《素问·灵台秘典论》云∶“心者，君主之官，神明出焉；肺者，相传之官，治节出焉
；肝者，将军之官，谋虑出焉；胆者，中正之官，决断出焉；膻中者，臣使之官，喜乐出焉
；脾胃者，仓廪之官，五味出焉；大肠者，传导之官，变化出焉；小肠者，受盛之官，化物
出焉；肾者，作强之官，伎巧出焉；三焦者，决渎之官，水道出焉；膀胱者，州都之官，津
液藏焉；气化则能出矣。”（按∶此以脾胃合为一官，恐错简耳。《灵枢·刺法补遗篇》云∶
脾者，谏议之官，知周出焉；仓廪之官，五味出焉，补此方是十二官之数也。
甲胆乙肝丙小肠，丁心戊胃己脾乡，大肠庚位原相属，牡肺（《内经》云∶“肺为牡脏。
”辛方更可详，壬水为膀胱肾癸合，三焦附丙膻（膻中即心包络）丁藏（旧诀云∶“三焦亦向壬中
寄，胞络同归入癸方”，今欲张氏改正。）阳干宜纳阳之腑，阴（脏）配阴干理自彰。
脏腑内景，各有区处。咽喉二窍，同出一腕，异途施化。喉窍俗名气管，咽窍俗名食管
。喉系坚空，连接肺本，为气息之路，呼吸出入，下通心肝之窍，以激诸脉之行，气之要道
，以行肌表脏腑者也。咽系柔空，下接胃本，为饮食之路，水谷同下，并归胃中，乃粮运之
关津，以司六腑之出纳者也。喉下为肺，谓之华盖，以覆诸脏，主呼吸出入，为人身之管龠
。肺之下为心，为五脏六腑之君主。心有丝络，上系于肺。肺受清气，下乃灌注。心之下，
有心包络，即膻中也，象为仰孟，为心之外胃。凡脾胃肝胆，两肾膀胱，各有一系，系于包
络之旁，以通于心。此下有膈膜，遮蔽浊气，使不得上熏心肺。膈膜之下有肝，肝之短叶中
，有胆附焉，此喉之一窍也。施气运化，熏蒸流行，以成脉络者如此。咽至胃，长一尺六寸
，通谓之咽门。咽下是膈膜，膈膜之下为胃，主纳受饮食。胃之旁有脾，脾动则磨胃，食乃
消化。胃之左有小肠，小肠上口，即胃下口，左回叠积十六曲。右有大肠，大肠上口，即小
肠下口，亦盘十六曲，后趋肛门，以出滓秽。膀胱当小肠下口，受小肠泌别，其汁清者渗入于
此，粗者转入大肠，脐下一寸，名水分穴，即指此而言也。膀胱上面，无所入之窍，止有下
口，其出其入，全假三焦之气化施行，此咽之一窍也，资生气血，转化糟粕之出入者如此。
三焦之说，古今议论不一，但以字义求之则得矣。夫所谓“三”者，取象三才，其腔腹周遭
上下，全体包罗不遗也。所谓“焦”者，火之象也，色赤属阳之谓也。其与心包络相表里者
，以三焦为脏腑之外卫，心包络为君主之外卫，犹乎帝阙之重城，故皆属阳，均称相火，而
其脉络，原自相通，故为表里也。肾有二，先天之本也，居于脊膂十四椎下，两旁相去各一
寸五分，形如豇豆相并，左肾为天一之水，右肾为地二之火。诸家各立议论，前后迥不相同
，然群言淆乱衷于圣，余惟以《内经》为主。张隐庵与其徒朱济公问答，于《内经》之旨，
甚为晓畅，今录于后。
朱济公问曰∶有云两肾皆属水，命门居两肾之中，在脊之十四椎内，为三焦生气之原，
有如坎中之满，此说甚为有理。
曰∶此不经之语耳。夫医道始于黄岐，脏腑血气之生始出入，非生知之圣，孰能究其精
微，奈何后学不体认圣经，反好为异说。夫人之始终胚胎，犹太极耳。三月而成形，先生两
肾，犹太极而生两仪，天一之水生木，木生火；地二之火生土，土生金；是先天止有水火，
后天始备五行，五行之中有二火，合而为三阴三阳，以配六脏六腑。故《灵枢·本枢篇》曰
∶“少阳属肾（此“肾”字指右肾，）肾上连肺（此“肾”字指左肾，）故将两脏。盖少阳乃三焦之
生气，发于右肾，上合包络，为相火之原，左肾属水，上连于肺，故为两脏也。（右肾而上合
左膻，左肾而上连右肺，是阴阳水火互换互根之道。）又《本脏篇》曰∶肾合于膀胱三焦，《素
问·咳论》曰∶肾咳不已，则膀胱受之，久咳不已，则三焦受之。是《内经》止曰肾，而原
无命门之名。盖以一肾合三焦，一肾合膀胱，是为两脏而配合两腑者也。夫人秉阴阳水火而
生，若以两肾象坎，取其中满，而名命门，将何脏以象离，取其中虚，而又名何物乎。学人
不可为前人所惑。
济公复问曰∶《难经》谓右肾主男子藏精，女子系胞。师言为相火生气之原，是左肾主
水，右肾主火，精水止生于左，而胞当偏于右矣。曰∶非此之谓也。夫天地阴阳之道，在无
形之气，曰阴曰阳，有形之气，曰水曰火，在人之元神，曰气曰精，天一生水，地二生火，
阴中有阳，阳中有阴，两肾之气，交相贯通，左右皆有精有气，水即是精，火即是气，阴阳
水火，互相资生，否则孤阳不生，独阴不长矣。夫藏精系胞之说，亦不过分别男女而言。然
五脏主藏精，在女子未尝无精。胞为血海，膀胱为胞之室，在男子亦未尝无胞者也。胞之所
系，盖言天主生物，地主成物，故系于右，乃气之所感，非胞之联系于右肾也。如云∶日月
星辰系焉，亦大气之所载，日月营运，星移斗转，又何尝有所系带乎。
《素问·灵台秘典论》中说：“心，是君主之官，神明由此产生；肺，是相傅之官，治节由此产生；肝，是将军之官，谋虑由此产生；胆，是中正之官，决断由此产生；膻中，是臣使之官，喜乐由此产生；脾胃，是仓廪之官，五味由此产生；大肠，是传导之官，变化由此产生；小肠，是受盛之官，化物由此产生；肾，是作强之官，伎巧由此产生；三焦，是决渎之官，水道由此产生；膀胱，是州都之官，津液在此储藏；气化功能正常则尿液能排出。”（按语：此处将脾胃合为一个官职，恐怕是竹简错乱所致。《灵枢·刺法补遗篇》说：“脾，是谏议之官，智周由此产生；胃，是仓廪之官，五味由此产生。”补充这一点才符合十二官的数量。）
甲对应胆，乙对应肝，丙对应小肠，丁对应心，戊对应胃，己对应脾，大肠对应庚位，肺属牡脏（《内经》说：“肺为牡脏。”）辛方更应详细考察，壬水对应膀胱和肾，癸与之相合，三焦依附于丙，膻中依附于丁（旧口诀说：“三焦也寄于壬中，胞络同归于癸方”，现依张氏改正。）阳干适宜配纳阳腑，阴（脏）配阴干道理自然显明。
脏腑的内景，各有区域分布。咽喉两个窍道，同出于一个部位，但路径不同，功能各异。喉窍俗名气管，咽窍俗名食管。喉体坚实中空，连接肺的根本，是气息通行的道路，呼吸出入，下通心肝的窍道，以激发各经脉的运行，是气的重要通道，用以运行于肌表和脏腑。咽体柔韧中空，下接胃的根本，是饮食通行的道路，水和谷物一同下行，并归入胃中，是粮食运输的关津，用以管理六腑的出纳。喉下是肺，称为华盖，覆盖诸脏，主管呼吸出入，是人身的管龠。肺之下是心，是五脏六腑的君主。心有丝络，上系于肺。肺接受清气，向下灌注于心。心之下，有心包络，即膻中，形象如仰置的盂，是心的外卫。凡脾胃肝胆、两肾膀胱，各有一系，系于心包络之旁，以通达于心。这下面有膈膜，遮蔽浊气，使其不能向上熏蒸心肺。膈膜之下有肝，肝的短叶中，附有胆，这是喉的一窍。施气运化，熏蒸流行，从而形成脉络，情况如此。咽至胃，长一尺六寸，通称为咽门。咽下是膈膜，膈膜之下是胃，主管纳受饮食。胃的旁边有脾，脾动则磨胃，食物才能消化。胃的左边是小肠，小肠上口即胃下口，向左回旋叠积十六曲。右边是大肠，大肠上口即小肠下口，也盘绕十六曲，向后趋向肛门，以排出糟粕。膀胱位于小肠下口处，接受小肠泌别清浊，其汁液中清的渗入于此，粗的转入大肠，脐下一寸处名为水分穴，就是指的这个位置。膀胱上面没有进入的窍道，只有下口，其出和入，完全依靠三焦的气化功能施行，这是咽的一窍，资助生成气血，转化糟粕的出入，情况如此。关于三焦的说法，古今议论不一，但只要从字义上推求就能明白了。所谓“三”，取象于三才，其腔腹周遭上下，全体包罗无遗漏。所谓“焦”，是火的象征，色赤属于阳的意思。它与心包络相表里，是因为三焦是脏腑的外卫，心包络是君主的外卫，犹如帝阙的重重城墙，所以都属阳，均称为相火，而其脉络，原本就相通，所以互为表里。肾有两个，是先天之本，居于脊柱第十四椎下方，两旁相距各一寸五分，形状像豇豆并列，左肾为天一之水，右肾为地二之火。各家各立议论，前后截然不同，然而众说纷纭，最终要回归圣人之言，我唯独以《内经》为主。张隐庵与其徒弟朱济公问答，对《内经》的宗旨，非常明白通畅，现在记录在后面。
朱济公问道：有人说两肾皆属水，命门居在两肾之间，在脊柱第十四椎内，是三焦生气之源，如同坎卦中的满实，这种说法很有道理。
回答说：这是不经之语。医道始于黄帝和岐伯，脏腑血气的生成始自出入，如果不是生而知之的圣人，谁能探究其精微之处？为何后学不体认经典，反而喜好异说。人的始终胚胎，就像太极一样。三个月成形，先生两肾，就像太极生出两仪，天一之水生木，木生火；地二之火生土，土生金；这是先天只有水火，后天才具备五行，五行中有两种火，合而为三阴三阳，以配合六脏六腑。所以《灵枢·本枢篇》说：“少阳属肾”（此“肾”字指右肾），肾上连肺（此“肾”字指左肾），故将两脏。盖少阳是三焦的生气，发于右肾，上合包络，为相火之源，左肾属水，上连于肺，所以为两脏。（右肾而上合左膻，左肾而上连右肺，这是阴阳水火互换互根的道理。）又《本脏篇》说：肾合于膀胱和三焦，《素问·咳论》说：肾咳不已，则膀胱受之，久咳不已，则三焦受之。这说明《内经》只说肾，而原本没有命门之名。大概是以一肾合三焦，一肾合膀胱，是为两脏而配合两腑。人禀受阴阳水火而生，如果以两肾象坎卦，取其中满，命名为命门，那将用何脏来象离卦，取其中虚，而又命名为什么呢？学者不可被前人迷惑。
济公又问道：《难经》说右肾主男子藏精，女子系胞。老师说右肾是相火生气之源，那么左肾主水，右肾主火，精水只生于左，而胞应当偏于右了。回答说：不是这个意思。天地的阴阳之道，在于无形之气，称为阴、阳；有形之气，称为水、火；在人的元神，称为气、精。天一生水，地二生火，阴中有阳，阳中有阴，两肾之气，交相贯通，左右皆有精有气，水即是精，火即是气，阴阳水火，互相资生，否则孤阳不生，独阴不长。至于藏精系胞的说法，也不过是分别男女而言。然而五脏主藏精，在女子未尝没有精。胞为血海，膀胱为胞之室，在男子也未尝没有胞。胞之所系，大概说的是天主生物，地主成物，所以系于右，是气所感应，并非胞联系于右肾。如果说日月星辰系焉，也是大气所承载，日月运转，星移斗转，又何尝有所系带呢？
The *Suwen: Lingtai Midian Lun* states: "The Heart is the official of the sovereign, from which Shenming (Spirit/Mind) emerges; the Lung is the official of the prime minister, from which Zhi Jie (regulation/governance) emerges; the Liver is the official of the general, from which Moulü (strategizing/planning) emerges; the Gallbladder is the official of integrity and justice, from which Jueduan (decision-making) emerges; the Shanzhong (Pericardium) is the official of the envoy, from which Xile (joy and happiness) emerges; the Spleen and Stomach are the officials of the granary, from which Wuwei (the five flavors) emerge; the Large Intestine is the official of transmission and conduction, from which Bianhua (transformation/changes) emerge; the Small Intestine is the official of reception and containment, from which Huawa (transformation of substances) emerges; the Kidney is the official of strength and exertion, from which Jiqiao (skill and dexterity) emerge; the Sanjiao (Triple Burner) is the official of drainage and irrigation, from which the water pathways emerge; the Bladder is the official of the capital city, where Jin Ye (body fluids) are stored; when Qi Hua (Qi transformation) occurs, they can be expelled." (Note: Here, the Spleen and Stomach are combined into one official, which is likely due to bamboo slip errors. The *Ling Shu: Cifa Buyi Pian* states: "The Spleen is the official of remonstrance, from which Zhizhou (wisdom and circumspection) emerges; the Stomach is the official of the granary, from which Wuwei (the five flavors) emerge." Adding this completes the count of twelve officials.)
Jia corresponds to the Gallbladder, Yi to the Liver, Bing to the Small Intestine, Ding to the Heart, Wu to the Stomach, Ji to the Spleen, the Large Intestine belongs to Geng, the Lung is a Yang organ (The *Neijing* states: "The Lung is a Yang organ."), Xin requires further detailed examination, Ren Water corresponds to the Bladder and Kidney, Gui combines with them, the Sanjiao (Triple Burner) attaches to Bing, and the Shanzhong (Pericardium) attaches to Ding (Old mnemonics state: "The Sanjiao also resides with Ren, and the Bao Luo [Pericardium] returns to Gui," now corrected according to Zhang's theory). Yang stems should correspond to Yang Fu (organs), and Yin stems to Yin Zang (organs); the principle is self-evident.
The internal structures of the Zang and Fu organs have distinct regions. The throat and pharynx share two openings originating from one area but follow different paths and functions. The Hou (throat/larynx) opening is commonly called the trachea, and the Yan (pharynx/esophagus) opening is commonly called the esophagus. The Hou structure is firm and hollow, connecting to the root of the Lung, serving as the pathway for breath. It facilitates respiration, connects downward to the orifices of the Heart and Liver, stimulates the flow of all meridians, acts as a vital channel for Qi, and distributes it to the muscles, skin, and organs. The Yan structure is soft and hollow, connecting downward to the root of the Stomach, serving as the pathway for food and drink. Water and grain descend together and converge in the Stomach, acting as the checkpoint for grain transport, managing the intake and output of the six Fu organs. Below the Hou lies the Lung, termed Huagai (Canopy), covering the other organs, governing respiration, and functioning as the bellows of the body. Below the Lung lies the Heart, the sovereign of the five Zang and six Fu organs. Silk-like vessels connect the Heart upward to the Lung. The Lung receives clear Qi and pours it downward into the Heart. Below the Heart lies the Pericardium (Bao Luo), also known as Shanzhong, shaped like an inverted bowl, serving as the outer guard of the Heart. The Spleen, Stomach, Liver, Gallbladder, both Kidneys, and Bladder each have a connection attached to the side of the Pericardium to communicate with the Heart. Below this lies the diaphragm, shielding turbid Qi from ascending to steam the Heart and Lung. Below the diaphragm lies the Liver, within the short leaves of which the Gallbladder is attached; this constitutes one of the Hou's orifices. Through the distribution of Qi and transformation, steaming and circulating, meridians are formed. From the Yan to the Stomach, the length is one chi and six cun, collectively called Yanmen. Below the Yan lies the diaphragm, and below the diaphragm lies the Stomach, responsible for receiving food and drink. Beside the Stomach lies the Spleen; when the Spleen moves, it grinds the Stomach, allowing food to digest. To the left of the Stomach is the Small Intestine; its upper orifice is the lower orifice of the Stomach, looping back sixteen times. To the right is the Large Intestine; its upper orifice is the lower orifice of the Small Intestine, also coiling sixteen times, leading posteriorly to the anus to expel waste. The Bladder is located at the lower orifice of the Small Intestine, receiving the separation performed by the Small Intestine; the clear fluid permeates here, while the coarse part turns into the Large Intestine. One cun below the navel is named Shuifen acupoint, referring to this location. The Bladder has no upper orifice for entry, only a lower orifice for exit; its entry and exit rely entirely on the Qi transformation of the Sanjiao (Triple Burner). This constitutes one of the Yan's orifices, facilitating the generation of Qi and Blood and the transformation/excretion of waste. Opinions on the Sanjiao vary since ancient times, but understanding its literal meaning suffices. The term "San" (Three) takes imagery from the Three Powers (Heaven, Earth, Man); its cavity surrounds above and below, encompassing everything without omission. The term "Jiao" (Burner/Fire) symbolizes fire, red in color, belonging to Yang. It forms a exterior-interior relationship with the Pericardium because the Sanjiao is the external guard of the Zang-Fu organs, and the Pericardium is the external guard of the Sovereign (Heart). Like the multiple walls of the imperial palace, both belong to Yang and are referred to as Ministerial Fire. Their meridians originally connect, thus establishing their exterior-interior relationship. There are two Kidneys, the root of congenital constitution, located below the 14th thoracic vertebra of the spine, one inch and five fen apart on each side, shaped like joined kidney beans. The Left Kidney is Tianyi Water, and the Right Kidney is Dier Fire. Various schools hold differing views, often contradictory, but amidst confused discussions, one must return to the Sage's words. I primarily rely on the *Neijing*. Zhang Yinan and his disciple Zhu Jigong discussed the essence of the *Neijing* clearly; I record their dialogue below.
Zhu Jigong asked: Some say both Kidneys belong to Water, and the Mingmen (Gate of Life) resides between the two Kidneys, inside the 14th thoracic vertebra, serving as the source of Qi generation for the Sanjiao, resembling the fullness in the Kan hexagram. This explanation seems reasonable.
I replied: This is unorthodox talk. Medical Dao began with Huangdi and Qibo. The generation and movement of Zang-Fu organs and Qi-Blood were not understood by those born with knowledge; who else could explore such subtleties? Why do later learners fail to comprehend the classics and instead favor heterodox theories? Human embryonic development is akin to Taiji. At three months, form appears, and the two Kidneys are formed first, just as Taiji generates Liangyi (Two Modes). Tianyi Water generates Wood, Wood generates Fire; Dier Fire generates Earth, Earth generates Metal. Thus, in the pre-heaven stage, there is only Water and Fire; in the post-heaven stage, the Five Elements are complete. Among the Five Elements, there are two Fires, combining to form Three Yin and Three Yang, corresponding to the six Zang and six Fu organs. Therefore, the *Ling Shu: Benshu Pian* states: "Shaoyang belongs to the Kidney" (this "Kidney" refers to the Right Kidney), "The Kidney connects upward to the Lung" (this "Kidney" refers to the Left Kidney), thus governing both organs. Shaoyang is the generating Qi of the Sanjiao, arising from the Right Kidney, connecting upward to the Pericardium, serving as the origin of Ministerial Fire. The Left Kidney belongs to Water and connects upward to the Lung, hence representing the two organs. (The Right Kidney connects upward to the Left Shanzhong, and the Left Kidney connects upward to the Right Lung, illustrating the mutual interchange and root of Yin-Yang and Water-Fire.) Furthermore, the *Benzang Pian* states: The Kidney harmonizes with the Bladder and Sanjiao. The *Suwen: Ke Lun* states: If Kidney cough persists, the Bladder is affected; if long-term cough persists, the Sanjiao is affected. This indicates that the *Neijing* mentions only the Kidney and originally had no concept of Mingmen. Presumably, one Kidney harmonizes with the Sanjiao, and one Kidney harmonizes with the Bladder, forming two organs paired with two Fu organs. Humans are born endowing Yin-Yang and Water-Fire. If we use the two Kidneys to symbolize the Kan hexagram, taking its central fullness as Mingmen, what organ would symbolize the Li hexagram, taking its central emptiness, and what would we name it? Scholars must not be misled by predecessors.
Jigong asked again: The *Nan Jing* states that the Right Kidney governs storing essence in men and binding the Chong/Ren vessels (Baopao) in women. You stated the Right Kidney is the origin of Ministerial Fire and generating Qi. Does this mean the Left Kidney governs Water and the Right Kidney governs Fire? Since Jing-Shui (Essence-Water) is generated only in the Left, should the Baopao be biased to the Right? I replied: That is not what is meant. The Dao of Heaven and Earth Yin-Yang exists in formless Qi, called Yin and Yang; in有形 (formed) Qi, called Water and Fire; in human Yuan Shen (Original Spirit), called Qi and Jing. Tianyi generates Water, Dier generates Fire. Yin contains Yang, and Yang contains Yin. The Qi of the two Kidneys penetrates each other; both left and right possess Jing and Qi. Water is Jing, Fire is Qi. Yin-Yang and Water-Fire mutually nourish each other; otherwise, solitary Yang cannot generate, and solitary Yin cannot grow. The saying about storing essence and binding the Baopao merely distinguishes between males and females. However, the five Zang organs store essence; females certainly possess essence. The Baopao is the Sea of Blood, and the Bladder is the chamber of the Baopao; males certainly possess a Baopao. The phrase "binding to the right" implies that Heaven governs the generation of life and Earth governs the completion of things, so it binds to the right due to Qi induction, not because the Baopao is physically connected to the Right Kidney. Just as the sun, moon, and stars are said to be bound, they are carried by the great Qi; the sun and moon revolve, and stars shift positions—do they truly have physical bindings?