腹中悒悒。（木气不舒。昂按。伤寒言足经而不及手经。本篇论疟。亦言足而不及手经。岂疟邪亦传足不传手乎。抑足经
可以该手经也。篇后言府疟。仅胃府而不及他府。又岂以胃为六府之长乎。）肺疟者。令人心寒。（肺为心盖。脉入心中。
邪反乘其胜已。）寒甚热。（肺主皮毛。主表。亦能作寒作热。）热间善惊。（肝主惊而金克木。）如有所见者。（心气不足。
肺邪有余。）心疟者。令人烦心甚。欲得清水。反寒多。不甚热。（寒多不甚热而嗜水。未详。按太素云。欲得清水。反
寒多。寒不甚。热甚也。）肝疟者。令人色苍苍然。太息。（木气不舒。）其状若死者。（生气不荣。）脾疟者。令人寒。（脾
虚恶寒。）腹中痛。热则肠中鸣。（火气冲击。）鸣已汗出。（热蒸为汗。）肾疟者。令人洒洒然。（寒意。）腰脊痛。（腰为
肾府。膀胱与肾相表里。脉贯腰脊。）宛转大便难。（肾主二便。）目 然。（水亏。）手足寒。（阳虚。）胃疟者。令人且
（将。）病也。善饥而不能食。胃热故善饥。脾虚故不能食。）食而支满腹大。（脉循腹里。）诸疟而脉不见。刺十指间出
血。血出必已。（刺井穴。脉始出处。〔刺疟篇〕）
【素】肺之令人咳何也。（肺属金而主气。其变动为咳。）曰。五脏六腑皆令人咳。非独肺也。（张注。五脏六腑之邪。
皆能上归于肺而为咳也。）皮毛者。肺之合也。皮毛先受邪气。邪气以从其合也。其寒饮食入胃。（皮毛受寒为外伤寒。
餐寒饮冷为内伤寒。今人惟知外伤寒而不知有内伤寒。讹为阴症者是也。不读内经。乌能知此。）从肺脉上至于肺则肺寒。
（肺恶寒。）肺寒则外内合邪。因而客之。则为肺咳。五脏各以其时受病。非其时各传以与之。（时。旺月也。非其时。
则各传与肺而作咳。昂按。心小肠肝胆三焦之火。脾肾膀胱之湿。冒大肠之燥。传入于肺。皆能作咳。不独风寒也。马
注作肺传邪于五脏而咳。李士材宗之。谬。观篇首肺之令人咳。篇后关于肺二语。则咳之必由于肺明矣。）时感于寒则受
病。微则为咳。（凡伤风寒嗽者为轻。）甚者为泻为痛。（寒邪入里。则为泄为痛。不传于肺。而不作咳矣。）乘秋则肺先
受邪。乘春则肝先受之。乘春则肝先受之。乘夏则心先受之。乘至阴（四季。）则脾先受之。乘冬则肾先受之。（张注。
言先□□。谓次则传及于肺而作咳也。昂按。若不传则各□本藏之病。若移邪于他藏。则又为他病矣。）肺咳之状。咳而
喘息有音。（肺藏气而主喘主音。）甚则唾血。（肺络伤则唾。此本经自病。）心咳之状。咳则心痛。喉仲介介如梗状。甚
则咽肿喉痹。（此五脏之移邪。心脉侠咽。火旺克金。）肝咳之状。咳则两胁下□。（肝脉布胁肋。上注肺。）甚则不可以
转。转则两 （即胁。）下满。脾咳之状。咳则右胁下痛。（脾主右。）阴阴引肩背（□在肩背。）甚则不可以动。动则咳
剧。肾咳之状。咳则腰痛相引而痛。（肾脉入肺。贯脊。腰为肾府。）甚则咳涎。（脾为涎。肾为唾。涎唾相近。马注。东
垣治五脏咳。肺用麻黄汤。心用桔梗汤。肝用小柴胡汤。脾用升麻汤。肾用麻黄附子细辛汤。虽未必尽中。姑备采择。）
五脏之久咳。乃移于六
府。脾咳不已。则胃受之。胃咳之状。咳而呕。（胃寒则呕。）呕甚则长虫出。肝咳不已。则胆受之。胆咳之状。咳呕胆
汁。肺咳不已。则大肠受之。大肠咳状。咳而遗失。（甲乙作失。是。大肠为传导之官。寒入则遗失。）心咳不已。则小
肠受之。小肠咳状。咳而失气。气与咳俱失。（气下奔而出屁。）肾咳不已。则膀胱受之。膀胱咳状。咳而遗溺。久咳不
已。则三焦受之。三焦咳状。咳而腹满。不欲食饮。（上中二焦脉循胃口。）此皆聚于胃。（胃为五脏六腑之海。）关于肺。
（昂按。肺主气。又属金。主声。故咳必由于肺也。凡伤风寒而咳嗽者为轻。以肺主皮毛而在表也。若风寒径伤经络腑
脏。而不传于肺。则不咳。不咳者重。如真伤寒类伤寒之属是也。又有久病。火热伤肺。而为咳痰咳血声哑声嘶者。此
病久传变之咳。亦重症也。）使人多涕唾。（凡咳嗽必多涕唾。）而面浮肿气逆也。（气逆故咳而面亦肿。马注。东垣治六
腑咳。胃用乌梅丸。胆用黄芩加半夏生姜汤。大肠用赤石脂禹余粮汤桃花汤。不止。用猪苓汤分水。小肠用芍药甘草汤。
膀胱用茯苓甘草汤。三焦用钱氏异功散。）（咳论）
【素】举痛论、（举痛者。举凡痛而为言也。吴鹤皋改作卒痛论。亦有痛而不卒者。又何以说焉。）经脉流行不止。
环周不休。寒气入经而稽迟。泣（涩。）而不行。客于脉外则血少。客于脉中则气不通。故卒然而痛。其痛或卒然而止者。
或痛甚不休者。或痛甚不可按者。或按之而痛止者。或按之无益者。或喘动应手者。或心与背相引而痛者。或胁肋与少
腹相引而痛者。或腹痛引阴股者。或痛宿昔而成积者。或卒然痛死不知人。有少间复生者。或痛而呕者。或腹痛而后泄
者。或痛而闭不通者。寒气客于脉外则脉寒。脉寒则缩蜷。缩蜷则脉绌急。（逢寒则急。）绌急则外引小络。故卒然而痛。
得炅则痛立止。（炅。音炯。热也。热则血气行。而寒邪散。）因重中于寒。则痛久矣。寒气客于经脉之中。与炅气相薄
则脉满。满则痛而不可按也。寒气稽留。炅气从上。则脉充大。而血气乱。故痛甚不可按也。寒气客于肠胃之间。膜原
之下。（膈之膜。肓之原。）血不得散。（寒则血凝。）小络急引故痛。按之则血气散。故按之痛止。寒气客于挟脊之脉（督
脉。）则深。按之不能及。故按之无益也。寒气客于冲脉。冲脉起于关元。（穴在脐下三寸。其本起于肾下。出关元而上。）
随腹直上。（会于咽喉。）寒气客则脉不通。脉不通则气因之。故喘动应手矣。（冲脉与少阴肾脉并行。少阴之气。因之上
满。故喘动应手。）寒气客于背俞之脉。（背之心俞。）则脉泣。脉泣则血虚。血虚则痛。其俞注于心。（心主血。背俞属
膀胱经。凡五脏六腑之俞。皆属膀胱经。而内通于脏腑。）故相引而痛。按之则热气至。热气至则痛止矣。寒气客于厥阴
之脉。厥阴之脉者络阴器。系于肝。寒气客于脉中则血泣脉急。故胁肋与小腹相引痛矣。（肝脉布胁肋。抵小腹。）厥气
客于阴股。（厥阴脉循股阴。）寒气上及少腹。血泣在下相引。故腹痛引阴股。寒气客于小肠膜原之间。络血之中。血泣
不能注于大经。血气稽留不得行。故宿昔而成积矣。（按此即今之小肠气也。）寒气客于五脏。厥逆上泄。（呕吐。）阴气
竭。阳气未入。故卒然痛死不知人。气复反。则生矣。寒气客于肠胃。厥逆上出。故痛而呕也。（此为寒呕。亦有胃热上
冲而呕者。）寒气客于小肠。小肠不得成聚。故后泄腹痛矣。（小肠为受盛之官。寒客之。故不能成聚。传入大肠而泄也。）
热气留于小肠。肠中痛。瘅热焦渴。则坚干不得出。（热伤津。）故痛而闭不通矣。（通则不痛。痛则不通。）视其五色。
黄赤为热。白为寒。青黑为痛。百病生于气也。怒则气上。喜则气缓。悲则气消。恐则气下。寒则气收。炅则气泄。惊
则气乱。劳则气耗。思则气结。九气不同。何病之生。曰怒则气逆。甚则呕血（火逼血随气而上升。）及飧泄。（木上盛
克土。故下为飧泄。）故气上矣。喜则气和志达。荣卫通利。故气缓矣。（和缓。）悲则心系急。肺布叶举。（肺叶随心系。
而开布张举。）而上焦不通。荣卫不散。（上焦宗气不得布散于荣卫。）热气在中。则气消矣。（热伤气。）恐则精却。（恐
伤肾。故精气却退。）却则上焦闭。闭则气还。还则下焦胀。（不能上行。还而为胀。）故气不行矣。（新校正。气不行。
当作气下行。）寒则腠理闭。气不行。故气收矣。（王注。腠。谓津液渗泄之所。理。谓文理逢会之中。昂按。凡伤寒必
卫气闭拒。故治寒疾者。多用发散之剂。）炅则腠理开。荣卫通。汗大泄。故气泄矣。惊则心无所倚。神无所归。虑无所
定。故气乱矣。劳则喘息汗出。外内皆越。（越其常度。）故气耗矣。思则心有所存。神有所归。正气留而不行。故气结
矣。（志之所至。气亦至焉。）（举痛）
【素】风之伤人也。或为寒热。或为热中。或为寒中。或为疠（癞。）风。或为偏枯。或为风也。（下文诸风。）其病
各异。其名不同。或内至五脏六腑。愿闻其说。曰。风气藏于皮肤之间。内不得通。外不得泄。（此风邪初感于表。玄府
封闭。故内不得通。外不得泄。昂按。寒邪有饮冷而内伤者。风邪则俱从外入。）风者善行而数变。腠理开则洒然寒。闭
则热而闷。（风内郁而为热。）其寒也。则衰饮食。（胃中寒。则食少。）其热也。则消肌肉。（热入内。则肉消。）故使人
（音突。）栗（寒意。）而不能食。名曰寒热。风气与阳明入胃。循脉而上。至目内 。其人肥则风气不得外泄。则为
热中而目黄。（风内郁而为热为黄。）人瘦则外泄而寒。则为寒中（腠理疏而外泄。故中寒。）而泣出。（多泪。）风气与太
阳俱入。行诸脉俞。（脏腑十二俞穴。皆在背面。属太阳经。）散于分肉之间。（卫气行处。）与卫气相干。其道不利。（风
气与卫气相薄。为所持阻。）故使肌肉愤 （音嗔。）而有疡。（疮痈。）卫气有所凝而不行。故其肉有不仁也。（卫气久不
流通。则肉顽痹。不知痛痒。）疠者有荣气热 。（腐同。荣卫脉中。风入营血。变为热而血肉腐坏。）其气不清。故使其
鼻柱坏（气为呼吸出入之处。）而色败。皮肤疡溃。风寒客于脉而不去。名曰疠风。或名曰寒热。（王注。始为寒热。成
为疠风。）以春甲乙（属木。）伤于风者。为肝风。以夏丙丁（属火。）伤于风者。为心风。以季夏戊己（属土。）伤于邪
者。为脾风。以秋庚辛（属金。）中于邪者。为肺风。以冬壬癸（属水。）中于邪者。为肾风。风中五脏六腑之俞。（穴俞。）
亦为脏腑之风。（故有中经中腑中脏之殊。）风各入其门户。所中则为偏风。（或左或右。或上或下。偏中一处。则为偏枯。）
风气循风府而上。（脑后穴名。）则为脑风。风入系头。则为目风眼寒。（眼当畏寒。目在前而系在脑后。故曰系头。灵枢
终始篇。足太阳有通顶入脑者。正属目本。名曰眼系。头目苦痛取之。）饮酒中风。则为漏风。（多汗。）入房汗出中风。
则为内风。（令人遗精咳血。寝汗骨蒸。）新沐中风。则为首风。久风入中。则为肠风。（便血。）飧泄。（食不化。而泄泻。）
外在腠理。则为泄风。（多汗。）故风者。百病之长也。至其变化。乃为他病也。无常方然。致有风气也。（致有风气诸病。）
肺风之状。多汗恶风。（伤寒无汗。伤风有汗。故伤风皆有汗恶风。汗出皮腠疏。故恶风。）色 （音烹。上声。）然白。
时咳短气。（本经病。）昼日则瘥。暮则甚。（暮则阳气入里。风内应之。故甚。或曰。昼则肺垂而顺。夜则偏壅。）诊在
眉上。其色白。（眉上。阙庭之部。灵枢五色篇。阙中者。肺也。）心风之状。多汗恶风焦绝。善怒赫。赤色。病甚则言
不可快。（心脉挟咽喉而主舌。风中之。故难言。）诊在口。（唇。）其色赤。肝风之状。多汗恶风。善悲。（悲为肺志。金
来克木。）色微苍。嗌干（脉循喉咙。）善怒。（肝志怒。）时憎女子。（肝脉络阴器而主筋。肝衰则恶色。凡阳痿者。皆筋
衰也。）诊在目下。其色青。脾风之状。多汗恶风。身体怠惰。四肢不欲动。（脾主四肢。）色薄微黄。不嗜食。诊在鼻上。
其色黄。（鼻居中央主土。）肾风之状。多汗恶风。面 然浮肿。（肾有水则面肿。有风面亦肿。平人气象论。面肿曰风。）
脊痛（肾脉贯脊。）不能正立。（骨衰。）其色 。（音台。黑色。）隐曲不利。（肾精衰。则不能交接。）诊在肌上。（精衰
则肌不泽。）其色黑。胃风之状。颈多汗恶风。（胃脉从颐。循喉咙。下缺盆。）食饮不下。膈塞不通。（胃脉下膈。属胃
络脾。）腹善满。（脉循腹里。）失衣则 胀。（外寒则胀。）食寒则泄。诊形瘦而腹大。首风之状。头面多汗恶风。当先风
一日。则病甚。（人身阳旺。外应于风。）头痛不可以出内。至其风日。则病少愈。漏风之状。或多汗。常不可单衣。（汗
多腠疏。故常畏寒。马注作畏热。虽单衣亦欲却之。昂按。既云畏热。下何以又言恶风乎。）食则汗出。甚则身汗。喘息。
恶风。衣常濡。口干善渴。（外多汗则中干。）不能劳事。（漏风即酒风也。病能论。有病身热解堕。汗出如浴。恶风少气。
病名酒风。）泄风之状。多汗。汗出泄衣上。口中干。上渍其风。不能劳事。身体尽痛则寒。（有风故痛。汗多亡阳故寒。
按素问风论痹论痿论。分为三篇。病原不同。治法亦异。今世多混同论治。故丹溪着论辨之。又按中风大法有四。一曰
The abdomen feels depressed and uncomfortable. (Liver Qi is not free-flowing. Wang Ang notes: In the treatment of Cold Damage, discussion often focuses on the Foot meridians while neglecting the Hand meridians. This chapter discusses Malaria, also mentioning only the Foot meridians and neglecting the Hand meridians. Does the malaria pathogen only transmit to the Foot meridians and not the Hand meridians? Or do the Foot meridians encompass the Hand meridians? Later in the chapter, regarding Fu-organ Malaria, only the Stomach Fu is mentioned without other Fu organs. Is this because the Stomach is the chief of the Six Fu organs?) Lung Malaria causes a sensation of cold in the heart. (The Lung sits above the Heart like a canopy, and its vessels enter the heart. The pathogen attacks what overcomes it.) Severe chills followed by fever. (The Lung governs the skin and hair and the exterior, and can also cause chills and fever.) After the fever subsides, the patient is prone to fright. (The Liver governs fright; Metal overcomes Wood.) The patient may see hallucinations. (Heart Qi is deficient, while Lung pathogen is excessive.) Heart Malaria causes severe mental restlessness, a desire for cold water, but with more chills than heat. (More chills, less heat, and craving cold water—the reason is unclear. According to *Tai Su*: craving cold water with more chills actually means less heat and more cold.) Liver Malaria causes the complexion to appear bluish-green, with frequent sighing. (Liver Qi is not free-flowing.) The condition resembles death. (Vital Qi fails to nourish.) Spleen Malaria causes chills. (Spleen deficiency leads to aversion to cold.) Abdominal pain occurs, and intestinal sounds arise when heat appears. (Fire Qi impacts.) Sweating follows the cessation of intestinal sounds. (Heat steams into sweat.) Kidney Malaria causes a shivering sensation. (Chilliness.) Lower back and spine pain. (The lower back is the mansion of the Kidney; the Bladder and Kidney are interior-exteriorly related, and their vessels pass through the lower back and spine.) Restlessness and difficulty with defecation. (The Kidney governs the two orifices.) Blurred vision. (Kidney Water deficiency.) Cold hands and feet. (Yang deficiency.) Stomach Malaria causes the patient to feel as if illness is impending; they feel hungry but cannot eat. (Stomach heat causes hunger; Spleen deficiency prevents eating.) Fullness and distension after eating, with an enlarged abdomen. (The vessels run inside the abdomen.) In various forms of Malaria where the pulse is imperceptible, prick the spaces between the ten fingers to induce bleeding; once blood flows, the disease will certainly resolve. (Pricking the Jing-Well points, where the pulse qi originates. [Refer to *Ci Mie Pian*].)
[Su Wen] Why does the Lung cause coughing? (The Lung belongs to Metal and governs Qi; its pathological change manifests as cough.) It is said: The pathogens of all Five Zang and Six Fu organs can cause coughing, not just the Lung. (Zhang Jingyue’s commentary: Pathogens from all Five Zang and Six Fu organs can ascend to the Lung and cause cough.) The skin and hair are the external correspondence of the Lung. When the skin and hair are first attacked by pathogens, the pathogens follow into the Lung. If cold food and drink enter the stomach, (Cold attacking the skin/hair is external cold damage; consuming cold food/drink is internal cold damage. Modern people only know of external cold damage and ignore internal cold damage, erroneously classifying it as Yin syndrome. Without reading the *Nei Jing*, how could one know this?) The cold travels up the Lung vessels to the Lung, causing Lung cold. (The Lung dislikes cold.) Lung cold combines external and internal pathogens, which then lodge in the Lung, resulting in Lung cough. Each of the Five Zang organs becomes diseased in its respective prosperous season; if not affected in that season, the pathology transmits to the Lung causing cough. ("Season" refers to the month of prosperity. If not the season, each organ's pathogen transmits to the Lung to cause cough. Wang Ang notes: Fire from the Heart, Small Intestine, Liver, Gallbladder, and Sanjiao; Dampness from the Spleen, Kidney, and Bladder; Dryness from the Large Intestine, all transmitting to the Lung can cause cough, not just Wind-Cold. Ma Shi’s commentary suggests the Lung transmits pathogens to the Five Zang, and Li Shicai followed this, which is incorrect. Given the opening statement "Why the Lung causes cough" and the closing remarks about the Lung, it is clear that cough must originate from the Lung.) Contracting cold according to the seasons causes disease; mild cases result in cough. (Cough due to Wind-Cold injury is considered mild.) Severe cases result in diarrhea or pain. (Cold pathogens entering the interior cause diarrhea or pain; if they do not transmit to the Lung, no cough occurs.) In Autumn, the Lung is first affected by cold; in Spring, the Liver is first affected; in Summer, the Heart is first affected; in Late Summer (end of four seasons), the Spleen is first affected; in Winter, the Kidney is first affected. (Zhang Jingyue’s commentary: "First..." implies subsequent transmission to the Lung to cause cough. Wang Ang notes: If there is no transmission, each organ suffers its own disease; if pathogens shift to another organ, it becomes a different disease.) The symptoms of Lung cough include coughing with wheezing and audible sounds. (The Lung stores Qi and governs wheezing and sound.) Severe cases involve spitting blood. (Lung collaterals are damaged, leading to hemoptysis; this is primary disease of the meridian.) The symptoms of Heart cough include coughing accompanied by heart pain, a sensation of obstruction in the throat like a lump, and in severe cases, swollen throat and throat bi. (This is the transfer of pathogens among the Five Zang; the Heart vessel runs alongside the throat, and Fire overcomes Metal.) The symptoms of Liver cough include pain in both hypochondriac regions upon coughing. (The Liver vessel distributes along the costal region and ascends to the Lung.) In severe cases, the body cannot turn; turning causes fullness in both hypochondriac regions. The symptoms of Spleen cough include pain in the right hypochondrium upon coughing. (The Spleen governs the right side.) Dull pain radiating to the shoulder and back (pain located in the shoulder/back), and in severe cases, inability to move; movement exacerbates the cough. The symptoms of Kidney cough include lower back pain radiating upon coughing. (The Kidney vessel enters the Lung and pierces the spine; the lower back is the mansion of the Kidney.) Severe cases involve coughing up saliva. (The Spleen produces saliva, the Kidney produces thick saliva; saliva and phlegm are similar. Ma Shi’s commentary: Dong Yuan treated Five Zang coughs using Mahuang Tang for the Lung, Jiegeng Tang for the Heart, Xiaochaihu Tang for the Liver, Shengma Tang for the Spleen, and Mahuang Fuzi Xixin Tang for the Kidney. While not necessarily accurate in all cases, it is provided for reference.)
If cough from the Five Zang persists for a long time, it transfers to the Six Fu organs. If Spleen cough persists, the Stomach is affected. The symptoms of Stomach cough include coughing with vomiting. (Stomach cold causes vomiting.) Severe vomiting may expel roundworms. If Liver cough persists, the Gallbladder is affected. The symptoms of Gallbladder cough include coughing and vomiting bile. If Lung cough persists, the Large Intestine is affected. The symptoms of Large Intestine cough include coughing with fecal incontinence. (*Jia Yi Jing* reads "loss," which is correct. The Large Intestine is the official of conduction; cold invasion leads to incontinence.) If Heart cough persists, the Small Intestine is affected. The symptoms of Small Intestine cough include coughing with flatus, where gas escapes with the cough. (Gas rushes downward and exits as flatulence.) If Kidney cough persists, the Bladder is affected. The symptoms of Bladder cough include coughing with urinary incontinence. If chronic cough persists, the Sanjiao is affected. The symptoms of Sanjiao cough include coughing with abdominal fullness and loss of appetite. (The vessels of the Upper and Middle Jiao circulate around the stomach entrance.) All these coughs gather at the Stomach. (The Stomach is the sea of the Five Zang and Six Fu organs.) and relate to the Lung. (Wang Ang notes: The Lung governs Qi, belongs to Metal, and governs sound, so cough must originate from the Lung. Cough due to Wind-Cold is mild because the Lung governs the skin/hair and is exterior. If Wind-Cold directly damages meridians and organs without transmitting to the Lung, there is no cough; absence of cough indicates severe disease, such as True Cold Damage resembling Cold Damage. Also, chronic diseases where fire-heat damages the Lung, causing cough with phlegm, hemoptysis, hoarseness, or aphonia, represent chronic transmission and are also severe conditions.) These conditions cause excessive mucus and saliva. (All coughs involve excessive mucus and saliva.) and facial edema with rebellious Qi. (Rebellious Qi causes cough and facial swelling. Ma Shi’s commentary: Dong Yuan treated Six Fu coughs using Wu Mei Wan for the Stomach, Huangqin Banxia Shengjiang Tang for the Gallbladder, Chishizhi Yuyuliang Tang/Taohua Tang for the Large Intestine, Zhuling Tang for differentiation if uncontrolled, Shaoyao Gancao Tang for the Small Intestine, Fuling Gancao Tang for the Bladder, and Qian Shi Yigong San for the Sanjiao.) (From *Ke Lun*)
[Su Wen] Ju Tong Lun, (Ju Tong refers to enumerating various pains. Wu Hegao changed it to *Cu Tong Lun*, but some pains are not sudden, so how does that explain them?) Meridian Qi flows continuously, circling without rest. When Cold pathogen enters the meridians, flow slows, becoming stagnant and obstructed. Lodging outside the vessels reduces Blood; lodging inside blocks Qi, causing sudden pain. This pain may stop suddenly, persist severely, be unbearable to pressure, cease with pressure, remain unaffected by pressure, pulsate under the finger, refer between the heart and back, refer between the hypochondrium and lower abdomen, refer from the abdomen to the inner thigh, become a mass over time, cause sudden fainting with delayed recovery, accompany vomiting, precede diarrhea, or accompany constipation. When Cold lodges outside the vessels, the vessels become cold, contract, and become tense. (Cold causes tension.) Tension pulls on small collaterals, causing sudden pain. Heat stops the pain immediately. (Jiong means heat. Heat promotes Qi and Blood flow and disperses Cold.) Repeated Cold exposure prolongs pain. When Cold lodges in the meridians and clashes with Heat, vessels become full, causing severe pain unresponsive to pressure. Cold stagnation combined with ascending Heat enlarges vessels and disrupts Qi and Blood, causing severe pain unresponsive to pressure. When Cold lodges between the intestines/stomach and the membrane source (the membrane of the diaphragm and the origin of the peritoneum), Blood cannot disperse. (Cold causes Blood stasis.) Small collaterals contract, causing pain. Pressure disperses Qi and Blood, stopping pain. When Cold lodges in the paraspinal vessels (Du Mai), it is deep; pressure cannot reach it, so pressure is ineffective. When Cold lodges in the Chong Mai, which originates at Guanyuan (3 cun below the umbilicus, originating from below the Kidney, emerging at Guanyuan and ascending), running straight up the abdomen to meet the throat. Cold lodgment blocks vessels, blocking Qi, causing pulsation felt under the hand. (Chong Mai runs parallel to the Shaoyin Kidney vessel; Shaoyin Qi rebels upward, causing pulsation.) When Cold lodges in the Back-Shu vessels (Heart Shu), vessels become stagnant, Blood becomes deficient, and pain arises. The Shu points connect to the Heart. (The Heart governs Blood; Back-Shu points belong to the Bladder meridian, connecting internally to the Zang-Fu organs.) Thus, pain refers between them. Heat applied via pressure stops the pain. When Cold lodges in the Jueyin vessel, which connects to the genitalia and ties to the Liver. Cold in the vessel causes Blood stasis and vessel tension, referring pain between the hypochondrium and lower abdomen. (Liver vessel distributes along the costal region to the lower abdomen.) Juevi Qi lodges in the inner thigh. (Jueyin vessel follows the inner thigh.) Cold ascends to the lower abdomen; Blood stasis below refers pain, causing abdominal pain radiating to the inner thigh. When Cold lodges in the membrane source and collateral blood of the Small Intestine, Blood stagnates and cannot enter major vessels, causing Qi and Blood retention and eventual mass formation over time. (This corresponds to modern Small Intestine Qi.) When Cold lodges in the Five Zang organs, rebellion causes upper discharge (vomiting). Yin Qi is exhausted, Yang has not entered, causing sudden fainting. Recovery of Qi brings life. When Cold lodges in the intestines/stomach, rebellion causes upward discharge, resulting in painful vomiting. (This is Cold vomiting; there is also Vomiting due to Stomach Heat rebellion.) When Cold lodges in the Small Intestine, it cannot perform its function of receiving and storing, causing diarrhea and abdominal pain. (The Small Intestine is the official of reception; Cold prevents proper processing, transmitting to the Large Intestine causing diarrhea.) Heat lingering in the Small Intestine causes intestinal pain. Excessive heat scorches fluids and causes thirst, leading to hard, dry stool that cannot exit. (Heat injures fluids.) Thus, pain accompanies constipation. (Free flow means no pain; pain means obstruction.) Observing the five colors: yellow/red indicates Heat; white indicates Cold; blue/black indicates Pain. Hundred diseases arise from Qi. Anger causes Qi to rise; Joy causes Qi to slacken; Grief consumes Qi; Fear causes Qi to sink; Cold causes Qi to contract; Heat causes Qi to leak; Shock causes Qi to disorder; Labor exhausts Qi; Pondering knots Qi. The nine Qi differ; what diseases arise? It is said: Anger causes Qi rebellion, severe cases vomiting blood (Fire forces Blood to rise with Qi) and undigested diarrhea. (Wood excess overcomes Earth, causing lower undigested diarrhea.) Thus, Qi rises. Joy harmonizes Qi and will, benefiting Ying and Wei, so Qi slackens. Grief tightens the Heart tie and raises Lung leaves. (Lung leaves expand with the Heart tie.) Upper Jiao becomes blocked, Ying and Wei do not disperse. (Upper Jiao Zong Qi fails to distribute to Ying and Wei.) Heat in the center consumes Qi. (Heat injures Qi.) Fear causes Essence to retreat. (Fear injures the Kidney, causing Essence to retreat.) Retreat blocks the Upper Jiao; blockage causes Qi to return; returning causes Lower Jiao distension. (Cannot ascend, returns causing distension.) Thus, Qi moves downward. (New Correction: "Qi does not move" should be read as "Qi moves downward.") Cold closes the cou li, blocking Qi, so Qi contracts. (Wang Bing’s commentary: Cou refers to the place of fluid seepage; Li refers to the intersection of textures. Wang Ang notes: In Cold Damage, Wei Qi closes and resists, so treatments for Cold often use dispersing agents.) Heat opens the cou li, benefits Ying and Wei, causes heavy sweating, so Qi leaks. Shock leaves the Heart unsupported, Spirit unanchored, and thoughts unsettled, so Qi disorders. Labor causes panting and sweating, with internal and external leakage. (Leaving normal limits.) So Qi is exhausted. Pondering fixes the mind and Spirit, causing Zheng Qi to stagnate and not move, so Qi knots. (Where Will goes, Qi goes.) (From *Ju Tong Lun*)
[Su Wen] Wind pathogen injuring humans may manifest as chills/fever, heat-in-the-center, cold-in-the-center, leprosy-like wind, hemiplegia, or general wind diseases. (Subsequent winds.) Their symptoms vary, and names differ. Some affect the interior Zang-Fu organs. I wish to hear the explanation. It is said: Wind lodges between the skin and hair, unable to communicate internally or externally. (This is initial Wind attack on the exterior; xuanfu pores close, preventing internal communication and external release. Wang Ang notes: Cold can invade internally via cold drinks, but Wind always enters from outside.) Wind travels quickly and changes frequently. When cou li open, there is shivering cold; when closed, there is heat and stuffiness. (Wind stagnating internally generates Heat.) With cold, appetite decreases. (Stomach cold reduces food intake.) With heat, muscles emaciate. (Heat entering interior consumes flesh.) Thus, the person shivers and cannot eat, named Chills/Fever. Wind Qi entering the Yangming and flowing into the stomach, ascending along vessels to the inner canthus. In obese individuals, Wind cannot escape externally, causing Heat-in-the-Center and yellow eyes. (Wind stagnating internally generates Heat and jaundice.) In thin individuals, Wind escapes externally causing cold, leading to Cold-in-the-Center (cou li loose, external escape causes internal cold) and tearing. (Excessive tears.) Wind entering with Taiyang travels through various Shu points. (Twelve Shu points of Zang-Fu are on the back, belonging to Taiyang.) Scattering between muscle intervals. (Where Wei Qi travels.) Clashing with Wei Qi, obstructing its path. (Wind clashing with Wei Qi causes obstruction.) Thus, muscles swell and develop sores. (Abscesses.) Wei Qi coagulates and fails to flow, causing numbness. (Prolonged Wei Qi stagnation leads to numbness and lack of pain/itch sensation.) Leprosy involves hot, rotting Ying Qi. (Rot same. Wind enters Ying/Blood in vessels, transforming into Heat, rotting flesh and blood.) Qi becomes turbid, causing collapse of the nasal bridge (pathway for breath) and ruined complexion, with ulcerated skin. Wind and Cold lodging in vessels and remaining is called Leprosy Wind, or sometimes Chills/Fever. (Wang Bing’s commentary: Initially Chills/Fever, becoming Leprosy Wind.) Wind contracted on Jia/Yi days in Spring (Wood) is Liver Wind. Wind contracted on Bing/Ding days in Summer (Fire) is Heart Wind. Wind contracted on Wu/Ji days in Late Summer (Earth) is Spleen Wind. Wind contracted on Geng/Xin days in Autumn (Metal) is Lung Wind. Wind contracted on Ren/Gui days in Winter (Water) is Kidney Wind. Wind striking the Shu points of the Five Zang and Six Fu organs also creates Zang-Fu Wind. (Thus distinctions exist between affecting meridians, Fu organs, and Zang organs.) Wind enters through its gate, causing Biased Wind in the struck area. (Left/right, up/down, striking one side causes hemiplegia.) Wind ascending along Fengfu causes Brain Wind. Wind entering the head system causes Eye Wind/Cold. (Eyes fear cold; eyes are anterior, system posterior, hence "head system." *Ling Shu · Zhong Shi Pian*: Taiyang has a pathway entering the brain, connecting to the eye root, named Eye System. For head/eye pain, treat here.) Drinking alcohol and contracting Wind causes Leaking Wind. (Excessive sweating.) Having sex with sweat and contracting Wind causes Internal Wind. (Causes seminal emission, hemoptysis, night sweats, bone-steaming fever.) Washing hair and contracting Wind causes Head Wind. Chronic Wind entering the interior causes Intestinal Wind. (Blood in stool.) Undigested diarrhea. (Food not digested, leading to diarrhea.) Wind at the exterior cou li causes Ventilation Wind. (Excessive sweating.) Therefore, Wind is the chief of hundred diseases. Its transformations become other diseases, lacking fixed patterns, but all stem from Wind. (Diseases caused by Wind.)
Lung Wind symptoms: Excessive sweating and aversion to wind. (Cold Damage has no sweat; Wind Injury has sweat, so Wind Injury always presents with sweating and wind aversion. Sweating loosens cou li, causing wind aversion.) Pale white complexion, occasional cough and shortness of breath. (Primary meridian disease.) Better during the day, worse at night. (Night Yang enters interior, Wind responds internally, worsening symptoms. Alternatively: Daytime Lung hangs smoothly; nighttime congestion worsens.) Diagnosis at the brow ridge, color white. (Brow ridge is the Que Ting area. *Ling Shu · Se Pian*: Que Zhong is the Lung.) Heart Wind symptoms: Excessive sweating, wind aversion, dry mouth/throat, irritability, red complexion. Severe cases have slurred speech. (Heart vessel surrounds the throat and governs the tongue; Wind attack makes speech difficult.) Diagnosis at the lips, color red. Liver Wind symptoms: Excessive sweating, wind aversion, sadness. (Sadness is the emotion of the Lung; Metal overcomes Wood.) Bluish-green complexion, dry throat (vessel runs along the throat), irritability. (Irritability is the emotion of the Liver.) Sometimes aversion to women. (Liver vessel connects to genitalia and governs sinews; Liver decline causes aversion to beauty; impotence is due to sinew decline.) Diagnosis under the eyes, color blue. Spleen Wind symptoms: Excessive sweating, wind aversion, lethargy, unwillingness to move limbs. (Spleen governs limbs.) Pale yellow complexion, loss of appetite. Diagnosis at the nose tip, color yellow. (Nose is central, governing Earth.) Kidney Wind symptoms: Excessive sweating, wind aversion, facial edema. (Kidney water causes facial swelling; Wind also causes swelling. *Ping Ren Qi Xiang Lun*: Facial swelling is Wind.) Back pain (Kidney vessel pierces the spine), inability to stand upright. (Bone decline.) Black complexion. (Tai, black.) Difficulty with urination/sexual function. (Kidney Essence decline prevents intercourse.) Diagnosis at the muscles, color black. Stomach Wind symptoms: Neck sweating and wind aversion. (Stomach vessel from jaw, along throat, to clavicle.) Dysphagia, chest obstruction. (Stomach vessel descends through diaphragm, connects to Stomach and Spleen.) Abdominal fullness. (Vessel runs inside abdomen.) Bloating when clothes are removed (external cold causes bloating). Diarrhea from cold food. Diagnosis shows emaciated form with large abdomen. Head Wind symptoms: Head/face sweating and wind aversion. Condition worsens one day before wind. (Human Yang is vigorous, responding externally to Wind.) Headache prevents going out; on windy days, condition improves slightly. Leaking Wind symptoms: Excessive sweating, inability to wear single layers. (Sweat loosens cou li, causing cold aversion. Ma Shi notes heat aversion, wanting to remove even single layers. Wang Ang notes: If heat aversion, why mention wind aversion later?) Sweating while eating, severe cases whole-body sweating, panting, wind aversion, wet clothes, dry mouth, thirst. (External sweat depletes internal fluids.) Inability to labor. (Leaking Wind is Wine Wind. *Bing Neng Lun*: Disease with body heat, weakness, bathing-like sweat, wind aversion, shortness of breath, named Wine Wind.) Ventilation Wind symptoms: Excessive sweating, sweat soaking clothes, dry mouth, upper body wind infiltration, inability to labor, body-wide pain with chills. (Wind causes pain; heavy sweat depletes Yang causing chills. Note: *Su Wen · Feng Lun*, *Bi Lun*, *Wei Lun* are separate chapters with different etiologies and treatments. Modern practice often conflates them, so Dan Xi wrote treatises to distinguish. Also, Stroke has four main types, one being