黄帝问曰。余闻方士或以脑髓为脏。或以肠胃为脏。或以为腑。敢问更相反。皆自谓是。不知其道。愿闻其说。（方
士、修炼方术之士。道、理也。凡藏物者。皆可名脏名腑。故皆自以为是也。按以上十篇。首四篇论精神气血。后六篇
论脏腑阴阳。是以此篇申明藏精气者名脏。传化物者为腑。然又有脑、髓、骨、脉、胆、女子胞。亦所以藏精神气血者
也。修养之士。欲积精全神。通玄牝。养胎息。结灵孕者。不可不知也。脑名泥丸宫。为上丹田。骨藏髓。脉藏血。诸
髓血脉。皆会于脑。故脑为精髓之海。舌下为华池。有廉泉玉英二窍。通于胆液。黄庭经曰。玉池清水灌灵根。审能修
之可常存。女子、玄母也。胞者。养胎息。结灵胎者也。胎息经曰。胎从伏气中结。气从有胎中息。结精育胞化生身。
留胎止精可长生。故曰脑、髓、骨、脉、胆、女子胞。此六者。更当藏密而不可虚泻者也。）岐伯对曰。脑、髓、骨、
脉、胆、女子胞。此六者。地气之所生也。皆藏于阴而象于地。故藏而不泻。名曰奇恒之府。（地主闭藏而上升。天主化
施而下降。言人之脏腑形骸。应象天地阴阳之气。此六者。与传化之府不同。故名曰奇恒之府。）夫胃、大肠、小肠、三
焦、膀胱。此五者。天气之所生也。其气象天。故泻而不藏。此受五脏浊气。名曰传化之府。此不能久留。输泻者也。
（夫脏为阴。地为阴。地之浊气升于天。天受之而复降于下。故名曰传化之府。天主化施也。）魄门亦为五脏使。水谷不
得久藏。（魄门、肛门也。上合于肺。故名魄门。五脏之浊。从此而出。故亦为五脏之下使。肠胃之腐秽。从此而泻出。
故曰水谷不得久藏。）所谓五脏者。藏精气而不泻也。故满而不能实。（王氏曰。精气为满。水谷为实。但藏精气。故满
而不能实。）六腑者。传化物而不藏。故实而不能满也。（水谷充实于内。而不得久留。故实而不能满。）所以然者。水谷
入口。则胃实而肠虚。食下。则肠实而胃虚。（此复申明实而不满之义。）故曰实而不满。满而不实也。（此总结上文两节
之义。）帝曰。气口何以独为五脏主。（气口。手太阴之两脉口。五脏之气。皆变见于气口。故为五脏主。此论水谷入
胃。以养五脏。五脏之精气。复荣于脉。而见于气口也。盖水谷之清者。荣于五脏。水谷之浊者。出于六腑。清中之清
者。荣于经脉。清中之浊者。复传化于肠胃膀胱。此节论饮食于胃。有气味清浊上下出入之分。当知奇恒之府。亦受清
中之清者也。）岐伯曰。胃者。水谷之海。六腑之大源也。五味入口。藏于胃。以养五脏气。气口亦太阴也。是以五脏六
腑之气味。皆出于胃。变见于气口。（水谷入胃。由足太阴脾脏转输。以灌溉四脏。然水入于胃。又由手太阴肺藏之通调
四布。谷入于胃。淫精于脉。肺朝百脉。输精于皮毛。毛脉合精。行气于脏腑。是五脏六腑之气味。皆出于胃。变见于
气口。故曰气口亦太阴也。言足太阴转输水谷之精。而手太阴亦为胃以养五脏气。是以五脏之气。皆见于气口也。）故五
气入鼻。藏于心肺。心肺有病。而鼻为之不利也。（心肺居上为阳。肺乃心之盖而主气。开窍于鼻。故引脏象论。而言味
归阴而气归阳也。道书云。鼻为天门。口为地户。）凡治病。必察其下。（下、谓肠胃水谷之所出也。按玉机论曰。五实
死。五虚死。腹胀。前后不通。闷瞀。此谓实。泄利前后。饮食不入。此为虚。浆粥入胃。泄注止。则虚者活。身汗得
后利。则实者活。又曰。仓廪不藏者。是门户不要也。得守者生。失守者死。是以凡病必察其下二便也。）适其脉。（调
适其太阴气口之脉。以决脏腑之气。）观其志意。与其病也。（志意者。所以御精神。收魂魄。适寒温。和喜怒者也。故
当观其志意。与其所受之病焉。）拘于鬼神者。不可与言至德。（拘于鬼神者。欲其祝由而愈病也。然祝由之道。移精
变气。以我之神而通神明。若惟拘于鬼神之事。不可与言至德矣。）恶于针石者。不可与言至巧。（用针石者。有至巧之
妙道。）病不许治者。病必不治。治之无功矣。（不能藏此精神以通鬼神。当以针石治其外。汤药治其内矣。若恶于针石。
不许治以汤药。治之亦无功矣。按以上七篇。论阴阳脏腑。而脏腑阴阳之病。必须审证辨脉。治以针石醪醴。是以下编
论五方有五治之法。病在外者。治以针石。病在内者。治以醪醴汤液。即欲祝由愈病。亦须移精变气。而后能通于神明。
故此篇末结曰。拘于鬼神者。不可与言至德。恶于针石者不可与言至巧。乃承上起下之文也。）
黄帝问道：我听说有些方士，有的把脑和髓称为脏，有的把肠胃称为脏，有的又把它们称为腑。请问为什么说法相反，却都自认为正确？我不明白其中的道理，希望听听您的解释。（方士，指修炼方术的人士。道，指原理。凡是能容纳物质的器官，都可以称为脏或腑，所以他们都自以为是。按以上十篇的内容，前四篇论述精神气血，后六篇论述脏腑阴阳，因此本篇旨在阐明：贮藏精气的器官叫作“脏”，传导消化物的器官叫作“腑”。然而又有脑、髓、骨、脉、胆、女子胞这六个器官，它们也是用来贮藏精神气血的。修养身心的人，想要积聚精气、保全神气，通晓玄牝之门，调养胎息，凝结灵胎，是不可不知晓这些道理的。脑被称为泥丸宫，是上丹田；骨中藏髓，脉中藏血，所有的髓和血脉最终都会聚于脑，所以脑是精髓之海。舌下称为华池，有廉泉、玉英两个窍穴，与胆汁相通。《黄庭经》说：“玉池清水灌灵根，审能修之可常存。”女子称为玄母，胞宫是用来养育胎息、凝结灵胎的地方。《胎息经》说：“胎从伏气中结，气从有胎中息，结精育胞化生身，留胎止精可长生。”所以说脑、髓、骨、脉、胆、女子胞这六个器官，更应当密闭贮藏而不能随意泻泄。）
岐伯回答说：脑、髓、骨、脉、胆、女子胞，这六个器官，是由地气所生成的。它们都贮藏阴精而象征大地，所以只贮藏而不排泄，称之为奇恒之府（奇恒之府，意为异于寻常的腑）。（大地主闭藏而上升，天主化施而下降。这是说人的脏腑形骸，应象天地阴阳之气。这六个器官，与传导消化物的腑不同，所以称之为奇恒之府。）至于胃、大肠、小肠、三焦、膀胱，这五个器官，是由天气所生成的。它们的性质象征天，所以只排泄而不贮藏，接受五脏传来的浊气，称之为传化之府（传化之府，指传导和变化水谷的腑）。这些器官不能长久停留，而是不断输注排泄的。（脏属阴，地也属阴，地的浊气升腾到天上，天接受它后又降下来，所以称之为传化之府。天主管化生和施予。）肛门（魄门）也是五脏的使者，水谷糟粕不能在体内久藏。（魄门，即肛门。它与肺相合，所以叫魄门。五脏的浊气由此排出，所以它也是五脏的下行使者。肠胃中的腐秽之物由此泻出，所以说水谷不得久藏。）
所谓五脏，是贮藏精气而不向外排泄的，所以保持充满状态但不能被实物填塞。（王冰注：精气充盈称为“满”，水谷充实称为“实”。因为只贮藏精气，所以满而不能实。）六腑，是传导消化物而不贮藏的，所以可以被实物填塞但不能保持充满状态。（水谷充实于内，但不能长久停留，所以实而不能满。）之所以这样，是因为水谷入口，则胃充实而肠空虚；食物下行，则肠充实而胃空虚。（这里再次阐明“实而不满”的道理。）所以说，六腑是实而不满，五脏是满而不实。
黄帝问：为什么寸口脉（气口）唯独能够反映五脏的情况？（气口，即手太阴肺经的脉口。五脏的气机变化都显现于气口，所以它是五脏的主宰。这里论述的是水谷进入胃中，滋养五脏，五脏的精气反过来荣养经脉，并显现于气口。大概水谷中的清轻部分，荣养五脏；水谷中的浊重部分，出于六腑。清中之清者，荣养经脉；清中之浊者，再传导至肠胃和膀胱。这一节论述饮食入胃后，气味有清浊、上下出入的区别，应当知道奇恒之府也接受清中之清的部分。）
岐伯说：胃是水谷汇聚的海，是六腑的大源头。五味入口后，贮藏于胃，用来滋养五脏之气。气口也属于太阴经（手太阴肺经）。因此，五脏六腑的气味，都源于胃，并变化显现于气口。（水谷入胃，由足太阴脾脏转输，以灌溉其他四脏。然而水入于胃，又由手太阴肺进行通调散布；谷物入于胃，精华渗入脉中，肺朝会百脉，将精气输送到皮毛，毛与脉中的精气结合，在脏腑中运行气机。因此五脏六腑的气味都源于胃，并变化显现于气口，所以说气口也属于太阴。意思是足太阴转输水谷的精微，而手太阴也通过胃来滋养五脏之气，所以五脏之气都显现于气口。）
所以，五气从鼻吸入，贮藏于心肺。如果心肺有病，鼻子就会不通利。（心肺居于上部属阳，肺是心的覆盖物且主司呼吸之气，开窍于鼻，所以引用《脏象论》，来说明味归阴而气归阳的道理。道家书籍说：鼻为天门，口为地户。）
大凡治病，必须检查二便（下）。（下，指肠胃水谷排出的部位。按《玉机真脏论》所说：五实死，五虚死。腹胀，前后二便不通，胸闷昏蒙，这叫实症；腹泻不止，饮食不入，这叫虚症。如果能喝进浆粥，腹泻停止，则虚症可活；身体出汗且二便通畅，则实症可活。又说：仓廪不藏守，是门户失约。能守住者生，失守者死。所以凡是疾病必须检查其二便。）要调适其脉象（适其脉）。（调适观察太阴气口的脉象，以决断脏腑之气。）要观察患者的志意及其病情。（志意，是用来驾驭精神、收敛魂魄、适应寒温、调和喜怒的。所以应当观察患者的志意以及他所患的疾病。）对于拘泥于鬼神迷信的人，不可以跟他谈论高深的医德（至德）。（拘泥于鬼神的人，希望用祝由术来治愈疾病。然而祝由之道，是通过移精变气，用我的神气去沟通神明，如果仅仅拘泥于鬼神之事，就不可以跟他谈论高深的医德了。）对于厌恶针石治疗的人，不可以跟他谈论高超的技巧（至巧）。（使用针石治疗，有着高超巧妙的妙道。）病人不允许治疗的，病一定治不好，治疗也不会见效。（如果不能收敛精神以沟通神明，就应当用针石治其外，汤药治其内。如果既厌恶针石，又不允许用汤药治疗，那么治疗也不会见效。按以上七篇，论述阴阳脏腑，而脏腑阴阳的疾病，必须审证辨脉，用针石和醪醴治疗。所以下编论述五方有不同的治疗方法：病在外部的，用针石治疗；病在内部的，用醪醴汤液治疗。即使想用祝由术治愈疾病，也必须先移精变气，然后才能通于神明。所以本篇结尾说：拘泥于鬼神的人，不可与他谈论至德；厌恶针石的人，不可与他谈论至巧。这是承上启下的文字。）
Huangdi asked: I have heard that some practitioners of alchemical arts (Fangshi) consider the brain and marrow to be Zang organs, others consider the stomach and intestines to be Zang organs, and still others consider them to be Fu organs. May I ask why these views are contradictory, yet each claims to be correct? I do not understand the principle behind this and wish to hear your explanation. (Practitioners of alchemical arts refer to those who cultivate spiritual techniques. "Dao" here refers to principles. Any organ capable of containing substances can be named a Zang or a Fu, hence they all claim correctness. Regarding the preceding ten chapters, the first four discuss spirit, Qi, blood, and essence, while the last six discuss Zang-Fu organs and Yin-Yang. Therefore, this chapter clarifies that organs storing essence and Qi are called Zang, while those conducting and transforming food are called Fu. However, there are also the brain, marrow, bones, vessels, gallbladder, and uterus in women, which serve to store spirit, Qi, blood, and essence. Those engaged in self-cultivation, wishing to accumulate essence, preserve spirit, comprehend the mysterious female (Xuanpin), nourish fetal breathing, and condense spiritual embryos, must not be ignorant of these matters. The brain is known as the Mud Pill Palace (Niwan Gong), the Upper Dantian. Bones store marrow, and vessels store blood; all marrow and blood vessels converge at the brain, making it the sea of essence and marrow. Below the tongue lies the Hua Chi, with two orifices, Lianquan and Yuying, connecting to bile fluid. The *Huangting Jing* states: "Clear water from the Jade Pool irrigates the spiritual root; if cultivated properly, one may endure forever." Women are referred to as the Mysterious Mother, and the uterus is for nurturing fetal breathing and condensing spiritual embryos. The *Taixi Jing* states: "The embryo forms from submerged Qi; Qi breathes within the embryo. Condensing essence and nurturing the uterus transforms into life. Retaining the embryo and stopping essence leakage allows for longevity." Thus, the brain, marrow, bones, vessels, gallbladder, and uterus—these six organs—should be kept tightly sealed and not subjected to emptying or purging.)
Qibo replied: The brain, marrow, bones, vessels, gallbladder, and uterus in women—these six organs—are generated by Earth Qi. They all store Yin and correspond to the Earth; therefore, they store but do not excrete. They are named the Extraordinary Fu Organs (Qi Heng Zhi Fu). (Earth governs closure and storage, rising upward; Heaven governs transformation and distribution, descending downward. This indicates that human Zang-Fu organs and physical forms correspond to the Yin-Yang Qi of Heaven and Earth. These six organs differ from the Fu organs that conduct transformations, hence they are named the Extraordinary Fu Organs.) As for the stomach, large intestine, small intestine, Sanjiao (Triple Burner), and bladder—these five organs—are generated by Heaven Qi. Their nature corresponds to Heaven; therefore, they excrete but do not store. They receive turbid Qi from the Zang organs and are named the Transmitting and Transforming Fu Organs (Chuan Hua Zhi Fu). These cannot remain long inside but are constantly transported and excreted. (Zang organs belong to Yin, and Earth belongs to Yin. Turbid Qi from Earth rises to Heaven; Heaven receives it and descends it again, hence named Transmitting and Transforming Fu Organs. Heaven governs transformation and distribution.) The anal sphincter (Po Men) also serves as an envoy for the five Zang organs; food and water residues cannot be stored for long. (Po Men refers to the anus. It connects with the Lung, hence the name Po Men. Turbidity from the five Zang organs exits through here, so it acts as a subordinate envoy for the Zang organs. Rotrid matter from the stomach and intestines is excreted through here, hence it is said that food and water cannot be stored long.)
What is meant by the five Zang organs is that they store essence and Qi without excreting, thus remaining full but not solidly packed. (Wang Bing noted: Fullness refers to the abundance of essence and Qi; solidity refers to the presence of food and water. Since they only store essence and Qi, they are full but not solid.) The six Fu organs conduct and transform substances without storing, thus being solidly packed but not permanently full. (Food and water fill the interior but cannot remain long, hence solid but not full.) The reason for this is that when food and water enter the mouth, the stomach becomes solid and the intestines hollow; after digestion, the intestines become solid and the stomach hollow. (This further elucidates the meaning of "solid but not full.") Therefore, it is said that the Fu organs are solid but not full, while the Zang organs are full but not solid.
Huangdi asked: Why does the Qi Kou (Radial Pulse) alone serve as the master of the five Zang organs? (Qi Kou refers to the pulse point of the Hand Taiyin Lung Meridian. The Qi of the five Zang organs manifests at the Qi Kou, hence it serves as the master. This section discusses how food and water enter the stomach to nourish the Zang organs, and the essence and Qi of the Zang organs subsequently nourish the vessels and manifest at the Qi Kou. Generally, the clear part of food and water nourishes the Zang organs, while the turbid part exits via the Fu organs. The clearest part nourishes the meridians, while the clearer-turbid part is transmitted to the stomach, intestines, and bladder. This section discusses the distinction between clear and turbid aspects of diet entering the stomach, involving ascent, descent, entry, and exit. One should understand that the Extraordinary Fu Organs also receive the clearest-clear aspect.)
Qibo said: The stomach is the sea of food and water and the great source of the six Fu organs. When the five flavors enter the mouth, they are stored in the stomach to nourish the Qi of the five Zang organs. The Qi Kou also belongs to the Taiyin (Hand Taiyin Lung Meridian). Therefore, the Qi and flavor of all five Zang and six Fu organs originate from the stomach and manifest at the Qi Kou. (After food and water enter the stomach, they are transported by the Foot Taiyin Spleen Meridian to irrigate the other four Zang organs. However, water entering the stomach is regulated and distributed by the Hand Taiyin Lung Meridian. Grain entering the stomach infuses essence into the vessels. The Lung meets all vessels and transmits essence to the skin and hair. The essence of skin and hair combines, and Qi circulates through the Zang and Fu organs. Thus, the Qi and flavor of all Zang and Fu organs originate from the stomach and manifest at the Qi Kou, hence it is said that the Qi Kou also belongs to Taiyin. This means that while the Foot Taiyin transports the essence of food and water, the Hand Taiyin also uses the stomach to nourish the Qi of the five Zang organs. Consequently, the Qi of the five Zang organs manifests at the Qi Kou.)
Therefore, the five Qi inhaled through the nose are stored in the Heart and Lung. If the Heart or Lung has disease, the nose will become obstructed. (The Heart and Lung reside in the upper part and belong to Yang. The Lung covers the Heart and governs Qi, opening into the nose. Thus, citing the *Zang Xiang Lun*, it explains that flavors return to Yin and Qi returns to Yang. Daoist texts state: The nose is the Heavenly Gate, and the mouth is the Earthly Door.)
In treating any disease, one must examine the lower orifices (excretion). (Lower refers to the exit of food and water from the stomach and intestines. According to the *Yu Ji Zhen Zang Lun*: Death occurs in cases of Five Excesses and Five Deficiencies. Abdominal distension, obstruction of both bowels, chest tightness, and dizziness constitute Excess. Diarrhea, inability to eat, and inability to retain food constitute Deficiency. If gruel enters the stomach and diarrhea stops, the Deficient case can survive. If sweating occurs and bowels open, the Excess case can survive. It also states: If the granary cannot be guarded, the gates are uncontrolled. Survival depends on guarding; death results from losing control. Therefore, in all diseases, one must examine the lower orifices, i.e., urination and defecation.) One must adjust and observe the pulse. (Adjust and observe the pulse at the Taiyin Qi Kou to determine the Qi of the Zang and Fu organs.) One must observe the patient's mental state (Zhi Yi) and their condition. (Mental state refers to the capacity to control spirit, gather soul, adapt to cold and heat, and harmonize joy and anger. Thus, one should observe the patient's mental state and the disease they have contracted.) For those bound by ghosts and spirits, one cannot speak of the highest virtue (Zhi De). (Those bound by ghosts and spirits desire healing through Zhu You (spiritual incantations). However, the way of Zhu You involves shifting spirit and changing Qi, using one's own spirit to communicate with the divine. If one is merely bound by ghostly matters, one cannot speak of the highest virtue with them.) For those who detest acupuncture and stone therapy, one cannot speak of supreme skill (Zhi Qiao). (The use of needles and stones possesses supreme skill and subtle ways.) If the patient refuses treatment, the disease will certainly not be cured, and treatment will yield no merit. (If one cannot gather spirit to communicate with the divine, one should treat externally with needles and stones and internally with decoctions. If one detests needles and stones and does not permit treatment with decoctions, treatment will yield no merit. Referring to the previous seven chapters discussing Yin-Yang and Zang-Fu, diseases of Zang-Fu Yin-Yang require careful syndrome differentiation and pulse diagnosis, treated with needles, stones, and fermented wines. The following sections discuss five treatments for five directions: external diseases are treated with needles and stones; internal diseases are treated with fermented wines and decoctions. Even if one wishes to heal through Zhu You, one must first shift spirit and change Qi to communicate with the divine. Hence, the conclusion of this chapter states: Those bound by ghosts and spirits cannot be spoken to regarding the highest virtue; those who detest needles and stones cannot be spoken to regarding supreme skill. This is transitional text connecting the preceding and following sections.)