官。谓所司之事也。无病则各效其职。有病则自失所司。
心者君主之官。神明出焉。
人身知觉运动。无一不本于心。故百体皆为之臣而心为君主也。西医言人心。只是顽然一物。不能司知觉运动。其
司知觉运动者。全在脑髓。尝割兔脑。剜其脑之后筋。则身缩。可知司运动者。是脑后筋。剜其脑之前筋。则叫号。可
知司知觉者。是脑前筋。以此拟人。亦无不然。予谓西医此说。非也。人身破一皮。拔一毛。无不痛缩叫号者。何必剜
脑气筋而后身缩叫号哉。盖西医知髓而不知髓是何物。内经云。肾主髓。髓者肾精所生。肾与心。原互为功用。髓筋通
于心。乃肾交于心。合为离卦中含坎水之象所以能司神明也。详心藏神注。即如西医所云脑后筋。剜之亦不知叫号。必
其筋不与心通故也。西医又言脑有筋。通于心。当是彼所谓脑前筋。司知觉者也。夫因其与心通故司知觉则司知觉者仍
是此心。设以知觉为脑所司何以不通心之脑筋。剜之亦不叫号哉。即彼之说。刺彼之谬可不辨而自明矣。盖肾足则髓足。
髓筋入心以水济火真精内含则真光外发神明于是出焉。盖心属火有光髓属肾水。能收引光。气心神上注于脑髓则光气相
照而事物晓。然参看上肾藏志注尤明。
肺者相傅之官。制节出焉。
心为君主。肺在心外。以辅相之心火恐其大过。则肺有清气以保护之。如师傅之辅助其君也。故称相傅之官。究其
迹象。则因心血回入于肺。得肺气吹出。血中浊气。则复变红而。返入于心。在内经乃营血与卫会于肺中之说又即相傅
之官。所司职事也。西医则云。回血返入肺中。吹出血中炭气。则紫色退而变为赤血。复入于心。肺是淘汰心血之物。
此即内经肺为相傅之义。但中国不名炭气。只名浊气也。心火太过。则气有余而上逆下注。心火不足。则下泄。上为饮
咳。皆不得其制节之故也。惟肺制心火。使不太过。节心火。不使不及。则上气下便无不合度。
肝者将军之官。谋虑出焉。
凡人身之阴阳。阴主静。静则有守。阳主动。动则有为。肝为厥阴经。乃阴之尽也。故其性坚忍而有守厥阴中见少
阳。阴尽阳生。胆火居于肝中。阴中含阳。阳气发动故能有为谋虑从此而出。所以称为将军之官。故肝气横者。敢为狂
乱。肝气虚者。每存惧怯。
胆者中正之官。决断出焉。
西医言苦胆汁。乃肝血所生中国旧说。皆谓胆司相火。乃肝木所生之气。究之有是气。乃有是汁。二说原不相悖。
惟西医言人之惧与不惧。不关于胆。而又不能另指一所。实未知胆为中正之官故也。盖以汁论。则胆汁多者。其人不惧。
以气论。则胆火旺者。其人不惧。太过者不得乎中。则失其正。是以有敢为横暴之人。不及者。每存惧怯。亦不得乎中
正也。胆气不刚不柔。则得成为中正之官。而临事自有决断。以肝胆二者合论。肝之阳藏于阴故主谋。胆之阳出于阴。
故主断。
膻中者臣使之官。喜乐出焉。
膻即胸前膈膜。周回连着胁脊。以遮浊气。膈膜名膻。而居膻之中者。则是心包络。旧注以膈为膻中不知膈遮浊气。
只是上焦一大膜耳。不能代心宣化何得名臣使之官惟心包络。则相心布令。居于膻膈之中故名膻中属相火。又主血。以
血济火。则和而不烈。故主喜乐。心忧者包络之火不宣也。心过喜者包络之火太盛也。西医言心上。半有夹膜裹之。即
包络之谓也。但西医不知包络。所司何事。
脾胃者。仓廪之官。五味出焉。
各脏腑。各名一官。惟脾胃两者。合名一官。何也。盖胃主纳谷脾主消谷。二者相合。而后成功。故脾与胃。统称
仓廪之官。言脾胃。主消纳五谷也。而又云。五味出焉者。盖五谷备具五味。一入胃中。即化为汁液从脾之。油膜散走
达五脏出焉者。出脾胃而达诸脏腑营卫也。胃不纳谷。则五味不入胃。属阳宜燥之。脾不化谷。则五味不能达于各脏。
脾属阴宜滋之。
小肠者。受盛之官。化物出焉。
盛音承。贮也。小肠上接于胃。凡胃所纳之物。皆受盛于小肠之中。西医云。小肠通体皆是油膜相连。其油膜中。
皆有微丝血管。与小肠通胆之苦汁。从微丝血管注入肠中以化食物脾之甜肉汁。亦注入。小肠化物而物所化之精汁。即
从膜中出小肠而达各脏。故曰化物出焉。王清任医林改错。以附小肠者。为鸡冠油。更名气府。谓为元气所存。主化饮
食。而不知内经明言。小肠者受盛之官。化物出焉。已实指。小肠之气化矣其附小肠之油膜。即中焦也。属之于脾。小
肠又系心之腑。其相通之路则从油膜。中之丝管上膈达包络以达于心。心遗热于小肠。则化物不出。为痢为淋。脾阴。
不足则中焦不能受盛膈食便结。三焦相火不足不能薰。化水谷则为溏泻西医又有小肠发炎之症。即中国之泄痢肠痈等症。
中国近说。水入小肠。然后从阑门下飞渡入膀胱。西医斥其非也。水从胃已散出。走连网中。详下三焦注。然则小肠中
所受盛者。只是食物。乃阴质也。饮主化气。食主化血。食物在小肠。皆化为液以出于连网遂上奉心而生血。所以小肠
为心之腑。乃心所取材处也。
大肠者。传道之官。变化出焉。
变化出三字。谓小肠中物至此。精汁尽化变为糟粕而出其所以能出之故。则赖大肠为之传道。而大肠所以能传道者。
以其为。肺之腑。肺气下达故能传道是以理大便必须调肺气也。另详五脏所合条。
肾者。作强之官。伎巧出焉。
西医云。人之才智。均出于脑髓人之筋力。均出于脑气筋究问脑髓何物则西医不知也。盖髓者。肾精所生精足则髓
足。髓在骨内髓足。则骨强。所以能作强而才力。过人也。精以生神。详见心藏神注。精足神强。自多伎巧。髓不足者
力不强。精不足者智不多西医论髓之法多。而治髓之法少。以不知髓是肾所生是以无从施治。也中国近医。则又知肾不
知髓反为西医所笑。不知古圣内经已有髓海论骨空论。又将肾与髓合论之。甚矣。古圣人千。古莫及矣。
三焦者。决渎之官水道出焉。
焦古作 。即人身之膜膈所以行水也。今医皆谓水至小肠下口。乃渗漏入膀胱。非也医林改错。西医。均笑斥之。
盖自唐以后。皆不知三焦为何物。西医云。饮水入胃。胃之四面。皆有微丝血管。吸出所饮之水。散走。膈膜达于连网
油膜之中而下入膀胱。西医所谓连网。即是膈膜。及俗所谓网油并周身之膜。皆是也网油连着。膀胱水因得从网。油中
渗入膀胱即古所名三焦者。决渎之官。水道出焉是矣。三焦之根出于肾中。两肾之间。有油膜一条。贯于脊骨。名曰命
门。是为焦原从此系发生板油。连胸前之膈。以上循胸中。入心包络。连肺系上咽。其外出。为手背胸前之腠理。是为上焦从板油连及鸡冠油。着于小肠。其外出为腰腹之腠理。是为中焦从板油连及网油。后连大肠前连膀胱。中为胞室。
其外出为臀胫少腹之腠理。是为下焦。人饮之水。由三焦而。下膀胱。则决渎通快如三焦不利。则水道闭外为肿胀矣。
西医知连网之形甚悉。然不名三焦。又不知连网源头。并其气化若何。皆不知也。
膀胱者。州都之官。津液藏焉。气化则能出焉。
凡人饮食之水。无不入于膀胱。膀胱如人身之洲渚。故曰州都之官。人但知膀胱主溺。而不知水入膀胱。化气上行。
则为津液。其所剩余质。乃下出而为溺。经文所谓气化则能出者。谓出津液非出溺也。气化二字。自唐以下。无人知之
吾于此特详言曰。火交于水即化为气观西法以火煎水。而取轻气即是火交于水。化气之一证。人身之水火。如何交哉。
盖人心主火。人鼻吸入之气。乃天阳也。亦属火。西医云。气从鼻入。其管入肺。历心系。循背脊。以下入肾系。又从
肾系达连网。以至于脐下。按西医所说。吸入之路推究其理。则知吸入者。是天阳。属火也。历心系则引心火而并下入
脐下。即气海也女子名为胞宫。经云膀胱者。胞之室。胞即油膜一大夹室。能伸能缩。实大过于膀胱胞与膀胱只隔一间
又全在微丝血管与膀胱。相通凡人吸入之天阳合心火下。至胞中则蒸动膀胱之水化而为气与西法以火煎。水取气无异夫
此膀胱之水。既化为气。则透出。膀胱入于胞中上循脐旁。气冲上膈入肺。而还出于口鼻上出之气。着漆石。则为露珠
在口舌脏腑之中。则为津液且气之退场门鼻。其显然者也。又外出于皮毛以薰肤润。肌而为汗。所谓气化则津液。能出者
此也。老人溺多。化气少而水质多。壮者溺少。化气多而水质少也。西医但言气从肺历心系而至脐下。未言出气之路其
意以为仍由原路而出。不知非也。盖气之出路实循气冲上达于膈而出于肺。西医云胸膈乃助肺扇动呼吸之物。不知膈为
出气之路。非入气之路不得混言扇动。呼吸也夫吸从脊入。督脉主之。呼从膈出。任脉主之。吸入阳也。火交于水也。
呼出阴也。气仍可返为水也。呼吸循环。道家以为秘诀。医家昧其指归。惟内经气化则能出矣。一语明明指破。何注家
多不识耶。火不足以蒸水。则津液不升。气不得化。水不足以济火。则津液干枯。小水不下。
按上言脏腑所合。只有五脏六腑。此条出兰台秘典论。又添出膻中一脏。是为六脏六腑。论乃备矣。且肾具水火中
系属火为命门故上条云。少阳属肾。谓三焦相。火其根在命门也。肾上连肺谓金水相生。而膀胱为之府也。又曰故将两
脏。是肾与命门又可分为两脏而配三焦。膀胱之两腑矣。难经以左为肾。右为命门。自有取义。然则言五脏六腑者。举
其要也。言六脏六腑者。备其物也。再加命门。而为七脏六腑。又其零也。盖天地阴阳奇耦。不无零正。参伍错综。以
尽其变。人之脏腑应之。所以经有奇经。而脏腑亦有零奇欤。
官，指的是所掌管的事务。没有疾病时，各脏腑都能发挥其职能；有了疾病时，就会失去其所掌管的功能。
心是君主之官，人的精神意识思维活动由此产生。
人体的知觉和运动，无一不是以心为根本。因此，全身各部都作为臣属而听命于心，心则是君主。西医所说的“人心”，不过是一块顽钝的肌肉，不能主管知觉和运动。主管知觉和运动的，完全在于脑髓。曾经有人割除兔子的脑髓，挖去脑后的筋络，兔子身体就收缩；由此可知，主管运动的，是脑后的筋络。挖去脑前的筋络，兔子就会叫唤；由此可知，主管知觉的，是脑前的筋络。以此推测人体，也没有不对的地方。我认为西医的这种说法是不对的。人只要破一点皮、拔一根毛，没有不感到疼痛、收缩或叫唤的，何必非要挖去脑部的神经后才会出现身体收缩和叫唤呢？大概西医只知道有脑髓，却不知道脑髓究竟是什么东西。《黄帝内经》说：肾主骨生髓，髓是由肾精生成的。肾与心，原本互为功用。脑髓的筋络通于心，这是肾气上交于心，合起来呈现离卦（☲）中含坎水（☵）的象，所以能够主管精神意识。详细解释见“心藏神”注。就像西医所说脑后那根筋，如果把它挖掉，兔子也不会叫唤，必定是因为那根筋不与心相通的原因。西医又说脑部有筋络通于心，应当就是他们所说的脑前筋，主管知觉的。正因为它与心相通，所以主管知觉，那么主管知觉的仍然是这颗心。如果把知觉当作由脑来主管，为什么不通向心脏的脑神经被挖掉后也不叫唤呢？即使按照他们的说法，刺破他们的谬误，不用辩论也就自然明白了。大概肾气充足则髓气充足，髓的筋络进入心中，以肾水济助心火，真精内含则真光外发，精神意识于是由此产生。心属火，有光芒；髓属肾水，能收敛光芒。当心神之气上注于脑髓时，光与气相互照应，事物就能清晰明了。参看“肾藏志”的注释更加明白。
肺是相傅之官，治理和调节功能由此产生。
心是君主，肺在心之外，辅助心火防止其太过，则肺有清气来保护它，如同师傅辅助君主一样。所以称为相傅之官。究其迹象，是因为心血回流到肺中，得到肺气的吹送，血中的浊气排出，血液重新变红，再返回心中。在《黄帝内经》中，这就是营血与卫气在肺中会合的说法，也就是相傅之官所掌管的事务。西医则说：回心血流入肺中，吹出血液中的炭气（二氧化碳），紫色消退变为赤色血液，再返回心中。肺是淘汰心血中废物的器官。这也就是《内经》中“肺为相傅”的含义。只是中国医学不称其为炭气，只称为浊气。心火太过，则气有余而上逆下注；心火不足，则下泄。上表现为饮邪咳嗽，都是不得到肺的治理调节的缘故。只有肺制约心火，使其不太过；节制心火，使其不低于正常水平，那么上焦之气和下焦之气便无不合乎法度。
肝是将军之官，谋略思虑由此产生。
大凡人体的阴阳，阴主静，静则有守持；阳主动，动则有作为。肝属于厥阴经，是阴气的尽头。所以它的性质坚忍而有守持。厥阴中见少阳，阴尽阳生，胆火居于肝中，阴中含阳，阳气发动所以能有作为，谋略思虑从此而出。所以称为将军之官。因此，肝气横逆的人，敢于狂妄乱为；肝气虚弱的人，常常心存恐惧怯懦。
胆是中正之官，决断能力由此产生。
西医说苦胆汁，是由肝血生成的；中国旧说，都认为胆主管相火，是肝木所生的气。研究起来，有这种气，才有这种汁液，两种说法原本不相违背。只是西医说人的恐惧与否，与胆无关，而又不能另指一个器官，这实在是不知道胆是中正之官的缘故。大概从胆汁来说，胆汁多的人，他不恐惧；从胆气来说，胆火旺盛的人，他不恐惧。太过的人不得其中和，就失去了中正，因此有敢作横暴之人；不及的人，常常心存恐惧怯懦，也是不得其中正。胆气不刚不柔，才能成为中正之官，面临事情自然有决断。将肝胆二者合而论之，肝的阳气藏于阴中，所以主谋略；胆的阳气出于阴中，所以主决断。
膻中是臣使之官，喜乐情绪由此产生。
膻即胸前的膈膜，周围连着胁肋脊柱，用来遮挡浊气。膈膜名为膻，而居住在膻之中的，则是心包络。旧注把膈当作膻中，不知道膈遮挡浊气，只是上焦的一大块膜而已，不能代替心宣发化育，怎么能称为臣使之官呢？只有心包络，才辅佐心布达命令，居住在膻膈之中，所以名叫膻中。它属相火，又主血，以血济火，则温和而不猛烈，所以主管喜乐。心忧闷是因为包络之火不宣畅；心过度喜悦是因为包络之火太盛。西医说心脏上面有一半被夹膜包裹着，就是指包络而言。但西医不知道包络所掌管的是什么事务。
脾胃是仓廪之官，五味营养由此产生。
各个脏腑，各自命名为一个官职，只有脾胃两者，合称为一个官职。为什么呢？因为胃主受纳谷物，脾主消化谷物，两者结合，而后才能成功。所以脾与胃，统称仓廪之官，意思是脾胃主要消化和容纳五谷。而又说“五味出焉”，是因为五谷具备各种味道，一旦进入胃中，就化为汁液，通过脾的油膜散布运行，到达五脏。所谓“出焉”，是指出自脾胃而通达诸脏腑的营卫之气。胃不纳谷，则五味不入胃；胃属阳，宜用燥法治疗。脾不化谷，则五味不能通达各脏；脾属阴，宜用滋法治疗。
小肠是受盛之官，化物功能由此产生。
“盛”音同“承”，意为贮存。小肠上接于胃，凡是胃所接纳的食物，都在小肠中贮存。西医说，小肠整体都是由油膜相连，其油膜中都有微细血管。小肠与胆囊的苦汁，通过微细血管注入肠中以消化食物；脾的甜肉汁（胰液），也注入小肠。食物在小肠中被消化，而食物所化生的精微汁液，就从膜中渗出，从小肠通达各脏。所以说“化物出焉”。王清任在《医林改错》中，把附属于小肠的，称为鸡冠油，更名叫气府，认为是元气所在，主管消化饮食，却不知道《内经》明确说：“小肠者，受盛之官，化物出焉。”已经实指小肠的气化功能了。其附属于小肠的油膜，就是中焦，归属于脾。小肠又是心的腑，其相通的路径是从油膜中的丝管向上穿过膈肌到达心包络，进而通达于心。心遗留热邪于小肠，则化物不出，导致痢疾或淋证。脾阴不足，则中焦不能受盛饮食，导致大便干结。三焦相火不足，不能熏蒸消化水谷，则导致溏泻。西医又有小肠发炎的症状，即中国的泄痢、肠痈等症。中国近来的说法，认为水进入小肠后，然后从阑门飞渡进入膀胱。西医斥责这种说法是错误的。水从胃里已经散出，走在连网（系膜）中，详见下文“三焦”注。然而小肠中所受盛的，只是食物，乃是阴质。饮水主要化生为气，进食主要化生为血。食物在小肠，都化为液汁，通过连网上奉于心而生血。所以小肠为心的腑，是心取材的地方。
大肠是传道之官，变化排泄由此产生。
“变化出”三个字，是指小肠中的物质到这里，精微汁液全部化尽，变为糟粕而排出。之所以能排出，依靠大肠来进行传导。而大肠之所以能传导，是因为它是肺的腑，肺气下达所以能传导。因此，调理大便必须调治肺气。另外详见“五脏所合”条目。
肾是作强之官，技巧能力由此产生。
西医说，人的才智，都出于脑髓；人的筋力，都出于脑气筋。追问脑髓是什么东西，西医也不知道。大概髓，是由肾精生成的。精足则髓足，髓在骨内，髓足则骨强，所以能动作强劲而才力超过常人。精以生神，详见“心藏神”注。精足神强，自然多有技巧。髓不足则力量不强，精不足则智慧不多。西医论述髓的方法很多，而治疗髓的方法很少，因为不知道髓是肾所生的，所以无从施治。中国近代的医生，又只知道肾而不知道髓，反而被西医嘲笑。不知道古代圣人在《内经》中已有《髓海论》、《骨空论》，又将肾与髓合而论之。古圣人真是千古莫及啊！
三焦是决渎之官，水道由此产生。
“焦”古字写作“膲”，即人身上的膜膈，用来通行水液。现在的医生都认为水到了小肠下口，才渗漏入膀胱，这是不对的。《医林改错》和西医都嘲笑并驳斥这种说法。大概自从唐代以后，都不知道三焦是什么东西。西医说，饮水入胃，胃的四面都有微细血管，吸出所饮之水，散布运行，经过膈膜到达连网油膜之中，然后下入膀胱。西医所谓的“连网”，就是膈膜，以及俗话所说的网油，还有周身所有的膜，都是这样的。网油连着膀胱，水因此能从网油中渗入膀胱，这就是古时候所说的三焦，决渎之官，水道由此产生，是正确的。三焦的根本出于肾中，两肾之间有一条油膜，贯穿脊骨，名叫命门，这是三焦的原动力。从此系发生板油，连着胸前的膈，以上循行胸中，进入心包络，连着肺系上至咽喉。其向外分布的，是手背胸前的腠理，这叫上焦。从板油连着及鸡冠油，附着于小肠，其向外分布的是腰腹的腠理，这叫中焦。从板油连着及网油，后连大肠，前连膀胱，中间为胞室，其向外分布的是臀胫少腹的腠理，这叫下焦。人饮用的水，由三焦而下入膀胱，则决渎通畅；如果三焦不利，则水道闭塞，外部表现为肿胀。西医对连网的形态非常熟悉，但不称之为三焦，又不知道连网的源头，以及它的气化情况，都不了解。
膀胱是州都之官，津液贮藏于此，气化作用后才能排出。
凡是人饮食的水，没有不进入膀胱的。膀胱像人身上的洲渚（水中的小块陆地），所以叫州都之官。人们只知道膀胱主司排尿，而不知道水进入膀胱后，化气上行，就成为津液。其所剩余的渣滓，才向下排出成为尿液。经文所说的“气化则能出”，是指出津液，而不是指出尿液。“气化”二字，自唐代以来，没有人真正理解。我在此特别详细说明：火与水交合就化为气。观察西方方法用火煎水，而取得轻气，这就是火交于水化为气的一个证明。人身的水火，如何交合呢？大概人心主火，人鼻吸入的空气，是天阳，也属火。西医说，气从鼻入，其管道进入肺，经过心系，沿背脊，以下进入肾系，又从肾系到达连网，以至于脐下。按西医所说的吸入路径推究其理，就知道吸入的是天阳，属火。经过心系则牵引心火一并下入脐下，即气海，女子名为胞宫。经文说“膀胱者，胞之室”，胞即油膜构成的一大夹室，能伸能缩，实际上比膀胱大得多。胞与膀胱只隔一间，又全在微细血管与膀胱相通。凡人吸入的天阳合心火下至胞中，则蒸动膀胱之水化而为气，与西方用火煎水取气无异。这膀胱之水，既然化为气，则透出膀胱进入胞中，上循脐旁，气冲上膈入肺，而还出于口鼻。上出的气，接触冰冷的物体如漆石，就成为露珠；在口舌脏腑之中，就成为津液。而且气退出的门户，鼻子是最明显的。又向外出于皮毛，薰肤润肌，成为汗。所谓“气化则津液能出”，就是这个意思。老人溺多，是因为化气少而水质多；壮年人溺少，是因为化气多而水质少。西医只说气从肺经过心系而至脐下，没说气排出的路径，其意思以为仍由原路而出，不知道这是不对的。气的出路实际上是循气冲穴上达于膈而出于肺。西医说胸膈是帮助肺扇动呼吸的东西，不知道膈是出气的路径，不是入气的路径，不能混言扇动呼吸。吸气从脊背入，督脉主之；呼气从膈出，任脉主之。吸入的是阳，是火交于水；呼出的是阴，气仍可返为水。呼吸循环，道家视为秘诀，医家却不明白其旨归，只有《内经》“气化则能出矣”这一句明明指破了，为什么注家大多不认识呢？火不足以蒸水，则津液不升，气不得化；水不足以济火，则津液干枯，小便不下。
按上文所言脏腑所合，只有五脏六腑。此条出自《兰台秘典论》，又添出膻中一脏，是为六脏六腑，论述才算完备。且肾具水火，中系属火为命门，所以上条说“少阳属肾”，谓三焦相火，其根在命门也。肾上连肺，谓金水相生，而膀胱为之腑。又说“故将两脏”，是肾与命门又可分为两脏而配三焦、膀胱之两腑。《难经》以左为肾，右为命门，自有其取义。然而说五脏六腑，是举其要点；说六脏六腑，是备其物数。再加命门，而为七脏六腑，又是零数。盖天地阴阳奇耦，不无零正，参伍错综，以尽其变。人之脏腑应之，所以经有奇经，而脏腑亦有零奇吗？
The term "Guan" (Minister/Official) refers to the affairs one is in charge of. When there is no disease, each organ performs its duties effectively; when disease occurs, it loses its specific function.
The Heart is the Sovereign Official, from which Shen (Spirit/Mind) emerges.
All perception and movement in the human body originate from the Heart. Therefore, all parts of the body act as ministers subject to the Heart, making the Heart the Sovereign. Western medicine regards the heart merely as a dull muscle incapable of governing perception and movement. It claims that perception and movement are entirely governed by the brain marrow. For instance, if the brain marrow of a rabbit is removed and the nerves at the back of the brain are excised, the body shrinks; this indicates that the nerves at the back of the brain govern movement. If the nerves at the front of the brain are excised, the rabbit cries out; this indicates that the nerves at the front of the brain govern perception. Applying this to humans, the logic holds true. However, I argue that this Western view is incorrect. Any minor injury to the skin or plucking of a hair causes pain, shrinking, or crying out in humans; why must brain nerves be excised for such reactions to occur? It seems Western medicine knows of the brain marrow but does not understand what marrow truly is. The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "The Kidney governs bone and produces marrow," and marrow is generated from Jing (Essence). The Kidney and Heart originally function mutually. The nerves of the marrow connect to the Heart; this represents Kidney Qi ascending to interact with the Heart, forming an image similar to Kan Water (☵) contained within Li Fire (☲), thereby enabling the governance of Shen. For details, see the annotation on "Heart Stores Shen." Even regarding the nerve at the back of the brain mentioned by Westerners, if excised, the rabbit would not cry out because that nerve does not connect to the Heart. Westerners also state that brain nerves connect to the Heart; these must be the anterior brain nerves governing perception. Because they connect to the Heart, they govern perception; thus, the organ governing perception remains the Heart itself. If perception were governed solely by the Brain, why would excising the brain nerves connecting to the Heart result in no crying out? Even accepting their premise, their fallacy becomes self-evident without debate. Essentially, when Kidney Qi is sufficient, Marrow is sufficient. The nerves of the Marrow enter the Heart, using Kidney Water to balance Heart Fire. With True Essence contained internally, True Light radiates externally, and Shen emerges. The Heart belongs to Fire and emits light; Marrow belongs to Kidney Water and can gather light. When Shen-Qi ascends to the brain marrow, light and Qi illuminate each other, allowing clear understanding of things. Referencing the annotation on "Kidney Stores Zhi (Will)" clarifies this further.
The Lung is the Minister of Instruction, from which regulation and control emerge.
The Heart is the Sovereign, and the Lung is outside the Heart, assisting the Heart Fire to prevent excess. The Lung provides clear Qi to protect it, much like a tutor assisting a ruler. Hence, it is called the Minister of Instruction. Analyzing its mechanism: blood returns to the Lung, where Lung Qi blows upon it, expelling turbid Qi from the blood. The blood then turns red again and returns to the Heart. In the *Neijing*, this describes the convergence of Ying (Nutritive) Blood and Wei (Defensive) Qi in the Lung, which constitutes the duty of the Minister of Instruction. Western medicine states: returning blood enters the Lung, carbon dioxide (referred to as "carbon gas") is expelled, the purple color fades turning into red blood, which then returns to the Heart. The Lung acts as a filter for blood waste. This aligns with the *Neijing*'s concept of the Lung as the Minister of Instruction. The difference lies only in terminology: Chinese medicine calls it "turbid Qi" rather than "carbon gas." If Heart Fire is excessive, Qi surges upward and downward; if insufficient, it leaks downward. Upward manifestations include fluid retention and coughing, all due to a lack of regulatory control. Only when the Lung restrains Heart Fire from being excessive and regulates it from being deficient will the Qi above and below function harmoniously.
The Liver is the General Official, from which strategy and deliberation emerge.
In the body, Yin governs stillness, providing stability; Yang governs movement, providing action. The Liver belongs to the Jueyin channel, representing the extreme of Yin. Its nature is resilient and stable. Jueyin reveals Shaoyang; as Yin reaches its end, Yang is born. Gallbladder Fire resides within the Liver, meaning Yang is contained within Yin. The activation of Yang enables action, giving rise to strategy and deliberation. Thus, it is called the General Official. Consequently, those with stagnant Liver Qi may act recklessly, while those with deficient Liver Qi often feel fearful and timid.
The Gallbladder is the Official of Uprightness, from which decision-making emerges.
Western medicine claims bitter bile is produced from Liver Blood. Traditional Chinese Medicine (TCM) asserts that the Gallbladder governs Xiang Huo (Ministerial Fire), which is the Qi generated by Liver Wood. Upon investigation, having this Qi results in having this fluid; the two views do not contradict. However, Western medicine denies that fear relates to the Gallbladder and cannot identify another organ responsible, failing to recognize the Gallbladder as the Official of Uprightness. From the perspective of bile, those with abundant bile are not fearful. From the perspective of Qi, those with vigorous Gallbladder Fire are not fearful. Excess leads to deviation from the mean, resulting in loss of uprightness and aggressive behavior. Deficiency leads to timidity, also deviating from uprightness. When Gallbladder Qi is neither too rigid nor too soft, it achieves uprightness, enabling decisive judgment. Combining Liver and Gallbladder: Liver Yang is hidden within Yin, governing strategy; Gallbladder Yang emerges from Yin, governing decision.
The Pericardium (Shanzhong) is the Envoy Official, from which joy and pleasure emerge.
"Shanzhong" refers to the diaphragm in the chest, connected around the ribs and spine, blocking turbid Qi. While the diaphragm is named Shanzhong, the organ residing within it is the Pericardium. Old annotations confused the diaphragm with Shanzhong, failing to realize the diaphragm is merely a large membrane in the Upper Jiao that blocks turbid Qi and cannot replace the Heart in disseminating transformation, hence cannot be the Envoy Official. The Pericardium, however, assists the Heart in issuing commands. Residing within the Shanzhong diaphragm, it is named Shanzhong. It belongs to Xiang Huo and governs Blood. Using Blood to nourish Fire ensures harmony without烈 (intensity), thus governing joy. Depression arises when Pericardium Fire is blocked; excessive joy arises when Pericardium Fire is too strong. Western medicine notes a membrane wrapping half of the heart, referring to the Pericardium, but fails to understand its specific functions.
The Spleen and Stomach are the Granary Officials, from which the Five Flavors emerge.
While other organs have individual titles, the Spleen and Stomach share one title. Why? The Stomach receives grain, and the Spleen transforms it. Together, they achieve success. Thus, they are collectively called the Granary Officials, responsible for digesting and absorbing the five grains. "Five Flavors emerge" means that once food enters the Stomach, it transforms into fluids. Through the fatty membranes of the Spleen, these nutrients disperse to the five Zang organs. "Emerging" refers to reaching the various organs via Ying and Wei Qi. If the Stomach fails to receive grain, flavors do not enter; the Stomach, belonging to Yang, requires drying methods. If the Spleen fails to transform grain, flavors do not reach the organs; the Spleen, belonging to Yin, requires nourishing methods.
The Small Intestine is the Receiving Official, from which transformation emerges.
"Cheng" (Receive/Hold) implies storage. The Small Intestine connects to the Stomach above. All food received by the Stomach is stored in the Small Intestine. Western medicine describes the Small Intestine as interconnected by fatty membranes containing capillaries. Bile from the Gallbladder injects into the intestines via capillaries to digest food; sweet pancreatic juice from the Spleen also injects into the Small Intestine. Food is transformed in the Small Intestine, and the refined essence exits through the membranes to reach various organs. Hence, "transformation emerges." Wang Qingren in *Yi Lin Gai Cuo* identified the tissue attached to the Small Intestine as "chicken crest oil," naming it Qifu, believing it stores Yuan Qi and aids digestion. However, he ignored the *Neijing*'s explicit statement that the Small Intestine governs transformation via Qi dynamics. The fatty membrane attached to the Small Intestine constitutes the Middle Jiao, associated with the Spleen. The Small Intestine is also the Fu organ of the Heart. The pathway connects via capillaries in the membrane, crossing the diaphragm to the Pericardium, and finally to the Heart. Heat lingering in the Small Intestine from the Heart prevents proper transformation, leading to dysentery or strangury. Insufficient Spleen Yin hinders the Middle Jiao's ability to receive food, causing constipation. Insufficient Sanjiao Xiang Huo fails to warm and transform water and grain, causing loose stools. Western medicine's "small intestine inflammation" corresponds to TCM conditions like diarrhea, dysentery, and intestinal abscesses. Recent Chinese theories suggest water passes from the Small Intestine through the Lanmen (Gate) into the Bladder, a view Western medicine rejects. Water disperses from the Stomach into the mesenteric network (Lianwang), as detailed in the Sanjiao annotation. What the Small Intestine receives is food (Yin substance). Drinks primarily transform into Qi, while food primarily transforms into Blood. Food in the Small Intestine converts to liquid, rising via the mesentery to the Heart to generate Blood. Thus, the Small Intestine is the Fu organ of the Heart, serving as the source of material for the Heart.
The Large Intestine is the Transmission Official, from which change and excretion emerge.
"Change and excretion" refers to the process where substances from the Small Intestine arrive here,精华 (essence) is fully extracted, leaving waste to be expelled. The Large Intestine facilitates this transmission. It can transmit because it is the Fu organ of the Lung; descending Lung Qi enables transmission. Therefore, regulating bowel movements requires adjusting Lung Qi. See also the section on "Integration of Five Zang Organs."
The Kidney is the Official of Strength, from which skill and dexterity emerge.
Western medicine attributes intellect to brain marrow and physical strength to brain nerves, yet fails to define marrow. Marrow is generated from Kidney Essence. Sufficient Essence yields sufficient Marrow. Since Marrow fills the bones, sufficient Marrow strengthens bones, enabling great physical strength and talent. Essence generates Spirit (see "Heart Stores Shen"). Sufficient Essence and strong Spirit lead to skillfulness. Insufficient Marrow weakens strength; insufficient Essence limits wisdom. Western medicine discusses marrow extensively but lacks treatment methods because it ignores that Marrow is generated by the Kidney. Modern Chinese doctors, knowing only the Kidney and ignoring Marrow, are mocked by Westerners. They fail to realize that ancient sages in the *Neijing* already discussed Marrow Sea (*Sui Hai Lun*) and Bone Emptiness (*Gu Kong Lun*), integrating Kidney and Marrow theory. Ancient sages are indeed unparalleled.
The Sanjiao (Triple Burner) is the Official of Ditches, from which water pathways emerge.
"Jiao" (ancient form: 膲) refers to the membranes facilitating water flow. Modern physicians incorrectly believe water seeps into the Bladder only after passing the lower opening of the Small Intestine. Both *Yi Lin Gai Cuo* and Western medicine ridicule this. Since the Tang Dynasty, the nature of Sanjiao has been misunderstood. Western medicine states: water ingested enters the Stomach, where capillaries absorb it, distributing it through membranes to the mesenteric fat (Lianwang), then into the Bladder. This "mesenteric network" includes the diaphragm, abdominal fat, and all body membranes. These membranes connect to the Bladder, allowing water to渗 (seep) in. This is the ancient Sanjiao, the Official of Ditches, governing water pathways. The root of Sanjiao lies between the two Kidneys, where a strip of membrane runs along the spine, named Mingmen (Gate of Life), the origin of Sanjiao. From here, plate fat extends, connecting to the chest diaphragm, ascending through the chest to the Pericardium, linking to the Lung system up to the throat. Outwardly, it distributes to the interstices of the hands, arms, and chest, constituting the Upper Jiao. From plate fat to chicken crest oil attaching to the Small Intestine, outwardly to the waist and abdomen interstices, constitutes the Middle Jiao. From plate fat to net oil connecting posteriorly to the Large Intestine and anteriorly to the Bladder (with the uterus in between), outwardly to the buttocks, calves, and lower abdomen interstices, constitutes the Lower Jiao. Water drunk by humans flows via Sanjiao to the Bladder; if Sanjiao is unobstructed, water flows freely. If Sanjiao is obstructed, water pathways close, causing edema. Western medicine understands the morphology of the mesenteric network but does not name it Sanjiao, nor does it know its origin or Qi dynamics.
The Bladder is the Official of the Prefecture, storing Jin Ye (Body Fluids); Qi transformation allows excretion.
All dietary water enters the Bladder. Like a lake or island, the Bladder is the "Prefecture." People know the Bladder governs urination but ignore that water entering the Bladder transforms into Qi, ascending to become Jin Ye. The remaining residue descends as urine. "Qi transformation allows excretion" refers to the emergence of Jin Ye, not just urine. The concept of "Qi transformation" has been misunderstood since the Tang Dynasty. I explain in detail: Fire interacting with Water generates Qi. Observing Western methods of boiling water to produce steam confirms this interaction. How do Fire and Water interact in the body? The Heart governs Fire. Air inhaled through the nose is Heavenly Yang, also belonging to Fire. Western medicine states air enters the nose, goes to the Lung, passes the Heart system, follows the spine to the Kidney system, then to the mesentery, reaching below the umbilicus. Tracing this path reveals inhaled air is Heavenly Yang (Fire). Passing the Heart system draws Heart Fire down to the Qi Sea (below the umbilicus), also known as the Bao Gong (Uterus) in women. The *Neijing* states: "The Bladder is the chamber of the Bao." The Bao is a large fatty cavity capable of expansion and contraction, larger than the Bladder. Separated by a thin layer, it connects via capillaries to the Bladder. Heavenly Yang combined with Heart Fire descends to the Bao, steaming Bladder water into Qi, analogous to boiling water. This Qi penetrates the Bladder into the Bao, ascends alongside the umbilicus, crosses the diaphragm into the Lung, and exits via mouth and nose. Condensing on cold surfaces, it forms dew; within the mouth and organs, it becomes Jin Ye. Exiting via the nose is obvious. Exiting via skin pores warms the skin and moistens muscles as sweat. This is "Qi transformation allowing Jin Ye to emerge." Elderly people have more urine because less Qi is transformed, leaving more water quality. Young adults have less urine because more Qi is transformed. Western medicine describes inhalation to the umbilicus but omits the exhalation path, assuming it retraces the entry route. This is incorrect. Exhalation ascends via Qichong point to the diaphragm and exits via the Lung. Western medicine views the diaphragm as aiding lung ventilation, missing that it is the exit path for Qi, not just an inspiratory aid. Inhalation enters via the spine, governed by the Du Mai (Governing Vessel); exhalation exits via the diaphragm, governed by the Ren Mai (Conception Vessel). Inhalation is Yang (Fire meeting Water); exhalation is Yin (Qi returning to Water). Respiratory circulation is a Daoist secret, often misunderstood by medical practitioners. Only the *Neijing* phrase "Qi transformation allows excretion" clearly explains this. If Fire is insufficient to steam Water, Jin Ye does not ascend, and Qi does not transform. If Water is insufficient to cool Fire, Jin Ye dries up, and urination ceases.
Regarding the integration of Zang and Fu organs mentioned earlier, only Five Zang and Six Fu were listed. This excerpt from *Lantai Midian* adds the Pericardium, creating Six Zang and Six Fu, completing the theory. The Kidney contains both Water and Fire; the Fire aspect is Mingmen. Thus, the previous section stated "Shaoyang belongs to the Kidney," indicating Sanjiao Xiang Huo originates from Mingmen. The Kidney connects to the Lung, representing Metal generating Water, with the Bladder as its Fu organ. It is said "thus dividing two Zang organs," meaning Kidney and Mingmen can be treated as two Zang organs pairing with the Sanjiao and Bladder as two Fu organs. The *Nanjing* assigns the Left Kidney and Right Mingmen, having its own rationale. Saying "Five Zang and Six Fu" highlights the essentials; saying "Six Zang and Six Fu" enumerates all components. Adding Mingmen creates Seven Zang and Six Fu, representing the odd numbers. Heaven and Earth follow patterns of odd and even numbers, varying intricately. Human organs reflect this, explaining why there are Extraordinary Vessels and oddities among the Zang and Fu organs.