夫人禀天地阴阳而生者。盖天有六气。人以三阴三阳而上奉之。地有五行。
人以五脏六腑而下应之。于是资生皮肉。筋骨。精髓。血脉。四肢九窍
唇舌。总而成体。外则气血循环。流注经络。喜伤六淫。内则精神魂魄志意
淫者。寒暑燥湿风热。七情者。喜怒忧思悲恐惊。若将护得宜。怡然安泰。
生焉。病症既成。须寻所自。故前哲示教。谓之病源。经不云乎。治之极于
户塞牖。系之病者。数问其经。以从其意。是欲知致病之本也。然六淫天之
自经络入内。合于腑脏。为外所因。七情人之常性。动之则先自脏腑郁发。
内所因。其
折。疰忤
附着。畏压溺等。有背常理。为不内外因。金匮有言。千般 难。不越三条。以此详之。病
源都尽。如欲救疗。就中寻其类例。别有三因。或内外兼并。淫情交错。推其深浅。断以所
随因施治。药石针艾。无施不可。
辨脉。古人以脉上辨内外伤于人迎气口。人迎脉大于气口、为外伤。气口脉大于人迎为
内伤
左手
右
是足太阳寒水之脉。按之洪大而有力。中见
脉也。若外感风邪。则人迎脉缓而大。或大
口脉大于人迎一倍。伤之重者过之。少阴则
此内伤饮食之脉。若饮食不节。劳役过甚。则三脉遍见于气口。是心火刑肺。其肝木挟
心火
涩者
挟心
也。如
一代也。
乎。辨寒热。外伤寒邪之证。与饮食不节劳役形质之病。及内伤饮食。俱有寒热。举世尽将
饮食
热恶
在表也
乘之。郁
已不能
寒。一
不节。
内伤
寒邪
平常
无所
阳日
所恶
下。
凉处
辨之
不通
郁
咽
表虚之弱。为阴火所乘。燥发须臾而过。表虚无阳。不任风寒复见矣。
是表虚无阳。常常有之。
其燥热则间而有之。此二者不齐作。燥作寒已。寒作燥已。非若外伤之寒热齐作。无有
间断
之热
故难
辨外感内伤恶风。外感八风之邪。乃有余之证也。内伤饮食不节。劳役所伤。皆不足之
病也
细分
入里
常。
居
鼻
不
初劳役得病食少。小便赤黄。大便常难。或秘或结或虚坐。只见些小白脓。时有下气。或泄
黄如糜。或溏泄色白。或结而不通。若心下痞。或胸中闭塞。如刀 之痛。二者亦互相见、
不并出也。有时胃脘当心而痛。上肢两胁痛。心脐下相火之势。如巨川之水不可遏而上行。
使
而
俱无此证。故易为分别耳。复有一等。乘天气大热之时。在于路
途
得
甚
证
减。
不
足
矣
有
寒凉
免者
日之
外伤贼
必短气
人禀受天地阴阳之气而生。天有六气，人以三阴三阳上承奉之；地有五行，人以五脏六腑下应和之。于是资生皮肉、筋骨、精髓、血脉、四肢、九窍、唇舌，总合而成人体。在外则气血循环，流注于经络，易受六淫（风、寒、暑、湿、燥、火六种外感病邪）侵袭；在内则精神、魂魄、志、意，易受七情（喜、怒、忧、思、悲、恐、惊七种情志变化）影响。若调护得当，则怡然安泰，生命得以延续。病症既已形成，必须追溯其根源。所以前代哲人示教，称之为“病源”。《内经》不云乎：“治疗的关键在于堵塞门户窗户（指防止外邪入侵），联系患病者，多次询问其经脉状况，以顺从其心意。”这是为了探求致病的根本原因。
然而，六淫从天通过经络侵入体内，合于脏腑，属于“外所因”；七情是人的本性，触动它则先自脏腑郁结发作，属于“内所因”；还有折伤、疰忤（中恶邪气）、附着、畏惧压迫溺水等违背常理的因素，属于“不内外因”。《金匮要略》有言：“千般疢难，不越三条。”据此详细分析，疾病的源头就穷尽了。如果想要救治治疗，就在其中寻找其类别例证，辨别出有三因。或者内外兼有，淫邪与情志交错，推究其深浅，根据所随的病因施治，药物、金石、针刺、艾灸，没有不可施用的。
辨别脉象：古人通过脉象在人迎穴和气口穴来辨别内外伤于人。人迎脉大于气口，为外伤；气口脉大于人迎，为内伤。左手……是足太阳寒水之脉，按之洪大而有力，中见……脉也。若外感风邪，则人迎脉缓而大，或大……气口脉大于人迎一倍，伤之重者超过这个比例。少阴则……此内伤饮食之脉。若饮食不节制，劳役过度，则三脉遍见于气口，这是心火刑克肺金。其肝木挟带心火……涩者……挟心……也。如一代也。
辨别寒热：外伤寒邪的证候，与饮食不节、劳役损伤形质的病，以及内伤饮食，都伴有寒热。举世之人都将……热恶……在表也……乘之，郁……已不能……寒。一……不节……内伤……寒邪……平常……无所……阳日……所恶……下。凉处……辨之……不通……郁……咽……表虚之弱，为阴火所乘，燥热发须臾而过，表虚无阳，不耐风寒，又复见了。是表虚无阳，常常有之。其燥热则间而有之。这两者不齐作，燥作寒已，寒作燥已，不像外伤之寒热齐作，无有间断之热，故难辨。
辨外感内伤恶风：外感八风之邪，乃有余之证也。内伤饮食不节、劳役所伤，皆不足之病也。细分……入里……常。居……鼻……不……初劳役得病食少，小便赤黄，大便常难，或秘或结或虚坐，只见些小白脓，时有下气，或泄黄如糜，或溏泄色白，或结而不通。若心下痞，或胸中闭塞，如刀割之痛。二者亦互相见，不并出也。有时胃脘当心而痛，上肢两胁痛，心脐下相火之势，如巨川之水不可遏而上行。使……而……俱无此证，故易为分别耳。复有一等，乘天气大热之时，在于路途……得……甚……证……减。不……足……矣……有……寒凉……免者……日之……外伤贼……必短气。
Human beings are born by inheriting the Yin and Yang of Heaven and Earth. Heaven has the Six Qi (Six atmospheric influences), which humans receive upwards through the Three Yin and Three Yang meridians; Earth has the Five Elements, to which humans correspond downwards through the Zang and Fu organs. Thus, skin, flesh, sinews, bones, marrow, essence, blood vessels, limbs, nine orifices, lips, and tongue are nourished and combined to form the human body. Externally, Qi and Blood circulate and flow into the meridians, making one susceptible to injury by the Six Pathogenic Factors (Wind, Cold, Summer-heat, Dampness, Dryness, Fire). Internally, Spirit, Soul, Will, and Intent are susceptible to influence by the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). If care is taken appropriately, one remains peaceful and tranquil, and life is sustained. Once a disease pattern is established, its origin must be traced. Therefore, ancient sages taught that this is called the "Source of Disease." Does not the Classic say: "The extremity of treatment lies in sealing doors and windows [preventing external invasion]; connect with the patient, frequently inquire about their meridians, and follow their intent." This is to know the root cause of the disease.
However, the Six Pathogenic Factors enter from Heaven via the meridians into the interior, combining with the Zang and Fu organs, constituting the "External Etiology"; the Seven Emotions are human nature; when stirred, they first stagnate and erupt from the Zang and Fu organs, constituting the "Internal Etiology"; there are also fractures, possession by evil spirits, attachments, fear of pressure or drowning, etc., which go against normal principles, constituting the "Neither Internal nor External Etiology." The *Jin Gui Yao Lue* states: "A thousand kinds of ailments do not exceed three categories." Based on this detailed analysis, the sources of disease are exhausted. To seek cure, one must find the categories within them and distinguish the Three Etiologies. Whether internal and external combine, or pathogenic factors and emotions intermingle, one must deduce the depth and treat according to the accompanying cause. Medicines, minerals, acupuncture, and moxibustion can all be applied without restriction.
Differentiating Pulse: Ancient people differentiated internal and external injuries in humans by the pulse at the Renying (ST9) and Qikou (LU9) points. If the Renying pulse is larger than the Qikou pulse, it indicates an external injury; if the Qikou pulse is larger than the Renying pulse, it indicates an internal injury. The left hand... is the pulse of Foot-Taiyang Bladder Water. Pressing it reveals a surging and forceful quality, with intermediate manifestations... If externally affected by Wind Evil, the Renying pulse becomes slow and large, or large... The Qikou pulse is larger than the Renying pulse by one fold; for severe injuries, it exceeds this proportion. Shaoyin then... This is the pulse of internal injury due to diet. If diet is irregular or labor/exertion is excessive, these three pulses appear throughout the Qikou area. This indicates Heart Fire punishing Lung Metal. Liver Wood carries Heart Fire... Choppy pulse... Carries Heart... As in one generation.
Differentiating Cold and Heat: Patterns of external Cold Evil injury, as well as diseases of dietary irregularity and physical exhaustion from labor, and internal injury from diet, all present with cold and heat. The world generally regards... Heat aversion... At the exterior... Invading, stagnating... Unable to... Cold. One... Irregular diet... Internal injury... Cold evil... Ordinary... Nothing... Yang day... Aversion... Downward. Cool place... Differentiate... Unblocked... Stagnation... Throat... Weakness of exterior deficiency, attacked by Yin Fire, dryness/heat arises briefly and passes; the exterior lacks Yang, unable to withstand Wind-Cold, which reappears. Exterior lack of Yang occurs frequently. Dryness/heat occurs intermittently. These two do not occur simultaneously; when dryness/heat appears, cold subsides, and when cold appears, dryness/heat subsides. Unlike external injuries where cold and heat occur together without interruption, making them difficult to differentiate.
Differentiating Wind Aversion in External vs. Internal Injury: External contraction of the Eight Winds is a syndrome of excess. Internal injury from dietary irregularity and labor/exertion are syndromes of deficiency. Subdivide... Entering the interior... Common. Dwelling... Nose... Not... Initially contracting illness from labor, food intake is low, urine is dark yellow, stool is often difficult, either constipated, bound, or feeling the urge to defecate but passing only small amounts of white pus, accompanied by occasional flatulence, or diarrhea yellow like millet gruel, or loose pale stool, or binding without passage. If there is epigastric fullness/stuffiness, or chest obstruction, pain like knife cutting. These two may appear mutually exclusively, not simultaneously. Sometimes pain occurs in the stomach region below the heart, radiating to both hypochondriac regions. The momentum of Ministerial Fire below the heart and umbilicus rises uncontrollably like a great river. Make... And... None of these symptoms... Hence easy to distinguish. Additionally, there are cases occurring during times of extreme weather heat, while traveling... Contracted... Severe... Syndrome... Reduced. Not... Deficient... Yes... Have... Cold/Cool... Avoid... Day... External thief... Must have shortness of breath.