夫色以应天。脉以应地。天主生。地主成。此篇无问答。而直曰心之合脉。似承上编天地之阴阳。而复应乎色脉也。
无问答。故不曰论。
心之合脉也。其荣色也。（心主血脉。故合于脉。经云。脉出于气口。色见于明堂。心之华在面。故其荣在色。）其
主肾也。（五脏合五行。各有相生相制。制则生化。心主火而受制于肾水。是肾乃心脏生化之主。故其主肾也。）肺之合
皮也。其荣毛也。其主心也。（肺主气。气主表。故合于皮。伤寒论曰。寸口脉缓而迟。缓则阳气长。其声商。毛发长。
毛附于皮。气长则毛荣。）肝之合筋也。其荣爪也。其主肺也。（髓生肝。肝生筋。故所合在筋。爪乃筋之余。故其荣在
爪。）脾之合肉也。其荣唇也。其主肝也。（脾主中央土。乃仓廪之官。主运化水谷之精。以生养肌肉。故合肉。脾开窍
于口。故荣在唇。）肾之合骨也。其荣发也。其主脾也。（肾藏精而主髓。故所合在骨。发乃精血之余。故其荣在发。五
营运大论曰。北方生寒。寒生水。水生咸。咸生肾。肾生骨髓。髓生肝。肝生筋。筋生心。心生血。血生脾。脾生肉。
肉生肺。肺生皮毛。皮毛生肾。此天乙生水。而五脏之相生也。六微旨大论云。帝曰。地理之应。六节气位何如。岐伯
曰。相火之下。水气承之。水位之下。土气承之。土位之下。风气承之。风位之下。金气承之。金位之下。火气承之。
君火之下。阴精承之。亢则害。承乃制。制则生化。故曰心之合脉也。肺之合皮也。言五脏之相生也。其主肾也。其主
心也。言五脏之相成也。朱济公曰。先心而肺。肺而肝。肝而脾。脾而肾。乃归重于成与。曰、然）是故多食咸。则
脉凝泣而色变。多食苦。则皮槁而毛拔。多食辛。则筋急而爪枯。多食酸。则肉胝 而唇揭。多食甘。则骨痛而发落。
此五味之所伤也。（此承上文而言太过之为害也。夫五行有相生相制。不可偏废者也。如制之太过。则又有克贼之害矣。
是故多食咸。则水味太过而伤心。其脉凝泣而色变矣。多食苦。是火味太过而伤肺。则皮槁而毛落矣。多食辛。是金味
太过而伤肝。则筋缩急而爪干枯矣。多食酸。是木味太过而伤脾。则肉胝 而唇掀揭矣。多食甘。是土味太过而伤肾。
则骨痛而发落矣。五味所以养五脏者也。脏有偏胜。则所不胜之脏受伤。此又承制之不可太过也。）故心欲苦。肺欲辛。
肝欲酸。脾欲甘。肾欲咸。此五味之所合也。（五味入口。藏于肠胃。以养五脏气。故五味为五脏之所欲。无有偏胜。则
津液相成。而神自生矣。）五脏之气。（五味藏于肠胃。以养五脏之气。五脏内藏五神。五气外见五色。此以下论五脏
之经气。而见死生之色。与生于心生于肺之色。各有不同。故首提曰五脏之气。）故色见青如草兹者死。（故者。承上文
而言。五脏之气受伤。则见五行之败色矣。兹、蓐席也。兹草者。死草之色。青而带白也。）黄如枳实者死。（黄而带青
色也。）黑如 者死。（ 音台。烟尘也。黑而带黄。）赤如 血者死。（ 铺杯切。 者。败恶凝聚之血。色赤黑也。）白
如枯骨者死。（死白而枯干也。）此五色之见。死也。（五色干枯。而兼有所胜之色。故死。）青如翠羽者生。赤如鸡冠者
生。黄如蟹腹者生。白如豕膏者生。黑如乌羽者生。此五色之见。生也。（五色正而华彩光润。故生。）生于心。如以缟
裹朱。生于肺。如以缟裹红。生于肝。如以缟裹绀。生于脾。如以缟裹栝蒌实。生于肾。如以缟裹紫。此五脏所生之外
荣也。（此言五脏所生之荣色。见于外也。上节言五脏之气。见五色于外。此复言藏真之荣。隐见于皮肤之间。有若缟裹
者也。缟、素白也。朱、红之深也。红、淡白红也。绀、青扬赤也。栝蒌实。红黄色也。紫、赤黑之间色也。此五行之
色。而俱兼红者也。盖气主白而荣主红。如以缟裹者。五脏之气包于外也。五色之俱兼红者。五脏之荣隐见于内也。上
节言五脏之气色。此论五脏之血色。王子方问曰。气色有死生。血气无死生耶。曰。外因之病。由气而经。经而脏。内
因之病。由脏而经。经而气。内外二因。俱伤五脏之气而后死。是以五色之见死者。五脏之气绝也。）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。（当、承也。值也。谓色味之应五脏者。色外而味内也。故曰白当
肺辛。言辛生肺而肺生白也。此复结五脏死生之色。生于五脏之气。五脏之神气。生于五味也。）故白当皮。赤当脉。青
当筋。黄当肉。黑当骨。（肺合皮。心合脉。肝合筋。脾合肉。肾合骨。此言生于心生于肺之色。承五脏之合。而见于外
也。）诸脉者。皆属于目。（五脏六腑之精。十二经脉皆上注于目。属于脑。后出于顶。故曰诸脉皆属于目。此节论五
脏经气之所循行。盖脏而经。经而气。气而色也。头痛巅疾。过在足少阴巨阳。是气而经。经而脏也。是以此节与头痛
巅疾节。照应五脏之气节。故人卧血归于肝节。与赤脉之至节。照应生于心如以缟裹朱节。）诸髓者。皆属于脑。（脑为
精髓之海也。）诸筋者。皆属于节。（节、骨节也。筋生于骨。联系于骨节之间。）诸血者。皆属于心。（血者。神气也。
中焦之汁。五脏之精。奉心神化赤而为血。故诸血皆属于心。）诸气者。皆属于肺。（上焦开发。宣五谷味。熏肤充身泽
毛。若雾露之溉。是谓气。五谷入胃。淫精于脉。肺居上焦。朝百脉而输精于皮毛。故主周身之气也。）此四肢八溪之朝
夕也。（四肢、五脏经俞之所出也。八溪、即四肢股肱之肉。五脏元真之所通会也。此言五脏之经血总属于心。五脏之气
总属于肺。经气循行于四肢八溪。注于目。会于脑。濡筋骨。利关节。朝夕循行。外内出入。如环无端者也。故善察色
者。当知五脏之气。善诊脉者。当以五脉为始也。）故人卧血归于肝。（此复论血随卫气之行于脉外也。夫血乃水谷之
精。流溢于中。布散于外。专精者。行于经隧。是行于经隧者。经脉之荣血也。流溢于中者。流溢于冲任也。冲任起于
胞中。上循背里。为经络之海。其浮而外者。循腹右上行。布散于外。渗皮肤。生毫毛。寤则随卫行于肤表。卧则随卫
内入而归于肝。是冲任主发原。而肝主受纳。是以伤寒热入血室。而刺肝之期门。故者。承上文而言。经脉之血。随荣
气行于四肢之三阴三阳。昼夜环转。冲任之血。随卫气而日行于阳。夜归于阴也。）肝受血而能视。（肝开窍于目。故肝
受血而能视。夫见色于明堂者。五脏之气色也。五脏所生之外荣者。血色而见于目也。故曰五色之奇脉者。奇经之血色
也。夫水谷入胃。津液各走其道。五脏主藏精者也。五脏之精。化赤而为血。溢于冲任。归受于肝。开窍于目。是于五
脏所生之色。外荣于目。而肝主色也。）足受血而能步。掌受血而能握。指受血而能摄。（血者。所以濡筋骨。利关节者
也。此言冲任之血。亦循行于四肢。渗于指掌。而无处不到也。）卧出而风吹之。血凝于肤者为痹。（金匮要略曰。血痹
病从何得之。师曰。重困疲劳汗出。卧不时动摇。加被微风。遂得之。汗出者。言卫气之虚于外也。卧则卫归于阴。出
则血行于外。加被风吹。则血凝于皮肤而为痹矣。痹者。痹闭而不遂也。此言卫气之留于阴也久。不能为血之外卫故也。）
凝于脉者为泣。（脉者。见于皮肤之络脉也。冲任之血。溢于皮肤。渗于络脉。故凝于皮肤则为痹。凝于络脉。则泣涩而
不能流行矣。）凝于足者为厥。（厥者。逆冷也。夫阴阳气不相顺接则为厥。下为阴。血为阴。如血凝于下。则上下阴阳。
不相顺接而为厥矣。此言血随卫行。而阴阳之不相和者也。诸生起跃曰。荣卫之循行。经旨似乎矛盾。久为人所疑。今
夫子发明之。始知血随卫气之日行于阳。夜行于阴者。皮肤之血也。阴经行尽。阳经继之。阳经行尽。阴经继之者。十
二脏腑之经荣也。）此三者。血行而不得反其空。故为痹厥也。（空、骨空也。骨空者。节之交三百六十五穴会。络脉之
渗灌诸节者也。血行于皮肤。不得反循于穴会。故为痹厥也。）人有大谷十二分。小溪三百五十四名。少十二俞。此皆卫
气之所留止。邪气之所客也。针石缘而去之。（此言卫气之行于溪谷也。溪谷者。分肉之交会处也。气穴论曰。肉之大会
为谷。肉之小会为溪。分肉之间。溪谷之会。以行荣卫。以会大气。溪谷三百六十五穴会。亦应一岁。人有大谷十二分
者。肉之大分处也。小溪三百五十四名者。肉之小分处也。分者。肉分而有纹理也。名、穴名也。盖肉分之间而有交会。
交会之处而有穴名也。溪谷之数。以应一岁者。岁止三百六十日。内朔虚六日。止三百五十四日。以应小溪之数也。少
十二俞者。言大谷十二分。而有十二俞穴也。气盈五日九百四十分。朔虚五日九百四十分。共计十二日。以应十二俞也。
以岁之三百五十四日。合气盈朔虚之十二日。共三百六十五日有奇。以成一岁。故日期三百有六旬有六日。以闰月定四
时而成岁也。卫气者。行于脉外。温分肉。充皮肤。肥腠理。司开合者也。此腠理分肉之间。皆卫气之所留止。卧出而
风吹之。则血凝而为痹厥矣。针石缘而去之者。言分肉之间。亦有三百六十五穴也。杨君立问曰。气穴论云。气穴三百
六十五。以应一岁。今则三百六十六矣。曰。岁缘三百六十六日。而少有不足。故合而论之。则曰三百六十五日。今分
而论之。则每岁有三百五十四日。而又有气盈朔虚之十二日也。）诊病之始。五决为纪。欲知其始。先建其母。所谓五决
者。五脉也。（诊、视也。始者。言邪始在三阴三阳之气分也。五决者。审别五脏阴阳之经气。以决其病也。欲知其病之
始在某经。先分立五脏为根本。审其邪病某经之气。某脏之经也。夫五脏之体藏于内。而五脏之经气行于外。故色见草
兹者死。青如翠羽者生。是五脏死生之经气。发于外而成于色也。诊病之始。五决为纪者。复言邪之始病在气。气而经。
经而脏也。）是以头痛巅疾。下虚上实。过在足少阴巨阳。甚则入肾。（少阴巨阳。相为表里。阳气生于水脏水腑之中。
而上出于巅顶。实者邪实。虚者正虚。是以头痛巅疾。乃邪气实于上。而使正气虚于下也。盖邪之中人。始于皮毛气分。
留而不去。则转入于经。是以过在巨阳少阴之经。而甚则入肾。盖经络受邪。则内干脏腑矣。） 蒙招尤。目冥耳聋。下
实上虚。过在足少阳厥阴。甚则入肝。（ 、 同。蒙、昏冒也。招、摇也。尤、甚也。足少阳厥阴经脉。布胁肋而下循
足跗。厥阴肝脏。开窍于目。少阳经脉。上出于耳。邪实于下。而经气不能上通。是以目冥耳聋。正气虚于上。致动视
而昏冒摇掉之甚也。此始伤气而致正虚于上。过在经而复邪实于下也。上节论邪实为病。此复论正虚为病。盖邪之所凑。
其正必虚。王子方问曰。五脏之邪。只言甚则入肾入肝。何也。曰。邪入于经。则内干脏腑。然干脏者半死半生。故
曰不必动脏。邪入于阴经。其脏气实。则溜于腑。此章论五脏三阴三阳之经气。故曰甚则入肾入肝。如不甚。则或留于
经。或溜于腑。是以首提二脏。而不尽言之者。欲使后学之不可执一而论也。）腹满 胀。支膈 胁。下厥上冒。过在足
太阴阳明。（腹者。脾胃之郛郭也。腹满 胀。邪薄于太阴阳明之气分。支、支络。膈、内膈也。太阴阳明之支络贯膈。
气分之邪传入于经。是以连及支膈 胁皆胀满也。）咳嗽上气。厥在胸中。过在手阳明太阴。（手太阴主气而主皮毛。邪
伤皮毛气分。则咳嗽而气上逆矣。手太阴之脉。起于中焦。循胃上膈。手阳明之脉。入缺盆。络肺下膈。属肠。邪过在
经。是以胸中厥逆也。）心烦头痛。病在膈中。过在手巨阳少阴。（经曰。心部于表。君火之气。外受于邪。则心烦于内
矣。太阳之气受邪。则头痛于上矣。手太阳之脉。循咽下膈。手少阴之脉。出属心系。下膈络小肠。病在膈中。是过在
手太阳少阴之经矣。此节以审证而知五脏之病。盖脏腑之经气上下内外。各有部分。故曰诊病之始。五决为纪。诊、视
也。）夫脉之大小滑涩浮沉。可以指别。五脏之象。可以类推。五脏相音。可以意识。五色微诊。可以目察。能合色脉。
可以万全。（此以诊脉察色。而知五脏之病也。小者正气虚。大者邪气盛。滑主血伤。涩为少气。浮为在外在腑。沉为在
里在脏。此六者。脉之提纲。而可以指别也。五脏在内。而气象见于外。以五行之理。可类而推之。五脏之相合于五音。
发而为声。可以意识。视五色之微见。可以目内察之。能审色脉之相应。以辨病之死生。则万全而无失矣。此与上节审
证以决五脉之病。又一法也。）赤脉之至也。喘而坚。诊曰有积气在中。时害于食。名曰心痹。得之外疾。思虑而心虚。
面色反映天的变化，脉象反映地的变化。天主生长，地主成形。这一篇没有问答形式，而是直接论述心的配合是脉，这似乎是承接上编关于天地阴阳的内容，进而说明色与脉的对应关系。
因为没有问答，所以不称为“论”。
心与脉相合，其荣华表现在面色。（心主管血脉，所以与脉相合。经文说：脉气显现于气口，面色显现于明堂。心的华彩在面部，所以其荣华在面色。）心的制约者是肾。（五脏配合五行，各有相生相克的关系。有克制才能生化。心属火而受肾水的克制，因此肾是心脏生化的主宰，所以说心的制约者是肾。）肺与皮相合，其荣华表现在毛发，其制约者是心。（肺主气，气主表，所以与皮相合。《伤寒论》说：寸口脉缓而迟，缓则阳气长，其声音商，毛发长。毛附着于皮，气长则毛荣。）肝与筋相合，其荣华表现在爪甲，其制约者是肺。（髓生肝，肝生筋，所以所合在筋。爪甲是筋的余气，所以其荣华在爪甲。）脾与肉相合，其荣华表现在嘴唇，其制约者是肝。（脾主中央土，是仓廪之官，主管运化水谷的精微，以生养肌肉，所以与肉相合。脾开窍于口，所以荣华在唇。）肾与骨相合，其荣华表现在头发，其制约者是脾。（肾藏精而主髓，所以所合在骨。头发是精血的余气，所以其荣华在发。《五运行大论》说：北方生寒，寒生水，水生咸，咸生肾，肾生骨髓，髓生肝，肝生筋，筋生心，心生血，血生脾，脾生肉，肉生肺，肺生皮毛，皮毛生肾。这是天乙生水，以及五脏之间的相生关系。《六微旨大论》说：黄帝问：地理的相应，六个节气的位置如何？岐伯说：相火之下，有水气来承制；水位之下，有土气来承制；土位之下，有风气来承制；风位之下，有金气来承制；金位之下，有火气来承制；君火之下，有阴精来承制。亢盛就会为害，有承制才能平衡，平衡才能生化。所以说心与脉相合、肺与皮相合，讲的是五脏的相生关系；其制约者是肾、其制约者是心，讲的是五脏的相成关系。朱济公说：先心后肺，肺后肝，肝后脾，脾后肾，这是归于重视“成”吧。回答说：是的。）
因此，多吃咸味食物，则血脉凝滞而面色改变；多吃苦味食物，则皮肤枯槁而毛发脱落；多吃辛味食物，则筋脉拘急而爪甲干枯；多吃酸味食物，则肌肉增厚（胝）而嘴唇掀揭；多吃甘味食物，则骨痛而头发脱落。这是五味过度所造成的伤害。（这是承接上文来说太过分的危害。五行有相生相制，不可偏废。如果克制太过，又有克贼的危害。因此，多吃咸味，是水味太过而伤心，导致血脉凝滞而面色改变；多吃苦味，是火味太过而伤肺，导致皮肤枯槁而毛发脱落；多吃辛味，是金味太过而伤肝，导致筋脉收缩拘急而爪甲干枯；多吃酸味，是木味太过而伤脾，导致肌肉增厚而嘴唇掀揭；多吃甘味，是土味太过而伤肾，导致骨痛而头发脱落。五味是用来滋养五脏的。脏气有偏胜，则所不胜之脏受伤。这又说明了承制不可太过。）
所以，心喜欢苦味，肺喜欢辛味，肝喜欢酸味，脾喜欢甘味，肾喜欢咸味。这是五味与五脏的配合。（五味入口，藏于肠胃，以滋养五脏之气。所以五味是五脏所喜欢的，如果没有偏胜，津液就能相互成就，神气自然产生。）
五脏之气。（五味藏于肠胃，以滋养五脏之气。五脏内藏五神，五气外现五色。以下论述五脏的经气，以及显示死生的面色，与生于心、生于肺的面色各不相同，所以首先提出“五脏之气”。）
所以，面色呈现青色如死草者死。（“故”字承接上文而言。五脏之气受伤，则出现五行败坏之色。“兹”即蓐席，死草的颜色，青中带白。）黄色如枳实者死。（黄中带青色。）黑色如烟灰者死。（“台”音，烟尘也，黑中带黄。）红色如凝血者死。（“铺杯切”，“ ”指败恶凝聚之血，色赤黑。）白色如枯骨者死。（死白且枯干。）这五种颜色的出现，预示死亡。（五色干枯，且兼有相克之色，所以死。）青色如翠鸟羽毛者生，红色如鸡冠者生，黄色如蟹腹者生，白色如猪油者生，黑色如乌鸦羽毛者生。这五种颜色的出现，预示生存。（五色纯正而有光泽润泽，所以生。）
生于心的面色，像白绢裹着朱砂；生于肺的面色，像白绢裹着红颜色；生于肝的面色，像白绢裹着深青带红的颜色；生于脾的面色，像白绢裹着瓜蒌实；生于肾的面色，像白绢裹着紫色。这是五脏所生的外部荣华。（这里说的是五脏所生的荣华之色，显露于外。上一节讲五脏之气，在外显现五色；这里再次讲藏真之荣，隐约见于皮肤之间，好像被白绢包裹一样。“缟”是素白色，“朱”是深红，“红”是淡白红，“绀”是青扬赤，“栝蒌实”是红黄色，“紫”是赤黑之间的颜色。这些五行之色都兼有红色。因为气主白而荣主红，像被白绢包裹，表示五脏之气包于外；五色都兼有红色，表示五脏之荣隐见于内。上一节讲五脏之气色，这里论述五脏之血色。王子方问：气色有死生之分，血气没有死生之分吗？回答说：外因致病，由气入经，由经入脏；内因致病，由脏入经，由经入气。内外二因都损伤五脏之气才会致死。所以五色出现死象，是因为五脏之气绝了。）
色与味应当对应五脏：白色对应肺和辛味，红色对应心和苦味，青色对应肝和酸味，黄色对应脾和甘味，黑色对应肾和咸味。（“当”意为承接、值遇。谓色味应合于五脏。色在外，味在内。所以说白对应肺辛，意思是辛生肺而肺生白。这再次总结五脏死生的面色，生于五脏之气，五脏的神气生于五味。）
所以，白色对应皮，红色对应脉，青色对应筋，黄色对应肉，黑色对应骨。（肺合皮，心合脉，肝合筋，脾合肉，肾合骨。这里说的生于心、生于肺的面色，承接五脏的相合关系，而显露于外。）
所有经脉，都汇聚于目。（五脏六腑的精气，十二经脉都上行注于目，属于脑，后出于头顶。所以说诸脉皆属于目。这一节论述五脏经气的循行，大概是脏而经，经而气，气而色。头痛巅顶疾病，过错在于足少阴和足太阳经，这是气而经，经而脏。因此这一节与头痛巅疾一节，呼应五脏之气一节；与人卧血归于肝一节，与赤脉之至一节，呼应生于心如以缟裹朱一节。）
所有髓，都归属于脑。（脑是精髓的海。）
所有筋，都归属于节。（节，指骨节。筋生于骨，联系于骨节之间。）
所有血，都归属于心。（血，是神气。中焦的汁液，五脏的精气，奉心神化赤而为血，所以诸血皆属于心。）
所有气，都归属于肺。（上焦开发，宣发五谷的气味，熏肤充身泽毛，像雾露灌溉一样，这叫气。五谷入胃，精气渗入脉中。肺居上焦，朝百脉而输精于皮毛，所以主管周身之气。）
这是四肢八溪的朝夕循环。（四肢，是五脏经俞发出的地方。八溪，即四肢股肱的肉，是五脏元真之气通会的地方。这里说五脏的经血总属于心，五脏的气总属于肺。经气循行于四肢八溪，注入目，汇聚于脑，濡养筋骨，利关节，朝夕循行，内外出入，如环无端。所以善于观察面色的人，应当知道五脏之气；善于诊察脉象的人，应当以五脉为开始。）
所以人睡觉时，血归于肝。（这里再次论述血随卫气行于脉外的情况。血是水谷的精微，流溢于中，布散于外。专精的部分，行于经隧，这是行于经隧的经脉营血。流溢于中的部分，流溢于冲任二脉。冲任起于胞中，上循背里，为经络之海。其中浮而外的部分，沿腹部右上行，布散于外，渗透皮肤，生成毫毛。醒时随卫气行于肤表，睡时随卫气内入而归于肝。所以冲任主发源，而肝主受纳。因此伤寒热入血室，要刺肝的期门穴。“故”字承接上文而言。经脉的血，随营气行于四肢的三阴三阳，昼夜环转；冲任的血，随卫气日行于阳，夜归于阴。）
肝受血而能视。（肝开窍于目，所以肝受血而能视。在明堂见到颜色，是五脏的气色。五脏所生的外部荣华，是血色而见于目。所以说五色的奇脉，是奇经的血色。水谷入胃，津液各走其道。五脏主藏精。五脏的精，化赤而为血，溢于冲任，归受于肝，开窍于目。所以在五脏所生的色，外荣于目，而肝主色。）
足受血而能行走，手掌受血而能握持，手指受血而能摄取。（血，是用来濡养筋骨、利关节的。这里说冲任的血，也循行于四肢，渗透于指掌，无处不到。）
睡觉醒来受到风吹，血凝于皮肤的就成为痹证。（《金匮要略》说：血痹病是怎么得的？老师说：极度疲劳汗出，睡觉时不时动摇，加上微风侵袭，就得了这个病。汗出，是说卫气虚于外。睡时卫气归于阴，出时血行于外，加上风吹，血就凝于皮肤而为痹。痹，就是痹闭而不通畅。这里说卫气留于阴的时间久，不能为血做外在护卫的缘故。）
凝于脉的就成为涩滞。（脉，指见于皮肤的络脉。冲任的血，溢于皮肤，渗于络脉，所以凝于皮肤则为痹，凝于络脉，则涩滞而不能流行。）
凝于足的就成为厥。（厥，是逆冷。阴阳气不相顺接就为厥。下为阴，血为阴。如果血凝于下，则上下阴阳不相顺接而为厥。这里说血随卫气行，而阴阳不相和。诸生起跃说：营卫的循行，经旨似乎矛盾，长久以来被人怀疑。现在老师阐明了它，才知道血随卫气日行于阳，夜行于阴的是皮肤之血。阴经行尽，阳经继之；阳经行尽，阴经继之的，是十二脏腑的经营血。）
这三种情况，血行而不能返回其空窍，所以成为痹和厥。（空，指骨空。骨空，是关节交会处三百六十五穴会，是络脉渗灌各个关节的地方。血行于皮肤，不能反循于穴会，所以成为痹厥。）
人有十二个大谷，三百五十四条小溪，减去十二个俞穴，这些都是卫气停留止息的地方，也是邪气客居的地方。针刺可以沿着这些部位去除邪气。（这里说卫气行于溪谷的情况。溪谷，是分肉的交会处。《气穴论》说：肉的大聚会叫谷，肉的小聚会叫溪。分肉之间，溪谷之会，用来运行营卫，汇聚大气。溪谷三百六十五穴会，也对应一年。人有十二个大谷，是肉的大分处。小溪三百五十四条，是肉的小分处。分，指肉分而有纹理。名，指穴名。大概肉分之间有交会，交会之处有穴名。溪谷的数量，对应一年：岁止三百六十日，扣除朔虚六日，止三百五十四日，对应小溪的数量。减去十二个俞，是说大谷十二分，而有十二个俞穴。气盈五日九百四十分，朔虚五日九百四十分，共计十二日，对应十二俞。以岁之三百五十四日，合气盈朔虚之十二日，共三百六十五日有余，以成一岁。所以日期三百有六旬有六日，以闰月定四时而成年。卫气，行于脉外，温分肉，充皮肤，肥腠理，司开合。这些腠理分肉之间，都是卫气停留止息的地方。睡觉醒来受到风吹，血凝而为痹厥。针刺沿着这些部位去除邪气，是说分肉之间，也有三百六十五个穴位。杨君立问：《气穴论》说气穴三百六十五，以应一岁，现在则是三百六十六了。回答说：岁缘三百六十六日而稍有不足，所以合而论之说三百六十五日。今分而论之，则每岁有三百五十四日，又有气盈朔虚之十二日。）
诊病的开始，以五决为纲纪。想要知道病的开始，先确立其根本。所谓五决，就是五脉。（诊，是视察。始，是说邪气始于三阴三阳之气分。五决，是审别五脏阴阳之经气，以决断疾病。想要知道病之始在某经，先分立五脏为根本，审察邪病在某经之气，某脏之经。五脏之体藏于内，而五脏之经气行于外。所以色见如死草者死，青如翠羽者生，这是五脏死生的经气，发于外而成于色。诊病的开始，以五决为纲纪，是再次说邪之始病在气，气而经，经而脏。）
因此，头痛巅顶疾病，下虚上实，过错在于足少阴和足太阳经，严重则传入肾。（少阴和巨阳，互为表里。阳气生于水脏水腑之中，而上出于巅顶。实是指邪实，虚是指正虚。所以头痛巅疾，是邪气实于上，而使正气虚于下。大概邪气中人，始于皮毛气分，停留不去，则转入于经。所以过错在巨阳少阴之经，严重则入肾。大概经络受邪，则内干脏腑。）
头昏目眩摇动，眼睛失明耳聋，下实上虚，过错在于足少阳和足厥阴经，严重则传入肝。（“ ”和“ ”同义。“蒙”是昏冒，“招”是摇动，“尤”是甚。足少阳厥阴经脉，布胁肋而下循足跗。厥阴肝脏，开窍于目；少阳经脉，上出于耳。邪实于下，而经气不能上通，所以目冥耳聋。正气虚于上，导致动视而昏冒摇掉之甚。这是始伤气而导致正虚于上，过错在经而复邪实于下。上一节论述邪实为病，这里再次论述正虚为病。大概邪之所凑，其正必虚。王子方问：五脏之邪，只说严重则入肾入肝，为什么呢？回答说：邪入于经，则内干脏腑。然而干脏者半死半生，所以说不必动脏。邪入于阴经，其脏气实，则溜于腑。这一章论述五脏三阴三阳之经气，所以说甚则入肾入肝。如果不严重，则或留于经，或溜于腑。所以首提二脏，而不尽言之，是想让后学不可执一而论。）
腹部胀满，胁部支撑胀满，下厥上冒，过错在于足太阴和足阳明经。（腹，是脾胃的外廓。腹满胀，是邪迫于太阴阳明之气分。支，指支络；膈，指内膈。太阴阳明的支络贯膈，气分之邪传入于经，所以连及支膈胁皆胀满。）
咳嗽上气，厥逆在胸中，过错在手阳明和手太阴经。（手太阴主气而主皮毛，邪伤皮毛气分，则咳嗽而气上逆。手太阴之脉，起于中焦，循胃上膈；手阳明之脉，入缺盆，络肺下膈，属肠。邪过在经，所以胸中厥逆。）
心烦头痛，病在膈中，过错在手巨阳和手少阴经。（经文说：心部于表。君火之气，外受于邪，则心烦于内。太阳之气受邪，则头痛于上。手太阳之脉，循咽下膈；手少阴之脉，出属心系，下膈络小肠。病在膈中，是过错在手太阳少阴之经。这一节通过审证而知五脏之病。大概脏腑的经气上下内外，各有部分。所以说诊病的开始，以五决为纲纪。诊，是视察。）
脉的大小滑涩浮沉，可以用手指辨别。五脏的形象，可以类推。五脏的声音，可以用意识感知。五色的细微诊断，可以用眼睛观察。能结合色脉，就可以万全。（这里是通过诊脉察色来知五脏之病。小是正气虚，大是邪气盛。滑主血伤，涩为少气。浮为在外在腑，沉为在里在脏。这六种是脉的提纲，可以用手指辨别。五脏在内，而气象见于外，以五行之理，可类而推之。五脏相合于五音，发而为声，可以用意识感知。视五色之微见，可以用眼睛内察。能审色脉之相应，以辨病之死生，则万全而无失。这与上节审证以决五脉之病，是另一种方法。）
Complexion reflects the changes of Heaven, and pulse reflects the changes of Earth. Heaven governs growth, and Earth governs formation. This chapter lacks question-and-answer format, directly stating that the heart corresponds to the vessels (Mai, blood vessels), seemingly continuing from the previous section on the Yin-Yang of Heaven and Earth, and further explaining the correspondence between complexion and pulse.
Since there is no question-and-answer, it is not called a "Treatise" (Lun).
The heart corresponds to the vessels (Mai, blood vessels), and its flourishing aspect manifests in the complexion. (The Heart governs the blood vessels, hence it corresponds to the vessels. The Classic states: Pulse Qi manifests at the Qi Kou [radial artery], and complexion manifests at the Ming Tang [nose]. The splendor of the Heart is in the face, hence its flourishing aspect is in the complexion.) The organ that controls the Heart is the Kidney. (The Five Zang organs correspond to the Five Elements, each having generating and controlling relationships. Control leads to transformation and generation. The Heart belongs to Fire and is controlled by Kidney Water; thus, the Kidney is the master of the Heart's transformation and generation, hence it is said that the Kidney controls the Heart.) The Lungs correspond to the skin, their flourishing aspect manifests in the hair, and the organ that controls them is the Heart. (The Lungs govern Qi, and Qi governs the exterior, hence they correspond to the skin. The Shanghan Lun states: The Cun Kou pulse is slow and delayed; slow indicates the growth of Yang Qi, the voice is Shang [metallic], and the hair grows long. Hair attaches to the skin; when Qi grows, the hair flourishes.) The Liver corresponds to the tendons, its flourishing aspect manifests in the nails, and the organ that controls it is the Lungs. (Marrow generates the Liver, and the Liver generates the tendons, hence the correspondence is with the tendons. The nails are the surplus of the tendons, hence their flourishing aspect is in the nails.) The Spleen corresponds to the muscles, its flourishing aspect manifests in the lips, and the organ that controls it is the Liver. (The Spleen governs Central Earth, is the official of the granary, and governs the transportation and transformation of the essence of water and grain to nourish the muscles, hence it corresponds to the muscles. The Spleen opens into the mouth, hence its flourishing aspect is in the lips.) The Kidneys correspond to the bones, their flourishing aspect manifests in the hair, and the organ that controls them is the Spleen. (The Kidneys store Essence and govern Marrow, hence the correspondence is with the bones. The hair is the surplus of Essence and Blood, hence its flourishing aspect is in the hair. The Wu Yun Xing Da Lun states: The North generates Cold, Cold generates Water, Water generates Salty, Salty generates the Kidneys, the Kidneys generate Bone Marrow, Marrow generates the Liver, the Liver generates Tendons, Tendons generate the Heart, the Heart generates Blood, Blood generates the Spleen, the Spleen generates Flesh, Flesh generates the Lungs, the Lungs generate Skin and Hair, and Skin and Hair generate the Kidneys. This is Tian Yi generating Water, and the generating relationship among the Five Zang organs. The Liu Wei Zhi Da Lun states: The Yellow Emperor asked: How does geography correspond to the positions of the six Qi? Qibo answered: Below Xiang Huo [Ministerial Fire], Shui Qi [Water Qi] bears it; below Shui Wei [Water Position], Tu Qi [Earth Qi] bears it; below Tu Wei [Earth Position], Feng Qi [Wind Qi] bears it; below Feng Wei [Wind Position], Jin Qi [Metal Qi] bears it; below Jin Wei [Metal Position], Huo Qi [Fire Qi] bears it; below Jun Huo [Ruler's Fire], Yin Jing [Yin Essence] bears it. Excess causes harm, bearing leads to control, and control leads to transformation and generation. Thus, it is said that the Heart corresponds to the vessels and the Lungs correspond to the skin, describing the generating relationship of the Five Zang organs; the Kidney controls the Heart, and the Heart controls the Lungs, describing the complementary relationship of the Five Zang organs. Zhu Jigong said: First Heart, then Lung, then Liver, then Spleen, then Kidney, this returns to emphasizing "formation." The answer was: Yes.)
Therefore, excessive consumption of salty food causes the vessels to coagulate and the complexion to change; excessive consumption of bitter food causes the skin to wither and the hair to fall out; excessive consumption of pungent food causes the tendons to contract and the nails to wither; excessive consumption of sour food causes the flesh to thicken and the lips to peel; excessive consumption of sweet food causes bone pain and hair loss. These are the harms caused by the excess of the five flavors. (This continues the previous text to discuss the harm of excess. The Five Elements have generating and controlling relationships and cannot be neglected. If control is excessive, there is the harm of over-restriction. Therefore, excessive salty food means Water flavor is excessive and injures the Heart, causing vessel coagulation and complexion change; excessive bitter food means Fire flavor is excessive and injures the Lungs, causing skin withering and hair loss; excessive pungent food means Metal flavor is excessive and injures the Liver, causing tendon contraction and nail withering; excessive sour food means Wood flavor is excessive and injures the Spleen, causing flesh thickening and lip peeling; excessive sweet food means Earth flavor is excessive and injures the Kidneys, causing bone pain and hair loss. The five flavors are used to nourish the Five Zang organs. If a Zang organ has an excess, the organ it cannot overcome is injured. This again illustrates that control must not be excessive.)
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 combination of the five flavors and the Five Zang organs. (The five flavors enter the mouth, are stored in the stomach and intestines, and nourish the Qi of the Five Zang organs. Thus, the five flavors are desired by the Five Zang organs. Without excess, Jin Ye [body fluids] can mutually achieve, and Shen [spirit] naturally arises.)
The Qi of the Five Zang organs. (The five flavors are stored in the stomach and intestines to nourish the Qi of the Five Zang organs. The Five Zang organs internally store the Five Shen [spirits], and the Five Qi externally manifest as five colors. The following discusses the Jing Qi [meridian Qi] of the Five Zang organs and the complexions indicating life and death, which differ from those generated by the Heart and Lungs. Hence, it first mentions "the Qi of the Five Zang organs".)
Therefore, if the complexion appears green like dead grass, death ensues. ("Gu" connects to the above text. When the Qi of the Five Zang organs is injured, the defeated colors of the Five Elements appear. "Zi" refers to a mat; the color of dead grass is green with white.) If yellow appears like Zhi Shi (Aurantii Fructus Immaturus), death ensues. (Yellow with a bluish tint.) If black appears like dust/smoke, death ensues. ("Tai" sound, meaning smoke/dust; black with a yellowish tint.) If red appears like clotted blood, death ensues. ("Pu Bei cut", " " refers to foul, coagulated blood; red-black in color.) If white appears like dry bone, death ensues. (Dead white and dry.) The appearance of these five colors indicates death. (The five colors are dry and accompanied by the conquering color, hence death.) If green appears like the feathers of a kingfisher, life ensues; if red appears like a rooster's comb, life ensues; if yellow appears like a crab's belly, life ensues; if white appears like pig fat, life ensues; if black appears like the feathers of a crow, life ensues. The appearance of these five colors indicates life. (The five colors are pure and lustrous, hence life.)
Life generated by the Heart resembles white silk wrapping cinnabar; life generated by the Lungs resembles white silk wrapping red; life generated by the Liver resembles white silk wrapping gan (dark blue-red); life generated by the Spleen resembles white silk wrapping Trichosanthis Fructus; life generated by the Kidneys resembles white silk wrapping purple. These are the external flourishing aspects generated by the Five Zang organs. (This describes the flourishing colors generated by the Five Zang organs manifesting externally. The previous section discussed the Qi of the Five Zang organs manifesting five colors externally; this reiterates the hidden splendor of the Cang Zhen [stored truth], faintly visible between the skin, as if wrapped in white silk. "Gao" is plain white; "Zhu" is deep red; "Hong" is pale red; "Gan" is dark blue-red; "Trichosanthis Fructus" is red-yellow; "Zi" is a mixture of red and black. These five element colors all include red. Since Qi is primarily white and Flourishing is primarily red, being wrapped in white silk signifies the Qi of the Five Zang organs enveloping the exterior; the inclusion of red in all five colors signifies the Flourishing of the Five Zang organs hidden within. The previous section discussed the Qi-color of the Five Zang organs; this discusses the Blood-color of the Five Zang organs. Wang Zifang asked: Do Qi-colors have distinctions of life and death, but Blood-Qi do not? The answer was: External pathogens cause disease progressing from Qi to Meridians to Zang organs; internal pathogens cause disease progressing from Zang organs to Meridians to Qi. Both external and internal factors injure the Qi of the Five Zang organs before death occurs. Thus, the appearance of death in the five colors indicates the exhaustion of the Qi of the Five Zang organs.)
Colors and flavors should correspond to the Five Zang organs: White corresponds to the Lungs and Pungent flavor; Red corresponds to the Heart and Bitter flavor; Green corresponds to the Liver and Sour flavor; Yellow corresponds to the Spleen and Sweet flavor; Black corresponds to the Kidneys and Salty flavor. ("Dang" means to correspond or match. It refers to the correspondence of color and flavor to the Five Zang organs. Color is external, flavor is internal. Thus, it is said White corresponds to Lungs and Pungent, meaning Pungent generates the Lungs and the Lungs generate White. This concludes the discussion on the life and death colors of the Five Zang organs, generated by the Qi of the Five Zang organs, whose Shen Qi [spiritual Qi] is generated by the five flavors.)
Therefore, White corresponds to the Skin, Red to the Vessels, Green to the Tendons, Yellow to the Muscles, and Black to the Bones. (The Lungs correspond to the Skin, the Heart to the Vessels, the Liver to the Tendons, the Spleen to the Muscles, and the Kidneys to the Bones. This describes the colors generated by the Heart and Lungs, continuing from the correspondence of the Five Zang organs and manifesting externally.)
All meridians converge upon the eyes. (The essence of the Five Zang and Six Fu organs, and the twelve regular meridians, all ascend to the eyes, connect to the brain, and emerge from the vertex. Thus, it is said all meridians converge upon the eyes. This section discusses the circulation of the Jing Qi of the Five Zang organs: Zang -> Meridian -> Qi -> Color. Headache and diseases of the vertex, the fault lies in the Foot Shaoyin and Foot Taiyang meridians; this is Qi -> Meridian -> Meridian -> Zang. Thus, this section corresponds to the section on the Qi of the Five Zang organs regarding headache and vertex diseases; the section on "When sleeping, blood returns to the Liver" and the section on "Arrival of Red Pulses" correspond to the section on "Life generated by the Heart resembling white silk wrapping cinnabar".)
All marrow belongs to the brain. (The brain is the sea of essence and marrow.)
All tendons belong to the joints. (Joints refer to bone joints. Tendons are born from bones and connect between bone joints.)
All blood belongs to the Heart. (Blood is Shen Qi. The fluid of the Middle Jiao, the essence of the Five Zang organs, offered to the Heart Spirit to transform into red blood, hence all blood belongs to the Heart.)
All Qi belongs to the Lungs. (The Upper Jiao develops and disseminates, spreading the flavors of grain, warming the skin, filling the body, moistening the hair, like mist and dew irrigation. This is called Qi. Grain enters the stomach, and its refined essence permeates the vessels. The Lungs reside in the Upper Jiao, gather all vessels, and transmit essence to the skin and hair, hence they govern the Qi of the whole body.)
This is the morning and evening circulation of the four limbs and eight streams. (The four limbs are where the Jing-Shu points of the Five Zang organs emerge. The eight streams are the fleshy parts of the thighs and arms, where the Yuan Zhen [original true Qi] of the Five Zang organs converges. Here it is said that the Jing-Blood of the Five Zang organs generally belongs to the Heart, and the Qi of the Five Zang organs generally belongs to the Lungs. Jing Qi circulates through the four limbs and eight streams, pours into the eyes, converges in the brain, nourishes sinews and bones, facilitates joint movement, circulates day and night, entering and exiting internally and externally, like a ring without end. Thus, those skilled in observing complexion should understand the Qi of the Five Zang organs; those skilled in diagnosing pulses should begin with the five pulses.)
Therefore, when a person sleeps, blood returns to the Liver. (This again discusses blood traveling outside the vessels with Wei Qi [defensive Qi]. Blood is the essence of water and grain, flowing within and distributing outward. The concentrated part travels in the Jing Sui [meridian tunnels], which is the Ying Blood [nutritive blood] of the meridians. The part flowing within flows into the Chong and Ren vessels. The Chong and Ren vessels originate in the Bao Zhong [uterus/pelvic center], ascend along the back interior, and serve as the Sea of the Meridians. Their floating and external branches ascend along the right side of the abdomen, distribute outward, penetrate the skin, and generate lanugo. Upon waking, they travel with Wei Qi on the skin surface; upon sleeping, they travel inward with Wei Qi and return to the Liver. Thus, the Chong and Ren vessels govern the origin, and the Liver governs reception. Therefore, in Shanghan syndrome where heat enters the Blood Chamber, the Qimen point of the Liver is needled. "Gu" connects to the above text. The blood of the meridians travels with Ying Qi through the three Yin and three Yang meridians of the four limbs, circulating day and night; the blood of the Chong and Ren vessels travels with Wei Qi during the day in the Yang and returns to the Yin at night.)
The Liver receives blood and enables vision. (The Liver opens into the eyes, so when the Liver receives blood, vision is enabled. Seeing colors at the Ming Tang is the Qi-color of the Five Zang organs. The external flourishing aspect generated by the Five Zang organs is the blood-color manifesting in the eyes. Thus, it is said that the strange pulses of the five colors are the blood-color of the Extraordinary Vessels. When water and grain enter the stomach, Jin Ye [body fluids] take different paths. The Five Zang organs store essence. The essence of the Five Zang organs transforms into red blood, overflows into the Chong and Ren vessels, is received by the Liver, and opens into the eyes. Thus, among the colors generated by the Five Zang organs, they flourish externally in the eyes, and the Liver governs color.)
The feet receive blood and enable walking; the palms receive blood and enabling grasping; the fingers receive blood and enabling holding. (Blood is what nourishes sinews and bones and facilitates joint movement. This says that the blood of the Chong and Ren vessels also circulates through the four limbs, penetrates the fingers and palms, and reaches everywhere.)
Upon waking and being exposed to wind, blood coagulating in the skin becomes Bi [obstruction] syndrome. (The Jin Gui Yao Lue states: From where does Blood Bi disease arise? The Master said: Severe fatigue with sweating, restless sleep, plus slight wind invasion, leads to this condition. Sweating indicates Wei Qi deficiency on the exterior. During sleep, Wei Qi returns to the Yin; upon waking, blood moves to the exterior. With wind exposure, blood coagulates in the skin, becoming Bi. Bi means obstruction and lack of free flow. This describes the situation where Wei Qi remains in the Yin for too long and fails to act as an external guard for the blood.)
Coagulating in the vessels becomes Qi [stagnation/deficiency]. (Vessels here refer to the Luo vessels [collaterals] visible on the skin. The blood of the Chong and Ren vessels overflows into the skin and permeates the Luo vessels; thus, coagulation in the skin becomes Bi, while coagulation in the Luo vessels becomes stagnant and unable to flow freely.)
Coagulating in the feet becomes Jue [reversal/cold extremities]. (Jue means reverse cold. When Yin and Yang Qi do not connect smoothly, it is called Jue. The lower part is Yin, and blood is Yin. If blood coagulates in the lower part, the upper and lower Yin and Yang do not connect smoothly, resulting in Jue. This describes blood traveling with Wei Qi, and the disharmony of Yin and Yang. Zhu Shengqi Yue said: The circulation of Ying and Wei seems contradictory in the Classic, long suspected by people. Now the Master clarifies it, and we realize that the blood traveling with Wei Qi during the day in Yang and at night in Yin is the blood of the skin. After the Yin meridians finish, the Yang meridians follow; after the Yang meridians finish, the Yin meridians follow; this is the Ying blood of the twelve Zang-Fu organs.)
In these three cases, blood flows but cannot return to its empty spaces (acupoints), hence it becomes Bi and Jue. (Kong refers to Gu Kong [bone spaces]. Bone spaces are the 365 junctions of joints where meridians meet, and are where Luo vessels permeate various joints. Blood flows in the skin and cannot return to the junctions, hence it becomes Bi and Jue.)
Humans have twelve major valleys and 354 minor streams, minus twelve Shu points. These are all places where Wei Qi stays and stops, and where pathogenic Qi lodges. Needles and stones [moxibustion/lancets] can remove pathogenic Qi along these pathways. (This discusses the movement of Wei Qi in the Xi Gu [streams and valleys]. Xi Gu are the junctions of muscle partitions. The Qi Kou Lun states: Large gatherings of flesh are called Gu; small gatherings are called Xi. Between muscle partitions, at the junctions of Xi and Gu, Ying and Wei circulate, and Da Qi [great Qi] converges. There are 365 Xi-Gu junctions, corresponding to one year. Humans have twelve major valleys, which are the large divisions of flesh. The 354 minor streams are the small divisions of flesh. Division refers to the texture of muscle partitions. Name refers to acupoint names. Generally, between muscle partitions there are junctions, and at junctions there are acupoint names. The number of Xi-Gu corresponds to one year: A year has 360 days; subtracting the 6 days of Shuo Xu [new moon void], there are 354 days, corresponding to the number of minor streams. Subtracting twelve Shu points means that among the twelve major valleys, there are twelve Shu points. Qi Ying [excess Qi] is 5 days and 940 fen; Shuo Xu is 5 days and 940 fen, totaling 12 days, corresponding to the twelve Shu points. Combining the 354 days of the year with the 12 days of Qi Ying and Shuo Xu totals 365+ days, forming one year. Thus, there are 366 days in a year, using leap months to define the four seasons and form the year. Wei Qi travels outside the vessels, warms the muscle partitions, fills the skin, plumps the Cou Li [pores/skin texture], and controls opening and closing. All these Cou Li and muscle partitions are places where Wei Qi stays and stops. Upon waking and being exposed to wind, blood coagulates, becoming Bi and Jue. Needles and stones removing pathogenic Qi along these pathways means that between the muscle partitions, there are also 365 acupoints. Yang Junli asked: The Qi Kou Lun says there are 365 acupoints to correspond to one year, but now there are 366. The answer was: A year has 366 days but is slightly short, so collectively it is said to be 365 days. Separately, each year has 354 days, plus the 12 days of Qi Ying and Shuo Xu.)
At the beginning of diagnosing disease, the Five Decisions [Wu Jue] are the guideline. To know the beginning, first establish the Mother [root]. The so-called Five Decisions refer to the five pulses. (Diagnosis is observation. Beginning refers to the pathogen initially affecting the Qi division of the Three Yin and Three Yang. The Five Decisions involve examining and distinguishing the Jing Qi of the Yin and Yang of the Five Zang organs to decide the disease. To know where the disease began in a specific meridian, first establish the Five Zang organs as the root, examining which meridian's Qi and which Zang organ's meridian is affected. The physical bodies of the Five Zang organs are stored internally, but their Jing Qi circulates externally. Thus, if the complexion appears like dead grass, death ensues; if green like kingfisher feathers, life ensues. This is the life and death Jing Qi of the Five Zang organs, emerging externally and forming the complexion. At the beginning of diagnosis, the Five Decisions are the guideline, reiterating that the pathogen initially affects Qi, then Meridians, then Zang organs.)
Therefore, headache and vertex diseases, with deficiency below and excess above, the fault lies in the Foot Shaoyin and Foot Taiyang meridians; severe cases enter the Kidneys. (Shaoyin and Taiyang are exterior-interior pairs. Yang Qi is born within the Water Zang and Water Fu organs and ascends to the vertex. Excess refers to pathogenic excess, deficiency refers to healthy Qi deficiency. Thus, headache and vertex diseases are pathogenic excess above and healthy Qi deficiency below. Generally, pathogens enter humans starting from the skin and Qi division, stay and do not depart, then transfer to the meridians. Thus, the fault lies in the Taiyang and Shaoyin meridians, and severe cases enter the Kidneys. Generally, when meridians are affected by pathogens, they internally affect the Zang organs.)
Dizziness and tremors, blindness and deafness, with excess below and deficiency above, the fault lies in the Foot Shaoyang and Foot Jueyin meridians; severe cases enter the Liver. (" " and " " are the same. "Meng" is dizziness/confusion, "Zhao" is trembling, "You" is severity. The Foot Shaoyang and Jueyin meridians distribute along the hypochondrium and descend along the foot dorsum. The Jueyin Liver opens into the eyes; the Shaoyang meridian emerges from the ears. Pathogenic excess below prevents Jing Qi from ascending, causing blindness and deafness. Healthy Qi deficiency above leads to severe visual disturbance, dizziness, and trembling. This is initial Qi injury leading to healthy Qi deficiency above, fault in the meridians, and subsequent pathogenic excess below. The previous section discussed disease due to pathogenic excess; this discusses disease due to healthy Qi deficiency. Generally, where pathogenic Qi gathers, healthy Qi must be deficient. Wang Zifang asked: Regarding pathogenic Qi of the Five Zang organs, why only mention severe cases entering the Kidneys and Liver? The answer was: Pathogens entering the meridians internally affect the Zang organs. However, affecting the Zang organs results in half-life half-death, hence it is said "no need to move the Zang organs." Pathogens entering Yin meridians, if the Zang Qi is solid, slip into the Fu organs. This chapter discusses the Jing Qi of the Five Zang and Three Yin Three Yang meridians, hence it says severe cases enter the Kidneys and Liver. If not severe, they either remain in the meridians or slip into the Fu organs. Thus, mentioning only two Zang organs at the beginning, without exhaustive explanation, is to prevent students from taking a rigid view.)
Abdominal fullness and distension, support and obstruction in the chest and hypochondrium, reversal below and冒 (mao, covering/obscuring) above, the fault lies in the Foot Taiyin and Foot Yangming meridians. (The abdomen is the outer wall of the Spleen and Stomach. Abdominal fullness and distension indicate pathogens pressing on the Qi division of Taiyin and Yangming. Zhi refers to collateral branches; Ge refers to internal diaphragm. The collaterals of Taiyin and Yangming pierce the diaphragm; when Qi-division pathogens transfer to the meridians, they involve the Zhi Ge and hypochondrium, causing fullness.)
Cough and rebellious Qi, Jue [reversal] in the chest, the fault lies in the Hand Yangming and Hand Taiyin meridians. (Hand Taiyin governs Qi and the skin/hair. When pathogens injure the skin/hair Qi division, cough and rebellious Qi occur. The Hand Taiyin meridian originates in the Middle Jiao, follows the stomach, and ascends through the diaphragm. The Hand Yangming meridian enters the supraclavicular fossa, connects to the Lungs, descends through the diaphragm, and belongs to the Large Intestine. When pathogens affect the meridians, Jue reversal occurs in the chest.)
Heart vexation and headache, disease in the Di Zhong [diaphragm region], the fault lies in the Hand Taiyang and Hand Shaoyin meridians. (The Classic states: The Heart distributes to the exterior. When the Ruler's Fire Qi is externally affected by pathogens, heart vexation occurs internally. When Taiyang Qi is affected by pathogens, headache occurs superiorly. The Hand Taiyang meridian follows the throat and descends through the diaphragm. The Hand Shaoyin meridian exits and connects to the Heart system, descends through the diaphragm, and connects to the Small Intestine. Disease in the Di Zhong indicates the fault lies in the Hand Taiyang and Shaoyin meridians. This section determines Zang organ diseases by examining symptoms. Generally, the Jing Qi of Zang and Fu organs has specific distributions in the upper/lower and internal/external. Hence, it is said: At the beginning of diagnosis, the Five Decisions are the guideline. Diagnosis is observation.)
The size, slipperiness, roughness, floating, and sinking of the pulse can be distinguished by finger. The images of the Five Zang organs can be inferred by analogy. The tones of the Five Zang organs can be perceived by consciousness. The subtle diagnosis of the five colors can be observed by eye. Combining color and pulse ensures complete accuracy. (This uses pulse diagnosis and complexion observation to know diseases of the Five Zang organs. Small indicates healthy Qi deficiency; large indicates pathogenic excess. Slippery mainly indicates blood injury; rough indicates Qi deficiency. Floating indicates exterior/Fu organs; sinking indicates interior/Zang organs. These six are the outlines of the pulse, distinguishable by finger. The Five Zang organs are internal, but their phenomena manifest externally; by the principles of the Five Elements, they can be inferred by analogy. The Five Zang organs correspond to the five tones, emitting sounds, which can be perceived by consciousness. Observing the subtle manifestations of the five colors can be done by internal observation with the eyes. By examining the correspondence of color and pulse to distinguish life and death in disease, one achieves completeness without error. This is another method compared to the previous section determining five-pulse diseases by symptom examination.)
The arrival of red pulses is rapid and firm; diagnosis indicates accumulation of Qi in the middle, occasionally hindering food intake, named Xin Bi [Heart Obstruction], acquired from external illness, due to overthinking and Heart deficiency.