六腑皆以出入名阳。而有重轻之别。其得与于三阳者。唯阳明胃。与少阳胆。连及三焦。他若大小肠膀胱。皆使器
传道受盛之官。不得列于阳数。其以六腑名者。以其同为形脏。同有出入。故名之耳。后学不察。以为生人之阳在此。
而加诸五脏之上。以经络表里之故。遂从而夫妻之。此大谬不然。试明之。夫阳明胃能合于二阳者。以胃为水谷之海。
六腑之大源也。五味入口。以养五脏气。是以五脏六腑之气。皆出于胃。而即为五脏之藏耳。五脏不得胃气。则不能至
于手太阴。与胃气。肾能为营卫周身脏腑之主。而其脉同变见于气口。故阳明独得列一位于五阴之间。本经曰。气口亦
太阴也。诊胃气者。亦得以右寸与关上。当肺气宁静。而右寸独盛者。此胃脉之盛也。且胃腑之位。为两阳合明。其经
属相火。夏气当乎二阳。经为二阳为卫。二阳为维。以其气用之大也。知气用之大。则知阳明之大矣。次则少阳胆。胆
列中正之官。决断出焉。又指为中精之腑。则其所主已异乎形脏。而其腑之气。直得先天甲气。而起于少阴。发于厥阴。
是二阴之真精所生。以为一阳之妙也。经曰。少阳连肾。肾上连肺。夫少阳起于夜半之子。为肾之天根。其气上升。以
应肺之治节。是所谓中和。极通之上下。故得游行于三焦。而即三焦之所治。以致用于阳明。凡诸腑脏不得此气。则不
能以为和。是胆之为用。能起九地。而升其地德。亦能出三阳。而布其天德。不止为中正之官。五神之决断。凡十一脏
皆取决于胆。经之所谓谓此也。要其为腑。虽微有出入。劳则有之。而其体则独居于清静之腑。以冲和之气。温养诸脏。
故有中精之目也。若膀胱者。其邪虽大。而其本则州都之官。津液藏焉。待气化而后能出。夫州都之下邑。绝远京师。
且津液必待化而出。则膀胱之为器。绝不得与诸阳并。而其经反纳太阳者。以太阳起于少阴。今归之以阳。故借纳之于
此也。其实太阳为三阳之主。为经为父。膀胱虽其本脏。而要不得竟以为父之太阳目之也。后学不详本经。皆谓膀胱为
太阳寒水。以主寒令。岂知六气寒水之所主。本为少阴肾。人身太阳之经。实非寒令。而膀胱之水。亦非寒水也。二肠
者。受盛传化之官。为胃之器使。亦供役动用之物耳。其腑无灵。其经亦非当阳之用。要以营气之隧道与心肺相接。故
经络得与心肺为表里。非曰此二物能与心肺为互用也。脉经以其络列寸口心肺之上。其说遗误后学。莫此为甚。夫心肺
为阳。在上主诸关前。以主夏秋。此岂可使二肠当之。即脉经伪揆种种。竟无二肠脉状。知其无以加心脉之浮大。肺脉
之浮涩。而别撰二肠络矣。经又曰。脾胃大小肠三焦膀胱者。仓廪之本。营之居也。名曰器。能化糟粕转味而出入者也。
此皆至阴之类。通乎土气。内经明指其阴。叔和以其为阳。读书无眼耳。
六腑都以“出入”的功能来命名，属于阳的范畴，但其中有轻重主次之分。其中能归属于三阳（太阳、阳明、少阳）体系的，只有阳明胃和少阳胆，以及关联到三焦。至于大肠、小肠和膀胱，它们都是传导和受纳的器官，不能列入阳气的主要序列。之所以统称为六腑，是因为它们同属于“形脏”（有具体形态的脏器），都具有“出入”的功能，所以这样称呼罢了。后世学者没有仔细考察，认为人体生命的阳气在于此，便将其凌驾于五脏之上。仅仅因为经络存在表里配合的关系，就强行将它们比作夫妻关系，这完全是错误的。让我阐明其中的道理。
阳明胃之所以能与二阳相合，是因为胃是“水谷之海”，是六腑能量的根本来源。各种味道进入口中，用来滋养五脏之气。因此，五脏六腑的气都源于胃，胃也就成为了五脏能量的储藏库。如果五脏得不到胃气，就不能输送到手太阴肺经。肾虽然能作为营卫之气周流全身脏腑的主宰，但其脉象变化也共同反映在气口（寸口脉）。所以，阳明胃独自在五阴经脉之间占据一个位置。《内经》说：“气口脉也是太阴肺经的反映。”诊察胃气时，也可以通过右寸脉和关脉来判断。当肺气宁静，而右寸脉单独盛大时，这就是胃脉旺盛的表现。而且，胃腑的位置被称为“两阳合明”，其经络属性属于相火，夏季的气候对应于二阳（阳明）。经文说：二阳为卫，二阳为维。这是因为它的气用非常宏大。知道了气用的宏大，就知道阳明的重要性了。
其次是少阳胆。胆被任命为“中正之官”，决断力由此产生。又被称为“中精之腑”，那么它所主管的功能已经不同于一般的形脏。胆腑的气直接禀受了先天的甲木之气，起始于少阴，发源于厥阴，这是由二阴的真精所化生，形成了一阳的精妙作用。经文说：“少阳连属肾脏，肾脏上连肺部。”少阳起始于夜半的子时，是肾脏的天根所在，其气上升，以顺应肺气的治节功能。这就是所谓的“中和”，贯通上下。因此，胆气能够游行于三焦之中，并受到三焦的治理，从而发挥作用于阳明。凡是诸脏腑如果没有这股气，就不能达到和谐。所以胆的作用，能够起于九地之下，提升大地的德性；也能出于三阳之外，布散天地的德性。不仅仅是作为中正之官，主宰五神的决断，凡是十一脏的功能都取决于胆。经文所说的就是这个意思。总之，胆虽然作为腑，在出入方面略有不同，劳碌有所承担，但其体独居于清静之腑，以冲和之气温养诸脏，所以有“中精”的称号。
至于膀胱，它的邪气虽然盛大，但其本质是“州都之官”，津液藏匿于此，必须等待气化之后才能排出。州都是京师的边远小邑，距离遥远，而且津液必须经过转化才能排出，所以膀胱作为器官，绝对不能与其他阳经并列。然而它的经络反而纳入太阳经系统，是因为太阳经起始于少阴，现在将其归入阳的范畴，所以借由收纳在这里。其实太阳是三阳之主，既是经络又是父亲般的存在。膀胱虽然是其本脏，但不能完全把它当作父亲的太阳来看待。后世学者不了解《内经》原意，都说膀胱是太阳寒水，主司寒冷时令。哪里知道六气中的寒水是由少阴肾所主。人身上的太阳经，实际上并非主司寒冷，而膀胱里的水，也不是寒水。
大肠和小肠，是受纳、盛装、传导和消化的器官，是胃的助手和仆役，也是供驱使使用的器物罢了。它们的腑没有灵性，其经络也不具备当阳（主要阳气）的作用。主要是作为营气运行的隧道与心肺相接，所以经络得以与心肺构成表里关系，并不是说这两个器官能与心肺互相利用。《脉经》将它们的络脉列在寸口心肺之上，这种说法误导后学，没有比这更严重的了。心肺属阳，位于上部，主管关前部位，对应夏秋季节，这怎么能让大小肠来担当呢？即使《脉经》胡乱推测种种情况，竟然没有大小肠独立的脉象特征，知道它无法超越心脉的浮大和肺脉的浮涩，于是另外编造了大小肠的络脉理论。经文又说：“脾胃、大小肠、三焦、膀胱，是仓廪的根本，营气居住的地方，名为器，能够消化糟粕、转化五味并实现出入。”这些都是至阴类的东西，通于土气。《内经》明确指出它们属阴，而王叔和却认为它们属阳，读书人真是没有眼力和耳聪啊。
The Six Fu Organs are all named according to their functions of "entering and exiting," belonging to the category of Yang, yet there are distinctions in weight and priority. Among them, only the Yangming Stomach (Stomach) and Shaoyang Gallbladder (Gallbladder), along with their connection to the Sanjiao (Triple Burner), can be included in the Three Yang (Taiyang, Yangming, Shaoyang). As for the Large Intestine (Large Intestine), Small Intestine (Small Intestine), and Bladder (Bladder), they are merely vessels for transmission and reception, and cannot be listed among the primary sequence of Yang Qi. They are collectively called the Six Fu Organs because they are all "Form Zang" (organs with specific physical forms) and share the function of "entering and exiting." Later scholars failed to examine this carefully, believing that the life-giving Yang of humans resides here, and thus placed them above the Five Zang Organs. Due to the exterior-interior relationship of meridians, they were forcibly compared to husband and wife relationships; this is a great error. Let me clarify.
The Yangming Stomach can combine with the Two Yangs because the Stomach is the "Sea of Water and Grain" and the great source of the Six Fu Organs. When flavors enter the mouth, they nourish the Qi of the Five Zang Organs. Therefore, the Qi of the Five Zang and Six Fu Organs all originates from the Stomach, which serves as the storehouse for the Five Zang. If the Five Zang do not receive Stomach Qi, it cannot reach the Hand-Taiyin Lung Meridian. Although the Kidney can act as the master of Ying (Nutritive) and Wei (Defensive) Qi circulating through the organs, its pulse changes are also manifested at the Qikou (Radial Pulse). Thus, the Yangming Stomach uniquely occupies a position among the Five Yin meridians. The Classic states: "The Qikou pulse is also that of the Taiyin." To diagnose Stomach Qi, one can also observe the Right Cun (Inch) and Guan (Bar) positions. When Lung Qi is tranquil but the Right Cun pulse is exclusively vigorous, this indicates the prosperity of Stomach pulse. Furthermore, the position of the Stomach organ is termed "Two Yangs Combined Brightness," and its meridian attribute belongs to Minister Fire. Its seasonal correspondence is Summer, aligning with the Two Yangs. The Classic says: "The Two Yangs serve as the Shield (Wei), and the Two Yangs serve as the Link (Wei)." This is due to the magnitude of its functional Qi. Understanding the magnitude of this functional Qi reveals the greatness of Yangming.
Next is the Shaoyang Gallbladder. The Gallbladder is appointed as the "Official of Uprightness," where decision-making arises. It is also referred to as the "Middle Essence Vessel," indicating that its governing function differs from ordinary form organs. The Qi of the Gallbladder directly inherits the innate Jia Wood Qi, originating from Shaoyin and emerging from Jueyin. This is generated by the true essence of the Two Yins, forming the subtle action of One Yang. The Classic states: "Shaoyang connects to the Kidney, and the Kidney connects upward to the Lung." Shaoyang begins at the Zi hour (midnight), serving as the Heavenly Root of the Kidney. Its Qi ascends to respond to the regulatory function of the Lung. This is what is meant by "Harmony and Centrality," connecting the upper and lower. Therefore, Gallbladder Qi can roam within the Sanjiao and is governed by it, thereby exerting its influence on Yangming. Without this Qi, no other organs or viscera can achieve harmony. Thus, the function of the Gallbladder can rise from the depths of the earth, elevating earthly virtue, and emerge beyond the Three Yangs, distributing heavenly virtue. It is not merely the Official of Uprightness making decisions for the Five Spirits; rather, all eleven organs depend on the Gallbladder for decision-making. This is what the Classic refers to. Ultimately, although the Gallbladder is a Fu organ with slight differences in entering/exiting and bears labor, its nature resides alone in the "Clear and Tranquil Vessel," warming and nourishing the other organs with harmonious Qi, hence the name "Middle Essence."
As for the Bladder, although its pathogenic factors may be prominent, its essence is the "Official of the Prefecture," storing fluids until Qi transformation allows for their expulsion. The Prefecture is a remote outpost far from the capital, and since fluids must undergo transformation before being expelled, the Bladder as a vessel absolutely cannot be grouped with other Yang meridians. However, its meridian is incorporated into the Taiyang system because the Taiyang Meridian originates from Shaoyin; now categorized under Yang, it is borrowedly accommodated here. In reality, Taiyang is the master of the Three Yangs, serving as both the Meridian and the Father. Although the Bladder is its root organ, it should not be entirely regarded as the Taiyang Father. Later scholars, unfamiliar with the original Classic, claim the Bladder is "Taiyang Cold Water" governing cold seasons. They fail to realize that among the Six Qi, Cold Water is governed by the Shaoyin Kidney. The Taiyang Meridian in the human body does not actually govern cold, nor is the water in the Bladder truly cold water.
The Large and Small Intestines are officials of receiving, holding, transmitting, and transforming, acting as assistants and servants to the Stomach, serving as tools for use. Their Fu organs lack spiritual agency, and their meridians do not possess the function of dominant Yang. Primarily, they serve as tunnels for Ying Qi to connect with the Heart and Lung, allowing their meridians to form exterior-interior pairs with these organs. This does not imply mutual utility between these two organs and the Heart/Lung. The *Mai Jing* (Pulse Classic) places their collaterals above the Heart and Lung at the Cun Kou, a statement that misleads later scholars more severely than any other. The Heart and Lung belong to Yang, located superiorly, governing the anterior part of the pulse, corresponding to Summer and Autumn. How could the Large and Small Intestines bear this role? Even the various speculations in the *Mai Jing* fail to present distinct pulse patterns for the intestines, knowing they cannot surpass the floating-and-large quality of the Heart pulse or the floating-and-choppy quality of the Lung pulse, leading to the fabrication of separate intestinal collateral theories. The Classic further states: "The Spleen, Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder are the roots of the granaries, the dwellings of Ying Qi, named 'Vessels,' capable of processing dregs, transforming flavors, and managing entry and exit." These all belong to the category of Extreme Yin, communicating with Earth Qi. The *Neijing* explicitly identifies them as Yin, whereas Wang Shuhe considered them Yang. Readers lacking insight have erred greatly.