（《素问·示从容论》全）
黄帝燕坐，召雷公而问之曰∶汝受术诵书者，若能览观杂学，及于比类，通合道理，为余言子所长，五脏六腑，胆
胃大小肠，脾胞膀胱，脑髓涕唾，哭泣悲哀，水所从行，此皆人之所生，治之过失。（比类者，比异别类以测病情也。义
详论治类十八。五脏六腑等义，详藏象类二十三。水，五液也，即指胆胃以下十四端血气而言，皆人之所赖以生者。此
而不明，动必多误，故凡治过于病谓之过，治不及病谓之失，不得其中，皆治之过失也。）子务明之，可以十全，即不能
知，为世所怨。（不能十全，必有过失，故招人之怨。）雷公曰∶臣请诵脉经上下编甚众多矣，别异比类，犹未能以十全，
又安足以明之？（古有脉经，意即《脉要精微》《平人气象》等论之义。）帝曰∶子别试通五脏之过，六腑之所不和，针
石之败，毒药所宜，汤液滋味，具言其状，悉言以对，请问不知。（别试通者，谓素之所通也。其有未通者，当请问其所
不知耳。）雷公曰∶肝虚肾虚脾虚，皆令人体重烦冤，当投毒药刺灸砭石汤液，或已或不已，愿闻其解。（肝主筋，筋病
则不能收持。肾主骨，骨病则艰于举动。脾主四肢，四肢病则倦怠无力，故皆令人体重。然三脏皆阴，阴虚则阳亢，故
又令人烦冤满闷也。）帝曰∶公何年之长而问之少，余真问以自谬也。吾问子窈冥，子言上下编以对何也？（言对非所问，
反若问者之自谬也。窈冥，玄微之谓。如《八正神明论》曰∶观其冥冥者，言形气营卫之不形于外，而工独知之，以日
之寒温，月之虚盛，四时气之浮沉，参伍相合而调之，工常先见之，然而不形于外，故曰观于冥冥焉。此即帝之所问，
而公对则误，故非之也。窈音杳。）夫脾虚浮似肺，肾小浮似脾，肝急沉散似肾，此皆工之所时乱也，然从容得之，（脾
本微软，病而虚浮，则似肺矣。肾本微沉，病而小浮，则似脾矣。肝本微弦，病而急沉散，则似肾矣。脉有相类，不能
辨之，则以此作彼，致于谬误，此皆工之不明，所以时多惑乱也。若能知从容篇之道而比类求之，则窈冥之妙可得矣。
按∶王氏曰∶浮而缓曰脾，浮而短曰肺，小浮而滑曰心，急紧而散曰肝，搏沉而滑曰肾。此详言五脏脉体，以明本节之
义也。所以诊法，有从部位察脏气者，有从脉体察脏气者，得其义则妙无不在，学人当于此而贯通焉。）若夫三脏土木水
参居，此童子之所知，问之何也？（脾合土，肝合木，肾合水，三脏皆在膈下，气脉相近，故曰参居。）
雷公曰∶于此有人，头痛筋挛骨重，怯然少气，哕噫腹满，时惊不嗜卧，此何脏之发也？脉浮而弦，切之石坚，不
知其解，复问所以三脏者，以知其比类也。（此下言肾病之疑似也。脉浮类肺，脉弦类肝，脉石坚类肾，难以详辨，故复
问三脏之比类也。哕，于决切，又音诲。噫，伊芳、隘二音。）帝曰∶夫从容之谓也。（引经语也，如下文。）夫年长则求之
于腑，年少则求之于经，年壮则求之于脏。（此总言比异别类之法也。夫年长者每多口味，六腑所以受物，故当求之于腑
以察其过。年少者每忽风寒劳倦，所受在经，故当求之于经以察其伤。年壮者多纵房欲，五脏所以藏精，故当求之于脏
以察其虚实。）今子所言，皆失八风菀热，五脏消烁，传邪相受。（帝言公之所问，但据病而言，而不知其所以然，故于
八风菀热之故，五脏消烁之由，及邪传相受之次，则皆失之也。菀，郁同。烁，式灼切。）夫浮而弦者，是肾不足也。（肾
脉宜沉，浮则阴虚，水以生木，弦则气泄，故为肾之不足。）沉而石者，是肾气内着也。（沉而石，沉甚而坚也。阴中无
阳则肾气不达，故内着不行也。）怯然少气者，是水道不行，形气消索也。（精所以成形，所以化气。水道不行则形气消
索，故怯然少气也。）咳嗽烦冤者，是肾气之逆也。（水脏空虚则上窃母气，故令人咳嗽烦冤，是肾气之上逆也。）一人之
气，病在一脏也。若言三脏俱行，不在法也。（凡此皆一人之气，病在肾之一脏耳。即如上文雷公所问头痛者，以水亏火
炎也。筋挛者，肾水不能养筋也。骨重者，肾主骨也。哕噫者，肾脉上贯肝膈，阴气逆也。腹满者，水邪侮土也。时惊
者，肾藏志，志失则惊也。不嗜卧者，阴虚目不瞑也。病本于肾，而言三脏俱行，故非法也。）
雷公曰∶于此有人，四肢解堕，喘咳血泄，而愚诊之以为伤肺，切脉浮大而紧，愚不敢治，粗工下砭石，病愈多出
血，血止身轻，此何物也？（此下言脾病之疑似也。砭，标兼切。）帝曰∶子所能治，知亦众多，与此病失矣。譬以鸿飞，
亦冲于天。（言子之所能，余亦知其多；但以此病为伤肺，则失之矣。譬以鸿飞，亦冲于天，虽所之任意，而终莫能得其
际，亦犹长空浩渺之难测耳。）夫圣人之治病，循法守度，援物比类，化之冥冥，循上及下，何必守经。（循守法度，遵
古人之绳墨也。援物比类，格事物之情状也。化之冥冥，握变化于莫测之间而神无方也。能如是则循上可也，及下亦可
也。然则法不可废，亦不可泥，弗拘形迹，何必守经，是乃所谓圣人之至治。）今夫脉浮大虚者，是脾气之外绝，去胃外
归阳明也。（此言所问脉证，皆脾胃病也。夫脾属阴，为胃之里；胃属阳，为脾之表。今脉来浮大而虚，则外有余，内不
足，是脾气之外绝于胃也。脾已去胃，故气归阳明而脉见如此。按《血气形志篇》曰∶阳明常多气多血，刺阳明出血气。
故雷公问粗工下砭石而愈者，正所以泄阳明之邪实耳。）夫二火不胜三水，是以脉乱而无常也。（二火，谓二阳脏，心肺
居于膈上也。三水，谓三阴脏，肝脾肾居于膈下也。此五脏之象，阴多于阳，故曰二火不胜三水。是以脾为阴土，须赖
火生。今之脾气去胃，外绝阳明，故脉乱无常者，以脾中无胃气也。）四肢解堕，此脾精之不行也。（脾主四肢也。）喘咳
者，是水气并阳明也。（脾病不能制水，则水邪泛溢，并于胃腑，气道不利，故为喘为咳，盖五脏六腑，皆能令人咳也。）
血泄者，脉急血无所行也。（经脉者，所以行血气而营阴阳也。脉之急疾，由于气乱，气乱则血乱，故注泄于便，无所正
行矣。血不守中，主在肺也。）若夫以为伤肺者，由失以狂也。不引比类，是知不明也。（狂，妄也。不引比类，故因喘
咳为伤肺，是知之不明也。若参合脉证而求之，则病在脾而不在肺，可类察之矣。）夫伤肺者，脾气不守，胃气不清，经
气不为使，真藏坏决，经脉旁绝，五脏漏泄，不衄则呕，此二者不相类也。（此明伤肺之候也。肺金受伤，窃其母气，故
脾不能守。人受气于谷，谷入于胃，以传于肺，肺病则谷气无以行，故胃不能清。肺者所以行营卫、通阴阳，肺伤则营
卫俱病，故经气不为使。真脏，言肺脏也。肺脏损坏，则治节不通，以致经脉有所偏绝，而五脏之气皆失其守，因为漏
泄，故不衄血于鼻，则呕血于口。此其在脾在肺，所本不同，故二者不相类也。愚按∶人有五脏，曰心肺肝脾肾，皆为
阴也。本篇发明三阴为病之义，独不及心肝二脏者，盖心为君主，邪不可伤，伤则死矣，不待言也。肝为将军之官，木
气多强，故于篇首但言脾肝肾相似之脉，土木水参居之理，亦不详言其病也。舍此二者，则肾为藏精之本，肺为藏气之
本，脾为水谷之本。水病则及肺，金病则及脾，盗母气也；土病则败及诸脏，失化生之原也。凡犯三阴亏损者，皆在此
三脏耳，三脏俱伤，鲜能免矣。故圣帝特言于此，学人当深察其义。）譬如天之无形，地之无理，白与黑相去远矣。（天
有象，地有位，若不知之，则天若无形，地若无理。此言三脏之伤，形证悬别，不能明辨，亦犹是也，黑白混淆，相去
远矣。）是失吾过矣，以子知之，故不告子。（是，此也。言雷公之失，以吾不告之过耳。）明引比类从容，是以名曰诊经，
是谓至道也。（谓此篇明引形证，比量异同，以合从容之法，故名曰诊经，乃至道之所在也。
（《素问·示从容论》全文）
黄帝安坐，召见雷公并问道：你学习医术、诵读医书，如果能博览杂学，善于运用比类的方法，贯通医理，那么请你说说你的专长所在。关于五脏六腑，包括胆、胃、大小肠、脾、胞、膀胱，以及脑髓、涕、唾、哭泣悲哀等情志表现，水液代谢的通道，这些都是人体赖以生存的基础，如果在治疗中出现偏差，就是过失。（所谓“比类”，就是比较不同症状以辨别病证类别来推测病情。其含义详见《论治类》第十八章。关于五脏六腑等的含义，详见《藏象类》第二十三章。“水”指五液，即指上述从胆到涕唾共十四种气血津液而言，都是人生存所依赖的。对这些如果不明白，行动必然多有误处，所以凡是治疗超过了病情限度叫做“过”，治疗达不到病情需要叫做“失”，不能掌握适中原则，都属于治疗上的过失。）你一定要阐明这些道理，这样就能做到十全十美；即使不能完全知晓，也不会遭到世人的埋怨。（如果不能做到十全十美，必定存在过失，因此会招致他人的怨恨。）
雷公回答说：我请求背诵《脉经》上下篇的内容，虽然内容很多，但在辨别异同、运用比类方面，我还未能做到十全十美，又怎么足以阐明医理呢？（古代有《脉经》，这里意指《脉要精微论》《平人气象论》等篇章的含义。）
黄帝说：你再试着通晓五脏的病变，六腑的不和，针灸治疗的失误，药物使用的适宜之处，汤液的滋味功效，详细陈述它们的情况，全部回答我的问题，如果有不知道的，可以提问。（所谓“别试通”，是指平时已经通晓的部分。那些尚未通晓的，应当询问你所不知道的地方罢了。）
雷公说：肝虚、肾虚、脾虚，都会让人身体沉重、心中烦闷冤屈，这时应该投用毒药、针刺、艾灸、砭石或汤液，有的治愈了，有的没治愈，我希望听听其中的解释。（肝主筋，筋有病则不能收持约束。肾主骨，骨有病则举动艰难。脾主四肢，四肢有病则倦怠无力，所以都会导致身体沉重。然而这三脏都属阴，阴虚则阳气亢盛，所以又让人烦闷满胀。）
黄帝说：你年纪多大却提出这么浅显的问题？我真正问的是深奥玄微的道理，你却拿上下编的内容来回答，这是为什么？（意思是回答的不是所问的内容，反而像是提问者自己搞错了。“窈冥”指玄妙细微的道理。如《八正神明论》所说：“观察那看不见的东西”，是说形气营卫的变化不显露于外表，只有高明的医生独自知道，结合日之寒温、月之盈亏、四时气候的浮沉，参互比较而加以调理，高明医生往往能先察觉，但这些变化不显露于外，所以说“观于冥冥”。这就是黄帝所问的，而雷公的回答是错误的，所以责备他。“窈”音同“杳”。）
脾脉虚弱浮起类似肺脉，肾脉小浮类似脾脉，肝脉急沉散类似肾脉，这些都是医生时常混淆的地方，但如果能从容地辨析就能搞清楚。（脾脉本应微软，生病后虚弱浮起，就类似肺脉了。肾脉本应微沉，生病后小浮，就类似脾脉了。肝脉本应微弦，生病后急沉散，就类似肾脉了。脉象有相似之处，如果不能辨别，就会以此作彼，导致谬误，这都是医生不明医理，所以时常迷惑混乱。如果能懂得《从容篇》的道理并通过比类去探求，那么玄妙的医理就可以掌握了。按：王冰注解说：浮而缓是脾脉，浮而短是肺脉，小浮而滑是心脉，急紧而散是肝脉，搏动沉而滑是肾脉。这是详细论述五脏脉象的特点，以阐明本节的意思。所以诊法中，有从部位察知脏气的，有从脉体察知脏气的，得其要领则妙处无处不在，学习者应当在此融会贯通。）至于三脏（肝木、脾土、肾水）参杂同居，这是童子都知道的，为什么要问这个？（脾合土，肝合木，肾合水，三脏都在膈下，气脉相近，所以说参居。）
雷公说：这里有个人，头痛、筋挛、骨重、怯弱少气、呃逆嗳气、腹满、时常惊恐、不喜欢睡觉，这是什么脏发病呢？脉象浮而弦，重按像石头一样坚硬，我不懂其中的解释，再次询问关于三脏比类的问题，以便通过比类来了解它。（以下讲述肾病疑似情况的辨析。脉浮类似肺，脉弦类似肝，脉石坚类似肾，难以详细辨别，所以再次询问三脏的比类关系。“哕”音jué，又音huì。“噫”音yī，又音ài。）
黄帝说：这就是所谓的“从容”之道。（引用经典语句，如下文所述。）对于年长的人，要从六腑去探求病因；年少的人，要从经脉去探求病因；年壮的人，要从五脏去探求病因。（这是总述辨别异同、分类比较的方法。年长者通常口味较重，六腑负责受纳食物，所以应当从六腑去考察其过失。年少者常常忽视风寒劳倦，邪气伤在经脉，所以应当从经脉去考察其损伤。年壮者多纵欲，五脏负责藏精，所以应当从五脏去考察其虚实。）
现在你所说的，都忽略了八风郁热导致的五脏消烁，以及邪气传受的规律。（黄帝说雷公所问，只是依据病症而言，却不知道其所以然的原因，所以对于八风郁热的缘故、五脏消烁的由来，以及邪气传变的次序，都失之于片面。“菀”同“郁”。“烁”音shuò。）
脉象浮而弦，这是肾气不足。（肾脉宜沉，浮则说明阴虚，水生木，弦则说明气泄，所以是肾气不足。）
脉象沉而石（坚硬），这是肾气内结不通。（沉而石，是沉得厉害且坚硬。阴中没有阳，则肾气不达，所以内结不行。）
怯弱少气，这是水道不通，形体之气消亡枯竭。（精用来成形，也用来化气。水道不通则形气消亡枯竭，所以怯弱少气。）
咳嗽烦闷，这是肾气上逆。（水脏空虚则向上窃取母气，所以让人咳嗽烦闷，这是肾气上逆。）
一个人的气，病只在一脏。如果说三脏都发病，就不符合医理了。（凡此皆是一个人的气机，病只在肾这一脏而已。就像上文雷公所问的头痛，是因为水亏火炎；筋挛，是肾水不能养筋；骨重，是肾主骨；呃逆嗳气，是肾脉上贯肝膈，阴气上逆；腹满，是水邪侮犯脾土；时常惊恐，是肾藏志，志失则惊；不喜欢睡觉，是阴虚目不瞑。病本源于肾，却说三脏都发病，所以不符合医理。）
雷公说：这里有个人，四肢懈怠无力，喘咳、便血，而我诊断认为是肺受伤，切脉发现浮大而紧，我不敢治疗，粗鲁的医生用砭石刺破皮肤放血，病反而好了，出血停止后身体变轻，这是什么病呢？（以下讲述脾病疑似情况的辨析。“砭”音biān。）
黄帝说：你能治疗的病，我知道也很多，但你对这个病的判断是错误的。这就好比大雁飞翔，虽然冲向天空，但也无法测度其边际。（意思是你的能力，我也知道很多；但把这个病当作肺伤，就错了。好比大雁飞翔，虽然任意冲天，但最终无法测得其际遇，也如同长空浩渺难以预测一样。）
圣人治病，遵循法度，援引事物进行比类，在幽微之中变化莫测，向上推及本源，向下联系表象，何必拘泥于常经？（遵循法度，是遵守古人的规矩。援引事物进行比类，是格究事物的情状。在幽微之中变化莫测，是在不可预测之间掌握变化，神妙无方。能做到这样，向上追溯也可以，向下推演也可以。然而法度不可废弃，也不可死板拘泥，不拘泥于形迹，何必死守常经，这就是所谓的圣人最高明的治疗境界。）
现在的脉象浮大虚，这是脾气外绝，离开胃气归于阳明。（这里所说的脉证，都是脾胃病。脾属阴，为胃之里；胃属阳，为脾之表。现在脉来浮大而虚，则是外有余，内不足，这是脾气在外与胃隔绝。脾已离开胃，所以气归阳明而脉象如此。按《血气形志篇》说：阳明经常多气多血，刺阳明可以泄出血气。所以雷公问的粗工用砭石治疗后痊愈，正是泄去了阳明之邪实。）
二火不胜三水，所以脉象紊乱无常。（二火，指心肺两脏，居于膈上。三水，指肝脾肾三脏，居于膈下。这是五脏的象，阴多于阳，所以说二火不胜三水。因此脾为阴土，必须依赖火生。现在的脾气离开胃，外绝阳明，所以脉象紊乱无常，是因为脾中没有胃气。）
喘咳，这是水气并犯阳明。（脾病不能制水，则水邪泛溢，并犯胃腑，气道不利，所以喘咳，因为五脏六腑都能让人咳嗽。）
便血，这是脉急迫，血无所行。（经脉是用来运行气血、营养阴阳的。脉象急疾，是由于气乱，气乱则血乱，所以血液注泄于大便，不能正常循行。血不守中，主要与肺有关。）
如果认为这是肺受伤，那是狂妄的错误。不引伸比类，说明认识不明。（狂，是妄乱之意。不引伸比类，所以因喘咳就认为是肺伤，这是认识不明。如果参合脉证来探求，则病在脾而不在肺，可以通过类比察知。）
所谓伤肺，其实是脾气不守，胃气不清，经气不能行使职能，真脏脉坏决，经脉旁绝，五脏漏泄，不流鼻血就是呕血，这两者是不相似的。（这是阐明伤肺的症状。肺金受伤，窃取母气，所以脾不能守。人受气于谷，谷入胃，传给肺，肺病则谷气无法运行，所以胃不能清。肺是运行营卫、通达阴阳的，肺伤则营卫俱病，所以经气不能行使职能。真脏，指肺脏。肺脏损坏，则治节不通，导致经脉有所偏绝，五脏之气都失去守持，因而发生漏泄，所以不流鼻血，就呕血。这在脾和在肺，根本不同，所以两者不相似。愚按：人有五脏，心肺肝脾肾，都为阴。本篇阐发三阴为病的意义，唯独不及心肝二脏，大概因为心为君主，邪不可伤，伤了就会死，不必多说。肝为将军之官，木气多强，所以在篇首只说脾肝肾相似的脉象，土木水参居的道理，也不详细言及其病。除了这两者，肾是藏精之本，肺是藏气之本，脾是水谷之本。水病则波及肺，金病则波及脾，是盗取母气；土病则败坏波及诸脏，失去化生之源。凡是侵犯三阴亏损的，都在这三脏身上，三脏都受伤，很少能幸免。所以圣帝特别在这里强调，学习者应当深刻考察其义。）
这就像天没有形状，地没有纹理，白与黑相差很远。（天有形象，地有位置，如果不知道，天就好像没有形状，地就好像没有纹理。这是说三脏的损伤，形态症状悬殊区别，不能明辨，也就像这样，黑白混淆，相差很远。）
这是我的过错，因为你知道这些，所以不告诉你。（是，这。意思是雷公的失误，是因为我没有告诉他的过错罢了。）
明确引用比类和从容之法，所以称之为“诊经”，这就是至高无上的医道。（说这篇明确引用形态症状，比较衡量异同，以符合从容之法，所以名叫“诊经”，这就是至道的所在。）
(Full text of *Suwen: Shi Congrong Lun* [Plain Questions: Discourse on Demonstrating the Method of Cong Rong])
The Yellow Emperor sat in repose and summoned Lei Gong, asking him: "You have studied arts and recited medical texts. If you can browse diverse studies, apply the method of 'Bi Lei' (comparative classification), and integrate principles to explain your strengths to me regarding the five zang organs and six fu organs, including the gallbladder, stomach, large and small intestines, spleen, bladder, brain marrow, nasal discharge, saliva, crying and sorrow, and the pathways of water metabolism—all these are what sustain human life—any negligence in treatment constitutes an error. ([Bi Lei] refers to comparing different symptoms to categorize them for assessing the condition; details are in Chapter 18 of 'Lun Zhi Lei'. Meanings of five zang and six fu organs are detailed in Chapter 23 of 'Zang Xiang Lei'. 'Water' refers to the five fluids, i.e., the fourteen aspects from the gallbladder to nasal discharge and saliva, representing blood and qi upon which life depends. If these are not understood, actions will inevitably be erroneous. Thus, treating beyond the disease's extent is called 'Guo' (excess), treating below the disease's need is called 'Shi' (deficiency), and failing to achieve balance is considered a treatment error.) You must clarify this to achieve perfection; even if you cannot know everything, you will avoid resentment from the world. (Failure to achieve perfection implies errors, leading to others' resentment.)"
Lei Gong replied: "I request to recite the upper and lower volumes of the *Mai Jing* (Pulse Classic). Although numerous, my ability to distinguish differences and apply comparative classification has not yet reached perfection, so how can I sufficiently clarify these matters?" (The ancient *Mai Jing* here refers to the meanings found in treatises such as *Mai Yao Jing Wei* and *Ping Ren Qi Xiang*.)
The Emperor said: "Try again to thoroughly understand the abnormalities of the five zang organs, the disharmony of the six fu organs, the failures of needle and stone therapies, the suitability of herbal medicines, and the flavors and effects of decoctions. State their conditions fully and answer my questions. If there is anything unknown, please ask." ('Bie Shi Tong' means reviewing what is already known. For what remains unclear, one should inquire about the unknown.)
Lei Gong said: "Liver deficiency, kidney deficiency, and spleen deficiency all cause heavy body and mental distress. Should one administer toxic drugs, acupuncture, moxibustion, bian stones, or decoctions? Some recover, some do not. I wish to hear the explanation." (The liver governs sinews; sinew pathology leads to inability to contract and hold. The kidney governs bones; bone pathology makes movement difficult. The spleen governs the four limbs; limb pathology causes fatigue and weakness, hence the heaviness. However, since these three zang organs are yin, yin deficiency leads to yang hyperactivity, causing irritability and fullness.)
The Emperor said: "How old are you to ask such superficial questions? I asked about profound mysteries (Yao Ming), yet you answered with general chapters. Why?" (This means the answer did not address the question, resembling the asker's own confusion. 'Yao Ming' refers to profound and subtle principles. As stated in *Ba Zheng Shen Ming Lun*: 'Observing the unseen' refers to the fact that changes in form, qi, ying, and wei are not visible externally, but only skilled physicians know them. By combining seasonal variations, lunar phases, and climatic shifts, they adjust treatments and often perceive changes before they manifest externally, thus 'observing the unseen.' This was what the Emperor asked, but Lei Gong's answer was wrong, hence the rebuke. 'Yao' sounds like 'Yao'.)
Spleen pulse weak and floating resembles lung pulse; kidney pulse small and floating resembles spleen pulse; liver pulse rapid, deep, and scattered resembles kidney pulse. These are areas where physicians often get confused. However, by applying the method of 'Cong Rong' (calm and comprehensive analysis), one can discern them." (Spleen pulse is naturally soft; when diseased and weak-floating, it resembles lung. Kidney pulse is naturally slightly deep; when diseased and small-floating, it resembles spleen. Liver pulse is naturally slightly wiry; when diseased, rapid, deep, and scattered, it resembles kidney. Pulses may be similar; failure to distinguish leads to error, confusing one for another, due to physician ignorance. If one understands the principles of *Cong Rong Pian* and applies comparative classification, the subtleties of profound medicine can be grasped. Note: Wang Bing commented: Floating and slow is spleen; floating and short is lung; small, floating, and slippery is heart; rapid, tight, and scattered is liver; pounding, deep, and slippery is kidney. This details the characteristics of five zang pulses to clarify this section. Diagnosis involves observing organ qi via location or pulse morphology; mastering the principle reveals infinite subtleties. Learners should integrate this.) As for the three organs (liver wood, spleen earth, kidney water) coexisting, this is known even to children; why ask?" (Spleen corresponds to earth, liver to wood, kidney to water. All three reside below the diaphragm with similar qi and pulses, hence 'coexisting'.)
Lei Gong said: "Here is a patient with headache, tendon cramping, heavy bones, timidity and shortness of breath, hiccups and belching, abdominal fullness, frequent fright, and insomnia. Which organ is affected? The pulse is floating and wiry, and firm like stone upon pressure. I do not understand. I re-ask about the comparative classification of the three organs to understand it." (This section discusses differential diagnosis of kidney disease. Floating pulse resembles lung; wiry pulse resembles liver; stone-firm pulse resembles kidney. Hard to distinguish precisely, hence the re-question on comparative classification. 'Yue' (hiccups) is pronounced jué or huì. 'Yi' (belching) is pronounced yī or ài.)
The Emperor said: "This is what is meant by 'Cong Rong'." (Quoting classic terminology, see below.) "For the elderly, seek pathology in the fu organs; for the young, in the meridians; for the prime-aged, in the zang organs." (This summarizes the method of distinguishing differences and classifying. Elderly people often have rich diets; fu organs receive food, so examine fu organs for excess. Young people often neglect wind-cold and fatigue; pathogens affect meridians, so examine meridians for injury. Prime-aged people often indulge in sexual activity; zang organs store essence, so examine zang organs for deficiency/excess.)
What you described ignores the stagnation of heat from the eight winds causing consumption of the five zang organs, and the transmission of pathogens." (The Emperor states Lei Gong's inquiry focused only on symptoms, ignoring causes such as eight-wind heat stagnation, zang consumption, and pathogen transmission sequences. 'Yun' is synonymous with 'Yu' (stagnation). 'Shuo' is pronounced shuò.)
A floating and wiry pulse indicates kidney insufficiency." (Kidney pulse should be deep; floating indicates yin deficiency. Water generates wood; wiry indicates qi leakage, hence kidney insufficiency.)
A deep and stone-like pulse indicates kidney qi internal stagnation." (Deep and stone-like means deeply hard. Yin without yang prevents kidney qi from reaching out, causing internal stagnation.)
Timidity and shortness of breath indicate blocked water pathways and depletion of form and qi." (Essence forms the body and transforms into qi. Blocked water pathways lead to depletion of form and qi, causing timidity and shortness of breath.)
Cough and irritability indicate rebellious kidney qi." (Empty water-zang steals mother qi upward, causing cough and irritability, indicating rebellious kidney qi.)
One person's qi pathology lies in one zang. To say three zang organs are involved violates medical principles." (All these refer to one person's qi pathology located solely in the kidney. For example, headache is due to water deficiency and fire flaring; tendon cramping is due to kidney water failing to nourish sinews; heavy bones relate to kidney governing bones; hiccups/belching involve kidney meridian passing through liver/diaphragm with rebellious yin qi; abdominal fullness is water evil insulting spleen earth; fright relates to kidney storing zhi (will); insomnia is due to yin deficiency preventing eye closure. The root is kidney, yet claiming three zang organs are involved contradicts principles.)
Lei Gong said: "Here is a patient with flaccid limbs, coughing, hematochezia. I diagnosed lung injury. The pulse was floating, large, and tight. I dared not treat. A crude practitioner used bian stones, resulting in bleeding, after which the patient recovered and felt lighter. What is this?" (This section discusses differential diagnosis of spleen disease. 'Bian' is pronounced biān.)
The Emperor said: "Your capabilities are extensive, but your diagnosis of this case is wrong. It is like a wild goose flying toward the sky; though it aims high, its limits are unfathomable." (Meaning: I know your skills are many, but diagnosing this as lung injury is incorrect. Like a goose flying high, its trajectory is as unpredictable as the vast sky.)
The sage treats disease by following laws, applying comparative classification, and navigating the unseen, tracing from top to bottom, without rigid adherence to fixed rules." (Following laws means adhering to ancient standards. Applying comparative classification means analyzing phenomena. Navigating the unseen means mastering change amidst uncertainty. One can trace upwards or downwards. Laws should not be abandoned nor rigidly applied; one should not be bound by appearances. This is the highest treatment of sages.)
A floating, large, and deficient pulse indicates spleen qi external severance, departing from stomach qi to return to Yangming." (The queried pulse/symptoms indicate spleen/stomach disease. Spleen is yin, interior to stomach; stomach is yang, exterior to spleen. Floating, large, deficient pulse suggests exterior excess and interior deficiency, meaning spleen qi is severed externally from stomach. Spleen qi departs to Yangming, causing this pulse. According to *Xue Qi Xing Zhi Pian*, Yangming has abundant qi and blood; puncturing Yangming releases qi and blood. Thus, the crude practitioner's use of bian stones likely drained Yangming excess.)
Two fires cannot overcome three waters, hence the chaotic and irregular pulse." ('Two fires' refer to heart and lung, above the diaphragm. 'Three waters' refer to liver, spleen, and kidney, below the diaphragm. This represents five zang imagery where yin exceeds yang, hence two fires cannot overcome three waters. Spleen is yin earth, relying on fire generation. Now spleen qi departs from stomach, severing Yangming externally, causing chaotic pulse due to lack of stomach qi in spleen.)
Flaccid limbs indicate spleen essence failing to circulate." (Spleen governs four limbs.)
Coughing indicates water qi merging with Yangming." (Spleen pathology fails to control water, causing water evil to overflow and invade stomach fu, obstructing airways, leading to cough. All zang/fu organs can cause cough.)
Hematochezia indicates urgent pulse and blood lacking proper pathways." (Meridians transport qi and blood to nourish yin/yang. Urgent pulse results from qi chaos; qi chaos leads to blood chaos, causing bleeding into stool, losing normal circulation. Blood failing to stay central relates primarily to lung.)
To consider this lung injury is madness. Failure to apply comparative classification shows unclear understanding." ('Kuang' means madness/error. Failing to apply comparative classification leads to misdiagnosing cough as lung injury due to unclear knowledge. Integrating pulse and symptoms would reveal spleen pathology, not lung, through analogy.)
Regarding 'lung injury,' it is actually spleen qi failing to maintain, stomach qi failing to clear, meridian qi failing to function, true zang pulse breaking, collateral meridians severing, and five zang leakage, manifesting as epistaxis or hematemesis. These two are dissimilar." (This clarifies lung injury signs. Lung metal injury steals mother qi, causing spleen failure. Grain enters stomach and transmits to lung; lung disease prevents grain qi transport, causing stomach turbidity. Lung regulates ying/wei and connects yin/yang; lung injury disrupts ying/wei, causing meridian dysfunction. 'True zang' refers to lung. Lung damage disrupts governance, causing meridian deviation and loss of zang stability, leading to leakage. Thus, either epistaxis or hematemesis occurs. Pathology in spleen vs. lung is fundamentally different, hence dissimilar. Note: Five zang (heart, lung, liver, spleen, kidney) are yin. This chapter focuses on three yin diseases, omitting heart and liver. Heart is monarch, inviolable; liver is general, strong wood. Hence, only spleen/kidney/liver pulses and earth/water/wood interactions are discussed initially. Excluding these, kidney stores essence, lung stores qi, spleen processes grain. Water disease affects lung; metal disease affects spleen (stealing mother qi); earth disease ruins other organs (losing transformation source). Three yin deficiencies center on these three zang. Injury to all three is rarely survivable. The Sage emphasizes this; learners must investigate deeply.)
This is like heaven having no shape and earth having no pattern, or white and black being far apart." (Heaven has images, earth has positions. Ignorance makes heaven seem shapeless and earth patternless. This illustrates that injuries to the three zang present distinct symptoms that are hard to distinguish, just as white and black are vastly different.)
This is my fault; because you know this, I did not tell you." ('Shi' means this. Meaning: Lei Gong's error stems from my failure to instruct him earlier.)
Clearly citing comparative classification and the Cong Rong method is called 'Zhen Jing' (Classic of Diagnosis), which is the supreme Dao." (This chapter clearly cites symptoms and uses comparative classification to align with Cong Rong methods, hence named 'Zhen Jing', representing the supreme Dao.)