黄帝问于岐伯曰。愿闻人之始生。何气筑为基。何立而为 。何失而死。何得而生。岐伯曰。
以母为基。以父为 。失神者死。得神者生也。
倪冲之曰。此篇论人之生死寿夭。皆本于少阴阳明也。夫阳为父。阴为母。基始也。言人生于
少阴而始生也。 者。干盾之属。所以 御四旁。谓得阳明之气。而能充实于四体也。两精相搏谓
之神。两精者。一生于先天之精。一生于水谷之精。相搏者。抟聚而合一也。谓得先后天之精气充
足。然后形与神俱。度百岁乃去。
黄帝曰。何者为神。岐伯曰。血气已和。营卫已通。五脏已成。神气舍心。魂魄毕具。乃成为人。
朱永年曰。此言有生之初。得先天之精气。生此营卫气血。五脏神志。而后乃成人。
黄帝曰。人之寿夭各不同。或夭寿。或卒死。或病久。愿闻其道。岐伯曰。五脏坚固。血脉和
调。肌肉解利。皮肤致密。营卫之行。不失其常。呼吸微徐。气以度行。六腑化谷。津液布扬。各如
其常。故能长久。
朱氏曰。此言已生之后。藉水谷之精气。资生营卫津液资养脏腑形身。而后能长久。
黄帝曰。人之寿百岁而死。何以知之。岐伯曰。使道隧以长。基墙高以方。通调营卫。三部三
里起。骨高肉满。百岁乃得终。
此总论人秉先后天之精气充足。营卫通调。骨肉丰满。可长享其天年。使道者。血脉之道路。
本输篇之所谓
间使之道。盖心包络之主血脉也。隧行列也。长者。环转之无端也。此言血气充足。循序而流通也。
土基高以方者。肌肉浓而充于四体也。脉道流长。肌肉高浓。则营卫通调矣。三部者。形身之上中下。
三里者。手足阳明之脉。皆起发而平等也。骨高者。少阴之气足也。肉满者。阳明之气盛也。如此者。
寿之征也。倪氏曰。心包络主脉。包络三焦。乃肾脏所生之气。出归于心下。为有形之脏腑而主血脉。
此先天之精气也。基墙者。土基浓而四壁坚固。此从天水谷之精气也。
黄帝曰。其气之盛衰。以至其死。可得闻乎。岐伯曰。人生十岁。五脏始定。血气已通。其气在
下。故好走。二十岁。血气始盛。肌肉方长。故好趋。三十岁。五脏大定。肌肉坚固。血脉盛满。故
好步。四十岁。五脏六腑。十二经脉皆大。盛以平定。腠理始疏。荣华颓落。发颇颁白。平盛不摇。故
好坐。五十岁。肝气始衰。肝叶始薄。胆汁始灭。目始不明。六十岁。心气始衰。善忧悲。血气懈
惰。故好卧。七十岁。脾气虚。皮肤枯。八十岁。肺气衰。魄离。故言善误。九十岁。肾气焦。四脏
经脉空虚。百岁。五脏皆虚。神气皆去。形骸独居而终矣。
此言人之生长。从阴而生。自下而上。故曰其气在下。好走好趋好步者。春夏生动之气也。人之衰
老。从上而下。自阳而阴。故肝始衰而心。心而脾。脾而肺。肺而肾。好坐好卧者。秋冬收藏之气也。
肌肉坚固。血脉盛满。少阴阳明之气盛也。腠理空疏。发颇颁白。阳明少阴之气衰也。朱氏曰。人之生
长。先本于肾脏之精气。从水火而生木金土。先天之五行也。人之衰老。从肝木以及于火土金水。后
天之五行也。
黄帝曰。其不能终寿而死者何如。岐伯曰。其五脏皆不坚。使道不长。空外以张。喘息暴疾。又卑
基墙。薄脉少血。其肉不石。数中风寒。血气虚。脉不通。真邪相攻。乱而相引。故中寿而尽也。（数叶朔）
此言人秉先天之气虚薄。而后天犹可资培。更能无犯贼风虚邪。亦可延年益寿。若秉气虚弱。而
又不能调养。兼之数中风寒。以致中道夭而不能尽其天年矣。五脏不坚。使道不长。空外以张。喘
息暴疾。先天之气不足也。又卑基墙。薄脉少血。其肉不石。又失其饮食起居之调养矣。数中风寒。
又不知虚邪贼风。避之有时矣。致使真邪相攻。乱而相引。故中寿而尽也。倪冲之曰。先天者。肾脏
之精气也。然有生之后。惟藉后天以资培。水谷入口。其味有五。津液各走其道。酸先入肝。苦先入
心。甘先入脾。辛先入肺。咸先入肾。五脏主藏水谷之精者也。肾为水脏。受五脏之精而藏之。是以先
天之精气不足。得后天以资养。亦可以享其永年。故曰六腑化谷。津液布扬。各如其常。故能久长。
黄帝向岐伯问道：我希望能了解人最初形成的过程。是什么构成了生命的基础？什么确立了生命的形态？失去什么会导致死亡？得到什么能够生存？
岐伯回答说：以母亲（阴精）作为基础，以父亲（阳气）作为护卫。失去“神”就会死亡，得到“神”就能生存。
倪冲之评论说：这一篇论述人的生死和寿命长短，都根本于少阴经和阳明经。阳对应父亲，阴对应母亲，“基”意为起始，说明人生于少阴而开始形成。“卫”是盾牌一类的事物，用来抵御四周的侵害，指获得阳明经的气血，从而能使四肢充实。两精相互结合称为“神”。所谓两精，一个是先天的精气，一个是水谷化生的后天精气。“相搏”是指聚拢合一。意思是说，只有当下先天和后天的精气充足，然后形体与精神才能俱备，度过百岁才离世。
岐伯回答：当气血已经调和，营气和卫气已经通畅，五脏已经形成，神气居于心中，魂和魄都已具备，这才成为完整的人。
朱永年评论说：这是说在生命初始阶段，获得先天的精气，化生出营卫气血和五脏神志，之后才成为人。
黄帝问：人的寿命长短各不相同，有的短命，有的长寿，有的突然死亡，有的久病不愈，我想听听其中的道理。
岐伯回答：如果五脏坚固，血脉调和，肌肉滑利通畅，皮肤致密，营卫的运行不失常态，呼吸轻微徐缓，气息按照节律运行，六腑消化谷物正常，津液分布扬散正常，各脏腑功能都保持其常规状态，所以能长久生存。
朱氏评论说：这是说出生后，借助水谷的精微物质，滋养营卫津液以供养脏腑和形体，之后才能长久。
黄帝问：人活到一百岁而死，如何判断一个人能否达到这个年龄？
岐伯回答：如果鼻道深邃且长，面部骨骼肌肉高大方正，营卫气血通调，上中下三部及手足三里的脉象起势良好，骨骼高耸、肌肉丰满，这样的人可以活到百岁终其天年。
这段总论人禀受先后天精气充足，营卫通调，骨肉丰满，可以尽享天年。“使道”指血脉运行的道路，即《本输》篇所说的“间使之道”，因为心包络主司血脉。“隧”指行列有序，“长”指循环无端。这是说血气充足，循序流通。“土基高以方”指肌肉浓厚并充盈于四肢。脉道流长，肌肉高厚，则营卫通调。“三部”指身体的上、中、下三个部位，“三里”指手足阳明经脉，皆起发且平衡。骨骼高耸，说明少阴之气充足；肌肉丰满，说明阳明之气旺盛。具备这些特征是长寿的征象。倪氏说：心包络主脉，包络与三焦相连，是肾脏产生的气，出于心下，是有形的脏腑并主管血脉，这属于先天的精气。“基墙”像土基浓厚且四壁坚固，这来自后天水谷的精气。
黄帝问：人体之气的盛衰变化，直到死亡的过程，可以听您讲讲吗？
岐伯回答：人十岁时，五脏始定，血气已通，气机主要在下部，所以喜欢跑动。二十岁时，血气开始旺盛，肌肉正在生长，所以喜欢快走。三十岁时，五脏发育完全，肌肉坚固，血脉盛满，所以喜欢步行。四十岁时，五脏六腑和十二经脉都发展到极大程度，由盛转平定，腠理开始疏松，荣华衰退，头发开始花白，身体平稳不再好动，所以喜欢静坐。五十岁时，肝气开始衰退，肝叶变薄，胆汁减少，眼睛开始看不清楚。六十岁时，心气开始衰退，容易忧愁悲伤，血气懈怠懒惰，所以喜欢躺卧。七十岁时，脾气虚弱，皮肤干枯。八十岁时，肺气衰退，魄离散，说话容易出错。九十岁时，肾气枯竭，其他四脏和经脉空虚。到了百岁，五脏都虚衰，神气离去，只剩形骸独自存在而终结。
这段论述人的生长是从阴而生，自下而上，所以说气在下。喜欢跑、快走、步行，是春夏季生动之气的表现。人的衰老是自上而下，自阳入阴，所以肝先衰，然后是心、脾、肺、肾。喜欢静坐、躺卧，是秋冬季收藏之气的表现。肌肉坚固、血脉盛满，是少阴和阳明之气旺盛的表现。腠理空疏、头发花白，是阳明和少阴之气衰退的表现。朱氏说：人的生长，首先基于肾脏的精气，从水火产生木金土，这是先天的五行。人的衰老，从肝木波及火土金水，这是后天的五行。
黄帝问：那些不能活到自然寿限而死的人是怎么回事？
岐伯回答：如果他们的五脏都不坚固，鼻道短浅，鼻孔外张，喘息急促暴疾，面部骨骼肌肉低矮单薄，血脉薄弱血量少，肌肉不坚实，经常遭受风寒侵袭，导致血气虚弱，脉道不通，正气与邪气相互攻伐，混乱互相牵引，所以只能在中寿时便去世了。（注：“数”读作shuò，意为频繁）
这段论述人禀受先天之气虚薄，但后天还可以资助培养，如果能不触犯贼风虚邪，也可以延年益寿。如果禀赋虚弱，又不能调养，加上频繁遭受风寒，以致中途夭折而不能尽其天年。五脏不坚固、鼻道短浅、鼻孔外张、喘息急促，是先天之气不足。面部骨骼肌肉低矮、血脉薄弱、肌肉不坚实，是失去了饮食起居的调养。频繁遭受风寒，是不懂得避开虚邪贼风。致使正气与邪气相争，混乱互相牵引，所以在中寿时便结束了。倪冲之说：先天之气源于肾脏的精气。然而出生之后，只依靠后天来资助培养。食物入口，味道分为五种，津液各自走向不同的通道：酸味先入肝，苦味先入心，甘味先入脾，辛味先入肺，咸味先入肾。五脏是主管储藏水谷精微的器官。肾是水脏，接受五脏的精微并加以储藏。因此，即使先天精气不足，得到后天的滋养，也可以享有长寿。所以说六腑消化谷物，津液分布扬散，各如其常，所以能长久。
Huangdi asked Qibo, saying: I wish to hear about the beginning of human life. What constitutes the foundation? What establishes the form? What loss leads to death? What gain leads to life?
Qibo replied: The mother serves as the foundation, and the father serves as the shield (Wei, protective energy). Loss of Shen (Spirit) leads to death; acquisition of Shen leads to life.
Ni Chongzhi commented: This chapter discusses human life, death, longevity, and brevity of life, all rooted in the Shaoyin (Lesser Yin) and Yangming (Bright Yang) meridians. Yang corresponds to the father, Yin to the mother. "Ji" (Foundation) means beginning, indicating that human life begins from Shaoyin. "Wei" refers to shields or armor, used to defend against attacks from all sides, signifying obtaining the Qi of the Yangming meridian to fill and strengthen the four limbs. The interaction of two Jings (Essences) is called Shen. The two Jings refer to one being congenital Jing (Prenatal Essence) and the other being postnatal Jing derived from food and water. "Xiang bo" (mutual interaction) means gathering and uniting. It implies that only when both prenatal and postnatal Jing are sufficient can Xing (Form) and Shen be complete, allowing one to live a hundred years before passing away.
Huangdi asked: What is Shen?
Qibo replied: When Blood and Qi are harmonized, Ying (Nutritive Qi) and Wei (Defensive Qi) are unobstructed, the Five Zang organs are formed, Shen resides in the Heart, and Hun (Ethereal Soul) and Po (Corporeal Soul) are fully present, then a human being is formed.
Zhu Yongnian commented: This describes the initial stage of life, where congenital Jing is acquired to generate Ying, Wei, Blood, and Qi, as well as the spirits and consciousness of the Five Zang organs, after which a person is formed.
Huangdi asked: People have different lifespans; some die young, some live long, some die suddenly, and some suffer from chronic illness. I wish to hear the principles behind this.
Qibo replied: If the Five Zang organs are solid, Blood vessels are harmonious, muscles are smooth and unobstructed, skin is dense, the circulation of Ying and Wei follows its normal pattern, breathing is gentle and slow, Qi moves according to its rhythm, the Six Fu organs digest grain properly, and Jin Ye (Body Fluids) are distributed normally, with each function maintaining its regular state, then one can live a long life.
Master Zhu commented: This states that after birth, one relies on the essence of food and water to nourish Ying, Wei, and Jin Ye, thereby supporting the Zang organs and body, enabling longevity.
Huangdi asked: How can one know if a person will live to a hundred years?
Qibo replied: If the Shi Dao (Nasal passage/Vessel pathway) is deep and long, the Ji Qiang (Facial base and walls/bony structure) is high and square, Ying and Wei are unobstructed, the pulses at the Three Parts (Upper, Middle, Lower) and San Li (Three Miles points) rise evenly, bones are prominent, and flesh is full, such a person can reach a hundred years and complete their natural lifespan.
This section summarizes that possessing sufficient congenital and postnatal Jing, unobstructed Ying and Wei, and full bones and flesh allows one to enjoy their natural lifespan. "Shi Dao" refers to the pathway of Blood vessels, known as the "Jian Shi pathway" in the *Ben Shu* chapter, because the Pericardium governs Blood vessels. "Sui" means orderly rows; "Chang" means endless circulation. This indicates abundant Blood and Qi flowing in order. "Tu Ji Gao Yi Fang" (Earthen base high and square) refers to thick muscles filling the limbs. Long vessel pathways and thick muscles ensure unobstructed Ying and Wei. "San Bu" refers to the upper, middle, and lower parts of the body; "San Li" refers to the Yangming meridities of the hands and feet, which originate equally. Prominent bones indicate sufficient Shaoyin Qi; full flesh indicates robust Yangming Qi. These are signs of longevity. Master Ni said: The Pericardium governs vessels; it connects with the San Jiao (Triple Burner), generating Qi from the Kidneys, emerging below the Heart, forming a tangible organ governing Blood vessels, which is congenital Jing. "Ji Qiang" resembles a thick earthen base with solid walls, derived from postnatal Jing from food and water.
Huangdi asked: May I hear about the decline of Qi until death?
Qibo replied: At ten years old, the Five Zang organs begin to stabilize, Blood and Qi circulate, and Qi is located in the lower part, so they like to run. At twenty, Blood and Qi become vigorous, muscles grow, so they like to walk briskly. At thirty, the Five Zang organs are fully established, muscles are firm, and Blood vessels are full, so they like to walk steadily. At forty, the Five Zang organs, Six Fu organs, and Twelve Meridians reach their peak and then stabilize; pores begin to loosen, radiance fades, hair turns gray, and movement decreases, so they like to sit. At fifty, Liver Qi begins to decline, liver leaves thin out, bile diminishes, and vision blurs. At sixty, Heart Qi declines, leading to sorrow and grief; Blood and Qi become sluggish, so they like to lie down. At seventy, Spleen Qi becomes deficient, and skin withers. At eighty, Lung Qi declines, Po scatters, and speech becomes erroneous. At ninety, Kidney Qi dries up, and the meridians of the other four Zang organs become empty. At one hundred, all Five Zang organs are deficient, Shen departs, and only the corpse remains until death.
This describes growth arising from Yin, moving upward from below; hence, Qi is lower. Running, brisk walking, and steady walking reflect the dynamic Qi of Spring and Summer. Aging moves downward from above, from Yang into Yin; thus, the Liver declines first, followed by the Heart, Spleen, Lungs, and Kidneys. Sitting and lying down reflect the storing Qi of Autumn and Winter. Firm muscles and full Blood vessels indicate strong Shaoyin and Yangming Qi. Loose pores and gray hair indicate declining Yangming and Shaoyin Qi. Master Zhu said: Growth is based on Kidney Jing, generating Wood, Metal, and Earth from Water and Fire, representing congenital Wu Xing (Five Phases). Aging proceeds from Liver Wood to Fire, Earth, Metal, and Water, representing postnatal Wu Xing.
Huangdi asked: What happens to those who do not reach their natural lifespan?
Qibo replied: If their Five Zang organs are not solid, the Shi Dao is short, nostrils flare outward, breathing is rapid and labored, the Ji Qiang is low and flat, pulses are thin with little Blood, flesh is not firm, and they frequently contract Wind-Cold, leading to deficiency of Blood and Qi, obstruction of pulses, conflict between True Qi (Zheng Qi) and Pathogenic factors (Xie Qi), chaos, and mutual entanglement, they will die at mid-life.
This section discusses individuals with weak congenital Qi, who may still benefit from postnatal nourishment and avoiding pathogenic winds to extend life. However, those with weak constitution who fail to regulate themselves and frequently contract Wind-Cold may die prematurely. Solid Zang organs and long nasal passages indicate sufficient congenital Qi. Low facial structure, thin pulses, and soft flesh indicate lack of dietary and lifestyle care. Frequent Wind-Cold contraction indicates failure to avoid pathogenic factors. This causes Zheng and Xie to clash, leading to mid-life death. Master Ni said: Congenital Qi originates from Kidney Jing. After birth, one relies on postnatal sources for nourishment. Food enters the mouth with five flavors; fluids go to their respective channels: Sour enters the Liver, Bitter the Heart, Sweet the Spleen, Pungent the Lungs, and Salty the Kidneys. The Zang organs store the essence of food and water. The Kidney is the Water organ, storing the essence of all Zang organs. Therefore, even with insufficient congenital Jing, adequate postnatal nourishment can ensure longevity. Thus, it is said that when the Six Fu organs digest grain and fluids are distributed normally, longevity is achieved.