脏腑各有主气。各有经脉。各有部分。故其主病。亦各有见证之不同。有一脏为病。而不兼别脏之病者。单
治一脏而愈。有一脏为病。而兼别脏之病者。兼治别脏而愈。业医不知脏腑。则病原莫辨。用药无方。乌睹
其能治病哉。吾故将脏腑大旨。论列于后。庶几于病证药方。得其门径云。
心者。君主之官。神明出焉。盖心为火脏。烛照事物。故司神明。神有名而无物。即心中之火气也。然此气非
虚悬无着。切而指之。乃心中一点血液。湛然朗润。以含此气。故其气时有精光发见。即为神明。心之能事。
又主生血。而心窍中数点血液。则又血中之最精微者。乃生血之原泉。亦出神之渊海。血虚则神不安而
怔忡。有瘀血亦怔忡。火扰其血则懊 。神不清明。则虚烦不眠。动悸惊惕。水饮克火。心亦动悸。血攻心则
昏迷。痛欲死。痰入心则癫。火乱心则狂。与小肠相为表里。遗热于小肠。则小便赤涩。火不下交于肾。则神
浮梦遗。心之脉上挟咽喉。络于舌本。实火上壅为喉痹。虚火上升。则舌强不能言。分部于胸前。火结则为
结胸。为痞。为火痛。火不宣发则为胸痹。心之积曰伏梁。在心下大如臂。病则脐上有动气。此心经主病之
大旨也。
包络者。心之外卫。心为君主之官。包络即为臣。故心称君火。包络称相火。相心经宣布火化。凡心之能事。
皆包络为之。见证治法。亦如心脏。
肝为风木之脏。胆寄其间。胆为相火。木生火也。肝主藏血。血生于心。下行胞中。是为血海。凡周身之血。总
视血海为治乱。血海不扰。则周身之血。无不随之而安。肝经主其部分。故肝主藏血焉。至其所以能藏之
故。则以肝属木。木气冲和条达。不致遏郁。则血脉得畅。设木郁为火。则血不和。火发为怒。则血横决。吐血
错经血痛诸证作焉。怒太甚则狂。火太甚则颊肿面青。目赤头痛。木火克土。则口燥泄痢。饥不能食。回食
逆满。皆系木郁为火之见。证也。若木挟水邪上攻。又为子借母势。肆虐脾经。痰饮泄泻呕吐头痛之病又
作矣。木之性主于疏泄。食气入胃。全赖肝木之气以疏泄之。而水谷乃化。设肝之清阳不升。则不能疏泄
水谷。渗泻中满之证。在所不免。肝之清阳。即魂气也。故又主藏魂。血不养肝。火扰其魂。则梦遗不寐。肝又
主筋。螈 囊缩。皆属肝病。分部于季胁少腹之间。凡季胁少腹疝痛。皆责于肝。其经名为厥阴。谓阴之尽
也。阴极则变阳。故病至此。厥深热亦深。厥微热亦微。血分不和。尤多寒热并见。与少阳相表里。故肝病及
胆。亦能吐酸呕苦。耳聋目眩。于位居左。多病左胁痛。又左胁有动气。肝之主病。大略如此。
胆与肝连。司相火。胆汁味苦。即火味也。相火之宣布在三焦。而寄居则在胆腑。胆火不旺。则虚怯惊悸。胆
火太亢。则口苦呕逆。目眩耳聋。其经绕耳故也。界居身侧。风火交煽。则身不可转侧。手足抽掣。以表里言。
则少阳之气。内行三焦。外行腠理。为荣卫之枢机。逆其枢机。则呕吐胸满。邪客腠理。入与阴争。则热。出与
阳争。则寒。故疟疾少阳主之。虚劳骨蒸。亦属少阳。以荣卫腠理之间不和。而相火炽甚故也。相火挟痰。则
为癫痫。相火不戢。则肝魂亦不宁。故烦梦遗精。且胆中相火。如不亢烈。则为清阳之木气。上升于胃。胃土
得其疏达。故水谷化。亢烈则清阳遏郁。脾胃不和。胸胁之间骨尽处。乃少阳之分。病则其分多痛。经行身
之侧。痛则不利屈伸。此胆经主病之大略也。
胃者。仓廪之官。主纳水谷。胃火不足。则不思食。食入不化。良久仍然吐出。水停胸膈。寒客胃中。皆能呕吐
不止。胃火炎上。则饥不能食。拒隔不纳。食入即吐。津液枯竭。则成隔食。粪如羊屎。火甚则结硬。胃家实则
谵语。手足出汗。肌肉潮热。以四肢肌肉。皆中宫所主故也。其经行身之前。至面上。表证目痛鼻干。发痉不
能仰。开窍于口。口干咽痛。气逆则哕。又与脾相表里。遗热于脾。则从湿化。发为黄瘅。胃实脾虚。则能食而
不消化。主燥气。故病阳明。总系燥热。独水泛水结。有心下如盘等证。乃为寒病。胃之大略。其病如此。
脾称湿土。土湿则滋生万物。脾润则长养脏腑。胃土以燥纳物。脾土以湿化气。脾气不布。则胃燥而不能
食。食少而不能化。譬如釜中无水。不能熟物也。故病隔食。大便难。口燥唇焦。不能生血。血虚火旺。发热盗
汗。若湿气太甚。则谷亦不化。痰饮泄泻肿胀腹痛之证作焉。湿气挟热。则发黄发痢。腹痛壮热。手足不仁。
小水赤涩。脾积名曰痞气。在心下如盘。脾病则当脐有动气。居于中州。主灌四旁。外合肌肉。邪在肌肉。则
手足蒸热汗出。或肌肉不仁。其体阴而其用阳。不得命门之火以生土。则土寒而不化。食少虚羸。土虚而
不运。不能升达津液。以奉心化血。渗灌诸经。经云。脾统血。血之营运上下。全赖乎脾。脾阳虚则不能统血。
脾阴虚又不能滋生血脉。血虚津少。则肺不得润养。是为土不生金。盖土之生金。全在津液以滋之。脾土
之义有如是者。
肺为干金。象天之体。又名华盖。五脏六腑。受其覆冒。凡五脏六腑之气。皆能上熏于肺以为病。故于寸口
肺脉。可以诊知五脏。肺之令主行制节。以其居高。清肃下行。天道下际而光明。故五脏六腑。皆润利而气
不亢。莫不受其制节也。肺中常有津液。润养其金。故金清火伏。若津液伤。则口渴气喘。痈痿咳嗽。水源不
清。而小便涩。遗热大肠。而大便难。金不制木。则肝火旺。火盛刑金。则蒸热喘咳。吐血痨瘵并作。皮毛者。肺
之合也。故凡肤表受邪。皆属于肺。风寒袭之。则皮毛洒淅。客于肺中。则为肺胀。为水饮冲肺。以其为娇脏。
故畏火。亦畏寒。肺开窍于鼻。主呼吸。为气之总司。盖气根于肾。乃先天水中之阳。上出鼻。肺司其出纳。肾
为水。肺为天。金水相生。天水循环。肾为生水之原。肺即为制气之主也。凡气喘咳息。故皆主于肺。位在胸
中。胸中痛属于肺。主右胁。积曰息贲。病则右胁有动气。肺为之义。大率如是。
肾者水脏。水中含阳。化生元气。根结丹田。内主呼吸。达于膀胱。营运于外则为卫气。此气乃水中之阳。别
名之曰命火。肾水充足。则火之藏于水中者。韬光匿彩。龙雷不升。是以气足而鼻息细微。若水虚。则火不
归元。喘促虚痨。诸证并作。咽痛声哑。心肾不交。遗精失血。肿满咳逆。痰喘盗汗。如阳气不足者。则水泛为
痰。凌心冲肺。发为水肿。腹痛奔豚。下利厥冷。亡阳大汗。元气暴脱。肾又为先天。主藏精气。女子主天癸。男
子主精。水足则精血多。水虚则精血竭。于体主骨。骨痿故属于肾。肾病者。脐下有动气。肾上交于心。则水
火既济。不交则火愈亢。位在腰。主腰痛。开窍于耳。故虚则耳鸣耳聋。瞳人属肾。虚则神水散缩。或发内障。
虚阳上泛。为咽痛颊赤。阴虚不能化水。则小便不利。阳虚不能化水。小便亦不利也。肾之病机。有如此者。
膀胱者。贮小便之器。经谓州都之官。津液藏焉。气化则能出矣。此指汗出。非指小便。小便虽出于膀胱。而
实则肺为水之上源。上源清。则下源自清。脾为水之堤防。堤防利。则水道利。肾又为水之主。肾气行。则水
行也。经所谓气化则能出者。谓膀胱之气。载津液上行外达。出而为汗。则有云行雨施之象。故膀胱称为
太阳经。谓水中之阳。达于外以为卫气。乃阳之最大者也。外感则伤其卫阳。发热恶寒。其经行身之背。上
头项。故头项痛。背痛。角弓反张。皆是太阳经病。皮毛与肺合。肺又为水源。故发汗须治肺。利水亦须治肺。
水天一气之义也。位居下部。与胞相连。故血结亦病水。水结亦病血。膀胱之为病。其略有如此。
三焦。古作 。即人身上下内外相联之油膜也。唐宋人不知 形。以为有名而无象。不知内经明言焦理
纵者。焦理横者。焦有文理。岂得谓其无象。西洋医书。斥中国不知人有连网。言人饮水入胃。即渗出走连
网而下。以渗至膀胱。膀胱上口。即在连网中也。中国医林改错一书。亦言水走网油而入膀胱。观剖牲畜。
其网油中有水铃铛。正是水过其处。而未入膀胱者也。此说近出。力斥旧说之谬。而不知唐宋后。古 作
焦。不知膜油即是三焦。是以致谬。然内经明言三焦者。决渎之官。水道出焉。与西洋医法。医林改错正合。
古之圣人。何尝不知连网膜膈也哉。按两肾中一条油膜。为命门。即是三焦之原。上连肝气胆气。及胸膈。
而上入心。为包络。下连小肠大肠。前连膀胱。下焦夹室。即血室气海也。循腔子为肉皮。透肉出外。为包裹
周身之白膜。皆是三焦所司。白膜为腠理。三焦气行腠理。故有寒热之证。命门相火布于三焦。火化而上
行为气。火衰则元气虚。火逆则元气损。水化而下行为溺。水溢则肿。结则淋。连肝胆之气。故多挟木火。与
肾心包相通。故原委多在两处。与膀胱一阴一阳。皆属肾之府也。其主病知矣。
小肠者。受盛之官。变化出焉。上接胃腑。下接大肠。与心为表里。遗热则小水不清。与脾相连属。土虚则水
谷不化。其部分。上与胃接。故小肠燥屎。多借胃药治之。下与肝相近。故小肠气痛。多借肝药治之。
大肠司燥金。喜润而恶燥。寒则滑脱。热则秘结。泄痢后重。痔漏下血。与肺相表里。故病多治肺以治之。与
胃同是阳明之经。故又借多治胃之法以治之。
以上条列。皆脏腑之性情部位。各有不同。而主病亦异。治杂病者宜知之。治血证者。亦宜知之。临证处方。
分经用药。斯不致南辕北辙耳。
Each Zang and Fu organ has its dominant Qi, its own meridian, and its specific anatomical region. Therefore, the diseases they suffer from also present with different manifestations. Some diseases occur in a single organ without involving others; treating only that organ can lead to recovery. Some diseases originate in one organ but involve others; treating the involved organs simultaneously is necessary for recovery. If a physician does not understand the Zang and Fu organs, the cause of the disease cannot be distinguished, and prescription lacks direction. How could such a physician treat diseases? Thus, I will discuss the general principles of the Zang and Fu organs below, hoping to provide a pathway for understanding diseases and prescriptions.
The Heart is the Official of the Sovereign, from which Shen (Spirit/Mind) emerges. As the Fire organ, it illuminates things and thus governs Shen. Shen exists as a name without physical substance; it is the Fire Qi within the Heart. However, this Qi is not suspended in emptiness. Upon palpation, it corresponds to a point of Blood in the Heart, clear and lustrous, containing this Qi. When this Qi occasionally manifests with brilliant light, it is called Shen. The Heart's function also includes generating Blood. The few drops of Blood in the Heart orifice are the most refined part of Blood, serving as the source of Blood generation and the abyss from which Shen arises. Blood deficiency leads to an unsettled Shen, manifesting as Zhengchong (palpitations). Blood stasis also causes palpitations. Fire disturbing Blood causes Aonao (restlessness and discomfort). If Shen is unclear, it results in empty irritability, insomnia, palpitations, and fright. Water-Fluids suppressing Heart Fire also cause palpitations. Blood attacking the Heart leads to coma and severe pain. Phlegm entering the Heart causes Dian (epilepsy/madness). Fire disrupting the Heart causes Kuang (mania). The Heart and Small Intestine are exterior-interior partners. Heat lingering in the Small Intestine causes red and scanty urination. If Fire fails to descend to communicate with the Kidney, Shen floats, leading to nocturnal emission. The Heart meridian ascends to flank the throat and connects to the root of the tongue. Excess Fire congesting upward causes Houbi (sore throat with obstruction). Deficient Fire rising causes a stiff tongue and inability to speak. Located in the chest, Fire condensation forms Jie Xiong (chest binding), Pi (fullness), and Huo Tong (fire pain). Failure of Fire to disperse causes Xiong Bi (chest bi-syndrome). The accumulation in the Heart is called Fu Liang (hidden beam), large as an arm below the heart; upon illness, there is pulsation above the umbilicus. This is the general principle of Heart meridian diseases.
The Pericardium (Bao Luo) is the external guard of the Heart. Since the Heart is the Sovereign, the Pericardium is the Minister. Thus, the Heart is called Jun Huo (Ministerial Fire), and the Pericardium is called Xiang Huo (Ministerial Fire). The Pericardium assists the Heart meridian in disseminating Fire transformation. All functions of the Heart are performed by the Pericardium. Its manifestations and treatment methods are similar to those of the Heart.
The Liver is the Wind-Wood organ, with the Gallbladder residing within it. The Gallbladder is Xiang Huo, as Wood generates Fire. The Liver stores Blood. Blood is generated by the Heart, descends to the Bao Zhong (uterus/blood sea), and is called Xue Hai (Blood Sea). All blood in the body depends on the stability of the Blood Sea for order or chaos. If the Blood Sea is undisturbed, all blood in the body remains peaceful. The Liver meridian governs its region, hence the Liver stores Blood. The reason it can store Blood is that the Liver belongs to Wood; Wood Qi is harmonious and free-flowing, preventing stagnation, allowing blood vessels to flow smoothly. If Wood stagnates and transforms into Fire, Blood becomes discordant. Anger arising from Fire causes Blood to rupture violently, leading to hematemesis, irregular menstruation, and blood pain. Extreme anger causes mania; extreme Fire causes swollen cheeks, blue face, red eyes, and headache. Wood-Fire overacting on Earth causes dry mouth, diarrhea/dysentery, hunger without appetite, and regurgitation with fullness, all signs of Wood stagnating into Fire. If Wood carries Water Evil upward, borrowing the Mother's power to harass the Spleen meridian, phlegm-fluids, diarrhea, vomiting, and headache arise. Wood's nature is primarily dispersing and draining. Food entering the stomach relies entirely on Liver Wood Qi to disperse it for digestion. If Liver Clear Yang fails to ascend, it cannot disperse food and fluids, inevitably leading to leakage and abdominal fullness. The Liver's Clear Yang is Hun Qi (Ethereal Soul), so it also stores Hun. Blood failing to nourish the Liver and Fire disturbing Hun leads to nocturnal emission and insomnia. The Liver also governs tendons; convulsions and testicular retraction belong to Liver diseases. Located between the hypochondrium and lower abdomen, hernia pain in these areas is attributed to the Liver. Its meridian is named Jue Yin (Terminal Yin), meaning the end of Yin. When Yin reaches its limit, it transforms into Yang; thus, at this stage, deep cold implies deep heat, and mild cold implies mild heat. Disharmony in the Blood level often presents with simultaneous cold and heat. It is exterior-interior with Shaoyang (Lesser Yang); Liver disease affecting the Gallbladder can cause sour regurgitation, bitter vomiting, deafness, and vertigo. Located on the left, it often causes left hypochondriac pain and pulsation. These are the general characteristics of Liver diseases.
The Gallbladder connects with the Liver and governs Xiang Huo. Bile is bitter, the taste of Fire. Xiang Huo is disseminated in the San Jiao (Triple Burner) but resides in the Gallbladder Fu. If Gallbladder Fire is insufficient, there is timidity and palpitations. If Gallbladder Fire is excessive, there is bitter taste, regurgitation, vertigo, and deafness due to the meridian encircling the ear. Situated on the side of the body, wind and fire fanning each other cause inability to turn the body and limb spasms. From the perspective of exterior-interior, Shaoyang Qi moves internally through the San Jiao and externally through the Cou Li (interstices), serving as the pivot of Ying and Wei (Nutritive and Defensive) Qi. Reversing this pivot causes vomiting and chest fullness. Pathogens lodging in the Cou Li, struggling with Yin internally, cause fever; struggling with Yang externally, cause chills. Thus, malaria is governed by Shaoyang. Consumption with bone-steaming fever also belongs to Shaoyang, due to disharmony between Ying/Wei and Cou Li with intense Xiang Huo. Xiang Huo carrying Phlegm causes epilepsy. Unchecked Xiang Huo disturbs Hun, causing irritability, dreams, and seminal emission. If Xiang Huo in the Gallbladder is not excessive, it acts as Clear Yang Wood Qi ascending to the Stomach, aiding Stomach Earth in digestion. If excessive, Clear Yang is stifled, leading to Spleen-Stomach disharmony. The bony ends of the hypochondrium are the domain of Shaoyang; illness here causes pain. The meridian runs along the side of the body; pain restricts flexion and extension. This is the general outline of Gallbladder meridian diseases.
The Stomach is the Official of Granaries, governing the reception of food and fluids. Insufficient Stomach Fire leads to lack of appetite, indigestion, and eventual vomiting. Fluid retention in the chest/diaphragm and Cold invading the Stomach both cause persistent vomiting. Stomach Fire flaming upward causes hunger without ability to eat, rejection of intake, and immediate vomiting after eating. Depletion of Jin Ye (Body Fluids) leads to Ge Shi (dysphagia/choking), with stool like sheep dung. Excessive Fire causes hardening. Fullness in the Stomach leads to delirium, sweating on hands and feet, and tidal fever of muscles, as limbs and muscles are governed by the Central Palace (Spleen/Stomach). The meridian runs anteriorly to the face; exterior syndromes present with eye pain, nasal dryness, spasm preventing backward bending. It opens into the mouth; dry mouth and sore throat occur. Rebellious Qi causes hiccup. It is exterior-interior with the Spleen. Heat lingering in the Spleen transforms into Dampness, causing Jaundice. Stomach excess with Spleen deficiency allows eating but prevents digestion. It governs Dry Qi, so diseases belong to Yangming, generally characterized by Dry-Heat. Only water flooding or binding, presenting with subcardiac mass like a plate, indicates Cold. These are the general diseases of the Stomach.
The Spleen is Wet Earth; wet Earth nurtures all things. Moist Spleen nourishes the Zang and Fu organs. Stomach Earth uses Dryness to receive substances; Spleen Earth uses Dampness to transform Qi. If Spleen Qi does not distribute, Stomach becomes dry, unable to eat or digest. Like a pot without water, food cannot cook. Thus, diseases include dysphagia, difficult defecation, dry mouth, and cracked lips. Inability to generate Blood leads to Blood deficiency with hyperactive Fire, fever, and night sweats. If Dampness is excessive, grains do not digest, leading to phlegm-fluids, diarrhea, swelling, and abdominal pain. Dampness carrying Heat causes jaundice and dysentery, with abdominal pain, high fever, numbness of limbs, and red/scanty urine. The Spleen accumulation is named Pi Qi (Stagnant Qi), resembling a plate below the heart. Spleen disease presents with pulsation at the umbilicus. Located in the Central Region, it irrigates the four peripheries and connects externally to muscles. Pathogens in muscles cause steaming heat and sweating in limbs, or muscle numbness. Its substance is Yin, its function is Yang. Without Ming Men Fire to warm Earth, Earth becomes cold and unable to transform, leading to poor appetite and emaciation. If Earth is deficient and unmovable, it cannot ascend Jin Ye to nourish the Heart for Blood generation and irrigate the meridians. The Classic states: "The Spleen controls Blood"; the circulation of Blood up and down relies entirely on the Spleen. Spleen Yang deficiency fails to control Blood; Spleen Yin deficiency fails to generate Blood vessels. Blood and Jin Ye deficiency means the Lung is not moistened, termed "Earth failing to generate Metal." Earth generates Metal solely through Jin Ye nourishment. Such is the significance of Spleen Earth.
The Lung is Dry Metal, resembling the Heaven, also called Hua Gai (Floral Canopy). The five Zang and six Fu organs are covered by it. Qi from all Zang and Fu can ascend to the Lung to cause disease. Thus, observing the Lung pulse at Cun Kou allows diagnosis of the five Zang. The Lung's authority exercises regulation and restraint. Being high, it clears and descends; as heavenly Dao descends to illuminate, all Zang and Fu remain moist and smooth without rebellious Qi, all subject to its regulation. The Lung constantly contains Jin Ye to moisten Metal, keeping Fire subdued. If Jin Ye is injured, there is thirst, asthma, abscesses, wasting-thirst, and cough. If the water source is unclear, urination is scanty. Heat lingering in the Large Intestine causes difficult defecation. Metal failing to control Wood leads to hyperactive Liver Fire. Excessive Fire punishing Metal causes steaming heat, asthma, cough, hemoptysis, and consumption. Skin and hair are the exterior correspondence of the Lung. Thus, pathogens attacking the surface belong to the Lung. Wind-Cold attacking causes chills; lodging in the Lung causes Lung distension and fluid rushing to the Lung. As a delicate organ, it fears Fire and Cold. The Lung opens into the nose, governs respiration, and is the master of Qi. Qi roots in the Kidney, which is the Yang within congenital Water, emerging via the nose. The Lung controls its entry and exit. Kidney is Water, Lung is Heaven; Metal and Water generate each other, heaven and water circulate. The Kidney is the source of Water generation; the Lung is the master of Qi regulation. All asthma, cough, and panting are governed by the Lung. Located in the chest, chest pain belongs to the Lung. It governs the right hypochondrium; accumulation is named Xi Ben (Panting Accumulation), presenting with pulsation in the right hypochondrium. Such is the general principle of Lung diseases.
The Kidney is the Water organ, containing Yang within Water, transforming Yuan Qi (Original Qi), rooted in the Dan Tian. Internally, it governs respiration, reaching the Bladder; externally, it circulates as Wei Qi. This Qi is Yang within Water, alternatively called Ming Huo (Gate of Life Fire). When Kidney Water is sufficient, the Fire hidden in Water hides its brilliance, Dragon and Thunder do not rise, resulting in ample Qi and subtle breathing. If Water is deficient, Fire fails to return to its origin, causing rapid breathing, consumption, and various syndromes. Sore throat, hoarseness, Heart-Kidney non-interaction, seminal emission, hemorrhage, edema, cough-reversal, phlegm-asthma, and night sweats occur. If Yang Qi is insufficient, Water floods forming Phlegm, harassing the Heart and Lung, causing edema, abdominal pain, Ben Tun (running piglet qi), diarrhea, cold extremities, Yang collapse with profuse sweating, and sudden depletion of Yuan Qi. The Kidney is congenital, storing Essence and Jing. In women, it governs Tian Gui (menstruation); in men, Jing (semen). Abundant Water means abundant Essence and Blood; deficient Water means exhausted Essence and Blood. It governs bones; bone萎 (atrophy/weakness) belongs to the Kidney. Kidney disease presents with pulsation below the umbilicus. When Kidney communicates upward with the Heart, Water and Fire are balanced; if not, Fire becomes hyperactive. Located in the waist, it governs waist pain. Opens into the ears; deficiency causes tinnitus and deafness. Pupils belong to the Kidney; deficiency causes dilation/constriction of Shen Shui (spiritual water) or internal cataracts. Floating Deficient Yang causes sore throat and red cheeks. Yin deficiency failing to transform Water causes difficult urination. Yang deficiency failing to transform Water also causes difficult urination. Such are the pathomechanisms of Kidney diseases.
The Bladder is the vessel storing urine. The Classic calls it the Official of the Prefecture, storing Jin Ye; Qi transformation allows it to exit. This refers to sweat excretion, not urine. Although urine exits from the Bladder, the Lung is actually the upper source of Water. If the upper source is clear, the lower source is clear. The Spleen is the dike of Water; if the dike is sound, waterways are smooth. The Kidney is the master of Water; if Kidney Qi moves, Water moves. What the Classic means by "Qi transformation allows exit" is that Bladder Qi carries Jin Ye upward and outward, exiting as sweat, resembling clouds moving and rain falling. Thus, the Bladder is called the Taiyang (Greater Yang) meridian, representing Yang within Water reaching the exterior as Wei Qi, the greatest of Yang. Exterior contraction injures Wei Yang, causing fever and aversion to cold. The meridian runs along the back, up to the head and neck; thus, head/neck pain, back pain, and opisthotonos are Taiyang meridian diseases. Skin/hair connect with the Lung, which is the water source; thus, inducing sweat requires treating the Lung, and promoting urination also requires treating the Lung, reflecting the unity of water and heaven. Located inferiorly, connected to the Bao (uterus/bladder area), blood stasis affects water, and water stasis affects blood. Such are the general diseases of the Bladder.
San Jiao (Triple Burner), anciently written as "Jiao," refers to the oily membranes connecting the upper, lower, interior, and exterior of the body. Tang and Song physicians did not know the form of "Jiao," believing it existed in name but not form. They ignored the Nei Jing stating longitudinal and transverse patterns of Jiao, proving it has texture and form. Western medical texts criticize Chinese medicine for not knowing the "reticulum," claiming water ingested enters the stomach, permeates out through the reticulum, and drains to the Bladder, whose opening is within the reticulum. The Chinese book *Yi Lin Gai Cuo* also states water travels through oily membranes into the Bladder. Observing dissected animals, water bells in the oily membranes indicate water passing through but not yet entering the Bladder. This recent theory refutes old errors, unaware that post-Tang/Song, ancient "Jiao" was written as "Jiao," and oily membranes are indeed the San Jiao, leading to confusion. However, the Nei Jing clearly states San Jiao is the Official of Ditches, where waterways emerge, aligning with Western medicine and *Yi Lin Gai Cuo*. Did ancient sages not know the reticulum and diaphragm? According to analysis, the oily membrane between the two Kidneys is Ming Men, the origin of San Jiao. It connects upward to Liver/Gallbladder Qi and chest/diaphragm, entering the Heart as Pericardium. Downward, it connects to Small/Large Intestines; anteriorly to the Bladder. The lower Jiao夾室 (clamped chamber) is the Blood Chamber and Qi Sea. Following the cavity as skin, penetrating flesh to become the white membrane wrapping the body, all are governed by San Jiao. The white membrane is Cou Li; San Jiao Qi moves through Cou Li, causing cold/heat syndromes. Ming Men Xiang Huo spreads through San Jiao; Fire transformation ascends as Qi. Fire decline depletes Yuan Qi; Fire rebellion damages Yuan Qi. Water transformation descends as urine. Water flooding causes edema; binding causes strangury. Connecting with Liver/Gallbladder Qi, it often carries Wood-Fire. Communicating with Kidney and Pericardium, its origins lie in these two locations. With the Bladder, one Yin and one Yang, both belong to the Kidney's residence. Its governing diseases are known.
The Small Intestine is the Official of Reception and Transformation, where changes occur. It connects superiorly to the Stomach and inferiorly to the Large Intestine, being exterior-interior with the Heart. Heat lingering causes turbid urine. Connected to the Spleen, Earth deficiency leads to undigested food/grains. Its region connects superiorly to the Stomach; thus, Small Intestine dry feces are often treated with Stomach herbs. Inferiorly near the Liver, Small Intestine Qi pain is often treated with Liver herbs.
The Large Intestine governs Dry Metal, preferring moisture and detesting dryness. Cold causes slipping/diarrhea; Heat causes constipation. Dysentery with tenesmus, hemorrhoids, and bleeding occur. Exterior-interior with the Lung, diseases are often treated by addressing the Lung. Sharing the Yangming meridian with the Stomach, treatments often borrow methods for the Stomach.
The above items list the natures and regions of Zang and Fu organs, which differ, leading to distinct governing diseases. Those treating miscellaneous diseases should know this. Those treating Blood Syndromes should also know this. In clinical prescription, prescribing according to meridians prevents going astray.