故曰“法天地”也。土为万物之木，脾胃为脏腑之本，故上至头，下至足，无所不及，又岂得独主一时而已哉！
所以四时五脏皆不可一日无土气也。）心之合脉也，其荣色也，其主肾也。（心生血，血行脉中，故合于脉。
血华在貌，故荣于色。心属火，受水之制，故以肾为主。）肺之合皮也，其荣毛也，其主心也。
（肺属金，皮得金之坚，故合于皮；毛得皮之养，故荣于毛。五脏之应天者肺，故肺主皮毛。凡万物之体，
其表必坚，正合干金之象，所谓物物一太极也。金受火之制，故肺以心为主。）肝之合筋也，其荣爪也，其主
肺也。（肝属木，木曲直而柔，筋体象之，故合于筋。爪者筋之余，故荣于爪。木受金之制，故肝以肺为主。）
脾之合肉也，其荣唇也，其主肝也。（脾属土，肉象地之体，故合肉也。脾气通于唇，故荣唇也。土受
木之制，故脾以肝为主。）肾之合骨也，其荣发也，其主脾也。（肾属水，肾藏精，骨藏髓，精髓同类，
故肾合骨。发为精血之余，精髓充
满，其发必荣，故荣在发。水受土之制，故肾以脾为主。）是故多食咸，则脉凝泣而变色，（咸从水化，水
能克火，故病在心之脉与色也。禁咸。泣、涩同。）多食苦则皮槁而毛拔，（苦从火化，火能克金，故病在肺
之皮毛也。禁苦。）多食辛则筋急而爪枯，（辛从金化，金能克木，故病在肝之筋爪也。禁辛。）多食酸则肉
胝而唇揭，（胝，皮浓也，手足胼胝之谓。酸从木化，木能克土，故病在脾之肉与唇也。禁酸。胝，音
支。 ，音绉。）多食甘则骨痛而发落，此五味之所伤也。（甘从土化，土能克水，故病在肾之骨与发也。禁
甘。）故心欲苦，（合于火也。）肺欲辛，（合于金也。）肝欲酸，（合于木也。）脾欲甘，（合于土也。）
肾欲咸，（合于水也。）此五味之所合，五脏之气也。（凡此皆五味之合于五脏者也。）凡刺之法，必先本于神。
血脉营气精神，此五脏之所藏也。至其淫 离脏则精失，魂魄飞扬，志意恍乱，智虑去身。何谓德、气、
生、精、神、魂、魄、心、意、志、思、智、虑耶？天之在我者德也，地之在我者气也，德流气
薄而生者也。（天地之大德曰生。人生于地，悬命于天。阳先阴后，阳施阴受。肇生之德本乎天，成形之
气本乎地。故“天之在我者德也，地之在我者气也，德流气薄而生者”，言理赋形全，而生成之道斯备矣。）
故生之来谓之精，（太极动而生阳，静而生阴。阴阳二气，各有其精。所谓精者，天以一生水，地以六成之，
而为五行之最先。故万物初生，其来皆水，如果核未实皆水也，卵胎未成犹水也，即凡人之有生，以及昆虫草
木，无不皆然。男女媾精，万物化生，此之谓也。）两精相搏谓之神，（两精者，阴阳之精也。搏，交接也。
二五之精，妙合而凝，万物生成之道，莫不阴阳交而后神明见。人之生也，必合阴阳之气，形神乃成。故曰
事其神者神去之，休其神者神居之。则凡治身者，太上养神，其次养形也。搏，音博。）随神往来者谓之魂，
并精而出入者谓之魄，（精对神而言，则神为阳而精为阴，魄对魂而言，则魂为阳而魄为阴。故魂则随神
而往来，魄则并精而出入也。）所以任物者谓之心，（心为君主之官，统神灵而参天地，故万物皆有所在。）
心有所忆谓之意，（忆，思忆也。谓一念之生，心有所向而未定者曰忆。）意之所存谓之志，（意之所存，
谓意已决而卓有所立者曰志。）因志而存变谓之思，（因志而存变，谓意志虽定而复有反复计度者曰思。）
因思而远慕谓之虑，（深思远慕，必生忧疑，故曰虑。）因虑而处物谓之智。（疑虑既生，而处得其善者曰
智。接此数者，各有所主之脏，今皆生之于心，此正诸脏为之相使而心则为之主宰耳。）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。（四时、寒暑、喜怒、
居处皆明显易晓，惟节阴阳，调刚柔，其义最精，其用最博。凡食息、起居、病治、脉药，皆有最切于此
而不可忍者。）是故怵惕思虑者则伤神，神伤则恐惧，流淫而不止。（言情志所伤之为害也。怵，恐也。
惕，惊也。流淫，谓流泄淫溢也。思虑而兼怵惕，则神伤而心怯，心怯则恐惧，恐惧则伤肾，肾伤则精不固。
盖以心肾不交，故不能摄收如此，怵，出、恤二音。）因悲哀动中者，竭绝而失生。（悲则气消。悲哀太甚
则胞络绝，故致失生。竭者绝之渐，绝则尽绝无余矣。）喜乐者神惮散而不藏，（喜发于心，乐散于外。暴
喜伤阳，故神气惮散而不藏。惮，惊惕也。）愁忧者气闭塞而不行，（愁忧则气不能舒，故脉道为之闭塞。）
盛怒者迷惑而不治，（怒则气逆，甚者必乱，故致昏迷皇惑而不治。不治，乱也。）恐惧者神荡惮而不收。（
恐惧则神志惊散，故荡惮而不收。上文云“不藏”者，神不能持而流荡也。此云“不收”者，神为恐惧而
散失也。）心怵惕思虑则伤神，神伤则恐惧自失，破 脱肉，毛悴色夭，死于冬。（言情志所伤之病，而死各
有时也。心藏神，神伤则心怯，故恐惧自失。 者，筋肉结聚之处。心虚则脾弱，故破 脱肉。毛悴者，皮
毛惟悴也。色夭者，心之色赤欲如白裹朱，不欲如赭也。火衰畏水，故死于冬。后仿此。 ，劬允切。）
脾愁忧而不解则
伤意，意伤则 乱，四肢不举，毛悴色夭，死于春。（忧本肺之志，而亦伤脾者，母子气通也。忧则脾气
不舒，不舒则不能营运，故 闷而乱。四肢皆禀气于胃而不得至经，必因于脾乃得禀也。故脾伤则四肢
不举。脾色之夭者土衰畏木，故死于春。 ，美本切。）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。（肝藏魂。悲哀过甚则伤魂，魂伤则为狂、为忘而不精
明，精明失则邪妄不正，其人当阴缩挛筋，两胁骨不举者，皆肝经之败也。肝色之夭者，木衰畏金，故死于秋。）
肺喜乐无极则伤魄，魄伤则狂，狂则意不存人。皮革焦，毛悴色夭，死于夏。（喜本心之志，而亦伤肺者，
暴喜伤阳，火邪乘金也。肺藏魄，魄伤则神乱而为狂。意不存人者。旁若无人也。五脏之伤，无不毛悴，而此
独云“皮革焦”者，以皮毛为肺之合而更甚于他也。肺色之夭者，金衰畏火，故死于夏。）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。（怒本肝之志，而亦
伤肾者，肝肾为子母，其气相通也。肾藏志，志伤则意失而善忘其前言也。腰脊不可俯仰屈伸者，腰为肾之
府也。肾色之夭者，水衰畏土，故死于季夏。）恐惧而不解则伤精，精伤则骨 痿厥，精时自下。
（此亦言心肾之受伤也。盖盛怒虽云伤肾，而恐惧则肾脏之本志，恐则气下而陷，故能伤精。肾主骨，故
精伤则骨 。痿者，阳之痿。厥者，阳之衰。命门不守则精时自下，是虽肾脏受伤之为病，与愁忧恐惧则伤
心之义同。 、酸同。）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。（此总
结上文而言五脏各有其精，伤之则阴虚，以五脏之精皆阴也。阴虚则无气，以精能化气也。气聚则
生，气散则死，然则死生在气，而气本于精。年四十而阴气自半者，正指此阴字也。）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。（用针者，必当察病
者之形态，以酌其可刺不可刺也。设或五脏精神已损，必不可妄用针矣。盖针能治有余，而不可治虚损也。）
肝藏血，血舍魂。肝气虚则恐，实则怒。（肝藏魂，人卧血归于肝。血有余则怒，不足则恐。）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。（营出中焦，受气取汁，变化而赤，是谓
血。故曰“脾藏营，营舍意”，即脾藏意也。脾虚则四肢不用，五脏不安，以脾主四肢而脾为五脏
之原也。太阴脉入腹络胃，故脾实则腹胀，经溲不利。经，当作泾。溲，音搜。）心藏脉，脉舍神。心气虚则
悲，实则笑不休。（心主脉，藏神。神有余则笑不休，神不足则悲。）肺藏气，气舍魂。肺气虚则
鼻塞不利、少气，实则喘喝，胸盈，仰息。（喘喝者，气促声粗也。胸盈，胀满也。仰息，仰面而喘也。
肺藏魄，气有余则喘咳上气，不足则息利少气。）肾藏精，精舍志。肾气虚则厥，实则胀。（肾藏精舍
志，志有余则腹胀飧泄，不足则厥。）五脏不安，必审五脏之病形，以知其气之虚实，谨而调之也。（既明
情志损伤，第分五脏虚实。凡五脏有不安者，必审其病形虚实、情志所属，乃可随其脏以调之也。
）气口独为五脏主。（气口之义，其名有三∶手太阴肺经脉也，肺主诸气，气之盛衰见于此，故曰气口；肺
朝百脉，脉之大会聚于此，故曰脉口；脉出太渊，其长一寸九分，故曰寸口。是名虽三而实则一耳。五脏六
腑之气味皆出于胃，变见于气口，故为五脏之主，乃统两手而言，非独指右手为气口也。因其为脉之大会，
五脏六腑之所终始，故取法焉。毋执左强为外感而攻其表，右盛为内伤而攻其里。人之脏气有不齐，脉候有禀
赋，或左脉素大于右，或右脉素大于左，孰者为常，孰者为变？或于偏弱中略见有力，已隐虚中之实；或于偏
盛中稍觉无神，便是实中之虚。设不知此，执左右以分表里，岂左无里而右无表乎？夫人迎为足阳明之脉，不
可以言于手，气口总手太阴而言，不可以分左右。三阳在头，人迎行气于三阳；三阴在手，脉口行气于三阴。
故诊法有三∶一取三部九候，以诊通
身之脉∶一取太阴、阳明，以诊阴阳之本；一取左右气口，以诊脏腑之气。则人迎自有其位，在结喉两旁，
足阳明之脉也。谓左手关前一分为人迎，误也。）胃者水谷之海，六腑之大源也。五味入口藏于胃，
以养五脏气。气口亦太阴也。是以五脏六腑之气味皆出于胃，变见于气口。（人有四海而胃居其一，是为水
谷之海，六腑之本，又为五脏六腑之海。气口本属太阴，而脾亦太阴者，何也？盖气口属肺，
手太阴也；布行胃气，则在于脾，足太阴也。胃气必归于脾，脾气必归于肺，而后行于脏腑营卫，所以气口
虽为手太阴，而实即足太阴之所归，故曰“气口亦太阴”也。是以五脏六腑之气味皆出于胃而变见于气口，
故胃为脏腑之大源，无不由脾达肺也。见，音现。）故五气入鼻，藏于心肺。心肺有病，而鼻为之不利也。
（气味之化，在天为气，在地为味。五味入口，藏于胃者，味为阴也。五气入鼻，藏于心肺者，气为阳也。
鼻为肺之窍，故心肺有病而鼻为之不利。）凡治病必察其下，适其脉，观其志意与其病也。（此治病之四要
也。“下”言二阴，二阴者，肾之窍，胃之关也。仓廪不藏者，是门户不要也。得守者生，失守者死。故二
便为胃气之关锁而系一生元气之安危，此“下”之不可不察也。适，测也。脉为气血之先，故独取寸口以决
吉凶之兆。人无胃气曰逆，逆者死；脉无胃气亦死，此脉之不可不察也。志意和则精神专直，魂魄不散，
悔怒不起，五脏不受邪矣。是志意关乎神气而存亡系之，此志意之不可不察也。病有标本，不知求本则失其
要矣。病有真假，不知逆从则及于祸矣。此病因之不可不察也。合是四者而会观之，则治病之妙，无遗法矣。）
拘于鬼神者不可与言至德，恶于针石者不可与言至巧，病不许治者病必不治，治之无功矣。
食气入胃，散精于肝，淫气于筋。（精，食气之精华也。肝主筋，故胃散谷气于肝则浸淫滋养于筋
也。）食气入胃，浊气归心，淫精于脉。（浊，言食气之浓者也。受谷者浊，受气者清。心主血脉，故食
气归心则精气浸淫于脉也。）脉气流经，经气归于肺，肺朝百脉，输精于皮毛。（精淫于脉，脉流于经，经
脉流通，必由于气。气主于肺，为百脉之朝会。毛为肺之合，故肺精输焉。）毛脉合精，行气于府。
（肺主毛，心主脉，肺藏气，心生血，一气一血，称为父母，二脏独占胸中，故曰“毛脉合精，行气于府”。
府者，气聚之府也，是谓气海，亦曰膻中。）府精神明，留于四脏，气归于权衡。（宗气积于肺，神明出于心。
气盛则神王，故气府之精为神明。神王则脏安，故肺、肝、脾、肾四脏，无不赖神明之留以为主宰，然后脏
气咸得其平而归于权衡矣。权衡，平也。）权衡以平，气口成寸，以决死生。（脏腑之气既得其平，则必变见
于气口而成寸尺，可于此以决生死也。上言“食气入胃”，下言“饮入于胃”也。）饮入于胃，游溢精气，
上输于脾，脾气散精，上归于肺。（游，浮游也。溢，涌溢也。水饮入胃，则其气化精微，必先输运于脾，是
谓“中焦如沤”也。脾乃散气，上如云雾而归于肺，是谓“上焦如雾”也。）通调水道，下输膀胱，（肺气运
所以说“效法天地”。土是万物的根本，脾胃是脏腑的根本，所以其气上至头顶，下至足底，无所不到，又怎能只主管一个季节呢！因此四时五脏都不可一日没有土气的滋养。心与小肠相合于脉，其荣华表现在面色，其制约者是肾。（心主生血，血运行在脉管中，所以与脉相合。血液的华彩反映在容貌上，所以荣华于面色。心属火，受水的克制，所以以肾为主宰制约者。）肺与大肠相合于皮，其荣华表现在毛发，其制约者是心。（肺属金，皮肤具有金的坚固特性，所以与皮相合；毛发得到皮肤的滋养，所以荣华于毛发。五脏中对应天象的是肺，所以肺主管皮毛。大凡万物的形体，外表必然坚固，正符合金的意象，所谓万物皆具太极之理。金受火的克制，所以肺以心为主宰制约者。）肝与胆相合于筋，其荣华表现在指甲，其制约者是肺。（肝属木，木性曲直而柔韧，筋的形态象征它，所以与筋相合。爪甲是筋的余气，所以荣华于爪甲。木受金的克制，所以肝以肺为主宰制约者。）脾与胃相合于肉，其荣华表现在口唇，其制约者是肝。（脾属土，肌肉象征地的形体，所以与肉相合。脾气通达于口唇，所以荣华于口唇。土受木的克制，所以脾以肝为主宰制约者。）肾与膀胱相合于骨，其荣华表现在头发，其制约者是脾。（肾属水，肾藏精，骨藏髓，精髓同类，所以肾与骨相合。头发是精血的余气，精髓充满，头发必然茂盛，所以荣华在头发。水受土的克制，所以肾以脾为主宰制约者。）因此，多吃咸味食物，则血脉凝涩而面色改变，（咸味从水化，水能克火，所以病变在心之脉与色。应禁食咸味。泣、涩同义。）多吃苦味食物则皮肤干枯而毛发脱落，（苦味从火化，火能克金，所以病变在肺之皮毛。应禁食苦味。）多吃辛味食物则筋脉拘急而指甲枯槁，（辛味从金化，金能克木，所以病变在肝之筋爪。应禁食辛味。）多吃酸味食物则肌肉厚硬如茧而口唇翻揭，（胝，指皮肤增厚，即手足老茧之意。酸味从木化，木能克土，所以病变在脾之肉与唇。应禁食酸味。胝，音支。 ，音绉。）多吃甘味食物则骨痛而头发脱落，这是五味过度所导致的损伤。（甘味从土化，土能克水，所以病变在肾之骨与发。应禁食甘味。）所以心喜苦味，（因为心合于火。）肺喜辛味，（因为肺合于金。）肝喜酸味，（因为肝合于木。）脾喜甘味，（因为脾合于土。）肾喜咸味，（因为肾合于水。）这是五味与五脏的对应关系，体现了五脏之气。（以上都是五味与五脏相合的道理。）凡是针刺的方法，必须首先以神为本。血脉、营气、精神，这是五脏所藏的东西。如果这些精气淫逸离脏，就会造成精失，魂魄飞扬，志意恍惚混乱，智虑离开身体。什么是德、气、生、精、神、魂、魄、心、意、志、思、智、虑呢？天赋予我们的是德，地赋予我们的是气，德流布、气交薄而产生了生命。（天地的大德叫做生。人生于地，命运系于天。阳先阴后，阳施予阴接受。肇始生命的德本乎天，形成形体的气本乎地。所以“天赋予我们的是德，地赋予我们的是气，德流布气交薄而产生生命”，是说理赋形全备，生成的道理就完备了。）所以生命的本源叫做精，（太极动而生阳，静而生阴。阴阳二气，各有其精。所谓精，是天以一生成水，地以六成之，成为五行中最先的。所以万物初生，其来皆源于水，如果核未实都是水，卵胎未成犹如水，即凡人的出生，以及昆虫草木，无不如此。男女媾精，万物化生，说的就是这个道理。）两精相互搏结叫做神，（两精，指阴阳之精。搏，指交接。阴阳二五之精，妙合而凝聚，万物生成的道理，无不经过阴阳交合而后神明显现。人的出生，必须结合阴阳之气，形神乃成。所以说侍奉神的人神会离去，休养神的人神会居住。那么凡修身养性的人，最上是养神，其次是养形。搏，音博。）随神往来叫做魂，并精而出入叫做魄，（精对神而言，则神为阳而精为阴；魄对魂而言，则魂为阳而魄为阴。所以魂随神而往来，魄并精而出入。）用来应对事物的叫做心，（心是君主之官，统摄神灵而参赞天地，所以万物都有其所在。）心有所回忆叫做意，（忆，即思忆。谓一念产生，心有所向而未定的状态叫忆。）意念所存留叫做志，（意念所存留，谓意志已决断且卓然有立的状态叫志。）根据意志而进行反复计度叫做思，（根据意志而进行反复计度，谓意志虽已定但又有反复考虑的情况叫思。）根据思而进行深远的谋划叫做虑，（深思远慕，必生忧疑，所以叫虑。）根据虑而处理事物叫做智。（疑虑既生，而处理得当的叫智。承接上述数者，各有所主的脏腑，现在都产生于心，这正是诸脏互相辅助而心作为主宰的缘故。）所以明智的人养生，必须顺应四时而适应寒暑，调和喜怒而安居处，节制阴阳而调畅刚柔，这样邪气就不会到来，能够长寿。（四时、寒暑、喜怒、居处都明显易懂，只有节阴阳、调刚柔，其意义最精深，其应用最广泛。凡饮食起居、疾病治疗、脉象药物，都有与此最密切且不可忽视的关系。）因此，惊恐思虑会伤神，神受伤则恐惧，精气流泄不止。（言情志所伤的害处。怵，是恐惧。惕，是惊骇。流淫，谓流泄淫溢。思虑兼加惊恐，则神伤而心怯，心怯则恐惧，恐惧则伤肾，肾伤则精不固。因为心肾不交，所以不能摄收如此。怵，出、恤二音。）因悲哀触动内心，会导致竭绝而丧失生机。（悲则气消。悲哀太甚则胞络断绝，所以导致丧失生机。竭是绝的渐进，绝则是尽绝无余。）喜乐过度则神气惮散而不内藏，（喜发于心，乐散于外。暴喜伤阳，所以神气惮散而不内藏。惮，惊惕也。）愁忧则气机闭塞而不行，（愁忧则气不能舒展，所以脉道为之闭塞。）盛怒则迷惑而昏乱不治，（怒则气逆，甚则必乱，所以导致昏迷惑乱而不治。不治，即乱也。）恐惧则神志荡散而不能收敛。（恐惧则神志惊散，所以荡散而不能收敛。上文说“不藏”，是神不能持守而流荡。这里说“不收”，是神因恐惧而散失。）心受惊恐思虑则伤神，神受伤则恐惧自失，肌肉破溃消瘦，毛发憔悴面色枯槁，死于冬季。（言情志所伤的病证，而死期各有定时。心藏神，神伤则心怯，所以恐惧自失。 者，筋肉结聚之处。心虚则脾弱，所以肌肉破溃消瘦。毛悴，是皮毛憔悴。色夭，是心之色赤欲如白裹朱，不欲如赭石色。火衰畏水，所以死于冬。后文仿此。 ，劬允切。）脾受愁忧不解则伤意，意受伤则思维混乱，四肢不能举动，毛发憔悴面色枯槁，死于春季。（忧本是肺之志，但也伤脾，是因为母子之气相通。忧则脾气不舒，不舒则不能运化，所以胸闷而乱。四肢都禀受胃气但不能直达经脉，必须依赖脾才能禀受。所以脾伤则四肢不能举动。脾色之夭，是土衰畏木，所以死于春。 ，美本切。）肝受悲哀触动内心则伤魂，魂受伤则狂妄健忘而不精明，不精明则行为不正，应当出现阴囊收缩而筋脉挛急，两胁骨骼不能举动，毛发憔悴面色枯槁，死于秋季。（肝藏魂。悲哀过甚则伤魂，魂伤则为狂、为忘而不精明，精明丧失则邪妄不正，其人当见阴缩挛筋，两胁骨不能举动者，都是肝经败坏的表现。肝色之夭，是木衰畏金，所以死于秋。）肺受喜乐无极则伤魄，魄受伤则狂，狂则目中无人。皮肤皮革焦枯，毛发憔悴面色枯槁，死于夏季。（喜本心之志，但也伤肺，是因为暴喜伤阳，火邪乘袭肺金。肺藏魄，魄伤则神乱而为狂。意不存人，是旁若无人。五脏之伤，无不毛悴，而这里独说“皮革焦”，是因为皮毛为肺之合，所以比其它脏更严重。肺色之夭，是金衰畏火，所以死于夏。）肾受盛怒不止则伤志，志受伤则喜欢忘记前言，腰脊不能俯仰屈伸，毛发憔悴面色枯槁，死于长夏。（怒本肝之志，但也伤肾，是因为肝肾为子母，其气相通。肾藏志，志伤则意失而善忘前言。腰脊不能俯仰屈伸者，腰为肾之府。肾色之夭，是水衰畏土，所以死于季夏。）恐惧不解则伤精，精受伤则骨痿厥冷，精液时常自行滑下。（这也是言心肾受伤。盖盛怒虽云伤肾，而恐惧则是肾脏的本志，恐则气下而陷，所以能伤精。肾主骨，所以精伤则骨 。痿，是阳之痿。厥，是阳之衰。命门不守则精时自下，这虽是肾脏受伤的病，与愁忧恐惧则伤心之义相同。 、酸同。）所以五脏是主藏精的，不可损伤，损伤则失守而阴虚，阴虚则无气，无气则死。（这是总结上文而言五脏各有其精，伤之则阴虚，因为五脏之精皆属阴。阴虚则无气，因为精能化气。气聚则生，气散则死，然而死生在气，而气本于精。年四十而阴气自半者，正是指这个阴字。）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。这五种精气如果受损，针不可以治疗。（用针者，必须察看病者的形态，以斟酌可刺不可刺。假如五脏精神已损，必不可妄用针。盖针能治有余，而不可治虚损。）肝藏血，血舍魂。肝气虚则恐，实则怒。（肝藏魂，人卧血归于肝。血有余则怒，不足则恐。）脾藏营，营舍意。脾气虚则四肢不用，五脏不安，实则腹胀大小便不利。（营出于中焦，受气取汁，变化而赤，是谓血。所以说“脾藏营，营舍意”，即脾藏意。脾虚则四肢不用，五脏不安，因为脾主四肢而脾为五脏之源。太阴脉入腹络胃，所以脾实则腹胀，泾溲不利。经，当作泾。溲，音搜。）心藏脉，脉舍神。心气虚则悲，实则笑不休。（心主脉，藏神。神有余则笑不休，神不足则悲。）肺藏气，气舍魄。肺气虚则鼻塞不利、少气，实则喘喝，胸盈，仰息。（喘喝，是气促声粗。胸盈，是胀满。仰息，是仰面而喘。肺藏魄，气有余则喘咳上气，不足则息利少气。）肾藏精，精舍志。肾气虚则厥，实则胀。（肾藏精舍志，志有余则腹胀飧泄，不足则厥。）五脏不安，必须审察五脏的病形，以知其气的虚实，谨慎地调治。（既然明了情志损伤，仅分五脏虚实。凡五脏有不安者，必须审其病形虚实、情志所属，方可随其脏以调之。）气口独为五脏之主。（气口的含义，其名有三：手太阴肺经脉也，肺主诸气，气的盛衰见于此处，所以叫气口；肺朝百脉，脉之大会聚于此，所以叫脉口；脉出太渊，其长一寸九分，所以叫寸口。名虽三而实为一。五脏六腑的气味皆出于胃，变见于气口，所以为五脏之主，这是统两手而言，并非独指右手为气口。因为它是脉之大会，五脏六腑之所终始，所以取法于此。不要执着左脉强为外感而攻其表，右脉盛为内伤而攻其里。人的脏气有不齐，脉候有禀赋，或左脉素大于右，或右脉素大于左，哪一个是常，哪一个是变？或在偏弱中略见有力，已是隐伏的虚中之实；或在偏盛中稍觉无神，便是实中之虚。假如不知此理，执着左右以分表里，难道左边无里证而右边无表证吗？夫人迎是足阳明之脉，不可以言于手，气口总手太阴而言，不可以分左右。三阳在头，人迎行气于三阳；三阴在手，脉口行气于三阴。所以诊法有三：一取三部九候，以诊通身之脉；一取太阴、阳明，以诊阴阳之本；一取左右气口，以诊脏腑之气。则人迎自有其位，在结喉两旁，是足阳明之脉。说左手关前一分为人迎，是错误的。）胃是水谷之海，六腑的大源。五味入口藏于胃，以滋养五脏气。气口也是太阴。所以五脏六腑的气味皆出于胃，变见于气口。（人有四海而胃居其一，是为水谷之海，六腑之本，又为五脏六腑之海。气口本属太阴，而脾也是太阴，为什么呢？盖气口属肺，是手太阴；布行胃气，则在于脾，是足太阴。胃气必归于脾，脾气必归于肺，而后行于脏腑营卫，所以气口虽为手太阴，而实即足太阴之所归，所以说“气口亦太阴”也。所以五脏六腑的气味皆出于胃而变见于气口，故胃为脏腑之大源，无不由脾达肺。见，音现。）所以五气入鼻，藏于心肺。心肺有病，而鼻为之不利。（气味之化，在天为气，在地为味。五味入口，藏于胃者，味为阴。五气入鼻，藏于心肺者，气为阳。鼻为肺之窍，所以心肺有病而鼻为之不利。）凡治病必须察其二便，测其脉象，观其志意与其病情。（这是治病的四个要点。“下”指二阴，二阴是肾之窍，胃之关。仓廪不藏者，是门户不固。得守者生，失守者死。所以二便是胃气之关锁而系一生元气之安危，此“下”之不可不察。适，测也。脉为气血之先，所以独取寸口以决吉凶之兆。人无胃气曰逆，逆者死；脉无胃气亦死，此脉之不可不察。志意和则精神专直，魂魄不散，悔怒不起，五脏不受邪。是志意关乎神气而存亡系之，此志意之不可不察。病有标本，不知求本则失其要。病有真假，不知逆从则及于祸。此病因之不可不察。合是四者而会观之，则治病之妙，无遗法矣。）拘泥于鬼神的人，不可以与他谈论至高医德；厌恶针石的人，不可以与他谈论高超技巧；病人不允许治疗的，病必定治不好，治疗也无功效了。
食气进入胃，将精华散布于肝，浸淫滋养于筋。（精，是食气的精华。肝主筋，所以胃散谷气于肝则浸淫滋养于筋。）食气进入胃，浊气归于心，精气浸淫于脉。（浊，言食气之浓稠者。受谷者浊，受气者清。心主血脉，所以食气归心则精气浸淫于脉。）脉气流经，经气归于肺，肺朝百脉，输精于皮毛。（精淫于脉，脉流于经，经脉流通，必由于气。气主于肺，为百脉之朝会。毛为肺之合，所以肺精输焉。）毛脉合精，行气于府。（肺主毛，心主脉，肺藏气，心生血，一气一血，称为父母，二脏独占胸中，所以说“毛脉合精，行气于府”。府，是气聚之府，这叫气海，也叫膻中。）府中精气神明，留于四脏，气归于权衡。（宗气积于肺，神明出于心。气盛则神王，所以气府之精为神明。神王则脏安，所以肺、肝、脾、肾四脏，无不赖神明之留以为主宰，然后脏气咸得其平而归于权衡。权衡，即平也。）权衡以平，气口成寸，以此决死生。（脏腑之气既得其平，则必变见于气口而成寸尺，可于此以决生死。上文说“食气入胃”，下文说“饮入于胃”。）饮入于胃，游溢精气，上输于脾，脾气散精，上归于肺。（游，浮游也。溢，涌溢也。水饮入胃，则其气化精微，必先输运于脾，这叫“中焦如沤”。脾乃散气，上如云雾而归于肺，这叫“上焦如雾”。）通调水道，下输膀胱，（肺气运
Therefore, it is said to "model after Heaven and Earth." Earth is the root of all things; the Spleen and Stomach are the foundation of the Zang-Fu organs. Thus, its influence extends from the head to the feet, leaving no area untouched, and how could it be limited to governing only one season? Hence, the Qi of Earth (Tu) cannot be absent for a single day in any of the four seasons or five Zang organs. The Heart corresponds to the Mai (Blood Vessels), its flourishing aspect manifests in the complexion, and it is controlled by the Kidney. (The Heart generates Blood, which flows within the Mai; thus, it corresponds to the Mai. The brilliance of Blood reflects in the countenance, hence its flourishing aspect is in the complexion. The Heart belongs to Fire and is restrained by Water; therefore, the Kidney acts as its controlling organ.) The Lung corresponds to the Pi (Skin), its flourishing aspect manifests in the hair, and it is controlled by the Heart. (The Lung belongs to Metal; the skin possesses the firmness characteristic of Metal, thus corresponding to the Pi. The hair receives nourishment from the skin, hence its flourishing aspect is in the hair. Among the five Zang organs, the Lung corresponds to Heaven; thus, the Lung governs the skin and hair. Generally, the exterior of all things must be firm, conforming to the image of Metal, as stated: "Each thing contains a Taiji." Metal is restrained by Fire; therefore, the Heart acts as the controlling organ for the Lung.) The Liver corresponds to the Jin (Tendons), its flourishing aspect manifests in the nails, and it is controlled by the Lung. (The Liver belongs to Wood; Wood is flexible and straight, mirroring the nature of Jin; thus, it corresponds to the Jin. Nails are the surplus of the Tendons, hence their flourishing aspect is in the nails. Wood is restrained by Metal; therefore, the Lung acts as the controlling organ for the Liver.) The Spleen corresponds to the Rou (Muscles), its flourishing aspect manifests in the lips, and it is controlled by the Liver. (The Spleen belongs to Earth; muscles mirror the form of Earth, thus corresponding to the Rou. The Qi of the Spleen connects to the lips, hence its flourishing aspect is in the lips. Earth is restrained by Wood; therefore, the Liver acts as the controlling organ for the Spleen.) The Kidney corresponds to the Gu (Bones), its flourishing aspect manifests in the hair, and it is controlled by the Spleen. (The Kidney belongs to Water; the Kidney stores Jing (Essence), and bones store Marrow. Essence and Marrow are of the same category, thus the Kidney corresponds to the Bones. Hair is the surplus of Essence and Blood; when Essence and Marrow are full, the hair flourishes, hence its flourishing aspect is in the hair. Water is restrained by Earth; therefore, the Spleen acts as the controlling organ for the Kidney.) Therefore, excessive consumption of salty taste leads to coagulation and stagnation of the Mai with changes in complexion. (Salty taste transforms into Water; Water can overcome Fire, thus pathology affects the Heart's Mai and complexion. Salty taste should be prohibited. 'Qi' and 'Se' share the same meaning here.) Excessive consumption of bitter taste leads to dry, shriveled skin and falling hair. (Bitter taste transforms into Fire; Fire can overcome Metal, thus pathology affects the Lung's skin and hair. Bitter taste should be prohibited.) Excessive consumption of pungent taste leads to tight tendons and withered nails. (Pungent taste transforms into Metal; Metal can overcome Wood, thus pathology affects the Liver's tendons and nails. Pungent taste should be prohibited.) Excessive consumption of sour taste leads to calloused flesh and peeling lips. ('Zhi' refers to thickened skin, i.e., corns on hands and feet. Sour taste transforms into Wood; Wood can overcome Earth, thus pathology affects the Spleen's flesh and lips. Sour taste should be prohibited.) Excessive consumption of sweet taste leads to bone pain and falling hair; this is the injury caused by the five tastes. (Sweet taste transforms into Earth; Earth can overcome Water, thus pathology affects the Kidney's bones and hair. Sweet taste should be prohibited.) Thus, the Heart desires bitter taste (corresponding to Fire), the Lung desires pungent taste (corresponding to Metal), the Liver desires sour taste (corresponding to Wood), the Spleen desires sweet taste (corresponding to Earth), and the Kidney desires salty taste (corresponding to Water). These are the correspondences of the five tastes to the five Zang organs, reflecting the Qi of the five Zang organs. (All these describe the correspondence of the five tastes to the five Zang organs.) In all acupuncture methods, one must first base oneself on Shen (Spirit). The Mai, Ying (Nutritive) Qi, and Jing Shen are stored within the five Zang organs. If these essences become excessive and leave the Zang organs, Jing is lost, Hun and Po fly away, Zhi and Yi become confused, and Zhi Lv departs from the body. What are De, Qi, Sheng, Jing, Shen, Hun, Po, Xin, Yi, Zhi, Si, Zhi, and Lv? De given by Heaven, Qi given by Earth; life arises from the flow of De and the interaction of Qi. (The great virtue of Heaven and Earth is Life. Humans are born from Earth, and their fate hangs from Heaven. Yang precedes Yin; Yang gives, Yin receives. The virtue initiating life originates from Heaven, while the Qi forming the body originates from Earth. Thus, "De given by Heaven, Qi given by Earth, life arising from the flow of De and interaction of Qi" means that when principle endows form completely, the way of generation is fully prepared.) Therefore, what comes with life is called Jing. (Taiji moves to generate Yang, stillness to generate Yin. Yin and Yang Qi each have their Jing. The so-called Jing is generated when Heaven creates One to produce Water, and Earth completes it with Six, becoming the first of the Five Elements. Thus, when all things are born, they originate from Water; even if seeds are not yet solid, they contain water; even if eggs or fetuses are not yet formed, they are like water. This applies to human birth, insects, plants, and trees alike. When male and female essence unite, all things are transformed and born; this is what is meant.) The mutual struggle of two Jings is called Shen. (The two Jings refer to the essence of Yin and Yang. 'Bo' means intersection. The essence of Yin, Yang, and the Five Elements subtly combine and condense; the way of generating all things requires Yin-Yang interaction before Shen Ming appears. Human birth requires the combination of Yin-Yang Qi for Xing (Form) and Shen to form. Thus, it is said: "Those who serve Shen lose it; those who rest Shen keep it." Therefore, for self-cultivation, the highest is nourishing Shen, followed by nourishing Xing. 'Bo', pronounced Bo.) That which accompanies Shen and comes and goes is called Hun. (Jing compared to Shen makes Shen Yang and Jing Yin; Po compared to Hun makes Hun Yang and Po Yin. Thus, Hun follows Shen in coming and going, while Po enters and exits with Jing.) That which handles external objects is called Xin. (The Heart is the official of the Sovereign, commanding Shen Ling and participating in Heaven and Earth; thus, all things have their place.) Memory of the mind is called Yi. ('Yi' means recollection. When a thought arises and the mind has a direction but is not fixed, it is called Yi.) What remains of Yi is called Zhi. (What remains of Yi, where the will is decided and firmly established, is called Zhi.) Considering changes based on Zhi is called Si. (Considering changes based on Zhi, where the will is set but there is repeated calculation, is called Si.) Far-reaching contemplation based on Si is called Lv. (Deep thinking and far-reaching admiration inevitably generate worry and doubt, hence called Lv.) Handling matters based on Lv is called Zhi. (When doubts arise and handling is appropriate, it is called Zhi. Connecting these several aspects, each has its governing Zang organ, but now they all arise from the Heart; this is precisely because the various Zang organs assist each other, with the Heart acting as the master.) Therefore, the wise person in nurturing life must adapt to the four seasons and accommodate cold and heat, harmonize joy and anger, and live in peace; regulate Yin and Yang and adjust Gang and Rou. In this way, Bi Xie (pathogenic factors) will not arrive, and one can live long and see clearly. (The four seasons, cold and heat, joy and anger, and dwelling are obvious and easy to understand; only regulating Yin and Yang and adjusting Gang and Rou are most profound in meaning and broad in application. All eating, breathing, daily life, disease treatment, pulse, and medicine have the closest connection to this and cannot be ignored.) Thus, fear and anxiety injure Shen; when Shen is injured, there is fear, and fluids leak without stopping. (This describes the harm of emotional injury. 'Chu' is fear; 'Ti' is alarm. 'Liu Yin' means leaking and overflowing. Anxiety combined with fear injures Shen and weakens the Heart; a weak Heart causes fear; fear injures the Kidney; an injured Kidney fails to secure Jing. Because Heart and Kidney do not interact, they cannot retain thus. 'Chu' is pronounced Chu or Xu.) Sorrow and grief moving the interior lead to exhaustion and loss of life. (Grief consumes Qi. Excessive grief severs the Bao Luo, leading to loss of life. 'Jie' is the gradual stage of 'Jue'; 'Jue' means complete extinction.) Excessive joy causes Shen to scatter and fail to be stored. (Joy originates in the Heart; pleasure disperses outward. Violent joy injures Yang, causing Shen Qi to scatter and fail to be stored. 'Dan' means alarm.) Worry and sorrow cause Qi to block and fail to circulate. (Worry and sorrow prevent Qi from relaxing, causing the Mai Dao to become blocked.) Extreme anger causes confusion and disorder. (Anger causes Qi to reverse; severely, it causes chaos, leading to coma and confusion. 'Bu Zhi' means disorder.) Fear causes Shen to荡散 (scatter) and fail to gather. (Fear causes Shen Zhi to startle and scatter, thus failing to gather. The previous text said "not stored," meaning Shen cannot hold and flows; here it says "not gathered," meaning Shen scatters due to fear.) If the Heart suffers from fear and anxiety, Shen is injured; when Shen is injured, there is fear and self-loss; muscles break down and waste away; hair becomes brittle and complexion fades; death occurs in Winter. (This describes diseases from emotional injury, with death occurring at specific times. The Heart stores Shen; Shen injury causes Heart weakness, leading to fear and self-loss. 'Qu' refers to areas where muscles and sinews cluster. Heart deficiency leads to Spleen weakness, causing muscle breakdown. 'Mao Cui' means hair and skin are withered. 'Se Yao' means the Heart's color should be red like white-wrapped cinnabar, not like hematite. Fire fears Water, hence death in Winter. The following cases follow this pattern. 'Qu', pronounced Qu Yun.) If the Spleen suffers from unresolved worry, Yi is injured; when Yi is injured, thoughts become chaotic, limbs cannot move, hair becomes brittle and complexion fades; death occurs in Spring. (Worry is originally the Zhi of the Lung but also injures the Spleen because Mother and Child Qi connect. Worry prevents Spleen Qi from relaxing; if not relaxed, it cannot transport, causing chest stuffiness and chaos. The four limbs receive Qi from the Stomach but cannot reach the meridians directly; they must rely on the Spleen to receive it. Thus, Spleen injury leads to immobility of the four limbs. The fading of Spleen color indicates Earth deficiency fearing Wood, hence death in Spring. 'Mei', pronounced Mei Ben.) If the Liver suffers from sorrow and grief moving the interior, Hun is injured; when Hun is injured, there is mania and forgetfulness lacking clarity; lacking clarity leads to impropriety; the person experiences yin contraction and tendon cramping, inability to lift the costal bones, hair becomes brittle and complexion fades; death occurs in Autumn. (The Liver stores Hun. Excessive grief injures Hun; Hun injury leads to mania and forgetfulness lacking clarity; loss of clarity leads to evil and impropriety. The person experiences yin contraction and tendon cramping; inability to lift the costal bones are all signs of Liver Meridian failure. The fading of Liver color indicates Wood deficiency fearing Metal, hence death in Autumn.) If the Lung suffers from endless joy, Po is injured; when Po is injured, there is mania; in mania, one ignores others. Skin and leather become scorched, hair brittle, complexion fades; death occurs in Summer. (Joy is originally the Zhi of the Heart but also injures the Lung because violent joy injures Yang, and Fire pathogen attacks Metal. The Lung stores Po; Po injury causes Shen chaos leading to mania. 'Yi Bu Cun Ren' means ignoring others. Injury to the five Zang organs all causes hair withering, but here it specifically mentions "skin and leather scorched" because skin and hair are the correspondence of the Lung, making it more severe than others. The fading of Lung color indicates Metal deficiency fearing Fire, hence death in Summer.) If the Kidney suffers from unceasing extreme anger, Zhi is injured; when Zhi is injured, one frequently forgets previous words, waist and spine cannot bend or stretch, hair becomes brittle and complexion fades; death occurs in Late Summer. (Anger is originally the Zhi of the Liver but also injures the Kidney because Liver and Kidney are Mother and Child, and their Qi connects. The Kidney stores Zhi; Zhi injury causes loss of Yi and forgetfulness. Inability to bend/stretch waist and spine occurs because the waist is the mansion of the Kidney. The fading of Kidney color indicates Water deficiency fearing Earth, hence death in Late Summer.) Unresolved fear injures Jing; when Jing is injured, there is bone Wei (atrophy) and Jue (cold extremities), and Jing spontaneously leaks. (This also discusses Heart and Kidney injury. Although extreme anger is said to injure the Kidney, fear is the original Zhi of the Kidney; fear causes Qi to sink and descend, thus injuring Jing. The Kidney governs bones; thus, Jing injury leads to bone issues. 'Wei' is Yang atrophy; 'Jue' is Yang decline. If the Ming Men does not guard, Jing leaks spontaneously. Although this is a disease of Kidney injury, it shares the same meaning as worry and grief injuring the Heart. 'Su', same as 'Suan'.) Therefore, the five Zang organs are primarily responsible for storing Jing; they 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. (This summarizes the preceding text: each Zang organ has its Jing; injuring it leads to Yin deficiency, as the Jing of the five Zang organs is all Yin. Yin deficiency leads to lack of Qi because Jing can transform into Qi. Qi gathering brings life; Qi scattering brings death. Thus, life and death depend on Qi, and Qi originates from Jing. When one reaches forty and Yin Qi is halved, this refers to this Yin.) Acupuncturists must observe the patient's state to know the existence, loss, gain, or loss of Jing, Shen, Hun, and Po. If these five are injured, acupuncture cannot treat them. (Acupuncturists must examine the patient's morphology to decide whether to puncture. If the Jing and Shen of the five Zang organs are damaged, acupuncture must not be used recklessly. Acupuncture treats excess but cannot treat deficiency.) The Liver stores Blood, and Blood houses Hun. Liver Qi deficiency causes fear; excess causes anger. (The Liver stores Hun; when humans sleep, Blood returns to the Liver. Blood excess causes anger; deficiency causes fear.) The Spleen stores Ying, and Ying houses Yi. Spleen Qi deficiency causes limb paralysis and Zang-Fu unrest; excess causes abdominal distension and difficult urination/defecation. (Ying emerges from the Middle Jiao, receiving Qi and extracting juice, transforming into red Blood. Thus, it is said "The Spleen stores Ying, Ying houses Yi," meaning the Spleen stores Yi. Spleen deficiency causes limb paralysis and Zang-Fu unrest because the Spleen governs the limbs and is the source of the five Zang organs. The Taiyin Meridian enters the abdomen and connects to the Stomach; thus, Spleen excess causes abdominal distension and difficult Jing/Sou passage. 'Jing' should be read as 'Jing'. 'Sou', pronounced Sou.) The Heart stores Mai, and Mai houses Shen. Heart Qi deficiency causes sadness; excess causes incessant laughter. (The Heart governs Mai and stores Shen. Shen excess causes incessant laughter; deficiency causes sadness.) The Lung stores Qi, and Qi houses Po. Lung Qi deficiency causes nasal congestion, difficulty breathing, and shortness of breath; excess causes panting and roaring, chest fullness, and仰息 (breathing with head tilted back). ('Chuan He' means rapid breathing and coarse sound. 'Xiong Ying' means fullness. 'Yang Xi' means breathing with head tilted back. The Lung stores Po; Qi excess causes panting, coughing, and upward rushing Qi; deficiency causes clear breathing but shortness of breath.) The Kidney stores Jing, and Jing houses Zhi. Kidney Qi deficiency causes Jue; excess causes distension. (The Kidney stores Jing and houses Zhi; Zhi excess causes abdominal distension and undigested stool diarrhea; deficiency causes Jue.) When the five Zang organs are uneasy, one must carefully examine the pathological forms of the five Zang organs to know the deficiency or excess of their Qi and regulate them cautiously. (Having clarified emotional injuries and divided Zang deficiency/excess, for any Zang organ unrest, one must examine the pathological form, deficiency/excess, and associated emotions to regulate according to the Zang.) The Qi Kou (Radial Pulse) alone is the master of the five Zang organs. (The meaning of Qi Kou has three names: It is the Hand Taiyin Lung Meridian; the Lung governs all Qi, and the abundance or scarcity of Qi is seen here, hence called Qi Kou; the Lung faces all Mai, and the great gathering of Mai is here, hence called Mai Kou; the Mai emerges from Taiyuan, measuring one inch and nine fen, hence called Cun Kou. Though named three ways, they are essentially one. The Qi and Wei of the six Fu and five Zang organs all emerge from the Stomach and manifest at the Qi Kou, thus it is the master of the five Zang organs. This refers to both hands collectively, not just the right hand. Because it is the great gathering of Mai and the beginning and end of the Zang-Fu organs, it is taken as the standard. Do not rigidly assume left pulse strength indicates exterior excess attacking the surface, or right pulse strength indicates interior injury attacking the interior. Organ Qi varies, and pulse constitution varies; some have naturally stronger left pulses, others stronger right pulses. Which is normal, which is abnormal? A slight strength in a weak pulse may hide excess within deficiency; a slight lack of Shen in a strong pulse may indicate deficiency within excess. If one does not understand this and rigidly divides exterior/interior by left/right, does the left have no interior and the right no exterior? Renying is the Foot Yangming Meridian, not applicable to the hand. Qi Kou generally refers to the Hand Taiyin, not divisible into left/right. Three Yang are in the head; Renying circulates Qi in the Three Yang. Three Yin are in the hand; Maikou circulates Qi in the Three Yin. Thus, there are three diagnostic methods: 1. Take Sanbu Jiuhou to diagnose whole-body Mai; 2. Take Taiyin and Yangming to diagnose the root of Yin and Yang; 3. Take left and right Qi Kou to diagnose Zang-Fu Qi. Then Renying has its own position, beside the Adam's apple, being the Foot Yangming Meridian. Saying the left hand Guan front一分 is Renying is incorrect.) The Stomach is the Sea of Water and Grain, the great source of the six Fu organs. The five tastes enter the mouth and are stored in the Stomach to nourish the Qi of the five Zang organs. The Qi Kou is also Taiyin. Therefore, the Qi and Wei of the five Zang and six Fu organs all emerge from the Stomach and manifest at the Qi Kou. (Humans have four Seas, and the Stomach is one of them, being the Sea of Water and Grain, the root of the six Fu organs, and the sea of the five Zang and six Fu organs. Qi Kou originally belongs to Taiyin, and the Spleen is also Taiyin; why? Qi Kou belongs to the Lung, which is Hand Taiyin; distributing Stomach Qi lies with the Spleen, which is Foot Taiyin. Stomach Qi must return to the Spleen, and Spleen Qi must return to the Lung, before circulating to the Zang-Fu organs and Ying-Wei. Thus, although Qi Kou is Hand Taiyin, it is actually the destination of Foot Taiyin, hence "Qi Kou is also Taiyin." Therefore, the Qi and Wei of the five Zang and six Fu organs all emerge from the Stomach and manifest at the Qi Kou; thus, the Stomach is the great source of the Zang-Fu organs, nothing bypassing the Spleen reaching the Lung. 'Jian', pronounced Xian.) Thus, the five Qi enter the nose and are stored in the Heart and Lung. If the Heart and Lung are diseased, the nose becomes obstructed. (The transformation of Qi and Wei: in Heaven it is Qi, in Earth it is Wei. The five tastes entering the mouth and stored in the Stomach are Wei, which is Yin. The five Qi entering the nose and stored in the Heart and Lung are Qi, which is Yang. The nose is the orifice of the Lung; thus, Heart and Lung disease causes nasal obstruction.) In treating diseases, one must always examine the lower orifices, measure the pulse, observe the Zhi Yi (will/intention), and the disease itself. (These are the four essentials of treatment. "Lower" refers to the two Yin orifices; the two Yin are the orifice of the Kidney and the gate of the Stomach. If the granary cannot be stored, the gates are not secure. Those who maintain security live; those who lose it die. Thus, the two excretions are the lock of Stomach Qi and determine the safety of the primordial Qi; this is why "the lower" must not be neglected. 'Shi' means measure. The pulse is the precursor of Qi and Blood; thus, taking only the Cun Kou determines omens of fortune and misfortune. Humans without Stomach Qi are termed Ni (Rebellious); Ni leads to death. Pulses without Stomach Qi also die; this is why the pulse must not be neglected. Harmonious Zhi Yi leads to focused Spirit, unscattered Hun and Po, no regret or anger, and protection from Zang pathogens. Thus, Zhi Yi concerns Shen Qi and determines survival; this is why Zhi Yi must not be neglected. Diseases have root and branch; not seeking the root loses the essence. Diseases have true and false; not knowing reversal and adherence leads to disaster. This is why the etiology must not be neglected. Combining these four for observation, the subtleties of treatment are complete without omission.) One constrained by ghosts and spirits cannot be spoken to regarding supreme Virtue; one who dislikes needles and stones cannot be spoken to regarding supreme skill; a patient who does not permit treatment will certainly not be cured, and treatment will be ineffective.
Food Qi entering the Stomach scatters its essence to the Liver, permeating the Tendons. (Jing is the essence of food Qi. The Liver governs Tendons; thus, the Stomach scatters grain Qi to the Liver, which then permeates and nourishes the Tendons.) Food Qi entering the Stomach sends turbid Qi to the Heart, permeating the essence into the Mai. ('Zhuo' refers to the dense nature of food Qi. Receiving grain is Zhuo; receiving Qi is Qing. The Heart governs Blood and Mai; thus, food Qi returning to the Heart permeates essence into the Mai.) Mai Qi flows through the Jing (Primary) Meridians, and Jing Qi returns to the Lung; the Lung faces all Mai, transmitting essence to the skin and hair. (Essence permeates the Mai, Mai flows through the Jing, and Mai-Jing circulation depends on Qi. Qi is governed by the Lung, the gathering of all Mai. Hair is the correspondence of the Lung; thus, Lung essence is transmitted there.) Skin and Mai combine their essence, circulating Qi to the Fu. (The Lung governs skin, the Heart governs Mai; the Lung stores Qi, the Heart generates Blood. One Qi, one Blood, called Parents; these two Zang organs occupy the Chest exclusively; thus, "Skin and Mai combine essence, circulating Qi to the Fu." Fu here means the residence of Qi gathering, called Qi Hai, also known as Dan Zhong.) The essence and Shen Ming of the Fu remain in the four Zang organs, and Qi returns to equilibrium. (Zong Qi accumulates in the Lung, Shen Ming emerges from the Heart. Abundant Qi leads to vigorous Shen; thus, the essence of the Qi Fu is Shen Ming. Vigorous Shen ensures Zang peace; thus, the Lung, Liver, Spleen, and Kidney all rely on the retention of Shen Ming as their master, allowing Zang Qi to achieve balance and return to equilibrium. 'Quan Heng' means balance.) With equilibrium achieved, the Qi Kou forms the Cun measurement, determining life and death. (When Zang-Fu Qi achieves balance, it manifests at the Qi Kou as Cun and Chi, allowing determination of life and death here. The above mentioned "Food Qi entering the Stomach"; the below mentions "Drinking entering the Stomach".) Drinking entering the Stomach floats and overflows with essence and Qi, transporting upwards to the Spleen; the Spleen scatters essence, returning it upwards to the Lung. ('You' means floating; 'Yi' means surging. When water drinks enter the Stomach, their Qi transforms into subtle essence, which must first be transported to the Spleen, called "Middle Jiao like a fermenting vat." The Spleen then scatters Qi, rising like mist to return to the Lung, called "Upper Jiao like a mist.") Regulating the water pathways, transporting downwards to the Bladder, (Lung Qi transports