1
黃帝曰：脉之應于寸口，如何而脹？
黄帝曰：脉之应于寸口，如何而胀？ Huáng Dì yuē: mài zhī yīng yú cùn kǒu, rú hé ér zhàng?
黄帝说：脉在寸口的反应，怎样就算是胀？
The Yellow Emperor said: What is it at the inch mouth that tells of distension?
2
歧伯曰：其脉大堅以濇者，脹也。
歧伯曰：其脉大坚以涩者，胀也。
Qí Bó yuē: qí mài dà jiān yǐ sè zhě, zhàng yě.
歧伯说：脉象大而坚、兼见涩的，就是胀。
Qi Bo said: A pulse that is large, firm and rough is distension.
3
黃帝曰：何以知藏府之脹也？
黄帝曰：何以知藏府之胀也？
Huáng Dì yuē: hé yǐ zhī zàng fǔ zhī zhàng yě?
黄帝说：怎么知道是脏胀还是腑胀呢？
The Emperor said: How does one know whether it is the zang or the fu that are distended?
4
歧伯曰：陰爲藏，陽爲府。
歧伯曰：阴为藏，阳为府。
Qí Bó yuē: yīn wéi zàng, yáng wéi fǔ.
歧伯说：阴脉属脏，阳脉属腑。
Qi Bo said: The yin pulse is the zang, the yang pulse the fu.
5
黃帝曰：夫氣之令人脹也，在于血脉之中耶？藏府之内乎？
黄帝曰：夫气之令人胀也，在于血脉之中耶？藏府之内乎？ Huáng Dì yuē: fū qì zhī lìng rén zhàng yě, zài yú xuè mài zhī zhōng yé? zàng fǔ zhī nèi hū?
黄帝说：气使人胀，是在血脉之中呢？还是在脏腑之内？
The Emperor said: When qi makes a person distended, is it within the blood and vessels, or within the zang and fu?
6
歧伯曰：三者皆存焉，然非脹之舍也。
歧伯曰：三者皆存焉，然非胀之舍也。
Qí Bó yuē: sān zhě jiē cún yān, rán fēi zhàng zhī shè yě.
歧伯说：三者都有，但都不是胀所居留的地方。
Qi Bo said: All three are involved, but none of them is the dwelling of distension.
7
黃帝曰：願聞脹之舍。
黄帝曰：愿闻胀之舍。
Huáng Dì yuē: yuàn wén zhàng zhī shè.
黄帝说：我想听听胀所居留的地方。
The Emperor said: I should like to hear where distension dwells.
8
歧伯曰：夫脹者，皆在于藏府之外，排藏府而郭胸脅，脹皮膚，故命曰脹。
歧伯曰：夫胀者，皆在于藏府之外，排藏府而郭胸胁，胀皮肤，故命曰胀。
Qí Bó yuē: fū zhàng zhě, jiē zài yú zàng fǔ zhī wài, pái zàng fǔ ér guō xiōng xié, zhàng pí fū, gù mìng yuē zhàng.
歧伯说：胀，都在脏腑之外，排挤脏腑而充廓胸胁，使皮肤胀起，所以叫做胀。
Qi Bo said: Distension always lies outside the zang and fu; it pushes against the zang and fu, spreads the chest and ribs, and swells the skin — therefore it is called distension.
9
黃帝曰：藏府之在胸脅腹裏之内也，若匣匱之藏禁器也，各有次舍，異名而同處，一域之中，其氣各異，願聞其故。
黄帝曰：藏府之在胸胁腹里之内也，若匣匮之藏禁器也，各有次舍，异名而同处，一域之中，其气各异，愿闻其故。 Huáng Dì yuē: zàng fǔ zhī zài xiōng xié fù lǐ zhī nèi yě, ruò xiá kuì zhī zàng jìn qì yě, gè yǒu cì shè, yì míng ér tóng chù, yī yù zhī zhōng, qí qì gè yì, yuàn wén qí gù.
黄帝说：脏腑在胸胁腹里之内，如同匣柜收藏珍宝，各有次序居处，名称不同而同处一域，其中的气各不相同，我想听听缘故。
The Emperor said: The zang and fu lie within the chest, ribs and belly as precious vessels lie in a box; each has its ordered place, different names in one region, and the qi of each is different. I should like to hear the reason.
10
黃帝曰：未解其意，再問。
黄帝曰：未解其意，再问。
Huáng Dì yuē: wèi jiě qí yì, zài wèn.
黄帝说：还没明白你的意思，再问一次。
The Emperor said: I do not understand. I ask again.
11
歧伯曰：夫胸腹，藏府之郭也；膻中者，心主之宫城也；胃者，太倉也；咽喉小腸者，傳送也。胃之五竅者，閭里門户也；廉泉玉英者，津液之道也。
歧伯曰：夫胸腹，藏府之郭也；膻中者，心主之宫城也；胃者，太仓也；咽喉小肠者，传送也。胃之五窍者，闾里门户也；廉泉玉英者，津液之道也。 Qí Bó yuē: fū xiōng fù, zàng fǔ zhī guō yě; shān zhōng zhě, xīn zhǔ zhī gōng chéng yě; wèi zhě, tài cāng yě; yān hóu xiǎo cháng zhě, chuán sòng yě. wèi zhī wǔ qiào zhě, lǘ lǐ mén hù yě; lián quán yù yīng zhě, jīn yè zhī dào yě.
歧伯说：胸腹，是脏腑的外郭；膻中，是心主的宫城；胃，是太仓；咽喉小肠，是传送的通道。胃的五窍，如同闾里的门户；廉泉、玉英，是津液的通路。
Qi Bo said: The chest and belly are the outer wall of the zang and fu; the chest is the palace city of the heart master; the stomach is the great granary; the throat and small intestine are the transport. The five openings of the stomach are its gates and doors; Lianquan and Yuying are the ways of the fluids.
12
故五藏六府者，各有畔界，其病各有形狀。
故五藏六府者，各有畔界，其病各有形状。 gù wǔ zàng liù fǔ zhě, gè yǒu pàn jiè, qí bìng gè yǒu xíng zhuàng.
所以五脏六腑，各有界限，发病各有形状。
So the five zang and six fu each have their boundary, and each disease has its own shape.
yíng qì xún mài, wèi qì nì, wéi mài zhàng; wèi qì bìng mài, xún fēn, wéi fū zhàng.
营气循脉而行，卫气逆乱，就成为脉胀；卫气并入脉中，循分肉而行，就成为肤胀。
When camp qi follows the vessels and guard qi runs counter, there is vessel distension; when guard qi joins the vessels and follows the interstices, there is skin distension.
14
三里而寫，近者一下，遠者三下，無問虚實，工在疾寫。
三里而写，近者一下，远者三下，无问虚实，工在疾写。 sān lǐ ér xiè, jìn zhě yī xià, yuǎn zhě sān xià, wú wèn xū shí, gōng zài jí xiè.
取足三里泻之，病近的一下就消，病远的三下才消，不必问虚实，要点在于速泻。
Drain at Zusanli: near cases subside at once, far cases after three sessions; ask nothing of deficiency or excess — the skill lies in draining quickly.
Huáng Dì yuē: yuàn wén zhàng xíng.
黄帝说：我想听听胀的形状。
The Emperor said: I should like to hear the shapes of distension.
16
歧伯曰：夫心脹者，煩心短氣，臥不安。
歧伯曰：夫心胀者，烦心短气，卧不安。 Qí Bó yuē: fū xīn zhàng zhě, fán xīn duǎn qì, wò bù ān.
歧伯说：心胀的，心烦气短，睡卧不安。
Qi Bo said: Distension of the heart gives vexation, shortness of breath and restlessness in sleep.
fèi zhàng zhě, xū mǎn ér chuǎn kài.
肺胀的，虚满而气喘咳嗽。
Distension of the lungs gives empty fullness, panting and cough.
18
肝脹者，脅下滿而痛引小腹。
肝胀者，胁下满而痛引小腹。
gān zhàng zhě, xié xià mǎn ér tòng yǐn xiǎo fù.
肝胀的，胁下胀满而痛，牵引小腹。
Distension of the liver gives fullness and pain below the ribs, drawing on the lower abdomen.
19
脾脹者，善噦，四肢煩悗，體重不能勝衣，臥不安。
脾胀者，善哕，四肢烦悗，体重不能胜衣，卧不安。
pí zhàng zhě, shàn yuě, sì zhī fán náo, tǐ zhòng bù néng shèng yī, wò bù ān.
脾胀的，常打呃，四肢烦闷，身体沉重得连衣服都承受不住，睡卧不安。
Distension of the spleen gives frequent retching, oppression of the limbs, a heaviness of body that cannot bear the clothes, and restlessness in sleep.
20
腎脹者，腹滿引背，央央然，腰髀痛。
肾胀者，腹满引背，央央然，腰髀痛。 shèn zhàng zhě, fù mǎn yǐn bèi, yāng yāng rán, yāo bì tòng.
肾胀的，腹部胀满牵引后背，悒悒不乐，腰髀疼痛。
Distension of the kidneys gives fullness of the belly drawing on the back, a sullen discomfort, and pain in the loins and hips.
liù fǔ zhàng, wèi zhàng zhě, fù mǎn wèi wǎn tòng, bí wén jiāo xiù, fáng yú shí, dà biàn nán.
六腑胀，胃胀的，腹部胀满，胃脘疼痛，鼻中闻到焦臭，妨碍饮食，大便困难。
Of the six fu, distension of the stomach gives fullness of the belly and pain at the stomach duct, the smell of burnt matter in the nose, hindrance to eating, and difficult stool.
22
大腸脹者，腸鳴而痛濯濯，冬日重感于寒，則飱泄不化。
大肠胀者，肠鸣而痛濯濯，冬日重感于寒，则飧泄不化。 dà cháng zhàng zhě, cháng míng ér tòng zhuó zhuó, dōng rì zhòng gǎn yú hán, zé sūn xiè bù huà.
大肠胀的，肠鸣而痛，濯濯有声，冬天再感寒邪，就会飧泄不化。
Distension of the large intestine gives rumbling and pain with a splashing sound; if cold is contracted again in winter, there is undigested diarrhoea.
xiǎo cháng zhàng zhě, shào fù chēn zhàng, yǐn yāo ér tòng.
小肠胀的，少腹胀起，牵引腰部而痛。
Distension of the small intestine gives swelling of the lower abdomen drawing on the loins with pain.
páng guāng zhàng zhě, shào fù mǎn ér qì lóng.
膀胱胀的，少腹胀满而小便不通。
Distension of the bladder gives fullness of the lower abdomen with retention of urine.
25
三焦脹者，氣滿于皮膚中，輕輕然而不堅。
三焦胀者，气满于皮肤中，轻轻然而不坚。 sān jiāo zhàng zhě, qì mǎn yú pí fū zhōng, qīng qīng rán ér bù jiān.
三焦胀的，气满在皮肤之中，按上去轻浮而不坚实。
Distension of the triple burner gives qi filling the skin, light and yielding to the touch, not firm.
26
膽脹者，脅下痛脹，口中苦，善太息。
胆胀者，胁下痛胀，口中苦，善太息。 dǎn zhàng zhě, xié xià tòng zhàng, kǒu zhōng kǔ, shàn tài xī.
胆胀的，胁下胀痛，口里发苦，常叹气。
Distension of the gallbladder gives pain and fullness below the ribs, a bitter taste, and frequent sighing.
27
凡此諸脹者，其道在一。明知逆順，鍼數不失，寫虚補實，神去其室，致邪失正，真不可定，麤之所敗，謂之夭命。補虚寫實，神歸其室，久塞其空，謂之良工。
凡此诸胀者，其道在一。明知逆顺，针数不失，写虚补实，神去其室，致邪失正，真不可定，麤之所败，谓之夭命。补虚写实，神归其室，久塞其空，谓之良工。 fán cǐ zhū zhàng zhě, qí dào zài yī. míng zhī nì shùn, zhēn shù bù shī, xiè xū bǔ shí, shén qù qí shì, zhì xié shī zhèng, zhēn bù kě dìng, cū zhī suǒ bài, wèi zhī yāo mìng. bǔ xū xiè shí, shén guī qí shì, jiǔ sāi qí kōng, wèi zhī liáng gōng.
所有这些胀，道理只有一个。明白逆顺，针刺的度数才不会差失；如果泻虚补实，神就离开它的居处，招来邪气而失掉正气，真气不能安定，这是粗工造成的败坏，叫做夭命。补虚泻实，神回到它的居处，长久地堵塞它的空隙，这才叫做良工。
For all these distensions the way is one. Know following and opposing and the measure of needling is not lost; drain the deficient and supplement the full, and the spirit leaves its chamber, evil is invited and right qi lost, true qi cannot settle — this is the ruin wrought by the coarse, and it is called a shortened life. Supplement the deficient and drain the full, and the spirit returns to its chamber; long stop its openings and it is called a good craftsman.
28
黃帝曰：脹者焉生？何因而有？
黄帝曰：胀者焉生？何因而有？
Huáng Dì yuē: zhàng zhě yān shēng? hé yīn ér yǒu?
黄帝说：胀是怎样产生的？因何而有？
The Emperor said: How does distension arise, and from what cause?
29
歧伯曰：衛氣之在身也，常然並脉循分肉，行有逆順，陰陽相隨，乃得天和。五藏更始，四時循序，五榖乃化。
歧伯曰：卫气之在身也，常然并脉循分肉，行有逆顺，阴阳相随，乃得天和。五藏更始，四时循序，五榖乃化。 Qí Bó yuē: wèi qì zhī zài shēn yě, cháng rán bìng mài xún fēn ròu, xíng yǒu nì shùn, yīn yáng xiāng suí, nǎi dé tiān hé. wǔ zàng gēng shǐ, sì shí xún xù, wǔ gǔ nǎi huà.
歧伯说：卫气在人身，通常并着脉、循着分肉而行，有逆有顺，阴阳相随，才得天然之和。五脏更替，四时有序，五谷才能化。
Qi Bo said: Guard qi in the body ordinarily runs beside the vessels through the interstices, moving with following and opposing, yin and yang attending one another, and so attains the harmony of heaven. The five zang take turns, the four seasons keep their order, and the five grains are transformed.
30
然後厥氣在下，營衛留止，寒氣逆上，真邪相攻，兩氣相搏，乃合爲脹也。
然后厥气在下，营卫留止，寒气逆上，真邪相攻，两气相搏，乃合为胀也。 rán hòu jué qì zài xià, yíng wèi liú zhǐ, hán qì nì shàng, zhēn xié xiāng gōng, liǎng qì xiāng bó, nǎi hé wéi zhàng yě.
然后厥气在下，营卫留止不行，寒气上逆，真气与邪气互相攻击，两气相搏，就合而成胀。
Then when reversal qi lies below, camp and guard halt and stay, cold qi rises against the current, true and evil attack one another, and the two qi wrestle — together they make distension.
31
黃帝曰：善。何以解惑？
黄帝曰：善。何以解惑？
Huáng Dì yuē: shàn. hé yǐ jiě huò?
黄帝说：好。怎样解除疑惑？
The Emperor said: Good. How is the doubt resolved?
32
歧伯曰：合之于真，三合而得。
歧伯曰：合之于真，三合而得。
Qí Bó yuē: hé zhī yú zhēn, sān hé ér dé.
歧伯说：把病与真气合起来审察，三方面合参就能明白。
Qi Bo said: Join it to the true qi; when the three are joined, it is grasped.
33
帝曰：善。
帝曰：善。
dì yuē: shàn.
黄帝说：好。
The Emperor said: Good.
34
黃帝問于歧伯曰：脹論言無間虚實，工在疾寫，近者一下，遠者三下。今有其三而不下者，其過焉在？
黄帝问于歧伯曰：胀论言无间虚实，工在疾写，近者一下，远者三下。今有其三而不下者，其过焉在？ Huáng Dì wèn yú Qí Bó yuē: zhàng lùn yán wú jiān xū shí, gōng zài jí xiè, jìn zhě yī xià, yuǎn zhě sān xià. jīn yǒu qí sān ér bù xià zhě, qí guò yān zài?
黄帝问歧伯说：胀论说不问虚实，要点在速泻，病近的一下，病远的三下。现在有泻了三次而胀不消的，过错在哪里？
The Emperor asked Qi Bo: The Discourse on Distension says, ask nothing of deficiency or excess, the skill lies in draining quickly, near cases at once and far cases after three sessions. Now there are cases where three sessions do not bring it down: where lies the fault?
35
歧伯對曰：此言陷于肉盲，而中氣穴者也。不中氣穴，則氣内閉，鍼不陷盲，則氣不行，上越中肉，則衛氣相亂，陰陽相逐。其于脹也，當寫不寫，氣故不下，三而不下，必更其道，氣下乃止，不下復始，可以萬全，烏有殆者乎？其于脹也，必審其𣍨，當寫則寫，當補則補，如鼓應桴，惡有不下者乎？
歧伯对曰：此言陷于肉盲，而中气穴者也。不中气穴，则气内闭，针不陷盲，则气不行，上越中肉，则卫气相乱，阴阳相逐。其于胀也，当写不写，气故不下，三而不下，必更其道，气下乃止，不下复始，可以万全，乌有殆者乎？其于胀也，必审其𣍨，当写则写，当补则补，如鼓应桴，恶有不下者乎？ Qí Bó duì yuē: cǐ yán xiàn yú ròu máng, ér zhòng qì xué zhě yě. bù zhòng qì xué, zé qì nèi bì, zhēn bù xiàn máng, zé qì bù xíng, shàng yuè zhōng ròu, zé wèi qì xiāng luàn, yīn yáng xiāng zhú. qí yú zhàng yě, dāng xiè bù xiè, qì gù bù xià, sān ér bù xià, bì gēng qí dào, qì xià nǎi zhǐ, bù xià fù shǐ, kě yǐ wàn quán, wū yǒu dài zhě hū? qí yú zhàng yě, bì shěn qí zhěn, dāng xiè zé xiè, dāng bǔ zé bǔ, rú gǔ yìng fú, wū yǒu bù xià zhě hū?
歧伯回答说：这是说针刺要陷进肉肓、正好刺中气穴。没有刺中气穴，气就在内闭住；针不陷进肉肓，气就不能行；上越而中于肉，卫气就相乱，阴阳相逐。对于胀，应当泻而不泻，气所以不下；泻三次而仍不下，一定要改变刺法，气下才停，不下就再来，这样可以万全，哪有危险呢？对于胀，一定要审察它的证候，当泻就泻，当补就补，像鼓应桴一样，哪有不消的呢？
Qi Bo answered: This speaks of sinking into the flesh and hitting the qi point. If the qi point is not hit, the qi closes within; if the needle does not sink into the flesh, the qi does not move; if it overshoots and strikes the flesh, guard qi is thrown into disorder and yin and yang chase one another. In distension, when one should drain and does not, the qi does not descend; if three sessions do not bring it down, the method must be changed, and when the qi descends one stops; if it does not descend, begin again. Thus one may be wholly safe — where is the danger? In distension one must examine the case; drain when draining is due and supplement when supplementing is due, and it answers like a drum to the drumstick — how should it not come down?