黄帝问曰。病有标本。刺有逆从。奈何。（标本者。六气之化。病传者。五脏相传。此篇承上章而言六气为病。有四
时之顺逆。而又有标本之逆从。五脏受伤。有刺中之死期。而又有病传之日数。是以灵枢原属二篇。本经合而为一。盖
谓五脏六气。外内相合。始病在六气而不亟治之。则传入五脏而为不救之死证矣。）岐伯对曰。凡刺之方。必别阴阳。前
后相应。逆从得施。标本相移。（阴阳者。三阴三阳之六气也。少阳标阳而本火。太阴标阴而本湿。少阴标阴而本热。太
阳标阳而本寒。阳明标阳而本燥。厥阴标阴而本风。少阳太阴从本。少阴太阳。从本从标。阳明厥阴。不从标本。从乎
中也。从本者。化生于本。从标本者。有标本之化。从中者。以中气为化也。前后相应者。有先病后病也。逆从得施者。
有逆取而得者。有从取而得者。标本相移者。有取标而得者。有取本而得者。）故曰。有其在标而求之于标。有其在本而
求之于本。有其在本而求之于标。有其在标而求之于本。故治有取标而得者。有取本而得者。有逆取而得者。有从取而
得者。故知逆与从。正行无间。知标本者。万举万当。不知标本。是谓妄行。（故曰者。引至真要大论而言也。有其在标
而求之于标者。谓病三阴三阳之六气。即于六经中求之以治标。有其在本而求之于本者。谓病风寒暑湿燥火。六淫之邪。
即于六气中求之以治本。有其在本而求之于标者。如寒伤太阳。乃太阳之本病。而反中标阳之热化。即求之于标。而以
凉药治其标热。有其在标而求之于本者。如病在少阴之标阴。而反得君火之本热。即求之于本。以急泻其火。故百病之
起。有生于本者。有生于标者。有取本而得者。有取标而得者。有逆取而得者。有从取而得者。逆取而得者。谓寒者热
之。热者寒之。结者散之。散者收之。留者攻之。燥者濡之。从取而得者。谓热因寒用。寒因热用。塞因塞用。通因通
用。必伏其所主。而先其所因。其始则同。其终则异。可使破积。可使溃坚。可使气和。可使必已。）夫阴阳逆从。标本
之为道也。小而大。言一而知百病之害。（阴阳逆从者。谓三阴三阳之气。有胜有复也。王冰曰。着之至也。言别阴阳。
知逆顺。法明着。见精微。观其所举则小。循其所利则大。以斯明着。故言一而知百病之害。）少而多。浅而博。可以言
一而知百也。（王冰曰。言少可以贯多。举浅可以料大者。何法之明。故非圣人之道。孰能至于是耶。故学之者。犹可以
言一而知百病也。博、大也。）以浅而知深。察近而知远。言标与本。易而勿及。（王冰曰。虽事极深远。人非咫尺。略
以浅近而悉贯之。然标本之道。虽易可为言。而世人识见。无能及者。）治反为逆。治得为从。（相反而治为逆治。相得
而治为从治。相得者。如热与热相得。寒与寒相得也。）先病而后逆者治其本。先逆而后病者治其本。（逆者。胜克之气
也。先病者。谓吾身中先有其病也。先逆先寒先热者。谓在天之六气也。先病而后逆者。如吾身中先有脾土之病。而后
复感其风邪。重伤脾土。则当先治其脾土。而后治其风邪。如先感天之风邪。克伤中土。以致脾脏为病。是当先治其风
邪。而后调其脾土。故曰。言标与本。易而勿损。察本与标。气可令调。明知胜复为万民式。天之道毕矣。）先寒而后生
病者治其本。先病而后生寒者治其本。（先寒者。寒淫所胜也。以吾身感之而生病者。是当治其寒邪。如先病而后生寒者。
当治其身之本病。而寒气自解矣。张兆璜曰。先寒者客气。生寒者同气。）先热而后生病者治其本。先热而后生中满者
治其标。（先热者。热淫所胜也。以吾身感之而生病者。是当治其本热。如吾身感之而生中满者。又当治其中满。盖六淫
之邪。始伤六气。若致中满。则病气入内。故当治其内。）先病而后泄者治其本。先泄而后生他病者治其本。必且调之。
乃治其他病。（泄者。湿土之病也。他病者。如湿邪所胜。民病心痛耳聋之类。故当先治其虚泄。必且调之脾土。而后治
其他病。）先病而后生中满者治其标。先中满而后烦心者治其本。人有客气。有同气。（至真要大论曰。诸胀腹大。皆属
于热。如先病热而后生中满者。是当治其中满。如先病中满而湿热之气。上乘于心。以致心烦者。亦当治其中满。而烦
自解矣。夫先热而后生中满者。感天之热淫而致生中满也。先病而后生中满者。病吾身中之热而生中满也。故曰。人有
客气。有同气。客气者。谓在天之六气。同气者。谓吾身中亦有此六气。而与天气之相同也。）小大不利治其标。小大利
治其本。（如中满而大小便不利者。当先利其二便。如小大便利者。仍治其中满。盖邪气入于腹内。必从二便而出。）病
发而有余。本而标之。先治其本。后治其标。病发而不足。标而本之。先治其标。后治其本。（有余者。邪气之有余。不
足者。正气之不足也。邪气者。风寒暑湿燥火。六淫之邪。正气者。三阴三阳之六气也。六微旨大论曰。少阳之上。火
气治之。阳明之上。燥气治之。太阳之上。寒气治之。厥阴之上。风气治之。少阴之上。热气治之。太阴之上。湿气治
之。所谓本也。本之下。气之标也。此皆以风寒暑湿燥火六气为本。而以三阴三阳之六气为标。故病发而有余者。此风
寒暑湿之本气有余。故当先散其邪气。而后理其阴阳。如病发而不足。当先调其阴阳。而后治其本气。盖邪气盛则实精
气夺则虚。是以邪气有余者。先散其邪气。精气不足者。先补其正虚。此标本之大纲领也。）谨察间甚。以意调之。间者
并行。甚者独行。先小大不利而后生病者治其本。（间去声。此言标本之间。而又当以意调其间甚也。夫邪之所凑。其正
必虚。间者。谓邪正之有余不足。二者兼于其间。故当并行其治。盖以散邪之中。兼补其正。补正之内。兼散其邪。如
偏甚者。则当独行其法。谓邪气甚者。竟泻其邪。正虚甚者。竟补其正。此为治之要道也。如先大小便不利而后生病者。
当专治其小大二便。又无论其邪正之间甚矣。朱永年曰。间甚之中。又分缓急。）夫病传者。（夫者。承上接下之辞。
按灵枢病传篇曰。折毛发理。正气横倾。淫邪泮衍。血脉传溜。大气入脏。腹痛下淫。可以致死。不可以致生。大气者。
即在天之六气。淫胜而太过者也。泮衍。散蔓而盛也。夫邪之中人。必先始于皮毛。次发于肉理。次入于络脉。此淫甚
之气。故始于皮毛而使毛折。发于肉理而使正气横倾。泮衍于脉中而使血气流传。入于脏腑以成卒死之病。夫所谓标本
者。感在天之六气。而病吾身中之阴阳。即入于腹内。以致中满者。在于募原腠理之气分。若淫邪泮衍于血脉之中。则
入脏腑。为内所因矣。故曰。善治者治皮毛。其次治肌肤。其次治筋脉。其次治六腑。其次治五脏。治五脏者。半死半
生也。）心病。先心痛。一日而咳。三日胁支痛。五日闭塞不通。身痛体重。三日不已死。冬夜半。夏日中。（心先痛者。
病先发于心。咳者。一日而之肺。胁支痛者。三日而之肝。闭塞不通。身痛体重者。五日而之脾。此皆逆传其所胜。是
以三日不已而死。心为火脏。冬之夜半者。水胜而火灭也。夏之日中者。亢极而自焚矣。）肺病。喘咳。三日而胁支满痛。
一日身重体痛。五日而胀。十日不已死。冬日入。夏日出。（肺病喘咳者。病先发于肺。三日而之肝。则胁支满痛。一日
而之脾。则身重体痛。五日而之胃则胀。再十日不已死。夫冬气收藏。夏气浮长。日出气始生。日入气收引。肺主气。
故终于气之出入也。系辞曰。日月营运。一寒一暑。故只言冬夏者。重阴阳寒暑之气也。至如所传之日数。有一三五之
奇。有二六十之偶。亦如六爻之有阴有阳也。王子律曰。日出为春。日中为夏。日入为秋。夜半为冬。以上有二节。
四时之气已备。）肝病。头目眩。胁支满。三日体重身痛。五日而胀。三日腰脊少腹痛。胫 。三日不已死。冬日入。夏
早食。（病先发于肝。则头目眩胁支满。三日而之脾。则体重身痛。五日而之胃则胀。三日而之肾。则腰脊少腹痛。三日
不已死。夏早食者。寅卯之时。木气绝而不生也。冬日入者。申酉之时。金气旺而木气绝也。）脾病。身痛体重。一日而
胀。二日少腹腰脊痛。胫 。三日背KT 筋痛。小便闭。十日不已死。冬人定。夏晏食。（KT 膂同。病先发于脾。则
身痛体重。二日而之胃则胀。二日而之肾。则少腹腰脊痛胫 。三日而之膀胱。则背KT 筋痛小便闭。十日不已死。马
莳曰。冬之人定在亥。谓土败而水胜也。夏之晏食在寅。木旺而土绝也。王冰曰。人定在申后二十五刻。晏食在寅后二
十五刻。王子律曰。膀胱之脉循于背。足太阳主筋。故背KT 筋痛。）肾病。少腹腰脊痛。 。三日背KT 筋痛。
小便闭。三日腹胀。三日两胁支痛。三日不已死。冬大晨。夏晏晡。（病先发于肾。则少腹腰脊痛。三日而之膂膀胱则背
KT筋痛。小便闭。三日而之胃则腹胀。三日而之肝。则两胁支痛。冬之大明在辰。土旺而木灭也。夏之晏晡在亥。水
绝而不能生也。按灵枢病传篇曰。三日而上之心。三日而之小肠。是水乘其所胜之火脏火腑也。此节与灵枢之不同者。
心乃君主之官。原不受邪。膀胱之气。上与阳明相合。水邪上乘。上焦不受。则还转于中焦。而留于阳明矣。阳明主秋
金之令。故复传之肝木而死。下二节大意相同。王子律曰。玉机真脏论曰。肾因传之心。心即复反传而行之肺。此亦
心不受邪。而复传之肺也。）胃病胀满。五日少腹腰脊痛。 。三日背KT 筋痛。小便闭。五日身体重。六日不已死。
冬夜半后。夏日 。（病先发于胃。故胀满。五日而之肾。则少腹腰脊痛胫 。三日而之膂膀胱。则背KT 筋痛。小便
闭。五日而之脾。则身体重。再六日不已而死。冬夜半后者。土败而水胜也。夏日 者。乃阳明所主之时。土绝而不能
生也。按灵枢经曰。五日而上之心。二日不已死。此言五日身体重者。亦心不受邪而还之脾。水行乘土。腑邪传脏而死。
徐东屏曰。一者数之始。十者数之终。阳数起于一。阴数起于二。三日死者。死于生数之始也。六日死者。终于成数之
始。十日死者。终于成数之终。是有终其所始。而终其所终者。有死于其所不胜者。有死于本气生之时者。此皆阴阳终
始之微妙。）膀胱病。小便闭。五日少腹胀。腰脊痛。 。一日腹胀。一日身体痛。二日不已死。冬鸡鸣。夏下晡。
（此亦腑邪传脏。水泛土败而死。病先发于膀胱。则小便闭。五日而之肾。则少腹胀。腰脊痛。一日而之胃。则腹胀。
一日而之脾。则身体痛。冬鸡鸣在丑。乃少阳太阳生气之时。气绝而不能生也。夏下晡。乃阳明生气之时。阳明之气亦
绝矣。董帷园曰。风乃百病之长。大气。风气也。风木之邪。故独乘胃土。而行涣膀胱之水液。）诸病以次是相传。
如是者。皆有死期。不可刺。间一脏止。及至三四脏者。乃可刺也。（以上诸病。如是相胜克而传者。皆有速死之期。非
刺之可能救也。或间一脏相传而止。不复再传别脏者。乃可刺也。假如心病传肝。肺病传脾。此乃子行乘母。至肝脏脾
脏而止。不复再胜克相传于他脏者。可刺也。假如心病传脾。肺病传肾。乃母行乘子。得母藏之生气。不死之证也。如
心病传肾。肺病传心。肝脏传肺。此从所不胜来者。为微邪。乃可刺也。金西铭曰。五脏相传。止可间二脏三脏。经言
四脏者。或脏传之于腑。而后传于他脏。腑亦可以名脏也。）
黄帝问道：疾病有标本之分，针刺有逆治与从治的区别，这是为什么呢？（所谓标本，是指六气的变化规律；病传，是指五脏之间的相互传变。本篇承接上一章，论述六气致病，有四时气候的顺逆，又有标本治疗的逆从关系。五脏受伤，有针刺致死的时间，又有疾病传变的天数。因此，《灵枢》中原本分为两篇的内容，在本经中合并为一篇。意思是说，五脏与六气，内外相合，如果初起在六气阶段不紧急治疗，就会传入五脏，成为无法挽救的死证。）
岐伯回答说：大凡针刺的方法，必须辨别阴阳，前后穴位相应，逆治和从治得当运用，根据病情在标或在本而灵活转移治疗重点。（阴阳，指的是三阴三阳六气。少阳以阳为标，以火为本；太阴以阴为标，以湿为本；少阴以阴为标，以热为本；太阳以阳为标，以寒为本；阳明以阳为标，以燥为本；厥阴以阴为标，以风为本。少阳和太阴的病机主要从本化生；少阴和太阳的病机既可以从本也可以从标；阳明和厥阴既不单纯从本也不单纯从标，而是从中气化生。从本的，是因为气化生于本气；从标本的，是有标本两种气化表现；从中气的，是以中气作为化生的基础。前后相应，指有先发病和后发病的区别。逆从得施，指有采用逆法治愈的，也有采用从法治愈的。标本相移，指有通过治标而痊愈的，也有通过治本而痊愈的。）所以说，病在标位的，就求之于标位治疗；病在本位的，就求之于本位治疗；病在本位的，却求之于标位治疗；病在标位的，却求之于本位治疗。所以治疗有取效于治标的，有取效于治本的，有取效于逆治的，有取效于从治的。因此，懂得逆治和从治的道理，就能正确施行而无差错；懂得标本理论，就能每举必中、万无一失；不懂得标本理论，就叫做盲目乱行。（“所以说”是引用《素问·至真要大论》的话。病在标位而求之于标位治疗，是指病在三阴三阳六气，就在六经中寻求方法来治标；病在本位而求之于本位治疗，是指病在风寒暑湿燥火六淫邪气，就在六气本源上寻求方法来治本；病在本位却求之于标位治疗，例如寒邪损伤太阳经，本是太阳经的本病（寒），却反而出现标阳的热化症状，这时就求之于标，用凉药治疗其标热；病在标位却求之于本位治疗，例如病在少阴的标阴，却反见君火之本热，这时就求之于本，急需泻其火热。所以百病的起因，有的生于本，有的生于标；治疗有效的，有的取效于治本，有的取效于治标，有的取效于逆治，有的取效于从治。所谓逆治取效，是指寒者热之，热者寒之，结聚者消散之，涣散者收敛之，留滞者攻逐之，干燥者滋润之。所谓从治取效，是指热因寒用，寒因热用，塞因塞用，通因通用。必须制服疾病的主因，先探究疾病的病因，开始治疗时方法似乎相同，但最终效果却不同，这样可以破除积滞，溃散坚块，调和气血，使疾病必定痊愈。）
阴阳逆从、标本的理论，看似微小实则宏大，言一理而知百病之害。（阴阳逆从，指三阴三阳之气有胜气和复气的变化。王冰说：阐述到极致。意思是辨别阴阳，知晓逆顺，法度明确，见解精微。观察其所列举的是微小的，遵循其所利益的是宏大的。以此阐明道理，所以说言一理而知百病之害。）言辞简少而含义丰富，浅显而广博，可以言一理而知百病。（王冰说：言辞少可以贯穿多义，举例浅近可以推知重大。什么法度如此明察？如果不是圣人的道，谁能达到这种境界呢？所以学习的人，也可以做到言一理而知百病。博，就是大。）以浅近推知深远，考察近处推知远处，谈论标与本，容易理解但世人难以企及。（王冰说：虽然事理极其深远，人非咫尺之间能完全看清，但略以浅近之事来全面贯通它。然而标本之道，虽然容易言说，但世人的见识，没有能达到的。）治疗相反称为逆治，治疗得当称为从治。（相反方向治疗叫逆治，相契合方向治疗叫从治。相契合，如热证用热药相得，寒证用寒药相得。）
先发病而后出现气机逆乱的，治疗其本；先出现气机逆乱而后发病的，治疗其本。（逆，指胜克之气。先病，指身体内部先有的疾病。先逆、先寒、先热，指天时的六气。先病而后逆，如体内先有脾土之病，后又感受风邪，重伤脾土，则应当先治脾土，后治风邪。如先感受天之风邪，克伤中土，导致脾脏生病，则应当先治风邪，后调理脾土。所以说，谈论标与本，容易但不易掌握。考察本与标，气机可令调和。明知胜复规律，可为万民表率，天的道理也就完备了。）
先感寒而后生病的，治疗其本；先有病而后生寒的，治疗其本。（先寒，指寒邪偏胜。因身体感受寒邪而生病的，应当治疗其寒邪。如先有病而后生寒的，应当治疗其身体的本病，寒气自然解除。张兆璜说：先寒者是客气，生寒者是同气。）
先感热而后生病的，治疗其本；先发热而后出现中满胀痛的，治疗其标。（先热，指热邪偏胜。因身体感受热邪而生病的，应当治疗其本热。如身体感受热邪而出现中满胀痛的，又应当治疗其中满。因为六淫邪气，起初伤害六气，若导致中满，则病气入内，所以应当治内。）
先有病而后泄泻的，治疗其本；先泄泻而后产生其他疾病的，治疗其本，必须先调护脾胃，然后再治疗其他疾病。（泄泻，是湿土之病。其他疾病，如湿邪偏胜，百姓患心痛、耳聋等类病。所以应当先治疗虚性泄泻，必须先调护脾土，然后治疗其他疾病。）
先有病而后出现中满胀痛的，治疗其标；先有中满胀痛而后心烦的，治疗其本。（人有客气，有同气。《至真要大论》说：各种胀大腹满，都归属于热。如先病热而后生中满的，应当治疗其中满。如先病中满，湿热之气上乘于心，以致心烦的，也应当治疗其中满，烦自会解除。先热而后生中满，是感受天之热邪所致；先病而后生中满，是身体内部之热所致。所以说，人有客气，有同气。客气，指天时的六气；同气，指身体内部也有此六气，且与天气相同。）
大小便不通利的，治疗其标；大小便通利的，治疗其本。（如中满且大小便不通利的，应当先通利二便。如大小便通利的，仍治疗其中满。因为邪气进入腹内，必然从二便排出。）
疾病发作表现为邪气有余的，先治其本，后治其标；疾病发作表现为正气不足的，先治其标，后治其本。（有余，指邪气有余；不足，指正气不足。邪气，指风寒暑湿燥火六淫邪气；正气，指三阴三阳六气。《六微旨大论》说：少阳之上，火气主司；阳明之上，燥气主司；太阳之上，寒气主司；厥阴之上，风气主司；少阴之上，热气主司；太阴之上，湿气主司。这就是所谓的“本”。本之下，是气的“标”。这都是以风寒暑湿燥火六气为本，以三阴三阳六气为标。所以疾病发作而有余的，是风寒暑湿之本气有余，应当先疏散邪气，后调理阴阳。如疾病发作而不足，应当先调理阴阳，后治疗本气。因为邪气盛则实，精气夺则虚。所以邪气有余者，先散其邪气；精气不足者，先补其正虚。这是标本的大纲领领。）
谨慎观察病情的轻重缓急，用心意来调节。病情轻缓的，标本兼治；病情严重的，单独治标或治本。先大小便不利而后生病的，治疗其本。（间，读去声。这里说标本之间，又当用心意调节其轻重缓急。邪气聚集的地方，正气必然虚弱。轻缓，指邪正有余不足两者兼有其间，所以应当并行治疗。即在散邪之中兼补正气，补正之内兼散邪气。如偏重严重的，则应当单独使用一种治法。谓邪气甚者，竟泻其邪；正气虚甚者，竟补其正。这是治疗的关键之道。如先大小便不利而后生病的，应当专门治疗大小便，无论邪正的轻重缓急。朱永年说：轻重缓急之中，又分缓急。）
关于疾病传变。（夫，是承上启下的语气词。按《灵枢·病传篇》说：折损毛发腠理，正气横倾，淫邪蔓延，血脉流传，大气入脏，腹痛下利，可以致死，不可以致生。大气，即天时的六气，淫胜而过度的。泮衍，散漫而盛大。邪气中人，必先始于皮毛，次发于肉理，次入于络脉。这是淫甚之气，故始于皮毛而使毛折，发于肉理而使正气横倾，蔓延于脉中而使血气流传，入于脏腑形成猝然死亡的病。所谓标本，是感受天时的六气，而病及身体内部的阴阳，若进入腹内导致中满，在于募原腠理的气分。若淫邪蔓延于血脉之中，则入脏腑，成为内因。所以说，善于治疗的治皮毛，其次治肌肤，其次治筋脉，其次治六腑，其次治五脏。治疗五脏的，半死半生。）
心病，先发心痛，一天后咳嗽，三天后胁肋支撑作痛，五天后闭塞不通、身体疼痛沉重，三天后不愈则死，死于冬季夜半，夏季日中。（心先痛，是病先发于心。咳，是一天后传肺。胁支痛，是三天后传肝。闭塞不通、身痛体重，是五天后传脾。这都是逆传其所胜之脏，所以三天不愈而死。心为火脏，冬之夜半，水胜火灭；夏之日中，亢极自焚。）
肺病，喘咳，三天后胁肋胀满疼痛，一天后身体沉重疼痛，五天后腹胀，十天后不愈则死，死于冬季日落，夏季日出。（肺病喘咳，是病先发于肺。三天后传肝，则胁肋胀满疼痛。一天后传脾，则身体沉重疼痛。五天后传胃，则腹胀。再十天不愈则死。冬气收藏，夏气浮长。日出气始生，日落气收引。肺主气，所以终于气的出入。《系辞》说：日月运行，一寒一暑。所以只言冬夏，是重视阴阳寒暑之气。至于所传的天数，有一三五的奇数，有二六十的偶数，也像六爻有阴有阳一样。王子律说：日出为春，日中为夏，日入为秋，夜半为冬。以上两节，四时之气已具备。）
肝病，头目眩晕，胁肋支撑胀满，三天后身体沉重疼痛，五天后腹胀，三天后腰脊少腹痛，小腿肿胀，三天后不愈则死，死于冬季日落，夏季早饭时。（病先发于肝，则头目眩晕、胁肋胀满。三天后传脾，则身体沉重疼痛。五天后传胃，则腹胀。三天后传肾，则腰脊少腹痛。三天后不愈则死。夏早食时，是寅卯之时，木气绝而不生。冬日入时，是申酉之时，金气旺而木气绝。）
脾病，身体疼痛沉重，一天后腹胀，二天后少腹腰脊痛，小腿肿胀，三天后背部脊柱筋肉疼痛，小便闭，十天后不愈则死，死于冬季人定，夏季晏食。（KT与膂同。病先发于脾，则身体疼痛沉重。二天后传胃，则腹胀。二天后传肾，则少腹腰脊痛、小腿肿胀。三天后传膀胱，则背膂筋痛、小便闭。十天后不愈则死。马莳说：冬之人定在亥时，谓土败水胜。夏之晏食在寅时，木旺土绝。王冰说：人定在申后二十五刻，晏食在寅后二十五刻。王子律说：膀胱之脉循行于背，足太阳主筋，故背膂筋痛。）
肾病，少腹腰脊痛，小腿肿胀，三天后背部脊柱筋肉疼痛，小便闭，三天后腹胀，三天后两胁支撑作痛，三天后不愈则死，死于冬季大晨，夏季晏晡。（病先发于肾，则少腹腰脊痛。三天后传膀胱，则背膂筋痛、小便闭。三天后传胃，则腹胀。三天后传肝，则两胁支撑作痛。冬之大明在辰时，土旺木灭。夏之晏晡在亥时，水绝不能生。按《灵枢·病传篇》说：三天后上传于心，三天后传小肠。这是水乘其所胜之火脏火腑。此节与《灵枢》不同的地方在于：心乃君主之官，原不受邪。膀胱之气，上与阳明相合，水邪上乘，上焦不受，则还转于中焦，而留于阳明。阳明主秋金之令，故复传之肝木而死。下两节大意相同。王子律说：《玉机真脏论》说：肾因传之心，心即复反传而行之肺。这也是心不受邪，而复传之肺。）
胃病，胀满，五天后少腹腰脊痛，小腿肿胀，三天后背部脊柱筋肉疼痛，小便闭，五天后身体沉重，六天后不愈则死，死于冬季夜半后，夏季日昳。（病先发于胃，故胀满。五天后传肾，则少腹腰脊痛、小腿肿胀。三天后传膀胱，则背膂筋痛、小便闭。五天后传脾，则身体沉重。再六天不愈而死。冬夜半后，土败水胜。夏日昳，是阳明所主之时，土绝不能生。按《灵枢经》说：五天后上传于心，二天不愈而死。这里说五天身体重，也是心不受邪而还之脾，水行乘土，腑邪传脏而死。徐东屏说：一是数的开始，十是数的终结。阳数起于一，阴数起于二。三日死者，死于生数之始。六日死者，终于成数之始。十日死者，终于成数之终。这是有终其所始，而终其所终。有死于其所不胜者，有死于本气生之时者。这些都是阴阳终始的微妙之处。）
膀胱病，小便闭，五天后少腹胀，腰脊痛，小腿肿胀，一天后腹胀，一天后身体疼痛，二天后不愈则死，死于冬季鸡鸣，夏季下晡。（这也是腑邪传脏，水泛土败而死。病先发于膀胱，则小便闭。五天后传肾，则少腹胀、腰脊痛、小腿肿胀。一天后传胃，则腹胀。一天后传脾，则身体疼痛。冬鸡鸣在丑时，乃少阳太阳生气之时，气绝不能生。夏下晡，乃阳明生气之时，阳明之气亦绝。董帷园说：风乃百病之长，大气即风气。风木之邪，故独乘胃土，而行涣膀胱之水液。）
各种疾病按次序这样相传，像这样，都有死期，不可针刺。如果间隔一脏停止，以及传到三四脏的，才可以针刺。（以上诸病，如是相胜克而传的，都有速死之期，不是针刺可能救活的。或者间隔一脏相传而止，不再传别脏的，才可以针刺。假如心病传肝，肺病传脾，这是子行乘母，至肝脏脾脏而止，不再胜克相传于他脏，可刺。假如心病传脾，肺病传肾，这是母行乘子，得母藏之生气，是不死之证。如心病传肾，肺病传心，肝脏传肺，这是从所不胜来的，为微邪，才可刺。金西铭说：五脏相传，止可间二脏三脏，经言四脏者，或是脏传之于腑，而后传于他脏，腑也可以名脏。）
Huangdi asked: Diseases have distinctions of Biao (Branch/Symptom) and Ben (Root/Cause), and acupuncture has methods of Ni (Reversal/Opposite) and Cong (Following/Concordant). How is this so? (Biao and Ben refer to the transformations of the Six Qi. Disease transmission refers to the mutual transmission among the Five Zang organs. This chapter follows the previous one, discussing diseases caused by the Six Qi, which have compliance or opposition with the four seasons, as well as reversal or concordance in treating Biao and Ben. When the Five Zang organs are injured, there are times of death from acupuncture, and there are days for disease transmission. Therefore, what was originally two chapters in the *Ling Shu* is combined into one in this classic. It means that the Five Zang and the Six Qi combine internally and externally. If not treated urgently when the disease begins in the Six Qi, it will transmit to the Five Zang organs and become an incurable fatal syndrome.)
Qibo replied: In general, the method of acupuncture must distinguish Yin and Yang, ensure correspondence between anterior and posterior points, apply Ni (reversal) and Cong (following) treatments appropriately, and shift focus between Biao and Ben according to the condition. (Yin and Yang refer to the Six Qi of Three Yin and Three Yang. Shaoyang has Yang as its Biao and Fire as its Ben; Taiyin has Yin as its Biao and Dampness as its Ben; Shaoyin has Yin as its Biao and Heat as its Ben; Taiyang has Yang as its Biao and Cold as its Ben; Yangming has Yang as its Biao and Dryness as its Ben; Jueyin has Yin as its Biao and Wind as its Ben. The diseases of Shaoyang and Taiyin primarily transform from their Ben. The diseases of Shaoyin and Taiyang may transform from either Ben or Biao. The diseases of Yangming and Jueyin do not strictly follow Ben or Biao but transform from their Zhong Qi (Middle Qi). Transforming from Ben means the transformation originates from the Ben Qi. Transforming from Ben and Biao means there are transformations of both Ben and Biao. Transforming from Zhong Qi means the transformation is based on the Middle Qi. Anterior-posterior correspondence refers to the distinction between primary and secondary diseases. Applying Ni and Cong means some are cured by Ni treatment and some by Cong treatment. Shifting between Biao and Ben means some are cured by treating Biao and some by treating Ben.) Therefore it is said: If the disease is at the Biao level, seek treatment at the Biao level; if the disease is at the Ben level, seek treatment at the Ben level; if the disease is at the Ben level, seek treatment at the Biao level; if the disease is at the Biao level, seek treatment at the Ben level. Thus, treatment can be effective by targeting Biao, by targeting Ben, by using Ni treatment, or by using Cong treatment. Therefore, knowing Ni and Cong allows correct application without error; knowing Biao and Ben ensures success in every attempt; not knowing Biao and Ben is called reckless action. ("Therefore it is said" quotes the *Su Wen: Zhi Zhen Yao Da Lun*. Seeking treatment at Biao for disease at Biao means treating the Six Qi of Three Yin and Three Yang by seeking methods within the Six Channels to treat Biao. Seeking treatment at Ben for disease at Ben means treating the Six Heterogeneous Pathogens (Wind, Cold, Summer-Heat, Dampness, Dryness, Fire) by seeking methods in the Six Qi origins to treat Ben. Seeking treatment at Biao for disease at Ben: for example, Cold damaging the Taiyang channel is a Ben disease of Taiyang (Cold), but it presents with Biao Yang Heat transformation symptoms; thus, one seeks treatment at Biao and uses cooling herbs to treat the Biao Heat. Seeking treatment at Ben for disease at Biao: for example, disease at the Biao Yin of Shaoyin but presenting with the Ben Heat of Ministerial Fire; thus, one seeks treatment at Ben and urgently drains the Fire. Hence, the origin of all diseases lies either in Ben or in Biao; effectiveness comes from treating Ben, treating Biao, Ni treatment, or Cong treatment. Ni treatment efficacy refers to: treating Cold with Heat, Heat with Cold, dispersing stagnation, consolidating dispersion, attacking retention, moistening dryness. Cong treatment efficacy refers to: using Cold for Heat, Heat for Cold, using obstruction for obstruction, using permeability for permeability. One must subdue the main cause and address the etiology first. Initially, the methods may seem similar, but the final results differ. This can break down accumulations, dissipate hardness, harmonize Qi and Blood, and ensure cure.)
The Dao of Yin-Yang, Ni-Cong, and Biao-Ben appears small but is great; understanding one principle reveals the harm of a hundred diseases. (Ni and Cong of Yin-Yang refer to the winning and retaliatory movements of the Three Yin and Three Yang Qi. Wang Bing said: To state to the utmost. It means distinguishing Yin and Yang, knowing Ni and Shun, having clear laws, and seeing subtleties. Observing what is listed is small; following what benefits is great. By clarifying this, one says knowing one thing reveals the harm of a hundred diseases.) Words are few but meaning is abundant; shallow yet broad; one can speak of one thing and know a hundred diseases. (Wang Bing said: Few words can cover many meanings; shallow examples can predict major issues. What law is so clear? Only the Dao of a Sage can reach this. Thus, learners can also speak of one thing and know a hundred diseases. "Broad" means great.) Using the shallow to understand the deep, observing the near to know the far; speaking of Biao and Ben is easy, yet people cannot reach it. (Wang Bing said: Although matters are profound and not immediately visible, one can comprehend them through shallow, proximate examples. However, although the Dao of Biao-Ben is easy to discuss, worldly insight rarely reaches it.) Opposing treatment is Ni; appropriate treatment is Cong. (Treating in the opposite direction is Ni treatment; treating in accordance is Cong treatment. Accordance means, for example, Heat matching Heat [Cong], Cold matching Cold [Cong].)
If disease occurs first and then Qi rebellion follows, treat the Ben; if Qi rebellion occurs first and then disease follows, treat the Ben. (Rebellion refers to the conquering Qi. Primary disease refers to pre-existing internal pathology. Primary rebellion/cold/heat refers to the Heavenly Six Qi. Primary disease then rebellion: e.g., pre-existing Spleen Earth disease followed by Wind pathogen injuring Spleen Earth; treat Spleen Earth first, then Wind. Primary Wind pathogen conquering Central Earth causing Spleen disease: treat Wind first, then regulate Spleen Earth. Thus, speaking of Biao and Ben is easy but hard to master. Examining Ben and Biao allows Qi regulation. Knowing winning and retaliatory cycles serves as a model for the people, completing the Dao of Heaven.)
If Cold sensation occurs first and then disease arises, treat the Ben; if disease arises first and then Cold sensation occurs, treat the Ben. (Primary Cold refers to excessive Cold pathogen. Feeling Cold and getting sick requires treating the Cold pathogen. If disease arises first and then Cold occurs, treat the body's primary disease, and Cold will resolve. Zhang Zhaohuang said: Primary Cold is Guest Qi; generating Cold is Same Qi.)
If Heat sensation occurs first and then disease arises, treat the Ben; if Heat arises first and then Fullness (Zhong Man) occurs, treat the Biao. (Primary Heat refers to excessive Heat pathogen. Feeling Heat and getting sick requires treating the primary Heat. If feeling Heat leads to Fullness, treat the Fullness. Because Six Heterogeneous Pathogens initially injure the Six Qi, but if they cause Fullness, the pathogenic Qi enters the interior, so treat the interior.)
If disease arises first and then Diarrhea occurs, treat the Ben; if Diarrhea occurs first and then other diseases arise, treat the Ben, after regulating the Spleen. (Diarrhea is a Damp-Earth disease. Other diseases include Heart pain or deafness caused by Dampness. Treat deficiency-type diarrhea first, regulate Spleen Earth, then treat other diseases.)
If disease arises first and then Fullness occurs, treat the Biao; if Fullness occurs first and then Vexation occurs, treat the Ben. (Humans have Guest Qi and Same Qi. *Zhi Zhen Yao Da Lun* states: All distension and abdominal enlargement belong to Heat. If Heat disease leads to Fullness, treat Fullness. If Fullness leads to Damp-Heat ascending to the Heart causing Vexation, treat Fullness, and Vexation resolves. Heat leading to Fullness is contracting Heavenly Heat; Disease leading to Fullness is internal Heat. Thus, humans have Guest Qi (Heavenly Six Qi) and Same Qi (Internal Six Qi identical to Heavenly Qi).)
If Urination and Defecation are obstructed, treat the Biao; if Urination and Defecation are free, treat the Ben. (If Fullness accompanies obstructed urination/defecation, unblock bowels/bladder first. If free, treat Fullness. Pathogenic Qi entering the abdomen must exit via bowels/bladder.)
If disease onset shows Excess (You Yu), treat Ben first, then Biao; if disease onset shows Deficiency (Bu Zu), treat Biao first, then Ben. (Excess refers to pathogenic excess; Deficiency refers to healthy Qi deficiency. Pathogens are Six Heterogeneous Pathogens; Healthy Qi is the Six Qi of Three Yin and Three Yang. *Liu Wei Zhi Da Lun* states: Above Shaoyang is Fire governance; above Yangming is Dryness governance; above Taiyang is Cold governance; above Jueyin is Wind governance; above Shaoyin is Heat governance; above Taiyin is Dampness governance. This is the Ben. Below Ben is the Biao of Qi. These take Six Heterogeneous Pathogens as Ben and Six Qi of Three Yin/Yang as Biao. Disease with Excess indicates excess of Wind/Cold/etc., so disperse pathogens first, then regulate Yin/Yang. Disease with Deficiency indicates deficiency of Healthy Qi, so regulate Yin/Yang first, then treat Ben Qi. Excess makes Shi (Fullness); Deficiency makes Xu (Empty). Thus, excess pathogens require dispersing pathogens first; deficient essence requires tonifying deficiency first. This is the general outline of Biao-Ben.)
Carefully observe severity and adjust accordingly. For mild cases, treat both Biao and Ben concurrently; for severe cases, treat singly. If Urination/Defecation obstruction precedes disease, treat the Ben. (Jian means mild. Adjust severity between Biao and Ben. Where evil gathers, healthy Qi is deficient. Mild cases involve both excess and deficiency, so treat concurrently: disperse evil while tonifying healthy Qi, and vice versa. Severe cases require single-method treatment: purge strong evil, or tonify strong deficiency. This is the key to treatment. If Urination/Defecation obstruction precedes disease, treat bowels/bladder exclusively, regardless of severity.)
Regarding disease transmission. (Fu is a transitional particle. *Ling Shu: Bing Chuan Pian* states: Damaging hair and pores, healthy Qi tilts, heterodox evil spreads, blood vessels transmit, Great Qi enters Zang, causing abdominal pain and dysentery, leading to death, not life. Great Qi is the Heavenly Six Qi, excessive and winning. Pand Yan means spreading and flourishing. Evil enters via skin/hair, then flesh/pores, then collaterals. This intense evil damages hair, tilts healthy Qi, spreads in vessels, enters Zang/Fu causing sudden death. Biao-Ben refers to contracting Heavenly Six Qi and injuring internal Yin/Yang. If entering abdomen causing Fullness, it is in Mo Yuan and Cou Li Qi compartments. If spreading in blood vessels, it enters Zang/Fu, becoming internal cause. Thus, good doctors treat skin/hair first, then muscle/skin, then sinews/vessels, then Fu organs, then Zang organs. Treating Zang organs results in half-death, half-life.)
Heart disease: First Heart pain. After one day, Cough. After three days, Hypochondriac distension/pain. After five days, Obstruction, Body pain/heaviness. If not resolved in three days, death. Dies at midnight in Winter, midday in Summer. (Heart pain first indicates disease starting in Heart. Cough after one day indicates transmission to Lung. Hypochondriac pain after three days indicates transmission to Liver. Obstruction/body pain after five days indicates transmission to Spleen. This is reverse transmission conquering the controlled element, hence death in three days. Heart is Fire Zang. Winter midnight: Water conquers Fire. Summer midday: Extreme Yang self-immolates.)
Lung disease: Panting/Cough. After three days, Hypochondriac fullness/pain. After one day, Body heaviness/pain. After five days, Abdominal distension. If not resolved in ten days, death. Dies at sunset in Winter, sunrise in Summer. (Panting/cough starts in Lung. Three days to Liver causes hypochondriac pain. One day to Spleen causes body heaviness. Five days to Stomach causes distension. Ten more days to death. Winter Qi stores, Summer Qi grows. Sunrise generates Qi, sunset collects Qi. Lung governs Qi, so death occurs at Qi entry/exit. *Xi Ci* states: Sun/Moon move, cold/summer alternate. Mentioning only Winter/Summer emphasizes Yin/Yang cold/summer. Transmission days use odd numbers (1,3,5) and even numbers (2,6,10), like Yin/Yang lines. Wang Zilv said: Sunrise is Spring, Midday is Summer, Sunset is Autumn, Midnight is Winter. These sections cover Four Seasons.)
Liver disease: Dizziness/Vision blur, Hypochondriac distension. After three days, Body heaviness/pain. After five days, Abdominal distension. After three days, Lower abdomen/Waist-Spine/Lower back pain, Leg swelling. If not resolved in three days, death. Dies at sunset in Winter, early morning meal in Summer. (Starts in Liver: dizziness/hypochondriac distension. Three days to Spleen: body heaviness. Five days to Stomach: distension. Three days to Kidney: lower abdomen/waist pain. Summer early meal (Yin-Mao hours): Wood Qi exhausted. Winter sunset (Shen-You hours): Metal Qi prosperous, Wood Qi exhausted.)
Spleen disease: Body pain/heaviness. After one day, Abdominal distension. After two days, Lower abdomen/Waist-Spine pain, Leg swelling. After three days, Back-Spine muscle pain, Urinary closure. If not resolved in ten days, death. Dies at Ren Ding time in Winter, Yan Shi time in Summer. (KT is same as Lv. Starts in Spleen: pain/heaviness. Two days to Stomach: distension. Two days to Kidney: lower abdomen/waist/leg pain. Three days to Bladder: back-spine pain/urinary closure. Ma Shi said: Winter Ren Ding (Hai hour): Earth fails, Water wins. Summer Yan Shi (Yin hour): Wood prosperous, Earth exhausted. Wang Bing said: Ren Ding is 25 ke after Shen; Yan Shi is 25 ke after Yin. Wang Zilv said: Bladder meridian runs along back; Foot Taiyang governs sinews, hence back-spine pain.)
Kidney disease: Lower abdomen/Waist-Spine pain, Leg swelling. After three days, Back-Spine muscle pain, Urinary closure. After three days, Abdominal distension. After three days, Bilateral Hypochondriac distension/pain. If not resolved in three days, death. Dies at Da Chen time in Winter, Yan Bu time in Summer. (Starts in Kidney: lower abdomen/waist pain. Three days to Bladder: back-spine pain/urinary closure. Three days to Stomach: distension. Three days to Liver: hypochondriac pain. Winter Da Chen (Chen hour): Earth prosperous, Wood extinguished. Summer Yan Bu (Hai hour): Water exhausted. *Ling Shu* says: Three days to Heart, three days to Small Intestine. Water conquers Fire Zang/Fu. Difference from *Ling Shu*: Heart is Ruler, does not accept evil. Bladder Qi combines with Yangming. Water evil ascends, Upper Jiao rejects, returns to Middle Jiao, stays in Yangming. Yangming governs Autumn Metal, transmits to Liver Wood causing death. Next sections similar. Wang Zilv cited *Yu Ji Zhen Zang Lun*: Kidney transmits to Heart, Heart transmits back to Lung. Heart does not accept evil, transmits to Lung.)
Stomach disease: Distension. After five days, Lower abdomen/Waist-Spine pain, Leg swelling. After three days, Back-Spine muscle pain, Urinary closure. After five days, Body heaviness. If not resolved in six days, death. Dies after midnight in Winter, Ri Die time in Summer. (Starts in Stomach: distension. Five days to Kidney: lower abdomen/waist/leg pain. Three days to Bladder: back-spine pain/urinary closure. Five days to Spleen: body heaviness. Six more days to death. Winter midnight: Earth fails, Water wins. Summer Ri Die: Yangming time, Earth exhausted. *Ling Shu* says: Five days to Heart, two days to death. Here, five days body heaviness implies Heart rejects evil, returns to Spleen. Water conquers Earth, Fu evil transmits to Zang causing death. Xu Dongping said: One is start of numbers, Ten is end. Yang starts at one, Yin at two. Death in three days: dies at start of Sheng numbers. Death in six days: ends at start of Cheng numbers. Death in ten days: ends at end of Cheng numbers. This is ending where it started. Some die to unconquered elements, some die at birth time of own Qi. These are subtleties of Yin-Yang beginning/end.)
Bladder disease: Urinary closure. After five days, Lower abdomen distension, Waist-Spine pain, Leg swelling. After one day, Abdominal distension. After one day, Body pain. If not resolved in two days, death. Dies at Ji Ming time in Winter, Xia Bu time in Summer. (Fu evil transmitting to Zang, Water flooding, Earth failing. Starts in Bladder: urinary closure. Five days to Kidney: lower abdomen/waist/leg pain. One day to Stomach: distension. One day to Spleen: body pain. Winter Ji Ming (Chou hour): Shaoyang/Taiyang Sheng Qi time, Qi exhausted. Summer Xia Bu: Yangming Sheng Qi time, Yangming Qi exhausted. Dong Weiyuan said: Wind is head of hundred diseases. Great Qi is Wind. Wind-Wood evil conquers Stomach Earth, disperses Bladder Water.)
Diseases transmit in this order. Such cases have fixed death dates and cannot be needled. If transmission stops after skipping one Zang, or reaches three/four Zangs, it can be needled. (Such conquering transmission has rapid death, not curable by needle. If skipping one Zang stops transmission, it can be needled. E.g., Heart to Liver, Lung to Spleen: Child conquers Mother, stops at Liver/Spleen, no further conquest, can needle. E.g., Heart to Spleen, Lung to Kidney: Mother conquers Child, gains Mother's Sheng Qi, not fatal. E.g., Heart to Kidney, Lung to Heart, Liver to Lung: From unconquered element, slight evil, can needle. Jin Ximing said: Zang transmission stops after skipping two/three Zangs. Classic mentions four Zangs: perhaps Zang transmits to Fu, then to another Zang; Fu can also be named Zang.)