（灵枢营卫生会篇）
黄帝问于岐伯曰∶人焉受气？阴阳焉会？何气为营？何气为卫？营安从生？卫于焉会？老壮不同气，阴阳异位，愿
闻其会。（焉，何也。会，合也。五十以上为老。二十以上为壮。此帝问人身之气，受必有由，会必有处，阴阳何所分，
营卫何所辨，而欲得其详也。）岐伯答曰∶人受气于谷，谷入于胃，以传于肺，五脏六腑，皆以受气，（人之生由乎气，
气者所受于天，与谷气并而充身者也。故谷食入胃，化而为气，是为谷气，亦曰胃气。此气出自中焦，传化于脾，上归
于肺，积于胸中气海之间，乃为宗气。宗气之行，以息往来，通达三焦，而五脏六腑皆以受气。是以胃为水谷血气之海，
而人所受气者，亦唯谷而已。故谷不入，半日则气衰，一日则气少矣。）其清者为营，浊者为卫，（谷气出于胃而气有清
浊之分，清者水谷之精气也，浊者水谷之悍气也，诸家以上下焦言清浊者皆非。清者属阴，其性精专，故化生血脉而周
行于经隧之中，是为营气。浊者属阳，其性 疾滑利，故不循经络而直达肌表，充实于皮毛分肉之间，是为卫气。然营
气卫气，无非资借于宗气，故宗气盛则营卫和，宗气衰则营卫弱矣。）营在脉中，卫在脉外，（营，营运于中也。卫，护
卫于外也。脉者非气非血，其犹气血之橐 也。营属阴而主里，卫属阳而主表，故营在脉中，卫在脉外。卫气篇曰∶其
浮气之不循经者为卫气，其精气之行于经者为营气。正此之谓。）营周不休，五十而复大会，阴阳相贯，如环无端。（营
气之行，周流不休，凡一昼一夜五十周于身而复为大会。其十二经脉之次，则一阴一阳，一表一里，迭行相贯，终而复
始，故曰如环无端也。五十周义，见下章及二十六。）卫气行于阴二十五度，行于阳二十五度，分为昼夜，故气至阳而起，
至阴而止。（卫气之行，夜则行阴分二十五度，昼则行阳分二十五度，凡一昼一夜亦五十周于身。义详后二十五。气至阳
而起，至阴而止，谓昼与夜息，即下文万民皆卧之义。）故曰日中而阳陇为重阳，夜半而阴陇为重阴。（此分昼夜之阴阳，
以明营卫之行也。陇，盛也，生气通天论作隆。昼为阳，日中为阳中之阳，故曰重阳。夜为阴，夜半为阴中之阴，故曰
重阴。陇音笼。）故太阴主内，太阳主外，各行二十五度，分为昼夜。（太阴，手太阴也。太阳，足太阳也。内言营气。
外言卫气。营气始于手太阴，而复会于太阴，故太阴主内。卫气始于足太阳，而复会于太阳，故太阳主外。营气周流十
二经，昼夜各二十五度。卫气昼则行阳，夜则行阴，亦各二十五度。营卫各为五十度以分昼夜也。）夜半为阴陇，夜半后
而为阴衰，平旦阴尽而阳受气矣。日中为阳陇，日西而阳衰，日入阳尽而阴受气矣。（夜半后为阴衰，阳生于子也。日西
而阳衰，阴生于午也。如金匮真言论曰∶平旦至日中，天之阳，阳中之阳也；日中至黄昏，天之阳，阳中之阴也；合夜
至鸡鸣，天之阴，阴中之阴也；鸡鸣至平旦，天之阴，阴中之阳也，故人亦应之。即此节之义。）夜半而大会，万民皆卧，
命曰合阴，平旦阴尽而阳受气，如是无已，与天地同纪。（大会，言营卫阴阳之会也。营卫之行，表里异度，故尝不相值；
惟于夜半子时，阴气已极，阳气将生，营气在阴，卫气亦在阴，故万民皆瞑而卧，命曰合阴。合阴者，营卫皆归于脏，
而会于天一之中也。平旦阴尽而阳受气，故民皆张目而起。此阴阳消息之道，常如是无已而与天地同其纪。所谓天地之
纪者，如天地日月各有所会之纪也。天以二十八舍为纪，地以十二辰次为纪，日月以行之迟速为纪。故天与地一岁一会，
如玄枵加于子宫是也。天与日亦一岁一会，如冬至日缠星纪是也。日与月则一月一会，如晦朔之同宫是也。人之营卫，
以昼夜为纪，故一日凡行五十周而复为大会焉。）黄帝曰∶老人之不夜瞑者，何气使然？少壮之人不昼瞑者，何气使然？
（此帝因上文言夜则万民皆卧，故特举老人之不夜瞑者，以求其详也。）岐伯答曰∶壮者之气血盛，其肌肉滑，气道通，
营卫之行不失其常，故昼精而夜瞑。老者之气血衰，其肌肉枯，气道涩，五脏之气相搏，其营气衰少而卫气内伐，故昼
不精，夜不瞑。（老者之气血衰，故肌肉枯，气道涩，五脏之气搏聚不行，而营气衰少矣。营气衰少，故卫气乘虚内伐，
卫失其常故昼不精，营失其常故夜不瞑也。）黄帝曰∶愿闻营卫之所行，皆何道从来？岐伯答曰∶营出于中焦，卫出于下
焦。（何道从来，言营卫所由之道路也。营气者，由谷入于胃，中焦受气取汁，化其精微而上注于肺，乃自手太阴始，周
行于经隧之中，故营气出于中焦。卫气者，出其悍气之 疾，而先行于四末分肉皮肤之间，不入于脉，故于平旦阴尽，
阳气出于目，循头项下行，始于足太阳膀胱经而行于阳分，日西阳尽，则始于足少阴肾经而行于阴分，其气自膀胱与肾，
由下而出，故卫气出于下焦。详义见后营气卫气二章。 愚按∶人身不过表里，表里不过阴阳，阴阳即营卫，营卫即血气。
脏腑筋骨居于内，必赖营气以资之，经脉以疏之。皮毛分肉居于外，经之所不通，营之所不及，故赖卫气以 之，孙络
以濡之。而后内而精髓，外而发肤，无弗得其养者，皆营卫之化也。然营气者，犹天之有宿度，地之有经水，出入有期，
营运有序者也。卫气者，犹天之有清阳，地之有郁蒸，阴阳昼夜，随时而变者也。卫气属阳，乃出于下焦，下者必升，
故其气自下而上，亦犹地气上为云也。营本属阴，乃自中焦而出于上焦，上者必降，故营气自上而下，亦犹天气降为雨
也。虽卫主气而在外，然亦何尝无血。营主血而在内，然亦何尝无气。故营中未必无卫，卫中未必无营，但行于内者便
谓之营，行于外者便谓之卫，此人身阴阳交感之道，分之则二，合之则一而已。前第六章有按，当与此互阅。）
黄帝曰∶愿闻三焦之所出。岐伯答曰∶上焦出于胃上口，并咽以上贯膈而布胸中，走腋循太阴之分而行，还至阳明，
上至舌，下足阳明，（胃上口，即上脘也。咽为胃系，水谷之道路也。膈上曰胸中，即膻中也。其旁行者，走两腋，出天
池之次，循手太阴肺经之分而还于手阳明。其上行者，至于舌。其下行者，交于足阳明，以行于中下二焦。凡此皆上焦
之部分也。）常与荣俱行于阳二十五度，行于阴亦二十五度，一周也，故五十度而复大会于手太阴矣。（上焦者，肺之所
居，宗气之所聚。营气者，随宗气以行于十四经脉之中。故上焦之气，常与营气俱行于阳二十五度，阴亦二十五度。阳
阴者，言昼夜也。昼夜周行五十度，至次日寅时复会于手太阴肺经，是为一周。然则营气虽出于中焦，而施化则由于上
焦也。）
黄帝曰∶愿闻中焦之所出。岐伯答曰∶中焦亦并胃中，出上焦之后，此所受气者，泌糟粕，蒸津液，化其精微，上
注于肺脉，乃化而为血，以奉生身，莫贵于此，故独得行于经隧，命曰营气。（胃中，中脘之分也。后，下也。受气者，
受谷食之气也。五谷入胃，其糟粕、津液、宗气，分为三隧以注于三焦。而中焦者，泌糟粕，蒸津液，受气取汁，变化
而赤是谓血，以奉生身而行于精隧，是为营气，故曰营出中焦。按下文云∶下焦者，别回肠，注膀胱。然则自膈膜之下，
至脐上一寸水分穴之上，皆中焦之部分也。泌，秘、弼二音。粕音朴。隧音遂，伏道也。）黄帝曰∶夫血之与气，异名同
类，何谓也？岐伯答曰∶营卫者精气也，血者神气也，故血之与气，异名同类焉。故夺血者无汗，夺汗者无血，故人生
有两死而无两生。（营卫之气，虽厘清浊，然皆水谷之精华，故曰营卫者精气也。血由化而赤，莫测其妙，故曰血者神气
也。然血化于液，液化于气，是血之与气，本为同类，而血之与汗，亦非两种；但血主营，为阴为里，汗属卫，为阳为
表，一表一里，无可并攻，故夺血者无取其汗，夺汗者无取其血。若表里俱夺，则不脱于阴，必脱于阳，脱阳亦死，脱
阴亦死，故曰人生有两死。然而人之生也，阴阳之气皆不可无，未有孤阳能生者，亦未有孤阴能生者，故曰无两生也。）
黄帝曰∶愿闻下焦之所出。岐伯答曰∶下焦者，别回肠，注于膀胱而渗入焉。故水谷者，常并居于胃中，成糟粕而
俱下于大肠，而成下焦，渗而俱下，济泌别汁，循下焦而渗入膀胱焉。（回肠，大肠也。济， 同，犹酾滤也。泌，如狭
流也。别汁，分别清浊也。别回肠者，谓水谷并居于胃中，传化于小肠，当脐上一寸水分穴处，糟粕由此别行回肠，从
后而出，津液由此别渗膀胱，从前而出。膀胱无上口，故云渗入。凡自水分穴而下，皆下焦之部分也。按三十一难曰∶
下焦者，当膀胱上口，主分别清浊。其言上口者，以渗入之处为言，非真谓有口也。如果有口，则不言渗入矣。何后世
不解其意而争言膀胱有上口，其谬为甚。三焦下 义，详前十六。酾音筛。滤音虑。）黄帝曰∶人饮酒，酒亦入胃，谷未
熟而小便独先下何也？岐伯答曰∶酒者熟谷之液也，其气悍以清，故后谷而入，先谷而液出焉。（此因上文言水谷入胃必
济泌别汁而后出，而何以饮酒者独先下也？盖以酒之气悍，则直连下焦，酒之质清，则速行无滞，故后谷而入，先谷而
出也。）黄帝曰∶善。余闻上焦如雾，中焦如沤，下焦如渎，此之谓也。（如雾者，气浮于上也。言宗气积于胸中，司呼
吸而布 于经隧之间，如天之雾，故曰上焦如雾也。沤者，水上之泡，水得气而不沉者也。言营血化于中焦，随气流行
以奉生身，如沤处浮沉之间，故曰中焦如沤也。渎者，水所注泄。言下焦主出而不纳，逝而不反，故曰下焦如渎也。然
则肺象天而居上，故司雾之化。脾象地而在中，故司沤之化。大肠膀胱象江河淮泗而在下，故司川渎之化也。愚按∶三
焦者，本全体之大脏，统上中下而言也。本经发明不啻再四，如本输、本脏、论勇、决气、营卫生会、五脏别论、六节
藏象论、邪客、背输等篇，皆有详义，而二十五难经独言三焦包络皆有名而无形，遂起后世之疑，莫能辨正。第观本经
所言，凡上中下三焦之义，既明且悉，乌得谓其以无为有、以虚为实哉？余因遍考诸篇，着有三焦包络命门辨，及藏象
类第三章俱有详按，所当互考。）
《灵枢·营卫生会篇》
黄帝向岐伯问道：人从何处接受气？阴阳如何交会？什么气称为营气？什么气称为卫气？营气从哪里产生？卫气在哪里与营气交会？老年人和壮年人的气不同，阴阳的位置也不同，我希望了解它们交会的规律。（“焉”意为“何”，即哪里；“会”意为“合”，即交会。五十岁以上称为老，二十岁以上称为壮。这是黄帝询问人体之气的来源必有依据，交会必有处所，阴阳如何区分，营卫如何辨别，从而想要得到详细的解释。）
岐伯回答说：人通过饮食接受气，食物进入胃中，然后传送给肺，五脏六腑都由此接受气。（人的生存依赖于气，气是禀受于先天之气与后天谷气结合而充养全身的物质。所以谷物进入胃后，转化为气，这称为谷气，也叫胃气。这种气出自中焦，在脾脏进行传化，向上归于肺，积聚在胸中的气海之间，这就形成了宗气（积聚于胸中的大气）。宗气的运行，随着呼吸的往来，通达三焦（上、中、下三个部位），从而使五脏六腑都接受到气。因此，胃是水谷和血气的海洋，人所接受的气，也仅仅来源于谷物罢了。所以如果几天不吃东西，半天就会气衰，一天就会气少。）其中清轻的部分成为营气，重浊的部分成为卫气。（谷气从胃出来后，有清浊之分。清者是指水谷的精微精气，重浊者是指水谷的剽悍之气。各家以上下焦来谈论清浊都是不对的。清者属于阴，性质精纯专一，所以能化生血脉并在经络隧道中周流运行，这就是营气。重浊者属于阳，性质疾速滑利，所以不遵循经络，而是直接到达肌表，充实于皮毛和分肉之间，这就是卫气。然而，营气和卫气无非都是借助于宗气，所以宗气旺盛则营卫调和，宗气衰弱则营卫虚弱。）营气行于脉管之中，卫气行于脉管之外。（营，是在体内营运的气。卫，是在体表护卫的气。脉管既不是气也不是血，它就像是一个鼓风箱，容纳气血。营属于阴而主里，卫属于阳而主表，所以营行于脉中，卫行于脉外。《卫气篇》说：那些浮散而不循经的气称为卫气，那些精纯而行于经脉的气称为营气。正是说的这个意思。）营气周流不息，每昼夜运行五十周后再次大会，阴阳相互贯通，像圆环一样没有端点。（营气的运行，周流不休，凡是一天一夜在身体内运行五十周后再次大会。其十二经脉的顺序，则是一阴一阳，一表一里，交替运行相互贯通，终而复始，所以说像圆环没有端点。关于“五十周”的含义，见下文章节及第二十六章。）卫气在阴分运行二十五周，在阳分运行二十五周，以此划分昼夜，所以卫气到达阳分人就醒来，到达阴分人就入睡。（卫气的运行，夜间在阴分运行二十五周，白天在阳分运行二十五周，一天一夜也是五十周于身。含义详见后文第二十五篇。气至阳分而起，至阴分而止，指的是白天和夜晚的休息，即下文所说的百姓都睡觉的意思。）所以说，中午时阳气隆盛称为重阳，半夜时阴气隆盛称为重阴。（这是划分昼夜的阴阳，来说明营卫的运行。陇，通“隆”，意为盛，《生气通天论》写作“隆”。昼为阳，中午是阳中之阳，所以叫重阳。夜为阴，半夜是阴中之阴，所以叫重阴。陇音同笼。）所以太阴（手太阴肺经）主管内部（营气），太阳（足太阳膀胱经）主管外部（卫气），各自运行二十五周，以此划分昼夜。（太阴指手太阴肺经，太阳指足太阳膀胱经。内指营气，外指卫气。营气始于手太阴肺经，又回会于太阴，所以太阴主管内部。卫气始于足太阳膀胱经，又回会于太阳，所以太阳主管外部。营气在十二经脉中周流，昼夜各二十五周。卫气白天行于阳，晚上行于阴，也各二十五周。营卫各为五十周以区分昼夜。）半夜时阴气最盛，半夜过后阴气开始衰退，黎明时阴气耗尽而阳气开始受气。中午时阳气最盛，日落时阳气衰退，太阳落山时阳气耗尽而阴气开始受气。（半夜过后阴气衰退，是因为阳气生于子时。日落时阳气衰退，是因为阴气生于午时。如《金匮真言论》所说：平旦到中午，是天的阳气，阳中之阳；中午到黄昏，是天的阳气，阳中之阴；合夜到鸡鸣，是天的阴气，阴中之阴；鸡鸣到平旦，是天的阴气，阴中之阳，所以人也顺应这种情况。就是这一节的含义。）半夜时营卫大会，百姓都睡觉，这叫做“合阴”（营卫皆归于阴分），黎明时阴气耗尽而阳气受气，如此循环不止，与天地运行的规律相同。（大会，说的是营卫阴阳的交会。营卫的运行，表里度数不同，所以常常不相遇；只有在半夜子时，阴气已极，阳气将生，营气在阴分，卫气也在阴分，所以百姓都闭眼睡觉，这叫合阴。合阴，意思是营卫都回归脏腑，而在天一之中交会。黎明时阴气耗尽而阳气受气，所以人们都睁眼起床。这是阴阳消长的道理，经常这样循环不止而与天地同其纪。所谓天地的纪，比如天有二十八宿作为纪，地有十二辰次作为纪，日月以其运行的快慢作为纪。所以天和地一年交会一次，比如玄枵加临于子宫；天和日一年交会一次，比如冬至日缠星纪；日和月一月交会一次，比如晦朔在同一宫位。人的营卫，以昼夜为纪，所以一天运行五十周后再次大会。）
黄帝说：老人晚上不睡觉，是什么气造成的？年轻人白天不睡觉，是什么气造成的？（这是黄帝因为上文提到晚上百姓都睡觉，所以特别提出老人晚上不醒觉的情况，来寻求详细的解释。）
岐伯回答说：壮年人的气血旺盛，肌肉滑润，气道通畅，营卫的运行不失常态，所以白天精神饱满，晚上能入睡。老年人的气血衰弱，肌肉枯槁，气道涩滞，五脏之气相互搏结，营气衰少而卫气向内侵扰，所以白天精神不振，晚上睡不着。（老年人气血衰弱，所以肌肉枯槁，气道涩滞，五脏之气聚结不行，导致营气衰少。营气衰少，所以卫气乘虚向内侵扰，卫气失去常态所以白天精神不振，营气失去常态所以晚上睡不着。）
黄帝说：我想听听营卫的运行，都是从哪条道路开始的？岐伯回答说：营气出于中焦，卫气出于下焦。（“何道从来”，是说营卫所经过的道路。营气，是由谷物进入胃中，中焦接受谷气并提取汁液，将其精微部分向上注入肺，于是从手太阴肺经开始，在经络隧道中周流运行，所以营气出于中焦。卫气，是发出其剽悍滑利的部分，先行于四肢末端、分肉和皮肤之间，不进入脉管，所以在黎明阴气尽、阳气出于眼睛时，沿着头部和颈部下行，始于足太阳膀胱经而在阳分运行，日落阳气尽时，则始于足少阴肾经而在阴分运行，其气从膀胱和肾由下而出，所以卫气出于下焦。详细含义见后文营气、卫气两章。我按语：人身不过表里，表里不过阴阳，阴阳即营卫，营卫即血气。脏腑筋骨居于体内，必须依靠营气来滋养，依靠经脉来疏通。皮毛分肉居于体外，经脉不通达的地方，营气达不到的地方，所以依靠卫气来温煦，依靠孙络来濡润。这样之后，内而精髓，外而发肤，无不得到滋养，这都是营卫的变化作用。然而，营气就像天有星辰度数，地有河流经纬，出入有定期，营运有秩序。卫气就像天有清阳，地有湿热蒸腾，阴阳昼夜，随时而变化。卫气属阳，却出于下焦，下部的东西必然上升，所以它的氣自下而上，也像地气上升变为云。营本属阴，却从中焦而出并于上焦发挥作用，上部的东西必然下降，所以营气自上而下，也像天气下降变为雨。虽然卫主气而在外，但难道就没有血吗？营主血而在内，但难道就没有气吗？所以营中未必没有卫，卫中未必没有营，只是行于内的就叫营，行于外的就叫卫，这是人身阴阳交感的道理，分开则是二，合起来则是一而已。前第六章有按语，应当与此互相参考。）
黄帝说：我想听听三焦是从哪里发出的。岐伯回答说：上焦出于胃的上口（贲门），沿着咽喉向上贯穿膈肌而分布于胸中，走向腋下，沿着手太阴肺经的部位运行，返回至手阳明大肠经，向上到达舌部，向下连接足阳明胃经。（胃上口，就是上脘穴的位置。咽是胃的系带，是水谷的道路。膈肌以上是胸中，就是膻中穴所在。其旁行的部分，走向两腋，出于天池穴附近，沿着手太阴肺经的部位而回到手阳明经。其上行的部分，到达舌部。其下行的部分，交于足阳明经，以行于中、下二焦。凡是这些都属于上焦的部分。）上焦常与营气一起在阳分运行二十五周，在阴分也运行二十五周，这是一周，所以五十周后再次在手太阴肺经大会。（上焦是肺居住的地方，是宗气聚集之处。营气，跟随宗气在十四经脉中运行。所以上焦之气，常与营气一起在阳分运行二十五周，在阴分也运行二十五周。这里的阴阳，指的是昼夜。昼夜周行五十周，到第二天寅时再次在手太阴肺经交会，这是一周。既然这样，营气虽然出于中焦，但其施化作用则由于上焦。）
黄帝说：我想听听中焦是从哪里发出的。岐伯回答说：中焦也位于胃中，处于上焦之后，这里所接受的气，是泌别糟粕，蒸腾津液，化生精微，向上注入肺脉，于是化为血液，以供养身体，没有比这更宝贵的了，所以它能单独在经络隧道中运行，称为营气。（胃中，是中脘穴所在的部位。“后”，指下方。受气，指接受谷食之气。五谷进入胃中，其糟粕、津液、宗气，分为三条通道注入三焦。而中焦，泌别糟粕，蒸腾津液，接受谷气并提取汁液，变化而变红，这就称为血，以供养身体并在精隧中运行，这就是营气，所以说营出中焦。参照下文说：下焦，别出回肠，注入膀胱。那么从膈膜之下，到脐上一寸水分穴之上，都是中焦的部分。泌，音秘、弼。粕，音朴。隧，音遂，指伏道。）
黄帝说：血和气，名称不同但同类，这是什么意思？岐伯回答说：营卫是精气，血是神气，所以血和气，名称不同但同类。所以失血的人不能发汗，大汗的人不能放血，所以人同时丧失血和汗会导致死亡，而没有只丧失一种就能存活的。（营卫之气，虽然分为清浊，但都是水谷的精华，所以说是精气。血由气化而来变成红色，其奥妙不可测度，所以说是神气。然而血由液化生，液由气化生，所以血和气本是同类，而血和汗也不是两种东西；只是血主营，属阴属里，汗属卫，属阳属表，一表一里，不能同时攻伐，所以失血的人不要取汗，大汗的人不要取血。如果表里都被攻夺，那么不是脱阴，就是脱阳，脱阳也会死，脱阴也会死，所以说人同时丧失血和汗会死。然而人的生存，阴阳之气都不可无，没有孤阳能生的，也没有孤阴能生的，所以说没有只丧失一种就能存活的情况。）
黄帝说：我想听听下焦是从哪里发出的。岐伯回答说：下焦，别出回肠，注入膀胱并渗入其中。所以水谷，经常共同居住在胃中，变成糟粕后一起下行到大肠，形成下焦的功能，渗滤分别汁液，沿着下焦渗入膀胱。（回肠，指大肠。济，通“筛”，犹过滤之意。泌，像狭小的水流。别汁，分别清浊。别回肠，是说水谷共同居住在胃中，传化于小肠，当脐上一寸水分穴处，糟粕由此别行进入回肠，从后面排出，津液由此别渗进入膀胱，从前面排出。膀胱没有上口，所以说渗入。凡是自水分穴以下，都是下焦的部分。参照《难经·三十一难》说：下焦，位于膀胱上口，主要功能是分别清浊。它说“上口”，是以渗入的地方而言，并不是真的有一个口。如果真的有口，就不会说渗入了。为什么后世人不理解这个意思而争论膀胱有上口，这种谬误非常严重。三焦下部的含义，详见前文第十六篇。酾，音筛。滤，音虑。）
黄帝说：人喝酒，酒也进入胃中，谷物还没消化完而小便却先排出了，为什么呢？岐伯回答说：酒是熟谷的液体，它的气味剽悍而且清澈，所以它在谷物之后进入，却在谷物之前以液体形式排出。（这是因为上文说水谷进入胃中必须经过滤分别汁液后才排出，为什么喝酒的人却先排出呢？大概因为酒的气剽悍，所以直接连通下焦；酒的质地清澈，所以迅速运行而无滞留，因此在谷物之后进入，却在谷物之前排出。）
黄帝说：好。我听说上焦如雾，中焦如沤，下焦如渎，说的就是这个意思。（如雾，是指气浮于上。说的是宗气积聚在胸中，主持呼吸并布散于经络隧道之间，像天上的雾，所以上焦如雾。沤，是水中的泡沫，水得气而不沉没。说的是营血化生于中焦，随气流行以供养身体，像沤处在浮沉之间，所以中焦如沤。渎，是水注泄的渠道。说的是下焦主出而不纳，流逝而不返回，所以下焦如渎。既然这样，肺象天而居上，所以主管雾的化生。脾象地而在中，所以主管沤的化生。大肠膀胱象江河淮泗而在下，所以主管川渎的化生。我按语：三焦，本来是整体的大脏，统括上、中、下而言。本经阐明这一点不只一次，如《本输》、《本脏》、《论勇》、《决气》、《营卫生会》、《五脏别论》、《六节藏象论》、《邪客》、《背输》等篇，都有详细的含义，而《难经·二十五难》唯独说三焦和心包络都有名而无形，于是引起后世的疑惑，不能辨正。只看本经所说的，凡上中下三焦的含义，既明确又详尽，怎么能说它是以无为有、以虚为实呢？我因此遍考诸篇，写了《三焦包络命门辨》，以及《藏象类》第三章都有详细按语，应当互相参考。）
(Lingshu: Yingwei Shenghui Chapter)
Yellow Emperor asked Qibo: From where does the human body receive Qi? How do Yin and Yang intersect? What Qi is called Ying (Nutrient) Qi? What Qi is called Wei (Defensive) Qi? Where does Ying Qi originate? Where does Wei Qi meet with Ying Qi? The Qi of the elderly and the vigorous differs, and the positions of Yin and Yang are distinct. I wish to understand their intersection. ("Yan" means "what/where"; "Hui" means "meet/join". Those over fifty are considered elderly; those over twenty are considered vigorous. This is the Yellow Emperor inquiring about the source of the body's Qi, which must have a cause, and its meeting point, which must have a location. He asks how Yin and Yang are distinguished, and how Ying and Wei are differentiated, seeking detailed explanations.)
Qibo replied: Humans receive Qi from food and drink. Food enters the stomach and is transmitted to the lungs; the five Zang organs and six Fu organs all receive Qi from it. (Human life depends on Qi. Qi consists of congenital Qi received from heaven and Gu Qi (Grain Qi) derived from food, which together nourish the body. When grain enters the stomach, it transforms into Qi, known as Gu Qi or Stomach Qi. This Qi originates from the Middle Jiao (Middle Burner), is transformed by the spleen, ascends to the lung, and accumulates in the chest between the sea of Qi, forming Zong Qi (Gathering Qi). Zong Qi moves with respiration, penetrates the Three Jiaos (Upper, Middle, Lower Burners), and allows the five Zang and six Fu organs to receive Qi. Thus, the stomach is the sea of water and grain and blood/Qi, and the Qi humans receive comes solely from grain. Therefore, if one does not eat for half a day, Qi declines; if one does not eat for a day, Qi becomes scarce.) The clear part becomes Ying Qi, and the turbid part becomes Wei Qi. (After Gu Qi leaves the stomach, it divides into clear and turbid parts. The clear part is the essence of water and grain; the turbid part is the fierce Qi of water and grain. It is incorrect for various schools to discuss clear and turbid in terms of upper and lower Jiaos. The clear part belongs to Yin, has a refined and dedicated nature, thus transforming into blood vessels and circulating through the meridians; this is Ying Qi. The turbid part belongs to Yang, has a swift and slippery nature, thus not following the meridians but reaching directly to the muscle surface, filling the skin and intermuscular spaces; this is Wei Qi. However, both Ying and Wei Qi rely on Zong Qi. Therefore, when Zong Qi is abundant, Ying and Wei are harmonious; when Zong Qi is deficient, Ying and Wei are weak.) Ying Qi circulates within the vessels, while Wei Qi circulates outside the vessels. (Ying operates within the interior; Wei guards the exterior. Vessels are neither Qi nor Blood but serve like bellows containing them. Ying belongs to Yin and governs the interior; Wei belongs to Yang and governs the exterior. Hence, Ying is inside the vessels, and Wei is outside. The *Wei Qi Chapter* states: "The floating Qi that does not follow the meridians is called Wei Qi; the essential Qi that travels within the meridians is called Ying Qi." This refers precisely to this concept.) Ying Qi circulates without rest, completing fifty cycles before meeting again. Yin and Yang interpenetrate like a ring without beginning or end. (Ying Qi flows continuously, completing fifty cycles around the body in one day and night before the great meeting. The sequence of the twelve meridians alternates between Yin and Yang, exterior and interior, connecting endlessly, hence described as a ring without end. The meaning of "fifty cycles" is explained in subsequent chapters and Chapter 26.) Wei Qi travels twenty-five cycles in the Yin aspects and twenty-five cycles in the Yang aspects, dividing day and night. Thus, when Qi reaches Yang, one awakens; when it reaches Yin, one sleeps. (Wei Qi travels twenty-five cycles in the Yin divisions at night and twenty-five cycles in the Yang divisions during the day, totaling fifty cycles in one day and night. See Chapter 25 for details. "Qi reaches Yang to rise, reaches Yin to stop" refers to waking during the day and sleeping at night, as mentioned later regarding people sleeping.) Therefore, it is said that at noon, Yang is abundant, called Chong Yang (Double Yang); at midnight, Yin is abundant, called Chong Yin (Double Yin). (This distinguishes Yin and Yang of day and night to explain the movement of Ying and Wei. "Long" means abundant/prosperous, written as "Long" in the *Shengqi Tongtian Lun*. Day is Yang; noon is Yang within Yang, hence Chong Yang. Night is Yin; midnight is Yin within Yin, hence Chong Yin. Long sounds like 'long'.) Thus, Taiyin (Hand Taiyin Lung Meridian) governs the interior (Ying Qi), and Taiyang (Foot Taiyang Bladder Meridian) governs the exterior (Wei Qi), each traveling twenty-five cycles to divide day and night. (Taiyin refers to Hand Taiyin; Taiyang refers to Foot Taiyang. Interior refers to Ying Qi; Exterior refers to Wei Qi. Ying Qi begins at Hand Taiyin and returns to Taiyin, so Taiyin governs the interior. Wei Qi begins at Foot Taiyang and returns to Taiyang, so Taiyang governs the exterior. Ying Qi circulates through the twelve meridians, twenty-five cycles day and night. Wei Qi travels in Yang during the day and Yin at night, also twenty-five cycles each. Ying and Wei each complete fifty cycles to distinguish day and night.) At midnight, Yin is most abundant; after midnight, Yin declines. At dawn, Yin is exhausted, and Yang receives Qi. At noon, Yang is most abundant; at sunset, Yang declines. At dusk, Yang is exhausted, and Yin receives Qi. (Yin declines after midnight because Yang arises at Zi hour. Yang declines at sunset because Yin arises at Wu hour. As stated in *Jinkui Zhenyan Lun*: Dawn to noon is Heaven's Yang, Yang within Yang; noon to dusk is Heaven's Yang, Yin within Yang; dusk to rooster crow is Heaven's Yin, Yin within Yin; rooster crow to dawn is Heaven's Yin, Yang within Yin. Humans correspond to this. This is the meaning of this section.) At midnight, there is a great meeting; all people sleep. This is called "He Yin" (Joining Yin). At dawn, Yin is exhausted, and Yang receives Qi. This continues endlessly, synchronized with the rhythms of Heaven and Earth. (Great meeting refers to the convergence of Ying, Wei, Yin, and Yang. Ying and Wei travel different paths and often do not meet; only at midnight Zi hour, when Yin is extreme and Yang is about to arise, are both Ying and Wei in the Yin division, causing people to sleep. "He Yin" means Ying and Wei return to the Zang organs and meet in the unity of Tian Yi. At dawn, Yin exhausts and Yang receives Qi, so people open their eyes and rise. This is the way of Yin-Yang waxing and waning, continuing endlessly in sync with Heaven and Earth. The "rhythm of Heaven and Earth" refers to celestial and terrestrial cycles: Heaven uses the Twenty-Eight Mansions; Earth uses the Twelve Earthly Branches; Sun and Moon use their speeds. Heaven and Earth meet once a year; Heaven and Sun meet once a year; Sun and Moon meet once a month. Human Ying and Wei use day and night as their rhythm, completing fifty cycles daily before the great meeting.)
Yellow Emperor said: Why do the elderly not sleep soundly at night? Why do the young not sleep during the day? (The Yellow Emperor, having heard that people sleep at night, specifically asks about the elderly's lack of night sleep for detailed explanation.)
Qibo replied: In the vigorous, Qi and Blood are abundant, muscles are smooth, Qi channels are unobstructed, and the movement of Ying and Wei follows normal patterns. Thus, they are energetic during the day and sleep at night. In the elderly, Qi and Blood decline, muscles become withered, Qi channels become obstructed, and the Qi of the five Zang organs clashes. Ying Qi becomes deficient, and Wei Qi invades inwardly. Thus, they lack energy during the day and cannot sleep at night. (Elderly have declining Qi and Blood, leading to withered muscles and obstructed Qi channels. The Qi of the five Zang organs stagnates, causing Ying Qi deficiency. Due to Ying deficiency, Wei Qi invades inwardly due to weakness. Loss of Wei's normal function causes daytime lethargy; loss of Ying's normal function causes nighttime insomnia.)
Yellow Emperor said: I wish to know from where the movements of Ying and Wei originate. Qibo replied: Ying Qi originates from the Middle Jiao, and Wei Qi originates from the Lower Jiao. ("From where" refers to the pathways. Ying Qi: Grain enters the stomach; the Middle Jiao receives Qi, extracts fluids, and sends essences upward to the lung, starting from Hand Taiyin, circulating through meridians. Thus, Ying originates from the Middle Jiao. Wei Qi: Its fierce and slippery part moves first in the extremities, muscles, and skin, not entering vessels. At dawn, when Yin ends and Yang emerges from the eyes, it descends along the head and neck, starting at Foot Taiyang Bladder Meridian in the Yang aspect. At sunset, when Yang ends, it starts at Foot Shaoyin Kidney Meridian in the Yin aspect. Its Qi exits from below via Bladder and Kidney. Thus, Wei originates from the Lower Jiao. For details, see chapters on Ying and Wei Qi. My Note: The human body consists of interior/exterior, which is Yin/Yang. Yin/Yang is Ying/Wei. Ying/Wei is Blood/Qi. Internal organs and bones/tendons reside inside, relying on Ying for nourishment and meridians for flow. External skin/muscles rely on Wei for warmth and collateral vessels for moistening. Thus, internal marrow and external hair/skin are all nourished by Ying and Wei transformations. Ying is like stars in the sky or rivers on earth, moving with order and timing. Wei is like clear Yang in the sky or steam on earth, changing with Yin/Yang and day/night. Although Wei is Yang and originates from the Lower Jiao, things from below must ascend, so its Qi rises like earth vapor becoming clouds. Although Ying is Yin and originates from the Middle Jiao acting in the Upper Jiao, things from above must descend, so Ying Qi descends like heavenly rain falling. Though Wei governs Qi externally, it contains Blood. Though Ying governs Blood internally, it contains Qi. Thus, Ying contains Wei, and Wei contains Ying. Those moving inside are called Ying; those moving outside are called Wei. This is the interaction of Yin and Yang: divided it is two, united it is one. Refer to the note in Chapter 6.)
Yellow Emperor said: I wish to know where the Three Jiaos originate. Qibo replied: The Upper Jiao originates from the upper opening of the stomach, runs up the throat, pierces the diaphragm, and distributes in the chest. It goes to the axilla, follows the Hand Taiyin division, returns to Hand Yangming, ascends to the tongue, and descends to Foot Yangming. (The upper opening of the stomach is the Shangwan point. The throat is the connection of the stomach, the pathway for food/drink. Above the diaphragm is the chest, the Danzhong area. The lateral path goes to the axillae, exits near Tianchi, follows Hand Taiyin Lung Meridian, and returns to Hand Yangming. The ascending path reaches the tongue. The descending path connects to Foot Yangming, operating in the Middle and Lower Jiaos. These constitute the Upper Jiao.) The Upper Jiao usually travels with Ying Qi twenty-five cycles in Yang and twenty-five in Yin, constituting one cycle. Thus, it meets again at Hand Taiyin after fifty cycles. (The Upper Jiao is the residence of the Lung and the gathering place of Zong Qi. Ying Qi follows Zong Qi through the fourteen meridians. Thus, Upper Jiao Qi travels with Ying Qi twenty-five cycles in Yang and twenty-five in Yin. Yin/Yang here refers to day/night. Fifty cycles daily, meeting at Hand Taiyin Lung Meridian at Yin hour the next day constitutes one cycle. Although Ying originates from the Middle Jiao, its transformation relies on the Upper Jiao.)
Yellow Emperor said: I wish to know where the Middle Jiao originates. Qibo replied: The Middle Jiao also resides in the stomach, behind the Upper Jiao. The Qi received here separates dregs, steams fluids, transforms essences, and injects them upward into the lung pulse, where they transform into blood to nourish the body. Nothing is more precious than this, so it alone travels in the meridians, named Ying Qi. (Stomach refers to Zhongwan area. "Behind" means below. Receiving Qi means receiving grain Qi. Five grains enter the stomach; dregs, fluids, and Zong Qi are separated into three tunnels for the Three Jiaos. The Middle Jiao separates dregs, steams fluids, receives Qi and extracts juice, transforms it red, which is Blood. It nourishes the body and travels in the fine tunnels, thus Ying Qi. Hence, Ying originates from the Middle Jiao. Referring to the text below: The Lower Jiao separates the ileum and pours into the bladder. Thus, from below the diaphragm to one cun above the Shuifen point at the umbilicus is the Middle Jiao. Bi sounds like mi/bi. Po sounds like pu. Sui sounds like sui, meaning hidden path.)
Yellow Emperor said: Blood and Qi have different names but are of the same category. What does this mean? Qibo replied: Ying and Wei are Essence Qi; Blood is Spirit Qi. Thus, Blood and Qi are different in name but similar in category. Therefore, those who lose blood should not sweat, and those who lose sweat should not bleed. Thus, a person facing simultaneous loss of blood and sweat will die, but survival without either is impossible. (Ying and Wei, though clear/turbid, are essences of water/grain, hence Essence Qi. Blood transforms red mysteriously, hence Spirit Qi. Blood forms from fluids, fluids from Qi; thus Blood and Qi are same-category. Blood and sweat are not two separate entities. Blood governs Ying, Yin, Interior; Sweat governs Wei, Yang, Exterior. One exterior, one interior; they cannot be attacked simultaneously. Thus, blood loss precludes sweating, and sweat loss precludes bleeding. If both exterior and interior are depleted, one loses either Yin or Yang. Loss of Yang leads to death; loss of Yin leads to death. Hence, simultaneous loss causes death. However, life requires both Yin and Yang. Neither solitary Yang nor solitary Yin can sustain life. Hence, survival without losing one type is impossible.)
Yellow Emperor said: I wish to know where the Lower Jiao originates. Qibo replied: The Lower Jiao separates the ileum, pours into the bladder, and infiltrates. Water and grain coexist in the stomach, become dregs, and descend together to the large intestine, forming the Lower Jiao function. They filter and separate juices, flowing along the Lower Jiao to infiltrate the bladder. (Ileum refers to Large Intestine. Ji means sieve/filter. Mi means narrow stream. Bie Zhi means separating clear and turbid. Separating ileum means water/grain in stomach/small intestine, at Shuifen point one cun above umbilicus: dregs go to ileum for posterior exit; fluids infiltrate bladder for anterior exit. Bladder has no upper opening, hence "infiltrate". Below Shuifen is Lower Jiao. Refer to *Nanjing 31*: Lower Jiao is at the upper opening of the bladder, governing separation of clear/turbid. "Upper opening" refers to the infiltration site, not a literal mouth. If it had a mouth, it wouldn't say "infiltrate". Later generations mistakenly debated the existence of a bladder opening. Details on Lower Jiao are in Chapter 16. Shi sounds like shai. Lv sounds like lv.)
Yellow Emperor said: When one drinks alcohol, it enters the stomach. Why does urine exit before the grain is digested? Qibo replied: Alcohol is the liquid of cooked grain. Its Qi is fierce and clear. Thus, it enters after grain but exits as liquid before grain. (Why does alcohol exit first despite the rule of filtering? Because its Qi is fierce, connecting directly to the Lower Jiao; its substance is clear, moving rapidly without stagnation. Hence, entering after grain but exiting before.)
Yellow Emperor said: Excellent. I have heard: Upper Jiao is like mist, Middle Jiao is like foam, Lower Jiao is like a ditch. This is what is meant. (Like mist: Qi floats upward. Zong Qi gathers in the chest, governs respiration, and distributes in meridians like sky mist, hence Upper Jiao like mist. Like foam: Bubbles on water, buoyant due to Qi. Ying/Blood forms in Middle Jiao, flows with Qi to nourish the body, floating like foam, hence Middle Jiao like foam. Like ditch: Channels for water drainage. Lower Jiao excretes without retaining, flowing away without returning, hence Lower Jiao like ditch. Lung resembles Heaven above, governing mist transformation. Spleen resembles Earth in middle, governing foam transformation. Large Intestine and Bladder resemble rivers below, governing ditch transformation. My Note: The Three Jiaos are the great organ encompassing Upper, Middle, and Lower. The Classic explains this repeatedly in chapters like *Ben Shu*, *Ben Zang*, *Lun Yong*, *Jue Qi*, *Ying Wei Sheng Hui*, *Wu Zang Bie Lun*, *Liu Jie Zang Xiang Lun*, *Xie Ke*, *Bei Shu*. However, *Nanjing 25* states Sanjiao and Pericardium have names but no form, causing later confusion. Reading the Classic, the meanings of Upper/Middle/Lower Jiao are clear and detailed; how can it be void/false? I have examined all chapters, wrote *Sanjiao Baoluo Mingmen Bian*, and provided notes in *Zang Xiang Class* Chapter 3. Cross-reference these.)