答曰。脾虽寄于坤。实用于巳。从上肺心。从下肾肝。脾中得三数也。如气寄于辛而用
于寅
。包络三焦。寄于丑而用。于申也。此人之所以肖天地而生。易曰干为首。坤为腹。震为足
巽为股。坎为耳。离为目。艮为手。兑为口。
答曰。十二大经之别。并任督之别。脾之大络脉。别名曰大包。是为十五络。诸经皆言
之
。予谓胃之大络。名曰虚思。贯膈络出于左乳下。其动应晨脉宗气也。是知络有十六也。
答曰。手少阳者。主三焦之气也。灵枢经云。足三焦者。太阳之别也。并太阳之证。入
络膀胱约下焦。是知三焦有二也。
答曰。肝心脾肺肾兼包络。一名命门。为六脏。胆小肠胃大肠膀胱兼三焦。为六腑。计
之十
二矣。故包则为一府矣。是为十三矣。经曰。胞移热于膀胱则癃溺血。又云。胞痹者。少腹
膀胱。按之内痛者。若沃以汤注云膀胱胞内居之。内外二境图云。膀胱者胞之室也以是知为
十三脏腑矣。
冬伤于寒。春必温病。盖因房室劳伤与辛苦之人腠理开泄。少阴不藏。肾水涸竭而得之
无水
则春水无以发生故为温病。至长夏之时。时强木长因绝水之源。无以滋化。故为大热病也。
伤寒之源如此四气调神论曰。运冬气则少阴不藏。肾气独沉。广成子云无劳汝形。无摇汝精
。金
匮真言曰。夫精者身之本也。故藏于精者春不病温。注云。冬不按跷。精气伏藏。阳不妄升
。故春不病温。又经云。不妄作劳。又云不知持满又云水冰地折。无扰乎阳。又云。无泄皮
肤。使气丞夺。启玄子云。肾水旺于冬。故行夏令。则肾气伤。春木旺而水废。故病于春也
。逆冬则伤肾。故少气以奉春生之令也。是以春为温病。夏为热。长夏为大热病。其变随乎
时而已。邪之所感浅者。其病轻而易治。深者其病重而难治。尤深者其病死而不治。
问：脾脏寄位于坤卦，其数如何？如果是从脾来说，第二数是脾；如果是从肾来说，第四数是肾。请说明脾的数理。
答：脾虽然寄位于坤卦，但实际上作用于巳位。它上承肺和心，下接肾和肝，因此脾中包含了这三个数字（指二、四及其中间或关联之数）。这就好比气寄位于辛金而作用于寅木。心包络与三焦，寄位于丑土而作用于申金。这就是人之所以效法天地而生成的道理。《易经》说：乾为首，坤为腹，震为足，巽为股，坎为耳，离为目，艮为手，兑为口。
问：十二正经的别络，以及任脉、督脉的别络，加上脾的大络脉，别名叫做“大包”，这被称为十五络。各经都有记载。我认为胃的大络，名字叫“虚里”（注：原文作“虚思”，据中医经典应为虚里），贯通膈肌，联络于左乳下，其跳动应合宗气。由此可知，络脉共有十六条。
问：手少阳三焦经，主要主管三焦之气。《灵枢经》说：足三焦是太阳膀胱经的别络，伴随太阳经的证候，进入络属膀胱，约束下焦。由此可知，三焦有两个概念（一指手少阳三焦经，一指足太阳之别络所主的下焦功能区域）。
问：肝、心、脾、肺、肾，兼用心包络，称为六脏。胆、胃、大肠、小肠、膀胱，兼用三焦，称为六腑。合计已有十二个。如果再加上胞宫（子宫/精室）作为一个腑，就是十三个了。医经说：“胞移热于膀胱则癃溺血。”又说：“胞痹者，少腹膀胱按之内痛。”王冰注解说：“膀胱是胞的居室。”《内外二境图》说：“膀胱是胞的室舍。”由此可知，脏腑共有十三个。
冬季感受寒邪，春季必然发生温病。这是因为房事过度劳伤，或者辛苦劳作之人腠理开泄，导致少阴肾气不藏，肾水枯竭而致病。如果没有肾水，春天就没有水源来生发万物，所以成为温病。到了长夏时节，时令强盛，木气生长，因为断绝了水的源头，无法滋养化生，所以成为大热病。伤寒的源流就是这样。《四气调神大论》说：违背冬令的养生原则，则少阴不藏，肾气独沉。广成子说：不要劳累你的形体，不要动摇你的精气。《金匮真言论》说：精，是身体的根本。所以能固藏精气的人，春天就不会得温病。王冰注解说：冬天不按跷导引，精气就会伏藏，阳气不会妄升，所以春天不得温病。又医经说：不要妄自劳倦。又说：不知道保持满溢的状态（指保精）。又说：水结冰地冻裂时，不要扰动阳气。又说：不要使皮肤开泄，导致正气被夺走。启玄子（王冰号）说：肾水在冬季旺盛，如果此时行夏令之法（如出汗、耗散），就会损伤肾气。春天木气旺盛而肾水废竭，所以春天发病。违背冬令就会伤肾，导致元气不足，无法奉养春天的生发之令。因此，春季发生温病，夏季发生热病，长夏发生大热病。病变随着时令而变化而已。邪气感浅的，病轻而易治；感深的，病重而难治；特别深的，病危而死，不可治愈。
Q: The spleen is associated with the Kun trigram. What is its numerical correspondence? If we consider it from the perspective of the spleen, the number is two; if from the kidney, the number is four. Please explain the numerology of the spleen.
A: Although the spleen is associated with the Kun trigram, it actually functions at the Si (Snake) position. It receives qi from above via the Lung and Heart, and connects below to the Kidney and Liver; thus, the spleen encompasses these three numbers. This is analogous to how Qi is associated with Xin (Metal) but functions at Yin (Wood). The Pericardium and Sanjiao are associated with Chou (Ox) but function at Shen (Monkey). This illustrates how humans are born in accordance with Heaven and Earth. The *I Ching* states: Qian is the head, Kun is the abdomen, Zhen is the foot, Xun is the thigh, Kan is the ear, Li is the eye, Gen is the hand, Dui is the mouth.
A: The collaterals of the twelve regular meridians, along with the collateral branches of the Ren Mai (Conception Vessel) and Du Mai (Governing Vessel), plus the large collateral vessel of the Spleen, known as "Dabao" (Great Wrap), constitute the fifteen collaterals. This is recorded in various classics. I propose that the large collateral vessel of the Stomach is named "Xuli" (likely a textual variant for Xuli/Vestibule), which penetrates the diaphragm and connects below the left nipple. Its pulsation corresponds to the Zongqi (Gathering Qi). From this, we know there are sixteen collateral vessels.
A: The Hand-Shaoyang Sanjiao Meridian primarily governs the Qi of the Sanjiao. The *Ling Shu* (Spiritual Pivot) states: The Foot-Sanjiao is a branch of the Taiyang (Bladder) meridian. It follows the Taiyang syndrome, enters and connects to the Bladder, and regulates the Lower Jiao. Thus, there are two concepts of Sanjiao (one referring to the Hand-Shaoyang meridian, the other to the functional area of the Lower Jiao regulated by the Taiyang branch).
A: The Liver, Heart, Spleen, Lung, and Kidney, combined with the Pericardium, are called the Six Zang Organs. The Gallbladder, Stomach, Large Intestine, Small Intestine, and Bladder, combined with the Sanjiao, are called the Six Fu Organs. This totals twelve. If we add the Bao Gong (Uterus/Essence Chamber) as one Fu organ, the total becomes thirteen. The classics state: "If heat transfers from the Bao Gong to the Bladder, it results in strangury and bloody urine." It also states: "In Bao Bi obstruction, pressing the lower abdomen and Bladder region causes internal pain." Wang Bing's commentary notes: "The Bladder is the chamber of the Bao Gong." The *Illustrations of Internal and External Realms* states: "The Bladder is the residence of the Bao Gong." From this, we deduce there are thirteen Zang-Fu organs.
Winter injury by Cold leads to Warm Diseases in Spring. This occurs because excessive sexual activity or hard labor causes the Couli (pores) to open, leading to failure of the Shaoyin (Kidney) to store essence. The Kidney Water dries up, causing disease. Without water, there is no source for the spring generation, resulting in Warm Disease. By the time of Late Summer, when Wood energy grows strongly, the source of Water is cut off, unable to nourish transformation, resulting in a Great Heat Disease. Such is the origin of Cold Damage. The *Si Qi Tiao Shen Lun* (Discourse on Regulating Spirit According to the Four Seasons) says: Violating the Winter Qi causes Shaoyin to fail to store, and Kidney Qi sinks alone. Guangchengzi said: Do not exhaust your form, do not shake your essence. The *Jin Gui Zhen Yan Lun* (True Words of the Golden Cabinet) states: Essence is the root of the body. Therefore, those who store essence will not suffer Warm Diseases in Spring. Commentary notes: In winter, without acupressure or stretching, essence remains hidden, Yang does not rise recklessly, so Warm Disease does not occur in spring. Furthermore, the classics say: Do not labor recklessly. Say: Do not know how to maintain fullness. Say: When water freezes and earth cracks, do not disturb Yang. Say: Do not let skin pores open, causing Qi to be depleted. Qixuanzi (Wang Bing) said: Kidney Water prospers in Winter. If one practices Summer methods (such as sweating/dispersing), Kidney Qi is injured. In Spring, Wood prospers while Water fails, so disease manifests in Spring. Violating Winter harms the Kidney, leading to shortness of breath and inability to support the Spring generating command. Hence, Warm Disease occurs in Spring, Heat Disease in Summer, and Great Heat Disease in Late Summer. Variations follow the seasons. If pathogenic factors penetrate shallowly, the disease is mild and easy to treat; if deep, it is severe and difficult to treat; if extremely deep, the patient dies and cannot be cured.