此承上编五脏生成，而复论五脏之别也，肝心脾肺肾，五脏之正也。脑髓骨脉胆女子胞，五脏之别也。
方术之士，五脏安和，更从事于脑髓肠胃之间，因脑髓而及于骨脉胆女子胞，六者为脏，因肠胃而及于三
焦膀胱，五者为腑，脏本有五，今举其六，腑本有六，今举其五，五脏藏精气，而脑髓为精气之主，六腑
化水谷，而肠胃为水谷之主，因方士之所尚而推论之，以为五脏之别也。
黄帝问曰∶余闻方士，或以脑髓为脏，或以肠胃为脏，或以为腑，敢问更相反，皆自
谓是，不知其道，愿闻其说。
更，平声。方士，方术之士也。脑，头脑。髓，周身骨髓也。方术之士，修炼形身，营运精气，五
脏无病，复蒸养脑髓，清澈肠胃，故问方士，或有以脑髓为脏者，或有以肠胃为脏者，或有以脑髓肠胃为
腑者，方士之中，更易其说，彼此相反，皆自谓是，余不知方士之道，愿闻其说。
岐伯对曰∶脑、髓、骨、脉、胆、女子胞，此六者地气之所生也，皆藏于阴而象于地，故藏而
不泻，名曰奇恒之府。
藏，如字。下除五脏余藏俱如字。方术之士，上通泥丸，薰灌脑髓，下养精血，以成胎息，故脑髓骨
脉胆女子胞，此六者，藏精藏血，胎息孕育，犹之地气之所生也，六者皆藏于阴，而象于地，故
藏而不泻，此脑髓骨脉胆女子胞六者，所以名脏也，或以为腑，亦不如六腑之传化，是名曰奇恒之府。奇，
异也。恒，常也。言异于常腑也。此方士以脑髓为脏，而或以为腑也。
夫胃大肠小肠三焦膀胱，此五者，天气之所生也。其气象天，故泻而不藏。此受五脏浊气，
名曰传化之府，此不能久留，输泻者也。
方术之士，炼液漱津，洗涤肠胃，又以肠胃为脏。夫胃大肠小肠以及三焦膀胱，此五者，传导水谷，
变化而出，犹之天气之所生也，从上而下，故其气象天，从上而下，故泻而不藏，若以为藏，
此受五脏浊气，受而不藏者也。若以为腑，则名曰传化之府，此虽受浊，不能久留。传化之府，则输泻者
也。此方士以肠胃为脏，而或以为腑也。
魄门亦为五脏使，水谷不得久藏。所谓五脏者，藏精气而不泻也，故满而不能实。六腑者，传
化物而不藏，故实而不能满也。所以然者，水谷入口，则胃实而肠虚。食下，则肠实而胃虚。故曰实
而不满，满而不实也。
使，去声。魄门，大肠之肛门也，大肠为肺腑，故名魄门。六腑为五脏之输泻，而魄门亦为五脏使。
既为五脏使，则肠胃之水谷，不得久藏，是魄门合脏腑而总为之传使也，申明所谓五脏者，藏精
气之凝结，而不输泻也。但藏精气，无有糟粕，故满而不能实。若六腑者，传化食物，输泻不藏，故实而不
能满也。盖凝结之精气充足，则曰满，饮食之糟粕充足则曰实。又申明六腑之所以实而不满，五脏之所以满
而不实者，水谷入口，则胃实而肠虚，食已而下，则肠实而胃虚，故曰六腑实而不满，五脏满而不实也。
此一节，言脑髓肠胃之所以为脏为腑，五脏精气之满，六腑水谷之实，皆脑髓肠胃之所主也。
帝曰∶气口何以独为五脏主。
气口，两手寸口之肺脉也。魄门为五脏使，气口为五脏主，帝欲彰明其义，故以为问。
岐伯曰∶胃者，水谷之海，六腑之大源也。五味入口，藏于胃，以养五脏气，气口亦太阴也。
是以五脏六腑之气味，皆出于胃，变见于气口，故五气入鼻，藏于心肺，心肺有病，而鼻为之不利也。
见，音现。为去声。水谷入胃，脉道乃行，故胃者水谷之海，乃六腑之大源也。凡五味入口，皆
藏于胃，籍足太阴脾气之转输，以养五脏气，今气口为五脏主，以气口肺脉，亦太阴也。是以五脏
六腑之气味，始则五味入口，藏于胃，继则脾气转输，气味皆出于胃，循经脉而变见于气口，脉道之行，
本于胃之气味，由下而上，故五脏之气入鼻，从心而肺，故曰藏于心肺，如心肺有病，而鼻窍
为之不利也。所以申明足太阴主五脏之味，手太阴主五脏之气，气口，所以为五脏主也，
凡治病必察其下，适其脉，观其志意，与其病也。拘于鬼神者，不可与言至德。恶于针石者，不
可与言至巧，病不许治者，病必不治，治之无功矣。
恶，去声。此结上文之义，魄门为五脏使，故凡治病必察其下，察其大便之通闭也。气口为五脏主，
故凡治病必适其脉，调适其气口之脉象也。更当观其志意之尚方术，与不尚方术，与其病可治与不可治也。
若尚方术，而拘于鬼神者，神道设教，不可与言天人之至德，尚方术而恶于针石者，自以为是，不可与
言砭刺之至巧。凡此拘鬼神，恶针石，是有病而不许治也。病不许治者，其病必归不治，虽治之亦无功矣。
此一节，承上文魄门为五脏使，因论气口为五脏主，故当察其下，适其脉，而方士不可与有为也。
This passage continues the discussion on the generation of the Five Zang Organs, further elaborating on their special classifications. The Liver, Heart, Spleen, Lung, and Kidney constitute the standard classification of the Five Zang Organs (Zang organs). The Brain, Marrow, Bones, Vessels, Gallbladder, and Uterus (Female Reproductive Organ) belong to the special category of the Zang organs.
Practitioners of arts and methods (Fangshi), after ensuring the harmony and health of the Five Zang Organs, extend their attention to the functions of the Brain, Marrow, Intestines, and Stomach. From the Brain and Marrow, they extend to the Bones, Vessels, Gallbladder, and Uterus; these six are classified as "Zang" (Storage organs). From the Intestines and Stomach, they extend to the Sanjiao (Triple Burner) and Bladder; these five are classified as "Fu" (Excreting organs). Originally, there are only five Zang organs, yet here six are listed; originally, there are six Fu organs, yet here only five are listed. The function of the Zang organs is to store Jing-Qi (Essence and Qi), and the Brain is the master of Jing-Qi. The function of the Fu organs is to transform and transport water and grain, and the Intestines and Stomach are the masters of this process. This reasoning is deduced from the theories esteemed by Fangshi, leading to the concept of the special classification of the Zang organs.
The Yellow Emperor asked: I have heard that practitioners of arts and methods consider the Brain and Marrow as Zang organs, or the Intestines and Stomach as Zang organs, or regard them as Fu organs. May I ask why these views contradict each other, yet all claim to be correct? I do not understand the rationale behind this and wish to hear your explanation.
"Geng" is pronounced with the level tone. "Fangshi" refers to practitioners of arts and methods. "Nao" refers to the brain/head, and "Sui" refers to the bone marrow throughout the body. Practitioners of arts and methods cultivate the physical form, circulate Jing-Qi, ensure the health of the Five Zang Organs, and then further nourish the Brain and Marrow while cleansing the Intestines and Stomach. Therefore, when inquiring about Fangshi, some may regard the Brain and Marrow as Zang organs, some may regard the Intestines and Stomach as Zang organs, and some may regard both as Fu organs. Within the group of Fangshi, opinions frequently change and even contradict each other, yet all assert their correctness. I am unaware of the principles held by Fangshi and wish to hear their perspective.
Qibo replied: The Brain, Marrow, Bones, Vessels, Gallbladder, and Uterus—these six—are generated by Earth Qi. They all store Yin and correspond to the Earth; therefore, they store but do not excrete. They are named the "Qi Heng Zhi Fu" (Extraordinary Fu Organs, literally "Strange/Abnormal Fu Organs").
"Cang" is read according to its original meaning. In the following text, except for "Wu Zang," all other instances of "Cang" are read according to their original meanings. Practitioners of arts and methods connect upwards to the Niwan Palace (the upper Dantian in the head), nourishing the Brain and Marrow, and downwards to nurture Essence and Blood, thereby achieving Taixi (fetal breathing). Thus, the Brain, Marrow, Bones, Vessels, Gallbladder, and Uterus store Essence and Blood and facilitate Taixi and gestation, resembling things generated by Earth Qi. These six are stored in Yin and correspond to the Earth, so they store but do not excrete. Although these six are sometimes referred to as Zang organs or Fu organs, they do not transmit and transform substances like the regular Six Fu organs. Hence, they are called "Qi Heng Zhi Fu." "Qi" means strange or unusual; "Heng" means ordinary or constant. It signifies that they are different from ordinary Fu organs. This explains why Fangshi regard the Brain as a Zang organ or alternatively as a Fu organ.
As for the Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder—these five—are generated by Heaven Qi. Their nature corresponds to Heaven; therefore, they excrete but do not store. They receive turbid Qi from the Five Zang Organs and are named the "Chuan Hua Zhi Fu" (Organs of Transmission and Transformation). These substances cannot remain long within them; they are rapidly transported and excreted.
Practitioners of arts and methods refine fluids and rinse saliva, cleansing the Intestines and Stomach, and thus regard the Intestines and Stomach as Zang organs. However, the Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder are responsible for transmitting and transforming water and grain, changing and expelling them, akin to things generated by Heaven Qi. They move from top to bottom; therefore, their nature corresponds to Heaven, and they excrete but do not store. If regarded as storage organs, they would receive turbid Qi from the Five Zang Organs, accepting it without storing it properly. If regarded as Fu organs, they are named "Chuan Hua Zhi Fu." Although they accept turbid matter, they cannot retain it for long. The Chuan Hua Zhi Fu are those responsible for transmission and excretion. This explains why Fangshi regard the Intestines and Stomach as Zang organs or alternatively as Fu organs.
The Po Men (anus) also serves as an envoy for the Five Zang Organs; water and grain residues cannot be stored for long. The so-called Zang organs store Jing-Qi and do not excrete; thus, their state is "Man" (full of essence) but not "Shi" (filled with solid matter). The Fu organs transmit and transform substances but do not store; thus, their state is "Shi" (filled with solid matter) but not "Man" (full of essence). The reason for this is that when food and drink enter the mouth, the Stomach becomes full (Shi) while the Intestines are empty (Xu). After food moves downward, the Intestines become full (Shi) while the Stomach becomes empty (Xu). Therefore, it is said that the Fu organs are Shi but not Man, and the Zang organs are Man but not Shi.
"Shi" is pronounced with the departing tone. "Po Men" refers to the anus of the Large Intestine. Since the Large Intestine is paired with the Lung (a Zang organ), it is named Po Men. The Six Fu organs serve as the excretory channels for the Five Zang Organs, and the Po Men also acts as an envoy for the Five Zang Organs. Having served as an envoy, the water and grain residues in the Intestines and Stomach cannot be stored for long. This demonstrates that the Po Men integrates the functions of Zang and Fu organs, overseeing transmission. This section clarifies that the so-called Zang organs store condensed Jing-Qi and do not excrete. Because they only store Jing-Qi and contain no waste, they are "Man" but not "Shi." As for the Fu organs, they transmit food, excrete without storing, and are therefore "Shi" but not "Man." Condensed Jing-Qi being abundant is called "Man," while dietary residue being abundant is called "Shi." This reiterates why the Fu organs are Shi but not Man, and the Zang organs are Man but not Shi: when food enters, the Stomach is Shi and the Intestines are Xu; after swallowing, the Intestines are Shi and the Stomach is Xu. Thus, the Fu organs are Shi but not Man, and the Zang organs are Man but not Shi. This paragraph explains why the Brain/Marrow and Intestines/Stomach are classified as Zang or Fu, and how the "Man" state of Zang organ Jing-Qi and the "Shi" state of Fu organ water/grain are primarily governed by the Brain/Marrow and Intestines/Stomach.
The Yellow Emperor said: Why can the Qikou (Radial Pulse at the Cun Kou point) alone serve as the master of the Five Zang Organs?
"Qikou" refers to the Lung pulse at the Cun Kou point on both wrists. The Po Men is the envoy of the Five Zang Organs, and the Qikou is their master. The Yellow Emperor wished to clarify this principle, hence the question.
Qibo said: The Stomach is the sea of water and grain and the great source of the Six Fu organs. When the five flavors enter the mouth, they are stored in the Stomach to nourish the Qi of the Five Zang Organs. The Qikou also belongs to the Taiyin channel.
Therefore, the Qi and flavor of the Five Zang and Six Fu organs all originate from the Stomach and manifest at the Qikou. Thus, the five qi inhaled through the nose are stored in the Heart and Lung. If the Heart or Lung has disease, the nose will become obstructed.
"Jian" is pronounced as "Xian." "Wei" is pronounced with the departing tone. When water and grain enter the Stomach, the vessel pathways begin to flow; thus, the Stomach is the sea of water and grain and the great source of the Six Fu organs. Whatever five flavors enter the mouth are stored in the Stomach. Relying on the transportation and transformation of the Foot-Taiyin Spleen Qi, they nourish the Qi of the Five Zang Organs. Now, since the Qikou serves as the master of the Five Zang Organs, it is because the Qikou, as the Lung pulse, also belongs to the Taiyin channel. Therefore, the Qi and flavor of the Five Zang and Six Fu organs initially enter the mouth and are stored in the Stomach; subsequently, Spleen Qi transports them, and their Qi and flavor emerge from the Stomach, traveling along the meridians to manifest at the Qikou. The flow of the vessel pathways originates from the Qi and flavor of the Stomach, moving from below to above. Thus, the Qi of the Five Zang Organs enters the nose, passing through the Heart to the Lung, hence it is said to be "stored in the Heart and Lung." If the Heart or Lung has disease, the nasal orifices become obstructed. This clarifies that the Foot-Taiyin governs the flavors of the Five Zang Organs, while the Hand-Taiyin governs their Qi; consequently, the Qikou serves as the master of the Five Zang Organs.
In general, treating disease requires examining the lower orifices (defecation and urination), assessing the pulse, observing the patient's aspirations and mental state, and evaluating the illness itself. One cannot discuss profound moral principles with those who are superstitious about ghosts and gods. One cannot discuss sophisticated acupuncture techniques with those who detest needles and stones. If a patient refuses treatment, the disease will certainly not be cured, and any attempt at treatment will yield no results.
"E" is pronounced with the departing tone. This section summarizes the preceding text. Since the Po Men is the envoy of the Five Zang Organs, one must examine the lower body (specifically bowel movements) when treating disease. Since the Qikou is the master of the Five Zang Organs, one must assess the pulse and adjust the Qikou pulse pattern when treating disease. Furthermore, one should observe whether the patient adheres to Fangshi practices and whether the disease is treatable. If the patient adheres to Fangshi and is superstitious about ghosts and gods, relying on divine teachings, one cannot discuss the highest virtues of Heaven and Humanity. If the patient adheres to Fangshi and detests needles and stones, being self-righteous, one cannot discuss the supreme skill of acupuncture. Those who are bound by superstition and reject needle therapy are essentially refusing treatment for their illness. If a patient refuses treatment, their illness will inevitably remain incurable, and even if treated, there will be no efficacy. This paragraph follows up on the statement that the Po Men is the envoy of the Five Zang Organs, discussing how the Qikou serves as their master, necessitating examination of the lower orifices and assessment of the pulse, while noting that one cannot engage deeply with those who adhere to Fangshi practices.