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Ma Yun: The beginning of this chapter asks about the "six-six segments" (the cyclical patterns of six times six), and later asks what "zang-xiang" (visceral manifestations) are, hence the chapter title. Gao Shishi's commentary: The characters "Lun Shang" (Discussion Upper) are large-character headings. Below the character "Yun" (says), the characters "Da Lun" (Great Discussion) were mistakenly transmitted in old editions as the lower part of the *Si Qi Tiao Shen Da Lun* (Great Discussion on Regulating the Spirit According to the Four Qi). Current editions have corrected this. Danbo Yuanjian's note: This chapter discusses Yunqi (Luck and Qi/Climate cycles), sharing the same principles as the *Tian Yuan Ji Da Lun*, which is why Gao states this; such an explanation should not be accepted. From Qibo's reply starting with "Zhao hu zai wen ye" (How clear your question is!) down to "Shu duo ke de wen hu" (How much more can I hear?), totaling 718 characters. The *Xin Zheng Xiao* (New Corrected Text) states that these passages are absent in Quanyuan Qi's annotated edition and the *Tai Su*, suspecting they were added by Wang Bing. Upon examination, the chapter mostly discusses Yunqi, which is not found in other chapters. Furthermore, it extracts thirty-one characters from the *Tong Tian Lun* ("Zi gu tong tian zhe...") and forty-five characters from the *San Bu Jiu Hou Lun* ("San er cheng tian..."), combining them into a theory whose meaning is incomprehensible. Additionally, the twelve characters "You qie li duan yu shi..." completely plagiarize the text from the first year of Duke Wen in the *Zuo Zhuan*. It is clearly not original classic text, so it is now deleted without interpretation. Yunqi constitutes a separate system and offers no benefit to medical practice. Previous scholars' discussions are detailed in the *Hui Kao* and the notes following the *Jie Jing Wei Lun*.

Six-Six Segments: Zhang Jingyue's commentary: Heaven has up, down, and four directions, forming the Six Harmonies (Liu He); Earth has center, corners, inside, and outside, forming the Nine Palaces (Jiu Gong). This is the great number of the union of Qian and Kun. All physical laws in the world follow this principle. Thus, the solar terms are structured by "six-six" (36) to form a year, and humans formulate their harmonizations based on "nine-nine" (81). Danbo Yuanjian's note: All commentators followed Wang Bing's annotation, except Zhang who wrote as above. If his statement were true, it should read "Six-segment, Nine-formula," not "Six-six, Nine-nine." Wang Bing's interpretation is superior.

Humans Formulate Harmonization via Nine-Nine: Wu Kun's commentary: The number of Huangzhong (the fundamental pitch pipe) originates from millet grains, multiplied ninefold to establish musical tones, measures, capacities, and weights. "Hui" refers to harmonization. In ancient times, when the Son of Heaven toured the realm and met feudal lords, he unified their tones, measures, capacities, and weights, called "Huitong" (Harmonious Communication). This is what humans established. The *Zhi* book states: Humans have nine orifices and nine viscera; Earth has nine provinces and nine fields. Three threes make Heaven, three threes make Earth, and three threes make Humanity. Hence, it first states that humans use nine-nine for harmonization, then states that Earth uses nine-nine for harmonization. Danbo Yuanjian's note: Wang Bing's and Wu/Zhang's interpretations are unsatisfactory. "Hui" likely refers to the "Yao Hui" (Annual Summary) in the *Zhou Li - Tianguan - Shaozai*. Zheng Xuan's commentary: Monthly calculation is called "Ji"; annual calculation is called "Hui". The *Kongzi Jiayu - Zhipi* chapter says: Heaven One, Earth Two, Human Three; three times three equals nine; nine times nine equals eighty-one. Since eighty-one is the limit of numbers, it is said that humans use nine-nine for harmonization.

Three Hundred and Sixty-Five Segments: The *Xie Ke* chapter states: A year has 365 days; humans have 360 joints. The *Lüshi Chunqiu* states: 366 days; humans also have four limbs, five viscera, nine orifices, and 366 joints. The *Zihua Zi* states: The human body as bone consists of 360 parts, nourished morning and evening by essence and fluid.

The Great Divine Spirit Asks: Wu Kun's commentary: "Shen Ling" (Divine Spirit) refers to Heaven and Earth Yin-Yang. Zhang Zhicong's commentary agrees. Danbo Yuanjian's note: Wang Bing's annotation seems appropriate.

Different Desires and Preferences: Wu Kun's commentary: Each of the five viscera has specific desires for sounds, colors, smells, and tastes, each having its own pathway into the viscera. All annotations agree; we follow this view.

Heaven Nourishes Humans with Five Qi: Wu Kun's commentary: The five qi are not merely the odors of sour, burnt, fragrant, fishy, and putrid; those are Earth Qi, not Heaven Qi. It refers to Wind Qi entering the Liver, Summer Heat Qi entering the Heart, Dampness Qi entering the Spleen, Dryness Qi entering the Lungs, and Cold Qi entering the Kidneys. When they are neither excessive nor harmful, they nourish humans. Humans exist within the intersection of Qi, receiving it through the nose to nourish the five viscera; this is how Heaven nourishes humans with five qi. Danbo Yuanjian's note: Wu's comment appears correct but is actually wrong. The text below states: "Five qi enter the nose and store in the Heart and Lungs." If Wu were correct, it should say "store in the five viscera." Zhang Jingyue follows Wang Bing's note, which is justified. (*Lihai Ji* states: The Shuigou acupoint, located below the nose and above the mouth, is also called Renzhong (Human Center), situated in the middle of heaven and earth in the human body. Heaven Qi connects to the nose, Earth Qi connects to the mouth. Heaven nourishes humans with five qi, received by the nose; Earth nourishes humans with five flavors, received by the mouth. The acupoint is in between, hence named Renzhong.)

Five Colors Refined and Bright: Wang Bing's commentary: Refined, clean, and distinct. "Xiu" is interpreted as adornment. The *Ling Shu - Xiao Zhen Jie* writes "Wu Se Xun Ming"; in ancient texts, "Xiu" and "Xun" were often used interchangeably.

To Nourish the Five Qi: Zhang Jingyue's commentary: The Stomach stores the five flavors to nourish the Qi of the five viscera.

The Transformation of Shen: The *Xin Zheng Xiao* states: Quanyuan Qi's edition and the *Tai Su* write "Shen Zhi Chu" (The Place of Shen), which is correct. The *Ling Shu - Ben Shen* chapter states: What exists at birth is called Jing (Essence); the interaction of two essences creates Shen (Spirit). The *Wu Xing Da Yi* states: The Heart stores Shen; Shen implies bright illumination and awareness, meaning the Heart can understand all things. Shen is the ruler of the body, symbolizing Fire. The *Huainanzi* states: Shen is the treasure of the Heart.

Its Flourishing Appears on the Face: Zhang Jingyue's commentary: The Heart governs blood vessels; sufficient blood results in a radiant complexion and full meridians; thus, its flourishing manifests on the face.

Sun of Yang Among Yang: The *Jiu Zhen Shi Er Yuan* chapter states: The Sun of Yang among Yang is the Heart. The *Yin Yang Xi Ri Yue* chapter states: The Heart is the Sun of Yang among Yang.

The Abode of Po: The *Ling Shu - Ben Shen* chapter states: That which enters and exits with Jing is called Po (Ethereal Soul).

Taiyin of Yang Among Yang: The *Shi Er Yuan* chapter states: Shaoyin of Yang among Yang is the Lung. The *Xin Zheng Xiao* considers this correct.

The Abode of Jing: The *Ben Shen* chapter states: What exists at birth is called Jing.

Shaoyin of Yin Among Yin: The *Shi Er Yuan* chapter states: Taiyin of Yin among Yin is the Kidney. The *Yin Yang Xi Ri Yue* chapter states: The Kidney is Taiyin of Yin among Yin. The *Xin Zheng Xiao* considers this correct. Danbo Yuanjian's note: Zhang Jingyue cites the *Ci Jin Lun* to support the *Xin Zheng Xiao*, which is a forced interpretation.

The Dwelling of Hun: The *Ben Shen* chapter states: That which accompanies Shen in movement is called Hun (Corporeal Soul). Danbo Yuanjian's note: In the *Zuo Zhuan* (7th Year of Duke Zhao), Zichan stated: The initial transformation at birth forms Po; once Po exists, Yang generates Hun. If one uses refined materials abundantly, Hun and Po become strong, leading to spiritual clarity and divinity. Du Yu's commentary: Po is form; Yang is spirit-energy. Kong Yingda's Justice states: Humans are born endowed with the Five Constants and animated by Yin-Yang. The physical substance is called Form; the act of breathing is called Qi. Form and Qi combine to function, strengthening intellect and power, enabling humanity. At birth, form changes first; the spirituality within form is called Po. Once Po exists, Yang Qi within itself generates Hun; the spirituality within Qi is called Hun. Hun and Po are names for spiritual entities. Spirituality attached to form is Po; spirituality attached to Qi is Hun. Spirituality attached to form refers to sensory perception, limb movement, crying, and vocalization at birth—this is the spirituality of Po. Spirituality attached to Qi refers to gradual cognitive development—this is the spirituality attached to Qi. The *Xiao Jing Shuo* states: Po means white (clarity); Hun means moving (activity). Form has substance, named for clarity; Qi only breathes, named for activity. Essence is also spirit; Shuang is also brightness. Essence is spirit unmanifested; Shuang is brightness unilluminated. The *Guan Yin Zi* states: Hun stores in the Liver, Po stores in the Lungs. (*Wu Xing Da Yi* quotes the *Laozi Jing* similarly.) The *Han Shi Wai Zhuan* states: Jing stores in the Kidney, Shen stores in the Heart, Hun stores in the Liver, Po stores in the Lung, Zhi stores in the Spleen. The *Shuo Wen Jie Zi* states: Hun is Yang Qi; Po is Yin Shen. These all corroborate the meaning of this classic.

To Generate Blood and Qi: Danbo Yuanjian's note: The text above states: The Heart fills the blood vessels; it also states: The Lung is the root of Qi. Yet regarding the Liver, it says "to generate blood and qi," which is highly suspicious. Following the pattern of the preceding text, these four characters should be deleted, adhering to the *Tai Su*, and supplemented with "its color and flavor."

Sanjiao and Bladder: Danbo Yuanjian's note: The *Wu Zang Bie Lun* states: The Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder are generated by Heaven Qi. The *Ben Zang* chapter states: The Kidney combines with Sanjiao and Bladder; it also states: Those with dense skin and thick texture have thick Sanjiao and Bladder; those with coarse skin and thin texture have thin Sanjiao and Bladder. The scripture consistently discusses Sanjiao and Bladder together. Furthermore, the *Wu Xing Da Yi* discusses the Kidney and Mingmen, stating that since Sanjiao and Bladder are both water fu-organs, they may share a designation. Referencing this and the scripture, Sanjiao and Bladder are essentially one fu-organ. The *Ling Lan Mi Dian Lun* states: Sanjiao is the official of dredging, where water channels emerge; Bladder is the official of the capital reservoir, where fluids are stored. Generally, the function of conducting water channels is called Sanjiao, specifically referring to the Lower Jiao; the form of storing fluids is called Bladder. Here, "named vessel" refers to the Sanjiao with specific name and shape, differing from the Sanjiao described in the *Ling Shu* as like foam, like drain, like mist (consistent with the *Nan Jing - Chapter 31*). The Sanjiao traversed by the Hand-Shaoyang Meridian is different. There are three types of Sanjiao in the classics, detailed in Zhang Jingyue's *Zhi Yi Lu*; reference is advised. (Wang Sanyang also has a *Sanjiao Lun*, similar in intent to Zhang's, from the *Shanghan Gangmu*.)

The Abode of Ying: Zhang Jingyue's commentary: Ying (Nutritive) Qi is the essence of food and drink. Food and drink are stored in the six fu-organs, hence it is the abode of Ying. Danbo Yuanjian's note: The *Ling Shu - Ying Qi* chapter states: The way of Ying Qi treasures internal grain. Grain enters the Stomach, Qi transmits to the Lung, flows within, spreads outward. The purest part travels through the meridians, circulating endlessly. The *Bi Lun* states: Ying Qi is the essence of food and drink. The *Ying Wei Sheng Hui* chapter states: Ying Qi arises from the Middle Jiao; all convey this meaning.

Entering and Exiting: Li Zhongzi's commentary: The Stomach receives the five grains, called Entering; the Spleen, Small Intestine, Large Intestine, Sanjiao, and Bladder all govern Exiting.

Si Bai: Danbo Yuanjian's note: Li Gao states: Si Bai should be Si Hong; this is incorrect.

Four Times Excess Indicates Ge Yang: The *Ling Shu - Zhong Shi* and *Jin Fu* state: When the Renying pulse is four times excess, large and rapid, it is named Yi Yang (Overflowing Yang). Yi Yang leads to External Ge (Gridlock). (Wang Bing's correction aligns with the *Li Lun* and the *Ping Mai Fa* of the *Shanghan Lun*.)

Four Times Excess indicates Guan Yin: The *Zhong Shi* and *Jin Fu* state: When the Maikou pulse is four times excess, large and rapid, it is named Yi Yin (Overflowing Yin). Yi Yin leads to Internal Guan (Closure).

More Than Four Times Excess indicates Guan Ge: The *Zhong Shi* and *Jin Fu* state: When both Renying and Taiyin Maikou pulses are excess, more than four times, it is named Guan Ge. Those with Guan Ge have a short life expectancy. Zhang Jingyue's commentary: Both being four times excess means exceeding the normal pulse by four times. Things cannot be excessively abundant; extreme abundance leads to decay. Pulse excess reaching Guan Ge occurs because Yin and Yang are severed and cannot nourish each other, leading to emaciation and decay. (Originally from Wu Kun's note; various editions write "Ying" meaning fullness.) Ji means end. Jing Qi is heavenly endowment. It means failing to complete one's natural lifespan and dying young. The *Mai Du* chapter states: Pathogens in Fu organs cause Yang pulse disharmony; disharmony causes Qi stagnation; stagnation causes Yang Qi excess. Extreme Yang excess impedes Yin; Yin pulse impairment causes Blood stagnation; stagnation causes Yin Qi excess. Extreme Yin excess prevents Yang Qi from nourishing, hence Guan. Extreme Yang excess prevents Yin Qi from nourishing, hence Ge. When both Yin and Yang are excess and cannot nourish each other, it is Guan Ge. Those with Guan Ge die before their time. Many people suffer from this;历代 physicians have propagated errors. Guan Ge refers to the condition of Yin-Yang blockage and separation, failure of mutual operation, and decline. Thus, isolated Renying excess indicates disease in the three Yang Fu organs; isolated Cunkou excess indicates disease in the three Yin Zang organs. Whether appearing at Renying or Cunkou, it is a sign of lone Yang rebellion and true Yin exhaustion. Without Yin, there is no root, and lone Yang floats externally. Such cases are invariably fatal, caused by damage to essence from alcohol and sexual indulgence. Since Renying is on the head and belongs to the Yangming exterior pulse, double enlargement is called Ge Yang. Cunkou is on the hand and belongs to the Taiyin interior pulse, so double enlargement is called Guan Yin. Yin and Yang reach extremes, resisting and blocking each other, hence Guan Ge. This cannot be changed. If in the Chi position, it is Guan; if in the Cun position, it is Ge. (The *Nan Jing - Ping Mai Fa*, Li Gao, Zhu Zhenheng, and previous commentators all hold this view.) Guan means inability to urinate; Ge means vomiting and reversal. (Zhu Danxi's *Zuan Yao* establishes a Guan Ge section as a disease name.) This specifically refers to dysphagia and strangury, not this context. Danbo Yuanjian's note: Guan Ge generally refers to the condition of Yin-Yang blockage between interior and exterior. Zhang Jingyue follows Ma Shi's note and expands upon it, making it clearer. However, the *Mai Yao Jing Wei Lun* states: When Yin and Yang do not correspond, the disease is named Guan Ge. Sima Qian's *Shiji* records Cang Gong saying: Cutting the pulse, Liver Qi is turbid and quiet, this is an Internal Guan disease. Thus, calling Guan Ge a pulse pattern rather than a disease name—is this acceptable? (Zhang Jingyue's *Yi Tong* establishes a Guan Ge section, detailing the errors of Ma and Zhang, which should be referenced.)

Unable to Reach the Extremes of Heaven and Earth's Jing Qi: Hua Shou's commentary: Exceeding the mean. Ji means the mean. Insufficiency does not constitute the mean; excess does not constitute the mean. Danbo Yuanjian's note: This interpretation is too aberrant.