黄帝问曰。足阳明之脉病。恶人与火。闻木音则惕然而惊。钟鼓不为动。闻木音而惊。何也。愿闻其故。（此篇论阳
明乃阳热之经。病则热盛而为狂也。阴阳系日月论曰。寅者。正月之生阳也。主左足之少阳。未者六月。主右足之少阳。
卯者二月。主左足之太阳。午者五月。主右足之太阳。辰者三月。主左足之阳明。巳者四月。主右足之阳明。此两阳合
于前。故曰阳明。是阳明乃三阳合并。阳热独盛之经矣。夫三部九候之道。总不外于脏腑阴阳。血气虚实。是以通评虚
实论曰癫疾。曰厥狂。曰痫惊。盖癫疾者。三阴之实证也。厥狂者。三阳之热狂也。痫惊者。阴阳五行之实邪也。是以
此篇复论其阳盛之狂焉。朱永年曰。五脏六腑。十二经脉。皆藉阳明水谷之所资生。病则阳热盛而津液竭矣。）岐伯对曰。
阳明者。胃脉也。胃者土也。故闻木音而惊者。土恶木也。（伯言阳明之所以热盛者。乃脉病也。阳明之脉者。乃胃之悍
气。别走阳明。悍热之气盛。则胃腑之气虚。胃者土也。故闻木音而惊者。土恶木也。）帝曰。善。其恶火何也。岐伯曰。
阳明主肉。其脉血气盛。邪客之则热。热甚则恶火。（此言三阳之气。主于皮肤肌腠之间。邪客之而易于为热也。太阳之
气主皮毛。阳明之气主肌肉。少阳之气主胸胁。言三阳之气。主于肤腠气分之间者也。夫邪之中人。始于皮毛。次于肌
肉。以及于经脉。邪在肌腠。则合于阳明气分之阳。入于经脉。而阳明又多血多气。是以邪客之则热。热甚则恶火也。）
帝曰。其恶人何也。岐伯曰。阳明厥则喘而惋。惋则恶人。（此言胃络之上通于心也。惋、惊恐貌。厥气上逆于肺则喘。
逆于心则惊。经言阳气入阴。阴阳相搏则恐。如人将捕之。盖阳明之热。上逆于少阴。阴阳相搏。则恐而恶人也。）帝
曰。或喘而死者。或喘而生者。何也。岐伯曰。厥逆连脏则死。连经则生。（连、谓脏腑经络之相连也。盖手太阴之脉还
循胃。阳明之络通于心。如热邪厥逆于上。干于心肺之经而为喘惋者生。干于心肺之脏则死矣。）帝曰。善。病甚则弃衣
而走。登高而歌。或至不食数日。逾垣上屋。所上之处。皆非其素所能也。病反能者。何也。（此复问其病甚而为狂也。）
岐伯曰。四肢者。诸阳之本也。阳盛则四肢实。实则能登高也。（经言阴者。主脏。阳者主腑。阳受气于四末。阴受气于
五脏。故四肢为诸阳之本。阳盛则四肢实。实则能登高矣。盖阳盛则升。四旁俱盛。故能升高。）帝曰。其弃衣而走者
何也。岐伯曰。热盛于身。故弃衣欲走也。（阳明之气主肌肉。故热盛于身。身热。故弃衣而走也。伤寒论曰。阳明病外
证云何。答曰。身热汗自出。不恶寒。反恶热也。盖热在外。故不欲衣。）帝曰。其妄言骂詈。不避亲疏而歌者。何也。
岐伯曰。阳盛则使人妄言骂詈。不避亲疏。而不欲食。不欲食。故妄走也。（胃络上通于心。阳盛则心神昏乱。故使人妄
言骂詈。不避亲疏。如热盛于胃。则不欲食。不饮食。故妄走。盖四肢禀气于胃故也。此言热盛于形身之外内上下。而
见证之各有不同焉。以上十一篇。论三部九候之道。各有天。各有地。各有人。有寒热阴阳。有脏腑虚实。故曰。土者。
生万物而法天地。是以末结脾胃之阴阳并交。雌雄输应。而并论阳明之实证焉。）
黄帝问道：足阳明经脉发生病变时，患者厌恶人和火光，听到木器的声音就会惊恐不安，但听到钟鼓的声音却不被惊动。为什么听到木声就惊恐呢？我想听听其中的原因。（这一篇论述阳明经是阳热之经，发病时热势亢盛会导致发狂。《阴阳系日月论》说：寅月是正月，生发的阳气所在，对应左足少阳经；未月是六月，对应右足少阳经；卯月是二月，对应左足太阳经；午月是五月，对应右足太阳经；辰月是三月，对应左足阳明经；巳月是四月，对应右足阳明经。这两股阳气合聚于前面，所以称为阳明。因此，阳明经是三阳经合并、阳热独盛的经脉。关于三部九候诊法的道理，总离不开脏腑、阴阳、气血的虚实变化。所以《通评虚实论》中提到癫疾、厥狂、痫惊等病。其中，癫疾属于三阴经的实证；厥狂属于三阳经的热盛发狂；痫惊属于阴阳五行邪气实盛所致。因此本篇再次论述阳盛导致的发狂病症。朱永年说：五脏六腑和十二经脉，都依赖阳明水谷精微的滋养。一旦生病，就会出现阳热亢盛而津液枯竭的情况。）
岐伯回答说：阳明经是胃的经脉，胃属土。所以听到木声就惊恐，是因为土畏惧木。（张志聪注释说：岐伯的意思是阳明之所以热盛，是因为经脉发生了病变。阳明经脉的气，是胃中悍气别行走向阳明的部分。当这种刚烈热盛之气亢盛时，胃腑本身的正气就会虚弱。因为胃属土，所以听到木声就惊恐，这是五行中土畏木的道理。）
岐伯说：阳明经主管肌肉，它的经脉气血旺盛，邪气侵入就会产生热象，热势严重就会厌恶火光。（张志聪注释说：这里论述三阳之气主要分布在皮肤和肌腠之间，邪气侵入容易化热。太阳经之气主管皮毛，阳明经之气主管肌肉，少阳经之气主管胸胁。这说明三阳之气主要分布在肤腠和气分之间。邪气伤人，始于皮毛，进而进入肌肉，再深入经脉。邪气在肌腠间，会与阳明气分的阳气相合；若进入经脉，由于阳明经多血多气，邪气侵入就容易产生热象，热势严重就会厌恶火光。）
岐伯说：阳明经气逆乱会导致气喘和心中烦闷惊恐，心中烦闷惊恐就会厌恶人。（张志聪注释说：这里论述胃络向上连通于心。惋，指惊恐的样子。逆乱之气上冲于肺则气喘，上冲于心则惊恐。经文说阳气入阴，阴阳相互搏结就会产生恐惧，就像被人追捕一样。这是因为阳明的热邪上逆侵犯少阴，阴阳相互搏结，导致恐惧并厌恶人。）
岐伯说：厥逆之气连及内脏就会死亡，仅连及经脉就能存活。（张志聪注释说：“连”，指脏腑经络相连。手太阴肺经的脉道环绕胃，阳明经的络脉通达于心。如果热邪厥逆向上，干扰心肺的经脉而导致气喘烦闷的，可以存活；如果干扰心肺的脏器，就会死亡。）
黄帝说：讲得好。病情严重时，病人会脱掉衣服奔跑，登上高处唱歌，甚至几天不吃饭，翻越墙垣屋顶。所去的地方，都不是他平时能做到的。病情反而使他具备这些能力，为什么呢？（这是再次询问病情严重到发狂的原因。）
岐伯说：四肢是诸阳经的根本。阳气亢盛则四肢充实有力，充实有力就能登高。（经文说：阴气主司内脏，阳气主司外腑。阳气接受水谷精微于四肢末端，阴气接受于五脏。所以四肢是诸阳经的根本。阳气亢盛则四肢充实，充实就能登高。因为阳气亢盛则上升，身体四周阳气都盛，所以能登高。）
黄帝说：那为什么脱掉衣服奔跑呢？
岐伯说：体内热势亢盛，所以脱掉衣服想要奔跑。（阳明经之气主管肌肉，所以热势充斥全身。身体发热，所以脱掉衣服奔跑。《伤寒论》说：阳明病的外证是什么？回答是：身体发热，自然出汗，不恶寒，反而恶热。因为热邪在体表，所以不想穿衣。）
岐伯说：阳气亢盛会使人胡言乱语、骂人，不分亲疏，并且不想吃东西。不想吃东西，所以胡乱奔跑。（胃络向上连通于心，阳气亢盛则心神昏乱，所以使人胡言乱语、骂人，不分亲疏。如果热邪盛于胃，就会不想吃东西。不进食，所以胡乱奔跑。这是因为四肢禀受胃气的原因。这里论述热邪盛于形体的内外上下，而表现出的症状各有不同。以上十一篇，论述了三部九候诊法的道理，各有天、地、人之应，有寒热阴阳，有脏腑虚实。所以说：土能生化万物并效法天地。因此在结尾处总结脾胃的阴阳交泰、雌雄输注相应，并一同论述阳明经的实证。）
Huangdi asked: When the Foot-Yangming meridian is diseased, the patient dislikes people and fire. Hearing the sound of wood causes them to startle in fear, yet they are not moved by the sound of bells and drums. Why does hearing the sound of wood cause alarm? I wish to hear the reason for this. (This chapter discusses that the Yangming meridian is a channel of yang heat. When diseased, excessive heat leads to mania. The "Lun on Yin-Yang Related to Sun and Moon" states: Yin month corresponds to the first lunar month, representing emerging yang qi, governing the Left Foot-Shaoyang meridian. Wei month corresponds to the sixth lunar month, governing the Right Foot-Shaoyang meridian. Mao month corresponds to the second lunar month, governing the Left Foot-Taiyang meridian. Wu month corresponds to the fifth lunar month, governing the Right Foot-Taiyang meridian. Chen month corresponds to the third lunar month, governing the Left Foot-Yangming meridian. Si month corresponds to the fourth lunar month, governing the Right Foot-Yangming meridian. These two yangs combine at the front, hence it is called Yangming. Thus, Yangming is the meridian where the three yang meridians merge, characterized by exclusive excess of yang heat. The principle of the Three Parts and Nine Probes diagnosis ultimately concerns the zang-fu organs, yin-yang, and the deficiency or excess of blood and qi. Therefore, the "Tong Ping Xu Shi Lun" mentions Dian disease (epilepsy/mania), Jue Kuang (rebellious mania), and Xian Jing (spasmodic fright). Dian disease is an excess syndrome of the three yin meridians; Jue Kuang is heat-induced mania of the three yang meridians; Xian Jing is caused by excess pathogenic factors of yin-yang and the five elements. Hence, this chapter re-discusses mania caused by yang excess. Zhu Yongnian stated: The five zang and six fu organs, along with the twelve meridians, all rely on the nourishment provided by Yangming from food and water. When diseased, yang heat becomes excessive while body fluids are depleted.)
Qibo replied: The Yangming meridian is the stomach meridian. The stomach belongs to Earth. Therefore, hearing the sound of wood causes alarm because Earth fears Wood. (Zhang Zhicong commented: Qibo means that the reason for the excessive heat in Yangming is due to meridian pathology. The qi of the Yangming meridian is the vigorous qi of the stomach that branches off to Yangming. When this fierce and hot qi becomes excessive, the qi of the stomach organ becomes deficient. Since the stomach belongs to Earth, hearing the sound of wood causes alarm, reflecting the Five Elements principle that Earth fears Wood.)
The Emperor said: Well said. Why do they dislike fire?
Qibo said: Yangming governs the flesh/muscles, and its meridian has abundant blood and qi. When pathogens invade, heat is generated. When heat is severe, they dislike fire. (Zhang Zhicong commented: This discusses how the qi of the three yang meridians is primarily located between the skin and muscle interstices, making it prone to generating heat when invaded by pathogens. Taiyang qi governs the skin and hair; Yangming qi governs the muscles; Shaoyang qi governs the chest and hypochondrium. This indicates that the qi of the three yang meridians resides in the superficial layers and qi level. Pathogens attacking humans begin at the skin and hair, then move to the muscles, and finally enter the meridians. When pathogens are in the muscle interstices, they combine with the yang of the Yangming qi level. If they enter the meridians, since Yangming has abundant blood and qi, invasion easily generates heat. Severe heat leads to a dislike for fire.)
The Emperor said: Why do they dislike people?
Qibo said: When Yangming qi rebels, it causes panting and mental distress/fear. Mental distress and fear lead to disliking people. (Zhang Zhicong commented: This discusses the connection between the stomach collaterals and the heart ascending upwards. 'Wan' refers to a look of fear and panic. Rebellious qi rushing up to the lungs causes panting; rushing up to the heart causes fright. The classics state that when yang qi enters yin, and yin and yang contend, fear arises, as if being chased by someone. This is because Yangming heat rebels upward to invade Shaoyin, causing yin and yang to contend, resulting in fear and a dislike for people.)
The Emperor said: Some die from panting, while others survive despite panting. Why?
Qibo said: If the rebellious qi connects to the zang organs, death occurs; if it connects only to the meridians, survival is possible. (Zhang Zhicong commented: "Connect" refers to the linkage between zang-fu organs and meridians. The Hand-Taiyin lung meridian circles around the stomach, and the Yangming collateral connects to the heart. If heat pathogens rebel upward and interfere with the meridians of the heart and lungs, causing panting and distress, the patient will survive. If they interfere with the heart and lung organs themselves, death will occur.)
The Emperor said: Well said. When the disease is severe, the patient discards their clothes and runs, climbs high places and sings, or goes several days without eating, climbing over walls and roofs. They go to places they could never reach under normal circumstances. The illness seemingly gives them these abilities. Why? (This further asks about the cause of mania when the disease is severe.)
Qibo said: The four limbs are the root of all yang meridians. When yang is excessive, the four limbs become solid and strong, enabling one to climb high. (The classics state: Yin governs the zang organs; Yang governs the fu organs. Yang receives qi at the extremities, while yin receives qi in the five zang organs. Thus, the four limbs are the root of all yang meridians. Excessive yang makes the four limbs solid and strong, enabling climbing. Because yang is excessive, it rises; when yang is abundant in all directions, one can ascend heights.)
The Emperor said: Why do they discard their clothes and run?
Qibo said: Heat is excessive in the body, so they discard clothes and wish to run. (Yangming qi governs the muscles, so heat fills the body. Due to body heat, they discard clothes and run. The "Shanghan Lun" states: What are the external manifestations of Yangming disease? The answer is: Body heat, spontaneous sweating, no aversion to cold, but rather aversion to heat. Because the heat is on the exterior, they do not desire clothing.)
The Emperor said: Why do they speak nonsense, curse, disregard kinship and distance, and sing?
Qibo said: Excessive yang causes people to speak nonsense, curse, and disregard relationships, and also causes loss of appetite. Loss of appetite leads to aimless running. (The stomach collaterals connect upward to the heart. Excessive yang confuses the mind spirit, causing people to speak nonsense, curse, and disregard relationships. If heat is excessive in the stomach, there is no desire to eat. Without eating, there is aimless running. This is because the four limbs receive their qi from the stomach. This passage discusses how heat excess in the interior and exterior, upper and lower parts of the body presents with different symptoms. The preceding eleven chapters discussed the principles of the Three Parts and Nine Probes diagnosis, corresponding to Heaven, Earth, and Man, involving cold-heat, yin-yang, and zang-fu deficiency-excess. It is said: Earth generates all things and models itself after Heaven and Earth. Therefore, the conclusion ties together the yin-yang of the spleen and stomach, the correspondence of yin-yang transmission, and jointly discusses the excess syndromes of the Yangming meridian.)