平按∶此篇自篇首至末，见《灵枢》卷十二第八十《大惑论》。又自篇首至甚者为惑，见《甲
乙经》卷十二第四，又自人之喜忘者至故不嗜食也，见《甲乙》卷十二第一。自病而不得卧出者
至末，见《甲乙》卷十二第三，惟编次小异。
黄帝问于岐伯曰∶余尝登于清冷之台，中阶而顾，匍匐而前，则惑。余私异之，窃内怪之，
狂瞑独视，安心定气，久而不解，独转独眩，被发长跪，俯而视之，后久之不已，卒然自止，何
气使然？（小怪曰异之，大异曰怪之。瞑，目合也。俯而视之，下直视也。何气使然，问其生惑所
由也。转有为传，眩有为脆，量误也。冷有本为零也。平按∶《灵枢》尝登作尝上，狂瞑作独瞑，
独转作独传，自止作自上。《甲乙》清冷之台作青霄之台，中阶作中陛，而顾作而惑，无匍匐至
怪之十四字，独瞑独视作独冥视之，被发上无独转独眩四字，后久之不已作久不已三字。）岐伯
曰∶五脏六腑之精气，皆上注于目而为之精。（五脏六腑精液，及脏腑之气清者，上升注目，以
为目之精也。平按∶《甲乙》无皆字。）精之果者为眼，（精之果别称为眼。果音
颗。平按∶《灵枢》果作窠，无者字。《甲乙》果作裹。）骨之精为瞳子，（肾精主骨，骨之精
气为目之瞳子。）筋之精为黑眼，（肝精主筋，筋气以为精之黑眼也。）血之精为络，（心精主血，
血气以为眼精赤络。）其果气之精为白眼，（肺精主气，气之精为白眼。平按∶《灵枢》果作窠，
《甲乙》其果作其络，白眼作白睛。）肌肉之精则为约束裹撷，（脾精主肉，肉气之精以为眼之
束约裹撷。撷，胡结反。平按∶《甲乙》撷作契。）筋骨血气之精而与脉并为系，上属于脑，后
出于项中。（四气之精并脉合为目系，其系上属于脑，后出项中。）故邪中于项，因逢其身虚，
其入深，则随眼系以入于脑，则脑转，脑转则引目系，目系急，急则目眩以转矣。（后曰项，前
曰颈。以目系入脑，故邪循目系，脑转目眩也。平按∶《甲乙》项作头，因作目。《灵枢》入于
脑下重入于脑三字，《甲乙》重入字。目系目系急急《灵枢》、《甲乙》作目系急目系急。）邪
中其精，所中不相比也则精散，精散则视歧，故见两物。（五精合而为眼，邪中其精，则五精不
得比和，别有所见，故视歧见于两物，如第二问等也。平按∶邪中其精《灵枢》作邪其精其精五字，
《甲乙》作邪中之精则其精。袁刻精误作经，注亦误。）目者，五脏六腑之精也，营卫魂魄之所
常营也，神气之所生也，故神劳则魂魄散，志意乱。（目之有也，凡因三物∶一为五脏六腑精之
所成，二为营卫魂魄血气所营，三为神明气之所生。是则以神为本，故神劳者，魂魄意志五神俱
乱也。）是故瞳子、黑眼法于阴，白眼、赤脉法于阳，故阴阳合传而精明也。（是以骨精瞳子，
筋精黑眼，此二是肝肾之精，故法于阴也。果气白眼及血之赤脉，此二是心肺两精，故法于阳也。
肺虽少阴，犹在阳中，故为阳也。此之阴阳四精和合，通传于气，故曰精明也。平按∶《甲乙》白
眼作白睛，合
传作合揣，注云∶《灵枢》作传。）目者心之使也，心者神之舍也，故神分精乱而不传，卒然见
非常之处，精神魂魄散不相得，故曰惑。（心藏者，心内形也。心者神之用，神者心之主也。故
神劳分散，则五精乱不相传，卒见非常两物者也，以其精神乱为惑也。平按∶传《灵枢》作转，
《甲乙》作揣，注云∶一作转。）黄帝曰∶余疑其然。余每之东苑，未尝不惑，去之则复，余惟
独为东苑劳神乎？何其异也？（清冷之台在东苑，故每往登台则惑，去台则复于常，岂不为彼东
苑劳神，遂至有惑，是所可怪也。）岐伯曰∶不然也。心有所喜，神有所恶，卒然相感，则精气
乱，视误故惑，神移乃复。（夫心者神用，谓之情也。情之所喜，谓之欲也。故情之起欲，是神
之所恶；神之所好，心之所恶。是以养神须去情欲，欲去神安，长生久视；任心所作，则情欲百
端，情欲既甚，则伤神害命。斯二不可并行，并行相感则情乱致惑；若得神移反本，则惑解神复。
平按∶卒然相感《灵枢》、《甲乙》感作惑。注并行相感，袁刻感误作惑。）是故闲者为迷，甚
者为惑。黄帝曰∶善。（闲，轻也。甚，重也。此为第一惑邪。）
黄帝曰∶人之喜忘者，何气使然？岐伯曰∶上气不足，下气有余，肠胃实而心肺虚，虚则营
卫留于下久，不以时上，故喜忘矣。（心肺虚，上气不足也。肠胃实，下气有余也。营卫行留于
肠胃不上，心肺虚故喜忘。复有上时，又得不忘也。此为第二喜忘邪也。平按∶喜忘《灵枢》、
《甲乙》作善忘。《灵枢》久下有之字。）黄帝曰∶人之喜饥而不嗜食者，何气使然？岐伯曰∶
精气并于脾，热气留于胃，胃热则消谷，谷消故喜饥，胃气逆上故胃管寒，胃管寒故不嗜食也。
（精气，阴气也。胃之阴气并在
脾内，则胃中独热，故消食喜饥。胃气独热，逆上为难，所以胃咽中冷，故不能食也。此为第三不
嗜食邪。平按∶《灵枢》、《甲乙》喜饥作善饥，胃管作胃脘。）黄帝曰∶病而不得卧出者，何气
使然？岐伯曰∶卫气不得入于阴，常留于阳，留于阳则阳气满，满则阳跷盛，不得入于阴，阴气
虚，故目不得瞑矣。（卫气昼行阳脉二十五周，夜行五脏二十五周，昼夜周身五十周。若卫行阳脉，
不入脏阴，则阳脉盛，则阳跷盛而不和，阴跷虚也。二跷并至于目，故阳盛目不得瞑，所以不卧。
此为第四不得卧邪。瞑音眠。平按∶《灵枢》卧下无出字，疑衍。《甲乙》瞑作眠。）黄帝曰∶
病而目不得视，何气使然？岐伯曰∶卫气留于阴，不得行于阳，留于阴则阴气盛，盛则阴跷满，
不得入于阳，阳气虚，故目闭焉。（卫气留于五脏，则阴跷盛不和，惟阴无阳，所以目闭不得视也。
以阳主开，阴主闭也。此为第五不得视邪也。平按∶病而目《灵枢》作病目而，《甲乙》作目闭
二字，留作行，行作入，注云∶“《九卷》行作留，入作行。”）黄帝曰∶人之多卧者，何气使
然？岐伯曰∶此人肠胃大而皮肤涩，而分肉不解焉。肠胃大则卫气留久，皮肤涩则分肉不解，其
行迟。夫卫气者，昼日常行于阳，夜行于阴，故阳气尽则卧，阴气尽则寤。故肠胃大，则卫气行
留久；皮肤涩，分肉不解，则行迟。留于阴也久，其气不精，则欲瞑，故多卧。肠胃小，皮肤滑
以缓，分肉解利，卫气之留于阳也久，故少卧焉。（其人肠胃能大，皮肤能涩，大则卫气停留，
涩则卫气行迟，留而行涩，其气不精，故多卧少寤；反之少卧。此为第六多卧邪也。平按∶涩《灵
枢》作湿，《甲乙》作涩。不精《灵枢》作不清。注多卧邪袁刻邪作者。）黄帝曰∶其非常经也，
卒然多卧者，何气
使然？岐伯曰∶邪气留于上焦，上焦闭而不通，已食若饮汤，卫反留于阴而不行，故卒然多卧。
（邪气留于上焦，上焦之气不行，或因饮食，卫气留于心肺，故闷而多卧。此为第七邪也。平按∶
卫反留《灵枢》作卫气留久，《甲乙》作卫气久留。）黄帝曰∶善。治此诸邪奈何？岐伯曰∶先
其腑脏，诛其小过，后调其气，盛者泻之，虚者补之，必先明知其形气之苦乐，定乃取之。（疗
此七邪之法，先取五脏六腑诸募等脏腑之上诸穴，除其微过，然后调其脏腑五输六输而补泻之。
补泻之前，必须明知形气虚实苦乐之志，然后取之。平按∶先其腑脏《灵枢》作先其脏腑，《甲乙》
作先视其腑脏。形气《灵枢》作形志。）
【平按】：本篇从开头到结尾，见于《灵枢》卷十二第八十篇《大惑论》。又从头至“甚者为惑”部分，见于《甲乙经》卷十二第四篇；又从“人之喜忘者”至“故不嗜食也”，见于《甲乙经》卷十二第一篇；从“病而不得卧出者”至结尾，见于《甲乙经》卷十二第三篇，只是编排次序略有不同。
黄帝问岐伯说：我曾经登上清冷之台，走到台阶中间回头张望，或者匍匐向前爬行，就会感到头晕目眩。我私下对此感到奇怪，内心暗自疑惑，即使闭上眼睛独自看、安定心神、调匀气息，长时间也不能消除这种眩晕感，独自转动眼球或感到天旋地转，披散头发长跪不起，低头向下看，过了很久症状仍未停止，突然才自行消失，这是什么气导致这样的呢？（小怪称为异之，大怪称为怪之。瞑，指闭眼。俯而视之，指低头直视。何气使然，是询问产生眩晕的原因。转有为传，眩有为脆，意为量词误用。冷有版本作零也。平按：《灵枢》中“尝登”作“尝上”，“狂瞑”作“独瞑”，“独转”作“独传”，“自止”作“自上”。《甲乙经》中“清冷之台”作“青霄之台”，“中阶”作“中陛”，“而顾”作“而惑”，没有“匍匐至怪之”这十四个字，“独瞑独视作独冥视之”，“被发”上无“独转独眩”四字，“后久之不已”作“久不已”三字。）
岐伯回答说：五脏六腑的精气，都向上灌注于眼睛，从而形成眼的精气。（五脏六腑的精液，以及脏腑之气中清轻的部分，上升注目，作为眼的精气。平按：《甲乙经》无“皆”字。）精气汇聚的结果形成眼珠，（精气的聚合处称为眼。果音同颗。平按：《灵枢》中“果”作“窠”，无“者”字。《甲乙经》中“果”作“裹”。）骨的精气形成瞳孔，（肾主骨，骨的精气成为眼中的瞳孔。）筋的精气形成黑眼珠，（肝主筋，筋的气成为眼中黑色的部分。）血的气形成络脉，（心主血，血的气成为眼中红色的络脉。）肺的气形成白眼珠，（肺主气，气成为眼中的白色部分。平按：《灵枢》中“果”作“窠”，《甲乙经》中“其果”作“其络”，“白眼”作“白睛”。）肌肉的精气形成眼睑的约束组织，（脾主肉，肉的气成为眼中束缚眼睑的组织。撷，音胡结反。平按：《甲乙经》中“撷”作“契”。）筋骨血气的精气与脉络结合成为目系，向上连接脑部，向后出于颈项中。（四种精气与脉络合为目系，其系向上连接脑部，向后出于颈项中。）所以邪气侵袭颈部，如果恰逢身体虚弱，邪气侵入较深，就会随着目系进入脑部，导致脑旋转，脑旋转则牵引目系，目系紧张，紧张就会导致眼睛眩晕转动。（后称项，前称颈。因为目系入脑，所以邪气循行目系，导致脑转目眩。平按：《甲乙经》中“项”作“头”，“因”作“目”。《灵枢》中“入于脑”下重复“入于脑”三字，《甲乙经》重复“入”字。“目系目系急急”在《灵枢》、《甲乙经》中作“目系急目系急”。）邪气侵入精气，如果所中的部位不相协调，那么精气就会涣散，精气涣散就会视物双影，所以看到两个物体。（五种精气合而为眼，邪气侵入精气，则五种精气不能和谐，出现异常视觉，所以视物成双，如第二个问题所述等。平按：邪中其精在《灵枢》中作“邪其精其精”五字，《甲乙经》作“邪中之精则其精”。袁刻本将“精”误作“经”，注释也误了。）眼睛，是五脏六腑精气的汇聚处，营卫魂魄经常在此营运，神气由此产生，所以神劳损则魂魄涣散，意志混乱。（眼睛的存在，凡是因为三件事：一是由五脏六腑精气构成，二是营卫魂魄血气所营运，三是神明气所产生。因此以神为本，所以神劳损，则魂魄意志五种神志都混乱。）因此瞳孔、黑眼珠效法阴，白眼珠、赤色络脉效法阳，所以阴阳结合传递而保持精明。（因此骨精瞳孔，筋精黑眼珠，这是肝肾的精气，所以效法阴。肺精气白眼珠及血的赤色络脉，这是心肺的精气，所以效法阳。肺虽属少阴，但仍在阳中，所以为阳。这四种阴阳精气和谐融合，通传于气，所以叫精明。平按：《甲乙经》中“白眼”作“白睛”，“合传”作“合揣”，注云：《灵枢》作“传”。）眼睛是心的使者，心是神的居所，所以神分散精气混乱而不能传递，突然看到不寻常的地方，精神魂魄散乱不相协调，所以称为惑。（心藏者，指心内的形态。心是神的作用，神是心的主宰。所以神劳损分散，则五种精气混乱不能传递，突然看到不寻常的两个物体，因为精神混乱称为惑。平按：“传”在《灵枢》中作“转”，《甲乙经》中作“揣”，注云：一作“转”。）
黄帝说：我怀疑是这样。我每次去东苑，没有不感到眩晕的，离开那里就恢复常态，难道只有我去东苑才劳神吗？为什么这么奇怪呢？（清冷之台在东苑，所以每次前往登台就眩晕，离开台就恢复常态，难道不是因为那个东苑劳神，从而导致眩晕，这是值得奇怪的。）
岐伯说：不是这样的。心中有所喜好，神有所厌恶，突然相互感应，导致精气混乱，视觉错误所以感到迷惑，神志回归正常就恢复了。（夫心是神的作用，称为情。情之所喜，称为欲。所以情的兴起欲望，是神所厌恶的；神所喜欢的，是心所厌恶的。因此养神必须去除情欲，欲去神安，长生久视；任由心所作所为，则情欲百端，情欲既严重，则伤神害命。这两者不可并行，并行相互感应则情乱导致迷惑；如果能得到神移反本，则迷惑解除神恢复。平按：“卒然相感”在《灵枢》、《甲乙经》中“感”作“惑”。注中“并行相感”，袁刻本“感”误作“惑”。）所以轻微的称为迷，严重的称为惑。黄帝说：好。（闲，轻微的意思。甚，严重的意思。这是第一种惑邪。）
黄帝说：人容易忘记事情，是什么气导致的呢？岐伯说：上气不足，下气有余，肠胃充实而心肺虚弱，虚弱则营卫之气滞留于下部，不能按时上行，所以容易忘记。（心肺虚，即上气不足。肠胃实，即下气有余。营卫行留于肠胃不上行，心肺虚所以容易忘记。有时上行时，又能不忘。这是第二种喜忘邪。平按：“喜忘”在《灵枢》、《甲乙经》中作“善忘”。《灵枢》中“久”下有“之”字。）
黄帝说：人容易感到饥饿但不想吃东西，是什么气导致的呢？岐伯说：精气合并于脾，热气停留于胃，胃热则消化食物快，食物消化快所以容易饥饿，胃气逆上导致胃脘寒冷，胃脘寒冷所以不想吃东西。（精气，指阴气。胃的阴气并在脾内，则胃中独热，所以消食易饥。胃气独热，逆上困难，所以胃咽中冷，所以不能进食。这是第三种不嗜食邪。平按：《灵枢》、《甲乙经》中“喜饥”作“善饥”，“胃管”作“胃脘”。）
黄帝说：生病而不能躺下睡觉，是什么气导致的呢？岐伯说：卫气不能进入阴分，常停留在阳分，停留在阳分则阳气满盛，满盛则阳跷脉旺盛，不能进入阴分，阴气虚弱，所以眼睛不能闭合睡眠。（卫气白天行于阳脉二十五周，夜晚行于五脏二十五周，昼夜周身五十周。如果卫气行于阳脉，不入脏阴，则阳脉盛，阳跷盛而不和，阴跷虚。二跷并至于目，所以阳盛眼睛不能闭合，所以不卧。这是第四种不得卧邪。瞑音眠。平按：《灵枢》中“卧”下无“出”字，疑为衍文。《甲乙经》中“瞑”作“眠”。）
黄帝说：生病而眼睛不能睁开视物，是什么气导致的呢？岐伯说：卫气停留在阴分，不能行于阳分，停留在阴分则阴气盛，盛则阴跷脉满盛，不能进入阳分，阳气虚弱，所以眼睛闭合。（卫气停留于五脏，则阴跷盛不和，只有阴没有阳，所以眼睛闭合不能视物。因为阳主开，阴主闭。这是第五种不得视邪。平按：“病而目”在《灵枢》中作“病目而”，《甲乙经》中作“目闭”二字，“留”作“行”，“行”作“入”，注云：“《九卷》行作留，入作行。”）
黄帝说：人容易多睡，是什么气导致的呢？岐伯说：这个人肠胃大而皮肤涩，且分肉不解利。肠胃大则卫气停留时间长，皮肤涩则分肉不解利，卫气运行迟缓。夫卫气，白天常行于阳，夜晚行于阴，所以阳气尽则睡觉，阴气尽则醒来。所以肠胃大，则卫气行留时间长；皮肤涩，分肉不解利，则运行迟缓。停留在阴分时间长，其气不精，则想睡觉，所以多睡。肠胃小，皮肤滑缓，分肉解利，卫气停留在阳分时间长，所以少睡。（其人肠胃能大，皮肤能涩，大则卫气停留，涩则卫气行迟，留而行涩，其气不精，所以多卧少醒；反之少卧。这是第六种多卧邪。平按：“涩”在《灵枢》中作“湿”，《甲乙经》中作“涩”。“不精”在《灵枢》中作“不清”。注中“多卧邪”袁刻本“邪”作“者”。）
黄帝说：如果不属于常规经络，突然多睡，是什么气导致的呢？岐伯说：邪气停留于上焦，上焦闭塞不通，刚吃过饭或者喝过汤，卫气反而停留于阴分而不行，所以突然多睡。（邪气停留于上焦，上焦之气不行，或因饮食，卫气停留于心肺，所以闷而多睡。这是第七种邪。平按：“卫反留”在《灵枢》中作“卫气留久”，《甲乙经》中作“卫气久留”。）
黄帝说：好。治疗这些邪气怎么办？岐伯说：先确定病变的脏腑，纠正小的过失，然后调理其气，盛的用泻法，虚的用补法，必须先明确知道形气的苦乐状况，确定后再取穴治疗。（治疗这七邪的方法，先取五脏六腑诸募等脏腑之上的诸穴，除去微小过失，然后调理脏腑五输六输而进行补泻。补泻之前，必须明知形气虚实苦乐之志，然后取穴。平按：“先其腑脏”在《灵枢》中作“先其脏腑”，《甲乙经》中作“先视其腑脏”。“形气”在《灵枢》中作“形志”。）
[Ping An]: This chapter, from beginning to end, is found in *Ling Shu* (Spiritual Pivot), Volume 12, Chapter 80, "Da Huo Lun" (Treatise on Great Confusion). Furthermore, the section from the beginning to "shen zhe wei huo" (severe cases are called confusion) is found in *Jia Yi Jing* (Essential Classic of Jia Yi), Volume 12, Chapter 4; the section from "ren zhi xi wang zhe" (those who easily forget) to "gu bu shi shi ye" (therefore they do not desire food) is found in *Jia Yi Jing*, Volume 12, Chapter 1; and the section from "bing er bu de wo chu zhe" (illness where one cannot lie down and sleep) to the end is found in *Jia Yi Jing*, Volume 12, Chapter 3. The arrangement differs slightly.
Yellow Emperor asked Qi Bo: I once ascended the Qing Leng Terrace. When I reached the middle of the stairs and looked back, or crawled forward, I felt dizzy. I privately found this strange and secretly wondered about it internally. Even with eyes closed, looking alone, calming the mind, and stabilizing the qi, for a long time I could not resolve it. I turned my eyes alone and felt vertigo, let my hair down, knelt upright, and looked down, but after a long time the condition did not cease. It suddenly stopped on its own. What qi causes this? (Small strangeness is called yi zhi, great strangeness is called guai zhi. Ming refers to closing the eyes. Fu er shi zhi means looking down straight ahead. He qi shi ran asks for the cause of generating confusion. Zhuan you wei chuan, xuan you wei cui, meaning measurement error. Leng has some versions as ling ye. Ping An: In *Ling Shu*, "chang deng" is written as "chang shang", "kuang ming" as "du ming", "du zhuan" as "du chuan", "zi zhi" as "zi shang". In *Jia Yi Jing*, "Qing Leng zhi tai" is written as "Qing Xiao zhi tai", "zhong jie" as "zhong bi", "er gu" as "er huo", without the fourteen characters from "pu fu" to "guai zhi", "du ming du shi" as "du ming shi zhi", without the four characters "du zhuan du xuan" above "bei fa", and "hou jiu zhi bu yi" as "jiu bu yi three characters".)
Qi Bo replied: The essence qi of the five zang organs and six fu organs all ascend and pour into the eyes to form the eye's essence. (The fluids of the five zang and six fu organs, and the clear part of the organ qi, ascend to focus on the eyes, serving as the eye's essence. Ping An: *Jia Yi Jing* lacks the character "jie".) The gathering point of the essence forms the eyeball. (The gathering point of the essence is called the eye. Guo sounds like ke. Ping An: In *Ling Shu*, "guo" is written as "ke", without the character "zhe". In *Jia Yi Jing*, "guo" is written as "guo".) The essence of bone forms the pupil. (Kidney essence governs bone; the essence qi of bone becomes the pupil of the eye.) The essence of tendon forms the black part of the eye. (Liver essence governs tendon; the qi of tendon serves as the black essence of the eye.) The essence of blood forms the collaterals. (Heart essence governs blood; the qi of blood serves as the red collaterals of the eye essence.) The qi of the lung forms the white part of the eye. (Lung essence governs qi; the qi of lung serves as the white part of the eye. Ping An: In *Ling Shu*, "guo" is written as "ke"; in *Jia Yi Jing*, "qi guo" is written as "qi luo", and "bai yan" as "bai jing".) The essence of muscle forms the binding and wrapping of the eyelids. (Spleen essence governs flesh; the qi of flesh serves as the binding and wrapping of the eye. Xie, pronounced hu jie fan. Ping An: In *Jia Yi Jing*, "xie" is written as "qi".) The essence of bone, tendon, blood, and qi, combined with the vessels, forms the eye system (mu xi), which connects upward to the brain and exits posteriorly through the neck. (The four essences of qi combine with the vessels to form the eye system; its system connects upward to the brain and exits posteriorly through the neck.) Therefore, if pathogenic factors strike the neck, and coincidentally the body is deficient, if the invasion is deep, it follows the eye system into the brain. Then the brain rotates, the brain rotation pulls the eye system, the eye system becomes tense, and tension leads to dizziness and vertigo. (Posteriorly called xiang, anteriorly called jing. Because the eye system enters the brain, pathogenic factors follow the eye system, causing brain rotation and dizziness. Ping An: In *Jia Yi Jing*, "xiang" is written as "tou", "yin" as "mu". In *Ling Shu*, "ru yu nao" repeats "ru yu nao" three times below; *Jia Yi Jing* repeats the character "ru". "Mu xi mu xi ji ji" in *Ling Shu* and *Jia Yi Jing* is written as "mu xi ji mu xi ji".) If pathogenic factors strike the essence, and the struck parts are not harmonious, then the essence scatters. When the essence scatters, vision becomes double, so one sees two objects. (Five essences combine to form the eye. If pathogenic factors strike the essence, the five essences cannot harmonize, leading to abnormal vision, thus seeing double, as described in the second question, etc. Ping An: "Xie zhong qi jing" in *Ling Shu* is written as "xie qi jing qi jing" five characters; *Jia Yi Jing* writes "xie zhong zhi qi jing ze qi jing". Yuan edition mistakenly wrote "jing" as "jing", and the note also erred.) The eyes are the gathering place of the essence of the five zang and six fu organs, where Ying and Wei qi, Hun and Po constantly circulate, and Shen qi is generated. Therefore, when Shen is overworked, Hun and Po scatter, and Zhi and Yi become chaotic. (The existence of the eyes depends on three things: first, formed by the essence of the five zang and six fu organs; second, circulated by Ying, Wei, Hun, Po, and blood qi; third, generated by Shen Ming qi. Thus, Shen is the root. Therefore, when Shen is overworked, the Hun, Po, Zhi, Yi, and the five spirits all become chaotic.) Hence, the pupil and the black part of the eye follow Yin, while the white part and red collaterals follow Yang. Therefore, Yin and Yang combine and transmit to maintain clarity. (Thus, bone essence pupil and tendon essence black part are the essence of Liver and Kidney, hence following Yin. Lung essence white part and blood red collaterals are the essence of Heart and Lung, hence following Yang. Although Lung belongs to Shaoyin, it is still within Yang, hence considered Yang. These four Yin-Yang essences harmonize and merge, transmitting through qi, hence called Jing Ming. Ping An: In *Jia Yi Jing*, "bai yan" is written as "bai jing", "he chuan" as "he chuai", with note: *Ling Shu* writes "chuan".) The eyes are the messengers of the Heart, and the Heart is the residence of Shen. Therefore, when Shen scatters and essence becomes chaotic and cannot transmit, suddenly seeing unusual places, the Spirit, Hun, and Po scatter and do not coordinate, hence called Huo (Confusion). (The Heart storehouse refers to the internal form of the Heart. The Heart is the function of Shen, and Shen is the master of the Heart. Therefore, when Shen is overworked and scattered, the five essences become chaotic and cannot transmit, suddenly seeing two unusual objects, because spiritual chaos is called Huo. Ping An: "Chuan" in *Ling Shu* is written as "zhuan", in *Jia Yi Jing* as "chuai", note: one version writes "zhuan".)
Yellow Emperor said: I doubt this. Every time I go to Dong Yuan, I always feel confused/dizzy. When I leave, it returns to normal. Am I the only one whose Shen is overworked at Dong Yuan? Why is it so different? (Qing Leng Terrace is in Dong Yuan, so every time I ascend the terrace there I feel confused/dizzy, and leaving the terrace restores normalcy. Is it not because that Dong Yuan overworks the Shen, leading to confusion? This is what is strange.)
Qi Bo said: No. The Heart has preferences, and Shen has aversions. Sudden mutual interaction causes Essence Qi to become chaotic, visual errors occur, hence confusion. When Shen shifts back to normal, it recovers. (The Heart is the function of Shen, called Qing. What Qing likes is called Yu (desire). Thus, the rise of Qing and desire is what Shen dislikes; what Shen likes is what the Heart dislikes. Therefore, nourishing Shen requires removing Qing and desire. When desire is removed, Shen is peaceful, leading to long life and clear vision. Acting according to the Heart results in myriad desires; when desires are severe, they harm Shen and life. These two cannot proceed together. Mutual interaction when proceeding together causes Qing chaos leading to confusion; if one can achieve Shen shifting back to the origin, confusion resolves and Shen recovers. Ping An: "Zu ran xiang gan" in *Ling Shu* and *Jia Yi Jing* writes "gan" as "huo". Note: "Bing xing xiang gan", Yuan edition mistakenly wrote "gan" as "huo".) Therefore, mild cases are called Mi (Lost/Confused), and severe cases are called Huo (Great Confusion). Yellow Emperor said: Good. (Xian means mild. Shen means severe. This is the first type of Huo pathogen.)
Yellow Emperor said: Why do people easily forget things? What qi causes this? Qi Bo said: Upper Qi is insufficient, Lower Qi is excessive. The intestines and stomach are full, while the Heart and Lungs are deficient. Deficiency causes Ying and Wei qi to remain in the lower part for a long time, unable to ascend in time, hence prone to forgetting. (Heart and Lung deficiency means Upper Qi insufficiency. Intestine and Stomach fullness means Lower Qi excess. Ying and Wei qi circulate and remain in the intestines and stomach without ascending; Heart and Lung deficiency leads to forgetting. When it ascends again, one does not forget. This is the second type of Xi Wang pathogen. Ping An: "Xi wang" in *Ling Shu* and *Jia Yi Jing* is written as "shan wang". *Ling Shu* has the character "zhi" after "jiu".)
Yellow Emperor said: Why do people easily feel hungry but lack appetite? What qi causes this? Qi Bo said: Essence Qi merges into the Spleen, and hot qi remains in the Stomach. Stomach heat digests food quickly; since food is digested quickly, one feels hungry easily. Stomach Qi rebels upward, causing cold in the gastric tube; gastric cold leads to lack of appetite. (Essence Qi refers to Yin Qi. The Yin Qi of the Stomach merges into the Spleen, making the Stomach independently hot, hence digesting food and feeling hungry easily. Stomach Qi is independently hot, rebelling upward is difficult, hence the gastric throat is cold, leading to inability to eat. This is the third type of Bu Shi Shi pathogen. Ping An: *Ling Shu* and *Jia Yi Jing* write "xi ji" as "shan ji", and "wei guan" as "wei wan".)
Yellow Emperor said: Why do people suffer from illness and cannot lie down to sleep? What qi causes this? Qi Bo said: Wei Qi cannot enter Yin, remaining constantly in Yang. Remaining in Yang makes Yang Qi full; fullness makes the Yang Qiao vessel vigorous. Unable to enter Yin, Yin Qi is deficient, hence the eyes cannot close for sleep. (Wei Qi travels twenty-five cycles in Yang meridians during the day and twenty-five cycles in the five Zang organs at night, totaling fifty cycles around the body day and night. If Wei Qi travels in Yang meridians and does not enter Zang Yin, Yang meridians become vigorous, Yang Qiao becomes vigorous and unharmonious, and Yin Qiao is deficient. Both Qiao vessels reach the eyes; thus Yang excess prevents eye closure, hence no sleep. This is the fourth type of Bu De Wo pathogen. Ming sounds like mian. Ping An: *Ling Shu* lacks the character "chu" after "wo", suspected to be an interpolation. *Jia Yi Jing* writes "ming" as "mian".)
Yellow Emperor said: Why do people suffer from illness and cannot open their eyes to see? What qi causes this? Qi Bo said: Wei Qi remains in Yin, unable to travel in Yang. Remaining in Yin makes Yin Qi vigorous; vigor makes the Yin Qiao vessel full. Unable to enter Yang, Yang Qi is deficient, hence the eyes close. (Wei Qi remaining in the five Zang organs makes Yin Qiao vigorous and unharmonious, having only Yin without Yang, hence eyes close and cannot see. Yang governs opening, Yin governs closing. This is the fifth type of Bu De Shi pathogen. Ping An: "Bing er mu" in *Ling Shu* is written as "bing mu er", in *Jia Yi Jing* as "mu bi" two characters; "liu" as "xing", "xing" as "ru", note: "*Jiu Juan* xing writes liu, ru writes xing.")
Yellow Emperor said: Why do people sleep excessively? What qi causes this? Qi Bo said: This person has large intestines and stomach, and tight skin, with intermuscular spaces not loose. Large intestines and stomach mean Wei Qi remains for a long time; tight skin means intermuscular spaces are not loose, so movement is slow. Wei Qi normally travels in Yang during the day and in Yin at night; thus when Yang Qi ends, one sleeps, and when Yin Qi ends, one wakes. Therefore, large intestines and stomach mean Wei Qi stays longer; tight skin and non-loose intermuscular spaces mean slow movement. Remaining in Yin for a long time, its qi becomes impure, leading to desire for sleep, hence excessive sleeping. Small intestines and stomach, smooth and relaxed skin, and loose intermuscular spaces mean Wei Qi remains in Yang for a long time, hence less sleeping. (If a person has large intestines/stomach and tight skin, largeness causes Wei Qi to stay, tightness causes slow Wei Qi movement; staying and slow movement make qi impure, hence excessive sleeping and little waking; conversely, less sleeping. This is the sixth type of Duo Wo pathogen. Ping An: "Se" in *Ling Shu* is written as "shi", in *Jia Yi Jing* as "se". "Bu jing" in *Ling Shu* is written as "bu qing". Note: "Duo wo xie" Yuan edition writes "xie" as "zhe".)
Yellow Emperor said: If it is not the regular meridians, but sudden excessive sleeping, what qi causes this? Qi Bo said: Pathogenic factors remain in the Upper Jiao, which closes and becomes blocked. After eating or drinking soup, Wei Qi instead remains in Yin and does not move, hence sudden excessive sleeping. (Pathogenic factors remaining in the Upper Jiao prevent Upper Jiao Qi from moving; due to diet, Wei Qi remains in Heart and Lung, causing stuffiness and excessive sleeping. This is the seventh pathogen. Ping An: "Wei fan liu" in *Ling Shu* is written as "Wei Qi liu jiu", in *Jia Yi Jing* as "Wei Qi jiu liu".)
Yellow Emperor said: Good. How to treat these various pathogens? Qi Bo said: First determine the affected Zang and Fu organs, correct minor faults, then regulate their Qi. Excess is treated with draining, deficiency with tonifying. One must first clearly know the suffering and comfort of Form and Qi, then select acupoints. (The method to treat these seven pathogens is to first select acupoints above the Zang and Fu organs, such as the Mu points of the five Zang and six Fu organs, to remove minor faults, then regulate the Five Shu and Six Shu points of the Zang and Fu organs for tonification and draining. Before tonification and draining, one must clearly know the emptiness/fullness and suffering/comfort of Form and Qi, then select acupoints. Ping An: "Xian qi fu zang" in *Ling Shu* is written as "xian qi zang fu", in *Jia Yi Jing* as "xian shi qi fu zang". "Xing Qi" in *Ling Shu* is written as "Xing Zhi".)