诸本无篇字。
已然 诸本作亦然。
美骨 甲乙作善骨。张云。美骨者。骨强之谓。
多热者（止）难已 张云。多热者。病在阳分。故易已。多寒者病在阴分。故难已。
故其瘦而薄胃者 甲乙无故字。胃字似是。张云。若肉瘦而胃薄者。气血本属不足。安能胜毒药也。
诸本无篇字。马云。内以百岁为论。故名篇。
以母为基。以父为 马云。方其始生。赖母以为之基。坤道成物也。赖父母为之 。阳气以为
捍卫也。张云。基、址也。 、材具也。人之生也。合父母之精而有其身。父得干之阳。母得坤之阴。阳一而
施。阴两而承。故以母为基。以父为 。譬之稼穑者。必得其地。乃施以种。种优地优。肖由乎父。种停地劣。
变成乎母。地种皆得。而阴阳失序者。虽育无成也。故三者相合而象。变斯无穷矣。夫地者
基也。种者 也。阴阳精气者神也。知乎此。则知人生之所以然矣。简案、 、说文阑槛也。王逸云。纵曰栏。
横曰 。今阶除木勾栏是也。马解为捍卫。盖本于此。张以为材具。未见所由。
失神者死 得神者生也 马云。素问移精变气论云。得神者昌。失神者亡。简案、庄子云。人之生
也。聚则为生。散则为死。
五脏坚固（止）故能长久 张云。坚固者不易损。和调者不易乱。解利者可无留滞。致密者可免中
伤。营卫之行。不失其常者。经脉和也。吸呼微徐。气以度行者。三焦治也。六腑化谷。津液布扬。则脏腑和
平。精神充畅。故能长久而多寿也。
使道隧（止）百岁乃得终 马志本隧、作队。马云。队、隧同。使道者水沟也。（俗云人中）其队
道以长面之地部为基。耳为蔽为墙。乃高以方。营卫之气。皆已通调。而面之三里。即三部也。（俗云三停）
皆已耸起。其骨高。其肉满。所以百岁乃得终也。张云。礼记百岁谓之期颐。使道。指七窍而言。谓五脏所使
之道路。如肺气通于鼻。肝气通于目。脾气通于口。心气通于舌。肾气通于耳。是即五官之道路也。玩、深邃
貌。基墙指面部而言。骨骼为基。蕃蔽为墙。见五色篇。凡营卫部里。及骨高肉满若此者。即致寿之道。志云。
使道者。血脉之道路。本输篇之所谓间使之道。盖心包络之主血脉也。队、行列也。长者环转之无端也。此言
血气充足。循序而流通也。土基高以方者。肌肉浓而充于四体也。脉道流长。肌肉高浓。则营卫通调矣。三部
者。形身之上中下。三里者。手足阳明之脉。皆起发而平等也。骨高者。少阴之气足也。肉满者。阳明之气盛
也。如此者寿之征也。简案、本篇三家
异义。然熟考经文。马注为允当。
好走 好趋。 马云。趋者较走更疾矣。步者较趋更缓矣。张云。天地之气。阳主乎升。升则向生。
阴主乎降。降则向死。故幼年之气在下者。亦自下而升也。志云。此言人之生长。从阴而生。自下而上。故曰
其气在下。好走、好趋、好步者。春夏生动之气也。方盛衰论曰。老从上。少从下。简案、说文。走、趋也。
又趋、走也。释名曰。疾趋曰走。又疾行曰趋。此乃走疾而趋徐。马注误。
好步 张云。盛满则不轻捷。故好步矣。
四十岁（止）好坐 甲乙。颓、作刷。马云。坐者较步似倦矣。张云。天地消长之道。物极必变。
盛极必衰。日中则昃。月盈则亏。人当四十。阴气已半。故发颇斑白。而平盛不摇。好坐者。衰之渐也。
五十岁（止）目始不明 志云。人之衰老。从上而下。自阳而阴。故肝始衰而心。心而脾。脾而
肺。肺而肾。好坐好卧者。秋冬收藏之气也。
六十岁（止）独居而终矣 甲乙。苦、作善。（马志亦作善）皮肤枯、作皮肤始枯。故四肢不举。
魄离、作魂魄离散。四藏、作脏乃萎枯。终矣、作终尽矣。马云。至五十岁以后。则肝生心。心生脾。脾生肺。
肺生肾者。每十岁而日衰。故五十岁肝胆衰。六十岁心气衰。七十岁脾气衰。八十岁肺气衰。九十岁肾气衰。
百岁五脏俱衰。善忧悲者。以心主于忧也。好卧者。卫气不精也。魄离散。以肺藏魄者。失其故处也。言善误。
肺主言也。肾气焦者。水竭则焦也。张云。魄离者。形体衰败也。肾气焦者。真阴亏竭也。此与上古天真论。
女尽七七。男尽八八。互相发明。彼以七八言者。言阴阳之限数。此以十言者。言人生之全数。然则人之气数。
固有定期。
而长短不齐者。有出于禀受。有因于人为。故惟智者。不以人欲害其天真。以自然之道。养自然之寿。而善终
其天年。此圣智之所同也。
使道不长 空外以张 喘息暴疾 马云。水沟不长。较之使道队以长者异也。其鼻孔向外而张。鼻为肺
窍。肺气泄矣。（师傅篇云鼻孔在外膀胱漏泄）又肺主气。今肺气不足。故喘息而为暴疾也。张云。喘息者气
促。暴疾者易伤。皆非延寿之征也。简案、喘息暴疾。谓喘息之气。卒暴疾速也。
其肉不石 张云。石、坚也。
数中风寒（止）相引 张云。数中风寒。表易犯也。血气虚。中不足也。脉不通。经络多滞也。故致真邪
易于相攻。然正本拒邪。正气不足。邪反随之而入。故曰相引。
故中寿而尽也 张云。凡此形体血气。既已异于上寿。则其中寿而尽。固有所由。此先天之禀受然也。
夫人生器局。既禀于有生之初。则其一定之数。似不可以人力强者。第禀得其全。而养能合道。必将更寿。禀
失其全。而养复违和。能无更夭。故知之者。下可以希中。中可以希上。不知者。上仅得其次。次仅得其下矣。
所谓天定则能胜人。人定亦能胜天也。夫禀受者先天也。修养者后天也。先天责在父母。后天责在吾心。
各版本中均无“篇”字。
马莳注：诸本作“亦然”。
美骨：《甲乙经》作“善骨”。张景岳说：“美骨”，是指骨骼强健的意思。
多热者（至）难已：张景岳说：“多热者，病在阳分，所以容易痊愈；多寒者，病在阴分，所以难以痊愈。”
所以那些身体消瘦且胃壁薄弱的人：《甲乙经》中没有“故”字。“胃”字似乎是衍文或误字。张景岳说：“如果肌肉消瘦且胃壁薄弱，气血本来就不充足，怎么能承受得住药性猛烈的药物呢？”
各版本中均无“篇”字。马莳说：本篇以百岁为论述标准，所以命名为“天年篇”。
以母亲作为基础，以父亲作为……马莳说：人刚出生时，依赖母亲作为根基，这是坤道成就万物的道理；依赖父母作为……阳气用来保卫护卫。张景岳说：“基”是地基，“栏”是栏杆、材具。人的出生，是结合了父母的精气而有了身体。父亲给予乾之阳，母亲给予坤之阴。阳是一而施予，阴是两而承载。所以以母亲为基础，以父亲为……就像耕种庄稼一样，必须得到土地，然后施加种子。种子优良、土地肥沃，肖似于父亲；种子停滞、土地贫瘠，变化取决于母亲。土地和种子都具备，但阴阳失去秩序，即使孕育也无法成功。所以三者相合而形成形象，变化就无穷无尽了。大地是基，种子是……阴阳精气是神。懂得这个道理，就知道人生之所以然了。简案：“栏”，《说文解字》解释为阑槛。王逸说：“纵向的叫栏，横向的曰栏。”现在台阶旁的木勾栏就是这种。马莳将其解释为捍卫，大概基于此意。张景岳认为是材具，没看到依据所在。
失神者死，得神者生也：马莳说：《素问·移精变气论》说：“得神者昌，失神者亡。”简案：庄子说：“人活着的时候，气聚则生，气散则死。”
五脏坚固（至）故能长久：张景岳说：“坚固就不易受损，调和就不易紊乱，疏泄通利就没有留滞，致密就不会受到内伤。营卫的运行不失常态，经脉就调和；呼吸微缓，气息按节度运行，三焦就治理正常。六腑消化水谷，津液布散扬溢，脏腑就和平，精神充畅，所以能长寿。”
使道深邃（至）百岁乃得终：马莳的版本中，“隧”写作“队”。马莳说：“队”、“隧”同义。“使道”就是水沟穴（俗称人中）。其深邃之道以长面部下方的区域为基础，耳朵作为遮蔽和墙壁，于是高且方正。营卫之气都已通调，面部的三里（即三部，俗称三停）都已耸起。骨骼高挺，肌肉丰满，所以能活到百岁才终结。张景岳说：《礼记》称百岁为期颐。“使道”指七窍而言，说是五脏所使的道路，如肺气通于鼻，肝气通于目，脾气通于口，心气通于舌，肾气通于耳，这就是五官的道路。“玩”意为深邃的样子。“基墙”指面部而言，骨骼为基，蕃蔽为墙，见《五色篇》。凡是营卫分部里，以及骨高肉满像这样的，就是长寿之道。马莳说：“使道”是血脉的道路，即《本输篇》所说的间使之道，大概是心包络主司血脉。“队”是行列的意思。“长”是环转没有尽头。这是说血气充足，循序流通。土基高且方正，是肌肉浓厚并充盈四肢。脉道流长，肌肉高厚，则营卫通调。三部是指形体的上中下，三里是指手足阳明经脉，都起始发育且平等。骨骼高，说明少阴之气充足；肌肉满，说明阳明之气旺盛。像这样的人是长寿的征兆。简案：本篇三家注解各有异义，然而仔细考证经文，马莳的注释最为允当。
好走：喜欢快走。马莳说：“趋”比“走”更快。“步”比“趋”更慢。张景岳说：天地之气，阳主升，升则趋向生；阴主降，降则趋向死。所以幼年时的气在下部，也是从下向上升。马莳说：这是说人的生长，从阴而生，自下而上，所以说“其气在下”。“好走”、“好趋”、“好步”是春夏生动之气。《方盛衰论》说：“老从上，少从下。”简案：《说文解字》说：“走，趋也。”又说：“趋，走也。”《释名》说：“疾趋曰走。”又说：“疾行曰趋。”这其实是走得快而趋得慢，马莳的注释有误。
好步：张景岳说：“身体盛满就不轻捷，所以喜欢慢步走了。”
四十岁（至）好坐：《甲乙经》中，“颓”写作“刷”。马莳说：“坐”比“步”似乎疲倦了。张景岳说：天地消长的道理，物极必变，盛极必衰。日中则斜，月盈则亏。人到了四十岁，阴气已经减半，所以头发开始斑白，而且平盛不摇。“好坐”是衰老的开始。
五十岁（至）眼睛开始不明：马莳说：人的衰老，从上而下，自阳而阴。所以肝先衰，然后是心，接着是脾，再是肺，最后是肾。“好坐”、“好卧”是秋冬收藏之气。
六十岁（至）独居而终矣：《甲乙经》中，“苦”写作“善”（马莳和马志也作“善”）。“皮肤枯”写作“皮肤始枯”，所以四肢不能抬起。“魄离”写作“魂魄离散”。“四藏”写作“脏乃萎枯”。“终矣”写作“终尽矣”。马莳说：到了五十岁以后，肝生心，心生脾，脾生肺，肺生肾，每十年日渐衰退。所以五十岁肝胆衰，六十岁心气衰，七十岁脾气衰，八十岁肺气衰，九十岁肾气衰，百岁五脏俱衰。“善忧悲”，是因为心主忧。“好卧”，是因为卫气不精。“魄离散”，是因为肺藏魄，失去了原来的位置。说“善”是错误的。肺主言。肾气焦，是水枯竭则焦。张景岳说：“魄离”是形体衰败。“肾气焦”是真阴亏竭。这与《上古天真论》中“女尽七七，男尽八八”互相发明。那里用七八来说，是讲阴阳的限数；这里用十来说，是讲人生的全数。然而人的气数，固有定期，而长短不齐，有的出于禀受，有的因于人为。所以只有智者，不以人欲损害其天真，以自然之道，养自然之寿，从而善终其天年。这是圣人和智者所共同的。
使道不长，空外以张，喘息暴疾：马莳说：水沟不长，与使道深邃的情况不同。鼻孔向外张开，鼻为肺窍，肺气泄了。（《师传篇》说鼻孔在外膀胱漏泄）又肺主气，现在肺气不足，所以喘息而且急促。张景岳说：“喘息”是气促，“暴疾”是易伤，都不是延寿的征兆。简案：“喘息暴疾”，是说喘息之气，突然急速。
其肉不石：张景岳说：“石”是坚硬的意思。
数中风寒（至）相引：张景岳说：“数中风寒”，表证易被侵犯。血气虚，中气不足。脉不通，经络多滞涩。所以导致真邪易于相互攻伐。然而正本拒邪，正气不足，邪气反而随之而入，所以说“相引”。
所以中寿而尽也：张景岳说：凡此形体血气，既然不同于上寿之人，那么其中寿而尽，固有所由。这是先天禀受如此。
人的器局，既然禀受于有生之初，那么一定的定数，似乎不可以人力强行改变。只是禀受得其全，而修养能合道，必将更长寿；禀受失其全，而修养又违和，能不更加夭折吗？所以知道的人，下可以希冀中，中可以希冀上；不知道的人，上仅能得到次，次仅能得到下。所谓天定则能胜人，人定亦能胜天。禀受是先天，修养是后天。先天责任在父母，后天责任在我们的心。
All versions lack the character "Pian" (Chapter).
Ma Shi's annotation: All versions read "Yi Ran" (also so).
Meigu (Beautiful bones): The *Jia Yi Jing* reads "Shangu" (Good bones). Zhang Jingyue states: "Meigu" refers to strong and robust bones.
Those with excessive heat (until) difficult to cure: Zhang Jingyue states: "Those with excessive heat, the disease is in the Yang aspect, therefore it is easy to cure. Those with excessive cold, the disease is in the Yin aspect, therefore it is difficult to cure."
Therefore, those who are thin and have a thin stomach wall: The *Jia Yi Jing* lacks the character "Gu" (Therefore). The character "Wei" (Stomach) seems to be an error or interpolation. Zhang Jingyue states: "If the flesh is thin and the stomach wall is thin, Qi and Blood are originally insufficient; how can they withstand potent medicinal drugs?"
All versions lack the character "Pian" (Chapter). Ma Shi states: This chapter discusses up to one hundred years, hence named "Tian Nian Pian" (Chapter on Natural Lifespan).
Relying on the mother as the foundation, relying on the father as... Ma Shi states: At the time of birth, one relies on the mother as the foundation; this is the way Kun (Earth/Yin) accomplishes things. One relies on parents as... Yang Qi serves as defense and protection. Zhang Jingyue states: "Ji" (Foundation) is the base; "Lan" (Railing/Barrier) refers to materials and tools. Human life arises from combining the essence of both parents. The father provides Qian (Heaven/Yang), and the mother provides Kun (Earth/Yin). Yang acts as one and imparts; Yin acts as two and receives. Thus, the mother is the foundation, and the father is the... Like farming, one must obtain the land before sowing seeds. If the seed is superior and the land fertile, the offspring resembles the father; if the seed is stagnant and the land inferior, changes depend on the mother. If both land and seed are present but Yin and Yang lose order, even if nurtured, there will be no success. Thus, when these three combine, forms arise, and changes become infinite. Earth is the foundation; seeds are the... Yin-Yang and Essence-Qi constitute Shen (Spirit). Understanding this, one understands why human life exists. Jian An: "Lan," according to *Shuowen Jiezi*, means a railing or fence. Wang Yi stated: "Vertical is Lan, horizontal is Lan." The wooden railings on steps today are examples of this. Ma Shi interpreted it as defense, likely based on this. Zhang believed it meant materials/tools, but the source is unclear.
Loss of Shen leads to death; acquisition of Shen leads to life: Ma Shi states: The *Suwen: Yijing Bianqi Lun* says: "Those who acquire Shen prosper; those who lose Shen perish." Jian An: Zhuangzi said: "When humans live, Qi gathers for life; when it scatters, it is death."
The Five Zang organs are solid and firm (until) therefore they can last long: Zhang Jingyue states: "Solidity means not easily damaged; harmony means not easily disturbed; smooth flow means no stagnation; density means avoiding internal injury. When Ying and Wei circulate without deviation, the meridians are harmonious. When breathing is slow and measured, and Qi moves according to rhythm, the Sanjiao functions normally. When the Six Fu organs transform grain and distribute fluids, the Zang and Fu organs are peaceful, and Spirit is abundant, thus enabling longevity."
The Shidao (Path of Command) is deep (until) one may reach a hundred years: In Ma Shi's edition, "Sui" (Deep) is written as "Dui". Ma Shi states: "Dui" and "Sui" are synonymous. "Shidao" refers to the Shuigou acupoint (commonly known as Renzhong). Its deep path takes the lower part of the face as its base, with the ears serving as cover and walls, thus high and square. Ying and Wei Qi are already regulated, and the three Li areas of the face (i.e., the Three Parts, commonly known as San Ting) are all prominent. With high bones and full flesh, one can live to a hundred years. Zhang Jingyue states: The *Liji* calls a hundred years "Qiyi". "Shidao" refers to the seven orifices, saying they are the paths used by the Five Zang organs, such as Lung Qi connecting to the nose, Liver Qi to the eyes, Spleen Qi to the mouth, Heart Qi to the tongue, and Kidney Qi to the ears; these are the paths of the five sense organs. "Wan" implies a profound appearance. "Jiqiang" refers to the face; bones are the foundation, and protective features are the walls, as seen in the *Wuse Pian*. Whenever Ying-Wei distribution and bone-high/flesh-full conditions exist like this, it is the way to longevity. Ma Shi states: "Shidao" is the path of blood vessels, referring to the Jianshi path mentioned in the *Benshu Pian*, likely because the Pericardium governs blood vessels. "Dui" means rows. "Chang" means endless rotation. This describes sufficient Qi and Blood flowing in order. A high and square earthen base indicates thick and full muscles in the four limbs. Long vessel paths and thick muscles mean Ying and Wei are regulated. The Three Parts refer to the upper, middle, and lower body; the Three Li refer to the Hand and Foot Yangming meridians, which start developing equally. High bones indicate sufficient Shaoyin Qi; full flesh indicates vigorous Yangming Qi. Such people show signs of longevity. Jian An: The three commentaries in this chapter differ, but upon careful examination of the classic text, Ma Shi's annotation is most appropriate.
Likes to run: Likes to walk quickly. Ma Shi states: "Qu" (hurry/walk fast) is faster than "Zou" (run/walk). "Bu" (step/walk slowly) is slower than "Qu". Zhang Jingyue states: The Qi of Heaven and Earth: Yang governs ascent, ascending towards life; Yin governs descent, descending towards death. Therefore, the Qi in youth located below also ascends from below. Ma Shi states: This refers to human growth arising from Yin, moving from bottom to top, hence "Qi is below". "Likes to run", "likes to hurry", "likes to step" represent the dynamic Qi of Spring and Summer. The *Fang Sheng Shuai Lun* states: "Old age follows from above, youth follows from below." Jian An: *Shuowen Jiezi* states: "Zou is Qu." Also: "Qu is Zou." *Shiming* states: "Fast Qu is called Zou." Also: "Fast walking is called Qu." This actually means running fast and hurrying slowly; Ma Shi's annotation is incorrect.
Likes to step: Zhang Jingyue states: "When the body is full and mature, it is not light and agile, hence likes to walk slowly."
Forty years old (until) likes to sit: The *Jia Yi Jing* writes "Tui" as "Shua". Ma Shi states: "Sitting" seems more tired than stepping. Zhang Jingyue states: The principle of Heaven and Earth's waxing and waning: things change at extremes; prosperity declines after peak. The sun sets at noon; the moon wanes after being full. At forty years old, Yin Qi has halved, so hair begins to gray, and stability remains without shaking. "Likes to sit" is the beginning of decline.
Fifty years old (until) eyes begin to see poorly: Ma Shi states: Human aging proceeds from top to bottom, from Yang to Yin. Thus, the Liver declines first, then the Heart, then the Spleen, then the Lungs, and finally the Kidneys. "Likes to sit" and "likes to lie down" represent the storage Qi of Autumn and Winter.
Sixty years old (until) lives alone and dies: The *Jia Yi Jing* writes "Ku" (bitter/suffer) as "Shan" (good); Ma Shi and Ma Zhi also write "Shan". "Skin dries" is written as "Skin begins to dry", hence limbs cannot lift. "Po leaves" is written as "Hun and Po scatter". "Four Zang" is written as "Zang organs wither". "Zhong yi" (end) is written as "Zhong jin yi" (completely end). Ma Shi states: After fifty years, Liver generates Heart, Heart generates Spleen, Spleen generates Lungs, Lungs generate Kidneys; each decade sees daily decline. Thus, at fifty, Liver and Gallbladder decline; at sixty, Heart Qi declines; at seventy, Spleen Qi declines; at eighty, Lung Qi declines; at ninety, Kidney Qi declines; at one hundred, all Five Zang organs decline. "Prone to sorrow and grief" is because the Heart governs sorrow. "Likes to lie down" is because Wei Qi is not refined. "Po scatters" because the Lung stores Po, losing its original place. Saying "Shan" (good/prone) is erroneous. The Lung governs speech. Kidney Qi scorches/dries because Water is exhausted. Zhang Jingyue states: "Po leaving" means physical decay. "Kidney Qi drying" means depletion of True Yin. This complements the *Shanggu Tianzhen Lun* regarding "Women complete seven sevens, men complete eight eights". There, using seven and eight explains the limits of Yin and Yang numbers; here, using ten explains the total number of human life. However, human Qi and lifespan have fixed periods, yet lengths vary due to innate endowment or human effort. Therefore, only the wise do not let human desires harm their natural truth, nurturing natural longevity with the Way of Nature, thus ending their natural lifespan well. This is shared by sages and the wise.
Shidao is not long, nostrils flare outward, panting is sudden and rapid: Ma Shi states: If Shuigou is not long, it differs from the deep Shidao. Nostrils flare outward; the nose is the orifice of the Lung, so Lung Qi leaks. (*Chuanshu Pian* states: Nostrils outside imply Bladder leakage). Furthermore, the Lung governs Qi; now Lung Qi is insufficient, hence panting and rapid breathing. Zhang Jingyue states: "Panting" is shortness of breath; "rapid" implies vulnerability to injury; neither are signs of longevity. Jian An: "Panting and rapid" refers to breath becoming suddenly swift.
Its flesh is not stone-hard: Zhang Jingyue states: "Shi" (Stone) means hard.
Frequently struck by wind and cold (until) drawn together: Zhang Jingyue states: "Frequently struck by wind and cold" means the exterior is easily invaded. Qi and Blood are deficient, Middle Qi is insufficient. Meridians are blocked, collaterals are stagnant. Thus, True Pathogens easily attack each other. However, to root out pathogens, if Righteous Qi is insufficient, Pathogenic Qi enters instead, hence "drawn together".
Thus ending at mid-life: Zhang Jingyue states: Since these physical forms and Qi/Blood differ from those of long life, ending at mid-life has reasons. This is due to innate endowment.
Human constitution is endowed at the beginning of life, so the fixed number seems unchangeable by human effort. Only if one receives complete endowment and cultivates according to the Way will one live longer; if endowment is incomplete and cultivation violates harmony, one will die younger. Thus, those who know can hope for mid-life from low potential, and high life from mid potential; those who do not know achieve only secondary from high, and low from secondary. As stated: Heaven's determination can overcome man, but man's determination can also overcome Heaven. Endowment is Xiantian (Pre-heaven); cultivation is Houtian (Post-heaven). Pre-heaven responsibility lies with parents; Post-heaven responsibility lies with our own mind.