黄帝问于少师曰。余闻人之生也。有刚有柔。有弱有强。有短有长。有阴有阳。愿闻其方。
此章论人秉天地阴阳而生。在天为气。在地成形。形与气相任则寿。不相任则夭。刚柔。阴
阳之道也。立天之道。曰阴与阳。立地之道。曰柔与刚。是故阴中有阴。阳中有阳。内有阴阳。外
亦有阴阳。玉师曰。强弱短长。即如四时有寒暑。昼夜有长短。盖人与万物。皆禀此天地阴阳之
形气。与时相应。故各有刚柔长短之不同。
少师答曰。阴中有阴。阳中有阳。审知阴阳。刺之有方。得病所始。刺之有理。谨度病端。与
时相应。内合于五脏六腑。外合于筋骨皮肤。是故内有阴阳。外亦有阴阳。在内者五脏为阴。六腑
为阳。在外者筋骨为阴。皮肤为阳。故曰病在阴之阴者。刺阴之荥输。病在阳之阳者。刺阳之合。
病在阳之阴者。刺阴之经。病在阴之阳者。刺络脉。故曰病在阳者名曰风。病在阴者名曰痹。阴
阳俱病。命曰风痹。病有形而不痛者。阳之类也。无形而痛者。阴之类也。无形而痛者。其阳完而
阴伤之也。急治其阴。无攻其阳。有形而不痛者。其阴完而阳伤之也。急治其阳。无攻其阴。阴
阳俱动。乍有形。乍无形。加以烦心。命曰阴胜其阳。此谓不表不里。其形不久。
夫阳者、天气也。主外。阴者、地气也。主内。然天地阴阳之气。上下升降。外内出入。是
故内有阴阳。外亦有阴阳。皮肉筋骨。五脏六腑。外内相合。与时相应者也。五脏为阴。六腑为
阳。在内之阴阳也。筋骨为阴。皮肤为阳。在外之阴阳也。病在阴之阴者。病内之五脏。故当刺
阴之荥输。病在阳之阳者。病在外之皮肤。故当刺阳之合。
谓六腑外合于皮肤。故当取腑经之合穴也。病在阳之阴者。病在外之筋骨。故当刺阴之经。谓五脏
外合于筋骨。故当取阴之经也。病在阴之阳者。病在内之六腑。故当刺络脉。故曰病在阳者名曰风。
病在阴者名曰痹。盖风者天之阳气。痹者人之阴邪。阴阳俱病。名曰风痹。外内之相合也。有形者。
皮肉筋骨之有形。无形者。五脏六腑之气也。病有形而不痛者。病在外之阳也。病无形而痛者。气
伤痛也。阴完阳完者。脏腑阴阳之气不伤也。夫天地者。万物之上下也。动静者。天地之体用也。
水火者。阴阳之征兆也。天气下降。气流于地。地气上升。气腾于天。天地之气交也。离中有虚。
坎中有满。水火之相济也。如阴阳俱动。乍有形。乍无形。乃阴阳之不表不里矣。心为阳而主火。
水为阴而居下。加以烦心。此阴胜其阳矣。阴阳外内不交。水火上下相克。此天地阴阳之气不调。
故其形不久。形气之相应也。开之曰。针合天地人三才之道。此篇论人。合天地阴阳。故用针以
调其不和。经中大义。当于针病之外求之。
黄帝问于伯高曰。余闻形气。病之先后。外内之应奈何。伯高答曰。风寒伤形。忧恐忿怒伤气。
气伤脏。乃脏病。寒伤形。乃应形。风伤筋脉。筋脉乃应。此形气内外之相应也。黄帝曰。刺之
奈何。伯高答曰。病九日者。三刺而已。病一月者。十刺而已。多少远近。以此衰之。久痹不去
身者。视其血络。尽出其血。黄帝曰。外内之病。难易之治奈何。
伯高答曰。形先病而未入脏者。刺之半其日。脏先病而形乃应者。刺之倍其日。此月内难易
之应也。
此论外因之病。从外而内。内因之病。从内而外。形气外内之相应也。风寒者。外受之邪。故
病形。忧恐忿怒。在内之气。故病脏。夫外为阳。内为阴。病九日者。病发于阳。故用三之奇。
病一月者。病发于阴。故用十之偶。此以
针之奇偶。应病之阴阳也。出络血者。通地之脉道也。形先病而未入脏者。病发于阳。而未入于
里也。故刺三时而可愈矣。脏先病而形乃应者。病发于阴。而出于外也。刺之倍其日而愈矣。夫病
发于阴而出于外者易愈。留于内者难已。故刺有十日者。有倍其日而刺两日者。此一月之病在内者。
有难易之应也。
黄帝问于伯高曰。余闻形有缓急。气有盛衰。骨有大小。肉有坚脆。皮有浓薄。其以立寿夭奈
何。伯高答曰。形与气相任则寿。不相任则夭。皮与肉相果则寿。不相果则夭。血气经络。胜形
则寿。不胜形则夭。黄帝曰。何谓形之缓急。伯高答曰。形充而皮肤缓者则寿。形充而皮肤急者则
夭。形充而脉坚大者顺也。形充而脉小以弱者气衰。衰则危矣。若形充而颧不起者骨小。骨小则
夭矣。形充而大肉。 坚而有分者肉坚。肉坚则寿矣。形充而大肉无分理不坚者肉脆。肉脆则夭矣。
此天之生命。所以立形定气。而视寿夭者。必明乎此。立形定气。而后以临病患。决死生。黄帝曰。
余闻寿夭。然以度之。伯高答曰。墙基卑。高不及其地者。不满三十而死。其有因加疾者。不
及二十而死也。黄帝曰。形气之相胜。以至寿夭奈何。伯高答曰。平人而气胜形者寿。病而形肉脱。
气胜形者死。形胜气者危矣。（颧音权 音窘度入声）
此论人秉天地阴阳。生成此形气。有寿夭之不同也。任、当也。果、成也。此天之生命。立形
定气。故形与气相任则寿。不相任则夭。夫人皮应天。人肉应地。故皮与肉相果则寿。不相果则
夭。形谓皮肉筋骨。血气经络。应经水气脉。通贯于地中。故胜形则寿。不胜形则夭。人之形气。
天命所生。皮肤缓者。天道之元亨也。是以缓则寿而急则夭。脉乃精血神气之所游行。故形充而
脉坚大者为顺。脉小以弱者。荣卫宗气俱衰。衰则危矣。夫肾
秉先天之阴阳而主骨。颧乃肾之外候。故颧不起者骨小。骨小则夭。此先天之气薄也。脾主地而
主肉。肉坚者寿。不坚者夭。此后天之土基有浓薄也。此天之生命。所以立形定气而视寿夭者。
必明乎此。先立形定气。而后以临病患。决死生。天年篇曰。以母为基。以父为 。人之寿百岁者。
使道隧以长。墙基高以方。墙基者。面部之四方也。地、地阁也。墙基卑。高不及地者。四方之
平陷也。此人秉母气之薄。盖坤道之成形也。天年篇曰。人生三十岁。五脏大定。不满三十而死者。
不能终地之五行也。其有因加疾者。不及二十而死。不能终地之生数也。平人气胜形者寿。谓地基
固宜博浓。而气更宜胜形。盖万物资始于天。而天包乎地之外也。病而形肉脱。气胜形者。邪气
胜也。形胜气者。正气脱也。
黄帝曰。余闻刺有三变。何谓三变。伯高答曰。有刺营者。有刺卫者。有刺寒痹之留经者。黄
帝曰。刺三变者奈何。伯高答曰。刺营者出血。刺卫者出气。刺寒痹者内热。黄帝曰。营卫寒痹
之为病奈何。伯高答曰。营之生病也。寒热少气。血上下行。卫之生病也。气痛时来时去。怫忾贲
响。风寒客于肠胃之中。寒痹之为病也。留而不去。时痛而皮不仁。（忾音戏）
夫形舍气。气归形。形气之相任也。然下焦所藏之精水。中焦所生之荣卫。所以温分肉。充皮
肤。濡筋骨。利关节。水随气而营运于肤表。环转无端。如营卫留阻。水道不行。则形气消索矣。
故刺有三变。变者。使之营运而变化也。荣之血。卫之气。道之出行于外。寒之痹。使之热散于
内。夫营卫血气。主出入于外内。故病则止上下行。而为寒热气痛矣。若怫忾贲响。此乃风寒客于
肠胃之中。盖以分别营卫之生病。寒痹之为病。本于自生。
非外因之邪也。痹者。闭也。寒痹者。寒水之为病也。肾为水脏而主骨。在外者皮肤为阳。筋骨为
阴。病在阴者名曰痹。留而不去。时痛而皮不仁者。谓肾脏寒水之痹。痛在于外合之骨。而及于
皮之不仁。病从内而外也。玉师曰。风寒客于肠胃之中。照应病而形肉脱气胜形者句。盖本篇先
论秉气之寿夭。后复论病气之寿夭。然病气有二。一因于风寒之病气。所谓气胜形者是也。一因于
营卫稽留。水道不行之病气。所谓形胜气者是也。
黄帝曰。刺寒痹内热奈何。伯高答曰。刺布衣者。以火 之。刺大人者。以药熨之。黄帝曰。
药熨奈何。伯高答曰。用醇酒二十斤。蜀椒一斤。干姜一斤。桂心一斤。凡四种皆 咀清酒中。
用绵絮一斤。细白布四丈。并纳酒中。置酒马矢 中。盖封涂。勿使泄。五日五夜。出布绵絮曝干
之。干复渍。以尽其汁。每渍必 其日乃出干。干。并用滓与绵絮。复布为复巾。长六七尺。为六
七则用之。生桑炭炙巾。以熨寒痹所刺之处。令热入至于病所。寒。复炙巾以熨之。三十遍而止。
汗出以巾拭身。亦三十遍而止。起步内中。无见风。每刺必熨。如此病已矣。此所谓内热也。
（矢屎同 音氲 音岁）
痹者。留而不行也。寒痹者。肾脏寒水之气也。夫人秉先天之水火。以化生五行。肾受天一
之精气。而交通于四脏。如水火不济。五行不交。则留而为寒痹疾。故以火 之者。以火益水也。
夫肺主皮毛。饮酒者先行皮肤。先充络脉。用醇酒者。使肺肾之相通者。蜀椒形色像心。皮红子
黑。具中虚之象。用蜀椒者。使心肾之相通也。脾为阴中之至阴。干姜主理中之君品。用干姜者。
使脾肾之相通也。桂为百木之长。用桂心者。使肝肾之相
通也。蚕食桑而成绵。三者皆白。肺之品也。用绵絮一斤。白布四丈。十遍者。使在地之阴邪。
从天表以终散。所谓热于内而使之外散也。夫王公大人。固不可以火 。而布衣独不可以药熨乎。
此盖假大人布衣。以明脏腑相通。阴阳交互。是以治法之有通变也。学人当体法先圣之用意周密。
取法精微。不可图安苟简也。张开之曰。上古用分两品数。汤丸散剂。各有精义。君一臣二。奇之制
也。君二臣四。偶之制也。君二臣三。奇之制也。君二臣六。偶之制也。近者奇之。远者偶之。
汗者不以奇。下者不以偶。近而奇偶。制小其服。远而偶奇。制大其服。大则数少。小则数多。
多则九之。少则二之。此品数奇偶多少之有法也。凡治中土者。多用五数。欲下行者。多用三数。
欲从阴而上升。有用至一两一分者。又如芫花乱发。熬如鸡子。石脂戎盐。大如弹丸。此分两
用法之精微也。夫理中者用丸。行散者用散。行于脏腑经络皮肤者用汤。又如抵当丸、陷胸丸、干
姜散、败酱散之类。捣为丸为散。而复以水煎服。此汤丸散剂之各有所取也。
黄帝向少师问道：我听说人的出生，有的刚强，有的柔和；有的虚弱，有的强壮；有的短命，有的长寿；有的属阴，有的属阳。希望能听听其中的道理。
这一章论述人禀受天地阴阳之气而生。在天表现为气，在地形成形体。形与气相称则长寿，不相称则夭折。刚柔、阴阳是自然的规律。确立天的规律，叫做阴与阳；确立地的规律，叫做柔与刚。因此阴中有阴，阳中有阳，内部有阴阳，外部也有阴阳。玉师（此处指代前文或泛指医理）说：强弱长短，就像四季有寒暑变化，昼夜有长短区别。大概人与万物，都禀受了天地阴阳的形气，与时令相应，所以各有刚柔长短的不同。
少师回答说：阴中有阴，阳中有阳。审察清楚阴阳，针刺就有方法。得知疾病发生的根源，针刺就有条理。谨慎地考察疾病的开端，使其与时令相应，内部合于五脏六腑，外部合于筋骨皮肤。因此内部有阴阳，外部也有阴阳。在内部，五脏为阴，六腑为阳；在外部，筋骨为阴，皮肤为阳。所以说，病在阴中之阴者（即五脏），针刺阴经的荥穴和输穴；病在阳中之阳者（即皮肤），针刺阳经的合穴；病在阳中之阴者（即筋骨），针刺阴经的经穴；病在阴中之阳者（即六腑），针刺络脉。所以说，病在阳分的称为风，病在阴分的称为痹。阴阳俱病，称为风痹。病有形状但不疼痛的，属于阳类；无形状但疼痛的，属于阴类。无形状而疼痛的，说明阳气完好而阴气受伤，应紧急治疗阴分，不要攻伐阳气；有形状而不疼痛的，说明阴气完好而阳气受伤，应紧急治疗阳气，不要攻伐阴气。如果阴阳都动乱，时而出现形状，时而没有形状，再加上心烦，这叫做阴胜其阳，这叫不表不里，其生命不会长久。
阳，是天之气，主外；阴，是地之气，主内。然而天地的阴阳之气，上下升降，内外出入。因此内部有阴阳，外部也有阴阳。皮肉筋骨、五脏六腑，内外相合，与时令相应。五脏为阴，六腑为阳，这是内部的阴阳；筋骨为阴，皮肤为阳，这是外部的阴阳。病在阴中之阴者，是病在内之五脏，所以应当针刺阴经的荥穴和输穴；病在阳中之阳者，是病在外之皮肤，所以应当针刺阳经的合穴。所谓六腑外合于皮肤，所以应当取六腑经脉的合穴。病在阳中之阴者，是病在外之筋骨，所以应当针刺阴经的经穴。所谓五脏外合于筋骨，所以应当取阴经的经穴。病在阴中之阳者，是病在内之六腑，所以应当针刺络脉。所以说，病在阳分的称为风，病在阴分的称为痹。风是天之阳气，痹是人之阴邪。阴阳俱病，称为风痹，这是外内相合的表现。有形状的，指皮肉筋骨等有形之物；无形状的，指五脏六腑之气。病有形状但不疼痛的，是病在外之阳；病无形状但疼痛的，是气伤痛。阴完阳完，指脏腑阴阳之气未伤。天地是万物的上下方位，动静是天地的体用，水火是阴阳的征兆。天气下降，气流于地；地气上升，气腾于天，这是天地之气的交合。离卦中有虚，坎卦中有满，这是水火相济。如果阴阳都动乱，时而出现形状，时而没有形状，这是阴阳不表不里的状态。心为阳而主火，水为阴而居下，加上心烦，这是阴胜其阳。阴阳内外不交，水火上下相克，这是天地阴阳之气不调，所以其生命不会长久。这是形气相应的道理。张开之说：针法合乎天地人三才之道。本篇论人，合于天地阴阳，所以用针来调和不和之处。经文中的大义，应当在针治疾病之外去探求。
黄帝问伯高：我听说形与气，有病的先后顺序，以及外内的对应关系是怎样的？伯高回答说：风寒伤害形体，忧恐忿怒伤害气机。气伤及脏，就是脏病；寒伤及形，就应验在形体上；风伤及筋脉，筋脉就会应验。这就是形气内外相应的道理。黄帝说：如何针刺？伯高回答说：患病九天的，刺三次就好了；患病一个月的，刺十次就好了。多少远近，以此类推递减。久痹不去身的，观察其血络，放尽瘀血。黄帝说：外内之病，治疗的难易程度如何？
伯高回答说：形体先病而未入脏的，针刺天数减半；脏先病而后形体应验的，针刺天数加倍。这是一个月内难易对应的道理。
这一段论述外因之病，从外向内传变；内因之病，从内向外发露。形气外内相应。风寒是外受的邪气，所以病在形体；忧恐忿怒是内在的气机失调，所以病在脏。外为阳，内为阴。病九天者，病发于阳，所以用三的奇数；病一月者，病发于阴，所以用十的偶数。这是以针数的奇偶，对应病的阴阳。放出络脉之血，是疏通地之脉道。形体先病而未入脏的，病发于阳而未入于里，所以刺三天时可愈。脏先病而后形体应验的，病发于阴而出于外，刺十天可愈。病发于阴而出于外的容易痊愈，留在于内的难以治愈。所以有的刺十天，有的加倍天数刺两天。这是一个月内病在体内的难易对应。
黄帝问伯高：我听说人有形的缓急，气的盛衰，骨的大小，肉的坚脆，皮的浓薄，根据这些如何判断寿夭？伯高回答说：形与气相称则长寿，不相称则夭折。皮与肉紧密配合则长寿，不紧密配合则夭折。血气经络胜过形体则长寿，不胜过形体则夭折。黄帝说：什么叫形的缓急？伯高回答说：形体充实而皮肤松弛的长寿，形体充实而皮肤紧绷的夭折。形体充实而脉象坚实大的为顺，形体充实而脉象小弱的为气衰，气衰则危险了。如果形体充实但颧骨不高，说明骨头小，骨头小则夭折。形体充实且大腿肌肉坚实且有纹理的，肉坚，肉坚则长寿。形体充实但大腿肌肉无纹理且不坚实的，肉脆，肉脆则夭折。这是天生的生命，用来确立形体、安定气机，从而观察寿夭的方法，必须明白这些。确立了形体、安定了气机，然后才能面对病患，决断生死。黄帝说：我听说关于寿夭的道理，试着衡量一下。伯高回答说：面部墙基低矮，高度不及地面的，活不到三十岁而死；如果有因病加重的，活不到二十岁而死。黄帝说：形气相胜，以至寿夭的情况如何？伯高回答说：普通人气胜于形者长寿，病人如果形体肌肉脱失，气胜于形者死，形胜于气者危。（颧音权，廪音窘，度入声）
这一段论述人禀受天地阴阳，生成此形气，有寿夭的不同。任，相当的意思；果，成的意思。这是天生的生命，确立形体、安定气机，所以形与气相称则长寿，不相称则夭折。人的皮应天，人的肉应地，所以皮与肉紧密配合则长寿，不紧密配合则夭折。形指皮肉筋骨，血气经络，应验如经水气脉，通贯于地中，所以胜过形体则长寿，不胜过形体则夭折。人的形气，由天命所生。皮肤松弛，是天道元亨的表现，所以缓则寿而急则夭。脉是精血神气游行的通道，所以形体充实而脉象坚实大的为顺，脉小弱的，营卫宗气都衰弱，衰弱则危险了。肾禀受先天阴阳而主骨，颧骨是肾的外候，所以颧骨不高的骨头小，骨头小则夭折，这是先天之气薄弱。脾属地而主肉，肉坚实者寿，不坚实者夭，这是后天土基有浓薄之分。这是天生的生命，用来确立形体、安定气机并观察寿夭，必须明白这些。先确立形体、安定气机，然后才能面对病患，决断生死。《天年篇》说：以母为基，以父为籓。人能活到一百岁的，使道深长，墙基高方。墙基是指面部的四方。地，指地阁。墙基低矮，高度不及地阁，是指四方平坦凹陷。这种人禀受母气薄弱，是坤道成形不足。《天年篇》说：人生三十岁，五脏大定。不满三十岁而死的，不能终尽地之五行。如果有因病加重的，不到二十岁而死，不能终尽地之生数。普通人气胜于形者长寿，谓地基稳固宜博浓，而气更宜胜过形体。盖万物资始于天，而天包乎地之外。病人形体肌肉脱失，气胜于形，是邪气胜；形胜于气，是正气脱。
黄帝说：我听说针刺有三种变化，什么叫三变？伯高回答说：有刺营的，有刺卫的，有刺寒痹留在经脉的。黄帝说：刺三变是怎么回事？伯高回答说：刺营要出血，刺卫要出气，刺寒痹要使内部发热。黄帝说：营、卫、寒痹的病证如何？伯高回答说：营生病，会出现寒热、少气、血上下逆行；卫生病，会出现气痛时来时去、怫忾贲响，风寒客于肠胃之中；寒痹的病，停留不去，时常疼痛而皮肤麻木不仁。（忾音戏）
形体舍藏气，气归于形，形气相互依存。然而下焦所藏的精水，中焦所生的营卫，用来温分肉，充皮肤，濡筋骨，利关节。水随气而在肤表营运，环转无端。如果营卫留阻，水道不行，那么形气就会消索。所以针刺有三变，变，是使之营运而变化。营之血，卫之气，道之行于外；寒之痹，使之热散于内。营卫血气，主出入于内外，所以生病则停止上下行，而为寒热气痛。若怫忾贲响，这是风寒客于肠胃之中。以此来分别营卫生病的情况。寒痹的病，本于自生，非外因之邪。痹，是闭的意思。寒痹，是寒水的病。肾为水脏而主骨，在外者皮肤为阳，筋骨为阴。病在阴分称为痹。停留不去，时常疼痛而皮肤麻木不仁，是说肾脏寒水之痹，痛在于外合之骨，而波及到皮之不仁。病从内而外。玉师说：风寒客于肠胃之中，照应“病而形肉脱，气胜形”这句话。大概本篇先论秉气的寿夭，后复论病气的寿夭。然而病气有二种，一种是因为风寒的病气，所谓气胜形的是这种；一种是因为营卫稽留，水道不行的病气，所谓形胜气的是这种。
黄帝说：刺寒痹使内部发热怎么做？伯高回答说：刺布衣（平民），用火焫（ruò，烧灼）它；刺大人（贵族），用药熨（wèi，热敷）它。黄帝说：药熨怎么做？伯高回答说：用醇酒二十斤，蜀椒一斤，干姜一斤，桂心一斤。共四种药材都切碎，放入清酒中。用绵絮一斤，细白布四丈，一起放入酒中，放置在马粪中，盖上封口涂泥，不要漏气。五天五夜后，取出布和绵絮晒干，干了再浸泡，以吸尽其汁。每次浸泡必须经过一天一夜才取出晒干。晒干后，将药渣与绵絮混合，再用布做成双层巾，长六七尺，分为六七节使用。用桑木炭加热毛巾，熨烫寒痹针刺的部位，让热力进入病所。冷了，再加热毛巾熨烫，三十遍为止。出汗后用毛巾擦拭身体，也是三十遍为止。擦完后进入室内，不要见风。每次针刺都要熨烫，这样病就好了。这叫做内热。（矢屎同，氲音云，岁音遂）
痹，是留滞不行。寒痹，是肾脏寒水之气。人禀受先天水火，以化生五行。肾受天一之精气，而交通于四脏。如果水火不济，五行不交，则留滞而为寒痹疾。所以用火焫，是以火益水。肺主皮毛，饮酒者先行皮肤，先充络脉。用醇酒，是使肺肾相通。蜀椒形色像心，皮红子黑，具中虚之象。用蜀椒，是使心肾相通。脾为阴中之至阴，干姜主理中之君品。用干姜，是使脾肾相通。桂为百木之长，用桂心，是使肝肾相通。蚕食桑而成绵，三者皆白，是肺之品。用绵絮一斤，白布四丈，十遍，是使在地之阴邪，从天表以终散。所谓热于内而使之外散。王公大人固然不可以用火焫，而布衣独不可以药熨吗？这是假借大人布衣，以明脏腑相通，阴阳交互，所以治法有通变。学人应当体会先圣用意周密，取法精微，不可图安苟简。张开之说：上古用分两品数，汤丸散剂，各有精义。君一臣二，是奇之制；君二臣四，是偶之制；君二臣三，是奇之制；君二臣六，是偶之制。近而奇偶，制小其服；远而偶奇，制大其服。大则数少，小则数多。多则九之，少则二之。这是品数奇偶多少的法度。凡治中土者，多用五数。欲下行者，多用三数。欲从阴而上升，有用至一两一分者。又如芫花乱发，熬如鸡子；石脂戎盐，大如弹丸。这是分两用法之精微。理中用丸，行散用散，行于脏腑经络皮肤用汤。又如抵当丸、陷胸丸、干姜散、败酱散之类，捣为丸为散，而复以水煎服。这是汤丸散剂各有所取。
Huangdi asked Shaoshi: I have heard that upon birth, people vary in constitution: some are rigid (gang), some are flexible (rou); some are weak, some are strong; some have short lifespans, some long; some are Yin, some Yang. I wish to hear the principles behind this.
This chapter discusses how humans are born endowing themselves with the Yin and Yang of Heaven and Earth. In Heaven, it manifests as Qi (vital energy); on Earth, it takes form. When Form (Xing) and Qi are in balance, one lives a long life; when not, one dies young. Rigid and flexible, Yin and Yang, are the ways of nature. Establishing the way of Heaven is called Yin and Yang; establishing the way of Earth is called flexible and rigid. Therefore, within Yin there is Yin, and within Yang there is Yang; internally there is Yin and Yang, and externally there is also Yin and Yang. Master Yu said: Strength and weakness, shortness and length, are like the four seasons having cold and heat, and day and night having length and shortness. Generally, humans and all things endow themselves with the form and Qi of Heaven and Earth's Yin and Yang, responding to time, thus having different degrees of rigidity, flexibility, length, and shortness.
Shaoshi answered: Within Yin there is Yin, and within Yang there is Yang. By thoroughly understanding Yin and Yang, acupuncture has its method. Knowing where the disease began, acupuncture has its rationale. Carefully measuring the onset of the disease, ensuring it corresponds with time, internally harmonizing with the Zang-Fu organs, and externally with sinews, bones, skin, and flesh, we see that internally there is Yin and Yang, and externally there is also Yin and Yang. Internally, the Five Zang organs are Yin, and the Six Fu organs are Yang. Externally, sinews and bones are Yin, and skin and flesh are Yang. Thus it is said: For diseases in Yin-within-Yin (i.e., the Five Zang organs), puncture the Ying-Spring and Shu-Stream points of the Yin meridians. For diseases in Yang-within-Yang (i.e., the skin), puncture the He-Sea points of the Yang meridians. For diseases in Yang-within-Yin (i.e., sinews and bones), puncture the Jing-River points of the Yin meridians. For diseases in Yin-within-Yang (i.e., the Six Fu organs), puncture the Luo-Collateral vessels. Thus it is said: Diseases in Yang are named Feng (Wind); diseases in Yin are named Bi (Obstruction). When both Yin and Yang are diseased, it is called Feng-Bi. If the disease has visible form but no pain, it belongs to the Yang category. If it has no visible form but causes pain, it belongs to the Yin category. No visible form but painful indicates Yang is intact while Yin is injured; urgently treat the Yin, do not attack the Yang. Visible form but painless indicates Yin is intact while Yang is injured; urgently treat the Yang, do not attack the Yin. If both Yin and Yang are disturbed, sometimes appearing with form, sometimes without, compounded by vexation of the heart, this is called Yin overcoming Yang. This is termed neither exterior nor interior, and the physical form will not endure long.
Yang is the Qi of Heaven, governing the exterior. Yin is the Qi of Earth, governing the interior. However, the Yin and Yang Qi of Heaven and Earth ascend and descend, enter and exit. Thus, internally there is Yin and Yang, and externally there is also Yin and Yang. Skin, flesh, sinews, bones, Five Zang organs, and Six Fu organs harmonize internally and externally, corresponding with time. The Five Zang organs are Yin, the Six Fu organs are Yang—this is the internal Yin and Yang. Sinews and bones are Yin, skin and flesh are Yang—this is the external Yin and Yang. Disease in Yin-within-Yin refers to disease in the internal Five Zang organs, so one should puncture the Ying-Spring and Shu-Stream points of the Yin meridians. Disease in Yang-within-Yang refers to disease in the external skin, so one should puncture the He-Sea points of the Yang meridians. Since the Six Fu organs correspond externally to the skin, one should take the He-Sea points of the Fu organ meridians. Disease in Yang-within-Yin refers to disease in the external sinews and bones, so one should puncture the Jing-River points of the Yin meridians. Since the Five Zang organs correspond externally to sinews and bones, one should take the Jing-River points of the Yin meridians. Disease in Yin-within-Yang refers to disease in the internal Six Fu organs, so one should puncture the Luo-Collateral vessels. Thus it is said: Diseases in Yang are named Wind; diseases in Yin are named Bi. Wind is the Yang Qi of Heaven; Bi is the Yin pathogen of humans. When both Yin and Yang are diseased, it is named Feng-Bi, representing the harmony of interior and exterior. "Visible form" refers to the tangible skin, flesh, sinews, and bones; "invisible form" refers to the Qi of the Five Zang and Six Fu organs. Disease with visible form but no pain is disease in the external Yang. Disease with invisible form but pain is Qi causing pain. Intact Yin and Yang means the Qi of the Zang-Fu organs and their Yin-Yang is unharmed. Heaven and Earth are the upper and lower of all things; movement and stillness are the substance and function of Heaven and Earth; Water and Fire are the omens of Yin and Yang. Heavenly Qi descends, flowing into the Earth; Earthly Qi ascends, rising to Heaven; this is the intersection of Heaven and Earth Qi. Li (Fire trigram) contains emptiness; Kan (Water trigram) contains fullness; this is the mutual nourishment of Water and Fire. If both Yin and Yang are disturbed, sometimes appearing with form, sometimes without, this is Yin and Yang being neither exterior nor interior. The Heart is Yang and governs Fire; Water is Yin and resides below. Compounded by vexation of the heart, this is Yin overcoming Yang. Yin and Yang do not communicate internally and externally; Water and Fire overcome each other vertically; this is the disharmony of Heaven and Earth's Yin and Yang Qi, hence the physical form will not endure long. This is the correspondence of Form and Qi. Zhang Kaizhi said: Acupuncture conforms to the Way of the Three Powers (Heaven, Earth, Human). This chapter discusses humans, conforming to Heaven and Earth's Yin and Yang, so acupuncture is used to regulate disharmony. The great principles of the classics should be sought beyond mere needle treatment of disease.
Huangdi asked Bogao: I have heard that regarding Form and Qi, there is a sequence of disease onset, and a correspondence between interior and exterior. How is this? Bogao answered: Wind and Cold damage the Form; Worry, Fear, Anger, and Resentment damage the Qi. Damage to Qi affecting the Zang organs results in Zang disease. Cold damaging the Form results in Form manifestation. Wind damaging sinews and bones results in sinew and bone manifestation. This is the correspondence of Form and Qi between interior and exterior. Huangdi asked: How should one puncture? Bogao answered: For illness lasting nine days, three punctures suffice. For illness lasting one month, ten punctures suffice. The number and distance decrease accordingly. For chronic Bi syndrome lingering in the body, observe the blood collaterals and drain all the blood. Huangdi asked: Regarding interior and exterior diseases, what is the ease or difficulty of treatment?
Bogao answered: If the Form is diseased first but has not entered the Zang organs, halve the number of days for treatment. If the Zang organs are diseased first and then the Form responds, double the number of days for treatment. This is the correspondence of ease and difficulty within a month.
This section discusses diseases from external causes, transmitting from outside to inside, and diseases from internal causes, manifesting from inside to outside. Wind and Cold are pathogens received externally, so they cause Form disease. Worry, fear, anger, and resentment are internal Qi disturbances, so they cause Zang disease. Exterior is Yang, Interior is Yin. Illness of nine days originates in Yang, so the odd number three is used. Illness of one month originates in Yin, so the even number ten is used. This uses the odd/even nature of needle counts to correspond to the Yin/Yang of the disease. Draining collateral blood unblocks the Earth's pulse pathways. Form disease first, not yet entering the Zang, originates in Yang and has not entered the Interior, so three days of puncturing can cure it. Zang disease first, then Form responds, originates in Yin and emerges outward, so ten days of puncturing can cure it. Disease originating in Yin and emerging outward is easy to cure; remaining inside is difficult to resolve. Thus, some require ten days of puncturing, others double the days for two days of treatment. This is the correspondence of ease and difficulty for a month-long disease residing inside.
Huangdi asked Bogao: I have heard that humans have forms that are lax or tense, Qi that is abundant or deficient, bones that are large or small, flesh that is firm or brittle, and skin that is thick or thin. How can these determine longevity or early death? Bogao answered: When Form and Qi are balanced, one lives long; when unbalanced, one dies young. When skin and flesh are tightly integrated, one lives long; when not, one dies young. When Blood-Qi and meridians exceed the Form, one lives long; when they do not exceed the Form, one dies young. Huangdi asked: What is meant by the laxity or tension of Form? Bogao answered: A well-developed body with loose skin indicates longevity; a well-developed body with tight skin indicates early death. A well-developed body with firm and large pulses is favorable; a well-developed body with small and weak pulses indicates Qi deficiency, which is dangerous. If the body is well-developed but the cheekbones (Quan) are not prominent, the bones are small, indicating early death. If the body is well-developed and the large muscles are firm with clear texture, the flesh is firm, indicating longevity. If the body is well-developed but the large muscles lack texture and are not firm, the flesh is brittle, indicating early death. These are innate life forces used to establish Form and stabilize Qi to observe longevity. One must understand this. Only after establishing Form and stabilizing Qi can one face patients and determine life and death. Huangdi said: I have heard the principles of longevity; let me try to measure them. Bogao answered: If the facial foundation (Qiangji) is low, with height less than the ground level, death occurs before thirty; if exacerbated by disease, death occurs before twenty. Huangdi asked: How does the superiority of Form over Qi lead to longevity or early death? Bogao answered: In healthy individuals, Qi exceeding Form indicates longevity. In sick individuals, if flesh and muscle are wasted and Qi exceeds Form, death occurs. If Form exceeds Qi, the condition is critical. (Quan sounds like Quan; Lin sounds like Jiong; Du enters tone.)
This section discusses how humans endow themselves with Heaven and Earth's Yin and Yang to generate Form and Qi, resulting in differences in longevity. Ren means equivalent/appropriate; Guo means complete/successful. This is the innate life force establishing Form and stabilizing Qi; thus, when Form and Qi are appropriate, one lives long, otherwise young. Human skin corresponds to Heaven, human flesh to Earth; thus, when skin and flesh are integrated, one lives long, otherwise young. Form refers to skin, flesh, sinews, bones. Blood-Qi and meridians correspond to water currents and pulse waves, penetrating through the earth; thus, exceeding Form indicates longevity, failing to exceed indicates early death. Human Form and Qi are generated by heavenly mandate. Loose skin reflects the original prosperity of Heavenly Dao, so laxity brings longevity and tension brings early death. Pulses are the channels where essence, blood, spirit, and Qi circulate; thus, well-developed body with firm/large pulses is favorable. Small/weak pulses indicate decline of Ying, Wei, and Zong Qi, leading to danger. Kidneys inherit primordial Yin and Yang and govern bones; cheekbones are the external indicator of kidneys; thus, non-prominent cheekbones mean small bones, indicating early death due to thin primordial Qi. Spleen corresponds to Earth and governs flesh; firm flesh indicates longevity, soft flesh indicates early death, reflecting the thickness of postnatal Earth foundation. This innate life force establishes Form and stabilizes Qi to observe longevity; one must understand this. Only after establishing Form and stabilizing Qi can one face patients and determine life and death. The *Tian Nian* chapter states: Mother provides the base, Father provides the fence. Those who live to a hundred have deep and long nasal passages and high, square facial foundations. Qiangji refers to the four sides of the face. Di refers to the jaw/chin area. Low Qiangji, height less than the jaw, indicates flatness and depression on the four sides. Such people inherit thin maternal Qi, reflecting insufficient formation by Kun (Earth) Dao. The *Tian Nian* chapter states: At thirty, the five Zang organs are fully developed. Dying before thirty fails to complete the Five Elements of Earth. Dying before twenty due to disease fails to complete the generative numbers of Earth. Healthy individuals with Qi exceeding Form live long, implying a solid, broad foundation where Qi should surpass Form. All things begin with Heaven, which envelops Earth. Sick individuals with wasted flesh/muscle and Qi exceeding Form indicate pathogenic Qi victory. Form exceeding Qi indicates righteous Qi depletion.
Huangdi said: I have heard there are three variations in acupuncture. What are these three variations? Bogao answered: There is puncturing Ying, puncturing Wei, and puncturing Cold-Bi lingering in the meridians. Huangdi asked: How are the three variations of puncturing performed? Bogao answered: Puncturing Ying releases blood; puncturing Wei releases Qi; puncturing Cold-Bi generates internal heat. Huangdi asked: What are the diseases caused by Ying, Wei, and Cold-Bi? Bogao answered: Diseases of Ying present with chills, fever, shortness of breath, and blood moving up and down. Diseases of Wei present with migratory Qi pain, bloating, and rumbling, with Wind-Cold lodging in the intestines and stomach. Diseases of Cold-Bi linger without resolving, causing intermittent pain and numbness of the skin. (Xi sounds like Xi.)
Form houses Qi; Qi returns to Form; Form and Qi depend on each other. The essence-water stored in the Lower Jiao and the Ying-Wei generated in the Middle Jiao warm the muscle intervals, fill the skin, moisten sinews and bones, and lubricate joints. Water follows Qi and circulates on the surface, turning endlessly. If Ying-Wei stagnates and water pathways fail, Form and Qi will wither. Thus, acupuncture has three variations. Variation means causing circulation and transformation. Ying blood and Wei Qi travel outward; Cold-Bi is made to dissipate heat inward. Ying-Wei and Blood-Qi govern entry and exit internally and externally; thus, disease stops upward/downward flow, causing cold, heat, Qi pain. Bloating and rumbling indicate Wind-Cold lodging in the intestines and stomach. This distinguishes diseases of Ying and Wei. Cold-Bi disease arises internally, not from external pathogens. Bi means obstruction. Cold-Bi is the disease of Cold-Water. Kidneys are Water organs governing bones. Externally, skin is Yang, sinews/bones are Yin. Disease in Yin is named Bi. Linger without resolving, causing intermittent pain and skin numbness, refers to Kidney Cold-Water Bi, where pain affects the externally connected bones and spreads to skin numbness. Disease moves from interior to exterior. Master Yu said: Wind-Cold lodging in intestines/stomachs echoes "disease with wasted flesh/muscle, Qi exceeding Form." This chapter first discusses innate Qi longevity, then disease Qi longevity. Disease Qi has two types: one due to Wind-Cold disease Qi, where Qi exceeds Form; another due to Ying-Wei stagnation and water pathway failure, where Form exceeds Qi.
Huangdi asked: How to generate internal heat when puncturing Cold-Bi? Bogao answered: For commoners (Bu Yi), use fire moxibustion (Ruo); for nobles (Da Ren), use herbal compresses (Yun). Huangdi asked: How is the herbal compress performed? Bogao answered: Use 20 jin of pure wine, 1 jin of Shu pepper, 1 jin of dried ginger, 1 jin of cinnamon heart. All four herbs are crushed and soaked in clear wine. Take 1 jin of cotton wadding and 4 zhang of fine white cloth, put them in the wine, place in horse manure, cover and seal with mud to prevent leakage. After five days and nights, remove the cloth and cotton, dry them in the sun, soak again until all juice is extracted. Each soaking must last a day and night before drying. Mix the dregs with cotton, wrap in double-layer cloth to make a towel, 6-7 chi long, divided into 6-7 sections. Heat the towel using mulberry charcoal and apply to the punctured sites of Cold-Bi, letting heat penetrate to the disease site. When cool, reheat and apply. Repeat 30 times. Wipe sweat with the towel, also 30 times. Then enter the room, avoiding wind. Apply heat every time you puncture. Thus the disease resolves. This is called generating internal heat. (Shi/Shi are the same character; Yun sounds like Yun; Sui sounds like Sui.)
Bi means stagnation. Cold-Bi is the Cold-Water Qi of the Kidneys. Humans inherit primordial Water and Fire to transform the Five Elements. Kidneys receive the Jing-Essence of Tian-Yi and communicate with the four Zang organs. If Water and Fire do not nourish each other and Five Elements do not interact, stagnation becomes Cold-Bi disease. Thus, using fire moxibustion adds Fire to Water. Lungs govern skin/hair; alcohol acts first on skin, filling collaterals. Using pure wine facilitates Lung-Kidney communication. Shu pepper resembles the Heart in shape/color, red skin/black seeds, hollow center. Using Shu pepper facilitates Heart-Kidney communication. Spleen is the ultimate Yin within Yin; dried ginger is the sovereign herb for regulating the Middle. Using dried ginger facilitates Spleen-Kidney communication. Cinnamon is the chief of trees; using cinnamon heart facilitates Liver-Kidney communication. Silkworms eat mulberry to produce silk; all three (silk, white cloth, white color) belong to the Lung element. Using 1 jin cotton and 4 zhang white cloth, repeated ten times, disperses Earthly Yin pathogens from Heavenly surface. This is generating internal heat to disperse externally. Nobles cannot use fire moxibustion, but can commoners not use herbal compresses? This borrows noble/commoner distinctions to illustrate Zang-Fu communication and Yin-Yang interaction, showing therapeutic flexibility. Students should appreciate the meticulous intent and subtle methods of the sages, not seeking convenience or simplicity. Zhang Kaizhi said: Ancient prescriptions had precise weights and ratios for decoctions, pills, and powders. Sovereign 1, Minister 2 is Odd formulation; Sovereign 2, Minister 4 is Even formulation; Sovereign 2, Minister 3 is Odd; Sovereign 2, Minister 6 is Even. Near diseases use Odd/Even, small dosage; distant diseases use Even/Odd, large dosage. Large dosage has fewer ingredients, small dosage has more. More approaches nine, less approaches two. This is the law of Odd/Even and quantity. Treating Middle Jiao often uses five. Descending treatments often use three. Ascending from Yin may use one liang one fen. Also, Yuanhua and hair boiled like an egg; Shi Zhi and Rong Yan salt sized like pellets. These are subtle weight/method applications. Regulating Middle uses pills; dispersing uses powders; treating Zang-Fu/meridians/skin uses decoctions. Examples include Didang Wan, Xianxiong Wan, Ganjiang San, Baijiang San, etc., pounded into pills/powders but decocted in water. This shows the specific uses of decoctions, pills, and powders.