按者为实也。）寒湿之中人也，皮肤不收，肌肉坚紧，营血涩，卫气去，故曰虚。虚者聂辟，气不足，按之
则气足以温之，故快然而不痛。（此外感之生虚也。凡寒湿中人，必伤卫气，故皮肤不收而为纵缓，肌肉坚
紧而为削瘦。营血涩于脉中，卫气去于脉外，所以为虚。凡言语轻小曰“聂”，足弱不能行曰“辟”，皆
气不足也。气虚作痛者，按之可以致气，气至则阳聚阴散，故可快然而痛止也。聂，尼辄切。辟。
音壁。）喜怒不节，则阴气上逆，上逆则下虚，下虚则阳气走之，故曰实矣。（此内伤之生实也，阴逆于上，
则虚于下，阴虚则阳邪凑之，所以为实。然则实因于虚，此所以内伤多不足也。所重在怒，故曰实也。怒
则气上，正此之谓。）喜则气下，悲则气消，消则脉空虚。因寒饮食，寒气熏满，则血涩气去，故曰虚矣。（此
内伤之生虚也，下，陷也。消，散也。因寒饮食者，寒气熏满中焦，必伤阳气，故
血涩气去而中为虚也，若饮食过度，留滞不消，虽亦内伤，此则虚中挟实，是又不可不辨矣。）
The condition where pressing reveals firmness is Excess (Shi, 实). When Cold-Dampness (Han-Shi, 寒湿) invades the human body, the skin becomes lax and fails to consolidate, while the muscles become stiff and tight. The Ying Blood (Ying Xue, 营血; Nutritive Blood) flows turbidly or sluggishly, and the Wei Qi (Wei Qi, 卫气; Defensive Qi) dissipates and departs; therefore, this is termed Deficiency (Xu, 虚). In Deficiency, the body exhibits a contracted and folded posture (Nie Pi, 聂辟), indicating insufficient Qi. Pressing the area gathers Qi, which provides warmth, thus resulting in relief and absence of pain. (This explains how external pathogens generate Deficiency. Whenever Cold-Dampness invades, it inevitably damages the Wei Qi, causing the skin to become lax and relaxed, and the muscles to become emaciated and hard. With Ying Blood stagnating within the vessels and Wei Qi dispersing outside them, Deficiency arises. "Nie" refers to speaking softly or lightly; "Pi" refers to weak legs unable to walk; both signify Qi insufficiency. For pain caused by Qi Deficiency, pressing can attract Qi. Once Qi arrives, Yang accumulates and Yin dissipates, leading to comfort and cessation of pain. "Nie" is pronounced as 'ni zhe qie'. "Pi" sounds like 'bi'.) Unregulated emotions of joy and anger cause Yin Qi to reverse upward. Upward reversal leads to deficiency below; when the lower part is deficient, Yang Qi rushes to fill the void, thus constituting Excess. (This explains how internal injuries generate Excess. Yin reverses upward, creating deficiency below. Yin Deficiency allows Yang pathogenic factors to converge, resulting in Excess. However, Excess stems from Deficiency, which is why internal injuries often manifest as insufficiency. The key factor is anger, hence it is called Excess. Anger causes Qi to ascend, which is precisely what is described here.) Joy causes Qi to descend; sorrow causes Qi to dissipate. Dissipation leads to emptiness in the vessels. If one consumes cold food and drink, Cold Qi steams and fills the interior, causing blood to stagnate and Qi to depart; thus, this is termed Deficiency. (This explains how internal injuries generate Deficiency. "Descend" implies sinking; "Dissipate" implies scattering. Consuming cold food and drink causes Cold Qi to steam and fill the Middle Jiao (Zhong Jiao, 中焦; Middle Burner), inevitably damaging Yang Qi. Consequently, blood stagnates and Qi departs, resulting in Deficiency in the middle. Conversely, if overeating leads to retention and indigestion, although this is also an internal injury, it constitutes Deficiency with夹杂 (Jia Za, 夹杂; mixed with) Excess, which must be distinguished carefully.)