生生子曰∶八十一难云∶“经言无实实虚虚，损不
足而益有余。是寸口脉耶？将病自有虚实耶？其损益奈何？然∶是病，非谓寸口脉也，谓病自有虚实也”云
云，彼注《难经》者，谓“是病”二字，非误即衍。愚谓二字，非误亦非衍，盖答辞也。言此是病之虚，而
非寸口脉也。与夫子答子路曰∶“然有是言也”一类，皆答问文法尔。经书中多有之，穷经者，能以意逆志而
玩其辞，斯得之矣。
生生子曰∶余惟医以《灵》《素》为祖，但其书出秦火之后，断简残篇，几至散失，虽命世之才如秦越
人、淳于意、张、华诸公，延医称神奇者，亦未之训释。至启玄子，始于《素问》掇摭成卷，门分章析，引
类注明，厥功亦伟矣。而偏执局曲之夫，尚吹毛索疵，妄加诃诋。乃于《灵枢》，非惟不敢注一字，且置此
书，略不涉目。夫《灵枢》一经，于脏腑经络，盈虚顺逆，针法疾徐，靡不周悉，顾弃而不读，何称医哉！何
称医哉！余观史嵩先生序《灵枢》有曰∶夫为医者，在读书，读而不能为医者有矣，未有不读而能为医者也。
余尝从事斯语，用节抄灵枢数条于后，以备参考云。
黄帝问于岐伯曰∶何谓德、气、生、精、神、魂、魄、心、意、志、思、智、虑，请问其故？岐伯答曰∶
天之在我者德也，地之在我者气也，德流气薄，而生者也。故生之来，谓之精，两精相搏，谓之神，随神
往来者，谓之魂，并精而出入者，谓之魄，所以任物者，谓之心，心有所忆，谓之意，意之所存，谓之志，
因志而存变，谓之思，因思而远慕，谓之虑，因虑而处物，谓之智。故智者之养生也，必顺四时而适寒暑，
和喜怒而安居处，节阴阳而调刚柔，如是则僻邪不至，长生久视。是故怵惕思虑者，则伤神，神伤则恐惧，流
淫而不止。因悲哀动中者，竭绝而失生。喜乐者，神惮散而不藏。愁忧者，气闭塞而不行。盛怒者，迷惑
而不治。恐惧者，神荡惮而不收。
心，怵惕思虑则伤神，神伤则恐惧自失，破KT 脱肉，毛悴色夭，死于冬。脾，愁忧而不解则伤意，意
伤则 乱，四肢不举，毛悴色夭，死于春。肝，悲哀动中则伤魂，魂伤则狂忘不精，不精则不正当人，阴缩
而挛筋，两胁骨不举，毛悴色夭，死于秋。肺，喜乐无极则伤魄，魄伤则狂，狂者意不存人，皮革焦，毛悴色
夭，死于夏。肾，盛怒而不止则伤志，志伤则喜忘其前言，腰脊不
可以俯仰屈伸，毛悴色夭，死于季夏。恐惧而不解则伤精，精伤则骨酸痿厥，精时自下。是故五脏主藏精者
也，不可伤，伤则失守而阴虚，阴虚则无气，无气则死矣。是故用针者，察观病患之态，以知精神魂魄之存
亡，得失之意，五者以伤，针不可以治之也。肝藏血，血舍魂，肝气虚则恐；实则怒。脾藏营，营舍意，脾
气虚则四肢不用，五脏不安；实则腹胀，经溲不利。心藏脉，脉舍神，心气虚则悲；实则笑不休。肺藏气，
气舍魄，肺气虚则鼻塞不利，少气∶实则喘喝，胸盈仰息。肾藏精，精舍志，肾气虚则厥；实则胀。五脏
不安，必审五脏之病形，以知其气之虚实，谨而调之也。
生生子说：《难经》第八十一难中说：“经文说不要使实证更实，虚证更虚，不要损伤不足的正气而补益有余的邪气。这是指寸口脉而言呢？还是指疾病本身自有虚实之分呢？其损益的原则是怎样的呢？”回答说：“这是指疾病（本身的虚实），不是指寸口脉，而是说疾病自有虚实之分。”等等。那些注释《难经》的人，认为“是病”这两个字，如果不是误写就是衍文。我认为这两个字，既不是误写也不是衍文，而是回答问话的文辞。意思是说这是指疾病的虚（或实），而不是指寸口脉。这与孔子回答子路时说：“是的，有这样的话”属于同一类，都是问答的文法罢了。经书中多有此类情况，精通经典的人，能够推究作者的心意来玩味其中的文辞，就能领会了。
生生子说：我唯独认为医学以《灵枢》和《素问》为祖师，但这两部书出自秦朝焚书坑儒之后，断简残篇，几乎散失。即使是像秦越人（扁鹊）、淳于意、张机、华佗这样名世之才，以及被延请为医并称神奇的人，也没有对它们进行训解注释。直到王冰（启玄子），才开始从《素问》中搜集整理成卷，分门别类，引证说明，他的功劳也是很大的。然而那些偏执狭隘的人，还要吹毛求疵，妄加指责。对于《灵枢》，他们不仅不敢注一个字，而且放置此书，连看都不看一眼。《灵枢》这部书，对于脏腑经络的盈虚顺逆，针刺手法的疾徐，无不详尽周全，如果抛弃而不阅读，怎么能称为医生呢！怎么能称为医生呢！我看史嵩先生为《灵枢》写的序言中说：“作为医生，在于读书，读过书而不能成为医生的有了，但没有不读书而能成为医生的。”我曾经践行这句话，因此节录《灵枢》中的几条内容在后面，以备参考。
黄帝问岐伯说：什么是德、气、生、精、神、魂、魄、心、意、志、思、智、虑？请问它们的缘故？岐伯回答说：天赋予我们的是德，地赋予我们的是气，德与气流动交薄，从而产生了生命。所以生命的来源，叫做精；两精相结合，叫做神；伴随神往来活动的，叫做魂；伴随精出入运行的，叫做魄；用来承担外物感应的，叫做心；心中有所回忆，叫做意；意念所存留的，叫做志；依据志向而进行存变思考，叫做思；依据思考而向远处慕念，叫做虑；依据思虑来处理事物，叫做智。所以明智的人养生，必须顺应四季变化以适应寒暑，调和喜怒情绪并安居处所，调节阴阳并调和刚柔，像这样则僻邪之气不会到来，可以长生久视。因此，惊恐思虑过度，就会损伤神，神受伤就会恐惧，精气流淫不止。因为悲哀触动内心的，会竭绝正气而失去生机。喜乐过度的，会使神惮散而不能内藏。愁忧过度的，会使气闭塞而不能运行。盛怒的，会使人迷惑而失去理智。恐惧的，会使神荡散而不能收敛。
心，受到惊恐思虑就会损伤神，神受伤就会恐惧且自我丧失控制，肌肉破溃消瘦，毛发憔悴面色枯槁，死于冬季。脾，愁忧不解就会损伤意，意受伤就会四肢倦怠无力，不能举动，毛发憔悴面色枯槁，死于春季。肝，悲哀触动内心就会损伤魂，魂受伤就会狂妄健忘且不精明，不精明就不能端正行为，阴器收缩且筋脉拘挛，两胁骨骼不能举动，毛发憔悴面色枯槁，死于秋季。肺，喜乐无节制就会损伤魄，魄受伤就会狂妄，狂妄的人心中没有他人，皮肤干枯，毛发憔悴面色枯槁，死于夏季。肾，盛怒不止就会损伤志，志受伤就会喜欢忘记以前的言语，腰脊不能俯仰屈伸，毛发憔悴面色枯槁，死于长夏。恐惧不解就会损伤精，精受伤就会骨酸痿厥，精气时常自行滑泄。因此五脏是主藏精的器官，不可损伤，损伤就会失守而导致阴虚，阴虚就没有气，没有气就会死亡。所以使用针法的人，要观察病患的状态，以此知道精神魂魄的存亡，得失的情况，这五者如果有伤，针法就不可以治疗它了。肝藏血，血舍魂，肝气虚就会恐惧；肝气实则易怒。脾藏营气，营气舍意，脾气虚就会四肢不能使用，五脏不安宁；脾气实则腹胀，大小便不利。心藏脉，脉舍神，心气虚就会悲伤；心气实则笑个不停。肺藏气，气舍魄，肺气虚就会鼻塞不利，气短；肺气实则喘促有声，胸部满闷需仰面呼吸。肾藏精，精舍志，肾气虚就会厥冷；肾气实则胀满。五脏不安宁，必须审察五脏的病状表现，以此来了解气的虚实，谨慎地进行调治。
Shengshengzi said: The Eighty-first Difficulty of the *Nan Jing* (Classic of Difficult Issues) states: "The Classics say, 'Do not make excess more excessive and deficiency more deficient; do not damage what is insufficient and benefit what is in excess.' Does this refer to the Cun Kou pulse? Or does it mean that diseases themselves have their own excess and deficiency? What are the principles of reduction and supplementation?" It answers: "This refers to the disease itself, not to the Cun Kou pulse; it means that diseases naturally possess excess and deficiency." Those who annotated the *Nan Jing* argued that the two characters "shi bing" (this disease) were either errors or interpolations. I believe these two characters are neither errors nor interpolations, but rather part of the responsive discourse. It means referring to the deficiency (or excess) of the disease, not the Cun Kou pulse. This is similar to Confucius answering Zilu by saying, "Yes, there is such a statement." These are all examples of question-and-answer rhetorical structures. Such instances are common in the Classics. Those who thoroughly study the Classics can grasp the author's intent by inferring meaning and savoring the wording.
Shengshengzi said: I hold that medicine takes the *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions) as its ancestors. However, these texts emerged after the burning of books in the Qin dynasty; they consist of broken slips and fragmented chapters, nearly lost to oblivion. Even renowned masters like Qian Yueren (Bian Que), Chunyu Yi, Zhang Zhongjing, and Hua Tuo, who were sought after for their miraculous medical skills, did not annotate them. It was not until Wang Bing (courtesy name Qixuanzi) that he began to compile excerpts from the *Su Wen* into volumes, categorizing them chapter by chapter and providing explanatory notes, which was indeed a great achievement. Yet, narrow-minded and biased individuals still nitpicked and falsely criticized. Regarding the *Ling Shu*, they not only dared not write a single annotation but also ignored the book entirely, never even glancing at it. The *Ling Shu* comprehensively details the fullness and emptiness, smoothness and reversal of the Zang-Fu organs and meridians, and the rapidity and slowness of acupuncture techniques. If one abandons it without reading, how can one be called a physician! How can one be called a physician! I read in Mr. Shi Song's preface to the *Ling Shu*: "To be a physician lies in reading books; there are those who read but cannot become physicians, but there has never been one who could become a physician without reading." Having practiced these words, I have excerpted several passages from the *Ling Shu* below for reference.
The Yellow Emperor asked Qibo: "What are De (Virtue/Heavenly Qi), Qi, Sheng (Life), Jing (Essence), Shen (Spirit), Hun (Ethereal Soul), Po (Corporeal Soul), Xin (Heart/Mind), Yi (Intent), Zhi (Will), Si (Reflection), Lv (Deliberation), and Zhi (Wisdom)? Please explain their origins." Qibo answered: "De bestowed by Heaven resides within us; Qi bestowed by Earth resides within us. When De flows and Qi condenses, life is generated. Therefore, the source of life is called Jing. When the two Jings combine, it is called Shen. That which accompanies Shen in its movement is called Hun. That which exits and enters with Jing is called Po. That which bears external stimuli is called Xin. Memory arising from Xin is called Yi. The retention of Yi is called Zhi. Reflection based on Zhi is called Si. Deliberation extending far based on Si is called Lv. Handling matters based on Lv is called Zhi. Thus, the wise nourish life by conforming to the four seasons and adapting to cold and heat, harmonizing joy and anger while dwelling peacefully, regulating Yin and Yang, and balancing rigidity and flexibility. In this way, pathogenic factors will not approach, allowing for long life and clear vision. Therefore, excessive fear and deliberation injure Shen; when Shen is injured, fear arises, and essence flows uncontrollably. Sorrow moving internally exhausts vital energy and leads to loss of life. Excessive joy causes Shen to scatter and fail to store. Excessive worry causes Qi to block and stagnate. Extreme anger causes confusion and loss of control. Fear causes Shen to agitate and fail to gather.
The Heart: Fear and deliberation injure Shen; when Shen is injured, fear arises and self-control is lost, muscles waste away, hair becomes brittle, complexion fades, and death occurs in Winter. The Spleen: Unresolved worry injures Yi; when Yi is injured, limbs become weak and immobile, hair becomes brittle, complexion fades, and death occurs in Spring. The Liver: Sorrow moving internally injures Hun; when Hun is injured, madness and forgetfulness occur, leading to improper behavior, retraction of the genitals and tendon spasms, inability to move the costal bones, hair becomes brittle, complexion fades, and death occurs in Autumn. The Lung: Unrestrained joy injures Po; when Po is injured, madness occurs, the mad person lacks regard for others, skin and leather dry up, hair becomes brittle, complexion fades, and death occurs in Summer. The Kidney: Unchecked anger injures Zhi; when Zhi is injured, one forgets previous words, the waist and spine cannot bend or stretch, hair becomes brittle, complexion fades, and death occurs in Late Summer. Unresolved fear injures Jing; when Jing is injured, bone soreness, flaccidity, and cold extremities occur, and essence leaks spontaneously. Therefore, the Five Zang organs store Essence and must not be injured. Injury leads to loss of control and Yin deficiency; Yin deficiency leads to lack of Qi; lack of Qi leads to death. Thus, practitioners of acupuncture must observe the patient's state to know the existence or absence of Spirit, Hun, and Po, and the gain or loss of Yi and Zhi. If these five are injured, acupuncture cannot treat them.
The Liver stores Blood, and Blood houses Hun. Liver Qi deficiency leads to fear; Liver Qi excess leads to anger. The Spleen stores Ying (Nutritive) Qi, and Ying Qi houses Yi. Spleen Qi deficiency leads to inability to use the limbs and disharmony of the Five Zang; Spleen Qi excess leads to abdominal distension and difficult urination and defecation. The Heart stores Mai (Vessels/Pulse), and Pulse houses Shen. Heart Qi deficiency leads to sorrow; Heart Qi excess leads to incessant laughter. The Lung stores Qi, and Qi houses Po. Lung Qi deficiency leads to nasal congestion and shortness of breath; Lung Qi excess leads to wheezing and chest fullness requiring仰息 (supine breathing). The Kidney stores Jing, and Jing houses Zhi. Kidney Qi deficiency leads to cold extremities; Kidney Qi excess leads to distension. To address disharmony of the Five Zang, one must carefully examine the pathological manifestations of the Zang organs to determine the excess or deficiency of Qi and regulate them cautiously.