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Taiyin and Yangming refer to the Spleen and Stomach, respectively. The Spleen and Stomach belong to Earth. Earth is the mother of all things; life relies on it as a foundation, and the Zang-Fu organs depend on it for nourishment. Its significance is extremely profound, incomparable to other Zang-Fu organs, hence they are discussed together specifically.

The Yellow Emperor asked: Taiyin and Yangming are exterior-interior pairs, corresponding to the Spleen and Stomach meridians, yet they manifest different diseases. Why? Qibo replied: Yin and Yang occupy different positions; they alternate between deficiency and excess, and between reversal and compliance. Some pathogens originate internally, others externally. Since their origins differ, the disease names differ accordingly. (Annotation: Yang Shangshan stated: "In spring and summer, Yangming is excess and Taiyin is deficiency; in autumn and winter, Taiyin is excess and Yangming is deficiency. This is the alternation of deficiency and excess. In spring and summer, Taiyin is reversal and Yangming is compliance; in autumn and winter, Yangming is reversal and Taiyin is compliance. This is the alternation of reversal and compliance." This explanation is most clear.)

The Yellow Emperor said: I wish to hear about their differing manifestations. Qibo said: Yang corresponds to Heavenly Qi and governs the exterior; Yin corresponds to Earthly Qi and governs the interior. (This is what is meant by Yin and Yang occupying different positions.) Thus, the pathway of Yang tends toward fullness, while the pathway of Yin tends toward emptiness. (Annotation: Regarding form, Yang is full due to odd numbers, Yin is empty due to even numbers. Regarding function, Yang is full due to movement, Yin is empty due to stillness.) Therefore, when attacked by treacherous winds and empty pathogens, the Yang meridians receive them; when injured by irregular diet and improper daily routine, the Yin meridians receive them. (This refers to some originating from outside, some from inside.) When received by Yang, the pathogen enters the Six Fu organs; when received by Yin, it enters the Five Zang organs. Entering the Six Fu organs results in fever, inability to sleep at proper times, and upward rebellion causing panting and calling; entering the Five Zang organs results in abdominal fullness and obstruction, downward diarrhea of undigested food, and over time, dysentery. (This refers to different origins leading to different disease names. Annotation: Wind comes from outside, thus belongs to Yang; diet and routine injure from within, thus belong to Yin. Yang pathogens enter the Six Fu organs, which are Yang meridians; Yin pathogens enter the Five Zang organs, which are Yin meridains. Yin has Yin diseases, Yang has Yang diseases. Sundun (diarrhea with undigested food) refers to stool containing uncooked grains. Changpi (dysentery) refers to bloody or mucoid stools. If there is already diarrhea of undigested food, why mention dysentery? It is likely that prolonged diarrhea severely damages Yin blood, leading to dysentery.)

Thus, the throat governs Heavenly Qi (respiration), and the pharynx governs Earthly Qi (swallowing). Therefore, Yang meridians receive wind pathogens, and Yin meridians receive dampness pathogens. (Annotation: The throat controls breathing, thus governing Heaven; the pharynx controls eating, thus governing Earth. Wind is a Yang pathogen, located superiorly; Dampness is a Yin pathogen, located inferiorly.) Therefore, 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. (Annotation: The *Ling Shu* 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 aligns with the above. It describes the fixed pathways of the six Yin and six Yang meridians. Because these pathways differ, the diseases naturally differ.) Thus it is said: Yang diseases, upon reaching their extreme upward progression, reverse downward; Yin diseases, upon reaching their extreme downward progression, reverse upward. (This describes general principles. However, the Foot Shaoyin Kidney meridian descends, differing from other Yin Qi. Annotation: Yang ascending and Yin descending are the normal state of disease; reversing at the extreme is the pathological variation. Similar to Yang syndromes resembling Yin, or Yin syndromes resembling Yang, these are caused by the extremity of the disease, akin to the principle in the *I Ching* that change occurs in old lines but not young ones.) Therefore, those injured by wind suffer first in the upper body; those injured by dampness suffer first in the lower body. (Annotation: Wind and dampness can affect anywhere in the human body, but tracing back to the origin, there are differences in which part is affected first.)

The Yellow Emperor asked: Why does Spleen disease lead to the inability to use the four limbs? (Annotation: This chapter is originally named after Taiyin and Yangming. Prior sections merely discussed the general principles of Yin-Yang, upper-lower, and internal-external. Qibo only answered the question regarding differing disease manifestations. From here onward, the essential principles of the Spleen and Stomach are formally discussed, comprising three segments, addressing different diseases.) Qibo said: The four limbs all derive Qi from the Stomach, but cannot reach the meridians directly. (Annotation: The Stomach nourishes the four limbs via water and grain, but cannot immediately reach the limbs. 'Reaching the meridians' means reaching the meridians of the hands and feet. *Tai Su* reads 'meridian reaches,' which is redundant. One must rely on the Spleen to transmit it, so that it can be received. Annotation: The four limbs certainly rely on water and grain for nourishment, but water and grain cannot be transformed without the Spleen. Thus, after the Spleen transforms water and grain, the four limbs receive nourishment.) Now, if the Spleen is diseased and cannot transport fluids for the Stomach, the four limbs do not receive Qi from water and grain. Vital energy declines day by day, the vessel pathways become obstructed, and sinews, bones, muscles, and flesh lack Qi to sustain themselves, hence they do not function. (Annotation: The *Jue Lun* chapter states: "The Spleen governs transporting fluids for the Stomach." If fluids do not circulate, the whole body loses its nourishment.)

The Yellow Emperor asked: Why does the Spleen not govern a specific season? Qibo said: The Spleen belongs to Earth, governs the Center, and constantly nourishes the Four Zang organs throughout the four seasons. It governs for eighteen days during each season's transition, and thus cannot exclusively govern one season. (Annotation: All things are born from Earth; Wood, Fire, Metal, and Water cannot exist apart from it. Although it rules during the four seasons, it is essentially the master of all seasons. Hence, in the Five Movements, Jia-Ji Earth is honored first.) The Spleen organ constantly manifests the essence of Stomach Earth. Earth generates all things and models Heaven and Earth; thus, its essence extends from head to foot, and it cannot exclusively govern one season. (Annotation: 'Zhuo' means to manifest. The Stomach receives, the Spleen transforms. The Stomach receives water and grain, and the Spleen transforms them, making them manifest throughout the body. This is the essence of Stomach Earth, actually manifested by the Spleen. If the Spleen also exclusively governed one season, how could it permeate from top to bottom like this? 'Zhuo' is pronounced zhù.)

The Yellow Emperor asked: The Spleen and Stomach are connected only by membranes, yet they can transport fluids for each other. Why? Qibo said: The Foot-Taiyin (Spleen) meridian belongs to the Three Yin meridians. Its vessels penetrate the Stomach, connect to the Spleen, and link to the pharynx. Therefore, Taiyin transports Qi to the Three Yin meridians. Yangming (Stomach) is the exterior (the Stomach is the exterior partner of the Spleen); it is the Sea of the Five Zang and Six Fu organs, and it also transports Qi to the Three Yang meridians. The Zang and Fu organs each receive Qi from Yangming through their respective meridians. Therefore, [the Spleen] transports fluids for the Stomach. (Annotation: The Spleen Zang and Stomach Fu are paired by Yin and Yang. Separately, each can transport Qi within Yin and Yang. Together, the Stomach receives water and grain and transforms fluids, but cannot do so without the Spleen's transformation. The 'meridians' mentioned refer to the Spleen meridian. It means the Five Zang and Six Fu organs must rely on the Spleen's transformation to receive Stomach Qi for nourishment. The Stomach's fluids must also rely on the Spleen's transformation to spread to the Five Zang and Six Fu organs. Previous annotations were brief and omitted this detail; why?) If the four limbs do not receive Qi from water and grain, they decline increasingly day by day, vessel pathways become obstructed, sinews, bones, muscles, and flesh lack Qi to generate, and thus they do not function. (This reiterates the meaning that the Spleen governs the four limbs.)