人必脏腑血气。先有亏损。然后生病。故论病机。先言五脏所伤。
忧愁思虑则伤心
心为火脏火气宣明。则能化生血液。流畅筋脉。血脉流行。则其志常喜若反乎喜而为忧愁。思虑。则心气遏抑火郁
血滞。故伤心也。治宜宣达心阳。通畅血脉又常以喜胜忧虑。斯愈矣。
形寒饮冷则伤肺。
肺金畏火。自然惧热。此又云畏寒冷者何也。盖肺之体虽是阴金。而肺之用实主阳气。气布于外则为卫阳以充皮毛
若衣服失。宜外形受寒则皮毛洒淅。渐入腠理。发热动饮为咳喘等症。治宜温散气布于内。则为宗气以司呼吸散津于脾
下。输膀胱。若饮水浆果瓜之属。多受冷气。则阳气不能布化水饮停积。为咳喘癖痛等症。治宜温降。
悲怒气逆则伤肝。
悲者肺主之。过悲则金来克木。木不能达。怒者肝主之。过怒则肝木横。决血不能静。二者皆逆气也。肝乃主血之
脏血。之所以流行不滞。潜伏不动者。全赖气之和。平有以配养此血耳。今其气逆则血逆。肝木郁于下。肝火犯于上。
而肝受伤矣悲则肝木郁于下。宜辛以升散之。怒则肝火犯乎上。宜苦以降解之。然总以养和神。得其平为要。
饮食劳倦则伤脾。
饮所以润脾。过多则停饮为湿。发为胀泄痰咳之证。土能治水。而反为水所困也。宜渗利食以养脾。过多则停食。
为泄为满。脾能化食。而反为食所困也。宜消导。脾主肌肉劳以运动肌肉。使其活泼。乃益得安然。劳至于倦。必致消
瘦发热。盖动而生阳伤脾之。阴故肌肉反受其病。治宜填补静养。
久坐湿地。强力入房。则伤肾。
肾中之阳。能化湿气。则水达膀胱。气行肢脊。若久坐湿地。则湿气太甚。而肾阳反受其伤。必生肢脊疼肿等证。
治宜燥之。肾中阴精充足无损则能种子。入房乃其常事。若力已竭。而犹勉强入房。则肾精枯矣。治宜滋补。
人必须脏腑气血，先有亏损，然后才会生病。因此论述病机时，首先谈论五脏所伤。
忧愁思虑则伤心。
心为火脏，火气宣明，则能化生血液，流畅筋脉。血脉流行，则其志常喜。若反乎喜而为忧愁、思虑，则心气遏抑，火郁血滞，所以伤害心脏。治疗宜宣达心阳，通畅血脉。又常用以喜胜忧的方法，这样就能痊愈。
形寒饮冷则伤肺。
肺金畏火，自然惧热。这又说畏惧寒冷，为什么呢？大概肺的体虽是阴金，而肺的用实主阳气。气布于外则为卫阳以充实皮毛。如果衣服失宜，外形受寒，则皮毛洒淅（恶寒战栗），渐入腠理，发热动饮，成为咳喘等症状。治疗宜温散。气布于内，则为宗气以司呼吸；散津于脾下，输膀胱。如果饮水浆果瓜之类，多受冷气，则阳气不能布化，水饮停积，成为咳喘癖痛等症状。治疗宜温降。
悲怒气逆则伤肝。
悲由肺主之，过悲则金来克木，木不能达。怒由肝主之，过怒则肝木横决，血不能静。二者都是逆气。肝是主血的脏，血之所以流行不滞、潜伏不动，全赖气之和平，有以配养此血耳。现在气逆则血逆，肝木郁于下，肝火犯于上，而肝受伤了。悲则肝木郁于下，宜用辛味药以升散之；怒则肝火犯乎上，宜用苦味药以降解之。然而总以养和神志，得其平和为要。
饮食劳倦则伤脾。
饮所以润脾，过多则停饮为湿，发为胀泄痰咳之证。土能治水，而反为水所困也。治疗宜渗利。食以养脾，过多则停食，为泄为满。脾能化食，而反为食所困也。治疗宜消导。脾主肌肉，劳以运动肌肉，使其活泼，乃益得安然。劳至于倦，必致消瘦发热。盖动而生阳，伤脾之阴，故肌肉反受其病。治疗宜填补静养。
久坐湿地。强力入房。则伤肾。
肾中之阳，能化湿气，则水达膀胱，气行肢脊。如果久坐湿地，则湿气太甚，而肾阳反受其伤，必生肢脊疼肿等证。治疗宜燥之。肾中阴精充足无损则能种子。入房乃其常事。如果力已竭，而犹勉强入房，则肾精枯矣。治疗宜滋补。
The human body must first suffer from a deficiency in the Zang-Fu organs, blood, and Qi before disease arises. Therefore, when discussing pathogenesis, one first addresses the injuries to the five Zang organs.
Sorrow and overthinking injure the Heart (Xin).
The Heart is the Fire organ; when its Fire Qi is bright and clear, it can transform into blood and ensure the smooth flow of the meridians. When blood vessels flow smoothly, the spirit is naturally joyful. If, contrary to joy, one experiences sorrow or overthinking, the Heart Qi becomes suppressed, Fire stagnates, and blood stasis occurs, thereby injuring the Heart. Treatment should aim to diffuse Heart Yang and unblock the blood vessels. Furthermore, using joy to overcome sorrow is an effective method for recovery.
Exposure to cold and consumption of cold drinks injure the Lung (Fei).
Metal of the Lung fears Fire and naturally dreads heat. Why then does it also fear cold? Although the substance of the Lung is Yin Metal, its function actually governs Yang Qi. When this Qi spreads outward, it becomes Defensive Yang (Wei Yang) to nourish the skin and hair. If clothing is inadequate and external cold invades, the skin and hair shiver with chills, which gradually penetrate the interstices (Cou Li), leading to fever, fluid agitation, and symptoms such as cough and asthma. Treatment should employ warming and dispersing methods. When this Qi spreads inward, it becomes Pectoral Qi (Zong Qi) to govern respiration; it distributes fluids downward to the Spleen and transports them to the Bladder. If one consumes excessive water, beverages, fruits, or melons, they absorb much cold energy, causing Yang Qi to fail in transformation and distribution. Fluid retention accumulates, resulting in symptoms like cough, asthma, hypochondriac pain, and colic. Treatment should employ warming and descending methods.
Grief and anger causing Qi reversal injure the Liver (Gan).
Grief is governed by the Lung; excessive grief causes Metal to overact on Wood, preventing Wood from extending freely. Anger is governed by the Liver; excessive anger causes Liver Wood to surge horizontally, preventing blood from remaining calm. Both conditions involve reversed Qi. The Liver is the organ that governs blood. The reason blood flows without stagnation and remains latent yet active is entirely due to the harmony and peace of Qi, which nourishes and supports the blood. Now, if Qi reverses, blood also reverses; Liver Wood stagnates below, and Liver Fire attacks above, thus injuring the Liver. Grief causes Liver Wood to stagnate below, so pungent (acrid) herbs should be used to ascend and disperse it. Anger causes Liver Fire to attack above, so bitter herbs should be used to descend and resolve it. However, the essential principle is always to nurture the spirit's harmony and achieve balance.
Dietary irregularities and fatigue injure the Spleen (Pi).
Drinks moisten the Spleen; excessive intake leads to fluid retention becoming dampness, manifesting as distension, diarrhea, phlegm, and cough. Earth controls Water, but here it is instead constrained by Water. Treatment should employ leaching and draining methods. Food nourishes the Spleen; excessive intake leads to food stagnation, causing diarrhea and fullness. The Spleen transforms food, but here it is constrained by food. Treatment should employ digestion-promoting and guiding methods. The Spleen governs the muscles. Physical activity exercises the muscles, keeping them agile and healthy. However, labor leading to exhaustion inevitably results in emaciation and fever. This is because movement generates Yang, injuring the Yin of the Spleen, so the muscles are adversely affected. Treatment should employ tonification and quiet rest.
Prolonged sitting in damp places and strenuous sexual intercourse injure the Kidney (Shen).
Yang within the Kidneys can transform dampness, allowing water to reach the Bladder and Qi to circulate through the limbs and spine. If one sits in damp places for long periods, dampness becomes excessive, and Kidney Yang is injured, inevitably producing symptoms such as pain and swelling in the limbs and spine. Treatment should employ drying methods. If Yin essence within the Kidneys is sufficient and undamaged, it can produce offspring. Sexual intercourse is a normal activity. However, if strength is exhausted and one still forces sexual intercourse, Kidney essence will become depleted. Treatment should employ nourishing and tonifying methods.