帝曰：病成而變，何謂？歧伯曰：風成爲寒熱，癉成爲消中，厥成爲巔疾，久風爲飱泄，脉風成爲癘。病之變化，不可勝數。
帝曰：病成而变，何谓？岐伯曰：风成为寒热，瘅成为消中，厥成为巅疾，久风为飧泄，脉风成为疠。病之变化，不可胜数。
dì yuē: bìng chéng ér biàn, hé wèi? qí bó yuē: fēng chéng wéi hán rè, dān chéng wéi xiāo zhōng, jué chéng wéi diān jí, jiǔ fēng wéi sūn xiè, mài fēng chéng wéi lì. bìng zhī biàn huà, bù kě shèng shǔ.
The Emperor says: What does it mean that an illness, once formed, changes? Qibo says: Wind, once formed, becomes cold and heat; heat, once formed, becomes wasting in the centre; counterflow, once formed, becomes disease of the crown; long-standing wind becomes food-diarrhoea; wind in the vessels becomes pestilent sores. The transformations of illness cannot be counted.
本篇「病成而變」一節：久風為飱泄，與風成為寒熱、癉成為消中、厥成為巔疾、脉風成為癘同列。飱，音 sūn，說文作「哺也」，謂夕食、食之餘；泄為漏下。飱泄者，食不化而完穀直出。與第三篇「洞泄」之傾注者各有所指。
脾病者，身重，善肌肉痿，足不收行，善瘈，脚下痛；虚則腹滿腸鳴，飱泄，食不化；取其經太陰、陽明、少陰血者。
脾病者，身重，善肌肉痿，足不收行，善瘈，脚下痛；虚则腹满肠鸣，飧泄，食不化；取其经太阴、阳明、少阴血者。
Pí bìng zhě, shēn zhòng, shàn jī ròu wěi, zú bù shōu xíng, shàn chì, jiǎo xià tòng; xū zé fù mǎn cháng míng, sūn xiè, shí bù huà; qǔ qí jīng tài yīn, yáng míng, shào yīn xuè zhě.
In spleen illness the body is heavy, the flesh is liable to wither, the feet cannot be gathered to walk, there is a tendency to spasm, and pain beneath the foot; in depletion there is abdominal fullness, rumbling in the bowels, sloppy diarrhoea and undigested food. Take the blood of its channels, the greater yin, the yang brilliance and the lesser yin.
「虚則腹滿腸鳴，飱泄，食不化」：本篇飱泄之義，屬脾虛不運：腹滿、腸鳴、食不化與飱泄同為一連，皆中土失其轉輸之候。與第十七篇「久風爲飱泄」者同條而義別：第十七篇重在風邪之久客而變此，本篇重在脾之自虛而失運。一由外邪，一由內傷，而其為完穀不化則同。
入六府則身熱不時卧，上爲喘呼；入五藏則䐜滿閉塞，下爲飱泄，久爲腸澼。
入六府则身热不时卧，上为喘呼；入五藏则䐜满闭塞，下为飧泄，久为肠澼。
Rù liù fǔ zé shēn rè bù shí wò, shàng wéi chuǎn hū; rù wǔ zàng zé chēn mǎn bì sè, xià wéi sūn xiè, jiǔ wéi cháng pì.
Entering the six palaces, there is heat in the body and sleep out of season, and above, panting and calling out. Entering the five depots, there is distension, fullness and blockage, and below, food-diarrhoea, which in time becomes intestinal flux.
本條「飱泄」於本站已立，本篇「下爲飱泄」是其最要之一見：與「上爲喘呼」對舉，是本篇以部位別府藏之例——府病見於上，藏病見於下。**「飱」讀 sūn，即「飧」之異體**，「飱泄」謂完榖不化之泄；本篇「飱」惟此一見，底本無「飧」字；「泄」讀 xiè，與「洩」形近義同而本篇作泄；「下」讀 xià；「爲」讀 wéi；「上」讀 shàng；「喘」讀 chuǎn；「呼」讀 hū；「入」讀 rù；「六」讀 liù；「府」讀 fǔ；「則」讀 zé；「身」讀 shēn；「熱」讀 rè；**「卧」讀 wò，底本作「卧」，不作「臥」**；「五」讀 wǔ；「藏」讀 zàng；**「䐜」讀 chēn，脹起也**；「滿」讀 mǎn；「閉」讀 bì；「塞」讀 sè。「下爲飱泄」與下句「久爲腸澼」相承：飱泄久而不愈則為腸澼，是病之由淺入深。
歧伯曰：怒則氣逆，甚則嘔血及飱泄，故氣上矣。
歧伯曰：怒则气逆，甚则呕血及飧泄，故气上矣。
Qí bó yuē: nù zé qì nì, shèn zé ǒu xuè jí sūn xiè, gù qì shàng yǐ.
Qi Bao says: anger makes qi rebel, and in severe cases there is vomiting of blood and loose stool with undigested food — hence qi rises.
**本篇「飱泄」1見**，**在九氣之首「怒」之一條**。**本站「飱泄」（#591）已收第十七篇「久風爲飱泄」、第二十二篇「虚則腹滿腸鳴，飱泄，食不化」、第二十九篇「下爲飱泄，久爲腸澼」**；**本篇之飱泄則不由於久風，而由於怒**：**怒則氣逆，甚則嘔血及飱泄，故氣上矣**——**氣逆之甚，上則血隨之而嘔，下則食不化而飱泄**；**嘔血與飱泄一上一下，皆一氣之逆為之**。「飱」讀 sūn，**讀 sūn，本篇1見，不作「飧」（「飧」）**；「泄」讀 xiè，**本篇7見，不作「洩」（「洩」）**；「嘔」讀 ǒu；「血」讀 xuè，**本站一律讀 xuè**；「怒」讀 nù；「逆」讀 nì。
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.
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.
「時發飱泄」——「飱」讀 sūn，**底本作「飱」，讀 sūn，食不化而出也**（王冰「飱泄者，食不化而出也」）。**與 ch42「腸風飧泄」字異而實同**：**ch42 作「飧」，本篇从底本作「飱」，兩存其形**；「泄」讀 xiè，**本篇「泄」1見，从底本作「泄」不作「洩」**。
歧伯曰：志有餘則腹脹飱泄，不足則厥。血氣未并，五藏安定，骨節有動。
歧伯曰：志有余则腹胀飧泄，不足则厥。血气未并，五藏安定，骨节有动。
Qí bó yuē: zhì yǒu yú zé fù zhàng sūn xiè, bù zú zé jué. Xuè qì wèi bìng, wǔ zàng ān dìng, gǔ jié yǒu dòng.
Qi Bo says: when the will is in excess there is swelling of the belly and sloppy diarrhoea; when it is insufficient, counterflow. If blood and qi have not pooled and the five depots are settled, and there is only a stirring in the joints of the bone.
「志有餘則腹脹飱泄，不足則厥」——**「飱泄」本篇1見，在志之有餘一證中**：**腎藏志，志有餘則腹脹而飱泄；「飱」讀 sūn，水澆飯也，引申為泄瀉**；**底本作「飱」，通行本作「飧」，第四十二篇之作「飧」者與此為跨篇異形**；**「泄」本篇7見，底本作「泄」，不从「洩」，本篇無「洩」字**
帝曰：五運之化，太過何如？歧伯曰：歲木太過，風氣流行，脾土受邪，民病飱泄食減，體重煩冤，腸鳴，腹支滿，上應歲星。甚則忽忽善怒，眩冒巔疾，化氣不政，生氣獨治，雲物飛動，草木不寧，甚而搖落，反脅痛而吐甚。衝陽絶者，死不治，上應太白星。
帝曰：五运之化，太过何如？歧伯曰：岁木太过，风气流行，脾土受邪，民病飧泄食减，体重烦冤，肠鸣，腹支满，上应岁星。甚则忽忽善怒，眩冒巅疾，化气不政，生气独治，云物飞动，草木不宁，甚而摇落，反胁痛而吐甚。冲阳绝者，死不治，上应太白星。
Dì yuē: wǔ yùn zhī huà, tài guò hé rú? Qí bó yuē: suì mù tài guò, fēng qì liú xíng, pí tǔ shòu xié, mín bìng sūn xiè shí jiǎn, tǐ zhòng fán yuān, cháng míng, fù zhī mǎn, shàng yìng suì xīng. Shèn zé hū hū shàn nù, xuàn mào diān jí, huà qì bù zhèng, shēng qì dú zhì, yún wù fēi dòng, cǎo mù bù níng, shèn ér yáo luò, fǎn xié tòng ér tù shèn. Chōng yáng jué zhě, sǐ bù zhì, shàng yìng tài bái xīng.
Huang Di said: as for the transformation of the five circuits, what is it like when there is surplus? Qi Bo said: in a year of wood in surplus, the qi of wind spreads and moves and the earth of the spleen receives evil; the people are ill with gruel diarrhoea and diminished eating, a heavy body and freting oppression, rumbling in the bowels and fullness propping the abdomen; it answers above to Jupiter. If it is severe they are dazed and quick to anger, dizzy and veiled, with illness at the crown; the qi of transformation does not govern and the qi of growth rules alone, clouds and things fly and move, plants and trees are not at rest and are even shaken bare, and there is counterflow pain in the flanks and severe vomiting. Where Chongyang is cut off there is death and no cure; it answers above to Venus.
「歲木太過，風氣流行，脾土受邪，民病飱泄食減，體重煩冤，腸鳴，腹支滿」——**「飱泄」本篇2見：此「飱泄食減」一見、「飱泄霍亂」一見**；**底本作「飱」，夕食合文，本篇2見；通行本多作「飧」，讀 sūn。字形照錄底本，別見校勘**；**本篇飱泄皆脾土受邪之候**
秋三月，此謂容平。天氣以急，地氣以明，早卧早起，與雞俱興，使志安寧，以緩秋刑，收斂神氣，使秋氣平，無外其志，使肺氣清。此秋氣之應，養收之道也。逆之則傷肺，冬爲飱泄，奉藏者少。
秋三月，此谓容平。天气以急，地气以明，早卧早起，与鸡俱兴，使志安宁，以缓秋刑，收敛神气，使秋气平，无外其志，使肺气清。此秋气之应，养收之道也。逆之则伤肺，冬为飧泄，奉藏者少。
Qiū sān yuè, cǐ wèi róng píng. tiān qì yǐ jí, dì qì yǐ míng, zǎo wò zǎo qǐ, yǔ jī jù xīng, shǐ zhì ān níng, yǐ huǎn qiū xíng, shōu liǎn shén qì, shǐ qiū qì píng, wú wài qí zhì, shǐ fèi qì qīng. cǐ qiū qì zhī yìng, yǎng shōu zhī dào yě. nì zhī zé shāng fèi, dōng wéi sūn xiè, fèng cáng zhě shǎo.
The three months of autumn are called the settled and the level. The qi of heaven turns sharp; the qi of earth turns clear. Sleep early and rise early, get up with the cockerel, keep the will at peace so as to soften the flaying of autumn, gather in the spirit and the qi so that the qi of autumn is level, keep the will from reaching outward, and let the lung qi be pure. This is the answer to the qi of autumn, and it is the way of nourishing the gathering in. Going against it harms the lung; in winter there is food-diarrhoea, and there is little to hand on to what must be stored.
「冬爲飱泄」——逆秋氣之罰，奉藏者少；飱讀 sūn，底本从夕；**「飱泄」本篇1見**
故冬不按蹻，春不鼽衄，春不病頸項，仲夏不病胸脅，長夏不病洞泄寒中，秋不病風瘧，冬不病痺厥、飱泄而汗出也。
故冬不按蹻，春不鼽衄，春不病颈项，仲夏不病胸胁，长夏不病洞泄寒中，秋不病风疟，冬不病痹厥、飧泄而汗出也。
gù dōng bù àn qiāo, chūn bù qiú nǜ, chūn bù bìng jǐng xiàng, zhòng xià bù bìng xiōng xié, cháng xià bù bìng dòng xiè hán zhōng, qiū bù bìng fēng nüè, dōng bù bìng bì jué, sūn xiè ér hàn chū yě.
Therefore if in winter one does not press and tread, then in spring there is no snivelling and nosebleed and no disease of the nape; in midsummer no disease of the chest and flanks; in late summer no pouring diarrhoea with cold within; in autumn no wind malaria; in winter no impediment inversion, no sloppy diarrhoea, and no sweating that will not stop.
「飱泄而汗出也」——冬不按蹻則精藏，精藏則春不病温、夏暑能汗，而冬不病痺厥、飱泄；飱讀 sūn，底本从夕；**「飱泄」本篇1見**
寒極生熱，熱極生寒，寒氣生濁，熱氣生清。清氣在下，則生飱泄；濁氣在上，則生䐜脹。此陰陽反作，病之逆從也。
寒极生热，热极生寒，寒气生浊，热气生清。清气在下，则生飧泄；浊气在上，则生䐜胀。此阴阳反作，病之逆从也。
hán jí shēng rè, rè jí shēng hán, hán qì shēng zhuó, rè qì shēng qīng. qīng qì zài xià, zé shēng sūn xiè; zhuó qì zài shàng, zé shēng chēn zhàng. cǐ yīn yáng fǎn zuò, bìng zhī nì cóng yě.
Cold at its extreme engenders heat; heat at its extreme engenders cold. Cold qi produces turbidity, hot qi produces clarity. When clear qi stays below, pouring diarrhoea results; when turbid qi stays above, distension results. This is yin and yang acting in reverse — the rebellion and compliance of disease.
「則生飱泄」——清氣在下則穀不化而為飱泄；下文「春傷於風，夏生飱泄」同例；**「飱泄」本篇2見**
少宫與少角同，上宫與正宫同，上角與正角同，其病飱泄，邪傷脾也。振拉飄揚，則蒼乾散落，其眚四維，其主敗折虎狼，清氣乃用，生政乃辱。
少宫与少角同，上宫与正宫同，上角与正角同，其病飧泄，邪伤脾也。振拉飘扬，则苍干散落，其眚四维，其主败折虎狼，清气乃用，生政乃辱。
Shào gōng yǔ shào jué tóng, shàng gōng yǔ zhèng gōng tóng, shàng jué yǔ zhèng jué tóng, qí bìng sūn xiè, xié shāng pí yě. Zhèn lā piāo yáng, zé cāng gān sàn luò, qí shěng sì wéi, qí zhǔ bài zhé hǔ láng, qīng qì nǎi yòng, shēng zhèng nǎi rǔ.
In the low-confinement year the lesser gong is one with the lesser jue; where the upper is gong it is one with the upright gong, and where the upper is jue it is one with the upright jue. Its illness is gruel diarrhoea; it is evil that injures the spleen. Then shaking and scattering come, blue-green things dry and drop, the calamity falls in the four corners; its charge is ruin and breaking, tigers and wolves; the clear qi comes into use and the governance of growth is disgraced.
**「飱泄」本篇1見，止在卑監之紀「其病飱泄，邪傷脾也」**；**土不及則木乘之，故其病在脾而見飱泄**
歧伯曰：厥陰之勝，耳鳴頭眩，憒憒欲吐，胃鬲如寒，大風數舉，倮蟲不滋，胠脅氣并，化而爲熱，小便黄赤，胃脘當心而痛，上支兩脅，腸鳴飱泄，少腹痛，注下赤白，甚則嘔吐，鬲咽不通。
歧伯曰：厥阴之胜，耳鸣头眩，愦愦欲吐，胃鬲如寒，大风数举，倮虫不滋，胠胁气并，化而为热，小便黄赤，胃脘当心而痛，上支两胁，肠鸣飧泄，少腹痛，注下赤白，甚则呕吐，鬲咽不通。
Qí bó yuē: jué yīn zhī shèng, ěr míng tóu xuàn, kuì kuì yù tù, wèi gé rú hán, dà fēng shuò jǔ, luǒ chóng bù zī, qū xié qì bìng, huà ér wéi rè, xiǎo biàn huáng chì, wèi wǎn dāng xīn ér tòng, shàng zhī liǎng xié, cháng míng sūn xiè, shào fù tòng, zhù xià chì bái, shèn zé ǒu tù, gé yān bù tōng.
Qi Bo said: when ceasing yin prevails, there is ringing in the ears and giddiness of the head, a muddled feeling with a wish to vomit, the stomach and the diaphragm as if cold, great winds rising again and again, the naked creatures failing to breed, qi gathering in the flanks and ribs and turning to heat, the urine yellow and red, the stomach duct paining under the heart and propping into the two ribs, rumbling in the bowels with undigested-food diarrhoea, pain of the lower belly, a pouring down of red and white, and in grave cases vomiting with the diaphragm and the throat stopped.
**「飱泄」本篇1見，止在此句**；**此段「腸鳴飱泄，少腹痛，注下赤白」，厥陰之勝所生**