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[Ping An] This section, from the beginning of the chapter to "thus menstruation does not come, Huangdi said: Excellent," is found in *Suwen* (Plain Questions), Volume 9, Chapter 33, "Evaluation of Heat Diseases." From "Huangdi asked Qibo: There is a disease with facial swelling" to the end, it is found in *Suwen*, Volume 13, Chapter 47, "Discussion on Rare Diseases." Furthermore, from start to finish, it appears in *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 8, Section 5.

Huangdi said: A patient suffering from Kidney Wind (Shen Feng) presents with facial edema and distension, and has difficulty speaking (hoarseness or inability to vocalize). Can this condition be treated with acupuncture? (Note: The character ' ' is pronounced 'fu fu fan' and means putrefaction; 'Pang' is pronounced 'pu jiang fan'. Damage and putrefaction of Kidney Qi cause facial edema and distension, leading to voicelessness, hence termed 'harmful speech'. These are signs of Kidney Wind; can it be needled? Ping An: In *Suwen* and *Jiayi Jing*, 'Pang' is written as ' '. *Jiayi Jing* adds the character 'swelling' before 'distension', noting that *Suwen* lacks this character. 'Bu' is written as 'Fou' in *Jiayi Jing*.)

Qibo replied: Treating deficiency with draining methods constitutes 'deficiency of deficiency,' which is contraindicated for needling. If needled erroneously, the pathogenic qi will arrive after five days. (Such presentation indicates Kidney Wind. With double deficiency of the Kidney and wind invasion, needling is forbidden. If needled, when the water number cycle completes, the pathogenic qi will manifest. Excluding the day of needling, counting forward five days totals six days, corresponding to the completed number of Water. Ping An: *Suwen* and *Jiayi Jing* read "deficiency should not be needled; if needled erroneously..." instead of "deficiency of deficiency...".)

Question: How will the condition develop? (Ping An: *Suwen* and *Jiayi Jing* read "What will happen upon arrival?")

Answer: Upon arrival, there will certainly be shortness of breath (Qi deficiency), intermittent fever, sweating from the chest and back up to the head, heat in the hands, dry mouth, bitter thirst, inability to lie supine, and coughing when lying supine. This disease is named Wind Water (Feng Shui). (When Kidney Wind pathogenic qi arrives, eight signs appear: one, shortness of breath; two, intermittent fever; three, sweating from chest to head; four, heat in hands; five, heat in mouth; six, bitter thirst; seven, inability to lie supine, meaning inability to lie flat, which induces coughing. These eight signs indicate Kidney Wind-Water disease. Ping An: *Suwen* repeats "intermittent fever"; *Jiayi Jing* omits "heat" after "time"; *Suwen* and *Jiayi Jing* add "out" after "sweat"; *Suwen* adds twenty-three characters after "bitter thirst": "yellow urine, swollen under-eyes, abdominal borborygmus, heavy body difficult to move, amenorrhea, irritability and inability to eat," identical in *Jiayi Jing* except for missing "yi" before "xing" and repeating "shi" at the end. Yuan edition inserted these into the main text, but based on annotations, they should not be; thus, following the original manuscript is correct.)

Huangdi said: I wish to hear the explanation.

Qibo said: Wherever pathogenic factors gather, Zheng Qi (True Qi) must be deficient. When Yin is deficient, Yang pathogenic factors inevitably converge upon it; thus, yellow urine indicates internal heat. (Pathogens gather in deficiency, specifically Kidney Qi deficiency. Once Kidney Qi is deficient, Yang Qi merges with it, causing internal heat and yellow urine. Ping An: *Suwen* reads "shortness of breath, intermittent fever, and sweating. Yellow urine indicates heat in the lower abdomen"; *Jiayi Jing* reads "shortness of breath, intermittent fever, sweating, and yellow urine. Yellow urine indicates heat in the lower abdomen Qi.")

Inability to lie supine is due to disharmony in the Stomach. Coughing worsens when supine because Qi presses upward against the Lung. (Kidney deficiency with wind causes Stomach disharmony. Supine position allows Qi to press against the Lung, causing cough.)

In all cases of fluid retention diseases, signs manifest under the eyes. Why say this? Because Water is Yin, and the area under the eyes is also Yin. The abdomen is the residence of Supreme Yin. Therefore, when water accumulates in the abdomen, swelling under the eyes necessarily occurs. (Water, under-eye area, and abdomen all belong to Yin; thus, abdominal water leads to under-eye swelling. Ping An: *Suwen* and *Jiayi Jing* read "slight swelling" instead of "signs". *Suwen* adds "Emperor said" before "Why say"; *Jiayi Jing* adds "said".)

When True Qi rebels upward, causing bitter taste and dry tongue, one cannot lie supine; supine posture induces coughing of clear fluid. (Abdominal water causes True Qi rebellion, bitter taste, dry tongue, and supine-induced coughing with expulsion of clear fluid. Ping An: *Suwen* and *Jiayi Jing* add "gu" after "ni", remove "zhe gu" after "gan", add "wo" after "gan", and add "chu" after "ke".)

In all water diseases, patients cannot lie down; lying down causes palpitations/fright, which exacerbates coughing. (Additionally, in water diseases, supine position causes fright, which intensifies coughing, serving as another sign. Ping An: The annotation's "fu" was mistakenly printed as "fu" [abdomen] in Yuan edition.)

Abdominal borborygmus and amenorrhea originate from the Stomach. Pathogenic influence on the Liver causes irritability and anorexia; food impaction results from Stomach obstruction. (Amenorrhea stems from Stomach Qi disharmony, causing Qi to affect the Liver, leading to irritability and anorexia, resulting in Stomach obstruction and lack of food in the abdomen, hence borborygmus. Ping An: *Suwen* and *Jiayi Jing* omit "amenorrhea"; *Jiayi Jing* writes "Spleen" for "disease"; *Suwen* and *Jiayi Jing* write "affect Spleen" for "affect Liver" and "Stomach Wan" for "Stomach Guan".)

Heavy body and difficulty walking occur because the Stomach Meridian resides in the foot. (The Foot-Yangming Stomach Meridian is in the foot. Current Stomach Qi disharmony causes Qi to descend to the feet, resulting in heaviness and inability to walk.)

Amenorrhea occurs because the Bao Mai (Uterine Vessels) are blocked. The Bao Mai belongs to the Heart and connects to the Bao (Uterus); Qi presses upward against the Lung, preventing Heart Qi from descending, thus causing amenorrhea. (Bao refers to the Ren and Chong vessels originating in the Bao, serving as the Sea of Meridians. The Chong vessel arises between the Bladder's Bao and the female opening, ascending to the throat, passing through the Heart and Lung. The Lung and Heart are interconnected. Currently, deficiency and pathogens block the Bao Mai; downward it overflows into Bao Qi, upward it presses against Lung Qi, preventing descent, hence amenorrhea. Ping An: *Suwen* and *Jiayi Jing* read "Bao Mai belongs to Heart and connects to Bao"; "ling" is "jin" (now); "Xin Zang" is "Xin Qi".)

Huangdi said: Excellent.

Huangdi asked Qibo: A patient presents with facial swelling resembling water accumulation. Palpation reveals a large and tight pulse. The body has no pain, form is not emaciated, yet the patient cannot eat and eats little. What is this disease?

Qibo replied: The disease originates in the Kidney and is named Kidney Wind. In Kidney Wind, if the patient cannot eat and experiences frequent fright, death ensues if accompanied by Heart Wei (Heart Atrophy/Deficiency). (Pangran describes facial skin swelling. Six distinctions characterize Kidney Wind: one, facial swelling; two, large and tight pulse; three, no body pain; four, non-emaciated form; five, poor appetite; six, predisposition to fright. Presence of these six signs indicates Kidney Wind. If Heart Qi is not atrophied, survival is possible; if atrophied, death occurs. Ping An: *Suwen* omits "qi" in "resembling water qi"; *Jiayi Jing* writes "zhu" for "sheng"; *Suwen* and *Jiayi Jing* write "shan" for "xi"; *Suwen* writes "jing yi" and *Jiayi Jing* writes "bu yi" for "jing yi"; *Suwen* and *Jiayi Jing* write "Xin Qi Wei" for "Xin Wei". Yuan edition writes "wei" as "wei".)