Library

merely adhering rigidly to these principles. For "Zhong Guiren" (a term of respect for nobles or eunuchs in ancient times), their illness often leads to sudden death because their constitution has not been directly invaded by external pathogenic factors (indicating that while righteous qi remains, it is susceptible to internal injury or sudden factors), resulting in a violent onset and death. However, what is referred to as "pathogen" here denotes the impact of abnormal climates caused by the winning and reversing changes of the Five Movements and Six Qi. When climate undergoes variation, pathogenic factors invade the body's qi opportunistically.

If clear qi (dryness) becomes predominant, this indicates an excess of Dryness-Metal; Wind-Wood is affected by pathogens, leading to Liver disease which then spreads to the Gallbladder.
If hot qi becomes predominant, this indicates an excess of Fire; Dryness-Metal is affected by pathogens, leading to Lung disease which then spreads to the Large Intestine.
If cold qi becomes predominant, this indicates an excess of Water; Hot-Fire is affected by pathogens, leading to Heart disease which then spreads to the Small Intestine.
If damp qi becomes predominant, this indicates an excess of Earth; Cold-Water is affected by pathogens, leading to Kidney disease which then spreads to the Bladder.
If wind qi becomes predominant, this indicates an excess of Wood; Damp-Earth is affected by pathogens, leading to Spleen disease which then spreads to the Stomach.
This is what is meant by contracting illness through pathogenic influence: there is an abnormal climate externally, while the internal organs dislike this climate; the internal and external are not harmonious, and through cyclic interaction, illness ensues. This is called "contracting."

If one encounters a year with deficient movement-qi (e.g., insufficient annual luck), the pathogenic factor will be more severe. For example, in years where Wood movement is deficient, if external cold-dry pathogens arrive, Liver disease and similar conditions may occur.
If the harmony of the season is violated, the pathogenic factor also intensifies. This refers to the situation where the Six Qi superimposed upon the time clash with the Principal Qi; contracting such pathogens leads to illness.
Encountering the "Moon Void" (period of lunar waning) also exacerbates the pathogenic effect. Specifically, after the lower half-moon phase and before the upper half-moon phase, this period is termed Moon Void. Contracting pathogens during this time results in aggravated illness.
Repeated exposure to pathogens leads to critical illness. This means that when the annual luck is already deficient and pathogenic qi arrives in force, it is termed the first contraction. If the annual luck is deficient and the heavenly weather overcomes it, and one contracts pathogens at this moment, it is termed repeated contraction. The internal qi summons the pathogen, and the protective mechanism of heaven fails; how could it not be dangerous? For instance, in Ding-Mao and Ding-You years, external cold-dry pathogens arrive causing Liver disease; in Ji-Si and Ji-Hai years, external wind pathogens arrive causing Spleen disease; in Xin-Chou and Xin-Wei years, external damp pathogens arrive causing Kidney disease.

Whenever discussing the prognosis of illness, one must clarify the deficiency or excess of the affected Zang-Fu organs, combine this with the variations of winning and reversing movements of the year, and consider the superimposition of Guest Qi to make judgments. Suppose Wind-Wood is excessive, and the people present with Excess patterns in the Spleen and Lung but Deficiency patterns in the Liver; the illness will be mild. Conversely, if there are Deficiency patterns in the Spleen and Lung but Excess patterns in the Liver, the illness will be severe. All other cases can be deduced similarly.

To understand the timing of severity fluctuations and life-death periods for diseases of the Five Zang organs, one must clearly examine the pulse conditions to identify the affected organ. For a diseased organ, recovery occurs on the Zi day (the day that generates the organ); if not recovered on Zi day, severity increases on the Gui (Ghost) day (the day that controls the organ); if death does not occur on the Ghost day, the condition stabilizes on the Mother day (the day generated by the organ). The methods for determining seasons, Heavenly Stems, and earthly branches follow the same principle. Thus, the Classics state: When pathogenic qi invades the body, it acts according to the five-element controlling relationship. Recovery occurs when reaching the day that generates the diseased organ (Son of the diseased Zang); severity increases when reaching the day that controls the diseased organ (Ghost of the diseased Zang); stability is maintained when reaching the day generated by the diseased organ (Mother of the diseased Zang); and onset occurs when reaching its own position of prosperity. This corresponds to the flourishing phases of the four seasons and five elements, as well as the alignment of Heavenly Stems and time segments with the diseased Zang. One must first determine the pulses of the five Zang organs before discussing the timing of severity fluctuations and life-death periods; this is what is meant.

To know the timing of severity fluctuations and profuse sweating in Heat diseases, one must refer to the days corresponding to the root organ. Severity increases on days that control the organ; profuse sweating occurs on days when the organ is prosperous; if qi rebels, death occurs on the controlling days. Thus, the Classics state: In Liver Heat disease, urine turns yellow first, accompanied by abdominal pain, somnolence, and fever. During the struggle between heat and pathogen, there is delirium and惊厥 (convulsions), hypochondriac pain, restlessness of hands and feet, and inability to lie down peacefully. Severity increases on Geng-Xin days (Metal days, controlling Wood); profuse sweating occurs on Jia-Yi days (Wood days, organ's own prosperity); if qi rebels, death occurs on Geng-Xin days. In Heart Heat disease, there is initial displeasure, followed by fever after several days. During the struggle, sudden heart pain, irritability, fullness, frequent vomiting, headache, flushed face, and absence of sweat occur. Severity increases on Ren-Gui days (Water days, controlling Fire); profuse sweating occurs on Bing-Ding days (Fire days, organ's own prosperity); if qi rebels, death occurs on Ren-Gui days. In Spleen Heat disease, there is heavy head, cheek pain, mental distress, bluish complexion, desire to vomit, and fever. During the struggle, lower back pain preventing bending or twisting, abdominal fullness, loose stools, and pain in both mandibles occur. Severity increases on Jia-Yi days (Wood days, controlling Earth); profuse sweating occurs on Wu-Ji days (Earth days, organ's own prosperity); if qi rebels, death occurs on Jia-Yi days. In Lung Heat disease, there is chills, gooseflesh, aversion to wind-cold, yellow tongue coating, and fever. During the struggle, wheezing and coughing occur, pain radiating to the chest, epigastrium, and back, difficulty taking deep breaths, mild headache, sweating followed by coldness. Severity increases on Bing-Ding days (Fire days, controlling Metal); profuse sweating occurs on Geng-Xin days (Metal days, organ's own prosperity); if qi rebels, death occurs on Bing-Ding days. In Kidney Heat disease, there is initial lower back pain and soreness, bitter taste, thirst with frequent drinking, and fever. During the struggle, neck pain and stiffness, aversion to cold with soreness, heat in the soles of the feet, and reluctance to speak occur. If qi rebels, there is dizzy neck pain and palpitations. Severity increases on Wu-Ji days (Earth days, controlling Water); profuse sweating occurs on Ren-Gui days (Water days, organ's own prosperity); if qi rebels, death occurs on Wu-Ji days. Regarding facial coloration at the onset: redness on the left cheek indicates Liver Heat; redness on the forehead indicates Heart Heat; redness on the nose indicates Spleen Heat; redness on the right cheek indicates Lung Heat; redness on the chin indicates Kidney Heat. These are all signs of the beginning of the disease. Regarding sweating: it occurs on the days when the organ's qi is victorious (i.e., prosperous days, such as Jia-Yi for Liver/Wood, Bing-Ding for Heart/Fire, etc.). After sweating, if the pulse is slow and calm, recovery ensues; if the pulse remains rapid and vigorous, death follows. If sweating does not correspond to these patterns, it indicates the treatment cannot overcome the disease. Delirium and loss of consciousness indicate death.

These are all the principles of the sacred classics. One must rely on inquiry, observation, auscultation/olfaction, and palpation to ascertain the root of the disease, align it with heaven, earth, time, and yin-yang, deduce the winning and controlling relationships, and establish treatment methods. By examining the severity and compliance/non-compliance of symptoms and treating accordingly based on the syndrome, and judging the feasibility of the treatment's compliance or opposition, one can predict auspiciousness or inauspiciousness. One must not merely adhere to yin-yang theory. Although yin-yang is the guideline for all things, when discussing fortune and misfortune, one must also rely on its practical application.

Generally speaking, death is caused by disease, disease arises from pathogens, pathogens arise from changes, and changes arise from imbalance. Balance brings peace without blame; otherwise, disaster arises. Internally, one verifies the state of the viscera; externally, one observes physical signs. External manifestations reflect the virtue or faults of the mind-heart; internal manifestations reflect the rise and decline of the zang-fu organs. Whether large or small, slow or urgent, everything corresponds. Thus, the Classics state: Virtue brings blessing, fault brings punishment. With virtue, heaven descends blessings to respond; with fault, heaven descends disasters to afflict. From this, we know that doors to disaster and fortune are not fixed; they are summoned by human actions. Therefore, it is said: If the ruler (Heart) is clear, the subordinates are peaceful. Using this for health preservation leads to longevity and safety throughout life; using this to govern the world leads to great prosperity. If the ruler is unclear, the twelve officials (organs) are endangered, the pathways become blocked and uncommunicative, and the form suffers greatly. Using this for health preservation leads to calamity; using this to govern the world leads to great danger for the lineage. Is this not due to human conduct!