黄帝问曰∶余闻善言天者，必有验于人；善言古者，必有合于今；善言人者，必有厌于己。如此，则道
不惑而要数极，所谓明也。今余问于夫子，令言而可知，视而可见，扪而可得，令验于己而发蒙解惑，可
得而闻乎？岐伯再拜稽首对曰∶何道之问也？帝曰∶愿闻人之五脏卒痛，何气使然？岐伯对曰∶经脉
流行不止，环周不休，寒气入经而稽迟，泣而不行，客于脉外则血少，客于脉中则气不通，故卒然而痛。帝
曰∶其痛或卒然而止者，或痛甚不休者，或痛甚不可
按者，或按之而痛止者，或按之无益者，或喘动应手者，或心与背相引而痛者，或胁肋与少腹相引而痛者，
或腹痛引阴股者，或痛宿昔而成积者，或卒然痛死不知人有少间复生者，或痛而呕者，或腹痛而后泄者，或
痛而闭不通者，凡此诸痛，各不同形，别之奈何？岐伯曰∶寒气客于脉外则脉寒，脉寒则缩 ，缩 则脉绌
急，绌急则外引小络，故卒然而痛，得炅则痛立止，因重中于寒，则痛久矣。寒气客于经脉之中，与炅气相
薄则脉满，满则痛而不可按也，寒气稽留，炅气从上，则脉充大而血气乱，故痛甚不可按也。寒气客于肠胃之
间，膜原之下，血不得散，小络急引故痛，按之则血气散，故按之痛止。寒气客于侠脊之脉，则深按之不能
及，故按之无益也。寒气客于冲脉，冲
脉起于关元，随腹直上，寒气客则脉不通，脉不通则气因之，故喘动应手矣。寒气客于背俞之脉则脉泣，脉
泣则血虚，血虚则痛，其俞注于心，故相引而痛，按之则热气至，热气至则痛止矣。寒气客于厥阴之脉，厥
阴之脉者，络阴器系于肝，寒气客于脉中，则血泣脉急，故胁肋与少腹相引痛矣。厥气客于阴股，寒气上及少
腹，血泣在下相引，故腹痛引阴股。寒气客于小肠膜原之间，络血之中，血泣不得注于大经，血气稽留不得行，
故宿昔而成积矣。寒气客于五脏，厥逆上泄，阴气竭，阳气未入，故卒然痛死不知人，气复反则生矣。寒气客
于肠胃，厥逆上出，故痛而呕也。寒气客于小肠，小肠不得成聚，故后泄腹痛
矣。热气留于小肠，肠中痛，瘅热焦渴则坚干不得出，故痛而闭不通矣。帝曰∶所谓言而可知者也，视
而可见奈何？岐伯曰∶五脏六腑固尽有部，视其五色，黄赤为热，白为寒，青黑为痛，此所谓视而可见
者也。帝曰∶扪而可得。奈何？岐伯曰∶视其主病之脉，坚而血及陷下者，皆可扪而得也。帝曰∶善。余知
百病生于气也，怒则气上，喜则气缓，悲则气消，恐则气下，寒则气收，炅则气泄，惊则气乱，劳则气耗，
思则气结，九气不同，何病之生？岐伯曰∶怒则气逆，甚则呕血及飧泄，故气上矣。喜则气和志达，荣卫通利，
故气缓矣。悲则心系急，肺布叶举，而
上焦不通，荣卫不散，热气在中，故气消矣。恐则精却，却则上焦闭，闭则气还，还则下焦胀，故气不行
矣。寒则腠理闭，气不行，故气收矣。炅则腠理开，荣卫通，汗大泄，故气泄。惊则心无所倚，神无所归，
虑无所定，故气乱矣。劳则喘息汗出，外内皆越，故气耗矣。思则心有所存，神有所归，正气留而不行，故气
结矣。
黄帝问道：我听说善于谈论天道的人，一定能在人体上得到验证；善于谈论古代的事理，一定与现在的情况相吻合；善于谈论他人之事，一定能印证于自身。像这样，就能使医道不被迷惑，并掌握其要领和规律，这就是所谓的“明”。现在我向先生请教，希望听到那些通过言语可以知晓、通过观察可以看见、通过触摸可以获取的知识，以便在我身上得到验证，启发蒙昧，解除疑惑，可以吗？岐伯拜了两拜，叩头回答说：您问的是哪方面的道理呢？黄帝说：我希望听听人的五脏突然疼痛，是什么气导致的？岐伯回答说：经脉中的气血流行不止，循环周身没有休止。寒气侵入经脉，导致气血运行迟缓，凝涩而不通畅。如果寒气停留在脉外，就会使血液减少；如果寒气客居于脉中，就会使气机阻滞不通，所以会突然发生疼痛。
黄帝说：这种疼痛有的突然停止，有的疼痛剧烈且不停止，有的疼痛剧烈不能按压，有的按压后疼痛停止，有的按压后毫无益处，有的脉搏跳动应手可感，有的心口与背部相互牵引而痛，有的胁肋部与小腹部相互牵引而痛，有的腹痛牵引到阴股部位，有的疼痛日久形成积聚，有的突然剧痛昏死不知人，过一会儿又苏醒过来，有的疼痛伴随呕吐，有的腹痛随后腹泻，有的疼痛伴随大便闭塞不通。所有这些疼痛，形态各不相同，如何加以辨别呢？
岐伯说：寒气客居在脉外，则经脉受寒，经脉受寒则收缩拘急，收缩拘急则脉络屈曲紧急，屈曲紧急则向外牵引细小的络脉，所以突然发生疼痛，遇到温热则疼痛立即停止。如果再次遭受寒邪侵袭，疼痛就会持久不愈。寒气客居在经脉之中，与体内的热气相互搏结，则脉道充盈胀满，胀满则疼痛剧烈而不能按压。如果寒气稽留不去，热气从上而来，则脉道充大，血气运行紊乱，所以疼痛剧烈不能按压。寒气客居在肠胃之间、膜原之下，血液不能散行，小络脉紧急牵引故而发生疼痛，按压时血气得以疏散，所以按压后疼痛停止。寒气客居在夹脊的经脉（督脉或足太阳膀胱经），位置较深，重按达不到病所，所以按压无效。寒气客居在冲脉，冲脉起于关元穴，沿腹壁直上，寒气客居则脉道不通，脉道不通则气随之逆乱，所以脉搏跳动应手可感。寒气客居在背俞之脉，则血脉凝涩，血脉凝涩则血虚，血虚则产生疼痛，因为背俞之气注于心，所以心与背部相互牵引而痛，按压时热气到达患处，热气到达则疼痛停止。寒气客居在厥阴肝经，厥阴肝经联络阴器并系属于肝，寒气客居在脉中，则血液凝涩，经脉拘急，所以胁肋与小腹部相互牵引而痛。厥逆之气客居在阴股，寒气上行波及小腹，血液凝涩在下部相互牵引，所以腹痛牵引到阴股。寒气客居在小肠的膜原之间和络脉血液中，血液凝涩不能注入大的经脉，血气稽留不能正常运行，所以日久形成积聚。寒气客居在五脏，导致气机厥逆向上发泄，阴气竭绝，阳气未能入内，所以突然剧痛昏死不知人，如果气机恢复返回体内，就能生存。寒气客居在肠胃，导致气机厥逆向上溢出，所以疼痛并伴有呕吐。寒气客居在小肠，小肠不能正常聚化食物，所以出现腹泻和腹痛。热气停留于小肠，肠中疼痛，热盛津伤焦渴，导致大便坚硬干燥无法排出，所以疼痛且大便闭塞不通。
黄帝说：所谓“通过言语可以知晓”，是指什么？“通过观察可以看见”又是怎样的情况？岐伯说：五脏六腑都有固定的体表对应部位，观察这些部位的五色变化，黄色和赤色主热证，白色主寒证，青色和黑色主痛证，这就是所谓“通过观察可以看见”的道理。黄帝说：“通过触摸可以获取”又是怎样的情况？岐伯说：观察主要病变部位的脉象，如果脉象坚实、有瘀血或者脉陷下不起，都可以通过触摸来获取诊断信息。
黄帝说：好。我知道百病都生于气机失调。愤怒会使气机上逆，喜悦会使气机舒缓，悲伤会使气机消沉，恐惧会使气机下陷，寒冷会使气机收敛，炎热会使气机泄越，惊吓会使气机紊乱，劳倦会使气机耗损，思虑会使气机郁结。这九种气机变化不同，会产生什么样的疾病呢？岐伯说：愤怒会导致气机上逆，严重时会出现呕血和完谷不化的泄泻，所以说是气机上逆。喜悦能使气和志达，营卫运行通畅，所以气机舒缓。悲伤会使心系拘急，肺叶上举，导致上焦不通畅，营卫之气不能布散，热气郁积在中焦，所以气机消沉。恐惧会使肾精退缩，精退缩则上焦闭塞，上焦闭塞则气还归下部，气还归下部则下焦胀满，所以气机运行不畅。寒冷使腠理闭塞，气机运行受阻，所以气机收敛。炎热使腠理开泄，营卫通畅，汗出大量外泄，所以气机泄越。惊吓使心神无所依托，神志无所归依，思虑无所定夺，所以气机紊乱。劳倦使人喘息出汗，内外之气皆外越，所以气机耗损。思虑使心神专注于某处，神志有所归依，正气留滞而不运行，所以气机郁结。
Huangdi asked, saying: I have heard that those who are good at discussing the Way of Heaven must have verification in human beings; those who are good at discussing ancient times must correspond to the present; and those who are good at discussing others must find confirmation in themselves. In this way, the Dao is not confused, and its essential principles are grasped, which is what is meant by "clarity." Now I ask you, Master, hoping to hear about things that can be known through words, seen through observation, and obtained through palpation, so that they may be verified on myself, dispelling my ignorance and resolving my doubts. Is this possible? Qibo bowed twice and kowtowed in reply, asking: What aspect of the Dao do you inquire about? The Emperor said: I wish to hear why sudden pain occurs in the five Zang organs, and what Qi causes it. Qibo replied: The flow of Qi and Blood in the meridians never ceases, circulating around without rest. When Cold pathogen enters the meridians, it causes stagnation and slowness, making the blood congeal and fail to flow. If it lodges outside the vessels, there is a deficiency of Blood; if it lodges inside the vessels, the obstruction of Qi occurs. Therefore, sudden pain arises.
The Emperor said: Sometimes the pain stops suddenly; sometimes it is severe and unceasing; sometimes it is so severe that it cannot be pressed; sometimes pressing stops the pain; sometimes pressing yields no benefit; sometimes the pulse moves visibly under the hand; sometimes the heart and back pull each other in pain; sometimes the hypochondrium and lower abdomen pull each other in pain; sometimes abdominal pain radiates to the inner thigh; sometimes pain persists for a long time and forms a mass; sometimes sudden severe pain causes fainting and loss of consciousness, followed by recovery after a short while; sometimes pain is accompanied by vomiting; sometimes abdominal pain is followed by diarrhea; sometimes pain is accompanied by constipation. All these pains differ in form. How should they be distinguished?
Qibo said: When Cold lodges outside the vessels, the vessels become cold. Cold causes contraction and curling, leading to tension and cramping of the vessels. This tension pulls on the small collaterals externally, causing sudden pain. Upon exposure to heat (Jiong), the pain stops immediately. However, if re-exposed to Cold, the pain becomes chronic. When Cold lodges within the vessels and contends with Heat (Jiong) energy, the vessels become full. Fullness leads to severe pain that cannot be pressed. If Cold lingers and Heat rises from above, the vessels swell greatly, and Qi and Blood become chaotic, resulting in severe pain that resists pressure. When Cold lodges between the stomach and intestines, below the membrane origins, Blood cannot disperse, and the small collaterals contract, causing pain. Pressing disperses the Qi and Blood, thus stopping the pain. When Cold lodges in the vessels along the spine, deep palpation cannot reach the affected area, so pressing is ineffective. When Cold lodges in the Chong Mai (Penetrating Vessel), which originates at Guanyuan (CV4) and ascends straight up the abdomen, the blockage of the vessel causes Qi to surge, making the pulse palpable under the hand. When Cold lodges in the Back-Shu vessels, the blood congeals, leading to Blood deficiency and pain. Since the Back-Shu points connect to the Heart, the heart and back pull each other in pain. Pressing brings warmth to the area, and when warmth arrives, the pain stops. When Cold lodges in the Jueyin Liver Meridian, which connects to the genitalia and ties to the Liver, Cold in the vessels causes Blood stasis and vessel tension, leading to pulling pain between the hypochondrium and lower abdomen. When Jueyin Qi lodges in the inner thighs, and Cold reaches the lower abdomen, Blood stasis below causes mutual pulling, resulting in abdominal pain radiating to the inner thighs. When Cold lodges in the membrane origins and collateral blood of the Small Intestine, Blood stagnates and cannot enter the main meridians. Qi and Blood remain stagnant and fail to circulate, eventually forming a mass over time. When Cold lodges in the Five Zang Organs, it causes rebellious Qi to rush upward and leak out, exhausting Yin Qi while Yang Qi fails to enter. This causes sudden severe pain, fainting, and loss of consciousness. If Qi returns, life is preserved. When Cold lodges in the stomach and intestines, rebellious Qi rushes upward, causing pain and vomiting. When Cold lodges in the Small Intestine, it fails to perform its function of gathering and transforming, leading to diarrhea and abdominal pain. When Heat remains in the Small Intestine, it causes intestinal pain. Excessive Heat scorches fluids and causes thirst, leading to dry, hard stool that cannot be expelled, resulting in pain and constipation.
The Emperor said: You mentioned "known through words." What does this mean? And how is it "seen through observation"? Qibo replied: The Five Zang and Six Fu Organs all have specific areas on the body surface. Observing the colors of these areas reveals that yellow and red indicate Heat, white indicates Cold, and blue/black indicates Pain. This is what is meant by "seen through observation." The Emperor asked: How is it "obtained through palpation"? Qibo replied: By observing the pulse of the primary diseased area, one can determine diagnosis through palpation if the pulse is firm, indicates Blood stasis, or appears sunken.
The Emperor said: Excellent. I know that all diseases arise from Qi dysfunction. Anger causes Qi to ascend; Joy causes Qi to relax; Sorrow causes Qi to dissipate; Fear causes Qi to descend; Cold causes Qi to contract; Heat causes Qi to escape; Shock causes Qi to become disordered; Labor causes Qi to be exhausted; Thought causes Qi to knot. These nine types of Qi changes differ. What diseases do they produce? Qibo replied: Anger causes Qi to rebel upward. In severe cases, it leads to hematemesis and undigested food diarrhea, hence "Qi ascending." Joy harmonizes Qi and spreads the will, allowing Ying and Wei Qi to flow freely, hence "Qi relaxing." Sorrow tightens the Heart connection and raises the Lung leaves, obstructing the Upper Jiao. Ying and Wei Qi do not disperse, and Heat accumulates in the middle, hence "Qi dissipating." Fear causes Essence to retreat. Retreat leads to closure of the Upper Jiao, which forces Qi to return downward, causing distension in the Lower Jiao, hence "Qi failing to move." Cold closes the interstices (Cou Li), blocking Qi movement, hence "Qi contracting." Heat opens the interstices, allowing Ying and Wei Qi to flow freely, leading to profuse sweating, hence "Qi escaping." Shock leaves the Heart without support, the Spirit without refuge, and thoughts without focus, hence "Qi becoming disordered." Labor causes panting and sweating, with both internal and external Qi leaking outward, hence "Qi being exhausted." Thought fixes the mind and spirit on a single object, causing Zheng Qi (Upright Qi) to stagnate and fail to move, hence "Qi knotting."