脏气怫郁而所致也。夫人之情。每有好恶。至其有感。则脏气为之动。动而中节。何害之有。一或有偏。则脏气为之倾
移。而运化失常。故因其偏虚。邪气凑焉。所谓肺病传肝者。肺邪乘肝虚。经云。虚者受邪是也。肝又欲传脾。是其道
也。然其时脾无虚。则邪无入地。而不能传焉。经云。实者不受邪是也。肝复欲还肺。然其不受者。横且有所不胜也。
故跋胡HT 尾。进退维谷。故留
结为积。是以相克之病。假令金克而土旺。则木邪何往。所以留结于本部也。余脏可以例
推。学人莫以文害辞。而以意逆志可矣。滑注情感之说。以性理言。迂远而阔于事情。不可从矣。
（第五十七旧同）难曰。泄凡有几。（泄名多故发问）皆有名不。然。泄凡有五。（约言）其名不同。有胃泄。有脾
泄。有大肠泄。有小肠泄。有大瘕泄。名曰后重。（五泄至甚乃为后重后重即痢滑注以后重蒙大瘕泄非是）胃泄者。（即
谓飧泄）饮食不化。（完谷挟风）色黄。（未失胃土本色故比诸后四泄则最易愈）脾泄者。（即濡泄）腹胀满。（有湿）泄
注。（涩滞）食即（或）呕〔声物（或）共出〕吐（无声有物）逆。大肠泄者。（即谓洞泄）食已窘迫。（肠胃有寒）大便
色白。（澄彻腥秽）肠鸣。（有寒邪故）切痛。（拘急而绞较前二证稍重不易治）小肠泄者。（即谓血泄）溲（小便通）而
便脓血。（赤白兼下）小腹痛。（痛在齐下是为痢候）大瘕（结瘕所成）泄者。（即谓肠 ）里急后重。（腹里急痛涩滞不
通）数（次）至圊而不能。（大）便（阴）茎中痛。（小便不通）此五泄之（紧）要（诊）法也。
按内经谓泄痢居多。所谓飧泄洞泄濡泄 溏瘕泄暴注下迫是也。其所谓痢。则曰肠 便血。曰下白沫。曰下脓血。
扁鹊乃去繁而就简。故脾胃大肠三焉者。此谓泄泻。小肠大瘕二泄。此谓痢疾。轩岐谓之肠 。仲景谓之滞下。其义一
也。总言之。则为五泄。泄一变至于后重。则为痢。然则泄与痢。固一源而二岐。素问云。下为飧泄。久为肠 。是也。
泄多属寒。痢多属热。且其泻与后重。亦自有别。盖灵素所载。其证多端。若无系属。扁鹊约为五泄。且以脏腑名蒙泄
字上。则有所归着。而至其审证施治。则有大裨于后人。后世方书。汗牛充栋。至其分泄痢之名。亦或倍蓰之。或什百
之。乃使后人有多岐亡羊之惑。学人务本。则其道自成矣。
（第五十八旧同）难曰。伤寒有几。（总括下文五种伤寒）其脉有变（滑注作辨义亦通）否。然。伤寒有五。（分别
五症）有中风。（仲景所云风邪在卫）有伤寒。（寒在荣）有湿温。（身体重）有热病。（热而不恶寒）有温病。（即四时不
正之气）其所苦（大义见素问故此不论）各不同。中风之脉。阳（寸）浮（表邪）而滑。（风）阴（尺下皆同）濡而弱。
（里气不和）湿温之脉。阳浮（表）而弱。（湿）阴小而急。（里寒）伤寒之脉。阴阳俱盛（有力）而紧（寒）涩。（邪在
血）热病之脉。阴阳俱浮（表里热）浮之而滑。（邪实）沉之散涩。（荣气不和）温病之脉。行在诸经。不知何经之动也。
各（已上五病）随其经（邪）所在而取之。（一句总结上诸病滑注以附温病一证非）
按内经云。热病者。皆伤寒之类。由是观之。则所谓热病。其所指义尤广矣。而至其论病。则唯言其传经。及两感
等症。未尝明分有五证之异。其命名亦仅举温暑二病耳。扁鹊始论五种伤寒者。壹唯于内经热论中。以其不言脉象。故
由所感之邪。立其病名与脉焉。名者人治之大者。名不正则言不顺。言不顺则事不成。夫医事不成。则民病无所措手足。
其伤寒有几。指病因别之。即内经所谓诸热病是也。五病中之伤寒。即真伤寒也。其余风热温湿四病者。类伤寒也。即
内经所谓皆伤寒之类是也。病俱热证。则其所苦。亦当无异。然谓各不同者。盖由有阴阳表里浅深之分故尔。内经既举
其传经之证。详且尽矣。然不言热病有五邪之别。于是扁鹊姑置其所苦不辨。独举脉状。以分五病之帜。则当有正鹄。
以便为治也。仲景伤寒论。皆据此篇引伸触类。殆无余蕴。学人察诸。
伤寒有汗出而愈。（表有邪）下之而死者。（里无邪）有汗出而死。（表无邪）下之而愈者。（里有邪）何也。然。阳
虚（正气逼中外虚故邪居之）阴盛。（里气内满正气盛）汗出而愈。（中的）下之即死。（不中的下同）阳盛（表气实无邪）
阴虚。（邪入里而正气虚）汗出而死。下之而愈。
凡治伤寒。有汗吐下三法。此即言汗下二法。而不言及吐者。盖寒邪在上焦为胸烦。乃当行吐。吐是所罕行。内经
云。未满三日者。可汗而已。其满三日者。可泄而已。未尝言及吐法。故扁鹊置而不论。独举汗下二法。以论之耳。所
谓阳虚阴盛。言邪在表。阳盛阴虚。言邪在里。然以常例推之。其义难通。何者。阳虚阴虚。共指邪凑之地而言。其谓
阴盛阳盛。言正气偏盛。由是观之。则两虚字谓正气方虚。两盛字谓经气偏盛。昆山王氏云。寒邪外客。非阴盛而阳虚
乎。热邪内炽。非阳盛而阴虚乎。似是而非。仲景云。桂枝下咽。而阳盛则毙。承气入胃。而阴盛则亡。此亦省文。义
本非异。滑注以阴阳字为表里大得其旨。故引外台所谓表病里和。里病表和。以通其义。然和自和。盛自盛。岂可混同
乎。且以虚为邪盛之处则可。以盛为气和之地则未可。何者。盛固为无邪处。然比诸经之和则有余。故扁鹊不言和而言
盛。可以见已。经云。邪气盛则实。精气夺则虚。此亦一义。王氏以阳虚阴虚。为阳经阴经之虚。以阳盛阴盛。为阳热
阴寒之邪。阴阳字分为二义。似反字例。姑且举之。以俟知者折衷。
寒热之病。候之如何也。然。皮寒热者。皮不可近（灵枢作附）席。毛发焦。鼻 （腊）不得汗。（取三阳之络以补
手太阴）肌寒热者。皮（灵枢作肌）肤痛。唇舌 。无汗。（取三阳于下以去其血补足太阴以出其汗）骨寒热者。病无所
安。汗注不休。齿本 痛。（灵枢作齿未槁取其少阴于阴股之络齿已槁死不治）
此一节见灵枢第二十一篇。扁鹊裁附诸此者。盖伤寒之为病。亦必因寒热之势。以知其苦。而征邪之浅深。故邪在
皮部。则皮不可近席。且不得汗。在肉分则唇舌干无汗。在骨属则汗注而不止。齿本 。盖在表者。心肺主之。在中者。
脾胃主之。在里者。肾肝主之。是扁鹊所以采摘古经而附焉。滑伯仁以为内伤寒热。王文洁以为外感寒热。皆非是。
（第五十九旧同）难曰。狂（与）癫之病。何以别之。然。狂疾之始发。少卧（阳多阴少）而不饥。（胃邪实）自高
贤也。自辨知也。自倨贵也。（三言共见狂者气机）妄笑（实火）好歌乐。（缓土）妄行不休。（手足诸阳之本邪气特甚）
是也。癫疾始发。意不乐（阴多阳少）僵仆（脊强反身阴邪搏阳）直视。（眼精凝而不转）是也。（二字旧本误出篇末然
则其脉三部共盛之语独属癫症且据前条文例则当在此故改移此）其脉三部阴阳俱盛。（总谓狂癫二证之脉分而言之三部阴
盛是癫脉三部阳盛是狂脉）
按灵枢谓癫狂者数件。癫曰先不乐。头重痛。视举目赤。烦心。曰引口啼呼喘悸。曰先反僵。因而脊痛。其余曰筋
癫疾。曰脉癫疾。是也。狂曰先自悲喜忘。若怒善恐者。得之忧饥。曰少卧不饥。自高贤也。自辨智也。自尊贵也。善
骂詈。日夜不休。曰狂言惊善笑。好歌乐妄行不休者。得之大恐。曰目妄见。耳妄闻。善呼者。少气之所生也。曰多食
善见鬼神。善笑而不发于外者。得之有所大喜。是也。此篇仅举一二条者。则去繁就简。而使人知其有属阳属阴之分焉。
大凡难经之为书也。其所论辨。率皆举其大义。庞安常谓引而不发是也。况若此篇所述。比诸灵枢。则其辞尤简。故能
知百病之本也。盖百病之发。其变虽多端。阴阳虚实。最为关系。至若狂癫之症。明分其阴阳。以施之治。则无有踏邪
路。陷大泽之忧。此扁鹊舍其余绪。而取则阴阳二证者。为使后学端末其本矣。古之义也。
（第六十旧同）难曰。头（与）心之病。有厥（逆）痛。有真（正）痛。何谓也。然。手足（旧本无足字按邪客足
三阳亦为头痛灵枢载六阳经头痛是其征故补之）三阳之脉。受风寒（邪气）伏留而不去者。（逆上）则名厥头痛。入（留）
连在脑（海）者。（邪深痛甚）名真头痛。（手足寒而至节者难治）其五脏（邪）气相干（触）名厥心痛。（东垣所云肺心
痛肾心痛等类是也有治法）其痛甚。但在心（脏）手足青（灵枢作清）者。即名真心痛。其真头（滑注云脱头字补之）
心痛者。旦发夕死。夕发旦死。（无治法）
按头心之痛。有厥真二焉。厥者。谓邪从是至彼而为痛。真者。谓邪直居其处而痛甚。凡头心厥痛。多与他病兼见。
如其真痛。则单发之病。而命悬旦夕。固难为治。所谓三阳经脉受邪而不去则逆。故冲头而痛者。以手足三阳。皆达于
头面故尔。若入于脑海。留连弥久而发者死矣。所谓五脏邪气。互相干犯。故冲心而痛者。以手足三阴。皆循于心胸故
尔。若其直在心脏。痛甚而手足清者死矣。据灵枢则知厥头痛六条。为手足六阳经之病也。厥心痛五条。所谓肺肝肾脾
胃之邪也。至其论治法。则悉且尽矣。此篇乃唯示其本焉耳。
（第六十一旧同）难曰。经言望（形色）而知之谓之神（明）闻（声音）而知之谓之圣（通）问（情性）而知之谓
之工。（术）切脉（象状）而知之谓之巧。（伎）何谓也。然。望而知之者。望见其五色。（荣枯逆从）以知其病。（目视）
闻而知之者。闻其五音。（清浊高下）以别其病。（耳听）问而知之者。问其所欲五味。（好恶多少）以知其病所（发）起
所（居）在也。（意断）切脉而知之者。诊其寸口。（总寸关尺）视其（正）虚（邪）实。以知其病（旧本剩病一字今削
去）在何脏腑也。（心决）经言。以外（望闻）知之曰圣。以内（问切）知之曰神。此之谓也。（上文以神圣属望闻以工
巧系问切是揭神圣二字总结内外可见不拘四等分发之名）
按灵枢见色而知曰明。按脉而知曰神。问病而知之曰工。此篇分神圣工巧。以配望闻问切。大率文异旨同。所谓五
色五音五味五脉者。望闻问切之大要。而岂止是已。其形肉之肥瘠。皮肤之荣枯。骨节之大小。是亦望也。哭泣歌乐。
谵语呻吟。诀别懊 等情。是亦闻也。或有忧郁。或有爱憎。或有妒 。或有嫌疑之类。是亦问也。尺肤之寒热滑涩。
经脉之逆顺。是亦切也。凡此四诊者。无贵无贱。无长无少。未曾容阙一焉。苟失之。则不足以为工巧之业。况于神圣
之术乎。四诊之义谛。出内经诸篇。宜以参看。
（第六十二旧同）难曰。脏（阴经）井荣（兼俞经合三字）有五（穴）腑（阳经）独有六（穴）者。何谓也。然。
腑（经）者阳也。三焦（气）行于诸阳。（经脉）故置一俞。（非井荣俞之俞而穴俞之俞）名曰原。（穴）腑有六者。亦与
三焦（无形之腑）共一气也。
按此篇所问。五脏每经有井荣俞经合。六腑每经五穴之外。增一原。有六者。何也。其答意谓原者三焦气所过。而
凡刺诸十二经穴于手足四关之末。则必兼俞与原。以调三焦之气化。然其在阴经。则以俞为原。而阳经独别有原者。盖
三焦是六腑之配。而虽无其形。然五腑非此气。则何缘能得干施运化水谷乎。然则腑之为物。专赖此气之运用耳。故曰。
府有六者。亦与三焦共一气也。此下五篇。通言井荣俞经合之义。但每篇各异其趣读者错综以求其义。斯得其旨矣。
（第六十三旧同）难曰。十变（说见第三十四篇古书篇目内经今无所见仅存此经）言。五脏六腑荣合。（余三穴略之）
皆以井（穴）为始者。何也。然。井者东方春也。万物之始行。诸 行（有足）喘息。（有音） 飞（有羽）蠕动。（无
足○四种皆虫豸之属）当生之物。莫不以春（气）生。故岁数（四时）始于春。日数（十干）
始于甲。故以井为始也。
按承上文问脏腑每经在爪甲端诸穴。皆以名井。且为始者。何也。答意以谓凡有脏腑之病。内郁不达。心胸支满等
症。乃取诸井。总主开郁发生之治。故曰井者东方春也。万物始生。内经所谓标取而得之是也。诸 行喘息。 飞蠕动
等语。是皆举春阳升腾之时。蠢然振发者言。此以示诸井特为开发之治尔。故结之曰。岁数始于春。日数始于甲。
（第六十四旧同）难曰。十变又言。阴井（乙）木。阳井（庚）金。阴荣（丁）火。阳荣（壬）水。阴俞（己）土。
阳俞（甲）木。阴经（辛）金。阳经（丙）火。阴合（癸）水。阳合（戊）土。阴阳皆不同。（五行配合）其意何也。然。
是刚（夫）柔（妇）之事也。阴（经）井（穴）乙木。阳（经）井（穴）庚金。阳井庚。庚（阳）者乙（阴）之刚（夫）
This is caused by the stagnation and depression of Zang Qi (Visceral Qi). Human emotions typically involve likes and dislikes. When affected by external stimuli, the Zang Qi moves accordingly. If this movement adheres to proper moderation (Zhongjie), what harm could there be? However, if there is any deviation, the Zang Qi will shift, leading to dysfunction in transportation and transformation. Therefore, taking advantage of the deficiency in the viscera, pathogenic factors gather there. This is what is meant by "Lung disease transmitting to the Liver," where Lung pathogens attack the deficiency of the Liver. The classics state: "Deficient organs are susceptible to pathogens," which is precisely this principle. The Liver then wishes to transmit the pathogen to the Spleen, following its natural course. Yet, if the Spleen is not deficient at that time, the pathogen cannot enter, and transmission cannot occur. The classics state: "Excess organs do not accept pathogens," which is also this principle. The Liver again wishes to return the pathogen to the Lung, but the Lung does not accept it because of horizontal overcoming and a state of "not prevailing" (Shengbu). Consequently, the condition advances and retreats with difficulty, remaining and knotting to form an accumulation (Ji). Thus, in diseases of mutual overcoming, for example, if Metal overcomes Wood while Earth is prosperous (Earth generates Metal, aiding Metal in overcoming Wood), where can the Wood pathogen go? Therefore, it remains and knots in its own sector. Transmission among other Zang organs can be inferred by analogy. Scholars should not let words obscure the meaning but should infer the intent through understanding. Hua Shou's commentary on emotions, based on Neo-Confucian principles, is pedantic and detached from reality, and should not be followed.
(Volume 57, same as old edition) Question: How many types of Xie (Diarrhea/Loose Stools) are there? (Since there are many names for Xie, a question is raised.) Do they all have names? Answer: Yes, there are five types of Xie in total. (In summary) Their names differ. There is Wei Xie (Stomach Diarrhea), Pi Xie (Spleen Diarrhea), Dachang Xie (Large Intestine Diarrhea), Xiaochang Xie (Small Intestine Diarrhea), and Da Jia Xie (Great Mass Diarrhea), named Houzhong (Tenesmus). (Houzhong only appears when the five types of Xie become severe; Houzhong refers to Li [Dysentery]. Hua Shou notes that using Houzhong to cover Da Jia Xie is incorrect.) Wei Xie is (also known as Sun Xie / Undigested Food Diarrhea); food is not digested (undigested grains mixed with Wind); stool color is yellow (retaining the original color of Stomach Earth, thus easier to cure than the latter four types). Pi Xie is (also known as Ru Xie / Moist Diarrhea); abdominal distension and fullness (due to Dampness); diarrhea like pouring (obstructed and sluggish); vomiting immediately after eating (Ou means vomiting with sound, Tu means vomiting without sound, or both together). Dachang Xie is (also known as Dong Xie / Cavity Diarrhea); urgency and distress after eating (Cold in intestines and stomach); stool color is white (clear and foul-smelling); borborygmus (due to Cold pathogen); cutting pain (cramping and twisting, slightly more severe than the previous two, difficult to treat). Xiaochang Xie is (also known as Xue Xie / Bloody Diarrhea); urination is smooth (tong), but stool contains pus and blood (red and white mixed); lower abdominal pain (pain below the navel indicates Li/Dysentery). Da Jia Xie is (formed by knotted masses, also known as Chang Pi / Intestinal Dysentery); Li Ji Hou Zhong (internal urgency and tenesmus, painful obstruction); frequent trips to the toilet but inability to defecate (Da Bian); pain in the penis (urinary obstruction). These are the essential diagnostic methods for the five types of Xie.
According to the *Neijing*, Xie and Li are common. Sun Xie, Dong Xie, Ru Xie, Tang Jia Xie, and Bao Zhu Xia Po refer to Xie (Diarrhea). Chang Pi with blood, passing white foam, and passing pus and blood refer to Li (Dysentery). Bian Que simplified these, categorizing Stomach, Spleen, and Large Intestine into three types as Xie (Diarrhea), and Small Intestine and Da Jia into two types as Li (Dysentery). Xuanqi (Yellow Emperor and Qibo) called it Chang Pi, Zhang Zhongjing called it Zhixia (Stagnant Downward Flow), and their meanings are identical. Generally, it is called Wu Xie (Five Diarrheas). When Xie changes to include Houzhong, it becomes Li. Thus, Xie and Li share the same source but diverge. The *Suwen* states: "Downward discharge of undigested food is Sun Xie; prolonged cases become Chang Pi." This is correct. Xie mostly belongs to Cold patterns, while Li mostly belongs to Heat patterns. Furthermore, diarrhea and tenesmus have distinct differences. The *Lingshu* and *Suwen* describe various symptoms without systematic classification. Bian Que summarized them into Five Xie and prefixed the organ names to "Xie" to provide attribution. Regarding syndrome differentiation and treatment, this greatly benefits later generations. Later medical texts are numerous; classifications of Xie and Li vary widely, causing confusion. Scholars should focus on the fundamentals to master the principles.
(Volume 58, same as old edition) Question: How many types of Shanghan (Cold Damage) are there? (Summarizing the five types below.) Are there variations in pulse? (Hua Shou interprets "Bian" as differentiation, which is also valid.) Answer: Yes, there are five types of Shanghan. (Differentiating five syndromes): You Fengzhong (Wind Strike, Wind pathogen in the Wei level per Zhang Zhongjing); You Shanghan (Cold in the Ying level); You Shiwen (Body heaviness); You Rebing (Heat without aversion to cold); You Wenbing (Abnormal Qi of the four seasons). Their suffering differs. The pulse of Fengzhong: Yang position (Cun) is floating (external pathogen) and slippery (Wind); Yin position (Chi) is soggy and weak (internal disharmony). The pulse of Shiwen: Yang position (External) is floating and weak (Dampness); Yin position is small and urgent (Internal Cold). The pulse of Shanghan: Both Yin and Yang positions are vigorous (forceful) and tight (Cold) and choppy (pathogen in Blood). The pulse of Rebing: Both Yin and Yang positions are floating (internal and external heat); superficially slippery (pathogen excess); deeply scattered and choppy (Ying Qi disharmony). The pulse of Wenbing: Moves through various meridians; unknown which meridian is active. For the above five diseases, treat according to the location of the pathogen in the meridians. (A summary sentence; Hua Shou's inclusion of Wenbing here is incorrect.)
According to the *Neijing*: "All Rebing belong to the category of Shanghan." Thus, the term Rebing has a broader meaning. In discussing diseases, the *Neijing* only mentions transmission and Lianggan syndromes, not distinguishing five specific types, naming only Wen and Shu. Bian Que began discussing five types of Shanghan based on the *Re Lun* chapter of the *Neijing*. Since the *Neijing* did not mention pulses, Bian Que established disease names and pulses based on the pathogen received. Names are crucial for governance; if names are incorrect, speech is improper, and affairs fail. If medical practice fails, patients suffer. "How many types of Shanghan?" refers to etiological differentiation, i.e., the various Rebing mentioned in the *Neijing*. Among the five, "Shanghan" refers to true Shanghan. The other four (Wind, Heat, Warmth, Dampness) are "Lei Shanghan" (Shanghan-like), corresponding to "all belong to the category of Shanghan" in the *Neijing*. Although all are heat syndromes with similar suffering, they differ due to Yin/Yang, Exterior/Interior, and depth. The *Neijing* detailed transmission but did not distinguish five pathogenic types. Bian Que omitted symptom differentiation and focused on pulses to distinguish the five, providing a clear target for treatment. Zhang Zhongjing's *Shanghan Lun* expands on this. Scholars should examine this carefully.
Shanghan may heal with sweating (Exterior has pathogen) or cause death if purged (Interior has no pathogen). It may cause death with sweating (Exterior has no pathogen) or heal if purged (Interior has pathogen). Why? Answer: Yang deficiency (Righteous Qi forced outward, exterior weak, so pathogen resides there) and Yin excess (Interior Qi full, Righteous Qi strong). Sweating heals (hits the target); purging causes death (misses the target). Yang excess (Exterior Qi solid, no pathogen) and Yin deficiency (Pathogen entered Interior, Righteous Qi weak). Sweating causes death; purging heals.
Generally, treating Shanghan involves Sweating, Vomiting, and Purging methods. This text mentions only Sweating and Purging, omitting Vomiting. Perhaps because Cold pathogen in the Upper Jiao causes chest irritability, requiring vomiting. However, vomiting is rarely used. The *Neijing* states: "If less than three days, sweat it out. If more than three days, purge it." It never mentions vomiting. Thus, Bian Que omits it, focusing only on Sweating and Purging. "Yang deficiency, Yin excess" refers to pathogen in the Exterior; "Yang excess, Yin deficiency" refers to pathogen in the Interior. However, applying this to general cases is difficult to justify. Why? "Yang/Yin deficiency" refers to the site of pathogen aggregation. "Yin/Yang excess" refers to Righteous Qi being predominant. Thus, "deficiency" implies Righteous Qi is weak, and "excess" implies Meridian Qi is strong. Wang Kunshan said: "Cold pathogen invading externally—is this not Yin excess and Yang deficiency? Heat pathogen blazing internally—is this not Yang excess and Yin deficiency?" This is plausible but flawed. Zhang Zhongjing said: "Guizhi Tang enters the throat, and if Yang is excess, death ensues; Chengqi Tang enters the stomach, and if Yin is excess, death ensues." This is elliptical; the meaning is consistent. Hua Shou’s note interpreting Yin/Yang as Exterior/Interior captures the essence, citing *Waitai Miyao*: "Exterior disease, Interior harmony; Interior disease, Exterior harmony." However, "Harmony" and "Excess" are not interchangeable. Using "deficiency" to denote the site of pathogen excess is acceptable, but using "excess" to denote harmonious Qi is not. "Excess" implies no pathogen, but compared to "Harmony," it is still surplus. Hence, Bian Que uses "Excess" rather than "Harmony." The classic states: "Pathogen excess is Excess (Shi); Essence depletion is Deficiency (Xu)." This is another perspective. Wang interpreted Yang/Yin deficiency as deficiency of Yang/Yin meridians, and Yang/Yin excess as Yang-Heat/Yin-Cold pathogens, splitting the meaning of Yin/Yang, which seems contrary to parallel structure. Listed here for scholarly deliberation.
How to observe Cold-Heat diseases? Answer: Pi Hanre (Skin Cold-Heat): Skin cannot touch the mat (*Lingshu* says "attach"), hair burns, nose dries, no sweat. (Take Luo-connecting points of Three Yang to tonify Hand Taiyin). Ji Hanre (Muscle Cold-Heat): Skin/muscle pain, lips/tongue dry, no sweat. (Reduce Three Yang below to remove blood, tonify Taiyin to induce sweat). Gu Hanre (Bone Cold-Heat): Restless, sweat pours continuously, root of teeth hurts. (*Lingshu* says: if teeth not decayed, take Shaoyin Luo in thigh; if decayed, incurable).
This section appears in *Lingshu* Chapter 21. Bian Que appended it because Shanghan must be understood through Cold-Heat patterns to gauge suffering and pathogen depth. Pathogen in Skin: cannot touch mat, no sweat. Pathogen in Muscle: dry lips/tongue, no sweat. Pathogen in Bone: continuous sweat, tooth root pain. Exterior is governed by Heart/Lung; Middle by Spleen/Stomach; Interior by Kidney/Liver. This is why Bian Que excerpted ancient classics. Hua Borren thought it referred to internal Cold-Heat; Wang Wenjie thought external Cold-Heat. Both are incorrect.
(Volume 59, same as old edition) Question: How to distinguish Kuang (Mania) and Dian (Epilepsy/Melancholia)? Answer: Kuang onset: sleeps little (Yang excess, Yin deficiency), not hungry (Stomach pathogen excess), considers oneself noble/worthy, claims wisdom, acts arrogantly (these three reflect Kuang Qi dynamics), laughs wildly (Excess Fire), loves singing/joy (Slow Earth), walks aimlessly (Yang meridians of hands/feet, pathogen extreme). This is Kuang. Dian onset: unhappy mood (Yin excess, Yang deficiency), stiff collapse (Spine rigid, Yin-Yang conflict), staring straight ahead (Eyes fixed). This is Dian. (These two characters were erroneously placed at the end in old editions; the phrase "pulse three parts both excess" belongs to Dian, so moved here per context). Pulse: All three parts (Cun, Guan, Chi) show Yin and Yang excess. (General pulse for both; specifically, Yin excess in three parts is Dian pulse; Yang excess is Kuang pulse).
*Lingshu* lists many Dian/Kuang types. Dian: First unhappy, heavy head/pain, eyes red/upturned, heart vexation, pulling mouth/crying, panting/palpitations, first stiff/back pain. Also Jin Dian Ji (Tendon Dian), Mai Dian Ji (Vessel Dian). Kuang: First sad/happy/amnesia, angry/fearful, from worry/hunger; sleeps little, not hungry, thinks self noble/wise/honored, curses day/night; wild talk, startled, laughs, sings, walks aimlessly, from great fright; sees/hears things, calls out, from Qi deficiency; eats much, sees ghosts, smiles inwardly, from great joy. This text cites only one or two items to simplify and highlight Yin/Yang distinction. The *Nanjing* generally presents broad principles, as Pang Anchang noted ("leads but does not exhaust"). Compared to *Lingshu*, this text is even simpler, helping identify the root of hundred diseases. Disease variations are many, but Yin/Yang and Deficiency/Excess are paramount. Distinguishing Yin/Yang in Kuang/Dian prevents therapeutic errors. Bian Que omitted details to focus on Yin/Yang, guiding students to trace roots. This is ancient wisdom.
(Volume 60, same as old edition) Question: Head and Heart diseases have Jue Tong (Rebellious Pain) and Zhen Tong (True Pain). What does this mean? Answer: Hand-Foot Three Yang meridians receive Wind-Cold, lingering and ascending, named Jue Tou Tong (Rebellious Headache). If entering and lingering in Brain Sea (deep/severe pain), named Zhen Tou Tong (True Headache) (Hand-foot cold to joints, hard to treat). Five Zang Qi interfere with each other, named Jue Xin Tong (Rebellious Heartache) e.g., Dong Yuan's Lung/Heart/Kidney pain (has treatments). If pain is severe, localized to Heart, hands/feet blue (*Lingshu* says Qing), named Zhen Xin Tong (True Heartache). True Head/Heartache: Morning onset, evening death; Evening onset, morning death (no treatment).
Head/Heart pain has Jue and Zhen. Jue means pathogen travels from elsewhere to cause pain; Zhen means pathogen stays directly causing severe pain. Jue pain often accompanies other diseases; Zhen pain occurs alone, life-threatening, hard to treat. Three Yang meridians reach head/face; pathogen stagnation rebels upward causing headache. If entering Brain Sea and lingering, death ensues. Five Zang meridians circulate around heart/chest; pathogen interference rebels to heart causing pain. If directly in Heart, severe pain, cold extremities, death ensues. *Lingshu* lists six Jue Headaches (Six Yang meridians) and five Jue Heartaches (Lung/Kidney/Spleen/Stomach pathogenesis). Treatment is detailed elsewhere; this text shows the root.
(Volume 61, same as old edition) Question: Classics say: "Seeing and knowing is Shen (Divine); Hearing and knowing is Sheng (Sage); Asking and knowing is Gong (Skilled); Palpating and knowing is Qiao (Clever)." What does this mean? Answer: Seeing and knowing: Observe Five Colors (Prosperity/Decline/Reverse/Compliance) to know disease (Eye). Hearing and knowing: Listen to Five Tones (Clear/Turbid/High/Low) to distinguish disease (Ear). Asking and knowing: Ask about desired Five Flavors (Likes/Dislikes/Quantity) to know disease origin/location (Mind). Palpating and knowing: Diagnose Cun Kou (Total Cun/Guan/Chi), view Deficiency/Excess to know affected Zang/Fu (Heart Decision). Classics: Knowing via Exterior (See/Hear) is Sheng; Knowing via Interior (Ask/Palpate) is Shen. (Previous text linked Sheng/Shen to See/Hear and Gong/Qiao to Ask/Palpate, summarizing Exterior/Interior, showing names are not rigidly fixed to four levels).
*Lingshu* says seeing is Ming, palpating is Shen, asking is Gong. This text aligns Sheng/Gong/Qiao with See/Hear/Ask/Palpate. Text differs, intent same. Five Colors/Tones/Flavors/Pulses are essentials of Four Diagnoses, but not limited to them. Flesh/skin/bone observation is See; Crying/singing/groaning is Hear; Emotions/Jealousy/Suspicion is Ask; Chi skin temperature/pulse smoothness is Palpate. All four diagnoses are indispensable regardless of status/age. Omission leads to failure in skill, let alone divinity. Four Diagnoses originate from *Neijing*; consult those chapters.
(Volume 62, same as old edition) Question: Zang (Yin meridians) have Jing-Rong (plus Shu-Jing-He) five acupoints; Fu (Yang meridians) have six. Why? Answer: Fu is Yang. Sanjiao Qi flows through Yang meridians, so one additional point is set, named Yuan (Source). Fu has six points, sharing Qi with Sanjiao (Formless Fu).
Question: Why do Zang have five points per meridian, while Fu have six (adding Yuan)? Answer: Yuan is where Sanjiao Qi passes. Needling the Four Gates requires using Shu and Yuan to regulate Sanjiao Qi. Yin meridians use Shu as Yuan; Yang meridians have separate Yuan. Sanjiao pairs with Six Fu. Though formless, Five Fu rely on this Qi for digestion/transport. Thus, Fu depend on this Qi. Hence, "Fu has six, sharing Qi with Sanjiao." The next five chapters discuss Jing-Rong-Shu-Jing-He, each with unique focus. Readers should synthesize to grasp the essence.
(Volume 63, same as old edition) Question: *Shibian* (see Ch. 34, *Neijing* lost, only in *Nanjing*) says Zang/Fu Jing-Rong-He all start with Jing. Why? Answer: Jing corresponds to East/Spring. Beginning of all things. Crawling, breathing, flying, moving creatures—all born in Spring. Year starts in Spring, Day stems start with Jia. Thus, Jing is first.
Continuing: Why are nail-bed points named Jing and considered first? Answer: For internal stagnation, chest fullness, etc., Jing points are used to open stagnation and generate Qi. "Jing is East/Spring, beginning of all things." *Neijing* says "biao" points achieve this. Creatures stirring in Spring demonstrate Jing's opening function. Thus, "Year starts in Spring, Days start with Jia."
(Volume 64, same as old edition) Question: *Shibian* says: Yin Jing (Yi) Wood, Yang Jing (Geng) Metal; Yin Rong (Ding) Fire, Yang Rong (Ren) Water; Yin Shu (Ji) Earth, Yang Shu (Jia) Wood; Yin Jing (Xin) Metal, Yang Jing (Bing) Fire; Yin He (Gui) Water, Yang He (Wu) Earth. Yin/Yang Five Elements differ. Why? Answer: This is Gang (Husband) and Rou (Wife) relationship. Yin Jing Yi Wood, Yang Jing Geng Metal. Yang Jing Geng, Geng (Yang) is the Gang (Husband) of Yi (Yin)...