出血必多。按灵素皆无痰字。惟此处有饮字。金匮痰饮。本作淡。）脉大血少者。脉有风气。水浆不入也。（有风故脉大。
水浆不入则血无借以生。）夫实者气入也。虚者气出也。（邪入故实。正出故虚。）气实者热也。气虚者寒也。（邪盛故热。
正虚故寒。）（刺志论）
【素】肝病者。两胁下痛引小腹。（肝脉布胁肋。抵小腹。）令人善怒。（实则善怒。）虚则目 （ 。音荒。）无所
见。耳无所闻。（血虚。）善恐。如人将捕之。（魂不安。又肝虚胆亦虚。）气逆则头痛。（厥阴与督脉会于巅。）耳聋不聪。
（肝与胆相表里。胆脉入耳中。）颊肿。（脉下颊里。）心病者。胸中痛。胁支满。胁下痛。（少阴心别脉。厥阴心主脉。
皆循胸出胁。）膺（胸也。）背肩甲（胛同。）间痛。两臂内痛。（心脉循臂内。小肠脉循臂。绕肩胛交肩上。）虚则胸腹大。
胁下与腰相引而痛。（手心主脉起胸中。下膈络三焦。支者循胸出胁。少阴心脉下膈络小肠。故皆引痛。）脾病者。身重。
善肌肉痿。（脾主肌肉。肉痿故身重。肌一作饥。）足不收。行善螈。脚下痛。（脾主四肢。脉起于足。）虚则腹满肠鸣。
（灵
枢云。中气不足。腹为之善满。肠为之苦鸣。）飧泄食不化。肺病者。喘咳逆气。肩背痛。汗出。（肺主皮毛。气逆于上。
则痛连肩背。而汗出。）尻阴股膝髀 （音善。足肚。） 足皆痛。（肺为肾母。母病则子亦受邪。气逆于下。故下部皆痛。）
虚则少气。不能报息。（气不相续。）耳聋嗌干。（肺络会耳中。肾脉入肺中。循喉咙。肺虚则肾气不能上润。故耳聋嗌干。）
肾病者。腹大胫肿。（肾脉循足上 。贯肝膈。）喘咳（脉入肺中。）身重。（骨痿故重。）寝汗出憎风。（肾属阴。阴虚故
寝而盗汗出。腠理不固。故憎风。）虚则胸中痛。（脉注胸中。）大腹小腹痛清厥。（足冷气逆。）意不乐。（肾中真阳不舒。）
（藏气法时篇）
【素】是以头痛巅疾。下虚上实。（下正气虚。上邪气实。）过在足少阴巨阳。甚则入肾。（肾与膀胱相表里。膀胱脉
交巅上。肾虚不能行巨阳之气。其气逆而上行。故头痛巅疾。甚则乘肾虚。而经邪入脏矣。） 蒙招尤。（ 蒙。目 物
而蒙昧也。尤。过也。王注。 。疾也。吴注。改 为 。未确。）目冥耳聋。下实上虚。过在足少阳厥阴。（胆与肝相
表里。胆脉起目锐 。入耳中。目为肝窍。肝脉连目系。今肝胆在下而火实。耳目在上而血虚。故冥聋。）甚则入肝。（经
邪入脏。）腹满 胀。支膈 胁。（胁上为 。支格于膈 胁。）下厥上冒。（下逆冷。上昏冒。）过在足太阴阳明。（脾与
胃相表里。脾脉入腹上膈。胃脉下膈。循腹里。）咳嗽上气。厥（气逆。）在胸中。过在手阳明太阴。（大肠与肺相表里。
肺脉络大肠。上膈大肠脉络肺。下膈。又肺主咳主气。）心烦头痛。病在膈中。过在手巨阳少阴。（小肠与心相表里。小
肠脉络心下膈。其支者循颈上颊。心脉下膈。络小肠。）（五脏生成论）
【素】二阳之病发心脾。有不得隐曲。女子不月。（二阳。足阳明胃手阳明大肠也。隐曲。隐蔽委曲之事也。心生血。
脾统血。胃为水谷之海。大肠为传送之官。血之所以资生者也。二经病。则心脾之精血衰少。故男为房事不利。女为月
事不下也。厥论曰。前阴者。宗筋之所聚。太阴阳明之所合也。痿论曰。阴阳总宗筋之会。而阳明为之长。故胃病则阳
事衰也。）其传为风消。其传为息贲者。死不治。（脾病不已。风木乘虚克之。故肌肉日消。心病不已。火邪乘肺。故气
息奔迫。）三阳为病发寒热。下为痈肿。及为痿厥 KT 。（三阳。手太阳小肠足太阳膀胱也。 。音善。足肚也。KT
。
音渊。酸痛也。膀胱水化。小肠火化。故发寒热。寒热郁结。则为肿为痈。热胜则痿。寒胜则厥。或不痿厥。则为酸痛。）
其传为索泽。（小肠膀胱主津液。津枯而色泽消索。）其传为 疝。（邪传入肝。而见症于小肠膀胱。则为 疝。）一阳发
病。少气善咳善泄。（一阳。手少阳三焦足少阳胆也。二经皆有相火。壮火食气。故少气。火邪乘肺。故咳。大肠燥金受
克。故泄也。）其传为心掣。其传为隔。（火邪乘心。故掣。三焦火盛。食入还出。故隔。）二阳一阴病。主惊骇背痛。善
噫善欠。名曰风厥。（二阳。大肠胃也。一阴。心包肝也。风火相薄。故惊骇。按四经皆与背无涉。而云背痛。未详。心
为噫。阳明络属心。故善噫。阴阳相引。故欠。风木干胃土。故厥。）二阴一阳发病。善胀心满。善气。（二阴。心肾也。
一阳。三焦胆也。心肾俱病。则水火不交。胆三焦俱病。则上下不通。故胀满善气。善气。气逆也。）三阳三阴发病。为
偏枯痿易。四肢不举。（三阳。小肠膀胱。三阴。脾肺也。小肠行手主液。膀胱行足主筋。脾主四肢。肺行诸气。四经并
病。故然。）二阳结谓之消。（胃大肠热结。则消谷善饥。所谓瘅成为消中也。）三阳结谓之隔。（小肠主液。膀胱主津。
二经热结。故隔塞不便。一作膈症。饮食不下。）三阴结谓之水。（肺不能行下降之令。使水精四布。脾失其营运之职。
而无以制防。遂令阴气停凝而为水。）一阴一阳结谓之喉痹。（肝胆心包三焦。皆有相火。脉循喉挟咽。故喉痹。）阴搏阳
别谓之有子。（以下阴阳。指尺寸言。尺脉搏手。异于寸口。阴中别有阳也。）阴阳虚。肠 死。（尺寸俱虚。下痢不止。
故死。）阳加于阴谓之汗。（阳气搏阴。蒸而为汗。）阴虚阳搏谓之崩。（阴虚而阳火搏之。能逼血妄行。）（阴阳别论）
【灵】胃中热则消谷。令人悬心善饥。脐以上皮热。肠中热则出黄如麋。脐以下皮寒。胃中寒则腹胀。肠中寒则肠
鸣飧泄。胃中寒肠中热。则胀而且泻。胃中热肠中寒。则疾饥。（胃热。）小腹痛胀。（肠寒。）（师传）
【素】太阳所谓肿。腰 痛者。（ 。臀也。）寅、太阳也。（太阳为三阳。寅月亦为三阳。）正月阳气出在上。而阴
气盛。阳未得自次也。故肿腰 痛也。病偏虚为跛者。（足不能履。）正月阳气冻解。地气而出也。冬寒颇有不足者。故
偏虚为跛也。所谓强上（头项强急。）引背者。阳气太上而争。故强上也。所谓耳鸣者。阳气万物盛。上而跃也。（太阳
耳鸣属外感。非肾虚。）所谓甚则狂巅疾者。（或狂或头痛。）阳尽在上。而阴气从下。下虚上实也。（正月三阴三阳平等。
今尽出在上。则下虚上实。故有巅狂脑痛之病。）所谓浮为聋者。皆在气也。（膀胱脉至耳上角。气逆故聋。）所谓入中为
喑者。（太阳与少阴为表里。表邪传里。则喑不能言。）阳盛已衰也。（如下文夺于内事。故阳虚不能言。）内夺而厥。则
为喑俳。（俳。当作痱。手足废也。内夺。房劳也。下虚故厥逆。而四肢不收。肾脉挟舌本。故喑。）此肾虚也。少阴不
至者厥也。（肾虚故少阴之脉不至。少阴不能行巨阳之气。故厥。）少阳所谓心胁痛者。（少阳脉。循胸胁。）言少阳盛也。
盛者心之所表也。（心属君火无为用。少阳相火而表着。）九月阳气尽而阴气盛。故心胁痛也。（火墓于戌。阴盛故痛。）
所谓不可反侧者。阴气藏物也。物藏则不动也。阳明所谓洒洒振寒者。阳明者午也。五月盛阳之阴也。（五阳一阴。）阳
盛而阴气加之。故洒洒振寒也。所谓胫肿而股不收者。阳者衰于五月。而一阴气上。与阳始争故也。（胃脉下髀关。抵伏
兔。入膝膑。循胫下足跗。）所谓上喘而为水者。阴气下而复上。上则邪客于脏腑间。故为水也。（脏一云肺。谓邪在肺。
不能通调水道。邪一云脾。谓脾不能为胃行其津液。邪府。胃腑也。肺伤。故上喘少气。）所谓胸痛少气者。水气在脏腑
也。水者阴气也。阴气在中。故胸痛少气也。（此下仍有甚则厥。恶人与火一段。与阳明脉解篇同。见后。）太阴所谓病
胀者。太阴子也。十一月万物气皆藏于中。故曰病胀。所谓上走心为噫者。阴盛而上走于阳明。阳明络属心也。（噫。俗
作嗳。太阴之气从阳明上出于心。则为噫。灵枢说噫。见后口问篇。）所谓食则呕者。万物盛满而上溢也。十一月阴气下
衰。而阳气且出。故曰得后与气。则快然如衰也。（后。大便。气。嗳气。衰。病衰也。噫为气上散。后为气下通。）少
阴所谓腰痛者。少阴者肾也。（腰为肾府。）十月万物阳气皆伤故也。所谓呕咳上气喘者。阴气在下。阳气在上。诸阳气
浮。无所根据从也。（肾脉贯膈入肺。十月阳气潜藏。而反上浮。故有呕咳气喘之症。）所谓色色（新校正云。色色字疑误。）
不能久立。久坐起则目 无所见者。万物阴阳不定。未有主也。所谓少气善怒者。阳气不治。则阳气不得出。肝气当
治而未得。故善怒。名曰煎厥。（冬阳不治。肾水不能生肝木。木气不舒。故煎烦厥逆而善怒。）所谓恐如人将捕之者。
阴气少阳气入。阴阳相薄。故恐也。（恐为肾志。阴虚而阳薄之。）所谓恶闻食臭（气也。）者。胃无气也。（肾命相火不
足以生胃土。故胃气败。）所谓面黑如地色者。秋气内夺。故变于色也。（秋金不能生肾水。）所谓咳则有血者。阳脉伤也。
阳气未盛于上而脉满。满则咳。故血见于鼻也。（阳未盛而脉满。是虚阳上攻。肾脉入肺中。故咳。鼻为肺窍。故出血。）
厥阴所谓 疝。妇人少腹肿者。（厥阴脉络阴器。抵小腹。）厥阴者辰也。三月阳中之阴。邪在中故也。（阴邪伏于阳中。）
所谓甚则嗌干热中者。阴阳相薄而热。故嗌干也。（三月五阳与一阴相薄。厥阴脉循喉咙。）（脉解篇）
【素】足阳明之脉病。恶人与火。钟鼓不为动。闻木音而惊。何也。阳明者胃脉也。胃者土也。故闻木音而惊者。
土恶木也。阳明主肉。其脉血气盛。（阳明多气多血。）邪客之则热。热甚则恶火。阳明厥则喘（胃热伤肺。）而惋。（热
郁而不能安。）惋则恶人。或喘而死。或喘而生者。何也。厥逆连脏则死。连经则生。（经邪浅而脏邪深。）病甚则弃衣而
走。登高而歌。或至不食数日。逾垣上屋。所上之处。皆非其素所能也。病反能者。何也。四肢者。诸阳之本也。阳盛
则四肢实。实则能登高也。热盛于身。故弃衣欲走也。阳盛则使人妄言骂詈。不避亲疏。而不欲食也。（阳明脉解篇。）
【素】脾病而四肢不用何也。（痿 不为人用。）四肢皆禀气于胃。（胃为水谷之海。）而不得至经。必因于脾。乃得
禀也。（脾传水谷精气。四肢乃得禀受。张注。畅于四肢。坤之德也。）今脾病不能为胃行其津液。四肢不得禀水谷气。
气日以衰。脉道不利。筋骨肌肉。皆无气以生。故不用焉。脾不主时。何也。脾者土也。治中央。常以四时长四脏。各
十八日寄治。不得独主于时也。（四季之月。土旺各十八日。）脾藏者。常着。（彰着。）胃土之精也。土者生万物而法天
地。故上下至头足。不得主时也。（土贯五行。无所不治。）脾与胃以膜相连耳。而能为之（为胃。）行其津液何也。足太
阴者三阴也。（肝为一阴。肾为二阴。脾为三阴。）其脉贯胃属脾。络嗌。故太阴为之行气于三阴。（脾为胃也。三阴。太
少厥也。）阳明者表也。（为脾之表。）五脏六腑之海也。亦为之行气于三阳。（胃为脾也。三阳。太阳少阳阳明也。）脏腑
各因其经。（脾经。）而受气于阳明。（胃。）故为胃行其津液。四肢不得禀水谷气。日以益衰。阴道不利。筋骨肌肉。（肝
主筋。肾主骨。肺主肌。脾主肉。）无气以生。故不用焉。（太阴阳明论）
【素】肾何以主水。肾者至阴也。至阴者盛水也。肺者太阴也。少阴者冬脉也。故其本在肾。其末在肺。皆积水也。
（肺肾为子母之脏。肺生水。肾主水。故二脏皆能积水。肾脉入肺中。肾气上逆。则水客肺中而为病。故云肾本肺标。）
肾何以能聚水而生病。肾者胃之关也。（前阴利水。后阴利谷。）关门不利。故聚水而从其类也。（膀胱为肾之腑。不能化
气。则关闭而水积。肾属阴。而体为坎。故水从而聚之也。）上下溢于皮肤。故为 肿。肾者牝脏也。地气上者。属于肾
而生水液也。故曰至阴。勇而劳甚。则肾汗出。肾汗出。逢于风。内不得入于脏腑。外不得越于皮肤。客于玄府。行于
皮里。传为 肿。名曰风水。（吴注。水因风得。故名风水。所以治水必兼风药。若但腹中坚胀。而身不肿。病名蛊胀。
与此不同。）所谓玄府者。汗空（孔同。）也。故水病下为 肿大腹。上为喘呼不得卧者。标本俱病。（肾本肺标。）故肺
为喘呼。肾为水肿。肺为逆不得卧。（水气上逆。）（水热穴论）
【素】肾移寒于脾。（肾伤于寒。而传之脾。薄其胜己。旧作肝误。）痈肿少气。（寒变为热而痈肿。脾不能运而少气。）
Hemorrhage will be massive. According to *Ling Shu* and *Su Wen*, the character "Tan" (Phlegm) does not appear. Only here does the character "Yin" (Fluid retention) appear. In *Jin Gui Yao Lue*, "Tan Yin" was originally written as "Dan". A pulse that is large but with scant blood indicates wind pathogen in the pulse, and inability to take fluids and food. (Wind causes the pulse to be large. Inability to take fluids means blood lacks the source for generation.) Excess refers to the entry of pathogenic factors; deficiency refers to the exit of healthy Qi. (Pathogen entry leads to excess. Healthy Qi loss leads to deficiency.) Qi excess manifests as heat; Qi deficiency manifests as cold. (Pathogen abundance causes heat. Healthy Qi deficiency causes cold.) (*Ci Zhi Lun*)
[Su Wen] Patients with Liver disease experience pain under both hypochondria radiating to the lower abdomen. (The Liver channel spreads over the hypochondria and reaches the lower abdomen.) They are prone to anger. (Excess leads to anger.) Deficiency leads to blurred vision and deafness. (Due to Blood deficiency.) They feel fearful, as if being hunted. (The Hun is unsettled; also, Liver deficiency leads to Gallbladder deficiency.) Qi rebellion causes headache. (Jueyin meets the Du vessel at the vertex.) Deafness and poor hearing. (Liver and Gallbladder are interior-exterior pairs; the Gallbladder channel enters the ear.) Cheek swelling. (The channel passes through the inner cheek.) Patients with Heart disease suffer from chest pain, fullness and distension in the hypochondria, and pain under the hypochondria. (The branch of the Shaoyin Heart channel and the Jueyin Pericardium channel all circulate through the chest and emerge from the hypochondria.) Pain between the chest, back, scapulae, and inner arms. (The Heart channel circulates along the inner arm; the Small Intestine channel circles the scapula and crosses the shoulder.) Deficiency leads to abdominal distension and pain radiating from the hypochondria to the waist. (The Pericardium channel originates in the chest, descends through the diaphragm to connect with the Sanjiao, and branches to the chest and hypochondria; the Heart channel descends through the diaphragm to connect with the Small Intestine, hence the radiating pain.) Patients with Spleen disease have heavy bodies and are prone to muscle flaccidity. (The Spleen governs muscles; flaccid muscles cause heaviness. Some versions read "hunger" instead of "muscle".) Foot weakness, frequent spasms while walking, and sole pain. (The Spleen governs the four limbs; the channel originates at the foot.) Deficiency leads to abdominal fullness and borborygmus. (*Ling Shu* states: Insufficiency of Middle Qi causes frequent abdominal fullness and painful borborygmus.) Stools containing undigested food. Patients with Lung disease suffer from asthma, cough, rebellious Qi, shoulder and back pain, and sweating. (The Lung governs skin and hair; Qi rebelling upwards causes pain radiating to the shoulder and back, and sweating.) Pain in the sacrum, yin region, thighs, knees, calves, and feet. (The Lung is the mother of the Kidney; when the mother is diseased, the child is affected. Qi rebelling downwards causes pain in the lower body.) Deficiency leads to shortness of breath and rapid, shallow breathing. (Qi is discontinuous.) Deafness and dry throat. (The Lung channel connects to the ear; the Kidney channel enters the Lung and circulates along the throat. Lung deficiency prevents Kidney Qi from ascending to moisten, causing deafness and dry throat.) Patients with Kidney disease have abdominal swelling and calf edema. (The Kidney channel ascends along the leg, passing through the Liver and diaphragm.) Asthma and cough (the channel enters the Lung). Heavy body. (Bone flaccidity causes heaviness.) Night sweats and aversion to wind. (The Kidney belongs to Yin; Yin deficiency causes night sweats. Unsecured couli causes aversion to wind.) Deficiency leads to chest pain. (The channel pours into the chest.) Lower abdominal pain, cold extremities. (Cold Qi rebels from the feet.) Unhappiness. (True Yang of the Kidney is not舒展.) (*Zang Qi Fa Shi Pian*)
[Su Wen] Therefore, headache and vertex disorders are due to deficiency below and excess above. (Deficiency of righteous Qi below, excess of pathogenic Qi above.) The disorder lies in the Foot Shaoyin and Foot Taiyang channels. Severe cases enter the Kidney. (Kidney and Bladder are interior-exterior pairs; the Bladder channel intersects at the vertex. Kidney deficiency fails to move Taiyang Qi, which rebels upward, causing headache. Severe cases allow channel pathogens to enter the zang organs.) Dizziness and swaying head. (Meng refers to visual obscurity; You refers to deviation. Wang Bing notes: You means disease. Wu Kun notes: changing You to Yong is inaccurate.) Blindness and deafness, excess below and deficiency above. The disorder lies in the Foot Shaoyang and Foot Jueyin channels. (Gallbladder and Liver are interior-exterior pairs; the Gallbladder channel starts at the outer canthus and enters the ear; the eye is the orifice of the Liver; the Liver channel connects to the eye system. With Fire excess below and Blood deficiency above, blindness and deafness occur.) Severe cases enter the Liver. (Channel pathogens enter the zang organs.) Abdominal fullness and distension, obstruction in the chest and hypochondria. (Zhi refers to the area above the hypochondria; obstruction in the chest and hypochondria.) Cold below and dizziness above. (Cold rebellion below, dizziness above.) The disorder lies in the Foot Taiyin and Foot Yangming channels. (Spleen and Stomach are interior-exterior pairs; the Spleen channel enters the abdomen and ascends to the diaphragm; the Stomach channel descends through the diaphragm and circulates in the abdomen.) Cough and rebellious Qi, Qi rebellion in the chest. The disorder lies in the Hand Yangming and Hand Taiyin channels. (Large Intestine and Lung are interior-exterior pairs; the Lung channel connects to the Large Intestine, ascends through the diaphragm to the Large Intestine, then descends. The Lung governs cough and Qi.) Vexation, heartache, and headache. The disease is in the diaphragm. The disorder lies in the Hand Taiyang and Hand Shaoyin channels. (Small Intestine and Heart are interior-exterior pairs; the Small Intestine channel connects to the Heart below the diaphragm, its branch circulates along the neck to the cheek; the Heart channel descends through the diaphragm to connect with the Small Intestine.) (*Wu Zang Sheng Cheng Lun*)
[Su Wen] Diseases of the Two Yang channels originate in the Heart and Spleen, involving hidden difficulties, and amenorrhea in women. (Two Yang refers to the Foot Yangming Stomach and Hand Yangming Large Intestine channels. Hidden difficulties refer to private matters. The Heart generates Blood; the Spleen controls Blood. The Stomach is the Sea of Water and Grain; the Large Intestine is the official of transmission. These are the sources of Blood. Disease in these two channels leads to depletion of Essence and Blood in the Heart and Spleen, causing impotence in men and amenorrhea in women. *Jue Lun* states: The anterior yin is the gathering place of the Sinews, where Taiyin and Yangming combine. *Wei Lun* states: Yin and Yang gather at the Sinews, with Yangming as their leader. Thus, Stomach disease leads to sexual dysfunction.) If it transmits to Feng Xiao (wind consumption), or Xian Ben (asthmatic distension), it is incurable and fatal. (Spleen disease allows Wind Wood to overcome it due to deficiency, causing daily muscle wasting. Heart disease allows Fire Pathogens to attack the Lung, causing forced breathing.) Diseases of the Three Yang channels manifest as chills and fever, abscesses/swellings below, and Wei Jue (flaccidity/cold limbs) and Suan Tong (soreness/aching). (Three Yang refers to Hand Taiyang Small Intestine and Foot Taiyang Bladder. Shan refers to the calf. KT refers to soreness. The Bladder governs water transformation; the Small Intestine governs fire transformation, hence chills and fever. Stagnation of chills and fever leads to swellings and abscesses. Heat excess causes flaccidity; Cold excess causes cold limbs. If neither, it causes soreness.) If it transmits to Suo Ze (withered skin/luster loss). (Small Intestine and Bladder govern Jin Ye; dryness of Jin Ye leads to loss of luster.) If it transmits to Chan Hernia. (Pathogens enter the Liver, manifesting symptoms in the Small Intestine and Bladder as hernia.) One Yang channel disease manifests as shortness of breath, frequent cough, and diarrhea. (One Yang refers to Hand Shaoyang Sanjiao and Foot Shaoyang Gallbladder. Both contain Ministerial Fire; vigorous Fire consumes Qi, causing shortness of breath. Fire pathogens attack the Lung, causing cough. Dry Metal of the Large Intestine is overcome, causing diarrhea.) If it transmits to Xin Che (heart palpitations/tugging), or Ge (regurgitation/blockage). (Fire pathogens attack the Heart, causing tugging. Sanjiao Fire excess causes regurgitation.) Disease of Two Yang and One Yin primarily presents with fright, back pain, frequent belching, and yawning, named Feng Jue. (Two Yang refers to Large Intestine and Stomach. One Yin refers to Pericardium and Liver. Wind and Fire clash, causing fright. These four channels do not directly relate to the back, so back pain is unclear. The Heart governs belching; Yangming meridians connect to the Heart, hence frequent belching. Yin and Yang attract each other, causing yawning. Wind Wood harasses Stomach Earth, causing Jue.) Disease of Two Yin and One Yang presents with frequent bloating, chest fullness, and sighing. (Two Yin refers to Heart and Kidney. One Yang refers to Sanjiao and Gallbladder. Disease in Heart and Kidney prevents Water and Fire interaction. Disease in Gallbladder and Sanjiao blocks upper and lower flow, causing bloating and sighing. Sighing refers to Qi rebellion.) Disease of Three Yang and Three Yin presents as hemiplegia, flaccidity, and inability to move the four limbs. (Three Yang refers to Small Intestine and Bladder. Three Yin refers to Spleen and Lung. Small Intestine governs hand fluids; Bladder governs foot sinews. Spleen governs four limbs; Lung moves all Qi. Disease in all four channels causes this.) Obstruction of Two Yang is called Xiao (consumption). (Heat obstruction in Stomach and Large Intestine causes rapid digestion and hunger, known as Dan becoming Xiao Zhong.) Obstruction of Three Yang is called Ge (blockage). (Small Intestine governs fluids; Bladder governs Jin Ye. Heat obstruction in these two channels causes blockage and difficulty defecating, also called Ge Zheng, inability to eat.) Obstruction of Three Yin is called Shui (edema). (Lung fails to descend, preventing distribution of Water Essence. Spleen loses its transport function, failing to control fluids, leading to Yin Qi stagnation and edema.) Obstruction of One Yin and One Yang is called Hou Bi (throat bi). (Liver, Gallbladder, Pericardium, and Sanjiao all have Ministerial Fire; their channels circulate along the throat, causing throat bi.) Yin pulse beating distinctly different from Yang pulse indicates pregnancy. (Yin and Yang here refer to Cun and Chi positions. The Chi pulse beats strongly, distinct from Cun, indicating Yang within Yin.) Deficiency of both Yin and Yang with persistent dysentery is fatal. (Cun and Chi pulses are both deficient; persistent dysentery is fatal.) Yang added to Yin is called Han (sweat). (Yang Qi forces Yin, steaming into sweat.) Yin deficiency with Yang pulsation is called Beng (metrorrhagia). (Yin deficiency with Yang Fire forcing blood causes reckless bleeding.) (*Yin Yang Bie Lun*)
[Ling Shu] Heat in the Stomach digests food quickly, causing a hanging sensation in the heart and hunger, with heat in the skin above the umbilicus. Heat in the Intestines causes yellow, millet-like stools, with cold in the skin below the umbilicus. Cold in the Stomach causes abdominal distension. Cold in the Intestines causes borborygmus and undigested stool diarrhea. Cold in the Stomach and Heat in the Intestines cause both distension and diarrhea. Heat in the Stomach and Cold in the Intestines cause rapid hunger and lower abdominal pain/distension. (Intestinal cold.) (*Shi Chuan*)
[Su Wen] Swelling and lower back/buttock pain described by the Taiyang channel. ( , buttocks.) Yin month corresponds to Taiyang. (Taiyang is Three Yang; Yin month is also Three Yang.) In the first lunar month, Yang Qi emerges upwards, but Yin Qi is still abundant. Yang cannot arrange itself sequentially, causing swelling and lower back/buttock pain. Hemiplegic lameness occurs due to partial deficiency. (Inability to walk.) In the first lunar month, Yang Qi thaws, and Earth Qi emerges. Winter cold is somewhat insufficient, causing partial deficiency and lameness. "Strong neck pulling the back" refers to Yang Qi excessive at the top contending, causing stiffness. "Tinnitus" refers to Yang Qi surging upwards with the flourishing of all things. (Taiyang tinnitus is due to external contraction, not Kidney deficiency.) "Severe cases lead to mania or vertex disease." (Either mania or headache.) Yang Qi is entirely above, while Yin Qi follows from below, resulting in deficiency below and excess above. (In the first month, Yin and Yang are equal; now Yang exits entirely above, causing deficiency below and excess above, leading to vertex mania and headache.) "Floating pulse causing deafness" is due to Qi rebellion. (Bladder channel reaches the upper angle of the ear; Qi rebellion causes deafness.) "Entering internally causing aphonia" occurs because Taiyang and Shaoyin are exterior-interior pairs; exterior pathogens transmitting internally cause aphonia. This is due to Yang excess followed by decline. (As mentioned later, internal depletion leads to Yang deficiency unable to speak.) Internal depletion and Jue lead to aphonia and Fei paralysis. (Fei should be Fei, meaning limb paralysis. Internal depletion refers to sexual exhaustion. Lower deficiency causes Jue and limb inaction. Kidney channel binds the tongue root, causing aphonia.) This is Kidney deficiency. Absence of Shaoyin pulse indicates Jue. (Kidney deficiency causes Shaoyin pulse absence; Shaoyin cannot move Juyang Qi, causing Jue.) Pain in the heart and hypochondria described by Shaoyang refers to Shaoyang excess. Excess is the manifestation of the Heart. (Heart belongs to Sovereign Fire, acting without action; Shaoyang Ministerial Fire manifests externally.) In the ninth month, Yang ends and Yin abounds, causing heart and hypochondriac pain. (Fire is buried in Xu; Yin abundance causes pain.) "Inability to turn sideways" is because Yin stores things; stored things do not move. "Chills and shivering" described by Yangming corresponds to Wu month. May is Yin within abundant Yang. (Five Yang, One Yin.) Yang abundance combined with Yin causes chills. "Calf swelling and thigh inaction" occurs because Yang declines in May, and One Yin rises to contend with Yang. (Stomach channel descends to Biguan, reaches Futu, enters knee patella, circulates along shin to foot dorsum.) "Upper asthma and edema" occurs because Yin Qi descends then ascends; ascending pathogens lodge in zang-fu, causing edema. (Zang refers to Lung; pathogens in Lung fail to regulate water passages. Or Zang refers to Spleen; Spleen fails to transport fluids for Stomach. Fu refers to Stomach. Lung injury causes upper asthma and shortness of breath.) "Chest pain and shortness of breath" is due to Water Qi in zang-fu. Water is Yin Qi; Yin Qi in the middle causes chest pain and shortness of breath. (Below this, there is a section on severe Jue, aversion to people and fire, same as *Yangming Maijie Pian*, see later.) "Abdominal distension" described by Taiyin corresponds to Zi month. In the eleventh month, Qi of all things hides inside, hence distension. "Qi moving up to the Heart causing belching" occurs because Yin abundance moves up to Yangming, which connects to the Heart. (Belching: Taiyin Qi emerges from Yangming to the Heart, causing belching. Explanation of belching in *Ling Shu* is in *Kou Wen Pian*.) "Vomiting after eating" occurs because things are full and overflow upwards. In the eleventh month, Yin Qi declines downward, and Yang Qi prepares to emerge, hence relief after defecation and belching. (Hou refers to stool; Qi refers to belching; Shuai refers to disease decline. Belching is Qi dispersing upward; stool is Qi conducting downward.) "Lower back pain" described by Shaoyin corresponds to the Kidney. (Waist is the mansion of the Kidney.) In the tenth month, Yang Qi of all things is injured. "Vomiting, coughing, and upper asthma" occur because Yin is below, Yang is above, and all Yang Qi floats without foundation. (Kidney channel pierces diaphragm and enters Lung. In the tenth month, Yang Qi hides but floats up, causing vomiting, cough, and asthma.) "Color changes, inability to stand long, dizziness upon rising from sitting" occurs because Yin and Yang of all things are unstable, lacking a master. "Shortness of breath and irritability" occurs because Yang Qi is unregulated, unable to exit, and Liver Qi fails to govern, causing Jian Jue (boiling Jue). (Winter Yang unregulated; Kidney Water fails to generate Liver Wood; Wood Qi uncomfortable causes boiling vexation, Jue, and irritability.) "Fear as if being hunted" occurs because Yin Qi is scarce and Yang Qi enters, clashing Yin and Yang, causing fear. (Fear is the emotion of the Kidney; Yin deficiency with Yang encroachment.) "Aversion to food odor" occurs because the Stomach has no Qi. (Kidney Mingmen Fire insufficient to generate Stomach Earth, causing Stomach Qi failure.) "Face black like earth color" occurs because Autumn Qi is internally depleted, changing the complexion. (Autumn Metal fails to generate Kidney Water.) "Coughing with blood" occurs because Yang vessels are injured. Yang Qi is not yet abundant above but vessels are full; fullness causes cough, hence blood from the nose. (Yang not abundant but vessels full indicates deficient Yang attacking upward. Kidney channel enters Lung, causing cough. Nose is Lung orifice, hence bleeding.) "Hernia and lower abdominal swelling in women" described by Jueyin. (Jueyin channel connects to genitalia and reaches lower abdomen.) Jueyin corresponds to Chen month. The third month is Yin within Yang; pathogens are in the middle. (Yin pathogens hide within Yang.) "Severe cases cause dry throat and internal heat" because Yin and Yang clash generating heat, causing dry throat. (Third month: Five Yang clash with One Yin; Jueyin channel circulates along the throat.) (*Mai Jie Pian*)
Disease of the Foot Yangming channel involves aversion to people and fire; bells and drums do not startle them, but wood sounds cause fright. Why? Yangming is the Stomach channel. Stomach belongs to Earth, hence fright at wood sounds is Earth fearing Wood. Yangming governs flesh; its channel has abundant Qi and Blood. (Yangming has much Qi and Blood.) Pathogens lodging cause heat; severe heat causes aversion to fire. Yangming Jue causes asthma (Stomach heat injures Lung) and Wǎn (heat stagnation causing unrest). Wǎn causes aversion to people. Some die of asthma, some live. Why? Jue connecting to zang organs is fatal; connecting to channels is survivable. (Channel pathogens are shallow; zang pathogens are deep.) Severe disease causes discarding clothes and running, climbing high and singing, or going days without eating, climbing walls and roofs, reaching places never accessible before. Why can they do this? The four limbs are the root of all Yang. Yang excess makes limbs solid, enabling climbing. Heat in the body causes discarding clothes and running. Yang excess causes wild speech, cursing regardless of intimacy, and anorexia. (*Yangming Maijie Pian*)
Why does Spleen disease cause limb inaction? (Flaccidity renders limbs useless.) The four limbs receive Qi from the Stomach. (Stomach is the Sea of Water and Grain.) But they cannot reach the channels directly; they must rely on the Spleen to receive it. (Spleen transmits Water and Grain Essence, allowing limbs to receive it. Zhang Jingyue notes: Flowing to the four limbs is the virtue of Kun.) Now, Spleen disease fails to transport fluids for the Stomach; limbs do not receive Water and Grain Qi; Qi declines daily; vessel pathways become obstructed; sinews, bones, and muscles lack Qi for generation, hence inaction. Why does the Spleen not govern a specific season? The Spleen belongs to Earth, governing the Center, nourishing the Four Zang Organs throughout the four seasons, ruling for 18 days each, not governing a single season alone. (In months of the four seasons, Earth prospers for 18 days each.) The Spleen organ constantly manifests the Essence of Stomach Earth. Earth generates all things following Heaven and Earth, extending from head to feet, thus not governing a single season. (Earth permeates the Five Elements, governing all.) The Spleen and Stomach are connected by membranes, yet the Spleen transports fluids for the Stomach. Why? The Foot Taiyin is the Third Yin. (Liver is First Yin, Kidney is Second Yin, Spleen is Third Yin.) Its channel pierces the Stomach, belongs to the Spleen, and connects to the pharynx, thus Taiyin transports Qi to the Three Yin. (Spleen transports Qi for the Stomach to the Three Yin. Three Yin: Taiyin, Shaoyin, Jueyin.) Yangming is the Exterior. (Exterior to the Spleen.) It is the Sea of the Five Zang and Six Fu Organs, transporting Qi to the Three Yang. (Stomach transports Qi for the Spleen to the Three Yang. Three Yang: Taiyang, Shaoyang, Yangming.) Zang and Fu organs receive Qi from Yangming via their respective channels. (Stomach.) Thus, it transports fluids for the Stomach. Limbs do not receive Water and Grain Qi, declining daily; Yin pathways become obstructed; sinews, bones, and muscles. (Liver governs sinews, Kidney governs bones, Lung governs muscles, Spleen governs flesh.) Lack of Qi for generation causes inaction. (*Taiyin Yangming Lun*)
Why does the Kidney govern Water? The Kidney is Supreme Yin. Supreme Yin stores Water. The Lung is Taiyin. Shaoyin is the Winter pulse. Thus, the root is in the Kidney, the branch in the Lung; both accumulate Water. (Lung and Kidney are mother-child organs; Lung generates Water, Kidney governs Water, so both can accumulate Water. Kidney channel enters Lung; Kidney Qi rebels upward, Water lodges in Lung causing disease, hence Kidney root, Lung branch.) Why can the Kidney accumulate Water and cause disease? The Kidney is the Gate of the Stomach. (Anterior yin drains water; posterior yin drains grain.) If the gate is not smooth, Water accumulates according to its kind. (Bladder is the Fu of the Kidney; if it cannot transform Qi, the gate closes and Water accumulates. Kidney belongs to Yin, its form is Kan, so Water gathers with it.) Overflowing up and down into the skin causes edema. The Kidney is a Yin organ. Earth Qi ascending belongs to the Kidney and generates fluid liquids, hence called Supreme Yin. Vigorous exertion and severe labor cause Kidney sweat. Kidney sweat encountering wind, unable to enter internally or exit externally, lodges in the Xuanfu, travels in the skin layers, transmitting to edema, named Feng Shui (Wind Edema). (Wu Kun notes: Water obtained via wind, hence named Wind Edema. Thus, treating water diseases requires wind herbs. If only abdominal hardness exists without body swelling, it is Gu Zhang, different from this.) The so-called Xuanfu is the sweat pore. Thus, water disease presenting as lower edema and abdominal distension, and upper asthma and inability to lie flat, indicates simultaneous root and branch disease. (Kidney root, Lung branch.) Hence, Lung causes asthma, Kidney causes edema, Lung causes rebellion and inability to lie flat. (Water Qi rebels upward.) (*Shui Re Xue Lun*)
Kidney transfers Cold to the Spleen. (Kidney injured by Cold, transmitting to Spleen, overcoming its controlling element. Old text mistakenly says Liver.) Abscesses/swellings and shortness of breath. (Cold transforms into Heat causing abscesses; Spleen fails to transport, causing shortness of breath.)