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The Qi of the five Zang organs must rely on the Qi of the five flavors (sour, bitter, sweet, pungent, salty) for nourishment. When Qi is harmonious, life activities arise; when body fluids are mutually generated, Shen (Spirit) naturally emerges.

The Yellow Emperor asked: What are the manifestations (Xiang) of the Zang organs? ("Xiang" refers to phenomena manifested externally that can be observed.) Qibo replied: The Heart is the root of life and the residence of Shen. Its brilliance manifests in the face, its filling is in the blood vessels, it belongs to Taiyang within Yang, and corresponds to the Qi of Summer. (As the Sovereign Official, the Heart governs Shen Ming [Mind/Spirit], and all things depend on it for rise and fall; thus it is called the root of life and the residence of Shen. Fire has a nature of flaming upward, so its brilliance manifests in the face. The Heart generates Blood and governs the vessels, so its filling is in the blood vessels. The Heart rules in Summer, and its Qi combines with Taiyang; since Taiyang resides within the fire of Summer, it is called Taiyang within Yang, corresponding to the Qi of Summer. Note: Wang Bing's edition reads "Bian of Shen," while Quanyuanqi's edition and *Tai Su* both read "Chu of Shen," which is correct; we adopt this reading here.) The Lung is the root of Qi and the residence of Po. Its brilliance manifests in the hair/body hair, its filling is in the skin, it belongs to Shaoyin within Yang, and corresponds to the Qi of Autumn. (The Lung stores Qi, its spirit is Po, and it connects with the skin and hair; hence this statement. Note: Wang Bing's edition reads "Taiyin within Yang," but *Jia Yi Jing* and *Tai Su* both read "Shaoyin." Lin Yi et al.'s *Xin Zheng Xiao* state: "Although the Lung belongs to Taiyin among the twelve meridians, within the Yang aspect it should be Shaoyin." This is correct; we adopt this reading.) The Kidney is the root of hibernation and storage, and the residence of Essence. Its brilliance manifests in the hair, its filling is in the bones, it belongs to Taiyin within Yin, and corresponds to the Qi of Winter. (The earth gates close, hibernating insects hide deeply; the Kidney governs Water, receiving and storing the Essence of the five Zang and six Fu organs; thus it is called the root of hibernation and storage, and the residence of Essence. The Brain is the Sea of Marrow, the Kidney governs bone marrow, and hair is nourished by the Brain; thus its brilliance is in the hair and its filling is in the bones. Note: Wang Bing's edition reads "Shaoyin," while Quanyuanqi's, *Jia Yi Jing*, and *Tai Su* all read "Taiyin." *Xin Zheng Xiao* states: "Although the Kidney belongs to Shaoyin among the twelve meridians, within the Yin aspect it should be Taiyin." We adopt this.) The Liver is the root of endurance against fatigue and the residence of Hun. Its brilliance manifests in the nails, its filling is in the tendons, thereby generating Blood and Qi... it belongs to Shaoyang within Yin, and corresponds to the Qi of Spring. (Human movement is performed by the strength of tendons; the Liver governs tendons and its spirit is Hun; thus it is called the root of endurance against fatigue and the residence of Hun. Nails are the surplus of tendons, nourished by the Liver; thus its brilliance is in the nails and its filling is in the tendons. The East is the beginning of generation, thus it can generate Blood and Qi. Note: "Ba" is interchangeable with "Pi" (fatigue); the Liver governs tendons, and overexertion leads to exhaustion and weariness, hence "Ba Ji." Furthermore, human Blood and Qi are generated by the Heart, controlled by the Spleen, and stored by the Liver. If the Liver is nourished, Blood and Qi are sufficient and disease-free; thus it is also said to generate Blood and Qi. "Yang Zhong" should be "Yin Zhong"; Quanyuanqi's, *Jia Yi Jing*, and *Tai Su* all agree.)* The Spleen, Stomach, Large Intestine, Small Intestine, San Jiao (Triple Burner), and Bladder are the root of the granaries (metaphor for digestive function) and the residence of Ying (Nutritive) Qi, named "Vessels/Containers," capable of transforming dregs and converting flavors for entry and exit. These belong to the category of Supreme Yin and correspond to the Qi of Earth. (They can receive and hold food, transporting without cease; thus they are the root of the granaries, named "Vessels." Ying Qi originates from the Middle Jiao, which is the location of the Spleen and Stomach; thus it is called the residence of Ying Qi. However, the flavors of water and grain enter the Spleen and Stomach; the Spleen and Stomach process the dregs and transform their flavors, expelling them via the San Jiao and Bladder; thus it is said to convert flavors for entry and exit. Earth combines with Supreme Yin; *Jin Gui Zhen Yan Lun* states: "Supreme Yin within Yin is the Spleen." Note: The terms "entry and exit" are profound; only with entry is there exit. The large intestine, small intestine, spleen, stomach, and bladder all enter first and then exit. The San Jiao governs Qi; why is it mentioned together? Presumably because the Qi of the San Jiao also relies on the flavors of diet to change and ascend/descend.) The functions of all eleven Zang organs depend on the Gallbladder. (From the Heart above to the Gallbladder below, there are eleven. However, the Gallbladder possesses uprightness, decisiveness, and impartiality; thus the functions of all organs depend on it.) Note: Each Zang organ has its own specific duty, hence the distinction of Twelve Officials in the *Mi Dian Lun*. Yet, those whose duties are exclusive cannot manage others; whereas those with similar efficacy and consistent goals must be discussed together. Therefore, although referring to the same Zang organs, this chapter sometimes discusses them separately and sometimes jointly, to show that the functions of the twelve Zang-Fu organs differ, completing the meaning.

Thus, if the Renying pulse is one-fold larger than the Cunkou pulse, the disease is in Shaoyang; two-fold larger, in Taiyang; three-fold larger, in Yangming; four-fold or more larger indicates Ge Yang (Rejection of Yang). ("One-fold" means the Renying pulse is one times larger than the Cunkou pulse. The method for other folds is the same. Four-fold or more indicates extreme excess of Yang, causing rejection where food cannot enter. *Zheng Li Lun* states: "Ge results in vomiting and regurgitation.") If the Cunkou pulse is one-fold larger than the Renying pulse, the disease is in Jueyin; two-fold larger, in Shaoyin; three-fold larger, in Taiyin; four-fold or more larger indicates Guan Yin (Closure of Yin). (The method of judging "Sheng" [excess/larger] is the same as for Yang. Four-fold or more indicates extreme excess of Yin, causing closure where urination cannot pass. *Zheng Li Lun* states: "Guan results in inability to urinate.") If both the Renying and Cunkou pulses are盛大 (excessively large) four-fold or more, it is called Guan Ge (Closure and Rejection). The Guan Ge pulse is exhausted (Note: In ancient texts, "Ying" [deficient] is often used interchangeably with "Ying" [full/excessive] in this context, implying extreme fullness leading to collapse); if it cannot reach the fullness of the essence of Heaven and Earth, death will ensue. ("Both excessive" means both are four times larger than the normal pulse. Things cannot remain excessively strong for long; extremity leads to decline; thus if it cannot reach the fullness of the essence of Heaven and Earth, death occurs. Note: *Xin Zheng Xiao* states: "In ancient texts, 'Ying' is used interchangeably with 'Ying' [full].") Those who oppose the Four Seasons: Excess manifests as pathogenic factors overcoming essence; deficiency manifests as consumption of essence. Should be excessive but is deficient indicates essence consumption; should be deficient but is excessive indicates pathogenic excess. When Yin and Yang Qi do not correspond, the disease is named Guan Ge. (This broadly elaborates on pulse correspondence. Regarding opposing the Four Seasons, all deficiencies are due to the depletion of Blood and Qi, and all excesses are due to pathogenic factors overcoming essence. Yin and Yang Qi do not correspond and cannot mutually nourish; thus it is called Guan Ge. Note: This section was originally printed in *Mai Yao Jing Wei Lun*, discussing Guan Ge alone without question-and-answer format, which must be a misplaced text (Cuo Jian). It is now moved here to ensure textual coherence. Carefully noting *Ling Shu · Zhong Shi Pian* states: "Renying one-fold, disease in Foot Shaoyang; one-fold and restless, disease in Hand Shaoyang. Renying two-fold, disease in Foot Taiyang; two-fold and restless, disease in Hand Taiyang. Renying three-fold, disease in Foot Yangming; three-fold and restless, disease in Hand Yangming. Renying four-fold, large and rapid, named Yi Yang (Overflowing Yang), Yi Yang is External Ge. Pulse Kou one-fold, disease in Foot Jueyin; one-fold and restless, disease in Hand Jueyin (Pericardium). Pulse Kou two-fold, disease in Foot Shaoyin; two-fold and restless, disease in Hand Shaoyin. Pulse Kou three-fold, disease in Foot Taiyin; three-fold and restless, disease in Hand Taiyin. Pulse Kou four-fold, large and rapid, named Yi Yin (Overflowing Yin), Yi Yin is Internal Guan. Internal Guan unblocked, death is incurable. Renying and Taiyin Pulse Kou both excessive four-fold or more, named Guan Ge; Guan Ge patients have a short life expectancy." Also *Mai Du Pian* states: "Pathogen in Fu organs causes Yang pulse disharmony; Yang pulse disharmony causes Qi stagnation; Qi stagnation causes Yang Qi excess. Extreme Yang excess makes Yin unfavorable; Yin unfavorability causes Blood stagnation; Blood stagnation causes Yin Qi excess. Extreme Yin excess prevents Yang Qi from nourishing; thus called Guan. Extreme Yang excess prevents Yin Qi from nourishing; thus called Ge. Both Yin and Yang are excessive and cannot mutually nourish; thus called Guan Ge. Guan Ge patients die before their time." Subsequently, *Jin Fu Pian* also discusses Guan Ge. Viewing these together, extreme external excess of Yin-Yang pulses is actually a sign of internal true Qi depletion; death follows swiftly, what is there to doubt? Differentiating Guan Ge began with *Nan Jing* Difficulty 3, stating pulses have excess, deficiency, Yin-Yang mutual multiplication, repetition, overflow, Guan, and Ge, described by physical characteristics. Zhang Zhongjing stated: "At Chi position is Guan, at Cun position is Ge; Guan results in inability to urinate, Ge results in vomiting and regurgitation." Wang Shuhe followed this. Li Dongyuan distinguished left as Renying and right as Qikou. If Qikou pulse is four times larger than Renying, this is clear Qi moving in turbid pathways, thus called Ge. If Renying pulse is four times larger than Qikou, this is turbid Qi moving in clear pathways, thus called Guan. Guan results in inability to urinate, Ge results in vomiting and regurgitation. Zhu Danxi established Guan Ge as a separate category, stating cold in Upper Jiao, heat in Lower Jiao, both Cun pulses excessive four-fold or more, such diseases often result in death. My fellow townsman Ma Xuantai stated that Guan Ge is a pulse condition, not a disease name. Zhang Jingyue praised him for surpassing previous generations, which is correct. However, Zhang exclusively identified the Renying mentioned in the classics as the Renying acupoint beside the larynx, and vigorously criticized previous views, blaming Li Dongyuan for erroneously creating the concept of Left Cun as Renying. Alas! His words were too extreme, his view biased and rigid. The Renying beside the larynx is indeed the Renying acupoint; although the classics mostly refer to this, there is no explicit text naming Left Cun as Renying, allowing for ambiguous interpretation. But to claim that both hands' Cun pulses belong entirely to Yin meridians is extremely erroneous. Let us prove this using the classics' statements on pulses. *Mai Yao Jing Wei Lun* states: "Inside Chi, sides are hypochondrium; outside Chi awaits Kidney, inside Chi awaits abdomen. Above Chi, left outside awaits Liver, inside awaits diaphragm; right outside awaits Stomach, inside awaits Spleen. Above that, right outside awaits Lung, inside awaits chest center; left outside awaits Heart, inside awaits Danzhong. Front awaits anterior, back awaits posterior." Observing this, not only are the Three Yin awaited in the three positions, but the Three Yang are also awaited in the three positions. Whenever the classics mention Renying, it is likely because the Three Yang meridians all ascend to the head, and the Renying beside the neck is an external indicator of the Yangming Stomach meridian, capable of awaiting the excess/deficiency of the Stomach meridian, but not the diseases of the Three Yang meridians. Moreover, naming Left Cun as Renying was not invented by Li Dongyuan. *Ling Shu · Wu Se Pian* states: "Renying excess and firm indicates injury from Cold; Qikou very firm indicates injury from Food." Renying and Qikou are symmetrical; Right Cun is Qikou, Right Guan is Spleen/Stomach; Spleen/Stomach food injury results in very firm pulse appearing at Right Cun. Left Cun is Renying, Left Guan is Liver/Gallbladder; Liver contracting wind-cold results in excess/firm pulse appearing at Left Cun. Thus, Renying indeed refers to Left Cun, as stated in this chapter. Because the classics did not explicitly name Left Cun as Renying, Zhang Jingyue could speak arbitrarily. Furthermore, within the human body, one name corresponding to two acupoints exists, such as Lin Qi, Qiao Yin, Qi Hai having upper and lower versions, San Li distinguishing hand and foot, Ju Xu distinguishing upper and lower Lian. Why must the one beside the larynx be named Renying, and the Left Cun not also be named Renying? Zhang Jingyue simply failed to think. And he himself claimed treating Ku Sima and Tian Zongbo, whose pulses were extremely firm and excessive, he only diagnosed the two Cun pulses, never diagnosing beside the throat. By regarding Guan Ge as a pulse condition, where extreme pulse excess indicates absence of Yin, true Yin exhaustion, and floating isolated Yang, this brilliant explanation deeply hits the crux of Guan Ge. It should not be discarded due to a single error in his statement.)