黄帝问曰。厥之寒热者何也。（厥、逆也。气逆则乱。故发为眩仆。卒不知人。此名为厥。与中风不同。有寒热者。
有阴有阳也。）岐伯对曰。阳气衰于下则为寒厥。阴气衰于下则为热厥。（阴阳二气。皆从下而上。是以寒厥热厥之因。
由阴阳之气衰于下也。）帝曰。热厥之为热也。必起于足下者。何也。（足下、足心也。热为阳厥。而反起于阴分。故问
之。）岐伯曰。阳气起于足五趾之表。阴脉者。集于足下。而聚于足心。故阳气胜则足下热也。（足三阳之血气。出于足
趾之端。表者。外侧也。三阴之脉。集于足下。而聚于足心。若阳气胜。则阴气虚而阳往乘之。故热厥起于足下也。张
兆璜曰。足心、足少阴经脉之所出。阴阳类论曰。三阳为表。二阴为里。盖太阳为诸阳主气。少阴为诸阴主气也。）帝曰。
寒厥之为寒也。必从五趾而上于膝者。何也。（上节论阳胜于阴。则为热厥。而寒厥起于阴之本位。故问之。兆璜曰。阴
阳二气。阴为之主也。）岐伯曰。阴气起于五趾之里。集于膝下。而聚于膝上。故阴气胜。则从五趾至膝上寒。其寒也。
不从外。皆从内也。（足三阴之血气。起于五趾内侧之端。里者内侧也。集于膝下者。三阴交于踝上也。聚于膝上者。三
阴经脉。皆循内股而上。故其寒也。不从外。皆从内也。兆璜曰。阴阳二气。皆起于足。是以伤寒病足经而不病手经
也。张应略曰。阴阳六气。只合六经。足之六经。复上合于手者也。）帝曰。寒厥何失而然也。（此下二节论寒厥热厥
之因。寒厥因失其所藏之阳。故曰失。）岐伯曰。前阴者。宗筋之所聚。太阴阳明之所合也。（宗筋根起于胞中。内连于
肾脏。阴阳二气。生于胃腑。输于太阴。藏于肾脏。太阴阳明。合聚于宗筋者。中焦之太阴阳明。与下焦之少阴太阳。
中下相合。而会合于前阴之间。兆璜曰。论寒厥曰太阴阳明之所合。论热厥曰脾主为胃行其津液。是阴阳二气。本于
先天之下焦。而生于后天之中焦也。）春夏则阳气多而阴气少。秋冬则阴气盛而阳气衰。此人者质壮。以秋冬夺于所用。
下气上争不能复。精气溢下。邪气因从之而上也。（此言寒厥之因。因虚其所藏之阳而致之也。夫秋冬之时。阳气收藏。
阴气外盛。此寒厥人者。因恃其质壮。过于作劳。则下气上争。不复藏于下矣。阳气上出。则阴藏之精气亦溢于下矣。
所谓烦劳则张。精绝也。邪气者。谓阴脏水寒之邪。夫阳气藏于阴脏。精阳外出。则阴寒之邪。因从之而上矣。）气因于
中。阳气衰。不能渗营其经络。阳气日损。阴气独在。故手足为之寒也。（此言气因于中焦水谷之所生。然藉下焦之气。
为阳明釜底之燃。如秋冬之时。过于作劳。夺其阳气。争扰于上。阴寒之邪。又因而从之。则中焦所生之阳亦衰。不能
渗营于经络矣。中下之气。不能互相资生。阳气日损。阴气独在。故手足为之寒也。兆璜曰。渗者。渗于脉外。营者。
营于脉中。营气宗气。皆精阳之气。营行于脉中。诸阳之气。淡渗于脉外。非独卫气之行于脉外也。）帝曰。热厥何如
而然也。岐伯曰。酒入于胃。则络脉满而经脉虚。脾主为胃行其津液者也。阴气虚则阳气入。阳气入则胃不和。胃不
和则精气竭。精气竭则不营于四肢也。（此言热厥之因。因伤其中焦所生之阴气也。灵枢经云。饮酒者。卫气先行皮肤。
先充络脉。夫卫气者。水谷之悍气也。酒亦水谷悍热之液。故从卫气先行于皮肤。从皮肤而充于络脉。是不从脾气而行
于经脉。故络脉满而经脉虚也。夫饮入于胃。其津液上输于脾。脾气散精于肺。通调于经脉。四布于皮毛。是从经脉而
行于络脉。从络脉而散于皮肤。自内而外也。酒入于胃。先行于皮肤。先充于络脉。是从皮肤而入于络脉。反从外而内
矣。不从脾气通调于经脉。则阴气虚矣。悍热之气。反从外而内。则阳气入矣。阳明乃燥热之府。藉太阴中见之阴化。
阴气虚而阳热之气内入。则胃气不和矣。胃不和。则所生之精气竭。精气竭。则不能营于四肢。而为热厥矣。） 此人必
数醉。若饱以入房。气聚于脾中不得散。酒气与谷气相搏。热盛于中。故热遍于身。内热而溺赤也。夫酒气盛而 悍。
肾气日衰。阳气独胜。故手足为之热也。（夫饮酒数醉。则悍热之气。反从外而内。而酒气聚于脾中矣。若饱以入房。则
谷食留于胃中。脾脏不能转输其精液。而谷气聚于脾中矣。气聚于中而不得散。酒气与谷气交相侵搏。则热盛于中矣。
中土之热。灌于四旁。故热遍于身也。入胃之饮食。不能游溢精气。下输膀胱。故内热而溺赤也。夫肾为水脏。受水谷
之精而藏之。酒气热盛而 悍。则肾脏之精气日衰。阴气衰于下。而阳气独胜于中。故手足为之热也。 张兆璜曰。寒
厥因失其所藏之阳。而致中气日损。热厥因伤其所生之阴。而致肾气日衰。当知中下二焦。互相资生者也。张应略曰。
上古之人。食饮有节。起居有常。不妄作劳。今时之人。以酒为浆。以妄为常。醉以入房。是人之所当调养者。阴阳精
气耳。苟得其养。可同归于生长之门。苟失其养。则为暴仆卒厥。） 帝曰。厥或令人腹满。或令人暴不知人。或至半日。
远至一日。乃知人者。何也。（暴不知人。卒然昏 。或仆扑也。半日气周之半。一日气行之周。）岐伯曰。阴气盛于上
则下虚。下虚则腹胀满。（阴气盛于上。谓中焦之阳气日损。阴气独盛于上也。阴盛于上。则下焦之阳气亦虚。阳虚于下。
是以腹胀满也。）阳气盛于上。则下气重上而邪气逆。逆则阳气乱。阳气乱则不知人也。（下气、谓下焦之元阳。邪气、
肾藏水寒之邪也。阳气盛于上。谓阴气虚而阳气独胜也。阳盛于上。则下气重上。下气上乘。则寒邪随之而上逆。逆则
阳气乱于上。而卒不知人。灵枢经曰。清浊之气乱于头。则为厥逆眩仆。此论阴阳二气之并逆也。兆璜曰。前论下气
上争。则中焦之阳气日损。阴气虚中。则下焦之肾气日衰。此复论阴气盛于上。则下气亦虚。阳气盛于上。则下气重上。
又一辙也。） 帝曰。善。愿闻六经脉之厥状病能也。（上节论阴阳二气之厥。故帝复问其经脉之厥状焉。病能者。能为
奇恒之病也。夫奇恒之病。不应四时。多主厥逆。是以六经之厥。能为诸脉作病者。皆属奇恒。因于论厥。故列于厥论
篇中。原属厥逆奇恒之病。故先提曰病能。而列于病能篇之前也。） 岐伯曰。巨阳之厥。则肿首头重。足不能行。发为
仆。（巨阳、太阳也。足太阳脉。起于目内 。上额交巅。从巅入络脑。还出别下项。循背挟脊。抵腰中。下贯臀。入
中。循 内。出外踝之后。是以厥逆于上。则为首肿头痛。厥逆于下。则为足不能行。神气昏乱。则为 仆。太阳为
诸阳主气也。此病在经而转及于气分。故曰发。）阳明之厥。则癫疾。欲走呼。腹满不得卧。面赤而热。妄见而妄言。
（癫狂走呼。妄言妄见。阳明之脉病也。其脉循腹里。属胃络脾。经气厥逆。故腹满胃不和。不得卧也。阳明乃燥热之
经。其经气上出于面。故面赤而热。）少阳之厥。则暴聋。颊肿而热。胁痛。 不可以运。（足少阳之脉。起于目锐 。
从耳后。入耳中。下颊车。循胸过季胁。出膝外廉。循足跗。故逆则暴聋。颊肿胁痛。足 不可以营运。）太阴之厥。则
腹满 胀。后不利。不欲食。食则呕。不得卧。（ 音嗔。引起也。足太阴之脉。入腹属脾络胃。故厥则腹满 胀。食饮
入胃。脾为转输。逆气在脾。故后便不利。脾不转运。则胃亦不和。是以食则呕。而不得卧也。）少阴之厥。则口干溺赤。
腹满心痛。（足少阴之脉。属肾络膀胱。贯肝膈。入肺中。出络心。注胸中。循喉咙。挟舌本。经脉厥逆。而阴液不能上
资。是以口干心痛。肺金不能通调于下。故溺赤。水火阴阳之气。上下不交。故腹满也。）厥阴之厥。则少腹肿痛。腹胀。
泾溲不利。好卧屈膝。阴缩肿。 内热。（足厥阴之脉。内抵少腹。挟胃属肝络胆。故厥则少腹肿痛而腹胀。其下循阴股。
入毛中。环阴器。抵少腹。是以泾溲不利。阴缩而肿。肝主筋。膝者经之会。经脉厥逆。不能濡养筋骨。故好卧而屈膝。
其脉起于大趾丛毛之际。上循足 。厥阴木火主气。荥俞厥逆。故 内肿热也。阴阳二气。皆起于足。故只论足之六经
焉。）盛则泻之。虚则补之。不盛不虚。以经取之。（此厥在经脉。故当随经以治之。如经气盛者。用针泻而疏之。经
气虚者。以针补之。不盛不虚。即于本经以和调之。名曰经刺。）太阴厥逆。 急挛。心痛引腹。治主病者。（此复论
三阴三阳之气厥也。夫手足三阴三阳之气。五脏六腑之所生也。脏腑之气逆于内。则阴阳之气厥于外矣。故复论手足十
二经气之厥逆也。中土之气。主溉四旁。足太阴气厥。故 为之急挛。食气入胃。浊气归心。脾气逆而不能转输其精气。
是以心气虚而痛引于腹也。此是主脾所生之病。故当治主病之脾气焉。按首言阳气起于足五趾之表。阴气起于足五趾之
里。是以先论足六经脉之厥状。次言阴阳二气。出中焦水谷之所生。脾主为胃行其精液。是太阴为之行气于三阴。阳明
为之行气于三阳。五脏六腑。皆受气于阳明。故复论手足三阴三阳之气厥也。）少阴厥逆。虚满呕变。下泄清。治主病者。
（少阴之气。上与阳明相合。而主化水谷。少阴气厥。以致中焦虚满而变为呕逆。上下水火之气不交。故下泄清冷也。
按呕变当作变呕。灵枢经云。苦走骨。多食之令人变呕。言苦寒之味。过伤少阴。转致中胃虚寒。而变为呕逆。与此节
大义相同。且有声无物曰呕。故不当作呕出变异之物解。）厥阴厥逆。挛。腰痛。虚满。前闭。谵言。治主病者。（挛者。
肝主筋也。腰者。肝之表也。虚满者。食气不能输精于肝也。前闭者。肝主疏泄也。肝主语。谵语者。肝气郁也。）三阴
俱逆。不得前后。使人手足寒。三日死。（三阴俱逆。是阴与阳别矣。不得前后者。阴关于下也。诸阳之气。皆生于阴。
三阴俱逆。则生气绝灭。是以手足寒而三日死矣。此厥在气分。故主三日死。谓三阴之气厥绝也。若厥在经脉。则为厥
状病能。而不至于死矣。）太阳厥逆。僵仆。呕血善衄。治主病者。（太阳主诸阳之气。阳气厥逆。故僵仆也。阳气上逆
则呕血。阳热在上则衄血。此太阳之气。厥逆于上。以致迫血妄行。）少阳厥逆。机关不利。机关不利者。腰不可以行。
项不可以顾。（少阳主枢。是以少阳气厥。而机关为之不利也。颈项者。乃三阳阳维之会。腰脊者。身之大关节也。故机
关不利者。腰不可以转行。项不可以回顾。）发肠痈。不可治。惊者死。（少阳相火主气。火逆于内。故发为肠痈。不可
治者。谓病在气分。而痈肿在内。非针刺之可能治也。若发惊者。其毒瓦斯干脏故死。）阳明厥逆。喘咳身热。善惊衄呕血。
（阳明气厥则喘。上逆则咳也。阳明之气主肌肉。故厥则身热。经云。三阳发病。主惊骇。衄血呕血者。阳明乃悍热之
气。厥气上逆。则迫血妄行。此病在气而及于经血。故皆曰善。）手太阴厥逆。虚满而咳。善呕沫。治主病者。（手太阴
厥逆。肺气逆也。肺主气。故虚满而咳。不能通布水津。故善呕沫。此是主肺所生之病。故当治主病之肺气焉。夫阴阳
之气。皆出于足。此论脏腑之气。故并及于手焉。）手心主少阴厥逆。心痛引喉。身热。死不可治。（手心主者。手厥阴
包络之气也。手少阴者。心藏之气也。包络为君主之相火。二火并逆。将自焚矣。故为死不可治。）手太阳厥逆。耳聋泣
出。项不可以顾。腰不可以俯仰。治主病者。（手太阳所生病者。耳聋。小肠主液。故逆则泣出也。夫心主血脉。小肠主
液。而为心之表。小肠气逆。则津液不能营养于经脉。是以项不可以顾。腰不可以俯仰。盖腰项之间。乃脉络经俞之大
会也。）手阳明少阳厥逆。发喉痹嗌肿。 。治主病者。（手阳明者。肺之府也。手少阳者。手厥阴三焦也。阳明主嗌。
肺主喉。兼三焦之火气并逆。是以发喉痹而嗌肿也。阳明乃燥热之经。三焦属龙雷之火。火热并逆。故发 也。张兆
璜问曰。手之六经。独心主少阴。与阳明少阳合论者。何也。曰。天之六气。化生地之五行。地之五行。以生人之五脏。
五脏配合五腑。是只五脏五腑。以应五方五行。五色五味。五音五数也。所谓六脏六腑者。心主与三焦为表里。俱有名
而无形。合为六脏六腑。复应天之六气。是以论手心主而兼于少阴。论手阳明而合少阳也。曰手厥阴为心脏之包络。固
可合并而论。手阳明与少阳并论者。其义何居。曰三焦者。中渎之府也。中上二焦。并出于胃口。下焦别手阳明之回肠
而出。故论手阳明。而兼于少阳也。）
Huangdi asked: What is the reason for cold or heat manifestations in Jue syndrome? (Jue means reversal. When Qi reverses, it becomes chaotic, leading to dizziness and collapse, sudden unconsciousness. This is called Jue, which is different from stroke. The presence of cold or heat indicates differences between Yin and Yang.)
Qibo replied: When Yang Qi is deficient at the lower part, Cold Jue occurs; when Yin Qi is deficient at the lower part, Heat Jue occurs. (Yin and Yang Qi both ascend from the lower part. Therefore, the cause of Cold Jue and Heat Jue lies in the deficiency of Yin and Yang Qi at the lower part.)
Huangdi said: Why does the heat sensation in Heat Jue always start from the sole of the foot? (The sole refers to the center of the foot. Heat belongs to Yang Jue, yet it arises from the Yin aspect, hence the question.)
Qibo said: Yang Qi originates from the lateral side of the five toes. The Yin meridians gather at the sole and converge at the center of the foot. Thus, when Yang Qi prevails, the sole becomes hot. (The blood and Qi of the three Foot-Yang meridians emerge from the tips of the toes. "Lateral" refers to the outer side. The three Foot-Yin meridians gather at the sole and converge at the center of the foot. If Yang Qi prevails, Yin Qi becomes deficient, allowing Yang Qi to invade, so Heat Jue starts from the sole. Zhang Zhaohuang stated: The center of the foot is where the Foot-Shaoyin meridian emerges. The *Treatise on Yin and Yang Categories* states: Three Yang are exterior, Two Yin are interior. Generally, the Taiyang meridian governs all Yang meridians, and the Shaoyin meridian governs all Yin meridians.)
Huangdi said: Why does the cold sensation in Cold Jue always spread upward from the five toes to the knee? (The previous section discussed Yang prevailing over Yin resulting in Heat Jue, whereas Cold Jue arises from the root position of Yin, hence the question. Zhaohuang stated: Among Yin and Yang Qi, Yin is dominant.)
Qibo said: Yin Qi originates from the medial side of the five toes, gathers below the knee, and converges above the knee. Thus, when Yin Qi prevails, coldness extends from the five toes to above the knee. This coldness does not come from the exterior but arises from within. (The blood and Qi of the three Foot-Yin meridians originate from the medial ends of the five toes. "Medial" refers to the inner side. They gather below the knee because the three Yin meridians intersect above the ankle. They converge above the knee because the three Yin meridians all run up along the medial thigh. Therefore, this coldness is not external but internal. Zhaohuang stated: Yin and Yang Qi both originate from the feet; thus, in Shanghan disease, only the Foot meridians are affected, not the Hand meridians. Zhang Yinglue stated: Yin and Yang Six Qi correspond only to the Six Meridians. The six meridians of the feet further connect upwards to the six meridians of the hands.)
Huangdi said: What error leads to Cold Jue? (The following two sections discuss the causes of Cold and Heat Jue. Cold Jue results from the loss of stored Yang Qi, hence termed "loss".)
Qibo said: The anterior yin is the gathering point of the Zongjin (tendons), where the Taiyin and Yangming meridians combine. (Zongjin originates from the Baozhong [uterus/pelvic cavity] and connects internally to the Kidneys. Yin and Yang Qi are generated in the Stomach, transmitted to the Taiyin, and stored in the Kidneys. The Taiyin and Yangming combine at the Zongjin, representing the combination of Middle Jiao Taiyin/Yangming with Lower Jiao Shaoyin/Taiyang, meeting at the anterior yin. Zhaohuang stated: In discussing Cold Jue, it says "Taiyin and Yangming combine"; in discussing Heat Jue, it says "Spleen governs transporting fluids for the Stomach." This indicates that Yin and Yang Qi originate from the congenital Lower Jiao and are generated by the postnatal Middle Jiao.) In spring and summer, Yang Qi is abundant and Yin Qi is scarce; in autumn and winter, Yin Qi is prosperous and Yang Qi is declining. Such individuals have strong constitutions but overexert themselves during autumn and winter, causing lower Qi to contend upward without recovering, essence overflowing downward, and pathogenic factors ascending along with it. (This explains the cause of Cold Jue: damaging the stored Yang Qi. During autumn and winter, Yang Qi stores and Yin Qi dominates externally. These individuals, relying on their strength, overwork, causing lower Qi to contend upward and fail to store below. As Yang Qi ascends, the essence stored in Yin organs also overflows downward. This is what is meant by "excessive labor causes Yang to flare, leading to essence depletion." Pathogenic factors refer to water-cold pathogens of Yin organs. When Yang Qi is stored in Yin organs and essence-Yang exits outward, Yin-cold pathogens ascend accordingly.) Qi stagnates in the Middle Jiao, Yang Qi declines, and cannot permeate and nourish the meridians. Yang Qi diminishes day by day, while Yin Qi remains alone, causing coldness in the hands and feet. (This explains that Qi is generated from water and grain in the Middle Jiao, but relies on Lower Jiao Qi as the fire under the Yangming cauldron. Overexertion in autumn/winter depletes Yang Qi, causing contention upward, and Yin-cold pathogens ascend. Consequently, Yang Qi generated in the Middle Jiao declines and cannot permeate/nourish the meridians. Middle and Lower Jiao Qi fail to mutually support each other; Yang Qi diminishes, Yin Qi remains alone, causing cold hands and feet. Zhaohuang stated: "Permeate" means entering outside the vessels; "Nourish" means circulating inside the vessels. Ying Qi and Zong Qi are essence-Yang Qi. Ying Qi circulates inside the vessels, while various Yang Qi permeates outside the vessels, not just Wei Qi.)
Huangdi said: How is Heat Jue formed?
Qibo said: When wine enters the Stomach, the Luo vessels become full while the Jing meridians become empty. The Spleen's function is to transport fluids for the Stomach. When Yin Qi is deficient, Yang Qi enters inward. When Yang Qi enters inward, Stomach Qi becomes disharmonious. Disharmonious Stomach Qi leads to exhaustion of essence-Qi. Exhausted essence-Qi fails to nourish the four limbs. (This explains the cause of Heat Jue: damaging the Yin Qi generated in the Middle Jiao. The *Ling Shu* states: After drinking, Wei Qi moves first through the skin, filling the Luo vessels first. Wei Qi is the fierce Qi of water and grain. Wine is also a fierce, hot liquid of water and grain, so it follows Wei Qi moving through the skin and filling the Luo vessels. It does not follow the Spleen's transformation into the Jing meridians, hence Luo vessels are full and Jing meridians are empty. Normally, ingested fluids go to the Stomach, are transported up to the Spleen, scattered by Spleen Qi to the Lungs, regulated through Jing meridians, and distributed to skin/hair. This is from interior to exterior. Wine enters the Stomach, moves first through the skin, fills Luo vessels first, going from exterior to interior. Without Spleen Qi regulating the Jing meridians, Yin Qi becomes deficient. Fierce-hot Qi enters from exterior to interior, so Yang Qi enters. Yangming is a dry-heat organ, relying on Taiyin's Yin transformation. With deficient Yin Qi and invading Yang-heat, Stomach Qi becomes disharmonious. Disharmonious Stomach Qi exhausts generated essence-Qi. Exhausted essence-Qi fails to nourish the four limbs, forming Heat Jue.) Such individuals must frequently get drunk or engage in sexual activity after full meals. Qi accumulates in the Spleen without dispersing. Wine Qi and Grain Qi struggle against each other, creating intense heat in the Middle Jiao. Thus, heat pervades the body, causing internal heat and red urine. Wine Qi is vigorous and fierce, causing daily decline of Kidney Qi and dominance of Yang Qi, resulting in hot hands and feet. (Frequent drunkenness causes fierce-hot Qi to enter from exterior to interior, accumulating in the Spleen. Full meals followed by sex leave food in the Stomach; the Spleen cannot transport fluids, so Grain Qi accumulates in the Spleen. Qi accumulates in the Middle Jiao without dispersing; Wine and Grain Qi clash, creating intense heat in the Middle. Middle Earth heat pours into the four directions, pervading the body. Food/drink in the Stomach cannot float and transmit essence to the Bladder, causing internal heat and red urine. The Kidney is the Water Organ, storing essence from food/drink. Vigorous/fierce wine heat causes daily decline of Kidney essence. Deficient Yin Qi below and dominant Yang Qi in the middle result in hot hands and feet. Zhang Zhaohuang stated: Cold Jue results from losing stored Yang, causing daily decline of Middle Qi; Heat Jue results from damaging generated Yin, causing daily decline of Kidney Qi. One must know that Middle and Lower Jiao mutually support each other. Zhang Yinglue stated: Ancients had regulated diet and routine, avoiding excessive labor. Modern people treat wine as water and recklessness as normal, engaging in sex while drunk. What humans should nurture is Yin-Yang essence. If nurtured, one returns to the gate of growth; if neglected, one suffers sudden collapse.)
Huangdi said: Some Jue cases cause abdominal fullness, some cause sudden unconsciousness, some recover in half a day, others take a full day. Why? (Sudden unconsciousness is sudden fainting. Half a day is half a cycle of Qi; a full day is a complete cycle.)
Qibo said: When Yin Qi is excessive in the upper part, the lower part becomes deficient. Lower deficiency causes abdominal distension. (Excess Yin Qi above refers to daily decline of Middle Jiao Yang Qi, leaving excess Yin Qi above. Excess Yin above causes deficiency of Lower Jiao Yang Qi. Lower Yang deficiency leads to abdominal distension.) When Yang Qi is excessive in the upper part, lower Qi repeatedly ascends and pathogenic Qi reverses. Reversal causes Yang Qi chaos. Yang Qi chaos leads to unconsciousness. (Lower Qi refers to Yuan Yang of the Lower Jiao. Pathogenic Qi refers to water-cold pathogens of the Kidney. Excess Yang above refers to deficient Yin and dominant Yang. Upper Yang excess causes lower Qi to ascend again. Ascending lower Qi brings cold pathogens upward. Reversal causes Yang Qi chaos above, leading to sudden unconsciousness. The *Ling Shu* states: Chaos of clear/turbid Qi in the head causes Jue, dizziness, and collapse. This discusses simultaneous reversal of Yin and Yang Qi. Zhaohuang stated: Previously, lower Qi contending upward caused daily decline of Middle Yang and Lower Kidney Qi due to Middle Yin deficiency. Here, excess Yin above causes lower deficiency; excess Yang above causes lower Qi to ascend again. The logic is consistent.)
Huangdi said: Good. I wish to hear about the manifestations and pathological capabilities of Jue in the Six Meridians.
Qibo said: Jue of the Ju Yang (Taiyang) meridian causes swelling of the head, heaviness of the head, inability to walk, and collapse. (Ju Yang is Taiyang. The Foot-Taiyang meridian starts at the inner canthus, goes up the forehead, crosses the vertex, enters the brain, exits down the neck, runs along the back beside the spine, reaches the waist, descends through the buttocks, enters the popliteal fossa, runs along the medial calf, exits behind the lateral malleolus. Thus, reversal above causes head swelling/pain; reversal below causes inability to walk; spirit chaos causes collapse. Taiyang governs all Yang meridians. This disease affects the meridian and spreads to the Qi level, hence "fa" [manifestation].)
Jue of the Yangming meridian causes manic epilepsy, desire to run and shout, abdominal fullness preventing lying down, red and hot face, visual hallucinations, and delirious speech. (Mania, running, shouting, delirium are diseases of the Yangming meridian. Its vessel runs in the abdomen, connects to the Stomach and spleen. Meridian Qi reversal causes abdominal fullness and Stomach disharmony, preventing sleep. Yangming is a dry-heat meridian; its Qi emerges on the face, causing redness and heat.)
Jue of the Shaoyang meridian causes sudden deafness, swollen and hot cheeks, hypochondriac pain, and inability to move the leg. (Foot-Shaoyang meridian starts at the outer canthus, goes behind the ear into the ear, descends to Jiache, runs through the chest past the costal margin, exits lateral to the knee, runs along the dorsum of the foot. Reversal causes sudden deafness, cheek swelling, hypochondriac pain, and leg immobility.)
Jue of the Taiyin meridian causes abdominal fullness and bloating, difficulty defecating, anorexia, vomiting after eating, and inability to sleep. ("Chen" [sound] causes bloating. Foot-Taiyin meridian enters the abdomen, connects to the Spleen and Stomach. Reversal causes abdominal fullness. Food enters the Stomach; Spleen transports. Rebellious Qi in the Spleen causes bowel dysfunction. Spleen failure to transport leads to Stomach disharmony, causing vomiting and insomnia.)
Jue of the Shaoyin meridian causes dry mouth, red urine, abdominal fullness, and heart pain. (Foot-Shaoyin meridian connects to the Kidney and Bladder, passes through the Liver and diaphragm, enters the Lungs, connects to the Heart, notes in the chest, runs along the throat, flanks the tongue base. Meridian reversal prevents Yin fluids from nourishing upward, causing dry mouth and heart pain. Lung Metal fails to regulate downward, causing red urine. Water-Fire and Yin-Yang Qi fail to interact上下, causing abdominal fullness.)
Jue of the Jueyin meridian causes swelling and pain in the lower abdomen, abdominal distension, difficulty urinating/defecating, preference for lying with knees flexed, contraction and swelling of the genitals, and heat in the medial calf. (Foot-Jueyin meridian reaches the lower abdomen, flanks the Stomach, connects to the Liver and Gallbladder. Reversal causes lower abdominal swelling/pain and distension. It runs down the medial thigh, enters the pubic region, circles the genitals, reaches the lower abdomen. Hence urinary/fecal difficulty, genital contraction/swelling. Liver governs tendons; the knee is the convergence of meridians. Meridian reversal fails to nourish tendons/bones, causing preference for flexed posture. The meridian starts at the hair tuft of the big toe, runs up the foot dorsum. Jueyin Wood-Fire governs Qi. Revulsion at Ying-Shu points causes medial calf swelling/heat. Yin-Yang Qi both originate from the feet, so only Foot meridians are discussed.)
Excess is drained, deficiency is tonified. Neither excess nor deficiency is treated by taking from the meridian itself. (This Jue is in the meridians, so treatment follows the meridian. Excess meridian Qi is drained with needles; deficient meridian Qi is tonified. Neither excess nor deficiency is harmonized in the source meridian, named "Meridian Needling".)
Taiyin Jue Qi causes gastrocnemius cramps, heart pain radiating to the abdomen. Treat the primary diseased organ. (This re-discusses Jue of Three Yin and Three Yang Qi. Hand/Foot Three Yin/Yang Qi are generated by Five Zang/Six Fu organs. Internal organ Qi rebellion causes external Yin/Yang Qi reversal. Thus, Twelve Meridian Qi Jue is discussed. Middle Earth Qi irrigates the four sides. Foot-Taiyin Qi reversal causes gastrocnemius cramps. Food Qi enters the Stomach, turbid Qi returns to the Heart. Spleen Qi rebellion fails to transport essence, causing Heart Qi deficiency and pain radiating to the abdomen. This is a disease generated by the Spleen, so treat the primary Spleen Qi. Note: Initially, Yang Qi starts laterally at toe tips, Yin Qi medially. Thus, Foot Six Meridian Jue is discussed first. Then, Yin/Yang Qi are generated from Middle Jiao water/grain; Spleen transports fluids for Stomach. Taiyin transmits Qi to Three Yin, Yangming to Three Yang. All Zang/Fu receive Qi from Yangming, hence Twelve Meridian Qi Jue is discussed.)
Shaoyin Jue Qi causes false fullness, vomiting/changing, and clear diarrhea. Treat the primary diseased organ. (Shaoyin Qi combines with Yangming to transform water/grain. Shaoyin Qi reversal causes Middle Jiao false fullness and vomiting. Upward/downward Water/Fire Qi do not interact, causing clear diarrhea. Note: "Ou Bian" should be "Bian Ou". *Ling Shu* states: Bitter taste enters bone; excess causes vomiting. Bitter-cold damages Shaoyin, turning Middle/Stomach cold, causing vomiting. This aligns with the main meaning. "Ou" implies sound without matter, so it shouldn't mean vomiting abnormal substances.)
Jueyin Jue Qi causes cramps, lower back pain, false fullness, anterior closure, and delirious speech. Treat the primary diseased organ. (Cramps: Liver governs tendons. Lower back: Exterior of Liver. False fullness: Food Qi fails to deliver essence to Liver. Anterior closure: Liver governs discharge. Delirium: Liver Qi stagnation.)
All Three Yin meridians reverse, blocking front and back passages, causing cold hands and feet. Death occurs in three days. (All Three Yin reversing separates Yin from Yang. Blocking front/back means Yin closes below. All Yang Qi is born from Yin. All Three Yin reversing extinguishes generating Qi, causing cold hands/feet and death in three days. This Jue is at the Qi level, hence death in three days signifies Three Yin Qi extinction. If Jue is in the meridians, it presents as symptoms/capabilities without death.)
Taiyang Jue Qi causes stiffness and collapse, hematemesis, and frequent epistaxis. Treat the primary diseased organ. (Taiyang governs all Yang Qi. Yang Qi reversal causes stiffness/collapse. Yang Qi rebelling upward causes hematemesis; Yang-heat above causes epistaxis. Taiyang Qi reversal above forces blood to flow recklessly.)
Shaoyang Jue Qi causes joint dysfunction. Joint dysfunction means inability to walk or look back. (Shaoyang governs the pivot. Shaoyang Qi reversal causes joint dysfunction. Neck/occiput are gatherings of Three Yang Yangwei vessels. Waist/spine are major joints of the body. Hence joint dysfunction prevents walking and looking back.)
Intestinal abscess develops, untreatable. Convulsions indicate death. (Shaoyang Xiang Huo governs Qi. Fire rebelling internally causes intestinal abscess. Untreatable means disease is at Qi level with internal abscess, beyond needle therapy. Convulsions indicate poison affecting Zang organs, leading to death.)
Yangming Jue Qi causes wheezing/cough, body heat, fright, epistaxis, and hematemesis. (Yangming Qi reversal causes wheezing; rebelling causes cough. Yangming Qi governs muscles, so reversal causes body heat. Text states: Three Yang disease causes fright. Epistaxis/hematemesis occur because Yangming is fierce Qi; reversal forces blood recklessly. Disease is at Qi level affecting blood vessels, hence "shan" [prone to].)
Hand-Taiyin Jue Qi causes false fullness and cough, frequent vomiting of froth. Treat the primary diseased organ. (Hand-Taiyin Jue is Lung Qi rebellion. Lung governs Qi, causing false fullness/cough. Failure to distribute water fluids causes frothy vomiting. This is a Lung-generated disease, so treat primary Lung Qi. Note: Yin/Yang Qi originate from feet, but here discussing Zang/Fu Qi includes Hands.)
Hand-Jueyin (Pericardium) and Hand-Shaoyin Jue Qi cause heart pain radiating to the throat, body heat. Death, untreatable. (Hand-Jueyin is Pericardium Qi. Hand-Shaoyin is Heart Qi. Pericardium is Ministerial Fire of the Monarch. Dual fire rebellion leads to self-immolation. Hence death, untreatable.)
Hand-Taiyang Jue Qi causes deafness and tearing, inability to look back or bend/extend waist. Treat the primary diseased organ. (Hand-Taiyang diseases include deafness. Small Intestine governs fluids, so reversal causes tearing. Heart governs blood vessels; Small Intestine governs fluids and is exterior to Heart. Small Intestine Qi reversal prevents fluid nourishment of vessels, causing neck/waist immobility. Waist/neck are major gatherings of vessels/acupoints.)
Hand-Yangming and Hand-Shaoyang Jue Qi cause throat obstruction and pharyngeal swelling, gastrocnemius cramps. Treat the primary diseased organ. (Hand-Yangming is Lung mansion. Hand-Shaoyang is Sanjiao. Yangming governs pharynx; Lung governs larynx. Combined Sanjiao fire rebellion causes throat obstruction/pharyngeal swelling. Yangming is dry-heat; Sanjiao is Dragon-Thunder fire. Fire-heat rebellion causes gastrocnemius cramps. Zhang Zhaohuang asked: Why are Hand Jueyin-Shaoyin and Yangming-Shaoyang combined? Answer: Heaven's Six Qi generate Earth's Five Elements. Earth's Five Elements generate Human Five Zang. Five Zang pair with Five Fu, corresponding to Five Directions/Elements/Colors/Flavors/Notes/Numbers. Six Zang/Fu arise because Pericardium and Sanjiao are interior-exterior, name-only formless, combining to match Heaven's Six Qi. Thus Hand Jueyin pairs with Shaoyin, Hand Yangming with Shaoyang. Question: Pericardium is Heart wrapper, understandable. Why Yangming with Shaoyang? Answer: Sanjiao is the Middle Ditch Mansion. Middle/Upper Jiao emerge from stomach entrance. Lower Jiao branches from Hand-Yangming's ileum. Thus Hand-Yangming is discussed with Shaoyang.)