越人《四十四难》曰∶唇为飞门，齿为户门，会厌为吸门，胃为贲门，太仓下口为幽门，大小肠会为阑
门，下极为魄门∶是谓七冲门。人但知饮食从飞门而
入，糟粕从魄门而出。不知所谓门者，有开有阖，有旋转之枢，神气之有出有入，皆由此门。如曰吸门，
必先呼出而后能吸入，有如辘轳之有升有降也。夫人之所以养生者，莫先乎饮食，如饮食不下，二便闭癃，
多有因于气机不转，人但知降下而不知升提，有如辘轳之绳，西不能下，因东之碍而不升。故曰∶将欲下
之，必先举之。此之谓也。
开之曰∶有碍于升者，有碍于降者，宜审别治之，又不可必其升而后降也。
东方生风，春之气也；中央生湿，土之气也，主于夏秋之交，故曰秋伤于湿。（玉师曰∶土主四气之七月八月，故
秋伤于湿。）夫身半以上为阳，身半以下为阴；腰以上为天，腰以下为地。故阳者，天气也，主外；阴者，地气
也，主内。故喉主天气，嗌主地气；（嗌乃胃土之门，脾脉贯胃络嗌。）阳受风气，阴受湿气。风乃阳邪，故伤于风
者，上先受之。阳病者，上行极而下，故春伤于风，夏生飧泄。湿乃阴邪，故伤于湿者，下先受之。阴病
者，下行极而上，故秋伤于湿，冬生咳嗽。此天地阴阳之邪，随人气之上下升降者也。（夏生飧泄，是天气之下降于地也。
肺主天，冬生咳嗽，是地气之上腾于天也。）
张开之曰∶因上受之邪，而生在下之病；下受之邪，而生在上之病，故曰生，谓从上而生于下，从下
而生于上也。
《难经·四十四难》中说：嘴唇称为飞门，牙齿称为户门，会厌称为吸门，胃的上口称为贲门，太仓（胃）的下口称为幽门，大小肠交接处称为阑门，肛门称为魄门：这被称为“七冲门”。人们只知道饮食从飞门进入，糟粕从魄门排出。却不知道所谓的“门”，是有开有关、有旋转枢纽的，神气的出入，都通过这些门。比如吸门，必须先呼出气后才能吸入气，就像井上的辘轳有升有降一样。人赖以养生的事物中，没有比饮食更重要的了，如果饮食不下，二便闭塞不通，大多是因为气机不运转。人们只知道降下而不知道升提，就像辘轳的绳子，西边不能下降，是因为东边的阻碍而不能上升。所以说：“想要向下疏导，必须先向上提升。”说的就是这个道理。
张志聪批注说：有阻碍升的因素，也有阻碍降的因素，应当仔细辨别并治疗，但又不能绝对地认为一定要先升而后降。
东方生风，这是春季的气候特征；中央生湿，这是土行的气候特征，主导于夏秋之交，所以说是“秋伤于湿”。（玉师说：土行主宰四季中的第七个月和第八个月，即农历七月和八月，所以说是秋伤于湿。）人体上半身为阳，下半身为阴；腰以上为天，腰以下为地。所以阳代表天气，主外；阴代表地气，主内。因此喉主管天气，嗌（咽喉下部，食道入口）主管地气。（嗌是胃土之门，脾脉贯穿胃并联络嗌。）阳经受风气，阴经受湿气。风属于阳邪，所以被风邪所伤的人，上部先受病。阳病发展到极点就会下行，所以春季伤于风邪，夏季会发生飧泄（完谷不化的腹泻）。湿属于阴邪，所以被湿邪所伤的人，下部先受病。阴病发展到极点就会上行，所以秋季伤于湿邪，冬季会发生咳嗽。这是天地阴阳之邪，随着人气机的上下升降而变化的。（夏季发生飧泄，是天气下降至地；肺主天，冬季发生咳嗽，是地气上腾至天。）
张开之批注说：因为上部受邪，而在下部产生疾病；下部受邪，而在上部产生疾病，所以用“生”字，意思是病从上而生于下，或从下而生于上。
The *Nan Jing* (Classic of Difficult Issues), Chapter 44, states: The lips are called the Flying Gate (Feimen); the teeth are called the Household Gate (Humen); the epiglottis is called the Inhaling Gate (Ximen); the upper orifice of the stomach is called the Constricting Gate (Benmen); the lower orifice of the Tai Cang (Stomach) is called the Hidden Gate (Youmen); the junction of the large and small intestines is called the Screen Gate (Lanmen); the anus is called the Corporeal Soul Gate (Pomen): these are known as the Seven Rush Gates (Qichongmen). People only know that food and drink enter through the Flying Gate, and waste excreta exit through the Corporeal Soul Gate. They do not understand that these so-called "gates" have opening and closing mechanisms, and rotating pivots; the entry and exit of Shen Qi (Spiritual Energy) all pass through these gates. For instance, at the Inhaling Gate, one must first exhale before being able to inhale, similar to how a windlass has both ascending and descending motions. Among the things humans rely on for nourishment, nothing is more important than diet. If food and drink cannot be swallowed, and urination and defecation are obstructed, it is often due to the stagnation of Qi mechanism (Qi Ji). People only know about descending but fail to recognize ascending and lifting, much like the rope of a windlass: if the west side cannot descend, it is because the east side is obstructed and cannot ascend. Therefore, it is said: "If you wish to guide downwards, you must first lift upwards." This refers to this principle.
Zhang Zhicong comments: There are factors that hinder ascending, and factors that hinder descending; one should carefully distinguish and treat them accordingly. However, one cannot absolutely assume that ascending must precede descending.
The East generates Wind, which is the Qi of Spring; the Center generates Dampness, which is the Qi of Earth, dominating the transition between Summer and Autumn; hence it is said, "Autumn injury by Dampness." (Master Yu says: Earth governs the seventh and eighth months of the four seasons, i.e., the seventh and eighth lunar months, hence it is said, "Autumn injury by Dampness.") The upper half of the body is Yang, and the lower half is Yin; above the waist is Heaven, and below the waist is Earth. Thus, Yang represents Heavenly Qi and governs the exterior; Yin represents Earthly Qi and governs the interior. Therefore, the throat (Hou) governs Heavenly Qi, and the pharynx/esophagus entrance (Yi) governs Earthly Qi. (The Yi is the gate of Stomach Earth, and the Spleen meridian passes through the Stomach and connects to the Yi.) Yang channels receive Wind Qi, and Yin channels receive Dampness Qi. Wind is a Yang pathogen, so those injured by Wind suffer in the upper part first. Yang diseases, when reaching their extreme, move downward; thus, Spring injury by Wind leads to Sundry Diarrhea (Sun Xie, diarrhea with undigested food) in Summer. Dampness is a Yin pathogen, so those injured by Dampness suffer in the lower part first. Yin diseases, when reaching their extreme, move upward; thus, Autumn injury by Dampness leads to Cough in Winter. These are pathogens of Heaven and Earth's Yin and Yang, changing according to the ascending and descending of human Qi. (Summer Sundry Diarrhea represents Heavenly Qi descending to Earth; the Lung governs Heaven, and Winter Cough represents Earthly Qi ascending to Heaven.)
Zhang Kaizhi comments: Because pathogens received in the upper part generate diseases in the lower part, and pathogens received in the lower part generate diseases in the upper part, the character "Sheng" (generate/produce) is used, meaning disease arises from the upper and manifests in the lower, or arises from the lower and manifests in the upper.