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(Suwen: Treatise on the Differences between Taiyin and Yangming)

The Yellow Emperor asked, "Taiyin (Spleen Meridian of Foot-Taiyin) and Yangming (Stomach Meridian of Foot-Yangming) are exterior-interior pairs, corresponding to the pulses of the Spleen and Stomach respectively. Why do they manifest different diseases?" (Taiyin belongs to the Spleen, Yangming belongs to the Stomach. Although both belong to Earth in the Five Elements, one is exterior and the other interior; therefore, the pathogenic factors they receive and the injuries they sustain differ.)

Qibo replied, "Yin and Yang occupy different positions, alternating between deficiency and excess, and between reversal and compliance. Some diseases originate internally, others externally. Because the pathways of onset differ, the names of the diseases also differ." (The Spleen is a Zang organ, belonging to Yin. The Stomach is a Fu organ, belonging to Yang. Yang governs the exterior, Yin governs the interior; Yang governs the upper, Yin governs the lower. This constitutes the difference in position between Yin and Yang. When Yang is deficient, Yin becomes excessive; when Yin is deficient, Yang becomes excessive. This is the alternation of deficiency and excess. Disease manifestation represents 'reversal' (Ni), while health represents 'compliance' (Cong). This is the alternation of reversal and compliance. All these cases arise because the pathways of onset differ, hence the disease names vary.)

The Yellow Emperor said, "I wish to hear about their specific differing symptoms." Qibo said, "Yang Qi is like Heaven's Qi, primarily governing the exterior; Yin Qi is like Earth's Qi, primarily governing the interior." (The Stomach belongs to the Three Yang meridians, thus governing Heaven's Qi. The Spleen belongs to the Three Yin meridians, thus governing Earth's Qi.) "Therefore, the pathway of Yang tends toward excess, and the pathway of Yin tends toward deficiency." (This refers to the principle that Yang is firm and Yin is soft. Furthermore, external pathogens often manifest as excess syndromes, so the Yang pathway is often solid. Internal injuries often manifest as deficiency syndromes, so the Yin pathway is often empty. Another view states that if Yin is excessive, Yang is deficient; this also aligns with the concept of alternating deficiency and excess mentioned earlier.)

Thus, those who contract thievish winds and empty evils (external pathogens) are affected by Yang first; those whose diet is irregular and daily routine unregulated are affected by Yin first. When Yang is affected, the pathogen enters the Six Fu organs; when Yin is affected, the pathogen enters the Five Zang organs. (Thievish winds and empty evils are external injuries, so they are received by Yang and enter the Fu organs. Diet and daily routine irregularities are internal injuries, so they are received by Yin and enter the Zang organs.)

When entering the Six Fu organs, it results in fever and inability to sleep at proper times, progressing upward to panting and calling out; when entering the Five Zang organs, it results in abdominal fullness and obstruction, progressing downward to undigested stool diarrhea (Sun-xie), and over time to intestinal dysentery (Chang-bi). ("Inability to sleep at proper times" means not being able to sleep according to the natural rhythm. Yang pathogens in the exterior and upper levels cause fever, insomnia, panting, and calling out. Yin pathogens in the interior and lower levels cause fullness, Sun-xie, and Chang-bi. 'Chen' sounds like 'chēn', 'Sun' sounds like 'sūn', 'Pi' sounds like 'pì'.)

Therefore, the throat governs Heaven's Qi, and the pharynx governs Earth's Qi. (The throat is the connection of the Lung system, used for receiving Qi, thus connecting upward to Heaven. The pharynx is the connection of the Stomach system, used for swallowing food and water, thus connecting downward to Earth.)

Consequently, Yang meridians are susceptible to Wind pathogens, and Yin meridians are susceptible to Dampness pathogens. (Wind is Yang Qi, so it is received by the Yang aspect. Dampness is Yin Qi, so it is received by the Yin aspect. This follows the principle of similarity.)

Yin Qi ascends from the feet to the head, then descends along the arms to the fingertips; Yang Qi ascends from the hands to the head, then descends to the feet. (The *Ling Shu: Chapter on Reverse, Smooth, Fat, and Thin* states: The three Yin meridians of the hand travel from the Zang organs to the hands; the three Yang meridians of the hand travel from the hands to the head. The three Yang meridians of the foot travel from the head to the feet; the three Yin meridians of the foot travel from the feet to the abdomen. This is what is meant. Generally, Yin Qi is below, and Qi from below must ascend; Yang Qi is above, and Qi from above must descend. The movement of Spleen Yin and Stomach Yang Qi follows this pattern.)

Therefore, it is said that Yang diseases tend to move upward to an extreme and then downward, while Yin diseases tend to move downward to an extreme and then upward. (When Yang disease reaches its extreme, it affects the lower part; when Yin disease reaches its extreme, it affects the upper part. Extremes lead to transformation. This applies not only to up and down but also to exterior and interior.)

Thus, those injured by Wind are affected on the upper part first; those injured by Dampness are affected on the lower part first. (Yang meridians receive Wind, so the upper part is affected first. Yin meridians receive Dampness, so the lower part is affected first. However, the upper part is not devoid of Dampness, nor is the lower part devoid of Wind; there is merely a sequence of reception. To say 'affected first' implies the order of subsequent reception.)

The Yellow Emperor asked, "Why does Spleen disease result in the inability to use the four limbs?" Qibo replied, "The four limbs all derive their Qi from the Stomach, but Stomach Qi cannot reach the meridians directly; it must rely on the Spleen to be distributed." (The following text explains that Stomach Qi must rely on Spleen Qi to function.)

"Now, when the Spleen is diseased and cannot transport fluids and essence for the Stomach, the four limbs do not receive Water-God Qi (nutritive essence from food and drink). Qi declines day by day, the meridians become obstructed, and the sinews, bones, muscles, and flesh lack the source of Qi to generate vitality, resulting in dysfunction." (The movement of the four limbs relies on Stomach Qi. However, Stomach Qi cannot reach the various meridians on its own; it requires the Spleen's transportation to transform the Qi of food and drink in the Stomach into refined essence, which then reaches the four limbs. If the Spleen is diseased, Stomach Qi fails to circulate, causing the meridians to decline daily, and the four limbs lose their function. The character 'Wei' is pronounced with the departing tone, same as below.)

The Yellow Emperor asked, "The Spleen and Stomach are connected only by membranes; why can the Spleen transport fluids for the Stomach?" (The following text explains that the meridians of the Three Yin and Three Yang all derive from the Qi of the Spleen and Stomach. 'Membrane' is pronounced as 'mo' or 'mò'.)

Qibo replied, "Foot-Taiyin is one of the Three Yin meridians. Its vessel penetrates the Stomach, connects to the Spleen, and links to the pharynx; therefore, Taiyin transports Qi to the Three Yin meridians." (What 'transports for it' means is transporting for the Stomach. The Spleen vessel penetrates the Stomach and connects to the Spleen, belonging to Foot-Taiyin; thus, it transports Qi to the Three Yin meridians. The Three Yin refer to the Five Zang organs.)

"Foot-Yangming is the exterior meridian and the Sea of the Five Zang and Six Fu organs; it also transports Qi to the Three Yang meridians." (Yangming is the exterior counterpart of Taiyin, governing the reception of food and drink to nourish the Zang and Fu organs, hence called the Sea of the Five Zang and Six Fu organs. Although Yangming transports Qi to the Three Yang meridians, it also relies on Spleen Qi to function, hence the word 'also'. The Three Yang refer to the Six Fu organs.)

"The Zang and Fu organs each receive Qi from Yangming through their respective meridians; therefore, [the Spleen] transports fluids for the Stomach." ('Through their respective meridians' refers to the Spleen meridian. The Zang and Fu organs receive from Yangming because the Spleen meridian penetrates the Stomach, enabling it to transport fluids for the Stomach.)

"When the four limbs do not receive Water-God Qi, they decline increasingly. The Yin vessels (blood vessels) become obstructed, and the sinews, bones, muscles, and flesh lack Qi to generate vitality, resulting in dysfunction." ('Yin vessels' refers to blood vessels. This reiterates the principle that the Spleen governs the four limbs.)