黄帝曰。余闻人有精气津液血脉。余意以为一气耳。今乃辩为六名。余不知其所以然。
此篇论精气津液血脉。生于后天而本于先天也。本于先天。总属一气。成于后天。辩为六名。
故帝意以为一而伯分为六焉。 、分也。 而和。故篇名决气。谓气之分判为六。而和合为一也。
岐伯曰。两神相抟。合而成形。常先身生是谓精。何谓气。岐伯曰。上焦开发。宣五谷味。熏
肤充身泽毛。若雾露之溉。是谓气。何谓津。岐伯曰。腠理发泄。汗出溱溱。是谓津。何谓液。岐
伯曰。谷入气满。淖泽注于骨。骨属屈伸。泄泽。补益脑髓。皮肤润泽。是谓液。何谓血。岐伯曰。
中焦受气取汁。变化而赤是谓血。何谓脉。岐伯曰。壅遏营气。令无所避。是谓脉。
吴氏曰。所生之来谓之精。两精相抟谓之神。又曰。神者。水谷之精气也。两神者。一本于天
一之精。一生于水
谷之精。两神相抟。合而成此形也。所生之来谓之精。故常先身生。谓未成形而先生此精也。上焦之
气。宣发五谷之精微。充肤热肉。润泽皮毛。若雾露之溉。是谓气。腠理者。肌肉之纹理。本经曰。
水谷入于口。其味有五。各注其海。津液各走道。故三焦出气以温肌肉。充皮肤。为其津。其流而
不行者为液。是以发泄于腠理。汗出溱溱。是谓津。谷入气满。淖泽注于骨。使骨属屈伸。泄泽。从
髓空而补益脑髓。皮肤润泽。是谓液。中焦受水谷之精气。济泌别汁。奉心神变化而赤。是谓血。壅、
培助也。遏、遮蔽也。避、违避也。言经脉壅蔽营气。行于脉中。昼夜环转。无所违逆。是谓脉。
黄帝曰。六气者。有余不足。气之多少。脑髓之虚实。血脉之清浊。何以知之。岐伯曰。精脱
者耳聋。气脱者目不明。津脱者。腠理开。汗大泄。液脱者。骨属屈伸不利。色夭。脑髓消。胫 耳
数鸣。血脱者。色白夭然不泽。其脉空虚。此其候也。
营者。精气也。血者。神气也。精血津液。皆本于气之生化。故谓之六气。清浊者。营卫之气也。
肾主藏精。开窍于耳。故精脱者耳聋。目之精明五色者。气之华也。故气脱者目不明。津发于腠理。
故津脱者腠理开。汗大泄。液淖泽于骨。补益脑髓。故液脱者。骨属屈伸不利。不能润泽皮肤。故
毛色夭焦也。肾主骨。而骨髓上通于脑。故脑髓消而胫 耳鸣。心主血。心之合脉也。其营色也。
是以血脱者。色白夭然不泽。其脉空虚。此其候也。
黄帝曰。六气者。贵贱何如。岐伯曰。六气者。各有部主也。其贵贱善恶。可为常主。然五谷与
胃。为大海也。
夫子曰。卑高以陈。贵贱位矣。谓居上者为尊贵。居下者为卑贱。言此六气。主于心肾。而生于
胃海也。各有部
主者。谓精之藏于肾。血之主于心。气之主于皮肤。津之发于腠理。液之淖于骨。资于脑。脉之循
于脏腑形身。各有所主之部。然以心肾为常主。五谷与胃为大海。津液血气。乃胃海之所生也。夫心
为君主之官而居上。水性润下而居下。火之精为血。水之精为精。水性柔善。火性猛恶。其贵贱善恶。
可为六气之常主也。盖水火者。阴阳之征兆也。谓六气辩为六名。然总归阴阳之一气。
黄帝说：我听说人有精、气、津、液、血、脉这六种物质。我心里认为它们其实是一气罢了，现在却被分辨为六个名称，我不知道其中的原因。
这一篇论述精、气、津、液、血、脉，说明它们生于后天而本源于先天。本源于先天时，总归是一气；形成于后天时，才分辨为六个名称。
所以黄帝心中认为是一，而伯高将其分为六。“决”意为分别，“判”意为区分，通过分别而达到和谐，因此篇名叫做《决气》，意思是气被分别判断为六种，而又和合为一。
岐伯说：男女两性的精气相结合，融合而成形体，这种在身体形成之前就已经存在的物质，就叫做“精”。什么是“气”？岐伯说：上焦（胸中部位）开发宣发，布散五谷的精微气味，熏蒸皮肤，充实全身，润泽毛发，就像雾露滋润万物一样，这就叫做“气”。什么是“津”？岐伯说：腠理（皮肤纹理及汗孔）开泄，汗水大量流出，这就叫做“津”。什么是“液”？岐伯说：谷物进入体内后，气机充满，浓稠的汁液注入骨骼，使骨节能够屈伸自如，渗出汁液以补益脑髓，使皮肤润泽，这就叫做“液”。什么是“血”？岐伯说：中焦（脾胃部位）接受水谷之气，提取其中的汁液，经过变化变成红色，这就叫做“血”。什么是“脉”？岐伯说：脉能约束营气，使其运行有度，不致散乱逃避，这就叫做“脉”。
吴氏评论说：生命的起源称为“精”，两精相搏产生“神”。又说：“神”，是水谷化生的精气。所谓“两神”，一个是禀受于天一的先天之精，一个是来源于水谷的后天之精。两神相互结合，融合而成这个形体。所谓“所生之来谓之精”，所以在身体成形之前先生出此精。上焦之气，宣发五谷的精微，充养皮肤，温暖肌肉，润泽皮毛，如同雾露灌溉一般，这就叫做“气”。腠理，是肌肉的纹理。《内经》其他篇章说：水谷入口，其味道分为五类，各自注入相应的海（指脏腑或特定部位），津液各自走向不同的通道。所以三焦发出气来温煦肌肉，充实皮肤，这就是“津”；流动缓慢而不外泄的就是“液”。因此，从腠理发泄出来，汗水溱溱而出的，叫做“津”。谷物进入后气机充满，浓稠的汁液注入骨骼，使骨节能够屈伸，渗出的汁液从骨髓的空隙中补益脑髓，使皮肤润泽，这就叫做“液”。中焦接受水谷的精气，过滤分离出汁液，奉输于心神，变化成红色，这就叫做“血”。“壅”，是培助的意思；“遏”，是遮蔽的意思；“避”，是违逆、逃避的意思。这句话的意思是经脉壅蔽着营气，使其行于脉管之中，昼夜循环运转，没有违逆散乱之处，这就叫做“脉”。
黄帝说：这六种气，有余和不足的情况，气的多少，脑髓的虚实，血脉的清浊，如何来判断呢？岐伯说：精脱失的人耳聋；气脱失的人视力不明；津脱失的人，腠理开张，大汗淋漓；液脱失的人，骨节屈伸不利，面色枯槁，脑髓消减，小腿酸软，耳朵经常鸣响；血脱失的人，面色苍白无光泽，脉象空虚。这些就是它们的征候。
营气，就是精气的一种表现；血，是神气的载体。精、血、津、液，都本源于气的生化作用，所以统称为“六气”。清浊，指的是营气和卫气。肾主藏精，开窍于耳，所以精脱失的人会耳聋。眼睛能辨别五色，是气的外在荣华表现，所以气脱失的人视力不明。津液发源于腠理，所以津脱失的人腠理开张，大汗淋漓。液滋润骨骼，补益脑髓，所以液脱失的人骨节屈伸不利，不能润泽皮肤，导致毛发枯焦、面色晦暗。肾主骨，骨髓向上连通于脑，所以脑髓消减会导致小腿无力、耳鸣。心主血，心与脉相合，脉反映心的营色，所以血脱失的人，面色苍白无光泽，脉象空虚。这些就是它们的征候。
黄帝说：这六种气，贵贱情况如何？岐伯说：这六种气，各有其主要归属的部位。它们的贵贱好坏，可以作为常例的主宰，然而五谷和胃，才是它们的“大海”（根本来源）。
孔子（此处借指古圣先贤之言）说：“高低位置已经陈列，贵贱之位也就确定了。”意思是居于上位者为尊贵，居于下位者为卑贱。这里说的是这六种气，主要归属于心和肾，而生成于胃海。所谓“各有部主”，是指精由肾所藏，血由心所主，气由皮肤所司，津由腠理所发，液由骨所淖注并资助于脑，脉循行于脏腑和身形，各自有所主的部位。然而以心和肾为通常的主宰，以五谷和胃为大海。津、液、血、气，都是胃海所化生的。心作为君主之官而居上，水性润下而居下。火的精华化为血，水的精华化为精。水性柔和善良，火性猛烈凶恶。它们的贵贱善恶，可以成为六种气的常规主宰。大概水火，是阴阳的象征征兆。意思是虽然六种气被分辨为六个名称，但最终都归结于阴阳这一气。
Huangdi said: I have heard that humans possess Jing (Essence), Qi (Vital Energy), Jin (Thin Fluids), Ye (Thick Fluids), Xue (Blood), and Mai (Vessels). In my mind, I considered them to be merely one Qi. Now they are distinguished into six names, and I do not understand the reason for this.
This chapter discusses Jing, Qi, Jin, Ye, Xue, and Mai, explaining that they are generated from the postnatal world but rooted in the prenatal essence. Rooted in the prenatal essence, they are essentially one Qi; once formed in the postnatal stage, they are distinguished into six names.
Therefore, Huangdi regarded them as one, while Bo Gao divided them into six. "Jue" (决) means to separate or decide, and "Pan" (判) means to distinguish. Through separation, harmony is achieved. Hence, the chapter is named *Jue Qi* (Deciding Qi), meaning that Qi is separated and judged into six aspects, yet harmonized into one.
Qibo said: When the Yin and Yang spirits (gametes of male and female) interact, they combine to form a body. This substance, which exists prior to the formation of the physical body, is called Jing (Essence). What is Qi? Qibo said: The Upper Jiao (Upper Burner) opens and develops, distributing the flavors of the five grains. It steams the skin, fills the body, and moistens the hair, resembling the irrigation of mist and dew. This is called Qi. What is Jin (Thin Fluid)? Qibo said: When the Cou Li (interstices and pores) open and sweat profusely, this is called Jin. What is Ye (Thick Fluid)? Qibo said: After food enters, Qi becomes full. The rich and viscous fluids flow into the bones, enabling flexion and extension of the skeletal joints. They exude moisture to nourish the brain and marrow, and moisten the skin. This is called Ye. What is Xue (Blood)? Qibo said: The Middle Jiao (Middle Burner) receives the Qi of water and grain, extracts its juices, transforms them, and turns them red. This is called Xue. What is Mai (Vessels)? Qibo said: Vessels contain and restrain Ying Qi (Nutritive Qi), preventing it from escaping or deviating. This is called Mai.
Wu commented: The origin of life is called Jing. The interaction of two Jings gives rise to Shen (Spirit). It is also said that Shen is the refined Essence of water and grain. The term "two spirits" refers to one originating from the Prenatal Jing (Tian Yi Jing) and the other from Postnatal Jing derived from water and grain. The interaction of these two spirits combines to form the physical body. Since "the origin of generation is called Jing," it implies that this Jing is generated before the body takes shape. The Qi of the Upper Jiao disseminates the fine essences of the five grains, nourishing the skin, warming the flesh, and moistening the hair and fur, like mist and dew irrigating. This is called Qi. Cou Li refers to the texture of muscles. As stated in other chapters of the Classic: Water and grain enter the mouth, their flavors divide into five categories, each flowing into its respective Sea. Jin and Ye follow different pathways. Thus, the Qi emitted by the Three Jiao warms the muscles and fills the skin, constituting Jin; the fluid that flows slowly and does not exit externally constitutes Ye. Therefore, what is excreted through the Cou Li with profuse sweating is called Jin. After grain enters and Qi becomes full, viscous fluids flow into the bones, allowing joint movement. The exuded fluids enter the bone cavities to nourish the brain and marrow, moistening the skin. This is called Ye. The Middle Jiao receives the refined Qi of water and grain, filters and separates the juices, offers them to the Heart Spirit, transforms them, and turns them red. This is called Xue. "Yong" (壅) means to support or embank; "E" (遏) means to block or cover; "Bi" (避) means to avoid or evade. This statement means that the meridians embank and block Ying Qi, keeping it circulating within the vessels day and night without deviation. This is called Mai.
Huangdi asked: Regarding these six Qi, how can we determine excess and deficiency, the quantity of Qi, the emptiness or fullness of the brain and marrow, and the clarity or turbidity of the blood vessels? Qibo replied: When Jing is depleted, there is deafness. When Qi is depleted, vision is unclear. When Jin is depleted, the Cou Li open, and there is massive sweating. When Ye is depleted, there is stiffness in joint flexion and extension, sallow complexion, depletion of brain and marrow, weakness in the shins, and frequent tinnitus. When Xue is depleted, the complexion is pale and lusterless, and the pulse is empty. These are the signs.
Ying Qi is a manifestation of Jing Essence; Xue carries Shen Qi. Jing, Xue, Jin, and Ye all originate from the transformation and production of Qi; therefore, they are collectively referred to as the Six Qi. Clarity and turbidity refer to Ying Qi and Wei Qi (Defensive Qi). The Kidney stores Jing and opens into the ears; thus, Jing depletion leads to deafness. The eyes' ability to distinguish colors is the brilliance of Qi; thus, Qi depletion leads to poor vision. Jin emanates from the Cou Li; thus, Jin depletion causes open Cou Li and massive sweating. Ye moistens the bones and nourishes the brain and marrow; thus, Ye depletion results in stiff joints and inability to moisten the skin, leading withered hair and dull complexion. The Kidney governs the bones, and bone marrow connects upward to the brain; thus, depletion of brain and marrow causes shin weakness and tinnitus. The Heart governs Xue, and the Heart's partnership is with the Mai; the Mai reflects the color of Ying. Thus, Xue depletion results in a pale, lusterless complexion and an empty pulse. These are the signs.
Huangdi asked: What is the hierarchy among the Six Qi? Qibo replied: Each of the Six Qi has its specific governing region. Their hierarchy and quality can serve as standard rulers; however, the five grains and the Stomach are their "Great Sea" (primary source).
As the Sages said: "When high and low positions are established, the ranks of noble and base are determined." This means those in upper positions are noble, and those in lower positions are base. This refers to the Six Qi, which are primarily governed by the Heart and Kidney but generated from the Stomach Sea. "Each having its governing region" means: Jing is stored by the Kidney, Xue is governed by the Heart, Qi is managed by the skin, Jin emanates from the Cou Li, Ye moistens the bones and benefits the brain, and Mai circulates through the Zang-Fu organs and the body, each having its specific domain. However, the Heart and Kidney act as the primary governors, and the five grains and Stomach serve as the Great Sea. Jin, Ye, Xue, and Qi are all generated from the Stomach Sea. The Heart, as the Sovereign Official, resides above; Water nature is moist and descends, residing below. The essence of Fire transforms into Blood, and the essence of Water transforms into Jing. Water nature is soft and benevolent, while Fire nature is fierce and aggressive. Their nobility and baseness, goodness and evil, can serve as the constant rulers of the Six Qi. Essentially, Water and Fire are the symbols of Yin and Yang. Although the Six Qi are distinguished into six names, they ultimately return to the single Qi of Yin and Yang.