（《灵枢·厥病篇》）
风痹淫泺，病不可已者，（病在阳命曰风，病在阴命曰痹，阴阳俱病，命曰风痹。淫泺者，浸淫日深之谓。泺音鹿。）
足如履冰，时如入汤中，股胫淫泺，烦心头痛，时呕时 ，眩已汗出，久则目眩，悲以喜恐，短气不乐，不出三年死也。
（足如履冰之寒，又如入汤之热，下而股胫，中而腹心，上而头目，无所不病，在表则汗出，在里则短气不乐，或为悲
哀，或为喜恐，此阴阳俱病之候，虽尚可支持，然不能出三年也。 ，美本切。）
（《灵枢·病传篇》全、《素问·标本病传论》）
黄帝曰∶余受九针于夫子，而私览于诸方，或有导引行气、乔摩灸熨、刺 饮药之一者，可独守耶？将尽行之乎？
（《灵枢·病传篇》全。乔，跷同。 ，如瑞切。）岐伯曰∶诸方者，众人之方也，非一人之所尽行也。（谓当因人所
宜以施治，是众人各有其方也。）黄帝曰∶此乃所谓守一勿失、万物毕者也。（人得其一，则万变之道可毕矣。《移精变气
论》曰∶治之极于一。即此谓也。）今余已闻阴阳之要，虚实之理，倾移之过，可治之属；愿闻病之变化，淫传绝败而不
可治者，可得闻乎？（淫邪传变，未必即危，正气绝败，则不可治矣。）岐伯曰∶要乎哉问。道，昭乎其如日醒，窘乎其
如夜瞑，能被而服之，神与俱成，毕将服之，神自得之，生神之理，可着于竹帛，不可传于子孙。（昭乎如醒，道之明也。
窘乎如瞑，察之难也。着之竹帛，则泽及于人；传之子孙，则道私于己，故不可也。）黄帝曰∶何谓日醒？岐伯曰∶明于
阴阳，如惑之解，如醉之醒。黄帝曰∶何谓夜瞑？岐伯曰∶喑乎其无声，漠乎其无形，折毛发理，正气横倾，淫邪泮衍，
血脉传溜，大气入脏，腹痛下淫，可以致死，不可以致生。（大气，大邪之气也。凡邪之中人，（喑乎其无声，不可得而
闻也。漠乎其无形，不可得而见也。至其绝败，则为折毛发理，正气横倾等证，故有死无生也。喑音音。）黄帝曰∶大气
入脏奈何？岐伯曰∶病先发于心，一日而之肺，三日而之肝，五日而之脾，三日不已死，冬夜半，夏日中。（病发于心而
传于肺，火乘金也。三日而金复乘木，故传之肝也。五日而木复乘土，故传之脾也。再三日而邪气不退，其甚则死。冬
月夜半，水王之极也。夏月日中，火王之极也。心火畏水，故冬则死于夜半。阳邪亢极，故夏则死于日中。盖衰极亦死，
盛极亦死，有所偏胜，则有所偏绝也。五行之气，无不皆然，下文之义皆仿此。）病先发于肺，三日而之肝，一日而之脾，
五日而之胃，十日不已死，冬日入，夏日出。（自肺而肝，自肝而脾，皆传所胜也。自脾而胃，表里相传也。肺邪王于申
酉，故冬则死于日入。金气绝于寅卯，故夏则死于日出。）病先发于肝，三日而之脾，五日而之胃，三日而之肾，三日不
已死，冬日入，夏早食。（此肝木传土，而土邪复传水脏也。木受伤者，金胜则危，故冬畏日入。肝发病者，木则同剧，
故夏畏早食时也。）病先发于脾，一日而之胃，二日而之肾，三日而之膂膀胱，十日不已死，冬人定，夏晏食。（此土邪
乘水而表里俱相传也。人定在亥，而土病于冬者畏之，寒水反能侮土也。晏食在巳，而脾病于夏者畏之，以戊己王乡而
合邪为患也。）病先发于胃，五日而之肾，三日而之膂膀胱，五日而上之心，二日不已死，冬夜半，夏日 。（此土邪传
水而水复传火，故自膀胱以及于心也。下文标本病传论云冬夜半后，丑也；夏日 ，未也。皆土王之时，故胃病逢之，
气极则败。 音迭。）病先发于肾，三日而之膂膀胱，三日而上之心，三日而之小肠，三日不已死，冬大晨，夏晏晡。（此
水病乘火而表里皆相传也。大晨，辰刻也，为水之库。晏晡，戌时也，土能伐水。故病发于肾者，不能出乎此也。晡，
邦模切。）病先发于膀胱，五日而之肾，一日而之小肠，一日而之心，二日不已死，冬鸡鸣，夏下晡。（此亦水火二脏自
表而里之相传也。冬之鸡鸣在丑，阴之极也。夏之下晡在未，水所畏也。膀胱为水府，故其盛极衰极皆能死。）诸病以次
相传，如是者皆有死期，不可刺也；间一脏及二三四脏者，乃可刺也。（间脏义，详脉色类十二。七传义，详藏象类二十
四。）
夫病传者，心病先心痛（《素问·标本病传论》），此下皆详明病传之见证也，故病发于心者，其证必先为心痛。）一
日而咳，（心病传肺也。上文病传论所谓一日而之肺者，即其义也。余脏准此。）三日胁支痛，（肺复传肝，故胁支痛，即
所谓三日而之肝也。）五日闭塞不通，身痛体重，（所谓五日之脾也。脾病则不能运化，故闭塞不通。）三日不已死，（再
三日不已，则脾又传肾，五脏俱伤故死。）冬夜半，夏日中。（此子午时也。释义虽如上文，然少阴君火主子午正对之化，
心通其气，失守则死，亦一义也。）
肺病喘咳，（肺主息，故病为喘咳。）三日而胁支满痛，（三日而之肝也。）一日身重体痛，（一日而之脾也。）五日而
胀，（五日而之胃，自脏传腑也。）十日不已死，（十日不已，则胃复传肾，而五行生成之数已极，故死。）冬日入，夏日
出。（此卯酉时也，属燥金之化，肺主气，失守则死，于义亦通。）
肝病头目眩、胁支满，（肝开窍于目，而经脉布于胁肋也。）三日体重身痛，（即三日而之脾也。）五日而胀，（即五日
而之胃也。）三日腰脊少腹痛、胫 ，（即三日而之肾也。）三日不已死，（三日不已，则肾复传心，故死。）冬日入，夏早
食。（卯酉时也，燥金主之，为木所畏，于义亦通。）
脾病身痛体重，（脾主肌肉也。）一日而胀，（即一日而之胃也。）二日少腹腰脊痛、胫 ，（即二日而之肾也。）三日
背KT 筋痛、小便闭，（即三日而之膂膀胱也。KT ，膂同，音吕。）十日不已死，（十日不已，则复传于心，故死。）冬
人定，夏晏食。（此巳亥时也，司风木之化，脾病畏之也。）
肾病少腹腰脊痛、 ，（肾主下部，其经脉行于少腹腰脊 骨之间也。 音杭。 音酸。）三日背KT 筋痛、小便
闭，（即三日而之膂膀胱也。）三日腹胀，（即三日而之小肠也。）三日两胁支痛，（即三日而上之心也。手心主之正，别下
渊腋三寸入胸中，故两胁支痛。）三日不已死，（复伤肺金也。）冬大晨，夏晏晡。（此辰戌时也。土王四季，为水所畏，
故肾病患之。）
胃病胀满，（胃脉布于腹里也。）五日少腹腰脊痛、 ，（即五日而之肾也。）三日背KT 筋痛、小便闭，（即三日
而之膂膀胱也。）五日身体重，（前《病传论》曰∶五日而上之心。此云身体重者，疑误。）六日不已死，（心复传肺也。）
冬夜半后，夏日 。（丑未司湿土之化，气通于胃，失守则死，理之自然。）
膀胱病小便闭，（膀胱为津液之府也。）五日少腹胀、腰脊痛、 ，（即五日而之肾也。）一日腹胀，（即一日而之小
肠也。）一日身体痛，（即一日而之心，腑传脏也。心主血脉，故为身体痛。）二日不已死，（心病不已，必又传金脏，故
死。）冬鸡鸣，夏下晡。（丑未时也。土能克水，故膀胱之病畏之。）诸病以次，是相传如是者，皆有死期，不可刺。（上
文相传，死期各有远近，盖其脏有要害，气有虚实也。仓公曰∶能谷者过期，不能谷者不及期。正此之谓。即有死征，
不可刺矣。）间一脏止，及至三四脏者，乃可刺也。（间三四脏者，皆非以次相传者也，治之则愈，故可针刺之。）
(From *Ling Shu: Jue Bing Pian*)
If Feng-Bi (Wind Bi, a type of bi syndrome caused by wind pathogen) has been infiltrating for a long time and deepening into the marrow, making the condition incurable: (When the pathogen is in the Yang aspect, it is called Feng; when in the Yin aspect, it is called Bi. When both Yin and Yang are affected, it is called Feng-Bi. "Yinluo" refers to the progressive infiltration and deepening of the disease. Luo is pronounced 'lu'.)
The patient feels cold in the feet as if treading on ice, yet at times feels hot as if entering boiling water. There is infiltrating soreness and weakness in the thighs and calves. The heart is vexed, there is headache, occasional vomiting, and occasional hiccuping. Dizziness occurs followed by sweating. Over time, vision becomes blurred. Emotions fluctuate between sadness, joy, and fear. There is shortness of breath and depression. Such a condition will result in death within three years.
(The coldness like treading on ice and heat like entering soup indicate that the lower part (thighs and calves), middle part (abdomen and heart), and upper part (head and eyes) are all affected. Exterior symptoms include sweating; interior symptoms include shortness of breath, depression, sadness, or fear-joy fluctuations. This is a sign of simultaneous Yin and Yang pathology. Although supportable for a while, survival beyond three years is impossible. [Character missing in source], pronounced 'meiben qie'.)
(From *Ling Shu: Bing Chuan Pian* complete text and *Su Wen: Biao Ben Bing Zhuan Lun*)
Huang Di said: I have learned the Nine Needles from my teacher and privately studied various medical formulas. Among them are methods such as Dao Yin (guided breathing and movement) and Qi regulation, Qiao Mo (massage), Moxibustion and warming, acupuncture, and herbal decoctions. Should one adhere exclusively to one method, or should all be practiced?
(*Ling Shu: Bing Chuan Pian* complete text. Qiao is synonymous with Qiao. [Character missing], pronounced 'ru rui qie'). Qi Bo replied: The so-called "various formulas" refer to the methods suitable for the masses; they are not all applicable to a single individual. (This means treatment should be tailored to the individual's suitability, so each person has their own appropriate method.) Huang Di said: This is what is meant by adhering to the One without deviation, thereby comprehending all things. (By grasping the One, the principles of ten thousand changes can be fully understood. As stated in *Yi Jing Bian Qi Lun*: "The ultimate of treatment lies in the One." This is what is meant here.) Now I have heard the essentials of Yin and Yang, the principles of Deficiency and Excess, and the errors of shifting pathogens; these belong to treatable conditions. I wish to hear about the changes of diseases, specifically those where evil qi spreads excessively, leading to exhaustion and failure of healthy qi, rendering them incurable. Can you explain this? (Excessive spreading of evil qi does not necessarily mean immediate danger; however, if healthy qi is exhausted and fails, it becomes incurable.) Qi Bo said: You ask an important question. The Dao, when understood, is clear as day upon waking; when confused, it is obscure as night in slumber. If one can align with and practice it, spirit will accompany its formation. If one fully practices it, spirit will naturally acquire it. The principles of generating spirit can be inscribed on bamboo slips and silk, but cannot be directly transmitted to descendants. (Clear as waking indicates the clarity of the Dao. Obscure as sleeping indicates the difficulty of perceiving it. Inscribing it benefits others; transmitting it privately to descendants makes it selfish, hence it cannot be directly transmitted.) Huang Di asked: What is meant by "clear as day"? Qi Bo replied: Understanding Yin and Yang is like resolving confusion, like waking from drunkenness. Huang Di asked: What is meant by "obscure as night"? Qi Bo replied: Silent without sound, formless without shape. It causes the breaking of hair and pores, the horizontal倾覆 (overturning/collapse) of healthy qi, the diffusion and spread of excessive evil, and the transmission and stagnation of blood vessels. When major evil qi enters the Zang organs, abdominal pain and continuous diarrhea occur, leading to death rather than life. (Major qi refers to major evil qi. Whenever evil attacks humans... [Silent without sound, inaudible. Formless without shape, invisible. Upon exhaustion and failure, symptoms such as broken hair/pores and overturning healthy qi appear, leaving only death, no life. Yin is pronounced 'yin'.] Huang Di asked: How does major evil qi enter the Zang organs? Qi Bo replied: If the disease originates in the Heart, after one day it transmits to the Lung, after three days to the Liver, after five days to the Spleen. If after another three days the condition does not improve, death ensues, occurring at midnight in winter or noon in summer. (Disease originating in the Heart and transmitting to the Lung represents Fire overcoming Metal. After three days, Metal overcomes Wood, so it transmits to the Liver. After five days, Wood overcomes Earth, so it transmits to the Spleen. If after another three days the evil qi does not recede and the condition worsens, death occurs. Midnight in winter is the peak of Water energy. Noon in summer is the peak of Fire energy. Heart Fire fears Water, so in winter death occurs at midnight. Yang evil reaching extreme excess leads to death at noon in summer. Generally, extreme deficiency leads to death, and extreme excess leads to death; partial dominance results in partial extinction. This applies to all Five Element energies; the meaning below follows this pattern.) If the disease originates in the Lung, after three days it transmits to the Liver, after one day to the Spleen, after five days to the Stomach. If after ten days the condition does not improve, death ensues, occurring at sunset in winter or sunrise in summer. (Transmission from Lung to Liver, and Liver to Spleen, is transmission to the overcome element. Transmission from Spleen to Stomach is transmission between exterior-interior pairs. Lung evil is prosperous at Shen-You hours, so in winter death occurs at sunset. Metal qi expires at Yin-Mao hours, so in summer death occurs at sunrise.) If the disease originates in the Liver, after three days it transmits to the Spleen, after five days to the Stomach, after three days to the Kidney. If after another three days the condition does not improve, death ensues, occurring at sunset in winter or early meal time in summer. (This is Liver Wood transmitting to Spleen Earth, and Earth evil transmitting to Kidney Water. When Wood is injured, Metal dominance brings danger, hence fearing sunset in winter. When Liver disease occurs, Wood energy intensifies, hence fearing early meal time in summer.) If the disease originates in the Spleen, after one day it transmits to the Stomach, after two days to the Kidney, after three days to the spine and Bladder. If after ten days the condition does not improve, death ensues, occurring at Ren Ding (9-11 PM) in winter or Yan Shi (9-11 AM) in summer. (This is Earth evil attacking Water, with simultaneous exterior-interior transmission. Ren Ding is Hai hour; Earth disease in winter fears it because Cold Water insults Earth. Yan Shi is Si hour; Spleen disease in summer fears it because Wu-Ji prosperity combines with evil to cause harm.) If the disease originates in the Stomach, after five days it transmits to the Kidney, after three days to the spine and Bladder, after five days upward to the Heart. If after two days the condition does not improve, death ensues, occurring at midnight in winter or midday [character missing] in summer. (This is Earth evil transmitting to Water, and Water transmitting back to Fire, thus from Bladder to Heart. The following *Biao Ben Bing Zhuan Lun* states winter midnight after is Chou hour; summer [character missing] is Wei hour. Both are times of Earth prosperity, so Stomach disease encountering these leads to qi exhaustion and failure. Die is pronounced 'die'.) If the disease originates in the Kidney, after three days it transmits to the spine and Bladder, after three days upward to the Heart, after three days to the Small Intestine. If after another three days the condition does not improve, death ensues, occurring at Da Chen (7-9 AM) in winter or Yan Bu (7-9 PM) in summer. (This is Water disease attacking Fire, with simultaneous exterior-interior transmission. Da Chen is Chen hour, the storehouse of Water. Yan Bu is Xu hour, where Earth controls Water. Thus, disease originating in the Kidney cannot escape these times. Bu is pronounced 'bang mu'.) If the disease originates in the Bladder, after five days it transmits to the Kidney, after one day to the Small Intestine, after one day to the Heart. If after two days the condition does not improve, death ensues, occurring at Ji Ming (1-3 AM) in winter or Xia Bu (3-5 PM) in summer. (This is also the self-transmission between Water and Fire organs from exterior to interior. Winter Ji Ming is Chou hour, the extreme of Yin. Summer Xia Bu is Wei hour, feared by Water. Bladder is the mansion of Water, so both its extreme prosperity and extreme deficiency lead to death.) Various diseases transmitted in sequence like this all have specific death periods and are not suitable for acupuncture. If transmission skips one organ or involves two, three, or four organs, then acupuncture is permissible. (The meaning of skipping organs is detailed in Pulse and Color Class, Part 12. The meaning of seven transmissions is detailed in Zang-Fu Class, Part 24.)
Regarding disease transmission, Heart disease first presents with Heart pain (*Su Wen: Biao Ben Bing Zhuan Lun*). The following details the manifestations of disease transmission. Thus, disease originating in the Heart must first present as Heart pain.) After one day, coughing occurs. (Heart disease transmitting to Lung. This corresponds to "transmitting to Lung after one day" mentioned earlier. Other organs follow this pattern.) After three days, distending pain in the hypochondrium occurs. (Lung transmitting back to Liver, hence distending pain in the hypochondrium, i.e., "transmitting to Liver after three days".) After five days, obstruction and blockage occur, accompanied by body pain and heaviness. (This is "transmitting to Spleen after five days". Spleen disease impairs transformation and transportation, causing obstruction.) If after another three days the condition does not improve, death ensues. (If not improving after another three days, Spleen transmits to Kidney, injuring all five Zang organs, leading to death.) Death occurs at midnight in winter or noon in summer. (These are Zi-Wu hours. Although the explanation is as above, Shaoyin Jun Fire governs Zi-Wu direct transformation. Heart connects with this qi; loss of control leads to death, which is another valid interpretation.)
Lung disease presents with wheezing and coughing. (Lung governs respiration, hence disease manifests as wheezing and coughing.) After three days, distending fullness and pain in the hypochondrium occur. (Transmitting to Liver after three days.) After one day, body heaviness and pain occur. (Transmitting to Spleen after one day.) After five days, abdominal distension occurs. (Transmitting to Stomach after five days, from Zang to Fu.) If after ten days the condition does not improve, death ensues. (If not improving after ten days, Stomach transmits to Kidney, and the numbers of generation and completion of Five Elements reach their limit, leading to death.) Death occurs at sunset in winter or sunrise in summer. (These are Mao-You hours, belonging to Dryness-Metal transformation. Lung governs Qi; loss of control leads to death, which is consistent with principle.)
Liver disease presents with dizziness of head and eyes, and distending fullness in the hypochondrium. (Liver opens into the eyes, and its meridians distribute along the hypochondrium.) After three days, body heaviness and pain occur. (Transmitting to Spleen after three days.) After five days, abdominal distension occurs. (Transmitting to Stomach after five days.) After three days, pain in the lower abdomen, waist, and spine, and soreness/weakness in the shins occur. (Transmitting to Kidney after three days.) If after another three days the condition does not improve, death ensues. (If not improving after three days, Kidney transmits back to Heart, leading to death.) Death occurs at sunset in winter or early meal time in summer. (Mao-You hours, governed by Dryness-Metal, feared by Wood, consistent with principle.)
Spleen disease presents with body pain and heaviness. (Spleen governs muscles.) After one day, abdominal distension occurs. (Transmitting to Stomach after one day.) After two days, pain in the lower abdomen, waist, and spine, and soreness/weakness in the shins occur. (Transmitting to Kidney after two days.) After three days, pain in the back and spinal tendons, and urinary retention occur. (Transmitting to spine and Bladder after three days. KT is synonymous with Lv, pronounced 'lv'.) If after ten days the condition does not improve, death ensues. (If not improving after ten days, it transmits back to Heart, leading to death.) Death occurs at Ren Ding in winter or Yan Shi in summer. (These are Si-Hai hours, governing Wind-Wood transformation, feared by Spleen disease.)
Kidney disease presents with pain in the lower abdomen, waist, and spine, and soreness/weakness in the shins. (Kidney governs the lower part; its meridians run through the lower abdomen, waist, spine, and thigh bones. Hang is pronounced 'hang'. Suan is pronounced 'suan'.) After three days, pain in the back and spinal tendons, and urinary retention occur. (Transmitting to spine and Bladder after three days.) After three days, abdominal distension occurs. (Transmitting to Small Intestine after three days.) After three days, distending pain in both hypochondria occurs. (Transmitting upward to Heart after three days. The regular meridian of Pericardium branches down three cun below Yuan Ye and enters the chest, hence distending pain in both hypochondria.) If after another three days the condition does not improve, death ensues. (Re-injuring Lung Metal.) Death occurs at Da Chen in winter or Yan Bu in summer. (These are Chen-Xu hours. Earth prospers in the four seasons and is feared by Water, hence affecting Kidney disease.)
Stomach disease presents with abdominal distension and fullness. (Stomach meridian distributes in the interior of the abdomen.) After five days, pain in the lower abdomen, waist, and spine, and soreness/weakness in the shins occur. (Transmitting to Kidney after five days.) After three days, pain in the back and spinal tendons, and urinary retention occur. (Transmitting to spine and Bladder after three days.) After five days, body heaviness occurs. (Previous *Bing Chuan Lun* states: "Transmits to Heart after five days." Here stating body heaviness is suspected to be an error.) If after six days the condition does not improve, death ensues. (Heart transmits to Lung.) Death occurs after midnight in winter or midday [character missing] in summer. (Chou-Wei governs Wet-Earth transformation, connecting with Stomach; loss of control leads to death, which is natural reason.)
Bladder disease presents with urinary retention. (Bladder is the mansion of fluids.) After five days, lower abdominal distension, pain in the waist and spine, and soreness/weakness in the shins occur. (Transmitting to Kidney after five days.) After one day, abdominal distension occurs. (Transmitting to Small Intestine after one day.) After one day, body pain occurs. (Transmitting to Heart after one day, from Fu to Zang. Heart governs blood vessels, hence body pain.) If after two days the condition does not improve, death ensues. (Heart disease unimproved will inevitably transmit to Metal Zang, leading to death.) Death occurs at Ji Ming in winter or Xia Bu in summer. (Chou-Wei hours. Earth controls Water, hence Bladder disease fears these.) Various diseases transmitted in sequence like this all have specific death periods and are not suitable for acupuncture. (As mentioned above, transmission leads to death periods varying in nearness or distance, likely due to vital points in organs and deficiencies/excesses of qi. Cang Gong said: Those who can eat exceed the death period; those who cannot eat do not reach it. This is exactly what is meant. Even with signs of death, acupuncture is contraindicated.) If transmission stops by skipping one organ, or reaches two, three, or four organs, then acupuncture is permissible. (Skipping two, three, or four organs means transmission is not sequential; treatment leads to recovery, hence acupuncture is permissible.)