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Ma Yun stated: "Neng" (能), pronounced as "Nai" (耐). In the *Book of Rites: Music* (*Liji Yueling*), it is written, "Therefore, one who cannot endure has no music." Here, "Nai" is written as "Neng". The *Ling Shu: Yin Yang Twenty-Five Person Types* chapter also contains the character "Neng". In ancient times, "Nai" and "Neng" were likely interchangeable.

The *Su Wen: Yin Yang Ying Xiang Da Lun* states: "The form and manifestation of disease" (Bing zhi xing neng ye). This refers to the shape and endurance of the disease, which is why this chapter is titled "Disease Manifestations" (Bing Neng). Zhang Zhaohuang said: "Bing Neng" refers to the forms and manifestations of rare diseases.

Commentary: Wu Kun explained the "Bing Neng" in the previous chapter as: "Neng" means "Xing" (form/shape). This explanation is correct.

Stomach Epigastrium Carbuncle (Wei Wan Yong): Wu Kun said: "Below the Hinge Gate (Xi Men) and above the Pylorus (Ben Men), the stomach that receives water and grain is called the Stomach Epigastrium (Wei Wan)." Commentary: The *Sheng Ji Zong Lu* states: "When Yin and Yang ascend and descend properly, Ying and Wei circulate freely; when Qi rebels and obstructs, stagnation and knotting occur, forming a carbuncle. The Stomach Epigastrium Carbuncle arises from cold qi isolating Yang, causing heat to gather at the stomach opening. Due to the disharmony of cold and heat, flesh and blood rot. Because Qi rebels in the stomach, the stomach pulse is deep and fine. Because Yang Qi cannot descend and communicate, the Renying point on the neck pulses vigorously. This causes chills and fever resembling malaria, skin dryness with scales, coughing or vomiting, or expectoration of pus and blood. Observing the condition of Fuliang (Voluta Mass), there are cases involving internal carbuncles of the stomach epigastrium, because it encases large amounts of pus and blood located outside the intestines and stomach. Formulas are attached in Volume 129."

One should observe the Stomach Pulse: Hua Shuo said: "This refers to 'Fushang Youwai' mentioned in the *Mai Yao Jingwei Lun*, used to observe the stomach pulse." Ma Yun said: "It refers to the Right Guan position." Wu Kun and Zhang Zhicong held the same view. Commentary: "Fushang Youwai" refers to the location for skin palpation (Chifu diagnosis), not the pulse taking site. The association of Cun, Guan, and Chi positions with the five Zang and six Fu organs is a theory from later texts like the *Nan Jing*. The "stomach pulse" mentioned here must refer to another observation site.

Rebellion (Ni): The *Jia Yi Jing* reads "Qi rebellion" (Qi ni zhe).

Renying Pulse Vigorous (Renying shen sheng): Zhang Zhicong said: "This refers to what is said in chapters such as *Zhong Shi*: 'Renying three-fold excess,' indicating disease in the Yangming meridian."

When Essence has a place to reside, it is peaceful (Jing you suo zhi ji ze an): Wu Kun's version reads "Jing you suo yi, ze wo bu an" (When essence has a bias, sleep is uneasy). The annotation states: "Zang organs belong to Yin, governing stillness. Thus, damage to Zang organs leads to deficiency; if Yin essence is biased, it leads to hyperactivity. Both cause restless sleep at night." Commentary: Various schools interpreted this literally, making the meaning difficult to understand. Wu Kun revised it based on the *Jia Yi Jing* but retained the character "Jing," making it clearer. I adopt his view.

Cannot suspend the disease (Bu neng xuan qi bing): Wu Kun said: "Cannot suspend the disease in the void so that it does not harm me." Ma Yun said: "Xuan means to sever." Commentary: The *Ni Diao Lun* Chapter 6 details symptoms such as inability to lie down with noisy breathing. However, here it says "uneasy," referring to the inability to sleep peacefully, which differs from the other text.

Supine Position (Yan wo): Gao Shixi said: "Proper lying down, i.e., supine." The *Ping Re Lun* states: "Inability to lie supine indicates disharmony in the stomach." Hence, it is raised for further inquiry.

The Lung is the Cover of the Viscera (Fei zhe zang zhi gai ye): The *Wu Lun* states: "The Lung is the Chief of the Zang organs and the Cover of the Heart." The *Ling Shu: Jiu Zhen Lun* states: "Among the five Zang organs corresponding to Heaven is the Lung; the Lung is the Cover of the five Zang and six Fu organs."

Right Pulse Deep and Tight, Left Pulse Floating and Slow (You mai chen er jin, zuo mai fu er chi): Ma Yun said: "This should be seen in both Chi positions." Wu Kun and Zhang Zhicong agreed. Commentary: The original classic does not discuss Cun, Guan, and Chi positions; this specifically refers to left and right sides, certainly not referring to the two Chi positions.

Otherwise (Bu ran): Ma Yun, Wu Kun, and Zhang Zhicong followed the *Jia Yi Jing*, interpreting "Ran" as "Zhi" (know). Gao Shixi interpreted from the old text, which is considered forced.

This goes against the Four Seasons (Ci ni si shi): Zhang Zhicong said: "Pulses conform to the four seasons. Therefore, when diagnosing in winter, both left and right pulses should be deep and tight. Now, the left pulse is floating and slow, which goes against the Qi of the four seasons."

Disease in the Kidney, somewhat related to the Lung (Bing zai shen po guan fei): Wu Kun said: "Guan means relationship." Zhang Zhicong said: "The Kidney governs Winter Qi, yet floats on the left. Thus, the primary disease is in the Kidney, but involves the Lung, likely manifesting as lower back pain." Commentary: The *Jia Yi Jing* lacks the character "Guan." The *Qi Bing Lun* states: "Its excess is in the Stomach, somewhat in the Lung," with identical syntax.

Kidney is the disease of lower back pain (Shen wei yao tong zhi bing ye): The *Jia Yi Jing* lacks the character "Shen."

Neck Carbuncle (Jing Yong): The *Yong Ju Pian* states: "Those arising in the neck are called Tian Ju. The carbuncle is large, red, and black. If not treated urgently, heat qi descends into Yuanye, damages the Ren Mai anteriorly, and internally steams the Liver and Lung. Death occurs within ten days."

Where lies the true method? (Qi zhen an zai): Wu Kun said: "Zhen refers to the correct treatment method." Commentary: It should follow the *Jia Yi Jing* reading "Qi Zhi" (its treatment).

Different Categories (Yi deng): Zhang Zhicong said: "Deng means category." Gao Shixi said: "Although the name Neck Carbuncle is the same, if the pathology is in Qi or in Blood, they are different categories."

Qi of Carbuncle Resting (Yong qi zhi xi): Ma Yun said: "Using a small needle to open and remove the pathogen works because the Qi in the carbuncle is stagnant/resting, not severe." Wu Kun changed "Xi" to "Fu" (rotten), stating: "Fu means rotten flesh. Needle refers to Pi needle, used to remove rotten flesh." Zhang Zhicong said: "Xi means stop. When Qi knots in a carbuncle and stays without dispersing, treatment should use a Pi needle to open and release the Qi. Once Qi moves, the carbuncle heals." Gao Shixi said: "For a neck carbuncle where Qi stops, the disease is in Qi, suitable for needle therapy to open and remove Qi. This is the true method for acupuncture when Qi stagnation forms a carbuncle. For a neck carbuncle where Qi is excessive and Blood gathers, the disease is in Blood, suitable for stone needle bleeding to drain it. This is the true method for stone needle therapy when Blood gathering forms a carbuncle. This explains treating the same disease differently, yet curing both." Commentary: The *Shuo Wen Jie Zi* defines "Fu" as parasitic flesh. Xu Kai stated: "Xi means growing outside the body." Hence, ancient texts call interest money "Xi Qian" and fertile soil "Xi Rang." Wang Niansun interpreted a term in *Fang Yan* as dead flesh, while Wu Kun interpreted it as rotten flesh, lacking evidence. Zhang Zhicong's annotation is appropriate, so I adopt it.

Treating the Same Disease Differently (Tong bing yi zhi ye): Wu Kun added ten characters below this: "For skin hardness and depression, moxibustion should be used to guide [the Qi]." He stated: "Since there was a question above, I presumptuously added this." Zhang Zhaohuang said: "Depressed conditions are also suitable for moxibustion. Initially mentioning acupuncture and moxibustion, then only discussing needles and stones, implies that since this chapter discusses the transmission of the Five Zang organs, and Kidney Qi has transmitted to the Liver, only needles and stones are suitable. If there is a re-depression in the Kidney, moxibustion is commonly used. Although not explicitly stated, readers should infer this. One should study carefully and not neglect any word." Commentary: Wu Kun's addition is presumptuous, and Zhang Zhicong's annotation is overly pedantic; neither should be adopted.

Mania (Kuang): The *Ling Shu: Dian Kuang Pian* states: "When mania first starts, the patient sleeps little, feels no hunger, considers themselves virtuous, wise, and noble, curses frequently, day and night without rest." The *Tong Ping Xu Shi Lun* states: "Epilepsy and manic reversal arise from long-term rebellion." Also, the *Qian Jin Fang* states: "Wild cursing and beating people is called Re Yang Feng, which is also angry mania."

Sudden frustration and difficulty in resolution (Bao zhe er nan jue): Ma Yun said: "This person, due to sudden trauma, faced obstacles where matters were hard to resolve, and their will could not be expressed." Wu Kun said: "Suddenly frustrated and suppressed, unable to be resolved." Zhang Zhicong said: "Jue means flow." Gao Shixi said: "Jue means disperse." Commentary: Wu Kun's note is correct.

Yangming is always moving (Yang ming zhe chang dong): Ma Yun said: "The *Ling Shu: Dong Shu Pian* states that only the Yangming meridian moves continuously. Therefore, points such as Chongyang (also known as Fuyang), Dicang, Daying, Xiaguan, Renying, and Qichong all have pulsating arteries, with Chongyang being the most prominent."

Juyang and Shaoyang do not move (Ju yang shao yang bu dong): Wu Kun said: "Juyang meridian has Weizhong and Kunlun points; Shaoyang meridian has Xuanzhong and Tinghui points. Their pulses do not move significantly. In these areas where pulses do not move significantly, if they suddenly move large and fast, this is a sign of Yang Jue (anger rebellion) and mania."

Moving Large and Fast (Dong da ji): Ma Yun said: "Da should be read as 'Chang' (long)." Commentary: Incorrect.

When food enters the Yin (Fu shi ru yu yin): Zhang Zhicong said: "The five flavors enter the mouth and transform in the Spleen; this is food entering the Yin. Stored in the Stomach to nourish the Qi of the five Zang organs; this is generating Qi in the Yang."

Raw Iron Falling (Sheng Tie Luo): Zhang Zhicong said: "These are iron filings hammered off in smelting furnaces. They belong to Metal, have cold and heavy Qi, and can best sink heat, open knots, and calm Wood and Fire pathogens. Thus, they can reduce rapid Qi movement and eliminate angry mania. Medicines using Iron Essence, Iron Flower Powder, Needle Sand, or Iron Rust Water share this intent." Commentary: The *Ben Cao Jing* writes "Tie Luo." The *Tang Ben Cao Zhu* states: "Luo refers to the black liquid coating on iron sheets, darker than other iron. Tao Hongjing claimed it could dye black and called it iron slurry, which is wrong." Su Song's *Tu Jing* states: "Tie Luo refers to the fine flakes hammered off red-hot iron by smiths, commonly called iron flowers, which is correct. Raw iron is used for casting after initial smelting; repeatedly refined iron is wrought iron, also called ripe iron. This view is correct. The *Bie Lu* states: Tie Luo is also named Tie Ye. Thus, Wang Bing calling it iron slurry is incorrect; it is raw iron liquid. Gao Shixi claimed 'Luo' is the same as 'Lao' (branding), implying turning red to black to calm Juyang Qi, which is even more absurd. The *Sheng Ji Zong Lu* states: Tie Luo is iron slurry for dyeing black, which is correct. Take one portion, warm in hot water, drink one cup after meals. This ignores Wang Bing's note and the *Tang Ben Cao*, merely copying Tao's error."

Make into a Drink (Wei Yin): Zhang Zhicong said: "Grind with water and soak to make a drink." Commentary: The *Tang Ben Cao Zhu* states: "Various iron treatments are not used in pills or powders but boiled to extract the liquid/slurry. Saying 'make into a drink' implies boiling to extract slurry as well?"

Reducing Rapid Qi Movement (Xia qi ji ye): Wu Kun said: "Cold and heavy, thus reducing Qi rapidly. When Qi descends, rebellion ceases." Zhang Zhicong said: "Iron is Black Gold, capable of subduing Liver Wood, thus rapidly reducing Liver Qi disorders." Li Shizhen said: "When Yang Qi is depressed and cannot diffuse, the Shaoyang Gallbladder Wood carries the Sanjiao Shaoyang Ministerial Fire, and Juyang Yin Fire ascends, causing irritability and mania. The pulses of Juyang and Shaoyang can be diagnosed. Deprive them of food to prevent Stomach Fire from aiding the pathogen. Drink Raw Iron Falling to use Metal to control Wood. When Wood is balanced, Fire descends. Hence, it reduces Qi rapidly. Qi is Fire." Commentary: The *Liezi: Tang Wen* mentions a tree in Wu and Chu called You, green in winter, with red sour fruit. Eating its peel and juice cures Fen Jue (frustrated rebellion). Zhang Zhan annotated: "Qi disorder." The *Book of Liang: Biography of Yao Cha* mentions developing Qi disorder after removing worry. Fen Jue is likely a type of Yang Jue, and Qi disorder covers various conditions including mania, epilepsy, dizziness, palpitations, and mental instability. Interpreting "Ji" as "fast" (speed of effect or speed of rebellious Qi) is erroneous.

Alisma, Atractylodes each one part, Elsholtzia half part (Zexie Shu ge shi fen, Mi Xian wu fen): Zhang Zhicong said: "Alisma (Zexie) is sweet, bland, slightly cold, promoting damp-heat drainage. Atractylodes (Baizhu) is sweet, bitter, warm, tonifying the center, drying dampness, and stopping sweating. Mi Xian is the same as Wei Xian, also called Wuxin Cao or Wufeng Cao in the south, bitter, neutral, slightly cold, treating wind-dampness. 'Ten parts' means double; 'five parts' means half." Commentary: Su Song stated: "In ancient formulas, 'Shu' refers to Baizhu (White Atractylodes). This formula is named Zexie Tang in *Sheng Ji Zong Lu* and Mixian Tang in *San Yin Fang*, both using Baizhu." Ma Yun said: "Shu refers to Cangzhu (Coarse Atractylodes), which is incorrect." *Ben Cao Jing* writes Wei Xian, also named Mi Xian. *Tang Ben Cao Zhu* states: "Also named Luxian Cao (Deer Foot Grass). It is said deer eat this grass when sick and recover." Chen Jiamo said: "Elk and deer eat this grass when sick and recover, hence the name in *Su Wen*." Li Shizhen said: "Based on Su Song, Wei Xian and Mi Xian should be Luxian Cao. This view is wrong. Elk and deer are similar; there is no need to change to Deer. Liu Yuxi collected Tian Ming Jing and revived... leading to the name Huolu Cao (Living Deer Grass). Is Mi truly an error for Deer? Huolu Cao should be written as Hu... Cao." *Sheng Ji Zong Lu* converts ten parts to 2.5 liang and five parts to 1.1 liang. Tao's Preface states: "Ancient weights had only Zhu and Liang, no Fen. Later, ten grains equal one Zhu, six Zhu equal one Fen, four Fen equal one Liang. However, four Fen equaling one Liang is a post-Six Dynasties development. The 'Fen' in this classic is not a unit of weight; the *Zong Lu* is mistaken." *San Yin Fang* converts ten parts to 1 liang and five parts to 0.5 liang, matching Zhang Zhicong's note.

Combine with Three-Finger Pinch (He yi san zhi cuo): Wu Kun said: "He means compounding. San Zhi Cuo means a pinch as wide as three fingers." Commentary: Tao Hongjing's Preface states: "One Cuo equals four Dao Gui. Dao Gui is one-tenth of a Fang Cun Bi, sized like a paulownia seed. This 'three-finger pinch' is slightly more than one Fang Cun Bi." Zhang Zhicong said: "Combine using three fingers, pinching together to approximate the quantity for decoction." Examining the classic text, this refers to powder medicine; Zhang's annotation is erroneous. *Sheng Ji Zong Lu* states: "Crush the three ingredients into powder, take two Qian Bi per dose, mix with boiling water, take after meals." *San Yin Fang* also states: "Powder, take two Qian per dose, mix with wine, take before meals."

After Eating (Wei hou fan): Ma Yun said: "Medicine taken after meals." Error.

What is meant by 'Deep and Subtle' (Suo wei shen zhi xi zhe): Gao Shixi moved the following twenty-four characters under the previous "Neck Carbuncle" section, and moved the sixty-nine characters under "Shang Jing Zhe" under the previous "Zai Yin Yang Qi Heng" section, annotating them. This is forced and should not be adopted.