素问·六节藏象论 Discourse on the Six Sections and Visceral Manifestations
黄帝问曰：余闻天以六六之节，以成一岁，人以九九制会，计人亦有三百六十五节以为天地久矣，不知其所谓也。歧伯对曰：昭乎哉问也，请遂言之。夫六六之节，九九制会者，所以正天之度、气之数也。天度者，所以制日月之行也；气数者，所以纪化生之用也。
天为阳，地为阴；日为阳，月为阴。行有分纪，周有道理，日行一度，月行十三度而有奇焉，故大小月三百六十五日而成岁积气馀而盈闰矣。立端于始，表正于中，推馀于终，而天度毕矣。
帝曰：余已闻天度矣，愿闻气数何以合之。歧伯曰：天以六六为节，地以九九制会，天有十日，日六竟而周甲，甲六复而终岁，三百六十日法也。夫自古通天者，生之本，本于阴阳。其气九州九窍，皆通乎天气。故其生五，其气三，三而成天，三而成地，三而成人，三而三之，合则为九，九分为九野，九野为九藏，故形藏四，神藏五，合为九藏以应之也。
帝曰：余已闻六六九九之会也，夫子言积气盈闰，愿闻何谓气。请夫子发蒙解惑焉。歧伯曰：此上帝所秘，先师传之也。帝曰：请遂闻之。歧伯曰：五日谓之候，三候谓之气，六气谓之时，四时谓之岁，而各从其主治焉。五运相袭，而皆治之，终朞之日，周而复始，时立气布，如环无端，候亦同法。故曰：不知年之所加，气之盛衰，虚实之所起，不可以为工矣。
帝曰：五运之始，如环无端，其太过不及何如。歧伯曰：五气更立，各有所胜，盛虚之变，此其常也。帝曰：平气何如？歧伯曰：无过者也。帝曰：太过不及奈何。歧伯曰：在经有也。帝曰：何谓所胜。歧伯曰：春胜长夏，长夏胜冬，冬胜夏，夏胜秋，秋胜春，所谓得五行时之胜，各以气命其藏。帝曰：何以知其胜。歧伯曰：求其至也，皆归始春，未至而至，此谓太过，则薄所不胜，而乘所胜也，命曰气淫。不分邪僻内生，工不能禁。至而不至，此谓不及，则所胜妄行，而所生受病，所不胜薄之也，命曰气迫。所谓求其至者，气至之时也。谨候其时，气可与期，失时反候，五治不分，邪僻内生，工不能禁也。帝曰：有不袭乎。歧伯曰：苍天之气，不得无常也。气之不袭，是谓非常，非常则变矣。帝曰：非常而变柰何。歧伯曰：变至则病所，胜则微，所不胜则甚，因而重感于邪，则死矣。故非其时则微，当其时则甚也。
帝曰：善。余闻气合而有形，因变以正名。天地之运，阴阳之化，其于万物，孰少孰多，可得闻乎。歧伯曰：悉哉问也，天至广不可度，地至大不可量，大神灵问，请陈其方。草生五色，五色之变，不可胜视；草生五味，五味之美，不可胜极，嗜欲不同，各有所通。天食人以五气，地食人以五味。五气入鼻，藏于心肺，上使五色修明，音声能彰。五味入口，藏于肠胃，味有所藏，以养五气，气和而生津液相成，神乃自生。
帝曰：藏象何如。歧伯曰：心者，生之本，神之变也，其华在面，其充在血脉，为阳中之太阳，通于夏气。肺者，气之本，魄之处也，其华在毛，其充在皮，为阳中之太阴，通于秋气。肾者，主蛰封藏之本，精之处也，其华在发，其充在骨，为阴中之少阴，通于冬气。肝者，罢极之本，魂之居也，其华在爪，其充在筋，以生血气，其味酸，其色苍，此为阳中之少阳，通于春气。脾胃大肠小肠三焦膀胱者，仓廪之本，营之居也，名曰器，能化糟粕，转味而入出者也，其华在唇四白，其充在肌，其味甘，其色黄，此至阴之类通于土气。凡十一藏取决于胆也。
故人迎一盛病在少阳，二盛病在太阳，三盛病在阳明，四盛已上为格阳。寸口一盛，病在厥阴，二盛病在少阴，三盛病在太阴，四盛已上为关阴。人迎与寸口俱盛四倍已上为关格，关格之脉赢，不能极于天地之精气，则死矣。
Huangdi asked: I have heard that heaven forms a year through six periods of six, while man corresponds to this through the framework of nine-nine, and that man likewise has three hundred sixty-five joints, matching heaven and earth from ancient times — yet I do not understand what this means. Qibo replied: What an illuminating question! Let me explain it fully. The six-six periods and the nine-nine correspondence are the means by which the measures of heaven and the numbers of qi are made correct. The measures of heaven govern the movements of the sun and moon; the numbers of qi record the workings of transformation and generation.
Heaven is yang and earth is yin; the sun is yang and the moon is yin. Their movements have divisions and order, their cycles have paths and patterns. The sun travels one degree each day, the moon travels thirteen degrees and a fraction more, so that through the alternation of long and short months, three hundred sixty-five days make up a year, and the accumulated surplus of qi fills out into an intercalary month. One establishes the starting point at the beginning, corrects the markers at the midpoint, and calculates the remainder at the end, and thus the measures of heaven are complete.
Huangdi said: I have now heard of the measures of heaven; I wish to hear how the numbers of qi correspond to them. Qibo said: Heaven takes six-six as its period, earth takes nine-nine as its framework of correspondence. Heaven has ten stems; when the stems have cycled six times, a sexagenary cycle is complete; when the sexagenary cycle repeats six times, the year is complete — this is the rule of three hundred sixty days. From ancient times, that which connects with heaven is the root of life, and this root lies in yin and yang. The qi of the nine provinces and the nine orifices of the body all connect with the qi of heaven. Thus it generates five, and its qi is three; three completes heaven, three completes earth, three completes man; three multiplied by three makes nine; nine divides into nine fields, and the nine fields correspond to the nine viscera. Hence there are four visceral forms and five spirit viscera, together constituting the nine viscera that correspond to heaven and earth.
Huangdi said: I have now heard of the correspondence of six-six and nine-nine. You have spoken of accumulated qi filling out into intercalation; I wish to hear what is meant by qi. Please, Master, dispel my ignorance and resolve my doubts. Qibo said: This was kept secret by the high sovereigns of antiquity and handed down by former teachers. Huangdi said: Please let me hear it fully. Qibo said: Five days are called a watch; three watches are called a qi-period; six qi-periods are called a season; four seasons are called a year, and each governs its own rule. The five movements succeed one another and each in turn governs; when the cycle of the year is complete, it turns and begins again — the seasons are established and the qi is distributed like a ring without end, and the watches follow the same pattern. Hence it is said: one who does not know what is added to the year, the flourishing and decline of qi, and where deficiency and excess arise, cannot be considered a skilled physician.
Huangdi said: The beginnings of the five movements are like a ring without end — what of their excess and insufficiency? Qibo said: The five qi arise in succession, each having what it overcomes; the changes of flourishing and deficiency are their constant pattern. Huangdi said: What is a balanced qi? Qibo said: It is one without excess. Huangdi said: What of excess and insufficiency? Qibo said: These are recorded in the classics. Huangdi said: What is meant by 'what it overcomes'? Qibo said: Spring overcomes late summer, late summer overcomes winter, winter overcomes summer, summer overcomes autumn, autumn overcomes spring — this is called the mutual overcoming of the seasons according to the five phases, each naming its viscus by its qi. Huangdi said: How does one know which overcomes? Qibo said: One seeks its arrival, always returning to the start of spring. If it arrives before its time, this is called excess; it then oppresses what it cannot overcome and rides roughshod over what it overcomes — this is called excessive qi. One cannot then distinguish whether evil and deviance arise internally, and the physician cannot prevent it. If it has not arrived by its time, this is called insufficiency; then what it normally overcomes acts recklessly, and that which it generates suffers illness, while that which it cannot overcome oppresses it — this is called qi under duress. What is meant by 'seeking its arrival' is the time when the qi arrives. If one carefully watches for that time, the qi's arrival can be anticipated; but if one misses the time and fails to observe correctly, the five modes of treatment cannot be distinguished, and evil and deviance arise internally, which the physician cannot prevent. Huangdi said: Can it ever fail to follow this succession? Qibo said: The qi of the blue heaven cannot be without constancy; when the qi fails to follow its succession, this is called abnormal, and when it is abnormal, change occurs. Huangdi said: When it is abnormal and changes, what then? Qibo said: When change arrives, sickness occupies its place; if it is what it overcomes, the illness is mild; if it is what it cannot overcome, the illness is severe; and if compounded further by being struck again by evil qi, death results. Hence, if it is not the proper time, the illness is mild; if it is the proper time, the illness is severe.
Huangdi said: Good. I have heard that when qi combines it gives rise to form, and that through its transformations one establishes its proper name. Regarding the movements of heaven and earth and the transformations of yin and yang, in relation to the myriad things, which are few and which are many — may I hear of this? Qibo said: What a thorough question! Heaven is so vast it cannot be measured, earth is so great it cannot be gauged. Since Your Majesty's spirit-like inquiry reaches so far, let me set forth its general pattern. Plants produce the five colors, and the transformations of the five colors cannot all be seen; plants produce the five flavors, and the excellence of the five flavors cannot be exhausted. People's cravings and desires differ, each connecting with what suits it. Heaven feeds man with the five qi, earth feeds man with the five flavors. The five qi enter through the nose and are stored in the heart and lungs, causing the five colors above to become clear and lustrous and the voice to become resonant. The five flavors enter through the mouth and are stored in the intestines and stomach; the flavors are stored so as to nourish the five qi. When the qi is harmonious, fluid and humor are thereby generated, and the spirit then arises of itself.
Huangdi said: What of the manifestations of the viscera? Qibo said: The heart is the root of life, the seat of the transformations of spirit; its bloom is in the face, its fullness is in the blood vessels; it is the greater yang within yang, and it connects with the qi of summer. The lung is the root of qi, the dwelling place of the corporeal soul; its bloom is in the body hair, its fullness is in the skin; it is the lesser yin within yang, and it connects with the qi of autumn. The kidney governs hibernation and storage, and is the root of sealing and storing, the dwelling place of essence; its bloom is in the hair of the head, its fullness is in the bones; it is the lesser yin within yin, and it connects with the qi of winter. The liver is the root of endurance against exhaustion, the residence of the ethereal soul; its bloom is in the nails, its fullness is in the sinews; it generates blood and qi; its flavor is sour, its color is blue-green; it is the lesser yang within yang, and it connects with the qi of spring. The spleen, stomach, large intestine, small intestine, triple burner, and bladder are the root of the granary and storehouse, the residence of the nutritive qi; they are called vessels, able to transform waste matter, turning over flavors so that they pass in and out; their bloom is in the four whites around the lips, their fullness is in the flesh; their flavor is sweet, their color is yellow; these belong to the category of utmost yin, connecting with the qi of earth. In all, the function of the eleven viscera depends upon the gallbladder.
Therefore, when the Renying pulse at the neck is one degree stronger than normal, the disease is in the lesser yang; when two degrees stronger, the disease is in the greater yang; when three degrees stronger, the disease is in the yang brightness; when four degrees or more, this is called blocked yang. When the Cunkou pulse at the wrist is one degree stronger, the disease is in the reverting yin; when two degrees stronger, the disease is in the lesser yin; when three degrees stronger, the disease is in the greater yin; when four degrees or more, this is called barred yin. When both the Renying and Cunkou pulses are four times stronger than normal, this is called barred-and-blocked; when the pulse of barred-and-blocked becomes excessive, it can no longer reach the utmost essential qi of heaven and earth, and death follows.