所结，深中骨，气因于骨，骨与气并日以益大，则为骨疽。（又有按之而坚者，其深中骨，是气因于骨而然。
骨与气并，其结日大，名为“附骨疽”也。）有所结，中于肉，宗气归之，邪留而不去，
有热则化而为脓，无热则为肉疽。（又有结于肉中者，则宗气归之。宗，大也。以阳明之气为言，邪留为热
则溃腐肌肉，故为脓；无热则结为粉浆之属，聚而不散，是为肉疽。）凡此数气者，其发无常处，而有
常名也。（虽有常名，而发无常处。无常处，则形证亦无常矣，此所以变化无常也。）
夫自古通天者，生之本，本于阴阳。天地之间，六合之内，其气九州，九窍、五脏、十二节，皆通于
天气。（自古之有生者，皆通天元之气以为生也，其生之本，阴阳而已，大为六合，广为九
州，人之九窍五脏，天之四时十二节，皆气候之所行，营卫之所通也，故曰∶“皆通于天气”。）其生五，
其气三。数犯此者，则邪气伤人，此寿命之本也。（人生虽本乎阴阳，而禀分五行、其生五也；阴阳盛衰，
少太有三，其气三也。有五有三，则生克强弱，变出其间矣。得其和，则为正气而生物；犯其变，则
为邪气而伤物，其生其死，皆此三、五耳，故
为寿命之本。）苍天之气清净则志意治，顺之则阳气固，（天色深玄，故曰“苍天”。天气者，阳气也。
上云生之本，本于阴阳，此专言阳气者。盖生气通天，以阳为本，阳气既固，阴必从之，故圣人谆谆于此，
其示人之意深矣。）虽有贼邪，勿能害也。此因时之序。（阳气固者，其天全也，天全则神全，虽有贼风邪
气，不能犯之，盖在乎因时之序，如四气调神之谓是也。）故圣人传精神，服天气而通神明。（传，授也。服，
佩也，惟圣人者，能得天之精神，服天之元气，所以与天为一，而神明可与天通矣。）失之则内闭九窍，外壅
肌肉，卫气散解，（九窍通于内。肌肉卫于外，其行其固，皆阳气为之主也。失之，则失其清阳之化，故九
窍肌肉皆为闭壅矣。人之卫气，本于天之阳气，阳虚则卫虚，卫气散解则天真失守，故重在卫阳也。）
此谓自伤，气之削也。（自伤其真阳，元气削也。）阳气者，若天与日，失其所，则折寿而不彰。（此发明阳
气之本也。日不明则天为阴晦，阳不固则人为夭折，皆阳气之失所也。）故天运当以日光明。（天不自明，
明在日月。月体本黑，得日乃明，此天运必以日光明也，日即阳也，阳即明也。阳之所在，明必随之；明之所
及，阳之至耳。阳明一体，本无二也。然阳在午则为昼而日丽中天，着有象之神明，离之阳在外也；阳在子
则为夜而火伏水中，化无形之元气，坎之阳在内也。君火以明，相火以位，曰君曰相，无非阳气之所在。苟或失
序，欲保天年，其可得乎？）是故阳因而上，卫外者也。欲如运枢，起居如惊，神气乃浮。（此下言阳气不固
者，四时之邪，皆得以伤之也。清阳为天，包覆万物，故因于上而卫于外。人之卫气，亦犹是
也，欲其如运枢周旋，不已不息。若举动躁妄，则神气浮越，即不能固其阳气也，邪乃侵之。）因于寒，体若
燔炭，汗出而散。（感寒邪则发热，得汗而解，南人曰“伤寒”，北人曰“热病”。其所感阴阳虚实，经络脏腑
，即病不即病，传变不传变，惟仲景书另为圣经，所当玩索者也。）因于暑，汗，烦则喘喝，静则多言。（
暑有阴、阳二证，阳证因于中热，
阴证因于中寒，但感在夏至之后者，皆谓之暑耳。暑是热中之凉气，非即热也。暑伤于阳者，汗出烦躁，为
喘，为大声呼喝；若其静者，亦不免于多言，盖邪伤于阴，精神内乱，故言无伦次也。故曰∶“静而得之
为中暑，动而得之为中热。”中暑者阴证，中热者阳证。避暑热于深堂大厦得之者，名曰“中暑”。其病必
头痛恶寒，身形拘急，肢节疼痛而烦心，肌肤火热无汗，此为房室之阴寒所遏，使周身阳气不得伸越也。又
有触热太过，气不得伸，面垢闷倒，名曰“中 ”。若行人或农夫于日中劳役得之者，名曰“中
热”。其病必苦头痛，发躁热，恶热，扪之肌肤大热，必大渴引饮，汗大泄，无气以动；乃为天热外伤肺
气也，一中于热，一中于寒，皆谓之“暑”。但治寒宜散，必汗出而解；治热宜凉，必热清而愈。然夏月浮
阳在外，伏阴在内。若人以饮食情欲伤其内，或冒暑贪凉，劳役过度伤其外，及元气素虚之辈，最易患此，
香薷等岂宜泛用？要当以调补元气为主，然后察其寒热而佐以解暑之剂。若果为阴寒所中，则附子、姜、桂，
先哲每多用之，不可因炎热在外而忽“舍时从证”之良法也。）因于湿，首如裹，湿热不攘，大筋 短，
小筋弛长。 短为拘，弛长为痿。（湿土用事，虽属长夏之气，然土王四季，则感发无时。但湿之中人，有内
外上下之辨，湿伤外者，雨雾阴湿之属也；湿伤内者，酒浆乳酪之属也，湿在上则首如裹，谓若以物蒙裹
然者，凡人行瘴雾之中，及酒多之后，觉胀壅头面，即其状也，湿热，湿郁成热也。攘，退也。湿热不退而下
及肢体，大筋受之则血伤，故为 短；小筋受之则柔弱。故为弛长。 短，故拘挛不伸；弛长，故痿弱无力。）
因于气，为肿，四维相代，阳气乃竭。（因于气者，凡卫气、营气、脏腑之气，皆气也，一有不调，皆能致
疾。四维，四肢也。相代，更迭而病也，因气为肿，气道不行也。四肢为诸阳之本，胃气所在，病盛而至于
四维相代，即上文“内闭九窍，外壅肌肉、卫气散解”之谓，其为阳气之竭也可知。）阳气者，烦劳则张，
精绝，辟积于夏，使人煎厥。（此下言起居不节，致伤阳气也。辟，病也，人以
阳气为生，惟恐散失。若烦劳过度，则形气弛张于外，精神竭绝于中，阳扰阴亏，不胜炎热，故病积至夏日
以益甚，令人五心烦热，如煎如熬；孤阳外浮，真阴内夺，气逆而厥，故名“煎厥”。）目盲不可以视，耳闭
不可以听，溃溃乎若坏都， 乎不可止。（目盲耳闭，九窍废也。溃溃，坏貌。都，城郭之谓。 ，逝
而不返也，阴以阳亏，精因气竭。精神日销，渐至衰败，真溃溃乎若都邑之坏， 乎其去不可绾也。 ，
音骨。）阳气者，大怒则形气绝而血菀于上，使人薄厥。（此下言怒气伤肝，及汗湿、肥甘、风寒之类，皆
足以伤阳气也。人之阳气，惟贵充和，若大怒伤肝则气血皆逆，甚至形气俱绝，则经脉不通，故血逆妄行。
菀积于上焦也。相迫曰薄，气逆曰厥。气血俱乱，故为薄厥。）有伤于筋，纵，其若不容。（怒伤形气，必
及于筋，肝主筋也。筋伤则纵缓不收，手足无措，其若不能容者。）汗出偏沮，使人偏枯。（沮，伤也。
坏也，有病偏汗者，或左或右，浸润不止，气血有所偏沮，久之则卫气不固于外，营气失守于中，故当
为半身不随偏枯之患。沮，将鱼切。）汗出见湿，乃生痤 。（汗方出则玄府开，若见湿气，或沃凉水，必
留肤腠。甚者为痤，微者为 。痤，小节也。 ，暑疹也。痤，才和切。 ，音沸。）高梁之变，足生大疔，
受如持虚。（高梁，即高粱，肥甘也。足，多也，能也。浓味太过，蓄为内热，其变多生大疔。热
侵阳分，感发最易，如持空虚之器以受物，故曰“受如持虚”。）劳汗当风，寒薄为 ，郁
乃痤。（形劳汗出，坐卧当风，寒气薄之，液凝为 ，即粉刺也。若郁而稍大，乃成小疖，是名曰痤。凡
若此者，皆阳气不固之使然。 ，支加切。）阳气者，精则养神，柔则养筋。（此下言阳气之运用，若有不
同，则为偻为 ，为畏为惊，为痈为疟，为隔等症也。神之灵通变化，阳气之精明也；筋之运动便利，阳气之
柔和也，故“精则养神，柔则养筋”。阳气去则神明乱，筋骨废，为病为危矣。）开阖不得，寒气从之，
乃生大偻。（开谓皮腠发泄，阖谓玄府闭封，皆卫气为之主也。若卫气失所，则当开不
开，当闭不闭，不得其宜，为寒所袭，结于经络之间， 急不伸，则形为偻俯矣，阳急则反折，阴急则
俯不伸，即此之谓。）陷脉为 ，留连肉腠。（陷脉，寒气自经络而陷入脉中也。 ，鼠 之属，邪结不散，
则留连肉腠，曼延日甚也。）俞气化薄，传为善畏，乃为惊骇。（寒气自脉渐深，流于经俞，气化内薄，
则侵及脏腑，故传为恐畏，为惊骇，以阳气受伤于内也。）营气不从，逆于肉理，乃生痈肿。（邪气陷脉，则
营气不从，营行脉中也。不从则不顺，故逆于肉理，聚为痈肿也。）魄汗未尽，形弱而气烁，穴俞以闭，
发为风疟。（魄，阴也。汗由阴液，故曰“魄汗”。汗出未止，卫气未固，其时形气正在消弱，而风寒薄之，
俞穴随闭，邪气留止，郁而为疟，以所病在风，故曰“风疟”，夏暑汗不出者，秋成风疟，亦言俞穴之闭也。）
故风者，百病之始也。清静则肉腠闭拒，虽有大风苛毒，弗之能害，此因时之序也。（凡邪伤
卫气，如寒暑湿气风者，莫不缘风气以入，故风为百病之始。然卫气者，阳气也。人惟清静，无过劳扰，则
腠理闭而阳气固，虽有大风苛毒，弗之能害也。所谓“清静”者无他，在因四时之气序耳。）故病久则传化，
上下不并，良医弗为。（并，阴阳交通也，病始因风，久必传化，及至上下不并，则阴阳相离，水火不相济
矣。虽有良医，弗可为也。）故阳蓄积，病死。而阳气当隔，隔者当泻，不亟正治，粗乃败之。（
若邪蓄阳分，积而不行，阳亢无阴，其病当死，盖即“上下不并”之谓也。何以验之？隔塞不通，则其证耳。
当泻不泻，正以粗工误之，故致败亡。）阳气者，一日而主外。平旦人气生，日中而阳气隆，日西而
阳气已虚，气门乃闭。（此下言阳气之盛衰，由于日之升降，正以明上文“若天与日”之义也。一日而主外，
昼则阳气在外也。平旦人气生，以日初升也。日中阳气隆，以日当午也。日西阳气虚，以日渐降也。人气应之，
故昼则卫气行于阳分二十五度，至日暮则阳气之门闭而行于阴分二十五度
矣。气门，玄府也，所以通行营卫之气，故曰“气门”。）是故暮而收拒，
无扰筋骨，无见雾露。反此三时，形乃困薄。（此所以顺阳气也∶阳出而出，阳藏而藏。暮时阳气藏于阴分，
故动宜收敛，以拒虚邪；无扰筋骨，则阳不耗于内；无见雾露，则邪不侵于外。若劳扰不分朝暮，反此
三时，则阳气失养，形体劳困衰薄矣。不但因时之序，一日之间，亦当如此也。）阴者，藏精而起亟也；阳
者，卫外而为固也。（此以专言阳气，夫及于阴，故特明之。人有阴阳，阳主外而为卫，所以固气也；阴主
内而藏精，所以起亟也。阴内阳外，气欲和平，不和则病矣。亟，即“气”也，精化为气，藏精起气之谓也。
亟，音气。）阴不胜其阳，则脉流薄疾，并乃狂。（薄，气相迫也。疾，急数也。并者，阳邪入于阳分，谓
重阳也。阴不胜阳，则阳邪盛，故当为阳脉阳证之外见者如此。）阳不胜其阴，则五脏气争，九窍不通。
（邪在阴分，则脏气不和，故有所争，上七窍，五官也；下二窍，二阴也。九窍之气，皆属于脏。阳不胜阴，
则阴邪盛，故当为阴病之内见者如此。）是以圣人陈阴阳，筋脉和同。骨髓坚固，气血皆从。（陈阴阳，犹言铺
设得所，不使偏胜也。故于筋脉骨髓，无不和调，气血皆从，从则顺矣。）如是则内外调和，邪不
能害，耳目聪明，气立如故。（耳目聪明，以九窍之要者言，神气之全可知也。人受天地之气以立命，故曰“气
立”。阴阳和而气立如故也。）风客淫气，精乃亡，邪伤肝也。（此下四节，皆失调和之道，所以为
筋骨气血之病也。淫气者，阴阳之乱气也。表不和则风邪客之，风木生火，淫气化热，热则伤阴，精乃消亡。
风气通于肝，故必先伤肝也。然风为百病之始，故凡病因于外而内连五脏者，皆由乎风也。）因而饱食，筋脉
横解，肠 为痔；（此下三节，皆兼上文“风客淫气”而言也。风气既淫于外，因而饱食。则随客阳明，必
肠胃横满，横满则有损伤，故筋脉弛解，病为肠 为痔，而下痢脓血也。）因而大饮则气逆；（酒挟风邪，
则因辛走肺、故肺布叶举而气逆上奔也。）因而强力，肾气乃伤，高骨乃坏。
（高骨，腰之高骨也，凡因风强力者，其伤在骨，骨伤则肾气亦伤，肾主骨
也。若强力入房，尤伤精髓。髓者骨之充，骨者髓之府，精髓耗伤，故高骨坏而不为用。）凡阴阳之要，阳
密乃固。（阳为阴之卫，阴为阳之宅。必阳气闭密于外，无所妄耗，则邪不能害，而阴气完固于内，此培养
阴阳之要也。）两者不和，若春无秋，若冬无夏，因而和之，是谓“圣度”。（两，阴阳也。不和，偏病也。）
故阳强不能密，阴气乃绝。（强，亢也。孤阳独用，不能固密，则阴气耗而竭绝也。）阴平阳秘，精神
Where the pathogenic factors knot, penetrating deeply into the bone, Qi adheres to the bone. The bone and Qi combine and increase daily, forming *Guju* (Bone Abscess) (bone abscess). (There are cases where pressing reveals hardness; this is because the pathogen penetrates deeply into the bone, causing Qi to adhere to the bone. When bone and Qi combine, the knot enlarges daily, named "Fuguju" (Attached Bone Abscess) (attached bone abscess).) If the pathogen knots in the flesh, Zong Qi (Pectoral Qi / Great Qi) gathers there. If the pathogen remains and does not depart, heat transforms it into pus; without heat, it forms Rouju (Flesh Abscess) (flesh abscess). (In cases of knotting in the flesh, Zong Qi gathers there. "Zong" means great, referring to the Qi of the Yangming channel. If the retained pathogen generates heat, it ulcerates and腐rots the muscle, thus forming pus; without heat, it knots into substances like paste, gathering without dispersing, which is Rouju.) These various pathogens have no fixed site of onset, but have fixed names. (Although they have fixed names, their onset has no fixed site. Without a fixed site, the signs and symptoms also vary; this is why changes are unpredictable.)
Since ancient times, those who connect with Heaven possess the root of life, which lies in Yin and Yang. Within the universe and the six directions, the Qi connects with the Nine Provinces. The nine orifices, five Zang organs, and twelve joints all connect with Heavenly Qi. (All living beings since ancient times derive life from the Primordial Qi of Heaven. The root of life is Yin and Yang. Macroscopically like the Six Directions, broadly like the Nine Provinces, human nine orifices and five Zang organs correspond to Heaven's four seasons and the body's twelve joints. All are pathways for climate movement and circulation of Ying and Wei Qi. Thus it is said: "All connect with Heavenly Qi".) Life derives from the Five Elements, and Qi exists in three phases. Repeatedly violating these principles allows pathogenic Qi to harm humans; this is the root of longevity. (Although life originates from Yin and Yang, endowment divides into the Five Elements—"its birth is five"; Yin and Yang wax and wane in three phases—Shao, Tai—"its Qi is three". With five and three, generation and restriction, strength and weakness emerge within. Achieving harmony yields Zheng Qi (Upright Qi / Healthy Qi) to generate things; violating change yields Xie Qi (Pathogenic Qi) to harm things. Life and death depend on these three and five, hence the root of longevity.) When the Qi of the Blue Heaven is clear and tranquil, will and intention are regulated. Following this ensures Yang Qi is solid. (The sky is deep dark, hence "Blue Heaven". Heavenly Qi is Yang Qi. The previous text stated the root of life is Yin and Yang; here it specifically discusses Yang Qi. Generally, Sheng Qi (Vital Qi) connecting with Heaven takes Yang as the root. Once Yang Qi is solid, Yin must follow. Thus the Sages emphasize this repeatedly, showing profound intent.) Even if treacherous pathogens exist, they cannot harm. This is due to following the seasonal order. (When Yang Qi is solid, Heavenly integrity is preserved. Preserved heavenly integrity means complete Shen (Spirit). Even with wind-pathogens, they cannot invade, provided one follows the seasonal order, as described in "Regulating the Spirit according to the Four Seasons".) Therefore, the Sages transmit Jing Shen (Spirit), accept Heavenly Qi, and communicate with Shen Ming (Divine Illumination). ("Chuan" means to transmit/maintain. "Fu" means to wear/accord with. Only Sages can obtain Heaven's Jing Shen and accord with Heaven's Yuan Qi (Primal Qi), thereby becoming one with Heaven, allowing Shen Ming to communicate with Heaven.) Violating this causes internal closure of the nine orifices, external obstruction of muscles, and dispersion/relaxation of Wei Qi (Defensive Qi). (Nine orifices connect internally. Muscles guard externally. Their movement and solidity are governed by Yang Qi. Violating this loses the transformation of Clear Yang, causing closure and obstruction of orifices and muscles. Human Wei Qi originates from Heavenly Yang Qi. Yang deficiency leads to Wei deficiency. Dispersion of Wei Qi means loss of Heavenly Truth, hence emphasis on Wei Yang.) This is called self-injury, weakening of Qi. (Self-injuring True Yang, weakening Yuan Qi.) Yang Qi is like Heaven and the Sun. Losing its proper place shortens life and obscures vitality. (This elucidates the root of Yang Qi. If the Sun is dim, Heaven becomes gloomy; if Yang Qi is not solid, humans suffer premature death. Both result from Yang Qi losing its place.) Thus, Heaven's movement relies on the Sun's brightness. (Heaven does not shine itself; brightness comes from Sun and Moon. The Moon is black by nature, shining only by reflecting the Sun. This shows Heaven's movement requires Sun's brightness. Sun is Yang; Yang is Brightness. Where Yang is, Brightness follows; where Brightness reaches, Yang arrives. Yang and Ming are one entity. However, when Yang is at Wu (noon), it is day, Sun high in mid-heaven, manifesting visible divine illumination (Li Fire/Yang outside); when Yang is at Zi (midnight), it is night, fire hidden in water, transforming into formless Yuan Qi (Kan Water/Yang inside). Ruler Fire illuminates, Minister Fire occupies position. Whether Ruler or Minister, it is merely the presence of Yang Qi. If order is lost, how can natural lifespan be preserved?) Therefore, Yang Qi is located superiorly and guards the exterior. It should move like a door pivot. If daily activities cause agitation, Shen Qi floats upward. (Here follows discussion on unsolidified Yang Qi, susceptible to four-season pathogens. Clear Yang is Heaven, covering all things, thus superior and guarding exterior. Human Wei Qi is similar, ideally rotating like a pivot incessantly. If movements are rash and wild, Shen Qi floats, failing to secure Yang Qi, allowing pathogens to invade.) Due to Cold, the body feels like burning charcoal; sweating resolves it. (Contracting Cold causes fever; sweating brings resolution. Southerners call this "Shanghan" (Cold Damage); Northerners call it "Re Bing" (Heat Disease). The Yin/Yang excess/deficiency, meridian/Zang involvement, immediate/delayed onset, transmission/non-transmission are detailed in Zhang Zhongjing's classics, which deserve careful study.) Due to Summerheat, sweating occurs. Irritability leads to panting and loud shouting; stillness leads to excessive talking. (Summerheat has Yin and Yang syndromes. Yang syndrome results from internal heat; Yin syndrome from internal cold. Anything contracted after Summer Solstice is called Summerheat. Summerheat is coolness within heat, not heat itself. Summerheat injuring Yang causes sweating, irritability, panting, loud shouting. If quiet, still prone to excessive talking because pathogen injures Yin, disturbing spirit internally, causing disordered speech. Hence: "Quiet onset is Zhongshu (Summerstroke); active onset is Zhongre (Heatstroke)." Zhongshu is Yin syndrome; Zhongre is Yang syndrome. Contracting heat in deep halls is "Zhongshu". Symptoms: headache, aversion to cold, stiffness, limb pain, vexation, hot skin without sweat. This is due to Yin-cold in rooms suppressing whole-body Yang expansion. Overexposure to heat causing Qi stagnation, greasy face, fainting is "Zhong Yue". Walking/farming in sun is "Zhongre". Symptoms: severe headache, restlessness, heat intolerance, hot skin, extreme thirst, lack of energy. This is Heavenly heat injuring Lung Qi. Both heat and cold contraction are called "Summerheat". Treat Cold with dispersal (sweating resolves); treat Heat with cooling (clearing heat resolves). In summer, floating Yang is outside, hidden Yin inside. Internal injury from diet/lust, or external injury from greed for coolness/overwork, especially in those with deficient Yuan Qi, are prone to this. Is Herba Moslatæ (Xiangru) suitable for general use? One must primarily regulate and tonify Yuan Qi, then observe cold/heat and add summerheat-resolving agents. If truly injured by Yin-Cold, Radix Aconiti Lateralis Preparata (Fuzi), Ginger, Cinnamon Twig are frequently used by ancients. Do not ignore the good method of "abandoning season for syndrome" just because it is hot outside.) Due to Dampness, the head feels wrapped. If Damp-Heat is not cleared, large tendons shorten, small tendons elongate. Shortening causes spasm; elongation causes flaccidity. (Damp Earth rules, associated with Late Summer, but Earth governs all four seasons, so onset is anytime. Damp invasion has internal/external and upper/lower distinctions. External damp: rain/fog/dampness. Internal damp: wine/dairy. Damp in upper body causes head feeling wrapped, like being covered. Seen in misty areas or after heavy drinking. Damp-Heat is Damp郁transforming into Heat. "Rang" means retreat. If Damp-Heat descends to limbs, Large Tendons suffer blood injury, shortening; Small Tendons become weak, elongating. Shortening causes spasms; elongation causes flaccid weakness.) Due to Qi disorder, swelling occurs. If four limbs alternate in disease, Yang Qi is exhausted. (Qi disorder refers to Wei Qi, Ying Qi, Zang-Fu Qi. Any disharmony causes disease. "Siwei" refers to four limbs. "Xiangdai" means alternating disease. Swelling due to Qi indicates blocked Qi channels. Limbs are root of Yang, seat of Stomach Qi. Disease progressing to alternating limb illness reflects "internal closure of orifices, external obstruction of muscles, dispersion of Wei Qi", indicating Yang Qi exhaustion.) Yang Qi, under excessive mental/physical labor, hyperactivates. Essence exhausts. Accumulating into summer causes Jian Jue (Frying Syncope). (This section discusses irregular lifestyle injuring Yang Qi. "Pi" means disease. Humans rely on Yang Qi for life, fearing dispersion. Excessive labor causes Form/Qi to expand outward, Spirit/Essence to exhaust inward. Yang disturbs, Yin亏s, unable to bear heat. Disease worsens in summer, causing five-palm heat, feeling fried/brewed. Lone Yang floats outward, True Yin is seized internally. Qi rebels and synapses, named "Jian Jue".) Blindness prevents vision, deafness prevents hearing. Ruin resembles collapsing city walls, sudden and unstoppable. (Blindness/deafness is failure of nine orifices. "Kui kui" is ruin appearance. "Du" is city wall. "Hu hu" is passing away irretrievably. Yin亏due to Yang deficiency, Essence depleted due to Qi exhaustion. Spirit/Essence daily diminishes to decay, truly like collapsing cities, suddenly gone beyond retrieval. "Hu" sounds like 'gu'.) Yang Qi, under great anger, causes Form/Qi separation and Blood stasis above, leading to Bo Jue (Thrusting Syncope). (This section discusses anger injuring Liver, and sweat/wet/greasy/cold-wind injuring Yang Qi. Yang Qi values fullness and harmony. Great anger injures Liver, causing Qi/Blood rebellion. Severe cases: Form/Qi separation, meridians blocked, Blood rebels and accumulates in Upper Jiao. "Bo" means pressing/thrusting; "Jue" means rebellion/synapse. Qi/Blood chaos causes Bo Jue.) Injury to tendons causes flaccidity, limbs unable to hold position. (Anger injures Form/Qi, affecting tendons. Liver governs tendons. Tendon injury causes flaccidity, limbs helpless, as if unable to contain them.) Sweating on only one side causes hemiplegia. ("Ju" means injury/ruin. Hemihyperhidrosis, left or right, continuous, indicates biased Qi/Blood injury. Long-term Wei Qi fails to guard exterior, Ying Qi loses control interior, leading to hemiplegia. "Ju" pronounced 'jiang yu'.) Sweating exposed to dampness produces acne and prickly heat. (Sweating opens pores. Exposure to dampness/cold water retains moisture in skin. Severe case: Acne; mild case: Prickly Heat. "Cuo" is small nodule; "Fei" is summer rash. "Cuo" pronounced 'cai he'; "Fei" pronounced 'fei'.) Excess rich food/grease generates large carbuncles; susceptibility is like holding an empty vessel. ("Gao Liang" refers to rich/greasy food. "Zu" means many/able. Excess rich flavors accumulate as internal heat, easily generating large carbuncles. Heat invading Yang division is easily triggered, like holding an empty vessel to receive objects, hence "susceptible like holding void".) Labor sweating exposed to wind: Cold pressing causes comedones,郁accumulation causes acne. (Labor sweating, sitting/sleeping in wind: Cold presses, fluids congeal into comedones (acne). If郁slightly larger, becomes small boil, named "Cuo". All such cases result from unsolidified Yang Qi. "Zha" pronounced 'zhi jia'.) Yang Qi, if refined, nourishes Spirit; if soft, nourishes tendons. (This section discusses Yang Qi application. Differences cause stooping, twitching, fear,惊startle, abscesses, malaria, obstruction. Spirit's agility is Yang's refinement; tendon mobility is Yang's softness. Hence "Refined nourishes Spirit, Soft nourishes Tendons". Loss of Yang leads to chaotic Spirit, disabled bones/tendons, dangerous disease.) Failure of opening/closing allows Cold to invade, causing severe stooping. ("Open" is pore release; "Close" is pore sealing, governed by Wei Qi. If Wei Qi is misplaced, opening/closing fails, Cold attacks, knots in meridians, tendons contract unable to extend, causing stooping. Yang tension causes backward arching; Yin tension causes forward bending.) Cold sinking into vessels causes scrofula, lingering in flesh. ("Xian Mai" is Cold sinking from meridians into vessels. "Lu Li" is scrofula type. Pathogen knots and lingers in flesh, spreading daily.) Acupoint Qi transformation presses inward, transmitting to fearfulness and惊startle. (Cold deepens from vessels to meridian acupoints, Qi transformation presses inward, invading Zang organs, causing fear/startle due to internal Yang injury.) Ying Qi not following, reversing in flesh理, causes abscesses/swelling. (Pathogen sinking into vessels disrupts Ying Qi. Ying flows in vessels. Disruption causes reversal in flesh理, gathering into abscesses.) Unfinished "Po Sweat" (Night Sweat/Spirit Sweat), weak form, scorched Qi, closed acupoints, develop Wind Malaria. ("Po" is Yin. Sweat from Yin fluid is "Po Sweat". Unfinished sweating, unsolid Wei Qi, weak Form/Qi, Cold/Wind attack, acupoints close, pathogen stays,郁becomes Malaria. Affected by Wind, called "Wind Malaria". Summer heat without sweating leads to Autumn Wind Malaria, also referring to acupoint closure.) Thus Wind is the beginning of hundred diseases. Clarity/tranquility closes pores/rejects pathogens. Even strong winds/toxins cannot harm, due to following seasonal order. (All pathogens harming Wei Qi—Cold, Summerheat, Damp, Wind—enter via Wind. Hence Wind is start. Wei Qi is Yang Qi. Clarity/tranquility prevents over-labor, closing pores, solidifying Yang. Even strong winds/toxins cannot harm. "Clarity/Tranquility" means following four-season order.) Long-standing disease transmits/transforms. If Upper/Lower do not connect, even good doctors cannot help. ("Bing" is Yin/Yang connection. Disease starts with Wind, transmits long-term. Upper/Lower disconnect means Yin/Yang separation, Water/Fire unconnected. Good doctors cannot treat.") Yang accumulation causes death. Yang obstruction requires draining. Failure to treat correctly promptly leads to failure by incompetent physicians. (Pathogen accumulating in Yang division, stagnant, Yang hyperactive without Yin, leads to death, i.e., "Upper/Lower disconnect". Verified by obstruction symptoms. Draining required. Failure to drain is incompetence, leading to ruin.) Yang Qi governs exterior daily. Dawn: Human Qi generates. Noon: Yang Qi peaks. Sunset: Yang Qi declines, Gate Qi closes. (This explains Yang Qi fluctuation with Sun rising/setting, clarifying "Like Heaven and Sun". Day: Yang outside. Dawn: Sun rises, Human Qi generates. Noon: Sun zenith, Yang peaks. Sunset: Sun declines, Yang declines. Human Qi responds: Day Wei Qi travels 25 degrees in Yang division; dusk Gate Qi closes, travels 25 degrees in Yin division. "Men Qi" is Xuanku, pathway for Ying/Wei Qi, hence "Gate Qi".) Therefore, evening requires gathering/rejection. Do not disturb sinews/bones, avoid fog/dew. Violating these three times causes form to weaken/thin. (Following Yang: Yang exits/exits, Yang hides/hides. Evening Yang hides in Yin, action should gather to reject empty pathogens. No disturbance to sinews/bones prevents internal Yang consumption. No exposure to fog/dew prevents external pathogen invasion. Irregular labor violates these three times, Yang loses nourishment, form weakens/thins. Not just seasons, but daily rhythm matters.) Yin stores Essence and generates Qi urgently; Yang guards exterior and solidifies. (Specifically discussing Yang, involving Yin. Humans have Yin/Yang. Yang guards exterior, solidifying Qi. Yin guards interior, storing Essence, generating Qi urgently. "Ji" means Qi. Essence transforms to Qi, storing Essence generating Qi. "Ji" pronounced 'qi'.) Yin unable to overcome Yang: Pulse flows rapidly/thrusting, entering Yang causes mania. ("Bo" is Qi pressing; "Ji" is rapid. "Bing" is Yang pathogen entering Yang division, Double Yang. Yin failing Yang means Yang pathogen excess, manifesting Yang pulse/syndromes.) Yang unable to overcome Yin: Five Zang Qi conflict, nine orifices blocked. (Pathogen in Yin division causes Zang Qi disharmony/conflict. Seven upper orifices (five senses + mouth/nose), two lower orifices (urethra/anus). Nine orifice Qi belongs to Zang. Yang failing Yin means Yin pathogen excess, manifesting Yin disease internally.) Thus Sages arrange Yin/Yang. Sinews/pulses harmonize. Marrow/bone solid. Qi/Blood flow smoothly. (Arranging Yin/Yang means proper placement, avoiding excess. Sinews/pulses/marrow/bone harmonize, Qi/Blood flow smoothly. Smoothness is adherence.) Thus internal/external harmonize, pathogens cannot harm. Eyes/ears bright, Qi establishment normal. (Eyes/ears bright represents key orifices, indicating complete Spirit/Qi. Humans receive Heaven/Earth Qi to establish life, called "Qi Establishment". Yin/Yang harmony maintains Qi Establishment.) Wind pathogen guests in chaotic Qi, Essence perishes, pathogen injures Liver. (Next four sections discuss disharmony causing sinew/bone/Qi/Blood disease. "Yin Qi" is chaotic Yin/Yang Qi. Exterior disharmony allows Wind guest. Wind Wood generates Fire, Yin Qi transforms to Heat, Heat injures Yin, Essence perishes. Wind Qi connects to Liver, so Liver injured first. Wind is start of hundred diseases; external pathogens connecting to five Zang originate from Wind.) Then overeating causes sinews/pulses to relax, intestinal discharge becomes hemorrhoids. (Next three sections relate to "Wind guest in chaotic Qi". Wind chaotic externally, plus overeating, affects Yangming, causing intestinal fullness/distension. Distension damages sinews/pulses, causing relaxation, intestinal discharge, hemorrhoids, bloody pus stool.) Then heavy drinking causes Qi rebellion. (Wine carries Wind pathogen. Pungent enters Lung. Lung leaves elevate, Qi rebels upward.) Then excessive force injures Kidney Qi, high bones deteriorate. ("High bone" is lumbar vertebrae. Wind/force injury affects bone. Bone injury injures Kidney Qi. Kidney governs bone. Excessive sexual activity especially injures Essence/Marrow. Marrow fills bone; bone is marrow house. Essence/Marrow depletion causes high bone failure.) Key to Yin/Yang: Yang density ensures solidity. (Yang guards Yin; Yin houses Yang. Yang must be dense externally, wasting nothing, preventing pathogen harm, ensuring Yin solidity internally. This is key to cultivating Yin/Yang.) Disharmony between both is like Spring without Autumn, Winter without Summer. Harmonizing them is "Sage Degree". (Two is Yin/Yang. Disharmony is bias.) Thus Yang hyperactivity without density causes Yin Qi exhaustion. ("Qiang" is hyperactivity. Lone Yang uses without solidifying, Yin Qi consumes/exhausts.) Yin level, Yang secret, Spirit...