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Pi means unblocking and promoting urination. If stomach qi fails to remain, the intestines open uncontrollably, this indicates the exhaustion and severance of yang qi, leading to death.

Yin deficiency with a forceful yang pulse is termed "Beng" (uterine bleeding).

When the yin pulse is deficient and the yang pulse is excessive, their interaction causes internal rupture and blood flow downward; this is due to fire attached within the yin.

In *Ling Shu: Jing Mai Bie Lun*, the Yellow Emperor asked: Do the pulses of people change according to their living environment, activity levels, and courage or timidity? Qibo replied: All states of fright, anger, and labor, as well as movement and stillness, cause changes in the pulses. Therefore, walking at night causes panting originating from the Kidney, and pathogenic qi may damage the Lung. Falling and fear cause panting originating from the Liver, and pathogenic qi may harm the Spleen. Fright causes panting originating from the Lung, and pathogenic qi may damage the Heart. Wading through water or falling causes panting originating from the Kidney and bones. At such times, those who are courageous recover because their qi flows smoothly, while the timid develop disease because the pathogen remains. This explains how disease changes and pathogenic qi invades other organs; the strong resist invasion, while the weak suffer harm.

Overeating causes sweat to originate from the Stomach. Fright that depletes essence causes sweat to originate from the Heart. Carrying heavy loads over long distances causes sweat to originate from the Kidney. Running fast and fearing causes sweat to originate from the Liver. Bodily shaking and toil cause sweat to originate from the Spleen. Thus, in the four seasons of spring, autumn, winter, and summer, governed by yin and yang, diseases arise from overexertion; this is the constant principle.

Forcing actions contrary to one's nature leads to disease when exceeding limits; this is the normal logic.

In *Ling Shu: Pi Bu Lun*: The onset of all diseases must begin in the skin and hair. When pathogenic factors attack, the interstices (Cou Li) open, allowing pathogens to enter the collaterals. If they remain there without departing, they transmit into the meridians. If they remain in the meridians without departing, they transmit into the fu organs, finally accumulating in the intestines and stomach. When pathogens first enter the skin, there is a shivering sensation, hair stands erect, and interstices open. When entering the collaterals, the collateral vessels become full and color changes. When entering the main meridians, if deficieny exists, the pathogen sinks inward. If remaining between sinews and bones, excess cold causes sinew spasms and bone pain; excess heat causes sinew flaccidity, bone wasting, muscle emaciation, skin ulceration, hair standing straight and deteriorating.

This describes disease starting in the skin and gradually penetrating to the sinews and bones if untreated, involving transformations between cold and heat.

In *Ling Shu: Ni Diao Lun*, the Yellow Emperor asked: Some people have rebellious qi preventing them from lying flat and breathing with sound; some cannot lie flat but breathe silently; some have normal daily activities but breathe with sound; some can lie on their side and walk but wheeze; some cannot lie flat nor walk but wheeze; some cannot lie flat and wheeze. Which organs cause these conditions?

The text above has six questions but only three answers, indicating missing bamboo slips.

Qibo replied: Those who cannot lie flat and breathe with sound have rebellion of the Yangming channel. The foot-three-yang channels normally descend; now they rebel and ascend, causing breathing sounds. The Yangming channel is the Stomach meridian; the Stomach is the sea of the six fu organs and the sea of water and grain. Its qi also descends. When Yangming qi rebels and cannot follow its proper pathway, one cannot lie flat. The *Xia Jing* (an ancient classic) says: "If the Stomach is not harmonious, sleep will be restless," which refers to this. For those whose daily activities are normal but breathe with sound, this is rebellion of the lung's collateral vessels. Collateral vessels cannot move up and down with the main meridians, so they stagnate in the meridians. Since collateral vessel pathology is minor, daily activities remain normal despite breathing sounds. For those who cannot lie flat and wheeze when lying down, this is water qi invading the body. Water follows fluids; the Kidney is the water organ, governing fluids, and controlling sleep and wheezing.

In *Bing Neng Pian*, the Yellow Emperor asked: Why can some people not lie on their backs? (Yan means lying on the back.) Qibo replied: The Lung is the canopy of the zang organs. When lung qi is excessive, the pulse becomes large; a large pulse prevents lying on the back. The Yellow Emperor asked: Why do some people feel uneasy when lying down? Qibo said: When zang organs are injured and essence has nowhere to settle, one feels uneasy; thus, one cannot arbitrarily guess the disease.

When the five zang organs are injured and essence has no proper residence, sleep is unrested; one cannot speculate on the cause in mid-air.

In *Ping Re Bing Lun*, the Yellow Emperor asked: A patient with Kidney Wind has facial edema and difficulty speaking. Can acupuncture be used?

Ran indicates swelling appearance. Yong refers to swelling under the eyes, resembling a silkworm. The Kidney meridian enters the Lung, runs along the throat, and attaches to the root of the tongue, hence interfering with speech.

Qibo replied: Deficiency patterns should not be needled. If needled inappropriately, the pathogenic qi will arrive in five days.

Zhi here refers to the arrival of organ qi. This states that with Kidney deficiency and insufficient true qi, acupuncture is contraindicated. The qi of the five zang organs arrives every five days; when it reaches the Kidney, the pathogenic qi also arrives.

Question: What are the symptoms upon arrival? Answer: Upon arrival, there will be shortness of breath, intermittent fever, sweating from the chest/back to the head, hot palms/soles, dry mouth with thirst, yellow urine, edema under the eyes, borborygmus, heaviness making walking difficult, amenorrhea, irritability, anorexia, inability to lie supine (supine position triggers coughing). The disease is named Feng Shui (Wind Water). The Yellow Emperor asked for an explanation. Qibo said: Where pathogenic factors gather, qi must be deficient. Yin deficiency allows yang pathogenic factors to gather, causing shortness of breath, intermittent fever, and sweating. Yellow urine indicates heat in the lower abdomen. Inability to lie supine indicates disharmony in the Stomach. Lying supine causes coughing because the pathogen presses upward on the Lung. In all water diseases, slight edema appears first under the eyes. Upward rebellion of qi causes bitter taste and dry tongue; inability to lie supine results in coughing up clear fluid. All water disease patients cannot lie down; lying down causes fright, and fright worsens coughing. Borborygmus originates from the Stomach. Pathogenic factors pressing on the Spleen cause irritability and anorexia; food failing to descend is due to obstruction in the epigastrium. Heaviness and difficulty walking relate to the Stomach meridian in the feet. Amenorrhea is due to closure of the Bao Mai (Uterine Vessel), which belongs to the Heart and connects to the uterus. Now, qi presses upward on the Lung, preventing Heart qi from descending, hence amenorrhea.

These are manifestations of Kidney qi insufficiency, all belonging to the Shaoyin meridians. Water fails to control Fire, resulting in these symptoms.

In *Shui Re Xue Lun*, the Yellow Emperor asked: Why does Shaoyin govern the Kidney, and why does the Kidney govern water? Qibo replied: The Kidney is Supreme Yin; Supreme Yin stores water. The Lung is Taiyin; Shaoyin is the Winter pulse. Thus, the root is in the Kidney, the branch in the Lung, both involving water accumulation. Question: How can the Kidney accumulate water and cause disease? Answer: The Kidney is the gate of the Stomach. If the gate is not functional, water accumulates following its kind.

Guan (gate) controls entry and exit. The Kidney governs the Lower Jiao; the Bladder is the fu organ, governing distribution to the orifices and two yins. Thus, when Kidney qi transforms, the two yins open. Closure of the two yins causes Stomach distension; therefore, the Kidney is called the gate of the Stomach. Closure leads to water accumulation; water accumulation leads to qi stagnation; qi stagnation generates water; water accumulation causes qi overflow. Qi and water are of the same category; thus, saying "closure is not functional, water accumulates following its kind." The Classics state: "Overflow from the Lower Jiao becomes water," referring to this.

Water overflowing up and down into the skin causes edema. Edema is disease caused by accumulated water. Question: Do all water diseases originate from the Kidney? Answer: The Kidney is a Yin organ (Pin Zang). Earthly qi ascending belongs to the Kidney and generates water fluids, hence called Supreme Yin. Vigorous exertion and fatigue cause Kidney sweat. If Kidney sweat encounters wind, it cannot enter the zang-fu internally nor exit the skin externally. It lodges in the Xuan Fu (pores), travels within the skin, and transmits into edema. Rooted in the Kidney, it is named Feng Shui (Wind Water).

Wind lodging in the Xuan Fu, with sweat retained, penetrates the skin internally and transforms into water, following the wind, hence named Feng Shui.

Xuan Fu refers to sweat pores. Thus, water disease manifests as lower limb edema and abdominal distension, upper wheezing, and inability to lie flat. Both root and branch are diseased: the Lung causes wheezing, the Kidney causes edema, and Lung qi rebellion causes inability to lie flat. They transmit to each other and are jointly affected by stagnant water qi.

Although these are diseases of the Kidney and Lung, essentially they are all caused by stagnant water qi.

In *Ping Ren Qi Xiang Lun*: Pulsation of the neck artery with panting and rapid cough indicates water disease.

The neck artery refers to the Ren Ying pulse on both sides of the ear below and the larynx. Water qi overflowing upward steams the Lung; yang qi rebels upward, causing the neck artery to throb and inducing cough/panting.

Slight edema of the eyelids resembling a silkworm indicates water disease. Yellow-red urine with preference for lying down indicates Jaundice.

The *Zheng Li Lun* states: Kidney labor and bladder heat, yellow urine with preference for lying down, is called Lao Dan (Labor Jaundice), acquired through sexual exertion.

Feeling hungry immediately after eating indicates Wei Dan (Stomach Jaundice).

Stomach heat accelerates digestion, so one feels hungry after eating.

Facial edema indicates Wind disease.

Wind attacks from above; thus, facial edema is named Wind disease.

Edema of the calves indicates Water disease.

Water in the Lower Jiao causes calf edema.

Yellow eyes indicate Jaundice.

Fire qi steaming upward causes yellow eyes. The *Ling Shu* states: "Yellow eyes indicate disease in the Chest."

In *Ni Diao Pian*, the Yellow Emperor asked: The body is not unusually warm, nor is there external cold, yet there is heat and vexation/fullness. Why? Qibo replied: Scanty yin qi and victorious yang qi cause heat and vexation/fullness. Question: The body is not chilled by clothes, nor is there internal cold, yet cold arises from within. Why? Answer: This person has much Bi qi (obstruction); scanty yang qi and abundant yin qi cause the body to feel cold as if emerging from water.

This discusses cold qi generated by yin cold, not external cold from clothing, but internal cold.

The Yellow Emperor asked: Some people have hot limbs; when encountering wind and cold, they feel as if roasting. Why? Answer: This person has deficient yin qi and excessive yang qi. Limbs belong to yang. Two yangs combine while yin qi is deficient; small amounts of water cannot extinguish the flourishing fire. Yang acts alone. Alone acting means it cannot grow; it only prevails and stops.

Zhi here means prosperous/victorious. Sheng means excessive. "Du Sheng" implies yang prevails exclusively while fire extinguishes.

Encountering wind and feeling like roasting indicates the person's muscles will emaciate. (Shuo means consume.) Question: Some people feel cold internally; hot baths and fires cannot warm them, thick clothes cannot heat them, yet they do not shiver. What disease is this? Answer: This person originally had strong Kidney qi but engaged in watery labor. Taiyang qi declined, Kidney marrow dried up and failed to grow. One water cannot overcome two fires. The Kidney is water, generating bone. If the Kidney fails to generate, marrow cannot fill, causing cold reaching the bones. The reason for not shivering is that the Liver is one yang, the Heart is two yang, and the Kidney is a solitary organ. One water cannot overcome two fires, hence no shivering. The disease is named Gu Bi (Bone Bi), and the person's joints will contract.

If the Kidney fails to generate water, marrow is insufficient, sinews and bones become dry, hence joint contraction.

In *Tong Ping Xu Shi Lun*, the Yellow Emperor asked: What about Chang Pi (intestinal dysentery) with blood stool? Qibo said: Body heat indicates death; body cold indicates survival. Question: What about Chang Pi with white mucus? Answer: Deep pulse indicates survival; floating pulse indicates death. (Yin disease showing yang pulse is contrary, hence death.) Question: What about Chang Pi with pus and blood? Answer: Suspended-extreme pulse indicates death; slippery-large pulse indicates survival. Question: For Chang Pi, if there is no body heat and no suspended-extreme pulse, what then? Answer: Slippery-large pulse indicates survival; suspended-rough pulse indicates death. Predict based on organ cycles. (Liver dies on Geng/Xin days; Heart dies on Ren/Gui days, etc.)

Question: What about Dian Ji (epilepsy/head disease)? Answer: Pulse large and slippery recovers spontaneously; pulse small, firm, and urgent indicates death/incurable. Question: Regarding Dian Ji pulse, what about deficiency vs. excess? Answer: Deficiency is treatable; excess is fatal.

Dian Ji pulse: deficiency is treatable, excess is fatal. This seems opposite to "forceful and slippery." Forceful and slippery is not true excess; it is slippery and bounding, hence spontaneous recovery.

Question: What about Xiao Bi (emaciating bi) deficiency/excess? Answer: Pulse large and solid, chronic disease is treatable; pulse suspended-small and firm, chronic disease is incurable.

Xiao means emaciation; Bi means labor-heat. Chronic emaciation-heat disease should have a weak pulse for survival. A large-solid pulse is treatable, seemingly contradictory; I believe this is a transcription error from the time of carving.

Generally, treating Xiao Dan (wasting-thirst), Pu Ji (sudden collapse), Pian Ku (hemiplegia), Wei Jue (flaccidity/cold limbs), and Qi Man Fa Ni (fullness/rebellious qi): these are diseases of rich people consuming rich foods (Gao Liang). Obstruction and blockage, upper-lower不通 (unconnected), result from sudden severe worry. Sudden jue with deafness and unilateral blockage results from sudden internal qi pressure. Diseases not from internal/external wind-stroke result in emaciation and lingering pathogens.

This states that Xiao Dan, Pu Ji, and Pian Ku are not variations of internal/external wind-stroke, but result from rich diet, sudden worry, sudden internal qi pressure, failure to diffuse and circulate, leading to blockage of excretions and lingering pathogens. Ni means hiding/storing.

Bo (limping) is a disease of cold, damp, and wind.

Jiao means foot. Bo means inability to walk. This is a disease of wind-cold-damp.

Jaundice, sudden disease, epilepsy, jue, and kuang result from prolonged rebellion.

Prolonged qi rebellion failing to descend accumulates in the Upper Jiao, causing jaundice and jue/kuang diseases.

Imbalance of the five zang organs results from blockage of the six fu organs.

If six fu organs are not unblocked, qi of the five zang organs stagnates and becomes imbalanced; e.g., constipation leading to lung qi rebellion and panting.

Headache, tinnitus, and dysfunction of the nine orifices result from the intestines and stomach.

This is a continuation of six fu blockage. The intestines and stomach are crucial among fu organs. Intestinal/stomach stagnation prevents qi circulation; stagnant qi rebels upward, causing headache and tinnitus.

In *Fu Zhong Lun*, the Yellow Emperor asked: There is a disease with heart and abdominal fullness; one cannot eat dinner if one eats breakfast. What is this disease? Qibo replied: It is named Gu Zhang (Drum Distension).

Question: How to treat? Answer: Treat with Ji Shi Li (Chicken Excrement Wine). One dose brings improvement; two doses cure. Question: Why does it sometimes recur? Answer: Irregular diet causes occasional illness. Although the disease subsides, it recurs when the timing is right because qi gathers in the abdomen. Question: There is a disease with flank/chest support-like fullness, interfering with eating. Before onset, one smells fishy/foul odor, produces clear fluid, spits blood first, limbs are cold, eyes are dizzy, and frequent bleeding occurs from front and back. What is this disease? How was it acquired? Answer: The disease is named Xue Ku (Blood Dryness). Acquired in youth from massive blood loss. Or, intercourse while drunk depleted qi and injured the Liver, causing menstrual decline and amenorrhea. Question: How to treat? Answer: Combine Si Wu Mei Gu (Four parts Cuttlefish Bone) and Yi Zhu (One part Cyathula Root), form pills with Sparrow Eggs, size of small beans. Take five pills after meals, washed down with Abalone Juice. This benefits the intestines and heals liver injury.

Note: Cuttlefish bone, Cyathula root, and Abalone juice all attack accumulated blood and disperse evil blood. Sparrow eggs treat impotence and stimulate yin. These are not blood-generating formulas for Blood Dryness; scholars should examine this carefully.

Question: There is a disease with fullness in the lower abdomen, rooted above, below, left, and right. What is this disease? Is it treatable? Answer: The disease is named Fu Liang (Hidden Beam). Question: What causes it? Answer: It wraps large amounts of pus and blood, residing outside the intestines and stomach. It is untreatable; pressing on it during treatment often causes death. Question: Why? Answer: Downward, it affects the yin organs, causing pus/blood in stool; upward, it presses on the epigastrium and diaphragm,夹 (clamping) the epigastrium causing internal abscess. This is a chronic disease, difficult to treat. Located above the navel is "Ni" (Rebellious/Opposing); located below the navel is "Cong" (Following/Favorable). Do not move it; repeatedly remove it.

This Fu Liang is a disease of the Chong Mai (Penetrating Vessel). Wrapping pus/blood outside the intestines/stomach, it ascends along the abdomen and descends connecting to the yin organs. Pressing on the yin organs causes bloody/purulent stool; pressing near the stomach causes qi to rise above the diaphragm, clamping the epigastrium and growing internal abscess. This is because large pus/blood originally existed outside the intestines/stomach; chronicity makes it hard to treat. Above the navel is close to the Heart, hence "Ni"; below the navel is far from the Heart, hence "Cong". Ji means frequently. Duo means to remove. It cannot be moved physically, but can be gradually reduced.

Question: There is a disease with swelling of the thighs/calves and pain around the navel. What is this disease? Answer: Named Fu Liang. This is the root of Wind. Its qi overflows into the Large Intestine and settles in the Huang (Ministerial Fire/Epigastric region). The source of Huang is below the navel, hence periumbilical pain. Do not manipulate it; manipulation leads to urinary retention.

This is also a Chong Mai disease, hence thigh/calf swelling, also named Fu Liang. Qi overflows into the great abdomen, settling at the source of Huang, causing periumbilical pain. "Do not manipulate" means do not use harsh toxic drugs to forcefully purge, which would transform it into water disease with urinary retention.

In *Bing Neng Pian*, the Yellow Emperor asked: How to diagnose a patient with Wei Wan Yong (Stomach Abscess)? Qibo replied: Diagnose by observing the Stomach pulse. The pulse should be deep and fine. Deep and fine indicates qi rebellion. Rebellion causes the Ren Ying pulse to be very full; fullness indicates heat. Ren Ying is the Stomach pulse. Rebellion and fullness cause heat to gather at the stomach opening without circulating, forming a stomach abscess.

This states that in stomach abscess, the stomach pulse is not normally deep/fine. Because the stomach pulse is fine, the Ren Ying pulse is large. Ren Ying is the artery beside the larynx. Large Ren Ying means heat gathers at the stomach opening, forming abscess due to qi rebellion and heat excess.

Question: Some patients with Neck Abscess are treated with stone therapy or acupuncture, and all recover. What is the underlying principle? Answer: Same name, different categories. If the abscess qi is relaxed/superficial, use needles to open and remove it. If qi is excessive and blood gathers, use stone (bi shi) to drain. This is "Same Disease, Different Treatment."

This states that although abscesses are similar, treatments differ. Abscess as qi relaxation means excessive qi and blood gathering; use bi stone/needles to drain evil blood for self-healing. Using drainage needles is correct.

The Yellow Emperor asked: A patient with anger and mania, where does this disease come from? Answer: It comes from Yang. Question: How does Yang cause mania? Answer: Yang qi, due to sudden frustration and inability to resolve, leads to irritability. The disease is named Yang Jue (Yang Jue). Question: How to know? Answer: Yangming constantly moves; Juyang (Taiyang) and Shaoyang do not normally move. If non-moving vessels move rapidly, this is the sign.

Yang pulse movement refers to the constant movement of the Ren Ying pulse. Juyang pulse is at Tian Rong; Shaoyang pulse is at Tian Chuang. These two pulses do not normally move; if they move, it indicates disease.

Question: How to treat? Answer: Deprive food intake to cure. Food enters yin and generates yang qi; depriving food cures it. (Less food means less qi; restricting food cures the disease.) Administer Sheng Tie Luo (Iron Slag) drink. (Iron slag/water.) Sheng Tie Luo rapidly descends qi. (Qi rebelling upward causes mania; drinking iron slag descends the rebellious qi.) Question: A patient has body heat, flaccidity, profuse sweating like bathing, aversion to wind, and shortness of breath. What disease is this? Answer: Named Jiu Feng (Wind Drink/Alcohol Wind). Question: How to treat? Answer: Use Ze Xie (Alisma) and Bai Zhu (Atractylodes) 10 parts each, Xi Xian Cao (Siegesbeckia) 5 parts. Mix and take three finger-widths after meals.

Ze Xie removes wind-damp and boosts qi; Bai Zhu stops sweating and removes fire-wind; Xi Xian Cao treats wind-damp sinew flaccidity. "After meals" means taking medicine after eating, hence "Hou Fan."

In *Qi Bing Pian*, the Yellow Emperor asked: Disease with hypochondriac fullness and qi rebellion lasting 2-3 years. What is this disease? Qibo replied: Named Xi Ji (Breathing Accumulation). It does not interfere with eating. Moxibustion and acupuncture are contraindicated. Accumulation requires guiding exercises and herbs; herbs alone cannot cure.

Qi rebellion and breathing difficulty is named Xi Ji. Qi is not in the Stomach, hence no interference with eating. Moxibustion sends fire pathogen inward; acupuncture leaks healthy qi outward; thus both are contraindicated. Only guiding exercises to circulate qi, combined with herbs, work. Without guiding exercises, herb-only treatment is difficult.

The Yellow Emperor asked: A patient has headache persisting for years. How was it acquired? What is the name? Qibo said: Likely exposure to severe cold, penetrating to the bone marrow. Marrow is dominated by the Brain. Brain qi rebels, causing headache; teeth also hurt. The disease is named Jue Ni (Rebellious Cold). The Yellow Emperor said: Good.

Cold pathogen lodging and rebelling, lingering unresolved, causes Jue Ni headache.

The Yellow Emperor asked: A patient has a sweet taste in the mouth. What is the disease name? How acquired? Answer: Overflow of the five qi, named Pi Dan (Spleen Heat). Five flavors enter the mouth, store in the Stomach; the Spleen transports their essence. Fluids staying in the Spleen cause sweet taste. This arises from rich/greasy food. Such people likely eat many sweet/rich foods. Greasy food causes internal heat; sweet food causes middle jiao fullness. Thus qi overflows upward, transforming into Xiao Ke (Wasting-Thirst). Treat with Lan (Orchid/Cypripedium) to remove stale qi.

Eating sweet/greasy food causes internal heat, stagnation without external release, leading to middle jiao fullness. Qi overflows upward becoming Xiao Ke. Treat with Orchid grass; orchid's pungency disperses stale accumulation.