少俞曰∶百疾之始期也，必生于风雨寒暑，循毫毛而入腠理，或复还，或留止，或为风肿汗出，或为
消瘅，或为寒热，或为留瘅，或为积聚，奇邪淫溢，不可胜数；同时得病，或病此，或病彼，非天之生风有所
私也。犯者得之，避者得无殆，非求人而人自犯之。（殆，危也。天非求人，而人自犯之，所以有少病多病
者，亦在乎人之慎与不慎也。）试比匠人磨斧斤砺刀，削斫材木；本之阴阳，尚有坚脆，坚者不入，脆者皮
弛，至其交节而缺斤斧焉。夫一木之中，坚脆不同，坚者则刚，脆者易伤，况其材木之不同，皮之浓薄，汁
之多少而各异耶？（此借木之材质，以方人之禀赋也。）夫木之早花先生叶者，遇春霜烈风，则花落而叶萎；
久曝大旱，则脆木薄皮者支条汁少而叶萎；久阴淫雨，则薄皮多汁者皮溃而漉；卒风暴起，则刚脆之木枝
折杌伤；秋霜疾风，则刚脆之木根摇而叶落。凡此五者，各有所伤，况于人乎！（此言木之凋残，各有所因，
以方人之疾病亦无不有所致之也。杌，音兀，木之无枝者也。）木之所伤也，皆伤其枝；枝之刚脆而坚，未
成伤也。人之有常病也，亦因其骨节、皮肤、腠理之不坚固者，邪之所舍也，故常为病也。（木有坚脆，所
以伤有重轻；人有坚脆，所以病有微甚。故虽同时遇风，而有受有不受，此病之所以异也。）人之善病风厥
漉汗者，何以候之？（风邪逆于腠理，而汗出漉漉不止者，病名风厥。）肉不坚，腠理疏，则善病风。何以
候肉之不坚也？ 肉不坚，而无分理者粗理；粗理而皮不致者，腠理疏。此言其浑然者。（膝湾
曰，即足太阳经委中穴也， 中为溪谷之大会，故其理粗而皮不致者，
可以验通身腠理之疏也。）人之善病消瘅者，何以候之，五脏皆柔弱者，善病消瘅。何以知五脏之柔弱也？
夫柔弱者必有刚强，刚强多怒，柔者易伤也。（性气刚暴而肌肉弱者，乃易于伤，故善病消瘅。）何以候柔
弱之与刚强？此人薄皮肤而目坚固以深者，长冲直扬，其心刚。（皮肤薄者，肌肉必弱；目坚固而视直扬者，
其心必刚。冲者，目光突露之谓。）刚则多怒，怒则气上逆，胸中蓄积，血气逆留， 皮充肌；血脉不行，
转而为热，热则消肌肤，故为消瘅，此其人暴刚而肌肉弱者也。（怒则气逆，气逆则血留，故郁而为热，而成
消瘅。）人之善病寒热者，何以候之？小骨弱肉者，善病寒热。（骨属肾，肉属脾，皆至阴之所在也。阴不
足则阳邪易入，故善病寒热。）何以候骨之小大、肉之坚脆、色之不一也？颧骨者，骨之本也。颧大则骨大，
颧小则骨小。（目下颊骨曰颧，周身骨骼大小，可验于此也。）皮肤薄而其肉无 ，其臂懦懦
然，其地色殆然，不与其天同色，污然独异，此其候也。（ ，肉之结聚而坚者也，懦懦然，柔弱貌。地气
阴浊，天气清明，质色有余而神色不足，是地不与天同色也；故殆然污然，其状有异，肉有坚脆，色
有不同，于此可验强弱也。）然后臂薄者其髓不满，故善变寒热也。（髓为骨之充，阴之精也。故髓不满者，
当病寒热。）何以候人之善病痹者？粗理而肉不坚者，善病痹。（肉不坚则风、寒、湿邪易以
入也。）欲知其高下者，各视其部。（人之上下、左右、虚实，自有不同，故当各视其部。）人之善病肠中积
聚者，何以候之？皮肤薄而不泽，肉不坚而淖泽，如此则肠胃恶，恶则邪气留止积聚，乃伤脾胃之间，寒
温不次，邪气稍至， 积留止，大聚乃起。（皮肤薄者，肉不坚也。不润泽者，血不足也。淖泽者，湿滞多
也。此其肠胃薄恶，气禀之有亏也，故或中外邪，留而不去；或肠胃寒温，有不以次，皆足致邪而大聚
起矣。）欲知其时，先立其年，时高
则起，时下则殆。（先立其年，则五运六气各有所主，故知其时。凡病遇生王，则时之高也，故可以起，起言
愈也∶如逢衰克，则时之下也，病当危殆矣。）虽不陷下，当年有冲通，其病必起，是谓因形而生
病，五变之纪也。（虽非衰克陷下之时，时年有所冲则气有所通，其病亦因而起。此非上节之所谓起也，如水
火相冲，火当畏水，金木相冲，木当畏金，然火胜则水亦病，木胜则金亦病，故有以金形之人而反病于丁壬
年者，有以木形之人而反病于甲巳年者，是谓因形生病，五变之纪也。）
少俞说：各种疾病的发生，必定源于风雨寒暑等外邪，顺着毫毛侵入腠理（皮肤纹理及汗孔），有的又返回体内，有的停留止于局部，有的表现为风肿、汗出，有的发展为消瘅（类似糖尿病或甲状腺机能亢进等消耗性疾病），有的表现为寒热往来，有的成为留瘅（久治不愈的热病），有的形成积聚（腹内结块），奇邪淫溢泛滥，多得数不清；同时遭受邪气侵袭，有的人患这种病，有的人患那种病，这并不是上天对风有所偏私。触犯邪气的人就会生病，躲避邪气的人就能避免危险，这不是人主动去招惹邪气，而是人自己不慎而触犯了它。（殆，指危险。天并没有特意求人来犯，是人自己不慎而触犯，所以有人病少有人病多，也在于人的谨慎与不谨慎。）试着把匠人磨斧头砺刀，用来砍削木材；从阴阳属性来看，木材还有坚硬与脆软的区别，坚硬的斧刃不易切入，脆软的木材表皮松弛，到了节疤处就会缺损斧刃。在一棵树中，坚硬与脆软不同，坚硬的则刚强，脆软的就容易受伤，何况不同的木材，皮质的厚薄、汁液的多少都各不相同呢？（这是借用木材的材质，来比喻人的先天禀赋。）树木如果早开花先长叶的，遇到春霜和猛烈大风，花就凋落叶子枯萎；长期暴晒和大旱，脆软且皮薄的树枝条汁液少而叶子枯萎；长期阴雨连绵，皮薄多汁的树木皮溃烂流水；突然刮起暴风，刚硬或脆软的树木枝条折断受损；秋霜和疾风，刚硬或脆软的树木根部动摇叶子脱落。这五种情况，各自有不同的损伤原因，何况是人呢！（这说明树木的凋零残败各有原因，以此比喻人的疾病也无不有导致的原因。杌，音兀，是没有枝丫的树桩。）树木受到的伤害，都是伤及其枝条；枝条的刚硬、脆软或坚固，尚未造成实质伤害。人之所以常有某种疾病，也是因其骨节、皮肤、腠理不够坚固的地方，是邪气潜伏之所，所以常在此发病。（树木有坚脆之分，所以伤害有轻重；人有刚脆之别，所以病情有微甚。因此虽然同时遭遇风邪，但有的受病有的不受病，这就是疾病差异的原因。）人容易患风厥、汗出不止的病，如何诊断呢？（风邪逆乱于腠理，导致汗出淋漓不止的疾病，名叫风厥。）肌肉不坚实，腠理疏松，就容易患风病。如何诊断肌肉是否不坚实呢？肌肉不坚实，且没有清晰纹理的是粗理；纹理粗糙且皮肤不致密的，就是腠理疏松。这是说的整体情况。（膝弯处，即足太阳膀胱经的委中穴，委中穴为溪谷之大会，所以此处纹理粗糙且皮肤不致密的人，可以推断全身腠理疏松。）人容易患消瘅病的，如何诊断呢？五脏都柔弱的人，容易患消瘅。如何知道五脏的柔弱呢？柔弱的人必然伴有刚强的性格，刚强的人容易发怒，柔弱体质容易受伤。（性情刚暴而肌肉软弱的人，容易受伤，所以善患消瘅。）如何诊断柔弱与刚强呢？这种人皮肤薄而眼睛深邃坚固，目光冲直上扬，内心刚强。（皮肤薄的人，肌肉一定弱；目光坚毅直视上扬的人，内心一定刚强。冲，指目光突露的样子。）刚强就容易发怒，发怒则气机上逆，胸中蓄积，血气逆乱停滞，皮肤充胀肌肉紧绷；血脉运行不畅，郁结转化为热，热则消耗肌肤，所以形成消瘅，这是那种外表暴戾刚强而肌肉软弱的人。（发怒则气逆，气逆则血留滞，所以郁结化为热，而成消瘅。）人容易患寒热病的，如何诊断呢？骨骼小、肌肉弱的人，容易患寒热病。（骨属肾，肉属脾，都是至阴所在。阴不足则阳邪容易入侵，所以善患寒热。）如何诊断骨骼的大小、肌肉的坚脆、颜色的不均呢？颧骨是骨的根本。颧骨大则骨骼大，颧骨小则骨骼小。（眼下颊骨叫颧，周身骨骼大小可由此验证。）皮肤薄而肌肉无结聚坚实之处，手臂柔弱无力，面色晦暗污浊，不与天色相同，独自显得怪异，这就是其征候。（ ，指肌肉结聚而坚实者。懦懦然，形容柔弱貌。地气阴浊，天气清明，体质颜色有余而神色不足，是地色不与天色相同；所以显得晦暗污浊，状貌有异，肌肉有坚脆，颜色有不同，由此可验证体质的强弱。）然后手臂薄的人骨髓不满，所以容易变换出现寒热病。（髓是骨的充盈物，是阴精。所以骨髓不满的人，应当患寒热病。）如何诊断人容易患痹病的情况呢？纹理粗糙且肌肉不坚实的人，容易患痹病。（肌肉不坚实则风、寒、湿邪容易侵入。）想知道病变部位的高下，分别观察其身体各部。（人的上下、左右、虚实，自然有所不同，所以应当分别观察各部位。）人容易患肠中积聚病的，如何诊断呢？皮肤薄而无光泽，肌肉不坚实而湿润，像这样肠胃功能就恶劣，恶劣则邪气停留积聚，进而损伤脾胃之间，寒温失调，邪气稍至，积聚留止，大聚便形成。（皮肤薄说明肌肉不坚实。不润泽说明血不足。淖泽说明湿滞多。这是肠胃薄弱恶劣，禀气有亏缺，所以无论是外感还是内伤邪气，停留不去；或者肠胃寒温失调，不按次序，都足以招致邪气而形成大聚。）想知道发病的时间，先确定当年的运气，时运高则病起，时运低则病危。（先确定当年运气，则五运六气各有主司，所以知道时间。凡是遇到相生旺盛的时候，就是时之高，所以可以起，起指痊愈；如果遇到相克衰弱的时候，就是时之下，病应当危殆。）即使没有陷入下陷的运势，当年如果有冲通之气，病必定发作，这叫做因形体特质而生病，是五变的纲领。（虽然不是相克下陷的时候，当年运气有冲通则气机通畅，病也会因而发作。这不是上一节所说的起，比如水火相冲，火本畏水，金木相冲，木本畏金，然而火胜则水也病，木胜则金也病，所以有金形之人反而在丁壬年生病的，有木形之人反而在甲巳年生病的，这叫做因形生病，是五变的纲领。）
Shao Yu said: The onset of various diseases must originate from wind, rain, cold, and heat. These pathogens enter through the hair follicles into the Couli (the interstices of the skin and muscle where Qi and blood circulate). They may return to the interior, remain stagnant, manifest as wind-induced edema with sweating, develop into Xiao Dan (wasting-thirst disorders similar to diabetes), present as alternating chills and fever, become chronic febrile conditions (Liu Dan), or form accumulations and masses (Ji Ju). Errant pathogens overflow in countless ways. Even when exposed simultaneously, some fall ill with one condition while others with another; this is not because Heaven shows favoritism toward the wind. Those who are exposed fall ill; those who avoid it remain safe. It is not that people actively seek out pathogens, but rather they inadvertently offend them due to negligence. (Danger refers to peril. Heaven does not seek to harm people, but people harm themselves through lack of caution, which explains why some have few illnesses and others many.) Consider a carpenter sharpening axes and knives to chop wood. Based on Yin and Yang properties, wood varies in hardness and brittleness. Hard wood resists cutting, while brittle wood causes the skin to slacken; at the knots, the axe head may chip. Within a single tree, hardness and brittleness differ; hard wood is tough, while brittle wood is easily damaged. How much more so for different types of wood, varying in bark thickness and sap content? (This metaphor of wood quality illustrates human constitutional endowment.) Trees that flower early and leaf out first will lose their flowers and wither leaves when encountering spring frost and fierce winds. Under prolonged sun exposure and drought, brittle trees with thin bark suffer from reduced sap in branches and withered leaves. During prolonged rainy seasons, trees with thin bark and abundant sap suffer from peeling bark and oozing fluids. When sudden storms arise, both hard and brittle trees suffer broken branches and damage. In autumn frost and gales, even hard and brittle trees experience root disturbance and leaf fall. All five scenarios cause specific damages; how much more so for humans! (This illustrates that just as tree decay has specific causes, human diseases also have distinct etiologies. "Wu" refers to a stump without branches.) Tree injuries primarily affect the branches; the hardness, brittleness, or firmness of branches indicates potential vulnerability before actual damage occurs. Humans often suffer from specific diseases because their joints, skin, and Couli are not robust enough, providing a dwelling place for pathogens, thus making these areas prone to disease. (Just as wood has hardness and brittleness leading to varying degrees of injury, humans have constitutionally strong and weak parts leading to varying severity of illness. Therefore, even when exposed to wind simultaneously, susceptibility differs, explaining the variation in diseases.) How can we diagnose those prone to Feng Jue (wind reversal) and profuse sweating? (When wind pathogens disrupt the Couli, causing continuous dripping sweat, the condition is named Feng Jue.) If muscles are not firm and Couli are loose, one is prone to wind diseases. How can we assess if muscles are not firm? Muscles that are not firm and lack clear striations have coarse texture; coarse texture combined with non-tight skin indicates loose Couli. This describes the general state. (The popliteal fossa, specifically the Weizhong acupoint [BL40] of the Foot-Taiyang Bladder Meridian, is the confluence of valleys. Thus, coarse texture and loose skin here indicate loose Couli throughout the body.) How can we diagnose those prone to Xiao Dan? Individuals with weak Zang organs are prone to Xiao Dan. How do we know if the Zang organs are weak? Weakness in the Zang organs is often accompanied by a strong-willed temperament; those who are strong-willed tend to anger easily, and their weak constitutions are susceptible to injury. (Individuals with a harsh temper but weak muscles are prone to injury and thus susceptible to Xiao Dan.) How can we distinguish between weakness and strength? Such individuals have thin skin, deep and firm eyes, straight and upward-gazing gaze, and a rigid heart/mind. (Thin skin implies weak muscles; firm, direct, and upward gaze implies a rigid mind. "Chong" refers to protruding or intense gaze.) Rigidity leads to frequent anger; anger causes Qi to rebel upward, accumulating in the chest, causing Qi and Blood to stagnate and reverse, leading to distended skin and tense muscles. If blood vessels fail to circulate properly, stagnation transforms into heat, which consumes flesh and skin, resulting in Xiao Dan. This characterizes individuals who are outwardly aggressive and rigid but inwardly muscularly weak. (Anger causes Qi rebellion; Qi rebellion causes Blood stagnation, leading to郁 heat formation and eventually Xiao Dan.) How can we diagnose those prone to alternating chills and fever? Individuals with small bones and weak muscles are prone to chills and fever. (Bones belong to the Kidney, and muscles belong to the Spleen, both being locations of extreme Yin. Yin deficiency allows Yang pathogens to invade easily, hence susceptibility to chills and fever.) How can we assess bone size, muscle firmness, and complexion variations? The zygomatic bone is the root of the skeletal structure. Large zygomatic bones indicate large skeletal frames; small zygomatic bones indicate small frames. (The cheekbone below the eye is the zygoma; overall skeletal size can be assessed here.) Thin skin, lack of firm muscle nodules, flaccid arms, and a dull, muddy complexion that differs from the natural sky-like clarity are diagnostic signs. (Refers to firm muscle aggregations. "Nuoruoruan" describes a flaccid appearance. Earthly Qi is turbid and Yin, Heavenly Qi is clear and Yang. A physical color that is excessive yet lacks spiritual luster indicates a mismatch between earthly and heavenly qualities; thus, the dull and muddy appearance signifies differences in muscle firmness and color, allowing assessment of strength and weakness.) Furthermore, individuals with thin arms have insufficient marrow, making them prone to fluctuating chills and fever. (Marrow fills the bones and is the essence of Yin. Insufficient marrow predisposes one to chills and fever.) How can we diagnose susceptibility to Bi syndrome (obstruction)? Individuals with coarse texture and unfirm muscles are prone to Bi syndrome. (Unfirm muscles allow Wind, Cold, and Damp pathogens to invade easily.) To determine the location of the pathology, observe each body region separately. (Upper/lower, left/right, and excess/deficiency vary naturally, so each region must be observed individually.) How can we diagnose those prone to intestinal accumulations? Thin, lusterless skin and unfirm, moist/soggy muscles indicate poor gastrointestinal function. Poor GI function allows pathogens to linger and accumulate, damaging the Spleen and Stomach area. Irregularities in cold and warmth within the gut allow even slight pathogenic invasion to lead to stagnation and mass formation. (Thin skin indicates unfirm muscles. Lack of luster indicates Blood deficiency. Moisture/sogginess indicates Damp stagnation. This reflects weak GI constitution and deficient Qi/Blood endowment, allowing external or internal pathogens to linger, or irregular thermal conditions in the gut to provoke pathogenic accumulation and mass formation.) To predict the timing, establish the annual climate cycle. Favorable cycles (Sheng/Wang) promote recovery ("Qi" means arising/recovery); unfavorable cycles (Shuai/Ke) indicate danger. (Establishing the year reveals the ruling Wu Yun Liu Qi. Encountering generating/prosperous phases favors recovery; encountering weakening/clashing phases indicates peril.) Even without unfavorable phases, if the annual cycle involves clashing or penetrating Qi, the disease will likely emerge. This is called "disease arising from constitution," the principle of the Five Transformations. (Even without clashing/downward phases, annual Qi clashes allow Qi to penetrate, triggering disease. This differs from the previous section's "arising." For example, though Fire fears Water and Wood fears Metal, if Fire prevails, Water suffers; if Wood prevails, Metal suffers. Thus, a Metal-type person may fall ill in Ding-Ren years, and a Wood-type person in Jia-Ji years. This is disease arising from constitution, the core of the Five Transformations.)