where pathogenic Qi knots and travels.) Yellow Emperor said: How does the initial formation of a mass proceed until it is fully formed? Qibo said: Masses initially form, arising from cold, and ascending Jue Qi forms the mass. (Ju is Yang pathogenic Qi, Ji is Yin pathogenic Qi; this speaks of disease completion; if speaking of generation, it involves Yin-Yang generation. Thus, mass initial formation, pathogen obtains cold Qi, enters and resides in foot, marking mass start, hence arising from cold. Cold Jue pathogenic Qi ascends, enters stomach and intestines, forming mass. Ping An: Under Jue in *Ling Shu* lacks Shang character; *Jia Yi Jing* writes Shang as Zhi.) Yellow Emperor said: How is the mass formed? Qibo said: Jue Qi generates foot overflow, foot overflow generates calf cold, calf cold causes blood vessels to coagulate and stagnate. Cold Qi ascends into stomach and intestines; entering stomach and intestines causes distension; distension forces extraintestinal fluid droplets to gather and not disperse, gradually forming a mass. (Above explains three origins of mass formation. External pathogenic Jue rebellious Qi attacks, causing Yang meridians to be deficient, hence calf cold. Calf vessels have thin skin, hence blood cold and coagulation/stagnation. Coagulation means solidifying. Cold blood follows Luo vessels upward, entering stomach and intestines. Cold blood entering stomach and intestines causes internal distension; cold fluid droplets outside intestines gather and cannot disperse, thus gradually forming mass. This is origin one of mass generation. Ping An: Zu in *Jia Yi Jing* is written as Zu Yi; note: *Ling Shu* writes Zu . Qi in *Ling Shu* is written as Ning Se; in *Jia Yi Jing* as Ning Qi. Han Qi Shang in *Jia Yi Jing* is written as Han Re Shang Xia.) Sudden excessive eating and drinking causes vessel fullness. Irregular living habits and excessive effort injure Luo vessels. Injury to Yang Luo causes blood to overflow externally, resulting in epistaxis. Injury to Yin Luo causes blood to overflow internally, resulting in hematochezia. Injury to extraintestinal Luo causes blood to overflow outside intestines. If there is cold outside intestines, fluid droplets and blood clash, combining and aggregating without dispersing, forming a mass. (Excessive drinking and eating without restraint causes vessel fullness. Irregular living and excessive effort injure internal Luo vessels. If internal Yang Luo of intestines is injured, epistaxis results; if internal Yin Luo of intestines is injured, hematochezia results; if extraintestinal Luo is injured, blood and cold fluid coagulate into mass. This is origin two of mass generation. Ping An: Sheng Shi Duo Yin in *Ling Shu* is written as Duo Shi Yin; Mai Man as Chang Man. Ju in *Ling Shu* and *Jia Yi Jing* is written as Ning Ju; San has Er character after it.) Sudden external strike by cold, or internal injury by sorrow and anger, causes Qi to rebel upward. Upward rebelling Qi blocks the six Shu points, preventing warm Qi from circulating. Coagulated blood is wrapped and does not disperse; fluids coagulate and stagnate, adhering and not leaving, thus masses form. (Sudden external cold entering internally, internal injury by sorrow and anger responding externally, internal and external clash, Jue Qi rebels upward. With abundant Yin Qi, six Fu organ Yang meridians and six Shu points cannot communicate, Wei Qi does not circulate, cold blood coagulates and stagnates, wraps and does not disperse, adhering to form mass, this is origin three. Ping An: You Nu in *Jia Yi Jing* is written as You Kong; Liu Shu as Xue Yu; Xue Yun Guo as Ning Xue Yun Guo; Qi Zao as Ning Se; *Ling Shu* writes Se Shen.) Yellow Emperor said: How about those originating in Yin? Qibo said: Worry and thought damage Heart. (Previously spoke of mass forming in Yang; below speaks of mass forming in Yin. Worry and thought labor Shen, thus damaging Heart.) Double cold damages Lung. (Dietary external cold, physical internal cold, hence double cold. Lung dislikes cold, thus double cold damages Lung.) Anger damages Liver. (Liver governs anger, thus excessive anger damages Liver.) Intercourse while drunk, sweating facing wind, damages Spleen. (Intercourse while drunk, sweating facing wind, Spleen sweat receives wind, thus damaging Spleen. Ping An: Zui Yi in *Jia Yi Jing* is written as Zui Bao.) Excessive effort or intercourse, sweating bathing in water, damages Kidney. (Kidney and Ming Men govern intercourse, thus effort and intercourse, sweating bathing in water, damages Kidney. Ping An: *Ling Shu* lacks Shui character.) These are the diseases generated by external, internal, and three parts. Yellow Emperor said: Good. (Worry and thought are internal, double cold is external, intercourse and facing wind constitute external/internal, thus combining the previous three parts' diseases. Ping An: *Ling Shu* and *Jia Yi Jing* write Wai Nei as Nei Wai.) How to treat? Qibo said: Observe the pain to know the response. With excess or deficiency, tonify if needed, drain if needed. Do not go against heavenly timing; this is called the highest treatment. (All mass diseases have pain; thus observe pain to await mass. Having obtained the disease, follow four seasons to apply tonification and drainage, achieving subtlety.)
Five Evils Enter: Evil entering Yang causes mania; evil entering Yin causes Blood Bi. Evil entering Yang, clashing causes epilepsy; evil entering Yin, clashing causes aphonia. Yang entering Yin, disease is quiet; Yin exiting to Yang, disease manifests as irritability. (Hot Qi entering Yang meridians, double Yang causes mania. Cold evil entering Yin meridians, double Yin causes Blood Bi. Yang evil entering Yang meridians, gathering causes epilepsy. Yang evil entering Yin meridians, gathering causes aphonia unable to speak. Yang evil entering Yin causes disease favoring quietness. Yin evil exiting to Yang, Yang movement causes frequent anger. Ping An: *Su Wen* Wu Xie Ru is written as Wu Xie Suo Luan; Ze Wei Xue Bi ze is written as Bi; Xie Ru Yu Yang Bo is written as Bo Yang two characters; Xie Ru Yu Yin Bo is written as Bo Yin two characters; Shang Wu Shan character before Nu. Xin Zheng Xiao says: "Nan Jing says: Double Yang is mania, double Yin is epilepsy. Chao Yuan Fang says: Evil entering Yin is epilepsy. Mai Jing says: Yin attaching to Yang is mania, Yang attaching to Yin is epilepsy. Sun Simiao says: Evil entering Yang is mania, evil entering Yin is Blood Bi. Evil entering Yang, transmitting causes epilepsy/spasm; evil entering Yin, transmitting causes pain/aphonia. Quan Yuanqi says: Evil already entered Yin, re-transmits to Yang, pathogenic Qi abundant, Zang-Fu receive evil, causing Qi not to arrive, Ying Qi not to circulate whole body, evil clashes with correct Qi, activating epilepsy. Evil already entered Yang, Yang now re-transmits to Yin, Zang-Fu receive evil, thus unable to speak, this is overcoming correct Qi. Various schools differ, thus all recorded." Also quotes Quan Yuanqi: Yang entering Yin is quiet, exiting is fear. Qian Jin Fang says: Yang entering Yin disease is quiet, Yin exiting to Yang disease is anger.) Five Manifestations: Yin disease manifests in bones, Yang disease manifests in blood, flavor disease manifests in Qi, Yang disease manifests in winter, Yin disease manifests in summer. (Yin disease manifests as bone pain etc. Yang disease manifests as Blood Bi etc. Five flavors disease manifests as Qi imbalance etc. Winter Yang is inside, thus disease manifests in winter. Summer Yang is outside, thus disease manifests in summer. Ping An: *Su Wen* Wu Fa is written as Wu Bing Suo Fa; Yi Wei Bing Fa Yu Qi is written as Yin Bing Fa Yu Rou.)