五脏六腑，主十二经脉，一气营运，环转不息，脏腑不和则气厥，气厥则寒热相移，寒热
相移，此皆得之气厥，故帝问寒热相移，伯举而论之，终言得之气厥也。
黄帝问曰∶五脏六腑，寒热相移者何？
五脏六腑，一气营运，寒热相移，由于气厥，帝故问之。
岐伯对曰；肾移寒于脾，痈肿，少气。
脾，旧本误肝，今改。五脏之气，以肾为本。如肾藏受寒，转
移于脾，脾主肌肉，故痈肿，痈肿则腠理的能外通皮毛，内合三焦，故少气。
脾移寒于肝，痈肿筋挛。
脾脏受寒，转移于肝，肝血凝聚，则痈肿。痈肿则筋不柔和，故筋挛。
肝移寒于心，狂，膈中。
肝脏受寒，转移于心，心者，火也，寒逆于心则狂，申明狂者由寒气之隔于中，故曰隔中。
心移寒于肺，肺消，肺消者，饮一溲二，死不治。
心脏受寒，转移于肺，则为肺消。申明肺消者，消渴欲饮，饮
一溲二也。水精不布，下而不上，故死不治。
肺移寒于肾，为涌水。涌水者，按腹不坚，水气寒于大肠，疾
行，则鸣濯濯，如囊裹浆，水之病也。
肺脏受寒，转移于肾，则为涌水，申明涌水者，土虚水泛，土虚则按腹不坚，水泛则水
气寒于大肠，疾行则肠鸣而濯濯有而，如囊之裹浆，此为涌水之病也。
脾移热于肝，则为惊衄。
承上文移寒，而复论移热也，脾脏受热，转移于肝，肝气热则
惊，肝血热则衄，故为惊衄。
肝移热于心，则死。
肝脏受热，转移于心，心者火也，火烈自焚，故死。
心移热于肺，传为膈消。
心脏受热，转移于肺，膈之上，心肺也，故传为膈消，消，消渴也。
肺移热于肾，传为柔 。
肺脏受热，转移于肾，肾主骨，骨属屈伸，故传为柔 。
肾移热于脾，传为虚肠 ，死不可治。
肾脏受热，转移于脾，脾者，土也，虚则清浊不分，故传为虚肠 ，虚而肠 ，死不可治。按
阴阳别论云，心之肺，谓之死阴。死阴之属，不过三日而死。肝之心，谓之生阳，生阳之属，不过四
日而死。肾之脾，谓之辟阴，死不治。故心移寒于肺，肝移热于心，肾移热于脾，皆言其死，此之谓也。
胞移热于膀胱，则癃溺血。
溺，鸟去声。承上文五脏寒热相移，而论六腑之移热也。胞者，血海也。膀胱者，胞中之室。如
胞移热于膀胱，热入膀胱则癃，血入膀胱则溺血。
膀胱移热于小肠，膈肠不便，上为口糜。
小肠居大肠之上，小肠受膀胱之热，不能化物而传于大肠，则
膈肠不便，热气上蒸，则为口糜。糜，腐烂也。
小肠移热于大肠，为 瘕，为沉痔。
，音伏，义同痔字，简脱今补。小肠清浊，兼收小肠受热，
移于大肠，则精汁凝聚，而为伏瘕；火热下行，而为沉痔。
大肠移热于胃，善食而瘦，又谓之食亦。
亦，作 ，下同。大肠与胃，皆属阳明燥气，大肠移热于胃，上热而燥，故善食而瘦。 者，懈
。土气不濡，灌溉不力，善食而瘦，又谓之食 。
胃移热于胆，亦曰食亦。
胃者，五谷之府。胆者，中精之府，胃移热于胆，胆受火热，精汁不布，亦善食而瘦，亦曰食 。
胆移热于脑，则辛 鼻渊。鼻渊者，浊涕下不止也，传为衄 ，瞑目。
，音灭，余篇仿此。鼻两旁曰 ，鼻血曰衄。血污曰 。胆藏精汁，脑为髓海。胆移热于脑，
脑受火热，则两 辛 而鼻渊。申明鼻渊者，浊涕下不止也。鼻渊不止，则传为衄 ，衄 则三阳
经脉皆虚，故瞑目。盖阳明之脉起于鼻 中，太阳少阳之脉，起于两目 也。
故得之气厥也。
五脏寒热相移，及六腑移热，皆由气厥所致，故曰得之气厥也。
The five zang organs and six fu organs govern the twelve meridians. Qi circulates continuously in a cycle. Disharmony among the zang and fu organs leads to Qi Jue (Qi Reversal, a pathological state of reversed or stagnant Qi flow). Qi Jue causes cold and heat pathogens to shift between organs. The shifting of cold and heat are all caused by Qi Jue. Therefore, the Yellow Emperor asked about the shifting of cold and heat, and Bo Gao explained it, ultimately concluding that it stems from Qi Jue.
The Yellow Emperor asked: What is the mechanism behind the shifting of cold and heat among the five zang organs and six fu organs?
The five zang organs and six fu organs rely on the circulation of one Qi. The shifting of cold and heat is due to Qi Jue; hence, the Yellow Emperor asked this question.
Qibo replied: When Kidney transfers Cold to Spleen, abscesses and swelling occur, accompanied by Shortness of Breath (Shao Qi, deficiency of vital energy).
Spleen was erroneously written as Liver in old editions; this is corrected here. The Qi of the five zang organs takes Kidney as its root. If Kidney absorbs Cold, and this Cold shifts to Spleen, since Spleen governs muscles, abscesses and swelling result. These abscesses impair the function of Cou Li (Pores and interstitial spaces), preventing them from connecting externally with the skin/hair and internally with the San Jiao (Triple Burner), leading to Shortness of Breath.
When Spleen transfers Cold to Liver, abscesses and swelling occur, along with Tendon Contraction (Jin Luan, spasms of tendons).
When Spleen absorbs Cold and this Cold shifts to Liver, Liver Blood stagnates, causing abscesses and swelling. Due to these abscesses, the tendons lose their flexibility, resulting in Tendon Contraction.
When Liver transfers Cold to Heart, Mania (Kuang, mental disorder) and Ge Zhong (Plugging sensation in the chest/diaphragm) occur.
When Liver absorbs Cold and this Cold shifts to Heart, which belongs to Fire, the counterflow of Cold into Heart causes Mania. This clarifies that Mania arises from Cold blocking the interior, hence termed Ge Zhong.
When Heart transfers Cold to Lung, Fei Xiao (Lung Wasting-Thirst) develops. Fei Xiao is characterized by drinking one unit of fluid but urinating two units; it is incurable and fatal.
When Heart absorbs Cold and this Cold shifts to Lung, Fei Xiao occurs. This explains that Fei Xiao involves excessive thirst and drinking, yet output exceeds intake (drinking one, urinating two). Water essence fails to distribute, sinking downward instead of ascending, making it fatal and incurable.
When Lung transfers Cold to Kidney, Yong Shui (Surging Water edema) develops. In Yong Shui, abdominal palpation reveals no hardness. Cold water-Qi stagnates in the Large Intestine; upon rapid movement, gurgling sounds (Zhuo Zhuo) are heard, resembling a bag containing liquid. This is a disease of water metabolism.
When Lung absorbs Cold and this Cold shifts to Kidney, Yong Shui develops. This explains that Yong Shui results from Earth Deficiency allowing Water to overflow. Earth Deficiency leads to soft abdomen upon palpation; Water Overflow causes Cold water-Qi to stagnate in the Large Intestine, producing gurgling sounds like a bag of liquid during rapid movement. This constitutes the disease of Yong Shui.
When Spleen transfers Heat to Liver, Fright (Jing) and Epistaxis (Nu, nosebleed) occur.
Following the discussion on Cold transfer, Heat transfer is now discussed. When Spleen absorbs Heat and this Heat shifts to Liver, Liver Qi Heat causes Fright, and Liver Blood Heat causes Epistaxis, resulting in both Fright and Epistaxis.
When Liver transfers Heat to Heart, death ensues.
When Liver absorbs Heat and this Heat shifts to Heart, which belongs to Fire, the intense Fire consumes itself, leading to death.
When Heart transfers Heat to Lung, it transmits to form Ge Xiao (Diaphragm Wasting-Thirst).
When Heart absorbs Heat and this Heat shifts to Lung, located above the diaphragm where Heart and Lung reside, it transmits to form Ge Xiao. "Xiao" refers to Wasting-Thirst syndrome.
When Lung transfers Heat to Kidney, it transmits to form Rou Ji (Soft Spasm/Flaccidity).
When Lung absorbs Heat and this Heat shifts to Kidney, which governs bones and controls flexion/extension, it transmits to form Rou Ji.
When Kidney transfers Heat to Spleen, it transmits to form Xu Chang Pi (Deficiency Dysentery/Purging), which is fatal and incurable.
When Kidney absorbs Heat and this Heat shifts to Spleen, which belongs to Earth, Deficiency leads to failure in separating clear from turbid. Thus, it transmits to form Xu Chang Pi. Being both deficient and suffering from dysentery makes it fatal and incurable. As stated in the *Yin Yang Bie Lun* chapter: "Heart transferring to Lung is called Dead Yin. Those under Dead Yin die within three days. Liver transferring to Heart is called Sheng Yang (Living Yang). Those under Sheng Yang die within four days. Kidney transferring to Spleen is called Bi Yin (Closing Yin), which is fatal and incurable." Therefore, Heart transferring Cold to Lung, Liver transferring Heat to Heart, and Kidney transferring Heat to Spleen are all described as fatal, which is what this refers to.
When Bao Gong (Uterus/Blood Sea) transfers Heat to Bladder, Long (Dysuria/Urinary retention) and Niao Xue (Hematuria) occur.
"Niao" is pronounced with the departing tone of "Niao". Following the discussion on the shifting of cold and heat among the five zang organs, the shifting of Heat among the six fu organs is now discussed. Bao Gong is the Sea of Blood. Bladder is the chamber within Bao Gong. If Bao Gong transfers Heat to Bladder, Heat entering Bladder causes Long, and Blood entering Bladder causes Hematuria.
When Bladder transfers Heat to Small Intestine, it causes Diaphragmatic Fullness and Bowel Obstruction, and upward steaming leads to Kou Mi (Oral Ulceration/Maceration).
Small Intestine is located above Large Intestine. When Small Intestine receives Heat from Bladder and cannot transform substances properly before transmitting to Large Intestine, it causes Diaphragmatic Fullness and Bowel Obstruction. Upward steaming of Heat leads to Oral Maceration. "Mi" means rotting/maceration.
When Small Intestine transfers Heat to Large Intestine, Fu Xia (Hidden Masses) and Chen Zhi (Deep Hemorrhoids) occur.
"Fu" sounds like "Fu", meaning similar to hemorrhoids; it was omitted in abbreviated texts and is added here. Small Intestine separates clear from turbid. If Small Intestine absorbs Heat and transfers it to Large Intestine, essential fluids coagulate, forming Fu Xia; Fire-Heat moving downward forms Chen Zhi.
When Large Intestine transfers Heat to Stomach, it causes Polyphagia with Emaciation, also known as Shi Yi (Eating Without Gaining Weight).
"Yi" is written as "Shi Yi", same below. Large Intestine and Stomach both belong to Yangming Dryness Qi. When Large Intestine transfers Heat to Stomach, upper Heat causes Dryness, leading to Polyphagia with Emaciation. "Shi Yi" implies lassitude and emaciation. Earth Qi fails to moisten, irrigation is ineffective; thus, despite eating much, the body becomes thin. This is also called Shi Yi.
When Stomach transfers Heat to Gallbladder, it is also called Shi Yi.
Stomach is the residence of the five grains. Gallbladder is the residence of pure essence. When Stomach transfers Heat to Gallbladder, Gallbladder absorbs Fire-Heat, preventing the distribution of pure essence. It similarly causes Polyphagia with Emaciation, hence also called Shi Yi.
When Gallbladder transfers Heat to Brain, it causes Xin Bi Yuan (Bitterness/Pain in Nose and Rhinorrhea). Bi Yuan is characterized by continuous discharge of turbid nasal mucus. Transmission may lead to Nu Mie (Epistaxis and Eye Closure).
"Mie" sounds like "Mie", applied similarly in other chapters. The sides of the nose are called "Bi Bian"; nosebleed is "Nu". Bloody discharge is "Nie". Gallbladder stores pure essence; Brain is the Sea of Marrow. When Gallbladder transfers Heat to Brain, Brain absorbs Fire-Heat, causing bitterness/pain in the nasal sides and Rhinorrhea. This clarifies that Bi Yuan is continuous turbid nasal discharge. Unchecked Bi Yuan transmits to Epistaxis and eye issues; Epistaxis and eye issues cause deficiency in all three Yang meridians, leading to closed eyes. The Yangming meridian originates near the side of the nose; Taiyang and Shaoyang meridians originate at the inner canthi of the eyes.
Therefore, these conditions stem from Qi Jue.
The shifting of cold and heat among the five zang organs, and the shifting of Heat among the six fu organs, are all caused by Qi Jue. Hence, it is said that they result from Qi Jue.