Library

Yang deficiency leads to aversion to cold and dislike of yin, thus the patient is calm in the morning but chaotic at dusk; (cold prevails at night.) Yin deficiency leads to aversion to heat and dislike of yang, thus the patient is peaceful at night but agitated in the morning; (heat prevails during the day.) This is the manifestation of righteous qi deficiency. When yang pathogenic factors are excess, they become more vigorous upon encountering yang, thus causing heat in the morning and alleviation at dusk; when yin pathogenic factors are excess, they become stronger upon encountering yin, thus causing cold at night and alleviation during the day. This is the manifestation of pathogenic excess. When yang is deficient and yin pathogenic factors invade the yang aspect, the disease manifests after the qi circulates through the yang twenty-five times, thus causing cold during the day and relief at night. When yin is deficient and yang pathogenic factors sink into the yin aspect (this syndrome is quite common), the disease manifests after the qi circulates through the yin twenty-five times, thus causing heat at night and coolness during the day (this can be observed in malaria which may occur either daily or nightly). This is the manifestation of righteous qi deficiency complicated by pathogenic factors. Those with severe heat both day and night represent excessive yang without yin; those with severe cold both day and night represent excessive yin without yang; those with cold during the day and heat at night represent an intermingling of yin and yang. For those with chronic illness and weakness, regardless of day or night, with symptoms appearing and ceasing irregularly, it is because the righteous qi cannot maintain control, leading to mutual invasion of yin and yang, with fluctuating dominance and recovery. If a robust person initially presents with this, it is due to the struggle between pathogenic and righteous qi, causing intermittent disturbance. Observing the Shaoyang syndrome in Cold Damage, where alternating chills and fever have no fixed schedule, confirms this.

Diarrhea followed by dysentery represents the transmission from Spleen to Kidney; dysentery followed by diarrhea represents transmission from Kidney to Spleen, and so on.

When Liver qi is deficient, there is fear; when excess, there is anger. Anger damages the Liver, which can be overcome by sorrow. When Liver fire invades the Heart, agitation and fright occur. When Heart qi is deficient, there is sadness; when excess, there is incessant laughter. Excessive joy damages the Heart, which can be overcome by fear. The Spleen is associated with overthinking; overthinking damages the Spleen, which can be overcome by anger. The Lung is associated with worry; worry damages the Lung, which can be overcome by joy. The Kidney is associated with fear; fear damages the Kidney, which can be overcome by thinking. Anger causes qi to ascend (also said as qi rebellion); joy causes qi to relax; sorrow causes qi to dissipate; fear causes qi to descend; fright causes qi to become disordered; thinking causes qi to knot.

The pulse is named from the combination of blood and qi within the meridians and collaterals. Without blood, it is not filled; without qi, it does not move; without meridians and collaterals, it scatters and fails to follow its course. Since meridians and collaterals are the pathways of the pulse, just as water has channels. There is no place in the human body without blood or qi, just as there is no place on earth without water, yet water must flow into rivers and seas to show its movement; therefore, pulse diagnosis must be performed on the meridians and collaterals. The pathways of blood and qi circulation in the body: large ones are Jing (Main Meridians), small ones are Luo (Collaterals). Jing are like main rivers, Luo are like tributaries. Wherever they are visible externally, they can all be diagnosed. The *Nei Jing* divides them into Three Regions and Nine Palpation Sites. (From *Su Wen: Chapter on Three Regions and Nine Palpation Sites*.) Upper Region Heaven: the arterial pulse at both temples (located at the boundary of Heyan, where the Qi of the Foot-Shaoyang Gallbladder Meridian travels). Used to observe the qi of the head and angles. Upper Region Human: the arterial pulse in front of the ears (i.e., Hegu, where the Qi of the Hand-Shaoyang Sanjiao Meridian travels). Used to observe the qi of the ears and eyes. Upper Region Earth: the arterial pulses on both cheeks (i.e., Dicang and Daying, where the Qi of the Foot-Yangming Stomach Meridian travels). Used to observe the qi of the mouth and teeth. Middle Region Heaven: Hand-Taiyin (i.e., Cun Kou, where the Qi of the Lung Meridian travels). Used to observe the Lung. Middle Region Human: Hand-Shaoyin (i.e., Shenmen, where the Qi of the Heart Meridian travels). Used to observe the Heart. Middle Region Earth: Hand-Yangming (i.e., Hegu, where the Qi of the Large Intestine Meridian travels). Used to observe the qi of the chest. Lower Region Heaven: Foot-Jueyin (the arterial pulse at Wuli, three cun below Qichong, where the Qi of the Liver Meridian travels. Taken while lying down. For women, take Dachi, located in the depression two cun distal to the base of the big toe). Used to observe the Liver. Lower Region Human: Foot-Taiyin (the arterial pulse at Jimen, above the fish belly between the tendons, obtained by deep palpation, where the Qi of the Spleen Meridian travels. To observe Stomach qi, one should take Chongyang on the dorsum of the foot). Used to observe the qi of the Spleen and Stomach. Lower Region Earth: Foot-Shaoyin (i.e., Taixi, where the Qi of the Kidney Meridian travels). Used to observe the Kidney. By observing the head via the upper region, it can be inferred that the feet are observed via the lower region. By observing the Zang organs via their own meridians, it can be inferred that the Fu organs are observed via their own meridians. Ancient authors often used parallel text to imply meaning, which should be understood well. Furthermore, there are twelve meridians of Zang and Fu organs, but only nine palpation sites are listed, leaving out the Hand-Taiyang Small Intestine, Hand-Jueyin Pericardium, and Foot-Taiyang Bladder meridians, making it unclear where to diagnose them. Additionally, the Renying pulse of the Stomach Meridian is diagnosed alongside Cun Kou but is not included in the nine sites, which is incomprehensible and has been abandoned by later generations without discussion.