《六节脏象论》曰∶天以六六之节,以成一岁,人以九九制会,计人亦有三百六
十五节以为天地久矣。(六六之节,谓六竟于六甲之日,以成一岁之节限。九九制会,谓九周于九野之数,
以制人形之会通也。言人之三百六十五节,以应天之六
六之节久矣。)夫六六之节,九九制会者,所以正天之度,气之数也。(六六之节,天之度也。九
九制会,天之数也。所谓气数者,生成之气也。周天之分,凡三百六十五度四分度之一,以十二节气均之,则
气有三百六十日而终,兼之小月,日又不足其数矣。是以六十四气而常置闰矣。何者?以其积差分故也。天地
之生育,本 于阴阳,人神之运为,始终于九气,然九之为用,岂不大哉!《律书》曰∶黄钟之律,管长九寸,
冬至之日,气应灰飞,由此则万物之生,咸因于九气矣。古之九寸,即今之七寸三分,大小不同,以其先 黍之
制而有异也。)天度者,所以制日月之行也。气数者,所以纪化生之用也。(制,谓准度。纪,谓
纲纪。准日月之行度者,所以明日月之行迟速也;纪化生之为用者,所以彰气至而斯应也。气应无差,则生成
之理不替,迟速以度,大小之月生焉。故日异长短,月移寒暑,收藏生长,无失时宜也。)天为阳,地为阴;
日为阳,月为阴;行有分纪,周有道理,日行一度,月行十三度而有奇,故大小月三
百六十五日而成岁,积气余而盈闰矣。(日行迟,故昼夜行天之一度,而三百六十五日一周天,而犹
有度之奇分矣。月行速,故昼夜行天之十三度余,而二十九日一周天也。言有奇者,谓十三度外,复行十九分
度之七,故云月行十三度而有奇也。《礼义》及汉《律历志》云∶二十八宿及诸星,皆从东而循天西行,日月及
五星,皆从西而循天东行,今太史说云∶并循天而东行,从东而西转也。诸历家说∶月一日至四日,月行最疾,日
夜行十四度余,自五日至八日行次疾,日夜行十三度余,自九日至十九日,其行迟,日夜行十二度余,二十日至
二十三日行又小疾,日夜行十三度余,二十四日至晦日,行又大疾,日夜行十四度余。今太史说∶月行之率不如
此矣,月行有十五日前疾,十五日后迟者,有十五日前迟,有十五日后疾者,大率一月四分之,而皆有迟疾,迟
速之度固无常准矣。虽尔,终以二十七日,月行一周天,凡行三百六十一度。二十九日日行二十九度,月行二百
八十七度,少七度而不及日也,至三十日,日复迁,计率至十三分,日之八,月方及日矣,此大尽之月也。大
率其计率至十三分日之半者,亦大尽法也。其计率至十三分之五之六而及日,小尽之月也。故云大小月三百六
十五日而成岁也。正言之者,三百六十五日四分日之一乃一岁,法以奇不成者,故举六以言之。若通以六小为
法,则一岁止有三百五十四日,岁少十一日余矣。取月所少之辰,加岁外余之日,故从闰后三十二日而盈闰焉。
《尚书》曰∶期三百有六旬有六日,以闰月定四时以成岁,则其义也。积余盈闰者,尽以月之大小,不尽天度故也。)
立端于始,表正于中,推余于终,而天度毕矣。(立端于始,言先王之正时也。履端于始,以冬
至之日为岁首也。表正于中,举中气以正月。推余于终,月有余日,则归之于终,积而为之闰月,故能令天度毕
焉。)天以六六为节,地以九九制会,天有十日,日六竟而周甲,甲六复而终岁,三百
六十日法也。(十日,谓甲乙丙丁戊己庚辛壬癸之日也。十者,天地之至数也。《易·系辞》曰∶天九地十,
则其义也。六十日而周甲子之数,甲子六周而复始,则终一岁之日,是三百六十五日之岁法也。)夫自古通天
者,生之本,本于阴阳,其气九州九窍,皆通乎天气。(元气,即天真也。形假地生,命惟天赋,
故奉生之气,通系于天,禀于阴阳,而为根本也。故曰人生于地,悬命于天也,天地合气,命之曰人。地列九
州,人施九窍,精神往复,气与参同。)故其生五,其气三,(形之所存,假五行而运用,征其本始,从三气
以生成,故云其生五、其气三也。)三而成天,三而成地,三而成人,(非惟人独由三气以生,天地之道
亦如是矣。故《易》干、坤诸卦,皆必三矣。)三而三之,合则为九,九分为九野,九野为九脏,
(九野者,应九脏而为邑也。邑外为郊,郊外为甸,甸外为牧,牧外为林,林外为 , 外为野,此之谓九野也。)
故形脏四,神脏五,合为九脏以应之也。(形脏四者,一头角,二耳目,三口齿,四胸中也。形合于
外,故以名焉。神脏五者∶肝、心、脾、肺、肾也。神藏于内,故以名焉。所谓神脏者,肝魂、心神、脾意、肺
魄、肾志也。)天食人以五气,地食人以五味。(五气食人者∶臊气凑肝,焦气凑心,香气凑脾,腥气凑
肺,腐气凑肾也。五味食人者;酸味入肝,苦味入心,甘味入脾,辛味入肺,咸味入肾也。清阳化气而上为天,浊
阴成味而下为地,故天食人以气,地食人以味也。)五气入鼻,藏于心肺,上使五色修明,声音能
彰。五味入口,藏于肠胃,味有所藏,以养五气,气和而生,津液相成,神乃自生。
(心荣面色,肺主音声,故气藏于心肺,上使五色修洁分明,音声彰着。气为水母,故味藏于肠胃,内养五气,五
气合化,津液方生,津液与气,相副化成,神气乃能生而宣化也。)脏象何如?(象谓所见于外,可阅者也。)心
者,生之本,神之变也。其华在面,其充在血脉,为阳中之太阳,通于夏气。(心者,君
主之官,神明出焉。万物系之以兴亡。故曰心者生之本,神之变也。火气炎上,故华在面,心养血,其主脉,故
充在血脉,心主于夏,气合太阳,以太阳居夏火之中,故曰阳中之太阳,通于夏气。)肺者,气之本,魄之
处也。其华在毛,其充在皮,为阳中之太阴,通于秋气。(肺藏气,其神魄,其养皮毛,故曰
肺者气之本,魄之处,华在毛,充在皮也,肺脏为太阴
之气,上主于秋,昼日为阳气所行,位非阴处,以太阴居于阳分,故曰阳中之太阴,通于秋气。)肾者,主蛰
封藏之本,精之处也。其华在发,其充在骨,为阴中之少阴,通于冬气。(地户封闭,蛰
虫深藏,肾又主水,受五脏六腑之精而藏之,故曰肾者主蛰封藏之本,精之处也。脑者,髓之海,肾主骨髓。发
者,脑之所养,故华在发,充在骨也。以盛阴居冬阴之分,故曰阴中之少阴,通于冬气。)肝者,罢极之本,
魂之居也。其华在爪,其充在筋,以生血气,为阳中之少阳,通于春气。(夫人之运动者,
皆筋力之所为,肝主筋,其神魂,故曰肝者罢极之本,魂之居也。爪者筋之余,筋者肝之养,故华在爪,充在筋,
东方为发生之始,故以生血气也。以少阳居于阳位,而王于春,故曰阳中之少阳,通于春气。)脾、胃、大
肠、小肠、三焦、膀胱者,仓廪之本,营之居也,名曰器,能化糟粕,转味而入出
者也。(皆可受盛而转运不息,故为仓廪之本,名曰器。营起于中焦,中焦为脾胃之位,故云营之居也。然水谷
滋味入于脾胃,脾胃糟粕转化其味,出于三焦膀胱,故曰转味而入出者也。)其华在唇四白,其充在肌,
此至阴之类,通于土气。(口为脾官,脾主肌肉,故曰华在唇四白,充在肌也。四白,谓唇四际之白色肉
也。脾藏土气,上合至阴,故曰至阴之类也,通于土气。)凡十一脏,取决于胆也。(上从心脏,下至于胆,
为十一也。胆者,中正刚断无偏,此明十一脏象,总取决于胆也。夫脏在内而形之于外者可阅,斯之谓脏象也。
天之在我者,德也。地之在我者,气也。德流气薄而生者也。故生之来谓之精,两精相搏谓之神,随神往来者
谓之魂,并精而出入者谓之魄,所以任物者谓之心,心有所忆谓之意,意之所存谓之志,因志而存变谓之思,因
思而远慕谓之虑,因虑而处物谓之智。)故人迎一盛病在少阳,二盛病在太阳,三盛病在阳明,
四盛已上为格阳。(阳脉法也。少阳,胆脉也。太阳,膀胱脉也。阳明,胃脉也。《灵枢经》曰∶一盛而躁在手
少阳,二盛而躁在手太阳,三盛而躁在手阳明、手少阳,三焦脉;手太阳,小肠脉;手阳明,大肠脉;一盛者,谓
人迎之脉,大于寸口一倍也,余盛同法。四倍以上,阳盛之极,故拒而食不得入也。《正理论》曰∶格则吐也。
)寸口一盛病在厥阴,二盛病在少阴,三盛病在太阴,四盛已上为关阴。(阴脉法也。厥阴,
肝脉也。少阴,肾脉也。太阴,脾脉也。《灵枢经》曰∶一盛而躁在手厥阴,二盛而躁在手少阴,三盛而躁在手
太阴。手厥阴,心包络也。手少阴,心脉也。手太阴,肺脉也。盛法同阳。四倍已上,阴盛之极,故关闭而溲不
得通也。《正理论》曰∶闭则不得溺溲小便也。)人迎与
寸口俱盛,四倍已上为关格,关格之脉羸,(羸当作盈。)不能极于天地之精气,则死矣。(俱
盛,谓俱大于平常四倍之脉也。物不可以久盛,极则衰败,故不能极于天地之精气则死矣。《灵枢经》曰∶阴阳
俱盛,不得相营,故曰关格,关格者,不得尽期而死矣。)
According to the "Liu Jie Zang Xiang Lun" (Treatise on the Six Sections and Visceral Manifestations): Heaven uses six cycles of sixty days (six-six jie, referring to the completion of six jia-zi periods) to form one year; humans use nine times nine (eighty-one) to correspond and converge, calculating that the human body also has three hundred and sixty-five joints to correspond with Heaven and Earth, a principle established for a long time. (The "six-six jie" refers to six completions of the six jia-zi days, forming the seasonal limits of a year. The "jiu jiu zhi hui" refers to nine cycles around the number of the nine wilds, used to regulate the convergence of the human form. It means that the three hundred and sixty-five joints of the human body have corresponded to the heaven's six-six jie for a long time.) The principles of the six-six jie and the jiu jiu zhi hui are used to rectify the degrees of Heaven and the numbers of Qi. (The six-six jie is the degree of Heaven. The jiu jiu zhi hui is the number of Heaven. What is meant by the number of Qi is the generating and completing Qi. The circumference of the sky is three hundred and sixty-five and one-quarter degrees. Divided equally by the twelve solar terms, there are three hundred and sixty days for Qi to complete, plus small months, falling short of this number. Therefore, leap months are often placed among the sixty-four Qi. Why? Because of the accumulation of fractional differences. The generation and reproduction of Heaven and Earth originate in Yin and Yang. The operation of human spirit begins and ends with the Nine Qi. Is not the function of "Nine" great indeed! The "Lu Shu" (Book of Music Standards) says: The Huangzhong pitch pipe is nine cun long. On the day of Winter Solstice, Qi responds causing caltrops ash to fly. From this, the birth of all things is due to the Nine Qi. Ancient nine cun is equivalent to seven cun and three fen today; sizes differ because of the ancient system using millet grains.) The degrees of Heaven are used to regulate the movement of the Sun and Moon. The numbers of Qi are used to record the function of transformation and generation. ("Zhi" means standard measurement. "Ji" means guideline. Using the motion of the Sun and Moon as a standard clarifies their speed; recording the function of transformation and generation manifests the response when Qi arrives. If Qi response is without error, the principle of generation does not decline. Measuring speed and slowness, the large and small months arise. Thus, the sun's length changes daily, the moon shifts cold and heat, storage and growth occur without missing the proper timing.) Heaven is Yang, Earth is Yin; the Sun is Yang, the Moon is Yin. Movement has divisions and records, and the cycle has principles. The Sun moves one degree per day, while the Moon moves thirteen degrees and a fraction. Thus, large and small months total three hundred and sixty-five days to form a year, accumulating residual Qi to fill leap months. (The Sun moves slowly, traveling one degree across the sky in a day and night, completing a circuit in three hundred and sixty-five days, yet still having fractional degrees remaining. The Moon moves fast, traveling over thirteen degrees in a day and night, completing a circuit in twenty-nine days. "Having a fraction" means beyond thirteen degrees, it travels seven parts of nineteen degrees, hence "the Moon moves thirteen degrees with a remainder." The "Li Yi" and Han Dynasty "Lü Li Zhi" state: The Twenty-Eight Mansions and other stars all move from East to West along the sky, while the Sun, Moon, and Five Planets move from West to East. However, the current Grand Astrologer states they all move East along the sky, turning from East to West. Various astronomers say: From the 1st to 4th day, the Moon moves fastest, over fourteen degrees daily; from the 5th to 8th, slightly faster, over thirteen degrees; from the 9th to 19th, slower, over twelve degrees; from the 20th to 23rd, slightly faster again, over thirteen degrees; from the 24th to the last day, fastest again, over fourteen degrees. The Grand Astrologer now says the Moon's rate is not so; sometimes it is fast before the 15th and slow after, or slow before and fast after. Roughly dividing the month into four parts, there are always variations in speed, which have no fixed standard. Nevertheless, ultimately the Moon completes a circuit in twenty-seven days, traveling three hundred and sixty-one degrees. In twenty-nine days, the Sun travels twenty-nine degrees, the Moon two hundred and eighty-seven, falling short of the Sun by seven degrees. By the thirtieth day, the Sun advances further; calculating the rate to eight-thirteenths, the Moon catches up. This is a full month. Roughly, calculating to half-thirteenths is also the method for a full month. Calculating to five or six-thirteenths to catch the Sun is a deficient month. Hence, large and small months total three hundred and sixty-five days to form a year. Strictly speaking, three hundred and sixty-five and one-quarter days make a year; since fractions do not form an integer, "six" is cited. If taking six small months as the rule, a year has only three hundred and fifty-four days, lacking eleven days. Taking the missing time of the Moon and adding the residual days outside the year, leap months are filled thirty-two days after the intercalation. The "Shang Shu" says: A period of three hundred and sixty-six days, using leap months to determine the four seasons to form a year, is the meaning. Accumulating residuals to fill leaps is entirely due to the size of months not perfectly matching heavenly degrees.) Establishing the beginning at the start, correcting the middle with major solar terms, and pushing residuals to the end, the degrees of Heaven are complete. ("Establishing the beginning at the start" refers to the ancient kings correcting time. Starting with the Winter Solstice as the beginning of the year. "Correcting the middle" refers to using major solar terms to establish the first month. "Pushing residuals to the end" means if a month has extra days, they are returned to the end, accumulated to form a leap month, thus allowing the degrees of Heaven to be complete.) Heaven uses six-six as its section, Earth uses nine-nine to converge. Heaven has ten Heavenly Stems. The Sun completes six cycles to finish a Jia-Zi cycle; six repetitions of Jia-Zi conclude the year, following the law of three hundred and sixty days. (Ten stems refer to Jia, Yi, Bing, Ding, Wu, Ji, Geng, Xin, Ren, Gui. Ten is the ultimate number of Heaven and Earth. The "Yi Jing · Xi Ci" says: Heaven Nine, Earth Ten, which is the meaning. Sixty days complete a Jia-Zi cycle; six cycles of Jia-Zi restart, concluding the days of a year, which is the law of three hundred and sixty-five days.) Since antiquity, those who connect with Heaven find the root of life in Yin and Yang. Their Qi connects through the Nine Provinces and Nine Orifices, all communicating with Heavenly Qi. (Primordial Qi, i.e., True Innocence. Form is borrowed from Earth to generate, Life is endowed by Heaven. Thus, the Qi sustaining life connects to Heaven, inheriting from Yin and Yang to become the root. Hence it is said: Humans are born from Earth, their fate hangs from Heaven. Heaven and Earth combine Qi, called Human. Earth divides into Nine Provinces, Humans have Nine Orifices. Spirit and Essence reciprocate, Qi participates equally.) Thus, life generates according to the Five Elements, and Qi is divided into Three. (What exists in form relies on the Five Elements for operation; tracing back to the origin, it is generated from Three Qi. Hence "Life generates Five, Qi is Three.") Three constitute Heaven, Three constitute Earth, Three constitute Man. (Not only does Man alone arise from Three Qi; the Way of Heaven and Earth is also like this. Thus, in the "Yi Jing," Qian and Kun hexagrams must all have three lines.) Three multiplied by three combines to Nine. Nine divides into Nine Wilds. Nine Wilds correspond to Nine Zang Organs. (Nine Wilds correspond to Nine Zang Organs to form districts. Outside the district is Jiao, outside Jiao is Dian, outside Dian is Mu, outside Mu is Lin, outside Lin is You, outside You is Ye. This is called Nine Wilds.) Thus, there are Four Xing (Form) Zang and Five Shen (Spirit) Zang, combining to Nine Zang to correspond. (The Four Xing Zang are: 1. Head/Horns, 2. Eyes/Ears, 3. Mouth/Teeth, 4. Chest/Middle. Form combines externally, hence named thus. The Five Shen Zang are: Liver, Heart, Spleen, Lung, Kidney. Spirit hides internally, hence named thus. The so-called Shen Zang are: Liver stores Hun, Heart stores Shen, Spleen stores Yi, Lung stores Po, Kidney stores Zhi.) Heaven feeds humans with Five Qi, Earth feeds humans with Five Flavors. (Five Qi feeding humans: Pungent Qi gathers in Liver, Scorched Qi gathers in Heart, Fragrant Qi gathers in Spleen, Fishy Qi gathers in Lung, Rotten Qi gathers in Kidney. Five Flavors feeding humans: Sour enters Liver, Bitter enters Heart, Sweet enters Spleen, Pungent enters Lung, Salty enters Kidney. Clear Yang transforms into Qi and rises to Heaven; Turbid Yin forms Flavor and descends to Earth. Thus Heaven feeds humans with Qi, Earth with Flavor.) Five Qi enter through the nose, store in Heart and Lung, causing the complexion above to be bright and clear, and voice to be distinct. Five Flavors enter the mouth, store in Stomach and Intestines. Flavors are stored to nourish the Five Qi. When Qi harmonizes, life arises; fluids and Qi mutually complete, and Spirit naturally generates. (Heart nourishes facial color, Lung governs voice/sound. Thus Qi storing in Heart/Lung causes colors to be pure and distinct, voice to be manifest. Qi is the mother of Water. Thus flavors store in Stomach/Intestines, internally nourishing Five Qi. Five Qi combine and transform, Fluids then generate. Fluids and Qi assist each other in transformation, allowing Spirit Qi to generate and disseminate.) What are the Visceral Manifestations? (Manifestation refers to what is seen externally and can be observed.) The Heart is the root of life and the change of Spirit. Its luster appears on the face, its filling is in the blood vessels. It is the Taiyang of Yang, connecting with Summer Qi. (The Heart is the official of the sovereign, where Spirit Ming emerges. All things depend on it for rise and fall. Thus, Heart is the root of life, the change of Spirit. Fire Qi flares upward, so luster is on the face. Heart nourishes Blood, governs vessels, so filling is in blood vessels. Heart governs Summer, Qi combines with Taiyang. As Taiyang resides in the fire of Summer, it is called Taiyang of Yang, connecting with Summer Qi.) The Lung is the root of Qi and the dwelling of Po. Its luster appears on hair, its filling is in skin. It is the Taiyin of Yang, connecting with Autumn Qi. (Lung stores Qi, its spirit is Po, it nourishes hair and skin. Thus, Lung is the root of Qi, dwelling of Po, luster in hair, filling in skin. The Lung organ is Taiyin Qi, governing Autumn above. Daytime is the path of Yang Qi, position is not Yin. With Taiyin residing in Yang division, it is called Taiyin of Yang, connecting with Autumn Qi.) The Kidney is the root of hibernation and sealing/storing, the dwelling of Essence. Its luster appears on hair, its filling is in bone. It is Shaoyin of Yin, connecting with Winter Qi. (Earth gates close, hibernating insects hide deep. Kidney governs Water, receiving essence from Five Zang and Six Fu organs to store it. Thus, Kidney is the root of hibernation/sealing, dwelling of Essence. Brain is the sea of Marrow. Kidney governs Marrow/Bone. Hair is nourished by Brain, so luster is in hair, filling in bone. With abundant Yin residing in Winter Yin division, it is called Shaoyin of Yin, connecting with Winter Qi.) The Liver is the root of fatigue/extremity, the dwelling of Hun. Its luster appears on nails, its filling is in sinews, generating Blood and Qi. It is Shaoyang of Yang, connecting with Spring Qi. (Human movement is performed by sinews and strength. Liver governs sinews, its spirit is Hun. Thus, Liver is the root of fatigue, dwelling of Hun. Nails are the surplus of sinews, sinews are nourished by Liver, so luster is in nails, filling in sinews. The East is the beginning of generation, thus generating Blood and Qi. With Shaoyang residing in Yang position and reigning in Spring, it is called Shaoyang of Yang, connecting with Spring Qi.) The Spleen, Stomach, Large Intestine, Small Intestine, Sanjiao, and Bladder are the root of granaries, the dwelling of Ying Qi, named vessels. They can transform dregs and convert flavors for entry and exit. (All can receive and transport continuously, thus being the root of granaries, named vessels. Ying Qi originates in Middle Jiao, which is the seat of Spleen/Stomach, thus dwelling of Ying Qi. However, water/grain flavors enter Spleen/Stomach; Spleen/Stomach transform dregs and flavors, exiting via Sanjiao/Bladder. Thus, converting flavors for entry and exit.) Its luster appears on the white flesh around the lips, its filling is in muscles. This is the category of Supreme Yin, connecting with Earth Qi. (Mouth is the official of Spleen, Spleen governs muscles. Thus luster on lip-white, filling in muscle. White flesh refers to the white meat at the four corners of the lips. Spleen stores Earth Qi, connecting above with Supreme Yin. Thus category of Supreme Yin, connecting with Earth Qi.) All Eleven Zang Organs depend on the Gallbladder. (From Heart above to Gallbladder below makes Eleven. Gallbladder is upright, firm, decisive, unbiased. This clarifies that the manifestations of all Eleven Zang Organs generally depend on the Gallbladder. Zang organs are internal but manifest externally for observation; this is called Visceral Manifestation. What Heaven gives us is Virtue (De). What Earth gives us is Qi. Life arises from the flow of Virtue and interaction of Qi. Thus, the source of life is called Jing (Essence). Two Essences clashing is called Shen (Spirit). That which accompanies Spirit going and coming is called Hun (Ethereal Soul). That which exits and enters with Essence is called Po (Corporeal Soul). That which handles external objects is called Xin (Heart/Mind). Memory of the Heart is called Yi (Intention). What Yi retains is called Zhi (Will). Variation based on Will is called Si (Thought). Far-reaching consideration based on Thought is called Lv (Deliberation). Handling matters based on Deliberation is called Zhi (Wisdom)."Therefore, if the Renying pulse is one-fold stronger than the Cunkou pulse, the disease is in Shaoyang; two-fold, in Taiyang; three-fold, in Yangming; four-fold or more is Ge Yang (Blocking Yang). (Method of Yang pulses. Shaoyang is Gallbladder pulse. Taiyang is Bladder pulse. Yangming is Stomach pulse. The "Ling Shu Jing" says: One-fold and restless in Hand Shaoyang, two-fold and restless in Hand Taiyang, three-fold and restless in Hand Yangming and Hand Shaoyang (Sanjiao pulse); Hand Taiyang (Small Intestine pulse); Hand Yangming (Large Intestine pulse). One-fold means the Renying pulse is greater than Cunkou by one fold, others follow similarly. Four times or more is extreme excess of Yang, thus rejecting food intake. The "Zheng Li Lun" says: Ge implies vomiting.) If the Cunkou pulse is one-fold stronger than the Renying pulse, the disease is in Jueyin; two-fold, in Shaoyin; three-fold, in Taiyin; four-fold or more is Guan Yin (Closing Yin). (Method of Yin pulses. Jueyin is Liver pulse. Shaoyin is Kidney pulse. Taiyin is Spleen pulse. The "Ling Shu Jing" says: One-fold and restless in Hand Jueyin, two-fold and restless in Hand Shaoyin, three-fold and restless in Hand Taiyin. Hand Jueyin is Pericardium. Hand Shaoyin is Heart. Hand Taiyin is Lung. Method of strength is same as Yang. Four times or more is extreme excess of Yin, thus closing and preventing urination. The "Zheng Li Lun" says: Guan implies inability to urinate.) If both Renying and Cunkou pulses are strong, four-fold or more, it is Guan Ge (Closing and Blocking). The Guan Ge pulse is weak (Lei should be Ying/Full), unable to reach the extremity of Heaven and Earth's Essence and Qi, then death occurs. (Both strong means both are greater than normal by four times. Things cannot remain strong forever; extremity leads to decline. Thus, unable to reach the extremity of Heaven and Earth's Essence and Qi leads to death. The "Ling Shu Jing" says: Yin and Yang both strong, unable to manage each other, thus called Guan Ge. Guan Ge means dying before the natural term.)