平按∶此篇自篇首至末，见《素问》卷四第十四《汤液醪醴论》篇。
黄帝问于岐伯曰∶为五谷汤液及醪醴奈何？（醪，汁泽酒。醴，宿酒也。此并拟以去病，为
之奈何也？平按∶《素问》无于岐伯三字。）岐伯对曰∶必以稻米，炊之稻薪，稻米者完，稻薪
者坚。曰此得之天之和，高下之宜，故能至完；伐取得时，故能至坚。（稻米得天之和气，又高
下得所，故完。稻薪收伐得时，所以坚实，用炊以为醪醴，可以疗病者也。平按∶曰此得上《素问》
有“帝曰∶何以然？岐伯”七字。之天之和《素问》作天地之和，至坚下有也字。）黄帝问于岐
伯曰∶上古圣人作汤液醪醴，为而不用何也？曰∶上古圣人作为汤液醪醴者，以为备耳。夫上古
作汤液，故为而弗服。（伏羲以上，名曰上古；伏羲以下，名曰中古；黄帝之时，称曰当今。上
古之时，呼吸与四时合气，不为嗜欲乱神，不为忧患
伤性，精神不越，志意不散，营卫行通，腠理致密，神清性明，邪气不入，虽作汤液醪醴，以为
备拟，不为服用者也。平按∶黄帝问于岐伯曰《素问》作帝曰。何也下《素问》有岐伯二字，上古
作自古，作为作之作。）中古之世，德稍衰也，邪气时至，服之万全。（上古行于道德，建德既
衰，下至伏羲，故曰稍衰也。帝王德衰，不能以神化物，使疵疠不起，嗜欲情生，腠理开发，邪
气因入，以其病微，故服汤液醪醴。稍衰而犹纯，故因汤液而万病万全。）曰∶今之世不必已何
也？（不定皆全，故曰不必已也。平按∶《素问》曰上有帝字。）曰∶当今之世，必齐毒药攻其
中， 石针艾治其外，形弊血尽而功不立者，何也？（广前问意。问意曰∶良药可以养性，毒药
以疗病。黄帝不能致德，邪气入深，百性疾甚，尽齐毒药以攻其内， 石针艾以疗其外，外则形
弊，内则血气尽，而形不愈，其意何也？平按∶《素问》曰上有岐伯二字，外下有也字及帝曰二
字。）曰∶神不使。何谓神不使？（人之神明有守，以营于身，即为有使也。平按∶曰上《素问》
有岐伯二字，何谓上有帝曰二字。）曰∶针石者，道也。精神越，志意散，故病不可愈也。（针
石道者，行针石者须有道也。有道者神不驰越，志不异求，意不妄思，神清内使，虽有邪客，服
之汤液醪醴万全也。平按∶《素问》曰上有岐伯二字，越作不进，散作不治。新校正云∶“按全
元起本云∶精神进，志意定，故病可愈。《太素》云∶精神越，志意散，故病不可愈。”与此正
同。）今精坏神去，营卫不可复收。（今时五脏精坏，五神又去，营卫之气去而不还，故病不愈。）
何者？视欲无穷而忧患不止，故精气施坏，营涩卫除，故神去之，而病之所以不愈也。（以下释
前精坏神去、营卫不行所由也。一则纵耳目于声色，乐而不穷；二则招忧患于悲怨，苦而不休。
天之道也，乐将未毕，哀已继之。故精气施坏，
营涩卫除，神明去身，所以虽疗不愈也。故无恒愚品，不可为医作巫，斯之谓也。平按∶视《素问》
作嗜。施《素问》作弛。营涩《素问》作荣泣。病下《素问》无之所以三字。）
平按：本篇从开头到结尾，见于《素问》卷四第十四篇《汤液醪醴论》。
黄帝向岐伯问道：制作五谷的汤液和醪醴，应该怎么做呢？（醪，指汁液浓厚的酒；醴，指隔宿的酒。这些都是用来治病的，为什么要这样制作呢？平按：《素问》中没有“于岐伯”这三个字。）岐伯回答说：必须用稻米作为原料，用稻秆作为燃料。因为稻米性质完备，稻薪质地坚实。（稻米得到了天地之和的气，又处于高下适宜的环境，所以性质完备；砍伐采集的时候令得当，所以质地坚实。（稻米得到天和之气，又高低得其所，所以完备。稻薪收割砍伐得时，所以坚实，用它来炊煮制成醪醴，可以治疗疾病。平按：曰此得上，《素问》有“帝曰：何以然？岐伯”七个字。“之天之和”在《素问》中作“天地之和”，“至坚”下有“也”字。）
黄帝又问岐伯：上古的圣人制作汤液醪醴，为什么制作了却不使用呢？回答说：上古圣人制作汤液醪醴，只是为了防备疾病罢了。上古时期制作汤液，所以只是预备而不服用。（伏羲以上，称为上古；伏羲以下，称为中古；黄帝之时，称为当今。上古之时，人的呼吸与四季之气相合，不被嗜欲扰乱心神，不被忧患损伤本性，精神不耗散，意志不涣散，营卫运行通畅，腠理致密，神清气爽，邪气无法侵入，虽然制作了汤液醪醴，也只是作为防备，并不服用。平按：“黄帝问于岐伯曰”在《素问》中作“帝曰”。“何也”之下，《素问》有“岐伯”二字，“上古”作“自古”，“作为”作“之作”。）
中古时代，道德稍微衰微了，邪气时常到来，服用汤液醪醴就能完全治愈。（上古时期奉行道德，建立德行既然衰微，下到伏羲时代，所以说稍微衰微。帝王德行衰微，不能用神力感化万物，使灾疫不起，嗜欲情感产生，腠理开发，邪气趁机进入，因为病情轻微，所以服用汤液醪醴。稍微衰微但依然纯朴，所以凭借汤液而万病全愈。）
又说：现在的时代不一定能痊愈，为什么呢？（不一定都能痊愈，所以说不一定痊愈。平按：《素问》“曰”上有“帝”字。）回答说：当今的时代，必须用齐备的毒药攻治其内部，用砭石、针具、艾灸治疗其外部，如果形体败坏、气血耗尽而疗效不显，这是为什么呢？（扩大前面的问意。问意说：良药可以养性，毒药可以疗病。黄帝不能致盛德，邪气深入，百姓疾病严重，用尽齐备的毒药来攻治内部，用砭石、针具、艾灸来治疗外部，外部则形体败坏，内部则气血耗尽，而形体不痊愈，这是什么意思呢？平按：《素问》“曰”上有“岐伯”二字，“外”下有“也”字及“帝曰”二字。）回答说：是因为神机不再发挥作用。什么叫神机不再发挥作用？（人的神明有所守持，以营运于身体之中，这就叫有使。平按：“曰”上《素问》有“岐伯”二字，“何谓”上有“帝曰”二字。）回答说：针石疗法，体现的是道。精神耗散，意志涣散，所以疾病不可治愈。（所谓针石之道，行针石者必须有道。有道的人精神不驰越，意志不异求，意念不妄思，神清内使，即使有邪气客居，服用汤液醪醴也能万全治愈。平按：《素问》“曰”上有“岐伯”二字，“越”作“不进”，“散”作“不治”。新校正说：“按全元起本云：精神进，志意定，故病可愈。《太素》云：精神越，志意散，故病不可愈。”与此正相同。）现在精气败坏，神明离去，营卫之气无法再恢复。（现在五脏精气败坏，五神又离去，营卫之气离去而不返还，所以疾病不愈。）为什么呢？（以下解释前面精坏神去、营卫不行的原因。）因为视欲无穷且忧患不止，所以精气弛坏，营血涩滞，卫气消散，所以神明离去，而疾病之所以不愈。（一则纵耳目于声色，乐而不穷；二则招忧患于悲怨，苦而不休。天道如此，乐将未毕，哀已继之。所以精气弛坏，营涩卫除，神明去身，所以虽然治疗也不痊愈。所以没有恒常愚钝品行的人，不可以做医生或巫师，说的就是这个道理。平按：“视”在《素问》中作“嗜”。“施”在《素问》中作“弛”。“营涩”在《素问》中作“荣泣”。“病”下《素问》无“之所以”三字。）
Ping An: This section, from the beginning to the end of the chapter, is found in Volume 4, Chapter 14 of the *Suwen* (Basic Questions), titled "Tangye Laoli Lun" (Discourse on Decoctions and Fermented Liquids).
The Yellow Emperor asked Qibo: How should one prepare the decoctions and fermented liquids made from the five grains? (Lao refers to a thick, juicy wine; Li refers to overnight wine. These are intended for curing diseases; why prepare them this way? Ping An: The *Suwen* lacks the three characters "yu Qibo".) Qibo replied: One must use rice as the grain and rice straw as the fuel. Rice is complete/perfect in nature, and rice straw is firm/solid. (Rice obtains the harmonious qi of heaven and earth, and grows in suitable elevations, thus it is complete; harvested at the proper time, thus it is firm. [Ping An: In the *Suwen*, above "yue ci de", there are seven characters: "Di yue: He yi ran? Qibo". "Zhi tian zhi he" in the *Suwen* reads "tiandi zhi he", and below "zhi jian" there is the character "ye".]
The Yellow Emperor asked Qibo again: Why did the sages of ancient times prepare decoctions and fermented liquids but not use them? He replied: The sages of ancient times prepared decoctions and fermented liquids merely as a precaution. In ancient times, decoctions were prepared but not consumed. (Above Fuxi is called Ancient Times; below Fuxi is called Middle Times; during the time of the Yellow Emperor, it is called Present Times. In Ancient Times, human respiration harmonized with the four seasons; they were not confused by desires nor injured by worries; their spirit did not escape, their will did not scatter, Ying and Wei Qi circulated smoothly, the interstices (Couli) were dense, their spirit was clear and nature bright, pathogenic factors could not enter. Although they prepared decoctions and fermented liquids as precautions, they did not consume them. [Ping An: "Huangdi wen yu Qibo yue" in the *Suwen* reads "Di yue". Below "He ye", the *Suwen* has the two characters "Qibo"; "Shangggu" reads "Zigu"; "Zuo wei" reads "Zhi zuo".])
In the Middle Ages, virtue declined slightly, and pathogenic factors arrived frequently; consuming these preparations ensured complete recovery. (In Ancient Times, morality was practiced; since established virtue declined, down to Fuxi's era, it is said to have declined slightly. When rulers' virtue declined, they could not transform things through spiritual power, causing epidemics to arise, desires and emotions to emerge, interstices to open, and pathogenic factors to enter. Because the illnesses were mild, decoctions and fermented liquids were consumed. Slightly declined yet still pure, thus relying on decoctions, all diseases were completely cured.)
It is also said: In the present age, recovery is not guaranteed; why is this? (Not all cases recover completely, hence it is said that recovery is not certain. [Ping An: Above "Yue" in the *Suwen*, there is the character "Di".]) He replied: In the present age, one must use properly formulated toxic medicines to attack internally, and use bian stones, needles, and moxa to treat externally. If the body becomes debilitated, blood and qi are exhausted, and no efficacy is achieved, why is this? (Expanding on the previous question. The meaning is: Good medicines nourish life, while toxic medicines cure disease. Since the Yellow Emperor could not attain supreme virtue, pathogenic factors penetrated deeply, and the people suffered severe illnesses. Using all available toxic medicines to attack internally, and bian stones, needles, and moxa to treat externally, the exterior becomes debilitated, and internally, blood and qi are exhausted, yet the body does not heal. What is the reason? [Ping An: Above "Yue" in the *Suwen*, there are the two characters "Qibo"; below "Wai", there are the characters "ye" and "Di yue".]) He replied: It is because the Shen (Spirit/Mind) no longer responds or functions. What is meant by "the Shen no longer functions"? (When a person's Shen has guardianship and circulates within the body, it is said to have a "functioning agent". [Ping An: Above "Yue" in the *Suwen*, there are the two characters "Qibo"; above "He wei", there are the two characters "Di yue".]) He replied: Acupuncture and stone therapy embody the Dao. If the Jing (Essence) and Shen (Spirit) are scattered and the Zhi (Will) is dispersed, the disease cannot be cured. (Regarding the Dao of acupuncture and stones, those who perform these therapies must follow the Dao. Those who follow the Dao do not let their Shen gallop away, their Zhi does not seek異ly, their Yi (Intent) does not think wildly; their Shen is clear and governs internally. Even if pathogenic factors reside, consuming decoctions and fermented liquids ensures complete recovery. [Ping An: Above "Yue" in the *Suwen*, there are the two characters "Qibo"; "Yue" reads "Bu jin", "San" reads "Bu zhi". Xin Zheng Jiao says: "According to Quan Yuanqi's edition: 'Jing Shen jin, Zhi Yi ding, gu bing ke yu.' The *Taisu* says: 'Jing Shen yue, Zhi Yi san, gu bing bu ke yu.' This matches exactly.] Now, essence is ruined and Shen departs, making it impossible to restore Ying and Wei Qi. (Currently, the essence of the Five Zang organs is ruined, the Five Shen have departed, and Ying and Wei Qi leave without returning, hence the disease does not heal.) Why? (This explains the reasons for the previous statements regarding ruined essence, departing Shen, and non-circulating Ying/Wei.) Because visual and auditory desires are endless and worries and sorrows never cease, essence is relaxed/ruined, Ying blood becomes stagnant, and Wei Qi dissipates. Thus, Shen departs, and the disease does not heal. [One indulges the eyes and ears in sounds and colors, finding pleasure without limit; the other invites worries and sorrows from grief and resentment, suffering without rest. The Way of Heaven is such that before joy ends, sorrow follows. Thus, essence is ruined, Ying is stagnant, Wei is removed, Shen leaves the body, so although treatment is applied, it does not heal. Therefore, those without constant, simple conduct cannot become physicians or shamans; this is what is meant. [Ping An: "Shi" in the *Suwen* reads "Shi"; "Shi" reads "Chi"; "Ying Se" reads "Rong Qi"; below "Bing" in the *Suwen*, the three characters "Zhi suo yi" are absent.]]