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Ping An: This section, from the beginning of the chapter to "swollen throat, treat the main disease," is found in *Suwen* (Basic Questions), Volume 12, Chapter 45, "Treatise on Jue" (Jue Lun). From "Jue of the Great Yang" to "take from the meridian," it is also found in *Jia Yi Jing* (The Systematic Classic of Acupuncture and Moxibustion), Volume 7, Chapter 3. From "Jue of the Foot Taiyin Meridian" to "swollen throat, treat the main disease," it is again found in *Jia Yi Jing*, Volume 4, Part 1, Middle Section. From "Kidney and Liver pulses both deep" to the end, it is found in *Suwen*, Volume 13, Chapter 48, "Treatise on Extraordinary Large Pulses" (Da Qi Lun), also in *Jia Yi Jing*, Volume 4, Part 1, Lower Section, and in this book, Volume 15, "Diagnosis of Five Zang Pulses." Additionally, from "Jue of the Great Yang" to "swelling with heat inside the shin," it is found in *Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang), Volume 12, "Various Syndromes of Cold and Heat Diseases · Syndrome of Cold and Heat Jue."

Yellow Emperor said: I wish to hear about the manifestations and pathological characteristics of Jue caused by the reversal of Qi movement in the six meridians. (Please explain the state where the Qi movement of the three Yin and three Yang meridians of the hands and feet reverses, leading to Jue. 'Neng' refers to the ability of Jue to cause disease. Ping An: In *Suwen*, there is no character 'Shi' before 'Jue'. Note regarding 'zhuang', the character 'Zhi' in Yuan edition is written as 'Ren'.) Qibo said: When the Great Yang (Taiyang) experiences Jue, there is heaviness in the head and pain in the heels, inability to walk, and sudden collapse. (Great Yang refers to Taiyang. Zhong refers to the foot. Shou refers to the head. The Foot-Taiyang meridian runs from the head to the foot; thus, when Taiyang Qi reverses, both the head and feet feel heavy. Due to this heaviness, walking is impossible. Both Hand and Foot Taiyang meridians enter the eyes, so the eyes shake during collapse. [Character], pronounced Hu Bian, means eye shaking. Ping An: Chao Shi writes 'Tai'. *Suwen* and *Jia Yi* write 'Zhong' as 'Zhong' (swelling). *Jia Yi* writes [Character] as 'Xuan' (dizziness).) When Yangming experiences Jue, there is mania, desire to run and shout, abdominal fullness preventing lying down, red and hot face, hallucinations, and delirious speech. (The Foot-Yangming meridian descends from the face into the abdomen to the foot; thus, when Yangming Qi reverses, mania, running and shouting, abdominal fullness preventing lying down, red and hot face, hallucinations, and delirious speech occur. These are all due to excessive heat in the Grain Qi of Yangming, invaded by pathogenic factors. Ping An: 'Cannot lie down' in *Suwen* and *Jia Yi* is written as 'Bu De Wo' (cannot lie down), in Chao Shi as 'Bu Wo' (does not lie down); two characters 'Wo Ze' appear before 'Mian Chi'.) When Shaoyang experiences Jue, there is sudden deafness, swollen and hot cheeks, hypochondriac pain, and inability to move the legs. (Both Hand and Foot Shaoyang meridians enter the ears; the Foot-Shaoyang meridian follows the cheek, descends to the hypochondrium, and then follows [Character] to the foot; thus, sudden deafness, swollen cheeks, hypochondriac pain, and immobility of the legs occur. Ping An: *Suwen*, *Jia Yi*, and Chao Shi all write [Character].) When Taiyin experiences Jue, there is abdominal fullness and distension, difficulty in defecation, loss of appetite, vomiting after eating, and inability to sleep. (The Foot-Taiyin Spleen meridian governs the intestines and stomach in the abdomen; thus, when Taiyin meridian Qi reverses, abdominal fullness, difficulty in defecation, anorexia, vomiting, and insomnia occur. Ping An: In the note, 'Chang Wei' (intestines and stomach) is written as 'Fu Wei' (abdominal stomach) in Yuan edition.) When Shaoyin experiences Jue, there is dry tongue, red urine, abdominal fullness, and heart pain. (Hand-Shaoyin connects with the small intestine; Foot-Shaoyin ascends from the foot through the inner thigh, penetrates the spine, belongs to the Kidney, connects with the Bladder, connects with the Heart, and flanks the root of the tongue. When Shaoyin Qi reverses, dry tongue, red urine, abdominal fullness, and heart pain occur. Ping An: In *Suwen*, 'She' (tongue) is written as 'Kou' (mouth). Chao Shi writes 'Ni' as 'Niao' (urine).) When Jueyin experiences Jue, there is swelling and pain in the lower abdomen, difficulty in urination, a preference for lying with knees flexed, contraction and swelling of the genitals, and heat inside the shins. (The Foot-Jueyin meridian ascends from the foot eight cun above the ankle, crosses behind the Taiyin meridian, ascends along the inner thigh, enters the pubic region surrounding the genitals, reaches the lower abdomen, and flanks the stomach; thus, when Jueyin meridian Qi reverses, lower abdominal pain, difficulty in urination, preference for lying with knees flexed, genital contraction and swelling, and heat inside the [Character] occur. Some versions write 'heat outside the shin,' but Foot-Jueyin does not run outside the vessel; writing 'outside' is an error. Ping An: 'Sou Bu Li' (difficulty in urination) in *Suwen* is written as 'Fu Zhang Jing Sou Bu Li' (abdominal distension, difficult urination); in *Jia Yi* as '[Character] Zhang Jing Sou Bu Li'; in Chao Shi as 'Jing Sou Bu Li'. 'Jing' (shin) in *Suwen* and *Jia Yi* is written as [Character]. Chao Shi writes 'Nei Re' (internal heat) as 'Wai Re' (external heat). In the note, 'Gu Shao Yin Mai Qi Shi Ni' (thus Shao Yin meridian Qi reverses) should be 'Jue Yin' according to the text, likely a copying error in the original manuscript.) Excess conditions are treated with draining methods; deficiency conditions with tonifying methods; neither excess nor deficiency is treated by taking points from the affected meridian. (For all six meridians experiencing Jue, one must assess excess or deficiency to apply tonification or drainage.)

When Foot-Taiyin meridian Qi reverses, there is spasm and contracture in the [Character] area, heart pain radiating to the abdomen; treatment should target the main disease points. (Foot-Taiyin meridian ascends from the foot, follows [Character], belongs to the Spleen, connects with the Stomach, and injects into the Heart; thus, Foot-Taiyin Qi reversal causes [Character] spasm and contracture, heart pain radiating to the abdomen. For those with [Character] spasm and contracture, treating the points emitted by the Foot-Taiyin meridian can cure this disease. Others follow this pattern. Question: The previous chapter already discussed the Jue of the six meridians; why discuss it again? Answer: The order of discussing meridian Jue differs between the two chapters, and the main disease points differ left and right. Ping An: In *Suwen* and *Jia Yi*, there is no 'Zu' (foot) before 'Taiyin' and no 'Mai' (meridian) after 'Xia' (lower).) When Foot-Shaoyin meridian Qi reverses, there is empty fullness in the chest and abdomen, vomiting and altered symptoms, and downward discharge of green stool; treatment should target the main disease points. (Foot-Shaoyin meridian penetrates the spine, belongs to the Kidney, connects with the Bladder, penetrates the Liver, enters the Lung, and injects into the chest; thus, Foot-Shaoyin Qi reversal causes empty fullness in the chest and abdomen, vomiting, and downward discharge of green stool, which is due to cold in the lower abdomen. Ping An: In *Suwen* and *Jia Yi*, 'Ou' is written as 'Ou' (vomit), 'Qing' as 'Qing' (clear/green).) When Foot-Jueyin meridian Qi reverses, there is waist contracture, empty fullness, anterior closure (urinary retention), and delirious speech; treatment should target the main disease points. (Foot-Jueyin surrounds the genitals, reaches the lower abdomen, follows the throat, and enters the pharynx; thus, Foot-Jueyin meridian reversal causes waist contracture and empty fullness, urinary retention. 'Zhan' is pronounced Zhu Yan, meaning excessive talking; traditionally pronounced Xian, meaning talking alone. Ping An: In *Suwen* and *Jia Yi*, there is a 'Tong' (pain) character after 'Yao' (waist). 'Zhan Yan' in *Jia Yi* is written as 'Zhan Yu'; *Suwen* New Correction states: "Quan Yuanqi said: Zhan Yan refers to speaking alone due to Qi deficiency.") When the three Yin meridians simultaneously reverse, causing inability to pass stool or urine, making the hands and feet cold, death occurs within three days. ('Ni' refers to Qi reversal, named Jue Ni. When the three Yin meridians of the foot simultaneously reverse, stool and urine will inevitably be blocked, hands and feet will be cold, and death will occur within three days. Ping An: In the note, 'Bi' (must) before 'Da Xiao Bian' is missing in Yuan edition.) When Foot-Taiyang meridian Qi reverses, there is stiff collapse, vomiting blood, and frequent nosebleeds; treatment should target the main disease points. (Foot-Taiyang meridian originates beside the nose at the inner canthus, flanks the spine, reaches the middle of the waist, connects with the Kidney, and belongs to the Bladder; thus, Foot-Taiyang Qi reversal causes stiff collapse, vomiting blood, and frequent nosebleeds. Falling backward is called Jiang (stiff); falling forward is called Pu (collapse). Injury from stiff collapse causes vomiting blood. Taiyang Jue involves the nose, hence frequent nosebleeds. Ping An: In *Suwen* and *Jia Yi*, there is no 'Zu' (foot) before 'Taiyang' and no 'Mai' (meridian) after 'Xia'; 'Ou' is written as 'Ou' (vomit).) When Foot-Shaoyang meridian Qi reverses, joint mobility is impaired, the waist cannot walk, the neck cannot look back; if abdominal carbuncle develops, it is incurable; if fright occurs, death ensues. (Foot-Shaoyang meridian follows the neck, descends under the armpit, follows the chest past the costal margin, meets at the hip joint, descends to the lateral aspect of the knee, before the outer fibular bone, reaches the upper external malleolus, ascends to the dorsum entering between the fourth and fifth toes; branch penetrates the nail bed, connecting all joints in the body; thus, Shaoyang Qi reversal impairs joint mobility. The waist is the seat of joints, hence immobility. Shaoyang follows the neck, hence neck immobility. The meridian runs in the hypochondrium, emerges at the Qi Street; if intestinal carbuncle develops, it is still treatable. Intestinal carbuncle Qi reversal injures the Gallbladder, leading to death. Ping An: In *Suwen* and *Jia Yi*, there is no 'Zu' (foot) before 'Shaoyang' and no 'Mai' (meridian) after 'Xia'; 'Guan Ji Bu Li' (joint immobility) is repeated four times; 'Fu Yong' (abdominal carbuncle) has 'Fu' written as 'Chang' (intestine); based on the note, it should be 'Chang', likely a copying error. 'Bu Ke Zhi' (incurable) has 'Bu' in *Suwen* and *Jia Yi*; based on the note, it should be 'You' (still).) When Foot-Yangming meridian Qi reverses, there is wheezing and coughing, body heat, frequent fright, nosebleeds, and vomiting blood; it is incurable, and if fright occurs, death ensues. (Foot-Yangming reversed Qi attacks the Lung, causing wheezing and coughing. Foot-Yangming governs body heat; reversed Qi attacking the body causes fright. Foot-Yangming originates at the nose, descends to belong to the Stomach; reversed Qi causes nosebleeds and vomiting blood without treatment. Adding fright symptoms leads to spirit disorder and death. Ping An: In *Suwen* and *Jia Yi*, there is no 'Zu' (foot) before 'Yangming' and no 'Mai' (meridian) after 'Xia'; 'Ou' is written as 'Ou' (vomit). *Suwen* lacks the six characters 'Bu Ke Zhi Jing Zhe Si' (incurable, if fright occurs, death).) When Hand-Taiyin meridian Qi reverses, there is empty fullness and coughing, frequent vomiting of saliva/phlegm; treatment should target the main disease points. (Hand-Taiyin meridian connects downward with the Large Intestine, returns following the stomach opening, ascends through the diaphragm to belong to the Lung; thus, Qi reversal causes disease. Ping An: 'Shan Ou Tuo Mo' in *Suwen* is written as 'Shan Ou Mo'; in *Jia Yi* as 'Shan Ou Tu Mo'.) When Hand-Xin Bao (Pericardium) and Hand-Shaoyin meridians reverse, there is heart pain radiating to the throat, body heat indicating death, and no heat indicating treatability. (Hand-Xin Bao, Hand-Jueyin Pericardium meridian originates in the chest, emerges belonging to the Pericardium, descends through the diaphragm, sequentially connects with the San Jiao; Hand-Shaoyin originates in the Heart, flanks the pharynx, and ascends; thus, when these two meridians reverse, heart pain radiating to the throat occurs. The Pericardium meridian sequentially connects with the San Jiao; thus, when the Heart is invaded by pathogens and hurts, spreading through the San Jiao, causing body heat, it is named True Heart Pain, which is incurable. If there is no body heat, the reversed Qi does not circulate through the San Jiao, hence it is treatable. Ping An: 'Bu Re Ke Zhi' in *Suwen* is written as 'Bu Ke Zhi'; in *Jia Yi* as 'Bu Re Zhe Ke Zhi'.) When Hand-Taiyang meridian Qi reverses, there is deafness, tearing, neck immobility, and inability to bend or extend the waist; treatment should target the main disease points. (Hand-Taiyang meridian originates at the tip of the little finger, ascends to the shoulder, enters the supraclavicular fossa, follows the neck to the outer canthus, then enters the ear; thus, Hand-Taiyang Qi reversal causes deafness, tearing, neck immobility, and inability to bend or extend. Ping An: In *Suwen* and *Jia Yi*, there is an 'Er' (ear) character before 'Long' (deaf).) When Hand-Yangming and Hand-Shaoyang meridians reverse, there is throat obstruction (Bi), swollen throat, and stiff neck; treatment should target the main disease points. (Hand-Yangming meridian ascends the shoulder, emerges at the anterior edge of [Character], ascends to meet at the cervical vertebrae, descends into the supraclavicular fossa; branch from the supraclavicular fossa ascends through the cheek; Hand-Shaoyang branch emerges from the Chest Center, goes to the supraclavicular fossa, ascends the neck, ties behind the ear; thus, when these two meridians reverse, throat Bi, swollen throat, and stiff neck occur. [Character], refers to stiffness of the body and neck. Ping An: *Suwen* New Correction states: "Quan Yuanqi's version writes [Character] as 'Jing' (spasm/stiffness).")

When Kidney and Liver pulses are both deep, it is diagnosed as Stone Water (Shi Shui). (Although Kidney and Liver are lower parts, Kidney pulse is deep, Liver pulse is floating and strong. Now that Liver and Kidney pulses are both deep, it indicates excessive Yin Qi. Kidney governs water, hence it is Stone Water. Stone Water refers to water frozen solid like stone in late winter, named Stone Water, indicating severe water disease. 'Ying' is pronounced Wu Meng, meaning strong. Ping An: In the note, 'Jian' (hard) in 'Jian Ying' is mistakenly written as 'Shen' (Kidney) in Yuan edition. Also, *Suwen* New Correction states: "Regarding 'Kidney and Liver both deep' down to 'both small and stringy, desiring fright', Quan Yuanqi's version was in 'Treatise on Jue', Wang moved it to 'Treatise on Extraordinary Large Pulses'. Based on this, this book matches the complete version, confirming Wang's relocation of the text.) When both are floating, it is diagnosed as Wind Water (Feng Shui). (Floating is Yang; Wind is Yang. Liver pulse is floating and stringy. Now Kidney and Liver pulses are both floating; although Kidney and Liver are both Yin residing in the lower part, it is diagnosed as Wind Water.) When both are deficient, it indicates death. (Kidney and Liver both deficient indicates simultaneous deficiency of Yin and Yang; water disease will definitely lead to death.) When both are small and stringy, there is fright. (Small pulse indicates insufficient Blood and Qi. When Kidney and Liver pulses both have insufficient Blood and Qi, yet remain stringy, it indicates both Kidney and Liver are deficient, and Spleen Qi is encroaching, hence there is fright. Ping An: 'Yi Jing' (also fright) in *Suwen* is written as 'Yu Jing' (desiring fright); in *Jia Yi* as 'Yu Wei Jing' (desiring to be frightened).)