真气者（止）充身也 甲乙。谷上有水字。张云。真气即元气也。气在天者。受于鼻而喉主之。在水谷
者。入于口而咽主之。然钟于未生之初者。曰先天之气。成于已生之后者。曰后天之气。气在阳分即阳气。在
阴即阴气。在表曰卫气。在里曰营气。在脾曰充气。在胃曰胃气。在上焦曰宗气。在中焦曰中气。在下焦曰元
阴元阳之气。皆无非其别名耳。
正气者（止）非虚风也 甲乙。无来非实风又五字。虚风注太素云。非灾风也。志云。正气者大块噫气。
其名为风。从一方来。非实风。又非虚风。此天地之正气也。张云。从一方来。谓太一所居之方也。风得时之
正者。是为正风。然正风实风。本同一方。而此曰非实风者。以正风之来徐而和。故又曰正气。实风之来暴而
烈。故与虚风对言也。按岁露篇曰。诸所谓风者。皆发屋折树木扬沙石。此虚风实风之谓也。
邪气者 马云。如冬居叶蛰之宫。而风自后来者是也。大义见岁露篇。
合而自去 甲乙无合字。张云。谓邪与正合而正胜之。故自去也。闵士先云。人秉天地之正气所生。
故天之正气。与人之真气相合。不能胜真气者。合并之气盛也。
洒淅 甲乙作凄索。张云。寒栗也。
阳胜者（止）搏于皮肤之间 张云。若与卫气相搏。阳胜则热。阴胜则寒。皆邪气也。何独曰寒则真气
去。去则虚。
盖气属阳。人以气为主。寒胜则阳虚。所重在气也。阳气既虚。则阴寒搏聚于皮肤之间矣。简案、马以阳经之
气胜阴经。阴经之气胜阳经释之。且以寒则真气去。去则虚云云。按下文为行则为痒之所因。并非也。
其气外发（止）为不仁 甲乙行上有微字。留上有气字。摇气、注云。一本作淫气。诸本为痹、作则痹。
马志与原文同。张云。邪之在表者。其气外发。或腠理开。则汗为不敛。或毫毛动摇。则毛悴而败。或气往来
行。则流而为痒。或邪留不去。则痛而为痹。若卫气受伤。虚而不行。则不知痛痒。是谓不仁。简案、张摇下
句。然不若作淫气。义易通。
虚邪偏容于身半（止）脉偏痛 甲乙。虚、作淫。容、作客。简案、中风偏枯之所因。的在于此。续命
诸汤。立方之皆。亦本于此。
骨蚀 马云。骨有所损也。张云。其最深者。内伤于骨。是为骨蚀。谓侵蚀及骨也。简案、骨蚀未详。
岂谓多骨附骨等之疽欤。
有所疾前筋筋屈 甲乙无一筋字。楼氏云。前筋二字。衍文也。筋当作结。简案、今从楼说。
筋溜 甲乙。溜、作瘤。张云。有所疾前筋。谓疾有始于筋也。筋之初着于邪。则筋屈不得伸。若久
居其间而不退。则发为筋溜。筋溜者。有所流注而结聚于筋也。即赘瘤之属。下仿此。简案、刘熙释名云。瘤、
流也。血气聚所生瘤肿也。陈氏外科正宗云。筋瘤者。坚而色紫。垒垒青筋。盘曲甚者。结若蚯蚓。
肠溜 甲乙作肠疸。注。肠、一本作疡。张云。留而不反。则蓄积于中。流注于肠胃之间。乃结为肠
溜。简案、肠溜、他书未见详论其证者。俟考。甲乙肠疽亦同。
昔瘤 张云。其有久者。必数岁而后成也。然其始也。按之虽柔。或上或下。已有所结。及其久也。
气渐归之。津液留之。复中邪气。则易于日甚。乃结为昔瘤。昔瘤者。非一朝夕之谓。简案、即宿瘤也。
骨疽 张云。又有按之而坚者。其深中骨。是气因于骨而然。骨与气并。其结日大。名为附骨疽也。
简案、骨疽不言有脓。此似指骨瘤而言。陈氏云。骨瘤者。形色紫黑。坚硬如石。疙瘩高起。推之不移。昂昂
坚贴于骨。
肉疽 张云。又有结于肉中者。则宗气归之。宗、大也。以阳明之气为言。邪留为热。则溃腐肌肉。
故为脓。无热则结为粉浆之属。聚而不散。是为肉疽。简案、无脓而谓之肉疽。此亦似指肉瘤而言。陈氏云。
肉瘤者。软若绵。硬似馒。皮色不变。不紧不宽。终年只似覆肝
凡此数气者（止）有常名也 张云。虽有常名。而发无常处。无常处则形证亦无常矣。此所以变化无常也。
楼氏云。此皆虚邪中人为病。弗去而久留着。故积岁累月。而成疽瘤也。
真气（人体最根本、最重要的气）充满全身。《甲乙经》中“谷上”有“水”字。张景岳说：真气就是元气。运行于天（呼吸之气）的，由鼻吸入，喉咙主管；进入饮食水谷的，由口摄入，咽喉主管。然而，在生命形成之前就已存在的，称为先天之气；在生命形成之后生成的，称为后天之气。气存在于阳分即为阳气，存在于阴分即为阴气。行于体表称为卫气（保卫体表的气），行于体内称为营气（化生血液、营养周身的气）。在脾称为脾气，在胃称为胃气。在上焦称为宗气（积聚于胸中的大气），在中焦称为中气，在下焦称为元阴元阳之气。这些都不过是气的不同别名罢了。
正气（正常的气候或人体抗病能力）……不是虚风（致病的风邪）。《甲乙经》中没有“来非实风又五字”。《太素》注解说：虚风不是灾风。王冰注解说：正气是大地的噫气，名为风。从一方而来，不是实风（正常之风），也不是虚风，这是天地的正气。张景岳说：从一方而来，指的是太一神所居的方向。顺应时令的正气，称为正风。然而正风和实风本来自同一方向，这里说“不是实风”，是因为正风到来时缓慢温和，所以又称为正气；实风到来时猛烈暴烈，所以与虚风相对而言。按《岁露篇》所说：所有提到的风，都能吹毁房屋、折断树木、扬起沙石，这就是所说的虚风和实风。
邪气（致病因素）：马莳说：比如冬天居住在叶蛰宫位，风从后面吹来的情况。其大意见于《岁露篇》。
合而自去：《甲乙经》没有“合”字。张景岳说：指邪气与正气相合，但正气战胜邪气，所以邪气自行离去。闵士先说：人秉承天地的正气而生，所以天的正气与人的真气相合，如果邪气不能胜过真气，合并后的正气就旺盛。
洒淅（恶寒战栗的样子）：《甲乙经》写作“凄索”。张景岳说：即寒栗。
阳胜者……搏于皮肤之间：张景岳说：如果与卫气相搏，阳胜则热，阴胜则寒，这都是邪气。为什么唯独说“寒则真气离去，离去则导致虚弱”？大概因为气属于阳，人以气为主，寒邪胜则阳气虚，重点在于气。阳气既然虚弱，阴寒就会搏结聚集在皮肤之间。简案：马莳用阳经之气胜阴经、阴经之气胜阳经来解释。并且对“寒则真气去，去则虚”等说法，按下文“行则为痒”的原因来看，并非如此。
其气外发……为不仁：《甲乙经》“行”上有“微”字，“留”上有“气”字。“摇气”，注云：一本作“淫气”。诸本作“痹”，作则“痹”。马莳的观点与原文相同。张景岳说：邪气在表，其气向外发散。或者腠理开泄，则汗出不收敛；或者毫毛动摇，则毛发憔悴败坏；或者气往来流动，则流变为瘙痒；或者邪气停留不去，则痛而成为痹证。如果卫气受伤，虚弱而不能运行，则不知痛痒，这叫做不仁。简案：张景岳在“摇”字下的句子，然而不如作“淫气”，义理更容易通顺。
虚邪偏容于身半……脉偏痛：《甲乙经》“虚”作“淫”，“容”作“客”。简案：中风偏枯的原因，确实在于此。续命诸汤的立方依据，也本于此。
骨蚀：马莳说：骨头有所损伤。张景岳说：最深层次的，内伤于骨，称为骨蚀，意思是侵蚀到了骨头。简案：骨蚀不详。难道是指多骨附骨之类的疽吗？
有所疾前筋筋屈：《甲乙经》无“一筋”字。楼氏说：“前筋”二字是衍文。筋应当作“结”。简案：现在采纳楼氏的说法。
筋瘤：《甲乙经》“溜”作“瘤”。张景岳说：有所疾病始于筋，称为“疾有始于筋”。筋最初附着邪气，则筋屈曲不能伸展。如果长久停留其间而不消退，则发展为筋瘤。筋瘤，是有邪气流注并结聚于筋的结果。即赘瘤之类，下文仿照此例。简案：刘熙《释名》说：瘤，流也。血气聚集所生的瘤肿。陈实功《外科正宗》说：筋瘤，坚硬且颜色紫红，青筋垒垒盘曲，严重时结块像蚯蚓一样。
肠瘤（肠疸）：《甲乙经》作“肠疸”。注：肠，一本作“疡”。张景岳说：停留而不返回，则蓄积于中，流注于肠胃之间，于是结为肠瘤。简案：肠瘤在其他书中未见详细论述其症状的，等待考证。《甲乙经》中肠疽也是同样的。
昔瘤（宿瘤）：张景岳说：那些存在时间久的，必须经过多年才能形成。然而开始时，按压虽然柔软，或上或下，已经有所结聚。等到久了，气逐渐归向它，津液停留其中，又夹杂邪气，则容易日益加重，于是结为昔瘤。昔瘤，不是一朝一夕形成的。简案：即宿瘤。
骨疽：张景岳说：又有按压坚硬的，病邪深中于骨，这是气因于骨而造成的。骨与气并结，结块日渐增大，名为附骨疽。简案：骨疽不说有脓，这似乎是指骨瘤而言。陈实功说：骨瘤，形色紫黑，坚硬如石头，疙瘩高起，推之不移，昂然坚硬贴附于骨。
肉疽：张景岳说：又有结在肉中的，则宗气归向它。宗，大也。以阳明之气来说。邪气停留化为热，则溃腐肌肉，所以化为脓。如果没有热，则结为粉浆之类，聚集不散，称为肉疽。简案：没有脓却称为肉疽，这也似乎是指肉瘤而言。陈实功说：肉瘤，软像棉花，硬像馒头，皮色不变，不紧不宽，终年只像覆盖着的肝脏。
凡此数气者……有常名也：张景岳说：虽然有固定的名称，但发病没有固定的部位。发病部位无常，那么形证也就无常了。这就是变化无常的原因。楼氏说：这些都是虚邪侵入人体致病，如果不去除而长久留着，所以积岁累月，而成疽瘤。
Zhenqi (True Qi, the most fundamental and vital qi of the body) fills the entire body. In *Jia Yi Jing*, there is a "water" character above "grain". Zhang Jingyue stated: Zhenqi is Yuanqi (Source Qi). The qi that operates in heaven (respiratory qi) is inhaled through the nose and governed by the throat; the qi entering food and drink is ingested through the mouth and governed by the pharynx. However, what existed before life was formed is called Xiantian zhiqi (Pre-heaven Qi); what is generated after life is formed is called Houtian zhiqi (Post-heaven Qi). When qi exists in the Yang aspect, it is Yangqi (Yang Qi); when it exists in the Yin aspect, it is Yinqi (Yin Qi). Circulating on the exterior, it is called Weiqi (Defensive Qi, qi that protects the body surface); circulating within, it is called Yingqi (Nutritive Qi, qi that transforms into blood and nourishes the body). In the Spleen, it is Piyang (Spleen Qi); in the Stomach, it is Weiqi (Stomach Qi). In the Upper Jiao, it is Zongqi (Gathering Qi, large qi accumulated in the chest); in the Middle Jiao, it is Zhongqi (Middle Qi); in the Lower Jiao, it is Yuanyin Yuanyang zhiqi (Primordial Yin and Primordial Yang Qi). These are all nothing but alternative names for qi.
Zhengqi (Normal climate or the body's resistance to disease)... is not Xufeng (Pathogenic wind). *Jia Yi Jing* lacks the five characters "lai fei shifeng you wu zi" (comes, not real wind, plus five other characters). The commentary in *Tai Su* states: Xufeng is not disaster wind. Wang Bing commented: Zhengqi is the breath of the earth, named wind. It comes from one direction, neither Shifeng (Normal Wind) nor Xufeng; this is the Zhengqi (Righteous Qi) of heaven and earth. Zhang Jingyue said: Coming from one direction refers to the direction where Taiyi resides. Wind that conforms to the correct season is called Zhengfeng (Regular Wind). However, Zhengfeng and Shifeng originally come from the same direction. Here it says "not Shifeng" because Zhengfeng arrives slowly and gently, hence also called Zhengqi; Shifeng arrives violently and fiercely, hence mentioned opposite to Xufeng. According to *Sui Lu Pian*: All winds mentioned can destroy houses, break trees, and raise sand and stones; this refers to Xufeng and Shifeng.
Xieqi (Pathogenic factors): Ma Shi said: For example, in winter, residing in the Ye Zhe palace position, with wind blowing from behind. The general meaning is seen in *Sui Lu Pian*.
He er zi qu (Combine and depart spontaneously): *Jia Yi Jing* lacks the character "he". Zhang Jingyue said: This means pathogen combines with Zhengqi, but Zhengqi overcomes the pathogen, so it departs spontaneously. Min Shixian said: Humans are born inheriting the Zhengqi of heaven and earth. Therefore, the Zhengqi of heaven combines with the Zhenqi of humans. If the pathogen cannot overcome the Zhenqi, the combined Zhengqi becomes prosperous.
Saxi (Shivering with cold): *Jia Yi Jing* writes "Qisuo". Zhang Jingyue said: It means chills.
Yang sheng zhe... bo yu pifu zhi jian (When Yang prevails... struggles between the skin and flesh): Zhang Jingyue said: If it struggles with Weiqi, Yang prevalence leads to heat, Yin prevalence leads to cold; both are pathogenic factors. Why specifically say "Cold causes Zhenqi to depart, departure leads to deficiency"? Generally, qi belongs to Yang, and humans rely on qi as their mainstay. Cold prevalence causes Yang deficiency, emphasizing the importance of qi. Once Yangqi is deficient, Yin-cold will struggle and accumulate between the skin and flesh. Commentary: Ma Shi explained this using the concept of Yang channel qi overcoming Yin channel qi, and Yin channel qi overcoming Yang channel qi. Furthermore, regarding the statement "Cold causes Zhenqi to depart, departure leads to deficiency," looking at the subsequent text regarding "movement leads to itching," it is not accurate.
Qi qi wai fa... wei bu ren (Its qi emits outward... becomes numbness): *Jia Yi Jing* has the character "wei" (slight) above "xing" (move), and "qi" above "liu" (stay). "Yao qi", commentary notes: One version writes "Yin qi". Most versions write "Bi" (Obstruction), and if acting, "Bi". Ma Shi's view aligns with the original text. Zhang Jingyue said: When pathogen is at the exterior, its qi emits outward. Either the Couli (pores) open, causing sweat not to consolidate; or the hair follicles shake, causing hair to become withered and ruined; or qi moves back and forth, flowing into itching; or pathogen stays without departing, causing pain and becoming Bi syndrome. If Weiqi is injured, becomes deficient, and fails to circulate, then pain and itch are not perceived, which is called Bu Ren (Numbness/Loss of sensation). Commentary: Zhang's sentence under "Yao" is less coherent than reading it as "Yin qi," which makes the meaning easier to understand.
Xu xie pian rong yu shen ban... mai pian tong (Deficient evil partially accommodates half the body... pulse pain on one side): *Jia Yi Jing* writes "Yin" for "Xu" and "Ke" for "Rong". Commentary: The cause of stroke hemiplegia lies precisely here. The prescriptions of the various Xuming Tangs are based on this principle.
Gu shi (Bone erosion): Ma Shi said: Bone damage. Zhang Jingyue said: At the deepest level, internal injury to bone is called Gu Shi, meaning erosion reaches the bone. Commentary: Gu Shi is unclear. Could it refer to abscesses like Duo Gu Fu Gu Ju?
You suo ji qian jin jin qu (Disease affecting the tendons, causing tendon flexion): *Jia Yi Jing* lacks the character "yi". Lou Shi said: The characters "Qian Jin" are redundant. "Jin" should be read as "Jie" (knot/tumor). Commentary: Following Lou Shi's theory now.
Jin liu (Tendon tumor): *Jia Yi Jing* writes "Liu" as "Liu" (tumor). Zhang Jingyue said: Disease starting in the tendon is called "disease starting in the tendon." Initially, when tendon attaches to pathogen, tendon flexes and cannot extend. If it remains there for a long time without receding, it develops into Jin Liu (Tendon Tumor). Jin Liu is the result of pathogenic flow and accumulation in the tendon, belonging to exophytic tumors. The following cases follow this pattern. Commentary: Liu Xi's *Shi Ming* states: Liu (tumor) means flow. Swelling generated by the aggregation of blood and qi. Chen Shigong's *Waike Zhengzong* states: Jin Liu is hard and purple, with coiled blue veins, knotting like earthworms when severe.
Chang liu (Intestinal tumor/jaundice): *Jia Yi Jing* writes "Chang Dan" (Intestinal Jaundice). Note: Chang, one version writes "Yang" (ulcer). Zhang Jingyue said: Staying without returning, it accumulates internally, flows into the intestines and stomach, and knots into Chang Liu. Commentary: Chang Liu is not discussed in detail regarding symptoms in other books; awaiting verification. *Jia Yi Jing*'s Chang Ju is the same.
Xi liu (Old/Long-standing tumor): Zhang Jingyue said: Those existing for a long time must take several years to form. Initially, although soft to touch, whether upper or lower, there is already some knotting. As time passes, qi gradually gathers there, fluids remain, mixed with pathogen, making it worsen day by day, thus forming Xi Liu. Xi Liu does not mean a matter of one morning or evening. Commentary: This is Jiuxiu (Old Tumor).
Gu ju (Bone abscess): Zhang Jingyue said: There are also those hard to touch, where pathogen deeply enters bone. This is qi caused by bone. Bone and qi combine, the knot grows daily, named Fugu Ju (Attached Bone Abscess). Commentary: Gu Ju does not mention pus; this seems to refer to Gu Liu (Bone Tumor). Chen Shigong states: Gu Liu is purple-black, hard as stone, nodular and raised, immovable upon pushing, firmly attached to the bone.
Rou ju (Flesh abscess): Zhang Jingyue said: There are also knots in the flesh, where Zongqi gathers. Zong means large, referring to Yangming qi. Pathogen staying generates heat, ulcerating muscle, thus forming pus. Without heat, it knots into paste-like substances, aggregating without dispersing, called Rou Ju. Commentary: Called Rou Ju without pus; this also seems to refer to Rou Liu (Flesh Tumor). Chen Shigong states: Rou Liu is soft as cotton, hard as steamed bun, skin color unchanged, neither tight nor loose, resembling covered liver throughout the year.
Fan ci shu qi zhe... you chang ming ye (All these several types of qi... have constant names): Zhang Jingyue said: Although they have constant names, their onset has no fixed location. No fixed location means manifestations and signs are also variable. This is why changes are unpredictable. Lou Shi said: These are all diseases caused by Xu Xie (Deficient Evil) invading humans. If not removed and left to linger, they accumulate over years and months, forming Ju (abscesses) and Liu (tumors).