（素问五脏别论）
帝曰∶气口何以独为五脏主？（气口之义，其名有三∶手太阴肺经脉也，肺主诸气，气之盛衰见于此，故曰气口；
肺朝百脉，脉之大会聚于此，故曰脉口；脉出太渊，其长一寸九分，故曰寸口。是名虽三而实则一耳。五脏六腑之气味，
皆出于胃，变见于气口，故为五脏之主。义见下文。愚按∶气口寸口脉口之义，乃统两手而言，非独指右手为气口也。
如经脉篇曰∶手太阴之脉入寸口，上循鱼际。又曰∶经脉者，常不可见也，其虚实也，以气口知之。经筋篇曰∶手太阴
之筋，结于鱼后，行寸口外侧。经脉别论曰∶权衡以平，气口成寸，以决死生。平人气象论曰∶欲知寸口太过与不及。
小针解曰∶气口虚而当补，盛而当泻。本篇曰∶气口何以独为五脏主？难经曰∶十二经皆有动脉，独取寸口，以决五脏
六腑死生吉凶之法，何谓也？曰∶寸口者，脉之大会，五脏六腑之所终始，故取法于寸口也。诸如此者，岂独指右手为
言耶？而王叔和未详经旨，突谓左为人迎，右为气口，左手寸口人迎以前、右手寸口气口以前等说，自晋及今，以讹传
讹，莫可解救；甚至以左候表，以右候里，无稽之言，其谬为甚。夫肝心居左，岂不可以为里？肠胃在右，岂不可以言
表？如仲景为伤寒之祖，但曰大浮数滑动者，此名阳也；沉涩弱弦微者，此名阴也。又曰∶表有病者，脉当浮而大；里
有病者，脉当沉而细。又如其上取寸口，太阴脉也；下取趺阳，阳明脉也。是皆阴阳表里之谓。初未闻以左为人迎而候
表，右为气口而候里。即余初年亦尝为左表右里之说所惑，及今见多识定，乃知脉体自有阴阳，诸经皆具表里。凡今之
习讹者，但见左强，便曰外感而攻其表；但见右盛，便曰内伤而攻其里。亦焉知脏气有不齐，脉候有禀赋，或左脉素大
于右，或右脉素大于左，孰者为常？孰者为变？或于偏弱中略见有力，已隐虚中之实；或于偏盛中稍觉无神，便是实中
之虚。设不知此而执欲以左右分表里，岂左无里而右无表乎？故每致攻伐无过，颠倒阴阳，非惟大失经旨，而遗害于人
不小，无怪乎脉之日难也，此不得不为辨正。再按∶人迎气口之脉，本皆经训；但人迎为足阳明之脉，不可以言于手，
气口总手太阴而言，不可以分左右，如动输、本输、经脉等篇，明指人迎为结喉旁胃经动脉。愚尝考之四时气篇曰∶气
口候阴，人迎候阳。五色篇曰∶人迎盛坚者伤于寒，气口盛坚者伤于食。禁服篇曰∶寸口主中，人迎主外。经脉、终始
等篇曰，人迎一盛二盛三盛，脉口一盛二盛三盛等义。皆言人迎为阳明之腑脉，故主乎表；脉口为太阴之脏脉，故主乎
里。如太阴阳明论曰∶太阴为之行气于三阴，阳明为之行气于三阳。阴阳别论曰三阳在头，正言人迎行气于三阳也；三
阴在手，正言脉口行气于三阴也。盖上古诊法有三∶一取三部九候以诊通身之脉，一取太阴阳明以诊阴阳之本，一取左
右气口以诊脏腑之气。然则人迎自有其位，脉经则扯人迎于左手，而分气口于右手，不知何据何见而云然？愚初惑之，
未敢遽辩，及见纲目之释人迎气口者，亦云人迎在结喉两旁，足阳明之脉也。又见庞安常论脉曰∶何谓人迎？喉旁取之。
近见徐东皋曰∶脉经谓左手关前一分为人迎，误也。若此数君者，已觉吾之先觉矣，兹特引而正之。呜呼！夫一言之谬，
遗误千古，成心授受，何时复正哉？立言者，可不知所慎乎？）岐伯曰∶胃者，水谷之海，六腑之大源也。五味入口，
藏于胃以养五脏气，气口亦太阴也。是以五脏六腑之气味，皆出于胃，变见于气口。（人有四海而胃居其一，是为水谷之
海。脏腑之属，阳为腑，阴为脏，胃属阳而为六腑之本，故云六腑之大源。然五味入口，藏于胃以养五脏气，故又曰胃
为五脏六腑之海。气口本属太阴，而曰亦太阴者何也？盖气口属肺，手太阴也；布行胃气，则在于脾，足太阴也。按营
卫生会篇曰∶谷入于胃，以传于肺，五脏六腑，皆以受气。厥论曰∶脾主为胃行其津液者也。经脉别论曰∶饮入于胃，
游溢精气，上输于脾，脾气散精，上归于肺。然则胃气必归于脾，脾气必归于肺，而后行于脏腑营卫，所以气口虽为手
太阴，而实即足太阴之所归，故曰气口亦太阴也。是以五脏六腑之气味，皆出于胃而变见于气口，故胃为脏腑之大源，
然无不由脾达肺也。见音现。）故五气入鼻，藏于心肺，心肺有病，而鼻为之不利也。（气味之化，在天为气，在地为味。
上文言五味入口藏于胃者，味为阴也；此言五气入鼻藏于心肺者，气为阳也。鼻为肺之窍，故心肺有病而鼻为之不利。
观此两节曰味曰气，皆出于胃而达于肺，既达于肺，亦必变见于气口，故气口独为五脏主。）凡治病必察其下，适其脉，
观其志意，与其病也。（此治病之四要也。下言二阴，二阴者，肾之窍，胃之关也。脉要精微论曰∶仓廪不藏者，是门户
不要也。得守者生，失守者死。故二便为胃气之关锁，而系一身元气之安危，此下之不可不察也。适，测也。脉为气血
之先，故独取寸口以决吉凶之兆。如平人气象论曰∶人无胃气曰逆，逆者死。脉无胃气亦死。此脉之不可不察也。志意
者，如本藏篇曰∶志意和则精神专直，魂魄不散，悔怒不起，五脏不受邪矣。是志意关乎神气而存亡系之，此志意之不
可不察也。病有标本，不知求本，则失其要矣；病有真假，不知逆从，则及于祸矣。此病因之不可不察也。合是四者而
会观之，则治病之妙，无遗法矣。）拘于鬼神者，不可与言至德。阳之灵曰神，阴之灵曰鬼。张子曰∶鬼神者，二气之良
能也。程子曰∶鬼神只是一个造化，天尊地卑，乾坤定矣，鼓之以雷霆，润之以风雨是也。然则鬼神者，即天地之灵耳。
祸福有因，惟人自作，天地无私，鬼神焉得而蔽之？彼昧理者，不知鬼神不可媚，而崇尚虚无，不求实济，何益之有？
若此者，即与论天人至德，必不见信，又何足与道哉？故曰信巫不信医，一不治也。即此之谓。）恶于针石者，不可与言
至巧。（针石之道，法三才而调阴阳，和气血而通经络，故曰知机之道者，不可挂以发，盖言其至精至微也；而或有恶于
针石者，诚不可与言至巧矣。）病不许治者，病必不治，治之无功矣。（不治已病治未病，圣人之道也。其有已病而尚不
许治者，特以偏见不明，信理不笃，如拘于鬼神、恶于针石之类皆是也。既不相信，不无掣肘，强为之治，焉得成功？
即有因治而愈者，彼亦犹谓不然，总亦属之无功也。）
《素问·五脏别论》
黄帝问道：气口脉为什么能单独作为诊断五脏病变的依据？（关于“气口”这一名称，包含三层含义：一是手太阴肺经的脉搏处，因为肺主一身之气，气的盛衰变化反映在此处，所以称为气口；二是肺朝会全身百脉，脉气在此大会聚，所以称为脉口；三是脉气出于太渊穴，长度一寸九分，所以称为寸口。这三个名称虽然不同，但实质上是同一个部位。五脏六腑的精微物质，都来源于胃，其变化反映在气口，因此气口成为五脏的主宰。详细道理见下文。我按语道：气口、寸口、脉口的概念，是统指双手而言，并非专指右手为气口。如《经脉篇》说：“手太阴肺经进入寸口，向上沿至鱼际。”又说：“经脉本身通常看不见，其虚实情况，通过气口可以知晓。”《经筋篇》说：“手太阴经筋，结于鱼际后方，行于寸口外侧。”《经脉别论》说：“权衡平衡后，气口形成寸口之象，以此决断生死。”《平人气象论》说：“想要知道寸口脉太过或不及的情况。”《小针解》说：“气口脉虚应当补，脉盛应当泻。”本篇说：“气口为什么能单独作为五脏的主宰？”《难经》说：“十二经都有动脉，唯独取寸口脉，作为决断五脏六腑生死吉凶的方法，这是什么意思呢？”回答说：“寸口是脉气的大会聚之处，是五脏六腑气血终始所在的地方，所以取法于寸口。”像这样的情形，难道只是指右手吗？然而王叔和没有详察经典原意，突然提出左手为人迎，右手为气口，以及左手寸口在人迎之前、右手寸口在气口之前等说法，从晋代到现在，以讹传讹，无法挽救；甚至认为左脉候表证，右脉候里证，这种无稽之谈，谬误非常严重。肝心位于左侧，难道不可以用来候里证吗？肠胃位于右侧，难道不可以用来候表证吗？如张仲景被尊为伤寒学派的祖师，他只说脉象大、浮、数、滑、动者，这名叫阳；沉、涩、弱、弦、微者，这名叫阴。他又说：表有病，脉象应当浮而大；里有病，脉象应当沉而细。又如上面取寸口，这是太阴脉；下面取趺阳脉，这是阳明脉。这些都是讲阴阳表里的关系。从未听说过以左手为人迎来候表证，以右手为气口来候里证。就连我年轻时也曾被左表右里的说法所迷惑，直到如今见识多了、认识确定了，才知道脉体自有阴阳，各条经脉都具备表里属性。凡是现在那些习染错误说法的人，只要见到左脉强盛，就说这是外感而攻治其表证；只要见到右脉旺盛，就说这是内伤而攻治其里证。他们又怎知脏气有不均衡，脉候有先天禀赋差异，或者左脉本来大于右脉，或者右脉本来大于左脉，哪一种是常态？哪一种是变症？或者在偏弱的脉象中略微见到有力，已经是隐伏的虚中之实；或者在偏盛的脉象中稍觉无神，便是实中之虚。如果不知道这些，却固执地用左右来区分表里，难道左边就没有里证而右边就没有表证吗？因此常常导致对无罪之人进行攻伐，颠倒阴阳，这不仅大大违背了经典原意，而且给人带来的危害不小，难怪脉学日益难以精通，这里不得不加以辨正。再按：人迎和气口这两个脉位，原本都是经典的训示；但人迎是足阳明胃经的脉，不能用于手部，气口总括手太阴肺经而言，不能分左右，如《动输》、《本输》、《经脉》等篇，明确指明人迎位于结喉旁侧的胃经动脉处。我曾经考证《四时气篇》说：“气口候阴，人迎候阳。”《五色篇》说：“人迎脉盛且坚者，伤于寒邪；气口脉盛且坚者，伤于饮食。”《禁服篇》说：“寸口主内伤病，人迎主外感病。”《经脉》、《终始》等篇说，人迎脉大一倍、二倍、三倍，脉口（气口）大一倍、二倍、三倍等义理。都是说人迎是阳明腑脉，所以主表证；脉口是太阴脏脉，所以主里证。如《太阴阳明论》说：“太阴脾脏为三阴经运行气机，阳明胃腑为三阳经运行气机。”《阴阳别论》说“三阳在头”，正是说人迎行气于三阳经；“三阴在手”，正是说脉口行气于三阴经。大概上古时期的诊法有三种：一是取三部九候来诊察全身的脉象，二是取太阴和阳明来诊察阴阳的根本，三是取左右气口来诊察脏腑的气机。既然这样，那么人迎自有其位置，《脉经》却将人迎扯到左手，并将气口分在右手，不知依据什么见解才这样说？我起初对此感到困惑，不敢立刻辩驳，后来看到《纲目》解释人迎气口时说：“人迎在结喉两旁，是足阳明胃经的脉。”又看到庞安常论述脉学说：“什么叫人迎？在喉旁取之。”最近看到徐东皋说：“《脉经》称左手关前一分为人迎，是错误的。”像这几位先生，已经觉得我是先觉者了，这里特意引用他们的观点来纠正谬误。唉！一句话的错误，遗误千古，成心相授受，什么时候才能纠正呢？立言的人，怎么能不谨慎呢？）
岐伯回答说：胃，是水谷汇聚的海，是六腑的大源头。五味入口，藏纳于胃中以滋养五脏之气，气口也属于太阴经。因此五脏六腑的精微物质，都来源于胃，其变化反映在气口。（人有四海，胃居其一，称为水谷之海。脏腑之中，阳为腑，阴为脏，胃属阳而为六腑之本，所以说它是六腑的大源头。然而五味入口，藏于胃中以养五脏之气，所以又说胃是五脏六腑的海。气口本属太阴肺经，为什么说“亦太阴”呢？盖因气口属肺，是手太阴经；布行胃气，则在于脾，是足太阴经。按《营卫生会篇》说：“食物进入胃中，传导给肺，五脏六腑都由此接受气机。”《厥论》说：“脾主要替胃输送津液。”《经脉别论》说：“饮入于胃，游溢精气，向上输送给脾，脾气散布精微，向上归于肺。”既然如此，胃气必然归于脾，脾气必然归于肺，然后运行于脏腑和营卫之间，所以气口虽然是手太阴经，但实际上就是足太阴经的归汇之处，所以说气口也属于太阴。因此五脏六腑的精微物质，都来源于胃而反映在气口，所以胃是脏腑的大源头，但这中间无不经过脾达于肺的过程。见音现。）
所以五气从鼻吸入，藏纳于心肺，心肺如果有病，鼻子就会不通利。（气味之化，在天为气，在地为味。上文讲五味入口藏于胃，是指味为阴；这里讲五气入鼻藏于心肺，是指气为阳。鼻是肺的窍道，所以心肺有病鼻子就不通利。看这两段话，一个讲味，一个讲气，都源于胃而达于肺，既已到达肺，也必然反映在气口，所以气口能单独作为五脏的主宰。）
大凡治病，必须考察二便情况，揣测脉象，观察患者的志意精神状态，以及病情本身。（这是治病的四个要点。“下”指二阴，二阴是肾之窍，也是胃之关隘。《脉要精微论》说：“仓廪不能固藏，是因为门户失守。”能够固守者生，失守者死。所以二便是胃气的关锁，关系到一身元气的安危，因此二便不可不考察。适，意为测度。脉是气血的先导，所以独取寸口脉来决断吉凶征兆。如《平人气象论》说：“人如果没有胃气叫逆，逆者死。脉中没有胃气也会死。”所以脉象不可不考察。志意，如《本藏篇》说：“志意调和则精神专注正直，魂魄不散，悔恨愤怒不起，五脏就不受邪气侵扰。”志意关乎神气存亡，所以志意不可不考察。病有标本，不知道求本，就失去了要领；病有真假，不知道顺逆，就会招致祸患。所以病因不可不考察。综合这四个方面来观察，那么治病的奥妙，就没有遗漏的方法了。）
拘泥于鬼神迷信的人，不可以与他谈论高深的医德。阳的精气叫做神，阴的精气叫做鬼。张子说：鬼神，是阴阳二气良好的功能表现。程子说：鬼神只是一个造化过程，天尊地卑，乾坤定位，雷霆鼓荡，风雨滋润，就是这个道理。那么鬼神，就是天地的灵妙罢了。祸福都有原因，只由人自己造成，天地无私，鬼神怎么会蒙蔽它呢？那些不明事理的人，不知道鬼神不可谄媚，反而崇尚虚无，不求实际效用，有什么益处呢？像这样的人，即使与他谈论天人至高的道德，他也一定不信，又有什么值得跟他说的呢？所以说信奉巫术而不相信医学，是四种不治之一。说的就是这个意思。）
厌恶针刺砭石治疗的人，不可以与他谈论高超的技巧。（针石之道，效法天地人三才来调和平衡阴阳，调和气血并疏通经络，所以说懂得机巧之道的人，差错不会超过一根头发，这是说它极其精微；而如果有厌恶针石的人，确实不可以与他谈论高超的技巧了。）
病人不允许治疗的，病一定治不好，治疗也不会见效。（主张治疗未病而非已病，是圣人的道理。那些已经生病却还不允许治疗的，往往是因为偏见不明，信念不坚定，就像拘泥于鬼神、厌恶针石之类的人一样。既然不相信，治疗时难免受到掣肘，强行去治疗，怎么能成功？即使有人因为治疗而痊愈，他仍然会说不是这么回事，总之也都算作无功而返。）
*Suwen: Treatise on the Distinctions of the Five Zang Organs*
The Yellow Emperor asked: Why can the Qi Kou (Crest of Breath, radial artery pulse) alone serve as the master for diagnosing the five Zang organs? (Regarding the meaning of "Qi Kou," there are three names: it is the pulse of the Hand Taiyin Lung Meridian; since the Lung governs all Qi, the prosperity and decline of Qi manifest here, hence called Qi Kou; the Lung meets with all vessels, and the great assembly of pulses gathers here, hence called Mai Kou (Pulse Crest); the pulse emerges from Taiyuan (LU-9), measuring one cun and nine fen in length, hence called Cun Kou (Inch Crest). Although the names are three, they are actually one. The essence and flavor of the five Zang and six Fu organs all originate from the Stomach, and their changes manifest at the Qi Kou, thus making it the master of the five Zang organs. The detailed reasoning is seen in the following text. My commentary states: The concepts of Qi Kou, Cun Kou, and Mai Kou refer collectively to both hands, not specifically to the right hand as Qi Kou. For instance, the *Meridians Chapter* states: "The Hand Taiyin meridian enters the Cun Kou and ascends along the Yuji." It also says: "The meridians themselves are usually invisible; their deficiency or excess is known through the Qi Kou." The *Meridian Sinew Chapter* states: "The sinews of the Hand Taiyin knot behind the大鱼际 (Yuji), running on the lateral side of the Cun Kou." The *Treatise on Distinctions of Meridians* states: "When balanced, the Qi Kou forms the Inch impression, used to determine life and death." The *Chapter on Normal People's Pulse and Qi Phenomena* states: "To know if the Cun Kou pulse is excessive or insufficient." The *Small Needle Explanation* states: "If the Qi Kou pulse is deficient, tonify; if full, sedate." This chapter asks: "Why does the Qi Kou alone serve as the master of the five Zang organs?" The *Nan Jing (Classic of Difficult Issues)* states: "All twelve meridians have pulsating arteries, yet only the Cun Kou is taken to determine the life, death, auspiciousness, and inauspiciousness of the five Zang and six Fu organs. What is the reason?" It answers: "The Cun Kou is the great assembly of pulses, the beginning and end of the five Zang and six Fu organs, therefore the method is derived from the Cun Kou." Such instances clearly do not refer solely to the right hand. However, Wang Shuhe failed to thoroughly understand the classic intent, abruptly claiming that the left hand is Ren Ying (Human Welcome) and the right hand is Qi Kou, and proposing theories such as "the Cun Kou before Ren Ying on the left hand" and "the Cun Kou before Qi Kou on the right hand." From the Jin Dynasty to the present, errors have been passed down erroneously, impossible to rectify; even going so far as to claim the left pulse diagnoses exterior syndromes and the right pulse diagnoses interior syndromes. This baseless talk is extremely erroneous. The Liver and Heart reside on the left; could they not be used to diagnose interior syndromes? The Intestines and Stomach reside on the right; could they not be used to diagnose exterior syndromes? Zhang Zhongjing, revered as the ancestor of Cold Damage studies, stated only that pulses that are Large, Floating, Rapid, Slippery, or Surging are named Yang; those that are Deep, Choppy, Weak, String-taut, or Micro are named Yin. He also said: When there is disease in the exterior, the pulse should be Floating and Large; when there is disease in the interior, the pulse should be Deep and Fine. Furthermore, taking the Cun Kou above refers to the Taiyin pulse; taking the Duzhong (Foot Yangming) below refers to the Yangming pulse. These all discuss Yin-Yang and Exterior-Interior relationships. There was never a mention of using the left hand as Ren Ying to diagnose the exterior and the right hand as Qi Kou to diagnose the interior. Even I myself was confused by the theory of left-exterior and right-interior in my early years. Only after gaining extensive experience and firm understanding did I realize that pulse bodies naturally possess Yin-Yang, and all meridians contain both Exterior and Interior aspects. Those who currently practice these erroneous teachings see a strong left pulse and immediately say it is an external contraction attacking the exterior; they see a vigorous right pulse and immediately say it is an internal injury attacking the interior. How can they know that Zang Qi may be uneven, and pulse conditions vary by constitution? Some may naturally have a larger left pulse than the right, or vice versa. Which is normal? Which is abnormal? Or, within a relatively weak pulse, slight strength indicates hidden Deficiency transforming into Excess; within a relatively strong pulse, slight lack of spirit indicates Excess transforming into Deficiency. If one does not understand this but rigidly divides Exterior and Interior by left and right, does the left have no Interior and the right have no Exterior? Thus, they often cause unnecessary attack and depletion, reversing Yin and Yang. This not only greatly deviates from the classic intent but also causes significant harm to people. No wonder pulse diagnosis has become increasingly difficult to master; it is necessary to clarify these points. Further analysis: The positions of Ren Ying and Qi Kou were originally defined by the classics. However, Ren Ying is the pulse of the Foot Yangming Stomach Meridian and cannot be applied to the hand; Qi Kou generally refers to the Hand Taiyin Lung Meridian and cannot be divided into left and right. As clearly pointed out in chapters like *Dongshu*, *Benshu*, and *Jingmai*, Ren Ying is located at the arterial pulse of the Stomach Meridian beside the laryngeal prominence. I once examined the *Sishi Qi Chapter*, which states: "Qi Kou diagnoses Yin, Ren Ying diagnoses Yang." The *Wuse Chapter* states: "A Ren Ying pulse that is full and firm indicates injury by Cold; a Qi Kou pulse that is full and firm indicates injury by food." The *Jinfu Chapter* states: "Cun Kou governs interior diseases, Ren Ying governs exterior diseases." The *Jingmai* and *Zhongshi Chapters* discuss the meanings of Ren Ying being one, two, or three times stronger, and the Mai Kou (Qi Kou) being one, two, or three times stronger. All state that Ren Ying is the Yangming Fu pulse, thus governing the Exterior; Mai Kou is the Taiyin Zang pulse, thus governing the Interior. As the *Taiyin Yangming Lun* states: "Taiyin circulates Qi among the three Yin meridians, Yangming circulates Qi among the three Yang meridians." The *Yinyang Bie Lun* states "Three Yang are at the head," correctly referring to Ren Ying circulating Qi among the three Yang meridians; "Three Yin are at the hand," correctly referring to Mai Kou circulating Qi among the three Yin meridians. Ancient diagnostic methods had three types: one was taking Three Parts and Nine Positions to diagnose whole-body pulses; another was taking Taiyin and Yangming to diagnose the root of Yin and Yang; the third was taking the left and right Qi Kou to diagnose Zang-Fu Qi. Therefore, Ren Ying has its own specific location. The *Mai Jing (Pulse Classic)* incorrectly places Ren Ying on the left hand and divides Qi Kou to the right hand. On what basis or insight is this claimed? I was initially confused and dared not argue immediately. Later, seeing the explanation in *Gangmu* stating: "Ren Ying is on both sides of the laryngeal prominence, the pulse of the Foot Yangming Meridian." And seeing Pang Anchang discuss pulses saying: "What is Ren Ying? Take it at the side of the throat." Recently, seeing Xu Donggao state: "The *Mai Jing* calling the point one division before the Guan on the left hand as Ren Ying is wrong." With these gentlemen, I feel I am not the first to awaken. Here I specifically cite them to correct the error. Alas! A single erroneous statement misleads for millennia. With fixed minds passing down traditions, when will it be corrected? Those who establish doctrines must be cautious.)
Qibo replied: The Stomach is the Sea of Water and Grain, the great source of the six Fu organs. The flavors of the five foods enter the mouth, are stored in the Stomach to nourish the Qi of the five Zang organs, and the Qi Kou also belongs to Taiyin. Therefore, the essence and flavor of the five Zang and six Fu organs all originate from the Stomach and manifest at the Qi Kou. (Humans have four Seas, and the Stomach is one of them, called the Sea of Water and Grain. Among Zang and Fu, Yang is Fu and Yin is Zang. The Stomach belongs to Yang and is the root of the six Fu organs, hence called the great source of the six Fu organs. However, since the five flavors enter the mouth and are stored in the Stomach to nourish the Qi of the five Zang organs, it is also said that the Stomach is the Sea of the five Zang and six Fu organs. The Qi Kou originally belongs to Taiyin Lung; why is it said "also Taiyin"? Because the Qi Kou belongs to the Lung, the Hand Taiyin; while distributing Stomach Qi lies with the Spleen, the Foot Taiyin. According to the *Yingwei Shenghui Chapter*: "Food enters the Stomach, transmits to the Lung, and the five Zang and six Fu all receive Qi." The *Juelun* states: "The Spleen primarily transports fluids for the Stomach." The *Jingmai Bie Lun* states: "Drinks enter the Stomach, overflowing with essence and Qi, transported upward to the Spleen; the Spleen scatters essence, returning upward to the Lung." Thus, Stomach Qi must return to the Spleen, and Spleen Qi must return to the Lung, before circulating to the Zang-Fu and Ying-Wei. Therefore, although the Qi Kou is the Hand Taiyin, it is essentially the convergence of the Foot Taiyin, hence called "Qi Kou also belongs to Taiyin." Thus, the essence and flavor of the five Zang and six Fu organs all originate from the Stomach and manifest at the Qi Kou, making the Stomach the great source of the Zang-Fu organs, though none bypass the Spleen reaching the Lung. See pronunciation Xian.)
Therefore, the five Qi enter through the nose, are stored in the Heart and Lung; if the Heart and Lung have disease, the nose becomes obstructed. (The transformation of Qi and Flavor: in Heaven it is Qi, in Earth it is Flavor. The previous text discussed flavors entering the mouth and storing in the Stomach, referring to Flavor as Yin; this text discusses five Qi entering the nose and storing in the Heart and Lung, referring to Qi as Yang. The nose is the orifice of the Lung, so when the Heart and Lung have disease, the nose becomes obstructed. Observing these two sections, one discussing Flavor and one discussing Qi, both originate from the Stomach and reach the Lung. Having reached the Lung, they must also manifest at the Qi Kou; thus, the Qi Kou alone serves as the master of the five Zang organs.)
Generally, in treating disease, one must examine defecation and urination, assess the pulse, observe the patient's aspirations and mental state, and analyze the disease itself. (These are the four essentials of treatment. "Lower" refers to the two Yin orifices. The two Yin orifices are the aperture of the Kidney and the gate of the Stomach. The *Maiyao Jingwei Lun* states: "If the granary cannot store, it is because the gates fail to guard." Those who maintain control live; those who lose control die. Thus, defecation and urination are the locks of Stomach Qi, relating to the safety of the body's primal Qi; therefore, the lower orifices must not be neglected. "Shi" means to measure. The pulse is the precursor of Qi and Blood, so only the Cun Kou is taken to determine omens of auspiciousness or inauspiciousness. As the *Pingren Qixiang Lun* states: "Humans without Stomach Qi are considered Ni (Rebellious/Reverse), and Ni leads to death. Pulses without Stomach Qi also lead to death." Thus, the pulse must not be neglected. Aspirations and mental state: as the *Ben Cang* chapter states: "When aspirations are harmonious, spirit is focused and upright, Hun and Po do not scatter, regret and anger do not arise, and the five Zang are not invaded by pathogenic factors." Aspirations relate to Spirit and Qi survival; thus, aspirations must not be neglected. Diseases have Root and Branch; failing to seek the Root loses the essence. Diseases have True and False; failing to understand Reverse and Follow leads to disaster. Thus, the etiology must not be neglected. Combining these four aspects for observation, the subtleties of treatment leave no method unexplored.)
Those constrained by ghosts and spirits cannot be spoken to regarding the highest virtue. The spiritual aspect of Yang is called Shen (Spirit/God); the spiritual aspect of Yin is called Gui (Ghost/Spirit). Master Zhang said: Ghosts and spirits are the excellent capabilities of the two Qi (Yin and Yang). Master Cheng said: Ghosts and spirits are merely creation itself. Heaven is high, Earth is low, Qian and Kun are established; thunder drums, wind and rain moisten—this is it. Thus, ghosts and spirits are the spirituality of Heaven and Earth. Fortune and misfortune have causes, created by humans themselves. Heaven and Earth are impartial; how can ghosts and spirits obscure them? Those ignorant of principles do not know that ghosts and spirits cannot be flattered, yet they advocate emptiness and void, seeking no practical benefit. What good is this? For such people, even discussing the highest virtues of Heaven and Humanity, they will not believe. What is there worth speaking to them about? Hence it is said: Believing in shamans but not in physicians is the first case of untreatable illness. This is what is meant.)
Those who detest needles and stones cannot be spoken to regarding supreme skill. The way of needles and stones follows the Three Powers (Heaven, Earth, Human) to regulate Yin and Yang, harmonize Qi and Blood, and unblock meridians. Hence it is said: "One who knows the way of subtle mechanisms cannot be delayed by a hair," indicating its utmost precision and subtlety. For those who detest needles and stones, it is indeed impossible to speak of supreme skill.)
Patients who do not permit treatment will certainly not be cured, and treatment will yield no merit. (Treating disease before it arises is the way of the sages. Those who already have disease but still do not permit treatment usually suffer from unclear biases and weak conviction, similar to those constrained by ghosts/spirits or detesting needles/stones. Since they do not believe, treatment will inevitably be hindered. Forcing treatment cannot succeed. Even if some recover due to treatment, they will still deny it, counting it altogether as no merit.)