黄帝曰。余闻十二经脉。以应十二经水者。其五色各异。清浊不同。人之血气若一。应之奈何。
岐伯曰。人之血气。苟能若一。则天下为一矣。恶有乱者乎。黄帝曰。余闻一人。非问天下之众。
岐伯曰。夫一人者。亦有乱气。天下之众。亦有乱人。其合为一耳。
此篇论阴阳清浊。交相于乱者也。人之十二经脉。外合十二经水。内合五脏六腑。其五色各异。
清浊不同。故一人之身有乱气。犹天下之众有乱人。其理可合之为一耳。恶有不乱者乎。杨元如曰。
清浊。天地之气也。天气下降。地气上升。清浊相干。命曰乱气。不乱则生化灭矣。故曰夫一人者。
亦有乱气。天下之众。亦有乱人。
谓天下之人。皆有此乱气也。
黄帝曰。愿闻人气之清浊。岐伯曰。受谷者浊。受气者清。清者注阴。浊者注阳。浊而清者。
上出于咽。清而浊者则下行。清浊相干。命曰乱气。
六腑为阳。五脏为阴。六腑受谷者浊。五脏受气者清。故清者注阴。浊者注阳。浊而清者。谓
水谷所生之清气。上出于咽喉。以行呼吸。清而浊者。肺之浊气。下注于经。内注于海。此人气之
清浊相干。命曰乱气。莫仲超曰。上节言天下之众。皆有此乱气。谓人合天地之清浊也。故复曰愿
闻人气之清浊。
黄帝曰。夫阴清而阳浊。浊者有清。清者有浊。清浊别之奈何。岐伯曰。气之大别。清者上注于
肺。浊者下走于胃。胃之清气。上出于口。肺之浊气。下注于经。内积于海。
此论人合天地之气也。大别者。应天地之大而有别也。天清地浊。而上下气交。故浊者有清。
清者有浊。而人亦应之。肺属天而阳明居中土。故清者上注于肺。浊者下走于胃。此清浊之上下也。
然浊者有清。胃之清气。上出于口。口鼻者。气出入之门户。此胃腑水谷之浊。生此清气。上出于
口。以司呼吸而应开阖者也。清者有
浊。肺之浊气。下注于经。内积于海。肺为精水之原。清中所生之津液。流溢于下。即所谓谷入于
胃。乃传之肺。流溢于中。布散于外。精专者行于经隧。下注于经者。行于经隧也。流溢于中者。
内积于海也。海者。下焦精髓之海也。此阴阳清浊之气交也。朱济公曰。天为阳。地为阴。天一生
水。地二生火。火为阳。水为阴。故清者有浊。浊者有清。
黄帝曰。诸阳皆浊。何阳独甚乎。岐伯曰。手太阳独受阳之浊。手太阴独受阴之清。其清者上
走空窍。其浊者下行诸经。诸阴皆清。足太阴独受其浊。
诸阳皆浊。而手太阳独受其浊之甚。盖手太阳小肠。主受盛胃腑之糟粕。有形者皆浊。而糟粕
为浊之甚者也。诸阴皆清。而手太阴为五脏之长。华盖于上。故手太阴独受阴之清。空窍者。皮毛
之汗空也。手太阴主周身之气。走于空窍。以司呼吸开阖。应天之道也。小肠受盛糟粕。济泌别汁。
化而为赤。下行于十二经脉。应地之道也。脾为仓禀之官。主输运胃腑水谷之精汁。故诸阴皆清。而
足太阴独受其浊。杨元如曰。手太阴主天。故独受其清。足太阴主地。故独受其浊。此篇论人之
阴阳清浊。应合天地经水。故帝曰十二经脉。应十二经水。伯曰天下之众。又曰气之大别。
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。故刺阴者深而留之。刺
阳者浅而疾之。清浊干者。以数调之也。
气之滑利者。应天运于外。故浅而疾之。涩浊者。应地居于中。故深而留之。清浊相干者。阴阳
之气交。故以数
调之。数者。天地之常数也。朱济公曰。以数调之。与逆顺篇之无失常数同义。此篇以人之清浊。
合天地之阴阳。下章论人之形体。应天地日月水火。
黄帝说：我听说十二经脉对应着十二条河流，这些河流的水色各不相同，水质有清有浊。如果人的气血是统一一致的，那么该如何应对这种差异呢？
岐伯说：如果人的气血真的完全一致，那么天下也就归于一统了，哪里还会有混乱呢？
黄帝说：我问的是一个人，并不是问天下的众人。
岐伯说：即使是个人，体内也有气机的紊乱；天下的众人中，也有行为混乱的人。这两者的道理是可以合而为一的。
这一篇论述的是阴阳清浊之气相互交错而产生的“乱气”。人体的十二经脉，外合十二条河流，内联五脏六腑。因为水色各异、清浊不同，所以一个人的身体里也会有乱气，就像天下的众人中有乱人一样，其道理是可以合并看待的，怎么会没有混乱的情况呢？杨元如说：清和浊，是天地的精气。天气下降，地气上升，清浊二气相互干扰，称为乱气。如果不发生这种干扰，生化之机就会灭绝。所以说，个人体内也有乱气，天下众人中也有乱人。
意思是说，天下的人都具备这种乱气。
黄帝说：我希望了解人体之气的清浊情况。岐伯说：受纳水谷之气则偏浊，受纳自然清气则偏清。清气注入阴分（脏），浊气注入阳分（腑）。在浊气中化生的清气，向上出于咽喉；在清气中混杂的浊质，则向下运行。清浊二气相互干扰，称为乱气。
六腑属阳，五脏属阴。六腑受纳水谷，故气偏浊；五脏受纳精气，故气偏清。因此，清气注入阴脏，浊气注入阳腑。所谓“浊而清者”，是指由水谷所化生的清气，向上出于咽喉，以主持呼吸运动；所谓“清而浊者”，是指肺中的浊气，向下注入经脉，向内汇聚于海（下焦精髓之海）。这就是人体清浊之气的相互干扰，称为乱气。莫仲超说：上一节讲的是天下的众人都有这种乱气，意思是人结合了天地的清浊之气。所以再次问道希望了解人体之气的清浊。
黄帝说：阴气清而阳气浊，浊气中含有清气，清气中含有浊质，如何区分它们呢？岐伯说：从气的总体分类来看，清气向上注入肺，浊气向下流入胃。胃中的清气，向上出于口；肺中的浊气，向下注入经脉，向内积聚于海。
这是论述人合应天地之气。所谓“大别”，是指顺应天地的大致区别而言。天清地浊，上下之气相交，所以浊气中有清气，清气中有浊质，人也随之相应。肺属天，阳明胃居中土，所以清气上注于肺，浊气下走于胃，这是清浊之气的上下分布。然而浊气中确有清气，即胃中水谷产生的清气，向上出于口鼻。口鼻是气出入的门户，这是胃腑水谷之浊气所化生的清气，向上出于口，以主持呼吸并适应开阖的功能。清气中确有浊质，即肺中的浊气，向下注入经脉，向内积聚于海。肺是精水的源头，清气中所生的津液，流溢向下，正如所说“食物进入胃后，传送给肺，在中焦流溢，布散于体表，其中精专的部分行于经隧，向下注入经隧的部分，就是流溢于中、内积于海的部分”。海，指的是下焦精髓之海。这就是阴阳清浊之气的交汇。朱济公说：天为阳，地为阴。天一生水，地二生火。火为阳，水为阴。所以清气中有浊，浊气中有清。
黄帝说：所有的阳经都受浊气，为什么唯独手太阳经受到的浊气最盛呢？岐伯说：手太阳小肠经独自承受阳分的浊气，手太阴肺经独自承受阴分的清气。手太阴的清气向上流向空窍，其浊气向下流注各条经脉。所有的阴经都受清气，唯独足太阴脾经承受浊气。
所有的阳经都受浊气，但手太阳小肠经独自承受其中最盛的浊气。这是因为手太阳小肠主受纳和盛装胃腑传来的糟粕，有形之物皆属浊，而糟粕更是浊中之最。所有的阴经都受清气，但手太阴肺为五脏之长，位置最高如华盖，所以手太阴独自承受阴分的清气。空窍，指皮毛上的汗孔。手太阴肺主周身之气，气流向空窍，以主持呼吸的开阖，顺应天的规律。小肠受纳盛装糟粕，过滤分别汁液，将其化为赤色血液，向下流注于十二经脉，顺应地的规律。脾是仓廪之官，主要输运胃腑水谷的精微汁液，所以所有的阴经都受清气，而足太阴脾经独自承受其中的浊气。杨元如说：手太阴主天，所以独自承受清气；足太阴主地，所以独自承受浊气。这一篇论述人的阴阳清浊，合应天地的河流，所以黄帝说十二经脉对应十二条河流，岐伯说天下的众人，又说气的大致分类。
黄帝说：治疗时该怎么办？岐伯说：清气性质滑利，浊气性质涩滞，这是气的常态。所以针刺阴经要深刺并留针，针刺阳经要浅刺并快速出针。对于清浊相干的情况，用适当的次数来调节它。
气机滑利的，应合天道运行于外，所以浅刺且快出；气机涩滞的，应合地道居守于中，所以深刺且久留。清浊相互干扰，是阴阳之气的交争，所以要用一定的法则（或针刺次数）来调节。所谓的“数”，是天地间的常数。朱济公说：“用数来调节”，与《逆顺篇》中说的“不要违背常数”意义相同。本篇将人的清浊与天地的阴阳相合，下一章论述人的形体应合天地的日月水火。
Huangdi said: I have heard that the twelve meridians correspond to the twelve rivers. The colors of these waters differ, and their clarity and turbidity vary. If human qi and blood are uniform, how should one respond to this?
Qibo replied: If human qi and blood were truly uniform, then the world would be unified, and where would there be chaos?
Huangdi said: I am asking about an individual person, not about the multitude of the world.
Qibo replied: Even within a single person, there is chaotic qi; among the multitude of the world, there are chaotic people. Their principles can be integrated into one.
This chapter discusses the chaotic qi arising from the intermingling of yin-yang, clarity, and turbidity. The twelve meridians of the human body correspond externally to the twelve rivers and internally to the five zang and six fu organs. Because the water colors differ and their clarity and turbidity vary, even a single body contains chaotic qi, just as there are chaotic individuals among the multitude of the world. Their logic can be viewed together; how could there be no chaos? Yang Yuanru stated: Clarity and turbidity are the qi of heaven and earth. Heaven’s qi descends, earth’s qi ascends. When clarity and turbidity interfere with each other, it is called chaotic qi. Without such interference, the process of generation and transformation would cease. Thus, it is said that even a single person has chaotic qi, and among the multitude of the world, there are chaotic people. This means that all people in the world possess this chaotic qi.
Huangdi said: I wish to hear about the clarity and turbidity of human qi. Qibo replied: Qi derived from grain is turbid; qi derived from air is clear. Clear qi enters the yin (zang organs), and turbid qi enters the yang (fu organs). The clear aspect within the turbid rises out through the pharynx; the turbid aspect within the clear flows downward. When clear and turbid interfere with each other, it is called chaotic qi.
The six fu organs are yang, and the five zang organs are yin. The fu organs receive grain, so their qi is turbid; the zang organs receive essence/air, so their qi is clear. Therefore, clear qi enters the yin, and turbid qi enters the yang. "Turbid yet clear" refers to the clear qi generated from food and drink, which rises out through the throat to facilitate respiration. "Clear yet turbid" refers to the turbid qi of the lung, which flows downward into the meridians and inwardly accumulates in the Sea (the lower jiao essence sea). This interaction of human clear and turbid qi is called chaotic qi. Mo Zhongchao stated: The previous section discussed how the multitude of the world possesses this chaotic qi, meaning humans combine the clarity and turbidity of heaven and earth. Hence, the question arises again regarding the clarity and turbidity of human qi.
Huangdi said: Yin is clear and yang is turbid. Turbid qi contains clear elements, and clear qi contains turbid elements. How can they be distinguished? Qibo replied: Broadly speaking, clear qi flows upward into the lung, and turbid qi flows downward into the stomach. The clear qi of the stomach rises out through the mouth; the turbid qi of the lung flows downward into the meridians and inwardly accumulates in the Sea.
This discusses how humans correspond to the qi of heaven and earth. "Broad distinction" refers to the major differences corresponding to heaven and earth. Heaven is clear, earth is turbid, and the upper and lower qi intersect. Thus, turbid qi contains clear elements, and clear qi contains turbid elements, and humans correspond accordingly. The lung corresponds to heaven, and the Yangming Stomach occupies the central earth position. Therefore, clear qi flows upward into the lung, and turbid qi flows downward into the stomach; this is the vertical distribution of clarity and turbidity. However, turbid qi indeed contains clear qi: the clear qi generated from food and drink in the stomach rises out through the mouth. The mouth and nose are the gates for qi entry and exit. This clear qi, generated from the turbidity of stomachal grain, rises out through the mouth to govern respiration and adapt to opening and closing. Clear qi indeed contains turbid elements: the turbid qi of the lung flows downward into the meridians and inwardly accumulates in the Sea. The lung is the source of essence fluids. The fluids generated from clear qi flow downward. As stated, "When food enters the stomach, it is transmitted to the lung, flows and overflows in the middle, and spreads outward. The most refined part travels through the vessel tunnels, and the part flowing downward into the vessels travels through the vessel tunnels." The part overflowing in the middle is what is inwardly accumulated in the Sea. The Sea refers to the lower jiao essence sea. This is the intersection of yin-yang, clear, and turbid qi. Zhu Jigong stated: Heaven is yang, earth is yin. One generates water, two generates fire. Fire is yang, water is yin. Therefore, clear qi contains turbid elements, and turbid qi contains clear elements.
Huangdi said: All yang meridians receive turbid qi. Why does the Hand-Taiyang meridian alone receive the most severe turbidity? Qibo replied: The Hand-Taiyang Small Intestine meridian alone receives the turbid qi of yang, and the Hand-Taiyin Lung meridian alone receives the clear qi of yin. The clear qi of the Hand-Taiyin flows upward to the orifices, while its turbid qi flows downward to the various meridians. All yin meridians receive clear qi, but the Foot-Taiyin Spleen meridian alone receives turbid qi.
All yang meridians receive turbid qi, but the Hand-Taiyang Small Intestine meridian alone receives the most severe turbidity. This is because the Small Intestine receives and holds the dregs from the stomach. Solid substances are turbid, and dregs are the most turbid. All yin meridians receive clear qi, but the Hand-Taiyin Lung is the leader of the five zang organs, covering them like a canopy above. Therefore, the Hand-Taiyin alone receives the clear qi of yin. Orifices refer to the sweat pores of the skin. The Hand-Taiyin Lung governs the qi of the whole body, flowing to the orifices to govern respiratory opening and closing, corresponding to the Way of Heaven. The Small Intestine receives and holds dregs, filters and separates juices, transforms them into red blood, and flows downward into the twelve meridians, corresponding to the Way of Earth. The Spleen is the official of granaries, primarily transporting the refined juices of stomachal grain. Therefore, all yin meridians receive clear qi, but the Foot-Taiyin Spleen meridian alone receives turbid qi. Yang Yuanru stated: The Hand-Taiyin corresponds to heaven, so it alone receives clear qi; the Foot-Taiyin corresponds to earth, so it alone receives turbid qi. This chapter discusses how human yin-yang, clarity, and turbidity correspond to the rivers of heaven and earth. Hence, Huangdi said the twelve meridians correspond to the twelve rivers, and Qibo spoke of the multitude of the world and the broad distinction of qi.
Huangdi said: How should treatment be conducted? Qibo replied: Clear qi is slippery and smooth, while turbid qi is sluggish and obstructed. This is the normal state of qi. Therefore, when needling yin meridians, one should insert deeply and retain the needle; when needling yang meridians, one should insert shallowly and withdraw quickly. For cases of clear-turbid interference, regulation is achieved by adjusting the number of manipulations.
Qi that is slippery and smooth corresponds to the heavenly way operating externally, so needling should be shallow and quick. Qi that is sluggish and turbid corresponds to the earthly way residing centrally, so needling should be deep and retained. Interference between clear and turbid represents the intersection of yin and yang qi, so regulation is achieved by using specific numbers (manipulation counts). The "number" refers to the constant laws of heaven and earth. Zhu Jigong stated: "Regulating by number" has the same meaning as "do not deviate from the constant numbers" in the *Ni Shun* chapter. This chapter combines human clarity and turbidity with the yin-yang of heaven and earth; the next chapter discusses how human form corresponds to the sun, moon, water, and fire of heaven and earth.