歧伯曰：灸之則喑，石之則狂，須其氣并，乃可治也。
歧伯曰：灸之则喑，石之则狂，须其气并，乃可治也。
Qí bó yuē: jiǔ zhī zé yīn, shí zhī zé kuáng, xū qí qì bìng, nǎi kě zhì yě.
Qi Bo says: cauterise it and there is loss of voice; stone it and there is madness. Wait until its qi has combined, and only then may it be treated.
**「灸之則喑，石之則狂，須其氣并，乃可治也」十六字**，**是本篇言治禁之最簡而最決者**。「灸」讀 jiǔ、**本篇2見**；「石」讀 shí**此「石」指砭石**，**與「石藥」之石同字而異物**（本篇「石」6見）；「狂」讀 kuáng、**本篇3見**；「須」讀 xū、**本篇2見**；「并」讀 bìng**不作「並」**；「乃」讀 nǎi、**本篇2見**。**下文「陽氣重上，有餘於上」即釋此條之故**：**上實者灸之則陽益入，石之則陽益虚**，**一入一虚，而喑與狂分**——**同是一病，而二治之害相反**。**本站「灸爇」（#455）、「灸刺」（#768）二條皆言灸法，此條則言其禁**。
胃脉沈鼓濇，胃外鼓大，心脉小堅急，皆鬲偏枯。男子發左，女子發右，不瘖舌轉，可治，三十日起。其從者瘖，三歲起；年不滿二十者，三歲死。
胃脉沉鼓涩，胃外鼓大，心脉小坚急，皆鬲偏枯。男子发左，女子发右，不瘖舌转，可治，三十日起。其从者瘖，三岁起；年不满二十者，三岁死。
Wèi mài chén gǔ sè, wèi wài gǔ dà, xīn mài xiǎo jiān jí, jiē gé piān kū. Nán zǐ fā zuǒ, nǚ zǐ fā yòu, bù yīn shé zhuǎn, kě zhì, sān shí rì qǐ.Qí cóng zhě yīn, sān suì qǐ; nián bù mǎn èr shí zhě, sān suì sǐ.
A stomach vessel sunken, beating up and rough, or beating up large on the outside, and a heart vessel small, hard and hurried, all give one-sided withering with blockage at the diaphragm. In men it appears on the left, in women on the right. If the person is not voiceless and the tongue still turns, it can be treated and he rises in thirty days. If, in the compliant case, the person is voiceless, he rises only after three years; one who is not yet twenty dies within three years.
**底本作「瘖」（疒旁字）而不作「喑」（口旁字）**——「瘖」讀 yīn、**本篇3見，讀 yīn**：**「不瘖舌轉」「其從者瘖」二見在此，與上文「脉不至若瘖」合為三見，皆與第四十七篇同从疒**。**本站「喑」目从口，故挂此一條以互注，不更立「瘖」目**。
所謂入中爲瘖者，陽盛巳衰，故爲瘖也。内奪而厥，則爲瘖俳，此腎虚也，少陰不至者，厥也。
所谓入中为瘖者，阳盛巳衰，故为瘖也。内夺而厥，则为瘖俳，此肾虚也，少阴不至者，厥也。
Suǒ wèi rù zhōng wéi yīn zhě, yáng shèng yǐ shuāi, gù wéi yīn yě. Nèi duó ér jué, zé wéi yīn fèi, cǐ shèn xū yě, shào yīn bù zhì zhě, jué yě.
What is called loss of voice when yang enters the centre: yang has flourished and now declines, hence the loss of voice. When depletion within is carried as far as inversion, the result is loss of voice with palsy; this is depletion of the kidney. When the lesser yin fails to reach, that is inversion.
「入中爲瘖者」——**本篇字作「瘖」从疒——「瘖」讀 yīn，本篇3見；本條作「喑」从口，二字同讀 yīn，此係互注，非本條字見於本篇**；**「瘖俳」之「俳」讀 fèi——「俳」讀 fèi，通痱，王冰注「俳，廢也」**；**陽盛巳衰故爲瘖，内奪而厥則爲瘖俳，此腎虚也**。
歲火不及，寒乃大行，長政不用，物榮而下，凝慘而甚，則陽氣不化，乃折榮美，上應辰星。民病胸中痛，脅支滿，兩脅痛，膺背肩胛間及兩臂内痛，鬱冒朦昧，心痛暴喑，胸腹大，脅下與腰背相引而痛，甚則屈不能伸，髖髀如別，上應熒惑、辰星。其榖丹。復則埃鬱，大雨且至，黑氣乃辱，病鶩溏腹滿，食飲不下，寒中腸鳴，泄注腹痛，暴攣痿痺，足不任身，上應鎮星、辰星。𤣥榖不成。
岁火不及，寒乃大行，长政不用，物荣而下，凝惨而甚，则阳气不化，乃折荣美，上应辰星。民病胸中痛，胁支满，两胁痛，膺背肩胛间及两臂内痛，郁冒朦昧，心痛暴喑，胸腹大，胁下与腰背相引而痛，甚则屈不能伸，髋髀如别，上应荧惑、辰星。其谷丹。复则埃郁，大雨且至，黑气乃辱，病鹜溏腹满，食饮不下，寒中肠鸣，泄注腹痛，暴挛痿痹，足不任身，上应镇星、辰星。𤣥谷不成。
Suì huǒ bù jí, hán nǎi dà xíng, zhǎng zhèng bù yòng, wù róng ér xià, níng cǎn ér shèn, zé yáng qì bù huà, nǎi zhé róng měi, shàng yìng chén xīng. Mín bìng xiōng zhōng tòng, xié zhī mǎn, liǎng xié tòng, yīng bèi jiān jiǎ jiān jí liǎng bì nèi tòng, yù mào méng mèi, xīn tòng bào yīn, xiōng fù dà, xié xià yǔ yāo bèi xiāng yǐn ér tòng, shèn zé qū bù néng shēn, kuān bì rú bié, shàng yìng yíng huò, chén xīng. Qí gǔ dān. Fù zé āi yù, dà yǔ qiě zhì, hēi qì nǎi rǔ, bìng wù táng fù mǎn, shí yǐn bù xià, hán zhōng cháng míng, xiè zhù fù tòng, bào luán wěi bì, zú bù rèn shēn, shàng yìng zhèn xīng, chén xīng. Xuán gǔ bù chéng.
In a year of fire falling short, cold then moves greatly, the governance of growth is not used, and things flourish and then sink. If the congealing bleakness is extreme, the yang qi does not transform and the glory and the beauty are snapped off; it answers above to Mercury. The people are ill with pain in the chest, propping fullness in the flanks, pain in both flanks, pain between the breast, the back and the shoulder blades and on the inner side of both arms, pent-up veiling and dimness, pain in the heart and sudden loss of voice, enlargement of the chest and abdomen, and pain under the flanks drawing into the back and loins; if it is severe they cannot straighten after bending, and the hip and the thigh feel as if they were sundered; it answers above to Mars and Mercury, and its grain is red. When revenge comes there is pent-up dust, great rain is about to arrive, and the black qi is put to shame; the people are ill with duck’s diarrhoea and fullness of the abdomen, food and drink do not go down, cold in the centre and rumbling in the bowels, discharge pouring with pain in the abdomen, sudden cramp, limpness and impediment, and the feet no longer bearing the body; it answers above to Saturn and Mercury, and the dark grain does not form.
「鬱冒朦昧，心痛暴喑，胸腹大」——**「喑」本篇1見，止此一見**；**喑者失音；「暴喑」謂猝然而不能言，本篇在歲火不及、寒氣大行之候**；**「喑」讀 yīn**
少陰之復，燠熱内作，煩躁鼽嚏，少腹絞痛，火見燔爇，嗌燥，分注時止，氣動於左，上行於右，欬皮膚痛，暴喑心痛，鬱冒不知人，乃洒淅惡寒，振慄譫妄，寒已而熱，渴而欲飲，少氣骨痿，隔腸不便，外爲浮腫，噦、噫，赤氣後化，流水不冰，熱氣大行，介蟲不復，病疿、胗、瘡瘍，癰疽、痤、痔，甚則入肺，欬而鼻淵，天府絶，死不治。
少阴之复，燠热内作，烦躁鼽嚏，少腹絞痛，火见燔爇，嗌燥，分注时止，气动于左，上行于右，咳皮肤痛，暴喑心痛，郁冒不知人，乃洒淅恶寒，振栗谵妄，寒已而热，渴而欲饮，少气骨痿，隔肠不便，外为浮肿，哕、噫，赤气后化，流水不冰，热气大行，介虫不复，病疿、胗、疮疡，痈疽、痤、痔，甚则入肺，咳而鼻渊，天府绝，死不治。
Shào yīn zhī fù, yù rè nèi zuò, fán zào qiú tì, shào fù jiǎo tòng, huǒ xiàn fán ruò, yì zào, fēn zhù shí zhǐ, qì dòng yú zuǒ, shàng xíng yú yòu, kài pí fū tòng, bào yīn xīn tòng, yù mào bù zhī rén, nǎi xiǎn xī wù hán, zhèn lì zhān wàng, hán yǐ ér rè, kě ér yù yǐn, shǎo qì gǔ wěi, gé cháng bù biàn, wài wéi fú zhǒng, yuě, ài, chì qì hòu huà, liú shuǐ bù bīng, rè qì dà xíng, jiè chóng bù fù, bìng fèi, zhěn, chuāng yáng, yōng jū, cuó, zhì, shèn zé rù fèi, kài ér bí yuān, tiān fǔ jué, sǐ bù zhì.
When lesser yin takes revenge, pent heat is generated within, with fretfulness and agitation, snivelling and sneezing, cramping pain of the lower belly, fire appearing and burning, a dry throat, and a pouring that stops and starts; qi moves on the left and goes up on the right; there is cough with pain of the skin, sudden loss of voice and pain of the heart, a clouded faintness in which a man does not know others, and then shivering aversion to cold, trembling and wild talk; when the cold is over heat comes, with thirst and a wish to drink, short qi and flaccid bones; the bowel is blocked and the stool does not pass, and outwardly there is swelling, retching and belching. The red qi transforms late, running water does not freeze, heat qi runs its course, and the shelled creatures do not breed again; there are prickly heat, rashes, sores, abscesses, boils, acne and piles, and in grave cases it enters the lung, with cough and a running nose. The tianfu pulse is extinguished — death, not to be treated.
**「喑」本篇1見，止在此句**；**此段「暴喑心痛，鬱冒不知人」，少陰之復所生**