灵枢·五乱 Miraculous Pivot · Five Disorders
黄帝曰：经脉十二者，别为五行，分为四时，何失而乱？何得而治？The Yellow Emperor said: The twelve regular meridians are differentiated into the five elements and divided into the four seasons. What causes them to be in disorder? And what makes them in order?
黄帝说：人体的十二经脉，其属性分别与五行相合，又与四时相应，但不知因何失调而引起脉气运行的逆乱？又是什么原因能使它正常运行呢？
岐伯曰：五行有序，四时有分，相顺则治，相逆则乱。Qibo said: The five elements have their proper order, and the four seasons have their divisions. When they are in harmony, there will be order; when they are in disharmony, there will be disorder.
岐伯说：木、火、土、金水五行的生克有一定的内在顺序，春、夏、秋、冬四季的变化也有一定的规律，而人体经脉的运行，也要与五行四季的规律相适应，才可以保持正常的活动，如果违反了这些规律就会引起经脉的运行紊乱。
黄帝曰：何谓相顺？The Yellow Emperor said: What does it mean by being in harmony?
黄帝说：怎样才能做到相互顺应呢？
岐伯曰：经脉十二者，以应十二月。十二月者，分为四时。四时者，春秋冬夏，其气各异，营卫相随，阴阳已和，清浊不相干，如是则顺之而治。Qibo said: The twelve regular meridians correspond to the twelve months. The twelve months are divided into the four seasons. The four seasons, namely spring, summer, autumn, and winter, have different qi. The nutrient qi and defensive qi follow each other, yin and yang are in harmony, and the clear and turbid do not interfere with each other. In this way, it is in harmony and there will be order.
岐伯说：人身十二经脉与一年的十二个月相应。十二个月分为四季，就是春、夏、秋、冬四季，这四季的气候特点各不相同，人体与之相适应，也有相应的差别。人体营气与卫气是内外相随，运行有序，阴阳互相协调，清气与浊气的运行也不互相干扰侵犯，这样就能顺应自然界的变化而使经脉运行正常。
黄帝曰：何为逆而乱？The Yellow Emperor said: What is it that causes disorder due to disharmony?
黄帝说：那逆乱的反常情况是什么样的呢？
岐伯曰：“清气在阴，浊气在阳，营气顺脉，卫气逆行，清浊相干，乱于胸中，是谓大悗。Qibo said: "When the clear qi is in the yin aspect and the turbid qi is in the yang aspect, the nutrient qi flows along the meridians while the defensive qi moves in the opposite direction, the clear and turbid interfere with each other, and there is disorder in the chest. This is called great distress.
岐伯说：”清阳之气应上升居于上部外部，浊阴之气应沉降居于下部内部，如果清气不能上升反居于下部内部，浊气不能下降反居于上部外部，这就是经气逆乱。营气顺脉而行，而卫气运行却不循常规，这样清浊相扰，乱于胸中就叫做大悗。
故气乱于心，则烦心密嘿，俛首静伏。乱于肺，则俛仰喘喝，接手以呼。Therefore, when the qi is in disorder in the heart, there will be vexation and the patient will be silent, bowing the head and lying still. When it is in disorder in the lungs, there will be gasping and wheezing when bending forward and backward, and the patient will stretch out the hands when breathing.
气乱于心，可见心中烦闷，沉默不言，低头静伏而不欲动。气乱于肺，使人俯仰不安，喘息喝喝有声，需用两手按于胸前帮助呼吸。
乱于肠胃，是为霍乱。乱于臂胫，则为四厥。乱于头，则为厥逆，头重眩仆。”When it is in disorder in the intestines and stomach, it is called cholera. When it is in disorder in the arms and shins, it is called four types of cold limbs. When it is in disorder in the head, it is called reversal of qi, with a feeling of heaviness in the head, dizziness, and fainting."
气乱于肠，就会发生吐泻交作的霍乱而上吐下泻。气乱于手臂、小腿，就会见四肢厥冷。气乱于头，就会见厥气上逆，头重眩晕，甚至仆倒在地。“
黄帝曰：五乱者，刺之有道乎？The Yellow Emperor said: For these five types of disorders, is there a proper way of needling?
黄帝说：发生上述这五种乱症，针刺治疗有什么法则吗？
岐伯曰：有道以来，有道以去，审知其道，是谓身宝。Qibo said: There is a way for the qi to come and a way for it to go. To clearly understand this way is regarded as a precious thing for the body.
岐伯说：病邪侵入，有它的脉路，祛除病邪，也有它的脉路，仔细观察掌握病邪来去的脉路，善于治疗疾病，这可称得上是养身之宝。
黄帝曰：善。愿闻其道。The Yellow Emperor said: Good. I would like to hear about this way.
黄帝说：讲得好。我想听你讲讲关于治疗方面的法则。
岐伯曰：“气在于心者，取之手少阴心主之俞。气在于肺者，取之手太阴荥、足少阴俞。气在于肠胃者，取之足太阴、阳明；不下者，取之三里。Qibo said: "When the qi is in the heart, select the back-shu points of the Hand-Shaoyin and the Heart Governor. When the qi is in the lungs, select the Ying point of the Hand-Taiyin and the back-shu point of the Foot-Shaoyin. When the qi is in the intestines and stomach, select the Foot-Taiyin and Yangming; if it does not work, select Sanli.
岐伯说：“气乱于心的，应针刺手少阴心经的输穴（神门穴），和手厥阴心包经的输穴（大陵穴）。气乱于肺的，应针刺手太阴肺经的荥穴（鱼际穴），和足少阴肾经的输穴（太溪穴）。气乱于肠胃的，应针刺足太阴脾经（的输穴太白穴），和足阳明胃经（的输穴陷谷穴），如果不能治愈，可以再针刺（足阳明胃经的合穴）足三里穴。
气在于头者，取之天柱、大杼；不知，取足太阳荥、俞。气在于臂足，取之先去血脉，后取其阳明、少阳之荥、俞。”When the qi is in the head, select Tianzhu and Dazhu; if it does not work, select the Ying and back-shu points of the Foot-Sun. When the qi is in the arms and legs, first remove the blood stasis and then select the Ying and back-shu points of the Yangming and Shaoyang."
气乱于头的，应针刺足太阳膀胱经的天柱穴和大杼穴，如果不能奏效，可再针刺足太阳膀胱经的荥穴（通谷穴）和输穴（束骨穴）。气乱于手臂足胫部的，如有瘀血可首先在相应部位的血脉上针刺放血，然后针刺取手阳明大肠经的荥穴（二间穴）、输穴（三间穴），和手少阳三焦经的荥穴（液门穴）、输穴（中渚穴）治疗上肢的病变；取足阳明胃经的荥穴（内庭穴）、输穴（陷谷穴），和足少阳胆经的荥穴（侠溪穴）、输穴（足临泣穴）治疗下肢的病变。“
黄帝曰：补泻奈何？The Yellow Emperor said: How about reinforcement and reduction?
黄帝说：如何运用补泻的手法呢？
岐伯曰：徐入徐出，谓之导气。补泻无形，谓之同精。是非有余不足也，乱气之相逆也。Qibo said: Inserting and withdrawing the needle slowly is called guiding the qi. Reinforcement and reduction without obvious form is called unifying the essence. It is not a matter of excess or deficiency, but the reverse of the disordered qi.
岐伯说：慢慢地进针慢慢地出针，这种手法叫做导气。在不运用明显的补泻手法的情况下，这称为同精。因为上述五乱病既不是邪气有余的实证，也不是正气不足的虚证，只是气机逆乱形成的病变，所以采用这种手法。
黄帝曰：允乎哉道！明乎哉论！请著之玉版，命曰《治乱》也。The Yellow Emperor said: What a wonderful way! What a clear discussion! Please record it on the jade tablets and name it "On Order and Disorder".
黄帝说：你讲的治疗方法真是恰当！你的分析真是明白确切啊！请允许我把这些内容刻录在玉版上，命名为《治乱》。
