平按∶此篇自篇首至三饮而已，见《灵枢》卷十第七十一《邪客》篇，又见《甲乙经》卷十
二第三。自黄帝曰余闻十二经脉至以数调之，见《灵枢》卷六第四十《阴阳清浊》篇。自黄帝曰
愿闻人之清浊至以数调之，又见《甲乙经》卷一第十二。自黄帝曰经脉十二者至末，见《灵枢》
卷六第三十四《五乱》篇，又见《甲乙经》卷六第四《阴阳清浊顺治逆乱大论》。
黄帝问伯高曰∶夫邪气之客于人也，或令人目不瞑不卧出者，何气使然？（厥邪客人为病，
目开不得合，卧起□□起也。平按∶目不瞑至使然十一字《甲乙》作目不得眠者何也七字。）伯
高答曰∶五谷入于胃也，其糟粕、精液、宗气，分为三隧。（宗，总也。隧，道也。糟粕、津液、
总气，分为三隧。）故宗气积于胸中，出于喉咙，以贯心肺而行呼吸焉。（糟粕津液，浊秽下流，
以为溲便。其清者宗气，积于膻中，名曰气海，其气贯于心肺，出入喉咙之中而行呼吸，一也。
平按∶心肺《灵枢》作心脉。）营气者，泌其津液，注之于脉，化而为血，以营四末，内注五脏
六腑，以应刻数焉。（营气起于中焦，泌五谷津液，注于肺脉手太阴中，化而为血，循脉营于手
足，回五脏六腑之中，旋还以应刻数，二也。）卫气者，出其悍气之 疾，而先行四末分肉皮肤
之间而不休者也。昼日行于阳，夜行于阴，其入于阴也，常从足少阴之分间，行于五脏六腑。（卫
气起于上焦，上行至目，行手足三阳已，夜从足少阴分，上行五脏，至昼还行三阳，如是行五脏。
行六腑者，夜行五脏之时，脏脉络腑，故兼行也，以腑在内故，三也。平按∶四末上《灵枢》、
《甲乙》有于字。不休者也《甲乙》作不休息也。昼下《甲乙》无日字。《灵枢》无其入于阴也
句。）今厥气客于脏腑，则卫气独卫其外，卫其外则阳气 ， 则阴气益少，阳乔满，是以阳盛，
故目不得瞑。（厥气，邪气也。邪气客于五内腑中，则卫气不得入于脏腑，卫气唯得卫外，则为
盛阳。 ，张盛也。脏腑内气不行，则内气益少。阳乔之脉在外营目，今阳乔盛溢，故目不得合
也。瞑音眠。平按∶脏腑《灵枢》作五脏六腑，《甲乙》作五脏。独卫其外《甲乙》作独营其外。
卫其外则阳气 至目不得瞑二十五字，《灵枢》作“行于阳则阳气盛，阳气盛则阳跷陷，不得入
于阴，阴虚故目不瞑”二十五字，《甲乙》同，惟《甲乙》阳乔陷作阳乔满，阴虚作阴气虚，故
目不瞑作故目不得眠，与《灵枢》小异。）黄帝曰∶善。治之奈何？伯高曰∶补其不足，泻其有
余，调其虚实，以通其道而去其邪，（不足，阴气也。有余，外阳气。）饮以半夏汤一齐，阴阳
以通，其卧立至。（以下言半夏汤方，以疗厥气，厥气既消，内外气通，则目合得卧。平按∶齐
《灵枢》、《甲乙》作剂。）黄帝曰∶善。此所谓决渎壅塞，经络大通，阴阳和得者也，愿闻其方。
（沟渎水壅，决之则通，阴阳气塞，针液导之，故曰决渎，所以请闻其方也。）伯高曰∶其汤方
以流水千里以外者八升，扬之万遍，取其清五升煮之，炊以苇薪，大沸，量秫米一升，治半夏五
合，徐炊，令竭为一升半，去其滓，饮汁一小杯，日三，稍益，以知为度。故其病新发者，覆杯
则卧，汗出则已矣；久者，三饮而已。（饮汤覆杯即卧、汗出病已者，言病愈速也。三饮者，一
升半为一齐，久病三服即瘥，不至一齐，新病一服即愈也。平按∶大沸，大字《灵枢》、《甲
乙》均作火。）
黄帝曰∶余闻十二经脉，以应十二经水。十二经水者，其五色各异，清浊不同，人之血气若
一，应之奈何？（十二水，谓泾、渭、海、湖、汝、沔、淮、漯、江、河、济、漳。此十二水，
十二经所法，以应五行，故色各异也。江清河浊，即清浊不同也。若，如也。人血脉如一，若为
彼十二经水也？平按∶十二经水四字《灵枢》不重。）岐伯曰∶人之血气，苟能若一，则天下为一
矣，恶有乱者乎？（人之血气苟能一种无差者，不可得应于十二经水，正以血脉十二经不同，故得
应于十二经水，所以有相乱也。）黄帝曰∶余问一人，非问天下之众。岐伯曰∶夫一人者，亦有乱
气，天下之众，亦有乱气，其□为一耳。（非直天下众人血脉有乱，一人自有十二经脉，故有乱
也。平按∶其下原缺一字，《灵枢》作合，袁刻作理。）黄帝曰∶愿闻人气之清浊。岐伯曰∶受
谷者浊，受气者清，（受谷之浊，胃气也；受气之清，肺气也。）清者注阴，（阴，肺也。）浊者
注阳，（阳，胃也。）浊而清者上出于咽，（谷气浊而清者，上出咽口，以为噫气也。）清而浊
者则下行，（谷气清而浊者，下行经脉之中，以为营气。平按∶则下行《甲乙》作下行于胃。）
清浊相干，命曰乱气。（清者为阴，浊者为阳，清浊相干，则阴阳气乱也。平按∶命《甲乙》作
名。）黄帝曰∶夫阴清而阳浊，浊者有清，清者有浊，别之奈何？（问清浊之状也。平按∶别上
《灵枢》有清浊二字。）岐伯曰∶气之大别，（气之细别多种，今言其大略耳。）清者上注于肺，
（谷之清气，上注于肺。）浊者下流于胃。（谷之浊者，下流于胃。）胃之清气，上出于口；（胃
中谷气浊而清者，上咽退场门，以为噫气。）肺之浊气，下注于经，内积于海。（注肺清而浊气，下注
十二经，并积膻中，以为气海而成呼吸也。）黄帝曰∶诸阳皆浊，何阳独甚乎？（诸阴皆清，诸阳
皆浊。诸阳之脉皆浊，未知何经独受中之浊也。）岐伯曰∶手太阳独受阳之浊。（胃者，腐熟水谷，
传与小肠，小肠受盛，然后传与大肠，大肠传过，是为小肠受秽浊最多，故小肠经受阳之浊也。）
手太阴独受阴之清，其清者上走空窍，（肺脉手太阴受于清气，其有二别。有清清之气，行于三
百六十五络，皆上于面，精阳之气上行目而为精，其别气走耳而为听，其宗气上出于鼻而为臭，
其浊气出于唇口为味，皆是手太阴清气行之故也。平按∶空窍《甲乙》作孔窍。注精阳二字袁刻作
清。）其浊者下行诸经。（手太阴清而浊者，下入于脉，行十二经中也。）诸阴皆清，足太阴独
受其浊。（六阴之脉皆清，足太阴以是脾脉，脾主水谷浊气，故足太阴受阴之浊也。平按∶注脾
主，主字上半，虫伤不全，下半剩土字，当是主字剩文，袁刻作上。）黄帝曰∶治之奈何？岐伯曰∶
清者其气滑，浊者其气涩，此气之常也。故刺阳者，深而留之；刺阴者，浅而疾之；清浊相干者，
以数调之。（诸经多以清者为阳，浊者为阴；此经皆以谷之悍气为浊为阳，谷之精气为清为阴，
有此不同也。故人气清而滑利者，刺浅而疾之；其气浊而涩者，刺深而留之；阴阳清浊气并乱，
以理调之，理数然也。平按∶《灵枢》刺阳作刺阴，刺阴作刺阳，《甲乙》同。疾之《甲乙》作疾
取之。）
黄帝曰∶经脉十二者，别为五行，分为四时，何失而乱，何得而治？岐伯曰∶五行有序，四
时有分，相顺则治，相逆则乱。（相顺者，十二经脉皆有五行四时之分。诸摄生者，摄之当分，则
为和为顺；乖常失理，则为逆为乱也。）黄帝曰∶何谓相顺？（平按∶《甲乙》有而治二字。）岐
伯曰∶经脉十二
者，以应十二月。十二月者，分为四时。四时者，春夏秋冬，其气各异，营卫相随，阴阳已和，
清浊不相干，如是则顺而治。（营在脉中，卫在脉外，内外相顺，故曰相随，非相随行、相随和
也。）黄帝曰∶何谓逆而乱？岐伯曰∶清气在阴，浊气在阳，（清气在于脉内，为营为阴也；浊气在
于脉外，为卫为阳也。）营气顺行脉，卫气逆行，（营卫气顺逆十二经而行也。卫之悍气，上至于
目，循足太阳至足指为顺行；其悍气散者，复从目，循手太阳向手指，是为逆行也。此其常也。
平按∶《灵枢》、《甲乙》脉上无行字。）清浊相干，乱于胸中，是谓大 。（ 音闷。阳气入
阴，阴气入阳，即清浊乱也。营气逆行，卫气顺行，即逆顺乱也。）故气乱于心，则烦心密嘿，俯
首静伏；（密嘿烦心，不欲言也。俯首，低头静伏也。平按∶嘿《甲乙》作默。）乱于肺，则俯
仰喘喝，接手以呼；（肺手太阴脉行臂，故肺气乱，肺及臂手闷，所以接手以呼也。平按∶接《甲
乙》作按。）乱于肠胃，则为霍乱；（肠胃之中，营卫之气相杂为乱，故为霍乱。霍乱，卒吐利
也。）乱于臂胫，则为四厥；（四厥，谓四肢冷或四肢热也。）乱于头，则为厥逆，头重眩仆。
（厥逆头重，谓头寒或热，重而眩仆也。平按∶头重《甲乙》作头痛，注∶“一作头重。”）黄
帝曰∶五乱者，刺之有道乎？岐伯曰∶有道以来，有道以去，审知其道，是谓身宝。（有道者，
理其乱，使从其道。）黄帝曰∶善。愿闻其□。岐伯曰∶气在于心者，取之手少阴经、心主输。
（气在于心取手少阴经者，上经云心不受邪，今气在心，若为不受邪也？若言邪在心之包络，即
应唯疗手心主之经，何为心病二经俱疗？故知心者亦受邪也。输，谓手少阴、手心主二经各第三
输也。平按∶其下原缺一字，《灵枢》作道，袁刻作旨。少阴经心主输《灵枢》、《甲乙》作少
阴心主
之输。）气在于肺，取之手太阴荥、足少阴输。（手太阴荥，肺之本输。足少阴输，乃是肾脉。
以其肾脉上入于肺，上下气通，故上取太阴荥，下取足少阴输。）气在于肠胃，取之足太阴、阳
明下者取三里。（足太阴，脾脉也。脾胃腑藏阴阳气通，故肠胃气乱，取足太阴也。阳明之脉，
是胃本经，胃之上输在背，下输在三里也。平按∶下者《灵枢》、《甲乙》作不下者。）气在于
头，取之天柱、大杼；（足太阳脉行头，天柱、大杼，并是足太阳脉气所发，故取之也。）不知，
取足太阳荥输。（取前二穴不觉愈者，可取足太阳第二荥穴及第三输也。）气在于臂足，先去于
血脉，后取阳明、少阳之荥输。（手足四厥，可先刺去手足盛络之血，然后取于手足阳明荥之与
输，及手足少阳荥及输也。平按∶《灵枢》足下有取之二字，血上无于字。）黄帝曰∶补泻若何？
岐伯曰∶徐入徐出，谓之导气，（补者徐入疾出，泻者疾入徐出，是谓通导营卫之气，使之和也。）
补泻无形，所以谓之同精是非有余不足也，乱气之相逆也。（补泻虽复无形无状，所以同欲精于
气之是非有余不足及乱气之逆也。故精者，补泻之妙，意使之和也。）黄帝曰∶光乎哉道，明乎
哉论，请着之玉板，命曰治乱。（黄帝赞岐伯之言有二∶一则所言光扬大道，二则所论开道巧便。
故请传之不朽也。平按∶自黄帝曰光乎哉至末，《甲乙》无。）
【平按】：本篇从篇首至“三饮而已”，见于《灵枢》卷十第七十一《邪客》篇，又见于《甲乙经》卷十二第三。从“黄帝曰余闻十二经脉”至“以数调之”，见于《灵枢》卷六第四十《阴阳清浊》篇。从“黄帝曰愿闻人之清浊”至“以数调之”，又见于《甲乙经》卷一第十二。从“黄帝曰经脉十二者”至末尾，见于《灵枢》卷六第三十四《五乱》篇，又见于《甲乙经》卷六第四《阴阳清浊顺治逆乱大论》。
黄帝问伯高说：邪气侵犯人体，有的使人眼睛睁着睡不着觉，这是什么气造成的？（厥邪侵犯人体致病，表现为眼睛睁开不能闭合，躺下起来……也。平按：从“目不瞑”到“使然”这十一个字，《甲乙经》作“目不得眠者何也”七个字。）伯高回答说：五谷进入胃中，其糟粕、津液、宗气，分为三条通道。（宗，是总的意思。隧，是道路的意思。糟粕、津液、总气，分为三条通道。）所以宗气积聚在胸中，出于喉咙，贯通心肺而进行呼吸。（糟粕和津液，作为污秽向下流动，形成大小便。其中清的部分是宗气，积聚在膻中，名叫气海，它的氣贯通于心肺，出入于喉咙之中而进行呼吸，这是第一种情况。平按：《灵枢》中“心肺”作“心脉”。）营气，分泌津液，注入脉中，化生为血液，以营养四肢末端，向内灌注五脏六腑，以对应刻漏的计时。（营气起源于中焦，分泌五谷的津液，注入手太阴肺脉中，化生为血液，循行脉道营养手足，回转于五脏六腑之中，旋转运行以对应刻漏的计时，这是第二种情况。）卫气，发出其剽悍滑疾之气，先行于四肢、分肉和皮肤之间而不休息。白天行于阳分，夜晚行于阴分，它进入阴分时，常从足少阴肾经的分野间开始，行于五脏六腑。（卫气起源于上焦，上行至眼部，行完手足三阳经后，夜晚从足少阴分野开始，上行至五脏，到白天再行于三阳经，这样循环运行于五脏。运行于六腑的情况是，在夜晚运行于五脏时，脏经络络属于腑，所以兼行于腑，因为腑在内侧的缘故，这是第三种情况。平按：《灵枢》和《甲乙经》在“四末”上有“于”字。“不休者也”在《甲乙经》中作“不休息也”。“昼”下《甲乙经》无“日”字。《灵枢》无“其入于阴也”一句。）现在厥气侵犯脏腑，则卫气独自护卫在外，护卫在外则阳气盛，阴气就益发减少，阳跷脉满盛，因此阳气偏盛，所以眼睛不能闭合。（厥气，就是邪气。邪气侵犯五脏六腑中，卫气就不能进入脏腑，卫气只能护卫体表，这就导致阳气盛。 ，指张盛。脏腑内部的气不能运行，则内气益发减少。阳跷脉在外侧主管眼部，现在阳跷脉盛满溢出，所以眼睛不能闭合。瞑音同眠。平按：《灵枢》中“脏腑”作“五脏六腑”，《甲乙经》作“五脏”。“独卫其外”在《甲乙经》中作“独营其外”。“卫其外则阳气 至目不得瞑”这二十五个字，《灵枢》作“行于阳则阳气盛，阳气盛则阳跷陷，不得入于阴，阴虚故目不瞑”二十五个字，《甲乙经》相同，只是《甲乙经》中“阳跷陷”作“阳跷满”，“阴虚”作“阴气虚”，“故目不瞑”作“故目不得眠”，与《灵枢》略有不同。）黄帝说：好。怎么治疗呢？伯高说：补其不足，泻其有余，调和虚实，疏通其道并去除邪气，（不足，指阴气。有余，指体表的阳气。）用半夏汤一方服用，阴阳得以通畅，睡眠立刻就能恢复。（以下讲述半夏汤的方子，用来治疗厥气，厥气消除后，内外气机通畅，就能闭眼入睡。平按：“齐”在《灵枢》和《甲乙经》中作“剂”。）黄帝说：好。这就是所说的决开沟渠壅塞，经络大通，阴阳调和的方法，我想听听这个方子。（沟渠水壅塞，决口就能通畅，阴阳气机阻塞，用针药疏导，所以叫决渎，因此请教这个方子。）伯高说：煮汤的水要用千里之外的流水八升，扬动一万遍，取其清水五升来煮，用芦苇做燃料，大火煮沸，放入秫米一升，炮制过的半夏五合，慢慢煎煮，直到剩下药汁一升半，去掉药渣，每次饮用一小杯，每天三次，逐渐增加剂量，以见效为限度。所以新发的病，喝完药盖上被子就能睡着，出汗就好了；病程久的，喝三次药就好了。（喝药盖被即睡、出汗病愈的，是说病愈得快。三次服药，一升半为一剂，久病服三次即痊愈，不到一剂；新病服一次即痊愈。平按：“大沸”的“大”字，《灵枢》和《甲乙经》都作“火”。）
黄帝说：我听说十二经脉对应十二条河流。十二条河流，颜色各异，清浊不同，人的血气如果都一样，该如何对应呢？（十二条水，指泾、渭、海、湖、汝、沔、淮、漯、江、河、济、漳。这十二条水，是十二条经脉所效法的，以对应五行，所以颜色各异。江水清澈河水浑浊，就是清浊不同。若，如的意思。人血脉如果一样，如何对应那十二条河流呢？平按：“十二经水”四个字，《灵枢》不重复。）岐伯说：人的血气，如果能完全一样，那么天下也就统一了，哪里会有混乱呢？（人的血气如果能完全一致没有差异，就不可能对应十二条河流，正因为血脉和十二条经脉各不相同，所以才能对应十二条河流，因此才有相乱的情况。）黄帝说：我问的是一个人，不是问天下的众人。岐伯说：一个人也有乱气，天下的众人也有乱气，它们是相合的。（不仅天下众人的血脉有乱，一个人自身也有十二条经脉，所以也有乱气。平按：原文此处缺一字，《灵枢》作“合”，袁刻本作“理”。）黄帝说：想听人气清浊的道理。岐伯说：受纳谷物的气是浊的，受纳天气的气是清的，（受纳谷物的浊气，是胃气；受纳天气的清气的，是肺气。）清气注入阴分，（阴，指肺。）浊气注入阳分，（阳，指胃。）浊中之清者向上出于咽喉，（谷物之气浊而其中的清者，向上出于咽口，成为嗳气。）清中之浊者则向下行走，（谷物之气清而其中的浊者，向下行走于经脉之中，成为营气。平按：“则下行”在《甲乙经》中作“下行于胃”。）清浊相互干扰，叫做乱气。（清者为阴，浊者为阳，清浊相互干扰，则阴阳气机紊乱。平按：“命”在《甲乙经》中作“名”。）黄帝说：阴清而阳浊，浊中有清，清中有浊，如何区分呢？（询问清浊的状态。平按：“别”上《灵枢》有“清浊”二字。）岐伯说：气的总体区别，（气的细微区别很多，现在只说大概。）清气向上注入肺，（谷物的清气，向上注入肺。）浊气向下流入胃。（谷物的浊者，向下流入胃。）胃中的清气，向上出于口；（胃中谷物之气浊而其中的清者，向上出于咽部退出口门，成为嗳气。）肺中的浊气，向下注入经脉，内积于气海。（注入肺的清而浊的气，向下注入十二条经脉，并积聚在膻中，成为气海而形成呼吸。）黄帝说：诸阳经都是浊的，为什么唯独太阳经最浊？（诸阴经都是清的，诸阳经都是浊的。诸阳经的脉气都是浊的，不知道哪条经脉单独承受其中的浊气。）岐伯说：手太阳小肠经单独承受阳气的浊气。（胃腐熟水谷，传送给小肠，小肠受盛，然后传给大肠，大肠传过后，这是小肠承受的秽浊最多，所以小肠经受阳气的浊气。）手太阴肺经单独承受阴气的清气，其清气向上走空窍，（肺脉手太阴经受纳清气，它有两条分支。有清清之气，行于三百六十五络，都上行于面部，精阳之气上行于目成为视觉，其别气走耳成为听觉，其宗气上出于鼻成为嗅觉，其浊气出于唇口成为味觉，这些都是手太阴清气运行的结果。平按：“空窍”在《甲乙经》中作“孔窍”。注“精阳”二字袁刻本作“清”。）其浊气向下行走于各条经脉。（手太阴清而浊的气，向下进入脉中，行于十二条经脉中。）诸阴经都是清的，足太阴脾经单独承受其中的浊气。（六条阴经的脉气都是清的，足太阴因为是脾脉，脾主水谷浊气，所以足太阴承受阴气的浊气。平按：注“脾主”，“主”字上半残缺，虫伤不全，下半剩“土”字，应当是“主”字的残文，袁刻本作“上”。）黄帝说：怎么治疗呢？岐伯说：清气的气机滑利，浊气的气机涩滞，这是气的常态。所以刺阳经，要深刺并留针；刺阴经，要浅刺并快出；清浊相干扰的，用数理来调和。（诸经多以清气为阳，浊气为阴；此篇都以谷物的悍气为浊为阳，谷物的精气为清为阴，有不同的地方。所以人气清而滑利的，刺浅而快出；气浊而涩滞的，刺深而留针；阴阳清浊气并乱，用道理调和，这是必然的道理。平按：《灵枢》中“刺阳”作“刺阴”，“刺阴”作“刺阳”，《甲乙经》相同。“疾之”在《甲乙经》中作“疾取之”。）
黄帝说：十二经脉，分别对应五行，分为四季，什么情况下会紊乱，什么情况下能治愈？岐伯说：五行有序，四季有定分，顺应则治，违背则乱。（顺应，是指十二条经脉都有五行四季的区分。各种养生的人，调养得当符合分际，就是和谐顺应；违背常规失去条理，就是逆乱。）黄帝说：什么叫顺应？（平按：《甲乙经》有“而治”二字。）岐伯说：十二经脉，对应十二月。十二月，分为四季。四季，春、夏、秋、冬，气候各异，营卫相随，阴阳已经调和，清浊不相干扰，像这样就是顺应而治。（营气在脉中，卫气在脉外，内外相顺，所以说相随，并不是指相随而行、相随而和。）黄帝说：什么叫逆而乱？岐伯说：清气在阴分，浊气在阳分，（清气在于脉内，作为营气属阴；浊气在于脉外，作为卫气属阳。）营气顺行于脉，卫气逆行，（营卫之气顺逆地行于十二条经脉。卫气的悍气，上行至于眼部，循足太阳经至足趾为顺行；其散开的悍气，又从眼部，循手太阳经向手指，这是逆行。这是常态。平按：《灵枢》、《甲乙经》中“脉”上无“行”字。）清浊相互干扰，扰乱于胸中，这叫大 。 （ 音闷。阳气入阴，阴气入阳，就是清浊乱了。营气逆行，卫气顺行，就是逆顺乱了。）所以气乱于心，就会心烦沉默，低头静伏；（心烦沉默，不想说话。低头，低头静伏。平按：“嘿”在《甲乙经》中作“默”。）乱于肺，就会俯仰喘息有声，用手按住胸部呼吸；（肺手太阴脉行于臂，所以肺气乱，肺及手臂胸闷，所以用手按住胸部呼吸。平按：“接”在《甲乙经》中作“按”。）乱于肠胃，就会霍乱；（肠胃之中，营卫之气混杂紊乱，所以霍乱。霍乱，突然吐泻。）乱于臂胫，就会四肢厥冷；（四肢厥冷，指四肢冷或四肢热。）乱于头，就会厥逆，头重眩晕跌倒。（厥逆头重，指头寒或热，沉重而眩晕跌倒。平按：“头重”在《甲乙经》中作“头痛”，注：“一作头重。”）黄帝说：五种乱气，针刺有方法吗？岐伯说：有道而来，有道而去，审慎知道这个方法，是身体的珍宝。（有道，指调理乱气，使其回归正道。）黄帝说：好。想知道那个……（缺字）。岐伯说：气在心，取手少阴经、心包经的输穴。（气在心取手少阴经，上文说心不受邪，现在气在心，怎么能说不受邪呢？如果说邪在心包络，就应该只治疗手厥阴心包经，为什么心病两经都治疗？所以知道心也是受邪的。输，指手少阴、手心主二经各自的第三个输穴。平按：原文此处缺一字，《灵枢》作“道”，袁刻本作“旨”。“少阴经心主输”在《灵枢》、《甲乙经》中作“少阴心主之输”。）气在肺，取手太阴荥穴、足少阴输穴。（手太阴荥穴，是肺的本输。足少阴输穴，是肾脉。因为肾脉上行进入肺，上下气机相通，所以上取太阴荥穴，下取足少阴输穴。）气在肠胃，取足太阴、阳明经，下部取足三里。（足太阴，是脾脉。脾胃腑藏阴阳气相通，所以肠胃气乱，取足太阴经。阳明经，是胃的本经，胃的上输穴在背部，下输穴在足三里。平按：“下者”在《灵枢》、《甲乙经》中作“不下者”。）气在头，取天柱、大杼穴；（足太阳脉行于头部，天柱、大杼，都是足太阳脉气所发，所以取这两个穴位。）如果不愈，取足太阳经的荥穴和输穴。（取前两个穴位不觉得好的，可以取足太阳第二个荥穴及第三个输穴。）气在臂足，先去血脉瘀血，后取阳明、少阳经的荥穴和输穴。（手足四肢厥冷，可以先刺去手足盛络之血，然后取手足阳明经的荥穴和输穴，以及手足少阳经的荥穴和输穴。平按：《灵枢》中“足”下有“取之”二字，“血”上无“于”字。）黄帝说：补泻怎么做？岐伯说：慢进慢出，叫做导气，（补法是慢进快出，泻法是快进慢出，这是通导营卫之气，使之调和。）补泻无形，所以叫做同精，这不是有余不足的问题，而是乱气相逆。（补泻虽然没有形状，但所以要精细地对待气的有余不足及乱气之逆。所以精妙之处在于补泻，意在使之调和。）黄帝说：真光辉啊大道，真明彻啊论述，请刻在玉板上，命名为治乱。（黄帝称赞岐伯的话有两层意思：一是所言光扬大道，二是所论开导巧妙便利。所以请求流传不朽。平按：从“黄帝曰光乎哉”至末尾，《甲乙经》没有。）
[Ping An]: This section, from the beginning of the chapter to "three doses and it is finished," is found in *Ling Shu* (Spiritual Pivot), Volume 10, Chapter 71, "Xie Ke" (Evil Guest), and also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 12, Section 3. From "Huang Di said: I have heard that the twelve meridians..." to "...regulate them according to their numbers," it is found in *Ling Shu*, Volume 6, Chapter 40, "Yin Yang Qing Zhuo" (Clear and Turbid Yin and Yang). From "Huang Di said: I wish to hear about the clear and turbid qi of humans..." to "...regulate them according to their numbers," it is also found in *Jia Yi Jing*, Volume 1, Section 12. From "Huang Di said: The twelve meridians..." to the end, it is found in *Ling Shu*, Volume 6, Chapter 34, "Wu Luan" (Five Disorders), and also in *Jia Yi Jing*, Volume 6, Chapter 4, "Da Lun Yin Yang Qing Zhuo Shun Zhi Ni Luan" (Great Treatise on the Smooth Governance and Reverse Chaos of Clear and Turbid Yin and Yang).
Huang Di asked Bo Gao: When pathogenic factors invade the human body, some cause a person's eyes to remain open so they cannot sleep or lie down. What qi causes this? (The invasion of Jue [reversal] pathogenic factors causes disease, manifesting as eyes opening but unable to close, rising from bed... Ping An: The eleven characters from "Bu Ming Ming" [not closing eyes] to "Shi Ran" [is it so] are written as seven characters "Mu Bu De Mian Zhe He Ye" [Why can the eyes not sleep?] in *Jia Yi Jing*.) Bo Gao replied: When five grains enter the stomach, their dregs, fluids, and Zong Qi (Gathering Qi) are divided into three pathways. (Zong means gathering. Sui means pathway. Dregs, fluids, and Gathering Qi are divided into three pathways.) Therefore, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart and Lung to facilitate respiration. (Dregs and fluids, being turbid and impure, flow downward to form urine and feces. The clear part is Zong Qi, accumulating in Dan Zhong [Conception Vessel point CV-17], named Qi Hai [Sea of Qi]. Its qi penetrates the Heart and Lung, entering and exiting through the throat to facilitate respiration; this is the first case. Ping An: *Ling Shu* writes "Heart Mai" [Heart Meridian] instead of "Heart Lung".) Ying Qi (Nutritive Qi) secretes fluids, injects them into the vessels, transforms them into blood, and nourishes the four extremities, internally infusing the Five Zang and Six Fu organs to correspond with the timing of water clocks. (Ying Qi originates in the Middle Jiao, secreting the fluids of five grains, injecting into the Hand Taiyin Lung Meridian, transforming into blood, circulating through the vessels to nourish the hands and feet, returning within the Five Zang and Six Fu organs, rotating to correspond with water clock timings; this is the second case.) Wei Qi (Defensive Qi) emits its fierce, rapid, and slippery qi, proceeding first among the four extremities, muscles, and skin without rest. During the day, it travels in the Yang aspects; at night, it travels in the Yin aspects. When entering Yin, it usually starts from the interspaces of the Foot Shaoyin Kidney Meridian, traveling through the Five Zang and Six Fu organs. (Wei Qi originates in the Upper Jiao, ascending to the eyes. After traversing the Hand and Foot Three Yang meridians, at night it begins from the Foot Shaoyin interspace, ascending to the Five Zang. By day, it returns to travel the Three Yang meridians, thus cycling through the Five Zang. Regarding the Six Fu organs: when traveling through the Five Zang at night, since the Zang meridians connect to the Fu, it travels through them simultaneously because the Fu are interior; this is the third case. Ping An: *Ling Shu* and *Jia Yi Jing* add "Yu" [on] before "Si Mo" [four extremities]. "Bu Xiu Ye Zhe" [without resting] is written as "Bu Xiu Xi Ye" [without resting] in *Jia Yi Jing*. *Jia Yi Jing* omits "Ri" [day] after "Zhou" [day]. *Ling Shu* lacks the sentence "Qi Ru Yu Yin Ye" [When it enters Yin].) Now, if Jue Qi [reversal qi/pathogenic qi] invades the Zang and Fu organs, Wei Qi alone guards the exterior. Guarding the exterior causes Yang Qi to be abundant, while Yin Qi becomes increasingly deficient. The Yang Qiao vessel becomes full, leading to an excess of Yang, hence the eyes cannot close. (Jue Qi refers to pathogenic qi. When pathogenic qi invades the interior Zang and Fu, Wei Qi cannot enter the organs and can only guard the exterior, resulting in abundant Yang. [Character missing/obscured] indicates expansion/excess. Internal qi of the Zang and Fu fails to circulate, making internal qi increasingly deficient. The Yang Qiao vessel governs the eyes externally; now Yang Qiao is overflowing, so the eyes cannot close. Ming sounds like Mian [sleep]. Ping An: *Ling Shu* writes "Wu Zang Liu Fu" [Five Zang Six Fu] for "Zang Fu", while *Jia Yi Jing* writes "Wu Zang" [Five Zang]. "Du Wei Qi Wai" [alone guards the exterior] is written as "Du Ying Qi Wai" [alone nourishes the exterior] in *Jia Yi Jing*. The twenty-five characters from "Wei Qi Wze Yang Qi ..." to "Gu Mu Bu De Ming" are written in *Ling Shu* as "Xing Yu Yang Ze Yang Qi Sheng, Yang Qi Sheng Ze Yang Qiao Xian, Bu De Ru Yu Yin, Yin Xu Gu Mu Bu Ming" [Traveling in Yang makes Yang Qi abundant; abundant Yang Qi makes Yang Qiao sunken; unable to enter Yin, Yin deficiency causes eyes not to close]. *Jia Yi Jing* is identical except "Yang Qiao Xian" is "Yang Qiao Man" [full], "Yin Xu" is "Yin Qi Xu" [Yin Qi deficient], and "Gu Mu Bu Ming" is "Gu Mu Bu De Mian" [therefore eyes cannot sleep], slightly differing from *Ling Shu*.) Huang Di said: Excellent. How should it be treated? Bo Gao said: Tonify the deficiency, drain the excess, regulate the deficiency and excess, unblock the pathways, and expel the pathogenic factors. (Deficiency refers to Yin Qi. Excess refers to exterior Yang Qi.) Administer Ban Xia Tang (Pinellia Decoction) once. When Yin and Yang become unblocked, sleep will return immediately. (The following describes the formula for Ban Xia Tang to treat Jue Qi. Once Jue Qi dissipates and internal-external qi flows freely, the eyes close and sleep ensues. Ping An: "Qi" [dose/formula] is written as "Ji" [dose] in *Ling Shu* and *Jia Yi Jing*.) Huang Di said: Excellent. This is what is meant by opening up blocked channels, allowing meridians to flow freely, and harmonizing Yin and Yang. I wish to hear the formula. (Water in ditches blocked by silt flows freely when opened; similarly, blocked Yin-Yang qi is guided by acupuncture and herbs, hence called "Jue Du" [opening ditches]. Thus, I ask for the formula.) Bo Gao said: For the decoction, use eight sheng [units] of flowing water from a thousand li away, churn it ten thousand times, and take five sheng of the clear water to boil. Cook it using reed firewood. When it boils vigorously, add one sheng of Shu Mi [glutinous rice] and five he [units] of prepared Ban Xia [Pinellia Rhizome]. Simmer slowly until only one and a half sheng of liquid remains. Remove the dregs. Drink one small cup, three times a day. Gradually increase the dose until therapeutic effects are observed. For newly onset diseases, sleep comes immediately after drinking and covering oneself; sweating cures it. For chronic diseases, three doses are sufficient. (Sleeping immediately after drinking and sweating indicates rapid recovery. One and a half sheng constitutes one dose. Chronic diseases heal after three doses, less than one full dose; new diseases heal after one dose. Ping An: The character "Da" [great/vigorous] in "Da Fei" [boiling vigorously] is written as "Huo" [fire] in *Ling Shu* and *Jia Yi Jing*.)
Huang Di said: I have heard that the twelve meridians correspond to twelve rivers. These twelve rivers have different colors and varying degrees of clarity and turbidity. If human blood and qi were all uniform, how would they correspond? (The twelve waters refer to Jing, Wei, Hai, Hu, Ru, Mian, Huai, Luo, Jiang, He, Ji, and Zhang. These twelve waters are modeled by the twelve meridians to correspond to the Five Elements, hence their colors differ. Jiang River is clear, He River is turbid, indicating different clarity. Ruo means like. If human blood vessels are uniform, how do they correspond to these twelve rivers? Ping An: The four characters "Shi Er Jing Shui" [Twelve Meridian Waters] are not repeated in *Ling Shu*.) Qi Bo said: If human blood and qi were completely uniform, then the world would be unified. Where would there be chaos? (If human blood and qi were entirely consistent without difference, they could not correspond to the twelve rivers. Precisely because blood vessels and the twelve meridians differ, they can correspond to the twelve rivers, hence the potential for disorder.) Huang Di said: I am asking about one person, not the multitude of the world. Qi Bo said: One person also has chaotic qi, and the multitude of the world also has chaotic qi; they are consistent. (Not only do the blood vessels of the multitude have chaos, but one person also has chaos within their own twelve meridians. Ping An: One character is missing here; *Ling Shu* fills it with "He" [combine], Yuan edition uses "Li" [reason/principle].) Huang Di said: I wish to hear about the clear and turbid qi of humans. Qi Bo said: Qi receiving grain is turbid; Qi receiving Heaven's breath is clear. (Turbid Qi receiving grain is Stomach Qi; Clear Qi receiving breath is Lung Qi.) Clear Qi enters Yin, (Yin refers to the Lung.) Turbid Qi enters Yang, (Yang refers to the Stomach.) The clear portion of the turbid ascends out of the pharynx, (The clear part of grain Qi, though turbid overall, ascends out of the mouth/throat to form belching.) The turbid portion of the clear descends, (The turbid part of grain Qi, though clear overall, descends into the meridians to form Ying Qi. Ping An: "Ze Xia Xing" [then descends] is written as "Xia Xing Yu Wei" [descends into the Stomach] in *Jia Yi Jing*.) When Clear and Turbid interfere with each other, it is called Chaotic Qi. (Clear is Yin, Turbid is Yang. Interference leads to chaotic Yin-Yang Qi. Ping An: "Ming" [name/call] is written as "Ming" [name] in *Jia Yi Jing*.) Huang Di said: Yin is clear and Yang is turbid. Turbid contains clear, and clear contains turbid. How can they be distinguished? (Asking about the state of clear and turbid. Ping An: "Qing Zhuo" [Clear and Turbid] appears before "Bie" [distinguish] in *Ling Shu*.) Qi Bo said: The general distinction of Qi, (There are many subtle distinctions of Qi, but we speak of the general overview here.) Clear Qi ascends to the Lung, (The clear Qi of grain ascends to the Lung.) Turbid Qi flows down to the Stomach. (The turbid part of grain flows down to the Stomach.) The clear Qi of the Stomach ascends out of the mouth; (The clear part of grain Qi in the Stomach, though turbid overall, ascends out of the throat/mouth to form belching.) The turbid Qi of the Lung descends into the meridians and accumulates internally in the Sea. (The clear yet turbid Qi injected into the Lung descends into the twelve meridians and accumulates in Dan Zhong, forming Qi Hai [Sea of Qi] for respiration.) Huang Di said: All Yang meridians are turbid. Why is the Taiyang [Greater Yang] uniquely the most turbid? (All Yin meridians are clear, all Yang meridians are turbid. Among the Yang meridians, which one uniquely bears the turbidity?) Qi Bo said: The Hand Taiyang Small Intestine Meridian uniquely receives the turbidity of Yang. (The Stomach ripens food and transmits it to the Small Intestine. The Small Intestine receives and holds it, then transmits it to the Large Intestine. After passing through, this is where the Small Intestine bears the most filth and turbidity; thus, the Small Intestine Meridian receives the turbidity of Yang.) The Hand Taiyin Lung Meridian uniquely receives the clarity of Yin. Its clear Qi ascends to the empty orifices, (The Hand Taiyin Lung Meridian receives clear Qi. It has two branches. One branch of pure clear Qi travels through the 365 collaterals, all ascending to the face. Essence-Yang Qi ascends to the eyes for vision. Its separate Qi travels to the ears for hearing. Its Zong Qi [Gathering Qi] ascends out of the nose for smell. Its turbid Qi exits the lips and mouth for taste. All these are results of the Hand Taiyin clear Qi's operation. Ping An: "Kong Qiao" [empty orifices] is written as "Kong Qiao" [hole/orifice] in *Jia Yi Jing*. Note: "Jing Yang" [Essence Yang] is written as "Qing" [clear] in Yuan edition.) Its turbid Qi descends into the various meridians. (The clear yet turbid Qi of Hand Taiyin enters the vessels and travels through the twelve meridians.) All Yin meridians are clear, but the Foot Taiyin Spleen Meridian uniquely receives their turbidity. (The six Yin meridians' Qi is clear. Foot Taiyin is the Spleen Meridian. The Spleen governs the turbid Qi of grain and water; thus, Foot Taiyin receives the turbidity of Yin. Ping An: In the note "Pi Zhu" [Spleen governs], the top half of "Zhu" [govern] is damaged by insects, leaving only the bottom "Tu" [earth] radical. It should be the remnant of "Zhu". Yuan edition reads "Shang" [upper].) Huang Di said: How should it be treated? Qi Bo said: Clear Qi is slippery/slippery-flowing; Turbid Qi is sluggish/stagnant. This is the normal state of Qi. Therefore, when needling Yang meridians, insert deeply and retain the needle; when needling Yin meridians, insert shallowly and withdraw quickly; when Clear and Turbid interfere, regulate them according to numerical principles. (Most meridians consider Clear Qi as Yang and Turbid Qi as Yin; this chapter considers the fierce Qi of grain as Turbid/Yang and the essence Qi of grain as Clear/Yin. There are differences. Thus, for human Qi that is clear and slippery, needle shallowly and withdraw quickly; for Qi that is turbid and sluggish, needle deeply and retain; for chaotic Yin-Yang Clear-Turbid Qi, regulate according to principle, which is the natural order. Ping An: *Ling Shu* swaps "Needle Yang" to "Needle Yin" and vice versa; *Jia Yi Jing* agrees. "Ji Zhi" [withdraw quickly] is written as "Ji Qu Zhi" [withdraw and take] in *Jia Yi Jing*.)
Huang Di said: The twelve meridians correspond to the Five Elements and are divided into the Four Seasons. Under what conditions do they become disordered, and under what conditions are they cured? Qi Bo said: The Five Elements have order, and the Four Seasons have fixed divisions. Following them brings health; opposing them brings chaos. (Following means the twelve meridians have divisions of Five Elements and Four Seasons. Those who practice self-cultivation align with these divisions to achieve harmony and following; deviating from norms and losing principle leads to opposition and chaos.) Huang Di said: What does "following" mean? (Ping An: *Jia Yi Jing* adds "Er Zhi" [and cure].) Qi Bo said: The twelve meridians correspond to the twelve months. The twelve months are divided into the Four Seasons. The Four Seasons—Spring, Summer, Autumn, Winter—have different climates. Ying Qi and Wei Qi follow each other, Yin and Yang are harmonized, and Clear and Turbid do not interfere. This is following and health. (Ying Qi is inside the vessels, Wei Qi is outside. They follow each other internally and externally, hence "follow." It does not mean walking together or harmonizing together.) Huang Di said: What does "opposing and chaotic" mean? Qi Bo said: Clear Qi is in Yin, Turbid Qi is in Yang, (Clear Qi is inside the vessels, forming Ying Qi and Yin; Turbid Qi is outside the vessels, forming Wei Qi and Yang.) Ying Qi moves smoothly along the vessels, Wei Qi moves in reverse. (Ying and Wei Qi move forward and backward through the twelve meridians. The fierce Qi of Wei Qi ascends to the eyes, follows the Foot Taiyang to the toes as smooth movement; its scattered fierce Qi returns from the eyes, follows the Hand Taiyang to the fingers, which is reverse movement. This is the normal state. Ping An: *Ling Shu* and *Jia Yi Jing* omit "Xing" [move] before "Mai" [vessel].) When Clear and Turbid interfere and chaos arises in the chest, it is called Da Men [Great Oppression/Stifling]. (Men sounds like Men [stifled/oppressed]. Yang Qi entering Yin, Yin Qi entering Yang, is Clear/Turbid chaos. Ying Qi moving reverse, Wei Qi moving smooth, is Reverse/Smooth chaos.) Thus, if Qi is chaotic in the Heart, there is mental distress, silence, bowing the head, and quiet sitting; (Silent mental distress, unwillingness to speak. Bowing head means sitting quietly with head lowered. Ping An: "Hei" is written as "Mo" [silent] in *Jia Yi Jing*.) If chaotic in the Lung, there is panting and gasping while bending forward and backward, holding the chest to breathe; (Hand Taiyin Lung Meridian travels along the arm. When Lung Qi is chaotic, the Lung and arm feel stifled, hence holding the chest to breathe. Ping An: "Jie" [touch/connect] is written as "An" [press] in *Jia Yi Jing*.) If chaotic in the intestines and stomach, there is Huo Luan [Colic with vomiting and diarrhea]; (In the intestines and stomach, Ying and Wei Qi mix chaotically, causing Huo Luan. Huo Luan is sudden vomiting and diarrhea.) If chaotic in the arms and legs, there is Si Jue [Four Reversals/Cold Extremities]; (Si Jue refers to cold or hot extremities.) If chaotic in the head, there is Jue Ni [Reversal Cold/Heat], heavy head, dizziness, and falling. (Jue Ni heavy head refers to cold or heat in the head, heaviness, dizziness, and falling. Ping An: "Tou Zhong" [heavy head] is written as "Tou Tong" [headache] in *Jia Yi Jing*, note: "One version says heavy head.") Huang Di said: Is there a method for treating the Five Disorders with acupuncture? Qi Bo said: There is a way they come, and a way they go. Understanding this way thoroughly is the treasure of the body. (Having a way means regulating chaos, making it return to the correct path.) Huang Di said: Excellent. I wish to hear the ... [missing character]. Qi Bo said: If Qi is in the Heart, select the Shu [Transport] points of the Hand Shaoyin Pericardium Meridian and Heart Meridian. (Selecting Hand Shaoyin for Qi in the Heart: The earlier text says the Heart does not receive evil. Now Qi is in the Heart; how can it not receive evil? If the evil is in the Pericardium, why treat both Heart and Pericardium meridians? Thus, we know the Heart also receives evil. Shu refers to the third Shu points of both Hand Shaoyin and Hand Jueyin [Pericardium]. Ping An: One character is missing; *Ling Shu* fills it with "Dao" [way], Yuan edition uses "Zhi" [essence/purpose]. "Shao Yin Jing Xin Zhu Shu" is written as "Shao Yin Xin Zhu Zhi Shu" in *Ling Shu* and *Jia Yi Jing*.) If Qi is in the Lung, select the Ying [Spring] point of the Hand Taiyin and the Shu point of the Foot Shaoyin. (Hand Taiyin Ying point is the root Shu of the Lung. Foot Shaoyin Shu point is the Kidney Meridian. Because the Kidney Meridian ascends into the Lung, upper and lower Qi connect, so select Hand Taiyin Ying above and Foot Shaoyin Shu below.) If Qi is in the intestines and stomach, select the Foot Taiyin and Foot Yangming meridians; for the lower part, select Zu San Li [ST-36]. (Foot Taiyin is the Spleen Meridian. Spleen and Stomach Zang-Fu have connecting Yin-Yang Qi. Thus, for intestinal/stomach Qi chaos, select Foot Taiyin. Yangming Meridian is the Stomach's own meridian. The Stomach's upper Shu is on the back, lower Shu is at Zu San Li. Ping An: "Xia Zhe" [lower part] is written as "Bu Xia Zhe" [not lower part] in *Ling Shu* and *Jia Yi Jing*.) If Qi is in the head, select Tian Zhu [BL-10] and Da Zhu [BL-11]; (Foot Taiyang Meridian travels on the head. Tian Zhu and Da Zhu are emission points of Foot Taiyang Qi, so select them.) if no improvement, select the Ying and Shu points of the Foot Taiyang. (If the previous two points do not help, select the second Ying point and third Shu point of Foot Taiyang.) If Qi is in the arms and feet, first remove blood from the vessels, then select the Ying and Shu points of the Yangming and Shaoyang meridians. (For Four Reversals in limbs, first prick the abundant collaterals of hands and feet to release blood, then select Ying and Shu points of Hand/Foot Yangming and Hand/Foot Shaoyang. Ping An: *Ling Shu* adds "Qu Zhi" [take them] after "Zu" [foot]; "Xue" [blood] lacks "Yu" [from/in] before it.) Huang Di said: How to apply tonification and drainage? Qi Bo said: Slow insertion and slow withdrawal is called Dao Qi [Guiding Qi]. (Tonification is slow insertion and quick withdrawal; drainage is quick insertion and slow withdrawal. This guides Ying and Wei Qi to harmonize.) Tonification and drainage are formless, hence called Tong Jing [Same Essence]. This is not about excess or deficiency, but about reverse chaotic Qi. (Although tonification and drainage are formless, one must be precise regarding the excess/deficiency of Qi and the reversal of chaotic Qi. Thus, the subtlety lies in tonification/drainage, aiming for harmony.) Huang Di said: How glorious is the Dao! How illuminating is the discussion! Please inscribe it on jade tablets, naming it "Zhi Luan" [Treating Chaos]. (Huang Di praises Qi Bo's words in two ways: first, praising the great Dao; second, praising the skillful and convenient discussion. Thus, requesting it be passed down immortally. Ping An: From "Huang Di said Guang Hu Zai Dao" to the end, *Jia Yi Jing* does not include this section.)