马云。篇内。首问六六之节。后又问脏象何如。故名篇。高。论上。加大字。云。大论二字。旧本。误
传四气调神下。今各改正。简按此篇论运气。与天元纪大论等义同。故高云尔。不可从也。篇内。自岐伯对曰
昭乎以下。至孰多可得闻乎。七百一十八字。新校正云。全元起注本。及太素并无。疑王氏之所补也。今考篇
中。多论运气。他篇所无。且取通天论。自古通天者云云。其气三三十一字。与三部
九候论。三而成天云云四十五字。凑合为说。其意竟不可晓。又且立端于始云云十二字。全袭左传文公元年语。
明是非旧经之文。故今除之。不及释义。运气别是一家。无益于医术。前贤诸论。详载于汇考。及解精微论后。
六六之节 张云。天有上下四方。是为六合。地有正隅中外。是为九宫。此乾坤合一之大数也。凡
寰中物理。莫不由之。故节以六六而成岁。人因九九以制会。简按诸家俱仍王注。独张注如此。若果如其言。
则当云六之节九制会。而不可云六六九九。王义为得矣。
人以九九制会 吴云。黄钟之数。起于 黍。以九重之。而制律制度。制量制衡。会。会通也。古
者天子巡狩。会诸侯。必同其律。同其度。同其量。同其衡。谓之会通。此人之所制也。志云。盖人有九窍九
藏。地有九州九野。以合三而成天。三而成地。三而成人。故先言人以九九制会。而后言地以九九制会也。简
按王注及吴志解未允。会。盖周礼天官少宰要会之会。郑注。月计曰计。岁计曰会。家语执辔篇。天一地二人
三。三三如九。九九八十一。盖九九八十一。数之极。故曰人以九九制会。
三百六十五节 邪客篇云。岁有三百六十五日。人有三百六十节。吕览云。三百六十六日。人亦有
四肢五脏九窍三百六十六节。子华子云。一人之身为骨。凡三百有六十。精液之所朝夕也。
大神灵问 吴云。神灵。指天地阴阳而言。志注同。简按王注似允当。
嗜欲不同 吴云。五脏各有嗜欲声色臭味。各有所通。而入五脏也。诸注并同。今从之。
天食人以五气 吴云。五气非徒臊焦香腥腐而已。此乃
地气。非天气也。盖谓风气入肝。暑气入心。湿气入脾。燥气入肺。寒气入肾。当其不亢不害。则能养人。人
在气交之中。以鼻受之。而养五脏。是天食人以五气也。简按吴注似是而却非。下文云。五气入鼻。藏于心肺。
若如吴说。则当云藏于五脏。张仍王注。固有以也。（蠡海集云。人之水沟穴。在鼻下口上。一名人中。盖居
人身天地之中也。天气通于鼻。地气通于口。天食人以五气。鼻受之。地食人以五味。口受之。穴居其中。故
名之曰人中。）
五色修明 王注修洁分明。盖以为修饰之修也。灵小针解。五色循明。古书修循多通用。
以养五气 张云。胃藏五味。以养五脏之气。
神之变也 新校正云。全元起本。并太素。作神之处。为是。灵本神篇云。生之来谓之精。两精相
搏谓之神。五行大义云。心藏神者。神以神明照了为义。言心能明了万事。神是身之君。象火。淮南子云。神
者。心之宝也。
其华在面 张云。心主血脉。血足则面容光彩。脉络满盈。故曰其华在面。
阳中之太阳 九针十二原篇云。阳中之太阳。心也。阴阳系日月篇云。心为阳中之太阳。
魄之处也 灵本神篇云。并精而出入者。谓之魄。
阳中之太阴 十二原篇云。阳中之少阴。肺也。新校正为是。
精之处也 本神篇云。生之来谓之精。
阴中之少阴 十二原篇云。阴中之太阴。肾也。系日月篇云。肾为阴中之太阴。新校正为是。简按
张注引刺禁论。规新校正之说。为强解焉。
魂之居也 本神篇云。随神往来者。谓之魂。简按左传昭七年。子产曰。人生始化曰魄。既生魄阳
曰魂。用物精多
则魂魄强。是以有精爽至于神明。杜注。魄。形也。阳。神气也。孔颖达正义云。人禀五常以生。感阴阳以灵。
有身体之质。名之曰形。有嘘吸之动。谓之为气。形气合而为用。知力以此而强。故得成为人也。其初人之生
也。始变化为形。形之灵者。名之曰魄也。既生魄矣。魄内自有阳气。气之神者。名之曰魂也。魂魄。神灵之
名。附形之灵为魄。附气之神为魂也。附形之灵者。谓初生之时。耳目心识。手足运动。啼呼为声。此则魄之
灵也。附气之神者。谓精神性识。渐有所知。此则附气之神也。孝经说曰。魄。白也。魂。芸也。白。明白也。
芸。芸动也。形有体质。取明白为名。气唯嘘吸。取芸动为义。盖精亦神也。爽亦明也。精是神之未着。爽是
明之未昭。关尹子云。魂藏肝。魄藏肺。（五行大义。引老子经亦同。）韩诗外传云。精藏肾。神藏心。魂藏
肝。魄藏肺。志藏脾。说文。魂。阳气也。魄。阴神也。俱与本经之义相发焉。
以生血气 简按上文云。心其充在血脉。又云。肺者。气之本。而又于肝云。以生血气。最可疑。宜
根据上文例。删此四字。从太素。而补入其色与味。
三焦膀胱 简按五脏别论云。夫胃大肠小肠三焦膀胱。此五者。天气之所生也。本脏篇云。肾合三焦
膀胱。又云。密理浓皮者。三焦膀胱浓。粗理薄皮者。三焦膀胱薄。经文并言三焦膀胱如此。又五行大义。论
肾命门云。犹如三焦膀胱俱是水腑。不妨两号。今以大义之言。参诸经文。三焦膀胱。乃是一腑。灵兰秘典云。
三焦者决渎之官。水道出焉。膀胱者。州都之官。津液藏焉。盖以通行水道之用。谓之三焦。其实专指下焦而
言。以收藏津液之体。谓之膀胱。此云名曰器。则正有名有状之三焦。与灵枢如沤如渎如雾之三焦。（此乃与
三十一难所论同。）手少阳三焦经脉所行之三焦。各各不同。凡
经论中有三三焦。详见于张氏质疑录。当参考。（王三阳亦有三焦论。其旨略与张意同。出于伤寒纲目。）
营之居也 张云。营者。水谷之精气也。水谷贮于六腑。故为营之所居。简按灵营气篇云。营气之道。
内谷为宝。谷入于胃。气传之肺。流溢于中。布散于外。精专者行于经隧。常营无已。痹论云。营气者。水谷
之精气也。营卫生会篇云。营气出于中焦。皆其义也。
入出者也 李云。胃受五谷。名之曰入。脾与大小肠三焦膀胱。皆主出也。
四白 简按李杲云。四白。当作四红。非。
四盛以上为格阳 灵终始禁服并云。人迎四盛。且大且数。名曰溢阳。溢阳为外格。（王引正理论。
与伤寒论平脉法之文同。）
四盛以上为关阴 终始禁服并云。脉口四盛。且大且数。名曰溢阴。溢阴为内关。
四倍以上为关格 终始禁服并云。人迎与太阴脉口俱盛。四倍以上。命曰关格。关格者。与之短期。
张云。俱盛四倍以上。谓盛于平常之脉四倍也。物不可以过盛。盛极则败。凡脉盛而至于关格者。以阴阳离绝。
不能相营。故致羸败。（此本吴注。诸家作赢。为盈义。）极。尽也。精气。天禀也。言不能尽其天年。而夭
折也。脉度篇曰。邪在腑则阳脉不和。阳脉不和。则气留之。气留之。则阳气盛矣。阳气大盛。则阴不利。阴
脉不利。则血留之。血留之。则阴气盛矣。阴气大盛。则阳气不能荣也。故曰关。阳气大盛。则阴气弗能荣也。
故曰格。阴阳俱盛。不得相荣。故曰关格。关格者。不得尽期而死也。世人病此不少。历代医师。相传谬甚。
夫所谓关格者。阴阳痞绝。不相营运。乖羸离败之候也。故人迎独盛者。病在三阳之腑也。寸口独盛者。病在
三阴之脏也。或见于人迎。或
见于气口。皆孤阳之逆候。实真阴之败竭也。无阴则无根。而孤阳浮露于外耳。凡犯此者。必死无疑。是皆酒
色伤精所致。又以人迎在头。系阳明表脉。故人迎倍大者。曰格阳。寸口在手。系太阴里脉。故寸口倍大者。
曰关阴。阴阳互极。抗拒不通。故名关格。不可易也。若在尺为关。在寸为格。（难经。平脉法。及李杲朱震
亨。并从前诸注。皆如此。）关则不得小便。格则吐逆。（丹溪纂要。竟立关格门。为病名。）特言膈食与癃
闭耳。非此之谓也。简按盖关格。言表里阴阳痞绝之候。张氏仍马注。发其余义。尤为明确。然脉要精微论曰。
阴阳不相应。病名曰关格。史记。仓公曰。切其脉。肝气浊而静。此内关之病也。则谓之关格为脉体。而非病
名。可耶。（张氏医通。立关格门。辨马张二家之误尤详。当参考。）
不能极于天地之精气 滑云。过乎中也。盖极者。中也。不及则不得为中。太过亦不得为中。简按此说太异。
马云：本篇开头询问“六六之节”，后来又问“脏象”是什么，所以以此命名。高世栻注：“论上”二字是大字标题，“云”字下面，“大论”二字在旧本中误传为《四气调神大论》的下篇，现在各版本都已改正。丹波元简按语：这一篇讨论运气学说，与《天元纪大论》等篇义理相同，所以高世栻那样说，这种说法不可采纳。篇内从岐伯回答说“昭乎哉问也”以下，到“孰多可得闻乎”，共七百一十八字。林亿等《新校正》说：全元起注本及《太素》都没有这些内容，怀疑是王冰所补入的。现在考证篇中，大多论述运气，其他篇章没有，而且截取《通天论》中“自古通天者……”这三十一个字，与《三部九候论》中“三而成天……”这四十五字，凑合在一起成说，其意思竟然无法理解。另外，“又且立端于始……”这十二个字，完全袭用《左传·文公元年》的话，明显不是旧经原文，所以现在将其删除，不进行释义。运气学说是另一套体系，对医术无益，前贤的各种论述，详细记载在《汇考》及《解精微论》后的注释中。
六六之节：张景岳注：天有上下四方，称为六合；地有正隅中外，称为九宫。这是乾坤合一的大数。凡是世间万物的物理，没有不遵循这个规律的。所以节气以“六六”（三十六）来构成一岁，人依据“九九”（八十一）来制定会通之法。丹波元简按语：各家都沿袭王冰的注，只有张景岳的注像这样。如果真的像他所说，那么应该说“六之节、九制会”，而不应说“六六、九九”。王冰的解释更为恰当。
人以九九制会：吴崑注：黄钟律管的数值，起源于黍粒，经过九重推算，从而制定音律、度量衡。会，指会通。古代天子巡狩，会见诸侯，必须统一他们的律、度、量、衡，称为会通。这是人所制定的制度。《志》书说：大概人有九窍九脏，地有九州九野，以三合成天，三合成地，三合成人。所以先说人依据九九制会，然后说地依据九九制会。丹波元简按语：王冰注及吴崑、张志聪的解释都不妥当。“会”，大概是《周礼·天官·少宰》中“要会”的会。郑玄注：按月计算叫计，按年计算叫会。《孔子家语·执辔篇》说：天一、地二、人三，三三得九，九九八十一。大概九九八十一是数的极限，所以说人依据九九制会。
三百六十五节：《邪客篇》说：一年有三百六十五日，人有三百六十节。《吕氏春秋》说：三百六十六日，人也有四肢、五脏、九窍、三百六十六节。《子华子》说：一个人的身体作为骨骼，共有三百六十个，是精液早晚滋养的地方。
大神灵问：吴崑注：神灵，指天地阴阳而言。张志聪注相同。丹波元简按语：王冰的注似乎比较恰当。
嗜欲不同：吴崑注：五脏各有对声色臭味等的嗜好欲望，各自有所通达，并进入五脏。诸家注释都相同，现在遵从他的说法。
天食人以五气：吴崑注：五气不仅仅是臊、焦、香、腥、腐五种气味，那是地气，不是天气。大概是指风气入肝，暑气入心，湿气入脾，燥气入肺，寒气入肾。当它们不亢盛不伤害人体时，就能养人。人处于气交之中，用鼻子接受它，从而滋养五脏，这就是天用五气供养人。丹波元简按语：吴注看似有理却不对。下文说：“五气入鼻，藏于心肺。”如果像吴崑所说，那就应该说“藏于五脏”。张景岳沿袭王冰的注，是有道理的。（《蠡海集》说：人的水沟穴，在鼻下口上，一名人中，大概居于人身天地之中。天气通于鼻，地气通于口。天用五气供养人，由鼻接受；地用五味供养人，由口接受。穴位居在其中，所以名叫人中。）
五色修明：王冰注：修洁分明，大概认为是修饰的“修”。《灵枢·小针解》作“五色循明”，古书中“修”和“循”多通用。
神之变也：《新校正》说：全元起本及《太素》，作“神之处”，这是对的。《灵枢·本神篇》说：生下来就有的叫精，两精结合产生的叫神。《五行大义》说：心藏神，神以神明照察万物为含义，指心能明了万事。神是身体的君主，象征火。《淮南子》说：神是心的宝贝。
其华在面：张景岳注：心主血脉，血充足则面容光彩，脉络满盈，所以说它的荣华表现在面部。
阳中之太阳：《九针十二原篇》说：阳中的太阳，是心。《阴阳系日月篇》说：心是阳中之太阳。
阳中之太阴：《十二原篇》说：阳中的少阴，是肺。《新校正》认为是对的。
阴中之少阴：《十二原篇》说：阴中的太阴，是肾。《阴阳系日月篇》说：肾是阴中之太阴。《新校正》认为是对的。丹波元简按语：张景岳引用《刺禁论》来支持《新校正》的说法，属于牵强附会的解释。
魂之居也：《本神篇》说：跟随神往来运动的，叫做魂。丹波元简按语：《左传·昭公七年》子产说：人刚出生时变化形成的形体叫魄，有了魄之后阳气产生的叫魂。使用的物质精细繁多，那么魂魄就强盛，因此有精爽以至于神明。杜预注：魄，形也；阳，神气也。孔颖达正义说：人禀受五常而生，感应阴阳而灵动。有身体的实质，命名为形；有呼吸的动作，称之为气。形气结合发挥作用，知力因此强盛，所以能成为人。在人刚出生时，首先变化形成形，形中的灵性，命名为魄。既然有了魄，魄内自有阳气，气中的神灵，命名为魂。魂魄，是神灵的名称。依附于形的灵性叫魄，依附于气的灵性叫魂。依附于形的灵性，指刚出生时，耳目心识、手足运动、啼哭发声，这是魄的灵性。依附于气的灵性，指精神性识逐渐有所知觉，这是依附于气的灵性。《孝经纬说》说：魄，白也；魂，芸也。白，明白也；芸，芸动也。形有体质，取明白为名；气唯呼吸，取芸动为义。大概精也是神，爽也是明。精是神未显着的状态，爽是明未昭著的状态。《关尹子》说：魂藏于肝，魄藏于肺。（《五行大义》引用的《老子经》也相同。）《韩诗外传》说：精藏于肾，神藏于心，魂藏于肝，魄藏于肺，志藏于脾。《说文解字》：魂，阳气也；魄，阴神也。这些都与本经的意义相互印证。
以生血气：丹波元简按语：上文说：心充实于血脉，又说：肺是气之本，而又在肝说“以生血气”，最可疑。应该根据上文的体例，删去这四个字，从《太素》，并补入“其色与味”。
三焦膀胱：丹波元简按语：《五脏别论》说：胃、大肠、小肠、三焦、膀胱，这五个器官，是天气所生的。《本脏篇》说：肾合三焦膀胱，又说：纹理密致皮肤厚实的，三焦膀胱厚实；纹理粗糙皮肤薄的，三焦膀胱薄弱。经文都这样谈论三焦膀胱。另外，《五行大义》论肾命门说：犹如三焦膀胱都是水腑，不妨有两个名称。现在以大义之言，参考经文，三焦和膀胱其实是一个腑。《灵兰秘典论》说：三焦是决渎之官，水道出焉；膀胱是州都之官，津液藏焉。大概以通行水道的功能，称为三焦，其实专指下焦而言；以收藏津液的形态，称为膀胱。这里说“名曰器”，正是有名有状的三焦，与《灵枢》中如沤、如渎、如雾描述的三焦不同。（这与《难经·三十一难》所论相同。）手少阳三焦经脉所运行的三焦，各不相同。凡经论中有三种三焦，详见于张景岳的《质疑录》，应当参考。（王三阳也有《三焦论》，主旨大致与张景岳相同，出自《伤寒纲目》。）
营之居也：张景岳注：营气，是水谷的精气。水谷贮存在六腑，所以是三焦所在之处。丹波元简按语：《灵枢·营气篇》说：营气的道理，以内谷为宝。谷进入胃，气传导至肺，流溢于中，布散于外。精纯的部分运行于经络隧道，常年运行不止。《痹论》说：营气，是水谷的精气。《营卫生会篇》说：营气出于中焦，都是这个意义。
入出者也：李中梓注：胃接受五谷，称为入；脾与小肠、大肠、三焦、膀胱，都主出。
四盛以上为格阳：《灵枢·终始》和《禁服》都说：人迎脉大四倍，而且大且快，名为溢阳。溢阳导致外格。（王冰纠正《理论》与《伤寒论·平脉法》的文字相同。）
四盛以上为关阴：《终始》和《禁服》都说：脉口大四倍，而且大且快，名为溢阴。溢阴导致内关。
四倍以上为关格：《终始》和《禁服》都说：人迎与太阴脉口都盛大，大四倍以上，名为关格。关格的人，寿命不长了。张景岳注：都盛大四倍以上，是指比平常的脉搏盛大四倍。事物不能过于盛大，盛极则败。凡是脉盛大至于关格的，是因为阴阳离绝，不能相互资生，所以导致衰弱败坏。（这原本出自吴崑注，各家写作“赢”，意为充盈之意。）极，尽也。精气，是天赋予的禀赋。言不能享尽天年，而夭折。《脉度篇》说：邪气在腑则阳脉不和，阳脉不和则气停留，气停留则阳气盛大。阳气盛大则阴不利，阴脉不利则血停留，血停留则阴气盛大。阴气盛大则阳气不能荣养，所以说关。阳气盛大则阴气不能荣养，所以说格。阴阳俱盛，不得相互荣养，所以说关格。关格的人，不能活到寿限而死。世人患此病不少，历代医师相传谬误甚多。所谓关格，是阴阳痞塞隔绝，不相营运，乖违衰弱离败的征候。所以人迎脉独盛的，病在三阳之腑；寸口脉独盛的，病在三阴之脏。或见于人迎，或见于气口，都是孤阳逆乱的征候，是真阴败竭的表现。无阴则无根，而孤阳浮露于外罢了。凡是犯此病的，必死无疑。这都是酒色伤精所致。又因为人迎在头部，属于阳明表脉，所以人迎倍大的，叫格阳；寸口在手部，属于太阴里脉，所以寸口倍大的，叫关阴。阴阳互相极端，抗拒不通，所以名叫关格，不可改变。如果在尺部为关，在寸部为格。（《难经·平脉法》及李杲、朱震亨，以及从前诸家注释，都是这样。）关则小便不通，格则呕吐逆乱。（朱丹溪《纂要》竟设立关格门，作为病名。）特指膈食与癃闭罢了，不是这个意思。丹波元简按语：大概关格，是说表里阴阳痞塞隔绝的征候。张景岳沿袭马莳注，发挥其余义，尤为明确。然而《脉要精微论》说：阴阳不相应，病名叫关格。《史记》仓公说：切其脉，肝气浊而静，这是内关的病。那么称关格为脉象，而不是病名，可以吗？（张景岳《医通》设立关格门，辨明马莳、张景岳两家之误尤为详细，应当参考。）
不能极于天地之精气：滑寿注：超过其中和之道。大概极，就是中。不及就不能称为中，太过也不能称为中。丹波元简按语：这种说法太奇异了。
Ma Yun: The beginning of this chapter asks about the "six-six segments" (the cyclical patterns of six times six), and later asks what "zang-xiang" (visceral manifestations) are, hence the chapter title. Gao Shishi's commentary: The characters "Lun Shang" (Discussion Upper) are large-character headings. Below the character "Yun" (says), the characters "Da Lun" (Great Discussion) were mistakenly transmitted in old editions as the lower part of the *Si Qi Tiao Shen Da Lun* (Great Discussion on Regulating the Spirit According to the Four Qi). Current editions have corrected this. Danbo Yuanjian's note: This chapter discusses Yunqi (Luck and Qi/Climate cycles), sharing the same principles as the *Tian Yuan Ji Da Lun*, which is why Gao states this; such an explanation should not be accepted. From Qibo's reply starting with "Zhao hu zai wen ye" (How clear your question is!) down to "Shu duo ke de wen hu" (How much more can I hear?), totaling 718 characters. The *Xin Zheng Xiao* (New Corrected Text) states that these passages are absent in Quanyuan Qi's annotated edition and the *Tai Su*, suspecting they were added by Wang Bing. Upon examination, the chapter mostly discusses Yunqi, which is not found in other chapters. Furthermore, it extracts thirty-one characters from the *Tong Tian Lun* ("Zi gu tong tian zhe...") and forty-five characters from the *San Bu Jiu Hou Lun* ("San er cheng tian..."), combining them into a theory whose meaning is incomprehensible. Additionally, the twelve characters "You qie li duan yu shi..." completely plagiarize the text from the first year of Duke Wen in the *Zuo Zhuan*. It is clearly not original classic text, so it is now deleted without interpretation. Yunqi constitutes a separate system and offers no benefit to medical practice. Previous scholars' discussions are detailed in the *Hui Kao* and the notes following the *Jie Jing Wei Lun*.
Six-Six Segments: Zhang Jingyue's commentary: Heaven has up, down, and four directions, forming the Six Harmonies (Liu He); Earth has center, corners, inside, and outside, forming the Nine Palaces (Jiu Gong). This is the great number of the union of Qian and Kun. All physical laws in the world follow this principle. Thus, the solar terms are structured by "six-six" (36) to form a year, and humans formulate their harmonizations based on "nine-nine" (81). Danbo Yuanjian's note: All commentators followed Wang Bing's annotation, except Zhang who wrote as above. If his statement were true, it should read "Six-segment, Nine-formula," not "Six-six, Nine-nine." Wang Bing's interpretation is superior.
Humans Formulate Harmonization via Nine-Nine: Wu Kun's commentary: The number of Huangzhong (the fundamental pitch pipe) originates from millet grains, multiplied ninefold to establish musical tones, measures, capacities, and weights. "Hui" refers to harmonization. In ancient times, when the Son of Heaven toured the realm and met feudal lords, he unified their tones, measures, capacities, and weights, called "Huitong" (Harmonious Communication). This is what humans established. The *Zhi* book states: Humans have nine orifices and nine viscera; Earth has nine provinces and nine fields. Three threes make Heaven, three threes make Earth, and three threes make Humanity. Hence, it first states that humans use nine-nine for harmonization, then states that Earth uses nine-nine for harmonization. Danbo Yuanjian's note: Wang Bing's and Wu/Zhang's interpretations are unsatisfactory. "Hui" likely refers to the "Yao Hui" (Annual Summary) in the *Zhou Li - Tianguan - Shaozai*. Zheng Xuan's commentary: Monthly calculation is called "Ji"; annual calculation is called "Hui". The *Kongzi Jiayu - Zhipi* chapter says: Heaven One, Earth Two, Human Three; three times three equals nine; nine times nine equals eighty-one. Since eighty-one is the limit of numbers, it is said that humans use nine-nine for harmonization.
Three Hundred and Sixty-Five Segments: The *Xie Ke* chapter states: A year has 365 days; humans have 360 joints. The *Lüshi Chunqiu* states: 366 days; humans also have four limbs, five viscera, nine orifices, and 366 joints. The *Zihua Zi* states: The human body as bone consists of 360 parts, nourished morning and evening by essence and fluid.
The Great Divine Spirit Asks: Wu Kun's commentary: "Shen Ling" (Divine Spirit) refers to Heaven and Earth Yin-Yang. Zhang Zhicong's commentary agrees. Danbo Yuanjian's note: Wang Bing's annotation seems appropriate.
Different Desires and Preferences: Wu Kun's commentary: Each of the five viscera has specific desires for sounds, colors, smells, and tastes, each having its own pathway into the viscera. All annotations agree; we follow this view.
Heaven Nourishes Humans with Five Qi: Wu Kun's commentary: The five qi are not merely the odors of sour, burnt, fragrant, fishy, and putrid; those are Earth Qi, not Heaven Qi. It refers to Wind Qi entering the Liver, Summer Heat Qi entering the Heart, Dampness Qi entering the Spleen, Dryness Qi entering the Lungs, and Cold Qi entering the Kidneys. When they are neither excessive nor harmful, they nourish humans. Humans exist within the intersection of Qi, receiving it through the nose to nourish the five viscera; this is how Heaven nourishes humans with five qi. Danbo Yuanjian's note: Wu's comment appears correct but is actually wrong. The text below states: "Five qi enter the nose and store in the Heart and Lungs." If Wu were correct, it should say "store in the five viscera." Zhang Jingyue follows Wang Bing's note, which is justified. (*Lihai Ji* states: The Shuigou acupoint, located below the nose and above the mouth, is also called Renzhong (Human Center), situated in the middle of heaven and earth in the human body. Heaven Qi connects to the nose, Earth Qi connects to the mouth. Heaven nourishes humans with five qi, received by the nose; Earth nourishes humans with five flavors, received by the mouth. The acupoint is in between, hence named Renzhong.)
Five Colors Refined and Bright: Wang Bing's commentary: Refined, clean, and distinct. "Xiu" is interpreted as adornment. The *Ling Shu - Xiao Zhen Jie* writes "Wu Se Xun Ming"; in ancient texts, "Xiu" and "Xun" were often used interchangeably.
To Nourish the Five Qi: Zhang Jingyue's commentary: The Stomach stores the five flavors to nourish the Qi of the five viscera.
The Transformation of Shen: The *Xin Zheng Xiao* states: Quanyuan Qi's edition and the *Tai Su* write "Shen Zhi Chu" (The Place of Shen), which is correct. The *Ling Shu - Ben Shen* chapter states: What exists at birth is called Jing (Essence); the interaction of two essences creates Shen (Spirit). The *Wu Xing Da Yi* states: The Heart stores Shen; Shen implies bright illumination and awareness, meaning the Heart can understand all things. Shen is the ruler of the body, symbolizing Fire. The *Huainanzi* states: Shen is the treasure of the Heart.
Its Flourishing Appears on the Face: Zhang Jingyue's commentary: The Heart governs blood vessels; sufficient blood results in a radiant complexion and full meridians; thus, its flourishing manifests on the face.
Sun of Yang Among Yang: The *Jiu Zhen Shi Er Yuan* chapter states: The Sun of Yang among Yang is the Heart. The *Yin Yang Xi Ri Yue* chapter states: The Heart is the Sun of Yang among Yang.
The Abode of Po: The *Ling Shu - Ben Shen* chapter states: That which enters and exits with Jing is called Po (Ethereal Soul).
Taiyin of Yang Among Yang: The *Shi Er Yuan* chapter states: Shaoyin of Yang among Yang is the Lung. The *Xin Zheng Xiao* considers this correct.
The Abode of Jing: The *Ben Shen* chapter states: What exists at birth is called Jing.
Shaoyin of Yin Among Yin: The *Shi Er Yuan* chapter states: Taiyin of Yin among Yin is the Kidney. The *Yin Yang Xi Ri Yue* chapter states: The Kidney is Taiyin of Yin among Yin. The *Xin Zheng Xiao* considers this correct. Danbo Yuanjian's note: Zhang Jingyue cites the *Ci Jin Lun* to support the *Xin Zheng Xiao*, which is a forced interpretation.
The Dwelling of Hun: The *Ben Shen* chapter states: That which accompanies Shen in movement is called Hun (Corporeal Soul). Danbo Yuanjian's note: In the *Zuo Zhuan* (7th Year of Duke Zhao), Zichan stated: The initial transformation at birth forms Po; once Po exists, Yang generates Hun. If one uses refined materials abundantly, Hun and Po become strong, leading to spiritual clarity and divinity. Du Yu's commentary: Po is form; Yang is spirit-energy. Kong Yingda's Justice states: Humans are born endowed with the Five Constants and animated by Yin-Yang. The physical substance is called Form; the act of breathing is called Qi. Form and Qi combine to function, strengthening intellect and power, enabling humanity. At birth, form changes first; the spirituality within form is called Po. Once Po exists, Yang Qi within itself generates Hun; the spirituality within Qi is called Hun. Hun and Po are names for spiritual entities. Spirituality attached to form is Po; spirituality attached to Qi is Hun. Spirituality attached to form refers to sensory perception, limb movement, crying, and vocalization at birth—this is the spirituality of Po. Spirituality attached to Qi refers to gradual cognitive development—this is the spirituality attached to Qi. The *Xiao Jing Shuo* states: Po means white (clarity); Hun means moving (activity). Form has substance, named for clarity; Qi only breathes, named for activity. Essence is also spirit; Shuang is also brightness. Essence is spirit unmanifested; Shuang is brightness unilluminated. The *Guan Yin Zi* states: Hun stores in the Liver, Po stores in the Lungs. (*Wu Xing Da Yi* quotes the *Laozi Jing* similarly.) The *Han Shi Wai Zhuan* states: Jing stores in the Kidney, Shen stores in the Heart, Hun stores in the Liver, Po stores in the Lung, Zhi stores in the Spleen. The *Shuo Wen Jie Zi* states: Hun is Yang Qi; Po is Yin Shen. These all corroborate the meaning of this classic.
To Generate Blood and Qi: Danbo Yuanjian's note: The text above states: The Heart fills the blood vessels; it also states: The Lung is the root of Qi. Yet regarding the Liver, it says "to generate blood and qi," which is highly suspicious. Following the pattern of the preceding text, these four characters should be deleted, adhering to the *Tai Su*, and supplemented with "its color and flavor."
Sanjiao and Bladder: Danbo Yuanjian's note: The *Wu Zang Bie Lun* states: The Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder are generated by Heaven Qi. The *Ben Zang* chapter states: The Kidney combines with Sanjiao and Bladder; it also states: Those with dense skin and thick texture have thick Sanjiao and Bladder; those with coarse skin and thin texture have thin Sanjiao and Bladder. The scripture consistently discusses Sanjiao and Bladder together. Furthermore, the *Wu Xing Da Yi* discusses the Kidney and Mingmen, stating that since Sanjiao and Bladder are both water fu-organs, they may share a designation. Referencing this and the scripture, Sanjiao and Bladder are essentially one fu-organ. The *Ling Lan Mi Dian Lun* states: Sanjiao is the official of dredging, where water channels emerge; Bladder is the official of the capital reservoir, where fluids are stored. Generally, the function of conducting water channels is called Sanjiao, specifically referring to the Lower Jiao; the form of storing fluids is called Bladder. Here, "named vessel" refers to the Sanjiao with specific name and shape, differing from the Sanjiao described in the *Ling Shu* as like foam, like drain, like mist (consistent with the *Nan Jing - Chapter 31*). The Sanjiao traversed by the Hand-Shaoyang Meridian is different. There are three types of Sanjiao in the classics, detailed in Zhang Jingyue's *Zhi Yi Lu*; reference is advised. (Wang Sanyang also has a *Sanjiao Lun*, similar in intent to Zhang's, from the *Shanghan Gangmu*.)
The Abode of Ying: Zhang Jingyue's commentary: Ying (Nutritive) Qi is the essence of food and drink. Food and drink are stored in the six fu-organs, hence it is the abode of Ying. Danbo Yuanjian's note: The *Ling Shu - Ying Qi* chapter states: The way of Ying Qi treasures internal grain. Grain enters the Stomach, Qi transmits to the Lung, flows within, spreads outward. The purest part travels through the meridians, circulating endlessly. The *Bi Lun* states: Ying Qi is the essence of food and drink. The *Ying Wei Sheng Hui* chapter states: Ying Qi arises from the Middle Jiao; all convey this meaning.
Entering and Exiting: Li Zhongzi's commentary: The Stomach receives the five grains, called Entering; the Spleen, Small Intestine, Large Intestine, Sanjiao, and Bladder all govern Exiting.
Si Bai: Danbo Yuanjian's note: Li Gao states: Si Bai should be Si Hong; this is incorrect.
Four Times Excess Indicates Ge Yang: The *Ling Shu - Zhong Shi* and *Jin Fu* state: When the Renying pulse is four times excess, large and rapid, it is named Yi Yang (Overflowing Yang). Yi Yang leads to External Ge (Gridlock). (Wang Bing's correction aligns with the *Li Lun* and the *Ping Mai Fa* of the *Shanghan Lun*.)
Four Times Excess indicates Guan Yin: The *Zhong Shi* and *Jin Fu* state: When the Maikou pulse is four times excess, large and rapid, it is named Yi Yin (Overflowing Yin). Yi Yin leads to Internal Guan (Closure).
More Than Four Times Excess indicates Guan Ge: The *Zhong Shi* and *Jin Fu* state: When both Renying and Taiyin Maikou pulses are excess, more than four times, it is named Guan Ge. Those with Guan Ge have a short life expectancy. Zhang Jingyue's commentary: Both being four times excess means exceeding the normal pulse by four times. Things cannot be excessively abundant; extreme abundance leads to decay. Pulse excess reaching Guan Ge occurs because Yin and Yang are severed and cannot nourish each other, leading to emaciation and decay. (Originally from Wu Kun's note; various editions write "Ying" meaning fullness.) Ji means end. Jing Qi is heavenly endowment. It means failing to complete one's natural lifespan and dying young. The *Mai Du* chapter states: Pathogens in Fu organs cause Yang pulse disharmony; disharmony causes Qi stagnation; stagnation causes Yang Qi excess. Extreme Yang excess impedes Yin; Yin pulse impairment causes Blood stagnation; stagnation causes Yin Qi excess. Extreme Yin excess prevents Yang Qi from nourishing, hence Guan. Extreme Yang excess prevents Yin Qi from nourishing, hence Ge. When both Yin and Yang are excess and cannot nourish each other, it is Guan Ge. Those with Guan Ge die before their time. Many people suffer from this;历代 physicians have propagated errors. Guan Ge refers to the condition of Yin-Yang blockage and separation, failure of mutual operation, and decline. Thus, isolated Renying excess indicates disease in the three Yang Fu organs; isolated Cunkou excess indicates disease in the three Yin Zang organs. Whether appearing at Renying or Cunkou, it is a sign of lone Yang rebellion and true Yin exhaustion. Without Yin, there is no root, and lone Yang floats externally. Such cases are invariably fatal, caused by damage to essence from alcohol and sexual indulgence. Since Renying is on the head and belongs to the Yangming exterior pulse, double enlargement is called Ge Yang. Cunkou is on the hand and belongs to the Taiyin interior pulse, so double enlargement is called Guan Yin. Yin and Yang reach extremes, resisting and blocking each other, hence Guan Ge. This cannot be changed. If in the Chi position, it is Guan; if in the Cun position, it is Ge. (The *Nan Jing - Ping Mai Fa*, Li Gao, Zhu Zhenheng, and previous commentators all hold this view.) Guan means inability to urinate; Ge means vomiting and reversal. (Zhu Danxi's *Zuan Yao* establishes a Guan Ge section as a disease name.) This specifically refers to dysphagia and strangury, not this context. Danbo Yuanjian's note: Guan Ge generally refers to the condition of Yin-Yang blockage between interior and exterior. Zhang Jingyue follows Ma Shi's note and expands upon it, making it clearer. However, the *Mai Yao Jing Wei Lun* states: When Yin and Yang do not correspond, the disease is named Guan Ge. Sima Qian's *Shiji* records Cang Gong saying: Cutting the pulse, Liver Qi is turbid and quiet, this is an Internal Guan disease. Thus, calling Guan Ge a pulse pattern rather than a disease name—is this acceptable? (Zhang Jingyue's *Yi Tong* establishes a Guan Ge section, detailing the errors of Ma and Zhang, which should be referenced.)
Unable to Reach the Extremes of Heaven and Earth's Jing Qi: Hua Shou's commentary: Exceeding the mean. Ji means the mean. Insufficiency does not constitute the mean; excess does not constitute the mean. Danbo Yuanjian's note: This interpretation is too aberrant.