《逆调论》曰∶阴气少而阳气胜,故热而烦满也。(言病有热而烦满者,阴气少而阳气多也。)
阳气少,阴气多,故身寒如从水中出。(言病有寒从中生者,阳气少而阴气多也。)
不得卧而息有音者,是阳明之逆也,足三阳者下行,今逆而上行,故息有音也。阳
明者胃脉也,六腑之海,(即水谷之海。)其气亦下行,阳明逆不得从其道,故不得卧也。胃
不和则卧不安,此之谓也。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。
《举痛论》曰∶百病生于气也。(气之为用,虚实逆顺缓急皆能为病,故发此问。)怒则气上,喜
则气缓,悲则气消,恐则气下,寒则气收,炅则气泄,惊则气乱,劳则气耗,思则气
结,九气不同,何病之生?怒则气逆,甚则呕血及飧泄,故气上矣。(怒则阳气逆上肝气乘
脾,故甚则呕血及飧泄也。)喜则气和志达,荣卫通利,故气缓矣。(气脉和调故志达畅。荣卫通利,
故气徐缓。)悲则心系急,肺布叶举,而上焦不通,荣卫不散,热气在中,故气消矣。(悲则
损于心,心系急则动于肺,肺气系诸经,逆则肺布而叶举。)恐则精却,却则上焦闭,闭则气还,还
则下焦胀,故气不行矣。(恐则阳精却上而不下流,故却则上焦闭也。上焦既闭,气不行流,下焦阴气,亦
还回不散,而聚为胀。然上焦固禁,下焦气还,各守一处,故气不行也。)寒则腠理闭,气不行,故气
收矣。(身寒则卫气沉,故皮肤文理及渗泄之处,皆闭密而气不流行,卫气收敛于中而不发散也。)炅则腠理
开,荣卫通,汗大泄,故气泄矣。(热则肤腠开发,荣卫大通,津液外渗而汗大泄。)惊则心无所倚,
神无所归,虑无所定,故气乱矣。(气奔越故不词理。)劳则喘且汗出,外内皆越,故气耗矣。
(疲力役则气奔速,故喘息。气奔速则阳外发,故汗出。喘且汗出,内外皆逾越于常纪,故气耗损也。)思则心有
所存,神有所归,正气留而不行,故气结矣。(系心不散,故气亦停留。以九气为问而言之也。)
《逆调论》说:阴气少而阳气盛,所以出现发热且心烦胀满的症状。(意思是患有发热且心烦胀满的病证,是因为阴气少而阳气多。)
阳气少,阴气多,所以身体寒冷,感觉像从水中出来一样。(意思是患有寒从中生的病证,是因为阳气少而阴气多。)
不能平卧且呼吸有声的,这是阳明经之气上逆所致。足三阳经的气本应下行,如今反而上行,所以呼吸有声。阳明经是胃的经脉,也是六腑气血汇聚的大海(即水谷之海),其气也应当下行。如果阳明经之气上逆,不能顺着正常的通道运行,就会导致无法平卧。胃不和则睡眠不安,说的就是这个道理。如果起居如常但呼吸有声的,这是肺的络脉之气上逆所致。络脉之气不能随着主经上下运行,所以滞留在经中而不能通行,这是络脉病变,病情较轻,所以起居如常但呼吸有声。至于不能平卧,一躺下就喘息的,这是水气侵犯所致。水液是跟随津液流动的,肾是水脏,主管津液,同时也主宰睡眠和喘息。
《举痛论》说:各种疾病都产生于气的异常。(气的作用,无论是虚、实、逆、顺、缓、急都能导致疾病,所以提出这个问题。)愤怒会使气上逆,喜悦会使气舒缓,悲伤会使气消减,恐惧会使气下沉,寒冷会使气收敛,炎热会使气外泄,惊吓会使气紊乱,劳累会使气耗散,思虑会使气结聚。这九种气的变化不同,会产生什么疾病呢?愤怒会导致气逆,严重时会出现呕血和完谷不化的腹泻,这就是气上逆的表现。(愤怒时阳气逆乱向上,肝气乘犯脾土,所以严重时会出现呕血和完谷不化的腹泻。)喜悦使气和顺、意志通达、营卫通畅流利,所以气机舒缓。(气脉调和所以意志畅达,营卫通畅所以气机徐缓。)悲伤使心脉拘急,肺叶张举,导致上焦不通畅,营卫之气不能布散,热气郁结在中焦,所以气被消减。(悲伤损伤心脏,心脉拘急就会影响肺,肺系连接各经,气逆则肺叶张开而上举。)恐惧使精气退缩,精气退缩则上焦闭塞,上焦闭塞则气还返,气还返则下焦胀满,所以气不能正常运行。(恐惧使阳气精气退缩而不向下流动,所以退缩导致上焦闭塞。上焦既已闭塞,气不能流通,下焦的阴气也会还回不散,积聚而成胀满。既然上焦固闭,下焦气还,各自守在一处,所以气不能运行。)寒冷使腠理闭塞,气不能运行,所以气收敛。(身体寒冷则卫气沉潜,所以皮肤纹理及汗孔都闭合严密,气不流行,卫气收敛在体内而不发散。)炎热使腠理开放,营卫通畅,大汗淋漓,所以气外泄。(热则肌肤腠理开发,营卫大通,津液外渗而大汗出。)惊吓使心神无所依托,神志无所归依,思虑无所定夺,所以气机紊乱。(气奔逸越所以不合常理。)劳累则喘息且出汗,内外之气都向外逾越,所以气耗散。(体力过度役使则气奔速,所以喘息。气奔速则阳气外发,所以出汗。喘息且出汗,内外都逾越了常规节度,所以气耗损。)思虑使心有所专注,神有所归依,正气停留而不能运行,所以气结聚。(心系心不散,所以气也停留。以九种气机变化来提问并阐述。)
The *Ni Tiao Lun* (Treatise on Counterflow Regulation) states: When Yin Qi is deficient and Yang Qi is excessive, heat and vexation with fullness occur. (This refers to diseases characterized by heat and vexation/fullness, caused by a deficiency of Yin Qi and an excess of Yang Qi.)
When Yang Qi is deficient and Yin Qi is excessive, the body feels cold, as if emerging from water. (This refers to diseases where cold arises from within, caused by a deficiency of Yang Qi and an excess of Yin Qi.)
Inability to lie down accompanied by audible breathing indicates counterflow in the Yangming Channel. The Foot Three Yang Channels normally descend; now they ascend counterflow, hence the audible breathing. The Yangming Channel is the Stomach Meridian, the Sea of the Six Fu Organs (i.e., the Sea of Water and Grain), and its Qi also descends. If Yangming Qi counterflows and cannot follow its proper pathway, one cannot lie down. "When the Stomach is disharmonious, sleep is uneasy," this is what is meant. If daily activities remain normal but breathing is audible, this is due to counterflow in the collaterals of the Lung. Collateral Qi cannot move up and down with the main channels, so it remains stagnant in the channels without circulating. This is a minor disorder of the collaterals, hence daily activities are normal but breathing is audible. As for inability to lie down and panting when lying down, this is due to the invasion of Water Qi. Water follows Jin Ye (Body Fluids) in its flow. The Kidney is the Water Organ, governing Jin Ye, and also controls sleep and panting.
The *Ju Tong Lun* (Treatise on Pain Caused by Pathogenic Factors) states: All diseases arise from Qi. (The function of Qi, whether deficient, excessive, counterflow, smooth, slow, or urgent, can all cause disease, thus this inquiry is raised.) Anger causes Qi to ascend; joy causes Qi to relax; grief causes Qi to dissipate; fear causes Qi to sink; cold causes Qi to contract; heat causes Qi to leak; shock causes Qi to become chaotic; labor causes Qi to be exhausted; thought causes Qi to knot. These Nine Qi differ; what diseases do they produce? Anger causes Qi counterflow; severely, it leads to hematemesis and undigested food diarrhea, thus Qi ascends. (Anger causes Yang Qi to counterflow upward, and Liver Qi invades the Spleen, hence severe cases involve hematemesis and undigested food diarrhea.) Joy harmonizes Qi, allows the will to reach, and ensures Ying Wei (Nutritive and Defensive Qi) flow smoothly, thus Qi relaxes. (Harmonized Qi vessels allow the will to reach freely; smooth Ying Wei flow makes Qi slow and relaxed.) Grief tightens the Heart Tie (Heart connections), lifts the Lung Lobes, obstructs the Upper Jiao, prevents Ying Wei from dispersing, and traps heat in the center, thus Qi dissipates. (Grief damages the Heart; tight Heart connections affect the Lung; Lung connections link all channels; counterflow causes Lung lobes to lift.) Fear causes Jing (Essence) to retreat; retreat leads to closure of the Upper Jiao; closure causes Qi to return; return leads to distension of the Lower Jiao, thus Qi does not flow. (Fear causes Yang Essence to retreat upward and not flow downward, hence retreat closes the Upper Jiao. Once the Upper Jiao is closed, Qi cannot flow; Lower Jiao Yin Qi also returns and fails to disperse, gathering into distension. Since the Upper Jiao is sealed and Lower Jiao Qi returns, each staying in place, Qi does not flow.) Cold closes Cou Li (Pores/Skin texture), preventing Qi flow, thus Qi contracts. (Cold body causes Wei Qi to sink, so skin texture and sweat pores close tightly, Qi does not circulate, and Wei Qi converges internally without dispersing.) Heat opens Cou Li, unblocks Ying Wei, causes profuse sweating, thus Qi leaks. (Heat develops skin pores, unblocks Ying Wei greatly, Body Fluids seep outward causing profuse sweating.) Shock leaves the Heart without support, Shen (Spirit) without refuge, and thoughts without certainty, thus Qi becomes chaotic. (Qi rushes and overflows, hence illogical.) Labor causes panting and sweating, with internal and external Qi overflowing, thus Qi is exhausted. (Physical exhaustion causes Qi to rush fast, hence panting. Fast-rushing Qi causes Yang to emit externally, hence sweating. Panting and sweating mean both internal and external aspects exceed normal limits, thus Qi is exhausted.) Thought keeps the Heart focused, Shen has a refuge, Zheng Qi (Upright Qi) stays and does not flow, thus Qi knots. (Heart connection does not scatter, so Qi also stagnates. This is discussed through the question of the Nine Qi.)