马云。首二节。论热病。故名篇。后二节。则论劳风肾风也。
阴阳交 滑云。交。谓交错也。张云。以阳邪交入阴分。则阴气不守。故曰阴阳交。汪昂云。按
五营运大论云。尺寸反者死。阴阳交者死。盖言脉也。简按仓公传云。热病阴阳交者死。即是。
无俾也 汪机云。愚谓谷气化为精。今不能食。则精无所俾益。高云。俾。补益也。简按俾。尔
雅释诂云。使也。说文云。益也。王本于尔雅。汪高原于说文。并通。
病而留者 简按新校正。引甲乙。作而热留者。今从之。
脉尚躁盛 马云。按灵枢热病篇云。热病已得汗出。而脉尚躁喘。且复热。勿刺肤。喘甚者死。
又曰。热病已得汗。而脉尚躁盛。此阴脉之极也。死。
三死 马云。汗后辄复热。不能食者。一死。汗后脉尚躁盛者。二死。汗后反狂言失志者。三死。
简按王以不胜其病为二死。考上文。此乃谓汗出而脉尚躁盛之证。故今从马义。志云。病而留者。一死也。胃
气绝者。一死也。肾气绝者。一死也。胃气绝。肾气绝。上文所不言。此注非也。
风厥 张云。按风厥之义不一。如本篇者。言太阳少阴病也。其在阴阳别论者。云。二阳一阴发病。
名曰风厥。言胃与肝也。在五变篇者。曰。人之善病风厥漉汗者。肉不坚。腠理疏也。高云。承上文汗出复热
之死证。复举汗出烦满之病以问之。风为阳邪。性主开发。凡汗出而身发热者。风也。汗乃阴液。外出于阳。
今汗出而心烦胸满不解者。乃阴竭阳虚。不相交济。是为厥也。此因风致汗。因汗致厥。病名曰风厥。简按仓
公传云。风蹶胸满。过入其阳。阳气尽而阴气
入。阴气入张。则寒气上。而热气下。故胸满汗出。与此少异。
巨阳主气 志云。巨阳。太阳也。太阳之气主表。风为阳邪。伤人阳气。两阳相搏。则为病热。少
阴与太阳。相为表里。阳热在上。则阴气从之。从之则为厥逆矣。
服汤 张云。即脉度篇所谓虚者饮药以补之之意。简按药汤。古单谓之汤。华佗传。为汤下之。果
下男形。是也。志云。以助水津之汗。似为白汤之谓。误也。
劳风 张云。因劳伤风也。王氏曰。劳。谓肾劳也。此固一说。第劳之为病。所涉者多。恐不止于
肾经耳。马云。细玩此节之辞。似为医经中之劳证。简按此一时劳而受风之证。未见劳证咳出青黄涕而愈者。
则马注难凭。（巢源风热候云。肤腠虚。则风热之气。先伤皮毛。乃入肺也。其状。使人恶风寒战。目欲脱。
涕唾出。候之三日内。及五日内。不精明者。是也。七八日微有青黄脓涕。如弹丸大。从口鼻内出。为善也。
若不出则伤肺。变咳嗽唾脓血也。即本节劳风也。本节劳风。张氏医通详论之。文繁不录。当参看。出咳嗽门。）
叶文龄医学统旨云。劳风。即 之属。强上者。似角弓反张也。冥视者。目开不见物也。凡 病皆同不识人。
或反视斜视也。治法当与 同。又王好古医垒元戎。以此证为肺痿。并误也。方具于圣济总录十三卷。
法在肺下 吴云。其受邪由于肺下。盖四椎五椎六椎之间也。张同。
强上冥视 简按脉解篇云。所谓强上引背者。阳气大上而争。故强上也。王注。强上。谓头项禁强
也。乃与此注同。马志从此。吴张根据杨义。恐非也。今千金。作弦上而目眩。盖冥视。即目眩之谓。
唾出如涕 吴云。肺中津液。为风热蒸灼稠粘。故唾出若鼻中之涕。肺主皮毛。肺既受伤。则脏真
之气。不足以充
皮毛。故恶风而振寒也。张氏医通云。唾出若涕者。痰饮上溢之征也。简按古无痰字。此云唾出如涕。谓吐粘痰也。
以救俯仰 吴云。肺下有风热。 胀。俯与仰皆不利。故必救其俯仰。
巨阳引精者 吴云。巨阳与少阴肾为表里。肾者精之府。精。阴体也。不能自行。必巨阳之气引之。
乃能施泄。故曰。巨阳引精。是为少壮人也。水足以济火。故三日可愈。中年者。精虽未竭。比之少壮则弱矣。
故五日可愈。老年之人。天癸竭矣。故云不精。不精者。真阴衰败。不足以济火。故治之七日始愈。张云。风
邪之病肺者。必由足太阳膀胱经风门肺俞等穴。内入于脏。太阳者。水之府。三阳之表也。故当引精上行。则
风从咳散。若巨阳气盛。引精速者。应在三日。中年精衰者。应在五日。衰年不精者。应在七日。张氏医通。
引下句云。治此证者。当急使巨阳之上引。恐非。
咳出青黄涕 千金。涕上。有浓字。张云。当咳出青黄痰涕而愈。如下文者。即引精之谓。张璐云。
大如弹丸者。乃久已支塞肺窍之结痰。见邪蓄之盛也。
若鼻中出 千金。出下。有为善二字。王注蓄门。即喉屋上通鼻之窍门也。出灵营气篇。新校正失考。
不出则伤肺 张云。咳涕不出。即今人所谓干咳嗽也。甚至金水枯竭。虚劳之候。故死。
肾风 奇病论云。帝曰。有病 然如有水状。切其脉大紧。身无痛者。形不瘦。不能食。食少。名
为何病。岐伯曰。病生在肾。名为肾风。简按当与奇病论及风论参考。
面 然 甲乙。然下。有肿字。吴云。 。肿也。张云。 。浮肿也。 然。失色貌。志高并云。
肿貌。简按山海经。竹山有草焉。其名曰黄 。浴之已疥。又可以已 。
郭璞注云。 。肿也。可以证吴张之言矣。马及志则云。 者。足面也。盖以其与趺通也。而水热穴论云。上
下溢于皮肤。故为 肿。则岂足趺之义乎。高则云。皮里内外曰 。此因误读水热穴论。行于皮肤。传为 肿
之文。俱不可从。王注奇病论则云。 然。谓面目浮起。而色杂也。与此注少异。又注风论面 然浮肿。乃与
本篇同。广韵。 。莫江切。病困。并与此不相涉。因疑 即庞。庞。又作 。奇病论 然。马本作庞。而考
说文。 。石大貌。一曰。浓也。玉篇。大也。知是 然即 然。为肿大貌。其从 者。乃HT HT 之类。
张注非也。
壅害于言 吴云。面 然壅者。肾风并于上。而令壅塞也。故害于言。张云。壅。重浊不清也。
病风则肾脉不利。故壅害于言语。简按王吴以壅字接上句。张则属下句。志高并仍此。今从张义。
可刺不 马云。不。否同。
时热从胸背上至头汗出手热口干苦渴 马本。汗出。手热。各二字句。口干苦渴。四字句。张本。
汗出手热。口干苦渴。各四字句。高同。志。汗出以下。各二字一句。吴本与原本同。简按张本似是。苦渴。
盖谓口苦而渴。下文云。口苦舌干。
不能正偃 吴云。偃。仰卧也。
风水 张云。肾主水。风在肾经。即名风水。志云。病名风水者。因风而动其水也。高云。此肾风
之病。肾受风邪。风行水涣。故病名曰风水。马云。风水之证。又见水热穴论。奇病论。论疾诊尺篇。简按本
篇所谓风水者。乃因肾风误刺。而变之称。犹伤寒论。温病发汗身灼热者。名风温。与水热穴论等所论稍异。
（水热穴论云。肾汗出。逢于风。传为 肿。本之肾。名曰风水。
金匮要略云。风水。其脉自浮。外证骨节疼疼。恶风。又云。寸口脉沉滑者。中有水气。面目肿大有热。名曰风水。）
论在刺法中 张云。水热穴论也。志高同。
邪之所凑 说文。凑。水上人所会也。玉篇。竞进也。
上迫肺也 病能篇云。人之不得偃卧者。何也。岐伯曰。肺者。脏之盖也。肺气盛则脉大。脉大则
不得偃卧也。
卧则惊 志云。胃络上通于心。阳气入阴。阴阳相薄。故惊恐也。高云。水气凌心也。
病本于胃 张云。脾胃属土。所以制水。土弱则寒水反侮之。故腹中鸣。而食不下也。
身重难以行 张云。胃主肌肉。其脉行于足。水气居于肉中。故身重不能行。
胞脉闭也 张云。胞。即子宫。马云。愚观月事不来。似为妇人而论。然男子之肾风。诸证俱同。惟
此一证。则有异耳。
Ma Yun states: The first two sections discuss heat diseases, hence the chapter title. The latter two sections discuss labor wind (Laofeng) and kidney wind (Shenfeng).
Yin-Yang Intersection (Yin Yang Jiao): Hua Shou explains that "intersection" means interlacing. Zhang Jingyue states that when yang pathogenic factors intersect into the yin aspect, the yin qi cannot maintain its position, thus it is called Yin-Yang Intersection. Wang Ang cites the *Da Lun of Five Movements and Six Transformations*, stating: "Death occurs if the cun and chi pulses are reversed; death occurs in Yin-Yang Intersection." This refers to pulse diagnosis. I verify this with the *Biographies of Cang Gong*, which states: "Heat disease with Yin-Yang Intersection results in death," which confirms this meaning.
Without Assistance (Wu Bi): Wang Ji argues that grain qi transforms into essence. Now, since one cannot eat, there is no essence to be assisted or nourished. Gao Shishi explains that "bi" means to assist or nourish. I verify that the character "bi" is defined in the *Erya · Shi Gu* as "to make" or "to cause," and in the *Shuowen Jiezi* as "benefit." Wang Bing relies on the *Erya*, while Wang Ji and Gao Shishi rely on the *Shuowen*; both interpretations are valid.
Disease Lingers (Bing Er Liu Zhe): I verify that the *Xin Zheng* commentary cites the *Jia Yi Jing*, writing "and heat lingers." I follow this reading.
Pulse Remains Restless and Exuberant (Mai Shang Zao Sheng): Ma Yun cites the *Ling Shu · Heat Disease Chapter*: "In heat disease, if sweat has been produced but the pulse remains restless and rapid with panting, and fever recurs, do not puncture the skin. If panting is severe, death ensues." It also states: "In heat disease, if sweat has been produced but the pulse remains restless and exuberant, this is the extreme of yin pulses. Death ensues."
Three Deaths (San Si): Ma Yun states: 1. Fever recurs immediately after sweating, accompanied by inability to eat; 2. Pulse remains restless and exuberant after sweating; 3. Delirious speech and loss of mental clarity occur after sweating. I verify that Wang Bing considers "inability to overcome the disease" as the second death. Examining the preceding text, this refers to the syndrome where the pulse remains restless and exuberant after sweating. Therefore, I follow Ma Yun's interpretation. Zhang Zhicong states: 1. Disease lingers without resolving; 2. Stomach qi is exhausted; 3. Kidney qi is exhausted. Since stomach qi exhaustion and kidney qi exhaustion are not mentioned in the preceding text, this annotation is incorrect.
Wind Jue (Feng Jue): Zhang Jingyue notes that the meaning of Wind Jue varies. In this chapter, it refers to Taiyang and Shaoyin diseases. In the *Treatise on Differentiating Yin and Yang*, it says: "Disease onset involving Two Yang and One Yin is named Wind Jue," referring to the Stomach and Liver. In the *Five Changes Chapter*, it says: "Those prone to Wind Jue with profuse sweating have weak flesh and loose interstices." Gao Shishi explains: Following the discussion on death from recurrent fever after sweating, he raises the question of a disease presenting with sweating, irritability, and chest fullness. Wind is a yang pathogen, characterized by opening and dispersing. Any case of sweating with body heat is due to wind. Sweat is yin fluid, exiting outward to the yang aspect. Now, sweating accompanied by persistent heart vexation and chest fullness indicates exhaustion of yin and deficiency of yang, failing to interact and support each other; this is Jue. Thus, wind causes sweating, and sweating leads to Jue; the disease is named Wind Jue. I verify with the *Biographies of Cang Gong*: "Wind Jue with chest fullness... yang qi exhausts and yin qi enters. When yin qi enters and expands, cold qi ascends and hot qi descends, causing chest fullness and sweating." This differs slightly from the current text.
Taiyang Governs Qi (Ju Yang Zhu Qi): Zhang Zhicong states: Ju Yang is Taiyang. Taiyang qi governs the exterior. Wind is a yang pathogen that damages human yang qi. The interaction of two yangs results in heat disease. Shaoyin and Taiyang are interior-exterior pairs. When yang heat is above, yin qi follows it upward. Following upward leads to Jue Ni (reversal).
Taking Decoction (Fu Tang): Zhang Jingyue states this aligns with the *Mai Du Chapter*: "For deficiency, drink medicine to tonify." I verify that ancient texts referred to medicinal decoctions simply as "tang." The *Biography of Hua Tuo* mentions "administering tang to purge," resulting in the expulsion of a male fetus. Zhang Zhicong suggests it refers to plain boiled water to aid fluid secretion for sweating; this is an error.
Labor Wind (Laofeng): Zhang Jingyue defines it as wind contracted due to labor/fatigue. Wang Shi defines "labor" as kidney fatigue. While plausible, "labor" covers many conditions, likely not limited to the kidney meridian. Ma Yun suggests the text refers to general labor syndromes in medical classics. I verify that this describes a condition of acute fatigue followed by wind contraction. There are no records of labor syndromes curing via expectoration of green-yellow nasal discharge. Thus, Ma's note is unreliable. (*Zhu Bing Yuan Hou Lun · Wind-Heat Syndrome* states: Weak pores allow wind-heat to damage skin and hair first, then enter the lungs. Symptoms include aversion to wind/cold, trembling, eyes feeling like they will pop out, and discharge of mucus/saliva. If not improving within 3-5 days... after 7-8 days, small green-yellow purulent sputum resembling a pill emerges from mouth/nose, which is favorable. If not expelled, it damages the lungs, leading to coughing up pus and blood. This is the Laofeng discussed here. See *Medical Mirror* for detailed discussion under Cough.) Ye Wenling's *Medical Principles* states Laofeng belongs to the category of Spasm disorders. "Qiang Shang" resembles opisthotonos. "Ming Shi" means open eyes but unable to see. Treatment should align with Spasm disorders. Wang Haogu's *Medical Fortress Original Records* incorrectly identifies this as Lung萎 (Fei Wei). Prescriptions are in *Sheng Ji Zong Lu*, Vol. 13.
Method Located Below the Lung (Fa Zai Fei Xia): Wu Kun states the pathogen affects the area below the lung, specifically between the 4th, 5th, and 6th thoracic vertebrae. Zhang Jingyue agrees.
Stiff Neck and Dim Vision (Qiang Shang Ming Shi): I verify the *Mai Jie Chapter*: "Stiff neck pulling to the back is due to excessive rising of yang qi competing." Wang Bing annotates "Qiang Shang" as stiffness of the head and neck, consistent with this note. Ma Yun and Zhang Zhicong follow this. Wu Kun and Zhang Jingyue follow Yang Shangshan, which is likely incorrect. The *Qian Jin Fang* reads "tense neck and dizzy eyes," suggesting "Ming Shi" equates to dizziness/vertigo.
Expectorating Like Mucus (Tuo Chu Ru Ti): Wu Kun states lung fluids become thick and sticky due to wind-heat steaming, so expectoration resembles nasal mucus. The lung governs skin and hair; once damaged, true organ qi fails to nourish the exterior, causing aversion to wind and chills. *Medical Mirror* states expectorating like mucus is a sign of phlegm-fluid overflowing upward. I verify that the character for "phlegm" (tan) did not exist in ancient times; "expectorating like mucus" refers to vomiting sticky phlegm.
To Rescue Flexion and Extension (Yi Jiu Fu Yang): Wu Kun states wind-heat below the lung causes distension, making flexion and extension difficult; thus, treatment must rescue these movements.
Taiyang Guides Essence (Ju Yang Yin Jing): Wu Kun states Taiyang and Kidney are interior-exterior pairs. The Kidney is the residence of essence. Essence is yin substance and cannot move on its own; it requires Taiyang qi to guide it for excretion. Hence, "Taiyang guides essence." This applies to young and vigorous individuals whose water (kidney yin) can control fire, allowing recovery in three days. Middle-aged individuals have weaker essence than the young, recovering in five days. Elderly individuals have exhausted Tian Gui (essence), described as "not having essence." Lack of essence means true yin decline, insufficient to control fire, requiring seven days for recovery. Zhang Jingyue adds that wind pathogens attacking the lung enter via Bladder Meridian points Fengmen and Feishu. Taiyang is the reservoir of water and the exterior of Three Yang. Guiding essence upward helps disperse wind through cough. Recovery time depends on age/strength: 3 days for strong Taiyang, 5 days for middle-aged, 7 days for elderly. *Medical Mirror* suggests urgently guiding Taiyang upward, which is likely incorrect.
Expectoring Green-Yellow Nasal Discharge (Ke Chu Qing Huang Ti): *Qian Jin Fang* adds "thick" before "ti." Zhang Jingyue states recovery occurs upon expectorating green-yellow phlegm/mucus, as described below, which corresponds to guiding essence. Zhang Lu notes that pill-sized masses are accumulated phlegm blocking lung orifices, indicating intense pathogenic accumulation.
If Expelled from Nose (Ruo Bi Zhong Chu): *Qian Jin Fang* adds "is favorable" after "chu." Wang Bing's annotation on the accumulation gate refers to the opening connecting the throat to the nose, cited from *Ling Shu · Ying Qi Chapter*. The *Xin Zheng* commentary failed to verify this source.
If Not Expelled, Damages Lung (Bu Chu Ze Shang Fei): Zhang Jingyue states failure to expectorate mucus corresponds to modern dry cough. It may lead to depletion of Metal and Water, signs of consumptive disease, resulting in death.
Kidney Wind (Shen Feng): *Qi Bing Lun* states: The Emperor asks about a disease with edema resembling water retention, large tight pulse, no body pain, thin body, anorexia, and low food intake. Qibo replies: The disease originates in the Kidney and is named Kidney Wind. I verify this should be cross-referenced with *Qi Bing Lun* and *Feng Lun*.
Facial Swelling (Mian Pang Ran): *Jia Yi Jing* adds "swollen" after "Pang." Wu Kun defines Pang as swelling. Zhang Jingyue defines it as pitting edema. Pang ran describes a pale/discolored appearance. Zhang Zhigao defines it as swollen appearance. I verify *Shan Hai Jing*: A plant called Huang Guan grows on Bamboo Mountain; bathing with it cures scabies and edema. Guo Pu annotates "Cu" as swelling, supporting Wu and Zhang. Ma Yun and Zhang Zhicong argue Pang refers to the dorsum of the foot, linking it to "Fu." However, *Shui Re Xue Lun* says "overflowing to skin causes Fu swelling," questioning if it refers to the foot. Gao Shishi defines Fu as inside/outside skin, likely misreading *Shui Re Xue Lun*. Wang Bing annotates Pang ran in *Qi Bing Lun* as facial swelling with discoloration, differing slightly. His annotation in *Feng Lun* matches this chapter. *Guang Yun* defines Pang as "illness distress," unrelated here. Suspecting Pang is variant for Pang (large/swollen). *Qi Bing Lun* uses Pang. *Shuowen* defines Pang as large stone or thick. *Yupian* defines it as large. Thus Pang ran means large/swollen appearance. Characters with moon radical belong to "Fu" type. Zhang's note is incorrect.
Obstruction Harming Speech (Yong Hai Yu Yan): Wu Kun states facial swelling and obstruction result from Kidney Wind merging upward, causing blockage that harms speech. Zhang Jingyue defines Yong as heavy and turbid. Wind disease impairs Kidney pulses, causing obstruction harming speech. I verify Wang and Wu attach "Yong" to the previous sentence; Zhang attaches it to the next. Zhang Zhigao follows Zhang. I follow Zhang's interpretation.
Can Be Punctured? (Ke Ci Bu): Ma Yun states "Bu" is equivalent to "No" (Fou).
Intermittent Heat Rising from Chest/Back to Head, Sweating, Hot Hands, Dry Mouth, Bitter Taste, Thirst (Shi Re Cong Xiong Bei Shang Zhi Tou Han Chu Shou Re Kou Gan Ku Ke): Ma Ben separates "Han Chu" and "Shou Re" as two-character phrases, and "Kou Gan Ku Ke" as four characters. Zhang Ben groups "Han Chu Shou Re" and "Kou Gan Ku Ke" as four-character phrases. Gao Shishi agrees. Zhang Zhicong treats all as two-character phrases. Wu Ben matches original. I verify Zhang Ben is likely correct. "Ku Ke" implies bitter taste and thirst. The text later says "bitter mouth and dry tongue."
Unable to Lie Flat (Bu Neng Zheng Yan): Wu Kun states "Yan" means lying supine.
Wind Edema (Feng Shui): Zhang Jingyue states Kidney governs water; wind in Kidney meridian is named Wind Edema. Zhang Zhicong states the name arises because wind moves water. Gao Shishi states Kidney Wind involves wind pathogen affecting Kidney; wind moves water, hence the name. Ma Yun notes Wind Edema appears in *Shui Re Xue Lun*, *Qi Bing Lun*, and *Lun Ji Zhen Chi Pian*. I verify the Wind Edema in this chapter results from mistaken puncture of Kidney Wind, similar to how Warm Disease becoming burning hot after sweating is named Wind Warmth in *Shang Han Lun*. It differs slightly from *Shui Re Xue Lun* etc. (*Shui Re Xue Lun*: Kidney sweat meets wind, transmits to Fu swelling, originating in Kidney, named Wind Edema. *Jin Gui Yao Lue*: Wind Edema has floating pulse, external symptoms of joint pain, aversion to wind. Also: Cun-kou pulse deep and slippery indicates internal water qi, facial swelling with heat, named Wind Edema.)
Discussion in Acupuncture Methods (Lun Zai Ci Fa Zhong): Zhang Jingyue refers to *Shui Re Xue Lun*. Zhang Zhigao agrees.
Where Pathogen Assembles (Xie Zhi Suo Cou): *Shuowen* defines "Cou" as where people gather on water. *Yupian* defines it as advancing competitively.
Pressing Upward on the Lung (Shang Po Fei Ye): *Bing Neng Pian* asks why one cannot lie flat. Qibo answers: Lung is the canopy of organs. Lung qi excess makes pulses large; large pulses prevent lying flat.
Startled When Lying Down (Wo Ze Jing): Zhang Zhicong states Stomach collaterals connect to Heart. Yang qi entering Yin causes Yin-Yang conflict, leading to fear/startle. Gao Shishi states Water qi overwhelms Heart.
Disease Rooted in Stomach (Bing Ben Yu Wei): Zhang Jingyue states Spleen/Stomach belong to Earth, controlling Water. If Earth is weak, Cold Water insults it, causing abdominal borborygmus and inability to eat.
Heavy Body, Difficulty Walking (Shen Zhong Nan Yi Xing): Zhang Jingyue states Stomach governs muscles, its meridian runs on the legs. Water qi residing in flesh causes heaviness and inability to walk.
Closing of Uterine Collaterals (Bao Mai Bi Ye): Zhang Jingyue states Bao is the uterus. Ma Yun observes amenorrhea seems to discuss women. However, men with Kidney Wind share all symptoms except this one, which differs.