上编揆度奇恒，未畅其旨，故相继而有奇病之论。奇病者，形居母腹，胎失其养，既生之后，经脉
脏气不足，当天癸未至之时，病从内生，卒然而起，病久且死，故曰奇也。如九月而喑，则胞胎
内虚，既生之后，天癸未至，致有息积伏梁疹筋厥逆，以及脾甘胆苦癃厥癫疾肾风之病，类而举之，皆先
天受病，卒然而发，故曰奇病。
黄帝问曰∶人有重身九月而喑，此为何也？
重，平声。为，去声。下俱同。惟为水为主转为发为之为如字。妇人怀孕，谓之重身。喑，声不出
也。怀孕九月，卒然无声，此何病也。
岐伯对曰∶胞之络脉绝也。
胞之络脉，系母腰肾。绝，不相维系也。九月而喑，以此故也。
帝曰∶何以言之？
何以络脉绝而当喑。
岐伯曰∶胞络者，系于肾，少阴之脉，贯肾系舌本，故不能言。
胞络者，系于母之腰者。肾者，少阴也。少阴之脉下贯肾，上
系舌本，肾不系胎，则少阴脉虚，虚则上下不交，故不能言而喑也。
帝曰∶治之奈何？
治喑奈何？
岐伯曰∶无治也，当十月复。
九月而喑，无可治也，当十月则非少阴主胎，斯时则复旧能言。
刺法曰，无损不足，益有余，以成其疹，然后调之。
所以无治者，如刺法有曰，无损不足，益有余，以成其疹，然
后调之之也。疹，犹病也。刺法，针刺之法也。
所谓无损不足者，身羸瘦，无用 石也。无益其有余者，腹中
有形而泄之。泄之则精出而病独擅中，故曰疹成也。
，犹针也。益，犹治也。刺法所谓无损不足者，如身羸瘦无用针石也。所谓无益其有余者，重身
则腹中有形，如腹中有形而泄之，泄之则精出而病独擅中，精出正虚，擅中邪实，故曰疹成也。
疹成而后调之，不若无损其不足，无治其有余矣。此胞络脉绝，先天不足，为奇病之先基，无客治也。
帝曰∶病胁下满，气逆，二三岁不已，是为何病？
胁满气逆，病之常也，二三岁不已则为奇病，故举以问。
岐伯曰∶病名曰息积，此不妨于食，不可灸刺，积为导引服药，药不能独治也。
胁满气逆，病名曰息积，二三岁不已，故此不妨于食，先天经脉受亏，病久不愈，故不可灸刺。积，
渐次也，须渐次为之导引而服药。导引，营运也。营运则经脉之亏者可复，若但服药，则药不
能独治也，此息积为先天奇病，而药不能治也。
帝曰∶人有身体髀股 皆肿，环齐而痛，是如何病？
齐，脐通，下同。身体髀股 皆肿，则气越于外，环脐而痛，
则气凝于内，病机各异，是为奇病，故复问之。
岐伯曰∶病名曰伏梁，此风根也，其气溢于大肠，而着于盲，盲之原
在齐下，故环齐而痛也，不可动之，动之为水溺涩之病也。
溺，鸟去声。邪积于内，致环脐而痛，故病名曰伏梁，风动水涣，致身体髀股 皆肿，故曰此风根也。
风根而为伏梁者，其风根之气，溢于大肠之外，而内着于盲，盲之原出了脖 。脖 ，脐下
也，故盲之原在脐下，溢大肠而着盲，故环脐而痛也，外则身体肿，内则环脐痛，亦属先天奇病，故
不可妄攻以动之，动之则土气益虚，身肿不消，而为水溺涩之病，此风根伏梁，为先天奇病而不可动也。
帝曰∶人有尺脉动甚，筋急而见，此为何病？
数，音朔。尺脉数甚，阴血虚也。筋急而见，肌肉脱也，脉数筋急，亦为奇病，故举以问。
岐伯曰∶此所谓疹筋，是人腹必急，白色黑色见，则病甚。
疹，犹病也。筋急而见，其病在筋，此所谓疹筋，肌肉虽脱，是人腹必急，其面白色黑色见，腹主地，面
主天，腹急，地气虚也。白色黑色见，天气虚也，则病当甚，难以治也，此疹筋腹急为先天奇病，而病必甚也。
帝曰∶人有病头痛，以数岁不已，此安得之，名为何病？
头者，诸阳之会，头痛而数岁不已，亦奇病也。
岐伯曰∶当有所犯大寒，内至骨髓，髓者以脑为主，脑逆故会头痛、齿亦痛，病名曰厥逆。
头者阳也，头痛者，当有所犯大寒，其室内至骨髓，脑为髓海，故髓者以脑为主，寒入于髓，则
脑逆，脑逆故令人头痛。齿者骨之余，寒入骨髓，故齿亦痛，病名曰厥逆，言阴阳之气不相顺
接，为厥为逆也，此大寒犯髓，头痛不已之奇病，而名为厥逆也。
帝曰∶善。
三字衍文。
帝曰∶有病口甘者，病名为何？何以得之？
承上文头痛齿痛之意，而问口甘，乃触类引伸以问也。
岐伯曰∶此五气之溢也，名曰脾瘅。
五气，土气也。溢，泛溢也。瘅，热也。土气泛溢，名曰脾瘅，言土虚脾热而口甘也。
夫五味入口，藏于胃，脾为之行其精气，津液在脾，故令人口甘也，此肥类之所发也，此
人必数食甘美而多肥也，肥者，令人内热，甘者，令人中满，故其气上溢，转为
消渴，治之以兰，除陈气也。
藏，如字。数，音朔。胃者土也。夫五味入口，皆藏于胃，而脾则为之行其精气，今津液在脾，不
能四布，故令人口甘也。此口甘者，乃肥美之味所发也。肥美者，此人必数食甘美而多肥也。肥
者，性浓，故令人内热。甘者，性缓，故令人中满，内热中满，故其气上溢，上溢而热，转为消渴。兰，
香草也，治之以兰，可以除陈气也。除陈者，推陈致新之意。
帝曰∶有病口苦，取阳陵泉。口苦者，病名为何？何以得之？
承上文口甘中满治之以兰之意，复问有病口苦，取阳陵泉刺之，而口苦不愈，何也？
岐伯曰∶病名曰胆瘅。夫肝者，中之将也，取决于胆，咽为之
使，此人者数谋虑不决，故胆虚，气上溢，而口为之苦，治之以胆
募俞，治在《阴阳十二官相使》中。
将、使，俱去声。数，音朔。口苦，胆热也，故病名曰胆瘅。胆附于肝，肝者将军之官。故夫肝者，
中之将也。胆居肝内，肝主谋虑，故取决于胆，肝脉上循喉咙，故咽为之使，此人所以口苦
者，必数谋虑不决，致胆气不和于肝，故胆虚，胆气上溢而口为之苦，但治胆合穴之阳陵泉，无裨也，当
治之以胆募俞。胆募者，胸之分，胆俞者，背之分。胆募俞者，胆俞在脊背第十椎下两旁，以
背之俞而合于胸之募，则当期门之处，胆附于肝，故当取募俞而合治之。灵兰秘典论曰∶肝者，将军之官，
谋虑出焉。胆者，中正之官，决断出焉。十二官者，相使而不得相失也。夫肝谋虑，胆决
断，是肝胆之气相使而不得相失，治以胆募俞者，乃胆病治肝，其施治之义，在《阴阳十二官相使》中，此
承上文大寒入髓之奇病，而论脾瘅胆瘅之热病，先圣立教之大法也。
帝曰∶有癃者，一日数十溲，此不足也，身热如炭，颈膺如
格。人迎躁盛，喘息气逆，此有余也。太阴脉微细如发者，此不足也。其病安在，各为何病？
小便不利日癃，病癃一日数溲，此不足也，不足而复有诸有余
之病，有余而复有不足之脉，不足而有余，有余而不足，病之奇也，故举以问。
岐伯曰∶病在太阴，其盛在胃，颇在肺，病名曰厥，死不治。此所谓得五有余、二不足也。
病癃数十溲，太阴脉微细如发，则病在太阴，身热如炭，颈膺如格，人迎躁盛，喘息气逆，则其
盛在胃。太阴者，肺也，病在太阴，故颇在肺，阴阳之气，不相交合，病名曰厥，是为癃厥，死不
治，此所谓得五有余、二不足也。有余不足，详见下文。
帝曰∶何谓五有余二不足？岐伯曰∶所谓五有未者，五病之气
有未也；二不足者，亦病气之不足也。
所谓五有余者∶一身热如炭，二颈膺如格，三人迎躁盛，四喘息，五气逆，此五病之气为有余也。所谓二不足者∶
一病癃数十溲，二太阴脉微细如发，病有有余，即有不足，此二者亦病气之不足也。
今外得五有余，内得二不足，此其身不表不里，亦正死明矣。
阳明者，阳也，主外主表。太阴者，阴也，主内主里。今外得五有余则阳明真气不行于表，内得二不足，
则太阴真气不行于里，此其身不表不里，亦正死明矣，所以癃厥之病，死不治也。
帝曰∶人生而有病巅疾者，病名曰何，安所得之？
巅，作癫，下同。癫，癫痫也，生而病癫，亦先天奇病，故举以问。
岐伯曰∶病为名胎病，此得之在母腹中时，其母有所大惊，气
上而不下，精气并居，故令子发为巅疾也。
生而病癫，先天所受之病也，故名为胎病，此得之在母腹中时，其母有所大惊，其气上而不下，精以养
胎气，上不下则精与惊气并居，既生以后，故令子发为巅疾也，此癫疾为先天奇病，而属于不治也。
帝曰∶有病庞然如有水状，切其脉大紧，身无痛者，形不瘦，不能食，食少，名为何病？
庞然如水状，病之深也，脉大紧，身无痛，形不瘦，病之浅
也。不能食，食少，病之深也。病似深复似浅，似浅复似深，病之奇也，故举以问。
岐伯曰∶病生在肾，名为肾风，肾风而不能食，善惊，惊已，心气痿者死。
肾为水脏，今庞然浮肿，如有水状，故病生于肾，水因风动，故名为肾风。肾者，水也。水寒之气，籍
阳火以营运，今肾风而不能食，火气虚也。火虚则善惊，惊已，而心气痿者，神机化灭也，
故死。此肾风为先天奇病，而必死也。
帝曰∶善。
重身九月而喑，胞络脉绝，先天受亏，发为奇病，病不能治，且至于死，帝通承上文而善之。
上编《揆度奇恒》篇，未能详尽阐述其主旨，因此相继有论述“奇病”的篇章。所谓奇病，是指胎儿在母腹中时，胎元失于滋养，出生后经脉与脏气不足，到了天癸（促进性发育和生殖功能的物质）尚未到来的时候，疾病从体内产生，突然发作，病程长久会导致死亡，所以称为“奇”。例如怀孕九月出现失音，是因为胞胎内部虚弱，出生后天癸未至，导致出现息积、伏梁、疹筋、厥逆，以及脾瘅、胆瘅、癃闭、厥证、癫疾、肾风等疾病，列举这些病症，都是先天受病，突然发作，所以称为奇病。
黄帝问道：有人怀孕到第九个月时失音，这是什么原因呢？
重，读平声。为，读去声。下文同。惟、为水为主、转为发、为之，均读如字音。妇人怀孕，称为“重身”。喑，指声音发不出。怀孕九月，突然无声，这是什么病呢？
岐伯回答说：是胞宫的络脉阻滞不通。
胞宫的络脉，系属于母亲的腰部肾脏。绝，指不相维系。怀孕九月而失音，就是这个缘故。
黄帝说：为什么这样说呢？
为什么络脉阻滞就会失音呢？
岐伯说：胞络系属于肾，足少阴肾经贯穿肾脏并系连舌根，所以不能说话。
胞络系属于母亲腰部的是肾。肾，属少阴。足少阴经脉下行贯穿肾脏，上行系连舌根，若肾气不能系固胎元，则少阴脉虚，虚则上下气机不交，所以不能言语而失音。
黄帝说：如何治疗呢？
如何治疗失音呢？
岐伯说：不需要治疗，等到第十个月自然会恢复。
怀孕九月而失音，没有可治之法，等到十月分娩后，不再由少阴主司胎元，此时就能恢复旧态，重新能说话。
《刺法》说：不要损伤正气不足的人，不要补益邪气有余的人，以免加重病情形成疹病，然后再进行调理。
之所以说不需要治疗，是因为《刺法》中说：“无损不足，益有余，以成其疹，然后调之。”疹，即病的意思。刺法，指针刺的方法。
所谓“无损不足”，是指身体羸弱消瘦的人，不要用针石攻伐。所谓“无益其有余”，是指腹中有形积块的人，不要用泻法攻逐。如果攻逐，则精气外泄而病邪独留于体内，所以称为疹病已成。
，即针的意思。益，即治疗的意思。《刺法》所说的“无损不足”，是指身体羸弱消瘦的人不要用针石。所谓“无益其有余”，是指孕妇腹中有形积块，如果对其用泻法，则精气外泄而病邪独盛于中，精气出则正气虚，病邪盛则实，所以称为疹病已成。
疹病已成后再去调理，不如不损伤其不足，不治疗其有余。这是胞络脉绝，先天不足，是奇病的先兆，没有外邪可治，故无需治疗。
黄帝问：有人胁下胀满，气机上逆，两三年不好，这是什么病？
胁满气逆，是常见的病症，但如果两三年不好，就是奇病了，所以提出来询问。
岐伯说：这个病名叫息积，这不影响饮食，不能用灸法和刺法，需要通过导引配合服药来治疗，单靠药物不能单独治愈。
胁满气逆，病名叫息积，两三年不好，所以说不影响饮食。因先天经脉亏损，病程长久不愈，所以不能用灸刺。积，指渐次积累，必须逐渐进行导引并服用药物。导引，指运行动作。通过运行动作可以使亏损的经脉得以恢复，如果只服药，则药物不能单独治愈，这是息积作为先天奇病，药物无法单独治愈。
黄帝问：有人身体大腿和小腿都肿胀，环绕肚脐疼痛，这是什么病？
齐，通“脐”，下同。身体大腿小腿都肿胀，说明气机外越；环绕肚脐疼痛，说明气机凝滞于内。病机各异，这是奇病，所以再次询问。
岐伯说：这个病名叫伏梁，这是风邪留下的病根。风气溢于大肠，附着于盲膜，盲膜的根源在肚脐下方，所以环绕肚脐疼痛。不可触动它，触动它会引发小便涩滞的病症。
溺，读鸟去声。邪气积聚于内，导致环绕肚脐疼痛，所以病名叫伏梁。风动水散，导致身体大腿小腿都肿胀，所以说这是风邪留下的病根。风邪留下的病根成为伏梁，其风邪之气，溢出于大肠之外，向内附着于盲膜，盲膜的根源出了脖胦（脖胦，指脐下部位）。脖胦，即脐下，所以盲膜的根源在脐下，风气溢于大肠而附着于盲膜，所以环绕肚脐疼痛。外部身体肿胀，内部环绕肚脐疼痛，也属于先天奇病，所以不可妄加攻伐触动它，一旦触动，土气更加虚弱，身体肿胀不消，从而引发小便涩滞的病，这是风邪留下的伏梁，属于先天奇病，不可触动。
黄帝问：有人尺脉搏动剧烈，筋脉拘急且显露，这是什么病？
数，音朔。尺脉数甚，说明阴血虚。筋脉拘急且显露，说明肌肉脱失。脉数筋急，也是奇病，所以提出来询问。
岐伯说：这叫疹筋，这个人腹部必然拘急，面色出现白色或黑色，则病情严重。
疹，即病的意思。筋脉拘急且显露，病在筋，这叫疹筋。虽然肌肉脱失，但此人腹部必然拘急。面部主天，腹部主地。腹部拘急，说明地气虚。面色出现白色或黑色，说明天气虚，那么病情应当严重，难以治愈，这是疹筋伴腹部拘急，属于先天奇病，病情必定严重。
黄帝问：有人患头痛，多年不愈，这是怎么得的？叫什么病？
头是诸阳经汇聚的地方，头痛多年不愈，也是奇病。
岐伯说：这是因为遭受了大寒侵袭，寒气深入骨髓。髓以脑为主，脑气上逆所以导致头痛，牙齿也会痛，这个病名叫厥逆。
头属阳，头痛是因为遭受大寒，寒气室内深入骨髓。脑为髓海，所以髓以脑为主。寒气进入骨髓，则脑气上逆，脑气上逆所以令人头痛。齿是骨之余，寒气进入骨髓，所以牙齿也痛，这个病名叫厥逆，意思是阴阳之气不相顺接，发生厥逆。这是大寒侵犯骨髓，头痛不已的奇病，名叫厥逆。
黄帝说：好。
三字为衍文。
黄帝问：有人口甜，病名是什么？是怎么得的？
承接上文头痛齿痛的意思，进而询问口甜，是触类旁通地询问。
岐伯说：这是五气泛溢，病名叫脾瘅。
五气，指土气。溢，指泛溢。瘅，指热。土气泛溢，名叫脾瘅，意思是土虚脾热而口甜。
五味入口，藏于胃，脾为之运行精气。津液停留在脾，所以使人口甜。这是肥美食物引发的疾病，这种人一定经常食用甘美且多脂肪的食物。肥腻使人内生热，甘甜使人中焦痞满，所以气机上溢，转化为消渴病。治疗用兰草，以去除陈腐之气。
藏，读如字音。数，音朔。胃属土。五味入口，都藏于胃，脾为之运行精气。现在津液停留在脾，不能四布全身，所以使人口甜。这种口甜，是由肥美味道引发的。肥美之物，这种人一定经常吃甘美多脂的食物。肥腻性质浓烈，所以使人内热。甘甜性质缓和，所以使人中焦痞满。内热中满，所以气机上溢，上溢而热，转化为消渴。兰，是香草，用兰草治疗，可以去除陈腐之气。除陈，即推陈致新的意思。
黄帝问：有人口苦，取阳陵泉穴。口苦的人，病名是什么？是怎么得的？
承接上文口甜中满治疗用兰草的意思，又询问有病人口苦，取阳陵泉针刺，但口苦不愈，为什么呢？
岐伯说：病名叫胆瘅。肝是中焦的将军，取决于胆，咽喉是胆气的通道。这种人经常谋虑而不能决断，所以胆气虚，气机上溢，所以口苦。治疗应取胆的募穴和俞穴，治疗方法在《阴阳十二官相使》篇中。
将、使，俱读去声。数，音朔。口苦，是胆热，所以病名叫胆瘅。胆附于肝，肝是将军之官。所以肝是中焦的将军。胆居肝内，肝主谋虑，所以取决于胆。肝脉上行经过喉咙，所以咽喉是胆的通道。这个人之所以口苦，一定是因为经常谋虑而不能决断，导致胆气不和于肝，所以胆气虚，胆气上溢而口苦。仅仅治疗胆的合穴阳陵泉，没有益处，应当治疗胆的募穴和俞穴。胆募穴在胸部分，胆俞穴在背部分。胆募俞，即胆俞在脊柱第十椎下两旁，以背部的俞穴结合胸部的募穴，即在期门穴处。胆附于肝，所以应当取募俞配合治疗。《灵兰秘典论》说：肝是将军之官，谋虑由此发出。胆是中正之官，决断由此发出。十二脏腑器官，相互辅助而不相失。肝主谋虑，胆主决断，肝胆之气相互辅助而不相失。治疗用胆募俞，是胆病治肝，其施治的意义，在《阴阳十二官相使》篇中。这是承接上文大寒入髓的奇病，论述脾瘅胆瘅的热病，是先圣立教的大法。
黄帝问：有人患癃闭，一天几十次小便，这是正气不足。身体发热像火炭，颈部和胸部像被格拒一样。人迎脉躁动盛大，喘息气逆，这是邪气有余。太阴脉微细如头发，这是正气不足。病在哪里？各是什么病？
小便不利叫癃，患癃病一天多次小便，这是正气不足。不足而又出现各种有余的病，有余而又出现不足的脉象，不足而有有余，有余而有不足，这是病的奇特之处，所以提出来询问。
岐伯说：病在太阴，其盛在胃，颇涉及肺，病名叫厥，死症，无法治疗。这就是所谓的得五有余、二不足。
患癃病数十次小便，太阴脉微细如发，说明病在太阴。身体发热像火炭，颈部胸部像被格拒，人迎脉躁动盛大，喘息气逆，说明其盛在胃。太阴指肺，病在太阴，所以颇涉及肺。阴阳之气不相交合，病名叫厥，这是癃厥，死症，无法治疗。这就是所谓的得五有余、二不足。有余不足，详见下文。
黄帝问：什么叫五有余二不足？岐伯说：所谓五有余，是五种病气有余；二不足，也是病气不足。
所谓五有余：一身体发热像火炭，二颈部胸部像被格拒，三人迎脉躁动盛大，四喘息，五气逆，这五种病气是有余。所谓二不足：一患癃病数十次小便，二太阴脉微细如发，病有有余，就有不足，这两个也是病气不足。
现在外部得到五有余，内部得到二不足，这说明病不在表也不在里，也是明显的死症。
阳明属阳，主外主表。太阴属阴，主内主里。现在外部得到五有余，则阳明真气不能行于表；内部得到二不足，则太阴真气不能行于里。这说明病不在表也不在里，也是明显的死症，所以癃厥之病，死症无法治疗。
黄帝问：人生下来就患有巅疾，病名是什么？是怎么得的？
巅，通“癫”，下同。癫，癫痫。生来就患癫病，也是先天奇病，所以提出来询问。
岐伯说：病名叫胎病，这是在母腹中时得的。当时他的母亲受到大惊吓，气上逆而下不去，精气并聚，所以让孩子发为巅疾。
生来就患癫病，是先天所受的疾病，所以名叫胎病。这是在母腹中时得的。当时母亲受到大惊吓，其气上逆而下不去，精气用来养胎，气上不下则精与惊气并聚，出生后，所以让孩子发为巅疾。这是癫病作为先天奇病，属于不治之症。
黄帝问：有人身体浮肿像有水状，切其脉大紧，身体无痛，形体不瘦，不能进食，吃得少，叫什么病？
庞然如水状，说明病深。脉大紧，身体无痛，形体不瘦，说明病浅。不能进食，吃得少，说明病深。病似深复似浅，似浅复似深，这是病的奇特之处，所以提出来询问。
岐伯说：病生在肾，名叫肾风。肾风而不能进食，容易惊吓，惊吓之后，心气痿废的会死。
肾是水脏，现在身体浮肿像有水状，所以病生于肾。水因风动，所以名叫肾风。肾属水。水寒之气，依靠阳火来运行动转。现在肾风而不能进食，说明火气虚。火虚则容易惊吓，惊吓之后，心气痿废，神机化灭，所以死。这是肾风作为先天奇病，必定致死。
黄帝说：好。
怀孕九月而失音，胞络脉绝，先天受亏，发为奇病，病不能治，且至于死，黄帝通承上文而称赞。
The preceding chapter, *Kui Du Qi Heng* (Measuring the Extraordinary and Constant), failed to fully elucidate its purport; therefore, discussions on "Qi Bing" (Extraordinary Diseases) followed. Qi Bing refers to conditions where the fetus lacked proper nourishment in the womb, resulting in insufficiency of meridians and Zang-Fu Qi after birth. When Tian Gui (the substance promoting sexual maturation and reproductive function) has not yet arrived, diseases arise internally, manifesting suddenly. If prolonged, they lead to death; hence, they are termed "extraordinary." For instance, aphonia occurring at the ninth month of pregnancy indicates deficiency within the Bao Luo (uterine network vessels). After birth, with Tian Gui absent, conditions such as Xi Ji (Breathing Accumulation), Fu Liang (Hidden Beam), Zhen Jin (Rash of Sinews), Jue Ni (Reversal and Counterflow), Pi Dan (Spleen Heat), Dan Dan (Gallbladder Heat), Long Jue (Urethral Obstruction and Reversal), Dian Ji (Epilepsy), and Shen Feng (Kidney Wind) may occur. Listing these, all stem from congenital disease and sudden onset, thus called Qi Bing.
Huang Di asked: There is a person who becomes aphonic at the ninth month of pregnancy. What is this condition?
Chong (double/heavy) is pronounced with the level tone. Wei (to be/for) is pronounced with the departing tone, as below. Only, Wei as water, Zhu (main) turns into Fa (develop), Wei as Zhi (particle) are read as their original characters. Pregnancy in women is called "Chong Shen" (Double Body). Yin (aphonia) means inability to produce sound. Becoming suddenly mute at the ninth month of pregnancy—what disease is this?
Qi Bo replied: The network vessels of the Bao (uterus) are obstructed.
The network vessels of the Bao connect to the mother's lumbar Kidneys. Jue (severance/obstruction) means lack of connection. Aphonia at the ninth month occurs due to this reason.
Huang Di said: Why do you say so?
Why does obstruction of network vessels lead to aphonia?
Qi Bo said: The Bao Luo connects to the Kidney. The Shaoyin (Lesser Yin) meridian passes through the Kidney and connects to the root of the tongue; therefore, speech is impossible.
The Bao Luo connects to the Kidney in the mother's lumbar region. The Kidney belongs to Shaoyin. The Shaoyin meridian descends through the Kidney and ascends to connect to the root of the tongue. If Kidney Qi fails to anchor the fetus, the Shaoyin pulse becomes deficient. Deficiency leads to failure of upper and lower interaction, resulting in inability to speak and aphonia.
Huang Di said: How should it be treated?
How should aphonia be treated?
Qi Bo said: No treatment is needed; recovery will occur in the tenth month.
Aphonia at the ninth month requires no treatment. By the tenth month, when the Shaoyin no longer governs the fetus, one will return to normal and regain speech.
The *Ci Fa* (Needling Methods) states: Do not damage what is insufficient, nor tonify what is excessive, lest you create a Zhen (disease/rash), and only then regulate.
The reason for no treatment is that the *Ci Fa* states: "Do not damage insufficiency, do not benefit excess, to form a Zhen, then regulate." Zhen means disease. Ci Fa refers to needling methods.
What is meant by "do not damage insufficiency" is that for those emaciated and thin, needle-stone therapies should not be used. "Do not benefit excess" means for those with palpable masses in the abdomen, purgation should not be applied. Purging causes essence to exit while pathology dominates the interior, thus termed "Zhen formed."
Ci (needle) implies acupuncture. Yi (benefit) implies treatment. The *Ci Fa* states "do not damage insufficiency," meaning emaciated individuals should not undergo needle-stone therapy. "Do not benefit excess" means if a pregnant woman has a palpable mass in the abdomen and purges it, essence exits and pathology dominates the center. Essence loss leads to Zheng (Righteous Qi) deficiency, while pathology dominance leads to Shi (Excess). Thus, it is said "Zhen is formed."
After Zhen forms, regulation is less effective than not damaging insufficiency or treating excess. This Bao Luo obstruction stems from congenital insufficiency, forming the basis of Qi Bing. There is no external pathogen to treat; hence, no intervention is required.
Huang Di asked: A person suffers from hypochondriac fullness and rebellious Qi persisting for two or three years without resolution. What disease is this?
Hypochondriac fullness and Qi rebellion are common. Persistence for two or three years makes it a Qi Bing; thus, it is asked.
Qi Bo said: The disease is named Xi Ji (Breathing Accumulation). It does not affect eating. Moxibustion and needling are contraindicated. Treatment requires Daoyin (guiding and pulling exercises) combined with herbal medicine; herbs alone cannot cure it.
Hypochondriac fullness and Qi rebellion are named Xi Ji. Persistence for years implies it does not affect eating. Due to congenital meridian deficiency and chronicity, moxibustion and needling are contraindicated. Ji (accumulation) implies gradual progression. One must gradually practice Daoyin and take medicine. Daoyin involves movement. Movement restores meridian deficiency. Herbs alone cannot cure this congenital Qi Bing.
Huang Di asked: A person has swelling in the thighs and calves, with pain encircling the navel. What disease is this?
Qi (navel) is synonymous with Umbilicus. Swelling in thighs and calves indicates Qi dispersing outward; periumbilical pain indicates Qi stagnating inward. Different pathomechanisms constitute a Qi Bing; thus, it is asked again.
Qi Bo said: The disease is named Fu Liang (Hidden Beam). It is rooted in Wind. The Qi overflows into the Large Intestine and attaches to the Mang (blind membrane). The origin of the Mang is below the navel, causing periumbilical pain. It must not be manipulated; manipulation leads to difficulty in urination.
Niao (urine) is pronounced with the departing tone. Pathogenic accumulation inside causes periumbilical pain, named Fu Liang. Wind movement causes water dispersion, leading to swelling in thighs and calves, hence "rooted in Wind." The Wind root becoming Fu Liang means Wind Qi overflows the Large Intestine and attaches to the Mang. The origin of the Mang is at Bo Yang (below the navel). Overflowing the Large Intestine and attaching to the Mang causes periumbilical pain. External swelling and internal pain belong to congenital Qi Bing. Therefore, aggressive attack/manipulation is forbidden. Manipulation weakens Earth Qi further, preventing swelling resolution and causing urinary obstruction. This Wind-rooted Fu Liang is a congenital Qi Bing that must not be manipulated.
Huang Di asked: A person has a vigorous pulse at the Chi position, with spasmodic sinews visible. What disease is this?
Shuo (rapid) is the pronunciation. Rapid Chi pulse indicates Yin Blood deficiency. Visible spasmodic sinews indicate muscle wasting. Rapid pulse with spasmodic sinews is also a Qi Bing; thus, it is asked.
Qi Bo said: This is called Zhen Jin (Rash of Sinews). The abdomen will necessarily be tight. Appearance of white or black color on the face indicates severe disease.
Zhen means disease. Spasmodic sinews indicate pathology in the sinews, called Zhen Jin. Despite muscle wasting, the abdomen is tight. The face represents Heaven; the abdomen represents Earth. Abdominal tightness indicates Earth Qi deficiency. White or black facial color indicates Heaven Qi deficiency. Thus, the disease is severe and difficult to treat. Zhen Jin with abdominal tightness is a congenital Qi Bing, destined to be severe.
Huang Di asked: A person suffers from headache persisting for many years. How did it originate? What is it named?
The head is the convergence of all Yang meridians. Headache persisting for years is a Qi Bing.
Qi Bo said: It results from exposure to severe Cold, penetrating to the bone marrow. Marrow is dominated by the Brain. Brain Qi rebels, causing headache; teeth also hurt. The disease is named Jue Ni (Reversal and Counterflow).
The head is Yang. Headache arises from severe Cold entering deep into bone marrow. The Brain is the Sea of Marrow; thus, Marrow is dominated by the Brain. Cold entering marrow causes Brain Qi rebellion, leading to headache. Teeth are the surplus of bone; Cold in marrow causes toothache. Named Jue Ni, indicating failure of Yin and Yang Qi to connect smoothly, resulting in Jue (Reversal) and Ni (Counterflow). This severe Cold invading marrow causing persistent headache is named Jue Ni.
Huang Di said: Excellent.
Three characters are superfluous.
Huang Di asked: A person has a sweet taste in the mouth. What is the disease name? How did it arise?
Continuing from headache/toothache, asking about sweet taste extends the inquiry by analogy.
Qi Bo said: This is overflow of Five Qi, named Pi Dan (Spleen Heat/Damp-Heat).
Five Qi refers to Earth Qi. Yi (overflow) means flooding. Dan (heat/damp-heat) means heat. Earth Qi flooding is named Pi Dan, indicating Spleen deficiency with Heat causing sweet taste.
Five flavors enter the mouth and store in the Stomach; the Spleen distributes their essence. Fluids remaining in the Spleen cause sweet taste. This originates from rich foods. Such persons frequently consume sweet and fatty foods. Fatty foods generate internal heat; sweet foods cause middle-jiao fullness. Thus, Qi overflows upward, transforming into Xiao Ke (Wasting-Thirst). Treatment uses Lan Cao (Orchid/Calamus) to remove stale Qi.
Cang (store) is read as original. Shuo (frequent) is rapid. Stomach is Earth. Five flavors store in Stomach; Spleen distributes essence. Fluids staying in Spleen fail to distribute, causing sweet taste. Sweet taste arises from rich flavors. Rich flavors imply frequent consumption of sweet/fatty foods. Fatty nature is dense, causing internal heat. Sweet nature is slow, causing middle-fullness. Internal heat and middle-fullness cause Qi overflow. Upward overflow with heat transforms into Xiao Ke. Lan is an aromatic herb. Treating with Lan removes stale Qi. Chu Chen (removing stale) implies pushing out the old to bring forth the new.
Huang Di asked: A person has bitter taste in the mouth, treated by taking Yang Ling Quan. Bitter taste—what is the disease name? How did it arise?
Continuing from sweet taste/middle-fullness treated with Lan, asking why bitter taste persists despite needling Yang Ling Quan.
Qi Bo said: The disease is named Dan Dan (Gallbladder Heat/Damp-Heat). The Liver is the General within; it depends on the Gallbladder. The throat serves as its envoy. Frequent deliberation without decision leads to Gallbladder deficiency. Qi overflows upward, causing bitter taste. Treatment should target Gallbladder Mu and Shu points. Methods are detailed in *Yin Yang Twelve Officials Mutual Assistance*.
Jiang/Shi (General/Envoy) are departing tones. Shuo (frequent) is rapid. Bitter taste indicates Gallbladder Heat, named Dan Dan. Gallbladder attaches to Liver; Liver is the General of the Middle. Gallbladder resides within Liver. Liver governs deliberation; thus, it depends on Gallbladder. Liver meridian ascends through the throat; thus, throat is the envoy. Frequent indecision causes Gallbladder-Liver disharmony, leading to Gallbladder deficiency and Qi overflow causing bitterness. Treating only the He-Sea point Yang Ling Quan is ineffective. One must treat Gallbladder Mu and Shu points. Gallbladder Mu is in the chest; Shu is in the back. Gallbladder Shu is beside the 10th thoracic vertebra. Combining back Shu with chest Mu corresponds to Qimen. Attaching to Liver, Mu and Shu should be treated together. *Ling Lan Mi Dian Lun* states: Liver is the General, source of deliberation. Gallbladder is the Official of Uprightness, source of decision. The twelve officials assist each other without loss. Liver deliberates, Gallbladder decides; their Qi assists without loss. Treating Gallbladder Mu-Shu treats Liver via Gallbladder pathology. This principle is in *Yin Yang Twelve Officials Mutual Assistance*. This follows the previous severe Cold-in-marrow Qi Bing, discussing Pi Dan and Dan Dan heat diseases, following ancient sage principles.
Huang Di asked: A person suffers from Long (urinary retention), urinating dozens of times daily (deficiency). Body hot as charcoal, neck/chest feels blocked. Ren Ying pulse is restless and vigorous (excess). Panting and rebellious Qi (excess). Taiyin pulse is fine as hair (deficiency). Where is the disease? What are the names?
Urinary difficulty is Long. Frequent urination indicates deficiency. Deficiency coexists with excess symptoms; excess coexists with deficiency pulses. This paradox is a Qi Bing; thus, asked.
Qi Bo said: Disease is in Taiyin, excess is in Stomach, involvement in Lung. Named Jue (Reversal). Death is inevitable. This is "Five Excesses, Two Deficiencies."
Long with frequent urination and fine Taiyin pulse indicate Taiyin disease. Charcoal-like heat, blocked neck/chest, vigorous Ren Ying, panting/rebellious Qi indicate Stomach excess. Taiyin refers to Lung; disease in Taiyin involves Lung. Yin-Yang Qi fail to interact. Named Jue, specifically Long Jue. Incurable death. This is Five Excesses, Two Deficiencies. Details follow.
Huang Di asked: What are Five Excesses and Two Deficiencies? Qi Bo said: Five Excesses refer to five pathological Qi excesses; Two Deficiencies refer to pathological Qi deficiencies.
Five Excesses: 1. Body hot as charcoal, 2. Neck/chest blocked, 3. Vigorous Ren Ying, 4. Panting, 5. Rebellious Qi. These five are excess. Two Deficiencies: 1. Long with frequent urination, 2. Fine Taiyin pulse. Presence of excess implies deficiency; these two are Qi deficiency.
External Five Excesses and internal Two Deficiencies mean the disease is neither exterior nor interior, clearly fatal.
Yangming is Yang, governing exterior/exterior. Taiyin is Yin, governing interior/interior. External Five Excesses mean Yangming True Qi fails to circulate externally. Internal Two Deficiencies mean Taiyin True Qi fails to circulate internally. Disease is neither exterior nor interior, clearly fatal. Thus, Long Jue is incurable death.
Huang Di asked: A person born with Dian Ji (epilepsy/seizure disorder). What is the name? How acquired?
Dian is synonymous with Dian (epilepsy). Congenital epilepsy is a Qi Bing; thus, asked.
Qi Bo said: Named Tai Bing (Fetal Disease). Acquired in utero when the mother suffered great fright. Qi rose and did not descend. Essence and fright Qi merged, causing the child to develop Dian Ji.
Congenital epilepsy is inherited pathology, named Tai Bing. Acquired in utero due to maternal fright. Qi rose but did not descend. Essence nourishes fetus; rising Qi prevents descent, merging essence with fright Qi. Post-birth, this causes Dian Ji. Congenital epilepsy is incurable.
Huang Di asked: A person has edema resembling water retention. Pulse is large and tight. Body painless, not emaciated. Cannot eat, eats little. What disease?
Edema indicates deep disease. Large/tight pulse, painless, non-emaciated indicate superficial disease. Anorexia indicates deep disease. Alternating deep/superficial signs constitute a Qi Bing; thus, asked.
Qi Bo said: Disease originates in Kidney, named Shen Feng (Kidney Wind). Inability to eat, propensity to fright, followed by Heart Qi atrophy leads to death.
Kidney is Water organ. Edema resembles water, originating in Kidney. Water moves with Wind, named Shen Feng. Kidney is Water. Cold-Water Qi relies on Fire Qi for circulation. Shen Feng with anorexia indicates Fire deficiency. Fire deficiency causes fright. Post-fright, Heart Qi atrophy destroys Shen (Spirit) mechanism, leading to death. Congenital Shen Feng is invariably fatal.
Huang Di said: Excellent.
Pregnancy ninth-month aphonia, Bao Luo obstruction, congenital deficiency, manifesting as Qi Bing, untreatable leading to death. Huang Di acknowledges the preceding discussion.