余二十年来。读经至此。始悟造化之蕴。至矣微矣。益见内经千言万语。翻来覆去。横
说直
说。都是为此一二字上灵通变化。何等奥渺。又何等明白。夫既曰膀胱为津液之府。意必积
满当自出。何须借气始能化。因化而方出乎。至上文三焦者决渎之官。水道出焉。奈何独不
需气乎。彼此印证。细究其义。夫三焦既主相火。水道之出。无非禀气以为决也。不曰能出
。而曰出焉。盖气本自化不待化于气而始能出也。今津液主水。膀胱司水。水不自化而化于
气此。阴以阳为用未免少费工夫。故不曰出焉。而曰则能出矣。语意之决又包许多妙用今夫
津液固全资气化。设使气一凝滞不运则膀胱虽满积而不能出矣。气一虚陷无制则膀胱不待积
满淋沥频数随泌而随出矣。又气一浮越不守则膀胱绝阳无气可化。津液随脱便不知。而自出
矣。嗟夫一气耳。无处不到。无息不运。无物不司。何独膀胱明言气化。方知是气化。三焦
主气。不明言气化。亦知是气化。若大肠传导而出变化。小肠受盛而出化物。何莫非气化也
。至乎心为君主之官。肺为相傅之官。肝为将军之官。胆为中正之官。膻中为臣使之官。脾
胃为仓禀之官。肾为作强之官。使非气化。何以能神明出焉。治节出焉。谋虑出焉。决断出
焉。喜乐出焉。五味出焉。伎巧出焉。思至此则。人一身皆气化也万物皆气化也。六合以内
以外亦无非气化也。学人试潜心详玩。悟到化景政如释氏所云。得HT 然一声。便立证菩提矣
。
我二十年来，读到《内经》此处，才领悟到造化的深奥蕴意，真是精妙到了极点。更加看出《内经》千言万语，翻来覆去，横说直说，都是为了这“气化”二字上的灵通变化。这是何等奥妙深远，又是何等明白易懂。
既然说膀胱是津液之府，心想必定积满后自然排出，何须借助气的作用才能化生并排出呢？至于上文提到三焦是决渎之官，水道由此而出，为何唯独不需要气的参与呢？彼此相互印证，细细考究其义理。既然三焦主司相火，水道的流出，无非是禀受气的作用来进行疏通决泄。这里不说“能出”，而说“出焉”，大概是因为气本身具有化生的功能，不依赖于其他气来化它，然后才能流出。
如今津液主司水液，膀胱主管水液。水液自身不能化生，而是依靠气来化生，这是阴以阳为用，未免稍微费些功夫。所以不说“出焉”，而说“则能出矣”。这句话的意思决断分明，又包含了许多妙用。
如今津液固然完全依赖气化作用。假如气一旦凝滞不运行，那么膀胱即使积满也不能排出；假如气一旦虚陷失去制约，那么膀胱不待积满，就会淋沥频数，随着泌别随即流出；假如气一旦浮越不固守，那么膀胱绝灭阳气，没有气可化，津液随之脱失，便不知不觉地自行流出。
唉！只是一股气罢了，无处不到，无时不运，无物不司。为什么唯独对膀胱明确说出“气化”二字？才知道这是气化。三焦主司气，虽然没有明确说出“气化”，但也知道这是气化。至于大肠传导糟粕而出，小肠受盛化物而出，哪一点不是气化呢？
至于心是君主之官，肺是相傅之官，肝是将军之官，胆是中正之官，膻中是臣使之官，脾胃是仓廪之官，肾是作强之官。假使没有气化，凭什么能让神明从中生出？治节从中生出？谋虑从中生出？决断从中生出？喜乐从中生出？五味（感知）从中生出？伎巧（技能）从中生出？
想到这些，就知道人身一身都是气化，万物都是气化，六合以内、以外，也无非都是气化。求学之人试着潜心详细玩味，悟到化境之时，正如佛教所说，得豁然开朗的一声，便立刻证得菩提了。
For twenty years, upon reading this passage in the *Neijing* (Inner Canon), I finally comprehended the profound mysteries of creation. It is truly exquisite and subtle. This further reveals that the thousands of words in the *Neijing*, whether stated directly or indirectly, revolve around the spiritual transformation and change inherent in these two characters: Qi transformation (Qi Hua). How profound and obscure it is, yet how clear and understandable it becomes.
Since it is stated that the Bladder (Pang Guang) is the mansion of Jin-Ye (body fluids), one might assume that once full, they would naturally discharge. Why is there a need to rely on Qi to transform them before they can exit? Regarding the earlier mention that the San-Jiao (Triple Burner) is the official responsible for irrigation, through which water passages flow, why does it not explicitly require Qi? Comparing these two statements and investigating their meaning carefully: since the San-Jiao governs Ministerial Fire (Xiang Huo), the flow of water passages relies entirely on Qi to facilitate irrigation and drainage. The text says "flow out" (Chu Yan) rather than "can flow out" (Neng Chu), implying that Qi inherently possesses transformative power and does not need to be transformed by another Qi to enable flow.
Currently, Jin-Ye governs water, and the Bladder manages water. Water cannot transform itself but relies on Qi for transformation; this represents Yin utilizing Yang, which requires some effort. Therefore, the text says "then it can flow out" (Ze Neng Chu Yi) rather than "flows out." This phrasing is decisive and encompasses many subtle applications.
Jin-Ye indeed relies entirely on Qi transformation. If Qi becomes stagnant and fails to circulate, even if the Bladder is full, the fluids cannot be discharged. If Qi becomes deficient and sinks without control, the Bladder will experience frequent, dribbling urination as soon as fluid is secreted, regardless of volume. If Qi floats away and fails to secure, the Bladder loses its Yang Qi and has no Qi to transform; consequently, Jin-Ye will escape, and the patient will unknowingly leak urine spontaneously.
Alas! It is merely Qi. It reaches everywhere, operates continuously, and governs all things. Why is Qi transformation explicitly mentioned only for the Bladder? We realize it is Qi transformation. The San-Jiao governs Qi; although "Qi transformation" is not explicitly stated, we understand it is still Qi transformation. Similarly, the Large Intestine transmits and discharges waste, and the Small Intestine receives and transforms substances; are these not also manifestations of Qi transformation?
As for the Heart being the Sovereign Official, the Lung the Prime Minister Official, the Liver the General Official, the Gallbladder the Upright Official, the Pericardium (Dan Zhong) the Envoy Official, the Spleen and Stomach the Granary Official, and the Kidney the Official of Strength—if there were no Qi transformation, how could Spirit (Shen) emerge? How could governance and regulation (Zhi Jie) emerge? How could planning and deliberation (Mou Lv) emerge? How could decision-making (Jue Duan) emerge? How could joy and happiness (Xi Le) emerge? How could the perception of five flavors emerge? How could dexterity and skill (Ji Qiao) emerge?
Reflecting on this, one realizes that the entire human body is composed of Qi transformation, all ten thousand things are composed of Qi transformation, and within and beyond the Six Directions (the universe), nothing exists outside of Qi transformation. Students should earnestly study and ponder this. When you comprehend the realm of transformation, it is like the Buddhist saying: with a sudden enlightenment, one immediately attains Bodhi.