黄帝曰。余闻十二经脉。以应十二经水者。其五色各异。清浊不同。人之血气若一。应之奈何。
岐伯曰。人之血气。苟能若一。则天下为一矣。恶有乱者乎。黄帝曰。余闻一人。非问天下之众。
岐伯曰。夫一人者。亦有乱气。天下之众。亦有乱人。其合为一耳。
此篇论阴阳清浊。交相于乱者也。人之十二经脉。外合十二经水。内合五脏六腑。其五色各异。
清浊不同。故一人之身有乱气。犹天下之众有乱人。其理可合之为一耳。恶有不乱者乎。杨元如曰。
清浊。天地之气也。天气下降。地气上升。清浊相干。命曰乱气。不乱则生化灭矣。故曰夫一人者。
亦有乱气。天下之众。亦有乱人。
谓天下之人。皆有此乱气也。
黄帝曰。愿闻人气之清浊。岐伯曰。受谷者浊。受气者清。清者注阴。浊者注阳。浊而清者。
上出于咽。清而浊者则下行。清浊相干。命曰乱气。
六腑为阳。五脏为阴。六腑受谷者浊。五脏受气者清。故清者注阴。浊者注阳。浊而清者。谓
水谷所生之清气。上出于咽喉。以行呼吸。清而浊者。肺之浊气。下注于经。内注于海。此人气之
清浊相干。命曰乱气。莫仲超曰。上节言天下之众。皆有此乱气。谓人合天地之清浊也。故复曰愿
闻人气之清浊。
黄帝曰。夫阴清而阳浊。浊者有清。清者有浊。清浊别之奈何。岐伯曰。气之大别。清者上注于
肺。浊者下走于胃。胃之清气。上出于口。肺之浊气。下注于经。内积于海。
此论人合天地之气也。大别者。应天地之大而有别也。天清地浊。而上下气交。故浊者有清。
清者有浊。而人亦应之。肺属天而阳明居中土。故清者上注于肺。浊者下走于胃。此清浊之上下也。
然浊者有清。胃之清气。上出于口。口鼻者。气出入之门户。此胃腑水谷之浊。生此清气。上出于
口。以司呼吸而应开阖者也。清者有
浊。肺之浊气。下注于经。内积于海。肺为精水之原。清中所生之津液。流溢于下。即所谓谷入于
胃。乃传之肺。流溢于中。布散于外。精专者行于经隧。下注于经者。行于经隧也。流溢于中者。
内积于海也。海者。下焦精髓之海也。此阴阳清浊之气交也。朱济公曰。天为阳。地为阴。天一生
水。地二生火。火为阳。水为阴。故清者有浊。浊者有清。
黄帝曰。诸阳皆浊。何阳独甚乎。岐伯曰。手太阳独受阳之浊。手太阴独受阴之清。其清者上
走空窍。其浊者下行诸经。诸阴皆清。足太阴独受其浊。
诸阳皆浊。而手太阳独受其浊之甚。盖手太阳小肠。主受盛胃腑之糟粕。有形者皆浊。而糟粕
为浊之甚者也。诸阴皆清。而手太阴为五脏之长。华盖于上。故手太阴独受阴之清。空窍者。皮毛
之汗空也。手太阴主周身之气。走于空窍。以司呼吸开阖。应天之道也。小肠受盛糟粕。济泌别汁。
化而为赤。下行于十二经脉。应地之道也。脾为仓禀之官。主输运胃腑水谷之精汁。故诸阴皆清。而
足太阴独受其浊。杨元如曰。手太阴主天。故独受其清。足太阴主地。故独受其浊。此篇论人之
阴阳清浊。应合天地经水。故帝曰十二经脉。应十二经水。伯曰天下之众。又曰气之大别。
黄帝曰。治之奈何。岐伯曰。清者其气滑。浊者其气涩。此气之常也。故刺阴者深而留之。刺
阳者浅而疾之。清浊干者。以数调之也。
气之滑利者。应天运于外。故浅而疾之。涩浊者。应地居于中。故深而留之。清浊相干者。阴阳
之气交。故以数
调之。数者。天地之常数也。朱济公曰。以数调之。与逆顺篇之无失常数同义。此篇以人之清浊。
合天地之阴阳。下章论人之形体。应天地日月水火。
Huangdi said: I have heard that the twelve meridians correspond to the twelve rivers. The colors of these waters differ, and their clarity and turbidity vary. If human qi and blood are uniform, how should one respond to this?
Qibo replied: If human qi and blood were truly uniform, then the world would be unified, and where would there be chaos?
Huangdi said: I am asking about an individual person, not about the multitude of the world.
Qibo replied: Even within a single person, there is chaotic qi; among the multitude of the world, there are chaotic people. Their principles can be integrated into one.
This chapter discusses the chaotic qi arising from the intermingling of yin-yang, clarity, and turbidity. The twelve meridians of the human body correspond externally to the twelve rivers and internally to the five zang and six fu organs. Because the water colors differ and their clarity and turbidity vary, even a single body contains chaotic qi, just as there are chaotic individuals among the multitude of the world. Their logic can be viewed together; how could there be no chaos? Yang Yuanru stated: Clarity and turbidity are the qi of heaven and earth. Heaven’s qi descends, earth’s qi ascends. When clarity and turbidity interfere with each other, it is called chaotic qi. Without such interference, the process of generation and transformation would cease. Thus, it is said that even a single person has chaotic qi, and among the multitude of the world, there are chaotic people. This means that all people in the world possess this chaotic qi.
Huangdi said: I wish to hear about the clarity and turbidity of human qi. Qibo replied: Qi derived from grain is turbid; qi derived from air is clear. Clear qi enters the yin (zang organs), and turbid qi enters the yang (fu organs). The clear aspect within the turbid rises out through the pharynx; the turbid aspect within the clear flows downward. When clear and turbid interfere with each other, it is called chaotic qi.
The six fu organs are yang, and the five zang organs are yin. The fu organs receive grain, so their qi is turbid; the zang organs receive essence/air, so their qi is clear. Therefore, clear qi enters the yin, and turbid qi enters the yang. "Turbid yet clear" refers to the clear qi generated from food and drink, which rises out through the throat to facilitate respiration. "Clear yet turbid" refers to the turbid qi of the lung, which flows downward into the meridians and inwardly accumulates in the Sea (the lower jiao essence sea). This interaction of human clear and turbid qi is called chaotic qi. Mo Zhongchao stated: The previous section discussed how the multitude of the world possesses this chaotic qi, meaning humans combine the clarity and turbidity of heaven and earth. Hence, the question arises again regarding the clarity and turbidity of human qi.
Huangdi said: Yin is clear and yang is turbid. Turbid qi contains clear elements, and clear qi contains turbid elements. How can they be distinguished? Qibo replied: Broadly speaking, clear qi flows upward into the lung, and turbid qi flows downward into the stomach. The clear qi of the stomach rises out through the mouth; the turbid qi of the lung flows downward into the meridians and inwardly accumulates in the Sea.
This discusses how humans correspond to the qi of heaven and earth. "Broad distinction" refers to the major differences corresponding to heaven and earth. Heaven is clear, earth is turbid, and the upper and lower qi intersect. Thus, turbid qi contains clear elements, and clear qi contains turbid elements, and humans correspond accordingly. The lung corresponds to heaven, and the Yangming Stomach occupies the central earth position. Therefore, clear qi flows upward into the lung, and turbid qi flows downward into the stomach; this is the vertical distribution of clarity and turbidity. However, turbid qi indeed contains clear qi: the clear qi generated from food and drink in the stomach rises out through the mouth. The mouth and nose are the gates for qi entry and exit. This clear qi, generated from the turbidity of stomachal grain, rises out through the mouth to govern respiration and adapt to opening and closing. Clear qi indeed contains turbid elements: the turbid qi of the lung flows downward into the meridians and inwardly accumulates in the Sea. The lung is the source of essence fluids. The fluids generated from clear qi flow downward. As stated, "When food enters the stomach, it is transmitted to the lung, flows and overflows in the middle, and spreads outward. The most refined part travels through the vessel tunnels, and the part flowing downward into the vessels travels through the vessel tunnels." The part overflowing in the middle is what is inwardly accumulated in the Sea. The Sea refers to the lower jiao essence sea. This is the intersection of yin-yang, clear, and turbid qi. Zhu Jigong stated: Heaven is yang, earth is yin. One generates water, two generates fire. Fire is yang, water is yin. Therefore, clear qi contains turbid elements, and turbid qi contains clear elements.
Huangdi said: All yang meridians receive turbid qi. Why does the Hand-Taiyang meridian alone receive the most severe turbidity? Qibo replied: The Hand-Taiyang Small Intestine meridian alone receives the turbid qi of yang, and the Hand-Taiyin Lung meridian alone receives the clear qi of yin. The clear qi of the Hand-Taiyin flows upward to the orifices, while its turbid qi flows downward to the various meridians. All yin meridians receive clear qi, but the Foot-Taiyin Spleen meridian alone receives turbid qi.
All yang meridians receive turbid qi, but the Hand-Taiyang Small Intestine meridian alone receives the most severe turbidity. This is because the Small Intestine receives and holds the dregs from the stomach. Solid substances are turbid, and dregs are the most turbid. All yin meridians receive clear qi, but the Hand-Taiyin Lung is the leader of the five zang organs, covering them like a canopy above. Therefore, the Hand-Taiyin alone receives the clear qi of yin. Orifices refer to the sweat pores of the skin. The Hand-Taiyin Lung governs the qi of the whole body, flowing to the orifices to govern respiratory opening and closing, corresponding to the Way of Heaven. The Small Intestine receives and holds dregs, filters and separates juices, transforms them into red blood, and flows downward into the twelve meridians, corresponding to the Way of Earth. The Spleen is the official of granaries, primarily transporting the refined juices of stomachal grain. Therefore, all yin meridians receive clear qi, but the Foot-Taiyin Spleen meridian alone receives turbid qi. Yang Yuanru stated: The Hand-Taiyin corresponds to heaven, so it alone receives clear qi; the Foot-Taiyin corresponds to earth, so it alone receives turbid qi. This chapter discusses how human yin-yang, clarity, and turbidity correspond to the rivers of heaven and earth. Hence, Huangdi said the twelve meridians correspond to the twelve rivers, and Qibo spoke of the multitude of the world and the broad distinction of qi.
Huangdi said: How should treatment be conducted? Qibo replied: Clear qi is slippery and smooth, while turbid qi is sluggish and obstructed. This is the normal state of qi. Therefore, when needling yin meridians, one should insert deeply and retain the needle; when needling yang meridians, one should insert shallowly and withdraw quickly. For cases of clear-turbid interference, regulation is achieved by adjusting the number of manipulations.
Qi that is slippery and smooth corresponds to the heavenly way operating externally, so needling should be shallow and quick. Qi that is sluggish and turbid corresponds to the earthly way residing centrally, so needling should be deep and retained. Interference between clear and turbid represents the intersection of yin and yang qi, so regulation is achieved by using specific numbers (manipulation counts). The "number" refers to the constant laws of heaven and earth. Zhu Jigong stated: "Regulating by number" has the same meaning as "do not deviate from the constant numbers" in the *Ni Shun* chapter. This chapter combines human clarity and turbidity with the yin-yang of heaven and earth; the next chapter discusses how human form corresponds to the sun, moon, water, and fire of heaven and earth.