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[Ping An]: This chapter, from beginning to end, is found in *Su Wen* (Basic Questions), Volume 12, Chapter 45 "Jue Lun" (Treatise on Jue), also in *Jia Yi Jing* (The Classic of A-Bio Points), Volume 7, Chapter 3, and in *Chao Shi Bing Yuan* (Source of Diseases by Master Chao), Volume 12, "Cold-Heat Disorders · Cold-Heat Jue Disorder". The only difference is the slight variation in the order of arrangement.

Huang Di asked Qi Bo: What is the cause of cold and heat manifestations in Jue syndrome? (Jue refers to the rebellion of Qi movement. When Qi moves rebelliously, it can manifest as cold or heat; thus, it is called Cold-Heat Jue. In the ninth month, Yin Qi begins to rise; if Qi rebels, disease occurs. Ping An: In Yang Shangshan's note, "Qi loses its normal direction" is written as "movement" in the Yuan edition.) Qi Bo replied: When Yang Qi is deficient in the lower part (the feet), Cold Jue occurs; when Yin Qi is deficient in the lower part (the feet), Heat Jue occurs. (The "lower part" refers to the feet. If Yang Qi in the feet is deficient, Yin Qi takes advantage of this deficiency to invade, causing coldness in the feet, which is named Cold Jue. If Yin Qi in the feet is deficient, Yang Qi takes advantage of this deficiency to invade, causing heat in the feet, which is named Heat Jue.)

Huang Di said: Why does the heat sensation in Heat Jue always start from the sole of the foot? (Does the rebellious Qi of cold and heat originate in the feet, causing heat there, rather than originating from the top of the foot? Why?) Qi Bo replied: The Qi of the Yang meridians originates at the lateral aspect of the five toes, gathers at the sole, and generates heat at the center of the foot; therefore, when Yang is predominant, the sole becomes hot. (The lateral aspect of the five toes belongs to Yang. The center of the foot belongs to Yin. Yang Qi originates from the exterior to warm the sole. Now, due to Yin deficiency and Yang excess in the sole, heat is generated, named Heat Jue. Ping An: *Su Wen* reads "Yang Qi originates from the lateral aspect of the five toes of the foot." The New Correction states: "*Jia Yi Jing* reads 'Yang Qi originates from the foot' and 'walks to the foot'; 'originate' should be 'walk'. The current version of *Jia Yi Jing* still uses 'originate'. According to the three Yang meridities of the foot, they walk from the head to the foot, so 'walk' is more appropriate. Also, *Su Wen* and *Jia Yi Jing* have the characters 'Yin Mai Zhe' (meridians of Yin) after 'biao' (surface/lateral); and the character 'Re' (heat) is written as 'Ju' (gather) in *Jia Yi Jing*, and also in *Chao Shi Bing Yuan*. In the note, the character 'Zhe' in 'Biao Zhe' is missing in the Yuan edition. In the current text, the character 'Jin' (now) in 'Jin Zu Xia' is written as 'Ling' (make/cause) in the Yuan edition.)

Huang Di said: Why does the coldness in Cold Jue always start from the five toes and extend upward to below the knee? Qi Bo replied: The Qi of the Yin meridians originates at the medial aspect of the five toes, gathers below the knee, and accumulates above the knee; therefore, when Yin is predominant, coldness extends from the five toes to above the knee. This coldness does not come from the exterior but is generated internally from within. Huang Di said: Well said. (The medial aspect of the five toes belongs to Yin. From below the knee to above the knee belongs to Yang. Now, due to Yang deficiency and Yin excess, coldness occurs above and below the knee. This coldness does not come from outside but arises from the medial aspect of the five toes, where cold Qi ascends to cause coldness. Ping An: The character 'Bi' (must) in 'Bi Cong' is missing in the Yuan edition. "Starts and goes up below the knee" in *Su Wen* and *Jia Yi Jing* is written as "and goes up to the knee". Also, *Su Wen* writes "all from internal cold", with "Han" (cold) as "Ye" (particle); *Jia Yi Jing* has no "Han"; *Chao Shi Bing Yuan* writes "all from internal cold", same as this book.)

Huang Di said: What loss or error leads to Cold Jue? (Jue means loss. Where does the rebellious Qi of cold lose its proper course, causing coldness in the hands and feet?) Qi Bo replied: The anterior yin (genitals) is the gathering place of the Zong Jin (major sinews/tendons) and the convergence point of the Tai Yin and Yang Ming meridians. In spring and summer, Yang Qi is abundant and Yin Qi is scarce; in autumn and winter, Yin Qi is abundant and Yang Qi is scarce. (The anus is the posterior yin, and the genitals are the anterior yin. "Zong" means total/gathering. The major sinews of the body gather to form the anterior yin. The Hand Taiyin Lung meridian connects with the Large Intestine and follows the stomach opening; the Foot Taiyin Spleen meridian connects with the Stomach; the Hand Yangming Large Intestine meridian belongs to the Large Intestine; the Foot Yangming Stomach meridian belongs to the Stomach. The meridities of the hand and foot, both Yin and Yang, all govern water and grain essence, jointly using the Qi of water and grain to nourish various sinews. Therefore, the Foot Taiyin, Foot Shaoyin, Foot Jueyin, and Foot Yangming meridities all converge at the genitalia to form the Zong Jin. Thus, the Zong Jin is the convergence of the Taiyin and Yangming meridities. Spring and summer belong to Yang, so the Foot Yangming meridian is vigorous in these seasons; autumn and winter belong to Yin, so the Foot Taiyin meridian is vigorous in these seasons. Ping An: "Anterior yin is the gathering place of Zong Jin" in *Jia Yi Jing* is written as "Jueyin is the gathering place of many sinews". The New Correction of *Su Wen* states: "*Jia Yi Jing* reads 'Jueyin is the gathering place of many sinews'. Quan Yuanqi says: 'Anterior yin is Jueyin.' This differs from Wang Bing's note but is another valid interpretation. *Chao Shi Bing Yuan* lacks the character 'Qian' (anterior) before 'Yin'. The character 'Duo' (many) in 'Yang Qi Duo' is incomplete in the original manuscript; *Su Wen*, *Jia Yi Jing*, and *Chao Shi Bing Yuan* all use 'Duo', while the Yuan edition uses 'Sheng' (abundant). The character 'Shuai' (decline) in 'Yin Qi Shuai' is written as 'Shao' (few) in *Su Wen* and *Jia Yi Jing*.)

A person of robust constitution who overuses their vital energy during autumn and winter causes the Qi in the lower jiao to contend upwards without being able to recover. Essence and Qi overflow downwards, and pathogenic Qi follows it upward, stagnating in the middle. Yang Qi declines and cannot penetrate and nourish the meridians. Thus, Yang Qi is daily diminished, while Yin Qi remains alone, causing coldness in the hands and feet. (This person refers to one suffering from Cold Jue with cold hands and feet. Although physically strong, indulging desires during the season when Yang Qi is weak (autumn/winter) through excessive sexual activity causes damage, termed "depriving oneself of usage". Due to this deprivation, upper Yang becomes deficient, Yin contends upwards, harmony and recovery fail, essence and Qi overflow and become further depleted, and cold pathogenic Qi takes advantage of the deficiency to ascend and reside in the middle. With cold residing in the middle, Yang Qi becomes deficient. Yang Qi, which is Wei Qi (Defensive Qi), circulates outside the vessels, penetrating and irrigating the meridians to nourish the body. With cold pathogen residing above, Wei Qi is daily diminished, and Yin Qi acts alone, causing cold hands and feet, named Cold Jue. Ping An: "Wei Neng Fu" (unable to recover) in *Su Wen* is written as "Bu Neng Fu" (cannot recover). "Qie Cong Zhi Er Shang" (and follows it upward) in *Su Wen* and *Chao Shi Bing Yuan* has "Qie" as "Yin" (because); *Jia Yi Jing* writes "Cong Zhi Er Shang Zhi". "Qi Ju Yu Zhong" (Qi resides in the middle) in *Jia Yi Jing* is written as "Suo Zhong" two characters.)

Huang Di said: What about Heat Jue? Qi Bo replied: When wine enters the stomach, the Luo vessels (collaterals) become full while the Jing vessels (main channels) become empty. The Spleen is responsible for transporting fluids for the Stomach. If Yin Qi is deficient, Yang Qi enters; if Yang Qi enters, the Stomach becomes disharmonious; if the Stomach is disharmonious, essence and Qi are exhausted; if essence and Qi are exhausted, they cannot nourish the four limbs. (Wine is a hot liquid; upon drunkenness, wine first enters and fills the Luo vessels, making the Jing vessels empty. The Spleen originally transports fluids for the Stomach to irrigate the four Zang organs. Now, wine and food first fill the Luo vessels, causing Spleen Yin deficiency. Spleen Yin deficiency leads to Spleen Meridian deficiency. Once the Spleen Meridian is deficient, Yang Qi invades. When Yang Qi gathers in the Spleen, grain essence and Qi are exhausted. When grain essence and Qi are exhausted, the four limbs are not nourished. Yang pathogen acts alone, causing heat in the hands and feet.)

Such a person must frequently drink until drunk or engage in sexual activity immediately after eating. Qi gathers in the Spleen and fails to disperse. The Qi of wine and the Qi of grain fight each other, generating heat in the interior. Thus, heat pervades the body, causing internal heat and dark urine. The Qi of wine is vigorous and fierce. If Kidney Qi declines, Yang Qi becomes predominant alone, causing heat in the hands and feet. (This specifically explains the origin of the disease. This person refers to one suffering from Heat Jue with hot hands and feet, who has been intoxicated multiple times and eaten to fullness, engaging in sexual activity before the wine and grain are digested. Qi gathers in the Spleen, and the two types of Qi fight, generating internal heat that pervades the exterior. Both interior and exterior are hot, Kidney Yin declines internally, and Yang Qi dominates externally, causing heat in the hands and feet, named Heat Jue. Ping An: "Ci Ren Bi Shu Zui" (This person must frequently get drunk), the character "Bi" is missing in the Yuan edition. *Su Wen* and *Jia Yi Jing* write "Bao Yi" (after fullness) instead of "Bao Yi" (already full); "Wei De San" as "Bu De San"; "Xiang Bo" as "Xiang Bo" (thin/conflict); *Chao Shi Bing Yuan* writes "Xiang Bing" (combine). "Re Yu Zhong" (heat in the middle) in *Su Wen* is "Re Sheng Yu Zhong" (heat is abundant in the middle); *Jia Yi Jing* lacks these three characters; *Chao Shi Bing Yuan* writes "Re Qi Yu Nei" (heat rises from inside). "Gu Nei Re Ni Chi" (thus internal heat and red urine) in *Su Wen* and *Jia Yi Jing* is "Nei Re Er Ni Chi"; *Chao Shi Bing Yuan* writes "Niao" (urine) instead of "Ni". "You Shuai" (has decline) in *Jia Yi Jing* is "Ri Shuai" (daily decline); *Su Wen* and *Chao Shi Bing Yuan* both write "You Shuai", while the Yuan edition writes "Ri Shuai".)

Huang Di asked: Jue syndrome sometimes causes abdominal fullness, sometimes sudden unconsciousness, and sometimes consciousness returns after half a day or even a full day. Why is this? (Abdominal fullness and unconsciousness are both attributed to rebellious Qi loss, hence called Jue. Please explain the reason.) Qi Bo replied: When Yin Qi is abundant in the upper part, the lower part becomes deficient. Lower deficiency leads to abdominal fullness. (Upper refers to the heart and abdomen. Lower refers to the feet. Upper Yang is not devoid of Yin, and lower Yin is not devoid of Yang; this is the normal state of Qi. Now, Yin Qi surges abundantly in the upper part, causing lower deficiency, hence abdominal fullness. Ping An: *Jia Yi Jing* lacks the character "Zhang" (fullness). *Chao Shi Bing Yuan* adds "Ci You" (this is because) before "Yin Qi" and lacks the fourteen characters from "Ze Xia Xu" to "Yang Qi Sheng Yu Shang" in the next section.) When Yang Qi is abundant in the upper part, the Qi from the lower part repeatedly ascends, and pathogenic Qi rebels. Rebellion causes Yang Qi to become chaotic; chaos leads to unconsciousness. Huang Di said: Well said. (The heart and abdomen belong to Yang. The Yang Qi from the lower part repeatedly ascends to the heart and abdomen, constituting rebellious and chaotic pathogenic Qi, hence unconsciousness. Ping An: "Yang Qi Sheng Yu Shang" in *Jia Yi Jing* is written as "Fu Man" (abdominal fullness), with a note stating: "*Su Wen* reads 'Yang Qi Sheng Yu Shang'." The New Correction of *Su Wen* states: "One should follow the explanation of *Jia Yi Jing*. Why? Another source in *Jia Yi Jing* states: 'Yang meridians sink downward, Yin meridians contend upward, resulting in Corpse Jue.' How can Yin Qi be abundant in the upper part and then Yang Qi also be described as abundant in the upper part? Furthermore, Zhang Zhongjing stated: 'When the Shaoyin pulse is absent, Kidney Qi is weak, essence and blood are scant, rushing Qi presses urgently, ascending into the chest and diaphragm, Zong Qi reverses and gathers, blood knots below the heart, Yang Qi retreats downward, heat returns to the inner thighs, interacting with Yin, causing insensibility of the body, this is Corpse Jue.' Zhongjing mentions Yang Qi retreating downward, indicating that Yang Qi cannot be abundant in the upper part. Therefore, we know we should follow *Jia Yi Jing*." This book agrees with *Su Wen* and disagrees with *Jia Yi Jing* and *Chao Shi Bing Yuan*, so it is preserved here for further study.)