帝复承上编脉病之意，错举《灵枢·经脉》论之言，及本经所已言者，而申解之，故曰脉解。六气主时，
始于厥阴，终于太阳。此举三阳三阴经脉之病，则太阳主春，正月为春之首，太阳为阳之首
也。少阳主秋，九月为秋之终，少阳为阳之终也。阳明主夏，五月为夏之中，阳明居阳之中也。三阴经脉，
外合三阳，雌雄相应，太阴合阳明，故主十一月，十一月，冬之中也。少阴合太阳，故主十
月，十月冬之首也。厥阴合少阳，故主三月，三月，春之经也，太阴为阴中之至阴，故又主十二月，十二月，
阴中之至阴也，错举六经之病，复以三阳三阴，主四时之月，而错综解之，所以为脉解也。
太阳所谓肿，腰 痛者，正月太阳寅，寅太阳也，正月阳气出
在上，而阴气盛，阳未得自次也，故肿，腰 痛也。
，音谁，余篇仿此。 ，尻也。《灵枢·经脉》论云，手太阳所生
病，颌肿颊肿。《六元正纪大论》云，太阳终之气，则病腰 痛。
故申明太阳所谓肿，以及腰 痛者，太阳居三阳之首，正月建寅，为一岁之首，故正月太阳寅，寅，太阳也，
正月之时，其气始春。故阳气出在上，寒气未散，而阴气犹盛，则阳气未得自次而出也，
故太阳经脉之病，有肿以及腰 痛也。
所谓病偏虚为跛者，正月阳气冻解，地气而出也，偏虚者，冬
寒颇有不足者，故偏虚为跛也。
旧本“所谓”二字，误传出也，下今改正。偏虚，犹偏枯。本经《大奇篇》云，肾壅则髀 大，跛
易偏枯。故申明所谓病偏虚为跛者，正月阳气始生，地冻始解，地气从下而上出也，其病偏虚者，
肾主冬令之寒，冬寒颇有不足者，故偏虚而为跛也。此言冬失其藏，至春有偏枯之跛病也。
所谓强上引背者，阳气大上而争，故强上也。
强，去声。本经《热论》云，伤寒一日，巨阳受之，头项痛，腰脊强，是腰脊之强，上引于背，而
至头项也，故申明所谓强上引背者，乃太阳阳气，大上而争，故腰脊强而上引背也。
所谓耳鸣者，阳气万物盛上而跃，故耳鸣也。
《灵枢·经脉》篇云，手太阳之筋，其病应耳中鸣。故申明所
谓耳鸣者，乃阳气万物盛上而跃，跃则振动，故耳鸣也。
所谓甚则狂巅疾者，阳尽在上，而阴气从下，下虚上实，故狂巅疾也。
巅，癫同。经脉论云∶足太阳所生病者，狂巅疾。故申明所谓甚则狂癫疾者，乃阳尽在上，而阴气以
下，阴气从下则下寒而虚，阳尽在上，则上热而实，下虚上实，故有太阳经脉之狂癫疾也。
所谓浮为聋者，皆在气也。
经脉论云∶手太阳之脉入耳中，所生病者，耳聋，故申明所谓
浮为聋者，是逆气上浮而为聋，皆在气也。
所谓入中为喑者，阳气已衰，故为喑也，内夺而厥，则为喑
俳，此肾虚也，少阴不至者厥也。
俳，痱同，音肥。本经《腹中论》云∶阳气入阴，入则喑，故申明
所谓入中为喑者，阳气盛时则不喑，阳盛已衰，故为喑也，若阳气内夺而厥逆，不充于外，则为喑痱。喑痱
者，口无言而四肢不收，故曰此肾虚也，肾虚则少阴之脉不出于阳，故少阴不至者，则内夺
而厥也，太阳、少阴，表里相应，故解太阳经脉之病，而兼言少阴也。此解太阳经脉之病也。
少阳所谓心协痛者，言少阳盛也，盛者心之所表也，九月阳气尽而阴气盛，故心协痛也。
《经脉》论云∶足少阳则病心协痛，故申明少阳所谓心协痛者，言少阳火气当盛也，心为君火，少
阳为相火，故盛者心之所表也。若九月之时，阳气已尽而阴气方盛，少阳火气不盛，不能为心之表，
故有心协痛之病也，少阳言九月者，九月为秋之终，少阳居阳之终也。
所谓不可反侧者，阴气藏物也，物藏则不动，故不可反侧也。
藏，如字。反侧，犹转侧。《经脉》论云∶足少阳病，不能转侧，故申明所谓不可反侧者，九月阴
气方盛，阴气所以藏物也，物藏则不动，故少阳经脉，有不可反侧之病也。
所谓甚则跃者，九月万物尽衰，草木毕落而堕，则气去阳而之
阴，气盛而阳之下长，故谓跃。
长，上声。上文云∶阳气万物，盛上而跃。跃者，少阳枢转之象，故申明所谓甚则跃者，九月之时，万
物尽衰，草木毕落而堕，人身之气，则去阳而之阴，去阳之阴，则阴之盛，阴气居阳之下，
故气盛而阳之下长，阳之下长，故谓跃也。此解少阳经脉之病也。
阳明所谓洒洒振寒者，阳明者午也，五月盛阳之阴也，阳盛而阴气加之，故洒洒振寒也。
《经脉论》云∶足阳明之脉，则病洒洒振寒，故申阴阳明，所谓洒洒振寒者。阳明者，午也，午
主五月，一阴始生，故五月盛阳之阴也，盛阳之阴，则阳盛而阴气加之，故阳明经脉有洒洒振寒之
病也，阳明言五月者，五月为夏之中，阳明居阳之中也。
所谓胫肿而股不收者，是五月盛阳之阴也，阳者，衰于五月，
而一阴气上，与阳始争，故胫肿而股不收也。
经筋篇云∶足阳明之筋，其病支胫转筋，髀前肿，筋弛纵，缓不胜收，故申明所谓胫肿，而股
不收者，是五月之时，盛阳之阴也，阳者衰于五月，而一阴之气上，与阳明始争，故阳明经脉，有
胫肿而股不收之病也。
所谓上喘而为水者，阴气下而复上，上则邪客于脏腑间，故为水也。
本经《逆调论》云∶卧则喘者，是水气之客也，故申明所谓上喘而为水者，冬至一阳初生，阴气下降，
五月之时，一阴始生，阴气下而复上，上则水邪客于脏腑之间，故为水也。
所谓胸痛少气者，水气在脏腑也，水者阴气也，阴气在中，故胸痛少气也。
此举胸痛少气，以明水气在脏腑之意。上文云，邪客于脏腑间，故为水也。此申明水气在脏腑者。所
谓胸痛少气者，即水气在脏腑也。夫水者阴气也。阴气在阳明中土，故胸痛少气而病阳明之
经脉也。胸痛少气，经中多各言之，此则合举之也。
所谓甚则厥，恶人与火，闻木音则惕然而惊者，阳气与阴气相薄，水火相恶，故惕然而惊也。
恶，去声，下同。《经脉》论云∶阳明病至，则恶人与火，闻木音则惕然而惊，甚则 厥，故申明所
谓甚则厥，恶人与火，闻木音则惕然而惊者，乃阳明之阳气，与阴气相薄，故甚则厥而恶人也。恶
火者，厥为阴为水，乃水火相恶，又木能生火，故闻木音则惕然而惊也。
所谓欲独闭户牖而处者，阴阳相薄也，阳尽而阴盛，故欲独闭户牖而居。
《经脉》论云，阳明病至，独闭户塞牖而处。故申明所谓欲独闭户牖而处者，乃阴加于阳，阴阳相
薄也。阳明者，阳也。阳尽而阴盛，故欲独闭户牖而居。居，犹处也。
所谓病至则欲乘高而歌，弃衣而走者，阴阳复争，而外并于
阳，故使之弃衣而走也。
《经脉》论云∶阳明病至，甚则欲上高而歌，弃衣而走，故申明所谓病至则欲乘高而歌，弃
衣而走者，始则阳尽阴盛，继则阴阳复争，而外并于阳，故使之乘高而歌，弃衣而走也。
所谓客孙脉，则头痛鼻鼽腹肿者，阳明并于上，上者则其孙络
太阴也，故头痛鼻鼽腹肿也。
出处未详，大抵皆阳明之病，孙脉，孙络脉也，所谓客孙脉，则头痛鼻鼽腹肿者，乃阳明之脉，不从
下行，而并于上，并于上者则其孙络之脉，合脾之大络而为太阴也，阳明并于上，故头痛鼻鼽，
孙络太阴，故腹肿也。此解阳明之脉病也。
太阴所谓病胀者，太阴子也，十一月万物气皆藏于中，故曰病胀。
藏，如字。《经脉》论云∶太阴病腹胀，故申明太阴所谓病胀者，太阴阳明，雌雄相合，阳明主夏之中，
则太阴主冬之中，故太阴子也，子，十一月也。十一月万物之气，皆藏于中，藏于中，故太阴经脉，则曰病胀也。
所谓上走心为噫者，阴盛而上走于阳明，阳明络属心，故曰上走心为噫也。
《经脉》论云∶太阴病善噫。本经《宣明五气篇》云，心为噫，故申明所谓上走心为噫者，太阴阴
盛而上走于阳明，阳明胃络，连属心包之络，故太阴经脉，而曰上走心为噫也。
所谓食则呕者，物盛满而上溢，故呕也。
《经脉》论云∶太阴病，食则呕，故申明所谓食则呕者，物盛充满，脾不消磨，而反上溢，故呕也。
所谓得后与气则快然如衰者，十二月阴气下衰，而阳气且出，故曰得后与气，则快然如衰也。
《经脉》论云，腹胀善噫，得后与气则快然如衰，故申明所谓得后与气，则快然如衰者，太阴为阴中
之至阴，十二月至阴也。至阴，则阴气下衰而阳气且将出，故太阴经脉，腹胀善噫，而曰得后
与气则快然如衰也。此太阴外合阳明，又为阴中之至阴也。
少阴所谓腰痛者，少阴者肾也，十月万物阳气皆伤，故腰痛也。
《经脉》论云∶足少阴之别，虚则腰痛，故申明少阴所谓腰痛者，腰乃肾府。少阴者肾也。少阴太阳，
雌雄相合，太阳主春之首，则少阴主冬之首，十月之时，万物阳气皆伤，所以然者，承秋之肃杀
也，故少阴经脉而病腰痛也。
所谓呕咳上气喘者，阴气在下，阳气在上，诸阳气浮，无所根据从，故呕咳上气喘也。
《经脉》论云∶足少阴脉病，则咳唾，喝喝而喘，咽肿上气，故申明所谓呕咳上气喘者，少阴阴气在下，
君火阳气在上，水火之气，贵乎相交，诸阳气浮，肾水不上，则阳气无所根据从，故少阴经脉内
虚，而病呕咳上气喘也。
所谓色色不能久立久坐，起则目KT KT 无所见者，万物阴阳不定，未有主也，
秋气始至，微霜始下，而方杀万物，阴阳内夺，故目KT KT 无所见也。
色色，二字衍文。不能久立久坐，乃坐而欲起之意，经脉论云∶坐而欲起，目KT KT 如无所见，故申
明不能久立久坐，起则目KT KT 无所见者，十月之时，万物阴阳不定，未有主也，所以然者，秋
气已过，冬气未盛，故阴阳不定未有主也，其时秋气始至于冬，微霜始下，而方杀万物，万物方杀，则阴阳
内夺，不荣于外，故少阴经脉之病，而目KT KT 无所见也。
所谓少气善怒者，阳气不治，阳气不治则阳气不得出，肝气常
治而未得，故善怒，善怒者名曰煎厥。
少气者，气并于下也。本经《调经论》云∶血并于上，气并于下，心烦惋善怒，故申明所谓少气善怒
者，乃君火之阳气不治，阳气不治则阳气不得上出，并于下而少气矣。气并于下，则血并于上，肝
主血，肝气当治而未得治，故善怒，申明善怒者，如火之烈，名曰煎厥，此少阴有少气善怒之病也。
所谓恐如人将捕之者，秋气万物未有毕去，阴气少、阳气入，阴阳相薄，故恐也。
《经脉》论云∶肾病则善恐，心惕惕如人将捕之，故申明所谓恐，如人将捕之者，秋气万物凋谢，
十月始冬，未能尽藏，故万物未有毕去。毕，尽也，未能尽去，阳入阴也。十月始冬，故阴气少，万
物凋谢，故阳气入，阳入于阴，则阴阳相薄，故少阴经脉，而有内恐之病也。
所谓恶闻食臭者，胃无气，故恶闻食臭也。
恶闻食臭者，不欲食也。经脉论云，肾病饥不欲食，故申明所谓恶闻食臭者，三焦出气于胃，腐化水谷，
令胃无三焦火热之气，故少阴脉病，饥不欲食，而恶闻食臭也。三焦，少阳也，本俞论云，少阳属肾，此之谓也。
所谓面黑如地色者，秋气内夺，故变于色也。
地色，地苍之色，如漆柴也，经脉论云∶肾病面如漆柴，故申
明所谓面黑如地色者，因秋时肃杀之气，内夺其精华，故至冬则变于色，而黑如地色也。
所谓咳则有血者，阳脉伤也，阳气未盛于上，而脉满，满则咳，故血见于鼻也。
《经脉》论云∶肾病咳唾则有血，故申明所谓咳则有血者，乃阴血乘于阳位，阳脉不归于阴，故曰阳
脉份也，阴血乘阳，脉不归阴，则阳脉满，十月之时，阳气未盛于上，未当盛时而脉满，则阳
气内逆，故满则咳，咳则有血，而且见于鼻也。此少阴外合太阳而为冬之首也。
厥阴所谓 疝，妇人少腹肿者，厥阴者辰也，三月阳中之阴，
邪在中，故曰 疝，少腹肿也。
疝，犹 疝，言高肿也。《经脉》论云∶厥阴病丈夫 疝，妇人少腹肿，故申明厥阴所谓 疝，妇人
少腹肿者，厥阴少阳雌雄相合，少阳主秋之终，则厥阴主春之终，故厥阴者辰也。辰，三月
也。三月之时，其气将阳，阳中之阴，言阳未尽阳，阳中有阴也，
阳中之阴，则阴邪在厥阴经脉中，故厥阴而曰 疝少腹肿也。
所谓腰脊痛不可以俯仰者，三月一振荣华，万物一俯而不仰也。
《经脉》论云∶厥阴病腰痛不可以俯仰，故申明所谓腰脊痛不可以俯仰者，三月之时，振动发生，草
木向荣而华秀，故三月一振荣华，生机虽盛，犹未畅达，故万物一皆俯而不仰也。厥阴主三月，
故厥阴经脉之病，腰脊痛，不可以俯而复仰也。
所谓 癃疝，肤胀者，日阴亦盛，而脉胀不通，故曰 癃疝也。
出处未详，大抵皆厥阴之病。 ， 疝也。癃，溺闭也。 癃疝肤胀者，阴器肿，不得小便，则肤胀
The Yellow Emperor again follows the meaning of the relationship between pulses and diseases from the previous section, interlacing citations from the *Ling Shu: Jing Mai* (Spiritual Pivot: Meridians) chapter and statements already mentioned in this classic (*Su Wen*), to further explain them; hence it is called "Jie Mai" (Explanation of Pulses). The Six Qi govern the seasons, starting with Jue Yin and ending with Tai Yang. Here, the diseases of the Three Yang and Three Yin meridians are listed because Tai Yang governs Spring, the first month is the beginning of Spring, and Tai Yang is the head of the Yang; Shao Yang governs Autumn, the ninth month is the end of Autumn, and Shao Yang is the end of Yang; Yang Ming governs Summer, the fifth month is the middle of Summer, and Yang Ming resides in the middle of Yang. The Three Yin meridians externally correspond to the Three Yang, male and female matching each other: Tai Yin combines with Yang Ming, thus governing the eleventh month, which is the middle of Winter; Shao Yin combines with Tai Yang, thus governing the tenth month, which is the beginning of Winter; Jue Yin combines with Shao Yang, thus governing the third month, which is the end of Spring. Tai Yin is the extreme Yin within Yin, thus also governing the twelfth month, which is also the extreme Yin within Yin. Interlacing the diseases of the Six Channels and combining them with the months of the four seasons governed by the Three Yang and Three Yin, explaining them in a complex manner, is what is meant by "Jie Mai".
Regarding Tai Yang's mention of swelling and lower back pain: In the first month, Tai Yang corresponds to Yin (Tiger), and Yin represents Tai Yang. In the first month, Yang Qi begins to rise upward, while Yin Qi remains abundant. Since Yang Qi cannot ascend according to its proper order, swelling and lower back pain occur. "Xiao" (pain/aching), pronounced like "shui", follows this pattern in other chapters. "Xiao" refers to the sacrum/coccyx. The *Ling Shu: Jing Mai* states that diseases generated by the Hand Tai Yang meridian include swelling of the jaw and cheek. The *Li Yuan Zheng Ji Da Lun* states that during the final phase of Tai Yang, lower back pain occurs. Thus, it is clarified that Tai Yang's swelling and lower back pain arise because Tai Yang is the head of the Three Yang, the first month establishes Yin (Tiger) as the beginning of the year, so "first month Tai Yang Yin" means Yin is Tai Yang. At the time of the first month, the climate begins to turn spring-like. Yang Qi emerges in the upper part, cold Qi has not yet dissipated, and Yin Qi is still strong, so Yang Qi cannot freely ascend. Therefore, diseases of the Tai Yang meridian manifest as swelling and lower back pain.
Regarding the condition where weakness on one side leads to limping: This is because in the first month, Yang Qi thaws the ice, and Earth Qi rises from below. "Pian Xu" (partial deficiency) refers to a slight insufficiency of winter cold Qi, leading to partial deficiency and limping.
The characters "Suo Wei" (so-called) in old editions were transmission errors and have been corrected here. "Pian Xu" is akin to "Pian Ku" (hemiplegia). The *Da Qi Lun* of this classic states that when Kidney Qi is obstructed, the thigh swells, and one limps and is prone to hemiplegia. Thus, it is explained that the condition of partial deficiency leading to limping occurs because in the first month, Yang Qi begins to generate, frozen ground begins to thaw, and Earth Qi rises from below to above. The disease manifests as partial deficiency because the Kidney governs the cold of winter; if winter cold is somewhat deficient, it leads to partial deficiency and limping. This describes how failure to store during winter results in hemiplegic limping in spring.
Regarding stiff neck pulling into the back: This is because Yang Qi surges greatly upward and contends, causing stiffness in the neck.
"Qiang" is pronounced with the departing tone. The *Re Lun* of this classic states that on the first day of Shang Han (Cold Damage), the Ju Yang (Tai Yang) receives the pathogen, causing headache, neck pain, and stiffness of the waist and spine. This stiffness of the waist and spine pulls upward into the back and reaches the head and neck. Thus, it is clarified that the stiff neck pulling into the back is due to Tai Yang Yang Qi surging greatly upward and contending, causing stiffness of the waist and spine that pulls upward into the back.
Regarding tinnitus: This is because Yang Qi, like all things, becomes abundant and rises upward, jumping/vibrating, causing tinnitus.
The *Ling Shu: Jing Mai* states that diseases of the sinews of the Hand Tai Yang should manifest as ringing in the ears. Thus, it is clarified that tinnitus occurs because Yang Qi, like all things, becomes abundant and rises upward, jumping; jumping causes vibration, resulting in tinnitus.
Regarding severe cases developing mania and epilepsy (dian疾): This is because Yang Qi is entirely accumulated in the upper part, while Yin Qi is relatively empty in the lower part, creating a condition of emptiness below and excess above, leading to mania and epilepsy.
"Dian" is synonymous with "Dian" (epilepsy/mania). The Jing Mai Lun states: Diseases generated by the Foot Tai Yang meridian include mania and epilepsy. Thus, it is clarified that severe mania and epilepsy occur because Yang Qi is entirely accumulated in the upper part, while Yin Qi is in the lower part. Yin Qi from below implies coldness and emptiness below; Yang Qi entirely above implies heat and excess above. Emptiness below and excess above lead to Tai Yang meridian mania and epilepsy.
Regarding deafness caused by floating pulse: This is all due to Qi dynamics.
The Jing Mai Lun states: The Hand Tai Yang meridian enters the ear; diseases generated include deafness. Thus, it is clarified that deafness caused by a floating pulse is due to rebellious Qi floating upward, and this is fundamentally a matter of Qi.
Regarding entering the interior leading to aphonia: This is because Yang Qi has already declined, leading to aphonia. If internal essence is depleted and Jue (cold extremities/reversal) occurs, it becomes aphonia accompanied by flaccidity (Yin Fei); this is Kidney deficiency. When Shao Yin Qi does not arrive, it is Jue.
"Pai" is synonymous with "Fei", pronounced like "fei". The *Fu Zhong Lun* of this classic states: When Yang Qi enters Yin, it leads to aphonia. Thus, it is clarified that aphonia upon entering the interior occurs because when Yang Qi is abundant, there is no aphonia; but after Yang Qi declines, aphonia occurs. If Yang Qi is internally depleted and reverses, failing to nourish the exterior, it becomes Yin Fei. Yin Fei refers to inability to speak and flaccidity of the four limbs. Hence, it is said this is Kidney deficiency. When the Kidney is deficient, the Shao Yin meridian Qi does not emerge to the Yang aspect; thus, when Shao Yin Qi does not arrive, it is internal depletion and Jue. Tai Yang and Shao Yin are exterior-interior counterparts; therefore, in explaining Tai Yang meridian diseases, Shao Yin is also mentioned. This explains Tai Yang meridian diseases.
Regarding Shao Yang's mention of hypochondriac pain: This indicates Shao Yang Fire Qi is abundant. Abundance is the external manifestation of Heart Fire. In the ninth month, Yang Qi is exhausted and Yin Qi is abundant, leading to hypochondriac pain.
The *Jing Mai* chapter states: Foot Shao Yang meridian disease causes hypochondriac pain. Thus, it is clarified that Shao Yang's hypochondriac pain indicates Shao Yang Minister Fire is abundant. The Heart is Sovereign Fire, and Shao Yang is Minister Fire; thus, abundance is the external manifestation of the Heart. However, in the ninth month, when Yang Qi is exhausted and Yin Qi is just becoming abundant, Shao Yang Fire is not abundant and cannot serve as the external manifestation for the Heart, leading to hypochondriac pain. Shao Yang is associated with the ninth month because the ninth month is the end of Autumn, and Shao Yang is the end of Yang.
Regarding inability to turn or roll over: This is because Yin Qi governs storage. Things that are stored do not move, hence the inability to turn.
"Cang" is read as written. Fan Ce refers to turning sideways. The *Jing Mai* chapter states: Foot Shao Yang meridian disease causes inability to turn. Thus, it is clarified that the inability to turn arises because in the ninth month, Yin Qi is just abundant, and Yin Qi's function is to store things. Things stored do not move, so Shao Yang meridian disease manifests as inability to turn.
Regarding severe cases exhibiting leaping/jumping movements: This is because in the ninth month, all things wither completely, grass and trees fall and drop. Human Qi leaves Yang and enters Yin. Qi is abundant, and Yang Qi grows downward, hence termed "Yue" (leap/jump).
"Zhang" is pronounced with the rising tone. The text previously stated: Yang Qi, like all things, becomes abundant and rises upward, jumping. Yue is the image of Shao Yang pivot transformation. Thus, it is clarified that severe leaping occurs because in the ninth month, all things wither, grass and trees fall. Human Qi leaves Yang and enters Yin. Leaving Yang to enter Yin means Yin becomes abundant. Yin Qi resides below Yang, so Qi is abundant and Yang Qi grows downward. Yang growing downward is termed "Yue". This explains Shao Yang meridian diseases.
Regarding Yang Ming's mention of shivering chills: Yang Ming corresponds to Wu (Horse), the fifth month is Yin within abundant Yang. Yang is abundant and Yin Qi adds to it, causing shivering chills.
The *Jing Mai Lun* states: Foot Yang Ming meridian disease causes shivering chills. Thus, it clarifies Yang Ming's shivering chills. Yang Ming corresponds to Wu; Wu governs the fifth month, when one Yin begins to generate. Thus, the fifth month is Yin within abundant Yang. Yin within abundant Yang means Yang is abundant and Yin Qi adds to it, causing Yang Ming meridian shivering chills. Yang Ming is associated with the fifth month because the fifth month is the middle of Summer, and Yang Ming resides in the middle of Yang.
Regarding swelling of the shins and flaccidity of the thighs: This is because the fifth month is Yin within abundant Yang. Yang Qi declines in the fifth month, and one Yin Qi ascends, beginning to contend with Yang, causing shin swelling and thigh flaccidity.
The *Jing Jin* chapter states: Foot Yang Ming sinew disease causes supportless shins, cramps, anterior thigh swelling, flaccid sinews, and inability to contract. Thus, it clarifies shin swelling and thigh flaccidity as occurring in the fifth month, Yin within abundant Yang. Yang declines in the fifth month, and one Yin Qi ascends to contend with Yang Ming, causing Yang Ming meridian shin swelling and thigh flaccidity.
Regarding wheezing and water retention (edema): This is because Yin Qi descends and then rises again; rising allows evil Qi to lodge between the Zang-Fu organs, causing edema.
The *Ni Diao Lun* of this classic states: Wheezing when lying down is due to Water Qi lodging. Thus, it clarifies that wheezing and edema occur because at Winter Solstice, one Yang initially generates and Yin Qi descends; by the fifth month, one Yin begins to generate, Yin Qi descends and then rises. Rising allows Water Evil to lodge between the Zang-Fu, causing edema.
Regarding chest pain and shortness of breath: This is because Water Qi is in the Zang-Fu. Water is Yin Qi; Yin Qi in the interior causes chest pain and shortness of breath.
This lists chest pain and shortness of breath to illustrate the meaning of Water Qi in the Zang-Fu. The text previously stated evil lodges between Zang-Fu, causing edema. Here, it clarifies that chest pain and shortness of breath indicate Water Qi in the Zang-Fu. Water is Yin Qi. Yin Qi in the Yang Ming Central Earth causes chest pain, shortness of breath, and Yang Ming meridian disease. Chest pain and shortness of breath are often discussed separately in the classics; here they are combined.
Regarding severe cases with Jue, aversion to people and fire, and startle at the sound of wood: This is because Yang Qi and Yin Qi contend, Water and Fire oppose each other, causing startle.
"E" is pronounced with the departing tone, same below. The *Jing Mai* chapter states: Yang Ming disease arrives, causing aversion to people and fire, startle at the sound of wood, and severe cases develop Jue. Thus, it clarifies that severe Jue, aversion to people/fire, and startle at wood sounds occur because Yang Ming Yang Qi contends with Yin Qi, leading to severe Jue and aversion to people. Aversion to fire occurs because Jue is Yin/Water, representing Water-Fire opposition. Since Wood generates Fire, hearing wood sounds causes startle.
Regarding the desire to close doors and windows and stay alone: This is because Yin and Yang contend. Yang is exhausted and Yin is abundant, so one desires to close doors and windows and stay alone.
The *Jing Mai* chapter states: Yang Ming disease arrives, causing one to close doors and windows and stay alone. Thus, it clarifies that the desire to close doors and windows arises because Yin adds to Yang, and Yin-Yang contend. Yang Ming is Yang. Yang exhausted and Yin abundant leads to the desire to stay alone behind closed doors. Ju is synonymous with Chu (stay/reside).
Regarding climbing high and singing, discarding clothes and running: This is because Yin and Yang contend again, and Yang Qi merges outwardly to the Yang aspect, causing discarding clothes and running.
The *Jing Mai* chapter states: Yang Ming disease arrives, severe cases desire to climb high and sing, discard clothes and run. Thus, it clarifies that climbing high/singing and discarding clothes/running begin with Yang exhaustion and Yin abundance, followed by renewed Yin-Yang contention, with Yang Qi merging outward to the Yang aspect, causing climbing high/singing and discarding clothes/running.
Regarding pathogens lodging in Sun (branch) collaterals causing headache, nasal discharge, and abdominal swelling: This is because Yang Ming merges upward; the upper part connects to its Sun collaterals and Tai Yin, causing headache, nasal discharge, and abdominal swelling.
Source unclear, generally Yang Ming diseases. Sun Mai refers to Sun Collaterals. Pathogens lodging in Sun collaterals causing headache, nasal discharge, and abdominal swelling occur because Yang Ming meridian Qi does not descend but merges upward. Merging upward, its Sun collateral Qi combines with the large Luo of the Spleen to become Tai Yin. Yang Ming merging upward causes headache and nasal discharge; Sun collaterals connecting to Tai Yin cause abdominal swelling. This explains Yang Ming meridian diseases.
Regarding Tai Yin's mention of abdominal distension: Tai Yin corresponds to Zi (Rat), the eleventh month. All things' Qi hides within, hence abdominal distension.
"Cang" is read as written. The *Jing Mai* chapter states: Tai Yin disease causes abdominal distension. Thus, it clarifies Tai Yin's abdominal distension. Tai Yin and Yang Ming match male/female; Yang Ming governs the middle of Summer, so Tai Yin governs the middle of Winter, corresponding to Zi. Zi is the eleventh month. In the eleventh month, all things' Qi hides within. Hiding within causes Tai Yin meridian abdominal distension.
Regarding Qi moving upward to the Heart causing belching: This is because Yin Qi is abundant and moves upward to Yang Ming; Yang Ming's collaterals connect to the Heart, hence moving upward to the Heart causes belching.
The *Jing Mai* chapter states: Tai Yin disease causes frequent belching. The *Xuan Ming Wu Qi Pian* of this classic states: The Heart is responsible for belching. Thus, it clarifies that Qi moving upward to the Heart causes belching because Tai Yin Yin Qi is abundant and moves upward to Yang Ming; Yang Ming Stomach collaterals connect to the Pericardium collaterals, so Tai Yin meridian Qi moves upward to the Heart causing belching.
Regarding vomiting after eating: This is because food is full and overflows upward, causing vomiting.
The *Jing Mai* chapter states: Tai Yin disease causes vomiting after eating. Thus, it clarifies that vomiting after eating occurs because food is full, the Spleen fails to digest it, and it overflows upward, causing vomiting.
Regarding feeling relieved and symptoms subsiding after defecation and passing gas: This is because in the twelfth month, Yin Qi declines downward, and Yang Qi is about to emerge, so defecation and passing gas bring relief and symptom reduction.
The *Jing Mai* chapter states: Abdominal distension and frequent belching are relieved after defecation and passing gas. Thus, it clarifies that relief after defecation/gas occurs because Tai Yin is Extreme Yin within Yin, and the twelfth month is Extreme Yin. Extreme Yin means Yin Qi declines downward and Yang Qi is about to emerge, so Tai Yin meridian abdominal distension and belching are relieved after defecation/gas. This shows Tai Yin externally combines with Yang Ming and is Extreme Yin within Yin.
Regarding Shao Yin's mention of lower back pain: Shao Yin corresponds to the Kidney. In the tenth month, all things' Yang Qi is injured, hence lower back pain.
The *Jing Mai* chapter states: Deficiency of the Foot Shao Yin branch causes lower back pain. Thus, it clarifies Shao Yin's lower back pain: the waist is the mansion of the Kidney. Shao Yin corresponds to the Kidney. Shao Yin and Tai Yang match; Tai Yang governs the beginning of Spring, so Shao Yin governs the beginning of Winter. In the tenth month, all things' Yang Qi is injured due to the lingering肃杀 (severe/cold) energy of Autumn, causing Shao Yin meridian lower back pain.
Regarding vomiting, coughing, and wheezing: This is because Yin Qi is below, Yang Qi is above, all Yang Qi floats without foundation, causing vomiting, coughing, and wheezing.
The *Jing Mai* chapter states: Foot Shao Yin meridian disease causes coughing, spitting, wheezing, swollen throat, and upward Qi. Thus, it clarifies that vomiting, coughing, and wheezing occur because Shao Yin Yin Qi is below, Sovereign Fire Yang Qi is above. Water and Fire Qi must interact. All Yang Qi floats, Kidney Water does not ascend, so Yang Qi has no foundation. Thus, Shao Yin meridian internal deficiency causes vomiting, coughing, and wheezing.
Regarding pallor, inability to stand or sit long, dizziness upon standing: This is because Yin and Yang of all things are unsettled, lacking a master. Autumn Qi begins, light frost falls, killing all things. Yin and Yang are internally depleted, causing dizziness/blurred vision.
"Sese" are redundant characters. Inability to stand/sit long means wanting to rise from sitting. The *Jing Mai Lun* states: Wanting to rise from sitting, eyes blurred as if unable to see. Thus, it clarifies that in the tenth month, Yin and Yang are unsettled without a master because Autumn has passed but Winter is not yet strong. Autumn Qi reaches Winter, light frost falls, killing all things. Killing all things depletes Yin and Yang internally, failing to nourish the exterior, causing Shao Yin meridian dizziness/blurred vision.
Regarding shortness of Qi and irritability: This is because Yang Qi fails to govern. Yang Qi failing to govern means it cannot exit; Liver Qi should be governed but is not, causing irritability. Irritability is named Jian Jue (Frying Reversal).
Shortness of Qi is Qi merging downward. The *Tiao Jing Lun* states: Blood merging upward, Qi merging downward causes vexation and irritability. Thus, it clarifies that shortness of Qi and irritability occur because Sovereign Fire Yang Qi fails to govern, cannot ascend, merges downward causing shortness of Qi. Qi merging downward causes Blood merging upward. The Liver governs Blood; Liver Qi should be governed but is not, causing irritability. Irritability is fierce like fire, named Jian Jue. This describes Shao Yin shortness of Qi and irritability.
Regarding fear as if being hunted: This is because Autumn Qi has not fully departed, Yin Qi is scarce, Yang Qi enters, Yin and Yang contend, causing fear.
The *Jing Mai* chapter states: Kidney disease causes fear, feeling timid as if being hunted. Thus, it clarifies that fear as if being hunted occurs because Autumn Qi withers all things; the tenth month starts Winter, unable to fully store, so all things have not fully departed. Bi means complete. Not fully departing means Yang entering Yin. Tenth month starts Winter, so Yin Qi is scarce; all things wither, so Yang Qi enters. Yang entering Yin causes Yin-Yang contention, leading to Shao Yin meridian internal fear.
Regarding aversion to the smell of food: This is because the Stomach lacks Qi, causing aversion to food smells.
Aversion to food smells means lack of appetite. The *Jing Mai* states: Kidney disease causes hunger but lack of appetite. Thus, it clarifies that aversion to food smells occurs because the San Jiao outputs Qi to the Stomach to rot and transform food, leaving the Stomach without San Jiao Fire-Heat Qi. Thus, Shao Yin meridian disease causes hunger without appetite and aversion to food smells. San Jiao is Shao Yang. The *Ben Shu* chapter states: Shao Yang belongs to the Kidney, referring to this.
Regarding face black like earth color: This is because Autumn Qi internally depletes, changing the complexion.
Earth color is dark/black like lacquered charcoal. The *Jing Mai* states: Kidney disease makes the face look like lacquered charcoal. Thus, it clarifies that face black like earth color occurs because Autumn's severe Qi internally depletes essence, so by Winter the color changes to black like earth.
Regarding coughing with blood: This is because Yang meridians are injured. Yang Qi is not yet abundant above, but the pulse is full. Fullness causes coughing, so blood appears in the nose.
The *Jing Mai* states: Kidney disease coughing/spitting brings blood. Thus, it clarifies that coughing with blood occurs because Yin Blood attacks Yang positions, Yang meridians do not return to Yin, so Yang meridians are injured. Yin Blood attacking Yang, pulse not returning to Yin, causes Yang pulse fullness. In the tenth month, Yang Qi is not yet abundant above; full pulse when not supposed to be abundant means Yang Qi rebels internally. Fullness causes coughing, coughing brings blood, appearing in the nose. This describes Shao Yin externally combining with Tai Yang as the beginning of Winter.
Regarding Jue Yin's mention of hernia and women's lower abdominal swelling: Jue Yin corresponds to Chen (Dragon), the third month is Yin within Yang. Pathogen in the middle causes hernia and lower abdominal swelling.
"Han" is akin to "Jia Han", indicating high swelling. The *Jing Mai* states: Jue Yin disease causes men's hernia and women's lower abdominal swelling. Thus, it clarifies Jue Yin's hernia and women's lower abdominal swelling: Jue Yin and Shao Yang match; Shao Yang governs the end of Autumn, so Jue Yin governs the end of Spring, corresponding to Chen. Chen is the third month. In the third month, Qi trends toward Yang; Yin within Yang means Yang is not purely Yang, containing Yin. Yin within Yang means Yin pathogen is in the Jue Yin meridian, causing hernia and lower abdominal swelling.
Regarding lower back and spine pain preventing bending and stretching: This is because in the third month, all things vibrate with glory, all things bow but do not stretch up.
The *Jing Mai* states: Jue Yin disease causes lower back pain preventing bending/stretching. Thus, it clarifies that lower back/spine pain preventing movement occurs because in the third month, vibration occurs, grass and trees flourish and bloom. Third month vibrates with glory. Although vitality is strong, it is not yet smooth, so all things bow but do not stretch up. Jue Yin governs the third month, so Jue Yin meridian disease causes lower back/spine pain preventing bending and stretching.
Regarding Long Hernia and skin swelling: This is because Yin Qi is also abundant, causing vessel swelling and blockage, hence Long Hernia.
Source unclear, generally Jue Yin diseases. "Long" refers to urinary obstruction. Long Hernia and skin swelling mean genital swelling, inability to urinate, leading to skin swelling.