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The *Mai Jie* (Explanation of Pulses) chapter aims to explain the principles of meridian pathologies. The entire chapter consists of thirty-four sections, originally lacking a clear context of questions and answers; it merely provides commentary on each section of the scripture, with some parts aligning with medical theory and others not. For instance, when explaining various syndromes, the text often refers to specific months. I privately believe that illness can occur at any time in human life, and should not be rigidly confined to specific months. However, I dare not arbitrarily delete these contents, but rather preserve them to maintain the ancient textual structure.

Regarding the Sun Taiyang (Greater Yang) meridian's description of swelling and pain in the lower back: This is because the first lunar month corresponds to the Earthly Branch *Yin* (Tiger), which belongs to Sun Taiyang. (Note: Refers to the gluteal muscles. In the first month, the Three Yang energies arise, governing *Jian Yin*; the Three Yang are called Sun Taiyang, hence "Yin is Sun Taiyang".) In the first month, Yang Qi emerges upwards, while Yin Qi remains abundant, and Yang Qi has not yet settled into its proper order. (Although the Three Yang arise in the first month, the weather is still cold; due to this coldness, it is said that Yin Qi is abundant. "Ci" refers to the position of establishment.) Therefore, swelling and pain in the lower back occur. (This is because the meridian reaches the middle of the waist and penetrates the buttocks.)

When the disease manifests as hemiparesis leading to limping, it is because in the first month, Yang Qi thaws and Earth Qi emerges. The term "partial deficiency" refers to a slight insufficiency caused by winter cold, resulting in partial weakness and limping. (The meridian runs along the posterior medial aspect of the thigh, converges in the popliteal fossa, descends along the leg, passes behind the lateral malleolus, follows Jinggu (BL64), and reaches the lateral side of the little toe. Hence this explanation. Note: The New Corrections state: "Wang Bing's claim that the meridian runs inside the thigh is incorrect. According to the *Jia Yi Jing*, the Taiyang flow does not reach the inside of the thigh; 'inside the thigh' is an error for 'outside the thigh'. It should read 'posterior lateral aspect of the thigh'.")

Regarding the description of neck stiffness radiating to the back: This occurs because Yang Qi rises excessively and contends, causing neck stiffness. (Neck stiffness refers to rigidity of the neck and jaw; in severe cases, it radiates to the back. This is because the meridian exits from the brain and branches down to the nape and back.)

Regarding tinnitus: This happens because Yang Qi surges upward like flourishing things, causing tinnitus. (This is because a branch of the meridian goes from the vertex to the upper angle of the ear.)

Regarding severe cases developing into mania or *Dian* disease (diseases of the vertex): This is because Yang Qi accumulates entirely at the top, while Yin Qi follows from below, creating a condition of deficiency below and excess above, leading to mania or *Dian* disease. (The meridian ascends to the forehead, crosses the vertex, and enters the brain. A branch goes from the vertex to the upper angle of the ear. Hence mania or *Dian* disease. The top of the head is called the vertex. Note: There is no single disease named 'Mania-Dian' in other texts; although mentioned together here, they are two distinct conditions. Mania involves excessive Fire energy, confusion of the spirit, and is known as 'Double Yang leads to Mania'. *Dian* refers to the vertex itself; the head is the gathering place of all Yang Qi. When Yang Qi is entirely at the top, diseases vary but are collectively named *Dian*. The commentary lacks distinction between the two.)

Regarding deafness caused by a floating pulse: This is due to issues with Qi mechanism. (Also because the meridian reaches the ear.)

Regarding muteness caused by pathogenic invasion inward: This occurs because Yang Qi, after being excessive, declines, leading to muteness. (Excessive Yang Qi enters inward and presses against the Bladder and Kidney, blocking the Qi of the Bladder Collaterals and Kidney Collaterals. Since the Bladder's meridian connects to the Kidney, and the Kidney's meridian flanks the root of the tongue, muteness and inability to speak result.)

Internal depletion leading to厥 (Jue/Reversal Cold) causes muteness and foot paralysis, indicating Kidney Deficiency. (*Pai* means paralysis/disability. The Kidney meridian travels with the Chong Mai from Qichong (ST30), along the medial aspect of the inner thigh, obliquely into the popliteal fossa, along the medial aspect of the fibula, and behind the medial malleolus into the sole of the foot. Thus, if Kidney Qi is internally depleted and不顺 (not smooth), the tongue becomes mute and the feet become disabled. Hence, this is Kidney Deficiency. Note: The Taiyang Bladder internally harmonizes with the Kidney. Kidney deficiency leads to muteness and paralysis. Muteness implies inability to speak; *Pai* implies limb paralysis. The Kidney meridian flanks the tongue root, so disease prevents speech. The Kidney governs bones; Kidney deficiency leads to bone萎 (atrophy/weakness) and lack of strength, hence *Pai*. Treating muteness and paralysis solely as Wind-Phlegm is a mistake. New Corrections note: "Wang Bing states the Kidney meridian travels with the Chong Mai, but the *Jia Yi Jing* says it is the Kidney Luo (Collateral). Furthermore, Wang Bing's commentaries on the Wei Lun, Qi Bing Lun, and Da Qi Lun all refer to the Kidney Luo. Therefore, the character 'meridian' here should likely be 'Luo/Collateral'.")

If the Shaoyin pulse is absent, it indicates Jue syndrome. (Shaoyin refers to the Kidney pulse. If Kidney Qi is internally exhausted, the Shaoyin pulse will be absent. Absence of the Shaoyin pulse means Taiyin Qi rebels and moves upward.)

Regarding the Shaoyang meridian's description of chest and hypochondriac pain: This speaks of Shaoyang abundance. Abundance here refers to its relationship as the exterior counterpart to the Heart. (Note: Shaoyang refers to the Gallbladder meridian. The Gallbladder meridian runs through both hypochondria. When Shaoyang is abundant, Wood becomes strong and Fire blazes, causing chest and hypochondriac pain. The hypochondria govern Wood, and the Heart governs Fire. Excess Wood generates Fire, and Fire is born from Wood, hence the Heart and Gallbladder are interior-exterior counterparts. The commentary is unclear.)

In the ninth month, Yang Qi ends and Yin Qi becomes abundant, causing chest and hypochondriac pain. (Fire is buried in Xu, so in the ninth month Yang Qi ends and Yin Qi becomes abundant. Note: Shaoyang Gallbladder Wood should govern Spring; why it mentions the ninth month is unknown.)

Regarding the inability to turn or roll over: This is because Yin Qi stores things. When things are stored, they do not move, hence the inability to turn or roll over. (Note: The meaning is unclear.)

Regarding severe jumping/restlessness: (*Yue* means jumping.) In the ninth month, all things decline, grass and trees fall and drop. Qi leaves Yang and turns to Yin. Qi is abundant, and Yang grows downward, hence termed "jumping". (Note: The scriptural explanation seems to refer to Heaven and Earth Qi, while Wang Bing's commentary explains it via meridians and acupoints, missing the true intent.)

Regarding the Yangming meridian's description of shivering chills: Yangming corresponds to Wu (Noon). The fifth month represents Yin within abundant Yang. (Yang is abundant and bright, hence called Wu. At the Summer Solstice in the fifth month, one Yin Qi rises while Yang Qi descends, hence "Yin within abundant Yang".) When Yang is abundant and Yin adds to it, shivering chills occur. (Note: Yin rising and Yang descending means Yin adds to Yang, suppressing Yang, hence shivering chills.)

Regarding swelling of the calves and laxity of the thighs: This is because the fifth month is Yin within abundant Yang. Yang Qi declines in the fifth month, and one Yin Qi begins to contend with Yang, causing calf swelling and thigh laxity. (Note: The fifth month sees extreme Yang abundance, with one Yin beginning to generate, and Yang turning into Yin. Calves and thighs belong to the Yin sector. However, this is merely interpreting the text; in reality, calf swelling can occur in any month, making such rigid interpretation difficult.)

Regarding wheezing and edema: This occurs because Yin Qi descends and then rises again. Rising, it allows pathogenic factors to lodge between the Zang-Fu organs, causing water disorders. (Note: Water belongs to Yin. Yin rising from below constitutes Water Pathogen lodging in the Lung, causing wheezing.)

Regarding chest pain and shortness of breath: This is because Water Qi resides in the Zang-Fu organs. Water is Yin Qi; with Yin Qi in the center, chest pain and shortness of breath occur. (Shortness of breath indicates Cold. When Cold Yin Qi enters the Zang organs, pain results.)

Regarding severe cases involving厥 (cold extremities), aversion to people and fire, and startle upon hearing wooden sounds: This is because Yang Qi and Yin Qi press against each other, and Water and Fire oppose each other, causing startle. Regarding the desire to close doors and windows and stay alone: This is because Yin and Yang press against each other, Yang ends and Yin becomes abundant, hence the desire to stay alone behind closed doors. (Yang is blocked by Yin, causing fear. Yin nature dislikes movement and prefers stillness, hence the desire for solitude.)

Regarding behaviors such as wanting to climb high, sing, discard clothes, and run when the disease strikes: This is because Yin and Yang contend again, and Yang Qi merges outwardly into the Yang aspect, causing the patient to discard clothes and run. (Yang refuses to be controlled by Yin.)

Regarding pathogenic factors lodging in the Sun Luo (Branch Collaterals) causing headache, nasal congestion/runny nose, and abdominal swelling: This is because Yangming Qi merges upward. Upward merging affects the Sun Luo and Taiyin, causing headache, nasal symptoms, and abdominal swelling. (The meaning of "Sun Luo Taiyin" is unclear.)

Regarding the Taidaiyin meridian's description of abdominal distension: Taidaiyin corresponds to Zi (Rat). In the eleventh month, the Qi of all things is stored within, hence termed "disease of distension". (Yin Qi is greatly abundant; Taidaiyin begins at Zi, hence "Zi". Because the meridian enters the abdomen, connects to the Spleen, and links to the Stomach, disease manifests as distension.)

Regarding Qi moving upward to the Heart causing belching: This is because Yin Qi is abundant and moves upward to Yangming. Yangming connects to the Heart, hence it is said to move upward to the Heart causing belching. (Note: New Corrections state: "Wang Bing claims the Foot Yangming meridian does not reach the Heart. However, the *Jia Yi Jing* states the Yangming meridian connects upward to the Heart, runs through the pharynx, and emerges from the mouth. Thus, the scripture saying 'Yangming connects to the Heart causing belching' makes sense. How could Wang Bing say it doesn't?")

Regarding vomiting after eating: This occurs because food becomes overly full and overflows upward, causing vomiting. (Note: Excessive eating leads to stomach fullness; if the Spleen fails to transport, vomiting occurs. This is one type of vomiting.)

Regarding feeling relieved and as if the disease has subsided after defecation or passing gas: This is because in the twelfth month, Yin Qi declines downward and Yang Qi is about to emerge. Hence, relief after bowel movement or gas passage is described as "feeling as if the disease has subsided". ("As if subsided" means the disease is going away; "Hou" refers to stool; "Qi" refers to gas escaping, commonly known as farting. After the Winter Solstice, Yang Qi begins to grow, and Yin Qi gradually retreats, so the disease trend daily weakens.)

Regarding the Shaoyin meridian's description of lower back pain: Shaoyin corresponds to the Kidney. In the tenth month, the Yang Qi of all things is injured, hence lower back pain. (The waist is the mansion of the Kidney. Before the Winter Solstice, Yang Qi is declining. The Kidney relies on Yang; as Yang Qi declines, lower back pain occurs.)

Regarding vomiting, coughing, and wheezing: This is because Yin Qi is below and Yang Qi is above. All Yang Qi floats without foundation or guidance, leading to vomiting, coughing, and wheezing. (Note: Although Yang Qi rises, its root is always below. If Yin is deficient below and cannot support Yang, Qi must detach from its root and float upward. Yang and Yin separate, drifting without basis, causing vomiting, coughing, and wheezing. Treating this as Yang excess and using only clearing/draining methods is far off the mark.)

Regarding depression, inability to stand or sit for long periods, and blurred vision upon standing: This is because the Yin and Yang of all things are unsettled and lack a master. Autumn Qi arrives, light frost falls, and things are being killed/slain. Yin and Yang contend internally, causing blurred vision. (Note: Internal contention leads to external disorder.)

Regarding shortness of breath and irritability: This is because Yang Qi is not regulated. If Yang Qi is not regulated, it cannot exit. Liver Qi should regulate but fails to do so, leading to irritability. Irritability is named Jian Jue (Frying Jue). (Note: The *Sheng Qi Tong Tian Lun* defines Jian Jue as excessive fatigue; here it is defined as excessive anger. In summary, internal Fire movement and agitation fall under this meaning.)

Regarding fear as if being chased: This is because in Autumn, all things have not completely departed. Yin Qi is scarce, Yang Qi enters, and Yin and Yang contend, causing fear. (Note: Fear belongs to the Kidney; Yang cannot overcome Yin.)

Regarding aversion to the smell of food: This is because the Stomach lacks Qi, hence aversion to food smells. (Note: "Chou" refers to the aroma of the Five Flavors. Due to Stomach deficiency, there is no Qi to perceive flavors, leading to self-imposed aversion.)

Regarding a face dark as earth: This is because Autumn Qi causes internal depletion, changing the complexion. (Note: Dark color is most ominous, appearing only in critical illnesses; it seems not solely due to Autumn Qi internal depletion.)

Regarding coughing up blood: This is because the Yang meridians are injured. Yang Qi is not yet abundant above, but the vessels are full. Fullness causes coughing, hence blood appears in the nose. (Note: Coughing blood is expectoration; nasal bleeding is epistaxis. The explanations before and after are inconsistent. Moreover, these two syndromes mostly belong to Yin deficiency, yet here it claims Yang injury; there must be an error here.)

Regarding the Jueyin meridian's description of hernia and lower abdominal swelling in women: Jueyin corresponds to Chen (Dragon). The third month is Yin within Yang. Pathogens are in the middle, hence termed hernia and lower abdominal swelling. (Note: This occurs in all seasons; claiming pathogens are specifically in the third month is inexplicable.)

Regarding lower back and spine pain preventing bending or stretching: This is because in the third month, everything vibrates with glory; all things bend but do not stretch. (Note: The meaning is inexplicable.)

Regarding strangury, hernia, and skin distension: ... Yin ... becomes abundant, causing vessel distension and blockage, hence termed strangury and hernia. (Note: Only due to Yin abundance does Qi become congested and blocked.)

Regarding severe dry throat and internal heat: This is because Yin and Yang contend, generating heat, hence dry throat. (Note: Dry throat can be deficient or excess; this case is excess Fire rising.)