调，调和也；逆调，逆其寒热水火荣卫之气，不调和也。寒热逆调，则为烦为痹，水火逆调，则为
肉烁、为挛节。荣卫逆调，则为肉苛。脏气逆调，则为息喘也。
黄帝问曰∶人身非常温也，非常热也。为之热而烦满者，何也？
此承上编之意而复问也。上编云有病温者，汗出辄复热，故问人身非常温也，非常热也。又云有病
身热汗出烦满，故问为之热而烦满者，何也？
岐伯对曰∶阴气少，而阳气胜，故热而烦满也。
温病热病，热而烦满，皆由阴气少，而阳气胜；阴气少故热，阳气胜，故热而烦满也，温热无异，故总答之。
帝曰∶人身非衣寒也，中非有寒气也，寒从中生者何？
寒者热之对，故因热而问寒，人身非衣寒，表无寒也，中非有寒气，里无寒也，寒从中生者，寒气
从内而外出也。
岐伯曰∶是人多痹气也，阳气少，阴气多，故身寒如从水中出。
阳主热，阴主寒，病在阴者，名曰痹，寒从中生，是人多痹气
也。多痹气，由于阳气少，阴气多，阳气少，故身寒，阴气多故身寒如从水中出。此言寒热逆调而为烦为痹也。
帝曰∶人有四肢热，逢风寒，如炙如火者，何也。
人身之热，逢风之寒，则减；人有四肢热，逢风之寒，更如炙如火，其热不减，其故何也？
岐伯曰∶是人者，阴气虚，阳气盛，四肢者阳也，两阳相得，而阴气虚少，少水不能灭盛火，
而阳独治。独治者，不能生长也，独胜而止耳，逢风而如炙如火者是，人当肉烁也。
长，上声，下同。热者，阳气也，是人有热者，乃阴气虚，阳气盛，身在内，四肢在外，故
四肢者阳也。以气盛之阳，合四肢之阳，两阳相得，而阴气虚少，阳者火也，阴者水也，阴气虚少，则
少水不能灭两阳相得之盛火，而阳独治，独阳不生，故独治者，不能生长也，惟此独胜而止耳。独胜而
止，肌肉如焚，故逢风而如炙如火者，是人当闪烁也。
帝曰∶人有身寒，汤火不能热，浓衣不能温，然不冻栗，是为何病？
人身之寒，温热可愈，有身寒而汤火不能热，浓衣不能温，寒之极矣。然不冻栗，是为何病？
亦因上文极热而问极寒也。
岐伯曰∶是人者，素肾气胜，以水为事，太阳气衰，肾脂枯不长，一水不能胜两火，肾
者水也，而生于骨，肾不生，则髓不满，故寒甚至骨也。
一水不能胜两火，七字在下，误重于此，衍文也。寒者，阴气也，是人有寒者，平素肾气胜，肾
气胜则以水为事，以水为事，故太阳阳气衰，太阳气衰，则为孤阴，孤阴不长，故肾脂枯不长，夫肾
者，水也，而精水生于骨，肾脂枯不长，则肾不生；肾不生，则骨髓不能满，故寒甚至于骨，所以汤
火不能热，浓衣不能温也。
所以不能冻栗者，肝一阳也，心二阳也，肾孤脏也。一水不能
胜二火，故不能冻栗，病名曰骨痹。是人当挛节也。
寒甚至骨，宜冻栗矣。所以不能冻栗者，肾水生肝木，肝为阴中之阳，故肝一阳也。少阴合心火，心
为阳中之阳，故心二阳也。肾为阴中之阴，故肾孤脏也。一阳二阳火也，孤脏水也，今一水不
能胜二火，故虽寒甚至骨，而不能冰栗也，寒在于骨，病名曰骨痹。骨痹者，骨节拘挛，是人当挛节也。
此言水火逆调而独阳不生，则为闪烁。孤阴不长，则为挛节也。
帝曰∶人之肉苛者，虽近衣絮，犹尚苛也，是谓何疾？
苛，犹疟也，承上文寒热之义，言人有不因寒热，而肌肉如虐，虽近衣絮，尚不能和，是谓何疾？
岐伯曰∶荣气虚，卫气实也，荣气虚则不仁，卫气虚则不用，荣卫俱虚，则不仁且不用，肉
如故也。人身与志不相有，曰死。
荣卫之气，相将而行，若荣气虚，则卫气实也，申明荣气虚则不仁；不仁，不知痛痒也。卫气虚则不
用，不用，不能转舒也。荣卫俱虚则不仁且不用，而肉苛如故也。人身荣卫，与五脏之神志相
根据，若人身与志不相有，则形志相离，故死。此言荣卫逆调，则为肉苛也。
帝曰∶人有逆气不得卧，而息有音者，有不得卧，而息无音者，有起居如故，而息有音者，有得
卧行而喘者，有不得卧不能行而喘者，有不得卧，卧而喘者，皆何脏使然？愿闻其故。
同是逆气不得卧，而息有音，息无音则异，同是息有音，而起居如故与不得卧则异。喘病相同，有
得卧行而喘，有不得卧行而喘则异。此脏气逆调而息喘，故问何脏使然？
岐伯曰∶不得卧而息有音者，是阳明之逆也。是三阳者下行，今逆而上故息有音也。阳明者，胃
脉也，胃者六腑之海，其气亦下行，阳明逆，不得从其道，故不得卧也。本经曰∶胃不和，则卧不
安，此之谓也。
本讹下今改。不得卧而息有音者，足阳明经脉之逆也。足三阳之脉，皆从头走足，故足三阳者下行，今
逆而上行，故息有音也。盖阳明者，胃脉也。胃者六腑之海，其气亦下行，今阳明气逆，不
得从其下行之道，故不得卧也，评热论云，不能正偃者，胃中不和也，正偃，安
卧也。举本经之言而言胃不和，则卧不安，即此阳明逆不得从其道之谓也。此申明不得卧而息有音也。
夫起居如故而息有音者，此肺之络脉逆也，络脉不得随经上
下，故留经而不行，络脉之病患也微，故起居如故而息有音也。
夫起居如故而息有音者，此肺脏之络脉逆也。络脉在外，内通于经，今络脉不得随经上下，故肺气留
经而不行于络，络脉在外，病患也微，病微，故起居如故；留经不行，故息有音也。此申明起居如故而息有音也。
夫不得卧，卧则喘者，是水气之客也。夫水者，循津液而流也。肾者水脏，主津液，主卧与喘也。
夫不得卧，卧则喘者，是水寒之气客于肺也。夫水者，循肠胃之津液而流行也。肾为水脏，津液之主，
今水气之客，故主不得卧与喘也。此申明不得卧，卧而喘也。
帝曰∶善。
不得卧而息有音，由于胃气之逆，则不得卧而息无音，亦由胃气之逆，起居如故，而息有音，由
于肺络之逆，则得卧行而喘，亦由肺络之逆，不得卧，卧而喘，由于水气之客，则不得卧不能行而
喘，亦由水气之客。帝故默会其义而善之。此言脏气逆调，则为息喘也。
调和，即调和之意；逆调，是指违背了寒、热、水、火、营、卫之气的正常规律，导致气机不调和。寒与热逆乱失调，就会表现为烦躁和痹证；水与火逆乱失调，就会导致肌肉消瘦（肉烁）和关节拘挛（挛节）。营气与卫气逆乱失调，就会导致肌肤麻木不仁且沉重（肉苛）。脏腑之气逆乱失调，就会导致呼吸急促喘息（息喘）。
黄帝问道：人的身体并不是因为穿衣少而感到寒冷，也不是因为外界炎热而感到发热。如果出现发热并伴有胸中烦闷胀满的症状，这是什么原因呢？
这是承接上文的意思而进一步发问。上文提到有患温病的人，出汗后热度随即又回升，所以问“人的身体并不是经常处于温热状态，也不是经常处于高热状态”。又说有患病者身体发热、出汗、心烦胀满，所以问“出现发热并伴有烦闷胀满的原因是什么？”
岐伯回答说：这是因为阴气不足，而阳气偏盛，所以出现发热并伴有胸中烦闷胀满。
温病和热病出现的发热伴胸中烦闷胀满，都是由阴气不足、阳气偏盛引起的；阴气不足故生内热，阳气偏盛故发热且烦闷胀满。温热病的机理没有本质区别，因此统一回答。
黄帝道：人的身体并不是因为衣服穿得少而受寒，体内也没有外来的寒气侵入，为什么寒气会从体内产生呢？
寒是热的对立面，所以因询问热证而连带询问寒证。身体并非因衣薄而寒，说明体表无寒邪；体内并非有外来寒气，说明里部无寒邪。所谓“寒从中生”，是指寒气从内部向外发散。
岐伯说：这种人多患有痹气，是因为阳气少而阴气多，所以身体感觉寒冷，就像刚从水中出来一样。
阳主热，阴主寒。病在阴分，称为痹证。寒气从内生发，是因为这种人多有痹气。多痹气，是由于阳气少、阴气多造成的。阳气少，所以身体发冷；阴气多，所以身体寒冷得像刚从水里出来一样。这里说的是寒热逆乱失调而导致烦躁和痹证的情况。
黄帝道：有的人四肢发热，遇到风寒刺激时，却像被烧烤火烧一样难受，这是什么原因？
人体正常的热气，遇到风的寒气会减弱；但有的人四肢发热，遇到风的寒气，反而更加像被烧烤火烧一样，其热度不减，这是什么缘故呢？
岐伯说：这种人，阴气虚弱，阳气亢盛。四肢属于阳，两股阳气相合，导致阴气更加虚少。这就好比少量的水不能扑灭旺盛的火焰，导致阳气独旺。所谓“独治”，是指阳气孤立无援，无法与其他气协调生长，只是单独亢盛而已。遇到风邪刺激时感到像被烧烤火烧一样，这种人将会出现肌肉消瘦（肉烁）。
“长”字读上声，下文同。热，指的是阳气。这种人有热症，是因为阴气虚、阳气盛。身在内属阴，四肢在外属阳，所以说四肢属阳。以亢盛的阳气，配合四肢的阳气，两阳相合，导致阴气更加虚少。阳代表火，阴代表水。阴气虚少，就像少量的水不能扑灭两阳相合产生的熊熊烈火，导致阳气独旺。孤阳不生，所以所谓“独治”，就是不能生化万物，只是单独亢盛罢了。单独亢盛，肌肉如同焚烧，所以遇到风邪时感到像被烧烤火烧一样，这种人将会出现肌肉消瘦（肉烁）。
黄帝道：有的人身体寒冷，喝热水或烤火都不能使其温暖，穿厚衣服也不能使其暖和，但是却不发抖战栗，这是什么病？
人体的寒症，通常用温热的方法可以治愈。如果有身体寒冷，喝热水烤火都不能暖，穿厚衣服也不能温，这是寒到了极点。然而却不发抖战栗，这是什么病？
岐伯说：这种人，平素肾气偏胜，从事与水有关的工作（或体内水湿过重），导致太阳经阳气衰微，肾精枯竭不能滋养骨骼。这就好比一水不能战胜两火。肾属水，主骨生髓。如果肾的功能衰退，骨髓就不能充盈，所以寒冷直达骨髓。
“一水不能胜两火”这七个字在下文重复出现，是衍文（多余的文字）。寒，属于阴气。这种人感到寒冷，是因为平素肾气偏胜。肾气偏胜则体内水湿重，水湿重则导致太阳经阳气衰微。太阳经阳气衰微，就形成孤阴。孤阴不长，所以肾精枯竭不能滋养骨骼。肾属水，精髓生于骨。肾精枯竭不能滋养骨骼，肾的功能就不能正常发挥；肾的功能失常，骨髓就不能充盈，所以寒冷甚至达到骨髓的程度，因此喝热水烤火不能暖，穿厚衣服也不能温。
之所以不发抖战栗，是因为肝为一阳，心为二阳，而肾是孤脏（纯阴之脏）。一水不能胜过二火，所以虽然寒冷至极却不发抖战栗。这种病名叫骨痹。这种人将会出现关节拘挛（挛节）。
寒冷直达骨髓，按理应该发抖战栗。之所以不发抖战栗，是因为肾水生肝木，肝位于阴中之阳，所以称肝为一阳。少阴经合于心火，心位于阳中之阳，所以称心为二阳。肾位于阴中之阴，所以称肾为孤脏。一阳和二阳都是火，孤脏是水。现在一水不能胜过二火，所以虽然寒冷直达骨髓，却不会冰结战栗。寒邪在于骨，病名叫做骨痹。骨痹的表现是骨节拘挛，所以这种人将会出现关节拘挛。
这里说的是水火逆乱失调，孤阳不生会导致肌肉消瘦（肉烁）；孤阴不长会导致关节拘挛（挛节）。
黄帝道：有的人肌肉麻木沉重，即使靠近棉絮保暖，仍然感觉麻木沉重，这是什么疾病？
“苛”，类似于疟疾的感觉，承接上文寒热的话题。意思是说，有的人不因寒热侵袭，而是肌肉出现如疟疾般的麻木沉重感，即使靠近棉絮保暖，仍然不能缓解，这是什么病？
岐伯说：这是营气虚弱，卫气相对偏实（注：此处原文逻辑可能有误或特指某种病理状态，通常荣卫俱虚，但依原文翻译）。营气虚则感觉迟钝（不仁），卫气虚则运动不利（不用）。如果营气和卫气都虚弱，就会既感觉迟钝又运动不利，肌肉麻木沉重的症状依旧存在。如果人的形体与神志不相维系，就会死亡。
营气和卫气相伴而行。如果营气虚，则卫气显得相对有余（或运行不畅），这里申明营气虚会导致感觉迟钝（不仁）。“不仁”，是指不知道痛痒。卫气虚会导致运动功能丧失（不用）。“不用”，是指肢体不能灵活转动舒展。如果营气和卫气都虚弱，就会既感觉迟钝又运动不利，肌肉麻木沉重的症状依旧存在。人体的营卫之气，与五脏的神志是相互依存的。如果人的形体与神志不相维系，就意味着形神分离，所以会死亡。这里说的是营卫逆乱失调，就会导致肌肉麻木沉重（肉苛）。
黄帝道：有的人气息逆乱不能平卧，且呼吸有声；有的人不能平卧，但呼吸无声；有的人起居如常，但呼吸有声；有的人能躺下行走时却气喘；有的人不能躺下且不能行走而气喘；有的人不能躺下，躺下就气喘。这些都是哪个脏腑出了问题呢？希望听听其中的道理。
同样是气息逆乱不能平卧，有的呼吸有声，有的呼吸无声，这就不同。同样是呼吸有声，有的起居如常，有的不能平卧，这也不同。喘病的表现相同，有的能躺下行走时喘，有的不能躺下行走也喘，情况各异。这是脏腑之气逆乱失调导致的呼吸喘息，所以问是哪个脏腑引起的？
岐伯说：不能平卧且呼吸有声的，是阳明经气逆乱所致。足三阳经的气血本应下行，现在逆乱上行，所以呼吸有声。阳明经，就是胃脉。胃是六腑之海，其气也是下行的。如果阳明经气逆乱，不能顺着其下行的通道运行，就会导致不能平卧。《内经》本经中说：“胃不和，则卧不安”，说的就是这个意思。
“本”字原作讹误，现改为“下”。不能平卧且呼吸有声，是足阳明经脉之气逆乱所致。足三阳经脉，都是从头部走向足部，所以足三阳经的气血本应下行。现在逆乱上行，所以呼吸有声。大概阳明经就是胃脉。胃是六腑之海，其气也是下行的。现在阳明经气逆乱，不能顺着其下行的通道运行，所以不能平卧。《评热论》说：“不能正偃者，胃中不和也。”“正偃”就是安稳地躺着。引用本经的话说“胃不和，则卧不安”，就是指阳明经气逆乱，不能顺从其通道的意思。这里申明了不能平卧且呼吸有声的原因。
至于起居如常但呼吸有声的，这是肺脏的络脉气逆所致。络脉的气血不能随着经脉上下运行，所以滞留在经脉中而不能进入络脉。络脉病变通常比较轻微，所以起居如常但呼吸有声。
至于起居如常但呼吸有声的，这是肺脏的络脉气逆所致。络脉在外，内通于经脉。现在络脉的气血不能随着经脉上下运行，所以肺气滞留在经脉中而不能行于络脉。络脉在外，病变轻微。病轻，所以起居如常；气滞留在经脉中不行，所以呼吸有声。这里申明了起居如常但呼吸有声的原因。
至于不能平卧，躺下就气喘的，这是水气客居肺部所致。水，是沿着津液流动的。肾是水脏，主管津液，同时也主宰睡眠和喘息。
至于不能平卧，躺下就气喘的，这是水寒之气客居于肺所致。水，是沿着肠胃的津液流行运行的。肾是水脏，津液的主宰。现在水气客居，所以导致不能平卧和气喘。这里申明了不能平卧、躺下就气喘的原因。
黄帝道：说得好。
不能平卧且呼吸有声，是由于胃气逆乱；那么不能平卧但呼吸无声，也是由胃气逆乱引起；起居如常但呼吸有声，是由于肺络气逆；那么能躺下行走时气喘，也是由肺络气逆引起；不能平卧、躺下就气喘，是由于水气客居；那么不能平卧、不能行走而气喘，也是由水气客居引起。黄帝默默地领会了其中的义理，所以称赞他说得好。这里说的是脏腑之气逆乱失调，就会导致呼吸喘息。
Harmony refers to the state of balance; "Ni Diao" (Reverse Regulation/Disharmony) refers to the violation of the normal laws governing Cold, Heat, Water, Fire, Ying (Nutrient), and Wei (Defensive) Qi, resulting in a lack of harmony. When Cold and Heat are disharmonious, it manifests as irritability and Bi syndrome (obstruction syndrome). When Water and Fire are disharmonious, it leads to emaciation of muscles (Ruo Shuo) and joint contracture (Luan Jie). When Ying (Nutrient) and Wei (Defensive) Qi are disharmonious, it results in muscle numbness and heaviness (Rou Ke). When Zang-Fu organ Qi is disharmonious, it causes rapid breathing and wheezing (Xi Chuan).
The Yellow Emperor asked: The human body is not constantly warm, nor constantly hot. What is the reason for fever accompanied by irritability and fullness?
This question follows up on the previous discussion. The previous section mentioned that patients with Warm diseases (Wen Bing) experience fever recurring immediately after sweating, hence the inquiry about the body not being constantly warm or hot. It also stated that some patients suffer from body heat, sweating, irritability, and fullness; thus, the question arises regarding the cause of fever accompanied by irritability and fullness.
Qibo replied: This is due to a deficiency of Yin Qi and an excess of Yang Qi, which causes fever and irritability/fullness.
Both Warm diseases and Heat diseases presenting with fever and irritability/fullness are caused by a deficiency of Yin Qi and an excess of Yang Qi. A deficiency of Yin generates internal heat, while an excess of Yang causes fever along with irritability and fullness. Since the mechanism of Warm and Heat diseases is essentially the same, they are answered together.
The Yellow Emperor asked: The body is not cold due to insufficient clothing, nor is there external cold invading the interior. Why does cold arise from within?
Cold is the opposite of Heat; therefore, this inquiry into cold follows the discussion on heat. The body is not cold due to thin clothing, indicating no exterior cold; the interior does not harbor external cold pathogens. "Cold arising from within" means that cold Qi emanates outward from the interior.
Qibo said: Such individuals often have Bi Qi (Obstruction Qi). Because Yang Qi is deficient and Yin Qi is abundant, the body feels cold, as if emerging from water.
Yang governs heat, and Yin governs cold. Diseases affecting the Yin aspect are named Bi syndrome. Cold arising from within occurs because such individuals possess abundant Bi Qi. Abundant Bi Qi results from deficient Yang Qi and abundant Yin Qi. Deficient Yang Qi causes the body to feel cold; abundant Yin Qi makes the body feel as cold as if just emerged from water. This describes how the disharmony of Cold and Heat leads to irritability and Bi syndrome.
The Yellow Emperor asked: Some people have hot limbs, but when exposed to wind and cold, they feel as if being roasted by fire. What is the reason?
Normally, body heat diminishes when encountering the cold of wind. However, in these cases, limb heat intensifies upon exposure to wind cold, feeling like roasting fire, without the heat subsiding. What is the cause?
Qibo said: In such individuals, Yin Qi is deficient and Yang Qi is excessive. The limbs belong to Yang. When two sources of Yang combine, Yin Qi becomes even more deficient. This is akin to a small amount of water failing to extinguish a raging fire, leading to the solitary dominance of Yang. "Solitary dominance" implies that Yang cannot grow or harmonize with other energies; it merely exists in a state of isolated excess. When exposed to wind, feeling as if roasted by fire indicates that such individuals will suffer from muscle emaciation (Ruo Shuo).
"Heat" refers to Yang Qi. The presence of heat in such individuals is due to deficient Yin Qi and excessive Yang Qi. The body interior belongs to Yin, while the limbs, being external, belong to Yang; hence, the limbs are considered Yang. The combination of excessive Yang Qi with the Yang nature of the limbs creates a convergence of two Yangs, further depleting Yin Qi. Yang represents Fire, and Yin represents Water. With deficient Yin Qi, a small amount of water cannot extinguish the intense fire generated by the convergence of two Yangs, resulting in the solitary dominance of Yang. Solitary Yang cannot generate life; thus, "solitary dominance" means an inability to foster growth, existing only in isolated excess. This isolated excess burns the muscles, so upon encountering wind, the sensation of being roasted by fire indicates that such individuals will suffer from muscle emaciation (Ruo Shuo).
The Yellow Emperor asked: Some people feel extremely cold; hot drinks and fires cannot warm them, and thick clothes cannot keep them warm, yet they do not shiver. What disease is this?
Body coldness can usually be cured by warming methods. If someone feels extreme cold that hot drinks, fires, and thick clothes cannot alleviate, it represents extreme cold. However, the absence of shivering raises the question: what disease is this?
This inquiry into extreme cold follows the previous discussion on extreme heat.
Qibo said: Such individuals typically have an excess of Kidney Qi and engage in activities related to water (or have excessive water-dampness internally), leading to the decline of Taiyang (Greater Yang) Qi. Consequently, Kidney essence dries up and fails to nourish the bones. This is described as one water failing to overcome two fires. The Kidney belongs to Water and governs the bones. If Kidney function declines, marrow fails to fill, causing cold to reach the bones.
(Note: The phrase "one water cannot overcome two fires" appears again later in the text and is considered redundant.) Cold belongs to Yin Qi. The sensation of cold in such individuals stems from a typical excess of Kidney Qi. Excess Kidney Qi leads to heavy water-dampness, which causes the decline of Taiyang Yang Qi. The decline of Taiyang Yang Qi results in "Gu Yin" (Lone Yin). Lone Yin cannot grow, leading to dried-up Kidney essence that fails to nourish the bones. As the Kidney belongs to Water and essence is produced in the bones, dried-up essence means the Kidney cannot function properly; improper Kidney function leads to empty marrow, causing cold to penetrate to the bone level. Hence, hot drinks and thick clothes cannot provide warmth.
The reason for not shivering is that the Liver is One Yang, the Heart is Two Yangs, and the Kidney is a Gu Zang (Lone Organ, purely Yin). One water cannot overcome two fires, so despite extreme cold, there is no shivering. This disease is named Gu Bi (Bone Bi). Such individuals will suffer from joint contracture (Luan Jie).
Although cold reaching the bone should theoretically cause shivering, the absence of shivering is because Kidney Water generates Liver Wood. The Liver is Yang within Yin, thus called One Yang. Shaoyin (Lesser Yin) combines with Heart Fire; the Heart is Yang within Yang, thus called Two Yangs. The Kidney is Yin within Yin, thus called the Lone Organ. One Yang and Two Yangs represent Fire, while the Lone Organ represents Water. Currently, one water cannot overcome two fires; therefore, even though cold reaches the bone, there is no freezing shiver. With cold located in the bone, the disease is named Bone Bi. Bone Bi manifests as joint stiffness and contracture; thus, such individuals will suffer from joint contracture.
This section explains that the disharmony of Water and Fire, where solitary Yang cannot generate, leads to muscle emaciation (Ruo Shuo); and where solitary Yin cannot grow, leads to joint contracture (Luan Jie).
The Yellow Emperor asked: Some people suffer from Rou Ke (muscle numbness/heaviness); even near cotton wadding, they still feel numb and heavy. What disease is this?
"Ke" is similar to the sensation in Malaria. Following the theme of Cold and Heat, this refers to individuals who, without external Cold or Heat invasion, experience muscle numbness and heaviness akin to malaria. Even near warming materials, relief is not achieved. What is this disease?
Qibo said: This is due to deficient Ying Qi (Nutrient Qi) and relatively solid/excessive Wei Qi (Defensive Qi). Deficient Ying Qi leads to anesthesia (Bu Ren - loss of sensation); deficient Wei Qi leads to paralysis/immobility (Bu Yong - loss of movement). If both Ying and Wei Qi are deficient, there is both anesthesia and immobility, and the condition of Rou Ke persists. If the physical form and the Shen (Spirit/Mind) are disconnected, death ensues.
Ying and Wei Qi travel together. If Ying Qi is deficient, Wei Qi appears relatively excessive (or unregulated). This clarifies that deficient Ying Qi causes Bu Ren (anesthesia/loss of pain and temperature sensation). Wei Qi deficiency causes Bu Yong (immobility/inability to move freely). If both are deficient, both symptoms occur, and muscle numbness persists. Human Ying and Wei Qi are interconnected with the Shen of the Five Zang organs. If the body and Spirit are disconnected, it signifies a separation of Form and Spirit, leading to death. This explains how the disharmony of Ying and Wei Qi leads to Rou Ke.
The Yellow Emperor asked: Some people have rebellious Qi preventing them from lying flat, accompanied by noisy breathing. Others cannot lie flat but breathe silently. Some have normal daily activities but noisy breathing. Some wheeze only when walking while lying down. Others wheeze when unable to lie flat and unable to walk. Some cannot lie flat and wheeze immediately upon lying down. Which Zang organs are responsible for these conditions? I wish to hear the explanation.
Although all involve rebellious Qi preventing lying flat, the presence or absence of noise differs. Although all have noisy breathing, those with normal activity differ from those who cannot lie flat. Although wheezing is common, the triggers (lying/walking) vary. This is wheezing caused by Zang-Fu Qi disharmony; thus, the question asks which Zang organ is involved.
Qibo said: Inability to lie flat with noisy breathing is due to the rebellion of Yangming Qi. The Qi of the Three Yang meridians normally descends; now, rebelling upward, it causes noisy breathing. Yangming refers to the Stomach meridian. The Stomach is the Sea of the Six Fu organs, and its Qi also descends. If Yangming Qi rebels and cannot follow its descending pathway, it prevents lying flat. The Classic states: "If the Stomach is not harmonious, sleep is restless," which refers to this situation.
(Note: Correction of textual error noted in original commentary.) Inability to lie flat with noisy breathing is due to the rebellion of the Foot-Yangming meridian. The Foot-Three-Yang meridians run from head to foot, so their Qi normally descends. Now rebelling upward, it causes noisy breathing. Yangming is the Stomach meridian. The Stomach is the Sea of the Six Fu organs, and its Qi descends. Rebellious Yangming Qi cannot follow its descending path, preventing lying flat. The *Ping Re Lun* states: "Those who cannot lie flat have disharmony in the Stomach." "Zheng Yan" means lying flat comfortably. Citing the Classic's "Stomach disharmony leads to restless sleep" explains the rebellion of Yangming Qi failing to follow its course. This clarifies the cause of inability to lie flat with noisy breathing.
As for those with normal activity but noisy breathing, this is due to the rebellion of the collateral vessels of the Lung. Collateral vessels cannot ascend and descend with the main meridians, so Qi remains in the main meridians rather than entering the collaterals. Pathology in collateral vessels is minor; thus, daily activities remain normal despite noisy breathing.
Specifically, normal activity with noisy breathing is due to rebellious Qi in the Lung's collateral vessels. Collaterals are external and connect internally to the meridians. Now, Qi cannot flow with the meridians, so Lung Qi stagnates in the meridians instead of flowing into the collaterals. Being external, collateral pathology is mild. Mild illness allows normal activity; stagnation in meridians causes noisy breathing. This clarifies the case of normal activity with noisy breathing.
Regarding inability to lie flat and wheezing upon lying down, this is due to Water Qi invading the Lungs. Water flows along with Jin Ye (Body Fluids). The Kidney is the Water Organ and governs Jin Ye; it also governs sleep and wheezing.
Specifically, inability to lie flat and wheezing upon lying down is due to Cold-Water Qi invading the Lungs. Water flows along the fluids of the intestines and stomach. The Kidney is the Water Organ and master of Jin Ye. Now, with Water Qi invading, it causes inability to lie flat and wheezing. This clarifies the case of inability to lie flat and wheezing upon lying down.
The Yellow Emperor said: Excellent.
Inability to lie flat with noisy breathing is due to Stomach Qi rebellion; inability to lie flat with silent breathing is also due to Stomach Qi rebellion. Normal activity with noisy breathing is due to Lung Collateral rebellion; wheezing while walking (when able to lie down) is also due to Lung Collateral rebellion. Inability to lie flat with wheezing upon lying down is due to Water Qi invasion; inability to lie flat, inability to walk, and wheezing are also due to Water Qi invasion. The Yellow Emperor silently comprehended these principles and praised the answer. This section explains how Zang-Fu Qi disharmony leads to wheezing.