大惑

dà huò

Great confusion · da huo

Also rendered: great confusion (Keeps the word short; 惑 is as much not-knowing-which as disorder) · grave delusion (Stronger, and 惑 does not carry the clinical sense of delusion)

Pathology

Reviewed · 2026-09

At a glance

Pinyin: dà huò
Simplified: 大惑
Literal: 惑 is 說文's 亂, disorder, and the graph is a heart under 或 — the either/or, the not-knowing-which. 大惑 is therefore not a mistake but a category of mistake: the confusion in which you cannot tell which of two things you are looking at. Chapter 27 names it for one specific act — 誅罰無過, punishing where there is no fault — and the paragraph then spells out what that confusion consists of: treating repletion as vacuity, taking the evil for the true, using the needle without principle. The chapter is not describing a poor outcome. It is describing a physician who has lost the ability to tell the two sides apart.
Shuowen: 《說文解字》：惑，亂也。从心或聲。或者不定之辭，故惑為心之不定、迷而不能别。本篇之目：誅罰無過，命曰大惑。《靈樞》別有〈大惑論〉一篇，專論目眩善忘之惑，與本篇之惑同名而所指異：彼為病證之名，此為醫者之失。

In brief

Great confusion — in chapter 27, the name for a specific and serious failure: punishing where there is no fault. What makes it confusion rather than mere error is that the physician cannot distinguish the pairs: he takes repletion for vacuity, the evil for the true, following for going against. The consequence is not just that the treatment fails but that the great channels are thrown into disorder and the true qi cannot be restored. Note that the Lingshu has a chapter of the same name about a quite different matter — dizziness and forgetfulness — so the word is not automatically this chapter’s sense.

Senses in the classical corpus

Punishing where there is no fault 誅罰無過

攻伐本無過之處

誅罰無過，命曰大惑 — Suwen 27

Confusing repletion and vacuity 用實爲虚

以實為虚而補之

用實爲虚，以邪爲真 — Suwen 27

Confusing evil and true 以邪爲真

認邪作真，攻補俱反

以邪爲真 — Suwen 27

Using the needle without principle 用鍼無義

用針而無義理法度

用鍼無義，反爲氣賊 — Suwen 27

Its consequence 反亂大經，真不可復

大經反亂，真氣不可復

反亂大經，真不可復 — Suwen 27

The same word, a different thing 大惑

《靈樞》大惑論之惑是病名，與此別

誅罰無過，命曰大惑 — Lingshu 80

Occurrences in the classics

Passages where the term does real work, with the original, pinyin and English on the same line.

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1 passages

素問·離合真邪論 Suwen 27 · 離合真邪論 Read in context →

誅罰無過，命曰大惑，反亂大經，真不可復。用實爲虚，以邪爲真，用鍼無義，反爲氣賊，奪人正氣，以從爲逆，榮衛散亂，真氣已失，邪獨内著，絶人長命，予人天殃。诛罚无过，命曰大惑，反乱大经，真不可复。用实为虚，以邪为真，用针无义，反为气贼，夺人正气，以从为逆，荣卫散乱，真气已失，邪独内著，绝人长命，予人天殃。

Zhū fá wú guò, mìng yuē dà huò, fǎn luàn dà jīng, zhēn bù kě fù.Yòng shí wéi xū, yǐ xié wéi zhēn, yòng zhēn wú yì, fǎn wéi qì zéi, duó rén zhèng qì, yǐ cóng wéi nì, róng wèi sàn luàn, zhēn qì yǐ shī, xié dú nèi zhuó, jué rén cháng mìng, yǔ rén tiān yāng.

To punish where there is no fault is called great confusion: it throws the great channels into disorder, and the true cannot be restored. To treat repletion as vacuity and take the evil for the true, to use the needle without principle, is to become a thief of the qi: it robs people of their upright qi, turns following into going against, scatters the bloom and defence, loses the true qi, leaves the evil lodged alone within, cuts short the long life that was theirs, and hands them a calamity from heaven.

兩段連讀，是《素問》中責醫最峻的一段，而「大惑」二字是它的題目——不是「誤治」，不是「失治」，而是「惑」：分不清實與虚、邪與真、從與逆。**「誅」讀 zhū，本篇惟此一見**，誅伐、責罰之義；**「罰」讀 fá，本篇惟此一見**；**「惑」讀 huò，本篇惟此一見**；「亂」讀 luàn，本篇二見；「復」讀 fù。**「義」讀 yì，本篇惟此一見**，義理、法度之義；**「賊」讀 zéi，本篇惟此一見**，賊害之義——「反爲氣賊」四字最為刺骨：醫者本當護氣，卻反成了賊害人氣的人。**「奪」讀 duó，本篇惟此一見**；**「著」讀 zhuó，本篇惟此一見**，附著、留著之義，底本作著不作「着」。「邪獨内著」四字是結果：真氣已失，只剩邪氣獨自留著於內。

Compounds built on this term

大惑

dà huò

great confusion

本篇惟此一見，責醫之辭

誅罰無過

zhū fá wú guò

punishing where there is no fault

誅讀 zhū，罰讀 fá，皆本篇一見

用實爲虚

yòng shí wéi xū

treating repletion as vacuity

惑之實事

反亂大經

fǎn luàn dà jīng

throwing the great channels into disorder

大惑之效

How it has been translated

Every rendering below is a decision about which reader is being addressed. There is no neutral option.

Wiseman & Feng	great confusion	They keep 大 as great and 惑 as confusion, which is the pairing that makes the word usable in both this chapter and the Lingshu.
Unschuld	great delusion	Unschuld reaches for delusion, which is defensible for the Lingshu chapter's dizziness but too psychiatric for a passage about misreading repletion as vacuity.
This site	great confusion	We keep confusion because what the paragraph describes is specifically a failure to distinguish pairs — repletion from vacuity, evil from true, following from going against — and confusion is the English word that keeps that failure to tell two things apart at the centre.

Entry status

Review pending — who reviews this?

2026-09

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