（《素问·调经论》 连前篇）
帝曰∶余已闻虚实之形，不知其何以生？岐伯曰∶气血以并，阴阳相倾，气乱于卫，血逆于经，血气离居，一实一
虚，（并，偏胜也。倾，倾陷也。气为阳，故乱于卫。血为阴，故逆于经。阴阳不和，则气血离居，故实者偏实，虚者偏
虚，彼此相倾也。）血并于阴，气并于阳，故为惊狂。（血并于阴，是重阴也。气并于阳，是重阳也。重阴者癫，重阳者
狂，故为惊狂。）血并于阳，气并于阴，乃为炅中。（血并于阳，阴在表也。气并于阴，阳在里也。故为炅中。炅，热也。
炅，居永切。）血并于上，气并于下，心烦惋善怒。（上，膈上也。下，膈下也。血并于上，则阴邪抑心，故烦惋。气并
于下，则火动于肝，故善怒。惋，乌贯切。）血并于下，气并于上，乱而喜忘。（血并于下则阴气不升，气并于上则阳气
不降，阴阳离散，故神乱而喜忘。）帝曰∶血并于阴，气并于阳，如是血气离居，何者为实？何者为虚？（血并于阴则阳
中无阴，气并于阳则阴中无阳，阴阳不和，故血气离居。）岐伯曰∶血气者，喜温而恶寒，寒则泣不能流，温则消而去之。
（血之与气，体虽异而性则同，故皆喜温而恶寒，寒则凝泣而留滞，温则消散而营运。邪之或并于血，或并于气，由于
此矣。泣，涩同。）是故气之所并为血虚，血之所并为气虚。（气并于阳则无血，是血虚也。血并于阴则无气，是气虚也。）
帝曰∶人之所有者，血与气耳。今夫子乃言血并为虚，气并为虚，是无实乎？岐伯曰∶有者为实，无者为虚，（有血无气，
是血实气虚也。有气无血，是气实血虚也。）故气并则无血，血并则无气，今血与气相失，故为虚焉。（相失者，不相济。
失则为虚矣。）络之与孙脉俱输于经，血与气并，则为实焉。血之与气并走于上，则为大厥，厥则暴死，气复反则生，不
反则死。（上文言血与血并，气与气并，偏虚偏实也。此言血与气并，并者为实，不并者为虚也。血气并走于上则上实下
虚，下虚则阴脱，阴脱则根本离绝而下厥上竭，是为大厥，所以暴死。若气极而反，则阴必渐回，故可复苏。其有一去
不反者，不能生矣。）帝曰∶实者何道从来？虚者何道从去？虚实之要，愿闻其故。岐伯曰；夫阴与阳皆有俞会，阳注于
阴，阴满之外，阴阳匀平，以充其形，九候若一，命曰平人。（俞会，经穴有俞有会也。阳注于阴，则自经归脏；阴满之
外，则自脏及经。九候若一，则阴阳和，血气匀，身安无病，故曰平人。）夫邪之生也，或生于阴，或生于阳。其生于阳
者，得之风雨寒暑；其生于阴者，得之饮食居处，阴阳喜怒。（风雨寒暑，生于外也，是为外感，故曰阳。饮食居处，阴
阳喜怒，生于内也，是为内伤，故曰阴。外感多有余，内伤多不足，此实之所以来，虚之所以去也。）帝曰∶风雨之伤人
奈何？岐伯曰∶风雨之伤人也，先客于皮肤，传入于孙脉，孙脉满则传入于络脉，络脉满则输于大经脉，血气与邪并客
于分腠之间，其脉坚大，故曰实。实者外坚充满，不可按之，按之则痛。（此外感之生实也。实痛者必坚满，中有留邪也。
按之则实邪相拒，故痛愈甚。虚痛者必柔软，中空无物也。按之则气至而温，故其痛止。是以可按者为虚，拒按者为实
也。此节与《皮部论》《缪刺论》大同，一见经络类三十一，一见针刺类三十。）帝曰∶寒湿之伤人奈何？岐伯曰∶寒湿
之中人也，皮肤不收，肌肉坚紧，荣血泣，卫气去，故曰虚。虚者聂辟气不足，按之则气足以温之，故快然而不痛。（此
外感之生虚也。凡寒湿中人，必伤卫气，故皮肤不收而为纵缓，肌肉坚紧而为消瘦，营血涩于脉中，卫气去于脉外，所
以为虚。凡言语轻小曰聂，足弱不能行曰辟，皆气不足也。气虚作痛者，按之可以致气，气至则阳聚阴散，故可快然而
痛止也。聂，尼辄切。辟音壁。）帝曰∶善。阴之生实奈何？岐伯曰∶喜怒不节则阴气上逆，上逆则下虚，下虚则阳气走
之，故曰实矣。（此内伤之生实也。阴逆于上则虚于下，阴虚则阳邪凑之，所以为实。然则实因于虚，此所以内伤多不足
也。按∶下文以喜则气下为虚，而此节所重在怒，故曰实也。观阴气上逆之意，言怒可知。又《举痛论》曰怒则气上，
正此之谓。）帝曰∶阴之生虚奈何？岐伯曰∶喜则气下，悲则气消，消则脉虚空，因寒饮食，寒气熏满，则血泣气去，故
曰虚矣。（此内伤之生虚也。下，陷也。消，散也。《举痛论》曰喜则气缓，与此稍异。因寒饮食者，寒气熏满中焦，必
伤阳气，故血涩气去而中为虚也。若饮食过度，留滞不消，虽亦内伤，此则虚中挟实，是又不可不为详辨。）
（《素问·调经论》 承接上一篇）
黄帝说：我已经了解了虚证和实证的表象，但不知道它们是如何产生的？岐伯说：气与血相互偏并，阴阳相互倾陷，气在卫分紊乱，血在经脉中逆乱，气血分离居住，一方偏盛为实，一方偏衰为虚。（并，指偏胜。倾，指倾陷。气属阳，所以扰乱卫气。血属阴，所以逆乱于经脉。阴阳不和，导致气血分离居住，所以实证者偏实，虚证者偏虚，彼此相互倾陷。）血偏并于阴分，气偏并于阳分，所以产生惊狂之症。（血偏并于阴分，是重阴。气偏并于阳分，是重阳。重阴则发癫病，重阳则发狂病，所以出现惊狂。）血偏并于阳分，气偏并于阴分，于是产生内热之症。（血偏并于阳分，阴邪在表。气偏并于阴分，阳邪在里。所以产生内热。炅，即热。炅，读音居永切。）血偏并于上部，气偏并于下部，心中烦闷易怒。（上，指膈肌以上。下，指膈肌以下。血偏并于上部，阴邪抑制心火，所以心烦闷。气偏并于下部，肝火妄动，所以易怒。惋，读音乌贯切。）血偏并于下部，气偏并于上部，神志错乱且健忘。（血偏并于下部则阴气不升，气偏并于上部则阳气不降，阴阳离散，所以神志混乱且容易遗忘。）黄帝说：血偏并于阴分，气偏并于阳分，像这样气血分离居住，哪一个是实？哪一个是虚？（血偏并于阴分则阳分中无阴，气偏并于阳分则阴分中无阳，阴阳不和，所以气血分离居住。）岐伯说：血和气，喜欢温暖而厌恶寒冷，寒冷则凝涩不能流通，温暖则消散运行。（血与气，形体虽然不同但本性相同，所以都喜欢温暖而厌恶寒冷，寒冷则凝滞留伏，温暖则消散营运。邪气或偏并于血，或偏并于气，原因就在于此。泣，同涩。）因此气偏并的地方血就虚，血偏并的地方气就虚。（气偏并于阳分则无血，这是血虚。血偏并于阴分则无气，这是气虚。）黄帝说：人拥有的东西，不过是血和气罢了。现在先生您说血偏并导致虚，气偏并导致虚，难道就没有实证了吗？岐伯说：有者为实，无者为虚，（有血无气，是血实气虚。有气无血，是气实血虚。）所以气偏并则无血，血偏并则无气，现在血与气不相协调，所以表现为虚。（相失，指不相济助。失去济助则为虚。）络脉与孙脉都输送血液到经脉，血与气相并，就成为实证。血与气一起向上冲逆，就会发生大厥证，厥证发作会突然死亡，如果气能回复则生，不能回复则死。（上文讲的是血与血并、气与气并，导致偏虚偏实。这里讲的是血与气并，并者为实，不并者为虚。血气并走于上则上实下虚，下虚则阴脱，阴脱则根本离绝而下厥上竭，这就是大厥，所以突然死亡。如果气极而反回，则阴气必逐渐恢复，所以可以苏醒。如果一去不返，就不能生存了。）黄帝说：实证是从什么途径来的？虚证是从什么途径去的？虚实的关键，希望听您讲讲原因。岐伯说：阴与阳都有腧穴交会处，阳气注入阴分，阴气充满于外，阴阳匀平，以充实形体，三部九候脉象一致，称为平人。（俞会，指经穴中有腧穴也有会穴。阳气注入阴分，则是从经脉归于脏腑；阴气充满于外，则是从脏腑及于经脉。三部九候脉象一致，则阴阳调和，气血均匀，身体安康无病，所以称为平人。）邪气的产生，有的生于阴分，有的生于阳分。生于阳分的，是由于风雨寒暑侵袭；生于阴分的，是由于饮食起居失调，以及喜怒情绪过激。（风雨寒暑，生于外部，这是外感，所以叫阳。饮食起居，喜怒情绪，生于内部，这是内伤，所以叫阴。外感多有余，内伤多不足，这就是实证来源、虚证形成的原因。）黄帝说：风雨伤人是怎么回事？岐伯说：风雨伤害人体，先客居于皮肤，传入孙脉，孙脉满溢则传入络脉，络脉满溢则输注到大经脉，血气与邪气相并客居于分肉腠理之间，脉象坚实盛大，所以称为实证。实证体表坚硬充满，不可按压，按压则疼痛。（这是外感产生的实证。实证疼痛必然坚硬满胀，中有留邪。按压则实邪抗拒，所以疼痛更甚。虚证疼痛必然柔软，中空无物。按压则气至而温煦，所以疼痛停止。因此可按的为虚，拒按的为实。这一节与《皮部论》《缪刺论》大体相同，一见经络类第三十一，一见针刺类第三十。）黄帝说：寒湿伤人是怎么回事？岐伯说：寒湿中人，皮肤松弛不收，肌肉坚紧，营血凝涩，卫气离去，所以称为虚证。虚证表现为气息微弱、肢体萎软、气不足，按压则气足能够温煦，所以舒适而不痛。（这是外感产生的虚证。凡是寒湿中人，必伤卫气，所以皮肤松弛而为纵缓，肌肉坚紧而为消瘦，营血在脉中涩滞，卫气在脉外离去，所以成为虚证。凡言语轻小叫做聂，脚弱不能行走叫做辟，都是气不足的表现。气虚作痛，按压可以致气，气至则阳聚阴散，所以可舒适而痛止。聂，读音尼辄切。辟音壁。）黄帝说：好。阴分产生实证是怎么回事？岐伯说：喜怒没有节制则阴气上逆，上逆则下部虚，下部虚则阳气趋向那里，所以称为实证。（这是内伤产生的实证。阴气逆于上则下部虚，阴虚则阳邪凑集，所以为实。然而实因于虚，这就是内伤多不足的原因。按：下文说喜则气下为虚，而这一节重在怒，所以说实。观察阴气上逆的意思，说怒就可以知道了。又《举痛论》说怒则气上，正是这个意思。）黄帝说：阴分产生虚证是怎么回事？岐伯说：喜则气缓而下陷，悲则气消减，消减则脉道虚空，再加上吃冷饮食，寒气熏满中焦，则血涩气去，所以称为虚证。（这是内伤产生的虚证。下，指陷下。消，指消散。《举痛论》说喜则气缓，与此稍有不同。因为吃冷饮食，寒气熏满中焦，必伤阳气，所以血涩气去而中焦为虚。如果饮食过度，留滞不消，虽然也是内伤，这则是虚中夹实，又是不可不详细辨别的。）
(Su Wen · Tiao Jing Lun, continuing from the previous chapter)
The Yellow Emperor said: I have already heard of the forms of deficiency and excess, but do not know how they arise? Qi Bo said: When Qi and Blood (Xue, blood) merge and bias towards one side, Yin and Yang (Yin-Yang, the fundamental opposing forces in nature) incline against each other. Qi becomes chaotic in the Wei Qi (Defensive Qi), and Blood reverses in the meridians. When Blood and Qi separate from their proper residence, one side becomes excess and the other deficiency. (Merge means bias towards excess. Inclination means collapse. Qi is Yang, so it disrupts the Defensive Qi. Blood is Yin, so it reverses in the meridians. When Yin and Yang are disharmonious, Blood and Qi separate, thus the excess side becomes relatively more excess, and the deficient side becomes relatively more deficient, leaning against each other.) When Blood biases towards the Yin aspect and Qi biases towards the Yang aspect, it results in fright and mania. (Blood biasing towards Yin constitutes Heavy Yin. Qi biasing towards Yang constitutes Heavy Yang. Heavy Yin leads to manic-depressive psychosis [Dian], and Heavy Yang leads to mania [Kuang], hence fright and mania occur.) When Blood biases towards the Yang aspect and Qi biases towards the Yin aspect, it results in internal heat. (Blood biasing towards Yang implies Yin pathogen on the exterior. Qi biasing towards Yin implies Yang pathogen in the interior. Hence, internal heat occurs. Jiong means heat. Jiong is pronounced Ju Yong.) When Blood biases towards the upper part and Qi biases towards the lower part, there is mental vexation and irritability. (Upper refers to above the diaphragm. Lower refers to below the diaphragm. Blood biasing upwards suppresses the Heart with Yin pathogen, causing vexation. Qi biasing downwards stirs Fire in the Liver, causing irritability. Wan is pronounced Wu Guan.) When Blood biases towards the lower part and Qi biases towards the upper part, confusion and forgetfulness occur. (Blood biasing downwards prevents Yin Qi from ascending; Qi biasing upwards prevents Yang Qi from descending. With Yin and Yang separated, the Spirit becomes disordered and prone to forgetfulness.) The Yellow Emperor said: When Blood biases towards Yin and Qi biases towards Yang, as described, where Blood and Qi separate, which is excess and which is deficiency? (When Blood biases towards Yin, there is no Yin in the Yang aspect; when Qi biases towards Yang, there is no Yang in the Yin aspect. Yin and Yang are disharmonious, hence Blood and Qi separate.) Qi Bo said: Blood and Qi prefer warmth and dislike cold. Cold causes stagnation and inability to flow, while warmth promotes dispersion and circulation. (Although Blood and Qi differ in form, they share the same nature, preferring warmth and disliking cold. Cold causes coagulation and stagnation, while warmth allows for dispersion and movement. Pathogens biasing towards either Blood or Qi stem from this. Qi is synonymous with Se.) Therefore, where Qi biases, Blood becomes deficient; where Blood biases, Qi becomes deficient. (Qi biasing towards Yang leaves no Blood, constituting Blood deficiency. Blood biasing towards Yin leaves no Qi, constituting Qi deficiency.) The Yellow Emperor said: What humans possess is merely Blood and Qi. Now you say that Blood biasing leads to deficiency and Qi biasing leads to deficiency. Does this mean there is no excess? Qi Bo said: That which is present is excess, that which is absent is deficiency. (Presence of Blood without Qi is Blood excess and Qi deficiency. Presence of Qi without Blood is Qi excess and Blood deficiency.) Thus, when Qi biases, there is no Blood; when Blood biases, there is no Qi. Since Blood and Qi now lose mutual support, it manifests as deficiency. (Losing support means failing to assist each other. Loss results in deficiency.) Collaterals and Sun vessels all transport to the main meridians. When Blood and Qi merge, it becomes excess. If Blood and Qi both rush upwards, it results in Great Jue syndrome, leading to sudden death. If Qi returns, life is preserved; if it does not return, death ensues. (The preceding text discussed Blood merging with Blood and Qi merging with Qi, leading to partial deficiency and excess. This section discusses Blood merging with Qi. Merged elements are excess, unmixed elements are deficient. Blood and Qi rushing upwards creates Upper Excess and Lower Deficiency. Lower deficiency leads to Yin collapse. Yin collapse severs the root, causing Lower Jue and Upper exhaustion, known as Great Jue, hence sudden death. If Qi reverses after reaching its extreme, Yin will gradually recover, allowing revival. If it goes and does not return, survival is impossible.) The Yellow Emperor said: From what pathway does excess come? From what pathway does deficiency depart? I wish to hear the essence of excess and deficiency and their causes. Qi Bo said: Both Yin and Yang have Shu points and Hui meetings. Yang flows into Yin, and Yin fills the exterior. When Yin and Yang are balanced, they fill the body, and the Nine Pulses are uniform, called a healthy person. (Shu Hui refers to Shu and Hui points in the meridians. Yang flowing into Yin means returning from meridians to Zang organs; Yin filling the exterior means extending from Zang organs to meridians. Uniformity in the Nine Pulses indicates harmony of Yin and Yang and balance of Blood and Qi, ensuring health, thus termed a healthy person.) Pathogens arise either from Yin or from Yang. Those arising from Yang result from wind, rain, cold, and heat; those arising from Yin result from diet, living conditions, and emotional extremes like joy and anger. (Wind, rain, cold, and heat originate externally, constituting external contraction, hence Yang. Diet, living conditions, and emotions originate internally, constituting internal injury, hence Yin. External contractions often involve surplus, while internal injuries often involve insufficiency. This explains the origin of excess and the departure of deficiency.) The Yellow Emperor said: How do wind and rain injure people? Qi Bo said: Wind and rain first lodge in the skin, then transmit to Sun vessels. When Sun vessels are full, they transmit to Luo vessels; when Luo vessels are full, they transport to the large meridians. Blood and Qi merge with pathogens and lodge between the muscle layers and interstices. The pulse becomes firm and large, hence termed excess. Excess presents as firmness and fullness on the exterior, cannot be pressed, and pressing causes pain. (This is excess generated by external contraction. Excess pain is necessarily firm and full, with lingering pathogens inside. Pressing causes the excess pathogen to resist, intensifying pain. Deficient pain is necessarily soft, hollow, and empty. Pressing brings Qi and warmth, stopping the pain. Therefore, tenderness to pressure indicates deficiency, while resistance to pressure indicates excess. This section is largely consistent with Pi Bu Lun and Miu Ci Lun, appearing in Meridian Category 31 and Acupuncture Category 30 respectively.) The Yellow Emperor said: How do cold and dampness injure people? Qi Bo said: When cold and dampness invade, the skin loses tension, muscles become firm and tight, Ying Blood stagnates, and Wei Qi departs, hence termed deficiency. Deficiency manifests as weak breathing, flaccidity, and insufficient Qi. Pressing restores Qi and provides warmth, resulting in comfort and absence of pain. (This is deficiency generated by external contraction. Cold and dampness invariably injure Wei Qi, causing skin laxity and muscle atrophy due to tightness. Ying Blood stagnates within the vessels, while Wei Qi departs from outside the vessels, creating deficiency. Whispering lightly is called Nie; leg weakness preventing walking is called Pi; both indicate Qi insufficiency. For pain caused by Qi deficiency, pressing can attract Qi. Upon arrival, Yang gathers and Yin disperses, bringing comfort and stopping pain. Nie is pronounced Ni Zhe. Pi is pronounced Bi.) The Yellow Emperor said: Excellent. How does Yin generate excess? Qi Bo said: Unregulated joy and anger cause Yin Qi to reverse upwards. Upward reversal leads to Lower deficiency. Lower deficiency causes Yang Qi to rush towards it, hence termed excess. (This is excess generated by internal injury. Yin reversing upwards causes Lower deficiency. Yin deficiency attracts Yang pathogens, resulting in excess. However, excess stems from deficiency, explaining why internal injuries often involve insufficiency. Note: The following text states that Joy causes Qi to sink, leading to deficiency, whereas this section emphasizes Anger, hence excess. Observing the meaning of Yin Qi reversing upwards clarifies the role of Anger. Also, Ju Tong Lun states Anger causes Qi to ascend, which is precisely this case.) The Yellow Emperor said: How does Yin generate deficiency? Qi Bo said: Joy causes Qi to relax and sink; grief causes Qi to dissipate. Dissipation leads to empty vessels. Combined with consuming cold food and drink, cold qi fills the middle jiao, causing Blood stagnation and Qi departure, hence termed deficiency. (This is deficiency generated by internal injury. Sink means depression. Dissipate means scattering. Ju Tong Lun states Joy causes Qi to relax, slightly different here. Consuming cold food causes cold qi to fill the middle jiao, injuring Yang Qi, leading to Blood stagnation and Qi departure, resulting in Middle Jiao deficiency. If overeating causes retention and indigestion, although also an internal injury, this represents deficiency mixed with excess, requiring careful differentiation.)