辟左右 马云。辟、 同。孟子云。辟土地。张云。此下十二问。既非风寒之外感。又非情志之内
伤。论不在经。所当口传者也。故曰口问。
欠 马云。欠、音牵。江左谓之呵欠。张云。欠者张口呵吸。成伸辟展腰。以阴阳相引而然也。夫
阳主昼。阴主夜。阳主升阴主降。凡人之寤寐。由于卫气。卫气者昼行于阳则动而为寤。夜行于阴则静而为寐。
故人于欲卧未卧之际。欠必先之者。正以阳气将入阴分。阴积于下。阳犹未静。故阳欲引而升。阴欲引而降。
上下相引而欠出生也。今人有神疲劳倦而为欠者。即阳不胜阴之候。
阳气尽（止）寤矣 张云。大惑论曰。卫气不得入于阴。常留于阳。留于阳则阳气满。阳气满则阳跷
盛。不得入于阴则阴气虚。故目不瞑矣。卫气留于阴。不得行于阳。留于阴则阴气盛。阴气盛则阴跷满。不得
入于阳。则阳气虚。故目闭也。吴玄纲曰。觉与阳合。寐与阴并。觉多者魂强。寐久者魄壮。魂强者生之徒。
魄壮者死之徒。是皆阴阳盛衰之义。
泻足少阴 补足太阳 张云。卫气之行于阳者自足太阳始。阴盛阳衰。所以为欠。故当泻少阴之照
海。阴跷所出
也。补太阳之申脉。阳跷所出也。
真邪相攻 气并相逆 甲乙无气并二字。马云。真气即胃气。邪气即寒气。
补手太阴 泻足少阴 张云。手太阴肺经也。足少阴肾经也。寒气自下而升逆则为哕。故当补肺于
上以壮其气。泻肾于下以引其寒。盖寒从水化。哕之标在胃。哕之本在肾也。汪云。呃逆有实有虚。有寒有热。
病源病候。种种不同。此特言其一端耳。若以哕作呕吐。则呃逆亦病中要症。二经者岂漫无一字及之哉。
唏 马云。唏、许几切。释文言哀痛不泣曰唏。张云。唏、欷同。 欷也。释义云。悲泣气咽而抽
息也。一云泣余声。一云哀而不泣曰唏。悲忧之气生于阴惨。故为阴盛阳虚之候。
补足太阳 泻足少阴 马云。当于足太阳膀胱经。阳跷脉气所出者补之。足少阴肾经。阴跷脉气所
出者泻之。
振寒（止）补诸阳 张云。振寒者。身怯寒而振栗也。补诸阳者。凡手足三阳之原合。及阳跷等穴。
皆可酌而用之。
噫 张云。嗳气也。释义曰。饱食息也。按、此节与上文之哕。皆以寒气在胃而然。但彼云故寒气
者。以久寒在胃。言其深也。此云寒客于胃者。如客之寄。言其浅也。故厥逆之气。从下上散。则复出于胃而
为噫。简案、噫、说文饱食息也。而马云。噫、不平声也。此为五噫之噫者。误甚。
补足太阴（止）眉本也 张云。补足太阴阳明二经。使脾胃气温。则客寒自散。而噫可徐。眉本、即
足太阳经攒竹穴。是亦补阳气也。
嚏 张云。阳气和平。顺利而满溢于心。必上达于肺。故出于鼻而为嚏。然人有感于风寒而为嚏者。
以寒邪束于皮
毛。则阳气无从泄越。故喷而上出。是嚏从阳气而发。益又可知。仲景曰。欲嚏不能。此人肚中寒。正谓其阳
虚也。故人病阳虚等证者。久无嚏而忽得之。则阳气渐回之佳兆也。简案、嚏、说文牾解气也。玉篇。喷鼻也。
补足太阳（止）眉上也 张云。凡阳虚于下。则不能上达而为嚏。补足太阳之荣于眉本者。其名攒竹。
一曰眉上。亦即此穴。盖太阳与肾为表里。所以补阴中之阳也。观宣明五气篇曰。肾为欠为嚏。其义正与此通。
甲乙作 、马云音妥。释云。下垂貌。则是首身下垂而不能举也。观本经下文。有因其所在补
分肉间。则 必有定所。且有分部。彼以避为释者。（案熊音了可反避也）是乃以读之为躲。而遂释之为避也。
义甚不通。简案、 、广韵。垂下貌。 、正字通。为 之 讹。巢源。风 曳候云。肢体弛缓不收摄也。人以
胃气养于肌肉经络也。胃若衰损。其气不实。经脉虚则筋肉懈惰。故风邪搏于筋而使 曳也。即本节之 也。
千金小儿门。 HT 僻不能行步。中风门作 曳。并同。而张云。俗语有战 之说。即古人之遗言。意者 即战
之属也。但因寒而战者谓之寒战。其有战不因寒者由气虚耳。此因楼氏纲目颤振门。治 曳之方而误。不可从
也。志云。 者。垂首斜倾。懈惰之态。古乐府云。髻半 。此说虽是。而唯以垂首释之。不若马说允当。
行阴用力 志云。阳明主润宗筋。阳明虚则宗筋纵。是以筋脉懈惰。则阳明之气行于宗筋。而用力
于阴器矣。行阴用力。则阳明之气不能复养于筋脉。故为 。
目者宗脉之所聚也 张云。宗、总也。凡五脏六腑之精气。皆上注于目而为之精。故目为宗脉之所
聚。马云。此节可与素问解精微论参看。
目无所见矣 张云。世之因泣而丧目者。盖亦不少矣。
补天柱 经侠颈 甲乙挟颈下有挟颈者。头中分也。七字据下文甲乙为是。马云。当补足太阳膀胱
经之天柱穴。此经乃挟于后之项颈者是也。志云。膀胱之津。外濡空窍。液道开而泣不立则液竭而濡空窍之精。
不能灌于目而目不明矣。故命曰夺精。谓夺其外濡空窍之精也。当补膀胱经之天柱于挟颈间。以资津液上灌。
盖液随气行者也。
太息者（止）以伸出之 张云。太息者息长而大。即叹息也。约、犹束缚也。忧愁思虑则气抑不伸。
而心系急气道约。约则满闷于中。此叹息之不容已也。
补手少阴（止）留之也 张云。手少阴心经也。心主手厥阴经也。足少阳胆经也。助木火之脏。则阳
气可舒。抑郁可解。故皆宜留针补之。
涎下者（止）故涎下 涎、甲乙作羡。下同。张云。足阳明之脉出于口。胃中有热则虫动。胃缓故廉
泉开而涎下。凡目之多泪。鼻之多涕。亦皆因热而上。液之道开也。有谓肺热甚则鼻涕出者。义亦犹此。
补足少阴 张云。肾为胃关。而脉系于舌。故当补之以壮水制火。则液有所主而涎自止也。
耳中鸣者（止）故耳鸣 张云。手足三阳三阴之脉。皆入耳中。故耳亦宗脉之所聚也。阳明为诸脉之
海。故胃中空则宗脉虚。宗脉虚则阳气不升而下溜。下溜则上竭。轻则为鸣。甚则为聋矣。然少阳太盛。壅窒
为鸣者亦有之。但虚者渐而实者暴。虚者多而实者少。其辨在有邪无邪耳。学人当推展之。汪云。此论他书不
载。仅见于此。按、人夜卧之时。五官皆不用事。惟耳能听。岂非以宗脉所聚。故能有所警觉也乎。又人在母
腹中。仅一血胚。闻雷霆火爆之声则惊而跳。
此时五官未备。而闻性已与外物相通。故楞严二十五圆通。独重耳根。孔子亦言六十而耳顺。则耳之异于诸官
也明矣。又云。即下文上气不足。耳为之苦鸣之义。
补客主人（止）交者也 张云。客主人足少阳经穴。为手足少阳足阳明之会手大指爪甲上者。手太阴之
少商穴。为肺气所出之井。故皆当补之以助其阳气。
啮舌者 何气使然 马张志并云。缺岐伯曰。
脉气辈至也 甲乙。辈、作皆。吴本注云。辈、疑误。马辈至作使然。张云。辈者类也。厥逆走上则
血涌气腾。至生奇疾。所至之处。各有其部。如少阴之脉行舌本。少阳之脉循耳颊。阳明之脉环唇口。故或为
肿胀。或为怪痒。各因其处。随而啮之。不独止于舌也。志云。肾脏之生气。厥逆走上。与中焦所生之脉气相
辈而至。则舌在齿之内。而反向外矣。唇在齿之外。而反向内矣。颊在齿之旁。而反向中矣。
凡此十二邪者 甲乙此下载大惑论。善忘善饥二条。以为十四邪。岂皇甫氏以意添之耶。
奇邪 张云。不同常疾。故曰奇邪。
若倾 张云。倾者沉重不能支也。
胃使为之变 肠为之苦鸣 诸本。胃使、作溲便。当改。但熊本作凌使。亦误。张云。水由气化。故
中气不足。则溲便变常。而或为黄赤。或为短涩。多有情欲劳倦过伤精气而然。昧者概认为火。鲜不误矣。且
中气不足。则浊气居之。故肠胃为之苦鸣也。汪云。按内经无遗精白浊之文。但云出白溲。白、白淫。溲、便
变也。又云。水液混浊。皆属于热。
为痿厥 心 张云。痿、足萎弱也。厥、四肢清冷也。 、闷也。下气不足。则升降不交。故心气
不舒而为
闷。
补足外踝下留之 张云。此昆仑穴也。为足太阳所行之经。凡于上中下气虚之病。皆可留针补之。
治之奈何 张云。此下复问治法者。所以补上文之缺略也。
肾主为欠 张云。上文未言属肾。故此复明之。
肺主为哕 张云。上文言哕出于胃。此言哕主于肺。盖寒气上逆而为哕。气病于胃而主于肺也。
唏者（止）泻足少阴 甲乙。与、作盛。张云。阴与阳绝则阳不附阴。补阳泻阴则刚柔相济。乖者和矣。
振寒者（止）外踝下留之 张云。诸冶。俱同上文。
刺足大趾间（止）足外踝下留之 张本脱外字。张云。大趾间上二寸。足厥阴之大冲也。或曰足
太阴之太白也。此与上文稍异。外踝下留之义如前。
Opening the pathway, Ma Yun explains: "Bi" is synonymous with. Mencius said, "To open up land." Zhang Yun stated: The following twelve questions are neither external contractions of wind-cold nor internal injuries from emotional factors. Since these discussions are not recorded in the meridians, they should be transmitted orally. Hence, it is called "Kou Wen" (Oral Questions).
Yawning. Ma Yun explains: "Qian" is pronounced like "qian". In Jiangzuo, it is called "heqian" (yawn). Zhang Yun stated: Yawning involves opening the mouth to breathe and stretching the waist. This occurs due to the mutual attraction between Yin and Yang. Yang governs the day, while Yin governs the night. Yang ascends, and Yin descends. A person's wakefulness and sleep depend on Wei Qi (Defensive Qi). When Wei Qi circulates in the Yang aspects during the day, movement results in wakefulness; when it circulates in the Yin aspects at night, stillness results in sleep. Therefore, just before falling asleep, yawning always precedes it because Yang Qi is about to enter the Yin aspect. Yin accumulates below, while Yang has not yet settled. Thus, Yang desires to ascend, and Yin desires to descend. Their mutual attraction produces yawning. Now, if someone yawns due to mental fatigue and weariness, this is a sign that Yang cannot overcome Yin.
When Yang Qi is exhausted, one wakes up. Zhang Yun cited the *Da Huo Lun* (Treatise on Great Confusion): "If Wei Qi cannot enter the Yin, it remains in the Yang. Remaining in the Yang causes Yang Qi to become full; when Yang Qi is full, the Yang Qiao Mai becomes vigorous. If it cannot enter Yin, Yin Qi becomes deficient, resulting in insomnia (inability to close the eyes). If Wei Qi remains in Yin and cannot circulate in Yang, Yin Qi becomes excessive; when Yin Qi is excessive, the Yin Qiao Mai becomes full. Unable to enter Yang, Yang Qi becomes deficient, resulting in closed eyes." Wu Xuangang stated: "Awakening combines with Yang, while sleeping merges with Yin. Those who awaken often have strong Hun (Ethereal Soul); those who sleep long have strong Po (Corporeal Soul). Strong Hun leads to life; strong Po leads to death." These illustrate the principles of Yin-Yang excess and deficiency.
To drain Foot Shaoyin and tonify Foot Taiyang: Zhang Yun stated: Wei Qi begins its circulation in Yang from Foot Taiyang. Excess Yin and deficient Yang cause yawning. Therefore, one should drain Zhaohai (KI6), the exit point of the Yin Qiao Mai, and tonify Shenmai (BL62), the exit point of the Yang Qiao Mai.
True pathogenic factors attack each other, and Qi moves counter to normal flow. The *Jia Yi Jing* lacks the characters "Qi Bing". Ma Yun explained: True Qi refers to Stomach Qi, while Pathogenic Qi refers to Cold Qi.
Tonify Hand Taiyin and drain Foot Shaoyin: Zhang Yun stated: Hand Taiyin is the Lung Meridian; Foot Shaoyin is the Kidney Meridian. If Cold Qi rises reversely from below, it causes hiccup (Yue). Therefore, one should tonify the Lung above to strengthen Qi and drain the Kidney below to draw out Cold. Generally, Cold transforms from Water. The branch manifestation of hiccup is in the Stomach, but its root lies in the Kidney. Wang Yun stated: Hiccups can be excess or deficiency, cold or heat. The pathological sources and symptoms vary greatly. This text only mentions one aspect. If hiccup is equated with vomiting, then hiccup is also a crucial symptom in disease. Do the two meridians mentioned here ignore this entirely?
Sighing/Xi. Ma Yun explained: "Xi" is pronounced "xu ji". The *Shi Wen* states that sighing without weeping due to grief is called "Xi". Zhang Yun stated: "Xi" is the same as "Xi" (sobbing). The *Shi Yi* says: Sobbing involves choking breath and gasping for air. Some say it is the lingering sound after crying; others say it is grieving without tears. The Qi of sorrow and worry arises from Yin and desolation, thus indicating a pattern of Excess Yin and Deficient Yang.
Tonify Foot Taiyang and drain Foot Shaoyin: Ma Yun stated: One should tonify the point where the Yang Qiao Mai Qi emerges from the Foot Taiyang Bladder Meridian and drain the point where the Yin Qiao Mai Qi emerges from the Foot Shaoyin Kidney Meridian.
Chills/Shivering (Stop) Tonify all Yang meridians: Zhang Yun stated: Chills refer to feeling fearful of cold and shivering. To tonify all Yang means selecting appropriate points among the Yuan-Lu points of the three Yang meridities of the hands and feet, as well as points like Yang Qiao, depending on the situation.
Belching/Yi. Zhang Yun stated: Belching is eructation. The *Shi Yi* defines it as a sigh after a full meal. Note: This section and the previous discussion on hiccup both attribute the condition to Cold Qi in the Stomach. However, the previous text said "because of chronic Cold," implying depth. Here, it says "Cold invading the Stomach," likening it to a guest staying temporarily, implying superficiality. Thus, rebellious Qi scatters upward from below, re-emerges from the Stomach, and causes belching. Jian An noted: The *Shuo Wen* defines "Yi" as a sigh after eating. Ma Yun defined it as an expression of discontent. Interpreting this as one of the "Five Belches" is a significant error.
Tonify Hand Taiyin (Stop) Eyebrow root: Zhang Yun stated: Tonifying the Hand Taiyin and Yangming meridians warms the Spleen and Stomach, causing invading Cold to dissipate gradually and relieving belching. "Meiben" refers to the Cuanzhu acupoint (BL2) of the Foot Taiyang Meridian. This also serves to tonify Yang Qi.
Sneezing. Zhang Yun stated: When Yang Qi is harmonious, smooth, and overflows into the Heart, it must reach the Lungs, emerging from the nose as a sneeze. However, when people sneeze due to wind-cold, it is because Cold pathogens constrict the skin and hair, preventing Yang Qi from venting outward, so it sprays upward. Thus, sneezing originates from Yang Qi, which further confirms this. Zhongjing said: "If one wants to sneeze but cannot, there is Cold in the abdomen." This refers to Yang deficiency. Therefore, if a patient with Yang deficiency suddenly sneezes after a long period of not sneezing, it is a good omen of returning Yang Qi. Jian An noted: The *Shuo Wen* defines sneezing as expelling Qi against resistance. The *Yu Pian* defines it as spraying from the nose.
Tonify Foot Taiyang (Stop) Above the eyebrows: Zhang Yun stated: Whenever Yang is deficient below, it cannot reach above to cause sneezing. Tonifying Foot Taiyang at Meiben, named Cuanzhu, or simply "above the eyebrows," refers to this acupoint. Since Taiyang and Kidney are exterior-interior pairs, this tonifies the Yang within Yin. Observing the *Xuan Ming Wu Qi Pian*: "The Kidney governs yawning and sneezing," aligns perfectly with this meaning.
The *Jia Yi Jing* writes [character missing/unclear], Ma Yun pronounces it "tuo". The commentary describes it as a drooping appearance, meaning the head and body droop and cannot be lifted. Looking at the subsequent text in this classic, which mentions tonifying between muscle layers according to location, [the condition] must have a fixed location and distribution. Interpreting it as "avoidance" (bi) is illogical. (Note: Xiong’s pronunciation allows reversing to 'bi'). Reading it as "duo" (hide) and interpreting it as "avoid" makes no sense. Jian An noted: The *Guang Yun* defines it as a drooping appearance. The *Zheng Zi Tong* states it is a corruption of another character. The *Chao Yuan Fang Lun* in the chapter on Wind Dragging Syndrome states: "Limbs are flaccid and uncontrolled." Humans rely on Stomach Qi to nourish muscles and meridians. If the Stomach declines, Qi becomes insufficient, meridians become weak, and muscles become lax. Thus, Wind pathogens attack tendons, causing dragging/flaccidity, which corresponds to the condition in this section. The *Qian Jin Fang* Pediatrics section mentions inability to walk due to lateral deviation. The Stroke section calls it "dragging." They are consistent. Zhang Yun stated: Common speech uses the term "trembling/shaking," which is an ancient saying. It likely belongs to trembling. Shivering due to cold is called cold chills; trembling not due to cold is caused by Qi deficiency. This error arose from Lou Shigangmu’s Tremor section prescribing formulas for dragging, which should not be followed. Zhi Yun stated: It means hanging the head askew, a lazy posture. Ancient folk songs mention half-hanging hairpins. While true, interpreting it solely as hanging the head is less accurate than Ma Yun’s explanation.
Moving Yin with effort. Zhi Yun stated: Yangming moistens the Zong Jin (General Tendons). If Yangming is deficient, Zong Jin becomes lax. Due to tendon and meridian laxity, Yangming Qi moves to the Zong Jin and exerts effort on the genitalia. Moving Yin with effort prevents Yangming Qi from nourishing the tendons again, leading to [flaccidity/dragging].
The Eyes are the gathering place of Zong Mai (Major Meridians). Zhang Yun stated: "Zong" means total/gathering. The essence of all five Zang and six Fu organs flows upward to the eyes to form vision. Thus, the eyes are the gathering place of major meridians. Ma Yun stated: This section can be cross-referenced with the *Su Wen: Jie Jing Wei Lun*.
Loss of vision. Zhang Yun stated: There are indeed many cases in the world where tears lead to blindness.
Tonify Tianzhu, the meridian runs alongside the neck. The *Jia Yi Jing* adds "alongside the neck" under "Jia Yi". The head is divided in the middle. These seven characters are correct based on the *Jia Yi Jing* below. Ma Yun stated: One should tonify Tianzhu (BL10) of the Foot Taiyang Bladder Meridian. This meridian runs along the back of the neck. Zhi Yun stated: The fluids of the Bladder moisten the empty orifices externally. If the fluid pathways open and tears do not stop, fluids are depleted, and the essence moistening the orifices cannot irrigate the eyes, causing blurred vision. This is called "Duojing" (Depriving Essence), meaning depriving the essence that moistens the external orifices. One should tonify Tianzhu of the Bladder Meridian between the neck to assist fluids in flowing upward, as fluids follow Qi.
Sighing/Taixi (Stop) To extend it. Zhang Yun stated: Taixi refers to long and deep breathing, i.e., sighing. "Yue" means binding/restriction. Worry and thought suppress Qi, preventing it from extending, causing the Xin Mai (Heart Vessel) to tighten and the Qi pathway to bind. Binding causes fullness and oppression in the center, making sighing unavoidable.
Tonify Hand Shaoyin (Stop) Retain the needle. Zhang Yun stated: Hand Shaoyin is the Heart Meridian. Xin Bao (Pericardium) is the Hand Jueyin Meridian. Foot Shaoyang is the Gallbladder Meridian. Assisting the Wood and Fire organs allows Yang Qi to relax and depression to resolve. Therefore, retaining the needle for tonification is suitable for all.
Drooling (Stop) Therefore, drooling. "Xian" (Saliva) is written as "Xian" (Envy/Excess) in the *Jia Yi Jing*, same below. Zhang Yun stated: The Foot Yangming meridian emerges from the mouth. Heat in the Stomach causes parasites to move. Flaccidity of the Stomach opens Lianquan, causing saliva to drop. Similarly, excessive tearing and nasal discharge are due to heat rising and opening fluid pathways. Some say severe Lung heat causes nasal discharge; the principle is similar.
Tonify Foot Shaoyin: Zhang Yun stated: The Kidney is the gate of the Stomach, and its meridian connects to the tongue. Therefore, one should tonify it to strengthen Water to control Fire, giving mastery over fluids so drooling stops naturally.
Tinnitus in the ears (Stop) Therefore, tinnitus. Zhang Yun stated: The three Yang and three Yin meridities of the hands and feet all enter the ears. Thus, the ear is also a gathering place of major meridians. Yangming is the sea of all meridians. If the Stomach is empty, the major meridians become deficient. Deficiency of major meridians prevents Yang Qi from ascending, causing it to sink downward. Downward sinking leads to upper depletion. Mildly, this causes ringing; severely, deafness. However, excessive Shaoyang causing blockage and ringing also exists. But deficiency develops gradually, while excess is sudden. Deficiency is common; excess is rare. The distinction lies in the presence or absence of pathogens. Students should expand upon this. Wang Yun stated: This theory is not recorded in other books, appearing only here. Note: At night, when lying down, the five senses are inactive, except hearing. Is it not because the major meridians gather there, allowing alertness? Also, in the womb, there is only a blood embryo. Hearing thunder or firecrackers causes jumping in fear. At this stage, the five senses are not fully developed, but the nature of hearing is already connected to external objects. Thus, in the *Lankavatara Sutra*'s Twenty-Five Perfect Penetrations, the Ear Root is emphasized alone. Confucius also said, "At sixty, my ear was obedient." Clearly, the ear differs from other organs. Furthermore, this refers to the meaning below: "When Upper Qi is insufficient, the ears suffer from ringing."
Tonify Kerenren (Stop) Intersection. Zhang Yun stated: Kerenren is an acupoint of the Foot Shaoyang Meridian, an intersection of Hand/Foot Shaoyang and Foot Yangming. On the dorsal side of the big toe, near the nail, is Shaoshang (LU11) of the Hand Taiyin Meridian, the Jing-Well point where Lung Qi exits. Both should be tonified to assist Yang Qi.
Biting the tongue. What Qi causes this? Ma and Zhang both state: Missing Qibo's answer.
Meridian Qi arrives in groups. The *Jia Yi Jing* writes "Jie" instead of "Bei". Wu Ben notes: "Bei" is suspected to be an error. Ma reads "Bei Zhi" as "Shi Ran". Zhang Yun stated: "Bei" means category/group. Rebellious Qi moving upward causes blood surging and Qi rising, leading to strange diseases. Each location has its specific area. For example, the Shaoyin meridian runs along the base of the tongue; Shaoyang follows the cheek/jaw; Yangming circles the lips. Thus, swelling or strange itching occurs depending on the location, biting accordingly. It is not limited to the tongue. Zhi Yun stated: The vital Qi of the Kidneys, moving rebelliously upward, meets the meridian Qi generated in the Middle Jiao. The tongue, inside the teeth, turns outward. The lips, outside the teeth, turn inward. The cheeks, beside the teeth, turn inward.
These twelve pathogenic factors. The *Jia Yi Jing* records the *Da Huo Lun* sections on forgetfulness and hunger, totaling fourteen factors. Did Huangfu Mi add them arbitrarily?
Strange pathogens. Zhang Yun stated: Different from common diseases, hence called "Strange Pathogens".
As if collapsing. Zhang Yun stated: "Qing" means heavy and unable to support oneself.
The Stomach causes changes, the Intestines suffer from painful rumbling. Most editions read "Stomach Shi" as "Pian Bian" (Urination and Defecation). This should be corrected. However, Xiong Ben reads "Ling Shi", which is also incorrect. Zhang Yun stated: Water transforms via Qi. Insufficient Middle Qi causes abnormal urination/defecation, appearing yellow/red or short/astringent. This is often due to excessive injury to essence and Qi from desire, labor, and fatigue. Ignorant people generally attribute this to Fire, rarely avoiding error. Moreover, insufficient Middle Qi allows Turbid Qi to reside, causing painful rumbling in the intestines. Wang Yun stated: The *Nei Jing* has no text on seminal emission or white turbidity, only mentioning "Chu Bai Sou" (Discharging White Urine). "Bai" refers to white leukorrhea/emission; "Sou" refers to urine changes. It also states: "Cloudy fluids all belong to Heat."
For Wei Jue (Flaccidity and Cold Extremities), Heart [obstruction]. Zhang Yun stated: "Wei" refers to weak legs. "Jue" refers to cold limbs. "[Character]" means oppression. Insufficiency of Lower Qi prevents interaction between ascending and descending, causing Heart Qi to stagnate and result in oppression.
Tonify below the outer ankle and retain the needle. Zhang Yun stated: This is Kunlun (BL60), a channel point of Foot Taiyang. For conditions of Qi deficiency in the Upper, Middle, or Lower Jiao, retaining the needle for tonification is applicable.
How to treat? Zhang Yun stated: The following questions regarding treatment methods supplement the omissions in the previous text.
The Kidney governs yawning. Zhang Yun stated: The previous text did not specify the Kidney, so this clarifies it.
The Lung governs hiccup. Zhang Yun stated: The previous text said hiccup originates from the Stomach; this says it is governed by the Lung. Cold Qi rebelling upward causes hiccup; the Qi pathology is in the Stomach but governed by the Lung.
Xi (Sighing) (Stop) Drain Foot Shaoyin. The *Jia Yi Jing* writes "Sheng" instead of "Yu". Zhang Yun stated: If Yin and Yang are severed, Yang cannot attach to Yin. Tonifying Yang and draining Yin creates harmony between rigid and flexible, resolving discord.
Chills (Stop) Below the outer ankle, retain the needle. Zhang Yun stated: All treatments are the same as above.
Puncture between the big toes (Stop) Below the outer ankle, retain the needle. Zhang Ben omitted the character "Wai" (Outer). Zhang Yun stated: Two cun above the space between the big toes is Dazhong (KI4) of Foot Jueyin. Or it may be Taibai (SP3) of Foot Taiyin. This differs slightly from the previous text. The meaning of retaining the needle below the outer ankle is as previously stated.