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When the Lung is invaded by Wind pathogen, there is dryness of the mouth and panting, dizziness with heaviness of the body, a sensation of being stunned (Mao) accompanied by swelling.
[Note] "Heaviness of the body with dizziness" should be "dizziness with heaviness of the body"; "Stunned due to Wind and swelling" should be "swelling due to Wind pathogen," which aligns with the textual meaning. This is evidently a transcription error.
[Annotation] The Lung governs Qi and corresponds externally to the skin and hair. When Wind pathogen invades the Lung, Wind damages Qi, causing Jin-Ye (Body Fluids) to coagulate and fail to circulate, resulting in dryness of the mouth; Wind damages the Lung, causing Qi to rebel upward, resulting in panting and coughing. Dizziness and heaviness of the body occur because Qi is damaged and strength is lacking. Swelling due to Wind occurs because the skin and flesh are injured, leading to a struggle between Wind and Water.
[Collected Notes] Li said: The Lung governs Qi. When Wind pathogen invades, Qi becomes obstructed and Jin-Ye fails to circulate, causing dryness of the mouth; Qi rebels and breathing is difficult, causing panting.

When Cold pathogen invades the Lung, turbid mucus is expectorated.
[Annotation] When Cold pathogen invades the Lung, the Yang Qi in the chest cannot be regulated, causing Jin-Ye to accumulate and fail to circulate, resulting in the expectoration of turbid saliva resembling mucus.
[Collected Notes] Li said: The five fluids transform into mucus when entering the Lung. The Lung corresponds to the skin and hair and opens into the nose. When Cold pathogen enters the Lung from the skin and hair, the nasal orifice becomes obstructed, causing nasal congestion and flow of mucus and saliva. Turbid saliva becomes blocked and cannot circulate, thus being expectorated from the mouth.

The pulse of a dying Lung is floating and empty on light pressure, weak and hollow like a scallion leaf on heavy pressure, with no root below. This indicates death.
[Annotation] When the Lung is invaded by Wind-Cold pathogen, if the pulse is extremely empty on light pressure and weak and hollow like a scallion leaf on heavy pressure, with no root below, this is the pulse of a dying Lung organ. The mention of "floating" for the following five Zang organs clarifies the pulse corresponding to external invading pathogens.
[Collected Notes] Cheng Lin said: The true Lung pulse arrives as if feathers touch the skin; is this not floating and empty? A scallion leaf is hollow inside; feeling weak like a scallion leaf on heavy pressure with no root below means the floating and fine weakness indicates the absence of Stomach Qi. Since the True Zang pulse has appeared, death ensues.

When the Liver is invaded by Wind pathogen, there is twitching of the head and eyes, pain in both hypochondria, a habitual stooping posture while walking, and a craving for sweet flavors.
[Annotation] The Liver governs Wind and corresponds externally to the sinews. When Wind pathogen invades the Liver, excessive Wind causes movement, resulting in twitching of the head and eyes. The hypochondria are the region of the Liver; disease of the Liver causes pain in both hypochondria. Wind damages the sinews, causing a habitual stooping posture. The Liver suffers from tension and desires Sweet flavor to relax it, hence the craving for sweets.
[Collected Notes] Xu Bin said: Above the high summit, only Wind can reach. The nature of Wind is shaking, causing twitching of the head and eyes. The Liver meridian passes through the diaphragm; now there is pathogen in the costal region, causing pain. The Liver governs the sinews; excessive Wind causes sinew tension, leading to stooping. Humans rely on the Spleen and Stomach as the foundation; when Wood pathogen is excessive and Earth suffers, Sweet flavor benefits the Spleen, and craving for sweets is a form of self-rescue.

When Cold pathogen invades the Liver, the arms cannot be raised, the root of the tongue is dry, there is frequent sighing, chest pain, inability to turn over, vomiting upon eating, and sweating.
[Note] The phrases "arms cannot be raised" and "root of the tongue is dry," along with "and sweating," do not fit the context logically and are likely misplaced text (Cuo Jian); therefore, they are not explained.
[Annotation] The Liver's nature is to be smooth and unobstructed, with Qi circulating in the chest and sides. When Cold pathogen invades the Liver, Qi is suppressed and cannot extend, leading to frequent sighing. Qi stagnation and failure to move cause pain preventing turning over. Vomiting upon eating is also due to Cold pathogen rebelling upward.

The pulse of a dying Liver is weak on light pressure, and on heavy pressure feels like a cord that does not return, or curved like a snake moving away. This indicates death.
[Annotation] When the Liver is invaded by Wind-Cold pathogen, if the pulse is extremely weak on light pressure and does not feel wiry on heavy pressure, it has lost its fundamental Liver pulse. Now, feeling like a cord that does not return on heavy pressure, or curving like a snake moving away—such cords curving and snakes moving, going without returning—are these not all pulses of a dying Liver organ?
[Collected Notes] Zhou Yangjun said: Feeling like a cord on heavy pressure shows both Wiry and Tight qualities. A pulse with arrival and departure follows the principle of Yin-Yang reciprocation. Now, saying "no arrival, only departure" indicates the absence of Stomach Qi. Otherwise, the True Qi is scattering, with forced entry and exit, showing a state of reluctance to advance and difficulty bending and extending, hence curving like a snake.

In Gan Zhuo (Liver Fixation), the patient often desires someone to tread on their chest. Initially, before suffering, they only desire hot drinks. Xuan Fu Hua Tang (Inula Flower Decoction) is indicated.
[Note] The six characters "Xuan Fu Hua Tang is indicated" do not match the pathology of Gan Zhuo and are likely superfluous text (Yan Wen).
[Annotation] Gan Zhuo refers to Liver Qi becoming fixed and failing to circulate, leading to chest fullness and discomfort. Thus, the patient often desires massage of the chest to unblock the Qi. When initially not suffering from fullness, desiring only hot drinks indicates that Cold pathogen is the disease.
[Collected Notes] Li said: The Liver governs free flow. Fixation leads to Qi depression and lack of extension. The patient often desires someone to tread on the chest to soothe the Qi. Additionally, because Cold pathogen is firmly bound within, they desire hot drinks to overcome the Cold.

When Wind pathogen invades the Heart, there is mild fever (Xi Xi Fa Re), inability to rise, a sensation of hunger in the heart/chest, and vomiting immediately after eating.
[Note] Mild fever is the primary symptom of Wind invasion. Inability to rise, hunger in the chest, and vomiting after eating do not fit the context logically and are likely misplaced text; therefore, they are not explained.

When Cold pathogen invades the Heart, the patient suffers as if eating garlic, with a pungent sensation piercing the heart. In severe cases, heart pain radiates to the back, and back pain radiates to the heart, resembling Gu Zhu (worm-like transmission). If the pulse is Floating, spontaneous vomiting will lead to recovery.
[Annotation] Suffering as if eating garlic refers to the pungent, piercing sensation of the heart. Severe heart pain radiating to the back and back pain radiating to the heart means the heart and back correspond in pain. Resembling Gu Zhu means the pain comes and goes incessantly like a worm. These are all symptoms of Cold pathogen in the Heart. If the pulse is Floating, it indicates the Heart has its fundamental pulse, representing an indication of Cold pathogen moving upward; thus, spontaneous vomiting expels the pathogen, leading to recovery.
[Collected Notes] Xu Bin said: Cold is a Yin pathogen. Externally constrained, Fire is internally depressed, hence the sensation like eating garlic, which is spicy but not painful. In severity, the pathogen is strong, attacking outward to cause back pain and inward to cause heart pain. "Che" (penetrating/radiating) means correspondence. Resembling Gu Zhu, it is continuous. If the pulse is Floating, the pathogen is not yet knotted, so spontaneous vomiting leads to recovery.

If the Heart organ is injured, upon fatigue and exhaustion, the head and face become red while the lower body feels heavy. There is heart pain, internal restlessness, fever, pulsation at the umbilicus, and the pulse is Wiry. This is caused by injury to the Heart organ.
[Note] The character "Wiry" (Xian) in "pulse is Wiry" should be "Deep" (Chen). Deep is the Kidney pulse, which fits the context. This is evidently a transcription error.
[Annotation] Injury to the Heart refers to patients with Heart organ disease. Fatigue and exhaustion disturb the Heart. Heart Yang is abundant above, causing redness of the head and face. Abundance above leads to deficiency below, causing heaviness and weakness in the lower body. Heart pain, internal restlessness, fever, and pulsation at the umbilicus with a Deep pulse indicate that the Kidney is overcoming the injured Heart.
[Collected Notes] You Yi said: In injury to the Heart, upon fatigue, the head and face become red while the lower body feels heavy. Generally, when the Heart is deficient, its Yang floats easily; when abundance is above, deficiency must be below. Heart pain and internal restlessness with fever indicate Heart deficiency failing to nourish, with Heat stirring within. Pulsation at the umbilicus indicates Heart deficiency above and Kidney activity below.

Abnormal crying causing insecurity of the Hun and Po is due to scarcity of Blood and Qi. Scarcity of Blood and Qi belongs to the Heart. When Heart Qi is deficient, the person fears, closes their eyes desiring sleep, dreams of traveling far, and their Spirit scatters while Hun and Po wander recklessly. Deficiency of Yin leads to Dian (catatonic schizophrenia); deficiency of Yang leads to Kuang (manic psychosis).
[Note] The character "Dian" in "Deficiency of Yin leads to Dian" should be "Kuang"; the character "Kuang" in "Deficiency of Yang leads to Kuang" should be "Dian." The Nei Jing states: Heavy Yin leads to Dian, Heavy Yang leads to Kuang. This is evidently a transcription error.
[Annotation] Abnormal crying refers to a person with Heart injury crying without cause. Abnormal crying causes insecurity of Hun and Po due to scarcity of Heart Blood and Qi. Scarcity of Blood and Qi leads to Heart deficiency, causing fear. Closing eyes desiring sleep and dreaming of traveling far indicates scattered Spirit and reckless wandering of Hun and Po. Heart Blood is Yin; excessive deficiency of Yin leads to excess Yang, resulting in Kuang (mania). Heart Qi is Yang; excessive deficiency of Yang leads to excess Yin, resulting in Dian (catatonia).

The pulse of a dying Heart is solid like pills or beans on light pressure, and becomes increasingly restless and rapid on heavy pressure. This indicates death.
[Annotation] When the Heart is invaded by Wind-Cold pathogen, if the pulse is extremely solid on light pressure, like pills or beans, and becomes increasingly vigorous, restless, rapid, and chaotic on heavy pressure, this is the pulse of a dying Heart organ.
[Collected Notes] Li said: The Nan Jing states the Heart pulse is Floating, Large, and Scattered. If it is solid like hemp beans on light pressure and increasingly restless on heavy pressure, the True Zang pulse appears, and Stomach Qi is completely absent, hence death. The Nei Jing states: The True Heart pulse is firm and beating, like searching for Coix seeds, accumulating like hemp beans. The meaning can be cross-referenced here.

When the Spleen is invaded by Wind pathogen, there is mild fever, the appearance resembles that of a drunk person, abdominal烦重 (fullness and heaviness), eyelid twitching, and shortness of breath.
[Note] The section on Spleen invaded by Cold pathogen is missing, likely due to lost bamboo slips.
[Annotation] When Wind pathogen invades the Spleen, mild fever is the primary symptom of Wind invasion. The appearance resembling a drunk person is also a symptom expected from Wind-Heat disturbing internally. Abdominal discomfort and vexation, physical lassitude and heaviness, eyelid twitching, and shortness of breath are all Spleen meridian symptoms.
[Collected Notes] Li said: Wind is a Yang pathogen that causes dispersion. Appearance resembling a drunk person refers to a red face and soft limbs. Internal disturbance by Wind causes abdominal fullness and heaviness. Eyelid twitching refers to the upper and lower eyelids.

The pulse of a dying Spleen is large and hard on light pressure, and on heavy pressure feels like an inverted cup, clean and empty, appearing to shake. This indicates death.
[Annotation] When the Spleen is invaded by Wind-Cold pathogen, if the pulse is large and hard on light pressure, losing its harmonious and slow quality, and on heavy pressure feels like an inverted cup, high and clear, forceful and shaking, this is the pulse of a dying Spleen organ.
[Collected Notes] Li said: A pulse that is weak and slippery indicates the presence of Stomach Qi. Floating, large, and hard indicates the extinction of Stomach Qi and the appearance of the True Zang pulse. An inverted cup is empty inside. "Jie Jie" describes an empty and void appearance. Appearing to shake indicates a restless and agitated pulse, suggesting Qi is scattering, hence death.

The Fu Yang pulse is Floating and Choppy. Floating indicates strong Stomach Qi; Choppy indicates frequent urination. The interaction of Floating and Choppy results in hard stools. The Spleen is constrained (Yue). Ma Zi Ren Wan (Hemp Seed Pill) is indicated.
[Note] This passage should belong under "Difficult Urination" in the "Abdominal Fullness Chapter" and is likely misplaced here.
[Annotation] Fu Yang is the Stomach pulse. If the pulse were Choppy without Floating, it would indicate Spleen Yin deficiency, and Stomach Qi would not be strong, making purgation inadvisable. Now, the pulse is Floating and Choppy, indicating strong Stomach Yang (strong Stomach Qi) and Spleen Yin deficiency. Spleen Yin deficiency cannot transport essence and Qi to the Stomach; water descends alone, causing frequent urination. Strong Stomach Qi constrains the Spleen, preventing the transformation of Jin-Ye, resulting in hard stools. Ma Zi Ren Wan is used to nourish fluids, moisten dryness, clear heat, and unblock the interior. One dares not freely use Cheng Qi Tang because the Choppy pulse ultimately indicates a deficiency pathogen.
[Collected Notes] Xu Bin said: Using a pill instead of a decoction for Spleen Constraint aims to slowly resolve the knot without abruptly damaging Yuan Qi. It must be known that Spleen Constraint arises because Yuan Qi is insufficient and Jin-Ye does not reach.
Li said: Fu Yang is the Stomach pulse. The Stomach is the sea of water and grain. Floating is a Yang pulse, so Stomach Qi is strong and appetite is good. Frequent urination depletes Jin-Ye, hence the Choppy pulse. Generally, the Spleen governs transporting Jin-Ye for the Stomach. Here, due to strong Stomach and weak Spleen, Jin-Ye is constrained, unable to distribute widely, but only transported to the Bladder, causing frequent urination and hard stools. Ma Zi Ren Wan unblocks the interior and moistens dryness.

Ma Zi Ren Wan Formula
Hemp Seed (2 Sheng)
Peony Root (0.5 Jin)
Immature Bitter Orange (1 Jin)
Rhubarb (1 Jin)
Magnolia Bark (1 Chi)
Apricot Seed (1 Sheng)
Grind the above six herbs into powder; mix with refined honey to make pills the size of walnut seeds. Take 10 pills with water, three times daily, adjusting dosage until effect is achieved.

In Shen Zhuo (Kidney Fixation), the patient has a heavy body, coldness in the waist, a sensation of sitting in water, and an appearance resembling edema, yet there is no thirst, urination is normal, and diet remains unchanged. The disease is located in the Lower Jiao. It is caused by long-term exposure to cold dampness due to sweating from labor while wearing cold, wet clothes. There is cold pain below the waist, and heaviness in the abdomen as if carrying five thousand coins. Gan Jiang Ling Zhu Tang (Ginger, Gastrodia, Poria, and Atractylodes Macrocephala Decoction) is indicated.
[Note] The sections on Kidney invaded by Wind and Cold are missing, likely due to lost bamboo slips.
[Annotation] Shen Zhuo refers to the Kidney being injured by Cold-Dampness, which adheres and fails to move. The Kidney receiving Cold-Dampness causes body heaviness and waist coldness, like sitting in water. Although resembling edema, the absence of thirst and normal urination indicate it is not Water retention but Dampness. Diet remains unchanged because the disease is in the Lower Jiao (Kidney) and not the Middle Jiao (Spleen). Asking about the cause, labor-induced sweating with cold, wet clothes for a long time injures the body, causing cold pain below the waist due to Cold dominance. Abdominal heaviness is due to Dampness dominance. "Carrying five thousand coins" describes the extreme heaviness. Gan Jiang Ling Zhu Tang tonifies the Upper to control Water, disperses Cold, and leaches out Dampness.
[Collected Notes] You Yi said: The disease is not in the inner Zang of the Kidney but in the outer mansion of the Kidney. Therefore, treatment does not focus on warming the Kidney to disperse Cold, but on warming the Earth (Spleen) to overcome Water.

Gan Jiang Ling Zhu Tang Formula
Licorice Root (2 Liang)
Atractylodes Macrocephala Rhizome (2 Liang)
Dried Ginger (4 Liang)
Poria Cocos (4 Liang)
Boil the above four herbs in 5 Sheng of water to obtain 3 Sheng. Divide into three warm doses. The waist will become warm.

The pulse of a dying Kidney is hard on light pressure, and on heavy pressure moves chaotically like a rolling ball, extending downward into the Chi position. This indicates death.
[Annotation] When the Kidney is invaded by Wind-Cold pathogen, if the pulse is extremely hard on light pressure, moves chaotically on heavy pressure like a rolling ball, and extends downward into the Chi position with chaotic movement throughout, these are all pulses of a dying Kidney True Zang.
[Collected Notes] Cheng Lin said: The dying Kidney pulse, hard on light pressure, agrees with the Nei Jing's description of "Pi Pi like striking stone" for dying Kidney, both indicating hardness. On heavy pressure, it moves chaotically like a rolling ball, extending into the Chi position; this is a state of separation of Yin and Yang, hence death. The True Zang pulses above differ slightly from the Nei Jing. In summary, the pulse lacks Stomach Qi, appearing in the three positions, with various descriptive images.

Question: What does it mean when the San Jiao departments are exhausted, specifically the Upper Jiao exhaustion causing frequent belching?
Master said: The Upper Jiao receives Qi from the Middle Jiao. If they are not harmonized, digestion of grain fails, hence belching occurs. Exhaustion of the Lower Jiao leads to urinary incontinence and fecal loss. Due to disharmony of Qi, self-control is lost. No treatment is needed; it will heal itself over time.
[Annotation] Exhaustion of San Jiao departments means the San Jiao, due to deficiency and exhaustion, does not return to its respective department and fails to function mutually. The Upper Jiao receives Qi from the Middle Jiao, and the Lower Jiao generates Qi from the Middle Jiao; mutual functioning constitutes harmony. If the Middle Jiao is exhausted and cannot digest food and water, Grain Qi is not received, causing the Upper Jiao to fail in mutual function and become disharmonious. Disharmony causes Grain Qi to stagnate and fail to diffuse, hence frequent belching. Lower Jiao exhaustion fails to provide ascending and generating Qi to the Middle Jiao, causing disharmony. Disharmony causes Kidney Qi to sink alone, losing self-control, hence urinary incontinence and fecal loss. No treatment is needed for healing over time applies to belching. However, for urinary incontinence and fecal loss, healing without treatment is unlikely; this may be misplaced text.
[Collected Notes] Cheng Lin said: "Jie" means deficiency. The Classic states: When San Jiao does not return to its department, Upper Jiao not returning causes belching and acid regurgitation; Middle Jiao not returning causes inability to digest grain and induce eating; Lower Jiao not returning causes urinary incontinence. The Upper Jiao is the stomach opening; the Middle Jiao is the Spleen. The Spleen is prone to belching; Spleen disharmony causes food and breath to reverse against the stomach opening, causing belching. The Classic states: Bladder failing to constrain causes urinary incontinence; Qi disharmony causes urine and stool to be unconstrained. Hence, loss and inability to self-control.

Master said: Heat in the Upper Jiao leads to Lung Wei (Lung Withering) due to coughing. Heat in the Middle Jiao leads to hardness. Heat in the Lower Jiao leads to hematuria and also causes strangury and retention of urine. Cold in the Large Intestine causes frequent loose stools; Heat in the Large Intestine causes passage of intestinal mucus. Cold in the Small Intestine causes tenesmus and bloody stools; Heat in the Small Intestine必然 leads to hemorrhoids.
[Annotation] Heat in the Upper Jiao refers to Lung Wei with expectoration of saliva and foam mentioned in this chapter. Heat in the Middle Jiao refers to abdominal fullness, hardness, and pain. Heat in the Lower Jiao refers to dribbling urination mentioned in this chapter. Externally, Cold in the Large Intestine causes clear and thin loose stools (diarrhea with loose stools). Heat causes thick and sticky intestinal mucus (dysentery with pus and blood). Cold in the Small Intestine causes tenesmus and bloody stools (Jie Yin bloody stools). Heat flows into the Large Intestine and accumulates in the anus, inevitably causing hemorrhoids.
[Collected Notes] Xu Bin said: The Small Intestine is the official of reception and transformation, exterior-interior related to the Heart. Bing represents the Small Intestine. It carries Fire to nourish Yin, preventing Yin stagnation; it carries Qi to transform Blood, ensuring Blood returns to the vessels. Cold prevents Qi from ascending, causing lower heaviness; Blood lacks Qi mastery and flows recklessly. The rectum is the head of the Large Intestine; the anus is the gate. Heat in the Small Intestine transmits heat to the Large Intestine, causing Qi to knot in the anus, hence hemorrhoids. Hemorrhoids represent the stagnation of Bing (Small Intestine) Heat in this location.

Question: Diseases include Ji (Accumulation), Ju (Gathering), and Ben Qi (Rushing Qi). What are they?
Master said: Ji is a Zang disease, finally immobile. Ju is a Fu disease, occurring at times, with shifting pain migration, and is treatable. Ben Qi is pain under the hypochondria, relieved by pressure, recurring as Ben Qi. The general principle for all Accumulations: A pulse that is fine and adheres to the bone indicates Accumulation. At Cun Kou (Inch position), Accumulation is in the chest; slightly beyond Cun Kou, Accumulation is in the throat. At Guan (Bar position), Accumulation is beside the navel; above Guan, Accumulation is below the heart; slightly below Guan, Accumulation is in the lower abdomen. At Chi (Cubit position), Accumulation is at Qi Chong; if the pulse emerges on the Left, Accumulation is on the Left; if on the Right, Accumulation is on the Right; if emerging on both, Accumulation is in the center. Diagnose the location of Accumulation according to each position. (Ben is interpreted as Rushing, see first chapter.)
[Annotation] Diseases include Ji, Ju, and Ben Qi, which must be distinguished. Ji is a Zang disease, present at all times, immobile in location. Ju is a Fu disease, occurring at times, with shifting pain. "Treatable" means Fu diseases are easier to treat. Ben Qi involves fluid accumulation causing hypochondriac pain, relieved by pressure, recurring without pressure, as Water Qi temporarily disperses with pressure, hence pain temporarily stops. This describes the symptoms. However, the general principle for Accumulations emphasizes diagnosis via pulse. A pulse that is deep,伏 (hidden), adheres to the bone, and is fine is the diagnostic sign for all Accumulations. If seen at both Cun positions, Accumulation is in the chest; slightly beyond near Yu Ji, Accumulation is in the throat. At both Guan positions, Accumulation is beside the navel; Guan near Cun, Accumulation is below the heart; slightly below near Chi, Accumulation is in the lower abdomen. At Chi, Accumulation is at Qi Chong; pulse emerging on Left, Accumulation is on Left; on Right, Accumulation is on Right; pulse emerging on both means seen on left and right, Accumulation is in the center. Diagnose the location of Accumulation according to each position.
[Collected Notes] Xu Bin said: Ji means trace; it is a pathogenic Qi belonging to Yin. Zang belongs to Yin; two Yins combine, hence immobility. Immobility means there is a specific painful area without migration. Ju is like market goods, gathering occasionally; pathogenic Qi belongs to Yang. Fu belongs to Yang; two Yangs compare, unlike Yin congealing, so Cold Qi manifests when encountered, otherwise ceases. This is "occurring at times." Having no fixed location, pain has no constant place, hence shifting pain migration. Its root is shallow, hence more treatable than Ji.
Li said: Ji is a Zang disease, deeply rooted internally, hence the pulse is fine and adheres to the bone. Cun, Guan, Chi, up/down, left/right distinguish the location of Ji disease, all pointing to the fine and bone-adhering pulse parts, consistent with Nei Jing: front to examine front, back to examine back. "Shang Jing Shang" concerns the chest and throat; "Xia Jing Xia" concerns the lower abdomen, waist, thighs, knees, shins, and feet.