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Zhang Zhongjing's *Zubing Lun* (Treatise on Acute Diseases) has been lost. In my discussions on sudden cold-stroke syndromes, I emphasize the True Yang (Yuan Qi of the Kidney) of the Shaoyin Kidney Zang. It is only when this True Yang is weak and failing that external cold pathogens can suddenly invade the body. I have written treatises on Yin diseases to fully expound this theory. Once this key point is thoroughly understood, reading Zhang Zhongjing's works will reveal profound insights everywhere. For instance, in the section on Water-Qi Disease Diagnosis and Treatment in the *Jingui Yaolue*, a superficial reading might suggest it merely discusses water metabolism disorders. Initially, I did not grasp its true meaning; upon careful reflection, I realized that although water has Yin and Yang distinctions, it essentially belongs to Yin manifestations and is specifically governed by the Shaoyin Kidney. If the True Yang of Shaoyin is firmly established and remains hidden, water fluids will adhere internally, functioning in harmony with the Kidney's storage capacity, leaving no room for water disasters. Only when the True Yang within the Kidney is depleted can water flood throughout the body, submerging and depressing Heart Fire, and drowning Spleen Earth, creating a momentum like an uncontrollable flood. Therefore, I hereby elucidate several profound principles regarding water disease from the *Jingui Yaolue* below, to illustrate a facet of its treatment.

The *Jingui Yaolue* categorizes water diseases into five types: Feng Shui (Wind Water), Pi Shui (Skin Water), Zheng Shui (Regular Water), Shi Shui (Stone Water), and Huang Han (Yellow Sweat).
Among these, Feng Shui, Pi Shui, and Huang Han, although related to the Kidney, belong to Yang-level pathologies. In contrast, Zheng Shui and Shi Shui are Yin-level water diseases; all methods used to treat Yang-water are ineffective here.
Zheng Shui presents with a deep and slow pulse (*Chen Chi*), and external symptoms include wheezing. This occurs because the North Ren-Gui (corresponding to the Kidney) is diseased itself, hence the deep and slow pulse. The Kidney stores water, and the Lung generates water; disease in the child affects the mother, involving both root and branch, thus causing external wheezing. The *Huangdi Neijing* states: "The Kidney is the gate of the Stomach. If the gate is dysfunctional, water accumulates to cause disease, overflowing up and down onto the skin, resulting in edema of the dorsum of the foot and abdominal distension. Upward, it causes wheezing and inability to lie flat." The term Zheng Shui in the *Jingui Yaolue* likely originates from this passage. Shi Shui naturally presents with a sunken pulse, and external symptoms include abdominal fullness without wheezing. This is because Kidney Qi binds with water and remains static, resulting in a sunken pulse. Water accumulates in the bladder and uterus (Bao Luo), causing only lower abdominal fullness and hardness, without Qi harassing the Lung, hence no wheezing. The *Huangdi Neijing* says: "When Yin and Yang bind obliquely, with Yin exceeding Yang, it is named Shi Shui." It also states: "Simultaneous sunken pulses of the Kidney and Liver indicate Shi Shui," as the Qi of both organs penetrates the Bao Luo. However, the *Chushi Bingyuan Fanglun* (Source Book of Pathogenesis and Prescriptions for All Diseases) claims: "In Shi Shui, pain and distension radiate from under both hypochondria. If pain extends to the epigastrium, death ensues." On what basis is this claim? Since Shi Shui involves the Liver and Kidney, if Kidney pathology predominates, it binds downward and struggles to ascend; if Liver pathology predominates, it carries Wood energy to invade the Stomach boundary. Both are inevitable outcomes. Ye Yongyan once suffered from a mass (*Jia*) in the lower abdomen, which was a case of Shi Shui. Triggered accidentally by an exogenous pathogen, he cried out in severe pain. The physician failed to observe correctly, mistakenly using Chai Hu (Bupleuri Radix) formulas to disturb Liver Qi, and additionally applied mild purgation. This resulted in vomiting blood resembling mud, leading to death. The cases described by Chao Yuanfang likely refer to such scenarios. A student asked how Ye Yongyan’s illness should be treated to recover. I replied: The *Classic* states, "If pain precedes the disease, treat the root." One must first warm and dissipate the hernia/mass, using Fuzi (Aconiti Lateralis Radix Preparata) and Rougui (Cinnamomi Cortex) to overcome cold, rescue Yang, and stop pain, before treating the exogenous factor. The physician, unaware of this, used Xiao Chai Hu Tang (Minor Bupleurum Decoction) without effect. Seeing constipation, they used enemas, without effect, then applied mild purgation. They failed to realize that when turbid Yin rises, warming herbs are required to open the Yin orifices. Had they used cold purgatives, it would have exacerbated Yin-Cold, aiding the rampant expulsion of corrupt matter upwards, potentially penetrating the stomach and anus, which is unavoidable. Zhang Zhongjing warned against sweating and purgation when there is "moving Qi in the lower abdomen" and stated that the Duyang pulse should be hidden but is now tight, indicating pre-existing hernia/mass and abdominal pain. If the physician purges, chest fullness and shortness of breath result. Had this been anticipated earlier, recognizing that failing to warm the hernia/mass but instead using cold purgation depletes Upper Jiao Yang, preventing Yang distribution and allowing Yin to harass upward, leading to chest fullness, shortness of breath, and death from surging corrupt matter, one would understand. From this, we infer that for any hernia/mass abdominal pain syndrome compounded by exogenous cold, warming meridians and rescuing Yang is indeed the definitive method. Refer to the Wutou Jian (Aconite Decoction) for cold hernia treatment recorded later in this volume.

The *Jingui Yaolue* states: "Shaoyin pulse is tight and deep; tight indicates pain, deep indicates water, urination becomes difficult. When pulses are generally deep, suspect water. With bodily swelling and heaviness, if the water disease pulse floats out, it indicates death."
This discusses the pulse of Shaoyin water disease; if it appears floating and large, it indicates death. However, in Feng Shui and Pi Shui, pulses are floating. In pregnant women with water disease, pulses are also floating, which is an exception. Shaoyin belongs to Extreme Yin and governs Winter in the seasonal cycle. A deep pulse reflects both water manifestation and meridian Qi, which is appropriate. Thus, if the pulse unexpectedly floats out, it means Shaoyin meridian Qi cannot store and is externally severed, definitely indicating death. Ultimately, "pulse floating out indicates death" does not solely mean it is floating. It specifically refers to the condition where the pulse is absent upon deep pressure but appears upon superficial pressure, indicating death.

The *Jingui Yaolue* states: "Cunkou pulse is deep and slow; deep indicates water, slow indicates cold. Cold and water contend. Duyang pulse is hidden, food and water are not transformed. Spleen Qi decline leads to loose stools; Stomach Qi decline leads to bodily swelling. Shaoyang pulse is low/subdued, Shaoyin pulse is fine/thin. In men, urination is difficult; in women, menstruation stops. Menstruation is blood; if blood circulation is impaired, it transforms into water, named Blood Partition (*Xue Fen*)."
Cunkou deep pulse indicates water, slow indicates cold. Water and cold are not external pathogens but result from combined pathology of the Spleen/Stomach and the Chong Mai (Penetrating Vessel) Blood Sea. Because the Yang of the Stomach (transforming food/water) fails to distribute, the Five Yangs become deficient and exhausted, generating cold. The Yin of the Chong Mai Blood Sea fails to generate and transform, causing internal binding of Yin pathogens, generating water. Cold and water contend in the Two Seas, so the water-cold state borne by the twelve meridians manifests at the Cunkou. The Duyang pulse, representing Spleen/Stomach, is hidden and hard to locate; the patient certainly suffers from undigested food/water. Spleen Qi decline causes failure to separate clear/turbid internally, leading to loose stools. Stomach Qi decline prevents Yang Qi from reaching the exterior, leading to bodily swelling. These are inevitable consequences. The Chong Mai is the Sea of Blood, associated with the Right Kidney Zang, with the Sanjiao as its Fu organ. In men, it stores essence; in women, it connects to the uterus; their source is identical. However, in women, Yin/Blood dominates, and the Blood Sea is often diseased; in men, Yang dominates, and the Sanjiao is often diseased. Their flows differ. Moreover, the Chong Mai cannot be directly palpated. In men, a low Shaoyang pulse indicates Sanjiao Qi transformation failure and urinary difficulty. In women, a fine Shaoyin pulse indicates Blood Sea pathology and amenorrhea. Thus, male water disease stems from Qi transformation failure; female water disease stems from blood stasis. This is a fixed principle. However, men can suffer from blood diseases, and women from Qi diseases. In Zhang Zhongjing's prescriptions, Qi-treating formulas often include blood-invigorating herbs, and blood-treating formulas often include Qi-moving herbs. One must master flexibility to reach subtle profundity.

The *Jingui Yaolue* outlines the sequence for treating water-cold through Q&A. Question: "A patient suffers from water disease, with swelling of face, body, and limbs, and urinary difficulty. Pulse diagnosis does not mention water but reports chest pain, Qi rushing up the throat feeling like stuck meat, accompanied by slight cough and wheezing. If this matches the Master's description, what is the pulse?" Master replies: "Cunkou pulse is deep and tight. Deep is water, tight is cold. Deep and tight contend, knotting at the Guanyuan acupoint. Initially, symptoms were mild, unnoticed in youth. After Yang decline, Ying and Wei interfere. Yang damage and Yin excess cause the knotted cold to stir slightly. Kidney Qi rushes upward, causing throat obstruction and hypochondriac urgency/pain. Physicians mistook this for retained fluid (*Liu Yin*) and used strong purgatives. The Qi knot remained, disease persisted. Repeated emesis caused Stomach deficiency irritability, dry throat craving water, urinary difficulty, indigestion, and facial/hand/foot edema. Then Tingli Wan (Descurainiae Fructus Pill) was given to drain water. Symptoms improved temporarily, but overeating caused swelling to return, chest/hypochondriac pain, resembling Ben Tun (Rushing Pig) Qi. Water overflowed, causing floating cough and wheezing. One must first attack the Chong Qi, stop it, then treat cough; once cough stops, wheezing resolves naturally. Treat new disease first; old disease follows later."

Pulse deep indicates water, tight indicates cold/pain; water-cold belongs to the Kidney. The Foot Shaoyin Meridian ascends from the Kidney through the Liver and Diaphragm, enters the Lung, and follows the throat. Its branch emerges from the Lung, connects to the Heart, and pours into the Chest. Whenever Kidney Qi rebels, it travels alongside the Chong Mai. Following the meridian path, it clashes with healthy Qi, causing the aforementioned symptoms. After Yang decline, knotted cold pathogens flare and rush upward. If physicians fail to treat the Chong Qi and recklessly use emesis/purgation, they damage the Stomach responsible for digesting food and transforming fluids. This leads to thirst, drinking water, urinary difficulty, and widespread water accumulation. As Chong Qi strikes due to deficiency, how can one casually treat the water? Thus, one must first treat the root of Chong Qi. Once Chong Qi stops and Kidney Qi calms, other symptoms resolve. For unresolved cases, treat according to suitability: tonify Yang, drain Yin, move water, strengthen Stomach, and unblock accumulated cold/stagnation at Guanyuan. Establishing this law clarifies the sequence without error. Should students not know whom to follow?

Master says: "Cunkou pulse is slow and choppy; slow indicates cold, choppy indicates blood deficiency. Duyang pulse is faint and slow; faint indicates Qi deficiency, slow indicates cold. Cold Qi and deficiency coexist, causing cold extremities. Cold extremities lead to poor Ying/Wei circulation. Poor Ying/Wei circulation causes abdominal fullness and borborygmus chasing each other, Qi transferring to the Bladder, exhausting Ying/Wei. Yang blockage causes body coldness; Yin blockage causes bone pain. If Yang opens first, aversion to cold occurs; if Yin opens first, numbness/paralysis occurs. When Yin and Yang harmonize, Qi flows; when Great Qi rotates, stagnation disperses. Excess leads to flatus; deficiency leads to enuresis. This is named Qi Partition (*Qi Fen*). (22)"
Guizhi Qu Shaoyao Jia Mahuang Fuzi Tang (Cinnamon Twig Decoction minus Peony plus Ephedra and Prepared Aconite). (Discussion see under this formula.)

Cunkou monitors Ying/Wei; Duyang monitors Spleen/Stomach. Spleen/Stomach deficiency-cold means extremities cannot receive Grain Qi, declining daily, hence cold extremities. Cold Qi accumulating centrally without discharge causes internal warmth to leave, leaving only cold, hence abdominal fullness. The Spleen's Front-Mu point is Zhangmen at the costal margin. Cold invading the Mu point passes through the Shaoyang meridian. The Shaoyang Fu is the Sanjiao. Unable to ascend Qi to the Upper Jiao, it drags abdominal and Mu-point cold into the Bladder, where it stagnates. Ying/Wei become increasingly blocked; how can abdominal fullness disperse? Sometimes Yang opens first, but solitary Yang arrives, Wei Qi fails to fill the interstices, hence aversion to cold. Sometimes Yin opens first, but solitary Yin arrives, failing to warm muscles, hence numbness. Only when Yin and Yang harmonize, and Ying/Wei circulate freely, does the Zong Qi (Gathering Qi) in Danzhong rotate. Once Zong Qi rotates, it is like the sun shining brightly. Turbid Yin disperses through the two Yin orifices of the Lower Jiao. Dispersal differs by excess/deficiency: excess disperses via the posterior orifice (flatulence); deficiency disperses via the anterior orifice (urine). Thus, cold aggregation/dispersion depends on the presence/absence of Warm Qi, hence named Qi Partition.
These words of further progress... readers who do not understand them after studying the books, akin to drinking from the upper pool (referring to Bian Que) yet tasting nothing, are surely muddied by filth?