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Words cannot be arbitrarily attached to matters, and things cannot be forcibly compared; there is a strict distinction among them.

The Yellow Emperor asked: When a person grows old and loses the ability to reproduce, is it because their vital energy (Jing-Qi) has been exhausted, or is it due to the natural decree of Heaven? (Supplementary note: "Cai" refers to the capacity to establish oneself in life; "Tian Shu" refers to the fixed cycle of Tian Gui.)

Biqi replied: At the age of seven, a girl's Kidney Qi becomes abundant, her teeth change, and her hair grows. (Supplementary note: The number of Old Yang reaches its limit at nine, while Young Yang follows at seven. Girls belong to the Shaoyin Qi, so they correspond to the number of Young Yang. This demonstrates that when Yin and Yang Qi harmonize, the physical form is generated. Thus, at seven, with abundant Kidney Qi, teeth change and hair grows.) At fourteen, Tian Gui arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant. Menstruation occurs regularly, enabling reproduction. (Supplementary note: "Gui" is the Heavenly Stem associated with Water in the North. The Ren and Chong vessels are part of the Eight Extraordinary Vessels. At this stage, Kidney Qi is fully mature, allowing the flow of Chong and Ren vessels, filling the menstrual blood which descends on schedule. The innate true Qi descends with it, hence called "Tian Gui." The Chong vessel is the Sea of Blood, and the Ren vessel governs the uterus; their mutual support enables reproduction. "Menstruation" refers to the peaceful Qi appearing approximately every thirty days. If delayed, it indicates pathology.) At twenty-one, Kidney Qi is balanced, wisdom teeth emerge, and physical growth reaches its peak. (Supplementary note: "Zhen Ya" refers to the last teeth to grow; teeth are considered the surplus of bone.) At twenty-eight, sinews and bones become firm, hair reaches its maximum length, and the body is in its prime. (Supplementary note: Tian Gui ends at forty-nine (7x7). At twenty-eight (4x7), one possesses half of one's vitality, yet the body is robust, having reached its developmental peak.) At thirty-five, the Yangming Meridian begins to decline, the face starts to wither, and hair begins to fall out. (Supplementary note: The Qi and Blood of the Hand and Foot Yangming meridians nourish the face and extend to the forehead. Decline leads to hair loss and facial withering.) At forty-two, the Three Yang meridians decline on the face, causing facial withering and whitening of the hair. (Supplementary note: All Three Yang meridians ascend to the head; their decline causes facial withering and white hair. This decline occurs because women have an excess of Qi but a deficiency of Blood due to regular menstrual blood loss.) At forty-nine, the Ren Mai becomes deficient, the Chong Mai's Qi and Blood diminish, Tian Gui is exhausted, the "Earthly Way" (menstruation) ceases, the physical form deteriorates, and reproduction becomes impossible. (Supplementary note: The cessation of menstruation is the closure of the Earthly Way. With the decline of Chong and Ren, the form deteriorates.)

At eight years old, a boy's Kidney Qi becomes solid, his hair grows, and his teeth change. (Supplementary note: The number of Old Yin reaches its limit at ten, while Young Yin follows at eight. Boys belong to Shaoyang Qi, corresponding to the number of Young Yin. As stated in the *I Ching*: "Heaven is nine, Earth is ten.") At sixteen, Kidney Qi is abundant, Tian Gui arrives, essence overflows and is emitted, Yin and Yang harmonize, enabling reproduction. (Supplementary note: Male constitution differs; the forms of Jing and Blood vary. Yin is still like a full sea releasing blood; Yang is active, responding to union by emitting essence. Their harmony allows reproduction. As the *I Ching* states: "When male and female combine essence, all things are transformed.") At twenty-four, Kidney Qi is balanced, sinews and bones are strong, wisdom teeth emerge, and physical growth peaks. At thirty-two, sinews and bones are vigorous, muscles are full and robust. (Supplementary note: Tian Gui ends at sixty-four (8x8). At thirty-two (4x8), one possesses half of one's vitality.) At forty, Kidney Qi declines, hair falls out, and teeth become dry and brittle. (Supplementary note: The Kidney governs bone, and teeth are the surplus of bone. With declining Kidney Qi and lack of essence nourishment, hair falls and teeth dry out.) At forty-eight, Yang Qi declines on the upper body, the face withers, and the temples turn gray. (Supplementary note: Here, Yang Qi refers to Yangming Qi.) At fifty-six, Liver Qi declines, tendons lose mobility, Tian Gui is exhausted, essence decreases, Kidney Qi declines, and the physical form becomes extremely fatigued. (Supplementary note: Liver Qi nourishes tendons; liver decline causes tendon immobility. Kidney Qi nourishes bone; kidney decline causes physical exhaustion. With exhausted Tian Gui, essence is scarce. With depleted Yang Qi and essence, teeth and hair fall. This is not merely a decline in vitality but also the decree of Heaven.)

The Kidney governs water and receives the essence of the Five Zang and Six Fu organs to store it. Therefore, only when the essence of the Five Zang organs is abundant can the Kidney excrete it. (Supplementary note: The essence of the Five Zang and Six Fu organs overflows and seeps into the Kidney, which then stores it. The Kidney is the gathering place and gatekeeper, not possessing essence exclusively. Hence, "when the Five Zang are abundant, [the Kidney] can excrete.") Now, as the Five Zang organs decline, sinews and bones become lax, Tian Gui is exhausted, temples turn white, the body feels heavy, gait becomes unsteady, and reproduction ceases.

The Yellow Emperor asked: Why do some elderly people retain the ability to reproduce? (Supplementary note: This refers to cases deviating from the standard Tian Gui cycle.) Biqi replied: This is because their natural lifespan exceeds the norm, their Qi and pulses remain smooth and unobstructed, and their Kidney Qi remains sufficient. (Supplementary note: They were endowed with an inherent surplus of innate true Qi.) Although such individuals may reproduce, men do not exceed the age of sixty-four (8x8), and women do not exceed forty-nine (7x7), because the essence and Qi of Heaven and Earth are ultimately exhausted. (From *Shanggu Tianzhen Lun*)

Heaven nourishes humans with the Five Qi, and Earth nourishes humans with the Five Flavors. (Supplementary note: Heaven feeds humans with Five Qi: Sour Qi gathers in the Liver, Scorched Qi in the Heart, Fragrant Qi in the Spleen, Fishy Qi in the Lungs, and Rotten Qi in the Kidneys. Earth feeds humans with Five Flavors: Sour enters the Liver, Bitter enters the Heart, Sweet enters the Spleen, Pungent enters the Lungs, and Salty enters the Kidneys. Clear Yang transforms into Qi and ascends to become Heaven; Turbid Yin forms Flavor and descends to become Earth. Thus, Heaven feeds with Qi, and Earth feeds with Flavor. The Classic states: Yang is Qi, Yin is Flavor.) The Five Qi enter through the nose and are stored in the Heart and Lungs, uplifting to make the complexion bright and the voice resonant. The Five Flavors enter the mouth, are stored in the Stomach and Intestines, and nourish the Five Qi. When the Five Qi are harmonious, Body Fluids are generated; when Body Fluids and Qi complement each other, Spirit (Shen) is naturally produced. (Supplementary note: The Heart manifests in the complexion, and the Lungs govern the voice. Qi stored in the Heart and Lungs brightens the five colors and clarifies the voice. Qi is the mother of Water. Flavors stored in the Stomach and Intestines internally nourish the Five Qi. Harmonized Five Qi transform into Body Fluids, which combine with Qi to generate Shen Qi. From *Liu Jie Zang Xiang Lun*)

The Qi of Heaven is clear, quiet, and luminous. (I surmise: Because Heaven's Qi is clear and quiet, its luminosity is inexhaustible; if humans are clear and quiet, their lifespan will also be prolonged.) It hides its virtue without revealing itself, thus it does not fall. ("Zhi" is alternatively read as "Shang". Supplementary note: The four seasons form order, and the seven luminaries revolve. Heaven does not display itself; this is hiding its virtue. When virtue is hidden, its applications are unimpeded, so it does not fall. Heaven possesses supreme virtue yet responds appropriately; how much more should human conduct follow Heaven?) If Heaven displays its brightness, the Sun and Moon would lose their light, and evil Qi would invade the orifices. (Supplementary note: When the Great Brightness appears, the Lesser Brightness vanishes. Thus, the virtue of Great Brightness must be hidden. If Heaven displays itself, the Sun and Moon's light is obscured. This metaphorically advises humans to maintain clarity and quietude, following the Dao to preserve innate truth. Departing from the Dao allows empty evils to enter the orifices.)

If Yang Qi is blocked and Earth Qi is murky, clarity is obscured. (Supplementary note: Yang refers to Heavenly Qi, also Wind-Heat; Earth Qi refers to Dampness, also Fog/Mist. Wind-Heat harming humans blocks the nine orifices; Fog-Dampness causing illness obscures clarity. By analogy, in Heaven, the Sun and Moon lose their radiance; in humans, the eyes become dim.) If clouds and mist are not refined, the White Dew that should descend from Heaven will not fall. (Supplementary note: Mist is a type of cloud; Dew is a type of rain. If Yang is excessive, Earth Qi does not ascend to respond; if Yin is deficient, Heaven Qi does not descend to intersect. Thus, clouds and mist do not transform, and refined Qi fails to ascend, resulting in the failure of White Dew to descend. The Classic states: "Earth Qi ascends to become clouds; Heaven Qi descends to become rain," indicating that the intersection of two Qi forms dew and rain. It also states: "Extreme Yin cuts off Heaven Qi; Extreme Yang depletes Earth Qi," meaning if Qi does not attract, they cannot intersect.)

If Heaven and Earth do not communicate, the lives of all things cannot be sustained, and even majestic trees will perish. (Supplementary note: "Biao" means to manifest. The *I Ching* states: "Heaven and Earth... cause all things to mature perfectly." If communication is absent, it becomes the hexagram Pi (Stagnation). "Ming" refers to famous fruits and precious trees. If clouds and mist do not transform, and their refined essence/dew does not nourish the plains, it signifies Heaven Qi not descending and Earth Qi not ascending. The way of transformation is flawed, and the source of life is extinguished. Thus, the lives of all things lack sustenance. In death, majestic trees are the first to show signs.) If harmful Qi does not disperse, wind and rain are irregular, and White Dew does not fall, plants will wither and fail to flourish. (Supplementary note: "E" refers to harmful Qi; "Fa" to dispersion; "Jie" to regulation; "Si" to accumulation; "Gao" to withering. Constant Qi remains hidden and undispersed; wind and rain are unregulated, causing excessive damage. Withered matter accumulates, failing to flourish in spring. This applies not only to objects but also to humans who depart from the Dao, as mentioned below.)

If thief winds arrive frequently and torrential rains rise often, Heaven and Earth fail to preserve the four seasons, and humanity loses connection with the Dao, life will be cut short before its time. (Supplementary note: Disregarding the harmony of the four seasons and repeatedly suffering from the Eight Winds. Losing connection with the Dao causes innate true Qi to drift far from its proper state, leading to premature death. "Yang" implies longevity/extent; "Yuan" implies distance.)

Only the Sage follows this pattern; thus, his body suffers no strange diseases, all things retain their vital energy, and his essence is not exhausted. (Wang Bing's commentary: The Sage models Heaven and Earth's hidden virtue, remaining tranquil and empty, guarding spirit within. How could disease arise? Also: "Following" means complying, i.e., obeying the commands of the four seasons. However, these commands must not be violated; violation injures the internal Five Zang and triggers other diseases.)

The Qi of Cangtian (Azure Heaven) is pure and quiet. (Supplementary note: Spring is Cangtian, the master of generation.) If one's will and intent are governed and compliant, Yang Qi becomes secure. Even if thief邪 (evil pathogens) attack, they cannot harm. (This uses Heavenly Dao to illustrate human conduct.) This is adhering to the sequence of time. (By following the sequence of Heavenly Qi of the four seasons, thief邪 cannot harm.) Therefore, the Sage transmits spirit, absorbs Heavenly Qi, and connects with Divine Illumination. (Flowing spirit without depletion. Wang Bing's commentary: Long-term absorption of innate true Qi allows miraculous functions to naturally connect with Divine Illumination.)

If one violates this, the nine orifices close internally, muscles become obstructed externally, and Wei Qi scatters and dissolves. (Supplementary note: Violation refers to opposing the purity of Cangtian. Wei Qi combines with Heavenly Yang Qi, warming the flesh, filling the skin, thickening the interstices, and controlling opening/closing. Loss of measure leads to internal closure of nine orifices and external obstruction of muscles, as Wei Qi fails to circulate.) This is self-injury, weakening Zheng Qi. (Supplementary note: Opposing Heavenly Qi and violating quietude causes Zheng Qi to be stripped away, not by Heaven's decree, but by human action.)

Yang Qi is like Heaven and the Sun. If it loses its proper function, lifespan is shortened and brilliance is obscured. (Supplementary note: This illustrates the function of Yang Qi. Human Yang is like Heavenly Sun. If Heaven loses its function, the Sun is unclear; if humans lose their function, Yang is insecure. If the Sun is clear, Heaven is dark; if Yang is insecure, humans die young.) Therefore, the movement of Heaven relies on the brightness of the Sun. (Illustrating that human life depends on Yang Qi. ○ I surmise: Heaven's operation is ceaseless, hiding its Qi so that the Sun and Moon may shine. From *Sheng Qi Tong Tian Lun*)

Yin Qi, when quiet, stores Spirit; when agitated, Spirit dissipates and perishes. (Supplementary note: Yin refers to the Five Spirit Zang organs. Quietude without pathogenic invasion keeps Auspicious Qi calm and internally stored. Movement exposing one to pathogens harms Spirit, causing dispersion and loss of storage, hence "dissipation and perishing.")

Overeating damages the Stomach and Intestines. (Supplementary note: Zang organs are injured by agitation; Fu organs by food and drink. Both result from overuse and exceeding limits, inviting pathogens.)

Biqi said: Rooted within is called Shen Ji (Spirit Mechanism); if Spirit departs, the mechanism stops. Rooted without is called Qi Li (Qi Establishment); if Qi stops, transformation ceases. (Among all有形 (form-bearing) entities, those rooted within derive their source from Heaven; their movements and floating are primarily driven by Shen Qi as the master of mechanism. Thus, their actions are unknown to others. When Shen leaves the mechanism, the way of activation and use ceases. Those rooted without derive their source from Earth; their growth, transformation, storage, and collection respond to the creative Qi of nature. Thus, their emergence is also unknown to others. When Qi stops, the way of biochemical formation ceases. Wood, Fire, Earth, Metal, Water, Dryness, Dampness, Liquid, and Kidney are soft and weak, easily changing nature. If external living Qi leaves the root, transformation ceases, and the constant physical nature and color inevitably shift slightly from their original state. *Liu Wei Zhi Lun* states: "If exit and entry cease, Shen Ji is extinguished; if ascent and descent stop, Qi Li stands alone in danger." Therefore, without exit and entry, there is no growth, strengthening, aging, or dying; without ascent and descent, there is no growth, transformation, storage, or collection. From *Wu Chang Zheng Da Lun*)

The Yellow Emperor asked: What are the Three Parts? Biqi replied: There are Lower, Middle, and Upper parts. Each part has three observations (Hou), corresponding to Heaven, Earth, and Man. One must guide with fingers (requiring teacher's instruction) to ascertain the truth.

Upper Part Heaven: Arteries at both temples. (Supplementary note: Located on both sides of the forehead, responding to the Qi flow of Hand and Foot Shaoyang meridians.)
Upper Part Earth: Arteries at both cheeks. (Near Ju Liao, responding to the Qi flow of Hand and Foot Yangming meridians.)
Upper Part Man: Arteries in front of the ears. (In the depression in front of the ear, responding to the Qi flow of Hand Shaoyang meridian.)

Middle Part Heaven: Hand Taiyin Meridian. (Lung pulse, located at the radial styloid process in the Cun Kou area, known as Jing Qu, responding to the hand.)
Middle Part Earth: Hand Yangming Meridian. (Large Intestine pulse, at He Gu, responding to the hand.)
Middle Part Man: Hand Shaoyin Meridian. (Heart pulse, at the end of the ulnar styloid process in the Shen Men area, responding to the hand. *Ling Shu* states: "Shaoyin has no Shu points; does the Heart never get sick?" Answer: "Its exterior meridian may be diseased while the organ remains healthy; thus, we select only the exterior meridian point at the sharp bone of the wrist posterior, referring to this.")

Lower Part Heaven: Foot Jueyin Meridian. (Liver pulse, outside the pubic symphysis, 1.5 cun below Yang Shi, in the depression of Wu Li, taken while supine, responding to the hand. For women, take Tai Chong, 2 cun behind the metatarsophalangeal joint of the big toe, in the depression.)
Lower Part Earth: Foot Shaoyin Meridian. (Kidney pulse, behind the medial malleolus, in the depression above the calcaneus, at Tai Xi, responding to the hand.)
Lower Part Man: Foot Taiyin Meridian. (Spleen pulse, above the fish belly, between the tendons, straight up to the lower gate of Wu Li. Press deeply with wide, thin clothing to obtain it; responds to the hand. ○ To observe Stomach Qi, take the pulse at Chong Yang on the dorsum of the foot, where the artery responds to the hand.)

Thus, Lower Part Heaven observes the Liver; Earth observes the Kidney; Man observes Spleen and Stomach Qi (since Spleen and Stomach are connected by membranes, Stomach Qi is also observed).

Question: How is the Middle Part observed? Answer: It also has Heaven, Earth, and Man. Heaven observes the Lung; Earth observes Qi in the Chest (Hand Yangming meridian passes through this area; the Classic states "Intestines and Stomach are observed together," thus observing the chest). Man observes the Heart.

Question: How is the Upper Part observed? Answer: It also has Heaven, Earth, and Man. Heaven observes Qi in the head and horns (forehead/temples); Earth observes Qi in the mouth and teeth; Man observes Qi in the ears and eyes (positioned near the ear anterior to the outer canthus of the eye, thus used for observation).

The Three Parts each have Heaven, Earth, and Man. Three constitute Heaven, three constitute Earth, three constitute Man. Three times three equals Nine. Divided into Nine, they correspond to the Nine Fields (Outside the city is Jiao, outside Jiao is Dian, outside Dian is Mu, outside Mu is Lin, outside Lin is ... ... outside is Ye, indicating remoteness. See *Liu Jie Zang Xiang Lun*).

Nine Fields correspond to Nine Zang Organs. (Supplementary note: Thus responding to the ultimate numbers of Heaven and Earth.)

Therefore, there are Five Spirit Zang and Four Form Zang. (Supplementary note: Hun, Po, Xin, Yi, Shen all reside in the Five Zang, hence called Spirit Zang. Form Zang are like vessels, open outward, hollow inside, storing things, hence called Form Zang. I surmise: Having only the vessel without storage content emphasizes the importance found in *Xuan Ming Wu Zang Pian*, *Sheng Qi Tong Tian Lun*, and *Liu Jie Zang Xiang Lun*.) Together, they form Nine Zang.

If the essence of the Five Zang fails, the complexion will appear premature (Tao), and premature appearance indicates death. (Supplementary note: Tao refers to abnormal death-like complexion. Complexion is the flag of Spirit; Zang is the residence of Spirit. When Spirit leaves, Zang fails; when Zang fails, complexion becomes abnormal, indicating death.)

Question: How are life and death judged? Answer: If the body is robust but the pulse is fine/thin, with insufficient Qi to breathe, it is critical. (Supplementary note: When Form and Qi match, it is treatable. Here, fine pulse and scant Qi indicate weak Qi despite robust form, meaning Form and Syndrome do not support each other, hence critical. Critical implies near-death but potentially survivable.)

If the body is emaciated but the pulse is large, with excess Qi in the chest, it is death. (Supplementary note: Here, Form and Qi are insufficient, but Pulse Qi is excessive, hence death. Generally, mismatched Form and Qi leads to death.)

If Form and Qi match, life prevails; if they are irregular (Can Wu), disease exists. (Supplementary note: "Can" means comparison; "Wu" means grouping. Irregularity means deviation from normal patterns, hence disease.)

If all Nine Hous are discordant, it is death. (Supplementary note: Discordance means observational climates do not match. There are seven types of discordant observations described below.)

If pulses in upper/lower/left/right correspond like pounding rice, disease is severe; if they are discordant and uncountable, it is death. (Supplementary note: There are eighteen diagnoses across three parts and nine observations. "Like pounding rice" means rapid and forceful, like a pestle. "Uncountable" means more than ten breaths per respiration.)

If Middle Part pulse is alone harmonious but discordant with other Zang, it is death; if Middle Part pulse is diminished, it is death. (Supplementary note: If Upper/Lower parts do not correspond, even if Middle is harmonious, death is imminent. If diminished relative to Upper/Lower, it indicates Qi decline, hence death. "Diminished" means smaller on one side.)

If the eyes are sunken, it is death. (Supplementary note: Taiyang meridian originates at the inner canthus. Sunken eyes indicate Taiyang exhaustion. Taiyang is singled out because it governs all Yang Qi.)

Biqi said: The Nine Hous should correspond, acting as one, without discord. If one Hou lags, disease exists; if two lag, disease is severe; if three lag, disease is critical. "Lagging" means the responses are not simultaneous (Ju means same/unified).

Observe the Fu and Zang organs to determine the timing of death. (Supplementary note: Disease entering Fu heals; entering Zang dies. Thus, the timing of death can be known by observation.) One must first understand Normal Pulses before understanding Disease Pulses. (Supplementary note: Normal pulses relate to the four seasons and Five Zang.)

The Yellow Emperor asked: How do we know where the disease is? Biqi replied: Observe the Nine Hous. A pulse that is uniquely small, large, rapid, slow, hot, cold, or depressed indicates disease. (These seven discordant observations are the seven types mentioned. Pulse variations showing irregularity, depending on unique abnormalities, indicate disease.)

If muscles are wasted and the body cannot move, it is death. (Supplementary note: External decline of Grain Qi leads to muscle wasting; exhaustion of True Tian肉 (flesh) prevents movement.)

If Middle Part pulse is intermittently sparse and rapid, it is death. (Supplementary note: Indicates scattered Qi.)

If flesh and form are wasted, even if Nine Hous are harmonious, it is death. (Supplementary note: Also indicates mismatched Form and Qi. As previously noted, even if Nine Hous are flat/harmonious, if muscles are wasted, it is death.)

The Yellow Emperor asked: Winter Yin pulses and Summer Yang pulses—what does this mean? Biqi replied: If all Nine Hou pulses are deep, fine, and suspended/extreme, they are Yin, governing Winter, so death occurs at midnight. If pulses are vigorous, rapid, panting, and numerous, they are Yang, governing Summer, so death occurs at noon. (Supplementary note: Positions have no fixed abode; extremes reverse. Text of Qian/Kun: "At extreme Yin, dragons fight in the wild; at extreme Yang, the arrogant dragon regrets." Thus, extreme Yin/Yang pulses lead to death at midnight/noon.)

Therefore, patients with Cold-Heat diseases die at dawn. (Supplementary note: Also due to extremity reversal. Dawn is Wood's reign; Wood Qi is Wind. Thus, Cold-Heat diseases die during Wood's reign. The Classic states: "Due to exposure to wind, Cold-Heat arises," indicating Cold-Heat is caused by Wind invasion.)

Patients with Heat Zhong (internal heat) or Heat diseases die at noon. (Supplementary note: Extremity of Yang.)

Patients with Wind diseases die at dusk. (Supplementary note: Mao-You axis. I surmise: Cold-Heat patients have excess Wood Qi, dying in Wood's reign. Wind patients have deficient Wood Qi. You hour is Metal's reign; Wood deficiency allows Metal dominance, hence dying at You.)

Patients with Water diseases die at midnight. (Because Water reigns.)

If pulses are intermittently sparse/rapid or slow/fast, death occurs during the transition hours of the four seasons (Chen, Xu, Chou, Wei). (Spleen Qi is internally severed, hence death during these hours.)

If the Seven Diagnoses are present but all Nine Hous comply, death does not occur. (Supplementary note: If Nine Hous comply with the four seasons' commands, even if Seven Diagnoses appear alternately, life is preserved.)

What is meant by "not dying" refers to Wind diseases and Menstrual diseases, which resemble the Seven Diagnoses but are not, hence "not dying." (Supplementary note: Wind disease pulses are large and rapid; menstrual disease pulses are small and subtle. Although symptoms resemble the Seven Diagnoses, the prognosis differs, hence survival.)

If the Seven Diagnoses are present AND the pulse conditions are also failed/collapsed, it is death. (Supplementary note: If Seven Diagnoses appear but Nine Hous comply, death does not occur. If disease resembles Seven Diagnoses but pulses are chaotic/disordered, even if Nine Hous seem compliant, survival is impossible.)

There will definitely be hiccups (Yue) and belching (Yi). (Supplementary note: Heart manifests as Yi; Stomach as Yue. Exhaustion of Stomach essence and Spirit failing to guard the Heart causes these symptoms at death.)

One must carefully inquire about the initial cause of illness and current symptoms. (Supplementary note: "Fang Zheng" means currently. Seek the beginning to understand the end.)

Then, palpate the pulses separately, observe the meridians' floating/sinking, and analyze upward/downward and rebellious/compliant flows. Rapid pulses indicate no disease (pulse channel is abundant); slow pulses indicate disease (Qi is insufficient); pulses that do not come and go indicate death (Spirit has departed); skin adhering to bone indicates death (bone and tendon are withered. From *San Bu Jiu Hou Lun*).

The Yellow Emperor said: I know that hundred diseases arise from Qi. (Supplementary note: Qi's usage involves deficiency/excess, rebellion/compliance, slack/tight, all capable of causing disease, hence the question.) Anger causes Qi to ascend; Joy causes Qi to slacken; Grief causes Qi to consume; Fear causes Qi to sink; Cold causes Qi to contract; Heat causes Qi to leak; Fright causes Qi to scatter; Labor causes Qi to exhaust; Thought causes Qi to knot. The Nine Qi differ; what diseases arise?

Biqi said: Anger causes Qi to rebel; severely, it leads to vomiting blood and undigested stool diarrhea, hence Qi ascends. (Supplementary note: Anger causes Yang Qi to rebel upward; Liver Qi invades Spleen, leading to vomiting blood and diarrhea. How to verify? Anger causes red face; severely, blue/pale face. The Classic states: "Unrestrained anger injures Wisdom; anger causes Qi to rebel upward and not descend.")

Joy causes Will to harmonize, Qi to reach, Ying and Wei to flow smoothly, hence Qi slackens.

Grief causes Heart Tie to tighten, Lung leaves to expand and raise, Upper Jiao to block, Ying and Wei to not distribute heat, heat stays in the middle, hence Qi consumes. (Supplementary note: Grief injures Heart; tight Heart Tie moves Lung; Lung Qi strikes other meridions in rebellion, causing Lung expansion and leaf raising.)

Fear causes Essence to retreat; retreat causes Upper Jiao to close; closure causes Qi to return; return causes Upper Jiao to distend, hence Qi does not flow. (Supplementary note: Fear causes Yang Essence to retreat upward and not descend, closing Upper Jiao. Once closed, Qi cannot flow; Lower Jiao Yin Qi also returns, accumulating as distension. Upper Jiao is sealed, Lower Jiao Qi returns, each staying in place, hence Qi does not flow.)

Cold causes Cou Li (pores/striae) to close, Qi not to flow, hence Qi contracts. (Supplementary note: Cou refers to sites of fluid secretion; Li refers to intersecting lines. Closure is tight sealing; Qi is Wei Qi; Flow is circulation; Contract is convergence. Body cold makes Wei Qi sink, so skin striae and secretion sites close tightly, Qi does not circulate, and Wei Qi converges internally without dispersing.)

Heat causes Cou Li to open, Ying and Wei to flow, sweat to pour out, hence Qi leaks. (Supplementary note: In Yang, one is comfortable; in Yin, one perspires. Heat opens skin pores, Ying and Wei flow freely, fluids seep externally as heavy sweating.)

Fright causes the Heart to have no anchor...