奇经病非自生，盖因诸经溢出而流入之也。
阳维之病苦寒热，阴维之病苦心痛。阳跷之病，阳急而狂奔；阴跷之病，阴急而足直。冲病则气逆而里
急，督病则脊强而折厥，任病则男疝而女带瘕，带病则腹胀满而腰溶溶，其冲任二经，是又妇人乳血月候之所
从出。（男女之异，正在此处。）奇经之脉其如是乎！
（先儒叹世人务穷天地万物之理，不知一身五脏六腑毛发筋骨之所在，况医者乎？）
脏者，藏乎也，藏诸神而精气流通也；腑者，府库也，出纳转输之谓也。脏腑，兄弟也，同气而异形耳。
《素问》曰∶五脏者，藏精气而不泻，故满而不能实；六腑者，传化物而不藏，故实而不能满。所以然者，水
谷入口，则胃实而肠虚。食下，则肠实而胃虚。故曰实而不能满，满而不能实也。《难经》曰∶呼出心与肺，
吸入肾与肝。呼吸之间，脾受谷味，言心肺在上为阳，肝肾在下为阴，脾居中州，而播敷四脏，以为一身之运
斡也。又曰∶五脏六腑皆相近，而心肺独与大肠小肠相远者何也？经言∶心荣肺卫，通行阳气，故居在上。大
小肠传阴气而下，故居在下，所以相去而远也。观《素》、《难》所论脏腑，分阴分阳，而脾胃其中之太极矣乎！
至于气血多少，体用上下，亦不可以不知。诗曰∶多气多血经须记，手经大肠足经胃；多气少血有六经，三焦
胆肾心脾肺；多血少气心胞络，膀胱小肠肝所异。（病值气血少者补之，多者损之）《此事难知》曰∶天六腑气表，
其体在上，其用在下。（胆胃膀胱大肠小肠）地五脏血里，其体在下，其用在上。（耳目口鼻）言阴阳互相为用，则
天气左旋而降下，地气右旋而上升，气血和，表里静，上下通，如天地之泰然，人身其小天地乎？（气属阳，象
天左旋；血属阴，象地右旋。血从气行，其体静而不动，故气血如磨形，上转而西，下安不动。虽云不动，自
有东行之意，以其上动下静，不得不尔也。）
以声色臭味常变言之∶肝主色，（应春，物皆有色，五色皆肝变化，然不特脏病征于面也。经言小肠谓赤肠，
大肠谓白肠，胆谓青肠，胃谓黄肠，膀胱谓黑肠，言腑病当与色相合也。又言赤脉、青脉、黄脉、白脉、黑脉
者，言脉与色亦当相合也。观色为医家大务如此） 自入为青，入心为赤，入脾为黄，入肺为白，入肾为黑。假如
中风，肝为心邪，则知色当赤也。心主臭，应夏，（火能焦物，五臭皆心所主） 自入为焦臭，入肝为臊臭，入脾
为香臭，入肺为腥臭，入肾为腐臭。假如心经伤暑，则知其症当恶臭也。脾主味，（应季夏，味自土生，行五味
以养五脏者，脾所主也） 自入为甘，入肝为酸，入心为苦，入肺为辛，入肾为咸。假如饮食劳倦，以致脾邪入
心，则知当喜苦味也。肺主声，（应秋，金之有声也，五声皆肺所发） 自入为悲，（即哭也，金气肃杀凄惨） 入肝
为呼，（金胜肝，故发为呼） 入心为言，（火克金，故述为言） 入脾为歌，（母见子则乐而歌） 入肾为呻，（子见母
则
娇而呻吟）假如伤寒肺邪入心，则知当谵言妄语也。肾主液，（应冬，水性濡润，五液皆出于肾，分灌五脏）自入
为唾，（肾主骨，则肾之液从齿中而生） 入肝为泣，入心为汗，入脾为涎，入肺为涕。假如中湿，为肾邪入心，
则知当汗出不可止也。
以主病要略言之∶三阴之脉荣于脏，三阳之脉荣于腑，阴阳和而无关格之患。惟五脏不和，则气滞而为
九窍不通；六腑不和，则荣聚而为痈疽。（九窍∶耳目口鼻为阳七窍，大小便为阴二窍。盖肝气通于目，目和则
知白黑。心气通于舌，舌和则知五味，脾气通于口，口和则知谷味。肺气通于鼻，鼻和则知香臭。肾气通于耳，
耳和则知五音。五脏不和，则荣卫不通，邪气不得外泄，故九窍壅滞。九窍既滞，则六腑阳气亦不得通和于内。
内外不通，故留结为痈疽疮疖） 盖邪在六腑，则阳脉不和，而气留在内，则阳气太盛，而阴气不得相荣于下，故
曰关。凡外感是动气病，而下窍不利者，皆关之类也。邪在五脏，则阴脉不和，而血留在内，则阴气太盛，而
阳气不得相荣于上，故曰格。凡杂病由血所生，而上窍不利者，皆格之类也。（经言是动者，气也；所生者，
血也。邪在气，气为是动∶邪在血，血为所生。盖气先中于邪，则留止不行，而为邪所动，气既受邪，必传与
血，则血壅不行，而不能润泽经络，病所由生，是知气先病而血后病也。但外感从气而入，杂病从血而出，此
又东垣独得之见。丹溪尝分为十二经歌括，今悉篡于后条分，故不重录）阴阳俱甚，阴中无阳，阳中无阴，阴阳相
离，使荣卫痞塞，气血不相营运，此则五脏六腑皆受邪也，故曰关格。关格者，不得尽其命而死。关格，其百
病之关健矣乎！病有咳嗽泄痛 疟者，何也？人与天地相参，故五脏各以时感于寒则受病，微则为咳，甚则为
泄为痛。春则肝先受之，夏则心先受之，余仿此。 者，间日一发；疟者，一日一发。脏腑之疟各不同，当随所
状而刺之。（刺法见后。）病有积聚者，何也？积者，五脏所生，其始发有常处，其痛不离其部，或上或下，或
左或右。聚者，六腑所成，其始发无根本，其痛无常处，上下往来不定。积者阴气，聚者阳气，故不同也。凡
阳病欲得寒冷，又欲见人者，属腑；阴病欲得温热，又欲闭户独处，恶闻人声者，属脏。然脏病所以难治者，
传其所胜也。假令心病传肺，肺传肝，肝传脾，脾传肾，肾传心，一脏不再传，故言七传者死。腑病所以易治者，
传其所生也。假令心病传脾，脾传肺，肺传肾，肾传肝，肝传心，是子母相传，周而复始，如环无端，故言
生也。经曰∶邪气之客于身也，以胜相加，至其（己）所生而愈，至其（己）所不胜而甚，至于所生（己）
而持，自得其位
而起。（病在肝，愈于夏。夏不愈，甚于秋。秋不死，持于冬，起于春，禁当风。肝病者，愈在丙丁。丙丁不愈，
加于庚辛。庚辛不死，持于壬癸，起于甲乙。肝病者，平旦慧爽，下晡甚，夜半静退。病在心，愈于长夏。长
夏不愈，甚于冬。冬不死，持于春，起于夏，禁温食、热衣。心病者，愈在戊己。戊己不愈，加于壬癸。壬癸
不死，持于甲乙，起于丙丁。心病者，日中慧，夜半甚，平旦静。病在脾，愈于秋。秋不愈，甚于春，春不死，
持于夏，起于长夏，禁温食、饱食、湿地、濡衣。脾病者，愈在庚辛。庚辛不愈，加于甲乙。甲乙不死，持于
丙丁，起于戊己。脾病者，日晡慧，日出甚，下晡静。病在肺，愈于冬。冬不愈，甚于夏。夏不死，持于长夏，
起于秋，禁寒饮食、寒衣。肺病者，愈在壬癸。壬癸不愈，加于丙丁。丙丁不死，持于戊己，起于庚辛。肺病
者，下晡慧，日中甚，夜半静。病在肾，愈在春。春不愈，甚于长夏。长夏不死，持于秋，起于冬，禁犯淬炒、
热食、温炙衣。肾病者，愈在甲乙。甲乙不愈，甚于戊己。戊己不死，持于庚辛，起于壬癸。肾病者，夜半慧，
四季甚，下晡静） 必先定五脏之脉，乃可言间甚之时，死生之期也。（必先知经脉，然后知病脉。）
自其补泻言之∶外感内伤，病有虚、实、贼、微、正五邪之分。从后来者为虚邪，从前来者为实邪，从
所不胜来者为贼邪，从所胜来者为微邪，自病为正邪。假令心病，伤暑得之为正邪，中风得之为虚邪，饮食劳
倦得之为实邪，伤寒得之为微邪，中湿得之为贼邪，是之谓五邪也。忧愁思虑则伤心，形寒饮冷则伤肺，怒
气逆上而不下则伤肝，饮食劳倦则伤脾，久坐湿地，强力入水则伤肾，是正经自病也。虚则补其母，实则泻其
子。假如肝乃心之母，心虚当补肝。脾乃心之子，心实当泻脾。余经脏仿之，是以五补五泻为方之祖与。（心
虚，朱砂安神丸；肝肾虚，肾气丸；脾虚，益黄散；肺虚，阿胶散。心热，单泻心汤、导赤散；肝热，泻青丸；
脾热，泻黄散；肺热，泻白散∶肾热，泻肾汤。后之补泻方，皆推此。）
抑又闻腑有五，脏有六、有九者，何谓也？腑有六者，谓三焦为外腑也。上焦者，在心下胃上口，主内
而不出，其治在膻中；中焦者，在胃中脘，不上不下，主腐熟水谷，其治在脐两旁；下焦者，在脐下，当膀胱
上口，主分别清浊，出而不内，以传道也，其治在脐下一寸，故曰三焦。是腑之所以有六也。脏亦有六者，
谓肾有两脏，左为肾，右为命门。命门者，精神之所舍也，男以藏精，女以系胞，其气与肾相
通，故言脏亦有六也。（华氏谓自喉咙以下六腑以应天气，肺之系也；自咽门以下六腑以应地气，胃之系也。
前喉纳气，后咽纳食，有谓三管者非） 脏有九者，神脏五∶肝藏魂，心藏神，脾藏意，肺藏魄，肾藏精与志，
以其皆神气居之，故曰神脏五也。形脏四∶一头角，二耳目，三口齿，四胸中。以其如器外张，虚而不屈伸，
以藏于物，故曰形脏四。合之则为九脏矣。或疑气冲为腑，古人议论最活。他如《内经》又言脑、髓、骨、脉、
胆、女子胞六者，名曰奇恒之府。胃、大小肠、三焦、膀胱五者，名曰传化之府，此皆不能久留输泻者。魄
门亦为五脏使，水谷不得久藏。又头者，精明之府，头倾视深，精神将夺矣。背者，胸中之府，背曲肩随，府
将坏矣。腰者，肾之府，转摇不能，肾将惫矣。膝者，筋之府，屈伸不能，行则偻附，筋将惫矣。骨者，髓之府，
不能久立，行则振掉，骨将惫矣。得强则生，失强则死。是脏腑之散殊如此，然岂无其要乎！经曰∶凡十一脏
皆取决于胆。盖风寒在下，燥热在上，湿气居中，火独游行其间，以主荣卫而不息，火衰则为寒湿，火盛则
为燥热，故曰中正之官，决断出焉。噫！胃胆随人神所在，象胆随斗柄所指，物亦且然，而况于人乎！人之所
以灵于物者，心乎神乎！至尊至贵，至清至净，其十二官之主乎！故曰∶心静则万病息，心动则万病生。
奇经的病证并非自行产生，而是因为其他经脉的气血溢出而流入奇经所致。
阳维脉发病时，患者苦于寒热往来；阴维脉发病时，患者苦于心痛。
阳跷脉发病，表现为阳气侧拘急而狂奔乱走；阴跷脉发病，表现为阴气侧拘急而足部僵硬挺直。
冲脉发病，则气机上逆且腹部拘急；督脉发病，则脊柱强直甚至折断厥逆；任脉发病，男子患疝气，女子患带下及瘕聚；带脉发病，则腹胀满且腰部松软无力。其中冲脉和任脉，又是女性乳汁、血液及月经的来源所在。（男女生理的差异，正在于此。）奇经的病变表现就是这样的！
（先前的儒者感叹世人致力于穷尽天地万物的道理，却不知道自身五脏六腑、毛发筋骨的具体位置，何况是医生呢？）
脏的功能，是藏纳精气，神志寄居其中，精气得以流通；腑的功能，如同府库，负责出纳和转输水谷精微。脏腑的关系，如同兄弟，同属一气但形态不同。
《素问》说：五脏的作用是藏精气而不泻出，所以保持“满”的状态但不能被实物填塞；六腑的作用是传化水谷而不藏留，所以可以被实物填塞但不能保持“满”的状态。之所以这样，是因为水谷入口后，胃充实而肠道空虚；食物下行后，肠道充实而胃变空虚。所以说六腑是“实而不能满”，五脏是“满而不能实”。
《难经》说：呼气与心、肺相关，吸气与肾、肝相关。在呼吸之间，脾接受水谷的精微。这说明心肺在上属阳，肝肾在下属阴，脾居中焦，向四周脏腑布散精气，作为全身气机运转的中枢。
又说：五脏六腑位置相近，为什么唯独心肺与大、小肠距离较远？经文解释：心主营血，肺主卫气，共同通行阳气，所以位居上；大、小肠传导阴气向下，所以位居下，因此相距较远。观察《素问》、《难经》关于脏腑的论述，区分阴阳，而脾胃正是其中的太极枢纽！
至于气血的多少、体用的上下关系，也不可不了解。诗中说：多气多血的经脉要记住，手经是大肠经，足经是胃经；多气少血的有六条经脉，分别是三焦、胆、肾、心、脾、肺；多血少气的有心包络、膀胱、小肠、肝。（当病情涉及气血不足时予以补益，气血有余时予以损耗。）《此事难知》说：天对应六腑之气，其形体在上，其作用在下。（指胆、胃、膀胱、大肠、小肠）地对应五脏之血，其形体在下，其作用在上。（指耳目口鼻等感官）。如果说阴阳互相为用，那么天气左旋而降下，地气右旋而上升，气血调和，表里安宁，上下通畅，就像天地交泰一样，人身不就是小天地吗？（气属于阳，象征天左旋；血属于阴，象征地右旋。血随气运行，其本体静止不动，所以气血的运行像磨盘一样，上部转动向西，下部安稳不动。虽然说不运动，自然有向东运行的意向，因为上动下静，不得不如此。）
从声色臭味的常理与变化来说：
肝主色，（对应春季，万物皆有颜色，五色皆由肝变化而来，但这不仅限于脏病反映在面色上。经文说小肠叫赤肠，大肠叫白肠，胆叫青肠，胃叫黄肠，膀胱叫黑肠，意思是腑病应当与相应的颜色相符合。又提到赤脉、青脉、黄脉、白脉、黑脉，是说脉象与颜色也应当相符。观察面色是医家的重要任务，由此可见。）
肝气自入为青色，入心为赤色，入脾为黄色，入肺为白色，入肾为黑色。例如中风，若肝邪传入心，则知道面色应当发赤。
心主嗅觉，对应夏季，（火能烧焦物体，五臭皆由心所主），
自入为焦臭味，入肝为臊臭味，入脾为香味，入肺为腥臭味，入肾为腐臭味。例如心经受暑邪侵袭，则知道症状应当厌恶臭味。
脾主味觉，（对应长夏，味道自土而生，行五味以滋养五脏，是脾所主管的），
自入为甘味，入肝为酸味，入心为苦味，入肺为辛味，入肾为咸味。例如饮食劳倦导致脾邪传入心，则知道应当喜好苦味。
肺主声音，（对应秋季，金有声，五声皆由肺发出），
自入为悲声，（即哭声，金气肃杀凄惨），
入肝为呼号，（金克肝，故发为呼号），
入心为言语，（火克金，故述为言语），
入脾为歌咏，（母见子则乐而歌），
入肾为呻吟，（子见母则娇而呻吟）。例如伤寒肺邪传入心，则知道应当出现胡言乱语的症状。
肾主津液，（对应冬季，水性濡润，五液皆出于肾，分灌五脏），
自入为唾，（肾主骨，则肾之液从齿中生出），
入肝为泪，入心为汗，入脾为涎，入肺为涕。例如中湿邪，为肾邪传入心，则知道应当汗出不止。
从主治疾病的概要来说：
三阴经的脉气荣养五脏，三阳经的脉气荣养六腑，阴阳调和就没有关格（大小便不通）的祸患。
只有五脏不和，则气机阻滞而导致九窍不通；六腑不和，则营血郁聚而生成痈疽。
（九窍：眼、耳、口、鼻为阳七窍，大小便为阴二窍。大概肝气通于目，目调和则能辨别黑白；心气通于舌，舌调和则能辨别五味；脾气通于口，口调和则能辨别谷味；肺气通于鼻，鼻调和则能辨别香臭；肾气通于耳，耳调和则能辨别五音。五脏不和，则营卫不通，邪气不能外泄，所以九窍壅滞。九窍既已壅滞，则六腑阳气也不能在内通达调和。内外不通，所以停留结聚成为痈疽疮疖。）
大概邪气在六腑，则阳脉不和，气留在体内，则阳气太盛，而阴气不能在下方得到荣养，所以称为“关”。凡是外感引起的经气病变，而下窍不利的，都属于关的范畴。
邪气在五脏，则阴脉不和，血留在体内，则阴气太盛，而阳气不能在上方得到荣养，所以称为“格”。凡是杂病由血所生，而上窍不利的，都属于格的范畴。
（经文说“是动”指的是气，“所生”指的是血。邪气在气分，气被邪气扰动；邪气在血分，血被邪气所生。大概气先受邪，则停留不行，而为邪气所动；气既受邪，必传给血，则血壅滞不行，不能润泽经络，疾病由此产生，可知气先病而血后病。但是外感病从气而入，杂病从血而出，这又是李东垣独到的见解。朱丹溪曾将其分为十二经歌诀，现在全部删减收录在后条分缕析中，所以不再重复记录。）
如果阴阳都极度偏盛，阴中没有阳，阳中没有阴，阴阳分离，使营卫痞塞，气血不能相互营运，这就是五脏六腑都受邪了，所以称为关格。关格的人，寿命将尽而死。关格，可以说是百病的关键啊！
疾病有咳嗽、泄泻、疼痛、疟疾等，为什么呢？人与天地相应，所以五脏各自按时令感受寒邪而生病，轻微的就咳嗽，严重的就泄泻或疼痛。春季肝先受邪，夏季心先受邪，其余依此类推。
间日一发的是疟疾；一日一发的是疟疾。（注：此处原文可能有误或特指某种分类，通常疟疾多为间日或三日，原文区分可能指发作频率的不同类型或笔误，此处直译）脏腑的疟疾各不相同，应当根据症状进行针刺治疗。（刺法见后文。）
疾病有积聚，是什么呢？
积，是由五脏产生的，开始发病时有固定部位，疼痛不离其处，或上或下，或左或右。
聚，是由六腑形成的，开始发病没有根本，疼痛没有固定位置，上下往来不定。
积属于阴气，聚属于阳气，所以不同。
凡是阳病想要寒冷，又想要见人的，属于腑病；阴病想要温热，又想要关门独处，讨厌听到人声的，属于脏病。
然而脏病之所以难治，是因为它会传给它所克的脏器。假使心病传肺，肺传肝，肝传脾，脾传肾，肾传心，一脏不再传，所以说“七传者死”。
腑病之所以易治，是因为它传给它所生的脏器。假使心病传脾，脾传肺，肺传肾，肾传肝，肝传心，这是母子相传，周而复始，如环无端，所以说“生”。
经文说：邪气客居人体，是以相胜的关系相加，到了它所生的时令痊愈，到了它所不胜的时令加重，到了它所生的时令维持，到了本脏当令的时令起病。
（肝病，愈于夏季。夏季不愈，甚于秋季。秋季不死，持于冬季，起于春季，禁忌当风。肝病者，愈在丙丁日。丙丁日不愈，加于庚辛日。庚辛日不死，持于壬癸日，起于甲乙日。肝病者，平旦清醒，下午加重，半夜安静。
心病，愈于长夏。长夏不愈，甚于冬季。冬季不死，持于春季，起于夏季，禁忌温食、热衣。心病者，愈在戊己日。戊己日不愈，加于壬癸日。壬癸日不死，持于甲乙日，起于丙丁日。心病者，中午清醒，半夜加重，平旦安静。
脾病，愈于秋季。秋季不愈，甚于春季，春季不死，持于夏季，起于长夏，禁忌温食、饱食、湿地、湿衣。脾病者，愈在庚辛日。庚辛日不愈，加于甲乙日。甲乙日不死，持于丙丁日，起于戊己日。脾病者，下午清醒，日出时加重，下午安静。
肺病，愈于冬季。冬季不愈，甚于夏季。夏季不死，持于长夏，起于秋季，禁忌寒饮食、寒衣。肺病者，愈在壬癸日。壬癸日不愈，加于丙丁日。丙丁日不死，持于戊己日，起于庚辛日。肺病者，下午清醒，中午加重，半夜安静。
肾病，愈于春季。春季不愈，甚于长夏。长夏不死，持于秋季，起于冬季，禁忌煎炸、热食、温炙衣。肾病者，愈在甲乙日。甲乙日不愈，甚于戊己日。戊己日不死，持于庚辛日，起于壬癸日。肾病者，半夜清醒，四季末加重，下午安静。）
必须先确定五脏的脉象，才能谈论病情轻重变化的时间以及死生的期限。（必须先知正常经脉，然后才知道病脉。）
从补泻的角度来说：
外感和内伤，疾病有虚、实、贼、微、正五种邪气的区分。从后来者为虚邪，从前来者为实邪，从所不胜（克我）来者为贼邪，从所胜（我克）来者为微邪，自病为正邪。
假使心病，伤暑得之为正邪，中风得之为虚邪，饮食劳倦得之为实邪，伤寒得之为微邪，中湿得之为贼邪，这就叫做五邪。
忧愁思虑则伤心，形体受寒、饮用冷物则伤肺，怒气逆上不下则伤肝，饮食劳倦则伤脾，久坐湿地、强力入水则伤肾，这是正经自病。
虚则补其母，实则泻其子。假如肝是心的母，心虚当补肝。脾是心的子，心实当泻脾。其余经脉脏腑仿照此例，因此五补五泻是方剂的祖法。（心虚，用朱砂安神丸；肝肾虚，用肾气丸；脾虚，用益黄散；肺虚，用阿胶散。心热，用单泻心汤、导赤散；肝热，用泻青丸；脾热，用泻黄散；肺热，用泻白散；肾热，用泻肾汤。后来的补泻方剂，都是推演此法而来的。）
我又听说腑有五，脏有六、有九的说法，这是什么意思呢？
腑有六个，是指三焦为外腑。
上焦，在心下胃上口，主管摄入而不排出，治疗部位在膻中；
中焦，在胃中脘，不上不下，主管腐熟水谷，治疗部位在脐两旁；
下焦，在脐下，正当膀胱上口，主管分别清浊，只出不入，以传导排泄，治疗部位在脐下一寸，所以叫三焦。这就是腑之所以有六个的原因。
脏也有六个，是指肾有两个脏，左边为肾，右边为命门。命门，是精神居住的地方，男性用来藏精，女性用来系胞，其气与肾相通，所以说脏也有六个。（华佗认为自喉咙以下六腑以应天气，是肺的系连；自咽门以下六腑以应地气，是胃的系连。前喉纳气，后咽纳食，有人说有三管，这是不对的。）
脏有九个，神脏五个：肝藏魂，心藏神，脾藏意，肺藏魄，肾藏精与志，因为它们都是神气居住的地方，所以叫神脏五个。
形脏四个：一头角，二耳目，三口齿，四胸中。因为它们像器皿一样外张，虚空而不屈伸，用来容纳物体，所以叫形脏四个。合起来就是九脏了。
有人怀疑气冲穴为腑，古人的议论最为灵活。其他的如《内经》又提到脑、髓、骨、脉、胆、女子胞六个，名叫奇恒之府。胃、大小肠、三焦、膀胱五个，名叫传化之府，这些都不能久留，需要输泻。魄门（肛门）也是五脏的使者，水谷不得久藏。
另外，头是精明之府，头低垂视深陷，精神将要耗尽了。背是胸中之府，背弯曲肩膀下垂，府将毁坏。腰是肾之府，转动摇晃不能，肾将疲惫。膝是筋之府，屈伸不能，行走则弯腰依附，筋将疲惫。骨是髓之府，不能久立，行走则颤抖，骨将疲惫。得到强健就能生存，失去强健就会死亡。脏腑的分散情况就是这样，难道没有关键吗！经文说：凡十一脏皆取决于胆。大概风寒在下，燥热在上，湿气居中，火独游行其间，以主持营卫而不息，火衰则为寒湿，火盛则为燥热，所以胆被称为中正之官，决断由此而出。唉！胃和胆随着人的神志所在，胆象北斗斗柄所指的方向，事物尚且如此，何况是人呢！人之所以比万物灵秀，在于心和神啊！至尊至贵，至清至净，它是十二官的主宰啊！所以说：心静则万病息灭，心动则万病丛生。
Diseases of the extraordinary vessels (Qi Jing) do not arise spontaneously, but are caused by the overflow of Qi and Blood from the twelve regular meridians flowing into them.
Disease of Yang Wei Mai (Yang Linking Vessel) suffers from alternating chills and fever; disease of Yin Wei Mai (Yin Linking Vessel) suffers from heart pain.
Disease of Yang Qiao Mai (Yang Heel Vessel) presents with spasticity on the Yang side and frantic running; disease of Yin Qiao Mai (Yin Heel Vessel) presents with spasticity on the Yin side and rigid straightening of the feet.
Disease of Chong Mai (Penetrating Vessel) results in rebellious Qi and abdominal urgency; disease of Du Mai (Governing Vessel) results in rigidity of the spine, potential fracture-like sensation, and syncope; disease of Ren Mai (Conception Vessel) results in hernia in men and leukorrhea or masses in women; disease of Dai Mai (Girdle Vessel) results in abdominal distension and fullness with a feeling of looseness in the waist. Among these, Chong Mai and Ren Mai are the sources of milk, blood, and menstruation in women. (The difference between men and women lies precisely here.) Thus are the manifestations of diseases in the extraordinary vessels!
(The earlier Confucian scholars sighed that people strive to exhaust the principles of heaven, earth, and all things, yet do not know the locations of their own five zang organs, six fu organs, hair, skin, bones, and tendons, let alone physicians?)
Zang organs (Viscera) function to store essence and spirit, allowing the smooth circulation of essence and Qi; Fu organs (Hollow Organs) function like granaries, responsible for receiving, storing, transforming, and transporting substances. Zang and Fu are like brothers, sharing the same Qi but differing in form.
The *Su Wen* states: The five zang organs store essence and Qi without draining it, thus maintaining a state of "fullness" (Man) but cannot be filled with solid food; the six fu organs transmit and transform substances without storing them, thus can be filled with solid food but cannot maintain "fullness." This is because when food enters the mouth, the stomach becomes full while the intestines are empty; after digestion, the intestines become full while the stomach empties. Therefore, it is said that fu organs are "filled but not full," and zang organs are "full but not filled."
The *Nan Jing* states: Exhalation is associated with the Heart and Lung, inhalation with the Kidney and Liver. Between breaths, the Spleen receives the essence of grain. This indicates that Heart and Lung are superior and Yang, Liver and Kidney are inferior and Yin, while the Spleen resides in the central region, distributing essence to the four other organs, acting as the pivot for the body's movement.
It also states: Although the five zang and six fu organs are close, why are the Heart and Lung far from the Large and Small Intestines? The classics explain: Heart governs Ying (Nutritive) Blood, Lung governs Wei (Defensive) Qi, together they circulate Yang Qi, hence located superiorly. Large and Small Intestines transmit Yin Qi downward, hence located inferiorly, thus distant from each other. Observing the discussions on zang and fu in the *Su Wen* and *Nan Jing*, distinguishing Yin and Yang, the Spleen and Stomach serve as the Taiji (Supreme Ultimate) within!
One must also understand the differences in the quantity of Qi and Blood, and the relationships of substance/function and upper/lower. As the poem says: Remember the meridians abundant in both Qi and Blood: Hand-Large Intestine and Foot-Stomach; there are six meridians abundant in Qi but deficient in Blood: San Jiao, Gallbladder, Kidney, Heart, Spleen, Lung; those abundant in Blood but deficient in Qi are Pericardium, Bladder, Small Intestine, and Liver. (When disease involves deficiency of Qi/Blood, tonify; when excess, reduce.) *Ci Shi Nan Zhi* states: Heaven corresponds to the Qi of the six fu organs, whose form is superior but function is inferior. (Gallbladder, Stomach, Bladder, Large Intestine, Small Intestine). Earth corresponds to the Blood of the five zang organs, whose form is inferior but function is superior. (Eyes, ears, mouth, nose). If Yin and Yang mutually support each other, then Heaven's Qi rotates left and descends, Earth's Qi rotates right and ascends. When Qi and Blood harmonize, exterior and interior remain tranquil, and upper and lower connect smoothly, resembling the harmony of Heaven and Earth; the human body is indeed a small universe. (Qi belongs to Yang, symbolizing Heaven's left rotation; Blood belongs to Yin, symbolizing Earth's right rotation. Blood follows Qi, its substance being static. Thus, Qi and Blood move like a millstone: the upper part turns westward, while the lower part remains stable. Although stated as static, there is an inherent tendency to move eastward due to the upper motion and lower stability.)
Speaking of the constant and variable aspects of color, sound, odor, and taste:
The Liver governs color. (Corresponding to Spring, all things have color; the five colors are transformations of the Liver. However, this is not limited to zang diseases manifesting on the face. The classics refer to the Small Intestine as the Red Intestine, Large Intestine as White, Gallbladder as Green, Stomach as Yellow, Bladder as Black, meaning fu diseases should correspond to specific colors. It also mentions red, green, yellow, white, and black pulses, indicating that pulse qualities should match colors. Observing color is a major task for physicians.)
Liver Qi entering itself manifests as Green; entering Heart as Red; entering Spleen as Yellow; entering Lung as White; entering Kidney as Black. For example, in wind-stroke, if Liver pathogen enters the Heart, the complexion will likely be red.
The Heart governs smell. (Corresponding to Summer, fire scorches objects; the five odors are governed by the Heart.)
Entering itself manifests as Scorched odor; entering Liver as Fishy/Pungent odor; entering Spleen as Fragrant odor; entering Lung as Raw/Fishy odor; entering Kidney as Putrid odor. For example, if the Heart channel is injured by summer-heat, the symptom would likely be aversion to odors.
The Spleen governs taste. (Corresponding to Late Summer; tastes originate from Earth, and the Spleen distributes the five tastes to nourish the five zang organs.)
Entering itself manifests as Sweet; entering Liver as Sour; entering Heart as Bitter; entering Lung as Pungent; entering Kidney as Salty. For example, if dietary indiscretion or fatigue causes Spleen pathogen to enter the Heart, there would likely be a craving for bitter taste.
The Lung governs voice/sound. (Corresponding to Autumn, Metal has sound; the five vocalizations emanate from the Lung.)
Entering itself manifests as Sorrow/Crying (Metal energy is austere and desolate); entering Liver as Calling out (Metal overcomes Liver, causing calls); entering Heart as Speaking (Fire overcomes Metal, leading to speech); entering Spleen as Singing (Mother sees child, joy leads to singing); entering Kidney as Groaning (Child sees mother, affection leads to groaning). For example, in cold damage where Lung pathogen enters the Heart, symptoms may include delirious speech.
The Kidney governs fluids. (Corresponding to Winter, Water is moistening; the five fluids originate from the Kidney and distribute to the five zang organs.)
Entering itself manifests as Saliva (Kidney governs bone, so Kidney fluid emerges from teeth); entering Liver as Tears; entering Heart as Sweat; entering Spleen as Drool; entering Lung as Nasal Mucus. For example, in dampness invasion where Kidney pathogen enters the Heart, sweating that cannot stop may occur.
Regarding the general principles of treating diseases:
The three Yin meridians nourish the zang organs, and the three Yang meridians nourish the fu organs. When Yin and Yang harmonize, there is no risk of Guan Ge (obstruction and reversal).
If the five zang organs are disharmonious, Qi stagnates, leading to obstruction of the nine orifices; if the six fu organs are disharmonious, Ying Blood accumulates, leading to carbuncles and ulcers.
(The nine orifices: eyes, ears, mouth, nose are the seven Yang orifices; urination and defecation are the two Yin orifices. Liver Qi connects to the eyes; when harmonious, one distinguishes black and white. Heart Qi connects to the tongue; when harmonious, one tastes the five flavors. Spleen Qi connects to the mouth; when harmonious, one tastes grain. Lung Qi connects to the nose; when harmonious, one smells fragrances and foul odors. Kidney Qi connects to the ears; when harmonious, one hears the five tones. Disharmony of the five zang disrupts Ying and Wei, preventing evil from escaping, causing obstruction of the nine orifices. Once obstructed, Yang Qi of the six fu cannot harmonize internally. Internal and external blockage leads to accumulation and formation of carbuncles, ulcers, and boils.)
Generally, if evil is in the six fu organs, Yang meridians are disharmonious, Qi stays inside, Yang Qi becomes excessive, and Yin Qi cannot nourish from below; this is called "Guan" (Obstruction). All exogenous diseases involving meridian Qi pathology with dysfunction of the lower orifices belong to Guan.
If evil is in the five zang organs, Yin meridians are disharmonious, Blood stays inside, Yin Qi becomes excessive, and Yang Qi cannot nourish from above; this is called "Ge" (Reversal/Blockage). All endogenous diseases arising from Blood pathology with dysfunction of the upper orifices belong to Ge.
(The classics state "Shi Dong" refers to Qi; "Suo Sheng" refers to Blood. Evil in Qi causes "Shi Dong"; evil in Blood causes "Suo Sheng." Qi is first affected by evil, stagnating and moving erratically; once Qi is affected, it transmits to Blood, causing Blood stasis and failure to nourish meridians, giving rise to disease. Thus, Qi disease precedes Blood disease. However, exogenous diseases enter via Qi, while endogenous diseases emerge via Blood; this is Li Dongyuan's unique insight. Zhu Danxi divided this into songs for the twelve meridians, which are now summarized in subsequent sections, so they are not repeated here.)
If Yin and Yang are both extreme, with no Yang in Yin and no Yin in Yang, and Yin and Yang separate, causing stagnation of Ying and Wei and lack of mutual operation of Qi and Blood, then all five zang and six fu organs are affected by evil; this is called Guan Ge. Those with Guan Ge will not survive their natural lifespan. Guan Ge is indeed the key to all diseases!
Why do diseases include cough, diarrhea, pain, and malaria? Humans correspond to Heaven and Earth, so each zang organ is susceptible to cold according to the season, resulting in illness. Mild cases cause cough; severe cases cause diarrhea or pain. In Spring, the Liver is affected first; in Summer, the Heart is affected first; others follow this pattern.
"Malaria" (Jue) occurs every other day; "Malaria" (Nuè) occurs daily. (Note: Text distinguishes frequency/types). Malaria affecting different zang/fu organs varies; treatment should involve acupuncture based on symptoms. (Acupuncture methods see later.)
What are Accumulation (Ji) and Gathering (Ju)?
Accumulation arises from the five zang organs; it starts at a fixed location, pain remains localized, moving up/down or left/right.
Gathering arises from the six fu organs; it has no fixed root, pain moves unpredictably up/down.
Accumulation is Yin Qi; Gathering is Yang Qi; hence they differ.
Yang diseases desire cold and social interaction belong to fu organs; Yin diseases desire warmth and isolation, disliking noise, belong to zang organs.
Zang diseases are difficult to treat because they transmit to the organ they overcome (Ke). E.g., Heart transmits to Lung, Lung to Liver, Liver to Spleen, Spleen to Kidney, Kidney to Heart. One organ does not transmit twice, hence "Seven transmissions lead to death."
Fu diseases are easier to treat because they transmit to the organ they generates (Sheng). E.g., Heart transmits to Spleen, Spleen to Lung, Lung to Kidney, Kidney to Liver, Liver to Heart. This is mother-to-son transmission, cycling endlessly, hence "Life."
The classics say: Evil invading the body follows the cycle of overcoming. Recovery occurs in the season it generates; worsening in the season it overcomes; persistence in the season generating it; onset in its own season.
(Liver disease: recovers in Summer; worsens in Autumn; persists in Winter; starts in Spring. Avoid wind. Best days: Bing/Ding. Worsens: Geng/Xin. Persists: Ren/Gui. Starts: Jia/Yi. Time of day: Clear at dawn, worse in afternoon, quiet at midnight.
Heart disease: recovers in Late Summer; worsens in Winter; persists in Spring; starts in Summer. Avoid warm food/clothes. Best days: Wu/Ji. Worsens: Ren/Gui. Persists: Jia/Yi. Starts: Bing/Ding. Time of day: Clear at noon, worse at midnight, quiet at dawn.
Spleen disease: recovers in Autumn; worsens in Spring; persists in Summer; starts in Late Summer. Avoid warm/heavy food, damp places/clothes. Best days: Geng/Xin. Worsens: Jia/Yi. Persists: Bing/Ding. Starts: Wu/Ji. Time of day: Clear in afternoon, worse at sunrise, quiet in late afternoon.
Lung disease: recovers in Winter; worsens in Summer; persists in Late Summer; starts in Autumn. Avoid cold food/clothes. Best days: Ren/Gui. Worsens: Bing/Ding. Persists: Wu/Ji. Starts: Geng/Xin. Time of day: Clear in afternoon, worse at noon, quiet at midnight.
Kidney disease: recovers in Spring; worsens in Late Summer; persists in Autumn; starts in Winter. Avoid fried/hot foods, heated clothes. Best days: Jia/Yi. Worsens: Wu/Ji. Persists: Geng/Xin. Starts: Ren/Gui. Time of day: Quiet at midnight, worse at seasonal transitions, clear in late afternoon.)
One must first determine the pulse of the five zang organs to discuss the timing of improvement/worsening and prognosis. (Must know normal meridians before identifying pathological pulses.)
From the perspective of tonification and reduction:
Exogenous and endogenous diseases are classified into five types of pathogens: Deficiency (Xu), Excess (Shi), Robbery (Zei), Minor (Wei), and Correct (Zheng).
Pathogens coming from the "later" generation are Deficiency pathogens; from the "earlier" generation are Excess pathogens; from the organ that overcomes (Me) are Robbery pathogens; from the organ I overcome are Minor pathogens; originating from the organ itself are Correct pathogens.
For Heart disease: Summer-heat injury is Correct pathogen; Wind stroke is Deficiency pathogen; Dietary/Fatigue injury is Excess pathogen; Cold damage is Minor pathogen; Dampness invasion is Robbery pathogen. These are the Five Pathogens.
Worry/thought injures Heart; cold form/drink injures Lung; anger rising injures Liver; diet/fatigue injures Spleen; sitting in dampness/straining in water injures Kidney. These are self-injuries of the regular channels.
Tonify the Mother in deficiency; Reduce the Child in excess. E.g., Liver is Mother of Heart; Heart deficiency tonifies Liver. Spleen is Child of Heart; Heart excess reduces Spleen. Other organs follow this. Thus, the five tonifications and five reductions are the ancestors of formulas. (Heart deficiency: Cinnabar Spirit-Calming Pill; Liver/Kidney deficiency: Kidney Qi Pill; Spleen deficiency: Yi Huang San; Lung deficiency: Ejiao San. Heart heat: Single Heart-Reducing Decoction, Guide Out Redness Powder; Liver heat: Qing Wan; Spleen heat: Huang San; Lung heat: Bai San; Kidney heat: Shen Tang. Later formulas derive from this.)
I have also heard of five fu organs and six/nine zang organs. What does this mean?
There are six fu organs because San Jiao is considered an external fu.
Upper Jiao is below the heart, above the stomach opening; it manages intake without excretion; treatment site is Dan Zhong.
Middle Jiao is in the middle of the stomach; neither ascending nor descending; it manages rotting and ripening of food; treatment site is beside the navel.
Lower Jiao is below the navel, at the bladder opening; it separates clear from turbid, excretes without reabsorbing, managing transmission; treatment site is one cun below the navel. Hence, San Jiao. This explains why there are six fu organs.
There are also six zang organs because the Kidneys are two: Left is Kidney, Right is Ming Men (Gate of Life). Ming Men houses the spirit; in men, it stores essence; in women, it anchors the uterus. Its Qi connects with the Kidney, hence six zang organs. (Hua Tuo stated that the six fu organs below the throat correspond to Heaven's Qi via the Lung connection; the six fu organs below the pharynx correspond to Earth's Qi via the Stomach connection. Anterior throat takes air, posterior pharynx takes food; some speak of three tubes, which is incorrect.)
There are nine zang organs: Five Spirit Zang (Shen Zang): Liver stores Hun (Ethereal Soul), Heart stores Shen (Spirit), Spleen stores Yi (Intellect), Lung stores Po (Corporeal Soul), Kidney stores Jing (Essence) and Zhi (Will). Since they house spiritual energy, they are called Five Spirit Zang.
Four Form Zang (Xing Zang): Head/Horns (metaphorical for head shape), Eyes/Ears, Mouth/Teeth, Chest/Middle. Like vessels open outward, hollow and non-flexible, storing objects, hence Four Form Zang. Together, they make nine zang organs.
Some doubt whether Qi Chong is a fu; ancient discussions were flexible. Additionally, the *Nei Jing* mentions Brain, Marrow, Bone, Vessel, Gallbladder, and Uterus as the Six Extraordinary Fu Organs. Stomach, Large Intestine, Small Intestine, San Jiao, and Bladder are the Five Transmitting Fu Organs, which cannot retain substances long but must transport and excrete them. The Po Men (anus) is also an envoy of the five zang organs; food and water cannot stay long.
Furthermore, the Head is the Mansion of Clarity; if the head droops and eyes sink, spirit is exhausted. The Back is the Mansion of the Chest; if the back curves and shoulders droop, the mansion is failing. The Waist is the Mansion of the Kidney; if turning/shaking is impossible, the Kidney is exhausted. The Knees are the Mansion of Tendons; if flexion/extension is impossible and walking requires leaning, tendons are exhausted. The Bones are the Mansion of Marrow; if standing long is impossible and walking causes trembling, bones are exhausted. Strength brings life; loss of strength brings death. Such is the dispersion of zang and fu organs. Is there no key principle? The classics say: All eleven organs depend on the Gallbladder. Generally, cold/damp are below, dry/heat above, dampness in the center, Fire moves uniquely among them, governing Ying and Wei ceaselessly. Fire deficiency leads to cold/damp; Fire excess leads to dry/heat. Thus, it is called the Official of Equilibrium, from whom decision-making arises. Alas! The Stomach and Gallbladder follow the person's spirit; the Gallbladder points like the Big Dipper's handle. Even objects follow this, how much more humans! Human superiority over animals lies in the Heart and Spirit! Supreme, noble, pure, and clean, it is the master of the twelve officials. Thus it is said: When the Heart is still, all diseases cease; when the Heart moves, all diseases arise.