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The nose is the external orifice of the Lung, the eyes are the external orifice of the Liver, the lips and mouth are the external orifice of the Spleen, the tongue is the external orifice of the Heart, and the ears are the external orifice of the Kidney. These five orifices are used to observe the condition of the five Zang organs. In cases of Lung disease, there is panting and flaring of the nostrils; in cases of Liver disease, the area around the eyes turns greenish; in cases of Spleen disease, the lips turn yellow; in cases of Heart disease, the tongue curls and the malar region becomes red; in cases of Kidney disease, the malar region and the face turn black. Thus, Lung Qi connects with the nose; when the nose is harmonious, one can distinguish odors. Heart Qi connects with the tongue; when the tongue is harmonious, one can distinguish the five flavors. The *Su Wen* states: "The Heart opens into the ear" (another version says the tongue). Since the Heart belongs to Fire and the Kidney to Water, they achieve mutual interaction (Water-Fire Ji Ji). Heart Qi connects with the tongue, but the tongue is not traditionally considered a "orifice"; its function of connecting to an orifice is entrusted to the ear (Wang Bing notes that the collateral of the Hand-Shaoyin Heart meridian converges in the ear). Thus, Liver Qi connects with the eyes; when the eyes are harmonious, one can see the five colors. The *Su Wen* states: "All meridians belong to the eyes." Furthermore, the *Jiu Juan* (i.e., *Ling Shu*) states: "The Heart stores Shen (Spirit), and the Lung houses Shen." Shen permeates the whole body, hence it is said to belong to the eyes. Spleen Qi connects with the mouth; when the mouth is harmonious, one can distinguish the flavors of the five grains. Kidney Qi connects with the ears; when the ears are harmonious, one can hear the five tones.

The *Su Wen* states: "The Kidney opens into the ears." Therefore, Kidney Qi connects upward to the ears and downward to the genitalia. If the five Zang organs are not harmonious, the nine orifices will be blocked. If the six Fu organs are not harmonious, stagnation and accumulation will form abscesses. Thus, if pathogenic factors are in the Fu organs, the Yang meridians are disharmonious; disharmony of the Yang meridians leads to Qi stagnation, and Qi stagnation results in excess Yang Qi. If pathogenic factors are in the Zang organs, the Yin meridians are disharmonious; disharmony of the Yin meridians leads to Blood stagnation, and Blood stagnation results in excess Yin Qi. When Yin Qi is excessively strong, Yang Qi cannot interact with it harmoniously, which is called "Ge" (blocking/rejection). When both Yin and Yang are excessive and cannot interact harmoniously, it is called "Guan Ge" (closing and blocking). Those suffering from Guan Ge will die before their natural lifespan expires.

Yellow Emperor asked: "All humans receive Qi from Heaven. Why do some enjoy a full natural lifespan while others inevitably fall ill?" Qibo replied: "The five Zang organs naturally vary in size, position (high/low), firmness, and alignment (straight/oblique). The six Fu organs also vary in size, length, thickness, structure (tied/straight), and tension (tight/loose). These twenty-five variations differ from person to person, being either favorable or unfavorable, auspicious or inauspicious."

A small Heart is stable and resistant to external pathogens but susceptible to worry; a large Heart is resistant to worry but susceptible to external pathogens; a high-positioned Heart compresses the Lungs, causing chest stuffiness, forgetfulness, and difficulty in verbal communication; a low-positioned Heart exposes the organ, making it susceptible to Cold and fear induced by speech; a firm Heart ensures stability and security; a fragile Heart is prone to Xiao Dan (wasting-thirst) and internal heat; a properly aligned Heart is harmonious and difficult to injure; an obliquely positioned Heart lacks consistency and resolve. (Yang Shangshan notes: The Heart is described with eight variations of Shen, while the other four Zang organs only describe physical variations because Shen is the master of Hun, Po, Yi, etc.; describing Shen's variations implies the state of the other organs, so it is omitted.)

A small Lung drinks little water and does not suffer from asthma; a large Lung drinks much water and is prone to Xiong Bi (chest bi-syndrome) and rebellious Qi; a high-positioned Lung causes rebellious Qi, panting, and cough; a low-positioned Lung compresses the贲门 (cardia) and presses on the Lung, causing hypochondriac pain; a firm Lung does not suffer from cough and rebellious Qi; a fragile Lung is prone to Xiao Dan and susceptibility to pathogens (another version adds susceptibility to Heat, panting, and epistaxis); a properly aligned Lung is harmonious and difficult to injure; an obliquely positioned Lung causes unilateral chest and hypochondriac pain.

A small Liver is stable and free from hypochondriac disease; a large Liver compresses the Stomach and pharynx, causing dysphagia and hypochondriac pain; a high-positioned Liver supports upwards against the cardia, causing tightness in the hypochondrium and Xi Ben syndrome; a low-positioned Liver compresses the Stomach, leaving the hypochondrium empty and susceptible to pathogens; a firm Liver is stable and hard to injure; a fragile Liver is prone to Xiao Dan and susceptibility to pathogens; a properly aligned Liver is harmonious and difficult to injure; an obliquely positioned Liver causes unilateral hypochondriac pain.

A small Spleen is stable and resistant to pathogens; a large Spleen causes dense interstices with pain and inability to walk quickly; a high-positioned Spleen pulls on the costal margin causing pain; a low-positioned Spleen presses on the Large Intestine, exposing the organ and making it susceptible to pathogens; a firm Spleen is stable and hard to injure; a fragile Spleen is prone to Xiao Dan and susceptibility to pathogens; a properly aligned Spleen is harmonious and difficult to injure; an obliquely positioned Spleen causes convulsions and distension.

A small Kidney is stable and resistant to injury; a large Kidney is prone to lower back pain, inability to bend or twist, and susceptibility to pathogens (another version mentions deafness, tinnitus, and sweating); a high-positioned Kidney causes lower back and spine pain, inability to bend or twist (another version mentions back stiffness, purulent otorrhea, or flesh growth); a low-positioned Kidney causes buttock pain, inability to bend or twist, and Hu Shan hernia; a firm Kidney does not suffer from lower back pain; a fragile Kidney is prone to Xiao Dan and susceptibility to pathogens; a properly aligned Kidney is harmonious and difficult to injure; an obliquely positioned Kidney is prone to lower back and buttock pain. These twenty-five variations explain why people are either healthy or prone to disease.

Question: How do we know this? Answer: Red complexion with fine texture indicates a small Heart; coarse texture indicates a large Heart; no depression indicates a high Heart; short and raised indicates a low Heart; elongated indicates a firm Heart; small, weak, and thin indicates a fragile Heart; straight and downward without protrusion indicates a properly aligned Heart; asymmetrical indicates an oblique Heart.

White complexion with fine texture indicates a small Lung; coarse texture indicates a large Lung; broad shoulders, reversed chest, and depressed larynx indicate a high Lung; closed axillae and spread ribs indicate a low Lung; thick shoulders and back indicate a firm Lung; thin shoulders and back indicate a fragile Lung; thick back and chest indicate a properly aligned Lung; crooked chest indicates an oblique Lung.

Green complexion with fine texture indicates a small Liver; coarse texture indicates a large Liver; broad chest and reversed ribs indicate a high Liver; contracted ribs and fragile ribs indicate a low Liver; good chest and rib shape indicate a firm Liver; weak rib bones indicate a fragile Liver; well-proportioned chest, ribs, and abdomen indicate a properly aligned Liver; elevated unilateral rib bones indicate an oblique Liver.

Yellow complexion with fine texture indicates a small Spleen; coarse texture indicates a large Spleen; upturned lips indicate a high Spleen; drooping lips indicate a low Spleen; firm lips indicate a firm Spleen; large but soft lips indicate a fragile Spleen; well-formed upper and lower lips indicate a properly aligned Spleen; unilateral elevated lip indicates an oblique Spleen.

Black complexion with fine texture indicates a small Kidney; coarse texture indicates a large Kidney; high ears indicate a high Kidney; depressed behind ears indicate a low Kidney; firm ears indicate a firm Kidney; thin and non-firm ears indicate a fragile Kidney; well-shaped ears positioned forward near the jaw indicate a properly aligned Kidney; high-set ears indicate an oblique Kidney. Maintaining these structures ensures health; diminishing them leads to disease.

Question: I wish to hear about those who do not get sick, live out their natural years, and remain unaffected by deep sorrow, great fear, extreme cold, or intense heat. And why do some who stay indoors without fear still fall ill? Answer: The five Zang and six Fu organs are abodes for pathogens. Those with small Zang organs rarely get sick but are prone to anxiety and worry. Those with large Zang organs are slow in affairs and hard to worry. Those with high Zang organs aspire to lofty actions. Those with low Zang organs prefer to submit to others. Those with firm Zang organs have no disease. Those with fragile Zang organs are constantly ill. Those with properly aligned Zang organs are harmonious and popular. Those with oblique Zang organs harbor evil thoughts, steal, are untrustworthy, and speak inconsistently.

Question: I wish to hear about the correspondences of the six Fu organs. Answer: The Lung combines with the Large Intestine; the Large Intestine corresponds to the skin. The *Su Wen* states: "The Lung combines with the skin, its flourishing aspect is in the hair, and it is controlled by the Heart." The next chapter stating the Kidney corresponds to hair is erroneous in meaning.

The Heart combines with the Small Intestine; the Small Intestine corresponds to the vessels. The *Su Wen* states: "The Heart combines with the vessels, its flourishing aspect is in the complexion, and it is controlled by the Kidney." This is consistent.

The Liver combines with the Gallbladder; the Gallbladder corresponds to the sinews. The *Su Wen* states: "The Liver combines with the sinews, its flourishing aspect is in the nails, and it is controlled by the Lung." This is consistent.

The Spleen combines with the Stomach; the Stomach corresponds to the muscles. The *Su Wen* states: "The Spleen combines with the muscles, its flourishing aspect is in the lips, and it is controlled by the Liver." This is consistent.

The Kidney combines with the San Jiao and Bladder; the San Jiao and Bladder correspond to the interstices and hair. The *Jiu Juan* also states: "The Kidney combines with the bones." The *Su Wen* states: "The Kidney combines with the bones, its flourishing aspect is in the hair, and it is controlled by the Spleen." This is identical in meaning.

Question: How are these correspondences manifested? Answer: The Lung corresponds 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 loose and long Large Intestine; tight skin indicates a tight 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 skin indicates thick vessels, which indicate a thick Small Intestine; thin skin indicates thin vessels, which indicate a thin Small Intestine; loose skin indicates loose vessels, which indicate a large and long Small Intestine; thin skin with small, faint pulses indicates a small and short Small Intestine; many tortuous Yang meridians indicate a knotted Small Intestine.

The Spleen corresponds to the muscles. Firm and large muscles indicate a thick Stomach; small muscles indicate a thin Stomach; small and weak muscles indicate an insecure Stomach; muscles disproportionate to the body indicate a low Stomach, where the lower Wan (lower orifice) is constrained (*Tai Su* reads "lower Wan not yet constrained"); non-firm muscles indicate a loose Stomach; muscles lacking small nodular tightness indicate a tense Stomach; muscles with many small nodules indicate a knotted Stomach, where the upper Wan (upper orifice) is constrained.

The Liver corresponds to the sinews. Thick, yellow nails indicate a thick Gallbladder; thin, red nails indicate a thin Gallbladder; firm, blue-green nails indicate a tense Gallbladder; soft, red nails indicate a loose Gallbladder; straight, white nails without constraint indicate a straight Gallbladder; ugly, black nails with many markings indicate a knotted Gallbladder.

The Kidney corresponds to the bones. Fine texture and thick skin indicate a thick San Jiao and Bladder; coarse texture and thin skin indicate a thin San Jiao and Bladder; loose interstices indicate a loose San Jiao and Bladder; tight skin without hair indicates a tense San Jiao and Bladder; beautiful and coarse hair indicates a straight San Jiao and Bladder; sparse hair indicates a knotted San Jiao and Bladder.

Question: Regardless of thickness or beauty, all have corresponding forms. I wish to hear about the diseases they cause. Answer: By observing external signs to infer the internal state of the five Zang organs, one can know the potential diseases.