明以告我。曰∶其理蕴奥，甚矣难言。虽然，若夫天人之理不明，其可谓之医乎，请略陈其梗 如下∶凡万物之有形质
着乎地者，必有象以应乎天也。且以五行之理论之，如在地有木火土金水之五行，在天则有风热湿燥寒火之六气，盖人
肖天地，其五脏六腑之具于身者，与天地造化生成之理若合符节。是故在天为风，在地为木，在人脏腑为肝为胆。在天
为热，在地为火，在人脏腑为心为小肠。在天为湿，在地为土，在人脏腑为脾为胃。在天为燥，在地为金，在人脏腑为
肺为大肠。在天为寒，在地为水，在人脏腑为肾为膀胱。五者之外，又有相火游行于天地上下气交之中，故合为五运六
气；人身之相火，亦游行于腔子之内，上下肓膜之间，命名三焦，亦合于五脏六腑。丹溪曰∶天非此火，不能生物；人
非此火，不能有生。夫《内经》以心胞络为脏，配合三焦而为六脏六腑，总为十二经也，其两肾本为一脏，初无左右之
分。越人始分之，亦未尝言其为相火之脏。玉叔和始立说，以三焦合命门为表里，亦有深意寓焉。盖命门虽为水脏，实
为相火所寓之地。其意盖谓左属阴，右属阳，左属血，右属气，左属水，右属火，静守常而主乎水，动处变而化为火者
也。然而相火固无定体，在上则寄于肝胆胞络之间，发则如龙火飞跃于霄汉而为雷霆也；在下则寓于两肾之内，发则如
龙火鼓舞于湖海而为波涛也。或曰∶尝闻人身之有腑者，若府库然，能盛贮诸物之名也。若大小肠、胃、膀胱、胆五腑，
皆有攸受而盛之者，未审三焦为腑，何所盛乎？曰∶三焦者，指腔子而言，包函乎肠胃之总司也。胸中肓膜之上，曰上
焦；肓膜之下，脐之上，曰中焦；脐之下，曰下焦，总名曰三焦，其可谓之无攸受乎。其体有脂膜在腔子之内，包罗乎
六脏五腑之外也。其心胞络实乃裹心之膜，包于心外，故曰心胞络，其系与三焦之系连属。故指相火之脏腑皆寄于胸中，
此知始而未知终也。其余诸说，皆辗转传讹之语耳。管见如斯， 俟知者再论。
或问∶东垣用药，多以升阳益胃目之，而悉以升麻柴胡之类佐之，何欤？曰∶夫天地四时之令，春夏之气，温而升
浮，则万物发生；秋冬之气，寒而降沉，则万物肃杀。人肖天地，常欲使胃气温而升浮，而行春夏生发之令；不欲使胃
气寒而降沉，而行秋冬肃杀之令耳。又升麻能令清气从右而上达，柴胡能令清气从左而上达。经曰∶清气在下，则生飧
泄；浊气在上，则生 胀。是以清气一升，则浊气随降，而无以上等证。又参 等补剂，皆味浓而气滞者，若不以升柴
等药提之，何以得行于经络肌表而滋补哉。或曰∶东垣生于北方，天倾西北，阳气下陷，此法固宜，恐东南方土不宜也。
曰∶地不满东南，土气下陷，故脾胃之气不升。脾胃之气不升，则上脘不通，谷气不行，而内伤之病作矣。是以此法，
尤利于东南方也，学人不可不知此意。
或问∶内伤发热之证，其为有痰有食胸中迷闷者，固不敢骤用补气之剂；其有察脉审证，明白知是虚损内伤之候，
而投以东垣补中益气汤等，遂致胸中满闷难当，医者其技穷矣。若此者，又将何法以治之乎？曰∶此盖浊气在上而清气
不能上升，故浊气与药气相拒故耳。宜以升柴二物用酒制炒，更加附子一片，以行参 之气，及引升柴直抵下焦，引清
气上升而浊气下降，则服参 等补药不致满闷矣。学人其可不知此乎。
或问∶六淫之邪，当从《内经》六气之太过为是也。昔医和对晋平公之文，不曰风寒暑湿燥火，而曰阴阳风雨晦明，
何也？曰∶辞虽异而理实同焉。彼谓阴淫寒疾者，即太阳寒水之令太过而为寒疾也。阳淫热疾者，即少阳相火之令太过
而为热疾也。风淫末疾者，即厥阴风木之令太过而为末疾也。雨淫腹疾者，即太阴湿土之令太过而为腹疾也。晦淫惑疾
者，即阳明燥金之令太过而为疫疾也。明淫心疾者，即少阴君火之令太过而为心疾也。或曰∶阴阳风雨即为寒热风湿之
疾，彼此固 合矣；所谓晦淫惑疾与明淫心疾二者，似不相符，请明以告我。曰∶岁金太过，燥令大行，久晴不
雨，黄埃蔽空，日月冒明，当为疫疠之疾，山岚瘴气是也。惑当作疫，传写之误耳。君火太过，热令早行，火为离明之
象，故曰明淫，如《内经》所谓天明则日月不明是也。少阴君火司令，故曰心疾，春分至小满时太热也。有释明为昼明，
晦为夜晦，惑为蛊惑心志，皆非也。夫昼明夜晦，天道自然之理，何淫之有。其蛊惑心志者，亦非天地之淫邪也。学人
宜再思之。
或问∶饮食同入于胃，而水谷二者何如而分乎？且如膀胱止有下口而无上口，其水固可出，不知从何而入乎？又何
其如是之清乎？曰∶经曰∶饮食入胃，游溢精气，上输于脾。脾气散精，上归于肺，通调水道，下输膀胱。水精四布，
五经并行，合于四时五行阴阳，揆度以为常也。夫胃为仓廪之官，无物不受全借脾土转输而运化焉。盖水谷入胃，其浊
者为渣滓，下出幽门，达大小肠而为粪，以出于谷道。其清者，倏焉而化为气，根据脾气而上升于肺。其至清而至精者，
由肺而灌溉乎四体，而为汗液津唾，助血脉，益气力，而为生生不息之运也。其清中之浊者，下入膀胱而为溺，以出乎
小便耳。其未入而在膀胱之外者，尚为浊气；既入而在膀胱之内者，即化为水。是故东垣有曰∶饮者无形之气。正谓此
也。盖肺属金而复乎脾胃之上，即如天之复于地之上也。经曰∶清阳为天，浊阴为地。地气上而为云，天气下而为雨。
水入于胃，辄化气而上升，亦犹天降霖雨于地，倏焉化气上腾而为云，又复化为霖雨而下降也。或曰∶老人与壮年者，
饮水无异多寡，壮年小便甚少，而老者小便甚多，何也？曰∶壮者如春夏之气，升者多而降者少；老人如秋冬
之气，降者多而升者少耳。或曰∶降多即小便多，升多者未见其为何物而出于上窍焉。曰∶经曰∶清阳出上窍，浊阴出
下窍；清阳发腠理，浊阴走五脏；清阳实四肢，浊阴归六腑。各从其化也。夫大块之为器，不可论其涵容之量，人之气
化亦犹是也，贤者宜再思之。
或问∶人之寿夭不齐何欤？曰∶元气盛衰不同耳。夫人有生之初，先生二肾，号曰命门，元气之所司，性命之所系
焉。是故肾元盛则寿延，肾元衰则寿夭，此一定之理也。或曰∶今见肥白之人多寿夭，元气反衰乎？瘦黑之人多寿延，
元气反盛乎？曰∶丹溪谓白者肺气弱，黑者肾气足。又曰肥不如瘦，白不如黑。或曰∶四方之人皆同乎？曰∶不同也。
《内经》五常政大论云∶阴精所奉其人寿，阳精所降其人夭。又曰∶东南方阳也，阳者其精降于下，故右热而左温。西
北方阴也，阴者其精奉于上，故左寒而右凉。王注曰∶阴精所奉，高之地也。阳精所降，下之地也。阴方之地，阳不
妄泄，寒气外持，邪不数中而正气坚守，故寿延。阳方之地，阳气耗散，发泄无度，风湿数中，真气倾竭，故夭折。或
曰∶常闻天人之理，同一揆也。今见于天地之四方者，既得闻命矣；而具于人之五脏者，未之闻也，请申明其说可乎？
曰∶西北二方，在人为肾水肺金所居之地，二脏常恐其不足；东南二方在人为肝木心火所处之位，二脏常恐其有余。《难
经》曰东方实、西方虚、泻南方、补北方等语，即此之义也。夫肾水既实，则阴精时上，奉于心肺，故东方之木气不实，
而西方之金气不虚，此子能令母实，使金得以平木也，是故水日以盛而火日以亏，此阴精所奉于上而令人寿延也。若夫
肾水虚弱，则无以制南方之心火，故东方实而西方虚，其命门与胞络之相火，皆挟心火之势而来，侮所不胜之水，使水
日亏而火日盛，此阳精所降于下，故令人夭折也。大抵王冰主天地之四方言，越人主人身之五脏论，皆不失《内经》之
旨，同归于一理也，学人详之。
或问∶经谓清气在下，则生飧泄；浊气在上，则生 胀。夫病在上者，法当用木香、槟榔等药以降之，病在下者，
法当用升麻、柴胡等药以提之，理宜然也。其或泄痢，脱肛后重，大孔痛不可忍，是为气下陷也，法当举之以升麻、柴
胡，和之以木香、槟榔。若夫四药同剂，不无升降混淆，奚有归一治病之功邪？曰∶天生药石，治病各逞其能。如张仲
景制大柴胡汤，用柴胡、大黄同剂，以治伤寒表里俱见之证。然柴胡升而散外邪，大黄降而泄内实，使病者热退气和而
愈。今用升麻、柴胡，自能升清气而上行；木香、槟榔，自能逐邪气而下降。故使脱肛举而后重除，故可同剂而成功矣，
何疑之有哉。欲用药者，宜仿此而扩充之可也。
或问∶人身之两肾，犹车之有两轮，其形同，色亦无异，不知王叔和何所见而独谓左肾属水而右肾属火，又指右肾
为命门以配三焦之经？尝闻有生之初，胚胎未成之际，先生二肾，即造化天一生水之义，今以水火岐之，冰炭相反何欤？
曰∶予尝私淑丹溪而得其说矣。按《内经》以心胞络为三焦相火之配而并行于经也，其两肾本为一脏，初未尝有左右之
分。而越人始分之，亦不言其为相火之脏。叔和立说，以三焦合命门为表里，亦有深意存焉。盖谓肾属阴而本主乎静，
静则阳孕于其中阳既孕矣，其能纯乎静而无生气之动欤。若经所谓肾属水，受五脏六腑之精而藏之，是阳归之阴而成孕
者也。又谓肾为作强之官，伎巧出焉，阳出之阴而化生者也。是故肾为一脏配五行而言者，则属之水矣。以其两肾之形
有二象而言者，亦得以左右分阴阳刚柔而命为五脏之根元也。以左为阴，右为阳，阴为水，阳为火，水为血，火为气，
于是左肾之阴水生肝木，肝木生心火，右肾之阳火生脾土，脾土生肺金，其四脏之于肾，犹枝叶之出于根也。虽然，但
不可独指右肾为命门耳。经曰∶太冲之地，名曰少阴，少阴之上，名曰太阳，太阳根起于至阴，结于命门。按王注∶《灵
枢经》云∶命门者目也。抑考《明堂》、《铜人》等经，命门一穴在脊中行第十四椎下陷中两肾之间。夫两肾固为真元之
根本，性命之所关，虽为水脏，而实有相火寓乎其中，象水中之龙火，因其动而发也。愚意当以两肾总号为命门，其命
门穴正象门中之枨 ，司开阖之象也。惟其静而阖，涵养乎一阴之真水；动而开，鼓舞乎龙雷之相火。夫水者常也，火
者变也。若独指乎右肾为相火，以为三焦之配，尚恐立言之未精也，未知识者以为何如？
或问∶《内经》所谓壮火之气衰，少火之气壮，壮火食气，气食少火，壮火散气，少火生气，何谓也？曰∶王太仆已
有注文，但未甚详耳，请陈一得如下∶夫壮火之气衰、少火之气壮者，言造化胜复之理，少而壮，壮而衰，衰而复生，
循环无端，生生不息。经虽不言衰而复生，其理实在其中矣。壮火食气者，言元气见食于壮火也。气食少火者，言元气
见助于少火也。壮火散气谓耗散元气，少火生气谓滋生元气，此二句申明上文二句之言耳。盖火不可无，亦可少而不可
壮也，少则滋助乎真阴，壮则烧烁乎元气。阴阳造化之理，无往不复，夫火壮而亢极，则兼水化以制之。经曰亢则害，
承乃制也。又曰制则生化。故壮火衰而少火复生，是以阴阳调和，万物生旺，四时生长化收藏之道，即此理也。以人论
之，胚胎未成之初，先生二肾以涵养真阴，是故名为元气，天一生水之义焉，然后肝心脾肺以及五腑相继而生。五脏五
腑之外，又有胞络相火，游行于三焦之间，故以三焦为配，二者皆有名无实之腑脏，盖相火无定位故也。抑考先哲有曰∶
天非此火，不能生物；人非此火，不能有生。言其不可无也，此非少火生气之意乎。又曰∶火与元气不两立，一胜
则一负。言其不可亢也，又非壮火散气之谓乎。管见如斯，未知是否？
或问∶越人《难经》第一难中所谓∶十二经皆有动脉，独取寸口以决五脏六腑死生吉凶之法。又曰∶寸口者，脉之
大会，手太阴之脉动也。夫寸口一脉，何以能决脏腑死生吉凶乎？鳌峰熊氏注为右寸，谓右寸之属肺也。四明张氏注为
两寸，谓脉会太渊穴也。二说不同，其孰非而孰是欤？请明以告我。曰∶古圣立法，以三部九候决人死生，以六脏六腑
分发于六部之中，故可以验人脏腑之吉凶也，殊不知《内经》言寸口者颇多，悉兼关尺而言也，大 古人以寸口为六脉
之总名耳。不然，《内经》何以言寸口之脉中手短者曰头痛，寸口脉中手长者曰足胫痛，寸口脉中手促上击者肩背痛，若
此之类，莫能尽述。先哲注谓中手为医者之中指也，然则非病者之关脉乎。夫越人之《难经》，因《内经》而作，故有是
语。今之注者，皆以己意妄释，故与经旨不合。学人宜再思之。
或问∶《难经》第八难曰∶寸口脉平而死者，何谓也？然。诸十二经脉者，皆系于生气之源。所谓生气之源者，十二
经之根本也，谓肾间动气也，此五脏六腑之本，十二经之根，呼吸之门，三焦之源，一名守邪之神。故气者，人之根本
（有人）明白地告诉我。（我）说：其中的道理深奥微妙，很难用言语表达清楚。虽然如此，如果天与人的道理不明白，那能称之为医生吗？请让我简略陈述其大概情况如下：
凡是万物中拥有形体和质地的，附着于地面的，必定有相应的形象来对应上天。就拿五行理论来说，在地面上有木、火、土、金、水这五行；在天空中则有风、热、湿、燥、寒、火这六气。大概人效法天地，人体内的五脏六腑，与天地造化生成的道理是吻合的。所以在天空表现为风，在地面表现为木，在人脏腑中表现为肝和胆。在天空表现为热，在地面表现为火，在人脏腑中表现为心和小肠。在天空表现为湿，在地面表现为土，在人脏腑中表现为脾和胃。在天空表现为燥，在地面表现为金，在人脏腑中表现为肺和大肠。在天空表现为寒，在地面表现为水，在人脏腑中表现为肾和膀胱。在这五者之外，又有相火（寄居于体内的非正火，主要指命门之火及三焦之火）在天地上下之气交之中运行，所以合称为五运六气；人身中的相火，也运行在胸腔之内，上下肓膜之间，命名为三焦，这也与五脏六腑相配合。朱丹溪说：天如果没有这把火，就不能化生万物；人如果没有这把火，就不能维持生命。《黄帝内经》将心包络视为脏，与三焦配合成为六脏六腑，总共为十二经脉。两肾原本是一个脏，起初并没有左右之分。扁鹊（越人）开始将其分为左右，但也未曾说它们是相火之脏。王叔和开始提出学说，认为三焦与命门互为表里，其中也有深意寓含其中。大概命门虽然属于水脏，但实际上是相火寄居的地方。他的意思大概是说左边属阴，右边属阳；左边属血，右边属气；左边属水，右边属火；静守常态而主司水，动处变化而化为火。然而相火本来没有固定的形体，在上部则寄居于肝胆和心包络之间，发作时就像龙火飞跃在云霄天际而变成雷霆；在下部则寓居在两肾之内，发作时就像龙火在湖海中鼓舞而变成波涛。
有人说：曾经听说人身上的腑，就像府库一样，是能盛放各种东西的名称。像大肠、小肠、胃、膀胱、胆这五个腑，都有所承受并盛放东西，不知道三焦作为腑，它盛放什么呢？回答说：三焦，是指胸腔而言，是包容肠胃的总体主管。胸中肓膜之上，叫做上焦；肓膜之下，肚脐之上，叫做中焦；肚脐之下，叫做下焦，总名叫三焦，能说它是无所承受的吗？它的体形有脂膜在胸腔之内，包裹在六脏五腑之外。心包络实际上是包裹心脏的膜，包在心外，所以叫心包络，它的脉络与三焦的脉络相连属。所以指着相火的脏腑都寄居在胸部，这是只知道开始却不知道结局的说法。其余的各种说法，都是辗转传抄讹误的话罢了。我的见解就是这样，等待懂行的人再讨论。
有人问：李东垣用药，多以升发阳气、补益脾胃为目的，并且都用升麻、柴胡之类的药来辅助，为什么呢？回答说：天地四季的命令，春夏的气，温和而上升浮越，所以万物发生生长；秋冬的气，寒冷而下降沉潜，所以万物肃杀凋零。人效法天地，常希望胃气温和而上升浮越，以执行春夏生发的命令；不希望胃气寒冷而下降沉潜，以执行秋冬肃杀的命令。另外，升麻能使清气从右侧向上到达，柴胡能使清气从左侧向上到达。医经说：清气在下，就会产生完谷不化的泄泻；浊气在上，就会产生胀满。因此清气一上升，浊气就随之下降，就不会出现上述病症。另外人参等补剂，都是味道浓厚而气机滞涩的，如果不以升麻、柴胡等药提升，怎么能使它们行于经络肌表从而起到滋补作用呢？有人说：李东垣生于北方，天倾西北，阳气下陷，这种方法固然适宜，恐怕东南方的土地就不适宜了。回答说：大地不满于东南，土气下陷，所以脾胃之气不能上升。脾胃之气不能上升，就会上脘不通，谷气不行，于是内伤疾病就产生了。因此这种方法，尤其有利于东南方的人，学医的人不可不知道这个意思。
有人问：内伤发热这种病证，那些因为有痰、有食积导致胸中迷闷的，固然不敢贸然使用补气药剂；那些通过诊察脉象审辨症状，明确知道是虚损内伤的征候，而投用李东垣的补中益气汤等药，却导致胸中满闷难以忍受，医生的技术就穷尽了。对于这种情况，又将用什么方法来治疗呢？回答说：这大概是浊气停留在上部而清气不能上升，所以浊气与药气相互排斥的缘故。应该用酒制炒过的升麻、柴胡二味药，再加一片附子，来推动人参等药的气机，以及引导升麻、柴胡直达下焦，引导清气上升而浊气下降，那么服用参芪等补药就不会导致满闷了。学医的人怎么可以不知道这一点呢？
有人问：六淫（风、寒、暑、湿、燥、火六种外感病邪）的邪气，应当遵从《黄帝内经》中六气太过来理解才对。以前医和对晋平公说的话，不说风寒暑湿燥火，而说阴阳风雨晦明，为什么呢？回答说：言辞虽然不同，但道理其实是一样的。他说“阴淫寒疾”，就是太阳寒水之气太过而导致寒性疾病。说“阳淫热疾”，就是少阳相火之气太过而导致热性疾病。说“风淫末疾”，就是厥阴风木之气太过而导致四肢末端疾病。说“雨淫腹疾”，就是太阴湿土之气太过而导致腹部疾病。说“晦淫惑疾”，就是阳明燥金之气太过而导致疫病（注：原文此处可能有误，通常对应疫疠或特定疾病，下文解释为疫疾）。说“明淫心疾”，就是少阴君火之气太过而导致心脏疾病。有人说：阴阳风雨即为寒热风湿的疾病，彼此固然符合了；所谓“晦淫惑疾”与“明淫心疾”这两句，似乎不相符，请明白地告诉我。回答说：岁金太过，燥令大行，久晴不下雨，黄埃遮蔽天空，日月昏暗，应当发生疫病，这就是山岚瘴气。惑字当作疫字，是传写时的错误。君火太过，热令早行，火是离明之象，所以叫明淫，就像《黄帝内经》所说的“天明则日月不明”。少阴君火当令，所以叫心疾，指春分到小满时节过于炎热。有解释把明解释为白昼明亮，晦解释为夜晚昏暗，惑解释为蛊惑心志，都不对。白昼明亮夜晚昏暗，是天道的自然规律，有什么淫邪的呢？那种蛊惑心志的，也不是天地的淫邪之气。学医的人应该再思考一下。
有人问：饮食同时进入胃中，水和谷二者是如何区分的呢？而且膀胱只有下口而没有上口，它的水当然可以排出，不知道是从哪里进入的呢？又为什么如此清澈呢？回答说：医经说：饮食进入胃中，游溢精气，向上输送给脾。脾气散布精微，向上归于肺，通调水道，向下输送到膀胱。水精四布，五条经脉并行，配合四时五行阴阳，衡量作为常规。胃是仓廪之官，没有不接受的东西，全靠脾土的转输和运化。大概水谷进入胃中，浑浊的部分成为渣滓，向下从幽门出来，到达大小肠成为粪便，从肛门排出。清的部分，忽然化为气，依靠脾气而上升到肺。其中最清最精的部分，由肺灌溉到四肢，成为汗液、津液和唾沫，帮助血脉，益气力，成为生生不息的运行。其中清中之浊的部分，向下进入膀胱成为尿液，从小便排出。那些未进入而在膀胱之外的，还是浊气；已经进入而在膀胱之内的，就化为水。所以李东垣说：饮是无形的和气。正是说的这个意思。大概肺属金且位于脾胃之上，就像天覆盖在地之上。医经说：清阳为天，浊阴为地。地气上升而为云，天气下降而为雨。水进入胃中，随即化为气而上升，也就像天降霖雨于地面，忽然化为气上升成为云，又再化为霖雨下降。有人说：老人与壮年人，饮水多少无异，壮年人小便很少，而老人小便很多，为什么呢？回答说：壮年人像春夏之气，上升的多而下降的少；老人像秋冬之气，下降的多而上升的少。有人说：下降多即小便多，上升多的没见其为何物从上窍排出呢？回答说：医经说：清阳出上窍，浊阴出下窍；清阳发腠理，浊阴走五脏；清阳充实四肢，浊阴归入六腑。各自遵循其变化规律。大地作为容器，不能谈论其容纳的量，人的气化也是如此，贤明的人应该再思考。
有人问：人的寿命长短不齐是怎么回事？回答说：元气盛衰不同罢了。人在刚出生时，先生两个肾，号称命门，是元气的掌管处，性命的系念所在。所以肾元旺盛则寿命延长，肾元衰弱则寿命短促，这是确定的道理。有人说：现在看到肥胖面白的人多长寿短命，元气反而衰弱吗？瘦黑的人多长寿，元气反而旺盛吗？回答说：朱丹溪说白色的人肺气弱，黑色的人肾气足。又说胖不如瘦，白不如黑。有人说：四方的人都是一样的吗？回答说：不一样。《黄帝内经·五常政大论》说：阴精所奉之地的人长寿，阳精所降之地的人夭折。又说：东南方属阳，阳者的精微降于下，所以右热左温。西北方属阴，阴者的精微奉于上，所以左寒右凉。王冰注释说：阴精所奉，是高峻之地。阳精所降，是低下之地。阴方之地，阳气不妄泄，寒气在外持守，邪气不频繁侵袭而正气坚守，所以寿命延长。阳方之地，阳气耗散，发泄无度，风湿频繁侵袭，真气倾竭，所以夭折。有人说：常听说天人的道理，是同一准则的。现在见于天地四方的，已经听明白了；而在人身上五脏的表现，还没听说过，请阐明这个道理可以吗？回答说：西北二方，在人身上是肾水肺金居住的地方，这两个脏器常担心不足；东南二方在人身上是肝木心火所处的位置，这两个脏器常担心有余。《难经》说东方实、西方虚、泻南方、补北方等话，就是这个意思。既然肾水充实，那么阴精时常上行，奉养于心肺，所以东方木气不实，而西方金气不虚，这是子能令母实，使金得以平抑木，所以水日益旺盛而火日益亏损，这是阴精奉于上而让人寿命延长。如果肾水虚弱，就无法制约南方的心火，所以东方实而西方虚，命门与心包络的相火，都挟带心火之势而来，欺侮所不胜的水，使水日益亏损而火日益旺盛，这是阳精降于下，所以让人夭折。大体上王冰主要从天地四方来说，扁鹊主要从人身五脏来论述，都没有违背《黄帝内经》的宗旨，同归于一个道理，学医的人要详细研究。
有人问：医经说清气在下，则生飧泄；浊气在上，则生胀满。病在上部的，依法应当用木香、槟榔等药来降气；病在下部的，依法应当用升麻、柴胡等药来提升，道理应该是这样的。如果是泄痢、脱肛、后重、肛门疼痛不可忍受，这是气下陷，依法应当用升麻、柴胡举提，用木香、槟榔调和。如果这四味药同用，不免升降混淆，哪里有统一治病的效果呢？回答说：天生药物，治病各显其能。比如张仲景制作大柴胡汤，用柴胡、大黄同用，来治疗伤寒表里俱见的病证。然而柴胡升散外邪，大黄降泄内实，使病人热退气和而痊愈。现在用升麻、柴胡，自然能升清气而上行；木香、槟榔，自然能逐邪气而下降。所以使脱肛举起而后重消除，因此可以同用而成功，有什么可怀疑的呢？想用药的人，应该仿照这个来扩充应用。
有人问：人身的两个肾，就像车轮有两个轮子，形状相同，颜色也没有差异，不知道王叔和凭什么单独说左肾属水而右肾属火，又指右肾为命门来配三焦经脉？曾经听说在生命初始，胚胎未成之际，先生两个肾，即造化“天一生水”的意义，现在用水火分开它们，冰炭相反，为什么呢？回答说：我曾私下仰慕朱丹溪而得到他的学说。查考《黄帝内经》将心包络作为三焦相火的配合而并行于经脉，两肾本是一个脏，起初并未有左右之分。而扁鹊开始将其分开，也不说它们是相火之脏。王叔和提出学说，以三焦合命门为表里，其中也有深意存留。大概认为肾属阴而本来主静，静则阳孕育在其中；阳既已孕育，难道能纯静而无生气之动吗？如果像医经所说肾属水，接受五脏六腑的精气而藏之，这是阳归于阴而成孕。又说肾为作强之官，伎巧出焉，这是阳出于阴而化生。所以肾作为一个脏配合五行来说，则属于水。以其两肾的形状有二象来说，也可以以左右分阴阳刚柔，命名为五脏的根本。以左为阴，右为阳；阴为水，阳为火；水为血，火为气。于是左肾的阴水生肝木，肝木生心火；右肾的阳火生脾土，脾土生肺金。这四个脏对于肾，就像枝叶出于根。虽然这样，但不可单独指右肾为命门。医经说：太冲之地，名叫少阴；少阴之上，名叫太阳；太阳根起于至阴，结于命门。按王冰注：《灵枢经》说：命门就是眼睛。再考证《明堂》、《铜人》等经，命门穴在脊背正中第十四椎下的凹陷中，两肾之间。两肾固然是真元的根本，性命的关键，虽然是水脏，而实际上有相火寓居在其中，像水中的龙火，因其动而发作。我的意见应当以两肾总称为命门，其命门穴正像门中的门栓，司开阖的形象。因为静而闭合，涵养一阴的真水；动而开启，鼓舞龙雷的相火。水是常态，火是变化。如果单独指右肾为相火，作为三焦的配合，还恐怕立言不够精密，不知识者以为如何？
有人问：《黄帝内经》所谓壮火之气衰，少火之气壮，壮火食气，气食少火，壮火散气，少火生气，是什么意思？回答说：王冰已有注文，但不是很详细，请陈述一点心得如下：壮火之气衰、少火之气壮，说的是造化胜复的道理，少而壮，壮而衰，衰而复生，循环无端，生生不息。医经虽没说衰而复生，但道理实在其中。壮火食气，说的是元气被壮火吞噬。气食少火，说的是元气得到少火的帮助。壮火散气谓耗散元气，少火生气谓滋生元气，这两句是申明上文两句的意思。大概火不可无，也可少而不可壮，少则滋助真阴，壮则烧烁元气。阴阳造化的道理，无往不复，火壮而亢极，则兼水化以制约它。医经说：亢则害，承乃制。又说：制则生化。所以壮火衰而少火复生，因此阴阳调和，万物生旺，四时生长化收藏之道，就是这个道理。以人来说，胚胎未成之初，先生两个肾以涵养真阴，所以名为元气，是天一生水的意义，然后肝心脾肺以及五腑相继而生。五脏五腑之外，又有胞络相火，游行于三焦之间，所以以三焦为配合，这两者都是有名无实的腑脏，因为相火没有固定位置。再考证先哲有说：天没有这把火，不能生物；人没有这把火，不能有生。说的是不可无，这不是少火生气的意思吗？又说：火与元气不两立，一胜则一负。说的是不可亢，又不是壮火散气的话吗？我的见解就是这样，不知道是否正确？
有人问：扁鹊《难经》第一难中所谓：十二经皆有动脉，独取寸口以决五脏六腑死生吉凶之法。又说：寸口者，脉之大会，手太阴之脉动也。寸口一脉，怎么能决定脏腑死生吉凶呢？鳌峰熊氏注为右寸，认为右寸属肺。四明张氏注为两寸，认为脉会太渊穴。两种说法不同，哪个错哪个对呢？请明白地告诉我。回答说：古圣立法，以三部九候决定人生死，以六脏六腑分发于六部之中，所以可以验证人脏腑的吉凶，殊不知《黄帝内经》说寸口的地方很多，都兼关尺而言，大概古人以寸口为六脉的总名。不然，《黄帝内经》为什么说寸口脉中手短者曰头痛，寸口脉中手长者曰足胫痛，寸口脉中手促上击者肩背痛，像这类情况，不能尽述。先哲注谓中手为医者的中指，那么就不是病人的关脉吗。扁鹊的《难经》，因《黄帝内经》而作，所以有这样的话。现在的注者，都以己意妄加解释，所以与经旨不合。学医的人应该再思考。
有人问：《难经》第八难说：寸口脉平而死者，什么意思？是的。所有十二经脉，都系于生气之源。所谓生气之源，是十二经的根本，叫做肾间动气，这是五脏六腑的本，十二经的根，呼吸的门，三焦之源，一名守邪之神。所以气，是人的根本
(I was) clearly informed by me. I said: The principles are profound and subtle, extremely difficult to express in words. Nevertheless, if the principles of Heaven and humanity are not understood, how can one be called a physician? Please allow me to briefly state the general outline as follows:
All things that possess form and substance, adhering to the earth, must have corresponding images to respond to Heaven. Taking the theory of Five Phases (Wu Xing) for example, on the ground there are Wood, Fire, Earth, Metal, and Water; in the sky there are Wind, Heat, Dampness, Dryness, Cold, and Fire—the Six Qi (Liu Qi). Generally speaking, humans emulate Heaven and Earth; the Five Zang (Zang organs) and Six Fu (Fu organs) within the body correspond perfectly with the principles of creation and generation of Heaven and Earth. Therefore, in Heaven it manifests as Wind, on Earth as Wood, and in human Zang-Fu as Liver and Gallbladder. In Heaven it manifests as Heat, on Earth as Fire, and in human Zang-Fu as Heart and Small Intestine. In Heaven it manifests as Dampness, on Earth as Earth, and in human Zang-Fu as Spleen and Stomach. In Heaven it manifests as Dryness, on Earth as Metal, and in human Zang-Fu as Lung and Large Intestine. In Heaven it manifests as Cold, on Earth as Water, and in human Zang-Fu as Kidney and Bladder. Beyond these five, there is also Ministerial Fire (Xiang Huo, non-standard fire residing in the body, mainly referring to Mingmen fire and Sanjiao fire) circulating in the intersection of Qi between Heaven and Earth above and below, thus combining into the Five Movements (Wu Yun) and Six Qi. The Ministerial Fire in the human body also circulates within the thoracic cavity, between the upper and lower Hui membranes (San Jiao), named Sanjiao (Triple Burner), which also corresponds to the Five Zang and Six Fu organs. Zhu Danxi said: Without this Fire, Heaven cannot generate living things; without this Fire, humans cannot sustain life. *The Yellow Emperor's Inner Canon* (*Huangdi Neijing*) regards the Pericardium (Xin Bao Luo) as a Zang organ, paired with the Sanjiao to form six Zang and six Fu organs, totaling twelve meridians. The two kidneys originally constituted one Zang organ, initially having no distinction between left and right. Bian Que (Yue Ren) began to divide them, but did not claim they were organs of Ministerial Fire. Wang Shuhe proposed the theory that the Sanjiao and Mingmen (Gate of Life) are exterior-interior pairs, implying deep significance. Presumably, although Mingmen belongs to the Water Zang, it is actually the residence of Ministerial Fire. His meaning seems to be that the left belongs to Yin, the right to Yang; the left to Blood, the right to Qi; the left to Water, the right to Fire; stillness maintains constancy and governs Water, while movement undergoes change and transforms into Fire. However, Ministerial Fire has no fixed form; when located superiorly, it resides between the Liver, Gallbladder, and Pericardium, and upon manifestation, it leaps like dragon fire in the clouds and skies, becoming thunder; when located inferiorly, it resides within the two kidneys, and upon manifestation, it stirs like dragon fire in lakes and seas, becoming waves.
Someone asked: I have heard that the Fu organs in the human body are like storehouses, names for containers that hold various substances. The Large Intestine, Small Intestine, Stomach, Bladder, and Gallbladder all receive and contain specific substances. I wonder, as a Fu organ, what does the Sanjiao contain? The answer is: The Sanjiao refers to the thoracic-abdominal cavity, serving as the general supervisor encompassing the stomach and intestines. Above the Hui membranes in the chest is called the Upper Jiao; below the Hui membranes and above the navel is called the Middle Jiao; below the navel is called the Lower Jiao. Collectively named Sanjiao, how can it be said to have nothing to contain? Its structure includes fatty membranes within the cavity, enveloping the outside of the six Zang and five Fu organs. The Pericardium is actually the membrane wrapping the heart, enclosing it externally, hence named Pericardium. Its channels are connected to those of the Sanjiao. Thus, pointing out that the Zang-Fu of Ministerial Fire all reside in the chest reflects knowing the beginning but not the end. The remaining theories are merely errors passed down through transcription. My insights are thus; awaiting further discussion by experts.
Someone asked: Li Dongyuan’s medication often aims to raise Yang and tonify the Stomach, assisted by herbs like Shengma (Rhizoma Cimicifugae) and Chaihu (Radix Bupleuri). Why? The answer is: The commands of the four seasons of Heaven and Earth dictate that the Qi of Spring and Summer is warm and ascending/floating, causing all things to grow; the Qi of Autumn and Winter is cold and descending/sinking, causing all things to wither. Humans emulate Heaven and Earth, constantly desiring the Stomach Qi to be warm, ascending, and floating, executing the generative command of Spring and Summer; and not allowing Stomach Qi to be cold, descending, and sinking, executing the withering command of Autumn and Winter. Furthermore, Shengma allows Clear Qi to ascend from the right side, and Chaihu allows Clear Qi to ascend from the left side. The Classics state: When Clear Qi is below, it generates undigested diarrhea (Sun Xie); when Turbid Qi is above, it generates distension. Therefore, once Clear Qi ascends, Turbid Qi descends accordingly, preventing such symptoms. Additionally, tonics like Renshen (Radix Ginseng) are thick-flavored and Qi-stagnating; without lifting agents like Shengma and Chaihu, how can they travel through the meridians and muscle-skin layers to provide nourishment? Someone asked: Li Dongyuan was born in the North, where Heaven tilts northwest, causing Yang Qi to sink; this method is suitable, but perhaps not for the Southeast. The answer is: The earth is incomplete in the southeast, causing Earth Qi to sink, so Spleen-Stomach Qi fails to ascend. If Spleen-Stomach Qi fails to ascend, the upper epigastrium becomes blocked, Grain Qi fails to move, and internal injury diseases arise. Thus, this method is particularly beneficial for people in the Southeast; students of medicine must understand this point.
Someone asked: Regarding internal injury fever, cases with phlegm or food retention causing chest stuffiness should not hastily use Qi-tonifying formulas. However, in cases where pulse and symptoms clearly indicate deficiency and internal injury, administering Li Dongyuan’s Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) leads to unbearable chest fullness, leaving the physician at a loss. What method should be used here? The answer is: This is likely due to Turbid Qi stagnating above while Clear Qi fails to ascend, causing resistance between Turbid Qi and the medicinal Qi. One should use Jiuzhi Chao Shengma and Chaihu (Shengma and Chaihu processed with wine and stir-fried), adding one slice of Fuzi (Radix Aconiti Lateralis Preparata) to propel the Qi of Renshen, and guide Shengma and Chaihu directly to the Lower Jiao, guiding Clear Qi upward and Turbid Qi downward. Then, taking Renshen and Huangqi (Radix Astragali) tonics will not cause fullness. How can students ignore this?
Someone asked: The pathogenic factors of the Six Excesses (Liu Yin) should be understood according to the excess of the Six Qi in *The Yellow Emperor's Inner Canon*. In the past, Yi Dui spoke to Duke Ping of Jin, mentioning Yin-Yang, Wind-Rain, Dark-Bright instead of Wind-Cold-Heat-Dryness-Fire. Why? The answer is: Although the wording differs, the principle is the same. "Yin excess causes cold disease" refers to the excess of Taiyang Cold-Water leading to cold disease. "Yang excess causes heat disease" refers to the excess of Shaoyang Ministerial Fire leading to heat disease. "Wind excess causes extremity disease" refers to the excess of Jueyin Wind-Wood leading to extremity disease. "Rain excess causes abdominal disease" refers to the excess of Taiyin Damp-Earth leading to abdominal disease. "Darkness excess causes confusion disease" refers to the excess of Yangming Dryness-Metal leading to epidemic disease (Note: Text suggests 'Huò' is a typo for 'Yì'). "Brightness excess causes heart disease" refers to the excess of Shaoyin Sovereign Fire leading to heart disease. Someone asked: Yin-Yang-Wind-Rain correspond to Cold-Heat-Wind-Dampness, which fits; but "Darkness excess causes confusion disease" and "Brightness excess causes heart disease" seem inconsistent. Please explain. The answer is: When Metal Qi is excessive, Dryness prevails, long sunny days without rain, yellow dust obscures the sky, sun and moon are dimmed, leading to epidemics like mountain miasma. 'Huò' (confusion) should be 'Yì' (epidemic), a transcription error. When Sovereign Fire is excessive, Heat arrives early; Fire is the image of Li-Brightness, hence 'Ming Yin'. As stated in *Neijing*: "When Heaven is bright, sun and moon are not distinct." Shaoyin Sovereign Fire commanding leads to heart disease, referring to excessive heat from Spring Equinox to Minor Fullness. Interpreting 'Ming' as daylight, 'Hui' as night darkness, and 'Huò' as bewitching the mind is incorrect. Daylight and night darkness are natural laws of Heaven, not excess pathogens. Bewitching the mind is also not a heavenly excess pathogen. Students should reflect further.
Someone asked: Food and drink enter the Stomach together; how are Water and Grain distinguished? The Bladder has only an outlet, no inlet; water exits, but where does it enter? And why is it so clear? The answer is: The Classics state: Food and drink enter the Stomach, their essence floats up and is transported to the Spleen. The Spleen scatters essences, sending them up to the Lung, which regulates water passages, transporting them down to the Bladder. Water essences distribute everywhere, flowing through the five meridians, harmonizing with the four seasons, five phases, Yin-Yang, forming the constant rule. The Stomach is the official of granaries, accepting everything, relying entirely on Spleen Earth for transport and transformation. When water and grain enter the Stomach, the turbid part becomes dregs, exiting via the pylorus, reaching the intestines as feces, and leaving through the anus. The clear part suddenly transforms into Qi, rising to the Lung with the Spleen's help. The clearest and most refined part irrigates the four limbs via the Lung, becoming sweat, fluids, and saliva, assisting blood vessels, boosting Qi and strength, sustaining endless life processes. The turbid part within the clear flows down to the Bladder as urine, exiting via urination. That which is outside the Bladder is still turbid Qi; that which enters the Bladder transforms into water. Hence, Li Dongyuan said: Drink is formless Qi. This refers to this process. The Lung belongs to Metal and sits above the Spleen and Stomach, just as Heaven covers the Earth. The Classics state: Clear Yang is Heaven, Turbid Yin is Earth. Earth Qi rises to become clouds; Heaven Qi descends to become rain. Water entering the Stomach transforms into Qi and rises, just as rain falling on earth transforms into vapor rising to become clouds, then condenses back into rain. Someone asked: Elderly and young adults drink similar amounts, yet young adults have little urine while the elderly have much. Why? The answer is: Young adults resemble Spring-Summer Qi, ascending more than descending; the elderly resemble Autumn-Winter Qi, descending more than ascending. Someone asked: If descending means more urine, where does the ascending part exit from the upper orifices? The answer is: The Classics state: Clear Yang exits the upper orifices, Turbid Yin exits the lower orifices; Clear Yang disperses to the interstices, Turbid Yin travels to the Zang organs; Clear Yang fills the four limbs, Turbid Yin returns to the Fu organs. Each follows its transformation. The Great Earth as a vessel cannot be measured by capacity; human Qi transformation is the same. Wise ones should reflect.
Someone asked: Why do human lifespans vary? The answer is: Differences in the prosperity and decline of Yuan Qi (Primal Qi). At birth, the two kidneys form first, called Mingmen, governing Yuan Qi and anchoring life and nature. Thus, robust Kidney Yuan extends life; weak Kidney Yuan shortens it. This is a fixed principle. Someone asked: Fat, pale people often live long or die young; is Yuan Qi weak? Thin, dark people often live long; is Yuan Qi strong? The answer is: Zhu Danxi said: Pale indicates weak Lung Qi; dark indicates sufficient Kidney Qi. He also said: Fat is inferior to thin; pale is inferior to dark. Someone asked: Is this true for people from all directions? The answer is: No. *Neijing·Wu Chang Zheng Da Lun* states: Where Yin Essence is offered up, people live long; where Yang Essence descends, people die young. It also says: The Southeast is Yang; Yang essence descends, making the right hot and left warm. The Northwest is Yin; Yin essence is offered up, making the left cold and right cool. Wang Bing’s commentary notes: Yin essence offered up refers to high lands; Yang essence descended refers to low lands. In Yin regions, Yang does not leak recklessly, cold holds externally, pathogens rarely strike, and righteous Qi remains firm, extending life. In Yang regions, Yang dissipates, sweating is excessive, wind-damp strikes frequently, and true Qi exhausts, leading to premature death. Someone asked: I often hear that Heaven and Human principles are consistent. I understand this regarding the four directions of Heaven and Earth; but what about the Five Zang organs in humans? Please elaborate. The answer is: The Northwest corresponds to Kidney Water and Lung Metal in humans, organs often prone to deficiency. The Southeast corresponds to Liver Wood and Heart Fire, organs often prone to excess. *Nan Jing* mentions "East is Excess, West is Deficient, Drain South, Tonify North," reflecting this meaning. Since Kidney Water is substantial, Yin Essence constantly ascends to nourish Heart and Lung, so East Wood is not excessive, and West Metal is not deficient. This is "Child makes Mother substantial," allowing Metal to control Wood. Thus, Water grows daily while Fire declines; this is Yin Essence offered up, extending life. If Kidney Water is weak, it cannot control Southern Heart Fire, so East is Excess and West is Deficient. Mingmen and Pericardium Ministerial Fire join Heart Fire, bullying the unconquerable Water, causing Water to decline and Fire to flourish. This is Yang Essence descending, leading to premature death. Generally, Wang Bing focused on the four directions of Heaven and Earth, while Bian Que focused on the five Zang organs of the human body; both adhere to *Neijing* principles, returning to one truth. Students should study carefully.
Someone asked: The Classics state: Clear Qi below causes Sun Xie (undigested diarrhea); Turbid Qi above causes distension. For diseases above, one should use Muxiang (Radix Aucklandiae) and Binglang (Semen Arecae) to descend; for diseases below, Shengma and Chaihu to ascend. This seems logical. However, in cases of diarrhea/dysentery, rectal prolapse, tenesmus, and severe anal pain, this is Qi sinking. One should lift with Shengma/Chaihu and harmonize with Muxiang/Binglang. Using all four together might confuse ascending/descending; how can they achieve unified therapeutic effect? The answer is: Nature provides herbs, each capable in treating disease. Zhang Zhongjing’s Da Chaihu Tang uses Chaihu and Dahuang together to treat Shaoyang-Taiyang combined syndrome. Chaihu ascends and disperses external pathogens; Dahuang descends and drains internal excess, allowing heat to recede and Qi to harmonize for recovery. Now, using Shengma and Chaihu naturally ascends Clear Qi; Muxiang and Binglang naturally expel pathogens and descend. Thus, rectal prolapse is lifted, tenesmus removed. They can work together successfully. Why doubt? Users should emulate and expand this approach.
Someone asked: The two kidneys resemble the two wheels of a cart, same shape and color. Why did Wang Shuhe alone say the left kidney belongs to Water and the right to Fire, and designate the right kidney as Mingmen to pair with the Sanjiao meridian? I heard that at conception, before the embryo forms, two kidneys appear first, embodying "Heaven generates One, Water." Dividing them into Water and Fire seems contradictory like ice and charcoal. Why? The answer is: I privately admired Zhu Danxi and adopted his view. According to *Neijing*, the Pericardium pairs with Sanjiao Ministerial Fire running in the meridians. The two kidneys were originally one Zang, with no left-right division. Bian Que divided them but didn't call them Ministerial Fire organs. Wang Shuhe’s theory pairing Sanjiao and Mingmen implies deep meaning. It suggests Kidney belongs to Yin and governs Stillness; Stillness allows Yang to gestate within. Once Yang is gestated, can it remain purely still without dynamic life force? As *Neijing* states, Kidney belongs to Water, receiving and storing essence from all Zang-Fu; this is Yang returning to Yin to gestate. Also, Kidney is the official of strength, producing skill and ingenuity; this is Yang emerging from Yin to transform. Thus, regarding Kidney as one Zang matching Five Phases, it belongs to Water. Regarding the two kidneys having two images, they can be divided into left-right, Yin-Yang, Gang-Rou, named the root of the five Zang. Left is Yin, Right is Yang; Yin is Water, Yang is Fire; Water is Blood, Fire is Qi. Thus, Left Kidney Yin Water generates Liver Wood, Liver Wood generates Heart Fire; Right Kidney Yang Fire generates Spleen Earth, Spleen Earth generates Lung Metal. These four Zang are to Kidney as branches are to roots. However, one should not solely designate the right kidney as Mingmen. *Neijing* states: The place of Taichong is named Shaoyin; above Shaoyin is named Taiyang; Taiyang roots at Zhiyin and knots at Mingmen. Wang Bing’s note: *Lingshu* says Mingmen is the eye. Further research into *Mingtang* and *Tongren* classics shows the Mingmen acupoint is in the depression below the 14th thoracic vertebra on the midline, between the two kidneys. The two kidneys are indeed the root of true Yuan Qi and life. Though Water Zang, they harbor Ministerial Fire, like dragon fire in water, manifesting through movement. My opinion is that both kidneys should be collectively called Mingmen. The Mingmen acupoint resembles the door bolt, governing opening and closing. Through stillness and closing, it nurtures True Water of Yin; through movement and opening, it stirs Dragon-Lei Ministerial Fire. Water is constancy; Fire is change. Solely designating the right kidney as Ministerial Fire paired with Sanjiao may lack precision. What do experts think?
Someone asked: *Neijing* states: Strong Fire causes Qi to decline; Mild Fire causes Qi to strengthen. Strong Fire consumes Qi; Qi feeds on Mild Fire. Strong Fire scatters Qi; Mild Fire generates Qi. What does this mean? The answer is: Wang Bing provided commentary, but not in detail. Here is my insight: "Strong Fire causes Qi to decline; Mild Fire causes Qi to strengthen" describes the cycle of victory and restitution in creation: small becomes strong, strong becomes declining, declining regenerates, cycling endlessly, generating life continuously. Though *Neijing* doesn't explicitly state regeneration after decline, the principle is inherent. "Strong Fire consumes Qi" means Yuan Qi is consumed by Strong Fire. "Qi feeds on Mild Fire" means Yuan Qi is aided by Mild Fire. "Strong Fire scatters Qi" means depleting Yuan Qi; "Mild Fire generates Qi" means nourishing Yuan Qi. These two sentences clarify the previous two. Fire is necessary but should be mild, not strong. Mildness nourishes True Yin; strength scorches Yuan Qi. The principle of Yin-Yang creation is cyclical. When Fire is extreme, Water transformation controls it. *Neijing* states: Extremity brings harm, succession brings control. Control brings transformation. Thus, Strong Fire declines, Mild Fire regenerates, harmonizing Yin-Yang, thriving all things, following the four seasons' growth-transformation-storage. Regarding humans: Before embryo formation, two kidneys form to nurture True Yin, named Yuan Qi, embodying "Heaven generates One, Water." Then Liver, Heart, Spleen, Lung, and five Fu organs sequentially form. Beyond the five Zang-Fu, there is Pericardium Ministerial Fire, circulating in Sanjiao, paired with Sanjiao. These are named but formless Zang-Fu because Ministerial Fire has no fixed location. Predecessors said: "Without this Fire, Heaven cannot generate; without this Fire, humans cannot live." This means it is indispensable, aligning with "Mild Fire generates Qi." Also: "Fire and Yuan Qi cannot coexist; if one wins, the other loses." This means it must not be excessive, aligning with "Strong Fire scatters Qi." My insights are thus; unsure if correct?
Someone asked: In *Nan Jing* First Difficulty, it says: All twelve meridians have pulsating points, but only the Cun Kou (Radial Artery at the wrist) is taken to determine life/death and fortune/misfortune of the five Zang and six Fu. It also says: Cun Kou is the great meeting of pulses, the movement of the Hand Taiyin meridian. How can one pulse determine Zang-Fu fate? Xiong Shi of Aofeng annotated it as Right Cun, belonging to Lung. Zhang Shi of Siming annotated it as both Cuns, meeting at Taiyuan Acupoint. Which is wrong and which is right? Please explain. The answer is: Ancient sages established methods using Three Regions and Nine Hopes to determine life/death, distributing six Zang-Fu into six positions to verify Zang-Fu fortune. Little did they know, *Neijing* mentions Cun Kou frequently, including Guan and Chi. Generally, ancients used Cun Kou as the collective name for six pulses. Otherwise, how could *Neijing* say: Short pulse at Cun Kou indicates headache; Long pulse at Cun Kou indicates leg/shin pain; Rapid/upward-hitting pulse at Cun Kou indicates shoulder/back pain? Such examples are countless. Annotators say "Zhong Shou" refers to the doctor's middle finger, implying it's not the patient's Guan pulse. *Nan Jing* by Bian Que was written based on *Neijing*, hence these words. Modern annotators interpret arbitrarily, conflicting with canonical intent. Students should reflect.
Someone asked: *Nan Jing* Eighth Difficulty says: Cun Kou pulse is level, yet the person dies. What does this mean? Indeed. All twelve meridians connect to the Source of Living Qi. This Source of Living Qi is the root of the twelve meridians, called Kidney Interstitial Moving Qi. This is the root of five Zang and six Fu, the root of twelve meridians, the gate of respiration, the source of Sanjiao, also named the Spirit guarding against pathogens. Thus, Qi is the root of humans.