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[Ping An]: This section, from the beginning of the chapter to "thus life ends in middle age," is found in Volume 8, Chapter 54, "Tian Nian" (Heavenly Years) of *Ling Shu* (Spiritual Pivot). From "Huang Di said: The flourishing and declining of its Qi..." to the end, it is found in Volume 6, Chapter 12 of *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion). From "Huang Di asked Qi Bo: When a person grows old and has no children..." to the end, it is found in Volume 1, Chapter 1, "Shang Gu Tian Zhen Lun" (Discourse on the Heavenly Truth of Ancient Times) of *Su Wen* (Basic Questions).

Huang Di said: The premature death and longevity of people vary; some die young, some live long, some die suddenly, and some suffer from chronic illness. I wish to hear the principles behind this. (The question contains four aspects: premature death, longevity, sudden death, and chronic illness. Ping An: In *Ling Shu*, it reads "the longevity and premature death of people," and "some die young or live long" as "some die young or live long.")

Qi Bo said: (In the answer, the reasons for obtaining longevity are primarily explained, while the other three conditions are briefly mentioned. There are nine manifestations for obtaining longevity:) The five Zang organs are solid and firm, (referring to the physical form of the five Zang organs, being solid without deficiency and stable without change; this is the first reason for longevity.) The blood vessels are harmonious and regulated, (meaning the blood is always harmonious and the meridians are always smooth; this is the second reason for longevity.) The muscles are loose and unobstructed, (referring to the superficial muscles, each having distinct separation and lubrication; this is the third reason for longevity. Ping An: The character "rou" (muscle) above in the annotation is likely a typo for "nei" (internal).) The skin is dense and tight, (Dense, pronounced 'da li'. Refers to the pores being closed tightly and the flesh being compact; this is the fourth reason for longevity.) The movement of Ying (Nutritive) and Wei (Defensive) Qi does not deviate from its norm, (meaning Ying and Wei Qi, within one day and night, each follow their respective paths, circulating fifty cycles to protect the body without error; this is the fifth reason for longevity.) Breathing is gentle and slow, (referring to inhalation and exhalation, slightly not coarse and slowly not rapid; this is the sixth reason for longevity.) Qi moves according to measure, (between breaths, Qi moves six cun, following degrees, over a hundred ke in day and night; this is the seventh reason for longevity.) The six Fu organs transform grain, (the Stomach receives the five grains, the Small Intestine holds them, the Large Intestine conducts them, the Gallbladder serves as the center of essence and judgment, the San Jiao (Triple Burner) manages drainage, and the Bladder governs fluids, jointly transforming the five grains to nourish the body; this is the eighth reason for longevity.) Body fluids are distributed and spread, (such as tears, sweat, saliva, nasal mucus, and spit, spreading through various orifices; this is the ninth reason for longevity. Ping An: In the annotation, 'Yuan Ke' originally wrote 'ye' instead of 'xian'.) Each adhering to its norm, thus enabling longevity. (The above nine matters of nourishing the body, each without error, maintaining constancy without cessation, thus allowing for a long life and prolonged vision. Ping An: "Jiu chang" (long life) in *Ling Shu* is written as "chang jiu".)

Huang Di said: For those who live to a hundred years before dying, what leads to this? (Asking about the cause of obtaining longevity.)

Qi Bo said: The Shi Dao (nose passage) is deep and long, (indicating four factors contributing to longevity: Shi Dao refers to the nasal cavity through which air passes; being deep and long means exhalation is not obstructed, which is the first factor for longevity.) The Ji Qiang (base wall, referring to facial features around the nose) is high and square, (the Ming Tang (bright hall/nose area) has a base wall that is high, large, and square, which is the second factor for longevity.) The Ying and Wei Qi are smoothly regulated, along with the San Bu (three regions) and San Li (three miles/acupoints), (San Bu refers to the regions of the San Jiao. San Li refers to the acupoint below the knee, belonging to the Stomach meridian. Both the San Jiao and San Li are smoothly regulated, which is the third factor for longevity.) The Qi Gu (prominent bones) are high and the flesh is full, leading to a lifespan of a hundred years. (Qi Gu refers to the bones of the Ming Tang. If the bones of the Ming Tang are high and substantial with full flesh, then bone and flesh are solid, which is the fourth factor for longevity. Due to these four factors, one can reach the end of a hundred years.)

Huang Di said: What about those who cannot complete their natural lifespan and die? (Asking about premature death. Ping An: In *Ling Shu*, the section from "Huang Di said: Those who cannot complete their lifespan and die..." to "...thus life ends in middle age" appears after the phrase "the corporeal shell remains alone." )

Qi Bo said: Their five Zang organs are all not solid, (premature death also has four aspects: the five Zang organs are all deficient, making them susceptible to pathogenic invasion, which is the first aspect of premature death.) The Shi Dao is not long, the nostrils are wide and flared, and breathing is violent and rapid, (the Shi Dao is short, the nasal cavity is large, leading to excessive loss of Qi, which is the second aspect of premature death. Ping An: "Bu chang" (not long) is written as "bu tong" (not open) in Yuan and Ke editions; corrected based on the original manuscript, *Ling Shu* also writes "bu chang".) Furthermore, the Ji Qiang is low, (the Ming Tang of the nose has a low base wall, which is the third aspect of premature death.) The pulses are thin with little blood, the flesh is not firm, frequently contracting wind-stroke, blood and Qi are blocked, true Qi and evil Qi attack each other, causing chaos and mutual entanglement, (thin pulses and little blood, empty skin and flesh, often contracting external pathogens, blood and Qi stagnation, true Qi and evil Qi clashing, disturbing and drawing in the true Qi, which is the fourth aspect of premature death. Ping An: In *Ling Shu*, "bu shi" (not firm) is written as "bu shi" (not stone-like), and "zhong feng" (wind-stroke) as "zhong feng han" (contracting wind-cold).) Thus, life ends in middle age.

Huang Di said: Excellent. (Huang Di praised and elaborated upon hearing the causes of premature death and longevity. Ping An: "Gu zhong nian er shou jin yi" in *Ling Shu* is written as "gu zhong shou er jin ye".)

Huang Di said: May I ask about the flourishing and declining of Qi, up to death? (Fluctuation and fullness/emptiness are the constant laws of transformation of things; thus, human Qi declines and changes constantly until reaching death, with different forms, so please explain.)

Qi Bo said: At ten years of age, the five Zang organs begin to stabilize, blood and Qi are already flowing, and Qi is located lower down, so they like to run. At twenty years of age, blood and Qi begin to flourish, muscles are just growing, so they like to walk briskly. At thirty years of age, the five Zang organs are greatly stabilized, muscles are firm, and blood vessels are full, so they like to walk steadily. At forty years of age, the five Zang organs, six Fu organs, and twelve regular meridians are all greatly flourishing and stable, but the Cou Li (pores/cutaneous spaces) begin to become sparse, glory fades, hair and temples turn gray, stability does not shake, so they like to sit. (Ping An: In *Jia Yi Jing*, "ren sheng" is written as "ren nian", "shi shu" as "shi kai", "tui luo" as "bo luo", and "fa bin" as "bin fa". In *Ling Shu*, "bin" is written as "po", and "ban" as "ban". Also note: In the original manuscript, next to "ping sheng bu yao", there are six characters "pi bi bei fan da ye" meaning 'large', suggesting "ping sheng" should be "pi sheng"; other versions write "pi".) At fifty years of age, Liver Qi begins to decline, liver leaves begin to thin, bile begins to decrease, and eyes begin to see poorly. At sixty years of age, Heart Qi begins to decline, prone to sorrow and grief, blood and Qi become slack and lazy, so they like to lie down. At seventy years of age, Spleen Qi is deficient, and skin becomes dry. At eighty years of age, Lung Qi declines, Po (Corporeal Soul) scatters, and because Po scatters, speech tends to err. At ninety years of age, Kidney Qi dries up, organs wither, and meridians become empty. At one hundred years of age, all five Zang organs are deficient, Shen (Spirit) and Qi have departed, and only the corporeal shell remains to finish its course. (Liver corresponds to Wood, Heart to Fire, Spleen to Earth, Lung to Metal, and Kidney to Water; this is the sequence of mutual generation among the Five Elements, hence Liver declines first, followed sequentially to Kidney. Upon reaching one hundred, the five Zang organs are deficient and damaged, the five spirits depart, the withered corpse remains alone, which is called death. Ping An: "Shi jian" in *Ling Shu* is written as "shi mie". "Xi you bei" in *Ling Shu* is written as "ku you bei", and in *Jia Yi Jing* as "nai shan you bei". Also in *Jia Yi Jing*, "duo" is written as "duo", and "pi fu ku" as "pi fu shi ku gu si zhi bu ju". The two characters "po li" do not repeat in *Ling Shu*; *Jia Yi Jing* writes "hun li po san". "Xi wu" in both *Ling Shu* and *Jia Yi Jing* is written as "shan wu". "Zang ku" in *Jia Yi Jing* is written as "zang wei ku"; in *Ling Shu*, there are four characters above "zang" and no "ku" below. Also, *Jia Yi Jing* adds "zhi" before "bai sui" and "jin" after "zhong".)

Huang Di asked Qi Bo: When a person grows old and has no offspring, is it because their vital energy is exhausted? Or is it determined by Heaven's number? (Cai Li refers to the power of nurturing and preservation. Tian Shu refers to the number of destiny/heaven. Ping An: *Jia Yi Jing* lacks this section and the subsequent "Qi Bo said".)

Qi Bo said: At seven years of age, a girl's Kidney Qi flourishes, teeth change, and hair grows. (Kidney governs bones and hair; thus, when Kidney Qi flourishes, teeth change and hair grows. Ping An: "Geng chi" in *Su Wen* and *Jia Yi Jing* is written as "chi geng".) At fourteen years (two sevens), Tian Gui arrives, the Ren Mai (Conception Vessel) opens, the Fu Chong Mai (Hidden Chong Vessel) flourishes, menstruation comes at the proper time, and thus she can bear children. (Tian Gui refers to essential essence. The Ren and Chong vessels originate from the Bao Zhong (uterus/lower extremity); now that Tian Gui has arrived, the Ren Mai opens. The Fu Chong vessel originates from Qi Chuan; combined with the arrival of Tian Gui, the Chong vessel flourishes. These two vessels jointly nourish the Bao Zhong, hence menstruation occurs and conception is possible. Ping An: "Tian Gui" in *Jia Yi Jing* is written as "Tian Shui", same below. "Fu Chong" in *Su Wen* is written as "Tai Chong"; Xin Zheng Xiao notes: *Tai Su* writes "Fu Chong", same below. This matches exactly.) At twenty-one years (three sevens), Kidney Qi is balanced, so wisdom teeth grow and height reaches its limit. (Zhen Ya refers to back teeth. Chang Ji refers to body growth.) At twenty-eight years (four sevens), sinews and bones are strong, hair reaches its limit, and the body is robust. (Sinews, bones, body, and hair of the person are all at their peak.) At thirty-five years (five sevens), the Yang Ming Meridian declines, the face begins to wither, and hair begins to fall. (The Yang Ming Meridian starts at the face and runs through the head; thus, when Yang Ming declines, the face and hair begin to wither and fall. Ping An: "Shi jiao" in *Jia Yi Jing* is written as "jie jiao", "duo" as "bai", and in *Su Wen* as "duo".) At forty-two years (six sevens), the Three Yang Meridians decline upwards, the face completely withers, and hair turns white. (Three Yang refers to Tai Yang, Shao Yang, and Yang Ming. The Three Yang meridians are all in the head; thus, when they decline, the face withers and hair turns white. Ping An: "Fa bai" in *Su Wen* is written as "fa shi bai". *Jia Yi Jing* lacks this section.) At forty-nine years (seven sevens), the Ren Mai is deficient, the Fu Chong declines and becomes scarce, Tian Gui is exhausted, the earthly pathway (menstruation) is blocked, thus the form deteriorates and she cannot bear children. (Qi and blood of the Ren and Chong vessels are both scarce, essence is exhausted, Zi Men (subdoor/cervix) closes, and the uterus deteriorates, hence no children. Ping An: "Fu Chong shuai shao" in *Su Wen* and *Jia Yi Jing* is written as "Tai Chong Mai shuai shao".)

At eight years of age, a boy's Kidney Qi becomes substantial, hair grows, and teeth change. At sixteen years (two eights), Kidney Qi flourishes, Tian Gui arrives, essence overflows and is discharged, Yin and Yang harmonize, and thus he can have children. At twenty-four years (three eights), Kidney Qi is balanced, sinews and bones are strong and powerful, so wisdom teeth grow and height reaches its limit. At thirty-two years (four eights), sinews and bones are prominent and vigorous, muscles are full. At forty years (five eights), Kidney Qi declines, hair falls, and teeth wither. At forty-eight years (six eights), Yang Qi declines upwards, the face withers, and hair and temples turn gray. At fifty-six years (seven eights), Liver Qi declines, sinews cannot move, Tian Gui is exhausted, essence is scant, Kidney organ declines, and the entire body reaches its extreme. At sixty-four years (eight eights), teeth and hair fall out. (Withered teeth indicate bone decline first, flesh not attaching, causing teeth to wither. Ping An: Written version *Jia Yi Jing* writes "xie", same below. "Ji rou man" in *Su Wen* and *Jia Yi Jing* is written as "ji rou man zhuang". "Yang qi shuai yu shang" in *Su Wen* is written as "yang qi shuai jie yu shang". "Shen zang shuai" in *Jia Yi Jing* is written as "shen qi shuai".) The Kidney generates water and receives the essence of the five Zang and six Fu organs to store it; thus, only when the five Zang organs are flourishing can essence be discharged. Now that all five Zang organs are declining, (Ping An: *Su Wen* and *Jia Yi Jing* write "shui sheng" as "zhu shui", and "nai xie" as "nai neng xie". The following text is supplemented based on *Su Wen: Shang Gu Tian Zhen Lun* and *Jia Yi Jing: Xing Qi Sheng Shuai Da Lun*.) sinews and bones become lax and weak, Tian Gui is exhausted, thus hair and temples turn white, the body feels heavy, walking posture is unsteady, and there are no children.