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The fatness or thinness, size of the body, and tolerance to cold or heat vary among individuals, with distinctions between the elderly (Lao), the vigorous (Zhuang), the young (Shao), and children (Xiao). Those aged fifty and above are called elderly; those above twenty are called vigorous; those below eighteen are called young; and those below six are called children.

There are three types: Fat (Fei), Gao (Gao), and Rou (Rou). One is classified as Fat if the muscles are firm and the skin is full; as Gao if the muscles are not firm and the skin is lax; and as Rou if the skin and flesh are closely attached and do not separate easily. ("Rou" refers to the accumulation of muscle tissue. This passage describes robust individuals who differ in having characteristics of Zhi [adipose], Gao, or Rou.) In Gao type, the muscles are soft and moist; those with coarse texture feel cold, while those with fine texture feel hot. In Zhi type, the muscles are firm; those with fine texture feel hot, while those with coarse texture feel cold. ("Nao" means soft and moist. In Gao type, muscles are soft and moist; in Zhi type, muscles are firm. Regarding cold and heat, those with coarse texture all feel cold, and those with fine texture all feel hot. "Nao" is pronounced like "nao".) People of Gao type have abundant Qi, and their skin is loose and relaxed, hence they tend to have a protruding abdomen with hanging fat. People of Rou type have a large body capacity. People of Zhi type have a compact and smaller body. ("Zong" means loose. "Yu" refers to fatty adipose tissue. Gao type has a protruding abdomen with hanging fat, while Zhi type has a compact small body, indicating that Gao is fatter than Zhi. Rou type consists of solid skin and flesh, distinct from Zhi and Gao. "Zong" is pronounced with the departing tone. "Yu" is pronounced like "yu".) Gao type people have abundant Qi; abundant Qi leads to heat, and heat allows tolerance to cold. Rou type people have abundant blood, which fills the form, resulting in a balanced constitution. Zhi type people have thin blood and slippery, scanty Qi, so their bodies cannot grow large. These are distinctions from the general population. (Gao type has abundant Qi; Qi belongs to Yang, so the constitution is hot and tolerant to cold. Rou type has abundant blood; blood nourishes the form, so the body is filled and the constitution is balanced. Zhi type has thin blood and slippery, scanty Qi, so the body is not large. Although these three types are obese, they differ from ordinary people, but the Qi and Blood of Zhi type seem inferior to Gao and Rou types. Fat and white-skinned people often have deficient Qi; dark-skinned and thin people with Qi deficiency may not be less deficient than fat and white-skinned ones; one should not be dogmatic.) In the general population (Zhongren), the proportions of skin, flesh, Zhi, and Gao are balanced, and Blood and Qi do not excessively dominate each other. Thus, their bodies are neither too small nor too large, proportionate to themselves, and are called "Zhongren" (ordinary people). (Zhongren refers to the multitude of ordinary people outside the three special types. Their skin, flesh, Zhi, Gao, Blood, and Qi have fixed qualities, so they cannot be added up or multiplied, and their body sizes are all proportionate.) One must first distinguish these three body types, determine the amount of Blood and the clarity/turbidity of Qi, and then regulate them; treatment will not deviate from standard principles. (Once the three types are established and Blood/Qi conditions are clear, whether to tonify or drain can follow standard principles without error.)

The twelve Meridians correspond to the twelve Rivers, which differ in clarity and turbidity. (Meridians and rivers both have differences in clarity and turbidity.) The Qi derived from grains is Turbid (Zhuo), while the Qi derived from Heaven is Clear (Qing). (There are two types of Qi in the human body: Turbid Qi is Grain Qi, hence "receiving grains results in turbidity"; Clear Qi is Heavenly Qi, hence "receiving Qi results in clarity." Together, they are called True Qi. The Heavenly Qi received from Heaven combines with Grain Qi to nourish the body. The general rule of Heaven and Earth's essence is that three parts exit and one part enters. Thus, without food intake, Qi declines in half a day and diminishes in a day. This indicates that what enters is Heavenly Qi, and what exits is Grain Qi.) Clear Qi flows into Yin (the Five Zang Organs), and Turbid Qi flows into Yang (the Six Fu Organs). (The throat governs Heavenly Qi, so Clear Qi flows from the throat into Yin, where Yin refers to the Five Zang Organs; the pharynx governs Earthly Qi, so Turbid Qi flows from the pharynx into Yang, where Yang refers to the Six Fu Organs.) The clear portion of Turbid Qi ascends and exits through the pharynx, while the turbid portion of Clear Qi descends. When Clear and Turbid interfere with each other, it is called Disordered Qi (Luan Qi). (The clear part of Turbid Qi emerges from within and thus ascends; the turbid part of Clear Qi enters from without and thus descends. Ascending and descending, the Qi inevitably intersects. When these two combine, any irregularity generates Disordered Qi.) Yin is Clear, and Yang is Turbid. Turbid contains Clear, and Clear contains Turbid. The major distinction of Qi is: Clear Qi ascends to the Lung, and Turbid Qi descends to the Stomach. The Clear Qi of the Stomach ascends and exits through the mouth, while the Turbid Qi of the Lung descends into the meridians and accumulates internally in the Sea of Qi. ("Da Bie" refers to the general distinction. Clear Qi rises, so it flows to the Lung; Turbid Qi descends, so it goes to the Stomach. However, Turbid contains Clear, so the Clear Qi of the Stomach ascends to the mouth to facilitate respiration and fluids; Clear contains Turbid, so the Turbid Qi of the Lung descends into the meridians to form blood vessels, Ying, and Wei Qi, accumulating in the Sea of Qi. The Upper Sea of Qi is at Danzhong, and the Lower Sea of Qi is at Dantian.) All Yang meridians receive Turbid Qi, but the Hand-Taiyang (Small Intestine) alone receives the Turbidness of Yang. The Hand-Taiyin (Lung) alone receives the Clarity of Yin. (Hand-Taiyang is the Small Intestine. Located below the Stomach, it receives water and grains from the Stomach. Before separation of clear and turbid, this is where waste exits. Although all Yang meridians receive turbidity, this is the turbidness of turbidity, hence "alone receives the Turbidness of Yang." Hand-Taiyin is the Lung. The Lung is the canopy of the five Zang and six Fu organs and is the site where Clear Qi gathers. Although all Yin meridians receive clarity, this is the clarity of clarity, hence "alone receives the Clarity of Yin.") All Yin meridians receive Clear Qi, but the Foot-Taiyin (Spleen) alone receives its Turbidity. (Foot-Taiyin is the Spleen. The Stomach is responsible for receiving and storing water and grains, while the Spleen receives the Qi for transformation and transportation, thus uniquely receiving turbidity, becoming "turbidity within clarity.") Clear Qi has slippery movement, and Turbid Qi has sluggish movement; this is the normal state of Qi. Therefore, when needling Yin meridians, one should insert deeply and retain the needle; when needling Yang meridians, one should insert shallowly and withdraw quickly. For cases where Clear and Turbid interfere, adjust the number of manipulations accordingly. (This refers to the sensation of Qi under the needle regarding Clear/Turbid and Yin/Yang. Clear Qi is slippery, favoring quick needling; Turbid Qi is sluggish, favoring slow needling. Yin is interior, favoring deep insertion and retention; Yang is exterior, favoring shallow insertion and quick withdrawal. If Clear contains Turbid or Turbid contains Clear, causing interference, observe which is dominant and adjust the manipulation count to harmonize.)

The head and face are connected to the body via bones and sinews, sharing Blood and Qi. In cold weather, hands and feet become weak and lazy, but the face does not require clothing. (The head, face, and body share one Qi. In severe cold, limbs shiver, but the face remains unaffected.) This is because the twelve meridians and 365 collaterals all send their Blood and Qi upward to the face and enter the orifices. (The head and face are the summit of the body, where all Yin and Yang meridians converge. Thus, Blood and Qi ascend to the face and enter the orifices. "Kong" is synonymous with "Kong".) Essence-Yang Qi ascends to the eyes to enable vision. (Essence-Yang Qi is the essence of Yang Qi. The essence of all five Zang and six Fu organs ascends to the eyes to form vision.) Branch Qi flows to the ears to enable hearing. (Branch Qi is lateral Qi. Qi ascends from both sides to the ears; when Qi reaches, the orifice becomes acute, enabling hearing.) Zong Qi (Pectoral Qi) ascends through the nose to enable smell. (Zong Qi is Great Qi. It accumulates in the chest, connects to the nose, and facilitates respiration, enabling smell.) Turbid Qi (Grain Qi) originates from the Stomach, flows to the lips and tongue, and enables taste. (Turbid Qi is Grain Qi. Grains enter the Stomach, and Qi reaches the lips and tongue, enabling taste.) The fluids of all Qi ascend to fumigate the face. (The fluids of all Qi ascend to fumigate the face: Lung Qi connects to the nose, Heart Qi to the tongue, Liver Qi to the eyes, Spleen Qi to the mouth, and Kidney Qi to the ears. The Qi of the five Zang organs all connect to the seven orifices, not just the Yang meridians reaching the head. The Hand-Shaoyin meridian ascends alongside the throat, passes through the larynx, ties to the root of the tongue, emerges on the face, connects to the eye system, and meets at the inner canthus. The Hand-Jueyin meridian follows the throat, emerges behind the ear, and meets the Shaoyang meridian below the Wangu point. The Hand and Foot Taiyin and Shaoyin meridians meet in the ear and ascend to connect the left corner. The Hand-Taiyin meridian follows the throat; the Foot-Shaoyin meridian follows the throat, ties to the root of the tongue, ascends to the nape, knots at the occipital bone, and merges with the sinews of the Foot-Taiyang meridian. The Foot-Taiyin meridian joins the Yangming meridian ascending, knots at the throat, and connects to the root of the tongue. A branch knots at the root of the tongue, penetrates the middle of the tongue, and scatters under the tongue. The Foot-Jueyin meridian follows behind the throat, enters the Ying-Sang, connects to the root of the tongue, links to the eye system, ascends to the forehead, and meets the Du meridian at the vertex. A branch descends from the eye system to the cheek interior, encircling the inside of the lips.)

Some people act and stand together, are of similar age, wear clothes of equal thickness, yet suddenly encounter violent wind and heavy rain; some fall ill, some do not, some all fall ill, some all remain healthy. ("Cu" is pronounced like "cu".) Shao Yu said: The green wind of spring, the yang wind of summer, the cool wind of autumn, and the cold wind of winter—these winds of the four seasons cause different forms of disease: (The winds of the four seasons each have a period of dominance. Where there is dominance, there is restriction, so the diseases caused differ in form.) People with yellow complexion, thin skin, and weak flesh cannot withstand the empty wind of spring. (Yellow is the color of Earth. Yellow complexion, thin skin, and weak flesh indicate insufficient Spleen Qi, hence unable to withstand the empty wind of Spring Wood. Empty wind refers to false evil and thieving wind.) People with white complexion, thin skin, and weak flesh cannot withstand the empty wind of summer. (White is the color of Metal. White complexion, thin skin, and weak flesh indicate insufficient Lung Qi, hence unable to withstand the empty wind of Summer Fire.) People with blue/green complexion, thin skin, and weak flesh cannot withstand the empty wind of autumn. (Blue/Green is the color of Wood. Blue/Green complexion, thin skin, and weak flesh indicate insufficient Liver Qi, hence unable to withstand the empty wind of Autumn Metal.) People with red complexion, thin skin, and weak flesh cannot withstand the empty wind of winter. (Red is the color of Fire. Red complexion, thin skin, and weak flesh indicate insufficient Heart Qi, hence unable to withstand the empty wind of Winter Water.) People with black complexion, thick skin, and firm flesh are naturally not injured by the winds of the four seasons. However, those with thin skin, unfirm flesh, and uneven complexion will fall ill if exposed to empty wind during late summer. (Black is the color of Water. Black complexion, thin skin, unfirm flesh, and changing/uneven complexion indicate insufficient Kidney Qi, hence unable to withstand the empty wind of Late Summer Earth.) Those with thick skin and firm flesh will not fall ill even if exposed to empty wind during late summer. Those with thick skin and firm flesh must suffer a double exposure to cold, affecting both exterior and interior, to fall ill. (If a person is black-complexioned with thick skin and firm flesh, they will not fall ill even with late summer empty wind. But if they are affected by wind and then by cold, it is called double exposure; injured internally and externally, they inevitably fall ill. Thus, black-complexioned people with firm skin and flesh are indeed different from others who are weak and prone to illness.) The difference between enduring pain and not enduring pain lies in the thickness of the skin, the firmness or fragility of the muscles, and the tension or relaxation of the tissues; this does not refer to courage or cowardice. (This requires distinguishing temperament.) Courageous people have deep and stable eyes, broad and straight eyebrows, horizontal Sanjiao texture, upright heart, large and firm liver, and full and expanded gallbladder. When angry, Qi is abundant and the chest expands; the Liver rises and the Gallbladder becomes horizontal; the corners of the eyes split and the eyes look up; hair stands erect, and the face turns pale. (Eyes are the gathering place of the essence of the five Zang and six Fu organs. Deep and stable eyes indicate firm organ Qi. Chang Heng means broad, implying longitudinal and transverse directions. Zhi Yang means looking straight with exposed light. Horizontal Sanjiao texture implies that rigid and urgent people have horizontal muscle texture, while soft and slow people have vertical texture. An upright heart reflects courageous Qi. Large and firm, full and expanded means expanding beyond normal limits. Anger causes Qi abundance and chest expansion due to strong Liver and Gallbladder in courageous people, with Liver Qi rushing upward. Hair standing is Liver Blood overflowing outward. Face turning pale is Liver color manifesting externally. The difference between courage and cowardice stems from the Liver and Gallbladder; thus, the Liver is called the General Officer, and decisions lie with the Gallbladder.) Cowardly people have large but unsealed eyes, loss of Yin-Yang balance, vertical Sanjiao texture, short and humble heart, relaxed Liver connection, empty and sagging Gallbladder, straight intestines and stomach, and empty hypochondrium. Even when extremely angry, Qi cannot fill the chest; although Liver and Lung rise, Qi declines and sinks again, so anger cannot be sustained. ("Jian" should be "Jian," meaning sealing/storing. Large but unsealed eyes indicate unstable Shen Qi. Loss of Yin-Yang balance means Blood and Qi are easily disturbed, i.e., startled glances. Vertical Sanjiao texture means non-horizontal muscle texture. Short and humble heart means the heart is lowly and willing to yield. Relaxed Liver connection means lack of urgency. Empty and sagging Gallbladder means little bile and fearful appearance. Straight intestines and stomach mean few curves. Empty hypochondrium means insufficient Liver Qi. This is due to downward sinking of Liver and Gallbladder, inability to fill Qi, leading to rapid decline after anger, which is the cause of cowardice. Courageous people possess rigid Qi; cowardly people possess weak nature. However, courage has two types: Blood-Qi courage and Ritual-Righteousness courage. Facing danger without fear and pain without moving indicates superior endowment, but reacting spontaneously may not always be moderate. Ritual-Righteousness courage also involves no fear or movement, but with composure and measure, far surpassing Blood-Qi courage. Blood-Qi courage originates from the Liver; Ritual-Righteousness courage originates from the Heart. If guarded by ritual and controlled by righteousness, Blood-Qi courage can be eliminated; if enriched by learning and expanded by insight, Ritual-Righteousness courage can be developed. Ancients said courage can be learned, relying on understanding principles and nurturing nature. Thus, whether one is courageous depends on the Liver and Gallbladder, but the master is the Heart. "Zong" is pronounced with the level tone. "KT" is pronounced like "jie yu".)

Cowardly people, when drunk, become angry and do not avoid brave men. Wine is the essence of water and grains, the liquid of cooked grains. Its Qi is fierce. Upon entering the Stomach, it causes distension, and Qi rebels upward, filling the chest. The Liver floats, and the Gallbladder becomes horizontal. At this time, one compares oneself to a brave man; when the Qi subsides, regret follows. This is called "Wine Rebelliousness" (Jiu Bei). (" " means urgent. "Han" means fierce. The nature of wine is hot and fierce. Thus, it distends the Stomach, floats the Liver, raises Qi, and strengthens the Gallbladder. While intoxicated, the spirit is confused, and nature is disrupted, leading one to compare oneself to a brave man. When Qi dissipates and the Liver calms, regret sets in. This behavior is driven by wine, constituting rebellion, hence "Wine Rebelliousness." Wine is the liquid of water and grains; Blood is the essence of water and grains. Wine entering the Middle Jiao seeks its kind, so it first enters the Blood aspect. All drinkers have red faces and bodies, which is a sign. Blood belongs to Yin and is gentle; Wine belongs to Yang and is fierce. Blood desires stillness, but wine agitates it; Blood desires storage, but wine disrupts it. Blood cannot move without Qi, so when Blood is disrupted, Qi is also disrupted; when Qi dissipates, Blood also dissipates. After such disturbance, can Blood and Qi remain undamaged? No. Furthermore, human endowments have Yin and Yang aspects in organs, and wine also has Yin and Yang qualities. Wine is fermented, its nature is hot; its juice is derived from water, its substance is cold. Thus, those with Yang organs become hotter; those with Yin organs become colder. Therefore, unrestrained drinking harms everyone regardless of Yin or Yang. Those with excess heat who drink excessively experience increasing Yang and decreasing Yin, often developing Wind-Damp swelling. Those with excess cold who drink excessively lose the hot nature but retain the cold substance, often damaging the Kidney and Spleen. In youth, consumption and generation balance, so no harm is felt; in middle age, strength wanes, and old ailments cause disaster, which cannot be resisted. Thus, the harm of Wine Rebelliousness affects longevity significantly; how can one not know moderation? " " is pronounced "piao"; "Han" is pronounced "han".)

Those with strong bones, weak sinews, loose muscles, and thick skin endure pain well, as do they with needles, stones, and fire moxibustion. Those with black complexion and beautiful bones endure pain; those with firm muscles and thin skin do not endure pain. ("Mei Gu" means strong bones.) Diseases may occur simultaneously, resolve easily, or be difficult to resolve: Those with more Heat resolve easily; those with more Cold are difficult to resolve. (Referring to diseases caused by external pathogens. More Heat means disease in the Yang aspect, hence easy resolution; more Cold means disease in the Yin aspect, hence difficult resolution.) Those with thick Stomach walls, black complexion, large bones, and obesity can tolerate toxic drugs; those who are thin with thin Stomach walls cannot tolerate toxic drugs. (Thick Stomach walls indicate firm organ Qi; black complexion indicates solid exterior; large bones indicate strong physique; fleshy body indicates abundant Blood, so they can withstand harsh drugs. If thin and with thin Stomach walls, Blood and Qi are inherently deficient, how can they withstand toxic drugs? "Sheng" is pronounced with the level tone.)

The Brain, Marrow, Bones, Vessels, Gallbladder, and Uterus (in women)—these six—are generated by Earth Qi. They store Yin and resemble Earth, so they store essence without excreting, and are named the Extraordinary Fu Organs (Qi Heng Zhi Fu). (These six are not part of the standard Six Fu Organs. Because they store Yin essence, they are called "generated by Earth Qi" and termed Fu organs. However, the Gallbladder is one of the Six Fu Organs, but uniquely stores without excreting, differing from other Fu organs that transform and transmit. The Uterus is the womb, also considered extraordinary because it receives and releases essence to form pregnancy. Thus, these six are called "Extraordinary Fu Organs." Qi means strange/extraordinary; Heng means constant.) The Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder—these five—are generated by Heaven Qi. Their nature resembles Heaven, so they excrete without storing. They receive turbid Qi from the Five Zang Organs and are named the Transmitting and Transforming Fu Organs (Chuan Hua Zhi Fu). These cannot retain contents for long but are responsible for transport and excretion. (These five are named the Six Fu Organs. Since the Gallbladder is called Extraordinary, only five remain. These five Fu organs contain substances and belong to Yang, hence "generated by Heaven Qi"; they transmit turbid Qi without retaining, hence "excrete without storing"; due to their transport and movement, they "resemble Heaven Qi.") The Po Men (anus) is also an envoy of the Five Zang Organs; water and grain residues cannot be stored for long. (Po Men is the anus. The Large Intestine and Lung are exterior-interior pairs. The Lung stores Po and governs Qi. If the anus loses control, Qi sinks and Shen departs, hence "Po Men." Moreover, although waste from all Fu organs is excreted here, the ascending and descending of Zang Qi also relies on this for regulation, so it is also called an envoy of the Five Zang Organs.) The Five Zang Organs store essence and Qi without excreting, so they are full but not solid. The Six Fu Organs transmit and transform substances without storing, so they are solid but not full. (The Five Zang Organs govern storing essence and Qi; the Six Fu Organs govern transmitting and transforming substances. Essence and Qi are clear, stored without excretion, so they are full but not solidly accumulated. Water and grains are turbid, transmitted and transformed without storage, so they are solidly accumulated but not full.) This is because when water and grains enter the mouth, the Stomach becomes solid and the Intestines empty (before food descends); after food descends, the Intestines become solid and the Stomach empty. Hence, it is said, "Solid but not full, full but not solid." The Five Zang Organs receive Qi from the organ they generate, transmit it to the organ they overcome; Qi stays in the organ that generates them, and death occurs at the organ that overcomes them. When a disease is fatal, it must first transmit to the organ it cannot overcome, and then the patient dies. (All Zang organ diseases have reception, transmission, residence, and death. She means staying/residing. Receiving Qi from what it generates means receiving from the child organ. Transmitting to what it overcomes means transmitting to the conquered organ. Qi residing in what generates it means staying in the mother organ. Death from what overcomes it means dying from the conquering organ.) This describes the retrograde flow of Qi, hence death. (Being overcome leads to retrogression, hence "retrograde flow." Retrogression leads to death.) The Liver receives Qi from the Heart, transmits it to the Spleen, Qi resides in the Kidney, and death occurs at the Lung. (This details how the Qi of one organ spreads to all. Liver Qi receives from the Heart; the Heart is the Liver's child, receiving from what it generates. The Spleen is overcome by the Liver, transmitting to what it overcomes. The Kidney is the Liver's mother, Qi resides in what generates it. The Lung is feared by the Liver, death occurs from what overcomes it.) The Heart receives Qi from the Spleen, transmits it to the Lung, Qi resides in the Liver, and death occurs at the Kidney...