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[Ping An]: This chapter, from beginning to end, is found in *Ling Shu* (Spiritual Pivot), Volume 1, Chapter 4 "Disease Forms of Pathogenic Factors and Zang-Fu Organs", and also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 4, Part 2, Upper Section.

Yellow Emperor asked Qi Bo: How do pathogenic factors invade the human body? Qi Bo replied: Pathogenic factors invade the human body from the upper part. Yellow Emperor asked: Is there a rule regarding high and low positions? Qi Bo replied: The upper half of the body is invaded by wind and rain pathogens; the lower half of the body is invaded by dampness. (Note: "High" refers to the upper part. The upper half of the body is where wind and rain pathogens strike, hence called "invading the high". Wind is the chief of all diseases, thus it alone bears the name "pathogen". The lower half of the body is affected by cold-damp pathogens; dampness is heaviest, so it attacks the lower part, hence emphasis on dampness. Ping An: *Ling Shu* reads "Gao ye" instead of "Ye gao". *Jia Yi Jing* reads "Yi xia" instead of "Yi xia".)

Therefore it is said: Pathogenic factors invading the human body have no fixed pattern; if they invade Yin, they remain in the Fu organs; if they invade Yang, they remain in the meridians. (If pathogens strike the Yin aspect of the arm, they exclusively injure the Yin meridians and flow into the Zang organs. However, since the Zang qi is solid and does not accept external pathogens, the pathogens turn and remain in the six Fu organs. If pathogens strike the Yang aspect of the head and face, they follow the Three Yang meridians downward and remain in the Yang meridians, hence saying there is no fixed pattern. Ping An: *Ling Shu* omits the character "Heng"; "Liu" is written as "Liu". *Jia Yi Jing* writes "Zang" instead of "Jing".)

Yellow Emperor said: Yin and Yang have different names but are of the same category; they meet above and below. (Yin and Yang have different names but belong to the same Qi category. The Three Yang are exterior and superior, the Three Yin are interior and inferior; the Qi of exterior and interior communicates, hence called "meeting".) The meridians interconnect like a circle without beginning or end. (The meridians of the Three Yin branch into the Three Yang, and the meridians of the Three Yang branch into the Three Yin. The Qi of Yin and Yang circulates, completing a cycle, hence called "without end".) When pathogenic factors invade the human body, sometimes they strike Yin, sometimes Yang, in the upper, lower, left, or right, with no fixed pattern. What is the reason for this? (The interconnection and circulation of meridians is the constant principle. The invasion of pathogens follows the meridians, which can be consistent with meridian pathways. However, why do invasions of Yin/Yang, upper/lower, left/right result in different illnesses? What is the cause?)

Qi Bo answered: The convergence of all Yang meridians is at the face. When a person is deficient, or has just exerted themselves physically, or after drinking hot food/beverages causing sweating and opening of the pores (Cou Li), they are susceptible to pathogens. (The convergence of the Hand and Foot Three Yang meridians is all at the face. There are three reasons for humans being invaded by pathogens: first, during periods of annual deficiency; second, after recent physical exertion; third, after hot drinks/food causing sweating and open pores. With these three types of deficiency, pathogens invade humans. Ping An: *Ling Shu* reads "Zhong ren ye" instead of "Ren zhi"; there is no "Re" character after "Ruo".)

If pathogens strike the face, they descend into the Yangming Meridian; if they strike the neck, they descend into the Taiyang Meridian; if they strike the cheek, they descend into the Shaoyang Meridian; if they strike the chest, back, and flanks, they also strike their respective meridians. (Generally, when pathogens strike the face, they enter the Hand and Foot Yangming meridians and descend along them. If they strike the back of the head and neck, they enter the Hand and Foot Taiyang meridians and descend. If they strike the cheeks, they enter the Hand and Foot Shaoyang meridians and descend. If they strike the chest, back, and flanks, they also enter the Three Yang meridians and descend along them.)

Yellow Emperor asked: How do pathogens strike the Yin aspect? Qi Bo answered: Striking the Yin aspect usually begins at the arms and legs. The skin on the Yin aspect of the arms and legs is thin, and the flesh is soft and moist, so they are all susceptible to wind pathogens, exclusively injuring the Yin meridians. (This section discusses pathogens striking the Yin meridians. On the limbs, arms, and legs, the skin over the Yin meridians is thin, and the flesh is moist, so all four areas are susceptible to wind pathogens, thus exclusively injuring the Yin meridians. The previous text mentioned wind/rain attacking the upper and cold-damp attacking the lower, speaking generally; in fact, the legs are also susceptible to wind. Ping An: In the commentary, "Zhuo ze" should be "Nao ze" according to the main text.)

Yellow Emperor asked: Does this injure the Zang organs? Qi Bo replied: Invasion by wind pathogens does not necessarily disturb the Zang organs. Therefore, if pathogens enter the Yin meridians and the Zang qi is solid, the pathogens cannot lodge there, so they return to the Fu organs. Thus, Yang meridians struck by pathogens flow into the meridians, while Yin meridians struck by pathogens flow into the Fu organs. (When pathogens injure the Yin meridians and transmit to the Zang, because the Zang qi does not accept external pathogens, they flow back into the six Fu organs. Thus, Yang pathogens striking the face flow into the Three Yang meridians; Yin pathogens striking the arms and legs flow into the six Fu organs. Ping An: *Jia Yi Jing* writes "Rong" instead of "Ke", "Liu" instead of "Liu", "Fu" instead of "Fu".)

Yellow Emperor asked: How do pathogens strike the Five Zang organs? (Previously it was stated that external pathogens do not strike the Five Zang; next, it discusses pathogens arising internally to strike the Five Zang, hence the question.) Qi Bo replied: Sorrow, worry, and fear injure the Heart. (Sorrow, worry, and fear arise internally and damage the Shen (Spirit), thus injuring the Heart.) Cold exposure of the body and consumption of cold drinks injure the Lung, because internal and external colds interact, damaging both inside and outside, causing Qi to rebel and move upward. (Cold exposure and cold drinks constitute internal and external colds injuring the Lung, as the Lung dislikes cold. Ping An: *Ling Shu* reads "Han yin" instead of "Yin han"; *Jia Yi Jing* reads "Yin leng".) Falling or trauma causes bad blood to remain inside; or extreme anger causes Qi to rise and not descend, accumulating under the flanks, thus injuring the Liver. (Trauma from falling causes bad blood retention, an external injury. Extreme anger is an internal injury. Both internal and external injuries accumulate under the flanks, injuring the Liver. Ping An: *Ling Shu* and *Jia Yi Jing* omit "Ruo".) Being beaten or fallen, or engaging in sexual activity while drunk, with sweat exposed to wind, injures the Spleen. (Being beaten/fallen and exposed to wind is external damage. Drunken sexual activity with sweating is internal damage. Both internal and external damages thus injure the Spleen. Ping An: *Jia Yi Jing* adds "Yi" before "Zui".) Exerting force to lift heavy objects, or excessive sexual activity, with sweat bathing in water, injures the Kidney. (Exerting force and bathing in sweat/water is external damage. Excessive sexual activity is internal damage. These two damages thus injure the Kidney. Ping An: In Yuan's edition, the character "Shui" in "Yu shui" is mistakenly printed as "Ye".)

Yellow Emperor asked: How do the Five Zang organs contract wind? Qi Bo replied: When both Yin and Yang are affected (i.e., both interior and exterior are deficient), then pathogens can enter. Yellow Emperor said: Good. (Previously it discussed injuries to the Five Zang; next it discusses wind contracting the Five Zang. When Yin-Yang and Blood-Qi are both deficient, they are all susceptible to wind, thus allowing pathogens to enter. Ping An: *Jia Yi Jing* reads "Ju xiang gan" instead of "Ju gan".)

Yellow Emperor asked Qi Bo: The head and face, and the body shape, belong to bone connected to tendon, sharing blood and combining Qi. When heaven is cold, the earth cracks and ice forms. Sudden cold may cause the hands and feet to become slack and weak, yet the face is uncovered. Why is this? (Both the head/face and the body belong to bone, connect to tendons, share blood, and combine Qi. Why do hands and feet become cold and slack in cold weather, while the uncovered face does not feel cold? What is the reason? Ping An: Yuan's edition omits the character "Er" after "Qi".)

Qi Bo replied: The Twelve Primary Meridians and the Three Hundred Sixty-five Collateral vessels, their Blood and Qi all ascend to the face and travel through the orifices. (The Six Yang meridians all ascend to the face. Among the Six Yin meridians, only the Foot Jueyin ascends to the face; the other two reach only under the tongue and do not ascend to the face. Saying "all ascend to the face" speaks generally. Their meridian networks and Blood-Qi are interconnected, thus all ascending to the seven orifices for function. Ping An: In the commentary, Yuan's edition prints "Zhi" instead of "Zhi" in "Liu yang zhi jing".)

Its refined Yang Qi ascends to the eyes to form vision. (The refined Yang Qi of the meridians ascends to the eyes, forming eye clarity. Ping An: *Jia Yi Jing* adds "Zhi" before "Qi". *Ling Shu* reads "Shang zou yu mu" instead of "Shang yu mu", and "Wei jing" instead of "Wei jing"; *Jia Yi Jing* is the same.) Its separate Qi travels to the ears to form hearing. (The separate refined Yang Qi enters the ears to enable hearing.) Its ancestral Qi (Zong Qi) ascends out of the nose to form smell. (The Five Zang gather Qi to form Zong Qi; Zong Qi enters the nose, enabling the perception of odors.) Its turbid Qi emerges from the Stomach, travels to the lips and tongue to form taste. (Eyes and ears for seeing/hearing are generated by clear Qi. Lips and tongue for tasting are formed by turbid Qi. Taste refers to the perception of flavor. Ping An: *Jia Yi Jing* adds "Xia" before "Chu".)

The fluids of Qi all ascend and steam upon the face. The facial skin is thick, and the flesh is firm, so heat is abundant, and cold cannot overcome it. (Because the Blood and Qi of the Twelve Primary Meridians and Three Hundred Sixty-five Collaterals all ascend and steam upon the face, due to abundant Yang Qi, the skin is thick and firm, thus generating heat to resist cold. Ping An: *Ling Shu* and *Jia Yi Jing* read "Er pi" instead of "Mian pi". *Ling Shu* adds "Tian" before "Re"; *Jia Yi Jing* adds "Da". All add "Zhi" after "Sheng".)