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Yang generates, Yin grows; Yang kills, Yin stores (from *Da Yi Lun* of *Yin Yang Ying Xiang*)

When Yang generates and Yin grows, this is the mandate of Spring and Summer; when Yang kills and Yin stores, this is the mandate of Autumn and Winter. Yin and Yang wax and wane mutually. Spring governs Yang; when Yang is abundant, Yin begins to generate. Thus, at the Summer Solstice, after six Yang lines reach their peak, one Yin line is born. By Autumn, Yang Qi gradually declines; this is what is called "Yang kills." "Kill" means decline, referring to the gradual weakening of Yang. By Winter, all Yang Qi retreats and stores within Yin. Although stored in Yin, a single Yang Qi returns and revives on the day of the Winter Solstice. Therefore, within the human Kidney, a single Yang Qi also secretly grows. At this time, the four limbs and five Zang organs are not yet in the phase where Yang dominates. The key here should be to support Yang; one must not harm the root of Yang with Yin-cold and cooling agents. The Winter Solstice marks the birth of one Yang; by early Spring, three Yangs advance gradually. Therefore, medication should also open the path of generation to follow its mechanism of growth, again emphasizing the support of Yang. By Summer, Yang is abundant externally; one must then connect with the True Yang so that its root does not detach. Thus, the use of Cinnamon Twig (*Guizhi*) in *Wuling San* (Five-Ingredient Powder with Poria) embodies this principle. By Autumn, Yang gradually returns to Yin; one should guide its return path and prevent it from being cut off externally. Formulas such as *Xiangsu Yin* (Fragrant Perilla Decoction) and *Zhengqi San* (Regulating Qi Powder) embody this principle. By Winter, Yang returns to its hidden abode, while the exterior is entirely Yin. At this time, one must protect the interior to command the exterior, preventing the loss of its root. In this way, there is birth and growth, killing and storing, and Yin and Yang face no danger of isolation or partial harm. If one does not understand "birth," one cannot support the initial Yang; if one does not understand "growth," one cannot supplement deficiencies; if one does not understand "killing," one cannot guide return; if one does not understand "storing," one cannot anchor the root. This is nothing but taking Yang as the foundation, with all four seasons requiring mutual care.

Cold generates turbidity; Heat generates clarity (ibid.)

Cold belongs to Yin; cold causes firmness and coagulation, so Yin corresponds to Earth, which is the most turbid substance. Heat belongs to Yang; heat causes flow and diffusion, so Yang corresponds to Heaven, which is the most clear substance. This states that Yin is turbid and Yang is clear, Heaven is clear and Earth is turbid. (Zhang Dongfu says: The character "clear" should not be interpreted merely as a positive term. Since clarity and turbidity arise from cold and heat, both can become diseases in the human body.)

Essence transforms into Qi; Qi is injured by flavors (ibid.)

Essence belongs to Yin; Qi belongs to Yang. Essence transforming into Qi indicates that Yang is rooted in Yin. Flavors belong to Yin; when Yin is excessive, Yang declines. Indulging excessively in flavors causes Qi to stagnate and fail to circulate; thus, flavors can injure Qi.

Injuring dampness in Autumn leads to coughing in Winter (ibid.)

Earth naturally generates Metal; Metal corresponds to the Lung, and Earth corresponds to the Spleen. Dry earth cannot nurture life, nor can muddy earth. Therefore, if Spleen Earth is damp, it cannot generate Lung Metal. Dampness is Water Qi. Once Water Qi enters, during Autumn when Lung Qi is strong, it may not yet cause harm. But by Winter, when Metal Qi declines and Water Qi is strong, dampness takes advantage of the season to cause harm, resulting in cough. Lung Metal is the purest and cannot tolerate pathogens; injuring dampness makes Metal cold, leading to cough.

Loosen hair and relax the body to allow the will to generate (ibid.)

During Spring and Summer, Yang Qi rises and desires to expand. Loosening hair and relaxing the body allows Yang to rise and Qi to舒展 (smoothly flow). Therefore, for diseases in Spring and Summer, one must not overuse cold, cool, astringent, or binding agents. For wind-cold injury in Spring, it is appropriate to use Tangerine Peel (*Chenpi*) and Perilla Leaf (*Zisuye*) to diffuse the Middle Jiao. Gypsum (*Shigao*) should not be used in Spring; all these follow this principle.

When Heaven is bright, the sun and moon lose their brilliance; pathogens harm the empty orifices (from *Si Qi Tiao Shen Da Lun*)

Yang is Heaven; Yin is Earth. Clear Yang Qi is the Qi of Heaven. In the human body, Clear Yang Qi circulates through the empty orifices of the Five Zang and Six Fu organs without stagnation. The reason it circulates freely without stagnation is that each Zang organ stores its own pure, original, unified Qi, avoiding invasion or usurpation. If the Qi of the Five Zang organs is not secure, it becomes inverted and overflowing. Shao Huo (Lesser Fire) transforms into Zhuang Huo (Blazing Fire), and Clear Yang turns into Turbid Yin. Everything circulating in and out of the orifices belongs to Yin pathogens. For example, Lung Qi should normally descend to transmit to other organs; now it rebels upward causing harm. Spleen Qi should normally ascend to the Lung; now it sinks downward becoming a pathogen. Liver should soothe Earth; now it reverses, becoming depressed and injuring the Spleen. Water should generate Wood; now it overflows, floating Wood. Everywhere in the body, from top to bottom, circulating through the orifices, there is only congealed Turbid Yin, and Clear Yang Qi fails to move. Heaven is originally Yang but can store its true, original, pure Qi. Thus, the vast blue sky above opens only to the sun and moon, shining light universally. If the entire sky were as bright as the sun and moon, the light of the sun and moon would be completely hidden. Between heaven and earth, there would be no more circulating Clear Qi. Without Clear Qi, pathogenic turbid Qi fills the void and causes harm. How is disease in the human body any different?

When Yang Qi is blocked, Earth Qi obscures the brightness (ibid.)

The Qi of the Azure Heaven is pure and clear, allowing Yang to rise and Yin to descend. Heaven and Earth are harmonious; Heaven moves vigorously and Earth follows smoothly. At this time, Heavenly Qi descends and Earthly Qi ascends; Heaven and Earth interact to form *Tai* (Peace/Prosperity). What disasters could there be? If Heaven is not vigorous, Earth does not follow. Heaven and Earth separate; Yin and Yang do not harmonize. If Yang does not harmonize with Yin, Yang becomes hyperactive alone. If Yin does not harmonize with Yang, Yin becomes stagnant alone. It is no longer the pure, clear, circulating Qi of Heaven; the realm of brightness becomes a realm of darkness. Therefore, if the True Fire of the human body does not move, Yang Qi is blocked, and throughout the body, Yin Fire runs rampant. This is called "Earth Qi obscuring the brightness." Earth Qi refers to Yin Qi; "obscuring the brightness" means Yin Qi dims the bright Yang portion.

Accumulation in Summer leads to *Jian Jue* (Scorching Reversal) (from *Sheng Qi Tong Tian Lun*)

When Summer commands prevails, Yang Qi floats entirely to the exterior, leaving the interior deficient. The Kidney is the place where Yang is stored. Once Yang floats to the exterior, the interior becomes deficient, and Kidney Qi also weakens. If labor and sexual excess are added at this time, the exterior becomes solid while the interior is deficient, the upper becomes solid while the lower is deficient. How could reversal (*Jue*) not occur? "Jian" (Scorch) refers to the upper and exterior; "Jue" (Reversal) refers to the interior and lower. Scorching in the upper and exterior leads to reversal in the interior and lower. The treatment method should focus on guiding Qi back to the Kidney. (Note: *Pi* means disease. *Pi Ji* means accumulation of disease. *Jian* refers to mental restlessness and heat, as if being scorched. *Jue* refers to rebellious Qi causing collapse/reversal.)

Meridians loosen transversely; intestinal discharge becomes hemorrhoids (ibid.)

Meridians govern Qi; collaterals govern Blood. The Lung governs Qi; the Large Intestine is the exterior-interior pair of the Lung. When meridians loosen transversely, Qi movement is slow. Slow Qi movement means the Lung cannot exercise its command. Food in the stomach reaches the Large Intestine but cannot obey the Lung's descending command, causing Qi stagnation in the Large Intestine. Where Qi moves, Blood moves; where Qi stagnates, Blood knots. Blood knotting and Qi stagnating in the Large Intestine is the origin of hemorrhoids.

Diseases of Er Yang (Two Yang) originate in the Heart and Spleen (from *Yin Yang Bie Lun*)

Er Yang refers to Yangming Stomach. The Stomach is the husband of the Spleen. If the Stomach is diseased, how can the Spleen remain peaceful? When Spleen Qi moves, the Heart receives nourishment and Blood generates. Thus, the Heart generates Blood, and the Spleen controls Blood. Both the Heart and Spleen meridians are the sources of Blood generation. Blood belongs to Yin; Yin is born from Yang. If Yangming Stomach Yang is diseased and lacks generating energy, the source of Yin-Blood generation is diseased. How could it not affect the Heart and Spleen?

Regarding those who hold the pulse of the True Zang organs: If the Liver pulse is suspended and extreme, death occurs in eighteen days; if the Heart pulse is suspended, death occurs in nine days; if the Lung pulse is suspended, death occurs in twelve days; if the Kidney pulse is suspended, death occurs in seven days; if the Spleen pulse is suspended, death occurs in four days. (ibid.)

The True Zang pulse is the true pulse of the respective Zang organ, lacking Stomach Qi. The number of days until death is calculated using completed numbers (*Cheng Shu*), generative numbers (*Sheng Shu*), or both. Generally, Yin meets Yin, Yang meets Yang, and death occurs when subjected to overcoming. For example, in suspended Liver pulse, the completed number of Liver is eight, and the completed number of Lung is nine. Eight plus nine equals seventeen. Subtract seventeen and add one, reaching eighteen days until death. Heaven generates Wood with three, Earth completes it with eight. Earth is Yin. Earth generates Metal with four, Heaven completes it with nine. Although Heaven is Yang, its completed number is Yin. Thus, completed numbers are used. For suspended Heart pulse, Earth generates Fire with two (generative number). Heaven generates Water with one, Earth completes it with six. Six plus two equals eight. Subtract eight and add one, so death occurs in nine days. For suspended Lung pulse, the generative number of Metal is four, and the completed number of Fire is seven. Four plus seven equals eleven. Subtract eleven and add one, so death occurs in twelve days. For suspended Kidney pulse, the generative number of Water is one, and the generative number of Earth is five. One plus five equals six. Subtract six and add one, so death occurs in seven days. Only for suspended Spleen pulse, death occurs in four days, which people find hard to understand. Earth prospers in the four seasons and occupies the center. Thus, when Spleen pulse is suspended, it dies upon meeting overcoming. Heaven generates Wood with three. Three minus three plus one equals four, so death occurs in four days.

Those who violate the Four Seasons: Excess manifests as essence accumulation; deficiency manifests as essence depletion. Responding to excess, deficiency indicates essence depletion; responding to deficiency, excess indicates depletion. (Violating the Four Seasons refers to pulses contrary to seasonal changes, e.g., thin pulses in Spring/Summer, floating pulses in Autumn/Winter. "Excess" refers to essence gathering; gathering above causes below to be deficient, gathering below causes above to be deficient, hence excess indicates essence accumulation. "Deficiency" refers to righteous Qi deficiency, hence deficiency indicates depletion. "Responding to excess" means gathering above (excess above) or gathering below (excess below); having excess implies having deficiency, hence "responding to excess, deficiency indicates essence depletion." When righteous Qi depletes, pathogenic Qi flourishes; pathogenic flourishing stems from righteous depletion, hence "responding to deficiency, excess indicates depletion.")

What Taiyang calls swelling and lower back pain: In the first month, Taiyang corresponds to Yin. Yin represents Taiyang. In the first month, Yang Qi emerges upwards, but Yin Qi is abundant. Yang has not yet obtained its proper position, hence swelling and lower back pain. Disease presenting as hemiplegic limpness in the first month: Yang Qi thaws, and Earth Qi emerges. "Hemiplegic deficiency" refers to winter cold being somewhat insufficient, hence hemiplegia results. (From *Mai Jie Pian*)

Taiyang is one of the Three Yangs. One Yang rises from Winter Solstice; by the first month (Yin), Three Yangs are born. Swelling and lower back pain in Three Yangs occur because Taiyang cannot fulfill its generating nature. By the first month (Yin), Yang has not fully emerged but is constrained below, hence pain. Saying "Yin is abundant, Yang has not obtained its position" means it has not attained its rightful place. Disease causing limpness is like Yang Qi: upon thawing from freezing, although moving, it has not risen, remaining constrained below. Limpness involves the Taiyang Bladder Meridian, which starts at the Little Toe, Zhiyin point. Yang is suppressed at Zhiyin ("Extreme Yin"), hence unilateral limpness. Limpness means inability to walk. (Note: This detailed explanation covers various diseases of the Six Channels; here only two cases from Taiyang are cited as examples.)

The Liver and Eyes correspond to Man. There are 9x9=81 orifices and 6x6=365 joints. Man uses "One" to observe movement and stillness; Heaven uses "Two" to await the Five Colors; Seven Stars respond to await hair growth; Mother Nourishes Five Tones to await Gong, Shang, Jue, Zhi, Yu; Six Lüyü respond to excess and deficiency; Earth Two awaits high and low excess; Nine Regions and One Joint-Shu respond to await closed joints. Three changes in Man; One part of Man awaits teeth, leakage indicates much blood and little blood; Ten parts of Jue change; Five parts await slackness and urgency; Six parts deficiency, Three parts cold joints; Ninth part Four Seasons; Man's cold, warmth, dryness, dampness; Four Seasons respond once to await four reversals; One Four Directions each make explanations. (Wang Bing on *Zhen Jie Pian*: These 124 characters are worm-eaten and rotten text, meaning is incomplete, impossible to investigate.)

The Liver opens into the eyes. There are 81 orifices and 365 joints. All that moves and operates is the Qi of the Liver, the nature of Wood. Thus, "One" observes movement and stillness. In Man, it is born of Tian One; in Heaven, it is born of Water, rising to become Fire. Liver governs movement; Fire also governs movement, hence awaiting the Five Colors. Seven Stars are stars rotating through twelve months, also governing movement. In Heaven, they are Fire, and their movement corresponds to Seven Stars. To await hair growth: Hair is on the head, occupying the Fire sector, hence the upper part corresponds. [Missing three sentences regarding "Mother Nourishes"]: Water is the mother of Wood. When Water is strong, Wood flourishes and nourishes. Five Colors are in Heaven; Five Sounds are in Man. Gong, Shang, Jue, Zhi, Yu transform into Six Lüyü. Within them, excess and deficiency are distinguished by sound, hence "excess and deficiency respond." Five Colors in Heaven are mostly seen on the face; Five Sounds in Earth are mostly seen in the chest and throat, hence "Earth Two" follows. Earth Two awaits high and low excess. Nine Regions in Man refer to Five Zang and Six Fu organs, responded to by One Joint-Shu. Shu means back; Shu is the gateway of Zang and Fu organs. Here Earth connects with Heaven. Abdomen is Yin, Earth; Back is Yang, Heaven. Hence "respond to await joints." (The character "Guan" was changed by Shenzhai; original was "Bi".) This is Two. Three lies in the frequent changes in Man. One part awaits teeth; leakage indicates much blood and little blood. Ten parts of Jue change: Jue belongs to Wood, Wood is Liver, Liver governs movement, movement brings change, hence "Ten parts Jue change." This shows that nine out of ten diseases originate from the Liver. Five parts await slackness and urgency: Liver is the General Officer, prone to urgency and difficult to relax. Urgency means disease strikes suddenly and fiercely; relaxation means even if disease strikes, it is easy to control. Six parts deficiency, Three parts cold joints due to cold in joints. Ninth part Four Seasons: In Heaven, Four Seasons; in Man, Cold, Warmth, Dryness, Dampness. Man's Cold, Warmth, Dryness, Dampness are Heaven's Four Seasons. Respond once to await opposition: e.g., Heaven's Winter is hot, Hot is cold. Opposition causes disease; conformity brings peace. However, heights and depths of Four Directions, distances of Nine Regions differ; one must deduce differences in Heaven's timing and Human affairs based on location, not applying a uniform interpretation. Therefore, when using medication to resolve disease, one must consult Heaven's timing and observe Earth's suitability, then nothing remains unresolved. (Wang Xushan says: The 100+ characters following "Liver and Eyes correspond... Nine" in *Zhen Jie Pian* are damaged, hard to fully understand, so ancients left no commentary, following the principle of leaving doubts. Shenzhai considered ancient sage words as precious treasures, not to be discarded as missing text. He elucidated what could be understood, showing his utmost cherishing. Ancients treated fragmented bamboo slips as gold books and jade tablets, not discarding a single word. Today's students have never reviewed *Ling Shu* and *Su Wen* in their lives yet boast of their medical skills. Alas!...)

Winter diseases are in Yin; Summer diseases are in Yang; Spring diseases are in Yin; Autumn diseases are in Yang. (From *Jin Gui Zhen Yan Lun*)

In Winter, Yang stores internally. Internally belongs to Yin. If Yang can store in Yin, there is no disease. If Yang does not store in Winter, Yin is suppressed by Yang. Can there be no disease? Hence, Winter diseases are in Yin. In Summer, Yang emits externally. Externally belongs to Yang. If Yang cannot emit in Summer, Yang is suppressed by Yin. Can there be no disease? Hence, Summer diseases are in Yang. In Spring, Yang desires to emit but Qi is still weak. If invaded by Seven Emotions, labor, or external pathogens, Yang is suppressed in the Yin portion, causing Yin disease. Hence, Spring diseases are in Yin. In Autumn, Yang Qi should gradually descend. If it cannot descend when the time comes, Yang Qi is weak. Weakness leads to disease arising. Hence, Autumn diseases are in Yang.

Zang Organs Not Storing Essence

If Lung does not store essence, Kidney is inevitably injured. If Kidney does not store essence, Liver does not develop. If Liver does not store essence, Heart is not nourished. If Heart does not store essence, Spleen is inevitably harmed. If Spleen does not store essence, Lung suffers disaster. In short, if Mother does not store, Child does not develop. If Child does not develop, disease still affects Mother. Thus, Heart affects Liver, Liver affects Kidney, Kidney affects Lung, Lung affects Spleen, Spleen affects Heart. Mother and Child are related; the root and branch of disease are determined here. This states the general principle. If there is infection or not, or light/heavy/shallow/deep infection, it depends on the person's constitution. This is identifying future symptoms based on seasonal Qi. As for the present time, it is different: If Fire does not store, Lung disease occurs; if Metal does not store, Liver disease occurs; if Wood does not store, Spleen disease occurs; if Earth does not store, Kidney disease occurs; if Water does not store, Heart disease occurs. This is affecting the "Wife" (element controlled by the excessive element) due to current excess. If Husband and Wife are both diseased, the principles of tonification and sedation can be deduced. For example, in Chen/Xu years, the first Qi is Ministerial Fire, indicating Fire does not store. Current Lung disease and future Spleen disease can be known. From this one case, the rest can be inferred.