平按∶此篇见《素问》卷一第三《生气通天论》。
黄帝问于岐伯曰∶夫自古通天者，生之本也，（古，谓上古、中古者也。调阴阳而摄其生，则通
天之义。上古中古人君摄生，莫不法于天地，故生同天地，长生久视。通天地者，生之本也。不言通
地者，天为尊也。）本于
阴阳。（本于天地阴阳之气。）天地之间，六合之内，其气九州九窍五脏十二节，皆通于天气。（在
于天地四方上下之间，所生之物，即九州等也。九州，即是身外物也。九窍等物，身内物也。十二节
者，谓人四肢各有三大节也。谓九州等内外物，皆通天气也。平按∶《素问》于作乎。）其生在其气
三，（谓天地间九州等物，其生皆在阴阳及和三气。平按∶《素问》在作五，别本亦作五。）谓数犯
此者，则邪气伤人，此寿之本。（阴阳分为四时和气，人之纵志不顺四时和气摄生，为风寒雨湿邪气
伤也。此顺三气养生，寿之本也。平按∶《素问》数上无谓字，寿下有命字，本下有也字。）苍天之
气清静，则志意治，（苍，天色也。气，谓四时和气者也。天地之和气，清而不浊，静而不乱，能令
人志意皆清静也。平按∶《素问》静作净。）夫顺之则阳气固，虽有贼邪，弗能害也，此因时之序也。
（人能顺清静和气，则脏气守其内，腑气固其外，则虽有八正虚风贼邪，不能伤也，斯因四序之和自
调摄也。平按∶《素问》顺上无夫字，序下无也字。）故圣人搏精神，或服天气，通神明。（搏，附
也，或有也。圣人令精神相附不失，有服清静之气，通神令清，通性令明，故得寿弊天地而不道夭。
平按∶《素问》搏作传，服天上无或字，通上有而字。）气失之，则内闭九窍，外壅肌肉，卫气散解，
此谓自伤，气之削也。（阴气失和，则内闭九窍，令便不通，外壅肌肉，使腠理壅塞也。阳气失和，
则腠理开解，卫气发泄也。此之失者，皆是自失将摄，故令和气销削也。平按∶《素问》失上无气字。
卫原抄作冲，据本注应作卫，《素问》亦作卫。）阳气者，若天与日，失其行，独寿不章，故天运当
以日光明，是故阳因上而卫外者也。（人之阳气，若
天与日，不得相无也。如天不得无日，日失其行，则天不明也。故天之运动，要藉日行，天得光明也。
人与阳气不得相无，若无三阳行于头上，则人身不得章延寿命也。故身之生运，必待阳脉行身以上，
故寿命章也。是以阳上于头，卫于外也。平按∶《素问》行独二字作所则折三字，上而二字作而上二
字。）因于寒，志欲如连枢，起居如惊，神气乃浮。（连，数也。枢，动也。和气行身，因伤寒气，
则志欲不定，数动不住，故起居如惊，神魂飞扬也。平按∶《素问》寒下无志字，连枢作运枢，新校
正云∶全元起本作连枢。）因于暑，汗烦则喘喝，静则多言，体若燔炭，汗出如散。（喝，汉曷反，
呵也，谓喘呵出气声也。汗者，阴气也，故汗出即热去。今热，汗出而烦扰也。若静而不扰，则内热
狂言。如此者，虽汗犹热。汗如沐浴，汗不作珠，故曰如散也。平按∶《素问》如散作而散。）因于
湿首如裹攘，大筋濡短，小筋施长，施长者为痿。（如，而也。攘，除也。人有病热，用水湿头而以
物裹人，望除其热，是则大筋得寒湿缩，小筋得热缓长。施，缓也，绝尔反。筋之缓 ，四肢不收，
故为痿也。平按∶《素问》裹下有湿热不三字，濡作 ，施作弛，小筋施长下有 短为拘四字，为痿
上无者字。）因阳气为肿，四维相代，阳气而竭。（因邪气客于分肉之间，卫气壅遏不行，遂聚为
肿。四时之气，各自维守，今四气相代，则卫之阳气竭壅不行，故为肿也。平按∶因阳气为肿《素问》
作因于气为肿，而竭作乃竭。）阳气者，烦劳则张，精绝辟积，于夏使人前厥，（辟，稗尺反。夏日
阳气盛时，入房过多，则阳虚起，精绝辟积，生前厥之病也。辟积，辟叠停废之谓也。
前厥，即前仆也。平按∶前厥《素问》作煎厥。）目盲不可以视，耳闭不可以听，（精绝则肾腑足太
阳脉衰，足太阳脉起目内 ，故太阳衰者即目盲也。精绝肾虚，则肾官不能听也。）溃溃乎若坏都，
滑滑不止。（溃，胡对反。溃溃、滑滑，皆乱也。阳气烦劳，则精神血气乱，若国都亡坏，不可止也。
一曰滑不正则。都，大也。言非直精神血气溃乱，四肢十二大骨痿 不正也。平按∶滑滑不止《素问》
作 乎不可止。注滑不正则应作都骨不正，按原抄滑滑不止右偏，有滑滑不止都骨不正八小字。）
阳气大怒，则形气而绝，血宛于上，使前厥，有伤于筋纵，（阴并于阳，盛怒则卫气壅绝，血之宛陈，
上并于头，使人有仆，故曰前厥，并伤于筋，故痿 也。平按∶阳气下《素问》有者字，而绝作绝而，
宛作菀，使前厥作使人薄厥。）其若不容，而出汗偏阻，使人偏枯。（阻，坏也，慈吕反。容，缓也。
阳气盛者必伤筋痿缓，其若不缓，则冷汗偏出坏身。偏枯，不随之病也，或偏枯疼者也。平按∶而出
汗偏阻《素问》作汗出偏沮。）汗出见湿，乃生痤疽。（若汗遍身，见湿于风，即邪风客于肌肉，壅
遏营卫，伤肉以生痤疽也。痤，痈之类，然小也，俗谓之疖子。久壅陷骨者，为痤疽也。平按∶《素
问》疽作 。）膏粱之变，足生大钉，受如持虚。（膏粱血食之人，汗出见风，其变为病，与布衣不
同，多足生大钉肿。膏粱身虚，见湿受病，如持虚器受物，言易得也。平按∶《素问》膏作高，钉作
丁。新校正云∶按丁生之处，不常于足，盖谓膏粱之变，饶生大丁，非偏着足也。又《素问》持虚下
有劳汗当风寒薄为 郁乃痤十一字。）阳气者，精则养神，柔则养筋，（卫之精气，昼行六腑，夜行
五脏，令五神清明，行四肢及身，令筋柔弱也。）开阖不得，寒气从之，乃生大偻。（腠理有邪，开
令邪出，则开为得也。腠理无邪，闭令不开，即阖为得也。今腠理开邪入，即便闭之，故不得也。寒
邪入已，客于
腰脊，以尻代踵，故曰大偻。偻，曲也，力矩反。）陷脉为 ，流连肉腠。（寒邪久客不散，寒热
陷脉以为脓血，流连在肉腠之间，故为 。平按∶流《素问》作留。）输气化薄，传为善畏，乃为
惊骇。（输者各系于脏气化薄则精虚不守，故善畏而好惊也。平按∶《素问》输作俞，乃作及。）营气
不顺，逆于肉理，乃生 痈肿。（脉肉营气，为邪气伤，不得循脉阴阳相注，故逆于肉理，败肉即生痈
也。平按∶《素问》顺作从， 作痈。注脉肉，肉字别本作内。）魄汗不尽，形弱而气烁，穴输已闭，
发为风疟，故风者，百病之始也。（魄，肺之神也，肺主皮毛腠理，人之汗者，皆是肺之魄神所营，
因名魄汗。夏伤于暑，汗出不止，形之虚弱，气之衰损，淫邪藏于腠理，腠理已闭，至秋得寒，内外
相感，遂成风疟而气烁，故邪风者百病始。烁，式药反。淫邪气。平按∶《素问》不尽作未尽。）清
静则肉腠闭距，虽有大风苛毒，弗之能客，此因时之序也。（不为躁动，毛腠闭距，八风不能伤者，
顺四时之序调养，故无病也。苛，害也，音柯。平按∶《素问》距作拒，客作害。）故人病久则传化，
上下不并，良医弗为。（人病虽久，得有传变，上下阴阳不并，至其所王，必当自愈，故良医不为也。
平按∶《素问》病上无人字。）故阳蓄积病死，而阳气当隔，隔者当泻，不亟正治，旦乃败亡。（故
阳病者，蓄积不得传化，有其死期者，阳脉当隔，脉有隔之时，当即泻之，不急疗者，必当死也。隔，
格也。亟，急也。平按∶旦乃败亡《素问》作粗乃败之，别本旦作且。注疗者别本作疗之。）故阳气
者，一日而主外，平旦人气生，日中而阳气隆，日西阳气已虚，气门乃开，是故暮而收距，毋扰筋骨，
毋见雾露。（夫阳者，生气也。阴者，死气也。故阳气
一日而主外，阴气一夜而主内。一日外者分为三时∶平旦人气始生，为少阳也；日中人气隆盛，为太
阳也；日西人气始衰，为虚阳也。阳气虚者，阴气即开也。阴气开者，即申酉戌，少阴生也，故暮须
收距，无令外邪入皮毛也；亥子丑时，即至阴也，故至阴时无扰骨也；寅卯辰，即厥阴也，故厥阴时
无扰于筋，见雾露也，阴衰见湿，因招寒湿病。平按∶《素问》开作闭。）反此三时，形乃困薄。
（不顺昼夜各三时气以养生者，必为病困迫于身。薄，迫也。）
岐伯曰∶阴者，藏精而极起者也；阳者，卫外而为固者也。（五脏藏精，阴极而阳起也；六腑卫
外，阳极而阴固也。故阴阳相得，不可偏胜也。平按∶《素问》极起作起亟。）阴不胜其阳，则其脉
流薄，疾并乃狂。（阳胜，即人迎脉动，或停或速，是则阴并阳盛，发为狂病。平按∶《素问》脉上
无其字。）阳不胜其阴，五脏气争，九窍不通。（阴胜，则脏气无卫，故外九窍闭而不通也。平按∶五
脏上《素问》有则字。）是以圣人陈阴阳，筋脉和同，骨髓坚固，气血皆顺，如是则外内调和，邪不
能客，耳目聪明，气立如故。（故圣人陈阴阳，使人调内外之气，和而不争也。平按∶《素问》顺作
从，外内作内外，客作害。）风客淫气，精乃亡，邪伤肝。（风客淫情之气，遂令阴盛，施精不已，
故精亡也。肝脉循阴入肝，故精亡伤肝也。平按∶注淫情，情字别本作精。）因而饱食，筋脉横解，
肠为痔。（ ，音僻，泄脓血也。肝主于筋，亦生于血，肝既伤已，又因饱食，谷气盛迫，筋脉解
裂，广肠漏泄脓血，名之为痔也。平按∶肠 袁刻误作伤 。）因而一饮，则逆气。（一者，大也。
既已亡筋伤肝，又因大饮，则为逆气之病也。平按∶一《素问》作大。）因而强力，肾气乃
伤，高骨乃坏。（亡精伤肝，复因力已入房，故伤肾也。肾以藏精主骨，肾伤则大骨坏也。高，大也。）
凡阴阳之要，阴密阳固，而两者不和，若春无秋，若冬无夏，因而和之，是谓圣度。（腠理密不泄者，
乃内阴之力也。五脏藏神固者，外阳之力也。故比四时和气，不得相无也。因四时和气和于身者，乃是
先圣法度也。平按∶阴密阳固《素问》作阳密乃固。）故强不能，阴气乃绝，（阴气衰者，可以补阴，
更强入房泻其阴，故阴气绝也。平按∶故强不能《素问》作故阳强不能密，袁刻于能下加一密字，与
原抄不合。）因于露风，乃生寒热。（精亡肝伤，更得寒湿风邪，邪风成者为寒热病也。平按∶《素
问》此段上有“阴平阳秘，精神乃治，阴阳离决，精气乃绝”四句。后二句，本书见下文。）是以春
伤于风，邪气流连，乃为洞泄；夏伤于暑，秋为 疟；秋伤于湿，气上逆而咳，发为痿厥，阴阳离决，
精气乃绝；冬伤于寒，春乃病热。（洞，大贡反，疾流也。肺恶寒湿之气，故上逆咳也。至冬寒湿变
热，四肢不用，名曰痿厥。二气离分不和，故精气绝也。平按∶《素问》流连作留连，春乃病热作春
必温病。）四时之气争，伤五脏也。（风寒暑湿，四时邪气争而不和，即伤五脏也。）阴之生，本在
五味。（身内五脏之阴，因五味而生也。平按∶《素问》生上有所字。）阴之五官，阳在五味。（五脏，
阴之官也。谓眼耳鼻口舌等五官之阳，本于五味者也。故五味内滋五脏，五官于是用强也。平按∶《素
问》官作宫，阳作伤。）是故味过酸，肝气以津，肺气乃绝；（夫五味者，各走其脏，得中则益，伤
多则损。故伤酸者，能令肝气下流，膀胱胞薄，遂成于癃漏泄病也。肺气克肝，今肝气津泄，则肺无
所克，故肺气无用也。平按∶肺《素问》作脾。）味过于咸，则大骨气劳，短肌气抑；（咸以资骨，今
咸过伤骨，则脾无所克，故肌肉短小，脾气壅抑也。）
（平按∶《素问》肌下有心字。）味过苦，心气喘满，色黑肾不卫；（苦以资心，今苦过伤心，
喘满呕吐，则肾气无力，故色黑而不能卫也。平按∶《素问》苦作甘，肾不卫作肾气不衡。）味过于
甘，脾气濡，胃气乃浓；（甘以资脾气，今甘过伤脾气濡，令心闷胃气浓盛也。平按∶《素问》甘作
苦，濡上有不字。）味过于辛，筋脉沮弛，精神乃英。（辛以资肺，今辛多伤肺，肺以主气，筋之气
坏，泄于皮毛也。心神克肺气沮泄，神气英盛，浮散无用也。平按∶英《素问》作央，王注作久字解。
新校正谓此论味过所伤，不宜作精神长久解，央乃殃也，此古文简略，字多假借用也。其说为长。）
是故谨和五味，则骨正筋柔，气血以流，腠理以密。（谓五味各得其所者，则咸能资骨，故骨正也；
酸能资筋，故筋柔也；辛能资气，故气流也；苦能资血，故血流也；甘能资肉，故腠理密也。）如是
则气骨以精，谨道如法，长有天命。（谨，顺也。如是调养身者，则气骨常得精胜，上顺天道，如先
圣法，则寿弊天地，故长有天命也。平按∶顾本《素问》气骨作骨气，赵府本仍作气骨。）
【平按】：此篇见于《素问》卷一第三篇《生气通天论》。
黄帝向岐伯问道：自古以来，人与天相通，这是生命的根本。（古，指上古和中古时期。调和阴阳以保养生命，这就是通天的含义。上古和中古的君主在养生方面，没有不效法天地的，所以生命与天地相同，能够长寿且目光明亮。与天地相通，是生命的根本。这里只说通天而不说通地，是因为天为尊贵。）其根本在于阴阳。（根本在于天地阴阳之气。）在天地之间，六合之内（指东南西北上下四方），人体的气、九州（指人体对应的外部地理区域）、九窍（眼、耳、口、鼻等九个孔道）、五脏、十二节（四肢的大关节），都与天气相通。（存在于天地四方上下之间，所生成的事物，就是九州等。九州，是指身外的物象；九窍等，是身内的物象。十二节，是指人的四肢各有三个大关节。所谓九州等内外之物，都通于天气。【平按】：《素问》中“于”字作“乎”。）人的生命依赖于三气（指天地间九州等万物，其生存都依赖于阴、阳及和这三种气。【平按】：《素问》中“在”字作“五”，其他版本也作“五”。）。如果屡次违背这个原则，那么邪气就会伤害人，这是寿命的根本。（阴阳分为四时和气，人如果放纵心意，不顺从四时和气来养生，就会被风寒雨湿等邪气所伤。顺应这三气来养生，是长寿的根本。【平按】：《素问》中“谓”字在“数”字之上无，“寿”字下有“命”字，“本”字下有“也”字。）苍天之气清静，人的志意就能安定。（苍，是天色。气，指四时的和气。天地之间的和气，清而不浊，静而不乱，能让人志意都保持清静。【平按】：《素问》中“静”字作“净”。）顺应它，阳气就固密，即使有贼邪，也不能伤害人，这是因为遵循了时序。（人能顺应清静的和气，脏气就能守持于内，腑气就能固护于外，那么即使有八正虚风贼邪，也不能伤害，这都是因为四季之和气自我调摄的结果。【平按】：《素问》中“顺”字上无“夫”字，“序”字下无“也”字。）所以圣人聚精会神，或者服食天气，通达神明。（搏，是附着的意思，或者是有。圣人让精神相互依附而不失散，服食清静之气，使神通达而清，性通达而明，所以能寿命终结于天地之间而不早夭。【平按】：《素问》中“搏”字作“传”，“服天”上无“或”字，“通”字上有“而”字。）如果气失调，就会内部闭塞九窍，外部壅滞肌肉，卫气散漫解怠，这叫做自伤，是气的削弱。（阴气失和，就会内部闭塞九窍，导致大小便不通；外部壅滞肌肉，使腠理堵塞。阳气失和，就会腠理开泄，卫气发泄。这些失和，都是由于自己缺乏调养所致，所以使和气消减。【平按】：《素问》中“失”字上无“气”字。卫原抄本作“冲”，据本注应作“卫”，《素问》也作“卫”。）阳气，就像天和日，失去了它的运行，寿命就不能彰显，所以天的运行应当依靠日光来光明，因此阳气在上面护卫体表。（人的阳气，就像天和日，不能互相缺少。如天不能没有日，日失去运行，天就不明亮。所以天的运动，要借助于日的运行，天才能得光明。人与阳气不能互相缺少，如果没有三阳行于头上，人身就不能延长寿命。所以身体的生运，必须等待阳脉行于身上部，所以寿命才彰显。因此阳在上，护卫于外。【平按】：《素问》中“行独”二字作“所则折”三字，“上而”二字作“而上”二字。）
因于寒邪，意志像连枢一样频繁变动，起居惊慌失措，神气就会浮越。（连，是数的意思。枢，是动的意思。和气行于身体，如果受到寒气损伤，意志就不稳定，频繁变动不止，所以起居像受惊一样，神魂飞扬。【平按】：《素问》中“寒”字下无“志”字，“连枢”作“运枢”，新校正云：全元起本作“连枢”。）因于暑邪，出汗、烦躁则喘息有声，安静则多语，身体像燃烧的炭火，汗出如散落。（喝，音汉曷，呵气，指喘气呵出的声音。汗，是阴气，所以汗出热就去。现在热，汗出却烦躁。如果安静而不扰，则内热狂言。这样的人，虽然出汗仍然发热。汗像沐浴一样，汗珠不凝聚，所以说像散落。【平按】：《素问》中“如散”作“而散”。）因于湿邪，头部像被包裹一样沉重，大筋收缩变短，小筋松弛变长，松弛变长的导致痿证。（如，是而的意思。攘，是除的意思。人有病热，用水湿头并用物包裹，希望除去其热，这样大筋得到寒湿而收缩，小筋得到热而缓长。施，是缓的意思，音绝尔反。筋缓弛，四肢不能收持，所以为痿证。【平按】：《素问》中“裹”字下有“湿热不”三字，“濡”作“濡”，“施”作“弛”，“小筋施长”下有“短为拘”四字，“为痿”上无“者”字。）因阳气受阻而肿胀，四维之气交替失常，阳气因而衰竭。（因邪气客居在分肉之间，卫气壅遏不行，于是聚集为肿。四时之气，各自维守，现在四气相代，则卫之阳气竭滞不行，所以为肿。【平按】：因阳气为肿，《素问》作“因于气为肿”，“而竭”作“乃竭”。）
阳气者，烦劳过度则亢张，精气枯竭，叠加积累，到了夏天使人发生煎厥（前厥）。（辟，音稗尺反。夏日阳气盛时，房事过多，则阳虚起，精气枯竭叠加，产生前厥的病。辟积，是重叠停废的意思。前厥，即前仆。【平按】：前厥，《素问》作“煎厥”。）眼睛看不见，耳朵听不到。（精气枯竭则肾腑足太阳脉衰，足太阳脉起于目内眦，所以太阳衰者即目盲。精气枯竭肾虚，则肾官不能听。）混乱不堪像都城崩塌，滑滑不停止。（溃，胡对反。溃溃、滑滑，都是乱的意思。阳气烦劳，则精神血气乱，像国都亡坏，不可停止。一说滑不正则是都骨不正。都，大也。言不仅精神血气溃乱，四肢十二大骨痿软不正。【平按】：滑滑不止，《素问》作“涣乎不可止”。注“滑不正则”应作“都骨不正”，按原抄“滑滑不止”右偏，有“滑滑不止都骨不正”八小字。）
阳气大怒，则形气断绝，血液郁结于上部，使人发生薄厥，损伤筋脉使其纵缓。（阴并于阳，盛怒则卫气壅绝，血之郁积，上并于头，使人有仆倒，所以叫前厥，并伤于筋，所以痿软。【平按】：阳气下，《素问》有“者”字，“而绝”作“绝而”，“宛”作“菀”，“使前厥”作“使人薄厥”。）身体僵硬不能舒展，出汗偏侧阻滞，使人半身不遂。（阻，坏的意思，音慈吕反。容，缓的意思。阳气盛者必伤筋痿缓，如果不缓，则冷汗偏出坏身。偏枯，是不随行的病，或者偏枯疼。【平按】：而出汗偏阻，《素问》作“汗出偏沮”。）
汗出见湿，就生痤疽。（如果汗遍全身，见到湿气于风中，即邪风客于肌肉，壅遏营卫，伤肉而生痤疽。痤，是痈的一类，但较小，俗称为疖子。久壅陷骨者，为痤疽。【平按】：《素问》中“疽”作“疽”。）膏粱之变，足生大丁，接受病邪如同拿着空容器。（膏粱血食之人，汗出见风，其变为病，与布衣不同，多足生大丁肿。膏粱身虚，见湿受病，如持虚器受物，言容易得病。【平按】：《素问》中“膏”作“高”，“钉”作“丁”。新校正云：按丁生之处，不常于足，盖谓膏粱之变，饶生大丁，非偏着足也。又《素问》持虚下有“劳汗当风寒薄为郁乃痤”十一字。）
阳气者，精微则养神，柔和则养筋。（卫之精气，昼行六腑，夜行五脏，令五神清明，行四肢及身，令筋柔弱也。）开阖不得，寒气从之，就生大偻。（腠理有邪，开令邪出，则开为得。腠理无邪，闭令不开，即阖为得。今腠理开邪入，即便闭之，故不得。寒邪入已，客于腰脊，以尻代踵，故曰大偻。偻，曲也，力矩反。）寒邪陷入脉中成为脓血，流连在肉腠之间。（寒邪久客不散，寒热陷脉以为脓血，流连在肉腠之间，故为脓血。【平按】：流，《素问》作“留”。）输穴气化薄弱，传变为善畏，甚至惊骇。（输者各系于脏，气化薄则精虚不守，故善畏而好惊。【平按】：《素问》中“输”作“俞”，“乃”作“及”。）营气不顺，逆于肉理，就生痈肿。（脉肉营气，为邪气伤，不得循脉阴阳相注，故逆于肉理，败肉即生痈。【平按】：《素问》中“顺”作“从”，“痈”作“痈”。注“脉肉”，肉字别本作“内”。）魄汗不尽，形体虚弱而气耗损，穴输已闭，发为风疟，所以风是百病的始源。（魄，肺之神也，肺主皮毛腠理，人之汗，皆是肺之魄神所营，因名魄汗。夏伤于暑，汗出不止，形之虚弱，气之衰损，淫邪藏于腠理，腠理已闭，至秋得寒，内外相感，遂成风疟而气烁，故邪风者百病始。烁，式药反。淫邪气。【平按】：《素问》中“不尽”作“未尽”。）
清静则肉腠闭合，即使有大风苛毒，也不能侵害，这是因为遵循了时序。（不为躁动，毛腠闭合，八风不能伤者，顺四时之序调养，故无病也。苛，害也，音柯。【平按】：《素问》中“距”作“拒”，“客”作“害”。）所以人病久了就会传变，上下不并，良医也难治。（人病虽久，得有传变，上下阴阳不并，至其所王，必当自愈，故良医不为也。【平按】：《素问》中“病”上无人字。）所以阳气蓄积致死，而阳气当隔阂，隔阂者当泻，不紧急正确治疗，就会败亡。（故阳病者，蓄积不得传化，有其死期者，阳脉当隔，脉有隔之时，当即泻之，不急疗者，必当死也。隔，格也。亟，急也。【平按】：旦乃败亡，《素问》作“粗乃败之”，别本旦作且。注疗者别本作疗之。）
所以阳气者，一日而主外，平旦人气生，日中而阳气隆，日西阳气已虚，气门乃开，是故暮而收拒，毋扰筋骨，毋见雾露。（夫阳者，生气也。阴者，死气也。故阳气一日而主外，阴气一夜而主内。一日外者分为三时：平旦人气始生，为少阳也；日中人气隆盛，为太阳也；日西人气始衰，为虚阳也。阳气虚者，阴气即开也。阴气开者，即申酉戌，少阴生也，故暮须收拒，无令外邪入皮毛也；亥子丑时，即至阴也，故至阴时无扰骨也；寅卯辰，即厥阴也，故厥阴时无扰于筋，见雾露也，阴衰见湿，因招寒湿病。【平按】：《素问》中“开”作“闭”。）违反这三个时辰的规律，形体就会困迫。（不顺昼夜各三时气以养生者，必为病困迫于身。薄，迫也。）
岐伯说：阴，是藏精而且极起的；阳，是护卫体表而且固密的。（五脏藏精，阴极而阳起也；六腑卫外，阳极而阴固也。故阴阳相得，不可偏胜也。【平按】：《素问》中“极起”作“起亟”。）阴不胜其阳，则其脉流薄疾，并乃狂。（阳胜，即人迎脉动，或停或速，是则阴并阳盛，发为狂病。【平按】：《素问》中“脉”上无“其”字。）阳不胜其阴，五脏气争，九窍不通。（阴胜，则脏气无卫，故外九窍闭而不通也。【平按】：五脏上，《素问》有“则”字。）
所以圣人陈列阴阳，筋脉和同，骨髓坚固，气血皆顺，如是则外内调和，邪不能客，耳目聪明，气立如故。（故圣人陈阴阳，使人调内外之气，和而不争也。【平按】：《素问》中“顺”作“从”，“外内”作“内外”，“客”作“害”。）风客淫气，精乃亡，邪伤肝。（风客淫情之气，遂令阴盛，施精不已，故精亡也。肝脉循阴入肝，故精亡伤肝也。【平按】：注“淫情”，情字别本作“精”。）因而饱食，筋脉横解，肠为痔。（ ，音僻，泄脓血也。肝主于筋，亦生于血，肝既伤已，又因饱食，谷气盛迫，筋脉解裂，广肠漏泄脓血，名之为痔也。【平按】：肠 袁刻误作伤 。）因而大饮，则逆气。（一者，大也。既已亡筋伤肝，又因大饮，则为逆气之病也。【平按】：一，《素问》作“大”。）因而强力，肾气乃伤，高骨乃坏。（亡精伤肝，复因力已入房，故伤肾也。肾以藏精主骨，肾伤则大骨坏也。高，大也。）
凡阴阳之要，阴密阳固，而两者不和，若春无秋，若冬无夏，因而和之，是谓圣度。（腠理密不泄者，乃内阴之力也。五脏藏神固者，外阳之力也。故比四时和气，不得相无也。因四时和气和于身者，乃是先圣法度也。【平按】：阴密阳固，《素问》作“阳密乃固”。）故强不能，阴气乃绝，（阴气衰者，可以补阴，更强入房泻其阴，故阴气绝也。【平按】：故强不能，《素问》作“故阳强不能密”，袁刻于能下加一密字，与原抄不合。）因于露风，乃生寒热。（精亡肝伤，更得寒湿风邪，邪风成者为寒热病也。【平按】：《素问》此段上有“阴平阳秘，精神乃治，阴阳离决，精气乃绝”四句。后二句，本书见下文。）
是以春伤于风，邪气流连，乃为洞泄；夏伤于暑，秋为 疟；秋伤于湿，气上逆而咳，发为痿厥，阴阳离决，精气乃绝；冬伤于寒，春乃病热。（洞，大贡反，疾流也。肺恶寒湿之气，故上逆咳也。至冬寒湿变热，四肢不用，名曰痿厥。二气离分不和，故精气绝也。【平按】：《素问》中“流连”作“留连”，“春乃病热”作“春必温病”。）四时之气争，伤五脏也。（风寒暑湿，四时邪气争而不和，即伤五脏也。）
阴之生，本在五味。（身内五脏之阴，因五味而生也。【平按】：《素问》中“生”上有所字。）阴之五官，阳在五味。（五脏，阴之官也。谓眼耳鼻口舌等五官之阳，本于五味者也。故五味内滋五脏，五官于是用强也。【平按】：《素问》中“官”作“宫”，“阳”作“伤”。）
是故味过酸，肝气以津，肺气乃绝；（夫五味者，各走其脏，得中则益，伤多则损。故伤酸者，能令肝气下流，膀胱胞薄，遂成于癃漏泄病也。肺气克肝，今肝气津泄，则肺无所克，故肺气无用也。【平按】：肺，《素问》作“脾”。）味过于咸，则大骨气劳，短肌气抑；（咸以资骨，今咸过伤骨，则脾无所克，故肌肉短小，脾气壅抑也。）（平按：《素问》中“肌”下有心字。）味过苦，心气喘满，色黑肾不卫；（苦以资心，今苦过伤心，喘满呕吐，则肾气无力，故色黑而不能卫也。【平按】：《素问》中“苦”作“甘”，“肾不卫”作“肾气不衡”。）味过于甘，脾气濡，胃气乃浓；（甘以资脾气，今甘过伤脾气濡，令心闷胃气浓盛也。【平按】：《素问》中“甘”作“苦”，“濡”上有“不”字。）味过于辛，筋脉沮弛，精神乃英。（辛以资肺，今辛多伤肺，肺以主气，筋之气坏，泄于皮毛也。心神克肺气沮泄，神气英盛，浮散无用也。【平按】：英，《素问》作“央”，王注作“久”字解。新校正谓此论味过所伤，不宜作精神长久解，央乃殃也，此古文简略，字多假借用也。其说为长。）
是故谨和五味，则骨正筋柔，气血以流，腠理以密。（谓五味各得其所者，则咸能资骨，故骨正也；酸能资筋，故筋柔也；辛能资气，故气流也；苦能资血，故血流也；甘能资肉，故腠理密也。）如是则气骨以精，谨道如法，长有天命。（谨，顺也。如是调养身者，则气骨常得精胜，上顺天道，如先圣法，则寿弊天地，故长有天命也。【平按】：顾本《素问》“气骨”作“骨气”，赵府本仍作“气骨”。）
[Ping An]: This chapter appears in *Suwen* (Basic Questions), Volume 1, Chapter 3, "Treatise on the Interaction between Human Life and the Heaven" (*Shengqi Tongtian Lun*).
The Yellow Emperor asked Qibo: Since ancient times, the connection between humans and Heaven is the root of life. (Ancient refers to the Upper Antiquity and Middle Antiquity periods. Harmonizing Yin and Yang to nurture life constitutes the meaning of connecting with Heaven. Rulers of the Upper and Middle Antiquities, in their health preservation practices, modeled themselves after Heaven and Earth; thus, their lives were identical to Heaven and Earth, enabling them to live long and see clearly. Connecting with Heaven and Earth is the root of life. The text mentions only connecting with Heaven, not Earth, because Heaven is honored.) Its root lies in Yin and Yang. (Rooted in the Qi of Heaven, Earth, Yin, and Yang.) Within the space of Heaven and Earth, inside the Six Directions (North, South, East, West, Up, Down), the Qi of the human body, corresponding to the Nine Provinces (external geographical regions corresponding to the body), the Nine Orifices (eyes, ears, mouth, nose, etc.), the Five Zang Organs, and the Twelve Joints (major joints of the four limbs), all connect with the Qi of Heaven. (Existing within the space of Heaven and Earth's four directions and up and down, the generated things are the Nine Provinces, etc. The Nine Provinces refer to external objects relative to the body; the Nine Orifices, etc., are internal objects. The Twelve Joints refer to the three major joints in each of the four limbs. These internal and external entities all connect with the Qi of Heaven. [Ping An]: In *Suwen*, the character "yu" is written as "hu".) Life depends on the Three Qi (referring to the things between Heaven and Earth like the Nine Provinces; their life depends on the three Qi of Yin, Yang, and Harmony. [Ping An]: In *Suwen*, "zai" is written as "wu", and other versions also write "wu"). If one repeatedly violates this principle, pathogenic factors will harm the person; this is the foundation of longevity. (Yin and Yang divide into the Four Seasons and Harmony. If a person indulges their will and does not follow the Four Seasons and Harmony for health preservation, they will be harmed by pathogenic factors such as wind, cold, rain, and dampness. Following these three Qi for health preservation is the foundation of longevity. [Ping An]: In *Suwen*, the character "wei" is absent before "shu"; "ming" is added after "shou"; "ye" is added after "ben".) When the Qi of the Blue Heaven is clear and tranquil, the mind and will are regulated. (Cang refers to the color of the sky. Qi refers to the harmonious Qi of the four seasons. The harmonious Qi of Heaven and Earth is clear and not turbid, quiet and not chaotic, allowing people's minds and wills to remain clear and tranquil. [Ping An]: In *Suwen*, "jing" is written as "jing" (pure).) Adhering to it makes Yang Qi solid; even if there are thief pathogens, they cannot cause harm. This is due to following the order of time. (If a person adheres to the clear and tranquil harmonious Qi, the Zang Qi guards internally, and the Fu Qi secures externally. Thus, even if there are empty winds and thief pathogens from the Eight Normals, they cannot cause injury. This is because the harmony of the four seasons self-regulates. [Ping An]: In *Suwen*, the character "fu" is absent before "shun"; "ye" is absent after "xu".) Therefore, the sages gather their spirit and essence, or ingest the Qi of Heaven, and communicate with the divine. (Bo means to attach or have. Sages ensure that spirit and essence adhere to each other without loss, ingesting the clear and tranquil Qi, making the Shen (Spirit) clear through communication, and making the nature bright through communication. Thus, they can live out their lifespan comparable to Heaven and Earth without premature death. [Ping An]: In *Suwen*, "bo" is written as "zhuan"; "huo" is absent before "tian shang"; "er" is added before "tong".) If Qi is lost, the Nine Orifices become internally blocked, muscles become externally congested, and Wei Qi (Defensive Qi) scatters and dissipates. This is called self-injury, the wasting of Qi. (When Yin Qi is out of harmony, the Nine Orifices are internally blocked, leading to difficulty in urination and defecation; externally, muscles are congested, causing the Cou Li (pores/skin texture) to block. When Yang Qi is out of harmony, the Cou Li opens, and Wei Qi leaks out. These losses are all due to a lack of self-care, causing the harmonious Qi to diminish. [Ping An]: In *Suwen*, the character "qi" is absent before "shi". The original manuscript writes "chong" instead of "wei"; according to the commentary, it should be "wei", which matches *Suwen*.). Yang Qi is like Heaven and the Sun; if its movement is lost, longevity cannot be manifest. Therefore, the movement of Heaven relies on the brightness of the Sun. Thus, Yang Qi protects the exterior from above. (Human Yang Qi is like Heaven and the Sun; they cannot exist without each other. Just as Heaven cannot exist without the Sun, if the Sun loses its movement, Heaven is not bright. Therefore, the movement of Heaven relies on the Sun's movement to achieve brightness. Humans and Yang Qi cannot exist without each other; without the Three Yang channels running on the head, the human body cannot extend its lifespan. Therefore, the vitality of the body awaits the Yang meridians to run along the upper part of the body, so that longevity is manifest. Hence, Yang is above and protects the exterior. [Ping An]: In *Suwen*, "xing du" is written as "suo ze zhe"; "shang er" is written as "shang er".)
Due to Cold, the will fluctuates frequently like a pivot; daily activities become startled, and the Shen Qi floats upward. (Lian means frequent; Shu means movement. When harmonious Qi moves through the body, if injured by Cold, the will becomes unstable and moves frequently without stopping. Thus, daily activities seem startled, and the Hun and Shen fly about. [Ping An]: In *Suwen*, "zhi" is absent after "han"; "lian shu" is written as "yun shu". Xin Jiaozheng states: Quan Yuanqi's version writes "lian shu".) Due to Summer-Heat, sweating occurs; if irritable, there is panting and loud breathing; if quiet, there is excessive talking. The body feels like burning charcoal, and sweat pours out like scattered droplets. (He is pronounced Han-e, meaning exhalation, referring to the sound of panting breath. Sweat is Yin Qi, so when sweat exits, heat leaves. Now, despite heat and sweating, irritability persists. If quiet and undisturbed, internal heat causes delirious speech. In such cases, even with sweating, heat remains. Sweat flows like a bath, not forming beads, hence described as scattered. [Ping An]: In *Suwen*, "ru san" is written as "er san".) Due to Dampness, the head feels wrapped; large tendons become short and flaccid, small tendons become long and lax; the long and lax tendons lead to Wei syndrome (flaccidity). (Ru means "like"; Rang means remove. A person with fever wraps their wet head to remove heat; this causes large tendons to contract due to cold-dampness and small tendons to lengthen due to heat. Shi means lax, pronounced jue-er fan. Lax tendons cannot control the limbs, resulting in Wei syndrome. [Ping An]: In *Suwen*, "re shi bu" is added after "guo"; "ru" is written as "ru"; "shi" is written as "chi"; "duan wei ju" is added after "xiao jin shi chang"; "zhe" is absent before "wei".) Due to obstruction of Yang Qi, swelling occurs; the four dimensions alternate abnormally, and Yang Qi exhausts. (Pathogenic factors lodge between the muscle layers, obstructing Wei Qi flow, leading to accumulation and swelling. The Qi of the four seasons guards itself; now that the four Qi alternate, the defensive Yang Qi becomes exhausted and stagnant, causing swelling. [Ping An]: "Yin yang qi wei zhong" in *Suwen* is written as "yin yu qi wei zhong"; "er jie" is written as "nai jie".)
Yang Qi, when subjected to excessive fatigue and strain, becomes hyperactive; essence is depleted and accumulates, leading to Jian Jue (Frying Faintness) in summer. (Pi is pronounced bai-chi fan. During summer when Yang Qi is abundant, excessive sexual activity depletes Yang, causing essence to be exhausted and accumulated, leading to Qian Jue (fainting forward). Pi Ji means overlapping stagnation. Qian Jue means fainting forward. [Ping An]: Qian Jue in *Suwen* is written as "Jian Jue".) Eyes become blind and cannot see; ears become closed and cannot hear. (Exhaustion of essence leads to decline of the Kidney Fu and Foot Taiyang channel. The Foot Taiyang channel originates at the inner canthus; thus, decline of Taiyang results in blindness. Exhaustion of essence and Kidney deficiency impair the Kidney's ability to hear.) Chaos ensues like a collapsing capital; sliding and unceasing. (Kui is pronounced hu-dui fan. Kui Kui and Hua Hua both mean chaos. Excessive strain on Yang Qi causes chaos in spirit, blood, and Qi, like a capital falling apart, unstoppable. Alternatively, "Hua Hua bu zhi" implies bone misalignment. Du means great. It says not only is spirit and blood chaotic, but the twelve major bones of the limbs are also flaccid and misaligned. [Ping An]: "Hua Hua bu zhi" in *Suwen* is written as "Huan hu bu ke zhi". The note "Hua bu zheng ze" should be "Du Gu Bu Zheng". On the right margin of the original manuscript, there are eight small characters: "Hua Hua bu zhi Du Gu Bu Zheng".)
Anger causes Yang Qi to disrupt form and Qi, leading to blood stasis in the upper body, causing Bo Jue (Thin Faintness), damaging tendons and causing flaccidity. (Yin merges with Yang; extreme anger causes Wei Qi to be obstructed and cut off. Blood stagnates and rises to the head, causing fainting, hence called Qian Jue. It also damages tendons, causing flaccidity. [Ping An]: In *Suwen*, "zhe" is added after "Yang Qi"; "er jue" is written as "jue er"; "wan" is written as "wan"; "shi qian jue" is written as "shi ren bo jue".) The body becomes stiff and unable to move freely; sweating occurs asymmetrically with blockage, leading to hemiplegia. (Zu means damage, pronounced ci-lü fan. Rong means lax. Excess Yang damages tendons, causing flaccidity; if not lax, cold sweat flows asymmetrically, damaging the body. Pian Ku is paralysis on one side, inability to move, or pain. [Ping An]: "Er chu han pian zu" in *Suwen* is written as "han chu pian ju".)
Sweating followed by exposure to dampness generates Cuo Ju (acne and carbuncles). (If sweat covers the whole body and encounters dampness in the wind, pathogenic wind lodges in the muscles, obstructing Ying and Wei Qi, damaging flesh and generating Cuo Ju. Cuo is a type of abscess but smaller, commonly known as a boil. Long-term stagnation sinking into the bone is called Cuo Ju. [Ping An]: In *Suwen*, "ju" is written as "ju".) Changes from rich food (Gao Liang) can cause large Ding (boils) on the feet; receiving disease is like holding an empty vessel. (People who eat rich foods, when sweating and exposed to wind, develop diseases different from commoners, often developing large boils on the feet. Their bodies are deficient due to rich diet; encountering dampness and disease is like holding an empty vessel to receive items, indicating ease of contracting illness. [Ping An]: In *Suwen*, "gao" is written as "gao" (high); "ding" is written as "ding". Xin Jiaozheng states: Ding usually does not appear only on the feet; it implies that changes from rich diet often cause large boils, not exclusively on the feet. Also, *Suwen* adds eleven characters after "chi xu": "Lao han dang feng han bo wei yu nai cuo".)
Yang Qi nourishes the Shen (Spirit) when refined, and nourishes the tendons when soft. (Refined Wei Qi travels through the Six Fu organs during the day and the Five Zang organs at night, keeping the Five Spirits clear and making the tendons soft throughout the limbs and body.) If opening and closing fail, Cold Qi enters, leading to Da Lou (severe curvature/hunchback). (If pathogens are in the Cou Li, opening allows them out, which is correct closing. If no pathogens, closing prevents opening, which is correct opening. Now, if Cou Li opens and pathogens enter, then closes immediately, it fails. Cold pathogens enter and lodge in the waist and spine, using the buttocks instead of heels, hence called Da Lou. Lou means curved, pronounced li-ju fan.) Pathogens sink into the vessels forming pus and blood, lingering in the muscle layers. (Cold pathogens linger long without dispersing; cold and heat sink into vessels forming pus and blood, lingering between muscle layers, hence forming pus. [Ping An]: Liu in *Suwen* is written as "liu".) Transmission via acupoints with weak Qi leads to fearfulness and惊骇 (startle/terror). (Acupoints are connected to the Zang organs; weak Qi transformation leads to insecurity of essence, causing fearfulness and startle. [Ping An]: In *Suwen*, "shu" is written as "yu"; "nai" is written as "ji".) Ying Qi (Nutritive Qi) becomes disordered, reversing in the muscle tissue, leading to Yong Zhong (abscess/swelling). (Muscle and Ying Qi are damaged by pathogens, unable to circulate through Yin-Yang meridians, reversing in muscle tissue, rotting flesh and generating abscesses. [Ping An]: In *Suwen*, "shun" is written as "cong"; "yong" is written as "yong". Note: "Mai Rou", the character "rou" is written as "nei" in other versions.) Po Han (Pore Sweat) does not cease; the form weakens and Qi scorches; acupoints close, leading to Feng Nue (Wind Malaria). Thus, Wind is the beginning of all diseases. (Po is the Spirit of the Lung. The Lung governs skin, hair, and Cou Li. Human sweat is managed by the Lung's Po Spirit, hence named Po Han. Summer injury by Summer-Heat causes continuous sweating, weakening the form and depleting Qi. Wandering pathogens hide in the Cou Li; when Cou Li closes in autumn and cold strikes, internal and external sensations combine, forming Wind Malaria and scorching Qi. Thus, pathogenic wind is the start of all diseases. Shuo is pronounced shi-yao fan. Yin Xie Qi. [Ping An]: In *Suwen*, "bu jin" is written as "wei jin".)
Clarity and tranquility cause the Cou Li to close tightly; even with severe wind and toxic pathogens, they cannot invade. This is due to following the order of time. (Without agitation, hair and Cou Li close; Eight Winds cannot injure. This is because one follows the order of the four seasons for regulation, thus having no disease. Ke means harm, pronounced ke. [Ping An]: In *Suwen], "ju" is written as "ju"; "ke" is written as "hai".) Therefore, if a person's disease lasts long, it transforms; if Upper and Lower do not connect, even good doctors cannot treat it. (Even if a disease is long-standing, it may transform. If Upper and Lower Yin-Yang do not connect, until the ruling season arrives, it must heal itself; thus, good doctors do not intervene. [Ping An]: In *Suwen*, "ren" is absent before "bing".) If Yang Qi accumulates excessively, death occurs; Yang Qi becomes blocked. Blocked conditions require purging. If not treated urgently and correctly, ruin and death follow. (In Yang diseases, accumulation prevents transformation; if there is a death date, Yang meridians are blocked. When blocking occurs, purging should be immediate. If not treated urgently, death is certain. Ge means gridlock/blockage. Ji means urgent. [Ping An]: "Dan nai bai wang" in *Suwen* is written as "cu nai bai zhi"; alternative versions write "qie" for "dan". Note: "liao zhe" in alternative versions is "liao zhi".)
Yang Qi governs the exterior for one day. At dawn, Ren Qi (Human Qi) arises; at noon, Yang Qi peaks; at sunset, Yang Qi declines, and the Qi Gates open. Therefore, in the evening, one should withdraw and resist (pathogens), not disturb sinews and bones, and avoid fog and dew. (Fu Yang is Sheng Qi (Vital Qi). Fu Yin is Si Qi (Death Qi). Thus, Yang Qi governs the exterior for the day, and Yin Qi governs the interior for the night. The daytime exterior is divided into three periods: Dawn, when Ren Qi begins to rise, is Shao Yang; Noon, when Ren Qi is abundant, is Tai Yang; Sunset, when Ren Qi declines, is Xu Yang. When Yang Qi is weak, Yin Qi opens. When Yin Qi opens (Shen, You, Xu hours), Shao Yin arises. Thus, evening requires withdrawal/resistance to prevent external pathogens from entering the skin; Hai, Zi, Chou hours are Zhi Yin, so bones should not be disturbed at Zhi Yin; Yin, Mao, Chen hours are Jue Yin, so sinews should not be disturbed, and fog/dew avoided. Yin decline with dampness invites cold-damp disease. [Ping An]: In *Suwen*, "kai" is written as "bi".) Violating these three times causes the form to be distressed and pressed. (Not following the Qi of the three times of day and night for health preservation inevitably leads to disease distressing the body. Bo means pressing.)
Qibo said: Yin stores essence and initiates rising; Yang protects the exterior and secures. (Five Zang store essence; Yin reaches extremum and Yang rises; Six Fu protect the exterior; Yang reaches extremum and Yin secures. Thus, Yin and Yang must be compatible and not allow one to dominate. [Ping An]: In *Suwen], "ji qi" is written as "qi ji".) If Yin cannot overcome Yang, the pulse flows rapidly and forcefully, leading to mania. (Yang excess causes the Renying pulse to beat intermittently or quickly, indicating Yin merging with Yang excess, resulting in mania. [Ping An]: In *Suwen*, "qi" is absent before "mai".) If Yang cannot overcome Yin, the Qi of the Five Zang contends, and the Nine Orifices become blocked. (Yin excess means Zang Qi lacks protection, so the external Nine Orifices close and block. [Ping An]: In *Suwen*, "ze" is added before "Wu Zang".)
Therefore, the sages arrange Yin and Yang; sinews and pulses are harmonious, marrow and bones are solid, Qi and blood are smooth. Thus, interior and exterior are harmonized, pathogens cannot lodge, eyes and ears are acute, and Qi stands firm as before. (Thus, sages arrange Yin and Yang, regulating internal and external Qi to be harmonious and non-contentious. [Ping An]: In *Suwen*, "shun" is written as "cong"; "wai nei" is written as "nei wai"; "ke" is written as "hai".) Wind lodging and disorderly Qi causes essence to perish, and pathogens damage the Liver. (Wind lodging in disorderly Qi causes Yin excess, leading to continuous emission of essence, hence essence perishes. The Liver channel circles the genitals and enters the Liver; thus, essence loss damages the Liver. [Ping An]: Note "yin qing", "qing" is written as "jing" in other versions.) If followed by overeating, sinews and pulses relax transversely, and the intestines develop hemorrhoids. (Bi, pronounced pi, means discharging pus and blood. The Liver governs sinews and generates blood. Having injured the Liver, overeating causes grain Qi to press heavily, tearing sinews and pulses, leaking pus and blood from the large intestine, named hemorrhoids. [Ping An]: Chang Bi in Yuan edition mistakenly written as Shang Bi.) If followed by heavy drinking, counterflow Qi occurs. (Yi means big. Having lost sinews and injured the Liver, heavy drinking causes counterflow Qi disease. [Ping An]: Yi in *Suwen* is written as "da".) If followed by excessive physical effort, Kidney Qi is injured, and high bones (large bones) are destroyed. (Loss of essence and Liver injury, compounded by strenuous sexual activity, injures the Kidney. The Kidney stores essence and governs bones; Kidney injury destroys large bones. Gao means big.)
The key to Yin and Yang is dense Yin and solid Yang. If the two are not in harmony, it is like Spring without Autumn, or Winter without Summer. Harmonizing them is called the Sage's standard. (Dense Cou Li that does not leak is the power of internal Yin. Solid storage of Shen in the Five Zang is the power of external Yang. Thus, like the harmonious Qi of the four seasons, they cannot exist without each other. Harmonizing the body with the harmonious Qi of the four seasons is the method of the former Sages. [Ping An]: "Yin mi yang gu" in *Suwen* is written as "yang mi nai gu".) Forcing what cannot be endured causes Yin Qi to exhaust. (When Yin Qi is deficient, it can be supplemented; forcing further sexual activity drains Yin, causing Yin Qi to exhaust. [Ping An]: "Gu qiang bu neng" in *Suwen* is written as "gu yang qiang bu neng mi"; Yuan edition adds "mi" after "neng", inconsistent with original manuscript.) Exposure to wind generates cold and heat. (Essence loss and Liver injury, combined with cold-damp-wind pathogens, form cold-heat disease. [Ping An]: *Suwen* has four sentences above this paragraph: "Yin ping yang mi, jing shen nai zhi; yin yang li jue, jing qi nai jue". The last two sentences appear later in this book.)
Therefore, Spring injury by Wind causes pathogens to linger, leading to Dong Xie (profuse diarrhea); Summer injury by Summer-Heat leads to Nue Malaria in Autumn; Autumn injury by Dampness causes Qi to reverse upward with cough, developing Wei Jue (flaccidity and cold limbs); Yin and Yang separate and disconnect, essence and Qi perish; Winter injury by Cold leads to Heat disease in Spring. (Dong is pronounced da-gong fan, meaning rapid flow. The Lung dislikes cold-damp Qi, so Qi reverses upward with cough. By winter, cold-damp transforms into heat, limbs cannot move, named Wei Jue. Two Qi separating and discordant causes essence and Qi to perish. [Ping An]: In *Suwen*, "liu lian" is written as "liu lian"; "chun nai bing re" is written as "chun bi wen bing".) Contention of the Qi of the four seasons injures the Five Zang. (Wind, cold, summer-heat, and dampness are pathogens of the four seasons; contention and disharmony injure the Five Zang.)
The generation of Yin originates in the Five Flavors. (Internal Yin of the Five Zang is generated by the five flavors. [Ping An]: In *Suwen*, "suo" is added before "sheng".) The five orifices of Yin rely on Yang in the five flavors. (The Five Zang are the officials of Yin. The Yang of the five orifices (eyes, ears, nose, mouth, tongue) originates in the five flavors. Thus, five flavors nourish the Five Zang internally, strengthening the five orifices. [Ping An]: In *Suwen*, "guan" is written as "gong"; "yang" is written as "shang".)
Therefore, if taste is excessively sour, Liver Qi floods, and Lung Qi perishes. (The five flavors each enter their respective Zang; moderation benefits, excess harms. Sour injury causes Liver Qi to flow downward, thinning the bladder and causing strangury and leakage. Lung controls Liver; now Liver Qi leaks, leaving Lung with nothing to control, so Lung Qi is useless. [Ping An]: Fei in *Suwen* is written as "Pi".) If taste is excessively salty, large bone Qi labors, and muscle Qi is suppressed. (Salt nourishes bone; excessive salt injures bone, leaving Spleen with nothing to control, so muscles shrink and Spleen Qi is congested. [Ping An]: In *Suwen*, "xin" is added after "ji".) If taste is excessively bitter, Heart Qi pants and feels full, and Kidney color is black and fails to guard. (Bitter nourishes Heart; excessive bitterness injures Heart, causing panting, fullness, and vomiting, leaving Kidney Qi powerless, hence black complexion and failure to guard. [Ping An]: In *Suwen*, "ku" is written as "gan"; "shen bu wei" is written as "shen qi bu heng".) If taste is excessively sweet, Spleen Qi becomes moist and soft, and Stomach Qi becomes thick. (Sweet nourishes Spleen Qi; excessive sweetness injures Spleen Qi, making it moist, causing heart stuffiness and thick Stomach Qi. [Ping An]: In *Suwen*, "gan" is written as "ku"; "bu" is added before "ru".) If taste is excessively pungent, sinews and pulses become flaccid, and spirit becomes endangered. (Pungent nourishes Lung; excessive pungency injures Lung. Lung governs Qi; sinew Qi is damaged, leaking through skin and hair. Heart Spirit controls Lung Qi damage and leakage; Shen Qi becomes abundant, floating and useless. [Ping An]: Ying in *Suwen* is written as "yang". Wang Zhu interprets "yang" as "jiu" (long). Xin Jiaozheng states this discusses harm from excess flavors,不宜 interpreting as long-lived spirit; "yang" is actually "yang" (disaster). Ancient text is concise, using many phonetic loans. This explanation is superior.)
Therefore, carefully harmonizing the five flavors makes bones straight and sinews flexible, Qi and blood flow smoothly, and Cou Li closes densely. (When five flavors are appropriate, salt nourishes bone, so bones are straight; sour nourishes sinews, so sinews are flexible; pungent nourishes Qi, so Qi flows; bitter nourishes blood, so blood flows; sweet nourishes flesh, so Cou Li is dense.) Thus, Qi and bones become refined; following the Dao and methods ensures long life and destiny. (Jin means obey. Regulating the body thus keeps Qi and bones refined, complying with Heavenly Dao and Sage methods, living out lifespan like Heaven and Earth, hence long possession of destiny. [Ping An]: Gu edition *Suwen* writes "gu qi" for "qi gu"; Zhao Fu edition still writes "qi gu".)