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The changes of Yin and Yang are infinite, therefore their names also vary. This chapter regards the Zang-Organ Pulse (Zhen Zang Mai) as Yin and the Stomach Qi (Wei Wan Zhi Yang) as Yang, which differs significantly from the discussions of Yin and Yang in other chapters; hence it is named "Bie Lun" (Differentiated Discussion).

However, the death periods specified therein should not be rigidly adhered to. Since humans are not Huangdi (Yellow Emperor) or Qibo, their statements may not be entirely indisputable; thus, they have been summarized and abridged here.

The Yellow Emperor asked: "Humans have Four Channels (Si Jing) and Twelve Attachments (Shi Er Cong). What does this mean?" Qibo replied: "The Four Channels correspond to the Four Seasons, the Twelve Attachments correspond to the Twelve Months, and the Twelve Months correspond to the Twelve Meridians." (Commentary: The Four Channels refer to the Liver, Heart, Lung, and Kidney meridians. The Spleen is omitted because Earth governs the last 18 days of each season, and the Spleen does not rule a specific season alone; thus, mentioning the Four Channels implies the Spleen is included within them, rather than there being four channels outside the Five Zang Organs. 'Cong' means attachment. The main pulse is called 'Jing' (Channel), and the attached pulse is called 'Cong'. 'Jing' refers specifically to the Zang organs, while 'Cong' includes both Zang and Fu organs. This is similar to how combining them yields the Four Seasons, while separating them yields the Twelve Months. 'Cong' is pronounced with the departing tone.)

Pulses have Yin and Yang. To understand Yang is to understand Yin, and to understand Yin is to understand Yang. (Deep understanding allows for comprehensive recognition of their transformations.) There are five types of Yang, and five times five equals twenty-five Yang. (The five Yangs refer to the Yang Qi of the Five Zang Organs. Each Zang organ corresponds to a season and forms one pulse; within each pulse, the Yang Qi of all five Zang organs is encompassed. Thus, five times five results in twenty-five Yangs.) What is referred to as Yin is the Zang-Organ Pulse (Zhen Zang Mai). Its appearance indicates deterioration, and deterioration inevitably leads to death. (The Five Zang Organs belong to Yin, hence it is said: 'What is Yin is the Zang-Organ Pulse.' Commentary: Although the Five Zang Organs are indeed Yin, why are they directly called 'True Zang'? The commentary does not clearly explain the character 'Zhen' (True), merely citing the pulse image of the Zang-Organ Pulse, lacking sufficient elaboration. I propose that 'Zhen' refers to the true nature/color. The Five Zang Organs are Yin, and the Six Fu Organs are Yang. All Yang must be born through Yin, and Yin must be transformed by Yang. The Classic states: 'When Yin is balanced and Yang is secure, spirit and vitality are regulated.' Now, if the pulse arrives like the Liver's pulse—urgent inside and out, like touching a blade—it shows only Yin urgency without Yang harmony. This reveals the true nature of the Five Zang Organs alone, indicating that the Zang Qi has deteriorated. How can one not die? Is this explanation of 'Zhen' reasonable?) What is referred to as Yang is the Yang of the Stomach Chamber (Wei Wan Zhi Yang). (The Yang of the Stomach Chamber refers to the Qi at the Renying point. The Renying point is located on both sides of the larynx, where the artery beats palpably. Its pulsation is usually smaller on the left and larger on the right. The smaller left pulse often reflects Zang Qi, and the larger right pulse often reflects Fu Qi. Another theory claims it is the Yang of the stomach cavity, which is incorrect.) Distinguishing Yang lesions allows one to know the location of the disease; distinguishing Yin lesions allows one to know the period of life or death. (Yang protects the exterior and secures the body. When external pathogens invade, distinguishing Yang reveals the disease site. Yin stores the Spirit and guards internally. To examine true success or failure, distinguishing Yin reveals the prognosis of life or death.) The Qi of the Three Yang meridians gathers at the head, and the Qi of the Three Yin meridians gathers at the hand; this is called 'One'. (...The head refers to the Renying pulse, and the hand refers to the Qikou pulse. These two correspond, coming and going together, equal in size, termed a 'Ping Ren' (Normal Person); hence it is said to be 'One'. Commentary: 'One' means that both can be used to determine the life or death of diseases.) One must diligently master Yin and Yang and not consult with the masses. (Commentary: 'Jin' (Diligent/Careful) means deep contemplation; 'Shu' (Proficient) means thorough clarity without doubt. If the changes of Yin and Yang cannot confuse the mind, then various diseases will be resolved easily. Confusing Yin with Yang and Yang with Yin constitutes the 'masses'. The masses are mediocre, achieving failure without merit. Not consulting the masses is the mindset of sages and heroes.)

Regarding Yin and Yang: That which departs is Yin, that which arrives is Yang; that which is still is Yin, that which moves is Yang; that which is slow is Yin, that which is rapid is Yang. (...Commentary: This describes the Yin-Yang attributes inherent in the pulse body itself. It differs slightly from previous discussions and should be viewed separately.)

It is stated: Diseases of the Two Yang meridians originate in the Heart and Spleen, manifesting as difficult-to-disclose issues (sexual or excretory dysfunction) and amenorrhea in women. (Two Yang refers to the pulses of the Yangming Stomach and Large Intestine meridians. 'Yinqu' refers to hidden or delicate matters. Commentary: The original note suggests that in men, the Spleen is affected leading to poor digestion and scanty essence; in women, the Heart is affected leading to blood stagnation and amenorrhea. Dividing Heart and Spleen pathology by gender is questionable. Wang Andao's argument is most accurate: 'Two Yang is Yangming... "Originating in Heart and Spleen" means extending to the Heart and Spleen. Spleen and Stomach are interior-exterior pairs; Stomach disease affecting the Spleen is logical. However, the Large Intestine and Heart are not paired. Why does Large Intestine disease affect the Heart? The Stomach is the palace of reception, and the Large Intestine is the palace of transmission. Food enters the Stomach, turbid Qi goes to the Heart; water enters the Stomach, refined essence goes to the Spleen. This relies on the Stomach's ability to receive and the Large Intestine's ability to transform. If the intestines and stomach are diseased, they cannot receive or transform, leaving the Heart and Spleen without resources. Without resources, the Heart and Spleen cannot transport and transform to produce essence and blood. Thus, intestinal and stomach diseases affect the Heart and Spleen, causing scanty essence in men and amenorrhea in women. Heart and Spleen should be discussed collectively for both genders; only the specific symptoms of Yinqu and amenorrhea should be differentiated. If Wang's view were correct, men's essence would rely solely on the Spleen and not the Heart, and women's blood solely on the Heart and not the Spleen—is this logical? ...The Classic originally states that both men and women suffer Heart-Spleen disease, but in men it manifests as Yinqu dysfunction, and in women as amenorrhea.' Andao's discussion is precise and unchangeable. I initially intended to revise the original note, but upon reading *Suhui Ji*, I found no better explanation and retained it.) If the condition transmits to become Feng Xiao (wasting-thirst with muscle emaciation) or Xi Ben (asthma with upward rebellion), death occurs and is untreatable. (This refers to prolonged and deep disease. Chronic Stomach disease transmitting to the Spleen generates wind-heat that consumes muscles. Severe Large Intestine disease transmitting to the Lung causes asthma and upward rebellion. The intestines, stomach, spleen, and lungs, along with the Heart, mutually oppress each other, leading to death and incurability. Commentary: From this section onwards regarding the six paragraphs of Yin-Yang meridian diseases, Wang Bing's notes cover both hand and foot meridians. Ma Xuan Tai's view that they refer only to foot meridians is erroneous, likely due to adherence to the 'foot-transmission only' theory. Wang Bing's note should be considered correct.)

It is stated: Diseases of the Three Yang meridians manifest as chills and fever, sores and swellings below, and Wei Jue (flaccidity and cold extremities). (Three Yang refers to the pulses of the Taiyang Small Intestine and Bladder meridians. The Small Intestine meridian starts at the hand, runs along the arm, around the shoulder, and up to the head. The Bladder meridian descends from the head down the back, through the buttocks, into the popliteal fossa, and down the calf. Disease above manifests as chills and fever; disease below manifests as sores, swellings, flaccidity, and cold extremities. Shuan refers to pain in the calf muscle. Wei means weakness. Jue means cold feet, i.e., rebellious Qi. Commentary: Shuan (sound shan) refers to the calf muscle. Shuan (sound yuan) refers to soreness/pain.) If the condition transmits to become Suo Ze (dry skin lacking moisture) or Tui Shan (scrotal hernia)... (Commentary: Suo means wasting away. Ze means moisture. Prolonged heat causes dry, rough skin lacking moisture because the Bladder governs the exterior. Tui Shan refers to heavy, drooping testicles, commonly known as 'small intestine qi'. Shan is a disease caused by stagnant cold Qi. The Small Intestine governs Fire; prolonged illness weakens the meridians, allowing cold to stagnate within, transmitting to Tui Shan.)

It is stated: Disease of the One Yang meridian manifests as shortness of breath, frequent coughing, and frequent diarrhea. (One Yang refers to the pulses of the Shaoyang Gallbladder and Sanjiao meridians. Gallbladder Qi invading the Stomach causes diarrhea; internal Sanjiao disease causes shortness of breath; Yang Qi steaming the Lung causes coughing. Why? Because of internal correspondence with Heart Fire.) If the condition transmits to become Xin Che (pulling sensation in the heart) or Ge (obstruction)... (Commentary: The Gallbladder belongs to Wood. Untreated Gallbladder disease leads to Wood stagnation and Fire closure, obstructing Heart Qi, feeling like a pulling sensation. Ge means obstruction. The Sanjiao governs Qi, circulating throughout the body. Prolonged disease causes obstruction of Qi between upper and lower jiao.)

Disease of the Two Yang and One Yin meridians primarily manifests as fright and terror, back pain, frequent belching, and frequent yawning, named Feng Jue (Wind Reversal). (One Yin refers to the pulses of the Jueyin Pericardium and Liver meridians. Commentary: Two Yang are Stomach and Large Intestine; One Yin is Liver and Pericardium. Saying they cause disease implies all four meridians are involved, hence these four symptoms. The original note only explains Liver and Pericardium, ignoring Two Yang, and attributes yawning to Kidney Qi invasion, which is biased. Liver disease causes fright; Heart disease causes back pain and belching; Stomach disease causes belching and yawning. Furthermore, Liver is Wood, Large Intestine is Metal. Metal Qi oppressing Wood causes fright and terror. Fright and terror stir Wind. The reversal of Wood, Metal, Fire, and Qi constitutes Feng Jue.)

Disease of the Two Yin and One Yang meridians manifests as distension, chest fullness, and frequent sighing. (Two Yin refers to the pulses of the Shaoyin Heart and Kidney meridians. Commentary: Two Yin are Heart and Kidney; One Yang is Gallbladder and Sanjiao. The Sanjiao governs Qi. When Qi is regulated, it flows freely; when diseased, it becomes obstructed. The current diseases of these four meridians—distension, fullness, sighing—seem to belong exclusively to the Sanjiao. However, the Sanjiao is the official of drainage, the source of water passages, connecting Qi to the Heart above, draining Qi to the Kidney below, and depending on the Gallbladder in the middle. Thus, disease in all four leads to distension and fullness, upper congestion and lower stagnation, Qi accumulation without movement, resembling a Sanjiao meridian disease. The note saying Gallbladder and Kidney reverse together and Sanjiao fails to move leaves 'reverse' undefined and focusing solely on Sanjiao is biased.)

Disease of the Three Yang and Three Yin meridians manifests as hemiplegia (Pian Ku), variable flaccidity (Wei Yi), and inability to move the limbs. (Commentary: The original note does not specify which Three Yin meridians, attributing hemiplegia to Three Yin deficiency and variable flaccidity to Three Yang excess. Hemiplegia is indeed deficiency, but flaccidity becoming unpredictable is hardly excess. Truly strange. The Three Yin here refer to the Taiyin Spleen and Lung. The Spleen governs Blood; Spleen disease leads to blood deficiency and hemiplegia. The Lung governs Qi; Lung disease leads to Qi deficiency and flaccidity. 'Yi' means changeable/unstable; sometimes the hand recovers while the leg remains paralyzed, or vice versa, hence inability to move limbs. However, the limbs are the root of all Yang. The Taiyang Small Intestine and Bladder are Yang meridians. The Small Intestine receives and transforms; the Bladder stores fluids. Disease in both deprives the body of irrigation, causing dry sinews and tendons, leading to hemiplegia and flaccidity. I believe the note for this section is even more erroneous than the note for 'Two Yang Disease'. Even Wang Andao, who corrected the distribution error, failed to correct the 'Three Yang Excess' fallacy. How can such defects be fully remedied!)

Beating One Yang pulse is called Gou (Hook); beating One Yin pulse is called Mao (Feather); beating Yang-excess urgent pulse is called Xian (Bowstring); beating Yang-extreme dying pulse is called Shi (Stone); Yin-Yang interlacing pulse is called Liu (Slippery/Flowing). (Commentary: This likely describes pathological pulses of Yin-Yang disease. Gou is Heart pulse, Mao is Lung pulse, Xian is Liver pulse, Shi is Kidney pulse, but the meaning of Liu is unverified. Observing phrases like 'beating One Yang', it neither describes pulse shape nor etiology, lacking clear meaning. Thus, although original and other notes force interpretations, none are clear. I believe such content in *Suwen* need not be forced into interpretation; preserving it is acceptable.) Yin contends internally, Yang disturbs externally. Po Han (profuse sweating) fails to consolidate. Si Ni (extremity cold/reversal) arises. Upon arising, heat steams the Lung, causing wheezing and rattling. (...Commentary: This describes Yin-Yang chaos leading to Qi rebellion and acute asthma, a manifestation of Lung disease. Yin governs interior, Yang governs exterior. Internal/external contention causes Qi chaos and profuse sweating. More sweat leads to more Qi chaos. Here, 'Si Ni' does not mean limb coldness, but rather Qi from various meridians rushing to the Lung, causing acute wheezing and shouting. The note claiming endless metal-drumming causes Lung disease misinterprets the preceding text. 'Po Han' was explained previously. 'Wei Cang' means continuous sweating. 'Chuan Ming' means wheezing due to air hunger and audible breathing sounds.) Therefore, Gang with Gang (Yang combined with Yang) causes Yang Qi to break and scatter, and Yin Qi to perish. (...Gang refers to Yang. Extreme prosperity does not last; Yang Qi scatters naturally. Once Yang is broken, Yin cannot exist alone, so both Yang and Yin perish. Commentary: The note is profound, but the previous section said Yin-Yang contention harms the Lung, while this section says two Yangs combine, creating pure Yang without Yin. 'Gang' is Yang. Saying 'Gang with Gang' instead of 'Yang with Yang' implies two Yangs combining, representing violent, fierce Qi, which is Yang hyperactivity. Another perspective: If a patient already suffers from Yang-strength syndrome, and the doctor tonifies Yang, or lightly uses Ginseng/Atractylodes, or mistakenly uses Ginger/Aconite, this is also 'Gang with Gang', risking breakdown and perishing.)

Those belonging to Death Yin die within three days; those belonging to Life Yang survive no more than four days. (Commentary: The original text says 'die within four days', which contradicts the context and is erroneous. Quan Yuanqi's edition says 'survive no more than four days', which is adopted here.) Regarding Life Yang and Death Yin: Liver transmitting to Heart is called Life Yang (Mother generating Child, hence Life Yang; not only Wood generating Fire, but also Yang Qi governing generation). Heart transmitting to Lung is called Death Yin (Yin governs punishment/death; Fire attacking Metal, Metal destroyed by Fire, hence Death). Lung transmitting to Kidney is called Chong Yin (Heavy Yin) (Also Mother-Child relationship, but both belong to Yin Qi, hence Heavy Yin). Kidney transmitting to Spleen is called Pi Yin (Deviant Yin), death and untreatable. (Commentary: The explanation of Pi Yin in the note is unclear. Pi means deviant/perverse. Kidney is Shaoyin; Spleen is Taiyin. Kidney disease involving Spleen is deviant toward Yin, consistent with Lung-to-Kidney being Heavy Yin. Humans are born from Yang and die from Yin. Thus, illness gets lighter with Yang and heavier with Yin. Why do Wood-Fire diseases generate? They belong to Yang. Why do Heart-to-Lung, Lung-to-Kidney, Kidney-to-Spleen transmissions result in death? They all belong to Yin. Knowing why Yang generates, one knows why Yin kills.)

Yang Qi knotting leads to swelling of the four limbs. (Because limbs are the root of all Yang.) Yin Qi knotting leads to bloody stool of one sheng. (Yin governs Blood.) Second knotting leads to two sheng, third knotting leads to three sheng. (Commentary: 'Jie' (Knot) means gathering without dispersing. Yang governs Qi, Yin governs Blood. Heat knotting in Yang division causes Qi stagnation in limbs and edema; heat knotting in Yin division causes blood movement downward appearing in stool/urine, with volume varying by depth of knotting.) Yin-Yang knotting obliquely (biased), with much Yin and little Yang, is called Shi Shui (Stone Water), with swelling of the lower abdomen. (Commentary: It is the same 'knotting', why 'oblique/biased'? 'Xie' means biased. Biased toward Yang is heat; biased toward Yin is cold. Since Yin and Yang both knot, but the Qi knots biased toward Yin, it is much Yin and little Yang, constituting Yin-cold coagulation, named Shi Shui. Stone Water is water Qi coagulating like stone, such as hard swelling of lower abdomen and groin.) Two Yang knotting is called Xiao (Wasting-Thirst). (Heat knotting in Stomach and Large Intestine. Heat stored in intestines/stomach increases consumption of water and grain.) Three Yang knotting is called Ge (Obstruction). (Heat knotting in Small Intestine and Bladder. Heat knot in Small Intestine dries blood vessels; heat in Bladder dries fluids, causing obstruction and constipation.) Three Yin knotting is called Shui (Water Disease). (Cold knotting in Spleen and Lung meridians. Cold knot in Spleen/Lung disrupts Qi transformation into water.) One Yin and One Yang knotting is called Hou Bi (Throat Bi). (Sanjiao and Pericardium meridians connect to the throat. Internal heat knotting causes Throat Bi.) Yin pulse beats distinctly different from Yang pulse is called You Zi (Pregnancy). (Commentary: 'Zi' is a general term for child/offspring. Yin refers to Chi pulse, Yang refers to Cun pulse. Yin pulse slippery and rapid, beating distinctly, indicates female; Yang pulse sliding, distinct from others, indicates male. Yin/Yang should distinguish genders. If following the note, it becomes indistinguishable. The note says Chi pulse beats distinctly, Cun pulse stands firm, indicating pregnancy. If Chi is Yin, why say Chi pulse beating indicates Yang standing firm?! If Yang stands firm, it should indicate male, leaving no diagnostic method for females. Qixuanzi, a master physician, erred thus.)

Yin and Yang both deficient, suffering Chang Pi (dysentery) leads to death. (Commentary: Yin-Yang deficiency means Qi and Blood depletion. For other diseases, mild tonification suffices. But for dysentery with pus and blood, Yin exhausts further, Yang dissipates completely, inevitably leading to death. 'Pi' pronounced [pi].) Yang added to Yin is called Han (Sweat). (Commentary: Cun-Guan floating and large, double the Chi pulse, indicates pathogenic Qi moving outward, causing sweating. Why? Pathogens hide internally with Yin and move outward with Yang. The note saying 'Yang attacks above, Yin consolidates' is incomprehensible.) Yin deficient and Yang pulse beats forcefully is called Beng (Metrorrhagia/Metrorrhea). (...Insufficient Yin pulse, vigorous Yang pulse leads to internal collapse and downward bleeding. Commentary: Yin deficiency means fluid depletion failing to control Fire; Yang becomes restless, disturbing Yin internally, causing blood instability, leading to metrorrhagia/menorrhagia.)