《内经》列九气为病。一曰怒则气上，甚则呕血（暴怒伤阴，血随气逆、飧泄。完谷而出也。怒
气上冲则呕血，下郁则飧泄，气郁不运，则水谷不分也。）或血菀于上，（不呕则郁积于上焦。）形气绝，
（卒然倒毙）名薄厥。（薄，迫也。谓血气厥逆，迫于上焦。）或胸满胁痛，食则气逆而不下。一曰喜则
气缓。志气通畅和缓，本无病。然过于喜，则心神散荡而不藏，为笑不休，为气不
收，甚则为狂，有喜极气暴脱而死者，必其人素虚，气浮无根也。（所谓暴喜伤阳。）一曰
悲则气消。心志摧抑沮丧，则气亦因之消索。以怒则气盛而张反观之，可见悲则气
衰而敛矣。为目昏，（悲泣多则目昏。）为筋挛，为阴缩，（皆有降无升，肝木受克所致也。）为酸鼻辛
、为少气不能报息，（报，接续意。）为下血，（气不能摄血也。）为泣则臂麻。一曰恐则气
下。精却、（肾精方欲化气而上，因恐则却而退下也。王太仆谓；恐则伤精，却而上，不下流，下焦阴气亦回环
而不散，故聚而胀。未妥。）气还，下焦胀，为阴痿骨酸，精时自下。一曰惊则气乱。心无
所倚，神无所归，虑无所定，为痴痫，（惊则神不守舍，痰涎入心所致。）为不省人事，为僵仆。
一曰思则气结。心有所存，神有所归，正气留而不行，为不眠，为中痞，三焦闭塞，
为不嗜食，为昏瞀，为得后（即大便）与气，（嗳气，或屁。气郁下陷之屁，不若伤食之屁臭甚。）则快然
而衰。（结气得通而滞减也。）一曰寒则气收。腠理闭，气不行，上下所出水液，澄澈清冷。
一曰热则气泄。腠理开，汗大泄，喘呕吐酸，暴迫下注，所谓壮火食气，又曰热伤
气也。（气乘风则飘，遇火则散，火主发泄，一夜热作而身顿怯，可见。）一曰劳则气耗。喘息汗出，内
外皆越，精神竭绝，（《经》曰∶静则神藏，躁则消亡。）为促乏，为嗽血，为腰痛骨痿，为高骨
坏，为煎厥。（五心烦热，如煎熬而厥逆也。）男为少精，女为不月。按七情皆生于心，以悲则
气下，故属之肺；怒则气上，故属之肝；恐则怯而欲藏匿，故属于肾；思则无所不
通，故属之脾耳，此义宜知。（惊属心肝气动，故风火交煽，则病发惊骇。）清气在下，则生
飧泄，浊气在上，则生 胀。《经》谓清浊相干为乱气，（水谷之清气注五脏，浊气注六腑，清气
上升，浊气下行，反之则乱也。）予谓邪正相干亦然。（此如卦画之交错，阴阳揉杂。）于此想见霍乱情状。
气滞必痛。《经》云诸痛皆因于气。又云气伤痛，形伤肿。先痛后肿者，气伤形
也；先肿后痛者，形伤气也。丹溪谓气有余便是火。自觉冷气自下而上者，非真冷
也，火极似水耳，不治其火，则气不降。（火极似水，犹云热证似寒，气为火所冲突，飘忽若风，故
冷也。）气本清，滞而痰凝血瘀，则浊矣。不治其痰血，则气不行。
《黄帝内经》列举了九种气机失调导致的病证。第一种是“怒则气上”，（暴怒损伤阴血，血液随逆乱之气上行导致吐血；若怒气下郁，则导致完谷不化的泄泻，这是因为气机郁滞不能运化，致使水谷无法分清。）或者血液郁积于上部，（若不呕吐，则郁积在上焦。）导致形体与元气隔绝，（突然昏倒死亡），这种病称为“薄厥”。（“薄”意为迫近、逼迫。指气血厥逆，逼迫于上焦。）或者出现胸胁胀满疼痛，进食后气机上逆而不能下行。第二种是“喜则气缓”，志气通畅和缓本是正常状态，并无疾病。然而过度喜悦，会导致心神涣散而不能内守，表现为笑个不停，气机不收摄，严重时甚至发狂，也有因喜极而气暴脱致死的，这必定是因为其人平时体虚，气浮而无根。（这就是所说的“暴喜伤阳”。）第三种是“悲则气消”，心志受到摧抑沮丧，气也随之消损枯竭。从“怒则气盛而张”反过来推想，可见悲伤时气机是衰败而收敛的。表现为眼睛昏花，（因为悲伤哭泣多所致），筋脉拘挛，前阴收缩，（这些都是只有下降没有上升，肝木受克所致），鼻子感觉酸涩或辛辣，气短不足以接续呼吸，（“报”意为接续），下部出血，（因为气不能统摄血液），哭泣时手臂麻木。第四种是“恐则气下”，肾精退缩，（肾精正要化气上行，因恐惧而退却下行。王太仆说：恐则伤精，精气退却向上，不再向下流注，导致下焦阴气回环不散，从而聚集成胀满。这种说法不妥当。）气机还复于下焦，导致下焦胀满，阳痿，骨骼酸痛，精液自行滑出。第五种是“惊则气乱”，心神无所依托，神志无所归依，思虑无所定夺，表现为痴痫，（因为惊吓导致神不守舍，痰涎侵入心窍所致），人事不知，身体僵直仆倒。第六种是“思则气结”，心思有所存留，神志有所归宿，正气停留而不运行，表现为失眠，中脘痞塞，三焦闭塞，食欲不振，头昏目眩，在大便通畅或嗳气/放屁之后，（如果是气郁下陷引起的放屁，其气味不如伤食引起的放屁臭），反而感到轻松舒适。（因为郁结的气得以疏通，滞塞减轻。）第七种是“寒则气收”，腠理闭合，气机不行，上下排出的水液清澈寒冷。第八种是“热则气泄”，腠理开泄，大汗淋漓，气喘呕吐酸水，急迫的下利，这就是所谓的“壮火食气”，又说“热伤气”。（气遇到风则飘散，遇到火则消散，火主发泄，一夜发热发作而身体顿时虚弱，由此可见。）第九种是“劳则气耗”，喘息出汗，内外之气皆外越，精神竭绝，《内经》说：“静则神藏，躁则消亡。”表现为气促乏力，咳血，腰痛骨痿，高骨崩坏，煎厥。（五心烦热，如同被煎熬而厥逆。）男性表现为少精，女性表现为闭经。按七情都产生于心，但因为悲伤使气下沉，所以归属于肺；愤怒使气上逆，所以归属于肝；恐惧使人怯懦想要隐藏，所以归属于肾；思虑无所不通，所以归属于脾，这个道理应当知晓。（惊属于心肝气动，所以风火交煽，就会引发惊骇之病。）清气在下，就会产生完谷不化的泄泻；浊气在上，就会产生胀满。《内经》说清浊相干就是乱气，（水谷的清气注入五脏，浊气注入六腑，清气上升，浊气下行，反之则混乱。）我认为邪气与正气相干也是如此。（这就好比卦画的交错，阴阳混杂。）由此可以想象霍乱的病情状况。气机阻滞必然疼痛。《内经》说各种疼痛都因于气。又说气受伤导致疼痛，形质受伤导致肿胀。先痛后肿的，是气伤及形质；先肿后痛的，是形质伤及气。丹溪说气有余便是火。自觉有冷气从下往上走的，并不是真正的寒冷，而是火极似水的表现，如果不治疗火，气就不会下降。（火极似水，就是说热证似寒，气被火所冲撞，飘忽如风，所以感觉冷。）气本来是清的，如果滞涩导致痰凝和血瘀，就变得浊了。如果不治疗痰和血，气就无法运行。
The *Neijing* (Yellow Emperor's Inner Classic) lists nine types of qi disorders. The first is "anger causes qi to ascend." (Violent anger damages yin blood, and blood follows the rebellious qi upward, causing hematemesis; if angry qi stagnates downward, it causes diarrhea with undigested food, because stagnant qi fails to transform, leading to the failure to separate water and grain.) Alternatively, blood may stagnate in the upper part, (if not vomited, it accumulates in the Upper Jiao,) leading to a severance of form and qi, (sudden collapse and death), a condition named *Bo Jue* (Forced Syncope). ("Bo" means pressing or forcing. It refers to rebellious qi and blood forcing their way to the Upper Jiao.) Or there may be chest fullness and hypochondriac pain, with qi rebelling upward after eating and failing to descend. The second is "joy causes qi to slacken." Smooth and relaxed zhi-qi is normal and not diseased. However, excessive joy causes the heart-mind to scatter and fail to store, resulting in incessant laughter, uncontrolled qi, and in severe cases, mania. Some may die from sudden qi collapse due to extreme joy, which must be because the person was constitutionally deficient, with floating and rootless qi. (This is what is meant by "sudden joy damages yang.") The third is "grief causes qi to consume." When the heart-mind is depressed and discouraged, qi also becomes consumed and depleted. By contrasting this with "anger causes qi to flourish and expand," one can see that grief causes qi to decline and contract. Symptoms include dim vision, (caused by excessive weeping), tendon cramping, retraction of the genitals, (all due to descending without ascending, caused by liver wood being overcome), nasal sourness or pungency, shortness of breath unable to continue inhalation, ("Bao" means to connect or follow up), lower bleeding, (because qi fails to control blood), and arm numbness when weeping. The fourth is "fear causes qi to sink." Essence retreats, (kidney essence intends to transform into qi and ascend, but due to fear, it retreats downward. Wang Taipu stated: "Fear damages essence, causing it to retreat upward and not flow downward, leading to lower jiao yin qi circulating without dispersing, thus gathering and causing distension. This view is inappropriate.") Qi returns to the Lower Jiao, causing lower abdominal distension, impotence, bone soreness, and spontaneous seminal emission. The fifth is "startle causes qi to become chaotic." The heart has no support, the spirit has no return, and thoughts have no certainty. This leads to dementia and epilepsy, (because startle causes the spirit to lose its residence, allowing phlegm-saliva to enter the heart), loss of consciousness, and rigid collapse. The sixth is "pensiveness causes qi to knot." The mind dwells on something, and the spirit has a destination, causing righteous qi to remain stagnant and not move. This results in insomnia, epigastric stuffiness, closure of the Sanjiao, lack of appetite, dizziness and blurred vision. After defecation or belching/passing gas, (gas from qi depression sinking is less odorous than gas from food stagnation), one feels relieved and comfortable. (Because the knotted qi is unblocked and stagnation decreases.) The seventh is "cold causes qi to contract." Pores close, qi does not move, and fluids excreted from above and below are clear and cold. The eighth is "heat causes qi to leak." Pores open, sweat pours out profusely, accompanied by wheezing, vomiting acid, and acute, urgent diarrhea. This is what is meant by "vigorous fire consumes qi," and also "heat damages qi." (Qi drifts when encountering wind and scatters when encountering fire; fire governs dispersion. A night of fever followed by sudden physical weakness demonstrates this.) The ninth is "labor causes qi to be exhausted." Wheezing and sweating occur, with internal and external qi both escaping, leading to exhaustion of spirit and essence. The *Classic* says: "Stillness allows the spirit to be stored; restlessness causes it to perish." This manifests as rapid fatigue, coughing blood, lower back pain and bone atrophy, destruction of high bones, and *Jian Jue* (Frying Syncope). (Five-center heat, feeling as if being fried, leading to syncope.) In men, it presents as scanty sperm; in women, as amenorrhea. Note that all seven emotions arise from the heart. Because grief causes qi to sink, it is associated with the Lung; because anger causes qi to ascend, it is associated with the Liver; because fear makes one timid and wanting to hide, it is associated with the Kidney; because pensiveness permeates everything, it is associated with the Spleen. This principle should be understood. (Startle involves movement of heart and liver qi, so when wind and fire stir together, panic and fright ensue.) Clear qi settling in the lower part causes diarrhea with undigested food; turbid qi rising to the upper part causes distension. The *Classic* states that interference between clear and turbid constitutes chaotic qi. (Clear qi from water and grain enters the five zang organs, turbid qi enters the six fu organs; clear qi ascends, turbid qi descends. Reversal leads to chaos.) I propose that interference between pathogenic and righteous qi is similar. (This is like the interlacing of hexagram lines, where yin and yang are mixed.) From this, one can imagine the condition of cholera-like disorder. Qi stagnation inevitably causes pain. The *Classic* says all pains are due to qi. It also says qi injury causes pain, while form injury causes swelling. Pain preceding swelling indicates qi injuring form; swelling preceding pain indicates form injuring qi. Danxi said that excess qi is fire. The sensation of cold air rising from below is not true cold, but rather fire mimicking water. If the fire is not treated, qi will not descend. (Fire mimicking water means heat conditions mimicking cold; qi is conflicted by fire, drifting like wind, hence the sensation of cold.) Qi is originally clear, but if stagnation leads to phlegm coagulation and blood stasis, it becomes turbid. If phlegm and blood are not treated, qi cannot move.