前五脏所属内只七窍。此条备论九窍。乃无遗漏。
肝开窍于目。
注见前五脏所属条。
心开窍于耳。
耳系肾窍此。言心窍者。心与肾相交。听音者肾精也。而辨语者心神也。心小肠之脉入听宫。陈修园以此为司听之
主。而不知耳通于脑髓。脑气筋下通于心。西医言之甚详。故耳为肾窍。又为心窍。均由脑通。从可识矣。三焦为肾腑。
耳内为肾窍。故耳外则三焦之脉绕之。耳又为心窍。故耳外之小肠经脉亦注于听宫。以见腑之应脏有如是者。不得指小
肠之脉。为耳窍通心之路也。修园之说。犹差一黍。
脾开窍于口。
注见五脏所属条。
肺开窍于鼻。
同前。
肾开窍于二阴。
前阴是膀胱下口。主出溺。膀胱者肾之腑也。肾主水。化气化水。从前阴而出。故前阴为肾之窍。又前阴有精窍。
与溺窍相附。而各不同。溺窍内通于膀胱。精窍则内通于胞室。女子受胎。男子藏精之所。尤为肾之所司。故前阴有病。
溺窍者。有病精。窍者不可不详辨也。后阴是大肠下口。宜属于脾胃。然其体在下。以部位言之。凡在下者。皆肾所司。
肾液充腴。则肛门不结肾气充摄。则不脱肛。惟其二阴皆。属肾窍故经言肾为胃关以饮食之质。皆从二阴出也。西医图
画二阴甚悉。然不知二阴究属何脏。所以治法不精。
余按肾开窍于二阴。而前阴之病。多出心肝。后阴之病多由脾胃。又以耳为心窍。与心开窍于舌之义不同。总见五
脏错综。互相通贯。学人宜详参焉。
The five Zang organs correspond internally to only seven orifices. This section discusses the nine orifices in detail, thus leaving no omissions.
The Liver opens into the Eyes (Mu).
See notes under the "Five Zang Organs and Their Correspondences" section.
The Heart opens into the Ears (Er).
The ears are traditionally considered the orifice of the Kidney. Here it is stated that the Heart opens into the ears because the Heart and Kidney interact and communicate. Hearing relies on Kidney Essence (Jing), while distinguishing speech relies on Heart Spirit (Shen). The meridians of the Heart and Small Intestine enter the Tinggong (SI 19) acupoint. Chen Xiuyuan regarded this as the primary mechanism for hearing, but failed to realize that the ears connect to the brain marrow, and the nerves of the brain descend to connect with the Heart. Western medicine explains this in great detail. Therefore, the ears serve as both the orifice of the Kidney and the orifice of the Heart, communicating through the brain, which clarifies their relationship. The Sanjiao (Triple Burner) is the Fu organ of the Kidney. Since the interior of the ear is the orifice of the Kidney, the meridian of the Gallbladder/Sanjiao system winds around the exterior of the ear. Since the ear is also the orifice of the Heart, the meridian of the Small Intestine also pours into the Tinggong acupoint. This demonstrates how Fu organs correspond to Zang organs. One must not identify the pathway of the Small Intestine meridian as the route connecting the ear orifice to the Heart. Chen Xiuyuan's theory is slightly inaccurate.
The Spleen opens into the Mouth (Kou).
See notes under the "Five Zang Organs and Their Correspondences" section.
The Lungs open into the Nose (Bi).
Same as above.
The Kidneys open into the Two Yins (Lower Orifices).
The anterior yin is the lower opening of the Bladder, primarily responsible for discharging urine. The Bladder is the Fu organ of the Kidney. The Kidney governs water, transforming Qi and converting fluids, which exit from the anterior yin. Thus, the anterior yin is the orifice of the Kidney. Furthermore, the anterior yin contains a seminal orifice (Jing Qiao), which is adjacent to but distinct from the urinary orifice (Niao Qiao). The urinary orifice connects internally to the Bladder, while the seminal orifice connects internally to the Bao Palace (Uterus/Womb), the place where women conceive and men store essence. This function is particularly governed by the Kidney. Therefore, when diseases occur in the anterior yin, one must carefully distinguish between disorders of the urinary orifice and the seminal orifice. The posterior yin is the lower opening of the Large Intestine, theoretically belonging to the Spleen and Stomach. However, its location is inferior; from a positional perspective, anything located below is governed by the Kidney. When Kidney fluids are abundant and nourishing, the anus does not become constipated; when Kidney Qi is sufficient and securing, prolapse of the rectum does not occur. Precisely because both yins belong to the orifices of the Kidney, the classic states that "the Kidney is the gate of the Stomach," as the residues of food and drink all exit through the two yins. Western medicine illustrates the anatomy of the two yins in great detail, yet fails to determine which Zang organ they ultimately belong to, resulting in less precise treatment methods.
My commentary: Although the Kidneys open into the two yins, diseases of the anterior yin often originate from the Heart and Liver, while diseases of the posterior yin often arise from the Spleen and Stomach. Additionally, considering the ear as the orifice of the Heart differs from the principle that "the Heart opens into the tongue." Overall, this illustrates that the five Zang organs are intricate and interconnected. Students should study these aspects in detail.