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In the "Bai Bing Shi Sheng Pian" (Chapter on the Origin of Hundred Diseases) of the *Ling Shu* (Spiritual Pivot), the Yellow Emperor asked: The origin of all diseases arises from wind, rain, cold, and heat, clear dampness, and joy and anger. If joy and anger are not regulated, they damage the Zang organs; wind and rain damage the upper part; clear dampness damages the lower part. The Qi of these three parts differs in what it damages. I wish to hear how they intersect. Qibo replied: The Qi of the three parts is different; some originate from Yin, some from Yang. Please allow me to explain the principles. Unregulated joy and anger damage the Zang organs; since Zang organs belong to Yin, disease originates from Yin. Clear dampness invading deficiency causes disease to originate from below; wind and rain invading deficiency cause disease to originate from above. This is called the Three Parts. As for their spreading and transformation, there are countless variations.

This passage generally categorizes exogenous and endogenous diseases, distinguishing them by dividing into three parts. Joy and anger encompass the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). The Seven Emotions damage the Zang organs; since Zang organs are Yin, disease originates from Yin. Wind and rain pathogens are received from above; the upper part is Yang, so disease originates from Yang. Clear dampness refers to cold-dampness; its pathogen is received from below. The lower part corresponds to the Foot meridians, which contain both Yin and Yang, so disease may originate from Yin or Yang, and must be differentiated according to the syndrome. As for the spreading of disease, like flooding water, its changes are countless.

The Yellow Emperor said: I wish to hear this principle in detail. Qibo said: Wind, rain, cold, and heat, if not acting as Empty Pathogens (Xu Xie, pathogenic factors taking advantage of bodily weakness), cannot injure people alone. Those who suddenly encounter fierce winds and heavy rains without getting sick do so because they lack deficiency; thus, pathogens cannot injure alone. It is necessary for an Empty Pathogen wind to meet with bodily deficiency. When two deficiencies meet, the pathogen resides in the body. When two realities meet (robust constitution and strong pathogen?), the flesh remains firm. Contracting empty pathogens depends on heavenly timing and bodily condition, combined with assessment of deficiency and excess, leading to major illness. Qi has fixed abodes; names are given based on location, divided into Upper, Middle, and Lower sections. Therefore, when empty pathogens enter humans, they start at the skin. If the skin is lax, the Cou Li (pores/clefts) open; when open, pathogens enter via hair follicles. Upon entering, they reach depth; at depth, hair stands erect. Erect hair causes a sensation of chilliness (Sa Ran), hence skin pain. If lingering and not expelled, they transmit to the Luo vessels (Collaterals). At the stage of the Luo vessels, muscle pain occurs; this pain may cease intermittently, while the larger meridians take over symptoms. If lingering further, they transmit to the Jing meridians (Main Meridians). At this stage, one feels chilly and prone to fright. If lingering further, they transmit to the Fu Chong Mai (Hidden Rush Vessels). At this stage, the body feels heavy and painful. If lingering further, they transmit to the intestines and stomach. At this stage, there is rushing sounds and abdominal distension; excessive cold leads to borborygmus and undigested stool diarrhea; excessive heat leads to loose, mushy stools. If lingering further, they reside outside the intestines and stomach, between the Mu Yuan (Moyuan/Roots of the Peritoneum), staying within the vessels. Lingeringly remaining, they gradually form Jis (Accumulations/Masses). They may attach to Sun Luo vessels (Branch Collaterals), Luo vessels, Jing meridians, Shu vessels, Fu Chong Mai, Lv Jin (Spinal Muscles/Tendons), or the Mu Yuan of the intestines and stomach, connecting upwards to Huan Jin (Relaxing Tendons). The spreading of pathogens is incalculable.

Ordinary wind, rain, cold, and heat cannot injure people; it requires the meeting of Empty Pathogen winds and bodily deficiency. When two deficiencies meet, the pathogen resides. Generally, wind coming from behind the Tai Yi palace (referring to celestial directions) is an Empty Pathogen; wind coming from the front is a Real Pathogen (Shi Xie). Detailed meanings are found in the previous volume, *Ling Shu*, "Jiu Gong Ba Feng Pian". If the body is solid and the pathogen is real, their meeting results in firm flesh that resists injury. If heavenly timing and bodily condition involve mixed deficiency and excess, contracting the pathogen leads to major illness. Pathogens residing in the body have fixed abodes; disease names are established based on the pathogen's location, divided into Upper, Middle, and Lower parts. Vertically, there are the Triple Burner (San Jiao); horizontally, there are Exterior, Interior, and Middle layers. Empty pathogens entering humans start at the skin. Lingering and not expelled, they gradually deepen, each stage having observable signs. If not treated according to the syndrome, the disease root becomes deep and stubborn. Initially, the pathogen's transmission is不定 (uncertain), shallow or deep, lingering to cause disease. Prolonged lingering leads to the formation of Jis (Accumulations), ceasing transmission as it binds with Qi and Blood to form stasis. Thus, the spreading of pathogens is incalculable.

The Yellow Emperor said: I wish to hear the reasons for their formation in full. Qibo said: For Jis formed by attachment to Sun Luo vessels, the accumulation moves up and down. Since the arms and hands are where Sun Luo vessels reside, and these vessels are superficial and lax, they cannot confine the accumulation, causing it to migrate between the intestines and stomach. Fluids gather and permeate, making a gurgling sound (Zhuo Zhuo). With cold, there is fullness, rumbling, and traction, causing sharp pain. For those attaching to the Yangming Meridian, the accumulation resides flanking the navel; it enlarges after eating and shrinks when hungry. For those attaching to Huan Jin, it resembles Yangming accumulations; it hurts after eating but is comfortable when hungry. For those attaching to the Mu Yuan of the intestines and stomach, pain radiates outward to the Huan Jin; it is comfortable after eating but hurts when hungry. For those attaching to the Fu Chong Mai, palpation reveals pulsation under the fingers; upon releasing pressure, heat flows down to the thighs, resembling hot water pouring. For those attaching to Lv Jin behind the intestines and stomach, the accumulation appears when hungry and disappears when full; it cannot be felt by pressing. For those attaching to Shu vessels, blockage prevents fluids from descending, causing dryness and obstruction of orifices. These describe pathogens entering from outside to inside, from top to bottom.

Fine collaterals floating in the skin are called Sun Luo vessels. Slightly deeper and thicker ones are called Da Luo vessels. Da Luo vessels connect internally to Jing meridians; Yang meridians connect to Fu organs, Yin meridians to Zang organs. Thus, Yin meridians are deeper than Yang meridians. Since meridians have Yin and Yang, collaterals also have Yin and Yang. Qi and Blood circulate internally and externally, reaching everywhere. When pathogens reside, Qi and Blood stagnate, eventually knotting into Jis. Accumulations in Sun Luo vessels move up and down because the arms and hands are their residence; their Qi is superficial and lax, unable to stop the accumulation, so it migrates to the intestines and stomach. The intestines and stomach are places where fluids pour and seep; pathogens gather from the side, causing gurgling sounds. If cold accumulation, fullness and rumbling occur, causing sharp pain due to collateral blockage and stagnant Qi. If attaching to the Stomach Meridian of Yangming, it resides flanking the navel because Qi gathers there. After eating, Stomach Qi overflows into the meridian, enlarging the mass; when hungry, Qi dissipates, shrinking it. The meridian lies in flesh without touching the stomach wall directly, lacking tangible obstruction, so no pain. Attaching to Huan Jin, which adheres to the stomach, resembles Yangming accumulation. Because it adheres to the stomach, fullness causes swelling and stimulation, leading to pain; hunger brings relief. Attaching to the Membrane Source (Mu Yuan) of the intestines and stomach, which shields turbid Qi in the stomach, hunger triggers deficient fire causing pain; fullness extinguishes fire, bringing relief. Pain connecting to Huan Jin occurs because Huan Jin is a branch of the Mu Yuan. Attaching to Fu Chong Mai, located in the back muscles where Ying Qi circulates, blockage by the accumulation causes pulsation on palpation. Releasing pressure disperses Qi flow, causing heat to rush down to the thighs like hot water. Accumulation on Lv Jin, behind the intestines and stomach, appears when the intestines/stomach are empty (hungry) and disappears when Qi fills them (full). Being deep in the body behind the viscera, it cannot be palpated. Accumulation on Shu vessels causes blockage, preventing fluid descent, leading to dryness in the bowels. These all describe the formation of Jis from external-to-internal and superior-to-inferior pathogen entry.