上古。谓所生之来。天真。天乙始生之真元也。首四篇。论调精神气血。所生之来谓之精。故首论精。两精相搏谓
之神。故次论神。气乃精水中之生阳。故后论气。
昔在黄帝。生而神灵。弱而能言。幼而徇齐。长而敦敏。成而登天。（徇音循长上声按史记、黄帝姓公孙。名轩辕。
有熊国君少典之子。继神农氏而有天下。都轩辕之丘。以土德王。故号黄帝。神灵、智能也。徇顺、齐正、敦信、敏达
也。此节记圣德禀性之异。发言之早。方其幼也。能顺而正。及其长也。既敦且敏。故其垂拱致治。教化大行。广制度
以利天下。垂法象以教后世。生知之圣人也。后铸鼎于鼎湖山。鼎成而白日升天。此亦寿敝天地。无有终时之真人也。）
乃问于天师曰。余闻上古之人。春秋皆度百岁。而动作不衰。今时之人。年半百而动作皆衰者。时世异耶。人将失之耶。
（天师。尊称岐伯也。天者。谓能修其天真。师乃先知先觉者也。言道者。上帝之所贵。师所以传道而设教。故称伯曰
天师。度、越也。度百岁者。百二十岁也。）岐伯对曰。上古之人。其知道者。法于阴阳。和于术数。（上古。太古也。
知道。谓知修养之道也。法。取法也。阴阳。天地四时。五行六气也。和。调也。术数者。调养精气之法也。盖阴阳者。
万物之终始。死生之本。逆之则灾害生。从之则苛疾不起。故能取法以和调。是谓得道。）食饮有节。起居有常。不妄作
劳。故能形与神俱。而尽终其天年。度百岁乃去。（灵枢决气篇曰。上焦开发。宣五谷味。熏肤充身泽毛。若雾露之溉。
是谓气。饮食有节。养其气也。生气通天论曰。起居如惊。神气乃浮。起居有常。养其神也。烦劳则张。精绝。不妄作
劳。养其精也。夫神气去。形独居。人乃死。能调养其神气。故能与形俱存。而尽终其天年。）今时之人不然也。以酒为
浆。以妄为常。醉以入房。（酒能伤脾。脾气伤。则不能宣五谷味。而生气伤矣。以妄为常。伤其神矣。醉以入房。伤其
精矣。言今时之人。不知道者。纵嗜欲而伤其精气神也。）以欲竭其精。以耗散其真。不知持满。不时御神。（乐色曰欲。
轻散曰耗。真者。元真之气也。不知持满。不慎谨也。不时御神。不能四时调御其神也。言不知道者。不能慎谨调养。
而丧其精气神也。）务快其心。逆于生乐。起居无节。故半百而衰也。（心藏神。务快其心。丧其神守矣。乐则气缓。而
更逆之。伤其气矣。起居无节。耗其精矣。言今时之人。惟务快乐。不能积精全神。是以半百而衰也。）夫上古圣人之教
下也。皆谓之虚邪贼风。避之有时。恬淡虚无。真气从之。精神内守。病安从来。（虚邪、虚乡不正之邪风也。恬、安静
也。淡、朴素也。虚无。不为物欲所蔽也。言上古之人。得圣人之教化。内修养生之道。外避贼害之邪。所以年皆度百
岁。而动作不衰。）是以志闲而少欲。心安而不惧。形劳而不倦。气从以顺。各从其欲。皆得所愿。（恬淡无为。是以志
闲而少欲矣。精神内守。是以心安而不惧。形劳而不倦矣。真气从之。是以气从以顺矣。五方之民。衣食居处。各从
其欲。是以皆得所愿也。）故美其食。任其服。乐其俗。高下不相慕。其民故曰朴。（故者。承上文而言。按异法方宜论。
东方之民。皆安其处。美其食。西方之民。根据山陵而居。不衣而褐荐。华食而肥脂。北方之域。其地高陵居。风寒冰冽。
其民乐野处而乳食。南方之域。其地下。水土弱。其民嗜酸而食 。中央者。其地平以湿。其民食杂而不劳。此五方之
民。随天地万物之所生。山川地土之高下。衣食居处。各从其欲。彼此不相爱慕。故其民曰朴。）是以嗜欲不能劳其目。
淫邪不能惑其心。（此复言五方之民。各有嗜欲淫邪而致病。惟上古恬淡之世。民皆安居乐俗。而无外慕之思。故虽有嗜
欲淫邪。不能伤其内也。）愚智贤不肖。不惧于物。故合于道。（上古之人。无贵贱贤愚。皆全德不危。故不外惧于物。
而合于养生之道焉。）所以能年皆度百岁。而动作不衰者。以其德全不危也。（德者。所得乎天之明德也。全而不危者。
不为物欲所伤也。庄子曰。执道者德全。德全者形全。形全者。圣人之道也。）帝曰。人年老而无子者。材力尽邪。将
天数然也。（阴阳者。万物之终始也。此复论男女阴阳气血。有始有终。有盛有衰。各有自然之天数。材力、精力也。）
岐伯曰。女子七岁。肾气盛。齿更发长。（更平声长上声七为少阳之数。女本阴体。而得阳数者。阴中有阳也。人之初
生。先从肾始。女子七岁。肾气方盛。肾主骨。齿者骨之余。故齿更。血乃肾之液。发乃血之余。故发长也。按阴阳之
道。孤阳不生。独阴不长。阴中有阳。阳中有阴。是以天乙生水。地二生火。离为女。坎为男。皆阴阳互换之道。故女
得阳数。而男得阴数也。）二七而天癸至。任脉通。太冲脉盛。月事以时下。故有子。（天癸、天乙所生之癸水也。冲脉
任脉、奇经脉也。二脉并起于少腹之内胞中。循腹上行。为经血之海。女子主育胞胎。夫月为阴。女为阴。月一月而一
周天。有盈有亏。故女子亦一月而经水应时下泄也。亏即复生。故于初生之时。男女构精。当为有子。虚则易受故也。）
三七肾气平均。故真牙生而长极。（长上声肾气者。肾脏所生之气也。气生于精。故先天癸至。而后肾气平。肾气足。
故真牙生。真牙者。尽根牙也。）四七筋骨坚。发长极。身体盛壮。（肾生骨髓。髓生肝。肝生筋。母子之相生也。女子
四七。精血盛极之时。是以筋骨坚。发长极也。血气盛则充肤热肉。是以身体盛壮。）五七阳明脉衰。面始焦。发始堕。
（阳明之脉荣于面。循发际。故其衰也。面焦发堕。夫气为阳。血脉为阴。故女子先衰于脉。而男子先衰于气也。再按
足阳明之脉。并冲任挟脐上行。冲任脉虚。而阳明脉亦虚矣。）六七三阳脉衰于上。面皆焦。发始白。（三阳之脉。尽上
于头。三阳脉衰。故面皆焦。血脉华于色。血脉衰。故发白也。）七七任脉虚。太冲脉衰少。天癸竭。地道不通。故形坏
而无子也。（地道、下部之脉道也。三部九候论曰。下部地。足少阴也。癸水藏于肾。天癸竭。是足少阴下部之脉道不通。
冲任虚。是以形衰而无子也。）丈夫八岁肾气实。发长齿更。（八为少阴之数。男本阳体。而得阴数者。阳中有阴也。）二
八肾气盛。天癸至。精气溢泻。阴阳和。故能有子。（灵枢经曰。冲脉任脉。皆起于胞中。上循背里。为经络之海。其浮
而外者。循腹右上行。会于咽喉。别而络唇口。血气盛则充肤热肉。血独盛则淡渗皮肤。生毫毛。今妇人之生。有余于
气。不足于血。以其数脱血也。冲任之脉。不荣口唇。故须不生焉。是则男子之天癸。溢于冲任。充肤热肉。而生髭须。
女子之天癸。溢于冲任。充肤热肉。为经水下行而妊子也。男子二八精气满溢。阴阳和合。泻泄其精。故能有子也。）三
八肾气平均。筋骨劲强。故真牙生而长极。（平、足也。均、和也。极、止也。故真牙生而筋骨所长。以至于极矣。）四
八筋骨隆盛。肌肉满壮。（四居八数之半。是以隆盛之极。）五八肾气衰。发堕齿槁。（肾为生气之原。男子衰于气。故根
气先衰。而发堕齿槁也。）六八阳气衰竭于上。面焦。发鬓颁白。（根气先衰。而标阳渐竭矣。平脉篇曰。寸口脉缓而迟。
缓则阳气长。其色鲜。其颜光。其声商。毛发长。阳气衰。故颜色焦而发鬓白也。）七八肝气衰。筋不能动。天癸竭。精
少。肾脏衰。形体皆极。（肝乃肾之所生。肾气衰。故渐及于肝矣。肝生筋。肝气衰。故筋不能运动。肾主骨。筋骨皆衰。
故形体疲极也。）八八则齿发去。（数终衰极。是以不惟颁白枯槁。而更脱落矣。）肾者主水。受五脏六腑之精而藏之。故
五脏盛。乃能泻。今五脏皆衰。筋骨解堕。天癸尽矣。故发鬓白。身体重。行步不正。而无子耳。（此复申明先天之癸水。
又藉后天之津液所资益也。肾者主水。言肾脏之主藏精水也。受五脏六腑之精而藏之者。受后天水谷之精也。盖五味入
胃。各归所喜。津液各走其道。肾为水脏。受五脏之精而藏之。肾之精液。入心化赤而为血。流溢于冲任。为经血之海。
养肌肉。生毫毛。所谓流溢于中。布散于外者是也。故曰。天癸者。天乙所生之精也。是以男子天癸至而精气溢泻。肾
之精。化赤为血。溢于冲任。生髭须。女子天癸至而月事以时下。故精血皆谓之天癸也。再按、经云。荣血之道。内谷
为宝。谷入于胃。乃传之肺。流溢于中。布散于外。专精者行于经隧。常荣无已。男子八八。女子七七。天地之数终而
天癸绝。然行于经隧之荣血未竭也。是以老年之人。能饮食而脾胃健者。尚能筋骨坚强。气血犹盛。此篇论天癸绝而筋
骨衰。其后天水谷之精。又不可执一而论也。再按、女子过七七而经淋不绝者。此系行于经隧之血。反从冲任而下。是
以面黄肌瘦。骨惫筋柔。当知经隧之血。行于脉中。冲任之血。兼渗于脉外。）帝曰。有其年已老而有子者。何也。岐
伯曰。此其天寿过度。气脉常通。而肾气有余也。此虽有子。男不过尽八八。女不过尽七七。而天地之精气皆竭矣。（此
复申明天地阴阳之数。止尽终于七七八八也。天寿过度。先天所秉之精气盛也。气脉常通。后天之地道尚通也。是以肾
气有余而有子。此虽有子。然天地之精气。尽竭于七八之数者也。）帝曰。夫道者年皆百数。能有子乎。岐伯曰。夫道者。
能却老而全角身。年虽寿。能生子也。（此承上文而言。惟修道者。能出于天地阴阳之数也。）
黄帝曰。余闻上古有真人者。提挈天地。把握阴阳。呼吸精气。独立守神。肌肉若一。故能寿敞天地。无有终时。
此其道生。（上古真人者。言所生之来。自然合道。而能全其天真之人也。天真完固。故能斡旋造化。燮理阴阳。吐纳精
气。与道独存。守神全角。是以肌肤若冰雪。绰约如处子。寿过天地。无有终极之时。此由道之所生。故无为而道自合
也。玉师曰、天命之性。复归于无极。是谓真人。佛老以真空见性。本经谓空中有真）中古之时。有至人者。淳德全道。
和于阴阳。调于四时。去世离俗。积精全神。游行天地之间。视听八达之外。此盖益其寿命而强者也。亦归于真人。（中
古至人者。谓有为以入道。而能全所生之天真者也。天真虽泄。复能修德全道。积精养神。故令神气充塞于天地之间。
耳目聪明于八达之外。此盖从修炼保固得来。亦能复完天真。而同归大道。夫真人者。得先天之真者也。至人者。得后
天一气者也。其趋则一。故亦归于真人。）其次有圣人者。处天地之和。从八风之理。适嗜欲于世俗之间。无恚嗔之心。
行不欲离于世。被服章。举不欲观于俗。外不劳形于事。内无思想之患。以恬愉为务。以自得为功。形体不敝。精神不
散。亦可以百数。（至人真人者。去世离俗。修道全真。无妻室之爱。无嗜欲之情。所谓游方之外。高出人类者也。圣人
者。处天地之内。顺八方之理。教以人伦。法于制度。黻冕于朝堂之上。不欲离于世俗章服。无为而治。不劳其形。随
机而应。不役其神。此治世之圣人也。亦可以优游泮涣。而长享百年矣。）其次有贤人者。法则天地。象似日月。辨列星
辰。逆从阴阳。分别四时。将从上古。协议于道。亦可使益寿而有极时。（贤人者。处尘俗之内。鲜拘蔽之习。取法天地。
如日月之光明。推测象纬。顺逆二气。序别四时。将与上古天真之圣。同合于道。亦可使益寿而至于寿敝天地之极。此
修道之贤人。而由人以合天。超凡以至圣者也。此帝勉人修为。而不得以凡庸自弃。故移精变气章曰。去故就新。乃得
真人。）
上古，指人类生命的起源。天真，指天地初开时生成的先天真元之气。《素问》首四篇，论述调摄精神气血的方法。生命的本源称为“精”，因此首先论述精。两性的精气结合产生“神”，因此接着论述神。“气”是精水中产生的阳气，因此最后论述气。
从前，黄帝出生时就具有神灵般的智慧，幼小时就能说话，童年时行为顺从且端正，成年后敦厚敏捷，成熟后登上帝位。（徇音同“循”，长读上声。据《史记》记载，黄帝姓公孙，名轩辕，是有熊国君少典的儿子，继承了神农氏的天下，建都于轩辕之丘，以土德王天下，所以号称黄帝。神灵，指智能；徇，指顺从；齐，指端正；敦，指诚信；敏，指通达。这一节记录了圣人禀赋性情的特异之处：发言很早。在他年幼时，能顺从而端正；等他长大后，既敦厚又敏捷。所以他能够垂衣拱手而天下大治，教化广泛推行，制定制度以利天下，树立法则形象以教导后世，是一位生而知之的圣人。后来他在鼎湖山铸鼎，鼎成之后白日升天，这也是一位寿命与天地等同、没有终结时的真人。）
于是黄帝向天师（岐伯）问道：“我听说上古时代的人，年龄都超过百岁，但动作依然不衰老。现在的人，年龄刚过五十，动作就都衰败了。这是时代不同呢？还是人们自己失去了养生之道呢？”（天师是对岐伯的尊称。天，指能修养其天真之气；师，指先知先觉的人。说道的人是上帝所尊贵的，老师用来传道设教，所以称岐伯为天师。度，即越过。度百岁，指一百二十岁。）
岐伯回答说：“上古时代的人，那些懂得养生之道的人，效法阴阳的变化，调和养生术数。（上古，指太古时代。知道，指懂得修养之道。法，指取法。阴阳，指天地四时、五行六气。和，指调和。术数，指调养精气的方法。大概阴阳是万物始终的根本，死生的关键，违背它就会产生灾害，顺应它就不会发生重病，所以能够取法阴阳来调和身心，这就叫做得道。）饮食有节制，起居有规律，不妄自过度劳累，所以能够形体与精神俱在，从而享尽天然赋予的寿命，活到百岁才离开人世。（《灵枢·决气篇》说：上焦开发，宣发五谷的味道，熏蒸皮肤，充实身体，润泽毛发，像雾露灌溉一样，这叫做气。饮食有节制，是为了养气。《生气通天论》说：起居惊慌不定，神气就会浮越。起居有规律，是为了养神。烦劳则阳气张盛，精气耗竭，不妄自劳累，是为了养精。如果神气离去，只剩形体独存，人就死了。能够调养神气，所以能与形体共存，享尽天然寿命。）
现在的人就不是这样了。把酒当作浆水喝，把妄动当作常态，醉酒后行房事。（酒能伤脾，脾气受伤，就不能宣发五谷的味道，生气也就受损了。把妄动当作常态，损伤了神。醉酒后行房，损伤了精。这是在说现在的人不懂养生之道，放纵嗜欲而损伤精气神。）因为欲望而耗尽精气，因为耗散而亏损真元，不知道保持精气充盈，不能适时地调御精神。（乐色称为欲，轻浮散乱称为耗。真，指元真之气。不知道保持充盈，是不谨慎。不时御神，指不能随四季变化调御精神。这是在说不懂养生之道的人，不能谨慎调养，从而丧失了精气神。）只追求心意的快乐，违背了生命的乐趣，起居没有节制，所以不到五十岁就衰败了。（心藏神，只追求快乐，就丧失了神的守持。乐则气缓，反而逆乱，损伤了气。起居无节制，耗损了精。这是在说现在的人只求快乐，不能积精全神，所以不到五十岁就衰败了。）
上古圣人对百姓的教诲，都是说要随时避开虚邪贼风，心境恬淡虚无，真气就能顺从，精神内守，疾病从哪里产生呢？（虚邪，指来自虚乡不正的邪风。恬，指安静；淡，指朴素。虚无，指不被物欲遮蔽。这是在说上古之人得到圣人的教化，对内修养养生之道，对外避开贼害之邪，所以年龄都超过百岁，动作不衰。）因此志意清闲而欲望少，内心安宁而不恐惧，形体劳动但不疲倦，气机顺从，各随其心愿，都能实现愿望。（恬淡无为，所以志意清闲欲望少。精神内守，所以内心安宁不恐惧。形体劳动不疲倦。真气顺从，所以气机顺畅。五方的百姓，衣食居处，各随其心愿，所以都能实现愿望。）所以满足于他们的食物，听任他们的服饰，喜爱他们的风俗，高低贵贱互不羡慕，这样的百姓被称为质朴。（故，承接上文而言。按《异法方宜论》，东方的百姓，安于住所，美食佳肴；西方的百姓，依山陵居住，不穿衣裳，铺草席，吃华美的食物而肥胖；北方的地域，地势高陵，风寒冰冽，百姓喜欢野外居住而以乳食为主；南方的地域，地势低下，水土弱，百姓喜欢吃酸味食物；中央地区，地势平坦潮湿，百姓食物杂而不劳作。这五方的百姓，随着天地万物的生长，山川地土的高低，衣食居处，各随其心愿，彼此不互相爱慕，所以百姓被称为质朴。）因此嗜欲不能劳累他们的眼睛，淫邪不能迷惑他们的心。（这里再次说明五方百姓各有嗜欲淫邪致病的情况，只有在上古恬淡的时代，百姓安居乐业，没有外求羡慕的心思，所以虽然有嗜欲淫邪，也不能伤害他们的内心。）无论愚笨、聪明、贤良还是不肖，都不因外物而恐惧，所以符合养生之道。（上古之人，无论贵贱贤愚，都保全德行而不危险，所以不向外恐惧于外物，而合于养生之道。）之所以能年龄都超过百岁，动作不衰败，是因为他们的道德完备而没有危险。（德，指从天那里得到的明德。全而不危，指不被物欲伤害。庄子说：执守大道的人道德完备，道德完备的人形体完备，形体完备，就是圣人的道。）
黄帝说：“人老了没有子女，是精力耗尽了呢？还是天数本来如此？”（阴阳是万物始终的根本，这里再次论述男女阴阳气血，有始有终，有盛有衰，各有自然的定数。材力，指精力。）
岐伯说：“女子七岁时，肾气旺盛，牙齿更换，头发增长。（七是少阳之数。女子本属阴体，却得到阳数，是因为阴中有阳。人刚出生，先从肾开始。女子七岁，肾气方才旺盛。肾主骨，齿是骨的余气，所以换牙。血是肾的液，发是血的余气，所以头发增长。按阴阳的道理，孤阳不生，独阴不长，阴中有阳，阳中有阴，所以天乙生水，地二生火，离卦代表女，坎卦代表男，都是阴阳互换的道理，所以女子得阳数，男子得阴数。）十四岁时，天癸至，任脉通畅，太冲脉旺盛，月经按时来潮，所以能生育。（天癸，是天乙所生的癸水。冲脉、任脉是奇经八脉。这两条脉都起于小腹内的胞中，沿腹部上行，是经血的海。女子主司孕育胞胎。月为阴，女为阴，月亮一个月运行一周天，有盈有亏，所以女子也一个月经水按时下泄。亏缺后即再生，所以在初生之时，男女交合，应当能生育，因为此时空虚容易受孕。）二十一岁时，肾气平和，智齿长出，身体发育达到极点。（长读上声。肾气，指肾脏产生的气。气生于精，所以当天癸到来后，肾气才平和。肾气充足，所以智齿长出。真牙，即智齿。）二十八岁时，筋骨坚固，头发长到极点，身体强壮。（肾生骨髓，髓生肝，肝生筋，这是母子相生。女子四七，是精血极盛的时候，所以筋骨坚固，头发长到极点。血气盛则充满皮肤，温热肌肉，所以身体强壮。）三十五岁时，阳明脉开始衰弱，面部开始憔悴，头发开始脱落。（阳明脉荣养面部，沿发际而行，所以它衰弱时，面部憔悴，头发脱落。气为阳，血脉为阴，所以女子先衰于脉，男子先衰于气。再按足阳明脉，并冲任脉挟脐上行，冲任脉虚，阳明脉也虚了。）四十二岁时，三阳脉在上部开始衰弱，面部全部憔悴，头发开始变白。（三阳脉都上行到头，三阳脉衰弱，所以面部全部憔悴。血脉荣华于面色，血脉衰弱，所以头发变白。）四十九岁时，任脉虚衰，太冲脉衰少，天癸枯竭，月经停止，所以形体衰老而不能生育。（地道，指下部的脉道。《三部九候论》说：下部地，对应足少阴。癸水藏于肾，天癸枯竭，就是足少阴下部脉道不通，冲任虚，所以形体衰败而不能生育。）
男子八岁时，肾气充实，头发增长，牙齿更换。（八是少阴之数。男子本属阳体，却得到阴数，是因为阳中有阴。）十六岁时，肾气旺盛，天癸至，精气满溢而排泄，阴阳调和，所以能生育。（《灵枢经》说：冲脉、任脉，都起于胞中，上行背部内部，是经络的海。其中浮而外的部分，沿腹部右上行，会于咽喉，分支联络唇口。血气盛则充满皮肤，温热肌肉。血特别盛则渗透皮肤，生出毫毛。现在妇女生来，气有余而血不足，因为经常失血。冲任脉不荣养口唇，所以胡须不生。那么男子的天癸，溢于冲任，充满皮肤，温热肌肉，生出胡须；女子的天癸，溢于冲任，充满皮肤，作为经水下行为妊子。男子二八精气满溢，阴阳和合，排泄其精，所以能生育。）二十四岁时，肾气平和，筋骨强劲有力，智齿长出，身体发育达到极点。（平，指足；均，指和；极，指止。所以智齿长出，筋骨生长达到极点。）三十二岁时，筋骨隆盛，肌肉丰满强壮。（四居八数的一半，所以是隆盛的极点。）四十岁时，肾气开始衰退，头发脱落，牙齿枯槁。（肾是生气的源头，男子衰于气，所以根本之气先衰，导致头发脱落，牙齿枯槁。）四十八岁时，阳气在上部衰竭，面部憔悴，两鬓斑白。（根本之气先衰，标阳逐渐枯竭。《平脉篇》说：寸口脉缓而迟，缓则阳气长，面色鲜艳，容颜光亮，声音洪亮，毛发长。阳气衰，所以颜色憔悴，两鬓白发。）五十六岁时，肝气衰退，筋脉不能灵活运动，天癸枯竭，精少，肾脏衰退，形体极度疲乏。（肝由肾所生，肾气衰，所以逐渐波及肝脏。肝生筋，肝气衰，所以筋不能运动。肾主骨，筋骨都衰，所以形体疲乏。）六十四岁时，牙齿头发脱落。（数终衰极，所以不仅斑白枯槁，而且脱落。）
肾主水，接受五脏六腑的精气而储藏它，所以五脏旺盛，才能排泄。（这里再次申明先天的癸水，又借助后天的津液资助。肾主水，指肾脏主藏精水。接受五脏六腑的精气而储藏，是指接受后天水谷的精气。五味入胃，各归其所喜，津液各行其道。肾为水脏，接受五脏的精气而储藏。肾的精液，入心化赤成为血，流溢于冲任，成为经血的海，养肌肉，生毫毛，所谓流溢于中，布散于外。所以说，天癸是天乙所生的精。因此男子天癸至而精气溢泻，肾精化赤为血，溢于冲任，生胡须；女子天癸至而月经按时来潮，所以精血都叫天癸。再按经文所说，营血之道，以内谷为宝。谷入于胃，传给肺，流溢于中，布散于外。专精者行于经隧，常荣不已。男子八八，女子七七，天地之数终而天癸绝，然而行于经隧的营血并未枯竭。所以老年人，如果能饮食且脾胃健旺，还能筋骨坚强，气血犹盛。本篇论天癸绝而筋骨衰，其后天水谷之精，又不能固执一端而论。再按，女子过了七七之年而经血淋漓不绝的，这是行于经隧的血，反从冲任而下，所以面黄肌瘦，骨惫筋柔，应当知道经隧之血行于脉中，冲任之血兼渗于脉外。）
黄帝说：“有的人年纪已老却有子女，为什么呢？”岐伯说：“这是因为他们天赋寿命超过常人，气脉常通，肾气有余。这样的人虽然有子女，但男子不超过八八六十四岁，女子不超过七七四十九岁，天地精气就都竭尽了。”（这里再次申明天地阴阳之数，止尽于七八八八。天寿过度，指先天秉受的精气盛。气脉常通，指后天的地道尚通。所以肾气有余而有子。这种人虽然有子，但天地精气已在七八之数时尽竭。）
黄帝说：“修道的人年龄都上百岁，能有子女吗？”岐伯说：“修道的人，能抗拒衰老而保全形体，虽然长寿，也能生育。”（承接上文，只有修道的人，能超出天地阴阳的定数。）
黄帝说：“我听说上古有真人，提挈天地，把握阴阳，呼吸精气，独立守神，肌肉若一，所以能寿命与天地等同，没有终结之时，这是因为他的道长生。”（上古真人，指生命本源自然合道，能保全天真之人。天真完固，所以能斡旋造化，燮理阴阳，吐纳精气，与道独存，守神全角，所以肌肤如冰雪，绰约如处女，寿命超过天地，没有终极之时，这是由道所生，所以无为而道自合。玉师说：天命之性，复归于无极，这叫真人。佛家道家以真空见性，本经谓空中有真。）
中古时代，有至人，淳厚品德，全备大道，调和阴阳，适应四时，远离世俗，积聚精气，保全精神，游行于天地之间，视听达于八方之外，这大概是增益寿命而强健的人，也归于真人。（中古至人，指有为而入道，能保全所生之天真。天真虽泄，又能修德全道，积精养神，所以令神气充塞于天地之间，耳目聪明于八达之外。这大概是从修炼保固得来，也能复完天真，而同归大道。真人得先天之真，至人得后天一气，其趋向一致，所以也归于真人。）
其次有圣人，处于天地之和，顺从八风之理，在世俗之间调节嗜欲，没有愤怒嗔恨之心，行为不想脱离世俗，穿着章服，举止不想观察俗世，对外不使形体劳碌于事，对内没有思想忧患，以恬愉为事务，以自得为功效，形体不敝坏，精神不散失，也可以活到百岁。（至人真人，去世离俗，修道全真，无妻室之爱，无嗜欲之情，所谓游方之外，高出人类。圣人，处天地之内，顺八方之理，教以人伦，法于制度，在朝堂之上穿黻冕，不想脱离世俗章服，无为而治，不劳其形，随机应变，不役其神，这是治世的圣人。也可以优游自在，长享百年。）
其次有贤人，效法天地，象似日月，辨别星辰，顺逆阴阳，分别四时，追随上古，协议于道，也可以使寿命延长而有极限。（贤人，处尘俗之内，少有拘束习气，取法天地，如日月光明，推测象纬，顺逆二气，序别四时，将与上古天真之圣，同合于道，也可以使寿命延长至于寿蔽天地之极。这是修道的贤人，由人以合天，超凡以至圣。这是皇帝勉励人修为，不要以凡庸自弃，所以《移精变气章》说：去故就新，乃得真人。）
In ancient times, referring to the origin of human life, "Tianzhen" (Heavenly Innocence/True Essence) denotes the primordial vital energy generated at the beginning of heaven and earth. The first four chapters of the *Suwen* discuss the regulation of spirit, qi, and blood. The source of life is called "Jing" (Essence), hence Jing is discussed first. When the essence of two sexes combines, it produces "Shen" (Spirit), hence Shen is discussed next. "Qi" (Vital Energy) is the yang energy generated within the essence water, hence Qi is discussed last.
In antiquity, the Yellow Emperor was born with spiritual wisdom, could speak in infancy, behaved obediently and correctly in childhood, became diligent and agile in adulthood, and ascended the throne upon maturity. (Xun sounds like "xun", Chang is pronounced with the rising tone. According to the *Records of the Grand Historian*, the Yellow Emperor's surname was Gongsun, his given name Xuanyuan, and he was the son of Shaodian, ruler of Youxiong State. He succeeded Shennong to rule the world, established his capital at Xuanyuan Hill, and reigned with the Virtue of Earth, thus being titled the Yellow Emperor. "Shenling" refers to intelligence; "Xun" means obedience; "Qi" means correctness; "Dun" means sincerity; "Min" means agility. This section records the unique endowment and nature of sages: speaking early. In his youth, he was obedient and correct; upon growing up, he was both sincere and agile. Thus, he could govern effectively by doing little, spreading education widely, establishing systems for the benefit of the world, and setting laws and images to teach future generations. He was a sage who knew from birth. Later, he cast cauldrons on Dinghu Mountain, and upon their completion, ascended to heaven in broad daylight. He was also a true person whose lifespan equaled that of heaven and earth, having no end.)
The Yellow Emperor then asked the Heavenly Master (Qibo): "I have heard that people in ancient times lived beyond a hundred years while their movements remained vigorous. People today, however, begin to decline in movement before reaching fifty. Is this due to differences in the times, or did people lose the way?" (Heavenly Master is an honorific for Qibo. 'Tian' refers to cultivating one's Tianzhen; 'Shi' refers to those who know beforehand and awaken first. Those who speak of the Dao are esteemed by the Supreme Lord; teachers transmit the Dao and establish teachings, hence Qibo is called Heavenly Master. 'Du' means to exceed. Living beyond a hundred years refers to living to 120 years.)
Qibo replied: "People in ancient times who understood the Dao modeled themselves on Yin and Yang and harmonized with shu-shu (methods and numbers for health preservation). (Ancient times refer to primeval eras. Understanding the Dao means knowing the way of cultivation. 'Fa' means to take as a model. Yin and Yang refer to heaven, earth, four seasons, five elements, and six qi. 'He' means harmony. Shu-shu refers to methods for nourishing essence and qi. Yin and Yang are the beginning and end of all things, the root of life and death. Violating them brings disaster; following them prevents severe illness. Thus, modeling oneself on them to achieve harmony is called understanding the Dao.) They had regulated diet and drink, regular daily routines, and avoided excessive labor. Therefore, their form and spirit coexisted, allowing them to complete their natural lifespan and pass away after a hundred years. (*Lingshu: Jueqi Chapter* states: The Upper Jiao opens and disseminates, promoting the flavors of grains, steaming the skin, filling the body, and moistening hair, like mist and dew. This is called Qi. Regulated diet nourishes Qi. *Shengqi Tongtian Lun* states: If daily life is惊 (startled/unstable), Spirit and Qi will float. Regular routines nourish Spirit. Excessive fatigue causes Yang to flare and Essence to exhaust. Avoiding excessive labor nourishes Essence. When Spirit and Qi depart, only the form remains, and the person dies. By nourishing Spirit and Qi, they coexist with the form and complete their natural lifespan.)
People today are different. They treat wine as water, make recklessness a habit, and engage in sexual intercourse while drunk. (Wine damages the Spleen; when Spleen Qi is damaged, it cannot promote grain flavors, damaging generating Qi. Making recklessness a habit damages Spirit. Intercourse while drunk damages Essence. This describes how modern people, not understanding the Dao, indulge desires and damage Essence, Qi, and Spirit.) They exhaust their Essence through desires and dissipate their True Yuan (Primal Qi). They do not know how to maintain fullness nor regulate Spirit according to the seasons. (Pleasure in lust is called desire; frivolous dissipation is called hao. Zhen refers to Primal Qi. Not knowing how to maintain fullness implies lack of caution. Failing to regulate Spirit timely means failing to adjust Spirit according to the four seasons. This describes how those who do not understand the Dao fail to cultivate cautiously, losing Essence, Qi, and Spirit.) They seek only mental pleasure, going against the joy of life, and have irregular routines, thus declining by age fifty. (The Heart houses Spirit; seeking only pleasure loses the guarding of Spirit. Joy relaxes Qi, but reversing this damages Qi. Irregular routines consume Essence. Modern people seek only happiness, failing to accumulate Essence and preserve Spirit, hence declining by fifty.)
The sages of ancient times taught their subjects to avoid empty evils and thief winds in time, remain tranquil and void, allow True Qi to follow, keep Spirit inward, so how could disease arise? (Empty evil refers to unhealthy winds from empty directions. Tranquil means quiet; Dan means simple. Void means not obscured by material desires. Ancient people received sage teaching, cultivated internally, and avoided external evils externally, thus living past a hundred with vigorous movements.) Therefore, their wills were leisurely with few desires, hearts were peaceful without fear, bodies labored without fatigue, Qi flowed smoothly, each followed their wishes, and all achieved their hopes. (Tranquility and non-action lead to leisurely wills and few desires. Keeping Spirit inward leads to peace and lack of fear. Laboring without fatigue. True Qi following leads to smooth Qi flow. People of the five directions, in food, clothing, and dwelling, followed their wishes, achieving their hopes.) Thus, they found beauty in their food, accepted their clothing, enjoyed their customs, did not envy high or low status, and were called simple. (Connecting to the above, *Yifa Fangyi Lun* states: Eastern people settle comfortably, enjoy good food; Western people live near hills, wear hides, eat rich foods, and become fat; Northern regions are high and cold, people like wild living and dairy; Southern regions are low and damp, people prefer sour food; Central regions are flat and humid, people eat mixed foods without hard labor. These five groups follow the growth of heaven, earth, and things, adapting to terrain, food, and custom, without envying each other, thus called simple.) Thus, desires did not tire their eyes, and licentiousness did not confuse their minds. (Reiterating that although five-directional people have desires and licentiousness leading to disease, in the tranquil ancient era, people lived peacefully without external longing, so internal harm was prevented.) Whether foolish, wise, virtuous, or unworthy, they feared nothing from external objects, thus conforming to the Dao. (Ancient people, regardless of status or virtue, preserved integrity and danger-free existence, fearing nothing externally, conforming to the health-preserving Dao.) Their ability to live past a hundred with vigorous movements is because their Virtue was complete and unharmed. (Virtue is the bright virtue obtained from Heaven. Complete and unharmed means not injured by desires. Zhuangzi says: Those who hold the Dao have complete Virtue; those with complete Virtue have complete Form; complete Form is the Way of the Sage.)
The Emperor said: "When people grow old and have no children, is it because their strength is exhausted, or is it the natural decree?" (Yin and Yang are the root of life and death. This discusses male and female Yin-Yang Qi and Blood, having beginnings and ends, prosperity and decline, each with a natural numerical limit. Caoli refers to physical strength.)
Qibo said: "At seven years old, girls' Kidney Qi becomes abundant, teeth change, and hair grows. (Seven is the number of young Yang. Girls are fundamentally Yin yet receive Yang numbers because Yin contains Yang. Life begins with the Kidneys. At seven, Kidney Qi is strong. The Kidneys govern bones; teeth are the surplus of bones, hence tooth change. Blood is the fluid of the Kidneys; hair is the surplus of blood, hence hair growth. Yin and Yang interact; isolated Yang does not generate, isolated Yin does not grow. Heaven generates Water, Earth generates Fire. Li represents Female, Kan represents Male, showing Yin-Yang exchange. Hence females get Yang numbers, males get Yin numbers.) At fourteen, Tian Gui (Heavenly Water/Menstrual Essence) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant. Menstruation occurs regularly, enabling conception. (Tian Gui is the Gui Water generated by Tian Yi. Chong and Ren are extraordinary vessels arising from the Bao Zhong (Uterus) in the lower abdomen, ascending along the abdomen, serving as the sea of menstruation. Women govern reproduction. The moon is Yin, women are Yin. The moon completes a cycle monthly with waxing and waning; thus, women's menses occur monthly. Waning regenerates, so conception is possible at birth due to emptiness.) At twenty-one, Kidney Qi is balanced, wisdom teeth emerge, and the body reaches its peak development. (Kidney Qi is the Qi produced by the Kidneys. Qi generates from Essence; thus, after Tian Gui arrives, Kidney Qi balances. Abundant Kidney Qi allows wisdom teeth to grow. Zhen Ya refers to wisdom teeth.) At twenty-eight, sinews and bones are firm, hair reaches its maximum length, and the body is robust. (Kidneys generate Marrow, Marrow generates Liver, Liver generates Sinews. At twenty-eight, Essence and Blood are at their peak, making sinews and bones firm and hair long. Abundant Qi and Blood fill the skin and warm the flesh, making the body robust.) At thirty-five, the Yangming Meridian declines, the face begins to wither, and hair starts to fall. (Yangming meridians nourish the face and run along the hairline. Decline causes facial withering and hair loss. Qi is Yang, Blood vessels are Yin; thus, women decline in vessels first, men in Qi first. Foot Yangming runs with Chong and Ren alongside the navel; if Chong and Ren are deficient, Yangming is also deficient.) At forty-two, the Three Yang meridians decline upwards, the face fully withers, and hair turns white. (Three Yang meridians ascend to the head; their decline causes facial withering. Blood vessels manifest in complexion; vessel decline causes white hair.) At forty-nine, the Ren Mai is deficient, Chong Mai is depleted, Tian Gui is exhausted, the earthly pathway is blocked, the form deteriorates, and fertility ceases. (Earthly pathway refers to lower meridians. *Sanbu Jiuhou Lun* states the lower Earth corresponds to Foot Shaoyin. Gui Water is stored in the Kidneys; exhaustion of Tian Gui means Foot Shaoyin lower pathways are blocked. Deficient Chong and Ren cause deterioration and infertility.)
Boys at eight years old have solid Kidney Qi, hair grows, and teeth change. (Eight is the number of young Yin. Boys are fundamentally Yang yet receive Yin numbers because Yang contains Yin.) At sixteen, Kidney Qi is abundant, Tian Gui arrives, Essence overflows and is discharged, Yin and Yang harmonize, enabling conception. (*Lingshu* states: Chong and Ren arise from Bao Zhong, ascending the back, serving as the sea of meridians. The floating external part ascends the abdomen to the throat, connecting to lips. Abundant Qi and Blood fill skin and warm flesh. Excess Blood permeates skin, growing fine hair. Women are born with excess Qi and deficient Blood due to frequent blood loss. Chong and Ren do not nourish lips, hence no beard. Men's Tian Gui overflows into Chong and Ren, warming flesh and growing beards; women's Tian Gui overflows into Chong and Ren, becoming menstrual blood for pregnancy. At sixteen, male Essence is full, Yin-Yang harmonize, discharge occurs, enabling conception.) At twenty-four, Kidney Qi is balanced, sinews and bones are strong, wisdom teeth emerge, and the body peaks. (Ping means sufficient; Jun means harmonious; Ji means limit. Wisdom teeth grow, and sinew/bone development reaches its limit.) At thirty-two, sinews and bones are luxuriant, muscles are full and strong. (Four is half of eight, representing the peak of luxuriance.) At forty, Kidney Qi declines, hair falls, and teeth dry out. (Kidneys are the source of generating Qi; men decline in Qi, so root Qi fails first, causing hair loss and dry teeth.) At forty-eight, Yang Qi衰竭 (depletes) upwards, the face withers, and temples turn gray. (Root Qi fails first, then superficial Yang depletes. *Pingmai Pian* states: Slow and delayed pulse indicates growing Yang, fresh color, bright face, resonant voice, long hair. Declining Yang causes withered color and gray hair.) At fifty-six, Liver Qi declines, sinews cannot move, Tian Gui is exhausted, Essence is scarce, Kidneys decline, and the form is exhausted. (Liver is generated by Kidneys; Kidney decline affects Liver. Liver generates sinews; Liver Qi decline causes immobility. Kidneys govern bones; sinew and bone decline exhausts the form.) At sixty-four, teeth and hair fall out. (Numbers reach their limit of decline, causing not just graying and drying, but falling out.)
The Kidneys govern Water and store the Essence of the Five Zang and Six Fu organs. Thus, only when the Five Zang are abundant can Essence be discharged. (Reiterating prenatal Tian Gui supported by postnatal fluids. Kidneys govern Water, storing Essence. Storing Essence of Five Zang and Six Fu refers to postnatal Grain Essence. Flavors enter the Stomach, go to their preferred organs, and fluids travel their paths. Kidneys, as Water organs, store Essence from Five Zang. Kidney Essence enters Heart, turns red to become Blood, flows into Chong and Ren, becoming the sea of menstruation, nourishing flesh and growing hair. Thus, Tian Gui is Essence generated by Tian Yi. Men's Tian Gui causes Essence overflow and discharge; Kidney Essence turns to Blood, flows to Chong/Ren, growing beards. Women's Tian Gui causes regular menses. Thus, Essence and Blood are both called Tian Gui. *Jing* states: Ying Blood values Grain. Grain enters Stomach, transmits to Lungs, flows internally, spreads externally. Specialized Essence travels meridians, continuously nourishing. At 8x8 and 7x7, heavenly-earthly numbers end, Tian Gui ceases, but Ying Blood in meridians remains. Elderly with healthy digestion retain strong sinews/bones and abundant Qi/Blood. This chapter discusses Tian Gui cessation and sinew/bone decline; postnatal Grain Essence cannot be viewed rigidly. Also, women past 7x7 with continuous bleeding have Ying Blood from meridians flowing down Chong/Ren, causing yellow face, thin flesh, weak bones/sinews. One must know Ying Blood stays in vessels, while Chong/Ren blood seeps outside.)
The Emperor said: "Some elderly people have children. Why?" Qibo said: "This is because their innate longevity exceeds normal limits, Qi and vessels remain open, and Kidney Qi is abundant. Although they have children, men do not exceed 8x8 (64), and women do not exceed 7x7 (49); Heaven and Earth's Essence are exhausted." (Reiterating Yin-Yang numbers end at 7x7 and 8x8. Exceeding innate longevity means abundant prenatal Essence. Open Qi/vessels mean postnatal pathways remain open. Thus, abundant Kidney Qi allows conception. However, Heaven/Earth Essence is exhausted at these numerical limits.)
The Emperor said: "Can Dao cultivators, living past a hundred, have children?" Qibo said: "Dao cultivators resist aging and preserve their form. Even if long-lived, they can sire children." (Only cultivators transcend the fixed numbers of Yin and Yang.)
The Yellow Emperor said: "I hear there were True Persons in ancient times who grasped Heaven and Earth, controlled Yin and Yang, breathed Essence, stood alone guarding Spirit, and had unified muscles/flesh. Thus, their lifespan equaled Heaven and Earth, having no end, because their Dao generated life." (True Persons naturally conformed to the Dao, preserving Tianzhen. With intact Tianzhen, they manipulated creation, balanced Yin-Yang, practiced breathing exercises, existed solely with the Dao, guarded Spirit and form, resulting in skin like ice/snow and youthful appearance. Lifespan exceeding heaven/earth has no end, generated by Dao, achieving non-action and natural Dao compliance. Master Yu said: Returning nature to Wuji is the True Person. Buddhism/Taoism see nature in emptiness; this text says truth exists in emptiness.)
In middle antiquity, there were Perfect Persons (Zhiren) with pure virtue, complete Dao, harmonized Yin-Yang, adapted to four seasons, left worldly俗 (customs), accumulated Essence, preserved Spirit, traveled between heaven and earth, and saw/heard beyond the eight directions. They extended life and strengthened the body, returning to True Persons. (Zhiren entered Dao through action, preserving innate Tianzhen. Though Tianzhen leaked, they cultivated virtue and Dao, accumulating Essence/Spirit, filling heaven/earth with Shen-Qi, and sharpening senses. Through cultivation, they restored Tianzhen and returned to the Great Dao. True Persons obtain prenatal Truth; Zhiren obtain postnatal Qi. Their goal is one, hence returning to True Persons.)
Next were Sages (Shengren), dwelling in harmony with heaven/earth, following Eight Winds, adjusting desires in secular life, free from anger, staying close to society, wearing official robes, avoiding vulgar displays, not exhausting form in affairs, free from mental worry, pursuing tranquility and self-satisfaction, keeping form intact and Spirit undissipated, living to a hundred. (True/Perfect Persons left society, cultivated Dao, devoid of family love/desires, transcending humanity. Sages dwelled within heaven/earth, followed Eight Winds, taught ethics, modeled systems, wore court attire, stayed close to secular customs, governed by non-action, not exhausting form, responding spontaneously, not draining Spirit. These are governing sages, enjoying leisure and longevity.)
Next were Worthies (Xianren), modeling heaven/earth, imitating sun/moon, distinguishing stars, following/opposing Yin/Yang, separating four seasons, following ancient times, agreeing with Dao, extending life to its limit. (Worthies lived in society, free from constraints, modeled heaven/earth like sun/moon light, predicted astronomy, adjusted Qi, ordered seasons, aiming to unite with ancient sages in Dao, extending life to match heaven/earth. These are cultivating worthies, merging human effort with heaven, transcending to sagehood. The Emperor encouraged cultivation, not abandoning oneself as ordinary, citing *Yijing Bianqi Chapter*: Leaving old for new yields True Persons.)