黄帝问曰。有病心腹满。旦食则不能暮食。此为何病。（此篇论外不涉于形身。内不关乎脏腑。在于宫城空郭之中。
或气或血。或风或热。以至于女子之妊娠。皆在于空腹之中。故篇名腹中论。帝曰。心腹满者。谓胸膈间乃心主之宫城。
腹中乃脏腑之郛郭也。）岐伯对曰。名为鼓胀。（鼓胀者。如鼓革之空胀也。此因脾土气虚。不能磨谷故旦食而不能暮食。
以致虚胀如鼓也。）帝曰。治之奈何。岐伯曰。治之以鸡矢醴。一剂知。二剂已。（鸡矢、取鸡屎上之白色者。鸡之精也。
鸡属阳明秋金。在卦配巽风木。此乃脾土艰于运化。以致胀满不食。风木制化土气。阳明燥合太阴。醴乃熟谷之液。酿
以稻米。炊之稻薪。主补益中土。而先行于荣卫者也。故一剂则腹中温和。二剂其病则已。张兆璜曰。鸡鸣于寅酉之
时。鸣则先鼓其翼。风木之象也。盖木击金而后鸣矣。又说者曰。羽虫无肺。故无前阴。屎中之白者精也。）帝曰。其时
有复发者何也。岐伯曰。此饮食不节。故时有病也。虽然。其病且已时。故当病气聚于腹也。（饮食不节。则复伤其脾。
故时有复发也。或虽非饮食不节。值其病且已之时。而即受其饮食。故当病气聚于腹。此深戒其慎节于饮食也。）帝曰
有病胸胁支满者。妨于食。病至则先闻腥臊臭。出清液。先唾血。四肢清。目眩。时时前后血。病名为何。何以得之。
（上节论腹中气虚。其病在脾。此论腹中血脱。所伤在肝也。夫血乃中焦水谷之汁。专精者行于经隧。为经脉之血。其
流溢于中者。注于肾脏而为精。复奉心化赤而为血。从胞中而注于冲脉。循腹上行。至胸中而散。充肤热肉。淡渗于皮
肤。而生毫毛。卧则归藏于肝。寤则随卫气而复行于皮肤之气分。男子络唇口而生髭须。女子以时下为月事。此流溢于
中。布散于外之血也。是以此血虚脱。则肝气大伤。有病胸胁支满者。肝虚而胀满也。食气入胃。散精于肝。肝气伤。
故妨于食也。肝臭臊。肺臭腥。不能淡渗皮毛则肺虚。无所归藏于肝则肝虚。肝肺两虚。是以病至则先闻腥臊臭也。肺
气虚。出清液。肝脏虚。先唾血也。不能充肤热肉则四肢冷。肝开窍于目。故目眩也。肝主疏泄。时时前后血者。肝无
所藏而虚泄矣。）岐伯曰。病名曰血枯。此得之年少时。有所大脱血。若醉入房中。气竭肝伤。故月事衰少不来也。（有
所大脱血则伤肝。肝伤。在女子则月事衰少不来矣。醉以入房。在男子则伤精。精伤则无从而化赤矣。气生于精血。精
血虚脱则气竭矣。杨元如曰。伤寒论热入血室。刺肝经之期门。本经曰肝伤。故月事衰少。是女子之月事。发原于胞中。
上行于冲任。布散于皮毛。归藏于肝脏。而后下为月事者也。）帝曰。治之奈何。复以何术。（问治以何药。复以何法救
之。）岐伯曰。以四乌 骨一 茹。二物并合之。丸以雀卵。大如小豆。以五丸为后饭。饮以鲍鱼汁利肠中及伤肝也。（
贼同 茹当作茹 。乌 骨、乌贼鱼之骨也。 鱼状若胞囊。腹中有墨。脊上只生一骨。轻脆如通草。盖乌者肾之色。
骨乃肾所生。主补益肾藏之精血者也。茹 一名茜草。又名地血。汁可染绛。其色紫赤。延蔓空通。乃生血通经之草也。
夫鱼乃水中动物。属阴中之阳。血中之气。故用乌 骨四者。以布散于四肢也。血乃中焦所生。用茹 一者。主生聚于
中焦也。夫飞者主气。潜者主血。卵白主气。卵黄主血。雀乃羽虫。丸以雀卵者。因气竭肝虚。补血而补气也。豆乃肾
之谷。五者土之数。气血皆中焦所生。故宜饭后而服五豆许也。鲍鱼味咸气臭。主利下行。故饮鲍鱼汁以利肠中。而后
补及于肝之伤也。又按。甲乙经 茹作 茹。）帝曰。病有少腹盛。上下左右皆有根。此为何病。可治不。岐伯曰。病
名曰伏梁。（盛、满也。少腹、脐下也。上下左右皆有根。此病在血分。有脉络之联系于上下四旁也。伏梁、如梁之横伏
于内也。按上二节论气血之虚胀。此下二节论血气之实胀也。）帝曰。伏梁因何而得之。岐伯曰。裹大脓血。居肠胃之外。
不可治。治之每切按致死。（裹大。如囊之裹物而大也。居肠胃之外。在空郭之间也。不可治者。不可治以按摩也。如急
切欲其解散而按摩之。必致痛而欲死。盖有形之邪。不易散也。）帝曰。何以然。岐伯曰。此下则因阴必下脓血。上则
迫胃脘。生膈挟胃脘内痈。（此下、谓少腹阴前后二阴也。冲脉起于胞中。并足阳明。挟脐左右。循腹上行。此因阴中必
下脓血。循经而上。则迫及胃脘。生膈挟胃脘内痈。以致留积脓血于肠胃之外。而如囊裹之大也。张兆璜曰。胃脘正
当膈间。曰膈挟胃脘内痈者。谓痈生于膈胃之间。乃在胃外之膜原。而非胃上也。朱圣公曰。此系热中之病。故在阴
则下脓血。上则迫生胃痈。）此久病也。难治。居齐上为逆。居齐下为从。（齐脐同。久病者。谓痈生于膈胃之间。病者
不觉。故痈脓渐积于腹中。而成裹大也。脐上乃腹中之气分。故为逆。脐下乃胞中之血分。易于行泄。故为从。）勿动亟
夺。论在刺法中。（勿动者。不可按摩引动也。亟、急也。言亟当迎而夺之以泻之。其刺取之法。用圆利针。微大其末。
反小其身。令可深纳以取痈痹。此论在针经之刺法中。）帝曰。人有身体髀股 皆肿。环脐而痛。是为何病。岐伯曰。
病名伏梁。此风根也。（此论邪留气分而为伏梁也。气行于肌腠之间。是以身体股 皆肿。风为阳邪。伤人阳气。此风邪
伤气。而留于脐腹之间。故曰此风根也。）其气溢于大肠。而着于肓。肓之原在脐下。故环脐而痛也。（肓音荒。大肠、
谓大肠之外。空郭之间。风邪之气。充溢于大肠之外。而留着于肓。肓乃膏肓。即膜原之属。肓之原。出于脖 。正在
脐下。故绕脐而痛也。）不可动之。动之为水。溺涩之病。（不可动者。不可妄攻以动之也。盖风邪之根。留于脐下。动
之则风气淫佚。而鼓动其水矣。水溢于上。则小便为之不利矣。）帝曰。夫子数言热中消中。不可服膏粱芳草石药。石药
发癫。芳草发狂。（热中、谓脓血风邪留中而为热也。消中、谓气虚血脱。而为消中之虚满也。膏粱、浓味也。芳草、芳
香之草。石药、金石之药也。芳草之气。升散为阳。故令人发狂。金石之药。沉重为阴。故令人发癫也。）夫热中消中者。
皆富贵人也。今禁膏粱。是不合其心。禁芳草石药。是病不愈。愿闻其说。（富贵之人。形乐而志苦。华食而纵淫。夫四
体不劳则血气留滞。心志烦苦则中气内伤。膏粱华食则脾胃有亏。放纵淫欲则精血耗竭。是以热中消中。多生于富贵之
人。如不丰美其食。是不合其心。留中之病。宜于上下分消。若禁芳草石药。故病不能愈。）岐伯曰。夫芳草之气美。
石药之气悍二者其气急疾坚劲。故非缓心和人。不可以服此二者。（芳草者。其气急疾于馨散。石药者。其性坚劲于下沉。
故非中心和缓之人。服之则中气易于虚散也。）帝曰。不可以服此二者。何以然。岐伯曰。夫热气 悍。药气亦然。二者
相遇。恐内伤脾。脾者土也。而恶木。服此药者。至甲乙日更论。（此言腹中之气。脾所主也。和柔敦化。土之德也。热
中消中。有虚有实。皆为热气留中。若更服芳香悍热之药。二者相遇。则内伤中和之脾土矣。脾病者。加于甲乙。至甲
乙日。恐有胜克之变。故至期更当别论也。）帝曰。善。有病膺肿颈痛。胸满腹胀。此为何病。何以得之。岐伯曰。名
厥逆。（以下三节。复申明腹中之气与血焉。腹气者。脾气也。内主于腹。外主于肌。与手足三阴三阳之气不同也。腹中
之血者。起于胞中。散于脉外。与十二经脉之血不同也。是以腹中之气血虚脱。则为消中之虚胀。腹中之血
裹气伤。皆为有余之伏梁。今复论腹中之气。反厥逆于上。则为膺颈胸腹之肿痛满胀。下节论腹中之血气和平。则
为怀子之且生。末节论三阳之气。反下入于阴。则为腹中之 胀。当知血气流行。而又各有
所主之部署也。倪冲之曰。胸腹胀满者。因中气厥逆于上而虚胀也。）帝曰。治之奈何。岐伯曰。灸之则喑。石之则狂。
须其气并。乃可治也。帝曰。何以然。岐伯曰。阳气重上。有余于上。灸之则阳气入阴。入则喑。石之。则阳气虚。虚
则狂。须其气并而治之。可使全也。（夫诸阳之气上升。而腹气又厥逆于上。是阳气重上。而有余于上矣。夫阳气陷下则
灸之。今阳盛于上。而反灸之。则阳热之气。反入于经脉之阴则为喑。若以石砭之。则阳气外泄而虚。虚则狂矣。气并
者。血气合并也。须其厥逆之气。与血相并。而后治之。可使全也。张兆璜曰。脾气主于腹中。行于肌肉。乃五脏元
真之气也。冲脉之血。亦从胸中而散于肌腠皮肤之间。故与脾气并合。须其气并者。使气归于肌腠。而与血交并。如石
之则泄于皮肤之外。灸之则逆于经脉之中。）帝曰。善。何以知怀子之且生也。岐伯曰。身有病而无邪脉也。（此论腹中
之血气和平。而有生成之造化也。夫气主生物。血主成物。怀子者。血气之相和也。且生者。谓血气之所以成胎者。虚
系于腹中。而无经脉之牵带。故至十月之期。可虚脱而出。当知月事怀妊之血。在气分而不在经脉也。身有病者。月事
不来也。无邪脉者。血气和平也。杨元如曰。至哉坤元。资生万物。腹中之气。坤土之气也。是以白术补脾。为养胎
之圣药。冲任之血。原于肾藏之精。阳主施化。阴主成形。是以归芎熟地。乃胎产之神方。）帝曰。病热而有所痛者何也。
岐伯曰。病热者。阳脉也。以三阳之动也。人迎一盛少阳。二盛太阳。三盛阳明。入阴也。夫阳入于阴。故病在头与腹。
乃胀而头痛也。帝曰。善。（此言三阳之气。主于形身之表。如下入于阴中。则为腹胀矣。夫病热者。阳脉盛也。阳脉
盛者。三阳之气动之也。是以人迎之脉。一盛盛在少阳之气。二盛盛在太阳之气。三盛盛在阳明之气。三阳俱盛。当主
病热头疼。腹为阴。阴中之至阴。脾也。如阳入于阴。又当病在头与腹。乃 胀而头痛也。盖言表里阴阳之气。各有所
主之部署。如阴气厥逆于上。则为膺颈肿痛。阳气下入于阴中。则为腹中 胀也。莫仲超曰。伯言病热者。阳脉也。
以三阳之动也。谓阳脉之盛。乃三阳之气动之。兼申明阳入于阴。乃是三阳之气。而非三阳之经脉也。伤寒论曰。脏腑
相连。邪高痛下。此言经病于表阳之上。而下连于里阴。经脉上下相连。故病在上而痛在下也。当知病在经脉。而随经
下入于里阴者。则痛而不胀。此病在气分。而阳气下入于腹中。故胀而不痛也。）
黄帝问道：有一种病，表现为心口和腹部胀满，早上吃了饭，晚上就不能再吃。这是什么病？（这一篇讨论的病证，外在不涉及形体身躯，内在不关乎脏腑实质，而是位于子宫和腹腔的空廓之中。无论是气、血，还是风、热邪气，乃至女子的妊娠，都发生在空腹的腔隙中，所以这篇名为《腹中论》。黄帝说：所谓心腹满，是指胸膈之间是心主的宫城，腹部是脏腑的外郭。）岐伯回答说：这种病名叫鼓胀。（鼓胀，就像鼓皮一样中空膨胀。这是因为脾土之气虚弱，不能磨化谷物，导致早上吃了饭，晚上就不能消化进食，从而引起虚胀如鼓的症状。）黄帝说：怎么治疗呢？岐伯说：用鸡矢醴来治疗，服一剂见效，服两剂痊愈。（鸡矢，取鸡屎上面的白色部分，这是鸡的精气所在。鸡属阳明秋金，在八卦中配属巽风木。这是因为脾土运化艰难，导致胀满不食，风木制约并转化土气，阳明燥金与太阴湿土相合。醴是熟谷的液体，用稻米酿造，用稻秆炊煮，主要补益中焦脾胃之气，并先行作用于营卫之气。所以服一剂后腹中温和，服两剂病就好了。张兆璜说：鸡在寅酉之时鸣叫，鸣叫前先振动翅膀，这是风木之象。大概是木击打金而后鸣叫。另有说法说：羽虫没有肺，所以没有前阴，屎中的白色部分是精气。）黄帝说：这种病有时复发，是什么原因呢？岐伯说：这是因为饮食不节制，所以时常发病。虽然如此，但在病情即将好转的时候，如果立即进食，就会导致病气积聚在腹部。（饮食不节制，就会再次损伤脾脏，所以时常复发。或者虽然不是饮食不节制，但在病情将愈之时就进食，就会导致病气聚于腹部，这是深深告诫要谨慎节制饮食。）
黄帝问道：有一种病，表现为胸胁部支撑胀满，妨碍进食，发病时先闻到腥臊臭味，流出清稀液体，先唾血，四肢发冷，目眩，时常大小便出血。这是什么病？是怎么得的？（上一节论述的是腹中气虚，病位在脾；这一节论述的是腹中血脱，所伤在肝。血是中焦水谷的汁液，其中精华部分运行于经络隧道，成为经脉之血；其流溢于体内的，注入肾脏成为精，又奉心化赤成为血；从胞中注入冲脉，沿腹部上行，至胸部散开，充盈皮肤，温暖肌肉，淡渗于皮肤而生毫毛。卧睡时回归藏于肝脏，醒来时随卫气重新运行于皮肤的气分。男子联络唇口而生胡须，女子按时下行成为月经。这就是流溢于体内、布散于体外的血。因此，当这种血虚脱时，肝气大伤，出现胸胁支撑胀满，这是肝虚而胀满。食物进入胃，精微散布于肝，肝气受伤，所以妨碍进食。肝的气味是臊，肺的气味是腥。如果不能淡渗皮毛则肺虚，无所归藏于肝则肝虚。肝肺两虚，所以发病时先闻到腥臊臭味。肺气虚，流出清液；肝脏虚，先唾血。不能充盈皮肤温暖肌肉则四肢冷。肝开窍于目，所以目眩。肝主疏泄，时常大小便出血，是因为肝无所藏而虚泄。）岐伯说：这种病名叫血枯。这是在年轻时，有过大量失血，或者醉酒后行房事，导致气竭肝伤，所以月经衰少甚至不来。（有大量失血会伤肝，肝受伤，在女子就会导致月经衰少不来。醉酒入房，在男子会伤精，精伤则无法化赤为血。气生于精血，精血虚脱则气竭。杨元如说：《伤寒论》中热入血室，刺肝经的期门穴。本经说肝伤，所以月经衰少。女子的月经，发源于胞中，上行于冲任二脉，布散于皮毛，归藏于肝脏，然后下行成为月经。）
黄帝说：怎么治疗呢？用什么方法？（问用什么药治疗，用什么法补救。）岐伯说：用四份乌贼骨和一份茜草，两味药混合，用雀卵做丸，大小如小豆。每次服五丸，作为饭后服，用鲍鱼汁送服，以通利肠道及修复肝脏损伤。（“茹”同“茜”，应作“茜”。乌贼骨，是乌贼鱼的骨。乌贼形状像胞囊，腹中有墨，脊上只生一根骨头，轻脆如通草。乌是肾的颜色，骨是肾所生，主要补益肾脏的精血。茜草一名地血，汁液可染成红色，颜色紫赤，藤蔓中空通透，是生血通经的草药。鱼类是水生动植物，属阴中之阳，血中之气。所以用四份乌贼骨，是为了布散于四肢。血由中焦生成，用一份茜草，主要是为了在中焦生聚气血。飞行的动物主气，潜水的动物主血，卵白主气，卵黄主血。雀是羽虫，用雀卵做丸，是因为气竭肝虚，补血的同时也要补气。豆类是肾之谷，五是土之数。气血都由中焦生成，所以适合饭后服用约五粒豆大小的药丸。鲍鱼味咸气臭，主要引导下行，所以饮鲍鱼汁以通利肠道，然后补益肝脏的损伤。另外考证，《甲乙经》中“茹”写作“茹”。）
黄帝问道：有一种病，表现为少腹部坚硬胀满，上下左右都有根脚，这是什么病？可以治吗？岐伯说：这种病名叫伏梁。（盛，即满。少腹，指脐下部位。上下左右都有根脚，说明病在血分，有脉络联系于上下四旁。伏梁，像横梁一样横伏在体内。按：上两节论述气血的虚胀，这两节论述血气的实胀。）黄帝说：伏梁是怎么得的？岐伯说：包裹着大量的脓血，居住在肠胃之外，不可治愈，治疗时如果切按会导致死亡。（裹大，像袋子包裹物体而变大。居肠胃之外，在空廓之间。不可治，是指不能用按摩治疗。如果急切想要它解散而进行按摩，必然导致疼痛欲死。因为是有形的邪气，不易消散。）黄帝说：为什么这样？岐伯说：向下则会因阴部而下脓血，向上则会压迫胃脘，产生膈间夹胃脘的内痈。（此下，指少腹的前后二阴。冲脉起于胞中，伴足阳明经，挟脐左右，沿腹部上行。这是因为阴部必下脓血，循经而上，则压迫到胃脘，产生膈间夹胃脘的内痈，导致留积脓血于肠胃之外，像袋子包裹一样大。张兆璜说：胃脘正当膈间，所谓膈挟胃脘内痈，是指痈生于膈胃之间，乃在胃外的膜原，而不是胃上。朱圣公说：这是热中的病，所以在阴部则下脓血，在上部则压迫产生胃痈。）这是久病，难治。病灶在脐上为逆证，在脐下为顺证。（齐，同脐。久病，是指痈生于膈胃之间，病人不觉察，所以痈脓逐渐积聚于腹中，形成包裹状的大肿块。脐上是腹中的气分，所以为逆。脐下是胞中的血分，易于排泄，所以为顺。）不要动用手术或急攻，相关论述在《刺法》中。（勿动，指不可按摩引动。亟，急也。意思是应当急迫地迎而夺之以泻之。其针刺方法，使用圆利针，末端稍大，身部稍细，以便深纳以取出痈痹。这论述在《针经》的刺法中。）
黄帝问道：人有身体、大腿和小腿都肿胀，环绕肚脐疼痛，这是什么病？岐伯说：这种病名叫伏梁，这是风邪的根本。（这一节论述邪气留滞气分而为伏梁。气运行于肌腠之间，所以身体、大腿和小腿都肿胀。风为阳邪，伤害人体阳气，这种风邪伤气，而留滞于脐腹之间，所以叫作风根。）风气溢于大肠，而附着于肓。肓的原气在脐下，所以环绕肚脐疼痛。（肓音荒。大肠，指大肠之外，空廓之间。风邪之气，充溢于大肠之外，而留着于肓。肓即膏肓，属于膜原一类。肓的原气，出于脖胦，正在脐下，所以绕脐疼痛。）不可动用它，动了就会造成水肿、小便涩痛的病。（不可动，指不可妄加攻伐以扰动它。因为风邪的根本，留滞于脐下，动它则风气淫佚，而鼓动水液。水液溢于上，则小便不利。）
黄帝说：先生多次说热中、消中病，不可服用膏粱厚味、芳草和石药。石药使人发癫，芳草使人发狂。（热中，指脓血风邪留滞于中而产生热。消中，指气虚血脱，而产生消中的虚满。膏粱，指浓味食物。芳草，指芳香的草。石药，指金石类药物。芳草之气，升散为阳，所以令人发狂。金石之药，沉重为阴，所以令人发癫。）那些患热中、消中的人，都是富贵之人。现在禁止他们吃膏粱，不合他们的心意；禁止他们吃芳草石药，病又不能好。希望听听其中的道理。（富贵之人，形体安逸而意志劳苦，饮食华丽而放纵淫欲。四肢不劳动则血气留滞，心志烦苦则中气内伤。膏粱华食则脾胃亏损，放纵淫欲则精血耗竭。所以热中消中，多生于富贵之人。如果不丰富他们的饮食，是不合他们的心意。留中之病，宜于上下分消。如果禁止芳草石药，所以病不能愈。）岐伯说：芳草的气味美，石药的气味悍烈，这两种药的气机急疾坚劲。所以如果不是心情平缓柔和的人，不可以服用这两种药。（芳草者，其气急疾于馨散；石药者，其性坚劲于下沉。所以不是内心平和舒缓的人，服用它们则中气容易虚散。）黄帝说：不可以服用这两种药，为什么呢？岐伯说：热气悍烈，药气也是这样，两者相遇，恐怕内伤脾脏。脾属土，而恶木。服用这些药的人，到了甲乙日需要另行讨论。（这里说的是腹中的气，由脾所主。和柔敦化，是土的德行。热中消中，有虚有实，都是热气留滞于中。如果再服用芳香悍热的药，两者相遇，则内伤中和的脾土。脾病者，加重于甲乙日。到了甲乙日，恐怕有胜克的变化，所以届时应当另行讨论。）
黄帝说：好。有一种病，表现为胸部肿胀，颈部疼痛，胸满腹胀，这是什么病？是怎么得的？岐伯说：名叫厥逆。（以下三节，再次申明腹中的气与血。腹气，是脾气，内主于腹，外主于肌，与手足三阴三阳之气不同。腹中之血，起于胞中，散于脉外，与十二经脉之血不同。因此腹中的气血虚脱，则为消中的虚胀；腹中的血裹气伤，皆为有余的伏梁。现在又论述腹中的气，反逆于上，则为膺颈胸腹的肿痛满胀。下一节论述腹中的血气和平，则为怀孕将要生产。末节论述三阳之气，反下入于阴，则为腹中的胀满。应当知道血气流行，而又各有其所主的部署。倪冲之说：胸腹胀满，是因为中气厥逆于上而虚胀。）黄帝说：怎么治疗？岐伯说：用灸法则失音，用砭石法则发狂。必须等到气并，才可以治疗。黄帝说：为什么？岐伯说：阳气重聚于上，有余于上。用灸法则阳气入阴，入阴则失音。用砭石法则阳气虚，虚则发狂。必须等到气并而治之，可以使病痊愈。（诸阳之气上升，而腹气又厥逆于上，这是阳气重上，而有余于上。阳气陷下则灸之，现在阳盛于上，反而灸之，则阳热之气，反入于经脉之阴则为失音。如果用石砭之，则阳气外泄而虚，虚则发狂。气并，指血气合并。必须等到厥逆之气，与血相并，而后治之，可以使病痊愈。张兆璜说：脾气主于腹中，行于肌肉，是五脏元真之气。冲脉之血，也从胸中散于肌腠皮肤之间，所以与脾气并合。所谓气并，是使气归于肌腠，而与血交并。如果用石砭之，则泄于皮肤之外；用灸之，则逆于经脉之中。）
黄帝说：好。怎么知道怀孕的人快要生产了？岐伯说：身体有病象但没有邪脉。（这一节论述腹中的血气和平，而有生成的造化。气主生物，血主成物。怀孕，是血气相和。将要生产，是指血气之所以成胎，虚系于腹中，而没有经脉的牵带，所以到十个月的期限，可以虚脱而出。应当知道月经和怀孕的血，在气分而不在经脉。身有病，指月经不来。无邪脉，指血气和平。杨元如说：坤元伟大，资助万物生长。腹中的气，是坤土之气。所以白术补脾，是养胎的圣药。冲任之血，源于肾脏之精。阳主施化，阴主成形。所以归芎熟地，是胎产的神方。）
黄帝说：患热病并且伴有疼痛，是什么情况？岐伯说：患热病，是阳脉的表现，因为三阳之气发动。人迎脉盛大一分是少阳，二分是太阳，三分是阳明。阳气入于阴。阳入于阴，所以病在头部和腹部，于是胀满而头痛。黄帝说：好。（这里说三阳之气，主于形身之表，如下入于阴中，则为腹胀。患热病，是阳脉盛。阳脉盛，是三阳之气发动所致。所以人迎之脉，大一倍盛在少阳之气，大二倍盛在太阳之气，大三倍盛在阳明之气。三阳俱盛，应当主病热头疼。腹为阴，阴中之至阴是脾。如果阳入于阴，又当病在头与腹，于是胀满而头痛。大概意思是表里阴阳之气，各有所主的部署。如阴气厥逆于上，则为膺颈肿痛；阳气下入于阴中，则为腹中胀满。莫仲超说：岐伯说病热者是阳脉，因为三阳之动。谓阳脉之盛，乃三阳之气发动所致。兼申明阳入于阴，乃是三阳之气，而非三阳之经脉。《伤寒论》说：脏腑相连，邪高痛下。这里说经病于表阳之上，而下连于里阴，经脉上下相连，所以病在上而痛在下。应当知道病在经脉，而随经下入于里阴者，则痛而不胀。此病在气分，而阳气下入于腹中，故胀而不痛。）
Yellow Emperor asked, saying: There is a disease characterized by fullness and distension in the heart and abdomen. After eating in the morning, one cannot eat in the evening. What is this disease? (This chapter discusses pathologies that do not involve the external form or body, nor relate to the internal Zang-Fu organs, but exist within the empty spaces of the uterus and abdominal cavity. Whether it is Qi, Blood, Wind, or Heat pathogens, or even female pregnancy, all occur within these empty cavities; hence the chapter is named "Lun Yu Fu Zhong" [Discussion on Abdominal Interior]. The Yellow Emperor said: By "heart and abdominal fullness," I refer to the chest and diaphragm as the palace city of the Heart Master, and the abdomen as the outer wall of the Zang-Fu organs.)
Qi Bo replied, saying: It is named "Gu Zhang" [Drum Distension] (Drum Distension refers to an empty swelling like a drum skin. This occurs because the Qi of Spleen Earth is deficient and unable to grind and digest grains, leading to the inability to eat in the evening after eating in the morning, resulting in a deficiency-type distension resembling a drum.)
The Yellow Emperor asked, saying: How should it be treated?
Qi Bo replied, saying: Treat it with Ji Shi Li [Chicken Dropping Sweet Wine Decoction]. One dose brings improvement; two doses bring recovery. (Ji Shi refers to taking the white part found on chicken droppings, which is considered the essence of the chicken. The chicken belongs to Yangming Autumn Metal and corresponds to Xun Wind Wood in the Bagua. This pathology arises because Spleen Earth finds transportation and transformation difficult, leading to distension and anorexia. Wind Wood controls and transforms Earth Qi, while Yangming Dryness combines with Taiyin Dampness. Li is a liquid made from cooked grains, brewed with rice and cooked with rice straw. It primarily tonifies Middle Jiao Earth Qi and acts first on Ying and Wei Qi. Thus, after one dose, the abdomen becomes warm; after two doses, the disease resolves. Zhang Zhaohuang stated: Cocks crow at Yin and You hours, flapping their wings before crowing, which is the image of Wind Wood. It is said that Wood strikes Metal before crowing. Another view states: Feathered creatures lack lungs and thus have no anterior yin opening; the white substance in their feces is essence.)
The Yellow Emperor asked, saying: Why does this disease sometimes recur?
Qi Bo replied, saying: This is due to irregular diet, hence the occasional recurrence. Although so, when the disease is about to resolve, if food is consumed immediately, pathological Qi will accumulate in the abdomen. (Irregular diet re-injures the Spleen, causing occasional recurrences. Or, even without irregular diet, consuming food when the disease is near resolution causes pathological Qi to gather in the abdomen. This serves as a deep warning to exercise caution in dietary regulation.)
The Yellow Emperor asked, saying: There is a disease characterized by support-like fullness in the chest and hypochondrium, interfering with eating. At onset, the patient first smells fishy and rank odors, secretes clear fluid, expectorates blood first, experiences cold limbs, dizziness, and frequent bleeding from both upper and lower orifices. What is this disease? How is it contracted? (The previous section discussed deficiency of Qi in the abdominal interior, with pathology in the Spleen. This section discusses depletion of Blood in the abdominal interior, with injury to the Liver. Blood is the juice of water and grain from the Middle Jiao. Its refined portion travels through the meridians to become meridian Blood. The portion overflowing internally enters the Kidney to become Essence, then ascends to the Heart to transform into red Blood. From the Bao Zhong [Uterus], it enters the Chong Mai [Penetrating Vessel], travels up along the abdomen, disperses in the chest, fills the skin, warms the flesh, seeps淡ly into the skin to generate hair. During sleep, it returns to store in the Liver; upon waking, it travels with Wei Qi through the Qi aspect of the skin. In men, it connects to the lips and mouth to grow beard; in women, it descends monthly to become menstruation. This is the Blood that overflows internally and distributes externally. Therefore, when this Blood is depleted, Liver Qi is severely injured, causing support-like fullness in the chest and hypochondrium—this is Liver deficiency causing distension. Food enters the Stomach, and its essence scatters to the Liver. If Liver Qi is injured, eating is hindered. The odor of the Liver is rank (Sao); the odor of the Lung is fishy (Xing). Inability to seep淡ly into the skin and hair indicates Lung deficiency; failure to return and store in the Liver indicates Liver deficiency. With both Liver and Lung deficient, the patient smells fishy and rank odors at onset. Lung Qi deficiency leads to secretion of clear fluid; Liver deficiency leads to expectoration of blood. Inability to fill the skin and warm the flesh leads to cold limbs. The Liver opens into the eyes, hence dizziness. The Liver governs free flow; frequent bleeding from upper and lower orifices indicates the Liver fails to store and leaks due to deficiency.)
Qi Bo replied, saying: The disease is named "Xue Ku" [Blood Dryness/Depletion]. This results from having suffered major blood loss in youth, or from sexual intercourse while intoxicated, leading to exhaustion of Qi and injury to the Liver, causing menstrual flow to diminish or cease. (Major blood loss injures the Liver. When the Liver is injured, in women, menstrual flow diminishes or ceases. Intoxicated intercourse injures Essence in men; damaged Essence cannot transform into red Blood. Qi is generated from Essence and Blood; depletion of Essence and Blood leads to Qi exhaustion. Yuan Ru Yang stated: In the Shang Han Lun, for Heat entering the Blood Chamber, one punctures the Qi Men point of the Liver Meridian. This classic states Liver injury causes diminished menstruation. Women's menstruation originates in the Bao Zhong, ascends via the Chong and Ren Mai, distributes to the skin and hair, stores in the Liver, and then descends as menstruation.)
The Yellow Emperor asked, saying: How should it be treated? What method should be used? (Asking what medicine treats it and what method rescues it.)
Qi Bo replied, saying: Use Si Wu Gu Yi Ru Wan [Four Parts Cuttlebone and One Part Qiancao Pill]. Combine four parts Wu Gu [Cuttlebone] and one part Ru [Qiancao/Cyan Grass]. Form pills using Sparrow Eggs, sized like small beans. Take five pills as a post-meal dose, washed down with Bao Yu Zhi [Abalone Juice] to benefit the intestines and heal liver injury. ("Ru" is synonymous with "Qian". Wu Gu is the bone of the cuttlefish. The cuttlefish resembles a sac, contains ink in its abdomen, and has a single light, brittle bone on its spine. "Wu" (black) is the color of the Kidney; bone is produced by the Kidney, primarily tonifying Kidney Essence and Blood. Qiancao, also known as Di Xue [Earth Blood], has juice that dyes crimson, is purple-red, and has hollow, creeping vines; it is a herb that generates Blood and unblocks meridians. Fish are aquatic animals, belonging to Yang within Yin, and Qi within Blood. Thus, four parts Cuttlebone are used to distribute to the four limbs. Blood is generated in the Middle Jiao; one part Qiancao is used to primarily generate and gather in the Middle Jiao. Flying creatures govern Qi; swimming creatures govern Blood; egg white governs Qi; egg yolk governs Blood. Sparrows are feathered creatures; using sparrow eggs addresses Qi exhaustion and Liver deficiency by tonifying Blood and Qi simultaneously. Beans are the grain of the Kidney; five is the number of Earth. Since Qi and Blood are generated in the Middle Jiao, they are suitable for post-meal administration of approximately five bean-sized pills. Abalone juice is salty and foul-smelling, guiding downward; thus, drinking abalone juice benefits the intestines, followed by healing the Liver injury. Note: The Jia Yi Jing writes "Ru" as "Ru".)
The Yellow Emperor asked, saying: There is a disease where the lower abdomen is firm and full, with roots extending up, down, left, and right. What is this disease? Is it treatable?
Qi Bo replied, saying: The disease is named "Fu Liang" [Hidden Beam]. (Sheng means fullness. Lower abdomen refers to below the navel. Roots extending in all directions indicate the pathology is in the Blood aspect, with meridians connecting up, down, left, and right. "Fu Liang" implies something lying hidden inside like a beam. Note: The previous two sections discussed deficiency distension of Qi and Blood; these two sections discuss excess distension of Blood and Qi.)
The Yellow Emperor asked, saying: How is Fu Liang contracted?
Qi Bo replied, saying: It wraps large amounts of pus and blood, residing outside the intestines and stomach. It is untreatable; treatment involving pressing or kneading can cause death. (Large wrapping refers to being wrapped like a bag and enlarged. Residing outside the intestines and stomach means it is in the empty spaces. Untreatable means it cannot be treated with massage. If one urgently attempts to disperse it via massage, it will inevitably cause severe pain and desire for death, as有形 [formative] pathogens are difficult to dissipate.)
The Yellow Emperor asked, saying: Why is this so?
Qi Bo replied, saying: Downward, it will cause pus and blood to discharge from the yin orifices; upward, it will press against the epigastrium, generating an internal abscess between the diaphragm and the epigastrium. (This downward aspect refers to the anterior and posterior yin orifices of the lower abdomen. The Chong Mai originates in the Bao Zhong, runs alongside the Foot-Yangming, flanks the navel left and right, and ascends along the abdomen. Because yin orifices must discharge pus and blood, ascending along the meridian presses against the epigastrium, generating an internal abscess between the diaphragm and epigastrium, leading to accumulated pus and blood outside the intestines and stomach, wrapped like a bag. Zhang Zhaohuang stated: The epigastrium lies exactly at the diaphragm level. "Internal abscess between diaphragm and epigastrium" means the abscess forms between the diaphragm and stomach, in the membrane origin outside the stomach, not in the stomach itself. Zhu Shenggong stated: This is a disease of "Re Zhong" [Heat in the Middle]; thus, in the yin aspect it discharges pus and blood, and upward it presses to generate a stomach abscess.) This is a chronic disease and difficult to treat. If located above the navel, it is a adverse prognosis (Ni); if below the navel, it is a favorable prognosis (Cong). (Qi is synonymous with Navel. Chronic disease refers to an abscess forming between the diaphragm and stomach, unnoticed by the patient, allowing pus to gradually accumulate in the abdomen, forming a large wrapped mass. Above the navel is the Qi aspect of the abdomen, hence adverse. Below the navel is the Blood aspect of the Bao Zhong, which is easier to drain, hence favorable.) Do not manipulate or urgently deplete. Discussion is found in the "Ci Fa" [Needling Methods] chapter. (Do not manipulate means do not use massage to agitate. Ji means urgent. It means one should urgently meet and deplete it to drain it. The needling method uses a Yuan Li Zhen [Round Sharp Needle], slightly larger at the tip and smaller in the shaft, allowing deep insertion to extract abscess and bi-syndrome. This discussion is in the needling methods of the Zhen Jing [Classic of Acupuncture].)
The Yellow Emperor asked, saying: A person has swelling in the body, thighs, and calves, with pain circling the navel. What is this disease?
Qi Bo replied, saying: The disease is named Fu Liang. This is the root of Wind. (This section discusses pathogens lingering in the Qi aspect causing Fu Liang. Qi circulates between muscle clefts, hence swelling in the body, thighs, and calves. Wind is a Yang pathogen injuring Yang Qi. This Wind pathogen injures Qi and lingers in the umbilical-abdominal region, hence called the root of Wind.) The Qi overflows into the Large Intestine and attaches to Huang [Gao Huang]. The source of Huang is below the navel, hence pain circling the navel. (Huang sounds like 'huang'. Large Intestine here refers to outside the Large Intestine, in the empty spaces. Wind pathogen Qi overflows outside the Large Intestine and lingers in Huang. Huang is Gao Huang, belonging to the membrane origin. The source of Huang emerges from Bo Yang, directly below the navel, hence periumbilical pain.) It must not be manipulated; manipulation will lead to edema and dysuria. (Do not manipulate means do not blindly attack or agitate it. Since the root of the Wind pathogen lingers below the navel, agitating it causes Wind Qi to scatter and stir Water. Water overflowing upward leads to difficult urination.)
The Yellow Emperor said: Master has often said that patients with Re Zhong [Heat in the Middle] and Xiao Zhong [Consumption in the Middle] cannot take Gao Liang [rich foods], Fang Cao [aromatic herbs], or Shi Yao [mineral drugs]. Mineral drugs cause Dian [mania/depression], and aromatic herbs cause Kuang [madness]. (Re Zhong refers to pus, blood, and wind pathogens lingering in the middle generating heat. Xiao Zhong refers to Qi deficiency and Blood depletion causing consumption-type fullness. Gao Liang refers to rich flavors. Fang Cao refers to aromatic herbs. Shi Yao refers to metallic and mineral drugs. The Qi of aromatic herbs is ascending and dispersing, Yang in nature, thus causing madness. Metallic/mineral drugs are heavy and Yin in nature, thus causing dian.) Those with Re Zhong and Xiao Zhong are all wealthy people. Now, forbidding Gao Liang goes against their desires; forbidding Fang Cao and Shi Yao prevents cure. I wish to hear the explanation. (Wealthy people have comfortable bodies but distressed minds, luxurious diets, and indulgent lust. Lack of physical labor causes stagnation of Qi and Blood; mental distress injures Middle Qi. Rich diets impair Spleen and Stomach; indulgent lust depletes Essence and Blood. Thus, Re Zhong and Xiao Zhong often arise in wealthy people. Not enriching their diet contradicts their wishes. Pathogens lingering in the middle should be dispersed up and down. If Fang Cao and Shi Yao are forbidden, the disease cannot be cured.)
Qi Bo replied, saying: The Qi of Fang Cao is beautiful, and the Qi of Shi Yao is fierce. Both have urgent, rapid, firm, and strong properties. Therefore, unless one has a calm and gentle mind, one should not take these two types of drugs. (Fang Cao has Qi that is urgent and rapidly dispersing; Shi Yao has nature that is firm and sinking. Therefore, those without a peaceful and relaxed inner state will easily suffer deficiency and dispersion of Middle Qi if they take them.)
The Yellow Emperor asked, saying: Why can they not take these two types?
Qi Bo replied, saying: Hot Qi is fierce, and drug Qi is likewise. When the two meet, there is fear of internal injury to the Spleen. The Spleen is Earth and dislikes Wood. Those taking these drugs will require further discussion on Jia-Yi days. (This speaks of Qi in the abdomen, governed by the Spleen. Gentle and transformative qualities are the virtue of Earth. Re Zhong and Xiao Zhong can be deficiency or excess, but all involve hot Qi lingering in the middle. If one takes fragrant, fierce, and hot drugs, the meeting of the two will internally injure the harmonious Spleen Earth. Diseases of the Spleen worsen on Jia-Yi days. On Jia-Yi days, one fears overcoming/restriction changes, hence further discussion is needed at that time.)
The Yellow Emperor said: Good. There is a disease characterized by swelling of the chest and neck, fullness of the chest and abdomen. What is this disease? How is it contracted?
Qi Bo replied, saying: It is named "Jue Ni" [Rebellious Counterflow]. (The following three sections reiterate Qi and Blood in the abdominal interior. Abdominal Qi is Spleen Qi, governing the interior abdomen and exterior muscles, distinct from the Qi of the Hand and Foot Three Yin and Three Yang meridians. Blood in the abdominal interior originates in the Bao Zhong and disperses outside the vessels, distinct from Blood in the Twelve Primary Meridians. Therefore, depletion of Qi and Blood in the abdominal interior leads to consumption-type deficiency distension; injury to Blood wrapping Qi leads to excess Fu Liang. Now discussing Abdominal Qi rebelling upward leads to swelling, pain, fullness, and distension in the chest, neck, and abdomen. The next section discusses harmonious Blood and Qi in the abdominal interior leading to impending childbirth. The final section discusses Three Yang Qi descending into Yin leading to abdominal distension. One must understand that while Qi and Blood circulate, they each have specific domains. Ni Chongzhi stated: Chest and abdominal fullness is due to Middle Qi rebelling upward causing deficiency distension.)
The Yellow Emperor asked, saying: How should it be treated?
Qi Bo replied, saying: Moxibustion causes aphonia; stone lancets cause madness. One must wait for Qi to merge before treating.
The Yellow Emperor asked, saying: Why?
Qi Bo replied, saying: Yang Qi heavily accumulates upward, being excessive in the upper body. Moxibustion causes Yang Qi to enter Yin; entering Yin causes aphonia. Stone lancets cause Yang Qi to become deficient; deficiency causes madness. Treating only when Qi merges can ensure complete recovery. (All Yang Qi ascends, and abdominal Qi rebels upward; this is Yang Qi heavily accumulating and being excessive in the upper body. Yang Qi sinking requires moxibustion; now Yang is excessive upward, and moxibustion is applied inversely, causing Yang-Heat Qi to reverse into the Yin aspect of the meridians, resulting in aphonia. If stone lancets are used, Yang Qi escapes externally and becomes deficient; deficiency leads to madness. Qi merging refers to the merger of Blood and Qi. One must wait for the rebellious Qi to merge with Blood before treating, ensuring complete recovery. Zhang Zhaohuang stated: Spleen Qi governs the abdominal interior and moves through muscles; it is the Yuan Zhen Qi of the Five Zang. Blood of the Chong Mai also disperses from the chest into muscle clefts and skin, thus combining with Spleen Qi. "Waiting for Qi to merge" means allowing Qi to return to the muscle clefts and merge with Blood. If stone lancets are used, it drains to the outside of the skin; if moxibustion is used, it reverses into the meridians.)
The Yellow Emperor said: Good. How does one know that a pregnant woman is about to give birth?
Qi Bo replied, saying: The body shows signs of illness, but the pulse lacks evil characteristics. (This section discusses the harmony of Blood and Qi in the abdominal interior, possessing the creative power of generation. Qi generates life; Blood forms matter. Pregnancy is the harmony of Blood and Qi. Impending birth means the Blood and Qi that formed the fetus are loosely held in the abdominal interior without meridian traction, allowing delivery at the ten-month term. One must understand that menstrual and pregnancy Blood resides in the Qi aspect, not the meridians. "Body shows signs of illness" refers to amenorrhea. "Pulse lacks evil" refers to harmonious Blood and Qi. Yuan Ru Yang stated: Kun Yuan is profound, nourishing all things. Abdominal Qi is Kun Earth Qi. Hence Bai Zhu tonifies Spleen and is the holy medicine for nourishing the fetus. Blood of the Chong and Ren Mai originates from Kidney Essence. Yang governs transformation; Yin governs formation. Hence Gui Xin Shu Di [Angelica, Ligusticum, Rehmannia] is the divine formula for fetal production.)
The Yellow Emperor asked, saying: In febrile diseases accompanied by pain, what is the situation?
Qi Bo replied, saying: Febrile diseases manifest in Yang pulses, driven by the movement of the Three Yang. If the Ren Ying pulse is盛大 (excessive) by one degree, it is Shaoyang; by two degrees, Taiyang; by three degrees, Yangming. Yang enters Yin. Since Yang enters Yin, the disease affects the head and abdomen, causing distension and headache.
The Yellow Emperor said: Good. (This states that Three Yang Qi governs the exterior of the form and body; if descending into Yin, it causes abdominal distension. Febrile disease indicates盛 [excess] Yang pulse. Excess Yang pulse is driven by the movement of Three Yang. Thus, the Ren Ying pulse, one degree excess, indicates Shaoyang Qi excess; two degrees, Taiyang Qi excess; three degrees, Yangming Qi excess. When Three Yang are all excess, it should primarily indicate febrile disease and headache. The abdomen is Yin; the extreme Yin within Yin is the Spleen. If Yang enters Yin, disease affects head and abdomen, causing distension and headache. Generally, Exterior-Interior and Yin-Yang Qi have specific domains. If Yin Qi rebels upward, it causes chest/neck swelling and pain; if Yang Qi descends into Yin, it causes abdominal distension. Mo Zhongchao stated: Qi Bo says febrile disease involves Yang pulses due to Three Yang movement. The excess of Yang pulses is driven by Three Yang Qi, clarifying that Yang entering Yin refers to Three Yang Qi, not merely Three Yang meridians. The Shang Han Lun states: Zang-Fu are connected; pathogen high, pain low. Here, meridian disease on the exterior Yang upper part connects downward to interior Yin. Meridians connect up and down, hence disease above causes pain below. One must understand that disease in meridians descending into interior Yin causes pain without distension. This disease is in the Qi aspect, with Yang Qi descending into the abdomen, hence distension without pain.)