五脏六腑病形百出。然各有自为之病形。以为证据。如心为噫。非心止有噫之一证。谓无论何证。但见噫气。则知
属于心矣。余仿此。
心为噫。
噫者胸中结气。哽之使出俗说是打格顿非也。打格顿与噫。音义不符。打格顿是气厄于胸而出于口。故名曰呃。二
者均病在胸前。属心之部位。故皆属心经。柿形象心而蒂苦涩。治呃降心气也。胸满噫气。乃是肺胃痰火。仲景旋覆麦
冬治之。而必用赭石破心血镇心气也。久病闻呃为胃绝。则以其火不生土。心气逆也。心病不止一噫。然见噫气。便知
属心。用药乃知方向。
肺为咳。
内经言五脏六腑。皆有咳证。而无不聚于胃关于肺。盖肺主气管。气管中非痰饮。即风寒火燥。令其气逆故咳。有
从皮毛口鼻入气管者。有从肠胃膈膜入气管者。当分头治之。按 咳二证。道路不同。鼻主吸气。 字从鼻。是吸入之
气管不利。此管详膀胱肺肾条。咳字从欠。欠者口气下垂也。口主出气是呼出之气管不利。此管在胸。膈故每咳必胸前。
痒滞。详三焦条。
肝为语。
谵语属阳明燥热。郑声属心神虚恍。而此云肝为语。盖燥热乃木火克土。神恍乃肝魂不清。因而心神扰惑。故皆宜
泻木火安魂也。
脾为吞。
脾主化谷生津。凡口中津液少者。时常作吞。引之状反吞为吐又是水谷不下之故。皆属脾病。可以互勘。
肾为欠为嚏。
欠者阴。引阳入。故呵欠。至而欲寐嚏者。阳引阴出故喷嚏出而人醒。二者皆根于气海。故肾病则见此二证。
胃为气逆。为哕为恐。
阳明主纳。其气以下行为顺。气逆则反其令也。冲脉丽于阳明冲逆亦属阳明胃。哕者。吐秽恶之气也。吞酸嗳腐之
类。皆反其纳物之令也。恐者肾所主。肾水动而胃土不能制之。故恐亦属胃。
大小肠为泄。
泄多是脾胃中焦之证。然总出于肠中。故皆属于大小肠之病。小肠属火以化谷。火虚则谷不化而飧泄。大肠属金以
燥粪燥气不足则粪溏泻。小肠火甚则又胶结为痢。大肠燥粪则又秘结不便。此又为泄之变态矣。
下焦溢为水肿。
三焦乃决渎之官前已详注。此但云下焦者。因上焦连心肺。中焦连脾胃。多兼心肺脾胃之证。尚非三焦专责。惟下
焦当膀胱上口为水入膀胱之路此处不利则水溢于上。达于外而发水肿。下焦属肾属肝治宜疏泄肝肾。又肺居高能御下。
主通调水道。非开利。肺气不能治下焦也。
膀胱不利为癃。不约为遗溺。
膀胱下为溺管。溺管淋涩不通为癃肺主水道。由肺气闭。则宜清利。肝脉绕茎。由肝血滞。则宜滑利。据西医之说。
以为溺管发炎肿塞或砂淋内塞究之。皆肺肝两端所致也。又溺管之后为精窍。精窍有败精死血。亦能挤塞溺管。法当利
肾。夫肺以阴气下达膀胱。通调水道而主制节。使小便有度。不得违碍肝肾以阳气达于膀胱蒸发水气使其上腾。不得直
泻。若阳气不能蒸。发则水无约束。发为遗溺。治宜温胞室。盖膀胱如釜。胞如灶温。胞室者。釜底添薪也。参看十二
官条自见。
胆气郁为怒。
胆者木生之大也。西医论胆专言汁不知有汁即有气。故内经均以气立论。木气条畅。火气宣达。则清和朗润。其人
和平。若木郁生火。火郁暴发则为震怒凡病之易怒者皆责于胆气也。
脏腑之证。不一而足。举此为验。任其证形百变均莫得而遁情矣。
五脏六腑的病变表现千变万化，但各自有其特定的病形作为诊断依据。例如，心系的病变表现为“噫”（嗳气）。这并不是说心脏只有嗳气这一种症状，而是指无论出现何种病症，只要见到嗳气的表现，就可以判断其归属于心经。其余脏腑依此类推。
心主噫。
所谓噫，是胸中郁结之气，强行哽出所致。世俗常将其误认为是打嗝（呃逆），这是不对的。打嗝与噫在声音和意义上都不相符。打嗝是气受阻于胸中而冲出口腔，所以称为“呃”。这两种病证虽然都发生在胸前部位，属于心的解剖区域，因此都归属于心经。柿子形状像心，其蒂味苦涩，能治疗呃逆，起到降心气的作用。胸满伴嗳气，通常是肺胃有痰火所致，张仲景用旋覆花、麦冬治疗，但必须配合赭石来破心血、镇心气。久病中出现呃逆，被认为是胃气绝的表现，这是因为心火不能生脾土，导致心气上逆。心病不仅仅表现为嗳气，但只要见到嗳气，就知道病属于心，用药时便有了方向。
肺主咳。
《内经》说五脏六腑都有咳嗽的症状，但没有不汇聚于胃并关联到肺的。因为肺主管气管，气管中如果不是痰饮，就是风寒火燥，导致气机上逆而引发咳嗽。有的病邪从皮毛口鼻进入气管，有的从肠胃膈膜进入气管，应当分别从头部和下部进行治疗。按咳嗽二字分析：咳字从“亥”，道路不同；鼻主吸气，“咳”字从“口”旁（注：原文此处可能有误或通假，通常咳从口，嗽从欠，或反之，依原文逻辑解读），吸入的气管不利，此管详见膀胱、肺、肾条；“嗽”字从“欠”，欠是指口气下垂，口主呼气，呼出的气管不利，此管在胸膈之间，所以每次咳嗽必然伴有胸前痒滞感，详见三焦条。（注：原文对汉字构形的解释较为独特，此处忠实翻译原文意思）
肝主语（谵语/郑声等言语异常）。
谵语属于阳明燥热，郑声属于心神虚恍。而这里说肝主言语异常，是因为燥热是木火克伐脾土，神恍是肝魂不清，进而扰乱心神，所以都应该采用泻木火、安神魂的方法治疗。
脾主吞。
脾主消化谷物、生津液。凡是口中津液少的人，时常做出吞咽的动作。如果反而将食物吐出，又是水谷不能下咽的缘故，这些都归属于脾病，可以互相参照验证。
肾主呵欠和喷嚏。
呵欠是阴气牵引阳气入内，所以会打哈欠想睡觉；喷嚏是阳气牵引阴气外出，所以打喷嚏后人就醒了。这两种现象都根源于气海（丹田），所以肾病时会出现这两种症状。
胃主气逆、哕（干呕/呃逆）和恐惧。
阳明胃主受纳，其气以下行为顺，气逆则违背了其生理功能。冲脉附丽于阳明，冲气上逆也属于阳明胃的病证。哕，是吐出秽恶之气的表现。吞酸、嗳腐等，都是违背了受纳食物的指令。恐惧本是肾所主，但如果肾水妄动而胃土不能制约它，那么恐惧也与胃有关。
大小肠主泄泻。
泄泻多是脾胃中焦的病证，但最终都出于肠道，所以都属于大小肠的病。小肠属火以消化谷物，火虚则谷物不化，导致完谷不化的飧泄；大肠属金以燥化粪便，燥气不足则粪便溏薄腹泻。小肠火盛则会胶结为痢疾；大肠燥结则会导致便秘不通。这又是泄泻的各种变证。
下焦溢流导致水肿。
三焦是决渎之官，前文已详细注释。这里只提下焦，是因为上焦连接心肺，中焦连接脾胃，多兼有心肺脾胃的病证，尚不是三焦单独的责任。只有下焦位于膀胱上口，是水进入膀胱的道路，此处不利则水溢出向上，通达体表而发为水肿。下焦属肾属肝，治疗宜疏泄肝肾。另外，肺居高位能御下，主通调水道，如果不宣利肺气，就不能治理下焦的水病。
膀胱不利导致癃闭，约束无力导致遗尿。
膀胱下方为尿道，尿道淋涩不通称为“癃”。肺主水道，因肺气闭塞，宜清利；肝脉绕阴茎，因肝血瘀滞，宜滑利。据西医说法，认为尿道发炎肿胀堵塞或砂淋内塞，究其根本，都是肺和肝两端的问题。另外，尿道之后为精窍，精窍中有败精死血，也能挤压堵塞尿道，治疗方法应当利肾。肺通过阴气下达膀胱，通调水道并主节制，使小便有度，不违碍肝肾；肝肾通过阳气达于膀胱，蒸发水气使其上腾，不得直泻。如果阳气不能蒸化，水就无约束，发为遗尿。治疗宜温补胞室（此处指下焦元气/命门之火），因为膀胱像锅，胞室像灶，温胞室就是在锅底添柴加火。参看十二官条自见。
胆气郁结导致易怒。
胆是木气生发的大脏。西医论胆专言胆汁，不知道有汁就有气，所以《内经》均以气立论。木气条畅，火气宣达，人体就清和朗润，性情平和。如果木郁生火，火郁暴发就会震怒，凡容易发怒的病，都应归责于胆气。
脏腑的病证，不一而足，举这些例子作为验证，任凭证候形态如何变化，都无法逃脱这些规律。
The pathological manifestations of the Zang and Fu organs are myriad, yet each has its specific signs serving as diagnostic evidence. For instance, heart pathology manifests as "Yi" (belching). This does not imply that the heart only presents with belching; rather, it signifies that regardless of other symptoms, if belching is observed, the pathology can be attributed to the Heart channel. The same logic applies to other organs.
Heart governs belching.
Belching refers to Qi stagnating in the chest and being forced out through the throat. It is commonly mistaken for hiccuping (E), which is incorrect. Hiccups and belching differ in sound and meaning. Hiccups occur when Qi is obstructed in the chest and expelled through the mouth, hence named "E". Both conditions occur in the anterior chest region, corresponding to the anatomical area of the Heart, and thus both are attributed to the Heart channel. Persimmons resemble the shape of the heart, and their calyxes are bitter and astringent; they treat hiccups by descending Heart Qi. Chest fullness accompanied by belching is typically caused by Phlegm-Fire in the Lung and Stomach. Zhang Zhongjing treats this with Xuanfu Daiduzhong Decoction (Inula and Ophiopogon Decoction), but must include Hematite (Hematitum) to break Blood stasis and calm Heart Qi. Hiccups appearing in chronic illness indicate the exhaustion of Stomach Qi, resulting from Heart Fire failing to generate Spleen Earth and causing rebellious Heart Qi. Heart disease is not limited to belching, but observing belching indicates Heart involvement, providing direction for treatment.
Lung governs cough.
The *Neijing* states that all Zang and Fu organs can present with cough, but none do so without gathering at the Stomach and relating to the Lung. The Lung governs the airways; if these contain Phlegm-Fluids or are affected by Wind-Cold, Fire, or Dryness, Qi rebels upward causing cough. Pathogens may enter the airways from the skin and hair or nose/mouth, or from the intestines and diaphragm; these should be treated separately according to their entry points. Analyzing the characters: "Ke" (cough) relates to inhalation via the nose; obstruction here affects the airway detailed in the Bladder, Lung, and Kidney sections. "Sou" (clearing phlegm/coughing sound) relates to exhalation via the mouth; obstruction here affects the thoracic diaphragm, often causing itching and stagnation in the anterior chest during coughing, detailed in the Sanjiao section.
Liver governs speech abnormalities (such as delirium or muttering).
Delirious speech (Zhanyu) belongs to Yangming Dryness-Heat; murmuring speech (Zhengsheng) belongs to Heart Spirit deficiency and confusion. Here, liver governance of speech implies that Dryness-Heat involves Wood-Fire overacting on Earth, while confusion involves unclear Liver Hun (Ethereal Soul), thereby disturbing the Heart Shen (Spirit). Therefore, treatment should focus on draining Wood-Fire and calming the Hun.
Spleen governs swallowing.
The Spleen transforms food and generates fluids. Individuals with insufficient oral fluids often exhibit frequent swallowing motions. Conversely, inability to swallow food and fluid also indicates Spleen pathology. These signs can be cross-referenced.
Kidney governs yawning and sneezing.
Yawning occurs when Yin draws Yang inward, leading to drowsiness. Sneezing occurs when Yang draws Yin outward, waking the person upon expulsion. Both originate from the Qi Sea (Lower Dantian); thus, Kidney pathology presents with these two signs.
Stomach governs rebellious Qi, hiccups (Yue), and fear.
Yangming Stomach receives food, and its Qi should descend smoothly. Rebellious Qi violates this function. The Chong Mai connects to Yangming; rebellious Qi from the Chong Mai also pertains to the Stomach. Yue refers to expelling foul-smelling Qi. Acid regurgitation and belching of rotten food violate the receiving function. Fear is primarily governed by the Kidney, but if Kidney Water moves recklessly and Stomach Earth fails to control it, fear also relates to the Stomach.
Large and Small Intestines govern diarrhea.
Diarrhea is mostly a Middle Jiao disorder involving the Spleen and Stomach, but ultimately originates in the intestines, thus belonging to Large and Small Intestine pathology. The Small Intestine belongs to Fire and transforms food; Fire deficiency leads to undigested food in stool (Sunxie). The Large Intestine belongs to Metal and dries feces; insufficiency of drying Qi leads to loose stools. Excessive Fire in the Small Intestine causes sticky dysentery; dryness in the Large Intestine causes constipation. These are variations of diarrhea.
Excess in the Lower Jiao leads to edema.
The Sanjiao is the official of drainage, as noted previously. Mentioning only the Lower Jiao here is because the Upper Jiao connects to the Heart and Lung, and the Middle Jiao to the Spleen and Stomach, often presenting combined syndromes not solely attributable to the Sanjiao. Only the Lower Jiao, located at the entrance to the Bladder, serves as the pathway for water entry. Obstruction here causes water to overflow upwards and reach the exterior, resulting in edema. The Lower Jiao belongs to the Kidney and Liver; treatment should promote the free flow of Liver and Kidney Qi. Additionally, the Lung resides high and controls the lower regions, governing the regulation of water passages. Without promoting Lung Qi, the Lower Jiao water pathology cannot be resolved.
Bladder dysfunction leads to strangury (Long), and lack of restraint leads to enuresis.
Below the Bladder lies the urethra. Obstruction and painful urination constitute strangury. The Lung governs water passages; closure of Lung Qi requires clearing and promoting. The Liver channel wraps around the penis; blood stasis requires lubricating and unblocking. Western medicine attributes urethral inflammation, swelling, or sand blockage to local issues, but fundamentally, these stem from Lung and Liver dysfunction. Behind the urethra lies the essence aperture; retained semen or dead blood can compress the urethra, requiring treatment to benefit the Kidney. The Lung transmits Yin Qi to the Bladder to regulate water passages and ensure controlled urination, preventing interference from Liver-Kidney Yang. Liver-Kidney Yang reaches the Bladder to evaporate water vapor, preventing direct leakage. If Yang fails to evaporate, water lacks constraint, leading to enuresis. Treatment should warm the "Bao Shi" (Uterus/Lower Jiao furnace). The Bladder is like a pot, and the Bao Shi is like the stove; warming the Bao Shi is akin to adding firewood to the stove. Refer to the Twelve Officials section for details.
Gallbladder Qi stagnation leads to anger.
The Gallbladder is the major organ of Wood generation. Western medicine focuses on bile, ignoring Qi. The *Neijing* discusses Qi. When Wood Qi flows freely and Fire Qi spreads, the body remains clear, harmonious, and peaceful. If Wood stagnates generating Fire, and Fire stagnates erupting violently, it results in rage. All cases of irritability are attributed to Gallbladder Qi.
Syndromes of the Zang and Fu organs are numerous. These examples serve as verification. Regardless of how varied the clinical presentations, they cannot escape these fundamental principles.