(朱丹溪擅改经文，窃未为安。今根据经衍义，颇觉通畅，虽改一字，增二字，皆协于本
文上下词意，考于全书，确有证据，名曰正义，似当本旨。明者鉴之!)
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。
此合论天人，以起下文也。人有阳气，如天之有日。“与”当作“于”。二字古文通用
。若
阳气失所，则损折夭寿，而不见其天命之本数矣。故天之营运也，以日光在上而始明，人之
有阳气也，亦充因于上，不陷于下，始得周行卫外，不致为邪所侵也。因，充积之义也。
因于寒，欲(当做咳)如运枢，起居如惊，神气乃浮。
此下四节，皆言阳气失所，不能卫外之病也。“欲”，盖“咳”之讹也。《灵枢》曰∶
形寒
寒饮则伤肺，气逆而上行；气上逆，故咳也。如运枢者，言其咳之连连不已，内动五脏，外
振经脉也。若曰“欲如运枢”则不致伤于寒，似与“冬不按跷”之义不合，且与上下文气不
续。坐卧不宁，神采不定，其状如惊狂者然。至真要论曰∶寒气大来，水之胜也，火热受邪
，心病生焉。心病则神敝，故起居如惊也。久则大气浮越，而为吐血、咯血诸症矣。所谓风
寒不醒成劳病也。荣卫生会曰∶血者，神气也。
因于暑，汗(当有“不出”二字)烦则喘喝，静则多言，体若燔炭，汗出而散。
此暑闭于内之症也，故知“汗”下当有“不出”二字。烦者，暑扰于气也，气扰则喘喝
。静
者，暑陷于阴也。阴伤则神明颠倒而多妄言。是症也，体若燔炭，仍宜汗出，暑气乃散，以
其始因于汗不出而暑郁于内也。但体若燔炭，津液已伤，仍必出汗始散，则急宜养津之意自
在言外。或曰烦、静，即东垣动暑、静暑义也。动暑伤气，故喘喝；静暑中气郁而不宣，故
多言也。亦通。
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。
此节丹溪所议极是。湿则浊气上升，头重而神识不清，故如裹。久 则化热，不急攘除
，则热
气内烁，伤液而大筋软短矣；湿气外淫，而小筋弛长矣。夫湿热者，发为痿 ，而拘急者，
必因
于寒。此乃湿热，亦有拘急者，何也?热，内也；湿，外也。大筋居内，小筋居外。在内者
，湿不敌热，则液燥，燥则缩矣。寒而拘急者，亦以其化燥也。寒热不同，其燥一也。在外
者，热不敌湿，则肉濡，濡则纵矣。大筋软短，则屈伸不能；小筋弛长，则操纵无力，而合
病为痿矣。
因于气，为肿，四维相代，阳气乃竭。
此卫气郁滞也。血滞于脏，则为积；气滞于脏，则为聚。血滞于身，则为痹；气滞于身
，则
为肿。肿则四肢必有废而不用者，则不废者代其职矣。脊以代头，尻以代踵，代之义也。
四末为诸阳之本，有所废而不用，久则阳气必偏竭矣，非气竭而死也。不曰不用，而曰相代
者，痹气走刺无定，彼此互易，非四肢全废也。仲景曰∶病患一臂不遂，时复转移在一臂，
是也。
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， 乎不可止。
此言养阳者，宜调其形体也。形体烦劳，则血脉争张，津液必有偏绝，屡犯而辟积以至
于夏
，则阴精内竭，时火外迫，如煎而厥矣。辟积，即襞积，犹言零碎累积也。盖烦劳偶犯，津
液
犹可渐复，惟屡犯不止，而至于夏，则内外合邪，变症作矣。目盲以下，煎厥证状也。都，
防也。凡中风卒倒，痰涎潮涌，腹中比水流波浪之声更甚。煎厥由于阴虚，薄厥由于阳实。
煎、薄二字可味。
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。
此言养阳者，宜和其心性也。若大怒，则形与气必相离绝，不相维矣。何则?怒则气逆
，而
血随气升，亦菀于上，血气相薄，上实下虚，其人必厥。薄者，迫也。气血并迫，经络壅塞
而不通，故厥也。亦有不发为厥者，怒生于肝，肝主于筋，怒则血气奔逸，火升液耗而筋伤
，筋则肌肉无所束，而形体纵大若不容矣。此皆形气离绝之证也。筋非骨会之大筋，乃散络
之管摄肌肉者，常有怒骂叫号，以致头面 肿，四肢酸软难动，如痿废者，见之屡矣。气复
即愈，此形与气绝，非死绝也。经中言“绝”，义多如此。薄厥见症于气，筋纵见症于形。
《阴阳应象》曰∶暴怒伤阴，暴喜伤阳，厥气上行，满脉去形。即此义也。
（朱丹溪擅自修改经文，我认为并不妥当。如今我依据经典推演其义，觉得颇为通畅，虽然改了一个字，增加了两个字，都符合原文上下文的词意，在全书中考证确有证据，命名为“正义”，似乎更贴近本旨。明眼人请鉴察！）
阳气，就像天空和太阳一样，如果失去了它应有的位置，就会折损寿命而不显赫，所以上天运行需要太阳的光明来照耀，因此阳气位于上部，具有护卫体外的功能。
这一段综合论述天人关系，以引出下文。人有阳气，就像天有太阳。“与”字应当作“于”。这两个字在古文中通用。如果阳气失去其正常位置，就会损伤折寿，无法展现天赋的自然寿命。所以天的运行，依靠日光在上而开始明亮；人的阳气，也充盛于上部，不陷于下部，才能周流全身护卫体外，不致使邪气侵袭。因，是充积的意思。
感受寒邪，咳嗽像转动门轴一样连连不已，起居举动如同受惊一般，神气就会浮越。
以下四节，都是讲阳气失位，不能护卫体外的病证。“欲”，大概是“咳”字的讹误。《灵枢》说：形体受寒、喝冷饮料就会伤肺，气逆而上行；气上逆，所以咳嗽。像转动门轴一样，是说咳嗽连连不断，内动五脏，外振经脉。如果说“想要像转动门轴”，就不会伤于寒，似乎与“冬天不按跷”的意义不合，而且与上下文气不连贯。坐卧不宁，神采不定，状态像发狂受惊的人。《素问·至真要大论》说：寒气大来，是水气胜的表现，火热受邪，心病就产生了。心病则神气败坏，所以起居举动像受惊一样。时间久了大气浮越，出现吐血、咯血等症状。这就是所谓风寒不解变成劳病。《灵枢·营卫生会》说：血就是神气。
感受暑邪，汗不出，心烦则气喘有声，安静时则多言乱语，身体像燃烧的炭火一样热，出汗后热散。
这是暑气闭塞在体内的症状，所以知道“汗”字下面应当有“不出”二字。烦，是暑气扰乱气机，气被扰乱则气喘有声。静，是暑气陷入阴分。阴分受伤则神明颠倒而多胡言乱语。这个病症，身体像燃烧的炭火，仍然适宜出汗，暑气才能散去，因为起初是因为汗不出导致暑气郁结在体内。但是身体像燃烧的炭火，津液已经受伤，一定要出汗才能散去，那么急需滋养津液的意思自然在言语之外。有人说烦、静，就是李东垣所说的动暑、静暑的意义。动暑伤气，所以气喘；静暑中气郁结而不宣通，所以多言。也讲得通。
感受湿邪，头部像被包裹住一样沉重。湿热不除去，大筋变软缩短，小筋松弛延长，软短导致拘挛，弛长导致痿废。
这一节朱丹溪议论得非常正确。湿气使浊气上升，头重且神识不清，所以像被包裹。时间久了化热，如果不及时清除，热气内灼，伤及津液而使大筋变软缩短；湿气外淫，使小筋松弛延长。湿热会导致痿病，而拘急通常是因为寒邪。这里却是湿热也有拘急的情况，为什么呢？热在内，湿在外。大筋居内，小筋居外。在内部的，湿不敌热，则津液干燥，干燥则收缩。寒邪导致的拘急，也是因为化燥。寒热不同，但化燥是一样的。在外部的，热不敌湿，则肌肉濡软，濡软则纵弛。大筋软短，则屈伸不能；小筋弛长，则操纵无力，合起来病为痿病。
感受气邪，导致浮肿，四肢交替出现功能障碍，阳气于是衰竭。
这是卫气郁滞。血滞留在脏腑，就成为积；气滞留在脏腑，就成为聚。血滞留在身体，就成为痹；气滞留在身体，就成为肿。肿则四肢一定有废弃不用的，不废弃的就代替它的职能。脊背代替头部，尾骨代替脚跟，这就是替代的意义。四肢末端是诸阳之本，有所废弃不用，时间久了阳气必然偏衰竭绝，并不是气竭而死。不说不用，而说相互替代，是因为痹气走窜刺痛没有定处，彼此互换，并不是四肢完全废弃。张仲景说：病人一只手臂不遂，时常转移到另一只手臂，就是这个意思。
阳气，烦劳过度就会亢张，精血枯竭，反复积累到夏季，使人发生煎厥。眼睛失明看不见，耳朵闭塞听不见，混乱的样子像堤坝崩溃，汹涌之势不可止住。
这是说保养阳气的人，应该调节形体。形体烦劳，则血脉争张，津液必有偏绝，屡次犯病并积累到夏季，则阴精在内枯竭，时火在外逼迫，像煎熬一样导致厥逆。辟积，即襞积，意思是零碎累积。大概烦劳偶尔犯病，津液还可以逐渐恢复，只有屡次犯病不止，到了夏季，则内外合邪，变症发作。目盲以下，是煎厥的症状表现。都，是堤防的意思。凡是中风卒倒，痰涎潮涌，腹中比水流波浪的声音更甚。煎厥由于阴虚，薄厥由于阳实。煎、薄二字值得玩味。
阳气，大怒则形体与气分离隔绝，血液郁积在上面，使人发生薄厥。如果有伤于筋，筋脉弛纵，身体就像不受控制一样。
这是说保养阳气的人，应该调和心性。如果大怒，则形与气必然分离隔绝，不相维系。为什么呢？怒则气逆，血随气升，也郁积在上面，血气相搏，上实下虚，其人必定厥逆。薄，是迫近的意思。气血并迫，经络壅塞不通，所以厥逆。也有不发为厥的，怒生于肝，肝主筋，怒则血气奔逸，火升液耗而伤筋，筋则肌肉无所约束，而形体纵弛扩大好像不受控制。这些都是形气离绝的证候。筋不是骨会的大筋，而是散络中管摄肌肉的，常有因愤怒叫骂号哭，导致头面肿胀，四肢酸软难动，像痿废的人，见过很多次了。气复即愈，这是形与气绝，并非死绝。经文中说的“绝”，意义大多如此。薄厥见症于气，筋纵见症于形。《素问·阴阳应象大论》说：暴怒伤阴，暴喜伤阳，厥气上行，满脉去形。就是这个意思。
(Zhu Danxi arbitrarily altered the classic texts, which I consider inappropriate. Now, based on the classics to deduce their meanings, it seems quite coherent. Although one character was changed and two characters added, they all align with the context of the original text, and there is solid evidence throughout the book. Naming this "Righteous Meaning" (Zhengyi) seems to better reflect the original intent. Those who are enlightened should observe this!)
Yang Qi (vital energy) is like the sky and the sun. If it loses its proper position, lifespan will be shortened and vitality will not be manifest. Therefore, just as the movement of heaven relies on the brightness of the sun, Yang Qi resides in the upper part and functions to protect the exterior.
This section synthesizes the relationship between Heaven and humanity to introduce the following discussion. Humans possess Yang Qi, just as Heaven possesses the Sun. The character "Yu" (with) should be read as "Yu" (at/in). These two characters are interchangeable in ancient texts. If Yang Qi loses its proper position, it damages longevity, preventing the manifestation of one's natural lifespan. Thus, Heaven's operation begins to shine because sunlight is above; similarly, human Yang Qi must be abundant in the upper part, not sinking to the lower part, to circulate fully and protect the exterior, thereby preventing invasion by pathogenic factors. "Yin" here means accumulation or filling.
Contracting cold pathogens causes coughing that continues incessantly, like turning a door pivot; daily activities and rest resemble being startled, causing Shen Qi (spiritual energy) to float upward.
The following four sections all discuss diseases where Yang Qi has lost its position and cannot protect the exterior. "Yu" (desire/want) is likely a textual error for "Ke" (cough). The *Ling Shu* states: "Cold affecting the form and cold drinks injure the Lung, causing Qi to reverse and move upward; Qi reversing upward results in cough." Being like a turning pivot describes the continuous nature of the cough, internally disturbing the Five Zang organs and externally vibrating the meridians. If interpreted as "desiring to act like a turning pivot," it would not imply injury from cold, which contradicts the meaning of "not performing acupressure/massage in winter," and disrupts the coherence with the surrounding text. Restlessness in sitting and lying down, unsettled spirit, resembling a state of fright or madness. The *Su Wen · Zhi Zhen Yao Da Lun* states: "When cold qi arrives greatly, Water overcomes Fire; when Heat receives the pathogen, Heart disease arises." Heart disease leads to the deterioration of Shen, hence movements resemble being startled. Over time, Great Qi floats outward, leading to symptoms such as hematemesis and hemoptysis. This is what is meant by wind-cold unresolved becoming a chronic consumption disease. The *Ling Shu · Ying Wei Hui Sheng* states: "Blood is Shen Qi."
Contracting summer-heat pathogens results in absence of sweating; if vexed, there is panting with audible breathing; if quiet, there is excessive talking; the body feels hot like burning charcoal, and heat dissipates upon sweating.
These are symptoms of summer-heat blocked internally. Therefore, it is known that the phrase "absence of sweating" should follow the word "sweat." "Fan" (vexation) indicates summer-heat disturbing Qi; when Qi is disturbed, there is panting with audible breathing. "Jing" (quiet) indicates summer-heat sinking into the Yin aspect. Injury to Yin leads to disordered Spirit and妄言 (delirious speech). For this condition, although the body is hot like burning charcoal, sweating is still appropriate to dissipate the summer-heat, because initially, the lack of sweating caused summer-heat to stagnate internally. However, since the body is hot like burning charcoal and fluids are already injured, the necessity of sweating to dissipate the heat implies an urgent need to nourish fluids, a meaning inherent in the text. Some argue that "fan" and "jing" correspond to Li Dongyuan's concepts of "Dong Shu" (Active Summer-heat) and "Jing Shu" (Quiet Summer-heat). Active Summer-heat injures Qi, causing panting; Quiet Summer-heat causes stagnation of Middle Qi without dispersion, leading to excessive talking. This interpretation is also valid.
Contracting dampness results in a sensation of heaviness in the head as if wrapped. If damp-heat is not eliminated, the large tendons become soft and short, and the small tendons become lax and long. Softness and shortness lead to spasms (ju), while laxity and length lead to flaccidity (wei).
Zhu Danxi's commentary on this section is highly accurate. Dampness causes turbid Qi to rise, resulting in heavy head and unclear consciousness, hence the sensation of being wrapped. Over time, it transforms into heat. If not promptly cleared, internal heat scorches and injures fluids, causing the large tendons to become soft and short; external invasion of dampness causes the small tendons to become lax and long. Damp-heat develops into Wei syndrome (flaccidity), whereas spasms are usually due to cold. Here, however, damp-heat also presents with spasms. Why? Heat is internal; Dampness is external. Large tendons reside internally; small tendons reside externally. Internally, if Dampness does not overcome Heat, fluids dry up, leading to contraction. Spasms caused by Cold also result from drying up. Although Cold and Heat differ, the result of drying up is the same. Externally, if Heat does not overcome Dampness, muscles become flaccid and relaxed, leading to laxity. When large tendons are soft and short, flexion and extension are impossible; when small tendons are lax and long, manipulation lacks strength. Together, these conditions constitute Wei syndrome (flaccidity).
Contracting Qi disorder leads to edema/swelling. The four limbs alternate in dysfunction, and Yang Qi eventually exhausts.
This refers to the stagnation of Wei Qi (Defensive Qi). Blood stasis in the Zang organs forms Ji (accumulations); Qi stagnation in the Zang organs forms Ju (masses). Blood stasis in the body forms Bi (obstruction/painful obstruction); Qi stagnation in the body leads to swelling. Swelling implies that some parts of the four limbs may become useless; the non-useless parts compensate for their function. The spine compensates for the head, and the coccyx compensates for the heels; this is the meaning of substitution. The four extremities are the root of all Yang Qi. If some parts are unused for a long time, Yang Qi will inevitably become unevenly exhausted, though this does not mean death from Qi exhaustion. The term "substitution" is used instead of "non-use" because Bi Qi moves and pierces without fixed location, alternating between sides, indicating that the limbs are not completely paralyzed. Zhang Zhongjing stated: "A patient has one arm paralyzed, which then shifts to the other arm." This illustrates the point.
Yang Qi, when subjected to excessive mental/physical labor, becomes hyperactive; essence is exhausted. Repeated accumulation of this stress into summer leads to Jian Jue (Frying Syncope). Eyes become blind unable to see, ears become closed unable to hear; the chaotic state resembles a breached dam, with surging force unstoppable.
This discusses how those preserving Yang Qi should regulate their physical form. Physical and mental fatigue causes blood vessels to distend and compete, leading to uneven distribution of fluids. Repeated offenses accumulating until summer cause internal depletion of Yin Essence and external pressure from seasonal Fire, resulting in syncope as if fried. "Pi Ji" (accumulation) refers to pleated accumulation, meaning gradual buildup. Occasional fatigue allows fluids to gradually recover, but repeated offenses continuing into summer cause internal and external pathogens to combine, triggering severe symptoms. The blindness and deafness below describe Jian Jue. "Du" refers to a dike or embankment. In sudden stroke, saliva surges, and sounds in the abdomen exceed those of flowing water waves. Jian Jue is due to Yin deficiency; Bo Jue is due to Yang excess. The characters "Jian" (fry) and "Bo" (press/thin) are worth pondering.
Yang Qi, under great anger, causes the separation of Form and Qi, with blood pooling at the upper body, leading to Bo Jue (Pressing Syncope). If tendons are injured, they become lax, and the body appears uncontrollable.
This discusses how those preserving Yang Qi should harmonize their mind and temperament. Great anger causes Form and Qi to separate and lose connection. Why? Anger causes Qi to reverse, and Blood follows Qi rising, pooling at the upper body. Blood and Qi clash, creating excess above and deficiency below, leading to syncope. "Bo" means pressing or approaching. Blood and Qi press together, blocking meridians and causing obstruction, hence syncope. Some do not develop syncope. Anger originates in the Liver, which governs tendons. Anger causes Blood and Qi to rush, Fire rises, fluids deplete, and tendons are injured. Tendons no longer bind muscles, causing the body to relax and expand as if uncontrollable. These are all signs of Form-Qi separation. The tendons referred to are not the major tendons of bone convergence, but the dispersed collaterals that control muscles. It is common to see cases of anger-induced shouting leading to facial swelling and limb weakness resembling paralysis. Recovery occurs when Qi returns; this separation of Form and Qi is not fatal. The term "jue" (separation/extinction) in the classics often carries this meaning. Bo Jue manifests in Qi disorders, while tendon laxity manifests in Form disorders. The *Su Wen · Yin Yang Ying Xiang Da Lun* states: "Violent anger injures Yin, violent joy injures Yang, rebellious Qi moves upward, full pulses depart from the form." This conveys the same meaning.