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Recorded in *Suwen: Commentary on Heat Diseases* (*Suwen · Ping Re Bing Lun*):
The Yellow Emperor asked, saying: There is a person suffering from a warm disease (Wenbing, febrile diseases caused by warm pathogens). After sweating, the fever returns immediately, and the pulse is rapid and restless. The sweating does not alleviate the condition; instead, the patient speaks deliriously and cannot eat. What is the name of this disease?
Qibo replied: This disease is named "Yin-Yang Jiao" (Intertwining of Yin and Yang). "Jiao" indicates a fatal outcome.
(Note: Sweat is the fluid of Yin. Body heat and a restless pulse are manifestations of Yang pathogenic factors. After sweating in a warm disease, the pathogen should resolve with the sweat, and the heat and pulse should subside and calm down. Now that the condition does not improve after sweating, it signifies extreme excess of Yang, and Yin Qi cannot recover. Hence, delirium and anorexia occur. Precisely because Yang pathogens intertwine into the Yin aspect, causing Yin Qi to lose its hold, it is called "Yin-Yang Jiao," where "Jiao" implies death.)

The Yellow Emperor said: I wish to hear the explanation.
Qibo said: The reason humans produce sweat lies in Gu Qi (Grain Qi/Nutritive Qi derived from food), which generates Jing Qi (Essence Qi).
(Gu Qi abundant internally generates Jing Qi. When Jing Qi reaches the exterior, it transforms into sweat.)
Now, when pathogenic factors contend with healthy Qi in the muscles and bones, resulting in sweating, it means the pathogen is retreating and Jing Qi is prevailing. If Jing Qi prevails, the patient should be able to eat and not have recurrent fever.
(Only when Jing Qi defeats the pathogen can sweat be produced. As the pathogen disperses with the sweat, the patient should be able to eat and no longer experience fever.) Recurrent fever indicates the presence of pathogenic factors. Sweat represents the leakage of Jing Qi. Now, sweating followed immediately by recurrent fever indicates that the pathogen is prevailing over the Jing Qi. Inability to eat means that Jing Qi lacks support/nourishment.
(Bi means to enable or assist. Jing refers to Yin Qi. The Zang organs store Jing Qi. If the Qi of the Zang organs is deficient, they cannot facilitate digestion and intake, hence it is said "Jing has no Bi." Bi is pronounced like "Bi".) If the disease lingers, life expectancy will end abruptly.
(If pathogenic Qi remains without receding, Yuan Qi (Original Qi) will deteriorate daily, inevitably leading to death.) Furthermore, *Re Lun* (Treatise on Heat) states: Those who sweat but whose pulses remain rapid and vigorous will die.
(*Re Lun* refers to the chapter "Heat Diseases" in *Lingshu*, see Acupuncture Category 40. Generally, after sweating, the pulse should become slow and quiet. If it remains rapid and vigorous, it directly indicates exhaustion of Yin and exclusive dominance of the pathogen, so the disease is fatal.) Now, the pulse does not correspond with the sweating, indicating that healthy Qi cannot overcome the disease; death is evident.
(Jing Qi fails to overcome pathogenic Qi.) Delirious speech indicates loss of Zhi (Will/Spirit). Loss of Zhi leads to death.
(This generally refers to the Five Zhi associated with the Five Zang organs. Zhi resides in Jing. If Jing cannot resist the pathogen, the Zhi of all five Zang organs will be lost, leading to delirium and often death.) Now, three signs of death are observed, while no sign of life is seen. Even if there is temporary improvement, death is inevitable.
(Sweating followed by immediate fever and inability to eat is the first sign of death; sweating followed by a still rapid and vigorous pulse is the second sign of death; sweating followed by delirium and loss of Zhi is the third sign of death. With these three conditions present, they are indicators of certain death.)