逆走上也。此皆足太阳与少阴之津气为病。太阳之气。生于膀胱。少阳之气。发于肾脏。肾与
膀胱。雌雄相合。皆为水脏而为生气之原。膀胱之津水。随太阳之气。营运于肤表。以濡空窍。应
六气之旋转。肾脏之精气。贯通于五脏。应五运之神机。此皆不在六经阴阳逆顺之论。故帝辟左右而
问曰。愿闻口传。王芳侯曰。此篇论先后天之阴阳为病。
黄帝曰。余闻先师有所心藏。弗着于方。余愿闻而藏之。则而行之。上以治民。下以治身。使百
姓无病。上下和亲。德泽下流。子孙无忧。传于后世。无有终时。可得闻乎。岐伯曰。远乎哉问也。夫治
民与自治。治彼与治此。治大与治小。治国与治家。未有逆而能治之也。夫惟顺而已矣。顺者。非独阴
阳脉论气之逆顺也。百姓民众。皆欲顺其志也。黄帝曰。顺之奈何。岐伯曰。入国问俗。入家问讳。
上堂问礼。临病患问所便。
吴懋先曰。师传者。先知觉后知。先觉觉后觉。即夫子所谓明德新民之意。上以治国。下以治民。
治大治小治国治家。乃修身齐家治国平天下之道。顺、和也。气之逆顺者。阴阳寒暑之往来也。入国
问俗。入家问讳。上堂问礼。临病患问所便。即治国齐家治民之要。志者。心之所之也。骄恣纵欲。
恶死乐生。意之所发也。所谓欲治其身者。必先正心诚意。此上医医国之道也。
黄帝曰。便病患奈何。岐伯曰。夫中热消瘅则便寒。寒中之属则便热。胃中热则消谷。令人悬心
善饥。脐以上皮热。肠中热则出黄如糜。脐以下皮寒。胃中寒则腹胀。肠中寒则肠鸣飧泄。胃中寒。
肠中热。则胀而且泄。胃中热。肠中寒。则疾饥。小腹痛胀。
吴懋先曰。便者。所以更人之逆也。热者更之寒。寒者更之热也。热中寒中者。寒热之气。皆
由中而发。内而外也。脐以上皮热者。肠中热。脐以下皮寒者。胃中寒。寒热外内之相应也。
黄帝曰。胃欲寒饮。肠欲热饮。两者相逆。便之奈何。且夫王公大人。血食之君。骄恣纵欲轻
人。而无能禁之。禁之则逆其志。顺之则加其病。便之奈何。治之何先。岐伯曰。人之情。莫不恶
死而乐生。告之以其败。语之以其善。导之以其所便。开之以其所苦。虽有无道之人。恶有不听者乎。
吴懋先曰。寒热者。阴阳之气也。言上医者。具阿衡之材。能调燮其阴阳。尤能格君心之非也。
黄帝曰。治之奈何。岐伯曰。春夏先治其标。后治其本。秋冬先治其本。后治其标。
姚士因曰。本标者。内为本而外为标也。春夏之气。发越于外。故当先治其标。后治其本。秋
冬之气。收藏于内。故当先治其本。后治其标。知本末之先后。气可令调。为万民式。天之道毕矣。
黄帝曰。便其相逆者奈何。岐伯曰。便此者。饮食衣服。亦欲适寒温。寒无 怆。暑无出汗。饮
食者。热无灼灼。寒无沧沧。寒温中适。故气将持。乃不致邪僻也。（适叶的）
姚士因曰。此言饮食衣服。乃日用平常之事。所当适其和平。则阴阳之气。可以持平。不致邪
僻之所生也。便其相逆者。谓胃欲寒饮。肠欲热饮。两者相逆。便之奈何。夫胃中热。肠中寒。则胃
欲寒饮。肠欲热饮矣。如胃中寒。肠中热。则胃欲热饮。肠欲寒饮矣。此寒热之在内也。故饮食者。
热无灼灼。寒无沧沧。则在内之寒热可调
矣。四时之气。寒暑之在外也。时值凉寒。无使其 怆。时值暑热。无使其汗出。则在外之阴阳可
调矣。吴氏曰。通篇大义。在调和外内之阴阳。非阴阳脉论。乃论气之逆顺也。故曰寒温中适。故气
将持。乃不致邪僻也。谓天有寒暑。人有阴阳。我之阴阳既和。可以御天之寒暑。
黄帝曰。本脏以身形支节 肉候五脏六腑之小大焉。今夫王公大人。临朝即位之君而问焉。谁
可扪循之而后答乎。岐伯曰。身形支节者。脏腑之盖也。非面部之阅也。黄帝曰。五脏之气。阅于面
者。余已知之矣。以支节知而阅之奈何。岐伯曰。五脏六腑者。肺为之盖。巨肩陷咽。候见其外。
黄帝曰善。岐伯曰。五脏六腑。心为之主。缺盆为之道。 骨有余。以候 。黄帝曰善。岐伯曰。
肝者主为将。使之候外。欲知坚固。视目小大。黄帝曰善。岐伯曰。脾者主为卫使之迎粮。视唇舌
好恶以知吉凶。黄帝曰善。岐伯曰。肾者主为外。使之远听。视耳好恶。以知其性。
黄帝曰善。愿闻六腑之候。岐伯曰。六腑者。胃为之海。广骸大颈张胸。五谷乃容。鼻隧以长。
以候大肠。唇浓人中长。以候小肠。目下果大。其胆乃横。鼻孔在外。膀胱漏泄。鼻柱中央起。三焦
乃约。此所以候六腑者也。上下三等。脏安且良矣。（ 音括 音歇 音干）
此言望而知之者。斯可谓国士也。夫人生于地。悬命于天。天地合气。命之曰人。在天主气。
在地成形。此天之生命。所以立形定气。而视寿夭者。必明乎此。是以五脏之气见于色。脏腑之体
应乎形。既能阅于面而知五脏之气。又当阅其形以知脏腑之形。知气知形。斯可谓望知之神。
。胸骨也。肝乃将军之官。故主为将。脾乃转运之官。故主为卫。肾开窍于耳。故主为外。言其听
之远也。坚固者。五脏之有坚脆也。吉凶者。脏安则吉。
脏病则凶也。性者。五脏有端正偏倾之性也。鼻乃肺之窍。大肠者。肺之腑。故鼻以候大肠。口乃脾
之窍。小肠受盛脾胃之浊。而上属于胃。故唇与人中。以候小肠。目乃肝之窍。故目下以候胆。膀胱
者。津液之府。气化则出。鼻孔在外。谓鼻孔之气出在外。则膀胱漏泄。盖上窍通而下窍泄也。
三焦者。决渎之官。水道出焉。气约则止。不约则遗。鼻柱中央起者。谓鼻之吸气。从中央而起。
则三焦乃约。盖上气吸入则下约。上气呼出则下通。上下开阖之相应也。此言脏腑之形。外内相应者。
亦由气之所感也。上下三等。谓天地人三部之相等也。
The qi mechanism rebels and moves upward. These pathologies are all caused by disorders of the fluid and qi of the Foot-Taiyang (Bladder) and Foot-Shaoyin (Kidney) meridians. The Qi of Taiyang is generated in the Bladder; the Qi of Shaoyang (Note: Text says Shaoyang, but context implies Kidney/Origin of Qi) originates from the Kidney. The Kidney and Bladder combine like male and female, both being Water organs and the source of generating Qi. The fluids and water of the Bladder, following the Qi of Taiyang, circulate on the skin surface to moisten the orifices, responding to the rotation of the Six Qi. The essence and qi of the Kidney penetrate through the Five Zang organs, responding to the divine mechanisms of the Five Movements. These contents do not fall within the discussion of the reversal and smoothness of Yin and Yang in the Six Meridians. Therefore, the Yellow Emperor dismissed his attendants and asked: I wish to hear the oral transmission. Wang Fanghou stated: This chapter discusses diseases caused by disorders of pre-heaven and post-heaven Yin and Yang.
The Yellow Emperor said: I have heard that my former teachers had knowledge stored in their hearts, which was not recorded in medical formulas. I wish to hear it and preserve it, so that I may follow its principles and practice them. Above, I can govern the people; below, I can cultivate myself, ensuring the people are free from disease, harmony prevails between superiors and inferiors, virtue flows downwards, descendants are worry-free, and it is passed down to future generations without end. May I hear this? Qibo replied: Is your question not profound? To govern the people is like self-governance; to govern others is like governing oneself; to manage great matters is like managing small ones; to govern a state is like governing a family. There has never been a case where one could achieve governance by going against the natural order. Only by complying with it can one succeed. By "complying," we do not merely refer to the reversal and smoothness of Qi in Yin-Yang pulse theory. The common people all desire for their wills to be respected. The Yellow Emperor asked: How should one comply? Qibo replied: When entering a country, inquire about its customs; when entering a home, ask about its taboos; when ascending the hall, ask about its etiquette; when facing a patient, ask about what brings them comfort.
Wu Maoxian stated: "Teacher's Transmission" means that the enlightened enlighten the unenlightened, and those who perceive first help those who perceive later. This aligns with Confucius's concept of "illuminating illustrious virtue" and "renewing the people." Governing above and below, managing great and small matters, states and families, constitutes the Way of cultivating oneself, regulating the family, governing the state, and bringing peace to the world. "Compliance" implies "harmony." The reversal and smoothness of Qi refer to the coming and going of Yin-Yang and cold-heat. Inquiring about customs, taboos, and etiquette, and asking patients about their comfort, are the essentials of governing a state, family, and people. "Zhi" (Will) is where the heart directs itself. Arrogance, indulgence in desires, aversion to death, and love for life are the emanations of intention. As the saying goes, one who wishes to govern oneself must first rectify the mind and sincere the intentions. This is the Way of the Superior Physician governing the state.
The Yellow Emperor asked: How does one accommodate the patient's needs? Qibo replied: For internal heat leading to Xiao-Dao (wasting-thirst), cold methods are suitable. For conditions involving cold in the middle jiao, warm methods are suitable. Heat in the Stomach causes rapid digestion, making one feel empty-hearted and prone to hunger, with heat on the skin above the navel. Heat in the Intestines leads to yellow, porridge-like stools, with coldness on the skin below the navel. Cold in the Stomach causes abdominal distension. Cold in the Intestines causes borborygmus and undigested food in stool. If there is cold in the Stomach and heat in the Intestines, there will be both distension and diarrhea. If there is heat in the Stomach and cold in the Intestines, there will be urgent hunger and pain/distension in the lower abdomen.
Wu Maoxian stated: "Bian" (Accommodate/Comfort) is used to correct the rebellious Qi in humans. Heat is corrected with cold, and cold is corrected with heat. Zhong-Re (Heat in the Middle) and Zhong-Han (Cold in the Middle) arise because cold and heat Qi originate internally and manifest externally. Heat on the skin above the navel indicates heat in the Intestines; coldness on the skin below the navel indicates cold in the Stomach. This reflects the correspondence between internal and external cold and heat.
The Yellow Emperor said: The Stomach prefers cold drinks, while the Intestines prefer warm drinks. These two desires contradict each other. How should one accommodate this? Moreover, kings and nobles, rulers who consume meat and wine, are arrogant, indulge in desires, and despise others. They cannot be strictly prohibited from doing so. Prohibiting them would go against their wills, while accommodating them would worsen their conditions. How should one accommodate them? Where should treatment begin? Qibo replied: Human nature is such that no one dislikes death and loves life. Tell them of the disastrous consequences of violating health principles; speak to them of the benefits of adhering to them; guide them toward what is comfortable and convenient for them; open up avenues to relieve their suffering. Even if they are unruly individuals, how could they fail to listen?
Wu Maoxian stated: Cold and heat are the Qi of Yin and Yang. The term "Superior Physician" refers to someone with the talent of a prime minister, capable of harmonizing Yin and Yang, and especially able to correct the flaws in the ruler's mind.
The Yellow Emperor asked: How should one treat them? Qibo replied: In Spring and Summer, treat the Biao (Branch/Symptom) first, then the Ben (Root/Cause). In Autumn and Winter, treat the Ben first, then the Biao.
Yao Shiyin stated: Ben and Biao refer to the Internal as Ben and the External as Biao. The Qi of Spring and Summer diverges outward, so one should treat the Biao first and the Ben second. The Qi of Autumn and Winter stores inward, so one should treat the Ben first and the Biao second. Knowing the priority of root and branch allows the Qi to be regulated, serving as a model for the people, completing the Way of Heaven.
The Yellow Emperor asked: How does one accommodate these contradictory situations? Qibo replied: To accommodate such situations, diet and clothing must also adapt to cold and warmth. In cold weather, do not let yourself feel chilled; in summer heat, do not let yourself sweat profusely. Regarding diet, hot food should not be scalding, and cold food should not be icy. With moderate cold and warmth, the Zheng Qi (Upright Qi) will remain stable, preventing the onset of pathological deviations. ("Shi" here implies appropriateness.)
Yao Shiyin stated: The mention of diet and clothing refers to ordinary daily matters, which should be kept in a state of peaceful moderation, allowing the Yin and Yang Qi to remain balanced and preventing the generation of pathological deviations. Accommodating contradictions refers to the Stomach desiring cold drinks and the Intestines desiring warm drinks. If the Stomach is hot and the Intestines are cold, the Stomach wants cold drinks and the Intestines want warm drinks. If the Stomach is cold and the Intestines are hot, the Stomach wants warm drinks and the Intestines want cold drinks. This addresses internal cold and heat. Therefore, regarding diet, avoiding extreme heat and cold regulates the internal cold and heat. The Qi of the four seasons, cold and heat externally, requires protection from chilling in cool/cold weather and protection from excessive sweating in hot weather, thereby regulating external Yin and Yang. Wu Shi stated: The main theme of this chapter is the harmonization of internal and external Yin and Yang, not merely discussing Yin-Yang pulse theory, but the reversal and smoothness of Qi. Thus, it states that with moderate cold and warmth, Qi remains stable, preventing pathology. It means that Heaven has cold and heat, and Humans have Yin and Yang. If Human Yin and Yang are harmonized, one can resist Heaven's cold and heat.
The Yellow Emperor said: By observing the body's shape, limbs, joints, and muscles, one can predict the size and strength of the Five Zang and Six Fu organs. Now, if kings and nobles, rulers sitting on the throne, were to ask this, who could answer by palpating and tracing the body parts? Qibo replied: The body shape and limbs/joints are the external coverings of the Zang and Fu organs; diagnosis is not limited to facial inspection. The Yellow Emperor said: I already know how the Qi of the Five Zang manifests on the face. How can one know and inspect through the limbs and joints? Qibo replied: Among the Five Zang and Six Fu organs, the Lung acts as the Canopy (Hua Gai). Broad shoulders and a depressed throat allow observation of the Lung's condition externally. The Yellow Emperor said: Good. Qibo replied: Among the Five Zang and Six Fu organs, the Heart is the Sovereign. The Quepen (Supraclavicular fossa) is the pathway. The integrity of the clavicle/sternum area allows prediction of the Heart's condition. The Yellow Emperor said: Good. Qibo replied: The Liver is the General, responsible for external command. To know its firmness, observe the size of the eyes. The Yellow Emperor said: Good. Qibo replied: The Spleen acts as the Guard, receiving grain. Observing the goodness or badness of the lips and tongue reveals auspiciousness or inauspiciousness. The Yellow Emperor said: Good. Qibo replied: The Kidney governs the exterior and enables distant hearing. Observing the condition of the ears reveals the nature of the Kidney.
The Yellow Emperor said: Good. I wish to hear the signs for the Six Fu organs. Qibo replied: Among the Six Fu organs, the Stomach is the Sea. A broad skeleton, thick neck, and expanded chest allow the containment of five grains. A long nasal passage predicts the Large Intestine; thick lips and a long philtrum predict the Small Intestine; large and full infraorbital areas indicate a robust Gallbladder; nostrils flaring outward indicate bladder leakage; a prominent central nasal bridge indicates the constraint of the Sanjiao (Triple Burner). These are the methods for predicting the Six Fu organs. If the upper, middle, and lower sections are equal and coordinated, the Zang organs will be peaceful and healthy.
This text states that one who can diagnose through observation alone can be called a National Scholar. Humans are born from Earth, and their lives depend on Heaven. Heaven and Earth combine their Qi to create humans. Heaven governs Qi, and Earth forms Form. This is the life bestowed by Heaven, establishing form and fixing Qi. To observe longevity or premature death, one must understand this principle. Therefore, the Qi of the Five Zang appears in the complexion, and the form of the Zang-Fu corresponds to the body shape. Since one can read the Qi of the Five Zang from the face, one must also read the body shape to know the form of the Zang-Fu. Knowing both Qi and Form qualifies one as a master of Observation Diagnosis.
(Note: Some characters in the original text are missing or variant, filled based on standard editions of Ling Shu and Zhang Zhicong's commentary.) The sternum/clavicle area relates to the Heart. The Liver is the Official of the General, hence it governs as the General. The Spleen is the Official of Transport, hence it governs as the Guard. The Kidney opens into the ears, hence it governs the exterior, implying distant hearing. "Firmness" refers to the inherent fragility or solidity of the Zang organs. "Auspiciousness/Inauspiciousness" means health is auspicious, and disease is inauspicious. "Nature" refers to the upright or deviant characteristics of the Zang organs. The nose is the orifice of the Lung, and the Large Intestine is its Fu organ, so the nose predicts the Large Intestine. The mouth is the orifice of the Spleen, and the Small Intestine receives turbid matter from the Spleen and Stomach and connects upward to the Stomach, so the lips and philtrum predict the Small Intestine. The eye is the orifice of the Liver, so the area under the eye predicts the Gallbladder. The Bladder is the mansion of fluids, excreting urine upon Qi transformation. Flaring nostrils indicate air exiting externally, leading to bladder leakage, as the upper orifice connects and the lower orifice drains. The Sanjiao is the Official of Ditches, where waterways exit. Constrained Qi stops flow; unconstrained Qi leads to enuresis. A prominent nasal bridge indicates inhalation starting centrally, constraining the Sanjiao, as inhalation constricts the lower orifice and exhalation opens it, reflecting the coordination of opening and closing between upper and lower. This describes the correspondence between internal and external forms of Zang-Fu organs, driven by Qi interaction. "Upper, middle, and lower equal" refers to the equality of the Heaven, Earth, and Human sectors.