平按∶此篇自篇首至故中年而寿尽矣，见《灵枢》卷八第五十四《天年》篇。自黄帝曰其气盛衰
至末，见
《甲乙经》卷六第十二。自黄帝问于岐伯曰人年老而无子者至末，见《素问》卷一第一《上古天真
论》。
黄帝曰∶人之夭寿各不同，或夭，或寿，或卒死，或病久，愿闻其道。（问有四意∶夭，寿，卒
死，病久。平按∶《灵枢》人之夭寿作人之寿夭，或夭或寿作或夭寿。）岐伯曰∶（答中答其得寿，
余三略之。得寿有九∶）五脏坚固，（谓五脏形，坚而不虚，固而不变，得寿一也。）血脉和调，（谓
血常和，脉常调，得寿二也。）肌肉解利，（谓外肌肉肉，各有分利，得寿三。平按∶注上肉字恐是
内字之误。）皮肤致密，（致，大利反。谓皮腠闭密，肌肤致实，得寿四。）营卫之行，不失其常，
（谓营卫气，一日一夜，各循其道，行五十周，营卫其身，而无错失，得寿五。）呼吸微徐，（谓吐
纳气，微微不粗，徐徐不疾，得寿六。）气以度行，（呼吸定息，气行六寸，以循度数，日夜百刻，
得寿七。）六腑化谷，（胃受五谷，小肠盛受，大肠传导，胆为中精决，三焦司决渎，膀胱主津液，
共化五谷，以奉生身，得寿八。）津液布扬，（所谓泣汗涎涕唾等，布扬诸窍，得寿九也。平按∶注
涎袁刻作液。）各如其常，故能久长。（上之九种营身之事，各各无失，守常不已，故得寿命长生久
视也。平按∶久长《灵枢》作长久。）黄帝曰∶人之寿百岁而死者，何以致之？（问其得寿所由。）
岐伯曰∶使道隧以长，（谓有四事得寿命长∶使道谓是鼻空使气之道，隧以长，出气不壅，为寿一也。）
基墙高以方，（鼻之明堂，墙基高硕方正，为寿二也。）通调营卫，三部三里，（三部，谓三焦部也。
三里，谓是膝下三里，胃脉者也。三焦三里，皆得通调，为寿三。）起骨高肉满，百岁乃得终也。
（起骨，谓是明堂之骨。明堂之骨，高硕肉满，则骨肉坚实，为寿四也。由是四事，遂得百岁终也。）
黄帝曰∶其不能终寿而死者，何如？（问其夭死。平按∶《灵枢》自黄帝曰其不能终寿而死者至故中
年而寿尽
矣一段，叙次在形骸独居而终矣之后。）岐伯曰∶其五脏皆不坚，（夭者亦四∶五脏皆虚，易受邪
伤，为夭一也。）使道不长，空外以张，喘息暴疾，（使道短促，鼻空又大，泄气复多，为夭二也。
平按∶不长袁刻作不通，根据原抄更正，《灵枢》亦作不长。）又卑基墙，（鼻之明堂，基墙卑下，为
夭三也。）薄脉少血，其肉不实，数中风，血气不通，真邪相攻，乱而相引，（脉小血少，皮肉皆虚，
多中外邪，血气壅塞，真邪相攻，引乱真气，为夭四。平按∶《灵枢》不实作不石，中风作中风寒。）
故中年而寿尽矣。黄帝曰∶善。（黄帝闻夭寿之所由，故赞述之也。平按∶故中年而寿尽矣《灵枢》
作故中寿而尽也。）
黄帝曰∶其气之盛衰，以至其死，可得闻乎？（消息盈虚，物化之常，故人气衰，时时改变，以
至于死地，各不同形，故请陈之也。）岐伯曰∶人生十岁，五脏始定，血气已通，其气在下，故好走。
二十岁，血气始盛，肌肉方长，故好趋。三十岁，五脏大定，肌肉坚固，血脉盛满，故好步。四十岁，
五脏六腑十二经脉，皆大盛以平定，腠理始疏，荣华颓落，发鬓颁白，平盛不摇，故好坐。（血，营
血也。气，卫气也。大盛，内盛也。始疏，外衰。平按∶《甲乙经》人生作人年，始疏作始开，颓落
作剥落，发鬓作鬓发。《灵枢》鬓作颇，颁作斑。又按∶原抄平盛不摇，平字旁有丕彼悲反大也六字，
疑平盛应作丕盛，别本作丕。）五十岁，肝气始衰，肝叶始薄，胆汁始减，目始不明。六十岁，心气
始衰，喜忧悲，血气懈惰，故好卧。七十岁，脾气虚，皮肤枯。八十岁，肺气衰，魄离，魄离故言喜
误。九十岁，肾气焦，脏枯，经脉空虚。百岁，五脏皆虚，神气皆去，形骸独居而终矣。（肝为木，
心为火，脾为土，
肺为金，肾为水，此为五行相生次第，故先肝衰次第至肾也。至于百岁，五脏虚坏，五神皆去，枯
骸独居，称为死也。平按∶始减《灵枢》作始灭。喜忧悲《灵枢》作苦忧悲，《甲乙经》作乃善忧悲。
又《甲乙经》惰作堕，皮肤枯作皮肤始枯故四肢不举。魄离二字《灵枢》不重，《甲乙经》作魂离魄
散。喜误《灵枢》、《甲乙经》均作善误。脏枯《甲乙经》作脏萎枯，《灵枢》脏上有四字，下无
枯字。又《甲乙经》百岁上有至字，终下有尽字。）
黄帝问于岐伯曰∶人年老而无子者，材力尽邪？将天数然？（材力，摄养之力也。天数，天命之
数也。平按∶《甲乙经》无此一段及下岐伯曰三字。）岐伯曰∶女子七岁，肾气盛，更齿发长。（肾
主骨发，故肾气盛，更齿发长。平按∶更齿《素问》、《甲乙经》均作齿更。）二七而天癸至，任脉
通，伏冲脉盛，月事以时下，故有子。（天癸，精气也。任冲脉起于胞中下极者也，今天癸至，故任
脉通也，伏冲之脉起于气街，又天癸至，故冲脉盛也。二脉并营子胞，故月事来以有子也。平按∶天
癸《甲乙经》作天水，下同。伏冲《素问》作太冲，新校正云∶《太素》作伏冲，下同。与此正合。）
三七，肾气平均，故真牙生而长极。（真牙，后牙也。长极，身长也。）四七，筋骨坚，发长极，身
体盛壮。（身之筋骨体发，无不盛极。）五七，阳明脉衰，面始焦，发始惰。（阳明脉起于面，行于
头，故阳明衰，面与发始焦落。平按∶始焦《甲乙经》作皆焦，惰作白，《素问》作堕。）六七，三阳
脉衰于上，面皆焦，发白。（三阳，太阳、少阳、阳明也。三阳脉俱在头，故三阳衰，面焦发白。平
按∶发白《素问》作发始白。《甲乙经》无此一段。）七七，任脉虚，伏冲衰少，天癸竭，地道不
通，故形坏而无子。（任冲二脉气血俱少，精气尽，子门闭，子宫坏，故无子。平按∶伏冲衰少《素
问》、
《甲乙经》作太冲脉衰少。）丈夫年八岁，肾气实，发长齿更。二八，肾气盛，天癸至，精气溢泻，
阴阳和，故能有子。三八，肾气平均，筋骨劲强，故真牙生而长极。四八，筋骨隆盛，肌肉满。五八，
肾气衰，发惰齿 。六八，阳气衰于上，面焦，鬓发颁白。七八，肝气衰，筋不能动，天癸竭，精少，
肾脏衰，形体皆极。八八，则齿发去。（齿 者，骨先衰，肉不附，故令齿枯也。平按∶写《甲乙经》
作泻，下同。肌肉满《素问》、《甲乙经》均作肌肉满壮。阳气衰于上《素问》作阳气衰竭于上。肾
脏衰《甲乙经》作肾气衰。）肾者生水，受五脏六腑之精而藏之，故五脏盛乃泻。今五脏皆衰，（平按∶
《素问》、《甲乙经》生水均作主水，乃泻均作乃能泻。以下据《素问·上古天真论》及《甲乙经·
形气盛衰大论》补入。）筋骨解堕，天癸尽矣，故发鬓白，身体重，行步不正，而无子耳。
【平按】：本篇从篇首至“故中年而寿尽矣”，见于《灵枢》卷八第五十四《天年》篇。从“黄帝曰其气盛衰”至末尾，见于《甲乙经》卷六第十二。从“黄帝问于岐伯曰人年老而无子者”至末尾，见于《素问》卷一第一《上古天真论》。
黄帝说：人的夭折与长寿各不相同，有的早逝，有的长寿，有的突然死亡，有的久病不愈，我希望听您讲讲其中的道理。（此处提问包含四层意思：夭、寿、卒死、病久。平按：《灵枢》中作“人之寿夭”，“或夭或寿”作“或夭寿”。）
岐伯说：（回答中主要阐述了获得长寿的原因，其余三种情况略述。获得长寿有九种表现：）五脏坚固，（指五脏的形体，坚实而不虚弱，稳固而不改变，这是得寿的第一点。）血脉和调，（指血液常和谐，脉道常通畅，这是得寿的第二点。）肌肉解利，（指体表的肌肉，各有分理且滑利，这是得寿的第三点。平按：注文中上面的“肉”字恐怕是“内”字的误写。）皮肤致密，（致，音大利反。指皮腠闭合严密，肌肤坚实，这是得寿的第四点。）营卫之行，不失其常，（指营气和卫气，一日一夜，各自循行其道，运行五十周次，护卫身体，而没有错失，这是得寿的第五点。）呼吸微徐，（指吐纳气息，微微不粗重，徐徐不急疾，这是得寿的第六点。）气以度行，（呼吸定息之间，气行六寸，遵循度数，日夜百刻，这是得寿的第七点。）六腑化谷，（胃受纳五谷，小肠承受，大肠传导，胆为中精之府决断，三焦司职决渎，膀胱主司津液，共同消化五谷，以供养生命身体，这是得寿的第八点。）津液布扬，（所谓泪、汗、涎、涕、唾等，布散宣扬于诸窍，这是得寿的第九点。平按：注文中“涎”后的“袁刻”本作“液”。）各如其常，故能久长。（以上九种滋养身体的事情，各自没有失误，坚守常态不停止，所以能得到寿命长生久视。平按：“久长”在《灵枢》中作“长久”。）
黄帝说：人活到百岁而死的人，是什么使他们达到这样的？（询问获得长寿的原因。）
岐伯说：使道深邃而长，（指有四件事使人寿命长：使道指的是鼻孔中通气道的地方，深邃而长，呼气不壅塞，这是长寿的第一点。）基墙高以方，（鼻部的明堂，墙基高硕方正，这是长寿的第二点。）通调营卫，三部三里，（三部，指三焦的部位。三里，指膝下的三里穴，是胃经的脉位。三焦和三里，都得到通调，这是长寿的第三点。）起骨高肉满，百岁乃得终也。（起骨，指明堂的骨骼。明堂的骨骼，高硕肉满，则骨肉坚实，这是长寿的第四点。由于这四件事，于是得以活到百岁终老。）
黄帝说：那些不能终享天年而死的人，是什么样的？（询问夭折死亡的原因。平按：《灵枢》从“黄帝曰其不能终寿而死者”至“故中年而寿尽矣”这一段，叙述顺序在“形骸独居而终矣”之后。）
岐伯说：他们的五脏都不坚固，（夭折也有四点：五脏都虚弱，容易受邪气伤害，这是夭折的第一点。）使道不长，空外以张，喘息暴疾，（使道短促，鼻孔又大，泄气又多，这是夭折的第二点。平按：“不长”在袁本、刻本中作“不通”，根据原抄本更正，《灵枢》也作“不长”。）又卑基墙，（鼻部的明堂，基墙低矮，这是夭折的第三点。）薄脉少血，其肉不实，数中风，血气不通，真邪相攻，乱而相引，（脉小血少，皮肉皆虚，多次感受风邪，血气壅塞，真气与邪气相互攻击，扰乱并牵引真气，这是夭折的第四点。平按：《灵枢》中“不实”作“不石”，“中风”作“中风寒”。）所以中年就寿尽了。
黄帝说：好。（黄帝听闻了夭折与长寿的原因，所以加以赞许阐述。平按：“故中年而寿尽矣”在《灵枢》中作“故中寿而尽也”。）
黄帝说：人体气的盛衰，以至于死亡，可以讲给我听吗？（消息盈虚，是万物变化的常态，所以人气衰退，时时改变，以至于到达死亡之地，形态各不相同，所以请陈述它。）
岐伯说：人十岁时，五脏始定，血气已通，其气在下，所以喜欢跑。二十岁时，血气开始旺盛，肌肉刚刚长成，所以喜欢快走。三十岁时，五脏大大安定，肌肉坚固，血脉盛满，所以喜欢步行。四十岁时，五脏六腑十二经脉，都盛大而平稳，腠理开始疏阔，荣华颓落，两鬓斑白，平盛不摇（平按：《甲乙经》中“人生”作“人年”，“始疏”作“始开”，“颓落”作“剥落”，“发鬓”作“鬓发”。《灵枢》中“鬓”作“颇”，“颁”作“斑”。另外按：原抄本“平盛不摇”，“平”字旁有“丕彼悲反大也”六字，怀疑“平盛”应作“丕盛”，别本作“丕”。），所以喜欢坐。五十岁时，肝气开始衰退，肝叶开始变薄，胆汁开始减少，眼睛开始不明亮。六十岁时，心气开始衰退，易喜忧悲，血气懈惰，所以喜欢躺卧。七十岁时，脾气虚，皮肤枯槁。八十岁时，肺气衰退，魄离散，魄离散所以说话喜欢出错。九十岁时，肾气枯竭，脏腑干枯，经脉空虚。一百岁时，五脏都虚弱，神气都离去，形骸独自存在而终老。（肝属木，心属火，脾属土，肺属金，肾属水，这是五行相生的次序，所以先肝衰依次至肾。至于百岁，五脏虚坏，五神都离去，枯骸独存，称为死亡。平按：“始减”在《灵枢》中作“始灭”。“喜忧悲”在《灵枢》中作“苦忧悲”，《甲乙经》作“乃善忧悲”。另外《甲乙经》中“惰”作“堕”，“皮肤枯”作“皮肤始枯故四肢不举”。“魄离”二字《灵枢》不重复，《甲乙经》作“魂离魄散”。“喜误”在《灵枢》、《甲乙经》中均作“善误”。“脏枯”在《甲乙经》中作“脏萎枯”，《灵枢》“脏”上有四字，下无“枯”字。另外《甲乙经》在“百岁”上有“至”字，“终”下有“尽”字。）
黄帝问岐伯说：人年老而没有子女，是精力耗尽了呢？还是天命如此？（材力，指摄养的精力。天数，指天命的定数。平按：《甲乙经》没有这一段及下面的“岐伯曰”三字。）
岐伯说：女子七岁，肾气盛，换牙头发长。（肾主骨发，所以肾气盛，换牙头发长。平按：“更齿”在《素问》、《甲乙经》中均作“齿更”。）二七（十四岁）时天癸至，任脉通，伏冲脉盛，月经按时来潮，所以能生育。（天癸，指精气。任冲脉起于胞宫下极处，现在天癸至，所以任脉通。伏冲之脉起于气街，加上天癸至，所以冲脉盛。这两条脉共同营养于胞宫，所以月经来潮而有子。平按：“天癸”在《甲乙经》中作“天水”，下同。“伏冲”在《素问》中作“太冲”，新校正云：《太素》作“伏冲”，下同。与此正合。）三七（二十一岁），肾气平均，所以智齿生长而身高长到极点。（真牙，指后牙。长极，指身长。）四七（二十八岁），筋骨坚，发长到极点，身体盛壮。（身体的筋骨体发，无不盛极。）五七（三十五岁），阳明脉衰，面部开始憔悴，头发开始脱落。（阳明脉起于面部，行于头部，所以阳明衰，面与发开始焦落。平按：“始焦”在《甲乙经》中作“皆焦”，“惰”作“白”，《素问》作“堕”。）六七（四十二岁），三阳脉衰于上，面部皆憔悴，头发变白。（三阳，指太阳、少阳、阳明。三阳脉都在头部，所以三阳衰，面焦发白。平按：“发白”在《素问》中作“发始白”。《甲乙经》没有这一段。）七七（四十九岁），任脉虚，伏冲衰少，天癸竭，地道不通，所以形体败坏而不能生育。（任冲二脉气血俱少，精气尽，子门闭，子宫坏，所以无子。平按：“伏冲衰少”在《素问》、《甲乙经》中作“太冲脉衰少”。）
男子八岁，肾气实，头发长牙齿换。二八（十六岁），肾气盛，天癸至，精气溢泻，阴阳调和，所以能有子。三八（二十四岁），肾气平均，筋骨劲强，所以智齿生长而身高长到极点。四八（三十二岁），筋骨隆盛，肌肉满壮。五八（四十岁），肾气衰，头发脱落牙齿枯槁。六八（四十八岁），阳气衰于上，面部憔悴，两鬓斑白。七八（五十六岁），肝气衰，筋不能动，天癸竭，精少，肾脏衰，形体皆极。八八（六十四岁），则牙齿头发脱落。（牙齿枯槁者，是骨头先衰，肉不附着，所以令牙齿枯槁。平按：写本《甲乙经》作“泻”，下同。“肌肉满”在《素问》、《甲乙经》中均作“肌肉满壮”。“阳气衰于上”在《素问》中作“阳气衰竭于上”。“肾脏衰”在《甲乙经》中作“肾气衰”。）肾生水，受五脏六腑之精而藏之，所以五脏盛才能泻。现在五脏都衰，（平按：《素问》、《甲乙经》“生水”均作“主水”，“乃泻”均作“乃能泻”。以下据《素问·上古天真论》及《甲乙经·形气盛衰大论》补入。）筋骨解堕，天癸尽矣，所以头发两鬓白，身体沉重，行走不正，而不能生育。
[Ping An]: This section, from the beginning of the chapter to "thus life ends in middle age," is found in Volume 8, Chapter 54, "Tian Nian" (Heavenly Years) of *Ling Shu* (Spiritual Pivot). From "Huang Di said: The flourishing and declining of its Qi..." to the end, it is found in Volume 6, Chapter 12 of *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion). From "Huang Di asked Qi Bo: When a person grows old and has no children..." to the end, it is found in Volume 1, Chapter 1, "Shang Gu Tian Zhen Lun" (Discourse on the Heavenly Truth of Ancient Times) of *Su Wen* (Basic Questions).
Huang Di said: The premature death and longevity of people vary; some die young, some live long, some die suddenly, and some suffer from chronic illness. I wish to hear the principles behind this. (The question contains four aspects: premature death, longevity, sudden death, and chronic illness. Ping An: In *Ling Shu*, it reads "the longevity and premature death of people," and "some die young or live long" as "some die young or live long.")
Qi Bo said: (In the answer, the reasons for obtaining longevity are primarily explained, while the other three conditions are briefly mentioned. There are nine manifestations for obtaining longevity:) The five Zang organs are solid and firm, (referring to the physical form of the five Zang organs, being solid without deficiency and stable without change; this is the first reason for longevity.) The blood vessels are harmonious and regulated, (meaning the blood is always harmonious and the meridians are always smooth; this is the second reason for longevity.) The muscles are loose and unobstructed, (referring to the superficial muscles, each having distinct separation and lubrication; this is the third reason for longevity. Ping An: The character "rou" (muscle) above in the annotation is likely a typo for "nei" (internal).) The skin is dense and tight, (Dense, pronounced 'da li'. Refers to the pores being closed tightly and the flesh being compact; this is the fourth reason for longevity.) The movement of Ying (Nutritive) and Wei (Defensive) Qi does not deviate from its norm, (meaning Ying and Wei Qi, within one day and night, each follow their respective paths, circulating fifty cycles to protect the body without error; this is the fifth reason for longevity.) Breathing is gentle and slow, (referring to inhalation and exhalation, slightly not coarse and slowly not rapid; this is the sixth reason for longevity.) Qi moves according to measure, (between breaths, Qi moves six cun, following degrees, over a hundred ke in day and night; this is the seventh reason for longevity.) The six Fu organs transform grain, (the Stomach receives the five grains, the Small Intestine holds them, the Large Intestine conducts them, the Gallbladder serves as the center of essence and judgment, the San Jiao (Triple Burner) manages drainage, and the Bladder governs fluids, jointly transforming the five grains to nourish the body; this is the eighth reason for longevity.) Body fluids are distributed and spread, (such as tears, sweat, saliva, nasal mucus, and spit, spreading through various orifices; this is the ninth reason for longevity. Ping An: In the annotation, 'Yuan Ke' originally wrote 'ye' instead of 'xian'.) Each adhering to its norm, thus enabling longevity. (The above nine matters of nourishing the body, each without error, maintaining constancy without cessation, thus allowing for a long life and prolonged vision. Ping An: "Jiu chang" (long life) in *Ling Shu* is written as "chang jiu".)
Huang Di said: For those who live to a hundred years before dying, what leads to this? (Asking about the cause of obtaining longevity.)
Qi Bo said: The Shi Dao (nose passage) is deep and long, (indicating four factors contributing to longevity: Shi Dao refers to the nasal cavity through which air passes; being deep and long means exhalation is not obstructed, which is the first factor for longevity.) The Ji Qiang (base wall, referring to facial features around the nose) is high and square, (the Ming Tang (bright hall/nose area) has a base wall that is high, large, and square, which is the second factor for longevity.) The Ying and Wei Qi are smoothly regulated, along with the San Bu (three regions) and San Li (three miles/acupoints), (San Bu refers to the regions of the San Jiao. San Li refers to the acupoint below the knee, belonging to the Stomach meridian. Both the San Jiao and San Li are smoothly regulated, which is the third factor for longevity.) The Qi Gu (prominent bones) are high and the flesh is full, leading to a lifespan of a hundred years. (Qi Gu refers to the bones of the Ming Tang. If the bones of the Ming Tang are high and substantial with full flesh, then bone and flesh are solid, which is the fourth factor for longevity. Due to these four factors, one can reach the end of a hundred years.)
Huang Di said: What about those who cannot complete their natural lifespan and die? (Asking about premature death. Ping An: In *Ling Shu*, the section from "Huang Di said: Those who cannot complete their lifespan and die..." to "...thus life ends in middle age" appears after the phrase "the corporeal shell remains alone." )
Qi Bo said: Their five Zang organs are all not solid, (premature death also has four aspects: the five Zang organs are all deficient, making them susceptible to pathogenic invasion, which is the first aspect of premature death.) The Shi Dao is not long, the nostrils are wide and flared, and breathing is violent and rapid, (the Shi Dao is short, the nasal cavity is large, leading to excessive loss of Qi, which is the second aspect of premature death. Ping An: "Bu chang" (not long) is written as "bu tong" (not open) in Yuan and Ke editions; corrected based on the original manuscript, *Ling Shu* also writes "bu chang".) Furthermore, the Ji Qiang is low, (the Ming Tang of the nose has a low base wall, which is the third aspect of premature death.) The pulses are thin with little blood, the flesh is not firm, frequently contracting wind-stroke, blood and Qi are blocked, true Qi and evil Qi attack each other, causing chaos and mutual entanglement, (thin pulses and little blood, empty skin and flesh, often contracting external pathogens, blood and Qi stagnation, true Qi and evil Qi clashing, disturbing and drawing in the true Qi, which is the fourth aspect of premature death. Ping An: In *Ling Shu*, "bu shi" (not firm) is written as "bu shi" (not stone-like), and "zhong feng" (wind-stroke) as "zhong feng han" (contracting wind-cold).) Thus, life ends in middle age.
Huang Di said: Excellent. (Huang Di praised and elaborated upon hearing the causes of premature death and longevity. Ping An: "Gu zhong nian er shou jin yi" in *Ling Shu* is written as "gu zhong shou er jin ye".)
Huang Di said: May I ask about the flourishing and declining of Qi, up to death? (Fluctuation and fullness/emptiness are the constant laws of transformation of things; thus, human Qi declines and changes constantly until reaching death, with different forms, so please explain.)
Qi Bo said: At ten years of age, the five Zang organs begin to stabilize, blood and Qi are already flowing, and Qi is located lower down, so they like to run. At twenty years of age, blood and Qi begin to flourish, muscles are just growing, so they like to walk briskly. At thirty years of age, the five Zang organs are greatly stabilized, muscles are firm, and blood vessels are full, so they like to walk steadily. At forty years of age, the five Zang organs, six Fu organs, and twelve regular meridians are all greatly flourishing and stable, but the Cou Li (pores/cutaneous spaces) begin to become sparse, glory fades, hair and temples turn gray, stability does not shake, so they like to sit. (Ping An: In *Jia Yi Jing*, "ren sheng" is written as "ren nian", "shi shu" as "shi kai", "tui luo" as "bo luo", and "fa bin" as "bin fa". In *Ling Shu*, "bin" is written as "po", and "ban" as "ban". Also note: In the original manuscript, next to "ping sheng bu yao", there are six characters "pi bi bei fan da ye" meaning 'large', suggesting "ping sheng" should be "pi sheng"; other versions write "pi".) At fifty years of age, Liver Qi begins to decline, liver leaves begin to thin, bile begins to decrease, and eyes begin to see poorly. At sixty years of age, Heart Qi begins to decline, prone to sorrow and grief, blood and Qi become slack and lazy, so they like to lie down. At seventy years of age, Spleen Qi is deficient, and skin becomes dry. At eighty years of age, Lung Qi declines, Po (Corporeal Soul) scatters, and because Po scatters, speech tends to err. At ninety years of age, Kidney Qi dries up, organs wither, and meridians become empty. At one hundred years of age, all five Zang organs are deficient, Shen (Spirit) and Qi have departed, and only the corporeal shell remains to finish its course. (Liver corresponds to Wood, Heart to Fire, Spleen to Earth, Lung to Metal, and Kidney to Water; this is the sequence of mutual generation among the Five Elements, hence Liver declines first, followed sequentially to Kidney. Upon reaching one hundred, the five Zang organs are deficient and damaged, the five spirits depart, the withered corpse remains alone, which is called death. Ping An: "Shi jian" in *Ling Shu* is written as "shi mie". "Xi you bei" in *Ling Shu* is written as "ku you bei", and in *Jia Yi Jing* as "nai shan you bei". Also in *Jia Yi Jing*, "duo" is written as "duo", and "pi fu ku" as "pi fu shi ku gu si zhi bu ju". The two characters "po li" do not repeat in *Ling Shu*; *Jia Yi Jing* writes "hun li po san". "Xi wu" in both *Ling Shu* and *Jia Yi Jing* is written as "shan wu". "Zang ku" in *Jia Yi Jing* is written as "zang wei ku"; in *Ling Shu*, there are four characters above "zang" and no "ku" below. Also, *Jia Yi Jing* adds "zhi" before "bai sui" and "jin" after "zhong".)
Huang Di asked Qi Bo: When a person grows old and has no offspring, is it because their vital energy is exhausted? Or is it determined by Heaven's number? (Cai Li refers to the power of nurturing and preservation. Tian Shu refers to the number of destiny/heaven. Ping An: *Jia Yi Jing* lacks this section and the subsequent "Qi Bo said".)
Qi Bo said: At seven years of age, a girl's Kidney Qi flourishes, teeth change, and hair grows. (Kidney governs bones and hair; thus, when Kidney Qi flourishes, teeth change and hair grows. Ping An: "Geng chi" in *Su Wen* and *Jia Yi Jing* is written as "chi geng".) At fourteen years (two sevens), Tian Gui arrives, the Ren Mai (Conception Vessel) opens, the Fu Chong Mai (Hidden Chong Vessel) flourishes, menstruation comes at the proper time, and thus she can bear children. (Tian Gui refers to essential essence. The Ren and Chong vessels originate from the Bao Zhong (uterus/lower extremity); now that Tian Gui has arrived, the Ren Mai opens. The Fu Chong vessel originates from Qi Chuan; combined with the arrival of Tian Gui, the Chong vessel flourishes. These two vessels jointly nourish the Bao Zhong, hence menstruation occurs and conception is possible. Ping An: "Tian Gui" in *Jia Yi Jing* is written as "Tian Shui", same below. "Fu Chong" in *Su Wen* is written as "Tai Chong"; Xin Zheng Xiao notes: *Tai Su* writes "Fu Chong", same below. This matches exactly.) At twenty-one years (three sevens), Kidney Qi is balanced, so wisdom teeth grow and height reaches its limit. (Zhen Ya refers to back teeth. Chang Ji refers to body growth.) At twenty-eight years (four sevens), sinews and bones are strong, hair reaches its limit, and the body is robust. (Sinews, bones, body, and hair of the person are all at their peak.) At thirty-five years (five sevens), the Yang Ming Meridian declines, the face begins to wither, and hair begins to fall. (The Yang Ming Meridian starts at the face and runs through the head; thus, when Yang Ming declines, the face and hair begin to wither and fall. Ping An: "Shi jiao" in *Jia Yi Jing* is written as "jie jiao", "duo" as "bai", and in *Su Wen* as "duo".) At forty-two years (six sevens), the Three Yang Meridians decline upwards, the face completely withers, and hair turns white. (Three Yang refers to Tai Yang, Shao Yang, and Yang Ming. The Three Yang meridians are all in the head; thus, when they decline, the face withers and hair turns white. Ping An: "Fa bai" in *Su Wen* is written as "fa shi bai". *Jia Yi Jing* lacks this section.) At forty-nine years (seven sevens), the Ren Mai is deficient, the Fu Chong declines and becomes scarce, Tian Gui is exhausted, the earthly pathway (menstruation) is blocked, thus the form deteriorates and she cannot bear children. (Qi and blood of the Ren and Chong vessels are both scarce, essence is exhausted, Zi Men (subdoor/cervix) closes, and the uterus deteriorates, hence no children. Ping An: "Fu Chong shuai shao" in *Su Wen* and *Jia Yi Jing* is written as "Tai Chong Mai shuai shao".)
At eight years of age, a boy's Kidney Qi becomes substantial, hair grows, and teeth change. At sixteen years (two eights), Kidney Qi flourishes, Tian Gui arrives, essence overflows and is discharged, Yin and Yang harmonize, and thus he can have children. At twenty-four years (three eights), Kidney Qi is balanced, sinews and bones are strong and powerful, so wisdom teeth grow and height reaches its limit. At thirty-two years (four eights), sinews and bones are prominent and vigorous, muscles are full. At forty years (five eights), Kidney Qi declines, hair falls, and teeth wither. At forty-eight years (six eights), Yang Qi declines upwards, the face withers, and hair and temples turn gray. At fifty-six years (seven eights), Liver Qi declines, sinews cannot move, Tian Gui is exhausted, essence is scant, Kidney organ declines, and the entire body reaches its extreme. At sixty-four years (eight eights), teeth and hair fall out. (Withered teeth indicate bone decline first, flesh not attaching, causing teeth to wither. Ping An: Written version *Jia Yi Jing* writes "xie", same below. "Ji rou man" in *Su Wen* and *Jia Yi Jing* is written as "ji rou man zhuang". "Yang qi shuai yu shang" in *Su Wen* is written as "yang qi shuai jie yu shang". "Shen zang shuai" in *Jia Yi Jing* is written as "shen qi shuai".) The Kidney generates water and receives the essence of the five Zang and six Fu organs to store it; thus, only when the five Zang organs are flourishing can essence be discharged. Now that all five Zang organs are declining, (Ping An: *Su Wen* and *Jia Yi Jing* write "shui sheng" as "zhu shui", and "nai xie" as "nai neng xie". The following text is supplemented based on *Su Wen: Shang Gu Tian Zhen Lun* and *Jia Yi Jing: Xing Qi Sheng Shuai Da Lun*.) sinews and bones become lax and weak, Tian Gui is exhausted, thus hair and temples turn white, the body feels heavy, walking posture is unsteady, and there are no children.