心腹满 高云。心腹。心之下腹之上也。满。胀满也。
旦食则不能暮食 吴云。是朝宽暮急。张云。内伤脾肾。留滞于中。则心腹胀满。不能再食。
鼓胀 志云。鼓胀者。如鼓革之空胀也。此因脾土气虚。不能磨谷。故旦食而不能暮食。以致虚胀如鼓也。
鸡矢醴 张云。鸡矢之性。能消积下气。通利大小二便。盖攻伐实邪之剂也。凡鼓胀由于停积。及
湿热有余者。皆宜用之。若脾肾虚寒发胀。及气虚中满等证。最所忌也。误服则死。正传云。用羯鸡矢一升。
研细。炒焦色。地上出火毒。以百沸汤淋汁。每服一大盏。调木香槟榔末。各一钱。日三服。空腹服。以平为
度。又医鉴等书云。用干羯鸡矢八合。炒微焦。入无灰好酒三碗。共煎干至一半许。用布滤取汁。
五更热饮则腹鸣。辰巳时行二三次。皆黑水也。次日觉足面渐有绉纹。又饮一次。则渐绉至膝上而病愈矣。此
二法似用后者为便。简按圣济总录。治鼓胀旦食不能暮食。鸡屎醴法。鸡屎干者。上一味为末。每用醇酒。调
一钱匕。食后临卧服。宣明论。鸡屎醴散。鸡屎醴。干者炒。大黄。桃仁。各等分。上为末。每服二钱。水盏
半。生姜三片。煎七分。食前服。此他有数方。宜根据证而择用。（千金。产后中风。鸡粪酒。妇人良方引。作
鸡屎醴。鸡粪一升。熬令黄。乌豆一升。熬令声绝。勿焦。以清酒三升半。先淋鸡粪。次淋豆。取汁。一服。
一升。温服取汗。）
一剂知二剂已 吴云。知。效之半也。已。效之至也。
虽然其病且已时故当病气聚于腹也 吴。已下句。注云。言虽是饮食不节。时有病者。但此病且已
之后。时有自然病者。此由病气聚于腹。未尽已也。病根未拔。故亦复发焉。简按虽然。诸注未妥。吴注稍通。
时故当病气。甲乙。作因当风气。无时字。
支满 张云。满如支膈也。
先闻腥臊臭 马云。金匮真言论。肝其臭臊。肺其臭腥。张云。肺主气。其臭腥。肝主血。其臭臊。
肺气不能平肝。则肝肺俱逆于上。浊气不降。清气不升。故闻腥臊。而吐清液也。
出清液 简按王注窈漏。谓阴户。又见骨空论注。此乃为白沃之属也。马则非之。为清涕从鼻出之
义。吴同。考上文。张注为吐清液者。似是。
血枯 妇人良方。骆龙吉曰。夫肝藏血。受天一之气。以为滋荣者也。其经上贯膈。布胁肋。今脱
血失精。肝气已伤。故血枯涸而不荣。胸胁满。以经络所贯也。然妨于食。则以肝病传脾胃。病至则先闻腥臊
臭。出清液。则以肝病而
肺乘之。先唾血。四肢清。目眩。时时前后血。皆肝病血伤之证也。
中气竭 吴本。竭下有及字。马云。醉以入房。致使醉则损伤其中气而竭绝。入房则劳其肝气而受伤。
盖司闭藏者。肾也。司疏泄者。肝也。故入房不惟伤肾。而且伤肝。张云。血枯者。月水断绝也。致此之由。
其源有二。一则以少时有所大脱血。如胎产既多。及崩淋吐衄之类。皆是也。一则以醉后行房。血盛而热。因
而纵肆。则阴精尽泄。精去则气去。故中气竭也。夫肾主闭藏。肝主疏泄。不惟伤肾。而且伤肝。及至其久。
则三阴俱亏。所以有先见诸证。如上文所云。而终必至于血枯。则月事衰少不来也。此虽以女子为言。若丈夫
有犯前证。亦不免为精枯之病。则劳损之属皆是也。
乌鲫骨 诸本。鲫。作 。简按说文。 。乌 鱼也。又 。或从即。知 鲫一字。本草。作乌贼。
罗愿云。此鱼有文墨可法则。故名乌 。 者。则也。骨名螵蛸。象形也。王所谓古本草经。即证类白字文。
吴云。乌 骨。涩物也。可以止血。张云。气味咸温下行。故主女子赤白漏下。及血闭。（以上神农本经）血
枯。其性涩。故亦能令人有子。李时珍云。乌 骨。厥阴血分药也。其味咸而走血也。故血枯血瘕。经闭崩带
下痢。厥阴本病也。厥阴属肝。肝主血。故诸血病皆治之。
茹 张云。 茹。亦名茹 。即茜草也。气味甘寒无毒。能止血治崩。又能益精气。活血。通血脉。
按甲乙经。及太素。新校正。俱作 茹者。非。盖 茹有毒。岂血枯者所宜。皆未之详察耳。志云。 茹。当
茹。高云。茹 。旧本误 茹。今改。简按本草。有 茹。而无 茹。故新校正云。当改 作 。然南齐王
子隆年三十一。而体过充壮。
常服芦茹丸。以自销损。证类本草 茹条。引本篇王注文。知是 芦 一音。古通用。张则以为茹 一名。考
诗郑风。茹 在阪。尔雅。茹 。 也。郭注。可以染绛。邢疏。一名地血。齐人谓之茜。别录。茜根。一名
茹。乃以为茹 一名者非。然血枯所用。当是茹 。故志。高。并仍张注。而改茹 。极是。李时珍云。茜
根。色赤而气温。味微酸而带咸。色赤入营。气温行滞。味酸入肝。而咸走血。手足厥阴血分之药也。专于行
血活血。俗方用治女子经水不通。以一两煎酒服之。一日即通。甚效。此可以为张注之左证矣。四乌 骨。一
茹。诸家不释。圣济总录。乌贼鱼骨。去甲。四两。 茹一两。妇人良方同。此盖谓 茹用乌 骨四之一。
古法不必拘于秤量。故云尔。
雀卵 张云。雀。即麻雀也。李时珍云。俗呼老而斑者。为麻雀。简按王注气味主疗。见于别录。
遂云。兹四药用入房焉。误。
后饭 吴云。先药后饭也。高云。使药下行。而以饭压之也。
鲍鱼汁 马云。俗谓之腌鱼卤。张云。鲍鱼。即今之淡干鱼也。诸鱼皆可为之。惟石首鲫鱼者为胜。
其气味辛温无毒。通血脉。益阴气。煮汁服之。能同诸药。通女子血闭也。以上四药。皆通血脉。血主于肝。
故凡病伤肝者。亦皆可用之。李时珍云。鲍鱼。别录既云。勿令中咸。即是淡鱼无疑矣。简按妇人良方。圣济
总录。并云。以鲍鱼煎汤下。以饭厌之。马以鲍鱼为腌鱼。以汁为卤。并误。（千金翼。治妇人漏血崩中。鲍
鱼汤。鲍鱼。当归。阿胶。艾叶。凡四味。可见其有益阴之功也。）
利肠中及伤肝也 吴删及伤肝也四字。非。
小腹盛 马云。少腹盛满。
皆有根 吴云。根。病之所穷止也。
可治不 马云。不。否同。
伏梁 张云。伏。藏伏也。梁。 梁坚硬之谓。按邪气脏腑病形篇曰。心脉微缓。为伏梁。在心下上
下行。时唾血。又经筋篇曰。手少阴之筋病。内急心承伏梁。故五十六难曰。心之积。名曰伏梁。起脐上。大
如臂。上至心下。其义本此二篇。然观本节云。齐上为逆。齐下为从。下节云。环齐而病。病名伏梁。是又不
独以心积为伏梁也。盖凡积有内伏而坚强者。皆得名之。故本篇独言伏梁者。其总诸积为言。可知也。吴云。
伏梁。言如潜伏之桥梁。为患深着之名。此与难经论伏梁不同。彼为心之积。是脏之阴气也。此为聚脓血。是
阳毒也。
裹大脓血 志云。裹大。如囊之裹物而大也。简按此说迂僻。不可从。
每切按之 吴云。谓以手切近而按之。张云。按。抑也。高云。每急切而按摩之。必真气受伤。故致死。
此下则因阴 马云。其下与足之三阴而相因。必有时亦下有余之脓血。志云。此下。谓少腹。阴。
前后二阴也。简按当从志注。
生膈 高云。当生膈挟胃脘之内痈。简按不必根据王注生改出。
挟胃脘 甲乙。挟。作根据。
内痈 吴云。内溃之痈。不显于外也。
此久病也 张云。此非一朝夕所致者。延积既久。根结日深。
居齐下为从 吴云。齐。脐同。齐下之分。大小肠。膀胱之所部也。皆能受伤。即脓血穿溃。而不系
人之生死。故为从。
勿动亟夺 马云。不可轻动之也。如上文切按之谓。必数数泻以夺之。则可以渐减。而不使之上
迫耳。吴云。动。动胃气也。动大便也。亟。数也。夺。谓下之也。言勿得动胃气行大便。而数夺之也。高云。
勿动亟夺。犹言勿用急切按摩以夺之。不当亟夺而妄夺。必真气受伤而致死。简按高注允当。今从之。
论在刺法中 张云。按伏梁一证。即今之痞块也。欲治之者。莫妙于灸。
髀股 甲乙。千金。根据腰股。
环齐 王注奇病论云。环。谓圆绕如环也。
风根 张云。即寒气也。如百病始生篇曰。积之始生。得寒乃生。厥乃成积。即此谓也。汪云。此
风根也。四字疑衍。或郁而不已。气化为风。故曰风根。简按张注义略通。今从之。
肓之原在齐下 吴云。腔中无肉空腋之处。名曰肓。（腋。疑隙误。）原。源也。脐下。气海也。
一名脖 。灵枢曰。肓之原。名曰脖 。（出九针十二原。）此之谓也。简按吴释肓乃似。张解募原。恐无明
据。左传成公十年云。疾居肓之上膏之下。说文。肓。心下膈上也。（下上原错。今从左传音义引。）傅氏左
传辨误云。杜云。肓。膈也。心下为膏。愚考素问刺禁篇云。膈肓之上。中有父母。杨上善云。心下膈上为肓。
曾亲观猪脏心膈之处。方忆膈者隔也。自膈以上。皆心肺清洁之属。自膈以下。皆肠胃污浊之属。则心在上。
膈在下。固矣。而心下有微脂为膏。膈上有薄膜为肓也。其痹论又云。皮肤之中。分肉之间。熏于肓膜。注云。
肓膜。谓五脏之间。膈中膜也。则正与心下之微脂相对。益明矣。傅此说太详备。可谓发前
注所未发矣。
为水溺涩之病 吴云。水溺。小便也。志云。盖风邪之根。留于脐下。动之则风气淫 。而鼓动其水
矣。水溢于上。则小便为之不利矣。高云。此伏梁之在气分。不同于裹大脓血之伏梁也。简按志。水下句。与
诸注异。
高梁 甲乙。作膏梁。（详出生气通天论。）
马云。 。癫同。简按 。说文。病也。一曰。腹胀也。乃 从 者。而战国策。为癫狂之癫。
古通用可知矣。第王多喜多怒之解太误。（详出宣明五气篇。）甲乙作疽。似是。
禁芳草石药 张云。芳草。辛香之品也。石药。 炼金石之类。皆能助热。亦能销阴。凡病热者。所
当禁用。高云。热中消中者。精血内竭。火热消烁。皆富贵人之病也。富贵之人。浓味自养。今禁膏梁。是不合
其心。富贵之人。土气壅滞。宜升散其上。镇重其下。今禁芳草石药。是病不愈。简按据张注。禁上。阙一不字。
悍 熊音。 。音票。急也。悍。音汗。猛也。（二字。见阴阳应象大论。）
更论 甲乙。作当愈甚三字。
膺肿颈痛胸满 马云。膺颈胸腹。皆在上中二焦也。今膺肿颈痛。胸满腹胀。则下气上逆。病名曰
厥逆。甲乙。膺。作痈。简按痈。壅同。详见于气厥论。
名厥逆 张云。此以阴并于阳。下逆于上。故病名厥逆。
须其气并 张云。气并者。谓阴阳既逆之后。必渐通也。志云。血气合并也。
入则喑 张云。阳气有余于上。而复灸之。是以火济火也。阳极乘阴。则阴不能支。故失声为喑。
虚则狂 张云。阳并于上。其下必虚。以石泄之。则阳
气随刺而去。气去则上下俱虚。而神失其守。故为狂也。
怀子之且生也 志云。且生者。谓血气之所以成胎者。虚系于腹中。而无经脉之牵带。故至十月之
期。可虚脱而出。简按且生。志意似指分娩之际。而味经文。殊不尔。吴云。生者无后患之意。
身有病 汪昂云。病字。王注解作经闭。按妇人怀子。多有呕恶头痛诸病。然形虽病。而脉不病。
若经闭。其常耳。非病也。
无邪脉也 张云。身病者。脉亦当病。或断续不调。或弦涩细数。是皆邪脉。则真病也。若六脉和
滑。而身有不安者。其为胎气无疑矣。
三阳之动 动。甲乙作盛。张云。阳脉者。火邪也。凡病热者。必因于阳。故三阳之脉。其动甚也。
人迎一盛少阳 甲乙。盛下有在字。下同。
入阴也 张云。人迎足阳明脉。所以候阳也。如终始禁服六节脏象等篇。俱详明其义。凡邪热在表。
三阳既毕。则入于阴分矣。简按吴。入上。补未字。非。
阳入于阴 张云。头主阳。腹主阴。阳邪在头则头痛。及其入于阴分。则腹为 胀也。简按吴。阳
上。补始字。赘。
Heart and abdominal fullness. Gao Yun: "Heart and abdomen" refers to the area below the heart and above the abdomen. "Fullness" denotes a sensation of distension.
Able to eat in the morning but not in the evening. Wu Yun: This is what is meant by "comfortable in the morning, urgent in the evening." Zhang Yun: This is due to internal injury to the Spleen and Kidney, with qi stagnation in the middle jiao, leading to fullness and distension in the heart and abdomen, making further ingestion of food impossible.
Drum distension (Gu Zhang). Zhi Yun: Drum distension is like the hollow distension of a drum skin. This occurs because of deficiency of Spleen Earth qi, which fails to grind and transform grains; thus, one can eat in the morning but not in the evening, resulting in empty distension resembling a drum.
Ji Shi Li (Chicken Dropping Wine). Zhang Yun: The nature of chicken droppings is to resolve accumulation, direct qi downward, and promote the free flow of both large and small bowels. It is an agent that attacks and expels excess pathogens. For drum distension caused by retention of accumulation or by excess damp-heat, it is suitable. However, for distension caused by Spleen and Kidney deficiency-cold, or middle-fullness due to qi deficiency, it is strictly contraindicated. Ingestion by mistake leads to death. *Zheng Chuan* records: Take one sheng of male rooster droppings, grind finely, stir-fry until scorched, place on the ground to remove fire toxicity, pour boiling water over them to extract the juice. Take one large cup each time, mixed with one qian of powder of Muxiang (Costus Root) and Binglang (Areca Seed), three times daily, taken on an empty stomach, stopping when symptoms subside. Other books such as *Yi Jian* record: Take eight he of dry male rooster droppings, stir-fry until slightly scorched, add three bowls of good wine without ash, boil together until reduced by half, filter the juice through cloth. Drink hot at wu geng (3-5 AM); abdominal borborygmus will occur, and two or three bowel movements of black water will happen during Chen and Si hours (7 AM - 11 AM). The next day, wrinkles will gradually appear on the dorsum of the feet. Drink once more, and the wrinkles will extend up to the knees, curing the disease. Between these two methods, the latter seems more convenient. Jian An: *Sheng Ji Zong Lu* treats drum distension with inability to eat in the evening using the Chicken Dropping Li method: Use dry chicken droppings, grind into powder. Mix one qian bi with mellow wine, take after meals and before sleep. *Xuan Ming Lun* has Ji Shi Li San. For Ji Shi Li: Dry chicken droppings are stir-fried, along with equal parts Dahuang (Rhubarb Rhizome) and Taoren (Peach Seed). Grind into powder. Take two qian each time with one and a half cups of water and three slices of Shengjiang (Fresh Ginger), decoct to seven-tenths, take before meals. There are several other formulas; choose according to the syndrome. (*Qian Jin Fang* treats postpartum wind-stroke with Chicken Dropping Wine; *Fu Ren Liang Fang* cites it as Ji Shi Li: One sheng of chicken droppings, roasted until yellow; one sheng of black beans, roasted until sound ceases, do not burn. Pour three and a half sheng of clear wine over the chicken droppings first, then over the beans, collect the juice. Take one sheng at a time, warm administration to induce sweating.)
One dose brings improvement, two doses bring cure. Wu Yun: "Zhi" (know/improve) means half of the therapeutic effect is achieved; "Yi" (stop/cure) means the therapeutic effect is fully realized.
Although the disease temporarily subsides, there are times when pathogenic qi gathers in the abdomen. Wu's annotation: The following sentence implies that although irregular diet causes occasional illness, after this illness temporarily subsides, spontaneous recurrences still occur. This is because pathogenic qi gathers in the abdomen and has not completely dissipated. Since the root of the disease remains unextracted, recurrence happens. Jian An: The phrase "Sui Ran" (although) is not well explained by various annotations; Wu's annotation is somewhat coherent. "Shi Gu Dang Bing Qi" (time therefore should pathogenic qi) in *Jia Yi Jing* reads "Yin Dang Feng Qi" (due to should wind qi), without the character "Shi".
Zhi Man (Distension with a supporting sensation). Zhang Yun: Fullness feels like something supporting the diaphragm.
First smell fishy and musky odors. Ma Yun: *Jin Gui Zhen Yan Lun* states that the odor of the Liver is musky (sao), and the odor of the Lung is fishy (xing). Zhang Yun: The Lung governs qi, its odor is fishy; the Liver governs blood, its odor is musky. If Lung qi cannot regulate Liver wood, both Liver and Lung qi rebel upwards; turbid qi does not descend, clear qi does not ascend, hence smelling fishy and musky odors and vomiting clear fluid.
Vomiting clear fluid. Jian An: Wang Bing's annotation interprets "vomiting clear fluid" as leukorrhea from the yin orifice. Also seen in the annotation of *Gu Kong Lun*. This belongs to the category of Bai Wo (white discharge). Ma Shi disagrees, interpreting it as clear nasal mucus. Wu Kun agrees. Examining the context above, Zhang Jingyue's annotation of "vomiting clear fluid" seems correct.
Xue Ku (Blood Depletion). *Fu Ren Liang Fang*, Luo Longji says: The Liver stores blood and receives the Qi of Heaven One to nourish and enrich the body. Its meridian passes upward through the diaphragm and spreads over the hypochondrium. Now, if there is loss of blood or essence, the Liver qi is already injured, so blood becomes depleted and dry, failing to nourish the body, causing fullness in the chest and hypochondrium due to the pathway of the meridians. However, interference with eating indicates Liver disease transmitting to the Spleen and Stomach. When the disease manifests, one first smells fishy and musky odors and vomits clear fluid; this is because Liver disease allows Lung Metal to overcome Liver Wood. First spitting blood, cold limbs, dizziness, frequent bleeding from front and back (urinary and anal passages) are all syndromes of Liver disease injuring blood.
Exhaustion of Middle Qi. Wu edition has the character "Ji" (and) after "Jie" (exhaust). Ma Yun: Intercourse while drunk damages the Middle Qi, causing exhaustion. Intercourse fatigues the Liver qi, causing injury. The organ governing closure and storage is the Kidney; the organ governing dispersion and excretion is the Liver. Thus, intercourse injures not only the Kidney but also the Liver. Zhang Yun: Xue Ku refers to amenorrhea. The causes are twofold. First, major blood loss in youth, such as multiple pregnancies and childbirth, metrorrhagia, menorrhagia, hematemesis, or epistaxis. Second, intercourse after drunkenness; when blood is abundant and hot, indulgence leads to complete depletion of Yin essence. Loss of essence leads to loss of qi, hence exhaustion of Middle Qi. The Kidney governs storage, the Liver governs dispersion; it injures not only the Kidney but also the Liver. Eventually, the Three Yin meridians are all deficient, so the aforementioned symptoms appear first, ultimately leading to Blood Depletion, where menstruation becomes scanty or stops. Although stated regarding women, if men suffer from the preceding syndromes, they inevitably develop Essence Depletion diseases, belonging to consumption disorders.
Wu Ze Gu (Cuttlefish Bone). Various editions write "Ji" differently. Jian An: *Shuo Wen Jie Zi* explains this character as Wuzeyu (cuttlefish). Some versions use the phonetic component "Ji", indicating "Ji" is one character. *Ben Cao* calls it Wu Zei. Luo Yuan says: This fish has patterns and ink that can be imitated, hence named Wuzei ("Ze" means rule/model). The bone is called Piaoxiao, named by pictographic principles. Wang Bing's ancient *Ben Cao Jing* corresponds to the text in *Zheng Lei Ben Cao*. Wu Kun says: Wuzei gu is astringent and can stop bleeding. Zhang Yun: Flavor salty, temperature warm, directs downward, thus treating red and white leukorrhea and blood obstruction in women. (From *Shen Nong Ben Cao Jing*). For Blood Depletion, due to its astringent nature, it can also facilitate conception. Li Shizhen says: Wuzei gu is a medicine for the Jueyin blood level. Its salty flavor enters the blood. Thus, it treats blood depletion, blood masses, amenorrhea, metrorrhagia, leukorrhea, and dysentery, which are primary diseases of the Jueyin. Jueyin belongs to the Liver, and the Liver governs blood, so it treats all blood diseases.
Qian Cao (Rubia Cordifolia Root). Zhang Yun: Qian Cao, also known as Ru Cao, is Rubia cordifolia. Flavor sweet, temperature cold, non-toxic. It stops bleeding, treats metrorrhagia, benefits essence and qi, invigorates blood, and unblocks blood vessels. According to *Jia Yi Jing*, *Tai Su*, and Xin Zheng Jiao, all read "Lu Ru", which is incorrect. Lu Ru is toxic and unsuitable for Blood Depletion; they failed to examine carefully. Shi Zhi says: "Lu Ru" should be "Qian Ru". Gao Yun: "Qian Ru" was mistakenly written as "Lu Ru" in old editions, now corrected. Jian An: *Ben Cao* contains "Lu Ru" but no "Qian Ru", so Xin Zheng Jiao says change "Lu" to "Qian". However, Wang Zilong of Southern Qi, aged 31, overly robust, often took Lu Ru Wan to reduce himself. *Zheng Lei Ben Cao* under Lu Ru cites Wang Bing's annotation from this chapter, knowing "Lu" and "Qian" were homophones and used interchangeably in antiquity. Zhang Jingyue considers Ru Cao a name for Qian Cao. Checking *Shi Jing · Zheng Feng*: "Ru Lu on the slope," *Er Ya*: "Ru Lu, Di Xue." Guo Pu's note: Can dye crimson. Xing Ying's疏: Also called Di Xue, people of Qi call it Qian. *Bie Lu*: Qian Gen, also called Ru. Thus, claiming Qian Cao is named Ru Cao is incorrect. However, for Blood Depletion, it should be Qian Cao. Therefore, Shi Zhi and Gao Yun retain Zhang's annotation but correct it to "Qian Cao", which is very appropriate. Li Shizhen says: Qian Cao root is red in color and warm in temperature, slightly sour with a salty taste. Red enters the Ying level, warm moves stagnation, sour enters the Liver, salty enters the blood; it is a medicine for the blood level of the Hand and Foot Jueyin. It specifically promotes blood circulation and resolves blood stasis. Folk prescriptions use it for female menstrual obstruction: decoct one liang in wine and take; menstruation flows within a day, very effective. This supports Zhang's annotation. Four parts Wu Ze Gu, one part Qian Cao. Experts do not explain. *Sheng Ji Zong Lu*: Cuttlefish bone, remove shell, four liang; Qian Cao one liang. *Fu Ren Liang Fang* is the same. This likely means Qian Cao uses one-fourth the amount of Wu Ze Gu. Ancient methods did not strictly adhere to weighing, hence the statement.
Que Luan (Sparrow Eggs). Zhang Yun: Que is the sparrow. Li Shizhen says: Commonly called sparrow for those old and spotted. Jian An: Wang Bing's notes on flavor, temperature, and indications are found in *Bie Lu*, leading him to say these four medicines are used for sexual practices, which is erroneous.
Hou Fan (Eat meal after medicine). Wu Yun: Take medicine first, then eat. Gao Yun: To make the medicine descend, press it down with food.
Bao Yu Zhi (Abalone Juice). Ma Yun: Commonly known as brine from pickled fish. Zhang Yun: Bao Yu is dried salted fish in modern times. Any fish can be used, but those from Sciaenidae (Croakers) and Carassius auratus are superior. Flavor pungent, temperature warm, non-toxic. Unblocks blood vessels, benefits Yin qi. Decocted juice taken can combine with other medicines to unblock menstrual obstruction in women. The above four medicines all unblock blood vessels. Blood is governed by the Liver, so any disease injuring the Liver can use them. Li Shizhen says: *Bie Lu* says "do not let it become salty," confirming Bao Yu is undoubtedly fresh/dried fish without heavy salting. Jian An: *Fu Ren Liang Fang* and *Sheng Ji Zong Lu* state: Decoct Bao Yu in soup, administer with rice pressing down the medicine. Ma Yun equating Bao Yu with pickled fish and juice with brine is wrong. (*Qian Jin Yi Fang* treats female leakage and metrorrhagia with Bao Yu Tang: Bao Yu, Dang Gui, E Jiao, Ai Ye, four ingredients, showing its benefit to Yin.)
Li Chang Zhong Ji Shang Gan Ye (Benefit intestines and injure Liver). Wu Kun deleted "Ji Shang Gan Ye" (and injure Liver), which is incorrect.
Xiao Fu Sheng (Lower Abdomen Fullness). Ma Yun: Shaofu (lower abdomen) is full and distended.
Jie You Gen (All have roots). Wu Yun: Gen refers to the origin or termination point of the disease.
Ke Zhi Bu (Can it be treated?). Ma Yun: "Bu" is the same as "Fou" (No).
Fu Liang (Hidden Beam). Zhang Yun: Fu means hidden/lodged. Liang refers to the hardness of the spine. According to *Xie Qi Zang Fu Bing Xing Pian*: A slight slackness in the Heart pulse indicates Fu Liang, located below the heart, moving up and down, with frequent spitting of blood. Also, *Jing Jin Pian* states: Disease of the Hand Shaoyin tendon causes internal urgency and Heart bearing Fu Liang. Thus, *Nan Jing · Chapter 56* says: The accumulation of the Heart is named Fu Liang, starting above the navel, as thick as an arm, extending up to below the heart. This meaning originates from these two chapters. However, observing this section: Above the navel is Ni (Rebellious), below the navel is Cong (Compliant). The next section says: Disease circling the navel is named Fu Liang. This implies Fu Liang is not solely the Heart accumulation. Generally, any accumulation that is internally lodged and hard can be named Fu Liang. Thus, this chapter mentions Fu Liang generally referring to all accumulations, which can be understood. Wu Yun: Fu Liang describes a condition deep-seated like a hidden bridge, a name for severe affliction. This differs from the Fu Liang discussed in *Nan Jing*. *Nan Jing* refers to Heart accumulation, Yin qi of the Zang organs; here it refers to accumulated pus and blood, Yang toxin.
Guo Da Nong Xue (Wrapping large amounts of pus and blood). Zhi Yun: Guo Da means wrapping like a bag containing objects, becoming large. Jian An: This explanation is pedantic and obscure, should not be followed.
Mei Qie An Zhi (Every time pressing causes pain). Wu Yun: Means pressing closely and massaging with hand. Zhang Yun: An means to suppress. Gao Yun: Every time massaging urgently will surely injure True Qi, leading to death.
Xia Yu Zu San Yin Xiang Yin (Lower part relates to Foot Three Yin). Ma Yun: The lower part correlates with the Foot Three Yin meridians, sometimes having residual pus and blood flowing downward. Zhi Yun: "This lower part" refers to Shaofu; "Yin" refers to the anterior and posterior yin orifices. Jian An: Should follow Zhi's annotation.
Sheng Ge (Developing Ge Syndrome). Gao Yun: Should develop Ge syndrome involving internal abscess in the epigastrium. Jian An: No need to change "Sheng" (generate) to "Chu" (exit) based on Wang Bing's note.
Xia Wei Wan (Clasping the Epigastrium). *Jia Yi Jing*: "Xia" is written as "Ju".
Nei Yong (Internal Abscess). Wu Yun: Internal ulcerative abscess, not manifesting externally.
Ci Jiu Bing Ye (This is a long-standing disease). Zhang Yun: This is not caused overnight; it has dragged on for a long time, accumulating deeply.
Ju Qi Xia Wei Cong (Located below navel is Cong/Compliant). Wu Yun: Qi is synonymous with Navel. The area below the navel is the domain of Large Intestine, Small Intestine, and Bladder. All can be injured; even if pus and blood perforate, it does not determine life or death, hence called Cong.
Wu Dong Ji Duo (Do not move, do not urgently deprive). Ma Yun: Do not lightly disturb it. Like the pressing mentioned above, repeatedly purging to deprive it can gradually reduce it without forcing it upward. Wu Yun: Dong means disturbing Stomach qi and bowels. Ji means frequently. Duo means purging/downward draining. Meaning: Do not disturb Stomach qi to move bowels, nor frequently purge. Gao Yun: Wu Dong Ji Duo means do not use urgent massage to deprive. Do not urgently deprive when inappropriate, lest True Qi be injured leading to death. Jian An: Gao's annotation is appropriate; follow it now.
Lun Zai Ci Fa Zhong (Discussion is in the Acupuncture Methods). Zhang Yun: Regarding Fu Liang syndrome, which is now known as痞块 (masses), the best treatment is moxibustion.
Bi Gu (Thighs). *Jia Yi Jing*, *Qian Jin*: Based on Waist and Thighs.
Huan Qi (Circling the Navel). Wang Bing's annotation in *Qi Bing Lun*: Huan means circular around like a ring.
Feng Gen (Wind Root). Zhang Yun: Refers to Cold Qi. As *Bai Bing Shi Sheng Pian* states: Accumulations begin to form, arising from Cold, completed by Jue (reversal). This refers to that. Wang Ang says: These four characters "Feng Gen Ye" are likely superfluous. Or stagnation persists, transforming into Wind, hence called Wind Root. Jian An: Zhang's interpretation is roughly coherent; follow it.
Huang Zhi Yuan Zai Qi Xia (The Source of Huang is below the Navel). Wu Yun: The empty space in the cavity without flesh is named Huang. (Ye is suspected to be a typo for Xi). Yuan means source. Below the navel is Qihai acupoint, also named Bo Yang. *Ling Shu* says: The Source of Huang is named Bo Yang. (From *Jiu Zhen Er Shi Er Yuan*). This refers to it. Jian An: Wu's explanation of Huang is plausible. Zhang's explanation of Mu Yuan lacks clear evidence. *Zuo Zhuan · Cheng Gong Year 10* says: Disease resides above the Huang and below the Gao. *Shuo Wen*: Huang is above the heart and below the diaphragm. (Original order of upper/lower was wrong, corrected here citing *Zuo Zhuan* phonology commentary). Fu Shi's *Zuo Zhuan Bian Wu* says: Du Pre's note: Huang is the diaphragm. Below the heart is Gao. I examined *Su Wen · Ci Jin Pian*: Above the Diaphragm and Huang, there are Parents. Yang Shangshan says: Above the heart and below the diaphragm is Huang. I personally observed pig hearts and diaphragms, recalling that Diaphragm means partition. Above the diaphragm are clean parts of Heart and Lung; below are dirty parts of Intestines and Stomach. Thus, Heart is above, Diaphragm is below, confirmed. Below the heart is thin fat called Gao; above the diaphragm is a membrane called Huang. *Bi Lun* also says: Between skin and muscles, steaming into Huang Mo. Note: Huang Mo refers to membranes between five Zang organs, in the diaphragm. This corresponds perfectly with the thin fat below the heart, making it clearer. Fu's explanation is detailed and comprehensive, uncovering what previous annotations missed.
Wei Shui Niao Se Zhi Bing (Disease of difficult urination). Wu Yun: Shui Niao is urine. Zhi Yun: Perhaps the root of Wind Evil remains below the navel; disturbing it causes Wind Qi to overflow and agitate water. Water overflowing upward causes difficult urination. Gao Yun: This Fu Liang is in the Qi level, different from Fu Liang wrapping pus and blood. Jian An: Zhi's annotation below "Shui" differs from others.
Gao Liang (Rich Food). *Jia Yi Jing*: Written as Gao Liang. (See *Sheng Qi Tong Tian Lun*).
Dian (Epilepsy/Madness). Ma Yun: is the same as Dian. Jian An: *Shuo Wen*: Disease. Or, abdominal distension. It derives from . In *Zhan Guo Ce*, it is Dian of madness, known to be interchangeable in antiquity. However, Wang Bing's interpretation of excessive joy and anger is too erroneous. (See *Xuan Ming Wu Qi Pian*). *Jia Yi Jing* writes Ju, which seems plausible.
Jin Fang Cao Shi Yao (Prohibit Fragrant Herbs and Stone Medicines). Zhang Yun: Fang Cao are pungent and aromatic items. Shi Yao are refined minerals/metals. Both can assist Heat and consume Yin. For heat diseases, they must be prohibited. Gao Yun: Re-Zhong and Xiao-Zhong involve internal exhaustion of essence and blood, consumed by Fire Heat; these are diseases of the wealthy. The wealthy nourish themselves with rich flavors. Prohibiting Gao Liang goes against their desires. The wealthy have stagnant Earth Qi; it should be dispersed upward and anchored downward. Prohibiting Fang Cao and Shi Yao means the disease will not heal. Jian An: Based on Zhang's note, a "Bu" (not) is missing before "Jin" (prohibit).
Han (Piao Han). Xiong pronunciation: . Sound Piao. Urgent. Han, sound Han. Fierce. (Two characters, see *Yin Yang Ying Xiang Da Lun*).
Geng Lun (Further Discussion). *Jia Yi Jing*: Reads "Dang Yu Shen" (Should become worse).
Ying Zhong Jing Tong Xiong Man (Swelling of Chest, Neck Pain, Chest Fullness). Ma Yun: Ying, neck, chest, abdomen are all in Upper and Middle Jiao. Now swelling of chest, neck pain, chest fullness, abdominal distension indicate Lower Qi rebelling upward, disease named Jue Ni. *Jia Yi Jing*: "Ying" is written as "Yong". Jian An: Yong is the same as Yong (obstruction). See *Qi Jue Lun*.
Ming Jue Ni (Named Jue Ni). Zhang Yun: This is Yin merging with Yang, Lower Qi rebelling upward, hence named Jue Ni.
Xu Qi Bing (Wait for Qi to Merge). Zhang Yun: Qi Bing means after Yin and Yang reverse, they gradually connect. Zhi Yun: Blood and Qi merge.
Ru Ze Yin (Entering causes Aphonia). Zhang Yun: Excess Yang Qi above, plus moxibustion, is adding fire to fire. Extreme Yang attacks Yin, Yin cannot support, hence loss of voice (Yin).
Xu Ze Kuang (Deficiency causes Mania). Zhang Yun: Yang merges above, below must be deficient. Using Shi Jie (Calcite) to drain, Yang Qi leaves with the needle. Qi departure causes deficiency above and below, Spirit loses its guard, hence mania.
Huai Zi Zhi Qie Sheng Ye (When Pregnant and About to Give Birth). Zhi Yun: Qie Sheng means the blood and qi forming the fetus hang loosely in the abdomen without meridian traction, so at ten months, it can be born via virtual collapse. Jian An: Qie Sheng seems to refer to delivery, but reading the text, it is not so. Wu Yun: Sheng means without subsequent complications.
Shen You Bing (Body has Disease). Wang Ang says: Bing character, Wang Bing annotates as Amenorrhea. Pregnant women often have nausea, headache, etc. Though the body appears diseased, the pulse is not diseased. If amenorrhea, it is normal, not disease.
Wu Xie Mai Ye (No Pathological Pulse). Zhang Yun: If body has disease, pulse should also be diseased. Irregular, wiry, choppy, fine, or rapid pulses are pathological, indicating true disease. If six pulses are harmonious and slippery, yet body feels uncomfortable, it is undoubtedly fetal qi.
San Yang Zhi Dong (Movement of Three Yang). Dong, *Jia Yi Jing* writes Sheng (Prosperity). Zhang Yun: Yang pulse is Fire Evil. All heat diseases originate from Yang, hence the movement of Three Yang pulses is vigorous.
Ren Ying Yi Sheng Shao Yang (Ren Ying One Degree Prosperity is Shaoyang). *Jia Yi Jing*: After Sheng, there is "Zai" (at), same below.
Ru Yin Ye (Entering Yin). Zhang Yun: Ren Ying Foot Yangming pulse observes Yang. As in *Zhong Shi*, *Jin Fu*, *Liu Jie Zang Xiang* chapters, meanings are detailed. When pathogenic heat is in the exterior, after Three Yang are exhausted, it enters the Yin level. Jian An: Wu adds "Wei" (not) before "Ru", incorrect.
Yang Ru Yu Yin (Yang Enters Yin). Zhang Yun: Head governs Yang, Abdomen governs Yin. Yang evil in head causes headache; entering Yin level causes abdominal distension. Jian An: Wu adds "Shi" (begin) before "Yang", redundant.