（《灵枢·五癃津液别篇》全）
黄帝问于岐伯曰∶水谷入于口，输于肠胃，其液别为五，天寒衣薄则为溺与气，天热衣浓则为汗，悲哀气并则为泣，
中热胃缓则为唾。邪气内逆，则气为之闭塞而不行，不行则为水胀，余知其然也，不知其何由生？愿闻其道。（五液者，
阴精之总称也。本篇以溺、汗、泣、唾、水，故名为五。《宣明五气篇》曰∶五脏化液∶心为汗，肺为涕，肝为泪，脾为
涎，肾为唾，是为五液。《决气篇》曰精、气、津、液、血、脉，其辨有六。又道家曰涕、唾、精、津、汗、血、液，其
名则七。皆无非五液之属耳。）岐伯曰∶水谷皆入于口，其味有五，各注其海，津液各走其道。（水谷入口，五液之所由
生也。五味之入，各有所归，辛先入肺，苦先入心，甘先入脾，酸先入肝，咸先入肾也。各注其海者，人身有四海，脑
为髓海，冲脉为血海，膻中为气海，胃为水谷之海也。五脏四海，各因经以受水谷之气味，故津液随化而各走其道。）故
三焦出气，以温肌肉，充皮肤，为其津；其流而不行者，为液。（此津液之有辨也。宗气积于上焦，营气出于中焦，卫气
出于下焦。达于表者，阳之气也，故三焦出气以温肌肉，充皮肤，而为其津，津属阳也。营于里者，阴之气也，故周流
于血脉之间，而不散行于外，注于脏腑，益于精髓，而为之液，液属阴也。又津液义，详藏象类二十五。）天暑衣浓则腠
理开，故汗出；寒留于分肉之间，聚沫则为痛。（此津液之为汗也。热蒸于表则津泄，故腠理开而汗出。或为寒邪所感则
液凝，留于肌肉之间，故汁沫聚而为痛。）天寒则腠理闭，气湿不行，水下留于膀胱，则为溺与气。（此津液之为溺气也。
腠理闭密则气不外泄，故气化为水。水必就下，故留于膀胱。然水即气也，水聚则气生，气化则水注，故为溺与气。）五
脏六腑，心为之主，耳为之听，目为之候，肺为之相，肝为之将，脾为之卫，肾为之主外。（此二节言津液之为涕泣也。
心总五脏六腑，为精神之主，故耳目肺肝脾肾，皆听命于心。是以耳之听，目之视，无不由乎心也。肺朝百脉而主治节，
故为心之相。肝主谋虑决断，故为心之将。脾主肌肉而护养脏腑，故为心之卫。肾主骨而成立其形体，故为心之主外也。）
故五脏六腑之津液，尽上渗于目，心悲气并则心系急，心系急则肺举，肺举则液上溢。夫心系与肺不能常举，乍上乍下，
故咳而泣出矣。（心为脏腑之主，故五脏之系皆入于心，心之总系复上贯于肺，通于喉，而息由以出。故心悲则系急而肺
叶举，液即随之而上溢。然心系与肺本不常举，故有乍上乍下。当其气举而上，则为咳为泣也。凡人之泣甚而继以嗽者，
正以气并于上而奔迫于肺耳。按∶《口问篇》曰∶心者，五脏六腑之主也；目者，宗脉之所聚也，上液之道也；口鼻者，
气之门户也。故悲哀愁忧则心动，心动则五脏六腑皆摇，摇则宗脉感，液道通，故涕泣出焉。）中热则胃中消谷，消谷则
虫上下作，肠胃充郭故胃缓，胃缓则气逆，故唾出。（此津液之为唾也。虫为湿热所化，常居肠中，胃热则消谷中空，虫
行求食，故或上或下，动作于肠胃之间。充郭者，纵满之谓。肠郭则胃缓，胃缓则气逆上行，涎随而溢，故多唾也。按∶
《宣明五气篇》曰肾为唾，而此曰胃为唾，是胃之与肾皆主为唾，盖土郁之唾在胃，水泛之唾在肾也。郭，廓同。）五谷
之精液和合而为膏者，内渗入于骨空，补益脑髓，而下流于阴股。（此津液之为精髓也。膏，脂膏也。精液和合为膏，以
填补于骨空之中，则为脑为髓，为精为血，故上至巅顶，得以充实，下流阴股，得以交通也。）阴阳不和，则使液溢而下
流于阴，髓液皆减而下，下过度则虚，虚故腰背痛而胫 。（阴阳不和则精气俱病，气病则不摄，精病则不守，精气不相
统摄，故液溢于下而流泄于阴窍。精髓皆减，输泄过度，则真阴日虚，故为腰痛胫 等病，此劳瘵之所由作也。胫，形
景、形敬二切。 音酸。）阴阳气道不通，四海闭塞，三焦不泻，津液不化，水谷并于肠胃之中，别于回肠，留于下焦，
不得渗膀胱则下焦胀，水溢则为水胀，（此津液之为水胀也。三焦为决渎之官，膀胱为津液之府，气不化则水不行，所以
三焦不能泻，膀胱不能渗，而肿胀之病所由作，故治此者，当以气化为主。试观水潦为灾，使非太阳照临，则阴凝终不
能散，泥泞终不能干，能知此义，则知阴阳气化之道矣。）此津液五别之逆顺也，（阴阳和，则五液皆精而充实于内，阴
阳不和，则五精皆液而流溢于外，此其所谓逆顺也。）
《灵枢·五癃津液别篇》（全文）
黄帝向岐伯问道：饮食水谷进入口中，输送到肠胃，其中的液体分为五种。天气寒冷、衣着单薄时，就化为小便和气体；天气炎热、衣着厚重时，就化为汗液；悲哀情绪导致气机郁结时，就化为眼泪；体内有热且胃壁松弛时，就化为唾液。如果邪气在体内逆乱，就会导致气机闭塞而不运行，气不运行就会形成水胀病。我知道这些现象的存在，但不知道它们产生的具体原因，希望能听您讲讲其中的道理。（所谓“五液”，是阴精的总称。本篇因为论述了溺、汗、泣、唾、水这五种液体，所以命名为“五”。《宣明五气篇》说：五脏化生五液：心化汗，肺化涕，肝化泪，脾化涎，肾化唾，这就是五液。《决气篇》说精、气、津、液、血、脉，辨别起来有六种。另外道家说涕、唾、精、津、汗、血、液，名称则有七种。这些都不外乎属于五液的范畴。）
岐伯回答说：水谷都从口进入，其味道分为五味，各自注入相应的“海”（指人体重要的脏腑或经络汇聚处），津液也各自走向它特定的通道。（水谷入口，是产生五液的来源。五味进入人体，各有归属：辛味先入肺，苦味先入心，甘味先入脾，酸味先入肝，咸味先入肾。所谓“各注其海”，是指人身有四海：脑为髓海，冲脉为血海，膻中为气海，胃为水谷之海。五脏和四海，各自通过经脉接受水谷的气味，所以津液随着气化而各自走向它的通道。）因此，三焦发出阳气，用来温煦肌肉，充实皮肤，这就称为“津”；那些流动缓慢、不向外散发运行的，就称为“液”。（这是区分津和液的不同。宗气积聚在上焦，营气产生于中焦，卫气产生于下焦。达于体表的，是阳性的气，所以三焦发出的气能温煦肌肉、充实皮肤，成为津，津属于阳。行于体内的，是阴性的气，所以在血脉之间周流，不分散运行于体表，注入脏腑，补益精髓，成为液，液属于阴。关于津和液的义理，详见《藏象类》第二十五节。）
天气暑热、衣着厚重时，腠理（皮肤毛孔及纹理间隙）张开，所以出汗；寒气停留在分肉（肌肉间隙）之间，凝聚成汁沫，就会引起疼痛。（这是津液转化为汗的过程。热气蒸腾于体表则津液外泄，所以腠理张开而出汗。如果被寒邪侵袭，则液体会凝结，停留在肌肉之间，所以汁沫聚集而产生疼痛。）天气寒冷时，腠理闭合，气湿不能外行，水向下流留在膀胱，就化为小便和气体。（这是津液转化为溺和气的过程。腠理闭密则气不外泄，所以气化为水。水性就下，所以留存在膀胱。然而水即是气，水聚集则气产生，气气化则水流注，所以表现为小便和气体。）
五脏六腑中，心是主宰，耳是听觉器官，目是观察器官，肺是辅佐大臣，肝是将领，脾是卫士，肾是主管外部的官员。（这两节论述津液转化为涕和泪的机理。心统领五脏六腑，是精神的主宰，所以耳、目、肺、肝、脾、肾都听从心的命令。因此耳的听觉、目的视物，没有不由心主导的。肺朝会百脉并主治节，所以作为心的辅佐。肝主谋虑决断，所以作为心的将领。脾主肌肉并护养脏腑，所以作为心的卫士。肾主骨并确立形体，所以作为心主管外部事务的官员。）
因此，五脏六腑的津液，全部向上渗入眼睛。当人心悲时，气机郁结导致心脉拘急，心脉拘急则牵引肺叶上举，肺叶上举则津液上溢。但是心脉和肺叶不能经常保持上举的状态，而是忽上忽下，所以会出现咳嗽并流出眼泪的现象。（心是脏腑的主宰，所以五脏的系络都连入于心，心的总系络又向上贯通于肺，通于喉咙，呼吸由此而出。所以心悲伤时，系络拘急而肺叶上举，津液随之而上溢。然而心脉和肺本不常处于上举状态，所以会有忽上忽下的情况。当气机上举时，就会引发咳嗽和流泪。凡是人哭泣严重时接着出现咳嗽的，正是因为气机并聚于上部并逼迫于肺的缘故。按：《口问篇》说：心是五脏六腑的主宰；目是宗脉汇聚的地方，也是上液通行的道路；口鼻是气的门户。所以悲哀愁忧会导致心动，心动则五脏六腑都摇动，摇动则宗脉感应，液道通畅，所以鼻涕和眼泪流出。）
体内有热则胃中消化食物过快，消化过快则肠道寄生虫上下活动，肠胃充满胀满导致胃壁松弛，胃壁松弛则气机上逆，所以吐出唾液。（这是津液转化为唾液的机理。虫是由湿热化生的，常居住在肠中，胃热则消化食物使胃肠中空，虫爬行寻找食物，所以在肠胃之间上下动作。“充郭”的意思是纵满。肠道充满则胃壁松弛，胃壁松弛则气逆上行，涎液随之溢出，所以多唾。按：《宣明五气篇》说肾化唾，而这里说胃化唾，这说明胃和肾都主管唾液的生成，大概土气郁滞导致的唾在胃，水气泛滥导致的唾在肾。“郭”与“廓”同义。）
五谷的精微液体混合而成膏脂状的物质，向内渗入骨骼的空隙，补益脑髓，并向下流注到大腿内侧。（这是津液转化为精髓的机理。膏，就是脂膏。精液混合成为膏，用来填补在骨空之中，就成为脑、髓、精、血，所以上至头顶得以充实，下流至大腿内侧得以交通。）
如果阴阳不和，就会使津液外溢并向下流入阴窍，精髓也都减少并下行，下行过度则导致虚损，虚损所以出现腰痛和小腿酸痛无力。（阴阳不和则精气都生病，气病则不能固摄，精病则不能守持，精气不能相互统摄，所以津液在下部外溢流入阴窍。精髓都减少，输泄过度，则真阴日益虚弱，所以出现腰痛、小腿酸痛等病症，这是劳瘵（慢性消耗性疾病）产生的原因。胫，读音为形景、形敬二切。酸，读音为音酸。）
如果阴阳气道不通畅，四海闭塞，三焦不能通泻，津液不能正常化生，水谷混杂在肠胃之中，分流到回肠，停留于下焦，不能渗入膀胱，则下焦胀满，水液外溢则形成水胀病。（这是津液转化为水胀病的机理。三焦是决渎之官，膀胱是津液之府，气不化则水不行，所以三焦不能通泻，膀胱不能渗利，肿胀的病由此产生，所以治疗此病，应当以恢复气化为主。试看洪水为灾，如果不是太阳照耀，那么阴凝之气终究不能消散，泥泞终究不能变干，懂得这个道理，就知道阴阳气化的奥妙了。）
这就是津液五种转化途径的逆顺规律。（阴阳调和，则五液都精纯而充实于内；阴阳不和，则五精都变为津液而流溢于外，这就是所谓的逆和顺。）
Ling Shu: Chapter on the Differentiation of Five Fluids and Body Fluids (Full Text)
The Yellow Emperor asked Qibo, saying: When food and water enter the mouth, they are transported to the intestines and stomach. Their fluids differentiate into five types. In cold weather with thin clothing, they become urine and gas; in hot weather with thick clothing, they become sweat; when grief causes Qi stagnation, they become tears; when internal heat is present and the stomach wall is relaxed, they become saliva. If pathogenic factors reverse internally, Qi becomes blocked and fails to circulate. Failure of circulation leads to water distension (Shui Zhang). I understand these phenomena, but I do not know their origin. I wish to hear the principle behind them. (Note: "Five Fluids" is a general term for Yin Essence. This chapter is named after the discussion of urine, sweat, tears, saliva, and water. The Xuan Ming Wu Qi Pian states: The Five Zang organs transform fluids: Heart transforms sweat, Lungs transform nasal mucus, Liver transform tears, Spleen transform drool, Kidneys transform saliva; these are the Five Fluids. The Jue Qi Pian distinguishes six categories: Essence, Qi, Jin, Ye, Blood, and Pulse. Additionally, Daoist texts list seven: nasal mucus, saliva, essence, Jin, sweat, blood, and fluid. All belong to the category of Five Fluids.)
Qibo replied: Food and water enter through the mouth, and their flavors divide into five categories, each entering its respective "Sea." Body fluids follow their specific pathways. (Food and water entering the mouth are the source of the Five Fluids. Each flavor has its destination: Pungent enters the Lung first, Bitter enters the Heart first, Sweet enters the Spleen first, Sour enters the Liver first, Salty enters the Kidney first. "Entering its respective Sea" refers to the Four Seas of the body: the Brain is the Sea of Marrow, the Chong Mai is the Sea of Blood, the Dan Zhong is the Sea of Qi, and the Stomach is the Sea of Food and Water. The Five Zang organs and Four Seas receive the qi and flavors of food and water via their meridians, so body fluids transform and follow their respective paths.) Therefore, San Jiao emits Qi to warm the muscles and fill the skin, which is called "Jin" (thin fluid); that which flows slowly and does not disperse outward is called "Ye" (thick fluid). (This distinguishes Jin from Ye. Zong Qi accumulates in the Upper Jiao, Ying Qi arises from the Middle Jiao, and Wei Qi arises from the Lower Jiao. That which reaches the exterior is Yang Qi; thus, the Qi emitted by San Jiao warms the muscles and fills the skin, becoming Jin, which belongs to Yang. That which nourishes the interior is Yin Qi; it circulates within the blood vessels, does not disperse externally, injects into the Zang-Fu organs, and benefits the marrow and essence, becoming Ye, which belongs to Yin. For detailed meanings of Jin and Ye, see Zang Xiang Class, Section 25.)
When the weather is hot and clothing is thick, the Cou Li (pores and interstices) open, causing sweat to flow. When cold lingers between the Fen Rou (muscle intervals), condensed fluid forms沫 (foam/droplets), causing pain. (This describes the transformation of body fluids into sweat. Heat steaming the exterior causes fluid leakage, opening the Cou Li and producing sweat. If affected by Cold pathogens, fluids coagulate and remain in the muscle tissue, where accumulated droplets cause pain.) When the weather is cold, the Cou Li close, and Qi/moisture cannot move outward. Water flows downward and remains in the Bladder, becoming urine and gas. (This describes the transformation of body fluids into urine and gas. Closed Cou Li prevent Qi from escaping, so Qi transforms into water. Water naturally flows downward, remaining in the Bladder. Since water is Qi, accumulation of water generates Qi, and transformation of Qi produces water flow, resulting in urine and gas.)
Among the Five Zang and Six Fu organs, the Heart is the Master, the Ears are the listeners, the Eyes are the observers, the Lungs are the Ministers, the Liver is the General, the Spleen is the Guard, and the Kidneys are the managers of the exterior. (These sections explain the mechanism of fluids transforming into nasal mucus and tears. The Heart commands all Zang-Fu organs as the master of spirit, so the ears, eyes, lungs, liver, spleen, and kidneys obey the Heart. Thus, hearing and vision are governed by the Heart. The Lungs govern all vessels and regulate functions, acting as the Heart's minister. The Liver governs planning and decision-making, acting as the Heart's general. The Spleen governs muscles and protects the Zang-Fu, acting as the Heart's guard. The Kidneys govern bones and establish the physical form, acting as the manager of the exterior for the Heart.)
Therefore, the body fluids of the Five Zang and Six Fu organs all seep upward into the eyes. When the Heart is sorrowful, Qi stagnation causes the Xin Mai (Heart Vessel/Connection) to contract. Contraction of the Xin Mai lifts the Fei Ye (Lung Lobes). When the Lung Lobes lift, fluids overflow upward. However, the Xin Mai and Lung Lobes cannot remain lifted constantly; they rise and fall intermittently, causing coughing and tearing. (The Heart is the master of the Zang-Fu, so the connections of all Zang organs enter the Heart. The main connection of the Heart extends upward through the Lungs, connecting to the throat, allowing respiration. Thus, heart sorrow causes contraction of the connections and lifting of the Lung Lobes, carrying fluids upward. Since the Heart connection and Lungs do not stay lifted, there is intermittent rising and falling. When Qi rises, it causes coughing and tearing. Severe crying followed by coughing occurs because Qi converges upward and presses upon the Lungs. Note: The Kou Wen Pian states: The Heart is the master of the Zang-Fu; the Eyes are the gathering place of Zong Mai and the pathway for upper fluids; the Mouth and Nose are the gates of Qi. Sorrow moves the Heart, shaking all Zang-Fu, stimulating Zong Mai, opening fluid pathways, and causing nasal mucus and tears to flow.)
Internal heat causes rapid digestion of grain in the Stomach. Rapid digestion leads to intestinal parasites moving up and down. Fullness in the intestines relaxes the Stomach wall. Relaxation of the Stomach wall causes Qi to rebel upward, resulting in the expulsion of saliva. (This describes the transformation of body fluids into saliva. Parasites are transformed from damp-heat and reside in the intestines. Stomach heat digests food quickly, emptying the intestines, prompting parasites to move seeking food, acting within the intestines. "Chong Guo" means fullness. Intestinal fullness relaxes the Stomach, causing Qi rebellion and overflow of saliva, leading to excessive spitting. Note: The Xuan Ming Wu Qi Pian states the Kidneys transform saliva, while this text says the Stomach transforms saliva. Both Stomach and Kidneys govern saliva: turbid Earth-related saliva originates in the Stomach, while water-flooding-related saliva originates in the Kidneys. "Guo" is synonymous with "Kuo".)
The refined fluids of the five grains combine to form a paste-like substance (Gao). This substance penetrates inward into the bone cavities, supplements the brain and marrow, and flows downward to the inner thighs. (This describes the transformation of body fluids into essence and marrow. Gao refers to fat/lard. Refined fluids combine into Gao to fill the bone cavities, forming brain, marrow, essence, and blood. Thus, it reaches the vertex to provide fullness and flows to the inner thighs to facilitate communication.)
If Yin and Yang are disharmonious, fluids overflow and flow downward into the Yin orifices. Marrow fluids decrease and sink. Excessive sinking leads to deficiency, resulting in lower back pain and soreness/weakness in the shins. (Disharmony of Yin and Yang causes disease in both Qi and Essence. Qi disease fails to secure, and Essence disease fails to hold. Lack of mutual control causes fluids to overflow downward into the Yin orifices. Decrease and excessive excretion of marrow essence lead to daily depletion of True Yin, causing lower back pain and shin soreness, which are the origins of Lao Zhai (chronic consumptive diseases). "Jing" is pronounced xing-jing/xing-jing. "Suan" is pronounced suan.)
If the Qi pathways of Yin and Yang are obstructed, the Four Seas are blocked, San Jiao fails to drain, and body fluids fail to transform. Food and water mix in the intestines and stomach, separate into the Ileum, and remain in the Lower Jiao without permeating into the Bladder. This causes Lower Jiao distension. Overflowing water results in water distension (Shui Zhang). (This describes the transformation of body fluids into water distension. San Jiao is the official of irrigation, and the Bladder is the mansion of body fluids. Without Qi transformation, water does not move. Thus, San Jiao cannot drain, and the Bladder cannot permeate, leading to swelling. Treatment should focus on restoring Qi transformation. Consider flood disasters: without solar heat, condensation will not dissipate, and mud will not dry. Understanding this reveals the principles of Yin-Yang Qi transformation.)
These are the normal and abnormal patterns of the five differentiations of body fluids. (When Yin and Yang are harmonious, the five fluids are pure and filled internally. When Yin and Yang are disharmonious, the five essences become fluids and overflow externally. This is what is meant by "abnormal" and "normal.")