《读医随笔》者，学海之所以备遗忘也，意在温故以求新，实无新意之可采。徒以同志
传诵
医也，先治脉，次治药。脉有《脉义简摩》、《诊家直诀》之刻；药以亲尝未遍，不敢臆说
，久未成书。若夫病证众矣，治法繁矣，虽古之名医，犹不能以一身尽历天下之病变也，何
况
小子，敢以管蠡之见，妄事窥测乎!仅于读书、临诊之际，随听见而记之，缺略琐碎，固不
足为成书，亦复凌躐拉杂，未有体例，粗为分类，以付手民。其中陈陈相因者；蹇涩未畅者
；繁沓不检者；前后重复异同互见者；触目皆是，识浅笔孱，贻讥大雅，知不免矣。昔之人
，或广搜旧说，辑为宏编；或澄炼精思，约为枕秘。以此方彼，不亦蔑乎!虽然窃有说焉，
宋人怀燕石而自以为宝也，一旦出示于人，乃悟其非宝矣；朱奉议作《伤寒百问》，早刊行
世，得某友指摘之，遂改着《活人书》而传矣。学海深羡宋人之善悟，而将勉为奉议之能改
也。然则是刻也，非自炫也，亦非非自炫也。
光绪戊戌暮春皖南建德周学海澄之甫书于邵伯埭舟中
医者，道之流也。道家以精、气、神，谓之三宝，不言血者，赅于精也。是故气有三∶
曰宗
气也，荣气也，卫气也。精有四∶曰精也，血也，津也，液也。神有五∶曰神也，魂也，魄
也，意与智也，志也，是五脏所藏也。凡此十二者，为之大纲，而其变则通于天地万物，而
不可以数纪。
《内经》邪客曰∶五谷入于胃也，其糟粕、津液、宗气，分为三隧。故宗气积于胸中
，出于
喉咙，以贯心肺，而行呼吸焉；营气者，泌其津液，注之于脉，化而为血，以荣四末，内注
五脏六腑，以应刻数焉；卫气者，出其悍气之 疾，而先行于四末分肉皮肤之间，而不休者
也。五味曰∶谷入于胃，其精微者，先出于胃之两焦，以溉五脏，别出两行，营卫之道。其
大气之转而不行者，积于胸中，命曰气海，出于肺，循喉咙，呼则出，吸则入。营卫生会曰
∶谷入于胃，以传与肺，五脏六腑，皆以受气。其清者为营，浊者为卫；营在脉中，卫在脉
外
，营周不息，阴阳相贯，如环无端。营出中焦，卫出下焦。中焦受气，泌糟粕，蒸津液，化
其精微，上注于肺脉，乃化而为血，以奉生身，莫贵于此，故独得行于经隧，命曰营气。营
卫者，精气也。血者，神气也。上焦如雾，中焦如沤，下焦如渎。刺节真邪曰∶气积于胃，
以通营卫，各行其道。宗气留于海，其下者注于气街，其上者走于息道。决气曰∶两神相搏
，合而成形，常先身生，是谓精。上焦开发，宣五谷味，熏肤、充身、泽毛，若雾露之溉，
是谓气。腠理发泄，汗出溱溱，是谓津。谷入气满，淖泽注于骨，骨属曲伸，泄泽，补益脑
髓，皮肤润泽，是谓液。中焦受气取汁，变化而赤，是谓血。壅遏营气，令无所避，是谓脉
。五癃津液别曰∶水谷入口，输于肠胃，其味有五，各注其海；其液别为五，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。天暑衣浓，则腠理开，故汗
出；天寒衣薄，腠理闭，气湿不行，水下溜于膀胱，则为溺与气。非哀气并，则为泣；中热
胃缓，则为唾。本神曰∶天之在我者德也，地之在我者气也，德流气薄而生者也。故生之来
谓之精，两精相搏谓之神，随神往来谓之魂，并精出入谓之魄，所以任物谓之心，心有所忆
谓之意，意有所存谓之志，因志而存变谓之思，因思而远慕谓之虑，因虑而处物谓之智
。天年曰∶血所已和，营卫已通，五脏已成，
神气舍心，魂魄毕具，乃成为人。本脏曰∶人之血气精神者，所以奉生而周于性命者也；经
脉者，所以行血气而营阴阳，濡筋骨利关节者也；卫气者，所以温分肉，充皮肤，肥腠理，
司开合者也；志意者，所以御精神，收魂魄，适寒温，和喜怒者也。是故血和则经脉流行，
营复阴阳，筋骨劲强，关节清利矣；卫气和则分肉解利，皮肤调柔腠理致密矣；志意和，则
精神专直，魂魄不散，恚怒不起，五脏不受邪矣；寒温和则六腑化谷，风痹不作，经脉通利
，肢节得安矣。此人之常平也。五脏者，所以藏精、神、血、气、魂、魄者也。六腑者，所
以化水谷而行津液者也。此人之所以具受于天者，无智愚贤不肖，不能相倚也。伟哉论也
!美矣备矣!
其合之于五脏，则有肝木、心火、脾土、肺金、肾水，五行之气之不同也；有肝泪、心
汗、
脾涎、肺涕、肾唾，五液之精之各足也；有肝魂、心神、脾意、肺魄、肾志，五蕴之神之至
灵也。其为变也，气之乱，则为五胀出《灵枢·胀论》，为癫厥；精之乱，则为五水，为淋
浊；血之乱，则为痈疽，为积聚，为鼽衄，为咯血；神之乱也，精神虚而相并∶并于心则喜
；并于肺则悲；并于肝则忧；并于脾则畏；并于肾则恐。纷纭纠错，盖有不可以数计而口辨
者。而兹乃括之以三气、四精、五神者，何也?道其常而已矣。其常奈何?气者，无形而有机
者也。以其机之所动，有三焦之分出也。精者，有形者也。有形则有质，以其质之所别，有
四等之不同也。神者，无形无机而有用者也。以其用之所成，故推见五性之大本也。
卫气者，本于命门，达于三焦，以温肌肉、筋骨、皮肤， 悍滑疾，而无所束者也；营
气者
，出于脾胃，以濡筋骨、肌肉、皮肤，充满推移于血脉之中而不动者也；宗气者，营卫之所
合也，出于肺，积于气海，行于气脉之中，动而以息往来者也。是故卫气者，热气也。凡肌
肉之所以能温，水谷之所以能化者，卫气之功用也。虚则病寒，实则病热。营气者，湿气
也。凡经隧之所以滑利，发肤之所以充润者，营气之功用也。虚则皴揭槁涩，实则淖泽 肿
，光浮于外。卫气失常曰∶营气沛然者，病在血脉。宗气者，动气也。凡呼吸言语声音，以
及肢体运动、筋力强弱者，宗气之功用也。虚则短促少气，实则喘喝胀满。凡人之身，卫气
不到则冷；荣气不到则；宗气不到则痿痹而不用。此三者，《内经》谓之“肉苛”，谓其
枯
槁缩瑟，而光彩不发也。故卫气有寒热病；营气有湿病、燥病；宗气有郁结病，有劳倦病。
三气互为体用，有两得而无两离者也。
秦景明曰∶“气犹火也；水谷犹薪也。火大则能化薪，薪多则益能生火。此先天后天，
还相
为质者也。故热气蒸则湿气生，湿热盛则动气疾，而热亢则孔窍生烟，湿胜则水精不布。世
谓补火即是补气，又谓降气即是降火，是止言卫气而已。柯韵伯曰∶“水谷之精气，行于脉
中者为营气；其悍气行于脉外者为卫气；大气之积于胸中而司呼吸者为宗气，是分后天运用
之元气而为三也。又外应皮毛，协营卫而主一身之表者，为太阳膀胱之气；内通五脏，司治
节而主一身之里者，为太阴肺金之气；通内联外，应腠理而主一身之半表 半里者，为少阳
三焦之气，是分先天营运之元气而为三也。是有六气矣，谬立名义，显悖经旨。试思所谓先
天三气，何尝越于卫出下焦之外耶?后世言气者，遗宗气而言卫出上焦。其说始于华佗《中
藏经》，盖误会《难经》心营、肺卫之义也。 《难经》言心营、肺卫者，气行之机，非气
出之本也。是故三气者，各有其本，各行其道，而不可相干，失常则变矣。寿夭刚柔曰∶营
之生病也，寒热少气，血上下行；卫之生病也，气痛，时来时去，怫忾贲响，风寒客于肠胃
之中，寒痹之为病也，留而不去，时痛而皮不仁。平人气象曰∶胃之大络，名曰虚里，
贯膈络肺，出左乳下，其动应脉。宗气也，其动应衣，宗气泄也。此三气之自敝也。五乱曰
∶气乱于心，则烦心密默，俯首静伏；乱于肺，则俯仰喘喝，接手以呼；乱于肠胃，则为霍
乱；乱于胫臂，则为四厥；乱于头，则为厥逆，头重眩仆。病能曰∶有病怒狂者，病名曰阳
厥。阳气者，因暴折而难决，故善怒也。何以知之?阳明者常动，巨阳、少阳不动，不动而
动大疾，此其候也。癫狂曰∶厥逆为病也，足暴清，胸若将裂，肠若将以刀切之。着至教
曰∶三阳独至者，是三阳并至，并至如风雨，上为巅疾，下为漏 。《口问》曰∶人之自啮
舌者，此厥逆上走，脉气辈至也。少阴气至则啮舌，少阳气至则啮颊，阳明气至则啮唇矣。
调经曰∶气血以并，阴阳相倾，气乱于卫，血逆于经，血气离居，一实一虚。血并于阴，气
并于阳，故为惊狂；血并于阳，气并于阴，乃为炅中；血并于上，气并于下，心烦惋，善怒
；血并于下，气并于上，乱而善忘。气之所并为血虚，血之所并为气虚。血气相失，故为虚
焉；血与气并，故为实焉。此数病者，是三气之并而相乱也。调经曰∶“阳虚生外寒者，阳
受气于上焦，以温皮肤分肉之间。今寒气在外，则上焦不通；上焦不通，则寒气独留于外，
故寒栗。阴虚生内热者，有所劳倦，形气衰少，谷气不盛，上焦不行，下脘不通，胃气热，
熏胸中，故内热。(言劳倦伤气，不能鼓动谷气精微达于周身，是以上下不通。而胃中水谷
气热，仅能熏积于胸中也。此隔病之所起也。生气通天曰∶阳蓄积则当隔，隔者当泻。)阳
盛生外热者，上焦不通利，则皮肤致密，腠理闭塞，玄府不通，卫气不得泄越，故外热。阴
盛生内寒者，厥气上逆，寒气积于胸中而不泻，不泻则温气去，寒独留，则血凝泣，凝则脉
不通，其脉盛大以涩，故中寒。生气通天曰∶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。此三气之虚实相胜，所谓阴虚阳往，营竭卫降，即其事也。
精之以精、血、津、液，列为四者，何也?本神曰∶五脏主藏精者也，故统谓之精。夫
血者
，水谷之精微，得命门真火蒸化，以生长肌肉、皮毛者也。凡人身筋骨、肌肉、皮肤、毛发
有形者，皆血类也。精者，血之精微所成，生气之所根据也。生气者，卫气之根，即命门真火
是也，精竭则生气绝矣。髓与脑，皆精之类也。津亦水谷所化，其浊者为血，清者为津，以
润脏腑、肌肉、脉络，使气血得以周行通利而不滞者此也。凡气血中不可无此，无此则槁涩
不行矣。发于外者，泪、唾、汗，皆其类也。小便，其糟粕也。液者，淖而极浓，不与气同
奔逸者也。亦水谷所化，藏于骨节筋会之间，以利屈伸者。其外出于孔窍，曰涕、曰涎，皆
其类也。四者各有功用，而体亦不同。血之质最重浊；津之质最轻清；而液者清而晶莹，浓
而凝结，是重而不浊者也；精者合血与津液之精华，极清极浓，而又极灵者也，是神之宅
也
。西医谓精中有三物∶一曰虫，能蠕动者，男女交媾，即此虫与女精合而成形也；一曰珠，
极细极明而中空，精平方一寸，约有珠五百颗；一曰白汁，极明而淖，珠与虫皆藏汁中。汁
与珠二者，其于交媾结形，不知何用也?西医徒恃窥测，而不能明理，虽曰征实，然未免滞
于象矣!
四者之在人身也，血为最多，精为最重，而津之用为最大也。内之脏腑筋骨，外之皮肤
毫毛
，即夫精也、血也、液也，莫不赖津以濡之，乃能各成其体而不敝。津枯则精血可粉，毛发
可折。故决气曰∶精脱者，耳聋；气脱者，目不明；津脱者，腠理开，汗大泄；液脱者，骨
属屈伸不利，色夭，脑髓消，胫酸，耳数鸣；血脱者，色白，夭然不泽，其脉空虚。经脉别
论曰∶饮食饱甚，汗出于胃；惊而夺精，汗出于心；持重远行，汗出于肾；疾走恐惧，汗出
于肝；摇体劳苦，汗出于脾。此非汗出于脏也
，各因其脏气之动，鼓津以外出也。营卫生会曰∶夺血者无汗，夺汗者无血。夫汗即津也，
其与血，非一物也。而有无相应者?气机应也。故三气为阳，而营为阳之阴，以气与津并与
。四精为阴，而津为阴之阳，以津随气行也。生气通天曰∶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，(都，堤防也。高士宗曰
国都。) 乎不可以止。精绝者，津耗也。叶香岩《温热论》谓养阴不在补血，而在生津
。王孟英释之曰∶此增水行舟之法也。有味乎其言之也。
五神者，血气之性也。喜、怒、思、忧、恐，本于天命，人而无此，谓之大痴，其性死
矣。
然而神之病，其变不可测，而又最不易治，则其本末不可不知也。大抵神之充也，欲其调；
神之调也，欲其静。痹论曰∶阴气者，静则神藏，躁则消亡。生气通天曰∶阳
气者，静则养神，柔则养筋。(柔者，动而和也。)又曰∶阳
气者，大怒则形气绝(形气乖离。)血菀于上，使人薄厥。有伤于筋纵，其若不容。阴阳应象
曰∶暴怒伤阴，暴喜伤阳，厥气上行，满脉去形，喜怒无度，生乃不固。故四气调神篇大义
，所恶者逆，而所以奉生、奉长、奉收、奉藏者，必赖乎预也。故阴阳应象曰∶怒伤肝，悲
《读医随笔》这本书，是我周学海用来防备遗忘的，意在温习旧知以求新知，实在没有什么新颖独到之处可供采纳。只是因为有志同道合的人传诵我的医学见解，所以我先论述脉诊，再论述药物。脉学方面有《脉义简摩》、《诊家直诀》等刻印本；对于药物，因为我亲自尝试品尝的并不全面，不敢妄加臆测，所以很久没有写成书。至于疾病证候众多，治疗方法繁杂，即使是古代的名医，也不能凭一己之力经历天下所有的病变，何况像我这样的后辈，怎敢以管中窥豹的浅见，妄自推测呢！只是在读书、临诊的时候，随着听到的和看到的记录下来，缺漏琐碎，本来不足以成为成体系的著作，而且杂乱无章，没有体例，粗略地分类，交给刻工印刷。其中沿袭旧说的；生涩不通畅的；繁琐不严谨的；前后重复、异同混杂的，到处都是。我见识浅薄、笔力软弱，被高雅之士讥笑，是不可避免的。过去的人，有的广泛搜集旧说，编辑成宏大的篇章；有的澄清提炼精妙思考，简约为枕边秘籍。以此相比彼，不是太渺小了吗！虽然如此，我私下里有一番说法：宋人怀揣像燕石一样的石头却自以为宝贝，一旦展示给别人看，才明白它不是宝贝；朱奉议编写《伤寒百问》，早已刊行于世，得到某位朋友的指摘后，于是改著《活人书》而流传下来。我非常羡慕宋人的善于领悟，也将努力效仿奉议的能够改正错误。然而这部刻印的书，既不是自我炫耀，也不是完全不自我炫耀。
光绪戊戌年暮春时节，皖南建德周学海澄之甫在邵伯埭的船中书写
医生，是“道”的流派之一。道家把精、气、神称为三宝，不说血，是因为血包含在精之中。所以气有三种：叫宗气（积聚于胸中的大气）、营气（行于脉中化生血液的气）、卫气（行于脉外护卫体表的气）。精有四种：叫精（生殖之精）、血、津（清稀的体液）、液（稠厚的体液）。神有五种：叫神（主宰生命活动的主宰）、魂（随神往来的精神活动）、魄（并精出入的感觉本能）、意与智（心有所忆为意，因虑处物为智）、志（意之所存），这是五脏所藏的精神意识。所有这些十二项，是大纲，而它们的变化则通达天地万物，不能用数字来记录。
《内经·邪客篇》说：五谷进入胃后，其糟粕、津液、宗气，分为三条通道。所以宗气积聚在胸中，出于喉咙，贯通心肺，推动呼吸；营气，分泌津液，注入脉中，变化为血，以营养四肢末端，向内灌注五脏六腑，以应合呼吸的节律；卫气，发出其剽悍滑疾之气，先行于四肢、肌肉、皮肤之间，不停息。《五味篇》说：谷食进入胃，其中的精微物质，先从胃的两焦出来，以灌溉五脏，分出两条路径，即营气和卫气的运行之道。那大气中转动而不运行的，积聚在胸中，名叫气海，出于肺，循喉咙，呼则出，吸则入。《营卫生会篇》说：谷食进入胃，传给肺，五脏六腑都从中受气。其中清的部分为营气，浊的部分为卫气；营气在脉中，卫气在脉外，营气周流不息，阴阳相互贯通，如圆环没有端点。营气出自中焦，卫气出自下焦。中焦接受水谷之气，分离糟粕，蒸腾津液，化生精微，向上注于肺脉，于是变化为血，以供养身体，没有比这更宝贵的了，所以独能行于经脉隧道，名叫营气。营气和卫气，就是精气。血，就是神气。上焦像雾露弥漫，中焦像沤渍发酵，下焦像沟渠排水。《刺节真邪篇》说：气积聚在胃，以通调营卫，各自运行其道。宗气留滞于气海，其下的部分注入气街，其上的部分走向息道（呼吸之道）。《决气篇》说：两性的精气结合，形成形体，常在身体之前生成，这叫精。上焦开发，宣发五谷的味道，熏肤、充身、泽毛，像雾露灌溉一样，这叫气。腠理发泄，汗出淋漓，这叫津。谷食进入，气机充满，浓稠润泽注入骨骼，使骨属屈伸自如，排泄润泽，补益脑髓，皮肤润泽，这叫液。中焦接受水谷之气，提取汁液，变化为红色，这叫血。壅遏营气，使其无处躲避，这叫脉。《五癃津液别篇》说：水谷入口，输送到肠胃，味道有五种，各注入其相应的海；其液体分为五种，各走其道。所以三焦发出气，以温暖肌肉，充实皮肤，这就是津；其流动而不运行的，就是液。天气炎热衣服厚，则腠理开，所以出汗；天气寒冷衣服薄，腠理闭，气湿不行，水向下流入膀胱，就成为尿和气。如果不是哀伤之气合并，就会流泪；体内热而胃缓，就会流唾液。《本神篇》说：天赋予我们的是德，地赋予我们的是气，德流布气交迫而生出生命。所以生命的来源叫做精，两精相搏产生神，随神往来的叫做魂，伴随精出入的叫做魄，用来应对事物的叫做心，心中有所记忆叫做意，意有所保存叫做志，依据志而进行变通叫做思，依据思而远慕叫做虑，依据虑而处理事物叫做智。《天年篇》说：血已经调和，营卫已经通畅，五脏已经形成，神气舍居于心，魂魄具备，才成为人。《本脏篇》说：人的血气精神，是用来奉养生命并周遍性命的；经脉，是用来运行血气而营护阴阳，濡润筋骨利关节的；卫气，是用来温暖分肉，充实皮肤，肥实腠理，司管开合的；志意，是用来驾驭精神，收敛魂魄，适应寒温，调和喜怒的。所以血调和则经脉流行，营复阴阳，筋骨强劲，关节清利；卫气调和则分肉解利，皮肤柔润，腠理致密；志意调和，则精神专注正直，魂魄不散，愤怒不起，五脏不受邪气；寒温适宜则六腑消化水谷，风痹不发生，经脉通利，肢节安适。这是人的常态平衡。五脏，是用来藏精、神、血、气、魂、魄的。六腑，是用来消化水谷而行津液的。这是人所从上天那里完全接受的，无论智慧愚蠢贤良不肖，都不能偏倚。伟大的论述啊！美好而完备啊！
将其合于五脏，则有肝木、心火、脾土、肺金、肾水，五行之气的不同；有肝泪、心汗、脾涎、肺涕、肾唾，五液之精的各足；有肝魂、心神、脾意、肺魄、肾志，五蕴之神的最灵。它们的变化，气的紊乱，则为五脏胀（出自《灵枢·胀论》），为癫厥；精的紊乱，则为五水，为淋浊；血的紊乱，则为痈疽，为积聚，为鼻出血，为咯血；神的紊乱，精神虚弱而相并：并于心则喜笑；并于肺则悲伤；并于肝则忧愁；并于脾则畏缩；并于肾则恐惧。纷纭交错，大概有不可用数字计算和口辩说明的。而这里却用三气、四精、五神来概括，为什么呢？说的是它们的常道罢了。它们的常道是怎样的？气，是无形而有机的。以其机动的所在，有三焦的分出。精，是有形的。有形就有质，以其质的区别，有四等的不同。神，是无形无机而有用的。以其作用的成就，所以推见五性的根本。
卫气，源于命门，通达三焦，以温暖肌肉、筋骨、皮肤，剽悍滑疾，而没有束缚；营气，出于脾胃，以濡润筋骨、肌肉、皮肤，充满推移于血脉之中而不乱动；宗气，是营卫的合和，出于肺，积聚于气海，行于气脉之中，随着呼吸而动。所以卫气，是热气。凡肌肉之所以能温暖，水谷之所以能消化的，是卫气的功用。虚则病寒，实则病热。营气，是湿气。凡经脉之所以滑利，发肤之所以充润的，是营气的功用。虚则皮肤皴裂干枯涩滞，实则肿胀光亮浮于外。《卫气失常篇》说：营气充沛的，病在血脉。宗气，是动气。凡呼吸言语声音，以及肢体运动、筋力强弱的，是宗气的功用。虚则短促少气，实则喘喝胀满。凡人的身体，卫气不到则冷；营气不到则枯槁；宗气不到则痿痹而不用。这三者，《内经》称之为“肉苛”，谓其枯槁缩瑟，而光彩不发。所以卫气有寒热病；营气有湿病、燥病；宗气有郁结病，有劳倦病。三气互为体用，有两得而无两离的。
秦景明说：“气就像火；水谷就像柴。火大则能化柴，柴多则益能生火。这是先天后天，互相作为物质的。所以热气蒸腾则湿气产生，湿热盛则动气急，而热亢则孔窍生烟，湿胜则水精不布。世人说补火即是补气，又说降气即是降火，这只是说了卫气而已。”柯韵伯说：“水谷的精气，行于脉中的为营气；其剽悍之气行于脉外的为卫气；大气积聚于胸中而司呼吸的为宗气，这是将后天的运用之元气分为三种。又外应皮毛，协营卫而主一身之表的，为太阳膀胱之气；内通五脏，司治节而主一身之里的，为太阴肺金之气；通内联外，应腠理而主一身之半表半里的，为少阳三焦之气，这是将先天的营运之元气分为三种。这就有了六气，谬立名义，显悖经旨。试想所谓先天三气，何尝超出卫出下焦之外？后世言气的人，遗忘了宗气而言卫出上焦。这种说法始于华佗《中藏经》，大概是误会了《难经》中心营、肺卫的意义。《难经》言心营、肺卫，是指气运行的机制，而非气产生的本源。所以三气，各有其本源，各行其道，而不可相干，失常则变了。《寿夭刚柔篇》说：营生病，寒热少气，血上下行；卫生病，气痛，时来时去，怫忾贲响，风寒客于肠胃之中，寒痹之为病，留而不去，时痛而皮不仁。《平人气象论》说：胃的大络，名叫虚里，贯膈络肺，出左乳下，其动应脉，是宗气，其动应衣，是宗气泄。这是三气的自弊。《五乱篇》说：气乱于心，则烦心密默，俯首静伏；乱于肺，则俯仰喘喝，接手以呼；乱于肠胃，则为霍乱；乱于胫臂，则为四厥；乱于头，则为厥逆，头重眩仆。《病能篇》说：有病怒狂的，病名叫阳厥。阳气者，因暴折而难决，故善怒。怎么知道？阳明脉常动，巨阳、少阳不动，不动而动大疾，这是其征候。《癫狂篇》说：厥逆为病，足暴清，胸若将裂，肠若将以刀切。《着至教论》说：三阳独至的，是三阳并至，并至如风雨，上为巅疾，下为漏泄。《口问篇》说：人自啮舌的，这是厥逆上走，脉气辈至。少阴气至则啮舌，少阳气至则啮颊，阳明气至则啮唇。《调经篇》说：气血以并，阴阳相倾，气乱于卫，血逆于经，血气离居，一实一虚。血并于阴，气并于阳，故为惊狂；血并于阳，气并于阴，乃为炅中；血并于上，气并于下，心烦惋，善怒；血并于下，气并于上，乱而善忘。气之所并为血虚，血之所并为气虚。血气相失，故为虚焉；血与气并，故为实焉。这些病，是三气并而相乱的。《调经篇》说：“阳虚生外寒者，阳受气于上焦，以温皮肤分肉之间。今寒气在外，则上焦不通；上焦不通，则寒气独留于外，故寒栗。阴虚生内热者，有所劳倦，形气衰少，谷气不盛，上焦不行，下脘不通，胃气热，熏胸中，故内热。（言劳倦伤气，不能鼓动谷气精微达于周身，是以上下不通。而胃中水谷气热，仅能熏积于胸中也。此隔病之所起也。）《生气通天论》说：阳蓄积则当隔，隔者当泻。”阳盛生外热者，上焦不通利，则皮肤致密，腠理闭塞，玄府不通，卫气不得泄越，故外热。阴盛生内寒者，厥气上逆，寒气积于胸中而不泻，不泻则温气去，寒独留，则血凝泣，凝则脉不通，其脉盛大以涩，故中寒。《生气通天论》说：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。这是三气的虚实相胜，所谓阴虚阳往，营竭卫降，就是这事。
精以精、血、津、液列为四种，为什么呢？《本神篇》说：五脏主藏精的，所以统谓之精。夫血，是水谷的精微，得命门真火蒸化，以生长肌肉、皮毛的。凡人身筋骨、肌肉、皮肤、毛发有形的，都是血类。精，是血的精微所成，生气的所根据。生气，是卫气的根，即命门真火，精竭则生气绝了。髓与脑，都是精之类。津也是水谷所化，其浊者为血，清者为津，以润脏腑、肌肉、脉络，使气血得以周行通利而不滞的，就是这个。凡气血中不可无此，无此则枯槁涩滞不行了。发于外的，泪、唾、汗，都是其类。小便，是其糟粕。液，是浓而极浓，不与气同奔逸的。也是水谷所化，藏于骨节筋会之间，以利屈伸的。其外出于孔窍的，曰涕、曰涎，都是其类。四者各有功用，而体也不同。血的质最重浊；津的质最轻清；而液者清而晶莹，浓而凝结，是重而不浊的；精者合血与津液的精华，极清极浓，而又极灵的，是神的宅子。西医谓精中有三物：一曰虫，能蠕动者，男女交媾，即此虫与女精合而成形；一曰珠，极细极明而中空，精平方一寸，约有珠五百颗；一曰白汁，极明而淖，珠与虫皆藏汁中。汁与珠二者，其在交媾结形，不知何用？西医徒恃窥测，而不能明理，虽曰征实，然未免滞于象了！
四者在人身，血为最多，精为最重，而津的用为最大。内的脏腑筋骨，外的皮肤毫毛，即夫精、血、液，无不赖津以濡之，乃能各成其体而不败。津枯则精血可粉，毛发可折。所以《决气篇》说：精脱者，耳聋；气脱者，目不明；津脱者，腠理开，汗大泄；液脱者，骨属屈伸不利，色夭，脑髓消，胫酸，耳数鸣；血脱者，色白，夭然不泽，其脉空虚。《经脉别论》说：饮食饱甚，汗出于胃；惊而夺精，汗出于心；持重远行，汗出于肾；疾走恐惧，汗出于肝；摇体劳苦，汗出于脾。这不是汗出于脏，各因其脏气之动，鼓津以外出。《营卫生会篇》说：夺血者无汗，夺汗者无血。夫汗即津，其与血，非一物。而有无相应？气机应。所以三气为阳，而营为阳之阴，以气与津并与。四精为阴，而津为阴之阳，以津随气行。《生气通天论》说：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，（都，堤防。高士宗曰国都。）潏潏乎不可以止。精绝，是津耗。叶香岩《温热论》谓养阴不在补血，而在生津。王孟英释之曰：此增水行舟之法。有味乎其言之也。
五神，是血气的性。喜、怒、思、忧、恐，本于天命，人而无此，谓之大痴，其性死了。
然而神的病，其变不可测，而又最不易治，则其本末不可不知。大抵神之充，欲其调；神之调，欲其静。《痹论》说：阴气者，静则神藏，躁则消亡。《生气通天论》说：阳气者，静则养神，柔则养筋。（柔者，动而和。）又说：阳气者，大怒则形气绝（形气乖离。）血菀于上，使人薄厥。有伤于筋纵，其若不容。《阴阳应象大论》说：暴怒伤阴，暴喜伤阳，厥气上行，满脉去形，喜怒无度，生乃不固。所以《四气调神大论》大义，所恶者逆，而所以奉生、奉长、奉收、奉藏的，必赖乎预。所以《阴阳应象大论》说：怒伤肝，悲
"Du Yi Sui Bi" (Notes on Reading Medicine) is what I, Zhou Xuehai, use to prevent forgetfulness. Its intention is to review the old to seek the new, and there is truly no novel insight worth adopting. It is merely because like-minded individuals circulate my medical views that I first discuss pulse diagnosis (Mai Zhen), then discuss herbs (Yao). For pulse diagnosis, there are printed editions such as "Mai Yi Jian Mo" (Simplified Discussion on Pulse Principles) and "Zhen Jia Zhi Jue" (Direct Guidelines for Pulse Diagnosis); regarding herbs, since I have not personally tasted them all, I dare not speculate arbitrarily, so I have not completed a book on this topic for a long time. As for diseases and syndromes (Bing Zheng), they are numerous; treatment methods (Zhi Fa) are complex. Even famous doctors of antiquity could not experience all pathological changes in the world with their own bodies, let alone a junior like me. How dare I use the limited view of looking through a tube to make presumptuous speculations! I only recorded whatever I heard and saw while reading and attending clinical cases. These records are incomplete, trivial, and certainly insufficient to constitute a formal book. Moreover, they are disorganized and lack structure, roughly classified here for printing. Instances of following conventions without innovation; awkward and unsmooth expressions; verbose and unrigorous content; repetitions and contradictions between front and back sections; are everywhere. With my shallow knowledge and weak writing skills, being ridiculed by elegant scholars is inevitable. In the past, some people extensively collected old theories and compiled them into grand volumes; others clarified and refined their thoughts, condensing them into secret manuals kept at the pillow. Compared to these, mine is indeed insignificant! Nevertheless, I have a private explanation: A Song dynasty person cherished a stone from Yan, thinking it a treasure, but when shown to others, realized it was not a treasure; Zhu Fengyi wrote "Shang Han Bai Wen" (One Hundred Questions on Cold Damage), which was published early, but after being pointed out by a friend, he revised it into "Huo Ren Shu" (Book of Living People) and it was transmitted. I deeply admire the Song person's ability to realize truth, and will strive to emulate Fengyi's ability to correct errors. Thus, this printed work is neither purely self-display nor entirely devoid of self-display.
Written in the boat at Shaobai Dai in late spring of the Wuxu year of Guangxu, by Zhou Xuehai, courtesy name Chengzhi, from Jiande, Southern Anhui.
The physician is a stream of the Dao. The Daoist school regards Jing (Essence), Qi (Vital Energy), and Shen (Spirit) as the Three Treasures, not mentioning Blood (Xue) because it is included within Essence. Therefore, Qi has three types: namely Zong Qi (Pectoral Qi/Gathering Qi), Ying Qi (Nutritive Qi), and Wei Qi (Defensive Qi). Essence has four types: namely Jing (Reproductive Essence), Blood, Jin (Thin Body Fluids), and Ye (Thick Body Fluids). Spirit has five types: namely Shen (Master Spirit), Hun (Ethereal Soul), Po (Corporeal Soul), Yi and Zhi (Intellect and Will - Yi is memory, Zhi is determination), and Zhi (Will/Intention), which are stored by the Five Zang Organs. All these twelve items form the general outline, and their variations extend to heaven, earth, and all things,不可 be counted numerically.
The Nei Jing (Inner Canon) chapter "Xie Ke" states: When grains enter the stomach, their dregs, body fluids, and Zong Qi are divided into three pathways. Thus, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart and Lungs, and governs respiration; Ying Qi secretes body fluids, injects them into the vessels, transforms into Blood, nourishes the four extremities, and internally irrigates the Five Zang and Six Fu organs, corresponding to the rhythmic cycles; Wei Qi emits its fierce, rapid, and slippery energy, moving first among the four extremities, muscles, and skin, without rest. The chapter "Wu Wei" states: When food enters the stomach, its subtle essence first emerges from the two Jiao of the stomach to irrigate the Five Zang, dividing into two paths, the ways of Ying and Wei Qi. The large Qi that rotates but does not move accumulates in the chest, named Qi Hai (Sea of Qi), emerges from the Lung, follows the throat, exits upon exhalation, and enters upon inhalation. The chapter "Ying Wei Sheng Hui" states: When food enters the stomach, it is transmitted to the Lung, and all Five Zang and Six Fu organs receive Qi from it. The clear part becomes Ying Qi, the turbid part becomes Wei Qi; Ying Qi is inside the vessels, Wei Qi is outside the vessels, Ying Qi circulates endlessly, Yin and Yang connect continuously like a circle without end. Ying Qi originates from the Middle Jiao, Wei Qi originates from the Lower Jiao. The Middle Jiao receives Qi, separates dregs, steams body fluids, transforms fine essence, which flows upward to the Lung vessels, thereby transforming into Blood to sustain the body. Nothing is more precious than this, so it alone travels through the meridians, named Ying Qi. Ying and Wei Qi are Jing and Qi. Blood is Shen Qi. The Upper Jiao is like mist, the Middle Jiao like fermentation, the Lower Jiao like drainage. The chapter "Ci Zhen Zhen Xie" states: Qi accumulates in the stomach to regulate Ying and Wei, each following its path. Zong Qi remains in the Sea of Qi; the lower part flows into the Qie Street (Groin area), the upper part goes to the Xi Dao (Respiratory pathway). The chapter "Jue Qi" states: When the spirits of male and female interact, they combine to form a shape, existing before the body, this is called Jing. The Upper Jiao opens and develops, distributing the flavors of grains, warming the skin, filling the body, moistening hair, like mist and dew irrigating, this is called Qi. When pores open and sweat pours forth, this is called Jin. When grain enters and Qi fills, thick moisture notes into bones, allowing flexion and extension of bone joints, excreting moisture, benefiting brain marrow, and moistening skin, this is called Ye. The Middle Jiao receives Qi, extracts juice, transforms it red, this is called Blood. Confining Ying Qi so it has nowhere to hide, this is called Mai (Vessel). The chapter "Wu Long Jin Ye Bie" states: Water and grain enter the mouth, transport to the intestines and stomach; their flavors are five, each pouring into their respective Seas; their fluids divide into five, each going its way. Thus, the San Jiao emits Qi to warm muscles and fill skin, this is Jin; that which flows but does not run off, is Ye. If weather is hot and clothes are thick, pores open, so sweat occurs; if cold and clothes thin, pores close, Qi and moisture do not move, water flows down to the Bladder, becoming urine and gas. If not merged with grief Qi, then tears flow; if internal heat and Stomach slackness, then saliva flows. The chapter "Ben Shen" states: What Heaven gives us is De (Virtue/Energy), what Earth gives us is Qi; life arises from the flow of De and interaction of Qi. Thus, the source of life is called Jing; the interaction of two Jings creates Shen; following Shen and coming and going is Hun; entering and exiting with Jing is Po; that which handles external objects is Xin (Heart/Mind); remembering things in the mind is Yi; storing Yi is Zhi; varying based on Zhi is Si (Thinking); far-reaching contemplation based on Si is Lv (Deliberation); handling matters based on Lv is Zhi (Wisdom). The chapter "Tian Nian" states: When Blood is harmonized, Ying and Wei are smooth, Five Zang are formed, Shen Qi resides in the Heart, Hun and Po are complete, then a human is formed. The chapter "Ben Zang" states: Human Blood, Qi, Jing, and Shen are used to nourish life and encompass destiny; Meridians are used to circulate Blood and Qi, nourish Yin and Yang, moisten sinews and bones, and benefit joints; Wei Qi is used to warm muscles, fill skin, fatten pores, and control opening and closing; Zhi Yi (Will and Intention) is used to control Spirit, gather Hun and Po, adapt to cold and heat, and harmonize joy and anger. Therefore, when Blood is harmonized, meridians flow, Ying circulates Yin and Yang, sinews and bones are strong, joints are clear and free; when Wei Qi is harmonized, muscles are loose, skin is soft, pores are dense; when Zhi Yi is harmonized, Spirit is focused and upright, Hun and Po do not scatter, anger does not rise, Five Zang are not invaded by pathogens; when cold and heat are moderate, Six Fu digest grain, wind-bi does not occur, meridians are smooth, limbs and joints are safe. This is the normal state of balance. Five Zang store Jing, Shen, Blood, Qi, Hun, and Po. Six Fu digest water and grain and transport body fluids. This is what humans fully receive from Heaven; whether wise or foolish, virtuous or unworthy, none can deviate from this. Great is this discussion! Beautiful and complete!
When combined with the Five Zang, there are Liver Wood, Heart Fire, Spleen Earth, Lung Metal, Kidney Water, representing the differences in the Qi of the Five Elements; there are Liver Tears, Heart Sweat, Spleen Saliva, Lung Mucus, Kidney Spittle, representing the sufficiency of the essence of the Five Fluids; there are Liver Hun, Heart Shen, Spleen Yi, Lung Po, Kidney Zhi, representing the utmost spirituality of the Five Spirits. Their variations: Disorder of Qi leads to distension of the Five Zang (from Ling Shu Chapter Zhang Lun), Dian Ju (Manic-Depressive Disorders); Disorder of Jing leads to Five Edemas, Lin Zhuo (Dysuria and Turbid Urine); Disorder of Blood leads to Yong Ju (Carbuncles and Ulcers), Ji Ju (Accumulations and Masses), Qiu Nu (Nosebleed), Ge Xue (Coughing up Blood); Disorder of Shen involves deficiency of Spirit leading to merging: merging with Heart causes excessive laughter; merging with Lung causes sorrow; merging with Liver causes worry; merging with Spleen causes fear; merging with Kidney causes fright. These are complex and intertwined, beyond calculation or verbal description. Why summarize them here as Three Qi, Four Jing, and Five Shen? It speaks of their constant principles. What are these constants? Qi is formless yet functional. Due to its functional movement, it divides via the San Jiao. Jing is form. Having form means having substance; due to the distinction of substance, there are four levels. Shen is formless, non-functional in structure, yet effective. Due to its effectiveness, we deduce the root of the Five Natures.
Wei Qi originates from the Ming Men (Gate of Life), reaches the San Jiao, warms muscles, sinews, and skin, is fierce, slippery, and rapid, and is unrestrained; Ying Qi originates from the Spleen and Stomach, moistens sinews, muscles, and skin, fills and moves within the blood vessels without chaotic movement; Zong Qi is the combination of Ying and Wei, originates from the Lung, accumulates in the Qi Hai, moves in the Qi vessels, and fluctuates with breath. Thus, Wei Qi is Hot Qi. The reason muscles are warm and grains are digested is the function of Wei Qi. Deficiency leads to Cold diseases, Excess leads to Heat diseases. Ying Qi is Damp Qi. The reason meridians are smooth and hair/skin are plump is the function of Ying Qi. Deficiency leads to rough, dry, and cracked skin; Excess leads to edema, glossiness, and floating appearance. The chapter "Wei Qi Shi Chang" states: Abundant Ying Qi indicates disease in the blood vessels. Zong Qi is Moving Qi. The reason for breathing, speech, voice, limb movement, and strength of sinews is the function of Zong Qi. Deficiency leads to shortness of breath and low energy; Excess leads to panting, roaring, and distension. In the human body, where Wei Qi does not reach, there is cold; where Ying Qi does not reach, there is withering; where Zong Qi does not reach, there is flaccidity and bi-syndrome (impairment of use). These three are called "Rou Ke" in the Nei Jing, meaning withered, shrunken, and lacking luster. Thus, Wei Qi has Cold/Heat diseases; Ying Qi has Damp/Dry diseases; Zong Qi has Stagnation diseases and Fatigue diseases. The Three Qi are mutually substance and function, co-existing but never separating.
Qin Jingming said: "Qi is like fire; water and grain are like firewood. Strong fire can digest wood; abundant wood generates stronger fire. This is the mutual material basis of Pre-heaven and Post-heaven. Thus, steamy heat generates dampness; when Damp-Heat is strong, Moving Qi becomes rapid; when Heat is extreme, pores produce smoke; when Dampness prevails, Water Essence is not distributed." People say tonifying Fire is tonifying Qi, and descending Qi is descending Fire; this only refers to Wei Qi. Ke Yunbo said: "The essence of water and grain flowing in the vessels is Ying Qi; its fierce energy flowing outside the vessels is Wei Qi; the large Qi accumulating in the chest governing respiration is Zong Qi. This divides the Post-heaven operational Yuan Qi into three. Additionally, externally responding to skin and hair, coordinating Ying and Wei to govern the exterior of the body is the Qi of the Taiyang Bladder; internally connecting to Five Zang, governing regulation and governance, and governing the interior of the body is the Qi of the Taiyin Lung Metal; connecting inside and outside, responding to pores, and governing the half-exterior/half-interior of the body is the Qi of the Shaoyang San Jiao. This divides the Pre-heaven operational Yuan Qi into three. Thus, there are Six Qi. Establishing these names erroneously blatantly contradicts the Classic's intent. Consider, how did the so-called Pre-heaven Three Qi ever exceed 'Wei Qi originating from the Lower Jiao'? Later physicians discussing Qi forgot Zong Qi and spoke only of Wei Qi originating from the Upper Jiao. This theory started with Hua Tuo's 'Zhong Zang Jing', likely misunderstanding the Nei Jing's meaning of Heart Ying and Lung Wei. The Nei Jing speaking of Heart Ying and Lung Wei referred to the mechanism of Qi movement, not the origin of Qi. Therefore, the Three Qi each have their own origin, follow their own paths, and cannot interfere with each other; when abnormal, they change. The chapter 'Shou Yao Gang Rou' states: Disease of Ying involves cold/heat, shortness of breath, Blood moving up and down; Disease of Wei involves Qi pain, coming and going intermittently, bloating and rumbling, Wind-Cold lodging in intestines/stomach, Cold-Bi disease lingering causing intermittent pain and numb skin. The chapter 'Ping Ren Qi Xiang' states: The great collateral of the Stomach is named Xu Li, piercing the diaphragm and connecting to the Lung, emerging below the left breast, its pulsation corresponds to the pulse. This is Zong Qi; if its pulsation is visible through clothing, it indicates leakage of Zong Qi. This is the self-destruction of the Three Qi. The chapter 'Wu Luan' states: Qi disorder in Heart causes vexation, silence, bowing head and resting; disorder in Lung causes difficulty breathing, taking hands to help exhale; disorder in intestines/stomach causes Cholera-Restlessness; disorder in legs/arms causes Four Reversions (Cold limbs); disorder in head causes Reversion Cold, heavy head, dizziness, and collapse. The chapter 'Bing Neng' states: There is a disease of anger and mania, named Yang Jue. Yang Qi, due to sudden frustration and inability to resolve, leads to frequent anger. How do we know? The Yangming pulse is always moving, the Juyang and Shaoyang pulses do not move. If non-moving pulses move rapidly, this is the sign. The chapter 'Dian Kuang' states: Jue Ni disease presents with sudden cold feet, chest feeling like splitting, intestines feeling like cutting with a knife. The chapter 'Zhi Jiao Lun' states: When only Taiyang is present, it is the convergence of the Three Yang, arriving like wind and rain, causing Head Diseases above and Leakage below. The chapter 'Kou Wen' states: Self-biting of the tongue is due to Jue Ni rising, Qi arriving in waves. When Shaoyin Qi arrives, the tongue is bitten; when Shaoyang Qi arrives, the cheek is bitten; when Yangming Qi arrives, the lip is bitten. The chapter 'Tiao Jing' states: When Qi and Blood merge, Yin and Yang tilt, Qi disorders in Wei, Blood rebels in vessels, Blood and Qi separate, one Excess one Deficient. Blood merging in Yin, Qi merging in Yang, causes Fright and Mania; Blood merging in Yang, Qi merging in Yin, causes Internal Heat; Blood merging in Upper, Qi merging in Lower, causes Vexation and Anger; Blood merging in Lower, Qi merging in Upper, causes Confusion and Forgetfulness. Where Qi merges, Blood is deficient; where Blood merges, Qi is deficient. Loss of Blood-Qi relationship leads to Deficiency; merging of Blood-Qi leads to Excess. These diseases result from the merging and confusion of the Three Qi. The chapter 'Tiao Jing' states: "Yang Deficiency generating External Cold: Yang receives Qi from the Upper Jiao to warm skin and muscles. Now Cold Qi is outside, so Upper Jiao is blocked; if Upper Jiao is blocked, Cold Qi stays exclusively outside, causing chills. Yin Deficiency generating Internal Heat: Due to fatigue, Form and Qi decline, Grain Qi is weak, Upper Jiao fails to function, Lower Wan is blocked, Stomach Qi becomes hot, steaming the chest, causing internal heat. (This means fatigue injures Qi, unable to drive Grain Essence to the whole body, causing blockage above and below. Stomach Grain Qi becomes hot, only steaming the chest. This is the origin of Ge disease.) The chapter 'Sheng Qi Tong Tian Lun' states: Yang accumulation leads to Ge (Blockage), and Ge should be purged." Yang Excess generating External Heat: Upper Jiao is not smooth, skin is dense, pores closed, Xuan Fu (pores) blocked, Wei Qi cannot vent, causing External Heat. Yin Excess generating Internal Cold: Jue Qi rises, Cold Qi accumulates in the chest and is not discharged; if not discharged, Warm Qi leaves, Cold remains exclusively, Blood congeals and stagnates, vessels become blocked, pulse is large and choppy, causing Internal Cold. The chapter 'Sheng Qi Tong Tian Lun' states: If Yin cannot overcome Yang, vessels flow rapidly and violently, merging leads to Mania; if Yang cannot overcome Yin, Five Zang Qi contends, Nine Orifices are blocked. This is the victory of Excess/Deficiency among the Three Qi, namely Yin Deficiency with Yang advancing, Ying exhaustion and Wei descent, which is the case.
Why is Jing listed as four types: Jing, Blood, Jin, Ye? The chapter "Ben Shen" states: The Five Zang primarily store Jing, so collectively called Jing. Blood is the subtle essence of water and grain, steamed and transformed by the True Fire of the Ming Men, to grow muscles and skin/hair. All有形 (form) parts of the body like sinews, bones, muscles, skin, and hair belong to the Blood category. Jing is formed from the subtle essence of Blood, the basis of Sheng Qi (Vital Qi). Sheng Qi is the root of Wei Qi, i.e., the True Fire of the Ming Men; if Jing is exhausted, Sheng Qi perishes. Marrow and Brain are categories of Jing. Jin is also transformed from water and grain; its turbid part becomes Blood, its clear part becomes Jin, moistening Zang-Fu, muscles, and collaterals, allowing Qi and Blood to circulate freely without stagnation. Qi and Blood cannot exist without this; without it, they wither and stagnate. Those emitted externally, like tears, saliva, and sweat, are its categories. Urine is its dreg. Ye is thick and viscous, not rushing with Qi. Also transformed from water and grain, stored between bone joints and tendon intersections, facilitating flexion and extension. Those emitted externally from orifices, like mucus and saliva, are its categories. The four have different functions and forms. Blood's quality is heaviest and most turbid; Jin's quality is lightest and clearest; Ye is clear and crystalline, thick and condensed, heavy but not turbid; Jing combines the essence of Blood and Jin, extremely clear, extremely thick, and extremely spiritual, being the residence of Shen. Western medicine claims Jing contains three substances: 1. Worms, capable of movement; during intercourse, these worms combine with female essence to form a fetus; 2. Pearls, extremely fine, bright, hollow; in one square inch of semen, there are about 500 pearls; 3. White fluid, extremely bright and viscous, containing pearls and worms. The utility of fluid and pearls in conception is unknown. Western medicine relies solely on observation/speculation and cannot understand principles; although claiming empirical evidence, it is stuck on phenomena!
Among the four in the human body, Blood is most abundant, Jing is heaviest/most important, and Jin's function is greatest. Internally for Zang-Fu and sinews/bones, externally for skin and hair, Jing, Blood, and Ye all rely on Jin to moisten them, so they can form their structures and not deteriorate. If Jin is exhausted, Jing and Blood can turn to powder, hair can break. Thus, the chapter "Jue Qi" states: Exhaustion of Jing causes deafness; Exhaustion of Qi causes poor vision; Exhaustion of Jin causes open pores and profuse sweating; Exhaustion of Ye causes difficulty in joint flexion/extension, sallow complexion, brain marrow depletion, sore calves, frequent tinnitus; Exhaustion of Blood causes pale complexion, lack of luster, empty pulse. The chapter "Jing Mai Bie Lun" states: After eating until full, sweat comes from the Stomach; shock stealing Jing, sweat comes from the Heart; carrying heavy weights and traveling far, sweat comes from the Kidney; running fast and fearing, sweat comes from the Liver; shaking body and laboring bitterly, sweat comes from the Spleen. This is not sweat originating from the Zang, but each Zang Qi moving, driving Jin outward. The chapter "Ying Wei Sheng Hui" states: One who loses Blood should not sweat; one who loses sweat should not lose Blood. Sweat is Jin, distinct from Blood. Yet their presence/absence correspond? It is due to Qi mechanism. Thus, the Three Qi are Yang, and Ying is Yin within Yang, as Qi and Jin act together. The Four Jing are Yin, and Jin is Yang within Yin, as Jin follows Qi. The chapter "Sheng Qi Tong Tian Lun" states: Yang Qi, when overworked, expands; Jing is exhausted; accumulated through summer, causing Jian Jue (Frying Jue). Blindness prevents seeing, deafness prevents hearing, collapsing like a broken dam, uncontrollable. Jing exhaustion is Jin consumption. Ye Xianyan's "Wen Re Lun" states: Nourishing Yin is not about tonifying Blood, but generating Jin. Wang Mengying explained: This is the method of increasing water to float the boat. Profound is his words.
The Five Shen are the nature of Blood and Qi. Joy, Anger, Pondering, Worry, Fear originate from Heavenly Mandate. Without these, one is called profoundly stupid, and their nature is dead.
However, diseases of Shen are unpredictable and difficult to treat, so their root and branch must be known. Generally, abundance of Shen desires harmony; harmony of Shen desires stillness. The chapter "Bi Lun" states: Yin Qi, when still, Shen is hidden; when restless, Shen dissipates. The chapter "Sheng Qi Tong Tian Lun" states: Yang Qi, when still, nourishes Shen; when gentle, nourishes sinews. (Gentle means moving harmoniously.) It also states: Yang Qi, when greatly angered, Form and Qi sever (Form and Qi diverge). Blood stagnates above, causing Bo Jue (Thin Jue/Syncope). Injury to sinews leads to flaccidity, as if uncontrollable. The chapter "Yin Yang Ying Xiang Da Lun" states: Sudden anger injures Yin, sudden joy injures Yang, Jue Qi ascends, filling vessels and departing from Form. Unrestrained joy and anger make life unstable. Thus, the main idea of the "Si Qi Tiao Shen Da Lun" chapter is that what is disliked is reversal, and what sustains growth, harvest, and storage relies on preparation. Thus, the chapter "Yin Yang Ying Xiang Da Lun" states: Anger injures the Liver, Sadness...