厥 厥之有寒热者。阳气衰于下则为寒厥。阴气衰于下则为热厥。人之阴阳元气皆起于下。故少阴之上。名为太阳。
以真阳之生本于阴也。太冲之地。名曰少阴。以真阴之归根在肾也。夫阳气自上而下。今衰于下是不下矣。不下是寒独
治也。阴气自下而上。今衰于下是不上矣。不上是阳独胜也。然阳胜而又必起于下者。足五指之表为三阳之所起。而足
下足心。又为三阴之所聚。足心则少阴肾之涌泉也。阴气既衰而阳胜。阳乘阴位。故热厥必从足下也。凡人病阴虚者。
足心必热。此其证也。寒厥起于足下。久必从五指而上于膝者。以阴气起于五指之里。集于膝下而聚于膝上。阳气衰则
阴气胜。阳不胜阴。其厥反从阳分而上。故必超于五指而上寒至膝。然其寒也非从外入。皆由内而生也。凡人病阳虚者。
必手足多寒。皆从指端始。此其症也。顾二厥之成。 其由则皆以阴虚。寒厥之故。以其人质壮。秋冬夺于所用。既于
阴盛时多欲不休。以夺质中之精气。则精虚于下。而其气将取足于上。是以下气上争。上而不下。故不能复其阳气。于
是气去则阳虚。寒气因而上逆。又以精虚无火。不能固脾元。而气衰于中。中气不能渗荣其经络。于是阳气日损。阴气
独在。故手足为之寒也。热厥之由。以酒入于胃而伤脾阴。脾阴伤则阳气入而精气竭。精气日竭。不能荣其四肢。而又
数醉饱以入房。使气聚脾中而不得散。酒气谷气相搏。热盛于中。故热遍于身。内热而溺赤也。要此寒热二厥。一由恃
壮夺于所用。故阳衰而为寒。一由数醉入房故精竭而为热。唯其伤真元。乃有是病。后世不详。但以手足寒或以香港脚为
厥者大谬。今人多不知此证。而指为中风。夫风病多经络之受伤。厥逆由真精之内夺。若以风治厥。更谬之谬矣。
厥有腹满而暴不知人者。以阴气盛于上。则不守于下，而脾肾肝足三阴之气不化。故腹满胀。阳气盛于上。则下气
并上而邪气逆。逆则阳气乱而神明失守。故暴不知人。
阴阳不从则气逆而上。故手足十二经皆有寒热之厥。若巨阳之厥。肿首头重。足不能行。发为 仆。太阳为阳之极
盛。其根起于足少阴。其气必得阴而下行于足。令虚则逆而上盛。故肿首头重。上逆则不能下行。故足不能行而发为
仆也。 仆。目眩猝倒也。
阳明之厥。癫疾欲走呼。腹满不得卧。面赤而热。妄见妄言。阳明乃气盛血多之经。令气胜其血则阳邪实。阳邪实
则神明乱。故癫疾走呼也。气盛不行而在腹。故腹满胃逆。故不得卧面赤而热。阳明脉在面也。妄见妄言。神明之乱。
更甚于走呼矣。
少阳之厥。暴聋颊肿胁痛。 不可以运。少阳起于下而与厥阴之气并行。故其经和而无病。今少阳之厥。是相火上
炎而无阴也。其脉入耳故暴聋。脉下颊车故颊肿。皆火症也。胁痛。其部气逆而不和也。 不可以运。则少阳不能及下
矣。
太阴之厥。腹满 胀。后不利。不欲食。食则呕。不得卧。阴为阳根。而阳为阴使。三阴不能副阳。则三阳厥。三
阳不为阴使。则三阴亦厥。太阴虽阴盛。而常秉少阳之气以为和。今太阴独阴无阳而不能下行。则阴自上逆。脾既不运。
胃气亦留而不行。故腹满 胀也。不能行气于三阴。则肾气亦不效用。故后不利也。不欲食者。中气壅也。食则呕者。
气壅金逆也。不得卧者。胃不和则卧不安也。
少阴之厥。口干。溺赤。腹满心痛。少阴兼水火阴阳二气。若失其所以涵藏。其气必偏发而上。故少阴恒兼寒热二
厥。且又为十二经厥逆之主也。经曰。少阴不至者。厥也。不至亦兼水火。今此厥者。阴虚火厥也。少阴脉循喉。故口
干。与膀胱相络。故热入膀胱而溺赤。不为胃关而上行。故腹满。不贡精于心而反上乘于心。故心痛。
厥阴之厥。少腹肿痛。腹胀泾溲不利。好卧屈膝。阴缩肿。 内热。厥阴阴之绝。昼而不绝者。为阳生也。今虚而
为纯阴则无气。是以当其部位。少腹肿痛。纯阳结而不舒。故腹胀。不舒则下焦之气亦不化。故泾溲不利。肝主筋。筋
无气故足软好卧而屈膝。脉环阴器。故阴缩肿。当所过脉不行。故 内热。盖郁则热也。
手太阴厥逆。虚满而咳。善呕沫。手太阴为元气之主。虚则不能治节而苦气上逆。故虚满而咳。虚满者。上焦之满。
虚而无实也。满则咳矣。善呕沫者。其脉循中焦胃口。逆则精不能散。故呕沫也。
手心主少阴厥逆。心痛引喉。身热死不可治。二经属火。为神明之府。血脉之主。今俱厥逆则阴精无以承阳矣。阳
独亢则自焚。故心痛也。其系皆上挟喉。故痛引喉也。身热者。血脉 胀也。心为脏腑之大主。逆之则死。
手太阳厥逆。耳聋泣出。项不可以顾。腰不可以俯仰。小肠经为心之下流。属带脉之间。其气若逆则必使其经俱逆。
小肠经主目之内外 。故泣出。又皆入耳。故耳聋。从缺盆循头。故项不可顾。小肠连睾丸属脊。故腰不可俯仰。
手阳明少阳厥逆。发喉痹。嗌肿。痉。手阳明为胃之下流。手少阳为胃之孔道。其气皆逆。必从其经上逆。大肠之
脉。上头贯项。三焦之脉。出缺盆上项。故皆发喉痹。嗌肿。痉。以致手臂肩背强直也。
有厥逆而为头痛数哕不已者。以其人所犯大寒。内至骨髓。髓以脑为主。故寒逆而 于脑。今头痛齿亦痛。是邪之
逆于上也。故亦名厥逆。
有厥逆而病在太阴。盛在胃。颇在肺者。其为痛。死不治。太阴脉细如发而身热如炭。头膺如格。人迎躁盛。喘息
气逆。一日数十溲。夫太阴脉微细如发。而又一日数十溲。此脏气不足。中气不摄。溲便为之变也。乃热留在胃。阳明
方盛。见于人迎。身膺则如炭如烙。此为阳不入阴。故盛在胃。惟阳不入阴。故太阴细微喘息气逆。颇在肺也。欲泻其
邪。则阴虚于里。欲补其虚。则阳实于外。所谓不表不里。阳证阴脉之类也。故死不可治。
有病膺肿颈痛胸满腹胀。此厥逆也。治之须并其气而治之。肿痛满胀。皆在上中二焦。此为阴并于阳。下逆于上。
正所谓厥逆也。治之之法。不可灸。以有余于上。灸之则以火济火。阳极乘阴。阴不能支。当失声为喑。亦不可石。以
阳并上则下虚。刺之则阳气去。上下俱虚。神失其守。故必为狂。惟俟其既逆之后。其气并而渐通。然后随其盛衰而调
之。庶可无偏绝之患也。
痹 内经曰。病在阳曰风。病在阴曰痹。故痹也者。风寒湿杂至。犯其经络之阴。为合而痹。痹者闭也。三气杂
至。壅闭经络。血气不行。故名为痹。以风胜者为行痹。行痹者走注历节疼痛之类也。寒气胜者为痛痹。以寒凝气聚壅
而不行。痛不可忍。所谓痛风也。湿气胜者为着痹。重着不移。或顽木不仁。多发于肌肉。湿从土化也。然而三气之合。
有轻有重。故有或痛。或不痛或不仁。或寒或热。或燥或湿之异。其痛者。寒多则血脉凝滞。故必为痛。其不痛不仁者。
痛久入深。营卫行涩。经络时疏。则血气衰少而滞逆亦少。故不痛。皮肤不荣。血气不至故不仁。其寒者。其人阳气少
而阴气多。与病相益故寒。其热者。其人阳气多而阴气少。阳与病气胜而阴不胜故热。阳胜其阴而阴不能荣故燥。其逢
湿之甚。与寒相感者。则阳少而阴盛。故多汗而濡也。而其不痛者。则又有五痹。在于骨则重。在于脉则血凝而不流。
在于筋则屈而不伸。在于肉则不仁。在于皮则寒。盖筋皮肉血脉之间。得痹则气缓。故虽痹而不得为痛也。是以凡痹之
类。逢寒则筋挛如虫缩。逢热则弛纵筋缓也。然痹之所由成。其风寒湿三气每各以时而遇。冬气在骨。以冬遇为骨痹。
春气在筋。以春遇为筋痹。夏气在脉。季夏气在肌。秋气在皮。皆以主时之气相遇而受。而皮肉筋骨脉又各有五脏之合。
苟五者受而不去。则必内舍于其合。而五脏之痹起矣。
五脏痹者。皮肉筋骨脉。痹不已将复感于邪而内舍五脏。遂为五脏之痹。肺痹者。烦满喘呕。痹既入脏。则脏气闭
而不通。本气不能升举。肺职治节。痹则上焦不通而胃气逆。故烦满喘而呕也。
心痹者。脉不通。烦则心下鼓暴。上气而喘。嗌干善噫。厥气上则恐。心合脉而痹入之则脉不通。不通则心气郁。
故心下鼓暴。鼓暴则上气而喘也。嗌干善噫。以心脉起心中。上挟胃挟咽也。厥气上则恐。心火衰而邪乘之。故神怯而
恐也。
肝痹。夜卧则惊。多饮数小便。上为引如怀。肝藏魂。血和则魂安。今肝痹则气血两衰。故魂不归而多惊也。肝内
热而脾不淫精于肝。故渴而多饮。肝热下乘膀胱。故数小便也。上为引如怀者。经络有气无血。故上下相引而血不得赴。
若结于中而如有所怀也。
脾痹。四肢解惰。发咳呕汁。上为大塞。又经曰、太阴有余病肉痹。寒中不足病脾痹。四肢解惰。则肉痹之类也。
脾痹者。本脏不足。不能散精。反上壅于肺。故发咳。上焦不通故呕汁。甚则痞塞为大塞也。
肾痹。善胀。尻以代踵。脊以代头。善胀者。阳明之气下行。肾为胃之关。痹气在肾。肾气不行。是阳明逆也。故
善胀。肾为作强之官。痹则足挛而不能伸。故尻代踵。身偻而不能直。故脊代头。
肠痹者。数饮而水出不得。中气喘争。时发飧泄。肠痹兼大小而言。二肠病痹。则下焦之气热郁不化。故虽数饮而
水不得出。水不出则本末俱病。故与中气喘争。其清浊不分。故时发飧泄。
胞痹者。少腹膀胱按之内痛。若沃以汤。涩于小便。上为清涕。胞。膀胱之胞也。气闭故按之内痛。水闭不行故蓄
热若沃汤。且小便涩也。太阳之脉。从巅络脑。故上为清涕也。
凡七情过用。则亦能伤脏气而为痹。不必三气入舍于其合也。所以然者。阴气静则神藏。躁则消亡。故气不养而上
逆喘息。则痹聚在肺。忧思过用。则痹聚在心心。不谨而遗热阴茎以成淋。则痹聚在肾。用力不息而致乏竭。则痹聚在
肝。营卫之气不行以致肌绝。则痹聚在脾。盖七情过用。而淫气能聚而为痹。以躁则消阴故也。其客于六腑者。亦以饮
食居处为其病本。然后风寒中其俞而内应之。是以循其俞而各舍于其腑也。诸痹惟风胜者易已。寒湿留滞不已。亦益入
内不易行也。入脏者死。真阴已伤也。留连筋骨脂而痛久邪深也。留皮肤者易已邪浅也。
十二经筋之病。支转筋痛。皆曰痹者。缘其经筋在外。其病不及经隧之营气。故脏腑亦无涉焉。此惟风寒湿三气得
以病之。故按为四季之痹以见其所感之由。然而三阴手足之筋。皆内结于胸腹肓膜之间。其为病则有异焉。如足少阴筋
主痫螈及痉。足厥阴之阴器不用与不起不收。手厥阴之舌卷。手太阴之息贲胁急吐血。手少阴之伏梁吐脓血。虽属筋痹
病。而已动脏腑之气矣。
诸痹不已。亦益入内而伤脏气。然有三阴三阳应之。而为有余不足者。有曰厥阴有余病阴痹。不足病生热痹。滑则
病狐风疝。涩则少腹积气。涩与滑者。其脉之现于其部。而知其有余不足者也。厥阴位下焦而总诸筋。有余则为阴痹者。
不壅而不升。则邪郁阴分故病阴痹也。若不足则虚而生热。故病热痹也。其脉见滑。是邪有余也。病狐风疝。其疝如狐
而数变如风也。疝在前阴少腹之间。肝气郁于此。正当其部。盖即阴痹也。其脉见涩。为气虚血滞。故邪气留止而为积
聚。亦所谓热痹也。
少阴有余。病皮痹。瘾疹。不足病肺痹。滑则病肺风疝。涩则病积溲血。少阴为君火之气。有余则克金。肺合皮故
皮痹。瘾疹不足。则不能温金。故病肺痹。若脉滑则心火不胜水。邪使郁而实于肺。故病肺风疝。风则肺动。疝则肺聚
也。脉涩则为心血不足。火收于内而入胞络与小肠。故病积与溲血也。
太阴有余。病肉痹寒中。不足病脾痹。滑则病脾风疝。涩则病积心腹时痛。至阴为湿土之气。位处中焦。邪入之而
有余。是湿壅于中。脾主肉。脾湿不运。故为肉痹。中风湿则阳明之火不能扬。故寒中。若不足则脾自受之。故成脾痹。
盖本气窒而不行也。脉滑者水湿壅土。当为 肿重坠之病。亦病在湿也。脉涩者积而不运。满于中州。故心腹时满也。
阳明有余。病脉痹身时热。不足病心痹。滑则病心风疝。涩则病积时善惊。阳明为燥金之气。肺应之。而燥有余则
伤及血脉。故病脉痹。燥伤阴。则病内热。故身热。肺为心行脉者也。若不足则心脉反窒。故病心痹。脉滑者风燥合邪
而伤肺伤血。将心气抽掣而不得散。故病心风疝。涩则金 敛而不舒。而脉为之不行。故病积善惊者。木侮金也。
太阳有余。病骨痹身重。不足病肾痹。滑则病肾风疝。涩则善时巅疾。肾气应太阳。太阳之气有余。则浸淫及骨。
故为骨痹。水邪盛则作强之官弛。故身重。不足则本脏先受。故为肾痹。肾痹者。足缓脉缓而精不固也。滑脉见则太阳
之风寒合邪。故病肾风疝也。涩则邪痹太阳经脉。当见有积而又善时巅疾也者。阳气不通巅顶。故常风痛也。
少阳有余。病筋痹胁满。不足病肝痹。滑则病肝风疝。涩则病积时筋急目痛。相火之气犯阴则肝受之。若邪有余则
Jue (Reversal) syndrome includes those presenting with cold and heat manifestations. When Yang Qi is deficient in the lower part, Cold Jue occurs. When Yin Qi is deficient in the lower part, Heat Jue occurs. The Yuan Qi of both Yin and Yang in humans originates from the lower part. Therefore, above Shaoyin (Kidney Meridian), it is named Taiyang (Bladder Meridian). This is because the True Yang originates from Yin. The place of Taichong is named Shaoyin, because the True Yin returns to its root in the Kidney. Yang Qi moves from top to bottom; now that it is deficient in the lower part, it fails to descend. Failure to descend means Cold dominates exclusively. Yin Qi moves from bottom to top; now that it is deficient in the lower part, it fails to ascend. Failure to ascend means Yang dominates exclusively. However, the dominance of Yang must originate from the lower part: the dorsal surface of the five toes is where the three Yang meridians originate, while the sole of the foot is where the three Yin meridians gather. The sole of the foot is Yongquan (KI 1), the acupoint of Shaoyin Kidney. Since Yin Qi is deficient and Yang is excessive, Yang invades the Yin position; thus, Heat Jue necessarily begins from the sole of the foot. In general, patients with Yin deficiency always have hot soles; this is their clinical manifestation. Cold Jue begins at the sole of the foot and, over time, spreads upward from the five toes to the knees. This is because Yin Qi originates inside the five toes, gathers below the knee, and converges above the knee. When Yang Qi is deficient, Yin Qi becomes excessive, and Yang cannot control Yin. The reversal then tends to rise from the Yang aspect, so it necessarily surpasses the five toes upward, with cold reaching the knees. However, this cold does not enter from the exterior but arises from within. Generally, patients with Yang deficiency always have cold hands and feet, starting from the tips of the fingers and toes; this is their clinical manifestation. Examining the formation of these two types of Jue, the underlying cause is always Yin deficiency. The reason for Cold Jue is that the person was physically robust but overexerted themselves during autumn and winter. Even when Yin Qi was abundant, they indulged in sexual activity without restraint, depleting the essence and Qi of their constitution. This results in deficiency of essence and Qi in the lower part, while the Qi attempts to compensate from the upper part. Consequently, lower Qi contends with upper Qi, rising instead of descending, thus failing to restore Yang Qi. As Qi departs, Yang becomes deficient, and Cold Qi rebels upward. Furthermore, due to the deficiency of essence and lack of fire, the Spleen's origin cannot be secured, leading to deficiency of Middle Qi. Middle Qi fails to moisten and nourish the collaterals, causing Yang Qi to diminish daily while Yin Qi remains alone, resulting in cold hands and feet. The cause of Heat Jue lies in alcohol entering the Stomach and damaging Spleen Yin. Damage to Spleen Yin causes Yang Qi to enter internally while Essence and Qi are exhausted. As Essence and Qi are depleted daily, they fail to nourish the four limbs. Additionally, frequent drunkenness and sexual intercourse cause Qi to accumulate in the Spleen without dispersing. The Qi of alcohol and grain contend with each other, generating intense heat in the center, causing heat to pervade the body, internal heat, and dark urine. In summary, these two types of Jue—one caused by relying on robustness and overexertion leading to Yang deficiency and cold, and the other by frequent drunkenness and sexual intercourse leading to essence exhaustion and heat—arise solely from damage to the True Yuan. Later generations failed to understand this, mistakenly identifying mere cold extremities or podagra as Jue, which is a major error. Nowadays, people often do not recognize this syndrome and misdiagnose it as Wind Stroke. Wind diseases typically involve injury to the meridians, whereas Jue results from internal depletion of true essence. Treating Jue with methods for Wind is an error compounded by another.
Jue accompanied by abdominal fullness and sudden loss of consciousness occurs because Yin Qi is excessive in the upper part and fails to guard the lower part, causing the Qi of the Foot-Taiyin (Spleen), Foot-Shaoyin (Kidney), and Foot-Jueyin (Liver) to fail to transform. Thus, abdominal distension occurs. If Yang Qi is excessive in the upper part, lower Qi merges and rises, and pathogenic Qi rebels. Rebellion causes Yang Qi to become chaotic and the Shen (Spirit) to lose its residence, resulting in sudden unconsciousness.
When Yin and Yang do not follow each other, Qi rebels upward, so all twelve meridians of the hands and feet can present with cold or heat Jue. In Taiyang (Greater Yang) Jue, there is swelling of the head and heaviness, inability to walk, and collapse. Taiyang is the meridian of extreme Yang abundance, rooted in Foot-Shaoyin. Its Qi requires Yin to descend to the feet. Deficiency leads to rebellion and excess in the upper part, causing head swelling and heaviness. Upward rebellion prevents downward movement, hence the inability to walk and collapse. "Collapse" refers to sudden dizziness and falling.
In Yangming (Bright Yang) Jue, there is mania, desire to run and shout, abdominal fullness, inability to lie down, red and hot face, hallucinations, and delirious speech. Yangming is a meridian abundant in Qi and blood. If Qi exceeds Blood, Yang pathogen becomes solid. Solid Yang pathogen confuses the Shen, causing mania and running/shouting. Excess Qi stagnates in the abdomen, causing fullness and rebellious Stomach Qi, leading to inability to sleep. The face is red and hot because the Yangming meridian traverses the face. Hallucinations and delirium indicate Shen confusion more severe than running and shouting.
In Shaoyang (Lesser Yang) Jue, there is sudden deafness, swollen cheeks, hypochondriac pain, and difficulty moving. Shaoyang originates from below and runs parallel with Jueyin Qi; thus, when harmonious, there is no disease. Current Shaoyang Jue indicates Minister Fire flaming upward without Yin restraint. The meridian enters the ear, causing sudden deafness. It passes through Jiache, causing cheek swelling; both are Fire symptoms. Hypochondriac pain indicates Qi rebellion and disharmony in that region. Difficulty moving indicates Shaoyang Qi fails to reach the lower part.
In Taiyin (Greater Yin) Jue, there is abdominal fullness, constipation, anorexia, vomiting after eating, and insomnia. Yin is the root of Yang, and Yang is the servant of Yin. If the Three Yin cannot assist Yang, the Three Yang suffer Jue; if the Three Yang do not serve Yin, the Three Yin also suffer Jue. Although Taiyin has abundant Yin, it usually relies on Shaoyang Qi for harmony. Now, Taiyin has only Yin without Yang and cannot descend, causing Yin Qi to rebel from above. The Spleen fails to transport, and Stomach Qi stagnates, causing abdominal fullness. Failure to move Qi through the Three Yin causes Kidney Qi to be ineffective, leading to constipation. Anorexia is due to Middle Qi obstruction. Vomiting after eating is due to Qi obstruction causing Lung Qi to rebel. Insomnia occurs because "when the Stomach is discordant, sleep is uneasy."
In Shaoyin (Lesser Yin) Jue, there is dry mouth, dark urine, abdominal fullness, and heart pain. Shaoyin encompasses both Water and Fire, Yin and Yang. If it loses its ability to store, its Qi rebels upward. Thus, Shaoyin often presents with both cold and heat Jue and serves as the master of Jue in the twelve meridians. The Classic states: "If Shaoyin Qi does not arrive, it is Jue." Non-arrival involves both Water and Fire. This current Jue is Yin deficiency with Fire rebellion. The Shaoyin meridian follows the throat, causing dry mouth. It connects with the Bladder, so heat entering the Bladder causes dark urine. Failing to act as the gate for the Stomach and ascending instead causes abdominal fullness. Failing to contribute essence to the Heart and instead overwhelming it causes heart pain.
In Jueyin (Terminal Yin) Jue, there is swelling and pain in the lower abdomen, abdominal distension, difficulty urinating and defecating, preference for lying down with knees flexed, contraction and swelling of the genitals, and internal heat. Jueyin is the termination of Yin; it does not cease during the day due to Yang generation. Now, due to deficiency, it becomes pure Yin without Qi. Hence, in its location, there is lower abdominal swelling and pain. Pure Yang knots without relaxation, causing abdominal distension. Lack of relaxation prevents transformation of Lower Jiao Qi, causing urinary and fecal difficulty. The Liver governs tendons; without Qi, the legs are weak, preferring to lie down with flexed knees. The meridian circles the genitalia, causing contraction and swelling. Where the meridian fails to circulate, internal heat arises from stagnation.
Hand-Taiyin Jue reversal presents with empty fullness and cough, and frequent vomiting of frothy saliva. Hand-Taiyin is the master of Original Qi. Deficiency leads to failure in regulation and distress from rebellious Qi, causing empty fullness and cough. Empty fullness refers to upper Jiao fullness that is deficient without excess pathogens. Fullness triggers cough. Frequent vomiting of froth occurs because the meridian passes through the Middle Jiao stomach opening; rebellion prevents essence dispersion, causing frothy vomiting.
Heart Protector (Pericardium) and Shaoyin Jue reversal presents with heart pain radiating to the throat, body heat, and death (incurable). These two meridians belong to Fire and are the residence of the Shen and masters of blood vessels. Jue reversal in both means Yin Essence cannot support Yang. Yang hyperactivity leads to self-burning, causing heart pain. Their connections ascend along the throat, so pain radiates to the throat. Body heat indicates blood vessel distension. The Heart is the great master of the Zang-Fu; rebellion leads to death.
Hand-Taiyang Jue reversal presents with deafness, tearing, inability to turn the neck, and inability to bend or extend the waist. The Small Intestine meridian is the downstream of the Heart and belongs between the Dai Mai. Rebellious Qi causes the entire meridian to rebel. The Small Intestine meridian governs the inner and outer canthus, causing tearing. It enters the ears, causing deafness. It travels from Jianjing to the head, causing neck stiffness. The Small Intestine connects to the testes and belongs to the spine, causing lumbar immobility.
Hand-Yangming and Hand-Shaoyang Jue reversal presents with throat bi (obstruction), pharyngeal swelling, and spasms. Hand-Yangming is the downstream of the Stomach; Hand-Shaoyang is the passage of the Stomach. Rebellious Qi ascends along the meridians. The Large Intestine meridian goes up the head and through the neck. The Sanjiao meridian exits Jianjing and goes up the neck. Thus, throat bi, pharyngeal swelling, and spasms occur, leading to rigidity of the arms, shoulders, and back.
Some cases of Jue present with headache and persistent hiccups. This is because the patient suffered severe cold, penetrating to the bone marrow. Marrow is governed by the brain; thus, cold rebels upward to the brain. Headache and toothache indicate pathogenic rebellion upward, hence named Jue reversal.
Some Jue involves Taiyin, is excessive in the Stomach, and affects the Lung. The pain is incurable. The Taiyin pulse is fine as hair, the body is hot as charcoal, the head and chest feel blocked, the Renying (Stomach) pulse is restless and rapid, there is wheezing and rebellious Qi, and frequent urination (dozens of times a day). A Taiyin pulse fine as hair with frequent urination indicates insufficient organ Qi and Middle Qi failure to secure, causing changes in urination. Heat remains in the Stomach, Yangming is flourishing, reflected in the Renying pulse. The chest feels like burning charcoal, indicating Yang not entering Yin, hence excess in the Stomach. Because Yang does not enter Yin, the Taiyin pulse is fine, with wheezing and rebellious Qi affecting the Lung. To purge the pathogen harms the interior Yin; to tonify deficiency exacerbates exterior Yang excess. This is "neither exterior nor interior," a Yang syndrome with Yin pulse, hence incurable death.
Disease presenting with chest swelling, neck pain, chest fullness, and abdominal distension is Jue reversal. Treatment must address the Qi simultaneously. Swelling, pain, fullness, and distension are in the Upper and Middle Jiao. This is Yin merging with Yang, lower Qi rebelling upward, truly Jue reversal. Treatment should not use moxibustion, as there is excess above; moxibustion adds fire to fire. Extreme Yang attacks Yin, which cannot withstand it, leading to loss of voice (aphonia). Stone needle lancing is also contraindicated because Yang gathering above causes lower deficiency; lancing dissipates Yang, causing dual deficiency and loss of Shen, leading to madness. One must wait until after the rebellion, when Qi merges and gradually unblocks, then regulate according to excess or deficiency to avoid deviation.
Bi Syndrome: The *Neijing* states: Disease in Yang is Feng (Wind); disease in Yin is Bi (Obstruction). Thus, Bi syndrome is caused by Wind, Cold, and Dampness combining to invade the Yin aspects of the meridians, resulting in obstruction. "Bi" means closure. The three pathogens obstruct the meridians, blocking Blood and Qi flow. If Wind predominates, it is Xing Bi (Wandering Bi), characterized by migratory joint pain. If Cold predominates, it is Tong Bi (Painful Bi), where Cold congeals Qi, causing unbearable pain, known as Gout. If Dampness predominates, it is Zhuo Bi (Fixed Bi), characterized by heaviness, fixed pain, or numbness, often in muscles, as Dampness transforms from Earth. The combination of these three pathogens varies in severity, leading to variations in pain, absence of pain, numbness, cold, heat, dryness, or dampness. Pain occurs because Cold coagulates blood vessels. Absence of pain and numbness occur when pain persists deeply, Wei Qi and Ying Qi flow sluggishly, and meridians become sparse; Blood and Qi decline, and stagnation decreases. Skin lacks nourishment, and Blood/Qi do not reach, causing numbness. Cold sensation occurs when the person has little Yang and much Yin, enhancing the pathogenic cold. Heat sensation occurs when the person has much Yang and little Yin, allowing Yang to overcome the pathogen. Dryness occurs when Yang overcomes Yin, preventing Yin nourishment. Severe Dampness combined with Cold leads to Yang deficiency and Yin excess, causing sweating and wetness. There are also Five Bi types without pain: in Bone (heaviness), Pulse (blood stasis), Tendon (flexion without extension), Flesh (numbness), and Skin (cold). In tendons, skin, flesh, pulse, and blood, Bi causes Qi slackness, so pain may not occur. Bi worsens with Cold (tendon contraction) and improves with Heat (tendon relaxation). Bi forms when Wind, Cold, and Damp encounter their respective seasons: Winter/Bone (Gu Bi), Spring/Tendon (Jin Bi), Summer/Pulse (Mai Bi), Late Summer/Muscle (Ji Bi), Autumn/Skin (Pi Bi). These correspond to the Five Zang organs. If not expelled, they enter the corresponding Zang, causing Zang Bi.
Five Zang Bi: If Pi, Rou, Jin, Gu, and Mai Bi persist and re-exposure occurs, they enter the Zang. Lung Bi presents with irritability, fullness, wheezing, and vomiting. Pathogen entering the Zang blocks Qi, preventing ascent. Lung governs regulation; blockage in Upper Jiao causes Stomach Qi rebellion, leading to irritability, fullness, wheezing, and vomiting.
Heart Bi presents with blocked pulses, irritability with sudden palpitations, rebellious Qi with wheezing, dry throat, frequent belching, and fear from rebellious Qi. Heart governs pulses; Bi blocks them, causing Qi stagnation and palpitations. Palpitations cause rebellious Qi and wheezing. Dry throat and belching occur because the Heart meridian rises from the heart, passing the Stomach and throat. Fear arises because Heart Fire declines and pathogen invades, weakening the Shen.
Liver Bi presents with night terrors, polydipsia, frequent urination, and upper牵引 like pregnancy. Liver stores Hun; harmonious blood calms Hun. Liver Bi causes Qi and Blood deficiency, so Hun wanders, causing terrors. Internal Liver heat and Spleen failure to send essence to Liver cause thirst and drinking. Liver heat attacking the Bladder causes frequent urination. Upper牵引 like pregnancy occurs because meridians have Qi but no Blood, causing mutual traction without Blood filling, resembling pregnancy.
Spleen Bi presents with flaccid limbs, cough, vomiting fluid, and severe upper obstruction. The Classic states: Taiyang excess causes Rou Bi; Cold middle deficiency causes Spleen Bi. Flaccid limbs are Rou Bi. Spleen Bi stems from organ deficiency, failure to distribute essence, and upward congestion to the Lung, causing cough. Upper Jiao blockage causes vomiting fluid. Severe cases cause complete obstruction.
Kidney Bi presents with frequent bloating, sitting using buttocks instead of heels, and bending using the spine instead of the head. Frequent bloating occurs because Yangming Qi descends; Kidney is the gate of the Stomach. Bi in Kidney blocks Kidney Qi, reversing Yangming Qi, causing bloating. Kidney is the official of strength; Bi causes leg contracture, so buttocks replace heels. Spinal curvature causes spine to replace head.
Intestine Bi presents with frequent drinking but no water output, abdominal wheezing/struggling, and occasional undigested stool diarrhea. Intestine Bi covers both Large and Small Intestines. Bi in the lower Jiao causes heat stagnation, preventing water excretion despite intake. Water retention causes root and branch pathology, abdominal struggling, and unclear separation of clear/turbid, leading to diarrhea.
Bao (Uterus/Bladder) Bi presents with internal pain upon pressing the lower abdomen/bladder, feeling like pouring hot water, difficult urination, and clear nasal discharge above. Bao refers to the bladder. Qi blockage causes pain. Water blockage causes heat accumulation like hot water and difficult urination. The Taiyang meridian connects the vertex to the brain, causing clear nasal discharge.
Excessive Seven Emotions can also damage Zang Qi and cause Bi, not just the three pathogens. Stillness preserves Shen; agitation destroys Yin. Agitated Qi rebels, causing wheezing and Bi in the Lung. Excessive worry/sadness causes Bi in the Heart. Carelessness leading to seminal emission/heat causes Bi in the Kidney. Overexertion causing exhaustion causes Bi in the Liver. Blockage of Ying/Wei Qi causing muscle atrophy causes Bi in the Spleen. Excessive emotions generate pathogenic Qi that aggregates into Bi by consuming Yin. Bi in the Six Fu organs stems from diet/lifestyle, with Wind/Cold invading Shu points. Among BIs, Wind-predominant resolves easily; Cold/Damp linger and deepen. Entering Zang is fatal (True Yin damaged). Lingering in sinews/bones/fat is deep and painful. Lingering in skin resolves easily (shallow pathogen).
Twelve Sinew Diseases: Branching, twisting, cramping, and pain are called Bi because sinews are external, affecting Ying Qi less, and not involving Zang-Fu directly. Only Wind/Cold/Damp affect them. Seasonal Bi indicates the cause. Hand/Foot Three Yin sinews knot in the chest/abdomen/huangmo. Symptoms vary: Foot-Shaoyin sinews cause epilepsy/spasms; Foot-Jueyin sinews cause genital dysfunction; Hand-Jueyin sinews cause tongue curling; Hand-Taiyin sinews cause Xi Ben, rib tightness, hemoptysis; Hand-Shaoyin sinews cause Fu Liang, purulent hematemesis. Though Sinew Bi, they disturb Zang Qi.
Persistent Bi enters deeper, damaging Zang Qi, corresponding to Three Yin/Yang with excess/deficiency. Jueyin excess causes Yin Bi; deficiency causes Heat Bi. Slippery pulse indicates Hu Feng Hernia; choppy pulse indicates lower abdominal Qi accumulation. Slippy/choppy pulses reveal excess/deficiency. Jueyin governs lower Jiao and sinews. Excess causes Yin Bi (stagnation in Yin). Deficiency causes Heat Bi (empty heat). Slippy pulse indicates excess pathogen, Hu Feng Hernia (changeable like wind, located in lower abdomen/genitals, Liver Qi stagnation, essentially Yin Bi). Choppy pulse indicates Qi deficiency/Blood stasis, pathogen stagnation as accumulation, also Heat Bi.
Shaoyin excess causes Pi Bi (skin Bi) and urticaria; deficiency causes Lung Bi. Slippery pulse causes Lung Feng Hernia; choppy pulse causes accumulation and hematuria. Shaoyin is Minister Fire; excess conquers Metal (Lung/Skin), causing Pi Bi/urticaria. Deficiency fails to warm Metal, causing Lung Bi. Slippy pulse indicates Heart Fire failing to control Water, pathogen stagnating in Lung, causing Lung Feng Hernia (Wind moves Lung, Hernia gathers Lung). Choppy pulse indicates Heart Blood deficiency, Fire retreating internally to Bao Luo/Small Intestine, causing accumulation and hematuria.
Taiyin excess causes Rou Bi (flesh Bi) and Cold Middle; deficiency causes Spleen Bi. Slippery pulse causes Spleen Feng Hernia; choppy pulse causes accumulation and intermittent heart/abdominal pain. Taiyin is Wet Earth, located in Middle Jiao. Excess indicates Damp stagnation. Spleen governs flesh; Damp stagnation causes Rou Bi. Cold/Damp in Middle prevents Yangming Fire from rising, causing Cold Middle. Deficiency affects Spleen directly, causing Spleen Bi (organ Qi blockage). Slippy pulse indicates Water/Damp overwhelming Earth, causing edema/heaviness (Damp disease). Choppy pulse indicates accumulation/stagnation in Middle Jiao, causing intermittent fullness.
Yangming excess causes Mai Bi (pulse Bi) and intermittent body heat; deficiency causes Heart Bi. Slippery pulse causes Heart Feng Hernia; choppy pulse causes accumulation and frequent fright. Yangming is Dry Metal, corresponding to Lung. Excess Dryness damages blood vessels, causing Mai Bi. Dryness damages Yin, causing internal heat/body heat. Lung directs Heart pulses. Deficiency blocks Heart pulses, causing Heart Bi. Slippy pulse indicates Wind/Dryness combining to damage Lung/Blood, pulling Heart Qi without dispersion, causing Heart Feng Hernia. Choppy pulse indicates Metal constriction without relaxation, blocking pulses, causing accumulation. Frequent fright is Wood insulting Metal.
Taiyang excess causes Gu Bi (bone Bi) and heavy body; deficiency causes Kidney Bi. Slippery pulse causes Kidney Feng Hernia; choppy pulse causes frequent cephalic disease. Kidney Qi corresponds to Taiyang. Excess Taiyang Qi infiltrates bones, causing Gu Bi. Excess Water relaxes the official of strength, causing heaviness. Deficiency affects the organ directly, causing Kidney Bi (weak legs/pulses, insecure essence). Slippy pulse indicates Taiyang Wind/Cold combining, causing Kidney Feng Hernia. Choppy pulse indicates pathogen blocking Taiyang meridian, causing accumulation and frequent cephalic disease (Yang Qi blocked from vertex, causing wind pain).
Shaoyang excess causes Jin Bi (sinew Bi) and hypochondriac fullness; deficiency causes Liver Bi. Slippery pulse causes Liver Feng Hernia; choppy pulse causes accumulation, frequent tendon cramps, and eye pain. Minister Fire invading Yin affects the Liver. Excess pathogen...