三十难曰∶荣气之行，常与卫气相随不？
然∶经言人受气于谷，谷入于胃，乃传于五脏六腑，
五脏六腑，皆受于气。其清者为荣，浊者为卫，荣行脉中，卫行脉外，荣周不息，五十而复大会。
阴阳相贯，如环之无端，故知荣卫相随也。
荣卫循行之义，已详一难中。此言荣卫相随不息之原，起于胃之谷气，其清者为荣，即谷味
之精，乃阳中之阴也。血为荣，行于脉中，其浊者为卫，即谷味之气，乃阴中之阳，即所谓阳明悍
气也，化气为卫，以卫护于脉外。《素问·痹论》云∶营者，水谷之精气也，和调于五脏，洒陈于
六腑，乃能入于脉也。卫者，水谷之悍气也，其气 疾滑利，不能入于脉也。亦即此义。但此节
乃《灵枢·营卫生会篇》中语。惟《灵枢》作谷入于胃，以传于肺，五脏六腑皆以受气，为少殊耳。
然胃中水谷之精，为微丝液管吸至颈会管，过肺入心，化赤为血，以荣五脏六腑。经脉之中，删
去（以传于肺）四字，便乖脏腑传道之义，关系匪轻，不可缺也。
三十一难曰∶三焦者，何禀何生？何始何终？其治常当何许，可晓以不？
然∶
三焦者，水谷之道路，气之所终始也。上焦者，在心下，下膈，在胃上口，主内而不出，其治在膻
中，玉堂下一寸六分，直两乳间陷者是。中焦者，在胃中脘，不上不下，主腐熟水谷，其治在脐旁。
下焦者，当膀胱上口，主分别清浊，主出而不内。以传道也，其治在脐下一寸。故名曰三焦，其府
在气街。
前节举五脏六腑，禀水谷荣卫之气而相资养，为论脏腑之首条。此因三焦之气化，论其发用
之理也。夫三焦者，禀元气以资始，合胃气以资生，上达胸中而为用，往来通贯，宣布无穷，造化
出纳，作水谷之道路，为气之所终始也。上焦在膈膜之下者，以其上层与膈膜下层粘属也。其气自
下而上，散于胸中，分布薰蒸于皮肤腠理，故在胃上口，主纳而不令出，其治在膻中穴，属任脉，
在玉堂下同身寸之一寸六分陷者中，任脉气所发也。中焦在胃中脘，以其包肝裹胃也，其治在脐旁
之天枢，胃脉之穴也，其用在胃之中脘，中脘者，乃十二经所起所会，阴阳肉完之处，故曰脘也。
下焦者，当膀胱上口，乃阑门之分，盖由此清者入于膀胱而为气为溺，浊者入于大肠而为滓为秽，
故主出而不纳，以传道也，其治在脐下任脉之阴交穴。《素问·灵兰秘典论》曰∶三焦者，决渎之
官，水道出焉，即指此也。其所在气街者，气街在毛际两旁，足阳明经穴，乃三焦之根，原气所之
处，即由肾系所生之脂膜也。夫三焦属相火之宅，火之性自下而
上，故《素问·经脉别论》曰∶饮入于胃，游溢精气，上输于脾，此指中焦也。脾气散精，上
归于肺，此指上焦也。通调水道，下输膀胱，此指下焦也。然论上中下三焦之气，何以独重乎饮，
不知气乃水之所化也。膀胱之水，借吸入之天阳，引心火至下焦，薰蒸化而为气以上达，为津为
液为汗，此火交于水化气之理，即干阳入坤阴，随阳气上腾而为云为雨之义也。若夫三焦之形质，
详见于二十五难，可参互观之。
第三十难问道：营气的运行，总是与卫气相随吗？
回答说：经书中说人从饮食中摄取精气，饮食进入胃中，然后传布到五脏六腑，五脏六腑都接受这些精气。其中清轻的部分成为营气，重浊的部分成为卫气，营气在脉管中运行，卫气在脉管外运行，营气周流不息，每运行五十周次后会在手太阴肺经处重新会合。阴阳经脉相互贯通，像圆环一样没有尽头，因此知道营气和卫气是相随运行的。
关于营卫循行的道理，已经在第一难中详细论述过。这里说的是营卫相随且不停止的根源，起于胃中的谷气，其中清轻的部分就是营气，即谷物味道的精华，属于阳中之阴。血属于营气，运行在脉管中；其中重浊的部分就是卫气，即谷物的气，属于阴中之阳，也就是所谓的阳明悍气，由气化生为卫气，以护卫在脉管之外。《素问·痹论》中说：营气，是水谷的精气，调和于五脏，散布于六腑，然后才能进入脉管。卫气，是水谷的悍气，其气运行迅速滑利，不能进入脉管。也是这个意思。只是这一节内容出自《灵枢·营卫生会篇》。只有《灵枢》作“谷入于胃，以传于肺”，五脏六腑皆以受气，稍微有些不同罢了。然而胃中水谷的精华，被微丝液管吸收输送至颈部的会管，经过肺进入心脏，化为红色成为血液，以此滋养五脏六腑。经脉之中，如果删去“以传于肺”这四个字，就违背了脏腑传导的意义，关系重大，不可省略。
第三十一难问道：三焦，禀受什么而生？从哪里开始到哪里结束？它的治疗部位通常在哪里，可以说明白吗？
回答说：
三焦，是水谷运行的道路，也是气终结和起始的地方。上焦，位于心下，横膈膜之下，胃的上口之上，主要功能是受纳食物而不排出，它的治疗部位在膻中穴，即玉堂穴下一寸六分，正对两乳之间凹陷处的穴位。中焦，位于胃的中脘部，不上不下的位置，主要功能是腐熟消化水谷，它的治疗部位在肚脐旁边。下焦，位于膀胱上口的位置，主要功能是分别清浊，只排出废物而不受纳，起到传导的作用，它的治疗部位在肚脐下一寸。所以称为三焦，它的府库在气街穴。
前一节列举了五脏六腑，禀受水谷营卫之气而相互资助养育，这是论述脏腑的第一条原则。这里因为三焦的气化功能，来论述其发用的原理。所谓三焦，禀受元气作为起始，结合胃气作为生化之源，向上通达胸中发挥作用，往来贯通，宣布无穷，如同造化的出纳，作为水谷运行的道路，是气终结和起始的地方。上焦位于膈膜之下，是因为其上端与膈膜下层粘连附着。其气自下而上，散于胸中，分布熏蒸于皮肤腠理，所以在胃上口，主受纳而不令其外出，它的治疗部位在膻中穴，属于任脉，在玉堂穴下同身寸的一寸六分凹陷处，是任脉气所发出的穴位。中焦位于胃的中脘，因为它包裹着肝和胃，它的治疗部位在肚脐旁边的天枢穴，是胃经的穴位，它的作用在于胃的中脘，中脘穴，是十二经脉起始和汇聚的地方，阴阳之气完备之处，所以称为脘。下焦，位于膀胱上口，乃是阑门的分界，大概由此清的部分进入膀胱化为气化为尿液，浊的部分进入大肠化为渣滓化为秽物，所以主排出而不受纳，起到传导作用，它的治疗部位在肚脐下任脉的阴交穴。《素问·灵兰秘典论》说：三焦，是决渎之官，水道由此而出，就是指这个意思。它所在的气街，位于毛际两旁，是足阳明经的穴位，是三焦的根本，原气到达的地方，也就是由肾系所生的脂膜。三焦相火的宅邸，火的性质自下而上，所以《素问·经脉别论》说：饮水进入胃中，游溢精气，向上输注于脾，这指的是中焦。脾气散布精微，向上归于肺，这指的是上焦。通调水道，向下输注于膀胱，这指的是下焦。然而讨论上、中、下三焦的气，为什么唯独重视水呢？不知道气是由水所化生的。膀胱中的水，借助吸入的天阳之气，引心火到达下焦，熏蒸化气以上达，成为津液汗液，这是火与水相交化气的道理，也就是干阳进入坤阴，随着阳气上升变为云雨的意义。至于三焦的形质，详见于第二十五难，可以参考互观。
Chapter 30 asks: Does the movement of Ying Qi (Nutritive Qi) always accompany Wei Qi (Defensive Qi)?
The answer is: The classics state that humans derive Qi from food. When food enters the stomach, it is transmitted to the Zang and Fu organs. All Zang and Fu organs receive this Qi. The clear and light portion becomes Ying Qi (Nutritive Qi), while the turbid and heavy portion becomes Wei Qi (Defensive Qi). Ying Qi circulates within the vessels, while Wei Qi circulates outside the vessels. Ying Qi flows ceaselessly, completing fifty cycles before reuniting at the Lung Meridian of Hand-Taiyin. The Yin and Yang meridians interconnect like a circle without beginning or end; thus, we know that Ying Qi and Wei Qi move in concert.
The principles of Ying and Wei circulation were detailed in Chapter 1. This chapter discusses the origin of their ceaseless accompanying movement, which arises from the Grain Qi in the stomach. The clear portion is Ying Qi, the essence of grain flavors, belonging to Yin within Yang. Blood belongs to Ying Qi and moves within the vessels. The turbid portion is Wei Qi, the Qi of grain flavors, belonging to Yang within Yin, also known as the vigorous Qi of Yangming. It transforms into Wei Qi to protect the exterior of the vessels. *Su Wen: Pi Lun* states: "Ying Qi is the essence of water and grain, harmonizing with the five Zang organs and spreading to the six Fu organs, thereby entering the vessels." "Wei Qi is the vigorous Qi of water and grain; its nature is swift and slippery, unable to enter the vessels." This conveys the same meaning. However, this section originates from *Ling Shu: Ying Wei Sheng Hui Pian*. The only slight difference is that *Ling Shu* reads "grain enters the stomach and is transmitted to the lungs," allowing all Zang and Fu organs to receive Qi. Nevertheless, the essence of water and grain in the stomach is absorbed by capillary lymphatic vessels, transported to the jugular convergence, passes through the lungs to enter the heart, turns red to become blood, and nourishes the five Zang and six Fu organs. If the four characters "transmitted to the lungs" are omitted from the meridian text, it violates the principle of Zang-Fu transmission, a matter of significant consequence that cannot be omitted.
Chapter 31 asks: What does the San Jiao (Triple Burner) inherit for its origin? Where does it begin and end? Where is its treatment site usually located? Can this be explained?
The answer is:
The San Jiao (Triple Burner) is the pathway for water and grain and the starting and ending point of Qi. The Upper Jiao (Upper Burner) is located below the heart, beneath the diaphragm, and above the upper opening of the stomach. Its primary function is reception without discharge. Its treatment site is at Danzhong (CV-17), one cun and six fen below Yutang (CV-19), in the depression between the two breasts. The Middle Jiao (Middle Burner) is located at Zhongwan (CV-12) within the stomach, neither high nor low. Its primary function is the rotting and ripening of water and grain. Its treatment site is beside the umbilicus. The Lower Jiao (Lower Burner) is located at the upper opening of the bladder. Its primary function is separating the clear from the turbid, discharging waste without receiving new intake, serving as a conduit. Its treatment site is one cun below the umbilicus. Hence it is called the San Jiao (Triple Burner), and its fu organ connection is at Qijie (Stomach Channel points near the groin).
The previous section listed the five Zang and six Fu organs, which rely on the Nutritive and Defensive Qi derived from water and grain for mutual support; this was the first principle discussed regarding Zang and Fu organs. Here, due to the Qi transformation of the San Jiao (Triple Burner), the principle of its functional manifestation is discussed. The San Jiao (Triple Burner) inherits Yuan Qi (Original Qi) as its beginning and combines with Stomach Qi as its source of generation. It ascends to the chest to exert its function, flowing freely and unceasingly, announcing boundless changes, acting as the passage for water and grain and the cycle of Qi. The Upper Jiao is below the diaphragm because its upper layer adheres to the lower layer of the diaphragm. Its Qi rises from below, disperses in the chest, and distributes via steaming to the skin and interstices. Therefore, it is at the upper opening of the stomach, governing intake without allowing exit. Its treatment site is at Danzhong (CV-17), belonging to the Ren Mai (Conception Vessel), located in the depression one cun and six fen below Yutang (CV-19), where the Qi of the Ren Mai emerges. The Middle Jiao is at Zhongwan (CV-12) within the stomach because it envelops the Liver and Stomach. Its treatment site is Tian Shu (ST-25) beside the umbilicus, an acupoint of the Stomach Meridian. Its function lies in the middle of the stomach; Zhongwan (CV-12) is where the twelve meridians originate and converge, a place of complete Yin and Yang flesh, hence called "Wan" (cavity). The Lower Jiao is at the upper opening of the bladder, specifically the boundary of the Lanmen (Gate of Filth). Presumably, the clear part enters the bladder to become Qi and urine, while the turbid part enters the large intestine to become dregs and feces. Thus, it governs discharge without reception, serving as a conduit. Its treatment site is Yinjiao (CV-7) of the Ren Mai, one cun below the umbilicus. *Su Wen: Ling Lan Mi Dian Lun* states: "The San Jiao (Triple Burner) is the official of drainage; the water pathways emerge from it," referring to this. The location referred to as Qijie is on both sides of the pubic hairline, acupoints of the Foot-Yangming Meridian. It is the root of the San Jiao (Triple Burner) and the destination of Yuan Qi (Original Qi), essentially the fatty membrane generated from the kidney system. The San Jiao (Triple Burner) is the residence of Minister Fire. Since the nature of fire rises from below, *Su Wen: Jing Mai Bie Lun* states: "When drink enters the stomach, its essence overflows and is transported upward to the spleen." This refers to the Middle Jiao. "The Spleen scatters the essence upward to return to the lungs." This refers to the Upper Jiao. "Regulating the water pathways, transporting downward to the bladder." This refers to the Lower Jiao. However, when discussing the Qi of the Upper, Middle, and Lower Jiao, why is emphasis placed solely on water? One must not fail to realize that Qi is transformed from water. Water in the bladder, aided by the Heavenly Yang Qi inhaled, draws Heart Fire down to the Lower Jiao, where steaming transforms it into Qi to ascend, becoming Jin Ye (Body Fluids) and sweat. This is the principle of Fire and Water interacting to transform Qi, analogous to Dryness entering Earth's Yin, rising with Yang Qi to become clouds and rain. As for the physical form of the San Jiao (Triple Burner), it is detailed in Chapter 25 and can be cross-referenced.