岐伯录上编藏象之义，复论五脏之生成也。天主生，地主成，五脏之色征于外，天气之所主也。五脏
之脉行于内，地气之所主也，色者气所附，脉者味所归，合色脉气味而五脏之生成备矣。
心之合脉也，其荣色也，其主肾也。
岐伯录上编藏象之义，复论五脏之生成，五脏各有外合，脉者心之外合，故心之合脉也，五脏各有外荣，
色者，心之外荣，故其荣色也，五脏各有所主，肾者，心之主，故其主肾也，外合外荣者，脏之成，主者，脏
之生，五行之理，制而后生，主者生之谓也，火受水制，则水有余，而木气旺，木旺则生火，制之乃所以
生之，心肺肝脾肾之次序，亦制生之意也。
肺之合皮也，其荣毛也，其主心也。
皮者肺之外合，故肺之合皮也，毛者肺之外荣，故其荣毛也，心者，肺之主，故其主心也，金受火制，
则火有余，而土气旺，土旺则生金矣。
肝之合筋也，其荣爪也，其主肺也。
筋者，肝之外合，故肝之合筋也，爪者，肝之外荣，故其荣爪也，肺者，肝之主，故其主肺也，木受
金制，则金有余，而水气旺，水旺则生木矣。
脾之合肉也，其荣唇也，其主肝也。
肉者，脾之外合，故脾之合肉也，唇者，脾之外荣，故其荣唇也，肝者，脾之主，故其主肝也，
土受木制，则木有余，而火气旺，火旺则生土矣。
肾之合骨也，其荣发也，其主脾也。
骨者，肾之外合，故肾之合骨也，发者，肾之外荣，故其荣发也，脾者，肾之主，故其主脾也，木
受土制，则土有余，而金气旺，金旺则生水矣。
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KT 而唇揭，多食甘，则骨痛而发落，此五味之所伤也。
泣作涩，下同。胝音支。制之乃所以生之，然未生之先，则有所伤，是故多食咸，则肾气太过，太过
则心合之脉凝涩，而心荣之色变矣，多食苦，则心气太过，太过则肺合之皮槁，而肺荣之毛拔
矣，多食辛，则肺气太过，太过则肝合之筋急，而肝荣之爪枯矣，多食酸，则肝气太过，太过则脾合之
肉胝KT ，而脾荣之唇揭矣，多食甘，则脾气太过，太过则肾合之骨痛，而肾荣之发落矣，此五行
相制，制而未生，乃五味之所伤也。
故心欲苦，肺欲辛，肝欲酸，脾欲甘，肾欲咸，此五味之所合也。
多食则伤，适可则合，故心欲苦，肺欲辛，肝欲酸，脾欲甘，肾欲咸，此五味之所以合于五脏也，由
此观之，五脏不但合脉皮筋肉骨，而且合于五味也。
五脏之气，故色见青如草兹者，死，黄如枳实者，死。黑如 者，死。赤如 血者，死。白
如枯骨者，死。此五色之见死也。
，音台。余篇同。 ，音胚。有五脏之味，则有五脏之色，相生则生荣，见克则败死。五脏之色，
即五脏之气也，五脏之气，以色验之，草兹，死草之色，青兼白也，故色见青如草兹者死，肝
气败也，枳实黄色兼青，故黄如枳实者死，脾气败也。 ，烟尘也，尘色黑兼黄，故黑如 者死，肾气
败也。 血凝聚之血，赤兼黑
也，故赤如 血者死，心气败也。枯骨，枯朽之骨，白兼青也，故
白如枯骨者死，肺气败也。此五色之见克而死也。
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。
此举五色之正，光润华采，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，加以缟裹紫。此五脏所生之外荣也。
缟，素白也。五色之生，精华五内，更有含蓄，皆如缟裹，则内光华，外润泽，故曰此五脏之所生之
外荣也，由此观之，五脏不但荣于色毛爪唇发，而且荣于面之五色也。
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。故白当皮，赤当脉，青
当筋，黄当肉，黑当骨。
合五色五味而总论之，则色味当五脏，白色当肺脏，其味辛。赤色当心脏，其味苦。青色当肝脏，
其味酸。黄色当脾脏，其味甘。黑色当肾脏，其味咸。夫五脏藏于内，外合合于外，五色当五脏，
必于外合当之，故白当皮，皮者肺之合。赤当脉，脉者心之合。青当筋，筋者肝之合。黄当肉，肉者脾之合。
黑当骨，骨者肾之合。
此一节，论五脏之生成，而推展五脏之外合外荣也。
诸脉者皆属于目。
五脏在内，气行周身，诸脉者，周身血气循行之脉道也。五脏精华，上注于目，故诸脉者，皆属于目。
诸髓者皆属于脑。
诸髓者，周身血气凝聚之精髓也，脑为髓海，故诸髓者，皆属于脑。
诸筋者皆属于节。
诸筋者，周身血气贯通之筋路也。筋连于节，能屈能伸，故诸筋者，皆属于节。
诸血者皆属于心。
诸血者，周身经络内外之血也。心为君主，奉心化赤，故诸血者，皆属于心。
诸气者皆属于肺。
诸气者，周身荣卫外内之气也，肺为脏长，受朝百脉，故诸气者皆属于肺。
此四肢八溪之朝夕也。
四肢者两手两足，八溪者，两肘，两臂、两 、两髀，凡此血气周时环转，朝夕出入，故为四肢八溪
之朝夕也。
故人卧，血归于肝。
人之朝夕，即天之昼夜，天昼明夜晦，人朝精夕暝，朝则血外行，夕则血内藏，故人卧则血归于肝，盖
冲任之血，外行则淡渗皮肤，内入则归肝脏也。
肝受血而能视，足受血而能步，掌受血而能握，指受血而能摄。卧出而风吹之，血凝于肤者，为痹。
凝于脉者，为泣。凝于足者，为厥。此三者，血行而不得反其空，故为痹厥也。
冲任之血，上行头目，偏达四肢，故肝受血而目能视，足受血而足能步，掌受血而掌能握。指受血而指
能摄，其血不但上行头目，遍达四肢，且外充皮肤，内荣经脉，下行足之三阴，故举邪风凝之
于肤，凝于脉，凝于足以明之。人之卧也，必居户内，若卧出而风吹之，其冲任之血，外凝于肤表，则为
痹，痹，转动不利也。内凝于经脉则为涩，涩，涩滞不通也。下凝于足之三明，则为厥，厥，阴阳不相顺接
而逆冷也。此凝于肤、凝于脉、凝于足，三者乃血外行而不得内反其骨空，故为痹以及于厥也。
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。
《气穴论》曰，肉之大会为谷，肉之小会为溪，盖会之所在，即分之所在，故人有大谷十二分。凡会
之处，各有穴名，故小溪三百五十四名。气穴论凡三百六十六穴，今三百五十四名，尚少十二
俞。少十二俞即大谷十二分是也。凡此皆血气之循行，今血行而不
得反其空，此皆卫气之所留止。卫气留止，即邪气之所客也。邪气所客，必籍针石缘而去之，缘，因也，
因此针石，去其病也。此一节承上文外合外荣，言血气遍行通体，留止不行，则为病也。
诊病之始，五决为纪，欲知其始，先建其母，所谓五决者，五脉也。
五脏之病，贵乎能诊，诊病之始，当有五决以为之纪，所谓诊病之始者，乃欲知其始，当先建其
母，母，病本也，所谓五决为纪者，即以五脏之经脉而决之也。
是以头痛巅疾，下虚上实，过在足少阴巨阳，甚则入肾。
巨阳，太阳也，足太阳之脉，上额交巅，下属膀胱，络肾脏，是以头痛巅疾，足巨阳经脉病也，下虚
者，膀胱之气虚于下，上实者，头痛巅疾，实于上也，巨阳主表，少阴主里，故受病之，过在足少阴，巨阳，
病不能愈，必从经脉而入脏，故甚则入肾。
徇蒙招尤，目冥耳聋，下实上虚，过在足少阳厥阴，甚则入肝。
徇作 ，冥瞑同。 ，瞬视也，蒙，不明也，招，掉摇也。尤，甚也。足少阳之脉，起于目锐 ，从
耳后入耳中，出走耳前， 蒙而掉摇且甚。经脉虚而风气胜也。目瞑耳聋者，起于目，入于
耳也，上文头痛为上实，此蒙招为上虚，故曰下实上虚、言胆木之邪实于下少阳经脉虚于上也。少阳为表，
厥阴为里，故受病之过，在足少阳厥阴，设病不愈，必从经脉而入脏，故甚则入肝。
腹满 胀，支膈 胁，下厥上冒，过在足太阴阳明。
腹者，脾之部也，腹满 胀，脾土病也，支膈 胁者，《灵枢·经脉》论云，脾足太阴之脉，其支其，复
从胃，别上膈，谓 胀上连支膈，旁连 胁也，下厥上冒者，太阴脾气不升，则下厥，阳
明胃气不降，则上冒，阳明太阴，相为表里，故过在足太阴阳明，脾脏先病，故不言甚则入脾。
咳嗽上气，厥在胸中，过在手阳明太阴。
咳嗽上气，肺病也。厥在胸中者，经脉论云，肺手太阴之脉，
起于中焦，下络大肠，脏腑不和，故厥在胸，其受病之过，在手阳明太阴。肺脏先病，故不言甚则入肺。
心烦头痛，病在膈中，过在手巨阳少阴。
心烦头痛，心病也。病在膈中者，经脉论云，心手少阴之脉，下膈，络小肠，脏腑不和，故病在膈中，
其受病之过，在手巨阳少阴。心脏先病，故不言甚则入心。此论诊病之始。五决为纪，而及
于五脏五腑，故不言手少阳厥阴也。
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，可以音识，五色微诊，可以
目察。能合色脉，可以万全。
别，音逼。脉有阴阳，大为阳，小为阴，滑为阳，涩为阴，浮为阳，沉为阴。夫脉之大小滑涩浮沉，
可以指按而别之。脉之阴阳，内合五脏，五脏阴阳之脉象，亦可以大小滑涩浮沉而类推之。
如浮大为心肺，沉涩为肝肾，滑为脾脉者是也。五脏合五行，五音五色亦可以微诊，可以目察。能合色脉而
共诊之，可以万全。色脉共诊，有如下文所云也。
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，故邪从之。
赤，心色也，赤脉，合色脉以为诊也。喘而坚，脉体急疾而牢实也，诊其色脉如是，则曰有积气在中，
时害于食而不能食，病名曰心痹。心痹，心气闭而不舒也。盖积气非心脏之本病，故得之外
疾，乃思虑而心虚，故邪从之而致心痹也。
白脉之至也，喘而浮，上虚下实，惊，有积气在胸中，喘而虚，名曰肺痹。寒热，得之醉，而使内也。
白，肺色也，白脉，合色脉以为诊也。喘而浮，脉体急疾而上浮也，上虚下实，言脉喘而浮，则有上虚
下实之病。惊，上虚病也。有积气在胸中，下实病也。又曰喘而虚者，言脉喘而浮，则喘而虚也。此病名曰
肺痹，而有皮毛之寒热，盖惊积，非肺脏之本病，故得之醉，而使邪气之内入也。
青脉之至也，长而左右弹，有积气在心下支 ，名曰肝痹，得
之寒湿，与疝同法，腰疼足清头痛。
弹平声。青，肝色也，青脉，合色脉以为诊也，长而左右弹，脉体有余，左右两手之脉，如弦之弹
指也。此有积气在心下支 ，心下，膈也、支 ，左右胁肋，乃肝脉之循行也，故病名曰肝痹，盖积气非肝脏
之本病，故得之外感寒湿，疝病本于寒湿，故与疝同法，寒湿为病，则腰痛足清头痛，而致肝脏之病也，
黄脉之至也，大而虚，有积气在腹中，有厥气，名曰厥疝，女子同法，得之疾，使四肢汗出当风。
黄，脾色也，黄脉，合色脉以为诊也，大而虚，脉体张大而空虚也，此有积气在腹中，腹中，脾部也，
有厥气，乃土受木克，土气厥逆而不达也，土受木克，故不名曰脾痹，名曰厥疝。疝，肝病也。女子同法
者，女子无疝。肝木乘脾之法，则同也。夫厥疝非脾脏之本病，故得之疾，犹言得之外疾，使四肢汗出当风，
以致脾脏之病也。
黑脉之至也，上坚而大，有积气在小腹与阴。名曰肾痹。得之沐浴清水，而卧。
黑，肾色也。黑脉，合色脉以为诊也。上坚而大，坚大之脉，上浮而不沉也，此有积气在小腹与阴。
小腹者，肾之部，前阴者，肾之窍，故病名曰肾痹。夫积气非肾脏之本病，故得之沐浴于清水
中，水气未散，而即卧之所致也，此以五脏色脉，诊五脏之病，如是以诊，可以万全矣。
凡相五色之奇脉，面黄目青，面黄目赤、面黄目白，面黄目黑者，皆不死也。
相，去声。奇，音箕。奇，阳也。以色为脉，故曰奇脉。凡相五色之奇脉，但以目视，不必手诊。
目青目赤目白目黑，皆有面黄中土之色，是有胃气，故皆不死。
面青目赤，面赤目白、面青目黑，面黑目白，面赤目青，皆死也。
面无中土之黄色，若面青面赤面黑而兼目赤目白目黑目青，皆
死也。既曰面青目赤，又曰面青目黑者，言面青目赤为不宜，面青目黑亦不宜。引而伸之，青白皆不宜也，
既曰面赤目白，又曰面赤目青者，言面赤目白为不宜，面赤目青亦不宜。引而伸之，赤黑皆不宜也。夫面青
面赤如是，则面白面黑皆如是，此书不尽言，言不尽意，所以申明面无中土之黄色，则死，是以色脉而
知其死生也。此一节言诊色脉而知五脏之病，及于死生，以终五脏生成之义。
岐伯记录了上编关于藏象的理论，又进一步论述五脏的生成原理。天主管生命的起源，地主管形体的成就。五脏的颜色反映在体表，这是天气所主宰的；五脏的脉象运行于体内，这是地气所主宰的。颜色依附于气，脉象归源于味，综合观察色、脉、气、味，五脏生成的规律就完备了。
心与脉相合，其荣华表现在面色，其制约者是肾。
岐伯记录上编藏象的意义，再次论述五脏的生成。五脏各有外在的对应关系：脉是心的外在对应，所以说“心之合脉”；五脏各有外在的荣华表现，色是心的外在荣华，所以说“其荣色”；五脏各有所制约者，肾制约心，所以说“其主肾”。外在的对应和外在的荣华，代表脏腑的“成”（形体结构）；制约者，代表脏腑的“生”（功能生机）。五行的道理是，先有制约而后有生发，“主”即是生的意思。火受到水的制约，则水气有余，进而木气旺盛；木气旺盛则能生火，制约正是为了生发。心肺肝脾肾的次序，也体现了这种制与生的含义。
肺与皮相合，其荣华表现在毫毛，其制约者是心。
皮是肺的外在对应，所以“肺之合皮”；毫毛是肺的外在荣华，所以“其荣毛”；心制约肺，所以“其主心”。金（肺）受到火（心）的制约，则火气有余，进而生土气旺盛；土气旺盛则能生金。
肝与筋相合，其荣华表现在爪甲，其制约者是肺。
筋是肝的外在对应，所以“肝之合筋”；爪甲是肝的外在荣华，所以“其荣爪”；肺制约肝，所以“其主肺”。木（肝）受到金（肺）的制约，则金气有余，进而生水气旺盛；水气旺盛则能生木。
脾与肉相合，其荣华表现在口唇，其制约者是肝。
肉是脾的外在对应，所以“脾之合肉”；口唇是脾的外在荣华，所以“其荣唇”；肝制约脾，所以“其主肝”。土（脾）受到木（肝）的制约，则木气有余，进而生火气旺盛；火气旺盛则能生土。
肾与骨相合，其荣华表现在头发，其制约者是脾。
骨是肾的外在对应，所以“肾之合骨”；头发是肾的外在荣华，所以“其荣发”；脾制约肾，所以“其主脾”。木（肝）受到土（脾）的制约，则土气有余，进而生金气旺盛；金气旺盛则能生水。
因此，多吃咸味食物，会导致血脉凝滞涩结而面色改变；多吃苦味食物，会导致皮肤干枯而毫毛脱落；多吃辛味食物，会导致筋脉拘急而爪甲枯槁；多吃酸味食物，会导致肌肉增厚粗糙（胝疀）而口唇翻揭；多吃甘味食物，会导致骨骼疼痛而头发脱落。这是五味过度食用所造成的伤害。
（注：“泣”通“涩”，意为涩滞。“胝”音zhī，指老茧或皮肤增厚；“KT”为古籍排版异体字，此处指皮肤增厚粗糙如茧。）
五行之间的制约，在尚未产生相生作用之前，如果过度克制，就会造成伤害。因此，多吃咸味，肾气就会太过，太过则克制心，导致心所主的血脉凝滞涩结，心所主的色泽发生改变；多吃苦味，心气就会太过，太过则克制肺，导致肺所主的皮肤干枯，肺所主的毫毛脱落；多吃辛味，肺气就会太过，太过则克制肝，导致肝所主的筋脉拘急，肝所主的爪甲枯槁；多吃酸味，肝气就会太过，太过则克制脾，导致脾所主的肌肉增厚粗糙，脾所主的口唇翻揭；多吃甘味，脾气就会太过，太过则克制肾，导致肾所主的骨骼疼痛，肾所主的头发脱落。这就是五行相制，因制约而未得生发，从而导致五味伤害人体的道理。
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，这是五味与五脏的对应关系。
食用过多会伤害身体，适量则符合生理需求。所以心欲苦，肺欲辛，肝欲酸，脾欲甘，肾欲咸，这就是五味之所以与五脏相合的原因。由此看来，五脏不仅与脉、皮、筋、肉、骨相合，还与五味相合。
五脏之气显现于面色，如果青色像死草那样枯暗，主死；黄色像枳实那样晦暗，主死；黑色像烟灰那样黯淡，主死；红色像凝血那样紫黑，主死；白色像枯骨那样苍白无泽，主死。这是五色呈现死亡预兆的情况。
（注：“ ”音tái，指尘埃/烟尘；“ ”音pēi，指血块。）
有了五脏的味道，就有五脏的颜色。相生则生机勃勃，被克则败坏致死。五脏的颜色，就是五脏之气的体现。通过颜色来验证五脏之气：死草的颜色是青中带白，所以青色像死草的主死，这是肝气败坏的表现；枳实的颜色是黄中带青，所以黄色像枳实的主死，这是脾气败坏的表现；烟尘的颜色是黑中带黄，所以黑色像烟尘的主死，这是肾气败坏的表现；凝聚的血块是赤中带黑，所以红色像凝血的主死，这是心气败坏的表现；枯朽的骨头是白中带青，所以白色像枯骨的主死，这是肺气败坏的表现。这是五色因受克而呈现死亡预兆的情况。
青色像翠鸟羽毛那样光亮润泽，主生；红色像鸡冠那样鲜艳红润，主生；黄色像蟹腹那样明润黄亮，主生；白色像猪油那样洁白滋润，主生；黑色像乌鸦羽毛那样黑亮有神，主生。这是五色呈现生机预兆的情况。
这里列举的是五色的正色，具有光泽、润泽和华彩，所以主生。
心脏的生旺之色，好像白绢包裹着朱砂；肺脏的生旺之色，好像白绢包裹着红石脂；肝脏的生旺之色，好像白绢包裹着青丝织品；脾脏的生旺之色，好像白绢包裹着瓜蒌果实；肾脏的生旺之色，好像白绢包裹着紫色物体。这是五脏所生发的外在荣华表现。
缟，即素白色的丝绸。五色的生机，蕴含五脏精华，更有含蓄内敛之意，都像被白绢包裹一样，内部光华外露，外部润泽，所以说是五脏所生发的外在荣华。由此看来，五脏不仅在色、毛、爪、唇、发上表现荣华，而且在面部的五色上也表现荣华。
颜色和味道应当对应五脏：白色对应肺和辛味，赤色对应心和苦味，青色对应肝和酸味，黄色对应脾和甘味，黑色对应肾和咸味。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。
综合五色和五味总论，颜色味道对应五脏：白色对应肺脏，其味为辛；赤色对应心脏，其味为苦；青色对应肝脏，其味为酸；黄色对应脾脏，其味为甘；黑色对应肾脏，其味为咸。五脏藏于体内，外在对应体表组织。五色对应五脏，必须通过外在对应组织来印证，所以白色对应皮，皮是肺的对应；赤色对应脉，脉是心的对应；青色对应筋，筋是肝的对应；黄色对应肉，肉是脾的对应；黑色对应骨，骨是肾的对应。
这一节论述五脏的生成，并推展五脏的外在对应和外在荣华。
所有的脉道都汇聚于目。
五脏在体内，气行遍全身。所谓的“诸脉”，是周身气血运行的脉道。五脏的精华向上灌注于眼睛，所以所有的脉道都归属于目。
所有的髓都归属于脑。
所谓的“诸髓”，是周身气血凝聚而成的精髓。脑为髓海，所以所有的髓都归属于脑。
所有的筋都归属于关节。
所谓的“诸筋”，是周身气血贯通的筋络。筋连接于关节，能够屈伸运动，所以所有的筋都归属于关节。
所有的血都归属于心。
所谓的“诸血”，是周身经络内外的血液。心为君主之官，奉心化赤（将营气转化为血液），所以所有的血都归属于心。
所有的气都归属于肺。
所谓的“诸气”，是周身营卫内外之气。肺为脏之长，接受百脉朝会，所以所有的气都归属于肺。
这就是四肢和八溪气血朝夕循环的道理。
四肢指双手双足，八溪指两肘、两腋、两髀（大腿根部）、两髎（此处原文可能有误，通常指膝窝等凹陷处，高士宗注为两臂、两髀等，依原文译作两臂、两髀等关键部位）。凡此气血周流环转，早晚出入循环，所以称为四肢八溪的朝夕循环。
所以人躺下睡觉时，血液回归肝脏。
人的昼夜循环即天的昼夜。天白天明亮夜晚昏暗，人早晨精神清醒傍晚困倦。早晨气血外行，傍晚气血内藏。所以人躺下睡觉时，血液回归肝脏。因为冲脉和任脉的血液，外行则淡渗于皮肤，内入则归藏于肝脏。
肝得到血液滋养就能视物，脚得到血液滋养就能行走，手掌得到血液滋养就能握持，手指得到血液滋养就能摄取。如果睡醒后外出被风吹袭，血液凝结在皮肤，就会形成痹证；凝结在脉道，就会形成涩滞不通；凝结在足部，就会形成厥逆。这三种情况，都是血液运行而不能返回其空窍（骨空/脉道），所以形成痹证和厥证。
冲任的血液，上行至头目，偏达四肢。所以肝得到血液，眼睛就能视物；脚得到血液，脚就能行走；手掌得到血液，手掌就能握持；手指得到血液，手指就能摄取。这些血液不仅上行头目、遍达四肢，而且外充皮肤、内荣经脉，下行至足三阴经。所以举例说明邪风凝结于皮肤、脉道、足部以阐明此理。人睡觉时，一定在屋内居住，如果睡醒外出被风吹袭，冲任的血液外凝于肤表，就形成痹证，痹证表现为转动不利；内凝于经脉就形成涩滞，涩滞表现为涩滞不通；下凝于足部就形成厥逆，厥逆表现为阴阳不相顺接而逆冷。这三种凝结于肤、脉、足的情况，乃是血液外行而不能内返其骨空，所以形成痹证以及厥证。
人体有大谷十二处，小溪三百五十四处，减去十二俞穴，这些都是卫气停留止聚的地方，也是邪气客居的地方。针刺砭石可以顺着经络祛除邪气。
《气穴论》说，肌肉的大交会处称为谷，肌肉的小交会处称为溪。大概交会的所在，就是分界的所在，所以人体有大谷十二处。凡是交会之处，都有穴位名称，所以有小溪三百五十四处。《气穴论》记载共有三百六十六个穴位，现在只有三百五十四处，还缺少十二个俞穴。缺少的十二个俞穴即是大谷十二处。凡是这些部位都是气血循行的地方，如果血行不能返回其空窍，这些部位就是卫气停留止聚的地方。卫气停留止聚，也就是邪气客居的地方。邪气客居，必须借助针石顺着经络将其祛除。“缘”意为顺着、依据，即依据此经络使用针石去除疾病。这一节承接上文的外合外荣，说明气血遍行通体，如果停留不行，就会生病。
诊断疾病的开始，以五脏脉象决断为纲纪。想要知道疾病的起始，先要确立病本。所谓“五决”，是指五脏的脉象。
五脏的疾病，贵在能够诊断。诊断疾病的开始，应当有五决作为纲纪。所谓诊断疾病的开始，就是想要知道疾病的起始，应当先确立病本。“母”即病本。所谓“五决为纪”，就是以五脏的经脉来进行决断。
因此，头痛巅顶疾病，属于下虚上实，病变在于足少阴肾经和足太阳膀胱经，严重时病邪入肾。
巨阳即太阳。足太阳膀胱经的脉气，上行至额部交会于巅顶，下属膀胱，联络肾脏。所以头痛巅顶疾病，是足太阳经脉的病。下虚，指膀胱之气虚于下；上实，指头痛巅顶之邪实于上。巨阳主表，少阴主里，所以受病的经过，在于足少阴和足太阳。如果病不能痊愈，必然从经脉传入内脏，所以严重时入肾。
头晕眼花，摇动不定，视物不明，耳聋，属于下实上虚，病变在于足少阳胆经和足厥阴肝经，严重时病邪入肝。
“徇”同“眩”，眨眼视物貌；“蒙”，视物不明；“招”，掉摇；“尤”，甚也。足少阳胆经的脉气，起于目锐眦，从耳后入耳中，出走耳前。出现眩晕、掉摇且严重，是经脉虚而风气胜。视物不明、耳聋，是因为经脉起于目、入于耳。上文头痛为上实，此处眩晕为上虚，所以说下实上虚，指胆木之邪实于下，少阳经脉虚于上。少阳为表，厥阴为里，所以受病的经过，在于足少阳和足厥阴。如果病不愈，必然从经脉传入内脏，所以严重时入肝。
腹部胀满，胁肋支撑不适，下部厥冷上部昏冒，病变在于足太阴脾经和足阳明胃经。
腹部是脾的所属部位。腹满胀，是脾土有病。支撑膈部、连及胁肋，《灵枢·经脉》论说：足太阴脾经的支脉，复从胃别上膈。指胀满上连支撑膈部，旁连胁肋。下部厥冷上部昏冒，太阴脾气不升则下部厥冷，阳明胃气不降则上部昏冒。阳明和太阴互为表里，所以病变在于足太阴和足阳明。脾脏先病，所以不说“甚则入脾”。
咳嗽气逆，气厥在胸中，病变在于手阳明大肠经和手太阴肺经。
咳嗽气逆，是肺病。气厥在胸中，《经脉论》说：手太阴肺经起于中焦，下络大肠。脏腑不和，所以气厥在胸中。其受病的经过，在于手阳明和手太阴。肺脏先病，所以不说“甚则入肺”。
心烦头痛，病位在膈中，病变在于手太阳小肠经和手少阴心经。
心烦头痛，是心病。病在膈中，《经脉论》说：手少阴心经下膈，络小肠。脏腑不和，所以病在膈中。其受病的经过，在于手太阳和手少阴。心脏先病，所以不说“甚则入心”。这一段论述诊断疾病的开始，以五决为纲纪，涉及五脏五腑，所以没有提及手少阳和三焦、足厥阴肝经（因前文已述）。
脉的大小、滑涩、浮沉，可以用手指辨别；五脏的征象，可以类推；五脏对应的声音，可以通过听音识别；五色的细微变化，可以用眼睛观察。能将色脉结合诊察，就可以万无一失。
“别”音bié。脉有阴阳，大为阳，小为阴，滑为阳，涩为阴，浮为阳，沉为阴。脉的大小、滑涩、浮沉，可以用手指按压来辨别。脉的阴阳，内合五脏，五脏阴阳的脉象，也可以通过大小、滑涩、浮沉来类推。例如浮大脉对应心肺，沉涩脉对应肝肾，滑脉对应脾脉等。五脏合五行，五音五色也可以微细诊察，用眼睛观察。能将色脉结合共同诊察，就可以万无一失。色脉共诊，有如下文所述。
赤色的脉象到来时，急促而坚实，诊断为：中有积气，时常妨碍饮食，名叫心痹。这是由于外感邪气，加上思虑过度导致心虚，所以邪气随之而入。
赤是心色。赤脉，是结合颜色和脉象进行诊断。急促而坚实，指脉体急疾而牢实。诊察其色脉如此，就说中有积气，时常妨碍饮食而不能食，病名叫做心痹。心痹，指心气闭阻而不舒展。积聚之气并非心脏的本病，所以得自外感邪气，是由于思虑过度导致心虚，所以邪气随之而入导致心痹。
白色的脉象到来时，急促而浮，表现为上虚下实，易惊，胸中有积气，脉喘而虚，名叫肺痹。伴有寒热症状，这是由于醉酒后进行房事所致。
白是肺色。白脉，是结合颜色和脉象进行诊断。急促而浮，指脉体急疾而上浮。上虚下实，指脉象急促而浮，则有上虚下实的病机。惊，是上虚的病证。胸中有积气，是下实的病证。又说“喘而虚”，指脉象急促而浮，则表现为喘而虚。此病名叫肺痹，并伴有皮毛的寒热。惊和积气并非肺脏的本病，所以得自醉酒，使邪气内入。
青色的脉象到来时，脉长而左右弹指，有心下支撑胀满的感觉，名叫肝痹。这是由于感受寒湿，治疗方法与疝病相同，伴有腰痛、足冷、头痛。
“弹”读平声。青是肝色。青脉，是结合颜色和脉象进行诊断。长而左右弹指，指脉体有余，左右两手之脉，像琴弦弹指一样。这表示有心下支撑胀满，心下即膈部，支撑胀满指左右胁肋，乃肝脉循行之处，所以病名叫肝痹。积聚之气并非肝脏的本病，所以得自外感寒湿。疝病本于寒湿，所以治疗方法与疝病相同。寒湿致病，则腰痛、足冷、头痛，从而引发肝脏的疾病。
黄色的脉象到来时，脉大而虚，腹中有积气，有厥逆之气，名叫厥疝，女子患病机理相同。这是由于疾行劳累，使四肢出汗当风所致。
黄是脾色。黄脉，是结合颜色和脉象进行诊断。大而虚，指脉体张大而空虚。这表示腹中有积气，腹中是脾的所属部位。有厥气，是土受木克，土气厥逆而不通达。土受木克，所以不叫脾痹，而叫厥疝。疝，属于肝病范畴。女子同法，指女子虽无典型疝病，但肝木乘脾的机理是相同的。厥疝并非脾脏的本病，所以得自外感（疾行劳累），使四肢出汗当风，以致引发脾脏的疾病。
黑色的脉象到来时，脉上浮而坚大，有小腹与前阴部位的积气，名叫肾痹。这是由于在清水中沐浴后，湿气未散就躺下睡觉所致。
黑是肾色。黑脉，是结合颜色和脉象进行诊断。上浮而坚大，指坚大的脉象，浮于表面而不沉。这表示有小腹与前阴部位的积气。小腹是肾的所属部位，前阴是肾的窍道，所以病名叫肾痹。积聚之气并非肾脏的本病，所以得自在清水中沐浴，水气未散就躺下睡觉所致。这是通过五脏的色脉来诊断五脏的疾病，如此诊察，就可以万无一失。
凡是观察五色中的奇脉，面黄目青、面黄目赤、面黄目白、面黄目黑的，都不会死。
“相”音xiàng。“奇”音jī，意为阳。以色为脉，所以叫奇脉。凡是观察五色的奇脉，只需目视，不必用手诊脉。目青、目赤、目白、目黑，只要面部有黄色（中土之色），就是有胃气，所以都不会死。
面青目赤、面赤目白、面青目黑、面黑目白、面赤目青的，都会死。
面部没有中土的黄色。如果面青、面赤、面黑而兼见目赤、目白、目黑、目青，都会死。既说面青目赤，又说面青目黑，意思是面青目赤不宜，面青目黑也不宜。引申开来，青白皆不宜。既说面赤目白，又说面赤目青，意思是面赤目白不宜，面赤目青也不宜。引申开来，赤黑皆不宜。面部青色、赤色如此，那么白色、黑色也都如此。这本书没有详尽说完，言不尽意，所以申明面部如果没有中土的黄色，就会死。这是通过色脉来推断生死。这一节论述通过诊察色脉来知晓五脏的疾病及生死，以此结束五脏生成的意义。
Qibo recorded the theory of Zang-Fu manifestations from the previous section and further discussed the generation of the Five Zang organs. Heaven governs the origin of life, and Earth governs the formation of form. The colors of the Five Zang organs manifest on the exterior; this is governed by the Qi of Heaven. The pulses of the Five Zang organs circulate within; this is governed by the Qi of Earth. Color attaches to Qi, and Pulse returns to Flavor. By integrating Color, Pulse, Qi, and Flavor, the principles of the generation of the Five Zang organs are complete.
The Heart corresponds to the Mai (Vessels/Pulse), its flourishing manifestation is in the complexion, and it is controlled by the Kidney.
Qibo records the meaning of Zang-Fu manifestations from the previous section and reiterates the discussion on the generation of the Five Zang organs. Each Zang organ has an external correspondence: the Mai is the external correspondence of the Heart, hence "the Heart corresponds to the Mai." Each Zang organ has an external flourishing manifestation: Color is the external flourishing of the Heart, hence "its flourishing is in Color." Each Zang organ has a controlling organ: the Kidney controls the Heart, hence "it is controlled by the Kidney." External correspondences and external flourishing represent the "Cheng" (formation/structure) of the Zang; the controller represents the "Sheng" (generation/vitality) of the Zang. The principle of the Five Elements is that control precedes generation. "Controller" implies generation. Fire is controlled by Water; when Water is in excess, Wood Qi becomes vigorous. When Wood is vigorous, it generates Fire. Control is precisely for the sake of generation. The sequence of Heart, Lung, Liver, Spleen, and Kidney also reflects the intent of control and generation.
The Lung corresponds to the Skin, its flourishing manifestation is in the body hair, and it is controlled by the Heart.
Skin is the external correspondence of the Lung, hence "the Lung corresponds to the Skin." Body hair is the external flourishing of the Lung, hence "its flourishing is in hair." The Heart controls the Lung, hence "it is controlled by the Heart." Metal (Lung) is controlled by Fire (Heart); when Fire is in excess, Earth Qi becomes vigorous. When Earth is vigorous, it generates Metal.
The Liver corresponds to the Tendons, its flourishing manifestation is in the nails, and it is controlled by the Lung.
Tendons are the external correspondence of the Liver, hence "the Liver corresponds to the Tendons." Nails are the external flourishing of the Liver, hence "its flourishing is in nails." The Lung controls the Liver, hence "it is controlled by the Lung." Wood (Liver) is controlled by Metal (Lung); when Metal is in excess, Water Qi becomes vigorous. When Water is vigorous, it generates Wood.
The Spleen corresponds to the Flesh/Muscles, its flourishing manifestation is in the lips, and it is controlled by the Liver.
Flesh is the external correspondence of the Spleen, hence "the Spleen corresponds to the Flesh." Lips are the external flourishing of the Spleen, hence "its flourishing is in the lips." The Liver controls the Spleen, hence "it is controlled by the Liver." Earth (Spleen) is controlled by Wood (Liver); when Wood is in excess, Fire Qi becomes vigorous. When Fire is vigorous, it generates Earth.
The Kidney corresponds to the Bones, its flourishing manifestation is in the hair, and it is controlled by the Spleen.
Bones are the external correspondence of the Kidney, hence "the Kidney corresponds to the Bones." Hair is the external flourishing of the Kidney, hence "its flourishing is in hair." The Spleen controls the Kidney, hence "it is controlled by the Spleen." Wood (Liver) is controlled by Earth (Spleen); when Earth is in excess, Metal Qi becomes vigorous. When Metal is vigorous, it generates Water.
Therefore, excessive consumption of salty flavor causes the vessels to become stagnant and viscous, leading to changes in complexion; excessive consumption of bitter flavor causes the skin to wither and body hair to fall out; excessive consumption of pungent flavor causes tendons to become tight and nails to wither; excessive consumption of sour flavor causes the flesh to become calloused and thickened (Zhi) and the lips to peel; excessive consumption of sweet flavor causes bone pain and hair loss. These are the injuries caused by the five flavors.
(Note: "Qi" here is a variant for "Se" (viscous/stagnant). "Zhi" refers to calluses or thickened skin.)
In the mutual control of the Five Elements, before the phase of generation occurs, excessive control leads to injury. Therefore, excessive salt intake causes Kidney Qi to become excessive; excess leads to the suppression of the Heart, causing the Heart's vessels to become stagnant and viscous, and the Heart's complexion to change. Excessive bitter intake causes Heart Qi to become excessive; excess leads to the suppression of the Lung, causing the Lung's skin to wither and the Lung's hair to fall out. Excessive pungent intake causes Lung Qi to become excessive; excess leads to the suppression of the Liver, causing the Liver's tendons to tighten and the Liver's nails to wither. Excessive sour intake causes Liver Qi to become excessive; excess leads to the suppression of the Spleen, causing the Spleen's flesh to thicken and the Spleen's lips to peel. Excessive sweet intake causes Spleen Qi to become excessive; excess leads to the suppression of the Kidney, causing the Kidney's bones to ache and the Kidney's hair to fall out. This is the injury caused by the five flavors due to the Five Elements' mutual control, where control prevents generation.
Thus, the Heart desires bitter, the Lung desires pungent, the Liver desires sour, the Spleen desires sweet, and the Kidney desires salty. This is the correspondence between the five flavors and the five Zang organs.
Excessive consumption injures the body, while moderate consumption aligns with physiological needs. Thus, the Heart desires bitter, the Lung desires pungent, the Liver desires sour, the Spleen desires sweet, and the Kidney desires salty. This is why the five flavors correspond to the five Zang organs. From this, we see that the Five Zang organs not only correspond to vessels, skin, tendons, flesh, and bones, but also to the five flavors.
Regarding the Qi of the Five Zang organs manifesting as color: if the green color resembles dead grass, death ensues; if the yellow color resembles the fruit of the Akebia (Zhi Shi), death ensues; if the black color resembles soot/dust, death ensues; if the red color resembles clotted blood, death ensues; if the white color resembles dry bones, death ensues. These are the signs of death presented by the five colors.
(Note: "Tai" refers to dust/soot; "Pei" refers to blood clots.)
With the flavors of the Five Zang organs come their colors. Mutual generation brings vitality; being overcome leads to decay and death. The colors of the Five Zang organs are the manifestation of their Qi. Verifying the Qi of the Five Zang organs through color: Dead grass is green mixed with white, so green resembling dead grass indicates death, representing the failure of Liver Qi. Zhi Shi fruit is yellow mixed with green, so yellow resembling Zhi Shi indicates death, representing the failure of Spleen Qi. Soot is black mixed with yellow, so black resembling soot indicates death, representing the failure of Kidney Qi. Clotted blood is red mixed with black, so red resembling clotted blood indicates death, representing the failure of Heart Qi. Dry bones are white mixed with green, so white resembling dry bones indicates death, representing the failure of Lung Qi. These are the signs of death presented by the five colors due to being overcome.
If the green color resembles the feathers of a kingfisher (bright and lustrous), life is indicated; if the red color resembles the comb of a rooster (vivid and ruddy), life is indicated; if the yellow color resembles the belly of a crab (bright and moist), life is indicated; if the white color resembles the fat of a boar (white and nourishing), life is indicated; if the black color resembles the feathers of a crow (black and shiny), life is indicated. These are the signs of life presented by the five colors.
This lists the proper colors of the five elements, characterized by luster, moisture, and brilliance, thus indicating life.
The vibrant color of the Heart is like cinnabar wrapped in white silk; the vibrant color of the Lung is like red stone脂 wrapped in white silk; the vibrant color of the Liver is like cyan silk wrapped in white silk; the vibrant color of the Spleen is like the fruit of Trichosanthes wrapped in white silk; the vibrant color of the Kidney is like purple wrapped in white silk. These are the external flourishing manifestations generated by the Five Zang organs.
"Gao" refers to plain white silk. The vitality of the five colors contains the essence of the five internal organs, with a sense of containment, all like being wrapped in white silk. The inner brilliance shines outward, and the exterior is moist, hence these are called the external flourishing manifestations generated by the Five Zang organs. From this, we see that the Five Zang organs not only flourish in color, hair, nails, lips, and head hair, but also in the five colors of the face.
Colors and flavors should correspond to the Five Zang organs: White corresponds to the Lung 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 Kidney and Salty flavor. Therefore, White corresponds to Skin, Red to Vessels, Green to Tendons, Yellow to Flesh, and Black to Bones.
Integrating the five colors and five flavors in a general discussion: Colors and flavors correspond to the Five Zang organs. White corresponds to the Lung, its flavor is Pungent. Red corresponds to the Heart, its flavor is Bitter. Green corresponds to the Liver, its flavor is Sour. Yellow corresponds to the Spleen, its flavor is Sweet. Black corresponds to the Kidney, its flavor is Salty. The Five Zang organs reside internally and correspond externally to specific tissues. To verify the correspondence of the five colors to the five Zang organs, one must look at the external correspondences. Thus, White corresponds to Skin, which is the correspondence of the Lung. Red corresponds to Vessels, which is the correspondence of the Heart. Green corresponds to Tendons, which is the correspondence of the Liver. Yellow corresponds to Flesh, which is the correspondence of the Spleen. Black corresponds to Bones, which is the correspondence of the Kidney.
This section discusses the generation of the Five Zang organs and extends to their external correspondences and flourishing manifestations.
All vessels converge at the eyes.
The Five Zang organs are internal, and Qi circulates throughout the body. The term "all vessels" refers to the channels through which Qi and Blood circulate throughout the body. The essence of the Five Zang organs flows upward into the eyes; therefore, all vessels belong to the eyes.
All marrow belongs to the brain.
"All marrow" refers to the refined essence condensed from Qi and Blood throughout the body. The Brain is the Sea of Marrow; therefore, all marrow belongs to the brain.
All tendons belong to the joints.
"All tendons" refer to the tendon networks through which Qi and Blood circulate throughout the body. Tendons connect to the joints, enabling flexion and extension; therefore, all tendons belong to the joints.
All blood belongs to the Heart.
"All blood" refers to the blood in the meridians inside and outside the body. The Heart is the Sovereign Monarch, transforming Ying Qi into Blood (Fei Xin Hua Chi); therefore, all blood belongs to the Heart.
All Qi belongs to the Lung.
"All Qi" refers to the Ying and Wei Qi circulating internally and externally throughout the body. The Lung is the Chief of the Zang organs, receiving the convergence of all vessels; therefore, all Qi belongs to the Lung.
This is the daily cycle of Qi and Blood in the four limbs and eight crevices.
The four limbs refer to the two hands and two feet. The eight crevices refer to the two elbows, two axillae, two thighs, and two popliteal fossae (note: Gao Shong's commentary mentions arms and thighs, but standard interpretation focuses on major joint depressions). All these areas undergo cyclical rotation of Qi and Blood, entering and exiting morning and night; hence they are called the daily cycle of the four limbs and eight crevices.
Therefore, when a person lies down to sleep, blood returns to the Liver.
The human daily cycle mirrors the heavenly day and night. Heaven is bright by day and dark by night; humans are clear-spirited in the morning and drowsy in the evening. In the morning, Qi and Blood move outward; in the evening, they store inward. Therefore, when a person sleeps, blood returns to the Liver. The blood of the Chong and Ren meridians, when moving outward, seeps into the skin; when moving inward, it returns to the Liver.
When the Liver receives blood, vision is possible; when the feet receive blood, walking is possible; when the palms receive blood, grasping is possible; when the fingers receive blood, holding is possible. If one wakes up and goes out into the wind, and blood coagulates in the skin, Bi syndrome (obstruction) results. If it coagulates in the vessels, stagnation results. If it coagulates in the feet, Jue syndrome (cold extremities/reversal) results. These three conditions occur because blood circulates but cannot return to its empty spaces (bone cavities/channels), resulting in Bi and Jue syndromes.
The blood of the Chong and Ren meridians ascends to the head and eyes and extends to the limbs. Thus, when the Liver receives blood, the eyes can see; when the feet receive blood, they can walk; when the palms receive blood, they can grasp; when the fingers receive blood, they can hold. This blood not only ascends to the head and eyes and extends to the limbs but also fills the skin externally and nourishes the meridians internally, descending to the Three Yin meridians of the feet. Thus, examples of evil wind coagulating in the skin, vessels, and feet are given to illustrate this. When people sleep, they stay indoors. If they go out after sleeping and are exposed to wind, the blood of the Chong and Ren meridians coagulates externally on the skin surface, causing Bi syndrome, characterized by stiffness and difficulty in movement. Internally, coagulation in the meridians causes Stagnation (Se), characterized by blockage. Downward, coagulation in the feet causes Jue syndrome, characterized by coldness due to the failure of Yin and Yang to connect smoothly. These three types of coagulation in the skin, vessels, and feet occur because blood moves outward but cannot return inward to the bone cavities, resulting in Bi and Jue syndromes.
The human body has twelve major valleys (Da Gu) and 354 minor creeks (Xiao Xi). Subtracting the twelve Shu points, these are all places where Wei Qi (Defensive Qi) stays and stops, and where pathogenic factors lodge. Acupuncture and stone therapy can be used along the meridians to remove them.
The *Ling Shu: Qi Xue Lun* states that large intersections of muscle are called "Gu" (valleys), and small intersections are called "Xi" (creeks). Where intersections exist, boundaries exist; hence there are twelve major valleys. Every intersection has an acupoint name, hence there are 354 minor creeks. The *Qi Xue Lun* records 366 acupoints in total. Here, 354 are mentioned, leaving 12 Shu points unaccounted for. The missing 12 Shu points are the twelve major valleys. All these areas are where Qi and Blood circulate. If blood flow cannot return to its cavities, these are places where Wei Qi stays and stops. Where Wei Qi stays and stops, pathogenic factors also lodge. Where pathogenic factors lodge, acupuncture and stone therapy must be used along the meridians to remove the disease. "Yuan" means following or according to; thus, using acupuncture and stone therapy according to the meridians removes the illness. This section follows the previous discussion on external correspondences, explaining that when Qi and Blood circulate throughout the body but fail to move freely, disease arises.
At the beginning of diagnosing disease, the Five Decisions (Wu Jue) serve as the guideline. To know the beginning, one must first establish the root (Mu). The so-called "Five Decisions" refer to the pulses of the five Zang organs.
Diseases of the Five Zang organs require accurate diagnosis. At the beginning of diagnosis, the Five Decisions serve as the guideline. The "beginning of diagnosis" means wanting to know the origin of the disease, one must first establish the root. "Mu" means the root or origin. The "Five Decisions as guideline" means making decisions based on the meridians of the five Zang organs.
Therefore, headache and disorders of the vertex indicate deficiency below and excess above. The pathology lies in the Foot Shaoyin (Kidney) and Foot Taiyang (Bladder) meridians. If severe, the disease enters the Kidney.
Juyang is Taiyang. The meridian of the Foot Taiyang Bladder ascends to the forehead and intersects at the vertex, descends to connect with the Bladder, and links to the Kidney. Thus, headache and vertex disorders are diseases of the Foot Taiyang meridian. Deficiency below refers to the deficiency of Bladder Qi in the lower part; excess above refers to the excess of pathogenic factors causing headache at the vertex in the upper part. Taiyang governs the exterior, and Shaoyin governs the interior. Therefore, the pathology involves the Foot Shaoyin and Foot Taiyang. If the disease does not resolve, it must enter the zang organs from the meridians; thus, if severe, it enters the Kidney.
Dizziness, blurred vision, trembling, deafness, and ear obstruction indicate excess below and deficiency above. The pathology lies in the Foot Shaoyang (Gallbladder) and Foot Jueyin (Liver) meridians. If severe, the disease enters the Liver.
"Xun" is synonymous with "Xuan" (dizziness/blurred vision). "Meng" means unclear vision. "Zhao" means trembling/shaking. "You" means severe. The meridian of the Foot Shaoyang Gallbladder originates at the outer canthus, enters the ear from behind, and emerges in front of the ear. Dizziness, shaking, and severity occur due to meridian deficiency and prevailing Wind Qi. Blurred vision and deafness arise because the meridian starts at the eye and enters the ear. The previous text described headache as excess above; here, dizziness is described as deficiency above. Thus, it is said "excess below and deficiency above," referring to the excess of Wood-Gallbladder pathogen below and the deficiency of the Shaoyang meridian above. Shaoyang governs the exterior, and Jueyin governs the interior. Therefore, the pathology involves the Foot Shaoyang and Foot Jueyin. If the disease does not resolve, it must enter the zang organs from the meridians; thus, if severe, it enters the Liver.
Abdominal fullness and distension, support across the diaphragm and hypochondrium, reversal cold below and confusion above. The pathology lies in the Foot Taiyin (Spleen) and Foot Yangming (Stomach) meridians.
The abdomen is the domain of the Spleen. Abdominal fullness and distension indicate Spleen Earth disease. Support across the diaphragm and hypochondrium: The *Ling Shu: Jing Mai Lun* states that the branch of the Foot Taiyin Spleen meridian rises from the stomach through the diaphragm. This refers to distension connecting upward to the diaphragm and laterally to the hypochondrium. Reversal cold below and confusion above: When Taiyin Spleen Qi fails to ascend, reversal cold occurs below; when Yangming Stomach Qi fails to descend, confusion occurs above. Yangming and Taiyin are exterior-interior pairs; thus, the pathology lies in the Foot Taiyin and Foot Yangming. Since the Spleen organ is affected first, it does not say "if severe, it enters the Spleen."
Cough and rebellious Qi, with Qi reversal in the chest. The pathology lies in the Hand Yangming (Large Intestine) and Hand Taiyin (Lung) meridians.
Cough and rebellious Qi are Lung diseases. Qi reversal in the chest: The *Jing Mai Lun* states that the Hand Taiyin Lung meridian originates in the middle jiao and connects downward to the Large Intestine. Disharmony of the zang and fu organs causes Qi reversal in the chest. The pathology lies in the Hand Yangming and Hand Taiyin. Since the Lung organ is affected first, it does not say "if severe, it enters the Lung."
Heart vexation and headache, with the disease located in the diaphragm region. The pathology lies in the Hand Taiyang (Small Intestine) and Hand Shaoyin (Heart) meridians.
Heart vexation and headache are Heart diseases. Disease in the diaphragm region: The *Jing Mai Lun* states that the Hand Shaoyin Heart meridian passes through the diaphragm and connects to the Small Intestine. Disharmony of the zang and fu organs causes disease in the diaphragm region. The pathology lies in the Hand Taiyang and Hand Shaoyin. Since the Heart organ is affected first, it does not say "if severe, it enters the Heart." This section discusses the beginning of diagnosis, using the Five Decisions as guidelines, extending to the five zang and fu organs; thus, the Hand Shaoyang (San Jiao) and Foot Jueyin (Liver) are not mentioned again (as Liver was covered previously).
The size, slipperiness, roughness, floating, and sinking of the pulse can be distinguished by finger palpation. The images of the Five Zang organs can be inferred by analogy. The sounds corresponding to the Five Zang organs can be identified by listening. The subtle diagnoses of the five colors can be observed by the eye. Integrating color and pulse diagnosis ensures complete accuracy.
"Bie" means to distinguish. Pulses have Yin and Yang characteristics: Large is Yang, Small is Yin; Slippery is Yang, Rough is Yin; Floating is Yang, Sinking is Yin. The size, slipperiness, roughness, floating, and sinking of the pulse can be distinguished by finger palpation. The Yin and Yang of the pulse internally correspond to the Five Zang organs. The pulse images of the Yin and Yang of the Five Zang organs can also be inferred by size, slipperiness, roughness, floating, and sinking. For example, Floating and Large pulses correspond to the Heart and Lung; Sinking and Rough pulses correspond to the Liver and Kidney; Slippery pulses correspond to the Spleen. The Five Zang organs correspond to the Five Elements; the five tones and five colors can also be diagnosed subtly and observed by the eye. Integrating color and pulse diagnosis ensures complete accuracy. Color and pulse combined diagnosis is as described below.
When the Red pulse arrives, rapid and firm, the diagnosis is: Accumulated Qi in the middle, occasionally hindering food intake. The disease is named Xin Bi (Heart Obstruction). It is caused by external pathogens, combined with excessive worry leading to Heart deficiency, allowing evil to enter.
Red is the color of the Heart. Red pulse refers to diagnosis combining color and pulse. Rapid and firm means the pulse body is swift and solid. Diagnosing the color and pulse thus indicates accumulated Qi in the middle, occasionally hindering food intake. The disease is named Xin Bi (Heart Obstruction), meaning Heart Qi is blocked and not free. Accumulated Qi is not the primary disease of the Heart organ; thus, it is acquired from external pathogens. Due to excessive worry causing Heart deficiency, evil enters, resulting in Heart Obstruction.
When the White pulse arrives, rapid and floating, indicating deficiency above and excess below, with fright, accumulated Qi in the chest, and a rapid yet deficient pulse. The disease is named Fei Bi (Lung Obstruction), accompanied by aversion to cold and fever. It is caused by drunkenness followed by sexual intercourse.
White is the color of the Lung. White pulse refers to diagnosis combining color and pulse. Rapid and floating means the pulse body is swift and floating superficially. Deficiency above and excess below: A rapid and floating pulse indicates deficiency above and excess below. Fright is a symptom of deficiency above. Accumulated Qi in the chest is a symptom of excess below. It is also described as "rapid and deficient," meaning the rapid and floating pulse presents as rapid yet deficient. The disease is named Fei Bi (Lung Obstruction), accompanied by aversion to cold and fever affecting the skin and hair. Fright and accumulated Qi are not the primary diseases of the Lung organ; thus, they are caused by drunkenness, allowing pathogenic factors to enter internally.
When the Green pulse arrives, long and snapping left and right, with a sensation of support and distension below the heart. The disease is named Gan Bi (Liver Obstruction). It is caused by cold-dampness, treated similarly to Shan (Hernia) diseases, accompanied by lower back pain, cold feet, and headache.
"Dan" is pronounced with a level tone. Green is the color of the Liver. Green pulse refers to diagnosis combining color and pulse. Long and snapping left and right means the pulse body is abundant; the pulses in both hands feel like a plucked string. This indicates support and distension below the heart. "Below the heart" refers to the diaphragm; "support and distension" refers to the hypochondrium, which is the pathway of the Liver meridian. Hence, the disease is named Gan Bi (Liver Obstruction). Accumulated Qi is not the primary disease of the Liver organ; thus, it is caused by external cold-dampness. Hernia diseases originate from cold-dampness, so the treatment is similar. Cold-dampness causes lower back pain, cold feet, and headache, leading to Liver disease.
When the Yellow pulse arrives, large and deficient, with accumulated Qi in the abdomen and rebellious Qi. The disease is named Jue Shan (Reversal Hernia). Women are affected similarly. It is caused by strenuous exertion, sweating from the four limbs, and exposure to wind.
Yellow is the color of the Spleen. Yellow pulse refers to diagnosis combining color and pulse. Large and deficient means the pulse body is expansive yet empty. This indicates accumulated Qi in the abdomen. The abdomen is the domain of the Spleen. Rebellious Qi indicates Earth being overcome by Wood, causing Earth Qi to rebel and fail to penetrate. Because Earth is overcome by Wood, it is not named Pi Bi (Spleen Obstruction) but Jue Shan (Reversal Hernia). Hernia is related to Liver disease. Women are affected similarly because although women may not have typical hernia, the mechanism of Liver Wood overacting on Spleen Earth is the same. Jue Shan is not the primary disease of the Spleen organ; thus, it is caused by external factors (strenuous exertion), sweating from the limbs, and exposure to wind, leading to Spleen disease.
When the Black pulse arrives, firm and large floating upward, with accumulated Qi in the lower abdomen and genitalia. The disease is named Shen Bi (Kidney Obstruction). It is caused by bathing in cold water and lying down immediately afterward.
Black is the color of the Kidney. Black pulse refers to diagnosis combining color and pulse. Firm and large floating upward means the firm and large pulse floats superficially rather than sinking. This indicates accumulated Qi in the lower abdomen and genitalia. The lower abdomen is the domain of the Kidney; the external genitalia are the orifice of the Kidney. Hence, the disease is named Shen Bi (Kidney Obstruction). Accumulated Qi is not the primary disease of the Kidney organ; thus, it is caused by bathing in cold water and lying down while the water vapor has not dissipated. This demonstrates diagnosing diseases of the five Zang organs using their respective colors and pulses. Such diagnosis ensures complete accuracy.
Whenever observing the "extraordinary pulses" of the five colors: Face yellow with eyes green, face yellow with eyes red, face yellow with eyes white, face yellow with eyes black—all will not die.
"Xiang" means to observe. "Qi" means odd/unusual, associated with Yang. Using color as pulse is called "Qi Mai." Observing the extraordinary pulses of the five colors requires only visual inspection, not manual pulse taking. If the eyes are green, red, white, or black, but the face has a yellow hue (Earth color), it indicates the presence of Stomach Qi (Wei Qi), so death will not occur.
Face green with eyes red, face red with eyes white, face green with eyes black, face black with eyes white, face red with eyes green—all result in death.
If the face lacks the central Earth yellow hue, and the face is green, red, or black while the eyes are red, white, black, or green respectively, death ensues. Saying "face green with eyes red" and "face green with eyes black" means both combinations are unfavorable. Extending this, green and white are both unfavorable. Saying "face red with eyes white" and "face red with eyes green" means both combinations are unfavorable. Extending this, red and black are both unfavorable. The same logic applies to white and black faces. The text does not exhaustively list every combination, as words cannot fully convey meaning. It emphasizes that if the face lacks the central Earth yellow hue, death occurs. This section explains how to determine the prognosis of the Five Zang organs and life or death through color and pulse diagnosis, concluding the discussion on the generation of the Five Zang organs.