大肠传导糟粕，通调为顺，溏泄则有阴伤之患，秘结则有阳亢之虞。昔人治便频无度，
多以
补脾为主，亦扶土生金之义也。有火则闭塞不通，须用攻下之品，釜底抽薪，诚妙法也。稍
涉虚者，如景岳济川煎，亦可采用。凡目病在肺经者，治其大肠，以其表里相应，所谓上病
治下也。
膀胱为巨阳，其经脉最长，统束一身。凡外感症皆太阳受之，羌防发汗，治其经，五苓
利水
，治其腑。更有湿热下注，二便不调，专治膀胱，其病自愈。与肾为表里，肾无泻法，泻膀
胱即所以泻肾。沟渎既清，水泉不竭，肾精自然充足。目珠上属太阳，见症甚多，如头风损
目，垂帘成障皆是。故凡治目，不可不细究膀胱也。
病之发也，有因外感内伤，前已详论之矣。至于杂症，不过气血痰食郁五者而已。然五
者之
中，惟气血为甚。盖人有阴阳，即为气血，阳主气，故气全则神旺。阴主血，故血盛则形强
。然而身形之中，有营气，有卫气，凡人受气于谷，谷入于胃，以传于肺，五脏六腑，皆得
受气。清者为营，浊者为卫。营行脉中，卫行脉外。其所以统摄一身，环流不息者，全赖元
气为之主持。元气者，先天之气，命门之主也。卫气者，后天之气，生命之原也。元气为卫
气之母，母能益子，子赖谷气之津以养生。故元气衰，则营卫之气皆有不充矣。夫血生于心
，统于脾，藏于肝，布于肺，泄于肾，灌溉一身，为七窍之灵，四肢之用。润颜色，充营卫
，津液得以通行，二便得以调畅。然血为气化，亦能助气，故一气一血，相为表里也。痰饮
一症，内经止有积饮之说，本无痰症之名。盖痰涎之化，本由中气衰弱，水谷入胃，不能尽
化，留而为痰，使脾强胃健则随食随化，皆成津液，焉能成痰。故肥人多痰者，因中气不能
健运所致。经云∶形盛气虚，此之谓也。若实痰者，或因风因热因湿因寒，郁结于脏腑经络
之间，血气不能通达，凝而为痰。祛其外感，而痰自消也。内经之不言痰者，正以痰必因病
而生，非病之因痰而致也。经云∶人以水谷为本，人绝水谷则死，脉无胃气亦死。又曰∶谷
盛气盛，谷虚气虚，此其常也。反此者病。盖五味入口，脏受于胃，游溢精气，散布于五脏
，酸入肝，苦入心，甘入脾，辛入肺，咸入肾，此五脏各归所喜也。凡人偶食生冷油浊之物
，积滞于肠胃之间，此邪气之实也。若食入即胀，或胸胁作痛者，乃中气不旺之故也。盖脾
胃为仓廪之官，职司化食，脾胃强壮者，即滞亦易化。如其不能化者，皆由脾胃之虚也。郁
病者，滞而不通之义也。经言五郁者，乃五行之化，气运有乖，则五郁之病生焉。滑氏曰∶
木性本条达，火性本发扬，土性本冲和，金性本整肃，水性本流通。五者一有所郁，斯失其
性矣。至于情志之郁，不过忧思怒三者而已。盖忧则气聚，思则气结，怒则气逆也。初病宜
顺宜开，若郁久则伤及中宫，神志日消，心脾日耗，非补不可也。余谓痰食郁三者，总由气
血不调之故。若气血和平，则神魂安静，肤腠固密，外来之邪无隙可乘，内生之郁无由而起
。即使寒温不测，世事无常，或外犯客邪，或内为郁病，只宜祛其外感，调其郁气则安矣，
宁有大病之足虑哉！
大肠负责传导糟粕，通畅调和为顺；若出现溏泄（大便稀薄），则有损伤阴液的隐患；若出现秘结（大便秘结），则有阳气亢盛的忧虑。过去人们治疗大便频繁且无节制，多以补脾为主，这也是“扶土生金”（通过健脾来益肺）的道理。如果有火邪导致闭塞不通，必须使用攻下的药物，如同从锅底抽走柴火以灭火，这确实是妙法。如果病情稍涉虚证，如张景岳的济川煎，也可以采用。凡是眼病属于肺经的，治疗其大肠，因为肺与大肠互为表里、相互呼应，这就是所谓的“上病下治”。
膀胱被称为巨阳，其经脉最长，统摄约束全身。凡是外感病症，都是太阳经受邪，用羌活、防风发汗，是治疗其经络；用五苓散利水，是治疗其腑。更有湿热下注，导致大小便不调，专门治疗膀胱，疾病自然痊愈。膀胱与肾互为表里，肾没有泻法，泻膀胱就是用来泻肾。沟渠既然清澈，水源就不会枯竭，肾精自然充足。眼球上部归属于太阳经，出现的症状很多，如头风损伤眼睛、眼睑下垂形成障翳等都是。所以凡是治疗眼病，不可不仔细研究膀胱。
疾病的发作，有因外感或内伤引起的，前面已经详细论述过了。至于杂症，不过是气、血、痰、食、郁这五种情况罢了。然而在这五种之中，只有气和血最为重要。大概人有阴阳，就体现为气血，阳主气，所以气充足则精神旺盛；阴主血，所以血盛则形体强健。然而在身体形态之中，有营气，有卫气，人从食物中摄取精气，食物进入胃中，传送给肺，五脏六腑都能得到精气。清轻的部分成为营气，重浊的部分成为卫气。营气运行在脉管之中，卫气运行在脉管之外。它们之所以能统摄全身，循环不息，全赖元气来主持。元气，是先天之气，由命门主宰。卫气，是后天之气，是生命的本源。元气是卫气的母亲，母亲能滋养儿子，儿子依赖谷气津液来养生。所以元气衰弱，那么营气和卫气都会有不充足的时候。血产生于心，统摄于脾，储藏于肝，布散于肺，排泄于肾，灌溉全身，是七窍灵敏、四肢有用的基础。滋润面色，充实营卫，使津液得以通行，二便得以调畅。然而血由气化而生，也能辅助气，所以气和血，互为表里。痰饮这一病症，《内经》中只有积饮的说法，本来没有痰症的名目。大概痰涎的形成，原本是由中气衰弱，水谷进入胃中，不能完全消化，停留而变成痰，如果脾强胃健，就会随着食物一起消化，都变成津液，怎么能形成痰呢？所以肥胖的人多痰，是因为中气不能健运所致。《内经》说：“形体壮盛但气虚”，说的就是这个道理。如果是实痰，可能是因为风、热、湿、寒，郁结在脏腑经络之间，气血不能通达，凝结而成痰。祛除外感邪气，痰自然就会消除。《内经》不讲痰，正是因为痰必定因病而生，不是病因为痰而导致。《内经》说：“人以水谷为本，人断绝水谷就会死亡，脉象没有胃气也会死亡。”又说：“谷气盛则正气盛，谷气虚则正气虚”，这是正常规律。与此相反的就会生病。大概五味入口，脏器受之于胃，游溢精气，散布于五脏，酸味入肝，苦味入心，甘味入脾，辛味入肺，咸味入肾，这是五脏各自归其所喜。凡人偶尔吃生冷油腻浑浊的食物，积滞于肠胃之间，这是邪气的实证。如果吃进去就胀满，或者胸胁作痛，那是中气不旺盛的缘故。大概脾胃是仓廪之官，职责是消化食物，脾胃强壮的人，即使有停滞也容易化解。如果不能化解，都是由脾胃虚弱造成的。郁病，意思是停滞而不通。经文所说的五郁，乃五行化生的变化，气运有乖违，就会产生五郁的病。滑寿先生说：木性本条达，火性本发扬，土性本冲和，金性本整肃，水性本流通。这五种属性一旦有所郁结，就失去了本性。至于情志之郁，不过是忧、思、怒这三种罢了。大概忧愁则气聚，思虑则气结，愤怒则气逆。初病适宜顺遂开导，如果郁久则伤及中宫（脾胃），神志日渐消减，心脾日渐耗损，非补不可。我认为痰、食、郁这三种，总归是由于气血不调的缘故。如果气血平和，那么神魂安静，肤腠固密，外来的邪气没有空隙可乘，内生的郁结没有缘由而起。即使寒温变化莫测，世事无常，或者外犯客邪，或者内为郁病，只宜祛除外感，调理郁气就能安康了，哪里还有大病值得忧虑呢！
The Large Intestine is responsible for conducting waste; smooth and harmonious flow constitutes normalcy. Loose stools (loose, watery bowel movements) pose a risk of Yin injury, while constipation (hard, dry stool) carries the danger of Yang hyperactivity. In the past, treating frequent and uncontrolled defecation primarily focused on tonifying the Spleen, which also embodies the principle of "Supporting Earth to Generate Metal" (strengthening the Spleen to benefit the Lung). If fire pathogens cause obstruction and blockage, purgative agents must be used to remove the fuel from under the pot (clearing heat from the source), which is indeed a brilliant method. For cases involving slight deficiency, such as Jichuan Jian (Jingyue's Decoction for Crossing the River) by Zhang Jingyue, it may also be adopted. Whenever eye diseases belong to the Lung Meridian, treat the Large Intestine, because they are exterior-interior partners, corresponding to each other; this is what is meant by "treating upper disorders from below."
The Bladder is called the Great Yang; its meridian is the longest, governing and binding the entire body. All external contraction syndromes are first affected by the Taiyang (Greater Yang) channel. Using Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix) to induce sweating treats the meridian; using Wuling San (Five-Ingredient Powder with Poria) to promote urination treats the fu organ. Furthermore, when damp-heat flows downward causing irregularities in both urine and stool, specifically treating the Bladder allows the disease to heal spontaneously. The Bladder and Kidney are exterior-interior partners. Since there is no draining method for the Kidney, draining the Bladder serves to drain the Kidney. Once the ditches are clear, the water springs will not dry up, and Kidney Essence will naturally become sufficient. The eyeballs are superiorly connected to the Taiyang channel, presenting many symptoms, such as head wind damaging the eyes or ptosis forming cataracts/opacities. Therefore, whenever treating eye diseases, one cannot fail to investigate the Bladder carefully.
Diseases arise from either external contractions or internal injuries, which have been discussed in detail previously. As for miscellaneous syndromes, they are merely five categories: Qi, Blood, Phlegm, Food, and Stagnation. However, among these five, only Qi and Blood are most significant. Generally, humans possess Yin and Yang, manifested as Qi and Blood. Yang governs Qi, so abundant Qi leads to vigorous spirit; Yin governs Blood, so abundant Blood leads to strong physique. Within the physical form, there is Ying (Nutritive) Qi and Wei (Defensive) Qi. Humans receive Qi from food; once food enters the Stomach, it is transmitted to the Lung, allowing all Zang and Fu organs to receive Qi. The clear and light portion becomes Ying Qi, while the turbid and heavy portion becomes Wei Qi. Ying Qi circulates within the vessels, while Wei Qi circulates outside the vessels. Their ability to govern the whole body and circulate endlessly relies entirely on Yuan Qi (Original Qi) to preside. Yuan Qi is congenital Qi, governed by the Gate of Life (Mingmen). Wei Qi is acquired Qi, the origin of life. Yuan Qi is the mother of Wei Qi; the mother benefits the son, and the son relies on the fluids of grain Qi to nourish itself. Thus, if Yuan Qi declines, both Ying and Wei Qi will be insufficient. Blood is produced in the Heart, governed by the Spleen, stored in the Liver, distributed by the Lung, and excreted via the Kidney. It irrigates the whole body, serving as the basis for the sensitivity of the seven orifices and the function of the four limbs. It moistens the complexion, fills Ying and Wei Qi, allows body fluids to flow freely, and ensures smooth passage of urine and stool. However, Blood is generated by Qi transformation and can also assist Qi; thus, Qi and Blood are exterior-interior partners. Regarding the syndrome of Phlegm and Fluid Retention, the *Neijing* (Classic of Internal Medicine) only mentions accumulated fluid retention and originally had no name for "Phlegm Syndrome." The formation of phlegm saliva originates from the weakness of Middle Qi. When food and water enter the Stomach but cannot be fully transformed, they remain and become phlegm. If the Spleen is strong and the Stomach healthy, food is digested immediately and transforms into body fluids, how could it become phlegm? Therefore, obese people often have phlegm due to the inability of Middle Qi to transport and transform effectively. The Classics state: "A robust physique with deficient Qi," referring to this condition. If it is excess phlegm, it may be due to Wind, Heat, Dampness, or Cold stagnating between the Zang-Fu organs and meridians, preventing the free flow of Qi and Blood, condensing into phlegm. Removing the external contraction causes the phlegm to dissipate naturally. The reason the *Neijing* does not discuss phlegm is precisely that phlegm arises from disease, not that disease is caused by phlegm. The Classics say: "Humans rely on water and grain as their foundation; without water and grain, humans die; without Stomach Qi in the pulse, death occurs." It also says: "Abundant grain leads to abundant Qi; deficient grain leads to deficient Qi." This is the normal pattern. Deviating from this results in disease. Generally, the five flavors enter the mouth, are received by the Zang organs via the Stomach, overflow with essence and Qi, and distribute to the five Zang organs: Sour enters the Liver, Bitter enters the Heart, Sweet enters the Spleen, Pungent enters the Lung, Salty enters the Kidney. This represents each Zang organ returning to its preference. If a person occasionally consumes cold, raw, greasy, or turbid foods, accumulating stagnation in the intestines and stomach, this is an excess of pathogenic factors. If bloating occurs immediately after eating, or pain arises in the chest and hypochondrium, it is due to weak Middle Qi. The Spleen and Stomach are the officials of the granaries, responsible for digesting food. Those with strong Spleen and Stomach can easily resolve even stagnation. If digestion fails, it is always due to Spleen-Stomach deficiency. "Yu" (Stagnation) means blockage and lack of flow. The "Five Yu" mentioned in the classics refer to the transformations of the Five Elements; when the movement of Qi deviates, diseases of the Five Yu arise. Mr. Hua (Huashi) stated: The nature of Wood is naturally flexible and spreading; Fire is naturally uplifting and radiant; Earth is naturally balanced and mild; Metal is naturally orderly and solemn; Water is naturally flowing and permeable. If any of these five properties becomes stagnant, they lose their nature. As for emotional stagnation, it is limited to Worry, Pensiveness, and Anger. Worry causes Qi to gather; Pensiveness causes Qi to knot; Anger causes Qi to rebel. In early stages, treatment should facilitate flow and open blockages. If stagnation persists, it damages the Middle Palace (Spleen/Stomach), gradually depleting Shen (Spirit) and exhausting Heart and Spleen, requiring tonification. I believe that Phlegm, Food, and Stagnation all stem from the imbalance of Qi and Blood. If Qi and Blood are harmonious, then Hun and Po (Soul and Spirit) are calm, skin and pores are secure, external pathogens have no gap to exploit, and internal stagnation has no cause to arise. Even if temperature changes unpredictably or worldly affairs are irregular, whether suffering from external pathogens or internal stagnation, one should only dispel external contractions and regulate stagnant Qi to achieve peace. Where would there be major diseases worthy of concern!