平按∶此篇自篇首至末，见《素问》卷四第十四《汤液醪醴论》篇。
黄帝问岐伯曰∶法病之始生也，极微极精，必先舍于皮肤。今良工皆称曰病成，名曰逆，则
针石不能治也，良药不能及也，今良工皆持法守其数。亲戚兄弟远近，音声日闻于耳，五色日见于
目，而病不愈者，亦可谓不早乎？（精，谓有而不虚也。但有病在皮肤，微小精实不虚，若不疗
者，定成大病，故良工称为病成。以其病者精志眷慕于亲戚，耳目玩乐于声色，日久病成，不可
疗也，由其不破于脆微也。平按∶《素问》法病作夫病，必先舍作必先入结，持法作得其法，可谓
作何暇，新校正云∶“按别本暇作谓。”
注有而不虚原抄作有而虚不，原校作不虚。精实不虚，虚字袁刻误作无。）岐伯曰∶病为本，工
为标，标本不得，邪气不服，此之谓也。（若本无病，则亦无疗方，故知有病为本，然后设工，
是则以病为本，以工为末也。标，末也。风寒暑湿所生之病以为本也，工之所用针石汤药以为标也。
故病与工相契当者，无大而不愈；若工病不相符者，虽微而不遣，故曰不得，邪不服也。）黄帝
问曰∶其病有不从豪毛生，而五脏伤以竭，（有病不以风寒暑湿外邪袭于豪毛腠理入而为病而五
脏伤竭，此为总言。平按∶《素问》有上无病字，生而作而生，伤以竭作阳以竭也。新校正云∶
“按全元起本及《太素》阳作伤，义亦通。”）津液虚廓，（肾伤竭也。廓，空也。平按∶虚廓
《素问》作充郭。廓袁刻误作廊。）其魂魄独，（心伤竭也。平按∶其魂魄独《素问》作其魄独
居。）孤精于内，气耗于外，（虽有五脏之精，而外少吐纳之气。耗，少也，肺伤竭也。）形别
不与衣相保，（皮肤不仁，不与衣相近，脾伤竭也。保，近也。平按∶形别不与衣相保《素问》
作形不可与衣相保。）此四亟急而动中，是气巨于内，而形施于外，治之奈何？（此四候即是五
脏伤竭，病生于内，故曰动中。亟，数也。是为五脏大气数发，病生于内，病形施外，疗之奈何
也。平按∶《素问》亟作极，巨作拒。注巨，大气也，应作巨，袁刻作拒。）岐伯曰∶卒治权衡，
（卒，终也。权衡，脏腑阴阳二脉也。病从内起，终须调于脏腑阴阳二脉，使之和也。平按∶《素
问》作平治于权衡。）去宛陈，（宛陈，恶血聚也。有恶血聚，刺去也。）茎微动中四亟，（肾
间动气得和，则阴茎微动，四竭得生，故本标得，邪气服。平按∶《素问》茎作 ，新校正云∶
“《太素》 作茎。”与此正同。动下无中字，亟作极。）湿衣缪处以复其形，（缪，异也。衣
肉不相保附，故曰缪处。调之既得肾气动已，则衣肉相得，故曰复其形也。平
按∶湿衣缪处《素问》作温衣缪刺其处。）开鬼门，（五神通之者也。）洁净府，洁，清静也。心
之不浊乱。精以时，（命门所藏之精既多，以时而有。）服五汤，有五疏，修五脏，（五汤，五
味汤也。药有五味，以合五行，相克相生，以为补泻，五气得有疏通，以修五脏也。平按∶《素问》
五汤作五阳，有五疏修五脏作已布疏涤五脏。）故精自生，形自盛，骨肉相保，巨气乃平。黄帝
曰∶善哉。（肾间动气，人之生命，故气之和则精生，精生则形盛，形精既盛则骨肉相亲，于是
大气平和，是为病形虽成，疗之有验。平按∶注下精生，精字袁刻脱。）
平按：本篇从开头到结尾，见于《素问》卷四第十四篇《汤液醪醴论》。
黄帝询问岐伯说：按照规律，疾病刚开始产生时，极其微小且精实（指存在而并非虚弱），必定先停留在皮肤。现在优秀的医生都称这种状态为“病成”，命名为“逆”，此时针石不能治疗，良药也无法达到病灶。然而现在的优秀医生都掌握法则并坚守其度数。亲戚兄弟无论远近，他们的声音每天都能听到，五色每天都能看见，但病却没有痊愈，这难道可以说是不早吗？（注：“精”是指有邪气存在而不虚损。只要病在皮肤，虽然微小但精实不虚，如果不治疗，一定会发展成大病，所以优秀的医生称之为“病成”。因为病人精神眷顾于亲戚，耳目沉溺于声色享乐，日子久了病就形成了，无法治疗，这是因为他没有及早破除脆弱微小的病邪。）平按：《素问》中“法病”作“夫病”，“必先舍”作“必先入结”，“持法”作“得其法”，“可谓”作“何暇”。新校正说：“按其他版本‘暇’作‘谓’。” 注文“有而不虚”原抄本写作“有而虚不”，原校改为“不虚”。“精实不虚”的“虚”字，袁刻本误作“无”。
岐伯回答说：病人为本，医生为标，如果标本不相得（医患配合不当或病重医轻），邪气就不能被制服，说的就是这个道理。（如果没有病，也就没有治疗的方药，所以知道以病为本，然后才设立医生，这就是以病为本，以医生为末。标，就是末。风寒暑湿所导致的病作为本，医生所使用的针石汤药作为标。所以病与医生相契合相应的，没有治不好的大病；如果医生与病情不相符，即使病轻微也不能去除，所以说“不得”，邪气不服。）
黄帝问道：有的病不是从毫毛开始产生的，而是五脏受伤衰竭，（有的病不是因为风寒暑湿等外邪侵袭毫毛腠理而入里致病，导致五脏伤竭，这是总括而言。平按：《素问》在此处没有“病”字，“生而”作“而生”，“伤以竭”作“阳以竭”。新校正说：“按全元起本及《太素》，‘阳’作‘伤’，义理也通顺。”）津液空虚廓落，（肾受伤衰竭。廓，即空的意思。平按：《素问》中“虚廓”作“充郭”。“廓”字袁刻本误作“廊”。）魂魄单独存在，（心受伤衰竭。平按：《素问》中“其魂魄独”作“其魄独居”。）精气孤立于内，元气耗散于外，（虽然有五脏的精气，但外部缺少吐纳之气。耗，即少，肺受伤衰竭。）形体分离，不能与衣服相亲近（皮肤麻木不仁，不与衣服相近，脾受伤衰竭。保，即近的意思。平按：《素问》中“形别不与衣相保”作“形不可与衣相保”）。这四种情况紧急危急并触动内脏，这是气机壅盛于内，而形体衰败于外，治疗该怎么办呢？（这四种征象就是五脏伤竭，病生于内，所以叫“动中”。亟，即数、多次。这是五脏的大气屡次发作，病生于内，病形表现于外，治疗该怎么办呢？平按：《素问》中“亟”作“极”，“巨”作“拒”。注解说“巨”是大气的意思，应当作“巨”，袁刻本作“拒”。）
岐伯回答说：最终要权衡调节（卒，终也。权衡，指脏腑阴阳二脉。病从内部兴起，最终必须调节脏腑阴阳二脉，使它们和谐。平按：《素问》作“平治于权衡”），去除郁积的陈腐之物（宛陈，指恶血积聚。如果有恶血积聚，就用针刺去除），阴茎微动于内（肾间动气得到调和，则阴茎微动，四种衰竭得以恢复，所以本标相得，邪气服从。平按：《素问》中“茎”作“𦝫”，新校正说：“《太素》中‘𦝫’作‘茎’。”与此正相同。动字下没有“中”字，“亟”作“极”），用温热的衣服交错刺处来恢复形体（缪，异也。衣肉不相保附，所以叫缪处。调理得当，肾气动之后，则衣肉相得，所以叫恢复形体。平按：《素问》中“湿衣缪处”作“温衣缪刺其处”），打开鬼门（五神通达之处），洁净府（洁，清静也。心不浊乱。精按时生成，命门所藏的精髓既多，按时而有），服用五味汤，有五疏泄的作用，修养五脏（五汤，即五味汤。药物有五味，配合五行，相生相克，作为补泻，五气得疏通，从而修养五脏。平按：《素问》中“五汤”作“五阳”，“有五疏修五脏”作“已布疏涤五脏”）。所以精气自然产生，形体自然强盛，骨肉相亲，大气乃平和。
黄帝说：太好了。（肾间动气是人的生命根本，所以气调和则精生，精生则形盛，形精既然强盛则骨肉相亲，于是大气平和，这就是虽然病形已成，治疗有效。平按：注文中“精生”下的“精”字，袁刻本脱漏。）
Ping An: This section, from the beginning to the end of the chapter, is found in Volume IV, Chapter 14 of the *Suwen* (Basic Questions), titled "Tangye Laoli Lun" (Discourse on Decoctions and Fermented Liquors).
Huangdi asked Qibo: According to the principles, when a disease first begins, it is extremely subtle and solid (referring to the presence of pathogenic factors without deficiency), and must initially reside in the skin. Now, skilled physicians all describe this state as "disease established," naming it "adverse." At this stage, acupuncture and stone tools cannot treat it, and fine medicines cannot reach the lesion. However, current skilled physicians adhere to methods and maintain their numerical standards. Relatives and brothers, whether near or far, their voices are heard daily, and their colors are seen daily, yet the illness does not heal. Can this be considered not early enough? (Note: "Jing" (solid/subtle) means that the pathogen exists and is not deficient. As long as the disease is in the skin, although small, it is substantial and not deficient. If left untreated, it will definitely develop into a major disease, hence skilled physicians call it "disease established." Because the patient's spirit is attached to relatives, and ears and eyes indulge in sounds and colors for a long time, the disease becomes established and incurable. This is because they did not break through the fragile and minute pathogenic factors early.) Ping An: In the *Suwen*, "Fa bing" is written as "Fu bing," "Bi xian she" as "Bi xian ru jie," "Chi fa" as "De qi fa," and "Ke wei" as "He xia." The New Correction states: "According to other editions, 'xia' is written as 'wei.'" The annotation "You er bu xu" was originally copied as "You er xu bu," corrected by the original editor to "Bu xu." In "Jing shi bu xu," the character "xu" was erroneously printed as "wu" in the Yuan edition.)
Qibo replied: The disease is the root (Ben), and the physician is the branch (Biao). If the root and branch do not correspond, the pathogenic factor cannot be subdued; this is what is meant. (If there were no disease, there would be no treatment method, so we know that the disease is the root, and then the physician is established. Thus, the disease is the root, and the physician is the branch. Biao refers to the branch. Diseases caused by wind, cold, summer-heat, and dampness constitute the root, while the acupuncture, stone tools, decoctions, and medicines used by the physician constitute the branch. Therefore, when the disease and the physician are in harmony, no major disease remains untreatable; if the physician and the disease do not match, even minor ailments cannot be dispelled. Hence it is said "not corresponding," and the pathogenic factor is not subdued.)
Huangdi asked: There are diseases that do not originate from the hair follicles but result from injury and exhaustion of the five Zang organs. (Some diseases do not arise from external pathogens like wind, cold, summer-heat, and dampness invading the hair follicles and interstices, leading to injury and exhaustion of the five Zang organs; this is a general statement. Ping An: In the *Suwen*, the character "bing" (disease) is absent here; "sheng er" is written as "er sheng"; "shang yi jie" is written as "yang yi jie." The New Correction states: "According to Quan Yuanqi's edition and the *Taisu*, 'yang' is written as 'shang,' which also makes sense.") The body fluids become empty and hollow. (Kidney injury and exhaustion. Kuo means empty. Ping An: In the *Suwen*, "xu kuo" is written as "chong guo." The character "kuo" was erroneously printed as "lang" in the Yuan edition.) The soul and spirit exist alone. (Heart injury and exhaustion. Ping An: In the *Suwen*, "qi hun po du" is written as "qi po du ju.") Essence stands solitary within, while Qi dissipates outside. (Although there is essence in the five Zang organs, there is little respiratory Qi externally. Hao means little; Lung injury and exhaustion.) The form separates and cannot be protected by clothing. (Skin insensitivity, not close to clothing; Spleen injury and exhaustion. Bao means close. Ping An: In the *Suwen*, "xing bie bu yu yi xiang bao" is written as "xing bu ke yu yi xiang bao"). These four conditions are urgent and critical, disturbing the interior. This indicates excessive Qi inside and deterioration of the form outside. How should this be treated? (These four signs indicate injury and exhaustion of the five Zang organs, with disease arising from within, hence called "moving the interior." Ji means frequent/numerous. This is the frequent eruption of the great Qi of the five Zang organs, disease arising from within, and pathological forms manifesting outside. How should it be treated? Ping An: In the *Suwen*, "ji" is written as "ji" (extreme), and "ju" as "ju" (resist). The annotation explains "ju" as great Qi, which should be written as "ju," but the Yuan edition writes "ju".)
Qibo replied: Ultimately, one must balance and weigh (Zu means end/final. Quanheng refers to the Yin and Yang meridians of the Zang and Fu organs. Since the disease arises internally, one must ultimately regulate the Yin and Yang meridians of the Zang and Fu organs to achieve harmony. Ping An: The *Suwen* reads "Ping zhi yu quanheng"). Remove stagnant and old accumulation (Wanchen refers to the accumulation of foul blood. If foul blood accumulates, it should be pricked out). The penis moves slightly within (When the moving Qi between the kidneys is harmonized, the penis moves slightly, and the four exhaustions recover, thus the root and branch correspond, and the pathogenic factor submits. Ping An: In the *Suwen*, "jing" is written as "𦝫"; the New Correction states: "In the *Taisu*, '𦝫' is written as 'jing.' This matches exactly. There is no character "zhong" after "dong," and "ji" is written as "ji"). Apply warm clothes and cross-stitching to restore the form (Mou means different/distinct. Clothing and flesh do not adhere properly, hence called Mou chu. After proper regulation, when the Kidney Qi moves, clothing and flesh align, hence called restoring the form. Ping An: In the *Suwen*, "shi yi mou chu" is written as "wen yi mou ci qi chu"). Open the ghost gates (The orifices connected to the Five Passages), purify the fu organs (Jie means purity/tranquility. The Heart is not turbid or chaotic. Essence is generated in due time. The essence stored in the Gate of Life is abundant and generated timely). Take the Five Flavors Decoction, which has five dispersing actions, to cultivate the five Zang organs (Wu Tang refers to the Five Flavors Decoction. Medicines have five flavors, corresponding to the Five Elements, interacting through generation and restriction to provide tonification and sedation. When the Five Qi are unblocked, the five Zang organs are cultivated. Ping An: In the *Suwen*, "wu tang" is written as "wu yang," and "you wu shu xiu wu zang" is written as "yi bu shu di wu zang"). Thus, essence generates naturally, the form becomes robust, bones and flesh protect each other, and the Great Qi becomes peaceful.
Huangdi said: Excellent. (The moving Qi between the kidneys is the life source of humans. Therefore, when Qi is harmonized, essence generates; when essence generates, the form becomes robust. Once the form and essence are robust, bones and flesh are intimate, and thus the Great Qi becomes peaceful. This shows that even if the pathological form is established, treatment yields results. Ping An: In the annotation under "jing sheng," the character "jing" is missing in the Yuan edition.)