更逆更从 张云。病者为逆。不病者为从。简按当从杨义。
阳道实阴道虚 张云。阳刚阴柔也。又外邪多有余。故阳道实。内伤多不足。故阴道虚。一曰。阴
道实则阳道虚矣。所谓更虚更实者。亦通。志云。阳刚阴柔。故阳道常实。阴道常虚。系辞曰。阴阳之义配日
月。白虎通曰。日之为言。实也。常满有节。月之为言。阙也。有满有阙也。所以有阙。何。归功于日也。简
按吴此下。补阴道实阳道虚一句。张引一曰。盖指吴注。然考上文云。阳者。天气也。主外。阴者。地气也。
主内。则阳刚阴柔之解。于文意较顺。
阳受之则入六腑 徐云。此言贼风虚邪。阳受之入六腑。饮食起居。阴受之入五脏。与阴阳应象论。
天之邪气。害人五脏。水谷寒热。害人六腑。两说相反。其理安在。此谓虚邪外伤有余。饮食内伤不足。二者
之伤。互有所受。不可执一而言伤也。
不时卧 张云。不能以时卧也。
故喉主天气 志云。此节用八故字。为阴阳异位故也。
上行极而下 志云。此言邪随气转也。人之阴阳出入。随时升降。是以阳病在上者。久而随气下行。
阴病在下者。久而随气上逆。
上先受之 简按百病始生篇云。清湿袭虚。则病起于下。风雨袭虚。则病起于上。辨脉篇云。清邪
中于上焦。浊邪中于下焦。正其义也。张云。上非无湿。下非无风。但受有先后耳。曰先受之。则后者可知矣。
不得至经 马云。胃气不能自至于四肢之各经。必因于脾气之所运。简按至经。从太素作径至。为胜。
长四脏 马云。长。掌同。主也。
着胃 高云。着。昭着也。胃土水谷之精。昭着于外。简按马云。着。着同。此从王注也。高属强解。
上下至头足 张云。脾为脏腑之本。故上至头。下至足。无所不及。又岂独主一时而已哉。
足太阴者三阴也 高云。厥阴为一阴。少阴为二阴。太阴为三阴。故足太阴者。三阴也。
为之行气于三阴 吴云。为之。为胃也。三阴。太少厥也。脾为胃行气于三阴。运阳明之气。入于诸阴也。
为之行气于三阳 吴云。为之。为脾也。行气于三阳。运太阴之气。入于诸阳也。
阴道不利 吴云。血道不滑利也。高云。即脉道不利也。简按上文云。脉道不利。高注为长。
更逆更从：张云认为，患病者为“逆”，未患病者为“从”。简按（丹波元简按语）认为应当遵从杨上善的解释。
阳道实阴道虚：张云解释为阳刚阴柔。又说外邪多表现为有余之证，所以称“阳道实”；内伤多表现为不足之证，所以称“阴道虚”。另一种说法是，如果“阴道实”了，那么“阳道”就虚了。所谓“更虚更实”（交替出现虚实），也是通的。志（王冰注）说，因为阳刚阴柔，所以“阳道常实，阴道常虚”。《系辞》说：“阴阳的意义配属日月。”《白虎通》说：“日”这个字，意思是“实”，常常圆满而有节律；“月”这个字，意思是“阙”（缺），有满也有缺。之所以有缺，是因为归功于日吗？简按认为，吴崑在此处补入了“阴道实阳道虚”一句，张景岳引用的“一曰”，大概是指吴崑的注释。然而考证上文说：“阳者，天气也，主外；阴者，地气也，主内。”那么用“阳刚阴柔”来解释，文意较为顺畅。
阳受之则入六腑：徐大椿说，这里说的是贼风虚邪，阳经受之则传入六腑；饮食起居失调，阴经受之则传入五脏。这与《阴阳应象大论》中“天之邪气，害人五脏；水谷寒热，害人六腑”的说法相反。其中的道理在哪里呢？这是因为虚邪外伤属于有余之证，饮食内伤属于不足之证。这两种损伤，互有所受，不可固执一端来说明损伤的情况。
故喉主天气：志（王冰注）说，这一节用了八个“故”字，是因为阴阳位置不同所致。
上行极而下：志（王冰注）说，这是说病邪随着气机转化。人的阴阳出入，随着时间升降。因此阳病在上部的，时间久了会随气下行；阴病在下部的，时间久了会随气上逆。
上先受之：简按《百病始生篇》说：“清湿袭虚，则病起于下；风雨袭虚，则病起于上。”《辨脉篇》说：“清邪中于上焦，浊邪中于下焦。”这正是对这句话的正确解释。张云说，上部并非没有湿，下部并非没有风，只是受邪有先后罢了。说“先受之”，那么后受的情况就可以推知了。
不得至经：马云说，胃气不能自行到达四肢的各条经脉，必须依赖脾气的运化。简按认为，“至经”二字，依《太素》作“径至”更好。
长四脏：马云说，“长”同“掌”，即主宰的意思。
着胃：高世栻说，“着”意为昭著、明显。胃土所化的水谷精气，昭著于外。简按马云的观点，“着”同“著”，此处遵从王冰的注释。高世栻的解释属于牵强附会。
上下至头足：张云说，脾是脏腑的根本，所以上至头部，下至足部，无所不及。又岂止主管一个季节而已呢？
足太阴者三阴也：高世栻说，厥阴为一阴，少阴为二阴，太阴为三阴。所以足太阴是三阴。
为之行气于三阴：吴崑说，“为之”是为了胃。三阴指太阴、少阴、厥阴。脾为胃运行气机到三阴经，将阳明之气导入诸阴经。
为之行气于三阳：吴崑说，“为之”是为了脾。在三阳经运行气机，将太阴之气导入诸阳经。
阴道不利：吴崑说，血道不滑利。高世栻说，就是脉道不利。简按上文说“脉道不利”，高世栻的注释更为恰当。
More Reversal and More Compliance: Zhang Yun states that those who are ill represent "reversal" (Ni), while those who are not ill represent "compliance" (Cong). Jian An (Danbo Yuanjian's commentary) believes one should follow Yang Shangshan's interpretation.
The Path of Yang is Solid, the Path of Yin is Deficient: Zhang Yun explains this as Yang being firm and Yin being soft. Furthermore, external pathogens often manifest as excess conditions, hence "the Path of Yang is solid"; internal injuries often manifest as deficiency conditions, hence "the Path of Yin is deficient." Another view holds that if "the Path of Yin is solid," then "the Path of Yang" becomes deficient. The concept of "alternating deficiency and excess" is also considered valid. Zhi (Wang Bing's commentary) states that because Yang is firm and Yin is soft, "the Path of Yang is always solid, and the Path of Yin is always deficient." The *Xi Ci* (Commentary on the Appended Statements) says: "The meaning of Yin and Yang corresponds to the Sun and Moon." The *Baihu Tong* states: "Sun" implies "solidity," always full yet regulated; "Moon" implies "deficiency" (que), having both fullness and waning phases. Why is there waning? Is it attributed to the Sun? Jian An notes that Wu Kun added the phrase "Yin Path solid, Yang Path deficient" here. Zhang Jingyue's reference to "another saying" likely refers to Wu Kun's annotation. However, examining the preceding text: "Yang is Heavenly Qi, governing the exterior; Yin is Earthly Qi, governing the interior." Therefore, interpreting this through "Yang firmness and Yin softness" aligns better with the textual context.
When Yang receives it, it enters the Six Fu Organs: Xu Dachun states that this refers to treacherous winds and empty evils; when received by the Yang channels, they enter the Six Fu Organs. Dietary and lifestyle irregularities, when received by the Yin channels, enter the Five Zang Organs. This contradicts the *Yin Yang Ying Xiang Da Lun*, which states: "Heavenly pathogenic qi harms the Five Zang Organs; cold and heat from water and grain harm the Six Fu Organs." What is the rationale behind this contradiction? It is because empty evils from external injury are excess conditions, while dietary internal injuries are deficiency conditions. These two types of damage affect different aspects, and one cannot rigidly generalize about injury based on a single perspective.
Irregular Sleep: Zhang Yun explains this as the inability to sleep at appropriate times.
Therefore, the Throat Governs Heavenly Qi: Zhi (Wang Bing's commentary) notes that this section uses the character "gu" (therefore/cause) eight times, due to the differing positions of Yin and Yang.
Ascending to the Extreme, Then Descending: Zhi (Wang Bing's commentary) explains that this describes pathogens transforming along with Qi movement. Human Yin and Yang exit and enter, rising and falling according to time. Thus, Yang diseases located in the upper body will, over time, descend with the Qi; Yin diseases located in the lower body will, over time, rebel upward with the Qi.
Received First in the Upper Part: Jian An references the *Bai Bing Shi Sheng Pian*: "Clear dampness attacks deficiency, so disease arises from below; wind and rain attack deficiency, so disease arises from above." The *Bian Mai Pian* states: "Clear pathogens strike the Upper Jiao, turbid pathogens strike the Lower Jiao." This correctly interprets the meaning. Zhang Yun states that the upper part is not without dampness, nor the lower part without wind; it is merely a matter of sequence. Saying "received first" allows one to infer what is received later.
Cannot Reach the Meridians: Ma Shi states that Stomach Qi cannot naturally reach the various meridians of the four limbs; it must rely on the transportation function of Spleen Qi. Jian An considers the reading "jing zhi" (directly reaching) from the *Tai Su* to be superior to "zhi jing" (reaching the meridians).
Governs the Four Viscera: Ma Shi states that "zhang" is synonymous with "zhang" (to manage/govern), meaning to control.
Manifesting in the Stomach: Gao Shiqi states that "zhao" means manifest or obvious. The essence of water and grain transformed by Stomach Earth manifests outwardly. Jian An follows Ma Shi's view that "zhao" is the same as "zhuo" (manifest), adhering to Wang Bing's commentary. Gao's interpretation is considered forced.
Extending Up to the Head and Down to the Feet: Zhang Yun states that the Spleen is the root of the Zang and Fu organs, thus extending up to the head and down to the feet, covering everything. How could it only govern a single season?
Foot Taiyin is the Third Yin: Gao Shiqi states that Jueyin is the First Yin, Shaoyin is the Second Yin, and Taiyin is the Third Yin. Therefore, Foot Taiyin is the Third Yin.
Transporting Qi to the Three Yin: Wu Kun states that "wei zhi" means for the Stomach. The Three Yin refer to Taiyin, Shaoyin, and Jueyin. The Spleen transports Qi for the Stomach into the Three Yin meridians, conveying Yangming Qi into the various Yin meridians.
Transporting Qi to the Three Yang: Wu Kun states that "wei zhi" means for the Spleen. Transporting Qi into the Three Yang meridians conveys Taiyin Qi into the various Yang meridians.
Deficiency of the Yin Path: Wu Kun states that the blood vessels are not smooth and unobstructed. Gao Shiqi states that this refers to the pulse vessels being obstructed. Jian An notes that since the preceding text mentions "pulse vessels obstructed," Gao's annotation is more appropriate.