目 外决于面者为锐 。在内近鼻者为内 。上为外 。下为内 。
锐 内 者。睛外之眼角也。太阴之气主合同束。目外角为锐 。内角为内 者。乃太阴之气。
主乎外内之目 也。太阳为目上纲。阳明为目下纲。上为外 。下为内 者。乃太阳阳明之气。主
于上下之目 也。手太阴主天。足太阴主地。太阳为开。阳明为阖。天地之气。昼明夜晦。人之两
目。昼开夜阖。此人应天地之昼夜开阖者也。一息之中。有开有阖。以应呼吸漏下者也。天地开阖
之气不清。阴阳出入之气混浊。则神志昏而癫狂作矣。是以治癫狂之法。独取手足之太阴太阳阳
明焉。夫肺主皮毛。目之拳毛。天气之所生也。肌肉之精为约束。地气之所生也。目 之外内上下。
又统属天地阴阳之气而为开阖者也。王芳侯曰。癫狂之疾。最为难治。得此篇之理。可批却导 矣。
癫疾始生。先不乐。头重痛。视举目赤甚。作极已而烦心。候之于颜。取手太阳阳明太阴。血
变而止。
夫癫狂之疾。乃阴阳之气。先厥于下。后上逆于巅而为病。故通评虚实篇曰。癫疾厥狂。久逆
之所生也。又曰。
厥成为癫疾。夫少阴者。先天之水火。太阴者。后天之地土。天地水火之气。上下平交者也。厥则
不平而为病矣。水之精为志。火之精为神。先不乐者。神志不舒也。举视目赤者。心气上逆也。癫
甚作极。已而心烦者。厥逆之气。上下于太阴阳明。而复之于少阴之心主也。五色篇曰。庭者、颜
也。首面上于阙庭。王宫在于下极。盖谓天阙在上。王宫在下。故候之于颜者。候天之气色也。身
半以上为阳。手太阴阳明皆主之。故取手太阴阳明。以清天气之混浊。取手太阳。以清君主之心
烦。心主血。血变则神气清而癫疾止矣。
癫疾始作。而引口啼呼喘悸者。候之手阳明太阳。左强者攻其右。右强者攻其左。血变而止。
此论厥气上乘。致开阖不清而为癫疾也。啼悸者。太阳之气混乱也。喘呼者。阳明之气不清也。
太阳主开。阳明主阖。故当候之手阳明太阳。夫天地开阖之气。左旋而右转。故左强者攻其右。右
强者攻其左。莫云从曰。手太阳者心之表。手阳明者肺之表。在心为啼悸。在肺为喘呼。因开阖不
清而啼悸喘呼者。病在表而及于内也。
癫疾始作。先反僵。因而脊痛。候之足太阳阳明太阴。手太阳。血变而止。
癫疾始作。先反僵者。厥气逆于寒水之太阳也。因而脊痛者。寒气乘于地中也。脊。背也。易
曰艮其背。艮为山。止而不动。乃坤土之高阜者。故当候之足太阳阳明太阴。按首节论厥气上乘于
天。及太阳君火。次节论开阖之不清。此节论厥气逆于水土之中。盖天地水火之气不清。而为癫
疾也。复取手太阳者。水火神志相交。足太阳之水邪上逆。必致心主之神气昏乱。故俟其血变。则
神气清矣。沈亮宸曰。以上三证。曰始生始作。
盖厥气始上逆于太阴太阳阳明之气。而未及乎有形之筋骨也。疾在气者。易于清散。其病已入深。
虽司命无奈之何。故骨脉之癫疾。皆多不治。使良医得早从事。则疾可已。身可治也。奈人之所
病。病疾多。而医之所病。病道少。
治癫疾者。常与之居。察其所当取之处。病至。视其有过者泻之。置其血于瓠壶之中。至其发
时。血独动矣。不动灸穷骨二十壮。穷骨者。 骨也。
此言治癫疾者。当分别天地水火之气而治之。太阳之火。日也。随天气而日绕地一周。动而不
息者也。地水者。静而不动者也。常与之居者。得其病情也。察其所当取之处。视其有过者泻之。
谓视疾之在于手足何经而取之也。匏壶。葫芦也。致其血于壶中。发时而血独动者。气相感召也。
如厥气传于手太阴太阳。则血于壶中独动。感天气太阳之运动也。不动者。病入于地水之中。故当
灸骨二十壮。经云陷下则灸之。此疾陷于足太阳太阴。故当灸足太阳之 骨。二者阴之始。十乃
阴之终。地为阴而水为阴也。朱永年曰。素问长刺节论云。初发岁一发。不治则月一发。名曰癫疾。
夫岁一发者。日一岁而一周天。日以应火也。月一发者。月一月而一周天。月以应水也。
骨癫疾者。 齿诸 分肉皆满而骨居。汗出烦 。呕多沃沫。气下泄不治。（ 叶坎面也 音
瞒闷也）
齿者骨之余。分肉属骨。是以骨癫疾者。 齿诸分肉皆满。骨居者。骨肉不相亲也。汗者血之
液。汗出烦 者。病在足少阴肾。而上及于手少阴心也。呕多沃沫。太阴阳明之气上脱也。肾为生
气之原。气下泄。少阴之气
下泄也。阴阳上下离脱。故为不治。莫云从曰。病入骨髓。虽良医无所用其力。故不列救治之法。
此下三证。病在有形之筋骨。故不言太少之阴阳。
筋癫疾者。身倦。挛急大。刺项大经之大杼脉。呕多沃沫。气下泄不治。
病在筋。故身倦挛而脉急大。足太阳主筋。故当刺膀胱经之大杼。呕多沃沫。气下泄者。病有
形之脏腑。而致阴阳之气脱也。
脉癫疾者。暴仆。四肢之脉。皆胀而纵。脉满。尽刺之出血。不满。灸之。挟项太阳。灸带脉
于腰。相去三寸。诸分肉本输。呕多沃沫。气下泄不治。
经脉者。所以濡筋骨而利关节。脉癫疾。故暴仆也。十二经脉皆出于手足之井荥。是以四肢之
脉。皆胀而纵。脉满者。病在脉。故当尽刺之。以出其血。不满者。病气下陷也。夫心主脉。而为
阳中之太阳。不满者。陷于足太阳也。十二脏腑之经俞。皆属于太阳。故当灸太阳于项间。以启陷
下之疾。带脉起于季胁之章门。横束诸经脉于腰间。相去季胁三寸。乃太阳经俞之处也。诸分肉本
俞。 谷之俞穴也。盖使脉内之疾。仍从分肉气分而出。
癫疾者。疾发如狂者。死不治。
夫阴盛者病癫。阳盛者病狂。癫疾者。疾发如狂者。阴阳之气并伤。故死不治。夫阴阳离脱
者死。阴阳两伤者亦死。莫云从曰。阳病速。故疾发。用二者字。以分阴阳。
狂始生先自悲也。喜忘苦怒善恐者。得之忧饥。治之取手太阴阳明。血变而止。及取足太阴阳明。
此以下论狂疾之所生。有虚而有实也。先自悲者。先因于肾虚也。经云。水之精为志。精不上
传于志。而志独悲。故泣出也。喜忘善恐者。神志皆虚也。苦怒者。肝气虚逆也。盖肝木神志。
皆肾精之所生也。此得之忧饥。夫忧则伤肺。饥则谷精不生。肺伤则肾水之生原有亏。谷精不生。则
肾精不足矣。阴不足。则阳盛而为狂。取手太阴阳明者。逆气上乘于手太阴阳明。泻出其血。而逆
气散矣。及取足太阴阳明者。补足太阴阳明。资谷精以助肾气也。此节首论阴虚以致阳狂。即末节
之所谓短气。息短不属。动作气索。补足少阴。去血络也。盖癫狂乃在上之见证。厥逆乃在下之始
因。故篇名癫狂。而后列厥逆。上工之治未病者。治其始蒙也。夫癫疾多因于阴实。狂疾有因于阴
虚。故越人曰。重阴者癫。重阳者狂。盖阴虚则阳盛矣。夫阴虚阳盛。则当泻阳补阴矣。然阴精生于
阳明。而阳气根于阴中。阴阳互相资生之妙用。学人细心体会。大有裨于治道者也。
狂始发。少卧不饥。自高贤也。自辨志也。自尊贵也。善骂詈。日夜不休。治之取手阳明太阳
太阴。舌下少阴。视之盛者皆取之。不盛释之也。
此心气之实狂也。夫阴气盛则多卧。阳气盛则少卧。食气入胃。精气归心。心气实。故不饥。
心乃君主之官。虚则自卑下。实则自尊高。阳明实则骂詈不休。心火盛而传乘于秋金也。肺者心之
盖。火炎上则天气不清矣。故当取手太阳之腑。以泻君火之实。取手阳明太阴。以清乘传之邪。舌
下少阴。心之血络也。此病心之神志。而不在血脉。故当视之。如盛者并皆取之。如不盛。则释之
而勿取也。盖病在无形之神志。皆从腑以清脏。腑
为阳而主气也。如入于血络。则取本脏之脉络矣。马氏曰。上节言始生。而此曰始发。则病已成而
发也。
狂言。惊善笑。好歌乐。妄行不休者。得之大恐。治之取手阳明太阳太阴。此肾病上传于心。
而为心气之实狂也。得之大恐。则伤肾。阴虚阳盛。故狂言而发惊也。经云。心气实则善笑。虚则
善悲。实则心志郁结。故好歌乐以伸舒之。神志皆病。故妄行不休也。取手太阳以清心气之实。取
手阳明太阴。以资肾气之伤。
狂。目妄见。耳妄闻。善呼者。少气之所生也。治之取手太阳太阴阳明。足太阴头两 。
此因肾气少而致心气虚狂也。心肾水火之气。上下相济。肾气少则心气亦虚矣。心肾气虚。是以目
妄见。耳妄闻。善呼者。虚气之所发也。当取手太阳太阴阳明。以清狂妄。补足太阴阳明。以资谷
精。盖水谷入胃。津液各走其道。肾为水脏。受藏五脏之精。气生于精也。本经曰。胃气上注于肺。
其悍气上冲头者。循咽上走虚窍。循眼系入络脑。出 下客主人。循牙车合阳明。并下人迎。此阳
明之气。上走空窍。出于头之两 。不曰足阳明而曰头两 者。盖取阳明中上二焦之气。以纳化水
谷也。按、此节即下文之少气身漯漯也。言吸吸也。盖始见在下之虚。即补少阴之阴。今发于上而
为狂。又当用治狂之法矣。
狂者多食。善见鬼神。善笑而不发于外者。得之有所大喜。治之取足太阴太阳阳明。后取手太
阴太阳阳明。此喜伤心志而为虚狂也。心气虚故饮多食。神气虚。故善见鬼神也。因得之大喜。故
善笑。不发于外者。冷笑而无声也。食气入胃。浊气归心。故当先补足太阴阳明。以养心精。补足
太阳之津。以资神气。后取手太阴太阳阳明以清其狂焉。按因于足少阴者。先取手而后取足。因于手少
阴者。先取足而后取手。皆上下
气交之妙用。
狂而新发。未应如此者。先取曲泉左右动脉。及甚者见血。有顷已。不已。以法取之。灸骨
二十壮。
此总结以上之狂疾。如从下而上者。则当先取肝经之曲泉。应者。谓因于下而应于上也。盖言
狂乃心气虚实之为病。如因于肾气之实虚。皆从水而木。木而火也。故狂而新发。未见悲惊喜怒。
妄见妄闻。如此之证者。先取曲泉左右之动脉。盛者见血即已。盖病从木气清散。而不及于心神矣。
如不已。用灸法以取之。 骨。乃督脉之所循。督脉与肝脉会于头项。故灸骨 。引厥阴之脉气。
复从下散也。按脊骨之尽处为 骨。乃足太阳与督脉交会之处。曰穷骨。曰 骨。曰骨 。盖亦有
所分别也。
风逆。暴四肢肿。身漯漯。唏然时寒。饥则烦。饱则善变。取手太阴表里。足少阴阳明之经。
肉清取荥。骨清取井经也。
经云。厥成为癫疾。盖因厥气上逆。而成癫疾也。夫肾为水脏。风行则水涣。风逆者。因感外
淫之风。以致少阴之气上逆也。风淫末疾。故暴肿四肢。漯漯。寒湿也。唏然。寒竞貌。乃风动水
寒之气。而见此证也。风伤肾水。则心气亦虚。故饥则烦。风木之邪。贼伤中土。故饱则善变也。
取手太阴表里。以清风邪。足少阴阳明之经。以调逆气。清、冷也。肉清者。凉出于肌腠。故取荥
火以温肌寒。盖土主肌肉。火能助土也。骨清者。尚在于水脏。故取井木以泻水邪。余伯荣曰。
取手太阴表里者。取汗也。如用麻黄以通毛窍。配杏子以利肺金。盖里气疏而后表气通也。
厥邪为病也。足暴清。胸将若裂。肠若将以刀切之。烦而不能食。脉大小皆涩。暖取足少阴。
清取足阳明。清则补之。温则泻之。
此足少阴之本气厥逆而为病也。少阴之大络起于肾。下出于气街。循阴股内廉。斜入 中。下
出内踝之后。入足下。少阴之气逆于内。故足暴清也。胸将若裂。肠若将以刀切之。烦而不能食者。
厥气从腹而上及于心胸也。血脉资始于肾。脉来或大或小皆涩者。肾气逆而致经脉之不通也。肾为
生气之原。如身体暖者。实逆也。故当取足少阴以泻之。清者。虚逆也。故当补足阳明。以资肾脏
之精气。以上二节。一因外感之厥。一因本气之厥。皆为癫疾之生始。见厥证而先以治厥之法清之。
即所以治未病也。
厥逆腹胀满。肠鸣。胸满不得息。取之下胸二胁。咳而动手者。与背 以手按之。立快者是也。
此言厥逆之气。上乘于太阴阳明。而将成癫疾也。腹胀满者。乘于足太阴阳明也。肠鸣者。乘
于手阳明也。胸满不得息者。乘于手太阴也。胸下二胁。乃手太阴中府云门之动脉处。背俞者。肺
之俞也。取之下胸二胁。咳而动手者。再以手按其背俞。而病患立快者。是厥逆之气上乘。是成癫
疾矣。病在气。故按之立快。盖言厥癫疾者。在气而不在经也。朱卫公曰。肺合天气。故候于手
太阴。
内闭不得溲。刺足少阴太阳。与 上。以长针。
此承上文而言厥逆之气。惟逆于下而不上乘者也。逆气在下。故内闭不得溲。当刺足少阴太
阳与 上。以
泻逆气。而通其溲便焉。夫足少阴。先天之两仪也。手足太阴阳明。后天之地天也。先后天之气。
Rui (the outer canthus) is located on the lateral side of the face, while Nei (the inner canthus) is medial, near the nose. The upper aspect is considered external, and the lower aspect internal.
The terms "Rui" and "Nei" refer to the lateral and medial canthi of the eye, respectively. The Qi of the Taiyin meridian primarily governs contraction and binding. The lateral canthus is termed "Rui," and the medial canthus "Nei," because the Qi of the Taiyin meridian governs the ocular systems at these internal and external aspects. The Taiyang meridian serves as the governing structure for the upper eyelid/eye region, while the Yangming meridian governs the lower aspect. The upper being external and the lower internal reflects the governance of the ocular regions by the Qi of the Taiyang and Yangming meridians. The Hand-Taiyin Lung meridian corresponds to Heaven, and the Foot-Taiyin Spleen meridian corresponds to Earth. The Taiyang meridian governs opening, and the Yangming meridian governs closing. The Qi of Heaven and Earth is bright during the day and dark at night. Human eyes open during the day and close at night, mirroring the opening and closing rhythms of Heaven and Earth. Within each breath, there is opening and closing, corresponding to the rhythm of respiration. If the opening and closing Qi of Heaven and Earth becomes turbid, and the entering and exiting Qi of Yin and Yang becomes mixed and impure, then the Shen (Spirit) and Zhi (Will) will become confused, leading to the onset of Dian-Kuang (epilepsy and mania). Therefore, the treatment for Dian-Kuang specifically selects points from the Taiyin, Taiyang, and Yangming meridians of both the hands and feet. The Lung governs the skin and hair; the eyelashes are generated by Heavenly Qi. The essence of muscle forms the constraints of the eyelids, generated by Earthly Qi. The movements of the eyes in all directions are collectively governed by the opening and closing mechanisms of Heaven, Earth, Yin, and Yang Qi. Wang Fanghou stated: "Dian-Kuang is a difficult disease to treat, but understanding the principles of this chapter allows one to dissect it with ease, like carving bone."
When Dian-Ji (epilepsy/melancholic psychosis) first begins, the patient initially feels unhappy, experiences heavy head pain, looks upward with intensely red eyes, and after extreme fatigue, feels mental restlessness. Observation should focus on the facial area (Yan). Points from the Hand-Taiyang, Hand-Yangming, and Hand-Taiyin meridians are selected until the blood color changes.
Dian-Kuang diseases arise when Yin and Yang Qi first jues (reverses) downward and then rebels upward to the vertex, causing pathology. Thus, the *Tong Ping Xu Shi Pian* states: "Dian-Ji and Jue-Kuang are generated by prolonged reversal." It also says: "Jue evolves into Dian-Ji." The Shaoyin meridian represents the先天 (innate) Water and Fire, while the Taiyin meridian represents the 后天 (acquired) Earth. The Qi of Heaven, Earth, Water, and Fire should intersect and balance above and below. When Jue occurs, this balance is lost, leading to disease. The essence of Water is Zhi (Will), and the essence of Fire is Shen (Spirit). Initial unhappiness indicates that Shen and Zhi are not舒展 (smooth/unfettered). Looking upward with red eyes indicates Heart Qi rebelling upward. When Dian is severe and leads to extreme exhaustion, followed by mental irritability, it is because the Jue Qi moves up and down between the Taiyin and Yangming, ultimately affecting the Heart Master of the Shaoyin. The *Se Wu Pian* states: "Ting" refers to the forehead/facial area. The head and face are located above the Que Ting (Gate Courtyard), while the Wang Gong (Heart) is located at the lower extremity (below the nose). This means the Heavenly Gate is above, and the Royal Palace (Heart) is below. Observing the Yan (face) is observing the Qi color of Heaven. The upper half of the body belongs to Yang, governed by the Hand-Taiyin and Hand-Yangming meridians. Therefore, selecting Hand-Taiyin and Hand-Yangming clears the turbidity of Heavenly Qi, while selecting Hand-Taiyang clears the Heart's irritability. Since the Heart governs Blood, when the blood color normalizes, the Shen Qi clears, and Dian-Ji stops.
When Dian-Ji first manifests with mouth deviation, crying, calling, panting, and palpitations, observe the Hand-Yangming and Hand-Taiyang meridians. If the left side is rigid, treat the right; if the right is rigid, treat the left. Stop when the blood color changes.
This section discusses how Jue Qi ascending causes unclear opening and closing, leading to Dian-Ji. Crying and palpitations indicate chaos in Taiyang Qi; panting and calling indicate uncleanness in Yangming Qi. Since Taiyang governs opening and Yangming governs closing, one must observe the Hand-Yangming and Hand-Taiyang meridians. The opening and closing Qi of Heaven and Earth rotates left and turns right; thus, rigidity on the left is treated on the right, and vice versa. Mo Yuncong stated: "Hand-Taiyang is the exterior of the Heart, and Hand-Yangming is the exterior of the Lung. In the Heart, it manifests as crying and palpitations; in the Lung, as panting and calling. Because unclear opening and closing leads to these symptoms, the disease is in the exterior but affects the interior."
When Dian-Ji first manifests with initial opisthotonos (body stiffening backward) followed by spinal pain, observe the Foot-Taiyang, Foot-Yangming, Foot-Taiyin, and Hand-Taiyang meridians. Stop when the blood color changes.
Initial opisthotonos in Dian-Ji occurs because Jue Qi rebels against the Cold-Water nature of the Taiyang meridian. Spinal pain follows because Cold Qi invades the Earthly center. The spine refers to the back. The *I Ching* states "Gen its back"; Gen symbolizes the mountain, stillness, and immobility, representing the high mounds of Kun Earth. Therefore, one should observe the Foot-Taiyang, Foot-Yangming, and Foot-Taiyin meridians. While the first section discussed Jue Qi ascending to Heaven and Taiyang Ministerial Fire, and the second discussed unclear opening/closing, this section discusses Jue Qi reversing in the Water and Earth. Impurity in the Qi of Heaven, Earth, Water, and Fire generates Dian-Ji. Re-selecting the Hand-Taiyang meridian is because Water and Fire interact with Shen and Zhi; rebellion of Water Evil from Foot-Taiyang inevitably confuses the Shen Qi of the Heart Master. Waiting for the blood color to change ensures the Shen Qi clears. Shen Liangchen said: The three preceding syndromes use the terms "initial generation" and "initial onset."
This implies that Jue Qi has just begun to rebel in the Qi of Taiyin, Taiyang, and Yangming, without yet reaching the有形 (formative) sinews and bones. Disease in the Qi level is easy to disperse. If the disease has penetrated deeply, even a master physician cannot help. Thus, Dian-Ji involving bones and vessels is often untreatable. If a good physician treats it early, the disease can be cured, and the body healed. However, people worry about many diseases, while physicians worry about few methods.
Physicians treating Dian-Ji should reside with the patient to observe where points should be taken. When the disease strikes, observe the excess areas and drain them. Place the extracted blood in a gourd vessel. At the time of attack, the blood in the vessel will move independently. If it does not move, moxa twenty cones on the Qionggu (coccyx/sacrum). Qionggu refers to the sacrum.
This explains that treating Dian-Ji requires distinguishing and treating the Qi of Heaven, Earth, Water, and Fire. The Fire of Taiyang is like the sun, circling the earth daily, moving ceaselessly. Earth and Water are static. Residing with the patient allows understanding of the condition. Observing where to take points and draining excess means identifying which hand or foot meridian is affected. A gourd vessel is a calabash. Placing blood in it, where it moves independently during an attack, is due to mutual resonance of Qi. If Jue Qi transmits to Hand-Taiyin and Hand-Taiyang, the blood moves independently, resonating with the movement of Heavenly Taiyang Qi. If it does not move, the disease has entered Earth and Water, so one must moxa the sacrum twenty cones. The classic states, "If sinking, moxa." This disease sinks into Foot-Taiyang and Foot-Taiyin, so one moxas the sacrum of Foot-Taiyang. Two is the beginning of Yin, ten is the end of Yin. Earth is Yin, and Water is Yin. Zhu Yongnian said: The *Su Wen · Chang Ci Jie Lun* states: "In the initial stage, it attacks once a year; if untreated, it attacks once a month, named Dian-Ji." Attacking once a year corresponds to the sun completing a cycle in a year, associating Sun with Fire. Attacking once a month corresponds to the moon completing a cycle in a month, associating Moon with Water.
Gu Dian Ji (Bone Dian-Ji): Teeth and surrounding muscles are full/distended, bones protrude, sweating, irritability, vomiting much saliva/phlegm, Qi leaking downward. This is untreatable. (Note: 叶坎面也 音瞒闷也 - likely textual corruption referring to facial features or sensation).
Teeth are the surplus of bone; muscles belong to bone. Thus, Gu Dian-Ji presents with fullness in teeth and surrounding muscles. "Bone Ju" means bone and flesh are not closely united. Sweat is the fluid of blood. Sweating and irritability indicate disease in Foot-Shaoyin Kidney extending to Hand-Shaoyin Heart. Vomiting much saliva indicates rebellion of Taiyin and Yangming Qi. The Kidney is the source of generating Qi; Qi leaking downward indicates Shaoyin Qi descending uncontrollably. With Yin and Yang separating above and below, it is untreatable. Mo Yuncong said: Once disease enters the bone marrow, even a good physician has no power, so no rescue method is listed. The following three syndromes involve formative sinews and bones, hence discussing Tai/Shao Yin is omitted.
Jin Dian Ji (Sinew Dian-Ji): Body fatigue, spasms/tightness, large pulse. Puncture the Da Shu point of the major channel in the neck. Vomiting much saliva, Qi leaking downward: untreatable.
Disease in sinews causes body fatigue, spasms, and a tight/large pulse. Foot-Taiyang governs sinews, so puncture Da Shu of the Bladder meridian. Vomiting saliva and Qi leakage indicate disease in formative organs causing loss of Yin/Yang Qi.
Mai Dian Ji (Vessel Dian-Ji): Sudden collapse, swelling and flaccidity of pulses in four limbs, full pulses. Pierce all to bleed. If not full, moxa. Moxa Taiyang at the nape, Dai Mai at the waist (three cun from hypochondrium), and Ben Shu points of various muscles. Vomiting much saliva, Qi leaking downward: untreatable.
Meridians nourish sinews and benefit joints. Mai Dian-Ji causes sudden collapse. The twelve meridians originate from Jing-River points of hands and feet, causing swelling and flaccidity in limb pulses. Full pulses indicate disease in vessels, requiring piercing all to bleed. Not full indicates sinking Qi. The Heart governs vessels and is the Great Yang within Yang. Not full indicates sinking into Foot-Taiyang. The acupoints of the twelve zang-fu belong to Taiyang, so moxa Taiyang at the nape to lift sinking disease. Dai Mai originates at Zhang Men in the hypochondrium, encircling the waist, three cun from the hypochondrium, where Taiyang acupoints are located. Ben Shu of muscles are acupoints of Grain Qi. This allows vessel disease to exit through muscle Qi layers.
Dian-Ji manifesting like Kuang (mania) at onset: death, untreatable.
Excess Yin causes Dian; Excess Yang causes Kuang. Dian-Ji manifesting like Kuang indicates damage to both Yin and Yang Qi, hence death. Separation of Yin and Yang leads to death; damage to both Yin and Yang also leads to death. Mo Yuncong said: Yang disease is rapid, hence "rapid onset." These two characters distinguish Yin and Yang.
Kuang (Mania) begins with self-sadness, forgetfulness, bitter anger, and fear, caused by worry and hunger. Treat by selecting Hand-Taiyin and Hand-Yangming until blood color changes, and also select Foot-Taiyin and Foot-Yangming.
The following discusses the origin of Kuang, involving both deficiency and excess. Initial sadness stems from initial Kidney deficiency. The classic states: Essence of Water is Zhi. If Essence does not transmit upward to Zhi, Zhi becomes sad alone, causing tears. Forgetfulness and fear indicate emptiness of Shen and Zhi. Bitter anger indicates deficiency and rebellion of Liver Qi. Liver Wood Shen and Zhi are generated by Kidney Essence. Worry injures Lung; hunger prevents grain essence production. Lung injury depletes Kidney Water source; lack of grain essence depletes Kidney Essence. Yin deficiency leads to Yang excess and Kuang. Selecting Hand-Taiyin and Hand-Yangming drains rebellious Qi via bloodletting. Selecting Foot-Taiyin and Foot-Yangming tonifies them to aid Kidney Qi via grain essence. This section discusses Yin deficiency leading to Yang Kuang, corresponding to the final section's "shortness of breath, irregular respiration, exhaustion upon movement, tonify Foot-Shaoyin, remove blood collaterals." Dian-Kuang is a manifestation above; Jue-Ni is the cause below. Thus, the chapter is named Dian-Kuang but lists Jue-Ni. Superior physicians treat before disease arises, addressing the initial萌 (sprouting). Dian-Ji often stems from Yin Excess; Kuang can stem from Yin Deficiency. Hence, *Nan Jing* states: "Heavy Yin is Dian; Heavy Yang is Kuang." Yin deficiency leads to Yang excess. One should drain Yang and tonify Yin. However, Yin Essence is born from Yangming, and Yang Qi is rooted in Yin. The subtle interaction of mutual generation is crucial for scholars to understand for therapeutic benefit.
Kuang onset: little sleep, no hunger, arrogance (considering oneself wise, capable, noble), cursing, day and night without rest. Treat by selecting Hand-Yangming, Hand-Taiyang, Hand-Taiyin, and Shaoyin under the tongue. Observe these points; if full, select them; if not full, release them.
This is Heart Qi Excess Kuang. Yin excess causes sleepiness; Yang excess causes wakefulness. Food Qi enters the Stomach, essence goes to the Heart. Heart Qi excess causes lack of hunger. The Heart is the Ruler; deficiency causes inferiority, excess causes arrogance. Yangming excess causes constant cursing; Heart Fire excess transmits to Metal (Lung). Lung is the canopy of the Heart; Fire flaming upward clouds Heavenly Qi. Thus, select Hand-Taiyang Fu to drain Heart Fire excess, and Hand-Yangming/Taiyin to clear transmitted pathogens. Shaoyin under the tongue is the Heart's blood collateral. This disease affects Heart Shen/Zhi, not blood vessels, so observe. If full, select; if not, do not select. Disease in formless Shen/Zhi is cleared via Fu organs. Fu is Yang and governs Qi. If entering blood collaterals, select the organ's own vessels. Ma Shi said: The previous section said "initial generation," here "initial onset," meaning the disease is formed and erupting.
Delirious speech, fright, excessive laughter, singing, joy, aimless walking without cessation, caused by great fright. Treat by selecting Hand-Yangming, Hand-Taiyang, Hand-Taiyin.
This is Kidney disease transmitting to Heart, becoming Heart Qi Excess Kuang. Great fright injures Kidney. Yin deficiency and Yang excess cause delirium and fright. The classic states: Heart Qi excess causes laughter; deficiency causes sadness. Excess implies constrained Heart Will, so singing/laughter expresses it. Shen and Zhi are diseased, causing aimless walking. Select Hand-Taiyang to clear Heart excess, Hand-Yangming/Taiyin to aid injured Kidney Qi.
Kuang: visual hallucinations, auditory hallucinations, frequent shouting, caused by Short Qi. Treat by selecting Hand-Taiyang, Hand-Taiyin, Hand-Yangming, and Foot-Taiyin at the temples (Liang Ying).
This is Kidney Qi deficiency leading to Heart Qi deficiency Kuang. Heart and Kidney Water/Fire should assist each other. Kidney Qi deficiency leads to Heart Qi deficiency. Both deficient, causing hallucinations and shouting (emission of deficient Qi). Select Hand-Taiyang, Taiyin, Yangming to clear madness; tonify Foot-Taiyin/Yangming to aid grain essence. Grain/Water enter Stomach, fluids follow their paths. Kidney is Water Organ, storing essence of five zang; Qi is born from Essence. The Classic states: Stomach Qi ascends to Lung; its fierce Qi rushes to the head, travels through pharynx to orifices, along optic nerve to brain, exits below cheekbone to Guest Master point, along jaw to merge with Yangming, descends to Renying. This is Yangming Qi ascending to orifices, emerging at temples. It mentions temples rather than Foot-Yangming to extract Qi from Middle/Upper Jiao of Yangming to transform water/grain. Note: This section corresponds to "Short Qi, cold dampness, panting" below. Initially seeing deficiency below, tonify Shaoyin Yin. Now erupting above as Kuang, use Kuang treatment.
Kuang patients eat much, see ghosts/gods, laugh silently (cold laugh without sound), caused by great joy. Treat by selecting Foot-Taiyin, Foot-Taiyang, Foot-Yangming, then Hand-Taiyin, Hand-Taiyang, Hand-Yangming.
This is Joy injuring Heart Zhi, causing Deficiency Kuang. Heart Qi deficiency causes polyphagia; Shen Qi deficiency causes seeing ghosts. Great joy causes laughter. Silent laughter is cold laughter without sound. Food Qi enters Stomach, turbid Qi returns to Heart. First tonify Foot-Taiyin/Yangming to nourish Heart Essence; tonify Foot-Taiyang Jin to aid Shen Qi. Then select Hand meridians to clear Kuang. Note: For Foot-Shaoyin origin, select Hand then Foot; for Hand-Shaoyin origin, select Foot then Hand. This is the subtle use of Upper/Lower Qi intersection.
New onset Kuang, not yet showing previous symptoms: First select Ququan (Liver 3) arterial points on both sides. Severe cases: bleed. After a while, it stops. If not, use standard methods. Moxa sacrum twenty cones.
This summarizes Kuang diseases. If rising from below, first select Ququan of Liver meridian. "Responding" means originating below and manifesting above. Kuang is Heart Qi excess/deficiency. If originating from Kidney excess/deficiency, it moves Water -> Wood -> Fire. New Kuang without sadness, fright, anger, joy, or hallucinations: first select Ququan arteries. Excess bleeding stops it. Disease clears via Wood Qi without affecting Heart Shen. If not stopped, use moxa. Sacrum is path of Du Mai. Du Mai meets Liver Meridian at head/nape. Moxa sacrum to draw Jueyin Qi to disperse from below. Note: End of spine is sacrum, junction of Foot-Taiyang and Du Mai, called Qionggu, Di Gu, or Qian Gu. Distinctions exist.
Feng Ni (Wind Reversal): Sudden limb swelling, body cold/damp, occasional chills, irritability when hungry, mood swings when full. Select Hand-Taiyin table-relation meridians, Foot-Shaoyin/Yangming meridians. For muscle cold, select Ying-Spring points; for bone cold, select Jing-Well and Jing-River points.
Classic states: Jue evolves into Dian-Ji. Caused by Jue Qi rebelling upward. Kidney is Water Organ; wind scatters water. Feng Ni is external Wind invading, causing Shaoyin Qi to rebel. Wind invades extremities, causing sudden limb swelling. Luo Luo indicates cold-damp. Xi Ran indicates shivering from Wind/Water-Cold. Wind injures Kidney Water, weakening Heart Qi, causing irritability when hungry. Wind-Wood evil damages Central Earth, causing mood swings when full. Select Hand-Taiyin table-relation to clear Wind; Foot-Shaoyin/Yangming to regulate rebellious Qi. Qing means cold. Muscle cold: coolness in muscle-coupling, so select Ying-Fire points to warm muscle cold. Earth governs muscles; Fire assists Earth. Bone cold: remains in Water Organ, so select Jing-Wood points to drain Water evil. Yu Borong said: Selecting Hand-Taiyin table-relation induces sweating. Using Ephedrae Herba (Mahuang) to open pores, paired with Armeniacae Semen Amarum (Xingren) to benefit Lung Metal. Interior Qi must loosen before Exterior Qi opens.
Jue Evil disease: sudden cold feet, chest feeling like tearing, intestines feeling like cutting, irritability, inability to eat, pulses small and large but all choppy. Warm: select Foot-Shaoyin. Cold: select Foot-Yangming. Cold: tonify. Warm: drain.
This is Foot-Shaoyin innate Qi Jue-Ni disease. Shaoyin large collateral originates in Kidney, descends to Qijie, runs along medial thigh, obliquely into popliteal fossa, descends behind medial malleolus, enters sole. Shaoyin Qi rebelling internally causes sudden cold feet. Chest tearing and intestinal cutting pain with irritability/anorexia indicate Jue Qi ascending from abdomen to heart/chest. Vessels originate in Kidney; varying sizes and choppy pulses indicate Kidney Qi rebellion blocking vessels. Kidney is source of Qi. If body is warm, it is Excess Rebellion, so select Foot-Shaoyin to drain. If cold, it is Deficiency Rebellion, so tonify Foot-Yangming to aid Kidney Essence/Qi. Previous two sections: one external Wind Jue, one innate Qi Jue. Both are beginnings of Dian-Ji. Treating Jue syndrome first clears the root, preventing disease (Zhi Wei Bing).
Jue-Ni with abdominal distension, borborygmi, chest fullness, dyspnea. Select lower chest and two hypochondria. If coughing moves hands, press back Shu points. Immediate relief indicates correct points.
This describes Jue-Ni Qi ascending to Taiyin/Yangming, impending Dian-Ji. Abdominal distension involves Foot-Taiyin/Yangming. Borborygmi involves Hand-Yangming. Chest fullness/dyspnea involves Hand-Taiyin. Lower chest/hypochondria are Zhongfu and Yunmen arteries of Hand-Taiyang. Back Shu points are Lung Shu. Selecting lower chest/hypochondria, pressing back Shu points with immediate relief, indicates Jue-Ni Qi ascending, impending Dian-Ji. Disease is in Qi, so pressure brings relief. Jue-Dian-Ji is in Qi, not meridians. Zhu Weigong said: Lung combines with Heavenly Qi, so observe Hand-Taiyin.
Internal blockage with urinary retention. Puncture Foot-Shaoyin, Foot-Taiyang, and upper sacrum with long needles.
Continuing from above, this describes Jue-Ni Qi rebelling only downward, not ascending. Qi rebelling below causes internal blockage and urinary retention. Puncture Foot-Shaoyin, Foot-Taiyang, and upper sacrum with long needles to drain rebellious Qi and promote urination. Foot-Shaoyin is the Innate Two Powers. Hand/Foot Taiyin/Yangming are Acquired Heaven/Earth. Innate/Acquired Qi...