西医谓造化主。惠育群黎。所谓造化主。即天地之神也。与中国人本天地之中以生之义。不谋而合。但语言文本。
略不同耳。兹且举天地生人之理。先注明之。天地只此阴阳。化生五运六气。人身秉此阴阳。乃生五脏六腑。
夫自古通天者。生之本。本于阴阳。
凡人未生之前。男女媾精。而成此胎孕。即本天地水火之气而交媾也。既生之后。鼻息呼吸。得天之阳以养气饮食
五味。得天之阴以养血是未生之前。既生之后皆无不与天相通。而所以相通之故。则以人身之阴阳实本于天地之阴阳而
已。西洋化学。言人吸空中养气而活。所谓养气。即天阳也。至于饮食五味。不知是地之阴质。虽西医书先有博物一篇。
而未将阴阳两字分晰。究不得其主宰。
阴者藏精而起亟也。阳者卫外而为固也。
人身之阴阳互为功用。阳无阴则亡。阴无阳则脱。阴主藏精于内。而阴中之气。乃常亟起。以应乎外。有如皮肤在
外属阳。而在内之血液。必达于皮肤。以为毛为汗。气退场门鼻为阳。而在下之水津。必出于孔窍以为津为液。此即亟起
应阳之一端也。又亟与极通。阴精生阳气如太极之动而生阳也。故曰起亟。阳者阴之卫也。有阳卫于外。而阴乃固于中。
譬之女子之胎。内有血衣是阴也。其外先有水衣包之。水衣包血衣。此即阳卫于外。阴乃得固之义。又如伤寒。邪入皮
毛。继乃传经入里。盖因阳不卫外。是以阴不能固于其内。此可见阴阳交互之理。
言人之阴阳。则外为阳内为阴。言人身之阴阳。则背为阳腹为阴。言人身脏腑中阴阳。则脏者为阴。腑者为阳。
就人浑而论之。则在外者。皮肉筋骨皆属阳。在内者。五脏六腑皆属阴。若就人身分而论之。则背象天覆为阳。督
脉统之而太阳经全司之腹象地载为阴任脉统之而太阴经全司之再以脏腑分论之。则五脏主藏为阴。六腑主泻为阳。夫外
为阳。而有腹背之阴阳者。阳中有阴阳也。内为阴。而有脏腑之阴阳者。阴中有阴阳也。人必先明天地阴阳之理。而后
知人身之气化。西医剖割视验。人之背面前面左右内外。层折详矣。而不能将各层分出阴阳。则上知其形。不知其气。
以所剖割只能验死尸之形。安能见生人之气化哉。
此节生气通天论。金匮真言论文合为一章。以为医理之大源也。
五脏所生。
天有五气。地有五行。人本天地之中以生。而有五脏。脏者藏也。藏天地之精气。所以成其形而为人也。故欲知人
身之阴阳。须先知五脏之气化。
东方生风。
东方于卦为震。于时为春。阳气发动。而阴应之。遂生风气。风气者。乃天春生无形之气也。西洋天学。言空气有
冷热相吸而成风。夏月热带在北。则风从南至。冬月热带在南。则风自北来。内经所谓东方当南北之间。是西洋言风之
往来。内经则风所从生。南北是阴阳两殊。故风从此异。东方是阴阳交应。故风从此生。内经探生风之源。比西洋更精。
风生木。
由无形之五气。生有形之五行。春气所生为甲乙木。西洋格致。皆以草木有根芽子核而生。然当天地开辟。实有风
气。而后化生草木即以芽核论之。仍是秉风气所生。盖地土阴质。得发动之阳气。即风气也。邵康节所谓地下。有雷声
春光弥宇宙是矣。既萌芽后。则感受空中之风。而天又有风星。以司其气化。虽西洋有引土膏吸炭气之说。亦只是火来
就木水来生木。而究木之体。则总属风气。盖在天则木本风化而在人则肝为风脏。
木生酸。
有木之形。即有性味。木之味酸。故凡果实。味皆带酸。变酒为醋。亦只是风气酿成。
酸生肝。
五气五行。亦既朕兆而成性味矣。然后人得秉之而生五脏。秉风木之气所生。则为肝脏焉。盖人所以日食五味者。
借以生养五脏也。酸味入腹。则生养肝脏焉。子孕母腹中。亦赖母所食五味合之气血以生五脏。
南方生热。
南方正当赤道。于卦为离。阳气外发。是生热气。即西洋所谓热带。日行赤道生热也。故日为众阳之精。
热生火。
热者夏之令也。夏气所生。于地之五行。为丙丁火。热是无形之天气。火是有形之地气。故河图之数。地二生火西
洋化学。言以钢击石。所生之热。与钢镰磨下石屑。与空中养气化合而燃。钻木相磨。亦与空中养气化合而燃。即内经
热生火之证。
火生苦。
凡物经火。味无不苦。盖火之性使然也。草木秉火之性者。其味皆苦。另详性味篇。
苦生心。
生人秉火之性味。于是而生心脏。与酸生肝义同。
中央生湿。
中央。阴阳交会之所。阴属水。阳属火。水火交会。而生湿气。为长夏之令。以化生万物。央者。阴阳二字。双声
合为一音也。盖天阳地阴。下下相交。南热北寒。水火相交。遂蒸为湿。西洋言谈养炭轻四气。弥漫地球。而古圣。只
以中央二字。已赅其义。
湿生土。
湿气无形。化生有形。为戊己土。土之生物。全在于中含湿气也。西洋言土即是地。不知古圣。却有分别。天是阳
在上。地是阴在下。而土在阴阳相交之中央也。西洋言土。是物质腐烂而成。而不知所以腐烂。皆借湿气。
土生甘。
土之味本淡。而所生五谷则味甘。故甘者。土之性味也。西洋但知现成之五味。而不知五味所自生。故其论药多误。
甘生脾。
人秉土之性味。于是而生脾脏。
西方生燥。
西方主秋金之气。收敛肃杀。其气为燥。在一日为申酉日入之时。阴收阳敛。气泽消灭。致成燥气。在一刻为秋令。
收敛肃杀。所以成物。赖此燥气也。西洋化学。不知燥气。因此为水火消耗之气。不能以器取得故不知也。
燥生金。
有此无形之燥气。乃生有形之金。于地之五行为庚辛金。秋日燥气用事。则草木黄落。即是生金之验。土之所以生
金者。亦以其由湿返。燥凝而成质也。
金生辛。
有燥金之气性。然后生此辛味。
辛生肺。
人秉金之性味。于是而生肺脏。所以藏天地之金气也。
北方生寒。
北方主冬令。生寒气。热带在南。冷带在北 。故西洋有北冰海之说。
寒生水。
气以生形。寒气所生。为壬癸水。西洋谓水。是轻养气所化。独内含轻气。以冷玻璃罩之。则与空中养气。化为水
珠。然必罩以冷玻璃。仍从冷而化也。又云将二气放水银盆内烧之。复化为水。水银极寒。是与内经寒生水之义亦合。
水生咸。
寒水之性。其味为咸。
咸生肾。
人生秉寒水之性味。而生肾脏。以司人周身之水。
人生本天亲地。故生此五脏。以应天地之阴阳。必先知人之五脏。本于五行。然后发之为百骸。推之为万物。莫不
本于五行焉。五行之气偏则为病。草木各得五行之气。借以调五脏之偏。药之功用以着设非先明五行之理。不可以言医
也。故引素问阴阳应象论文以明之。西洋天学化学。虽与中国五行之说不同。而义实相通。惟西洋医学。则止就人身形
质立论。不知人之气化。实与天地同体也。
Western medicine posits the Creator, who bestows grace and nurtures all living beings. The so-called Creator is the Spirit of Heaven and Earth. This coincides with the Chinese doctrine that humans are born by inheriting the Qi of Heaven and Earth. There is a convergence in meaning, though the language and textual expressions differ slightly. Here, we shall cite the principle of Heaven and Earth generating humans and annotate it first. Heaven and Earth possess only Yin and Yang, which transform into the Five Movements (Wu Yun) and Six Qi (Liu Qi). The human body inherits this Yin and Yang to generate the Zang-Fu organs (Five Zang organs and Six Fu organs).
Since ancient times, the connection between humanity and Heaven has been the root of life, and this root lies in Yin and Yang.
Before birth, the conjunction of male and female essence forms the fetus, which is essentially the interaction of the Qi of Heaven, Earth, Water, and Fire. After birth, through nasal breathing, one inherits the Yang Qi of Heaven to nourish the Qi; through dietary flavors, one inherits the Yin substance of Earth to nourish the Blood. Whether before or after birth, there is no instance where one does not connect with Heaven. The reason for this connection is that the Yin and Yang of the human body are fundamentally rooted in the Yin and Yang of Heaven and Earth. Western chemistry states that humans survive by inhaling "oxygen" from the air; this "oxygen" is the Yang Qi of Heaven. As for dietary flavors, they are unknown as the Yin substance of Earth. Although Western medical texts include a section on natural history, they fail to analyze the concepts of Yin and Yang clearly, thus failing to identify the governing principle.
Yin stores essence and rises urgently to respond externally; Yang guards the exterior and ensures internal stability.
The Yin and Yang of the human body function mutually. Without Yin, Yang perishes; without Yang, Yin collapses. Yin governs the storage of essence internally, yet the Qi within Yin often rises urgently to respond externally. For example, the skin is external and belongs to Yang, but blood from inside must reach the skin to become hair and sweat. Breath entering and exiting through the mouth and nose belongs to Yang, while fluids from below must exit through pores to become saliva and secretions. This is one aspect of Yin rising urgently to respond to Yang. "Ji" (urgent) is interchangeable with "Ji" (extreme). Yin essence generates Yang Qi just as Taiji moves to generate Yang. Hence it is called "rising urgently." Yang is the guard of Yin. With Yang guarding externally, Yin remains stable internally. Consider a woman's pregnancy: the inner blood membrane is Yin, wrapped externally by a water membrane. The water membrane wrapping the blood membrane illustrates the meaning of Yang guarding externally so Yin can be secured. Similarly, in Cold Damage disease, pathogenic factors enter the skin and hair, then transmit through meridians inward because Yang fails to guard the exterior, causing Yin to fail to stabilize internally. This demonstrates the principle of Yin-Yang interaction.
When discussing human Yin and Yang, the exterior is Yang and the interior is Yin. When discussing body parts, the back is Yang and the abdomen is Yin. When discussing Zang-Fu organs, the Zang organs are Yin and the Fu organs are Yang.
Viewing the human body as a whole, the skin, flesh, tendons, and bones outside belong to Yang, while the five Zang and six Fu organs inside belong to Yin. If analyzing specific body regions, the back symbolizes Heaven covering (Yang), governed by the Du Mai (Conception Vessel of the Back) and fully managed by the Taiyang Meridians. The abdomen symbolizes Earth carrying (Yin), governed by the Ren Mai (Conception Vessel) and fully managed by the Taiyin Meridians. Further analyzing Zang-Fu, the five Zang organs govern storage (Yin), and the six Fu organs govern drainage/excretion (Yang). Although the exterior is generally Yang, it contains Yin-Yang differentiation between the back and abdomen, showing Yin within Yang. Although the interior is generally Yin, it contains Yin-Yang differentiation between Zang and Fu, showing Yang within Yin. One must first understand the principles of Heaven and Earth Yin and Yang to comprehend human physiological transformation. Western anatomical observation details the layers of the back, front, left, right, inside, and outside, but cannot distinguish Yin and Yang attributes in these layers. Thus, they know the form but not the Qi transformation. Since dissection only verifies the form of corpses, how can one observe the Qi transformation of the living?
This section combines content from *Suwen: Shengqi Tongtian Lun* and *Jinkui Zhenyan Lun* into one chapter, serving as the great source of medical theory.
Generation of the Five Zang Organs:
Heaven has Five Qi, Earth has Five Elements. Humans are born inheriting the middle Qi of Heaven and Earth, forming the five Zang organs. "Zang" means to store; it stores the essence of Heaven and Earth to form the human body. Therefore, to understand human Yin and Yang, one must first know the Qi transformation of the five Zang organs.
East Generates Wind:
In the Eight Trigrams, East corresponds to Zhen; in seasons, it corresponds to Spring. Yang Qi activates, and Yin responds, generating wind. Wind is the formless Qi of spring generation in Heaven. Western astronomy explains wind as caused by attraction between hot and cold air: when the tropical zone is north in summer, wind blows from south to north; when south in winter, wind blows from north to south. *Neijing* states "East is between South and North," referring to the direction of wind flow described by the West, whereas *Neijing* explores the origin of wind generation. South and North represent distinct Yin and Yang, hence different winds; East represents the interaction of Yin and Yang, hence the generation of wind. *Neijing* probes the source of wind generation more precisely than Western science.
Wind Generates Wood:
From formless Five Qi, tangible Five Elements are generated. Spring Qi generates Jia-Yi Wood. Western natural sciences state that plants grow from roots, buds, seeds, and nuts. However, at the beginning of creation, there was Wind Qi, which transformed into plants. Even buds and nuts inherit Wind Qi. Earth's Yin substance receives activating Yang Qi (Wind Qi), as Shao Kangjie said: "Thunder sounds underground, spring light fills the universe." After sprouting, plants absorb wind from the air, and celestial Wind Stars govern their Qi transformation. Although Western science mentions soil absorbing carbon gas, this is merely fire approaching wood and water generating wood. Ultimately, the nature of wood belongs to Wind Qi. In Heaven, wood originates from wind transformation; in humans, the Liver is the Wind Organ.
Wood Generates Sour:
With the form of wood comes its nature and flavor. Wood's flavor is sour; thus, fruits taste sour. Wine turning to vinegar is also the result of wind fermentation.
Sour Generates Liver:
After Five Qi and Five Elements manifest signs and form flavors, humans inherit them to generate the five Zang organs. Inheriting Wind-Wood Qi generates the Liver. Humans consume five flavors daily to nourish the five Zang organs. Sour flavor enters the abdomen and nourishes the Liver. A fetus in the womb relies on the mother's consumption of five flavors combined with Qi and Blood to generate the five Zang organs.
South Generates Heat:
South lies on the equator, corresponding to Li in the Eight Trigrams. Yang Qi radiates outward, generating heat, known in the West as the tropical zone where the sun generates heat upon reaching the equator. Thus, the Sun is the essence of all Yang.
Heat Generates Fire:
Heat is the command of Summer. Summer Qi generates Bing-Ding Fire in the Earthly Five Elements. Heat is formless Heavenly Qi, while Fire is tangible Earthly Qi. Thus, Hetu numerology states "Earth Two Generates Fire." Western chemistry states that striking steel produces heat, which reacts with iron filings and atmospheric oxygen to burn; rubbing wood similarly reacts with oxygen to burn. This proves *Neijing*'s "Heat Generates Fire."
Fire Generates Bitter:
Anything subjected to fire tastes bitter due to the nature of fire. Plants inheriting Fire's nature taste bitter (see Flavor Chapter).
Bitter Generates Heart:
Humans inheriting Fire's nature and flavor generate the Heart, analogous to Sour generating Liver.
Center Generates Dampness:
The Center is where Yin and Yang intersect. Yin belongs to Water, Yang to Fire. Their intersection generates Dampness, the command of Late Summer, used to transform and generate all things. "Yang" (center) is a homophonic combination of "Yin" and "Yang." Heaven Yang and Earth Yin interact vertically; Southern Heat and Northern Cold interact horizontally, steaming into Dampness. Western science describes gases permeating the globe, but the ancient sages summarized this meaning simply with "Center."
Dampness Generates Earth:
Formless Dampness transforms into tangible Wu-Ji Earth. Earth's ability to generate life depends entirely on containing Dampness. Western science equates Earth with soil, unaware of the ancient distinction: Heaven is Yang above, Earth is Yin below, and Earth exists in the center of Yin-Yang interaction. Western science views soil as decomposed matter, ignoring that decomposition relies on Dampness.
Earth Generates Sweet:
Earth's inherent flavor is bland, but the grains it produces taste sweet. Thus, Sweet is the flavor of Earth. Western science knows only existing flavors, not their origins, leading to errors in pharmacology.
Sweet Generates Spleen:
Humans inheriting Earth's nature and flavor generate the Spleen.
West Generates Dryness:
West governs Autumn Metal Qi, characterized by contraction and肃杀 (severity/killing), resulting in Dryness. In a day, this corresponds to Shen-You hours (sunset), where Yin contracts and Yang gathers, eliminating moisture to create Dryness. In a season, it corresponds to Autumn, where contraction and severity mature crops, relying on Dryness. Western chemistry ignores Dryness because it is a gas consumed by Water and Fire, uncollectible in vessels.
Dryness Generates Metal:
This formless Dryness Qi generates tangible Metal, specifically Geng-Xin Metal in the Earthly Five Elements. When Autumn Dryness prevails, plants yellow and fall, verifying Metal generation. Earth generates Metal because it transitions from Dampness to Dryness, condensing into substance.
Metal Generates Pungent:
With the nature of Dry-Metal Qi, the Pungent flavor arises.
Pungent Generates Lung:
Humans inheriting Metal's nature and flavor generate the Lung, which stores the Metal Qi of Heaven and Earth.
North Generates Cold:
North governs Winter, generating Cold Qi. With the tropical zone in the South and cold zones in the North, Western science acknowledges the Arctic Ocean.
Cold Generates Water:
Qi generates form. Cold Qi generates Ren-Gui Water. Western science states water is formed from Hydrogen reacting with Oxygen under cold conditions (e.g., using a cold glass cover). Heating gases in a mercury basin also yields water. Mercury is extremely cold, aligning with *Neijing*'s "Cold Generates Water."
Water Generates Salty:
The nature of Cold Water is Salty.
Salty Generates Kidney:
Humans inheriting Cold-Water nature and flavor generate the Kidney, which governs bodily fluids.
Humans originate from Heaven and亲近 Earth, generating five Zang organs to correspond to Heaven and Earth Yin and Yang. One must know that the five Zang organs are based on the Five Elements to understand their manifestation in the body and extension to all things. Imbalance in Five Element Qi causes disease. Herbs inherit Five Element Qi to correct Zang organ imbalances. Understanding the principles of Five Elements is essential for medicine. Thus, citing *Suwen: Yin Yang Ying Xiang Da Lun*. While Western astronomy and chemistry differ from Chinese Five Elements theory, their underlying principles are compatible. However, Western medicine focuses solely on physical structure, ignoring that human Qi transformation is identical to that of Heaven and Earth.