承痹证、痿证而论厥证也。经脉，阴阳之气，不可偏胜。阳气
损，阴气独在，则手足寒厥，或令人腹满；阴气衰，阳气独胜，
则手足热厥，或令人暴不知人。经脉厥而形诸病，则有厥状，气机
逆而形诸病，则有病能，故终举手足六经之厥状病能以明之。
黄帝问曰∶厥之寒热者何也？
厥，犹逆也。经脉之血，皮毛之气，不相顺接而厥逆也。盖经脉之血，出于手足之指井，合皮毛之气，
而溜于荣，注于俞，过于原，行于经，入于合。若经气不相通贯，致有寒热之厥，故以为问。
岐伯对曰∶阳气衰于下，则为寒厥。阴气衰于下，则为热厥。
厥有寒热，其根皆起于下。故阳气衰于下，则为寒厥。阴气衰于下，则为热厥。下，足下也。
帝曰∶热厥之为热也，必起于足下者何也？
热为阳，足为阴，热厥之为热也。何以必起于足下？
岐伯曰∶阳气起于足五指之表。阴脉者，集于足下，而聚于足
心。故阳气胜则足下热也。
阳气之热，本于阴气之虚。故阳气、阴气皆起于足，而有表里之分。太阳根起于足小趾外侧，阳明
根起于足大次趾之端，少阳根起于足小次趾之端，是阳气起于足五指之表。太阴根起于隐白，少
阴根起于涌泉，厥阴根起于大敦，是阴脉者集于足下，而聚于足心。三阳三阴，皆起于足。今阴气衰，故
阳气胜，阳气胜则足下热也。此热厥所以起于足下也。
帝曰∶寒厥之为寒也，必从五指而上于膝者，何也？
寒为阴，膝为阳，寒厥之为寒也，何以必从五指而上于膝？
岐伯曰∶阴气起于五指之里，集于膝下，而聚于膝上，故阴气
胜则从五指至膝上寒。其寒也，不从外，皆从内也。
阳气起于足五指之表，则阴气当起于五指之里。三阴经气，集于膝下而聚于膝上。今阳气衰，故
阴气胜；阴气胜则从五指至膝上寒。膝外为阳，膝内为阴。故其寒也，不从外，皆从内也。此寒厥
所以从五指，而上于膝也。
帝曰∶寒厥，何失而然也？
失其所用之阳气，则为寒厥，故问寒厥何失而然？
岐伯曰∶前阴者，宗筋之所聚，太阴阳明之所合也。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，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。
《痿论》云，入房太甚，宗筋弛纵。故前阴者乃宗筋之所聚，阳明主润宗筋，而阳明胃腑，水谷之精，又
借太阴脾土以营运。故宗筋乃太阴阳明之所合也。时当春夏，则人身阳气多而阴气少，阴气虽少，阳之守也。
时当秋冬，则人身阴气盛而阳气衰，阳气虽衰，阴之使也。此人寒厥者，秉质壮盛，以秋冬用阳之时，而
夺于所用，则在下之阴气，上争于阳，致阳气不能复。复，内藏也。阳气不复，不和于阴，则精气散溢于下，
正虚邪生，故邪气因从之而上也。阴寒之邪气因于中，而阳气日衰，不能渗营其经络；阳气日
损，阴气独在，故手足为之寒也。是失其所用之阳气，而为寒厥也。
帝曰，热厥何如而然也？
失其所藏之阴精，则为热厥，故问热厥何如而然？
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，精气竭则不营其四肢也，此人必数醉，若饱以入房，气聚于脾中不得
散，酒气与谷气相薄，热盛于中，故热偏于身，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。
数，音朔。溺，鸟去声，下同。阴虚阳胜，则为热厥，故假饮酒以明之，酒入于胃，先行皮肤，先充
络脉，则络脉满而经脉虚，不由脾气之营运，故曰脾主为胃行其津液者也。今不由脾运，是阴
气虚，酒气先行皮毛络脉而后入，则阳气入。入者，络脉之热，复入于胃也。故阳气入，则胃不和，胃不和
则经隧之精气竭，精气竭则不营灌其四肢也，此人热厥者，必数饮酒而醉，若既醉且饱以入
房，其谷气聚于脾中不得散，酒气复与谷气相薄，酒性热，故热盛
于中，盛于中故热遍于身，内外皆热，故内热而溺赤也，夫酒气盛而性 悍，致肾精之气日衰，而阳气
独胜，阳气独胜故手足为之热也，是失其所藏之阴精，而为热厥也。
帝曰∶厥，或令人腹满，或令人暴不知人，或至半日，运至一日，乃知人者，何也？
上文寒厥热厥，其厥在于经脉，故复问厥，或令人腹满，则脾
土内虚，或令人暴不知人，或至半日一日乃知，则心神失守，不在经脉，其故何也？
岐伯曰∶阴气盛于上，则下虚，下虚，则腹胀满。
阴寒之气盛于上，则上下皆阴，而阳气虚于下，下虚则腹胀满，以明腹满而为寒厥之意。
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。
重，平声。阳热之气盛于上，则下气重上，而邪气逆，逆则阳气乱，乱则心神不宁，故暴不知人。或
至半日，远至一日乃知也，以明暴不知人而为热厥之意。
此一节，论厥证之寒热阴阳，阳虚则为寒厥，阴虚则为热厥也。
帝曰∶善。愿闻六经脉之厥状病能也。
腹满不知人，仍不外阴阳寒热之义，帝故善之。而三阳三阴之六经脉，皆有厥状病能，故举以问。
岐伯曰∶巨阳之厥，则肿首头重，足不能行，发为 仆。
厥状属经，病能属气。巨阳，太阳也，其脉上额交巅，下出足外踝之后，故巨阳之厥，其状则上为
肿首头重，下为足不能行，病经而转于气，则发为 仆。此明巨阳经脉之厥状，而兼及病能也。
阳明之厥，则癫疾欲走呼，腹满不得卧，面赤而热，妄见而妄言。
阳明之厥，则阳明经脉不和，故巅疾欲走呼，其脉下循腹里，故腹满。状为巅疾，故
不得卧。阳明之脉起面 ，故面赤而热，状欲
走呼，故妄见而妄言，此明阳明之厥状也。
少阳之厥，则暴聋，颊肿而热，胁痛， 不可以运。
少阳之厥，则少阳经脉不和，其脉从耳后，入耳中，出走耳前，故暴聋。其脉加颊车，循胁里，行身
之侧，故颊肿而热，胁痛，出膝外廉，下辅骨，故 不可以远，此明少阳之厥状也。
太阴之厥，则腹满 胀，后不利，不欲食，食则呕，不得卧。
太阴之厥，则太阴经脉不和，其脉入腹，属脾络胃，故腹满 胀。腹满则脾土不和， 胀则胃土不
和，其状腹满，故后便不利，其状 胀，故不欲食，不欲食而强食则呕。脾胃不和，故不得卧。此明太阴之厥状也。
少阴之厥，则口干，溺赤，腹满，心痛。
少阴之厥，则少阴经脉不和。少阴，肾脉也。肾为水脏，厥则
水竭火盛，故口干溺赤。溺赤则水道不利而腹满，口干则火热上炎而心痛，此明少阴之厥状也。
厥阴之厥，则少腹肿痛，腹胀，泾溲不利，好卧屈膝，阴缩肿， 内热。
好，去声。厥阴之厥，则厥阴经脉不和，其脉过阴器，抵小腹，故少腹肿痛，少腹不但肿痛而
且胀，肿痛而胀，故径溲不利，肝木不舒，故好卧。筋不柔和，故屈膝。屈膝，蜷卧也。阴缩肿，
前阴萎缩而囊肿也。厥阴之脉，上 内廉，故 内热。此明厥阴之厥状也。
盛则泻之，虚则补之，不盛不虚，以经取之。
结上文而言三阳三阴之厥，当以针刺治之。故经脉有余而盛，
则针刺以泻之；经脉不足而虚，则针刺以补之；经脉不盛不虚，则各随其经脉，取而调和之。
太阴厥逆， 急挛，心痛引腹，治主病者。
上文申明厥状，故但言厥，此下兼论病能，故言厥逆。太阴厥逆，经厥而气亦逆也。 急挛，太
阴之气不和于髀 也。心痛引腹，太阳之气不能从腹上交于心，故心痛复引于腹也。此太阴厥逆
之病能，乃太阴所主之病，故曰治主病者。
少阴厥逆，虚满，呕变，下泄清，治主病者。
少阴经厥气逆，少阴火气虚于上，故虚满而有欲呕之变证。少
阴水气虚于下，故下泄而其便复清，此少阴厥逆之病能，故当治其主病者。
厥阴厥逆，挛腰痛，虚满，前闭， 言，治主病者。
厥阴经厥气逆，则筋挛腰痛；肝气郁，则虚满，而前阴闭结；
肝木不生心火，故 言。此厥阴厥逆之病能，故当治其主病者。
三阴俱逆，不得前后，使人手足寒，三日死。
结上文而言。三阴厥者，病在经；三阴逆者，病在气。故三阴
俱逆，不得阳气以和之，致不得前后，使人手足寒。三日、三阴，不和于阳，故三日死。
太阳厥逆，僵仆，呕血善衄，治主病者。
太阳经厥气逆，则阳气不能周遍，故僵仆。僵仆，即上文发为 仆之义。阳热之气，不行皮毛，内
伤络脉，阳络伤则血外溢，故呕血善衄。此太阳厥逆之病能，故当治主病者。
少阳厥逆，机关不利，机关不利者，腰不可以行，项不可以顾，发肠痈，不可治；惊者死。
少阳经厥气逆，则枢转有乖，故机关不利。申明机关不利者，病于下，则腰不可以行，病于上，则
项不可以顾；不能枢转从外，则发肠痈，发肠痈则内郁之气，从痈而泄，不可治。少阳之主病，
当治阳明之肠痈。若治少阳，虚其旋转之气，神机内乱，而发惊，枢将折也，故死。此少阳厥逆病能，发
于阳明，当治阳明，故不言治主病者。
阳明厥逆，喘咳，身热，善惊，衄，呕血。
阳明经厥气逆，则阳明燥金之气，不和于肺，故喘咳。阳明气逆，故身热，闻木音则善惊，热迫于经，
则衄、呕血。上文发肠痈，不可治少阳，当治阳明，是治阳明之意已寓于上，故此不言治主病者。
手太阴厥逆，虚满而咳，善呕沫，治主病者。
上文论六经之厥状，复论六经之病能，而经脉之中，又有手之六经，故复举手六经之厥逆，以终经
脉病能之义。手太阴经厥气逆，则肺气虚、满而咳。肺气满、咳，不能四布其水津，故善呕沫，此
手太阴厥逆之病能，故当治主病者。
手心主少阴厥逆，心痛引喉，身热，死不可治。
手心主厥阴包络，手少阴心经，经厥气逆，皆有心痛之病。喉者，肺气也。心痛引喉，则两火上炎
而烁金，又兼身热为焚为焰，则死不可治。由是而知心包与心，不可皆病也。
手太阳厥逆，耳聋、泣出、项不可以顾，腰不可以俯仰，治主病者。
《经脉》论云，小肠手太阳之脉，是主液所生病者，耳聋、目黄。故手太阳经厥气逆，则耳聋、泣
出。耳聋、泣出者，液虚也。液虚，则骨属屈伸不利，故项不可以顾，腰不可以俯仰。此手太阳厥之病
能，故当治主病者。
手阳明、少阳厥逆，发喉痹，嗌肿， ，治主病者。
经脉论云∶三焦手少阳之脉，则病嗌肿喉痹。今手少阳经气厥逆，不能外通腠理，故上逆而喉痹、
嗌肿，当治手少阳之三焦。 者，头面摇，卒口噤，背反张也。《经脉》论云，大肠手阳明之脉，是主津
液所生病者。今手阳明经气厥逆，津液不荣于经脉，故 。当资手阳明之津液，故治主病者。
此一节言，厥状在经，病能在气，举手足六经之主病，以终厥论之义。
Following the discussion on Bi syndrome (Bi Syndrome) and Wei syndrome (Wei Syndrome), this section discusses Jue syndrome (Jue Syndrome). The yin and yang qi in the meridians must not be excessively dominant. If yang qi is damaged and yin qi remains alone, it results in cold Jue (Cold Jue) with cold hands and feet, or abdominal fullness; if yin qi declines and yang qi becomes excessively dominant, it results in hot Jue (Hot Jue) with hot hands and feet, or sudden loss of consciousness. When meridian Jue manifests as disease, there are specific Jue manifestations; when qi mechanism reversal manifests as disease, there are specific pathological features. Therefore, the manifestations and pathological features of Jue in the six meridians of the hand and foot are listed to clarify them.
Huangdi asked: What causes the cold and heat variations in Jue?
Jue means reversal. It occurs when the blood in the meridians and the qi of the skin and hair fail to connect smoothly, leading to reversal. Generally, the blood in the meridians originates from the Jing-Well points at the tips of the fingers and toes, merges with the qi of the skin and hair, flows into the Ying (Nutrient) level, pours into the Shu (Stream) points, passes through the Yuan (Source) points, travels along the meridians, and enters the He-Sea points. If the meridian qi does not flow continuously, causing cold or heat Jue, this question is raised.
Qibo replied: When yang qi is deficient in the lower part, it forms Cold Jue. When yin qi is deficient in the lower part, it forms Hot Jue.
Jue has cold and heat types, both originating from the lower part. Thus, deficiency of yang qi in the lower part leads to Cold Jue, and deficiency of yin qi in the lower part leads to Hot Jue. "Lower" refers to the feet.
Huangdi asked: Why does the heat sensation in Hot Jue always start from the sole of the foot?
Heat belongs to Yang, and the foot sole belongs to Yin. Why does the heat in Hot Jue necessarily start from the sole?
Qibo said: Yang qi originates from the lateral side of the five toes. Yin meridians gather at the sole and converge at the center of the foot. Therefore, when Yang qi is excessive, the sole becomes hot.
The heat of Yang qi stems from the deficiency of Yin qi. Thus, both Yang and Yin qi originate from the foot, having exterior and interior distinctions. The Taiyang channel roots at the lateral side of the little toe, the Yangming channel roots at the end of the great toe and the second toe, and the Shaoyang channel roots at the end of the second and little toes; this is how Yang qi originates from the lateral side of the five toes. The Taiyin channel roots at Yinbai (SP 1), the Shaoyin channel roots at Yongquan (KI 1), and the Jueyin channel roots at Dazhun (LR 1); this is how Yin meridians gather at the sole and converge at the center of the foot. All three Yang and three Yin channels originate from the foot. Now, since Yin qi is deficient, Yang qi becomes excessive, and excessive Yang qi causes heat in the sole. This is why Hot Jue starts from the sole.
Huangdi asked: Why does the cold sensation in Cold Jue always rise from the five toes up to the knee?
Cold belongs to Yin, and the knee belongs to Yang. Why does the cold in Cold Jue necessarily rise from the five toes to the knee?
Qibo said: Yin qi originates from the medial side of the five toes, gathers below the knee, and converges above the knee. Therefore, when Yin qi is excessive, it feels cold from the five toes up to the knee. This cold does not come from the outside but arises from within.
Since Yang qi originates from the lateral side of the five toes, Yin qi should originate from the medial side. The Qi of the three Yin meridians gathers below the knee and converges above the knee. Now, because Yang qi is deficient, Yin qi becomes excessive; when Yin qi is excessive, it feels cold from the five toes up to the knee. The lateral side of the knee is Yang, and the medial side is Yin. Therefore, this cold does not come from the outside but arises from within. This is why Cold Jue rises from the five toes to the knee.
Huangdi asked: What loss causes Cold Jue?
Loss of its functional Yang qi leads to Cold Jue, so the question asks what is lost to cause Cold Jue.
Qibo said: The anterior yin is the gathering place of the Zong Jin (Tendon Sheath), where the Taiyin and Yangming meridians combine. In spring and summer, human body Yang qi is abundant and Yin qi is scarce; in autumn and winter, Yin qi is prosperous and Yang qi declines. A person with a robust constitution who overuses their Yang qi during autumn and winter causes the lower Qi to contend upward without recovery, essence and Qi overflow downward, and pathogenic Qi follows upward. The Qi stagnates in the middle, Yang qi declines and cannot nourish the meridians, Yang qi is daily diminished, and Yin qi remains alone, causing cold hands and feet.
As stated in the *Pi Wei Lun* (Treatise on Flaccidity and Weakness): "Excessive sexual intercourse leads to flaccidity of the Zong Jin." Thus, the anterior yin is the gathering place of the Zong Jin. The Yangming Stomach governs moistening the Zong Jin, and the water-grain essence of the Yangming Stomach relies on the transport and transformation of the Taiyin Spleen for distribution. Therefore, the Zong Jin is the combination of Taiyin and Yangming. During spring and summer, human Yang qi is abundant and Yin qi is scarce; although Yin qi is scarce, it guards Yang. During autumn and winter, human Yin qi is prosperous and Yang qi declines; although Yang qi declines, it serves Yin. This patient with Cold Jue has a robust constitution but overuses Yang during the time when Yang should be stored (autumn/winter). Consequently, the lower Yin contends with upper Yang, preventing Yang from recovering. "Recover" refers to the internal storage. If Yang does not recover and harmonizes with Yin, essence and Qi scatter downward. With righteous Qi deficient, pathogenic Qi arises, so pathogenic Qi follows upward. Yin-cold pathogenic Qi stagnates in the middle, Yang qi daily declines, unable to nourish the meridians; Yang qi daily diminishes, Yin qi remains alone, causing cold hands and feet. This is losing its functional Yang qi, resulting in Cold Jue.
Huangdi asked: How is Hot Jue formed?
Loss of its stored Yin Jing (Essence) leads to Hot Jue, so the question asks how Hot Jue is formed.
Qibo said: When wine enters the stomach, the Luo (Collateral) vessels become full, while the main meridians become empty. The Spleen governs transporting fluids for the Stomach. When Yin qi is deficient, Yang qi enters. When Yang qi enters, the Stomach becomes disharmonious. When the Stomach is disharmonious, the essence and Qi are exhausted. When essence and Qi are exhausted, they cannot nourish the four limbs. Such a person must frequently get drunk or engage in sexual intercourse after being full. Qi gathers in the Spleen and cannot disperse. Wine Qi and Grain Qi struggle against each other, causing intense heat in the middle. Thus, heat predominates in the body, causing internal heat and red urine. Wine Qi is vigorous and fierce, causing Kidney Qi to daily decline and Yang qi to become excessively dominant, resulting in hot hands and feet.
"Frequent" (Shuo) is pronounced 'shuo'. "Urine" (Niao) is pronounced 'niao', same below. Yin deficiency and Yang excess lead to Hot Jue, so wine is used to illustrate this. Wine enters the stomach, first traveling through the skin and filling the Luo vessels, making Luo vessels full and meridians empty. This is not due to Spleen transport, hence "Spleen governs transporting fluids for the Stomach." Now, without Spleen transport, Yin qi is deficient. Wine Qi first travels through the skin and Luo vessels before entering, so Yang qi enters. "Entering" means the heat of the Luo vessels re-enters the Stomach. Thus, Yang qi entering causes Stomach disharmony; Stomach disharmony exhausts the essence and Qi in the meridians; exhaustion prevents nourishing the limbs. This Hot Jue patient must frequently drink to drunkenness or engage in intercourse when drunk and full. Grain Qi gathers in the Spleen and cannot disperse; Wine Qi struggles with Grain Qi. Since wine is hot, heat intensifies in the middle, spreading throughout the body, causing internal heat and red urine. Wine Qi is vigorous and fierce, causing Kidney Essence to daily decline and Yang qi to become excessively dominant, resulting in hot hands and feet. This is losing its stored Yin Jing, resulting in Hot Jue.
Huangdi asked: Why does Jue sometimes cause abdominal fullness, sometimes sudden unconsciousness, and sometimes recovery after half a day or a day?
The previous discussion on Cold and Hot Jue focused on the meridians. Now asking about Jue causing abdominal fullness indicates internal deficiency of Spleen Earth; sudden unconsciousness or delayed recovery indicates loss of control by the Heart Spirit, not merely meridian issues. What is the reason?
Qibo said: When Yin qi is excessive in the upper part, the lower part becomes deficient. Lower deficiency causes abdominal fullness.
Excess Yin-cold Qi in the upper part makes both upper and lower Yin, leaving Yang Qi deficient in the lower part. Lower deficiency causes abdominal fullness, illustrating that abdominal fullness is a sign of Cold Jue.
When Yang Qi is excessive in the upper part, the lower Qi repeatedly ascends, pathogenic Qi reverses, reversing causes Yang Qi chaos, and chaos leads to unconsciousness.
"Chong" (repeatedly) is pronounced 'chong'. Excess Yang-hot Qi in the upper part causes lower Qi to ascend repeatedly, pathogenic Qi reverses, reversing causes Yang Qi chaos, chaos disturbs the Heart Spirit, causing sudden unconsciousness. Recovery may take half a day or up to a day, illustrating that sudden unconsciousness is a sign of Hot Jue.
This section discusses the cold, heat, yin, and yang of Jue syndrome: Yang deficiency leads to Cold Jue, Yin deficiency leads to Hot Jue.
Huangdi said: Good. I wish to hear about the manifestations and pathological features of Jue in the six meridians.
Abdominal fullness and unconsciousness still fall under the principles of Yin, Yang, cold, and heat. Huangdi praises this. Since all three Yang and three Yin meridians have Jue manifestations and pathological features, he asks about them.
Qibo said: Jue of the Ju Yang (Taiyang) causes swelling of the head and heaviness, inability to walk, and collapse.
Jue manifestations belong to the meridians, pathological features belong to Qi. Ju Yang is Taiyang. Its channel goes up to the forehead, crosses the vertex, and comes down behind the lateral malleolus. Thus, Taiyang Jue manifests as upper swelling/head heaviness and lower inability to walk. Disease in the meridian affecting Qi causes collapse. This clarifies Taiyang meridian Jue manifestations and includes pathological features.
Jue of Yangming causes manic epilepsy, desire to run and shout, abdominal fullness, inability to lie down, red and hot face, hallucinations, and delirious speech.
Yangming Jue causes disharmony of the Yangming meridian, leading to manic epilepsy and desire to run/shout. Its channel descends along the abdomen, causing abdominal fullness. As a manic condition, it causes inability to lie down. Yangming channel originates on the face, causing red/hot face. As a condition resembling running/shouting, it causes hallucinations and delirium. This clarifies Yangming Jue manifestations.
Jue of Shaoyang causes sudden deafness, swollen and hot cheeks, flank pain, and inability to move the legs.
Shaoyang Jue causes disharmony of the Shaoyang meridian. Its channel goes from behind the ear into the ear, emerging in front of the ear, causing sudden deafness. Its channel passes Jiache, runs along the flank, and travels down the lateral body, causing swollen/hot cheeks and flank pain. Emerging from the lateral knee and descending the fibula, it causes inability to walk far. This clarifies Shaoyang Jue manifestations.
Jue of Taiyin causes abdominal fullness and distension, difficulty defecating, anorexia, vomiting after eating, and inability to lie down.
Taiyin Jue causes disharmony of the Taiyin meridian. Its channel enters the abdomen, connects to the Spleen and links to the Stomach, causing abdominal fullness. Abdominal fullness indicates Spleen Earth disharmony; distension indicates Stomach Earth disharmony. Abdominal fullness causes difficult defecation; distension causes anorexia. Forcing food when anorexic causes vomiting. Spleen-Stomach disharmony causes inability to lie down. This clarifies Taiyin Jue manifestations.
Jue of Shaoyin causes dry mouth, red urine, abdominal fullness, and heart pain.
Shaoyin Jue causes disharmony of the Shaoyin meridian. Shaoyin is the Kidney channel. The Kidney is the Water organ. Jue leads to water depletion and fire excess, causing dry mouth and red urine. Red urine indicates obstructed water passages leading to abdominal fullness; dry mouth indicates fire-heat flaming upward causing heart pain. This clarifies Shaoyin Jue manifestations.
Jue of Jueyin causes lower abdominal swelling and pain, abdominal distension, difficulty urinating and defecating, preference for lying with knees flexed, genital shrinkage and swelling, and heat in the inner thigh.
"Hao" (preference) is pronounced 'hao'. Jueyin Jue causes disharmony of the Jueyin meridian. Its channel passes the genitalia and reaches the lower abdomen, causing lower abdominal swelling/pain. Swelling/pain with distension causes urinary/fecal difficulty. Liver Wood stagnation causes preference for lying down. Tendon inflexibility causes knee flexion. Genital shrinkage/swelling refers to penile shrinkage and scrotal edema. Jueyin channel ascends the medial thigh, causing inner thigh heat. This clarifies Jueyin Jue manifestations.
Excess is drained, deficiency is tonified, and neither excess nor deficiency is treated by selecting points from the affected meridian.
Summarizing the previous text, Jue of the three Yang and three Yin meridians should be treated with acupuncture. If the meridian is excess/full, drain with acupuncture; if deficient/empty, tonify with acupuncture; if neither, select points from the respective meridian to harmonize.
Taiyin Jue-Ni (Reversal) causes thigh cramping/spasm, heart pain radiating to the abdomen. Treat the primary diseased meridian.
The previous text described Jue manifestations; now discussing pathological features uses "Jue-Ni". Taiyin Jue-Ni involves both meridian and Qi reversal. Thigh cramping/spasm indicates Taiyin Qi disharmony in the thigh. Heart pain radiating to the abdomen indicates Taiyang Qi failing to ascend from the abdomen to the heart. This is the pathological feature of Taiyin Jue-Ni, a disease governed by Taiyin, hence "treat the primary diseased meridian."
Shaoyin Jue-Ni causes false fullness, vomiting/variations, and clear diarrhea. Treat the primary diseased meridian.
Shaoyin meridian Qi reversal, with Shaoyin Fire Qi deficient above, causes false fullness and vomiting variations. Shaoyin Water Qi deficient below causes clear diarrhea. This is the pathological feature of Shaoyin Jue-Ni, hence treat the primary diseased meridian.
Jueyin Jue-Ni causes tendon cramping and lumbar pain, false fullness, anterior closure, and delirious speech. Treat the primary diseased meridian.
Jueyin meridian Qi reversal causes tendon cramping and lumbar pain; Liver Qi stagnation causes false fullness and anterior closure; Liver Wood failing to generate Heart Fire causes delirious speech. This is the pathological feature of Jueyin Jue-Ni, hence treat the primary diseased meridian.
Simultaneous Jue-Ni of the three Yin meridians causes inability to pass stool and urine, cold hands and feet, leading to death in three days.
Summarizing the previous text: Jue of the three Yin affects the meridians; Jue-Ni of the three Yin affects the Qi. Simultaneous Jue-Ni of the three Yin lacks Yang Qi for harmony, causing inability to pass stool/urine and cold extremities. Three days correspond to the three Yin; lack of harmony with Yang leads to death in three days.
Taiyang Jue-Ni causes stiffness and collapse, hematemesis, and frequent epistaxis. Treat the primary diseased meridian.
Taiyang meridian Qi reversal prevents Yang Qi from circulating fully, causing stiffness and collapse (same as previous collapse). Yang-hot Qi failing to circulate in the skin damages the collaterals; damage to Yang collaterals causes external bleeding (hematemesis/epistaxis). This is the pathological feature of Taiyang Jue-Ni, hence treat the primary diseased meridian.
Shaoyang Jue-Ni causes joint dysfunction. Dysfunction means inability to walk (lower) or look back (upper). Failure to pivot externally causes intestinal abscess, which is incurable; if accompanied by fright, it is fatal.
Shaoyang meridian Qi reversal disrupts pivoting, causing joint dysfunction. Dysfunction below prevents walking; above prevents looking back. Failure to pivot externally leads to intestinal abscess. Abscess allows stagnant Qi to vent, making it incurable. The primary disease of Shaoyang should be treated via Yangming's intestinal abscess. Treating Shaoyang directly would further weaken the pivoting Qi, disturb the Shen Mechanism internally, cause fright, and break the pivot, leading to death. This is the pathological feature of Shaoyang Jue-Nii, manifesting in Yangming, so treat Yangming; thus, "treat primary diseased meridian" is omitted.
Yangming Jue-Ni causes wheezing/cough, body heat, fright, epistaxis, and hematemesis.
Yangming meridian Qi reversal causes Yangming Dry Metal Qi to disharmonize with the Lung, causing wheezing/cough. Yangming Qi reversal causes body heat; hearing wood sounds causes fright; heat forcing into meridians causes epistaxis/hematemesis. The previous mention of treating Yangming for intestinal abscess implies treatment here, so "treat primary diseased meridian" is omitted.
Hand Taiyin Jue-Ni causes false fullness and cough, frequent vomiting of froth. Treat the primary diseased meridian.
After discussing six-meridian Jue manifestations and features, including Hand meridians, this section concludes the meaning of meridian pathological features. Hand Taiyin Qi reversal causes Lung Qi deficiency/fullness and cough. Lung Qi fullness/cough fails to distribute fluids, causing frequent vomiting of froth. This is the pathological feature of Hand Taiyin Jue-Ni, hence treat the primary diseased meridian.
Hand Conception Vessel (Pericardium) and Hand Shaoyin Jue-Ni cause heart pain radiating to the throat, body heat, which is fatal and incurable.
Hand Conception Vessel is the Jueyin Pericardium; Hand Shaoyin is the Heart. Meridian Jue-Ni causes heart pain. The throat belongs to Lung Qi. Heart pain radiating to the throat indicates two fires flaming upward, burning Metal, combined with body heat, leading to fatality and incurability. Thus, Pericardium and Heart should not both be diseased.
Hand Taiyang Jue-Ni causes deafness, tearing, inability to look back, and inability to bend/extend the waist. Treat the primary diseased meridian.
The *Jing Mai* chapter states: Small Intestine Hand Taiyang channel diseases involve fluid, such as deafness and yellow eyes. Hand Taiyang Qi reversal causes deafness and tearing. Deafness/tearing indicates fluid deficiency. Fluid deficiency causes bone/joint stiffness, preventing looking back and bending/extending the waist. This is the pathological feature of Hand Taiyang Jue, hence treat the primary diseased meridian.
Hand Yangming and Hand Shaoyang Jue-Ni cause throat obstruction, pharyngeal swelling, and convulsions. Treat the primary diseased meridian.
The *Jing Mai* chapter states: Sanjiao Hand Shaoyang channel diseases include pharyngeal swelling and throat obstruction. Hand Shaoyang Qi reversal fails to open the interstices, causing upward reversal leading to throat obstruction/pharyngeal swelling. Treat Hand Shaoyang Sanjiao. Convulsions refer to head/face shaking, sudden jaw locking, and opisthotonos. The *Jing Mai* chapter states: Large Intestine Hand Yangming channel diseases involve fluid. Hand Yangming Qi reversal fails to nourish meridians with fluid, causing convulsions. Nourish Hand Yangming fluid, hence treat the primary diseased meridian.
This section states that Jue manifestations are in the meridians, and pathological features are in the Qi. Listing the primary diseases of the hand and foot six meridians concludes the Treatise on Jue.