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36. Excessive Wood Qi causes strong Wind, Spleen Earth is affected causing intestinal borborygmus; diarrhea with undigested food, reduced appetite, abdominal fullness and distension, heavy body, and vexation with suppressed Qi rising. Clouds and objects fly, grass and trees move; when Wood overcomes and declines, it is conquered by Metal. Severe cases manifest as irritability, epilepsy, dizziness, vertigo, and fainting, hypochondriac pain, severe vomiting leading to Stomach collapse and peril.

[Note] The preceding text generally discusses diseases caused by the Main Transport (Zhu Yun) and Main Qi (Zhu Qi); this section details diseases specifically governed by the Guest Transport (Ke Yun). When Year Wood is excessive (Ren years), or Year Earth is deficient (Si years), Wood excess leads to aggressive control over Earth. If Earth is deficient, its mother (Fire) is weak and its child (Metal) declines, lacking the power to restrain Wood, thus Wood attacks Earth. Hence, abundant Wood Qi causes strong Wind, representing the transformation of excessive Wood. In humans, Spleen Earth is pathologically affected, suffering from intestinal borborygmus, stool with undigested food (Sun Xie), poor appetite, abdominal fullness, heaviness, and vexation due to depressed middle Qi ("Fan Yuan" refers to depression of middle Qi failing to unblock). In nature, there are changes of flying clouds and objects, and transformations of swaying grass and trees. When Wood overcomes and eventually declines, it is counter-attacked by Metal, resulting in withering and falling (retribution). Thus, further symptoms appear: irritability, epilepsy, dizziness/vertigo/fainting, hypochondriac pain, and severe vomiting—liver and spleen diseases. "Stomach collapse and peril" means the pulse at Chongyang (ST42) of the Stomach meridian ceases, indicating Spleen Qi exhaustion, signifying life-threatening danger.

37. Excessive Fire Qi causes intense Heat, Lung Metal is affected causing wheezing, coughing, and asthma; shortness of breath, blood loss, malaria, profuse diarrhea, dry throat, and excessive internal heat. Scorching fires dry up water springs; ice rain and cold frost occur as Water reasserts itself. Severe cases manifest as delirium, mania, chest and back pain; if Taiyuan pulse ceases, recovery is difficult.

[Note] When Year Fire is excessive (Wu years), or Year Metal is deficient (Yi years), Fire excess aggressively controls Metal. If Metal is deficient, its mother (Earth) is weak and its child (Water) declines, lacking power to restrain Fire, thus Fire attacks Metal. Hence, abundant Fire Qi causes intense summer heat, representing the transformation of excessive Fire. In humans, Lung Metal is pathologically affected, manifesting as wheezing and coughing, insufficient breath, emaciation (blood loss), malaria, profuse diarrhea, dry throat, and internal heat. In nature, there are transformations of scorching heat and boiling fervor, and on earth, withered matter and dried springs. When Fire overcomes and eventually declines, it is counter-attacked by Water, resulting in rain, hail, early frost, and cold (retribution). Thus, further symptoms appear: delirious speech, madness, chest and back pain—heart and lung diseases. Taiyuan is the Lung meridian point; if the Lung pulse ceases, it indicates Lung Qi exhaustion, signifying that the disease is hard to cure.

38. Excessive Earth Qi causes heavy Dampness, Kidney Water is affected causing abdominal pain; heavy body, vexation, and unhappiness. Heavy rain and dampness cause rivers to overflow and fish to appear in dried ponds. Wind and rain cause soil collapse and scales appearing on land; abdominal fullness, loose stools, distressing borborygmus, foot weakness, spasms, pain, and fluid retention. If Taixi pulse ceases, life is hard to preserve.

[Note] When Year Earth is excessive (Jia years), or Year Water is deficient (Xin years), Earth excess aggressively controls Water. If Water is deficient, its mother (Fire) is weak and its child (Wood) declines, lacking power to restrain Earth, thus Earth attacks Water. Hence, abundant Earth Qi causes heavy dampness, representing the transformation of excessive Earth. In humans, Kidney Water is pathologically affected, manifesting as cold limbs, abdominal pain, heavy body, vexation, and low mood. In nature, there are changes of frequent rain and dampness, and on earth, overflowing rivers and fish in dried marshes. When Dampness overcomes and eventually declines, it is counter-attacked by Wood, resulting in violent wind and rain, soil collapse, and fish leaping onto land (retribution). Thus, further symptoms appear: abdominal fullness, loose stools, borborygmus, foot weakness/spasms/pain, and fluid retention—spleen and stomach diseases. Taixi is the Kidney meridian point; if the Kidney pulse ceases, it indicates Kidney Qi exhaustion, signifying that life is hard to preserve.

39. Excessive Metal Qi causes clear Dryness, Liver Wood is affected causing deafness; pain under hypochondrium and lower abdomen, red and painful eyes. Grass and trees wither and die; severe cases manifest as chest pulling back pain, inability to turn side-to-side due to flank pain, wheezing, coughing, rebellious Qi, and bleeding. If Taichong pulse ceases, life is hard to sustain.

[Note] When Year Metal is excessive (Geng years), or Year Wood is deficient (Ding years), Metal excess aggressively controls Wood. If Wood is deficient, its mother (Water) is weak and its child (Fire) declines, lacking power to restrain Metal, thus Metal attacks Wood. Hence, abundant Metal Qi causes clear dryness, representing the transformation of excessive Metal. In humans, Liver Wood is pathologically affected, manifesting as deafness, hypochondriac pain, lower abdominal pain, and red/painful eye corners. In nature, there are changes of cool/dry austerity, and on earth, withering grass and trees. When Dryness overcomes and eventually declines, it is counter-attacked by Fire, resulting in arid drying and withering (retribution). Thus, further symptoms appear: chest pulling back pain, flank pain, inability to turn, wheezing, coughing, rebellious Qi, and hemorrhage—liver and lung diseases. Taichong is the Liver meridian point; if the Liver pulse ceases, it indicates Liver Qi exhaustion, signifying that life is hard to sustain.

40. Excessive Water Qi causes severe Cold, harming Heart Fire causing vexation; restlessness, palpitations, delirium, and heart pain. Sky brings ice, frost, snow; earth cracks and hardens. Dust and fog linger, cold rain arrives; severe cases manifest as edema, cough, cold pain, abdominal fullness, loose stools with rumbling, and undigested food. If Shenmen pulse ceases, death is inevitable.

[Note] When Year Water is excessive (Bing years), or Year Fire is deficient (Gui years), Water excess aggressively controls Fire. If Fire is deficient, its mother (Wood) is weak and its child (Earth) declines, lacking power to restrain Water, thus Water attacks Fire. Hence, abundant Water Qi causes severe cold, representing the transformation of excessive Water. In humans, Heart Fire is pathologically affected, manifesting as heart vexation, palpitations, delirious speech, and hot pain in the heart. In nature, there are changes of rain, ice, frost, and snow, and on earth, frozen cracked hardness. When Cold overcomes and eventually declines, it is counter-attacked by Earth, resulting in lingering dust/fog and sudden cold rain (retribution). Thus, further symptoms appear: edema, wheezing, cold strike, abdominal fullness, loose stools, borborygmus, and indigestion—kidney and spleen diseases. Shenmen is the Heart meridian point; if the Heart pulse ceases, it indicates Heart Qi exhaustion, signifying death.