夫脾胃虚，则湿土之气溜于脐下，肾与膀胱受邪。膀胱主寒，肾为阴火，二者俱弱，润
泽之气不行。大肠者，庚也，燥气也，主津；小肠者，丙也，热气也，主液。此皆属胃，胃
虚则无所受气而亦虚，津液不濡，睡觉口燥咽干，而皮毛不泽也。甲胆，风也，温也，主生
化周身之血气；丙小肠，热也，主长养周身之阳气。亦皆禀气于胃，则能浮散也，升发也；
胃虚则胆及小肠温热生长之气俱不足，伏留于有形血脉之中，为热病，为中风，其为病不可
胜纪，青、赤、黄、白、黑五腑皆滞。三焦者，乃下焦元气生发之根蒂，为火乘之，是六腑
之气俱衰也。腑者，腑库之腑，包含五脏及形质之物而藏焉。且六腑之气，外无所主，内有
所受。感天之风气而生甲胆，感暑气而生丙小肠，感湿化而生戊胃，感燥气而生庚大肠，感
寒气而生壬膀胱，感天一之气而生三焦，此实父气，无形也。风、寒、暑、湿、燥、火，乃
温、热、寒、凉之别称也，行阳二十五度，右迁而升浮降沉之化也，其虚也，皆由脾胃之弱
。
以五脏论之，心火亢甚，乘其脾土曰热中，脉洪大而烦闷。《难经》云∶脾病，当脐有
动气，按之牢若痛。动气，筑筑然坚牢，如有积而硬，若似痛也，甚则亦大痛，有是则脾虚
病也，无则非也。更有一辨，食入则困倦，精神昏冒而欲睡者，脾亏弱也。且心火大盛，左
迁入于肝木之分，风湿相搏，一身尽痛，其脉洪大而弦，时缓，或为眩运战摇，或为麻木不
仁，此皆风也。脾病，体重即痛，为痛痹，为寒痹，为诸湿痹，为痿软失力，为大疽大痈。
若以辛热助邪，则为热病，为中风，其变不可胜纪。木旺营运，北越左迁，入地助其肾水，
水得子助，入脾为痰涎，自入为唾，入肝为泪，入肺为涕，乘肝木而反克脾土明矣。当先于
阴分补其阳气升腾，行其阳道而走空窍，次加寒水之药降其阴火，黄柏、黄连之类是也。先
补其阳，后泻其阴，脾胃俱旺而复于中焦之本位，则阴阳气平矣。火曰炎上，水曰润下，今
言肾主五液，上至头，出于空窍，俱作泣、涕、汗、涎、唾者何也？曰∶病痫者，涎沫出于
口，冷汗出于身，清涕出于鼻，皆阳跷、阴跷、督、冲四脉之邪上行，肾水不任煎熬，沸腾
上行为之也。此奇邪为病，不系五行阴阳十二经所拘，当从督、冲、二跷、四穴中奇邪之法
治之。
五脏外有所主，内无所受。谓无所受盛，而外主皮毛、血脉、肌肉、筋骨及各空窍是也
；若胃气一虚，脾无所禀受，则四脏经络皆病。况脾全藉胃土平和，则有所受而生荣，周
身四脏皆旺，十二神守职，皮毛固密，筋骨柔和，九窍通利，外邪不能侮也。
脾胃虚弱，则湿土之气流注于脐下，导致肾与膀胱受邪。膀胱主寒，肾为阴火，二者皆虚弱，滋润身体的气机运行不畅。大肠属庚金，性质燥，主管津液；小肠属丙火，性质热，主管体液。这些脏腑的气都依赖于胃，胃虚则无法接受水谷精气而自身也虚，导致津液不能濡润身体，醒来时口燥咽干，皮肤毛发失去光泽。胆属甲木，性质为风和温，主管化生周身的气血；小肠属丙火，性质为热，主管长养周身的阳气。它们也都从胃接受气，才能浮散升发；若胃虚，则胆和小肠温热生长的气都不足，伏留于有形的血脉之中，引发热病、中风等病症，其病变不可胜数，青、赤、黄、白、黑五腑的气机都会滞涩。三焦是下焦元气生发的根本，被火邪所乘，因此六腑之气都衰弱了。腑，是库藏之腑，包含五脏及形体物质而储藏其中。况且六腑之气，对外没有主宰，对内有所接受。感受天的风气而生甲胆，感受暑气而生丙小肠，感受湿化而生戊胃，感受燥气而生庚大肠，感受寒气而生壬膀胱，感受天一之气而生三焦，这实际上是父气，是无形的。风、寒、暑、湿、燥、火，是温、热、寒、凉的不同称呼，它们在阳分运行二十五度，向右迁移而上升、下降、沉降的转化过程，它们的虚弱，都是由脾胃的衰弱引起的。
从五脏来论述，心火亢盛，克制脾土称为“热中”，脉象洪大而伴有烦闷。《难经》说：脾病，当脐部有动气，按压时坚硬如痛感。动气，跳动坚实牢固，好像有积块且硬，如果疼痛，严重时也会很痛，有此症状则是脾虚病，没有则不是。再有一个辨别方法，进食后感到困倦，精神昏沉想睡觉的，是脾亏弱所致。而且心火大盛，向左迁入肝木之分，风湿相搏，全身疼痛，脉象洪大而弦，时而缓和，或者出现眩晕颤抖，或者麻木不仁，这都是风邪所致。脾病，身体沉重即疼痛，属于痛痹、寒痹、各种湿痹，以及痿软无力、大的疽痈。如果用辛热药物助长邪气，就会变成热病、中风，其变化不可胜数。木气旺盛营运，向北越过并左迁，进入地下帮助肾水，水得到子的帮助，进入脾成为痰涎，自入成为唾，进入肝成为泪，进入肺成为涕，克制肝木进而反克脾土是很明显的。应当先在阴分补益阳气使其升腾，沿着阳道运行而走空窍，其次加入寒水性质的药物降低阴火，如黄柏、黄连之类。先补阳，后泻阴，脾胃都旺盛并恢复在中焦的本位，那么阴阳之气就平衡了。火性炎上，水性润下，现在说肾主管五液，上行至头部，出于空窍，都表现为泣、涕、汗、涎、唾，这是为什么呢？回答说：患痫病的人，涎沫出于口，冷汗出于身，清涕出于鼻，都是阳跷、阴跷、督脉、冲脉这四条经脉的邪气上行，肾水承受不住煎熬，沸腾上行造成的。这种奇邪致病，不受五行、阴阳、十二经的限制，应当从督脉、冲脉、二跷脉、四穴中的奇邪治法来治疗。
五脏对外有所主宰，对内无所接受。指的是无所受盛（容纳），而对外主宰皮毛、血脉、肌肉、筋骨及各空窍；如果胃气一虚，脾无所禀受，那么四脏经络都会生病。何况脾完全依赖胃土的平和，才能有所接受而生发荣气，周身四脏都旺盛，十二神各司其职，皮毛固密，筋骨柔和，九窍通利，外邪就不能侵犯。
When the Spleen and Stomach are deficient, the Qi of damp Earth flows to below the umbilicus, causing pathogenic invasion of the Kidney and Bladder. The Bladder governs cold, while the Kidney is associated with Yin Fire; when both are weak, the moistening Qi fails to circulate. The Large Intestine corresponds to Geng Metal, possesses a dry nature, and governs Jin (thin fluids); the Small Intestine corresponds to Bing Fire, possesses a hot nature, and governs Ye (thick fluids). All these organs rely on the Stomach for Qi; if the Stomach is deficient, it cannot receive Qi and becomes deficient itself, leading to a lack of fluid nourishment. Upon waking, one experiences dry mouth and throat, and the skin and hair lose luster. The Gallbladder corresponds to Jia Wood, characterized by wind and warmth, and governs the generation of Qi and Blood throughout the body; the Small Intestine corresponds to Bing Fire, characterized by heat, and governs the nurturing of Yang Qi throughout the body. They also receive Qi from the Stomach to enable floating, dispersing, ascending, and emerging functions. If the Stomach is deficient, the warm, hot, and growing Qi of the Gallbladder and Small Intestine become insufficient, stagnating within the有形 (form/blood vessels), causing Heat Diseases (Re Bing) or Wind-Stroke (Zhong Feng). These pathological changes are countless, causing stagnation in the five Zang organs represented by green, red, yellow, white, and black. The Sanjiao (Triple Burner) is the root of Yuan Qi generation in the Lower Burner; invaded by Fire, the Qi of all six Fu organs declines. Fu organs are repositories that contain and store the five Zang organs and physical substances. Moreover, the Qi of the six Fu organs has no external governance but receives internally. The Jia Gallbladder arises from Heaven's Wind Qi; the Bing Small Intestine from Summer Heat Qi; the Wu Stomach from Dampness Transformation; the Geng Large Intestine from Dryness Qi; the Ren Bladder from Cold Qi; and the Sanjiao from Tianyi Qi. These are essentially Paternal Qi, which is formless. Wind, Cold, Summer Heat, Dampness, Dryness, and Fire are alternative names for Warm, Hot, Cold, and Cool. They circulate twenty-five times in the Yang aspect, moving rightward, ascending, descending, and sinking. Their deficiency stems entirely from the weakness of the Spleen and Stomach.
Discussing from the perspective of the Five Zang organs: Excessive Heart Fire overacting on Spleen Earth is called "Heat Zhong" (Heat Center), presenting with a surging pulse and irritability. The *Nan Jing* states: In Spleen disease, there is pulsation at the umbilicus, which feels hard and painful upon pressure. This pulsation is firm and solid, resembling an accumulation or hardness, and may cause severe pain; its presence indicates Spleen deficiency disease, while its absence rules it out. Another distinguishing sign is drowsiness, mental confusion, and sleepiness after eating, indicating Spleen deficiency. Furthermore, excessive Heart Fire moves leftward into the Liver Wood sector. Wind and Dampness contend, causing whole-body pain, with a surging and wiry pulse that may occasionally be slow, or manifest as vertigo, tremors, numbness, and loss of sensation—all attributable to Wind. Spleen disease presents with heavy body and pain, classified as Painful Bi (Tong Bi), Cold Bi, various Damp Bi syndromes, flaccidity with weakness, or large abscesses and ulcers. If acrid-hot herbs are used to assist the pathogen, it transforms into Heat Disease or Wind-Stroke, with variations too numerous to recount. When Wood Qi is vigorous and circulates northward and leftward, entering the earth to assist Kidney Water, the Water, aided by the Son (Wood generates Fire, Fire generates Earth, Earth generates Metal, Metal generates Water... wait, Wood controls Earth, Earth controls Water? No, Wood generates Fire, Fire generates Earth, Earth generates Metal, Metal generates Water, Water generates Wood. Here "Zi" likely refers to the generative cycle or specific interaction context, but text says "Water gets Zi's help", implying Wood helps Water? Actually, in Five Elements, Wood generates Fire. The text says "Wood旺... enters earth to help Kidney Water". This implies a complex interaction where Wood's excess affects Water via Earth or direct control reversal. Let's stick to literal translation: Wood assists Kidney Water). Water, assisted by this, enters the Spleen to become Phlegm-Saliva, self-enters as Spittle, enters the Liver as Tears, and enters the Lung as Nasal Mucus. It clearly overacts on Liver Wood and counter-overacts on Spleen Earth. One should first tonify Yang Qi in the Yin aspect to promote its ascent, allowing it to travel along the Yang pathways to open orifices; subsequently, add Cold-Water natured herbs to drain Yin Fire, such as Huangbo (Phellodendri Cortex) and Huanglian (Coptidis Rhizome). By tonifying Yang first and draining Yin subsequently, the Spleen and Stomach become robust and return to their central position in the Middle Burner, achieving balance of Yin and Yang Qi. Fire tends to blaze upward; Water tends to moisten downward. Why does the text state that the Kidney governs the five fluids, which ascend to the head and exit through the orifices as tears, nasal discharge, sweat, saliva, and spittle? The answer is: In patients with epilepsy (Xian Bing), saliva and foam emerge from the mouth, cold sweat from the body, and clear nasal mucus from the nose. This is due to pathogenic factors from the Yang Qiao, Yin Qiao, Du Mai (Governing Vessel), and Chong Mai (Penetrating Vessel) meridians ascending. The Kidney Water cannot withstand the boiling and scorching, causing it to surge upward. This type of illness caused by odd pathogens is not constrained by the Five Elements, Yin-Yang, or the twelve regular meridians. It should be treated according to the methods for odd pathogens in the Du, Chong, two Qiao vessels, and four acupoints.
The Five Zang organs have external governance but no internal reception. This means they do not receive or hold contents, but externally govern the skin, hair, blood vessels, muscles, tendons, bones, and various orifices. If Stomach Qi becomes deficient, the Spleen has nothing to receive, and the meridians of the other four Zang organs will all become diseased. Moreover, the Spleen completely relies on the peaceful state of Stomach Earth to receive and generate Ying (Nutritive) Qi. When the four Zang organs throughout the body are prosperous, the Twelve Spirits perform their duties, the skin and hair are dense and secure, the tendons and bones are soft and flexible, the nine orifices are unobstructed, and external pathogens cannot invade.