吴云。奇病。特异于常之病也。简按凡风也。痹也。厥也。痿也。属类颇多。此篇所载。重身声喑。息
积。疹筋等。率皆奇特之病。故以奇病名篇。
重身 诗大雅。大任有身。毛传。身。重也。笺。谓怀孕也。马。重。平声。
九月而喑 马云。喑。哑也。医书。谓人之受孕者。一月肝经养胎。二月胆经养胎。三月心经养
胎。四月小肠经养胎。五月脾经养胎。六月胃经养胎。七月肺经养胎。八月大肠经养胎。九月肾经养胎。十月
膀胱经养胎。先阴经而后阳经。始于木而终于水。以五行之相生为次也。然以理推之。则手足十二经之经脉。
昼夜流行无间。无日无时而不共养胎气也。必无分经养胎之理。今曰九月而喑。盖时至九月。则妊胎已久。儿
体日长。胞络宫之络脉。系于肾经者。阻绝而不通。故间有为之喑者。非人人然也。（此乃阻绝之绝。非断绝
之谓。生气通天论云。大怒则形气绝。而血菀于上。亦阻绝之绝。灵经脉篇云。肾足少阴之脉。从肾上贯肝膈。
入肺中。循喉咙。挟舌本。）张云。喑。声哑不能出也。简按徐之才逐月养胎法。见于千金方。萧氏女科经论
云。张 璜按喑。谓有言而无声。故经曰。不能言。此不能二字。非
绝然不语之谓。凡人之音。生于喉咙。发于舌本。因胎气肥大。阻肾上行之经。以肾之脉入肺中。循喉咙。系
舌本。喉者肺之部。肺主声音。其人切切私语。心虽有言。而人不能听。故曰喑。肺肾子母之脏。故云不必治。
若大全解作不语。则为心病。以心主发声为言也。与子喑。了不相干。 璜所论如此。然医说引邵氏后闻见录
云。郝翁名允。博陵人。一妇人妊。咽嘿不能言。翁曰。儿胞大经壅。儿生经行则言矣。不可毒以药。又引医
余云。孕妇小语。非病也。闻如此者。不须服药。临产日。但服保生丸四物汤之类。产后便语。亦自然之理。
非药之功。并是子喑。喑。乃舌喑。肾之脉系舌本。其理自明。萧所引却是迂谬。又考郭氏保庆集。第九论。
有产后不语。用七珍散。则知不啻胎前有此证也。
胞络 张云。胞中之络。冲任之络也。吴云。谓子室中之支络也。系。根系也。
刺法曰 此以下。止疹成也。吴志为别章。是。
成其疹 吴云。疹。病也。张志同。简按国语。孤子寡妇疾疹。伤寒例云。小人触冒。必婴暴疹。
王注恐非。
然后调之 此四字。宜据新校正删之。明是全注羼入。诸家为原文释之者。何诸。
无用 石也 志云。 。谓针。石。砭石也。针经曰。形气不足。病气不足。此阴阳气俱不足也。
不可刺之。刺之则重不足。重不足。则阴阳俱竭。血气皆尽。五脏空虚。筋骨髓枯。老者绝灭。壮者不复矣。
是以身羸瘦者。不可妄用针石。
腹中有形而泄之 志云。泄。谓用针泻之。针经曰。刺之害。中而不去则精泄。精泄则病益甚而 。
按腹中胞积皆为有形。在女子胞。则无益其有余。在息积。曰不可灸刺。
在伏梁。曰不可动之。是腹中有形者。皆不可刺泄。刺虽中病。而有形之物不去。则反泄其精气。正气出。而
邪病反独擅于其中。故为疹成也。简按马张仍王。为重身之义。非也。
胁下满气逆 马云。胁下胀满。气甚喘逆。
息积 吴云。息积。即息贲肺积也。张云。积不在中。而在胁之下者。初起微小。久而至大。则胁满气
逆。喘促息难。故名息积。今人有积。在左胁之下。俗名为痞者。其即此证。惟小儿为尤多。盖饮食过伤。脾
不及化。则余气留滞。而结聚于此。其根正在胁间。阳明病剧。则上连于肺。此其所以为息积也。简按百病始
生篇云。稽留不去。息而成积。据此则息谓生长。（出前汉宣帝纪师古注。）犹 肉之 也。圣济总录云。夫
消息者。阴阳之更事也。今气聚胁下。息而不消。积而不散。故满逆为病。然气客于外。不干胃腑。故不妨食。
特害于气息也。导引能行积气。药力亦藉导引而行故也。有方附于五十七卷。此以息而不消。积而不散。解息
积之义。极是矣。而至谓害于气息。则竟未免歧误。
积为导引服药 高云。积。渐次也。须渐次为之导引而服药。导引。营运也。营运则经脉之亏者可
复。若但服药。则药不能独治也。
尺脉数甚 简按十三难云。脉数。尺之皮肤亦数。丁氏注。数。心也。所以臂内之皮肤热也。盖与
此同义。
筋急而见 吴云。身之大筋劲急也。简按王注为是。
疹筋 吴云。病筋也。简按圣济总录云。夫热则筋缓。寒则筋急。今也肝气内虚。虚则生寒。故筋
急而见。其尺脉数甚者。盖尺里以候腹中。其人腹急。则尺脉见数。数亦为虚。以腹内气虚故也。气既寒而筋
急。其色又见白黑。是为
寒甚之证。有方。附于四十二卷。又外台云。 癖。发即两筋弦急。陈氏妇人良方云。 者。在腹内近脐左右。
各有一条筋脉急痛。大者如臂。次者如指。因气而成。如弦之状。名曰 气也。慧琳一切经音义云。 病。即
腹中冷气病也。发即脉胀牵急。如似弓弦。故俗呼为 气病也。据王注。此即疹筋也。
名曰厥逆 圣济总录。方附于五十一卷。李氏兰室秘藏。有羌活附子汤。罗氏卫生宝鉴。有麻黄附
子细辛汤。危氏得效方。有白附子散。并治大寒犯脑头痛。
帝曰善 高云。三字衍文。
五气之溢也 吴云。腥焦香臊腐也。张云。五味之所化也。马云。五脏之气也。志云。五气者。土
气也。土位中央。在数为五。在味为甘。在脏为脾。高同。云。溢。泛溢也。简按万历本医说。作土气。志注
为是。王意亦当如此。
脾瘅 圣济总录云。夫食入于阴。长气于阳。肥甘之过。令人内热而中满。则阳气盛矣。故单阳为
瘅也。其证口甘。久而弗治。转为消渴。以热气上溢故也。有方。附于四十五卷。
食甘美而多肥 甲乙。作数食美。而多食甘肥。简按甲乙为是。枚乘七发。甘脆肥浓。命曰腐肠之药。
转为消渴 吴。转。作传。云。传。日久传变也。消渴。饮水善消。而渴不止也。
以兰除陈气 圣济总录。治脾瘅口甘中满。兰草汤。兰草。一两。切。 上一味。以水三盏。煎取一
盏半。去滓。分温三服。不拘时候。张云。兰草。性味甘寒。其气清香。能生津止渴润肌肉。故可除陈积蓄热
之气。简按李杲试效方。有兰香饮子。兰室秘藏。名甘露膏。治消渴。饮水极甚。善
食而瘦。王逊药性纂要云。素问所谓。治之以兰除陈气者。幽兰建兰之叶。非兰草泽兰也。建兰幽兰。古所无。
此袭寇宗 陈嘉谟之谬说耳。
口苦取阳陵泉 此六字。宜据新校正而删之。诸家费解。
夫肝者中之将也 甲乙。肝上。有胆者中精之府六字。与新校正所援异。灵师传篇云。肝主为将。六
节脏象论云。十二脏皆取决于胆。本输篇云。肝合胆。胆者。中精之府。（五行大义。引河图。文同。）盖本
节主胆而言。甲乙文为正焉。圣济总录。作夫胆为中正之官。清净之腑。十一脏之所取决。咽为之使。
咽为之使 张云。足少阳之脉。上挟咽。足厥阴之脉。循喉咙之后。上入颃颡。是肝胆之脉。皆会于
咽。故咽为之使。
胆虚气上溢 甲乙。无虚字。吴。虚。作嘘。云。嘘气。气上溢也。汪昂云。吴改胆虚。作胆嘘。欠
通。气上溢。即嘘字之义。马云。此胆气以烦劳而致虚。张云。数谋虑不决。则肝胆俱劳。劳则必虚。虚则气
不固。故胆气上溢。简按数谋虑不决。宜胆气怫郁。甲乙似是。圣济总录云。数谋不断。则清净者。浊而扰矣。
故气上溢。而为口苦也。经所谓是动则病口苦。以气为是动也。有方。附于四十二卷。卫生宝鉴。有龙胆泻肝
汤。（与东垣方不同。）
胆募俞 吴云。胆募。日月穴也。胆俞。在脊十椎下。两旁各一寸五分。简按甲乙云。日月。胆募
也。在期门下五分。马以为期门。误。王注腹募背俞。原于六十七难。
治在阴阳十二官相使中 治。吴改作论。注云。即灵兰秘典所论也。张同。简按王云。今经已亡。
未知何是。
有癃者 吴云。癃。不得小便也。癃而一日数十溲者。
由中气虚衰。欲便则气不能传送。出之不尽。少间则又欲便。而溲出亦无多也。简案口问篇云。中气不足。溲
便为之变。陈氏三因方云。淋。古谓之癃。名称不同也。癃者。罢也。淋者。滴也。今名虽俗。于义为得。此
说非是。戴侗六书故曰。淋。癃。实一声也。汉殇帝讳淋。故改癃为HT 。改隆虑县。为林虑县。盖内经。本草
经。皆用癃字。作淋皆后人所改。
身热如炭颈膺如格 吴云。身热如炭。胃主肌肉故也。颈膺如格。胃脉循喉咙。下乳内廉故也。张
云。如格者。上下不通。若有所格也。
喘息气逆 马云。其息喘。其气甚逆。张云。喘息者。呼吸急促也。气逆者。治节不行也。
细微如发 甲乙。无微字。
病在太阴其盛在胃颇在肺 马云。此病在太阴。经之不足。观气口微细之脉可知也。其气盛在于胃。
观人迎躁盛之脉可知也。六节脏象论。灵枢终始禁服等篇。皆以人迎三盛。为病在阳明。所以谓之其盛在胃也。
至于喘息气逆。颇关在肺。然肺虚也。非盛也。特邪气耳。简按参之于王说。义尤明晰。吴以太阴为脾。张则
为脾肺二脏。与经旨左矣。
此所谓得五有余 甲乙。无所谓二字。
五病之气有余也 甲乙。无五字。
此其身不表不里亦正死明矣 甲乙。无身字。正死。作死证。
巅疾 张云。即癫痫也。本经。巅。癫通用。于此节之义可见。诸家释为顶巅者非。盖儿之初生。
即有病癫痫者。今人呼为胎里疾者即此。未闻有胎病顶巅者也。
母有所大惊 甲乙。母下。有数字。张兆璜云。胎中受
病。非止惊痫。妊娠女子。饮食起居。大宜谨慎。则生子聪俊。无病长年。高云。其气上不下。则精与惊气并
居。既生以后。故令子发为癫疾也。此癫疾为先天奇病。而属于不治也。
然 。庞 同。玉篇。大也。乃状浮起貌也。庞。又庞杂之庞。故王兼二义而释之。详见于评热
病论。马本。 。作 。
身无痛者 吴云。以其病不系于表。故身无痛。
肾风 马云。肾属水。故肾虚则水搐。肾不宜感风。故风在则体浮。风热则脉大。风与水搏。则脉
紧。胀满则薄脾。而不能食。虽食亦少。水热穴论云。肾者。胃之关也。关门不利。故聚水而成其病。则欲其
能食也难矣。高云。水因风动。故名肾风。简按王注风论云。肾脏受风。则面 然而肿。而张则云。非外感之
风。乃风由内生者。内风之说未经见。则不可从。
惊已心气痿者死 吴云。肾邪陵心。令人善惊。若惊已而心气犹壮。是谓神正。生之徒也。惊已而
心气痿者。是谓神亡。死之属也。志云。肾风非死证。此病生在肾。逆传其所胜。故死。简按痿。马张仍王义。
吴云：奇病，是不同于常规疾病的病症。简按：凡是风病、痹病、厥病、痿病等，所属类别很多。本篇所载的重身声喑（怀孕后失音）、息积、疹筋等，都属于奇特的疾病，所以用“奇病”命名本篇。
重身：《诗经·大雅》说：“大任有身。”毛传解释：“身，就是重。”郑笺解释：“谓怀孕也。”马莳注：“重，读平声。”
九月而喑：马云：“喑，就是哑。”医书说：人受孕后，第一个月肝经养胎，第二个月胆经养胎，第三个月心经养胎，第四个月小肠经养胎，第五个月脾经养胎，第六个月胃经养胎，第七个月肺经养胎，第八个月大肠经养胎，第九个月肾经养胎，第十个月膀胱经养胎。先阴经后阳经，始于木终于水，以五行相生为次序。然而从道理上推究，手足十二经脉的气血昼夜流行无间断，没有哪一天哪一时不共同滋养胎气。必定没有分经养胎的道理。现在说“九月而喑”，大概是到了第九个月，妊娠已久，胎儿身体日渐长大，胞宫络脉系于肾经的部分，被阻绝而不通，所以偶尔有人出现失音的情况，并非人人都这样。（这里的“绝”是阻绝的意思，不是断绝的意思。《生气通天论》说：“大怒则形气绝，而血菀于上。”也是指阻绝之绝。《灵枢·经脉篇》说：“肾足少阴之脉，从肾上贯肝膈，入肺中，循喉咙，挟舌本。”）张景岳注：“喑，声音嘶哑不能发出。”简按：徐之才的逐月养胎法，见于《千金方》。萧氏《女科经论》引张璜按语说：“喑，谓有言而无声，所以经文说‘不能言’。这个‘不能’二字，并非绝对不说话的意思。凡人的声音，产生于喉咙，发源于舌本。因为胎体肥大，阻断了肾上行至喉咙的经脉，而肾脉入肺中，循喉咙，系舌本。喉是肺的部位，肺主声音。这个人虽然心里想说话，但别人听不见，所以叫作喑。肺和肾是子母关系，所以说不必治疗。如果把《大全解》解释为不说话，那就是心病了，因为心主发声。这与子喑毫无关系。”张璜的论述如此。然而医家学说引用邵氏《后闻见录》说：“郝翁名允，博陵人。有一个妇人怀孕，咽喉沉默不能说话。郝翁说：‘胎儿胞宫大导致经络壅塞，孩子出生后经络通畅就能说话了。不可用毒药治疗。’又引用《医余》说：‘孕妇小声说话，不是病。听到这种情况，不需要服药。临产那天，只服用保生丸、四物汤之类的药物，产后自然能说话，这也是自然的道理，不是药物的功效。’这些都是子喑。喑，乃是舌喑，肾脉系舌本，这个道理很明白。萧氏所引却是迂腐荒谬的。又考证郭氏《保庆集》，第九论中有产后不语，用七珍散治疗，就知道不仅胎前有这种证候。”
胞络：张景岳注：“胞中的络脉，冲脉和任脉的络脉。”吴崑注：“谓子宫中的支络。”系：根系也。
刺法曰：以下直到“成其疹”。吴崑认为这是别章，是正确的。
成其疹：吴崑注：“疹，病也。”张志聪观点相同。简按：《国语》说：“孤子寡妇疾疹。”《伤寒例》说：“小人触冒，必婴暴疹。”王冰注恐怕不对。
然后调之：这四个字，应该根据《新校正》删除。明显是全注混入原文。各家作为原文解释的，为何？
无用 石也：张志聪注：“石，谓针、石、砭石也。”《针经》说：“形气不足，病气不足，此阴阳气俱不足也。不可刺之。刺之则重不足。重不足，则阴阳俱竭。血气皆尽。五脏空虚。筋骨髓枯。老者绝灭。壮者不复矣。”所以身体瘦弱的人，不可妄用针石。
腹中有形而泄之：张志聪注：“泄，谓用针泻之。”《针经》说：“刺之害，中而不去则精泄。精泄则病益甚而 [虚]。”按：腹中胞积皆为有形之物。在女子胞，则无益于其有余；在息积，说不可灸刺；在伏梁，说不可动之。所以腹中有形之物，都不可刺泄。即使针刺中了病邪，但有形之物不去，反而泄其精气，正气外出，而邪病反独擅于其中，所以成为疹成。简按：马莳、张景岳仍依王冰注，认为是重身的含义，是不对的。
息积：吴崑注：“息积，即息贲、肺积也。”张景岳注：“积不在中，而在胁之下者，初起微小，久而至大，则胁满气逆，喘促息难，故名息积。今人有积，在左胁之下，俗名为痞者，其即此证。惟小儿为尤多。盖饮食过伤，脾不及化，则余气留滞，而结聚于此。其根正在胁间，阳明病剧，则上连于肺。此其所以为息积也。”简按：《百病始生篇》说：“稽留不去，息而成积。”据此则“息”谓生长。（出自前汉宣帝纪师古注。）犹如肉之 [增生] 也。《圣济总录》说：“夫消息者，阴阳之更事也。今气聚胁下，息而不消，积而不散，故满逆为病。然气客于外，不干胃腑，故不妨食，特害于气息也。导引能行积气，药力亦藉导引而行故也。有方附于五十七卷。”此处以“息而不消，积而不散”解释息积之义，极为正确。至于说“害于气息”，则未免歧误。
积为导引服药：高世栻注：“积，渐次也。须渐次为之导引而服药。导引，营运也。营运则经脉之亏者可复。若但服药，则药不能独治也。”
尺脉数甚：简按：《难经·十三难》说：“脉数，尺之皮肤亦数。”丁氏注：“数，心也。所以臂内之皮肤热也。”盖与此同义。
筋急而见：吴崑注：“身之大筋劲急也。”简按：王冰注是正确的。
疹筋：吴崑注：“病筋也。”简按：《圣济总录》说：“夫热则筋缓，寒则筋急。今也肝气内虚，虚则生寒，故筋急而见。其尺脉数甚者，盖尺里以候腹中。其人腹急，则尺脉见数。数亦为虚，以腹内气虚故也。气既寒而筋急，其色又见白黑，是为寒甚之证。有方，附于四十二卷。”又《外台秘要》说：“[癖] 气，发即两筋弦急。陈氏《妇人良方》说：[癖] 者，在腹内近脐左右，各有一条筋脉急痛，大者如臂，次者如指，因气而成，如弦之状，名曰 [癖] 气也。慧琳《一切经音义》说：[癖] 病，即腹中冷气病也。发即脉胀牵急，如似弓弦，故俗呼为 [癖] 气病也。”据王冰注，此即疹筋也。
名曰厥逆：《圣济总录》方附于五十一卷。李氏《兰室秘藏》有羌活附子汤。罗氏《卫生宝鉴》有麻黄附子细辛汤。危氏《得效方》有白附子散，并治大寒犯脑头痛。
帝曰善：高世栻注：“三字衍文。”
五气之溢也：吴崑注：“腥焦香臊腐也。”张景岳注：“五味之所化也。”马云：“五脏之气也。”张志聪注：“五气者，土气也。土位中央，在数为五，在味为甘，在脏为脾。”高世栻同。云：“溢，泛溢也。”简按：万历本《医说》作“土气”，志注是正确的。王意亦当如此。
脾瘅：《圣济总录》说：“夫食入于阴，长气于阳。肥甘之过，令人内热而中满，则阳气盛矣。故单阳为瘅也。其证口甘，久而弗治，转为消渴，以热气上溢故也。有方，附于四十五卷。”
食甘美而多肥：《甲乙经》作“数食美，而多食甘肥”。简按：《甲乙经》是正确的。枚乘《七发》说：“甘脆肥浓，命曰腐肠之药。”
转为消渴：吴崑注：“转，作传。云：传，日久传变也。消渴，饮水善消，而渴不止也。”
以兰除陈气：《圣济总录》治脾瘅口甘中满，用兰草汤。兰草一两，切。上一味，以水三盏，煎取一盏半，去滓，分温三服，不拘时候。张景岳注：“兰草，性味甘寒，其气清香，能生津止渴润肌肉，故可除陈积蓄热之气。”简按：李杲《试效方》有兰香饮子，《兰室秘藏》名甘露膏，治消渴，饮水极甚，善食而瘦。王逊《药性纂要》说：“素问所谓‘治之以兰除陈气者’，幽兰建兰之叶，非兰草泽兰也。建兰幽兰，古所无，此袭寇宗奭、陈嘉谟之谬说耳。”
夫肝者中之将也：《甲乙经》中，“肝”上有“胆者中精之府”六字，与《新校正》所援不同。《灵枢·师传篇》说：“肝主为将。”《六节脏象论》说：“十二脏皆取决于胆。”《本输篇》说：“肝合胆，胆者，中精之府。”（《五行大义》引《河图》，文同。）盖本节主胆而言，《甲乙经》文为正焉。《圣济总录》作“夫胆为中正之官，清净之腑，十一脏之所取决，咽为之使。”
咽为之使：张景岳注：“足少阳之脉，上挟咽。足厥阴之脉，循喉咙之后，上入颃颡。是肝胆之脉，皆会于咽。故咽为之使。”
胆虚气上溢：《甲乙经》无“虚”字。吴崑：“虚，作嘘。云：嘘气，气上溢也。”汪昂注：“吴改胆虚作胆嘘，欠通。气上溢，即嘘字之义。”马云：“此胆气以烦劳而致虚。”张景岳注：“数谋虑不决，则肝胆俱劳。劳则必虚。虚则气不固，故胆气上溢。”简按：数谋虑不决，宜胆气怫郁。《甲乙经》似是。《圣济总录》说：“数谋不断，则清净者，浊而扰矣。故气上溢，而为口苦也。经所谓是动则病口苦，以气为是动也。有方，附于四十二卷。《卫生宝鉴》有龙胆泻肝汤。（与东垣方不同。）”
胆募俞：吴崑注：“胆募，日月穴也。胆俞，在脊十椎下，两旁各一寸五分。”简按：《甲乙经》说：“日月，胆募也。在期门下五分。”马莳以为期门，误。王注腹募背俞，原于《难经·六十七难》。
治在阴阳十二官相使中：治，吴崑改作“论”。注云：“即《灵兰秘典》所论也。”张景岳同。简按：王冰注：“今经已亡，未知何是。”
有癃者：吴崑注：“癃，不得小便也。癃而一日数十溲者，由中气虚衰，欲便则气不能传送，出之不尽，少间则又欲便，而溲出亦无多也。”简按：《口问篇》说：“中气不足，溲便为之变。”陈氏《三因方》说：“淋，古谓之癃，名称不同也。癃者，罢也。淋者，滴也。今名虽俗，于义为得。此说非是。”戴侗《六书故》说：“淋，癃，实一声也。汉殇帝讳淋，故改癃为HT。改隆虑县为林虑县。盖《内经》、《本草经》，皆用癃字，作淋皆后人所改。”
身热如炭颈膺如格：吴崑注：“身热如炭，胃主肌肉故也。颈膺如格，胃脉循喉咙，下乳内廉故也。”张景岳注：“如格者，上下不通，若有所格也。”
喘息气逆：马云：“其息喘，其气甚逆。”张景岳注：“喘息者，呼吸急促也。气逆者，治节不行也。”
细微如发：《甲乙经》无“微”字。
病在太阴其盛在胃颇在肺：马云：“此病在太阴，经之不足。观气口微细之脉可知也。其气盛在于胃，观人迎躁盛之脉可知也。《六节脏象论》、《灵枢·终始》、《禁服》等篇，皆以人迎三盛，为病在阳明。所以谓之其盛在胃也。至于喘息气逆，颇关在肺。然肺虚也，非盛也。特邪气耳。”简按：参之于王说，义尤明晰。吴崑以太阴为脾，张景岳则为脾肺二脏，与经旨左矣。
此所谓得五有余：《甲乙经》无“无所谓”三字。
五病之气有余也：《甲乙经》无“五”字。
此其身不表不里亦正死明矣：《甲乙经》无“身”字。“正死”作“死证”。
巅疾：张景岳注：“即癫痫也。本经，巅、癫通用。于此节之义可见。诸家释为顶巅者非。盖儿之初生，即有病癫痫者，今人呼为胎里疾者即此。未闻有胎病顶巅者也。”
母有所大惊：《甲乙经》中，“母”下有数字。张兆璜云：“胎中受病，非止惊痫。妊娠女子，饮食起居，大宜谨慎，则生子聪俊，无病长年。”高世栻注：“其气上不下，则精与惊气并居。既生以后，故令子发为癫疾也。此癫疾为先天奇病，而属于不治也。”
[庞] 然 [肿] ：庞 [ ] 同。《玉篇》：“大也。”乃状浮起貌也。庞，又庞杂之庞。故王兼二义而释之。详见于《评热病论》。马本，[ ] 作 [ ] 。
身无痛者：吴崑注：“以其病不系于表，故身无痛。”
肾风：马云：“肾属水，故肾虚则水搐。肾不宜感风，故风在则体浮。风热则脉大。风与水搏，则脉紧。胀满则薄脾，而不能食。虽食亦少。《水热穴论》说：‘肾者，胃之关也。关门不利，故聚水而成其病。’则欲其能食也难矣。”高世栻注：“水因风动，故名肾风。”简按：王冰注《风论》说：“肾脏受风，则面 [庞] 然而肿。”而张景岳则云：“非外感之风，乃风由内生者。”内风之说未经见，则不可从。
惊已心气痿者死：吴崑注：“肾邪陵心，令人善惊。若惊已而心气犹壮，是谓神正，生之徒也。惊已而心气痿者，是谓神亡，死之属也。”张志聪注：“肾风非死证。此病生在肾，逆传其所胜，故死。”简按：痿，马莳、张景岳仍依王冰义。
Wu Yun: "Qi disease" (Strange Disease) refers to illnesses that are distinct from ordinary diseases. Jian An: Conditions such as Wind disease (Wind Syndrome), Bi disease (Obstruction Syndrome), Jue disease (Jue Syndrome), and Wei disease (Flaccidity Syndrome) belong to many categories. The cases recorded in this chapter, such as aphonia during pregnancy (Chongshen Shengyin), Xiji (Accumulated Breath), and Zhenjin (Tendon Rash), are all peculiar diseases; hence the chapter is named "Qi Disease."
Chongshen (Pregnancy): The *Book of Songs* (Shijing) states, "Da Ren had a body." Mao's Commentary explains: "Body means heavy." Zheng's Subcommentary explains: "It refers to pregnancy." Ma Shi notes: "Heavy is pronounced with a level tone."
Aphonia at Nine Months: Ma Yun says: "Yin means mute." Medical texts state that after conception, the Liver Meridian nourishes the fetus in the first month, the Gallbladder Meridian in the second, the Heart Meridian in the third, the Small Intestine Meridian in the fourth, the Spleen Meridian in the fifth, the Stomach Meridian in the sixth, the Lung Meridian in the seventh, the Large Intestine Meridian in the eighth, the Kidney Meridian in the ninth, and the Bladder Meridian in the tenth. Yin meridians precede Yang meridians, starting with Wood and ending with Water, following the sequence of the Five Elements generating each other. However, reasoning from principles, the Qi and Blood of the twelve meridians of the hands and feet flow continuously day and night without interruption; there is no day or time when they do not jointly nourish the fetal Qi. There must be no principle of meridians nourishing the fetus separately. Now, saying "aphonia at nine months," it is likely that by the ninth month, the pregnancy has been long-standing, and the fetal body grows daily. The collateral vessels of the uterus connected to the Kidney Meridian become obstructed and blocked, so occasionally some individuals experience aphonia; this does not happen to everyone. (Here, "jue" means obstruction, not severance. The *Suwen: Shengqi Tongtian Lun* states: "Great anger causes the form and Qi to be obstructed, and blood stagnates above." This also refers to obstruction. The *Linghu: Jingmai Pian* states: "The Foot-Shaoyin Kidney Meridian ascends from the kidney, passes through the liver and diaphragm, enters the lung, follows the throat, and clamps the root of the tongue.") Zhang Jingyue notes: "Yin means hoarseness where the voice cannot be produced." Jian An: Xu Zhicai's method of monthly fetal nourishment is found in the *Qianjin Fang*. Xiao's *Nuke Jinglun* cites Zhang Huang's commentary: "Yin means having speech but no sound, hence the classic says 'cannot speak.' These two characters 'bu neng' (cannot) do not mean absolute silence. Human sound originates in the throat and issues from the root of the tongue. Because the fetal mass is large, it obstructs the meridian ascending from the kidney to the throat. Since the Kidney Meridian enters the lung, follows the throat, and ties to the root of the tongue, and the throat is the domain of the Lung which governs sound, the person may wish to speak internally, but others cannot hear, thus it is called Yin. The Lung and Kidney are mother-son organs, hence it is said that no treatment is necessary. If the *Daquan Jie* interprets this as not speaking, it would be a Heart disease, because the Heart governs vocalization. This is unrelated to fetal aphonia." Zhang Huang's discussion is as follows. However, medical theories cite Shao's *Houwenjianlu*: "Hao Weng, named Yun, was from Boling. A pregnant woman could not speak due to silent throat. Hao Weng said: 'The fetal sac is large, causing meridian congestion. Once the child is born and meridians flow, speech will return. Do not use toxic medicines.' It also cites *Yiyu*: 'Pregnant women whispering is not a disease. Upon hearing this, medication is unnecessary. On the day of delivery, only administer Baosheng Wan or Siwu Tang; natural speech returns postpartum, which is natural law, not the merit of medicine.' All these refer to fetal aphonia. Yin is tongue aphonia; the Kidney Meridian ties to the root of the tongue, making the principle clear. Xiao's citation is pedantic and absurd. Furthermore, Guo's *Baoqing Ji*, Chapter 9, mentions postpartum aphonia treated with Qizhen San, indicating that this syndrome occurs not only before birth."
Baoluo (Uterine Collaterals): Zhang Jingyue notes: "Collaterals within the uterus, collaterals of the Chong and Ren meridians." Wu Kun notes: "Refers to branch collaterals within the uterine chamber." Xi: Root system.
Ci Fa Yue (The Method of Needling States): From here until "Cheng Qi Zhen." Wu Kun considers this a separate chapter, which is correct.
Cheng Qi Zhen (Forming Rash/Disease): Wu Kun notes: "Zhen means disease." Zhang Zhicong agrees. Jian An: The *Guoyu* states: "Orphans and widows suffer from zhen." The *Shanghan Li* states: "Common people exposed to pathogens inevitably contract sudden zhen." Wang Bing's annotation is likely incorrect.
Ranhou Tiao Zhi (Then regulate them): These four characters should be deleted according to the *Xin Zhengxiao*. They are clearly annotations mixed into the original text. Why did various families interpret them as original text?
Wu Yong Shi Ye (Useless Stone): Zhang Zhicong notes: "Shi refers to needles, stones, and bi-shi (stone needles)." The *Zhenjing* states: "If both form-Qi and disease-Qi are insufficient, this indicates insufficiency of both Yin and Yang Qi. One must not needle. If one needles, it leads to double insufficiency. Double insufficiency leads to exhaustion of Yin and Yang, depletion of Blood and Qi, emptiness of the five Zang organs, withering of sinews, marrow, and bones. The elderly perish, and the robust do not recover." Therefore, emaciated individuals should not recklessly use needles and stones.
Fu Zhong You Xing Er Xie Zhi (Draining what is tangible in the abdomen): Zhang Zhicong notes: "Xie means draining via needling." The *Zhenjing* states: "The harm of needling: if inserted and not removed, essence leaks. Essence leakage makes the disease worse and [weak]." Note: Abdominal accumulations are tangible. In the female uterus, it does not benefit excess; in Xiji, it is stated that moxibustion and needling are contraindicated; in Fuliang, it is stated that it should not be moved. Thus, tangible things in the abdomen should not be drained by needling. Even if the needle hits the pathogen, if the tangible object remains, it drains the vital essence instead. The healthy Qi exits, while the pathogenic disease dominates within, leading to Cheng Qi Zhen. Jian An: Ma Shi and Zhang Jingyue follow Wang Bing's note, interpreting it as related to pregnancy, which is incorrect.
Xie Xia Man Qi Ni (Fullness under the ribs and rebellious Qi): Ma Yun says: "Fullness and distension under the ribs, with severe rebellious Qi causing panting."
Xiji (Accumulated Breath): Wu Kun notes: "Xiji is the same as Xiben and Feiji." Zhang Jingyue notes: "Accumulations not in the center but under the ribs start small and grow large over time, causing rib fullness, rebellious Qi, panting, and difficulty breathing, hence named Xiji. Currently, some have accumulations under the left rib, commonly called Pi; this is this condition. It is especially common in children. Likely due to excessive dietary injury, the Spleen fails to transform, leaving residual Qi stagnant and accumulating here. Its root lies between the ribs. When the Yangming disease worsens, it connects upward to the Lung. This is why it is called Xiji." Jian An: The *Baibing Shisheng Pian* states: "Stagnation remaining prevents resolution, Xiji forms accumulation." Based on this, "Xi" means growth. (From Gusu's annotation in the *Book of Han: Annals of Emperor Xuan*.) Like the proliferation of flesh. The *Shengji Zonglu* states: "Xi and Xi are alternating events of Yin and Yang. Now Qi gathers under the ribs, resting without dissipating, accumulating without dispersing, thus causing fullness and rebellion as disease. However, since the Qi resides externally and does not affect the Stomach and Intestines, eating is not hindered; it specifically harms respiration. Daoyin can move accumulated Qi, and medicinal power also relies on Daoyin to act. There is a formula attached in Volume 57." Interpreting Xiji as "resting without dissipating, accumulating without dispersing" is very accurate. However, saying it "harms respiration" is somewhat misleading.
Ji Wei Daoyin Fu Yao (Accumulation requires gradual Daoyin and medication): Gao Shishi notes: "Ji means gradually. One must gradually perform Daoyin and take medication. Daoyin means operation/circulation. Circulation allows recovery of deficient meridians. If only taking medication, medicine cannot cure alone."
Chi Mai Shuo Shen (Radial pulse rapid and severe): Jian An: The *Nanjing: Thirteenth Nan* states: "If the pulse is rapid, the skin of the Chi position is also hot." Ding's annotation: "Shuo corresponds to Heart. Hence the skin inside the arm is hot." This shares the same meaning as this context.
Jin Ji Er Xian (Sinew tension becomes visible): Wu Kun notes: "The large sinews of the body become tense and rigid." Jian An: Wang Bing's annotation is correct.
Zhenjin (Tendon Rash): Wu Kun notes: "Disease of the sinews." Jian An: The *Shengji Zonglu* states: "Heat causes sinews to relax; cold causes sinews to tense. Now, Liver Qi is internally deficient. Deficiency generates cold, hence sinews tense and become visible. The Radial pulse being rapid and severe suggests that the Chi position examines the abdomen. If the abdomen is tense, the Radial pulse appears rapid. Rapid also indicates deficiency due to internal Qi deficiency. Since Qi is cold and sinews tense, and the complexion shows white and black, this is a sign of extreme cold. There is a formula attached in Volume 42." Also, the *Waitai Mi Yao* states: "[Pi] Qi, upon onset, both sinews become string-tense. Chen's *Furen Liangfang* states: '[Pi]' refers to a tendon vessel in the abdomen near the umbilicus on either side, painful and tense. The larger is like an arm, the smaller like a finger. Formed by Qi, shaped like a string, named '[Pi] Qi.' Huilin's *Yiqie Jing Yinyi* states: '[Pi] disease' is cold Qi disease in the abdomen. Upon onset, vessels swell and pull tightly, like a bowstring, hence commonly called '[Pi] Qi disease.'" According to Wang Bing's note, this is Zhenjin.
Ming Yue Jueni (Named Jueni/Reversal Cold): The *Shengji Zonglu* attaches formulas in Volume 51. Li's *Lanshi Micang* has Qianghuo Fuzi Tang. Luo's *Weisheng Baojian* has Mahuang Fuzi Xixin Tang. Wei's *Defang Fang* has Baifuzi San, all treating headache caused by severe cold invading the brain.
Di Yue Shan (The Emperor said: Excellent): Gao Shishi notes: "These three characters are superfluous."
Wu Qi Zhi Yi Ye (Overflow of the Five Qi): Wu Kun notes: "Fishy, scorched, fragrant, musky, putrid." Zhang Jingyue notes: "Transformations of the Five Flavors." Ma Yun: "Qi of the Five Zang organs." Zhang Zhicong notes: "Wu Qi refers to Earth Qi. Earth is central, number five, flavor sweet, organ Spleen." Gao Shishi agrees. Cloud: "Yi means overflowing." Jian An: The Wanli edition of *Yishuo* writes "Earth Qi"; Zhicong's note is correct. Wang's intent should be the same.
Pi Dan (Spleen Pungency): The *Shengji Zonglu* states: "Food enters Yin and boosts Yang. Excess of rich and sweet foods causes internal heat and middle-fullness, making Yang Qi abundant. Hence single Yang is Dan. The symptom is a sweet taste in the mouth. If untreated for a long time, it transforms into Xiao Ke (Wasting-Thirst) due to rising heat Qi. There is a formula attached in Volume 45."
Shi Gan Mei Er Duo Fei (Eating sweet/delicious and fatty foods): The *Jiayi Jing* reads "Frequently eat delicious food and consume much sweet/fatty food." Jian An: The *Jiayi Jing* is correct. Mei Cheng's *Qi Fa* states: "Sweet, crisp, rich, and thick foods are called drugs that rot the intestines."
Zhuan Wei Xiao Ke (Transforming into Wasting-Thirst): Wu Kun notes: "Zhuan, written as Chuan. Chuan means transmission over a long time. Xiao Ke drinks water, consumes it quickly, yet thirst does not cease."
Yi Lan Chu Chen Qi (Using Orchid to remove stale Qi): The *Shengji Zonglu* treats Pi Dan with sweet taste and middle-fullness using Lancao Tang. Lancao (Orchid herb) one liang, sliced. Take one ingredient, boil in three cups of water to obtain one and a half cups, remove dregs, divide into three warm doses, anytime. Zhang Jingyue notes: "Lancao is sweet and cold in nature, with a fresh fragrance. It can generate fluids, quench thirst, and moisten muscles, thus removing stale, accumulated heat Qi." Jian An: Li Gao's *Shixiao Fang* has Lanxiang Yinzi. *Lanshi Micang* names it Ganlu Gao, treating Xiao Ke with extreme thirst, good appetite but emaciation. Wang Xun's *Yaoxing Zuanyao* states: "What the *Suwen* calls 'treating with orchid to remove stale Qi' refers to the leaves of Youlan and Jianlan, not Lancao or Zelan. Jianlan and Youlan did not exist in ancient times; this plagiarizes the erroneous theory of Kou Zongshi and Chen Jiamo."
Kou Ku Qu Yanglingquan (Bitter taste in mouth, select Yanglingquan): These six characters should be deleted according to the *Xin Zhengxiao*. Various families find them confusing.
Fu Gan Zhe Zhong Jiang Ye (The Liver is the General within): The *Jiayi Jing* has the six characters "Dan Zhe Zhong Jing Zhi Fu" (The Gallbladder is the Middle Essence Mansion) above "Gan," differing from the *Xin Zhengxiao*. The *Lingshu: Shichuan Pian* states: "The Liver governs as the General." The *Liujie Zangxiang Lun* states: "All twelve organs depend on the Gallbladder." The *Benshu Pian* states: "The Liver combines with the Gallbladder; the Gallbladder is the Middle Essence Mansion." (*Wuxing Dayi* citing *Hetu* has the same text). This section primarily discusses the Gallbladder; the *Jiayi Jing* text is correct. The *Shengji Zonglu* writes: "The Gallbladder is the Official of Uprightness, the Pure Mansion, upon which the eleven organs depend, and the throat acts as its envoy."
Yan Wei Zhi Shi (The Throat Acts as Envoy): Zhang Jingyue notes: "The Foot-Shaoyang Gallbladder Meridian ascends clamping the throat. The Foot-Jueyin Liver Meridian follows behind the throat, entering the Yingse. Thus, Liver and Gallbladder meridians all converge at the throat. Hence the throat acts as its envoy."
Dan Xu Qi Shang Yi (Gallbladder Deficiency, Qi Overflows Upward): The *Jiayi Jing* lacks the character "Xu" (Deficiency). Wu Kun: "Xu, written as Xu (Exhale). Cloud: Exhaling Qi, Qi overflows upward." Wang Ang notes: "Wu changed Dan Xu to Dan Xu, which is inadequate. Qi overflowing upward is the meaning of the character Xu." Ma Yun: "This Gallbladder Qi becomes deficient due to excessive labor." Zhang Jingyue notes: "Frequent deliberation without decision exhausts both Liver and Gallbladder. Exhaustion leads to deficiency. Deficiency means Qi is not secure, hence Gallbladder Qi overflows upward." Jian An: Frequent deliberation without decision should cause Gallbladder Qi depression. The *Jiayi Jing* seems plausible. The *Shengji Zonglu* states: "Frequent indecision makes the pure turbid and disturbed. Hence Qi overflows upward, causing bitter taste in the mouth. The Classic states 'Movement disorders cause bitter taste,' attributing it to Qi movement. There is a formula attached in Volume 42. *Weisheng Baojian* has Longdan Xiegan Tang. (Different from Dongyuan's formula.)"
Dan Mu Yu (Gallbladder Front-Mu and Back-Shu Points): Wu Kun notes: "Dan Mu is the Riyue point. Dan Yu is below the tenth thoracic vertebra on the spine, one and a half cun lateral on both sides." Jian An: The *Jiayi Jing* states: "Riyue is the Gallbladder Front-Mu point, located five fen below Qimen." Ma Shi mistakenly identified it as Qimen. Wang Bing's notes on Front-Mu and Back-Shu points originate from the *Nanjing: Sixty-Seventh Nan*.
Zhi Zai Yin Yang Shi'er Guan Xiangshi Zhong (Treatment lies within the mutual assistance of the Yin-Yang Twelve Officials): Zhi, Wu Kun changes to "Lun" (Discussion). Note: "This refers to the discussion in *Linglan Midian*." Zhang Jingyue agrees. Jian An: Wang Bing notes: "The current classic is lost; unknown what this refers to."
You Long Zhe (Those with Long/Urine Retention): Wu Kun notes: "Long means inability to urinate. Those with Long who urinate dozens of times a day..." Due to deficiency and decline of Middle Qi, when attempting to urinate, Qi cannot transport, resulting in incomplete emptying. After a short while, the urge arises again, but the output is scant. Jian An: The *Kouwen Pian* states: "Insufficiency of Middle Qi causes changes in urination and defecation." Chen's *Sanyin Fang* states: "Lin (Strangury) was anciently called Long; names differ. Long means fatigue/exhaustion. Lin means dripping. Although the modern name is vulgar, it fits the meaning. This explanation is incorrect." Dai Tong's *Liushu Gu* states: "Lin and Long are essentially one sound. Emperor Shang of Han had the taboo name Lin, hence Long was changed to HT. Longlv County was changed to Lvlv County. Both the *Neijing* and *Bencao Jing* use the character Long; writing Lin is a later alteration."
Shen Re Ru Tan Jing Ying Ge (Body heat like charcoal, neck/chest like a barrier): Wu Kun notes: "Body heat like charcoal, because the Stomach governs muscles. Neck/chest like a barrier, because the Stomach Meridian follows the throat and descends along the inner breast margin." Zhang Jingyue notes: "Like a barrier means upper and lower communication is blocked, as if obstructed."
Chuanxi Qi Ni (Panting and rebellious Qi): Ma Yun: "His breath pants, his Qi is severely rebellious." Zhang Jingyue notes: "Chuanxi means rapid breathing. Qi Ni means failure of regulation/control."
Xiwei Ru Fa (Fine and thin like hair): The *Jiayi Jing* lacks the character "Wei" (Fine).
Bing Zai Taiyin Qi Sheng Zai Wei Po Zai Fei (Disease in Taiyin, Excess in Stomach, Partially in Lung): Ma Yun: "This disease is in Taiyin, meridian insufficiency. Observed by the fine and weak pulse at the Qi Kou. The Qi excess is in the Stomach, observed by the agitated and full pulse at the Renying. The *Liujie Zangxiang Lun*, *Lingshu: Zhongshi*, *Jinfu*, etc., all state that a Renying pulse three times fuller indicates disease in Yangming. Hence it is called 'excess in Stomach.' As for panting and rebellious Qi, it partially concerns the Lung. However, the Lung is deficient, not excess. It is merely pathogenic Qi." Jian An: Comparing with Wang's explanation, the meaning is clearer. Wu Kun identifies Taiyin as Spleen; Zhang Jingyue identifies it as Spleen and Lung, which deviates from the classic's intent.
Ci Suo Wei De Wu Youyu (This is called obtaining Five Excesses): The *Jiayi Jing* lacks the three characters "Wu Suo Wei" (No such thing).
Wu Bing Zhi Qi Youyu Ye (Qi of the Five Diseases is in excess): The *Jiayi Jing* lacks the character "Wu" (Five).
Ci Qi Shen Bu Biao Bu Li Yi Zheng Si Ming Yi (This body is neither exterior nor interior, clearly a death case): The *Jiayi Jing* lacks the character "Shen" (Body). "Zheng Si" is written as "Si Zheng" (Death syndrome).
Dian Ji (Dian Disease/Epilepsy): Zhang Jingyue notes: "This is epilepsy. In the original classic, Dian and Dian are interchangeable. The meaning of this section is visible. Families explaining it as the vertex/top of the head are incorrect. Infants born with epilepsy are now called congenital diseases. I have never heard of a congenital disease of the vertex."
Mu You Suo Da Jing (Mother experienced great fright): The *Jiayi Jing* has several characters below "Mu." Zhang Zhaohuang says: "Diseases contracted in the womb are not limited to fright-epilepsy. Pregnant women must be extremely cautious in diet and lifestyle to produce intelligent, healthy offspring." Gao Shishi notes: "If Qi rises but does not descend, essence and fright Qi reside together. After birth, this causes the child to develop epilepsy. This epilepsy is a congenital strange disease and belongs to untreatable conditions."
[Pang] Ran [Zhong]: Pang [ ] are identical. The *Yupian* states: "Large." It describes a floating/swelling appearance. Pang also refers to miscellaneous/mixed. Hence Wang Bing interprets both meanings. Detailed in the *Ping Re Bing Lun*. Ma's version, [ ] is written as [ ].
Shen Wu Tong Zhe (Body without pain): Wu Kun notes: "Because the disease is not related to the exterior, the body has no pain."
Shen Feng (Kidney Wind): Ma Yun: "Kidney belongs to Water, hence Kidney deficiency causes water contraction. The Kidney should not be affected by Wind. Hence if Wind is present, the body floats. Wind-heat makes the pulse large. Wind combats Water, making the pulse tight. Fullness attacks the Spleen, causing inability to eat. Even if eating, intake is small. The *Shuire Xuelun* states: 'The Kidney is the gate of the Stomach. If the gate is not functional, water gathers to form disease.' Then it is difficult to desire eating." Gao Shishi notes: "Water moves due to Wind, hence named Kidney Wind." Jian An: Wang Bing's annotation in *Feng Lun* states: "When the Kidney receives Wind, the face swells [Pang] and becomes puffy." Zhang Jingyue, however, says: "Not external Wind, but Wind generated internally." The concept of internal Wind is unverified, thus it should not be followed.
Jing Yi Xin Qi Wei Zhe Si (After fright, if Heart Qi is flaccid, death ensues): Wu Kun notes: "Kidney pathogen overwhelms the Heart, causing susceptibility to fright. If after fright the Heart Qi remains strong, this is called correct Spirit, belonging to life. If after fright the Heart Qi is flaccid, this is called loss of Spirit, belonging to death." Zhang Zhicong notes: "Kidney Wind is not a death case. This disease originates in the Kidney and transmits inversely to what it conquers, hence death." Jian An: Wei, Ma Shi, and Zhang Jingyue still follow Wang Bing's meaning.