马云。此篇推本五脏之神。故名篇。简案、篇首有凡刺之法。必先本于神语。故命篇。
乱 史音 、音闷。简案、懑闷并通。道藏本及马、张、志作恍。误。
天之罪与人之过乎 志与下句。简案、根据志意。与、平声。
天之在我者（止）生者也 张云。人禀天地之气以生。天地者。阴阳之道也。自太极而生两仪。
则清阳为天。浊阴为地。自两仪而生万物。则干知大始。坤作成物。故易曰。天地之大德曰生。宝命全角论曰。
人生于地。悬命于天。然则阳先阴后。阳施阴受。肇生之德本乎天。成形之气本乎地。故天之在我者德也。地
之在我者气也。德流气薄而生者。言理赋形全。而生成之道斯备矣。
故生之来谓之精 张云。所谓精者。天之一。地之六也。天以一生水。地以六成之。而为五
行之最先。故万物初生。其来皆水。如果核未实。犹水也。胎卵未成。犹水也。即凡人之有生。以及昆虫草木。
无不皆然。易曰。男女构精。万物化生。此之谓也。志云。决气篇曰。常先身生是谓精。盖未成形。而先受天
一之精。故所生之来谓之精。简案、此以下止于谓之智。见子华子。
两精相搏谓之神 张云。两精者。阴阳之精也。搏、
交结也。易曰。天数五。地数五。五位相得。而各有合。周子曰。二五之精。妙合而凝。是皆两精相搏之谓。
凡万物生成之道。莫不阴阳交而后神明见。故人之生也。必合阴阳之气。构父母之精。两精相搏。形神乃成。
所谓天地合气。命之曰人也。又决气篇曰。两神相搏。合而成形。常先身生。是谓精。志云。平人绝谷篇曰。
神者水谷之精气也。盖本于先天所生之精。后天水谷之精。而生此神。故曰。两精相搏谓之神。真邪章曰。真
者所受于天。与谷气并而充身者也。简案、两精之解。张义似长矣。马云。相搏之搏音博。礼儒行、鸷虫攫搏
不程勇者。亦读为博。此恐非也。博、子华子作薄。乃易所谓雷风相薄之薄。二字古通用。见通雅。
随神往来者谓之魂 并精而出入者谓之魄 张云。精对神而言。则神为阳而精为阴。魄对魂而
言。则魂为阳而魄为阴。故魂则随神而往来。魄则并精而出入。愚按、精、神、魂、魄。虽有阴阳之别。而阴
阳之中。复有阴阳之别焉。如神之与魂皆阳也。何谓魂随神而往来。盖神之为德。如光明爽朗。聪慧灵通之类
皆是也。魂之为言。如梦寐恍惚。变幻游行之境皆是也。神藏于心。故心静则神清。魂随于神。故神昏则魂荡。
此则神魂之义。可想象而悟矣。精之与魄。皆阴也。何谓魄并精而出入。盖精之为物。重浊有质。形体因之而
成也。魄之为用。能动能作。痛痒由之而觉也。精生于气。故气聚则精盈。魄并于精。故形强则魄壮。此则精
魄之状。亦可默会而知也。然则神为阳中之阳。而魂则阳中之阴也。精为阴中之阴。而魄则阴中之阳者乎。虽
然。此特其阴阳之别耳。至若魂魄真境。犹有显然可鞫者。则在梦寐之际。如梦有作为而身不应者。乃魂魄之
动静。动在魂而静在魄也。梦能变化而寤不能者。乃阴阳之离合。离从虚而合从实也。
此虽皆魂魄之证。而实即死生之几。苟能致心如太虚。而必清必静。则梦觉死生之关。知必有洞达者矣。诸家
得理之论。再附于下。以详其义。唐孔氏曰。人之生也。始变化为形。形之灵曰魄。魄内自有阳气。气之神曰
魂。魂魄神灵之名。初生时。耳目心识。手足运动。此魄之灵也。及其精神性识。渐有知觉。此则气之神也。
乐祁曰。心之精爽。是谓魂魄。魄属形体。魂属精神。精又是魄。魄是精之神。神又是魂。魂是气之神。邵子
曰。气形盛则魂魄盛。气形衰则魂魄亦从而衰。魂随气而变。魄随形而化。故形存则魄存。形化则魄散。朱子
曰。魂神而魄灵。魂阳而魄阴。魂动而魄静。生则魂载于魄。而魄检其魂。死则魂游散而归于天。魄沦坠而归
于地。运用动作底是魂。不运用动作底是魄。魄盛则耳目聪明。能记忆。老人目昏耳聩。记事不得者。魄衰也。
又曰。人生则魂魄相交。死则各相离去。月之黑晕是魄。其光是魂。魂是魄之光焰。魄是魂之根柢。火是魂镜。
其魄灯有光焰。物来便烧。镜虽照见。却在里面。火日外景。金水内景。火日是魂。金水是魄。阴主藏受。故
魄能记忆在内。阳主运用。故魂能发用出来。二物本不相离。精聚则魄聚。气聚则魂聚。是为人物之体。至于
精竭魄降。则气散魂游而无知矣。
所以任物者谓之心 马云。其所谓心意、志思、智虑。举不外于一心焉耳。故凡所以任物者谓之
心。素问灵兰秘典论曰。心者君主之官。神明出焉。则万物之机。孰非吾心之所任者乎。简案、白虎通云。心
之为言任也。任于思也。
心有所忆谓之意 张云。忆、思忆也。谓一念之生。心有所响而未定者曰意。李云。心已起而未
有定属者意也。简案、礼大学疏。总包万虑谓之心。为情所意念谓之意。又礼运注。意、心所无虑也。
意之所存谓之志 甲乙意下之字作有。张云。意之所存。谓意已决。而卓有所立者曰志。李云。
意已决而确然不变者志也。
因志而存变谓之思 张云。因志而存变。谓意志虽定。而复有反复计度者曰思。
因思而远慕谓之虑 张云。深志远慕。必生忧疑。故曰虑。简案、子华子。远慕作有所顾。荀
子礼论。礼之中焉能思索。谓之能虑。说文。虑、谋思也。大学朱注。处事精详也。
因虑而处物谓之智 张云。疑虑既生。而处得其善者曰智。按此数者。各有所主之脏。今皆生
之于心。此正诸脏为之相使。而心则为之主宰耳。简案、子华子处物。作有所决择。
长生久视 老子五十九章云。是谓深根固柢。长生久视之道。
怵惕 史云。悚惧也。张云。怵、恐也。惕、惊也。简案、书。 命。怵惕惟厉。孔注。言常悚
惧惟危。
流淫而不止 甲乙止、作正。张云。流淫谓流泄淫溢。如下文所云恐惧而不解则伤精。精时自
下者是也。
竭绝而失生 张云。悲则气消。悲哀太甚则胞络绝。故至失生。竭者绝之渐。绝则尽绝无余矣。
神惮散而不藏 张云。喜发于心。乐散在外。暴喜伤阳。故神气惮散而不藏。惮、惊惕也。简
案、诗。云汉。我心惮暑。笺。惮、犹畏也。国语周语。惮其牺也。注。惮、惧也。文选西京赋。惊 。惮
蛟蛇。薛综注。惊、惮、谓皆使骇怖也。
迷惑而不治 张云。怒则气逆。甚者心乱。故至昏迷
皇惑而不治。不治、乱也。
荡惮而不收 甲乙注云。不、收、太素作失守。张云。恐惧则神志惊散。故荡惮而不收。上文言
喜乐者。神惮散而不藏。与此稍同。但彼云不藏者。神不能持而流荡也。此云不收者。神为恐惧而散失也。所
当详辨。
心怵惕（止）死于冬 张云。此下言情志所伤之病。而死各有时也。心藏神。神伤则心怯。故恐
惧自失。 者筋肉结聚之处。心虚则脾弱。故破 脱肉。毛悴者。皮毛憔悴也。下文准此。色夭者心之色。赤
欲如白裹朱。不欲如赭也。火衰畏水。故死于冬。
脾愁忧（止）死于春 张云。忧本肺之志。而亦伤脾者。母子气通也。忧则脾气不舒。不舒则不
能营运。故 闷而乱。四肢皆禀气于胃。而不得至经。必因于脾。乃得禀也。故脾伤则四肢不举。脾色之夭者。
黄欲如罗裹雄黄。不欲如黄土也。土衰畏木。故死于春。
肝悲哀（止）死于秋 甲乙作狂妄。其精不守。令人阴缩而筋挛。张云。肝藏魂。悲哀过甚则伤
魂。魂伤则为狂为妄而不精明。精明失则邪妄不正。其人当阴缩筋挛。两胁骨不举者。皆肝经之败也。肝色之
夭者。青欲如苍壁之泽。不欲如蓝也。木衰畏金。故死于秋。李云。悲哀亦肺之志。而伤肝者。金伐木也。
肺喜乐（止）死于夏 甲乙作意不存其人。简案、其人接下句似是。张云。喜本心之志。而亦伤
肺者。暴喜伤阳。火邪乘金也。肺藏魄。魄伤则神乱而为狂。意不存人者。旁若无人也。五脏之伤。无不毛悴。
而此独云皮革焦者。以皮毛为肺之合。而更甚于他也。肺色之夭者。白欲如鹅羽。不欲如盐也。金衰畏火。故
死于夏。
肾盛怒（止）死于季夏 张云。怒本肝之志。而亦伤肾者。肝肾为子母。其气相通也。肾藏志。志
伤则意失。而善忘其前言也。腰脊不可俯仰屈伸者。腰为肾之府也。肾色之夭者。黑欲如重漆色。不欲如地苍
也。水衰畏土。故死于季夏。
恐惧而不解（止）精时自下 张云。此亦言心肾之受伤也。盖盛怒虽云伤肾。而恐惧则肾脏之本。
志恐则气下而陷。故能伤精。肾主骨。故精伤则骨 。痿者阳之痿。厥者阳之衰。命门不守。则精时自下。是
虽肾脏受伤之为病。然邪气脏腑病形篇曰。愁忧恐惧则伤心。上文曰。神伤则恐惧。流淫而不止。义与此通。
李云。此亦肾伤也。特伤于本脏之志。为异于前耳。闭藏失职。则不因交感。精自下。志云。上节论伤肾脏之
志。此论伤肾脏之精。盖魂、魄、智、意、本于心肾精神之所生。故首言怵惕思虑者则伤神。末言恐惧而不解
则伤精。神生于精。而精归于神也。
是故五脏（止）不可以治之也 张云。此承篇首之问而言。凡用针者。必当察病者之形态。以酌其可
刺不可刺也。设或五脏精神已损。必不可妄用针矣。故邪气脏腑病形篇曰。诸小者。阴阳形气俱不足。勿取以
针。而调以甘药也。根结篇曰。形气不足。病气不足。此阴阳气俱不足也。不可刺之。
肝藏血 张云。宣明五气篇曰。肝藏魂。五脏生成篇曰。人卧则血归于肝。调经论曰。肝藏血。血
有余则怒。不足则恐。
脾藏营（止）经溲不利 张云。营出中焦。受气取汁。变化而赤。是为血。故曰。脾藏营。营舍意。
即脾藏意也。脾虚则四肢不用。五脏不安。以脾主四肢。而脾为五脏之原也。太阴脉入腹络胃。故脾实则腹胀。
经溲不利。调经论曰。形有余则腹胀。经溲不利。经、当作泾。简案、甲乙。经、作
泾。厥论亦作泾。
心藏脉 张云。宣明五气篇曰。心主脉。调经论曰。心藏神。神有余则笑不休。神不足则悲。
肺藏气（止）胸盈仰息 张云。喘喝者。气促声粗也。胸盈。胀满也。仰息。仰面而喘也。宣明
五气篇曰。肺藏魄。调经论曰。气有余则喘咳上气。不足则息利少气。甲乙。盈、作凭。注云。九墟作盈。
肾藏精（止）实则胀 张云。九针论曰。肾藏精志也。调经论曰。肾藏志。志有余则腹胀、飧泄。
不足则厥。
五脏不安（止）调之也 张云。前章言情志损伤、此分五脏虚实。故凡五脏有不安者。必审其病
形虚实。情志所属。乃可随其脏以调之。此总结前章而言其治方也。
马云：此篇推究五脏之神的本源，因此以“本神”命名。简案：篇首有“凡刺之法，必先本于神”的话语，所以以此命篇。
乱（音mèn）：通“懑闷”。简案：“懑闷”二字通用。道藏本及马、张、志书作“恍”，是错误的。
“天之罪与人之过乎”：志与下句相连。简案：依据《志意》篇，“与”读平声。
“天之在我者（止）生者也”：张景岳说：人禀受天地之气而生成。天地，就是阴阳的道理。从太极生出两仪，那么清阳上升为天，浊阴下沉为地。从两仪生出万物，乾知大始，坤作成物。所以《易经》说：“天地的大德叫做生。”《宝命全形论》说：“人生于地，悬命于天。”既然这样，阳先阴后，阳施予阴承受，创始生命的德性源于天，形成形体之气源于地。所以“天赋予我们的”是德，“地赋予我们的”是气。“德流气薄而生者”，是说理赋形全备，生成的道理就完备了。
“故生之来谓之精”：张景岳说：所谓精，就是天一、地六之数。天以一生水，地以六成之，这是五行的最先。所以万物初生，其来源都是水。如果果核未实，就像水一样；胎卵未成，也像水一样。即使是普通人的出生，以及昆虫草木，没有不是这样的。《易经》说：“男女构精，万物化生。”说的就是这个意思。《志意》引《决气》篇说：“常先身生是谓精。”大概是在形体未成之前，先受天一之精，所以所说的生命来源叫做精。简案：从这里以下直到“谓之智”，见于《子华子》。
“两精相搏谓之神”：张景岳说：两精，就是阴阳之精。“搏”，是交结的意思。《易经》说：“天数五，地数五，五位相得，而各有合。”周敦颐说：“二五之精，妙合而凝。”这些都是指两精相搏。凡是万物生成的道理，没有不是阴阳交合而后神明显现的。所以人的出生，必须合阴阳之气，结合父母的精，两精相搏，形神乃成。这就是所谓的“天地合气，命之曰人也”。又《决气》篇说：“两神相搏，合而成形，常先身生，是谓精。”《志意》引《平人绝谷》篇说：“神者，水谷之精气也。”大概是基于先天所生之精和后天水谷之精，从而产生这个神。所以说：“两精相搏谓之神。”《真邪章》说：“真者，所受于天，与谷气并而充身者也。”简案：关于两精的解释，张景岳的意见似乎更长远。马云：相搏的“搏”音博。《礼记·儒行》：“鸷虫攫搏不程勇者。”也读为博。这恐怕不对。“博”，在《子华子》中作“薄”，也就是《易经》所谓“雷风相薄”的“薄”。这两个字古时通用，见《通雅》。
“随神往来者谓之魂” “并精而出入者谓之魄”：张景岳说：精对神而言，则神为阳而精为阴。魄对魂而言，则魂为阳而魄为阴。所以魂随神而往来，魄并精而出入。愚按：精、神、魂、魄，虽然有阴阳的区别，但在阴阳之中，又有阴阳的区别。比如神与魂都属于阳，为什么说魂随神而往来？盖神的美德，如光明爽朗、聪慧灵通之类都是。魂的含义，如梦寐恍惚、变幻游行之境都是。神藏于心，所以心静则神清；魂随于神，所以神昏则魂荡。这神魂的意义，可以想象而领悟。精与魄，都属于阴，为什么说魄并精而出入？盖精作为物质，重浊有质，形体因此而成。魄的作用，能动能作，痛痒由此而觉。精生于气，所以气聚则精盈；魄并于精，所以形强则魄壮。这精魄的状态，也可以默会而知。既然如此，神是阳中之阳，而魂是阳中之阴；精是阴中之阴，而魄是阴中之阳吗？虽然如此，这只是它们的阴阳区别罢了。至于魂魄的真境，还有明显可以探究的，就在梦寐之际。如梦中有作为而身体不响应，这是魂魄的动静，动在魂而静在魄。梦能变化而醒时不能，这是阴阳的离合，离从虚而合从实。这些虽然是魂魄的证候，但实际上就是死生的关键。如果能做到心如太虚，必清必静，那么梦觉死生的关口，必定会有洞达的时候。各家得理之论，再附在下面，以详细说明其义。唐代孔颖达说：人出生时，开始变化为形，形的灵性叫魄。魄内自有阳气，气的神灵叫魂。魂魄神灵之名，初生时，耳目心识，手足运动，这是魄的灵性。等到精神性识，渐渐有知觉，这是气的神灵。乐祁说：心的精爽，叫做魂魄。魄属于形体，魂属于精神。精又是魄，魄是精的神灵。神又是魂，魂是气的神灵。邵雍说：气形盛则魂魄盛，气形衰则魂魄也随之衰。魂随气而变，魄随形而化。所以形存则魄存，形化则魄散。朱熹说：魂神而魄灵，魂阳而魄阴，魂动而魄静。生时魂载于魄，而魄检束其魂；死后魂游散而归于天，魄沦坠而归于地。运用动作的是魂，不运用动作的是魄。魄盛则耳目聪明，能记忆。老人目昏耳聩，记事不得，是魄衰。又说：人活着则魂魄相交，死了则各自离去。月的黑晕是魄，其光是魂。魂是魄的光焰，魄是魂的根柢。火是魂镜，其魄灯有光焰，物来便烧。镜虽照见，却在里面。火日外景，金水内景。火日是魂，金水是魄。阴主藏受，所以魄能记忆在内；阳主运用，所以魂能发用出来。二者本不相离，精聚则魄聚，气聚则魂聚，这是人物之体。至于精竭魄降，则气散魂游而无知了。
“所以任物者谓之心”：马云：其所谓心意、志思、智虑，都不外乎一心而已。所以凡是能够承担事物的叫做心。《素问·灵兰秘典论》说：“心者，君主之官，神明出焉。”那么万物的机枢，哪不是我们心所承担的？简案：《白虎通》说：心的意思是“任”，任于思虑。
“心有所忆谓之意”：张景岳说：忆，是思忆。谓一念产生，心有所向而未定的叫做意。李云：心已起而未有定属的叫做意。简案：《礼记·大学》疏：总包万虑谓之心，为情所意念谓之意。又《礼运》注：意，心所无虑也。
“意之所存谓之志”：《甲乙经》在“意”下有“之”字。张景岳说：意之所存，谓意已决，而卓然有所立的叫做志。李云：意已决而确然不变的叫做志。
“因志而存变谓之思”：张景岳说：因志而存变，谓意志虽定，而复有反复计度的叫做思。
“因思而远慕谓之虑”：张景岳说：深志远慕，必生忧疑，所以叫做虑。简案：《子华子》：“远慕”作“有所顾”。《荀子·礼论》：“礼之中焉能思索，谓之能虑。”《说文》：虑，谋思也。《大学》朱熹注：处事精详也。
“因虑而处物谓之智”：张景岳说：疑虑既生，而处理得当的叫做智。按这几者，各有所主的脏腑，现在都产生于心，这正是诸脏互相役使，而心为之主宰。简案：《子华子》“处物”作“有所决择”。
“长生久视”：《老子》五十九章说：这叫深根固柢，长生久视之道。
“怵惕”：史崧说：悚惧。张景岳说：怵，恐也；惕，惊也。简案：《尚书·君奭》：“怵惕惟厉。”孔安国注：言常悚惧惟危。
“流淫而不止”：《甲乙经》“止”作“正”。张景岳说：流淫指流泄淫溢，如下文所说恐惧不解则伤精，精时常自下的情况。
“竭绝而失生”：张景岳说：悲则气消，悲哀太甚则胞络绝，所以至失生。竭是绝的渐进，绝则是尽绝无余。
“神惮散而不藏”：张景岳说：喜发于心，乐散在外，暴喜伤阳，所以神气惮散而不藏。惮，惊惕也。简案：《诗经·云汉》：“我心惮暑。”笺：惮，犹畏也。《国语·周语》：“惮其牺也。”注：惮，惧也。《文选·西京赋》：“惊惮蛟蛇。”薛综注：惊、惮，谓皆使骇怖也。
“皇惑而不治”：不治，即乱。
“荡惮而不收”：《甲乙经》注：不、收，《太素》作“失守”。张景岳说：恐惧则神志惊散，所以荡惮而不收。上文说喜乐者，神惮散而不藏，与此稍同。但彼说不藏，是神不能持而流荡；此说不收，是神为恐惧而散失。应当详细辨别。
“心怵惕（止）死于冬”：张景岳说：以下讲情志所伤的病，而死各有时。心藏神，神伤则心怯，所以恐惧自失。“䐜”是筋肉结聚之处，心虚则脾弱，所以破䐜脱肉。毛悴，是皮毛憔悴。下文据此类推。色夭是心的颜色，赤欲如白裹朱，不欲如赭。火衰畏水，所以死于冬。
“脾愁忧（止）死于春”：张景岳说：忧本是肺之志，但也伤脾，因为母子气通。忧则脾气不舒，不舒则不能营运，所以䐜闷而乱。四肢都禀气于胃，而不能直达经脉，必须通过脾，才能禀受。所以脾伤则四肢不举。脾色之夭，黄欲如罗裹雄黄，不欲如黄土。土衰畏木，所以死于春。
“肝悲哀（止）死于秋”：《甲乙经》作“狂妄”。其精不守，令人阴缩而筋挛。张景岳说：肝藏魂，悲哀过甚则伤魂，魂伤则为狂为妄而不精明。精明失则邪妄不正，其人当阴缩筋挛。两胁骨不举，都是肝经的败象。肝色之夭，青欲如苍壁之泽，不欲如蓝。木衰畏金，所以死于秋。李云：悲哀也是肺之志，而伤肝，是金伐木。
“肺喜乐（止）死于夏”：《甲乙经》作“意不存其人”。简案：“其人”接下句似是。张景岳说：喜本心之志，但也伤肺，因为暴喜伤阳，火邪乘金。肺藏魄，魄伤则神乱而为狂。意不存人，是旁若无人。五脏之伤，无不毛悴，而这里独说皮革焦，是因为皮毛为肺之合，而比其他的更严重。肺色之夭，白欲如鹅羽，不欲如盐。金衰畏火，所以死于夏。
“肾盛怒（止）死于季夏”：张景岳说：怒本肝之志，但也伤肾，因为肝肾为子母，其气相通。肾藏志，志伤则意失，而善忘其前言。腰脊不可俯仰屈伸，腰是肾之府。肾色之夭，黑欲如重漆色，不欲如地苍。水衰畏土，所以死于季夏。
“恐惧而不解（止）精时自下”：张景岳说：这也是讲心肾受伤。盖盛怒虽云伤肾，而恐惧则是肾脏之本。志恐则气下而陷，所以能伤精。肾主骨，所以精伤则骨痿。痿是阳之痿，厥是阳之衰。命门不守，则精时自下。这虽是肾脏受伤的病，然而《邪气脏腑病形》篇说：愁忧恐惧则伤心。上文说：神伤则恐惧，流淫而不止。义与此相通。李云：这也是肾伤，只是伤于本脏之志，与前不同。闭藏失职，则不因交感，精自下。志云：上节论伤肾脏之志，此论伤肾脏之精。盖魂、魄、智、意，本于心肾精神之所生，所以首言怵惕思虑者则伤神，末言恐惧而不解则伤精。神生于精，而精归于神。
“是故五脏（止）不可以治之也”：张景岳说：这是承接篇首的问题而言。凡是用针的，必须观察病人的形态，以斟酌可刺不可刺。假如五脏精神已损，必不可妄用针。所以《邪气脏腑病形》篇说：诸小者，阴阳形气俱不足，勿取以针，而调以甘药。《根结》篇说：形气不足，病气不足，此阴阳气俱不足也，不可刺之。
“肝藏血”：张景岳说：《宣明五气》篇说：肝藏魂。《五脏生成》篇说：人卧则血归于肝。《调经论》说：肝藏血。血有余则怒，不足则恐。
“脾藏营（止）经溲不利”：张景岳说：营出中焦，受气取汁，变化而赤，是为血。所以说：脾藏营。营舍意，即脾藏意。脾虚则四肢不用，五脏不安，因为脾主四肢，而脾为五脏之源。太阴脉入腹络胃，所以脾实则腹胀，泾溲不利。《调经论》说：形有余则腹胀，泾溲不利。经，当作泾。简案：《甲乙经》“经”作“泾”。《厥论》也作“泾”。
“心藏脉”：张景岳说：《宣明五气》篇说：心主脉。《调经论》说：心藏神。神有余则笑不休，神不足则悲。
“肺藏气（止）胸盈仰息”：张景岳说：喘喝，是气促声粗。胸盈，是胀满。仰息，是仰面而喘。《宣明五气》篇说：肺藏魄。《调经论》说：气有余则喘咳上气，不足则息利少气。《甲乙经》“盈”作“凭”。注：《九墟》作“盈”。
“肾藏精（止）实则胀”：张景岳说：《九针论》说：肾藏精志。《调经论》说：肾藏志。志有余则腹胀、飧泄，不足则厥。
“五脏不安（止）调之也”：张景岳说：前章讲情志损伤，此分五脏虚实。所以凡五脏有不安的，必须审其病形虚实、情志所属，然后才可随其脏以调之。这是总结前章而言其治方。
Ma Yun: This chapter investigates the origin of the Shen (Spirit) of the Five Zang organs, hence named "Ben Shen" (Root of Spirit). Jian An: The beginning of the chapter states, "In all acupuncture methods, one must first base oneself on the Shen," thus the name.
Luan (sound mèn): Interchangeable with "Men Men" (oppression/stuffiness). Jian An: "Men Men" are interchangeable. The Daozang edition and editions by Ma, Zhang, and Zhi write it as "Huang," which is incorrect.
"The sin of Heaven or the fault of man?": The word "Zhi" connects to the following sentence. Jian An: Based on the "Zhi Yi" chapter, "Yu" is pronounced in the level tone.
"What Heaven has within us... is life itself": Zhang Jingyue said: Humans are born from the Qi of Heaven and Earth. Heaven and Earth are the principles of Yin and Yang. From Taiji emerge Liangyi (Two Powers), so clear Yang becomes Heaven, and turbid Yin becomes Earth. From Liangyi emerge all things; Qian knows the great beginning, Kun creates the substance. Thus, the I Ching says, "The great virtue of Heaven and Earth is called Life." The "Bao Ming Quan Xing Lun" says, "Humans are born from Earth, their fate hangs from Heaven." Therefore, Yang precedes Yin, Yang gives, and Yin receives. The virtue that initiates life comes from Heaven, while the Qi that forms the body comes from Earth. Thus, "what Heaven endows us with is De (Virtue/Principle)," and "what Earth endows us with is Qi." "De flows and Qi interacts to generate life" means that when principle is endowed and form is complete, the way of generation is fully prepared.
"Therefore, what comes with life is called Jing (Essence)": Zhang Jingyue said: What is called Jing corresponds to the numbers One of Heaven and Six of Earth. Heaven generates Water with One, and Earth completes it with Six, making it the first of the Five Elements. Thus, when all things are initially born, their source is Water. Just as a seed kernel before it is full is like water, and a fetus or egg before formation is like water. So too with human birth, and insects, birds, and plants—none are different. The I Ching says, "When male and female combine their Jing, all things transform and generate." This is what is meant. The "Zhi Yi" chapter quotes the "Jue Qi" chapter: "What is born before the body is called Jing." Generally, before the form is established, one first receives the Jing of Heaven's One. Hence, the source of life is called Jing. Jian An: From here until "called Zhi," this appears in the "Zi Hua Zi."
"When two Jings interact, it is called Shen (Spirit)": Zhang Jingyue said: The two Jings refer to the Jing of Yin and Yang. "Bo" means interlocking or combining. The I Ching says, "The numbers of Heaven are five, the numbers of Earth are five; the five positions correspond and each has its union." Zhou Dunyi said, "The essence of Two and Five combines wondrously and condenses." All these refer to the interaction of two Jings. In the way all things are generated, none occur without the intersection of Yin and Yang, after which Shen manifests. Thus, human birth requires the combination of Yin and Yang Qi, and the joining of parental Jing. When the two Jings interact, form and Shen are formed. This is what is meant by "Heaven and Earth combine their Qi, and this is called Man." Again, the "Jue Qi" chapter says, "When two Shens interact, they combine to form shape; what is born before the body is called Jing." The "Zhi Yi" chapter quotes the "Ping Ren Jue Gu" chapter: "Shen is the refined Qi of water and grain." It is based on the Jing born from the先天 (pre-heaven) and the Jing of post-heaven water and grain, thereby generating this Shen. Hence, "When two Jings interact, it is called Shen." The "Zhen Xie Zhang" says, "Zhen is what is received from Heaven, combined with Grain Qi to fill the body." Jian An: Regarding the explanation of two Jings, Zhang's view seems more profound. Ma Yun: The "Bo" in "Xiang Bo" sounds like "Bo." In the *Book of Rites*, "Ru Xing": "Fierce beasts seize and strike without measuring against the brave," also read as "Bo." This is likely incorrect. "Bo" is written as "Bo" (thin/close) in the *Zi Hua Zi*, which is the same "Bo" as in "Thunder and Wind approach each other" in the I Ching. These two characters were interchangeable in ancient times, see *Tong Ya*.
"What follows Shen and comes and goes is called Hun (Ethereal Soul)": "What exits and enters together with Jing is called Po (Corporeal Soul)": Zhang Jingyue said: Relative to Jing, Shen is Yang and Jing is Yin. Relative to Hun, Hun is Yang and Po is Yin. Thus, Hun follows Shen and comes and goes; Po exits and enters with Jing. I observe: Although Jing, Shen, Hun, and Po have Yin-Yang distinctions, within Yin and Yang there are further Yin-Yang distinctions. For example, both Shen and Hun are Yang. Why does Hun follow Shen? The virtue of Shen is like brightness, clarity, wisdom, and spiritual penetration. The meaning of Hun is like dream states, illusions, transformations, and wandering realms. Shen resides in the Heart, so when the Heart is quiet, Shen is clear. Hun follows Shen, so when Shen is confused, Hun is scattered. The meaning of Shen and Hun can be understood through imagination. Jing and Po are both Yin. Why does Po exit and enter with Jing? Jing is heavy, turbid, and substantial; the physical body is formed because of it. The function of Po is movement and action; pain and itch are perceived because of it. Jing is born from Qi, so when Qi gathers, Jing is abundant. Po attaches to Jing, so when the form is strong, Po is robust. The state of Jing and Po can be known through silent contemplation. Thus, Shen is Yang within Yang, and Hun is Yin within Yang; Jing is Yin within Yin, and Po is Yang within Yin. Although this is merely their Yin-Yang distinction, the true realm of Hun and Po has obvious aspects to investigate, particularly in dreams. If one acts in a dream but the body does not respond, this is the movement and stillness of Hun and Po; movement lies in Hun, stillness in Po. Dreams can change, but waking consciousness cannot; this is the separation and union of Yin and Yang, separation from emptiness and union from reality. Although these are proofs of Hun and Po, they are actually the threshold of life and death. If one can make the mind like Great Emptiness, necessarily clear and quiet, then the passage between dreaming/waking and life/death will surely be thoroughly understood. Various theories that grasp the principle are attached below to detail their meanings. Tang Kong Yingda said: When humans are born, they first transform into form. The spirituality of the form is called Po. Within Po is naturally Yang Qi. The spirit of this Qi is called Hun. The names Hun, Po, Shen, and Ling appear at birth: eyes, ears, heart-mind awareness, hand and foot movements—this is the spirituality of Po. Later, when spiritual nature and awareness gradually develop perception, this is the spirit of Qi. Le Qi said: The refined clarity of the Heart is called Hun and Po. Po belongs to the physical form, Hun belongs to the spirit. Jing is again Po; Po is the spirit of Jing. Shen is again Hun; Hun is the spirit of Qi. Shao Yong said: When Qi and Form are vigorous, Hun and Po are vigorous; when Qi and Form decline, Hun and Po also decline. Hun changes with Qi, Po transforms with Form. Thus, when Form exists, Po exists; when Form transforms, Po scatters. Zhu Xi said: Hun is divine, Po is spiritual; Hun is Yang, Po is Yin; Hun moves, Po is still. While alive, Hun is carried by Po, and Po restrains Hun. After death, Hun wanders and returns to Heaven, Po sinks and returns to Earth. That which operates and moves is Hun; that which does not operate or move is Po. When Po is strong, eyes and ears are acute, and memory is retained. Old people with dim eyes, deaf ears, and poor memory suffer from weak Po. He also said: When alive, Hun and Po intersect; when dead, they separate. The dark halo of the moon is Po; its light is Hun. Hun is the flame of Po; Po is the root of Hun. Fire is the mirror of Hun; its lamp has a flame. When an object comes, it burns. The mirror sees, but remains inside. Fire and Sun are external scenes; Metal and Water are internal scenes. Fire and Sun are Hun; Metal and Water are Po. Yin governs storage and reception, so Po can memorize internally. Yang governs operation, so Hun can manifest externally. These two do not originally separate; when Jing gathers, Po gathers; when Qi gathers, Hun gathers. This constitutes the body of humans and things. When Jing exhausts and Po descends, Qi scatters, Hun wanders, and there is no awareness.
"That which bears responsibility for things is called Xin (Heart)": Ma Yun: What is called Xin Yi (Heart-Mind), Zhi (Will), Si (Thought), and Zhi (Wisdom) does not go beyond the single Heart. Therefore, whatever bears responsibility for things is called Heart. The *Su Wen: Ling Lan Mi Dian Lun* says, "The Heart is the official of the Sovereign, from whom Shen emerges." Then, which mechanism of all things is not borne by our Heart? Jian An: *Bai Hu Tong* says: The meaning of Xin is "Ren" (to bear/responsibility), bearing thought.
"When the Heart has recollections, it is called Yi (Intention)": Zhang Jingyue said: Yi refers to reminiscence. When a thought arises, and the Heart has a direction but is not yet fixed, it is called Yi. Li Yun: When the Heart has arisen but has not settled on a specific object, it is Yi. Jian An: Commentary on the *Great Learning*: To encompass all thoughts is Xin; to be moved by emotion to think is Yi. Commentary on *Li Yun*: Yi is what the Heart thinks about without deliberation.
"What Yi stores is called Zhi (Will)": The *Jia Yi Jing* adds the character "Zhi" after "Yi". Zhang Jingyue said: What Yi stores means the intention has decided and stands firmly; this is called Zhi. Li Yun: When intention has decided and remains firm and unchanging, it is Zhi.
"Based on Zhi and considering changes is called Si (Reflection)": Zhang Jingyue said: Based on Zhi and considering changes means that although the will is fixed, there is repeated calculation and planning; this is called Si.
"Based on Si and longing afar is called Lv (Deliberation)": Zhang Jingyue said: Deep will and distant longing inevitably produce worry and doubt; hence it is called Lv. Jian An: *Zi Hua Zi*: "Longing afar" is written as "having concerns." *Xunzi: Li Lun*: "Able to reflect within the ritual is called able to deliberate." *Shuo Wen*: Lv means planning and thinking. Zhu Xi's commentary on the *Great Learning*: Handling affairs with precision and detail.
"Based on Lv and handling things is called Zhi (Wisdom)": Zhang Jingyue said: When doubts arise, and one handles them properly, it is called Zhi. Note that these several faculties each have their governing Zang organ, but now they all arise from the Heart. This is precisely because the various Zang organs serve one another, with the Heart as the master. Jian An: *Zi Hua Zi*: "Handling things" is written as "making choices."
"Long life and enduring vision": Chapter 59 of the *Laozi* says: "This is called deep roots and solid foundations, the way of long life and enduring vision."
"Chu Ti": Shi Song said: Fearful and apprehensive. Zhang Jingyue said: Chu means fear; Ti means alarm. Jian An: *Book of Documents*: "Fearful and apprehensive only in danger." Kong Anguo's commentary: Speaking of constant fearfulness and peril.
"Flowing and overflowing without stopping": The *Jia Yi Jing* writes "Zhi" as "Zheng". Zhang Jingyue said: Liu Yin refers to flowing and overflowing, such as described later: fear without resolution injures Jing, and Jing spontaneously leaks out.
"Exhausted, cut off, and losing life": Zhang Jingyue said: Sorrow causes Qi to dissipate. Excessive sorrow cuts off the Bao Luo (Pericardium Collateral), leading to loss of life. Jie is the gradual stage of Jue; Jue means completely exhausted with nothing left.
"Shen is terrified, scattered, and not stored": Zhang Jingyue said: Joy originates in the Heart, pleasure disperses outward. Violent joy injures Yang, causing Shen Qi to be terrified, scattered, and not stored. Dan means alarm and fright. Jian An: *Classic of Poetry, Yun Han*: "My heart fears the heat." Commentary: Dan means to fear. *Guo Yu, Zhou Yu*: "Fear his sacrifice." Annotation: Dan means to dread. *Wen Xuan, Xi Jing Fu*: "Startled and fearing dragons and snakes." Xue Zong's annotation: Startle and fear mean to cause terror.
"Confused and unable to be governed": Zhang Jingyue said: Anger causes Qi to rebel; severely, the Heart becomes chaotic, leading to coma.
"Huang Huo and unable to be governed": Bu Zhi means chaos.
"Scattered and terrified, unable to gather": The *Jia Yi Jing* annotation: "Bu Shou" is written as "Shi Shou" in *Tai Su*. Zhang Jingyue said: Fear causes Shen and Zhi to startle and scatter, thus scattering and terrifying without gathering. The earlier text said those who are joyful have Shen terrified, scattered, and not stored, which is slightly similar. However, "not stored" there means Shen cannot hold and flows away; "unable to gather" here means Shen is scattered and lost due to fear. This should be distinguished carefully.
"Xin Chu Ti ... dies in Winter": Zhang Jingyue said: Below discusses diseases injured by emotions, and death occurs at different times. The Heart stores Shen; if Shen is injured, the Heart becomes timid, so fear arises spontaneously. "Dan" is where muscles and tendons gather. If Heart is deficient, Spleen is weak, so Dan breaks and flesh wastes. Mao Cui means hair and skin become emaciated. The following cases follow this pattern. Se-tian color refers to the Heart's color: Red should be like white silk wrapping cinnabar, not like hematite. Fire declines and fears Water, so death occurs in Winter.
"Pi Chou You ... dies in Spring": Zhang Jingyue said: Worry is originally the Will of the Lung, but it also injures the Spleen because Mother and Child Qi connect. Worry causes Spleen Qi to stagnate; stagnation prevents transportation and transformation, causing Dan oppression and chaos. The four limbs receive Qi from the Stomach but cannot reach the meridians directly; they must pass through the Spleen to receive it. Thus, Spleen injury causes the four limbs to fail to move. The Se-tian color of the Spleen: Yellow should be like silk wrapping realgar, not like yellow earth. Earth declines and fears Wood, so death occurs in Spring.
"Gan Bei Ai ... dies in Autumn": The *Jia Yi Jing* writes "Kuang Wang". If its Jing is not guarded, it causes Yin contraction and tendon spasms. Zhang Jingyue said: The Liver stores Hun. Excessive sorrow injures Hun; Hun injury leads to madness and delusion, lacking clarity. Loss of clarity leads to evil and deviation; the person suffers Yin contraction and tendon spasms. Inability to raise the costal bones indicates failure of the Liver Meridian. The Se-tian color of the Liver: Blue-Green should be like the luster of green jade, not like indigo. Wood declines and fears Metal, so death occurs in Autumn. Li Yun: Sorrow is also the Will of the Lung, but it injures the Liver because Metal chops Wood.
"Fei Xi Le ... dies in Summer": The *Jia Yi Jing* writes "Yi Bu Cun Qi Ren". Jian An: "Qi Ren" seems to connect to the next sentence. Zhang Jingyue said: Joy is originally the Will of the Heart, but it also injures the Lung because violent joy injures Yang, and Fire pathogen attacks Metal. The Lung stores Po; Po injury causes Shen chaos and madness. "Yi bu Cun Ren" means acting as if no one else is present. Injuries to the Five Zang all cause hair and skin emaciation, but here it specifically mentions leather and skin scorched because skin and hair are the exterior of the Lung, and the condition is worse than others. The Se-tian color of the Lung: White should be like goose feathers, not like salt. Metal declines and fears Fire, so death occurs in Summer.
"Shen Sheng Nu ... dies in Late Summer": Zhang Jingyue said: Anger is originally the Will of the Liver, but it also injures the Kidney because Liver and Kidney are Mother and Child, and their Qi connects. The Kidney stores Zhi; Zhi injury causes loss of Yi (Intention) and forgetfulness of previous words. Inability to bend, extend, lean, or stretch the waist and spine occurs because the waist is the mansion of the Kidney. The Se-tian color of the Kidney: Black should be like heavy lacquer, not like earthy cyan. Water declines and fears Earth, so death occurs in Late Summer.
"Fear without resolution ... Jing spontaneously leaks": Zhang Jingyue said: This also discusses injury to the Heart and Kidney. Although excessive anger is said to injure the Kidney, fear is the root of the Kidney. Fear injures Zhi, causing Qi to sink and descend, thus injuring Jing. The Kidney governs bone, so Jing injury causes bone weakness. Wei is deficiency of Yang; Jue is decline of Yang. If the Ming Men (Gate of Life) is not secured, Jing spontaneously leaks. Although this is a disease of Kidney injury, the *Xie Qi Zang Fu Bing Xing* chapter says: "Worry and fear injure the Heart." The earlier text said: "Shen injury causes fear, flowing and overflowing without stopping." The meaning is consistent with this. Li Yun: This is also Kidney injury, specifically injured by its own Zang's Will, differing from the previous ones. Failure of closure and storage means Jing leaks spontaneously without sexual stimulation. Zhi notes: The previous section discussed injuring the Kidney's Will; this section discusses injuring the Kidney's Jing. Since Hun, Po, Zhi, and Yi originate from the Shen and Jing of Heart and Kidney, the first part says fear and anxiety injure Shen, and the last part says unresolved fear injures Jing. Shen is born from Jing, and Jing returns to Shen.
"Therefore, the Five Zang ... cannot be treated": Zhang Jingyue said: This continues the question from the beginning of the chapter. In all acupuncture, one must observe the patient's morphology to determine what can and cannot be needled. If the Shen and Jing of the Five Zang are already damaged, one must not recklessly use needles. Thus, the *Xie Qi Zang Fu Bing Xing* chapter says: "For all small pulses, Yin-Yang, Form, and Qi are all deficient; do not use needles, but regulate with sweet medicines." The *Gen Jie* chapter says: "Form and Qi are deficient, Disease Qi is deficient; this is deficiency of Yin-Yang Qi, cannot be needled."
"The Liver stores Blood": Zhang Jingyue said: The *Xuan Ming Wu Qi* chapter says: The Liver stores Hun. The *Wu Zang Sheng Cheng* chapter says: When humans sleep, blood returns to the Liver. The *Tiao Jing Lun* says: The Liver stores Blood. Blood excess leads to anger; deficiency leads to fear.
"The Spleen stores Ying ... Jing and Xiao are not smooth": Zhang Jingyue said: Ying emerges from the Middle Jiao, receives Qi and extracts juices, transforms and turns red, becoming Blood. Hence, "The Spleen stores Ying." Ying houses Yi, meaning the Spleen stores Yi. Spleen deficiency causes the four limbs to be useless and the Five Zang to be uneasy, because the Spleen governs the four limbs and is the source of the Five Zang. The Taiyin Meridian enters the abdomen and connects with the Stomach; thus, Spleen excess causes abdominal distension and Jing/Xiao (urination and defecation) obstruction. The *Tiao Jing Lun* says: Form excess causes abdominal distension and Jing/Xiao obstruction. "Jing" should be read as "Jing" (channel/ditch). Jian An: The *Jia Yi Jing* writes "Jing" as "Jing". The *Jue Lun* also writes "Jing".
"The Heart stores Mai (Pulse/Vessels)": Zhang Jingyue said: The *Xuan Ming Wu Qi* chapter says: The Heart governs the Mai. The *Tiao Jing Lun* says: The Heart stores Shen. Shen excess leads to incessant laughter; deficiency leads to sorrow.
"The Lung stores Qi ... Chest fullness and仰息 (breathing with head tilted back)": Zhang Jingyue said: Chuan He means rapid breathing and coarse voice. Xiong Ying means chest fullness/distension. Yang Xi means panting with the head tilted back. The *Xuan Ming Wu Qi* chapter says: The Lung stores Po. The *Tiao Jing Lun* says: Qi excess causes wheezing, coughing, and rebellious Qi; deficiency causes easy breathing but shortness of breath. The *Jia Yi Jing* writes "Ying" as "Ping". Annotation: *Jiu Xu* writes "Ying".
"The Kidney stores Jing ... Excess causes distension": Zhang Jingyue said: The *Jiu Zhen Lun* says: The Kidney stores Jing and Zhi. The *Tiao Jing Lun* says: The Kidney stores Zhi. Zhi excess causes abdominal distension and undigested stool diarrhea; deficiency causes Jue (cold extremities/reversal).
"Five Zang Uneasy ... regulate them": Zhang Jingyue said: The previous chapter discussed emotional injuries; this distinguishes Five Zang Excess and Deficiency. Therefore, for any Five Zang uneasiness, one must examine the pathology, excess/deficiency, and emotional association, then regulate according to the specific Zang. This summarizes the previous chapter and presents the treatment method.