《疏五过论》曰∶凡未诊病者，必问尝贵后贱，虽不中邪，病从内生，名曰脱营。
（神屈故也，贵之尊荣，贱之屈辱，心怀眷慕，志结忧惶，虽不中邪，病从内生，血脉虚减，故曰脱营。）尝富后
贫，名曰失精，五气留连，病有所并。（富而从欲，贫夺丰财，内结忧煎，外悲故物。则心从想慕，神
随往计，营卫之道，闷以迟留，气血不行而积并为病。）身体日减，气虚无精，（气血相迫，形肉消灼，故身
体日减。气归精，精食气。今气虚不化，精无所滋故也。）病深无气，洒洒然时惊，（病气深，谷气尽，阳气
内薄，故恶寒而惊。洒洒，寒貌。）病深者，以其外耗于卫，内夺于荣。（血为忧煎，气随悲减，故外耗
于卫，内夺于荣，病深者何？以此耗夺故耳。）良工所失，不知病情，此亦治之一过也。（失，谓失问
其所始也。）凡欲诊病者，必问饮食居处，（饮食居处，五方不同，故问之也。）暴乐暴苦，始乐
后苦，皆伤精气，精气竭绝，形体毁沮。（喜则气缓，悲则气消。悲哀动中者，竭绝而失生，故精气
竭绝，形体残毁，心神沮丧矣。）愚医治之，不知补泻，不知病情，精华日脱，邪气乃并，此
治之二过也。（不知喜怒哀乐之殊情，概为补泻而同贯，则五脏精华之气日脱，邪气薄蚀而乃并于真正之气
矣。）善为脉者，必以比类奇恒从容知之，为工而不知道，此诊之不足贵，此治之三过
也。（奇恒，谓气候奇异于恒常之侯也。从容，谓分别脏气虚实，脉见上下，几相似也。《示从容论》曰∶脾虚浮
似肺，肾小浮似脾，肝急沉散似肾，此皆工之所时乱，后容分别而得之矣。）诊有三常，必问贵贱，封君
败伤，及欲侯王。（贵则形乐志乐，贱则形苦志苦，音乐殊贯，故先问也。封君败伤，降君之位，封公卿也。
及欲侯王，谓情慕富贵，而妄为不已也。）故贵脱势，虽不中邪，精神内伤，身必败亡。（忧惶煎迫，
怫结所为。）始富后贫，虽不伤邪，皮焦筋屈，痿 为挛。（以五脏气留连，病有所并而为是也。）医
不能严，不能动神，外为柔弱，乱至失常，病不能移，则医事不行，此治之四过也。（严，
谓戒，所以禁非也，所以令从命也。外为柔弱，言委随
而顺从也。然戒不足以禁非，动不足以从令，委随任物，乱失天常，病且不移，何医之有！）凡诊者，必知终
始，有知余绪，切脉问名，当合男女。（终始，谓气色也。知外者终而始之。明知五色气象，终而复始
也。余绪，谓病发端之余绪也。切，谓以指按脉也。问名，谓问病诊之名也。男子阳气多而左脉大为顺，女子
阴气多而右脉大为顺，故宜先合之也。）离绝莞结，忧恐喜怒，五脏空虚，血气离守，工不能知，
何术之语。（离，谓离间亲爱。绝，谓绝念所怀。莞，谓莞结思虑。结，谓结固余怨。间亲爱者魂游。绝所怀
者意丧，积所虑者神劳，结余怨者志苦，忧愁者闭塞而不行，恐惧者荡惮而失守，盛怒者迷惑而不治，喜乐者
惮散而不藏，由是八者，故以五脏空虚，血气离守，工不能思晓，又何言哉！）此治之五过也。
《疏五过论》说：凡是还没有给病人诊察病情时，必须询问病人过去地位尊贵后来变得卑贱的情况。即使没有受到外邪侵袭，疾病也会从体内产生，这种病叫做“脱营”。（这是因为精神受屈辱的缘故。曾经地位尊贵享有荣耀，后来变得卑贱遭受屈辱，心中眷恋羡慕，意志郁结忧愁惶恐，虽然未受外邪侵袭，但病从内生，导致血脉虚弱减少，所以称为脱营。）曾经富有后来贫穷的，叫做“失精”，五脏之气留滞连延，各种病邪相互搏结。（因为富有时可以随心所欲，贫穷时剥夺了丰厚的财物，内心郁结忧虑煎熬，对外界旧物感到悲伤。于是心神随着思念和往日的算计而动摇，营卫之气的运行道路因郁闷而迟缓停留，气血不能正常运行而积聚合并成为疾病。）身体一天天消瘦，气虚且精气不足。（气血相互逼迫，形体肌肉消损灼热，所以身体一天天减少。气能化生精，精依赖气来滋养。现在气虚无法化生，精无所滋育的缘故。）病情深重而正气衰微，时常感到寒冷战栗并惊恐。（病气深入，谷气耗尽，阳气内迫于脏腑，所以恶寒且惊恐。“洒洒”是形容寒冷颤抖的样子。）病情深重的原因，是因为外在耗损了卫气，内在掠夺了营血。（血液被忧思煎熬，气随悲伤而减少，所以外在耗损卫气，内在掠夺营血。病情为什么深重呢？就是因为这种耗损和掠夺的缘故。）高明的医生如果失误，不了解病情，这也是治疗上的第一种过失。（“失”，是指未能询问清楚疾病的起始原因。）凡是想要诊察病情的人，必须询问病人的饮食起居情况。（饮食起居在不同地区有所不同，所以要询问。）突然的大乐或突然的大苦，开始快乐后来痛苦，都会损伤精气，精气枯竭断绝，形体毁损败坏。（喜则气机舒缓，悲则气机消散。悲哀触动内脏的，会导致精气枯竭断绝而失去生机，所以精气竭绝，形体残破毁坏，心神沮丧。）愚笨的医生治疗这些病人，不懂得补泻原则，也不了解病情，导致人体精华日益脱失，邪气趁机搏结，这是治疗上的第二种过失。（如果不分辨喜怒哀乐的不同情状，一概用补泻之法同样对待，那么五脏的精华之气就会日益脱失，邪气侵蚀并与真正的正气相并合。）善于切脉的医生，一定运用类比、比较异常脉象以及从容分析的方法来知晓病情。作为医生如果不懂这些道理，这种诊法就不值得推崇，这是治疗上的第三种过失。（“奇恒”，是指气候或脉象奇异于平常的状态。“从容”，是指分别脏气的虚实，观察脉象在上下部位的细微相似之处。《示从容论》说：脾虚浮的脉象似肺，肾小浮的脉象似脾，肝急沉散的脉象似肾，这些都是医生时常混淆的，需要从容分辨才能得知。）诊察有三大常规，必须询问病人的贵贱身份、封君地位的败落伤害，以及渴望侯王地位的心理。（尊贵的人形体安逸心情愉悦，卑贱的人形体劳苦心情痛苦，音乐喜好不同，所以先要询问。封君败伤，是指君主之位降格，封为公卿。以及渴望侯王，是指情欲羡慕富贵，而不止境地妄求。）所以贵族失去了权势，虽然没有受到外邪侵袭，精神内部受伤，身体必然败亡。（这是由于忧愁惶恐煎熬逼迫，愤懑郁结所造成的。）开始富有后来贫穷，虽然没有受到外邪伤害，但会出现皮肤焦枯、筋脉拘挛，形成痿证和挛缩。（这是因为五脏之气留滞连延，病邪相互搏结而导致这样的结果。）医生如果不能严肃庄重，不能感动病人的神志，外表显得柔弱顺从，扰乱了正常的诊疗秩序，疾病不能移动改变，那么医疗事务就无法推行，这是治疗上的第四种过失。（“严”，是指告诫，用来禁止非分行为，用来命令病人服从。外表柔弱顺从，是指委曲随从而顺从。然而告诫不足以禁止非分，感动不足以让病人服从，委曲随随便便地顺从万物，扰乱丧失了天然常理，疾病尚且不移动改变，这算什么医生！）凡是诊察的病人，必须知道疾病的始终，了解其余绪，切脉问名，应当结合男女生理特点。（“终始”，是指气色。了解外部表现就是终而复始。明确知道五色气象，循环往复。“余绪”，是指疾病发作端绪之后的余波。“切”，是指用手指按压脉搏。“问名”，是指询问疾病诊断的名称。男子阳气多，左脉大为顺；女子阴气多，右脉大为顺，所以适宜先结合这一点来判断。）分离断绝、郁结不解，忧愁恐惧喜怒，导致五脏空虚，血气离散不守，医生如果不能知晓，谈什么医术呢。（“离”，是指离间亲爱之情。“绝”，是指断念所怀想的对象。“莞”，是指莞结思虑。“结”，是指固结剩余的怨恨。离间亲爱的人，魂游荡不定；断念所怀想的人，意志丧失；积累思虑的人，神气劳累；固结怨恨的人，志意困苦。忧愁的人，气机闭塞不行；恐惧的人，心神动荡失守；盛怒的人，迷惑混乱不能治理；喜乐的人，神气惮散不能藏蓄。由于这八种情况，所以导致五脏空虚，血气离散不守，医生如果不能思考晓悟，又说什么医术呢！）这是治疗上的第五种过失。
The *Shu Wu Guo Lun* (Discourse on the Five Errors) states: When diagnosing a patient who has not yet been examined, one must inquire about their history of formerly being noble and later becoming humble. Even if not afflicted by external pathogens, disease arises from within, named as "Tuo Ying" (Depletion of Ying/Nutritive Qi). (This is due to spiritual humiliation. Having once enjoyed honor and dignity, then suffering humiliation in a lower status, with lingering attachment and mental knotting of worry and fear, although not attacked by evil, disease originates internally, causing blood vessels to become deficient and reduced, hence called Tuo Ying.) Those who were formerly rich but later poor are named as "Shi Jing" (Loss of Jing/Essence), where the five qi remain stagnant and linked, and diseases combine. (Being rich allows desires to be fulfilled; poverty strips away wealth, leading to internal knotting of sorrow and torment, and external grief over past possessions. Thus, the heart follows longing, and spirit follows past calculations. The pathways of Ying and Wei (Nutritive and Defensive Qi) become obstructed and delayed, blood and qi fail to circulate, accumulating and combining to cause disease.) The body decreases day by day, qi becomes deficient and essence is lacking. (Blood and qi press against each other, flesh and muscles consume and burn, so the body diminishes daily. Qi transforms into essence, and essence feeds on qi. Now, with deficient qi unable to transform, there is no nourishment for essence.) The disease is deep with depleted qi, accompanied by shivering cold and occasional fright. (Disease qi is deep, grain qi is exhausted, yang qi presses inward, hence aversion to cold and fright. "Sasha" describes the appearance of cold trembling.) Deep disease occurs because externally it consumes Wei Qi and internally it deprives Ying Blood. (Blood is tormented by worry, qi diminishes with grief, thus externally consuming Wei and internally depriving Ying. Why is the disease deep? Precisely because of this consumption and deprivation.) If a skilled physician errs by not understanding the condition, this is the first error in treatment. ("Error" refers to failing to ask about the origin of the disease.) Anyone wishing to diagnose must inquire about diet and living habits. (Diet and living habits differ among the five regions, hence inquiry is necessary.) Sudden joy or sudden sorrow, starting with joy and ending with sorrow, all damage Jing Qi. When Jing Qi is exhausted and severed, the physical form is ruined and collapsed. (Joy causes qi to relax; sorrow causes qi to dissipate. Sorrow that moves the interior leads to exhaustion and loss of life, hence Jing Qi is exhausted, the form is damaged, and the mind-spirit is depressed.) A foolish physician treating them, unaware of tonification and sedation principles, and ignorant of the condition, causes the essence to deplete daily while pathogenic factors combine. This is the second error in treatment. (Not distinguishing the distinct emotions of joy, anger, sorrow, and happiness, and applying tonification and sedation indiscriminately, causes the essence qi of the five zang organs to deplete daily, allowing pathogenic qi to erode and combine with the true qi.) A proficient pulse reader must use analogy, comparison with abnormal patterns, and calm analysis to understand the condition. If a practitioner does not know these principles, such diagnosis is not worthy of respect; this is the third error. ("Qi Heng" refers to conditions or pulses that are extraordinary compared to the constant norm. "Cong Rong" refers to distinguishing the deficiency and excess of organ qi and observing subtle similarities in pulse locations. The *Shi Cong Rong Lun* states: Spleen deficiency floating resembles Lung; Kidney small floating resembles Spleen; Liver urgent, sunken, and scattered resembles Kidney. These are often confused by practitioners, requiring calm differentiation to resolve.) There are three constants in diagnosis: one must ask about status (noble/base), the fall of feudal lords, and desires for nobility. (Nobles have comfortable bodies and happy minds; commoners have arduous bodies and bitter minds; musical preferences differ, hence inquiry comes first. "Fall of feudal lords" refers to demotion from ruler status to dukes/ministers. "Desires for nobility" refers to craving wealth and rank without restraint.) Thus, when nobles lose power, even without external pathogens, internal spiritual injury occurs, and the body will surely perish. (Due to fearful anxiety, torment, and suppressed knotting.) When one starts rich and ends poor, even without pathogenic injury, skin becomes dry, sinews contract, leading to Wei syndrome (flaccidity) and Luan syndrome (spasm/cramping). (Caused by stagnation of five zang qi and combination of pathogens.) If a physician cannot be strict, cannot move the patient's spirit, appears weak and yielding externally, disrupts normal order, and fails to alter the disease, medical practice fails. This is the fourth error. ("Strict" means admonition, to forbid misconduct and command obedience. Appearing weak and yielding means complying and following along. If admonition cannot forbid misconduct and influence cannot ensure obedience, blindly complying disrupts natural laws, and if the disease remains unchanged, what kind of doctor is this?) In all diagnoses, one must know the beginning and end, understand residual threads, take the pulse, and ask the name, aligning with male and female characteristics. ("Beginning and End" refers to complexion. Understanding externals is cyclical. Clearly knowing the five colors' manifestations cycles back. "Residual threads" refer to the aftermath of the disease's onset. "Take pulse" means pressing with fingers. "Ask name" means asking for the diagnostic label. Men have more yang qi, so a large left pulse is favorable; women have more yin qi, so a large right pulse is favorable; thus, alignment is necessary.) Separation, severance, depression, and knotting, along with worry, fear, anger, and joy, empty the five zang organs and scatter blood and qi. If the physician does not understand this, how can they speak of technique? ("Separation" means alienating loved ones. "Severance" means cutting off thoughts of cherished objects. "Guan" refers to tangled worries. "Knot" refers to fixed resentment. Alienating loved ones causes the soul to wander; severing cherished thoughts causes loss of intent; accumulated worries exhaust the spirit; fixed resentment makes the will bitter. Worry blocks qi flow; fear causes agitation and loss of guard; rage causes confusion and disorder; joy causes dispersion and lack of storage. Due to these eight factors, the five zang organs become empty, and blood and qi scatter. If the physician cannot reflect and understand, what words of medicine are there!) This is the fifth error in treatment.