Library

Patients suffering from Heart Heat Disease (Xin Re Bing) first experience several days of unhappiness, followed by fever. When heat struggles with righteous qi (Zheng Qi), sudden heart pain, irritability, frequent vomiting, headache, flushed face, and anhidrosis (absence of sweating) occur. The condition worsens on Ren-Gui days (days associated with Water), and if profuse sweating occurs on Bing-Ding days (days associated with Fire), the disease resolves. If qi mechanism becomes rebellious, death may ensue on Ren-Gui days. Treatment involves needling the Hand-Shaoyin (Heart) and Hand-Taiyang (Small Intestine) meridians.

The vitalizing yang qi of the five zang organs begins with Liver Wood; Wood generates Fire, Fire generates Earth, Earth generates Metal, Metal generates Water, and Water generates Wood again. This continuous cycle ensures health and absence of disease, a principle detailed in the opening section of the "Origin of Constitution" chapter. If pathogenic factors lie dormant within blood and qi, they inevitably move along with the vitalizing yang qi; when movement is vigorous, disease manifests. Thus, its manifestation follows the flow of qi without a fixed location. Therefore, the *Nan Jing* states that the pulse of warm diseases travels through various meridians, making it unclear which meridian's qi is moving; one should select points according to the location of each affected meridian. Hence, observing current symptoms is necessary to determine which meridian the pathogen originates from. This text arranges symptoms according to the sequence of generating qi (Wu Xing Sheng cycle), listing Liver disease first, followed by Heart, Spleen, Lung, and Kidney. As Zhang Zhongjing discussed, the transmission of pathogens also lacks a fixed pattern, which can be cross-referenced with this classic to clarify the principles. For instance, if pathogenic heat emerges from the Heart Meridian, the patient first feels unhappy for several days (manifesting as internal restlessness); heat struggle causing qi rebellion leads to sudden heart pain and increased irritability; invasion of the Stomach causes vomiting; since the Heart and Small Intestine are exterior-interiorly related, and the Small Intestine meridian ascends to the head and face, heat exiting from interior to exterior results in headache and flushed face; closed cou-li (pores) result in anhidrosis. Ren-Gui corresponds to Water; Small Intestine corresponds to Bing Fire, and Heart to Ding Fire. Since Water overcomes Fire, the condition worsens on Ren-Gui days. Bing-Ding correspond to Fire and are prosperous; profuse sweating leads to resolution. If qi rebels, prosperous Water extinguishes Fire, leading to death. Needling the Hand-Shaoyin Heart and Hand-Taiyang Small Intestine meridians aims to drain the pathogen. One might ask: This chapter divides heat diseases of the five zang organs; does this not include pathogens transmitted from exterior to interior? Can you explain them all as latent pathogens emerging from within? I reply: Exterior pathogens transmitting to interior were clearly described in the previous chapter, starting with Taiyang on day one up to Jueyin on day six. This chapter mentions yellow urine appearing first, unhappiness preceding fever, etc., indicating interior symptoms manifest before disease onset, proving these are latent pathogens emerging from within. Furthermore, the previous chapter concluded that meat should be avoided after residual heat, exhausting that logic. The statement "any cold damage becoming warm disease" serves as the outline for this chapter. The discussion following Liver Heat Disease clarifies warm diseases occurring before the Summer Solstice; severe warmth becomes heat disease. Later scholars, unaware of this, due to the chapter title "Needling Heat," separated the outline into the previous chapter. Careful reading shows this separation is redundant. Since the beginning already states that cold injury leads to heat disease, explaining the logic fully, repeating "cold damage becoming warm" is indeed redundant. The core meaning lies in "before Summer Solstice" and "after Summer Solstice," specifically discussing the principle of latent pathogens changing disease nature with climate. Thus, this was likely the original outline, corrupted by later fragmentation. Moreover, the summary at the end states: "For Liver Heat Disease, redness appears on the left cheek first..." teaching practitioners to needle upon seeing color changes before latent pathogens emerge, termed "treating disease before it arises." This further proves the point. Additionally, diseases of the five zang organs require prosperous qi times for pathogens to move from interior to exterior and resolve via sweating. This contrasts with the progression from Taiyang to Jueyin, representing an exit vs. entry distinction. Thus, highlighting Liver and Heart Heat Diseases clarifies pathogens moving from interior to exterior, contrasting with those moving from exterior to interior. Why do readers and commentators remain oblivious and negligent? Some ignorant individuals deny the existence of latent pathogen emergence; for such people, discussing these scriptural meanings is futile.