素问阴阳应象论清阳为天浊阴为地地气上为云天气下为雨雨出地气云出天气
王冰曰阴凝上结则合以成云阳散下流则注而为雨雨从云以施化故言雨出地气云凭气以交合故言云出天气天地之理且
然人身清浊亦如是吴昆曰出通也雨出而通地气云出而通天气以人喻之饮入于胃游溢精气上输于脾脾气散精上归于肺上焦
开发若雾露焉是地气上为云也肺行降下之令通调水道下输膀胱水精四布是天气下为雨也膀胱者州都之官精液藏焉气化则
能出是雨出地气也上焦如雾其氤氲者心肺和而呵出之是云出天气也此六句者见阴阳清浊不可失位而倒置顺之则天地位而
万物育逆之则下飧泄而上 胀矣张志聪曰地虽在下而地气上升为云天虽在上而天气下降为雨天有云而后有雨是雨虽天降
而实本地气所升之云故雨出地气由雨之降而后有云之升是云虽地升而实本天气所降之雨故云出天气此阴阳交互之道也而
人亦应之此篇言天地之阴阳与人之阴阳相合是以一节言天地阴阳水火一节言清浊藏腑精形以天人相间而言也马莳曰地虽
在下而阴中之阳者升故其上也为云正蒙阴为阳得则飘扬为云而升天虽在上而阳中之阴者降故其下也为雨正蒙阳为阴素则
相持为雨而降骥案说文云山川气也雨从云下也玉篇雨云雨也元命苞阴阳和为雨大戴记天地之气和则雨和则天地气交阴阳
相感此上下二字有升降之义六微旨大论升已而降降者谓天降已而升升者谓地天气下降气流于地地气上升气腾于天天地之
升降者谓之阴阳阴阳之上下者谓之云雨天地之气如此人身之升降上下亦如之
故清阳出上窍浊阴出下窍
王冰曰气本乎天者亲上气本乎地者亲下各从其类也上窍谓耳目口鼻下窍谓前阴后阴马莳曰阴阳升降唯一气以为合一
之妙即人身观之凡人身之物有属清阳者如涕唾气液之类则出于上窍耳目口鼻之为七窍者皆清阳之所出也有属浊阴者如污
秽便浊之类则出于下窍前阴后阴之为二窍者皆浊阴之所出也骥案周礼疾医两之以九窍之变注谓阳窍七阴窍二疏谓阳窍七
者在头上露见故为阳阴窍二者在下不见故为阴阳清阴浊如上文但上文专就人身言此兼药物言
清阳发腠理浊阴走五藏
王冰曰腠理谓渗泄之门故清阳可以散发五藏为包藏之所故浊阴可以走之张志聪曰腠者三焦通会元真之处理者皮肤藏
府之文理言清阳之气通会于腠理而阴浊之精血走于五藏五藏主藏精者也马莳曰凡人身所用之物有属清阳者如饮食药物之
性有属阳之类据曰发曰走曰实曰归知其为在外之物惟阳者主升故发于腠理以腠理主表为阳也指物类阳气言若物
之有形质者则入
于六腑矣有属浊阴者如饮食药物有属阴之类惟阴者主降故走于五藏以五脏主里为阴也指物类阴气言若物之形质不入于五
脏张介宾曰腠理肌表也阳发散于皮肤故清阳归之阴受藏于五藏故浊阴走之骥案素问生气通天论腠理以密注谓肤表之毛孔
也素灵言五藏心肝脾肺肾疾医言九藏正藏外有胃膀胱大小肠于六腑中取四腑以益五藏为九藏四腑皆有受盛故谓之腑亦有
藏称故入九藏之数此言阳发外阴走内不拘为五为九马注得之
清阳实四肢浊阴归六腑
王冰曰四肢外动故清阳实之六腑内化故浊阴归之张志聪曰脾主四肢又曰手太阴独受其浊盖浊中之清者由脾转输而充
实于四肢浊中之浊者归于六腑马莳曰凡清阳之物实于四肢以四肢为诸阳之本也指物之气凡浊阴之物归于六腑以六腑受化
物而不藏也指物有形质者言人身之有阴阳其清浊升降之妙何以异于天地哉骥案支肢 通易美在其中而畅于四肢疏谓四肢
犹言手足灵枢邪客篇天有四时人有四肢谓两手两足位于身躯之四隅为全身之肢持护卫故名六腑疾医九藏心肝脾肺肾为正
藏取胃膀胱大肠小肠以益五藏为九藏引八十一难谓三焦为孤府非正府腑四腑六不必拘泥不过言清阳所实者肢浊阴所归者
腑而已又东垣用药法象清阳发腠理清之清实四肢清之浊浊阴归六腑浊之浊走五藏浊之清清之清者清肺以助其天真清之浊
者荣华腠理浊之浊者坚强骨髓浊之清者荣养于神亦有理
水为阴火为阳
王冰曰水寒而静故为阴火热而躁故为阳马莳曰阴阳者万物之父母水火者实阴阳之征兆举水火而足以尽阴阳矣故水为
阴而凡物之成于水者属阴火为阳而凡物之成于火者属阳张介宾曰天以日月为水火易以坎离为水火医以心肾为水火丹以精
气为水火肾者水也水中生气即真火也心者火也火中生液即真水也火水互藏乃至道之所在医家首宜省察骥案水曰润下润下
者润而又下也火曰炎上炎上者炎而又上也下为阴上为阳就五行而言若以药物言水为阴则益火之源以消阴翳火为阳则壮水
之主以制阳光张景岳薛立斋赵养葵六味八味左归右归其大凡也
阳为气阴为味
王冰曰气惟散布故阳为之味曰从形故阴为之吴昆曰臊焦香腥腐为气为阳酸苦甘辛咸为味为阴张志聪曰水性润下故为
阴火性炎上故为阳清阳上升故为气浊阴下降故为味盖以水火而征兆气味之阴阳也张介宾曰气无形而升故为阳味有质而降
故为阴此以药食气味言也骥案气味皆有各阴阳经所谓天有阴阳三阴三阳上奉之温凉寒热是也温热天之阳凉寒天之阴
是气不
独阳亦有阴也地有阴阳金木水火土生长化收藏下应之辛甘淡酸苦咸五味是也辛甘淡地之阳酸苦咸地之阴是味不独阴亦有
阳也
味归形形归气气归精精归化
王冰曰形食味故味归形气养形故形归气精食气故气归精化生精故精归化故下文曰吴昆曰五味入于阴血阴血根据于阳气
形归气也真阳之气根据于元精气归精也元精根据于元神精归化也马莳曰凡物之味所以养吾人之形故味归于形正以体属阴而味
亦为阴也然吾人之形必归于吾人之气岂非形必资气而后生乎凡物之气所以养吾人之精故气归于精正以精属阳而气亦属阳
也然吾人之精必归于吾精之化岂非精必资化而后有乎所谓气归精者以精能食万物之气精赖气而生犹云食此气耳所谓味归
形者以形能食万物之味也形赖味而滋犹云食此味耳所谓精归化者以化生此精也化为精之母故精归于化所谓形归气者以气
生此形也气为形之父故形归气张介宾曰归根据投也五味生精血以成形故味归于形形之存亡由气之聚散故形归于气气者真气
也所受于天与谷气并而充身者也人身精血由气而化故气归于精精者坎水也天一生水为五行之最先故物之形初生其形皆水
由精以化气由气以化神是水为万化之原故精归于化骥案张注归根据也地食人以五味味根据形形根据气天食人以五气气根据精精根据
化
精食气形食味
王冰曰气化则精生味和则形长故云食之也张志聪曰水谷之精气以生此精精食气也五味入胃以养此形形食味也马莳曰
精食气者明上文气归精也形食味者明上文味归形也张介宾曰食如子食母气之义气归精故精食气味归形故形食味
化生精气生形
王冰曰精微之液惟血化而成形质之有资气行营立故斯二者各各生乎吴昆曰精不自生生于运化之神形不自生生于无形
之气马莳曰化生精者明上文精归化也气生形者明上文形归气也末四句明上文中四句也阳为气气归精精食气三气字指万物
之气也形归气气生形二气字指人身自有之气也张介宾曰万物化生必从精始故化生精前言精归化者言未化之前由精为化也
此言化生精者言既化之后由化生精也气聚则形生气散则形死也
味伤形气伤精
王冰曰过其节也吴昆曰味过于酸肝气以津脾气乃绝之类味伤形也气有余便是火火炎则水干气伤精也马莳曰味或太过
适所以伤此形如生气通天论阴之所生本在五味阴之五宫伤在五味如肝在味为酸而酸又伤筋者是也气或太过适所以伤此精
指万物之气言上文言味能伤形则万物有味必有气其气岂不伤精
精化为气气伤于味
王冰曰精承化养则食气精若化生则不食气精血内结郁为秽腐攻胃则五味倨然不得入也女子重身精化百日皆伤于味也
马莳曰化生精者不自化也其始由气以化之然归精于化则既而精必化为气盖不但气之能生形而形归于气也正以精气神三者
相须以有成耳然则凡物之味既能伤人之形独不能伤人之气乎左传晋屠蒯曰味以行气故曰精化为气气伤于味又尝由此推彼
人之气能生形而形又归于人之气则凡物之气能伤人之精独不能伤人之气乎张介宾曰精化为气谓元气由精而化也珠玉集水
是三才之祖精为元气之根其义即此然上文既云气归精是气生精也而此又曰精化气是精生气也二者似乎相反而不知此正精
气互根之妙以应上文天地云雨之义也夫阳化气即云之类阴成形即雨之类雨乃不生于地而降于天之云气归于精也云乃不出
于天而升于地之气精化为气也人身精气全是如此故气聚则精盈精盈则气盛精气充而形自强矣帝所以先举云雨为言者正欲
示人精气升降之如此耳骥案阴阳五行生克胜复之理相生相克有胜有复不独气运为然此段药物气味阴阳亦复如是
阴味出下窍阳气出上窍
王冰曰味有质故下流于便泻之窍气无形故上出于呼吸之门马莳曰此言凡物之气味有浓薄而人身之所由以盛衰也凡物
之有味者属阴而人身之下窍亦属阴故味出于下窍凡物之有气者属阳而人身之上窍亦属阳故气出于上窍
味浓者为阴薄为阴之阳气浓者为阳薄为阳之阴
王冰曰阳为气气浓者为纯阳阴为味味浓者为纯阴故味薄者为阴中之阳气薄者为阳中之阴马莳曰味之浓为纯阴用之则
泄泻其物于下如大黄味之薄者为阴中之阳用之则流通不至于泄泻如木通泽泻气之浓者为纯阳用之则发热不止于发汗如附
子气之薄者为阳中之阴用之则发其汗于上如麻黄气味太浓者火之壮如乌附气味之温者火之少如参归骥案马注引东垣味薄
如木通泽泻与东垣原文稍异不如旧说兹将原图附后
\r气味寒热阴阳升降图\pt36a1.bmp\r
味浓则泄薄则通气薄则发泄浓则发热
王冰曰阴气润下故味浓则泄利阳气炎上故气浓则发热味薄为阴少故通泄气薄为阳少故汗出发泄谓汗出也张志聪曰味
浓为阴中之阴降也故主泄泻味薄为阴中之阳升也故主宣通气薄为阳中之阴降也故主发泄气浓为阳中之阳升也故主发热此
节论气味之阴阳升降马莳曰唯味之浓者为纯阴所以用之则泄泻其物于下如大黄气大寒味极浓为阴中之阴主于泄泻李东垣
曰酸苦咸寒是也味之薄者阴中之阳所以用之则流通不至于泄泻也如木通泽泻为阴中之阳主于流通李东垣曰酸苦咸平是也
气之薄者为阳中之阴所以用之则发其汗于上如麻黄气之薄者阳也升也故能发表出汗李东垣曰辛甘淡平凉寒是也气之浓者
为纯阳所以用之则发热不止于发汗也如用附子则大热之类李东垣曰辛甘温热是也骥案五味所用苦味泄甘味缓酸味收咸味
软淡味渗泄辛味散五气风气升生热气浮长湿气化成燥气降收寒气沉藏肝胆之味辛补酸泻气温补凉泻心小肠之味咸补甘泻
气热补寒泻脾胃之味甘补苦泻气温凉寒热补泻各从其宜肺大肠之味酸补辛泻气凉补温泻肾膀胱之味苦补寒泻气寒补热泻
其气味浓薄阴阳如马氏引东垣之例已发其大凡余详前图
壮火之气衰少火之气壮
王冰曰火之壮者壮已必衰火之少者少已则壮马莳曰气味太浓者火之壮也用壮火之品则吾人之气不能当之而反衰矣如
用乌附之类而吾人之气不能胜之故发热气味之温者火之少也用少火之品则吾人之气渐尔生旺而益壮也如用参归之类而气
血渐旺者是也骥案君火即壮火相火即少火火主少阳之经故曰少火位显明之右故曰壮六元纪大论君火以明相火以位王注谓
君火在相火之右但立名于君位不立岁气故曰君火以名相火守位奉命故云相火以位又六微旨大论显明之右君火之位也君火
之右退后一步相火主之是谓少阴君火退位少阳相火行权也今壮火气衰即君火退位少火气壮即相火行权之谓惟以气运言则
曰君曰相以气味言则曰壮曰少微有不同耳
壮火食气气食少火壮火散气少火生气
王冰曰气生壮火故云壮火食气少火滋气故云气食少火以壮火食气故气得壮火则耗散以少火益气故气得少火则生长人
之阳气壮少亦然张志聪曰夫气为阳火为阳合而言之气即火也少阳三焦之气生于命门游行于外内合于包络而为相火然即少
阳初生之气也归于下焦而主纳归于中焦而主化纳化水谷之精微而生此气以养此形故承上文而言五味太过则有伤于气而壮
火太过亦有伤于气盖气生于精而精之所生由气之所化形食其味而味之入胃亦出气化以养此形是气之不可有伤者也故曰壮
火之气衰少火之气壮盖阳亢则火壮而生气反衰阳和则火平而气壮盛矣如火壮于内则食气气盛于内则食火食犹入也言火
壮则气并于火气盛则火归于气气火之合一也如火壮于外则散气火平于外则生气故曰相火为元气之贼欲养此精
气形者又当平
息其火焉王子芳曰壮火之气少火之气是气即火之气也马莳曰壮火之气衰正以壮火能食吾人之气故壮火之气自衰耳少火之
气壮正以吾人之气能食少火故少火之气渐壮耳惟壮火为能食人之气此壮火所以能散吾人之气也食则必散散则必衰故曰壮
火之气衰惟吾人之气为能食少火之气此少火所以能生吾人之气也食则必生生则必壮故曰少火之气壮按此节分明论万物有
《素问·阴阳应象大论》中说：清阳之气上升形成天，浊阴之气下沉形成地。地气上升化为云，天气下降化为雨。雨水是从地气升腾后形成的云降下来的，所以说是“雨出地气”；云朵是凭借天地之气的交合而形成的，所以说是“云出天气”。
王冰注释说：阴气凝聚向上结聚，便结合而成云；阳气发散向下流动，便灌注而为雨。雨水从云中施化而降，所以说“雨出地气”；云朵凭借气以交合而生，所以说“云出天气”。天地的道理尚且如此，人身中的清浊之气也是如此。
吴昆注释说：“出”意为通达。雨水流出而通达地气，云朵流出而通达天气。用人体来比喻：饮水进入胃中，游溢精气，向上输送到脾；脾气散布精微物质，向上归于肺；上焦开发宣发，像雾露一样弥漫，这就是“地气上为云”。肺行使其肃降的政令，通调水道，向下输送到膀胱，水液精华四布周身，这就是“天气下为雨”。膀胱是州都之官，贮藏精液，经过气化作用才能排出尿液，这就是“雨出地气”。上焦像雾露一样氤氲，心肺调和呵呼气机，这就是“云出天气”。这六句话说明了阴阳清浊不可失位而倒置，顺应它则天地位置安定而万物化生，违背它则会导致下利完谷不化和上部胀满。
张志聪注释说：地虽然在下，但地气上升成为天（的云）；天虽然在上，但天气下降成为雨。天有云然后才有雨，所以雨虽然是从天降下，但实际上是本由地气所升腾的云，因此说“雨出地气”。由雨的降落而后有云的升腾，所以云虽然是从地上升起，但实际上是本由天气所降落之雨，因此说“云出天气”。这是阴阳交互的道理，人也与之相应。这篇经文讲天地的阴阳与人的阴阳相合，所以有一段讲天地阴阳水火，有一段讲清浊藏腑精形，是以天人相间的方式来论述的。
马莳注释说：地虽然在下，但阴中之阳者上升，所以其上是云，正如《正蒙》所说阴变为阳得到则飘扬为云而上升；天虽然在上，但阳中之阴者下降，所以其下是雨，正如《正蒙》所说阳变为阴素静则相持为雨而降落。
张骥按语：《说文解字》说：“云，山川气也。”《玉篇》说：“雨，云雨也。”《元命苞》说：“阴阳和合为雨。”《大戴记》说：“天地之气和谐则下雨。”和谐就是天地之气交感。这里的“上下”二字含有升降的意义。《素问·六微旨大论》说：“升已而降，降者谓天；降已而升，升者谓地。”天气下降，气流于地；地气上升，气腾于天。天地的升降称为阴阳，阴阳的上下称为云雨。天地之气如此，人身之升降上下也是如此。
王冰注释说：气本源于天，亲附于上；气本源于地，亲附于下。各依其类而行。上窍指耳、目、口、鼻；下窍指前阴和后阴。
马莳注释说：阴阳升降只有一气作为合一的奥妙。从人身来看，凡是属于清阳之物，如涕、唾、气、液等，都出于上窍。耳目口鼻这七个孔窍，都是清阳所出的地方。凡是属于浊阴之物，如污秽、便溺等，都出于下窍。前后二阴这两个孔窍，都是浊阴所出的地方。
张骥按语：《周礼·疾医》以九窍的变化来诊断疾病，注解说阳窍七，阴窍二。疏解释说阳窍七在头上显露可见，故为阳；阴窍二在下面不可见，故为阴。清阳浊阴如同上文所述，但上文专门就人身而言，这里兼及药物而言。
王冰注释说：腠理是渗泄的门户，所以清阳可以散发其中。五脏是包藏之所，所以浊阴可以走注其中。
张志聪注释说：腠是三焦通会元气真气的处所，理是皮肤脏腑的文理。清阳之气通会于腠理，而阴浊的精血走注于五脏。五脏主藏精。
马莳注释说：凡是人身所用之物，有属于清阳的，如饮食药物的性质属于阳类的，根据“发”、“走”、“实”、“归”等动词，知道它们是在外的物体。只有阳性的主升，所以发散于腠理，因为腠理主表属阳。这是指物类的阳气而言。如果是有形质的物体，则进入六腑。有属于浊阴的，如饮食药物属于阴类的，只有阴性的主降，所以走注于五脏，因为五脏主里属阴。这是指物类的阴气而言。如果是有形质的物体不入于五脏。
张介宾注释说：腠理即肌表，阳气发散于皮肤，所以清阳归之；阴受藏于五脏，所以浊阴走之。
张骥按语：《素问·生气通天论》说“腠理以密”，注解说是指肤表的毛孔。《素问》和《灵枢》言五脏为心、肝、脾、肺、肾；《周礼·疾医》言九脏，正脏之外有胃、膀胱、大肠、小肠，在六腑中取四腑以补益五脏为九脏。四腑皆有受盛功能，故称为腑，也有称其为藏的，故列入九脏之数。此处说阳发外阴走内，不拘泥于五或九。马注是正确的。
王冰注释说：四肢在外主动，所以清阳充实之。六腑在内主消化，所以浊阴归入之。
张志聪注释说：脾主四肢，又说手太阴肺经独受其浊。大概浊中之清者由脾转输而充实于四肢；浊中之浊者归于六腑。
马莳注释说：凡是清阳之物充实于四肢，因为四肢是诸阳之本。这是指物的气而言。凡是浊阴之物归于六腑，因为六腑受纳化物而不贮藏。这是指物有形质者而言。人身有阴阳，其清浊升降的奥妙，怎么会不同于天地呢？
张骥按语：“支”与“肢”通。《易经》说：“美在其中，而畅于四肢。”疏解释说四肢犹言手足。《灵枢·邪客》篇说：“天有四时，人有四肢。”谓两手两足位于身躯之四隅，为全身之肢持护卫，故名。六腑，《周礼·疾医》九脏以心、肝、脾、肺、肾为正脏，取胃、膀胱、大肠、小肠以补益五脏为九脏。引用《难经》谓三焦为孤府，非正府。四腑六腑不必拘泥，不过是说清阳所实者是肢，浊阴所归者是腑而已。又李东垣《用药法象》说：清阳发腠理，清之清；实四肢，清之浊。浊阴归六腑，浊之浊；走五脏，浊之清。清之清者，清肺以助其天真；清之浊者，荣华腠理；浊之浊者，坚强骨髓；浊之清者，荣养于神。这也是有道理的。
水是阴，火是阳。
王冰注释说：水寒而静，所以为阴；火热而躁，所以为阳。
马莳注释说：阴阳是万物的父母，水火实际上是阴阳的征兆。举出水火就足以尽括阴阳了。所以水为阴，而凡成于水的物体属阴；火为阳，而凡成于火的物体属阳。
张介宾注释说：天以日月为水火，易学以坎离为水火，医学以心肾为水火，丹道以精气为水火。肾是水，水中生气即是真火；心是火，火中生液即是真水。火水互藏，是至道的所在。医家首先应当省察。
张骥按语：《尚书·洪范》说水曰“润下”，润下即润而又下；火曰“炎上”，炎上即炎而又上。下为阴，上为阳。就五行而言，若以药物言，水为阴，则益火之源以消阴翳；火为阳，则壮水之主以制阳光。张景岳、薛立斋、赵养葵的六味地黄丸、八味地黄丸、左归丸、右归丸，其大体原理即在于此。
阳为气，阴为味。
王冰注释说：气惟独散布，所以阳为之；味曰随从形体，所以阴为之。
吴昆注释说：臊、焦、香、腥、腐为气，为阳；酸、苦、甘、辛、咸为味，为阴。
张志聪注释说：水性润下，所以为阴；火性炎上，所以为阳。清阳上升，所以为气；浊阴下降，所以为味。盖以水火来征兆气味之阴阳。
张介宾注释说：气无形而升，所以为阳；味有质而降，所以为阴。这是以药食的气味而言。
张骥按语：气味皆各有阴阳。《内经》所谓“天有阴阳，三阴三阳上奉之”，温凉寒热即是。温热是天之阳，凉寒是天之阴，这是气不独阳，亦有阴。地有阴阳，金木水火土生长化收藏下应之，辛甘淡酸苦咸五味即是。辛甘淡是地之阳，酸苦咸是地之阴，这是味不独阴，亦有阳。
味归形，形归气，气归精，精归化。
王冰注释说：形体食味，所以味归形；气养形体，所以形归气；精食气，所以气归精；化生精，所以精归化。所以下文说……
吴昆注释说：五味入于阴血，阴血根据于阳气，所以形归气；真阳之气根据于元精，所以气归精；元精根据于元神，所以精归化。
马莳注释说：凡是物的味道所以养育我们的形体，所以味归于形，正因为体属阴而味亦为阴。然而我们的形体必须归于我们的气，难道不是形体必资借气而后生成吗？凡是物的气所以养育我们的精，所以气归于精，正因为精属阳而气亦属阳。然而我们的精必须归于我们的化，难道不是精必资借化而后有吗？所谓“气归精”，是因为精能食万物之气，精赖气而生，犹如说食此气。所谓“味归形”，是因为形能食万物之味，形赖味而滋，犹如说食此味。所谓“精归化”，是因为化生此精，化为精之母，故精归于化。所谓“形归气”，是因为气生此形，气为形之父，故形归气。
张介宾注释说：“归”是根据、投合的意思。五味生精血以成形，所以味归于形；形之存亡由气之聚散，所以形归于气。气者真气也，所受于天与谷气并而充身者也。人身精血由气而化，所以气归于精。精者坎水也，天一生水，为五行之最先，故物之形初生，其形皆水。由精以化气，由气以化神，是水为万化之原，故精归于化。
张骥按语：张注“归”为根据。地食人以五味，味根据形；形根据气；天食人以五气，气根据精；精根据化。
精食气，形食味。
王冰注释说：气化则精生，味和则形长，所以说“食”之。
张志聪注释说：水谷之精气以生此精，精食气也；五味入胃以养此形，形食味也。
马莳注释说：“精食气”说明上文“气归精”；“形食味”说明上文“味归形”。
张介宾注释说：“食”如子食母之义。气归精，故精食气；气归形，故形食味。（注：此处原文可能有误，通常理解为气生精故精食气，味成形故形食味，或者气养形故形食气，味养精故精食味，需结合上下文，此处依原文逻辑翻译）。
化生精气，生形。
王冰注释说：精微之液惟血化而成形，质之有资气行营立，故斯二者各各生乎……
吴昆注释说：精不自生，生于运化之神；形不自生，生于无形之气。
马莳注释说：“化生精”说明上文“精归化”；“气生形”说明上文“形归气”。末四句说明上文中四句。阳为气，气归精，精食气，三个“气”字指万物之气；形归气，气生形，两个“气”字指人身自有之气。
张介宾注释说：万物化生必从精始，故化生精。前言“精归化”是说未化之前由精为化；此言“化生精”是说既化之后由化生精。气聚则形生，气散则形死也。
味伤形，气伤精。
王冰注释说：过其节度也。
吴昆注释说：味过于酸，肝气以津，脾气乃绝之类，是味伤形；气有余便是火，火炎则水干，是气伤精。
马莳注释说：味或太过，适所以伤此形，如《生气通天论》“阴之所生，本在五味；阴之五宫，伤在五味”，如肝在味为酸，而酸又伤筋者是也。气或太过，适所以伤此精，指万物之气言。上文言味能伤形，则万物有味必有气，其气岂不伤精？
精化为气，气伤于味。
王冰注释说：精承化养则食气，精若化生则不食气。精血内结，郁为秽腐，攻胃则五味倨然不得入也。女子重身，精化百日，皆伤于味也。
马莳注释说：“化生精”者不自化也，其始由气以化之。然归精于化，则既而精必化为气。盖不但气之能生形，而形归于气也。正以精气神三者相须以有成耳。然则凡物之味既能伤人之形，独不能伤人之气乎？《左传》晋屠蒯曰：“味以行气”，故曰“精化为气”。气伤于味，又尝由此推彼，人之气能生形，而形又归于人之气，则凡物之气能伤人之精，独不能伤人之气乎？
张介宾注释说：“精化为气”谓元气由精而化也。《珠玉集》说：“水是三才之祖，精为元气之根”，其义即此。然上文既云“气归精”，是气生精也；而此又曰“精化气”，是精生气也。二者似乎相反，而不知此正精气互根之妙，以应上文天地云雨之义也。夫阳化气，即云之类；阴成形，即雨之类。雨乃不生于地而降于天之云，气归于精也；云乃不出于天而升于地之气，精化为气也。人身精气全是如此，故气聚则精盈，精盈则气盛，精气充而形自强矣。帝所以先举云雨为言者，正欲示人精气升降之如此耳。
张骥按语：阴阳五行生克胜复之理，相生相克，有胜有复，不独气运为然。此段药物气味阴阳亦复如是。
阴味出下窍，阳气出上窍。
王冰注释说：味有质，故下流于便泻之窍；气无形，故上出于呼吸之门。
马莳注释说：此言凡物之气味有浓薄，而人身之所由以盛衰也。凡物之有味者属阴，而人身之下窍亦属阴，故味出于下窍；凡物之有气者属阳，而人身之上窍亦属阳，故气出于上窍。
味浓者为阴，薄为阴之阳；气浓者为阳，薄为阳之阴。
王冰注释说：阳为气，气浓者为纯阳；阴为味，味浓者为纯阴。故味薄者为阴中之阳，气薄者为阳中之阴。
马莳注释说：味之浓为纯阴，用之则泄泻其物于下，如大黄；味之薄者为阴中之阳，用之则流通不至于泄泻，如木通、泽泻。气之浓者为纯阳，用之则发热不止于发汗，如附子；气之薄者为阳中之阴，用之则发其汗于上，如麻黄。气味太浓者，火之壮，如乌头、附子；气味之温者，火之少，如人参、当归。
张骥按语：马注引李东垣“味薄如木通、泽泻”与东垣原文稍异，不如旧说，兹将原图附后。（此处省略图片描述）
味浓则泄，薄则通气；气薄则发泄，浓则发热。
王冰注释说：阴气润下，故味浓则泄利；阳气炎上，故气浓则发热。味薄为阴少，故通泄；气薄为阳少，故汗出。发泄谓汗出也。
张志聪注释说：味浓为阴中之阴，降也，故主泄泻；味薄为阴中之阳，升也，故主宣通；气薄为阳中之阴，降也，故主发泄；气浓为阳中之阳，升也，故主发热。此节论气味之阴阳升降。
马莳注释说：唯味之浓者为纯阴，所以用之则泄泻其物于下，如大黄，气大寒，味极浓，为阴中之阴，主于泄泻。李东垣曰：酸苦咸寒是也。味之薄者，阴中之阳，所以用之则流通不至于泄泻也，如木通、泽泻，为阴中之阳，主于流通。李东垣曰：酸苦咸平是也。气之薄者为阳中之阴，所以用之则发其汗于上，如麻黄。气之薄者，阳也，升也，故能发表出汗。李东垣曰：辛甘淡平凉寒是也。气之浓者为纯阳，所以用之则发热不止于发汗也，如用附子则大热之类。李东垣曰：辛甘温热是也。
张骥按语：五味所用：苦味泄，甘味缓，酸味收，咸味软，淡味渗泄，辛味散。五气：风气升生，热气浮长，湿气化成，燥气降收，寒气沉藏。肝胆之味辛补酸泻，气温补凉泻；心小肠之味咸补甘泻，气热补寒泻；脾胃之味甘补苦泻，气温凉寒热补泻各从其宜；肺大肠之味酸补辛泻，气凉补温泻；肾膀胱之味苦补寒泻，气寒补热泻。其气味浓薄阴阳，如马氏引东垣之例，已发其大凡，余详前图。
壮火之气衰，少火之气壮。
王冰注释说：火之壮者，壮已必衰；火之少者，少已则壮。
马莳注释说：气味太浓者，火之壮也。用壮火之品，则吾人之气不能当之而反衰矣，如用乌头、附子之类，而吾人之气不能胜之，故发热。气味之温者，火之少也。用少火之品，则吾人之气渐尔生旺而益壮也，如用人参、当归之类，而气血渐旺者是也。
张骥按语：君火即壮火，相火即少火。火主少阳之经，故曰少火；位显明之右，故曰壮。《六元纪大论》说：“君火以明，相火以位。”王注谓君火在相火之右，但立名于君位，不立岁气，故曰“君火以名”；相火守位奉命，故云“相火以位”。又《六微旨大论》说：“显明之右，君火之位也；君火之右，退后一步，相火主之。”是谓少阴君火退位，少阳相火行权也。今壮火气衰，即君火退位；少火气壮，即相火行权之谓。惟以气运言则曰君、曰相，以气味言则曰壮、曰少，微有不同耳。
壮火食气，气食少火；壮火散气，少火生气。
王冰注释说：气生壮火，故云壮火食气；少火滋气，故云气食少火。以壮火食气，故气得壮火则耗散；以少火益气，故气得少火则生长。人之阳气壮少亦然。
张志聪注释说：夫气为阳，火为阳，合而言之，气即火也。少阳三焦之气生于命门，游行于外，内合于包络而为相火，然即少阳初生之气也。归于下焦而主纳，归于中焦而主化，纳化水谷之精微而生此气以养此形，故承上文而言。五味太过则有伤于气，而壮火太过亦有伤于气。盖气生于精，而精之所生由气之所化；形食其味，而味之入胃亦出气化以养此形，是气之不可有伤者也。故曰“壮火之气衰，少火之气壮”。盖阳亢则火壮而生气反衰，阳和则火平而气壮盛矣。如火壮于内则食气，气盛于内则食火。“食”犹入也，言火壮则气并于火，气盛则火归于气，气火之合一也。如火壮于外则散气，火平于外则生气。故曰相火为元气之贼，欲养此精气形者，又当平息其火焉。
王子芳注释说：“壮火之气”、“少火之气”，是气即火之气也。
马莳注释说：“壮火之气衰”，正以壮火能食吾人之气，故壮火之气自衰耳；“少火之气壮”，正以吾人之气能食少火，故少火之气渐壮耳。惟壮火为能食人之气，此壮火所以能散吾人之气也。食则必散，散则必衰，故曰“壮火之气衰”。惟吾人之气为能食少火之气，此少火所以能生吾人之气也。食则必生，生则必壮，故曰“少火之气壮”。按此节分明论万物有……
The *Suwen* (Basic Questions) chapter "Yin Yang Ying Xiang Da Lun" states: Clear Yang ascends to form Heaven, and Turbid Yin descends to form Earth. Earth Qi ascends to become clouds, and Heaven Qi descends to become rain. Rain comes from the Earth Qi that has risen into clouds; thus it is said that "rain originates from Earth Qi." Clouds are formed through the interaction of Heaven and Earth Qi; thus it is said that "clouds originate from Heaven Qi."
Wang Bing commented: When Yin condenses and gathers upward, it combines to form clouds; when Yang scatters and flows downward, it pours to form rain. Rain undergoes transformation from clouds as it falls, hence "rain originates from Earth Qi." Clouds rely on Qi for interaction and combination, hence "clouds originate from Heaven Qi." The principles of Heaven and Earth are thus, and the clear and turbid Qi in the human body are also like this.
Wu Kun commented: "Chu" (out/exit) means to penetrate or connect. Rain flows out to connect with Earth Qi, and clouds flow out to connect with Heaven Qi. Using the human body as an analogy: when water is drunk, it enters the Stomach, its essence spreads and overflows, moving upward to the Spleen. The Spleen distributes the refined essence upward to the Lungs. The Upper Jiao opens and disseminates, resembling mist and dew; this is "Earth Qi ascending to become clouds." The Lungs issue commands of descent, regulating the water passages and transporting downward to the Bladder, where water essence is distributed throughout the body; this is "Heaven Qi descending to become rain." The Bladder is the official of the Zhou Du, storing essence and fluid; only after Qi transformation can it be excreted; this is "rain originating from Earth Qi." The Upper Jiao is like mist and dew; when Heart and Lung Qi harmonize and exhale, this is "clouds originating from Heaven Qi." These six sentences illustrate that Yin-Yang, Clear-Turbid must not lose their proper positions or be inverted. Following them leads to the stability of Heaven and Earth and the nurturing of all things; opposing them leads to diarrhea with undigested food below and distension above.
Zhang Zhicong commented: Although Earth is below, Earth Qi ascends to become the clouds of Heaven; although Heaven is above, Heaven Qi descends to become rain. Heaven has clouds before there is rain; thus, although rain falls from Heaven, it is actually the cloud that rose from Earth Qi, hence "rain originates from Earth Qi." After rain descends, clouds ascend; thus, although clouds rise from Earth, they are actually the rain that descended from Heaven, hence "clouds originate from Heaven Qi." This is the way of Yin-Yang interaction, and humans correspond to it. This text discusses the correspondence between Heaven-Earth Yin-Yang and Human Yin-Yang. One section discusses Heaven-Earth Yin-Yang and Water-Fire; another discusses Clear-Turbid, Zang-Fu, Essence, and Form, using a天人 (Heaven-Human) interwoven approach.
Ma Shi commented: Although Earth is below, the Yang within Yin ascends, so its upper aspect is clouds, as stated in *Zheng Meng*: Yin transforms into Yang and rises as clouds. Although Heaven is above, the Yin within Yang descends, so its lower aspect is rain, as stated in *Zheng Meng*: Yang transforms into Yin and descends as rain.
Zhang Ji noted: According to *Shuowen Jiezi*, "Cloud is the Qi of mountains and rivers." *Yupian* states, "Rain is cloud-rain." *Yuan Ming Bao* says, "Harmony of Yin and Yang produces rain." *Da Dai Li Ji* says, "When Heaven and Earth Qi harmonize, rain falls." Harmony implies the interaction of Heaven and Earth Qi. The characters "upper" and "lower" here imply ascending and descending. *Liu Wei Zhi Da Lun* states: "After ascending, one descends; descending refers to Heaven descending. After descending, one ascends; ascending refers to Earth ascending." Heaven Qi descends, flowing into Earth; Earth Qi ascends, rising into Heaven. The ascending and descending of Heaven and Earth is called Yin-Yang; the upper and lower of Yin-Yang is called clouds and rain. Just as Heaven and Earth Qi operate, so do the ascending and descending of the human body.
Therefore, Clear Yang exits through the upper orifices, and Turbid Yin exits through the lower orifices.
Wang Bing commented: Qi originating from Heaven attaches to the upper; Qi originating from Earth attaches to the lower. Each follows its kind. The upper orifices refer to the ears, eyes, mouth, and nose; the lower orifices refer to the anterior and posterior yin.
Ma Shi commented: The ascending and descending of Yin and Yang is a subtle unity of one Qi. Observing the human body, anything belonging to Clear Yang, such as mucus, saliva, breath, and fluids, exits through the upper orifices. The seven orifices of the ears, eyes, mouth, and nose are where Clear Yang exits. Anything belonging to Turbid Yin, such as waste and feces, exits through the lower orifices. The two orifices of the anterior and posterior yin are where Turbid Yin exits.
Zhang Ji noted: *Zhou Li - Ji Yi* diagnoses diseases by observing changes in the nine orifices. The commentary states there are seven Yang orifices and two Yin orifices. The sub-commentary explains that the seven Yang orifices are on the head and visible, hence Yang; the two Yin orifices are below and invisible, hence Yin. Clear Yang and Turbid Yin are as described above, but the previous text focused solely on the human body, whereas this section also includes herbs.
Clear Yang disperses into the Cou Li (interstices), and Turbid Yin travels to the Five Zang organs.
Wang Bing commented: Cou Li are the gates of seepage and excretion, so Clear Yang can disperse therein. The Five Zang are repositories, so Turbid Yin can travel therein.
Zhang Zhicong commented: "Cou" is where the San Jiao connects Yuan Zhen Qi; "Li" are the textures of skin and organs. Clear Yang Qi connects in the Cou Li, while Yin-Turbid blood and essence travel to the Five Zang. The Five Zang store essence.
Ma Shi commented: Regarding substances used in the body, those belonging to Clear Yang, such as the nature of diet and drugs that are Yang-type, are indicated by verbs like "disperse," "travel," "fill," and "return," showing they are external. Yang tends to ascend, so it disperses into the Cou Li, which govern the exterior and are Yang. This refers to the Yang Qi of substances. If a substance has form and quality, it enters the Six Fu organs. Those belonging to Turbid Yin, such as diet and drugs that are Yin-type, tend to descend, so they travel to the Five Zang, which govern the interior and are Yin. This refers to the Yin Qi of substances. Substances with form and quality do not enter the Five Zang.
Zhang Jiebin commented: Cou Li are the muscle surface. Yang disperses into the skin, so Clear Yang belongs to it. Yin is stored in the Five Zang, so Turbid Yin travels to them.
Zhang Ji noted: *Sheng Qi Tong Tian Lun* states "Cou Li are dense," interpreted as pores of the skin. *Suwen* and *Lingshu* mention the Five Zang: Heart, Liver, Spleen, Lung, Kidney. *Zhou Li - Ji Yi* mentions nine Zang: the five regular Zang plus Stomach, Bladder, Large Intestine, Small Intestine. These four Fu organs have receiving and transforming functions, hence called Fu, but also have storage functions, hence included in the nine Zang count. Here, Yang disperses outward and Yin travels inward, regardless of whether referring to five or nine. Ma's note is correct.
Clear Yang fills the four limbs, and Turbid Yin returns to the Six Fu organs.
Wang Bing commented: The four limbs move externally, so Clear Yang fills them. The Six Fu transform internally, so Turbid Yin returns to them.
Zhang Zhicong commented: The Spleen governs the four limbs. It is also said that the Hand Taiyin Lung channel alone receives its turbidity. Generally, the clear part of turbidity is transported by the Spleen to fill the four limbs; the turbid part of turbidity returns to the Six Fu organs.
Ma Shi commented: Clear Yang substances fill the four limbs because the four limbs are the root of all Yang. This refers to the Qi of substances. Turbid Yin substances return to the Six Fu organs because the Six Fu receive and transform without storing. This refers to substances with form and quality. How does the subtlety of Yin-Yang, Clear-Turbid, ascending and descending in the human body differ from Heaven and Earth?
Zhang Ji noted: "Zhi" and "Zhi" (limbs) are interchangeable. *I Ching* states: "Beauty lies within, flowing smoothly to the four limbs." The sub-commentary explains limbs refer to hands and feet. *Xie Ke Pian* states: "Heaven has four seasons, humans have four limbs." Hands and feet are at the four corners of the body, supporting and guarding the whole, hence named limbs. For the Nine Zang in *Ji Yi*, the five regular Zang are supplemented by Stomach, Bladder, Large Intestine, Small Intestine. Citing *Nan Jing*, San Jiao is a solitary Fu, not a regular Fu. There is no need to rigidly adhere to four or six Fu organs; it simply means Clear Yang fills the limbs, and Turbid Yin returns to the Fu organs. Furthermore, Li Dongyuan's *Yong Yao Fa Xiang* states: Clear Yang disperses into Cou Li (Clear of Clear); fills the four limbs (Clear of Turbid). Turbid Yin returns to Six Fu (Turbid of Turbid); travels to Five Zang (Turbid of Clear). Clear of Clear clears the Lung to assist True Heaven; Clear of Turbid nourishes Cou Li; Turbid of Turbid strengthens bone marrow; Turbid of Clear nourishes Shen (Spirit). This is also reasonable.
Water is Yin, Fire is Yang.
Wang Bing commented: Water is cold and still, hence Yin; Fire is hot and restless, hence Yang.
Ma Shi commented: Yin and Yang are the parents of all things; Water and Fire are the manifestations of Yin and Yang. Mentioning Water and Fire suffices to encompass Yin and Yang. Thus, Water is Yin, and things formed from Water belong to Yin; Fire is Yang, and things formed from Fire belong to Yang.
Zhang Jiebin commented: Heaven uses Sun and Moon as Water and Fire; I Ching uses Kan and Li as Water and Fire; Medicine uses Heart and Kidney as Water and Fire; Alchemy uses Essence and Qi as Water and Fire. Kidney is Water; Qi generated within Water is True Fire. Heart is Fire; Fluid generated within Fire is True Water. Fire and Water hiding within each other is the ultimate Dao. Physicians must first examine this.
Zhang Ji noted: *Shangshu* states Water is "moistening downward" (moist and sinking); Fire is "blazing upward" (blazing and rising). Down is Yin, Up is Yang. In terms of Five Elements, regarding herbs: Water is Yin, so benefit the source of Fire to eliminate Yin shadows; Fire is Yang, so strengthen the master of Water to control sunlight. The formulas of Zhang Jingyue, Xue Lizhai, and Zhao Yangkui—Liu Wei Di Huang Wan, Ba Wei Di Huang Wan, Zuo Gui Wan, You Gui Wan—follow this general principle.
Yang is Qi, Yin is Taste.
Wang Bing commented: Qi scatters freely, so it is Yang; Taste follows form, so it is Yin.
Wu Kun commented: Sour, scorched, fragrant, fishy, and putrid smells are Qi, which is Yang. Sour, bitter, sweet, pungent, and salty tastes are Taste, which is Yin.
Zhang Zhicong commented: Water nature is moistening downward, hence Yin; Fire nature is blazing upward, hence Yang. Clear Yang ascends, hence Qi; Turbid Yin descends, hence Taste. Water and Fire serve as manifestations of the Yin-Yang of Qi and Taste.
Zhang Jiebin commented: Qi is formless and ascends, hence Yang; Taste has substance and descends, hence Yin. This refers to the Qi and Taste of medicines and foods.
Zhang Ji noted: Qi and Taste each have Yin and Yang. As stated in the classics: "Heaven has Yin and Yang, Three Yin and Three Yang support it." Warm, cool, cold, and hot are examples. Warm and hot are Heaven's Yang; cool and cold are Heaven's Yin. This shows Qi is not exclusively Yang but also has Yin. Earth has Yin and Yang; Metal, Wood, Water, Fire, Earth correspond to growth, transformation, and storage. Pungent, sweet, bland, sour, bitter, salty are the five tastes. Pungent, sweet, and bland are Earth's Yang; sour, bitter, and salty are Earth's Yin. This shows Taste is not exclusively Yin but also has Yang.
Taste returns to Form, Form returns to Qi, Qi returns to Essence, Essence returns to Transformation.
Wang Bing commented: Form eats Taste, so Taste returns to Form. Qi nourishes Form, so Form returns to Qi. Essence eats Qi, so Qi returns to Essence. Transformation generates Essence, so Essence returns to Transformation.
Wu Kun commented: Five Tastes enter Yin Blood; Yin Blood relies on Yang Qi, so Form returns to Qi. True Yang Qi relies on Primordial Essence, so Qi returns to Essence. Primordial Essence relies on Primordial Spirit, so Essence returns to Transformation.
Ma Shi commented: The taste of substances nourishes our Form, so Taste returns to Form, because Form is Yin and Taste is Yin. However, our Form must return to our Qi, implying Form requires Qi to generate. The Qi of substances nourishes our Essence, so Qi returns to Essence, because Essence is Yang and Qi is Yang. However, our Essence must return to our Transformation, implying Essence requires Transformation to exist. "Qi returns to Essence" means Essence consumes the Qi of all things; Essence relies on Qi to live, akin to saying it eats this Qi. "Taste returns to Form" means Form consumes the Taste of all things; Form relies on Taste to nourish, akin to saying it eats this Taste. "Essence returns to Transformation" means Transformation generates this Essence; Transformation is the mother of Essence, hence Essence returns to Transformation. "Form returns to Qi" means Qi generates this Form; Qi is the father of Form, hence Form returns to Qi.
Zhang Jiebin commented: "Gui" (return) means to base upon or align with. Five Tastes generate Essence and Blood to form Form, so Taste returns to Form. The existence or destruction of Form depends on the gathering or scattering of Qi, so Form returns to Qi. Qi is True Qi, received from Heaven and combined with Grain Qi to fill the body. Human Essence and Blood are transformed by Qi, so Qi returns to Essence. Essence is Kan Water; Heaven generates Water first among the Five Elements. Thus, when things initially form, their form is Water. From Essence to Qi, from Qi to Spirit, Water is the origin of all transformations, hence Essence returns to Transformation.
Zhang Ji noted: Zhang's annotation defines "Gui" as basis. Earth feeds humans with five Tastes; Taste bases on Form; Form bases on Qi. Heaven feeds humans with five Qi; Qi bases on Essence; Essence bases on Transformation.
Essence eats Qi, Form eats Taste.
Wang Bing commented: Qi transformation generates Essence; Taste harmony allows Form to grow, hence the term "eat."
Zhang Zhicong commented: Jing Wei (water and grain) essence generates this Essence; Essence eats Qi. Five Tastes enter the Stomach to nourish this Form; Form eats Taste.
Ma Shi commented: "Essence eats Qi" clarifies "Qi returns to Essence"; "Form eats Taste" clarifies "Taste returns to Form."
Zhang Jiebin commented: "Eat" is like a child eating from a parent. Qi returns to Essence, so Essence eats Qi; Qi returns to Form, so Form eats Taste. (Note: Textual interpretation varies, but literal translation follows the provided structure).
Transformation generates Essence and Qi; generates Form.
Wang Bing commented: Fine fluids are transformed by Blood into Form; Substance relies on Qi circulation to establish Ying, so these two generate each other...
Wu Kun commented: Essence does not generate itself; it is born from the Spirit of Transformation. Form does not generate itself; it is born from Formless Qi.
Ma Shi commented: "Transformation generates Essence" clarifies "Essence returns to Transformation"; "Qi generates Form" clarifies "Form returns to Qi." The last four sentences clarify the middle four sentences. Yang is Qi, Qi returns to Essence, Essence eats Qi—the three "Qi" refer to the Qi of all things. Form returns to Qi, Qi generates Form—the two "Qi" refer to the innate Qi of the human body.
Zhang Jiebin commented: All things' generation begins with Essence, hence Transformation generates Essence. Previously, "Essence returns to Transformation" referred to the state before transformation, where Essence serves as the basis for transformation. Now, "Transformation generates Essence" refers to the state after transformation, where Transformation generates Essence. Qi gathering generates Form; Qi scattering causes death.
Taste injures Form, Qi injures Essence.
Wang Bing commented: Exceeding moderation.
Wu Kun commented: Excessive Sour taste causes Liver Qi to overflow and Spleen Qi to cease, etc., which is Taste injuring Form. Excess Qi becomes Fire; Fire blazes and dries Water, which is Qi injuring Essence.
Ma Shi commented: Excessive Taste appropriately injures Form, as in *Sheng Qi Tong Tian Lun*: "Yin is generated from the five Tastes; the five Zang of Yin are injured by the five Tastes." For example, Liver corresponds to Sour, yet Sour injures Sinews. Excessive Qi appropriately injures Essence, referring to the Qi of all things. Since Taste can injure Form, and all things with Taste have Qi, how can that Qi not injure Essence?
Essence transforms into Qi, Qi is injured by Taste.
Wang Bing commented: If Essence receives nourishment from Transformation, it consumes Qi. If Essence transforms and generates, it does not consume Qi. Internal accumulation of Essence and Blood, stagnating into foulness, attacking the Stomach, prevents Tastes from entering. In pregnant women, Essence transforms for a hundred days, all susceptible to injury by Taste.
Ma Shi commented: "Transformation generates Essence" does not self-generate; initially, it is transformed by Qi. However, returning Essence to Transformation, Essence must subsequently transform into Qi. Not only does Qi generate Form, but Form returns to Qi. This is because Essence, Qi, and Spirit depend on each other for completion. If the Taste of substances can injure human Form, can it not injure human Qi? *Zuo Zhuan* states: "Taste moves Qi," hence "Essence transforms into Qi." Qi is injured by Taste. Extending this logic, if human Qi generates Form and Form returns to human Qi, then the Qi of substances can injure human Essence, can it not injure human Qi?
Zhang Jiebin commented: "Essence transforms into Qi" means Primordial Qi transforms from Essence. *Zhu Yu Ji* states: "Water is the ancestor of the three powers; Essence is the root of Primordial Qi." This meaning applies. Although previously it was said "Qi returns to Essence" (Qi generates Essence), now it says "Essence transforms into Qi" (Essence generates Qi). They seem opposite but reveal the mutual root of Essence and Qi, corresponding to the Heaven-Earth Cloud-Rain metaphor. Yang transforms into Qi, like clouds; Yin forms into Shape, like rain. Rain does not originate from Earth but falls from Heaven's clouds; Qi returns to Essence. Clouds do not originate from Heaven but rise from Earth's Qi; Essence transforms into Qi. Human Essence and Qi are exactly like this. Thus, Qi gathering makes Essence full; Essence full makes Qi prosperous. When Essence and Qi are abundant, Form becomes strong. The Emperor mentioned clouds and rain first to show humans the ascending and descending of Essence and Qi.
Zhang Ji noted: The principles of Yin-Yang, Five Elements, generation, restriction, excess, and recovery apply not only to Qi movements but also to the Yin-Yang of herb Qi and Taste.
Yin Taste exits through lower orifices, Yang Qi exits through upper orifices.
Wang Bing commented: Taste has substance, so it flows down to the excretory orifices. Qi is formless, so it exits up through the respiratory gate.
Ma Shi commented: This discusses how the thickness and thinness of substance Qi and Taste relate to human prosperity and decline. Substances with Taste belong to Yin, and human lower orifices belong to Yin, hence Taste exits through lower orifices. Substances with Qi belong to Yang, and human upper orifices belong to Yang, hence Qi exits through upper orifices.
Thick Taste is Yin; Thin Taste is Yang within Yin. Thick Qi is Yang; Thin Qi is Yin within Yang.
Wang Bing commented: Yang is Qi; thick Qi is Pure Yang. Yin is Taste; thick Taste is Pure Yin. Thus, thin Taste is Yang within Yin; thin Qi is Yin within Yang.
Ma Shi commented: Thick Taste is Pure Yin; using it causes purging downwards, like Da Huang. Thin Taste is Yang within Yin; using it promotes circulation without purging, like Mu Tong and Ze Xie. Thick Qi is Pure Yang; using it causes fever beyond just sweating, like Fu Zi. Thin Qi is Yin within Yang; using it induces sweating upwards, like Ma Huang. Too thick Qi and Taste represent strong Fire, like Wu Tou and Fu Zi. Mild Qi and Taste represent weak Fire, like Ren Shen and Dang Gui.
Zhang Ji noted: Ma's citation of Li Dongyuan ("thin taste like Mu Tong, Ze Xie") differs slightly from Li's original text. The old theory is preferred. (Image omitted).
Thick Taste causes purging; Thin Taste promotes Qi circulation. Thin Qi causes sweating; Thick Qi causes fever.
Wang Bing commented: Yin Qi moistens downward, so thick Taste causes purging. Yang Qi blazes upward, so thick Qi causes fever. Thin Taste is less Yin, so it promotes purging. Thin Qi is less Yang, so it causes sweating. "Fa Xie" refers to sweating.
Zhang Zhicong commented: Thick Taste is Yin within Yin, descending, hence causes diarrhea. Thin Taste is Yang within Yin, ascending, hence promotes circulation. Thin Qi is Yin within Yang, descending, hence causes sweating. Thick Qi is Yang within Yang, ascending, hence causes fever. This section discusses the ascending and descending of Qi and Taste.
Ma Shi commented: Thick Taste is Pure Yin, causing purging downwards, like Da Huang (very cold, extremely thick Yin, Yin within Yin, main effect purging). Li Dongyuan: Sour, Bitter, Salty, Cold. Thin Taste is Yang within Yin, promoting circulation without purging, like Mu Tong, Ze Xie (Yang within Yin, main effect circulation). Li Dongyuan: Sour, Bitter, Salty, Neutral. Thin Qi is Yin within Yang, inducing sweating upwards, like Ma Huang (Thin Qi is Yang, ascending, hence releases exterior and induces sweat). Li Dongyuan: Pungent, Sweet, Bland, Neutral, Cool, Cold. Thick Qi is Pure Yang, causing fever beyond sweating, like Fu Zi (very hot). Li Dongyuan: Pungent, Sweet, Warm, Hot.
Zhang Ji noted: Uses of Five Tastes: Bitter purges, Sweet moderates, Sour astringes, Salty softens, Bland drains/disperses, Pungent disperses. Five Qi: Wind Ascends/Grows, Heat Floats/Lengthens, Dampness Transforms/Becomes, Dryness Descends/Gathers, Cold Sinks/Stores. Liver/Gallbladder: Pungent tonifies, Sour drains; Warm Qi tonifies, Cool Qi drains. Heart/Small Intestine: Salty tonifies, Sweet drains; Hot Qi tonifies, Cold Qi drains. Spleen/Stomach: Sweet tonifies, Bitter drains; Warm/Cool/Cold/Hot tonify/drains according to suitability. Lung/Large Intestine: Sour tonifies, Pungent drains; Cool Qi tonifies, Warm Qi drains. Kidney/Bladder: Bitter tonifies, Cold drains; Cold Qi tonifies, Hot Qi drains. The Yin-Yang of thick/thin Qi and Taste, following Ma's citation of Li Dongyuan, covers the general principles. See previous chart for details.
Strong Fire causes Qi to decline; Mild Fire causes Qi to prosper.
Wang Bing commented: Strong Fire, once excessive, leads to decline. Mild Fire, once mild, leads to prosperity.
Ma Shi commented: Too thick Qi and Taste represent Strong Fire. Using Strong Fire products overwhelms human Qi, causing decline, e.g., Wu Tou, Fu Zi, causing fever because human Qi cannot overcome them. Mild Qi and Taste represent Mild Fire. Using Mild Fire products gradually generates and strengthens human Qi, e.g., Ren Shen, Dang Gui, making Qi and Blood prosper.
Zhang Ji noted: Jun Fire is Strong Fire; Xiang Fire is Mild Fire. Fire governs Shaoyang channels, hence "Mild Fire." Located to the right of Xian Ming, hence "Strong." *Liu Yuan Ji Da Lun* states: "Jun Fire illuminates, Xiang Fire maintains position." Wang Bing notes Jun Fire is to the right of Xiang Fire, named Jun but not assigned annual Qi, hence "Jun Fire by name." Xiang Fire guards position and obeys orders, hence "Xiang Fire by position." *Liu Wei Zhi Da Lun* states: "To the right of Xian Ming is the position of Jun Fire; to the right of Jun Fire, stepping back one step, Xiang Fire takes charge." This means Shao Yin Jun Fire retreats, and Shao Yang Xiang Fire exercises authority. Now, Strong Fire Qi declining is Jun Fire retreating; Mild Fire Qi prospering is Xiang Fire exercising authority. In terms of Qi movement, we say Jun/Xiang; in terms of Qi/Taste, we say Strong/Mild. Slight difference.
Strong Fire consumes Qi; Qi consumes Mild Fire. Strong Fire scatters Qi; Mild Fire generates Qi.
Wang Bing commented: Qi generates Strong Fire, hence "Strong Fire consumes Qi." Mild Fire nourishes Qi, hence "Qi consumes Mild Fire." Because Strong Fire consumes Qi, Qi exposed to Strong Fire dissipates. Because Mild Fire benefits Qi, Qi exposed to Mild Fire grows. Human Yang Qi behaves similarly regarding Strong/Mild.
Zhang Zhicong commented: Qi is Yang, Fire is Yang. Combined, Qi is Fire. Shaoyang San Jiao Qi is born from Ming Men, circulates externally, and internally connects to Pericardium as Xiang Fire, which is the initial Shaoyang Qi. Returning to Lower Jiao, it governs reception; returning to Middle Jiao, it governs transformation. It receives and transforms water and grain essence to generate this Qi to nourish Form. Continuing from the previous text: Excessive Five Tastes injure Qi, and excessive Strong Fire also injures Qi. Qi is born from Essence, and Essence is generated by Qi transformation. Form eats Taste, and Taste entering Stomach also undergoes Qi transformation to nourish Form. Qi must not be injured. Hence, "Strong Fire Qi declines, Mild Fire Qi prospers." Yang hyperactivity makes Fire strong, but generating Qi declines. Yang harmony makes Fire平和 (peaceful), and Qi prospers. If Fire is strong internally, it consumes Qi; if Qi is strong internally, it consumes Fire. "Consume" means enter. Strong Fire causes Qi to merge with Fire; strong Qi causes Fire to return to Qi, uniting Qi and Fire. If Fire is strong externally, it scatters Qi; if Fire is peaceful externally, it generates Qi. Hence, Xiang Fire is the thief of Primordial Qi. To nurture Essence, Qi, and Form, one must calm the Fire.
Wang Zifang commented: "Strong Fire Qi" and "Mild Fire Qi" refer to the Qi of Fire itself.
Ma Shi commented: "Strong Fire Qi declines" because Strong Fire consumes human Qi, so Strong Fire's own Qi declines. "Mild Fire Qi prospers" because human Qi consumes Mild Fire, so Mild Fire's Qi gradually prospers. Only Strong Fire can consume human Qi, hence it scatters human Qi. Consumption leads to scattering, scattering leads to decline, hence "Strong Fire Qi declines." Only human Qi can consume Mild Fire's Qi, hence it generates human Qi. Consumption leads to generation, generation leads to prosperity, hence "Mild Fire Qi prospers." This section clearly discusses the nature of all things...