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Tonify its mother organ. Now, however, it is said to tonify its child organ. Why? Wang Bing said: Do you not know that deficiency consumption (Xu Lao) differs from other diseases? The *Qian Jin Fang* records: When Heart Qi is severely exhausted, one should tonify Spleen Qi to benefit it. When Spleen Qi is prosperous, it can sense and nourish the Heart. This is consistent with the meaning of Xunzi's statement that "there is no case where the son is wealthy while the father is poor." (Note: Haizang used Pi Bu Tang (Spleen Tonifying Decoction), assisted by Xiao Chai Hu Tang (Minor Bupleurum Decoction), to resolve body heat and spontaneous sweating. From this, we know that deficiency heat remains in the meridians; therefore, treatment does not focus exclusively on the Zang organs.)

Based on Shang Haicang's medical cases, it is evident that there are indeed diseases of the Hand-Shaoyin Meridian in Shanghan (Cold Damage), which is beyond doubt.

The Pericardium Meridian of Hand-Jueyin originates in the chest, emerges to connect with the Pericardium, descends through the diaphragm, and successively connects with the Triple Burner. (The Pericardium, also known as Shou Xin Zhu (Hand Heart Master). Hua Shou noted: In terms of function, the Hand-Jueyin Ministerial Fire acts on behalf of Sovereign Fire, thus serving as the master of the Heart. In terms of zang-xiang morphology, it is located outside the fat membrane surrounding the heart, connected to the Heart and Lungs by fine fibrous membranes, hence called the Pericardium of the Heart. For the explanation of the Triple Burner, see previous notes. This passage describes the Pericardium Meridian of Hand-Jueyin originating in the chest, emerging to connect with the Pericardium below the heart, descending through the diaphragm, passing the upper epigastrium (Shang Wan) of the stomach to connect with the Upper Burner; passing the middle epigastrium (Zhong Wan) to connect with the Middle Burner; reaching one cun below the umbilicus to connect with the Lower Burner. Hence it is said to "successively connect." Examining the location of the Upper Burner, it should be above the diaphragm below the heart, with its treatment site at Danzhong (CV17). Hua Shou's note stating "at the upper opening of the stomach" is incorrect; it is now corrected to "upper epigastrium," which aligns with "descending through the diaphragm." Since the upper epigastrium is below the diaphragm, although the function of the Upper Burner is primarily above the diaphragm, it actually communicates with the area below the diaphragm.) Its branch follows the chest, emerges from the hypochondrium, descends three cun below the axilla, ascends to reach the axilla, runs along the medial aspect of the arm, travels between the Taiyin and Shaoyin meridians, enters the elbow center, descends along the forearm, runs between two tendons, enters the palm, and follows the middle finger to its tip. (This describes the course of the branch meridian: from the point connecting with the Pericardium, it ascends along the chest, transversely emerges from the hypochondrium three cun below the axilla, returns upward to the axilla, runs along the inner aspect of the arm muscle, descends to lie between the Taiyin and Shaoyin meridians, enters the elbow, descends along the forearm between the two tendons, enters the palm, and follows the middle finger to its tip to terminate.) Another branch separates from the palm, follows the ring finger to its tip. (This refers to the intersecting branch: from the point entering the palm, it separately follows the ring finger to its tip to intersect with the Hand-Sanjiao Meridian.)

[Image: Diagram of the Pericardium Meridian of Hand-Jueyin]

Wang Hu notes: The Pericardium Meridian of Hand-Jueyin divides into six pathways up, down, left, and right. The root of the meridian, originating in the chest, emerging to connect with the Pericardium, and descending through the diaphragm to successively connect with the Triple Burner, constitutes two pathways (Some say this refers only to the single central pathway, but considering where it emerges to connect with the Pericardium, it must divide to connect on both left and right sides). These are the main meridians. The branches that follow the chest, emerge from the hypochondrium, ascend to the axilla, descend to the arm, elbow, forearm, and palm, and follow the middle finger to its tip constitute two pathways. Although these are branch meridians, they essentially connect with the main meridians and run along the hand. Furthermore, the branch that separates from the palm and follows the ring finger to its tip constitutes two pathways. These are the two small branch meridians for intersection. The earlier *Re Lun* (Treatise on Heat Diseases) states: "Vexation, fullness, and retraction of the testicles." Retraction of the testicles is undoubtedly a disease of the Foot-Jueyin Meridian. However, are not vexation and fullness diseases of the Hand-Jueyin Meridian? The Pericardium Meridian of Hand-Jueyin follows the chest and descends through the diaphragm. Vexation and fullness are currently diseases of the chest and diaphragm region, caused by injury to the Sanjiao collaterals. Physicians are often ignorant and fail to examine this.

Wu Yuanpan stated: In the *Shanghan Lun*, there are five formulas of Xiexin Tang (Drain the Epigastrium Decoction). Because these decoctions differ in cold and hot properties, Qibo said: This is not draining the heat of the Heart Fire, but draining the stuffiness (Pi) in the epigastrium. Little do they know that the stuffiness in Shanghan is due to an excess of heat pathogenic qi in the chest and diaphragm. Zhang Zhongjing's use of Xiexin Tang is actually to drain the heat of the Pericardium. Among these five formulas, Fuzi (Aconite Root) is the hottest herb. Yet, the formula contains two liang of Dahuang (Rhubarb Root), and one liang each of Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome), making it purely a bitter-cold agent to drain heat. This merely borrows the acridity of Fuzi to disperse the knotting of pathogenic factors in the Pericardium. Moreover, the Pericardium belongs to Fire, and Fuzi also belongs to Fire; employing the method of following treatment (Cong Zhi), nothing is more exquisite than this.

The *Baoming Ji* records: After purgation in Shanghan, if there is knotted stuffiness in the chest, the pathology lies in the Foot-Shaoyin Kidney Meridian and the Hand-Jueyin Pericardium Meridian. One should puncture the Jing-Well and Yuan-Source points of these two meridians to drain the qi in the chest.

Based on the above two discussions, it is undeniable that there are diseases of the Hand-Jueyin Meridian in Shanghan.

Summarizing the six passages regarding the hand meridians mentioned above, among people affected by cold pathogens and developing heat in all four seasons, such cases are not few. When heat pathogens injure the hand meridians, one should theoretically examine the syndrome and treat accordingly. However, current practitioners of Shanghan treatment consider the syndromes of the hand six meridians to be pedantic and irrelevant to the actual condition. Consequently, when encountering syndromes of the hand three yang meridians, they mix them with foot three yang meridians without realizing it; when encountering syndromes of the hand three yin meridians, they mix them with transmission syndromes of the foot three yin meridians, or with excess heat syndromes of the stomach fu-organs, without noticing. This leads to prescriptions mismatched to syndromes and medicines causing death, which is truly painful. I have privately examined that the *Suwen* classifies Shanghan as a heat disease etiology, recording the *Rebing Pian* (Chapter on Heat Diseases) and the *Ci Re Pian* (Chapter on Puncturing Heat Diseases). This chapter is entirely relevant; those who use acupuncture must investigate it. It briefly states: For Heart heat disease, puncture the Hand-Shaoyin and Hand-Taiyang meridians; for Lung heat disease, puncture the Hand-Taiyin and Hand-Yangming meridians. It also states: For heat disease beginning with arm pain, puncture the Hand-Yangming and Hand-Taiyin meridians. It further states: For severe heat disease, perform the fifty-nine punctures. The *Jia Yi Jing* states that the so-called fifty-nine punctures consist of three points on each side of the hands' outer and inner aspects, totaling twelve points; one point between each of the five fingers, totaling eight points; the feet are similar. Thus, the method of puncturing heat diseases cannot be limited to the foot meridians while neglecting the hand meridians.俗医 (Common physicians) do not study acupuncture methods, seeking only herbal decoctions, thereby ignoring the hand meridians. Little do they know that treating heat diseases without understanding the hand meridians results in omissions in herbal treatment methods. How can one claim to be a physician responsible for human life? Therefore, Sun Simiao in his *Xiye Pian* (Chapter on Professional Study) states: Anyone wishing to become a Grand Physician must be proficient in the *Jia Yi Jing*, *Suwen*, *Huangdi Zhenjing*, *Mingtang Liuzhu*, *Twelve Meridians*, and *Sanbu Jiuhou*. Only then can one be considered a Grand Physician; otherwise, it is like wandering blindfolded at night, inevitably leading to falls and death. Zhu Fengyi also stated: To treat Shanghan, one must first understand the meridians. Without understanding the meridians, one wanders blindly. Those engaged in medicine who wish to understand the transmission and strange syndromes of Shanghan must look to the twelve hand and foot meridians, the five zang and six fu organs, and the concepts of yin-yang and deficiency-excess. Why not devote yourself to studying this volume?