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Yellow Emperor asked: There is a patient with strangury (癃, difficulty in urination), who urinates dozens of times a day. This indicates deficiency (不足). The body is hot as if it were a charcoal brazier, the neck and chest feel obstructed or blocked (格), the Renying pulse (Renying, ST9) is agitated and vigorous, breathing is rapid with rebellious Qi. This indicates excess (有余). The Taiyin pulse is faint and thin like a hair, which also indicates deficiency. Where is the disease located? What is its name? Qibo replied: The disease is in the Taiyin, its excess lies in the Stomach, and it significantly involves the Lung. The disease is named Jue (厥, reversal/cold extremities syndrome), and it is untreatable death. This is what is called "five excesses and two deficiencies." The Yellow Emperor asked: What do you mean? Qibo said: The so-called five excesses refer to the excess of five pathogenic Qi factors; the two deficiencies also refer to the insufficiency of pathogenic Qi. Now, externally there are five excesses, and internally there are two deficiencies. The condition of this person is neither in the exterior nor in the interior, which is clearly a sign of death.

Kidney deficiency leads to heat in the Bladder. Heat causes strangury and obstruction; deficiency leads to an inability to consolidate and control, resulting in dozens of urinations per day. This is a disease of deficiency. Body heat like charcoal is due to the closure and binding of exterior pathogens; the feeling of obstruction in the neck and chest is due to the rejection by interior pathogens; the agitation and vigor of the Renying pulse on the side of the neck, along with panting and rebellious Qi, are all signs of excess pathogenic factors. The Taoyin Cun Kou pulses (Cunkou, Radial Artery at wrist) are faint and thin like hair, indicating exterior excess and interior insufficiency. The deficiency lies in the Taiyin (Lung/Spleen), while the excess lies in the Yangming (Stomach/Large Intestine). Since the Lung and Stomach are connected, Stomach Qi rebellion affects the Lung, causing panting. This is named Jue disease. With righteous Qi deficiency and pathogenic excess, Yin and Yang undergo Jue reversal. Attempting to treat the five excesses of exterior pathogens requires purging, but interior insufficiency prevents this; attempting to tonify the two deficiencies of original Qi meets rejection from exterior pathogens, preventing tonification. Inability to treat the exterior and inability to treat the interior constitute clear evidence of death. Zang organs belong to Yin, Fu organs belong to Yang. A Taiyin pulse like a hair indicates exhaustion of Zang Yin; an agitated Renying pulse indicates depletion of Fu Yang. Exhaustion of Yin and depletion of Yang lead to untreatable death.

In the *Suwen: Wei Lun* (Treatise on Flaccidity Syndromes), the Yellow Emperor asked: How can the Five Zang organs cause Wei syndromes (痿证, flaccidity syndromes)? Qibo replied: The Lung governs the skin and hair of the body; the Heart governs the blood vessels; the Liver governs the tendons and fascia; the Spleen governs the muscles; the Kidney governs the bones and marrow. Therefore, if Lung heat scorches the leaves, the skin and hair become weak, tight, and thin, leading to Pi Wei (皮痿, skin flaccidity); if Heart Qi is hot, lower vessel Qi reverses upward, making the lower vessels deficient, leading to Mai Wei (脉痿, vessel flaccidity), where the pivot breaks, the shins are flaccid and cannot support the body's weight; if Liver Qi is hot, Gallbladder bile leaks causing bitter taste, tendons become dry, leading to tendon spasm and contraction, developing into Jin Wei (筋痿, tendon flaccidity); if Spleen Qi is hot, the Stomach becomes dry causing thirst, muscles become insensate, developing into Rou Wei (肉痿, muscle flaccidity); if Kidney Qi is hot, the waist and spine cannot move, bones become withered and marrow decreases, developing into Gu Wei (骨痿, bone flaccidity).

The Qi inside and outside the body is regulated and distributed by the Lung. If Lung heat scorches the leaves, Qi cannot circulate, and there is no fluid to moisten the skin and hair, causing them to be weak, tight, and thin. "Zhuo" (着) refers to dryness, stagnation, and lack of softness in skin, flesh, blood, and Qi; "Wei" (痿) refers to difficulty in walking. Heart Qi heat causes Yang to rise and vessel Qi to reverse upward, making the lower part deficient. Vessels are the pivots of the limbs; Mai Wei causes pivot failure, with Qi rising and lower deficiency, causing flaccid shins unable to bear weight. Liver Qi heat causes bile leakage and bitter taste, drying tendons and causing Jin Wei. The Spleen transports fluids for the Stomach; Spleen Qi heat dries Stomach fluids causing thirst, failing to nourish muscles, leading to insensibility and Rou Wei. The Kidney stores essence and governs bones; Kidney Qi heat consumes essence, withering bones and reducing marrow, causing immobility of the waist and spine and Gu Wei. These Wei syndromes are all caused by pathogenic heat, mostly resulting from internal injury to the Zhen Qi (True Qi) of the Zang organs. It is essential to differentiate between deficiency and excess for treatment.