Classica Sinica Medica

The Five Disorders

五亂

Wǔ luàn

The five disorders are not five diseases but five places where one wrongness comes to rest. The chapter opens with a general theory — the channels follow the seasons, and disorder is what happens when clear and turbid stop keeping to their proper levels — and then follows that single disorder into heart, lung, stomach and intestines, arms and shins, and head, giving a picture and a point for each.Two things make the chapter distinctive. The first is its insistence on direction: camp qi runs with the vessels, guard qi against them, and the whole pathology is described as a traffic problem in which clear and turbid encroach on one another. The second is the closing exchange on technique, where slow entry and slow exit are named 導氣, guiding rather than correcting — the needles are not fighting an excess but restoring a route.The five points given are few and precise, and the instruction to bleed the vessels of the arms and feet before needling the yang ming and lesser yang is one of the earliest statements of a principle later taken for granted.

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黃帝曰：經脉十二者，别爲五行，分爲四時，何失而亂？何得而治？ 黄帝曰：经脉十二者，别为五行，分为四时，何失而乱？何得而治？
Huáng Dì yuē: jīng mài shí èr zhě, bié wéi wǔ xíng, fēn wéi sì shí, hé shī ér luàn? hé dé ér zhì?
黄帝说：十二经脉，分别配属五行，分应四时，怎样算失序而乱？怎样算得序而治？
The Yellow Emperor said: The twelve channels are divided among the five phases and apportioned to the four seasons; by what loss do they fall into disorder, and by what gain are they governed?
歧伯曰：五行有序，四時有分，相順則治，相逆則亂。 歧伯曰：五行有序，四时有分，相顺则治，相逆则乱。
Qí Bó yuē: wǔ xíng yǒu xù, sì shí yǒu fēn, xiāng shùn zé zhì, xiāng nì zé luàn.
歧伯说：五行各有次序，四时各有分界，相顺就治，相逆就乱。
Qi Bo said: The five phases have their order, the four seasons their divisions; to follow is to govern, to oppose is to fall into disorder.
黃帝曰：何謂相順？ 黄帝曰：何谓相顺？
Huáng Dì yuē: hé wèi xiāng shùn?
黄帝说：什么叫做相顺？
The Emperor said: What is meant by following?
歧伯曰：經脉十二者，以應十二月。十二月者，分爲四時。四時者，春秋冬夏，其氣各異，營衛相隨，陰陽已和，清濁不相干，如是則順之而治。 歧伯曰：经脉十二者，以应十二月。十二月者，分为四时。四时者，春秋冬夏，其气各异，营卫相随，阴阳已和，清浊不相干，如是则顺之而治。
Qí Bó yuē: jīng mài shí èr zhě, yǐ yīng shí èr yuè. shí èr yuè zhě, fēn wéi sì shí. sì shí zhě, chūn qiū dōng xià, qí qì gè yì, yíng wèi xiāng suí, yīn yáng yǐ hé, qīng zhuó bù xiāng gān, rú shì zé shùn zhī ér zhì.
歧伯说：十二经脉，与十二月相应。十二月，分为四时。四时就是春夏秋冬，气候各不相同，营卫相随而行，阴阳已经和调，清浊互不干犯，这样就是顺，顺就能治。
Qi Bo said: The twelve channels answer to the twelve months; the twelve months are divided into the four seasons; the four seasons are spring, summer, autumn and winter, and their qi differs one from another. When camp and guard follow one another, when yin and yang are already harmonious, and when clear and turbid do not encroach on each other, that is following, and following governs.
黃帝曰：何謂逆而亂？ 黄帝曰：何谓逆而乱？
Huáng Dì yuē: hé wèi nì ér luàn?
黄帝说：什么叫做逆而乱？
The Emperor said: What is meant by opposing and falling into disorder?
歧伯曰：清氣在陰，濁氣在陽，營氣順脉，衛氣逆行，清濁相干，亂于胸中，是謂大悗。 歧伯曰：清气在阴，浊气在阳，营气顺脉，卫气逆行，清浊相干，乱于胸中，是谓大悗。
Qí Bó yuē: qīng qì zài yīn, zhuó qì zài yáng, yíng qì shùn mài, wèi qì nì xíng, qīng zhuó xiāng gān, luàn yú xiōng zhōng, shì wèi dà mèn.
歧伯说：清气陷在阴分，浊气逆在阳分，营气顺着脉走，卫气逆着走，清浊互相干犯，乱在胸中，这就叫大悗。
Qi Bo said: When clear qi is in the yin and turbid qi in the yang, when camp qi runs with the vessels and guard qi runs against them, when clear and turbid encroach on each other and disorder arises in the chest, this is called great oppression.
故氣亂于心，則煩心密嘿，俛首靜伏；亂于肺，則俛仰喘喝，接手以呼；亂于腸胃，則爲霍亂；亂于臂脛，則爲四厥；亂于頭，則爲厥逆，頭重眩仆。 故气乱于心，则烦心密嘿，俛首静伏；乱于肺，则俛仰喘喝，接手以呼；乱于肠胃，则为霍乱；乱于臂胫，则为四厥；乱于头，则为厥逆，头重眩仆。
gù qì luàn yú xīn, zé fán xīn mì mò, fǔ shǒu jìng fú; luàn yú fèi, zé fǔ yǎng chuǎn hè, jiē shǒu yǐ hū; luàn yú cháng wèi, zé wéi huò luàn; luàn yú bì jìng, zé wéi sì jué; luàn yú tóu, zé wéi jué nì, tóu zhòng xuàn pū.
所以气乱在心，就心烦沉默，低头静伏；乱在肺，就俯仰喘促，两手交按在胸前呼气；乱在肠胃，就成为霍乱；乱在臂胫，就成为四肢厥冷；乱在头，就成为厥逆，头重眩晕而仆倒。
So when qi is disordered in the heart there is vexation, silence, a bowed head and still prostration; in the lungs, gasping on bending and stretching, with both hands pressed to the chest to breathe; in the stomach and intestines, sudden turmoil; in the arms and shins, cold reversal of the four limbs; in the head, reversal with heaviness of the head, dizziness and falling.
黃帝曰：五亂者，刺之有道乎？ 黄帝曰：五乱者，刺之有道乎？
Huáng Dì yuē: wǔ luàn zhě, cì zhī yǒu dào hū?
黄帝说：五乱，针刺有法度吗？
The Emperor said: For the five disorders, is there a method in needling?
歧伯曰：有道以來，有道以去，審知其道，是謂身寶。 歧伯曰：有道以来，有道以去，审知其道，是谓身宝。
Qí Bó yuē: yǒu dào yǐ lái, yǒu dào yǐ qù, shěn zhī qí dào, shì wèi shēn bǎo.
歧伯说：有法使它来，有法使它去，审察明白这个法度，就可称为身之宝。
Qi Bo said: There is a way to make it come and a way to make it go; to examine and know that way is called the treasure of the body.
黃帝曰：善。願聞其道。 黄帝曰：善。愿闻其道。
Huáng Dì yuē: shàn. yuàn wén qí dào.
黄帝说：好。我想听听这个法度。
The Emperor said: Good. I should like to hear that way.
歧伯曰：氣在于心者，取之手少陰，心主之輸。 歧伯曰：气在于心者，取之手少阴，心主之输。
Qí Bó yuē: qì zài yú xīn zhě, qǔ zhī shǒu shào yīn, xīn zhǔ zhī shū.
歧伯说：气在心的，取手少阴经和心主之输；
Qi Bo said: When qi is in the heart, take the hand lesser yin and the shu point of the heart master.
氣在於肺者，取之手太陰滎，足少陰輸。 气在于肺者，取之手太阴荥，足少阴输。
qì zài yú fèi zhě, qǔ zhī shǒu tài yīn xíng, zú shào yīn shū.
气在肺的，取手太阴的荥穴和足少阴的输穴；
When qi is in the lungs, take the hand greater yin xing point and the foot lesser yin shu point.
氣在于腸胃者，取之足太陰，陽明不下者，取之三里。 气在于肠胃者，取之足太阴，阳明不下者，取之三里。
qì zài yú cháng wèi zhě, qǔ zhī zú tài yīn, yáng míng bù xià zhě, qǔ zhī sān lǐ.
气在肠胃的，取足太阴；如果还不下行，就取足三里。
When qi is in the stomach and intestines, take the foot greater yin; if it does not descend, take Zusanli.
氣在于頭者，取之天柱、大杼，不知取足太陽滎輸。 气在于头者，取之天柱、大杼，不知取足太阳荥输。
qì zài yú tóu zhě, qǔ zhī tiān zhù, dà zhù, bù zhī qǔ zú tài yáng xíng shū.
气在头的，取天柱、大杼；如果还不好，就取足太阳的荥穴和输穴。
When qi is in the head, take Tianzhu and Dazhu; if it does not stop, take the foot greater yang xing and shu points.
氣在于臂足，取之先去血脉，後取其陽明少陽之榮輸。 气在于臂足，取之先去血脉，后取其阳明少阳之荣输。
qì zài yú bì zú, qǔ zhī xiān qù xuè mài, hòu qǔ qí yáng míng shào yáng zhī xíng shū.
气在臂足的，先取血络去其瘀血，然后取阳明、少阳的荥穴和输穴。
When qi is in the arms and feet, first remove the blood from the vessels, then take the xing and shu points of yang ming and lesser yang.
黃帝曰：補寫奈何？ 黄帝曰：补写奈何？
Huáng Dì yuē: bǔ xiè nài hé?
黄帝说：补泻怎样做？
The Emperor said: How are supplementing and draining done?
歧伯曰：徐入徐出，謂之導氣；補寫無形，謂之同精。是非有餘不足也，亂氣之相逆也。 歧伯曰：徐入徐出，谓之导气；补写无形，谓之同精。是非有余不足也，乱气之相逆也。
Qí Bó yuē: xú rù xú chū, wèi zhī dǎo qì; bǔ xiè wú xíng, wèi zhī tóng jīng. shì fēi yǒu yú bù zú yě, luàn qì zhī xiāng nì yě.
歧伯说：慢慢地进针，慢慢地出针，叫做导气；补泻都不见形迹，叫做同精。这不是有余或不足，而是乱气互相逆乱。
Qi Bo said: Slow entry and slow exit is called guiding the qi; supplementing and draining without visible form is called uniting the essence. This is neither excess nor deficiency, but disordered qi opposing itself.
黃帝曰：允乎哉！道明乎哉論！請著之玉版，命曰治亂也。 黄帝曰：允乎哉！道明乎哉论！请著之玉版，命曰治乱也。
Huáng Dì yuē: yǔn hū zāi! dào míng hū zāi lùn! qǐng zhuó zhī yù bǎn, mìng yuē zhì luàn yě.
黄帝说：说得对啊！道理讲得明白啊！请把它刻在玉版上，命名为治乱。
The Emperor said: How true! How clear the teaching! Let it be written on tablets of jade and called the governing of disorder.

Textual notes

Readings follow the base edition; significant variants are recorded here.

  1. 清濁不相干清濁不相干

    底本作「不相于」，于、干形近而訛，義不可通。同篇下文「清濁相干」、第四十篇「清濁相干，命曰亂氣」皆作「干」，據改。于、干之別，一字之微而句義全異。

  2. 是謂大悗是謂大悗

    悗，音悶，煩悶也。清濁亂於胸中，氣機壅塞，故曰大悗。與《素問·六元正紀大論》「心鬱怫熱」之怫義近，非「惋」字。

  3. 煩心密嘿煩心密嘿

    密嘿，沉默不語也，嘿讀若默。心氣亂則神不安，故煩而反默；與下文「俛首靜伏」同爲心神受擾之象，一躁一靜，皆非其常。

  4. 接手以呼兩手交按以呼

    接手，兩手相交而按於胸也。肺氣亂則呼吸不利，故俯仰皆喘喝，必按胸以助其呼。一本作「兩手交按」，義同而字繁。

  5. 不知取足太陽滎輸不已，取足太陽滎輸

    不知，當作「不已」，謂前取天柱、大杼而病不已，則更取足太陽滎輸。下文「陽明不下者，取之三里」亦此類遞取之法，可互證。

  6. 後取其陽明少陽之榮輸後取其陽明少陽之滎輸

    榮，讀爲滎，五輸之滎穴也。上文「手太陰滎」「足太陽滎輸」皆作滎，此獨作榮，乃同音假借，非營榮之榮。

  7. 徐入徐出，謂之導氣徐入徐出，謂之導氣

    導氣者，引其氣使歸經也。亂氣非實非虛，故不用疾徐補寫之常法，惟徐入徐出以順其勢，此五亂治法之要。

  8. 補寫無形，謂之同精補瀉無形，謂之同精

    同精，謂補寫皆不露形跡，與精氣相合爲一。承上句言，導氣之妙在無形，非另立一法；與「補寫無形」對看，文勢自明。

  9. 命曰治亂也命曰治亂也

    治亂，治其亂也，與篇題「五亂」相應。黃帝命此名而著之玉版，見古人於治法之鄭重，非泛然問答可比。

Cite this page

APA

Huangdi Neijing · Lingshu 黃帝內經靈樞 (Compiled over the same span as the Suwen; the present text was put in order in the Tang.). Wǔ luàn 五亂 [The Five Disorders], Chapter 34. In Classica Sinica Medica. Base text: 《黃帝素問靈樞經》十二卷八十一篇，宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入，卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」，並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。 Retrieved 28 October 2026, from https://classicstcm.com/classics/huangdi-neijing-lingshu/the-five-disorders/

MLA

"Wǔ luàn 五亂 [The Five Disorders]." Huangdi Neijing · Lingshu 黃帝內經靈樞, chapter 34, Classica Sinica Medica, 2026, https://classicstcm.com/classics/huangdi-neijing-lingshu/the-five-disorders/. Accessed 28 Oct. 2026. Base text: 《黃帝素問靈樞經》十二卷八十一篇，宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入，卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」，並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。

Chinese scholarly

《黃帝內經靈樞·五亂》（Huángdì Nèijīng Língshū）。《黃帝素問靈樞經》十二卷八十一篇，宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入，卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」，並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。Classica Sinica Medica，2026 年 10 月 28 日 存取，https://classicstcm.com/classics/huangdi-neijing-lingshu/the-five-disorders/。

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