平按∶此篇自篇首至故月事不来黄帝曰善哉，见《素问》卷九第三十三《评热病论》
篇。自黄帝问于岐伯曰有病庞然至末，见《素问》卷十三第四十七《奇病论》篇。又自
篇首至末，见《甲乙经》卷八第五。
黄帝曰∶有病肾风者，面 庞然壅，害于言，可刺不？（ ，扶付反，义当腐也。
庞，普江反。肾气损腐，令面庞然起壅也，而言无声，故曰害言。此为肾风之状，可刺
以不也？平按∶庞《素问》、《甲乙》作 。《甲乙》壅上有肿字，注云∶“《素问》
无肿字。”不《甲乙》作否。）岐伯曰∶虚虚不当刺，而刺，后五日其气必至。（如此
状者，肾风之状。肾之重虚之风，不可刺也。刺之，至其水数满日，其病气当至也。除
刺之日，后取五日，合有六日，水成数也。平按∶《素问》、《甲乙》“虚虚不当刺而
刺”作“虚不当刺，不当刺而刺”。）问曰∶何如？（平按∶《素问》、《甲乙》作其
至何如。）答曰∶至必少气，时热，从胸背上至头汗，手热，口干，苦渴，不能正偃，正
偃则咳，病名曰风水。（肾风病气至者，凡有八候∶一者少气，二时热，三从胸至头
汗出，四手热，五口热，六苦渴，七不能正偃谓不能仰卧，仰卧即咳。有此八候，候
是肾风水病也。平按∶《素问》时热下重时热二字。《甲乙》时下无热字。汗下《素问》、
《甲乙》有出字。苦渴下《素问》有“小便黄，目下肿，腹中鸣，身重难以行，月事
不来，烦而不能食”二十三字，《甲乙》同，惟行上少以字，食下重食字。袁刻补入正
经，据本注不应补入，仍从原抄为是。）黄帝曰∶愿闻其说。岐伯曰∶邪之所凑，其气
必虚，阴虚者阳必凑之，故小便黄者，中有热。（邪凑虚，肾气虚也。肾气既虚，则阳
气并之，故中有热小便黄也。平按∶小便黄者中有热《素问》作“少气时热而汗出也。
小便黄者，少腹中有热也”，《甲乙》作“少气时热而汗出小便黄。小便黄者，少腹
气热也”。）不能正偃者，胃中不和也。正偃则咳甚，上迫肺也。（肾有虚风，即胃中
不和。仰卧气上迫肺，故咳也。）诸有水气者，其征见于目下。何以言？曰∶水者阴也，
目下亦阴也，腹者至阴之所居也，故水在腹者，必使目下肿。（水与目下及腹皆阴，故
水在腹，即目下肿也。平按∶《素问》、《甲乙》其征作微肿。何以上《素问》有帝曰
二字，《甲乙》有曰字。）真气上逆，口苦舌干者，故不得正偃，正偃则咳清水。（以
水在腹，故真气上逆，口苦舌干，正偃则咳，咳则吐清水也。平按∶《素问》、《甲乙》
逆下有故字，干下无者故二字，有卧字，咳下有出字。）诸水病者，故不得卧，卧则惊，
惊则咳甚。（又诸水病仰卧，惊则咳甚，复为候也。平按∶注复袁刻误作腹。）腹中鸣
者，月事不来，病本于胃也，薄肝则烦不
能食，食不下者，胃管隔。（月事不来之病，由于胃气不和，故气薄于肝，烦不能食，
致使胃管隔塞，腹中无食，故腹鸣也。平按∶《素问》、《甲乙》无月事不来四字。
《甲乙》病作脾。《素问》、《甲乙》薄肝作薄脾，胃管作胃脘。）身重难以行者，胃
脉在足也。（胃脉足阳明在足，今胃气不和，气下于足，遂令身重，足不能行也。）月
事不来者，胞脉闭，肺属心而溢于胞中，令气上迫肺，心脏不得下通，故月事不来。黄
帝曰∶善哉。（胞者，任冲之脉，起于胞中，为经络海，故曰胞脉也。膀胱之胞与女子
子门之间，起此冲脉，上至咽喉，先过心肺。但肺与心共相系属。今胞脉虚邪闭塞，下
则溢于胞气，上则迫于肺气，不得下，故月事不来也。平按∶肺属心而溢于胞中《素问》、
《甲乙》作胞脉者属心而络于胞中，令作今，心脏作心气。）
黄帝问于岐伯曰∶有病庞然如有水气状，切其脉大紧，身无痛者，形不瘦，不能食，
食少，名为何病？岐伯曰∶病生在肾，名为肾风。肾风而不能食，喜惊，惊以心痿者死。
黄帝曰∶善哉。（庞然者，面皮起之貌。肾风之状，凡有六别∶一，面庞起；二，脉大
紧；三，身无痛；四，形不瘦；五，食少；六，喜惊。人有此六状，名曰肾风。心不痿
者可疗得生，痿者死矣。平按∶如有水气状，《素问》无气字。生《甲乙》作主。喜
《素问》、《甲乙》作善。惊以《素问》作惊已，《甲乙》作不已。心痿《素问》、
《甲乙》作心气痿。袁刻痿作委。）
【平按】本篇从篇首至“故月事不来，黄帝曰：善哉”，见于《素问》卷九第三十三《评热病论》篇。从“黄帝问于岐伯曰：有病庞然”至末尾，见于《素问》卷十三第四十七《奇病论》篇。又从头至尾，见于《甲乙经》卷八第五。
黄帝说：患有肾风病的患者，面部浮肿壅盛，言语不利（声音嘶哑或无法发声），可以用针刺治疗吗？（注：“ ”字读作扶付反，义同腐；“庞”字读作普江反。肾气受损腐败，导致面部浮肿壅盛，因而言语无声，所以叫“害言”。这是肾风的症状，是否可以针刺呢？平按：《素问》、《甲乙经》中“庞”写作“ ”。《甲乙经》在“壅”上有“肿”字，注释说：“《素问》没有‘肿’字。”“不”在《甲乙经》中写作“否”。）
岐伯说：对于虚证误用泻法称为“虚虚”，是不应当针刺的；如果误刺了，五天后邪气必然到达。（像这种状况，是肾风的症状。肾气双重虚弱而受风邪侵袭，不可针刺。如果针刺，等到水数满的日子，其病气就会到来。除去针刺的那天，往后取五日，合起来有六日，因为六是水的成数。平按：《素问》、《甲乙经》中“虚虚不当刺而刺”写作“虚不当刺，不当刺而刺”。）
问：病情会怎样发展？（平按：《素问》、《甲乙经》写作“其至何如”。）
答：病气到达时，必定会出现少气（气短）、时常发热，热气从胸背向上至头部出汗，手足发热，口干，苦渴，不能仰卧，仰卧就会咳嗽，这种病名叫风水。（肾风病气到达时，共有八种征候：一是少气，二是时常发热，三是从胸部至头部的汗出，四是手足发热，五是口热，六是苦渴，七是不能仰卧，所谓不能仰卧是指不能平躺，平躺即咳嗽。具备这八种征候，就是肾风水病。平按：《素问》在“时热”下重出“时热”二字。《甲乙经》在“时”下无“热”字。“汗”下《素问》、《甲乙经》有“出”字。“苦渴”下《素问》有“小便黄，目下肿，腹中鸣，身重难以行，月事不来，烦而不能食”二十三个字，《甲乙经》相同，只是“行”上少一个“以”字，“食”下重出“食”字。袁刻本补入正文，根据本注不应补入，仍依原抄本为是。）
黄帝说：希望听听其中的道理。
岐伯说：邪气聚集的地方，正气必然虚弱；阴虚则阳邪必凑之，所以小便黄是因为体内有热。（邪气凑聚于虚处，是肾气虚。肾气既已虚弱，阳气便并合于此，所以体内有热，小便发黄。平按：《素问》中“小便黄者中有热”写作“少气时热而汗出也。小便黄者，少腹中有热也”，《甲乙经》写作“少气时热而汗出小便黄。小便黄者，少腹气热也”。）
不能仰卧，是因为胃中不和。仰卧时咳嗽加剧，是因为气上迫于肺。（肾有虚风，则胃中不和。仰卧时气上迫于肺，所以咳嗽。）
凡是患有水气病的患者，其征象表现在眼下。为什么这样说？因为水是阴，眼下也是阴，腹部是至阴所在之处，所以水在腹部，必然导致眼下浮肿。（水、眼下及腹部皆属阴，所以水在腹部，眼下就浮肿。平按：《素问》、《甲乙经》中“其征”写作“微肿”。《素问》中“何以言”上有“帝曰”二字，《甲乙经》有“曰”字。）
真气上逆，口苦舌干，所以不能仰卧，仰卧则咳出清水。（因为水在腹部，所以真气上逆，口苦舌干，仰卧则咳嗽，咳嗽则吐出清水。平按：《素问》、《甲乙经》中“逆”下有“故”字，“干”下无“者故”二字，有“卧”字，“咳”下有“出”字。）
凡是水病患者，所以不能卧，卧则惊悸，惊悸则咳嗽加剧。（另外，凡水病患者仰卧，惊悸则咳嗽加剧，这也是征候之一。平按：注中的“复”字，袁刻本误作“腹”。）
腹中肠鸣，月经不来，病本在于胃。邪气薄于肝则心烦不能进食，食物不下，是因为胃脘隔塞。（月经不来的病，由于胃气不和，所以气薄于肝，心烦不能进食，致使胃脘隔塞，腹中无食，所以腹鸣。平按：《素问》、《甲乙经》无“月事不来”四字。《甲乙经》中“病”写作“脾”。《素问》、《甲乙经》中“薄肝”写作“薄脾”，“胃管”写作“胃脘”。）
身体沉重难以行走，是因为胃脉在足部。（胃脉足阳明经在足部，现在胃气不和，气下行于足，于是导致身体沉重，足不能行走。）
月经不来，是因为胞脉闭塞。胞脉属于心而络于胞中，令气上迫于肺，心脏之气不得下通，所以月经不来。（胞，指任脉和冲脉，起于胞中，为经络之海，所以叫胞脉。膀胱之胞与女子子门之间，由此发出冲脉，上行至咽喉，先经过心肺。但肺与心相互系属。现在胞脉虚邪闭塞，下则溢于胞气，上则迫于肺气，气不得下行，所以月经不来。平按：《素问》、《甲乙经》中“肺属心而溢于胞中”写作“胞脉者属心而络于胞中”，“令”作“今”，“心脏”作“心气”。）
黄帝说：讲得好。
黄帝问岐伯说：有人面部浮肿好像有水气的样子，切诊其脉象大且紧，身体没有疼痛，形体不消瘦，但不能进食，吃得很少，这是什么病？
岐伯说：病生在肾，名叫肾风。肾风病如果不能进食，容易惊悸，如果因惊悸导致心气痿弱死亡的，预后不良。（“庞然”是面皮浮肿的样子。肾风的症状，主要有六种区别：一是面部浮肿，二是脉象大紧，三是身体无痛，四是形体不瘦，五是吃得少，六是喜欢惊悸。人有这六种症状，名叫肾风。心气不痿弱的可以治愈生存，心气痿弱的则死亡。平按：“如有水气状”，《素问》无“气”字。“生”在《甲乙经》中写作“主”。“喜”在《素问》、《甲乙经》中写作“善”。“惊以”在《素问》中写作“惊已”，《甲乙经》写作“不已”。“心痿”在《素问》、《甲乙经》中写作“心气痿”。袁刻本“痿”写作“委”。）
[Ping An] This section, from the beginning of the chapter to "thus menstruation does not come, Huangdi said: Excellent," is found in *Suwen* (Plain Questions), Volume 9, Chapter 33, "Evaluation of Heat Diseases." From "Huangdi asked Qibo: There is a disease with facial swelling" to the end, it is found in *Suwen*, Volume 13, Chapter 47, "Discussion on Rare Diseases." Furthermore, from start to finish, it appears in *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 8, Section 5.
Huangdi said: A patient suffering from Kidney Wind (Shen Feng) presents with facial edema and distension, and has difficulty speaking (hoarseness or inability to vocalize). Can this condition be treated with acupuncture? (Note: The character ' ' is pronounced 'fu fu fan' and means putrefaction; 'Pang' is pronounced 'pu jiang fan'. Damage and putrefaction of Kidney Qi cause facial edema and distension, leading to voicelessness, hence termed 'harmful speech'. These are signs of Kidney Wind; can it be needled? Ping An: In *Suwen* and *Jiayi Jing*, 'Pang' is written as ' '. *Jiayi Jing* adds the character 'swelling' before 'distension', noting that *Suwen* lacks this character. 'Bu' is written as 'Fou' in *Jiayi Jing*.)
Qibo replied: Treating deficiency with draining methods constitutes 'deficiency of deficiency,' which is contraindicated for needling. If needled erroneously, the pathogenic qi will arrive after five days. (Such presentation indicates Kidney Wind. With double deficiency of the Kidney and wind invasion, needling is forbidden. If needled, when the water number cycle completes, the pathogenic qi will manifest. Excluding the day of needling, counting forward five days totals six days, corresponding to the completed number of Water. Ping An: *Suwen* and *Jiayi Jing* read "deficiency should not be needled; if needled erroneously..." instead of "deficiency of deficiency...".)
Question: How will the condition develop? (Ping An: *Suwen* and *Jiayi Jing* read "What will happen upon arrival?")
Answer: Upon arrival, there will certainly be shortness of breath (Qi deficiency), intermittent fever, sweating from the chest and back up to the head, heat in the hands, dry mouth, bitter thirst, inability to lie supine, and coughing when lying supine. This disease is named Wind Water (Feng Shui). (When Kidney Wind pathogenic qi arrives, eight signs appear: one, shortness of breath; two, intermittent fever; three, sweating from chest to head; four, heat in hands; five, heat in mouth; six, bitter thirst; seven, inability to lie supine, meaning inability to lie flat, which induces coughing. These eight signs indicate Kidney Wind-Water disease. Ping An: *Suwen* repeats "intermittent fever"; *Jiayi Jing* omits "heat" after "time"; *Suwen* and *Jiayi Jing* add "out" after "sweat"; *Suwen* adds twenty-three characters after "bitter thirst": "yellow urine, swollen under-eyes, abdominal borborygmus, heavy body difficult to move, amenorrhea, irritability and inability to eat," identical in *Jiayi Jing* except for missing "yi" before "xing" and repeating "shi" at the end. Yuan edition inserted these into the main text, but based on annotations, they should not be; thus, following the original manuscript is correct.)
Huangdi said: I wish to hear the explanation.
Qibo said: Wherever pathogenic factors gather, Zheng Qi (True Qi) must be deficient. When Yin is deficient, Yang pathogenic factors inevitably converge upon it; thus, yellow urine indicates internal heat. (Pathogens gather in deficiency, specifically Kidney Qi deficiency. Once Kidney Qi is deficient, Yang Qi merges with it, causing internal heat and yellow urine. Ping An: *Suwen* reads "shortness of breath, intermittent fever, and sweating. Yellow urine indicates heat in the lower abdomen"; *Jiayi Jing* reads "shortness of breath, intermittent fever, sweating, and yellow urine. Yellow urine indicates heat in the lower abdomen Qi.")
Inability to lie supine is due to disharmony in the Stomach. Coughing worsens when supine because Qi presses upward against the Lung. (Kidney deficiency with wind causes Stomach disharmony. Supine position allows Qi to press against the Lung, causing cough.)
In all cases of fluid retention diseases, signs manifest under the eyes. Why say this? Because Water is Yin, and the area under the eyes is also Yin. The abdomen is the residence of Supreme Yin. Therefore, when water accumulates in the abdomen, swelling under the eyes necessarily occurs. (Water, under-eye area, and abdomen all belong to Yin; thus, abdominal water leads to under-eye swelling. Ping An: *Suwen* and *Jiayi Jing* read "slight swelling" instead of "signs". *Suwen* adds "Emperor said" before "Why say"; *Jiayi Jing* adds "said".)
When True Qi rebels upward, causing bitter taste and dry tongue, one cannot lie supine; supine posture induces coughing of clear fluid. (Abdominal water causes True Qi rebellion, bitter taste, dry tongue, and supine-induced coughing with expulsion of clear fluid. Ping An: *Suwen* and *Jiayi Jing* add "gu" after "ni", remove "zhe gu" after "gan", add "wo" after "gan", and add "chu" after "ke".)
In all water diseases, patients cannot lie down; lying down causes palpitations/fright, which exacerbates coughing. (Additionally, in water diseases, supine position causes fright, which intensifies coughing, serving as another sign. Ping An: The annotation's "fu" was mistakenly printed as "fu" [abdomen] in Yuan edition.)
Abdominal borborygmus and amenorrhea originate from the Stomach. Pathogenic influence on the Liver causes irritability and anorexia; food impaction results from Stomach obstruction. (Amenorrhea stems from Stomach Qi disharmony, causing Qi to affect the Liver, leading to irritability and anorexia, resulting in Stomach obstruction and lack of food in the abdomen, hence borborygmus. Ping An: *Suwen* and *Jiayi Jing* omit "amenorrhea"; *Jiayi Jing* writes "Spleen" for "disease"; *Suwen* and *Jiayi Jing* write "affect Spleen" for "affect Liver" and "Stomach Wan" for "Stomach Guan".)
Heavy body and difficulty walking occur because the Stomach Meridian resides in the foot. (The Foot-Yangming Stomach Meridian is in the foot. Current Stomach Qi disharmony causes Qi to descend to the feet, resulting in heaviness and inability to walk.)
Amenorrhea occurs because the Bao Mai (Uterine Vessels) are blocked. The Bao Mai belongs to the Heart and connects to the Bao (Uterus); Qi presses upward against the Lung, preventing Heart Qi from descending, thus causing amenorrhea. (Bao refers to the Ren and Chong vessels originating in the Bao, serving as the Sea of Meridians. The Chong vessel arises between the Bladder's Bao and the female opening, ascending to the throat, passing through the Heart and Lung. The Lung and Heart are interconnected. Currently, deficiency and pathogens block the Bao Mai; downward it overflows into Bao Qi, upward it presses against Lung Qi, preventing descent, hence amenorrhea. Ping An: *Suwen* and *Jiayi Jing* read "Bao Mai belongs to Heart and connects to Bao"; "ling" is "jin" (now); "Xin Zang" is "Xin Qi".)
Huangdi said: Excellent.
Huangdi asked Qibo: A patient presents with facial swelling resembling water accumulation. Palpation reveals a large and tight pulse. The body has no pain, form is not emaciated, yet the patient cannot eat and eats little. What is this disease?
Qibo replied: The disease originates in the Kidney and is named Kidney Wind. In Kidney Wind, if the patient cannot eat and experiences frequent fright, death ensues if accompanied by Heart Wei (Heart Atrophy/Deficiency). (Pangran describes facial skin swelling. Six distinctions characterize Kidney Wind: one, facial swelling; two, large and tight pulse; three, no body pain; four, non-emaciated form; five, poor appetite; six, predisposition to fright. Presence of these six signs indicates Kidney Wind. If Heart Qi is not atrophied, survival is possible; if atrophied, death occurs. Ping An: *Suwen* omits "qi" in "resembling water qi"; *Jiayi Jing* writes "zhu" for "sheng"; *Suwen* and *Jiayi Jing* write "shan" for "xi"; *Suwen* writes "jing yi" and *Jiayi Jing* writes "bu yi" for "jing yi"; *Suwen* and *Jiayi Jing* write "Xin Qi Wei" for "Xin Wei". Yuan edition writes "wei" as "wei".)