Library

The Yellow Emperor asked: In cases of warm diseases, the patient sweats and then immediately fever returns, with a rapid and restless pulse that does not diminish after sweating. The patient also exhibits delirious speech and inability to eat. What is the name of this disease?

Qibo replied: This disease is named "Yin-Yang Jiao" (Crossing of Yin and Yang). "Jiao" indicates a critical condition where death is inevitable.

In the human body, Qi of Yin and Qi of Yang should originally interact and generate each other. However, due to the rampant pathogenic factors, external pathogenic factors affecting the Yang aspect combine with internal pathogenic factors arising from the Yin aspect, merging into one. This leads to the exhaustion of the primordial righteous Qi. Therefore, it is named "Yin-Yang Jiao" resulting in death, which is distinct from the normal interaction of righteous Yin and Yang Qi. The following text elucidates the rationale behind this.

Sweat in humans originates from grain (food), and grain essence is generated from Jing (Essence). When pathogenic factors contend between the muscles and bones, if sweat occurs, it indicates that the pathogen is retreating and the Jing is prevailing. If Jing prevails, the patient should be able to eat and the fever should not return. The recurrence of fever indicates the presence of pathogenic factors; the sweat represents the leakage of Jing. Now, since sweating is followed immediately by fever, it signifies that the pathogen is prevailing. The inability to eat means that Jing lacks support (Bi: assistance/supplement). With the disease lingering in this state, life can collapse at any moment. Furthermore, the *Neijing·Re Lun* (Treatise on Cold Heat) states: "If there is sweating but the pulse remains rapid and vigorous, death ensues." Since the pulse does not correspond to the state after sweating, it shows that the righteous Qi cannot overcome the disease; thus, death is evident. Delirious speech indicates the loss of Zhi (Will/Shen), and loss of Zhi leads to death. Currently, three signs of death are present, while no sign of life is visible. Even if recovery seems apparent, death is certain.

The phrase "sweat is born from grain, grain is born from Jing" refers to the transformation of food and water into Jin-Ye (Body Fluids) by the primordial Jing-Qi, which then disperses as sweat. If pathogens are expelled with the sweat, the pathogen retreats and Jing prevails. When Jing prevails, the patient can eat to transform food and water; since the pathogen has been expelled, fever will not return. The current recurrence of fever indicates that the pathogen has not left, and the sweat merely represents a futile leakage of Jing. Therefore, sweating followed immediately by fever indicates that Jing is retreating and the pathogen is prevailing. The inability to eat is because Jing lacks support ("Bi" means reliance or supplementation). Although the disease lingers, life can end instantly. Ancient texts state: "Sweating with a rapid and vigorous pulse indicates death." If the pathogen were gone and Jing preserved, the pulse would necessarily be calm. Since the pulse does not correspond to the sweating, it proves that the pathogen remains and Jing cannot overcome the pathogenic Qi; death is clear. Additionally, delirious speech is loss of Zhi, and loss of Zhi leads to death—this is the first sign of death; sweating followed by fever, indicating Jing's retreat and pathogen's victory—is the second sign; the mismatch between pulse and sweating is the third sign. With three signs of death present and no sign of life, even if it appears to recover, death is inevitable.