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When the pulse beats with one part of the Xian (String-like) Qi, it is called slightly Xian. If all three positions exhibit only Xian Qi without any Stomach Qi, it is called seeing the True Zang Pulse. Seeing the True Zang Pulse indicates death; the principle behind this is extremely subtle. Please elaborate on the principle, hence the question "Why?". (Ping An: The New Correction in *Su Wen* cites this annotation in great detail.) Answer: The Five Zang Organs all derive their Qi from the Stomach; the Stomach is the root of the Five Zang Organs. The Qi of the Five Zang Organs cannot reach the Cunkou (Inch position) of the Hand Taiyin Lung Meridian by itself; it must rely on Stomach Qi to arrive at the Hand Taiyin. (The Stomach receives water and grain, transforms them into Essence-Qi to nourish the Five Zang Organs, thus allowing the Zang Qi to reach the Cunkou of the Hand Taiyin, manifesting as a slightly Xian pulse.) Therefore, each of the Five Zang Organs arrives at the Hand Taiyin independently during its respective season. (Each Zang governs one of the five seasons. When the appropriate season arrives, if the corresponding Zang is severely diseased, Stomach Qi does not reside with it. Without relying on Stomach Qi, driven solely by the force of respiration, the pathogenic Qi alone reaches the Cunkou of the Taiyin, manifesting as a true Xian pulse. Ping An: The character "Zi" (self) is missing in the original text; added here based on *Su Wen*. In the annotation, "Bu Yu Zhi Ju" (does not dwell with it), other editions have "Ju" as "Ju" (together).) Thus, when pathogenic factors prevail, Essential Qi declines. (A True Zang pulse that is Xian but not gentle, lacking Stomach Qi, indicates that Liver disease pathogenic factors are prevailing. When Liver disease pathogenic factors prevail, the Essence-Qi from food and drink in the Spleen and Stomach declines.) Therefore, in severe illness, Stomach Qi cannot accompany the Zang Qi to reach the Hand Taiyin, so the Qi of the True Zang appears alone. Appearing alone means the disease overcomes the Zang, hence it is said to be fatal. Huangdi said: Excellent. (Truly seeing severe disease leads to death. Ping An: From "Asking about seeing the True Zang" onwards, the New Correction states that the Quan Yuanqi edition placed this in the chapter *Tai Yin Yang Ming Biao Li*, but Wang Bing moved it here. Checking the chapters *Tai Yin Yang Ming Lun* before and after, they remain here, while this specific passage is found in *Yu Ji Zhen Zang Lun*, further confirming it was moved by Wang Bing.)

Question: Why does Spleen disease cause the four limbs to become immobile? (The Five Zang Organs are all connected to the four limbs; why does Spleen disease specifically cause immobility in the limbs? Ping An: The character "Pi" (Spleen) is missing in the original text; added here based on *Su Wen*.) Answer: The four limbs all derive their Qi from the Stomach, but they cannot receive it directly; they must rely on the Spleen to receive it. Now, because of Spleen disease, the Spleen cannot transport fluids for the Stomach. The four limbs do not receive Water-Grain Qi; their Qi declines day by day, the meridians become obstructed, and the sinews, bones, muscles, and flesh lack Qi generation, hence they become immobile. (Earth prospers in the four seasons, and Earth exists in every season; the Spleen nurtures the Four Zang Organs, and the Four Zang Organs contain the Spleen's function. Why? The four limbs and hundred bodies derive Qi from the Stomach, which uses Water-Grain fluids to nourish the limbs. When nourishment is needed for the limbs, Stomach Qi cannot reach them directly; it must rely on the Spleen to obtain Water-Grain fluids and Ying-Wei (Nutritive and Defensive) Qi, circulating them in the limbs. Only when the limbs receive these Qi can they function. If Spleen disease causes meridian obstruction, then sinews, bones, muscles, and flesh lack Qi generation, hence immobility. Ping An: "Jing Zhi" (reach directly) in Yuan edition is erroneously printed as "Ju Zhi"; *Su Wen* has "Zhi Jing". New Correction says: *Tai Su* "Zhi Jing" is written as "Jing Zhi". Yang Shangshan stated: The Stomach nourishes the limbs with Water-Grain but cannot reach them directly; it must rely on the Spleen to obtain Water-Grain fluids and form Ying-Wei Qi in the limbs. This matches this annotation. "Bu Li" (not favorable/smooth) in *Jia Yi Jing* is "Bu Tong" (blocked). "Jie Wu Qi Sheng" (all no Qi generation) in *Su Wen* is "Jie Wu Qi Yi Sheng", same as *Jia Yi Jing*.)

Question: Why does the Spleen not govern a specific season? Answer: The Spleen belongs to Earth, governs the Center, and constantly nourishes the Four Zang Organs throughout the four seasons. It governs for eighteen days in each season (a period of residence), and thus cannot exclusively govern a season. The Spleen organ possesses the constant essence of Earth. (The root of the Four Zang Organs is Earth. Because it is used for eighteen days, it is called "residence" or "寄" (ji). Zhuo, pronounced Cheng-lue fan, means existing. The Spleen organ contains the exquisite essence of Earth. Ping An: "Zhi Zhong Yang" in *Jia Yi Jing* is "Tu Zhe Zhong Yang". "Bu De Du Zhu Shi" (cannot exclusively govern a season), *Jia Yi Jing* lacks the character "De", *Su Wen* has "Bu De Du Zhu Yu Shi Ye". "Pi Zang You Chang Zhuo" (Spleen organ has constant existence), *Jia Yi Jing* has "Pi Zhe Tu Zang Chang Zhuo Wei", *Su Wen* has "Pi Zang Zhe Chang Zhuo Wei".) Earth governs all things and models Heaven and Earth; therefore, from head to foot in the body, it does not exclusively govern a season. (Earth is the substance of all things, modeling Heaven and Earth, serving as the substance for all things. Thus, the body, head, hands, and feet constitute a whole, and the body does not exclusively govern a season. Ping An: "Zhu" (govern) in *Su Wen* and *Jia Yi Jing* is "Sheng" (generate). The characters "Tian Di" (Heaven and Earth), "Tian" (Heaven), and "Zhu Shi" (govern season) were missing in the original text; added here based on *Su Wen* and *Jia Yi Jing*.)

Question: The Spleen and Stomach are connected by membranes and have opposite positions, yet how can they jointly transport fluids for the Stomach? (Spleen is Yin, Stomach is Yang; Spleen is internal, Stomach is external. Their positions are distinct, hence they are considered opposite. Given such difference, how can they jointly transport fluids and Qi for the Stomach? Another view is that they are connected; Spleen and Stomach are interior-exterior, Yin-Yang counterparts. Since the membranes mutually assist each other, they are called connected. Ping An: "Yi Mu Xiang Ni" (connected by membranes and opposite) in *Su Wen* is "Yi Mo Xiang Lian Er" (connected by membranes). New Correction says: "According to *Tai Su*, it reads 'Yi Mu Xiang Ni'. Yang Shangshan stated: Spleen is Yin, Stomach is Yang; Spleen is internal, Stomach is external; their positions differ, hence they are opposite." Also, two characters are missing after "Gu Xiang" in the original manuscript; based on the New Correction citation, they should be "Ni Ye" (opposite). Yuan edition missed "Gu" before "Xiang" and "Ye" after "Ni". Also, "Yin Yang Mu", Yuan edition erroneously printed "Mu" as "Qian".) Answer: Foot-Taiyin (Spleen Meridian) belongs to the Three Yin meridians. Its vessel penetrates the Stomach, connects to the Spleen, and links to the throat. Therefore, Taiyin transports Qi to the Three Yin meridians. (Ai, pronounced Yu-mo fan, means pharynx/throat. The Foot-Taiyin vessel penetrates the Stomach, connects to the Spleen, ascends to link the throat. Its Qi is strong and vigorous, capable of transporting Qi through the Three Yin meridians; thus, the Taiyin meridian bears the name of the Three Yin. Ping An: The character "Qi" is present before "Mai" (vessel) in *Su Wen* and *Jia Yi Jing*.) Yangming (Stomach Meridian) is exterior; it is the Sea of the Five Zang and Six Fu Organs, and it also transports Qi to the Three Yang meridians. Each Zang and Fu organ receives Qi from Yangming via its own meridian; therefore, (the Spleen/Stomach system) transports fluids for the Stomach. If the four limbs do not receive Water-Grain Qi, they decline increasingly day by day, the Yin vessels become obstructed, and sinews, bones, vessels, and flesh lack Qi to sustain them, hence they become immobile. (Yangming is the Sea of Yin-Yang and Zang-Fu organs. The Five Zang and Six Fu organs each receive Qi from Yangming via the Twelve Primary Meridians; thus, the meridians can transport Fluid-Qi for the Stomach. The limbs receive... [text damaged] ...meridians do not... Yangming, then Yin vessels are blocked, and sinews, bones, vessels, and flesh lack Qi to sustain them. Ping An: "Yangming Zhe Biao Ye" (Yangming is exterior), the characters "Zhe Biao" were missing in the original text; added here based on *Su Wen* and *Jia Yi Jing*. After "Shui Gu" (Water-Grain), *Su Wen* and *Jia Yi Jing* lack the character "Zhi". "Ri Yi Yi Shuai" (decline increasingly day by day) in *Jia Yi Jing* is "Qi Ri Yi Shuai". The characters "Mai Rou" (vessels and flesh) were missing in the original text; *Su Wen* and *Jia Yi Jing* have "Ji Rou" (muscles and flesh); based on this annotation, it should be "Mai Rou".)