不知人，气复反则生矣。寒气客于肠胃，厥逆上出，故痛而呕也。寒气客于小肠，不得成聚，故
后泄腹痛矣。热气留于小肠，肠中痛，瘅热焦渴则坚干不得出，故痛而闭不通矣。帝曰∶所谓言
而可知者也，视而可见奈何？曰∶五脏六腑固尽有部，视其五色，黄赤为热，白为寒，青黑为痛，
此所谓视而可见者也。曰∶扪而可得奈何？曰∶视其主病之脉，坚而血及陷下者，皆可扪而得者也。
生气通天论篇 帝曰∶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，皆通乎天气。其生五，其气三，数犯此者，则邪气伤人，此寿命
之本也。（支氏曰∶人不知节欲而数犯，伤其正气，则邪气乘正气之虚而入为害也，故曰邪气伤
人。王注直云邪气伤正气，而不先言耗损之由，则邪何从而入也？）苍天之气，清冷则志意治，
顺之则阳气固，虽有贼邪，弗能害也，此因时之序。故圣人传精神，服天气，而通神明。失之则
内闭九窍，外壅肌肉，卫气散解，此谓自伤，气之削也。阳气者若天与日，失其所则折寿而不彰，
故天运当以日光明，是故阳因而上，卫外者也。
因于寒，欲如运枢，起居如惊，神气乃浮。
因于暑，汗，烦则喘喝，（大声也。）静则多言，体若燔炭，汗出而散。
病因于暑，则当汗泄，不为发表，邪热内攻，中外俱热，故烦躁喘数大呵而出其声也。
因于湿，首如裹，湿热不攘，大筋 短，小筋弛长， 短为拘，弛长为痿。因于气，为肿，
四维相代，阳气乃竭。
湿气熏蒸，清道不利，故首如有物蒙之若裹也。热伤血，不能养筋，致为拘挛。湿伤筋，
不能束骨，故为痿弱。湿热甚，以致正气不宣通，故四维发肿。诸阳受气于四肢也，今人见膝间
关节肿痛，便作风治者误矣。
阳气者，烦劳则张，精绝，辟积于夏，使人煎厥。（煎迫而成厥逆。）目盲不可以视，耳闭
不可以听，溃溃乎若坏都， 乎不可止。
阳气烦劳则主阴绝，辟积不已，至夏火愈亢，而时若煎迫而气逆上，火既亢上，则目盲耳
闭，精败神去，如溃散之坏都，所储之水散流而不可遏矣。病而至此，为坏极矣。
阳气者，大怒则形气绝，而血菀于上，使人薄厥。有伤于筋，纵，其若不容。
怒则气上，血随积焉。阴阳相搏，气血奔并，因薄厥生。菀，陈积也。薄，迫也。怒气伤
于筋则为痿，而不维持也，故曰纵，其若不容。
汗出偏沮，使人偏枯。
身常偏汗出者，久久而成偏枯。
汗出见湿，乃生痱痤。
阳气发泄，寒水制之，热郁皮肤，则为疮痱。
膏粱之变，足生大疔。
膏粱浓味，内多滞热，皮浓肉疏，故内变为疔。足，多也。
劳汗当风，寒薄为 ，郁乃痱。
此阳为阴遏，而不通畅，故迫为 ，粉刺也。轻为痱痤。
阳气者，精则养神，柔则养筋。开阖不得，寒气从之，乃生大偻。陷脉为痿，留连肉腠。
内精微以养神，外柔和以养筋。开阖失宜，为寒所袭，则筋络拘 ，形容偻俯矣。寒气下
陷于脉中，则为痿。留连于肉腠而不舒。
营气不从，逆于肉理，乃生痈肿。
营气不顺，血郁肌肉，故成痈肿。
魄汗未尽，形弱而气烁，穴俞以闭，发为风疟。
汗出未止，形弱气消，风寒薄之，穴俞随闭，热藏不出，以至秋阳复收，两热相合，寒热
相移。以所起为风，故为风疟。
风者，百病之始也。清净则肉腠闭拒，虽有大风苛毒，弗之能害。
起居有度，不妄作劳，是为清净。真气内固，故皮腠闭密。虽有大风苛毒，弗能伤害也。
病久则传化，上下不并，良医弗为。
病久上下不通，则阴阳否隔，良医妙法莫能为何也。
阳蓄积病死，而阳气当隔，隔者当泻。
三阳蓄积不通，不急泻之则死。
风客淫气，精乃亡，邪伤肝也。
淫气甚而风客之，则伤精。邪气伤于肝，为本经也。
因而饱食，筋脉横解，肠 为痔。因而大饮，则气逆。因而强力，肾气乃伤，高骨乃坏。
食甚饱，则肠胃横满而筋脉解，故有肠 为痔之患。大饮甚，则肺气逆而上奔。强力入房，
则肾气伤，高骨坏而不为用。高骨，谓腰之高骨。
春伤于风，邪气留连，乃为洞泄。夏伤于暑，秋为 疟。秋伤于湿，上逆为咳，发为痿厥。
冬伤于寒，春必病瘟，四时之气，更伤五脏。
阴阳应象篇 曰∶春伤于风，夏生飧泄。夏伤于暑，秋必 疟。秋伤于湿，冬生咳嗽。
冬伤于寒，春必病瘟。
二论大同。王安道云∶此四章诸家注释多戾经旨。盖非有四伤一定之说，原其病之根因有
此耳。其气盛者，有伤之而过后消散不作者，及过后作者，其为各时一病，而治各有方，又不必
拘定前之伤也。成无己、王海藏之注，皆推求过极。
阴阳应象论 曰∶寒伤形，热伤气。气伤痛，形伤肿。故先痛而后肿者，气伤形也；
先肿而后痛者，形伤气也。风胜则动，热胜则肿，燥胜则干，寒胜则浮，湿胜则濡泄。天有四时
五行，以生长收藏，以生寒暑燥湿风，人有五脏化五气，以生喜怒悲忧恐。故喜怒伤气，寒暑伤
形。暴怒伤阴，暴喜伤阳，厥气上行，满脉去形。喜怒不节，寒暑过度，生乃不固。
此言天以五行，以应人之五志。善摄养者，得其中和。不善节者，生乃不固。
脉要精微篇 曰∶风成为寒热。
经曰∶因于露风，乃生寒热。
瘅成为消中。
瘅，湿热也。湿热内积，故为消中。王注∶善食而瘦，乃食 也。
厥成为颠疾。
厥，气逆也。气逆上则为颠。
久风为飧泄。
即春伤于风，夏生飧泄，此其候者也。
脉风成为疠。
经曰∶风寒客于脉而不去名疠。
脉要精微篇 曰∶五脏者，中之守也。中盛脏满，气胜伤恐，声如从室中言，是中气之湿也。
腹中气盛，肺脏满变伤于恐，声如在室，腹中有湿气也。
言而微，终日乃复言者，此夺气也。
言微声低，不能相续，乃夺气不足然也。
衣被不敛，言语善恶，不避亲疏者，此神明之乱也。
此心火炽甚，而神志昏乱，故不知其亲疏也。
仓廪不藏者，是门户不要也。
仓廪，为脾胃。门户，为魄门，即肛门也。不藏、不要，皆不得其正，不禁固而时泻也。
水泉不止者，是膀胱不藏也。
小便流注而不度是也。
得守者生，失守者死。
总结上文两节之意，以起下文。
五脏者，身之强也。头者精明之府，头倾视深，精神将夺矣。背者胸中之府，背曲肩随，府
将坏矣。腰者肾之府，转摇不能，肾将惫矣。膝者筋之府，屈伸不能，行则偻附，（一作俯。）
筋将惫矣。骨者髓之府，不能久立，行则振掉，骨将惫矣。
五脏者，身之强也。今若所言皆失强也。盖五脏之气，内属本脏，外循各经，故为守为强，
有如是者。下文云∶
得强者生，失强者死。
总结上文之义。
玉机真藏篇 曰∶大骨枯槁，大肉陷下，胸中气满，喘息不便，其气动形，期六月死，
真藏脉见，乃予之期日。
肺司治节，气息由之，其气动形，为无气相接，故耸举肩背，以远求报气矣。夫如是，皆
形脏已败，神脏亦伤。见是证者，则后一百八十日内死矣。见真脏之脉候，乃与死日之期矣。此
肺之脏也。
大骨枯槁，大肉陷下，胸中气满，喘息不便，内痛引肩项，身热脱肉破 ，真藏见，十月之内死。
此脾脏之病也。真脏见，十月之内死，恐当作真脏未见，故远至十月方死。 ，肉之标，肘
膝后内如块者。阴气微弱，阳气内燔，故身热也。脾主肉，故肉如脱， 如破败也。
大骨枯槁，大肉陷下，肩髓内消，（缺盆深陷。）动作益衰，真藏未见，期一岁死。见其真
藏，乃予之期日。（此肾之脏也。）
大骨枯槁，大肉陷下，胸中气满，喘息不便，内痛引肩项，期一月死。真藏见，乃予之期日。
（此心之脏也。）
大骨枯槁，大肉陷下，胸中气满，喘息不便，腹内痛，肩项身热破 脱肉，目匡陷，真藏见，
目不见人，立死。其见入者，至其所不胜之期则死。
此肝脏病，故目陷也。不胜之时，谓庚辛也。
帝曰∶愿闻虚实以决死生。岐伯对曰∶五实死，五虚死。脉盛，（心也。）皮热，（肺也。）
腹胀，（脾也。）前后不通，（肾也。）闷瞀，（肝也。）此谓五实。
此五实，为五脏邪气之实。
脉细，（心也。）皮寒，（肺也。）气少，（肝也。）泄利前后，（肾也。）饮食不下，
（脾也。）此谓五虚。
此五虚，为五脏真气不足也。
帝曰∶其时有生者何也？岐伯曰∶浆粥入胃，泄注止，则虚者活；身汗得后利，则实者活。此其候也。
五虚五实得此二者则生，无此二者，其死必也。
五脏生成论 曰∶头痛颠疾，下虚上实，过在足少阴、巨阳，甚则入肾。 蒙招尤。
膀胱脉，从颠络脑，侠脊抵腰中，循膂络肾属膀胱。然肾虚不能引巨阳之气，故头痛而为
上颠之疾也，经病甚则入于脏。 当作 蒙招摇。 蒙谓目瞬动而蒙昧，下文之目冥是也；招摇
谓头振掉不定也。
目冥耳聋，下实上虚，过在足少阳、厥阴，甚则入肝。腹满 胀，支膈 胁。
，胁上也。支，执持也。胸膈 胁，皆不执持，不利也，肝胆之经也。
下厥上冒，（谓气逆上而冒于目。）过在足太阴、阳明。咳嗽上气，厥在胸中，过在手阳明、太阴。
此咳嗽上气，厥逆之病，在于胸中也。
心烦头痛，病在鬲中，过在手巨阳、少阴。
此相火为病，热在膈而心烦，上行而头痛。
阳明脉解篇 帝曰∶足阳明之脉病，恶人与火，闻木音则惕然而惊，钟鼓不为动、闻
木音而惊者何也？岐伯对曰∶阳明者胃脉也，胃者十也，故闻木音而惊者，土恶木也。曰∶其恶
火何也？曰∶阳明主肉，其脉血气盛，邪客之则热，热则恶火。曰∶其恶人何也？曰∶阳明厥则
喘而惋，（惋然郁内也）惋则恶人。（恶人，作烦也。）曰∶或喘而死者，或喘而生者何也？曰∶
厥逆连脏则死，连经则生。
厥连于经脉者易愈，连于脏者则神去而死也。
帝曰∶病甚则弃衣而走，登高而歌，或至不食数日，逾垣上屋，所上之处，皆非其素能也，
病反能者何也？曰∶四肢者，诸阳之本也。（阳受气于其四肢之故也。）阳盛则四肢实，实则能
登高也。曰∶其弃衣而走者何也？曰∶热盛
于身，故弃衣而欲走也。曰∶其妄言骂詈不避亲疏而歌者何也？曰∶阳盛则使人妄言骂詈不避亲
疏而不欲食，不欲食故妄走也。
阴阳别论篇 曰∶二阳之病发心脾，有不得隐曲，女子不月；其传为风消，其传为息
贲者，死不治。
汪氏《质疑》注，此言阳明燥金之气为病也。心以燥血不能生，而荣于百脉；脾以燥弱不
能卫津液，而润于四肢，则筋脉无所滋养，故肢体为之劲急，而不能伸曲也。在于女子则月经不
利，此燥之至也。燥立传变亦终归其所主，故燥甚则风热上攻于肺而为消渴。东垣云∶上消者多
饮水而少食，主于肺是也。其或津液生痰而不生血，痰积肺中，有时孤阳泛上，则痰随之贲上，
而喘急大作。孤阳降下，则痰随坠而喘急憩息，斯皆燥其不治之验。王注以大肠胃四经混说，强
谓以男子少精，牵扯曲说，愈讲愈繁而不通矣。
三阳为病发寒热，下为痈肿，及为痿厥 痛。其传为索泽，其传为颓疝。
三阳为太阳，寒气郁而不散，则发寒热，久之为痈肿，如流注之疾。痿厥，足冷无力。 ，
酸疼也。索泽，润泽之气消索也。颓疝，即睾垂纵缓，内作颓疝也。
一阳发病，少气善咳善泄。其传为心掣，其传为鬲。
此少阳相火为病，壮火食气，故少气。火烁肺金则善咳，火入于心故掣，三焦内结故隔塞
不通，皆火之过。
二阳一阴发病，主惊骇咳背痛，善噫善欠，名曰风厥。
此肝经风燥为病，故惊咳噫欠，为风厥。
二阴一阳发病，善胀心满善气。
君相二火之病，故善胀满。经曰∶诸腹胀大，皆属于热。
三阳三阴发病，为偏枯痿易，四肢不举。
此寒湿二气合病。寒湿之邪滞于经络，则血气不周荫于肢体，故偏枯痿易，四肢不举之证作矣。
阴结者，便血一升，（阴主血故。）再结二升，（二盛。）三结三升，阴阳结斜，多阴小阳曰石
水，少腹肿。
经曰，三阴独至，期于石水，为腹坚如石而水肿也。
二阳结谓之消。
阳明热结，故善消水谷。
三阳结谓之鬲。
太阳寒水凝蓄胸膈则嗝，其饮食犯寒而吐逆亦然。
三阴结谓之水。
太阴湿土人感之，内聚于脾，不能散布，积于腹而为水肿。其或溢于四肢，而为水肿之类是也。
一阴一阳结谓之喉痹。
此少阳相火与厥阴风木相扇而为病也。风火俱阳邪，阳邪从类而上攻，故为喉痹之病。治
以薄荷、荆芥以去风；生甘草、桔梗、玄参、黄芩之类以泄火是也。
阴搏阳别谓之有子。
阴脉中有阳之别，如尺脉搏手与寸口殊别，则为有孕。今诊尺脉滑利是也。
阳加于阴谓之汗。
阳气上搏，则蒸而为汗是也。
阴阳虚，肠辟死。
Loss of consciousness: if Qi recovers, the patient will survive. When cold pathogen lodges in the stomach and intestines, causing rebellious Qi to rush upward, pain and vomiting occur. When cold pathogen lodges in the small intestine, preventing proper accumulation and transformation, diarrhea and abdominal pain result. When heat pathogen remains in the small intestine, causing intestinal pain, excessive heat consumes fluids leading to dryness and thirst, resulting in hard, dry stool that cannot be expelled; thus, pain and constipation with obstruction occur. The Yellow Emperor asked: "It is said that one can know the condition by listening to the voice. How can it be known by observation?" The answer was: "The five Zang and six Fu organs each have their specific areas on the face. By observing the five colors, yellow and red indicate heat, white indicates cold, and green/black indicate pain. This is what is meant by 'visible through observation.'" He further asked: "How can it be known by palpation?" The answer was: "By observing the pulse of the primary diseased area, pulses that are firm with blood stasis, or those that are sunken, can all be detected by palpation."
*Chapter 4: Discussion on the Connection between Human Life and Heaven (Shengqi Tongtian Lun)*
The Yellow Emperor said: "Since ancient times, the connection between humans and Heaven is the root of life, which lies in Yin and Yang. Within the universe and the six directions, the Nine Orifices, Five Zang, and Twelve Joints of the human body are all connected with the Qi of Heaven. Life is based on the Five Elements, and Qi movement is divided into Three Realms (Heaven, Earth, Man). If these principles are frequently violated, pathogenic factors will harm the body, which is the foundation of longevity." (Zhi's commentary states: If people fail to regulate their desires and frequently violate natural laws, they damage their righteous Qi, allowing pathogenic factors to enter due to the deficiency of righteous Qi, hence 'pathogenic factors harm the body.' Wang Bing's note directly states 'pathogenic factors harm righteous Qi' without first mentioning the cause of depletion, so how do pathogenic factors enter?) When the Qi of the clear Heaven is cold and crisp, the mind and will are regulated; complying with it consolidates Yang Qi, so even if harmful pathogens exist, they cannot cause harm. This is because one follows the order of the seasons. Therefore, sages preserve their spirit, comply with the weather of Heaven, and communicate with divine clarity. Violating this leads to internal blockage of the nine orifices, external stagnation of muscles, and dispersion of Wei Qi, which is self-injury and depletion of Qi. Yang Qi is like Heaven and the Sun; if it loses its proper position, lifespan is shortened and brilliance is obscured. Thus, the movement of Heaven relies on the brightness of the Sun, so Yang Qi is superior and protects the exterior.
When affected by cold, Yang Qi should move freely like a door pivot. If daily activities are irregular and startle the spirit, Shen Qi becomes floating.
When affected by summer-heat, sweating occurs. If irritable, there is panting and loud breathing; if quiet, there is excessive talking. The body feels hot as burning charcoal, and the heat dissipates with sweating.
If the cause is summer-heat, sweat should be released. If not treated with releasing the exterior, pathogenic heat attacks internally, causing heat in both interior and exterior, leading to irritability, panting, and loud sighing.
When affected by dampness, the head feels wrapped. If damp-heat is not resolved, large tendons shorten and small tendons elongate. Shortening causes spasms, and elongation causes flaccidity. When affected by Qi (wind/Qi disorder), swelling occurs. If the four limbs alternate in disease, Yang Qi is exhausted.
Dampness steaming and obstructing the clear pathways causes the head to feel covered or wrapped. Heat injures Blood, failing to nourish tendons, causing spasms. Dampness injures tendons, failing to bind bones, causing flaccidity. Severe damp-heat prevents the free flow of righteous Qi, causing swelling in the four limbs. The Qi of all Yang meridians gathers in the four limbs. It is erroneous to treat knee joint pain and swelling solely as wind.
When Yang Qi is subjected to excessive mental or physical labor, it hyperactivity expands, leading to exhaustion of Essence. If this accumulates into summer, it causes Jian Jue (Fever-induced Collapse). Eyes become blind, ears become deaf, resembling a collapsing dam, uncontrollable and vast.
Yang Qi hyperactivity from labor leads to Yin essence exhaustion. If accumulated continuously, reaching summer when fire is strong, Qi rebels upward as if boiling. Fire rising causes blindness and deafness, essence decays, and spirit departs, like a broken dam leaking water. This is extreme deterioration.
Anger causes Yang Qi to rebel, severing the connection between form and Qi, causing Blood to stagnate at the upper part, leading to Bo Jue (Thrusting Collapse). Injuries to tendons cause flaccidity and loss of control.
Anger causes Qi to rise, carrying Blood with it. Yin and Yang struggle, Qi and Blood surge, causing Bo Jue. 'Wan' means accumulation; 'Bo' means thrusting. Anger injuring tendons causes flaccidity and loss of support, hence 'flaccid and uncontrolled.'
Hemihypohidrosis (sweating on only one side) leads to hemiplegia (Pian Ku).
Chronic hemihypohidrosis eventually results in hemiplegia.
Sweating followed by exposure to dampness generates Fei Cuo (miliaria and acne).
Yang Qi disperses, but cold water restricts it, trapping heat in the skin, forming sores and miliaria.
Long-term consumption of rich, greasy foods often leads to severe Ding Sores (furuncles).
Rich foods cause internal stagnation of heat; thick skin and loose flesh allow internal transformation into Ding sores. 'Zu' here means 'many'.
Sweating during labor and exposure to wind: cold constriction causes Fei Ci (acne/comedones); stagnation leads to Fei Cuo (miliaria).
This is Yang Qi blocked by Yin, lacking smooth flow, causing pressure and formation of acne. Mild cases are miliaria.
Yang Qi: its refined aspect nourishes the Spirit; its soft aspect nourishes the tendons. If opening and closing mechanisms fail, cold pathogen enters, causing severe kyphosis (Da Lou). Cold sinking into meridions causes flaccidity, lingering in muscle intervals.
Internal essence nourishes the Spirit; external softness nourishes the tendons. Failure of opening/closing allows cold invasion, causing tendon contraction and kyphosis. Cold sinking into vessels causes flaccidity. Lingering in muscle layers prevents relaxation.
Ying Qi failing to circulate, reversing in muscle tissue, generates carbuncles and swellings.
Ying Qi stagnation and Blood郁结 in muscles lead to carbuncles.
Incomplete cessation of 'Po Han' (night sweats/sweat during sleep), combined with weak form and scorched Qi, with closed acupoints, develops into Feng Nue (Wind Malaria).
Unstopped sweating, weak form, and consumed Qi allow wind-cold to invade, closing acupoints. Heat is trapped. In autumn, when Yang Qi收敛, two heats combine, causing alternating chills and fever. Onset defines it as Wind Malaria.
Wind is the beginning of all diseases. Maintaining purity and stillness closes the muscle intervals to resist pathogens. Even severe wind-toxins cannot harm.
Regular routine and moderate labor constitute 'purity'. Righteous Qi is solid internally, closing the skin and pores. Severe wind-toxins cannot harm.
In chronic disease, transmission occurs. If upper and lower parts do not connect, even skilled physicians cannot help.
Chronic disease with no connection between upper and lower leads to Yin-Yang blockage, beyond medical remedy.
Death from Yang accumulation occurs when Yang is blocked; blocking requires purgation.
Accumulation in the three Yang meridians without timely purgation leads to death.
Wind pathogen invading and disturbing Zheng Qi causes Essence loss and Liver injury.
Excessive Yin Qi with wind invasion injures Essence. Pathogen affects the Liver, its home meridian.
Overeating causes tendons and vessels to relax, leading to hemorrhoids. Excessive drinking causes Qi rebellion. Forceful sexual activity injures Kidney Qi and damages the lumbar vertebrae.
Extreme fullness causes intestinal distension and tendon relaxation, leading to hemorrhoids. Excessive drinking causes Lung Qi to rebel upward. Forceful intercourse injures Kidney Qi and damages the high bones (lumbar spine).
Spring wind injury lingers, causing severe diarrhea (Dong Xie). Summer heat injury manifests as malaria in autumn. Autumn dampness injury causes cough and flaccidity/collapse in winter. Winter cold injury manifests as epidemic febrile diseases in spring. The four seasonal pathogens sequentially injure the Five Zang.
*Chapter 1: Yin Yang Ying Xiang Da Lun*
Spring wind injury causes dysentery with undigested food in summer. Summer heat injury causes malaria in autumn. Autumn dampness injury causes cough in winter. Winter cold injury causes epidemic febrile diseases in spring.
These theories are largely consistent. Wang Andao stated: Commentaries on these four chapters often contradict the original intent. There is no fixed rule that seasonal injuries always cause specific diseases later. Those with strong Qi may recover spontaneously or develop different conditions later, each requiring specific treatments, not necessarily linked to the initial injury. Cheng Wuji and Wang Haizang over-interpreted.
Cold injures Form; Heat injures Qi. Qi injury causes pain; Form injury causes swelling. Pain then swelling indicates Qi injuring Form; swelling then pain indicates Form injuring Qi. Wind excess causes tremors; Heat excess causes swelling; Dryness excess causes dryness; Cold excess causes edema; Damp excess causes loose stools. Heaven has Four Seasons and Five Elements for growth, flourishing, harvesting, and storing, producing Cold, Heat, Dryness, Dampness, and Wind. Humans have Five Zang generating Five Emotions (Joy, Anger, Worry, Grief, Fear). Joy and Anger injure Qi; Cold and Heat injure Form. Sudden anger injures Yin; sudden joy injures Yang. Rebellious Qi rises, filling vessels and separating from form. Unregulated emotions and excessive climate changes weaken life.
This explains how Heaven's Five Elements correspond to human Five Emotions. Proper cultivation achieves harmony; improper regulation weakens life.
*Chapter 3: Mai Yao Jing Wei Lun*
Wind becoming chronic causes alternating chills and fever.
Scripture: Exposure to wind generates chills and fever.
Dan (fever-heat) becoming chronic causes Xiao Zhong (excessive eating/thirst).
Dan refers to damp-heat. Internal accumulation causes Xiao Zhong. Wang Bing notes: Eating much but losing weight indicates food stagnation.
Jue (reversal) becoming chronic causes Dian Ji (epilepsy/seizures).
Jue is Qi rebellion. Upward rebellion causes seizures.
Chronic wind causes Sung Xie (dysentery with undigested food).
Corresponds to spring wind injury causing summer dysentery.
Mai Feng (pulse wind) becomes Li (leprosy).
Scripture: Wind-cold lodging in pulses without departing is called Li.
The Five Zang are the guardians within. Fullness in the middle jiao and Zang organs, with Qi excess injuring fear, and muffled voice, indicates dampness in Middle Qi.
Abdominal Qi excess and Lung fullness injuring fear, with muffled voice, indicates abdominal dampness.
Whispering voice, speaking only once a day, indicates Qi depletion.
Low voice, inability to speak continuously, indicates Qi deficiency.
Disheveled clothing, inappropriate speech, ignoring social boundaries, indicates confusion of Shen Ming (Spirit).
Intense Heart Fire confuses the spirit, blurring social distinctions.
Failure of Cang Lin (Spleen/Stomach) to store indicates failure of Men Hu (Anus/Po Men) to secure.
Cang Lin refers to Spleen/Stomach; Men Hu refers to the anus. Failure to store/secures leads to incontinence.
Unceasing urine flow indicates Bladder failure to store.
Uncontrolled urination.
Those who maintain their Zang survive; those who lose them die.
Summarizes previous sections to introduce the next.
The Five Zang are the strength of the body. The head is the mansion of Jing Ming (Essence and Clarity); drooping head and deep-set eyes indicate Spirit depletion. The back is the mansion of the Chest; curved back and drooping shoulders indicate Mansion decay. The waist is the mansion of the Kidney; inability to twist indicates Kidney exhaustion. The knees are the mansion of Tendons; inability to bend/extend indicates Tendon exhaustion. The bones are the mansion of Marrow; inability to stand long or trembling gait indicates Bone exhaustion.
The Five Zang provide bodily strength. Loss of strength leads to death.
Summary of the above meaning.
*Chapter 2: Yu Ji Zhen Zang Lun*
Withered large bones, sunken large muscles, chest fullness, difficult breathing, body moving with breath, predicts death in six months. Appearance of Zhen Zang Pulse gives the exact date.
Lung governs regulation; breath depends on it. Body movement with breath indicates lack of Qi connection, causing shoulder shrugging to seek air. Form and Spirit Zang are damaged. Death within 180 days. Zhen Zang Pulse confirms the date. This is Lung Zang disease.
Withered large bones, sunken large muscles, chest fullness, difficult breathing, internal pain radiating to shoulders/neck, fever, muscle wasting, appearance of Zhen Zang Pulse, predicts death within ten months.
This is Spleen Zang disease. If Zhen Zang Pulse is absent, death may take up to ten months. 'Can' refers to muscle markers behind elbows/knees. Weak Yin and internal blazing Yang cause fever. Spleen governs flesh; wasting flesh resembles decay.
Withered large bones, sunken large muscles, internal consumption of shoulder marrow (sunken clavicles), worsening weakness with movement, Zhen Zang Pulse absent, predicts death in one year. Appearance of Zhen Zang Pulse gives the date. (This is Kidney Zang disease.)
Withered large bones, sunken large muscles, chest fullness, difficult breathing, internal pain radiating to shoulders/neck, predicts death in one month. Appearance of Zhen Zang Pulse gives the date. (This is Heart Zang disease.)
Withered large bones, sunken large muscles, chest fullness, difficult breathing, abdominal pain, shoulder/neck/back fever, muscle wasting, sunken eye sockets, Zhen Zang Pulse present, blindness, immediate death. If vision remains, death occurs during the phase overcoming the Liver (Metal days).
This is Liver disease, hence sunken eyes. Overcoming phase refers to Geng/Xin (Metal).
Yellow Emperor: "I wish to hear about Deficiency and Excess to determine life and death." Qibo replied: "Five Excesses lead to death; Five Deficiencies lead to death. Surging pulse (Heart), hot skin (Lung), abdominal distension (Spleen), obstruction of front and back (Kidney), oppression and dizziness (Liver) — these are Five Excesses. These are Excess of pathogenic factors in the Five Zang.
Fine pulse (Heart), cold skin (Lung), shortness of breath (Liver), diarrhea/incontinence (Kidney), inability to eat (Spleen) — these are Five Deficiencies. These are Deficiency of True Qi in the Five Zang.
Yellow Emperor: "Why do some survive?" Qibo: "If gruel enters the Stomach and diarrhea stops, the deficient survive; if sweating occurs and bowels/bladder open, the excess survive. These are the signs. Without these, death is certain."
*Chapter 5: Wu Zang Sheng Cheng Lun*
Headache and cephalic disorders, deficiency below and excess above, involve Foot Shaoyin and Taiyang, progressing to Kidney. Eye twitching and head tremor.
Bladder meridian connects to brain, runs along spine to kidney. Kidney deficiency fails to guide Taiyang Qi, causing headache. Meridian disease progresses to Zang. 'Nang Meng Zhao Yao' refers to eye twitching and head tremor.
Blindness and deafness, excess below and deficiency above, involve Foot Shaoyang and Jueyin, progressing to Liver. Abdominal fullness and hypochondriac distension.
Distension in hypochondrium indicates Liver/Gallbladder meridian involvement.
Lower Jue and Upper Mao (Qi rebelling to cover eyes), involves Foot Taiyin and Yangming. Cough and Qi rebellion in chest, involves Hand Yangming and Taiyin.
Cough and Qi rebellion located in the chest.
Heart vexation and headache, located in Diaphragm, involves Hand Taiyang and Shaoyin.
Ministerial Fire disease, heat in diaphragm causing vexation and ascending headache.
*Chapter 6: Yang Ming Mai Jie Pian*
Yellow Emperor: "Why does Foot Yangming disease cause aversion to people and fire, and startle at the sound of wood, but not at bells/drums?" Qibo: "Yangming is Stomach meridian, Stomach is Earth. Aversion to wood sound is Earth fearing Wood. Aversion to fire? Yangming governs flesh, has abundant Qi and Blood. Pathogen causes heat, hence aversion to fire. Aversion to people? Yangming Jue causes panting and depression, leading to aversion to people. Why do some die and some live from panting? Jue connecting to Zang causes death; connecting to Meridian allows survival.
Meridian connection heals easily; Zang connection leads to Spirit departure and death.
Yellow Emperor: "Why do severe patients discard clothes, run, climb high, sing, fast for days, and climb walls, exceeding their normal abilities?" Qibo: "Four limbs are the root of all Yang. Yang Qi gathers in limbs. Yang excess makes limbs solid, enabling climbing. Discarding clothes? Excess heat in body. Wild talk and cursing? Yang excess causes wild talk, cursing, and anorexia. Anorexia leads to aimless wandering."
*Chapter 7: Yin Yang Bie Lun*
Er Yang (Stomach/Large Intestine) disease originating in Heart/Spleen causes hidden distress and amenorrhea in women. Progression to Feng Xiao (wind consumption) or Xi Ben (lung distension/breathlessness) is fatal and untreatable.
Wang's commentary: Yangming Dry Metal pathology. Heart blood dryness fails to nourish vessels; Spleen dryness fails to moisten limbs, causing stiffness. In women, amenorrhea indicates extreme dryness. Dryness transforms into wind-heat attacking Lungs (Xiao Ke). Phlegm accumulation causes breathlessness. Wang Bing's interpretation mixing four meridians is confused.
San Yang (Taiyang) disease causes chills/fever, lower abscesses, and flaccidity/collapse with acid pain. Progression to Su Ze (loss of moisture) or Tui Shan (hernia) occurs.
Taiyang cold stagnation causes chills/fever and abscesses. Flaccidity/collapse is cold feet. Su Ze is loss of moisture. Tui Shan is scrotal hernia.
Yi Yang (Shaoyang) onset causes shortness of breath, cough, and diarrhea. Progression to Xin Che (heart pulling) or Ge (diaphragm obstruction) occurs.
Shaoyang Minister Fire consumes Qi (shortness of breath), scorches Lung (cough), affects Heart (pulling), blocks San Jiao (obstruction). All due to Fire.
Er Yang and Yi Yin onset causes fright, cough, back pain, belching, and yawning, named Feng Jue.
Liver meridian wind-dryness causes these symptoms, termed Wind Jue.
Er Yin and Yi Yang onset causes bloating, chest fullness, and sighing.
Master and Minister Fire disease causes bloating. Scripture: All abdominal distensions belong to Heat.
San Yang and San Yin onset causes hemiplegia, flaccidity, and immobility of limbs.
Cold-Damp combination. Pathogens stagnate in meridians, blocking Qi/Blood circulation to limbs, causing hemiplegia and flaccidity.
Yin Knotting: bleeding 1 sheng (Yin governs Blood), 2 sheng (double excess), 3 sheng. Yin-Yang oblique knotting, more Yin less Yang is Shi Shui (Stone Water), with lower abdominal swelling.
Scripture: San Yang alone reaching Shi Shui causes stone-hard abdominal edema.
Er Yang Knotting is called Xiao (Consumption).
Yangming heat knotting causes excessive consumption of food/water.
San Yang Knotting is called Ge (Diaphragm obstruction).
Taiyang cold water stagnating in chest/diaphragm causes regurgitation.
San Yin Knotting is called Shui (Water/Edeam).
Taiyin Damp Earth infection aggregates in Spleen, failing to distribute, accumulating as abdominal edema or limb edema.
Yi Yin and Yi Yang Knotting is called Hou Bi (Throat Bi).
Shaoyang Fire and Jueyin Wind interact. Wind-Fire are Yang pathogens attacking upward, causing throat obstruction. Treatment: Mint/Shangzi for wind; Licorice/Platycodon/Scrophularia/Scutellaria for fire.
Yin pulsing with Yang distinction indicates pregnancy.
Distinct Yang pulse in Yin position (e.g., slippery Chi pulse) indicates pregnancy.
Yang added to Yin is called Sweat.
Yang Qi forcing evaporation creates sweat.
Yin and Yang deficiency, Chang Pi (intestinal discharge) leads to death.