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(Not listed in the regular sequence.) If joy causes a severe deficiency of Heart Qi, then Kidney Qi will take advantage of this to invade. (Joy causes Qi to sink downward, thereby damaging the Heart. When the Heart is damaged and severely deficient, Kidney Qi invades; this represents Water overcoming Fire.) Anger causes Liver Qi to overact upon the Spleen. (Anger causes Qi to rebel upward in the Liver and attack the Spleen; this represents Wood overcoming Earth.) Grief causes Lung Qi to overact upon the Liver. (Grief causes Qi to gather in the Lungs and attack the Liver; this represents Metal overcoming Wood.) Fear causes Spleen Qi to overact upon the Kidneys. (Fear damages the Kidneys, causing Kidney Qi to become deficient, allowing Spleen Qi to invade; this represents Earth overcoming Water.) Worry causes Heart Qi to overact upon the Lungs. (Worry damages the Lungs, causing Lung Qi to become deficient, allowing Heart Qi to invade; this represents Fire overcoming Metal.) This is the principle of mutual overacting. (Some cases involve excess pathogenic factors attacking another organ, while others involve deficiency allowing another organ to attack. In all cases, the attack occurs on the organ that one cannot overcome in the normal cycle; this is the rule of irregular transmission.) Therefore, there are five basic types of diseases, and the mutual transmission among the five Zang organs can produce twenty-five variations; these are named "transmission" (Chuan) and "overacting" (Cheng). (There are only five Zang organs, but the transmission between them can involve each of the other four, resulting in twenty-five variations. "Transmission" refers to disease moving from one organ to another, while "overacting" refers to strong pathogenic factors bullying weak ones; hence the different names.)

There is a condition characterized by fever, sweating, and vexation with fullness, where the vexation does not resolve with sweating. ("Does not resolve with sweating" means that the vexation and heat persist after sweating.) Fever accompanied by sweating indicates Wind pathogen; sweating accompanied by unresolved vexation and fullness indicates Jue syndrome. This disease is named "Wind-Jue". The Taiyang (Greater Yang) channel governs the exterior Qi and is thus the first to be affected by pathogens; the Shaoyin (Lesser Yin) channel is interior-exterior paired with it. When heat affects the Taiyang, the Shaoyin Qi follows it upward, transforming into heat; when Qi rebels upward, it forms Jue. (Wind is a Yang pathogen, so although sweating occurs, the body remains hot. Taiyang governs the exterior Qi. Exterior disease prompts interior response; thus, when Shaoyin receives heat, the Yin Qi also follows the Yang upward and rebels, forming Jue. Hence the name "Wind-Jue". Note: "Wind-Jue" has multiple meanings; here it refers to simultaneous disease of Taiyang and Shaoyin. Another form involves Yangming and Jueyin channels, affecting the Stomach and Liver. People prone to Wind-Jue with profuse sweating have insecure flesh and loose interstices.) Laofeng (Labor-induced Wind) disease typically manifests below the Lungs. (Laofeng results from wind invasion following physical exhaustion. "Below the Lungs" refers internally to the chest and diaphragm region, and externally to the area between the fourth and fifth thoracic vertebrae. Wind enters from the exterior and manifests internally; those exhausted by labor inevitably pant, indicating that labor injures the Lungs.) Symptoms include stiffness of the neck and upper back, and dim vision. (Pathogens below the Lungs cause panting and rebellion, leading to neck stiffness preventing bowing. Wind-heat obstructs upward, causing photophobia, leading to closing eyes to see.) The patient expectorates thick sputum resembling phlegm, feels aversion to wind, and experiences chills. This is called "Laofeng". (Wind-heat damages Yin fluids, making secretions thick and turbid, hence sputum like phlegm. The Lungs govern skin and hair; damage to Wei Qi causes aversion to wind and chills.) Treatment should prioritize resolving difficulty in flexion and extension. (The severity of Wind is reflected in the limitation of flexion and extension movements; thus, relief must be sought first. However, treating this requires warming the Lung Qi first; warming dissipates Wind, and once Wind dissipates, movement returns to normal. If warming and dispersing fail, stagnation may turn into heat, requiring clearing and resolving methods thereafter. Improper use of warming or clearing will worsen the condition.) For patients who can guide Essence upward, recovery occurs in three days; for middle-aged patients with declining Essence, five days; for elderly patients with depleted Essence, seven days. (Wind pathogens injuring the Lungs enter via the Fengmen and Feishu acupoints of the Foot-Taiyang Bladder channel into the Zang organs. The Large Intestine is the Fu organ of Water and the exterior of the Three Yang channels; thus, guiding Essence upward allows Wind to be expelled through coughing. If Taiyang Qi is vigorous, guiding Essence is rapid, with recovery in three days; middle-aged patients with declining Essence recover in five days; elderly patients with depleted Essence recover in seven days, expectorating green-yellow sputum and nasal discharge, as described below. This is what is meant by "guiding Essence".) Expectoration of green-yellow purulent sputum, resembling pus and sized like a bullet, expelled from the mouth or nose, is critical. If not expelled, it damages the Lungs, leading to death. (Inability to cough up sputum, known today as dry cough, can progress to depletion of Metal and Water, presenting as consumptive disease, leading to death. Exhaustion of Kidney Qi and internal deficiency of Lung Qi, combined with forcing Yang Qi, prevents expulsion, damaging the Lungs and causing death.)

Patients with Shenfeng (Kidney Wind) present with facial edema, a pale and lusterless complexion, and heavy, unclear speech. (Edema. Pale/lusterless appearance. Heavy/unclear. The Kidney meridian circulates along the throat and flanks the tongue root; Wind pathology impedes the Kidney meridian, causing heavy and unclear speech.) They experience shortness of breath, intermittent fever, heat rising from the chest and back to the head, hot palms, dry mouth with bitter taste and thirst, yellow urine, edema under the eyes, borborygmus, heaviness of the body making movement difficult, amenorrhea, irritability preventing eating, inability to lie supine (supine position aggravates coughing). This disease is named "Fengshui" (Wind-Water). (The Kidneys govern Water; Wind in the Kidney meridian is named "Fengshui".) This occurs because where pathogens gather, Qi must be deficient. (Pathogens invade due to deficiency; thus, where pathogens gather, Qi is necessarily deficient.) Yin deficiency leads to Yang pathogens gathering in the Yin aspect, causing shortness of breath, intermittent fever, and sweating. (Yin deficiency results in lack of Qi, causing shortness of breath and intermittent fever. Yang tends to scatter and gather in the Yin aspect, causing sweating.) Yellow urine indicates heat in the lower abdomen. (Heat in the lower abdomen implies pathogen in the Yin aspect, hence yellow urine.) Inability to lie supine is due to disharmony in the Stomach. Supine position aggravates coughing because Qi rebels upward and presses on the Lungs. (Supine means lying flat. The Kidney meridian passes through the liver and diaphragm, enters the Lungs, and its branch enters the chest. Kidney pathogens move upward, causing Stomach Qi to rebel and become disordered, so supine position aggravates coughing and presses on the Lungs.) In all cases of fluid retention, slight edema appears first under the eyes. Water is Yin; the area under the eyes is also Yin. The abdomen is the residence of Supreme Yin; thus, fluid in the abdomen causes edema under the eyes. (Edema under the eyes resembling a sleeping silkworm indicates fluid retention in the abdomen.) Rebellion of True Qi causes bitter taste and dry tongue, inability to lie supine, and expectoration of clear water when supine. All water-disease patients cannot lie flat; lying down causes fright, which aggravates coughing. (Water pathogens stagnate in the Zang organs, causing Qi rebellion. Qi rebellion prevents lying flat, causing fright and severe coughing.) Borborygmus originates in the Stomach. Pathogens pressing on the Spleen cause irritability and anorexia; food impaction is due to obstruction in the epigastrium. Heaviness and difficulty walking relate to the Stomach meridian running on the feet. (Spleen and Stomach belong to Earth, controlling Water. If Earth is weak, Cold Water insults it, causing borborygmus and food impaction. The Stomach governs muscles, and its meridian runs on the feet. Fluid retention in muscles causes heaviness and immobility.) Amenorrhea is due to closure of the Bao Mai (Uterine Vessels). The Bao Mai belongs to the Heart and connects to the Bao (Uterus). Currently, Qi rebels upward pressing on the Lungs, preventing Heart Qi from descending, thus causing amenorrhea. (Bao is the Uterus, seat of Ministerial Fire; the Heart governs Blood vessels, seat of Sovereign Fire. Yang Qi communicates上下, so Bao Mai belongs to the Heart and connects to the Uterus to regulate menstruation. Now, Qi rebels upward, Yin pathogens block Yang pathways, Heart Qi cannot descend, Bao Mai closes, and menstruation stops.)

If the appearance resembles edema, but the pulse is large and tight, the body has no pain, the form is not emaciated, and the patient cannot eat or eats little, the disease is located in the Kidneys and is named "Shenfeng". (Resembling edema refers to facial swelling that looks like water but is not true water retention. A large pulse indicates Yin deficiency; a tight pulse indicates Cold. No pain and non-emaciation indicate the pathogen is in the Zang, not the exterior. Wind carrying Kidney pathogens injures the Spleen and Stomach, causing anorexia. Thus, Wind has external and internal distinctions that must be recognized. Eight Winds enter from outside, initially presenting with fever, aversion to cold, headache, and body pain. These external infections are clearly observable. Five Winds arise internally, presenting without external signs, suddenly appearing like Wind, indicating internal injury, such as "all sudden stiffness belongs to Wind" and "all Wind tremors and dizziness belong to the Liver." Generally, having been struck by something is called external infection; having no external strike is called internal injury. External infection attacks the muscle-surface, often presenting as Yang Excess; internal injury results from alcohol, sex, labor, fatigue, emotions, and diet, damaging Zang Qi, often presenting as Yin Deficiency. When Zang Qi is injured: Spleen failure manifests in limbs or phlegm-fluids; Kidney disease manifests in marrow or two yin openings; Heart disease manifests in blood vessels or spirit/mind; Lung disease manifests in Ying-Wei or voice; Liver disease manifests in sinews/claws or hypochondrium. All these Zang-type Wind diseases stem from Yin Deficiency. Only Li Dongguan grasped this principle: he stated that stroke-like sudden fainting and loss of consciousness is not external Wind pathogen, but self-disease of the Root Qi. People over forty with declining Qi often suffer this. At forty, Yin Qi naturally halves, making them prone to this; is it not Yin Deficiency? Humans are born from Yang but rooted in Yin. If the root declines, illness ensues; if the root fails, danger looms. The root is True Yin. People know Yin Deficiency as one category, but do not know there are two: Water deficiency within Yin affects Essence and Blood; Fire deficiency within Yin affects Spirit and Qi. Yang decline leads to Qi departure, causing mental confusion—is this not Fire deficiency? Yin depletion leads to physical deterioration, causing limb flaccidity—is this not Water deficiency? Now, facing symptoms of spirit separation and physical decay, if one does not seek the source of Water and Fire but treats with Wind-dispelling methods, danger is inevitable. Therefore, treating pseudo-Wind conditions requires specifically tonifying True Yin to save the root; restoring Yin eliminates Wind and Dryness. However, external infections are not devoid of deficiency (Qi deficiency is deficiency); internal injuries are not devoid of excess (stagnation is excess). Treating deficiency requires observing whether it is Yin or Yang and directly tonifying; treating excess requires observing if it is due to Phlegm or Qi and temporarily opening/resolving. In handling internal vs. external and deficiency vs. excess, one must carefully assess the presence and severity of subtle differences to adjust treatment. Even cases of inherent Yuan Qi deficiency presenting with sudden collapse, no phlegm above, incontinence below, closed eyes, and lethargy are Jue-Jie (Collapse) syndromes, unrelated to Wind pathogen. Without large doses of Ginseng, Rehmannia, or seven-year-old Mugwort to drastically rescue, how can one hope to restore Qi at the brink of extinction! If one cannot distinguish exterior-interior or deficiency-excess, and merely uses Wind-dispelling herbs because of the name "Wind," one ignores that Wind herbs are drying (injuring Yin) and dispersing (injuring Qi). Treating internal injury as external infection, and insufficiency as excess, hastens death.) If Shenfeng prevents eating, causes frequent fright, and leads to Heart Qi atrophy after fright, death occurs. (Wind generated in the Kidneys insults Earth, causing anorexia. Kidney pathogens invading the Heart cause loss of Spirit control, leading to fright. If Heart Qi remains atrophic and unable to recover after fright, both Heart and Kidney fail, and Water and Fire are trapped, leading to death.)

A condition characterized by fever, lassitude, profuse sweating like bathing, aversion to wind, and shortness of breath is named "Jiufeng" (Alcohol Wind). (This is the "Loufeng" mentioned earlier. Alcohol is inherently hot; excessive consumption causes fever. Damp-heat injures sinews, causing lassitude. Damp-heat steams the skin and pores, causing profuse sweating. Profuse sweating weakens Wei Qi, causing aversion to wind. Wei deficiency leads to Qi leakage, causing shortness of breath. Disease acquired from alcohol followed by Wind exposure is called "Alcohol Wind".) Treatment uses Ze Xie (Alisma Rhizome) and Bai Zhu (Atractylodes Macrocephala Rhizome), ten parts each, and Mi Xian (Dendranthemi Indici Herba), five parts. Mix and take three finger-widths as a dose, administered after meals. (Ze Xie is sweet, bland, slightly cold, promoting damp-heat drainage. Bai Zhu is sweet, bitter, warm, tonifying the Middle, drying dampness, and stopping sweating. Mi Xian, also known as Wei Xian or Wu Feng Cao, is bitter, neutral, slightly cold, treating Wind-Damp. Ten parts means double; five parts means half. Mixing with three fingers approximates the quantity for decoction. Taking medicine after food is called "Hou Fan".)

Zei Feng (Thieving Wind) pathogens injure humans, causing disease. Some people do not leave shelter or exit their rooms yet fall ill suddenly. This is not because they avoided Zei Feng pathogens; rather, they previously suffered moisture injury, which lodged in the blood vessels and between muscle layers, lingering long-term. Or they had previous falls causing blood stasis retained internally. Or they experienced uncontrolled anger/joy, improper diet, or temperature dysregulation, leading to closed and blocked interstices. (All these are called "Gu Xie" / Old Pathogens.) When the interstices open and encounter Wind-Cold, blood and Qi coagulate, combining with old pathogens to form "Han Bi" (Cold Bi). (Opening refers to exposure to Wind-Cold. Old pathogens are present; Wind-Cold follows. Their collision causes coagulation, forming Cold Bi; if Cold dominates, it is Painful Bi.) If there is heat, sweating occurs; sweating invites Wind. Even without encountering Zei Feng pathogens, new manifestations will arise from old triggers. (Sweating from heat invites Wind. Although not Zei Feng, it is still external contraction. New manifestations arise from old triggers, meaning old pathogens combine with new inducements, causing disease onset.) Patients are aware of these themselves. If no pathogen was encountered, nor any fright or anxiety, yet sudden illness occurs, is it due to ghosts and spirits? (Ghost/spirit stories have confused people since ancient times.) No. This is also due to old pathogens lingering unmanifested. Emotional aversion or obsession disturbs blood and Qi, causing internal chaos and conflict between pathogenic and healthy Qi. The origin is subtle, invisible and inaudible, seeming like ghosts/spirits. (Old pathogens refer to those "lingering unmanifested." Aversion refers to hating something; obsession refers to desiring something. Unmanifested old pathogens triggered by new stimuli allow Five Emotions to be possessed by pathogens, disturbing blood and Qi. Pathogenic and healthy Qi clash, generating false illness. The mechanism is too subtle for senses, leading to suspicion of ghosts/spirits, though it is not actually supernatural.) Those cured by Zhu You (Incantation Therapy) are healed because the shaman understands the mutual overcoming of the Five Elements in diseases, knowing the origin of the disease, and using incantations to shift spirit and change Qi, expelling pathogens. (Zhu refers to shamanic incantations, i.e., Zhu You therapy. Overcoming refers to the Five Element principles governing disease cure. One must first know the disease origin to apply the overcoming method, shifting spirit/Qi and expelling pathogens. Some diseases are beyond herbal/acupuncture reach, requiring this method. Ancient shamans knew this, so Zhu You works. The subtlety of Zhu You lies not in the incantation itself, but in the principle of "overcoming." Zhu and Zhou are synonymous.)