此复论阳明之气。不能分布于四末。而为痿厥也。痿者。手足委弃而不为我所用。厥者。手足
清冷也。夫阳明为阖。气不通则阖折。阖折则气无所止息而痿疾起矣。阳受气于四末。阳明之气不
行。故手足逆冷也。阳明
居中土。为水谷之海。海之所以行云气者。天下也。是以上文论阳明之气。不能升降于上下。此论
不得分布于四方。朱永年曰。 、闷也。为四末束 者。束缚其手足。使满闷而疾解之。导其气之
通达也。夫按之束之。皆导引之法。犹尺蠖之欲伸而先屈也。身半以上为阳。身半以下为阴。昼以
前为阳。昼以后为阴。日二者。使上下阴阳之气。表章而交通也。不仁者。荣血不行也。十日者。
阴数之周也。
岁。以草刺鼻嚏。嚏而已。无息而疾迎引之。立已。大惊之亦可已。（岁作哕嚏音啻）
哕、呃逆也。言其发声。如车銮之声而有输序。故名曰哕。此阳明所受之谷气。欲从肺而转达
于肤表。肺气逆还于胃。气并相逆。复出于胃。故为哕。故以草刺鼻取嚏以通肺气。肺气疏通。则
谷气得以转输而呃逆止矣。无息。鼻息不通也。疾迎引之。连取其嚏也。夫谷入于胃。散精于心肝。
大惊则肝心之气分散。胃之逆气。亦可从之而外达也。按、胃络上通于心。肝脏之脉挟胃。此言阳
明之气。从肺气而出于气分。亦可从肝心而出于血分也。此章论杂病之因。有因于气者。有厥在经
脉者。有经气之并逆者。首论太阳而末结阳明。盖太阳为诸阳主气。阳明乃血气之生原。故行于上下
四旁。气分血分。夫人之百病。不越外内二因。外内之病。皆能令血气厥逆。是以凡病多本于郁逆。
学人以数篇厥逆之因证。细心参求。为治之要。思过半矣。张介宾曰。岁、当作哕。
This passage further discusses the Qi of the Yangming channel failing to distribute to the four extremities, resulting in Wei syndrome (flaccidity) and Jue syndrome (cold limbs). "Wei" refers to the weakness of the hands and feet such that they cannot be controlled by one's will. "Jue" refers to the coldness of the hands and feet. The Yangming channel governs the "He" (closing function); if Qi flow is obstructed leading to a fracture of the closing function (He Zhe), the Qi has no place to rest and becomes disordered, giving rise to flaccidity diseases. Yang Qi receives nourishment at the four extremities; when the Qi of the Yangming channel fails to circulate normally, it results in cold extremities.
The Yangming channel resides in the center and belongs to Earth, serving as the "Sea" of water and grain. Just as the ocean generates clouds and mist across the world, the previous text discussed how the Qi of the Yangming channel fails to ascend and descend between the upper and lower parts, while this section discusses its failure to distribute to the four directions. Zhu Yongnian stated: "Shu" means stuffiness. The phrase "binding the four extremities" implies binding the hands and feet to induce a sensation of fullness, then releasing them to treat the disease, thereby guiding the free flow of Qi. Pressing and binding are both methods of Daoyin (guiding and pulling exercises), similar to how the inchworm must first curl up before extending itself. The upper half of the body belongs to Yin-Yang (Yang), and the lower half belongs to Yin; the first half of the day belongs to Yang, and the second half belongs to Yin. "Ri Er" (two days/times) signifies enabling the Qi of Yin and Yang above and below to manifest and communicate with each other. "Bu Ren" (loss of sensation) refers to the stagnation of Ying Blood (Nutritive Blood). Ten days represent the completion of one cycle of the Yin number.
Stimulating the nose with grass to induce sneezing (Ti) cures the condition once the sneeze occurs. If nasal breathing is blocked, rapidly guiding and attracting the Qi will also stop the condition immediately. Being greatly startled can also cure it. (Note: The character "Sui" here should be read as "Yue", pronounced like "Ti").
"Yue" refers to hiccuping. It is named so because the sound produced resembles the ringing of carriage bells with a rhythmic order. This occurs because the Grain Qi received by the Yangming channel attempts to transfer from the Lung to the skin surface, but Lung Qi rebels and returns to the Stomach. The Qi merges and rebels together, exiting again from the Stomach, thus causing hiccups. Therefore, stimulating the nose to induce sneezing is used to unblock Lung Qi. Once Lung Qi is unblocked, Grain Qi can be transported smoothly, and the hiccups cease. "Wu Xi" refers to blocked nasal breathing; "Ji Ying Yin Zhi" refers to continuously inducing sneezes. When food enters the Stomach, its essence scatters to the Heart and Liver. Great fright causes the Qi of the Liver and Heart to scatter, allowing the rebellious Qi of the Stomach to dissipate outward. According to meridian theory, the collaterals of the Stomach connect upwards to the Heart, and the meridians of the Liver flank the Stomach. This indicates that the Qi of the Yangming channel can exit via Lung Qi into the Qi aspect, or via the Liver and Heart into the Blood aspect.
This chapter discusses the causes of miscellaneous diseases: some arise from Qi dysfunction, some involve Jue pathogens in the meridians, and some involve the simultaneous rebellion of meridian Qi. It begins with the Taiyang channel and concludes with the Yangming channel. This is likely because the Taiyang channel is the master Qi of all Yang channels, and the Yangming channel is the source of Qi and Blood generation, allowing Qi to circulate through the upper, lower, and surrounding areas. Whether in the Qi aspect or the Blood aspect, human diseases do not exceed external and internal causes. Both external and internal diseases can cause Qi and Blood to rebel and become stagnant. Therefore, most diseases originate from stagnation and rebellion. If students carefully study the causes and syndromes of Jue rebellion described in these sections, they will grasp the essentials of treatment and understand more than half of the subject matter. Zhang Jiabin stated that "Sui" should be written as "Yue".