《内经·疏五过论》曰∶尝贵后贱，虽不中邪，病从内生，名曰脱营。启玄子云∶神屈故也。
以其贵之尊荣，贱之屈辱，心怀慕眷，志结忧惶，虽不中邪，病从内生，血脉虚减，名曰脱营。
凡病此者，心思郁结，忧虑不已，饮食少思，精神日减，气血渐衰，形容枯槁。粗工不察，妄投
药饵，速死有期。故经所论治有五过者是也。
病不可治有六失者，失于不审，失于不信，失于过时，失于不择医，失于不知病，失于不知
药。六失之中，有一于此，即为难治，非止医家之罪，亦病家之罪也。矧又医不慈仁，病者猜鄙，
二理交驰，于病何益？由是
言之，医者不可不慈仁，不慈仁则招祸；病者不可猜鄙，猜鄙亦招祸。贤者洞达物情，各就安乐，
亦治病之一说耳。《千金方》引《史记》云∶骄恣不论于理，一不治；轻身重财，二不治；衣食
不能适，三不治；阴阳并，脏气不定，四不治；形羸不能服药，五不治；信巫不信医，六不治。
有一于此，则重难治也。
病之始起，不能早治，以其浅薄，视之泛常。及致日月久淹，积小成大，乃求医药。法不及
用，而势已盈，岂为天命？
凡诊脉形证相应，因与服汤，食顷变大吐下腹痛，是为变怪。或有旧时服药，今乃发作，是
亦谓之灾怪耳。
丹溪云∶胃气者，纯清冲和之气，人之所赖以为生者也。若谋虑神劳，动作形苦，嗜欲无节，
思想无穷，饮食失宜，药饵违法，皆能致伤。既伤之后，须用调和。恬不知怪，或于病将小愈，
而乃恣意犯禁。旧病未除，而新证叠起。吾见医药将日不暇给，而戕贼之胃气无复完全之望，去
死近矣。愚见患者小愈，胃气才回，咸谓以为能食者不死，率意恣欲，妄投浓味，惟其不嗜胜人
为忧。噫！弗思甚也，殊不悟浓味助邪。古人摄养每以寡嗜欲薄滋味为先，况病患伤败之际，而
又重伤，其不危殆者寡矣。又见久病之人少愈，而目尚昏，腰尚重，谓病久郁抑，精闭不通，率
喻入房以疏郁结，往往一行而病遽起，反至不救者多矣。饮食不节，反轻为重，转安为危者，历
历有之。此天下之通弊，惟贤者知之。
《黄帝内经·疏五过论》中说：曾经地位尊贵后来变得卑贱，虽然未受外邪侵袭，但病从内生，这种病称为“脱营”。启玄子（王冰）解释说：这是因为神气屈折受损的缘故。
由于曾经享有尊荣，后来遭受屈辱，心中眷恋旧日荣光，意志郁结于忧愁惶恐之中，虽然未受外邪侵袭，但病从内生，导致血脉虚弱减少，这种病称为“脱营”。
凡是患此病的人，心思郁结，忧虑不止，饮食减少，精神日渐衰退，气血逐渐衰弱，形体枯槁消瘦。粗劣的医生不加审察，胡乱投药，患者很快便会死亡。所以经文中论述的治疗上的五种过失指的就是这种情况。
疾病有六种无法治愈的情况，分别是：因不审慎而失误，因不信任而失误，因延误时机而失误，因不选择良医而失误，因不了解病情而失误，因不了解药物而失误。这六种过失中，只要存在其中一种，就难以治疗，这不仅是医生的过错，也是患者的过错。况且如果医生缺乏仁慈之心，患者又猜忌鄙陋，两种不良因素交织冲突，对病情有何益处？由此而言，医生不可不仁慈，不仁慈就会招致祸患；患者不可猜忌鄙陋，猜忌鄙陋也会招致祸患。贤明之人能透彻洞察人情事理，各自安守本分、寻求安乐，这也是关于治病的一种说法。《备急千金要方》引用《史记》的话说：骄横放纵、不讲道理，是一不治；轻视身体、看重钱财，是二不治；衣食不能适应调节，是三不治；阴阳失调、脏腑之气不稳定，是四不治；形体极度消瘦、无法服药，是五不治；信奉巫术而不相信医学，是六不治。这六种情况中只要有一种存在，病情就会变得非常难治。
疾病在刚开始发生时，如果不能早期治疗，是因为觉得病势浅薄，将其视为平常之事。等到日久拖延，积小成大，才去求医问药。此时治疗方法已来不及发挥作用，而病势已经充盈盛大，这难道是天命吗？
凡是在诊脉时脉象与症状相符，因此给予汤药服用，不久后出现剧烈呕吐、腹泻、腹痛等变化，这被称为“变怪”。或者患者以前服用的药物，现在才发作反应，这也称之为“灾怪”。
朱丹溪说：胃气，是清纯冲和之气，是人赖以生存的根本。如果谋虑过度使神志劳损，动作劳累使形体受苦，嗜欲没有节制，思想无穷无尽，饮食失宜，用药违法度，都能导致损伤。一旦受伤之后，必须使用调和之法。然而人们恬不知怪，有的在病情刚有好转时，就肆意违反禁忌。旧病未除，新证又接连而起。我见到医药尚且应付不暇，而被戕害的胃气再也无望完全恢复，离死亡就不远了。我的见解是，当患者病情稍有好转，胃气刚刚恢复时，大家都认为能吃就不会死，于是随意放纵欲望，妄吃浓烈厚味的食物，只担心自己不如别人爱吃。唉！这太不思量了，全然不明白浓味会助长邪气。古人养生总是把寡欲淡食放在首位，何况病患身体衰败之际，如果再受重伤，能不危殆的就很少了。我又见到久病之人稍微好转，但眼睛尚且昏花，腰部尚且沉重，便认为是病久郁抑，精气闭塞不通，往往劝喻其通过房事来疏通郁结，结果往往一次性行房后病情立刻复发，反而导致无法救治的情况很多。饮食不节制，使轻病转为重病，使平安转为危险的情况，屡见不鲜。这是天下的普遍弊病，只有贤明之人才能知晓。
According to the *Shu Wu Guo Lun* (Discourse on Five Negligences) in the *Huangdi Neijing* (Yellow Emperor's Inner Canon): "One who was once noble but later became humble, although not struck by external pathogens, develops disease from within, known as 'Tuo Ying' (Depletion of Ying/Nutritive Qi)." Qixuanzi (Wang Bing) explained: "This is due to the屈折 (constraint/deflection) of Shen (Spirit/Mind)."
Because one once enjoyed honor and dignity but later suffered humiliation, harboring lingering attachment to past glory, with will bound by worry and fear, although not struck by external pathogens, disease arises from within. This leads to deficiency and reduction of blood vessels, a condition named "Tuo Ying" (Depletion of Ying/Nutritive Qi).
Those suffering from this condition have minds constrained by depression and endless worry. Their appetite diminishes, spirit declines daily, Qi and Blood gradually weaken, and their appearance becomes withered and emaciated. Crude physicians fail to examine carefully and administer drugs recklessly, leading to rapid death. Thus, the "five errors" discussed in the classic refer to these situations.
There are six types of negligence that render a disease incurable: negligence due to lack of scrutiny, negligence due to lack of trust, negligence due to missing the right time, negligence due to failing to select a proper physician, negligence due to ignorance of the disease, and negligence due to ignorance of the medicine. If any one of these six errors occurs, the disease becomes difficult to treat. This is not solely the fault of the physician, but also the fault of the patient. Moreover, if the physician lacks compassion and benevolence, and the patient is suspicious and derogatory, these two negative factors clash, benefiting the disease how? Therefore, a physician must be compassionate and benevolent; lacking this invites disaster. A patient must not be suspicious and derogatory; doing so also invites disaster. The wise understand human nature and circumstances, seeking peace and well-being for themselves. This is another perspective on treating illness. The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) cites the *Records of the Grand Historian*: "Arrogant and unreasonable behavior, this is the first non-treatable condition; valuing wealth over health, this is the second non-treatable condition; inability to adapt diet and clothing, this is the third non-treatable condition; Yin and Yang are disordered, Zang-Fu Qi is unstable, this is the fourth non-treatable condition; the body is emaciated and unable to take medicine, this is the fifth non-treatable condition; believing in sorcery rather than medicine, this is the sixth non-treatable condition." If any one of these exists, the disease becomes extremely difficult to treat.
When a disease first begins, if it is not treated early because it is considered superficial and ordinary, and then allowed to linger for days or months, accumulating from small to large, only then do people seek medical treatment. By then, therapeutic methods are no longer effective, and the pathological momentum is already full. Is this due to Mandate of Heaven?
Generally, when pulse and symptoms correspond, decoctions are administered. If shortly after ingestion, severe vomiting, diarrhea, or abdominal pain occurs, this is called "Bian Guai" (Abnormal Change/Monster). Or if previously taken medications suddenly manifest effects now, this is also called "Zai Guai" (Disaster Monster).
Zhu Danxi said: Wei Qi (Stomach Qi) is pure, clear, and harmonious Qi, upon which human life depends. If mental planning exhausts the Spirit, physical exertion苦s the form, desires are unregulated, thoughts are endless, diet is inappropriate, or medication violates regulations, all can cause injury. After injury, harmonization is required. Yet people remain unaware of danger. When the illness is slightly improving, they may indulge in forbidden activities. Old diseases remain, while new syndromes arise continuously. I have seen cases where medical resources were stretched thin, and the damaged Wei Qi had no hope of complete recovery, bringing death near. My view is that when a patient slightly improves and Wei Qi just returns, everyone assumes that being able to eat means survival. They act recklessly, indulging in desires and consuming rich, heavy flavors, worrying only that they cannot eat as much as others. Alas! This is very thoughtless. They fail to realize that rich flavors assist pathogenic factors. Ancients prioritized reducing desires and eating light flavors for preservation. How much more so for patients in a state of depletion and damage? If severely injured again, few would avoid peril. I have also seen long-term patients who slightly improved but still had blurry vision and heavy waists. Assuming this was due to long-standing stagnation blocking Jing (Essence), they were often advised to engage in sexual intercourse to relieve stagnation. Often, after a single instance, the disease surged back, leading to untreatable conditions frequently. Irregular diet turns mild illness into severe, and stability into danger, a phenomenon observed repeatedly. This is a common flaw in the world, known only to the wise.