应龙问曰：病有真假，症有从逆，予知之矣。但何以辨其真假也?岐伯曰：寒热之症，气顺者多真，气逆者多假。凡气逆者皆假寒假热也。知其假，无难治真矣。应龙曰：请问气逆者何症也?岐伯曰：真阴之虚也。应龙曰：真阴之虚何遂；成气逆乎?岐伯曰：真阴者，肾水也。肾水之中有火存焉，火得水而伏，火失水而飞，凡气逆之症皆阴水不能制阴火也。应龙曰：予闻阴阳则两相配也，未闻阴与阴而亦合也。岐伯曰：人身之火不同，有阴火、阳火，阳火得阴水而制者，阴阳之顺也。阴火得阴水而伏者，阴阳之逆也。应龙曰：阴阳逆矣，何以伏之?岐伯曰：此五行之颠倒也。逆而伏者正，顺而制之也。应龙曰：此则龙之所不识也。岐伯臼；肾有两歧，水火藏其内，无火而水不生，无水而火不长，不可离也。火在水中，故称阴火，其实水火自分阴阳也。应龙曰：阴；火善逆．。阴水亦易逆，何故?岐伯曰：此正显水火之不可离也。火离水而逆，水离火而亦逆也。应龙曰：水火相离者，又何故欤?岐伯曰：人节欲少而纵欲多，过泄其精则阴；水亏矣，水亏则火旺，水不能制火而火逆矣。应龙曰：泄精损水，宜火旺不宜火衰也，何火有时而寒乎?岐伯曰：火在水中，水泄而火亦泄也，泄久则阴火亏矣，火亏则水寒，火不能生水而水逆也。故治•气逆者皆以补肾为主，水亏致火逆者补肾则逆气自安，火亏致水逆者补肾而逆气亦安。应龙曰：不足宜补，有余宜泻，亦其常也，何治肾之水火不尚泻尚补乎?岐伯曰：肾中水火，各脏腑之所取资也，故可补不可泻，而水尤不可泻也。各脏腑有火无水，皆肾水滋之，一泻水则各脏腑立槁矣。气逆之症，虽有水火之分，而水亏者多也，故水亏者补水而火亏者亦必补水。盖水旺则火衰，水生则火长也。应龙曰：补水而火不衰，补水而水不长，又奈何?岐伯曰；补水以衰火者，益水之药宜重。补水以长火者，益水之药宜轻也。应龙曰：善。
陈士铎曰：人身之逆，全在肾水之不足。故补逆必须补水，水足而逆者不逆也。
移寒篇
应龙问曰：肾移寒于脾，脾移寒于肝，肝移寒于心，心移；寒于肺，肺移寒于肾，此五脏之移寒也。脾移热于肝，肝移热于心，心移热于肺，肺移热于肾，肾移热于脾，此五脏之移热也。五脏有寒热之移，六腑有移热无移寒何也?岐伯曰：五脏之五行正也，六腑之五行副也。五脏受邪，独当其胜，六腑受邪，分受其殃。且脏腑之病，热居什之八，寒居什之二也。寒易回阳，热难生阴，故热非一传而可止，脏传未已，又传诸腑，腑又相传，寒则得温而解，在脏有不再传者，脏不遍传，何至再传于腑乎。此六腑所以无移寒之证也。应龙曰：寒不移于腑，独不移于脏乎?岐伯曰：寒入于腑而传于腑，甚则传于脏，此邪之自传也，非移寒之谓也，应龙曰：移之义若何?岐伯曰：本经受寒，虚不能受，移之于他脏腑，此邪不欲去而去之，嫁其祸也。应龙曰：善。
陈士铎曰；六腑有移热而无移寒，以寒之不移也，独说得妙，非无征之文。
雷公问曰：病有寒热，皆成于外邪乎?岐伯曰：寒热不尽由于外邪也。雷公曰：斯何故欤?岐伯曰：其故在肝，肝喜疏泄，不喜闭藏，肝气郁而不宣，则胆气亦随之而郁，胆木气郁，何以生心火乎。故心之气亦郁也，心气郁则火不遂，其炎上之性何以生脾胃之土乎。土无火养，则土为寒土，无发生之气矣，肺金无土气之生，则其金不刚，安有清肃之气乎。木寡于畏，反克脾胃之土，土欲发舒而不能，土木相刑，彼此相角，作寒作热之病成矣。正未尝有外邪之千，乃五脏之郁气自病，徒攻其寒而热益盛，徒解其热而寒益猛也。雷公曰：合五脏以治之，何如?岐伯曰；舒肝木之郁，诸郁尽舒矣。
陈士铎曰：五郁发寒热，不止木郁也，而．解郁之法独贲于木，以木郁解而金土水火之郁尽解，故解五郁惟尚解木郁也，不必逐经解之。
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Yinglong asked: Diseases have true and false manifestations, and symptoms have compliant (shun) and rebellious (ni) patterns. I understand this. But how can one distinguish between the true and the false? Qibo replied: In cases of cold and heat symptoms, those with smooth Qi flow are mostly true, while those with rebellious Qi flow are mostly false. All instances of rebellious Qi flow constitute false cold or false heat. Once one recognizes them as false, treating the underlying truth is not difficult. Yinglong said: May I ask what symptoms characterize rebellious Qi flow? Qibo replied: This is a manifestation of deficiency of True Yin (Kidney Yin). Yinglong said: Why does deficiency of True Yin lead to rebellious Qi flow? Qibo replied: True Yin is Kidney Water. Within Kidney Water resides Fire. When Fire obtains Water, it remains submerged and tranquil; when Fire loses Water, it flies and becomes hyperactive. All symptoms of rebellious Qi flow occur because Yin Water fails to control Yin Fire (Ministerial Fire). Yinglong said: I have heard that Yin and Yang pair with each other, but I have never heard that Yin combines with Yin. Qibo replied: The Fire in the human body is not uniform; there is Yin Fire and Yang Fire. When Yang Fire is controlled by Yin Water, this is the compliant relationship of Yin and Yang. When Yin Fire is subdued by Yin Water, this is the rebellious relationship of Yin and Yang. Yinglong said: If Yin and Yang are in rebellion, how can they be subdued? Qibo replied: This involves the inversion of the Five Elements' interactions. Subduing through reversal is correct; controlling through compliance is also valid. Yinglong said: I do not understand this principle. Qibo said: The Kidneys have two aspects, with Water and Fire stored within. Without Fire, Water cannot generate; without Water, Fire cannot grow. They cannot be separated. Fire existing within Water is thus called Yin Fire, although Water and Fire themselves belong to Yin and Yang respectively. Yinglong said: Yin Fire tends to rebel, and Yin Water is also prone to rebellion. What is the reason? Qibo replied: This precisely demonstrates the inseparability of Water and Fire. When Fire separates from Water, it rebels; when Water separates from Fire, it also rebels. Yinglong said: Why do Water and Fire separate? Qibo replied: People practice restraint rarely but indulge frequently. Excessive loss of Essence causes Yin Water to become deficient. When Water is deficient, Fire becomes hyperactive. Because Water cannot control Fire, Fire rebels. Yinglong said: Loss of Essence damages Water, so Fire should be hyperactive rather than deficient. Why does Fire sometimes present with cold signs? Qibo replied: Fire exists within Water. When Water is depleted, Fire is also depleted. Prolonged depletion leads to deficiency of Yin Fire. When Fire is deficient, Water becomes cold. Because Fire cannot generate Water, Water rebels. Therefore, treating symptoms of rebellious Qi flow primarily focuses on tonifying the Kidneys. For rebellious Qi caused by Water deficiency, tonifying the Kidneys allows the rebellious Qi to settle naturally; for rebellious Qi caused by Fire deficiency, tonifying the Kidneys also settles the rebellious Qi. Yinglong said: Deficiency should be tonified, and excess should be purged; this is the general rule. Why is treatment of Kidney Water and Fire based on tonification rather than purgation? Qibo replied: The Water and Fire in the Kidneys are the resources drawn upon by all Zang-Fu organs. Thus, they can only be tonified, not purged, and Water especially must not be purged. If any Zang-Fu organ has Fire but lacks Water, it relies on Kidney Water for nourishment. If Kidney Water is purged, all Zang-Fu organs will immediately wither. Although symptoms of rebellious Qi flow are divided into Water deficiency and Fire deficiency, Water deficiency is more common. Therefore, for Water deficiency, one tonifies Water; for Fire deficiency, one must also tonify Water. This is because abundant Water leads to subdued Fire, and generating Water promotes the growth of Fire. Yinglong said: How can tonifying Water subdue Fire, and how can tonifying Water promote the growth of Fire? Qibo replied: To subdue Fire by tonifying Water, the dosage of water-tonifying herbs should be heavy. To promote the growth of Fire by tonifying Water, the dosage of water-tonifying herbs should be light. Yinglong said: Excellent.
Chen Shiduo commented: Human rebellious states depend entirely on the insufficiency of Kidney Water. Therefore, treating rebellion requires tonifying Water; when Water is sufficient, rebellion ceases.
Chapter on the Transmission of Cold
Yinglong asked: When Kidney transmits Cold to the Spleen, Spleen transmits Cold to the Liver, Liver transmits Cold to the Heart, Heart transmits Cold to the Lungs, and Lungs transmit Cold to the Kidneys, this is the transmission of Cold among the Five Zang organs. When the Spleen transmits Heat to the Liver, Liver transmits Heat to the Heart, Heart transmits Heat to the Lungs, Lungs transmit Heat to the Kidneys, and Kidneys transmit Heat to the Spleen, this is the transmission of Heat among the Five Zang organs. The Five Zang organs experience transmission of both Cold and Heat, but the Six Fu organs experience only transmission of Heat, not Cold. Why is this? Qibo replied: The Five Zang organs correspond to the Five Elements in their primary positions, while the Six Fu organs correspond to the Five Elements in secondary positions. When the Zang organs are invaded by pathogenic factors, they alone bear the impact of the overcoming element. When the Fu organs are invaded, they share the misfortune. Moreover, among diseases of the Zang and Fu organs, Heat accounts for eighty percent, and Cold accounts for twenty percent. Cold is easier to resolve by restoring Yang, whereas Heat is harder to resolve by generating Yin. Therefore, Heat transmission cannot be stopped after a single transfer; if the disease in the Zang organs has not ceased, it transfers to the Fu organs, and the Fu organs transmit it to one another. Cold resolves upon receiving warmth. If Cold does not fully transmit among the Zang organs, it will not reach the stage of transmitting again to the Fu organs. This is why the Six Fu organs do not exhibit signs of transmitted Cold. Yinglong said: If Cold does not transmit to the Fu organs, does it not transmit to the Zang organs either? Qibo replied: When Cold enters the Fu organs and transmits among them, and severely reaches the Zang organs, this is the self-transmission of pathogens, which is not referred to as "transmitted Cold." Yinglong said: What is the meaning of "transmission" (yi)? Qibo replied: When the channel affected by Cold is deficient and unable to contain the pathogen, the pathogen moves to other Zang-Fu organs. This is the pathogen unwilling to leave yet departing, shifting its disaster onto others. Yinglong said: Excellent.
Chen Shiduo commented: The statement that the Six Fu organs experience transmitted Heat but not transmitted Cold, due to the non-transmission of Cold, is exquisite and well-founded, not mere empty rhetoric.
Chapter on Relieving Liver Stagnation in Cold and Heat Patterns
Leigong asked: Do all cold and heat symptoms in disease arise from external pathogens? Qibo replied: Not all cold and heat symptoms are due to external pathogens. Leigong said: What is the reason? Qibo replied: The cause lies in the Liver. The Liver prefers free flow and discharge and dislikes closure and storage. If Liver Qi becomes stagnant and fails to disperse, Gallbladder Qi follows suit and becomes stagnant. If Gallbladder Wood Qi is stagnant, how can it generate Heart Fire? Consequently, Heart Qi also becomes stagnant. When Heart Qi is stagnant, Fire cannot function freely, and its nature of flaring upward cannot generate Earth in the Spleen and Stomach. Without Fire's nourishment, Earth becomes cold Earth, lacking generative energy. If Metal in the Lungs lacks the generation of Earth Qi, then Metal is not firm, and how can it possess clear and descending Qi? When Wood lacks fear (of Metal), it counter-attacks the Earth of the Spleen and Stomach. Earth desires to expand but cannot; Wood and Earth injure each other and contend, resulting in cold and heat diseases. There is no interference from external pathogens here; rather, the stagnant Qi of the Five Zang organs causes illness itself. Attacking only the cold makes the heat more intense, and resolving only the heat makes the cold more fierce. Leigong said: How about treating by harmonizing all five Zang organs? Qibo replied: By relieving the stagnation of Liver Wood, all stagnations are relieved.
Chen Shiduo commented: The emission of cold and heat due to the five types of stagnation is not limited to Wood stagnation. However, the method of relieving stagnation uniquely emphasizes Wood. Since relieving Wood stagnation relieves the stagnation of Metal, Earth, Water, and Fire, treating the five stagnations solely relies on relieving Wood stagnation, without needing to treat each meridian individually.
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