1
黄帝問曰：夫痎瘧皆生於風，其蓄作有時者，何也？
黄帝问曰：夫痎疟皆生于风，其蓄作有时者，何也？
Huáng dì wèn yuē: fú jiē nüè jiē shēng yú fēng, qí xù zuò yǒu shí zhě, hé yě?
黄帝问道：大凡痎疟都生于风，它蓄积而发作却有一定的时间，这是什么缘故？
The Yellow Emperor asks: now, the jie malarias all arise from wind, and yet their gathering and their breaking out keep to a set time. What is that?
2
歧伯對曰：瘧之始發也，先起於毫毛，伸欠乃作，寒慄鼓頷，腰脊俱痛，寒去則内外皆熱，頭痛如破，渴欲冷飲。
歧伯对曰：疟之始发也，先起于毫毛，伸欠乃作，寒栗鼓颔，腰脊俱痛，寒去则内外皆热，头痛如破，渴欲冷饮。
Qí bó duì yuē: nüè zhī shǐ fā yě, xiān qǐ yú háo máo, shēn qiàn nǎi zuò, hán lì gǔ hàn, yāo jǐ jù tòng, hán qù zé nèi wài jiē rè, tóu tòng rú pò, kě yù lěng yǐn.
歧伯回答说：疟病开始发作时，先起于毫毛，呵欠伸展之后随即发作，寒战战栗、下颌鼓动，腰脊都痛；寒退之后则内外都热，头痛得像要裂开，口渴想喝冷水。
Qi Bo replies: when malaria first breaks out it begins in the down of the skin; a stretching and a yawning, and then it comes — shivering and trembling, the jaw working, the lower back and spine both aching. When the cold withdraws, inner and outer are both hot, the head aches as if it would split, and there is thirst with a desire for cold drink.
3
帝曰：何氣使然？願聞其道。
帝曰：何气使然？愿闻其道。
Dì yuē: hé qì shǐ rán? yuàn wén qí dào.
帝问道：是什么气使它这样？我希望听听其中的道理。
The Emperor asks: what qi brings this about? I wish to hear its way.
4
歧伯曰：陰陽上下交爭，虚實更作，陰陽相移也。
歧伯曰：阴阳上下交争，虚实更作，阴阳相移也。
Qí bó yuē: yīn yáng shàng xià jiāo zhēng, xū shí gēng zuò, yīn yáng xiāng yí yě.
歧伯说：阴阳上下相互交争，虚实交替而作，阴阳彼此推移。
Qi Bo says: yin and yang, above and below, contend with one another; vacuity and repletion take turns acting; yin and yang shift into each other.
5
陽并於陰，則陰實而陽虚，陽明虚則寒慄鼓頷也。
阳并于阴，则阴实而阳虚，阳明虚则寒栗鼓颔也。
Yáng bìng yú yīn, zé yīn shí ér yáng xū, yáng míng xū zé hán lì gǔ hàn yě.
阳并入于阴，就阴实而阳虚；阳明虚，就会寒战战栗、下颌鼓动。
When yang merges into yin, yin is replete and yang vacuous; when yang brightness is vacuous there is shivering and the jaw works.
6
巨陽虚則腰背頭項痛，三陽俱虚，則陰氣勝，陰氣勝則骨寒而痛。寒生於内，故中外皆寒。
巨阳虚则腰背头项痛，三阳俱虚，则阴气胜，阴气胜则骨寒而痛。寒生于内，故中外皆寒。
Jù yáng xū zé yāo bèi tóu xiàng tòng, sān yáng jù xū, zé yīn qì shèng, yīn qì shèng zé gǔ hán ér tòng. Hán shēng yú nèi, gù zhōng wài jiē hán.
巨阳虚，就腰背头项疼痛；三阳都虚，就阴气偏胜，阴气偏胜则骨中发寒而痛。寒生于内，所以中外都寒。
When great yang is vacuous the lower back, back, head and nape ache; when the three yang are all vacuous the yin qi prevails, and when the yin qi prevails the bones are cold and ache. The cold is generated within, and so inner and outer are both cold.
7
陽盛則外熱，陰虚則内熱，外内皆熱，則喘而渴，故欲冷飲也。
阳盛则外热，阴虚则内热，外内皆热，则喘而渴，故欲冷饮也。
Yáng shèng zé wài rè, yīn xū zé nèi rè, wài nèi jiē rè, zé chuǎn ér kě, gù yù lěng yǐn yě.
阳盛就外热，阴虚就内热；内外都热，就气喘而口渴，所以想喝冷水。
Yang exuberant means heat without; yin vacuous means heat within. When outer and inner are both hot there is panting and thirst, and hence the desire for cold drink.
8
此皆得之夏傷於暑，熱氣盛，藏於皮膚之内，腸胃之外，此榮氣之所舍也。
此皆得之夏伤于暑，热气盛，藏于皮肤之内，肠胃之外，此荣气之所舍也。
Cǐ jiē dé zhī xià shāng yú shǔ, rè qì shèng, cáng yú pí fū zhī nèi, cháng wèi zhī wài, cǐ róng qì zhī suǒ shè yě.
这些都是得之于夏天被暑邪所伤：热气炽盛，伏藏在皮肤之内、肠胃之外，这正是荣气所居止的地方。
All this is got from being damaged by summerheat in summer: the hot qi is exuberant and lodges inside the skin and outside the stomach and intestines — which is where the construction qi abides.
9
此令人汗空疏，腠理開，因得秋氣，汗出遇風，及得之以浴，水氣舍於皮膚之内，與衛氣并居。
此令人汗空疏，腠理开，因得秋气，汗出遇风，及得之以浴，水气舍于皮肤之内，与卫气并居。
Cǐ lìng rén hàn kōng shū, còu lǐ kāi, yīn dé qiū qì, hàn chū yù fēng, jí dé zhī yǐ yù, shuǐ qì shè yú pí fū zhī nèi, yǔ wèi qì bìng jū.
这使人汗孔疏松，腠理开泄，于是感受秋气；汗出时遇到风，或是洗浴而得，水气便留止在皮肤之内，与卫气同居一处。
This makes a person’s sweat pores loose and the interstices open, and so the autumn qi is taken in: sweating out of doors one meets wind, or one takes it by bathing, and the water qi lodges inside the skin, dwelling together with the defensive qi.
10
衛氣者，晝日行於陽，夜行於陰，此氣得陽而外出，得陰而内薄，内外相薄，是以日作。
卫气者，昼日行于阳，夜行于阴，此气得阳而外出，得阴而内薄，内外相薄，是以日作。
Wèi qì zhě, zhòu rì xíng yú yáng, yè xíng yú yīn, cǐ qì dé yáng ér wài chū, dé yīn ér nèi bó, nèi wài xiāng bó, shì yǐ rì zuò.
卫气白天行于阳分，夜间行于阴分；这气得阳就外出，得阴就内迫，内外相迫，所以每日发作一次。
The defensive qi moves through yang by day and through yin by night. This qi, meeting yang, goes outward; meeting yin, presses inward. Inner and outer press against each other — and this is why the fit comes daily.
11
帝曰：其間日而作者，何也？
帝曰：其间日而作者，何也？
Dì yuē: qí jiàn rì ér zuò zhě, hé yě?
帝问道：那些隔一日才发作的，是什么缘故？
The Emperor asks: and those that break out every other day — what of them?
12
歧伯曰：其氣之舍深，内薄於陰，陽氣獨發，陰邪内著，陰與陽爭不得出，是以間日而作也。
歧伯曰：其气之舍深，内薄于阴，阳气独发，阴邪内著，阴与阳争不得出，是以间日而作也。
Qí bó yuē: qí qì zhī shè shēn, nèi bó yú yīn, yáng qì dú fā, yīn xié nèi zhuó, yīn yǔ yáng zhēng bù dé chū, shì yǐ jiàn rì ér zuò yě.
歧伯说：邪气留止得深，内迫于阴分，阳气独自发动，阴邪留着在内，阴与阳相争而不得外出，所以隔一日才发作。
Qi Bo says: where the qi lodges deep, pressing inward into yin, the yang qi breaks out alone while the yin evil stays fast within; yin and yang contend and it cannot get out, and this is why the fit comes every other day.
13
帝曰：善。
帝曰：善。
Dì yuē: shàn.
帝说：讲得好。
The Emperor says: good.
14
其作日晏與其日早者，何氣使然？
其作日晏与其日早者，何气使然？
Qí zuò rì yàn yǔ qí rì zǎo zhě, hé qì shǐ rán?
那些发作一天比一天晚，以及一天比一天早的，是什么气使它这样？
And those whose fit comes later each day, and those whose fit comes earlier — what qi brings that about?
15
歧伯曰：邪氣客於風府，循膂而下，衛氣一日一夜大會於風府，其明日日下一節，故其作也晏，此先客於脊背也。
歧伯曰：邪气客于风府，循膂而下，卫气一日一夜大会于风府，其明日日下一节，故其作也晏，此先客于脊背也。
Qí bó yuē: xié qì kè yú fēng fǔ, xún lǚ ér xià, wèi qì yī rì yī yè dà huì yú fēng fǔ, qí míng rì rì xià yī jié, gù qí zuò yě yàn, cǐ xiān kè yú jǐ bèi yě.
歧伯说：邪气客止于风府，沿着脊旁肌肉下行；卫气一日一夜大会于风府，其后每日下行一节，所以发作一天比一天晚——这是邪气先客于脊背的缘故。
Qi Bo says: the evil qi lodges at the wind palace and travels down along the spine. The defensive qi holds its great assembly at the wind palace once in a day and a night, and on the following day descends one joint. So the fit comes later — this is because the evil first lodged in the spine and back.
16
每至於風府，則腠理開，腠理開則邪氣入，邪氣入，則病作，以此日作稍益晏也。
每至于风府，则腠理开，腠理开则邪气入，邪气入，则病作，以此日作稍益晏也。
Měi zhì yú fēng fǔ, zé còu lǐ kāi, còu lǐ kāi zé xié qì rù, xié qì rù, zé bìng zuò, yǐ cǐ rì zuò shāo yì yàn yě.
每当卫气到达风府，腠理就开；腠理开，邪气就进入；邪气进入，病就发作。因此每日发作的时间便渐渐推迟。
Each time it reaches the wind palace the interstices open; the interstices open and the evil qi enters; the evil qi enters and the disease breaks out. By this means the daily fit grows gradually later.
17
其出於風府，日下一節，二十五日下至骶骨，二十六日入於脊内，注於伏膂之脉。
其出于风府，日下一节，二十五日下至骶骨，二十六日入于脊内，注于伏膂之脉。
Qí chū yú fēng fǔ, rì xià yī jié, èr shí wǔ rì xià zhì dǐ gǔ, èr shí liù rì rù yú jǐ nèi, zhù yú fú lǚ zhī mài.
邪气从风府外出，每日下行一节，二十五日下到骶骨，二十六日进入脊内，注入伏行于脊旁的经脉。
Issuing from the wind palace it descends one joint a day: on the twenty-fifth day it has reached the sacrum, and on the twenty-sixth it enters the interior of the spine and pours into the vessel that runs hidden along the spine.
18
其氣上行，九日出於缺盆之中，其氣日高，故作日益早也。
其气上行，九日出于缺盆之中，其气日高，故作日益早也。
Qí qì shàng xíng, jiǔ rì chū yú quē pén zhī zhōng, qí qì rì gāo, gù zuò rì yì zǎo yě.
邪气转而向上运行，九天后出于缺盆之中；邪气一天比一天高，所以发作也一天比一天早。
Then the qi travels upward, and on the ninth day emerges within the supraclavicular fossa. The qi grows higher day by day, and so the fit comes earlier day by day.
19
其間日發者，由邪氣内薄於五藏，横連募原也。其道遠，其氣深，其行遟，不能與衛氣俱行，不得皆出，故間日乃作也。
其间日发者，由邪气内薄于五藏，横连募原也。其道远，其气深，其行迟，不能与卫气俱行，不得皆出，故间日乃作也。
Qí jiàn rì fā zhě, yóu xié qì nèi bó yú wǔ zàng, héng lián mù yuán yě. Qí dào yuǎn, qí qì shēn, qí xíng chí, bù néng yǔ wèi qì jù xíng, bù dé jiē chū, gù jiàn rì nǎi zuò yě.
那些隔日发作的，是因为邪气内迫于五藏，横连于募原。它的路途远，邪气深，运行迟慢，不能与卫气同行，不能每日随卫气尽出，所以隔日才发作。
Those that break out every other day do so because the evil qi presses inward to the five stores and links crosswise with the membrane source. Its road is long, its qi deep, its movement slow: it cannot travel along with the defensive qi and cannot come all the way out, and so the fit comes only every other day.
20
帝曰：夫子言衛氣每至於風府，腠理乃發，發則邪氣入，入則病作。今衛氣日下一節，其氣之發也，不當風府，其日作者柰何？
帝曰：夫子言卫气每至于风府，腠理乃发，发则邪气入，入则病作。今卫气日下一节，其气之发也，不当风府，其日作者奈何？
Dì yuē: fū zǐ yán wèi qì měi zhì yú fēng fǔ, còu lǐ nǎi fā, fā zé xié qì rù, rù zé bìng zuò. Jīn wèi qì rì xià yī jié, qí qì zhī fā yě, bù dāng fēng fǔ, qí rì zuò zhě nài hé?
帝问道：夫子说卫气每到风府，腠理就开泄；开泄则邪气进入，进入则病发作。现在卫气每日下行一节，卫气发动时并不正当风府，那些每日发作的又如何解释？
The Emperor asks: you, master, say that whenever the defensive qi reaches the wind palace the interstices open, and that opening lets the evil qi in, and that its entering makes the disease break out. But now the defensive qi descends one joint a day, so that when it breaks out it is not at the wind palace at all. What of those that come daily?
21
歧伯曰：此邪氣客於頭項，循膂而下者也。故虚實不同，邪中異所，則不得當其風府也。
歧伯曰：此邪气客于头项，循膂而下者也。故虚实不同，邪中异所，则不得当其风府也。
Qí bó yuē: cǐ xié qì kè yú tóu xiàng, xún lǚ ér xià zhě yě. Gù xū shí bù tóng, xié zhòng yì suǒ, zé bù dé dāng qí fēng fǔ yě.
歧伯说：这是邪气客于头项，沿脊旁肌肉而下的那一类。所以虚实不同，邪气中于不同的部位，就未必正当风府了。
Qi Bo says: this is the evil qi lodging at the head and nape and travelling down along the spine. So where vacuity and repletion differ and the evil strikes a different place, it need not be at the wind palace.
22
故邪中於頭項者，氣至頭項而病；中於背者，氣至背而病；中於腰脊者，氣至腰脊而病；中於手足者，氣至手足而病。
故邪中于头项者，气至头项而病；中于背者，气至背而病；中于腰脊者，气至腰脊而病；中于手足者，气至手足而病。
Gù xié zhòng yú tóu xiàng zhě, qì zhì tóu xiàng ér bìng; zhòng yú bèi zhě, qì zhì bèi ér bìng; zhòng yú yāo jǐ zhě, qì zhì yāo jǐ ér bìng; zhòng yú shǒu zú zhě, qì zhì shǒu zú ér bìng.
所以邪气中于头项的，卫气到达头项就发病；中于背的，气到达背部就发病；中于腰脊的，气到达腰脊就发病；中于手足的，气到达手足就发病。
Thus where the evil has struck the head and nape, the disease comes when the qi reaches the head and nape; struck the back, when the qi reaches the back; struck the lower back and spine, when it reaches the lower back and spine; struck the hands and feet, when it reaches the hands and feet.
23
衛氣之所在，與邪氣相合，則病作。故風無常府，衛氣之所發，必開其腠理，邪氣之所合，則其府也。
卫气之所在，与邪气相合，则病作。故风无常府，卫气之所发，必开其腠理，邪气之所合，则其府也。
Wèi qì zhī suǒ zài, yǔ xié qì xiāng hé, zé bìng zuò. Gù fēng wú cháng fǔ, wèi qì zhī suǒ fā, bì kāi qí còu lǐ, xié qì zhī suǒ hé, zé qí fǔ yě.
卫气所在之处，与邪气相合，病就发作。所以风没有固定的府；卫气发动之处，必定开泄那里的腠理，邪气相合之处，就是风的府。
Where the defensive qi is, there the evil qi meets it, and the disease breaks out. Therefore wind has no fixed palace: wherever the defensive qi breaks out, it opens the interstices there, and where the evil qi joins it — that is its palace.
24
帝曰：善。
帝曰：善。
Dì yuē: shàn.
帝说：讲得好。
The Emperor says: good.
25
夫風之與瘧也，相似同類，而風獨常在，瘧得有時而休者，何也？
夫风之与疟也，相似同类，而风独常在，疟得有时而休者，何也？
Fú fēng zhī yǔ nüè yě, xiāng sì tóng lèi, ér fēng dú cháng zài, nüè dé yǒu shí ér xiū zhě, hé yě?
风病与疟病，相似而同类，然而风病常常持续存在，疟病却能有发作有时、休止有时，这是什么缘故？
Now wind and malaria resemble each other and are of one kind, yet wind alone is constantly present while malaria has its times of rest. What is that?
Qí bó yuē: fēng qì liú qí chù, gù cháng zài, nüè qì suí jīng luò, chén yǐ nèi bó, gù wèi qì yìng nǎi zuò.
歧伯说：风气留止在它所在的处所，所以常常存在；疟气随经络而行，沉伏在内而向内逼迫，所以卫气与之相应时才发作。
Qi Bo says: the wind qi stays in its place, and so is constant; the malarial qi follows the channels and networks, sinking to press inward, and so it breaks out only when the defensive qi answers it.
27
帝曰：瘧先寒而後熱者，何也？
帝曰：疟先寒而后热者，何也？
Dì yuē: nüè xiān hán ér hòu rè zhě, hé yě?
帝问道：疟病先寒而后热的，是什么缘故？
The Emperor asks: malaria that is cold first and hot afterwards — what is that?
28
歧伯曰：夏傷於大暑，其汗大出，腠理開發，因遇夏氣淒滄之水寒，藏於腠理皮膚之中，秋傷於風，則病成矣。
歧伯曰：夏伤于大暑，其汗大出，腠理开发，因遇夏气凄沧之水寒，藏于腠理皮肤之中，秋伤于风，则病成矣。
Qí bó yuē: xià shāng yú dà shǔ, qí hàn dà chū, còu lǐ kāi fā, yīn yù xià qì qī cāng zhī shuǐ hán, cáng yú còu lǐ pí fū zhī zhōng, qiū shāng yú fēng, zé bìng chéng yǐ.
歧伯说：夏天被大暑所伤，汗大出，腠理开发，因而遇到夏令凄沧的水寒之气，藏伏在腠理皮肤之中，秋天又被风所伤，病就形成了。
Qi Bo says: in summer one is damaged by great summerheat; the sweat comes out profusely and the interstices open wide, and one meets the bitter cold of water in the summer qi, which lodges among the interstices and the skin. In autumn one is damaged by wind, and the disease is complete.
29
夫寒者，陰氣也，風者，陽氣也，先傷於寒，而後傷於風，故先寒而後熱也，病以時作，名曰寒瘧。
夫寒者，阴气也，风者，阳气也，先伤于寒，而后伤于风，故先寒而后热也，病以时作，名曰寒疟。
Fú hán zhě, yīn qì yě, fēng zhě, yáng qì yě, xiān shāng yú hán, ér hòu shāng yú fēng, gù xiān hán ér hòu rè yě, bìng yǐ shí zuò, míng yuē hán nüè.
寒是阴气，风是阳气。先被寒所伤，然后被风所伤，所以先寒而后热；病按时发作，名叫寒疟。
Now cold is yin qi, and wind is yang qi. Being damaged first by cold and afterwards by wind is why there is cold first and heat afterwards. The disease breaks out by the clock, and it is named cold malaria.
30
帝曰：先熱而後寒者何也？
帝曰：先热而后寒者何也？
Dì yuē: xiān rè ér hòu hán zhě hé yě?
帝问道：先热而后寒的，又是什么缘故？
The Emperor asks: and those that are hot first and cold afterwards?
31
歧伯曰：此先傷於風，而後傷於寒，故先熱而後寒也，亦以時作，名曰温瘧。
歧伯曰：此先伤于风，而后伤于寒，故先热而后寒也，亦以时作，名曰温疟。
Qí bó yuē: cǐ xiān shāng yú fēng, ér hòu shāng yú hán, gù xiān rè ér hòu hán yě, yì yǐ shí zuò, míng yuē wēn nüè.
歧伯说：这是先被风所伤，然后被寒所伤，所以先热而后寒；也按时发作，名叫温疟。
Qi Bo says: this is being damaged first by wind and afterwards by cold, and so there is heat first and cold afterwards. It too breaks out by the clock, and it is named warm malaria.
32
其但熱而不寒者，陰氣先絶，陽氣獨發，則少氣煩冤，手足熱而欲嘔，名曰癉瘧。
其但热而不寒者，阴气先绝，阳气独发，则少气烦冤，手足热而欲呕，名曰瘅疟。
Qí dàn rè ér bù hán zhě, yīn qì xiān jué, yáng qì dú fā, zé shǎo qì fán yuān, shǒu zú rè ér yù ǒu, míng yuē dān nüè.
那些只发热而不恶寒的，是阴气先已断绝，阳气独自发动，于是气少、烦闷冤乱，手足发热而想要呕吐，名叫瘅疟。
Those with heat only and no cold have had the yin qi cut off first, so that the yang qi breaks out alone: there is scant qi with fretting distress, heat in the hands and feet and a wish to vomit. It is named dan malaria.
33
帝曰：夫經言有餘者寫之，不足者補之。今熱爲有餘，寒爲不足。夫瘧者之寒，湯火不能温也；及其熱，冰水不能寒也。此皆有餘不足之類。當此之時，良工不能止，必須其自衰乃剌之，其故何也？願聞其説。
帝曰：夫经言有余者写之，不足者补之。今热为有余，寒为不足。夫疟者之寒，汤火不能温也；及其热，冰水不能寒也。此皆有余不足之类。当此之时，良工不能止，必须其自衰乃刺之，其故何也？愿闻其说。
Dì yuē: fú jīng yán yǒu yú zhě xiě zhī, bù zú zhě bǔ zhī. Jīn rè wéi yǒu yú, hán wéi bù zú. Fú nüè zhě zhī hán, tāng huǒ bù néng wēn yě; jí qí rè, bīng shuǐ bù néng hán yě. Cǐ jiē yǒu yú bù zú zhī lèi. Dāng cǐ zhī shí, liáng gōng bù néng zhǐ, bì xū qí zì shuāi nǎi cì zhī, qí gù hé yě? yuàn wén qí shuō.
帝问道：医经上说，有余的用泻法，不足的用补法。如今热属有余，寒属不足。可是疟病的寒，热汤与火都不能使之温暖；到了发热时，冰水也不能使之寒凉。这都属于有余不足一类。正当发作之时，良医也不能制止，必须等它自行衰减才施针，这是什么缘故？我希望听听其中的说法。
The Emperor asks: the classic says that what is in excess is drained and what is insufficient is supplemented. Now heat is excess and cold is insufficiency — yet the cold of malaria cannot be warmed by hot broth or fire, and when the heat comes, ice water cannot cool it. Both belong to the class of excess and insufficiency. At just that moment a good practitioner cannot stop it, and must wait for it to decline of itself before needling. Why is that? I wish to hear the explanation.
Qí bó yuē: jīng yán wú cì hè hè zhī rè, wú cì hún hún zhī mài, wú cì lù lù zhī hàn, gù wéi qí bìng nì, wèi kě zhì yě.
歧伯说：医经上说，不要在炽烈的热势时针刺，不要在脉象浑乱时针刺，不要在汗出不止时针刺，因为这时病气上逆，还不可以施治。
Qi Bo says: the classic says — do not needle a scorching heat, do not needle a turbulent pulse, do not needle a streaming sweat. For its disease is in counterflow, and it cannot yet be treated.
35
夫瘧之始發也，陽氣并於陰，當是之時，陽虚而陰盛，外無氣，故先寒慄也。
夫疟之始发也，阳气并于阴，当是之时，阳虚而阴盛，外无气，故先寒栗也。
Fú nüè zhī shǐ fā yě, yáng qì bìng yú yīn, dāng shì zhī shí, yáng xū ér yīn shèng, wài wú qì, gù xiān hán lì yě.
疟病刚发作时，阳气并于阴分；在这个时候，阳虚而阴盛，外部无气，所以先发寒战。
When malaria first breaks out the yang qi merges into yin. At just that time yang is vacuous and yin exuberant and there is no qi without, and so shivering comes first.
36
陰氣逆極，則復出之陽，陽與陰復并於外，則陰虚而陽實，故先熱而渴。
阴气逆极，则复出之阳，阳与阴复并于外，则阴虚而阳实，故先热而渴。
Yīn qì nì jí, zé fù chū zhī yáng, yáng yǔ yīn fù bìng yú wài, zé yīn xū ér yáng shí, gù xiān rè ér kě.
阴气上逆到了极点，就重新出于阳分；阳与阴又并于外部，于是阴虚而阳实，所以先发热而口渴。
When the yin qi has reached the extreme of counterflow it comes out again into yang; yang and yin merge once more on the outside, and then yin is vacuous and yang replete — and so there is heat first, and thirst.
37
夫瘧氣者，并於陽則陽勝，并於陰則陰勝，陰勝則寒，陽勝則熱。
夫疟气者，并于阳则阳胜，并于阴则阴胜，阴胜则寒，阳胜则热。
Fú nüè qì zhě, bìng yú yáng zé yáng shèng, bìng yú yīn zé yīn shèng, yīn shèng zé hán, yáng shèng zé rè.
疟气并于阳分就阳胜，并于阴分就阴胜；阴胜就寒，阳胜就热。
The malarial qi: merged with yang, yang prevails; merged with yin, yin prevails. Yin prevailing means cold, yang prevailing means heat.
38
瘧者，風寒之氣不常也，病極則復至。病之發也，如火之熱，如風雨不可當也。
疟者，风寒之气不常也，病极则复至。病之发也，如火之热，如风雨不可当也。
Nüè zhě, fēng hán zhī qì bù cháng yě, bìng jí zé fù zhì. Bìng zhī fā yě, rú huǒ zhī rè, rú fēng yǔ bù kě dāng yě.
疟病是风寒之气变化无常所致，病到了极点又会再来。病发作时，像火一样炽热，像风雨一样不可抵挡。
Malaria is the qi of wind and cold without constancy: when the disease reaches its extreme it comes round again. When it breaks out it is like the heat of fire, like wind and rain that cannot be withstood.
39
故經言曰：方其盛時必毁，因其衰也，事必大昌，此之謂也。
故经言曰：方其盛时必毁，因其衰也，事必大昌，此之谓也。
Gù jīng yán yuē: fāng qí shèng shí bì huǐ, yīn qí shuāi yě, shì bì dà chāng, cǐ zhī wèi yě.
所以医经上说：正当邪气炽盛时攻治必定损伤正气，趁着邪气衰减而治，事情必定大为成功，说的就是这个道理。
Hence the classic says: at the very height of its vigour, any attack will ruin; follow its decline and the undertaking is sure to prosper greatly. This is what that means.
40
夫瘧之未發也，陰未并陽，陽未并陰，因而調之，真氣得安，邪氣乃亡。故工不能治其已發，爲其氣逆也。
夫疟之未发也，阴未并阳，阳未并阴，因而调之，真气得安，邪气乃亡。故工不能治其已发，为其气逆也。
Fú nüè zhī wèi fā yě, yīn wèi bìng yáng, yáng wèi bìng yīn, yīn ér tiáo zhī, zhēn qì dé ān, xié qì nǎi wáng. Gù gōng bù néng zhì qí yǐ fā, wèi qí qì nì yě.
疟病尚未发作时，阴还没有并于阳，阳还没有并于阴，趁此时加以调治，真气就能安宁，邪气就会消亡。所以医工不能治疗已经发作的疟病，是因为它的气上逆。
Before malaria has broken out, yin has not yet merged with yang nor yang with yin; regulate it then and the true qi is set at rest and the evil qi perishes. This is why a practitioner cannot treat it once it has broken out — its qi is in counterflow.
41
帝曰：善。
帝曰：善。
Dì yuē: shàn.
帝说：讲得好。
The Emperor says: good.
42
攻之柰何？早晏何如？
攻之奈何？早晏何如？
Gōng zhī nài hé? zǎo yàn hé rú?
怎样攻治它？时间上早一些还是晚一些？
How does one attack it? And what of earlier or later?
43
歧伯曰：瘧之且發也，陰陽之且移也，必從四末始也。陽已傷，陰從之，故先其時，堅束其處，令邪氣不得入，陰氣不得出。
歧伯曰：疟之且发也，阴阳之且移也，必从四末始也。阳已伤，阴从之，故先其时，坚束其处，令邪气不得入，阴气不得出。
Qí bó yuē: nüè zhī qiě fā yě, yīn yáng zhī qiě yí yě, bì cóng sì mò shǐ yě. Yáng yǐ shāng, yīn cóng zhī, gù xiān qí shí, jiān shù qí chù, lìng xié qì bù dé rù, yīn qì bù dé chū.
歧伯说：疟病将要发作、阴阳将要转移的时候，必定从四肢末端开始。阳分已伤，阴分随之，所以在发作之前，把那个部位牢牢束住，使邪气不能进入，阴气不能外出。
Qi Bo says: when malaria is about to break out and yin and yang are about to shift, it always begins from the four extremities. Yang is already damaged and yin follows it, so anticipate the hour: bind the place tightly, and let the evil qi be unable to enter and the yin qi unable to get out.
44
審候見之，在孫絡盛堅而血者，皆取之，此真往而未得并者也。
审候见之，在孙络盛坚而血者，皆取之，此真往而未得并者也。
Shěn hòu jiàn zhī, zài sūn luò shèng jiān ér xuè zhě, jiē qǔ zhī, cǐ zhēn wǎng ér wèi dé bìng zhě yě.
仔细诊察而发现它：孙络中盛满坚实而充血的，都刺取其血，这时真气已往而邪气尚未与之相并。
Examine and watch for it: wherever the grandchild networks are full, hard and blooded, take them all. This is the true qi having gone forth and not yet merged.
45
帝曰：瘧不發，其應何如？
帝曰：疟不发，其应何如？
Dì yuē: nüè bù fā, qí yīng hé rú?
帝问道：疟病不发的时候，它的征象是怎样的？
The Emperor asks: when malaria is not breaking out, what is its response?
46
歧伯曰：瘧氣者，必更盛更虚，當氣之所在也，病在陽，則熱而脉躁，在陰，則寒而脉靜。極則陰陽俱衰，衛氣相離，故病得休，衛氣集，則復病也。
歧伯曰：疟气者，必更盛更虚，当气之所在也，病在阳，则热而脉躁，在阴，则寒而脉静。极则阴阳俱衰，卫气相离，故病得休，卫气集，则复病也。
Qí bó yuē: nüè qì zhě, bì gēng shèng gēng xū, dāng qì zhī suǒ zài yě, bìng zài yáng, zé rè ér mài zào, zài yīn, zé hán ér mài jìng. Jí zé yīn yáng jù shuāi, wèi qì xiāng lí, gù bìng dé xiū, wèi qì jí, zé fù bìng yě.
歧伯说：疟气必定交替地盛、交替地虚。当邪气所在之处：病在阳分，就发热而脉躁；在阴分，就恶寒而脉静。到了极点则阴阳俱衰，卫气与邪气相离，所以病能休止；卫气再会集，就又发病了。
Qi Bo says: the malarial qi is necessarily now exuberant, now vacuous. Wherever the qi is: if the disease is in yang there is heat and a restless pulse; if in yin, cold and a quiet pulse. At the extreme, yin and yang both decline and the defensive qi draws apart, and so the disease rests; when the defensive qi gathers again, the disease returns.
47
帝曰：時有間二日，或至數日發，或渴或不渴，其故何也？
帝曰：时有间二日，或至数日发，或渴或不渴，其故何也？
Dì yuē: shí yǒu jiàn èr rì, huò zhì shù rì fā, huò kě huò bù kě, qí gù hé yě?
帝问道：有时隔两天，有的甚至隔数日才发作；有的口渴，有的不渴，这是什么缘故？
The Emperor asks: sometimes there is an interval of two days, or it may not break out for several days; sometimes there is thirst and sometimes not. What accounts for that?
48
歧伯曰：其間日者，邪氣與衛氣客於六府，而有時相失，不能相得，故休數日乃作也。瘧者，陰陽更勝也，或甚或不甚，故或渴或不渴。
歧伯曰：其间日者，邪气与卫气客于六府，而有时相失，不能相得，故休数日乃作也。疟者，阴阳更胜也，或甚或不甚，故或渴或不渴。
Qí bó yuē: qí jiàn rì zhě, xié qì yǔ wèi qì kè yú liù fǔ, ér yǒu shí xiāng shī, bù néng xiāng dé, gù xiū shù rì nǎi zuò yě. Nüè zhě, yīn yáng gēng shèng yě, huò shèn huò bù shèn, gù huò kě huò bù kě.
歧伯说：那些隔日发作的，是邪气与卫气客居在六府，有时彼此错过而不能相合，所以休止数日才发作。疟病是阴阳交替偏胜，有的偏胜得厉害，有的不那么厉害，所以有的口渴，有的不渴。
Qi Bo says: those with an interval of days have the evil qi and the defensive qi lodging in the six palaces, and at times they miss each other and cannot meet, which is why they rest several days before breaking out. As for the thirst: malaria is yin and yang prevailing by turns, sometimes severely and sometimes not, and hence sometimes thirst and sometimes none.
49
帝曰：論言夏傷於暑，秋必病瘧，今瘧不必應者，何也？
帝曰：论言夏伤于暑，秋必病疟，今疟不必应者，何也？
Dì yuē: lùn yán xià shāng yú shǔ, qiū bì bìng nüè, jīn nüè bù bì yīng zhě, hé yě?
帝问道：医论上说夏天被暑所伤，秋天必定发疟；现在疟病未必都应验，这是什么缘故？
The Emperor asks: the treatises say that damage by summerheat in summer means malaria in autumn without fail — yet malaria does not always answer to this. What is that?
Qí bó yuē: cǐ yīng sì shí zhě yě. Qí bìng yì xíng zhě, fǎn sì shí yě.
歧伯说：这是与四时相应的那一类。那些病状与此不同的，是反四时的。
Qi Bo says: that saying answers to the four seasons. Where the disease takes a different form, the four seasons are turned about.
51
其以秋病者寒甚，以冬病者寒不甚，以春病者惡風，以夏病者多汗。
其以秋病者寒甚，以冬病者寒不甚，以春病者恶风，以夏病者多汗。
Qí yǐ qiū bìng zhě hán shèn, yǐ dōng bìng zhě hán bù shèn, yǐ chūn bìng zhě wù fēng, yǐ xià bìng zhě duō hàn.
在秋天发病的寒得厉害，在冬天发病的寒不厉害，在春天发病的怕风，在夏天发病的多汗。
Those who sicken in autumn have severe cold; those who sicken in winter have cold that is not severe; those who sicken in spring are averse to wind; those who sicken in summer sweat much.
52
帝曰：夫病温瘧與寒瘧，而皆安舍，舍於何藏？
帝曰：夫病温疟与寒疟，而皆安舍，舍于何藏？
Dì yuē: fú bìng wēn nüè yǔ hán nüè, ér jiē ān shè, shè yú hé zàng?
帝问道：患温疟与寒疟的，邪气都安居在何处？止舍在哪一藏？
The Emperor asks: in warm malaria and in cold malaria, where does it rest — in what store does it lodge?
53
歧伯曰：温瘧者，得之冬中於風，寒氣藏於骨髓之中，至春則陽氣大發，邪氣不能自出，因遇大暑，腦髓爍，肌肉消，腠理發泄，或有所用力，邪氣與汗皆出，此病藏於腎，其氣先從内出之於外也。
歧伯曰：温疟者，得之冬中于风，寒气藏于骨髓之中，至春则阳气大发，邪气不能自出，因遇大暑，脑髓烁，肌肉消，腠理发泄，或有所用力，邪气与汗皆出，此病藏于肾，其气先从内出之于外也。
Qí bó yuē: wēn nüè zhě, dé zhī dōng zhòng yú fēng, hán qì cáng yú gǔ suǐ zhī zhōng, zhì chūn zé yáng qì dà fā, xié qì bù néng zì chū, yīn yù dà shǔ, nǎo suǐ shuò, jī ròu xiāo, còu lǐ fā xiè, huò yǒu suǒ yòng lì, xié qì yǔ hàn jiē chū, cǐ bìng cáng yú shèn, qí qì xiān cóng nèi chū zhī yú wài yě.
歧伯说：温疟是冬天感受风邪而得，寒气藏伏在骨髓之中；到了春天阳气大发，邪气不能自行外出，又遇到大暑，脑髓消烁，肌肉消瘦，腠理发泄，或者用力过度，邪气与汗一起外出。这种病藏伏在肾，它的气先从内出于外。
Qi Bo says: warm malaria is contracted by being struck by wind in winter, the cold qi lodging within the bone and marrow. When spring comes the yang qi breaks out greatly and the evil qi cannot get out by itself; then great summerheat is met, the brain and marrow are scorched, the flesh wastes, the interstices discharge, or a strain is taken — and the evil qi comes out together with the sweat. This disease lodges in the kidney, and its qi goes from within to without first.
54
如是者，陰虚而陽盛，陽盛則熱矣。衰則氣復反入，入則陽虚，陽虚則寒矣，故先熱而後寒，名曰温瘧。
如是者，阴虚而阳盛，阳盛则热矣。衰则气复反入，入则阳虚，阳虚则寒矣，故先热而后寒，名曰温疟。
Rú shì zhě, yīn xū ér yáng shèng, yáng shèng zé rè yǐ. Shuāi zé qì fù fǎn rù, rù zé yáng xū, yáng xū zé hán yǐ, gù xiān rè ér hòu hán, míng yuē wēn nüè.
像这样的，阴虚而阳盛，阳盛就发热。邪气衰减则气又返回内入，内入就阳虚，阳虚就恶寒，所以先热而后寒，名叫温疟。
In such a case yin is vacuous and yang exuberant, and yang exuberant means heat. When it declines the qi turns back and goes in; going in means yang vacuous, and yang vacuous means cold. Hence heat first and cold afterwards — it is named warm malaria.
Dì yuē: dān nüè hé rú?
帝问道：瘅疟是怎样的？
The Emperor asks: and what of dan malaria?
56
歧伯曰：癉瘧者，肺素有熱，氣盛於身，厥逆上衝，中氣實而不外泄，因有所用力，腠理開，風寒舍於皮膚之内，分肉之閒而發，發則陽氣盛，陽氣盛而不衰，則病矣。
歧伯曰：瘅疟者，肺素有热，气盛于身，厥逆上冲，中气实而不外泄，因有所用力，腠理开，风寒舍于皮肤之内，分肉之间而发，发则阳气盛，阳气盛而不衰，则病矣。
Qí bó yuē: dān nüè zhě, fèi sù yǒu rè, qì shèng yú shēn, jué nì shàng chōng, zhōng qì shí ér bù wài xiè, yīn yǒu suǒ yòng lì, còu lǐ kāi, fēng hán shè yú pí fū zhī nèi, fēn ròu zhī jiān ér fā, fā zé yáng qì shèng, yáng qì shèng ér bù shuāi, zé bìng yǐ.
歧伯说：瘅疟的人，肺中素来有热，气盛于全身，气逆上冲，中气壅实而不能外泄；因为用力，腠理开张，风寒留止在皮肤之内、分肉之间而发作；发作就阳气盛，阳气盛而不衰减，于是成病。
Qi Bo says: in dan malaria the lung has heat by long standing, the qi is exuberant in the body, and it surges upward in counterflow; the central qi is replete and does not discharge outward. Then a strain is taken, the interstices open, and wind and cold lodge inside the skin, breaking out between the parted flesh. When it breaks out the yang qi is exuberant, and being exuberant without declining, the disease is there.
57
其氣不及於陰，故但熱而不寒，氣内藏於心，而外舍於分肉之閒，令人消爍脱肉，故命曰癉瘧。
其气不及于阴，故但热而不寒，气内藏于心，而外舍于分肉之间，令人消烁脱肉，故命曰瘅疟。
Qí qì bù jí yú yīn, gù dàn rè ér bù hán, qì nèi cáng yú xīn, ér wài shè yú fēn ròu zhī jiān, lìng rén xiāo shuò tuō ròu, gù mìng yuē dān nüè.
邪气不及于阴分，所以只发热而不恶寒；气内藏于心，外舍于分肉之间，使人消烁消瘦、肌肉脱失，所以命名为瘅疟。
Its qi does not reach into yin, and so there is heat only and no cold. The qi lodges inward in the heart and outward between the parted flesh, and makes a person wasted, scorched and stripped of flesh. Hence it is named dan malaria.
58
帝曰：善。
帝曰：善。
Dì yuē: shàn.
帝说：讲得好。
The Emperor says: good.