六十一难曰。经言望而知之谓之神。闻而知之谓之圣。问而知之谓之工。切脉而知之谓之巧。何谓也。然。望而知
之者望见其五色以知其病。
杨曰。望色者、假令肝部见青色者。肝自病。见赤色者。心乘肝。肝亦病。故见五色知五病也。
闻而知之者。闻其五音以别其病。
杨曰。五音者、谓宫、商、角、征、羽也。以配五脏。假令病患好哭者。肺病也。好歌者。脾病也。故云闻其音知
其病也。
问而知之者。问其所欲五味。以知其病所起所在也。
杨曰。问病患云好辛味者。则知肺病也。好食冷者。则知内热。故云知所起所在。
切脉而知之者。诊其寸口。视其虚实。以知其病。病在何脏腑也。
丁曰。视当作持字。为以手循持其寸口也。杨曰。切、按也。谓按寸口之脉。若弦多者。肝病也。洪多者。心病也。
浮数则病在腑。沉细则病在脏。故云在何脏也。（按脏下似脱腑字。）
经言以外知之曰圣。以内知之曰神。此之谓也。
丁曰。夫脉合五色。色合五味。味合五音。故有此望闻问切之法。经内前篇具说。习之者能知此。乃是神圣工巧之
良医也。杨曰。视色听声、切脉。皆在外而知内之病也。
六十二难曰。脏井荥有五。腑独有六者。何谓也。然。腑者阳也。三焦行于诸阳。故置一俞名曰原。腑有六者。亦
与三焦共一气也。
丁曰。三焦者、臣使之官。位应相火。宣行君火命令。使行于诸阳经中。见置一俞名曰原。所以腑有六。亦是三焦
之一气。故三焦共一气也。杨曰。五脏之脉。皆以所出为井。所流为荥。所注为俞。所行为经。所入为合。是谓五俞。
以应金木水火土也。六腑亦并以所出为井。所流为荥。所注为俞。所过为原。所行为经。所入为合。其俞亦应五行。惟
原独不应五行。原者、元也。元气者、三焦之气也。其气尊大。故不应五行。所以六腑有六俞。亦以应六合于干道也。
然五脏亦有原。则以第三穴为原。所以不别立穴者。五脏法地。地卑。故三焦之气经过而已。所以无别穴。六腑既是阳。
三焦亦是阳。故云共一气也。虞曰。天以六气司下。地以五行奉上。六气者、风寒暑燥湿火也。五行者、金木水火土也。
十一之气相因而成。人应之。乃六腑法六气。五脏法五行。亦十一之气相因而成也。天得六。谓天属阳。以阴数配之。
地得五。谓地属阴。以阳数配之。而成阴阳也。人腑脏亦然。六腑配六气者。谓胆木配风。膀胱水配寒。小肠火配暑。
大肠金配燥。胃土配湿。三焦少阳配火。三焦为原气。在六腑阳脉中。自立一为原也。五脏配五行者。肝木。心火。脾
土。肺金。肾水。五脏法阴无原。一穴者。谓五行阴脉穴中原气暗主之。故原并俞同一穴也。（按五脏以俞为原。此井字
疑衍。）故曰。三焦共一气。其理明矣。详此经义前后问答。文理有阙。
六十三难曰。十变言五脏六腑荥合。皆以井为始者。何也。然。井者、东方春也。
虞曰。经言井者、东方春也。春者、施化育无求其报。春者、仁也。在五常。仁乃法水。水之有仁者。井水也。井
水济人亦无求报。故经云。井者、东方春也。易曰。井养而不穷。可象春仁也。
万物之始生。
虞曰。万物始生。由春气之化育也。
诸 行喘息。 飞蠕动。当生之物。莫不以春而生。
虞曰。井有仁焉。故圣人涉春育物以象于井也。夫葭灰方飞。蛰虫始振。所以 虫行。喘虫息。 虫飞。蠕虫动。
皆因春气而生故也。 乃井中虫。
故岁数始于春。
虞曰。春木也。下文甲亦木。井有仁。仁亦木也。今以井为始者。谓仁道至大。在岁春为首。在日甲为首。在经脉
井为首故也。
日数始于甲。故以井为始也。
杨曰。凡脏腑皆以井为始。井者、谓谷井尔。非谓掘作之井。山谷之中。泉水初出之处。名之曰井。井者、主出之
义也。泉水既生。留停于近。萦迂未成大流。故名之曰荥。荥者、小水之状也。留停既深。便有注射输文之处。故名之
曰俞。俞者、委积逐流行。经历而成渠径。经者、径也。亦经营之义也。经行既达。合会于海。故名之曰合。合者、会
也。此是水行流转之义。人之经脉。亦法于此。故取名焉。所以井为始春者。以其所生之义也。岁数始于春者、正月为
岁首故也。日数始于甲者、谓东方甲乙也。正月与甲乙。皆属于春也。
丁曰。十二经气穴三百六十五穴。皆以井为始。各有其终矣。
Difficulty 61 states: The classic texts say, "To know through observation is called 'Shen' (Divine); to know through listening and smelling is called 'Sheng' (Sage); to know through inquiry is called 'Gong' (Skillful); to know through palpation of the pulse is called 'Qiao' (Adroit)." What does this mean? The answer is: To know through observation means observing the five colors of the face to ascertain the disease.
Master Yang says: When inspecting facial colors, if a bluish color appears in the Liver area, it indicates a primary disease of the Liver; if a reddish color appears, it indicates the Heart overcoming the Liver (Heart Fire insulting Liver Wood), meaning the Liver is also diseased. Thus, by observing the five colors, one can know the five diseases.
To know through listening and smelling means distinguishing the disease by hearing the five tones.
Master Yang says: The five tones refer to Gong, Shang, Jue, Zhi, and Yu, which correspond to the five Zang organs. For example, if a patient tends to cry, it indicates a Lung disease; if they tend to sing, it indicates a Spleen disease. Hence, it is said that knowing the disease through sound.
To know through inquiry means asking about the patient's preference for the five flavors (sour, bitter, sweet, pungent, salty) to determine the origin and location of the disease.
Master Yang says: If the patient expresses a preference for pungent flavors, one knows it is a Lung disease; if they prefer cold food, one knows there is internal heat. Hence, it is said that one can know the origin and location.
To know through palpation of the pulse means examining the Cun Kou (Radial Pulse), observing its deficiency or excess, to ascertain the disease and which Zang-Fu organ is affected.
Master Ding says: The character "Shi" (observe/look at) should be read as "Chi" (hold/support), meaning to hold the Cun Kou pulse with the hand. Master Yang says: "Qie" (cut/palpate) means to press. It refers to pressing the Cun Kou pulse. If the Xian (Wiry) pulse predominates, it is a Liver disease; if the Hong (Surging) pulse predominates, it is a Heart disease. A Fu Shuo (Floating and Rapid) pulse indicates disease in the Fu organs; a Chen Xi (Deep and Fine) pulse indicates disease in the Zang organs. Hence, it is said that one can know which Zang organ is involved. (Note: It seems the character "Fu" is missing after "Zang".)
The classic texts state: "To know from the exterior is called 'Sheng'; to know from the interior is called 'Shen.' This is what is meant."
Master Ding says: The pulse corresponds to the five colors; the colors correspond to the five flavors; the flavors correspond to the five tones. Therefore, the methods of Observation, Listening/Smelling, Inquiry, and Palpation exist. These are fully explained in the previous chapters of the classics. Those who study them and understand these principles are excellent physicians possessing the skills of Shen, Sheng, Gong, and Qiao. Master Yang says: Observing colors, listening to sounds, and palpating pulses are all methods of knowing the interior disease from external signs.
Difficulty 62 states: The Jing-Well and Ying-Spring points of the Zang organs are five in number, but the Fu organs have six uniquely. What is the reason? The answer is: The Fu organs belong to Yang. The San Jiao (Triple Burner) Qi circulates among the Yang meridians, so an additional Yuan-Source point is established, named the Yuan point. The Fu organs have six points because they share one Qi with the San Jiao.
Master Ding says: The San Jiao is the official of the messenger, corresponding to Ministerial Fire, executing the commands of Sovereign Fire, causing Qi to circulate among the Yang meridians. The establishment of a point named Yuan explains why the Fu organs have six points; it is also due to the one Qi of the San Jiao, hence "sharing one Qi." Master Yang says: The meridians of the Five Zang organs take the exit point as Jing-Well, the flowing point as Ying-Spring, the pouring point as Shu-Stream, the passing point as Jing-River, and the entering point as He-Sea. These are called the Five Shu points, corresponding to Metal, Wood, Water, Fire, and Earth. The Six Fu organs similarly take the exit as Jing-Well, the flowing as Ying-Spring, the pouring as Shu-Stream, the passing as Yuan-Source, the passing-through as Jing-River, and the entering as He-Sea. Their points also correspond to the Five Elements, except the Yuan point, which does not directly correspond to the Five Elements. "Yuan" means "Yuan" (Original). Original Qi is the Qi of the San Jiao. This Qi is noble and grand, thus it does not correspond to the Five Elements. Therefore, the Fu organs have six Shu points, also corresponding to the Six Harmonies and the Way of Heaven. However, the Zang organs also have Yuan points, using the third point as the Yuan point. They do not establish separate points because the Zang organs emulate Earth, and Earth is low, so the Qi of the San Jiao merely passes through without a separate point. Since the Fu organs are Yang and the San Jiao is also Yang, it is said they share one Qi. Master Yu says: Heaven governs the lower with Six Qi, and Earth offers up the Five Elements. The Six Qi are Wind, Cold, Summer Heat, Dryness, Dampness, and Fire. The Five Elements are Metal, Wood, Water, Fire, and Earth. The eleven Qi interact to form existence, and humans respond to them. Thus, the Six Fu organs emulate the Six Qi, and the Five Zang organs emulate the Five Elements, formed by the interaction of the eleven Qi. Heaven obtains six, meaning Heaven belongs to Yang and pairs with Yin numbers; Earth obtains five, meaning Earth belongs to Yin and pairs with Yang numbers, thereby forming Yin and Yang. Human Zang-Fu are the same. The Six Fu organs pair with the Six Qi: Gallbladder Wood pairs with Wind, Bladder Water pairs with Cold, Small Intestine Fire pairs with Summer Heat, Large Intestine Metal pairs with Dryness, Stomach Earth pairs with Dampness, and San Jiao Shaoyang pairs with Fire. The San Jiao is Original Qi, and within the Yang meridians of the Six Fu organs, it establishes one point as the Yuan point. The Five Zang organs pair with the Five Elements: Liver Wood, Heart Fire, Spleen Earth, Lung Metal, Kidney Water. The Zang organs emulate Yin and have no independent Yuan point; the meaning of having one point is that the Original Qi within the Yin meridians of the Five Elements secretly governs it. Therefore, the Yuan point and Shu-Stream point occupy the same location. (Note: The Zang organs use the Shu-Stream point as the Yuan point; the character "Jing" here may be a scribal error.) Thus, it is said that the San Jiao shares one Qi, and the principle is clear. Examining the questions and answers before and after this passage, there are gaps in the text.
Difficulty 63 states: The "Ten Transformations" states that the Ying-Spring and He-Sea points of the Five Zang and Six Fu organs all begin with the Jing-Well point. Why? The answer is: The Jing-Well point corresponds to the East and Spring.
Master Yu says: The classic states that the Jing-Well point corresponds to the East and Spring. Spring represents bestowing transformation and nurturing without seeking reward. Spring represents Ren (Benevolence). Among the Five Constants, Ren emulates Water. Water that possesses Benevolence is Well Water. Well Water benefits people without seeking reward, hence the classic says: "The Jing-Well point corresponds to the East and Spring." The I Ching says: "The Well nourishes and never runs out," which can symbolize the Benevolence of Spring.
All things begin to grow.
Master Yu says: The beginning of all things grows due to the transformation and nurturing of Spring Qi.
All walking creatures breathing, flying insects, and all living beings that ought to exist, none do not arise through Spring.
Master Yu says: The Jing-Well contains Benevolence. Thus, the sage emulates the nurturing of things in Spring to symbolize the Jing-Well. When reed ash flies and hibernating insects begin to stir, the crawling insects move, the panting insects breathe, the flying insects soar, and the wriggling insects move; all are born due to Spring Qi. These are insects in the well.
Therefore, the count of years begins in Spring.
Master Yu says: Spring is Wood. The character "Jia" below is also Wood. The Jing-Well contains Benevolence, and Benevolence is also Wood. Now, taking the Jing-Well as the beginning means that the Way of Benevolence is great; it is first in the year (Spring), first in the day (Jia), and first in the meridians (Jing-Well).
The count of days begins with Jia, hence the Jing-Well is taken as the beginning.
Master Yang says: All Zang and Fu organs begin with the Jing-Well point. The Jing-Well refers to a valley spring, not a dug well. In the mountains, where spring water first emerges, it is called a Well. "Well" primarily signifies the meaning of "emerging." Once spring water is generated, it stays nearby, winding and not yet forming a large flow, so it is called the Ying-Spring point. "Ying" describes the shape of small water. After staying deep enough, there are places of pouring and transporting, so it is called the Shu-Stream point. "Shu" means accumulating and then flowing, forming channels through experience. "Jing" means path, and also implies management/circulation. When Jing Qi reaches its destination and converges into the sea, it is called the He-Sea point. "He" means convergence. This is the meaning of water flowing and circulating. Human meridians also emulate this, hence the names are derived. The reason Jing corresponds to Spring is due to its meaning of "generating." The count of years begins in Spring because the first month is the start of the year. The count of days begins with Jia, referring to the East Jia-Yi days. The first month and Jia-Yi days both belong to Spring.
Master Ding says: The acupoints of the Twelve Meridians, totaling three hundred and sixty-five, all begin with the Jing-Well point and each has its end.