（素问生气通天论 全）
黄帝曰∶夫自古通天者，生之本，本于阴阳。天地之间，六合之内，其气九州九窍、五脏十二节，皆通于天气。（大
哉干元，万物资始，生生不息，天之德也。凡自古之有生者，皆通天元之气以为生也。天元者，阴阳而已，故阴阳为有
生之本。如至大为六合，则上下四方也。至广为九州，则冀兖青徐扬荆梁雍豫也。人之外有九窍，阳窍七、阴窍二也。
内有五脏，心肺肝脾肾也。天有四时十二节，气候之所行也。人有四肢十二经，营卫之所通也。凡物之形而外者，为仪
象之流行，藏而内者，为精神之升降，幽明动静，孰匪由天，故曰皆通于天气。）其生五，其数三，数犯此者，则邪气伤
人，此寿命之本也。（人生虽本乎阴阳，而禀分五行，其生五也。阴阳衰盛，少太有三，其气三也。有五有三，则生克强
弱，变出其间矣。得其和则为正气而生物，犯其变则为邪气而伤物，其生其死，皆此三五耳，故为寿命之本。上二节大
义与六节藏象论同，详运气类第一章，所当互考。）苍天之气，清净则志意治，顺之则阳气固，（天色深玄，故曰苍天。
天气者，阳气也。苍天之气，清净光明者也，藏德不止，故不下也。人能法天道之清净，则志意治而不乱，阳气固而不
衰，弗失天和、长有天命矣。按∶上文云生之本本于阴阳，而自此以下凡专言阳气者七何也？盖生气通天，以阳为本，
阳气既固，阴必从之，故圣人谆谆于此，其示人之深意可知矣。）虽有贼邪，弗能害也，此因时之序。（阳气固者，其天
全也，天全则神全，虽有贼风邪气，不能犯之，盖在乎因时之序，如四气调神之谓是也。）故圣人传精神，服天气，而通
神明。（传，受也。服，佩也。惟圣人者，能得天之精神，服天之元气，所以与天为一而神明可与天通矣。）失之则内闭
九窍，外壅肌肉，卫气散解。（九窍通于内，肌肉卫于外，其行其固，皆阳气为之主也；失之则失其清阳之化，故九窍肌
肉皆为闭壅矣。人之卫气，本于天之阳气，阳虚则卫虚，卫气散解则天真失守，故本篇所重者特在卫气，正所以重阳气
也。）此谓自伤，气之削也。（真阳受伤，元气如削，非由天降，自作之耳。）
阳气者，若天与日，失其所则折寿而不彰，（此发明阳气之本也。日不明则天为阴晦，阳不固则人为夭折，皆阳气
之
失所也。）故天运当以日光明。（天不自明，明在日月，月体本黑，得日乃明，此天运必以日光明也。日即阳也，阳即明
也，阳之所在，明必随之，明之所及，阳之至耳，阳明一体，本无二也。然阳在午则为昼，而日丽中天，着有象之神明，
离之阳在外也；阳在子则为夜，而火伏水中，化无形之元气，坎之阳在内也。如天元纪大论曰君火以明，正此明也；相
火以位，亦此位也。盖明而在上则为君火，伏明而在下则为相火，曰君曰相，无非阳气之所在耳。然则天之阳气，惟日
为本，天无此日，则昼夜无分，四时失序，万物不彰矣。其在于人，则自表自里，自上自下，亦惟此阳气而已。人而无
阳，犹天之无日，欲保天年，其可得乎？内经一百六十二篇，天人大义，此其最要者也，不可不详察之。君火以明详义，
见运气类三。）是故阳因而上，卫外者也。（清阳为天，包复万物，故因于上而卫于外；人之卫风，亦犹是也。苟不知重，
则邪从而入。故禁服篇曰∶审察卫气，为百病母。）因于寒，欲如运枢，起居如惊，神气乃浮。（此下言阳气不固者，四
时之邪，皆得以伤之也。运枢，如天枢之独运于中也。如惊，谓举动卒暴，不慎重也。凡因于寒者，得冬之气，冬宜闭
藏，当使精神常运于中而身无妄动。若起居不节，则神气外浮，无复中存，邪乃易入矣。脉要精微论曰∶冬日在骨，蛰
虫周密，君子居室。四气调神论曰∶冬三月此谓闭藏，水冰地坼，无扰乎阳。又曰∶去寒就温，无泄皮肤，使气亟夺。
皆此谓也。）因于暑，汗烦则喘喝，静则多言，（暑有阴阳二证，阳证因于中热，阴证因于中寒，但感在夏至之后者皆谓
之暑耳。按热论篇曰∶凡病伤寒而成温者，先夏至日者为病温，后夏至日者为病暑。义可知也。此节所言，言暑之阳者
也。故为汗出烦躁，为喘，为大声呼喝。若其静者，亦不免于多言。盖邪热伤阴，精神内乱，故言无伦次也。）体若燔炭，
汗出而散。（此言暑之阴者也，故体热若燔炭，必须汗出，邪乃得散。如热病篇曰∶暑当与汗皆出，勿止。此之谓也。但
感而即病，则伤寒也。若不即病，至秋而发，则如阴阳应象大论曰∶夏伤于暑，秋必 疟。金匮真言论曰∶夏暑汗不出
者，秋成风疟。皆由此耳。愚按∶洁古曰∶静而得之为中暑，动而得之为中热；中暑者阴证，中热者阳证。东垣曰∶避
暑热于深堂大厦得之者，名曰中暑，其病必头痛恶寒，身形拘急，肢节疼痛而烦心，肌肤火热无汗，此为房室之阴寒所
遏，使周身阳气不得伸越也。若行人或农夫于日中劳役得之者，名曰中热，其病必苦头痛发躁热恶热，扪之肌肤大热，
必大渴引饮，汗大泄，无气以动，乃为天热外伤肺气也。观此二证，一中于热，一中于寒，皆谓之暑；但治寒宜散，必
汗出而解，治热宜凉，必热清而愈。然夏月浮阳在外，伏阴在内，若人以饮食情欲伤其内，或冒暑贪凉劳役过度伤其外，
及元气素虚之辈，最易患此，如刺志论曰气虚身热，得之伤暑者是也。治此者，又当以调补元气为主，然后察其寒热而
佐以解暑之剂。若果为阴寒所中，则附子姜桂，先哲每多用之，不可因炎热在外，而忽舍时从证之良法也。）因于湿，首
如裹，湿热不攘，大筋 短，小筋弛长， 短为拘，弛长为痿。（湿土用事，虽属长夏之气，然土王四季，则感发无时。
但湿之中人，有内外上下之辨∶湿伤外者，雨雾阴湿之属也。湿伤内者，酒浆乳酪之属也。湿在上则首如裹，谓若以物
蒙裹然者，凡人行瘴雾之中及酒多之后，觉胀壅头面，即其状也。湿热，湿郁成热也。攘，退也。湿热不退而下及肢体，
大筋受之则血伤，故为 短。小筋受之则柔弱，故为弛长。 短故拘挛不伸，弛长故痿弱无力。攘，如羊切。 音软，
缩也。弛音矢，废弛也。）因于气，为肿，四维相代，阳气乃竭。（因于气者，凡卫气营气脏腑之气，皆气也，一有不调，
均能致疾。四维，四肢也。相代，更迭而病也。因气为肿，气道不行也。四肢为诸阳之本，胃气所在，病甚而至于四维
相代，即上文内闭九窍、外壅肌肉、卫气解散之谓，其为阳气之竭也可知。）
阳气者，烦劳则张，精绝则辟积于夏，使人煎厥。（此下言起居不节，致伤阳气也。辟、病也。人以阳气为生，惟恐
散失。若烦劳过度，则形气施张于外，精神竭绝于中，阳扰阴亏，不胜炎热，故病积至夏，日以益甚，令人五心烦热，
如煎如熬，孤阳外浮，真阴内夺，气逆而厥，故名煎厥。脉解篇曰∶阳气不得出，肝气当治而未得，故善怒，善怒者名
曰煎厥。详本类后十一。辟音壁。）目盲不可以视，耳闭不可以听，溃溃乎若坏都， 乎不可止。（目盲耳闭，九窍废
也。溃溃，坏貌。都，城郭之谓。 ，逝而不返也。阴以阳亏，精因气竭，精神日销，渐至衰败，真溃溃乎若都邑之
坏， 乎其去不可绾也。 音骨。）
阳气者，大怒则形气绝而血菀于上，使人薄厥。（此下言怒气伤肝及汗湿肥甘风寒之类，皆足以伤阳气也。人之阳气，
惟贵充和。若大怒伤肝，则气血皆逆，甚至形气俱绝，则经脉不通，故血逆妄行，菀积于上焦也。相迫曰薄，气逆曰厥，
气血俱乱，故为薄厥。举痛论曰∶怒则气逆，甚则呕血。邪气脏腑病形篇曰∶有所大怒，气上而不下，积于胁下则伤肝。
皆此谓也。菀音郁。）有伤于筋，纵其若不容。（怒伤形气，必及于筋，肝主筋也。筋伤则纵缓不收，手足无措，其若不
能容者。）汗出偏沮，使人偏枯。（沮，伤也，坏也。有病偏汗者，或左或右，浸润不止，气血有所偏沮，久之则卫气不
固于外，营气失守于中，故当为半身不随偏枯之患。沮，将鱼切。）汗出见湿，乃生痤 。（汗方出则玄府开，若见湿气，
必留肤腠，甚者为痤，微者为 。痤，小 也。 ，暑疹也。痤，才何切。 音沸。）高梁之变，足生大丁，受如持虚。
（高梁，即膏粱，肥甘也。足，多也。浓味太过，蓄为内热，其变多生大疔。热侵阳分，感发最易，如持空虚之器以受
物，故曰受如持虚。）劳汗当风，寒薄为 ，郁乃痤。（形劳汗出，坐卧当风，寒气薄之，液凝为 ，即粉刺也。若郁而
稍大，乃成小 ，是名曰痤。凡若此者，皆阳气不固之使然。 ，支加切，中原雅音云∶酒 鼻。）
阳气者，精则养神，柔则养筋。（此下言阳气之运用，若有不固，则为偻为 ，为畏为惊，为痈为疟为隔等证也。神
之灵通变化，阳气之精明也。筋之运动便利，阳气之柔和也。故精则养神，柔则养筋。阳气去则神明乱，筋骨废，为病
为危，如上文矣。）开阖不得，寒气从之，乃生大偻。（开谓皮腠发泄，阖谓玄府闭封，皆卫气为之主也。若卫气失所，
则当开不开，当闭不闭，不得其宜，为寒所袭，结于筋络之间， 急不伸，则形为偻俯矣。经筋篇曰∶阳急则反折，阴
急则俯不伸。即此之谓。偻音吕。）陷脉为 ，留连肉腠。（陷脉，寒气自筋络而陷入脉中也。 ，鼠 之属。邪结不散，
则留连肉腠，蔓延日甚矣。 音陋，又音闾， 也。）俞气化薄，传为善畏，及为惊骇。（寒气自脉渐深，流于经俞，
气化内薄，则侵及脏腑，故传为恐畏，为惊骇，以阳气受伤于内也。俞音庶。）营气不从，逆于肉理，乃生痈肿。（邪气
陷脉，则营气不从，营行脉中也。不从则不顺，故逆于肉理，聚为痈肿也。）魄汗未尽，形弱而气烁，穴俞以闭，发为风
疟。（魄，阴也。汗由阴液，故曰魄汗。汗出未止，卫气未固，其时形气正在消弱，而风寒薄之，俞穴随闭，邪气留止，
郁而为疟。以所病在风，故名风疟。金匮真言论曰∶夏暑汗不出者，秋成风疟。亦言俞穴之闭也，其义即此。）故风者，
百病之始也，清静则肉腠闭拒，虽有大风苛毒，弗之能害，此因时之序也。（凡邪伤卫气、如上文寒暑湿气风者，莫不缘
风气以入，故风为百病之始。然卫气者，阳气也，人惟清静，无过劳扰，则腠理闭而阳气固，虽有大风苛毒，弗之能害
也。所谓清静者无他，在因四时之气序耳。如四气调神论曰，应春气以养生，应夏气以养长，应秋气以养收，应冬气以
养藏。逆之则灾害生，从之则苛疾不起，顺其自然，是得四时清静之道。又风为百病之始，义详针刺类三十六。）故病久
则传化，上下不并，良医弗为。（并，阴阳交通也。病始因风，久必传化，及至上下不并，则阴阳相离，水火不相济矣，
虽有良医，弗可为也。）故阳蓄积病死，而阳气当隔，隔者当泻，不亟正治，粗乃败之。（若邪蓄阳分，积而不行，阳亢
无阴，其病当死，盖即上下不并之谓也。何以验之？隔塞不通，则其证耳。当泻不泻，正以粗工误之，故致败亡。阴阳
别论曰∶刚与刚，阳气破散，阴气乃消亡。淖则刚柔不和，经气乃绝。亦此之谓。）
故阳气者，一日而主外，平旦人气生，日中而阳气隆，日西而阳气已虚，气门乃闭。（此下言阳气之盛衰，由于日之
升降，正以明上文若天与日之义也。一日而主外，昼则阳气在外也。平旦人气生，以日初升也。日中阳气隆，以日当午
也。日西阳气虚，以日渐降也。人气应之，故昼则卫气行于阳分二十五度，至日暮则阳气之门闭，而行于阴分二十五度
矣。气门，玄府也，所以通行营卫之气，故曰气门。）是故暮而收拒，无扰筋骨，无见雾露，反此三时，形乃困薄。（此
所以顺阳气也。阳出而出，阳藏而藏，暮时阳气藏于阴分，故动宜收敛，以拒虚邪。无扰筋骨，则阳不耗于内；无见雾
露，则邪不侵于外。若劳扰不分朝暮，反此三时，则阳气失养，形体劳困衰薄矣。上二节言不但因时之序，虽以一日之
间，亦当知所调养如此也。）
岐伯曰∶阴者，藏精而起亟也；阳者，卫外而为固也。（此以下伯因帝专言阳气未及于阴，故特明阴气亦所当重。谓
人有阴阳，阳虽主外而为卫，所以固气也；阴则主内而藏精，所以起亟也。阴内阳外，气欲和平，不和则病如下文矣。
亟，即气也，观阴阳应象大论曰精化为气，即此藏精起气之谓。又本神篇曰阴虚则无气，亦其义也。故此当以气字为解，
以见阳能生阴，阴亦能生阳，庶为得理。若诸书释为数字，则全无意义。亟音气。）阴不胜其阳，则脉流薄疾，并乃狂。
（薄，气相迫也。疾，急数也。并者，阳邪入于阳分，谓重阳也。阴不胜阳则阳邪盛，故当为阳脉阳证之外见者如此。）
阳不胜其阴，则五脏气争，九窍不通。（邪在阴分则藏气不和，故有所争。上七窍，五官也。下二窍，二阴也。九窍之气，
*Suwen: Treatise on the Life-Giving and Pathogenic Qi Communicating with Heaven* (Complete Text)
The Yellow Emperor said: Since ancient times, human beings have communicated with Heaven; this is the root of life, which originates from Yin and Yang. Within the universe and between the six directions, the nine regions, nine orifices, five zang organs, and twelve joints all communicate with the Qi of Heaven. (The Great Primal Power of Qian initiates all things, fostering endless generation; this is the virtue of Heaven. All living beings since antiquity rely on the primal Qi of Heaven for their existence. This primal Qi is nothing other than Yin and Yang; thus, Yin and Yang are the root of life. The term "six directions" refers to up, down, front, back, left, and right. The term "nine provinces" refers to Ji, Yan, Qing, Xu, Yang, Jing, Liang, Yong, and Yu. Humans have nine external orifices: seven yang orifices and two yin orifices. Internally, there are five zang organs: heart, lung, liver, spleen, and kidney. Heaven has four seasons and twelve solar terms, governing climate movement. Humans have four limbs and twelve meridians, through which Ying and Wei Qi circulate. External forms represent the flow of phenomena, while internal essence represents the ascent and descent of spirit. Darkness and light, motion and stillness—all derive from Heaven. Hence, it is said that they all communicate with the Qi of Heaven.) Life is generated according to the Five Phases, and its numerical structure involves three. If these principles are violated, pathogenic Qi will harm the person; this constitutes the foundation of longevity. (Although humans originate from Yin and Yang, they inherit the attributes of the Five Phases, hence "generated by five." The fluctuation of Yin and Yang manifests in three states: Shao (Lesser), Tai (Greater), etc., hence "numbered three." With five and three, generating and overcoming, strength and weakness, and transformations arise within. Harmony results in Zheng Qi (Upright Qi), which generates and nourishes; violation of harmony results in Xie Qi (Pathogenic Qi), which harms. Life and death depend on these "five" and "three," making them the root of longevity. The main meaning of the preceding two sections aligns with the *Treatise on Six Sections and Zang Image*; see Chapter 1 of the *Qi Yun Category* for detailed cross-reference.) The Qi of the Azure Heaven is pure and clear; when followed, one's will and intent remain orderly, and Yang Qi becomes secure. (The sky is deep black, hence called "Azure Heaven." Heavenly Qi is Yang Qi. The Qi of the Azure Heaven is pure, clear, and luminous, storing virtue without ceasing, thus not descending. If humans emulate the purity and clarity of Heaven, their will and intent remain orderly and unconfused, and Yang Qi remains secure and un-depleted, preserving Heavenly Harmony and prolonging life. Note: The text previously stated that the root of life lies in Yin and Yang, yet subsequently emphasizes Yang Qi seven times. Why? Because the Life-Giving Qi communicates with Heaven, relying fundamentally on Yang. Once Yang Qi is secure, Yin naturally follows. Thus, the Sage’s earnest emphasis reveals profound instructional intent.) Even if malicious pathogens exist, they cannot harm, provided one adheres to the sequence of seasons. (When Yang Qi is secure, Heavenly Virtue is preserved; when Heavenly Virtue is preserved, Spirit is complete. Although wind and pathogenic factors may be present, they cannot invade, as long as one follows the seasonal order, as described in the *Treatise on Regulating Spirit According to the Four Seasons*.) Therefore, the Sages preserve their spirit, assimilate the Qi of Heaven, and achieve communication with Divine Illumination. ("Chuan" means to receive; "Fu" means to wear/embrace. Only the Sages can receive the Spirit of Heaven and embrace the Primordial Qi of Heaven, thereby uniting with Heaven and allowing their Divine Illumination to communicate with Heaven.) Failure to do so results in the internal blockage of the nine orifices, external congestion of muscles, and the dispersion and dissolution of Wei Qi (Defensive Qi). (The nine orifices connect internally, and muscles protect externally; their function and security are governed by Yang Qi. Loss of this leads to the loss of Clear Yang transformation, causing blockage of orifices and muscles. Human Wei Qi originates from Heavenly Yang Qi; Yang deficiency leads to Wei deficiency. When Wei Qi disperses, Heavenly Truth is lost. Hence, this chapter specifically highlights Wei Qi to emphasize the importance of Yang Qi.) This is termed self-injury, leading to the depletion of Qi. (True Yang is injured, and Yuan Qi (Primal Qi) is diminished; this is not imposed by Heaven but is self-inflicted.)
Yang Qi is like the sky and the sun; if it loses its proper position, lifespan is shortened and brilliance is obscured. (This elucidates the fundamental nature of Yang Qi. If the sun is dim, the sky becomes dark; if Yang Qi is insecure, premature death occurs. Both result from Yang Qi losing its proper state.) Therefore, the movement of Heaven relies on the brightness of the sun. (Heaven does not shine on its own; illumination comes from the sun and moon. The moon is inherently dark and shines only by reflecting the sun. Thus, Heaven’s movement requires the sun’s brightness. The Sun is Yang, and Yang is Brightness. Wherever Yang resides, Brightness follows. Wherever Brightness reaches, Yang is supreme. Yang and Ming are one entity, originally undivided. However, when Yang is at Wu (noon), it is day, and the sun hangs in the mid-heaven, manifesting visible divine illumination; this is Li (Fire) Yang residing externally. When Yang is at Zi (midnight), it is night, and fire hides in water, transforming into invisible primordial Qi; this is Kan (Water) Yang residing internally. As stated in the *Treatise on the Great Principles of Heavenly Origins*: "Ruler Fire illuminates," referring to this brightness; "Minister Fire holds its position," referring to this positioning. Brightness above constitutes Ruler Fire; hidden brightness below constitutes Minister Fire. Whether called Ruler or Minister, both refer to the presence of Yang Qi. Thus, the Yang Qi of Heaven takes the Sun as its root. Without the Sun, there would be no distinction between day and night, disorder in the four seasons, and failure of all things to flourish. In humans, from exterior to interior, from top to bottom, only this Yang Qi exists. A person without Yang is like a heaven without the sun; how could one preserve their natural lifespan? Among the 162 chapters of the *Neijing*, the principle of Heaven and Humanity is most crucial here and must be examined in detail. For the detailed meaning of "Ruler Fire illuminates," see Part 3 of the *Qi Yun Category*.) Therefore, Yang Qi resides superiorly and protects the exterior. (Clear Yang constitutes Heaven, enveloping all things; thus, it resides superiorly and protects externally. Human protection against wind is similar. If this is neglected, pathogens enter easily. Hence, the *Jinfu Chapter* states: "Examine Wei Qi, for it is the mother of all diseases.")
If affected by Cold, Yang Qi should move freely like a door pivot; if daily activities are erratic or startling, Shen Qi (Spiritual Qi) will float outward. (This section discusses cases where Yang Qi is insecure, allowing seasonal pathogens to cause harm. "Moving pivot" implies central operation like Tianshu. "Startling" refers to sudden, rash movements lacking prudence. Cases involving Cold stem from Winter Qi. Winter favors storage; one should keep spirit centered and avoid reckless physical activity. Irregular lifestyle causes Shen Qi to float outward, leaving the center vulnerable to pathogens. The *Chapter on Essential subtleties of Pulse Diagnosis* states: "In winter, Yang resides in the bones... Gentlemen dwell indoors." The *Treatise on Regulating Spirit* states: "The three months of winter are called Storage... Do not disturb Yang. Avoid cold and seek warmth; do not allow skin pores to open, causing frequent Qi loss.")
If affected by Summer-Heat, sweating occurs; if agitated, panting and loud shouting follow; if quiet, excessive talking ensues. (Summer-Heat presents as either Yang or Yin syndromes. Yang syndrome stems from internal heat; Yin syndrome stems from internal cold. Any condition occurring after the Summer Solstice is termed Summer-Heat. The *Treatise on Heat Diseases* states: "Diseases transforming from Cold into Warmth occur before the Summer Solstice as Warm Disease, and after as Summer-Heat." This section describes Yang-type Summer-Heat. Symptoms include sweating, irritability, panting, and loud vocalization. Even in quiet states, excessive speech occurs due to pathogenic heat injuring Yin and disrupting internal spirit, leading incoherent speech.) The body feels hot as if burning charcoal; sweating dissipates the heat. (This describes Yin-type Summer-Heat. Body heat resembles burning charcoal; sweating is required to disperse the pathogen. The *Treatise on Heat Diseases* states: "Summer-Heat should exit with sweat; do not stop it." Immediate onset indicates Cold Damage; delayed onset until autumn manifests as Malaria, as stated in the *Treatise on Yin-Yang Correspondence*: "Summer injury by Summer-Heat leads to Autumn Malaria." Also, the *Golden Cabinet True Discourse* notes: "Failure to sweat in summer leads to Wind-Malaria in autumn." Jiegu stated: "Quiet acquisition is Zhongshu (Midsummer Stroke); active acquisition is Zhongre (Midsummer Heat). Zhongshu is Yin syndrome; Zhongre is Yang syndrome." Dongyuan added: "Acquired in cool halls is Zhongshu, presenting with headache, aversion to cold, stiffness, limb pain, vexation, hot skin without sweat, caused by indoor cold suppressing Yang. Acquired during outdoor labor is Zhongre, presenting with severe headache, restlessness, aversion to heat, high fever, extreme thirst, profuse sweating, and lethargy, caused by heavenly heat injuring Lung Qi." Treatment for Cold-induced Summer-Heat requires dispersal and sweating; treatment for Heat-induced Summer-Heat requires cooling and clearing heat. In summer, floating Yang is external and hidden Yin is internal. Internal injury from diet/desire or external injury from cold/labor in those with deficient Yuan Qi are prone to this. Treatment should primarily tonify Yuan Qi, then address cold/heat with resolving agents. If truly affected by Yin-Cold, herbs like Aconite, Ginger, and Cinnamon Twig are appropriate; do not ignore season-appropriate treatment due to external heat.)
If affected by Dampness, the head feels wrapped; if Damp-Heat is not resolved, large tendons shorten and small tendons relax. Shortening causes spasms; relaxation causes flaccidity. (Dampness belongs to Earth and Long Summer, but Earth governs all four seasons, so Dampness can strike anytime. External Dampness comes from rain/fog/mist; internal Dampness from alcohol/dairy. Dampness affecting the upper body causes a sensation of heaviness as if wrapped. Damp-Heat arises from Dampness stagnating into Heat. "Rang" means retreat/discharge. If Damp-Heat descends to limbs, damaging large tendons causes blood injury and shortening (spasms); damaging small tendons causes softness and relaxation (flaccidity).)
If affected by Qi disorders, swelling occurs; if the four limbs alternate in disease, Yang Qi is exhausted. (Qi disorders involve Wei Qi, Ying Qi, and Zang-Fu Qi. Imbalance causes disease. "Siwei" refers to the four limbs. "Xiangdai" means alternating affliction. Swelling due to Qi indicates obstruction of Qi pathways. The four limbs are the root of Yang and the seat of Stomach Qi. Severe disease affecting the limbs alternately reflects the earlier description of blocked orifices, congested muscles, and dispersed Wei Qi, indicating exhaustion of Yang Qi.)
Yang Qi, when subjected to excessive fatigue and strain, becomes hyperactive; if Essence is depleted, accumulation in summer leads to Jian Jue (Frying Syncope). (This section discusses lifestyle irregularities injuring Yang Qi. "Pi" means disease. Humans rely on Yang Qi for life. Excessive strain causes Form and Qi to expand outward while Spirit and Essence are exhausted inward. Yang disturbs and Yin亏损, unable to withstand heat. By summer, symptoms worsen, causing five-palm heat, feeling as if frying or boiling, with floating Yang and depleted True Yin, leading to Qi reversal and syncope, hence "Jian Jue." The *Pulse Resolution Chapter* states: "When Yang Qi cannot emerge... anger leads to Jian Jue.") Blindness prevents vision; deafness prevents hearing; the condition deteriorates rapidly like a collapsing city, irretrievably lost. (Blindness and deafness indicate failure of the nine orifices. "Kui kui" describes collapse. "Du" refers to city walls. "Gu" implies passing away without return. Yin declines due to Yang deficiency; Essence depletes due to Qi exhaustion. Spirit fades gradually until total collapse, like a ruined city, irrecoverable.)
Yang Qi, upon extreme anger, causes Form and Qi to sever, with Blood pooling upward, leading to Bo Jue (Thrusting Syncope). (Anger injures the Liver and damages Yang Qi. Anger causes Qi and Blood to reverse. Severe cases lead to meridian obstruction, with rebellious Blood pooling in the Upper Jiao. "Bo" means pressing/thrusting; "Jue" means reversal. Chaotic Qi and Blood cause Bo Jue. The *Treatise on Painful Conditions* states: "Anger causes Qi reversal, potentially leading to vomiting blood." The *Chapter on Pathogenic Factors and Zang-Fu Images* states: "Great anger causes Qi to rise and not descend, accumulating under the ribs and injuring the Liver.") Injury to tendons causes flaccidity and inability to control limbs. (Anger injures Form and Qi, affecting tendons, which are governed by the Liver. Tendon injury causes flaccidity and loss of motor control.)
Sweating on one side only leads to Piangu (Hemiplegia). ("Ju" means injury/destruction. Unilateral sweating indicates biased Qi and Blood. Over time, Wei Qi fails to protect externally, and Ying Qi fails to guard internally, resulting in hemiplegia.")
Sweating exposed to dampness generates Cuo (Miliaria/Pustules). (When pores open during sweating, dampness enters the skin. Severe cases cause Cuo (pustules); mild cases cause Fei (miliaria).)
Excessive consumption of rich food and drink produces large Ding (Carbuncles); susceptibility is like holding an empty vessel. ("Gaoliang" refers to rich, fatty foods. Excess creates internal heat, easily triggering Carbuncles. Heat invading Yang levels makes infection easy, like receiving objects in an empty container.")
Sweating while exposed to wind: Cold forces condensation into , which stagnates into Cuo. (Labor-induced sweating exposed to wind allows Cold to condense fluids into comedones. Stagnation enlarges them into pustules. These result from insecure Yang Qi.)
Yang Qi, when refined, nourishes Spirit; when soft, nourishes Tendons. (If Yang Qi is insecure, it leads to stooping, tremors, fear,惊骇 (startle), abscesses, malaria, and obstruction. Spiritual clarity derives from refined Yang Qi; tendon mobility derives from soft Yang Qi. Loss of Yang leads to mental confusion and tendon dysfunction.)
If opening and closing fail, Cold Qi invades, causing severe stooping. ("Kai" is pore opening; "He" is pore closing, governed by Wei Qi. Dysfunction allows Cold to bind tendons, causing flexion deformities. The *Meridian Sinew Chapter* states: "Yang tension causes backward arching; Yin tension causes forward flexion.")
Cold sinking into meridians causes Lu (Abscesses), lingering in flesh and fascia. (Cold penetrates from sinews into meridians, forming abscesses. Pathogens linger and spread.)
Weakened Qi transformation at Shu points transmits to fear and startle. (Cold moves deeper into meridians and Shu points, affecting internal organs via Qi transformation, causing fear and startle due to internal Yang injury.)
Blocked Ying Qi reverses in muscle tissue, generating abscesses and swelling. (Pathogens sinking into meridians block Ying Qi circulation. Reversal in muscle tissue causes abscesses.)
Incomplete expulsion of Po Han (Sweat associated with Po/Lung) leaves the form weak and Qi scorched; acupoints close, triggering Feng Nue (Wind Malaria). (Po relates to Yin; sweat is Yin fluid. Incomplete sweating leaves Wei Qi insecure. Wind-Cold closes acupoints, trapping pathogens as Malaria.)
Therefore, Wind is the beginning of all diseases. Purity and stillness close muscle fascia, repelling even severe pathogens, by following seasonal order. (All pathogens enter via Wind. Wei Qi is Yang Qi. Purity and stillness secure Yang Qi and close pores, preventing invasion. This follows the *Treatise on Regulating Spirit*: aligning with Spring, Summer, Autumn, and Winter preservation.)
Long-standing disease transforms and spreads; if Upper and Lower do not connect, even skilled physicians cannot treat. ("Bing" means connection/communication. Prolonged Wind pathology leads to separation of Yin and Yang, failing to balance Water and Fire. Treatment becomes impossible.)
Death from Yang accumulation occurs when Yang is obstructed; obstruction requires purging. Neglecting correct treatment leads to failure by incompetent practitioners. (Accumulated Yang without Yin leads to death, akin to Upper-Lower disconnection. Obstruction confirms this. Failure to purge leads to collapse. The *Treatise on Distinctions of Yin and Yang* warns: "Hardness meeting hardness breaks Yang Qi...")
Yang Qi governs the exterior throughout the day: at dawn, Ren Qi (Human Qi) rises; at noon, Yang Qi peaks; at dusk, Yang Qi wanes, and Gate Qi (acupoints/pores) close. (Daytime Yang resides externally. Dawn corresponds to sunrise; Noon to zenith; Dusk to sunset. Wei Qi circulates 25 degrees in Yang meridians by day and Yin meridians by night. "Gate Qi" refers to pores regulating Ying/Wei circulation.)
Therefore, evening requires conservation and rejection of pathogens; avoid disturbing sinews and bones, and avoid fog/dew. Violating these three times leads to physical decline. (Evening is for Yin storage. Conservation rejects vacuous pathogens. Protecting sinews/bones prevents internal Yang depletion; avoiding fog/dew prevents external invasion. Irregular timing depletes Yang and weakens the form.)
Qibo said: Yin stores Essence and generates Qi urgently; Yang protects the exterior and maintains security. (Yin stores Essence to generate Qi; Yang guards the exterior. Yin is internal, Yang is external. Harmony prevents disease. "Ji" means Qi. Essence transforms into Qi. Yin deficiency leads to Qi deficiency. Yin and Yang generate each other.)
If Yin cannot overcome Yang, pulses become rapid and forceful, leading to mania. (Yang excess overwhelms Yin, causing rapid pulses and Yang syndromes like mania.)
If Yang cannot overcome Yin, Zang Qi conflicts, and the nine orifices become blocked. (Pathogens in Yin disrupt Zang harmony. Nine orifices (seven upper, two lower) fail to function due to Yin dominance.)