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Huangdi asked: What is the reason for cold and heat manifestations in Jue syndrome? Qibo replied: When Yang Qi (Vital Energy) declines at the lower part of the body, it results in Cold Jue; when Yin Qi (Substantial Energy) declines at the lower part of the body, it results in Heat Jue. The Emperor said: Why does the heat sensation in Heat Jue always originate from the sole of the foot? Qibo said: Yang Qi originates from the dorsal aspect of the five toes of the foot, while Yin meridians converge at the sole and gather at the center of the foot. Therefore, when Yang Qi prevails, the sole becomes hot. The Emperor said: Why does the cold sensation in Cold Jue always extend from the five toes upward to the knee? Qibo said: Yin Qi originates from the plantar aspect of the five toes, converges below the knee, and gathers 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 entirely from within. The Emperor said: What imbalance causes Cold Jue? Qibo said: The anterior yin region is where the Zongjin (Major Sinews) gather and where the Taiyin Spleen Meridian and Yangming Stomach Meridian intersect. In spring and summer, Yang Qi is abundant and Yin Qi is scarce; in autumn and winter, Yin Qi is abundant and Yang Qi declines. If a person with a robust constitution overexerts themselves during autumn and winter, depleting their essence, the Qi from the lower body struggles upward but cannot recover. Essence leaks downward, and pathogenic factors follow this Qi upward. The Qi becomes stagnant in the middle jiao, causing Yang Qi to decline so that it cannot permeate and nourish the meridians. As Yang Qi diminishes day by day, only Yin Qi remains, resulting in cold hands and feet. The Emperor said: How does Heat Jue occur? Qibo said: When wine enters the stomach, the collateral vessels become full while the main meridians become empty. The Spleen is responsible for transporting fluids for the Stomach. When Yin Qi is deficient, Yang Qi enters inward; when Yang Qi enters inward, the Stomach loses harmony; when the Stomach lacks harmony, essential Qi is exhausted; when essential Qi is exhausted, it fails to nourish the four limbs. Such individuals likely engage in sexual intercourse after frequent intoxication or heavy meals. Qi accumulates in the Spleen and cannot disperse. The Qi of wine and the Qi of food contend with each other, generating intense heat in the middle jiao. Consequently, heat pervades the entire body, causing internal heat and dark red urine. Wine possesses a vigorous and fierce nature; if Kidney Qi is already declining, Yang Qi will prevail alone, resulting in hot hands and feet. The Emperor said: Some cases of Jue cause abdominal fullness, others cause sudden unconsciousness, and some take half a day to a full day to regain consciousness. Why is this? Qibo said: When Yin Qi is excessive in the upper part, the lower part becomes deficient. Lower deficiency leads to abdominal distension. When Yang Qi is excessive in the upper part, Qi from the lower part rises heavily, causing pathogenic Qi to reverse its flow. Reversal leads to chaos in Yang Qi, and chaotic Yang Qi results in loss of consciousness. The Emperor said: Excellent. I wish to hear about the symptoms and pathological states of Jue affecting the six meridian systems. Qibo said: When the Jueyang (Taiyang) Meridian experiences Jue reversal, there is swelling of the head, heaviness of the head, inability to walk, and sudden collapse. When the Yangming Meridian experiences Jue reversal, there is manic epilepsy, desire to run and shout, abdominal fullness preventing sleep, red and hot face, hallucinations, and delirious speech. When the Shaoyang Meridian experiences Jue reversal, there is sudden deafness, swollen and hot cheeks, flank pain, and immobility of the joints. When the Taiyin Meridian experiences Jue reversal, there is abdominal fullness and distension, difficulty with defecation, anorexia, vomiting after eating, and inability to sleep. When the Shaoyin Meridian experiences Jue reversal, there is dry mouth, dark red urine, abdominal fullness, and heart pain. When the Jueyin Meridian experiences Jue reversal, there is swelling and pain in the lower abdomen, abdominal distension, difficulty with urination and defecation, preference for lying down with knees flexed, contraction and swelling of the genitals, and heat in the medial thigh. The treatment principle is: excess conditions are treated with draining methods, deficiency conditions with tonifying methods, and neither-excess-nor-deficiency conditions by selecting points from the affected meridian directly. When the Taiyin Meridian experiences Qi Jue reversal, there is calf cramping and spasm, and heart pain radiating to the abdomen; treatment should target the primary disease. When the Shaoyin Meridian experiences Qi Jue reversal, there is vacuous fullness, vomiting with altered symptoms, and passage of clear diarrhea; treatment should target the primary disease. When the Jueyin Meridian experiences Qi Jue reversal, there is cramping and lower back pain, vacuous fullness, urinary retention, and delirious speech; treatment should target the primary disease. When all three Yin meridians experience Jue reversal, leading to obstruction of both urination and defecation, causing cold hands and feet, death occurs within three days. When the Taiyang Meridian experiences Qi Jue reversal, there is stiffness and collapse, hematemesis, and frequent epistaxis; treatment should target the primary disease. When the Shaoyang Meridian experiences Qi Jue reversal, there is joint dysfunction. Joint dysfunction manifests as inability to walk due to waist stiffness and inability to look back due to neck rigidity. If intestinal abscess develops, it is incurable; if accompanied by fright, it is fatal. When the Yangming Meridian experiences Qi Jue reversal, there is wheezing and coughing, fever, susceptibility to fright, epistaxis, and hematemesis. When the Hand-Taiyin Meridian experiences Qi Jue reversal, there is vacuous fullness with coughing and frequent vomiting of frothy saliva; treatment should target the primary disease. When the Hand-Jueyin Pericardium Meridian and Hand-Shaoyin Heart Meridian experience Qi Jue reversal, there is heart pain radiating to the throat and fever; this is a fatal condition and cannot be treated. When the Hand-Taiyang Meridian experiences Qi Jue reversal, there is deafness, tearing, inability to look back, and inability to bend or extend the waist; treatment should target the primary disease. When the Hand-Yangming and Hand-Shaoyang meridians experience Qi Jue reversal, there is Bi syndrome of the throat (throat obstruction) and swelling of the pharynx; treatment should target the primary disease.

Wind Chapter: Li (pronounced li) Kui (hu dui qie) Nao (nu hao qie)
Bi Syndrome Chapter: Huang (pronounced huang)
Flaccidity Chapter: Kuan (pronounced kuan) Kao (ku ao qie) Bin (pin)
Jue Chapter: Zhan (pronounced zhan) Jiang (ju liang qie) Pu (pronounced fu) Mao (pronounced mao)