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Yellow Emperor asked: In Jue syndrome, some cases cause abdominal fullness, some cause sudden loss of consciousness, and some take half a day or even a full day to regain consciousness. What is the reason for this? Qibo replied: When Yin Qi (Yin energy) is excessive in the upper part, the lower part becomes deficient. Deficiency in the lower part leads to abdominal distension and fullness. When Yang Qi (Yang energy) is excessive in the upper part, the Qi from below rises repeatedly, causing pathogenic factors to reverse. Reversal leads to chaos in Yang Qi, and chaotic Yang Qi results in unconsciousness. "Jue fullness" refers to abdominal distension caused by Qi reversal, due to excess Yin in the upper part and deficiency in the lower part. Generally, Yin cannot generate without Yang, and Yang cannot transform without Yin. If there is deficiency of Yin in the lower part, the Yang Qi of the Lower Jiao (Lower Burner) cannot diffuse and transform, leading to upward congestion, thus causing abdominal fullness. Excess Yang in the upper part occurs because Yang Qi from the Lower Jiao rises heavily; hyperactive Yang transforms into pathogenic factors and reverses. Reversal disrupts harmonious Qi, causing the Shen Spirit (Spirit/Mind) to fly away, resulting in coma and unconsciousness. The severity of Jue varies; some last half a day, others a day, and recovery occurs only when Qi returns to smooth flow. The above explains Cold-Heat Jue, while this section explains Yin-Yang Jue.

The Yellow Emperor said: I wish to hear about the manifestations and pathology of Jue in the six meridians. Qibo said: In Taiyang (Greater Yang) Jue, there is swelling of the head, heaviness in the head, inability to walk, and sudden collapse. In Yangming (Bright Yang) Jue, there is manic disorder with desire to run and shout, abdominal fullness preventing sleep, red and hot face, visual hallucinations, and delirious speech. In Shaoyang (Lesser Yang) Jue, there is sudden deafness, swollen and hot cheeks, hypochondriac pain, and difficulty moving. In Taiyin (Greater Yin) Jue, there is abdominal fullness, constipation, anorexia, vomiting after eating, and insomnia. In Shaoyin (Lesser Yin) Jue, there is dry mouth, dark urine, abdominal fullness, and heart pain. In Jueyin (Terminal Yin) Jue, there is swelling and pain in the lower abdomen, abdominal distension, difficulty urinating and defecating, preference for lying curled up with knees flexed, contraction and swelling of the genitals, and internal heat. For excess conditions, use draining methods; for deficiency conditions, use tonifying methods; for neither excess nor deficiency, treat the affected meridian directly. The following details Jue syndromes, clarifying that Jue is not limited to cold and heat in the hands and feet, but includes any condition where external pathogens or internal injuries cause imbalance of Qi and Blood, excess or deficiency, leading to disharmony of Yin and Yang and failure of meridians to circulate in order. Juyang is Taiyang. The Taiyang meridian is vigorous at the head; in Jue, its Qi becomes even more excessive in the upper part, causing head swelling and heaviness. Upper excess leads to lower deficiency, hence the inability to walk. Collapse refers to dizziness and falling, caused by Yin deficiency, instability of the root, and violent rebellion of Yang Qi. Yangming distributes Qi to the three Yang meridians. When pathogenic heat is excessive, Water fails to control Fire, and solitary Fire disturbs the Shen Spirit, causing mania, running, shouting, red face, heat, hallucinations, and delirium. This corresponds to the excess patterns treated by the Three Chengqi Decoctions. The Jue of Shaoyang and the three Yin meridians shares similar pathology and principles with those described in Zhang Zhongjing's *Treatise on Cold Damage* (*Shanghan Lun*). Understanding one illuminates the other, though differences in excess and deficiency exist, which are detailed later under Zhang Zhongjing's clauses. The statement "tonify or drain according to the meridian" refers to acupuncture techniques. Although named Jue of the Six Meridians, these often present as Zang-Fu symptoms because the six meridians connect internally to the Zang-Fu organs.

In Taiyin Jue, there is acute spasm, heart pain radiating to the abdomen; treatment should target the primary diseased organ. In Shaoyin Jue, there is vacuous fullness and vomiting, progressing to clear diarrhea; treatment should target the primary diseased organ. In Jueyin Jue, there is spasm, waist pain, vacuous fullness, urinary retention, and delirium; treatment should target the primary diseased organ. If all three Yin meridians are in Jue, with inability to pass stool and urine, causing cold limbs, death occurs within three days. In Taiyang Jue, there is rigidity and collapse, hematemesis, and frequent epistaxis; treatment should target the primary diseased organ. In Shaoyang Jue, there is dysfunction of joints. Dysfunction of joints means inability to walk due to waist stiffness and inability to look back due to neck stiffness. It may develop into intestinal abscess, which is incurable. Cases involving fright result in death. In Yangming Jue, there is wheezing, coughing, body heat, frequent fright, epistaxis, and hematemesis. In Hand-Taiyin Jue, there is vacuous fullness and cough, frequent vomiting of frothy saliva; treatment should target the primary diseased organ. In Hand-Jueyin Pericardium and Hand-Shaoyin Heart Jue, there is heart pain radiating to the throat and body heat. This is incurable and fatal. In Hand-Taiyang Jue, there is deafness, tearing, inability to look back, and inability to bend or extend the waist; treatment should target the primary diseased organ. In Hand-Yangming Large Intestine and Hand-Shaoyang Sanjiao Jue, there is Bi obstruction of the throat, pharyngeal swelling, and spasms; treatment should target the primary diseased organ.

According to the previous volume on Ying-Wei (Nutritive-Defensive) and Meridians, under the twelve meridians, diseases of Zang meridians are stated as "governing diseases generated by that Zang," while diseases of Fu meridians are stated as "governing diseases of fluids," "Qi," or "Blood," etc., varying by meridian. This indicates that diseases originate from these sources. Human generation begins with the five Zang forming the structure, and Zang Qi generating the six Fu for function. Thus, Zang stores essence and Qi without leaking, representing stable structure; Fu transmits and transforms substances without storing, representing dynamic function. Sinews, bones, blood, Qi, fluids, and meridians are further generated from Fu Qi, serving Fu functions. Therefore, Zang meridian diseases arise from the Zang structure itself, hence "governing diseases of that Zang." Fu meridian diseases arise from functional transformation, hence governing Qi, Blood, sinews, etc. This passage on Taiyin Jue refers to diseases governed by the Spleen. The Spleen is the Foot-Taiyin meridian, so foot spasms occur. The Spleen resides in the abdomen and connects to Heart Qi, causing heart pain radiating to the abdomen; thus, it should be treated via the Spleen Zang. The same logic applies subsequently. Shaoyin Jue refers to diseases governed by the Kidney. The Kidney governs the Lower Jiao; Jue of the Lower Jiao causes Qi stagnation in the Middle Jiao, leading to vacuous fullness and vomiting. Vomiting allows Qi to flow, leading to clear diarrhea. Clear diarrhea means thin stools due to undigested food in the Middle Jiao. Jueyin Jue refers to diseases governed by the Liver. The Liver governs sinews, causing spasms. Liver and Kidney share the same source, causing waist pain. Liver Qi rebelling horizontally causes vacuous fullness. The Liver governs urinary retention, causing genital blockage. The Liver houses the Hun Soul; Liver Jue damages the Hun, causing delirium or apparent death. If all three Yin meridians are in Jue, Liver, Spleen, and Kidney are injured, blocking bowel and bladder movements, causing cold limbs. Complete internal-external Qi reversal leads to death if not resolved within three days. Taiyang Bladder meridian Jue governs diseases of sinews. Sinew disease causes rigidity and collapse. Yang Qi reversal causes blood to spill recklessly, leading to hematemesis and epistaxis. Shaoyang Gallbladder meridian Jue governs diseases of bones. Located between exterior and interior, near bones, it acts as the pivot for Qi entry and exit. Jue breaks the pivot, causing bone disease and joint dysfunction. Bones derive from Kidney, causing waist immobility. Meridian Qi ascends to the neck, causing neck stiffness. Internal Yang stagnation generates heat, combining with turbid Qi in the intestines to form abscesses. The Gallbladder connects to the Liver; Liver injury causes fright. Combined Zang-Fu injury makes it incurable and fatal. Yangming Stomach meridian Jue governs diseases of Blood. Lung and Stomach are connected; Stomach Qi rebelling into the Lung causes wheezing and coughing. Spleen and Stomach govern flesh, causing body heat. Liver stores Blood, Heart governs Blood; Yangming is abundant in Qi and Blood. Diseases of Blood activation stir Heart and Liver fire, causing fright, epistaxis, and hematemesis. Hand-Taiyin Jue governs diseases of the Lung. Lung Qi rebellion causes vacuous fullness and cough. Froth originates from the Lung, causing vomiting of froth. Hand-Jueyin Pericardium and Hand-Shaoyin Heart Jue involve Pericardium and Heart rebellion. Pericardium governs Blood vessel diseases; Heart governs Heart organ diseases. Heart pain radiating to the throat and body heat occur because the Heart is near the throat; Heart Fire rebellion causes heat. As stated in the meridian text, "Heart diseases" refer to Pericardium receiving pathogens. The Heart is solid and does not receive pathogens; if it does, the Spirit departs and death ensues. "Incurable death" here indicates Heart injury. Hand-Taiyang Small Intestine meridian Jue governs diseases of fluids. The Small Intestine is the official of reception and transformation, transforming fluids from food and water. Jue prevents fluid transformation, causing disease. Its branch meridian runs to the eyes and ears, causing deafness, tearing, and neck stiffness. Upward Qi rebellion causes lower deficiency and rotational failure, leading to stiff waist unable to bend or extend. Hand-Yangming Large Intestine meridian governs diseases of Jin-Ye (Fluids). Hand-Shaoyang Sanjiao meridian governs diseases of Qi. Jue of these two meridians blocks Qi and fluid transport. Stagnant Yang transforms into Fire and flares upward, causing throat Bi obstruction and pharyngeal swelling. Lack of fluid transport causes dry sinews and spasms (Jing). All these should be treated by targeting the governing Zang-Fu.