上编论五脏之气，上法天时；此岐伯承上编之义，宣明五气。盖天地之数，不外于五，人身形藏，
总属于气。故举五味所入，五气所病，五精所并，五脏所恶，五脏化液，五味所禁，五病所发，
五邪所乱，五邪所见，五脏所藏，五脏所主，五劳所伤，五脉应象，而宣明五气也。
五味所入∶酸入肝，辛入肺，苦入心，咸入肾，甘入脾，是谓五入。
地之五味，养人五脏，五味入五脏，是谓五入。
五气所病∶心为噫，肺为咳，肝为语，脾为吞，肾为欠，为嚏，胃为气逆，为哕为恐，大肠小
肠为泄，下焦溢为水，膀胱不利，为癃，不约为遗溺，胆为怒，是谓五病。
溺，鸟去声。五气所病者，五脏本气为病也。病气在心，则为噫，噫，微嗳也；病气在肺，则为
咳，咳，气上逆也；病气在肺，则为语，语，多言也；病气在脾，则为吞，吞，舌本不和也；病气
在肾，则为欠为嚏，欠者阴阳相引，嚏者，阴出于阳也。此五脏本气不和而为病也。五脏不和则六腑不
利，故胃病，则为气逆；不能上出于肺，则为哕，哕，呃也，不能下交于肾，则为恐，恐，戊癸
不合也；大肠小肠病，则为泄，泄，水谷下注也；下焦病，不能决渎，则汛溢而为水，膀胱病，气滞不利，
则为癃，气虚不约，则为遗溺；胆病郁而不舒，则为怒。此五气为病，及于六腑，凡此是谓
五病。
五精所并∶精气并于心，则喜；并于肺，则悲；并于肝，则
忧；并于脾，则畏；并于肾，则恐，是谓五并。虚而相并者也。
五精所并者，脏虚而精气并之也。精者阴精，气者阳气。精气并于心，则心受所并而为喜，喜，心
之情也；并于肺，则肺受所并而为悲，悲，肺之情也；并于肝，则肝受所并而为忧，肝主怒，今
曰忧者，上文胆为怒，故此肝为忧，怒为有余，忧为不足也；并于脾，则脾受所并而为畏，思虑者，脾之
情，今曰畏者，虑之至也；并于肾，则肾受所并而为恐，恐，肾之情也。凡此是谓五并，申明
此之五并，乃虚而相并者也。是知精气并，乃精气之不足矣。
五脏所恶∶心恶热，肺恶寒，肝恶风，脾恶湿，肾恶燥，是谓五恶。
恶，去声。热气伤心，故心恶热；寒气伤肺，故肺恶寒，风气伤肝，故肝恶风；湿气伤脾，故脾
恶湿；燥气伤肾，故肾恶燥。凡此是谓五恶。
五脏化液∶心为汗，肺为涕，肝为泪，脾为涎，肾为唾，是谓五液。
化液者，水谷入口，津液各走其道。五脏受水谷之精，淖注于窍，化而为液也。汗乃血液，心所
主也，故心为汗；涕出于鼻，肺所主也，故肺为涕；泪出于目，肝所主也，故肝为泪；涎出于口，
脾所主也，故脾为涎；唾属水精，肾所主也，故肾为唾，凡此是谓五液。灵枢根结论云∶少阴根于涌泉，
结于廉泉，廉泉，舌下窍也，是肾为水脏，从下而上，液虽有五，肾实主之，是以五液皆咸，咸，水味也。
五味所禁∶辛走气，气病无多食辛；咸走血，血病无多食咸；
苦走骨，骨病无多食苦；甘走肉，肉病无多食甘，酸走筋，筋病无多食酸。是谓五禁，无令多食。
五味各有偏胜，故禁多食。味之辛者，则走气，气病肺虚，无多食也；味之咸者则走血，血病
心虚，无多食也；味之苦者则走
骨，骨病肾虚，无多食也；味之甘者则走肉，肉病脾虚，无多食也；味之酸者则走筋，筋病肝虚，无多食
也。凡此是谓五禁。申明禁者，非禁绝之谓，乃无令多食也。
五病所发∶阴病发于骨，阳病发于血，阴病发于肉，阳病发于冬，阴病发于夏，是谓五发。
五脏阴阳之病，各有所发。金匮真言论云∶阴中之阴，肾也；阳中之阳，心也∶阴中之至阴，脾也；
阴中之阳，肝也；阳中之阴，肺也。肾为阴，其主在骨，故肾阴之病发于骨；心为阳，其主
在血，故心阳之病发于血；脾为阴，其主在肉，故脾阴之病发于肉；肝为阳，于时为春，冬失其藏，
春无以生，故肝阳之病发于冬；肺为阴，于时为秋，夏失其长，秋无以收，故肺阴之病发于
夏，凡此阴病、阳病，各有所发，是谓五发。
五邪所乱∶邪入于阳，则狂；邪入于阴，则痹；搏阳则为癫
疾；搏阴则为喑；阳入之阴则静；阴出之阳则怒。是谓五乱。
喑，音因，余篇同。此举五邪所乱，以足上文之义。上文阳病发于血，心也；阳病发于冬，肝也，故
正为邪乱，而入于心肝之阳分，则狂。上文阴病发于骨，肾也；阴病发于肉，脾也；阴病发于
夏，肺也，故以邪乱正，而入于肾脾肺之阴分，则痹。痹者，邪留皮肉与骨，而为痹痛也。搏阳则为癫
疾，所以足阳狂之意，言邪入于阳则狂。亦有邪搏于阳，而为癫疾者矣。搏阴则为喑，所以足阴
痹之意，言邪入于阴则痹，亦有邪搏于阴，而为喑哑者矣。夫搏者，阴阳相搏也。搏阴为喑，乃阳入之阴，
则静而为喑也；搏阳为癫疾，乃出之阳，则怒而为癫疾也。凡此，皆五脏阴阳为邪所乱，
是谓五乱，以明五病所发，乃乱而始发，或发而更乱也。
五邪所见∶春得秋脉，夏得冬脉，长夏得春脉，秋得夏脉，冬得长夏脉，名曰阴出之阳，病
善怒，不治。是谓五邪皆同，命死不治。
见，音现。五邪所见者，五脏受邪，见于脉也。春得秋脉，金克木也，夏得冬脉，水克火也，长
夏得春脉，木克土也；秋得夏
脉，火克金也；冬得长夏脉，土克水也，名曰阴出之阳，言邪病五脏之阴，出于经脉之阳也。病善怒，言春得
秋脉，肝木受刑，故善怒也。当亟治之，若不治，则邪干五脏。是谓五邪皆同，言五脏受
邪，同于木受金刑之义。命死不治，言五脏受刑，其人虽存，其命已死，是不治也。
五脏所藏∶心藏神，肺藏魄，肝藏魂，脾藏意，肾藏志，是谓五脏所藏。
除五脏，余藏，如字。言心肺肝脾肾，藏神魄魂意志，是谓五脏，而各有所藏也。
五脏所主∶心主脉，肺主皮，肝主筋，脾主肉，肾主骨，是谓五主。
言心肺肝脾肾，主脉皮筋骨肉，是五脏外合，而谓之五主也。
五劳所伤∶久视伤血，久卧伤气，久坐伤肉，久立伤骨，久行伤筋，是谓五劳所伤。
言久视久卧久坐久立久行为五劳，劳则五脏因之以伤，心主血，久视则伤之；肺主气，久卧则伤之；
脾主肉，久坐则伤之；肾主骨，久立则伤之∶肝主筋，久行则伤之。凡此是谓五劳所伤。
五脉应象∶肝脉弦，心脉钩，脾脉代，肺脉毛，肾脉石，是谓五脏之脉。
言肝心脾肺肾，五脏之脉，应弦钩代毛石，四时五行之脉象也。天地之道，不外五行，人身形藏，
不离乎气，承脏气法时而宣明五气者如此。
上编论述五脏之气，上法天时；此篇岐伯承接上编之意，宣明五气。大概天地的数理，不出于“五”，人身形体与脏腑，总归属于“气”。所以列举五味所入、五气所病、五精所并、五脏所恶、五脏化液、五味所禁、五病所发、五邪所乱、五邪所见、五脏所藏、五脏所主、五劳所伤、五脉应象，以此来宣明五气。
五味所入：酸味入肝，辛味入肺，苦味入心，咸味入肾，甘味入脾，这叫做“五入”。
大地的五味，滋养人的五脏，五味进入五脏，这叫做“五入”。
五气所病：心病表现为噫（嗳气），肺病表现为咳，肝病表现为语（多言），脾病表现为吞（吞咽不利），肾病表现为欠（呵欠）和嚏（打喷嚏），胃病表现为气逆和哕（呃逆）及恐，大肠和小肠病表现为泄（泄泻），下焦病表现为水液溢满，膀胱病表现为小便不利和癃闭，约束无力则遗尿，胆病表现为怒，这叫做“五病”。
溺，读音同“鸟”。所谓五气所病，是指五脏本气发生病变。病气在心，则出现噫，噫就是轻微的嗳气；病气在肺，则出现咳，咳就是气机上逆；病气在肝，则出现语，语就是多说话；病气在脾，则出现吞，吞就是舌根不和；病气在肾，则出现欠和嚏，欠是阴阳相互牵引，嚏是阴气出于阳位。这是五脏本气不和而生病。五脏不和则六腑不利，所以胃病，则气机上逆；不能上出于肺，则出现哕，哕就是呃逆，不能下交于肾，则出现恐，恐是因为戊癸不合；大肠小肠病，则出现泄，泄是水谷向下灌注；下焦病，不能通调水道，则泛滥而为水湿，膀胱病，气滞不通利，则出现癃闭，气虚不能约束，则出现遗尿；胆病郁结而不舒展，则出现怒。这些五气为病，波及六腑，以上这些就叫做“五病”。
五精所并：精气并入于心，则喜；并入于肺，则悲；并入于肝，则忧；并入于脾，则畏；并入于肾，则恐，这叫做“五并”。这是脏气虚弱而精气相并的情况。
所谓五精所并，是脏气虚弱而精气并入其中。精指阴精，气指阳气。精气并入于心，则心受其并而表现为喜，喜是心的情志；并入于肺，则肺受其并而表现为悲，悲是肺的情志；并入于肝，则肝受其并而表现为忧，肝主怒，这里说忧，是因为上文提到胆主怒，所以此处肝主忧，怒属于有余，忧属于不足；并入于脾，则脾受其并而表现为畏，思虑是脾的情志，这里说畏，是因为思虑到了极点；并入于肾，则肾受其并而表现为恐，恐是肾的情志。以上这些就叫做“五并”，申明这里的五并，乃是因虚而精气相并。由此可知，精气相并，乃是精气不足所致。
五脏所恶：心恶热，肺恶寒，肝恶风，脾恶湿，肾恶燥，这叫做“五恶”。
恶，去声。热气伤心，所以心恶热；寒气伤肺，所以肺恶寒；风气伤肝，所以肝恶风；湿气伤脾，所以脾恶湿；燥气伤肾，所以肾恶燥。以上这些就叫做“五恶”。
五脏化液：心化为汗，肺化为涕，肝化为泪，脾化为涎，肾化为唾，这叫做“五液”。
化液，是指水谷入口后，津液各自运行其道。五脏接受水谷的精微，浸润注于孔窍，化而为液。汗乃血液，由心所主，所以心为汗；涕出于鼻，由肺所主，所以肺为涕；泪出于目，由肝所主，所以肝为泪；涎出于口，由脾所主，所以脾为涎；唾属水精，由肾所主，所以肾为唾。以上这些就叫做“五液”。《灵枢·根结》篇说：少阴经根于涌泉穴，结于廉泉穴，廉泉是舌下的孔窍，这说明肾是水脏，从下而上，液虽有五种，实则由肾主宰，所以五液都带有咸味，咸是水之味。
五味所禁：辛味走气，气病不要多吃辛味；咸味走血，血病不要多吃咸味；苦味走骨，骨病不要多吃苦味；甘味走肉，肉病不要多吃甘味；酸味走筋，筋病不要多吃酸味。这叫做“五禁”，不要让病人多吃。
五味各有偏胜，所以禁止多吃。味辛的，则走气，气病若肺气虚，不要多吃；味咸的，则走血，血病若心血虚，不要多吃；味苦的，则走骨，骨病若肾虚，不要多吃；味甘的，则走肉，肉病若脾虚，不要多吃；味酸的，则走筋，筋病若肝虚，不要多吃。以上这些就叫做“五禁”。申明禁，并非禁止绝食，而是不要多吃。
五病所发：阴病发于骨，阳病发于血，阴病发于肉，阳病发于冬，阴病发于夏，这叫做“五发”。
五脏阴阳之病，各有其发病部位。《金匮真言论》说：阴中之阴，是肾；阳中之阳，是心；阴中之至阴，是脾；阴中之阳，是肝；阳中之阴，是肺。肾为阴，其主在骨，所以肾阴之病发于骨；心为阳，其主在血，所以心阳之病发于血；脾为阴，其主在肉，所以脾阴之病发于肉；肝为阳，对应季节为春，若冬季失于封藏，春季就无法生发，所以肝阳之病发于冬；肺为阴，对应季节为秋，若夏季失于生长，秋季就无法收敛，所以肺阴之病发于夏。以上这些阴病、阳病，各有其发病之处，就叫做“五发”。
五邪所乱：邪气侵入阳分，则狂；邪气侵入阴分，则痹；邪气搏结于阳，则为癫疾；邪气搏结于阴，则为喑（失音）；阳气入于阴分则静；阴气出于阳分则怒。这叫做“五乱”。
喑，音同“因”，其他篇章相同。这里列举五邪所乱，以补充上文的意义。上文说阳病发于血，对应心；阳病发于冬，对应肝，所以正气被邪气扰乱，而入于心肝之阳分，则出现狂症。上文说阴病发于骨，对应肾；阴病发于肉，对应脾；阴病发于夏，对应肺，所以邪气扰乱正气，而入于肾脾肺之阴分，则出现痹证。痹，是指邪气留滞在皮肉与骨之间，形成痹痛。邪气搏结于阳则出现癫疾，这是为了补充阳狂的意思，说明邪入于阳则狂，也有邪气搏结于阳而成为癫疾的。邪气搏结于阴则出现喑哑，这是为了补充阴痹的意思，说明邪入于阴则痹，也有邪气搏结于阴而成为喑哑的。所谓搏，是阴阳相互搏结。搏结于阴导致喑哑，是阳气入于阴分，则静而致喑哑；搏结于阳导致癫疾，是阴气出于阳分，则怒而致癫疾。以上这些，都是五脏阴阳被邪气扰乱，就叫做“五乱”，以此阐明五病所发，是因乱而始发，或发作后更加紊乱。
五邪所见：春季见到秋季的脉象，夏季见到冬季的脉象，长夏见到春季的脉象，秋季见到夏季的脉象，冬季见到长夏的脉象，名叫“阴出之阳”，病人容易发怒，难以治愈。这叫做五邪皆同，预示死亡且无法治愈。
见，音同“现”。所谓五邪所见，是五脏受邪，反映在脉象上。春季见到秋脉，是金克木；夏季见到冬脉，是水克火；长夏见到春脉，是木克土；秋季见到夏脉，是火克金；冬季见到长夏脉，是土克水，这叫“阴出之阳”，意思是邪气侵犯五脏之阴，而出现在经脉之阳。病人容易发怒，是说春季见到秋脉，肝木受刑克，所以容易发怒。应当紧急治疗，如果不治，则邪气干犯五脏。这叫做五邪皆同，意思是五脏受邪，如同木受金刑克的道理一样。命死不治，意思是五脏受刑克，其人虽然活着，但命已死，这就是不治。
五脏所藏：心藏神，肺藏魄，肝藏魂，脾藏意，肾藏志，这叫做五脏所藏。
除五脏外，其余脏器如字面意思。指心肺肝脾肾，分别藏神、魄、魂、意、志，这就叫五脏，且各有所藏。
五脏所主：心主脉，肺主皮，肝主筋，脾主肉，肾主骨，这叫做五主。
指心肺肝脾肾，分别主脉、皮、筋、肉、骨，这是五脏的外合关系，所以称为五主。
五劳所伤：久视伤血，久卧伤气，久坐伤肉，久立伤骨，久行伤筋，这叫做五劳所伤。
指久视、久卧、久坐、久立、久行为五劳，劳倦则五脏因此受伤。心主血，久视则伤血；肺主气，久卧则伤气；脾主肉，久坐则伤肉；肾主骨，久立则伤骨；肝主筋，久行则伤筋。以上这些就叫做“五劳所伤”。
五脉应象：肝脉弦，心脉钩，脾脉代，肺脉毛，肾脉石，这叫做五脏之脉。
指肝心脾肺肾，五脏之脉，分别对应弦、钩、代、毛、石，这是四时五行之脉象。天地之道，不外乎五行，人身形体与脏腑，不离乎气，承接脏气法时而宣明五气的道理就是这样。
The first part discusses the Qi of the Five Zang organs, aligning with the Heavenly Times; in this section, Qibo continues the meaning of the previous part to elucidate the Five Qi. Generally, the numbers of Heaven and Earth do not exceed "Five," and the human body's form and viscera are all subordinate to Qi. Therefore, it lists the Five Flavors entering [specific organs], diseases caused by the Five Qi, the merging of Five Essences, what the Five Zang organs dislike, the transformation fluids of the Five Zang organs, prohibitions regarding the Five Flavors, the onset of Five Diseases, the disorder caused by Five Pathogenic Factors, the manifestations of Five Pathogenic Factors, what the Five Zang organs store, what the Five Zang organs govern, the injuries caused by Five Types of Strain, and the correspondences of the Five Pulses, thereby elucidating the Five Qi.
**The Five Flavors Entering:** Sour flavor enters the Liver (Gan), Pungent flavor enters the Lung (Fei), Bitter flavor enters the Heart (Xin), Salty flavor enters the Kidney (Shen), Sweet flavor enters the Spleen (Pi); this is called the "Five Entrances."
The five flavors of the earth nourish the human five Zang organs; when the five flavors enter the five Zang organs, this is called the "Five Entrances."
**Diseases Caused by the Five Qi:** Heart disease manifests as belching (Yi), Lung disease as cough (Ke), Liver disease as excessive speech (Yu), Spleen disease as swallowing difficulty (Tun), Kidney disease as yawning (Qian) and sneezing (Ti), Stomach disease as rebellious Qi (Qi Ni) and hiccup (Hui) along with fear (Kong), Large Intestine and Small Intestine diseases as diarrhea (Xie), Lower Jiao disease as overflowing water, Bladder disease as difficult urination (Bu Li) and strangury (Long), lack of restraint leading to enuresis (Yi Niao), and Gallbladder disease as anger (Nu); this is called the "Five Diseases."
"Niao" is pronounced like "Niao" (bird). The so-called diseases caused by the Five Qi refer to disorders of the original Qi of the five Zang organs. When pathogenic Qi affects the Heart, belching occurs; belching is mild eructation. When pathogenic Qi affects the Lung, cough occurs; cough is the rebellion of Qi upward. When pathogenic Qi affects the Liver, excessive speech occurs; excessive speech means talking too much. When pathogenic Qi affects the Spleen, swallowing difficulty occurs; swallowing difficulty refers to disharmony at the root of the tongue. When pathogenic Qi affects the Kidney, yawning and sneezing occur; yawning is the mutual attraction of Yin and Yang, and sneezing is Yin emerging from Yang. This is a disease caused by the disharmony of the original Qi of the five Zang organs. When the five Zang organs are disharmonious, the six Fu organs become obstructed. Thus, Stomach disease leads to rebellious Qi; if Qi cannot emerge upward from the Lung, hiccups occur; hiccups are eructations that fail to descend to the Kidney, leading to fear, which arises from the disharmony of Wu and Gui. Large and Small Intestine diseases lead to diarrhea, where water and grain flow downward. Lower Jiao disease fails to regulate water passages, leading to flooding and water retention. Bladder disease, with stagnant Qi and poor circulation, leads to strangury; Qi deficiency and lack of restraint lead to enuresis. Gallbladder disease, constrained and unrelieved, leads to anger. These diseases of the Five Qi affecting the six Fu organs constitute the "Five Diseases."
**The Merging of Five Essences:** If Essence-Qi merges into the Heart, there is joy (Xi); if it merges into the Lung, there is sorrow (Bei); if it merges into the Liver, there is worry (You); if it merges into the Spleen, there is dread (Wei); if it merges into the Kidney, there is fear (Kong); this is called the "Five Mergings." This occurs due to deficiency and mutual merging.
The so-called Five Mergings refer to the merging of Essence-Qi into deficient Zang organs. Essence refers to Yin Essence, and Qi refers to Yang Qi. When Essence-Qi merges into the Heart, the Heart receives the merged Qi and manifests joy, which is the emotion of the Heart. When it merges into the Lung, the Lung receives the merged Qi and manifests sorrow, which is the emotion of the Lung. When it merges into the Liver, the Liver receives the merged Qi and manifests worry. Although the Liver governs anger, here it is said to govern worry because the previous text stated the Gallbladder governs anger; thus, the Liver governs worry here. Anger represents excess, while worry represents deficiency. When it merges into the Spleen, the Spleen receives the merged Qi and manifests dread. While deliberation is the emotion of the Spleen, here it is said to be dread because extreme deliberation leads to fear. When it merges into the Kidney, the Kidney receives the merged Qi and manifests fear, which is the emotion of the Kidney. All these constitute the "Five Mergings," clarifying that these mergings occur due to deficiency. Thus, the merging of Essence-Qi indicates a insufficiency of Essence-Qi.
**What the Five Zang Organs Dislike:** The Heart dislikes Heat (Re), the Lung dislikes Cold (Han), the Liver dislikes Wind (Feng), the Spleen dislikes Dampness (Shi), and the Kidney dislikes Dryness (Zao); this is called the "Five Dislikes."
"Dislike" is pronounced with the departing tone. Heat Qi damages the Heart, so the Heart dislikes heat. Cold Qi damages the Lung, so the Lung dislikes cold. Wind Qi damages the Liver, so the Liver dislikes wind. Dampness Qi damages the Spleen, so the Spleen dislikes dampness. Dryness Qi damages the Kidney, so the Kidney dislikes dryness. All these constitute the "Five Dislikes."
**Transformation Fluids of the Five Zang Organs:** The Heart transforms sweat (Han), the Lung transforms nasal mucus (Ti), the Liver transforms tears (Lei), the Spleen transforms saliva/phlegm (Xian), and the Kidney transforms thick saliva (Tuo); this is called the "Five Fluids."
Transformation fluids refer to the process where food and drink enter, and body fluids travel their respective pathways. The five Zang organs receive the essence of food and drink, moistening and pouring it into orifices, transforming it into fluids. Sweat is blood-related, governed by the Heart, so the Heart produces sweat. Nasal mucus emerges from the nose, governed by the Lung, so the Lung produces nasal mucus. Tears emerge from the eyes, governed by the Liver, so the Liver produces tears. Saliva emerges from the mouth, governed by the Spleen, so the Spleen produces saliva. Thick saliva belongs to Water Essence, governed by the Kidney, so the Kidney produces thick saliva. All these constitute the "Five Fluids." The *Ling Shu: Gen Jie* chapter states: The Shaoyin channel roots at Yongquan (KI1) and knots at Lianquan (RN23). Lianquan is the orifice under the tongue. This shows the Kidney is the Water Organ, ascending from below. Although there are five fluids, they are actually governed by the Kidney; therefore, all five fluids have a salty taste, and salty is the taste of Water.
**Prohibitions Regarding the Five Flavors:** Pungent flavor moves Qi; for Qi diseases, do not eat much pungent flavor. Salty flavor moves Blood; for Blood diseases, do not eat much salty flavor. Bitter flavor moves Bones; for Bone diseases, do not eat much bitter flavor. Sweet flavor moves Flesh; for Flesh diseases, do not eat much sweet flavor. Sour flavor moves Tendons; for Tendon diseases, do not eat much sour flavor. This is called the "Five Prohibitions," meaning do not allow excessive consumption.
Each of the five flavors has its own predominance, hence the prohibition against excessive consumption. Pungent flavors move Qi; for Qi diseases involving Lung Qi deficiency, one should not eat much pungent flavor. Salty flavors move Blood; for Blood diseases involving Heart Blood deficiency, one should not eat much salty flavor. Bitter flavors move Bones; for Bone diseases involving Kidney deficiency, one should not eat much bitter flavor. Sweet flavors move Flesh; for Flesh diseases involving Spleen deficiency, one should not eat much sweet flavor. Sour flavors move Tendons; for Tendon diseases involving Liver deficiency, one should not eat much sour flavor. All these constitute the "Five Prohibitions." The term "prohibition" does not mean absolute abstinence but rather avoiding excessive consumption.
**Onset of Five Diseases:** Yin diseases manifest in bones, Yang diseases manifest in blood, Yin diseases manifest in flesh, Yang diseases manifest in winter, and Yin diseases manifest in summer; this is called the "Five Onsets."
Diseases of Yin and Yang within the five Zang organs each have specific sites of onset. The *Jin Gui Zhen Yan Lun* states: Yin within Yin is the Kidney; Yang within Yang is the Heart; Yin among Supreme Yin is the Spleen; Yin among Yang is the Liver; Yang within Yin is the Lung. The Kidney is Yin, governing bones, so Kidney Yin diseases manifest in bones. The Heart is Yang, governing blood, so Heart Yang diseases manifest in blood. The Spleen is Yin, governing flesh, so Spleen Yin diseases manifest in flesh. The Liver is Yang, corresponding to Spring; if Winter fails to store, Spring cannot generate, so Liver Yang diseases manifest in Winter. The Lung is Yin, corresponding to Autumn; if Summer fails to grow, Autumn cannot harvest, so Lung Yin diseases manifest in Summer. All these Yin and Yang diseases have specific onsets, constituting the "Five Onsets."
**Disorder Caused by Five Pathogenic Factors:** When pathogenic factors enter Yang, there is mania (Kuang); when they enter Yin, there is bi-syndrome (Bi); when they struggle with Yang, there is dian-jie disease (Dian Ji); when they struggle with Yin, there is aphonia (Yin); when Yang enters Yin, there is quietness; when Yin emerges to Yang, there is anger. This is called the "Five Disorders."
"Yin" is pronounced like "Yin," same as in other chapters. This lists the five disorders caused by pathogenic factors to supplement the previous text. The previous text stated Yang diseases manifest in blood (Heart) and in Winter (Liver); thus, when righteous Qi is disturbed by pathogens and enters the Yang aspects of the Heart and Liver, mania occurs. The previous text stated Yin diseases manifest in bones (Kidney), in flesh (Spleen), and in Summer (Lung); thus, when pathogens disturb righteous Qi and enter the Yin aspects of the Kidney, Spleen, and Lung, bi-syndrome occurs. Bi refers to pathogens lingering in skin, flesh, and bones, causing bi-pain. Struggling with Yang leads to dian-jie disease, supplementing the idea that pathogenic entry into Yang causes mania; there are cases where pathogens struggle with Yang leading to dian-jie. Struggling with Yin leads to aphonia, supplementing the idea that pathogenic entry into Yin causes bi-syndrome; there are cases where pathogens struggle with Yin leading to aphonia. "Struggle" refers to the contention between Yin and Yang. Struggling with Yin leads to aphonia, which is Yang entering Yin, resulting in quietness and aphonia. Struggling with Yang leads to dian-jie disease, which is Yin emerging to Yang, resulting in anger and dian-jie disease. All these involve the disturbance of Yin and Yang within the five Zang organs by pathogens, called the "Five Disorders," clarifying that the onset of five diseases is due to initial disorder or worsening after onset.
**Manifestations of Five Pathogenic Factors:** In Spring, obtaining an Autumn pulse; in Summer, obtaining a Winter pulse; in Late Summer, obtaining a Spring pulse; in Autumn, obtaining a Summer pulse; in Winter, obtaining a Late Summer pulse, is named "Yin emerging to Yang." The patient easily becomes angry and is incurable. This is called "All Five Pathogens are the Same," indicating death and incurability.
"Xian" is pronounced like "Xian" (appear). The so-called manifestations of five pathogens refer to the five Zang organs receiving pathogens, manifested in the pulses. Spring obtaining an Autumn pulse indicates Metal overcoming Wood. Summer obtaining a Winter pulse indicates Water overcoming Fire. Late Summer obtaining a Spring pulse indicates Wood overcoming Earth. Autumn obtaining a Summer pulse indicates Fire overcoming Metal. Winter obtaining a Late Summer pulse indicates Earth overcoming Water. This is named "Yin emerging to Yang," meaning pathogens invading the Yin of the five Zang organs emerge to the Yang of the meridians. The patient easily becomes angry because, in Spring, obtaining an Autumn pulse means Liver Wood is punished, hence anger. It must be treated urgently; if untreated, pathogens will interfere with the five Zang organs. This is called "All Five Pathogens are the Same," meaning the five Zang organs receiving pathogens is similar to Wood being punished by Metal. "Death and incurability" means that although the person lives, their life force is dead due to the punishment of the five Zang organs, hence incurable.
**What the Five Zang Organs Store:** The Heart stores Shen (Spirit), the Lung stores Po (Corporeal Soul), the Liver stores Hun (Ethereal Soul), the Spleen stores Yi (Intellect), and the Kidney stores Zhi (Will); this is called what the five Zang organs store.
Excluding the five Zang organs, other organs are taken literally. It refers to the Heart, Lung, Liver, Spleen, and Kidney storing Spirit, Corporeal Soul, Ethereal Soul, Intellect, and Will, respectively. This is called the five Zang organs, each having its specific storage.
**What the Five Zang Organs Govern:** The Heart governs vessels (Mai), the Lung governs skin (Pi), the Liver governs tendons (Jin), the Spleen governs flesh (Rou), and the Kidney governs bones (Gu); this is called the "Five Governs."
It refers to the Heart, Lung, Liver, Spleen, and Kidney governing vessels, skin, tendons, flesh, and bones, respectively. This is the external correspondence of the five Zang organs, hence called the "Five Governs."
**Injuries Caused by Five Types of Strain:** Prolonged viewing damages Blood, prolonged lying down damages Qi, prolonged sitting damages flesh, prolonged standing damages bones, and prolonged walking damages tendons; this is called the injuries caused by five types of strain.
Prolonged viewing, lying down, sitting, standing, and walking constitute the five strains. Strain causes injury to the five Zang organs. The Heart governs Blood; prolonged viewing damages it. The Lung governs Qi; prolonged lying down damages it. The Spleen governs flesh; prolonged sitting damages it. The Kidney governs bones; prolonged standing damages it. The Liver governs tendons; prolonged walking damages it. All these constitute the "Injuries Caused by Five Types of Strain."
**Correspondences of the Five Pulses:** The Liver pulse is Wiry (Xian), the Heart pulse is Hooked (Gou), the Spleen pulse is Interchangeable/Dai (Dai), the Lung pulse is Hairy/Feather-like (Mao), and the Kidney pulse is Stone-like (Shi); this is called the pulses of the five Zang organs.
It refers to the pulses of the Liver, Heart, Spleen, Lung, and Kidney corresponding to Wiry, Hooked, Interchangeable, Hairy, and Stone-like, which are the pulse images of the four seasons and five elements. The way of Heaven and Earth does not exceed the Five Elements, and the human body's form and viscera do not depart from Qi. This is how the Qi of the Zang organs follows the seasons to elucidate the Five Qi.