Library

Huangdi asked: There is a condition characterized by swelling of the chest and neck, fullness in the chest, and distension of the abdomen. What disease is this? How did it arise? Qibo replied: It is named Jue Ni (Jue-Ni, reversal counterflow). Huangdi asked: How should it be treated? Qibo replied: If moxibustion is applied, aphonia (loss of voice) will result; if Bian Shi (stone lancet therapy) is used, mania will ensue. One must wait until the Qi merges harmoniously before treatment can proceed. Huangdi asked: Why is this so? Qibo replied: This occurs because Yang Qi is heavy and reverses upward, being excessive in the upper body. If moxibustion is applied, Yang Qi enters the Yin aspect; entering Yin leads to aphonia. If stone lancets are used to drain, Yang Qi becomes deficient; deficiency leads to mania. Treatment must await the merging of Qi to ensure recovery.

This condition is named Jue Ni precisely because Yang Qi overlaps and reverses upward. The root cause of this Yang reversal is the failure of Yin Qi to secure itself. If fire moxibustion is further applied, forcing Yang into Yin, Qi will dissipate, and Fire pathogenic factors will damage the Lung, resulting in aphonia. "Stone" refers to Bian Shi (lancet therapy), which further drains Qi. When Qi is drained, Yang becomes deficient, and without the master control of the Heart Spirit (Shen), confusion and mania occur. However, this is not mania caused by excess real fire; the condition is critical. Therefore, moxibustion and Bian Shi methods are contraindicated. Generally, Jue syndrome involves the rejection and reversal of Yin and Yang. One must wait for the two Qi to merge and for Yin and Yang to gradually harmonize before regulating the body, thereby preserving life.

In *Su Wen: Bing Neng Lun*, Huangdi asked: A patient suffers from Jue syndrome. Palpation reveals a deep and tight pulse on the right side, and a floating and slow pulse on the left side. I do not know where the primary pathology lies. Qibo replied: If diagnosed in winter, the right pulse being naturally deep and tight corresponds to the four seasons and is normal. The left pulse being floating and slow violates the seasonal norms. Abnormality in the left pulse indicates the pathology is primarily in the Kidney, closely related to the Lung, and the patient likely suffers from lower back pain. Huangdi asked: Why do you say so? Qibo replied: The Shaoyin (Lesser Yin) channel penetrates the Kidney and connects with the Lung. Now that a Lung pulse pattern is obtained, it indicates disease in the Kidney; thus, Kidney deficiency is the cause of the lower back pain.

During winter, Yang Qi returns to storage. A deep and tight pulse conforms to the season and indicates no disease. The current floating and slow pulse on the left violates the seasonal norm. The violation is on the left, indicating the pathology is on the left (associated with the Kidney/Water). This is due to Kidney Water deficiency causing Yang to float and ascend, resulting in Jue syndrome. Since the Kidney channel connects to the Lung, the pathology involves the Lung. Floating is the pulse image of the Lung, but the primary pathology lies in Kidney deficiency. The waist is the residence of the Kidney; therefore, lower back pain must occur.