虚无。则精神内守。真气从之。其知道者。亦归于真人。高士宗曰。此节照应首篇之圣人。外不劳形于事。内无思想
之患。以恬愉为务。以自得为功。精神不散。亦能寿敝天地。无有终时。）天不足西北。故西北方阴也。而人右耳目不
如左明也。地不满东南。故东南方阳也。而人左手足不如右强也。（此言天地阴阳之所不能全。惟其阴阳精气营运。故能
生长收藏。化生万物。其在人亦当配天地以养头足。勿使邪气居之。天不足西北者。阳中之阴不足也。故西北方阴也。
而人之右耳目不如左明也。左为阳而右为阴。阴不足于上也。地不满东南者。阴中之阳不足也。故东南方阳也。而人左
手足不如右强也。右为阴而左为阳。阳不足于下也。）帝曰。何以然。岐伯曰。东方阳也。阳者其精并于上。并于上则上
明而下虚。故使耳目聪明而手足不便也。西方阴也。阴者。其精并于下。并于下则下盛而上虚。故其耳目不聪明而手足
便也。（天有精。地有形。东方阳也。其精气上升而并于上。并于上则上盛而下虚。故使人之耳目聪明。而手足不便也。
西方阴也。其精气下降而并于下。并于下则下盛而上虚。故其人之耳目不聪明。而手足便也。此以天地之左右而言也。
王子方曰。上编论阳气生于阴精。此复言天有精。而精气上下交并。是阴精又生于天也。）故俱感于邪。其在上则右甚。
在下则左甚。此天地阴阳所不能全也。故邪居之。（此以形身论之。其在上则右虚。在下则左虚。是天地阴阳之所不能全。
而人身亦有左右之不足也。上文言天地左右之上下。此言人身上下之左右。王子方曰。俱感于邪。然后知虚处之病甚。）
故天有精。地有形。天有八纪。地有五里。故能为万物之父母。（天有所生之精。地有所成之形。天有八方之纪纲。地有
五行之道理。其精气交通于九州八方之外。故能为万物生长之父母。又非止于上下之交并而已。）清阳上天。浊阴归地。
是故天地之动静。神明为之纲纪。故能以生长收藏。终而复始。（言天地之体位。虽有东西南北之不足。而神明为之纲纪。
故能以生长收藏。终而复始。化生万物。神明者。生五气。化五行者也。）惟贤人上配天以养头。下象地以养足。中旁人
事以养五脏。（上配天以养耳目之聪明。下象地以养腰以下之不足。节五味。适五志。以养五脏之太和。虽有贼邪。而勿
能居之矣。此篇曰圣人。曰贤人。谓惟贤圣能法则天地。逆从阴阳。恬 虚无。精神内守。可使益寿。无有终极之时。
而皆归于真人也。）天气通于肺。（肺脏属乎干金。位居至高。而主周身之气。故与天气相通。此复言非惟头之上窍通乎
天。从腰以下以象地。而五脏六腑九窍六经。皆与天地之气相通。惟贤人能法天之纪。用地之理以治身。故灾害不能及
也。）地气通于嗌。（嗌乃胃腑之门。主受湿浊之气以入胃。故与地气相通。太阴阳明篇曰。喉主天气。嗌主地气。）风气
通于肝。（风生木。木生肝。外内之气相通也。）雷气通于心。（雷、火之发声也。心为火脏。气相感召。故与心相通。）
谷气通于脾。（脾为土脏。而主司转运。谷气、山谷之通气也。故与脾气相通。）雨气通于肾。（肾为水脏。雨气。寒水之
气也。）六经为川。（六经、手足三阴三阳之经脉也。外内环转。如川流之不息。）肠胃为海。（肠胃受盛水谷。如海之无
所不容。又胃为水谷之海。而外合海水。肠为受盛之官。）九窍为水注之气。（精气通上窍。水浊出下窍。）以天地为之阴
阳。（阴阳者。天地之道也。以天地之道。通乎身之阴阳。）阳之汗。以天地之雨名之。（汗出于阴液。由阳气之宣发。故
曰阳加于阴谓之汗。雨乃地之阴湿。亦由天气之所化施。故可方人之汗。）阳之气。以天地之疾风名之。（风出于地之隧
谷。阳气发于里阴。以疾风名之者。言阳气之行。身有道。无少逆滞者也。）暴气象雷。逆气象阳。（气暴如雷火之发。
气逆如阳热之胜。此复言阳气之如风。行于上下四旁。无暴无逆也。）故治不法天之纪。不用地之理。则灾害至矣。（人
之阴阳。通乎天地。天有八纪。地有五里。为治不取法天地之阴阳。则灾害至矣。）故邪风之至。疾如风雨。（天之邪气。
始伤皮毛。由皮毛而至肌肉筋脉。由经脉而入于脏腑。故如风雨之骤至。而易入于内也。独言风者。风为百病之长。而
能开发皮腠。）故善治者治皮毛。（阳气者。卫外而为固也。天之阳邪。始伤皮毛气分。故善治者。助阳气以宣散其邪。
不使内入于阴也。）其次治肌肤。（邪在皮毛。留而不去。则入于肌肤矣。肌肤尚属外之气分。亦可使邪从外解。故其治
之次也。）其次治筋脉。（邪在肌肤。留而不去。则入于经络矣。经脉内连脏腑。外络形身。善治者。知邪入于经。即从
经而外解。不使内干脏腑。此为治之法。又其次也。灵枢经曰。邪留而不去。或着经脉。或着于膂筋。）其次治六腑。（金
匮要略曰。经络受邪。入脏腑。为内所因。邪入于经。留而勿治。则入于里矣。故止可从腑而解。）其次治五脏。治五脏
者。半死半生也。（六脏之脉。属脏络腑。六腑之脉。属腑络脏。脏腑经气。联系相通。邪入于内。而又不从腑解。则干
及于脏矣。邪在五脏经气之间。尚可救治而生。如干脏则死矣。故曰半死半生也。夫皮肤气分为阳。经络血分为阴。外
为阳。内为阴。腑为阳。脏为阴。邪在阳分为易治。邪在阴分为难治。以上论为治之道。当取法乎阴阳。）故天之邪气。
感则害人五脏。水谷之寒热。感则害于六腑。地之湿气。感则害皮肉筋脉。（天之邪气。由形层而入于里阴。故感则害人
五脏。水谷入胃。寒温不适。饮食不节。而病生于肠胃。故害于六腑。清湿地气之中人也。必从足始。故感则害皮肉筋
脉。夫脏为阴。腑为阳。经脉血分为阴。皮肉气分为阳。天地之邪。有阴有阳。水谷之气。有热有寒。而病患之形身脏
腑。亦有阴阳之别也。）故善用针者。从阴引阳。从阳引阴。以右治左。以左治右。以我知彼。以表知里。以观过与不
及之理。见微得过。用之不殆。（此言用针者。当取法乎阴阳也。夫阴阳气血。外内左右。交相贯通。故善用针者。从阴
而引阳分之邪。从阳而引阴分之气。病在左者取之右。病在右者取之左。以我之神。得彼之情。以表之证。知里之病。
观邪正虚实之理而补泻之。见病之微萌。而得其过之所在。以此法用之。而不致于危殆矣。）善诊者。察色按脉。先别阴
阳。（此言善诊者。宜审别其阴阳也。夫色为阳。血为阴。然色有阴阳。而脉有阴阳。故善诊者。察色按脉。当先审别其
阴阳。）审清浊而知部分。（夫色有清明。有浊暗。五色之见于面也。各有部分。审清浊。则知病之从来。知部分。则知
病之所在。）视喘息。听音声。而知所苦。（金匮要略曰。息摇肩者心中坚。息引心中上气者咳。息张口短气者。肺痿唾
沫。又曰。吸而微数。其病在中焦实也。当下之则愈。虚者不治。在上焦者其吸促。在下焦者其吸远。此皆难治。呼吸
动摇振振者不治。又曰。病患语声寂然。喜惊呼者。骨节间病。语声喑喑然不彻者。心膈间病。语声啾啾然。细而长者。
头中病。平脉篇曰。病患欠者。无病也。脉之而呻者。病也。言迟者。风也。摇头者。里痛也。里实护腹。如怀卵物者。
心痛也。此以望闻而知其病之所苦也。）观权衡规矩。而知病所主。（观四时所应之脉。而知病之所主者何脏。）按尺寸。
观浮沉滑涩。而知病所生以治。（寸主在上为阳。尺主在下为阴。浮为在表为阳。沉为在里为阴。滑主气为阳。涩主血为
阴。审察脉之上下表里气血。而知病之生于阴。生于阳。而以法治之也。）无过以诊。则不失矣。（夫诊有五过。诊无差
误。则治之不失矣。）故曰。病之始起也。可刺而已。其盛。可待衰而已。（此以下。言治病者。亦当取法于阴阳也。
夫针石所以治外者也。病之始起。尚在于外。故可刺而已。其病盛者。勿去其针。待其衰而后已。言始起在外在阳。盛
则在里在阴也。）故因其轻而扬之。因其重而减之。因其衰而彰之。（病之始起。则轻而浅。久则重而深。故因其轻而
发扬之。因其重而少减之。因其病势少衰而彰逐之。盖病之盛者。不可急逆。经曰。微者逆之。盛者从之。避其来锐。
击其惰归。此之谓也。）形不足者。温之以气。精不足者。补之以味。（形、谓形体肌肉。精、谓五脏之阴精。夫形归气。
气生形。温热气胜者。主补阳气。故形不足者。当温之以气。五脏主藏精者也。五味入口。各归所喜。津液各走其道。
故五味以补五脏之精。灵枢经曰。诸部脉小者。血气皆少。其阴阳形气俱不足。勿以针。而当调以甘和之药可也。是不
足者。不可妄用其针。又当温补其气味。）其高者。因而越之。其下者。引而竭之。中满者。泻之于内。（人有三部。在
上为阳。在下为阴。病在胸膈之上者。因其上而发越之。其在胸腹之下者。因其下而引去之。其在中者。宜从内而泻泄
之。此言病之有上下阴阳。而治之有法也。）其有邪者。渍形以为汗。（渍、浸也。古者用汤液浸渍。取汗以去其邪。此
言有邪之在表也。）其在皮者。汗而发之。（邪在皮毛。取汗而发散之。）其 悍者。按而收之。（气之悍利者。宜按摩而
收引。）其实者。散而泻之。（阳实者宜散之。阴实者宜泻之。此言病之有表里阴阳。而治之亦有法也。）审其阴阳。以别
柔刚。（阴阳者。天之道也。刚柔者。地之道也。参合天地之气者。人之道也。）阳病治阴。阴病治阳。（治、平治也。如
感天之阳邪。则当治人之阴气。阴气盛而阳热之邪自解矣。如感天之阴邪。则当治人之阳气。阳气盛而阴寒之邪自散矣。
此邪正阴阳之各有对待。而善治者之有法也。）定其血气。各守其乡。（承上文而言。如邪在气分。则当守其阴血。而勿
使邪入于阴。如邪在血分。则当守其阳气。而勿使阴邪伤阳。定其血分气分之邪。而各守其部署。盖阳邪伤气。阴邪伤
血。气血内守。则邪不敢妄侵。此即上文对待之意。）血实宜决之。气虚宜掣引之。（经曰。邪之所凑。其正必虚。实者
邪气实。而虚者正气虚也。血实者决之使行。气虚者掣之使升。盖阳气发原于下也。上节言各守其阴阳气血。使邪之不
敢妄传。此复言其在血分而血实者。宜行血以驱邪。邪在气分而气虚者。宜提掣阳气以助正。此又邪正对待之一法也。
按此篇论天地人之阴阳相应。而针石延医。亦皆法乎阴阳。故曰。天地者。万物之上下也。阴阳者。血气之男女也。盖
阴阳之在人。为男为女。在身。为气为血。故末结其气血焉。）
（保持精神虚无宁静，）那么精神就会内守，真气就会顺从。那些懂得大道的人，也归于真人境界。（高士宗说：这一节呼应了首篇中的圣人形象。他们在外不使形体被事务劳损，在内没有思虑的祸患，以恬淡愉悦为追求，以自得其乐为功效。精神不耗散，也能长寿直至天地尽头，没有终结之时。）
天的阳气在西北方不足，所以西北方属阴。因此人的右耳目不如左耳目光亮清晰。地的阴气在东南方不满，所以东南方属阳。因此人的左手足不如右手足强壮有力。（这里说的是天地阴阳之气不能完备之处。正因为阴阳精气运行营运，所以能生长收藏，化生万物。在人体上也应当配合天地来养护头足，不要让邪气占据它们。天在西北方阳气中的阴气不足，所以西北方属阴，而人的右耳目不如左耳目光亮。左边属阳右边属阴，上部阴气不足。地在东南方阴气中的阳气不足，所以东南方属阳，而人的左手足不如右手足强壮。右边属阴左边属阳，下部阳气不足。）
黄帝问：为什么这样呢？岐伯回答：东方属阳，阳气的气精并聚于上部。并聚于上部则上部明亮而下部虚弱，所以使人耳目聪明而手足不便。西方属阴，阴气的气精并聚于下部。并聚于下部则下部盛实而上部虚弱，所以使人耳目不聪明而手足便利。（天有精气，地有形质。东方属阳，其精气上升并聚于上部，并聚于上部则上部盛实而下部虚弱，所以使人耳目聪明而手足不便。西方属阴，其精气下降并聚于下部，并聚于下部则下部盛实而上部虚弱，所以使人耳目不聪明而手足便利。这是从天地的左右方位来说的。王子方说：上编论述阳气生于阴精，这里又讲天有精气，且精气上下交并，说明阴精又生于天。）
所以如果同时感受邪气，病在上部则右侧严重，在下部则左侧严重。这是天地阴阳不能完备之处，所以邪气就居住在虚处。（这是从形体身体来论述的。病在上部则右侧虚弱，在下部则左侧虚弱，这是天地阴阳不能完备之处，而人身也有左右方面的不足。上文讲的是天地左右方位的上下关系，这里讲的是人身上下部位的左右关系。王子方说：只有当邪气共同侵袭时，才能知道虚处患病更重。）
所以天有生成万物的精气，地有承载万物的形质。天有八方的纪纲，地有五行的道理，所以能成为万物的父母。（天有生育的精气，地有成形的物质。天有八方作为纲纪，地有五行作为道理。它们的精气在九州八方之外交通融合，所以能成为万物生长的父母。这不仅仅局限于上下之间的交并罢了。）
清阳之气上升于天，浊阴之气归藏于地。因此天地的动静变化，由神明作为纲纪，所以能以生长收藏为规律，循环往复，终而复始。（说的是天地的体位，虽然有东西南北的不完备，但由神明作为纲纪，所以能以生长收藏为规律，循环往复，化生万物。所谓神明，是指生五气、化五行者。）
只有贤人上配法天以养护头部，下象法地以养护足部，中参合人事以养护五脏。（上配法天以养护耳目的聪明，下象法地以养护腰部以下的不足，节制五味，调和五志，以养护五脏的太和之气。即使有贼邪之气，也不能占据身体。这篇文中提到圣人、贤人，是说只有贤圣之人能效法天地，顺应或逆从阴阳，保持恬淡虚无，使精神内守，可以延年益寿，没有终极之时，而都归于真人境界。）
天气通应于肺脏。（肺脏属金，位居最高，主司周身之气，所以与天气相通。这里再次强调不仅头部的上窍通于天，从腰部以下象法地，而且五脏六腑、九窍、六经，都与天地之气相通。只有贤人能效法天的纪纲，运用地的道理来治理身体，所以灾害不能波及他。）
地气通应于咽喉。（咽喉是胃腑的门户，主要受纳湿浊之气进入胃中，所以与地气相通。《太阴阳明篇》说：喉主天气，咽主地气。）
雷气通应于心脏。（雷是火的发声。心为火脏，气相感召，所以与心相通。）
谷气通应于脾脏。（脾为土脏，主司转运，谷气即山谷通气之象，所以与脾气相通。）
六经如同河流。（六经指手足三阴三阳经脉，内外环转，像川流一样不息。）
肠胃如同大海。（肠胃受纳和盛载水谷，像大海一样无所不容。另外胃是水谷之海，外合海水；肠是受盛之官。）
九窍是水注之气流通的通道。（精气通达上窍，水浊从下窍排出。）
用天地来比喻人体的阴阳。（阴阳是天地的法则，用天地的法则来贯通人体的阴阳。）
人的汗液，可以用天地的雨水来命名。（汗出于阴液，由阳气宣发而出，所以说“阳加于阴谓之汗”。雨水是地的阴湿之气，也由天气化施而来，所以可以比拟人的汗液。）
人的阳气，可以用天地的疾风来命名。（风出于地的隧谷，阳气发于里的阴分，用疾风来命名，是说阳气的运行，身体有道，没有丝毫的逆乱阻滞。）
暴烈的现象像雷，逆乱的现象像阳热。（气暴烈如雷火发作，气逆乱如阳热胜复。这里再次说明阳气像风一样，行于上下四旁，没有暴烈也没有逆乱。）
所以治疗如果不效法天的纪纲，不使用地的道理，那么灾害就会到来。（人的阴阳与天地相通，天有八方纪纲，地有五行道理，治疗若不取法天地的阴阳，灾害就会到来。）
所以邪风的到来，快如风雨。（天之邪气，起初伤害皮毛，由皮毛至肌肉筋脉，由经脉进入脏腑，所以像风雨一样骤至，容易侵入体内。独言风者，因为风是百病之长，能开发腠理。）
所以善于治疗的人，在皮毛阶段就进行治疗。（阳气卫护于外而固密。天之阳邪，起初伤害皮毛气分，所以善于治疗的人，助阳气以宣散邪气，不让它内入阴分。）
其次在肌肤阶段进行治疗。（邪气在皮毛，停留不去，就会进入肌肤。肌肤尚属于外之气分，也可以使邪气从外解除，所以这是次一级的治疗方法。）
其次在筋脉阶段进行治疗。（邪气在肌肤，停留不去，就会进入经络。经脉内连脏腑，外络形体。善于治疗的人，知道邪气入经，就从经向外解除，不让它内干犯脏腑，这是治疗的又一方法，又是次一级的。《灵枢经》说：邪气停留不去，或者附着于经脉，或者附着于膂筋。）
其次在六腑阶段进行治疗。（《金匮要略》说：经络受邪，传入脏腑，称为内因。邪气入经，停留而不治疗，就会进入里部。所以只能从腑来解除。）
最后在五脏阶段进行治疗。治疗五脏的病，是一半死一半生的局面。（六脏的脉，属脏络腑；六腑的脉，属腑络脏。脏腑经气联系相通。邪气进入内部，又不从腑解除，就会干犯及于脏。邪气在五脏经气之间，尚可救治而生；如果干犯脏本体则死。所以说一半死一半生。皮肤气分为阳，经络血分为阴；外为阳，内为阴；腑为阳，脏为阴。邪在阳分容易治疗，邪在阴分难治。以上论述治疗之道，应当取法于阴阳。）
所以天之邪气，感伤则危害五脏；水谷的寒热，感伤则危害六腑；地的湿气，感伤则危害皮肉筋脉。（天之邪气，由形层进入里阴，所以感伤则危害五脏。水谷进入胃，寒温不适，饮食不节，病生于肠胃，所以危害六腑。清湿地气中人，必从足开始，所以感伤则危害皮肉筋脉。脏为阴，腑为阳；经脉血分为阴，皮肉气分为阳。天地之邪，有阴有阳；水谷之气，有热有寒；而病患的形身脏腑，也有阴阳的区别。）
所以善于使用针法的人，从阴引阳，从阳引阴，以右治左，以左治右，以我知彼，以表知里，观察过与不及的道理，见微知著发现过错，使用这种方法就不会有危险。（这里说使用针法的人，应当取法于阴阳。阴阳气血，内外左右，交相贯通。所以善于使用针法的人，从阴分引出阳分之邪，从阳分引出阴分之气。病在左侧取右侧穴位，病在右侧取左侧穴位。以我的神气，了解病人的病情；以表证的迹象，推断里病的状况。观察邪正虚实之理而进行补泻，看到疾病的微小萌芽，就得到其过错所在。用这种方法治疗，就不会导致危殆。）
善于诊察的人，观察面色和按切脉象，先辨别阴阳。（这里说善于诊察的人，应该审别阴阳。色为阳，血为阴。然而色有阴阳，脉也有阴阳。所以善于诊察的人，观察面色按切脉象，应当先审别阴阳。）
审察颜色的清浊而知道病变的部位。（面色有清明，有浊暗。五色见于面部，各有对应部位。审察清浊，就知道病从哪里来；知道部位，就知道病在哪里。）
视呼吸喘息，听声音，而知道病人的痛苦。（《金匮要略》说：呼吸时耸肩的，心中坚满；呼吸时引动心胸上气的，咳嗽；张口短气的，是肺痿吐唾沫。又说：吸气轻微急促的，病在中焦实证，当下之则愈，虚证则难治。在上焦的吸气短促，在下焦的吸气深长，这些都难治。呼吸动摇振颤的，不治。又说：病人说话安静，喜欢惊呼的，是骨节间有病；说话声音沉闷不通畅的，是心膈间有病；说话声音细小而长的，是头部有病。《平脉篇》说：病人呵欠的，无病；切脉时呻吟的，有病；说话迟缓的，中风；摇头的，里痛；里实护腹，像怀着卵物似的，是心痛。这是通过望闻来知道病人所苦的地方。）
观察权衡规矩（四时脉象），而知道疾病的主宰脏腑。（观察四时所应的脉象，就知道疾病主宰在哪一脏。）
按寸口尺部，观察浮沉滑涩，而知道疾病的发生以进行治疗。（寸部主上属阳，尺部主下属阴；浮脉在表属阳，沉脉在里属阴；滑脉主气属阳，涩脉主血属阴。审察脉的上下表里气血，就知道病生于阴还是生于阳，从而以法治之。）
不犯诊断的错误，就不会失误了。（诊断有五种过失，诊断没有差错，治疗就不会失误。）
所以说，疾病刚开始起时，可以用针刺治愈。如果病势强盛，可以等待其衰退后再处理。（以下论述治病也要取法于阴阳。针石是用来治外病的。疾病刚开始，还在外部，所以可以用针刺治愈。病势强盛的，不要去掉针，等待其衰退后再停止。意思是始起在外在阳，强盛则在内在阴。）
所以根据病邪轻浅而发扬发散它，根据病邪沉重而消减它，根据病势衰退而彰逐它。（疾病刚开始，病邪轻浅；久病则病邪沉重深入。所以根据病邪轻浅而发扬发散它，根据病邪沉重而稍加消减它，根据病势稍衰而彰逐它。大概病势盛的时候，不可急逆，经书说：轻微的逆其病势，强盛的顺从其病势。避开它锐气正盛的时候，攻击它懈怠回归的时候。说的就是这个道理。）
形体不足的，用气温养它；精气不足的，用味厚滋补它。（形，指形体肌肉；精，指五脏的阴精。形依赖气，气生成形。温热性质的气偏胜者，主要补益阳气，所以形体不足的人，应当用气温养它。五脏主藏精。五味入口，各归其所喜好的脏器，津液各自走其道路，所以用五味来补益五脏的精气。《灵枢经》说：各部脉小的，血气都少。其阴阳形气都不足的，不要用针，而应当用甘平和缓的药物调理。这是说不足的情况，不可妄用针石，又应当温补其气味。）
病位高的，顺势使其涌吐；病位低的，引导使其排泄；中焦痞满的，从内部泻除。（人有三部，上为阳，下为阴。病在胸膈以上的，因其高位而发越之；病在胸腹以下的，因其低位而引去之；病在中间的，宜从内部泻泄。这是说病有上下阴阳，治疗有相应的方法。）
有邪气在表的，浸渍身体以求出汗。（渍，即浸。古时用汤液浸渍，取汗以去除邪气。这是说有邪气在体表。）
邪气在皮肤的，用发汗法发散它。（邪气在皮毛，取汗而发散之。）
邪气实的，消散和泻除它。（阳实者宜散之，阴实者宜泻之。这是说病有表里阴阳，治疗也有相应的方法。）
审察阴阳，以区别刚柔。（阴阳是天的法则，刚柔是地的法则，参合天地之气的是人的法则。）
阳病治阴，阴病治阳。（治，意为平治。如感受天的阳邪，则当治人的阴气，阴气盛而阳热之邪自然解除。如感受天的阴邪，则当治人的阳气，阳气盛而阴寒之邪自然消散。这是邪正阴阳各有对待，而善于治疗的人有相应的方法。）
确定血气，各守其乡。（承接上文而言。如邪在气分，则当守护阴血，不让邪气入阴；如邪在血分，则当守护阳气，不让阴邪伤阳。确定血分气分的邪气，而各守其部署。大概阳邪伤气，阴邪伤血，气血内守，则邪气不敢妄侵。这就是上文对待的意思。）
血实宜决破它，气虚宜提掣升举它。（经书说：邪气聚集的地方，正气必然虚弱。实者是邪气实，虚者是正气虚。血实者决破它使血行，气虚者提掣它使气升。大概阳气发源于下。上一节讲各守其阴阳气血，使邪气不敢妄传，这里再次讲其在血分而血实者，宜行血以驱邪；邪在气分而气虚者，宜提掣阳气以助正。这又是邪正对待的一种方法。按此篇论述天地人之阴阳相应，而针石医疗，也都效法阴阳，所以说：天地是万物的上下，阴阳是血气的男女。大概阴阳在人，表现为男女性别；在身，表现为气与血。所以最后归结于气血。）
(Void and empty), the spirit remains inwardly guarded, and the true Qi follows. Those who understand the Great Dao also return to the state of a True Person (Zhen Ren). Gao Shizong said: This section echoes the description of the Sages in the first chapter. They do not exhaust their physical form with external affairs, nor do they suffer from internal mental distress. They take tranquility and joy as their pursuit, and self-contentment as their achievement. Their spirit does not dissipate, allowing them to live as long as heaven and earth, without an end.) Heaven's Yang is deficient in the northwest, therefore the northwest belongs to Yin. Consequently, a person's right ear and eye are not as acute as the left. Earth's Yin is incomplete in the southeast, therefore the southeast belongs to Yang. Consequently, a person's left hand and foot are not as strong as the right. (This discusses the incompleteness of Heaven and Earth's Yin and Yang energies. It is precisely because of the operation and circulation of Yin and Yang essence that growth, harvest, storage, and transformation of all things occur. In the human body, one should correspond to Heaven and Earth to nourish the head and feet, preventing pathogenic factors from occupying them. The deficiency of Yin within Yang in the northwest makes the northwest belong to Yin, hence the right ear and eye are less acute than the left. The left is Yang and the right is Yin; there is a deficiency of Yin in the upper part. The incompleteness of Yang within Yin in the southeast makes the southeast belong to Yang, hence the left hand and foot are weaker than the right. The right is Yin and the left is Yang; there is a deficiency of Yang in the lower part.)
The Yellow Emperor asked: Why is this so? Qibo replied: The East belongs to Yang. The essence of Yang gathers in the upper part. When it gathers in the upper part, the upper becomes bright and clear while the lower becomes deficient. Thus, it makes the ears and eyes acute but the hands and feet inconvenient. The West belongs to Yin. The essence of Yin gathers in the lower part. When it gathers in the lower part, the lower becomes abundant while the upper becomes deficient. Thus, the ears and eyes are not acute, but the hands and feet are convenient. (Heaven has essence, Earth has form. The East belongs to Yang; its essence rises and gathers in the upper part. Gathering in the upper part makes the upper abundant and the lower deficient, making people's ears and eyes acute but hands and feet inconvenient. The West belongs to Yin; its essence descends and gathers in the lower part. Gathering in the lower part makes the lower abundant and the upper deficient, making people's ears and eyes not acute but hands and feet convenient. This speaks of Heaven and Earth from the perspective of left and right. Wang Zifang said: The previous section discussed Yang Qi born from Yin Essence; this section reiterates that Heaven has essence, and essence and Qi interact above and below, indicating that Yin Essence is also born from Heaven.)
Therefore, if simultaneously affected by pathogens, those affecting the upper part will be more severe on the right, and those affecting the lower part will be more severe on the left. This is due to the incompleteness of Heaven and Earth's Yin and Yang, so pathogens reside in these deficient areas. (This discusses from the perspective of the physical body. The upper right and lower left are deficient due to the incompleteness of Heaven and Earth's Yin and Yang, meaning the human body also has deficiencies on the left and right. The previous text discussed the vertical relationship of left and right in Heaven and Earth; this text discusses the horizontal relationship of upper and lower in the human body. Wang Zifang said: Only when pathogens jointly invade can one know that diseases are more severe in deficient areas.)
Therefore, Heaven has the essence to generate, and Earth has the form to complete. Heaven has the eight directions as its guidelines, and Earth has the Five Elements as its principles, thus becoming the parents of all things. (Heaven has the essence for generation, Earth has the form for completion. Heaven has the eight directions as its framework, and Earth has the Five Elements as its logic. Their essence and Qi communicate beyond the nine provinces and eight directions, thus becoming the parents of all things' growth. This is not limited to just the interaction above and below.)
Clear Yang ascends to Heaven, and turbid Yin returns to Earth. Therefore, the movement and stillness of Heaven and Earth are governed by Divine Spirit (Shen Ming), enabling the cycle of growth, harvest, storage, and renewal, ending and beginning again. (This refers to the positions of Heaven and Earth. Although there are deficiencies in the east, west, south, and north, Divine Spirit serves as the guideline, enabling the cycle of growth, harvest, storage, and renewal to transform all things. Divine Spirit refers to that which generates the Five Qi and transforms the Five Elements.)
Only the Wise Men (Xian Ren) emulate Heaven above to nourish the head, imitate Earth below to nourish the feet, and mediate between through human affairs to nourish the Zang organs. (Emulating Heaven above to nourish the acuity of the ears and eyes; imitating Earth below to nourish the deficiency below the waist; moderating the Five Flavors and regulating the Five Emotions to nourish the Great Harmony of the Five Zang organs. Even if there are harmful pathogens, they cannot occupy the body. This chapter mentions Sages and Wise Men, stating that only the Wise and Sage can model themselves after Heaven and Earth, follow or oppose Yin and Yang, maintain tranquility and emptiness, keep the spirit inwardly guarded, thereby extending life without limit, returning all to the state of True Persons.)
Heaven's Qi connects with the Lungs. (The Lung organ belongs to Metal, resides at the highest position, and governs the Qi of the whole body, thus connecting with Heaven's Qi. This reiterates that not only the upper orifices of the head connect with Heaven, but from the waist down imitating Earth, the Five Zang and Six Fu organs, nine orifices, and six meridians all connect with the Qi of Heaven and Earth. Only the Wise can model themselves after Heaven's guidelines and use Earth's principles to regulate the body, so disasters cannot reach them.)
Earth's Qi connects with the Pharynx/Oesophagus (Yi). (The Yi is the gate of the Stomach Fu, primarily receiving damp and turbid Qi into the Stomach, thus connecting with Earth's Qi. The *Taiyin Yangming Chapter* states: The throat governs Heaven's Qi, and the pharynx governs Earth's Qi.)
Wind Qi connects with the Liver. (Wind generates Wood, and Wood generates the Liver; external and internal Qi are connected.)
Thunder Qi connects with the Heart. (Thunder is the sound of Fire. The Heart is a Fire organ; Qi resonates, thus connecting with the Heart.)
Grain Qi connects with the Spleen. (The Spleen is an Earth organ, governing transportation and transformation. Grain Qi refers to the ventilation of valleys, thus connecting with Spleen Qi.)
Rain Qi connects with the Kidneys. (The Kidney is a Water organ; Rain Qi is Cold Water Qi.)
The Six Meridians are like rivers. (The Six Meridians refer to the three Yin and three Yang meridians of the hands and feet, circulating internally and externally like flowing water without ceasing.)
The Intestines and Stomach are like the sea. (The intestines and stomach receive and hold food and fluids, like the sea containing everything. Additionally, the Stomach is the Sea of Food and Fluids, corresponding externally to the ocean water; the Intestines are the officials of reception and holding.)
The Nine Orifices are the pathways for the flow of Water Qi. (Essence and Qi pass through the upper orifices; turbid water exits through the lower orifices.)
Using Heaven and Earth to represent Human Yin and Yang. (Yin and Yang are the Way of Heaven and Earth; using the Way of Heaven and Earth to penetrate the Yin and Yang of the body.)
Human sweat is named after Heaven and Earth's rain. (Sweat comes from Yin fluids, released by the dissemination of Yang Qi, hence "Yang added to Yin is called sweat." Rain is the dampness of Earth, transformed and applied by Heaven's Qi, so it can be compared to human sweat.)
Human Yang Qi is named after Heaven and Earth's swift wind. (Wind emerges from Earth's tunnels and valleys; Yang Qi emanates from inner Yin. Naming it swift wind indicates that the movement of Yang Qi in the body follows a path, with no obstruction or reversal.)
Violent phenomena resemble thunder; rebellious phenomena resemble Yang heat. (Qi violently erupts like thunder and fire; Qi rebels like excessive Yang heat. This reiterates that Yang Qi moves like wind through the upper, lower, and four sides, without violence or rebellion.)
Therefore, if treatment does not emulate Heaven's guidelines or utilize Earth's principles, disasters will arrive. (Human Yin and Yang connect with Heaven and Earth. Heaven has eight directional guidelines, and Earth has Five Element principles. If treatment does not model itself after the Yin and Yang of Heaven and Earth, disasters will arrive.)
Thus, the arrival of pathogenic winds is as swift as wind and rain. (Heaven's pathogenic Qi initially injures the skin and hair, then moves to muscles and sinews, and enters the Zang and Fu organs via the meridians. Thus, it arrives suddenly like wind and rain and easily enters the interior. Speaking solely of Wind is because Wind is the leader of a hundred diseases and can open the interstices.)
Therefore, skilled practitioners treat at the stage of skin and hair. (Yang Qi guards the exterior and maintains solidity. Heaven's Yang pathogens initially injure the Qi aspect of the skin and hair. Thus, skilled practitioners assist Yang Qi to disseminate and scatter the pathogens, preventing them from entering the Yin.)
Next, they treat the muscles and skin. (If pathogens remain in the skin and hair without being expelled, they enter the muscles and skin. The muscles and skin still belong to the exterior Qi aspect, allowing pathogens to be resolved from the outside; thus, this is the next level of treatment.)
Next, they treat the sinews and vessels. (If pathogens remain in the muscles and skin without being expelled, they enter the meridians. The meridians connect internally with Zang and Fu organs and externally with the physical body. Skilled practitioners, knowing pathogens have entered the meridians, resolve them outwardly from the meridians, preventing them from injuring the Zang and Fu organs internally. This is another method of treatment, yet the next level. The *Ling Shu* states: If pathogens remain and do not depart, they may attach to the meridians or the back sinews.)
Next, they treat the Six Fu organs. (The *Jin Gui Yao Lue* states: Pathogens entering the Zang and Fu organs via the meridians are considered internal causes. If pathogens enter the meridians and are left untreated, they enter the interior. Thus, resolution can only occur from the Fu organs.)
Finally, they treat the Five Zang organs. Treating diseases of the Five Zang organs results in a fifty-fifty chance of death or survival. (The pulses of the six Zang organs connect with the Zang and link to the Fu; the pulses of the six Fu organs connect with the Fu and link to the Zang. The Qi of Zang and Fu meridians is interconnected. If pathogens enter the interior and do not resolve from the Fu, they affect the Zang. If pathogens are between the Qi of the five Zang meridians, cure is possible and life can be saved; if they invade the Zang proper, death occurs. Hence, it is said to be half dead, half alive. Skin and Qi aspect are Yang; meridians and Blood aspect are Yin. Exterior is Yang, Interior is Yin. Fu is Yang, Zang is Yin. Pathogens in the Yang aspect are easier to treat; pathogens in the Yin aspect are difficult to treat. The above discusses the way of treatment, which should model itself after Yin and Yang.)
Therefore, Heaven's pathogenic Qi, once contracted, harms the Five Zang organs; the cold and heat of food and drink, once contracted, harm the Six Fu organs; Earth's dampness, once contracted, harms the skin, flesh, sinews, and vessels. (Heaven's pathogenic Qi enters from the layers into the interior Yin, so contraction harms the Five Zang organs. Food and drink enter the Stomach; if temperature is inappropriate or dietary habits irregular, disease arises in the intestines and stomach, thus harming the Six Fu organs. People struck by clear ground and Earth dampness must start from the feet, so contraction harms the skin, flesh, sinews, and vessels. Zang is Yin, Fu is Yang; meridian blood aspect is Yin, skin/flesh Qi aspect is Yang. Heaven and Earth pathogens have Yin and Yang; food and drink Qi have heat and cold; and patients' bodies and Zang/Fu organs also have Yin and Yang distinctions.)
Therefore, skilled practitioners of acupuncture draw Yang from Yin, draw Yin from Yang, treat the left with the right, treat the right with the left, know the other through oneself, know the interior through the exterior, observe the principles of excess and deficiency, see the subtle to detect faults, and using this method, avoid danger. (This states that practitioners of acupuncture should model themselves after Yin and Yang. Yin and Yang, Qi and Blood, interior and exterior, left and right, intersect and penetrate. Thus, skilled practitioners draw pathogenic factors from the Yang aspect out from the Yin aspect, and draw Qi from the Yin aspect out from the Yang aspect. For disease on the left, select points on the right; for disease on the right, select points on the left. Using one's own Shen (Spirit) to understand the patient's condition; using exterior signs to infer interior disease. Observing the principles of pathogenic and righteous Qi, excess and deficiency, to apply tonification and sedation. Seeing the subtle germination of disease to locate the fault. Using this method prevents danger.)
Skilled diagnosticians examine complexion and palpate pulses, first distinguishing Yin and Yang. (This states that skilled diagnosticians should carefully distinguish Yin and Yang. Complexion is Yang, Blood is Yin. However, complexion has Yin and Yang, and pulses have Yin and Yang. Thus, skilled diagnosticians examining complexion and palpating pulses must first distinguish Yin and Yang.)
Examining clarity and turbidity to know the location of the disease. (Complexion can be clear or turbid. The Five Colors appearing on the face each have specific locations. Examining clarity and turbidity reveals where the disease originated; knowing the location reveals where the disease is.)
Observing breathing and listening to voice sounds to know the patient's suffering. (The *Jin Gui Yao Lue* states: Shoulder shrugging during respiration indicates firmness in the heart/chest; drawing up chest Qi during respiration indicates coughing; open-mouthed shortness of breath indicates Lung萎 (Fei Wei) with spittle. Also: Slight rapidity in inhalation indicates excess in the Middle Jiao, requiring purgation for recovery; deficiency cases are untreatable. Rapid inhalation in the Upper Jiao, distant/deep inhalation in the Lower Jiao—these are difficult to treat. Respiration causing tremors is untreatable. Also: Patients speaking quietly but prone to sudden cries have joint diseases; patients speaking with muffled, obstructed voices have Heart/Diaphragm diseases; patients speaking with small, thin, long voices have Head diseases. The *Ping Mai Pian* states: Yawning indicates health; groaning during pulse-taking indicates disease; slow speech indicates Wind; shaking head indicates interior pain; protecting the abdomen as if holding an egg indicates Heart pain. This uses observation and listening to know where the patient suffers.)
Observing the balance, weights, rules, and compasses (seasonal pulse patterns) to know the governing Zang organ. (Observing pulses corresponding to the four seasons reveals which Zang organ governs the disease.)
Palpating the Cun and Chi positions, observing floating, sinking, slippery, and choppy qualities to know the origin of the disease for treatment. (Cun governs the upper/Yang; Chi governs the lower/Yin. Floating indicates exterior/Yang; Sinking indicates interior/Yin. Slippery governs Qi/Yang; Choppy governs Blood/Yin. Carefully examining the pulse's upper/lower, exterior/interior, Qi/Blood aspects reveals whether the disease originates from Yin or Yang, allowing for appropriate treatment.)
Avoiding diagnostic errors ensures no mistakes. (There are five types of diagnostic errors. Without diagnostic errors, treatment will not fail.)
It is said: At the beginning of a disease, acupuncture suffices. If the disease is vigorous, wait for it to decline before stopping. (The following discusses that treating disease should also model itself after Yin and Yang. Needles and stones treat exterior conditions. At the beginning, the disease is still exterior, so acupuncture suffices. For vigorous diseases, do not remove the needle immediately; wait for the decline to stop. This means starting in the exterior/Yang, progressing to the interior/Yin when vigorous.)
Therefore, according to lightness, disperse and elevate; according to heaviness, reduce; according to decline, manifest and expel. (At the beginning, disease is light and superficial; over time, it becomes heavy and deep. Thus, disperse and elevate based on lightness; reduce slightly based on heaviness; manifest and expel based on slight decline. Generally, when disease is vigorous, do not oppose it abruptly. The Classics state: Oppose mild disease; follow vigorous disease. Avoid its sharp onset; attack its fatigue and return. This is what is meant.)
For deficiency of Form, warm with Qi; for deficiency of Essence, tonify with Flavor. (Form refers to physical body and muscles; Essence refers to the Yin Essence of the Five Zang organs. Form relies on Qi; Qi generates Form. Warm and hot Qi predominates in tonifying Yang Qi; thus, for deficiency of Form, one should warm with Qi. The Five Zang store Essence. The Five Flavors enter the mouth, each returning to their preferred organ; Jing Ye flows along their respective paths. Thus, the Five Flavors tonify the Essence of the Five Zang organs. The *Ling Shu* states: Pulses small in all regions indicate deficiency of both Blood and Qi. When Yin/Yang, Form/Qi are all deficient, do not use needles; instead, regulate with sweet and harmonious medicines. This means for deficiency, one should not recklessly use needles but should warm and tonify with Qi and Flavor.)
For high locations, induce vomiting; for low locations, guide and drain; for fullness in the middle, purge from within. (Humans have three regions: Upper is Yang, Lower is Yin. For disease above the chest and diaphragm, induce vomiting due to the high location; for disease below the chest and abdomen, guide and drain due to the low location; for disease in the middle, purge from within. This states that disease has upper/lower Yin/Yang, and treatment has corresponding methods.)
For pathogens in the body, soak the form to induce sweat. (Soak means immerce. Ancients used decoctions for immersion to induce sweat and remove pathogens. This refers to pathogens on the exterior.)
For pathogens in the skin, induce sweat to disperse them. (Pathogens in the skin and hair are dispersed by inducing sweat.)
For fierce pathogens, massage and restrain them. (Fierce and sharp Qi should be restrained through massage.)
For excess conditions, disperse and purge them. (Yang excess should be dispersed; Yin excess should be purged. This states that disease has exterior/interior Yin/Yang, and treatment has corresponding methods.)
Examine Yin and Yang to distinguish Rigidity and Softness. (Yin and Yang are the Way of Heaven; Rigidity and Softness are the Way of Earth; combining Heaven and Earth Qi is the Way of Man.)
Treat Yin diseases by addressing Yang; treat Yang diseases by addressing Yin. (Treat means to pacify. If contracting Heaven's Yang pathogen, treat the person's Yin Qi; when Yin Qi is sufficient, Yang Heat pathogen resolves naturally. If contracting Heaven's Yin pathogen, treat the person's Yang Qi; when Yang Qi is sufficient, Yin Cold pathogen disperses naturally. This reflects the mutual opposition of pathogenic and righteous Yin/Yang, and the methods of skilled practitioners.)
Stabilize Blood and Qi, each guarding its territory. (Continuing from above: If pathogens are in the Qi aspect, guard the Yin Blood to prevent pathogens from entering Yin; if pathogens are in the Blood aspect, guard Yang Qi to prevent Yin pathogens from injuring Yang. Stabilize the pathogens in the Blood and Qi aspects, each guarding their deployment. Generally, Yang pathogens injure Qi, Yin pathogens injure Blood. If Blood and Qi are guarded inwardly, pathogens dare not invade recklessly. This is the meaning of mutual opposition mentioned above.)
For Blood excess, lancing/drainage is suitable; for Qi deficiency, lifting/pulling is suitable. (The Classics state: Where pathogens gather, Righteous Qi is necessarily deficient. Excess refers to pathogenic excess; deficiency refers to Righteous Qi deficiency. For Blood excess, lance/drain to promote flow; for Qi deficiency, lift/pull to raise it. Yang Qi originates from below. The previous section discussed guarding Yin/Yang, Qi/Blood to prevent reckless transmission of pathogens; this section reiterates that for Blood aspect excess, promote Blood flow to drive out pathogens; for Qi aspect deficiency, lift Yang Qi to assist Righteous Qi. This is another method of pathogenic/righteous opposition. Note: This chapter discusses the correspondence of Yin/Yang among Heaven, Earth, and Man; acupuncture and medicine also model themselves after Yin/Yang. Thus it says: Heaven and Earth are the upper and lower of all things; Yin and Yang are the male and female of Blood and Qi. Yin and Yang in humans manifest as male/female genders; in the body, as Qi and Blood. Thus, it concludes with Blood and Qi.)