Huáng dì wèn yuē: bì zhī ān shēng?
黄帝问道：痺病是怎样发生的？
The Emperor asks: how does obstruction arise?
2
歧伯對曰：風寒濕三氣雜至，合而爲痺也。
歧伯对曰：风寒湿三气杂至，合而为痹也。
Qí bó duì yuē: fēng hán shī sān qì zá zhì, hé ér wéi bì yě.
歧伯回答说：风、寒、湿三种邪气混杂而至，合在一起伤人，便成为痺病——不是三气各成一病，而是杂合伤人。
Qi Bo replies: the three qi of wind, cold and dampness arrive mingled together, and combining, they become obstruction.
Qí fēng qì shèng zhě, wéi xíng bì, hán qì shèng zhě, wéi tòng bì, shī qì shèng zhě, wéi zhuó bì yě.
其中风气偏盛的，叫行痺；寒气偏盛的，叫痛痺；湿气偏盛的，叫著痺。
Where wind qi prevails it is travelling obstruction; where cold qi prevails, painful obstruction; where dampness prevails, fixed obstruction — zhuó, settling, the evil lodging in one place.
4
帝曰：其有五者，何也？
帝曰：其有五者，何也？
Dì yuē: qí yǒu wǔ zhě, hé yě?
黄帝问：痺病又分五种，这是什么道理？
The Emperor asks: and what of the five kinds?
Qí bó yuē: yǐ dōng yù cǐ zhě, wéi gǔ bì; yǐ chūn yù cǐ zhě, wéi jīn bì; yǐ xià yù cǐ zhě, wéi mài bì; yǐ zhì yīn yù cǐ zhě, wéi jī bì; yǐ qiū yù cǐ zhě, wéi pí bì.
歧伯说：冬天感受此邪的为骨痺，春天的为筋痺，夏天的为脉痺，至阴的为肌痺，秋天的为皮痺——五时各有所主，故痺有五名。
Qi Bo says: meeting it in winter gives bone obstruction; in spring, sinew obstruction; in summer, vessel obstruction; at ultimate yin — the late summer — flesh obstruction; in autumn, skin obstruction.
Dì yuē: nèi shè wǔ zàng liù fǔ, hé qì shǐ rán?
黄帝问：痺邪羁留于内，舍于五藏六府，是什么气使它这样的？
The Emperor asks: when it lodges inward in the five stores and the six palaces, what qi brings that about?
7
歧伯曰：五藏皆有合，病久而不去者，内舍於其合也。
歧伯曰：五脏皆有合，病久而不去者，内舍于其合也。
Qí bó yuē: wǔ zàng jiē yǒu hé, bìng jiǔ ér bù qù zhě, nèi shè yú qí hé yě.
歧伯说：五藏各有与之相合的五体，痺病久留不去，就向内舍于与它相合的那一藏。
Qi Bo replies: each of the five stores has what it matches, and when the illness is long-standing and does not leave, it lodges inward in the one it matches.
8
故骨痺不已，復感於邪，内舍於腎；筋痺不已，復感於邪，内舍於肝；脉痺不已，復感於邪，内舍於心；肌痺不已，復感於邪，内舍於脾；皮痺不已，復感於邪，内舍於肺。
故骨痹不已，复感于邪，内舍于肾；筋痹不已，复感于邪，内舍于肝；脉痹不已，复感于邪，内舍于心；肌痹不已，复感于邪，内舍于脾；皮痹不已，复感于邪，内舍于肺。
Gù gǔ bì bù yǐ, fù gǎn yú xié, nèi shè yú shèn; jīn bì bù yǐ, fù gǎn yú xié, nèi shè yú gān; mài bì bù yǐ, fù gǎn yú xié, nèi shè yú xīn; jī bì bù yǐ, fù gǎn yú xié, nèi shè yú pí; pí bì bù yǐ, fù gǎn yú xié, nèi shè yú fèi.
所以骨痺不愈，再感受邪气，就内舍于肾；筋痺不愈，再感邪，内舍于肝；脉痺不愈，内舍于心；肌痺不愈，内舍于脾；皮痺不愈，内舍于肺。
Thus bone obstruction that does not mend, meeting evil again, lodges in the kidney; sinew obstruction in the liver; vessel obstruction in the heart; flesh obstruction in the spleen; skin obstruction in the lung.
9
所謂痺者，各以其時，重感於風寒濕之氣也。
所谓痹者，各以其时，重感于风寒湿之气也。
Suǒ wèi bì zhě, gè yǐ qí shí, chóng gǎn yú fēng hán shī zhī qì yě.
所谓痺，都是各藏在其所主的时令里，再次感受了风寒湿三气。
What is called obstruction is, in each case, meeting the qi of wind, cold and dampness again in the season belonging to that store.
10
凡痺之客五藏者，肺痺者，煩滿喘而嘔；心痺者，脉不通，煩則心下鼓，暴上氣而喘，嗌乾善噫，厥氣上則恐；肝痺者，夜卧則驚，多飲數小便，上爲引如懷；腎痺者，善脹，凥以代踵，脊以代頭；脾痺者，四支解墯，發欬嘔汁，上爲大塞；腸痺者，數飲而出不得，中氣喘爭，時發飱泄；胞痺者，少腹膀胱，按之内痛，若沃以湯，澀於小便，上爲清涕。
凡痹之客五脏者，肺痹者，烦满喘而呕；心痹者，脉不通，烦则心下鼓，暴上气而喘，嗌干善噫，厥气上则恐；肝痹者，夜卧则惊，多饮数小便，上为引如怀；肾痹者，善胀，凥以代踵，脊以代头；脾痹者，四肢解惰，发咳呕汁，上为大塞；肠痹者，数饮而出不得，中气喘争，时发飧泄；胞痹者，少腹膀胱，按之内痛，若沃以汤，涩于小便，上为清涕。
Fán bì zhī kè wǔ zàng zhě, fèi bì zhě, fán mǎn chuǎn ér ǒu; xīn bì zhě, mài bù tōng, fán zé xīn xià gǔ, bào shàng qì ér chuǎn, yì gān shàn ài, jué qì shàng zé kǒng; gān bì zhě, yè wò zé jīng, duō yǐn shuò xiǎo biàn, shàng wéi yǐn rú huái; shèn bì zhě, shàn zhàng, jū yǐ dài zhǒng, jǐ yǐ dài tóu; pí bì zhě, sì zhī jiě duò, fā kài ǒu zhī, shàng wéi dà sè; cháng bì zhě, shuò yǐn ér chū bù dé, zhōng qì chuǎn zhēng, shí fā sūn xiè; bāo bì zhě, shào fù páng guāng, àn zhī nèi tòng, ruò wò yǐ tāng, sè yú xiǎo biàn, shàng wéi qīng tì.
凡痺邪客于五藏，其症各别：肺痺，烦闷胀满、气喘而呕；心痺，脉道不通，心烦则心下鼓动，猝然气逆上冲而喘，咽干、善噫，厥逆之气上冲则生恐惧；肝痺，夜卧易惊，饮水多而小便频数，痛自上方牵引少腹如怀胎之状；肾痺，易于腹胀，凥以代踵、脊以代头；脾痺，四肢懈惰，发欬、呕出清水，上部痞塞不通；肠痺，频频饮水而小便不得出，肠中气逆喘争，时时发为飱泄；胞痺，少腹膀胱之处按之疼痛，如同被热水浇灌，小便涩滞不利，在上则流清涕。
For obstruction lodging in the five stores: lung obstruction is fullness and distress, panting and vomiting; heart obstruction is the vessels not passing through — distress brings a beating below the heart, sudden rising qi and panting, a dry pharynx and frequent belching, and when the counterflow qi rises, fear; liver obstruction is starting in the night, drinking much and passing water often, with a drawing upward that feels like carrying a child; kidney obstruction is a readiness to swell, the rump taking the place of the heel and the spine taking the place of the head; spleen obstruction is slackness of the four limbs, coughing and vomiting fluid, and great stoppage above; intestinal obstruction is drinking often and yet not passing it, the central qi contending with panting, and from time to time outflow diarrhea; bladder obstruction is pain within the lower abdomen and bladder when pressed, as though hot water had been poured in, rough passage of urine, and clear snivel above.
11
陰氣者，靜則神藏，躁則消亡，飲食自倍，腸胃乃傷。
阴气者，静则神藏，躁则消亡，饮食自倍，肠胃乃伤。
Yīn qì zhě, jìng zé shén cáng, zào zé xiāo wáng, yǐn shí zì bèi, cháng wèi nǎi shāng.
五藏之阴气，安静则神气内藏，躁扰则精气消亡；饮食若自倍其量，肠胃就会受伤。
As for yin qi: in stillness the spirit is stored, in agitation it is spent; and when food and drink are doubled, the stomach and intestines are harmed.
Yín qì chuǎn xī, bì jù zài fèi; yín qì yōu sī, bì jù zài xīn; yín qì yí niào, bì jù zài shèn; yín qì fá jié, bì jù zài gān; yín qì jī jué, bì jù zài pí.
淫乱逆乱之气表现为喘息的，痺聚于肺；表现为忧思的，痺聚于心；表现为遗溺的，痺聚于肾；表现为疲乏衰竭的，痺聚于肝；表现为肌肉消瘦断絶的，痺聚于脾。
When the errant qi shows itself as panting, the obstruction gathers in the lung; as worry and thought, in the heart; as bed-wetting, in the kidney; as exhaustion, in the liver; as wasting of the flesh, in the spleen.
Zhū bì bù yǐ, yì yì nèi yě.
各种痺病日久不愈，病变也会向内深入。
All obstructions that do not mend press further inward as well.
14
其風氣勝者，其人易已也。
其风气胜者，其人易已也。
Qí fēng qì shèng zhě, qí rén yì yǐ yě.
其中风气偏盛的，病人容易痊愈。
Where wind qi prevails, the person is easily cured.
15
帝曰：痺其時有死者，或疼久者，或易已者，其故何也？
帝曰：痹其时有死者，或疼久者，或易已者，其故何也？
Dì yuē: bì qí shí yǒu sǐ zhě, huò téng jiǔ zhě, huò yì yǐ zhě, qí gù hé yě?
黄帝问：痺病有时见死的，有的疼痛经久不愈，有的容易痊愈，这是什么缘故？
The Emperor asks: among the obstructed, some die, some ache for long, some mend easily — what accounts for it?
16
歧伯曰：其入藏者死，其留連筋骨間者疼久，其留皮膚間者易已。
歧伯曰：其入藏者死，其留连筋骨间者疼久，其留皮肤间者易已。
Qí bó yuē: qí rù zàng zhě sǐ, qí liú lián jīn gǔ jiān zhě téng jiǔ, qí liú pí fū jiān zhě yì yǐ.
歧伯说：痺邪深入五藏的死；留连于筋骨之间的，疼痛久不愈；留于皮肤之间的，容易痊愈——浅者易已，深者难愈，入藏则死。
Qi Bo replies: what enters the stores kills; what lingers between the sinews and the bones aches for long; what stays in the skin mends easily.
17
帝曰：其客於六府者，何也？
帝曰：其客于六腑者，何也？
Dì yuē: qí kè yú liù fǔ zhě, hé yě?
黄帝问：痺邪客于六府的，又是怎样的？
The Emperor asks: and when it lodges in the six palaces?
18
歧伯曰：此亦其食飲居處，爲其病本也。
歧伯曰：此亦其食饮居处，为其病本也。
Qí bó yuē: cǐ yì qí shí yǐn jū chù, wéi qí bìng běn yě.
歧伯说：这同样是以饮食不节、居处失宜为发病的根本——府痺与藏痺不同，藏痺由五体内传，府痺则由饮食居处先伤于内。
Qi Bo says: here too it is their food and drink and where they dwell that is the root of the illness.
Liù fǔ yì gè yǒu shù, fēng hán shī qì zhòng qí shù, ér shí yǐn yìng zhī, xún shù ér rù, gè shè qí fǔ yě.
六府也各有俞穴，风寒湿气中于其俞，而内里又有饮食所伤与之相应，邪气便循着俞穴而入，各舍于其本府。
The six palaces likewise each have their transport points; when wind, cold and dampness strike those points and what has been eaten and drunk answers to it, the evil follows the points inward and lodges in each of the palaces.
20
帝曰：以鍼治之柰何？
帝曰：以针治之奈何？
Dì yuē: yǐ zhēn zhì zhī nài hé?
黄帝问：用鍼治疗，该怎么办？
The Emperor asks: how is it treated with the needle?
21
歧伯曰：五藏有俞，六府有合，循脉之分，各有所發，各隨其過。
歧伯曰：五脏有俞，六腑有合，循脉之分，各有所发，各随其过。
Qí bó yuē: wǔ zàng yǒu shù, liù fǔ yǒu hé, xún mài zhī fēn, gè yǒu suǒ fā, gè suí qí guò.
歧伯说：五藏有俞穴，六府有合穴，循着经脉所分行的部位，各有发病的征象可察，各随其病变所在而取穴施治。
Qi Bo replies: the five stores have transport points, the six palaces have meeting points; following the divisions of the vessels, each has where it manifests, and each is treated according to where the fault lies.
22
則病瘳也。
则病瘳也。
Zé bìng chōu yě.
这样病就可以痊愈了。
Then the illness is cured.
23
帝曰：榮衛之氣，亦令人痺乎？
帝曰：荣卫之气，亦令人痹乎？
Dì yuē: róng wèi zhī qì, yì lìng rén bì hū?
黄帝问：荣气与卫气，也能使人发生痺病吗？
The Emperor asks: can construction qi and defensive qi themselves give a person obstruction?
24
歧伯曰：榮者，水榖之精氣也，和調於五藏，灑陳於六府，乃能入於脉也。
歧伯曰：荣者，水谷之精气也，和调于五脏，洒陈于六腑，乃能入于脉也。
Qí bó yuē: róng zhě, shuǐ gǔ zhī jīng qì yě, hé tiáo yú wǔ zàng, sǎ chén yú liù fǔ, nǎi néng rù yú mài yě.
歧伯说：荣是水榖所化的精气，调和于五藏，布散于六府，然后才能进入脉中。
Qi Bo replies: construction is the essential qi of grain and water; it is harmonised in the five stores and sprinkled abroad in the six palaces, and so is able to enter the vessels.
25
故循脉上下，貫五藏，絡六府也。
故循脉上下，贯五脏，络六腑也。
Gù xún mài shàng xià, guàn wǔ zàng, luò liù fǔ yě.
所以荣气循着经脉上下运行，贯通五藏，联络六府。
Thus it follows the vessels up and down, piercing the five stores and netting the six palaces.
26
衛者，水榖之悍氣也，其氣慓疾滑利，不能入於脉也。
卫者，水谷之悍气也，其气慓疾滑利，不能入于脉也。
Wèi zhě, shuǐ gǔ zhī hàn qì yě, qí qì piāo jí huá lì, bù néng rù yú mài yě.
卫是水榖所化的悍烈之气，其气慓悍急疾，所以它不能进入脉中——荣行脉中，卫行脉外。
Defensive qi is the fierce qi of grain and water; its qi is swift and slippery-smooth, and it cannot enter the vessels.
27
故循皮膚之中，分肉之間，熏於肓膜，散於胸腹，逆其氣則病，從其氣則愈，不與風寒濕氣合，故不爲痺。
故循皮肤之中，分肉之间，熏于肓膜，散于胸腹，逆其气则病，从其气则愈，不与风寒湿气合，故不为痹。
Gù xún pí fū zhī zhōng, fēn ròu zhī jiān, xūn yú huāng mó, sàn yú xiōng fù, nì qí qì zé bìng, cóng qí qì zé yù, bù yǔ fēng hán shī qì hé, gù bù wéi bì.
所以它循行于皮肤之中、分肉之间，熏蒸于肓膜，散布于胸腹。其气逆乱则病，顺从调和则愈。卫气不与风寒湿三气相合，所以卫气本身并不成为痺病。
So it runs within the skin and between the partings of the flesh, steams the membranes of the body cavities and spreads through the chest and belly. If its qi is counterflow there is illness; if it is compliant, recovery. It does not combine with the qi of wind, cold and dampness, and therefore does not itself make obstruction.
28
帝曰：善。
帝曰：善。
Dì yuē: shàn.
黄帝说：讲得好。
The Emperor says: good.
29
痺或痛，或不痛，或不仁，或寒或熱，或燥，或濕，其故何也？
痹或痛，或不痛，或不仁，或寒或热，或燥，或湿，其故何也？
Bì huò tòng, huò bù tòng, huò bù rén, huò hán huò rè, huò zào, huò shī, qí gù hé yě?
痺病有的痛，有的不痛，有的麻木不仁，有的畏寒，有的发热，有的皮肤干燥，有的湿润，这是什么缘故？
Obstruction may be painful or not painful, may be numbness, may be cold or hot, dry or damp — why is this?
30
歧伯曰：痛者，寒氣多也，有寒故痛也。
歧伯曰：痛者，寒气多也，有寒故痛也。
Qí bó yuē: tòng zhě, hán qì duō yě, yǒu hán gù tòng yě.
歧伯说：痛的，是寒气偏多；寒性凝敛收引，使气血不通、筋脉拘急，所以痛。
Qi Bo replies: the painful ones have much cold qi; where there is cold there is pain.
31
其不痛不仁者，病久入深，榮衛之行濇，經絡時疏，故不通，皮膚不營，故爲不仁。
其不痛不仁者，病久入深，荣卫之行涩，经络时疏，故不通，皮肤不营，故为不仁。
Qí bù tòng bù rén zhě, bìng jiǔ rù shēn, róng wèi zhī xíng sè, jīng luò shí shū, gù bù tōng, pí fū bù yíng, gù wéi bù rén.
那不痛而麻木不仁的，是病久邪深，荣卫的运行涩滞不利，经络时时空虚，所以不痛——不是病轻，而是正气大衰、不知痛痒；皮肤得不到营气的滋养，所以麻木不仁。
The ones that are not painful but numb are long-standing and deeply entered: the movement of construction and defensive qi is rough, the channels and network vessels are at times empty, and so there is no pain; the skin is not nourished, and so there is numbness.
32
其寒者，陽氣少，陰氣多，與病相益，故寒也。
其寒者，阳气少，阴气多，与病相益，故寒也。
Qí hán zhě, yáng qì shǎo, yīn qì duō, yǔ bìng xiāng yì, gù hán yě.
表现为寒的，是病人阳气少、阴气多，阴盛之体又与寒湿之邪相增益，所以见寒。
Where it is cold: yang qi is scant and yin qi abundant, and this adds to the illness — hence cold.
Qí rè zhě, yáng qì duō, yīn qì shǎo, bìng qì shèng, yáng zāo yīn, gù wéi bì rè.
表现为热的，是阳气多、阴气少，阳盛之体使邪从阳化热——阳遭阴，所以成为痺热。
Where it is hot: yang qi is abundant and yin qi scant, the illness qi prevails, and yang overcomes yin — hence heat in obstruction.
34
其多汗而濡者，此其逢濕甚也，陽氣少，陰氣盛，兩氣相感，故汗出而濡也。
其多汗而濡者，此其逢湿甚也，阳气少，阴气盛，两气相感，故汗出而濡也。
Qí duō hàn ér rú zhě, cǐ qí féng shī shèn yě, yáng qì shǎo, yīn qì shèng, liǎng qì xiāng gǎn, gù hàn chū ér rú yě.
那多汗而皮肤湿润的，是感受湿邪太甚；其人阳气少、阴气偏盛，阴气与湿邪两气相感相应，所以汗出而身常湿润。
Those who sweat much and are damp have met with dampness in excess; yang qi is scant and yin qi abundant, and the two qi answer to one another — hence the sweating and the dampness.
35
帝曰：夫痺之爲病，不痛何也？
帝曰：夫痹之为病，不痛何也？
Dì yuē: fú bì zhī wéi bìng, bù tòng hé yě?
黄帝问：大凡痺病却不痛的，又是什么道理？
The Emperor asks: and when obstruction is a disorder that does not hurt, why is that?
36
歧伯曰：痺在於骨則重，在於脉則血凝而不流，在於筋則屈不伸，在於肉則不仁，在於皮則寒，故具此五者，則不痛也。
歧伯曰：痹在于骨则重，在于脉则血凝而不流，在于筋则屈不伸，在于肉则不仁，在于皮则寒，故具此五者，则不痛也。
Qí bó yuē: bì zài yú gǔ zé zhòng, zài yú mài zé xuè níng ér bù liú, zài yú jīn zé qū bù shēn, zài yú ròu zé bù rén, zài yú pí zé hán, gù jù cǐ wǔ zhě, zé bù tòng yě.
歧伯说：痺在骨的则身重，在脉的则血凝而不流，在筋的则屈而不伸，在肉的则麻木不仁，在皮的则觉寒冷；这五者俱备，反而不痛——是病深正衰、不知痛痒，非病轻之象。
Qi Bo replies: in the bone it is heaviness; in the vessels, the blood congeals and does not flow; in the sinews, they bend and do not extend; in the flesh, numbness; in the skin, cold. When all five are present, there is no pain.
37
凡痺之類，逢寒則蟲，逢熱則縱。
凡痹之类，逢寒则虫，逢热则纵。
Fán bì zhī lèi, féng hán zé chóng, féng rè zé zòng.
大凡痺病一类，遇寒则拘急而痛，遇热则松弛纵缓。
In obstruction of every kind, meeting cold it bites — the base text writes 蟲 chóng, where the Jiayi jing and the Taisu write 急, tightening — and meeting heat it slackens.
38
帝曰：善。
帝曰：善。
Dì yuē: shàn.
黄帝说：讲得好。
The Emperor says: good.