五脏之气，必借五味之气以养也。）气和而生，津液相成，神乃自生。
帝曰∶脏象何如？（象谓所见于外，可阅者也。）岐伯曰∶心者，生之本，神之处也。其华在面，其充在
血脉，为阳中之太阳，通于夏气。（心者，君主之官，神明出焉，万物系之以兴亡，故曰心者，生之本，神之
处也。火气炎上，故华在面。心生血，其主脉，故充在血脉。心王于夏，气合太阳，以太阳居夏火之中，故曰
阳中之太阳，通于夏气也。按∶王本作神之变，元起、太素并作神之处，良是，今从之。）肺者，气之本，
魄之处也。其华在毛，其充在皮，为阳中之少阴，通于秋气。（肺藏气，其神魄，其合皮毛，故云。按∶王本
阳中之太阴，甲乙、太素并作少阴。新校正云∶“肺在十二经虽为太阴，然在阳分之中当为少阴也。”良是，
今从之。）肾者，主蛰封藏之本，精之处也。其华在发，其充在骨，为阴中之太阴，通于冬气。（地户封闭，
蛰虫深藏，肾又主水，受五脏六腑之精而藏之，故云主蛰封藏之本，精之处也。脑为髓之海，肾主骨髓，发者
脑之所养，故华在发，充在骨也。
按∶王本少阴，元起、甲乙、太素并作太阴。新校正云∶“肾在十二经虽为少阴，然在阴分之中当为太阴。”
从之。）肝者罢极之本，魂之居也。其华在爪，其充在筋，以生血气，……为阴中之少阳，通于春气。（夫
人之运动者，皆筋力之所为也，肝主筋，其神魂，故曰罢极之本，魂之居也。爪者筋之余，肝之养，故华在爪，
充在筋也。东方为发生之始，故以生血气也。按∶罢与疲通，肝主筋，过劳则运用乏竭而困倦矣，故云罢极。
又人之血气，生于心，统于脾，而藏于肝，肝得其养，则血气充足而无病，故又云以生血气也。阳中当作阴中，
新校正云全元起、甲乙、太素并同。）脾、胃、大肠、小肠、三焦、膀胱者，仓廪之本，营之居也，名曰器，
能化糟粕，转味而入出者也。此至阴之类，通于土气。（皆可受盛，转运不息，故为仓廪之本，名曰器也。
营起于中焦，中焦为脾胃之位，故云营之居也。然水谷滋味，入于脾胃，脾胃糟粕，转化其味，出于三焦膀胱，
故云转味而入出也。土合至阴，金匮真言论曰∶“阴中之至阴，脾也。”按∶入出二字妙，唯有入故有出也，
大小肠脾胃膀胱皆先入而后出者。三焦主气，何亦并言？盖三焦之气亦借饮食之味变化而为升降也。）凡十一
脏，取决于胆也。（上从心脏，下至于胆，为十一也。然胆者，中正刚断无私偏，故皆取决于胆也。）按∶一
脏有一脏之职司，故在秘典论有十二官之分。然职在专司者，自不可兼摄，乃功同一致者，则又不可不并言。
所以同一脏腑也，而此篇或分言，或并举，以见十二脏腑之功用不同，其义始全也。
故人迎一盛病在少阳，二盛病在太阳，三盛病在阳明，四盛以上为格阳。（一盛者，谓人迎之脉大于
寸口一倍也。余盛同法。四倍以上，阳盛之极，故格拒而食不得入也。正理论曰∶“格则吐逆。”）寸口一盛病
在厥阴，二盛病在少阴，三盛病在太阴，四盛以上为关阴。（盛法同阳。四倍以上，阴盛之极，故关闭而溲
不得通也。正理论曰∶“闭则不得溺。”）人迎与寸
口俱盛四倍以上为关格，关格之脉赢，不能极于天地之精气则死矣。（俱盛谓俱大于平常之脉四倍也。物不
可久盛，极则衰败，故不能极于天地之精气则死矣。按∶新校正云∶“古文赢与盈通用。”）反四时者，有余
为精，不足为消。应太过不足为精，应不足有余为消。阴阳不相应，病名曰关格。（广陈其脉应也。夫反四时
者，诸不足皆为血气消损，诸有余皆为邪气胜精也。阴阳之气，不相应合，不得相营，故曰关格也。按∶此一
段，原刻在脉要精微论中，独论关格，无问突答，必错简也。今移于此，庶文义相贯。谨按灵枢终始篇云∶“人
迎一盛，病在足少阳；一盛而躁，病在手少阳。人迎二盛，病在足太阳；二盛而躁，病在手太阳。人迎三盛，
病在足阳明；三盛而躁，病在手阳明。人迎四盛，且大且数，名曰溢阳，溢阳为外格。脉口一盛，病在足厥阴；
一盛而躁，病在手心主。脉口二盛，病在足少阴；二盛而躁，病在手少阴。脉口三盛，病在足太阴；三盛而躁，
病在手太阴。脉口四盛，且大且数，名曰溢阴，溢阴为内关，内关不通，死不治。人迎与太阴脉口俱盛四倍以上，
命曰关格，关格者与之短期。”又脉度篇云∶“邪在腑则阳脉不和，阳脉不和则气留之，气留之则阳气盛矣。
阳气太盛则阴不利，阴不利则血留之，血留之则阴气盛矣。阴气太盛，则阳气不能荣也，故曰关。阳气太盛，
则阴气弗能荣也，故曰格。阴阳俱盛，不得相荣，故曰关格，关格者，不得尽期而死也。”继是禁服篇亦言关
格。合而观之，脉阴阳外盛之极者，实真原内竭之象也，死不旋踵，又何疑焉。其辨关格者，始于越人三难，
谓脉有太过，有不及，有阴阳相乘，有复有溢，有关有格，以体象言也。仲景云∶“在尺为关，在寸为格，关
则不得小便，格则吐逆。”叔和因之。东垣则分左为人迎，右为气口。气口之脉，大四倍于人迎，此清气反行
浊道也，故曰格。人迎之脉，大四倍于气口，此浊气反行清道也，故曰关。关则不得小便，格则吐逆。至于丹
溪则别立关格一门，云寒在上，热在下，脉两寸俱盛四倍以上，此病多死。吾乡前辈马玄台，言关格是脉体，
非病名。张景岳称其独超前代，是也，乃以经中所言人迎，专属
之结喉旁之人迎穴，而力诋从前之非，且咎东垣创以左寸为人迎之谬。噫！何其言之过，而所见之偏且凿也。
夫结喉旁之人迎，人迎穴也，经中所言固多指此，且亦原无以左寸名人迎之明文，犹可蒙混言之。至谓两手寸
脉尽属三阴，则谬甚也。请即以经之言脉者证之，脉要精微论曰∶“尺内两旁则季胁也，尺外以候肾，尺里以
候腹中。附上，左外以候肝，内以候膈，右外以候胃，内以候脾。上附上，右外以候肺，内以候胸中，左外以
候心，内以候膻中。前以候前，后以候后。”观此，是不独三阴俱候于三部，即三阳亦皆候于三部也。经之凡
言人迎若何者，盖以三阳之脉皆上头，而颈旁之人迎，为阳明胃经之外候，可以候胃经之盛衰，不可以候三阳
经之疾病。且也，左寸名人迎，亦非创自东垣也。灵枢五色篇曰∶“人迎盛坚者伤于寒，气口甚坚者伤于食。”
夫人迎与气口对称，右寸为气口，右关即脾胃，脾胃伤食，则甚坚之脉形于右寸。左寸为人迎，左关则肝胆，
肝感风寒，以致盛坚之脉见于左寸也。是此人迎实指左寸，本篇固已言之矣。但因经无明指左寸为人迎之名，
故景岳可以率意言之耳。况人身之内，一名而两穴者，如临泣、窍阴、气海之有上下，三里之分手足，巨虚之
别上下廉也，安在结喉旁之名人迎，左寸之不当更名人迎乎。景岳诚未之思耳。且其自言尝治蒯司马、田宗伯，
脉来坚盛至极者，亦止诊之于两寸，初非上诊于喉旁。惟是以关格为脉体，脉盛之极为无阴，真阴败竭，孤阳
浮露，一段妙解，深中关格肯綮，未可以其一言之失而弃之也。）
五脏之气，必须借助五味（酸、苦、甘、辛、咸）的气味来滋养。气机调和则生命活动产生，津液相互化生，神志自然生成。
黄帝问：脏腑的征象是怎样的？（“象”指表现于外部的、可以观察到的现象。）岐伯回答：心是生命的根本，神志居住的地方。其荣华表现在面部，其充养组织在血脉，属于阳中的太阳，与夏气相通。（心作为君主之官，主宰神明，万物依靠它而兴衰，所以说是生命的根本，神志的居所。火性炎上，所以荣华表现在面部。心主血，统帅脉，所以充养在血脉。心王于夏季，气合于太阳，因为太阳居于夏火之中，所以称为阳中的太阳，与夏气相通。按：王冰注本作“神之变”，全元起本、《太素》均作“神之处”，这是正确的，现在采用此说。）肺是气的根本，魄居住的地方。其荣华表现在毫毛，其充养组织在皮肤，属于阳中的少阴，与秋气相通。（肺藏气，其神为魄，其合于皮毛，所以这样说。按：王冰注本作“阳中之太阴”，《甲乙经》、《太素》均作“少阴”。林亿等《新校正》说：“肺在十二经脉中虽属太阴，但在阳分之中应当属于少阴。”这是正确的，现在采用此说。）肾是主蛰伏封藏的根本，精居住的处所。其荣华表现在头发，其充养组织在骨骼，属于阴中的太阴，与冬气相通。（地户封闭，冬眠的虫类深藏，肾又主水，接受五脏六腑的精微并贮藏起来，所以说它是主蛰伏封藏的根本，精的居所。脑是髓的海，肾主骨髓，头发是脑所滋养的，所以荣华在头发，充养在骨骼。按：王冰注本作“少阴”，全元起本、《甲乙经》、《太素》均作“太阴”。《新校正》说：“肾在十二经脉中虽属少阴，但在阴分之中应当属于太阴。”采用此说。）肝是耐受疲劳的根本，魂居住的地方。其荣华表现在爪甲，其充养组织在筋腱，从而生化血气……属于阴中的少阳，与春气相通。（人的运动，都是筋力所为，肝主筋，其神为魂，所以说是耐受疲劳的根本，魂的居所。爪甲是筋的余气，由肝滋养，所以荣华在爪甲，充养在筋。东方是发生之始，所以能生化血气。按：“罢”通“疲”，肝主筋，过度劳累则运用乏力而困倦，所以叫“罢极”。另外人的血气，由心生，由脾统摄，由肝贮藏，肝得到滋养，则血气充足而无病，所以又说能生化血气。“阳中”应当是“阴中”，《新校正》说全元起本、《甲乙经》、《太素》都相同。）脾、胃、大肠、小肠、三焦、膀胱，是仓廪（储藏粮食之所，喻消化功能）的根本，营气居住的地方，名叫“器”，能够转化糟粕，将味道转化后出入体内。这些属于至阴的一类，与土气相通。（都能受纳和盛装食物，转运不停息，所以是仓廪的根本，名叫“器”。营气起于中焦，中焦是脾胃的位置，所以说是营气的居所。然而水谷的味道，进入脾胃，脾胃处理糟粕，转化其味，从三焦、膀胱排出，所以说是转化味道而入出。土合于至阴，《金匮真言论》说：“阴中之至阴，脾也。”按：“入出”二字很妙，只有有入才有出。大小肠、脾胃、膀胱都是先入而后出的。三焦主气，为什么也一并提及？大概是因为三焦之气也借助饮食的味道变化来进行升降。）凡十一脏的功能，都取决于胆。（从上心脏到下胆，共十一脏。然而胆具有中正、刚断、无私偏的特性，所以各脏的功能都取决于胆。）按：每一脏都有各自的职司，所以在《秘典论》中有十二官的区分。但是职责在于专司其职的，自然不能兼管其他；而功效相同、目标一致的，则又不能不一起论述。所以虽然是同一脏腑，但本篇有的分开说，有的并列说，以显示十二脏腑功用不同，这样义理才完整。
所以人迎脉大一倍于寸口，病在少阳；大两倍于寸口，病在太阳；大三倍于寸口，病在阳明；大四倍以上则为格阳。（“一盛”是指人迎脉比寸口脉大一倍。其余类推。四倍以上，是阳气盛极，所以格拒导致食物无法进入。《正理论》说：“格则呕吐逆乱。”）寸口脉大一倍于人迎，病在厥阴；大两倍于人迎，病在少阴；大三倍于人迎，病在太阴；大四倍以上则为关阴。（“盛”的判断方法同前。四倍以上，是阴气盛极，所以关闭导致小便不通。《正理论》说：“闭则不得排尿。”）人迎脉和寸口脉都盛大四倍以上，称为关格。关格的脉象羸弱（此处依上下文及校勘，原文“赢”通“盈”，指极盛），如果不能达到天地精气充盈的状态就会死亡。（“俱盛”指都大于平常的脉象四倍。事物不可能长久处于极盛状态，极盛则衰败，所以不能达到天地精气的充盈就会死。按：《新校正》说：“古文中‘赢’与‘盈’通用。”）违背四时规律的，有余表现为邪气胜精，不足表现为正气消损。应当太过却反而不足的是精气消损，应当不足却反而有余的是邪气亢盛。阴阳之气不相呼应，病名叫做关格。（广泛阐述脉象应合的情况。所谓违背四时，各种不足都是血气消损，各种有余都是邪气胜过精气。阴阳之气，不相呼应，不能相互营运，所以叫关格。按：这一段，原刻本在《脉要精微论》中，单独论述关格，没有问答，必定是错简。现在移到此处，使文义连贯。谨按《灵枢·终始篇》说：“人迎大一倍，病在足少阳；一倍且躁动，病在手少阳。人迎大二倍，病在足太阳；二倍且躁动，病在手太阳。人迎大三倍，病在足阳明；三倍且躁动，病在手阳明。人迎大四倍，且大且数，名叫溢阳，溢阳为外格。脉口大一倍，病在足厥阴；一倍且躁动，病在手心主。脉口大二倍，病在足少阴；二倍且躁动，病在手少阴。脉口大三倍，病在足太阴；三倍且躁动，病在手太阴。脉口大四倍，且大且数，名叫溢阴，溢阴为内关，内关不通，死不治。人迎与太阴脉口都盛大四倍以上，名叫关格，关格者预后不良，寿命不长。”又《脉度篇》说：“邪气在腑则阳脉不和，阳脉不和则气滞留，气滞留则阳气盛了。阳气太盛则阴不利，阴不利则血滞留，血滞留则阴气盛了。阴气太盛，则阳气不能荣养，所以叫关。阳气太盛，则阴气不能荣养，所以叫格。阴阳都盛，不能相互荣养，所以叫关格，关格者，活不到预期寿命而死。”此后《禁服篇》也讲关格。综合来看，脉象阴阳外盛到极点，实际上是内部真气枯竭的现象，死亡很快，又有什么怀疑的呢？辨别关格，始于《难经》第三难，说脉有太过，有不及，有阴阳相乘，有复有溢，有关有格，是从体象来说的。张仲景说：“在尺部为关，在寸部为格，关则不能小便，格则呕吐逆乱。”王叔和沿袭此说。李东垣则分左右，左为人迎，右为气口。气口脉比人迎大四倍，这是清气反行浊道，所以叫格。人迎脉比气口大四倍，这是浊气反行清道，所以叫关。关则不能小便，格则呕吐逆乱。至于朱丹溪则另立关格一门，说寒在上，热在下，两寸脉都盛大四倍以上，这种病多死。我的同乡前辈马玄台说，关格是脉象，不是病名。张景岳称赞他独超前代，是对的，但他把经文中所说的人迎，专属结喉旁的人迎穴，并且极力诋毁以前的说法，还责怪李东垣创立左寸为人迎的错误。唉！这话说过头了，而且见解片面且固执。结喉旁的人迎，是人迎穴，经文中所说固然多指这个，但也原本没有明确说左寸叫人迎的文字，还可以含糊地说。至于说两手寸脉尽属三阴，那就大谬特错了。请就用经文谈脉的内容来证明，《脉要精微论》说：“尺部内两旁是季胁，尺部外侧候肾，尺部内侧候腹中。附上，左侧外侧候肝，内侧候膈，右侧外侧候胃，内侧候脾。上附上，右侧外侧候肺，内侧候胸中，左侧外侧候心，内侧候膻中。前面候前面的病，后面候后面的病。”看这内容，不仅三阴都在三部有所候察，就是三阳也都在三部有所候察。经文凡是说人迎如何如何的，大概是因为三阳经脉都上行头部，而颈旁的人迎穴，是阳明胃经的外部候察，可以候察胃经的盛衰，不可以候察三阳经的疾病。而且，左寸叫人迎，也不是李东垣首创的。《灵枢·五色篇》说：“人迎盛坚者伤于寒，气口甚坚者伤于食。”人迎与气口对称，右寸为气口，右关即脾胃，脾胃伤食，则甚坚的脉形出现在右寸。左寸为人迎，左关则肝胆，肝感受风寒，以致盛坚的脉象见于左寸。这说明人迎确实指左寸，本篇已经说过了。只是因为经文没有明确指出左寸叫人迎的名字，所以张景岳可以随意这么说。况且人身之内，一个名字对应两个穴位的，如临泣、窍阴、气海有上有下，三里分手足，巨虚别上下廉，哪里规定结喉旁的叫人迎，左寸就不可以再叫人迎呢？张景岳真是没思考过。而且他自己曾说治疗蒯司马、田宗伯，脉来坚盛到极点的，也只是诊察两寸，起初并不是在喉旁诊察。只是他把关格看作脉象，脉盛到极点是无阴，真阴败竭，孤阳浮露，这一番妙解，深深切中关格的要害，不能因为他一句话的失误就抛弃他的观点。）
The Qi of the five Zang organs must rely on the Qi of the five flavors (sour, bitter, sweet, pungent, salty) for nourishment. When Qi is harmonious, life activities arise; when body fluids are mutually generated, Shen (Spirit) naturally emerges.
The Yellow Emperor asked: What are the manifestations (Xiang) of the Zang organs? ("Xiang" refers to phenomena manifested externally that can be observed.) Qibo replied: The Heart is the root of life and the residence of Shen. Its brilliance manifests in the face, its filling is in the blood vessels, it belongs to Taiyang within Yang, and corresponds to the Qi of Summer. (As the Sovereign Official, the Heart governs Shen Ming [Mind/Spirit], and all things depend on it for rise and fall; thus it is called the root of life and the residence of Shen. Fire has a nature of flaming upward, so its brilliance manifests in the face. The Heart generates Blood and governs the vessels, so its filling is in the blood vessels. The Heart rules in Summer, and its Qi combines with Taiyang; since Taiyang resides within the fire of Summer, it is called Taiyang within Yang, corresponding to the Qi of Summer. Note: Wang Bing's edition reads "Bian of Shen," while Quanyuanqi's edition and *Tai Su* both read "Chu of Shen," which is correct; we adopt this reading here.) The Lung is the root of Qi and the residence of Po. Its brilliance manifests in the hair/body hair, its filling is in the skin, it belongs to Shaoyin within Yang, and corresponds to the Qi of Autumn. (The Lung stores Qi, its spirit is Po, and it connects with the skin and hair; hence this statement. Note: Wang Bing's edition reads "Taiyin within Yang," but *Jia Yi Jing* and *Tai Su* both read "Shaoyin." Lin Yi et al.'s *Xin Zheng Xiao* state: "Although the Lung belongs to Taiyin among the twelve meridians, within the Yang aspect it should be Shaoyin." This is correct; we adopt this reading.) The Kidney is the root of hibernation and storage, and the residence of Essence. Its brilliance manifests in the hair, its filling is in the bones, it belongs to Taiyin within Yin, and corresponds to the Qi of Winter. (The earth gates close, hibernating insects hide deeply; the Kidney governs Water, receiving and storing the Essence of the five Zang and six Fu organs; thus it is called the root of hibernation and storage, and the residence of Essence. The Brain is the Sea of Marrow, the Kidney governs bone marrow, and hair is nourished by the Brain; thus its brilliance is in the hair and its filling is in the bones. Note: Wang Bing's edition reads "Shaoyin," while Quanyuanqi's, *Jia Yi Jing*, and *Tai Su* all read "Taiyin." *Xin Zheng Xiao* states: "Although the Kidney belongs to Shaoyin among the twelve meridians, within the Yin aspect it should be Taiyin." We adopt this.) The Liver is the root of endurance against fatigue and the residence of Hun. Its brilliance manifests in the nails, its filling is in the tendons, thereby generating Blood and Qi... it belongs to Shaoyang within Yin, and corresponds to the Qi of Spring. (Human movement is performed by the strength of tendons; the Liver governs tendons and its spirit is Hun; thus it is called the root of endurance against fatigue and the residence of Hun. Nails are the surplus of tendons, nourished by the Liver; thus its brilliance is in the nails and its filling is in the tendons. The East is the beginning of generation, thus it can generate Blood and Qi. Note: "Ba" is interchangeable with "Pi" (fatigue); the Liver governs tendons, and overexertion leads to exhaustion and weariness, hence "Ba Ji." Furthermore, human Blood and Qi are generated by the Heart, controlled by the Spleen, and stored by the Liver. If the Liver is nourished, Blood and Qi are sufficient and disease-free; thus it is also said to generate Blood and Qi. "Yang Zhong" should be "Yin Zhong"; Quanyuanqi's, *Jia Yi Jing*, and *Tai Su* all agree.)* The Spleen, Stomach, Large Intestine, Small Intestine, San Jiao (Triple Burner), and Bladder are the root of the granaries (metaphor for digestive function) and the residence of Ying (Nutritive) Qi, named "Vessels/Containers," capable of transforming dregs and converting flavors for entry and exit. These belong to the category of Supreme Yin and correspond to the Qi of Earth. (They can receive and hold food, transporting without cease; thus they are the root of the granaries, named "Vessels." Ying Qi originates from the Middle Jiao, which is the location of the Spleen and Stomach; thus it is called the residence of Ying Qi. However, the flavors of water and grain enter the Spleen and Stomach; the Spleen and Stomach process the dregs and transform their flavors, expelling them via the San Jiao and Bladder; thus it is said to convert flavors for entry and exit. Earth combines with Supreme Yin; *Jin Gui Zhen Yan Lun* states: "Supreme Yin within Yin is the Spleen." Note: The terms "entry and exit" are profound; only with entry is there exit. The large intestine, small intestine, spleen, stomach, and bladder all enter first and then exit. The San Jiao governs Qi; why is it mentioned together? Presumably because the Qi of the San Jiao also relies on the flavors of diet to change and ascend/descend.) The functions of all eleven Zang organs depend on the Gallbladder. (From the Heart above to the Gallbladder below, there are eleven. However, the Gallbladder possesses uprightness, decisiveness, and impartiality; thus the functions of all organs depend on it.) Note: Each Zang organ has its own specific duty, hence the distinction of Twelve Officials in the *Mi Dian Lun*. Yet, those whose duties are exclusive cannot manage others; whereas those with similar efficacy and consistent goals must be discussed together. Therefore, although referring to the same Zang organs, this chapter sometimes discusses them separately and sometimes jointly, to show that the functions of the twelve Zang-Fu organs differ, completing the meaning.
Thus, if the Renying pulse is one-fold larger than the Cunkou pulse, the disease is in Shaoyang; two-fold larger, in Taiyang; three-fold larger, in Yangming; four-fold or more larger indicates Ge Yang (Rejection of Yang). ("One-fold" means the Renying pulse is one times larger than the Cunkou pulse. The method for other folds is the same. Four-fold or more indicates extreme excess of Yang, causing rejection where food cannot enter. *Zheng Li Lun* states: "Ge results in vomiting and regurgitation.") If the Cunkou pulse is one-fold larger than the Renying pulse, the disease is in Jueyin; two-fold larger, in Shaoyin; three-fold larger, in Taiyin; four-fold or more larger indicates Guan Yin (Closure of Yin). (The method of judging "Sheng" [excess/larger] is the same as for Yang. Four-fold or more indicates extreme excess of Yin, causing closure where urination cannot pass. *Zheng Li Lun* states: "Guan results in inability to urinate.") If both the Renying and Cunkou pulses are盛大 (excessively large) four-fold or more, it is called Guan Ge (Closure and Rejection). The Guan Ge pulse is exhausted (Note: In ancient texts, "Ying" [deficient] is often used interchangeably with "Ying" [full/excessive] in this context, implying extreme fullness leading to collapse); if it cannot reach the fullness of the essence of Heaven and Earth, death will ensue. ("Both excessive" means both are four times larger than the normal pulse. Things cannot remain excessively strong for long; extremity leads to decline; thus if it cannot reach the fullness of the essence of Heaven and Earth, death occurs. Note: *Xin Zheng Xiao* states: "In ancient texts, 'Ying' is used interchangeably with 'Ying' [full].") Those who oppose the Four Seasons: Excess manifests as pathogenic factors overcoming essence; deficiency manifests as consumption of essence. Should be excessive but is deficient indicates essence consumption; should be deficient but is excessive indicates pathogenic excess. When Yin and Yang Qi do not correspond, the disease is named Guan Ge. (This broadly elaborates on pulse correspondence. Regarding opposing the Four Seasons, all deficiencies are due to the depletion of Blood and Qi, and all excesses are due to pathogenic factors overcoming essence. Yin and Yang Qi do not correspond and cannot mutually nourish; thus it is called Guan Ge. Note: This section was originally printed in *Mai Yao Jing Wei Lun*, discussing Guan Ge alone without question-and-answer format, which must be a misplaced text (Cuo Jian). It is now moved here to ensure textual coherence. Carefully noting *Ling Shu · Zhong Shi Pian* states: "Renying one-fold, disease in Foot Shaoyang; one-fold and restless, disease in Hand Shaoyang. Renying two-fold, disease in Foot Taiyang; two-fold and restless, disease in Hand Taiyang. Renying three-fold, disease in Foot Yangming; three-fold and restless, disease in Hand Yangming. Renying four-fold, large and rapid, named Yi Yang (Overflowing Yang), Yi Yang is External Ge. Pulse Kou one-fold, disease in Foot Jueyin; one-fold and restless, disease in Hand Jueyin (Pericardium). Pulse Kou two-fold, disease in Foot Shaoyin; two-fold and restless, disease in Hand Shaoyin. Pulse Kou three-fold, disease in Foot Taiyin; three-fold and restless, disease in Hand Taiyin. Pulse Kou four-fold, large and rapid, named Yi Yin (Overflowing Yin), Yi Yin is Internal Guan. Internal Guan unblocked, death is incurable. Renying and Taiyin Pulse Kou both excessive four-fold or more, named Guan Ge; Guan Ge patients have a short life expectancy." Also *Mai Du Pian* states: "Pathogen in Fu organs causes Yang pulse disharmony; Yang pulse disharmony causes Qi stagnation; Qi stagnation causes Yang Qi excess. Extreme Yang excess makes Yin unfavorable; Yin unfavorability causes Blood stagnation; Blood stagnation causes Yin Qi excess. Extreme Yin excess prevents Yang Qi from nourishing; thus called Guan. Extreme Yang excess prevents Yin Qi from nourishing; thus called Ge. Both Yin and Yang are excessive and cannot mutually nourish; thus called Guan Ge. Guan Ge patients die before their time." Subsequently, *Jin Fu Pian* also discusses Guan Ge. Viewing these together, extreme external excess of Yin-Yang pulses is actually a sign of internal true Qi depletion; death follows swiftly, what is there to doubt? Differentiating Guan Ge began with *Nan Jing* Difficulty 3, stating pulses have excess, deficiency, Yin-Yang mutual multiplication, repetition, overflow, Guan, and Ge, described by physical characteristics. Zhang Zhongjing stated: "At Chi position is Guan, at Cun position is Ge; Guan results in inability to urinate, Ge results in vomiting and regurgitation." Wang Shuhe followed this. Li Dongyuan distinguished left as Renying and right as Qikou. If Qikou pulse is four times larger than Renying, this is clear Qi moving in turbid pathways, thus called Ge. If Renying pulse is four times larger than Qikou, this is turbid Qi moving in clear pathways, thus called Guan. Guan results in inability to urinate, Ge results in vomiting and regurgitation. Zhu Danxi established Guan Ge as a separate category, stating cold in Upper Jiao, heat in Lower Jiao, both Cun pulses excessive four-fold or more, such diseases often result in death. My fellow townsman Ma Xuantai stated that Guan Ge is a pulse condition, not a disease name. Zhang Jingyue praised him for surpassing previous generations, which is correct. However, Zhang exclusively identified the Renying mentioned in the classics as the Renying acupoint beside the larynx, and vigorously criticized previous views, blaming Li Dongyuan for erroneously creating the concept of Left Cun as Renying. Alas! His words were too extreme, his view biased and rigid. The Renying beside the larynx is indeed the Renying acupoint; although the classics mostly refer to this, there is no explicit text naming Left Cun as Renying, allowing for ambiguous interpretation. But to claim that both hands' Cun pulses belong entirely to Yin meridians is extremely erroneous. Let us prove this using the classics' statements on pulses. *Mai Yao Jing Wei Lun* states: "Inside Chi, sides are hypochondrium; outside Chi awaits Kidney, inside Chi awaits abdomen. Above Chi, left outside awaits Liver, inside awaits diaphragm; right outside awaits Stomach, inside awaits Spleen. Above that, right outside awaits Lung, inside awaits chest center; left outside awaits Heart, inside awaits Danzhong. Front awaits anterior, back awaits posterior." Observing this, not only are the Three Yin awaited in the three positions, but the Three Yang are also awaited in the three positions. Whenever the classics mention Renying, it is likely because the Three Yang meridians all ascend to the head, and the Renying beside the neck is an external indicator of the Yangming Stomach meridian, capable of awaiting the excess/deficiency of the Stomach meridian, but not the diseases of the Three Yang meridians. Moreover, naming Left Cun as Renying was not invented by Li Dongyuan. *Ling Shu · Wu Se Pian* states: "Renying excess and firm indicates injury from Cold; Qikou very firm indicates injury from Food." Renying and Qikou are symmetrical; Right Cun is Qikou, Right Guan is Spleen/Stomach; Spleen/Stomach food injury results in very firm pulse appearing at Right Cun. Left Cun is Renying, Left Guan is Liver/Gallbladder; Liver contracting wind-cold results in excess/firm pulse appearing at Left Cun. Thus, Renying indeed refers to Left Cun, as stated in this chapter. Because the classics did not explicitly name Left Cun as Renying, Zhang Jingyue could speak arbitrarily. Furthermore, within the human body, one name corresponding to two acupoints exists, such as Lin Qi, Qiao Yin, Qi Hai having upper and lower versions, San Li distinguishing hand and foot, Ju Xu distinguishing upper and lower Lian. Why must the one beside the larynx be named Renying, and the Left Cun not also be named Renying? Zhang Jingyue simply failed to think. And he himself claimed treating Ku Sima and Tian Zongbo, whose pulses were extremely firm and excessive, he only diagnosed the two Cun pulses, never diagnosing beside the throat. By regarding Guan Ge as a pulse condition, where extreme pulse excess indicates absence of Yin, true Yin exhaustion, and floating isolated Yang, this brilliant explanation deeply hits the crux of Guan Ge. It should not be discarded due to a single error in his statement.)