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Cautia (Gardenia Trichocarpa Fruit) [Gardeniae Fructus] (stir-fried until slightly yellow) 1 fen, Adzuki Bean (Vigna angularis Seed) [Adzuki Bean] (boiled) 1 fen.
The above two ingredients are pounded into a powder. Use seven he of Xiangchi (Prepared Soybean) [Perillae Fructus Preparatus] decoction to mix with one qianbi of the powder and take it warm. If vomiting does not occur, increase the dose slightly; stop when profuse vomiting is achieved as the limit. It is contraindicated for those with blood loss or deficiency.

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When the pulse is tight like a turning rope and variable, there is retained food.
[Note]
"Turning rope and variable" describes the shape of a tight pulse. If floating and tight, it is Cold Damage (Shanghan); if deep and tight, it is cold pain. When cold invades the stomach region, causing grain qi to fail to move, it is said: there is retained food.

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Tight pulse with headache and wind-cold indicates retained food in the abdomen that is not digesting. (Another version states: tight pulse at the Cun Kou position.)
[Note]
A tight pulse with headache indicates an external contraction of wind-cold disease; a tight pulse with abdominal pain indicates internal injury from retained food disease.
[Collected Notes]
Li □ says: According to this pulse and syndrome, it resembles Cold Damage but is not Cold Damage, because the body does not ache and the waist and spine are not stiff. However, tight pulses can be distinguished: floating and tight indicates Cold Damage; deep and tight indicates food injury. The *Jia Yi Jing* states: A very tight Ren Ying pulse indicates injury by cold; a very tight Qi Kou pulse indicates injury by food. Thus, cold and food can be distinguished by the left and right hands, leading to the knowledge that there is undigested retained food in the abdomen.

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Wind striking the Lung causes dry mouth and panting, dizziness with heaviness of the body, vertigo, and swelling.
[Commentary]
"Heaviness of the body with dizziness" should likely be "dizziness of the head with heaviness of the body"; "vertigo and swelling" should likely be "vertigo due to wind and swelling". This aligns with the textual meaning, indicating a transcription error.
[Note]
The Lung governs Qi and connects externally with the skin and hair. When wind pathogen strikes the Lung, damaging Qi causes Jin-Ye (body fluids) to congeal and fail to circulate, resulting in dry mouth; wind damaging the Lung causes Qi to rebel and obstruct upwards, resulting in panting and coughing. Dizziness and heaviness indicate Qi damage and lack of strength; vertigo and swelling indicate skin damage by wind-water.
[Collected Notes]
Li □ says: The Lung governs Qi. When struck by wind pathogen, Qi becomes congested and Jin-Ye fails to circulate, causing dry mouth; Qi rebels and breathing is difficult, causing panting.

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Cold striking the Lung causes expectoration of turbid mucus resembling nasal discharge.
[Note]
When cold pathogen strikes the Lung, the Yang Qi in the chest fails to regulate, causing Jin-Ye to accumulate and fail to move, resulting in the expectoration of turbid saliva resembling mucus.
[Collected Notes]
Li □ says: The five fluids transform into nasal discharge in the Lung. The Lung connects with the skin and hair and opens into the nose. When cold pathogen enters the Lung via the skin and hair, the Lung orifice becomes obstructed, causing nasal congestion and discharge of mucus and saliva. Turbid saliva accumulates and cannot flow freely, being vomited out from the mouth.

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The dying organ pulse of the Lung is floating and empty on light pressure, weak like a scallion leaf on deep pressure, with no root below; this indicates death.
[Note]
When the Lung is struck by wind-cold pathogen, if the pulse is extremely empty on light pressure and weak like a hollow scallion leaf on deep pressure with no root below, it is the dying pulse of the Lung organ. The mention of "floating" for the following five organs clarifies the pulse corresponding to externally contracted pathogens.
[Collected Notes]
Cheng Lin says: The true Lung pulse arrives like a feather touching human skin; is this not floating and empty? A scallion leaf is hollow inside; feeling weak like a scallion leaf on deep pressure with no root below means the floating, feathery weakness indicates the absence of Stomach Qi. Since the Zang organ pulse has appeared, death ensues.

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Wind striking the Liver causes twitching of the head and eyes, pain in both hypochondria, habitual stooping while walking, and a craving for sweet flavors.
[Note]
The Liver governs wind and connects externally with the sinews. When wind pathogen strikes the Liver, excess wind causes movement, resulting in twitching of the head and eyes. The hypochondria are the region of the Liver; Liver pathology causes pain in both hypochondria. Wind damages the sinews, causing habitual stooping. The Liver suffers from urgency and desires sweetness to relax it, hence the craving for sweet flavors.
[Collected Notes]
Xu Bin says: At the highest peaks, only wind can reach; the nature of wind is shaking, causing twitching of the head and eyes. The Liver meridian passes through the diaphragm; now evil in the hypochondrium causes pain. The Liver governs sinews; excess wind causes sinew tension, leading to stooping. Humans rely on the Spleen and Stomach; when Wood evil is excessive and Earth bears the burden, sweet flavor benefits the Spleen, and craving sweets is self-rescue.

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Cold striking the Liver causes inability to raise both arms, dryness at the root of the tongue, frequent sighing, chest pain, inability to turn over, vomiting upon eating, and sweating.
[Commentary]
The phrases "inability to raise both arms" and "dryness at the root of the tongue," along with the three characters "and sweating," do not fit the context logically and are likely misplaced text (cuojian); they are not explained.
[Note]
The Liver's nature is free flow; Qi moves in the chest sides. When cold pathogen strikes the Liver, Qi is suppressed and cannot extend, causing frequent sighing; Qi stagnation and failure to move cause pain preventing turning over. Vomiting upon eating is also due to cold pathogen rebelling upward.

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The dying organ pulse of the Liver is weak on light pressure, feels like a cord that does not return on deep pressure, or curves like a snake moving away; this indicates death.
[Note]
When the Liver is struck by wind-cold pathogen, if the pulse is extremely weak on light pressure and does not feel wiry on deep pressure, it has lost the fundamental pulse of the Liver. Now, feeling like a cord that does not return on deep pressure, curving like a snake moving away—going without returning—is indeed the dying pulse of the Liver organ!
[Collected Notes]
Zhou Yangjun says: Feeling like a cord on deep pressure shows both wiry and tight qualities. A pulse with coming and going follows the principle of Yin-Yang reciprocation. Now, saying "no coming, only going" indicates the absence of Stomach Qi. Otherwise, the True Qi is scattering, forced entry and exit, showing a state of reluctance to advance and difficulty extending, hence curving like a snake.

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Liver Fixation (Gan Zhuo): The patient constantly desires someone to tread on their upper chest. Initially, before suffering, they only desire hot drinks. Xuan Fu Hua Tang (Inula Flower Decoction) is the primary treatment.
[Commentary]
The six characters "Xuan Fu Hua Tang is the primary treatment" do not match the disease of Liver Fixation and are likely interpolated text.
[Note]
Liver Fixation refers to Liver Qi being fixed and failing to move, causing chest fullness and discomfort. Hence, the patient constantly desires massage of the chest to unblock the Qi. When initially not suffering from fullness, desiring only hot drinks indicates the disease is caused by cold pathogen.
[Collected Notes]
Li □ says: The Liver governs free flow; fixation causes Qi depression and failure to extend. The patient constantly desires someone to tread on their chest to soothe the Qi. Additionally, cold pathogen is firmly knotted within, so they desire hot drinks to overcome the cold.

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Wind striking the Heart causes slight fever, inability to rise, a sensation of hunger in the heart/chest, and vomiting immediately after eating.
[Commentary]
"Slight fever" is the fundamental syndrome of wind striking the Heart. "Inability to rise," "hunger in the heart," and "vomiting after eating" do not fit the context logically and are likely misplaced text; they are not explained.

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Cold striking the Heart causes the patient to suffer from a sensation in the heart like eating garlic (spicy/stinging). In severe cases, heart pain radiates to the back, and back pain radiates to the heart, resembling Gu Zhu (parasitic affliction). If the pulse is floating, spontaneous vomiting leads to recovery.
[Note]
Suffering from a sensation like eating garlic refers to a spicy, stinging feeling in the heart. Severe heart pain radiating to the back and vice versa indicates corresponding pain between the heart and back. Resembling Gu Zhu means pain resembling insects moving incessantly. These are all syndromes of cold pathogen in the Heart. If the pulse is floating, it indicates the Heart has its fundamental pulse, signaling the expulsion of cold pathogen upwards; thus, spontaneous vomiting expels the evil and leads to recovery.
[Collected Notes]
Xu Bin says: Cold is a Yin pathogen; when constrained externally, Fire is depressed internally, hence the sensation like eating garlic, which is spicy-like but not painful. In severity, the evil is strong, attacking outward to cause back pain and inward to cause heart pain; "radiating" indicates correspondence. Resembling Gu Zhu, it is continuous. If the pulse is floating, the evil has not condensed, so spontaneous vomiting leads to recovery.

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Those injured in the Heart, when fatigued or overworked, develop redness of the head and face and heaviness in the lower body. They experience heart pain, spontaneous irritability, fever, pulsation at the umbilicus, and a wiry pulse. This is caused by injury to the Heart organ.
[Commentary]
The character "wiry" (xian) in "pulse is wiry" should likely be "deep" (chen), as deep corresponds to the Kidney pulse, making the context coherent. This is likely a transcription error.
[Note]
"Injured in the Heart" refers to patients with Heart injury. Fatigue disturbs the Heart; Heart Yang is excessive upwards, causing redness of the head and face. Excess above leads to deficiency below, causing heaviness and weakness in the lower body. Heart pain, spontaneous irritability, fever, umbilical pulsation, and a deep pulse indicate the Kidney exploiting the injured Heart.
[Collected Notes]
You Yi says: Those injured in the Heart, when fatigued, develop redness of the head and face and heaviness in the lower body. When the Heart is deficient, its Yang easily floats; when excessive above, the lower must be deficient. Heart pain, spontaneous irritability, and fever result from Heart deficiency failing to nourish, causing heat to stir within. Umbilical pulsation occurs because the Heart is deficient above and the Kidney moves below.

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Abnormal weeping causing insecurity of the Hun and Po spirits indicates insufficient Blood and Qi. Insufficient Blood and Qi belongs to the Heart. Those with Heart Qi deficiency fear easily, wish to sleep with eyes closed, dream of traveling far, have scattered spirit and essence, and wandering Hun and Po. Deficiency of Yin leads to Dian (depressive psychosis); deficiency of Yang leads to Kuang (manic psychosis).
[Commentary]
"Dian" in "deficiency of Yin leads to Dian" should likely be "Kuang"; "Kuang" in "deficiency of Yang leads to Kuang" should likely be "Dian". The *Nei Jing* states: Excess Yin leads to Dian, Excess Yang leads to Kuang. This is likely a transcription error.
[Note]
Abnormal weeping refers to crying without reason in those with Heart injury. Abnormal weeping makes Hun and Po insecure due to insufficient Blood and Qi of the Heart. Insufficient Blood and Qi and Heart deficiency cause fear; wishing to sleep with eyes closed and dreaming of far travel indicates scattered spirit and wandering Hun and Po. Blood of the Heart is Yin; excessive deficiency of Yin leads to excess Yang, causing Kuang (mania). Qi of the Heart is Yang; excessive deficiency of Yang leads to excess Yin, causing Dian (depression/psychosis).

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The dying organ pulse of the Heart is solid on light pressure, like pills or beans; on deep pressure, it becomes increasingly restless and rapid; this indicates death.
[Note]
When wind-cold pathogen strikes the Heart, if the pulse is extremely solid on light pressure, like pills or beans, and becomes increasingly vigorous, restless, and rapid on deep pressure, it is the dying pulse of the Heart organ.
[Collected Notes]
Li □ says: The *Nan Jing* states: The Heart pulse is floating, large, and scattered. If solid on light pressure like hemp seeds, and increasingly restless on deep pressure, the Zang organ pulse appears, and the complete absence of Stomach Qi leads to death. The *Nei Jing* states: The True Heart pulse is firm and beating, like searching for Coix seeds, numerous and piled up, i.e., like hemp seeds; the meaning can be referenced similarly here.

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Wind striking the Spleen causes slight fever, appearance resembling drunkenness, abdominal烦重 (heaviness and vexation), eyelid twitching, and shortness of breath.
[Commentary]
Text regarding Cold striking the Spleen is missing. Likely lost in bamboo slips.
[Note]
Wind striking the Spleen causes slight fever, the fundamental syndrome of wind striking. Appearance resembling drunkenness is also a symptom of wind-heat disturbing internally. Abdominal discomfort and vexation, physical lassitude and heaviness, eyelid twitching, and shortness of breath upon movement are all Spleen meridian symptoms.
[Collected Notes]
Li □ says: Wind is a Yang pathogen causing dispersion and leakage; appearance resembling drunkenness refers to red face and soft limbs. Internal disturbance by wind Qi causes abdominal heaviness and vexation. Pi Mu refers to the upper and lower eyelids.

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The dying organ pulse of the Spleen is large and firm on light pressure; on deep pressure, it feels like an overturned cup, clean and empty, shaking; this indicates death.
[Note]
When wind-cold pathogen strikes the Spleen, if the pulse is large and firm on light pressure, losing its harmonious and slow quality, and feels like an overturned cup on deep pressure—high, bright, clean, forceful, and shaking—it is the dying pulse of the Spleen organ.
[Collected Notes]
Li □ says: A pulse that is weak and slippery indicates the presence of Stomach Qi; floating, large, and firm indicates the extinction of Stomach Qi and the appearance of the Zang organ pulse. An overturned cup is hollow inside; "clean and empty" depicts the image of emptiness. Shaking indicates restless and agitated pulse, signifying dispersing Qi, hence death.

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Fu Yang pulse is floating and choppy. Floating indicates strong Stomach Qi; choppy indicates frequent urination. The interaction of floating and choppy results in hard stool. The Spleen is constrained (Yue); Hemp Seed Pill (Mazi Ren Wan) is the primary treatment.
[Commentary]
This passage should belong under "Difficulty in Defecation" in the *Abdominal Fullness Chapter*; it is likely misplaced here.
[Note]
Fu Yang is the Stomach pulse. If the pulse is choppy but not floating, it indicates Spleen Yin deficiency, and Stomach Qi would also not be strong, making purgatives unsuitable. Now, the pulse is floating and choppy: Stomach Yang is excess, indicating strong Stomach Qi, while Spleen Yin is also deficient. Spleen Yin deficiency cannot transport essence and Qi to the Stomach; water descends alone, causing frequent urination. Strong Stomach Qi constrains the Spleen, failing to transform Jin-Ye, causing hard stool. Mazi Ren Wan is used to nourish fluids, moisten dryness, clear heat, and unblock the interior. One dares not use Chengqi Decoctions recklessly because the choppy pulse ultimately indicates deficiency evil.
[Collected Notes]
Xu Bin says: Using pills instead of decoctions for Spleen Constraint aims to gently resolve knotting without abruptly damaging Yuan Qi. One must know that Spleen Constraint arises from insufficient Yuan Qi and Jin-Ye failing to reach.
Li □ says: Fu Yang is the Stomach pulse. The Stomach is the sea of water and grain. Floating is a Yang pulse, so Stomach Qi is strong and appetite is good. Frequent urination depletes Jin-Ye, hence the choppy pulse. The Spleen governs transporting Jin-Ye for the Stomach. Here, strong Stomach and weak Spleen constrain Jin-Ye, preventing its distribution, sending it only to the Bladder, causing frequent urination and hard stool. Mazi Ren Wan unblocks the interior and moistens dryness.