寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Qi

Gi

한글 기  ·  Pinyin Qi

Qi is the ancestor of the spirit and the son of the essence — and every disease is born of it

氣

The second of the three chapters — essence, qi, spirit — that open the Inner Landscape, and the one the rest of the book leans on most. It begins with a definition it borrows from Dongwon: qi is the ancestor of the spirit, and the essence is the son of qi. Then where qi comes from, which is food; what it does at the surface, which is the defence; how it circulates, fifty times a day in a scheme the Lingshu lays out in detail; and where it is rooted, which is the stirring between the kidneys below the navel. The middle of the chapter turns to breathing. Foetal breathing, the breathing of the sage from the heels, the three hundred breaths of Pengzu with a goose feather on the nose — these are the Daoist practices the Bogam records because a physician was expected to know them. Then the diseases: the seven qi and the nine, the centre qi stroke that looks like a stroke and is not, qi that rises and qi that sinks, short breath and scant breath, the pain that comes from qi and the depression that comes from thwarted feeling. Danxi's rule governs the treatment — every qi disease is the lung under fire, and the acrid warming formulas of the Gukbang feed the fire — and the chapter records both his rule and the Gukbang's formulas. It closes with the six-syllable breathing that each organ has its own sound for, and the acupuncture.

4.1 Qi Is the Root and Stem of Essence and Spirit 氣爲精神之根蔕

4.1.1
Source원문

東垣曰, 氣者神之祖, 精乃氣之子, 氣者, 精神之根蔕也.

Translation영역
Dongwon says: qi is the ancestor of the spirit, and the essence is the son of qi; qi is the root and stem of essence and spirit.
Clinical note임상 주석
The chapter opens on a genealogy — qi is older than spirit and father to essence — and the order matters. The Inner Landscape treats essence first, qi second, spirit third, and this line says why the middle one holds the other two.

Dongwon 東垣

4.1.2
Source원문

茅眞君曰, 氣是添年藥, 心爲使氣神, 若知行氣主, 便是得仙人. 《養性》

Translation영역
The True Lord Mao said: qi is the medicine that adds years, and the heart is the spirit that commands the qi; whoever knows the master of moving qi has become an immortal.
Clinical note임상 주석
The Daoist voice that runs through the first half of this chapter, and its claim is the plainest: qi is what lengthens life. Mao Ying is the patriarch of the Shangqing tradition, and the Bogam cites him as an authority on breathing without apology.

Yangseong 養性

4.2 Qi Is Engendered from Grain 氣生於穀

4.2.1
Source원문

靈樞曰, 人受氣於穀, 穀入於胃, 以傳與肺, 五藏六府, 皆以受氣. 其淸者爲榮, 其濁者爲衛, 榮在脉中, 衛在脉外. 營周不休, 五十度而復大會, 陰陽相貫, 如環無端.

Translation영역
The Lingshu says: a person receives qi from grain. Grain enters the stomach and is passed to the lung, and the five viscera and six bowels all receive qi from it. Its clear part becomes the construction and its turbid part the defence; the construction is within the vessels and the defence without. They circulate without rest, and after fifty circuits meet again in the great meeting; yin and yang thread each other, like a ring without end.
Clinical note임상 주석
The Blood chapter's 1.1 said the same thing of blood — made in the middle burner from food — and here the same food makes qi, divided into clear and turbid. The clear becomes the construction that runs inside the vessels, and the Blood chapter's 1.2 has it; the turbid becomes the defence that runs outside, and 4.3 has that.

Yeongchu 靈樞

4.2.2
Source원문

又曰, 上焦開發, 宣五穀味, 熏膚, 充身, 澤毛, 若霧露之漑, 是謂氣.

Translation영역
It also says: the upper burner opens and effuses, spreads the flavours of the five grains, steams the skin, fills the body and moistens the hair, like the irrigation of mist and dew — this is called qi.
Clinical note임상 주석
若霧露之漑 — like the watering of mist and dew — is the Lingshu's image for what qi does to the surface, and the chapter returns to it at 4.3.3. Qi is not felt as a thing; it is felt as the body being warm, full and moist.

Yeongchu 靈樞

4.2.3
Source원문

正理曰, 日啖飮食之精熟者, 益氣, 此氣生於穀, 故從气從米. 人身之中, 全具天地陰陽造化之氣, 得勤而用之. 人年二十而氣壯, 節慾少勞, 則氣長而緩, 多慾勞倦, 則氣少而短. 氣少則身弱, 身弱則病生, 病生則命危矣.

Translation영역
The Jeongni says: the refined and well-cooked part of what one eats and drinks each day boosts the qi. This qi is engendered from grain, and so the graph is written with 气 for breath and 米 for rice. Within the human body is the whole qi of the creative transformation of heaven and earth, yin and yang, and one must use it diligently. At twenty a person's qi is robust; with restraint of desire and little toil the qi grows and is easy, and with much desire and taxation the qi is scant and short. Scant qi, a weak body; a weak body, disease; disease, and life is in danger.
Clinical note임상 주석
The graph as argument: 氣 is written with breath above rice, and so qi comes from food. The etymology is real — the character does combine those elements — and the chapter uses it as proof. The chain at the end is the one 4.9.5 will pick up: desire spends qi, and spent qi is the beginning of every illness.

Jeongni 正理

4.3 Qi Is the Defence and Defends Without 氣爲衛衛於外

4.3.1
Source원문

靈樞曰, 衛氣者, 所以溫分肉, 而充皮膚, 肥腠理, 而司開闔, 故衛氣溫則形分足矣.

Translation영역
The Lingshu says: the defence qi is what warms the divisions of the flesh, fills the skin, fattens the interstices and governs opening and closing; hence where the defence qi is warm the form and its divisions are sufficient.

Yeongchu 靈樞

4.3.2
Source원문

內經曰, 衛者, 水穀之悍氣也. 其氣慓疾滑利, 不能入於脉也. 故循皮膚之中, 分肉之間, 熏於肓膜, 散於胸腹.

Translation영역
The Neijing says: the defence is the fierce qi of water and grain. Its qi is swift, quick, slippery and free, and cannot enter the vessels; so it runs within the skin, between the divisions of the flesh, steams the membranes and scatters through chest and abdomen.
Clinical note임상 주석
悍氣, the fierce qi — the defence is the rough part of what food yields, too coarse for the vessels and so running outside them. 慓疾滑利: four graphs for its speed. The construction is orderly and the defence is fast, and the Sweating chapter's whole method depends on that difference.

Naegyeong 內經

4.3.3
Source원문

又曰, 陽氣者, 一日而主外, 平旦人氣生, 日中而陽氣隆, 日西而陽氣虛, 氣門乃閉. 是故暮而收拒, 無擾筋骨, 無見霧露. 反此三時, 形乃困薄.

Translation영역
It also says: the yang qi governs the exterior for the day. At dawn the person's qi is born, at midday the yang qi is at its height, at sunset the yang qi is vacuous and the gate of qi closes. So at dusk gather in and shut out — do not stir the sinews and bones, do not go out into mist and dew. Go against these three times, and the form is worn and thin.
Clinical note임상 주석
The defence has a daily rhythm — born at dawn, full at noon, gone at dusk — and the advice that follows is to match it: no exertion after dark, no cold air. 氣門, the gate of qi, is the pore, and the Sweating chapter's 7.3 is built on when it is open.

Naegyeong 內經

4.3.4
Source원문

又曰, 陽氣若天與日, 失其所, 則折壽而不彰. 故天運當以日光明, 是故陽因而上, 衛外者也. 釋曰, 陽主動, 凡人之知覺運動, 耳目視聽言嗅, 皆陽氣熏膚, 充身, 澤毛, 若霧露之漑而充之耳. 若陽氣一失其所, 則散解不行, 而熏充澤漑之道澁, 所以九竅閉塞于內, 肌肉壅滯于外, 而知覺運動視聽言嗅之靈, 皆失也. 人之陽氣, 猶天之日光, 人失陽氣則壽命易折, 猶天失光明, 則萬物無以發生也.

Translation영역
It also says: the yang qi is like heaven and the sun; where it loses its place, the lifespan is cut short and does not shine. Hence the movement of heaven depends on the sun's light, and so the yang rises accordingly and defends without. The explanation says: yang governs movement, and all of a person's perceiving and moving — the ear's hearing, the eye's seeing, speech and smell — is the yang qi steaming the skin, filling the body and moistening the hair, like the irrigation of mist and dew filling them. If the yang qi once loses its place, it scatters and does not move, the road of steaming, filling, moistening and irrigating grows rough, the nine orifices are blocked within and the flesh congested without, and the faculties of perceiving and moving, seeing and hearing, speaking and smelling are all lost. A person's yang qi is like the sun's light to heaven; where a person loses the yang qi the lifespan is easily cut short, as when heaven loses its light the ten thousand things have no way to come forth.
Clinical note임상 주석
The Suwen's most-quoted line on yang — 陽氣若天與日, the yang is like heaven and the sun — with its commentary, and the commentary makes it clinical: sight, hearing, speech and smell are all the yang at work, and a patient who has lost them has lost the yang. The Fire chapter's 5.25 and the Cold Damage chapter's whole warming method rest on this passage.

Naegyeong 內經

4.3.5
Source원문

入門曰, 人身之氣流行, 每子時, 自左脚心涌泉穴起陽, 循左足腹脇手, 而上至頭頂顖門, 午位而止. 午時自頂門, 循右手脇腹足, 而下至右脚心而止. 是坎离爲陰陽消息也.

Translation영역
The Immun says: the flow of the body's qi begins yang at the ja hour from Yongcheon (湧泉, KI1) at the centre of the left sole, follows the left foot, abdomen, ribside and hand upward to the fontanelle at the crown, and stops at the o position. At the o hour it goes from the crown down the right hand, ribside, abdomen and foot to the centre of the right sole and stops. This is kan and li as the waxing and waning of yin and yang.
Clinical note임상 주석
A daily circuit up the left side by night and down the right by day — the Immun's scheme, and the chapter's earlier subsections give the Lingshu's, which is different. The Bogam records both. The left-up, right-down direction is the same one the Women chapter's left-male right-female rule rests on.

Immun 入門

4.4 The Course of the Defence Qi 衛氣行度

4.4.1
Source원문

靈樞曰, 衛氣之行, 一日一夜五十周於身, 晝日行於陽二十五周, 夜行於陰二十五周. 是故平旦陰盡, 陽氣出於目, 目張則氣上行於頭, 循項下足太陽, 循背下至小指之端. 其散者, 別於目銳眥, 下手太陽, 下至手小指之間外側. 其散者, 別於目銳眥, 下足少陽, 注小指次指之間, 以上循手少陽之分側, 下至小指之間. 其別者, 以上至耳前, 注足陽明, 以下行至跗上, 入五指之間. 其散者, 從耳下, 下手陽明, 入大指之間, 入掌中. 其至於足也, 入足心, 出內踝下, 行陰分, 復合於目, 故爲一周. 二十五周於身, 陽盡於陰, 陰受氣矣. 其始入於陰, 常從足少陰注於腎.

Translation영역
The Lingshu says: the defence qi in one day and one night makes fifty circuits of the body — twenty-five in the yang by day and twenty-five in the yin by night. So at dawn the yin is exhausted and the yang qi issues from the eyes; when the eyes open the qi goes up to the head, follows the nape down the foot greater yang, and follows the back down to the tip of the little toe. A branch of it parts at the outer canthus, goes down the hand greater yang to the outer side between the little fingers. Another branch parts at the outer canthus, goes down the foot lesser yang and pours between the little toe and the fourth, then up along the side of the hand lesser yang and down to between the little fingers. Another branch goes up to the front of the ear, pours into the foot yang brightness, and runs down to the top of the foot and between the five toes. Another scatters from below the ear, goes down the hand yang brightness, and enters between the thumb and finger and into the palm. When it reaches the foot it enters the sole, comes out below the inner ankle, runs in the yin division, and joins again at the eye — hence one circuit. After twenty-five circuits of the body the yang is exhausted in the yin and the yin receives the qi. When it first enters the yin it always pours from the foot lesser yin into the kidney.
Clinical note임상 주석
The Lingshu's map of where the defence qi goes in a day, and it is an anatomy: the six yang channels by daylight, in the order they are numbered, and the five viscera by night. The chapter includes it because the acupuncturist needed to know which channel was open at which hour, and 4.5 says why the construction is different.

Yeongchu 靈樞

4.4.2
Source원문

又曰, 人經脉上下左右前後二十八脉, 周身十六丈二尺, 以應二十八宿, 漏水下百刻, 以分晝夜, 故一萬三千五百息, 氣行五十營於身矣.

Translation영역
It also says: a person's channels, above and below, left and right, front and back, are twenty-eight vessels, sixteen jang and two cheok around the body, answering to the twenty-eight lunar lodges; the clepsydra's water falls a hundred marks to divide day and night, and so in thirteen thousand five hundred breaths the qi makes fifty circuits of the body.
Clinical note임상 주석
A calculation: the channels measured, the day divided by the water clock, and the breaths counted. Thirteen thousand five hundred breaths a day is about nine a minute, which is slow but not absurd for a man at rest. The tradition took the number seriously enough that 4.7.1 gives the distance qi travels per day from it.

Yeongchu 靈樞

4.4.3
Source원문

東垣曰, 元氣之來也, 徐而和, 細細如線. 邪氣之來也, 緊而强, 如巨川之水不可遏也.

Translation영역
Dongwon says: the coming of the origin qi is slow and harmonious, fine as a thread. The coming of the evil qi is tight and strong, like the water of a great river that cannot be checked.
Clinical note임상 주석
Two qualities under the finger, and the chapter's first statement of what the pulse feels like in health and in disease. The Pulse Diagnosis chapter's 4.3 made the same point with stomach qi: what is right is quiet, and what is wrong announces itself.

Dongwon 東垣

4.5 The Construction and Defence Move Differently 榮衛異行

4.5.1
Source원문

綱目曰, 榮氣之行, 自太陰始, 至足厥陰終, 一周於身也. 詳其一周於身, 外至身體四肢, 內至五藏六府, 無不周遍, 故其五十周, 無晝夜陰陽之殊. 衛氣之行則不然, 晝但周陽於身體四肢之外, 不入五藏六府之內, 夜但周陰於五藏六府之內, 不出於身體四肢之外. 故必五十周至平旦, 方與榮大會於肺手太陰也.

Translation영역
The Gangmok says: the construction qi begins at the hand greater yin and ends at the foot reverting yin, one circuit of the body. Examining this one circuit, it reaches without to the body and four limbs and within to the five viscera and six bowels, leaving nothing out; so its fifty circuits make no distinction of day and night, yin and yang. The defence qi's course is otherwise: by day it circles only the yang, outside in the body and limbs, and does not enter the viscera and bowels; by night it circles only the yin, within the viscera and bowels, and does not come out to the body and limbs. So it must complete fifty circuits to dawn before it has its great meeting with the construction at the lung, the hand greater yin.
Clinical note임상 주석
The construction goes everywhere all the time; the defence goes outside by day and inside by night. That is why the body is warm at the surface by day and why it is not at night — and why 4.3.3 says not to go out after dark. The two meet once a day, at dawn, at the lung.

Gangmok 綱目

4.6 The Origin of Engendering Qi 生氣之原

4.6.1
Source원문

難經疏曰, 十二經脉者, 皆係於生氣之原. 所謂生氣之原者, 謂腎間動氣也. 此五藏六府之本, 十二經脉之根, 呼吸之門, 三焦之原, 一名守邪之神. 故氣者, 人之根本也.

Translation영역
The commentary on the Nanjing says: the twelve channels are all bound to the origin of engendering qi. What is called the origin of engendering qi means the stirring qi between the kidneys. This is the root of the five viscera and six bowels, the root of the twelve channels, the gate of breathing, the origin of the three burners, also called the spirit that guards against evil. Hence qi is a person's root.
Clinical note임상 주석
The Nanjing's eighth difficulty, which the Pulse Diagnosis chapter cited at 4.16 to explain how a patient with a level wrist pulse can die. The stirring between the kidneys is the abdominal aorta felt below the navel, and the tradition placed the root of all qi there. 4.6.2 gives it a point.

Nangyeong 難經

4.6.2
Source원문

又曰, 氣海, 丹田, 實爲生氣之原. 氣海一穴, 在臍下一寸半. 丹田一穴, 一名關元, 在臍下三寸.

Translation영역
It also says: the sea of qi and the cinnabar field are in truth the origin of engendering qi. The point Gihae (氣海, CV6) is one and a half chon below the navel; the point Danjeon, also called Gwanwon (關元, CV4), is three chon below the navel.
Clinical note임상 주석
The origin located on the body — two points on the midline below the navel, and every chapter that moxas for collapse uses one or both. The Pulse Diagnosis chapter's 4.18 sends to Gihae for a pulse that has stopped, and the Women chapter's 1.51 to Gwanwon for a woman who cannot conceive.

Nangyeong 難經

4.7 Qi Is the Root of Breathing 氣爲呼吸之根

4.7.1
Source원문

正理曰, 人受生之初, 在胞胎之內, 隨母呼吸, 及乎生下, 剪去臍帶, 則一點眞靈之氣, 聚于臍下. 凡人唯氣最先, 莫先於呼吸. 眼耳鼻舌意是謂六慾, 皆由是氣, 非是氣, 則聲色香味觸法都不知覺. 氣之呼接于天根, 氣之吸接于地根, 氣之在人身, 一日周行八百一十丈.

Translation영역
The Jeongni says: at the beginning of a person's receiving life, within the womb, one breathes with the mother; when born and the cord cut, one point of true numinous qi gathers below the navel. For a person, nothing comes before qi, and nothing before breathing. Eye, ear, nose, tongue and mind are called the six desires, and all arise from this qi; without this qi, sound, colour, scent, taste, touch and phenomena are none of them perceived. The qi's exhalation joins the root of heaven, its inhalation the root of earth, and the qi within a person's body travels eight hundred and ten jang in a day.
Clinical note임상 주석
Eight hundred and ten jang is the Lingshu's sixteen jang two cheok multiplied by fifty circuits — the chapter's arithmetic from 4.4.2 carried through. The account of the newborn is the Women chapter's 1.49.1 from the other side: the cord is cut, and what was the mother's breathing becomes the child's own, gathered at the navel.

Jeongni 正理

4.7.2
Source원문

易曰, 一闔一闢謂之變, 往來不窮謂之通. 程伊川曰, 涵養之道, 出入之息者, 闔闢之機而已. 又曰, 闔闢往來, 見之鼻息. 張橫渠曰, 人之有息, 盖剛柔相摩, 乾坤闔闢之象也. 朱紫陽調息箴曰, 氤氳開闔, 其妙無窮, 誰其屍之, 不宰之功.

Translation영역
The Yi says: one closing and one opening is called change; coming and going without end is called passage. Cheng Yichuan said: the way of nourishing is the breath going out and coming in — no more than the mechanism of closing and opening. He also said: closing and opening, coming and going, are seen in the breath of the nose. Zhang Hengqu said: that a person breathes is hard and soft rubbing against each other, the image of qian and kun closing and opening. Zhu Ziyang's Admonition on Regulating the Breath says: the vapours open and close, and their subtlety is without end; who presides over it? It is the work of no master.
Clinical note임상 주석
Three Song philosophers — Cheng Yi, Zhang Zai, Zhu Xi — on breathing, and the Bogam quotes them as it quotes physicians. The claim they share is that the breath is the Yi's opening and closing in the body, and Zhu Xi's last line says it has no one behind it. The passage is the chapter's bridge from physiology to practice, and the next two sections are the practice.

Yeok 易

4.7.3
Source원문

參同契曰, 二用無爻位, 周流行六虛, 六虛, 卽卦之六畵也. 以喩一呼一吸, 往來上下, 久之則神凝息定, 所以成變化也. 呼則氣出, 陽之闢也. 吸則氣入, 陰之闔也. 盖人身之陰陽, 與天地陰陽相似, 若能御呼吸於上下, 使之周流不息, 則闔闢往來之妙, 盡在吾身中. 元和子曰, 人身大抵同天地, 是也.

Translation영역
The Cantong Qi says: the two uses have no fixed line-position but flow through the six voids — the six voids being the six lines of the hexagram. This is a figure for one exhalation and one inhalation, coming and going, up and down; kept up long, the spirit condenses and the breath settles, and so transformation is accomplished. Exhaling, the qi goes out — the opening of yang. Inhaling, the qi comes in — the closing of yin. The yin and yang of the body resemble the yin and yang of heaven and earth, and if one can drive the breath up and down and make it flow round without ceasing, the whole subtlety of closing and opening, coming and going, is within one's own body. Master Yuanhe said: the human body is broadly the same as heaven and earth — this is it.

Chamdonggye 參同契

4.7.4
Source원문

莊周曰, 眞人之息, 息之以踵, 衆人之息, 息之以喉. 盖氣在下焦, 其息遠, 氣在上焦, 其息促. 義亦類此.

Translation영역
Zhuang Zhou said: the true man breathes with his heels; the common people breathe with their throats. Where the qi is in the lower burner the breath is deep, and where the qi is in the upper burner the breath is short. The sense is of this kind.
Clinical note임상 주석
Zhuangzi's line, and the Bogam's gloss turns it clinical: heel-breathing is abdominal breathing, throat-breathing is the shallow breath of the anxious and the ill. 4.19 on short breath is this observation made into a disease.

Jangja 莊子

4.8 The Method of Foetal Breathing 胎息法

4.8.1
Source원문

眞詮曰, 人在胎中, 不以口鼻呼吸, 惟臍帶繫于母之任脉, 任脉通于肺, 肺通于鼻. 故母呼亦呼, 母吸亦吸, 其氣皆于臍上往來. 天台謂, 識神托生之始, 與精血合根在于臍. 是以人生時, 惟臍相連, 初學調息, 須想其氣出從臍出, 入從臍滅. 調得極細, 然後不用口鼻, 但以臍呼吸, 如在胞胎中, 故曰胎息. 初閉氣一口, 以臍呼吸, 數之至八十一, 或一百二十, 乃以口吐氣. 出之當令極細, 以鴻毛着于口鼻之上, 吐氣而鴻毛不動爲度. 漸習漸增, 數之久可至千, 則老者更少, 日還一日矣. 葛仙翁每盛暑, 輒入深淵之底, 十日許乃出, 以其能閉氣胎息耳. 但知閉氣, 不知胎息, 無益也.

Translation영역
The Jinquan says: in the womb a person does not breathe through mouth and nose; only the cord is bound to the mother's controlling vessel, the controlling vessel communicates with the lung, and the lung with the nose. So when the mother exhales one exhales too, and when she inhales one inhales too, the qi coming and going at the navel. Tiantai says the beginning of the knowing spirit's entrusting itself to life is its joining with essence and blood, rooted at the navel. So at birth only the navel connects, and one first learning to regulate the breath must imagine the qi going out from the navel and coming in to vanish at the navel. Regulated to the utmost fineness, one then does not use mouth and nose but breathes only with the navel, as in the womb — hence it is called foetal breathing. First hold one breath and breathe with the navel, counting to eighty-one or a hundred and twenty, then let the breath out through the mouth. Letting it out must be made very fine — set a goose down on the mouth and nose, and the measure is that the breath goes out without the down moving. Practising gradually and increasing gradually, in time one may count to a thousand, and then the old grow young again, day by day returning. The Immortal Ge would go to the bottom of a deep pool at the height of summer and come out after ten days or so, because he could hold his breath in foetal breathing. But to know holding the breath without knowing foetal breathing is no use.
Clinical note임상 주석
The practice in full: breathe from the navel, hold, count, let out so gently that a feather on the lip does not stir. Ge Hong at the bottom of the pool for ten days is the legend; the method itself is diaphragmatic breathing with breath retention, and it is what the chapter means by 胎息. The last line is the caution: holding the breath is not the point, and doing it without the rest is 無益, no use.

Jinjeon 眞詮

4.8.2
Source원문

養性曰, 胎息者, 如嬰兒在母胎中, 氣息自在, 上至氣關, 下至氣海, 不假口鼻之氣. 故能閉氣不息, 能入深泉, 旬日不出也.

Translation영역
The Yangseong says: foetal breathing is like an infant in the mother's womb, the breath free of itself, reaching up to the gate of qi and down to the sea of qi, without borrowing the breath of mouth and nose. So one can hold the breath without breathing, and can enter a deep spring and not come out for ten days.

Yangseong 養性

4.8.3
Source원문

又曰, 內觀之要, 靜神定心, 亂想不起, 邪妄不侵, 氣歸臍爲息, 神入氣爲胎, 胎息相合, 混而爲一, 名曰太乙.

Translation영역
It also says: the essential of inner observation is to still the spirit and settle the heart, so that disordered thoughts do not arise and wrong and false things do not invade; the qi returning to the navel is the breath, the spirit entering the qi is the foetus, and breath and foetus joined, mixed and made one, is called the Great One.
Clinical note임상 주석
太乙, the Great One — the Daoist name for the state the practice aims at, and the chapter gives it without comment. The Spirit chapter's cultivation sections and this one share their sources, and the Bogam's inclusion of them is a statement that a physician's knowledge did not stop at medicine.

Yangseong 養性

4.9 The Secret of Regulating the Qi 調氣訣

4.9.1
Source원문

彭祖曰, 和神導氣之道, 當得密室閉戶, 安床煖席, 枕高二寸半, 正身偃臥瞑目, 閉氣於胸膈中, 以鴻毛着鼻上而不動, 經三百息, 耳無所聞, 目無所見, 心無所思. 如此則寒暑不能侵, 蜂蠆不能毒, 壽三百六十歲, 此隣於眞人也.

Translation영역
Pengzu said: the way of harmonizing the spirit and guiding the qi requires a closed room with the door shut, a settled bed and warm mat, a pillow two and a half chon high; lie on the back with the body straight and the eyes closed, hold the breath in the chest and diaphragm with a goose down set on the nose not moving, through three hundred breaths, the ear hearing nothing, the eye seeing nothing, the heart thinking nothing. Then cold and heat cannot invade, bee and scorpion cannot poison, and one lives three hundred and sixty years — this is next to the true man.
Clinical note임상 주석
Pengzu, who is said to have lived eight hundred years, gives the recipe for three hundred and sixty. The method is the same feather on the nose as 4.8.1, and what the chapter is recording is that the practice was held to do more than calm — it was held to lengthen life.

Paengjo 彭祖

4.9.2
Source원문

養性曰, 人身虛無, 但有遊氣, 氣息得理, 卽百病不生. 故善攝養者, 須知調氣方焉. 調氣之法, 夜半後日中前, 氣生得調, 日中後夜半前, 氣死不得調. 調氣之時, 則仰臥, 床鋪厚軟, 枕高下, 共身平, 舒手展脚, 兩手握固, 去身四五寸, 兩脚相去四五寸, 數數叩齒, 飮玉漿. 引氣從鼻入腹, 足則停止, 有力更取. 久住氣悶, 從口細細吐出盡, 遠以鼻細細引入, 出氣一准前法, 閉口以心中數數, 令耳不聞, 能至千則去仙不遠矣. 若天陰風雨, 大寒暑, 勿取氣, 但閉之.

Translation영역
The Yangseong says: the body is empty and void, with only wandering qi in it; where the breath is rightly ordered, the hundred diseases do not arise. So one skilled in nurturing must know the method of regulating the qi. In the method of regulating the qi, from midnight to noon the qi is alive and may be regulated; from noon to midnight the qi is dead and may not be. At the time of regulating, lie on the back on a thick soft bed, the pillow level with the body, hands and legs stretched, the two hands clenched and four or five chon from the body, the two feet four or five chon apart; click the teeth many times and swallow the jade liquor. Draw the qi in through the nose to the belly, stop when full, and take more when there is strength. When it has stayed long and grows oppressive, let it out through the mouth very finely until it is gone, then draw it in again through the nose very finely, and let it out as before; close the mouth and count in the heart so that the ear does not hear, and if one can reach a thousand one is not far from the immortals. When the sky is overcast with wind and rain, or in great cold or heat, do not take the qi, only hold it.
Clinical note임상 주석
The fullest instruction in the chapter, and it is a protocol: position, timing, count. 夜半後 日中前 — after midnight and before noon — is when the qi is alive, which is 4.3.3's rhythm applied to practice. 玉漿, the jade liquor, is saliva, and 叩齒, clicking the teeth, is what brings it. The last line's prohibition on bad weather is the same caution the Sweating chapter gives for its baths at 7.5.

Yangseong 養性

4.9.3
Source원문

又曰, 凡吐者出故氣, 亦名死氣, 納者取新氣, 亦名生氣. 故老子云, 玄牝之門鼻曰玄門, 口曰牝戶, 天地之根, 綿綿若存, 用之不勤, 言口鼻, 天地之間, 可以出納陰陽死生之氣也.

Translation영역
It also says: what is breathed out is the old qi, also called the dead qi; what is taken in is the new qi, also called the living qi. So Laozi says: the gate of the dark female the nose is called the dark gate, the mouth the female door is the root of heaven and earth, continuous as though it were there, used without effort — meaning that mouth and nose, between heaven and earth, can send out and take in the qi of yin and yang, death and life.
Clinical note임상 주석
Laozi's sixth chapter read as a manual of breathing — the dark female is the nose and mouth, and the root of heaven and earth is the breath. The reading is the Daoist tradition's, and the Bogam passes it on.

Yangseong 養性

4.9.4
Source원문

正理曰, 守氣之妙, 在乎全精, 尤當防其睡眠. 夫人遇行走則氣急而嗄, 甚睡則氣麄而齁, 惟坐靜, 則氣平而緩.

Translation영역
The Jeongni says: the subtlety of guarding the qi lies in keeping the essence whole, and especially in guarding against sleep. When a person walks the breath quickens and is hoarse; in heavy sleep the breath is coarse and snores; only in sitting still is the breath level and easy.
Clinical note임상 주석
Three states of breathing observed: walking, sleeping, sitting. Snoring is named as a disorder of the breath in sleep, and the chapter's preference for the seated state is the meditator's.

Jeongni 正理

4.9.5
Source원문

醫鑑曰, 人自十六歲, 精氣漸減, 不但男女之慾足以損敗, 一與事應, 則視聽言動, 皆耗散精氣之原. 故釋氏面壁, 仙家坐關, 皆築基, 煉己苦行, 以防耗此神氣, 便是長生之術.

Translation영역
The Uigam says: from sixteen a person's essence and qi decline by degrees, and it is not only the desire between man and woman that suffices to spoil them; each response to affairs — seeing, hearing, speaking, moving — all wastes and scatters the origin of essence and qi. So the Buddhists face the wall and the immortals sit in retreat, all laying a foundation and disciplining themselves through hardship to guard against wasting this spirit and qi — and that is the art of long life.
Clinical note임상 주석
The decline begins at sixteen, and everything the senses do spends it. Bodhidharma facing the wall and the Daoist in retreat are given as one practice — withdrawing the senses to save what they cost. The chapter treats perception itself as an expenditure, which is 4.3.4's point read in reverse.

Uigam 醫鑑

4.10 The Lung Governs Qi 肺主氣

4.10.1
Source원문

內經曰, 肺主氣. 又曰, 諸氣者, 皆屬於肺. 註曰, 肺有六葉兩耳, 葉中有二十四孔行列, 分布陰陽淸濁之氣.

Translation영역
The Neijing says: the lung governs qi. It also says: all qi belongs to the lung. The commentary says: the lung has six lobes and two ears, and in the lobes are twenty-four holes in rows, distributing the clear and turbid qi of yin and yang.
Clinical note임상 주석
Six lobes, two ears and twenty-four holes — the tradition's lung anatomy, and the twenty-four holes are the twenty-four solar terms. What is right in it is the first line: the lung governs qi, and the chapter's diseases from 4.17 to 4.20 are all read at the lung.

Naegyeong 內經

4.10.2
Source원문

又曰, 肺藏氣. 氣有餘則喘咳上氣, 不足則息利少氣.

Translation영역
It also says: the lung stores qi. Where qi is in surplus there is panting, cough and qi ascent; where it is insufficient the breath is easy but scant.
Clinical note임상 주석
Surplus and deficiency of qi at the lung, and the two signs: too much is wheezing, too little is a breath that is easy but shallow. 4.17 and 4.20 are the two conditions.

Naegyeong 內經

4.10.3
Source원문

靈樞曰, 膻中爲氣之海. 膻中者, 肺室也, 有餘則胸面俱赤, 不足則少氣力不多言.

Translation영역
The Lingshu says: the centre of the chest is the sea of qi. The centre of the chest is the lung's chamber; where there is surplus the chest and face are both red, and where there is insufficiency there is little strength and little speech.
Clinical note임상 주석
膻中, the centre of the chest — Danjung, CV17 — is the sea of qi as Gihae below the navel is the sea of qi. The tradition has two, one for the breath and one for the root, and the acupuncture at 4.31 uses both.

Yeongchu 靈樞

4.11 Pulse Method 脉法

4.11.1
Source원문

仲景曰, 脉浮而汗出如流珠者, 衛氣衰也.

Translation영역
Zhongjing says: a pulse floating with sweat flowing out like beads is the defence qi declined.

Junggyeong 仲景

4.11.2
Source원문

又曰, 寸口脉微而澁, 微者衛氣衰, 澁者榮氣不足.

Translation영역
He also says: an inch-opening pulse faint and rough — faint is the defence qi declined, rough the construction qi insufficient.

Junggyeong 仲景

4.11.3
Source원문

脉經曰, 寸口脉, 瞥瞥如羹上肌者, 陽氣微, 縈縈如蜘蛛絲者, 陰氣衰也.

Translation영역
The Pulse Classic says: an inch-opening pulse fleeting like the skin on broth is the yang qi faint; wavering like a spider's thread is the yin qi declined.

Maekgyeong 脉經

4.11.4
Source원문

又曰, 代者氣衰, 細者氣少, 浮而絶者, 氣欲絶.

Translation영역
It also says: intermittent is the qi declined; fine is the qi scant; floating and breaking off is the qi about to be cut off.

Maekgyeong 脉經

4.11.5
Source원문

又曰, 趺陽脉浮而澁, 澁則衛氣虛, 虛則短氣.

Translation영역
It also says: the instep yang pulse floating and rough — rough is the defence qi vacuous, and vacuous is short breath.
Clinical note임상 주석
The instep yang is Chungyang (衝陽, ST42) on the top of the foot, and the Pulse Diagnosis chapter's 4.14 said it must be examined in grave illness. Here the Maekgyeong reads short breath from it.

Maekgyeong 脉經

4.11.6
Source원문

脉訣曰, 下手脉沈, 便知是氣, 沈極則伏, 濇弱難治, 其或沈滑, 氣兼痰飮.

Translation영역
The Pulse Verses say: when the hand goes down and the pulse is sunken, know at once it is qi; sunken to the extreme is hidden; rough and weak is hard to treat; and where it is sunken and slippery, the qi is joined by phlegm rheum.
Clinical note임상 주석
The pulse of a qi disease is sunken, and the rule is stated as a first impression — 下手脉沈, 便知是氣, when the hand goes down and finds it sunken, know it is qi. Slippery on top of sunken adds phlegm, which is what 4.14's formulas treat.

Maekgyeol 脉訣

4.11.7
Source원문

又曰, 沈弦細動, 皆氣痛證, 心痛在寸, 腹痛在關, 下部在尺, 脉象顯然.

Translation영역
It also says: sunken, stringlike, fine and stirring are all patterns of qi pain — heart pain at the inch, abdominal pain at the bar, the lower part at the cubit; the pulse image is plain.
Clinical note임상 주석
Where the pain is, by which position shows it — inch for the chest, bar for the belly, cubit for below. The three positions map the trunk, and a qi pain shows at the one that corresponds to its site.

Maekgyeol 脉訣

4.11.8
Source원문

仲景曰, 趺陽脉微而緊, 緊則爲寒, 微則爲虛, 微緊相搏則爲短氣.

Translation영역
Zhongjing says: the instep yang pulse faint and tight — tight is cold, faint is vacuity, and faint and tight striking together is short breath.

Junggyeong 仲景

4.12 Qi Makes All Diseases 氣爲諸病

4.12.1
Source원문

丹溪曰, 周流乎一身, 以爲生者氣也. 苟內無所傷, 外無所感, 何氣病之有哉. 今者冷氣, 滯氣, 逆氣, 上氣, 皆是肺受火邪, 氣得炎上之化, 有升無降, 熏蒸淸道甚而轉成劇病. 局方例用辛香燥熱之劑, 是以火濟火也.

Translation영역
Danxi says: what flows through the whole body and makes it live is qi. Were there no damage within and no contraction without, what disease of qi could there be? Now cold qi, stagnant qi, counterflowing qi and ascending qi are all the lung receiving the fire evil, the qi taking on the transformation of flaring upward, rising and not descending, steaming the clear passages until it turns into severe disease. The Gukbang as a rule uses acrid, fragrant, drying and hot preparations — which is aiding fire with fire.
Clinical note임상 주석
Danxi's rule for the whole chapter, and his quarrel with the Gukbang. Every qi disease is the lung under fire; the Gukbang's aromatic warming formulas — the whole of 4.21 and half of 4.14 to 4.17 — feed the fire they treat. 以火濟火, aiding fire with fire. The Bogam records the criticism and then registers the formulas. Both are in the chapter, and the reader is left to choose — which is the Medicine Use chapter's 5.1 in practice.

Dansim 丹心

4.12.2
Source원문

回春曰, 風傷氣者爲疼痛, 寒傷氣者爲戰慄, 暑傷氣者爲熱悶, 濕傷氣者爲腫滿, 燥傷氣者爲閉結.

Translation영역
The Hoechun says: wind damaging the qi makes pain; cold damaging it makes shivering; summerheat damaging it makes hot oppression; damp damaging it makes swelling and fullness; dryness damaging it makes blockage and binding.

Hoechun 回春

4.12.3
Source원문

序例曰, 人生氣中如魚在水, 水濁則魚瘦, 氣昏則人病. 邪氣之傷人最爲深重, 經絡旣受此氣, 傳入藏府, 隨其虛實, 冷熱結以成病, 病又相生, 故流變遂廣矣.

Translation영역
The Seorye says: a person lives in qi as a fish lives in water; where the water is muddy the fish grows thin, and where the qi is clouded the person falls ill. The evil qi's damage to a person is the deepest and gravest; once the channels have received it, it passes into the viscera and bowels, and according to their vacuity and repletion binds with cold or heat to form disease, and disease breeds disease, so that its changes spread wide.
Clinical note임상 주석
A fish in muddy water — the image for a body in bad air, and the chapter's clearest statement that qi is an environment as much as a substance. 序例 is the preface to the Shennong Bencao, and the Bogam cites it here for the origin of disease.

Seorye 序例

4.12.4
Source원문

張子和曰, 諸病皆生於氣, 諸痛皆因於氣.

Translation영역
Zhang Zihe says: all diseases are born of qi, and all pain comes from qi.
Clinical note임상 주석
Zhang Congzheng's two claims, and the section's title is the first of them. The second is the Medicine Use chapter's 5.28 — where there is no free passage there is pain — and 4.21 is the chapter's answer to it.

Jahwa 子和

4.13 Where Qi Is Idle It Stagnates 氣逸則滯

4.13.1
Source원문

臞仙曰, 人之勞倦, 有生於無端. 不必持重執輕, 仡仡終日, 惟是閑人, 多生此病. 盖閑樂之人, 不多運動氣力, 飽食坐臥, 經絡不通, 血脉凝滯使然也. 是以貴人貌樂而心勞, 賤人心閑而貌苦. 貴人嗜慾不時, 或昧於忌犯, 飮食珍羞, 便乃寢臥. 故常須用力, 但不至疲極. 所貴榮衛流通, 血脉調暢, 譬如流水不汚, 戶樞不蠹也.

Translation영역
Quxian said: a person's taxation and weariness can arise from nothing. It need not be from carrying heavy loads or bustling all day; it is precisely the idle who mostly get this disease. For those at leisure do not much exercise their strength, eat to fullness and sit or lie down, the channels do not pass and the blood vessels congeal and stagnate — that is what brings it on. So the noble look happy and their hearts are taxed; the lowly have easy hearts and look wretched. The noble indulge their appetites out of season, sometimes blind to what should be avoided, eat rare delicacies and then lie down to sleep. So one must always use one's strength, only not to the point of exhaustion. What is prized is the construction and defence flowing freely and the blood vessels regulated and easy — as running water does not foul and a door-hinge does not get worm-eaten.
Clinical note임상 주석
流水不汚, 戶樞不蠹 — running water does not foul, a hinge does not get worms. The proverb from the Lüshi Chunqiu, and the whole of the section is in it: the body that is used stays clean. The rich man's disease is named as such, and the cure is 用力, effort. The chapter's one formula for it, Gyulpiilmul-tang, is a single ingredient. The Immun says the light case is cured by walking.

Guseon 臞仙

4.13.2
Source원문

入門曰, 逸則氣滯, 亦令氣結. 輕者, 行動卽愈, 重者, 橘皮一物湯.

Translation영역
The Immun says: idleness stagnates the qi and also binds it. In the light case, moving about cures it at once; in the heavy case, Tangerine Peel Single-Ingredient Decoction.

Immun 入門

4.14 The Seven Qi 七氣

4.14.1
Source원문

七氣者, 喜怒悲思憂驚恐, 或以爲寒熱恚怒喜憂愁, 皆通也. 《直指》

Translation영역
The seven qi are joy, anger, grief, thought, worry, fright and fear; some make them cold, heat, resentment, anger, joy, worry and sorrow — either will do.
Clinical note임상 주석
Two lists of seven, and the Jikji says either. The first is the seven affects of the Neijing; the second mixes two climates in with five feelings, which is the older Qianjin list. The chapter does not choose, because the treatment is the same.

Jikji 直指

4.14.2
Source원문

直指曰, 人有七情, 病生七氣. 氣結則生痰, 痰盛則氣愈結. 故調氣必先豁痰, 如七氣湯, 以半夏主治, 而官桂佐之, 盖良法也.

Translation영역
The Jikji says: a person has seven affects, and disease arises from the seven qi. Where the qi binds it engenders phlegm, and where phlegm is exuberant the qi binds the more. So in regulating the qi one must first sweep the phlegm — as Seven Qi Decoction governs with pinellia and assists with cinnamon, which is a fine method.
Clinical note임상 주석
The circle the section turns on: bound qi makes phlegm, and phlegm binds qi. The treatment breaks the circle at the phlegm — 調氣必先豁痰, to regulate qi first sweep phlegm — which is why pinellia leads Chilgi-tang and Sachil-tang both.

Jikji 直指

4.14.3
Source원문

又曰, 七氣相干, 痰涎凝結, 如絮如膜, 甚如梅核, 窒碍於咽喉之間, 咯不出嚥不下, 或中滿艱食, 或上氣喘急, 曰氣隔, 曰氣滯, 曰氣秘, 曰氣中. 以至五積, 六聚, 疝癖, 癥瘕, 心腹塊痛, 發則欲絶, 殆無往而不至矣.

Translation영역
It also says: where the seven qi interfere with each other, phlegm and drool congeal and bind — like cotton wadding, like a membrane, at worst like a plum stone — and obstruct the throat so that it can be neither hawked out nor swallowed down; or there is fullness of the centre with difficulty eating, or qi ascent with hurried panting — called qi obstruction, qi stagnation, qi blockage, qi stroke. It goes as far as the five accumulations and six gatherings, mounting and aggregation, concretion and conglomeration, lumps and pain of heart and abdomen so that when it breaks out one is near death — there is nowhere it does not reach.
Clinical note임상 주석
From a lump in the throat to a tumour in the belly — one mechanism, the Jikji says, at every stage. The plum stone is the beginning, and the Accumulations chapter's masses are where it ends if left. Whether or not the chain holds, it is the reason the tradition treated the globus of 4.14's formulas seriously.

Jikji 直指

4.14.4
Source원문

宜服七氣湯ㆍ四七湯ㆍ分心氣飮ㆍ香橘湯.

Translation영역
Seven Qi Decoction, Four-Seven Decoction, Divide the Heart Qi Drink and Cyperus and Tangerine Decoction should be taken.

Donguibogam · Gi

4.15 The Nine Qi 九氣

4.15.1
Source원문

黃帝問曰, 余知百病生於氣也. 怒則氣上, 喜則氣緩, 悲則氣消, 恐則氣下, 寒則氣收, 炅則氣泄, 驚則氣亂, 勞則氣耗, 思則氣結, 九氣不同, 何病之生. 岐伯對曰, 怒則氣逆, 甚則嘔血及飱泄, 故氣上矣. 喜則氣和志達, 榮衛通利, 故氣緩矣. 悲則心系急, 肺布葉擧而上焦不通, 榮衛不散, 熱氣在中, 故氣消矣. 恐則精却, 却則上焦閉, 閉則氣還, 還則下焦脹, 故氣不行矣. 寒則腠理閉, 氣不行, 故氣收矣. 炅則腠理開, 榮衛通, 汗大泄, 故氣泄矣. 驚則心無所倚, 神無所歸, 慮無所定, 故氣亂矣. 勞則喘息汗出, 內外皆越, 故氣耗矣. 思則心有所存, 神有所歸, 正氣留而不行, 故氣結矣.

Translation영역
The Yellow Emperor asked: I know that the hundred diseases arise from qi. In anger the qi rises, in joy it slackens, in grief it dissolves, in fear it descends, in cold it draws in, in heat it discharges, in fright it is disordered, in taxation it is spent, in thought it binds — nine qi that differ; what diseases arise? Qi Bo answered: in anger the qi counterflows, and at worst there is vomiting of blood and undigested diarrhoea — hence the qi rises. In joy the qi is harmonious and the will reaches out, the construction and defence pass freely — hence the qi slackens. In grief the heart's cords tighten, the lung's lobes spread and lift, the upper burner does not pass, the construction and defence do not scatter, and hot qi is within — hence the qi dissolves. In fear the essence retreats; retreating, the upper burner closes; closing, the qi turns back; turning back, the lower burner distends — hence the qi does not move. In cold the interstices close and the qi does not move — hence the qi draws in. In heat the interstices open, the construction and defence pass, and sweat pours out — hence the qi discharges. In fright the heart has nothing to lean on, the spirit nowhere to return, the thoughts nowhere to settle — hence the qi is disordered. In taxation there is panting and sweating, and inside and outside both overflow — hence the qi is spent. In thought the heart has something it holds to, the spirit something it returns to, and the right qi stays and does not move — hence the qi binds.
Clinical note임상 주석
The Suwen's thirty-ninth chapter, and the tradition's foundational account of what emotion does to the body. Nine causes, nine directions of qi, and each with its mechanism — grief lifts the lung and blocks the chest, fear pulls the essence down and distends the belly, thought holds the qi still. The chapter has quoted this piecemeal since 4.1; here it is whole. Every formula at 4.14 and 4.15 answers one of these nine.

Naegyeong 內經

4.15.2
Source원문

又有九氣, 一曰膈氣, 二曰風氣, 三曰寒氣, 四曰熱氣, 五曰憂氣, 六曰喜氣, 七曰驚氣, 八曰怒氣, 九曰山嵐瘴氣. 積聚如盃, 心腹刺痛, 發則欲死, 宜神仙九氣湯, 正氣天香湯. 《得效》

Translation영역
There is another nine qi: the first diaphragm qi, the second wind qi, the third cold qi, the fourth heat qi, the fifth worry qi, the sixth joy qi, the seventh fright qi, the eighth anger qi, the ninth the miasmic qi of mountain mists. They accumulate and gather like a cup, with stabbing pain of heart and abdomen, and when they break out one is near death — Immortals' Nine Qi Decoction and Correct the Qi Heavenly Fragrance Decoction are appropriate.
Clinical note임상 주석
A second nine, and this one is a working list rather than the Neijing's — four feelings, three climates, one anatomical site and the malaria of the southern hills. The Deukhyo's nine are what a physician met, and the two formulas treat all of them alike.

Deukhyo 得效

4.15.3
Source원문

九氣治法, 高者抑之, 下者擧之, 寒者熱之, 熱者寒之, 驚者平之, 勞者溫之, 結者散之, 喜者以恐勝之, 悲者以喜勝之. 《心法》

Translation영역
The method of treating the nine qi: what is high, restrain it; what is low, lift it; what is cold, heat it; what is hot, cool it; what is frightened, calm it; what is taxed, warm it; what is bound, scatter it; joy, overcome it with fear; grief, overcome it with joy.
Clinical note임상 주석
Nine treatments for nine qi, and the last two are not medicine — joy is treated with fear and grief with joy. The five-phase scheme of emotions overcoming emotions, from the Suwen, and the Spirit chapter has the cases where it was done. The Medicine Use chapter's 5.3.2 gave the other seven as general rules.

Simbeop 心法

4.16 Centre Qi Stroke 中氣

4.16.1
Source원문

本事曰, 凡人暴喜傷陽, 暴怒傷陰, 憂愁怫意, 氣多厥逆, 便覺涎潮, 昏塞, 牙關緊急, 若槪作中風用藥, 多致殺人. 若有此證, 急化蘇合香元灌之, 醒後隨證調治.

Translation영역
The Bonsa says: sudden joy damages the yang, sudden anger damages the yin, and worry and thwarted feeling make the qi reverse and counterflow; at once there is a tide of drool, clouding and blockage, the jaw clenched tight. If this is treated wholesale as wind stroke with wind-stroke medicines, it mostly kills. Where this pattern is present, dissolve Storax Pill at once and pour it in, and after waking treat according to the pattern.
Clinical note임상 주석
The section's warning before its definition: a collapse from emotion looks like a stroke and is treated as one, and the treatment kills. 多致殺人. The next passage gives the test that tells them apart.

Bonsa 本事

4.16.2
Source원문

得效曰, 中風則脉浮身溫, 口多痰涎, 中氣則脉沈身涼, 口無痰涎. 中風而以中氣藥治之, 亦無所傷. 中氣而以中風藥投之, 禍不旋踵. 先用蘇合香元, 次用七氣湯, 加石菖蒲.

Translation영역
The Deukhyo says: in wind stroke the pulse is floating and the body warm, with much phlegm and drool in the mouth; in centre qi stroke the pulse is sunken and the body cool, with no phlegm or drool in the mouth. Treat wind stroke with centre-qi medicines and no harm is done; give centre qi stroke wind-stroke medicines and disaster follows before one can turn on one's heel. First use Storax Pill, then Seven Qi Decoction with acorus added.
Clinical note임상 주석
Three signs — pulse, body temperature, drool — and the two conditions sort on all three. Wind stroke is floating, warm and wet; centre qi stroke is sunken, cool and dry. The asymmetry of harm is the point: the safe mistake is to treat a stroke as emotion, and the fatal one is the reverse. **Sudden collapse with clenched jaw requires emergency assessment. The distinction here does not exclude stroke.**

Deukhyo 得效

4.16.3
Source원문

方氏曰, 中風多不能治, 中氣須臾便醒, 其故何歟. 夫中風中氣一源流也. 皆由忿怒所致. 人之五志, 惟怒爲甚, 所以爲病之暴也. 盖少壯之人, 氣血未虛, 眞水未竭, 火畏於水, 不能上升, 所以身涼無痰涎, 須臾便醒也. 老衰之人, 氣血俱虛, 眞水已竭, 火寡於畏, 得以上升, 所以身溫有痰涎, 多不能治也.

Translation영역
Master Fang said: wind stroke mostly cannot be treated, and centre qi stroke wakes in a moment — why is this? Wind stroke and centre qi stroke are one source and stream, both brought on by rage. Of a person's five minds, only anger is so severe, and so its disease is sudden. In the young and strong the qi and blood are not yet vacuous and the true water not yet exhausted; the fire fears the water and cannot rise, so the body is cool without drool and they wake in a moment. In the old and declining the qi and blood are both vacuous and the true water already exhausted; the fire has little to fear and can rise, so the body is warm with drool, and mostly cannot be treated.
Clinical note임상 주석
Fang's explanation of why the same rage fells the young and the old differently: the young have water to hold the fire down, and the old do not. What is being described is the difference between a vasovagal collapse and a haemorrhagic stroke, and the chapter has the risk factor right — age and the state of the vessels.

Bang Ssi (方氏)

4.16.4
Source원문

入門曰, 中氣, 虛者, 八味順氣散, 實者四七湯.

Translation영역
The Immun says: in centre qi stroke, for the vacuous, Eight Flavours Order the Qi Powder; for the replete, Four-Seven Decoction.

Immun 入門

4.16.5
Source원문

回春曰, 中氣者, 因與人相爭, 暴怒氣逆, 而暈倒也. 先用薑湯灌救, 甦後用木香順氣散.

Translation영역
The Hoechun says: centre qi stroke is fainting and falling from quarrelling with someone, sudden anger and the qi counterflowing. First pour in ginger decoction to rescue, and after reviving use Costus Order the Qi Powder.
Clinical note임상 주석
因與人相爭 — from quarrelling with someone. The Hoechun names the circumstance, and it is the one the section has been describing since 4.16.1: an argument, a rage, and a collapse.

Hoechun 回春

4.16.6
Source원문

醫鑑曰, 內經曰, 無故而瘖, 脉不至, 不治自己, 謂氣暴逆也. 氣復則已. 審如是, 雖不服藥亦可.

Translation영역
The Uigam says: the Neijing says that muteness without cause, with the pulse not arriving, recovers of itself untreated — meaning the qi has suddenly counterflowed, and when the qi returns it is over. Where this is clearly so, it may be left even without medicine.
Clinical note임상 주석
The Neijing's case of sudden aphonia with a pulse that cannot be found, and the instruction to do nothing. The Women chapter's 1.28.10 gave the same for a pregnant woman who loses her voice, and the principle is the same: a qi that has reversed will come back on its own.

Uigam 醫鑑

4.17 Qi Ascent 上氣

4.17.1
Source원문

靈樞曰, 邪在肺則寒熱上氣.

Translation영역
The Lingshu says: where the evil is in the lung there is cold and heat with qi ascent.

Yeongchu 靈樞

4.17.2
Source원문

內經曰, 肺藏氣. 氣有餘則喘咳上氣.

Translation영역
The Neijing says: the lung stores qi. Where qi is in surplus there is panting, cough and qi ascent.

Naegyeong 內經

4.17.3
Source원문

上氣者, 呼多吸少, 氣息促急也. 宜蘇子降氣湯ㆍ秘傳降氣湯ㆍ至聖來復丹方見下ㆍ沈香降氣湯ㆍ快氣湯.

Translation영역
Qi ascent is much exhaling and little inhaling, the breath hurried and urgent. Perilla Seed Downbear the Qi Decoction, Secretly Transmitted Downbear the Qi Decoction, Supreme Sage Return and Restore Elixir formula below, Aloeswood Downbear the Qi Decoction and Free the Qi Decoction are appropriate.
Clinical note임상 주석
呼多吸少 — more out than in. The definition is a description of air hunger, in which the patient cannot take a full breath and the breathing is fast and shallow. The four downbearing formulas answer it by sending the qi down where the inhalation can reach it.

Donguibogam · Gi

4.18 Qi Descent 下氣

4.18.1
Source원문

綱目曰, 下氣屬心. 經曰, 夏脉者, 心也. 心脉不及, 下爲氣泄, 是也.

Translation영역
The Gangmok says: qi descent belongs to the heart. The classic says: the summer pulse is the heart; where the heart pulse falls short, below there is qi discharge — this is it.
Clinical note임상 주석
下氣, qi descent — the passing of wind, and the chapter gives it a section because it was held to be a sign. The Gangmok assigns it to the heart on the Suwen's rule that a failing heart pulse shows as discharge below.

Gangmok 綱目

4.18.2
Source원문

又曰, 癲癎勞瘵者, 若氣下泄不止者, 必死. 此眞氣竭絶, 腸胃腠理閉塞, 穀氣不能宣通於腸胃之外, 故從腸胃中泄出也.

Translation영역
It also says: in epilepsy and consumption, where qi discharges below without stopping, death is certain. This is the true qi exhausted and cut off, the interstices of intestines and stomach blocked, the grain qi unable to diffuse beyond the intestines and stomach, and so discharging from within them.
Clinical note임상 주석
Incessant flatus in a patient wasting from epilepsy or consumption is read as the last sign — the grain qi has nowhere to go but out the way it came. The Pulse Diagnosis chapter's 4.18 read incontinence the same way.

Gangmok 綱目

4.18.3
Source원문

河間曰, 腸胃鬱結, 穀氣內發, 而不能宣通於腸胃之外, 故善噫而或下氣也.

Translation영역
Hejian says: where the intestines and stomach are depressed and bound, the grain qi issues within and cannot diffuse beyond them, and so there is much belching and sometimes qi descent.

Hagan 河間

4.18.4
Source원문

仲景曰, 傷寒陽明病, 胃中有燥屎者, 必轉矢氣, 下之卽愈. 轉矢氣, 乃氣下泄也. 詳見寒門

Translation영역
Zhongjing says: in the yang brightness disease of cold damage, where there is dry stool in the stomach, there will surely be the turning of flatus, and purging cures it at once. The turning of flatus is qi discharging below. treated in fuller detail in the Cold Damage chapter
Clinical note임상 주석
轉矢氣, the turning of flatus — Zhongjing's test for whether a constipated fever patient is ready to be purged. Wind passing means the bowel is moving and the purgative will work; no wind means it will not. The Purging chapter's 8.11 is built on this line.

Junggyeong 仲景

4.19 Short Breath 短氣

4.19.1
Source원문

明理曰, 短氣者, 氣短而不能相續者是已. 若有氣上衝, 而實非氣上衝也. 呼吸雖數, 而不能相續, 似喘而不搖肩, 似呻吟而無痛, 實爲難辨之證. 要識其眞者, 氣急而短促, 是也.

Translation영역
The Myeongni says: short breath is the breath short and unable to continue. It seems as though the qi surged upward, but in truth it is not qi surging upward. The breathing, though rapid, cannot continue — like panting but without the shoulders heaving, like groaning but without pain; in truth a pattern hard to tell. The way to know the real thing is that the breath is urgent and short — that is it.
Clinical note임상 주석
Short breath defined against what it resembles — not panting, because the shoulders do not lift; not groaning, because nothing hurts. Cheng Wuji's care in distinguishing it is the section's value: a patient who cannot finish a breath is not the same as one who is wheezing.

Myeongni 明理

4.19.2
Source원문

仲景曰, 平人寒熱, 短氣不足以息者, 實也. 又曰, 短氣有微飮, 當從小便去之. 苓桂朮甘湯主之, 腎氣丸亦主之方見虛勞.

Translation영역
Zhongjing says: in an ordinary person with cold and heat and short breath insufficient for breathing, it is repletion. He also says: short breath with slight rheum should be removed through the urine — Poria, Cinnamon, Atractylodes and Licorice Decoction governs it, and Kidney Qi Pill also governs it formula in the Vacuity Taxation chapter.
Clinical note임상 주석
Short breath from fluid — 微飮, slight rheum — and Zhongjing drains it. Yeonggyechulgam-tang is the Phlegm chapter's formula for fluid under the diaphragm, and the reasoning is that a chest with water in it cannot fill with air. **Breathlessness with fluid retention requires assessment for heart failure.**

Junggyeong 仲景

4.19.3
Source원문

入門曰, 氣短者, 呼吸不相接續, 是也. 有結胸者, 有停水怔忡者, 有風濕相搏者, 有素弱氣虛者. 大抵心腹脹滿者爲實, 爲邪在裏, 心腹濡滿者爲虛, 爲邪在表.

Translation영역
The Immun says: short breath is the breathing not joining up. There is the case of bound chest, the case of standing water with palpitation, the case of wind and damp striking together, and the case of one always weak and vacuous of qi. Broadly, where the heart and abdomen are distended and full it is repletion with the evil within; where they are soft and full it is vacuity with the evil without.
Clinical note임상 주석
Four causes and one test — press the belly. Hard and full is repletion; soft and full is vacuity. The Pulse Diagnosis chapter's 4.17 used pressure on the pulse the same way, and the Immun applies it to the abdomen.

Immun 入門

4.19.4
Source원문

東垣曰, 氣短, 小便利者, 四君子湯, 去茯苓, 加黃芪補之.

Translation영역
Dongwon says: for short breath with the urine passing freely, Four Gentlemen Decoction with the poria removed and astragalus added supplements it.
Clinical note임상 주석
Free urine means there is no fluid to drain, and so the poria — the draining medicinal in Sagunja-tang — comes out and astragalus goes in. Dongwon's modification is the opposite case from Zhongjing's at 4.19.2, decided by one sign.

Dongwon 東垣

4.19.5
Source원문

入門曰, 氣散則中虛, 倦怠無力, 短氣不足以息, 宜調中益氣湯方見內傷ㆍ人參養榮湯方見虛勞.

Translation영역
The Immun says: where the qi scatters the centre is vacuous, with weariness and no strength and short breath insufficient for breathing — Regulate the Centre and Boost the Qi Decoction formula in the Internal Damage chapter and Ginseng Nourish the Construction Decoction formula in the Vacuity Taxation chapter are appropriate.

Immun 入門

4.19.6
Source원문

脉經曰, 寸口脉沈, 胸中短氣.

Translation영역
The Pulse Classic says: the inch-opening pulse sunken is short breath in the chest.

Maekgyeong 脉經

4.20 Scant Qi 少氣

4.20.1
Source원문

綱目曰, 少氣者, 氣少不足以言也.

Translation영역
The Gangmok says: scant qi is the qi so scant it does not suffice for speech.
Clinical note임상 주석
Short breath and scant qi separated by one word: 短 is the breath that will not continue, 少 is the qi that will not sustain speech. The first is acute and the second chronic, and the formulas at 4.20 are all supplements.

Gangmok 綱目

4.20.2
Source원문

靈樞曰, 肺藏氣. 氣不足則息利少氣. 又曰, 肺虛則少氣不能報息. 又曰, 腎生氣. 腎虛則少氣力, 言吸吸, 骨痠, 懈惰不能動. 又曰, 膻中爲氣之海, 不足則少氣不足以言.

Translation영역
The Lingshu says: the lung stores qi; where qi is insufficient the breath is easy but scant. It also says: where the lung is vacuous the qi is scant and cannot answer a breath. And: the kidney engenders qi; where the kidney is vacuous there is little strength, the speech gasps, the bones ache, and one is slack and cannot move. And: the centre of the chest is the sea of qi; where it is insufficient the qi is scant and does not suffice for speech.
Clinical note임상 주석
Three organs that can leave the qi scant — the lung that stores it, the kidney that engenders it, the chest that holds it — and each with its sign. 言吸吸, speech that gasps, is the kidney's; the patient who cannot get through a sentence is short of the root, not the lung.

Yeongchu 靈樞

4.20.3
Source원문

內經曰, 怯然少氣者, 是水道不行, 形氣消索也. 言而微終日乃復言者, 奪氣也. 宜生脉散方見暑門ㆍ人參膏ㆍ獨參湯ㆍ黃芪湯.

Translation영역
The Neijing says: timid and scant of qi is the waterways not moving and the form and qi wasted away. Speaking faintly, and only after a whole day speaking again, is qi seized. Generate the Pulse Powder formula in the Summerheat chapter, Ginseng Paste, Lone Ginseng Decoction and Astragalus Decoction are appropriate.
Clinical note임상 주석
言而微終日乃復言 — speaking faintly, and not again until the next day. The Suwen's sign of qi seized, and the chapter's most severe grade of scant qi: a patient who has one sentence in them. Insam-go's pound of ginseng is the answer.

Naegyeong 內經

4.20.4
Source원문

易老曰, 眞氣虛弱, 脉弱懶語, 宜四君子湯ㆍ人參黃芪湯ㆍ益氣丸.

Translation영역
The Yeokro says: where the true qi is vacuous and weak, the pulse weak and one reluctant to speak — Four Gentlemen Decoction, Ginseng and Astragalus Decoction and Boost the Qi Pill are appropriate.

Yeokro 易老

4.20.5
Source원문

東垣曰, 內傷脾胃, 致中氣虛少, 宜補中益氣湯, 益胃升陽湯幷見內傷.

Translation영역
Dongwon says: where internal damage to spleen and stomach has brought the centre qi to vacuity and scarcity — Supplement the Centre and Boost the Qi Decoction and Boost the Stomach and Raise the Yang Decoction both in the Internal Damage chapter are appropriate.
Clinical note임상 주석
The section closes on Dongwon's formula, and 4.20's whole formulary is a ladder up to it: Sagunja-tang, then Insamhwanggi-tang, then Bojungikgi-tang with the lifting pair. Scant qi is the Internal Damage chapter's disease, and this section is where the two chapters meet.

Dongwon 東垣

4.21 Qi Pain 氣痛

4.21.1
Source원문

入門曰, 人身元氣, 與血循環, 彼横行藏府之間, 而爲疼痛, 積聚, 痃癖, 壅逆胸臆之上, 而爲痞滿, 刺痛等證. 多因七情飮食, 鬱爲痰飮. 初起宜辛溫, 開鬱, 行氣, 豁痰, 消積, 久則宜辛寒降火, 以除根. 《入門》

Translation영역
The Immun says: the body's origin qi circulates with the blood; where it runs sideways between the viscera and bowels it makes pain, accumulation and gathering, aggregation and lump; where it congests and counterflows above the chest it makes glomus and fullness, stabbing pain and the like. It is mostly from the seven affects and from food and drink, depressed into phlegm rheum. At the start, acrid and warm medicines should open the depression, move the qi, sweep the phlegm and disperse the accumulation; where it has lasted long, acrid and cold medicines should downbear the fire to remove the root.
Clinical note임상 주석
Warm at the start, cold at the end — the Immun's rule of sequence for qi pain, and it is the Medicine Use chapter's 5.21 applied. The whole of 4.21's formulary is the warm half; Cheonggyeokchangsa-hwan is the one cold formula in it, for the case that has lasted.

Immun 入門

4.21.2
Source원문

氣滯上焦, 爲心胸痞痛, 宜枳橘湯ㆍ䓀莄枳殼湯方見胸部ㆍ淸膈蒼莎丸上同. 氣滯中焦, 爲腹脇刺痛, 宜神保元ㆍ木香破氣散ㆍ撞氣阿魏丸.

Translation영역
Qi stagnant in the upper burner makes glomus and pain of the heart and chest — Bitter Orange and Tangerine Decoction, Platycodon and Bitter Orange Decoction formula in the Chest chapter and Clear the Diaphragm Atractylodes and Cyperus Pill as above are appropriate. Qi stagnant in the middle burner makes stabbing pain of abdomen and ribside — Spirit Protect Pill, Costus Break the Qi Powder and Strike the Qi Asafoetida Pill are appropriate.

Donguibogam · Gi

4.21.3
Source원문

氣滯下焦, 爲腰痛疝瘕, 宜蟠葱散方見前陰ㆍ四磨湯方見大便ㆍ木香順氣丸ㆍ木香檳榔丸.

Translation영역
Qi stagnant in the lower burner makes lumbar pain, mounting and conglomeration — Coiled Scallion Powder formula in the Genitals chapter, Four Milled Ingredients Decoction formula in the Stool chapter, Costus Order the Qi Pill and Costus and Areca Pill are appropriate.

Donguibogam · Gi

4.21.4
Source원문

氣滯於外, 則周身刺痛, 或浮腫, 宜流氣飮子ㆍ木香流氣飮ㆍ三和散ㆍ五皮散方見浮腫.

Translation영역
Qi stagnant without makes stabbing pain through the whole body, or puffy swelling — Flow the Qi Drink, Costus Flow the Qi Drink, Three Harmonies Powder and Five Peels Powder formula in the Oedema chapter are appropriate.
Clinical note임상 주석
Four places the qi can stick — upper, middle, lower, outside — and a formulary for each. The scheme is 4.11.7's pulse positions turned into treatment: where the pain is decides what is given.

Donguibogam · Gi

4.21.5
Source원문

凡氣痛, 宜烏沈湯ㆍ復元通氣散ㆍ神仙沈麝元ㆍ一粒金丹ㆍ小烏沈湯.

Translation영역
For any qi pain, Lindera and Aloeswood Decoction, Restore the Origin and Free the Qi Powder, Immortals' Aloeswood and Musk Pill, One Grain Gold Elixir and Minor Lindera and Aloeswood Decoction are appropriate.

Donguibogam · Gi

4.22 Qi Counterflow 氣逆

4.22.1
Source원문

靈樞曰, 黃帝曰, 何謂逆而亂. 岐伯對曰, 淸氣在陰, 濁氣在陽, 榮氣順脉, 衛氣逆行, 淸濁相干, 亂于胸中, 是爲太悗與悶同. 故氣亂于心, 則煩心密黙, 俛首靜伏. 亂于肺, 則俛仰喘喝, 按手以呼. 亂于腸胃, 則爲霍亂. 亂于臂脛, 則爲四厥. 亂于頭, 則爲厥逆, 頭重眩仆.

Translation영역
The Lingshu says: the Yellow Emperor said, what is meant by counterflow and disorder? Qi Bo answered: the clear qi in the yin and the turbid qi in the yang, the construction qi following the vessels and the defence qi running contrary, clear and turbid interfering and disordered in the chest — this is great oppression the same as 悶. So where the qi is disordered in the heart, there is vexation of the heart and silent withdrawal, the head bowed and lying still. Disordered in the lung, one bends and straightens, panting and gasping, and presses the hands to breathe. Disordered in the intestines and stomach, it becomes sudden turmoil. Disordered in the arms and legs, it becomes reversal of the four limbs. Disordered in the head, it becomes reversal counterflow, the head heavy and dizzy falling.
Clinical note임상 주석
The Lingshu's account of qi in the wrong place — the clear where the turbid should be, the defence running backward — and five sites with five presentations. The acupuncture at 4.31.4 gives a point set for each of the five, and the Lingshu's passage is the reason.

Yeongchu 靈樞

4.22.2
Source원문

入門曰, 氣逆者, 氣自腹中, 時時上衝也.

Translation영역
The Immun says: qi counterflow is qi surging upward from within the belly from time to time.

Immun 入門

4.22.3
Source원문

內經曰, 諸逆衝上, 皆屬於火.

Translation영역
The Neijing says: all counterflow surging upward belongs to fire.

Naegyeong 內經

4.22.4
Source원문

丹溪曰, 病人自言冷氣從下而上者, 此上升之氣, 自肝而出, 中挾相火, 其熱爲甚, 自覺其冷, 非眞冷也. 又曰, 氣之上逆屬陽, 無寒之理. 覺惡寒者, 乃火極似水也.

Translation영역
Danxi says: where the patient says a cold qi rises from below, this rising qi comes from the liver with the ministerial fire folded in it; its heat is severe, and the patient feels it as cold, but it is not true cold. He also says: qi counterflowing upward belongs to yang, and there is no principle by which it could be cold. Where one feels aversion to cold, it is fire at its extreme resembling water.
Clinical note임상 주석
The patient says cold and Danxi says fire. 自覺其冷, 非眞冷也 — they feel it as cold, but it is not true cold — and the reasoning is the Fire chapter's 5.16: a fire so extreme it feels like its opposite. The rule that follows is absolute — no rising qi is cold — and it is Danxi's most contested claim.

Dansim 丹心

4.22.5
Source원문

入門曰, 散火之法, 必先破氣, 氣降則火自降矣.

Translation영역
The Immun says: in the method of scattering fire, one must first break the qi; when the qi descends the fire descends of itself.
Clinical note임상 주석
The Blood chapter's 1.5.2 said 氣降則血歸經, when the qi descends the blood returns; here it is 氣降則火自降, when the qi descends the fire descends. The qi carries both, and both are treated through it.

Immun 入門

4.22.6
Source원문

氣逆, 宜退熱淸氣湯ㆍ導氣枳殼丸, 火盛者, 滋陰降火湯, 加便香附子ㆍ茯神ㆍ沈香方見虛勞.

Translation영역
For qi counterflow, Abate Heat and Clear the Qi Decoction and Conduct the Qi Bitter Orange Pill are appropriate; where fire is exuberant, Enrich the Yin and Downbear Fire Decoction with child-urine cyperus, poria with pine root and aloeswood added formula in the Vacuity Taxation chapter.

Donguibogam · Gi

4.23 Qi Depression 氣鬱

4.23.1
Source원문

丹溪曰, 氣之初病, 其端甚微, 或因七情, 或感六氣, 或因飮食, 以致津液不行, 淸濁相干, 自氣成積, 自積成痰, 氣爲之鬱, 或痞或痛.

Translation영역
Danxi says: at the beginning of a disease of qi, its start is very slight — from the seven affects, or contracting the six qi, or from food and drink — so that the fluids do not move, clear and turbid interfere, from qi comes accumulation, from accumulation comes phlegm, the qi is depressed by it, and there is glomus or there is pain.
Clinical note임상 주석
其端甚微 — its start is very slight. Danxi's account of how a small thing becomes a large one: the qi stops, the fluid stops with it, the stopped fluid becomes phlegm, and the phlegm blocks the qi further. 4.14.2 gave the same circle, and this section names the state it produces.

Dansim 丹心

4.23.2
Source원문

正傳曰, 氣鬱而濕滯, 濕滯而成熱. 故氣鬱之病, 多兼浮腫脹滿.

Translation영역
The Jeongjeon says: where qi is depressed, damp stagnates; where damp stagnates, heat forms. So the disease of qi depression mostly carries puffy swelling and distension with it.

Jeongjeon 正傳

4.23.3
Source원문

入門曰, 鬱者, 病結不散也. 氣鬱不散, 二陳湯煎水, 呑下交感丹. 又曰, 血凝氣滯, 宜復元通氣散, 痰壅氣滯, 宜順氣導痰湯方見風門.

Translation영역
The Immun says: depression is the disease bound and not scattering. Where qi depression does not scatter, decoct Two Matured Ingredients Decoction and swallow Intercourse Elixir down with it. It also says: where blood congeals and qi stagnates, Restore the Origin and Free the Qi Powder is appropriate; where phlegm congests and qi stagnates, Order the Qi and Abduct Phlegm Decoction formula in the Wind chapter.

Immun 入門

4.23.4
Source원문

氣鬱, 宜交感丹, 木香勻氣散, 木香調氣散方見積聚, 上下分消導氣湯. 鬱兼腫脹, 宜流氣飮子ㆍ木香流氣飮ㆍ五皮散ㆍ沈香降氣湯四方見上.

Translation영역
For qi depression, Intercourse Elixir, Costus Even the Qi Powder, Costus Regulate the Qi Powder formula in the Accumulations chapter and Disperse Above and Below and Conduct the Qi Decoction are appropriate. For depression with swelling and distension, Flow the Qi Drink, Costus Flow the Qi Drink, Five Peels Powder and Aloeswood Downbear the Qi Decoction four formulas above.

Donguibogam · Gi

4.24 Insufficient Qi Engenders Disease 氣不足生病

4.24.1
Source원문

靈樞曰, 邪之所在, 皆爲不足. 故上氣不足, 腦爲之不滿, 耳爲之苦鳴, 頭爲之苦傾, 目爲之瞑. 中氣不足, 溲便爲之變, 腸爲之苦鳴. 下氣不足, 乃爲痿厥心悗.

Translation영역
The Lingshu says: wherever the evil is, there is insufficiency. So where the upper qi is insufficient, the brain is not full for it, the ears ring for it, the head droops for it, the eyes dim for it. Where the middle qi is insufficient, urine and stool change for it, and the intestines rumble for it. Where the lower qi is insufficient, there is wilting, reversal and oppression of the heart.
Clinical note임상 주석
邪之所在, 皆爲不足 — wherever the evil is, there is insufficiency. The Lingshu's rule that disease settles where the qi has failed, and three levels with their signs: the head that rings and dims, the gut that changes and rumbles, the legs that wilt. The chapter's supplements at 4.20 are for the first two; the Wilting chapter takes the third.

Yeongchu 靈樞

4.24.2
Source원문

又曰, 上氣不足, 推而揚之, 下氣不足, 積而從之, 陰陽皆虛, 火自當之.

Translation영역
It also says: where the upper qi is insufficient, push and raise it; where the lower qi is insufficient, accumulate and follow it; where yin and yang are both vacuous, fire must answer for it.
Clinical note임상 주석
Three rules for three deficiencies, and the third — 火自當之, fire must answer for it — is moxibustion. Where there is nothing left to raise or gather, warmth is applied from outside, and 4.31.5's hundred cones at Gwanwon is that rule.

Yeongchu 靈樞

4.25 The Signs of Qi Expiring 氣絶候

4.25.1
Source원문

靈樞曰, 五陰氣俱絶, 則目系轉, 轉則目運, 目運者爲志先死. 志先死, 則遠一日半死矣. 六陽氣俱絶, 則陰與陽相離, 離則腠理發泄, 絶汗乃出. 故旦占夕死, 夕占旦死. 絶汗者, 大如珠, 出而不流也.

Translation영역
The Lingshu says: where the five yin qi are all cut off, the eye's cords turn; turning, the eyes roll; and rolling eyes mean the will has died first. Where the will dies first, death is at most a day and a half away. Where the six yang qi are all cut off, yin and yang part from each other; parting, the interstices open and discharge, and the sweat of expiry comes out. So what is seen in the morning dies by evening, and what is seen in the evening dies by morning. The sweat of expiry is large as beads, coming out and not flowing.
Clinical note임상 주석
Two signs of death, one for each of yin and yang. Rolling eyes for the yin, a day and a half; the sweat of expiry for the yang, half a day. 大如珠, 出而不流 — beads that stand and do not run — is the cold sweat of circulatory collapse, and the Sweating chapter's 7.11 and the Pulse Diagnosis chapter's 4.24 both cite it.

Yeongchu 靈樞

4.25.2
Source원문

又曰, 六府氣絶于外者, 上氣脚縮. 五藏氣絶于內者, 下利不禁, 甚者手足不仁.

Translation영역
It also says: where the qi of the six bowels is cut off without, there is qi ascent and the legs draw up. Where the qi of the five viscera is cut off within, there is diarrhoea without control, and at worst the hands and feet are numb.

Yeongchu 靈樞

4.25.3
Source원문

又曰, 若陽氣前絶, 陰氣後竭者, 其人死, 身色必靑. 陰氣前絶, 陽氣後竭者, 其人死, 身色必黃, 腋下溫, 心下熱也. 《仲景》

Translation영역
It also says: where the yang qi is cut off first and the yin qi exhausted after, the person dies and the body's colour is green. Where the yin qi is cut off first and the yang qi exhausted after, the person dies and the body's colour is yellow, the armpits warm and the region below the heart hot.
Clinical note임상 주석
Which failed first, read from the corpse. Green means the yang went first — the cold, cyanosed death of collapse; yellow with residual warmth means the yin went first — the death of fever and exhaustion. Zhongjing's line is the chapter's last on physiology, and it is forensic.

Junggyeong 仲景

4.26 Prohibitions 禁忌

4.26.1
Source원문

內經曰, 久臥傷氣.

Translation영역
The Neijing says: lying long damages the qi.
Clinical note임상 주석
One of the Suwen's five taxations, and the one this chapter needs. The Blood chapter's 1.26 took 久視傷血 from the same list; here it is the lying that costs, and 4.13 said why.

Naegyeong 內經

4.26.2
Source원문

西山記曰, 近穢氣觸眞氣, 近死氣亂生氣.

Translation영역
The Seosan-gi says: being near foul qi offends the true qi; being near the qi of death disorders the qi of life.

Seosangi 西山記

4.26.3
Source원문

凡人空腹, 不用見尸. 臭氣入鼻, 舌上白起, 口常臭. 欲見尸者, 皆須飮酒見之, 能辟毒. 《得效》

Translation영역
Do not view a corpse on an empty stomach. The foul qi enters the nose, white rises on the tongue, and the mouth is constantly foul. Whoever must view a corpse should drink wine first and then view it, for wine can ward off the poison.
Clinical note임상 주석
A rule for the physician and the mourner both: wine before a corpse, never an empty stomach. The white tongue and foul mouth are what the tradition observed in those who handled the dead, and the wine is prophylaxis. Whatever the mechanism, it is the same advice the next passage gives for a plague house.

Deukhyo 得效

4.26.4
Source원문

凡入疫癘熱病之家, 皆當防其毒氣傳染. 毒氣者, 大汗穢毒之氣也. 《類聚》

Translation영역
Whoever enters a house of epidemic or heat disease must guard against the contagion of its toxic qi. The toxic qi is the foul toxic qi of heavy sweating.
Clinical note임상 주석
傳染 — contagion — named as such, and the source of it located in the sick person's sweat. The chapter's account of infection is that the patient's own effluvia carry it, and the instruction is to guard against them on entering. The mechanism is wrong in its particulars and right in its direction.

Yuchwi 類聚

4.27 Methods of Using Medicines 用藥法

4.27.1
Source원문

正傳曰, 男子屬陽, 得氣易散, 女人屬陰, 遇氣多鬱. 是以男子之氣病常少, 女人之氣病常多. 故治法曰, 女人宜調其血, 以耗其氣, 男子宜調其氣, 以養其血.

Translation영역
The Jeongjeon says: a man belongs to yang, and his qi scatters readily; a woman belongs to yin, and her qi is mostly depressed. So men's diseases of qi are always few and women's always many. Hence the method of treatment says: in a woman, regulate the blood so as to spend the qi; in a man, regulate the qi so as to nourish the blood.
Clinical note임상 주석
Women's qi binds and men's scatters, and so women's qi diseases are the more common. The Women chapter's 1.39.3 gave the same reading — 氣盛於血 — and the whole of 1.36 treats it. The Jeongjeon's rule of treatment crosses over: treat a woman's qi through her blood, a man's blood through his qi.

Jeongjeon 正傳

4.27.2
Source원문

入門曰, 七情總發於一心, 七氣總隷於一氣, 氣陽也. 動則爲火. 故以降火化痰消積, 分治之. 大槪氣虛, 四君子湯, 氣實, 小烏沈湯, 火多, 合黃連解毒湯方見傷寒, 痰多, 合二陳湯方見痰飮, 積多, 合平胃散方見五藏.

Translation영역
The Immun says: the seven affects all issue from the one heart, and the seven qi all belong to the one qi; qi is yang, and moving it becomes fire. So it is treated by division — downbearing fire, transforming phlegm, dispersing accumulation. In outline: qi vacuity, Four Gentlemen Decoction; qi repletion, Minor Lindera and Aloeswood Decoction; much fire, combine with Coptis Resolve Toxin Decoction formula in the Cold Damage chapter; much phlegm, with Two Matured Ingredients Decoction formula in the Phlegm chapter; much accumulation, with Calm the Stomach Powder formula in the Five Viscera chapter.
Clinical note임상 주석
The chapter's prescribing summary: two base formulas, one for empty and one for full, and three combinations for what rides on top. Everything in 4.14 to 4.23 can be reached from this table.

Immun 入門

4.27.3
Source원문

丹溪曰, 久患氣證, 氣不歸元, 久服藥無效者, 以破故紙爲君則效. 其方, 破故紙(炒) 一兩, 茴香(炒)ㆍ乳香 各五錢爲末, 蜜丸梧子大, 空心, 白湯, 下五十丸.

Translation영역
Danxi says: in a long-standing qi pattern where the qi does not return to its origin and long medication has had no effect, take psoralea as chief and it takes effect. The formula: psoralea (stir-fried) 1 nyang, fennel (stir-fried) and frankincense 5 don each, powdered, made into honey pills the size of a firmiana seed, fifty taken on an empty stomach with plain hot water.
Clinical note임상 주석
Danxi's rule of last resort for qi, matching his rule of last resort for blood at Hyeol 1.27.1 — chuanxiong there, psoralea here. Psoralea warms the kidney, and the reasoning follows in 4.27.4: the qi has nowhere to go home to.

Dansim 丹心

4.27.4
Source원문

方氏曰, 氣病用氣藥而不效者, 氣之所藏無以收也. 盖肺主氣, 腎藏氣, 靑木香元ㆍ木香順氣丸, 皆用破故紙, 所以使氣升降而歸於腎藏也.

Translation영역
Master Fang said: where a qi disease is treated with qi medicines without effect, it is because there is nothing to gather the qi into where it is stored. The lung governs qi and the kidney stores it; Green Costus Pill and Costus Order the Qi Pill both use psoralea, to make the qi rise and descend and return to the kidney's store.
Clinical note임상 주석
The lung moves qi and the kidney keeps it — and a qi that will not settle has lost its keeper. This is why the kidney formulas appear in a qi chapter, and why 4.20.2 gave the kidney's own sign of scant qi.

Bang Ssi (方氏)

4.27.5
Source원문

入門曰, 氣病, 通用二陳湯方見痰飮. 上焦氣滯, 加枳殼ㆍ䓀莄ㆍ香附ㆍ縮砂. 中焦氣滯, 加厚朴ㆍ枳實ㆍ三稜ㆍ蓬朮. 下焦氣滯, 加靑皮ㆍ木香ㆍ檳榔. 氣痛, 加枳殼. 氣實, 加烏藥ㆍ香附, 氣虛, 加參朮ㆍ木香.

Translation영역
The Immun says: in diseases of qi, Two Matured Ingredients Decoction formula in the Phlegm chapter is used generally. For qi stagnant in the upper burner, add bitter orange, platycodon, cyperus and amomum. In the middle burner, add magnolia bark, immature bitter orange, sparganium and curcuma. In the lower burner, add green tangerine peel, costus and areca. For qi pain, add bitter orange. For qi repletion, add lindera and cyperus; for qi vacuity, add ginseng, atractylodes and costus.
Clinical note임상 주석
Ijin-tang as the base for every qi disease, and a table of additions by level and by state. It is the working prescriber's version of 4.27.2, and it starts from the phlegm formula because 4.14.2 said the phlegm comes first.

Immun 入門

4.27.6
Source원문

丹溪曰, 治上升之氣, 用香附ㆍ黃連ㆍ黃芩ㆍ梔子. 又曰, 氣無補法, 世俗之言也. 不思正氣虛者, 不能運行, 邪氣着而爲病. 經曰, 壯者氣行則愈, 怯者着而成病, 苟或氣怯, 不用補法, 氣何由行. 又曰, 氣鬱, 須用川芎ㆍ香附ㆍ梔子ㆍ芩連.

Translation영역
Danxi says: to treat qi rising upward, use cyperus, coptis, scutellaria and gardenia. He also says: that qi has no method of supplementing is a saying of the common world. It does not consider that where the right qi is vacuous it cannot move, and the evil qi settles and becomes disease. The classic says: in the strong, the qi moves and they recover; in the timid, it settles and becomes disease. If the qi is timid and supplementing is not used, by what road will the qi move? He also says: for qi depression, chuanxiong, cyperus, gardenia, scutellaria and coptis must be used.
Clinical note임상 주석
氣無補法, 世俗之言也 — that qi cannot be supplemented is a vulgar saying. Danxi argues against the tradition he otherwise leads: a qi too weak to move cannot be moved by moving it, and must first be fed. This is the concession that lets Sagunja-tang into 4.27.2, and it is the Medicine Use chapter's 5.2.1 in Danxi's words.

Dansim 丹心

4.27.7
Source원문

又曰, 木香行中下焦氣, 香附快滯氣, 陳皮泄逆氣, 紫蘇散表氣, 厚朴泄衛氣, 檳榔泄至高之氣, 沈香升降眞氣, 腦麝散眞氣. 凡此皆泄氣之標, 不能治氣之本.

Translation영역
He also says: costus moves the qi of the middle and lower burners; cyperus frees stagnant qi; tangerine peel discharges counterflowing qi; perilla scatters exterior qi; magnolia bark discharges the defence qi; areca discharges the highest qi; aloeswood raises and lowers the true qi; borneol and musk scatter the true qi. All of these discharge the branch of qi, and cannot treat its root.
Clinical note임상 주석
Eight qi medicinals, each with what it does, and then the verdict on all of them: 皆泄氣之標, they all discharge the branch. The eight are the whole of 4.21's formulary, and Danxi says they treat the symptom. The root is what 4.27.6 said must be fed. The last pair, borneol and musk, are the aromatics of Sohaphyang-won — and 散眞氣, scattering the true qi, is the cost of what they do.

Dansim 丹心

4.28 Medicines for the General Treatment of Qi 通治氣藥

4.28.1
Source원문

宜用蘇合香元ㆍ至聖來復丹ㆍ交感丹ㆍ四七湯ㆍ分心氣飮ㆍ上下分消導氣湯ㆍ烏沈湯ㆍ流氣飮子ㆍ木香流氣飮六方見上.

Translation영역
Storax Pill, Supreme Sage Return and Restore Elixir, Intercourse Elixir, Four-Seven Decoction, Divide the Heart Qi Drink, Disperse Above and Below and Conduct the Qi Decoction, Lindera and Aloeswood Decoction, Flow the Qi Drink and Costus Flow the Qi Drink six formulas above are used.
Clinical note임상 주석
Nine formulas for any qi disease, and two of them are emergency pills — Sohaphyang-won for collapse, Jiseongnaebok-dan for the critical case. The rest are the chapter's standing prescriptions for the ordinary run.

Donguibogam · Gi

4.29 Simple Medicinals 單方

4.29.1
Source원문

凡二十四種.

Translation영역
Twenty-four kinds in all.
Clinical note임상 주석
Twenty-four simples, and they are the chapter's qi-movers and supplements in their raw state — ginseng, costus, turmeric, astragalus, ginger, cyperus, cardamom, morning glory, aloeswood, bitter orange, lindera, areca, magnolia, chebula, borneol, musk, the two tangerine peels, radish, scallion, perilla, human milk, beef and dog meat. The last three are food, and 4.2 said why food is medicine for qi.

Donguibogam · Gi

4.30 The Six-Syllable Secret of Qi 六字氣訣

4.30.1
Source원문

噓肝氣, 呵心氣, 呼脾氣, 呬肺氣, 吹腎氣, 嘻三焦氣, 其法以口吐鼻取, 能去病延壽.

Translation영역
Xu for the liver's qi, he for the heart's, hu for the spleen's, si for the lung's, chui for the kidney's, xi for the three burners' — the method is to breathe out through the mouth and take in through the nose, and it can remove disease and lengthen life.
Clinical note임상 주석
Six exhalations, one for each organ — the Daoist practice the tradition calls 六字訣, and it is still taught. Each syllable is a shape of the mouth as much as a sound, and the shapes are what direct the breath.

Donguibogam · Gi

4.30.2
Source원문

肝若噓時目爭精, 肺知呬氣手雙擎, 心呵頂上連叉手, 腎吹抱取膝頭平, 脾病呼時須撮口, 三焦客熱臥嘻嘻.

Translation영역
For the liver, when breathing xu, the eyes glare; for the lung, breathing si, the two hands lift; for the heart, breathing he, the hands clasp above the crown; for the kidney, breathing chui, clasp the knees level; for spleen disease, breathing hu, the mouth must be pursed; for visiting heat in the three burners, lie down and breathe xi.
Clinical note임상 주석
A verse of postures to go with the six sounds — the eyes, the hands, the knees. The practice is a set of stretches with breath, and the verse is the mnemonic for it.

Donguibogam · Gi

4.30.3
Source원문

春噓養肝, 夏呵養心, 秋呬養肺, 冬吹養腎, 四季呼養脾, 不時嘻養三焦, 切忌出聲聞於口耳也. 《臞仙》

Translation영역
In spring breathe xu to nourish the liver; in summer he for the heart; in autumn si for the lung; in winter chui for the kidney; in the last month of each season hu for the spleen; and at any time xi for the three burners. On no account let the sound be heard by the mouth or ear.
Clinical note임상 주석
The six syllables assigned to the seasons, and the one instruction that matters: 切忌出聲, make no sound. The syllable is silent — a shaping of the breath rather than a word — and the tradition insists on it.

Guseon 臞仙

4.30.4
Source원문

肝病, 大呼三十遍, 細呼十遍, 心病, 大呵三十遍, 細呵十遍, 脾病, 大呼三十遍, 細呼十遍, 肺病, 大呬三十遍, 細呬十遍, 腎病, 大吹五十遍, 細吹十遍, 皆須左右導引然後乃爲之. 《得效》

Translation영역
For liver disease, thirty loud hu and ten fine; for heart disease, thirty loud he and ten fine; for spleen disease, thirty loud hu and ten fine; for lung disease, thirty loud si and ten fine; for kidney disease, fifty loud chui and ten fine — and all must be done after guiding and stretching to left and right.
Clinical note임상 주석
The Deukhyo's dosing — thirty loud and ten soft, fifty for the kidney — and its instruction to stretch first. The chapter's Daoist material ends here, with a count, as its medical material ends with a formulary.

Deukhyo 得效

4.31 Acupuncture and Moxibustion Methods 鍼灸法

4.31.1
Source원문

一切氣疾, 取氣海. 氣逆, 取尺澤ㆍ商丘ㆍ太白ㆍ三陰交. 噫氣上逆, 取太淵ㆍ神門. 短氣, 取大陵ㆍ尺澤. 少氣, 取間使ㆍ神門ㆍ大陵ㆍ少衝ㆍ足三里ㆍ下廉ㆍ行間ㆍ然谷ㆍ至陰ㆍ肝兪ㆍ氣海. 《神應》

Translation영역
For all diseases of qi, take Gihae (氣海, CV6). For qi counterflow, take Cheoktaek (尺澤, LU5), Sanggu (商丘, SP5), Taebaek (太白, SP3) and Sameumgyo (三陰交, SP6). For belching with qi counterflowing upward, take Taeyeon (太淵, LU9) and Sinmun (神門, HT7). For short breath, take Daereung (大陵, PC7) and Cheoktaek (尺澤, LU5). For scant qi, take Gansa (間使, PC5), Sinmun (神門, HT7), Daereung (大陵, PC7), Sochung (少衝, HT9), Joksamni (足三里, ST36), Haryeom (下廉, LI8), Haenggan (行間, LR2), Yeongok (然谷, KI2), Jieum (至陰, BL67), Gansu (肝兪, BL18) and Gihae (氣海, CV6).
Clinical note임상 주석
Gihae first, for everything — the sea of qi below the navel that 4.6.2 named. The rest is sorted by 4.17 to 4.20's conditions, and short breath and scant qi each get their own set.

Sineung 神應

4.31.2
Source원문

上氣, 灸大衝. 氣結, 食不消, 灸太倉. 冷氣, 臍下痛, 灸關元百壯. 短氣, 灸大顀隨年壯, 肺兪百壯, 神闕二七壯, 又灸第五顀下隨年壯. 《得效》

Translation영역
For qi ascent, moxa Taechung (太衝, LR3). For qi bound with food not digesting, moxa Taechang (太倉, CV12). For cold qi with pain below the navel, moxa Gwanwon (關元, CV4) a hundred cones. For short breath, moxa Daechu (大椎, GV14) as many cones as the years of age, Pyesu (肺兪, BL13) a hundred cones, Singwol (神闕, CV8) fourteen cones, and also below the fifth vertebra as many cones as the years of age.
Clinical note임상 주석
A hundred cones at Gwanwon for cold below the navel — the Lingshu's 火自當之 from 4.24.2 carried out. The Deukhyo's moxa doses are the heaviest in the chapter, and they are all for the deficient case.

Deukhyo 得效

4.31.3
Source원문

短氣, 取天井ㆍ大顀ㆍ肺兪ㆍ肝兪ㆍ魚際ㆍ尺澤. 《甲乙》

Translation영역
For short breath, take Cheonjeong (天井, TE10), Daechu (大椎, GV14), Pyesu (肺兪, BL13), Gansu (肝兪, BL18), Eoje (魚際, LU10) and Cheoktaek (尺澤, LU5).

Gabeul 甲乙

4.31.4
Source원문

氣亂于心, 取神門ㆍ大陵. 氣亂于肺, 取魚際ㆍ太谿. 氣亂于腸胃, 取太白ㆍ陷谷ㆍ足三里. 氣亂于頭, 取天柱ㆍ大杼ㆍ通谷ㆍ束骨. 氣亂于臂脛, 取二間ㆍ三間ㆍ內庭ㆍ陷谷ㆍ液門ㆍ中渚ㆍ俠谿ㆍ臨泣. 《靈樞》

Translation영역
For qi disordered in the heart, take Sinmun (神門, HT7) and Daereung (大陵, PC7). Disordered in the lung, take Eoje (魚際, LU10) and Taegye (太谿, KI3). Disordered in the intestines and stomach, take Taebaek (太白, SP3), Hamgok (陷谷, ST43) and Joksamni (足三里, ST36). Disordered in the head, take Cheonju (天柱, BL10), Daejeo (大杼, BL11), Tonggok (通谷, BL66) and Sokgol (束骨, BL65). Disordered in the arms and legs, take Igan (二間, LI2), Samgan (三間, LI3), Naejeong (內庭, ST44), Hamgok (陷谷, ST43), Aengmun (液門, TE2), Jungjeo (中渚, TE3), Hyeopgye (俠谿, GB43) and Imeup (臨泣, GB41).
Clinical note임상 주석
The five sites of 4.22.1 with a point set for each — the Lingshu's own prescription for its own scheme. The chapter closes where its acupuncture began, at the passage that named what qi in the wrong place does to the heart, the lung, the gut, the head and the limbs.

Yeongchu 靈樞

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 1, Qi chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.