云脾苦湿急食苦以燥之况肝心肺肾食宜皆与前文合独脾食咸不用苦故王氏特注其意）辛收酸收甘缓苦坚硬咸软（续皆自
然之气也然辛味匪唯能散而亦能润故曰坚苦燥急食辛以润之苦味匪唯能坚而亦能燥能泄故曰脾苦湿急食苦以燥之肺苦气
上逆急食苦以泄之）毒药攻邪五谷为养五果为助五畜为益五菜为克（续毒药谓金玉土石草木菜果虫鱼鸟兽之类然僻邪安
正唯毒乃能故通谓之毒药也五谷粳米小豆大豆麦黄黍五果桃李杏栗枣五菜葵藿薤葱韭愚谓充足也以五菜疏通肠胃令食气
是也）气味而服之合以补精益气（续气谓阳化味曰阴施气味合和则补益精气矣经曰形不足者温之以气精不足者补之以味
孙思邈曰精以食气气养精以荣色形以食味味养色以生力精顺五气以为灵也若食气相恶则伤精也形受味以成也若食味不调
则损形也是以圣人先用食禁以存性以防气味温补以存精形此谓气味合而服之以补精益气）此五者有辛酸甘苦咸各有所利
或散或收或缓或急或坚或软四时五脏病随五味所宜也（藏气法时论）五味所禁辛走气气病（续病谓力少不自胜也）无多
食辛咸走血血病无多食咸（血者水类故咸走之）苦走骨骨病无多食苦（续皇甫士安云咸先走肾此云走血者肾合三焦血脉
虽属肝心而为中焦之道故咸火而走血也苦走心此云走骨者水火相济骨气通于心也）甘走肉肉病无多食甘酸走筋筋病无多
食酸（续皆谓行其气速故不欲多食勿食则病甚也）是谓五禁无令多食（续口食而欲食之无令多也宣明五气论）多食咸则
脉凝泣而变色（续心合脉其荣色咸益肾而胜心故脉凝泣而颜色变易）多食苦则皮槁而毛拔（续肺合皮其荣毛苦益心胜肺
故皮槁苦而毛拔去也）多食苦则筋急而爪枯（续肝合筋其荣爪辛益肺胜肝故筋急而爪干枯也）多食酸则肉胝胸而唇揭（续
脾合肉其荣唇酸益肝胜脾故肉胝胸而唇皮揭举也）多食甘则骨痛而发落（续肾合骨其荣发甘益脾胜肾故骨痛而发坠落也）
此五味之所伤也（五味入口输于肠胃而内养五脏各有所养有所欲欲则互有所伤故下文曰）故心欲苦肺欲辛肝欲酸脾欲甘
肾欲咸此五味之所合五脏之气也（续各随所欲而归凑之全元起云五味合五脏气二句相连）色味当五脏白当肺辛赤当心苦
青当肝酸黄当脾甘黑当肾咸（续各当其所应而为色味也）故白当皮赤当脉青当筋黄当肉黑当骨（续各当其所养之脏气也
五脏生成篇）帝曰愿闻虚实之要岐伯曰气实形实气虚形虚此其常也反此者病（续气谓脉气形谓身形反谓不相合应失常平
之候也形气相反故病生）谷盛气盛谷虚气虚此其常也反此者病（续灵枢经曰营气之道内谷为实谷入于胃气传与肺精专者
上行经隧由是谷气虚实占必同焉侯不相应为则病也）脉实血实脉虚血虚此其常也反此者病（续脉者血之府故虚实同焉反
不相应则为病也）曰何如而反曰虚气身热此谓反也（续气虚为阳气不足阳气不足当身寒反身热者脉气当盛脉不盛而身热
症不相符故谓反也按甲乙经云气盛身寒气虚身热此谓反也当补此四字）谷入多而气少此谓反也（胃之所出者谷气而布于
经脉也谷入于胃脉道乃散今谷入多而气少者是胃气不能散故谓反也）谷不入而气多此谓反也（续胃气外散肺并之也）脉
血盛少此谓反也脉少血多此谓反也（续经脉行气络脉受血经气入络络受经气候不相合故皆反常也）气盛身寒得之伤寒气
虚身热得之伤暑（续寒伤形故气盛身寒热伤气虚身热）谷入多而气少者得之有所脱血湿居下也（续脱血则血虚血虚则气
盛内郁化成津液流入下焦故云湿下居也）谷入少而气多者邪在胃及与肺也（续胃气不足肺气下流于胃中故邪在胃然肺气
入胃则肺气不自守而邪气亦从之故云邪在胃及与肺也）脉小血多者饮中热也（续饮谓留饮也饮留脾胃之中则脾气热脾气
溢则发热中）脉大血少者脉有风气水浆不入此之谓也（续风气盛满则水浆不入于脉刺志论）天之邪气感则害人五脏（续
四时之气八正之风皆天邪也入风发邪经脉受之则循经而触于五脏）水谷之寒热感则害于六腑（续热伤胃及膀胱寒伤肠及
胆气）地之湿气感则害皮肉筋脉（湿气盛则营卫脉不行故感则害于皮肉筋脉阴阳应象论）岐伯曰阳者天气也主外阴者地
气也主内故阳道实阴道虚故犯贼风虚邪者阳受之饮食不节起居不时者阴受之阳受之则入六腑阴受之则入五脏六腑则身热
不时卧上为喘呼入五脏则 满闭塞下为飧泄久为肠 （愚谓阴阳应象论曰天之邪气感则害五脏水谷寒热感则害六腑太阴
阳明论曰犯贼风虚邪阳受之食饮起居阴受之阳受之则入六腑阴受之则入五脏两说相反何也此所谓似反而不反也夫天之邪
气贼风虚气外伤有余之病也水谷寒热饮食起居内伤不足之病也二者之伤脏腑皆当受之但随其所从所发之处而为尔不可以
此两说之异而致疑盖并行不相悖也天之邪气固伤五脏亦未必不伤六腑水谷寒热固伤六腑亦未必不伤五脏至于地之湿气亦
未必专害皮肉筋脉而不能害脏腑邪气水谷亦未必专害脏腑而不能害皮肉筋脉也但以邪气无形脏主藏精气故以类相从而多
伤脏水谷有形腑主传化物故因其所由而多伤腑湿气浸期其性缓慢其入人也以渐其始也自足故从一而上从浅而深而多伤于
皮肉筋脉耳孰谓湿气全无及于脏腑之理哉）故喉主天气咽主地气故阳受风气阴受湿气（续同气相求耳）故阴气从足上行
至头而下行循臂至指端阳气行从手上至头而下行至足（续灵枢经曰手之三阴从脏走手手之三阳从手走头足之三阳从头走
足足之三阴从足走腹所行而异故更逆更从）故曰阳病者上行极下阴病者下行极而上（续此言其大凡耳然足少阴下行则不
同诸阴之气也）故伤于风者上先受之伤于湿者下先受之（续阳气炎上故受风阴气润下故受湿盖同气相今故耳太阴阳明篇）
五脏受气于其所生传之于其所胜气舍于其所生死于其所不胜病之且死必先传行至其所不胜病乃死（续受气所生者谓受病
气于已之所生也传所胜者谓传于已之所克也气舍所生者谓舍于生已者也死所不胜者谓死于克已者之分位也所传不顺故必
死焉）此言气之逆行也故死（续所为逆者次如下说）肝受于心气（木生火也）传之于脾气舍于肾至肺而死心受气于脾传
之于肺气舍于肝至肾而死脾受气于肺传之于肾气舍于心至肝而死肺气受于肾传之于肝气舍于脾至心而死肾受气于肝传之
于心气舍于肺至脾而死此皆逆死也一日一夜五分之此所以占死生之早暮也（续肝死于肺位
秋庚辛余四仿此然朝主甲乙昼主丙丁四季土主戊己晡主庚辛夜主壬癸由此则死生之早暮可知矣校正云占死生当作占死者
玉机真藏论）天有四时五行（天元纪论作天有五行以御五位）以生长收藏以生寒暑燥湿风（续春生夏长秋收冬藏谓四时
之生长收藏冬水寒夏火暑秋金燥木春夏长风土湿谓五行之寒暑燥湿风也然四时之气土虽寄旺原其所主但居日中央故云五
行以生寒暑燥湿风五气也）人有五脏化五气以生喜怒悲思恐（续五气谓喜怒悲思恐然是五气更伤五脏之和气矣○校正按
天元纪论悲作思盖言悲者以悲能胜恐取五志迭相胜而言也 思者以思为之脾志也名 一则义俱不足两见之则互相成义
也）喜怒伤气寒暑伤悲（续喜怒皆生于气故云喜怒伤气寒暑皆胜于形故云寒暑伤形近取诸身则如斯矣细而言之则热伤于
气寒伤于形也）暴怒伤阴暴喜伤阳（续怒则气上喜则气下故暴卒气上则伤阴暴卒气下则伤阳）厥气上行满脉去形（续厥
气逆也逆气上行满于经络则浮气神越去离形髓也）喜怒不节寒暑过度生乃不固（灵枢经曰智者之养生也必顺四时而适寒
暑和喜怒而安居处然喜怒不常寒暑过度天真之气何可常久）故重阴必阳重阳必阴（续言伤寒暑伤亦如是阴阳应象论）风
胜则动（续不宁也风胜则庶物皆摇故为动左传曰风摇末疾是也校正详风胜则动至湿胜则濡泄五句与阴阳应象论文重而注
不同）热胜则肿（续热胜则阳气内郁故红肿暴作甚则营气逆于肉理聚为肿痈又云热胜气为丹 胜血为痈脓胜骨肉为 肿
按之不起）燥胜则干（续干于外则皮肤皴揭干于内则精血枯涸干于气及津液则肉干而皮着骨）寒胜则浮（续浮谓浮起按
之起见也又云寒胜则阴气结于玄府玄府闭密阳气内攻故为浮）湿胜则濡泄甚则水 闭肿（续湿胜则内攻脾胃脾胃受湿则
水谷不分故大肠传导而注泄也以湿内盛而泄故谓之濡泄左传曰雨淫腹疾是也濡泄水利也 肿肉泥按之陷而不起水闭则溢
于皮中也六元正纪论）帝曰脾病而四肢不用何也岐伯曰四肢皆禀气于胃而不得至经（续至经太素作径至杨上善云胃以水
谷资四肢不能径至于四肢要因于脾布化水谷津液四肢乃受禀可以也）必因于脾乃得禀也今脾病不能为胃行其津液四肢不
得禀水谷气日以衰脉道不利筋脉肌肉皆无气以生故不用焉曰脾不主时何也曰脾者土也治中央常以四时长四脏各十八日寄
治不独得主于时也脾脏者常着胃土之精也土者生万物而法天地故上下至头足不得主时也（续治主也着谓常约着于胃也土
气于四时之中各于季终寄王十八日则五行之气各王七十二日以终一岁之日矣外主四季则在人内应于手足也）曰脾与胃以
膜相连耳而能为之行其津液何也曰足太阴者三阴者其脉贯胃属脾络嗌故太阴为之行气于三阴阳明者表也（续胃是脾之
表）五脏六腑之海也亦为之行气于三阳脏腑各因其经而受气于阳明（太阴阳明论）形弱气虚死（续中外俱不足）形气有
余脉气不足死（续脏衰故脉不足也）脉气有余形气不足生（续脏盛故脉气有余方盛衰论）岐伯曰夫盐之味咸者其气令器
津液弦绝者其音嘶败木敷者其叶发病深者其声哕人有此三者是谓坏府毒药无治短针无败此皆绝皮伤肉血气争黑（此段有
缺误木敷者其叶发太素作木陈者其叶落争黑当作争异坏府谓三者之病犹云崩坏之处也详此文义若曰夫弦绝者其音嘶败木
陈者其叶落盐之味咸者其气令器津液泄深病者其声哕绝皮伤肉血气争异人有此三者是谓坏府毒药无治短针无取盖以弦绝
况声哕木落况绝伤津液况血气争异也庶通○杨上善云言欲知病散者须知其候盐之在于哭中津液泄于外见津而知盐之有咸
也声哕知琴瑟之弦将绝叶落知陈木之已尽养此三物衰坏之征以比声哕识病深之候人有声哕同三譬者是为府坏之候中府坏
者病之深也其病既深故斜药不能取以其皮肉血气各不相得故也○愚按杨注虽与问答义相贯茅终不若滑注之密也）岐伯曰
木得金而伐火得水而减土得木而达金得火而缺水得土而绝万物尽然不可胜揭（续达通也言物类虽不可竭尽而数要之皆如
五行之气而有胜负之性分耳宝命全角篇）阴盛则梦涉水恐惧（续阴为水故梦涉水而恐惧也）阳盛则梦大火（续阳为火故
梦火而燔灼也）阴阳俱盛则梦相杀毁伤（续亦类交争之象也）上盛则梦飞（续气上则梦故上飞）下盛则梦堕（续气下则
梦下故堕）甚饱则梦与（续内有余）甚饥则梦取（续内不足）肝气盛则梦怒（续肝在志为怒）肺气盛则梦哭（续肺声哀
故梦哭仍少心脾肾气所梦今具甲乙经中）短虫多则梦聚众长虫多则相击毁伤（续长虫动则内不安内不安则神躁扰故梦是
矣紧要精微论）
医之有素问犹吾儒之有四书不读素问不知病源不读四书不知道理时医只知检方疗疾不知病源误人多矣许昌滑伯仁氏
读素问钞九卷其删取之精编辑之审其功犹程朱二夫子之于四书也但微辞奥旨未易即晓祁门汪君省之复取王氏注参补其间
注之而未尽者用己意补之其继往开来之功甚伟吾HT 好事者为之刻梓以公于天下后世其亦仁者之心哉仍有末卷未完爰
命公以终之因忘其固陋而 识岁月如此
嘉平乙酉春二月朔旦休宁湖山程文杰识
（原文提到：脾脏厌恶湿气，应当急切地食用苦味食物来燥湿。至于肝、心、肺、肾的饮食宜忌，都应与前文相合，唯独脾脏饮食中咸味不用苦味，所以王冰特意注释了其中的深意。）辛味能散也能润，酸味能收，甘味能缓，苦味能坚能燥，咸味能软。（这些都是自然之气的作用。然而辛味不仅发散，也能滋润，所以说“脾苦湿，急食苦以燥之”；苦味不仅坚阴，也能燥湿泄热，所以说“肺苦气上逆，急食苦以泄之”。）毒药攻伐邪气，五谷作为滋养，五果作为辅助，五畜作为补益，五菜作为疏通（续注：毒药指金、玉、石、土、草、木、菜、果、虫、鱼、鸟、兽等具有偏性的药物，但只有毒性才能祛除邪气、安定正气，所以通称为毒药。五谷指粳米、小豆、大豆、麦、黄黍；五果指桃、李、杏、栗、枣；五菜指葵、藿、薤、葱、韭。我认为这是为了充足营养，用五菜疏通肠胃，使饮食之气得以运行）。通过气味配合服用，可以补精益气（续注：气属阳主化，味属阴主施。气味调和则能补益精气。《内经》说：“形体不足的，用气去温煦它；精气不足的，用味去滋补它。”孙思邈说：“精依靠食气来生成，气依靠养精来荣润面色；形依靠食味来构成，味依靠养色来产生力量。精顺应五气而成为灵物。如果食气相互排斥，就会损伤精；形受味而成，如果食味不调和，就会损害形。因此圣人先用饮食禁忌来保全本性，防止气味温补过度以保存精气。这叫做气味配合服用，以补精益气。”）这五味（酸、辛、甘、苦、咸）各有所利，有的发散，有的收敛，有的缓和，有的紧急，有的坚燥，有的软化。四时五脏的疾病，要根据五味的适宜性来选择（出自《藏气法时论》）。
五味有其所禁：辛味走气，气病不要多吃辛味；咸味走血，血病不要多吃咸味（血属于水类，所以咸味走向它）；苦味走骨，骨病不要多吃苦味（续注：皇甫士安说咸味先走肾，这里说走血，是因为肾合三焦，血脉虽属肝心，但位于中焦之道，所以咸火走向血；苦味走心，这里说走骨，是因为水火相济，骨气通于心）；甘味走肉，肉病不要多吃甘味；酸味走筋，筋病不要多吃酸味（续注：这都是因为行气迅速，所以不希望多吃，如果不吃反而病情加重）。这叫做五禁，不要让病人多吃（出自《宣明五气论》）。
多吃咸味，则血脉凝涩而颜色改变（续注：心合脉，其华在色，咸味益肾而克心，所以血脉凝涩而颜色变易）；多吃苦味，则皮肤枯槁而毛发脱落（续注：肺合皮，其华在毛，苦味益心而克肺，所以皮肤枯槁而毛发脱落）；多吃辛味，则筋脉拘急而指甲干枯（续注：肝合筋，其华在爪，辛味益肺而克肝，所以筋脉拘急而指甲干枯）；多吃酸味，则肌肉厚硬如茧且嘴唇掀揭（续注：脾合肉，其华在唇，酸味益肝而克脾，所以肌肉厚硬如茧且嘴唇皮掀揭）；多吃甘味，则骨头疼痛而头发脱落（续注：肾合骨，其华在发，甘味益脾而克肾，所以骨头疼痛而头发坠落）。这就是五味所导致的伤害（五味入口进入肠胃，内养五脏，各有所养，也有所欲，欲则互有所伤，所以下文说）：所以心欲苦，肺欲辛，肝欲酸，脾欲甘，肾欲咸，这是五味与五脏之气的配合（续注：各自随着所欲而归聚。全元起说五味合五脏气，这两句是相连的）。
颜色与味道对应五脏：白色对应肺，辛味；赤色对应心，苦味；青色对应肝，酸味；黄色对应脾，甘味；黑色对应肾，咸味（续注：各自对应其应有的色味）。所以白色对应皮，赤色对应脉，青色对应筋，黄色对应肉，黑色对应骨（续注：各自对应其所养的脏气。出自《五脏生成篇》）。
黄帝问：我想了解虚实的关键。岐伯说：气实形实，气虚形虚，这是常态。与此相反的就是病态（续注：气指脉气，形指身形。相反指不相符合，失去正常平候。形气相反，所以生病）。谷气盛则脉气盛，谷气虚则脉气虚，这是常态。与此相反的就是病态（续注：《灵枢经》说：营气的道，以内谷为实。谷入于胃，气传于肺，精专者上行于经隧，由此谷气虚实占必相同。如果候象不相应，就是病态）。脉实血实，脉虚血虚，这是常态。与此相反的就是病态（续注：脉是血的府库，所以虚实相同。反不相应就是病态）。
什么叫相反？气虚而身体发热，这叫相反（续注：气虚为阳气不足，阳气不足应当身寒，反而身热，脉气应当盛而不盛，症状不相符，所以叫相反。按《甲乙经》说：气盛身寒，气虚身热，这叫相反。应当补这四个字）。谷入多而气少，这叫相反（胃所出的是谷气，布于经脉。谷入于胃，脉道乃散。现在谷入多而气少，是胃气不能散布，所以叫相反）。谷不入而气多，这叫相反（续注：胃气外散，肺气并之）。脉盛血少，这叫相反；脉少血多，这叫相反（续注：经脉行气，络脉受血。经气入络，络受经气，气候不相合，所以都是反常）。
气盛身寒，得之于伤寒；气虚身热，得之于伤暑（续注：寒伤形，故气盛身寒；热伤气，故气虚身热）。谷入多而气少，得之于失血，湿气居下（续注：失血则血虚，血虚则气盛，内郁化成津液流入下焦，所以叫湿下居也）。谷入少而气多，邪在胃及肺（续注：胃气不足，肺气下流于胃中，所以邪在胃。然肺气入胃，则肺气不自守，而邪气亦从之，所以叫邪在胃及肺）。脉小血多，是饮中热（续注：饮指留饮。饮留脾胃之中，则脾气热，脾气溢则发热中）。脉大血少，脉有风气，水浆不入，这就叫作（续注：风气盛满，则水浆不入于脉。出自《刺志论》）。
天之邪气感受则伤害人五脏（续注：四时之气、八正之风皆天邪也。入风发邪，经脉受之，则循经而触于五脏）。水谷的寒热感受则伤害六腑（续注：热伤胃及膀胱，寒伤肠及胆）。地的湿气感受则伤害皮肉筋脉（湿气盛则营卫脉不行，所以感受则伤害皮肉筋脉。出自《阴阳应象大论》）。
岐伯说：阳者天气也，主外；阴者地气也，主内。所以阳道实，阴道虚。因此，遭受贼风虚邪的人，阳经受之；饮食不节、起居不时的人，阴经受之。阳经受之则传入六腑，阴经受之则传入五脏。传入六腑则身体发热、不时卧倒、上为喘呼；传入五脏则脘腹胀满闭塞、下为完谷不化的泄泻，久则发展为肠澼（愚按：《阴阳应象大论》说：天之邪气感则害五脏，水谷寒热感则害六腑。《太阴阳明论》说：犯贼风虚邪阳受之，食饮起居阴受之，阳受之则入六腑，阴受之则入五脏。两说相反，为什么呢？此所谓似反而不反也。夫天之邪气、贼风虚气，外伤有余之病也；水谷寒热、饮食起居，内伤不足之病也。二者之伤脏腑皆当受之，但随其所从、所发之处而为尔，不可以此两说之异而致疑，盖并行不相悖也。天之邪气固伤五脏，亦未必不伤六腑；水谷寒热固伤六腑，亦未必不伤五脏。至于地之湿气，亦未必专害皮肉筋脉而不能害脏腑。邪气水谷亦未必专害脏腑而不能害皮肉筋脉也。但以邪气无形，脏主藏精气，故以类相从而多伤脏；水谷有形，腑主传化物，故因其所由而多伤腑。湿气浸渍，其性缓慢，其入人也以渐，其始也自足，故从一而上，从浅而深，而多伤于皮肉筋脉耳。孰谓湿气全无及于脏腑之理哉！）。
所以喉主天气，咽主地气，故阳受风气，阴受湿气（续注：同气相求耳）。阴气从足上行至头，而下行循臂至指端；阳气行从手上至头，而下行至足（续注：《灵枢经》曰：手之三阴从脏走手，手之三阳从手走头，足之三阳从头走足，足之三阴从足走腹。所行而异，故更逆更从）。所以说：阳病者上行极而下，阴病者下行极而上（续注：此言其大凡耳。然足少阴下行则不同诸阴之气也）。所以说：伤于风者，上先受之；伤于湿者，下先受之（续注：阳气炎上，故受风；阴气润下，故受湿。盖同气相求故耳。出自《太阴阳明篇》）。
五脏受气于其所生，传之于其所胜，气舍于其所生，死于其所不胜。病将死，必先传行至其所不胜，病乃死（续注：受气所生者，谓受病气于已之所生也；传所胜者，谓传于已之所克也；气舍所生者，谓舍于生己者也；死所不胜者，谓死于克己者之分位也。所传不顺，故必死焉）。此言气之逆行也，故死（续注：所为逆者，次如下说）。肝受气于心（木生火也），传之于脾，气舍于肾，至肺而死；心受气于脾，传之于肺，气舍于肝，至肾而死；脾受气于肺，传之于肾，气舍于心，至肝而死；肺气受于肾，传之于肝，气舍于脾，至心而死；肾受气于肝，传之于心，气舍于肺，至脾而死。此皆逆死也。一日一夜五分之，此所以占死生之早暮也（续注：肝死于肺位秋庚辛，余四仿此。然朝主甲乙，昼主丙丁，四季土主戊己，晡主庚辛，夜主壬癸。由此则死生之早暮可知矣。校正云：占死生当作占死者。出自《玉机真藏论》）。
天有四时五行（《天元纪大论》作“天有五行以御五位”），以生长收藏，以生寒暑燥湿风（续注：春生夏长秋收冬藏，谓四时之生长收藏；冬水寒，夏火暑，秋金燥，木春夏风，土湿，谓五行之寒暑燥湿风也。然四时之气，土虽寄旺，原其所主，但居日中央，故云五行以生寒暑燥湿风，五气也）。人有五脏，化五气，以生喜怒悲思恐（续注：五气谓喜怒悲思恐。然是五气更伤五脏之和气矣。○校正按《天元纪大论》“悲”作“思”，盖言悲者以悲能胜恐，取五志迭相胜而言也；思者以思为之脾志也。名一则义俱不足，两见之则互相成义也）。
喜怒伤气，寒暑伤形（续注：喜怒皆生于气，故云喜怒伤气；寒暑皆胜于形，故云寒暑伤形。近取诸身，则如斯矣。细而言之，则热伤于气，寒伤于形也）。暴怒伤阴，暴喜伤阳（续注：怒则气上，喜则气下，故暴卒气上则伤阴，暴卒气下则伤阳）。厥气上行，满脉去形（续注：厥气逆也。逆气上行，满于经络，则浮气神越，去离形髓也）。喜怒不节，寒暑过度，生乃不固（《灵枢经》曰：智者之养生也，必顺四时而适寒暑，和喜怒而安居处。然喜怒不常，寒暑过度，天真之气何可常久？）。
故重阴必阳，重阳必阴（续注：言伤寒暑伤亦如是。出自《阴阳应象大论》）。风胜则动（续注：不宁也。风胜则庶物皆摇，故为动。《左传》曰：风摇末疾是也。校正详“风胜则动”至“湿胜则濡泄”五句，与《阴阳应象大论》文重而注不同）。热胜则肿（续注：热胜则阳气内郁，故红肿暴作。甚则营气逆于肉理，聚为肿痈。又云：热胜气为丹，胜血为痈脓，胜骨肉为胕肿，按之不起）。燥胜则干（续注：干于外则皮肤皴揭，干于内则精血枯涸，干于气及津液则肉干而皮着骨）。寒胜则浮（续注：浮谓浮起，按之起见也。又云：寒胜则阴气结于玄府，玄府闭密，阳气内攻，故为浮）。湿胜则濡泄，甚则水闭胕肿（续注：湿胜则内攻脾胃，脾胃受湿则水谷不分，故大肠传导而注泄。也以湿内盛而泄，故谓之濡泄。《左传》曰：雨淫腹疾是也。濡泄水利也。胕肿肉泥，按之陷而不起。水闭则溢于皮中也。出自《六元正纪大论》）。
黄帝问：脾病而四肢不用，何也？岐伯曰：四肢皆禀气于胃而不得至经（续注：至经，《太素》作径。至杨上善云：胃以水谷资四肢，不能径至于四肢，要因于脾布化水谷津液，四肢乃受禀，可以也）。必因于脾乃得禀也。今脾病不能为胃行其津液，四肢不得禀水谷气，日以衰，脉道不利，筋脉肌肉皆无气以生，故不用焉。
曰：脾不主时，何也？曰：脾者土也，治中央，常以四时长四脏，各十八日寄治，不独得主于时也。脾脏者，常着胃土之精也。土者生万物而法天地，故上下至头足，不得主时也（续注：治主也。着谓常约着于胃也。土气于四时之中，各于季终寄王十八日，则五行之气各王七十二日以终一岁之日矣。外主四季，则在人内应于手足也）。
曰：脾与胃以膜相连耳，而能为之行其津液，何也？曰：足太阴者，三阴也，其脉贯胃属脾络嗌，故太阴为之行气于三阴。阳明者，表也（续注：胃是脾之表）。五脏六腑之海也，亦为之行气于三阳。脏腑各因其经而受气于阳明（出自《太阴阳明论》）。
形弱气虚死（续注：中外俱不足）。形气有余，脉气不足死（续注：脏衰故脉不足也）。脉气有余，形气不足生（续注：脏盛故脉气有余。出自《方盛衰论》）。
岐伯曰：夫盐之味咸者，其气令器津液泄；弦绝者，其音嘶败；木敷者，其叶发；病深者，其声哕。人有此三者，是谓坏府。毒药无治，短针无取。此皆绝皮伤肉，血气争黑（此段有缺误。“木敷者其叶发”，《太素》作“木陈者其叶落”。“争黑”当作“争异”。坏府谓三者之病，犹云崩坏之处也。详此文义，若曰：夫弦绝者其音嘶败，木陈者其叶落，盐之味咸者其气令器津液泄，深病者其声哕。绝皮伤肉，血气争异。人有此三者，是谓坏府。毒药无治，短针无取。盖以弦绝况声哕，木落况绝伤，津液泄况血气争异也，庶通。○杨上善云：言欲知病散者，须知其候。盐之在于哭中，津液泄于外，见津而知盐之有咸也；声哕知琴瑟之弦将绝；叶落知陈木之已尽。养此三物衰坏之征，以比声哕识病深之候。人有声哕同三譬者，是为府坏之候。中府坏者，病之深也。其病既深，故斜药不能取，以其皮肉血气各不相得故也。○愚按：杨注虽与问答义相贯，茅终不若滑注之密也）。
岐伯曰：木得金而伐，火得水而灭，土得木而达，金得火而缺，水得土而绝。万物尽然，不可胜揭（续注：达通也。言物类虽不可竭尽，而数要之，皆如五行之气而有胜负之性分耳。出自《宝命全形论》）。
阴盛则梦涉水恐惧（续注：阴为水，故梦涉水而恐惧也）。阳盛则梦大火燔灼（续注：阳为火，故梦火而燔灼也）。阴阳俱盛则梦相杀毁伤（续注：亦类交争之象也）。上盛则梦飞（续注：气上则梦，故上飞）。下盛则梦堕（续注：气下则梦，故堕）。甚饱则梦予（续注：内有余）。甚饥则梦取（续注：内不足）。肝气盛则梦怒（续注：肝在志为怒）。肺气盛则梦哭（续注：肺声哀，故梦哭。仍少心脾肾气所梦，今具《甲乙经》中）。短虫多则梦聚众，长虫多则相击毁伤（续注：长虫动则内不安，内不安则神躁扰，故梦是矣。出自《紧要精微论》）。
(The original text states: The Spleen dislikes dampness and should urgently consume bitter flavors to dry it. As for the dietary preferences of the Liver, Heart, Lungs, and Kidneys, they should all align with the preceding text. However, for the Spleen, salty flavors are not used with bitter ones; therefore, Wang Bing specifically annotated the underlying meaning.) Pungent flavor can disperse and also moisten; Sour flavor can astringe; Sweet flavor can relax; Bitter flavor can firm and dry; Salty flavor can soften. (These are all natural properties of Qi. However, pungent flavor is not only dispersing but also moistening, hence it is said: "When the Spleen suffers from dampness, urgently eat bitter to dry it." Bitter flavor is not only firming but also drying and draining, hence it is said: "When the Lungs suffer from rebellious Qi, urgently eat bitter to drain it.") Toxic substances attack pathogens; Five Grains provide nourishment; Five Fruits assist; Five Livestock benefit; Five Vegetables clear and unblock. (Continued annotation: "Toxic substances" refer to metals, jade, stones, earth, herbs, trees, vegetables, fruits, insects, fish, birds, and beasts. However, only toxicity can remove pathogens and stabilize righteousness, so they are collectively called toxic substances. Five Grains include glutinous rice, adzuki beans, soybeans, wheat, and broomcorn millet. Five Fruits include peaches, plums, apricots, chestnuts, and jujubes. Five Vegetables include malva, vetches, wild leeks, green onions, and Chinese chives. I believe this is to ensure sufficient nutrition, using five vegetables to unblock the intestines and stomach, allowing the qi of food to circulate.) By consuming them in accordance with their flavors and properties, one can tonify essence and replenish Qi. (Continued annotation: Qi belongs to Yang and transforms; Flavor belongs to Yin and applies. When flavors and properties harmonize, they tonify essence and Qi. The Classic says: "For deficiencies of form, warm with Qi; for deficiencies of essence, tonify with flavor." Sun Simiao said: "Essence is generated by the Qi of food; Qi nourishes essence to luster the complexion; Form is constituted by food flavors; Flavors nourish the complexion to generate strength. Essence follows the Five Qi to become spiritual. If the Qi of foods repels each other, Essence is damaged; Form receives flavors to be formed; if food flavors are unharmonized, Form is harmed. Therefore, sages first use dietary taboos to preserve nature and prevent excessive warming/tonifying flavors from damaging Qi and Essence. This is called consuming flavors and properties in combination to tonify essence and replenish Qi.") These five flavors (Sour, Pungent, Sweet, Bitter, Salty) each have specific benefits: some disperse, some astringe, some relax, some urgent/firm, some dry/firm, some soften. Diseases of the Four Seasons and Five Zang Organs should be selected according to the suitability of the five flavors (from *Zang Qi Fa Shi Lun*).
There are prohibitions for the five flavors: Pungent moves Qi; those with Qi disorders should not eat much pungent. Salty moves Blood; those with Blood disorders should not eat much salty (Blood belongs to Water, so salty moves to it). Bitter moves to Bones; those with Bone disorders should not eat much bitter. (Continued annotation: Huangfu Mi said salty moves to the Kidney first; here it says it moves to Blood because the Kidney combines with the San Jiao, and although blood vessels belong to the Liver and Heart, they are located in the Middle Jiao pathway, so salty and Fire move to Blood. Bitter moves to the Heart; here it says it moves to Bones because Water and Fire interact, and Bone Qi connects to the Heart.) Sweet moves to Flesh; those with Flesh disorders should not eat much sweet. Sour moves to Sinews; those with Sinew disorders should not eat much sour. (Continued annotation: This is because they move Qi rapidly, so one does not wish to eat much. If not eaten, the disease may worsen.) This is called the Five Prohibitions; do not let patients eat too much (from *Xuan Ming Wu Qi Lun*).
Eating too much salty causes blood vessels to coagulate and stagnate, changing the complexion. (Continued annotation: The Heart governs vessels, its luster is in the face. Salty benefits the Kidney and overcomes the Heart, causing vessel coagulation and color change.) Eating too much bitter causes skin to wither and hair to fall out. (Continued annotation: The Lungs govern skin, their luster is in hair. Bitter benefits the Heart and overcomes the Lungs, causing skin withering and hair loss.) Eating too much pungent causes sinews to contract and nails to wither. (Continued annotation: The Liver governs sinews, its luster is in nails. Pungent benefits the Lungs and overcomes the Liver, causing sinew contraction and nail withering.) Eating too much sour causes flesh to become calloused and lips to peel/retract. (Continued annotation: The Spleen governs flesh, its luster is in the lips. Sour benefits the Liver and overcomes the Spleen, causing calloused flesh and peeling lips.) Eating too much sweet causes bone pain and hair loss. (Continued annotation: The Kidneys govern bones, their luster is in hair. Sweet benefits the Spleen and overcomes the Kidneys, causing bone pain and hair falling.) These are the injuries caused by the five flavors. (The five flavors enter the mouth, travel to the intestines and stomach, and internally nourish the five Zang organs. Each has what it nourishes and what it desires; desire leads to mutual injury, hence the following text says:) Thus, the Heart desires bitter, the Lungs desire pungent, the Liver desires sour, the Spleen desires sweet, and the Kidneys desire salty. This is the correspondence between the five flavors and the Qi of the five Zang organs. (Continued annotation: Each returns to where it is desired. Quan Yuanqi stated that the five flavors combine with the Qi of the five Zang organs; these two sentences are connected.)
Colors and flavors correspond to the five Zang organs: White corresponds to the Lungs and Pungent flavor; Red corresponds to the Heart and Bitter flavor; Green/Cyan corresponds to the Liver and Sour flavor; Yellow corresponds to the Spleen and Sweet flavor; Black corresponds to the Kidneys and Salty flavor. (Continued annotation: Each corresponds to its appropriate color and flavor.) Thus, white corresponds to skin, red to vessels, green/cyan to sinews, yellow to flesh, and black to bones. (Continued annotation: Each corresponds to the Qi of the organ it nourishes. From *Wu Zang Sheng Cheng Pian*.)
The Emperor asked: I wish to hear about the essentials of Deficiency and Excess. Qibo replied: Qi Excess with Form Excess, Qi Deficiency with Form Deficiency—this is the norm. Opposite to this is disease. (Continued annotation: Qi refers to pulse Qi, Form refers to physical body. Opposite means non-correspondence, losing the normal equilibrium. When Form and Qi are opposite, disease arises.) Grain abundance leads to Qi abundance; Grain deficiency leads to Qi deficiency—this is the norm. Opposite to this is disease. (Continued annotation: *Ling Shu Jing* states: The way of Ying Qi relies on internal grain for fullness. Grain enters the Stomach, Qi transmits to the Lungs, the refined part ascends through the meridians. Thus, the fullness or emptiness of Grain Qi must correspond. If the signs do not match, it is disease.) Pulse Excess with Blood Excess, Pulse Deficiency with Blood Deficiency—this is the norm. Opposite to this is disease. (Continued annotation: The Pulse is the residence of Blood, so fullness and emptiness are the same. Opposition and non-correspondence indicate disease.)
What constitutes opposition? Qi Deficiency with Body Heat—this is called opposition. (Continued annotation: Qi Deficiency means insufficient Yang Qi. Insufficient Yang Qi should result in cold body; instead, there is heat. The pulse should be full but is not, and symptoms do not match, hence called opposition. According to *Jia Yi Jing*: Qi Excess with Cold Body, Qi Deficiency with Heat Body—this is called opposition. These four characters should be added.) Abundant grain intake but little Qi—this is called opposition. (The Stomach produces Grain Qi which spreads to the meridians. Grain enters the Stomach, and the pulse channels scatter. Now, abundant grain intake but little Qi means the Stomach Qi cannot scatter, hence called opposition.) No grain intake but abundant Qi—this is called opposition. (Continued annotation: Stomach Qi scatters externally, and Lung Qi joins it.) Pulse Excess with Blood Scarcity—this is called opposition; Pulse Scarcity with Blood Excess—this is called opposition. (Continued annotation: Jing Meridians move Qi, Luo Meridians receive Blood. Jing Qi enters Luo, Luo receives Jing Qi. Climate and Qi do not match, so both are abnormal.)
Qi Excess with Cold Body results from Cold Injury; Qi Deficiency with Heat Body results from Summerheat Injury. (Continued annotation: Cold injures Form, hence Qi Excess and Cold Body; Heat injures Qi, hence Qi Deficiency and Heat Body.) Abundant grain intake but little Qi results from Blood Loss, with Dampness residing below. (Continued annotation: Blood loss leads to Blood Deficiency; Blood Deficiency leads to Qi Excess. Internally stagnant, it transforms into fluids flowing to the Lower Jiao, hence called Dampness residing below.) Scarce grain intake but abundant Qi indicates Pathogen in the Stomach and Lungs. (Continued annotation: Stomach Qi is insufficient, Lung Qi flows down into the Stomach, hence Pathogen in the Stomach. Since Lung Qi enters the Stomach, Lung Qi cannot guard itself, and Pathogen Qi follows, hence Pathogen in the Stomach and Lungs.) Small Pulse with Abundant Blood indicates Heat within Fluid Retention. (Continued annotation: Fluid Retention refers to retained fluids. Fluids retained in the Spleen and Stomach cause Spleen Heat; overflowing Spleen Heat generates heat in the middle.) Large Pulse with Scarce Blood indicates Wind Qi in the Pulse and inability to ingest water/gruel. This is called... (Continued annotation: Wind Qi is abundant and full, preventing water/gruel from entering the pulse. From *Ci Zhi Lun*.)
Heavenly pathogenic Qi, when contracted, harms the Five Zang Organs. (Continued annotation: Qi of the four seasons and wind of the eight directions are all Heavenly pathogens. Entering wind generates pathogenic Qi, meridians receive it, then it follows the meridians to touch the five Zang organs.) Cold and heat of water and grain, when contracted, harm the Six Fu Organs. (Continued annotation: Heat harms the Stomach and Bladder; Cold harms the Intestines and Gallbladder.) Earthly dampness, when contracted, harms the skin, flesh, sinews, and vessels. (When dampness is abundant, Ying and Wei Qi and vessels do not flow, so contraction harms skin, flesh, sinews, and vessels. From *Yin Yang Ying Xiang Da Lun*.)
Qibo said: Yang is Heavenly Qi, governing the Exterior; Yin is Earthly Qi, governing the Interior. Therefore, the Way of Yang is Full/Excess, and the Way of Yin is Empty/Deficient. Thus, those who suffer from treacherous wind and empty pathogens are affected in the Yang (meridians); those with irregular diet and improper daily routine are affected in the Yin (meridians). Affected in Yang, it enters the Six Fu Organs; affected in Yin, it enters the Five Zang Organs. Entering the Six Fu Organs causes fever, restlessness, and upper manifestations like wheezing; entering the Five Zang Organs causes abdominal fullness and obstruction, lower manifestations like undigested diarrhea, and long-term development into intestinal dysentery. (Commentary: *Yin Yang Ying Xiang Da Lun* states: Heavenly pathogenic Qi harms the Five Zang; cold/heat of water/grain harms the Six Fu. *Tai Yang Yang Ming Lun* states: Treacherous wind/empty pathogens affect Yang; diet/lifestyle affects Yin. Yang affects enters Six Fu; Yin affects enters Five Zang. Why do these two statements seem contradictory? They appear contrary but are not. Heavenly pathogenic Qi and treacherous wind are external excess diseases; cold/heat of water/grain and diet/lifestyle are internal deficiency diseases. Both can harm the Zang and Fu, depending on where they enter and manifest. One should not doubt due to apparent differences, as they run parallel without contradiction. Heavenly pathogenic Qi certainly harms the Zang but may also harm the Fu; cold/heat of water/grain certainly harms the Fu but may also harm the Zang. As for earthly dampness, it may not exclusively harm skin/flesh/sinews/vessels nor fail to harm Zang/Fu. Pathogenic Qi is formless, and Zang stores essence/Qi, so similar things attract, harming Zang more. Water/grain have form, and Fu transmit/digest, so they follow their path and harm Fu more. Dampness infiltrates slowly, entering gradually starting from the feet, moving upward from shallow to deep, thus mostly harming skin/flesh/sinews/vessels. Who would say dampness never reaches the Zang/Fu?)
Therefore, the Throat governs Heavenly Qi, and the Pharynx governs Earthly Qi; thus, Yang receives Wind Qi, and Yin receives Damp Qi. (Continued annotation: Like attracts like.) Yin Qi travels upward from the feet to the head, then descends along the arms to the fingertips. Yang Qi travels from the hands to the head, then descends to the feet. (Continued annotation: *Ling Shu Jing* states: Hand Three Yin move from Zang to Hands; Hand Three Yang move from Hands to Head; Foot Three Yang move from Head to Feet; Foot Three Yin move from Feet to Abdomen. Their paths differ, so they alternate in reversal and following.) Thus, it is said: Yang diseases ascend to the extreme and then descend; Yin diseases descend to the extreme and then ascend. (Continued annotation: This speaks generally. However, Foot Shaoyin descends differently from other Yin Qi.) Thus, those injured by Wind are first affected above; those injured by Dampness are first affected below. (Continued annotation: Yang Qi flares upward, so it receives Wind; Yin Qi moistens downward, so it receives Dampness. Because like attracts like. From *Tai Yang Yang Ming Pian*.)
The Five Zang receive Qi from what they generate, transmit it to what they overcome, store Qi in what generates them, and die from what overcomes them. When death is imminent, the disease must first transmit to what overcomes it before death occurs. (Continued annotation: Receiving Qi from what is generated means receiving pathological Qi from what one generates. Transmitting to what is overcome means transmitting to what one controls. Storing Qi in what generates means resting in what generates oneself. Dying from what overcomes means dying at the position of what controls oneself. Transmission is not smooth, hence death is inevitable.) This describes the reverse movement of Qi, hence death. (Continued annotation: The reasons for reversal are described below.) The Liver receives Qi from the Heart (Wood generates Fire), transmits to the Spleen, stores in the Kidney, and dies at the Lung. The Heart receives Qi from the Spleen, transmits to the Lung, stores in the Liver, and dies at the Kidney. The Spleen receives Qi from the Lung, transmits to the Kidney, stores in the Heart, and dies at the Liver. The Lung receives Qi from the Kidney, transmits to the Liver, stores in the Spleen, and dies at the Heart. The Kidney receives Qi from the Liver, transmits to the Heart, stores in the Lung, and dies at the Spleen. All these are deaths by reverse transmission. Dividing day and night into five parts allows one to predict the timing of death. (Continued annotation: Liver dies at Lung's position in Autumn, Geng/Xin days; the others follow similarly. Morning governs Jia/Yi, Day governs Bing/Ding, Four Seasons/Earth governs Wu/Ji, Afternoon governs Geng/Xin, Night governs Ren/Gui. From this, the early or late timing of death can be known. Correction: "Predict life and death" should be "Predict death". From *Yu Ji Zhen Cang Lun*.)
Heaven has the Four Seasons and Five Elements (*Tian Yuan Ji Da Lun* reads "Heaven has Five Elements to control Five Positions"), which promote growth, flourishing, harvesting, and storage, generating Cold, Heat, Dryness, Dampness, and Wind. (Continued annotation: Spring Growth, Summer Flourishing, Autumn Harvest, Winter Storage are the growth/storage of the four seasons. Winter Water Cold, Summer Fire Heat, Autumn Metal Dryness, Wood Spring/Summer Wind, Earth Dampness are the Cold/Heat/Dryness/Dampness/Wind of the Five Elements. Although Earth Qi寄旺 (is parasitically prosperous) in the four seasons, its primary governance is central, hence it is said Five Elements generate the five Qi: Cold, Heat, Dryness, Dampness, Wind.) Humans have Five Zang Organs that transform Five Qi, generating Joy, Anger, Sorrow, Thought, and Fear. (Continued annotation: Five Qi refers to Joy, Anger, Sorrow, Thought, Fear. However, these five Qi can damage the harmonious Qi of the five Zang. ○ Correction: In *Tian Yuan Ji Da Lun*, "Sorrow" is written as "Thought". Perhaps saying Sorrow wins Fear takes the perspective of five emotions mutually overcoming each other; Thought is the emotion of the Spleen. Naming one leaves meaning incomplete; seeing both complements the meaning.)
Joy and Anger damage Qi; Cold and Heat damage Form. (Continued annotation: Joy and Anger arise from Qi, hence Joy/Anger damage Qi. Cold and Heat prevail over Form, hence Cold/Heat damage Form. Taking examples from the body, this is how it is. Finely speaking, Heat damages Qi, Cold damages Form.) Violent anger damages Yin; violent joy damages Yang. (Continued annotation: Anger causes Qi to rise, Joy causes Qi to descend. Sudden rising of Qi damages Yin; sudden descending of Qi damages Yang.) Rebellious Qi moves upward, filling the vessels and separating spirit from form. (Continued annotation: Rebellious Qi is inverted. Inverted Qi moves upward, filling the collaterals, causing floating Qi and wandering Spirit to separate from Form and Marrow.) Unregulated Joy and Anger, excessive Cold and Heat, lead to unstable vitality. (*Ling Shu Jing* states: The wise nurture themselves by following the four seasons and adapting to cold/heat, harmonizing joy/anger and living securely. But if joy/anger are irregular and cold/heat excessive, how can primal Qi last long?)
Thus, Extreme Yin becomes Yang; Extreme Yang becomes Yin. (Continued annotation: Speaking of Cold and Summerheat injuries being the same. From *Yin Yang Ying Xiang Da Lun*). Wind Excess causes Tremor/Movement. (Continued annotation: Restlessness. Wind excess causes all things to shake, hence movement. *Zuo Zhuan* says: Wind shakes the tips, illness is severe. Correction details on "Wind excess causes movement" to "Dampness excess causes loose stool" five sentences differ from *Yin Yang Ying Xiang Da Lun* text and notes.) Heat Excess causes Swelling. (Continued annotation: Heat excess causes internal stagnation of Yang Qi, leading to sudden red swelling. Severe cases, Ying Qi reverses in muscle tissue, gathering into abscesses. Also: Heat excess Qi causes Erysipelas; excess Blood causes Pus/Abscess; excess Bone/Flesh causes Edema, pressing leaves no dent.) Dryness Excess causes Dryness. (Continued annotation: Dry externally causes skin cracking; dry internally causes essence/blood depletion; dry Qi/fluids causes flesh dryness and skin adhering to bone.) Cold Excess causes Floating/Edema. (Continued annotation: Floating means rising, visible upon pressing. Also: Cold excess causes Yin Qi to knot at the pores; pores close tightly, Yang Qi attacks internally, hence floating.) Dampness Excess causes Loose Stool; severe cases cause Urinary Obstruction and Edema. (Continued annotation: Dampness excess attacks internally the Spleen/Stomach; Spleen/Stomach receiving dampness fails to separate water/grain, hence Large Intestine conducts and pours out loose stool. Because dampness is internally abundant, it is called loose stool. *Zuo Zhuan* says: Rain indulgence causes abdominal illness. Loose stool is watery diarrhea. Edema is soft flesh, pressing sinks and does not rise. Urinary obstruction means overflow into subcutaneous tissue. From *Liu Yuan Zheng Ji Da Lun*.)
The Emperor asked: Why does Spleen disease cause immobility of the four limbs? Qibo said: The four limbs all receive Qi from the Stomach but cannot reach the meridians directly. (Continued annotation: *Tai Su* reads "reach the meridian path". Yang Shangshan said: The Stomass provides water/grain to nourish the four limbs but cannot reach them directly; it must rely on the Spleen to distribute transformed water/grain fluids, so the four limbs receive endowment.) It must rely on the Spleen to receive endowment. Now, Spleen disease cannot transport fluids for the Stomach; the four limbs cannot receive water/grain Qi; day by day they decline, pulse channels become obstructed, sinews/muscles lack Qi to generate, hence immobility.
Asked: Why does the Spleen not govern a specific season? Answered: The Spleen is Earth, governing the Center, constantly nurturing the Four Zang throughout the four seasons, ruling for 18 days each in succession, not solely governing a time. The Spleen organ constantly attaches to the essence of Stomach Earth. Earth generates all things and models Heaven and Earth, hence from top to bottom including head and feet, it cannot solely govern a time. (Continued annotation: Govern means rule. Attach means constantly bound to the Stomach. Earth Qi in the four seasons rules for 18 days at the end of each season, so Five Element Qi rules 72 days each to complete the year. Externally governing four seasons, internally corresponding to hands and feet.)
Asked: The Spleen and Stomach are connected by membranes, yet how can it transport fluids? Answered: Foot Taiyin is the Three Yin; its pulse penetrates the Stomach, belongs to the Spleen, and connects to the pharynx, thus Taiyin transports Qi to the Three Yin. Yangming is the Exterior. (Continued annotation: Stomach is the exterior of the Spleen.) It is the Sea of the Five Zang and Six Fu Organs, and also transports Qi to the Three Yang. The Zang and Fu each receive Qi from Yangming via their meridians. (From *Tai Yang Yang Ming Lun*.)
Weak Form and Deficient Qi lead to Death. (Continued annotation: Internal and external both deficient.) Form and Qi Excess but Pulse Qi Deficiency lead to Death. (Continued annotation: Zang decline causes pulse deficiency.) Pulse Qi Excess but Form and Qi Deficiency lead to Survival. (Continued annotation: Zang prosperity causes pulse Qi excess. From *Fang Sheng Shuai Lun*.)
Qibo said: Salt tastes salty; its vapor causes moisture in vessels to leak. Strings breaking produce hoarse sounds. Trees spreading (decaying) cause leaves to fall. Deep disease produces hiccups. A person having these three conditions is called having a Ruined Mansion (organ failure). Toxic drugs cannot treat it; short needles cannot take it. These are all severing skin, injuring flesh, and blood/Qi struggling turning black. (This section has errors. "Tree spreading leaves fall," *Tai Su* reads "Old trees shed leaves." "Struggle black" should be "Struggle different." Ruined Mansion refers to the disease of the three, like a collapsing place. Detailed meaning: Breaking strings mean hoarse sound; old trees shedding leaves; salty salt vapor leaks fluid; deep disease produces hiccups. Severing skin, injuring flesh, blood/Qi struggle differently. Having these three is Ruined Mansion. Drugs cannot treat, needles cannot take. Comparing string breaking to hiccups, tree falling to injury, fluid leaking to blood struggle. ○ Yang Shangshan said: To know scattered disease, know the signs. Salt in tears leaks fluid externally; seeing fluid knows salt is salty; hiccups know strings will break; leaf fall knows old tree is dead. Using these three decay signs to compare hiccups identifies deep disease. Having hiccups matching three metaphors is sign of Mansion ruin. Inner Mansion ruin is deep disease. Disease is deep, so medicine cannot take, because skin/flesh/blood/Qi do not get along. ○ Commentary: Yang's note connects well but Hua Shou's note is denser.)
Qibo said: Wood is felled by Metal; Fire is extinguished by Water; Earth is penetrated by Wood; Metal is lacking by Fire; Water is cut off by Earth. All things are thus, too numerous to list. (Continued annotation: Penetrate means通达 (penetrative/unimpeded). Though species are inexhaustible, summarily, they all have Five Element Qi with winning/losing natures. From *Bao Ming Quan Xing Lun*.)
Yin Excess dreams of wading in water and fear. (Continued annotation: Yin is Water, hence dreaming of wading and fear.) Yang Excess dreams of great fire burning. (Continued annotation: Yang is Fire, hence dreaming of fire burning.) Yin and Yang both Excess dream of killing and injuring. (Continued annotation: Also resembles images of conflict.) Upper Excess dreams of flying. (Continued annotation: Qi rises, hence dreaming of flying.) Lower Excess dreams of falling. (Continued annotation: Qi descends, hence dreaming of falling.) Very full dreams of giving. (Continued annotation: Internal surplus.) Very hungry dreams of taking. (Continued annotation: Internal deficit.) Liver Qi Excess dreams of anger. (Continued annotation: Liver emotion is Anger.) Lung Qi Excess dreams of crying. (Continued annotation: Lung voice is mournful, hence dreaming of crying. Still lacks Heart/Spleen/Kidney Qi dreams, now included in *Jia Yi Jing*.) Many short parasites dream of gathering crowds; many long parasites dream of fighting and injuring. (Continued annotation: Long parasites moving causes internal unrest; internal unrest causes spirit agitation, hence dreaming this. From *Jin Yao Jing Wei Lun*.)