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When the pulse is in a state of harmony, if it appears deep and hard, this is the Kidney's Zang-pulse without Stomach Qi, indicating that the true Qi has sunk into the bone marrow. (Feeling timid and short of breath indicates that the water passages are obstructed and the Qi of the form is exhausted.) (This is due to Heart Qi deficiency. When Kidney Qi is deficient, the Motile Qi between the Kidneys becomes weak, causing the Bladder's water passages to fail to flow smoothly. The Motile Qi between the Kidneys is the vital Qi sustaining the body and life; when True Qi is insufficient, it agitates the form to seek Qi, hence termed "Xing Qi Cheng".) Cough accompanied by vexation is caused by the rebellion of Kidney Qi. (Because the water passages are obstructed, Qi follows the Kidney meridian upwards into the Heart and Lungs, resulting in cough and vexation, which signifies the rebellion of Kidney Qi.) In one person, Qi pathology resides in a single Zang organ. To say that three Zang organs are simultaneously affected does not conform to medical principles. (This refers to Qi pathology residing in the Kidney, not implying that one person suffers from pathology in the Kidney, Spleen, and Liver Zang organs simultaneously.) Lei Gong said: "Here is a patient with flaccid limbs, asthma, cough, and bloody diarrhea. A foolish physician diagnosed it as Lung injury. Palpating the pulse, I found it floating, large, and tight, so I dared not treat. A crude physician used purgative methods, resulting in the cessation of bleeding and a feeling of lightness in the body. What disease is this? Can you treat it? Although your knowledge is extensive, it deviates from the treatment of this disease." (The symptoms of flaccidity, asthma, cough, and bloody diarrhea should present with a deep and fine pulse, but now they are洪大 (large and full) and tight. Although a foolish physician suspects Lung injury, he dares not treat. A crude physician, without assessing the cause, directly used purgatives, and the bleeding stopped, curing many cases. However, for major diseases, using purgatives incorrectly yet achieving cure raises the question: what is the rationale?) Huang Di said: "This is like a wild goose flying, capable of soaring divinely into the sky. The sage treats diseases by following laws, adhering to standards, transmitting knowledge, and using analogy to deduce changes in the unseen, adapting to circumstances rather than rigidly sticking to classics." (Birds fly without fixed patterns, allowing geese to soar. Sages do not rigidly stick to classics but adapt to changes. Thus, although a crude physician may err in classics, if he happens to be appropriate for the disease, it is not surprising.) A pulse that is floating, large, and empty indicates that Spleen Qi is externally severed and departs from Stomach Qi to return to the Yangming Meridian. The Two Fires cannot overcome the Three Waters, leading to a chaotic and irregular pulse. (Due to Spleen disease, its Qi fails to circulate to the Stomach, causing a floating and large pulse. Spleen Qi leaves the Stomach and attacks the Yangming Meridian. 'Two Fires' refers to Yangming (Two Yang), and 'Three Waters' refers to Taiyin (Three Yin). Now, Taiyang pathogenic Qi attacks Yangming externally, meaning Two Fires cannot overcome Three Waters. Yangming cannot overcome Taiyin, resulting in a chaotic and irregular pulse.) Flaccid limbs indicate the leakage of Spleen Essence. (Spleen essence scatters outward, hence termed 'Chu Xing'. Since it scatters and fails to nourish the limbs, the limbs become flaccid.) Asthma and cough are caused by Water Qi merging with the Yangming Meridian. (Taiyang Three Waters merge with Yangming. The Hand Yangming Meridian connects to the Lung, causing asthma.) Bloody diarrhea occurs because the pulse becomes erratic and blood has nowhere to flow. (Yangming blood vessels are full and urgent but stagnant, leading to hematemesis.) If one considers it Lung injury, it is due to delusion and a failure to use analogy, indicating unclear wisdom.所谓的 'Lung injury' actually involves Spleen Qi failing to remain, Stomach Qi failing to be clear, Essence and Qi failing to be driven, destruction of the Zang-pulse, severance of collateral pulses, fullness and leakage of the Five Zang organs. If there is no epistaxis, there will be vomiting. These two conditions are not similar; just as heaven has no shape and earth has no texture, white and black are far apart. This was my fault; knowing you understand, I did not tell you. One must clearly cite analogies and calmly examine, thus named 'Zhen Jing' (Classic of Diagnosis), which is the supreme Dao. (Light and clear Qi does not scatter; Stomach Qi exists alone. The difference between Lung injury with bleeding and Spleen deficiency with bleeding lies in their principles; considering them the same is an error. Saying I knew you understood but didn't tell you was my fault. If you can clearly cite analogies and examine prudently, this is called the Dao of 'Zhen Jing'.) Question: Do a person's dwelling, movement, stillness, courage, and timidity cause changes in the pulse? Answer: Fear, fright, willpower, labor, movement, and stillness all cause pulse variations. (Meaning that for courageous or timid people, not only movement/stillness affects the pulse, but also fear, fright, willpower, and labor cause rapid and panting pulses.) Therefore, walking at night causes panting, originating from the Kidney. (Night belongs to Yin, and the Kidney also belongs to Yin. Walking at night involves mental labor, causing Yin Qi to gather and break, resulting in panting from the Kidney.) Pathogenic Qi first damaging the Lung, combined with falling and fear, causes panting originating from the Liver. (Pathogenic Qi previously damaged the Lung; combined with falling and fear, panting results. This is Lung's thief evil attacking the Liver, causing Liver disease and panting.) Pathogenic Qi lodging in the Spleen, combined with fright, causes panting originating from the Lung. (Pathogenic Qi previously lodged in the Spleen; combined with fright, panting results. This is Spleen deficiency allowing evil to attack the Lung, causing Lung disease and panting.) Pathogenic Qi injuring the Heart, combined with wading through water and stumbling, causes panting originating from the Kidney and bones. At this time, the courageous have Qi flowing and recover, while the timid retain it and become ill. (The Kidney governs water and bones. Pathogenic Qi first injures the Heart; combined with wading and stumbling, Heart and Kidney Qi become excessive, acting as thief evil attacking the Heart, causing Heart disease and panting. During Heart disease caused by fright, losing water, and stumbling, the courageous have robust Qi helping the righteous Qi to flow, removing the illness; the timid lose their spirit, hence becoming ill with panting.) Therefore, the way of diagnosis is to observe a person's courage, timidity, bones, muscles, and skin to understand their condition, which constitutes the diagnostic method. (The way of diagnosis involves observing the five aspects of a person to grasp the condition, constituting the diagnostic method.) Excessive fullness leads to sweat from the Stomach. (Sweat is Yin fluid. Excessive activity causes Yang excess and relative Yin deficiency, leading to Yin fluid exiting. Fullness causes Qi excess and relative deficiency, leading to sweat from the Stomach.) Fright stealing Essence leads to sweat from the Heart. (Fright injures Shen, causing relative deficiency, leading to sweat from the Heart.) Carrying heavy weights and traveling far leads to sweat from the Kidney. (Carrying weight causes Qi excess and injures Zhi, leading to relative deficiency and sweat from the Kidney.) Running fast and fearing leads to sweat from the Hun. (Running fast and fearing causes Qi excess and injures Hun, leading to relative deficiency and sweat from the Liver.) Shaking the body and laboring leads to sweat from the Spleen. (The Spleen governs the interior; shaking the body and laboring causes Qi excess and relative deficiency, leading to sweat from the Spleen.) Thus, the four seasons' Yin and Yang changes, and illnesses arising from overuse, are constant principles. (People who cannot regulate diet and labor according to the four seasons develop various diseases, which is the constant principle of foolish people overusing themselves.) Food Qi enters the Stomach, disperses Essence to the Liver, and overflows to nourish tendons. (Food Qi enters the Stomach, and the Stomach's Blood and Qi essence disperse to the Five Zang organs. It mentions the Liver specifically because the Liver corresponds to Wood, the East, and Spring, being the beginning of things, so overflowing Qi nourishes tendons.) Food entering the Stomach, turbid Qi returns to the Heart. (Stomach Qi divides into two: clear becomes Qi, turbid becomes Blood. The Heart governs Blood, so turbid Qi returns to the Heart.) Essence overflows into the vessels, and vessel Qi remains in the meridians. (Heart essence is abundant and remains in the twelve great meridians.) Meridian Qi returns to the Lung. (The Lung governs Qi, so vessel Qi returns to the Lung; thus, the Lung governs Qi.) The Lung faces all vessels. (Twelve regular meridians, eight extraordinary meridians, and fifteen great collaterals all converge on the Lung meridian, gathering at the Cun Kou of both Hands Taiyin.) Distributing essence to hair and skin. (Lung Qi flows through Sun collaterals, distributing essence to hair and skin.) Hair and vessel essence combine, moving Qi to the Fu organs. (Hair vessels refer to Sun collaterals, where essence combines and moves to the six Fu organs, governed by Lung Qi.) Fu organ essence and spirit remain in the four Zang organs. (Six Fu organs store food and water; their Qi transforms into essence and spirit, remaining in the four Zang organs, also moved by Lung Qi.) Qi returns to the balance, forming the Cun inch at the Qi Kou to determine life and death. ('Balance' refers to Yin and Yang. Because Yin and Yang are balanced, the pulse at the Qi Kou forms nine fen as Cun, inspecting the pulses of the Five Zang and Six Fu organs to determine life and death.) Food entering the Stomach, swimming and overflowing essence transports upward to the Spleen; Spleen Qi disperses essence, transporting upward to the Lung. ('Gou Xu' refers to water channels; deep ones are Xu, shallow ones are Gou. Food enters the Stomach, fluids swim in the Lung, compared to swimming and overflowing. Essence transports up to the Spleen; the Spleen receives Qi and transports it up to the Lung. The character 'Xu' is the same as 'Yi', flowing from Stomach to Spleen, not scattering.') The Lung regulates water passages, transporting downward to the Bladder. (The Lung governs Qi and regulates fluids; turbid substances move downward to the Bladder for urination.) Water essence distributes in four directions; water essence is Blood and Qi, distributed by the Lung to the four Zang organs. The five meridians run together, harmonizing with the four seasons, measuring the movement and stillness of Yin and Yang in the Five Zang organs, which is the constant principle. (Four Zang meridians plus Lung meridian make five meridians. They run together externally harmonizing with four seasons Qi and internally responding to Yin/Yang movement/stillness of Five Zang, conforming to standards. 'Kui' means measure; 'Du' means standard.) Taiyang Zang pulse arrives exclusively, with reversal, asthma, and rebellious Qi, indicating Yin deficiency and Yang excess. Both exterior and interior should be drained, selecting lower Shu points. (Taiyang Foot Taiyang is Three Yang; Zang is Foot Sha Yin (Two Yin). One Fu and one Zang, Kidney and Bladder pulses arrive exclusively, showing reversal and asthma with rebellious Qi. Reversal and asthma indicate Yang excess; emptiness indicates Yin deficiency. Sha Yin deficiency is slight, Taiyang excess is severe. Thus, slightly drain Sha Yin to prevent excess, severely drain Taiyang to restore balance. Exterior and interior both select lower Shu points, referring to the lower Five Shu points of Foot Sha Yin and Foot Taiyang.) Yangming Zang pulse arrives exclusively, indicating heavy accumulation of Yang Qi. Drain Yang, tonify Yin, select lower Shu points. (Yangming Foot Yangming is Two Yang; Zang is Foot Tai Yin (Three Yin). One Fu and one Zang, Spleen and Stomach pulses arrive exclusively. If Yangming leads at Cun Kou alongside Taiyin, it indicates Yang Qi heavily accumulating on Yin. Thus, drain Foot Yangming, tonify Foot Taiyin. Select lower Five Shu points.) Shaoyang arrives exclusively, indicating Jue Qi. Qiao point suddenly large, select lower Shu points. Shaoyang Yang arriving exclusively is the fault of One Yang. (Foot Shaoyang is One Yang. Shaoyang arriving exclusively is Jue Ni Qi arrival. Shaoyang with Jue Ni Qi indicates Shaoyang excess as fault. Its collateral is suddenly large above the lateral malleolus, three cun anterior to Qiaomai Fuyang point, using the space between sinew and bone as lower Shu point.) Ta Yin Zang transmission uses sparing of True Five Pulses, Qi is scarce, Stomach Qi is uneven, Three Yin. Treat lower Shu points, tonify Yang, drain Yin. (Ta Yin Foot Ta Yin is Three Yin; Zang refers to Spleen. Transmission gathers but fails to nourish Five, using sparing. True Five Zang pulses are less than Stomach Qi, hence uneven. Ta Yin pulse is Three Yin. This indicates Yin excess and Yang deficiency, requiring tonification of Yang and draining of Yin, selecting lower Five Shu points.) One Yin exclusively whistles, indicating Sha Yin Jue. Yang merges upward, blood vessels compete and distend, Yin Qi returns to Kidney. Treat meridians, drain Yang, tonify Yin. (Foot Shaoyang enters ear from behind, exits anterior to ear; thus Yang excess causes tinnitus, termed 'One Yin exclusively whistles'. Kidney governs ear, Kidney meridian is Sha Yin. Yang excess tinnitus indicates Sha Yin Jue Ni, Yang excess upward, Yin Qi returning downward. Drain Yang, tonify Yin, treating meridians.) Two Yin arrives, treatment of Jue Yin. True deficiency, Heart Jue Qi lingers and thins, manifesting as white sweat. Regulate diet, harmonize medicine, treat lower Shu points. (Two Yin is Sha Yin. True deficiency. Sha Yin pulse is deficient, Jue Yin pulse is excess. Deficiency injures Heart, so Jue Qi lingers in Heart, manifesting as white sweat, Heart fluid. Thus, regulate diet, harmonize medicine, apply acupuncture/moxibustion to lower Five Shu points for separate treatment. Ju Xuan fan, color of anger.) What is the image of Taiyang Zang? Three Yang and floating. (Taiyang is Three Yang, so pulse image is Three Yang pulse floating.) What is the image of Shaoyang Zang? One Yang slippery and not solid. (Slippery indicates Yang Qi excess, slight heat, not solid indicates deficiency.) What is the image of Yangming Zang? Like the Heart's excessive floating. (Like Heart pulse excessively floating. Excessive indicates much or little Qi.) Ta Yin Zang pulsation refers to its hidden drumming. (Ta Yin pulse gathers, hides, and drums.) Two Yin pulsation arrives, Kidney sinks and does not float. (Sha Yin pulse gathers and arrives, sinking to the bone edge, not floating.)