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[Ping An]: This chapter, from beginning to end, is found in *Ling Shu* (Spiritual Pivot), Volume 12, Chapter 80, "Da Huo Lun" (Treatise on Great Confusion). Furthermore, the section from the beginning to "shen zhe wei huo" (severe cases are called confusion) is found in *Jia Yi Jing* (Essential Classic of Jia Yi), Volume 12, Chapter 4; the section from "ren zhi xi wang zhe" (those who easily forget) to "gu bu shi shi ye" (therefore they do not desire food) is found in *Jia Yi Jing*, Volume 12, Chapter 1; and the section from "bing er bu de wo chu zhe" (illness where one cannot lie down and sleep) to the end is found in *Jia Yi Jing*, Volume 12, Chapter 3. The arrangement differs slightly.

Yellow Emperor asked Qi Bo: I once ascended the Qing Leng Terrace. When I reached the middle of the stairs and looked back, or crawled forward, I felt dizzy. I privately found this strange and secretly wondered about it internally. Even with eyes closed, looking alone, calming the mind, and stabilizing the qi, for a long time I could not resolve it. I turned my eyes alone and felt vertigo, let my hair down, knelt upright, and looked down, but after a long time the condition did not cease. It suddenly stopped on its own. What qi causes this? (Small strangeness is called yi zhi, great strangeness is called guai zhi. Ming refers to closing the eyes. Fu er shi zhi means looking down straight ahead. He qi shi ran asks for the cause of generating confusion. Zhuan you wei chuan, xuan you wei cui, meaning measurement error. Leng has some versions as ling ye. Ping An: In *Ling Shu*, "chang deng" is written as "chang shang", "kuang ming" as "du ming", "du zhuan" as "du chuan", "zi zhi" as "zi shang". In *Jia Yi Jing*, "Qing Leng zhi tai" is written as "Qing Xiao zhi tai", "zhong jie" as "zhong bi", "er gu" as "er huo", without the fourteen characters from "pu fu" to "guai zhi", "du ming du shi" as "du ming shi zhi", without the four characters "du zhuan du xuan" above "bei fa", and "hou jiu zhi bu yi" as "jiu bu yi three characters".)

Qi Bo replied: The essence qi of the five zang organs and six fu organs all ascend and pour into the eyes to form the eye's essence. (The fluids of the five zang and six fu organs, and the clear part of the organ qi, ascend to focus on the eyes, serving as the eye's essence. Ping An: *Jia Yi Jing* lacks the character "jie".) The gathering point of the essence forms the eyeball. (The gathering point of the essence is called the eye. Guo sounds like ke. Ping An: In *Ling Shu*, "guo" is written as "ke", without the character "zhe". In *Jia Yi Jing*, "guo" is written as "guo".) The essence of bone forms the pupil. (Kidney essence governs bone; the essence qi of bone becomes the pupil of the eye.) The essence of tendon forms the black part of the eye. (Liver essence governs tendon; the qi of tendon serves as the black essence of the eye.) The essence of blood forms the collaterals. (Heart essence governs blood; the qi of blood serves as the red collaterals of the eye essence.) The qi of the lung forms the white part of the eye. (Lung essence governs qi; the qi of lung serves as the white part of the eye. Ping An: In *Ling Shu*, "guo" is written as "ke"; in *Jia Yi Jing*, "qi guo" is written as "qi luo", and "bai yan" as "bai jing".) The essence of muscle forms the binding and wrapping of the eyelids. (Spleen essence governs flesh; the qi of flesh serves as the binding and wrapping of the eye. Xie, pronounced hu jie fan. Ping An: In *Jia Yi Jing*, "xie" is written as "qi".) The essence of bone, tendon, blood, and qi, combined with the vessels, forms the eye system (mu xi), which connects upward to the brain and exits posteriorly through the neck. (The four essences of qi combine with the vessels to form the eye system; its system connects upward to the brain and exits posteriorly through the neck.) Therefore, if pathogenic factors strike the neck, and coincidentally the body is deficient, if the invasion is deep, it follows the eye system into the brain. Then the brain rotates, the brain rotation pulls the eye system, the eye system becomes tense, and tension leads to dizziness and vertigo. (Posteriorly called xiang, anteriorly called jing. Because the eye system enters the brain, pathogenic factors follow the eye system, causing brain rotation and dizziness. Ping An: In *Jia Yi Jing*, "xiang" is written as "tou", "yin" as "mu". In *Ling Shu*, "ru yu nao" repeats "ru yu nao" three times below; *Jia Yi Jing* repeats the character "ru". "Mu xi mu xi ji ji" in *Ling Shu* and *Jia Yi Jing* is written as "mu xi ji mu xi ji".) If pathogenic factors strike the essence, and the struck parts are not harmonious, then the essence scatters. When the essence scatters, vision becomes double, so one sees two objects. (Five essences combine to form the eye. If pathogenic factors strike the essence, the five essences cannot harmonize, leading to abnormal vision, thus seeing double, as described in the second question, etc. Ping An: "Xie zhong qi jing" in *Ling Shu* is written as "xie qi jing qi jing" five characters; *Jia Yi Jing* writes "xie zhong zhi qi jing ze qi jing". Yuan edition mistakenly wrote "jing" as "jing", and the note also erred.) The eyes are the gathering place of the essence of the five zang and six fu organs, where Ying and Wei qi, Hun and Po constantly circulate, and Shen qi is generated. Therefore, when Shen is overworked, Hun and Po scatter, and Zhi and Yi become chaotic. (The existence of the eyes depends on three things: first, formed by the essence of the five zang and six fu organs; second, circulated by Ying, Wei, Hun, Po, and blood qi; third, generated by Shen Ming qi. Thus, Shen is the root. Therefore, when Shen is overworked, the Hun, Po, Zhi, Yi, and the five spirits all become chaotic.) Hence, the pupil and the black part of the eye follow Yin, while the white part and red collaterals follow Yang. Therefore, Yin and Yang combine and transmit to maintain clarity. (Thus, bone essence pupil and tendon essence black part are the essence of Liver and Kidney, hence following Yin. Lung essence white part and blood red collaterals are the essence of Heart and Lung, hence following Yang. Although Lung belongs to Shaoyin, it is still within Yang, hence considered Yang. These four Yin-Yang essences harmonize and merge, transmitting through qi, hence called Jing Ming. Ping An: In *Jia Yi Jing*, "bai yan" is written as "bai jing", "he chuan" as "he chuai", with note: *Ling Shu* writes "chuan".) The eyes are the messengers of the Heart, and the Heart is the residence of Shen. Therefore, when Shen scatters and essence becomes chaotic and cannot transmit, suddenly seeing unusual places, the Spirit, Hun, and Po scatter and do not coordinate, hence called Huo (Confusion). (The Heart storehouse refers to the internal form of the Heart. The Heart is the function of Shen, and Shen is the master of the Heart. Therefore, when Shen is overworked and scattered, the five essences become chaotic and cannot transmit, suddenly seeing two unusual objects, because spiritual chaos is called Huo. Ping An: "Chuan" in *Ling Shu* is written as "zhuan", in *Jia Yi Jing* as "chuai", note: one version writes "zhuan".)

Yellow Emperor said: I doubt this. Every time I go to Dong Yuan, I always feel confused/dizzy. When I leave, it returns to normal. Am I the only one whose Shen is overworked at Dong Yuan? Why is it so different? (Qing Leng Terrace is in Dong Yuan, so every time I ascend the terrace there I feel confused/dizzy, and leaving the terrace restores normalcy. Is it not because that Dong Yuan overworks the Shen, leading to confusion? This is what is strange.)

Qi Bo said: No. The Heart has preferences, and Shen has aversions. Sudden mutual interaction causes Essence Qi to become chaotic, visual errors occur, hence confusion. When Shen shifts back to normal, it recovers. (The Heart is the function of Shen, called Qing. What Qing likes is called Yu (desire). Thus, the rise of Qing and desire is what Shen dislikes; what Shen likes is what the Heart dislikes. Therefore, nourishing Shen requires removing Qing and desire. When desire is removed, Shen is peaceful, leading to long life and clear vision. Acting according to the Heart results in myriad desires; when desires are severe, they harm Shen and life. These two cannot proceed together. Mutual interaction when proceeding together causes Qing chaos leading to confusion; if one can achieve Shen shifting back to the origin, confusion resolves and Shen recovers. Ping An: "Zu ran xiang gan" in *Ling Shu* and *Jia Yi Jing* writes "gan" as "huo". Note: "Bing xing xiang gan", Yuan edition mistakenly wrote "gan" as "huo".) Therefore, mild cases are called Mi (Lost/Confused), and severe cases are called Huo (Great Confusion). Yellow Emperor said: Good. (Xian means mild. Shen means severe. This is the first type of Huo pathogen.)

Yellow Emperor said: Why do people easily forget things? What qi causes this? Qi Bo said: Upper Qi is insufficient, Lower Qi is excessive. The intestines and stomach are full, while the Heart and Lungs are deficient. Deficiency causes Ying and Wei qi to remain in the lower part for a long time, unable to ascend in time, hence prone to forgetting. (Heart and Lung deficiency means Upper Qi insufficiency. Intestine and Stomach fullness means Lower Qi excess. Ying and Wei qi circulate and remain in the intestines and stomach without ascending; Heart and Lung deficiency leads to forgetting. When it ascends again, one does not forget. This is the second type of Xi Wang pathogen. Ping An: "Xi wang" in *Ling Shu* and *Jia Yi Jing* is written as "shan wang". *Ling Shu* has the character "zhi" after "jiu".)

Yellow Emperor said: Why do people easily feel hungry but lack appetite? What qi causes this? Qi Bo said: Essence Qi merges into the Spleen, and hot qi remains in the Stomach. Stomach heat digests food quickly; since food is digested quickly, one feels hungry easily. Stomach Qi rebels upward, causing cold in the gastric tube; gastric cold leads to lack of appetite. (Essence Qi refers to Yin Qi. The Yin Qi of the Stomach merges into the Spleen, making the Stomach independently hot, hence digesting food and feeling hungry easily. Stomach Qi is independently hot, rebelling upward is difficult, hence the gastric throat is cold, leading to inability to eat. This is the third type of Bu Shi Shi pathogen. Ping An: *Ling Shu* and *Jia Yi Jing* write "xi ji" as "shan ji", and "wei guan" as "wei wan".)

Yellow Emperor said: Why do people suffer from illness and cannot lie down to sleep? What qi causes this? Qi Bo said: Wei Qi cannot enter Yin, remaining constantly in Yang. Remaining in Yang makes Yang Qi full; fullness makes the Yang Qiao vessel vigorous. Unable to enter Yin, Yin Qi is deficient, hence the eyes cannot close for sleep. (Wei Qi travels twenty-five cycles in Yang meridians during the day and twenty-five cycles in the five Zang organs at night, totaling fifty cycles around the body day and night. If Wei Qi travels in Yang meridians and does not enter Zang Yin, Yang meridians become vigorous, Yang Qiao becomes vigorous and unharmonious, and Yin Qiao is deficient. Both Qiao vessels reach the eyes; thus Yang excess prevents eye closure, hence no sleep. This is the fourth type of Bu De Wo pathogen. Ming sounds like mian. Ping An: *Ling Shu* lacks the character "chu" after "wo", suspected to be an interpolation. *Jia Yi Jing* writes "ming" as "mian".)

Yellow Emperor said: Why do people suffer from illness and cannot open their eyes to see? What qi causes this? Qi Bo said: Wei Qi remains in Yin, unable to travel in Yang. Remaining in Yin makes Yin Qi vigorous; vigor makes the Yin Qiao vessel full. Unable to enter Yang, Yang Qi is deficient, hence the eyes close. (Wei Qi remaining in the five Zang organs makes Yin Qiao vigorous and unharmonious, having only Yin without Yang, hence eyes close and cannot see. Yang governs opening, Yin governs closing. This is the fifth type of Bu De Shi pathogen. Ping An: "Bing er mu" in *Ling Shu* is written as "bing mu er", in *Jia Yi Jing* as "mu bi" two characters; "liu" as "xing", "xing" as "ru", note: "*Jiu Juan* xing writes liu, ru writes xing.")

Yellow Emperor said: Why do people sleep excessively? What qi causes this? Qi Bo said: This person has large intestines and stomach, and tight skin, with intermuscular spaces not loose. Large intestines and stomach mean Wei Qi remains for a long time; tight skin means intermuscular spaces are not loose, so movement is slow. Wei Qi normally travels in Yang during the day and in Yin at night; thus when Yang Qi ends, one sleeps, and when Yin Qi ends, one wakes. Therefore, large intestines and stomach mean Wei Qi stays longer; tight skin and non-loose intermuscular spaces mean slow movement. Remaining in Yin for a long time, its qi becomes impure, leading to desire for sleep, hence excessive sleeping. Small intestines and stomach, smooth and relaxed skin, and loose intermuscular spaces mean Wei Qi remains in Yang for a long time, hence less sleeping. (If a person has large intestines/stomach and tight skin, largeness causes Wei Qi to stay, tightness causes slow Wei Qi movement; staying and slow movement make qi impure, hence excessive sleeping and little waking; conversely, less sleeping. This is the sixth type of Duo Wo pathogen. Ping An: "Se" in *Ling Shu* is written as "shi", in *Jia Yi Jing* as "se". "Bu jing" in *Ling Shu* is written as "bu qing". Note: "Duo wo xie" Yuan edition writes "xie" as "zhe".)

Yellow Emperor said: If it is not the regular meridians, but sudden excessive sleeping, what qi causes this? Qi Bo said: Pathogenic factors remain in the Upper Jiao, which closes and becomes blocked. After eating or drinking soup, Wei Qi instead remains in Yin and does not move, hence sudden excessive sleeping. (Pathogenic factors remaining in the Upper Jiao prevent Upper Jiao Qi from moving; due to diet, Wei Qi remains in Heart and Lung, causing stuffiness and excessive sleeping. This is the seventh pathogen. Ping An: "Wei fan liu" in *Ling Shu* is written as "Wei Qi liu jiu", in *Jia Yi Jing* as "Wei Qi jiu liu".)

Yellow Emperor said: Good. How to treat these various pathogens? Qi Bo said: First determine the affected Zang and Fu organs, correct minor faults, then regulate their Qi. Excess is treated with draining, deficiency with tonifying. One must first clearly know the suffering and comfort of Form and Qi, then select acupoints. (The method to treat these seven pathogens is to first select acupoints above the Zang and Fu organs, such as the Mu points of the five Zang and six Fu organs, to remove minor faults, then regulate the Five Shu and Six Shu points of the Zang and Fu organs for tonification and draining. Before tonification and draining, one must clearly know the emptiness/fullness and suffering/comfort of Form and Qi, then select acupoints. Ping An: "Xian qi fu zang" in *Ling Shu* is written as "xian qi zang fu", in *Jia Yi Jing* as "xian shi qi fu zang". "Xing Qi" in *Ling Shu* is written as "Xing Zhi".)