黄帝问于岐伯曰。愿闻人之始生。何气筑为基。何立而为 。何失而死。何得而生。岐伯曰。
以母为基。以父为 。失神者死。得神者生也。
倪冲之曰。此篇论人之生死寿夭。皆本于少阴阳明也。夫阳为父。阴为母。基始也。言人生于
少阴而始生也。 者。干盾之属。所以 御四旁。谓得阳明之气。而能充实于四体也。两精相搏谓
之神。两精者。一生于先天之精。一生于水谷之精。相搏者。抟聚而合一也。谓得先后天之精气充
足。然后形与神俱。度百岁乃去。
黄帝曰。何者为神。岐伯曰。血气已和。营卫已通。五脏已成。神气舍心。魂魄毕具。乃成为人。
朱永年曰。此言有生之初。得先天之精气。生此营卫气血。五脏神志。而后乃成人。
黄帝曰。人之寿夭各不同。或夭寿。或卒死。或病久。愿闻其道。岐伯曰。五脏坚固。血脉和
调。肌肉解利。皮肤致密。营卫之行。不失其常。呼吸微徐。气以度行。六腑化谷。津液布扬。各如
其常。故能长久。
朱氏曰。此言已生之后。藉水谷之精气。资生营卫津液资养脏腑形身。而后能长久。
黄帝曰。人之寿百岁而死。何以知之。岐伯曰。使道隧以长。基墙高以方。通调营卫。三部三
里起。骨高肉满。百岁乃得终。
此总论人秉先后天之精气充足。营卫通调。骨肉丰满。可长享其天年。使道者。血脉之道路。
本输篇之所谓
间使之道。盖心包络之主血脉也。隧行列也。长者。环转之无端也。此言血气充足。循序而流通也。
土基高以方者。肌肉浓而充于四体也。脉道流长。肌肉高浓。则营卫通调矣。三部者。形身之上中下。
三里者。手足阳明之脉。皆起发而平等也。骨高者。少阴之气足也。肉满者。阳明之气盛也。如此者。
寿之征也。倪氏曰。心包络主脉。包络三焦。乃肾脏所生之气。出归于心下。为有形之脏腑而主血脉。
此先天之精气也。基墙者。土基浓而四壁坚固。此从天水谷之精气也。
黄帝曰。其气之盛衰。以至其死。可得闻乎。岐伯曰。人生十岁。五脏始定。血气已通。其气在
下。故好走。二十岁。血气始盛。肌肉方长。故好趋。三十岁。五脏大定。肌肉坚固。血脉盛满。故
好步。四十岁。五脏六腑。十二经脉皆大。盛以平定。腠理始疏。荣华颓落。发颇颁白。平盛不摇。故
好坐。五十岁。肝气始衰。肝叶始薄。胆汁始灭。目始不明。六十岁。心气始衰。善忧悲。血气懈
惰。故好卧。七十岁。脾气虚。皮肤枯。八十岁。肺气衰。魄离。故言善误。九十岁。肾气焦。四脏
经脉空虚。百岁。五脏皆虚。神气皆去。形骸独居而终矣。
此言人之生长。从阴而生。自下而上。故曰其气在下。好走好趋好步者。春夏生动之气也。人之衰
老。从上而下。自阳而阴。故肝始衰而心。心而脾。脾而肺。肺而肾。好坐好卧者。秋冬收藏之气也。
肌肉坚固。血脉盛满。少阴阳明之气盛也。腠理空疏。发颇颁白。阳明少阴之气衰也。朱氏曰。人之生
长。先本于肾脏之精气。从水火而生木金土。先天之五行也。人之衰老。从肝木以及于火土金水。后
天之五行也。
黄帝曰。其不能终寿而死者何如。岐伯曰。其五脏皆不坚。使道不长。空外以张。喘息暴疾。又卑
基墙。薄脉少血。其肉不石。数中风寒。血气虚。脉不通。真邪相攻。乱而相引。故中寿而尽也。（数叶朔）
此言人秉先天之气虚薄。而后天犹可资培。更能无犯贼风虚邪。亦可延年益寿。若秉气虚弱。而
又不能调养。兼之数中风寒。以致中道夭而不能尽其天年矣。五脏不坚。使道不长。空外以张。喘
息暴疾。先天之气不足也。又卑基墙。薄脉少血。其肉不石。又失其饮食起居之调养矣。数中风寒。
又不知虚邪贼风。避之有时矣。致使真邪相攻。乱而相引。故中寿而尽也。倪冲之曰。先天者。肾脏
之精气也。然有生之后。惟藉后天以资培。水谷入口。其味有五。津液各走其道。酸先入肝。苦先入
心。甘先入脾。辛先入肺。咸先入肾。五脏主藏水谷之精者也。肾为水脏。受五脏之精而藏之。是以先
天之精气不足。得后天以资养。亦可以享其永年。故曰六腑化谷。津液布扬。各如其常。故能久长。
Huangdi asked Qibo, saying: I wish to hear about the beginning of human life. What constitutes the foundation? What establishes the form? What loss leads to death? What gain leads to life?
Qibo replied: The mother serves as the foundation, and the father serves as the shield (Wei, protective energy). Loss of Shen (Spirit) leads to death; acquisition of Shen leads to life.
Ni Chongzhi commented: This chapter discusses human life, death, longevity, and brevity of life, all rooted in the Shaoyin (Lesser Yin) and Yangming (Bright Yang) meridians. Yang corresponds to the father, Yin to the mother. "Ji" (Foundation) means beginning, indicating that human life begins from Shaoyin. "Wei" refers to shields or armor, used to defend against attacks from all sides, signifying obtaining the Qi of the Yangming meridian to fill and strengthen the four limbs. The interaction of two Jings (Essences) is called Shen. The two Jings refer to one being congenital Jing (Prenatal Essence) and the other being postnatal Jing derived from food and water. "Xiang bo" (mutual interaction) means gathering and uniting. It implies that only when both prenatal and postnatal Jing are sufficient can Xing (Form) and Shen be complete, allowing one to live a hundred years before passing away.
Huangdi asked: What is Shen?
Qibo replied: When Blood and Qi are harmonized, Ying (Nutritive Qi) and Wei (Defensive Qi) are unobstructed, the Five Zang organs are formed, Shen resides in the Heart, and Hun (Ethereal Soul) and Po (Corporeal Soul) are fully present, then a human being is formed.
Zhu Yongnian commented: This describes the initial stage of life, where congenital Jing is acquired to generate Ying, Wei, Blood, and Qi, as well as the spirits and consciousness of the Five Zang organs, after which a person is formed.
Huangdi asked: People have different lifespans; some die young, some live long, some die suddenly, and some suffer from chronic illness. I wish to hear the principles behind this.
Qibo replied: If the Five Zang organs are solid, Blood vessels are harmonious, muscles are smooth and unobstructed, skin is dense, the circulation of Ying and Wei follows its normal pattern, breathing is gentle and slow, Qi moves according to its rhythm, the Six Fu organs digest grain properly, and Jin Ye (Body Fluids) are distributed normally, with each function maintaining its regular state, then one can live a long life.
Master Zhu commented: This states that after birth, one relies on the essence of food and water to nourish Ying, Wei, and Jin Ye, thereby supporting the Zang organs and body, enabling longevity.
Huangdi asked: How can one know if a person will live to a hundred years?
Qibo replied: If the Shi Dao (Nasal passage/Vessel pathway) is deep and long, the Ji Qiang (Facial base and walls/bony structure) is high and square, Ying and Wei are unobstructed, the pulses at the Three Parts (Upper, Middle, Lower) and San Li (Three Miles points) rise evenly, bones are prominent, and flesh is full, such a person can reach a hundred years and complete their natural lifespan.
This section summarizes that possessing sufficient congenital and postnatal Jing, unobstructed Ying and Wei, and full bones and flesh allows one to enjoy their natural lifespan. "Shi Dao" refers to the pathway of Blood vessels, known as the "Jian Shi pathway" in the *Ben Shu* chapter, because the Pericardium governs Blood vessels. "Sui" means orderly rows; "Chang" means endless circulation. This indicates abundant Blood and Qi flowing in order. "Tu Ji Gao Yi Fang" (Earthen base high and square) refers to thick muscles filling the limbs. Long vessel pathways and thick muscles ensure unobstructed Ying and Wei. "San Bu" refers to the upper, middle, and lower parts of the body; "San Li" refers to the Yangming meridities of the hands and feet, which originate equally. Prominent bones indicate sufficient Shaoyin Qi; full flesh indicates robust Yangming Qi. These are signs of longevity. Master Ni said: The Pericardium governs vessels; it connects with the San Jiao (Triple Burner), generating Qi from the Kidneys, emerging below the Heart, forming a tangible organ governing Blood vessels, which is congenital Jing. "Ji Qiang" resembles a thick earthen base with solid walls, derived from postnatal Jing from food and water.
Huangdi asked: May I hear about the decline of Qi until death?
Qibo replied: At ten years old, the Five Zang organs begin to stabilize, Blood and Qi circulate, and Qi is located in the lower part, so they like to run. At twenty, Blood and Qi become vigorous, muscles grow, so they like to walk briskly. At thirty, the Five Zang organs are fully established, muscles are firm, and Blood vessels are full, so they like to walk steadily. At forty, the Five Zang organs, Six Fu organs, and Twelve Meridians reach their peak and then stabilize; pores begin to loosen, radiance fades, hair turns gray, and movement decreases, so they like to sit. At fifty, Liver Qi begins to decline, liver leaves thin out, bile diminishes, and vision blurs. At sixty, Heart Qi declines, leading to sorrow and grief; Blood and Qi become sluggish, so they like to lie down. At seventy, Spleen Qi becomes deficient, and skin withers. At eighty, Lung Qi declines, Po scatters, and speech becomes erroneous. At ninety, Kidney Qi dries up, and the meridians of the other four Zang organs become empty. At one hundred, all Five Zang organs are deficient, Shen departs, and only the corpse remains until death.
This describes growth arising from Yin, moving upward from below; hence, Qi is lower. Running, brisk walking, and steady walking reflect the dynamic Qi of Spring and Summer. Aging moves downward from above, from Yang into Yin; thus, the Liver declines first, followed by the Heart, Spleen, Lungs, and Kidneys. Sitting and lying down reflect the storing Qi of Autumn and Winter. Firm muscles and full Blood vessels indicate strong Shaoyin and Yangming Qi. Loose pores and gray hair indicate declining Yangming and Shaoyin Qi. Master Zhu said: Growth is based on Kidney Jing, generating Wood, Metal, and Earth from Water and Fire, representing congenital Wu Xing (Five Phases). Aging proceeds from Liver Wood to Fire, Earth, Metal, and Water, representing postnatal Wu Xing.
Huangdi asked: What happens to those who do not reach their natural lifespan?
Qibo replied: If their Five Zang organs are not solid, the Shi Dao is short, nostrils flare outward, breathing is rapid and labored, the Ji Qiang is low and flat, pulses are thin with little Blood, flesh is not firm, and they frequently contract Wind-Cold, leading to deficiency of Blood and Qi, obstruction of pulses, conflict between True Qi (Zheng Qi) and Pathogenic factors (Xie Qi), chaos, and mutual entanglement, they will die at mid-life.
This section discusses individuals with weak congenital Qi, who may still benefit from postnatal nourishment and avoiding pathogenic winds to extend life. However, those with weak constitution who fail to regulate themselves and frequently contract Wind-Cold may die prematurely. Solid Zang organs and long nasal passages indicate sufficient congenital Qi. Low facial structure, thin pulses, and soft flesh indicate lack of dietary and lifestyle care. Frequent Wind-Cold contraction indicates failure to avoid pathogenic factors. This causes Zheng and Xie to clash, leading to mid-life death. Master Ni said: Congenital Qi originates from Kidney Jing. After birth, one relies on postnatal sources for nourishment. Food enters the mouth with five flavors; fluids go to their respective channels: Sour enters the Liver, Bitter the Heart, Sweet the Spleen, Pungent the Lungs, and Salty the Kidneys. The Zang organs store the essence of food and water. The Kidney is the Water organ, storing the essence of all Zang organs. Therefore, even with insufficient congenital Jing, adequate postnatal nourishment can ensure longevity. Thus, it is said that when the Six Fu organs digest grain and fluids are distributed normally, longevity is achieved.