生生子曰∶呼吸者，即先天太极之动静，人一身之原气也（即肾间动气）。有生之初，就有此气，默
运于中，流动不息，然后脏腑得所司而行焉。《难经》曰∶“肾间动气者，五脏六腑之本，十二经脉之根
，呼吸之门。”《经》谓肺出气，出此也；肾纳气，纳此也。谓呼在肺而吸在肾者，盖肺高肾下，犹天地
也。故滑伯仁曰∶肺主呼吸，天道也（此呼吸，乃口鼻之呼吸，指谷气而言也），肾司阖辟，地道也（此阖
辟，乃真息，指原气而言也）。《灵枢》曰∶“五谷入于胃也，其糟粕、津液。宗气，分为三隧。故宗气
积于胸中，出于喉咙，以贯心脉，而行呼吸（行，犹承行）。”此指后天谷气而言，谓呼吸资宗气以行，
非谓呼吸属宗气也。何者？人一离母腹时，便有此呼吸，不待于谷气而后有也。虽然，原气使无宗气积而
养之，则日馁而瘁，呼吸何赖以行？故平人绝谷，七日而死者，以水谷俱尽，脏腑无所充养受气也。然必
待七日乃死，未若呼吸绝而即死之速也。以是知呼吸者，根于原气，不可须臾离也。宗气如《难经》一难
之义，原气如八难之义，原气言体，谷气言用也。（上原呼吸。）
生生子曰∶甚矣！脉之难言也。非脉之难言也，欲尽于寸关尺三部之难也。非尽于寸关尺三部之
难也，欲尽于寸关尺三部，而能以意会于脏腑之外之难也。盖脉通于经络，营运于脏腑，而充周于郛廓。
诊候者，不以意会，徒拘拘以一脏一腑而尽于寸关尺三部之中，则凡脏腑之外，经络之间，脑项胸背腰
膝HT 踝四肢百骸，无有不病者，又将安诊？吾谓三部之中，非一脏一腑所能尽也，彼《内经·脉要精微
论篇》，但言候五脏与胃，余大、小肠及胆、膀胱不言者，非略之也，各以部地而该之也。何哉？如曰
∶“尺外以候肾，尺里以候腹中”，所谓腹中者，何物也？盖小腹之下，大、小肠、膀胱所居之地也。又
如“左外以候肝，内以候膈”，膈非腑也，独非一身中物乎？膈之下，胆所居也。五脏之系，上下联系，
莫不经循膈过，然则候膈者，非即膈膜已也。又如“左外以候心，内以候膻中”，膻中虽非实脏，乃心
主之宫城，与“右内以候胸中”相同，皆即其部地言之也、腹中、胸膈之候，乃内景之事，而胸膈腹
之外，又何以候之？故后四句复申言曰∶“前以候前，后以候后，上竟上者，胸喉中事也，下竟下者，
小腹腰股膝胫足中事也”。观此，则三部中非拘拘一脏一腑所
可尽也，余故曰∶欲尽于三部而意会于脏腑之外之难也。古人以寸部之阳候头痛，以尺部诊大小二
便，虽云肾主二便，其实上以候上，下以候下之验也。特附于上，以广三部诊外之意云。
生生子说：呼吸，就是先天太极的动静变化，也是人身体的原气（即肾间动气）。在生命形成的初始阶段，就有了这种气，它在体内默默运行，流动不息，然后脏腑才能各司其职而发挥作用。《难经》说：“肾间动气，是五脏六腑的根本，十二经脉的根源，呼吸的门户。”医经中说肺主出气，出的就是这个气；肾主纳气，纳的也是这个气。所谓“呼出于肺而吸入于肾”，大概是因为肺的位置高、肾的位置低，就像天和地的关系一样。所以滑伯仁说：肺主管呼吸，这是天道（这里的呼吸，是指口鼻的呼吸，指的是谷气而言）；肾主管开阖，这是地道（这里的开阖，是指真息，指的是原气而言）。《灵枢》说：“五谷进入胃中，其糟粕、津液和宗气，分为三条通道。所以宗气积聚在胸中，出于喉咙，贯通心脉，并推动呼吸（‘行’，意为承继推行）。”这里说的是后天的谷气，意思是呼吸依靠宗气来推动运行，并不是说呼吸属于宗气。为什么呢？人一旦离开母腹，就有了这种呼吸，不需要等待谷气之后才产生。虽然如此，如果原气没有宗气的积聚和滋养，就会日渐衰弱枯竭，呼吸又靠什么来运行呢？所以普通人断绝饮食，七天就会死亡，是因为水谷都耗尽了，脏腑得不到充养和受气。但是必须等到七天才会死，不像呼吸停止那样立刻死亡那么快。由此可知，呼吸根源于原气，片刻也不能分离。宗气相当于《难经》第一难的含义，原气相当于第八难的含义，原气讲的是本体，谷气讲的是功用。（以上论述呼吸的根源。）
生生子说：脉象确实难以言说啊。不是脉象本身难以言说，而是想要完全通过寸、关、尺三部脉象来尽知病情很难。不是想要通过寸、关、尺三部脉象来尽知病情很难，而是想要通过寸、关、尺三部脉象，并能用心意领会脏腑之外病变的所在更难。因为脉与经络相通，在脏腑中营运，并充盈于体表皮肤之下。诊脉的人，如果不凭心意领会，只是拘泥地试图在一脏一腑上通过寸、关、尺三部来穷尽所有病情，那么凡是在脏腑之外、经络之间，以及脑、项、胸、背、腰、膝、踝、四肢百骸等部位，就没有不生病的了，这又将如何诊察呢？我认为在三部脉中，不是单一的一脏一腑所能完全涵盖的。《内经·脉要精微论篇》中，只提到候察五脏与胃，对于大肠、小肠以及胆、膀胱没有单独提及，并不是省略了它们，而是根据脉位的地域范围来概括包含它们。为什么呢？比如文中说：“尺部外侧以候察肾，尺部内侧以候察腹中”，所谓的腹中，是什么东西呢？大概是小腹下方，是大肠、小肠、膀胱所居住的地方。又如“左手外侧以候察肝，内侧以候察膈”，膈不属于腑，难道不是身体中的器官吗？膈的下方，是胆所居住的地方。五脏的联系系统，上下相连，无不经过膈膜，那么候察膈，不就是指膈膜吗？又如“左手外侧以候察心，内侧以候察膻中”，膻中虽然不是实质性的脏器，却是心主的宫城，与“右手内侧以候察胸中”相同，都是就其脉位地域而言的。腹中、胸膈的候察，属于内脏景象的事理，而在胸膈腹部之外，又怎么候察呢？所以后面四句再次申述说：“前部脉候察身体前侧，后部脉候察身体后侧，寸部向上延伸至尽头的，是胸喉中的事；尺部向下延伸至尽头的，是小腹、腰、股、膝、胫、足中的事”。看这些内容，就知道三部脉不是拘泥于一脏一腑所能完全涵盖的，所以我所以说：想要通过三部脉来尽知病情，并能用心意领会脏腑之外的病变，是很难的。古人用寸部的阳脉来候察头痛，用尺部来诊察大小便的情况，虽然常说肾主管二便，其实这也是上以候上、下以候下的验证。特此附记于此，以扩充对三部脉诊察脏腑之外病情的意义。
Mr. Shengsheng said: Respiration is the movement and stillness of the primordial Taiji, and it is also the Yuan Qi (Primordial Qi) of the human body (i.e., the dynamic Qi between the kidneys). From the very beginning of life, this Qi exists; it operates silently within, flowing without cease, so that the Zang-Fu organs can perform their respective functions. The *Nan Jing* (Classic of Difficult Issues) states: "The dynamic Qi between the kidneys is the root of the five Zang and six Fu organs, the source of the twelve meridians, and the gate of respiration." The medical classics state that the Lung governs the exhalation of Qi, which comes from here; the Kidney governs the inhalation of Qi, which is received here. The saying that "exhalation belongs to the Lung and inhalation to the Kidney" is likely because the Lung is high and the Kidney is low, analogous to Heaven and Earth. Therefore, Hua Borun said: The Lung governs respiration, which is the Way of Heaven (here, 'respiration' refers to breathing through the mouth and nose, relating to Gu Qi / Grain Qi); the Kidney governs opening and closing, which is the Way of Earth (here, 'opening and closing' refers to true respiration, relating to Yuan Qi / Primordial Qi). The *Ling Shu* (Spiritual Pivot) states: "When five grains enter the Stomach, their dregs, fluids, and Zong Qi (Gathering Qi) are divided into three pathways. Thus, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart vessels, and promotes respiration ('promotes' means to carry forward)." This refers to postnatal Grain Qi, meaning that respiration relies on Zong Qi for its operation, not that respiration belongs to Zong Qi. Why? Because as soon as a person leaves the mother's womb, they have this respiration; it does not wait for Grain Qi to exist before appearing. Nevertheless, if Yuan Qi lacks the accumulation and nourishment of Zong Qi, it will become daily weaker and emaciated; upon what would respiration rely to operate? Therefore, when an ordinary person fasts, they die after seven days because water and grain are exhausted, and the Zang-Fu organs receive no nourishment or Qi. However, death occurs only after waiting seven days, unlike the speed of immediate death when respiration ceases. From this, we know that respiration is rooted in Yuan Qi and cannot be separated for even a moment. Zong Qi corresponds to the meaning of the First Difficulty in the *Nan Jing*, while Yuan Qi corresponds to the Eighth Difficulty; Yuan Qi speaks of the substance, and Grain Qi speaks of the function. (Above: On the Origin of Respiration.)
Mr. Shengsheng said: How difficult it is to describe the pulse! It is not that the pulse itself is difficult to describe, but that it is difficult to fully comprehend conditions solely through the Cun, Guan, and Chi positions. It is not merely difficult to comprehend conditions through these three positions, but it is difficult to use the Cun, Guan, and Chi positions to intuitively understand pathologies outside the Zang-Fu organs. Since pulses connect with the meridians, circulate within the Zang-Fu organs, and fill the superficial layers of the body, a diagnostician who does not employ intuitive understanding, but instead rigidly attempts to exhaust all diagnoses of a single Zang or Fu organ within the Cun, Guan, and Chi positions, would find that there are no parts of the body—outside the Zang-Fu, between the meridians, including the head, neck, chest, back, waist, knees, ankles, limbs, and bones—that are free from disease. How then could one diagnose them? I assert that within the three positions, a single Zang or Fu organ cannot encompass everything. In the *Nei Jing* (Inner Canon), specifically the chapter "Mai Yao Jing Wei Lun" (Essential and Subtle Discussion on Pulses), only the five Zang organs and the Stomach are mentioned for diagnosis; the Large Intestine, Small Intestine, Gallbladder, and Bladder are not explicitly stated. This is not an omission, but rather a comprehensive inclusion based on the territorial location of the pulse positions. Why? For instance, it says: "The outer part of the Chi position diagnoses the Kidney, and the inner part of the Chi position diagnoses the abdominal cavity." What is meant by 'abdominal cavity'? It generally refers to the area below the lower abdomen, where the Large Intestine, Small Intestine, and Bladder reside. Again, it says: "The outer part of the Left hand diagnoses the Liver, and the inner part diagnoses the Diaphragm." The Diaphragm is not a Fu organ, yet is it not a part of the body? Below the Diaphragm resides the Gallbladder. The connections of the five Zang organs link up and down, all passing through the diaphragm; thus, diagnosing the Diaphragm indeed refers to the diaphragmatic membrane. Furthermore, it says: "The outer part of the Left hand diagnoses the Heart, and the inner part diagnoses the Dan Zhong (Chest Center)." Although Dan Zhong is not a solid organ, it is the palace city of the Heart Master, identical in principle to "the inner part of the Right hand diagnoses the Chest Center"; both refer to the pulse position territory. The diagnosis of the abdominal cavity and chest/diaphragm pertains to internal scenery matters. But how about areas outside the chest, diaphragm, and abdomen? Therefore, the following four sentences reiterate: "The anterior pulse diagnoses the anterior body, the posterior pulse diagnoses the posterior body; the upper extreme of the Cun position relates to matters of the chest and throat, and the lower extreme of the Chi position relates to matters of the lower abdomen, waist, thighs, knees, shins, and feet." Observing this, it is clear that the three positions cannot be restricted to a single Zang or Fu organ. Hence, I say: it is difficult to fully comprehend conditions through the three positions and intuitively grasp pathologies outside the Zang-Fu organs. Ancients used the Yang aspect of the Cun position to diagnose headache and the Chi position to diagnose urination and defecation. Although it is often said that the Kidney governs these two functions, this is actually a verification of the principle that the upper diagnoses the upper and the lower diagnoses the lower. This is attached here to expand the meaning of diagnosing beyond the Zang-Fu organs using the three positions.