人生本于天地气化
《素问·生气通天论》帝曰∶自古通天者，生之本，本于阴阳。天地之间，六合之内，其气九州、九
窍、五脏、十二节，皆通乎天气。其生五，其气三，数犯此者，则邪气伤人，此寿命之本也。苍天之气清净，
则志意治，顺之则阳气固，虽有贼邪，勿能害也，此因时之序。故圣人传精神、服天气，而通神明。失之则内
闭九窍，外壅肌肉，卫气散解，此谓自伤，气之削也。
此总标外感、内伤所由起也。人与天地同根，故形气之在天地间、六合内者，有九州；在人身者，有九窍，
有五脏、十二节，皆通乎天气者也。所禀以生者，有金木水火土五行之气；所赖以养者，有三阴三阳之生化万
物也。其阴阳五行，气化流行，必有衰旺偏驳，偏驳者为邪气。若不善调理，数犯其邪气，则伤人。故天地之
气化，为人生寿命之本也。若人身之气，能如苍天之气之清净，则心神和而志意治，其身中阳气固密，虽有贼
邪，勿能为害，此为顺天时气化之序。故圣人传教，以养精神、服天气，而通神明也。如失之而受邪，则内闭
九窍，外壅肌肉，卫气散解，此谓自伤，而元气削也。推原其要，在清净而治意志，为却病养生之道也。
阳气者，若天与日，失其所，则折寿而不彰，故天运当以日光明。是故阳，因而上，卫外者也。欲如运枢，
起居如惊，神气乃浮。因于暑，汗，烦则喘喝，静则多言；因于寒，体若燔炭，汗出而散；因于湿，首如裹，
湿热不攘，大筋软短，小筋弛长，软短为拘，弛长为痿；因于气，为肿，四维相代，阳气乃竭。
此承上文，言人身阳气当如苍天之清净，与日之光明，则心神和而志意治，如失其所，则折寿，而神明不
彰矣。故天之健运而不息者，以天体清净，而日光明照也，人能心净气清，则神光自然彰明矣。良以人身阳气
根于阴，自下而上升，外行以为卫也。升必有降，内外周流，欲如机枢之运转，而循环不息者，起居如有惊扰，
则神劳气动，而阳不固密，外邪因而伤之。若因伤于暑者，暑当与汗俱出勿止，盖暑由火湿合化，汗出而湿去，
火亦得泄也，若火盛上炎，则心烦而肺气喘喝，或气平静而心火不宁，则必多言；若因伤于寒邪，表阳被遏、
则身热如燔炭，仲景所云脉紧身热无汗为伤寒，用麻黄汤发汗，汗出则解散矣，此言阳经伤寒者，若寒伤阴经，
则无身热头痛，非可发汗也；若因伤于湿者，地之湿气，下先受之，雾露湿邪，上先受之，湿邪蒙蔽清阳，则
头目昏重，如被包裹之状，湿侵筋脉，阳郁化热，而不急为攘除，则筋伤而大筋软短，小筋弛长，乃成拘挛痿
之病矣；因于气为肿者，其湿不伤筋而伤阳气也，盖脾为太阴湿土，而主肌肉，湿邪伤阳而脾困，则肌肉肿
矣，脾土旺于辰戌丑未四季，为一岁之纲维者，脾伤身肿，而遇四维土旺之时不愈，至旺气过而时令相代，
则阳气竭而死，故曰∶四维相代，阳气乃竭也。旧注四维解作筋骨血肉，或解作四肢，而筋骨血肉与四肢，又
如何相代？则全无义理可通矣。况《至真要大论》岐伯曰∶夫气之生，与其化，衰盛异也。寒暑温凉，盛衰
之用，其
在四维。盖言寒暑温凉之气流行，有盛衰而后有变化，当变化之际，在辰戌丑未之四季，而立春夏秋冬之四时，
故土旺四季，而为一岁之纲维也。所以然者，春夏秋冬是木火金水四气，金木水火互相克贼，必赖四季之土于
中调理维持，方成造化之功，故曰∶盛衰之用，其在四维。观此，其义理岂不确然可证乎！
阳气者，烦劳则张，精绝，辟积于夏，使人煎厥，目盲不可以视，耳闭不可以听，溃溃乎若坏都，汨汨乎
不可止。阳气者，大怒则形气绝，而血菀于上，使人薄厥。有伤于筋，纵，其若不容，汗出偏沮，使人偏枯。
汗出见湿，乃生痤 。高粱之变，足生大疔，受如持虚。劳汗当风，寒薄为 ，郁乃痤。
上节言外邪所伤，此明劳欲所伤也。篇首云清净则志意治而阳气固，若烦劳不息，则阳气鸱张，化为邪火，
火炽则水耗，水者，精血所由生也，其水渐耗，而至精绝不生，其邪僻之气蓄积，而至夏令火旺之时，身中灼热
如煎，而经脉郁闭，阳气不得周行四肢，故反厥冷，名曰煎厥，俗称骨蒸干血劳者也。目得血而能视，精血枯，
故目盲，精脱者耳聋，故气闭不通，而耳不能听，伤损至此，身如溃败之坏都，而气血流散，如无防之水，汨
汨乎不可止遏而收摄，虽有药石，莫能治矣。若肝为刚脏，藏血而属木，主春升之气，大怒则肝气逆，而其充
形之气机遏绝，血随气郁，而菀结于上焦，因而营卫闭塞，经脉不通，使人薄厥者，怒气急迫暴厥也。肝主筋，
故致有伤于筋，而弛纵不能束骨，则行立战掉，其若不能整容也。夫气主煦之，血主濡之，阳气乖逆，则营卫
不和，而汗出偏沮，沮者，漏泄也，《月令》所
云∶地气沮泄，是津液不能周流，乃从或左或右而漏泄，以成偏枯之证也。以上皆言情欲所伤者也。如或汗
出腠开之时，而受湿邪，逆闭营气，乃生痤 、疮疖之类也。其有素贪高粱浓味而致伤者，足以生大疔毒，不
止痤 而已，良以日逐所蕴邪热，如持虚空之器而受物，其积蓄深也。若因劳汗出，而当风寒迫郁表阳，或为
为痤，俗称粉痣之类，皆浅在皮腠，尚无大害也。
阳气者，精则养神，柔则养筋，开阖不得，寒气从之，乃生大偻。陷脉为 ，留连肉腠。俞气化薄，传为
善畏，及为惊骇。营气不从，逆于肉里，乃生痈肿。魄汗未尽，形弱而气烁，穴俞以闭，发为风疟。故风者，
百病之始也，清净则肉腠闭拒，虽有大风苛毒，弗之能害，此因时之序也。故病久则传化，上下不并，良医弗
为。故阳蓄积病死，而阳气当膈，膈者当泻，不亟正治，粗乃败。
以上皆题阳气，谓阴阳两平，中和之气也。其中和而精粹者，以养心神，中和而柔润者，以养筋骨，敷布
周流，内自脏腑，外达经络，表里阴阳，循环无间者也，太阳为开，阳明为阖，少阳为枢，太阴为开，厥阴为
阖，少阴为枢，如气有乖逆，而升降开阖，不循轨则，外寒因而从之，使筋脉拘急，乃生大偻者，大体伛偻不
伸也。如或邪陷血脉，营气郁结，则成瘰 、鼠 等疮。如邪留连肉腠，与穴俞之气逼迫，久而侵入五内，
传为善畏惊骇之病，乃肝胆伤也。若营气不从轨则，逆于肉里，乃生痈肿也。肺藏魄，皮毛为肺之合，汗出毛
窍，乃名魄汗，汗出未尽者，由形气内弱，而邪风外加，穴俞以闭，乃发为风疟也。凡六气之邪伤人必兼风，
以风性尖利而易入，故风为百病之始也。若身中阳气清净而固密，则肉腠闭拒，虽有大风苛毒，弗能为害，
此因顺时序之气化也。大风苛毒，即《灵枢·九宫八风篇》所云
之虚风贼邪，故曰邪之所凑，其气必虚。至病久而邪传化，则上升下降，阴阳相格，而不相并，谓阴阳不相交
通，病至如此，虽有良医，弗能为矣。故其阳气化为邪气，蓄积至于病死，而邪阳之气郁结当膈，是当及早泻
之，乃不急急正治，而为粗工所败者也。
故阳气者，一日而主外∶平旦人气生，日中而阳气隆，日西而阳气虚，气门乃闭。是故暮而收拒，无扰筋
骨，无见雾露。反此三时，形乃困薄。
此总结上文之义也。上言阳因而上，卫外者也，故此专言卫阳之气，昼行于身之阳分，故一日而主外。平
旦自阴而出于阳，其气始生，日中而阳气隆盛，日西则又入于阴，故外卫之阳气虚，气门乃闭。是故暮而阳气
内收以拒外，无扰动筋骨，以伤内气也。表阳既虚，无见雾露阴湿之气，以伤外体也。如不知早、午、暮三时
阳气出入之序，而反逆之，则形气乃困迫而致委顿矣。此申明外邪所伤，必由阳气内乏之故，以应上文阳气固
密，外邪弗能为害之义也。
岐伯曰∶阴者，藏精而起亟也；阳者，卫外而为固也。阴不胜其阳，则脉流薄疾，并乃狂；阳不胜其阴，
则五脏气争，九窍不通。是以圣人陈阴阳，筋脉和同，骨髓坚固，气血皆从。如是则内外调和，邪不能害，耳
目聪明，气立如故。
此又申明阴阳互根之理，以表必使和平，不可偏胜也，经中反复详明，无非斯旨。自朱丹溪造阳常有余
阴常不足之论，至张景岳又反其说，云阳常不足阴常有余，两家虽各有见解，不免晦经旨而迷后学也。此节专
标阴阳偏胜之病，尤为明着。盖阴阳之气，出于命蒂，流为营卫。命蒂，象太极也。阴阳互根于太极，
故偏亢则偏绝矣。精者，阴中之阳也，阳根于阴，故阴藏精也；起者，坤下起复也，而阴根于阳，故干下变垢也，
亟者，谓起而又起，无间断，无穷已，乃阴阳相生而不息者。其流为营卫，则营行脉中为阴，卫行脉外为阳，
故阳者，卫外而为身之固也。若有偏胜，而阴不胜其阳，则营行脉中者不足，故脉流薄弱而速疾，以阳胜而行
速也；及其甚也，气尽归并于阳，乃发狂病矣。如阳不胜其阴，而阴属脏，其气凝滞，故不得调畅而相争，清阳
不能转旋于表里，以致九窍窒塞而不通也。是故圣人备陈阴阳生化之道，必使气血流通煦润，而筋脉和同，
骨髓坚固，则内外调和，邪不能害，自然耳目聪明，元气创建如故矣。
风客淫气，精乃亡，邪伤肝也。因而饱食，筋脉横解，肠 为痔；因而大饮，则气逆；因而强力，肾气乃
伤，高骨乃坏。凡阴阳之要，阳密乃固，两者不和，若春无秋，若冬无夏，因而和之，是谓圣度。故阳强不能
密，阴气乃绝；阴平阳秘，精神乃治；阴阳离决，精气乃绝。
此明阴阳不调而致病者也。风气通于肝，风邪客之，侵淫日久，则化热而伤阴精，精乃亡，由邪伤肝也。
肝主筋，既经邪伤，而又饱食，使脾气困乏，则筋脉横解，横解者，弛懈也，脾困则生湿，湿邪下注而为肠 、
痔漏也；因而又大饮其酒，则气逆；更强用力，肾气乃伤，而督脉损，高骨乃坏，高骨，背上天柱骨也。故凡
阴阳之要，阳密乃固，若两者不和，如四时之失序，而生化之道绝矣，因而和之，是谓圣人之法度，不循圣度，
不能和也。故阳强而不静密，则偏亢而阴气偏绝；若阴气和平，阳气秘密，自然互相生化，而精神乃治也；若
阴阳析离而决裂，
精气乃绝而死矣。
因于露风，乃生寒热。是以春伤于风，邪气留连，乃为洞泄；夏伤于暑，秋为 疟；秋伤于湿，上逆而咳，
发为痿厥；冬伤于寒，春必温病。四时之气，更伤五脏。
风露之邪，必伤营卫，乃生寒热之病。凡邪之浅深传化，病变多端。是以春为风木司令，而伤于风者，
邪气留连不解，传入肠胃而成洞泄之病，以风性疏泄也；夏伤于暑者，邪客膜原，夏气外浮而不即病，至秋凉
风外束，邪不能容，乃发为 疟， 音皆， 疟者，以邪内结外闭而难出，日久不愈也；秋伤于湿之湿，是燥
字之讹，余前集《素问辨疑》已申明矣，盖肺为燥金，秋为燥令，燥伤肺液，故上逆而咳，《痿论》曰∶肺热
叶焦，发为痿 ，经气因之不周，则厥矣，若湿邪属脾，多为肿病，而无咳逆，其讹可见也；冬伤于寒者，
肾为寒水之脏，而主冬令，同气感召，邪伏于经而不即发，至春阳气上升，邪化为热，乃发为温病。此四时之
气更迭而伤五脏者，正为人身之气通乎天气，故气有驳杂，即为所伤，又有偏亢、倚伏、传变多端之病，统会
上文义理，诚详悉也。
《素问·阴阳应象大论》曰∶天有四时五行，以生长收藏，而生寒暑燥湿风。人有五脏，化五气，以生喜
怒悲忧恐。故喜怒伤气，寒暑伤形。暴怒伤阴，暴喜伤阳。厥逆上行，满脉去形。喜怒不节，寒暑过度，生乃
不固。故重阴必阳，重阳必阴。故曰∶冬伤于寒，春必温病；春伤于风，夏生飧泄；夏伤于暑，秋必 疟；
秋伤于湿，冬生咳嗽。
此明天人协议气化，以表外感内伤之由也。盖在天为气，在
地成形，皆四时五行之所生长收藏者也。寒暑燥湿风，即水火金土木之气以生者，人禀其气而生，故有五脏化
五行之气，以生喜怒悲忧恐之五情。是故纵情喜怒则伤气，外感寒暑则伤形。暴怒则气逆化火而伤阴，暴喜则
神荡气弛而伤阳。阴阳偏伤，其气厥逆而上行，则脏虚脉满，气血奔腾，势将离形而去，盖志者气之帅也，气
者体之充也，喜怒动志而暴其气，气离形体而去也。先伤气者，后必至于伤形；先伤形者，后必至于伤气。
是故喜怒不节，寒暑过度，生命乃不固也。举喜怒，则悲忧恐亦然矣；举寒暑，则燥湿风亦然矣。此内伤、
外感之病因也。重阴必阳，重阳必阴，由太极动极而静，静极而动，乃变化生成自然之道也。故曰冬伤于寒云
云者，证明前文四时之气更伤五脏之义也。如冬之阴令，而伤寒之阴邪，是为重阴，至春变为温病，即重阴必
阳之理也；春之阳令，而伤风之阳邪，是为重阳，至夏而成飧泄，是阳邪传阴，亦即重阳必阴之理也。变化之
道，皆可类推矣。
《素问·生气通天论》中黄帝问道：自古以来，能够与天相通的生命根本，在于阴阳。天地之间，六合之内，其气贯通于九州（指大地）、九窍、五脏和十二关节，都与天气相通。生命基于五行（金木水火土），气机分为三阴三阳，如果多次触犯这些规律，邪气就会伤害人体，这是寿命的根本。苍天之气若保持清净，人的意志就能调顺，顺应它则阳气固密，即使有贼邪（致病因素），也不能伤害人体，这是遵循四时时序的结果。所以圣人保养精神，服食天气，从而通达神明。如果违背了这一点，就会导致内部九窍闭塞，外部肌肉壅滞，卫气散漫解体，这叫做自我伤害，元气因此削弱。
这一段总括了外感和内伤产生的原因。人与天地同根，所以在天地间、六合内的人体形体和气机，对应大地的九州；在人身则有九窍、五脏、十二关节，这些都与天气相通。人赖以生存的是金木水火土五行之气；赖以滋养的是三阴三阳生化万物的机制。阴阳五行，气化流行，必然有盛衰偏颇，偏颇之处即为邪气。如果不善于调理，多次触犯邪气，就会伤害人体。所以天地的气化，是人的生命寿命的根本。如果人身之气能像苍天之气那样清净，那么心神调和而意志有序，体内阳气固密，虽然有贼邪，也不能为害，这是顺应天时气化的秩序。所以圣人教导人们，通过调养精神、服食天气，来通达神明。如果失于调理而受邪，就会内部九窍闭塞，外部肌肉壅滞，卫气散漫解体，这叫做自我伤害，元气被削弱。推究其关键，在于保持清净以治理意志，这是祛病养生的道理。
阳气，就像天空和太阳一样，如果失去了它的正常位置和功能，就会折损寿命而不能彰显，所以天的运行应当依靠太阳的光明。因此，阳气位于上部，负责保卫体表。它应该像门轴一样运转自如，如果起居受到惊扰，神气就会浮越。
接着承接上文，说明人身阳气应当像苍天之清净，如日之光明，这样心神调和而意志有序；如果失去其正常位置，就会折寿，神明不能彰显。所以天健运不息，是因为天体清净，日光光明照耀。人能心净气清，神光自然彰明。因为人身阳气根于阴，自下而上生发，外行以作为卫护。升必有降，内外周流，想要像机枢一样运转循环不息，如果起居如有惊扰，就会神劳气动，阳气不固密，外邪因而伤害它。如果是因暑邪所伤，暑邪应当随汗而出而不宜止住，因为暑由火湿合化，汗出则湿去，火也能得以宣泄；如果火盛上炎，就会心烦而肺气喘喝，或者气平静而心火不宁，就会多言；如果是因寒邪所伤，表阳被遏制，身体热得像燃烧的炭火，张仲景所说脉紧、身热、无汗为伤寒，用麻黄汤发汗，汗出则解散，这是说阳经伤寒者；如果寒伤阴经，就没有身热头痛，不可发汗；如果是因湿邪所伤，地之湿气先伤下部，雾露湿邪先伤上部，湿邪蒙蔽清阳，头目昏重，像被包裹的样子，湿侵筋脉，阳郁化热，如果不及时清除，就会损伤筋脉，大筋软短，小筋弛长，软短导致拘挛，弛长导致痿证；因气（此处指湿邪伤阳）导致肿胀，是因为湿不伤筋而伤阳气，脾为太阴湿土，主肌肉，湿邪伤阳而脾困，肌肉就会肿胀，脾土旺于辰戌丑未四季，是一年的纲维，脾伤身肿，如果在四维土旺之时不愈，等到旺气过去时令更替，阳气就会竭尽而死，所以说“四维相代，阳气乃竭”。旧注将四维解释为筋骨血肉，或解释为四肢，但筋骨血肉与四肢如何相代？这就毫无义理可通了。况且《至真要大论》岐伯说：气的生成与其变化，盛衰是不同的。寒暑温凉，盛衰的作用，体现在四维。是说寒暑温凉之气流行，有盛衰而后有变化，当变化之际，在辰戌丑未的四季，确立春夏秋冬的四时，所以土旺四季，作为一年的纲维。之所以如此，是因为春夏秋冬是木火金水四气，金木水火互相克贼，必须赖四季之土在中调理维持，才能成就造化之功，所以说“盛衰之用，其在四维”。看此，其义理难道不是确凿可证吗！
阳气，烦劳过度就会亢盛，精血枯竭，这种偏积到了夏天，使人发生煎厥，眼睛失明不能视物，耳朵闭塞不能听声音，溃溃然像堤坝崩溃，汨汨然不可制止。阳气，大怒就会使形气隔绝，血液郁结于上部，使人发生薄厥。如果伤了筋，筋弛纵，肢体不能随意运动，出汗偏侧（半身出汗），使人发生偏枯。出汗时遇到湿气，就会产生痤疮。长期食用肥甘厚味，足以生出大疔毒，接受邪气就像拿着空容器一样容易。劳累出汗时当风，寒气迫郁成为痱子，郁结就成为痤疮。
上一节讲外邪所伤，这一节明确劳欲所伤。篇首说清净则志意治而阳气固，如果烦劳不息，阳气就会鸱张，化为邪火，火炽则水耗，水是精血生成的来源，水逐渐消耗，直到精绝不生，邪僻之气蓄积，到了夏令火旺之时，身体灼热如煎熬，经脉郁闭，阳气不能在四肢周行，反而厥冷，名叫煎厥，俗称骨蒸干血劳。眼睛得到血才能视物，精血枯，所以目盲，精脱者耳聋，所以气闭不通，耳不能听，损伤到这种程度，身体像溃败的坏都，气血流散，像没有防备的水，汨汨然不可止遏收摄，虽然有药石，也不能治疗了。如果肝为刚脏，藏血而属木，主春升之气，大怒则肝气逆，充形之气机遏绝，血随气郁，郁结于上焦，因而营卫闭塞，经脉不通，使人薄厥，即怒气急迫暴厥。肝主筋，所以导致伤筋，筋弛纵不能束骨，行走站立颤抖，好像不能整容。气主煦之，血主濡之，阳气乖逆，营卫不和，汗出偏沮，沮者，漏泄也，《月令》所说：地气沮泄，是津液不能周流，乃从或左或右而漏泄，形成偏枯之证。以上都是讲情欲所伤。如果出汗腠开之时，受湿邪，逆闭营气，产生痤疮、疮疖之类。如果有素来贪吃高粱浓味而致伤者，足以生大疔毒，不止痤疮而已，因为每日蕴藏的邪热，如同持虚空之器受物，积蓄很深。如果因劳汗出，当风寒迫郁表阳，或为痱子，或为痤，俗称粉痣之类，都在皮腠浅处，尚无大害。
阳气，精粹则养神，柔润则养筋，开阖不得，寒气从之，就产生大偻（驼背）。邪陷脉络成为瘰疬，留连肉腠。俞穴气化逼迫，传变为善畏及惊骇。营气不从，逆于肉里，产生痈肿。魄汗未尽，形体弱而气烁，穴俞闭塞，发为风疟。所以风，是百病的开始，清净则肉腠闭拒，即使有大风苛毒，也不能伤害，这是顺应时序。所以病久则传化，上下不并（不通），良医也无能为力。所以阳气蓄积致死，而阳气当膈（阻隔），膈者应当泻，不紧急正治，粗工就会败坏病情。
以上都题咏阳气，谓阴阳两平，中和之气。其中和而精粹的，以养心神，中和而柔润的，以养筋骨，敷布周流，内自脏腑，外达经络，表里阴阳，循环无间。太阳为开，阳明为阖，少阳为枢，太阴为开，厥阴为阖，少阴为枢，如果气有乖逆，升降开阖不循轨则，外寒因而从之，使筋脉拘急，产生大偻，大体伛偻不伸。如果邪陷血脉，营气郁结，成为瘰疬、鼠瘰等疮。如果邪留连肉腠，与穴俞之气逼迫，久而侵入五内，传为善畏惊骇之病，是肝胆伤。如果营气不从轨则，逆于肉里，产生痈肿。肺藏魄，皮毛为肺之合，汗出毛窍，名叫魄汗，汗出未尽者，由形气内弱，邪风外加，穴俞闭塞，发为风疟。凡六气之邪伤人必兼风，以风性尖利而易入，故风为百病之始。如果身中阳气清净而固密，肉腠闭拒，即使有大风苛毒，也不能为害，这是顺应时序的气化。大风苛毒，即《灵枢·九宫八风篇》所说的虚风贼邪，所以说邪之所凑，其气必虚。至病久而邪传化，上升下降，阴阳相格，不相并，谓阴阳不相通，病至如此，虽有良医，无能为力。所以阳气化为邪气，蓄积至于病死，邪阳之气郁结当膈，是当及早泻之，如果不急急正治，而为粗工所败。
所以阳气，一天之中主要主管外表：平旦人气生，日中阳气隆，日西阳气虚，气门乃闭。所以傍晚阳气内收拒外，不要扰动筋骨，不要见雾露。违反这三个时辰的规律，形体就会困顿薄弱。
这一段总结上文的意义。上面说阳因而上，卫外者也，所以这里专言卫阳之气，昼行于身之阳分，所以一天而主外。平旦自阴而出于阳，其气始生，日中阳气隆盛，日西又入于阴，所以外卫之阳气虚，气门乃闭。所以暮而阳气内收以拒外，无扰动筋骨，以伤内气。表阳既虚，无见雾露阴湿之气，以伤外体。如不知早、午、暮三时阳气出入之序，而反逆之，则形气乃困迫而致委顿。这是申明外邪所伤，必由阳气内乏的缘故，以应上文阳气固密，外邪弗能为害的意义。
岐伯说：阴，是藏精而起亟（频繁响应）的；阳，是卫外而为固的。阴不胜其阳，则脉流薄疾，并乃狂；阳不胜其阴，则五脏气争，九窍不通。所以圣人陈设阴阳，筋脉和同，骨髓坚固，气血皆从。这样内外调和，邪不能害，耳目聪明，气立如故。
这又申明阴阳互根的道理，以表明必须使阴阳和平，不可偏胜。经中反复详明，无非这个宗旨。自从朱丹溪造出阳常有余阴常不足的理论，到张景岳又反其说，云阳常不足阴常有余，两家虽各有见解，不免晦涩经旨而迷惑后学。这一节专门标示阴阳偏胜的病，尤为明显。盖阴阳之气，出于命蒂，流为营卫。命蒂，象太极。阴阳互根于太极，所以偏亢则偏绝。精者，阴中之阳也，阳根于阴，所以阴藏精；起者，坤下起复也，而阴根于阳，所以干下变垢，亟者，谓起而又起，无间断，无穷已，乃阴阳相生而不息者。其流为营卫，则营行脉中为阴，卫行脉外为阳，所以阳者，卫外而为身之固也。如果有偏胜，而阴不胜其阳，则营行脉中者不足，所以脉流薄弱而速疾，以阳胜而行速也；及其甚也，气尽归并于阳，乃发狂病。如阳不胜其阴，而阴属脏，其气凝滞，所以不得调畅而相争，清阳不能转旋于表里，以致九窍窒塞而不通。所以圣人备陈阴阳生化之道，必使气血流通煦润，而筋脉和同，骨髓坚固，则内外调和，邪不能害，自然耳目聪明，元气创建如故。
风客淫气，精乃亡，邪伤肝也。因而饱食，筋脉横解，肠澼为痔；因而大饮，则气逆；因而强力，肾气乃伤，高骨乃坏。凡阴阳之要，阳密乃固，两者不和，若春无秋，若冬无夏，因而和之，是谓圣度。故阳强不能密，阴气乃绝；阴平阳秘，精神乃治；阴阳离决，精气乃绝。
这说明阴阳不调而致病。风气通于肝，风邪客之，侵淫日久，则化热而伤阴精，精乃亡，由邪伤肝。肝主筋，既经邪伤，而又饱食，使脾气困乏，则筋脉横解，横解者，弛懈也，脾困则生湿，湿邪下注而为肠澼、痔漏；因而又大饮其酒，则气逆；更强用力，肾气乃伤，而督脉损，高骨乃坏，高骨，背上天柱骨。所以凡阴阳之要，阳密乃固，若两者不和，如四时之失序，而生化之道绝矣，因而和之，是谓圣人之法度，不循圣度，不能和。故阳强而不静密，则偏亢而阴气偏绝；若阴气和平，阳气秘密，自然互相生化，而精神乃治；若阴阳析离而决裂，精气乃绝而死。
因于露风，乃生寒热。所以春伤于风，邪气留连，乃为洞泄；夏伤于暑，秋为疟；秋伤于湿，上逆而咳，发为痿厥；冬伤于寒，春必温病。四时之气，更伤五脏。
风露之邪，必伤营卫，乃生寒热之病。凡邪之浅深传化，病变多端。所以春为风木司令，而伤于风者，邪气留连不解，传入肠胃而成洞泄之病，以风性疏泄；夏伤于暑者，邪客膜原，夏气外浮而不即病，至秋凉风外束，邪不能容，乃发为疟，疟音皆，疟者，以邪内结外闭而难出，日久不愈；秋伤于湿之湿，是燥字之讹，余前集《素问辨疑》已申明，盖肺为燥金，秋为燥令，燥伤肺液，故上逆而咳，《痿论》曰：肺热叶焦，发为痿，经气因之不周，则厥矣，若湿邪属脾，多为肿病，而无咳逆，其讹可见；冬伤于寒者，肾为寒水之脏，而主冬令，同气感召，邪伏于经而不即发，至春阳气上升，邪化为热，乃发为温病。这四时之气更迭而伤五脏，正是为人身之气通乎天气，所以气有驳杂，即为所伤，又有偏亢、倚伏、传变多端之病，统会上文义理，诚详悉。
《素问·阴阳应象大论》说：天有四时五行，以生长收藏，而生寒暑燥湿风。人有五脏，化五气，以生喜怒悲忧恐。所以喜怒伤气，寒暑伤形。暴怒伤阴，暴喜伤阳。厥逆上行，满脉去形。喜怒不节，寒暑过度，生乃不固。所以重阴必阳，重阳必阴。所以说冬伤于寒，春必温病；春伤于风，夏生飧泄；夏伤于暑，秋必疟；秋伤于湿，冬生咳嗽。
这说明天人协议气化，以表明外感内伤的由来。盖在天为气，在地成形，皆四时五行之所生长收藏。寒暑燥湿风，即水火金土木之气以生者，人禀其气而生，所以有五脏化五行之气，以生喜怒悲忧恐之五情。所以纵情喜怒则伤气，外感寒暑则伤形。暴怒则气逆化火而伤阴，暴喜则神荡气弛而伤阳。阴阳偏伤，其气厥逆而上行，则脏虚脉满，气血奔腾，势将离形而去，盖志者气之帅也，气者体之充也，喜怒动志而暴其气，气离形体而去。先伤气者，后必至于伤形；先伤形者，后必至于伤气。所以喜怒不节，寒暑过度，生命乃不固。举喜怒，则悲忧恐亦然；举寒暑，则燥湿风亦然。这是内伤、外感的病因。重阴必阳，重阳必阴，由太极动极而静，静极而动，乃变化生成自然之道。所以说冬伤于寒云云，证明前文四时之气更伤五脏的意义。如冬之阴令，而伤寒之阴邪，是为重阴，至春变为温病，即重阴必阳之理；春之阳令，而伤风之阳邪，是为重阳，至夏而成飧泄，是阳邪传阴，亦即重阳必阴之理。变化之道，皆可类推。
The root of human life lies in the Qi transformation of Heaven and Earth.
In *Suwen: Treatise on the Connection between Life and the Nourishing Heaven*, the Yellow Emperor asked: Since ancient times, those who can connect with Heaven—the root of life—lie in Yin and Yang. Within the space between Heaven and Earth, within the Six Directions, the Qi connects with the Nine Provinces (referring to the earth), the nine orifices, the five Zang organs, and the twelve joints, all communicating with the Heavenly Qi. Life is based on the Five Phases (Metal, Wood, Water, Fire, Earth), and the Qi is divided into Three Yin and Three Yang. If one frequently violates these principles, pathogenic Qi will harm the body; this is the root of longevity. If the Qi of the Blue Heaven remains pure and clear, one’s will and intent will be regulated; by complying with it, the Defensive Qi (Wei Qi) becomes solid, and even if there are thieving pathogens (pathogenic factors), they cannot cause harm. This is following the sequence of the seasons. Therefore, the sages conserve their spirit, ingest the Heavenly Qi, and thereby communicate with the Divine Spirit. If one deviates from this, the nine orifices internally become blocked, the muscles externally become congested, and the Defensive Qi scatters and dissolves. This is called self-injury, leading to the depletion of Yuan Qi (Original Qi).
This section summarizes the origins of external contraction and internal injury. Humans and Heaven and Earth share the same root; thus, the form and Qi within Heaven and Earth and the Six Directions correspond to the Nine Provinces of the earth. In the human body, there are nine orifices, five Zang organs, and twelve joints, all of which communicate with Heavenly Qi. What humans receive for life is the Qi of the Five Phases; what sustains them is the mechanism of the Three Yin and Three Yang that generates and nourishes all things. The circulation of Yin-Yang and the Five Phases involves Qi transformation, which inevitably has periods of prosperity, decline, and deviation. Deviation constitutes pathogenic Qi. If one does not regulate properly and frequently encounters pathogenic Qi, the body is harmed. Thus, the Qi transformation of Heaven and Earth is the root of human life and longevity. If the Qi of the human body can be as pure and clear as the Qi of the Blue Heaven, then the Heart-Mind will be harmonious and the will orderly, the internal Yang Qi will be solid and dense, and although thieving pathogens exist, they cannot cause harm. This is complying with the order of Heavenly Qi transformation. Therefore, the sages teach people to nourish the spirit and ingest Heavenly Qi to communicate with the Divine Spirit. If one fails to regulate and suffers from pathogens, the nine orifices internally block, the muscles externally congest, and the Defensive Qi scatters. This is self-injury, resulting in the depletion of Original Qi. The key lies in maintaining purity to regulate the will, which is the way to dispel disease and nurture life.
Yang Qi is like the sky and the sun. If it loses its proper position and function, it shortens life and fails to manifest. Therefore, the movement of Heaven relies on the brightness of the sun. Thus, Yang Qi is located superiorly and serves to defend the exterior. It should rotate freely like a door pivot; if daily activities involve sudden惊扰 (startle/disturbance), the Shen Qi (Spiritual Qi) will float upward.
Continuing from the above, it states that the Yang Qi of the human body should be as pure and clear as the Blue Heaven and as bright as the sun. In this state, the Heart-Mind is harmonious and the will is orderly. If it loses its proper position, life is shortened, and the Divine Spirit fails to manifest. Heaven moves vigorously without ceasing because the Heavenly body is pure and the sunlight shines brightly. If humans have a pure heart and clear Qi, the light of the Spirit naturally manifests. This is because Human Yang Qi is rooted in Yin, rises from below, and moves outward to serve as defense. Rising must be followed by descending, circulating internally and externally. To rotate continuously like a pivot, if daily activities involve disturbance, the Shen becomes labored and Qi agitated, causing Yang Qi to lose its solidity, allowing external pathogens to harm it. If injured by Summer-Heat, Summer-Heat should exit with sweat and should not be suppressed, as Summer-Heat is formed by the combination of Fire and Dampness; sweating eliminates Dampness and allows Fire to vent. If Fire flares upward, it causes mental restlessness and lung wheezing/panting; if the Qi is calm but Heart-Fire is unsettled, there will be excessive talking. If injured by Cold Pathogen, the Exterior Yang is constrained, causing body heat like burning charcoal. As Zhang Zhongjing stated, pulse tight, body hot, no sweat indicates Cold Damage (Shang Han), treated with Mahuang Decoction (Ephedra Decoction) to induce sweating; once sweat occurs, the pathogen disperses. This refers to Cold Damage affecting the Yang meridians. If Cold damages the Yin meridians, there is no body heat or headache, and sweating should not be induced. If injured by Dampness, Earthly Dampness affects the lower part first, while misty/dewy Dampness affects the upper part first. Dampness obscures the Clear Yang, causing heaviness in the head and eyes as if wrapped. Dampness invades the sinews, Yang stagnates and transforms into Heat. If not cleared promptly, the sinews are damaged: large sinews become soft and short (causing spasms/contracture), small sinews become lax and long (causing flaccidity/paralysis). Swelling caused by Qi (here referring to Dampness injuring Yang) occurs because Dampness injures Yang rather than sinews. Spleen is Taiyin Damp-Earth, governing the muscles. Dampness injures Yang and burdens the Spleen, causing muscle swelling. Spleen Earth prospers during the Chen, Xu, Chou, and Wei months (the four seasons/transition periods), serving as the framework of the year. If Spleen damage causes swelling and does not heal during these prosperous periods, when the prosperous Qi passes and seasons change, Yang Qi will exhaust and death will occur. Hence, "When the Four Dimensions succeed each other, Yang Qi exhausts." Old commentaries interpreted "Four Dimensions" as sinews, flesh, blood, and bone, or as the four limbs. However, how can sinews/flesh/blood/bone or four limbs succeed each other? This makes no logical sense. Furthermore, in *Suwen: Treatise on the Most Essential and Greatest Principles*, Qibo said: The generation and transformation of Qi differ in prosperity and decline. The effects of Cold, Heat, Warmth, and Coolness depend on their prosperity and decline, manifested in the Four Dimensions. This means the circulation of Cold, Heat, Warmth, and Coolness undergoes changes after prosperity and decline. At the time of change, during the four seasons of Chen, Xu, Chou, and Wei, the four seasons of Spring, Summer, Autumn, and Winter are established. Thus, Earth prospers in the four seasons, serving as the annual framework. This is because Spring, Summer, Autumn, and Winter correspond to the Qi of Wood, Fire, Metal, and Water. Metal, Wood, Water, and Fire mutually overcome each other; they rely on the Earth of the four seasons in the middle to regulate and maintain, thereby achieving the work of creation. Hence, "The use of prosperity and decline lies in the Four Dimensions." Does not this logic prove the point conclusively?
When Yang Qi is subjected to excessive fatigue and labor, it hyperactivates, leading to exhaustion of Essence. If this accumulation persists into Summer, it causes Jian Jue (Frying Syncope), characterized by blindness preventing vision, deafness preventing hearing, a crumbling state like a breached dam, and uncontrollable leakage. When Yang Qi is subjected to extreme anger, the form and Qi become severed, and Blood stagnates in the upper body, causing Bo Jue (Thin Syncope). Injury to the sinews leads to flaccidity and inability to control movement. Sweating on only one side (hemihidrosis) leads to hemiplegia. Sweating while exposed to Dampness generates acne (Cuo Chu). Long-term consumption of rich, fatty foods is sufficient to generate large carbuncles (Ding); accepting pathogens is as easy as holding an empty vessel. Labor-induced sweating exposed to wind, where Cold compresses the surface Yang, results in prickly heat (Fei); stagnation leads to acne.
The previous section discussed injuries from external pathogens; this section clarifies injuries from fatigue and desire. The beginning of the chapter states that purity regulates the will and consolidates Yang Qi. If fatigue is unceasing, Yang Qi hyperactivates, transforming into pathogenic Fire. Intense Fire consumes Water (Jing/Blood source). As Water gradually depletes until Essence is exhausted, pathogenic Qi accumulates. By Summer, when Fire is prosperous, the body feels scorched, meridians are obstructed, and Yang Qi cannot circulate to the limbs, resulting in cold extremities (Jue). This is called Jian Jue, commonly known as Bone Steaming Dry Blood Consumption. Eyes see due to Blood; with exhausted Essence and Blood, blindness occurs. Essence loss causes deafness; thus, Qi blockage prevents hearing. At such severe damage, the body is like a ruined city, with Qi and Blood scattering uncontrollably. Even with medicine, it cannot be cured. The Liver is a rigid organ, storing Blood and belonging to Wood, governing the ascending Qi of Spring. Extreme anger causes Liver Qi to rebel, blocking the Qi mechanism that fills the form. Blood follows Qi and stagnates in the Upper Jiao, blocking Ying and Wei Qi and meridians, causing Bo Jue (sudden syncope from angry rage). The Liver governs sinews; injury causes sinew flaccidity, inability to bind bones, trembling while walking/standing, and loss of posture. Qi warms, Blood moistens. Yang Qi rebellion disrupts Ying and Wei harmony, causing hemihidrosis. "Ju" means leakage. As stated in *Yueling*: Earthly Qi leaks, meaning Jin Ye (Body Fluids) do not circulate uniformly but leak from either left or right, forming hemiplegia. The above describes injuries from emotions and desires. If pores are open during sweating and Dampness invades, obstructing Ying Qi, acne and boils arise. Those accustomed to rich, fatty foods may develop large carbuncles, not just acne, because accumulated pathogenic Heat is deep, like filling an empty vessel. Labor-induced sweating exposed to Cold/Wind compresses Surface Yang, causing prickly heat or acne (commonly called freckles/moles), which are superficial and harmless.
Yang Qi, in its refined state, nourishes the Shen (Spirit); in its soft state, it nourishes the sinews. If opening and closing fail, Cold Qi enters, causing severe kyphosis (Da Lou). Pathogens sinking into vessels cause scrofula (Luo Li); lingering in flesh and skin causes issues. When Shu points' Qi transformation is forced, it transmits to fear and惊骇 (fright). If Ying Qi does not follow the course and rebels in the flesh, abscesses/swellings arise. If Po Sweat (Pore Sweat) is not fully expelled, the form weakens and Qi burns, acupoints close, and Wind Malaria develops. Therefore, Wind is the beginning of all diseases. Purity closes and rejects pathogens at the flesh and skin; even strong winds and severe toxins cannot harm, by following the seasonal order. If disease persists, transmission and transformation occur. If Upper and Lower do not connect, even good doctors cannot help. If Yang Qi accumulates to death, and Yang Qi is blocked at the diaphragm, it must be drained. Failure to treat urgently leads to failure by incompetent physicians.
All above discuss Yang Qi, referring to the balanced, neutral Qi of Yin and Yang. Its refined neutrality nourishes the Heart-Mind; its soft neutrality nourishes sinews and bones. It spreads and circulates, internally from Zang organs, externally to collaterals, cycling through interior/exterior and Yin/Yang without interruption. Taiyang is Opening, Yangming is Closing, Shaoyang is Pivot; Taiyin is Opening, Jueyin is Closing, Shaoyin is Pivot. If Qi rebels, disrupting rising/falling and opening/closing, external Cold enters, causing sinew stiffness and severe kyphosis. If pathogens sink into blood vessels, Ying Qi stagnates, forming scrofula or rat sores. If pathogens linger in flesh/skin, forcing Shu point Qi, invading internal organs over time, transmitting to fear/fright, it injures Liver/Gallbladder. If Ying Qi rebels in flesh, abscesses form. Lung stores Po; skin/hair pores are the exterior of Lung. Sweat from pores is Po Sweat. Incomplete sweating due to internal weakness of form/Qi and external Wind pathogens closes acupoints, causing Wind Malaria. All six climatic pathogens attacking humans involve Wind, as Wind is sharp and penetrates easily; thus, Wind is the beginning of all diseases. If internal Yang Qi is pure and solid, flesh/skin closes and rejects; even strong winds/toxins cannot harm, by following seasonal Qi transformation. Strong winds/toxins refer to Empty Winds/Thieving Pathogens mentioned in *Ling Shu: Chapter on Nine Palaces and Eight Winds*. Hence, "Where pathogens gather, Qi must be deficient." If disease persists and pathogens transform, ascending/descending Yin/Yang repel each other and do not connect. At this stage, even good doctors cannot help. If Yang Qi transforms into pathogenic Qi, accumulating to death, and pathogenic Yang is blocked at the diaphragm, it must be drained early. Failure to treat urgently leads to failure by incompetent physicians.
Therefore, Yang Qi governs the exterior throughout the day: At dawn, Human Qi arises; at noon, Yang Qi is robust; at sunset, Yang Qi is deficient, and the Qi Gates close. Thus, in the evening, Yang Qi retracts and rejects the exterior; do not disturb sinews and bones, nor expose oneself to mist and dew. Violating these three times leads to physical exhaustion and thinning.
This summarizes the previous text. Above, it stated Yang moves upward and defends the exterior; here, it specifically discusses Wei Yang Qi, which travels through the Yang aspects of the body during the day, thus governing the exterior daily. At dawn, emerging from Yin to Yang, Qi begins to arise. At noon, Yang Qi is abundant. At sunset, it returns to Yin, so Exterior Defending Yang Qi is deficient, and Qi Gates close. Thus, in the evening, Yang Qi retracts internally to reject the exterior; do not disturb sinews/bones to injure internal Qi. With deficient Surface Yang, avoid mist/dew Yin-Dampness to injure the exterior. If one does not know the sequence of Yang Qi entry/exit at morning, noon, and evening, and acts against it, Form and Qi become exhausted and listless. This clarifies that external pathogen injury is due to internal deficiency of Yang Qi, responding to the earlier principle that solid Yang Qi prevents external pathogens from harming.
Qibo said: Yin stores Essence and responds frequently (Qi Ji); Yang defends the exterior and provides solidity. If Yin cannot overcome Yang, pulses flow rapidly and violently, leading to mania. If Yang cannot overcome Yin, the Qi of the five Zang organs contends, and the nine orifices become blocked. Therefore, the sages arrange Yin and Yang, harmonizing sinews and pulses, solidifying marrow, and ensuring smooth Qi and Blood flow. In this way, interior and exterior are harmonized, pathogens cannot harm, ears and eyes are acute, and Qi stands firm as before.
This further explains the mutual root of Yin and Yang, showing that balance is essential and neither should dominate. The classics elaborate repeatedly on this principle. Since Zhu Danxi proposed "Yang is often in excess, Yin is often deficient," and Zhang Jingze countered with "Yang is often deficient, Yin is often in excess," both, despite their insights, obscure the classic teachings and confuse students. This section specifically highlights diseases of Yin-Yang imbalance. Yin and Yang Qi originate from the Life Root (Ming Di), flowing as Ying and Wei. The Life Root resembles the Taiji (Supreme Ultimate). Yin and Yang are rooted in Taiji; thus, hyperactivity leads to extinction. Essence is Yang within Yin; Yang is rooted in Yin, so Yin stores Essence. "Qi" (Rise) refers to Kun trigram rising from below, and Yin is rooted in Yang, so Qian trigram changes. "Ji" means rising again and again, without interruption or end, representing continuous mutual generation of Yin and Yang. Flowing as Ying and Wei, Ying flows in vessels (Yin), Wei flows outside vessels (Yang). Thus, Yang defends the exterior and provides bodily solidity. If imbalanced and Yin cannot overcome Yang, Ying in vessels is insufficient, so pulses flow weakly and rapidly due to Yang dominance. When extreme, Qi merges entirely into Yang, causing mania. If Yang cannot overcome Yin, and Yin belongs to Zang organs, its Qi stagnates, failing to circulate smoothly and contending. Clear Yang cannot rotate between interior/exterior, causing nine orifices to block. Therefore, the sages detail the generation/transformation of Yin and Yang, ensuring smooth Qi/Blood flow, harmonizing sinews/pulses, solidifying marrow, harmonizing interior/exterior, preventing pathogen harm, and naturally restoring acute senses and Original Qi.
Wind pathogens invade and disorder Qi, causing Essence to perish, damaging the Liver. If followed by overeating, sinews and pulses relax, leading to dysentery and hemorrhoids. If followed by heavy drinking, Qi rebels. If followed by excessive force, Kidney Qi is injured, and high bones (vertebrae) are damaged. The key to Yin and Yang is that Yang must be dense to provide solidity. If the two do not harmonize, it is like Spring without Autumn, or Winter without Summer. Harmonizing them is the Sage's standard. Thus, if Yang is hyperactive and not dense, Yin Qi perishes. If Yin is peaceful and Yang is secret/dense, Spirit and Essence are regulated. If Yin and Yang separate and sever, Essence and Qi perish.
This explains diseases caused by Yin-Yang disharmony. Wind Qi connects with the Liver. If Wind pathogens invade and linger, they transform into Heat and injure Yin Essence, causing Essence to perish, due to Liver injury. The Liver governs sinews. After pathogen injury, overeating burdens the Spleen, causing sinew/pulse relaxation (flaccidity). Spleen burden generates Dampness, which sinks downward causing dysentery/hemorrhoids. Heavy drinking causes Qi rebellion. Excessive force injures Kidney Qi and Du Mai, damaging the high bones (neck vertebrae). The key to Yin and Yang is Yang density for solidity. Disharmony is like seasonal disorder, cutting off generation/transformation. Harmonizing them is the Sage's method. Without following this, harmony is impossible. Hyperactive Yang without density leads to Yin depletion. Peaceful Yin and dense Yang allow mutual generation, regulating Spirit/Essence. Separation/severance of Yin/Yang leads to death.
Exposure to wind/dew causes chills and fever. Spring Wind injury lingers, causing profuse diarrhea. Summer Summer-Heat injury manifests as malaria in Autumn. Autumn Dampness injury (note: text suggests 'Damp' is likely a typo for 'Dry' in some contexts, but here retains Damp context or corrects to Dry/Lung issue) causes rebellious Qi and cough, developing into flaccidity/Jue. Winter Cold injury manifests as Warm Disease in Spring. The Qi of the four seasons alternately injure the five Zang organs.
Wind/Dew pathogens injure Ying and Wei, causing chills/fever. Pathogen depth and transformation vary. Spring is governed by Wind-Wood; Wind injury lingers, entering intestines/stomach causing profuse diarrhea due to Wind's dispersing nature. Summer Summer-Heat lodges in Membrane Source; Summer Qi floats outward without immediate illness. Autumn cool wind binds exterior, trapping pathogens, causing Malaria (Jie Nuè), where pathogens are trapped internally and closed externally, lasting long. Autumn "Dampness" is noted as a likely error for "Dryness" in previous works; Lung is Dry-Metal, Autumn is Dry season. Dryness injures Lung fluids, causing rebellious Qi and cough. *Treatise on Flaccidity* states Lung Heat scorches leaves, causing flaccidity; meridian Qi fails to circulate, causing Jue. If Dampness belonged to Spleen, it would cause swelling, not cough/rebellion, proving the error. Winter Cold injures Kidney (Cold-Water organ, governing Winter). Similar Qi attracts, pathogens hide in meridians. Spring Yang rises, pathogens transform into Heat, causing Warm Disease. The four seasons alternately injuring five Zang organs confirms human Qi connects with Heavenly Qi. Impure Qi is harmed, leading to various diseases of hyperactivity, hiding, and transmission, comprehensively summarizing the previous text.
*Suwen: Treatise on Yin-Yang Correspondence in Image* states: Heaven has four seasons and five phases, generating growth, flourishing, harvesting, and storage, producing Cold, Heat, Dryness, Dampness, and Wind. Humans have five Zang organs, transforming five Qi, producing Joy, Anger, Sorrow, Worry, and Fear. Thus, Joy/Anger injure Qi; Cold/Heat injure Form. Extreme Anger injures Yin; extreme Joy injures Yang. Rebellion upward fills pulses and separates from form. Unregulated Joy/Anger and excessive Cold/Heat make life unstable. Heavy Yin becomes Yang; Heavy Yang becomes Yin. Thus: Winter Cold injury leads to Spring Warm Disease; Spring Wind injury leads to Summer incomplete digestion diarrhea; Summer Summer-Heat injury leads to Autumn Malaria; Autumn Dampness injury leads to Winter Cough.
This explains Heaven-Human Qi agreement, indicating origins of external/internal injury. Heaven has Qi, Earth has Form, both generated/stored by four seasons/five phases. Cold/Heat/Dryness/Dampness/Wind are generated by Water/Fire/Metal/Wood/Earth Qi. Humans receive this Qi, having five Zang organs transform Five Phase Qi to produce five emotions. Indulging in emotions injures Qi; external Cold/Heat injures Form. Extreme Anger causes Qi rebellion transforming into Fire, injuring Yin. Extreme Joy causes Spirit agitation and Qi relaxation, injuring Yang. Yin/Yang partial injury causes Qi rebellion upward, emptying Zang organs, filling pulses, rushing Qi/Blood, separating from form. Will commands Qi; Qi fills form. Emotions move Will and暴 (violently release) Qi, separating it from form. Qi injury precedes Form injury; Form injury precedes Qi injury. Unregulated emotions/excessive climate exposure destabilizes life. Mentioning Joy/Anger implies Sorrow/Worry/Fear similarly; mentioning Cold/Heat implies Dryness/Dampness/Wind similarly. These are causes of internal/external injury. Heavy Yin becomes Yang, Heavy Yang becomes Yin, following Taiji's movement/stillness cycle, the natural way of change/generation. "Winter Cold...Spring Warm" proves the previous text on four seasons injuring five Zang organs. Winter Yin command + Cold Yin pathogen = Heavy Yin; transforms to Spring Warm Disease = Heavy Yin becomes Yang. Spring Yang command + Wind Yang pathogen = Heavy Yang; transforms to Summer Diarrhea = Yang pathogen transmits to Yin = Heavy Yang becomes Yin. The way of change can be extrapolated.