心藏神，脾藏智与意，肾藏精与志。人之思虑，智意主之；智意之运用，神主之。故或
曰思
虑伤心，或曰思虑伤脾者，举一言之也。究之，思虑之始构也，则因心以令脾，及思虑之既
竭也，则因脾以累心，是伤脾重于伤心矣。大抵五志所伤，每以过极而气并。思虑之过，气
并于脾，故经曰思则气结。并，乃结也。五行土克水，水主冬，为闭藏。脾实则有火，火性
发泄，以过极之实，乘受克之虚，以发泄之性，变闭藏之常，而复以脾病累心之故，处以无
主之神，于是乎恍惚离散，而精以泄。经云有余则梦予。脾以气并，而见为有余，故梦以精
予人也。论是症者，自当以脾火上蒙心神，下克肾水为正。或概执诸热属心之说以相列，见
其与五行生克之理不合，遂据《易》水火既济、未济二卦、证成心肾不交之论。岂知《易》
象止取贞悔为义，并非实事，若移此以论病，则大蓄天在山中，大壮雷行天上，亦将信为事
之所有，而以肺入脾中，心行肺上者，拟其病象何如乎？夫立论当取其推而皆准者。
以人之虚，因天之虚，为贼邪病，自春分至秋分之寒，自秋分至春分之热是也；以人之
虚，
因天之实，为正邪病，自春分至秋分之热，自秋分至春分之寒是也。总言之，则寒、热二者
以
应二气；析言之，则寒、热、凉、温四者以应四时，而皆生于风。故《内经》曰∶“风者百
病之长也”。风之温者必挟湿，其凉者但为风，与寒热分主四时，《灵》九宫所谓春湿、夏
热、秋风、冬寒是也。然湿与寒热，惟当其旺时则有之，而风乃四时皆有，故风之病患独多
。人以劳役解脱、喜怒阴阳、饮食醉饱、人鬼惊恐、跌打堕压、虫兽咬伤而致虚，有一于此
，则风即凑之；其在湿与寒热之令，及有贼邪时者，亦各凑之。故曰∶“邪之所凑，其气必
虚。”第既凑之后，反见为实。其为状也，有相半者，有相过者，无纯虚也。惟大病被汗、
吐、下后，邪去而气血不能遽复，及妇人新产后而液去，而形气不足以充，则纯虚。然一在
病后，一则非病，不可以治病之法治之。夫病无纯虚，则方无蛮补，无足怪者。或难之曰∶
老年聋盲，非纯虚乎？答曰∶此亦风也。老年血气当衰，药不能托，且托之而后者乘虚续至
，故永不愈耳！其不愈者在虚，其为病者仍属风。
心藏神，脾藏智与意，肾藏精与志。人的思虑活动，由智和意主导；而智和意的运用，则由神来主宰。因此有人说思虑伤心，也有人说思虑伤脾，这只是片面地强调其中一方面罢了。深入探究起来，思虑刚开始构思时，是心指挥脾；等到思虑过度耗竭时，则是脾累及心，所以说伤脾比伤心更重。大抵五志（喜、怒、忧、思、恐）所导致的损伤，往往是因为情绪过极导致气机汇聚。思虑过度，气机汇聚于脾，所以《内经》说“思则气结”。“并”就是“结”的意思。五行中土克水，水主冬季，对应闭藏的功能。脾实则有火，火的性质是发泄，以过极的实证，乘受克制的虚证，以发泄的性质，改变了闭藏的常态，再加上因为脾病累及心的缘故，使得心神失去主宰，于是出现恍惚离散，精气随之泄出。《内经》说“有余则梦予”。脾因气机汇聚而表现为有余，所以梦境中会出现将精气给予他人的情况。论述这种病症，自然应当以脾火上蒙心神、下克肾水为正解。如果一概执着于“诸热属心”的说法来归类，发现这与五行生克的道理不合，便依据《易经》中水火既济、未济两卦的理论，论证成心肾不交的观点。哪里知道《易经》的象数只取贞悔（卦爻）的含义，并非指实际事物，如果把这种理论移用来讨论疾病，那么大畜卦象显示天在山中，大壮卦象显示雷行天上，难道也要相信这是实际存在的事情吗？如果把肺放入脾中，让心运行在肺之上，又怎么描述它们的病象呢？确立论点应当选取推之皆准的道理。
以人体的虚弱，遭遇自然界虚邪（非当令之气），形成贼邪病，例如从春分到秋分期间的寒邪，从秋分到春分期间的热邪；以人体的虚弱，遭遇自然界实邪（当令之气），形成正邪病，例如从春分到秋分期间的热邪，从秋分到春分期间的寒邪。总括来说，寒、热两种邪气对应阴阳二气；具体分析，寒、热、凉、温四种邪气对应四季，且都生于风。所以《内经》说：“风者百病之长也”。风中的温邪必定挟带湿邪，风中的凉邪只是风，与寒热分别主管四季，《灵枢·九宫八风》所谓春湿、夏热、秋风、冬寒即是如此。然而湿与寒热，只有在它们旺盛的时节才有，而风却是四季都有，所以风的病患特别多。人因为劳役解脱、喜怒失调、饮食醉饱、人鬼惊恐、跌打堕压、虫兽咬伤而导致虚弱，只要具备其中一种情况，风邪就会侵袭；如果在湿与寒热的时令，以及有贼邪的时候，它们也各自侵袭。所以说：“邪之所凑，其气必虚。”只是既然邪气聚集之后，反而表现出实证的状态。其症状表现，有的虚实各半，有的实证超过虚证，没有纯粹的虚证。只有在大病经过汗、吐、下法治疗后，邪气去除但气血不能立即恢复，以及妇女新产后津液流失，形体和气不足以充盈时，才是纯虚证。然而前者是在病后，后者并非疾病所致，不能用治疗疾病的方法来对待。既然疾病没有纯虚的情况，那么方剂就没有蛮补之法，这不足为怪。有人反驳说：老年人耳聋目盲，难道不是纯虚吗？回答说：这也是风邪所致。老年人血气本应衰退，药物不能托举正气，而且即使托举了，后来的邪气也会乘虚继续侵入，所以永远无法痊愈！其无法痊愈的原因在于虚，但其致病因素仍然属于风。
The Heart stores Shen (Spirit), the Spleen stores Zhi (Intellect) and Yi (Intent), and the Kidney stores Jing (Essence) and Zhi (Will). Human thought and reflection are governed by Zhi and Yi; the application of Zhi and Yi is controlled by Shen. Therefore, some say that excessive thinking damages the Heart, while others say it damages the Spleen; this is merely emphasizing one aspect. Upon deeper investigation, when thought first begins to form, it is the Heart that directs the Spleen; when thought becomes exhausted, it is the Spleen that burdens the Heart. Thus, damaging the Spleen is heavier than damaging the Heart. Generally, injuries caused by the Five Emotions (Joy, Anger, Worry, Thought, Fear) often result from Qi converging due to excess. Excessive thought causes Qi to converge in the Spleen, hence the Classic says: "Thought causes Qi to knot." "Converge" means "knot." In the Five Elements, Earth overcomes Water; Water governs Winter and corresponds to closure and storage. When the Spleen is full, there is Fire; the nature of Fire is to dissipate. With an extreme excess condition overcoming a deficient condition, the dissipating nature alters the normal state of closure and storage. Furthermore, due to the Spleen disease burdening the Heart, the Shen, which lacks a master, becomes confused and scattered, causing Jing to leak. The Classic states: "Excess leads to dreams of giving." Because the Spleen shows excess due to Qi convergence, dreams involve giving away Jing. Discussing this syndrome, the correct approach is to view it as Spleen Fire harassing the Heart Shen above and overcoming Kidney Water below. If one rigidly adheres to the theory that "all heat belongs to the Heart," finding it inconsistent with the principles of Five Element generation and overcoming, and then relies on the Hexagrams Ji Ji (Water and Fire in their Proper Places) and Wei Ji (Before Completion) from the Book of Changes to argue for Heart-Kidney Non-Interaction, they fail to realize that the imagery in the Book of Changes only takes the meaning of Zhen and Hui (trigrams), not actual physical events. If this were applied to pathology, would one believe that "Great Accumulation: Heaven within the Mountain" or "Great Strength: Thunder moving in the Heavens" are literal realities? How would one describe the pathological image if the Lung were placed inside the Spleen and the Heart moved above the Lung? Establishing theories should rely on principles that hold true universally.
When human deficiency encounters natural deficiency (non-seasonal pathogens), it forms pathogenic diseases from hostile factors (Zei Xie), such as cold from Spring Equinox to Autumn Equinox, and heat from Autumn Equinox to Spring Equinox. When human deficiency encounters natural excess (seasonal pathogens), it forms pathogenic diseases from righteous factors (Zheng Xie), such as heat from Spring Equinox to Autumn Equinox, and cold from Autumn Equinox to Spring Equinox. Broadly speaking, Cold and Heat correspond to Yin and Yang Qi; specifically, Cold, Heat, Cool, and Warm correspond to the Four Seasons, all originating from Wind. Hence, the Inner Classic says: "Wind is the chief of a hundred diseases." Warm wind necessarily carries Dampness; cool wind is merely Wind, distinct from Cold and Heat which govern specific seasons, as described in the Ling Shu Nine Palaces: Spring Damp, Summer Heat, Autumn Wind, Winter Cold. However, Dampness, Cold, and Heat exist only during their prosperous times, whereas Wind exists in all four seasons, so wind-related illnesses are particularly numerous. Humans become deficient due to labor and rest imbalance, emotional extremes of Joy and Anger/Yin and Yang, dietary excesses of drunkenness and fullness, fright from humans and spirits, falls and crushings, and bites from insects and beasts. If any of these occur, Wind will invade; during periods of Dampness, Cold, or Heat, or when hostile factors are present, they also invade. Thus it is said: "Where pathogenic factors gather, Qi must be deficient." Yet, after gathering, the presentation often appears as Excess. The manifestations vary: some are half-excess/half-deficient, some have excess exceeding deficiency; there is no pure deficiency. Only after major illnesses treated with sweating, vomiting, or purging methods, where pathogens are removed but Qi and Blood cannot immediately recover, or in women shortly after childbirth where fluids are lost and form and Qi are insufficient to fill, is there pure deficiency. However, the former occurs post-illness, and the latter is not a disease per se; neither should be treated with standard disease-treatment methods. Since diseases do not present as pure deficiency, formulas do not use brute tonification, which is unsurprising. One might object: "Are not deafness and blindness in the elderly pure deficiency?" The answer is: This is also due to Wind. In the elderly, Qi and Blood naturally decline; medicines cannot support them, and even if supported, subsequent pathogens continue to invade the deficiency, leading to non-recovery. The reason for non-recovery lies in deficiency, but the pathogenic factor remains Wind.