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Taiyin (Great Yin) corresponds to the Spleen Zang organ, belonging to Earth. Yangming (Bright Yang) corresponds to the Stomach Fu organ, also belonging to Earth. The Stomach receives water and grain, relying on the transportation and transformation function of Spleen Qi to deliver essence to the Zang and Fu organs, thereby harmonizing the meridians and nourishing the four limbs. Earth generates all things and models itself after Heaven and Earth; therefore, this chapter discusses Taiyin and Yangming.

Huangdi asked: Taiyin and Yangming are exterior and interior counterparts, corresponding to the pulses of the Spleen and Stomach respectively. Why do they manifest different diseases?

Yangming governs the exterior, Taiyin governs the interior. Taiyin governs the Spleen, Yangming governs the Stomach. The Spleen and Stomach are exterior-interior pairs, both belonging to Earth. Why do their disease manifestations differ?

Qibo replied: Yin and Yang occupy different positions; deficiency and excess alternate; reversal and compliance alternate. Pathogens may arise from within or invade from without. Since the origins differ, the disease names vary.

"Geng" is pronounced with the level tone. Taiyin is Yin, with Yin residing internally; Yangming is Yang, with Yang residing externally. This is the difference in position between Yin and Yang. Spring and Summer belong to Yang, at which time Yang is full and Yin is deficient; Autumn and Winter belong to Yin, at which time Yin is full and Yang is deficient. This is the alternation of deficiency and excess. In Spring and Summer, when Yang prevails, if Yin becomes excessive it is a deviation (reversal), requiring compliance with the logic of Autumn and Winter; in Autumn and Winter, when Yin prevails, if Yang becomes excessive it is a deviation, requiring compliance with the logic of Spring and Summer. This is the alternation of reversal and compliance. Yin resides internally as the guardian of Yang; Yang resides externally as the attendant of Yin. In Autumn and Winter, one complies with Yin; in Spring and Summer, one complies with Yang. Yin and Yang mutually comply, meaning some conditions originate internally and others externally. Throughout the year, the mode of compliance differs; thus, the diseases that manifest have different Yin-Yang designations.

Huangdi said: I wish to hear about their specific symptomatic differences.

Different names necessarily imply different symptoms; symptoms are the reality behind the names.

Qibo said: Yang represents Heavenly Qi and governs the exterior; Yin represents Earthly Qi and governs the interior. Therefore, the Path of Yang tends toward Excess (Shi), and the Path of Yin tends toward Deficiency (Xu). Consequently, when attacked by treacherous winds and empty pathogens, Yang receives them first; when diet is irregular and daily routine is untimely, Yin receives them first. When Yang receives pathogens, they enter the Six Fu organs; when Yin receives pathogens, they enter the Five Zang organs. Entering the Six Fu organs results in body heat, inability to lie down at proper times, and upward progression to panting and calling out. Entering the Five Zang organs results in abdominal fullness and obstruction, downward progression to undigested diarrhea (Sun Xie), and over time, intestinal dysentery (Chang Pi).

Heaven is Yang, so Yang represents Heavenly Qi and governs the exterior. Earth is Yin, so Yin represents Earthly Qi and governs the interior. Yang has surplus rigidity, Yin has insufficient softness; thus, the Path of Yang is Excess, and the Path of Yin is Deficient. Yang governs the exterior, so treacherous winds and empty pathogens are received by Yang. Yin governs the interior, so irregular diet and untimely routine are received by Yin. Fu organs are Yang, so Yang pathogens enter the Six Fu organs. Zang organs are Yin, so Yin pathogens enter the Five Zang organs. Upon entering the Six Fu organs, Yang Qi floats outward and does not return to Yin, causing body heat, inability to rest properly, and upward panting. Upon entering the Five Zang organs, Yin Cold盛 (excessively flourishes) internally and fails to harmonize with Yang, causing abdominal fullness and obstruction, downward undigested diarrhea, and over time, intestinal dysentery. This difference between Yin and Yang explains the divergence in Fu-Zang and exterior-interior diseases.

Therefore, the throat governs Heavenly Qi, and the pharynx governs Earthly Qi. Thus, Yang meridians receive Wind Qi, and Yin meridians receive Dampness Qi. Yin Qi ascends from the feet to the head, then descends along the arms to the fingertips. Yang Qi ascends from the hands to the head, then descends to the feet. Hence, it is said that Yang diseases ascend to the extreme and then descend; Yin diseases descend to the extreme and then ascend. Therefore, those injured by Wind suffer first in the upper parts; those injured by Dampness suffer first in the lower parts.

The throat controls respiration, being the exit of Lung Qi, thus governing Heavenly Qi. The pharynx accepts food and drink, connecting downward to the Stomach, thus governing Earthly Qi. Wind is a Yang pathogen, so Yang meridians receive Wind Qi. Dampness is a Yin pathogen, so Yin meridians receive Dampness Qi. Yin Qi moves from below upward and from inside outward; thus, it ascends from the feet to the head, then descends along the arms to the finger tips. Yang Qi moves from outside upward and from above downward; thus, it ascends from the hands to the head, then descends to the feet. Yang Qi is above; upon reaching the extreme, it goes down. Yin Qi is below; upon reaching the extreme, it begins to go up. Hence, Yang diseases ascend to the extreme and then descend; Yin diseases descend to the extreme and then ascend. Those injured by Wind suffer first in the upper parts, eventually descending; those injured by Dampness suffer first in the lower parts, eventually ascending. This difference in Yin and Yang explains the divergence in Wind-Damp diseases affecting the upper and lower regions.

This section discusses the differences in Fu-Zang, exterior-interior, Wind-Damp, and upper-lower pathology, explaining why Taiyin and Yangming diseases differ.

Huangdi asked: Why does Spleen disease lead to the inability to use the four limbs?

The preceding text discussed the differences in pathology regarding Fu-Zang, exterior-interior, Wind-Damp, and upper-lower regions, but did not clarify the specific manifestations, hence the question regarding Spleen disease causing limb paralysis. The manifestation of limb inability is indeed distinct.

Qibo said: The four limbs all receive Qi from the Stomach, but Stomach Qi cannot reach the meridians of the limbs directly; it must rely on the Spleen to transport it, thereby receiving it.

"Wei" is pronounced with the departing tone, same for subsequent instances. "Bing" means to receive. The Qi of the four limbs originates from the Stomach, but Mingyang Stomach Qi cannot reach the limb meridians directly; it must pass through the Spleen to reach the meridians and receive Qi from the Stomach. Now, if Spleen disease prevents the Stomach from transporting fluids and essence, the four limbs cannot receive Water-Grain Qi. The Water-Grain Qi declines day by day, the vessel pathways become obstructed, and the sinews, bones, muscles, and flesh lack Qi to generate themselves, resulting in non-function.

Huangdi asked: Why does the Spleen not govern a specific season?

The Liver, Heart, Lung, and Kidney govern the four seasons of Spring, Summer, Autumn, and Winter respectively. The Spleen does not govern a single season, hence the inquiry.

Qibo said: The Spleen belongs to Earth, governs the Center, and constantly aids the four Zang organs (Liver, Heart, Lung, Kidney) throughout the four seasons. It governs for eighteen days during each season's transition, and thus cannot exclusively govern one season.

"Zhang" is pronounced with the rising tone. The Spleen does not govern a specific season because it belongs to Earth and occupies the Central position. It acts as the leader for the Liver, Heart, Lung, and Kidney throughout the four seasons, governing for eighteen days at the end of each season. One Zang organ governs for seventy-two days in total, so it cannot exclusively govern one season.

The Spleen organ constantly manifests the essence of Stomach Earth. Earth generates all things and models itself after Heaven and Earth. Therefore, Qi extends from the head to the feet, nowhere missing, making it impossible to govern only one season.

"Zhuo" means manifest or obvious. The essence of Water-Grain from Stomach Earth manifests externally through the transformative Qi of the Spleen organ. All things are born of Earth; thus, Earth generates all things and models itself after Heaven and Earth. The meridians above and below derive nourishment from Earth, extending from the head to the feet, encompassing all areas. Even if it wished to govern a specific season, it could not.

Huangdi asked: The Spleen and Stomach are connected merely by membranes, yet they can assist the Stomach in transporting fluids. Why?

The preceding text stated that Spleen disease prevents the transport of fluids for the Stomach. Thus, the question arises: since both Spleen and Stomach belong to Earth and are connected by membranes, how can the Spleen transport fluids for the Stomach?

Qibo said: Foot Taiyin is one of the Three Yin meridians. Its vessels penetrate the Stomach, belong to the Spleen, and connect to the pharynx. Therefore, Taiyin transports Qi to the Three Yin meridians. Yangming is the exterior and the Sea of the Five Zang and Six Fu organs; it also transports Qi to the Three Yang meridians.

Jueyin is First Yin, Shaoyin is Second Yin, and Taiyin is Third Yin; thus, Foot Taiyin is the Third Yin. Foot Taiyin governs the Spleen. Its vessels penetrate the Stomach centrally, belong to the Spleen inferiorly, and connect to the pharynx superiorly. The Qi of Spleen Earth communicates with the Yin of the Five Zang organs; thus, Taiyin transports Qi to the Three Yin meridians. The Three Yin meridians govern the Five Zang organs. Yin governs the interior, Yang governs the exterior; thus, Yangming governs the exterior. The Stomach receives water and grain and serves as the Sea of the Five Zang and Six Fu organs. It relies on the movement of Taiyin and transports Qi to the Three Yang meridians. The Three Yang meridians govern the Six Fu organs.

The Zang and Fu organs each follow their respective meridians to receive Qi from Yangming. Therefore, the Stomach can transport fluids. If the four limbs cannot receive Water-Grain Qi, Qi declines daily, the Yin pathways (vessel channels) become obstructed, and the sinews, bones, muscles, and flesh lack Qi to generate themselves, resulting in non-function.

Taiyin transports Qi to the Three Yin meridians. Yangming receives the Qi of Taiyin and transports it to the Three Yang meridings. Thus, the Five Zang and Six Fu organs each follow their meridians to receive Qi from Yangming. Receiving Qi from Yangming is essentially receiving Qi from Taiyin. Therefore, the Spleen organ transports fluids for the Stomach. This is why, despite being connected only by membranes, it can transport fluids. If the Spleen organ does not transport fluids for the Stomach, the four limbs cannot receive Yangming Water-Grain Qi, Qi declines daily, Lung Qi becomes deficient. Obstruction of Yin pathways implies obstruction of vessel pathways, leading to Heart Qi deficiency. The sinews governed by the Liver, bones governed by the Kidney, and muscles governed by the Spleen all lack Yangming Water-Grain Qi to generate themselves, resulting in the non-function of the four limbs.

This section explains that the Taiyin Spleen organ transports fluids for the Stomach, thereby nourishing the Zang and Fu organs and reaching the four limbs. This is why Spleen disease leads to the inability to use the four limbs.