也；今言一变具有五脏，方得尽理，故请言故也。）五脏皆小者，少病，善焦心愁忧；（夫五神
以根据脏，故前言心脏之变，神亦随之；次说四脏之变，不言神变；今总论五脏，初有四变，唯言
于神，次有二变，但说于脏，次有二变，复但言神也。心脏形小，外邪难入，故少病；神亦随小，
故不自申焦心愁忧也。平按∶《灵枢》、《甲乙》善均作苦，愁忧上均有大字。注自申，袁刻自
作白。）五脏皆大者，缓于事，难使忧。五脏皆高者，好高举措；（措，置也，旦故反。平按∶
忧上《灵枢》、《甲乙》均有以字。举措正统本《甲乙经》作举指。）五脏皆下者，好出人下。
（意志卑弱。）五
脏皆坚者，无病；五脏皆脆者，不离于病。五脏皆端正者，和利得人；五脏皆偏倾者，邪心喜盗，
不可以为人平，反复言语也。（喜，虚意反，好也。和谓神性和柔，利谓薄于名利，并为人所附
也。平按∶得人下《灵枢》、《甲乙》均有心字，喜盗均作善盗。不可以为人，《甲乙》无以字。
覆《甲乙》作复。）
平按∶此篇自篇首至末，见《灵枢》卷七第四十七《本藏》篇，又见《甲乙经》卷一第五。
黄帝问曰∶愿闻六腑之应。（五脏应候已说于前，六腑之候阙而未论，故次问之。）岐伯答
曰∶肺合大肠，大肠者，皮其应也。心合小肠，小肠者，脉其应也。肝合胆，胆者，筋其应也。脾
合胃，胃者，肉其应也。肾合三焦膀胱，三焦膀胱者，腠理豪毛其应也。（肾合三焦膀胱，故有
五腑也。五脏为阴，合于五腑。五腑为阳，故皮脉筋肉腠理豪毛，五腑候也。平按∶肝合胆，肝字
原缺，谨根据《灵枢》、《甲乙》补。豪《灵枢》、《甲乙》作毫。）黄帝曰∶应之奈何？岐伯答曰∶
肺应皮，皮浓者大肠浓，皮薄者大肠薄。皮缓腹果大者大肠大而长，皮急者大肠急而短。皮滑者
大肠直，皮肉不相离者大肠结。（应，候也。肺以皮为候，肺合大肠，故以其皮候大肠也。结，
纡屈多。平按∶果《灵枢》、《甲乙》作裹。大而长，大字《甲乙》作缓。皮急者大肠急而短《甲
乙》作皮急而短。皮滑，皮字原缺不全，《灵枢》、《甲乙》均作皮，袁刻作外，恐误。）心应
脉，皮浓者脉浓，脉浓者小肠浓；皮薄者脉薄，脉薄者小肠薄。皮
缓者脉缓，脉缓者小肠大而长；皮薄而脉波小者，小肠小而短。（心合于脉，脉在皮中，故得以
皮候脉，脉候小肠也。冲，虚也，脉虚小也。平按∶小肠大而长，小字原缺，谨根据《灵枢》、《甲乙》
补。脉波小者，冲字道藏本《灵枢》作冲。）诸阳经脉皆多纡屈者，小肠结。（诸阳脉，六阳经也。
小肠之脉，太阳也。太阳与诸阳为长，故诸阳经纡屈多者，则知小肠亦纡屈也，纡屈即名为结也。
阳经在于肤不见，候其阳络，即经可知矣。平按∶多字原缺，谨根据《灵枢》、《甲乙》补。注与
诸阳，与字袁刻脱。）脾应肉，肉 坚大者胃浓，肉 么者胃薄。肉 小而么者胃不坚。（脾以
合胃，故以肉 候于胃也。么，小也，莫可反。平按∶么袁刻作縻，注同，《灵枢》、《甲乙》
均作么。）肉 不称其身者胃下，下者下管约不利。肉 不坚者胃缓，（谓 颗累与身大小不相
称也。胃下逼于下管，故便溲不利。平按∶管《甲乙》作脘。下管约《甲乙》注云∶《太素》作下
脘未约。）肉 无小果累者胃急。肉 多小累者，胃结者胃上管约不利。（果音颗，谓肉 无小
颗段连累。平按∶果《灵枢》、《甲乙》作裹。小果累下《甲乙》有标紧二字。多小累《灵枢》
作多少裹累。胃结二字《灵枢》、《甲乙》重。）肝应爪，爪浓色黄者胆浓，爪薄者胆薄。爪坚
者胆急，爪濡者胆缓。（肝以合胆，胆以应筋，爪为筋余，故以爪候胆也。平按∶应爪《甲乙》
作应筋。爪薄、爪坚、爪濡下《灵枢》、《甲乙》有色红、色青、色赤等字。）爪无弱者胆直，
（无弱，强也。爪强，胆直也。平按∶无弱者《灵枢》、《甲乙》作直色白无约者。）爪恶色多
败者胆结。（人之爪甲色不得明净，又多好破坏者，其人胆纡屈结也。平按∶多败二字，《灵枢》
作黑多纹三字《甲乙》作黑多文三字。）肾应骨，密理浓皮者三焦膀胱浓，粗理薄皮者三
焦膀胱薄。腠理疏者三焦膀胱缓，急皮而无豪毛者三焦膀胱急。豪毛美而粗者三焦膀胱直，希豪
毛者三焦膀胱结。（肾以应骨，骨应三焦膀胱，三焦膀胱气发腠理，故以腠理候三焦膀胱也。三焦
之气如雾沤沟渎，与膀胱水腑是同，故合为一腑也。腠理豪毛在皮，故亦以皮之豪毛为候也。平
按∶腠理疏《灵枢》作疏腠理。急皮二字《灵枢》、《甲乙》均作皮急，希均作稀。）黄帝曰∶
薄浓美恶皆有形，愿闻其所病。（已闻六腑美恶之形，然未知美恶生病何如。平按∶薄浓《灵枢》
作浓薄。形上《甲乙》有其字。）岐伯曰∶各视其所外应，以知其五内，则知其所病矣。（各视
外候，则知所生病矣。平按∶各字《灵枢》无。所外应，所字《灵枢》、《甲乙》无。）
（……）现在说一种变化就具备五脏的情况，才能穷尽事理，所以请让我说明原因。）五脏都小的，很少生病，但容易焦心愁忧；（五神依附于五脏，所以前面论述心脏的变化时，神也随之变化；接着论述其他四脏的变化，没有提及神的改变；现在总论五脏，起初有四种变化，只谈论神，接着有两种变化，只谈论脏，再有两种变化，又只谈论神。心脏形态小，外邪难以侵入，所以很少生病；神也随着变小，所以不能自我舒展，表现为焦心愁忧。平按：《灵枢》、《甲乙经》中“善”均作“苦”，“愁忧”上均有“大”字。注中“自申”，袁刻本作“白”。）五脏都大的，处事迟缓，难以使其忧愁。五脏都高的，喜好高远的举措；（措，放置的意思，旦故反切音。平按：“忧”上《灵枢》、《甲乙经》均有“以”字。“举措”正统本《甲乙经》作“举指”。）五脏都低的，喜好处于人下。（意志卑弱。）五脏都坚实的，不生病；五脏都脆弱的，离不开疾病。五脏都端正的，性情和顺有利，受人喜爱；五脏都偏倾的，心存邪念喜欢偷盗，不可以作为公正之人，言语反复无常。（喜，虚意反切音，意为喜好。和谓神性和柔，利谓淡泊名利，并为人所依附。平按：“得人”下《灵枢》、《甲乙经》均有“心”字，“喜盗”均作“善盗”。“不可以为人”，《甲乙经》无“以”字。“覆”《甲乙经》作“复”。）
平按：此篇从篇首到末尾，见于《灵枢》卷七第四十七《本藏》篇，又见于《甲乙经》卷一第五。黄帝问道：希望听闻六腑的外应表现。（五脏应候已经在前文说过，六腑的应候缺失而未论述，所以接着询问。）岐伯回答说：肺合大肠，大肠的外应在于皮肤。心合小肠，小肠的外应在于脉。肝合胆，胆的外应在于筋。脾合胃，胃的外应在于肉。肾合三焦膀胱，三焦膀胱的外应在于腠理毫毛。（肾合三焦膀胱，所以有五腑。五脏为阴，合于五腑。五腑为阳，所以皮、脉、筋、肉、腠理、毫毛，是五腑的应候。平按：原文“肝合胆”缺“肝”字，谨根据《灵枢》、《甲乙经》补入。“豪”《灵枢》、《甲乙经》作“毫”。）黄帝说：如何对应？岐伯回答说：肺应于皮，皮肤厚的，大肠也厚；皮肤薄的，大肠也薄。皮肤松弛且腹部宽大的，大肠大而长；皮肤紧张的，大肠急而短。皮肤滑润的，大肠直；皮肉紧密相连不相分离的，大肠结曲。（应，即候。肺以皮为候，肺合大肠，所以通过皮来候大肠。结，纡屈多。平按：“果”《灵枢》、《甲乙经》作“裹”。“大而长”，“大”字《甲乙经》作“缓”。“皮急者大肠急而短”，《甲乙经》作“皮急而短”。“皮滑”，“皮”字原缺不全，《灵枢》、《甲乙经》均作“皮”，袁刻作“外”，恐怕有误。）心应于脉，皮肤厚的，脉也厚，脉厚的，小肠也厚；皮肤薄的，脉也薄，脉薄的，小肠也薄。皮肤松弛的，脉也缓，脉缓的，小肠大而长；皮肤薄而脉细弱的，小肠小而短。（心合于脉，脉在皮中，所以可以通过皮来候脉，通过脉来候小肠。冲，虚也，脉虚小。平按：“小肠大而长”，“小”字原缺，谨根据《灵枢》、《甲乙经》补入。“脉波小者”，“波”字道藏本《灵枢》作“冲”。）诸阳经脉大多纡屈的，小肠结曲。（诸阳脉，指六条阳经。小肠之脉属于太阳经。太阳经与诸阳经相比最长，所以诸阳经纡屈多的，就知道小肠也纡屈，纡屈就叫做结。阳经在肤表看不见，观察其阳络，就可以知道经脉情况了。平按：“多”字原缺，谨根据《灵枢》、《甲乙经》补入。注中“与诸阳”，“与”字袁刻脱漏。）脾应于肉，肌肉坚实丰隆的，胃也厚；肌肉细小的，胃也薄。肌肉细小且瘦弱的，胃不坚实。（脾合胃，所以通过肉来候胃。么，小也，莫可反切音。平按：“么”袁刻作“縻”，注同，《灵枢》、《甲乙经》均作“么”。）肌肉与身体不相称的，胃下垂，胃下垂则下脘约束不利。肌肉不坚的，胃弛缓，（谓肌肉颗粒累赘与身体大小不相称。胃下垂压迫下脘，所以二便不利。平按：“管”《甲乙经》作“脘”。“下管约”，《甲乙经》注云：《太素》作“下脘未约”。）肌肉没有小结节的，胃急迫。肌肉多有小结节的，胃结曲，胃上脘约束不利。（果音颗，谓肌肉没有小结节段连累。平按：“果”《灵枢》、《甲乙经》作“裹”。“小果累”下《甲乙经》有“标紧”二字。“多小累”《灵枢》作“多少裹累”。“胃结”二字《灵枢》、《甲乙经》重出。）肝应于爪，指甲厚色黄的，胆也厚；指甲薄的，胆也薄。指甲坚硬的，胆急迫；指甲柔软的，胆弛缓。（肝合胆，胆应于筋，爪为筋之余，所以通过爪来候胆。平按：“应爪”《甲乙经》作“应筋”。“爪薄”、“爪坚”、“爪濡”下《灵枢》、《甲乙经》有“色红”、“色青”、“色赤”等字。）指甲没有软弱的，胆正直，（无弱，即强。指甲强，胆直。平按：“无弱者”《灵枢》、《甲乙经》作“直色白无约者”。）指甲恶劣颜色多败坏的，胆结曲。（人的指甲颜色不得明净，又多喜好破坏的，其人胆纡屈结曲。平按：“多败”二字，《灵枢》作“黑多纹”三字，《甲乙经》作“黑多文”三字。）肾应于骨，纹理致密皮肤厚的，三焦膀胱也厚；纹理粗糙皮肤薄的，三焦膀胱也薄。腠理疏松的，三焦膀胱弛缓；皮肤紧张而没有毫毛的，三焦膀胱急迫。毫毛美而粗的，三焦膀胱正直；毫毛稀少的，三焦膀胱结曲。（肾应于骨，骨应于三焦膀胱，三焦膀胱之气发于腠理，所以通过腠理来候三焦膀胱。三焦之气如雾如沤如沟渎，与膀胱水腑相同，所以合为一腑。腠理毫毛在皮中，所以也以皮的毫毛为候。平按：“腠理疏”《灵枢》作“疏腠理”。“急皮”二字《灵枢》、《甲乙经》均作“皮急”，“希”均作“稀”。）黄帝说：薄厚美恶都有形征，希望听闻它们所导致的疾病。（已听闻六腑美恶的形征，然而不知道美恶生病如何。平按：“薄浓”《灵枢》作“浓薄”。“形”上《甲乙经》有“其”字。）岐伯说：各自观察其外应的表现，从而了解内脏，就知道它们所患的疾病了。（各自观察外候，就知道所患的疾病了。平按：“各”字《灵枢》无。“所外应”，“所”字《灵枢》、《甲乙经》无。）
(... ) Now, stating that one variation encompasses all five Zang organs allows for a complete understanding of the principles; therefore, I request to explain the reasoning. (When) all five Zang organs are small, the person is prone to few illnesses but suffers from anxiety and sorrow; (The Five Spirits reside within the Zang organs; thus, in the previous discussion on the Heart's variations, the Spirit also changed accordingly; subsequently, when discussing the variations of the other four Zang organs, no mention was made of spiritual changes; now, summarizing the five Zang organs, initially there were four variations discussed only regarding the Spirit, followed by two variations discussed only regarding the Zang organs themselves, and then another two variations again discussed only regarding the Spirit. The Heart's form is small, making it difficult for external pathogens to enter, hence few illnesses occur; the Spirit, being small as well, cannot express itself freely, resulting in anxiety and sorrow. Ping An: In *Ling Shu* and *Jia Yi Jing*, "shan" (good/often) is written as "ku" (bitter/suffer), and "da" (big) appears before "chou you" (sorrow). Note: "zi shen" (self-express) in Yuan edition is printed as "bai".) When all five Zang organs are large, the person is slow in handling affairs and difficult to make anxious. When all five Zang organs are high, the person prefers lofty actions; ("Cuo" means to place, pronounced with the fanqie of dan and gu.) Ping An: Before "you" (sorrow), *Ling Shu* and *Jia Yi Jing* both have the character "yi". "Ju cuo" (actions/measures) in the orthodox version of *Jia Yi Jing* is written as "ju zhi".) When all five Zang organs are low, the person prefers to be below others. (Willpower is humble and weak.) When all five Zang organs are firm, there are no illnesses; when all five Zang organs are fragile, illness is constant. When all five Zang organs are upright, the person is harmonious, advantageous, and likable; when all five Zang organs are tilted, the person harbors evil thoughts, likes stealing, cannot serve as an impartial person, and speaks inconsistently. ("Xi" is pronounced with the fanqie of xu and yi, meaning to like. "He" refers to a gentle and soft nature of the Spirit; "Li" refers to being detached from fame and profit, and being attached to by others. Ping An: After "de ren" (gain people's favor), *Ling Shu* and *Jia Yi Jing* both have the character "xin" (heart). "Xi dao" (like stealing) is written as "shan dao" (good at stealing) in both texts. "Bu ke yi wei ren" (cannot be a person) in *Jia Yi Jing* lacks the character "yi". "Fu" (repeat) in *Jia Yi Jing* is written as "fu".)
Ping An: This section, from the beginning to the end of this chapter, can be found in Volume 7, Chapter 47 "Ben Cang" of *Ling Shu*, and also in Volume 1, Chapter 5 of *Jia Yi Jing*. The Yellow Emperor asked: I wish to hear about the external manifestations of the Six Fu organs. (The external manifestations of the five Zang organs have been discussed previously; the manifestations of the six Fu organs were missing and not discussed, so I ask next.) Qi Bo replied: The Lung combines with the Large Intestine; the Large Intestine corresponds to the skin. The Heart combines with the Small Intestine; the Small Intestine corresponds to the vessels. The Liver combines with the Gallbladder; the Gallbladder corresponds to the tendons. The Spleen combines with the Stomach; the Stomach corresponds to the flesh. The Kidney combines with the San Jiao and Bladder; the San Jiao and Bladder correspond to the interstices and body hair. (The Kidney combines with the San Jiao and Bladder, hence there are five Fu organs. The five Zang organs are Yin and combine with the five Fu organs. The five Fu organs are Yang; thus, the skin, vessels, tendons, flesh, interstices, and body hair are the manifestations of the five Fu organs. Ping An: The character "Gan" (Liver) is missing in the original text after "Gan he Dan"; it has been supplemented according to *Ling Shu* and *Jia Yi Jing*. "Hao" (body hair) in *Ling Shu* and *Jia Yi Jing* is written as "Hao".) The Yellow Emperor said: How do they correspond? Qi Bo replied: The Lung corresponds to the skin. Thick skin indicates a thick Large Intestine; thin skin indicates a thin Large Intestine. Loose skin with a broad abdomen indicates a large and long Large Intestine; tight skin indicates a tense and short Large Intestine. Smooth skin indicates a straight Large Intestine; skin and flesh closely adhered without separation indicate a knotted Large Intestine. ("Ying" means manifestation. The Lung manifests through the skin; since the Lung combines with the Large Intestine, the skin is used to observe the Large Intestine. "Jie" means knotted or tortuous. Ping An: "Guo" in *Ling Shu* and *Jia Yi Jing* is written as "Guo". In "Da er chang" (large and long), the character "Da" in *Jia Yi Jing* is written as "Huan". "Pi ji zhe Da chang ji er duan" (Tight skin means tense and short Large Intestine) in *Jia Yi Jing* is written as "Pi ji er duan". For "Pi hua" (smooth skin), the character "Pi" is originally incomplete; both *Ling Shu* and *Jia Yi Jing* write "Pi", while the Yuan edition writes "Wai", which is likely incorrect.) The Heart corresponds to the vessels. Thick skin indicates thick vessels; thick vessels indicate a thick Small Intestine; thin skin indicates thin vessels; thin vessels indicate a thin Small Intestine. Loose skin indicates loose vessels; loose vessels indicate a large and long Small Intestine; thin skin and weak vessels indicate a small and short Small Intestine. (The Heart combines with the vessels, and the vessels lie within the skin; thus, the skin is used to observe the vessels, and the vessels are used to observe the Small Intestine. "Chong" means empty; the vessels are empty and small. Ping An: In "Xiao chang da er chang" (Small intestine large and long), the character "Xiao" is originally missing and has been supplemented according to *Ling Shu* and *Jia Yi Jing*. In "Mai bo xiao zhe" (Vessels wave/small), the character "Bo" in the Daozang edition of *Ling Shu* is written as "Chong".) When all Yang meridians are mostly tortuous, the Small Intestine is knotted. (All Yang meridians refer to the six Yang meridians. The meridian of the Small Intestine belongs to the Taiyang channel. Among the Yang meridians, the Taiyang is the longest; thus, if the Yang meridians are mostly tortuous, it can be known that the Small Intestine is also tortuous; tortuous is called knotted. Yang meridians are not visible on the surface; observing their Yang collaterals reveals the state of the meridians. Ping An: The character "Duo" (many) is originally missing and has been supplemented according to *Ling Shu* and *Jia Yi Jing*. In the note "Yu zhu yang" (with the Yang meridians), the character "Yu" is omitted in the Yuan edition.) The Spleen corresponds to the flesh. Firm and abundant flesh indicates a thick Stomach; fine flesh indicates a thin Stomach. Small and fine flesh indicates an unfirm Stomach. (The Spleen combines with the Stomach; thus, the flesh is used to observe the Stomach. "Me" means small, pronounced with the fanqie of mo and ke. Ping An: "Me" in the Yuan edition is written as "Mi", same as the note; both *Ling Shu* and *Jia Yi Jing* write "Me".) Flesh that does not match the body size indicates a dropped Stomach; a dropped Stomach leads to dysfunction of the lower Wan (opening). Unfirm flesh indicates a relaxed Stomach. (Refers to muscle nodules being disproportionate to the body size. A dropped Stomach presses on the lower Wan, causing difficulty in urination and defecation. Ping An: "Guan" in *Jia Yi Jing* is written as "Wan". "Xia guan yue" (Lower Guan constraint) in *Jia Yi Jing* note says: *Tai Su* writes "Xia Wan Wei Yue" (Lower Wan not constrained).) Flesh without small nodules indicates a tense Stomach. Flesh with many small nodules indicates a knotted Stomach; a knotted Stomach leads to dysfunction of the upper Wan (opening). ("Guo" sounds like "Ke", referring to flesh lacking small nodule segments. Ping An: "Guo" in *Ling Shu* and *Jia Yi Jing* is written as "Guo". After "Xiao guo lei" (small nodule accumulation), *Jia Yi Jing* has the characters "Biao jin" (tight binding). "Duo xiao lei" (many small accumulations) in *Ling Shu* is written as "Duo shao guo lei". The characters "Wei jie" (Stomach knotted) are repeated in *Ling Shu* and *Jia Yi Jing*.) The Liver corresponds to the nails. Thick nails with yellow color indicate a thick Gallbladder; thin nails indicate a thin Gallbladder. Hard nails indicate a tense Gallbladder; soft nails indicate a relaxed Gallbladder. (The Liver combines with the Gallbladder; the Gallbladder corresponds to the tendons; nails are the surplus of tendons; thus, the nails are used to observe the Gallbladder. Ping An: "Ying zhua" (Corresponds to nails) in *Jia Yi Jing* is written as "Ying jin" (Corresponds to tendons). After "Zhua bo" (thin nails), "Zhua jian" (hard nails), and "Zhua ru" (soft nails), *Ling Shu* and *Jia Yi Jing* add characters like "Se hong" (red color), "Se qing" (green/blue color), "Se chi" (red color).) Nails without weakness indicate a straight Gallbladder, (No weakness means strength. Strong nails mean a straight Gallbladder. Ping An: "Wu ruo zhe" (Those without weakness) in *Ling Shu* and *Jia Yi Jing* is written as "Zhi se bai wu yue zhe" (Straight white color without constraint).) Nails that are ugly and often damaged indicate a knotted Gallbladder. (If a person's nail color is not clear and pure, and they are prone to damage, their Gallbladder is tortuous and knotted. Ping An: The two characters "Duo bai" (many damages) in *Ling Shu* are written as "Hei duo wen" (black many lines), and in *Jia Yi Jing* as "Hei duo wen" (black many patterns).) The Kidney corresponds to the bones. Dense texture and thick skin indicate a thick San Jiao and Bladder; coarse texture and thin skin indicate a thin San Jiao and Bladder. Loose interstices indicate a relaxed San Jiao and Bladder; tight skin without body hair indicates a tense San Jiao and Bladder. Beautiful and coarse body hair indicates a straight San Jiao and Bladder; sparse body hair indicates a knotted San Jiao and Bladder. (The Kidney corresponds to the bones; bones correspond to the San Jiao and Bladder; the Qi of the San Jiao and Bladder emerges from the interstices; thus, the interstices are used to observe the San Jiao and Bladder. The Qi of the San Jiao is like mist, like fermentation, like ditches, and is identical to the Water Fu organ of the Bladder; hence, they are combined into one Fu organ. Interstices and body hair are in the skin; thus, the body hair of the skin is also used as an indicator. Ping An: "Cou li shu" (Loose interstices) in *Ling Shu* is written as "Shu cou li". "Ji pi" (Tight skin) in *Ling Shu* and *Jia Yi Jing* is written as "Pi ji". "Xi" (Sparse) is written as "Xi".) The Yellow Emperor said: Thinness, thickness, beauty, and ugliness all have forms; I wish to hear about the diseases they cause. (I have heard of the beautiful and ugly forms of the six Fu organs, but do not yet know how these conditions lead to disease. Ping An: "Bo nong" (Thin thick) in *Ling Shu* is written as "Nong bo". Before "Xing" (form), *Jia Yi Jing* has the character "Qi".) Qi Bo said: Observe each external manifestation to understand the internal organs, and you will know the diseases they suffer from. (By observing the external manifestations, one knows the diseases suffered. Ping An: The character "Ge" (Each) is absent in *Ling Shu*. In "Suo wai ying" (What corresponds externally), the character "Suo" is absent in *Ling Shu* and *Jia Yi Jing*.)