黄帝问曰。人有重身。九月而喑。此为何也。论奇恒之府。而为奇恒之病也。五脏别论曰。脑髓骨脉胆女子胞。
此六者。名为奇恒之府。是以本篇之所论。有犯大寒。内至骨髓。上逆于脑之脑髓骨病。脉解篇之脉病。口苦之胆病。
九月而喑。及母腹中受惊之女子胞病。皆奇恒之府而为病也。盖此六者。地气之所生。皆藏于阴。而象于地。与气之通
于天。病之变化者之不同。故所谓奇病也。张兆璜曰。一因子以病母。一因母以病子。妊娠子母。性命相关。岐伯对曰。
胞之络脉绝也。（胞之络脉。胞络之脉也。绝谓阻隔不通也。盖妊至九月。胞长已足。设有碍于胞络。即使阻绝而不通。）
帝曰。何以言之。岐伯曰。胞络者。系于肾。少阴之脉。贯肾系舌本。故不能言。（声音之道。在心主言。在肺主声。然
由肾间之动气。上出于舌。而后能发其音声。故曰。舌者。音声之机也。胞之络脉系于肾。足少阴之脉。贯肾系舌本。
胞之络脉阻绝。则少阴之脉亦不通。是以舌不能发机而为喑矣。）帝曰。治之奈何。岐伯曰。无治也。当十月复。（十月
胎出。则胞络通而音声复矣。）刺法曰。无损不足。益有余。以成其疹。然后调之。（刺法、谓针经内之法也。疹、病也。
言毋损其不足。益其有余。使成其病。而后复调治之。）所谓无损不足者。身羸瘦。无用 石也。（ 、谓针。石、砭石
也。针经曰。形气不足。病气不足。此阴阳气俱不足也。不可刺之。刺之则重不足。重不足则阴阳俱竭。血气皆尽。五
脏空虚。筋骨髓枯。老者绝灭。壮者不复矣。是以身羸瘦者。不可妄用针石。此章重在有余。而兼引其不足。）无益其有
余者。腹中有形而泄之。泄之则精出。而病独擅中。故曰疹成也。（泄、谓用针泻之。针经曰。刺之害。中而不去则精泄。
精泄则病益甚而 。按腹中胞积。皆为有形。在女子胞则曰无益其有余。在息积曰不可灸刺。在伏梁曰不可动之。是腹
中有形者。皆不可刺泄。刺虽中病。而有形之物不去。则反泄其精气。正气出而邪病反独擅于其中。故为疹成也。朱圣
公曰。女子胞。腹中积。皆为有余。）帝曰。病胁下满气逆。二三岁不已。是为何病。岐伯曰。病名曰息积。此不妨于
食。不可灸刺。积为导引服药。药不能独治也。（此肺积之为病也。肺主气而司呼吸定息。故肺之积曰息奔。在本经曰息
积。积者渐积而成。是以二三岁不已。夫肝肺之积。皆主胁下满。积在肝则妨于食。此积在肺。故不妨于食也。此病腹
中有形。不可灸刺。凡积当日用导引之功。调和之药。二者并行。斯病可愈。若只用药而不导引。则药不能以独治也。）
帝曰。人有身体髀股 皆肿。环脐而痛。是为何病。岐伯曰。病名曰伏梁。此风根也。其气溢于大肠。而着于肓。肓之
原在脐下。故环脐而痛也。不可动之。动之为水溺涩之病也。（此其气积于大肠之外而为伏梁也。大肠为肺之府。气逆不
通。是以身体髀股 皆肿。此根因于风邪伤气。留溢于大肠之间。而着于肓。肓者。即肠外之膏膜。其原出于脖 。正
在脐下。故环脐而痛也。不可动者。不可妄攻以动之。盖风气留溢于脐下。与水脏水腑相连。动之则风行水涣。而为水
病矣。水逆于上。则小便为之不利矣。张兆璜曰。奇恒之病。多因于积聚厥逆。
前论腹中。此论奇恒。不可谓之重出而置之勿论。应略曰。腹积有五。止论肺与大肠者。谓病在气
也。故在肺曰气逆。在大肠则曰其气溢于大肠。）帝曰。人有尺脉数甚。筋急而见。此为何病。岐伯曰。此所谓疹筋。
（此论诸筋之为病也。夫奇恒之势。诊有十度。度脉、度脏、度肉、度筋、度俞、度阴阳气。如心脉满大。肝脉小急。
脉来悬钩。脉至如喘之类。皆所以度脉也。如肝满肾满肺满则为肿。肝气予不足。木叶落而死。肾气予不足。去枣华而
死。皆所以度脏也。如肌气予不足。肤胀身肿。大肉陷下。皆所以度肉也。诊筋之病。所以度筋也。如十二俞之予不足。
水凝而死。所以度俞也。如正月太阳。三月厥阴。五月阳明。十月少阴。所以度阴阳气也。皆为病之异于恒常者也。夫
内有阴阳。外有阴阳。在外者皮肤为阳。筋骨为阴。是以筋病急而尺脉数也。）是人腹必急。白色黑色见。则病甚。（诸
筋之会。聚于宗筋。冲脉者。主渗灌溪谷。与阳明合于宗筋。是以筋病而腹必急也。夫十二经之筋病。惟手太阴甚。则
成息贲胁急吐血。是少阴筋病甚者。死不治。是以白色黑色见者。则病甚也。）帝曰。人有病头痛。以数岁不已。此
安得之。名为何病。岐伯曰。当有所犯大寒。内至骨髓。髓者以脑为主。脑逆。故令头痛齿亦痛。病名曰厥逆。帝曰。
善。（此论脑骨髓之为病也。夫在地为水。在天为寒。寒生水。水生咸。咸生肾。肾生骨髓。故所犯大寒之气。而内至骨
髓也。诸髓皆属于脑。故以脑为主。髓邪上逆。则入于脑。是以头痛数岁不已。齿乃骨之余。故齿亦痛也。此下受之寒。
上逆行巅顶。故名曰厥逆。）帝曰。有病口甘者。病名为何。何以得之。岐伯曰。此五气之溢也。名曰脾瘅。（五气者。
土气也。土位中央。在数为五。在味为甘。在臭为香。在脏为脾。在窍为口。多食甘美。则臭味留于脾中。脾气溢而证
见于外窍也。瘅、热也。按金匮要略曰。一者经络受邪。入脏腑为内所因。二者四肢九窍。血脉相传。壅塞不通。为外
皮肤所中也。三者房室金刃虫兽所伤。若人能养慎。更能无犯王法。禽兽灾伤。房室勿令竭乏。服食节其冷热苦酸辛甘。
如此人数食甘美。而致口甘消渴者。乃不内外因之病也。故列于奇病之中。）夫五味入口。藏于胃。脾为之行其精气。津
液在脾。故令人口甘也。此肥美之所发也。此人必数食甘美而多肥也。肥者令人内热。甘者令人中满。故其气上溢。转
为消渴。（脾主为胃行其津液者也。五味入口。津液各走其道。苦先入心。酸先入肝。甘先入脾。辛先入肺。咸先入肾。
此人必数食甘美而多肥。美者香美。肥者浓味也。浓味令人内热。甘者主于留中。津液不能输布于五脏。而独留在脾。
脾气上溢。发为口甘。内热不清。转为消渴。）治之以兰。除陈气也。（兰、香草。陈气、积气也。盖味有所积。以臭行
之。从其类而治之也。）帝曰。有病口苦。取阳陵泉口苦者。病名为何。何以得之。（胆病者口苦。阳陵泉、胆之合穴
也。帝言有病口苦。取阳陵泉而口苦者。病名为何。何以得之。按灵枢经曰。其寒热者。取阳陵泉。夫寒热。实证也。
此系胆虚气溢。当取募俞。不当取其合穴。故口苦之不愈也。）岐伯曰。病名曰胆瘅。夫肝者。中之将也。取决于胆。咽
为之使。（肝者将军之官。谋虑出焉。胆者中正之官。决断出焉。夫谋虑在肝。决断在胆。故肝为中之将。而取决于胆也。
肝脉挟胃贯膈。循喉咙。入颃颡。环唇内。故咽为肝之外使。是以肝病而亦证见于口也。）此人者。数谋虑不决。故胆虚
气上溢。而口为之苦。（谋虑不决。则肝气郁而胆气虚矣。胆之虚气上溢。而口为之苦矣。上节论脾气实。此论胆气虚。
虚实之气。皆能为热而成瘅。）治之以胆募俞。治在阴阳十二官相使中。（王冰曰。胸腹曰募。背脊曰俞。胆募在乳下二
肋外。期门下。同身寸之五分。俞在脊第十四椎两旁。相去脊中各一寸五分。其所治之法。在阴阳十二官相使中。今经
已亡。愚谓七十二篇系刺法论。抑或在此篇中。今所补遗经二篇。乃后人 撰者也。）帝曰。有癃者。一日数十溲。此
不足也。身热如炭。颈膺如格。人迎躁盛。喘息气逆。此有余也。太阴脉微细如发者。此不足也。其病安在。名为何病。
（此论阴阳二气。生于太阴阳明。阴阳不和而为死证也。夫水谷入胃。脾主行其津液。太阴为之行气于三阴。阳明为之
行气于三阳。太阴不足则阳明甚盛。太过不及则阴阳不和。阴阳不和则表里之气皆绝矣。夫入胃之饮。上输入脾。脾气
散精。上归于肺。通调水道。下输膀胱。今太阴病而不能转输于上。颇在肺而不能通调于下。则病癃矣。夫地气升而为
云。天气降而为雨。今地气不能上升。而惟下泄。是以一日数十溲。此太阴之不足也。阳明者表也。身热如炭。阳明盛
也。阳明脉挟喉。其 在膺中。颈膺如格。胃气强也。阳明盛强。则人迎躁急。颇关在肺。故喘息气逆。此阳明之有余
也。阳明盛强。则与脾阴相绝。太阴不得受水谷之精。是以脉微如发。此太阴之不足也。）岐伯曰。病在太阴。其盛在胃。
颇在肺。病名曰厥。死不治。（此病在太阴与胃肺也。夫阳明乃燥热之经。从中见太阴之湿化。太阴不足。则胃气热而人
迎躁盛矣。胃气上逆。颇关在肺。而为喘息气逆矣。胃气盛强。不能游溢精气。而太阴不足矣。太阴不足。则五脏六腑
皆无所受气。而为厥逆之死证也。兆璜曰。伤寒论云。胃气生热。其阳则绝。盖胃气生热。则阳明与太阴绝。而太阴
不足矣。太阴不足。则太阴与阳明绝。而胃中燥盛矣。阴阳表里之相关也。）此所谓得五有余。二不足也。帝曰。何谓五
有余二不足。岐伯曰。所谓五有余者。五病气之有余也。二不足者。亦病气之不足也。（此言有余不足之皆为病也。五有
余者。谓身热如炭。颈膺如格。人迎躁盛。喘息而气逆。此五病气之有余也。二不足者。病癃。一日数十溲。太阴脉微
细如发。亦病气之不足也。兆璜曰。在阳明曰五病气。在太阴曰亦病气。是先因有余。而致病不足也。）今外得五有余。
内得二不足。此其身不表不里。亦正死明矣。（阳明者表也。外得五有余。不能行气于表之三阳矣。太阴主里。内得二不
足。不能行气于里之三阴矣。此其身之表里阴阳皆为断绝。亦正死也明矣。）帝曰。人生而有病巅疾者。病名曰何。安
所得之。岐伯曰。病名为胎病。此得之在母腹中时。其母有所大惊。气上而不下。精气并居。故令子发为巅疾也。（此女
子胞之为病也。有所大惊。则气暴上而不下。夫精以养胎。而精气并居者也。母受惊而气上。则子之精气亦逆。故令子
发为巅疾也。愚谓巅亦作癫。按婴儿癫痫。多因母腹中受惊所致。然癫疾者。逆气之所生也。故因气上逆而发为癫疾。
兆
璜曰。胎中受病。非止惊痫。妊娠女子。饮食起居。大宜谨慎。则生子聪俊。无病长年。）帝曰。有病 然。如有水状。
切其脉大紧。身无痛者。形不瘦。不能食。食少。名为何病。（ 然、浮肿貌。如有水状者。水气上乘。非有形之水也。
是少阴寒水主气。大则为风。紧则为寒。故其脉大紧也。夫病风水者。外证骨节疼痛。此病在肾。非外受之风邪。故身
无痛也。水气上乘。故形不瘦。风木水邪。乘侮土气。故不能食。即食而亦不能多也。兆璜曰。邪干上焦则不能食。
在中焦则食少也。）岐伯曰。病生在肾。名为肾风。（肾为水脏。水生风木。此肾脏自生之风。非外受之邪。故曰病生在
肾。兆璜曰。天有六淫。人亦有六气。奇恒之病。多不因于外邪。）肾风而不能食。善惊。惊已心气痿者死。帝曰。善。
（水者火之胜。不能食者。水邪直入于上焦也。善惊者。水气搏于心下也。夫心不受邪。惊已而心气痿者。心受邪伤也。）
黄帝问道：有人怀有双胎，到了第九个月时出现失音的症状，这是什么原因呢？本篇论述的是奇恒之腑（形态似腑、功能似脏的器官）相关的奇异疾病。《五脏别论》中说：脑、髓、骨、脉、胆、女子胞（子宫），这六者被称为奇恒之腑。因此本篇所论述的疾病，包括受大寒侵袭，寒气深入骨髓，上逆于脑的脑髓骨病；《脉解篇》中提到的脉病；口苦的胆病；怀孕九月而失音；以及母腹中受惊导致的女子胞疾病，都属于奇恒之腑发生的病变。大概因为这六者是由地气所生，都藏纳于阴，象征大地，与天气相通及病情变化不同，所以称为“奇病”。张兆璜说：一种是因子病及母，一种是因母病及子。妊娠期间母子性命相连。岐伯回答说：这是因为胞宫的络脉阻隔不通。（胞宫的络脉，即联系胞宫的经脉。“绝”意为阻隔不通。大概怀孕到第九个月，胞宫发育已足，如果有阻碍胞络的情况，就会导致阻隔不通。）
黄帝问：为什么这样说？岐伯说：胞络系属于肾，足少阴肾经贯穿肾脏并系连舌根，所以不能说话。（声音的产生，心主言语，肺主发声，但由肾间的动气，向上出于舌，然后才能发出声音。所以说，舌是音声的关键机关。胞宫的络脉系属于肾，足少阴经脉贯穿肾脏系连舌根，胞络阻隔不通，则少阴经脉也不通，因此舌不能发挥机关作用而导致失音。）
黄帝问：如何治疗？岐伯说：不需要治疗，等到第十个月胎儿娩出后，症状就会恢复。（十月胎儿出生，胞络通畅，声音自然恢复。）《刺法》说：不要损伤不足的正气，也不要补益有余的邪气，以免加重病情形成疹疾，然后再进行调理。（《刺法》指《针经》内的治疗方法。“疹”指疾病。意思是不要损伤正气不足，不要补益邪气有余，使其成为病症，然后再调治。）所谓不损伤不足，是指身体消瘦虚弱的人，不要用砭石针刺。（“ ”指针刺，“石”指砭石。《针经》说：形体之气不足，病气也不足，这是阴阳之气都不足，不可针刺。如果针刺，会造成双重不足，双重不足则阴阳俱竭，血气耗尽，五脏空虚，筋骨骨髓枯竭，老年人会死亡，强壮的人也难以恢复。所以身体消瘦虚弱者，不可妄用针石。这一章重点在于论述有余，同时兼引不足的情况。）不要补益有余，是指腹中有形积块却用泻法，泻之则精气外泄，而病邪独留于体内，所以称为疹疾形成。（“泄”指用针泻法。《针经》说：针刺的危害，如果中病而不及时停止，就会耗泄精气。精气泄则病更重。按腹中的胞积等，都是有形之物，在女子胞则说“无益其有余”，在息积则说“不可灸刺”，在伏梁则说“不可攻动”。所以腹中有形之物，都不可针刺泻除。即使针刺中病，但有形之物不去，反而泄去精气，正气外出而邪病反独留其中，所以导致疹疾形成。朱圣公说：女子胞、腹中积块，都属于有余。）
黄帝问：有人胁下胀满，气机上逆，两三年不好，这是什么病？岐伯说：病名叫做息积。这种病不影响饮食，不可用灸法和针刺，积聚应当用导引术配合服药治疗，单靠药物不能单独治愈。（这是肺积的病证。肺主气而司呼吸定息，所以肺的积病叫息奔，在本经中叫息积。积是逐渐积累而成的，所以两三年不好。肝肺的积病，都表现为胁下胀满。积在肝则妨碍饮食，此积在肺，所以不妨碍饮食。此病腹中有形，不可灸刺。凡是积病，应当每天做导引功，服用调和药物，两者并行，病才可愈。如果只用药而不导引，则药不能单独治愈。）
黄帝问：有人身体大腿和小腿都肿胀，环绕肚脐疼痛，这是什么病？岐伯说：病名叫做伏梁。这是风邪留下的病根。其气溢于大肠，并附着于肓膜。肓的原气在脐下，所以环绕肚脐疼痛。不可攻动它，攻动它会导致小便涩滞的病变。（这是气积聚在大肠之外形成的伏梁。大肠是肺的腑，气逆不通，所以身体大腿小腿都肿胀。这根本原因是风邪伤气，停留溢于大肠之间，并附着于肓。肓，就是肠外的膏膜，其原气出于脖胦，正好在脐下，所以环绕肚脐疼痛。不可动，指不可妄加攻伐以扰动它。因为风气停留溢于脐下，与水脏水腑相连，扰动它则风行水散，从而产生水病。水气上逆，则小便不利。张兆璜说：奇恒之病，多因于积聚厥逆。前文论述腹中积，此文论述奇恒之病，不可说是重复而忽略不论。简要地说：腹积有五种，这里只论述了肺和大肠的，是因为病在气分。所以在肺叫气逆，在大肠则叫其气溢于大肠。）
黄帝问：有人尺部脉搏跳动很快，筋脉拘急且显露出来，这是什么病？岐伯说：这叫做疹筋。（这是论述各种筋的病证。奇恒之病的诊察有十种度法：度脉、度脏、度肉、度筋、度俞、度阴阳气。如心脉满大，肝脉小急，脉来像钩一样悬起，脉至像喘气一样急促之类，都是用来度脉的。如肝满、肾满、肺满则浮肿，肝气予不足，木叶落而死，肾气予不足，枣花落时死，都是用来度脏的。如肌气予不足，肤胀身肿，大肉陷下，都是用来度肉的。诊察筋的病，是用来度筋的。如十二俞予不足，水凝而死，是用来度俞的。如正月太阳，三月厥阴，五月阳明，十月少阴，是用来度阴阳气的。这些都是异于常人的病证。内有阴阳，外有阴阳，在外者皮肤为阳，筋骨为阴，所以筋病急而尺脉数。）这种人腹部一定拘急，如果面色现白色或黑色，则病重。（诸筋聚会于宗筋，冲脉主要渗灌溪谷，与阳明经合于宗筋，所以筋病则腹部一定拘急。十二经的筋病，只有手太阴严重时会形成息贲、胁急、吐血；少阴筋病严重的，死亡无法医治。所以见到白色或黑色，则病重。）
黄帝问：有人患病头痛，多年不愈，这是怎么得的？叫什么病？岐伯说：应当是遭受了大寒，寒气内入骨髓。髓是以脑为主的，脑气上逆，所以令头痛，牙齿也痛，病名叫做厥逆。黄帝说：好。（这是论述脑骨髓的病证。在地为水，在天为寒，寒生水，水生咸，咸生肾，肾生骨髓，所以所犯的大寒之气，内入骨髓。诸髓都归属于脑，所以以脑为主。髓邪上逆，则入于脑，所以头痛多年不愈。齿是骨的余气，所以牙齿也痛。这是下部受寒，向上逆行至巅顶，所以名叫厥逆。）
黄帝问：有人患病口甜，病名是什么？怎么得的？岐伯说：这是五气溢出，名叫脾瘅。（五气，即土气。土位中央，在数为五，在味为甘，在臭为香，在脏为脾，在窍为口。多吃甘美食物，则臭味留于脾中，脾气溢出而证候见于外窍。瘅，即热。按《金匮要略》说：一是经络受邪，入脏腑为内所因；二是四肢九窍，血脉相传，壅塞不通，为外皮肤所中；三是房室、金刃、虫兽所伤。如果人能养慎，又不犯王法，避免禽兽灾伤，房室不使过度，饮食节制冷热苦酸辛甘，这样的人多次食用甘美食物而导致口甘消渴的，属于不内外因的病。所以列于奇病之中。）五味入口，藏于胃，脾为之运行精气。津液留在脾，所以使人感到口甜。这是由肥美食物引发的。这种人必定经常食用甘美而多脂肪的食物。肥腻使人内热，甘甜使人中焦痞满，所以其气上溢，转而变为消渴。（脾主为胃运行津液。五味入口，津液各走其道，苦先入心，酸先入肝，甘先入脾，辛先入肺，咸先入肾。这种人必定经常食用甘美而多脂肪的食物。美指香美，肥指浓味。浓味令人内热，甘味主于留中，津液不能输布于五脏，而独留在脾，脾气上溢，发为口甘，内热不清，转为消渴。）用兰草治疗，以去除陈积之气。（兰，即香草；陈气，即积滞之气。大概味道有所积聚，用气味来化解，顺从其类而治疗。）
黄帝问：有人患病口苦，取阳陵泉穴治疗，口苦仍不愈，病名是什么？怎么得的？（胆病者口苦，阳陵泉是胆的下合穴。黄帝说有病人取阳陵泉而口苦不愈，问病名及成因。按《灵枢经》说：寒热病，取阳陵泉。夫寒热是实证。此处系胆虚气溢，应当取募穴和俞穴，不当取其合穴，所以口苦不愈。）岐伯说：病名叫做胆瘅。肝是将帅之官，取决于胆，咽喉是它的使者。（肝是将军之官，谋虑由此发出；胆是中正之官，决断由此发出。谋虑在肝，决断在胆，所以肝为中之将，而取决于胆。肝脉挟胃贯膈，循喉咙，入颃颡，环唇内，所以咽为肝之外使，肝病也会证候见于口。）这种人常常谋虑不决，所以胆气虚，气上溢而口苦。（谋虑不决，则肝气郁结而胆气虚。胆的虚气上溢，所以口苦。上一节论述脾气实，本节论述胆气虚，虚实之气，都能化为热而成瘅。）用胆的募穴和俞穴治疗，治疗方法在阴阳十二官相使的理论中。（王冰说：胸腹叫募，背脊叫俞。胆募在乳下二肋外侧，期门穴下，同身寸五分；俞在脊第十四椎两旁，距脊中各一寸五分。其所治之法，在阴阳十二官相使中。现在经文已亡佚，我认为七十二篇系《刺法论》，或许在此篇中。现在所补遗的经二篇，是后人撰写的。）
黄帝问：有人患癃病，一天几十次小便，这是不足的表现；身体发热像炭火，颈部和胸部像格拒不通，人迎脉躁动盛大，喘息气逆，这是有余的表现；太阴脉微细如头发，这是不足的表现。病在哪里？叫什么病？（这是论述阴阳二气生于太阴阳明，阴阳不和而成为死证。水谷进入胃，脾主行其津液，太阴为之在三阴经行气，阳明为之在三阳经行气。太阴不足则阳明甚盛，太过不及则阴阳不和，阴阳不和则表里之气都断绝。进入胃的饮食，上输入脾，脾气散精，上归于肺，通调水道，下输膀胱。现在太阴病而不能转输于上，颇涉肺而不能通调于下，则发生癃病。地气上升为云，天气下降为雨。现在地气不能上升，而只向下泄，所以一天几十次小便，这是太阴不足。阳明是表，身体热如炭，是阳明盛。阳明脉挟喉，其在膺中，颈膺如格，是胃气强。阳明盛强，则人迎躁急，颇涉在肺，所以喘息气逆，这是阳明有余。阳明盛强，则与脾阴相绝，太阴不得受水谷之精，所以脉微如发，这是太阴不足。）岐伯说：病在太阴，其盛在胃，颇涉在肺，病名叫做厥，死亡无法医治。（此病在太阴与胃肺。阳明乃燥热之经，从中见太阴之湿化。太阴不足，则胃气热而人迎躁盛。胃气上逆，颇涉在肺，而为喘息气逆。胃气盛强，不能游溢精气，而太阴不足。太阴不足，则五脏六腑皆无所受气，而为厥逆之死证。兆璜说：《伤寒论》云：胃气生热，其阳则绝。盖胃气生热，则阳明与太阴绝，而太阴不足。太阴不足，则太阴与阳明绝，而胃中燥盛。这是阴阳表里的相关关系。）这就是所谓的五有余、二不足。黄帝问：什么叫五有余二不足？岐伯说：所谓五有余，是五种病气的有余；二不足，也是病气的不足。（这是说有余不足皆为病。五有余，指身热如炭，颈膺如格，人迎躁盛，喘息而气逆，这五种是病气的有余。二不足，指病癃，一日数十溲，太阴脉微细如发，也是病气的不足。兆璜说：在阳明曰五病气，在太阴曰亦病气，是先因有余，而致病不足。）现在外得五有余，内得二不足，此人身之表里阴阳皆断绝，也是明显的死证。（阳明是表，外得五有余，不能行气于表之三阳。太阴主里，内得二不足，不能行气于里之三阴。此人身之表里阴阳都为断绝，显然是死证。）
黄帝问：人生下来就患有巅顶疾病的，叫什么病？怎么得的？岐伯说：病名叫做胎病，这是在母腹中时得的。当时他的母亲受到大惊吓，气上而不下，精气并居，所以令孩子发为巅疾。（这是女子胞的病。有大惊，则气暴上而不下。精以养胎，而精气并居。母亲受惊而气上，则孩子的精气也逆，所以令孩子发为巅疾。我认为巅也作癫。按婴儿癫痫，多因母腹中受惊所致。然癫疾者，是逆气所生，故因气上逆而发为癫疾。兆璜说：胎中受病，不止惊痫。妊娠女子，饮食起居，大宜谨慎，则生子聪俊，无病长年。）
黄帝问：有人患病浮肿，好像有水状，切其脉大紧，身体无痛，形体不瘦，不能食，吃得少，叫什么病？（“ 然”是浮肿貌。如有水状，是水气上乘，不是有形之水。这是少阴寒水主气，大则为风，紧则为寒，所以其脉大紧。患风水病的外证是骨节疼痛，此病在肾，非外受之风邪，所以身无痛。水气上乘，所以形不瘦。风木水邪，乘侮土气，所以不能食，即食也不能多。兆璜说：邪干上焦则不能食，在中焦则食少。）岐伯说：病生在肾，名叫肾风。（肾为水脏，水生风木，这是肾脏自生的风，非外受的邪，所以叫病生在肾。兆璜说：天有六淫，人亦有六气。奇恒之病，多不因于外邪。）肾风而不能食，容易惊吓，惊吓后若心气痿废则死。黄帝说：好。（水是火的胜气，不能食，是水邪直入上焦。善惊，是水气搏于心下。心不受邪，惊吓后若心气痿废，是心受邪伤了。）
Huangdi asked: "There is a person carrying twins who becomes aphonic (loss of voice) in the ninth month. What is the cause of this?" This chapter discusses diseases related to the Qi Heng Zhi Fu (Extraordinary Fu Organs, organs that resemble Fu in structure but function like Zang). As stated in the *Lun Wu Zang Bie* (Treatise on the Distinction of the Five Zang Organs): Brain, Marrow, Bone, Vessels, Gallbladder, and Nv Zi Bao (Uterus) are these six, named the Qi Heng Zhi Fu. Therefore, the diseases discussed in this chapter—including brain and bone diseases caused by severe cold invading deep into the marrow and reversing upward to the brain; vessel diseases mentioned in the *Mai Jie Pian*; gallbladder diseases manifesting as bitter taste; aphonia at nine months of pregnancy; and uterine diseases caused by fright during gestation—all belong to pathologies of the Qi Heng Zhi Fu. These six are generated by Earth Qi, stored in Yin, and symbolize the Earth, differing from Heaven Qi and the changes of disease, hence they are called 'Qi Bing' (Strange Diseases). Zhang Zhaohuang said: One involves the child affecting the mother, the other the mother affecting the child. During pregnancy, the life and destiny of mother and child are interconnected. Qibo replied: "It is because the collateral vessels of the uterus are obstructed." (The collateral vessels of the uterus refer to the meridians connecting to the uterus. 'Jue' means blocked and unconnected. By the ninth month of pregnancy, the uterus is fully developed; if there is an obstruction in the uterine collaterals, it leads to blockage.)
Huangdi asked: "Why do you say so?" Qibo said: "The uterine collaterals are connected to the Kidney. The Foot-Shaoyin Kidney Meridian passes through the Kidney and connects to the root of the tongue, thus causing inability to speak." (The mechanism of sound involves the Heart governing speech and the Lung governing voice, but it arises from the moving Qi between the Kidneys, emerging upward through the tongue to produce sound. Thus, the tongue is the pivot of sound. Since the uterine collaterals connect to the Kidney, and the Foot-Shaoyin Meridian passes through the Kidney to connect to the tongue root, obstruction of the uterine collaterals blocks the Shaoyin Meridian, preventing the tongue from functioning as a pivot, resulting in aphonia.)
Huangdi asked: "How should it be treated?" Qibo said: "No treatment is needed; after ten months when the fetus is born, the condition will resolve." (After the tenth month, when the fetus is delivered, the uterine collaterals become unobstructed, and voice returns.) The *Ci Fa* (Methods of Needling) states: "Do not damage deficiency, do not tonify excess, lest you create a pathological state (Zhen), and only then regulate." ('Zhen' refers to disease. It means do not damage deficient Zheng Qi or tonify excess Xie Qi, which would worsen the condition into a disease, before proceeding with regulation.) To 'not damage deficiency' refers to emaciated and weak individuals who should not use Bian Shi (stone needles). (*Zhen Jing* says: If both physical Qi and pathogenic Qi are deficient, indicating a deficiency of both Yin and Yang Qi, needling is contraindicated. Needling would cause double deficiency, leading to exhaustion of Yin and Yang, depletion of Blood and Qi, emptiness of the Five Zang, and withering of sinews, bones, and marrow. The elderly would perish, and even the strong would not recover. Thus, emaciated individuals must not recklessly use needle stones.) To 'not tonify excess' refers to using draining methods for palpable masses in the abdomen; draining causes Essence to leak out while pathogenic factors remain dominant internally, thus forming a pathological state. ('Xie' refers to draining via needling. *Zhen Jing* warns: If needling hits the target but is not stopped promptly, Essence leaks, worsening the disease. Palpable masses in the abdomen, such as uterine accumulations, are tangible. For the uterus, it is said 'do not tonify excess'; for Xi Ji, 'moxibustion and needling are forbidden'; for Fu Liang, 'do not move it.' Therefore, palpable abdominal masses should not be drained by needling. Even if needling addresses symptoms, if the tangible mass remains, it drains Zheng Qi while allowing pathogens to dominate, creating a pathological state. Zhu Shenggong noted: Uterine conditions and abdominal accumulations belong to Excess.)
Huangdi asked: "A person has fullness below the costal margin and rebellious Qi, persisting for two or three years. What disease is this?" Qibo said: "The disease is named Xi Ji (Breathing Accumulation). It does not interfere with eating, and moxibustion or needling is contraindicated. Accumulations require Daoyin (qigong exercises) combined with herbal medicine; herbs alone cannot cure it." (This is a Lung accumulation. The Lung governs Qi and respiration, hence its accumulation is called Xi Ben. In this classic, it is called Xi Ji. Accumulations form gradually, hence lasting years. Liver and Lung accumulations both cause hypochondriac fullness. Liver accumulation interferes with eating; since this is a Lung accumulation, eating is unaffected. As there is a palpable mass in the abdomen, moxibustion and needling are forbidden. For all accumulations, daily Daoyin practice and harmonizing herbs must be used together for recovery. Without Daoyin, herbs alone are insufficient.)
Huangdi asked: "A person has swelling of the thighs and calves, and pain encircling the navel. What disease is this?" Qibo said: "The disease is named Fu Liang (Hidden Beam). It is rooted in Wind Pathogen. Its Qi overflows into the Large Intestine and attaches to the Huang (Diaphragmatic Mesoenteron). The source of Huang is below the navel, hence the periumbilical pain. It must not be moved/aggressively treated, as doing so causes difficulty in urination." (This is Fu Liang formed by Qi accumulating outside the Large Intestine. The Large Intestine is the Fu organ of the Lung. Rebellious Qi causes blockage, leading to swelling of the body, thighs, and calves. The root cause is Wind injuring Qi, lingering in the Large Intestine, and attaching to Huang. Huang refers to the fatty membrane outside the intestines, originating from Bo Yang, located below the navel, causing periumbilical pain. 'Do not move' means do not aggressively attack. Wind lingering below the navel connects with Water Zang and Fu organs; disturbing it causes Wind to scatter Water, leading to Water Disease. Reverse-flowing Water causes dysuria. Zhang Zhaohuang noted: Qi Heng diseases often stem from Accumulations and Rebellion. Previous chapters discussed abdominal accumulations; this chapter discusses Qi Heng diseases. Briefly, there are five types of abdominal accumulations; here only Lung and Large Intestine are discussed because the pathology is in Qi. Hence, in the Lung it is called Qi Rebellion, and in the Large Intestine, Qi overflow.)
Huangdi asked: "A person has a rapid pulse at the Chi position, with spasmodic and visible sinews. What disease is this?" Qibo said: "This is called Zhen Jin (Rash Sinew Disease)." (This discusses various sinew diseases. Diagnosis of Qi Heng diseases involves ten measurements: Pulse, Zang, Flesh, Sinew, Shu points, and Yin-Yang Qi. E.g., full/large Heart pulse, small/urgent Liver pulse, suspended-hook pulse, panting-like pulse measure the Pulse. Swelling from full Liver/Kidney/Lung, death due to deficient Liver/Kidney Qi measure the Zang. Skin edema and sunken muscles measure Flesh. Measuring Sinew diseases measures Sinew. Death from frozen water due to deficient Twelve Shu points measures Shu. Seasonal meridian dominance (e.g., Taiyang in Jan, Jueyin in Mar) measures Yin-Yang Qi. These are deviations from normal. Internally and externally have Yin/Yang; skin is Yang, sinews/bones are Yin. Hence, urgent sinew disease presents with rapid Chi pulse.) If the abdomen is tight and white or black colors appear on the face, the disease is severe." (Sinews converge at Zong Jin. Chong Mai irrigates valleys and merges with Yangming at Zong Jin, so sinew disease causes abdominal tightness. Among the twelve sinew channels, Hand-Taiyang severity causes Xi Fen, rib tightness, and hemoptysis; severe Shaoyin sinew disease is fatal. Thus, white or black facial colors indicate severity.)
Huangdi asked: "A person suffers from headache for many years without relief. How did this occur? What is the name?" Qibo said: "It results from exposure to severe cold penetrating to the marrow. Marrow is governed by the Brain. Brain Qi rebels upward, causing headache and toothache. The disease is named Jue Ni (Rebellious Counterflow)." (This discusses Brain and Marrow diseases. On earth is Water, in heaven is Cold. Cold generates Water, Water generates Salty, Salty generates Kidney, Kidney generates Marrow. Thus, severe cold enters the marrow. All marrow belongs to the Brain. Pathogenic Marrow Qi rebels upward into the Brain, causing chronic headache. Teeth are the surplus of bone, hence toothache. Cold from below rebels to the vertex, hence named Jue Ni.)
Huangdi asked: "A person has a sweet taste in the mouth. What is the disease? How is it acquired?" Qibo said: "This is the overflow of Five Qi, named Pi Dan (Spleen Heat)." (Five Qi refers to Earth Qi. Earth is central, number five, flavor sweet, odor fragrant, Zang Spleen, orifice Mouth. Excessive sweet food leaves residue in the Spleen, causing Spleen Qi to overflow and manifest in the orifice. 'Dan' means heat. According to *Jin Gui Yao Lue*, causes include internal transmission, external skin/qiao invasion, and trauma/sexual excess. Dietary excess leading to sweet taste and Xiao Ke (Wasting-Thirst) is a non-internal/non-external cause, hence listed among Qi Bing.) When five flavors enter the mouth, they store in the Stomach, and the Spleen distributes their Jing Qi. Fluids remain in the Spleen, causing sweet taste. This originates from rich/greasy foods. Such people eat much sweet and fatty food. Fatty foods generate internal heat; sweet foods cause middle-jiao fullness. Qi overflows upward, transforming into Xiao Ke." (The Spleen distributes fluids for the Stomach. Flavors enter specific Zang: Bitter to Heart, Sour to Liver, Sweet to Spleen, Pungent to Lung, Salty to Kidney. Rich/fatty foods cause internal heat; sweet foods retain in the middle. Fluids fail to distribute to the Five Zang, staying in the Spleen. Spleen Qi overflows, causing sweet taste. Internal heat persists, transforming into Xiao Ke.) Treat with Lan Cao (Orchid/Iris herb) to remove stale Qi." (Lan is aromatic herb; Chen Qi is accumulated stale Qi. Use aroma to resolve accumulation, treating according to similarity.)
Huangdi asked: "A person has bitter taste. Why does needling Yang Ling Quan fail to cure it? What is the disease? How acquired?" (Gallbladder disease causes bitter taste. Yang Ling Quan is the He-Sea point of the Gallbladder. Huangdi asks why needling this point fails. *Ling Shu* says treat cold-heat with Yang Ling Quan. Cold-heat is Excess. Here, it is Deficiency of Gallbladder Qi overflowing. One should use Mu and Shu points, not He-Sea points, hence failure.) Qibo said: "The disease is named Dan Dan (Gallbladder Heat). The Liver is the General, depending on the Gallbladder. The throat is its envoy." (Liver is the General of strategy; Gallbladder is the Official of Justice making decisions. Strategy is in Liver, decision in Gallbladder. Liver channel passes through stomach/diaphragm, follows throat, enters nasopharynx, circles lips. Throat is the external envoy of Liver. Liver disease manifests in the mouth.) Such people constantly deliberate without deciding, causing Gallbladder Qi deficiency and upward overflow, leading to bitter taste." (Indecision causes Liver Qi stagnation and Gallbladder Qi deficiency. Deficient Gallbladder Qi overflows, causing bitter taste. Previous section discussed Spleen Excess; this discusses Gallbladder Deficiency. Both Excess and Deficiency can generate Heat and Dan.) Treat with Gallbladder Mu and Shu points. The method lies in the interaction of the Twelve Officials of Yin and Yang." (Wang Bing: Mu points on chest/abdomen, Shu points on back. Gallbladder Mu is Qimen, 0.5 cun below periodontal line; Shu is BL19, 1.5 cun lateral to spine. The text regarding 'Twelve Officials' is lost; likely part of *Ci Fa Lun*. Supplemental chapters are later additions.)
Huangdi asked: "A person has Long disease (urinary retention), urinating dozens of times daily (Deficiency); body hot as charcoal, neck/chest feeling blocked, Renying pulse rapid and large, wheezing with rebellious Qi (Excess); Taiyin pulse fine as hair (Deficiency). Where is the disease? What is the name?" (This discusses Yin-Yang Qi generated by Taiyang/Yangming. Disharmony leads to death. Food enters Stomach, Spleen transports fluids. Taiyin moves Qi in Three Yin; Yangming in Three Yang. Taiyin deficiency makes Yangming excessive. Imbalance cuts off exterior-interior Qi. Spleen fails to transport up, Lung fails to regulate down, causing Long. Earth Qi rises to clouds, Heaven Qi falls to rain. Earth Qi failing to rise causes frequent urination (Taiyin Deficiency). Yangming is Exterior; body heat as charcoal indicates Yangming Excess. Yangming channel follows throat; neck/chest blockage indicates strong Stomach Qi. Rapid Renying and wheezing indicate Yangming Excess overwhelming Lung. Yangming Excess cuts off Spleen Yin, causing fine Taiyin pulse (Taiyin Deficiency).) Qibo said: "Disease in Taiyin, Excess in Stomach, involvement of Lung. Named Jue (Rebellion). Fatal and untreatable." (Yangming is Dry-Heat, interacting with Taiyin Dampness. Taiyin deficiency leads to Hot Stomach Qi and rapid Renying. Stomach Qi rebels to Lung, causing wheezing. Strong Stomach Qi fails to nourish Taiyin. Taiyin deficiency means Five Zang receive no Qi, leading to fatal Jue Ni. Zhang Zhaohuang cited *Shang Han Lun*: 'Stomach Qi generates heat, cutting off Yang.' This isolates Taiyin and creates dryness in Stomach, showing Yin-Yang interdependence.) This is Five Excess and Two Deficiency. Huangdi asked: "What is Five Excess and Two Deficiency?" Qibo said: "Five Excess refers to five pathogenic excesses; Two Deficiency refers to two pathogenic deficiencies." (Five Excess: Body heat, neck/chest blockage, rapid Renying, wheezing/rebellious Qi. Two Deficiency: Long disease, frequent urination, fine Taiyin pulse. Zhang Zhaohuang: Excess in Yangming leads to Deficiency in Taiyin.) Now having exterior Five Excess and interior Two Deficiency, the body's exterior-interior Yin-Yang are severed, clearly a death case." (Yangming Exterior fails to move Qi in Three Yang; Taiyin Interior fails to move Qi in Three Yin. Severance of Yin-Yang in body confirms fatality.)
Huangdi asked: "A person is born with Dian Ji (epilepsy/seizure). What is it? How acquired?" Qibo said: "Named Tai Bing (Fetal Disease). Acquired in the womb when the mother suffered great fright. Qi rushed upward and did not descend, Jing Qi gathered together, causing the child to develop Dian Ji." (This is a Uterine disease. Great fright causes violent upward Qi. Jing nourishes the fetus; fright causes maternal Qi to rise, reversing fetal Jing Qi, leading to epilepsy. Zhang Zhaohuang noted: Fetal disease includes more than just epilepsy. Pregnant women must be cautious in diet and lifestyle to ensure healthy offspring.)
Huangdi asked: "A person has edema resembling water retention, pulse is large and tight, no body pain, not emaciated, anorexia, low food intake. What is the disease?" ('Ran Ran' describes edema. Resembling water but无形 (formless) indicates Water Qi attacking upward, not tangible fluid. Shaoyin Cold-Water governs Qi. Large indicates Wind, Tight indicates Cold, hence large-tight pulse. Feng Shui (Wind-Water) usually causes joint pain; this is Kidney disease, not external Wind, hence no pain. Water Qi causes non-emaciation. Wind/Wood/Water evil insults Earth Qi, causing anorexia. Zhang Zhaohuang: Evil in Upper Jiao causes anorexia; Middle Jiao causes low intake.) Qibo said: "Disease originates in Kidney, named Shen Feng (Kidney Wind)." (Kidney is Water organ; Water generates Wind-Wood. This is self-generated Wind, not external. Zhang Zhaohuang: Heaven has Six Evils, Humans have Six Qi. Qi Heng diseases often lack external pathogens.) Shen Feng with anorexia, prone to fright, dies if heart Qi wanes after fright." (Water overcomes Fire. Anorexia is Water evil entering Upper Jiao. Fright is Water Qi battling below Heart. Heart normally resists evil; if heart Qi wanes after fright, Heart is damaged.)