形有缓急，气有盛衰，骨有大小，肉有坚脆，皮有浓薄，以立寿夭。故形与气相任则寿，不相任则夭。
皮与肉相裹则寿，不相裹则夭。血气经络胜形则寿，不胜形则夭。故平人而气胜形者寿。病而形肉脱，气胜
形者死。形胜气者危矣。何谓形之缓急也？曰∶形充而皮肉缓者则寿，形充而皮
肉急者则夭，形充而脉坚大者顺也。形充而脉小以弱者气
衰，气衰则危矣。若形充而颧不起者骨小，骨小则夭矣。形充而大肉 坚而有分者肉坚，肉坚则寿矣。（有分，
谓有纵纹。即所谓皮肉缓。）形充而大肉无分理不坚者肉脆，肉脆则夭矣。此天之生命，所以立形定气而视寿夭
者也。必明乎此，而后可以临病患，决死生。故墙基卑高，不及其地者，不满三十而
死。其有因而加病者，不及二十而死也。
人之寿百岁而死者，使道隧以长，基墙高以方，通调荣卫，三部三里起，骨高肉满，百岁乃得终也。
故人生十岁，五脏始定，血气已通，其气在下，故好走。二十岁，血气始盛，肌肉方长，故好趋。三十岁，五
脏大定，肌肉坚固，血脉盛满，故好步。四十岁，五脏六腑十二经脉皆大盛以平定，腠理始疏，荣华颓落，发
颇斑白，平盛不摇，故好坐。五十岁，肝气始衰，肝叶始薄，胆汁始减，目始不明。六十岁，心气始衰，苦忧
悲，血气懈惰，故好卧。七十岁，脾气虚，皮肤枯。八十岁，肺气衰，魄离，故言善误。九十岁，肾
气焦，四脏经脉空虚。百岁，五脏皆虚，神气皆去，形骸独居而终矣。其不能终寿而死者，五脏皆不坚，使
道不长，空（音孔。）外以张，喘息暴疾，又卑基墙，薄脉少血，其肉不石，（即实字。）数中风寒，血气
虚，脉不通，真邪相攻，乱而相引，故中寿而尽也。
脉出气口，色见明堂，五色更出，以应五时，五官已辨，阙庭必张，乃立明堂。明堂广大，蕃蔽见外，
方壁高基，引垂见外，五色乃治，平博广大，寿中百岁，见此者刺之必已。如是之人，血气有余，肌肉坚致，
故可苦以针矣。五官不辨，阙庭不张，小其明堂，蕃蔽不见，又埤其墙，墙下无
基，垂角居外，如是者，虽平常殆，况加疾乎。（上寿夭。）
人之黑白肥瘦小长，（五十以上为老，二十以上为壮，十八以下为少，
六岁以下为小。）各有数也。
年质壮大，血气充盈，肤革坚固，因加以邪，刺此者，深而留之。此肥人也，广肩腋项，肉薄浓皮而
黑色，唇临临然，其血黑以浊，其气涩以迟，其为人也，贪于取与，刺此者，深而留之，多益其数也。
瘦人者，皮薄色少，肉廉廉然，薄唇轻言，其血清气滑，易脱于气，易损于血，刺此者，浅而疾之。
刺常人者，视其黑白，各为调之，其端正敦浓者，其血气和调，刺此者，无失常数也。
刺壮士真骨者，坚肉缓节，监监然。此人重则气涩血浊，
刺此者，深而留之，多益其数。劲则气滑血清，刺此者，浅而疾之。（重。浓浊也。劲， 捷也。）
婴儿者，其肉脆，血少气弱，刺此者，以毫针，浅刺而疾发针，日再可也。（上肥瘦常人壮士婴儿。）
夫忍痛不忍痛者，皮肤之浓薄，肌肉坚脆缓急之分也。非勇怯之谓也。故勇士之不忍痛者，见难则前，见
痛则止。怯士之忍痛者，闻难则恐，遇痛不动。勇士之忍痛者，见难不恐，遇痛不动，怯士之不忍痛者，见
难与痛，目转面盼，恐不能言，失气惊战，颜色无定，乍死乍生。夫勇士者，目深以固，长衡（当是冲字。）直
扬，三焦理横，其心端直，其肝大以坚，其胆满以傍，（平声，充溢于外。）怒则气盛而胸张，肝举而
胆横， 裂而目扬，毛起而面苍，此勇士之所由然也。怯士者，目大而不减，阴阳相失，三焦理纵， 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
胸，肝肺虽举，气衰复下，故不能久怒，此怯士之所由然也。（上忍痛不忍痛并勇怯。）
凡人之骨强筋弱肉缓皮肤浓者耐痛，其于针石之痛亦然，加以黑色而美骨者耐火 矣。坚肉薄皮者，不
耐针石火 之痛也。人之病，同时而伤，或易已或难已者，其身多热者易已，多寒者难已也。（伤科，气滑血
充者易复，气滞血少而湿多者每溃烂缠延。）人之胜毒不胜毒者，胃浓色黑大骨及肥者皆胜毒，
其瘦而薄胃者，皆不胜毒也。（胜毒者有病，可用大寒大热及诸毒药重
剂也。上耐痛不耐痛胜毒不胜毒，并出《灵枢》。）
人的形体有松缓与紧急之分，正气有旺盛与衰弱之别，骨骼有粗大与细小之异，肌肉有坚实与脆弱之差，皮肤有厚薄之不同，据此可以判断寿命的长短。所以，形体与正气相称（即形气相符）则长寿，不相称则短命。
皮肤与肌肉紧密包裹结合则长寿，不紧密包裹结合则短命。血气经络强盛超过形体表现则长寿，弱于形体表现则短命。因此，健康人如果正气强盛于形体表现为长寿；患病之人如果形体肌肉消瘦脱失，但正气仍强盛于形体者会死亡。如果形体强盛而正气虚弱则处于危险境地。
什么叫形体的松缓与紧急呢？回答说：形体充实且皮肤肌肉松缓的长寿，形体充实且皮肤肌肉紧绷的短命，形体充实且脉象坚实洪大的为顺证。形体充实但脉象细小虚弱的，说明正气衰弱，正气衰弱则危险。如果形体充实但颧骨不高，说明骨骼细小，骨骼细小则短命。形体充实且大腿肌肉坚实且有纹理分界的，说明肌肉坚实，肌肉坚实则长寿。（所谓“有分”，是指有纵纹，也就是前面所说的皮肉松缓。）形体充实但大腿肌肉没有纹理且质地不坚实的，说明肌肉脆弱，肌肉脆弱则短命。这是先天赋予的生命规律，通过确立形体和观察正气来判断寿夭。必须明白这些道理，然后才能面对病患，决断生死。所以，如果面部墙基（指下颏及周围骨骼）低矮，不如耳垂等部位高出的，活不到三十岁就会死亡。如果有病因导致病情加重，活不到二十岁就会死亡。
人能活到百岁才去世的，是因为鼻道（使道，指鼻孔至人中沟）深长，面部基墙高大方正，营卫气血通畅调和，三部九候（指头、手、足三部脉）及三里穴处脉搏充盈隆起，骨骼高耸肌肉丰满，这样才能享尽天年。
人生十岁时，五脏功能开始稳定，血气已经通畅，气机下行，所以喜欢奔跑。二十岁时，血气开始旺盛，肌肉正在生长，所以喜欢快走。三十岁时，五脏发育完全成熟，肌肉坚固，血脉充满，所以喜欢步行。四十岁时，五脏六腑及十二经脉都达到盛大并趋于平稳，腠理开始疏松，荣华之气衰退，头发开始花白，身体处于平盛状态不再剧烈摇动，所以喜欢静坐。五十岁时，肝气开始衰退，肝叶变薄，胆汁减少，眼睛开始看不清楚。六十岁时，心气开始衰退，容易忧愁悲伤，血气懈怠懒惰，所以喜欢躺卧。七十岁时，脾气虚弱，皮肤干枯。八十岁时，肺气衰退，魄离散，所以说话容易出错。九十岁时，肾气枯竭，其他四脏及经脉空虚。一百岁时，五脏皆虚，神气离去，只剩躯壳独自存在而终结。
那些不能享尽天年而死的人，是因为五脏都不坚固，鼻道不长，外窍（如鼻孔）开张，呼吸急促，而且面部基墙低矮，脉象微弱少血，肌肉不实，多次遭受风寒侵袭，血气虚弱，脉道不通，真气与邪气相互攻伐，紊乱相互牵引，所以在中年就去世了。
脉象显现于气口（寸口），面色显现于明堂（鼻部），五色随四季变化更替以对应五时，五官特征已可辨别，阙庭（两眉之间及前额）必定张开，这才确立了明堂的形态。明堂宽大，蕃蔽（面颊两侧及耳门）显露在外，方壁高基（面部轮廓方正高耸），引垂（耳垂）显露在外，五色正常调和，平坦广阔，这样的人能活到百岁，对此类人进行针刺治疗必能痊愈。像这样的人，血气有余，肌肉坚实致密，所以可以用针石强力治疗。如果五官特征不明显，阙庭不开张，明堂狭小，蕃蔽看不见，而且墙壁低矮，墙下无基，耳垂居外，像这样的人，即使平时也接近危险，何况加上疾病呢？（以上论述寿夭。）
人的肤色黑白、体型肥瘦、身高大小，（五十岁以上为老，二十岁以上为壮，十八岁以下为少，六岁以下为小），各有其相应的生理特点。
年富力强、体质壮大的人，血气充盈，皮肤坚固，如果再加上邪气侵袭，针刺这些人，应当深刺并留针。这是肥人，他们肩腋宽阔，颈部粗壮，肌肉薄弱而皮肤浓黑，嘴唇丰厚，他们的血液黑而浑浊，气行涩滞缓慢，这类人性格贪于索取与给予，针刺他们，应当深刺并留针，增加针刺次数。
瘦人，皮肤薄颜色淡，肌肉清瘦，嘴唇薄说话轻，他们的血清气滑，气容易耗散，血容易受损，针刺他们，应当浅刺并快速出针。
针刺普通人，要观察其肤色的黑白，分别进行调整。那些体态端正敦厚的人，血气和调，针刺他们，不要违背常规的针刺法则。
针刺体格强壮、骨骼真实的人，他们肌肉坚实关节舒缓，神态威严。这种人如果体质厚重，则气涩血浊，针刺他们，应当深刺并留针，增加针刺次数。如果体质劲健，则气滑血清，针刺他们，应当浅刺并快速出针。（“重”指浓浊，“劲”指敏捷。）
婴儿，肌肉脆弱，血少气弱，针刺他们，用毫针，浅刺并快速出针，每天可以针刺两次。（以上论述肥瘦、常人、壮士、婴儿的针刺原则。）
关于忍受疼痛和不忍受疼痛的区别，在于皮肤的厚薄、肌肉的坚实脆弱以及松缓紧急的不同。这并不是指勇敢或怯懦。所以，勇敢的士兵中不忍痛的人，见到危难就上前，见到疼痛就停止。怯懦的士兵中忍痛的人，听到危难就恐惧，遇到疼痛却不动弹。勇敢的士兵中忍痛的人，见到危难不恐惧，遇到疼痛不动弹。怯懦的士兵中不忍痛的人，见到危难和疼痛，眼睛转动脸色变幻，恐惧得说不出话，失气惊颤，脸色不定，忽死忽生。
所谓勇士，眼睛深邃且目光坚定，鼻梁高直上扬，三焦纹理横向分布，心脏端正正直，肝脏大而坚实，胆囊饱满充盈（傍，读平声，意为充溢于外）。发怒时气盛而胸廓张开，肝气上举而胆气横逆，眼眶裂开而眼珠突出，汗毛竖起而面色青苍，这就是勇士之所以成为勇士的原因。
所谓怯士，眼睛大但不深邃，阴阳失调，三焦纹理纵向分布，气管短小，肝系松弛，胆囊不满且下垂，肠胃挺直，胁下空虚，即使非常愤怒，气也不能充满胸廓，肝肺虽然气机上举，但气衰后又复降下，所以不能长久愤怒，这就是怯士之所以成为怯士的原因。（以上论述忍痛不忍痛及勇怯。）
凡是骨骼强健、筋脉柔弱、肌肉松缓、皮肤浓厚的人耐痛，他们对针石和火疗的疼痛也能耐受，如果再加上肤色黑且骨骼优美的人，更能耐火疗。肌肉坚实而皮肤薄的人，不耐受针石和火疗的疼痛。人患病，同时受到外伤，有的容易治愈有的难治愈，身体多热证的容易治愈，多寒证的难治愈。（伤科方面，气滑血充者容易恢复，气滞血少且湿多者往往溃烂缠绵。）
关于承受药毒和不承受药毒的区别，胃气浓厚、面色黑、骨骼大及肥胖的人都能够承受药毒，而消瘦且胃气薄弱的人，都不能承受药毒。（能承受药毒的人患病，可以使用大寒、大热及诸种毒药重剂。以上耐痛不耐痛、胜毒不胜毒的内容，均出自《灵枢》。）
The physical form varies in laxity and tension, vital qi (Zheng Qi) differs in abundance and deficiency, bones vary in size, muscles differ in firmness and fragility, and skin ranges from thick to thin; these factors determine longevity. Therefore, when the physical form and vital qi are balanced (mutually supportive), one lives long; when they are unbalanced, life is short.
When the skin and muscles are tightly enveloped together, one lives long; when they are not, life is short. When blood and qi and the meridians are stronger than the physical form, one lives long; when they are weaker, life is short. Thus, a healthy person whose vital qi exceeds their physical form will live long. However, if a sick person has emaciated flesh but their vital qi still exceeds the physical form, they will die. If the physical form exceeds the vital qi, the condition is critical.
What is meant by the laxity and tension of the form? It is said: Those with a substantial body but lax skin and muscles will live long; those with a substantial body but tense skin and muscles will have a short life; those with a substantial body and firm, large pulses are in a favorable state. If the body is substantial but the pulse is small and weak, it indicates deficient vital qi, which is dangerous. If the body is substantial but the cheekbones are not prominent, it indicates small bones, leading to a short life. If the body is substantial and the large muscles (thighs) are firm with distinct separations, the muscles are firm, indicating longevity. ("Distinct separations" refers to longitudinal striations, i.e., lax skin and muscles as mentioned earlier). If the body is substantial but the large muscles lack texture and are not firm, the muscles are fragile, indicating a short life. These are innate principles of life, used to establish the form and observe qi to judge longevity. One must understand this clearly before treating patients and determining life and death. Therefore, if the "wall base" (lower jaw and surrounding bone structure) is low and does not reach the level of the ears, death occurs before thirty. If illness exacerbates the condition, death occurs before twenty.
Those who live to a hundred years have deep and long nasal passages (Shi Dao), high and square facial structures, smooth and regulated Ying and Wei (Nutritive and Defensive) qi, prominent pulses at the Three Regions and Sanli points, high bones, and full muscles, allowing them to complete their natural lifespan.
At ten years old, the Zang organs begin to stabilize, blood and qi circulate, and qi moves downward, so children like to run. At twenty, blood and qi become abundant, muscles grow, so youths like to walk briskly. At thirty, the Zang organs are fully established, muscles are firm, and blood vessels are full, so adults like to walk steadily. At forty, the Zang organs, Fu organs, and twelve meridians reach peak stability, pores begin to loosen, luster declines, hair turns gray, and the body becomes stable, so middle-aged people prefer sitting. At fifty, Liver qi begins to decline, liver leaves thin, bile decreases, and vision blurs. At sixty, Heart qi declines, sorrow and grief increase, blood and qi become sluggish, so elders prefer lying down. At seventy, Spleen qi is deficient, and skin dries. At eighty, Lung qi declines, Po (Corporeal Soul) disperses, and speech errors occur. At ninety, Kidney qi is exhausted, and the other four Zang organs and meridians are empty. At one hundred, all Zang organs are deficient, Shen (Spirit) departs, and only the corpse remains until death.
Those who do not complete their lifespan die because their Zang organs are not solid, nasal passages are short, external orifices are open, breathing is rapid, the facial base is low, pulses are thin with little blood, muscles are not solid, they frequently suffer wind-cold, blood and qi are deficient, meridians are blocked, true qi and pathogenic factors attack each other, causing chaos and mutual entanglement, leading to premature death.
Pulses manifest at the Qikou (Cunkou) point, colors appear at the Mingtang (nose area). The five colors change according to the five seasons, and the five facial features become distinguishable. When the Que Ting (glabella and forehead) expands, the Mingtang is established. A large Mingtang, visible fan-like coverings (cheeks/ears), square walls with high bases, and visible earlobes indicate harmonious five colors, a flat and broad face, and longevity up to a hundred years. Such individuals have abundant blood and qi and firm muscles, making them suitable for strong needle therapy. If facial features are indistinct, Que Ting is not expanded, Mingtang is small, coverings are hidden, walls are low without a base, and earlobes are outward, such individuals are precarious even when healthy, let alone when ill. (This discusses longevity and brevity of life.)
People vary in color (black/white), build (fat/thin), and size (tall/short). (Over 50 is old, over 20 is strong, under 18 is young, under 6 is small). Each type has specific characteristics.
For robust, strong individuals with abundant blood and qi and firm skin, if pathogenic factors invade, needles should be inserted deeply and retained. This applies to fat people: broad shoulders and necks, thin muscles but thick dark skin, thick lips, dark and turbid blood, and slow, stagnant qi. They tend to be greedy in giving and taking. Needling requires deep insertion, retention, and increased frequency.
Thin people have thin skin, pale complexion, lean muscles, thin lips, and soft speech. Their blood is clear and qi is slippery; qi is easily depleted, and blood is easily damaged. Needling should be shallow and quick.
For normal people, adjust based on black or white complexion. Those with upright and honest builds have harmonious blood and qi; follow standard needling protocols.
For strong individuals with solid bones, firm muscles, and relaxed joints: If heavy/turbid, qi is stagnant and blood is turbid; needle deeply with retention and increased frequency. If agile/firm, qi is slippery and blood is clear; needle shallowly and quickly. ("Heavy" means turbid; "Agile" means swift.)
Infants have fragile muscles, little blood, and weak qi. Use fine needles, insert shallowly, and withdraw quickly. Treatment can be performed twice daily. (This covers needling for fat, thin, normal, strong, and infant types.)
Tolerance or intolerance to pain depends on skin thickness, muscle firmness/fragility, and laxity/tension, not necessarily courage or timidity. Brave soldiers who cannot tolerate pain advance in danger but stop at pain. Timid soldiers who tolerate pain fear danger but remain still at pain. Brave soldiers who tolerate pain neither fear danger nor move at pain. Timid soldiers who cannot tolerate pain show shifting eyes, changing faces, fear, loss of qi, trembling, unstable complexion, and near-death states upon facing danger or pain.
Brave individuals have deep, fixed eyes, straight and raised nasal bridges, horizontal San Jiao textures, upright heart, large and firm liver, and full gallbladder. Anger causes qi to surge, chest to expand, liver to rise, gallbladder to extend, eyes to protrude, hair to stand, and face to turn cyan. This is the nature of bravery.
Timid individuals have large but unfocused eyes, yin-yang imbalance, vertical San Jiao textures, short trachea, loose liver ties, empty and sagging gallbladder, straight intestines, and hollow hypochondrium. Even in great anger, qi cannot fill the chest; although liver and lung qi rise, they quickly sink due to weakness, preventing prolonged anger. This is the nature of timidity. (This discusses pain tolerance and courage/timidity.)
Those with strong bones, weak sinews, lax muscles, and thick skin tolerate pain, including needle and fire therapy. Those with black skin and beautiful bones also tolerate fire. Those with firm muscles and thin skin do not tolerate needle or fire pain. In injuries, those with excess heat recover easily; those with excess cold recover slowly. (In trauma, slippery qi and abundant blood aid recovery; stagnant qi, little blood, and dampness cause lingering ulcers.)
Regarding tolerance to toxic drugs: Those with strong stomach qi, dark complexion, large bones, and obesity can tolerate toxins. Those who are thin with weak stomach qi cannot tolerate toxins. (Those who tolerate toxins can use extreme hot/cold or potent medicinal agents. This section on pain tolerance and drug tolerance is derived from the *Ling Shu*.)