Classica Sinica Medica

病機 简体 病机

bìng jī

The mechanism of illness · bing ji

Also rendered: The mechanism of illness (this site; 機 as the trigger, which is what a physician must find and not merely the disease he must name) · The pathogenesis (standard modern usage; it names the process, and it flattens the image of the loose that the base text keeps)

Pathology

Reviewed · 2026-10-14

At a glance

Pinyin
bìng jī
Simplified
病机
Literal
機 jī — the trigger of a crossbow, the part that looses the bolt (《說文》: 機，主發謂之機), and from that the hidden spring of any affair, the point at which it turns one way or the other. The chapter never defines the word; it uses it as the name of a thing a physician must hold, and then gives the thing itself in nineteen articles.
Shuowen
**《說文》：機，主發謂之機**。**「病機」本篇4見，「機」字本篇亦止4見，皆在此二字之内**；**一見於「謹候氣宜，無失病機」，在論六化分治之末**；**二見於「審察病機，無失氣宜」與「帝曰：願聞病機何如」，此二語引出十九條**；**一見於篇末「謹守病機，各司其屬」**；**王冰以「得其機要」釋之，明張介賓《類經》十三卷專立「病機」一類，即由此十九條**

In brief

The mechanism of illness: what makes a disease do what it does. The chapter introduces it twice — 無失病機 at the end of the passage on the six transformations, 審察病機，無失氣宜 when the emperor asks for it outright — and then answers with nineteen articles, each of the form 諸…，皆屬於某: 諸風掉胘，皆屬於肝；諸寒收引，皆屬於腎；諸氣膹鬱，皆屬於肺. Fifteen articles name a viscus, four name heat, and the whole is closed by 謹守病機，各司其屬，有者求之，無者求之. What the word holds is therefore not a symptom but the point where the six qi and the viscera meet: the same shaking may belong to liver or to fire, and the article that claims it is the 機, the trigger.

Senses in the classical corpus

1
The word 病機
機者發動之要，病之樞紐
謹守病機 — Suwen 74
2
Held without loss 無失病機
候氣宜而不失其機
謹候氣宜，無失病機 — Suwen 74
3
Looked into 審察病機
察之而後無失氣宜
審察病機，無失氣宜 — Suwen 74
4
The nineteen articles 諸風掉胘，皆屬於肝
十九條皆以「諸」領之，各歸一藏一氣
諸濕腫滿，皆屬於脾 — Suwen 74
5
Each to its own 各司其屬
有無盛虚四者皆當求責
有者求之，無者求之 — Suwen 74
6
Where it is kept 必先五勝，疏其血氣
守機之先後次第
令其調達，而致和平 — Suwen 74

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
Suwen 74 Suwen 74 · 至真要大論 Read in context →
故大要曰：謹守病機，各司其屬，有者求之，無者求之，盛者責之，虚者責之。必先五勝，疏其血氣，令其調達，而致和平。此之謂也。 故大要曰：谨守病机，各司其属，有者求之，无者求之，盛者责之，虚者责之。必先五胜，疏其血气，令其调达，而致和平。此之谓也。
Gù dà yào yuē: jǐn shǒu bìng jī, gè sī qí shǔ, yǒu zhě qiú zhī, wú zhě qiú zhī, shèng zhě zé zhī, xū zhě zé zhī. Bì xiān wǔ shèng, shū qí xuè qì, lìng qí tiáo dá, ér zhì hé píng. Cǐ zhī wèi yě.
Hence the Great Essentials says: keep close watch on the mechanism of illness and let each take charge of what it belongs to; where there is, seek it; where there is not, seek it too; what is full, hold it to account; what is empty, hold it to account. First the five prevalences must be known, its blood and qi cleared, and made to run freely, so as to bring about levelness. This is what is meant.
**「病機」本篇4見，此為其一，在全篇收束處**；**「謹守病機」承上文十九條而言，故「各司其屬」即十九條之分屬**；**王冰注：「得其機要，則病無逃形」**；**「機」字本篇皆在此詞之内，别無他見**

Compounds built on this term

氣宜
qì yí
what is fitting for the qi
本篇2見；「無失病機」與「無失氣宜」對舉，機在病，宜在氣
五勝
wǔ shèng
the five prevalences
本篇一見；守病機者必先察五藏之相勝
十九條
shí jiǔ tiáo
the nineteen articles
本篇自「諸風掉胘」至「諸嘔吐酸」共十九段，本站分立其目
風寒暑濕燥火
fēng hán shǔ shī zào huǒ
wind, cold, summerheat, dampness, dryness, fire
本篇一見；病機之起，帝以此六者為言

How it has been translated

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

This sitethe mechanism of illnessthe point at which a disease turns; the chapter uses it as a thing to be kept, not described
Literalthe trigger of the illnessexact about 機, and in English it reads like a part of a machine
Descriptivewhat makes a disease do what it doesclear, and too long to stand where the chapter says 謹守病機

Entry status

Review pending — who reviews this?

2026-10-14

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Reading path

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