神无所归虑无所定故气乱矣（续气奔越故不调理）劳则喘息（一作且）汗出内外皆越故气耗矣（续疲于力役则气奔速故
喘息也气奔速则阳外发故汗出然喘且汗出内外皆逾越常纪故气耗损矣）思则心有所存神有所归正气留而不行故气结矣（续
击心不散故气亦停留举痛论）凡未诊病者必问尝贵后贱虽不中邪病从内生名曰脱营（续神屈故也贵之尊荣贱之屈辱心怀
眷慕志结忧惶而病从内生血脉虚减故曰脱营）尝富后贫名曰失精五气留连病有所并（续富而从欲贫则损财内结忧煎外悲
过物然则心随想慕从往计营卫之道闭以迟留气血不行积并为病）医工诊之不在脏腑不变躯形处之而疑不知病名（续言病
之初也病由想恋所为故未居脏腑事因情念所起故不变躯形医不悉之故疑而诊也）身体日减气虚无精（续言虚之次也气血
相迫形肉稍烁故身体日减经曰气归精精食气今气虚不化精无所滋故也）病深无气洒洒然时惊（续言病之深也病气深谷气
尽阳气内薄故恶寒而惊洒洒寒貌也）病深者以其外耗于卫内夺于营（续血为忧煎气随悲减故外耗于卫内夺于营病深者何
以此耗夺故尔）良工所失不知病情此治一过也（失谓失问其所始也）凡欲诊病者必问饮食居处（续饮食居处五方不同故
问之也详见异法方宜论今具论治钞愚按丹溪云凡治病必先问饮食起居何如盖主一人之身而言与此不同当参考之）暴乐暴
若始乐后苦皆伤精气（精气竭绝）形体毁沮（续喜则气缓悲则气消然悲衰动中者竭绝而伤生故精气竭绝形体浅毁心神沮
散矣）暴怒伤阴暴喜伤阳（续怒则气逆故伤阴喜则气缓故伤阳愚按此二句及下二句与阴阳应象论文重而注异今并具汇萃
钞）厥气上行满脉去形（续气厥逆也逆则气上行满于经络故神气荡散去离形骸矣）愚医治之不知补泻不知病情华日脱邪
气乃并此治之二过也（续不知喜怒衰乐之殊情概为补泻而同贯则五脏精华之气日脱邪气薄蚀而乃并于正真之气矣）善为
脉者必以此类奇恒从容知之为工而不知道此诊之不足贵此治之三过也（续奇恒谓气候奇异于常之候也从容谓分别脏气虚
实脉见高下几相似也示从容论曰脾虚浮似肺肾小浮似脾肝急沉散似肾此皆工之所惑乱然从容分别而得之矣）诊有三常必
问贵贱封君败伤乃欲侯王（续封君败伤降其君位而贬公卿也及欲侯王谓情慕尊贵而妄求不已也)故贵脱势虽不中邪精神内
伤身必败亡（续忧惶煎迫怫结所为）始富后贫虽不败邪皮焦筋屈痿癖为挛（续以五脏气留连病有所并而为是也）医不能
严不能动神外为柔弱乱至失常病不能移则医事不行此治之四过也（续严为禁戒其非所以令从命也外为柔弱言委随以顺从
也然戒不足以禁非动不足以从命委随任物乱失天常病且不移何医之有也）凡诊者必知终始有知余绪切脉问名当合男女（续
终始谓气色也经曰知外者终而始之明知五色气象终而复始也余绪谓病发端之余绪也切谓以指按脉也问明谓问病症之名也
男子阳气多而左脉大为顺女子阴气多而右脉大为顺故宜以候当先合之也）离绝菀结忧恐喜怒五脏空虚血气离守工不能知
何术之语（续离谓离间亲爱绝谓绝念所怀菀谓菀谓菀积思虑结谓结固余怨夫问亲爱者魂游绝所怀者意丧积所虑者神劳结
余怨者志苦忧愁者闭塞而不行恐惧者惕惮而守失盛怒者迷感而不治喜乐者荡散而不藏由是八者故五脏空虚气血离守工不
思晓又何言哉）尝富大伤斩筋绝脉身体复行令泽不息（续斩筋绝脉言非分之过损也身体虽已复旧而行且令泽液不为滋息
也何者精气耗减也泽液也）故阳败结留薄归阳脓积寒炅（续阳谓诸阳脉及六腑也炅谓热也言非分伤败筋脉之气血气内结
留而不去薄于阳脉则化为脓久积腹中而外为寒热也）粗工治之亟刺阴阳身体解散四肢转筋死日有期（续不知寒热为脓积
所生以为常热之疾概施其法数刺阴阳经脉气夺病甚故身体解散而不用四肢废运而转筋如是故死日有期乃医之罪也）医不
能明不问所废唯言死日亦为粗工此治之五过也（续诊不备三常疗不慎五过不求余绪不问持身亦足为粗略之医）凡此五者
皆受术不通人事不明也（续言受术之徒未通精微之理不明人问之事也）故曰圣人之治病也必知天地阴阳四时经纪五脏六
腑雌雄表里刺灸砭石毒药所主从容人事以明经道贵贱贫富各异品理问年少长勇怯之理审于部分知病本始八证九候诊必副
矣（续圣人备言知此工当勉之流五过论）帝曰夫经脉十二络脉三百六十五此皆人之明知工之所循用也（续谓循守而用）
所以不十全者精神不专志意不理外内相失故时疑殆（续外谓色内谓脉也所谓粗略揆度失常故色脉相失而时自疑殆也）诊
不知阴阳逆从之理此治之一失矣（续脉要精微论曰冬至四十五日阳气微上阴气微下夏至四十五日阴气微上阳气微下阴阳
有时与脉为期故诊不知阴阳逆从之理为一失矣）受师不卒妄作离术缪言为道更名自功妄用砭石后遗身咎此治之二失也（续
不终师术惟妄是为易古变常自动循已遗身之咎不亦宜乎故为失二也）不适贫富贵贱之居坐之薄浓形之寒温不适饮食之宜
不别人之勇怯不知比类足以自乱不足以自明此治之三失也（续夫勇者难感怯者易伤二者不同盖以其神气有壮弱也观其贫
贱富贵之义则坐之浓薄形之寒温饮食之宜理可知矣不知比类用必乖丧则适足以 乱心绪岂可通明之望乎故为失三也）诊
病不问其始忧患饮食之失节起居之过度或伤于毒不先言此卒持寸口何病能中妄言作为名粗所穷此治之四失也（忧谓忧惧
患谓患难不先言此愚谓不先问其患忧饮食起居及曾伤毒否而卒持寸口以言其病仲能中其病情是以妄言作名未免为粗工之
所穷也其意盖必先问后诊方得十全不可独凭乎脉也征四失论）东风生于春病在肝俞在颈项春风发荣于万物之上故俞在颈
项历忌日甲乙不治颈是也）南风生于夏病在心俞在胸胁（心少阴脉循胸出胁故俞在焉）西风生于秋病在肺俞在肩背（肺
处上焦背为胸肝肩背相次故俞在焉）北风生于冬病在肾俞在腰股（腰为肾股府接次之以气相连故兼言也）中央为土病在
脾俞在脊（以脊应土言居中尔）故春气者病在头（春气谓肝气各随其脏气之所应）夏气者病在脏（心之应也）秋气者病
在肩背（肺之应也）冬气者病在四肢（四肢气少寒毒善伤随所受邪则为病处）故春善病HT 衄（续在气以头也HT 鼻
出水衄鼻出血）仲夏善病胸胁（续心脉循胸胁故也）长夏善病洞泄寒中（续土主于中是为仓禀糟粕水谷故为洞泄寒中也）
秋善病风疟（续以凉折暑乃为是病月令曰孟秋行夏令则民多疟疾）冬善病痹厥（续血众于水寒则冰凝以气薄流故为痹厥）
故冬不按跷春HT 衄（续按谓按摩跷谓如跷捷者之举动手足所谓导引也然扰动筋骨则阳气不藏春阳气上升重热熏肺肺通
于鼻病则形乏故冬不按跷春不HT 衄HT 谓鼻流清水衄谓鼻中血出）春不病颈项仲夏不病胸胁长夏不病洞泄寒中秋不
病风疟冬不病痹厥（此上五句并为冬不按跷之所致也）夫精者身之本也故藏于精者春不病温（此一句因冬不按跷而言）
夏暑汗不出者秋成风疟（此正谓以风凉之气折暑汗也○此论似不相蒙与第三篇魄汗未尽云云相似王注冬月蛰藏之时也冬
而按跷扰其热伤故有四时之变如此者况精者身之本可不藏乎金匮真言论）诸脉者皆属于目（续脉者血之府经云久视伤血
由此明诸脉者皆属于目○校正云心藏脉脉舍神神明通体故云属目）诸髓者皆属于脑（续脑为髓海故诸髓属之）诸筋皆属
于节（续筋气之坚结者皆络于骨节之间经曰久行伤筋由此明诸筋皆属于节）诸血者皆属于心（续血居脉内属于心经曰血
气者人之神然神者心之主由此故诸血皆属于心）诸气者皆属于肺（续肺藏魄□□□□□□□□）□则血归于肝
（续肝藏血心行之人动则血运于诸经人静则血归□□□于肝藏以肝主血□□□□□而能视（续言其用也目为肝之宫故肝
受血而能视）足受血而能步掌受血而□□□指受血而能摄（谓收摄也血气者人之神故受血者皆能运用五脏生成论）五味
所入酸入肝辛入肺苦入心咸入肾甘入脾是谓五入（续肝合木而味酸肺合金而味辛心合火而味苦肾合水而味咸脾合土而味
甘至真要论云五味入胃各归所喜攻酸先入肝苦先入心甘先入脾辛先入肺咸先入肾）五气所病心为噫（续象火炎上烟随焰
出心不受秽故噫出之）肺为咳（续象金坚劲扣之有声邪击于肺故为咳也）肝为语（续象木枝条而形支别语宣委曲故出于
肝）脾为吞（续象土包容物归于内翕如皆受故为受也）肾为欠为 （续象水下流上生云雾气郁于胃故火生焉火阳之气和
利而薄于心出于鼻则生 ）胃为气逆为哕为恐（续胃为水谷之海肾与为关关闭不利则气逆上行也以包容水谷性喜受寒寒
谷相薄故为哕也寒盛则哕起热盛则恐生何者胃热则肾气微弱故为恐也下文曰精气并于肾则恐也）大肠小肠为泄下焦溢为
水（续大肠为传导之府小肠为受盛之府受盛之气既虚传导之司不禁故为泄利也下焦为分注之所气窒不泻则溢为而水）膀
胱不利不约为癃为遗溺（续膀胱为津液之府水注由之然足三焦脉实约下焦而不通则不得小便足三焦脉虚不约下焦则遗溺
也灵枢经曰足三焦者太阳之别也并太阳之正入络膀胱约下焦实则闭癃虚则遗溺）胆为怒（续中正决断无私无偏其性刚决
故为怒也经曰凡十一脏取决于胆也）是谓五病○五精所并精气并于心则喜（续精气谓大之精气也肺虚而心精并之则为喜
灵枢经曰喜乐无极则伤魄魄为肺神明心火并于肺金也）并于肺则悲（续肝虚而肺气并之则为悲灵枢经曰悲哀动中则伤魂
魂为肝神明肺金并于肝木也）并于肝则忧（续肝虚而肝气并之则为忧灵枢经曰忧愁不解则伤意意为并神明肝木并于脾土）
并于脾则畏（续肾虚而脾气脾之则为畏灵枢经曰心惧不解则伤精精为肾神明脾土并于肾水）并于肾则恐（续心虚而肾气
并之则为恐灵枢经曰怵惕思虑则伤神为心神明肾水并于心火也此皆正气不足而胜气并之乃是为矣故下文曰）是谓五并虚
而相并者也○五脏所恶心恶热（续热则脉溃浊）肺恶寒（续寒则气留滞）肝恶风（续风则筋燥急）脾恶湿（续湿则肉痿
肿）肾恶燥（续燥则精竭涸）是谓五恶○五脏化液心为汗（续泄于皮腠也）肺为涕（续润于鼻窍也）肝为泪（续注于眼
目也）脾为涎（续溢于唇口也）肾为唾（续生于牙齿也）是谓五液○五病所发阴病发于骨阳病发于血阴病发于肉（骨肉
阴精故阳气从之血脉阳动故阳气乘之）阳病发于冬阴病发于夏（夏阳气盛故阴病发于夏冬阴气盛故阳病发于冬各从其少
也）是谓五发○五邪所乱入于阳则狂邪入于阴则痹（续邪居于阴脉之中则四肢热盛故为狂邪入于阴脉之内则六经凝泣而
不通故为痹）搏阳则为癫疾搏阴则为喑（王注邪内搏于阳则脉流薄疾故为上癫之病邪内搏于阴则脉不流故令喑不能言○
校正按难经云重阳者狂重阴者癫巢元方云邪入于阴则为癫脉经云阴附阳则狂阳附阴则癫孙思邈云邪入于阳则为狂邪入于
阴则为血痹邪入于阳传则为癫痉邪入于阴传则为痛喑全元起云邪已入阴复传于阳邪气盛腑脏受邪使其气不朝营气不复周
身邪与正气相击发动为癫疾邪已入阳阳今复传于阴脏腑受邪故不能言是胜正也诸家之论不同今具载之）阳入之阴则精阴
出之阳则怒（续随所之而为疾也之往也）是谓五乱○五邪所见春得秋脉夏得冬脉长夏得春脉秋得夏脉冬得长夏脉是谓五
邪死不治○五脏所藏心藏神（续精气之化成也灵枢经曰两精相薄谓之神）肺藏魄（续精气之匡佐也灵枢曰并精而出入者
谓之魄）肝藏魂（续神气之辅弼也灵枢经曰随神而往来者谓之魂）脾藏意（续记而不忘者也灵枢经曰心有所忆谓之意）
肾藏志（续专意而不移者也灵枢经曰意之所存谓之志肾受五脏六腑之精元气之本生成之根根为胃之关是以志能则命通）
谓五脏所藏○五脏所主心主脉（续壅遏营气应息而动也）肺主皮（续包裹筋肉闭福诸邪也）肝主筋（续束络机关随神而
运也）脾主肉（续覆藏筋气骨通行卫也）肾主骨（续张筋化随 以立身也）是谓五主○五劳所伤久视伤血（续劳于心）
久卧伤气（续劳于肺）久坐伤肉（续劳于脾）久立伤骨（续劳于肾）久行伤筋（续劳于肝）是谓五劳所伤○五脉应象肝
脉弦（续软虚而滑之直以长也）心脉钩（续如钩之偃来盛去衰也）脾脉代（续软而弱）肺脉毛（续轻浮而虚如毛羽也）
肾脉石（续沉坚而搏如石之投也）是谓五脏之脉（宣疏五气论）肝色青宜食甘粳米牛肉枣葵皆甘心色赤宜食酸小豆犬肉
李韭皆酸肺色白宜食苦麦羊肉杏韭皆苦脾色黄宜食咸大豆豕肉栗藿皆咸肾色黑宜食辛黄黍鸡肉桃葱皆辛（续肝性喜急故
食甘物取其宽缓也心性喜缓故食酸物取其收敛也肺喜气逆故食苦物取其宣泄也肾性取燥故食辛物取其津润也究斯宜食乃
调利机关之义也肾为胃关脾与胃合故假咸柔软以利其关关利而胃气乃行胃行而脾气方化故脾宜味与众不同○校正按上文
神志没有归宿，思虑没有定准，所以气机就会紊乱。（续：气机奔逸散乱，因此不能调理。）过度劳累会导致喘息（另一种版本作“且”），出汗。体内外的气机都向外发散，所以正气就会耗损。（续：体力劳动过度则气机运行急促，所以出现喘息；气机急促则阳气外发，所以出汗。然而喘息和出汗使得内外之气都超越了正常的节度，所以正气耗损。）思虑过度会使心神专注于某处，神志有所归依，导致正气停留而不能正常运行，所以气机就会郁结。（续：心气不散，所以气也停留。出自《举痛论》。）
大凡没有诊察病情之前，必须询问病人过去地位尊贵后来变得卑贱的情况。虽然并没有受到外邪侵袭，但疾病从内生发，名叫“脱营”。（续：这是因为精神受屈辱的缘故。曾经尊贵时享有尊荣，后来卑贱时遭受屈辱，心中怀有眷念羡慕，志向郁结，忧愁惶恐，从而疾病从内生发，血脉虚少减弱，所以叫作“脱营”。）曾经富有后来贫穷的，名叫“失精”，五气滞留相连，病邪相互搏结。（续：富有时可以放纵欲望，贫穷时则损失财物，内心郁结忧煎，外部悲伤超过常理。这样心神随着想慕而向往过去，导致营卫之道闭塞，气血运行迟缓停滞，积滞并合而发病。）医生诊察时，发现病不在脏腑，形体也没有变化，对此处理感到疑惑，不知道这是什么病名。（续：说在病初起时，疾病是由思念眷恋引起的，所以尚未涉及脏腑；事情因情念而起，所以形体没有变化。医生不了解这些情况，所以感到疑惑并进行诊察。）身体一天天消瘦，气虚而没有精气。（续：说这是虚损的次一阶段。气血相互逼迫，肌肉稍微消烁，所以身体一天天减少。经书说：“气归于精，精由气滋养。”现在气虚不能化生精，精无所滋生的缘故。）病情深重，没有正气，感觉洒洒然恶寒，时常惊恐。（续：说这是病情深重的表现。病气深入，谷气耗尽，阳气内迫，所以恶寒而惊，洒洒然是形容寒冷貌。）病情深重，是因为在外耗散了卫气，在内夺走了营血。（续：血液被忧煎消耗，气随悲伤减少，所以在外耗散卫气，在内夺走营血。病情为什么深重呢？就是因为这种耗散和夺走造成的。）高明的医生如果失误，是因为不了解病情，这是治疗上的第一个过失。（失，指未能问清疾病的起始原因。）
大凡想要诊察病情的人，必须询问病人的饮食和居住情况。（续：饮食居处在不同地区有所不同，所以要询问。详见《异法方宜论》，现在简要论述于《治钞》中。我按语：朱丹溪说，凡是治病必须先问饮食起居如何，这主要是针对一个人自身的情况而言，与此处所说有所不同，应当参考对照。）突然的大乐或突然的大怒，起初快乐后来痛苦，都会损伤精气。（精气枯竭断绝。）形体毁坏沮丧。（续：喜则气缓，悲则气消。然而悲哀过度触动内脏，会导致精气竭绝而伤生，所以精气竭绝，形体浅毁，心神沮丧散乱。）暴怒会损伤阴气，暴喜会损伤阳气。（续：怒则气逆，所以损伤阴气；喜则气缓，所以损伤阳气。我按语：这两句及下面两句与《阴阳应象大论》文字重复但注释不同，现在一并收录于汇萃钞中。）厥气向上逆行，充满脉道，神气脱离形体。（续：气厥逆。逆则气向上行，充满经络，所以神气荡散，离开形骸了。）我医治他们，不知道补泻之法，不了解病情，华日（推测为人名或误字，此处依原文保留）脱去邪气，于是邪气并合于此，这是治疗的第二个过失。（续：不知道喜怒衰乐的不同情况，一概进行补泻，同一种贯注，那么五脏精华之气日渐脱失，邪气薄蚀并与真气并合。）善于切脉的人，一定通过这类方法，结合奇恒之候，从容分析，才能成为良工，如果不通晓道理，这样的诊断就不值得珍贵，这是治疗的第三个过失。（续：奇恒，指气候奇异于常态的征候。从容，指分别脏气虚实，脉象高低几近相似的情况。《示从容论》说：脾虚浮似肺，肾小浮似脾，肝急沉散似肾，这些都是医生容易困惑混乱的，但如果从容分别就能明白了。）
诊病有三项常规，必须询问贵贱、封君败伤以及妄求侯王的情况。（续：封君败伤，指降低君位而贬为公卿。及欲侯王，指情慕尊贵而妄求不已。）所以贵族失去权势，虽然没有中邪，但精神内伤，身体必然败亡。（续：由于忧愁惶恐煎熬逼迫，怫郁结聚所致。）开始富有后来贫穷，虽然不中邪，但皮肤焦枯，筋脉拘屈，痿痹成为挛缩。（续：因为五脏气机滞留相连，病邪相互搏结而导致这种情况。）医生如果不能严厉禁戒，不能感动神灵，外表显得柔弱顺从，就会扰乱至道的常规，疾病不能转移，那么医疗事务就无法施行，这是治疗的第四个过失。（续：严，是禁止戒除其非分行为，使其听从命令。外表柔弱，是说委曲顺从以迎合。然而禁令不足以禁止非分，感动不足以使人心从命，委曲顺从任由事物摆布，就会扰乱丧失天常，疾病尚且不移动，哪里还有医生的作用呢？）
大凡诊病的人，必须知道终始，了解余绪，切脉问名，应当结合男女差异。（续：终始，指气色。经书说：知道外在的表现，要从终结追溯到起始，明确五色气象终结又复始。余绪，指病发端之后的余绪。切，是用手指按脉。问明，是询问病症的名称。男子阳气多，左脉大为顺；女子阴气多，右脉大为顺，所以应当先合参这些情况。）离间亲爱、断绝所怀、郁积思虑、结固余怨、忧愁、恐惧、愤怒、喜乐，会导致五脏空虚，血气离散守位。医生如果不能知晓，还能说什么医术呢？（续：离，指离间亲爱；绝，指断绝所怀的念头；菀，指郁积思虑；结，指结固余怨。问亲爱的人魂游荡，断绝所怀的人意志丧失信仰，积聚所虑的人神劳苦，结固余怨的人志意困苦。忧愁者闭塞而不行，恐惧者惕惮而守失，盛怒者迷感而不治，喜乐者荡散而不藏。由于这八种情况，所以五脏空虚，气血离散守位。医生不思量晓悟，又有什么话可说呢？）曾经富有而大大受伤，斩断筋脉，身体虽然恢复行动，但津液不再滋润。（续：斩筋绝脉，指非分过度的损害。身体虽然已恢复旧状并能行走，但津液不再滋息。为什么呢？因为精气耗减的缘故。泽液，即津液。）
所以阳脉败坏，结滞停留，薄附于阳，化为脓积，伴有寒热。（续：阳，指诸阳脉及六腑。炅，指热。说非分损伤败坏筋脉的气血，气在内结滞停留不去，薄于阳脉，则化为脓，久积腹中，而外部表现为寒热。）低劣的医生治疗它，急切地针刺阴阳经脉，导致身体解散，四肢转筋，死期有定数。（续：不知道寒热是由于脓积产生的，以为是普通的热疾，一概施用这种方法，多次针刺阴阳经脉，导致气夺病重，所以身体解散而不能用，四肢废运而转筋。像这样，所以死期有定数，这是医生的罪过。）医生如果不能明察，不问所废的原因，只说死期，也是低劣的医生，这是治疗的第五个过失。（续：诊察不备三常，治疗不慎五过，不求余绪，不问持身，也足以称为粗略的医生。）
大凡这五种情况，都是因为医术不通达，人事不明白的缘故。（续：说接受医术的人，未通晓精微的道理，不明白人事的情况。）所以说，圣人治病，必须懂得天地阴阳、四时经纪、五脏六腑、雌雄表里，以及刺灸砭石毒药的主治功能，从容对待人事以明晓经道。贵贱贫富各有不同的品性条理，询问年少长幼、勇怯的道理，审察分部，了解病的根本起始，八证九候诊察必定相符。（续：圣人详尽说明知道这些，医生应当勉励自己。参见《五过论》。）
黄帝说：十二经脉，三百六十五络脉，这些都是人们所熟知的，医生所遵循使用的。（续：谓循守而用。）之所以不能十全十美，是因为精神不专一，志意不理顺，内外相失，所以时常怀疑危殆。（续：外指面色，内指脉象。所谓粗略揣测失常，所以色脉相失而时常自我怀疑危殆。）诊察不懂得阴阳逆从的道理，这是治疗的第一个失误。（续：《脉要精微论》说：冬至后四十五日，阳气微上，阴气微下；夏至后四十五日，阴气微上，阳气微下。阴阳有时限，与脉象相应，所以诊察不懂得阴阳逆从的道理，是一个失误。）师承学业未完成，就胡乱创立学说，谬误言论作为大道，更改名称自夸功效，滥用砭石，留下后患给病人，这是治疗的第二个失误。（续：不终师术，只是胡乱作为，改变古法变易常规，自动遵循己见，遗留身体的咎害，不也是应该的吗？所以是第二个失误。）不适用于贫富贵贱的居住环境，坐卧的浓薄，体形的寒温，不适用于饮食的适宜，不分辨人的勇怯，不知道比类推理，足以使自己混乱，不足以使自己明白，这是治疗的第三个失误。（续：勇者难感受邪，怯者易受伤，两者不同，大概是因为神气有壮弱的区别。观察贫贱富贵的意义，那么坐卧的浓薄、体形的寒温、饮食的适宜的道理就可以知道了。不知道比类运用，必定乖张丧失，那只能扰乱心绪，怎么能有通明期望呢？所以是第三个失误。）诊病不问起始，忧患、饮食失节、起居过度，或者中毒，不先问这些情况，突然切按寸口，什么病能诊中？胡乱言说装作名医，最终沦为粗工，这是治疗的第四个失误。（忧，指忧惧；患，指患难。不先问这些，愚意是不先问其患忧、饮食起居及曾否伤毒，就突然切按寸口来谈论病情，怎么能中其病情？因此胡乱言说装作名医，未免沦为粗工所困窘。其意思大概是必须先问后诊，方能十全，不可独凭脉象。参见《征四失论》。）
东风生于春季，病在肝，俞穴在颈项。（春风发荣于万物之上，所以俞穴在颈项。历忌日甲乙日不治颈项，就是这个意思。）南风生于夏季，病在心，俞穴在胸胁。（心少阴脉循胸出胁，所以俞穴在此。）西风生于秋季，病在肺，俞穴在肩背。（肺处上焦，背为胸之分野，肩背相次，所以俞穴在此。）北风生于冬季，病在肾，俞穴在腰股。（腰为肾府，股部相接次，以气相连，所以兼言。）中央属土，病在脾，俞穴在脊。（因为脊对应土，言居中而已。）
所以春气致病多在头部（春气指肝气，各随其脏气之所应）。夏气致病多在脏（心的应象）。秋气致病多在肩背（肺的应象）。冬气致病多在四肢（四肢气少，寒毒容易伤害，随所受邪气而为病处）。所以春季容易患鼽衄（续：在气在头。鼽，鼻出水；衄，鼻出血）。仲夏容易患胸胁病（续：心脉循胸胁，所以如此）。长夏容易患洞泄寒中（续：土主于中，是为仓廪糟粕水谷，所以为洞泄寒中）。秋季容易患风疟（续：以凉折暑，乃为此病。《月令》说：孟秋行夏令，则民众多患疟疾）。冬季容易患痹厥（续：血众于水，寒则冰凝，以气薄流，所以为痹厥）。
所以冬季不按跷，春季就不会发生鼽衄（续：按，指按摩；跷，指如跷捷者之举动手足，所谓导引。然而扰动筋骨则阳气不藏，春季阳气上升，重热熏肺，肺通于鼻，病则形乏，所以冬季不按跷，春季不发生鼽衄。鼽，指鼻流清水；衄，指鼻中血出）。春季不病颈项，仲夏不病胸胁，长夏不病洞泄寒中，秋季不病风疟，冬季不病痹厥（这上五句都是由于冬季不按跷所导致的）。
夫精，是身的根本，所以藏精的人，春季不患温病（这一句是因冬季不按跷而言）。夏季暑热汗不出的人，秋季将形成风疟（这正是说以风凉之气折暑汗。○此论似乎不相连贯，与第三篇“魄汗未尽”云云相似。王注：冬月蛰藏之时也，冬而按跷扰其热伤，故有四时之变如此者。况精者身之本，可不藏乎？参见《金匮真言论》）。
诸脉，都归属于目（续：脉是血的府库。经书说：久视伤血，由此明白诸脉都归属于目。○校正：心藏脉，脉舍神，神明通体，所以说属目）。诸髓，都归属于脑（续：脑为髓海，所以诸髓属于它）。诸筋，都归属于节（续：筋是气之坚结者，都络于骨节之间。经书说：久行伤筋，由此明白诸筋都归属于节）。诸血，都归属于心（续：血居脉内，属于心。经书说：血气者人之神，然神者心之主，由此故诸血都归属于心）。诸气，都归属于肺（续：肺藏魄……）。血则归于肝（续：肝藏血，心行之。人动则血运于诸经，人静则血归于肝。藏以肝主血……而能视（续：言其用也。目为肝之宫，所以肝受血而能视）。足受血而能步，掌受血而……指受血而能摄（谓收摄也。血气者人之神，故受血者皆能运用。参见《五脏生成论》）。
五味所入：酸入肝，辛入肺，苦入心，咸入肾，甘入脾，这叫做五入（续：肝合木而味酸，肺合金而味辛，心合火而味苦，肾合水而味咸，脾合土而味甘。《至真要论》说：五味入胃，各归所喜攻。酸先入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾）。
五气所病：心为噫（续：象火炎上，烟随焰出，心不受秽，所以噫出之）。肺为咳（续：象金坚劲，扣之有声，邪击于肺，所以为咳）。肝为语（续：象木枝条而形支别，语宣委曲，所以出于肝）。脾为吞（续：象土包容物归于内，翕如皆受，所以为受也）。肾为欠为嚏（续：象水下流，上生云雾，气郁于胃，故火生焉。火阳之气和利而薄于心，出于鼻则生嚏）。胃为气逆为哕为恐（续：胃为水谷之海，肾与之关，关闭不利则气逆上行。以包容水谷，性喜受寒，寒谷相薄，所以为哕。寒盛则哕起，热盛则恐生。何者？胃热则肾气微弱，所以为恐也。下文说：精气并于肾则恐也）。大肠小肠为泄，下焦溢为水（续：大肠为传导之府，小肠为受盛之府。受盛之气既虚，传导之司不禁，所以为泄利。下焦为分注之所，气窒不泻则溢为水）。膀胱不利不约为癃为遗溺（续：膀胱为津液之府，水注由之。然足三焦脉实，约下焦而不通则不得小便；足三焦脉虚，不约下焦则遗溺。《灵枢经》说：足三焦者，太阳之别也，并太阳之正，入络膀胱，约下焦。实则闭癃，虚则遗溺）。胆为怒（续：中正决断，无私无偏，其性刚决，所以为怒。经书说：凡十一脏取决于胆也）。这叫做五病。
五精所并：精气并于心则喜（续：精气谓太之精气。肺虚而心精并之，则为喜。《灵枢经》说：喜乐无极则伤魄，魄为肺神明。心火并于肺金也）。并于肺则悲（续：肝虚而肺气并之，则为悲。《灵枢经》说：悲哀动中则伤魂，魂为肝神明。肺金并于肝木也）。并于肝则忧（续：肝虚而肝气并之，则为忧。《灵枢经》说：忧愁不解则伤意，意为并神明。肝木并于脾土也）。并于脾则畏（续：肾虚而脾气并之，则为畏。《灵枢经》说：心惧不解则伤精，精为肾神明。脾土并于肾水也）。并于肾则恐（续：心虚而肾气并之，则为恐。《灵枢经》说：怵惕思虑则伤神，神为心神明。肾水并于心火也。此皆正气不足而胜气并之，乃是为矣。所以下文说）：这叫做五并，虚而相并者也。
五脏所恶：心恶热（续：热则脉溃浊）。肺恶寒（续：寒则气留滞）。肝恶风（续：风则筋燥急）。脾恶湿（续：湿则肉痿肿）。肾恶燥（续：燥则精竭涸）。这叫做五恶。
五脏化液：心为汗（续：泄于皮腠也）。肺为涕（续：润于鼻窍也）。肝为泪（续：注于眼目也）。脾为涎（续：溢于唇口也）。肾为唾（续：生于牙齿也）。这叫做五液。
五病所发：阴病发于骨，阳病发于血；阴病发于肉（骨肉阴精，故阳气从之；血脉阳动，故阳气乘之）。阳病发于冬，阴病发于夏（夏阳气盛，故阴病发于夏；冬阴气盛，故阳病发于冬。各从其少也）。这叫做五发。
五邪所乱：入于阳则狂，邪入于阴则痹（续：邪居于阴脉之中，则四肢热盛，故为狂；邪入于阴脉之内，则六经凝泣而不通，故为痹）。搏阳则为癫疾，搏阴则为喑（王注：邪内搏于阳，则脉流薄疾，故为上癫之病；邪内搏于阴，则脉不流，故令喑不能言。○校正：按《难经》说：重阳者狂，重阴者癫。巢元方说：邪入于阴则为癫。《脉经》说：阴附阳则狂，阳附阴则癫。孙思邈说：邪入于阳则为狂，邪入于阴则为血痹；邪入于阳传则为癫痉，邪入于阴传则为痛喑。全元起说：邪已入阴，复传于阳，邪气盛，腑脏受邪，使其气不朝营，气不复周身，邪与正气相击发动，为癫疾；邪已入阳，阳今复传于阴，腑脏受邪，故不能言，是胜正也。诸家之论不同，现在全部记载）。阳入之阴则精，阴出之阳则怒（续：随所之而为疾也。之，往也）。这叫做五乱。
五邪所见：春得秋脉，夏得冬脉，长夏得春脉，秋得夏脉，冬得长夏脉，这叫做五邪，死不治。
五脏所藏：心藏神（续：精气之化成。《灵枢经》说：两精相薄，谓之神）。肺藏魄（续：精气之匡佐。《灵枢》说：并精而出入者，谓之魄）。肝藏魂（续：神气之辅弼。《灵枢经》说：随神而往来者，谓之魂）。脾藏意（续：记而不忘者也。《灵枢经》说：心有所忆，谓之意）。肾藏志（续：专意而不移者也。《灵枢经》说：意之所存，谓之志。肾受五脏六腑之精，元气之本，生成之根，根为胃之关，是以志能则命通）。这叫做五脏所藏。
五脏所主：心主脉（续：壅遏营气，应息而动也）。肺主皮（续：包裹筋肉，闭福诸邪也）。肝主筋（续：束络机关，随神而运也）。脾主肉（续：覆藏筋气骨，通行卫也）。肾主骨（续：张筋化，随以立身也）。这叫做五主。
五劳所伤：久视伤血（续：劳于心）。久卧伤气（续：劳于肺）。久坐伤肉（续：劳于脾）。久立伤骨（续：劳于肾）。久行伤筋（续：劳于肝）。这叫做五劳所伤。
五脉应象：肝脉弦（续：软虚而滑之直以长也）。心脉钩（续：如钩之偃，来盛去衰也）。脾脉代（续：软而弱）。肺脉毛（续：轻浮而虚，如毛羽也）。肾脉石（续：沉坚而搏，如石之投也）。这叫做五脏之脉（参见《宣疏五气论》）。
肝色青，宜食甘，粳米、牛肉、枣、葵，皆甘心。色赤，宜食酸，小豆、犬肉、李、韭，皆酸。肺色白，宜食苦，麦、羊肉、杏、韭，皆苦。脾色黄，宜食咸，大豆、豕肉、栗、藿，皆咸。肾色黑，宜食辛，黄黍、鸡肉、桃、葱，皆辛（续：肝性喜急，故食甘物取其宽缓；心性喜缓，故食酸物取其收敛；肺喜气逆，故食苦物取其宣泄；肾性取燥，故食辛物取其津润。究斯宜食，乃调利机关之义。肾为胃关，脾与胃合，故假咸柔软以利其关，关利而胃气乃行，胃行而脾气方化，故脾宜味与众不同。○校正：按上文……）
When the Shen (Spirit) has no abode and thoughts have no stability, Qi becomes chaotic. (Continuation: When Qi rushes and scatters, it cannot be regulated.) Labor leads to panting (another version reads "qie") and sweating. The Qi inside and outside both scatter outward, thus causing Qi depletion. (Continuation: Physical labor makes Qi move rapidly, leading to panting; rapid Qi movement causes Yang to emit outward, leading to sweating. However, panting and sweating cause the internal and external Qi to exceed normal limits, resulting in Qi depletion.) Excessive thinking causes the mind to focus on one thing and the Shen to have a specific destination, causing Zheng Qi (Upright Qi) to remain stagnant and not flow freely, thus leading to Qi stagnation. (Continuation: If Heart Qi does not disperse, Qi also remains stagnant. From *Ju Tong Lun*.)
Generally, before diagnosing an illness, one must ask if the patient was formerly of high status but later became lowly. Although not afflicted by external pathogens, the disease arises from within, named "Tuo Ying" (Depletion of Ying). (Continuation: This is due to spiritual humiliation. Formerly honored with glory, now humiliated in lowliness, harboring longing and envy, with ambitions bound by worry and fear, diseases arise internally, blood vessels become deficient and reduced, hence called "Tuo Ying".) Those who were formerly rich but later poor are named "Shi Jing" (Loss of Jing), where the Five Qi linger and pathogenic factors combine. (Continuation: In wealth, desires are indulged; in poverty, wealth is lost, leading to internal knotting of worry and external sorrow exceeding norms. Thus, the mind follows past attachments, closing off the pathways of Ying and Wei, slowing blood and Qi circulation, accumulating and combining to cause disease.) When physicians examine, finding the disease not in the Zang-Fu organs and no change in body shape, they feel doubtful and do not know the disease name. (Continuation: At the onset, the disease is caused by longing and attachment, so it has not yet affected the Zang-Fu; arising from emotional thoughts, the body shape remains unchanged. Physicians unaware of this feel doubtful and examine.) The body wastes away day by day, Qi is deficient without essence. (Continuation: This describes the secondary stage of deficiency. Blood and Qi press against each other, flesh slightly emaciates, so the body wastes daily. The Classic says: "Qi returns to Essence, Essence nourishes Qi." Now, deficient Qi cannot transform into Essence, and Essence lacks nourishment.) The disease is deep, lacking Qi, with a shivering sensation and frequent fright. (Continuation: This describes deep disease. Pathogenic Qi is deep, Gu Qi (Grain Qi) is exhausted, Yang Qi presses inward, causing aversion to cold and fright; "shasha" describes the appearance of cold.) Deep disease occurs because Wei Qi is consumed externally and Ying Blood is robbed internally. (Continuation: Blood is consumed by worry, Qi decreases with sorrow, thus Wei Qi is consumed externally and Ying Blood robbed internally. Why is the disease deep? Because of this consumption and robbing.) A skilled physician's error lies in not understanding the condition; this is the first fault in treatment. (Error refers to failing to ask about the origin.)
To diagnose, one must ask about diet and living conditions. (Continuation: Diet and living vary by region, hence the inquiry. See *Yi Fa Fang Yi Lun*. My note: Danxi said treating requires asking about diet and起居 first, focusing on the individual, differing here; reference both.) Sudden joy or sudden anger, starting with joy and ending in suffering, all damage Jing Qi. (Jing Qi exhaustion.) The physical form is ruined and depressed. (Continuation: Joy relaxes Qi, sorrow dissipates Qi. But excessive sorrow moves the center, exhausting life, so Jing Qi exhausts, the form is shallowly destroyed, and Shen scatters.) Violent anger damages Yin; violent joy damages Yang. (Continuation: Anger causes Qi to reverse, damaging Yin; joy causes Qi to relax, damaging Yang. My note: These two sentences and the next repeat *Yin Yang Ying Xiang Da Lun* text but differ in notes; included here.) Jue Qi rises upward, filling the vessels, separating Shen from the form. (Continuation: Qi reversal. Reversal causes Qi to rise, filling meridians, so Shen scatters and leaves the body.) I treat them without knowing tonification or sedation, without understanding the condition; Hua Ri (name/typo) expels evil Qi, which then combines; this is the second fault. (Continuation: Not distinguishing different states of joy/anger, applying tonification/sedation uniformly, causing Zang essence to deplete daily, allowing evil Qi to erode and combine with true Qi.) Good pulse readers use such methods, combining extraordinary and ordinary signs, analyzing calmly to become skilled; without understanding principles, diagnosis is worthless; this is the third fault. (Continuation: Extraordinary refers to abnormal climate signs; calm analysis refers to distinguishing Zang deficiency/excess and similar pulses. *Shi Cong Rong Lun* says: Spleen deficiency floats like Lung, Kidney small float like Spleen, Liver urgent sink/scattered like Kidney; these confuse doctors, but calm analysis resolves them.)
Diagnosis has three constants: ask about nobility/commonness, loss of fiefdom, and desire for lordship. (Continuation: Loss of fiefdom means demotion from duke/minister; desiring lordship means craving high status endlessly.) Thus, nobles losing power, though not struck by evil, suffer internal spiritual injury, leading to bodily ruin. (Continuation: Due to worry, fear, torment, and knotting.) Once rich, now poor, though not struck by evil, skin dries, sinews contract, atrophy and spasms occur. (Continuation: Due to lingering Zang Qi and combined pathogens.) If the physician cannot be strict, cannot move the Shen, appears weak and compliant externally, disrupting the Dao, the disease cannot shift, and medical practice fails; this is the fourth fault. (Continuation: Strictness forbids misconduct to ensure obedience; external weakness implies compliance. Without prohibition or influence, complying with things disrupts heavenly norms; if disease doesn't shift, what use is the doctor?)
Diagnostician must know beginning and end, understand residual clues, palpate pulse, ask names, and consider gender differences. (Continuation: Beginning/end refers to complexion. Classic: Know exterior by tracing end to start, observing five colors cyclically. Residual clues refer to post-onset details. Palpate means finger pressure. Ask clearly means asking disease name. Men have more Yang, left pulse large is favorable; Women have more Yin, right pulse large is favorable; thus combine first.) Separation, severance, depression, knotting, worry, fear, anger, joy cause Zang emptiness and blood/Qi separation. If doctors don't know, what medicine can they speak of? (Continuation: Separation severs love; severance cuts hopes; depression accumulates thought; knotting holds grudges. Loving ones lose soul; severed ones lose intent; accumulated thoughts tire Shen; grudge-holders suffer will. Worry blocks flow; fear loses guard; anger confuses; joy scatters. These eight cause Zang emptiness and Qi/Bi separation. Doctors ignoring this speak nothing.) Once rich, greatly injured, sinews severed, body moves again, but fluids cease. (Continuation: Severed sinews mean excessive damage. Body recovers movement, but fluids don't nourish. Why? Essence depleted. Fluids refer to Jin Ye.)
Thus, Yang failure knots and stays, pressing on Yang, forming pus accumulation with cold/heat. (Continuation: Yang refers to Yang meridians and Fu organs. Jiong means heat. Non-standard damage to sinews/blood causes Qi to knot internally, pressing on Yang meridians, turning to pus, accumulating in abdomen, manifesting as external cold/heat.) Crude physicians treat urgently by needling Yin/Yang meridians, causing body dissolution, limb tetany, death has a date. (Continuation: Not knowing cold/heat stems from pus, mistaking for common heat, needling repeatedly drains Qi, worsening disease, dissolving body, paralyzing limbs. Death date is doctor's fault.) Doctors unclear, not asking causes, only stating death date, are crude; this is the fifth fault. (Continuation: Incomplete diagnosis, careless treatment, ignoring clues, poor conduct make one a crude doctor.)
These five cases stem from unmastered techniques and ignorance of human affairs. (Continuation: Practitioners not grasping subtle principles or human matters.) Thus, sages treating disease know Heaven/Earth, Yin/Yang, Four Seasons, Zang-Fu, Yin/Yang, Exterior/Interior, acupuncture, moxibustion, stones, drugs, handle human affairs calmly to clarify classics. Nobility/poverty/rich/poor have different traits; ask age, courage/fear; examine parts, know root, eight signs, nine pulses match. (Continuation: Sages explain this; doctors should strive. See *Wu Guo Lun*.)
Emperor said: Twelve meridians, 365 collaterals are known and used by doctors. (Continuation: Following and using.) Failure to be perfect comes from unfocused spirit, unruly will, internal/external mismatch, causing doubt/danger. (Continuation: Exterior is color, interior is pulse. Crude estimation fails, color/pulse mismatch, causing self-doubt.) Not knowing Yin/Yang reversal/submission in diagnosis is the first loss. (Continuation: *Mai Yao Jing Wei Lun*: Winter solstice +45 days, Yang rises slightly, Yin falls slightly; Summer solstice +45 days, Yin rises slightly, Yang falls slightly. Yin/Yang have timing matching pulses; not knowing this is one loss.) Incomplete apprenticeship, wild theories, false doctrines, changing names for credit, abusing stone needles, leaving harm, is the second loss. (Continuation: Not finishing study, acting wildly, changing ancient norms, following self, leaving harm, rightly a loss.) Ignoring poverty/nobility housing, seat thickness, body temperature, diet suitability, courage/fear, lacking analogy, confusing oneself, is the third loss. (Continuation: Brave hard to hurt, timid easy to hurt, due to Shen/Qi strength. Understanding poverty/nobility reveals seat/body/diet norms. Lacking analogy causes confusion, not clarity; third loss.) Diagnosing without asking origin, worry, diet irregularity,起居 excess, toxicity, not asking first, suddenly pulsing cunkou, guessing names, becoming crude, is the fourth loss. (Worry/fear/hardship. Not asking these, then pulsing cunkou, guessing disease, acting famous, becoming crude. Must ask then diagnose for perfection, not rely solely on pulse. See *Zheng Si Shi Lun*.)
East wind in Spring, disease in Liver, Shu points in neck/occiput. (Spring wind promotes growth, Shu in neck. Avoid treating neck on Jia/Yi days.) South wind in Summer, disease in Heart, Shu points in chest/hypochondrium. (Heart Shaoyin meridian passes chest/hypochondrium.) West wind in Autumn, disease in Lung, Shu points in shoulder/back. (Lung in upper Jiao, back corresponds to chest, shoulder/back adjacent.) North wind in Winter, disease in Kidney, Shu points in waist/thigh. (Waist is Kidney mansion, thigh connected by Qi.) Center is Earth, disease in Spleen, Shu points in spine. (Spine corresponds to Earth, central.)
Spring disease in head (Liver Qi responds). Summer disease in Zang (Heart response). Autumn disease in shoulder/back (Lung response). Winter disease in four limbs (Limbs lack Qi, cold easily harms, location depends on pathogen). Spring prone to rhinorrhea/epistaxis. (In Qi, in head. Qiu is nasal discharge, Nu is nosebleed.) Mid-summer prone to chest/hypochondrium disease. (Heart meridian passes there.) Late summer prone to severe diarrhea/cold middle. (Earth governs middle, grain processing, hence severe diarrhea/cold.) Autumn prone to wind-malaria. (Cool offsets heat, causing malaria. Monthly Ordinance: Early Autumn doing Summer rites causes malaria.) Winter prone to Bi/Jue. (Blood abundant in water, cold freezes, Qi flows thinly, causing Bi/Jue.)
Winter without massage/guiding prevents Spring rhinorrhea/epistaxis. (An is massage; Qiao is agile movement/guiding. Disturbing sinews/bones hides Yang; Spring Yang rises, heat steams Lung, Lung opens to nose, disease forms. Hence winter no massage, spring no rhinorrhea/epistaxis. Qiu is clear nasal discharge, Nu is blood.) Spring no neck disease, mid-summer no chest disease, late summer no diarrhea, autumn no malaria, winter no Bi/Jue. (All due to winter no massage.)
Essence is body root; storing essence prevents Spring warmth. (Due to winter no massage.) Summer heat without sweat leads to Autumn wind-malaria. (Wind-cool offsets heat sweat. Note: Seems disconnected from previous, similar to *Po Han Wei Jin*. Wang注: Winter hibernation; winter massage disturbs heat, causing seasonal changes. Essence is root, must store. See *Jin Gui Zhen Yan Lun*.)
All vessels belong to eyes. (Vessels are blood house. Long viewing hurts blood, hence vessels belong to eyes. Correction: Heart stores vessels, vessels house Shen, Shen permeates body, hence belongs to eyes.) All marrow belongs to brain. (Brain is sea of marrow.) All sinews belong to joints. (Sinews are firm Qi connecting bones/joints. Long walking hurts sinews.) All blood belongs to Heart. (Blood in vessels, belongs to Heart. Blood/Qi is Shen, Shen is Heart master.) All Qi belongs to Lung. (Lung stores Po...) Blood returns to Liver. (Liver stores blood, Heart moves it. Movement distributes blood to vessels; rest returns blood to Liver. Liver governs blood...) Eyes see when receiving blood. (Function. Eye is Liver palace, receives blood to see.) Feet walk receiving blood, palms... fingers grasp receiving blood. (Blood/Qi is Shen, receiving blood enables use. See *Zang Wu Sheng Cheng Lun*.)
Five flavors enter: Sour to Liver, Pungent to Lung, Bitter to Heart, Salty to Kidney, Sweet to Spleen. (Liver/Wood/Sour, Lung/Metal/Pungent, Heart/Fire/Bitter, Kidney/Water/Salty, Spleen/Earth/Sweet. *Zhi Yao Yao Lun*: Flavors enter stomach, return to preferred organ. Sour to Liver, Bitter to Heart, Sweet to Spleen, Pungent to Lung, Salty to Kidney.)
Five Qi diseases: Heart is belching. (Fire flares up, smoke follows; Heart rejects filth, belches it out.) Lung is cough. (Metal is hard, sounds when struck; pathogen hits Lung, causes cough.) Liver is speech. (Wood branches, speech expresses complexity, originates in Liver.) Spleen is swallowing. (Earth contains, accepts all, hence swallowing.) Kidney is yawning and sneezing. (Water flows down, clouds rise, Qi knots in Stomach, Fire generates. Fire Qi harmonizes, presses Heart, exits nose as sneeze.) Stomach is reflux, hiccup, fear. (Stomach is sea of grain/water, Kidney gate controls flow; blockage causes reflux. Grain likes cold, cold clashes, causes hiccup. Cold excess causes hiccup, heat excess causes fear. Heat weakens Kidney Qi, causing fear. Later: Essence combining in Kidney causes fear.) Large/Small Intestines are diarrhea; Lower Jiao overflow is water. (Large intestine conducts, Small intestine receives. Weak reception, uncontrolled conduction, causes diarrhea. Lower Jiao distributes; blockage causes water overflow.) Bladder dysfunction/incontinence is strangury/enuresis. (Bladder stores fluids. Foot Sanjiao vessel solid, constrains Lower Jiao, blockage causes strangury; vessel deficient, unconstrained, causes enuresis. *Ling Shu*: Foot Sanjiao is Taiyang branch, enters Bladder, constrains Lower Jiao. Solid = strangury, Deficient = enuresis.) Gallbladder is anger. (Decisive, impartial, rigid nature, hence anger. Classic: Eleven Zang depend on Gallbladder.) These are Five Diseases.
Five Essences Combine: Combining in Heart causes joy. (Lung deficient, Heart essence combines, joy. *Ling Shu*: Endless joy hurts Po, Po is Lung Shen. Heart Fire combines Lung Metal.) Combining in Lung causes sorrow. (Liver deficient, Lung essence combines, sorrow. *Ling Shu*: Sorrow hurts Hun, Hun is Liver Shen. Lung Metal combines Liver Wood.) Combining in Liver causes worry. (Liver deficient, Liver Qi combines, worry. *Ling Shu*: Unresolved worry hurts Yi, Yi is combined Shen. Liver Wood combines Spleen Earth.) Combining in Spleen causes fear. (Kidney deficient, Spleen Qi combines, fear. *Ling Shu*: Unresolved fear hurts Jing, Jing is Kidney Shen. Spleen Earth combines Kidney Water.) Combining in Kidney causes terror. (Heart deficient, Kidney Qi combines, terror. *Ling Shu*: Fear/worry hurts Shen, Shen is Heart Ming. Kidney Water combines Heart Fire. All due to righteous Qi deficiency allowing winning Qi to combine. Hence:) These are Five Combinations, combining due to deficiency.
Five Dislikes: Heart dislikes Heat. (Heat causes vessel turbidity.) Lung dislikes Cold. (Cold causes Qi stagnation.) Liver dislikes Wind. (Wind causes sinew dryness/tension.) Spleen dislikes Dampness. (Dampness causes muscle atrophy/swelling.) Kidney dislikes Dryness. (Dryness causes essence depletion.) These are Five Dislikes.
Five Transformations: Heart is sweat. (Exudes through skin.) Lung is mucus. (Moistens nose.) Liver is tears. (Nourishes eyes.) Spleen is saliva. (Overflows lips.) Kidney is thick saliva. (Generates teeth.) These are Five Fluids.
Five Disease Origins: Yin disease starts in bones, Yang disease starts in blood; Yin disease starts in flesh. (Bone/flesh are Yin essence, Yang Qi follows; blood vessels are Yang motion, Yang Qi attacks.) Yang disease starts in Winter, Yin disease starts in Summer. (Summer Yang strong, Yin disease starts; Winter Yin strong, Yang disease starts. Follows scarcity.) These are Five Origins.
Five Chaotic Evils: Entering Yang causes madness; entering Yin causes Bi. (Evil in Yin vessels, limbs hot, madness; evil in Yin meridians, six channels stagnant, Bi.) Clashing Yang causes mania; clashing Yin causes aphasia. (Wang注: Evil clashing Yang, vessels rush, mania; evil clashing Yin, vessels stop, aphasia. Correction: *Nan Jing*: Heavy Yang = madness, Heavy Yin = mania. Chao Yuansfang: Evil in Yin = mania. *Mai Jing*: Yin attaching Yang = madness, Yang attaching Yin = mania. Sun Simiao: Evil in Yang = madness, Evil in Yin = blood Bi; Yang transmitting = mania/spasm, Yin transmitting = pain/aphasia. Quan Yuanqi: Evil in Yin transmits to Yang, Qi doesn't circulate, clashes with righteous Qi, causes mania; Evil in Yang transmits to Yin, Zang/Fu affected, causes aphasia. Different views recorded.) Yang entering Yin causes essence issues; Yin exiting Yang causes anger. (Disease follows direction.) These are Five Chaos.
Five Evil Pulses: Spring getting Autumn pulse, Summer getting Winter pulse, Late Summer getting Spring pulse, Autumn getting Summer pulse, Winter getting Late Summer pulse. These are Five Evils, incurable death.
Five Zang Storage: Heart stores Shen. (Spiritual essence formation. *Ling Shu*: Two essences interacting is Shen.) Lung stores Po. (Essence assistant. *Ling Shu*: Exiting/entering with essence is Po.) Liver stores Hun. (Spirit assistant. *Ling Shu*: Coming/going with Shen is Hun.) Spleen stores Yi. (Memory without forgetting. *Ling Shu*: Heart recalling is Yi.) Kidney stores Zhi. (Focused will unmoving. *Ling Shu*: What Yi stores is Zhi. Kidney receives essence of all Zang/Fu, root of Yuan Qi, root of generation, gate of Stomach, thus Zhi connects to life.) These are Five Storages.
Five Zang Governing: Heart governs vessels. (Restricts Ying Qi, moves with breath.) Lung governs skin. (Wraps muscles, closes evils.) Liver governs sinews. (Binds joints, moves with Shen.) Spleen governs flesh. (Covers sinews/bones, circulates Wei.) Kidney governs bones. (Extends sinews, supports body.) These are Five Governances.
Five Labors: Long viewing hurts blood (Heart labor). Long lying hurts Qi (Lung labor). Long sitting hurts flesh (Spleen labor). Long standing hurts bones (Kidney labor). Long walking hurts sinews (Liver labor). These are Five Labors.
Five Pulse Images: Liver pulse Xian (String-like). (Soft, void, smooth, straight, long.) Heart pulse Gou (Hook). (Like hook, incoming strong, outgoing weak.) Spleen pulse Dai (Alternating). (Soft, weak.) Lung pulse Mao (Feather). (Light, floating, void, like feather.) Kidney pulse Shi (Stone). (Deep, firm, beating, like stone.) These are Five Zang Pulses (*Xuan Shu Wu Qi Lun*).
Liver color Green, eat Sweet: Millet, beef, dates, okra. (Sweet softens Liver urgency.) Red color, eat Sour: Mung bean, dog meat, plum, leek. (Sour astringes Heart relaxation.) Lung color White, eat Bitter: Wheat, mutton, apricot, leek. (Bitter disperses Lung Qi reversal.) Spleen color Yellow, eat Salty: Soybean, pork, chestnut, broad bean leaves. (Salty softens Kidney/Stomach gate. Spleen/Stomach combine, salty aids gate opening, Stomach Qi moves, Spleen transforms.) Kidney color Black, eat Pungent: Yellow millet, chicken, peach, green onion. (Pungent moistens Kidney dryness. Studying these flavors regulates mechanisms. Kidney is Stomach gate, Spleen combines with Stomach, salty softens gate, gate opens, Stomach Qi moves, Spleen transforms, hence Spleen flavor differs. Correction: See above...)