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Ping An: This chapter appears in the "Mai Jie" (Explanation of Pulse Changes) chapter, Volume 13, Chapter 49 of the *Su Wen* (Basic Questions). Furthermore, according to: The New Corrections of the *Su Wen* state: Upon detailed examination, the diseases explained in this chapter are mostly those of "Shi Dong" (Diseases of Movement) and "Suo Sheng" (Diseases Generated) from the *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion). Although there are slight differences, generally speaking, they are not distinct.

The swelling and lower back pain mentioned by the Taiyang (Greater Yang) meridian correspond to the first lunar month, Yin month. Yin represents Great Yang. ( , refers to the coccyx, pronounced "shui". In the eleventh month, one Yang is born; in the twelfth month, two Yangs are born; in the first month, three Yangs are born. At the time when three Yangs are born in Yin month, their Yang Qi is already grand, hence it is called Great Yang.) In the first month, Yang Qi emerges upwards. (One Yang is underground, like a deep tooth-like sprout just emerging; two Yangs are in the earth, like shallow sprouts emerging; three Yangs emerge on the ground, thus it is said that in the first month Yang Qi emerges upwards. Ping An: In the notes, the characters "two teeth" were misprinted as "shao" (few) in Yuan's edition.) And Yin Qi is abundant, while Yang Qi cannot act independently in sequence, resulting in swelling and lower back pain. (Three Yin are still above ground and have not fully subsided, so Yin Qi is abundant. Because Yin Qi blocks and isolates, Yang Qi cannot function sequentially on its own, thus causing swelling in the skin and muscles, and pain in the waist.) Unilateral deficiency leading to limping occurs because in the first month, frozen ice thaws and Earth Qi exits. The term "unilateral deficiency" implies that winter cold was somewhat insufficient, leading to unilateral weakness and thus limping. (In the first month, there are already three Yangs, so the ice thaws, and Yang Qi emerges from the ground. Previously there were three Yin, so winter cold remains, and Yang Qi is insufficient. The human body is similar; half-Yang is insufficient, leading to unilateral deficiency. Limping refers to limping on the left foot. Ping An: The *Su Wen* has the character "bing" (disease) before "pian xu wei bo zhe"; it has the character "qi" before "dong"; and "gu bo" is written as "gu bo ye". The phrase "po you" lacks the three characters "bu zu zhe" (lack of sufficiency) in Yuan's edition. The three characters "gu dong jie" in the note appear after "chu yu di ye" in Yuan's edition.) The term "strong upper body" (stiff neck/head) occurs because Yang Qi rises greatly and contends, causing stiffness in the head and neck. (Three Yang tend to prosper and battle with Three Yin, achieving great victory and rising up, yet Yin still contends. Ping An: After the four characters "suo wei qiang shang" in the *Su Wen*, the characters "yin bei" (pulling the back) appear. In the note, the character "de" in "de shang" is written as "de" (virtue) in Yuan's edition.) The term "tinnitus" occurs because Yang Qi leaps upward like all things, causing tinnitus. (In the first month, Yang Qi causes all things to leap and cry out upward; thus, when illness arises, Qi rushes upward causing tinnitus. Ping An: "Shang er yue" is written as "Sheng shang er yue" in the *Su Wen*.) When severe, it becomes mania and epilepsy because Yang Qi is entirely above and Yin Qi follows from below, creating a condition of deficiency below and excess above, thus leading to epilepsy. (Two Yang lines contend with Three Yin, but Three Yang prevail entirely in the head, causing excess above; Three Yin follow from below, causing deficiency below. Thus disease manifests: stripping clothes, climbing high, running wildly and speaking nonsense is called Mania (Kuang); stiffening and falling is called Epilepsy (Dian). Ping An: "Gu dian ji" in the *Su Wen* is written as "Gu kuang dian ji".) The term "floating pulse leads to deafness" refers to issues of Qi. (Diagnosing the Renying pulse, if the Three Yang pulse is floating, it is all due to Taiyang Qi causing deafness.) The term "entering middle leads to aphonia" occurs because Yang Qi has declined, thus causing aphonia. (When Taiyang Qi attacks humans, i.e., Yang Qi is extremely abundant, and then suddenly declines, aphonia results. Yin means inability to speak. Ping An: "Ren zhong" is written as "Ru zhong" in the *Su Wen*.) Internal depletion and reversal lead to aphonia and flaccidity, which is Kidney Deficiency. (Yang Qi declines externally, thus only causing aphonia; if Left Kidney Qi is internally depleted and reverses, it leads to aphonia and flaccidity, pronounced "fei", a wind disease causing inability to speak. It refers to limbs being unusable, aphonia, lack of mental awareness; severe cases die, mild cases can be treated. Ping An: "Fei" is written as "Pai" in the *Su Wen*. In the note, the character "Zuo" (Left) in "Zuo Shen" is written as "You" (Have) in Yuan's edition.) Shaoyin (Lesser Yin) pulse not arriving indicates Reversal. (Shaoyin is the Kidney pulse. If the Foot Shaoyin meridian is blocked, Blood and Qi do not nourish the Kidney, thus Reversal leads to aphonia and flaccidity. Ping An: The four characters "Shaoyin bu zhi" are not repeated in the *Su Wen*.)*

The Heart and hypochondriac pain mentioned by the Shaoyang (Lesser Yang) meridian refers to the Shaoyang Xu month. Xu is the exterior manifestation of the Heart. (Hand Shaoyang connects to the Pericardium; Foot Shaoyang follows the hypochondrium interior, so Shaoyang disease involves Heart and hypochondriac pain. Xu is the ninth month; Yang Qi is scarce in the ninth month, hence called Shaoyang. The Xu Shaoyang meridian scatters and connects to the Pericardium, thus it is the exterior of the Heart. Ping An: Both "Xu" characters in the *Su Wen* are written as "Sheng" (Abundant).) In the ninth month, Yang Qi ends and Yin Qi abounds, causing Heart and hypochondriac pain. (Yin Qi is already abundant, Yang Qi is about to end, Shaoyang disease arises, thus Heart and hypochondriac pain. Ping An: "Yang jin" is written as "Yang Qi jin" in the *Su Wen*.) The term "unable to turn or side" occurs because Yin Qi stores all things; when things are stored, they do not move, hence "unable to turn or side". (In the ninth month, all things are stored, quiet and unmoving, indicating abundance of Yin Qi, thus illness prevents turning or side-bending.) When severe, jumping occurs because in the ninth month all things decline, grass and trees fall completely, Qi leaves Yang and turns to Yin. (Yue means vigorous movement. Severe refers to the ninth month where Yin Qi is abundant externally, so the Qi of all things falls completely; thus the Qi of all things leaves Yang for Yin. Ping An: Yuan's edition omits the two characters "Yin Qi" after "September" in the note.) And Yang grows downward, hence called "jumping". (Yin Qi is abundant on the ground, Yang Qi is underground, vigorously moving the roots of all things to grow internally. Ping An: "Er Yang Shang" has the two characters "Qi Sheng" in the *Su Wen*, and Yuan's edition has "Qi Sheng Jiu".)*

The chills and trembling described by the Yangming (Bright Yang) meridian. (Yangming is the chief of the Three Yangs. Wu is the fifth month, the peak of Yang. Located in Guangming, hence called Yangming. Ping An: "Sa Sa" is written as "Sa Sa" in the *Su Wen*, same below, not repeated.)* Yangming corresponds to Wu. The fifth month is Yin within abundant Yang. (In the fifth month of abundant Yang, one Yin line is born, which is Yin within Yang.) Yang is abundant and Yin Qi adds to it, causing chills and trembling. (One Yin begins to generate, fierce and strong adding to Yang, thus chills and trembling.) The term "swollen calves and relaxed thighs" occurs because of Yin within abundant Yang in the fifth month. Yang declines in the fifth month, and Yin Qi descends, beginning to contend with Yang, thus swollen calves and relaxed thighs. (Waist above is Yang, waist below is Yin. In the fifth month, one Yin Qi begins to generate below, contending with Yang. Yang is strong and solid above, Yin is weak and deficient below, thus swollen calves and relaxed thighs. Ping An: "Yin Qi Yi Xia" is written as "Yi Yin Qi Shang" in the *Su Wen*.)* The term "upper wheezing indicates water retention" says that Yin Qi descends, descends again and ascends; ascending allows pathogenic factors to lodge between Zang and Fu organs, thus causing water disease. (In the fifth month Yangming, One Yin causes disease, referring to upper wheezing and coughing with water disease. One Yin moves up and down in the chest and abdomen without following normal rules, so pathogens follow Yin Qi and lodge between Fu and Zang organs, thus causing water disease. Ping An: "Yin Qi Xia Xia Fu Shang" is written as "Yin Qi Xia Er Fu Shang" in the *Su Wen*. In the note, "Du" is written as "Chu" in Yuan's edition.)* The term "chest pain and shortness of breath" occurs because water is in the Zang and Fu organs. Water is Yin Qi; Yin Qi in the middle causes shortness of breath. (Fire is Yang Qi, Water is Yin Qi. Water between Zang and Fu organs means Yang Qi is scarce. Ping An: In the *Su Wen*, "Shui Zai Zang Fu" is written as "Shui Qi Zai Zang Fu", and "Gu Shao Qi" is written as "Gu Xiong Tong Shao Qi".)* When severe, there is Reversal, fear of people and fire, and startle at the sound of wood, because Yang and Yin Qi contend, and Water and Fire are hostile, thus startling. (Yangming Meridian Qi and Yin Qi are both abundant, Water and Fire are hostile, thus startling. Wood overcomes Earth, thus startling at the sound of wood.)* The desire to close doors and windows and stay alone during severe illness occurs because Yin and Yang contend, Yang ends and Yin abounds, thus desiring to close doors and windows and live alone. (Yin and Yang contend and alternate in victory. Yang abundance has declined, next Yin Qi abounds, thus preferring to close doors and windows and live alone in the dark. Ping An: The character "Zhi" in "Zhi Yu" is absent in the *Su Wen*.)* When disease is severe and arrives, wanting to climb high and sing, discard clothes and run, occurs because Yin and Yang contend again and merge outwardly into Yang, thus causing discarding clothes and running. (Yin and Yang contend, Yin is few and Yang is many, Yin merges outwardly into Yang, thus wanting to discard clothes and run. Ping An: The character "Zhong" in "Bing Zhong Zhi" is absent in the *Su Wen*.)* When external pathogens affect Sun meridians, causing headache, nasal discharge, and abdominal swelling, it is because Yangming merges upward. Upward merging affects the Sun meridians of Taiyin, thus headache, nasal discharge, and abdominal swelling. (Taiyin Meridian reaches under the tongue; Taiyin Sun collateral networks the head and nose. Thus Yangming merging into Taiyin Sun collaterals leads to nasal discharge and abdominal swelling. Ping An: "Ze Qi Sun Mai", the character "Mai" is written as "Luo" in the *Su Wen*.)*

The bloating described by the Taiyin (Greater Yin) meridian refers to the Taiyin Zi month. In the eleventh month, the Qi of all things is stored within, hence called bloating. (Because Yin Qi is great in the eleventh month, it is called Taiyin. Yin Qi gathers internally, Yang Qi communicates externally. In the eleventh month, Yin Qi gathers internally; although one Yang begins to generate, its Qi is slight and cannot communicate externally, thus internal illness causes bloating.) The term "Qi moving upward to the heart causing belching" refers to Yin Qi being abundant and moving upward to Yang. Yang refers to Yangming connecting to the Heart, hence "moving upward to the heart causing belching". (In the eleventh month, there are five Yin lines, so Yin Qi is abundant. Taiyin is inside, thus considered lower; Yangming is outside, thus considered upper. The proper Qi of Yangming enters the abdomen interior, belongs to the Stomach, scatters to the Spleen, and communicates upward to the Heart, thus Yangming connects to the Heart. Cold pathogen first lodges in the Stomach, then Jue Qi disperses upward from the Stomach. This Jue Qi re-enters the upper opening of the Stomach. The Stomach connects to the Heart, thus "moving upward to the heart causing belching". Ping An: "Yin Qi Sheng" lacks the character "Qi" in the *Su Wen*, and Yuan's edition omits "Sheng". "Er Shang Zou Yang Yang Zhe" is written as "Er Shang Zou Yu Yang Ming" in the *Su Wen*.)* The term "vomiting after eating" occurs because food is full and overflows upward, thus vomiting. (Stomach contains full food, digested by Yang Qi. Now in the eleventh month, one Yang is weak and cannot fully digest, thus stomach fullness overflows, called Ou. This Ou is vomiting. Ping An: Note "Shi Man" is misprinted as "Qi Man" in Yuan's edition. The character "Yi" in "Yi Yang" is omitted in Yuan's edition.)* The term "relief after defecation and passing gas" refers to the eleventh month where Yin Qi declines downward and Yang Qi is about to emerge, hence relief after defecation and passing gas. (Yang Qi is not yet great, thus abdominal fullness causes bloating. Yin Qi moves downward, guided by one Yang, thus after defecation and passing gas, the abdomen feels relieved and reduced. Ping An: The two characters "Er" in "Er Shuai" are both written as "Ru" in the *Su Wen*. "November" is written as "December" in the *Su Wen*.)*

The lower back pain described by the Shaoyin (Lesser Yin) meridian refers to Shaoyin Kidney. In the seventh month, the Yang Qi of all things is injured on the back, thus lower back pain. (Autumn Qi begins in the seventh month, hence called Shaoyin. Shaoyin Qi is great in November, Jue occurred in March. Thus when Shaoyin reaches the Kidney in July, Three Yin have risen, and the Yang Qi of all things has declined. Taiyang governs the waist; since Taiyang declines, lower back pain occurs. Ping An: "July" is written as "October" in the *Su Wen*, "Bei Shang" is written as "Jie Shang". In the note, the character "Yin" in "Gu Shaoyin Zhi Shen" is omitted in Yuan's edition.)* The term "rising Qi, cough, and panting" refers to Yin Qi below and Yang Qi above. All Qi floats without foundation or direction, thus vomiting, coughing, and panting. (This is Kidney Cough. Yin and Yang Qi are discordant, each located above and below, thus all Yang Qi floats without foundation, prone to vomiting, coughing, and panting. Ping An: In the *Su Wen*, "Shang Qi Ke" is written as "Ou Ke", and "Zhu Qi Fu" is written as "Zhu Yang Qi Fu".)* The term "depressed, unable to stand long, and blurred vision upon sitting and standing" occurs because Yin and Yang of all things are undetermined, having no master. Autumn Qi begins, light frost descends, and all things are killed. Yin and Yang are internally depleted, hence blurred vision. (In July, Yin and Yang Qi are equal with no fixed master. Autumn Qi begins, Yang Qi is initially depleted, thus gazing sadly and unable to stand long. Also, Yin and Yang are internally insufficient, thus upon rising from sitting, vision is blurred. Some editions use "Lu", but White Dew is slight frost. Since heavy frost falls in October, editions using October are incorrect. Ping An: "Yi Yi" is written as "Se Se" in the *Su Wen*; New Corrections say "Se Se" is likely erroneous. "Zuo Shang" has the character "Jiu" in the *Su Wen*. "KT KT" is written as "KT KT". In the note, "Chang Wang" is misprinted as "Zhang" in Yuan's edition.)* The term "shortness of breath and mood swings" occurs because Yang Qi heat is unregulated, Yang Qi cannot exit, Liver Qi should regulate but fails, thus mood swings, named Qian Jue. (When Shaoyin Qi functions, Yang Qi heat does not function, thus cannot exit. Liver governs anger. When Shaoyin is in use, Liver Qi has not gained utility, thus mood swings. Diseases of mood swings are named Qian Jue. Ping An: "Yang Qi Re Bu Zhi" lacks the character "Re" in the *Su Wen*, written as "Yang Qi Bu Zhi" two sentences. "Gu Hu Nu Zhe" is written as "Shan Nu Shan Nu Zhe". "Qian Jue" is written as "Jian Jue". In the note, "Gan Yi Zhu Nu", the character "Gan" is misprinted as "Suo" in Yuan's edition.)* The term "fear as if being caught" occurs because in autumn, all things have not completely departed, Yin Qi is little, Yang Qi enters, Yin and Yang contend, thus fear. (In July, all things slightly decline, not yet withered, thus not completely departed. Just cool, not cold, thus Yin Qi is little. It is still hot, thus Yang Qi enters. However, the two Qi contend and are insufficient, advancing and retreating uncertainly, thus fear. Ping An: "Yang Qi Ru", the character "Ru" is omitted in the original manuscript, added here based on the *Su Wen* and this note.)* The term "aversion to the smell of food" occurs because the Stomach has no Qi, thus aversion to the smell of food. (In July, Yang declines, Stomach has little Qi, thus aversion to food smell.)* The term "face black like earth color" occurs because Autumn Qi depletes internally, thus changing color. (In July, Three Yang have declined, Three Yin have risen. However, Yang departs and Yin comes continuously, making Yin strong and Yang weak, thus depleting color and changing. Ping An: Note "Er Bian" is misprinted as "Er Qi" in Yuan's edition.)* The term "coughing with blood" occurs because Yang meridians are injured. Yang Qi is not yet abundant above; abdominal fullness causes cough, thus blood appears in the nose. (In July, Metal governs Lung. Lung governs cough. If not coughing, fine; if coughing, Yang is injured. Yang injury damages blood vessels, thus abdominal fullness and blood appearing in the nose. Ping An: "Fu Man Ze Ke" is written as "Er Mai Man Man Ze Ke" six characters in the *Su Wen*.)*

The Tui Shan (flaccid hernia) and lower abdominal swelling in women described by the Jueyin (Terminal Yin) meridian refer to the Jueyin Chen month. Chen is Yin within Yang. Pathogens in the middle, hence Tui Shan and lower abdominal swelling. (In March, Yin Qi is about to end, hence Jueyin. March is Yang, Jueyin meridian is in the middle, hence Yin within Yang. Pathogens lodge in the Jueyin meridian, thus Tui Shan. Tui refers to men where cold qi forms in the lower abdomen, accumulating in the genitalia causing pain. Shan refers to cold accumulated Qi rising, entering the lower abdomen causing pain. Disease in lower abdomen pain, inability to urinate or defecate, is named Shan. Ping An: "Tui" is written as " " in the *Su Wen*. In the note, "Shang Ru Xiao Fu", the character "Shang" is omitted in Yuan's edition.)* The term "lower back and spine pain unable to bend or extend" occurs because in March, all things shake and flourish, and all things bow down but do not look up. (Zhen means movement. In March, Three Yang combine to move for Spring. All things flourish, low branches and drooping leaves, bowing down but not looking up. Thus pathogens lodge in Jueyin, causing lower back and spine pain, unable to bend or extend.)* The term "Ning skin bloating" occurs because Yin is abundant and causes bloating. Yin bloaging is blocked, hence Tui . (Toxic heat lodges in Jueyin, thus Ning swelling. Pathogens lodge in genitalia, thus disease, difficult urination. Lodging in skin, thus skin bloating. March is Yang, Yin Qi is present and abundant, thus genitalia swelling. Genitalia swelling and blockage, thus Tui . Ping An: In the *Su Wen*, "Ning" is written as " ", "Fu" has "Shan" above, "Yi Sheng" is written as "Yi Sheng", "Er Zhang Yin Zhang Bu Tong" is written as "Er Mai Zhang Bu Tong", "Gu Yue " is written as "Gu Yue Shan".)* When severe, throat dryness and internal heat occur because Yin and Yang contend and heat causes dryness, hence throat dryness. (Severe refers to abundant Jueyin pathogenic Qi. The Jueyin meridian夹胃 belongs to Liver, connects to Gallbladder, and enters the Ying-Sang. Thus Yin and Yang contend, internal heat causes throat dryness. Ping An: The *Su Wen* lacks the two characters "Ze Gan".)*