Classica Sinica Medica

A Discourse on Qi Counterflow

氣厥論

Qì jué lùn

Chapter 37 is the shortest and most systematic treatise in the book: one question, and an answer that is nothing but a list. The question asks what happens when cold and heat shift from one viscus to another, and the answer gives fifteen cases in a fixed shape — this viscus passes its excess to that one, and the result is this named illness. The first five move cold, following the round of the five stores; the next ten move heat, and run through the stores and then down into the bowels and the bladder. Nothing is argued and nothing is proved. The chapter simply states what each transmission produces, and in three places adds the words that close a case for good: death, no treatment. Two of its names have outlived the theory that produced them. Eat-and-waste is a patient who eats well and yet grows thin. Deep-source nose is a discharge that will not stop — it is still the name for chronic sinusitis today. The last line returns to the title: however far the illness has travelled from the viscus that started it, all of it was got from counterflow of qi.

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19 paragraphs
黄帝問曰：五藏六府，寒熱相移者何？ 黄帝问曰：五藏六府，寒热相移者何？
Huáng dì wèn yuē: wǔ zàng liù fǔ, hán rè xiāng yí zhě hé?
黄帝问道：五脏六府之间，寒与热互相移传，是怎样的？
The Yellow Emperor asks: in the five stores and six palaces, what is it for cold and heat to shift into one another?
歧伯曰：腎移寒於肝，癰腫少氣。 歧伯曰：肾移寒于肝，痈肿少气。
Qí bó yuē: shèn yí hán yú gān, yōng zhǒng shǎo qì.
歧伯说：肾把寒移传给肝，就会痈肿而气短。
Qi Bo says: when the kidney shifts cold into the liver, there is abscessous swelling and scant qi.
脾移寒於肝，癰腫筋攣。 脾移寒于肝，痈肿筋挛。
Pí yí hán yú gān, yōng zhǒng jīn luán.
脾把寒移传给肝，就会痈肿而筋脉拘挛。
When the spleen shifts cold into the liver, there is abscessous swelling and the sinews draw up.
肝移寒於心，狂隔中。 肝移寒于心，狂隔中。
Gān yí hán yú xīn, kuáng gé zhōng.
肝把寒移传给心，就会发狂而膈中痞塞。
When the liver shifts cold into the heart, there is madness and obstruction in the centre.
心移寒於肺，肺消。 心移寒于肺，肺消。
Xīn yí hán yú fèi, fèi xiāo.
心把寒移传给肺，就成为肺消。
When the heart shifts cold into the lung, it becomes lung wasting.
肺消者，飲一溲二，死不治。 肺消者，饮一溲二，死不治。
Fèi xiāo zhě, yǐn yī sōu èr, sǐ bù zhì.
肺消这种病，饮一分而小便二分，属死证，不可治。
In lung wasting one drinks one measure and voids two: death, and no treatment.
肺移寒於腎，爲涌水，涌水者，按腹不堅，水氣客於大腸，疾行則鳴，濯濯如囊裹漿，水之病也。 肺移寒于肾，为涌水，涌水者，按腹不坚，水气客于大肠，疾行则鸣，濯濯如囊裹浆，水之病也。
Fèi yí hán yú shèn, wéi yǒng shuǐ, yǒng shuǐ zhě, àn fù bù jiān, shuǐ qì kè yú dà cháng, jí xíng zé míng, zhuó zhuó rú náng guǒ jiāng, shuǐ zhī bìng yě.
肺把寒移传给肾，就成为涌水。涌水这种病，按腹部并不坚硬，是水气客居在大肠，快走时肠中作响，濯濯有声，像皮囊裹着水浆一样，这是水病。
When the lung shifts cold into the kidney, it becomes gushing water. In gushing water the belly is not hard when pressed: water qi has lodged in the large intestine, and walking fast makes it rumble — a sloshing sound, like a bag holding watery pulp. It is an illness of water.
脾移熱於肝，則爲驚衄。 脾移热于肝，则为惊衄。
Pí yí rè yú gān, zé wéi jīng nǜ.
脾把热移传给肝，就会惊骇而鼻出血。
When the spleen shifts heat into the liver, there is fright and nosebleed.
肝移熱於心，則死。 肝移热于心，则死。
Gān yí rè yú xīn, zé sǐ.
肝把热移传给心，就会致死。
When the liver shifts heat into the heart, it is death.
心移熱於肺，傳爲鬲消。 心移热于肺，传为鬲消。
Xīn yí rè yú fèi, chuán wéi gé xiāo.
心把热移传给肺，传变成为鬲消。
When the heart shifts heat into the lung, it transmits and becomes diaphragm wasting.
肺移熱於腎，傳爲柔痓。 肺移热于肾，传为柔痓。
Fèi yí rè yú shèn, chuán wéi róu chì.
肺把热移传给肾，传变成为柔痓。
When the lung shifts heat into the kidney, it transmits and becomes soft convulsion.
腎移熱於脾，傳爲虚腸澼，死不可治。 肾移热于脾，传为虚肠澼，死不可治。
Shèn yí rè yú pí, chuán wéi xū cháng pì, sǐ bù kě zhì.
肾把热移传给脾，传变成为虚性的肠澼，属死证，不可治。
When the kidney shifts heat into the spleen, it transmits and becomes empty bowel flux: death, and it cannot be treated.
胞移熱於膀胱，則癃溺血。 胞移热于膀胱，则癃溺血。
Bāo yí rè yú páng guāng, zé lóng niào xuè.
胞把热移传给膀胱，就会小便癃闭而尿血。
When the bladder-wrapper shifts heat into the bladder, there is dribbling block and blood in the urine.
膀胱移熱於小腸，鬲腸不便，上爲口麋。 膀胱移热于小肠，鬲肠不便，上为口麋。
Páng guāng yí rè yú xiǎo cháng, gé cháng bù biàn, shàng wéi kǒu mí.
膀胱把热移传给小肠，肠道鬲塞而大便不通，上逆就成为口糜。
When the bladder shifts heat into the small intestine, the intestine is obstructed and the bowels do not move, and above it becomes mouth rot.
小腸移熱於大腸，爲虙瘕，爲沈。 小肠移热于大肠，为虙瘕，为沈。
Xiǎo cháng yí rè yú dà cháng, wéi fú jiǎ, wéi chén.
小肠把热移传给大肠，就成为虙瘕，成为沈。
When the small intestine shifts heat into the large intestine, it becomes the hidden mass, and it becomes the sunken illness.
大腸移熱於胃，善食而瘦入，謂之食亦。 大肠移热于胃，善食而瘦入，谓之食亦。
Dà cháng yí rè yú wèi, shàn shí ér shòu rù, wèi zhī shí yì.
大肠把热移传给胃，虽能吃却反见消瘦，这叫做食亦。
When the large intestine shifts heat into the stomach, one eats well and yet wastes away: this is called eat-and-waste.
胃移熱於膽，亦曰食亦。 胃移热于胆，亦曰食亦。
Wèi yí rè yú dǎn, yì yuē shí yì.
胃把热移传给胆，也叫食亦。
When the stomach shifts heat into the gallbladder, it is likewise called eat-and-waste.
膽移熱於腦，則辛頞鼻淵，鼻淵者，濁涕下不止也。 胆移热于脑，则辛頞鼻渊，鼻渊者，浊涕下不止也。
Dǎn yí rè yú nǎo, zé xīn è bí yuān, bí yuān zhě, zhuó tì xià bù zhǐ yě.
胆把热移传给脑，就会鼻梁辛酸而成为鼻渊。鼻渊这种病，是浊涕下流不止。
When the gallbladder shifts heat into the brain, the bridge of the nose is hot and sore and it becomes deep-source nose. Deep-source nose is turbid snivel running down without stopping.
傳爲衄衊瞑目，故得之氣厥也。 传为衄衊瞑目，故得之气厥也。
Chuán wéi nǜ miè míng mù, gù dé zhī qì jué yě.
再传变就成为鼻出血、污血与目眩，所以这些病都是得之于气逆。
Transmitted further it becomes nosebleed, defiled blood and darkened sight — all of it, then, is got from counterflow of qi.

Textual notes

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

  1. 黄帝問曰黄帝问曰

    「黄」讀 huáng，本篇惟此一見，底本从田从艸从八，不作「黃」；與第三十五篇同，而與第三十四篇之作「黃」者異，各从底本。

  2. 肝移寒於心，狂隔中肝移寒于心，狂隔中

    「隔」讀 gé，此處从阜；下文「傳爲鬲消」「鬲腸不便」作「鬲」二見，同篇二形三見，各从底本。

  3. 肺消者，飲一溲二肺消者，饮一溲二

    「溲」讀 sōu，本篇惟此一見，小便也；「飲一溲二」謂所溺反多於所飲。

  4. 則癃溺血则癃溺血

    「溺」讀 niào，本篇惟此一見，通「尿」；不讀 nì。

  5. 濯濯如囊裹漿濯濯如囊裹浆

    「濯」讀 zhuó，本篇二見疊用；「濯濯」者，水在腸中往來之聲。

  6. 肺移熱於腎，傳爲柔痓肺移热于肾，传为柔痓

    「痓」讀 chì，本篇惟此一見；底本作「痓」，不作「痙」，二字形近而音義並異。

  7. 小腸移熱於大腸，爲虙瘕小肠移热于大肠，为虙瘕

    「虙」讀 fú，本篇惟此一見，通「伏」；「虙瘕」者，伏匿之瘕。

  8. 大腸移熱於胃，善食而瘦入大肠移热于胃，善食而瘦入

    底本作「瘦入」，「入」字王注本亦有之，今通行本多無；一說衍文，一說「入」當屬下讀，姑从底本存之。

  9. 膽移熱於腦，則辛頞鼻淵胆移热于脑，则辛頞鼻渊

    底本「膽」字下衍一讀號，介於主謂之間，今刪；「頞」讀 è，鼻梁也，本篇惟此一見。

  10. 傳爲衄衊瞑目传为衄衊瞑目

    「衊」讀 miè，污血也，本篇惟此一見；「衄衊」連文，皆鼻血之屬；「瞑」从目，讀 míng，與从日之「暝」別。

Cite this page

APA

Huangdi Neijing · Suwen 黃帝內經素問 (c. 3rd c. BCE – 1st c. CE; recension c. 762 CE). Qì jué lùn 氣厥論 [A Discourse on Qi Counterflow], Chapter 37. In Classica Sinica Medica. Base text: 《重廣補註黃帝內經素問》二十四卷，唐·王冰注，宋·林億、孫奇、高保衡等校正，宋·孫兆重改誤。據上海涵芬樓《四部叢刊初編》影印明嘉靖二十九年（1550）顧從德覆宋刊本錄入，卷一牌記題「上海涵芬樓景印明顧氏翻宋本」。底本與影印本均屬公有領域。 Retrieved 11 October 2026, from https://classicstcm.com/classics/huangdi-neijing-suwen/qi-counterflow/

MLA

"Qì jué lùn 氣厥論 [A Discourse on Qi Counterflow]." Huangdi Neijing · Suwen 黃帝內經素問, chapter 37, Classica Sinica Medica, 2026, https://classicstcm.com/classics/huangdi-neijing-suwen/qi-counterflow/. Accessed 11 Oct. 2026. Base text: 《重廣補註黃帝內經素問》二十四卷，唐·王冰注，宋·林億、孫奇、高保衡等校正，宋·孫兆重改誤。據上海涵芬樓《四部叢刊初編》影印明嘉靖二十九年（1550）顧從德覆宋刊本錄入，卷一牌記題「上海涵芬樓景印明顧氏翻宋本」。底本與影印本均屬公有領域。

Chinese scholarly

《黃帝內經素問·氣厥論》（Huángdì Nèijīng Sùwèn）。《重廣補註黃帝內經素問》二十四卷，唐·王冰注，宋·林億、孫奇、高保衡等校正，宋·孫兆重改誤。據上海涵芬樓《四部叢刊初編》影印明嘉靖二十九年（1550）顧從德覆宋刊本錄入，卷一牌記題「上海涵芬樓景印明顧氏翻宋本」。底本與影印本均屬公有領域。Classica Sinica Medica，2026 年 10 月 11 日 存取，https://classicstcm.com/classics/huangdi-neijing-suwen/qi-counterflow/。

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