本篇虽以汤液醪醴名篇，而其要义在后半截。盖胀证一项，最为吃紧。去宛陈 者，除实积也。开鬼门者，
表外邪也。洁净府者，利小便而水下泄也。三者治胀之法略备矣。
黄帝问曰∶为五谷汤液及醪醴奈何？（按，张景岳曰∶“汤液醪醴，皆酒之属。”韵义云∶“醅酒浊酒曰
醪。”诗话云∶“酒之
甘浊而不 者曰醴。”然则汤液者，其即清酒之类欤。醪音劳。醴音礼。 音济。）岐伯对曰∶必以稻米，炊之
稻薪，稻米者完，稻薪者坚。帝曰∶何以然？岐伯曰∶此得天地之和，高下之宜，故能至完；伐取得时，故能
至坚也。（按∶完，全备也。坚，苍劲也。稻得四时中和之气，其性平，其味淡，日以养人，以其力全而功备
也。稻薪采于秋末冬初，故其色苍而质劲也。）帝曰∶上古圣人之作汤液醪醴，为而不用，何也？岐伯曰∶
自古圣人作汤液醪醴者，以为备耳，夫上古作汤液，故为而弗服也。按∶圣人不治已病治未病，故但为备用
而不服也。中古之世，道德稍衰，邪气时至，服之万全。（虽道德稍衰，邪气时至，以心犹近道，故服用万全
也。）帝曰∶今之世不必已，何也？（言不必如中古之世，何也？）岐伯曰∶当今之世，必齐毒药攻其中，
石针艾治其外也。（按∶世愈隆则法愈备。齐，剂同。）帝曰∶形弊血尽而功不立者何？岐伯曰∶神不使也。
（按∶张景岳曰∶“凡治病之道，攻邪在乎针药，行药在乎神气，故治施于外，而神应于中，使之升则升，使
之降则降，是其神之可使也。若以药剂治其内而脏气不应，针艾治其外而经气不应，是其神气已去而无可使，
虽竭力治之，终成虚废尔。”）帝曰∶何谓神不使？岐伯曰∶针石道也。精神进，志意治，故病可愈。（按∶
治病之法，必需针石，是针器也而道存焉。王本“精神不进，志意不治，故病不可愈。”今详上下文语气，
似有错误。按新校正云∶“全元起本作精神进，志意治，故病可愈。”文义较贯，今改从之。）今精坏神去，
荣卫不可复收。何者？嗜欲无
穷，而忧患不止，精气弛坏，荣泣卫除，故神去之而病不愈也。（按∶张景岳曰∶“肾藏精，精为阴；心藏神，
神为阳。精坏神去，则阴阳俱败，表里俱伤，荣卫不可复收拾矣。此其故，以今人嗜欲忧患不节，失其所养，
故致精气弛坏，荣泣卫除而无能为力也。荣，营同。泣，涩同。”）帝曰∶夫病之始生也，极微极精，必先入
结于皮肤。今良工皆称曰病成，名曰逆，则针石不能治，良药不能及也。今良工皆得其法，守其数，亲戚兄
弟，远近音声日闻于耳，五色日见于目，而病不愈者，亦何暇不早乎？（按。张景岳曰∶“极微者，言轻浅未
深，极精者，言专一未乱，斯时也，治之尚易。及其病成，则良工称为逆矣。然良工之治，既云得法，而至数
勿失，亲戚之闻见极熟，而声色无差，宜乎无不速愈者。而愿使其直至于精坏神去而病不能愈，亦何暇治之不
早乎。暇，犹言慢事也。”）岐伯曰∶病为本，工为标，标本不得，邪气不服，此之谓也。（按∶本犹先也，
标犹后也，言先有病而后有医治之也。病必得医而后愈，医能胜任谓之良。倘真良者或不任，而所任者未必良，
则邪仍暴横，病何由愈，是谓标本不相得，惜乎后世多蹈此弊也！五脏别论曰∶“拘于鬼神者，不可与言至
德；恶于针石者，不可与言至巧；病不许治者，病必不治，治之无功矣。”正此谓也。）
帝曰∶其有不从毫毛生，而五脏阳已竭也，津液充郭，其魄独居，孤精于内，气耗于外，形不可与衣相
保，此四极急而动中，是气拒于内，而形施于外，治之奈何？（按∶张景岳曰∶“不从毫毛生，病生于内也。
五脏阳已竭，有阴无阳也。津液，水也。郭，形体胸腹也。胀论曰∶‘夫胸腹，脏腑之郭也。’凡阴阳之要，
阴无阳不行，水无气不化。故灵兰秘典论曰∶‘气化则能出矣。’今阳气既竭，不能通调水道，故津液妄行，
充于郭也。魄者阴之属，形虽充而气则去，故其魄独居也。精中无气，则精孤于内。
阴内无阳，则气耗于外。三焦闭塞，水道不通，皮肤胀满，身体羸败，故形不可与衣相保也。四肢者诸阳之本，
阳气不行，故四极多阴而胀急也。胀由阴滞，以胃中阳气不能制水，而肺肾俱病，喘咳继之，故动中也。此以
阴气格拒于内，故水胀形施于外而为是病。”郭音廓。）岐伯曰∶平治于权衡。（按∶张景岳曰∶“平治之法
当如权衡者，欲得其平也。且如水胀一证，其本在肾，其标在肺。如五脏阳已竭，魄独居者，其主在肺，肺主
气，气须何法以化之。津液充郭，孤精于内，其主在肾，肾主水，水须何法以平之。然肺金生于脾，肾水制于
土，故治肿胀者，必求脾肺肾三脏，随盛衰而治得其平，是为权衡之道也。”）去宛陈 ，微动四极，温衣，
缪刺其处，以复其形，开鬼门，洁净府，精以时服，五阳已布，疏涤五脏，故精自生，形自盛，骨肉相保，
巨气乃平。帝曰∶善！（按∶张景岳曰∶“宛，积也。陈，久也。 ，斩草也。谓去其水气之陈积，欲如斩草
而渐除之也。四极，四肢也。微动之，欲其流通而气易行也。温衣，欲助其肌表之阳，而阴凝易散也。然后缪
刺之，以左取右，以右取左，而去其大络之留滞也。鬼门，汗空也，肺主皮毛，其藏魄，阴之属也，故曰鬼
门。净府，膀胱也，上无入孔而下有出窍，滓秽所不能入，故曰净府。邪在表者散之，在里者化之，故曰开鬼
门洁净府也。水气去则真精服。服，行也。阴邪除则五阳布。五阳，五脏之胃气也。由是精生形盛，骨肉相保，
而巨气可平矣。宛，郁同。 音 。”）
本篇虽然以“汤液醪醴”命名，但其核心要义在于后半部分。其中，“胀证”这一类病症最为关键。“去宛陈莝”，是指清除体内实性的积滞；“开鬼门”，是指发散体表的邪气；“洁净府”，是指通利小便使水液下泄。这三种方法是治疗胀证的要点，大致完备了。
黄帝问道：制作五谷的汤液和醪醴，应该怎么做？（按语：张景岳说：“汤液和醪醴，都属于酒类。”韵义说：“浑浊的酒称为醪。”诗话说：“甘甜浑浊而不清澈的酒称为醴。”既然如此，那么汤液大概就是清酒之类吧。醪音劳。醴音礼。莝音济。）岐伯回答说：必须用稻米，用稻秆作为燃料。因为稻米性质完备，稻秆质地坚实。黄帝问：为什么这样说？岐伯说：这是因为稻米获得了天地中和之气，适应高下的环境，所以性质能够极其完备；砍伐采集的时间得当，所以质地能够极其坚实。（按语：完，指全备。坚，指苍劲有力。稻米得到四时中和之气，其性平，其味淡，每日滋养人体，因其力量全面而功效完备。稻秆采于秋末冬初，所以颜色苍黑而质地强劲。）黄帝问：上古圣人制作汤液醪醴，做好了却不用，这是为什么？岐伯说：自古圣人制作汤液醪醴，只是为了备用罢了。上古时代制作汤液，所以只是做好而不服用。（按语：圣人不治疗已发生的疾病，而是预防未发生的疾病，所以只制作备用而不服用。中古时代，道德稍微衰退，邪气时常到来，服用汤液就能完全治愈。）（虽然道德稍衰，邪气时至，但人心仍接近道，所以服用后效果万全。）黄帝问：当今之世，病情不一定能像中古那样轻易治愈，这是为什么？（意思是为什么不像中古时代那样容易痊愈？）岐伯说：当今之世，必须用药物攻治内部，用砭石、针具和艾灸治疗外部。（按语：时代越发展，治疗方法越完备。齐，通“剂”。）黄帝问：如果形体败坏、血液耗尽，而治疗效果却不显著，这是为什么？岐伯说：这是因为“神不使”（神气不能发挥作用）。（按语：张景岳说：“大凡治病的方法，攻邪依靠针药，发挥药效依靠神气。所以治疗施加于外，而神气响应于内，让它上升它就上升，让它下降它就下降，这就是神气可以被驱使。如果用药剂治疗内部而脏气不响应，用针艾治疗外部而经气不响应，这说明神气已经离去而无法被驱使，即使竭尽全力治疗，最终也会成为虚废。”）黄帝问：什么叫“神不使”？岐伯说：这是指使用针石等疗法。如果精神振作，意志调摄得当，那么病就可以痊愈。（按语：治病的方法，必须依赖针石，这是器具，但其中蕴含道理。王冰注本中作“精神不进，志意不治，故病不可愈。”现在详细分析上下文语气，似乎有误。据新校正说：“全元起本作‘精神进，志意治，故病可愈。’文义更连贯，现在改正并遵从它。”如今精气败坏、神气离去，营气和卫气无法再恢复。为什么呢？因为嗜欲没有穷尽，而忧患不停止，导致精气松弛败坏，营血凝涩、卫气消散，所以神气离去而病不能痊愈。（按语：张景岳说：“肾藏精，精属阴；心藏神，神属阳。精坏神去，则阴阳俱败，表里俱伤，营卫无法再收拾。这其中的原因，是因为现代人嗜欲忧患不加节制，失去了所养，导致精气松弛败坏，营血凝涩、卫气消散而无能为力。荣，同营。泣，同涩。”）黄帝问：疾病刚开始产生时，极其细微精微，必定先结聚在皮肤。现在优秀的医生都称这种病为“成”，名叫“逆”，说针石不能治疗，良药也不能达到。现在的优秀医生都掌握了方法，遵守法则，亲戚兄弟远近的声音每天在耳边听到，五色每天在眼前看到，但病还是不愈，这难道不是治疗太晚了吗？（按语：张景岳说：“极微，指轻浅未深；极精，指专一未乱。这个时候，治疗还容易。等到病已成，良工就称之为‘逆’了。然而良工的治疗，既然说掌握了方法，而至数不失，亲戚的见闻极熟，声色无差，按理说应该无不迅速痊愈的。但如果任由病人直到精坏神去而病不能愈，这难道不是治疗不早吗？暇，犹言慢事也。”）岐伯说：病人为本，医生为标，标本不相得，邪气就不能被制服，说的就是这个意思。（按语：本犹先，标犹后，指先有病而后有医治。病必须得到医治才能痊愈，医生能胜任称为良。如果是真正的良医却不能胜任，或者胜任的人未必是良医，那么邪气仍然暴横，病怎么能好，这叫标本不相得，可惜后世多犯此弊！《五脏别论》说：“拘泥于鬼神的人，不可以跟他谈论至高的医德；厌恶针石的人，不可以跟他谈论高超的技巧；不允许治疗的患者，病一定治不好，治疗也没有功效。”正是这个意思。）
黄帝问：有一种病不是从毫毛（体表）产生的，而是五脏阳气已经衰竭，津液充满胸腹，只有魄（阴）独自存在，孤立的精在内部，耗散的气在外部，形体庞大到衣服都穿不下，四肢紧急且影响内脏，这是气拒于内，形施于外，怎么治疗？（按语：张景岳说：“不从毫毛生，说明病生于内部。五脏阳已竭，是有阴无阳。津液，即水。郭，指形体胸腹。《胀论》说：‘夫胸腹，脏腑之郭也。’大凡阴阳的关键，阴没有阳就不能运行，水没有气就不能气化。所以《灵兰秘典论》说：‘气化则能出矣。’现在阳气既已衰竭，不能通调水道，所以津液妄行，充满胸腹。魄属于阴，形虽充盛而气则离去，所以魄独居。精中没有气，则精孤立在内。阴内没有阳，则气耗散在外。三焦闭塞，水道不通，皮肤胀满，身体羸弱，所以形体与衣服不相保。四肢是诸阳之本，阳气不行，所以四肢多阴而胀急。胀由阴滞引起，因胃中阳气不能制水，而肺肾俱病，喘咳随之发生，所以动中。这是阴气格拒于内，所以水胀形施于外而成为这种病。”郭音廓。）岐伯说：要像权衡一样平治。（按语：张景岳说：“平治的方法应当像权衡一样，是为了求得平衡。比如水胀这一证，其本在肾，其标在肺。如五脏阳已竭，魄独居者，其主在肺，肺主气，气需要用何法来化？津液充郭，孤精于内，其主在肾，肾主水，水需要用何法来平？然而肺金生于脾，肾水制于土，所以治疗肿胀，必须求之于脾、肺、肾三脏，随着盛衰情况治疗以求得其平，这就是权衡之道。”）去除体内的陈积瘀滞，轻微活动四肢，穿着温暖衣物，用缪刺法针刺患处，以恢复形体，发汗，通利小便，精气按时运行，五脏阳气得以布散，疏通涤荡五脏，所以精气自然产生，形体自然强盛，骨肉相保，正气乃平和。黄帝说：好！（按语：张景岳说：“宛，积也。陈，久也。莝，斩草也。谓去除水气的陈旧积聚，想要像斩草一样逐渐清除。四极，即四肢。微动之，希望其流通而气易行。温衣，希望助其肌表之阳，使阴凝易散。然后用缪刺法，左病取右，右病取左，以去除大络中的留滞。鬼门，即汗孔，肺主皮毛，其藏魄，属于阴，所以叫鬼门。净府，即膀胱，上无入孔而下有出窍，滓秽所不能入，所以叫净府。邪在表则散之，在里则化之，所以叫开鬼门、洁净府。水气去则真精运行。服，行也。阴邪除则五阳布。五阳，即五脏的胃气。由此精生形盛，骨肉相保，而正气可平矣。宛，同郁。莝音cuò。”）
Although this chapter is titled "Decoctions and Malt Liquors," its essential meaning lies in the latter half. Among them, the syndrome of distension (Zhang Zheng) is most critical. "Removing accumulated stagnation" (Qu Wan Chen Cuo) refers to eliminating solid accumulations; "Opening the ghost gate" (Kai Gui Men) refers to dispersing pathogenic factors from the exterior; "Purifying the clean mansion" (Jie Jing Fu) refers to promoting urination to drain water downward. These three methods roughly cover the treatment for distension.
The Yellow Emperor asked: How should one prepare decoctions and malt liquors from the five grains? (Note: Zhang Jingyue said: "Decoctions and malt liquors both belong to the category of wine." Yunyi states: "Turbid wine is called Lao." Shihua states: "Sweet, turbid, but not clear wine is called Li." Thus, decoctions are likely similar to clear wine. Lao sounds like 'lao'. Li sounds like 'li'. Cuo sounds like 'ji'.) Qibo replied: One must use rice as the grain and rice straw as the fuel. Rice is complete/perfect, and rice straw is firm/strong. The Emperor asked: Why is this so? Qibo said: This is because they obtain the harmony of heaven and earth and the suitability of high and low places, thus achieving perfection; they are harvested at the appropriate time, thus achieving firmness. (Note: Complete means fully equipped. Firm means tough and vigorous. Rice obtains the harmonious qi of the four seasons, its nature is neutral, its taste is bland, nourishing people daily, because its power is complete and efficacy is ready. Rice straw is harvested in late autumn and early winter, hence its color is dark and texture is strong.) The Emperor asked: Why did the sages of ancient times make decoctions and malt liquors but not use them? Qibo said: Since ancient times, sages made decoctions and malt liquors merely for preparation/reserve. In ancient times, decoctions were made but not taken. (Note: Sages treat disease before it occurs, hence they only prepare for reserve and do not take them. In the middle antiquity, virtue and morality slightly declined, and pathogenic qi frequently arrived; taking them ensured complete cure.) (Although virtue declined slightly and pathogenic qi arrived, the heart was still close to the Dao, so taking them yielded perfect results.) The Emperor asked: Why is it that in today's world, recovery is not guaranteed as in middle antiquity? (Meaning: Why is it not as easy to recover as in middle antiquity?) Qibo said: In today's world, one must definitely use medicinal drugs to attack internally, and bi-shi (stone needles), acupuncture, and moxibustion to treat externally. (Note: The more advanced the era, the more complete the methods. Qi is synonymous with Ji/Dose.) The Emperor asked: If the form is exhausted and blood depleted, yet therapeutic effect is not established, why is this? Qibo said: It is because the Shen (Spirit) does not respond/be used. (Note: Zhang Jingyue said: "In treating disease, attacking pathogens relies on needles and drugs, while executing drug effects relies on Shen-Qi. Thus, treatment is applied externally, and Shen responds internally; making it ascend causes ascent, making it descend causes descent; this shows Shen can be directed. If internal treatment with drugs fails to elicit Zang-Qi response, or external treatment with needles/moxa fails to elist Jing-Qi response, it indicates Shen-Qi has departed and cannot be directed. Even with utmost effort, treatment ultimately becomes futile.") The Emperor asked: What is meant by "Shen does not respond"? Qibo said: This refers to the Way of needles and stones. If Spirit is advanced and Will is regulated, then the disease can be cured. (Note: Treatment methods require needles and stones; these are tools, but the Way resides within them. Wang Bing's edition reads "If Spirit does not advance and Will is not regulated, then disease cannot be cured." Analyzing the context tone, this seems erroneous. Xin Zhengjiao notes: "Quan Yuanqi's edition reads 'If Spirit advances and Will is regulated, then disease can be cured.' The textual logic is smoother; we now correct and follow it." Now, if Essence is ruined and Spirit departs, Ying (Nutritive) and Wei (Defensive) Qi cannot be recovered. Why? Because desires are endless, and worries/sorrow are unceasing, causing Jing-Essence to relax and ruin, Ying-Blood to become stagnant/astringent, and Wei-Defensive Qi to dissipate; thus Spirit departs and disease does not heal. (Note: Zhang Jingyue said: "Kidney stores Essence, Essence is Yin; Heart stores Spirit, Spirit is Yang. Essence ruin and Spirit departure mean both Yin and Yang fail, interior and exterior are injured, and Ying-Wei cannot be restored. The reason is that modern people indulge in desires and sorrows without restraint, losing their nourishment, leading to Jing-Essence ruin, Ying-Stagnation, and Wei-Dissipation, rendering them powerless. Ying is same as Rong. Qi (stagnant) is same as Se.") The Emperor asked: When a disease first arises, it is extremely subtle and refined, necessarily entering and knotting in the skin. Now, excellent physicians all call this disease "formed" (Cheng) and name it "adverse" (Ni), stating that needles and stones cannot treat it, and good medicines cannot reach it. Excellent physicians today all possess the method and guard the numbers/patterns. Relatives and brothers, near and far, hear voices daily and see colors daily, yet the disease does not heal. Is this not because treatment was too late? (Note: Zhang Jingyue said: "'Extremely subtle' means light and shallow, not deep; 'extremely refined' means focused and not chaotic. At this time, treatment is still easy. Once the disease forms, excellent physicians call it 'adverse'. However, if excellent physicians have mastered the method and lost no precision, and relatives' observations are familiar, with no error in sound or color, one would expect rapid healing. But allowing the patient to reach the point of essence ruin and spirit departure where disease cannot heal, is this not due to treatment being too late? Xia implies negligence/delay.) Qibo said: Disease is the root (Ben), physician is the branch (Biao). If root and branch do not match, pathogenic Qi will not be subdued; this is what is meant. (Note: Ben implies prior, Biao implies posterior, meaning disease exists first, then medical treatment follows. Disease must be treated to heal; a physician who can胜任 is called excellent. If a true excellent physician cannot handle it, or those who can handle it are not excellent, then pathogenic Qi remains rampant, and how can the disease heal? This is called root and branch mismatch. Alas, later generations often fall into this fault! *Wu Zang Bie Lun* says: "One constrained by ghosts and spirits cannot be spoken to regarding supreme virtue; one who dislikes needles and stones cannot be spoken to regarding supreme skill; if the patient does not permit treatment, the disease will certainly not heal, and treatment will be ineffective." This is exactly what is meant.)
The Emperor asked: There is a condition that does not arise from the hair and skin (exterior), but rather the Yang Qi of the Five Zang organs has already exhausted. Fluids fill the chest and abdomen (Guo), only Po (Corporeal Soul/Yin) remains alone. Solitary Essence is inside,耗散ed Qi is outside. The form is so swollen it cannot fit into clothes. The four extremities are urgent/tense and affect the interior. This is Qi rejecting inside, and Form manifesting outside. How to treat? (Note: Zhang Jingyue said: "Not arising from hair/skin means disease originates internally. Exhaustion of Five Zang Yang means there is Yin but no Yang. Fluids refer to water. Guo refers to the body/chest and abdomen. *Zhang Lun* says: 'Chest and abdomen are the Guo of the Zang-Fu.' The key to Yin-Yang is that Yin cannot move without Yang, and water cannot transform without Qi. Thus *Ling Lan Mi Dian Lun* says: 'Only after Qi transformation can it exit.' Now that Yang Qi is exhausted, it cannot regulate water passages, so fluids wander and fill the Guo. Po belongs to Yin; although form is full, Qi departs, so Po remains alone. Essence without Qi means Essence is solitary inside. Yin inside without Yang means Qi dissipates outside. San Jiao is blocked, water passages do not flow, skin is distended, body is emaciated, so form cannot be maintained by clothes. Four extremities are the root of all Yang; Yang Qi does not move, so four extremities have much Yin and become tense/distended. Distension is caused by Yin stagnation; because Stomach Yang cannot control water, Lung and Kidney are diseased, followed by wheezing/coughing, thus affecting the interior. This is Yin Qi rejecting inside, so water distension manifests outside as this disease." Guo sounds like 'kuo'.) Qibo said: Treat it by balancing the scales (Ping Zhi Yu Quan Heng). (Note: Zhang Jingyue said: "The method of balancing treatment should be like a scale, seeking equilibrium. For example, in water distension, the root is Kidney, the branch is Lung. If Five Zang Yang is exhausted and Po remains alone, the master is Lung; Lung governs Qi, what method transforms Qi? Fluids fill Guo, solitary Essence inside, the master is Kidney; Kidney governs Water, what method levels Water? However, Lung Metal is born from Spleen, Kidney Water is controlled by Earth. Therefore, treating swelling requires focusing on Spleen, Lung, and Kidney, treating according to excess or deficiency to achieve balance. This is the Way of the Scale.") Remove accumulated stagnation, slightly move the four extremities, wear warm clothing, apply Miu Ci (twisted needle) therapy at the sites, to restore the form. Open the Ghost Gate (sweat pores), purify the Clean Mansion (bladder). Essence will function timely. Five Yang will be distributed. Dredge and cleanse the Five Zang. Thus Essence generates spontaneously, Form prospers spontaneously, bone and flesh protect each other, and Great Qi becomes peaceful. The Emperor said: Excellent! (Note: Zhang Jingyue said: "Wan means accumulation. Chen means old/long-standing. Cuo means cutting grass. It means removing the old accumulation of water Qi, desiring to remove it gradually like cutting grass. Si Ji refers to four extremities. Slightly moving them desires circulation so Qi moves easily. Warm clothing desires to assist Muscular-Surface Yang so Yin coagulation disperses easily. Then apply Miu Ci, left treating right, right treating left, to remove stagnation in large collaterals. Ghost Gate refers to sweat pores; Lung governs skin/hair, stores Po, belongs to Yin, hence called Ghost Gate. Clean Mansion refers to Bladder; upper end has no entry hole, lower end has exit, impurities cannot enter, hence called Clean Mansion. Pathogens in exterior are scattered, in interior are transformed, hence Open Ghost Gate, Purify Clean Mansion. When water Qi leaves, True Essence functions. Fu means movement. When Yin pathogens are removed, Five Yang distribute. Five Yang refers to Stomach Qi of the Five Zang. From this, Essence generates, Form prospers, bone/flesh protect each other, and Great Qi can be pacified. Wan is same as Yu. Cuo sounds like 'cuo'.)"