黄帝问于岐伯曰。余尝上于清冷之台。中阶而顾。匍匐而前则惑。余私异之。窃内怪之。独瞑
独视。安心定气。久而不解。独博独眩。被发长跪。俯而视之。后久之不已也。卒然自上。何气使
然。岐伯对曰。五脏六腑之精气。皆上注于目而为之精。精之窠为眼。骨之精为瞳子。筋之精为黑
眼。血之精为络。其窠气之精为白眼。肌肉之精为约束。裹撷筋骨血气之精。而与脉并为系。上属于
脑。后出于项中。故邪中于项。因逢其身之虚。其入深。则随眼系以入于脑。入于脑则脑转。脑转
则引目系急。目系急则目眩以转矣。邪其精。其精所中。不相比也。则精散。精散则视歧。视歧见
两物。目者。五脏六腑之精也。营卫魂魄之所常营也。神气之所生也。故神劳则魂魄散。志意乱。是故
瞳子黑眼法于阴。白眼赤脉法于阳也。故阴阳合传而精明也。目者。心使也。心者。神之舍也。故神
精乱而不转。卒然见非常处。精神魂魄不相得。故曰惑也。
清冷之台。东苑之台名也。惑眩乱也。精、精明也。窠、藏也。眼者。瞳子黑白之总名也。骨之精
为瞳子。肾之精也。筋之精为黑眼。肝之精也。血之精为络。心之精也。窠气之精。为白眼。肺之精
也。约束者。目之上下纲。肌肉之睛为约束。脾之精也。裹撷筋骨血气之精。心主包络之精也。包络
之精。与脉并为目系。上属于脑。后出于项
中。是诸脉皆上系于目。会于脑。出于项。此脉系从下而上。从前而后也。若邪中于项。则随眼系
入于脑。入于脑则脑转。脑转则引目系急。目系急。则目眩以转矣。比、周密也。邪其精。其精为
邪所中。则不相比密。而精散矣。精散则视歧而见。两物矣。夫心藏神。肾藏志。肝藏魂。肺藏魄。
脾藏意。此五脏所藏之神志也。目者。五脏六腑之精也。是故瞳子黑眼法于阴。白眼赤脉法于阳。故
阴阳相合。传于目而为睛明也。夫心者。五脏之专精也。目者。其窍也。华色者。心之荣也。故目
乃心之使。心者。神之舍也。神精乱而不转。则卒然见非常处。精神魂魄散。不相得。故曰惑也。
黄帝曰。余疑其然。余每之东苑。未曾不惑。去之则复。余唯独为东苑劳神乎。何其异也。岐
伯曰。不然也。心有所喜。神有所恶。卒然相感。则精气乱。视误故惑。神移乃复。是故闻者为迷。
甚者为惑。
夫火之精为神。水之精为精。精上传于神。共凑于目而为精明。若神感于精。则精气乱而为惑矣。
盖精明者。从下而上。从前而后也。是以上文论从后而逆于前。此论上而感于下。皆反逆而为惑也。
心有所喜者。喜之东苑而上清冷之台也。神乃火之精。而恶清冷。故神有所恶。卒然相感者。神志相
感也。神乃清冷而有所感。则神反下交于阴矣。神气下交。则精气乱矣。精气乱。则视误而为惑矣。
候神移于上。而后乃复也。夫肾藏志而开窍于耳。是故志不上交于神则迷。甚则神反下交于志则惑
也。按此章总结九针之道。贵在得神。能存乎精气神者。可无惑于天下。故帝设此问。而伯论其精气神
焉。宝命全角论曰。凡刺之真。必先治神。又曰浅深在志。远近若一。八正神明论曰。神乎神。耳不闻。
目明心开。而志先慧然独悟。离合真邪论曰。诛罚无过。命
曰大惑。反乱大经。真不可复。盖治针之要。贵在诊视审察。存神定志。适其常变。万举万全。可
传于后世。令终而不灭。至于修身养生。治国治民。总在调养精气神三者。是以内经素问。首论上
古天真。末结解精微。论所以修身养生也。本经首论九针之道。末结大惑痈疽。所以治国治民也。知
修身则知所以治民。知治民则知所以治天下国家矣。
黄帝曰。人之善忘者。何气使然。岐伯曰。上气不足。下气有余。肠胃实而心肺虚。虚则营卫
留于下。久之不以时上。故善忘也。
本篇曰。目。者五脏六腑之精也。营卫魂魄之所常营也。八正神明论曰。观其冥冥者。言形气营
卫之不形于外。而工独知之。又曰养神者。必知营卫血气之盛衰。故此以下。复论营卫之行。所当详
审者也。夫营卫生于中焦之阳明。营运于形身之外内。气者。先天之真元。生于下焦精水之中。上通
于心肺。环转于上下。上气不足。下气有余。则肠胃实而心肺虚矣。虚则营卫留于下。久之不以时上。
故善忘也。倪仲玉曰。肠胃。阳明也。先天之气逆于下。则后天之气亦逆于中。中下并逆。则上气
大虚。故善忘也。
黄帝曰。人之善饥而不嗜食者。何气使然。岐伯曰。精气并于脾。热气留于胃。胃热则消谷。谷
消则善饥。胃气逆于上。胃脘寒。故不嗜食也。
脾主为胃行其津液者也。精气并于脾。则脾家实而不能为胃转输。则热气留于胃。而消谷善饥矣。
夫谷入于胃。五脏六腑。皆以受气。别出两行营卫之道。清者为营。浊者为卫。其大气之搏而不行者。
积于上焦之胸
中。胃气逆上者。谓之悍气。上冲于头而走空窍。盖脾不能为胃行其津液。则营卫大气。留而不行。
胃之逆气。反上冲于头。而别走阳明矣。胃脘者。胃之上脘。大气不行。则上焦虚而胃脘寒。上焦虚
寒。不能主纳。故不嗜食也。以上二节。论营卫生始之因。
黄帝曰。病而不得卧者。何气使然。岐伯曰。卫气不得入于阴。常留于阳。留于阳则阳气满。阳
气满则阳跷盛。不得入于阴则阴气虚。故目不瞑矣。黄帝曰。病目而不得视者。何气使然。岐伯曰。
卫气留于阴。不得行于阳。留于阴则阴气盛。阴气盛则阴跷满。不得入于阳。则阳气虚。故目闭也。
阳跷者。足太阳之别。起于足之外踝。循胁下肩膊。从口吻至目内 。与阴跷会于足太阳之睛明。阴
跷乃足少阴之别。起于然谷之后。循胸上入缺盆。从咽喉至目内 。与阳跷会于足太阳之睛明。卫气
行阳二十五周。下行阴分。而复会于目内。行于五脏之阴。亦如阳行之二十五周。而复会于目。是以
卫气出于阳。则目张而寤。入于阴。则目瞑而卧。故卫气留于阳。则阳跷盛。不得入于阴。则阴气
虚。故目不瞑。卫气留于阴。则阴跷满。不得入于阳。则阳气虚。故目闭也。此言卫气行阳行阴。皆
从目以出入。故曰目者。营卫魂魄之所常营也。
王子律曰。此节重见者再。盖其文则同。而各有所谓也。
黄帝曰。人之多卧者。何气使然。岐伯曰。此人肠胃大而皮肤涩。而分肉不解焉。肠胃大则卫气
留久。皮肤涩则分肉不解。其行迟。夫卫气者。昼日常行于阳。夜行于阴。故阳气尽则卧。阴气尽
则寤。故肠胃大则卫气行留久。皮肤湿。分肉不解。则行迟。留于阴也久。其气不精则欲瞑。故多卧
矣。其肠胃小。皮肤滑以缓。分肉解利。卫气之留于阳也久。故少瞑焉。
卫气外行于肌肉之纹理。内行于肠胃之募原。分肉者。肌肉之腠理。其人肠胃大。则卫气行于
阴而留久。皮肤涩。分肉不解。则出于阳而行迟。留于阴也久。其气不精。则欲瞑而多卧矣。其人肠
胃小。则卫气周于阴也速。皮肤滑以缓。分肉解利。卫气之行于阳也久。故少瞑焉。盖卫气日行于阳。
夜行于阴。阳气尽则入于阴而卧。阴气尽则出于阳而寤。如留于阴久则多卧。留于阳久则少瞑焉。上
节论卫气通贯于阳跷阴跷之脉中。
此论卫气出入于分肉募原之气分。夫卫者阳气也。主外而夜行于阴。卫者浊气也。注阳而复贯于脉。
此应天道之营运。无往而不遍者也。
黄帝曰。其非常经也。卒然多卧者。何气使然。岐伯曰。邪气留于上 。上 闭而不通。已食若饮
汤。卫气久留于阴而不行。故卒然多卧焉。（ 焦同）
此言卫气留于上而不行于上。则卒然多卧。盖身半以上为阳。身半以下为阴也。非常经者。非一日
行于阳。夜行于阴之经常出入。此因邪气留于上焦。则上焦闭而不通。饮食于胃。则中焦满实。以致
卫气久留于下之阴。而不能上行于阳。故卒然多卧也。
黄帝曰善。治此诸邪奈何。岐伯曰。先其脏腑。诛其小过。后调其气。盛者泻之。虚者补之。必
先明知其形志之苦乐。定乃取之。
先其脏腑者。先调其五脏六腑之精气神志。诛其小过者。去其微邪也。后调其气者。调其营卫
也。必先明知
其形志之苦乐。定其灸刺熨引。甘药醪醴以取之。盖志者。精神魂魄志意也。形者。营卫血气之
所营也。故志苦则伤神。行劳则伤精气矣。
Huangdi asked Qibo: "I once ascended the Qingleng Terrace. When I reached the middle of the stairs and looked back, or when I crawled forward, I felt dizzy and confused. I privately found this strange and wondered about it internally. Whether I closed my eyes alone or opened them alone, after calming my mind and stabilizing my Qi for a long time, the dizziness did not resolve. Whether I gazed far alone or stared at something, with hair disheveled, kneeling for a long time, and looking down, even after a long while, the symptoms persisted. This sudden onset from above—what Qi causes this?"
Qibo replied: "The essence (Jing) of the five Zang organs and six Fu organs all ascend to the eyes to form visual clarity. The gathering place of this essence is the eye socket. The essence of bone manifests as the pupil (Tongzi). The essence of sinew manifests as the black part of the eye (iris). The essence of blood manifests as the collaterals (blood vessels in the eye). The essence of Qi within the socket manifests as the white part of the eye (sclera). The essence of muscle manifests as the constraints (eyelids that control opening and closing). These essences of bone, sinew, blood, and Qi are wrapped together and merge with the meridians to form the Eye System (Mu Xi), which connects upward to the brain and emerges posteriorly from the neck. Therefore, if pathogenic factors invade the neck, coinciding with bodily deficiency, and penetrate deeply, they follow the Eye System into the brain. Once in the brain, it causes vertigo (brain rotation). Vertigo pulls on the Eye System, causing tension. Tension in the Eye System leads to dizziness and spinning of the eyes. Pathogenic factors disturb the essence; when the essence is invaded by pathogens, it cannot coordinate closely, leading to the scattering of essence. Scattered essence results in diplopia (seeing double objects). The eyes are the gathering place of the essence of the five Zang and six Fu organs, the constant residence of Ying-Wei (Defensive and Nutritive) Qi, Hun and Po souls, and the birthplace of Shen spirit. Thus, mental labor scatters Hun and Po and confuses Yi Zhi (will/intent). Therefore, the pupil and black part follow Yin, while the white part and red vessels follow Yang. Yin and Yang harmoniously transmit to create clear vision. The eyes are the envoys of the Heart; the Heart is the dwelling of Shen. Thus, if Shen Jing (spiritual essence) becomes chaotic and fails to rotate normally, and one suddenly sees unusual sights, the Spirit, Essence, Hun, and Po fail to harmonize. This is called 'Huo' (confusion/dizziness)."
*Note: Qingleng Terrace is a name for a terrace in Dongyuan. 'Huo' refers to dizziness and confusion. 'Jing' refers to visual clarity. 'Ke' refers to a storage place. The eye is the general term for the pupil and the black/white parts. Bone essence is the pupil, belonging to Kidney essence. Sinew essence is the black part, belonging to Liver essence. Blood essence is the collaterals, belonging to Heart essence. Qi essence in the socket is the white part, belonging to Lung essence. Constraints refer to the upper and lower eyelids; muscle essence is the constraint, belonging to Spleen essence. Wrapping and extracting the essence of bone, sinew, blood, and Qi belongs to the Pericardium essence. Pericardium essence merges with meridians to form the Eye System, connecting to the brain and emerging from the neck. All these meridians connect to the eyes, gather at the brain, and emerge from the neck. This system runs from below upward and from front to back. If pathogens invade the neck, they enter the brain via the Eye System. Brain entry causes vertigo, pulling the Eye System tight, causing dizziness. 'Bi' means close/united. Pathogens disturbing essence cause it to scatter, leading to diplopia. Heart stores Shen, Kidney stores Zhi, Liver stores Hun, Lung stores Po, Spleen stores Yi. Eyes gather essence of Zang-Fu. Pupil/black part follows Yin; white/red vessels follow Yang. Yin-Yang harmony creates brightness. Heart is the essence of Zang organs; eyes are its orifices. Complexion is Heart's glory. Eyes are Heart's envoys; Heart is Shen's dwelling. Chaotic Shen Jing seeing unusual sights causes scattered Spirit/Essence/Hun/Po, termed 'Huo'.*
Huangdi said: "I doubt this. Every time I go to Dongyuan, I feel dizzy; leaving restores me. Am I uniquely mentally taxed by Dongyuan? Why is it so different?"
Qibo said: "No. The Heart has preferences; Shen has aversions. Sudden mutual stimulation causes Qi chaos, leading to visual error and confusion. When Shen shifts, recovery occurs. Mild cases are 'Mi' (bewilderment); severe cases are 'Huo' (confusion)."
"The essence of Fire is Shen; the essence of Water is Jing. Jing transmits upward to Shen, gathering in the eyes to form clarity. If Shen is affected by Jing, Qi chaos ensues, causing confusion. Clarity moves upward from below and backward from front. The previous text discussed rear-to-front reversal; this discusses top-down influence. Both reversals cause confusion. Preference for Dongyeng/Qingleng Terrace involves Shen (Fire essence) encountering Cold (aversion). Sudden stimulation is Shen-Zhi interaction. Shen in cold interacts downward with Yin. Downward Shen-Qi causes Qi chaos. Chaos causes visual error ('Huo'). Recovery occurs when Shen returns upward. Kidney stores Zhi, opens to ears. Zhi failing to interact upward with Shen causes 'Mi'; Shen interacting downward with Zhi causes 'Huo'. This chapter summarizes the Nine Needles, emphasizing Shen preservation. One who preserves Jing-Qi-Shen has no confusion in the world. Huangdi asked; Qibo explained Jing-Qi-Shen. *Baoming Quanxue Lun* states: True acupuncture requires governing Shen first. *Bazheng Shenming Lun* states: Understanding invisible Qi requires knowing Ying-Wei/Blood-Qi fluctuations. Subsequent sections discuss Ying-Wei circulation. Ying-Nutritive Qi originates in Middle Jiao (Yangming Stomach), circulating externally and internally. Qi is Pre-heaven Yuan Yuan, originating in Lower Jiao essence/water, ascending to Heart/Lung, rotating up/down. Upper Qi deficiency and Lower Qi excess result in full Stomach/Intestines and deficient Heart/Lungs. Deficiency traps Ying-Wei below, preventing timely ascent, causing forgetfulness. Ni Zhongyu notes: Stomach/Intestines are Yangming. Pre-heaven Qi reversing downward causes Post-heaven Qi to reverse in Middle. Middle/Lower reversal causes severe Upper Qi deficiency, hence forgetfulness."
Huangdi said: "Why do some feel hungry but lack appetite?"
Qibo said: "Essence gathers in Spleen; Heat stays in Stomach. Stomach heat digests food quickly, causing hunger. Rebellious Stomach Qi causes cold in the Epigastrium, leading to lack of appetite."
*Spleen transports fluids for Stomach. Essence gathering in Spleen makes Spleen excess, unable to transport, trapping Heat in Stomach, causing hunger. Food enters Stomach; Zang-Fu receive Qi. Two paths emerge: Clear becomes Ying (Nutritive); Turbid becomes Wei (Defensive). Large Qi stagnating in Upper Jiao Chest. Rebellious Stomach Qi is Han Qi (Fierce Qi), rushing to head/orifices. Spleen failure to transport fluids stops Ying-Wei/Large Qi movement. Stomach rebellious Qi rushes to head, diverging to Yangming. Upper Epigastrium cold due to Upper Jiao deficiency prevents intake, causing lack of appetite. These sections discuss origins of Ying-Wei.*
Huangdi said: "Why can some not lie down to sleep?"
Qibo said: "Wei Qi fails to enter Yin, staying in Yang. Yang excess makes Yang Qiao vessel strong. Failure to enter Yin makes Yin Qi deficient, resulting in inability to close eyes (insomnia)."
Huangdi said: "Why can some not open their eyes to see?"
Qibo said: "Wei Qi stays in Yin, failing to move in Yang. Yin excess makes Yin Qiao vessel full. Failure to enter Yang makes Yang Qi deficient, resulting in closed eyes."
*Yang Qiao is a branch of Foot-Taiyang Bladder, starting at lateral ankle, passing shoulder/arm to inner canthus, meeting Yin Qiao at Jingming (BL1). Yin Qiao is a branch of Foot-Shaoyin Kidney, starting after RanGu (KI2), passing chest/clavicle/throat to inner canthus, meeting Yang Qiao at Jingming (BL1). Wei Qi circulates 25 cycles in Yang, descends to Yin, meets at inner canthus. Circulates 25 cycles in Five Zang Yin, meets at eyes. Wei exiting Yang opens eyes/waking; entering Yin closes eyes/sleeping. Yang retention strengthens Yang Qiao/Yin deficiency -> insomnia. Yin retention fills Yin Qiao/Yang deficiency -> closed eyes. Wei Qi enters/exits via eyes. Eyes are residence of Ying-Wei/Hun-Po.*
Wang Zilv noted: This section repeats twice with different emphases.
Huangdi said: "Why do some sleep excessively?"
Qibo said: "Those with large intestines/stomach and rough skin/tight muscles. Large gut retains Wei Qi longer; rough skin/tight muscles slow movement. Wei Qi travels Yang by day, Yin by night. Yang exhaustion leads to sleep; Yin exhaustion leads to waking. Large gut prolongs Yin stay; rough skin slows Yang exit. Prolonged Yin stay with impure Qi induces sleepiness (excessive sleeping). Small gut, smooth skin, loose muscles allow prolonged Yang stay, reducing sleep."
*Wei Qi moves externally in muscle textures, internally in Gut Mu-Yuan. Large gut prolongs Yin stay; rough skin slows Yang exit -> excessive sleep. Small gut speeds Yin cycle; smooth skin allows prolonged Yang stay -> less sleep. Day/Night Yang/Yin cycles govern sleep/wake. Prolonged Yin = sleep; Prolonged Yang = wake. Previous section discussed Yang/Yin Qiao meridians; this discusses Wei Qi in muscle/Mu-Yuan spaces. Wei is Yang (external, night Yin); Wei is Turbid (Yang injection, meridian connection). This follows Heaven's operation, pervasive everywhere.*
Huangdi said: "What causes sudden excessive sleep deviating from normal channels?"
Qibo said: "Pathogens linger in Upper Jiao, causing blockage. After eating or drinking soup, Wei Qi stays long in Yin without moving, causing sudden sleepiness."
*Pathogens blocking Upper Jiao prevent Wei Qi ascent. Food filling Middle Jiao traps Wei Qi in Lower Yin, preventing Yang ascent -> sudden sleep. Normal daily Yang/Night Yin cycles are disrupted.*
Huangdi said: "How to treat these conditions?"
Qibo said: "First identify the Zang-Fu organ involved; eliminate minor pathogenic errors. Then regulate Qi: Reduce Excess, Tonify Deficiency. Must first ascertain the patient's physical and mental state (pain/joy) before selecting treatment."
*Identifying Zang-Fu regulates Essence/Qi/Shen/Zhi. Eliminating minor errors removes slight pathogens. Regulating Qi balances Ying-Wei. Treatment selection (moxibustion, acupuncture, warming, herbs) depends on Form (Ying-Wei/Blood-Qi) and Will (Spirit/Hun-Po-Zhi-Yi). Mental distress harms Shen; physical labor harms Essence/Qi.*