黄帝问曰。人有四经十二从。何谓。岐伯对曰。四经应四时。十二从应十二月。十二月应十二脉。（四经者。春脉弦。
夏脉钩。秋脉毛。冬脉石。四时之经脉。以应四时之气也。十二从者。手足三阴三阳之气。从手太阴顺行至足厥阴也。
应十二月者。手太阴应正月寅。手阳明应二月卯。足阳明应三月辰。足太阴应四月巳。手少阴应五月午。手太阳应六月
未。足膀胱应七月申。足少阴应八月酉。手厥阴应九月戌。手少阳应十月亥。足少阳应十一月子。足太阴应十二月丑。
十二脉者。六腑六脏之经脉也。三阴三阳之气。以应岁之十二月。十二月。复应有形之十二脉也。此篇论分别阴阳。以
知死生。故曰阴阳别论。）脉有阴阳。知阳者知阴。知阴者知阳。（十二经脉。乃脏腑阴阳配合。故知阳者可以知阴。知
阴者可以知阳。能知阴阳。可别死生。方盛衰论曰。持雌失雄。弃阴附阳。不知并合。诊故不明。）凡阳有五。五五二
十五阳。（此节以胃脏藏真。而分别其阴阳也。胃脘之阳。资养五脏。五脏相生而各有五。是以五五二十五阳也。）所谓
阴者。真脏也。见则为败。败必死也。（五脏为阴。脏者藏也。神藏而不外见者也。如无阳和之胃气。而真脏之脉见。见
则脏气为败。败必死也。）所谓阳者。胃脘之阳也。（所谓二十五阳者。乃胃脘所生之阳气也。胃脘者。中焦之分。主化
水谷之精气。以资养五脏者也。夫四时之脉。春弦。夏洪。秋浮。冬沉。长夏和缓。五脏之脉。肝弦。心洪。脾缓。肺
涩。肾沉。如春时之肝脉微弦而长。心脉微弦而洪。脾脉微弦而缓。肺脉微弦而涩。肾脉微弦而沉。夏时之肝脉微洪而
弦。心脉微洪而大。脾脉微洪而缓。肺脉微洪而涩。肾脉微洪而沉。四时五脏。皆得微和之胃气。故为二十五阳也。）别
于阳者。知病处也。别于阴者。知死生之期。（能别阳和之胃气。则一有不和。便可知病处。能别真脏之阴脉。则知肝脉
至者。期十八日死。心脉至者。九日死也。此论真脏为阴。胃气为阳。与上下二节。论经脉之阴阳不同也。）三阳在头。
三阴在手。所谓一也。（此复论十二经脉之阴阳也。手足三阳之脉。手走头而头走足。故曰三阳在头。手足三阴之脉。足
走腹而腹走手。故曰三阴在手也。十二经脉虽有手足阴阳之分。然皆一以贯通。手太阴肺脉。交于手阳明大肠。大肠交
足阳明胃。胃交足太阴脾。脾交手少阴心。心交手太阳小肠。小肠交足太阳膀胱。膀胱交足少阴肾。肾交手厥阴心包络。
包络交手少阳三焦。三焦交足少阳胆。胆交足厥阴肝。肝复交于手太阴肺。故所谓一也。）别于阳者。知病忌时。别于
阴者。知死生之期。（能别于阳之脉证者。知一阳二阳三阳之发病。及阳结之为病也。至于三阳搏鼓三日死。二阳俱搏十
日死。忌、死忌也。言别于阳者。知所病之证。及死忌时也。别于阴之脉者。知一阴二阴三阴之发病。及肝之心。心之
肺。以至于阴搏之死证。此论别手足三阴三阳之脉证也。）谨熟阴阳。无与众谋。（此总结上文之意。所谓阴阳者。胃脘
之阳。真脏之阴。手足之三阳。手足之三阴也。言审别阴阳之脉。谨熟之于心。应之于手。无与众相谋论也。）所谓阴阳
者。去者为阴。至者为阳。静者为阴。动者为阳。迟者为阴。数者为阳。（此审别十二经脉之阴阳也。夫脏为阴。腑为阳。
手足之阴阳。乃六脏六腑之经脉。故当以脉之来去动静迟数。而分别其阴阳。）凡持真脉之脏脉者。肝至悬绝急。十八日
死。心至悬绝。九日死。肺至悬绝。十二日死。肾至悬绝。七日死。脾至悬绝。四日死。（此审别真脏胃脘之阴阳也。悬
绝者。真脏脉悬而绝。无胃气之阳和也。急者。肝死脉来。急益劲。如张弓弦也。六节藏象论。天以六六为节。地以九
九制会。计人亦有三百六十五节。以为天地久矣。此气之数也。木生于地。故死于九九之数。肺主天气。绝于六六之期。
水火本于先天。故死于生成之数。脾土寄于四季。故绝于四日之周。五脏死期。总合大衍之数。按王氏皆以天地生成之
数论之。马氏论天干之五行相克。其间多有不合。夫脏腑具五行之气。各有阴阳刚柔不同。不必执一而论。是以以下阴
阳相搏。亦止少阴太阳。死于天地生成之数。余皆不合也。此节论真脏脉见之死期。与后节阴阳相搏之死期。又少有异
同也。王子方曰。人秉天地之气数而生。故应天地之气数而死。气数者。天地五行之数也。）曰。二阳之病发心脾。有不
得隐曲。女子不月。其传为风消。其传为息贲者。死不治。（此审别三阴三阳之发病也。二阳者。足阳明胃经也。夫人之
精血。由胃腑水谷之所资生。脾主为胃行其精液者也。二阳病。则中焦之汁竭。无以奉心神而化赤。则血虚矣。水谷之
精。脾无转输于五脏。则肾无所藏而精虚矣。男子无精。有不得为隐曲之事。在女子无血。则月事不得以时下矣。此病
本于二阳。而发于心脾也。精血两虚。则热盛而生风。风热交炽。则津液愈消竭矣。火热烁金。而传为喘急息肩者。死
不治。盖胃乃津液之生原。肺乃津液之化原也。按阴阳离合论。只论足之三阴三阳。此章亦先论足经。至末章曰三阴俱
搏。三阳俱搏。是兼手经而言。故曰俱也。高士宗曰。不得隐曲。女子不月。病在肾也。风消肝木病也。息贲病在肺也。
二阳之病传。发于五脏而死。）曰。三阳为病发寒热。下为痈肿。及为痿厥 。（ 音善 音捐。三阳者。太阳之为病
也。太阳之气主表。邪之中人。始于皮毛。邪正相搏。发为寒热之病矣。太阳主开。病则开阖不得。邪气从之。逆于肉
理。乃生痈肿。太阳为诸阳主气而主筋。筋伤则为痿。气伤则为厥也。 、 股也。 、酸疼也。此皆太阳筋脉之为病
也。太阳之气主表。而经脉发原于下。是以始病寒热之在上在表。而渐为痈肿痿厥颓疝之在内在下也。张兆璜曰。太阳
标阳而本寒。故为寒热之病。谓其能为寒为热。故曰为。）其传为索泽。其传为颓疝。（太阳之经气。生于膀胱。膀胱者。
主藏津液。气化则出。太阳之气。病热于表。传入于里。则水津枯索而泽竭矣。颓疝。小腹控卵肿痛。所谓膀胱疝也。
盖始病标而及本。始病气而及经与筋也。）曰。一阳发病。少气。善咳善泄。（一阳者。少阳之气病也。少阳主初生之气。
病则生气少矣。足少阳相火主气。气少则火壮矣。火烁金故善咳。木火之邪。贼伤中土。故善泄也。）其传为心掣。其传
为隔。（饮食于胃。浊气归心。脾胃受伤而为泄。故心虚而掣痛矣。灵枢经云。脾脉微急为膈中。又曰。饮食不下。隔塞
不通。邪在胃脘。此皆少阳之木邪干土。亦始病气而后及经与腑也。）二阳一阴发病。主惊骇。背痛。善噫善欠。名曰风
厥。（二阳一阴者。阳明厥阴之为病也。东方肝木。其病发惊骇。足阳明之脉病。闻木音则惕然而惊。背为阳。厥阴主春
阳肝木。故引背痛也。邪气客于胃。厥逆从上下散。复出于胃。故为噫也。欠者。气引而上也。胃是动病。善伸数欠。
此厥阴风木厥逆之为病也。风木为病。干及胃土。故名风厥。）二阴一阳发病。善胀。心满善气。（二阴一阳者。少阴少
阳也。少阳之气。生于肾脏水中。经云。肾气实则胀。三焦病者。腹气满。小腹尤坚。此肾气与生阳并逆。故善胀。心
肾之气。不能相交。故心满善气也。善气者。太息也。心系急则气道约。故太息以伸出之。三焦、气也。此一阳之气病。
故引论于三焦。）三阳三阴发病。为偏枯痿易。四肢不举。（三阳三阴者。太阳三阴之为病也。偏枯者。半身不遂。痿易
者。委弃而不能如常之动作也。太阳为诸阳主气而主筋。阳气虚。则为偏枯。阳虚而不能养筋。则为痿。脾属四肢。故
不举也。此水腑为病。而逆乘脾土也。）鼓一阳曰钩。鼓一阴曰毛。鼓阳胜急曰弦。鼓阳至而绝曰石。阴阳相过曰溜。（钩
当作弦弦当作钩。此论四经之脉。以应四时也。鼓、动也。一阳之气初升。故其脉如弦之端直。以应春生之气也。一阴
之气初升。故其脉如毛之轻柔。以应秋阴之气也。阳气正盛。故其脉来盛去悠。如钩之急。以应夏热之气也。至者为阳。
阳气伏藏。故脉虽鼓至而断绝。以应冬藏之气也。溜。滑也。阴阳相过。其脉则滑。长夏之时。阳气微下。阴气微上。
阴阳相过。故脉滑也。此言人有四经。以应四时之气也。）阴争于内。阳扰于外。（内为阴。外为阳。脏为阴。腑为阳。
承上文而言。人之经气。阴阳相贯。外内循环。如阴不得阳气以和之。则阴争于内矣。阳不得阴气以和之。则阳扰于外
矣。高士宗曰。此言阴阳之气不和。则为阳结阴结之病。若夫刚与刚。是阳传于阳。阴传于阴。乃阴阳相绝之死候也。）
魄汗未藏。四逆而起。起则熏肺。使人喘鸣。（此言阴和于阳。而阴液不宜外泄者也。汗者。血之液也。魄汗、肺之汗也。
夫经气归于肺。肺朝百脉。输精于皮毛。皮毛汗出。而精血仍藏于阴。如魄汗未藏。是夺汗而伤其精血矣。脏真高于肺。
主行荣卫阴阳。肺脏之阴液外泄。则四脏之阴。并逆而起。起则上熏于肺。而使人喘急喉鸣。盖五脏主藏精者也。精化
而为血。血化而为汗。百脉虽朝于肺。而五脏相通。移皆有次。四逆而起。则失其次序旋转之机矣。）阴之所生。和本曰
和。（此言阳和于阴。而后谓之和也。夫外脉为阳。腑脉为阳。然皆本于五脏五行而生。故曰阴之所生也。阴之所生之阳
脉。与所本之阴脉相和。而始名曰和。盖阳予之正。阴为之主。既有所出。当有所入。是故刚与刚。则阳散而阴亡矣。）
是故刚与刚。阳气破散。阴气乃消亡。（刚与刚。是阳不与阴和矣。阳不归阴。则阳气破散。阳气外散。而孤阴亦内亡矣。）
淖则刚柔不和。经气乃绝。（此言柔与柔而生气绝也。淖、和也。阴与阴和。而刚柔不和。则阴无所生之阳矣。孤阴不生。
则经气乃绝。经气已绝。不过三日四日而死也。）死阴之属。不过三日而死。生阳之属。不过四日而死。（五脏相克而传。
谓之死阴。相生而传。谓之生阳。属、类也。如肝之心。心之脾。脾之肺。肺之肾。皆谓之生阳。如心之肺。肺之肝之
类。皆谓之死阴也。以阳脏相生而传。故不过四日之偶数而死。以阴脏相克而传。故不过三日之奇数而死也。莫子晋曰。
三日者。不过天地之生数。四日者。不能尽五行之数终。）所谓生阳死阴者。肝之心谓之生阳。心之肺谓之死阴。（之、
往也。传也。夫肝脉传肺。肺传大肠。大肠传胃。胃传脾。脾传心。心传小肠。小肠传膀胱。膀胱传肾。肾传心包络。
包络传三焦。三焦传胆。胆传肝。一脏一腑。一雌一雄。阴阳相间。循环无端。如肝之心。心之肺。肺之肾。肾之脾。
此皆经气绝而死不治者也。）肺之肾谓之重阴。肾之脾谓之辟阴。死不治。（肺之肾。亦生阳之属。因肺肾为牝脏。以阴
传阴。故名重阴。辟、偏辟也。以水脏而反传所不胜之脾土。故谓之辟阴。此皆不治之死候也。）结阳者。肿四肢。（此
言阴阳之气不和。自结而为病也。四肢为诸阳之本。气归形。气结故形肿也。此概三阳而言也。）结阴者。便血一升。再
结二升。三结三升。（阴气结于内而不得流行。则水亦留聚而下泄矣。一阴结。便血一升。二阴并结。便血二升。三阴俱
结。便血三升。此概三阴而言也。辨脉篇曰。脉有阳结阴结者。何以别之。答曰。其脉浮而数。能食。不大便者。名曰
阳结也。其脉沉而迟。不能食。身体重。大便反硬。名曰阴结也。盖欲审别阴阳之气结者。当以脉之去至动静。浮沉迟
数。以分阴阳。以证之肿四肢。知三阳并结。便血三升。知三阴并结也。以证之消。知结在二阳。当以二阳之法治之。
证之隔。知结在三阳。当以三阳之法治之可也。）阴阳结斜。多阴少阳。曰石水。少腹肿。（结斜者。偏结于阴阳之间也。
夫外为阳。内为阴。胃为阳。肾为阴。此结于形身之内。脏腑之外。胃肾空廓之间而为肿也。石水、肾水也。肾者胃之
关。关门不利。故聚水而从其类也。此多偏于肾脏。故为多阴少阳而少腹肿也。）二阳结。谓之消。（二阳、阳明胃气也。
消、消渴也。盖阳明气结。则水谷之津液不生。以致消渴而为病也。按灵枢以五脏之脉微为消瘅。盖水谷之津液不资。
则五脏之精气俱微弱矣。）三阳结。谓之隔。（三阳、太阳也。太阳为诸阳主气。太阳之气。生于膀胱。从内膈而出于胸
胁。从胸胁而达于肤表。阳气结则膈气不通。内膈之前。当胃脘贲门之处。膈气逆。则饮食亦隔塞而不下矣。）三阴结。
谓之水。（三阴、太阴脾土也。脾为转运之官。脾气结。则入胃之水液不行。而为水逆矣。）一阴一阳结。谓之喉痹。（一
阴一阳者。厥阴少阳也。厥阴风木主气。而得少阳之火化。风火气结。则金气受伤。是以喉痛而为痹也。痹者。痛也。
Huangdi asked, "In humans, there are four meridians and twelve conformities. What does this mean?" Qibo replied, "The four meridians correspond to the four seasons, the twelve conformities correspond to the twelve months, and the twelve months correspond to the twelve meridians. (The so-called 'four meridians' refer to: the spring pulse is wiry, the summer pulse is hooked, the autumn pulse is hairy [floating], and the winter pulse is stone-like [deep]. The meridians of the four seasons correspond to the qi of the four seasons. The so-called 'twelve conformities' refer to the qi of the three yin and three yang meridians of the hands and feet, proceeding in sequence from the Lung Meridian of Hand-Taiyin to the Liver Meridian of Foot-Jueyin. Corresponding to the twelve months: the Lung Meridian of Hand-Taiyin corresponds to the first month, Yin; the Large Intestine Meridian of Hand-Yangming corresponds to the second month, Mao; the Stomach Meridian of Foot-Yangming corresponds to the third month, Chen; the Spleen Meridian of Foot-Taiyin corresponds to the fourth month, Si; the Heart Meridian of Hand-Shaoyin corresponds to the fifth month, Wu; the Small Intestine Meridian of Hand-Taiyang corresponds to the sixth month, Wei; the Bladder Meridian of Foot-Taiyang corresponds to the seventh month, Shen; the Kidney Meridian of Foot-Shaoyin corresponds to the eighth month, You; the Pericardium Meridian of Hand-Jueyin corresponds to the ninth month, Xu; the Sanjiao Meridian of Hand-Shaoyang corresponds to the tenth month, Hai; the Gallbladder Meridian of Foot-Shaoyang corresponds to the eleventh month, Zi; the Spleen Meridian of Foot-Taiyin corresponds to the twelfth month, Chou. These twelve meridians are the meridians of the six fu organs and six zang organs. The qi of the three yin and three yang corresponds to the twelve months of the year; the twelve months further correspond to the tangible twelve meridians. This chapter discusses distinguishing yin and yang to know life and death, hence it is called 'Treatise on Distinguishing Yin and Yang'.) Pulses have yin and yang. To know yang is to know yin; to know yin is to know yang. (The twelve meridians are the pairing of zang and fu organ yin and yang. Thus, knowing yang allows one to know yin, and knowing yin allows one to know yang. One who can distinguish yin and yang can differentiate between life and death. As stated in the *Fang Sheng Shuai Lun*: 'Holding onto yin while losing yang, abandoning yin to attach to yang, not understanding their conjunction, leads to unclear diagnosis.') Generally, there are five types of yang pulses, and five times five make twenty-five yang pulses. (This section distinguishes yin and yang based on the true qi stored in the Stomach. The yang qi of the stomach cavity nourishes the five zang organs. Since the five zang organs generate each other and each has five variations, there are twenty-five yang pulses.) The so-called 'yin' refers to the Zang Organ Pulse (True Zang Pulse). If seen, it indicates collapse, and collapse inevitably leads to death. (The five zang organs belong to yin. 'Zang' means storage; the spirit is stored internally and does not manifest externally. If there is no stomach qi harmonizing with yang, and the True Zang Pulse appears, it means the zang qi has collapsed, and collapse inevitably leads to death.) The so-called 'yang' refers to the Yang Qi of the Stomach Cavity. (The so-called twenty-five yang pulses are the yang qi generated by the stomach cavity. The stomach cavity is located in the middle jiao, primarily responsible for transforming the essence of water and grain to nourish the five zang organs. The pulses of the four seasons are: spring wiry, summer surging, autumn floating, winter deep, and late summer moderate. The pulses of the five zang organs are: liver wiry, heart surging, spleen moderate, lung choppy, kidney deep. For example, in spring, the liver pulse is slightly wiry and long, the heart pulse is slightly wiry and surging, the spleen pulse is slightly wiry and moderate, the lung pulse is slightly wiry and choppy, and the kidney pulse is slightly wiry and deep. In summer, the liver pulse is slightly surging and wiry, the heart pulse is slightly surging and large, the spleen pulse is slightly surging and moderate, the lung pulse is slightly surging and choppy, and the kidney pulse is slightly surging and deep. The pulses of the four seasons and five zang organs all possess a slight harmony of stomach qi, hence they are called the twenty-five yang pulses.) By distinguishing yang, one knows the location of the disease; by distinguishing yin, one knows the time of death or survival. (If one can distinguish the harmonizing stomach qi, any disharmony reveals the disease location. If one can distinguish the yin pulse of the true zang, one knows that if the liver pulse arrives, death occurs in eighteen days; if the heart pulse arrives, death occurs in nine days. Here, the true zang is yin and stomach qi is yang, which differs from the discussion of meridian yin and yang in the preceding and following sections.) The three yang meridians are at the head, and the three yin meridians are at the hand; this is what is meant by 'one'. (This again discusses the yin and yang of the twelve meridians. The hand and foot three yang meridians: hand meridians go to the head, and head meridians go to the feet, hence 'three yang at the head'. The hand and foot three yin meridians: foot meridians go to the abdomen, and abdominal meridians go to the hands, hence 'three yin at the hand'. Although the twelve meridians are divided into hand and foot yin and yang, they are all connected as one. The Lung Meridian of Hand-Taiyin connects to the Large Intestine Meridian of Hand-Yangming; the Large Intestine Meridian connects to the Stomach Meridian of Foot-Yangming; the Stomach Meridian connects to the Spleen Meridian of Foot-Taiyin; the Spleen Meridian connects to the Heart Meridian of Hand-Shaoyin; the Heart Meridian connects to the Small Intestine Meridian of Hand-Taiyang; the Small Intestine Meridian connects to the Bladder Meridian of Foot-Taiyang; the Bladder Meridian connects to the Kidney Meridian of Foot-Shaoyin; the Kidney Meridian connects to the Pericardium Meridian of Hand-Jueyin; the Pericardium Meridian connects to the Sanjiao Meridian of Hand-Shaoyang; the Sanjiao Meridian connects to the Gallbladder Meridian of Foot-Shaoyang; the Gallbladder Meridian connects to the Liver Meridian of Foot-Jueyin; and the Liver Meridian reconnects to the Lung Meridian of Hand-Taiyin. Hence, it is said to be 'one'.) By distinguishing yang, one knows the contraindicated times of onset; by distinguishing yin, one knows the time of death or survival. (One who can distinguish yang pulse patterns knows the onset of diseases from one yang, two yang, and three yang, as well as diseases caused by yang knotting. For instance, violent pulsation of three yang leads to death in three days, and combined pulsation of two yang leads to death in ten days. 'Ji' refers to the taboo time of death. It means that by distinguishing yang, one knows the symptoms and the forbidden time of death. One who distinguishes yin pulses knows the onset of diseases from one yin, two yin, and three yin, as well as diseases where liver transmits to heart, heart to lung, up to the fatal signs of vigorous yin pulsation. This discusses distinguishing the pulse patterns of the hand and foot three yin and three yang meridians.) Carefully master yin and yang, and do not consult with others. (This summarizes the above meaning. The so-called yin and yang refer to the yang qi of the stomach cavity, the yin of the true zang, and the three yin and three yang meridians of the hands and feet. It means to carefully distinguish the yin and yang pulses, memorize them in the heart, and verify them with the hand, without needing to discuss them with others.) The so-called yin and yang: departing is yin, arriving is yang; stillness is yin, movement is yang; slow is yin, rapid is yang. (This examines the yin and yang of the twelve meridians. Zang organs are yin, fu organs are yang. The yin and yang of the hands and feet are the meridians of the six zang and six fu organs. Therefore, one should distinguish their yin and yang based on the pulse's coming and going, stillness and movement, slowness and speed.) Whenever holding the pulse of a zang organ with true pulses: if the liver pulse is suspended and extreme, death occurs in eighteen days; if the heart pulse is suspended, death occurs in nine days; if the lung pulse is suspended, death occurs in twelve days; if the kidney pulse is suspended, death occurs in seven days; if the spleen pulse is suspended, death occurs in four days. (This examines the yin and yang of the true zang and stomach qi. 'Suspended and extreme' means the true zang pulse is suspended and cut off, lacking the harmonizing yang qi of the stomach. 'Extreme' refers to the liver's death pulse, which comes rapidly and forcefully, like a drawn bowstring. The *Liu Jie Cang Xiang Lun* states: Heaven uses six-six as its segment, Earth uses nine-nine for its assembly. Calculating the human body, there are also 365 segments, enduring like heaven and earth. This is the number of qi. Wood is born from Earth, thus it dies according to the number nine-nine. The Lung governs heavenly qi, ending in the period of six-six. Water and Fire originate from the pre-heaven, thus they die according to the generating and completing numbers. Spleen Earth resides in the four seasons, thus it ends in the cycle of four days. The death periods of the five zang organs collectively sum up to the Great Extension number. According to Wang Bing, all discussions use the numbers of heaven and earth generation and completion. Ma Shi discusses the mutual overcoming of the Heavenly Stems and Five Elements, but there are many inconsistencies. The zang and fu organs possess the qi of the Five Elements, each having different yin, yang, rigidity, and softness; one need not adhere to a single theory. Therefore, regarding the subsequent mutual combat of yin and yang, only the death of Shaoyin and Taiyang according to the numbers of heaven and earth generation and completion are considered; the rest do not fit. This section discusses the death period when the true zang pulse appears, which differs slightly from the death period of mutual combat of yin and yang in the next section. Wang Zifang said: Humans are born inheriting the qi and numbers of heaven and earth, and thus die according to the qi and numbers of heaven and earth. Qi and numbers refer to the numbers of the Five Elements of heaven and earth.) It is said: Diseases of Er Yang (Two Yang) originate in the Heart and Spleen, involving difficulties in intimate matters, and amenorrhea in women. If it transmits, it becomes Wind Consumption; if it transmits further to become Breath Accumulation, it is incurable and fatal. (This examines the onset of diseases of the three yin and three yang. Er Yang refers to the Stomach Meridian of Foot-Yangming. Human essence and blood are generated from the water and grain in the stomach. The Spleen is responsible for transporting the essence fluids for the stomach. When Er Yang is diseased, the fluids in the middle jiao are exhausted, unable to nourish the Heart Spirit to transform into red blood, leading to blood deficiency. The essence of water and grain cannot be transported by the Spleen to the five zang organs, leaving the Kidney without storage, leading to essence deficiency. Men lacking essence experience difficulties in intimate matters; women lacking blood suffer from amenorrhea. This disease originates in Er Yang but manifests in the Heart and Spleen. With both essence and blood deficient, heat flourishes and generates wind. Wind and heat intensify each other, causing further depletion of body fluids. Fire scorches Metal, transmitting to cause panting and shoulder-lifting Breath Accumulation, which is fatal and incurable. The Stomach is the source of fluid generation, and the Lung is the source of fluid transformation. According to the *Yin Yang Li He Lun*, only the foot three yin and three yang are discussed. This chapter also begins with the foot meridians, but the final chapter mentions 'combined pulsation of three yin' and 'combined pulsation of three yang', implying the inclusion of hand meridians, hence the term 'combined'. Gao Shizong said: Difficulties in intimate matters and amenorrhea indicate disease in the Kidney. Wind Consumption is a Liver Wood disease. Breath Accumulation is a Lung disease. The transmission of Er Yang diseases manifests in the five zang organs and leads to death.) It is also said: Diseases of San Yang (Three Yang) manifest as chills and fever, abscesses and swelling below, and flaccidity and cold limbs. (San Yang refers to Taiyang disease. Taiyang qi governs the exterior. Pathogens attacking humans start at the skin and hair. The struggle between pathogen and healthy qi causes chills and fever. Taiyang governs opening; when diseased, opening and closing fail, and pathogens invade the muscle texture, causing abscesses and swelling. Taiyang is the master qi of all yang and governs the sinews. Sinew injury causes flaccidity; qi injury causes cold limbs. ' ' refers to the thigh; ' ' refers to soreness. These are all diseases of the Taiyang sinews and meridians. Taiyang qi governs the exterior, but its meridians originate from below. Thus, the initial disease is chills and fever in the upper and exterior parts, gradually progressing to abscesses, flaccidity, cold limbs, and hernia in the interior and lower parts. Zhang Zhaohuang said: Taiyang has superficial yang and root cold, hence it causes chills and fever. It is called 'wei' because it can manifest as either cold or heat.) If it transmits, it becomes dry skin; if it transmits further, it becomes Hernia. (The meridian qi of Taiyang is born in the Bladder. The Bladder stores body fluids and excretes them through qi transformation. When Taiyang qi is diseased with heat in the exterior and transmits inward, the water fluids become depleted and dry. Hernia involves pain and swelling in the lower abdomen radiating to the testicles, also known as Bladder Hernia. This starts with the superficial aspect affecting the root, and qi affecting the meridians and sinews.) It is said: Disease of Yi Yang (One Yang) manifests as shortness of breath, frequent coughing, and frequent diarrhea. (Yi Yang refers to Shaoyang disease. Shaoyang governs the nascent qi; when diseased, the nascent qi is insufficient. The Ministerial Fire of the Foot-Shaoyang governs qi. Insufficient qi leads to excessive fire. Fire scorching Metal causes frequent coughing. Wood and fire pathogens damage the central Earth, causing frequent diarrhea.) If it transmits, it becomes Heart Palpitation/Contraction; if it transmits further, it becomes Obstruction. (Food enters the stomach, and turbid qi returns to the Heart. Damage to the Spleen and Stomach causes diarrhea, leading to Heart deficiency and palpitation/pain. The *Ling Shu Jing* states: A slightly urgent Spleen pulse indicates obstruction in the chest. It also says: Inability to eat, blockage and不通, pathology in the stomach cavity. These are all due to Shaoyang Wood pathogens invading Earth, starting with qi and later affecting meridians and fu organs.) Disease of Er Yang and Yi Yin manifests mainly as fright, back pain, frequent belching, and yawning, named Wind Jue. (Er Yang and Yi Yin refer to diseases of Yangming and Jueyin. Eastern Liver Wood diseases manifest as fright. When the Foot-Yangming meridian is diseased, hearing wood sounds causes sudden fear. The back is yang; Jueyin governs spring yang and Liver Wood, thus pulling the back into pain. Pathogens lodging in the stomach cause Jue-ni qi to scatter upward and downward, then emerge from the stomach, causing belching. Yawning is qi drawing upward. The moving disease of the Stomach includes frequent stretching and yawning; this is a disease of Jueyin Wind Wood Jue-ni. Wind Wood diseases invade Stomach Earth, hence named Wind Jue.) Disease of Er Yin and Yi Yang manifests as frequent bloating, chest fullness, and frequent sighing. (Er Yin and Yi Yang refer to Shaoyin and Shaoyang. Shaoyang qi is born in the Kidney water. The classic states: Fullness of Kidney qi causes bloating. Sanjiao disease causes abdominal fullness, especially in the lower abdomen. This is the rebellion of Kidney qi combined with generative yang qi, causing frequent bloating. The inability of Heart and Kidney qi to interact causes chest fullness and frequent sighing. Frequent sighing is deep breathing. When the Heart tie is tight, the airway contracts, so deep breathing is used to extend it. The Sanjiao is the pathway of qi. This disease of one yang qi leads to the discussion of the Sanjiao.) Disease of San Yang and San Yin manifests as hemiplegia, flaccidity with loss of function, and inability to move the four limbs. (San Yang and San Yin refer to Taiyang and the three yin meridians. Hemiplegia is paralysis of half the body. Flaccidity with loss of function refers to abandonment and inability to move normally. Taiyang is the master qi of all yang and governs sinews. Yang deficiency causes hemiplegia. Yang deficiency failing to nourish sinews causes flaccidity. The Spleen governs the four limbs, hence they cannot move. This is a disease of the Water Fu organ rebelling against and attacking Spleen Earth.) When the pulse beats strongly like a hook, it is a Yang pulse; when it beats lightly like hair, it is a Yin pulse; when it beats vigorously and urgently like a string, it is an Excess Yang pulse; when it beats to the point of interruption like a stone, it is a Yin Excess pulse; when yin and yang pass over each other, the pulse is slippery. ('Hook' should be 'Wiry' and 'Wiry' should be 'Hook'. This discusses the four meridians' pulses corresponding to the four seasons. 'Beat' means movement. The rising of one yang qi makes the pulse straight like a string, corresponding to the spring generating qi. The rising of one yin qi makes the pulse light like hair, corresponding to the autumn yin qi. When yang qi is peak, the pulse comes strong and goes leisurely, like a hook, corresponding to summer heat. Arrival is yang; when yang qi hides, the pulse beats to the point of interruption, corresponding to winter storage. 'Slippery' means smooth. When yin and yang pass over each other, the pulse is slippery. In late summer, yang qi slightly descends and yin qi slightly ascends; their interaction makes the pulse slippery. This states that humans have four meridians corresponding to the four seasons.) Yin contends internally, Yang disturbs externally. (Inside is yin, outside is yang. Zang is yin, Fu is yang. Continuing from the previous text: Human meridian qi is interconnected by yin and yang, circulating inside and out. If yin does not receive yang qi to harmonize it, yin contends internally. If yang does not receive yin qi to harmonize it, yang disturbs externally. Gao Shizong said: This means that disharmony of yin and yang qi leads to diseases of yang knotting and yin knotting. If rigid meets rigid, it is yang transmitting to yang and yin to yin, which is a sign of yin and yang separation and death.) Po sweat fails to store, cold limbs arise upon rising, rising steams the Lungs, causing wheezing and stridor. (This states that when yin harmonizes with yang, yin fluids should not leak externally. Sweat is the fluid of blood. Po sweat is the sweat of the Lungs. Meridian qi returns to the Lungs; the Lungs face all vessels and transmit essence to the skin and hair. When skin and hair sweat, essence and blood remain stored in yin. If Po sweat fails to store, it is losing sweat and damaging essence and blood. The True Zang is highest in the Lungs, governing the circulation of Ying and Wei, yin and yang. If Lung yin fluids leak externally, the yin of the four zang organs rebels and rises. Rising, they steam the Lungs, causing wheezing and stridor. Because the five zang organs store essence. Essence transforms into blood, blood transforms into sweat. Although all vessels face the Lungs, the five zang organs are connected, and changes follow a sequence. When the four limbs rebel and rise, the mechanism of sequential rotation is lost.) What is generated by yin, harmonized with its root, is called Harmony. (This states that only when yang harmonizes with yin is it called Harmony. External vessels are yang, Fu vessels are yang, but all originate from the five zang organs and Five Elements, hence called 'generated by yin'. The yang vessels generated by yin, harmonized with the root yin vessels, are named Harmony. Yang provides righteousness, yin serves as the master. Once emitted, there must be return. Thus, if rigid meets rigid, yang scatters and yin perishes.) Therefore, when rigid meets rigid, yang qi breaks and scatters, and yin qi declines and perishes. (Rigid meeting rigid means yang does not harmonize with yin. If yang does not return to yin, yang qi scatters. Scattered externally, isolated yin also perishes internally.) If too soft, rigidity and softness are disharmonious, and meridian qi perishes. (This states that softness meeting softness leads to the extinction of vital qi. 'Nao' means harmony. If yin harmonizes with yin, but rigidity and softness are disharmonious, there is no yang generated by yin. Isolated yin cannot generate, so meridian qi perishes. Once meridian qi perishes, death occurs within three or four days.) Those belonging to Dead Yin do not survive beyond three days; those belonging to Living Yang do not survive beyond four days. (Transmission among five zang organs via mutual overcoming is called Dead Yin; transmission via mutual generation is called Living Yang. 'Shu' means category. For example, Liver transmitting to Heart, Heart to Spleen, Spleen to Lung, Lung to Kidney are all Living Yang. Heart transmitting to Lung, Lung to Liver, etc., are all Dead Yin. Because yang zang organs transmit via generation, death occurs within the even number of four days. Because yin zang organs transmit via overcoming, death occurs within the odd number of three days. Mo Zijin said: Three days do not exceed the generating numbers of heaven and earth; four days do not complete the numbers of the Five Elements.) The so-called Living Yang and Dead Yin: Liver transmitting to Heart is Living Yang; Heart transmitting to Lung is Dead Yin. ('Zhi' means going/transmitting. Liver pulse transmitting to Lung, Lung to Large Intestine, Large Intestine to Stomach, Stomach to Spleen, Spleen to Heart, Heart to Small Intestine, Small Intestine to Bladder, Bladder to Kidney, Kidney to Pericardium, Pericardium to Sanjiao, Sanjiao to Gallbladder, Gallbladder to Liver. One zang and one fu, one yin and one yang, yin and yang interlaced, cycling endlessly. Liver transmitting to Heart, Heart to Lung, Lung to Kidney, Kidney to Spleen—these are all cases where meridian qi perishes and death is incurable.) Lung transmitting to Kidney is Heavy Yin; Kidney transmitting to Spleen is Bi Yin; both are incurable and fatal. (Lung transmitting to Kidney belongs to Living Yang. However, since Lung and Kidney are yin zang organs, yin transmitting to yin is named Heavy Yin. 'Bi' means deviation. Transmitting from a Water zang organ to the Earth of Spleen, which it cannot overcome, is called Bi Yin. These are all fatal signs of incurable disease.) Knotting of Yang results in swelling of the four limbs. (This states that disharmony of yin and yang qi knots itself into disease. The four limbs are the root of all yang. Qi returns to form; qi knots, so form swells. This generally refers to the three yang meridians.) Knotting of Yin results in bloody stool of one sheng; if it knots again, two sheng; if it knots thrice, three sheng. (When yin qi knots internally and cannot circulate, water fluids accumulate and leak downward. One yin knotting causes one sheng of bloody stool; two yin knots cause two sheng; three yin knots cause three sheng. This generally refers to the three yin meridians. The *Bian Mai Pian* states: How to distinguish Yang Knotting and Yin Knotting? Answer: Floating and rapid pulse, able to eat, constipation is Yang Knotting. Deep and slow pulse, unable to eat, heavy body, hard stool is Yin Knotting. To examine knotting of yin and yang qi, one should distinguish yin and yang by the pulse's coming/going, stillness/movement, floating/sinking, slow/rapid. Swelling of limbs indicates knotting of three yang; bloody stool of three sheng indicates knotting of three yin. Thirst indicates knotting in Er Yang, treat with Er Yang methods; Obstruction indicates knotting in San Yang, treat with San Yang methods.) Yin and Yang knot obliquely, with much yin and little yang, named Stone Water, with lower abdominal swelling. (Knotting oblique means partial knotting between yin and yang. Exterior is yang, interior is yin. Stomach is yang, Kidney is yin. This knots inside the body, outside the zang and fu, in the empty space between Stomach and Kidney, causing swelling. Stone Water is Kidney Water. The Kidney is the gate of the Stomach; if the gate is blocked, water accumulates according to its kind. This disease favors the Kidney, hence much yin, little yang, and lower abdominal swelling.) Knotting of Er Yang is named Xiao (Consumption). (Er Yang is Yangming Stomach qi. Xiao is thirst consumption. Because Yangming qi knots, the fluids of water and grain are not generated, leading to thirst consumption.) Knotting of San Yang is named Ge (Obstruction). (San Yang is Taiyang. Taiyang is the master qi of all yang. Taiyang qi is born in the Bladder, exits the inner diaphragm to the chest and hypochondrium, and reaches the skin surface. Yang qi knotting blocks diaphragm qi. Before the inner diaphragm, at the cardia of the stomach cavity, rebellious diaphragm qi causes food and drink to be blocked and unable to descend.) Knotting of San Yin is named Shui (Water Disease). (San Yin is Taiyin Spleen Earth. The Spleen is the official of transport. When Spleen qi knots, water fluids entering the stomach do not circulate, causing water rebellion.) Knotting of Yi Yin and Yi Yang is named Hou Bi (Throat Bi). (Yi Yin and Yi Yang are Jueyin and Shaoyang. Jueyin Wind Wood governs qi and receives the fire transformation of Shaoyang. Knotting of wind and fire damages Metal, causing throat pain and Bi. Bi means pain.)