人之肥瘦大小寒温，有老壮少小之别。人年五十以上为老，二十以上为壮，十八以下为少，六岁以下为小。
有肥，有膏，有肉── 肉坚，皮满者肥； 肉不坚，皮缓者膏；皮肉不相离者肉。（ 肉，肉之聚处也。
此言伟壮之人，而有脂、膏、肉三者之异。）膏者其肉淖，而粗理者身寒，细理者身热；脂者其
肉坚，细理者热，粗理者寒。（淖，柔而润也。膏者肉淖，脂者肉坚，若其寒热，则粗理者皆寒，细理者
皆热。淖，音闹。）膏者多气而皮纵缓，故能纵腹垂腴，肉者身体容大，脂者其身收小。
（纵，宽纵也。腴，脂肥也。膏者纵腹垂腴，脂者其身收小，是膏肥于脂也。肉为皮肉连实，自与脂、膏者有
间。纵，去声。腴，音俞。）膏者多气，多气者热，热者耐寒；肉者多血则充形，充形则平；脂
者其，血清，气滑少，故不能大。此别于众人者也。（膏者多气，气为阳，故质热而耐寒也；肉者多血，血养
形，故形充而气质平也；脂者血清，而气滑少，故不能大。若此三者，虽肥盛皆别于众人，而脂者之气
血，似不及乎膏、肉也。肥白之人多气虚，苍瘦之气虚者、固不减于肥白，是不可泥也。）众人皮、肉、
脂、膏不能相加也。血与气不
能相多，故其形不小不大，各自称其身，命曰“众人”。（众人者，言三者之外众多之常人也。其皮、肉、
脂、膏、血、气各有品格，故不能相加，亦不能相多，而形体大小皆相称而已。）必先别其三形，血
之多少，气之清浊，而后调之，治无失常经也。（三形既定，血气既明，则宜补宜泻，自可勿失常经矣。）
十二经脉，以应十二经水，清浊不同。（经脉经水，各有清、浊之异。）受谷者浊，受气者清。（
人身之气有二，浊气者，谷气也，故曰“受谷者浊”；清气者，天气也，故曰“受气者清”。二者总称真气，
所受于天者，与谷气并而充身也。天地之精气，其大数常出三入一，故谷不入半日则气衰，一日则气少矣。
是又入者为天气，出者为谷气也。）清者注阴，浊者注阳。（喉主天气，故清气自喉而注阴，阴者五脏也；咽
主地气，故浊气自咽而注阳，阳者六腑也。）浊而清者上出于咽，清而浊者则下行。清浊相干，命曰乱
气。（浊之清者自内而出，故上行；清之浊者自外而入，故下行。一上一下，气必交并，二者相合，一有不
正，则乱气出乎其中矣。）夫阴清而阳浊，浊者有清，清者有浊。气之大别，清者上注于肺，浊者下
走于胃。胃之清气上出于口，肺之浊气下注于经，内积于海。（大别，言大概之分别也。清者上升，故
注于肺；浊者下降，故走于胃。然而浊中有清，故胃之清气上出于口，以通呼吸津液；清中有浊，故肺之浊
气下注于经，以为血脉营卫，而其积气之所，乃在气海间也。上气海在膻中，下气海在丹田。）诸阳皆浊，
手太阳独受阳之浊，手太阴独受阴之清。（手太阳，小肠也。小肠居胃之下，承受胃中水谷，清浊未
分，秽污所出，虽诸阳皆浊，而此其浊之浊者也，故曰“独受阳之浊”。手太阴，肺也。肺者，五脏六
腑之盖也，为清气之所注，虽诸阴皆清，而此其清之清者也，故曰“独受阴之清”。）诸阴皆清，足太阴独受
其浊。（足太阴，脾也。胃司受纳水谷，而脾受其气以为运化，所以独受其浊，而为“清中之浊”
也。）清者其气滑，浊者其气涩，此气之常也。故
刺阴者，深而留之；刺阳者，浅而疾之；清浊相干者，以数调之也。（此以针下之气言清、浊、阴、阳也。清
者气滑，针利于速；浊者气涩，针利于迟；阴者在里，故宜深而留之；阳者在表，故宜浅而疾
之。其或清中有浊，浊中有清，乃为清浊相干，当察其孰微孰甚，而酌其数以调之也。）首面与身，属骨连
筋，同血合气。天寒地裂，手足懈惰，其面不衣。（人之头面身形，本同一气。严寒地裂，肢体凛
栗，面独不惧。）盖十二经脉、三百六十五络，其血气皆上于面而走空窍。（头面为人之首，凡周身阴阳经
络无所不聚，故其血气皆上行于面而走诸窍。空、孔同。）其精阳气上走于目而为睛，（精阳气者，
阳气之精华也。五脏六腑之精气皆上注于目而为之精。）其别气走于耳而为听，（别气者，旁行之气也。气
自两侧上行于耳，气达则窍聪，所以能听。）其宗气上出于鼻而为臭，（宗气，大气也。宗气积于胸中，上
通于鼻而行呼吸，所以能臭。）其浊气出于胃，走唇舌而为味，（浊气，谷气也。谷入于胃，气达于唇舌，
所以知味。）其气之津液皆上熏于面，（凡诸气之津液，皆上熏于面∶肺气通于鼻，心气通于舌，肝气
通于目，脾气通于口，肾气通于耳。此五脏之气，皆上通乎七窍，不独诸阳经络乃得上头也。）而皮又浓，
其肉坚，故天气甚寒，不能胜之也。（一身血气，既皆聚于头面，故其皮浓肉坚，异于他处，而寒气不
能胜之也。盖头为诸阳之会，言为阳聚之处，非曰无阴也，如伤寒止言足经，而手在其中，非无手经也。
十二经脉，三百六十五络，其血气皆上于面而走空窍，其义明矣。手少阴上挟咽，走喉咙，系舌本，出于面，
系目系，合目内 。手厥阴循喉咙，出耳后，合少阳完骨之下。手足太阴、少阴，皆会于耳中，上络左角。
手太阴循喉咙，足少阴循喉咙，系舌本，上至项，结于枕骨，与足太阳之筋合。足太阴合于阳明上行，结
于咽，连舌本。支者结舌本，贯舌中，散舌下。足厥阴循喉咙之后，上入颃颡，络于
舌本，连目系，上出额，与督脉会于巅，其支者从目系下颊里，环唇内。）
人有并行并立，年之长少等，衣之浓薄均，卒遇烈风豪雨，或病或不病，或皆病，或皆不病。（卒，音猝。）
少俞曰∶春青风，夏阳风，秋凉风，冬寒风，此四时之风者，其所病各不同形∶（四时之风，各有所王。
有所王则有所制，故其所病各不同形也。）黄色薄皮弱肉者，不胜春之虚风；（黄者，土之色。黄色薄皮弱肉
者，脾气不足也，故不胜春木之虚风。虚风，虚邪贼风也。）白色薄皮弱肉者，不胜夏之虚风；（白者，金
之色，白色薄皮弱肉者，肺气不足也，故不胜夏火之虚风。）青色薄皮弱肉者，不胜秋之虚风；
（青者，木之色。青色薄皮弱肉者，肝气不足也，故不胜秋金之虚风。）赤色薄皮弱肉者，不胜冬之虚风也。
（赤色，火之色。赤色薄皮弱肉者，心气不足也，故不胜冬水之虚风。）黑色而皮浓肉坚，固不伤于
四时之风，其皮薄而肉不坚、色不一者，长夏至而有虚风者病矣。（黑者，水之色。黑色而皮薄肉不坚，及色
时变而不一者，肾气不足也，故不胜长夏土令之虚风。）其皮浓而肌肉坚者，长夏至而有虚风不病矣；其皮
浓而肌肉坚者，必重感于寒，外内皆然乃病。（若黑色而皮浓肉坚者，虽遇长夏之虚风，亦不能病。但既感
于风，又感于寒，是为重感，既伤于内，又伤于外，是为外内俱伤，乃不免于病也。然则黑色而皮肉坚者，诚
有异于他色之薄弱易病者矣。）人之忍痛与不忍痛者，皮肤之薄、浓，肌肉之坚脆、缓急之分，非勇怯
之谓也。（此性质之当辨也。）勇者目深以固，长衡直扬，三焦理横，其心端直，其肝大以坚，其胆满以旁；
怒则气盛而胸张，肝举而胆横， 裂而目扬，毛起而面苍。（目者，五脏六腑之精也，目深以固，脏气之坚
也。长衡，阔大也，即从衡之意。直扬，视直而光露也。三焦理横，凡刚急者肉必横，柔缓者肉必纵也。其心
端直者，刚勇之气也。大以坚，满以旁者，旁即旁开之谓，过于人之常度也。怒则气盛而胸张， 裂而目扬，
勇者之肝胆强，肝气上冲也。毛起者，肝
血外溢也。面苍者，肝色外见也。勇怯之异，由于肝胆，故肝曰将军之官而取决于胆。）怯者目大而不减，
阴阳相失，其焦理纵， KT 短而小，肝系缓，其胆不满而纵，肠胃挺，胁下空，虽方大
怒，气不能满其胸，肝肺虽举，气衰复下，故不能久怒。（减，当作缄，封藏之谓。目大不缄者，神气不坚
也。阴阳相失者，血气易乱也，即转盼惊顾之意。其焦理纵者，肉理不横也。 KT 短小者，其心卑
小而甘出人下也。肝系缓者，不急也。胆不满而纵者，汁少形畏也。肠胃挺者，曲折少也。胁下空者，肝气不
实也。此其肝胆下充，气不能满，以故旋怒旋衰，怯之由然。勇者刚之气，怯者懦之质，然勇有二∶曰血气之
勇，曰礼义之勇。若临难不恐，遇痛不动，此其资禀过人，然随触而发，未必皆能中节也。若夫礼义之勇，
固亦不恐不动，而其从容有度，自非血气之勇所可并言者。盖血气之勇出于肝，礼义之勇出乎心，苟能守之以
礼，制之以义，则血气之勇可自有而无；充之以学，扩之以见，则礼义之勇可自无而有。昔人谓勇可学人，
在明理养性而已。然则勇与不勇，虽由肝胆，而其为之主者，则仍在乎心耳。纵，平声。 KT ，音结于。）
怯士得酒，怒不避勇。酒者，水谷之精，熟谷之液也，其气 悍，其入于胃中，则胃胀，气上逆满于胸中，
肝浮胆横，当是之时，比于勇士，气衰则悔，名曰酒悖。（ ，急也。悍，猛也。酒之性热气悍。故能胀胃浮
肝，上气壮胆。方其醉也，则神为之惑，性为之乱，自比于勇，及其气散肝平，乃知自悔，是因酒之所使，作
为悖逆，故曰“酒悖”。夫酒为水谷之液，血为水谷之精，酒入中焦，必求同类，故先归血分，凡饮酒者身
面皆赤，即其征也。然血属阴而性和，酒属阳而气悍，血欲静而酒动之，血欲藏而酒乱之，血无气不行，故血
乱气亦乱，气散血亦散，扰乱一番，而血气能无耗损者，未之有也。又若人之禀赋，脏有阴阳，而酒之气质，亦
有阴阳，盖酒成于酿，其性则热，汁化于水，其质则寒，故阳脏者得之则愈热，阴脏者得之则愈寒，所以纵酒
不节者，无论阴阳，均能为害。凡热盛而过饮者，阳日盛则阴日消，每成风瘅肿胀；寒盛而过饮者，热性去
而寒质留，多至伤肾败脾。当其少壮。则旋耗旋生，固无所觉；及乎中衰，而力有不胜，则宿孽为殃，莫能御
矣。然则酒悖之为害也，所关于寿夭非细，其可不知节乎？ ，音飘。悍，音旱。）骨强筋弱，肉缓皮肤浓
者耐痛，其于针石火 亦然。黑色而美骨者耐，坚肉而薄皮者不耐。（美骨者，骨强之谓。）病或同时，
或易已，或难已∶其身多热者易已，多寒者难已。（指外邪致病为言也。多热者病在阳分，故易已，多寒者病
在阴分，故难已。）胃浓色黑，大骨及肥者胜毒，瘦而薄胃者不胜毒也。（胃浓者脏坚，色黑者表固，骨大者
体强，肉肥者血盛，故能胜峻毒之物；若肉瘦而胃薄者，血气本属不足，安能胜毒药也？胜，平声。）
脑、髓、骨、脉、胆、女子胞，此六者，地气之所生也，皆藏于阴而象于地，故藏而不泻，名曰奇恒之府。
（凡此六者，原非六腑之数，以其藏蓄阴精，故曰“地气所生”，皆称为腑。然胆居六腑之一，独其藏而不
泻，与他腑之传化者为异。女子之胞，子宫是也，亦以出纳精气而成胎孕者为奇，故此六者，均称为“奇恒
之府”。奇，异也。恒，常也。）胃、大肠、小肠、三焦、膀胱，此五者，天气之所生也，其气象天，故泻
而不藏，此受五脏浊气，名曰传化之府，此不能久留输泻者也。（凡此五者，是名六腑。胆称奇
恒，则此为五矣。若此五腑，包藏诸物而属阳，故曰天气所生；传化浊气而不留，故曰泻而不藏；因其转输
运动，故曰象天之气。）魄门亦为五脏使，水谷不得久藏。（魄门，肛门也。大肠与肺为表里，肺藏魄而主
气，肛门失守则气陷而神去，故曰“魄门”。不独是也，虽诸腑糟粕，固由其泻，而脏气升降，亦赖以调，故
亦为五脏使。）所谓五脏者，藏精气而不泻也，故满而不能实；六腑者，传化物而不藏，故实而
不能满也。（五脏主藏精气，六腑主传化物。精气质清，藏而不泻，故但
有充满而无所积实；水谷质浊，传化不藏，故虽有积实而不能充满。）所以然者，水谷入口，则胃实而肠虚，
（食未下也。）食下则肠实而胃虚，（水谷下也。）故曰“实而不满，满而不实也”。五脏受气于
其所生，传之于其所胜；气舍于其所生，死于其所不胜。病之且死，必先传行至其所不胜，病乃死。（凡五脏
病气，有所受，有所传，有所舍，有所死。舍，留止也。受气所生者，受于己之所生者也。传所胜者，传于己
之所克者也。气舍所生者，舍于生己者也；死所不胜者，死于克己者也。）此言气之逆行也，故死。
（不胜则逆，故曰“逆行”。逆则当死。）肝受气于心，传之于脾，气舍于肾，至肺而死；
（此详言一脏之气，皆能遍及诸脏也。肝气受于心，心者肝之子，受气于其所生也；脾者肝之克，传其所
胜也；肾者肝之母，气舍所生也；肺者肝之畏，死所不胜也。）心受气于脾，传之于肺，气舍于肝，至肾而
人的肥瘦、体型大小以及耐寒耐热能力，有老人、壮年、少年和儿童的差别。人年满五十岁称为老，二十岁以上称为壮，十八岁以下称为少，六岁以下称为小。
人有肥、膏、肉三种类型：肌肉坚实、皮肤丰满的称为肥；肌肉不坚实、皮肤松弛的称为膏；皮与肉紧密结合不易分离的称为肉。（“肉”，指肌肉聚积之处。这里说的是体格健壮的人，但在脂、膏、肉三者上有区别。）膏型的人肌肉柔润，纹理粗疏的怕冷，纹理细密的怕热；脂型的人肌肉坚实，纹理细密的怕热，纹理粗疏的怕冷。（“淖”，意为柔润。膏型的人肌肉柔润，脂型的人肌肉坚实，至于寒热反应，则是纹理粗疏的都怕冷，纹理细密都怕热。“淖”读音同“闹”。）膏型的人多气且皮肤松弛，所以腹部下垂、脂肪堆积；肉型的人身体宽大；脂型的人身体收缩较小。（“纵”，宽松之意。“腴”，指脂肪肥肉。膏型的人腹部下垂脂肪堆积，脂型的人身体收缩较小，这说明膏比脂更肥。肉型是皮肉连实，自然与脂、膏不同。“纵”读去声，“腴”音同“俞”。）膏型的人多气，多气则体质偏热，热则耐寒；肉型的人多血，血液充盈形体，所以体质平和；脂型的人血清稀，气滑利而量少，所以身体不能长得很大。这是与普通常人不同的地方。（膏型人多气，气属阳，所以体质热而耐寒；肉型人多血，血养形体，所以形体充实而气质平和；脂型人血清稀，气滑利而量少，所以身体不大。这三种人虽然都肥胖，但都与普通人不同，而脂型人的气血，似乎不如膏型和肉型人。肥胖白皙的人多气虚，面色黝黑消瘦且气虚的人，气虚程度并不少于肥胖白皙者，不可拘泥看待。）普通常人的皮、肉、脂、膏比例均衡，血与气也不偏多，所以他们的体型不大不小，与身体相称，称为“众人”。（所谓“众人”，是指除了上述三种特殊体型外的众多普通人。他们的皮、肉、脂、膏、血、气各有定数，所以不能互相叠加增多，形体大小也都相称而已。）必须先辨别这三种体型，明确血的多少、气的清浊，然后进行调理，治疗就不会违背常规法则了。（三种体型既定，血气状况既明，那么该补该泻，自然可以不失常规。）
十二经脉对应十二经水，水质有清浊之分。（经脉与经水，都有清浊的差异。）受纳水谷之气的是浊气，受纳天气之气的是清气。（人身之气有两种，浊气是谷气，所以说“受谷者浊”；清气是天气，所以说“受气者清”。这两者总称为真气，从天所受的天气与从谷所受的谷气结合以充养全身。天地精气的大致规律是出三入一，所以谷物不进，半天就会气衰，一天就会气少。这又说明进入人体的是天气，排出体外的是谷气。）清气注入阴分（五脏），浊气注入阳分（六腑）。（喉主司天气，所以清气从喉注入阴分，阴分指五脏；咽主司地气，所以浊气从咽注入阳分，阳分指六腑。）浊气中清的部分向上出于咽，清气中浊的部分向下行。清浊相互干扰，称为乱气。（浊气中的清部分从内而出，所以上行；清气中的浊部分从外而入，所以下行。一上一下，气必然交并，二者相合，只要有一点不正，乱气就从中产生。）阴气清而阳气浊，浊气中有清，清气中有浊。气的总体区别是：清气向上注入肺，浊气向下走于胃。胃中的清气向上出于口，肺中的浊气向下注入经脉，在内积聚于气海。（“大别”，言大概的区别。清气上升，所以注入肺；浊气下降，所以走于胃。然而浊中有清，所以胃中的清气向上出于口，以通呼吸津液；清中有浊，所以肺中的浊气向下注入经脉，化为血脉营卫，其积气之所，在于气海之间。上气海在膻中，下气海在丹田。）诸阳经皆受浊气，只有手太阳小肠独受阳分之浊气，手太阴肺经独受阴分之清气。（手太阳是小肠。小肠位于胃之下，承受胃中的水谷，清浊未分时，这里是秽污排出的地方，虽然诸阳经都受浊气，但这里是浊中之浊，所以说“独受阳之浊”。手太阴是肺。肺是五脏六腑的华盖，是清气汇聚的地方，虽然诸阴经都受清气，但这里是清中之清，所以说“独受阴之清”。）诸阴经皆受清气，只有足太阴脾经独受其浊气。（足太阴是脾。胃负责受纳水谷，而脾接受其中的气来进行运化，所以独受其浊气，成为“清中之浊”。）清气的气机滑利，浊气的气机涩滞，这是气的常态。所以刺阴经要深刺并留针，刺阳经要浅刺并快出针；清浊相干扰的，根据具体情况调整针刺次数。（这里是从针下的气感来说清、浊、阴、阳的。清气气机滑利，针刺利于快速；浊气气机涩滞，针刺利于迟缓；阴经在里，所以宜深刺留针；阳经在表，所以宜浅刺疾出。如果清中有浊，浊中有清，这就是清浊相干，应当观察孰轻孰重，酌情调整针刺次数来调和。）头面与身体，骨骼相连筋脉相通，共同拥有血液和气。天寒地冻时，手足懈怠无力，但面部不需要穿衣保暖。（人的头面身形，本是一气相通。严寒地裂时，肢体战栗，唯独面部不觉得冷。）因为十二经脉、三百六十五络，其气血都上行于面部并通达空窍。（头面是人体的上部，周身阴阳经络无所不聚，所以气血都上行于面部并通达各孔窍。“空”即“孔”。）精气阳气上行于目而表现为视觉，（精阳气，是阳气的精华。五脏六腑的精气都上注于目而形成视觉。）旁行之气上行于耳而表现为听觉，（别气，是旁行的气。气从两侧上行于耳，气达则耳窍聪敏，所以能听。）宗气上行出于鼻而表现为嗅觉，（宗气，是大气。宗气积聚于胸中，上通于鼻而行呼吸，所以能嗅。）浊气（谷气）出于胃，上行至唇舌而表现为味觉，（浊气，即谷气。谷物进入胃，气达于唇舌，所以能知味。）各种气的津液都向上熏蒸于面部，（凡各种气的津液，都向上熏蒸于面部：肺气通于鼻，心气通于舌，肝气通于目，脾气通于口，肾气通于耳。这五脏之气，都上通于七窍，不仅仅是诸阳经络才能上达头部。手少阴心经上行挟咽喉，走喉咙，系舌根，出于面部，系目系，合于目内眦。手厥阴心包经循喉咙，出耳后，合于少阳经完骨之下。手足太阴、少阴经，都会于耳中，上行联络左角。手太阴肺经循喉咙，足少阴肾经循喉咙，系舌根，上至项部，结于枕骨，与足太阳膀胱经之筋相合。足太阴脾经合于阳明经上行，结于咽，连舌根。分支结于舌根，贯穿舌中，散于舌下。足厥阴肝经循喉咙之后，上入颃颡，络于舌根，连目系，上出额部，与督脉会于头顶，其分支从目系下行至颊里，环绕唇内。）
有人同时行动、同时站立，年龄长幼相等，衣服厚薄相同，突然遇到狂风暴雨，有的生病，有的不生病，或者都生病，或者都不生病。（“卒”音同“猝”。）少俞说：春天的青风，夏天的阳风，秋天的凉风，冬天的寒风，这四时的风邪，致病形态各不相同：（四时之风，各有所旺。有所旺则有所制约，所以致病形态各不相同。）黄色、皮肤薄、肌肉弱的人，经受不住春天的虚风；（黄是土的颜色。黄色、皮肤薄、肌肉弱的人，脾气不足，所以经受不住春木的虚风。虚风，指虚邪贼风。）白色、皮肤薄、肌肉弱的人，经受不住夏天的虚风；（白是金的颜色，白色、皮肤薄、肌肉弱的人，肺气不足，所以经受不住夏火的虚风。）青色、皮肤薄、肌肉弱的人，经受不住秋天的虚风；（青是木的颜色。青色、皮肤薄、肌肉弱的人，肝气不足，所以经受不住秋金的虚风。）赤色、皮肤薄、肌肉弱的人，经受不住冬天的虚风。（赤色是火的颜色。赤色、皮肤薄、肌肉弱的人，心气不足，所以经受不住冬水的虚风。）黑色、皮肤厚、肌肉坚实的人，本来就不受四时风邪伤害，但如果皮肤薄、肌肉不坚实、肤色不均的人，在长夏时节遇到虚风就会生病。（黑是水色。黑色、皮肤薄、肌肉不坚实，以及肤色时常变化不均的人，肾气不足，所以经受不住长夏土令的虚风。）皮肤厚、肌肉坚实的人，在长夏遇到虚风也不会生病；皮肤厚、肌肉坚实的人，必须再次感受寒邪，内外都受邪才会生病。（如果是黑色、皮肤厚、肌肉坚实的人，即使遇到长夏的虚风，也不会生病。但是如果既感受了风邪，又感受了寒邪，这叫重感；既伤于内，又伤于外，这叫外内俱伤，这才不免于生病。那么黑色、皮肉坚实的人，确实不同于其他颜色薄弱易病的人。）人忍耐疼痛与不能忍耐疼痛的区别，在于皮肤的厚薄、肌肉的坚脆、缓急的不同，这并不是指勇敢或怯懦。（这是需要辨别的性质。）勇敢的人眼睛深邃且稳固，眉毛宽阔直扬，三焦纹理横列，心脏端正正直，肝脏大而坚实，胆囊饱满且扩张；发怒时气盛而胸膛张开，肝气上举而胆气横逆，眼角裂开而眼睛上扬，汗毛竖起而面色发青。（眼睛是五脏六腑精气的汇聚处，眼睛深邃稳固，说明脏气坚实。长衡，指宽阔，即纵横之意。直扬，指视物直视且目光外露。三焦纹理横列，凡是刚强急躁的人肌肉纹理必横，柔和缓慢的人肌肉纹理必纵。心脏端正正直，是刚勇之气。大且坚实，饱满且扩张，旁即旁开之意，超过常人的度量。发怒时气盛胸膛张开，眼角裂开眼睛上扬，是因为勇敢者的肝胆强健，肝气上冲。汗毛竖起，是肝血外溢。面色发青，是肝色外现。勇敢与怯懦的区别，源于肝胆，所以肝被称为将军之官而决断于胆。）怯懦的人眼睛大但不收敛（封藏），阴阳失调，三焦纹理纵列，心胸短小且卑微，肝系松弛，胆囊不满且松弛，肠胃挺直，胁下空虚，即使非常愤怒，气也不能充满胸膛，肝肺虽上举，但气衰后又下沉，所以不能持久愤怒。（“减”当作“缄”，意为封藏。眼睛大不缄藏，说明神气不坚。阴阳失调，说明血气容易紊乱，即转眼惊顾之意。三焦纹理纵列，说明肌肉纹理不横。心胸短小，说明心卑小而甘居人下。肝系松弛，说明不急迫。胆囊不满且松弛，说明胆汁少且形貌畏缩。肠胃挺直，说明曲折少。胁下空虚，说明肝气不实。这是因为肝胆下充，气不能充满，所以刚刚发怒随即衰弱，这是怯懦的原因。勇敢者是刚强之气，怯懦者是懦弱之质。然而勇敢有两种：一是血气之勇，二是礼义之勇。如果面临危难不恐惧，遇到疼痛不动弹，这是资质禀赋过人，但随触而发，未必都能合乎节度。至于礼义之勇，固然也不恐惧不动弹，但其从容有度，绝不是血气之勇所能相比的。血气之勇出于肝，礼义之勇出于心，如果能用礼来坚守，用义来节制，那么血气之勇可以自有而无；用学问来充实，用见识来扩充，那么礼义之勇可以自无而有。古人说勇敢可以学习，关键在于明理养性。那么勇敢与否，虽然由肝胆决定，但主宰它的，仍然在于心。纵，平声。KT，音同“结于”。）
怯懦的人喝了酒，发怒时不躲避勇士。酒，是水谷的精华，熟谷的液体，它的气性剽悍，进入胃中，会使胃胀，气上逆充满于胸中，肝浮胆横，在这个时候，比之于勇士，气衰后则会后悔，名叫“酒悖”。（“ ”，急也。“悍”，猛也。酒的性质热气剽悍。所以能胀胃、浮肝、上气、壮胆。当其醉酒时，精神被迷惑，本性被扰乱，自比为勇士，等到气散肝平，才知道后悔，这是因酒的作用，做出悖逆行为，所以叫“酒悖”。酒是水谷之液，血也是水谷之精，酒入中焦，必求同类，所以先归入血分，凡是饮酒的人面色发红，就是征象。然而血属阴而性柔和，酒属阳而气剽悍，血欲静而酒动之，血欲藏而酒乱之，血没有气就不能运行，所以血乱气也乱，气散血也散，扰乱一番，血气能不耗损吗？是没有的。另外，人的禀赋，脏腑有阴阳之分，而酒的质地也有阴阳，酒酿成，其性热，汁化于水，其质寒，所以阳脏的人得到它会更热，阴脏的人得到它会更寒，所以纵酒不节制的人，无论阴阳，都会造成危害。凡是热盛而过饮的人，阳日盛则阴日消，往往形成风瘅肿胀；寒盛而过饮的人，热性去而寒质留，多导致伤肾败脾。当人年轻力壮时，边消耗边生成，感觉不到什么；到了中年衰落，力量不胜任，那么宿疾为祸，无法抵御。那么酒悖的危害，关系到寿命长短非小，怎么不知道节制呢？“ ”音飘，“悍”音旱。）
骨骼强壮、筋脉柔弱、肌肉松弛、皮肤厚实的人耐痛，他们对针石、艾灸也是如此。黑色且骨骼美观的人耐痛，肌肉坚实而皮肤薄的人不耐痛。（美骨，指骨骼强壮。）疾病有时同时发生，有时容易治愈，有时难治愈：体内多热的容易治愈，多寒的难治愈。（指外邪致病而言。多热者病在阳分，所以易愈；多寒者病在阴分，所以难愈。）胃厚、色黑、大骨及肥胖的人能耐受药毒，消瘦且胃薄的人不能耐受药毒。（胃厚说明脏气坚实，色黑说明体表固密，骨大说明体质强健，肉肥说明血液旺盛，所以能承受峻烈的药物；如果肉瘦且胃薄，血气本来不足，怎么能承受毒药呢？“胜”读平声。）
脑、髓、骨、脉、胆、女子胞，这六个器官，是由地气所生，都藏于阴而象征大地，所以只藏精气而不排泄，称为奇恒之府。（这六个器官，原本不属于六腑之数，因为它们蓄藏阴精，所以叫“地气所生”，都称为腑。然而胆位居六腑之一，唯独它藏而不泻，与其他腑的传化功能不同。女子的胞，即子宫，也因为出纳精气而成胎孕而感到奇特，所以这六个都称为“奇恒之府”。奇，异也。恒，常也。）胃、大肠、小肠、三焦、膀胱，这五个器官，是由天气所生，其形象天，所以只排泄而不藏纳，这是受纳五脏浊气的器官，称为传化之府，这是不能久留、负责输送排泄的器官。（这五个器官，名为六腑。胆称为奇恒，那么这就剩五个了。如果这五腑，包藏诸物而属阳，所以叫天气所生；传化浊气而不留存，所以叫泻而不藏；因为其转输运动，所以叫象天之气。）魄门（肛门）也是五脏的使者，水谷糟粕不能在体内久藏。（魄门，即肛门。大肠与肺相表里，肺藏魄而主气，肛门失守则气陷而神去，所以叫“魄门”。不仅如此，虽然诸腑的糟粕由其排泄，但脏气的升降也依赖于此来调节，所以也称为五脏的使者。）所谓五脏，是藏精气而不排泄的，所以保持充满但不能填实；六腑，是传化物而不藏纳的，所以填实但不能充满。（五脏主藏精气，六腑主传化物。精气质清，藏而不泻，所以只有充满而没有积实；水谷质浊，传化不藏，所以虽有积实但不能充满。）之所以这样，是因为水谷入口，则胃实而肠虚，（食物尚未下行。）食物下行后则肠实而胃虚，（水谷已下行。）所以说“实而不满，满而不实”。五脏从其所生的脏器受气，传给其所克的脏器；气停留于生它的脏器，死于克它的脏器。病情即将死亡时，必先传行至其所不胜的脏器，病人才会死。（凡五脏病气，有所受、所传、所舍、所死。舍，留止。受气所生者，受于自己生出的脏器。传所胜者，传给自己所克的脏器。气舍所生者，停留在生自己的脏器；死所不胜者，死于克自己的脏器。）这是说气的逆行，所以致死。（不胜则逆，所以叫“逆行”。逆则当死。）肝受气于心，传给脾，气舍于肾，至肺而死；（详细讲述一脏之气，都能遍及诸脏。肝气受于心，心是肝之子，受气于其所生；脾是肝所克，传于所胜；肾是肝之母，气舍于所生；肺是肝所畏，死于所不胜。）心受气于脾，传给肺，气舍于肝，至肾而……
The fatness or thinness, size of the body, and tolerance to cold or heat vary among individuals, with distinctions between the elderly (Lao), the vigorous (Zhuang), the young (Shao), and children (Xiao). Those aged fifty and above are called elderly; those above twenty are called vigorous; those below eighteen are called young; and those below six are called children.
There are three types: Fat (Fei), Gao (Gao), and Rou (Rou). One is classified as Fat if the muscles are firm and the skin is full; as Gao if the muscles are not firm and the skin is lax; and as Rou if the skin and flesh are closely attached and do not separate easily. ("Rou" refers to the accumulation of muscle tissue. This passage describes robust individuals who differ in having characteristics of Zhi [adipose], Gao, or Rou.) In Gao type, the muscles are soft and moist; those with coarse texture feel cold, while those with fine texture feel hot. In Zhi type, the muscles are firm; those with fine texture feel hot, while those with coarse texture feel cold. ("Nao" means soft and moist. In Gao type, muscles are soft and moist; in Zhi type, muscles are firm. Regarding cold and heat, those with coarse texture all feel cold, and those with fine texture all feel hot. "Nao" is pronounced like "nao".) People of Gao type have abundant Qi, and their skin is loose and relaxed, hence they tend to have a protruding abdomen with hanging fat. People of Rou type have a large body capacity. People of Zhi type have a compact and smaller body. ("Zong" means loose. "Yu" refers to fatty adipose tissue. Gao type has a protruding abdomen with hanging fat, while Zhi type has a compact small body, indicating that Gao is fatter than Zhi. Rou type consists of solid skin and flesh, distinct from Zhi and Gao. "Zong" is pronounced with the departing tone. "Yu" is pronounced like "yu".) Gao type people have abundant Qi; abundant Qi leads to heat, and heat allows tolerance to cold. Rou type people have abundant blood, which fills the form, resulting in a balanced constitution. Zhi type people have thin blood and slippery, scanty Qi, so their bodies cannot grow large. These are distinctions from the general population. (Gao type has abundant Qi; Qi belongs to Yang, so the constitution is hot and tolerant to cold. Rou type has abundant blood; blood nourishes the form, so the body is filled and the constitution is balanced. Zhi type has thin blood and slippery, scanty Qi, so the body is not large. Although these three types are obese, they differ from ordinary people, but the Qi and Blood of Zhi type seem inferior to Gao and Rou types. Fat and white-skinned people often have deficient Qi; dark-skinned and thin people with Qi deficiency may not be less deficient than fat and white-skinned ones; one should not be dogmatic.) In the general population (Zhongren), the proportions of skin, flesh, Zhi, and Gao are balanced, and Blood and Qi do not excessively dominate each other. Thus, their bodies are neither too small nor too large, proportionate to themselves, and are called "Zhongren" (ordinary people). (Zhongren refers to the multitude of ordinary people outside the three special types. Their skin, flesh, Zhi, Gao, Blood, and Qi have fixed qualities, so they cannot be added up or multiplied, and their body sizes are all proportionate.) One must first distinguish these three body types, determine the amount of Blood and the clarity/turbidity of Qi, and then regulate them; treatment will not deviate from standard principles. (Once the three types are established and Blood/Qi conditions are clear, whether to tonify or drain can follow standard principles without error.)
The twelve Meridians correspond to the twelve Rivers, which differ in clarity and turbidity. (Meridians and rivers both have differences in clarity and turbidity.) The Qi derived from grains is Turbid (Zhuo), while the Qi derived from Heaven is Clear (Qing). (There are two types of Qi in the human body: Turbid Qi is Grain Qi, hence "receiving grains results in turbidity"; Clear Qi is Heavenly Qi, hence "receiving Qi results in clarity." Together, they are called True Qi. The Heavenly Qi received from Heaven combines with Grain Qi to nourish the body. The general rule of Heaven and Earth's essence is that three parts exit and one part enters. Thus, without food intake, Qi declines in half a day and diminishes in a day. This indicates that what enters is Heavenly Qi, and what exits is Grain Qi.) Clear Qi flows into Yin (the Five Zang Organs), and Turbid Qi flows into Yang (the Six Fu Organs). (The throat governs Heavenly Qi, so Clear Qi flows from the throat into Yin, where Yin refers to the Five Zang Organs; the pharynx governs Earthly Qi, so Turbid Qi flows from the pharynx into Yang, where Yang refers to the Six Fu Organs.) The clear portion of Turbid Qi ascends and exits through the pharynx, while the turbid portion of Clear Qi descends. When Clear and Turbid interfere with each other, it is called Disordered Qi (Luan Qi). (The clear part of Turbid Qi emerges from within and thus ascends; the turbid part of Clear Qi enters from without and thus descends. Ascending and descending, the Qi inevitably intersects. When these two combine, any irregularity generates Disordered Qi.) Yin is Clear, and Yang is Turbid. Turbid contains Clear, and Clear contains Turbid. The major distinction of Qi is: Clear Qi ascends to the Lung, and Turbid Qi descends to the Stomach. The Clear Qi of the Stomach ascends and exits through the mouth, while the Turbid Qi of the Lung descends into the meridians and accumulates internally in the Sea of Qi. ("Da Bie" refers to the general distinction. Clear Qi rises, so it flows to the Lung; Turbid Qi descends, so it goes to the Stomach. However, Turbid contains Clear, so the Clear Qi of the Stomach ascends to the mouth to facilitate respiration and fluids; Clear contains Turbid, so the Turbid Qi of the Lung descends into the meridians to form blood vessels, Ying, and Wei Qi, accumulating in the Sea of Qi. The Upper Sea of Qi is at Danzhong, and the Lower Sea of Qi is at Dantian.) All Yang meridians receive Turbid Qi, but the Hand-Taiyang (Small Intestine) alone receives the Turbidness of Yang. The Hand-Taiyin (Lung) alone receives the Clarity of Yin. (Hand-Taiyang is the Small Intestine. Located below the Stomach, it receives water and grains from the Stomach. Before separation of clear and turbid, this is where waste exits. Although all Yang meridians receive turbidity, this is the turbidness of turbidity, hence "alone receives the Turbidness of Yang." Hand-Taiyin is the Lung. The Lung is the canopy of the five Zang and six Fu organs and is the site where Clear Qi gathers. Although all Yin meridians receive clarity, this is the clarity of clarity, hence "alone receives the Clarity of Yin.") All Yin meridians receive Clear Qi, but the Foot-Taiyin (Spleen) alone receives its Turbidity. (Foot-Taiyin is the Spleen. The Stomach is responsible for receiving and storing water and grains, while the Spleen receives the Qi for transformation and transportation, thus uniquely receiving turbidity, becoming "turbidity within clarity.") Clear Qi has slippery movement, and Turbid Qi has sluggish movement; this is the normal state of Qi. Therefore, when needling Yin meridians, one should insert deeply and retain the needle; when needling Yang meridians, one should insert shallowly and withdraw quickly. For cases where Clear and Turbid interfere, adjust the number of manipulations accordingly. (This refers to the sensation of Qi under the needle regarding Clear/Turbid and Yin/Yang. Clear Qi is slippery, favoring quick needling; Turbid Qi is sluggish, favoring slow needling. Yin is interior, favoring deep insertion and retention; Yang is exterior, favoring shallow insertion and quick withdrawal. If Clear contains Turbid or Turbid contains Clear, causing interference, observe which is dominant and adjust the manipulation count to harmonize.)
The head and face are connected to the body via bones and sinews, sharing Blood and Qi. In cold weather, hands and feet become weak and lazy, but the face does not require clothing. (The head, face, and body share one Qi. In severe cold, limbs shiver, but the face remains unaffected.) This is because the twelve meridians and 365 collaterals all send their Blood and Qi upward to the face and enter the orifices. (The head and face are the summit of the body, where all Yin and Yang meridians converge. Thus, Blood and Qi ascend to the face and enter the orifices. "Kong" is synonymous with "Kong".) Essence-Yang Qi ascends to the eyes to enable vision. (Essence-Yang Qi is the essence of Yang Qi. The essence of all five Zang and six Fu organs ascends to the eyes to form vision.) Branch Qi flows to the ears to enable hearing. (Branch Qi is lateral Qi. Qi ascends from both sides to the ears; when Qi reaches, the orifice becomes acute, enabling hearing.) Zong Qi (Pectoral Qi) ascends through the nose to enable smell. (Zong Qi is Great Qi. It accumulates in the chest, connects to the nose, and facilitates respiration, enabling smell.) Turbid Qi (Grain Qi) originates from the Stomach, flows to the lips and tongue, and enables taste. (Turbid Qi is Grain Qi. Grains enter the Stomach, and Qi reaches the lips and tongue, enabling taste.) The fluids of all Qi ascend to fumigate the face. (The fluids of all Qi ascend to fumigate the face: Lung Qi connects to the nose, Heart Qi to the tongue, Liver Qi to the eyes, Spleen Qi to the mouth, and Kidney Qi to the ears. The Qi of the five Zang organs all connect to the seven orifices, not just the Yang meridians reaching the head. The Hand-Shaoyin meridian ascends alongside the throat, passes through the larynx, ties to the root of the tongue, emerges on the face, connects to the eye system, and meets at the inner canthus. The Hand-Jueyin meridian follows the throat, emerges behind the ear, and meets the Shaoyang meridian below the Wangu point. The Hand and Foot Taiyin and Shaoyin meridians meet in the ear and ascend to connect the left corner. The Hand-Taiyin meridian follows the throat; the Foot-Shaoyin meridian follows the throat, ties to the root of the tongue, ascends to the nape, knots at the occipital bone, and merges with the sinews of the Foot-Taiyang meridian. The Foot-Taiyin meridian joins the Yangming meridian ascending, knots at the throat, and connects to the root of the tongue. A branch knots at the root of the tongue, penetrates the middle of the tongue, and scatters under the tongue. The Foot-Jueyin meridian follows behind the throat, enters the Ying-Sang, connects to the root of the tongue, links to the eye system, ascends to the forehead, and meets the Du meridian at the vertex. A branch descends from the eye system to the cheek interior, encircling the inside of the lips.)
Some people act and stand together, are of similar age, wear clothes of equal thickness, yet suddenly encounter violent wind and heavy rain; some fall ill, some do not, some all fall ill, some all remain healthy. ("Cu" is pronounced like "cu".) Shao Yu said: The green wind of spring, the yang wind of summer, the cool wind of autumn, and the cold wind of winter—these winds of the four seasons cause different forms of disease: (The winds of the four seasons each have a period of dominance. Where there is dominance, there is restriction, so the diseases caused differ in form.) People with yellow complexion, thin skin, and weak flesh cannot withstand the empty wind of spring. (Yellow is the color of Earth. Yellow complexion, thin skin, and weak flesh indicate insufficient Spleen Qi, hence unable to withstand the empty wind of Spring Wood. Empty wind refers to false evil and thieving wind.) People with white complexion, thin skin, and weak flesh cannot withstand the empty wind of summer. (White is the color of Metal. White complexion, thin skin, and weak flesh indicate insufficient Lung Qi, hence unable to withstand the empty wind of Summer Fire.) People with blue/green complexion, thin skin, and weak flesh cannot withstand the empty wind of autumn. (Blue/Green is the color of Wood. Blue/Green complexion, thin skin, and weak flesh indicate insufficient Liver Qi, hence unable to withstand the empty wind of Autumn Metal.) People with red complexion, thin skin, and weak flesh cannot withstand the empty wind of winter. (Red is the color of Fire. Red complexion, thin skin, and weak flesh indicate insufficient Heart Qi, hence unable to withstand the empty wind of Winter Water.) People with black complexion, thick skin, and firm flesh are naturally not injured by the winds of the four seasons. However, those with thin skin, unfirm flesh, and uneven complexion will fall ill if exposed to empty wind during late summer. (Black is the color of Water. Black complexion, thin skin, unfirm flesh, and changing/uneven complexion indicate insufficient Kidney Qi, hence unable to withstand the empty wind of Late Summer Earth.) Those with thick skin and firm flesh will not fall ill even if exposed to empty wind during late summer. Those with thick skin and firm flesh must suffer a double exposure to cold, affecting both exterior and interior, to fall ill. (If a person is black-complexioned with thick skin and firm flesh, they will not fall ill even with late summer empty wind. But if they are affected by wind and then by cold, it is called double exposure; injured internally and externally, they inevitably fall ill. Thus, black-complexioned people with firm skin and flesh are indeed different from others who are weak and prone to illness.) The difference between enduring pain and not enduring pain lies in the thickness of the skin, the firmness or fragility of the muscles, and the tension or relaxation of the tissues; this does not refer to courage or cowardice. (This requires distinguishing temperament.) Courageous people have deep and stable eyes, broad and straight eyebrows, horizontal Sanjiao texture, upright heart, large and firm liver, and full and expanded gallbladder. When angry, Qi is abundant and the chest expands; the Liver rises and the Gallbladder becomes horizontal; the corners of the eyes split and the eyes look up; hair stands erect, and the face turns pale. (Eyes are the gathering place of the essence of the five Zang and six Fu organs. Deep and stable eyes indicate firm organ Qi. Chang Heng means broad, implying longitudinal and transverse directions. Zhi Yang means looking straight with exposed light. Horizontal Sanjiao texture implies that rigid and urgent people have horizontal muscle texture, while soft and slow people have vertical texture. An upright heart reflects courageous Qi. Large and firm, full and expanded means expanding beyond normal limits. Anger causes Qi abundance and chest expansion due to strong Liver and Gallbladder in courageous people, with Liver Qi rushing upward. Hair standing is Liver Blood overflowing outward. Face turning pale is Liver color manifesting externally. The difference between courage and cowardice stems from the Liver and Gallbladder; thus, the Liver is called the General Officer, and decisions lie with the Gallbladder.) Cowardly people have large but unsealed eyes, loss of Yin-Yang balance, vertical Sanjiao texture, short and humble heart, relaxed Liver connection, empty and sagging Gallbladder, straight intestines and stomach, and empty hypochondrium. Even when extremely angry, Qi cannot fill the chest; although Liver and Lung rise, Qi declines and sinks again, so anger cannot be sustained. ("Jian" should be "Jian," meaning sealing/storing. Large but unsealed eyes indicate unstable Shen Qi. Loss of Yin-Yang balance means Blood and Qi are easily disturbed, i.e., startled glances. Vertical Sanjiao texture means non-horizontal muscle texture. Short and humble heart means the heart is lowly and willing to yield. Relaxed Liver connection means lack of urgency. Empty and sagging Gallbladder means little bile and fearful appearance. Straight intestines and stomach mean few curves. Empty hypochondrium means insufficient Liver Qi. This is due to downward sinking of Liver and Gallbladder, inability to fill Qi, leading to rapid decline after anger, which is the cause of cowardice. Courageous people possess rigid Qi; cowardly people possess weak nature. However, courage has two types: Blood-Qi courage and Ritual-Righteousness courage. Facing danger without fear and pain without moving indicates superior endowment, but reacting spontaneously may not always be moderate. Ritual-Righteousness courage also involves no fear or movement, but with composure and measure, far surpassing Blood-Qi courage. Blood-Qi courage originates from the Liver; Ritual-Righteousness courage originates from the Heart. If guarded by ritual and controlled by righteousness, Blood-Qi courage can be eliminated; if enriched by learning and expanded by insight, Ritual-Righteousness courage can be developed. Ancients said courage can be learned, relying on understanding principles and nurturing nature. Thus, whether one is courageous depends on the Liver and Gallbladder, but the master is the Heart. "Zong" is pronounced with the level tone. "KT" is pronounced like "jie yu".)
Cowardly people, when drunk, become angry and do not avoid brave men. Wine is the essence of water and grains, the liquid of cooked grains. Its Qi is fierce. Upon entering the Stomach, it causes distension, and Qi rebels upward, filling the chest. The Liver floats, and the Gallbladder becomes horizontal. At this time, one compares oneself to a brave man; when the Qi subsides, regret follows. This is called "Wine Rebelliousness" (Jiu Bei). (" " means urgent. "Han" means fierce. The nature of wine is hot and fierce. Thus, it distends the Stomach, floats the Liver, raises Qi, and strengthens the Gallbladder. While intoxicated, the spirit is confused, and nature is disrupted, leading one to compare oneself to a brave man. When Qi dissipates and the Liver calms, regret sets in. This behavior is driven by wine, constituting rebellion, hence "Wine Rebelliousness." Wine is the liquid of water and grains; Blood is the essence of water and grains. Wine entering the Middle Jiao seeks its kind, so it first enters the Blood aspect. All drinkers have red faces and bodies, which is a sign. Blood belongs to Yin and is gentle; Wine belongs to Yang and is fierce. Blood desires stillness, but wine agitates it; Blood desires storage, but wine disrupts it. Blood cannot move without Qi, so when Blood is disrupted, Qi is also disrupted; when Qi dissipates, Blood also dissipates. After such disturbance, can Blood and Qi remain undamaged? No. Furthermore, human endowments have Yin and Yang aspects in organs, and wine also has Yin and Yang qualities. Wine is fermented, its nature is hot; its juice is derived from water, its substance is cold. Thus, those with Yang organs become hotter; those with Yin organs become colder. Therefore, unrestrained drinking harms everyone regardless of Yin or Yang. Those with excess heat who drink excessively experience increasing Yang and decreasing Yin, often developing Wind-Damp swelling. Those with excess cold who drink excessively lose the hot nature but retain the cold substance, often damaging the Kidney and Spleen. In youth, consumption and generation balance, so no harm is felt; in middle age, strength wanes, and old ailments cause disaster, which cannot be resisted. Thus, the harm of Wine Rebelliousness affects longevity significantly; how can one not know moderation? " " is pronounced "piao"; "Han" is pronounced "han".)
Those with strong bones, weak sinews, loose muscles, and thick skin endure pain well, as do they with needles, stones, and fire moxibustion. Those with black complexion and beautiful bones endure pain; those with firm muscles and thin skin do not endure pain. ("Mei Gu" means strong bones.) Diseases may occur simultaneously, resolve easily, or be difficult to resolve: Those with more Heat resolve easily; those with more Cold are difficult to resolve. (Referring to diseases caused by external pathogens. More Heat means disease in the Yang aspect, hence easy resolution; more Cold means disease in the Yin aspect, hence difficult resolution.) Those with thick Stomach walls, black complexion, large bones, and obesity can tolerate toxic drugs; those who are thin with thin Stomach walls cannot tolerate toxic drugs. (Thick Stomach walls indicate firm organ Qi; black complexion indicates solid exterior; large bones indicate strong physique; fleshy body indicates abundant Blood, so they can withstand harsh drugs. If thin and with thin Stomach walls, Blood and Qi are inherently deficient, how can they withstand toxic drugs? "Sheng" is pronounced with the level tone.)
The Brain, Marrow, Bones, Vessels, Gallbladder, and Uterus (in women)—these six—are generated by Earth Qi. They store Yin and resemble Earth, so they store essence without excreting, and are named the Extraordinary Fu Organs (Qi Heng Zhi Fu). (These six are not part of the standard Six Fu Organs. Because they store Yin essence, they are called "generated by Earth Qi" and termed Fu organs. However, the Gallbladder is one of the Six Fu Organs, but uniquely stores without excreting, differing from other Fu organs that transform and transmit. The Uterus is the womb, also considered extraordinary because it receives and releases essence to form pregnancy. Thus, these six are called "Extraordinary Fu Organs." Qi means strange/extraordinary; Heng means constant.) The Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder—these five—are generated by Heaven Qi. Their nature resembles Heaven, so they excrete without storing. They receive turbid Qi from the Five Zang Organs and are named the Transmitting and Transforming Fu Organs (Chuan Hua Zhi Fu). These cannot retain contents for long but are responsible for transport and excretion. (These five are named the Six Fu Organs. Since the Gallbladder is called Extraordinary, only five remain. These five Fu organs contain substances and belong to Yang, hence "generated by Heaven Qi"; they transmit turbid Qi without retaining, hence "excrete without storing"; due to their transport and movement, they "resemble Heaven Qi.") The Po Men (anus) is also an envoy of the Five Zang Organs; water and grain residues cannot be stored for long. (Po Men is the anus. The Large Intestine and Lung are exterior-interior pairs. The Lung stores Po and governs Qi. If the anus loses control, Qi sinks and Shen departs, hence "Po Men." Moreover, although waste from all Fu organs is excreted here, the ascending and descending of Zang Qi also relies on this for regulation, so it is also called an envoy of the Five Zang Organs.) The Five Zang Organs store essence and Qi without excreting, so they are full but not solid. The Six Fu Organs transmit and transform substances without storing, so they are solid but not full. (The Five Zang Organs govern storing essence and Qi; the Six Fu Organs govern transmitting and transforming substances. Essence and Qi are clear, stored without excretion, so they are full but not solidly accumulated. Water and grains are turbid, transmitted and transformed without storage, so they are solidly accumulated but not full.) This is because when water and grains enter the mouth, the Stomach becomes solid and the Intestines empty (before food descends); after food descends, the Intestines become solid and the Stomach empty. Hence, it is said, "Solid but not full, full but not solid." The Five Zang Organs receive Qi from the organ they generate, transmit it to the organ they overcome; Qi stays in the organ that generates them, and death occurs at the organ that overcomes them. When a disease is fatal, it must first transmit to the organ it cannot overcome, and then the patient dies. (All Zang organ diseases have reception, transmission, residence, and death. She means staying/residing. Receiving Qi from what it generates means receiving from the child organ. Transmitting to what it overcomes means transmitting to the conquered organ. Qi residing in what generates it means staying in the mother organ. Death from what overcomes it means dying from the conquering organ.) This describes the retrograde flow of Qi, hence death. (Being overcome leads to retrogression, hence "retrograde flow." Retrogression leads to death.) The Liver receives Qi from the Heart, transmits it to the Spleen, Qi resides in the Kidney, and death occurs at the Lung. (This details how the Qi of one organ spreads to all. Liver Qi receives from the Heart; the Heart is the Liver's child, receiving from what it generates. The Spleen is overcome by the Liver, transmitting to what it overcomes. The Kidney is the Liver's mother, Qi resides in what generates it. The Lung is feared by the Liver, death occurs from what overcomes it.) The Heart receives Qi from the Spleen, transmits it to the Lung, Qi resides in the Liver, and death occurs at the Kidney...