十二日死。肾至悬绝七日死。脾至悬绝四日死。悬绝者。绝无阳明之胃气。而真脏孤悬也。）帝曰。癫疾何如。岐伯曰。
脉搏大滑。久自已。脉小坚急。死不治。（此论五脏之外合为病。而有虚实也。灵枢经曰。肺脉急甚为癫疾。肾脉急甚为
骨癫疾。又曰。骨癫疾者。 齿诸俞分肉皆满。而骨居汗出。烦 。呕多沃沫。气下泄。不治。筋癫疾者。身倦挛急。
呕多沃沫。气下泄。不治。脉癫疾者。暴仆。四肢之脉皆胀而纵。呕多沃沫。气下泄。不治。是肺合之形。肾合之骨。
心合之脉。肝合之筋。为病于外。而有死生之分。脉搏大者。气盛于外。故生。小坚急者。气泄于下。故死。）帝曰。癫
疾之脉。虚实何如。岐伯曰。虚则可治。实则死。（经曰。重阴则癫。盖癫乃血实之证。故治癫疾者。泻出其血。置于瓠
壶之中。是以脉坚实者死。脉滑大者生。上节之大小者。论气之虚实。此言血脉之虚实。盖癫乃阴盛之病。故宜气盛而
不宜血实也。）帝曰。消瘅虚实何如。岐伯曰。脉实大。病久可治。脉悬小坚。病久不可治。（此论五脏之内因。而有
虚实也。少俞曰。五脏皆柔弱者。善病消瘅。消瘅者。五脏之精气皆虚。转而为热。热则消肌肉。故为消瘅也。脉实大
者。精血尚盛。故为可治。脉悬小者。精气渐衰。故为难治。上节论五脏之外实。此论五脏之内虚。灵枢病形篇。五脏
之脉微小为消瘅。朱永年曰。癫瘅之病。皆曰久者。盖癫因久实。瘅因久虚之所致也。）帝曰。形度骨度脉度筋度。
何以知其度也。（此言五脏之外合。各有度数。而应于四时者也。经曰。形寒饮冷则伤肺。谓皮毛肤腠为形。而内合于肺
者也。骨者肾之合。脉者心之合。筋者肝之合。然皆有浅深俞穴之度数。帝问何以知其度而刺之乎。）帝曰。春亟治经络。
夏亟治经俞。秋亟治六腑。冬则闭塞。闭塞者。用药而少针石也。（伯言五脏之气。合于四时。而刺度之各有浅深也。亟、
急也。春气生升。故亟取络脉。夏取分腠。故宜治经俞。盖经俞隐于肌腠间也。治六腑者。取之于合也。胃合于三里。
大肠合。入于巨虚上廉。小肠合。入于巨虚下廉。三焦合。入于委阳。膀胱合。入于委中央。胆合。入于阳陵泉。盖五
脏内合于六腑。六腑外合于原俞。秋气降收。渐入于内。故宜取其合以治六腑也。冬时之气。闭藏于内。故宜用药而少
针石。盖针石治外。毒药治内者也。帝曰。当作岐伯曰。）所谓少针石者。非痈疽之谓也。（此论痈疽之虚实也。言
痈疽之患。荣卫血气并实。皮肉筋骨皆伤。非若四时之有浅深。冬时之少针石也。）痈疽不得顷时回。（痈者拥也。疽者
阻也。谓热毒外壅内阻。宜即刺之。不得迟延时顷。而使邪毒之回转也。）痈不知所。按之不应手。乍来乍已。刺手太阴
旁三 。与缨脉各二。（ 音贿。此言痈毒之在气分者。宜刺手太阴足阳明也。毒在气分。故痈不知所。毒瓦斯流传。故脉
按之不应手。而乍来乍已也。腋内动脉。手太阴也。名曰天府。宜刺太阴动脉之旁各三 。手太阴之主气也。 者。皮
肤肿起之象。言刺在络脉之旁。/皮肤之间。气随针出。而针眼微肿如小疮。故曰 也。盖皮肤溪谷之间。亦有三百六十
五穴会。毒在气分。故宜刺在皮肤。而不刺经络也。缨脉、结缨处两旁之动脉。人迎穴间。乃卫气别走阳明之道路也。
四时气篇曰。风 肤胀。为五十七 。取皮肤之血者。尽取之。）掖痈大热。刺足少阳五。刺而热不止。刺手心主三。刺
手太阴经络者。大骨之会各三。（此言痈毒之在血分者。宜刺足少阳手心主也。掖痈者。谓在两旁之腋间。足厥阴少阳之
分也。经云。阳气有余。荣气不行。乃发为痈。阴阳不通。两热相搏。乃化为脓。毒在血分。故大热也。厥阴主血。故
从其所合而泻之。如刺之而热不止者。宜刺手心主之脉以泻之。心主主火而主血脉也。本输篇曰。腋下三寸。手心主也。
名曰天池。盖宜刺此也。夫肺朝百脉。而主行荣卫阴阳。若欲刺手太阴之经络者。宜刺在大骨之会各三。谓臂骨交会之
处。尺泽间也。骨之大会曰谷。络脉之渗灌诸节者也。）暴痈筋 。随分而痛。魄汗不尽。胞气不足。治在经俞。（ 软
同。此言痈毒之在筋骨间者。宜刺其经俞也。暴痈者。言毒瓦斯更深。为毒凶暴。筋 者。筋为热邪所伤也。随分而痛者。
在于分肉之处而痛。谓不肿痛于外。而隐然痛于内也。热毒在深。故表汗不出。骨伤髓消。故胞气不足也。宜治在经俞
者。随其所痛之处而深取之也。夫痈毒之患。或外因风寒之邪。或内因喜怒不测。五脏外合之皮肉筋骨。胃腑所生之荣
卫血气。皆为邪毒盛而正气虚。故当审其阴阳虚实以刺之也。张兆璜曰。皮肉筋骨皆伤。故为暴痈。皮伤故魄汗不尽。
骨伤故胞气不足。）腹暴满。按之不下。取手太阳经络者。胃之募也。少阴俞去脊椎三寸旁五。用圆利针。（此论中焦
之虚实也。经云。胃病者。腹胀满。腹暴满而按之不下。胃之实证也。宜取手太阳之经络。太阳之络。乃胃之募也。盖
小肠为受盛之府。故从手太阳以泻其胃焉。又肾者。胃之关也。关门不利。则聚水而为胀。故曰当刺足少阴之俞焉。手
太阳之络。名曰支正。在上腕五寸间。足少阴之俞。在脊下第十四椎。两旁各开一寸五分。故曰三寸旁也。圆利针者。
且圆且利。以取暴气者也。或曰脊椎两旁。各开三寸。名曰志室。亦足少阴之俞也。）霍乱。刺俞旁五。足阳明及上旁三。
（霍乱者。胃为邪干。胃气虚逆也。夫阳明胃土。藉足少阴之气以合化。故宜刺少阴俞旁以补之。五者追而济之。渐至
于骨也。又及上刺阳明俞旁三。三者先浅刺绝皮。以出阳邪。后刺深之。以出阴邪。最后极深入于分肉之间。以致谷气。
邪气出而谷气至。则胃气和而霍乱止矣。上节用泻。故曰圆利。此法用补。故不去针。徐公遐曰。取足少阴者。当刺骨。
三刺而至分肉。是五则至骨矣。）刺痫惊脉五。（此论刺五行之实证也。痫惊者。痫 筋挛。或外感六气。或内伤七情。
或饮食生痰。或大惊卒恐。病涉五脏五行。故当取其五脉。徐公遐曰。病涉五行。故有作猪犬牛羊之鸣者。）针手太
阴各五。刺经太阳五。刺手少阴经络旁者一。足阳明一。上踝五寸刺三针。（按九针之制。皆所以泻邪者也。此刺五脉之
实。故首句曰针手太阴。末句曰刺三针。谓当以针泻之。而不宜补之也。针手太阴。泻金实也。针太阳五。泻水实也。
针手少阴。泻火实也。针足阳明。泻土实也。上踝五寸。乃足少阳光明穴。刺三针以泻木实。盖脏腑相连。阴阳相合。
故或刺脏之经。或泻腑之络。朱永年曰。心肺居上为阳。故从脏。肝胃脾居下为阴。故从腑。盖五脉之阴邪。宜从阳以
泻出。朱圣公曰。太阳不言手足。知其为手乎为足乎。曰。上文曰手太阴。下文曰手少阴。则其为足也可知。若接上句
而为手太阳。则下句不必复云手矣。五刺之中。曰手。曰足。曰太阳。曰足上。宜细玩之。正见其经言错综之妙。）凡
治消瘅仆击偏枯痿厥。气满发逆。肥贵人则膏粱之疾也。隔塞闭绝。上下不通。则暴忧之病也。暴厥而聋。偏塞闭不通。
内气暴薄也。不从内外中风之病。故瘦留着也。 跛。寒风湿之病也。此言百病之始生也。皆生于风雨寒暑。阴阳喜怒。
饮食居处。大惊卒恐。则血气分离。阴阳破散。经络厥绝。脉道不通。阴阳相逆。卫气稽留。经脉空虚。血气不次。乃
失其常。故有为消瘅癫仆诸证。然皆有表有里。有实有虚。更贵更贱。或逆或从。皆当详审其脏腑经俞。三部九候。而
治以补泻也。凡治消瘅。五脏之内虚也。仆击、癫痫之外实也。偏枯、邪气之在上也。痿厥、清气之在下也。气满发逆。
浊气之在中也。贵人者。形乐而肌肤盛重。在贵人则为膏粱之浊。溜于肠胃。以致气满而发逆也。隔塞闭绝。中焦之气
不通也。上下不通。上下之气闭塞也。忧、郁也。三焦不通。五郁之为病也。暴厥而聋。厥气上逆。上窍不通也。偏塞
闭结。厥气下逆。下窍不通也。此内气暴薄。而为外窍之不通也。如不从内之忧怒。外之中风。而多病夭者。此缘形弱
气衰。墙基卑薄。故肌肉瘦而皮肤薄着也。 、足也。跛、行不正而偏费也。此风寒湿邪。皆能为此疾也。夫阳受风气。
阴受湿气。伤于风者。上先受之。伤于湿者。下先受之。然阳病者。上行极而下。阴病者。下行极而上。是以 跛之疾。
亦有因风邪之所致。盖言邪随气转。而外内上下之无常也。此言百病之生。皆有虚有实。然总不外乎内因于七情饮食。
外因于暑湿风寒。及不内外因之瘦留薄着也。徐公遐曰。 跛为风寒湿之病者。乃反结邪气在上。清气在下之义。知
跛之有风邪。则知偏枯之亦有湿邪矣。黄帝曰。黄胆暴痛癫疾厥狂。久逆之所生也。五脏不平。六腑闭塞之所生也。
头痛耳鸣。九窍不利。肠胃之所生也。（此言脏腑阴阳。表里上下。交相输应者也。如黄胆者。湿热内郁而色病见于外也。
暴痛者。五脏之气不平。卒然而为痛也。癫疾厥狂。阴阳偏胜之为病也。此皆阴阳五行之气。久逆不和之所生也。夫五
脏之气。久逆而不得和平者。六腑闭塞之所生也。六腑不和。则九窍为之不利。盖脏腑阴阳。表里相应。是以证见于外
者。病本于内。闭塞于内者。而外窍为之不通。盖言百病之生。总不外乎表里阴阳。血气虚实。读者无仅视为瘅疸。癫
痫、痈疽、肠 之虚实可也。徐公遐曰。此节照应首节气虚者肺虚也之义。首节论邪病之从外而内。此节言凡病之从
内而外。张兆璜曰。伯谓虚实。皆从物类始。帝言凡病由于内生。君臣反复咨论。各有其道。此篇论血气之生始出入。
外内虚实。乃医学之大纲。学人宜细心体认。）
(If the Kidney pulse exhibits "Xuan Jue" (suspension and isolation), death occurs after twelve days. If the Kidney pulse reaches Xuan Jue, death occurs after seven days. If the Spleen pulse reaches Xuan Jue, death occurs after four days. The term "Xuan Jue" refers to the complete absence of Stomach Qi from the Yangming channel, leaving the True Zang Qi isolated and suspended.) The Yellow Emperor asked: What are the manifestations of Dian Ji (epilepsy/mania)? Qibo replied: If the pulse is large and slippery, although the disease has lasted long, it will recover spontaneously. If the pulse is small, firm, and rapid, death is inevitable and untreatable. (This section discusses diseases arising from the external correspondence of the Five Zang organs, involving deficiency and excess. The *Ling Shu* states: An urgent Lung pulse indicates Dian Ji. An urgent Kidney pulse indicates Gu Dian Ji (bone epilepsy). It further states: In bone epilepsy, all acupoints around the teeth and intermuscular spaces are full, bones protrude, sweating occurs, irritability is present, excessive vomiting of saliva happens, and Qi leaks downward; this is untreatable. In tendon epilepsy, the body is fatigued with spasms and stiffness, excessive vomiting of saliva occurs, and Qi leaks downward; this is untreatable. In pulse epilepsy, sudden collapse occurs, pulses in the four limbs are distended and flaccid, excessive vomiting of saliva happens, and Qi leaks downward; this is untreatable. These describe the external manifestations of Lung corresponding to skin, Kidney to bone, Heart to vessels, and Liver to tendons, which have distinctions between life and death. A large pulse indicates Qi abundance on the exterior, hence survival. A small, firm, and rapid pulse indicates Qi leakage downward, hence death.) The Yellow Emperor asked: Regarding the pulse of Dian Ji, how do deficiency and excess present? Qibo replied: Deficiency can be treated; excess leads to death. (The classic states: Heavy Yin leads to Dian Ji. Dian Ji is essentially a condition of Blood excess. Therefore, treating Dian Ji involves draining blood into a gourd vessel. Hence, a firm pulse indicates death, while a slippery and large pulse indicates life. The previous section discussed the deficiency and excess of Qi; this section discusses the deficiency and excess of Blood vessels. Dian Ji is a disease of Yin excess, so it favors Qi abundance rather than Blood excess.) The Yellow Emperor asked: How do deficiency and excess present in Xiao Dan (wasting-thirst disorder)? Qibo replied: A solid and large pulse allows treatment even if the disease is chronic; a suspended, small, and firm pulse makes treatment impossible even if the disease is not yet chronic. (This section discusses internal deficiency and excess of the Five Zang organs. Shaoyu stated: Those with weak Five Zang organs are prone to Xiao Dan. Xiao Dan arises when the essence and Qi of the Five Zang are deficient, transforming into heat. Heat consumes muscle tissue, hence the name Xiao Dan. A solid and large pulse indicates that essence and blood are still abundant, making it treatable. A suspended and small pulse indicates gradual decline of essence and Qi, making it difficult to treat. The previous section discussed external excess of the Five Zang; this section discusses internal deficiency. The *Ling Shu: Bing Xing* chapter states: Microscopic and small pulses of the Five Zang indicate Xiao Dan. Zhu Yongnian noted: Both Dian Ji and Dan diseases often involve chronicity; Dian Ji results from chronic excess, while Dan disease results from chronic deficiency.) The Yellow Emperor asked: Regarding the measurements of Form (Xing), Bone (Gu), Pulse (Mai), and Tendon (Jin), how can one know their degrees? (This explains that the external correspondences of the Five Zang organs have specific degrees corresponding to the Four Seasons. The classic states: Cold exposure and cold drinks injure the Lung. This means skin, hair, and pores constitute the Form, internally corresponding to the Lung. Bones correspond externally to the Kidney, vessels to the Heart, and tendons to the Liver. However, each has specific depths and acupoint degrees. The Yellow Emperor asks how to determine these degrees for acupuncture.) The Yellow Emperor asked: In Spring, urgently treat the collaterals; in Summer, urgently treat the Jing-Stream points; in Autumn, urgently treat the Six Fu organs; in Winter, there is closure. Closure means using medicine and sparing needles and stones. (Zhang Zhicong's commentary: This states that the Qi of the Five Zang corresponds to the Four Seasons, and acupuncture depth varies. "Ji" means urgent. Spring Qi generates and ascends, so urgently selecting collateral vessels is appropriate. Summer selection focuses on intermuscular spaces, suitable for treating Jing-Stream points, as these points lie hidden within the muscle layers. Treating the Six Fu organs involves selecting their He-Sea points. The Stomach He-Sea is Zusanli; Large Intestine He-Sea is Shangjuxu; Small Intestine He-Sea is Xiajuxu; San Jiao He-Sea is Weiyang; Bladder He-Sea is Weizhong; Gallbladder He-Sea is Yanglingquan. Generally, the Five Zang internally correspond to the Six Fu, and the Six Fu externally correspond to Yuan and Shu points. Autumn Qi descends and gathers, moving inward, so selecting He-Sea points to treat the Six Fu is appropriate. Winter climate closes and stores inward, so using medicine and sparing needles/stones is appropriate. Needles and stones treat the exterior; drugs treat the interior.) The Yellow Emperor asked: It should read "Qibo said." The phrase "sparing needles and stones" does not refer to Carbuncles and Ulcers. (This section discusses the deficiency and excess of Carbuncles and Ulcers. It states that in carbuncle and ulcer conditions, Ying and Wei Qi and Blood are both excess, injuring skin, flesh, tendons, and bones. This differs from the seasonal variations in depth or the winter practice of sparing needles/stones.) Carbuncles and ulcers must not be delayed for even a moment. ("Yong" means obstruction; "Ju" means blockage. This refers to heat toxins obstructing externally and blocking internally. Immediate puncture is required without delay to prevent the pathogenic toxin from reversing.) For unknown carbuncle locations, where palpation yields no fluctuation, and swelling appears and disappears suddenly, puncture three points beside the Hand Taiyin channel and two points on each side of the Ying Mai (cervical artery). ("Hui" is the pronunciation. This describes carbuncle toxins in the Qi level, suitable for puncturing the Hand Taiyin and Foot Yangming channels. Toxin in the Qi level causes uncertainty in location; spreading toxin causes pulses that do not fluctuate upon pressure and appear/disappear suddenly. The arterial pulse in the axilla belongs to the Hand Taiyin channel, named Tianfu. Puncturing three points beside the Taiyin arterial pulse is appropriate. " " denotes skin swelling. Puncturing beside the collateral vessels, between skin layers, allows Qi to exit with the needle, causing slight swelling at the needle site like a small sore, hence the term " ". There are 365 acupoint intersections in the skin and muscle valleys. Since the toxin is in the Qi level, puncturing the skin is appropriate rather than the meridians. Ying Mai refers to the arterial pulse on both sides of the knotting area of the collar tie, located near the Renying point, which is the pathway where Wei Qi branches to the Yangming channel. The *Si Shi Qi* chapter states: Wind causing skin swelling requires treating fifty-seven " " points by extracting blood from the skin.) For large, hot carbuncles in the armpit, puncture five points on the Foot Shaoyang channel. If heat persists after puncture, puncture three points on the Hand Shaoyin (Pericardium) channel. If treating the Hand Taiyin meridian/collateral, puncture three points at the Great Bone Intersection. (This describes carbuncle toxins in the Blood level, suitable for puncturing the Foot Shaoyang and Hand Shaoyin channels. Armpit carbuncles occur in the lateral axillary region, the junction of Foot Jueyin and Foot Shaoyang. The classic states: Excess Yang Qi and stagnation of Ying Qi lead to carbuncles. Blockage of Yin and Yang causes two heats to clash, forming pus. Toxin in the Blood level causes high heat. Jueyin governs Blood, so draining from its corresponding channel is appropriate. If heat persists, puncturing the Hand Shaoyin meridian drains the fire. The Pericardium governs Fire and Blood vessels. The *Ben Shu* chapter states: Three cun below the axilla is the Hand Shaoyin channel, named Tianchi, which is an appropriate puncture site. The Lung directs all vessels and governs the movement of Ying, Wei, Yin, and Yang. When treating the Hand Taiyin meridian/collateral, puncture three points at the Great Bone Intersection, specifically where arm bones intersect, near Chize. The intersection of bones is called Gu, where collaterals permeate joints.) Sudden carbuncles with tendon softness/spasms, pain according to the affected part, unceasing Po Han (sweat associated with the Lungs), and insufficient Bao Qi (Kidney/Essence Qi) should be treated at the Jing-Shu points. ("Ruan" is synonymous with " ". This describes carbuncle toxins between tendons and bones, suitable for treating Jing-Shu points. "Bao Yong" implies deeper toxin and violent nature. Tendon "ruan" indicates tendon injury by heat pathogens. Pain "according to the part" means pain within the intermuscular spaces, not swelling externally but deep internal pain. Deep heat toxin prevents surface sweating. Bone injury and marrow depletion cause insufficient Bao Qi. Treating at Jing-Shu points means deep needling at the painful site. Carbuncle etiology includes external Wind-Cold or internal emotional disturbances. Pathogens overwhelm Zheng Qi in the skin, flesh, tendons, and bones corresponding to the Zang, and in the Ying/Blood generated by the Stomach Fu. One must examine Yin/Yang and deficiency/excess to needle accordingly. Zhang Zhaohuang noted: Injury to skin, flesh, tendons, and bones constitutes Bao Yong. Skin injury causes unceasing Po Han; bone injury causes insufficient Bao Qi.) Sudden abdominal fullness that does not decrease upon pressure: take the Luo-connecting point of the Hand Taiyang channel, which is the Mu-Alarming point of the Stomach. The Shu-point of the Foot Shaoyin channel, three cun from the spine and five cun lateral, use a Yuanli needle. (This discusses middle Jiao deficiency and excess. The classic states: Stomach disease presents as abdominal fullness. Sudden fullness unrelieved by pressure is Stomach excess. Taking the Hand Taiyang Luo point, which is the Stomach Mu point, is appropriate. The Small Intestine is the receiving organ, so draining the Stomach via the Hand Taiyang is logical. The Kidney is the gate of the Stomach; if the gate fails, water accumulates causing distension. Thus, needling the Foot Shaoyin Shu point is indicated. The Hand Taiyang Luo point is named Zhengzheng, five cun above the wrist. The Foot Shaoyin Shu point is at the 14th thoracic vertebra, 1.5 cun lateral, described here as "three cun lateral". The Yuanli needle is round and sharp, used to remove sudden Qi. Some say the Zhishi points, three cun lateral to the spine, are also Foot Shaoyin Shu points.) For Huo Luan (cholera-like syndrome), puncture five points beside the Shu points, the Foot Yangming channel, and three points superiorly. (Huo Luan results from pathogenic interference with the Stomach, causing deficiency and rebellious Stomach Qi. Yangming Earth relies on Foot Shaoyin Qi for transformation, so supplementing via the Shaoyin Shu vicinity is appropriate. "Five" represents chasing and assisting, reaching the bone. "Three" superiorly involves shallow puncture through the skin to expel Yang pathogens, deeper puncture to expel Yin pathogens, and finally deep insertion into muscle layers to restore Gu Qi. When pathogens exit and Gu Qi arrives, Stomach Qi harmonizes and Huo Luan stops. The previous section used draining (Yuanli); this method uses tonification, retaining the needle. Xu Gongxia noted: Needling Foot Shaoyin reaches the bone. Three punctures reach the muscles; thus, five punctures reach the bone.) Puncture five points on the pulses related to Epileptic Convulsions. (This discusses treating excess in the Five Elements. Epileptic convulsions may arise from external Six Qi, internal Seven Emotions, dietary phlegm, or sudden fright. The disease involves the Five Zang and Five Elements, so taking five pulses is appropriate. Xu Gongxia noted: Involvement of the Five Elements can manifest as animal-like cries.) Puncture five points on the Hand Taiyin channel. Puncture five points on the Jing-Taiyang channel. Puncture one point beside the Hand Shaoyin meridian/collateral. Puncture one point on the Foot Yangming. Puncture three needles at five cun above the ankle. (According to the Nine Needles system, all are designed to drain pathogens. Here, treating excess in five pulses begins with Hand Taiyin and ends with three needles, indicating draining rather than tonifying. Needling Hand Taiyin drains Metal excess. Needling Taiyang five times drains Water excess. Needling Hand Shaoyin drains Fire excess. Needling Foot Yangming drains Earth excess. Five cun above the ankle is the Guangming point of Foot Shaoyang; three needles drain Wood excess. Organs connect, Yin and Yang combine, so sometimes Zang meridians are needled, sometimes Fu collaterals drained. Zhu Yongnian stated: Heart and Lung are upper Yang, so follow Zang. Liver, Stomach, and Spleen are lower Yin, so follow Fu. Yin pathogens in the five pulses should be drained via Yang. Zhu Shenggong commented: "Taiyang" without hand/foot specification implies Foot Taiyang based on context (Hand Taiyin and Hand Shaoyin mentioned previously). If it were Hand Taiyang, "Hand" would be repeated. The variation in terms highlights the complexity of the text.) Generally, treating Xiao Dan, Pu Ji (sudden stroke/fainting), Pian Ku (hemiplegia), Wei Jue (atrophy/cold limbs), and Qi Man Fa Ni (fullness/rebellious Qi): For wealthy/noble individuals, these are disorders of rich food and drink. Ge Sai Bi Jue (blockage/intestinal obstruction) and lack of communication between upper and lower result from sudden sorrow. Sudden Jue with deafness, partial blockage, and closed orifices result from sudden internal Qi pressure. Diseases not caused by external Wind or internal emotions, but characterized by emaciation and lingering, are due to thinness and adherence. Bo Bi (limping) is caused by Cold, Damp, and Wind. This section explains the origin of hundred diseases: they arise from Wind, Rain, Cold, Heat, Yin-Yang, emotions, diet, lifestyle, sudden fright, or terror. This leads to separation of Blood and Qi, dispersion of Yin and Yang, severance of meridians, blockage of pulse pathways, reversal of Yin and Yang, stagnation of Wei Qi, emptiness of meridians, and disorder of Blood and Qi, losing normalcy. Thus, symptoms like Xiao Dan, Dian, and Pu arise. All have exterior/interior, excess/deficiency, noble/base, or rebellious/compliant aspects. One must carefully examine Zang-Fu, meridians, acupoints, and the Three Regions and Nine Pulses, treating with tonification or drainage. Treating Xiao Dan addresses internal Zang deficiency. Pu Ji and Dian Ji address external excess. Pian Ku addresses pathogenic Qi in the upper. Wei Jue addresses clear Qi sinking in the lower. Qi Man Fa Ni addresses turbid Qi in the middle. Noble individuals, enjoying ease and having robust flesh, accumulate turbidity from rich foods in the intestines and stomach, leading to Qi fullness and rebellion. Ge Sai Bi Jue indicates middle Jiao Qi blockage. Upper/lower不通 indicates closure of upper and lower Qi. Sorrow implies depression. San Jiao blockage causes Five Depressions. Sudden Jue with deafness indicates rebellious Qi ascending, blocking upper orifices. Partial blockage indicates rebellious Qi descending, blocking lower orifices. This is internal Qi pressure causing external orifice blockage. If not due to internal emotion or external wind, but frequent illness and short life, it is due to weak form, depleted Qi, low "wall base" (facial structure), thin muscles, and adherent skin. "Bi" refers to feet. "Bo" refers to abnormal gait. Cold, Damp, and Wind can all cause this. Yang receives Wind; Yin receives Damp. Wind injuries affect the upper first; Damp injuries affect the lower first. However, Yang diseases ascend to extreme then descend; Yin diseases descend to extreme then ascend. Thus, limping can also be caused by Wind. This illustrates that pathogens follow Qi, and exterior/interior, upper/lower dynamics are variable. Hundred diseases have deficiency and excess, rooted in internal Seven Emotions/Diet, external Wind/Cold/Damp/Heat, or non-internal/external factors like emaciation. Xu Gongxia noted: Limping due to Cold-Damp-Wind reflects pathogens settling in the upper and clear Qi in the lower. Knowing Wind causes limping implies Damp contributes to hemiplegia. The Yellow Emperor said: Jaundice, sudden pain, Dian Ji, Jue Kuang arise from prolonged rebellion. Unease of the Five Zang arises from blockage of the Six Fu. Headache, tinnitus, and dysfunction of the nine orifices arise from the intestines and stomach. (This explains the mutual transmission of Zang-Fu Yin-Yang, interior-exterior, and upper-lower. Jaundice results from internal damp-heat manifesting externally. Sudden pain results from abrupt Zang Qi imbalance. Dian Ji and Jue Kuang result from Yin-Yang dominance. These arise from prolonged disharmony of Yin-Yang and Five Elements Qi. Prolonged Zang Qi imbalance stems from Six Fu blockage. Six Fu disharmony causes nine orifice dysfunction. Zang-Fu Yin-Yang correspond internally and externally; external symptoms originate internally; internal blockage causes external orifice dysfunction. Readers should not view this merely as deficiency/excess of Xiao Dan, Jaundice, Dian Ji, Carbuncles, or intestinal issues. Xu Gongxia noted: This section echoes the opening statement that Qi deficiency relates to Lung deficiency. The opening discusses external pathogens entering inward; this section discusses internal diseases manifesting outward. Zhang Zhaohuang noted: Qibo began with deficiency/excess from material classes; the Emperor discussed internal origins. The dialogue explores different paths. This chapter outlines the generation, entry, and exit of Blood and Qi, and exterior-interior deficiency/excess, serving as a general outline of medicine. Students should study it carefully.)