夫百病（止）得脏而有名 马云。夫百病必始于外感内伤。
故燥湿寒暑风雨者。外感也。阴阳喜怒饮食居处者。内伤也。邪气相合于脏而病形成。得其分脏而病名别。张
云。气合而有形。脉证可据也。得脏而有名。表里可察也。
旦慧昼安 夕加夜甚 春秋繁露云。病者至夜而病愈甚。出同类相动篇。
春生夏长（止）故甚也 张云。春之生。阳气升也。夏之长。阳气盛也。秋之收。阳气降也。冬之藏。
阳气伏也。是气之常。皆以阳气为言也。天地之交。四时之序。惟阴阳升降而尽之矣。自子之后。太阳从左而
升。升则为阳。自午之后。太阳从右而降。降则为阴。大而一岁。小而一日。无不皆然。故一日亦分四时也。
朝时太阳在寅卯。自下而上。在人应之。阳气正升。故病气衰而旦慧。日中太阳在巳午。自东而中。在人应之。
阳气正盛。故能胜邪而昼安。夕时太阳在申酉。由中而昃。在人应之。阳气始衰。故邪气渐盛。而暮加重。夜
半太阳在戌亥。自上而降。在人应之。阳气伏藏。邪气正盛。故夜则甚。盖邪气之轻重。由于正气之盛衰。正
气者阳气也。升则从阳。从阳则生。降则从阴。从阴则死。天人之气。一而已矣。
其时有反者何也（止）逆者为粗 独主甚病。诸本作独主其病。此本误。当改。马云。帝疑病有旦昼。
或加或甚。而夕夜或慧或安者。故伯言此乃脏气独主其病。而不应一日分为四时之气也。如脾病不能胜旦之木。
肺病不能胜昼之火。肝病不能胜夕之金。心病不能胜夜之水。故为加为甚也。若人之脏气。能胜时之气。如肺
气能胜旦之木。肾气能胜昼之火。心气能胜夕之金。脾气能胜夜之水。故至昼慧旦安也。治之者。能顺其时。
如脾病不能胜旦之木。则补脾而泻肝。肺病不能胜昼之火。则补肺而泻心。肝病不能胜夕之金。则
补肝而泻肺。心病不能胜夜之水。则补心而泻肾。斯病可与期也。彼粗工者。则逆之而已。恶足以知此。
五脏有五变（止）以应五时 志云。五脏有五变者。有五时五行五音五色之变异。五变有五输者。一
脏之中。有春刺荥。夏刺输。长夏刺经。秋刺合。冬刺井之五输。故五五有二十五输。以应五时也。
肝为牡脏 张云。肝属木。为阴中之少阳。故曰牡脏。
心为牡脏 张云。心属火。为阳中之太阳。故曰牡脏。
脾为牝脏 张云。脾属土。为阴中之至阴。故曰牝脏。
肺为牝脏 张云。肺属金。为阳中之少阴。故曰牝脏。
肾为牝脏 张云。肾属水。为阴中之太阴。故曰牝脏。按、五脏配合五行。而惟肝心为牡脏。脾肺肾
皆为牝脏。盖木火为阳。土金水皆为阴也。
黄帝曰以主五输奈何 马云。缺、岐伯曰。张志同。
脏主冬（止）秋刺合 张云。五脏主藏。其气应冬。井之气深。亦应于冬。故凡病之在脏者。当取各经
之井穴也。五色蕃华。其气应春。荥穴气微。亦应乎春。故凡病见于色者。当取各经之荥也。五时长养。其气
应夏。输穴气盛。亦应于夏。故凡病之时作时止者。当取各经之输也。五音繁盛。气应长夏。经穴正盛。亦应
长夏。故凡病在声音者。当取各经之经也。五味成熟。以养五脏。其气应秋。合穴气敛。亦应于秋。故凡经满
而血者病在胃。及因饮食内伤者。当取各种之合也。按、本篇五时之刺。以应五输者。冬刺井。春刺荥。夏刺
输。长夏刺经。秋刺合者。以井应冬。荥应春。输应夏。经应长夏。合应秋也。如本输四时气水热穴等论所载。
皆同。不可易者。考之六十五难曰。井者东方春。合者北方冬也。七十四难曰。经言春刺井。夏刺荥。季夏刺
俞。秋刺经。冬
刺合。皆与本经不合。必难经之误也。当以本经为正。不可不辨。
以经合之 张云。上文止言五脏五输。以应五时。而不及六腑之原者。盖原合于经。不复应时。如长
夏之刺经。则原在其中。应其数矣。是即六腑之六输也。按、本输篇所载。六腑之原。在九针十二原篇。即谓
之。故六十六难曰。以 为原也。后世针灸诸书宗之。皆言阳经之 即为原。故治 即所以治原。阴经之
并于原。故治原即所以治输。今此节云。以经合之。以应其数。然则经原 三穴相邻。经亦可以代原矣。
经满而血者病在胃 甲乙注。经、作络。胃、作胸。志云。肺与阳明主秋金之令。饮入于胃。上输于
肺。食气于胃。淫精于脉。脉气流经。经气归于肺。肺朝百脉。输精于皮毛。毛脉合精。行气于肺。而通于四
脏。是入胃之饮食。由肺气通调输布。而生此荣卫血脉。故经满而血者。病在胃。饮食不节者。肺气不能转输
而得病也。按、灵素经中。凡论五脏必兼论胃腑。以胃为五脏之生原也。肺与阳明。并主秋令。此章以腑合脏。
而脏合于四时。五行味主秋。则秋令所主之脏腑。皆隐于中矣。简案、以阳明配秋。盖出于运气。疑非经旨。
此节马张不释。姑仍志注。
是谓五病也 诸本病、作变。此根据张本。误。当改。
百病（止）得脏而有名：马云。夫百病必始于外感内伤。
因此，燥、湿、寒、暑、风、雨属于外感病因；阴、阳、喜、怒、饮食、居处属于内伤病因。邪气与脏腑相合而疾病形成，根据所侵犯的特定脏腑不同，病名也就有所区别。张云。气机相合而显现出形体症状，脉象和证候可以作为依据；病变归属于特定脏腑，表里关系就可以被察知。
旦慧昼安 夕加夜甚：春秋繁露云。病者在夜间病情加重。出自《同类相动篇》。
春生夏长（止）故甚也：张云。春季的生发，是阳气上升；夏季的生长，是阳气旺盛；秋季的收敛，是阳气下降；冬季的闭藏，是阳气潜伏。这是气的常规变化，都是就阳气而言的。天地之间的交互，四季的顺序，完全通过阴阳的升降来体现。自子时之后，太阳从左方升起，升则为阳；自午时之后，太阳从右方降落，降则为阴。大到一年，小到一天，没有不是这样的。所以一天也可以分为四个时段。
早晨时，太阳位于寅卯位，由下向上，人体与之相应，此时阳气正在上升，所以病气衰退，清晨患者感觉清醒舒适；中午时，太阳位于巳午位，由东向正中，人体与之相应，此时阳气正盛，所以能战胜邪气，白天患者安宁；傍晚时，太阳位于申酉位，由正中向西斜落，人体与之相应，此时阳气开始衰退，所以邪气逐渐强盛，傍晚病情加重；半夜时，太阳位于戌亥位，由上向下潜降，人体与之相应，此时阳气伏藏，邪气正盛，所以夜间病情严重。大概邪气的轻重，取决于正气的盛衰。正气就是阳气，阳气上升则顺从阳道，顺从阳道则生机旺盛；阳气下降则顺从阴道，顺从阴道则趋向死亡。天人的气机，本质是一样的。
其时有反者何也（止）逆者为粗：独主甚病。诸本作“独主其病”，此本有误，应当改正。马云。皇帝疑惑为什么疾病在清晨或白天，有的加重有的严重，而在傍晚或夜晚，有的清醒有的安宁？所以伯高说这是因为脏气单独主导了疾病，而不符合一天分为四时之气的规律。比如脾病不能胜过清晨属木的时令之气，肺病不能胜过白昼属火的时令之气，肝病不能胜过傍晚属金的时令之气，心病不能胜过夜晚属水的时令之气，所以出现加重或严重的情况。如果人的脏气能够胜过时令之气，比如肺气能胜过清晨属木的时令之气，肾气能胜过白昼属火的时令之气，心气能胜过傍晚属金的时令之气，脾气能胜过夜晚属水的时令之气，所以到了白天就清醒，清晨就安宁。治疗的人，如果能顺应这种时机，比如脾病不能胜过清晨属木的时令之气，就补脾脏而泻肝脏；肺病不能胜过白昼属火的时令之气，就补肺脏而泻心脏；肝病不能胜过傍晚属金的时令之气，就补肝脏而泻肺脏；心病不能胜过夜晚属水的时令之气，就补心脏而泻肾脏。这样疾病就可以预期痊愈。那些粗劣的医生，则是违背这一原则罢了，哪里足以懂得这个道理。
五脏有五变（止）以应五时：志云。五脏有五变，是指有五时、五行、五音、五色等的变异。五变对应五输穴，是指在一脏之中，有春季刺荥穴、夏季刺输穴、长夏刺经穴、秋季刺合穴、冬季刺井穴的五种输穴。所以五五共有二十五输穴，以对应五个时节。
肾为牝脏：张云。肾属水，为阴中之太阴，所以称为牝脏。按语：五脏配合五行，只有肝和心是牡脏，脾、肺、肾都是牝脏。大概因为木和火属阳，土、金、水都属阴。
脏主冬（止）秋刺合：张云。五脏主收藏，其气应于冬季。井穴之气深沉，也对应冬季，所以凡是病在脏的，应当取各经的井穴。五色荣华，其气应于春季。荥穴之气微弱，也对应春季，所以凡是病表现在面色上的，应当取各经的荥穴。五时长养万物，其气应于夏季。输穴之气旺盛，也对应夏季，所以凡是病有时发作有时停止的，应当取各经的输穴。五音繁盛，其气应于长夏。经穴之气正盛，也对应长夏，所以凡是病在声音上的，应当取各经的经穴。五味成熟以滋养五脏，其气应于秋季。合穴之气收敛，也对应秋季，所以凡是经脉满溢而有血的病，或者病在胃腑，以及因饮食内伤的，应当取各种经的合穴。按语：本篇关于五时之刺以对应五输的说法，即冬刺井、春刺荥、夏刺输、长夏刺经、秋刺合，是因为井应冬、荥应春、输应夏、经应长夏、合应秋。如《本输》、《四时气》、《水热穴》等论中记载的，都相同，不可更改。考证《难经·六十五难》说：“井者东方春，合者北方冬。”《难经·七十四难》说：“经言春刺井，夏刺荥，季夏刺俞，秋刺经，冬刺合。”这些都与本经不合，必定是《难经》的错误。应当以本经为准，不可不辨明。
以经合之：张云。上文只讲了五脏五输以对应五时，而没有提到六腑的原穴。大概原穴合于经穴，不再单独对应时节，比如长夏刺经穴，原穴就在其中，应合其数了。这就是六腑的六输穴。按语：《本输》篇所载，六腑的原穴，在《九针十二原》篇中，就称之为原。所以《六十六难》说：“以...为原。”后世针灸诸书尊崇它，都说阳经的...即为原穴，所以治...就是治原穴；阴经的原穴并入了输穴，所以治原穴就是治输穴。现在这一节说“以经合之，以应其数”，那么经穴、原穴、...三穴相邻，经穴也可以代替原穴了。
经满而血者病在胃：《甲乙经》注。经，作络。胃，作胸。志云。肺与阳明主秋金之令。饮入于胃，上输于肺；食气于胃，淫精于脉。脉气流经，经气归于肺，肺朝百脉，输精于皮毛。毛脉合精，行气于肺，而通于四脏。这是进入胃的饮食，由肺气通调输布，而生此营卫血脉。所以经脉满溢而有血的病，病根在胃。饮食不节的，肺气不能转输而导致生病。按语：《灵枢》和《素问》中，凡是论述五脏必然兼论胃腑，因为胃是五脏生命的本源。肺与阳明，共同主管秋令。这一章以腑合脏，而脏合于四时，五行味主秋，那么秋令所主的脏腑，都隐含在其中了。简案：以阳明配属秋季，大概出于运气学说，怀疑不是经典的本意。这一节马莳和张介宾没有解释，姑且保留志的注释。
是谓五病也：诸本“病”字，作“变”字。此根据张本，有误，应当改正。
Hundred diseases (stop) are named according to the affected Zang organ: Ma Yun. All hundred diseases must originate from external contraction or internal injury.
Therefore, dryness, dampness, cold, heat, wind, and rain belong to external contraction; Yin, Yang, joy, anger, diet, and living conditions belong to internal injury. When pathogenic factors combine with the Zang organs, disease forms; based on the specific Zang organ involved, the disease name is distinguished. Zhang Yun. Qi combines to manifest physical symptoms, which can be verified by pulse and signs; lesions attributed to specific Zang organs allow the observation of interior-exterior relationships.
Clear in the morning, peaceful during the day, aggravated in the evening, severe at night: *Chunqiu Fanlu* states. Patients experience worsening of illness at night. Cited from the chapter "Lei Lei Xiang Dong".
Spring generates, Summer grows (stop) therefore it becomes severe: Zhang Yun. The generation of Spring corresponds to the rising of Yang Qi; the growth of Summer corresponds to the flourishing of Yang Qi; the harvesting of Autumn corresponds to the descending of Yang Qi; the storing of Winter corresponds to the hiding of Yang Qi. This is the normal cycle of Qi, all described in terms of Yang Qi. The interaction between Heaven and Earth, and the sequence of the four seasons, are fully expressed through the ascending and descending of Yin and Yang. After the Zi hour, the Sun rises from the left, rising constitutes Yang; after the Wu hour, the Sun descends from the right, descending constitutes Yin. Whether large as a year or small as a day, this principle applies universally. Thus, one day can also be divided into four phases.
In the morning, the Sun is in the Yin-Mao positions, rising from below; the human body responds to this. As Yang Qi is just rising, pathogenic Qi declines, so the patient feels clear-headed in the morning. At noon, the Sun is in the Si-Wu positions, moving from east to center; the human body responds. As Yang Qi is at its peak, it overcomes pathogenic Qi, so the patient is peaceful during the day. In the evening, the Sun is in the Shen-You positions, slanting from the center; the human body responds. As Yang Qi begins to decline, pathogenic Qi gradually strengthens, so the condition worsens at dusk. At midnight, the Sun is in the Xu-Hai positions, descending from above; the human body responds. As Yang Qi is hidden and stored, pathogenic Qi is strong, so the condition is severe at night. Generally, the severity of pathogenic Qi depends on the strength of Healthy Qi. Healthy Qi is Yang Qi; when rising, it follows the Yang path, leading to life; when descending, it follows the Yin path, leading to death. The Qi of Heaven and Humanity is essentially one.
Why are there times when this pattern is reversed (stop) those who go against it are crude: [The text implies] exclusively managing severe diseases. Most editions read "exclusively manages its disease," but this edition has an error and should be corrected. Ma Yun. The Emperor wondered why illnesses might aggravate or become severe in the morning or day, yet become clear or peaceful in the evening or night. Therefore, Bo Gao stated that this is because the Zang Qi exclusively dominates the disease, not conforming to the division of one day into four seasonal Qi patterns. For example, Spleen disease cannot overcome the Wood Qi of early morning; Lung disease cannot overcome the Fire Qi of midday; Liver disease cannot overcome the Metal Qi of evening; Heart disease cannot overcome the Water Qi of night. Hence, they aggravate or become severe. If the person's Zang Qi can overcome the seasonal Qi—for instance, Lung Qi overcoming the Wood Qi of morning, Kidney Qi overcoming the Fire Qi of midday, Heart Qi overcoming the Metal Qi of evening, Spleen Qi overcoming the Water Qi of night—then they will feel clear in the day and peaceful in the morning. A practitioner who can follow these timings can treat accordingly: if Spleen disease cannot overcome the Wood Qi of morning, tonify the Spleen and drain the Liver; if Lung disease cannot overcome the Fire Qi of midday, tonify the Lung and drain the Heart; if Liver disease cannot overcome the Metal Qi of evening, tonify the Liver and drain the Lung; if Heart disease cannot overcome the Water Qi of night, tonify the Heart and drain the Kidney. In such cases, recovery can be expected. Crude practitioners merely act against these principles; how could they understand this?
The Five Zang have five transformations (stop) to correspond to the five times: Zhi Yun. The "five transformations" of the Five Zang refer to variations in the five times, five elements, five tones, and five colors. The five transformations correspond to the five Shu points: within one Zang, there are Ying-Spring points for Spring, Shu-Stream points for Summer, Jing-River points for Late Summer, He-Sea points for Autumn, and Jing-Well points for Winter. Thus, five times five make twenty-five Shu points, corresponding to the five seasons.
Liver is a Male Organ: Zhang Yun. The Liver belongs to Wood and is the Lesser Yang within Yin, hence called a Male Organ.
Heart is a Male Organ: Zhang Yun. The Heart belongs to Fire and is the Supreme Yang within Yang, hence called a Male Organ.
Spleen is a Female Organ: Zhang Yun. The Spleen belongs to Earth and is the Ultimate Yin within Yin, hence called a Female Organ.
Lung is a Female Organ: Zhang Yun. The Lung belongs to Metal and is the Lesser Yin within Yang, hence called a Female Organ.
Kidney is a Female Organ: Zhang Yun. The Kidney belongs to Water and is the Supreme Yin within Yin, hence called a Female Organ. Note: The Five Zang correspond to the Five Elements, but only the Liver and Heart are Male Organs, while the Spleen, Lung, and Kidney are Female Organs. This is because Wood and Fire are Yang, while Earth, Metal, and Water are Yin.
Yellow Emperor asked: How to govern the five Shu points? Ma Yun. [Text missing]. Qi Bo said. Zhi Zhong [agrees].
Zang governs Winter (stop) Autumn punctures He-Sea: Zhang Yun. The Five Zang govern storage, their Qi corresponds to Winter. The Qi of Jing-Well points is deep, also corresponding to Winter. Therefore, for diseases located in the Zang organs, one should select the Jing-Well points of the respective meridians. The brilliance of five colors corresponds to Spring. The Qi of Ying-Spring points is slight, also corresponding to Spring. Therefore, for diseases manifesting in facial color, one should select the Ying-Spring points of the respective meridians. The nourishment of the five seasons corresponds to Summer. The Qi of Shu-Stream points is vigorous, also corresponding to Summer. Therefore, for diseases that come and go intermittently, one should select the Shu-Stream points of the respective meridians. The prosperity of five tones corresponds to Late Summer. The Qi of Jing-River points is at its peak, also corresponding to Late Summer. Therefore, for diseases involving voice/sound, one should select the Jing-River points of the respective meridians. The ripening of five flavors nourishes the Five Zang, their Qi corresponds to Autumn. The Qi of He-Sea points is convergent, also corresponding to Autumn. Therefore, for conditions where meridians are full and blood is present, or diseases in the Stomach, or injuries due to diet, one should select the He-Sea points of the various meridians. Note: The puncturing of the five times corresponding to the five Shu points in this chapter—Winter punctures Jing-Well, Spring punctures Ying-Spring, Summer punctures Shu-Stream, Late Summer punctures Jing-River, Autumn punctures He-Sea—is because Jing corresponds to Winter, Ying to Spring, Shu to Summer, Jing to Late Summer, and He to Autumn. Records in chapters such as *Ben Shu*, *Si Shi Qi*, and *Shui Re Xue* are identical and immutable. Examining *Nan Jing Chapter 65*: "Jing is East Spring, He is North Winter." *Nan Jing Chapter 74*: "The Classic says Spring punctures Jing, Summer punctures Ying, Late Summer punctures Shu, Autumn punctures Jing, Winter punctures He." These contradict this Classic and must be errors in *Nan Jing*. One must take this Classic as correct and distinguish them clearly.
Combine with the Meridian: Zhang Yun. The previous text only discussed the Five Zang and five Shu points corresponding to the five times, without mentioning the Yuan-Source points of the Fu organs. This is because Yuan-Source points merge with the Jing-River points and do not independently correspond to seasons; for example, puncturing the Jing-River point in Late Summer includes the Yuan-Source point, satisfying the number. These are the six Shu points of the Six Fu organs. Note: In the *Ben Shu* chapter, the Yuan-Source points of the Six Fu organs are recorded in the *Jiu Zhen Er Shi Yi Yuan* chapter, referred to as Yuan. Thus, *Nan Jing Chapter 66* states: "...is the Yuan." Later acupuncture books followed this, stating that for Yang meridians, ... is the Yuan point, so treating ... is treating the Yuan point; for Yin meridians, the Yuan point merges with the Shu point, so treating the Yuan point is treating the Shu point. Now this section says "combine with the meridian to correspond to the number." Since the Jing-River, Yuan-Source, and ... points are adjacent, the Jing-River point can also substitute for the Yuan-Source point.
When the meridian is full and blood is present, the disease is in the Stomach: *Jia Yi Jing* annotation. "Meridian" reads as "Luo"; "Stomach" reads as "Chest". Zhi Yun. The Lung and Yangming govern the command of Autumn Metal. Drinks enter the Stomach and are transported upward to the Lung; food qi enters the Stomach and diffuses essence into the vessels. Vessel qi flows through the meridians, and meridian qi returns to the Lung. The Lung faces all vessels, transmitting essence to skin and hair. Skin and vessel qi combine, circulating qi in the Lung, and connecting to the Four Zang. Thus, food and drink entering the Stomach are regulated and distributed by Lung Qi, generating this Ying-Wei blood and vessels. Therefore, when meridians are full and blood is present, the disease root lies in the Stomach. Irregular diet causes Lung Qi to fail in transformation and transport, leading to illness. Note: In *Ling Shu* and *Su Wen*, discussions of the Five Zang always include the Stomach Fu, because the Stomach is the source of life for the Five Zang. The Lung and Yangming jointly govern the Autumn command. This chapter matches Fu with Zang, and Zang with the four seasons; the Five Flavors govern Autumn, so the Zang-Fu governing the Autumn command are implicitly included here. Brief comment: Matching Yangming with Autumn likely stems from the theory of Five Movements and Six Qi, and is suspected not to be the original intent of the Classic. Ma Shi and Zhang Jiebin did not explain this section; we retain Zhi's annotation tentatively.
This is called the five diseases: Most editions read "Bian" (transformation) instead of "Bing" (disease). Based on Zhang's edition, this is an error and should be corrected.