此条先言所合。言本脏之内外相合也。后言所主。明其相制相成也。
心之合脉也。
西医云。心有运血管。回血管外则散达周身。内则入于心中。心中有上下四房。以存血。心体跳动不休。而周身血
管应之而动是为动脉此说极是。脉经云脉为血府即此之谓也。医林改错。谓脉是气管非血管。言气乃能动。血不能动。
夫果是气管则随气呼吸。一呼止。当动一至。一吸止当。动一至何以一呼动二至。一吸动二至。显与气息相错哉是脉非
气管。其应心而动为无疑矣。故云心之合脉也。西医言脉不足为诊具足见西医之粗浅也。脉诊两手。始于内经。详于难
经。事确理真非西人器具测量。所能得也。详下荣卫生会。及诊脉精要篇。
其荣色也。
心主血。血足则色华。血脱则色枯。
其主肾也。
五行之理。相生相制制则生化。心是。火脏而受制于肾水。是肾乃心脏生化之主。故其主肾也。心为离火。离卦中
之阴爻。即含坎。水之象也。心之所以生血。亦以水交于火即化为血。另详气血条。惟其以水济火。而火之功用乃成。
故心血虚者。必兼补肾水。观天王补心丹。仲景复脉汤均用地黄。其义可知。
肺之合皮也。
肺为干金。体高而大。如天之无不覆。气达于外。以卫周身。如天之无不包。故合于皮毛。西医云。周身气管。外
则散为毛。窍。内则总统于肺。故肺合皮毛。凡是外感。无不治肺也。西法用数百倍显微镜。照见毛形如树。其下有。
坑。坑内有许多虫。或进或出。其实皆气之出入也。盖肺主行气。肺中尽是气孔。鼻者直出之孔。毛者横出之孔鼻气大。
故人皆知之毛孔之气细故人不知。实则鼻气一出则毛孔之气俱出鼻气一入。则毛孔之气俱入。中国人不知皮毛与肺相连。
皆是从毛窍相通也。
其荣毛也。
毛者。血之余也。然实则血从气。化而生焉。气生于水。先天真气。名天癸水。女子以血为主。气从血化。故水化
为血。内行下达。则为月信男子以气为主。则血从。气化故血化。为水上行外达则生须与毛另详气血条。毛荣者气化之
盛也。肺主气故其荣在毛。
其主心也。
天之五行。火西流。而后能秋地之五行。火克金。而后成器人之五行。心火温肺。而后胸中阳和。无寒饮咳痹之证。
故心火者。乃肺之主也。心火太甚。则肺燥。心火不足。则肺寒。
肝之合筋也。
筋象甲乙木。故为肝所合。人但知筋着。于骨节间。而不知筋实与肝通盖肝中有大膈膜。内连肥网。外连皮肤。凡
有瘦肉。皆有网膜包之。凡肉之网膜。其两头皆连于筋。肝之气。即从内膈膜发为外之网膜。由网膜而发为筋。筋所以
为肝之合也。中医但言其义。未言其形。今借西法。指出迹象。尤为确实。合者。相连之谓也。凡 筋抽。皆是内膜。
伸缩收放。因牵动其筋而然。若不知筋所发生之源。则不能治也。
其荣爪也。
爪为之筋余。筋节柔和。故其荣发见于爪。
其主肺也。
肝主血主清阳之气。必得肺金制之。木不郁而为火。则清气得升。血脉和畅如金不能平。木则肝火上升。为痰咳虚
痨失血等证。
脾之合肉也。
肉是人身之阴质。脾为太阴。主化水谷以生肌肉。肌是肥肉。肉是瘦肉。肥肉是气所生瘦肉是血所生脾生连网之上。
脾气足则内。生膏油。透出于外。则生肥肉脾血足。则又从连网中凝结而生瘦肉。亦由内生出于。外肥肉包瘦肉者气包
血。故也。脾阳虚则肉浮。脾阴虚则肉消。脾生膏油。从膏油而生出肌肉。其形迹之相连最显然也。乃西医剖割但浅割
外皮。其肉象如何。深割内皮。其肉象又如何。究未知肌肉属脾。所以不得治法。
其荣唇也。
脾开窍于口。唇乃口之门户。故其荣在唇。凡病唇缩。为脾绝不治。
其主肝也。
肝属木。能疏泄水谷脾土得肝木之疏泄。则饮食化肝木之阳。不升则为泻泄。肝寒则腹痛。霍乱观建中汤。用桂枝
温肝。即知其义。肝火郁。则为痢。亦是肝病累脾。故肝为脾之所主西医谓肝生胆汁。入胃化谷即内经木能疏。土之义。
肾之合骨也。
骨内有髓。骨者。髓所生。周身之骨。以背脊为主肾系贯脊。肾藏精。精生髓。髓生骨故骨者。肾之所合也。西医
支解人而视之。详言脑髓。脑气筋。而不知髓是何物。因不知肾与骨合。所以其治多碍也。
其荣发也。
人之毛发。皆是血从气化所生。义详五脏所属条。及本条其荣毛句。但毛生于气孔中。属肺金。须生于唇。乃任脉
所终之地。属肝胃两经。而发则生于头。是督脉经与太阳经所交也太阳经。从背上头督脉经从脊贯头太阳膀胱。为肾之
府。督脉属肾均交于头。血在丹田之内。从气之化循经而上。生为头发。故肾精足。则其荣在发。老人肾竭。所以发白。
血从气化之理详天癸条。
其主脾也。
脾土能制水。所以封藏肾气也。脾不统摄。则遗精。脾不制水则肾水泛。而为痰饮。
张隐 注六微旨论云。土位之下。风气承之。风位之下。金气承之。金位之下。火气承之。君火之下。阴精承之。
亢则害承乃制。制则生化。故五脏所合。言其相生也。五脏所主。言其相成也。先心肺而后脾肾。乃归重于相成。之义
欤。西医不讲五行。分脏腑。截然各别而于交通之故。生成之理。概不能知。
这一条首先论述五脏与其所合组织的对应关系，阐明本脏与体表组织内外相合的联系。随后论述“所主”，明确五脏之间相互制约、相互成就的关系。
心脏所合的是脉。
西医认为，心脏有输送血液的血管（动脉）和回流血液的血管（静脉），它们向外散布至全身，向内汇聚于心脏。心脏分为上、下左右四个腔室，用于储存血液。心脏体不停跳动，全身的血管随之而动，这就是动脉。这种说法非常正确。《脉经》说“脉是血的府库”，就是这个意思。王清任在《医林改错》中认为脉是气管而非血管，认为只有气才能推动，血不能自行运动。如果脉真的是气管，那么它应该随着呼吸而跳动：呼气结束时，脉搏应动一次；吸气结束时，脉搏也应动一次。为什么实际上是一呼脉搏动两次，一吸脉搏也动两次呢？这明显与呼吸节奏不一致。因此，脉不是气管，它随心脏跳动而搏动是毫无疑问的。所以说“心之合脉”。西医认为脉诊不足以作为诊断依据，可见其医学理论尚显粗浅。两手脉诊始于《黄帝内经》，详备于《难经》，事实确凿、道理真实，不是西方人依靠器具测量所能得到的。详见后文《营卫生会》及《诊脉精要》篇。
心脏的外在荣华表现于面色。
心主司血液，血液充足则面色红润光泽，血液耗脱则面色枯槁无华。
心脏受制于肾。
五行运行的规律是相生相制，有制约才能生化不息，心脏正是如此。心属火脏，但受到肾水的制约，所以肾是心脏生化功能的主宰，因此说“其主肾”。心为离卦之火，离卦中间的阴爻，即含有坎卦（水）的形象。心之所以能生血，也是因为水交入火中，从而化为血液。另见“气血”条目。正因为用水来济助火，火的功用才能形成。所以心血虚的人，必须兼补肾水。观察天王补心丹、张仲景的复脉汤都使用地黄，其中的道理就可以知道了。
肺脏所合的是皮毛。
肺属金，位置高且大，像天一样无所不覆盖，肺气达于体表以护卫周身，像天一样无所不包容，所以与皮毛相合。西医认为，全身的支气管系统，向外分散为毛孔，向内统属于肺，所以肺合皮毛。凡是外感病邪，没有不治疗肺的。西方方法使用数百倍显微镜，观察到毛孔形状像树，下面有坑，坑内有许多虫子或进或出，其实都是气的出入。大概肺主司运行气，肺中全是气孔。鼻子是直出的孔，毛孔是横出的孔。鼻气量大，所以人人都知道；毛孔的气量细微，所以人们不知道。实际上，鼻气一出，毛孔的气就全部排出；鼻气一入，毛孔的气就全部吸入。中国人不知道皮毛与肺相连，都是通过毛窍相通。
肺脏的外在荣华表现于毛发。
毛发是血的余绪。然而实际上，血是从气化过程中产生的。气生于水，先天的真气名为天癸之水。女子以血为主，气从血化，所以水化为血，在内下行，就成为月经。男子以气为主，血从气化，所以血化为水向上行，向外达，就生成胡须和毛发。另见“气血”条目。毛发的荣润，是气化旺盛的表现。肺主气，所以其荣华在毛发。
肺脏受制于心。
天上的五行，火向西流，然后才能进入秋季；地上的五行，火克金，器物才能制成；人体的五行，心火温煦肺金，然后胸中阳气调和，就不会有寒饮咳嗽痹阻等病症。所以心火是肺的主宰。心火太盛，则肺燥；心火不足，则肺寒。
肝脏所合的是筋。
筋象甲乙木，所以为肝所合。人们只知道筋附着在骨节之间，却不知道筋实际上与肝相通。大概肝中有大的膈膜，向内连接肥网（脂肪组织），向外连接皮肤。凡是有瘦肉的地方，都有网膜包裹。凡是肉的网膜，两头都连于筋。肝的气，就从内部膈膜发出，成为外部的网膜，再由网膜发为筋。筋所以成为肝的合部。中医只讲其义理，未讲其形态，现在借用西医方法指出迹象，尤为确切。“合”就是相连的意思。凡是筋抽搐，都是内膜伸缩收放，因牵动其筋所致。如果不了解筋发生的源头，就不能治疗。
肝脏的外在荣华表现于指甲。
指甲是筋的余绪，筋节柔和，所以其荣华发见于指甲。
肝脏受制于肺。
肝主血，主清阳之气，必须得到肺金的制约，木才不会郁结化为火，这样清气才能上升，血脉和畅。如果金不能平抑木，则肝火上升，导致痰咳、虚劳、失血等病症。
脾脏所合的是肌肉。
肉是人身的阴质。脾为太阴，主运化水谷以生成肌肉。肌是肥肉，肉是瘦肉。肥肉是气所生，瘦肉是血所生。脾生连网之上，脾气足则内生膏油，透出于外，就生成肥肉；脾血足，则又从连网中凝结而生瘦肉，也是由内生出外。肥肉包瘦肉，是因为气包血。脾阳虚则肌肉浮肿，脾阴虚则肌肉消瘦。脾生膏油，从膏油生出肌肉，其形态联系最为明显。然而西医解剖只是浅割外皮，深割内皮，对于肌肉的样子究竟如何，终究不知道肌肉属于脾，所以得不到正确的治法。
脾脏的外在荣华表现于口唇。
脾开窍于口，口唇是口的门户，所以其荣华在口唇。凡是出现口唇收缩的症状，是脾绝的表现，不可治愈。
脾脏受制于肝。
肝属木，能疏泄水谷。脾土得到肝木的疏泄，饮食才能消化。肝木的阳气如果不升，就会发生泄泻。肝寒则腹痛、霍乱。观察建中汤使用桂枝温肝，就知道其中的道理。肝火郁结，则发生痢疾，这也是肝病累及脾脏。所以肝是脾的主宰。西医认为肝产生胆汁，进入胃中帮助消化谷物，这正是《内经》中“木能疏土”的道理。
肾脏所合的是骨骼。
骨内有髓，骨是由髓生成的。全身的骨骼，以背脊为主。肾系贯穿脊柱。肾藏精，精生髓，髓生骨，所以骨是肾所合的。西医解剖人体，详细谈论脑髓、脑神经，却不知道髓是什么东西。因为不知道肾与骨相合，所以他们的治疗方法多有阻碍。
肾脏的外在荣华表现于头发。
人的毛发，都是血从气化所生，义理详见“五脏所属”条及本条“其荣毛”句。但毛生于气孔中，属肺金；须生于嘴唇，是任脉终结之地，属肝、胃两经；而发生于头部，是督脉经与太阳经交汇之处。太阳经从背上头，督脉经从脊贯头。太阳膀胱经是肾之府，督脉属肾，均交汇于头部。血在丹田之内，从气化循经而上，生为头发。所以肾精充足，其荣华就在头发。老人肾气衰竭，所以头发变白。血从气化的道理详见“天癸”条。
肾脏受制于脾。
脾土能制水，所以能封藏肾气。脾不统摄，则遗精；脾不制水，则肾水泛滥，成为痰饮。
张隐庵注解《六微旨大论》说：“土位之下，风气承之；风位之下，金气承之；金位之下，火气承之；君火之下，阴精承之。亢则害，承乃制，制则生化。”所以五脏所合，讲的是相生关系；五脏所主，讲的是相成关系。先论心肺，后论脾肾，乃是回归重视相成的义理吧？西医不讲五行，将脏腑截然分开，而对于脏腑交通的原因、生成的道理，一概不知。
This section first discusses the correspondences (He), explaining the internal-external connection between the Zang organs and their associated tissues. It then discusses the "governing" (Zhu) aspect, clarifying the mutual restriction and completion among the Zang organs.
The Heart corresponds to the vessels (Mai).
Western medicine states that the heart has arteries (vessels transporting blood outwards) and veins (vessels returning blood inwards), which scatter throughout the body and converge into the heart. The heart consists of four chambers (upper and lower left and right) to store blood. The heart beats continuously, and the systemic vessels move in response, which constitutes the arterial pulse. This view is very correct. *Mai Jing* (Pulse Classic) states that "the vessel is the residence of blood," which refers to this. Wang Qingren's *Yi Lin Gai Cuo* (Correction of Errors in Medical Works) claims that vessels are air tubes rather than blood vessels, arguing that only Qi can move, while blood cannot move on its own. If vessels were indeed air tubes, they should beat in sync with respiration: ending an exhalation, the pulse should beat once; ending an inhalation, it should also beat once. Why does the pulse actually beat twice per exhalation and twice per inhalation? This clearly contradicts the rhythm of breathing. Therefore, vessels are not air tubes; it is beyond doubt that they beat in response to the Heart. Thus, it is said that "the Heart corresponds to the vessels." Western medicine considers pulse diagnosis insufficient as a diagnostic tool, revealing the superficiality of their medical theory. Two-hand pulse diagnosis originated in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) and was detailed in the *Nan Jing* (Classic of Difficult Issues). The facts are solid and the principles true, unattainable by Western instrumental measurement. See further details in the sections on *Ying Wei Sheng Hui* (Convergence of Ying and Wei Qi Generation) and *Zhen Mai Jing Yao* (Essentials of Pulse Diagnosis).
Its flourishing manifestation is in the complexion (Se).
The Heart governs Blood. When Blood is sufficient, the complexion is lustrous; when Blood is depleted, the complexion is withered.
It is governed by the Kidney.
The principle of the Five Elements involves mutual generation and mutual restriction; restriction enables bio-transformation. This applies to the Heart. As a Fire organ, the Heart is restricted by Kidney Water. Thus, the Kidney is the master of the Heart's bio-transformation, hence it is said that "it is governed by the Kidney." The Heart is Li Fire; the Yin line within the Li trigram contains the image of Kan Water. The reason the Heart generates Blood is precisely because Water enters Fire and transforms into Blood. Refer to the entry on Qi and Blood. Only by using Water to assist Fire can the function of Fire be realized. Therefore, for those with Heart Blood deficiency, one must simultaneously tonify Kidney Water. Observing that Tianwang Buxin Dan and Zhang Zhongjing's Fumai Tang both use Di Huang (Rehmanniae Radix), the rationale becomes clear.
The Lung corresponds to the skin and hair (Pi Mao).
The Lung belongs to Metal, is high and large, covering all like Heaven. Its Qi reaches the exterior to protect the whole body, encompassing all like Heaven. Thus, it corresponds to the skin and hair. Western medicine states that the entire bronchial system scatters outward into pores and converges inwardly into the Lung; therefore, the Lung corresponds to the skin and hair. In cases of external contraction, the Lung is invariably treated. Using microscopes with hundreds of times magnification, Western methods observe that pores resemble trees with pits underneath, where many insects enter or exit; these are actually the entry and exit of Qi. Generally, the Lung governs the movement of Qi, and the Lung is full of air pores. The nose is a vertically exiting pore, while pores are horizontally exiting pores. Nasal Qi volume is large, so everyone knows it; pore Qi volume is minute, so people do not notice it. In reality, when Nasal Qi exits, pore Qi all exits; when Nasal Qi enters, pore Qi all enters. Chinese people do not know that the skin and hair are connected to the Lung, communicating through the pores.
Its flourishing manifestation is in the body hair (Mao).
Body hair is the surplus of Blood. However, in truth, Blood is generated from Qi transformation. Qi is born from Water; the innate True Qi is named Tian Gui Water. Women primarily govern Blood, and Qi transforms from Blood; thus, Water transforms into Blood, moving internally downward to become menstruation. Men primarily govern Qi, and Blood transforms from Qi; thus, Blood transforms into Water, moving upward externally to generate beard and body hair. Refer to the entry on Qi and Blood. The flourishing state of hair is the prosperity of Qi transformation. Since the Lung governs Qi, its flourishing manifestation is in the hair.
It is governed by the Heart.
In the heavens' Five Elements, Fire flows westward before Autumn arrives. On earth, Fire overcomes Metal before vessels/utensils are formed. In humans, Heart Warms the Lung Metal, resulting in Yang harmony in the chest, preventing conditions such as cold-fluid retention, cough, and bi-syndrome. Thus, Heart Fire is the master of the Lung. If Heart Fire is excessive, the Lung becomes dry; if Heart Fire is insufficient, the Lung becomes cold.
The Liver corresponds to the sinews (Jin).
Sinews resemble Jia-Yi Wood, thus corresponding to the Liver. People only know that sinews attach to joints, but do not realize that sinews actually connect with the Liver. There is a large diaphragm within the Liver, connecting inwardly to fatty networks and outwardly to the skin. Wherever lean meat exists, it is wrapped in membranous tissue. Both ends of any muscular membrane connect to sinews. The Qi of the Liver originates from the internal diaphragm, emerges as external membranes, and develops into sinews. Hence, sinews are the correspondence of the Liver. Traditional Chinese Medicine (TCM) discusses the principle but not the morphology; now borrowing Western methods to point out signs makes it more accurate. "Correspondence" means connection. Sinew spasms are caused by the contraction and relaxation of internal membranes pulling on the sinews. Without knowing the source of sinew generation, treatment is impossible.
Its flourishing manifestation is in the nails (Zhao).
Nails are the surplus of sinews. Because sinews are flexible, their flourishing manifestation appears in the nails.
It is governed by the Lung.
The Liver governs Blood and Clear Yang Qi. It must be restrained by Lung Metal so that Wood does not stagnate and transform into Fire. Then Clear Qi can ascend, and blood vessels remain harmonious and smooth. If Metal fails to level Wood, Liver Fire rises, causing conditions such as phlegm-cough, consumptive disease, and bleeding.
The Spleen corresponds to the muscles (Rou).
Muscles are the Yin substance of the human body. The Spleen is Taiyin, governing the transformation of water and grain to generate muscle. Ji (deep muscle/fat) is fatty meat; Rou (superficial muscle) is lean meat. Fatty meat is generated by Qi; lean meat is generated by Blood. Above the connecting network generated by the Spleen, when Spleen Qi is sufficient, it generates fat/oil internally, which permeates outward to form fatty meat. When Spleen Blood is sufficient, it coagulates within the connecting network to form lean meat, also emerging from inside to outside. Fatty meat wrapping lean meat signifies Qi wrapping Blood. If Spleen Yang is deficient, muscles float/swell; if Spleen Yin is deficient, muscles atrophy. The Spleen generates fat/oil, from which muscles grow; the morphological connection is most obvious. However, Western dissection only cuts the outer skin shallowly; regarding what the muscle looks like when cutting deeply into the inner layer, they ultimately do not know that muscles belong to the Spleen, and thus cannot obtain the correct treatment method.
Its flourishing manifestation is in the lips (Chun).
The Spleen opens into the mouth, and the lips are the gateway of the mouth. Thus, its flourishing manifestation is in the lips. A condition where lips retract indicates Spleen exhaustion and is incurable.
It is governed by the Liver.
The Liver belongs to Wood and can dredge and drain water and grain. Spleen Earth receives the dredging of Liver Wood, allowing food to digest. If the Yang of Liver Wood does not ascend, diarrhea occurs. Liver Cold causes abdominal pain and cholera. Observing that Jianzhong Tang uses Gui Zhi (Cinnamomi Ramulus) to warm the Liver reveals the rationale. Liver Fire stagnation leads to dysentery, which is also Liver disease affecting the Spleen. Thus, the Liver is the master of the Spleen. Western medicine states that the Liver produces bile, which enters the stomach to help digest food; this is exactly the meaning of "Wood can dredge Earth" in the *Neijing*.
The Kidney corresponds to the bones (Gu).
Bones contain marrow; bones are generated by marrow. The whole body's bones are centered on the spine. The Kidney channel penetrates the spine. The Kidney stores Essence; Essence generates Marrow; Marrow generates Bones. Thus, bones are the correspondence of the Kidney. Western dissection examines the brain and brain nerves in detail but does not know what Marrow is. Because they do not know that the Kidney corresponds to the Bone, their treatments often encounter obstacles.
Its flourishing manifestation is in the hair (Fa).
Human hair is generated from Blood transforming via Qi; the principle is detailed in the "Five Zang Correspondences" entry and the "its flourishing manifestation in Mao" sentence above. Hair grows from air pores and belongs to Lung Metal; beard grows from the lips, the termination point of the Ren Mai, belonging to the Liver and Stomach meridians; whereas hair grows on the head, where the Du Mai intersects with the Taiyang Meridian. The Taiyang Meridian goes from the back to the head; the Du Mai penetrates the head from the spine. The Taiyang Bladder Meridian is the residence of the Kidney, and the Du Mai belongs to the Kidney; both intersect at the head. Blood within the Dantian, transformed by Qi, ascends along the meridians to generate scalp hair. Thus, when Kidney Essence is sufficient, its flourishing manifestation is in the hair. The elderly have white hair due to Kidney depletion. The principle of Blood transforming via Qi is detailed in the "Tian Gui" entry.
It is governed by the Spleen.
Spleen Earth can control Water, thereby sealing and storing Kidney Qi. If the Spleen fails to control and hold, seminal emission occurs. If the Spleen fails to control Water, Kidney Water floods, becoming phlegm-fluid retention.
Zhang Yin'an, commenting on the *Liu Wei Zhi Da Lun*, stated: "Below the position of Earth, Wind Qi succeeds it; below the position of Wind, Metal Qi succeeds it; below the position of Metal, Fire Qi succeeds it; below the Sovereign Fire, Yin Essence succeeds it. Excess brings harm; succession brings restraint; restraint allows bio-transformation." Therefore, the five Zang correspondences discuss mutual generation; the five Zang governance discusses mutual completion. Discussing Heart and Lung first, then Spleen and Kidney, returns to emphasizing the principle of mutual completion, does it not? Western medicine does not discuss the Five Elements, separating Zang and Fu organs distinctly, and knows nothing about the reasons for their communication or the principles of generation.