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Huangdi asked Qibo, saying: The blood, qi, and spirit of a person are what sustain life and circulate throughout the vital functions. The meridians (Jingmai) are what transport blood and qi, nourish yin and yang, moisten sinews and bones, and facilitate the joints. The defensive qi (Wei Qi) is what warms the flesh, fills the skin, thickens the interstices (Couli), and controls opening and closing. The will and intent (Zhi Yi) are what govern the spirit, collect the soul and ethereal soul, adapt to cold and heat, and regulate joy and anger. Therefore, when blood and qi are harmonious, the meridians flow smoothly, yin and yang are nourished, sinews and bones are strong, and the joints are clear and unobstructed. When defensive qi is harmonious, the muscles are relaxed and functional, the skin is supple, and the interstices are dense. When will and intent are harmonious, the spirit is focused, the soul and ethereal soul do not scatter, anger does arise, and the five zang organs are not invaded by pathogenic factors. When cold and heat are moderate, the six fu organs digest food and water, wind-bi does not occur, the meridians are unobstructed, and the limbs and joints are at peace. This is the state of normal health in humans.

The five zang organs store the spirit, blood, qi, soul, and ethereal soul. The six fu organs transform water and grain and distribute fluids and jinye. These are endowments received from heaven at birth; there is no difference between the foolish and the wise, the virtuous and the unworthy, that can be relied upon for distinction. However, some people enjoy their full natural lifespan without deviant diseases, remaining vigorous for a hundred years; even if they encounter wind, rain, sudden cold, or intense heat, these cannot harm them. Others, although staying indoors away from drafts and free from fear and alarm, still fall ill. Why is this? I wish to hear the reason.

Qibo replied: Your question is indeed perplexing! The five zang organs correspond to heaven and earth, align with yin and yang, operate according to the four seasons, and transform the five phases. The five zang organs vary in size, height, firmness, correctness, and inclination. The six fu organs also vary in size, length, thickness, knotting, straightness, and tension. These twenty-five variations differ from one another, being either auspicious or inauspicious, good or bad. Let me explain their principles.

If the heart is small, it is stable, and pathogens cannot injure it, but it is easily injured by sorrow. If the heart is large, sorrow cannot injure it, but it is easily injured by pathogens. If the heart is high, it overflows into the lungs, leading to forgetfulness and difficulty in being persuaded by words. If the heart is low, its viscera are exposed, making it susceptible to cold injury and fear induced by speech. If the heart is firm, the viscera are secure and stable. If the heart is fragile, it is prone to Xiao Shan (wasting-thirst) and Re Zhong (heat in the middle). If the heart is correct and upright, it is harmonious and difficult to injure. If the heart is inclined, its actions are inconsistent, lacking steadfastness.

If the lungs are small, the person drinks little and does not suffer from panting or wheezing. If the lungs are large, the person drinks much and is prone to Xiong Bi (chest bi), Hou Bi (throat bi), and rebellious qi. If the lungs are high, there is rebellious qi, shoulder breathing, and cough. If the lungs are low, they press against the贲门 (cardia) and approach the liver, causing pain under the ribs. If the lungs are firm, they do not suffer from cough and rebellious qi. If the lungs are fragile, they suffer from Xiao Shan and are easily injured. If the lungs are correct and upright, they are harmonious and difficult to injure. If the lungs are inclined, there is pain on one side of the chest.

If the liver is small, the viscera are stable, and there is no disease under the ribs. If the liver is large, it presses against the stomach and throat, causing discomfort in the diaphragm and pain under the ribs. If the liver is high, it extends upward, pressing against the cardia and ribs, forming Xi Ben (rebellious qi accumulation). If the liver is low, it presses against the stomach, leaving the area under the ribs empty; this emptiness makes it susceptible to pathogens. If the liver is firm, the viscera are stable and difficult to injure. If the liver is fragile, it is prone to Xiao Shan and easily injured. If the liver is correct and upright, it is harmonious and difficult to injure. If the liver is inclined, there is pain under the ribs.

If the spleen is small, the viscera are stable and difficult to injure by pathogens. If the spleen is large, it causes congestion and pain, preventing rapid walking. If the spleen is high, it pulls on the costal margin, causing pain. If the spleen is low, it descends onto the large intestine; descending onto the large intestine makes the viscera susceptible to pathogens. If the spleen is firm, the viscera are stable and difficult to injure. If the spleen is fragile, it is prone to Xiao Shan and easily injured. If the spleen is correct and upright, it is harmonious and difficult to injure. If the spleen is inclined, it is prone to fullness and distension.

If the kidneys are small, the viscera are stable and difficult to injure. If the kidneys are large, they are prone to lower back pain, inability to bend or twist, and susceptibility to pathogens. If the kidneys are high, they cause pain in the back and spine, preventing bending or twisting. If the kidneys are low, they cause pain in the loins and sacrum, preventing bending or twisting, and may form Hu Shen (fox hernia). If the kidneys are firm, they do not suffer from lower back or spinal pain. If the kidneys are fragile, they suffer from Xiao Shan and are easily injured. If the kidneys are correct and upright, they are harmonious and difficult to injure. If the kidneys are inclined, they suffer from pain in the loins and sacrum. These twenty-five variations constitute the common diseases that afflict humans.

Huangdi said: How do we know this? Qibo said: A red complexion with fine texture indicates a small heart; a coarse texture indicates a large heart. The absence of depressions indicates a high heart; small, short, and elevated depressions indicate a low heart; long and downward depressions indicate a low and firm heart; weak, small, and thin depressions indicate a fragile heart; straight and non-elevated depressions indicate a correct heart; depressions leaning to one side indicate an inclined heart.

A white complexion with fine texture indicates small lungs; coarse texture indicates large lungs. Broad shoulders, reversed sternum, and depressed larynx indicate high lungs; adducted axillae and spread ribs indicate low lungs. Thick shoulders and back indicate firm lungs; thin shoulders and back indicate fragile lungs; thick back and chest indicate correct lungs; inclined and sparse ribs indicate inclined lungs.

A blue/green complexion with fine texture indicates a small liver; coarse texture indicates a large liver. Broad chest and reversed ribs indicate a high liver; adducted ribs and rabbit-like protrusions indicate a low liver. Good chest and rib shape indicate a firm liver; weak rib bones indicate a fragile liver; well-proportioned chest and abdomen indicate a correct liver; inclined and elevated rib bones indicate an inclined liver.

A yellow complexion with fine texture indicates a small spleen; coarse texture indicates a large spleen. Upturned lips indicate a high spleen; drooping lower lips indicate a low spleen; firm lips indicate a firm spleen; large but unfirm lips indicate a fragile spleen; well-formed upper and lower lips indicate a correct spleen; inclined and elevated lips indicate an inclined spleen.

A black complexion with fine texture indicates small kidneys; coarse texture indicates large kidneys. High ears indicate high kidneys; depressed areas behind ears indicate low kidneys; firm ears indicate firm kidneys; thin and unfirm ears indicate fragile kidneys; ears well-formed and positioned forward near the mandible indicate correct kidneys; inclined and high ears indicate inclined kidneys. In all these variations, robust constitution brings health, while weakened constitution brings disease.

Huangdi said: Excellent. But this is not what I asked. I wish to know about those who cannot be diseased, living out their natural lifespan; even with deep sorrow and great fear, their spirit remains undiminished, and extreme cold and heat cannot harm them. Conversely, why do some who stay indoors away from drafts and without fear still fall ill? I wish to hear the reason.

Qibo said: The five zang and six fu organs are abodes for pathogens. Let me explain. Those whose five zang organs are all small get few diseases but suffer from mental unrest and constant worry. Those whose five zang organs are all large are slow in affairs and hard to worry. Those whose five zang organs are all high have lofty ambitions. Those whose five zang organs are all low prefer to submit to others. Those whose five zang organs are all firm have no disease. Those whose five zang organs are all fragile are never free from disease. Those whose five zang organs are all correct are harmonious and win people's hearts. Those whose five zang organs are all inclined have crooked minds, are prone to theft, cannot be fair, and speak inconsistently.

Huangdi said: I wish to hear about the correspondence of the six fu organs. Qibo answered: The lungs connect with the Large Intestine, which corresponds externally to the skin; the heart connects with the Small Intestine, which corresponds externally to the vessels; the liver connects with the Gallbladder, which corresponds externally to the sinews; the spleen connects with the Stomach, which corresponds externally to the flesh; the kidneys connect with the Sanjiao and Bladder, which correspond externally to the interstices and body hair.

Huangdi said: How does this correspondence work? Qibo said: The lungs correspond to the skin. Thick skin indicates a thick Large Intestine; thin skin indicates a thin Large Intestine; loose skin with a large abdomen indicates a large and long Large Intestine; tight skin indicates a tense and short Large Intestine; smooth skin indicates a straight Large Intestine; skin and flesh tightly adhered indicate a knotted Large Intestine. The heart corresponds to the vessels. Thick vessels indicate a thick heart vessel and a thick Small Intestine; thin vessels indicate a thin heart vessel and a thin Small Intestine; loose vessels indicate a loose heart vessel and a large, long Small Intestine; thin skin with weak, small pulses indicates a small and short Small Intestine; many tortuous Yang channel vessels indicate a knotted Small Intestine. The spleen corresponds to the flesh. Firm and large flesh indicates a thick Stomach; small flesh indicates a thin Stomach; small and weak flesh indicates an unfirm Stomach; flesh disproportionate to the body indicates a low Stomach; a low Stomach has poor pyloric function; unfirm flesh indicates a lax Stomach; flesh without small folds indicates a tense Stomach; flesh with many small folds indicates a knotted Stomach; a knotted Stomach has poor upper pyloric function. The liver corresponds to the nails. Thick, yellow nails indicate a thick Gallbladder; thin, red nails indicate a thin Gallbladder; firm, green nails indicate a tense Gallbladder; soft, red nails indicate a lax Gallbladder; straight, white nails without constraint indicate a straight Gallbladder; ugly, black, wrinkled nails indicate a knotted Gallbladder. The kidneys correspond to the bones. Fine texture and thick skin indicate a thick Sanjiao and Bladder; coarse texture and thin skin indicate a thin Sanjiao and Bladder; loose interstices indicate a lax Sanjiao and Bladder; tight skin without body hair indicates a tense Sanjiao and Bladder; beautiful, coarse body hair indicates a straight Sanjiao and Bladder; sparse body hair indicates a knotted Sanjiao and Bladder.

Huangdi said: Thickness, thinness, beauty, and ugliness all have external forms. I wish to know the diseases they cause. Qibo answered: Observe the external correspondences to know the internal zang organs, and thus know the diseases. (The beginning is grand and open; the ending is profound and reserved.)

The introductory words are exquisite. The subsequent text is extremely complex in detail, yet managed with order, creating a magnificent atmosphere. Its chapter structure and rhetoric are highly commendable, like a general taking command, maintaining composure amidst thousands of troops.