荣之生病也，寒热少气，血上下行。卫之生病也，气通，（当是冲痛。）时来时去，怫忾贲响，风寒客
于肠胃之外。寒痹之为病也，留而不去，时痛而皮不仁。（寒痹有椒姜桂心醇酒熨法。）
荣气虚则不仁，卫气虚则不用，荣卫俱虚则不仁，且不用，肉如故也，人身与志不相有，曰死。（
卫虚不用，故治偏废，重用 防。）
脉一来而久住者，宿病在心主中治。脉二来而久住者，病在肝支中治。脉三来而久住者，病在脾下中治。
脉四来而久住者，病在肾间中治。脉五来而久住者，病在肺支中治。五脉病，虚羸人得此者死。所以然者，
药不得而治，针不得而及。盛人可治，气全故也。（《脉经》。）
曹山跗，病肺消瘅，加寒热，不治。所以然者，其人尸夺，尸夺者形弊，形弊者不当关灸 石及饮毒药也。
齐丞相舍人奴伤脾，法当至春死，乃至四月泄血死者，诊其人时愈顺，愈顺者人尚肥也。奴之病得之流
汗数出，炙于火而以出，见大风也。（原文，一愈顺及一时。又安谷者过期，不安谷者不及期。上仓公传。）
《续名医类案》载∶白云集万 家贫，右臂痿废。一旦遇人谓之曰∶汝少饶今涩，怒盛于肝，火起于
脏也。因扪右臂曰∶幸尚瘦，可治也。武夷茶，涧水饮之，久自愈。合前诸论案，若不相合者。盖尝思之，肢
臂痿废者，正气不至其处，则喜其瘦，为邪气亦所不居，充其正气而可复也。虚损发于
五脏，见于周身，则喜其肥，为津液尚未销尽，扶其正气而
可复也。然肥瘦亦须不失常度，若瘦如枯柴，肥如腐尸，岂可为哉。
凡患香港脚诸风，其人本黑瘦者易治，肥大肉浓赤白者难愈。黑人耐风湿，赤白不耐风湿也。瘦人肉硬，肥
人肉软，肉软则受疾至深矣。（《千金方》。）
此论其人之本肥本瘦也，故与上文因病变肥变瘦者不同，肥人肉淖理疏，邪气易于深入，
而痰多气滞，又难于出，故难治也。凡痈疽痿痹者，俱当根据此例诊之。
肥人多中风，以形浓气虚难以周流，气滞痰生，痰积生火，故暴厥也。瘦人阴虚，血液衰少，相火易亢，
故多劳嗽。张石顽尝谓有人年盛体丰，冬时腰痛，不能转侧，怯然少气，足膝常冷。与肾气丸不应，反转寒
热喘满者，肥人多湿。脉沉者，湿遏气脉也。腰痛不能转侧者，湿伤经络也。怯然少气者，湿干肺胃，
气不舒也。足膝常冷者，阳气不能四达也。法当散气行血，以助流动，而反与滋腻养荣，宜其增剧也。
荣气发生病变时，会出现寒热往来、气短少气，血液运行紊乱，上下逆行的症状。卫气发生病变时，气机通畅但伴有冲痛（原文注：应当是冲痛），疼痛时发时止，胸胁胀闷且肠鸣有声，这是因为风寒之邪客居于肠胃之外所致。寒痹这种病症，病邪停留不去，时常疼痛且皮肤麻木不仁。（治疗寒痹有使用花椒、干姜、桂心配合醇酒进行热敷的方法。）
荣气虚弱则导致身体麻木不仁，卫气虚弱则导致肢体运动功能障碍，若荣卫二气都虚弱，则既麻木不仁又运动障碍，肌肉外观虽无变化，但人的形体与神志分离，这种情况属于死证。（卫气虚弱导致运动障碍，因此治疗偏瘫废用症时，重用防风。）
脉搏跳动一次后长时间停留的，说明宿疾在心主脉中，应从中治法调理。脉搏跳动两次后长时间停留的，病在肝支脉中，应从支中治法调理。脉搏跳动三次后长时间停留的，病在脾下脉中，应从下中治法调理。脉搏跳动四次后长时间停留的，病在肾间脉中，应从间中治法调理。脉搏跳动五次后长时间停留的，病在肺支脉中，应从支中治法调理。这五种脉象的病证，若是虚羸之人出现此脉，预后不良为死证。之所以如此，是因为药物难以奏效，针刺也难以达到病所。若是体质壮盛之人，则可以治愈，因为其元气充足。（出自《脉经》。）
曹山跗患有肺消瘅病，并伴有寒热症状，无法治愈。之所以如此，是因为此人正气极度衰竭，正气衰竭则形体败坏，形体败坏的人，不应当使用关元、气海等穴位的灸法以及石药和剧毒药物进行治疗。
齐丞相舍人的奴仆损伤了脾脏，按照常理应当在春季死亡，但他直到四月因便血而死，诊断时发现他当时的脉象尚属顺证，脉象顺证说明人体精气尚未完全耗竭，身形尚显丰盈。这个奴仆的病因是由于多次出汗后，又在火旁烤身外出，遭受大风侵袭所致。（原文中“一愈顺”及“一时”有误，另有一说：能进食者超过预期期限才死，不能进食者不到预期期限就死。出自仓公传。）
《续名医类案》记载：白云集中的万家家境贫寒，右臂痿软废用。有一天有人对他说：“你的脉象涩滞，这是怒气盛于肝脏，脏火亢盛所致。”于是摸他的右臂说：“幸好你还瘦，可以治愈。饮用武夷茶和山涧水，久而久之自然会痊愈。”将此案例与前文诸论结合来看，似乎不相吻合。但我曾思考过，四肢手臂痿软废用，是因为正气不能到达患处，所以喜欢患者消瘦，因为邪气也不会在消瘦之处占据，通过充养正气即可恢复。若是虚损发于五脏，表现在周身，则喜欢患者肥胖，因为津液尚未完全消耗，扶持正气即可恢复。然而，胖瘦也必须不失常态，如果瘦得像枯柴，胖得像腐尸，怎么能够治疗呢？
凡是患有香港脚（足部肿痛）及各种风病的人，原本肤色黑且瘦的人容易治愈，而肥大、肌肉浓密、肤色赤白的人难以痊愈。黑人耐受风湿，而肤色赤白的人不耐受风湿。瘦人肌肉坚实，肥人肌肉松软，肌肉松软则疾病容易深入体内。（出自《千金方》。）
这段论述的是人原本的肥瘦体质，所以与上文因病导致变肥或变瘦的情况不同。肥人肌肉淖泽、腠理疏松，邪气易于深入，而且痰多气滞，又难以排出，所以难治。凡是痈疽、痿痹等病症，都应当根据这一原则进行诊察。
肥人多患中风，因为形体丰满而气虚，气机难以周流全身，气滞则生痰，痰积则生火，所以会导致突然昏厥。瘦人阴虚，血液衰少，相火容易亢盛，所以多患劳嗽。张石顽曾经说，有一个人在年富力强、体型丰腴时，冬季出现腰痛，不能翻身侧卧，气息怯弱短少，足膝经常发冷。给予肾气丸治疗没有效果，反而出现了寒热、喘满的症状。这是因为肥人多湿。脉沉，是湿气遏制了气脉；腰痛不能转侧，是湿气损伤了经络；气息怯弱短少，是湿气干扰了肺胃，导致气机不舒展；足膝经常发冷，是阳气不能通达四肢。治疗方法应当是行气活血，以助气血流动，却反而使用了滋腻养血的药物，病情加重是必然的。
When Ying (Nutritive) Qi becomes diseased, there are alternating chills and fever, shortness of breath, and blood flowing upwards and downwards in disorder. When Wei (Defensive) Qi becomes diseased, the qi flows freely but is accompanied by rushing pain (the text notes: "should be rushing pain"), with pain coming and going intermittently, chest and hypochondriac distension, and borborygmus (intestinal rumbling), caused by wind-cold pathogens lodging outside the stomach and intestines. Han Bi (Cold Bi syndrome) as a disease lingers and does not depart, causing intermittent pain and numbness of the skin. (There is a method for treating Han Bi using hot compresses of Zanthoxylum, dried ginger, cinnamon heart, and strong wine.)
When Ying Qi is deficient, it leads to numbness; when Wei Qi is deficient, it leads to motor dysfunction. If both Ying and Wei Qi are deficient, there is both numbness and motor dysfunction. The muscles may appear unchanged, but the body and the mind/spirit become disconnected, which indicates death. (Wei Qi deficiency causes motor dysfunction; therefore, in treating hemiplegia or paralysis, Fangfeng [Saposhnikovia Root] is used heavily.)
If the pulse beats once and then stays long, the chronic disease is in the Heart Master vessel, and treatment should follow the Middle Treatment method. If the pulse beats twice and then stays long, the disease is in the Liver Branch vessel, and treatment should follow the Branch-Middle Treatment method. If the pulse beats three times and then stays long, the disease is in the Spleen Lower vessel, and treatment should follow the Lower-Middle Treatment method. If the pulse beats four times and then stays long, the disease is in the Kidney Intercalary vessel, and treatment should follow the Intercalary-Middle Treatment method. If the pulse beats five times and then stays long, the disease is in the Lung Branch vessel, and treatment should follow the Branch-Middle Treatment method. For these five pulse patterns, if seen in a emaciated person, it indicates death. This is because medicine cannot take effect, and acupuncture needles cannot reach the pathology. However, in robust persons, it can be treated because their Qi is complete. (From *Mai Jing* / *Pulse Classic*.)
Cao Shanfu suffered from Fei Xiao Dan (Lung Wasting-Thirst with heat toxin), complicated by chills and fever, which was untreatable. This is because his Zheng Qi (Upright Qi) had collapsed; collapse of Zheng Qi leads to deterioration of the physical form. In such cases of deteriorated form, one should not use moxibustion on Guan and Shi points, nor administer stone medicines or toxic drugs.
The servant of the Chancellor of Qi injured his Spleen. According to standard prognosis, he should have died in spring, but he actually died of bloody stool in April. Upon diagnosis, his pulse appeared relatively smooth/favorable ("Yu Shun"). A favorable pulse indicates that the person's essence and form are still substantial. The servant's illness resulted from profuse sweating, followed by exposure to fire and then to strong winds. (Note: The original text contains errors regarding "Yi Yu Shun" and "Yi Shi". Another version states: Those who can eat die after the expected period; those who cannot eat die before the expected period. From the Biography of Cang Gong.)
*Xu Mingyi Leian* records: Wan Jia, who was poor, lived in Baiyun Ji, suffered from flaccidity and paralysis of the right arm. One day, someone told him: "Your pulse is choppy (Se). Anger is excessive in the Liver, and fire arises from the Zang organs." Touching the right arm, he said: "Fortunately, you are thin, so it is treatable. Drink Wuyi tea and stream water, and it will heal over time." Combining this case with previous theories seems inconsistent. However, I have pondered this: In cases of limb flaccidity where Zheng Qi fails to reach the area, thinness is preferred because pathogenic factors also do not reside in a thin body; replenishing Zheng Qi allows recovery. In cases of deficiency damage originating from the Five Zang organs manifesting throughout the body, fatness is preferred because body fluids are not yet exhausted; supporting Zheng Qi allows recovery. Nevertheless, fatness and thinness must remain within normal limits. If one is as thin as a withered stick or as fat as a decaying corpse, treatment is impossible.
In all cases of Hongxiangjiao (Gout/Charley Horse affecting the feet) and various Wind diseases, individuals who are naturally dark-skinned and thin are easy to treat, while those who are fat, with dense flesh and red-white complexion, are difficult to cure. Dark-skinned people tolerate wind-dampness, whereas red-white complexions do not. Thin people have firm flesh; fat people have soft flesh. Soft flesh allows diseases to penetrate deeply. (From *Qianjin Fang* / *Essential Prescriptions Worth a Thousand Gold*.)
This discussion concerns the person's inherent constitution of fatness or thinness, thus differing from the previous section which discussed becoming fat or thin due to disease. Fat people have moist flesh and loose interstices (Li), allowing pathogens to easily penetrate deeply. Additionally, they tend to have much phlegm and stagnant Qi, which are difficult to expel, making them hard to treat. All cases of carbuncles, ulcers, flaccidity, and Bi syndrome should be diagnosed according to this principle.
Fat people are prone to Zhong Feng (Wind Stroke) because their ample form but deficient Qi makes circulation difficult. Qi stagnation generates Phlegm; Phlegm accumulation generates Fire, leading to sudden syncope. Thin people have Yin deficiency and depleted blood, causing Ministerial Fire to easily hyperactive, leading to frequent Lao Sou (Consumptive Cough). Zhang Shiwan once stated: There was a person in his prime, robust and plump, who suffered lower back pain in winter, unable to turn or lie sideways, with weak shortness of breath and cold feet/knees. Ren Shen Qi Wan (Kidney Qi Pill) was ineffective, and instead, chills, fever, wheezing, and fullness worsened. This is because fat people often have Dampness. A deep pulse indicates Dampness obstructing Qi vessels. Lower back pain preventing turning indicates Dampness damaging meridians. Weak shortness of breath indicates Dampness interfering with Lung and Stomach, causing Qi stagnation. Cold feet/knees indicate Yang Qi failing to reach the extremities. The correct method is to move Qi and circulate Blood to aid flow, but instead, cloying and nourishing-blood herbs were used, which inevitably aggravated the condition.