平按∶此篇自喜乐者以上，日本原抄正本残缺，篇目亦不可考。平从日本仁和寺宫御藏本残卷
十三纸中，检出自在我者以下至竭绝而失生经文杨注，证以《灵枢·本神》篇，补入喜乐者以上。
断零璧，缺而复完，洵堪宝贵。自在我者以上，惜无从查出，故自黄帝问于岐伯曰至地之，谨根据
《灵枢》卷二第八《本神》篇补入。自喜乐者以下至末，均见《本神》篇，又见《甲乙经》卷一第一。
黄帝问于岐伯曰∶凡刺之法，必先本于神。血脉营气精神，此五脏之所藏也，至其淫 离藏则
精失、魂魄飞扬、志意恍乱、智虑去身者，何因而然乎？天之罪与？人之过乎？何谓德气生精神魂
魄心意志思智虑？请问其故。岐伯答曰∶天之在我者德也，地之（以上从《灵枢·本神》篇补入。）
在我者气也，德流气薄而生者也。（未形之分， 与我身，谓之德者，天之道也。故《庄子》曰∶
未形之分，物得之以生，谓之德也。阴阳和气，质成我身者，地之道也。德中之分流动，阴阳之气
和亭，遂使天道无形之分，动气和亭，物得生也。平按∶注 字恐系施字之误。）故生之来谓之精，
（雄雌两神相搏，共成一形，先我身生，故谓之精也。）两精相搏谓之神，（即前两精相搏共成一
形，一形之中，灵者谓之神者也，即乃身之微也。问曰∶谓之神者，未知于此精中始生？未知先有
今来？答曰∶案此《内经》但有神伤、神去与此神生之言，是知来者，非曰始生也。及案释教精合
之时，有神气来托，则知先有，理不虚也。故孔丘不答有知无知，量有所由。唯佛
明言是可根据。）随神往来者谓之魂，（魂者，神之别灵也，故随神往来，藏于肝，名曰魂。）并精
而出入者谓之魄，（魄，亦神之别灵也，并精出此而入彼，谓为魄也。并，薄浪反。）所以任物者
谓之心，（物，万物也。心，神之用也。任知万物，必有所以，神□□□□□□物□任物，故谓之
心也。）心有所忆谓之意，（意，亦神之用也，任物之心，有所追忆，谓之意也。）意之所存谓之志，
（志，亦神之用也，所忆之意，有所专存，谓之志也。）因志而存变谓之思。（思，亦神之用也，
专存之志，变转异求，谓之思也。）因思而远慕谓之虑，（虑，亦神之用也。变求之思，逆慕将来，
谓之虑也。）因虑而处物谓之智。（智，亦神之用也，因虑所知，处物是非，谓之智也。）故智者
之养生也，（神之所用，穷在于智，故曰智者之养生也。）必顺四时而适寒暑，（智者养生要有之
道，春夏养阳，使适于暑也；秋冬养阴，使适于寒。）和喜怒而安居处，（喜怒所生，生于居处，
智者发而中节，故因以和安也。）节阴阳而调柔刚，（阴以致刚，阳以起柔，两者有节，则刚柔得
矣。平按∶柔刚《灵枢》、《甲乙》均作刚柔。）如是则邪僻不至，长生久视。（智者行和节养之
道，则五养神安，六腑气调，经脉用营，腠理密致，如此疵疠元本不生，八正四邪无由得至，自斯
已往，或齐天地，莫见冬 ，或类彭年，长生久视也。平按∶注五养恐系五脏之误，冬 二字未详，
因原抄如是，故仍之。）是故怵惕思虑者，流溢而不固。（怵惕思虑，多伤于心，神伤无守，所为不固也。）
悲哀动中者，竭绝而失生。（人之悲哀动中，伤于肝魂，泪竭筋绝，故失□也。平按∶注失下原缺一
字，据经文应作
生。）喜乐者， 散而不藏。（喜乐志达气散，□于肺魄，故精不守藏也。 ，立安反，牵引也。
平按∶ 《灵枢》、《甲乙》均作惮，原抄作 。考 音展，上声，木白理也。音义均不合。疑作掸，
音弹，寒韵。《太玄经》∶掸系其名。提持也。与本注音义为近。再查日本抄本，凡手旁多从木，
如搏作 之类，今 字恐系掸字传写之误。注气散下原缺一字，据上注伤于肝魂，应作伤。魄下原有
故精不守藏也六字，袁刻脱。）愁忧者，闭塞而不行。（愁忧气结，伤于脾意，故闭塞不行也。平
按∶闭上《灵枢》、《甲乙》有气字。）盛怒者，迷惑而不理。（盛怒气聚，伤于肾志，故迷惑失
理也。平按∶理《灵枢》、《甲乙》作治。）恐惧者，荡惮而不收。（右肾命门藏精气，恐惧惊荡，
则精气无守而精自下，故曰不收。平按∶《甲乙》注云∶《太素》不收作失守。今仍作不收，或另
有本耶？）心怵惕思虑则伤神，（心藏也。怵惕，肾来乘心也。思虑，则脾来乘心。二邪乘甚，故伤
神也。）神伤则恐惧自失，破 脱肉，神为其主，故伤神则反伤右肾，故恐惧自失也。亦反伤脾，
故破 脱肉也。毛悴色夭，死于冬。（毛悴肺伤，色夭肝伤也，以神伤则五脏皆伤也。冬，火死时
也。）肝悲哀动中则伤魂，（肝藏也。悲哀太甚伤肝，故曰动中。肝伤则魂伤。平按∶肝上《灵枢》
有脾忧愁至死于春一段，本书在后。）魂伤则狂忘不精，不敢正当人，（魂既伤已，肝肾亦伤，故
□□及□不精，不敢当人也。平按∶狂忘《甲乙》作狂妄。不精不敢正当人《甲乙》作其精不守，
注∶一本作不精不精则不正当。《灵枢》作狂忘不精不精则不正当人。注故下缺二字，及下缺一字，
袁刻作故狂妄不精，与原抄不合。）缩而挛筋，两胁骨举，（肝足厥阴脉环阴器，故魂肝伤宗筋缩
也。肝又主诸筋，故挛也。肝在两胁，故肝病两胁骨举也。平按∶缩上《灵枢》有阴字，骨举《灵枢》
作骨不举。《甲乙》作令人
阴缩而筋挛两胁肋骨不举。）毛悴色夭，死于秋。（秋，木死时也。）肺喜乐无极则伤魄，（肺脏
也。喜乐，心喜乘肺，无极伤魄也。平按∶无极《甲乙》作乐极。）魄伤则狂，狂者意不存人，皮
革焦，（魄伤则伤脏，故发狂病也。以乐荡神，故狂病意不当人。又肺病，皮革焦也。平按∶人
皮革焦《甲乙》作其人皮革焦。）毛悴色夭，死于夏。（夏，金死时。）脾愁忧而不解则伤意，
意伤则 乱，四肢不举，（肺来乘脾，故忧愁不已伤意，发狂 乱，并脾病四肢不举也。平按∶
《甲乙》作闷。）毛悴色夭，死于春。（春，土死时也。问曰∶脾主愁忧。又云精气并于肝则忧，
即肝为忧也。《素问》云心在变动为忧，即心为忧也。肺在志为忧也，即肺为忧。其义何也？答曰∶
脾为四脏之本，意主愁忧。故心在变动为忧，即意之忧也。或在肺志为忧，亦意之忧也。若在肾
志为忧，亦是意之忧也。故愁忧所在，皆属脾也。平按∶心之忧在心变动，肺之忧在肺之志，详《素
问·阴阳应象大论》新校正引杨注，又见《甲乙经·精神五脏论》所引杨注。按《甲乙经》云∶肝
之与肾，脾之与肺，互相成也。脾者土也，四脏皆受成焉。故恐发于肝而成于肾，爱发于脾而成于
肝。又云∶心之与肺，脾之与心，亦互相成也。故喜变于心而成于肺，思发于脾而成于心，一过
其节，二脏俱伤，此经互言其义耳。又新校正谓∶《甲乙经》具有此说，取五志迭相胜而为言，各
举一则义俱不足，两见之则互相成义也。）肾盛怒而不止则伤志，（肝来乘肾，故不已伤志也。）
志伤则善忘其前言，腰脊不可以俯仰屈伸，（肾志伤，故喜忘。肾在腰脊之中，故肾病不可俯仰屈
伸也。平按∶善《灵枢》、《甲乙》均作喜。屈伸二字《甲乙》无。）毛悴色夭，死于季夏；（季夏，
水死时也。）恐惧而不解则
伤精，（恐惧起自命门，故不解伤精也。）精伤则骨酸痿厥，精□□。（精为骨髓之液，故精伤
则骨酸疼及骨痿也。平按∶厥精下原缺二字《灵枢》、《甲乙》作时自下三字。）是故五脏，主
藏精者也，（人肾有二∶左为肾脏，右为命门。命门藏精，精者五脏精液，故五脏藏精。）不可
伤，伤则守失而阴虚，阴虚则无气，无气则死矣。（五脏之神不可伤也，伤五神者，则神去无守，
脏守失也。六腑为阳，五脏为阴，脏无神守，故阴虚也。阴脏气无，遂致死也。故不死之道者，
养五神也。人皆怵惕思虑，则以伤神，悲哀动中，日亡魂性，喜乐无极，神魄散扬，愁忧不解，
志意 乱，盛怒无止，失志多忘，恐惧惊神，伤精痿骨，□以千端之祸，害此一生，终以万品欲
情，浇乱真性，仍服金石贵宝，摧斯易生之躯，多求神仙芳草，日役百年之命。昔彭HT 以道怡性，
寿命遐长，秦武采药求仙，早升霞气。故广成子语黄帝曰∶来，吾语汝。至道无视无听，抱神以静，
形将自正也。必静必清，无劳汝形，无摇汝精，心无所知，神将守形，可以长生。故我修身千二百
岁，人皆尽死，而我独存。得吾道者，上为皇，下为王；失吾道者，上见光，下为土。是知安国
安人之道，莫大怡神，亡神亡国之灾，无出情欲。故岐伯以斯至道，上答黄轩，述千古之遗风，拯
万叶之荼苦也。平按∶守失《灵枢》、《甲乙》作失守。注痿骨下原缺一字，据下文终以终字，
此疑作始。又注遗风别本作道风。）是故用针者，察观病患之能，以知精神魂魄之存亡得失之意，五
脏已伤，针不可以治之也。（上古但有汤液之为而不用针，至黄帝贼邪伤物，故用针石，并药灸
等杂合行之，以除疾病。疗病之要，必本其人五神存亡可得可失死生之意，然后命诸针药，以行
调养。若其人纵逸，五神以伤，愚医不候神气存亡，更加针药，必其早夭不待时也。平按∶察观
《甲乙》作观察。能《灵枢》、《甲乙》均作态。）肝藏血，血舍魂，肝气虚则恐，实则
怒。（肝心脾肺肾谓之五脏，藏精气也。血脉营气精谓之五精气，舍五神也。肝主于筋，人卧之时，
血归于肝，故魂得舍血也。肾为水脏，主于恐惧；肝为木脏，主怒也。水以生木，故肝子虚者，
肾母乘之，故肝虚恐也。）心藏脉，脉舍神，心气虚则悲，实则笑不休。（肝为木脏，主悲哀也；
心为火脏，主于笑也。木以生火，故火子虚者，木母乘之，故心虚悲者也。）脾藏营，营舍意，脾
气虚则四肢不用，五脏不安，实则胀，经溲不利。（溲，小留反。营，血肉也。脾主水谷，脏腑
之主，虚则阳腑四肢不用，阴脏不安。实则胀满及女子月经并大小便不利，故以他乘致病也。平
按∶此段《灵枢》在心脏脉之上。则胀《灵枢》作则腹胀。经溲《甲乙》作泾溲。）肺藏气，气
舍魄，肺气虚则息利少气，实则喘喝胸凭仰息。（肺主五脏谷气，亦不受他乘，故虚则喘息利而
少气，实则胸满息难也。平按∶息利《灵枢》作鼻塞不利，《甲乙经》作鼻息不利。胸凭《灵枢》
作胸盈，《甲乙》作凭，注云∶《九墟》作盈。）肾藏精，精舍志，肾气虚则厥，实则胀，五脏
不安。（肺为金脏，主于狂厥；肾为水脏，主于水胀。五脏不安，金以生水，故水子虚者，金母
乘之，故狂厥逆也。平按∶志《甲乙》作气。）必审察五脏之病形，以知其气之虚实而谨调之。
（医疗之道，先识五脏气之虚实，及知虚实所生之病，然后命乎针药，谨而调之。平按∶《灵枢》
无察字，而谨调之作谨而调之也。）
【平按】：本篇从“喜乐者”以上部分，在日本原抄正本中残缺，篇目也无法考证。杨上善从日本仁和寺宫御藏本残卷十三张纸中，检阅出从“自在我者”以下至“竭绝而失生”的经文及杨注，并参照《灵枢·本神》篇，补入了“喜乐者”以上的内容。如同折断的玉璧，残缺后重新完整，确实值得宝贵。从“自在我者”以上部分，可惜无法查出，因此从“黄帝问于岐伯曰”到“地之”，谨根据《灵枢》卷二第八《本神》篇补入。从“喜乐者”以下直至末尾，均见于《本神》篇，也见于《甲乙经》卷一第一。
黄帝问岐伯说：大凡针刺的方法，必须首先以神为根本。血脉、营气、精神，这五脏所藏的内容，如果它们淫乱离位离开脏腑，就会导致精液流失、魂魄飞扬、志意恍惚混乱、智虑离开身体，这是什么原因造成的呢？是天的罪过吗？还是人的过错呢？什么是德、气、生、精神、魂、魄、心、意、志、思、智、虑？请问其中的道理。岐伯回答说：天赋予我们的叫作德，地赋予我们的叫作气，德与气流动交薄从而产生生命。（在形体未形成之前，分予我身，称为德，这是天的道。所以《庄子》说：在形体未形成之前，万物得到它而生存，称为德。阴阳和顺之气，构成我身体的质料，这是地的道。德中的分予流动，阴阳之气调和停匀，于是使天道无形的分予，动气和顺停匀，万物得以生存。杨上善按：注中的“ ”字恐怕是“施”字的误写。）所以生命的来源称为精，（雄性和雌性的两神相搏，共同形成一个形体，先于我的身体而生，所以称为精。）两精相搏称为神，（即前所述的两精相搏共同形成一个形体，在一个形体之中，灵妙的部分称为神，也就是身的细微之处。问：所说的神，不知道是在这个精中开始产生的？还是先有然后才来的？答：查考这部《内经》，只有神伤、神去和此神生的说法，由此可知是后来来的，不是说开始产生的。等到查考佛教经典，在精合之时，有神气来托生，则知道是先有的，道理不虚。所以孔丘不回答有知无知的问题，推测是有原因的。只有佛陀明确说明是可以依据的。）随神往来的是魂，（魂，是神的别灵，所以随神往来，藏在肝，名叫魂。）并精而出入的是魄，（魄，也是神的别灵，并精从此处出来进入彼处，称为魄。“并”读作薄浪反。）用来承担外物的是心，（物，指万物。心，是神的作用。能够认知万物，必定有所凭借，神……任物，所以称为心。）心中有所回忆称为意，（意，也是神的作用，承担外物的中心，有所追忆，称为意。）意中所存留的是志，（志，也是神的作用，所忆之意，有所专一存留，称为志。）因为志而进行存变思考称为思，（思，也是神的作用，专一存留的志，转变追求异求，称为思。）因为思而远慕未来称为虑，（虑，也是神的作用。转变追求的思，逆慕将来，称为虑。）因为虑而处理事物称为智。（智，也是神的作用，因为虑所知，处理事物的是非，称为智。）所以智者养生，（神的作用，穷尽在于智，所以说智者的养生之道，）必须顺应四时而适应寒暑，（智者养生的要有之道，春夏养阳，使之适应暑热；秋冬养阴，使之适应寒冷。）调和喜怒并安居处，（喜怒的产生，源于居处，智者发怒喜悦而合乎节度，所以因此调和安宁。）节制阴阳并调和柔刚，（阴导致刚，阳兴起柔，两者有节制，那么刚柔就得到了。杨上善按：柔刚，《灵枢》、《甲乙》均作刚柔。）像这样邪僻就不会到来，长生久视。（智者实行调和节制的养生之道，那么五脏安养神，六腑气机调畅，经脉运用营运，腠理致密，如此病疵的根本不生，八正四邪没有途径到达，从此以往，或许齐同天地，不见冬死，或许类似彭祖，长生久视。杨上善按：注中“五养”恐怕是“五脏”的误写，“冬 ”二字不详，因原抄如此，所以仍保留。）因此，惊恐思虑的人，精气流溢而不固。（惊恐思虑，多损伤于心，神受伤没有守持，所为不稳固。）悲哀触动内心的人，精气竭绝而失去生命。（人的悲哀触动内心，损伤肝魂，泪竭筋绝，所以失去生命。杨上善按：注中“失”下原缺一字，据经文应作“生”。）喜乐的人，精气散漫而不收藏。（喜乐志达气散，损伤肺魄，所以精不守藏。“ ”，立安反，牵引也。杨上善按：“ ”，《灵枢》、《甲乙》均作“惮”，原抄作“ ”。考“ ”音展，上声，木白理也。音义均不合。疑作“掸”，音弹，寒韵。《太玄经》：掸系其名。提持也。与本注音义相近。再查日本抄本，凡手旁多从木，如“搏”作“ ”之类，今“ ”字恐怕是“掸”字传写之误。注中“气散”下原缺一字，据上注“伤于肝魂”，应作“伤”。魄下原有“故精不守藏也”六字，袁刻脱漏。）愁忧的人，气机闭塞而不运行。（愁忧气结，损伤脾意，所以闭塞不运行。杨上善按：“闭上”，《灵枢》、《甲乙》有“气”字。）盛怒的人，迷惑而不理智。（盛怒气聚，损伤肾志，所以迷惑失理。杨上善按：“理”，《灵枢》、《甲乙》作“治”。）恐惧的人，动荡惊惮而不能收敛。（右肾命门藏精气，恐惧惊荡，则精气无守而精自下泄，所以说不能收敛。杨上善按：《甲乙》注云：《太素》“不收”作“失守”。今仍作“不收”，或者另有版本吧？）心惊恐思虑则伤神，（心是脏。怵惕，是肾来乘心。思虑，则是脾来乘心。二邪乘袭严重，所以伤神。）神受伤则恐惧自失，肌肉破败脱落，神为其主，所以伤神则反伤右肾，所以恐惧自失。也反伤脾，所以肌肉破败脱落。毛发憔悴面色枯槁，死于冬季。（毛悴是肺伤，色夭是肝伤，因为神伤则五脏都伤。冬，是火死的时候。）肝悲哀触动内心则伤魂，（肝是脏。悲哀太甚伤肝，所以说动中。肝伤则魂伤。杨上善按：肝上，《灵枢》有“脾忧愁至死于春”一段，本书在后。）魂受伤则狂妄健忘不精明，不敢正当人站立，（魂既已伤，肝肾也伤，所以……及……不精明，不敢当人。杨上善按：“狂忘”，《甲乙》作“狂妄”。“不精不敢正当人”，《甲乙》作“其精不守”，注：一本作“不精不精则不正当”。《灵枢》作“狂忘不精不精则不正当人”。注“故”下缺二字，“及”下缺一字，袁刻作“故狂妄不精”，与原抄不合。）身体蜷缩而筋脉拘挛，两胁肋骨抬起，（肝足厥阴脉环绕阴器，所以魂肝伤宗筋收缩。肝又主诸筋，所以拘挛。肝在两胁，所以肝病两胁肋骨抬起。杨上善按：“缩”上，《灵枢》有“阴”字，“骨举”，《灵枢》作“骨不举”。《甲乙》作“令人阴缩而筋挛两胁肋骨不举”。）毛发憔悴面色枯槁，死于秋季。（秋，是木死的时候。）肺喜乐无极则伤魄，（肺脏。喜乐，是心喜乘肺，无极伤魄。杨上善按：“无极”，《甲乙》作“乐极”。）魄受伤则发狂，狂者意念不在他人身上，皮肤皮革焦枯，（魄伤则伤脏，所以发狂病。因为乐荡神，所以狂病意念不当人。又肺病，皮肤皮革焦枯。杨上善按：“人皮革焦”，《甲乙》作“其人皮革焦”。）毛发憔悴面色枯槁，死于夏季。（夏，是金死的时候。）脾愁忧而不解则伤意，意受伤则神志错乱，四肢不能举动，（肺来乘脾，所以忧愁不已伤意，发狂神志错乱，并脾病四肢不能举动。杨上善按：《甲乙》作“闷”。）毛发憔悴面色枯槁，死于春季。（春，是土死的时候。问：脾主愁忧。又说精气并于肝则忧，即肝为忧。《素问》说心在变动为忧，即心为忧。肺在志为忧，即肺为忧。这是什么意思？答：脾为四脏之本，意主愁忧。所以心在变动为忧，即是意之忧。或在肺志为忧，也是意之忧。若在肾志为忧，也是意之忧。所以愁忧所在，皆属脾。杨上善按：心之忧在心变动，肺之忧在肺之志，详《素问·阴阳应象大论》新校正引杨注，又见《甲乙经·精神五脏论》所引杨注。按《甲乙经》云：肝之与肾，脾之与肺，互相成也。脾者土也，四脏皆受成焉。故恐发于肝而成于肾，爱发于脾而成于肝。又说：心之与肺，脾之与心，亦互相成也。故喜变于心而成于肺，思发于脾而成于心，一过其节，二脏俱伤，此经互言其义耳。又新校正谓：《甲乙经》具有此说，取五志迭相胜而为言，各举一则义俱不足，两见之则互相成义也。）肾盛怒而不止则伤志，（肝来乘肾，所以不已伤志。）志受伤则善于忘记前言，腰脊不可以俯仰屈伸，（肾志伤，所以喜忘。肾在腰脊之中，所以肾病不可俯仰屈伸。杨上善按：“善”，《灵枢》、《甲乙》均作“喜”。“屈伸”二字，《甲乙》无。）毛发憔悴面色枯槁，死于季夏；（季夏，是水死的时候。）恐惧而不解则伤精，（恐惧起自命门，所以不解伤精。）精受伤则骨酸痿厥，精气……（精为骨髓之液，所以精伤则骨酸痛及骨痿。杨上善按：“厥精”下原缺二字，《灵枢》、《甲乙》作“时自下”三字。）因此五脏，是主藏精的脏器，（人有二肾：左为肾脏，右为命门。命门藏精，精是五脏精液，所以五脏藏精。）不可损伤，损伤则守持丢失而阴虚，阴虚则无气，无气则死亡了。（五脏之神不可损伤，损伤五神，则神去无守，脏守丢失。六腑为阳，五脏为阴，脏无神守，所以阴虚。阴脏气无，遂致死。所以不死之道，是养五神。人都惊恐思虑，则伤神，悲哀触动内心，日亡魂性，喜乐无极，神魄散扬，愁忧不解，志意错乱，盛怒不止，失志多忘，恐惧惊神，伤精痿骨，……以千端之祸，害此一生，终以万品欲情，浇乱真性，仍服金石贵宝，摧斯易生之躯，多求神仙芳草，日役百年之命。昔彭祖以道怡性，寿命遐长，秦武采药求仙，早升霞气。所以广成子对黄帝说：来，我告诉你。至高之道无视无听，抱神以静，形将自然端正。必须静必须清，不要劳累你的形体，不要摇动你的精，心无所知，神将守形，可以长生。所以我修身一千二百岁，人都尽死，而我独存。得吾道者，上为皇，下为王；失吾道者，上见光，下为土。所以知道安国安人之道，没有比怡神更大的，亡神亡国之灾，没有出于情欲的。所以岐伯以此至道，向上答复黄轩，述说千古的遗风，拯救万代的苦难。杨上善按：“守失”，《灵枢》、《甲乙》作“失守”。注“痿骨”下原缺一字，据下文“终以”终字，此处疑作“始”。又注“遗风”别本作“道风”。）因此用针的人，观察病患的状态，以知道精神魂魄的存亡得失之意，五脏已经损伤，针不可以治疗它。（上古只有汤液而没有用针，到了黄帝贼邪伤物，所以用针石，并药灸等杂合施行，以除疾病。疗病的关键，必须基于其人五神存亡可得可失死生的意义，然后命令诸针药，以行调养。如果那人放纵安逸，五神已伤，愚医不候神气存亡，更加针药，必然早夭不待时。杨上善按：“察观”，《甲乙》作“观察”。“能”，《灵枢》、《甲乙》均作“态”。）肝藏血，血舍魂，肝气虚则恐，实则怒。（肝心脾肺肾称为五脏，藏精气。血脉营气精称为五精气，舍五神。肝主于筋，人卧之时，血归于肝，所以魂得舍血。肾为水脏，主于恐惧；肝为木脏，主怒。水以生木，所以肝子虚者，肾母乘之，所以肝虚恐。）心藏脉，脉舍神，心气虚则悲，实则笑不休。（肝为木脏，主悲哀；心为火脏，主笑。木以生火，所以火子虚者，木母乘之，所以心虚悲。）脾藏营，营舍意，脾气虚则四肢不用，五脏不安，实则胀，经溲不利。（溲，小留反。营，血肉也。脾主水谷，脏腑之主，虚则阳腑四肢不用，阴脏不安。实则胀满及女子月经并大小便不利，所以被他脏乘袭致病。杨上善按：此段《灵枢》在心脏脉之上。“则胀”，《灵枢》作“则腹胀”。“经溲”，《甲乙》作“泾溲”。）肺藏气，气舍魄，肺气虚则息利少气，实则喘喝胸凭仰息。（肺主五脏谷气，也不受他脏乘袭，所以虚则喘息利而少气，实则胸满息难。杨上善按：“息利”，《灵枢》作“鼻塞不利”，《甲乙经》作“鼻息不利”。“胸凭”，《灵枢》作“胸盈”，《甲乙》作“凭”，注云：《九墟》作“盈”。）肾藏精，精舍志，肾气虚则厥，实则胀，五脏不安。（肺为金脏，主于狂厥；肾为水脏，主于水胀。五脏不安，金以生水，所以水子虚者，金母乘之，所以狂厥逆。杨上善按：“志”，《甲乙》作“气”。）必须审察五脏的病形，以知道其气的虚实而谨慎调治。（医疗之道，先识五脏气之虚实，及知虚实所生之病，然后命令乎针药，谨慎调治。杨上善按：《灵枢》无“察”字，“而谨调之”作“谨而调之”也。）
[Ping An]: The section of this chapter from "those who are joyful" upwards is missing in the original Japanese manuscript, and the chapter title cannot be verified. Yang Shangshan examined thirteen sheets from the incomplete volume of the Imperial Library of Prince Reika-ji Temple in Japan, retrieved the text and Yang's commentary from "self-presence" downwards to "exhaustion and loss of life", and supplemented the content above "those who are joyful" by verifying it with the *Lingshu: Ben Shen* chapter. Like a broken jade disc restored to completeness, it is indeed precious. The part above "self-presence" could not be traced, so from "The Yellow Emperor asked Qibo" to "of the earth", it was supplemented based on Volume 2, Chapter 8 *Ben Shen* of the *Lingshu*. From "those who are joyful" to the end, it appears in the *Ben Shen* chapter and also in Volume 1, Chapter 1 of the *Jiayi Jing*.
The Yellow Emperor asked Qibo: In all acupuncture methods, one must first base oneself on Shen (Spirit). Blood vessels, Ying Qi (Nutritive Qi), and Spirit are what the Five Zang Organs store. If they become excessive and leave their organs, causing essence loss, wandering Hun and Po souls, confusion of Zhi and Yi, and departure of Zhi and Lv from the body, what is the cause? Is it Heaven's fault or human error? What are De (Virtue), Qi, Sheng (Life), Jing (Essence), Shen, Hun, Po, Xin (Heart/Mind), Yi (Intention), Zhi (Will), Si (Reflection), Lv (Deliberation), and Zhi (Wisdom)? Please explain the reason. Qibo replied: What Heaven gives us is called De, what Earth gives us is called Qi; De flows and Qi interacts to generate life. (Before form takes shape, the portion given to my body is called De, which is the Way of Heaven. Thus, *Zhuangzi* says: Before form takes shape, things obtain it to live, called De. Yin-Yang harmonious Qi constitutes my physical substance, which is the Way of Earth. The distribution within De flows, Yin-Yang Qi harmonizes and stabilizes, thus making the formless distribution of Heaven move with harmonious Qi, allowing things to be born. Ping An notes: The character ' ' in the commentary is likely a typo for 'Shi' (to bestow).) Therefore, the source of life is called Jing (Essence). (When male and female spirits interact, they form a single shape, born before my body, hence called Jing.) When two Jings interact, it is called Shen (Spirit). (This refers to the two Jings interacting to form a shape; within that shape, the spiritual aspect is called Shen, which is the subtle essence of the body. Question: Is Shen generated initially within this Jing, or did it exist beforehand? Answer: Examining this *Neijing*, there are only mentions of Shen injury, Shen departure, and Shen generation, indicating it comes later, not that it is initially generated. Consulting Buddhist scriptures, when Jing combines, Shen Qi arrives to take rebirth, proving it existed beforehand; the logic is sound. Thus, Confucius did not answer whether there is knowledge or ignorance, implying reasons exist. Only the Buddha's explicit statement can be relied upon.) That which follows Shen and goes back and forth is called Hun (Ethereal Soul). (Hun is a distinct spirit of Shen, thus following Shen, stored in the Liver, named Hun.) That which exits and enters with Jing is called Po (Corporeal Soul). (Po is also a distinct spirit of Shen, exiting here and entering there with Jing, called Po. 'Bing' is pronounced Bo-lang fan.) That which bears external objects is called Xin (Heart/Mind). (Objects refer to all things. Xin is the function of Shen. To perceive all things, there must be a basis... bearing objects, hence called Xin.) When the mind recalls something, it is called Yi (Intention). (Yi is also a function of Shen; the mind bearing objects, recalling something, is called Yi.) What Yi retains is called Zhi (Will). (Zhi is also a function of Shen; the recalled Yi, specifically retained, is called Zhi.) Because of Zhi, storing and changing is called Si (Reflection). (Si is also a function of Shen; the specifically retained Zhi, transforming and seeking differently, is called Si.) Because of Si, longing far ahead is called Lv (Deliberation). (Lv is also a function of Shen; the transforming-seeking Si, anticipating the future, is called Lv.) Because of Lv, handling objects is called Zhi (Wisdom). (Zhi is also a function of Shen; based on Lv's knowledge, handling right and wrong of objects, is called Zhi.) Therefore, the wise person's health preservation: (The function of Shen culminates in Zhi, hence the wise person's health preservation,) must follow the Four Seasons and adapt to cold and heat. (The way of the wise person's preservation: Nourish Yang in Spring and Summer to adapt to heat; nourish Yin in Autumn and Winter to adapt to cold.) Harmonize joy and anger, and dwell peacefully. (Joy and anger arise from dwelling; the wise person expresses them moderately, thus achieving harmony and peace.) Regulate Yin and Yang, and adjust softness and hardness. (Yin leads to hardness, Yang initiates softness; if both have regulation, hardness and softness are achieved. Ping An notes: 'Rou Gang' in *Lingshu* and *Jiayi* is written as 'Gang Rou'.) Thus, evil deviations will not arrive, ensuring long life and clear vision. (If the wise person practices harmonious and regulated preservation, the Five Zang calm the Shen, Six Fu organs regulate Qi, meridians circulate Ying, and cou li are dense. Thus, the root of disease does not arise, Eight Regularities and Four Evils have no path to enter. From then on, perhaps equal to Heaven and Earth, avoiding winter death, or like Peng Zu, living long. Ping An notes: 'Wu Yang' in the note is likely a typo for 'Wu Zang'; 'Dong [missing]' is unknown, kept as in the original.) Therefore, those who are startled and overthink have overflowing Jing that is not secure. (Startled and overthinking mostly injure the Heart; Shen injured has no guard, actions are insecure.) Those whose sorrow moves the center exhaust Qi and lose life. (Human sorrow moving the center injures Liver Hun, tears dry, sinews break, thus losing life. Ping An notes: One character is missing after 'Shi' in the note; based on the text, it should be 'Sheng'.) Those who are joyful have scattered Jing not stored. (Joyful will reaches, Qi scatters, injuring Lung Po, thus Jing does not guard storage. ' ' is pronounced Li-an fan, meaning to pull. Ping An notes: ' ' in *Lingshu* and *Jiayi* is 'Dan', original copy has ' '. ' ' is pronounced Zhan, upper tone, wood white grain. Sound and meaning do not match. Suspect it is 'Shan', pronounced Dan, Han rhyme. *Taixuan Jing*: Shan is its name. To hold up. Close to the note's sound and meaning. Checking Japanese copies, hand radicals often use wood, e.g., 'Bo' written as ' '. Thus ' ' is likely a transcription error for 'Shan'. Note missing one character after 'Qi San'; based on previous note 'Injures Liver Hun', it should be 'Shang'. Original below 'Po' had six characters 'Gu Jing Bu Shou Cang Ye', Yuan edition omitted.) Those who are worried have blocked Qi not flowing. (Worry knots Qi, injuring Spleen Yi, thus blocked and not flowing. Ping An notes: 'Bi Shang' in *Lingshu* and *Jiayi* has 'Qi'.) Those with intense anger are confused and irrational. (Intense anger gathers Qi, injuring Kidney Zhi, thus confused and losing reason. Ping An notes: 'Li' in *Lingshu* and *Jiayi* is 'Zhi'.) Those who are fearful are agitated and cannot gather. (Right Kidney Mingmen stores Jing Qi; fear and agitation cause Jing Qi to lack guard and leak downward, hence 'cannot gather'. Ping An notes: *Jiayi* commentary says: *Taisu* 'Bu Shou' is 'Shi Shou'. Still written as 'Bu Shou', or perhaps another version?) Heart startled and overthinking injures Shen. (Heart is an organ. Chu Ti is Kidney attacking Heart. Si Lv is Spleen attacking Heart. Two evils attacking severely, thus injuring Shen.) Shen injured causes fear and self-loss, muscle breakdown and wasting, Shen is master, thus injuring Shen reversely injures Right Kidney, hence fear and self-loss. It also reversely injures Spleen, hence muscle breakdown and wasting. Hair becomes brittle, complexion fades, dies in Winter. (Brittle hair is Lung injury, faded complexion is Liver injury; because Shen injury means all Five Zang are injured. Winter is the time Fire dies.) Liver sorrow moving the center injures Hun. (Liver is an organ. Excessive sorrow injures Liver, hence 'moving center'. Liver injury means Hun injury. Ping An notes: Above 'Gan', *Lingshu* has a paragraph 'Pi You Chou Zhi Si Yu Chun', this book places it later.) Hun injured causes madness, amnesia, and lack of clarity, daring not stand properly. (Once Hun is injured, Liver and Kidney are also injured, thus... and... not clear, daring not face people. Ping An notes: 'Kuang Wang' in *Jiayi* is 'Kuang Wang'. 'Bu Jing Bu Gan Dang Zheng Ren' in *Jiayi* is 'Qi Jing Bu Shou', commentary: Another version is 'Bu Jing Bu Jing Ze Bu Zheng Dang Ren'. *Lingshu* is 'Kuang Wang Bu Jing Bu Jing Ze Bu Zheng Dang Ren'. Note missing two characters after 'Gu', one after 'Ji'; Yuan edition writes 'Gu Kuang Wang Bu Jing', inconsistent with original copy.) Body curls and sinews contract, two hypochondriac ribs lift. (Liver Foot Jueyin meridian circles genitalia, thus Hun/Liver injury causes Zong Jin contraction. Liver governs all sinews, thus contraction. Liver is in two hypochondria, thus Liver disease causes two hypochondriac ribs to lift. Ping An notes: Above 'Suo', *Lingshu* has 'Yin'; 'Gu Ju' in *Lingshu* is 'Gu Bu Ju'. *Jiayi* is 'Ling Ren Yin Suo Er Jin Luan Liang Xie Lei Gu Bu Ju'.) Hair becomes brittle, complexion fades, dies in Autumn. (Autumn is the time Wood dies.) Lung extreme joy injures Po. (Lung organ. Joy is Heart fire attacking Lung, extreme joy injures Po. Ping An notes: 'Wu Ji' in *Jiayi* is 'Le Ji'.) Po injured causes madness, mad persons have no intention towards others, skin and leather parched. (Po injury injures Zang, thus causing madness. Because joy agitates Shen, thus madness and intention not towards others. Also Lung disease, skin and leather parched. Ping An notes: 'Ren Pi Ge Jiao' in *Jiayi* is 'Qi Ren Pi Ge Jiao'.) Hair becomes brittle, complexion fades, dies in Summer. (Summer is the time Metal dies.) Spleen worry unresolved injures Yi. Yi injured causes mental confusion, four limbs unable to move. (Lung attacks Spleen, thus unrelenting worry injures Yi, causing madness and confusion, and Spleen disease four limbs unable to move. Ping An notes: *Jiayi* is 'Men'.) Hair becomes brittle, complexion fades, dies in Spring. (Spring is the time Earth dies. Question: Spleen governs worry. Also says Jing Qi merging into Liver causes worry, i.e., Liver is worry. *Suwen* says Heart changes manifest as worry, i.e., Heart is worry. Lung in Zhi is worry, i.e., Lung is worry. What is the meaning? Answer: Spleen is the root of Four Zang, Yi governs worry. Thus Heart change manifesting as worry is Yi's worry. Or Lung Zhi being worry is also Yi's worry. If Kidney Zhi is worry, it is also Yi's worry. Thus wherever worry is, it belongs to Spleen. Ping An notes: Heart's worry is in Heart change, Lung's worry is in Lung Zhi, see *Suwen: Yin Yang Ying Xiang Da Lun* New Correction citing Yang's note, also seen in *Jiayi Jing: Jing Shen Wu Zang Lun* citing Yang's note. According to *Jiayi Jing*: Liver and Kidney, Spleen and Lung mutually complete each other. Spleen is Earth, all Four Zang receive formation from it. Thus Fear originates in Liver and completes in Kidney, Love originates in Spleen and completes in Liver. Also: Heart and Lung, Spleen and Heart mutually complete each other. Thus Joy changes in Heart and completes in Lung, Reflection originates in Spleen and completes in Heart. Exceeding moderation injures both Zang. This chapter discusses meanings mutually. New Correction also states: *Jiayi Jing* has this theory, taking Five Zhi alternating overcoming as speech, each mentioning one is insufficient, seeing both makes them mutually complete.) Kidney intense anger unceasing injures Zhi. (Liver attacks Kidney, thus unceasingly injuring Zhi.) Zhi injured causes frequent forgetting of previous words, waist and spine unable to bend, extend, flex, or stretch. (Kidney Zhi injured, thus prone to forgetting. Kidney is in waist and spine, thus Kidney disease unable to bend/extend. Ping An notes: 'Shan' in *Lingshu* and *Jiayi* is 'Xi'. 'Qu Shen' two characters absent in *Jiayi*.) Hair becomes brittle, complexion fades, dies in Late Summer. (Late Summer is the time Water dies.) Fear unresolved injures Jing. (Fear originates from Mingmen, thus unresolved injures Jing.) Jing injured causes bone soreness, flaccidity, and cold extremities, Jing ... (Jing is fluid of bone marrow, thus Jing injury causes bone soreness and bone flaccidity. Ping An notes: Two characters missing after 'Jue Jing'; *Lingshu* and *Jiayi* are 'Shi Zi Xia' three characters.) Therefore, Five Zang are the organs that primarily store Jing. (Humans have two Kidneys: Left is Kidney, Right is Mingmen. Mingmen stores Jing, Jing is Five Zang essence fluid, thus Five Zang store Jing.) Cannot be injured; injury causes loss of guarding and Yin deficiency; Yin deficiency causes lack of Qi; lack of Qi causes death. (Five Zang Shen cannot be injured; injuring Five Shen means Shen departs without guard, Zang guard lost. Six Fu are Yang, Five Zang are Yin; Zang without Shen guard is Yin deficiency. Yin Zang Qi gone, leading to death. Thus the way to avoid death is nourishing Five Shen. People are all startled and overthinking, thus injuring Shen; sorrow moves center, daily losing Hun nature; extreme joy, Shen Po scatter; worry unresolved, Zhi Yi confused; intense anger unceasing, losing Zhi and forgetting much; fear startling Shen, injuring Jing and bone flaccidity... causing thousand disasters, harming this life, finally with ten thousand desires, flooding true nature, still ingesting precious minerals and stones, destroying this easily born body, seeking many immortal herbs, daily serving hundred-year life. Formerly Peng Zu used Dao to please nature, lifespan long; Qin Wu sought medicine for immortality, ascended early to misty air. Thus Guang Cheng Zi said to Yellow Emperor: Come, I tell you. Supreme Dao ignores sight and hearing, embrace Shen with stillness, Form will naturally rectify. Must be still and clear, do not labor your Form, do not shake your Jing, Mind knows nothing, Shen will guard Form, can live long. Thus I cultivated for 1200 years, people all died, but I alone remain. Those obtaining my Dao, above become Huang, below become Wang; those losing my Dao, above see light, below become soil. Thus knowing the way to pacify State and Person, none is greater than pleasing Shen; disaster of losing Shen and State, none exceeds emotions and desires. Thus Qibo used this supreme Dao to reply to Huang Xu, recounting ancient legacy, saving ten thousand generations from bitterness. Ping An notes: 'Shou Shi' in *Lingshu* and *Jiayi* is 'Shi Shou'. Note missing one character after 'Wei Gu'; based on following 'Zhong Yi' final character, this suspects 'Shi'. Also note 'Yi Feng' another version 'Dao Feng'.) Therefore, the acupuncturist observes the patient's capability/state, to know the existence, death, gain, and loss of Jing, Shen, Hun, and Po, and the meaning of Five Zang already injured, needle cannot treat it. (Ancient times only had decoctions and did not use needles; until Yellow Emperor, evil pathogens harmed things, thus using needles and stones, combined with medicine and moxibustion, etc., to remove disease. Key to treating disease must be based on the person's Five Shen existence/death, gain/loss, life/death meaning, then order needles and medicines to perform nourishment and regulation. If the person is indulgent, Five Shen injured, foolish doctor does not wait for Shen Qi existence/death, adds more needles and medicines, surely early death not waiting for time. Ping An notes: 'Cha Guan' in *Jiayi* is 'Guan Cha'. 'Neng' in *Lingshu* and *Jiayi* is 'Tai'.) Liver stores Blood, Blood houses Hun, Liver Qi deficient causes fear, excess causes anger. (Liver, Heart, Spleen, Lung, Kidney are called Five Zang, storing Jing Qi. Blood vessels, Ying Qi, Jing are called Five Jing Qi, housing Five Shen. Liver governs sinews; when person lies down, Blood returns to Liver, thus Hun gets housed in Blood. Kidney is Water Zang, governing fear; Liver is Wood Zang, governing anger. Water generates Wood, thus Liver child deficient, Kidney mother attacks, thus Liver deficiency fear.) Heart stores Mai (Vessels), Vessels house Shen, Heart Qi deficient causes grief, excess causes laughing incessantly. (Liver is Wood Zang, governing grief; Heart is Fire Zang, governing laughter. Wood generates Fire, thus Fire child deficient, Wood mother attacks, thus Heart deficiency grief.) Spleen stores Ying, Ying houses Yi, Spleen Qi deficient causes four limbs unusable, Five Zang uneasy, excess causes distension, Jing and Sou difficult. (Sou, Xiao-liu fan. Ying, flesh and blood. Spleen governs water and grain, master of Zang Fu; deficient, Yang Fu four limbs unusable, Yin Zang uneasy. Excess, distension and women's menstruation plus urination/feces difficult, thus caused by other attacking disease. Ping An notes: This paragraph in *Lingshu* is above Heart Zang Mai. 'Ze Zhang' in *Lingshu* is 'Ze Fu Zhang'. 'Jing Sou' in *Jiayi* is 'Jing Sou'.) Lung stores Qi, Qi houses Po, Lung Qi deficient causes breathing smooth but short of breath, excess causes panting, drinking, chest leaning,仰息 (breathing while lying on back). (Lung governs Five Zang Grain Qi, also not subject to other attacks, thus deficient panting smooth but short of breath, excess chest full breathing difficult. Ping An notes: 'Xi Li' in *Lingshu* is 'Bi Sai Bu Li', *Jiayi Jing* is 'Bi Xi Bu Li'. 'Xiong Ping' in *Lingshu* is 'Xiong Ying', *Jiayi* is 'Ping', commentary: *Jiu Xu* is 'Ying'.) Kidney stores Jing, Jing houses Zhi, Kidney Qi deficient causes Jue (cold extremities/reversal), excess causes distension, Five Zang uneasy. (Lung is Metal Zang, governing madness/Jue; Kidney is Water Zang, governing water distension. Five Zang uneasy, Metal generates Water, thus Water child deficient, Metal mother attacks, thus madness/Jue reversal. Ping An notes: 'Zhi' in *Jiayi* is 'Qi'.) Must carefully examine Five Zang disease forms, to know their Qi deficiency/excess and carefully regulate. (Medical way, first recognize Five Zang Qi deficiency/excess, and know diseases generated by deficiency/excess, then order needles and medicines, carefully regulate. Ping An notes: *Lingshu* lacks 'Cha' character, 'Er Jin Tiao Zhi' is 'Jin Er Tiao Zhi'.)