《至真要大论》曰∶诸风掉眩，皆属于肝（诸风者，风病不一也。掉，摇动也。眩，昏花也。风木善动，
肝家之症也，掉眩虽同，而虚实有别，不可不察焉）；诸寒收引，皆属于肾（收，敛束也。引，牵急也。
筋脉挛急本是肝症，而属于肾者，一则以肾肝之症同一治，一则肾主寒水之化，肾虚则阳气不充，营卫凝泣；肢
体挛 。所谓寒则筋急也），诸气 郁，皆属于肺（ 者，喘急上逆。郁者，痞塞不通。肺主气，气有余者，
本经自伏之火；气不足者，则火邪乘之。虚实之分，极易淆误，所当精辨。近世庸者。概指为肺热而攻其有余，虚
虚之
祸，良可嗟悼）；诸湿肿满，皆属于脾（脾司湿化，又主肌肉，内受湿淫，肌体肿满，故属于脾，土气太过，
则湿邪盛行，其病骤至；法当分疏。土气不及，则木乘水侮，其病渐成，法当培补，二者易治，比于操刃）；
诸热瞀螈，皆属于火（昏闷曰瞀，抽掣曰螈，邪热伤神则瞀，亢阳伤血则螈，虽皆属火，亦有虚实之分。丹
溪曰；实火可泻。岑连之属；虚火可补，参 之属。仁人之言哉），诸痛痒疮，皆属于心（热甚则疮痛，热微
则疮痒，心主热火之化，故痛痒诸疮，皆属于心也），诸厥固泄，皆属于下，（厥者，自下而逆上也，阴衰于
下，则为热厥，阳衰于下，则为寒厥。固者，二便不通也。阳虚则无气，而清浊不化，寒也。火盛则水衰，而
精液干枯，热也。泄者，二便不固也。命门火衰则阳虚失禁，寒也。肾宫水衰则火迫注泄，热也。肾开窍于二
阴，肾主二便，居下故也）；诸痿喘呕，皆属于上（痿废应属下部而属于上者，何也？肺热叶焦，发为痿 。
气急曰喘，病在肺也。有声无物曰呕，肺胃司之，总属在上之症）；诸禁鼓栗，如丧神守，皆属于火（禁，即噤
也，寒厥切牙曰噤。鼓，鼓颔也。栗，战栗也。寒战而神不自持，如丧神守，皆火也。心火亢极，反兼胜己之
化，此火实也，阳虚阴盛，气不卫外而寒战者，此火虚也）；诸痉项强，皆属于湿（痉者，风湿而屈伸不利也。
项属足太阳寒水，水即湿也，故皆属于湿）；诸逆冲上，皆属于火（喘咳呕吐，气满逆急。皆冲逆之症，火性
炎上，故皆属于火）；诸胀腹大，皆属于热（热气内淫，变为烦满，故曰皆属于热。近世执此一句，因而误人不
可胜数，独不闻经曰∶岁水太过，腹大胫肿。岁火不及，胁满腹大。流衍之纪，病胀。水郁之发，善胀。太阳
之胜，腹满。阳明之复，腹胀。又曰∶适寒凉者胀。又曰∶藏寒生满病。又曰，胃中寒则胀满。此九者，皆言寒
胀也。故东垣曰，大抵寒胀多，热胀少，良有本矣），诸躁狂越，皆属于火（躁者，烦躁也。狂者，妄乱也，
越者，如登高而歌之类。火入于肺则烦。火入于肾则躁。又有阴盛发躁。成无己曰∶阴躁欲坐井中，但欲饮水、
不得入口。东垣曰，阴躁欲坐井中，阳已先亡，医犹不悟，重以寒药投之，其死何疑？故曰内热而躁者，有邪
之热也，属火，外热而躁者，无根之火也，属寒。经之论狂屡见，属虚寒者凡四条，是狂亦有寒热之辨矣）；诸
暴强直，皆属于风（暴，猝也。强者，筋强。直者，体直而不能屈伸也。肝主筋，其化风，故曰属风，非天外
入风也。内风多燥，若用风剂则益燥，故有治风先治血，血行风自灭之说也。轻与疏风则益燥，且腠理开张，反
招风矣）；诸病有声，鼓之如鼓，皆属于热（有声，谓肠鸣也，鼓之如鼓，谓腹胀也，皆阳气逆壅，故曰属热。
二症多有属于寒者，尽信不如无书，其是之谓耶）；诸病 肿，疼酸惊骇，皆属于火（ 肿者，浮肿也。疼酸
者，火在经也。惊骇者，火在脏也。然 肿酸疼，属于寒湿者不少，惊骇不宁，属于不足者常多也），诸转反戾，
水液混浊，皆属于火（转筋挛 ，燥热所致，小便混浊，清化不及，故皆属热，然而寒则筋急，喻如冬月严
寒，则角弓增劲。心肾不足，多有便浊。经云∶中气不足，溲便为之变。读者盖通之可耳）；诸病水液，澄澈
清冷，皆属于寒（澄澈清冷者，寒水之本体，故皆属寒），诸呕吐酸，暴注下迫，皆属于热（呕逆者，火
炎之象。吐酸者。肝木之实，暴注者，火性疾速，下迫者，火能燥物。此特道其常耳，虚寒之变，数症常作，
不可不知也）。
按∶经言十九条，道其常也。余每举其反者，尽其变也，王太仆深明病机之变，其所注疏，真《内经》
画龙点睛手也。启玄曰∶如大寒而甚，热之不热，是无火也，当助其心。又如大热而甚，寒之不寒，是无水也；
热动复止，倏忽往来，时动时止，是无水也，当助其肾。内格呕逆，食不得入，是有火也。病呕而吐，食入反
出，是无火也。暴速注下，食不及化，是无水也。溏泄而久。止发无恒，是无水也。故心盛则热，肾盛则寒，
肾虚则寒动于中，心虚则热收于内。又热不得寒，是无水也，寒不得热，是无火也，夫寒之不寒，责之无水，热
之不热，责其无火。热之不久，责心之虚，寒之不久，责肾之少。方有治热以寒，寒之而火食不入，攻寒以热，
热之而昏躁以生，此为气不疏通，壅而为是也。余以太仆此语为岐黄传神，常自诵忆，并勉同志。
《生气通天论》曰∶因于寒，欲如运枢，起居如惊，神气乃浮（阳气不固，四时之邪乃能干之。经曰∶冬三
月，此谓闭藏。水冰地坼，无扰乎阳。又曰∶冬日在骨，蛰虫周密，君子居室。皆言冬令宜闭藏也。因者，病
因也。因寒而动者，内而欲心妄动，如运枢之不停，外而起居不节。如惊气之震动，则与天令相违，神气不能
内敛，皆浮越于外矣）∶因于暑，汗，烦则喘喝，静则多言（此言动而得之，为中热之候也。炎蒸劳役。病属
于阳，故多汗而烦，气高喘喝。即感之轻而静者，亦精神内乱，言语无伦也），体若燔炭，汗出而散（此言静而
得之。为中暑之候也。纳凉饮冷，病属于阴，热气抑遏，体如燔炭，必得发汗，而阴郁之气始散也。香薷一味为
夏月发汗之要药，其性温热，止宜于中暑之人。若中热者误服之，反成大害，世所未知）；因于湿，首如裹，湿
热不攘，大筋软短，小筋弛长；软短为拘，弛长为痿（土旺四季之末，发无常期。首如裹者。湿伤则头面壅重也。
湿久成热，须药以攘夺之，苟为不夺，则热伤阴血，筋无以荣，大筋拘而不伸，小筋弛而无力矣）；因于气，为肿，
四维相代，阳气乃竭（肺金主气，病因于气者，秋令之邪也。肿者，气化失宜，乃为肿胀也。四维者，四肢也。相
代者，言足肿不能行，手代之以扶倚也，气不能治，终归于竭矣）。
阳气者，烦劳则张，精绝，辟积于夏，使人煎厥（阳春主生发之气，此言春令之邪也。气方生而烦劳太过，
则气张于外，精绝于内。春令邪辟之气，积久不散，至夏未痊，则火旺而真阴如煎，火炎而虚气逆上，故曰煎
厥。按《脉解篇》曰肝气失治，善怒者名曰煎厥。则此节指春令无疑。旧疏从未及之，岂非千虑一得）。
大怒则形气绝；而血菀（菀，茂也，结也）于上，使人薄厥（怒气伤肝，肝为血海，怒则气上，气逆则绝，
所以血菀上焦，相迫曰薄，气逆曰厥，气血俱乱，故为薄厥。盖积于上者，势必厥而吐也。薄厥者，气血之
多而盛者也）。有伤于筋，纵，其若不容（怒伤而至于血厥，则筋无以荣，缓纵不收，若不能容矣）。汗出偏
沮，使人偏枯（偏者，或左或右，止出半边也。沮者。言此既偏出，彼即阻滞矣。久则卫气不固，营气失守，当
为偏枯，即半身不遂也）。汗出见湿，乃生痤（音锄） （音沸，汗出则玄府开张，若凉水浴之，即见湿矣。留
于肤腠，甚者为痤，微者为痱。痤。小疖也。痱，暑疹也）。高粱之变，足生大疔，受如持虚（高粱，即肥甘
也。变，病也。足，能也。浓味不节，蓄为灼热，能生大疔。日积月累，感发最易，如持虚之器以受物也）。
劳汗当风，寒薄为 （音渣）。郁乃痤（形劳汗出，坐卧当风，寒气薄之，液凝为 ，即粉刺也。若郁而稍重，乃若小疖，
其名曰痤）。
开阖不得，寒气从之，乃生大偻（夏则腠理开而发泄，冬则腠理阖而闭藏，与时偕行也。若当开不开，当
闭不闭，不得其宜，为寒所袭，留于筋络之间，软急不舒，形为俯偻矣）。陷脉为 ，留连肉腠（陷脉者，寒
气自筋络而陷入脉中也。 ，鼠 之属，邪久不散，则渐深矣）。俞气化薄，传为善畏，及为惊骇（寒气渐深，
自脉而流于经俞，侵及脏腑，故为恐畏惊骇也）。营气不从，逆于肉理，乃生痈肿（营行脉中，邪气陷脉，则
营气不从，故逆于肉而痈肿生焉）。魄汗未尽，形弱而气烁，穴俞已闭，发为风疟（肺主皮毛，汗之窍也，肺
实藏魄，故名魄汗。汗出未透，则热郁于内，形气俱烁，俞穴以闭，留止之邪必为风疟矣）。
春伤于风，邪气留连，乃为洞泄（春伤于风，则肝木侮土，故为洞泄），夏伤于暑，秋为 疟（夏伤于暑，
伏而不发，秋气收束，寒郁为热，故寒热交争而成 疟。 者，疟之通称，非有别义）；秋伤于湿，上逆而咳，
发为痿厥（土旺于四季之末，秋末亦可伤湿，秋气通于肺，湿郁成热，上乘肺金，气逆而咳，曰上逆者，湿从下
受故也）；冬伤于寒，春必温病（冬伤于寒，寒毒藏于阴分，至春始发。名为温病，以时令得名也。春不发而至
于夏，即名热病矣）。
味过于酸，肝气以津，脾气乃绝（曲直作酸，肝之味也。过于食酸，久而增气，木乘土位，脾气乃绝）；
味过于咸，大骨气劳，短肌，心气抑（咸为肾味，过食则伤肾，肾主骨，故大骨气劳。咸走血，血伤故肌
肉短缩，咸从水化，水胜则火囚，故心气抑），味过于甘，心气喘满，色黑，肾气不衡（甘归土味，过食则缓滞
上焦，故心气喘满。甘从土化，土胜则水病，故黑色见而肾气不衡矣。衡，平也），味过于苦，脾气不濡，胃气乃
浓（苦味太过，则心伤而脾失其养，且苦者性燥，故不濡也。《五味论》曰∶苦入于胃，谷气不能
胜苦，苦入下脘，三焦之道闭而不通，故变呕。可见苦寒损中，令脾之正气不濡，胃之邪气乃浓。浓者，胀满
之类也）；味过于辛，筋脉沮弛，精神乃央（味过于辛，则肺气乘肝，肝主筋，故筋脉沮弛。辛味多散，则精
耗神伤，故曰央。央当作殃）。
《阴阳别论》曰∶二阳之病发心脾，有不得隐曲，女子不月（阳明为二阳，胃伤而心脾受病者，何也？
脾与胃为夫妻，夫伤则妻亦不利也。心与胃为子母，子伤则母亦不免焉。不得隐曲，阳事病也，胃为水谷气血
之海，化营卫而润宗筋。《厥论》曰∶前阴者，宗筋之所聚，太阴，阳明之所合也。《痿论》曰∶阴阳总宗筋
之会，而阳明为之长。故胃病则阳事衰也。女子不月者，心主血，脾统血，胃为血气之海，三经病而血闭矣），
其传为风消，其传为息贲者，死不治（胃家受病，久而传变，则肝木胜土，风淫而肌体消削，胃病则肺失所养，
故气息奔急。隐曲害者精伤，精伤则火亢乘金，元本败而贼邪兴，死不治矣）。
三阳为病发寒热，下为痈肿，及为痿厥 ，其传为索泽，其传为颓疝（太阳为三阳，属表，故发寒热
与痈肿。足太阳之脉从头下背，贯臀入 ，循 抵足，故足膝无力而痿，逆冷而厥，足肚酸疼而为 。表有
寒热，则润泽之气必皆消索。颓疝者，小腹控引睾丸而痛也）。
一阳发病，少气，善咳，善泄，其传为心掣，其传为隔（少阳为一阳，胆与三焦也。胆属木，三焦属火，
壮火食气，相火刑金，故少气善咳。木旺则侮土，故善泄。三焦火动，则心掣而不宁。胆气乘脾，则隔塞而不
利）。二阳一阴发病，主惊骇、背痛、善噫、善欠，名曰风厥（二阳，胃与大肠也。一阴，肝与心主也，肝胃
二经皆主惊骇，经曰∶东方通于肝，其病发惊骇。又曰足阳明病，闻木音则惕然而惊是也。手阳明之筋皆挟脊，故
背痛，噫，嗳气也，
其主在心。经曰∶上走心为噫者，阴盛而上走于阳明，阳明络属心也。欠虽主于肾，而经云足阳明病为数欠，
则胃亦病欠也。肝主风，心包主火，风热相搏，故病风厥）。二阴一阳发病，善胀、心满、善气（二阴，心
与肾也。一阳，胆与三焦也。胆乘心则胀，肾乘心则满，三焦病则上下不通，故善气）。三阳三阴发病，为偏
枯痿易，四肢不举（三阳，膀胱。小肠也。三阴，脾、肺也，膀胱之脉自头背下行两足，小肠之脉自两手上行
肩胛，且脾主四肢，肺主气，四经俱病，当为偏枯等症。易。变易也。强者，变而为痿也）。
所谓生阳、死阴者，肝之心谓之生阳（得阳则生，失阳则死，故曰生阳、死阴也，自肝传心，以木生火，
得之生气，是谓生阳，不过四日而愈），心之肺谓之死阴（心传肺者，为火克金，故曰死阴，不过三日死），
肺之肾谓之重阴（肺金肾水，虽曰子母相传，而金水俱病，则重阴而阳绝矣）。肾之脾谓之辟阴，死不治（土本
《至真要大论》说：各种风病引起的肢体摇动、头晕眼花，都归属于肝（所谓诸风，是指风病的种类繁多。掉，指肢体摇动。眩，指视物昏花。风木之气善于动摇，所以这是肝脏的病症表现。虽然掉和眩症状相似，但有虚证和实证的差别，不可不仔细辨别）；各种寒病引起的筋脉收缩牵引，都归属于肾（收，指收敛束缚。引，指牵拉拘急。筋脉挛急本来是肝的病症，但归属于肾的原因，一方面是因为肝肾两脏在治法上有相通之处，另一方面是因为肾主寒水之化气，肾气虚弱则阳气不充盛，营气和卫气凝滞不畅，导致肢体挛缩。这就是所说的“寒性使筋脉拘急”）；各种气机郁滞，都归属于肺（这里的“ ”指喘急上逆。“郁”，指痞塞不通。肺主气，气有余者，是本经自伏的火邪；气不足者，则是火邪乘虚侵袭。虚实之分，极易混淆误判，应当精细辨析。近代庸医，一概将其指为肺热而攻伐其有余，造成虚虚之祸，实在令人叹息悲哀）；各种湿病引起的肿胀腹满，都归属于脾（脾主管湿气的运化，又主肌肉，体内受湿气淫溢，肌体出现肿胀腹满，所以归属于脾。土气太过，则湿气盛行，发病急骤；治法应当分消疏导。土气不及，则木气来乘、水气来侮，病情逐渐形成；治法应当培补脾胃。这两种情况都比较容易治疗，如同操刀割物一样简单）；各种热病引起的神志昏闷、抽搐，都归属于火（昏闷称为瞀，抽掣称为螈。邪热损伤心神则出现昏闷，亢盛的阳热损伤血液则出现抽搐。虽然都归属于火，也有虚实之分。朱丹溪说：实火可以用泻法，如黄连之类；虚火可以用补法，如人参之类。真是仁者的言论啊）；各种疼痛、瘙痒、疮疡，都归属于心（热势严重则疮痛，热势轻微则疮痒。心主管热火的气化，所以疼痛、瘙痒等各种疮疡，都归属于心）；各种厥证、二便不通或失禁，都归属于下焦（厥，指气从下部向上逆行。阴气衰于下焦，则为热厥；阳气衰于下焦，则为寒厥。固，指二便不通。阳气虚弱则无气推动，清浊之气不能分化，属于寒证。火盛则水液枯竭，精液干枯，属于热证。泄，指二便失禁。命门火衰则阳气虚弱导致失禁，属于寒证。肾宫水液枯竭则火邪逼迫导致注泄，属于热证。肾开窍于前后二阴，肾主管二便，位居下焦，所以归属于下焦）；各种痿证、气喘、呕吐，都归属于上焦（痿废本应属于下部，却归属于上焦，为什么呢？因为肺热叶焦，发为痿证。气急称为喘，病位在肺。有声无物称为呕，由肺胃共同主管，总属于上焦的病症）；各种口噤、鼓颔战栗，像失去神志主宰一样，都归属于火（禁，即噤，寒厥时切牙咬齿称为噤。鼓，指鼓动下巴。栗，指战栗。寒战而神志不能自主，像失去神志主宰，都是火邪所致。心火亢盛到了极点，反而兼有克制它的那一行的气化表现，这是实火；阳气虚弱阴气盛，卫外之气不足而寒战，这是虚火）；各种痉挛、项部强直，都归属于湿（痉，指风湿导致屈伸不利。项部属于足太阳膀胱经寒水，水即是湿，所以都归属于湿）；各种气机上冲逆上的病症，都归属于火（气喘咳嗽呕吐，气满逆急，都是冲逆的病症。火性炎上，所以都归属于火）；各种胀满、腹部膨大，都归属于热（热气内侵，变为烦闷胀满，所以说都归属于热。近代人执着于这一句话，因而误人无数，难道没听说过经文说：岁水太过，腹胀大腿肿。岁火不及，胁肋胀满腹部膨大。流衍之年，病见胀满。水郁发作，容易胀满。太阳之气胜，腹部胀满。阳明之气复，腹部胀满。又说：适应寒凉而出现胀满。又说：脏腑寒冷产生胀满病。又说：胃中寒冷则胀满。这九种情况，都是说的寒胀。所以李东垣说，大概寒胀多，热胀少，是有根据的）；各种烦躁、狂乱、越常度，都归属于火（躁，指烦躁。狂，指妄乱。越，指像登高而歌之类的行为。火入于肺则烦。火入于肾则躁。又有阴盛导致的烦躁。成无己说：阴躁想坐在井中，只想喝水，却无法入口。李东垣说：阴躁想坐在井中，阳气已经先亡失了，医生如果不醒悟，再用寒药投喂，死亡还有什么可怀疑的呢？所以说内热而躁的，是有邪的热，归属于火；外热而躁的，是无根之火，归属于寒。经文论述狂症屡见不鲜，属于虚寒的有四条，可见狂症也有寒热的辨别）；各种突然发生的强直，都归属于风（暴，指猝然。强，指筋脉强急。直，指身体挺直而不能屈伸。肝主管筋，其气化表现为风，所以说归属于风，并非天外侵入的风邪。内风多燥，如果使用风药则会更加燥烈，所以有“治风先治血，血行风自灭”的说法。轻率使用疏风药则会增加燥性，而且腠理开张，反而招致风邪）；各种病伴有声响，叩击腹部像鼓声一样，都归属于热（有声，指肠鸣。鼓之如鼓，指腹胀。这都是阳气逆乱壅滞，所以说归属于热。这两种症状大多也属于寒证，完全相信经文不如没有书，说的就是这个道理吧）；各种浮肿、疼痛酸楚、惊骇，都归属于火（ 肿，指浮肿。疼酸，是火在经络的表现。惊骇，是火在脏腑的表现。然而浮肿酸痛，属于寒湿的不少；惊骇不宁，属于正气不足的常常很多）；各种转筋反折、小便混浊，都归属于火（转筋挛缩，由燥热引起；小便混浊，因清化功能不及，所以都归属于热。然而寒冷则筋脉拘急，例如冬月严寒，则角弓反张更加强劲。心肾不足，多有便浊。经文说：中气不足，大小便就会发生变化。读者应当通晓这一点即可）；各种水液排泄物，清澈清冷，都归属于寒（清澈清冷，是寒水的本体特征，所以都归属于寒）；各种呕吐酸水、急性腹泻伴里急后重，都归属于热（呕吐逆气，是火炎上的现象。吐酸，是肝木实证。急性腹泻，是火性疾速。里急后重，是火能燥物。这只是阐述常理，虚寒变证，这些症状也常出现，不可不知道）。
按语：经文所说的十九条，是阐述常理。我每次列举其反面的情况，是为了穷尽其变化。王冰（王太仆）深刻明了病机的变化，他的注释疏解，真是《内经》画龙点睛的手笔。启玄子（王冰号）说：如大寒且严重，用热药治疗却不发热，这是无火，应当助心阳。又如大热且严重，用寒药治疗却不退热，这是无水；热动反复停止，忽来忽去，时而动时而止，这是无水，应当助肾阴。内格呕逆，食物无法进入，是有火。病见呕吐并吐出食物，食物吃进去反而吐出，这是无火。暴速腹泻，食物来不及消化，这是无水。溏泄日久，停止和发作没有规律，这是无水。所以心盛则热，肾盛则寒，肾虚则寒动于中，心虚则热收于内。又热不得寒，是无水；寒不得热，是无火。寒之不寒，责任在于无水；热之不热，责任在于无火。热治不久，责任在于心虚；寒治不久，责任在于肾亏。方剂中有用寒药治热，用了寒药却火更盛食物不进；用热药攻寒，用了热药却昏躁产生，这是因为气机不疏通，壅滞而导致这样的结果。我认为王太仆的这段话是岐黄之术的传神之作，经常诵读记忆，并以此勉励志同道合的人。
《生气通天论》说：感受寒邪，阳气应当像门轴一样运转自如，如果起居失常，像受惊一样动荡，神气就会浮越（阳气不固密，四时的邪气就能侵犯它。经文说：冬季三个月，这叫闭藏。水结冰地裂开，不要扰动阳气。又说：冬日寒气深入骨髓，蛰虫严密潜伏，君子居室也要保暖。都在说冬季适宜闭藏。因，指病因。因寒而动者，内部想要心思妄动，像门轴不停转动；外部起居不节制，像受惊气震动，这就与天时相违背，神气不能内敛，都浮越于外了）；感受暑邪，出汗，心烦则气喘喝叫，安静则多言（这是说动而得之，属于中热的证候。炎热蒸腾劳累役使，病属于阳，所以多汗且烦，气高喘喝。即使是感之较轻而安静的，也是精神内乱，言语无条理）；身体像燃烧的炭火一样烫，出汗后热散（这是说静而得之，属于中暑的证候。纳凉饮冷，病属于阴，热气被抑制遏阻，身体像燃烧的炭火，必须得到发汗，阴郁之气才能消散。香薷一味药是夏季发汗的要药，其性温热，只适宜于中暑之人。如果是中热者误服，反而造成大害，世人尚不了解）；感受湿邪，头部像被包裹一样沉重，湿热不除，大筋软短，小筋弛长；软短导致拘挛，弛长导致痿废（土旺于四季之末，发作没有固定时间。首如裹，是湿气伤害导致头面壅重。湿久变成热，必须用药祛除，如果不祛除，则热伤阴血，筋脉得不到滋养，大筋拘急不能伸展，小筋松弛无力）；感受气邪，发生肿胀，四肢交替浮肿，阳气乃衰竭（肺金主气，病因于气，是秋季的邪气。肿，是气化失宜，成为肿胀。四维，指四肢。相代，是说脚肿不能行走，用手代替扶着倚靠。气不能治理，最终归于衰竭）。
阳气，烦劳过度则张弛失调，精气枯竭，积累到夏季，使人发生煎厥（阳春主管生发之气，这是说春季的邪气。气正在生发而烦劳太过，则气张于外，精绝于内。春季邪僻之气，积久不散，到夏季未痊愈，则火旺而真阴如被煎熬，火炎而虚气逆上，所以叫煎厥。按《脉解篇》说肝气失治，易怒的叫煎厥。那么这一节指春令无疑。旧注从未提及，难道不是千虑一得吗）。
大怒则形体和气机断绝，血液郁结于上部，使人发生薄厥（怒气伤肝，肝为血海，怒则气上，气逆则绝，所以血液郁结在上焦，相互逼迫叫薄，气逆叫厥，气血俱乱，所以为薄厥。积聚于上部，势必厥逆而呕吐。薄厥，是气血多而盛的结果）。有伤于筋，松弛，好像不能随意支配（怒伤以至于血厥，则筋得不到滋养，缓纵不收，好像不能容纳支配了）。汗出偏侧，使人发生偏枯（偏，指或左或右，只出一半边。沮，言此既偏出，彼即阻滞。久了则卫气不固，营气失守，应当成为偏枯，即半身不遂）。汗出见湿，乃生痤痱（音锄）（音沸，汗出则毛孔开张，如果用凉水沐浴，就是见湿。留于肤腠，严重的为痤，轻微的为痱。痤，是小疖子。痱，是暑疹）。高粱之变，足生大疔，受邪如持虚器（高粱，即肥甘厚味。变，指病。足，通“易”或指能够。浓味不节制，蓄积为灼热，能生大疔。日积月累，感发最容易，就像拿着空的容器接受东西一样）。劳汗当风，寒薄为 （音渣），郁乃痤（形体劳累汗出，坐卧当风，寒气迫近，津液凝结为 ，即粉刺。如果郁结稍重，就像小疖子，名叫痤）。
开阖不得，寒气从之，乃生大偻（夏天则腠理开而发泄，冬天则腠理闭而闭藏，与时节一起运行。如果该开不开，该闭不闭，不得其宜，被寒气袭击，留在筋络之间，软弱拘急不舒展，形体成为俯偻）。寒气陷入经脉成为鼠瘘，留连于肉腠（陷脉，是寒气从筋络陷入经脉中。 ，指鼠 等属，邪气久不散，则逐渐加深）。俞穴气化薄弱，传变为善畏及惊骇（寒气渐深，从经脉流于经俞，侵及脏腑，所以出现恐惧惊骇）。营气不从，逆于肉理，乃生痈肿（营气行于脉中，邪气陷脉，则营气不从，所以逆于肌肉而生痈肿）。魄汗未尽，形体虚弱而气耗损，穴俞已闭，发为风疟（肺主皮毛，汗之窍也，肺实藏魄，所以叫魄汗。汗出未透，则热郁于内，形气俱烁，俞穴以闭，留止之邪必为风疟）。
春季伤于风邪，邪气留连，乃为洞泄（春季伤于风，则肝木侮土，所以为洞泄）；夏季伤于暑邪，秋季为 疟（夏季伤于暑，伏而不发，秋气收束，寒郁为热，所以寒热交争而成 疟。 ，是疟的统称，没有别的含义）；秋季伤于湿邪，气上逆而咳，发为痿厥（土旺于四季之末，秋末也可伤湿，秋气通于肺，湿郁成热，上乘肺金，气逆而咳，叫上逆，是因为湿从下部受的缘故）；冬季伤于寒邪，春季必发温病（冬季伤于寒，寒毒藏于阴分，到春季才发。名为温病，以时令得名。春季不发而至于夏季，就名热病了）。
味道过于酸，肝气以津，脾气乃绝（曲直作酸，是肝的味道。过于食酸，久而增气，木乘土位，脾气乃绝）；味道过于咸，大骨气劳，短肌，心气抑（咸为肾味，过食则伤肾，肾主骨，所以大骨气劳。咸走血，血伤故肌肉短缩，咸从水化，水胜则火囚，所以心气抑）；味道过于甘，心气喘满，色黑，肾气不衡（甘归土味，过食则缓滞上焦，所以心气喘满。甘从土化，土胜则水病，所以黑色见而肾气不衡矣。衡，平也）；味道过于苦，脾气不濡，胃气乃浓（苦味太过，则心伤而脾失其养，且苦者性燥，所以不濡也。《五味论》说：苦入于胃，谷气不能胜苦，苦入下脘，三焦之道闭而不通，所以变呕。可见苦寒损中，令脾之正气不濡，胃之邪气乃浓。浓者，胀满之类也）；味道过于辛，筋脉沮弛，精神乃央（味过于辛，则肺气乘肝，肝主筋，所以筋脉沮弛。辛味多散，则精耗神伤，所以曰央。央当作殃）。
《阴阳别论》说：二阳的病发于心脾，有不得隐曲，女子不月（阳明为二阳，胃伤而心脾受病，为什么呢？脾与胃为夫妻，夫伤则妻亦不利。心与胃为子母，子伤则母亦不免焉。不得隐曲，指阳事病也，胃为水谷气血之海，化营卫而润宗筋。《厥论》说：前阴者，宗筋之所聚，太阴、阳明之所合也。《痿论》说：阴阳总宗筋之会，而阳明为之长。所以胃病则阳事衰也。女子不月者，心主血，脾统血，胃为血气之海，三经病而血闭矣），其传为风消，其传为息贲者，死不治（胃家受病，久而传变，则肝木胜土，风淫而肌体消削，胃病则肺失所养，故气息奔急。隐曲害者精伤，精伤则火亢乘金，元本败而贼邪兴，死不治矣）。
三阳为病发寒热，下为痈肿，及为痿厥 ，其传为索泽，其传为颓疝（太阳为三阳，属表，故发寒热与痈肿。足太阳之脉从头下背，贯臀入 ，循 抵足，故足膝无力而痿，逆冷而厥，足肚酸疼而为 。表有寒热，则润泽之气必皆消索。颓疝者，小腹控引睾丸而痛也）。
一阳发病，少气，善咳，善泄，其传为心掣，其传为隔（少阳为一阳，胆与三焦也。胆属木，三焦属火，壮火食气，相火刑金，故少气善咳。木旺则侮土，故善泄。三焦火动，则心掣而不宁。胆气乘脾，则隔塞而不利）。二阳一阴发病，主惊骇、背痛、善噫、善欠，名曰风厥（二阳，胃与大肠也。一阴，肝与心主也，肝胃二经皆主惊骇，经曰：东方通于肝，其病发惊骇。又曰足阳明病，闻木音则惕然而惊是也。手阳明之筋皆挟脊，故背痛，噫，嗳气也，其主在心。经曰：上走心为噫者，阴盛而上走于阳明，阳明络属心也。欠虽主于肾，而经云足阳明病为数欠，则胃亦病欠也。肝主风，心包主火，风热相搏，故病风厥）。二阴一阳发病，善胀、心满、善气（二阴，心与肾也。一阳，胆与三焦也。胆乘心则胀，肾乘心则满，三焦病则上下不通，故善气）。三阳三阴发病，为偏枯痿易，四肢不举（三阳，膀胱。小肠也。三阴，脾、肺也，膀胱之脉自头背下行两足，小肠之脉自两手上行肩胛，且脾主四肢，肺主气，四经俱病，当为偏枯等症。易。变易也。强者，变而为痿也）。
所谓生阳、死阴者，肝之心谓之生阳（得阳则生，失阳则死，故曰生阳、死阴也，自肝传心，以木生火，得之生气，是谓生阳，不过四日而愈），心之肺谓之死阴（心传肺者，为火克金，故曰死阴，不过三日死），肺之肾谓之重阴（肺金肾水，虽曰子母相传，而金水俱病，则重阴而阳绝矣）。肾之脾谓之辟阴，死不治（土本
The *Zhi Zhen Yao Da Lun* (Treatise on the Most Essential and Demanding Aspects of Truth) states: All wind disorders characterized by tremors and dizziness belong to the Liver (Gan). "All wind" refers to the various types of wind diseases. "Diao" means trembling or shaking. "Xuan" means blurred vision or vertigo. The Wood element associated with Wind is prone to movement, so these are manifestations of Liver pathology. Although tremors and dizziness may appear similar, they must be carefully differentiated into deficiency and excess patterns.
All cold disorders characterized by contraction and pulling belong to the Kidney (Shen). "Shou" means constriction or gathering. "Yin" means pulling or tugging. While spasms and contractures of sinews and vessels are primarily Liver issues, their attribution to the Kidney arises from two reasons: first, the treatment principles for the Liver and Kidney often overlap; second, the Kidney governs the transformation of Cold Water. When Kidney Qi is deficient, Yang Qi fails to充盈 (fill/permeate), causing Ying (Nutrient) and Wei (Defensive) Qi to stagnate, leading to limb spasms. This illustrates the principle that "Cold causes sinew stiffness."
All Qi disorders characterized by obstruction and stagnation belong to the Lung (Fei). The character here denotes panting or rebellious upward flow of Qi. "Yu" means blockage or stuffiness. The Lung governs Qi. An excess of Qi stems from latent Fire within the meridian itself; a deficiency of Qi allows pathogenic Fire to invade. The distinction between deficiency and excess is easily confused and requires precise differentiation. Modern mediocre physicians generally attribute this to Lung Heat and attack the excess, causing the disaster of "deficiency inducing deficiency," which is lamentable.
All dampness disorders characterized by edema and fullness belong to the Spleen (Pi). The Spleen governs the transformation of Dampness and controls the muscles. Internal invasion by excessive Dampness causes bodily swelling and abdominal distension, hence its attribution to the Spleen. If Earth Qi is excessive, Dampness prevails, and disease strikes suddenly; the method should be to disperse and drain. If Earth Qi is insufficient, Wood overacts and Water insults, and disease develops gradually; the method should be to tonify. Both are relatively easy to treat, like cutting with a sharp blade.
All heat disorders characterized by stupor and convulsions belong to Fire. "Mao" refers to mental cloudiness or stupor. "Chou" refers to convulsions or twitching. Pathogenic Heat damaging the Spirit causes stupor; hyperactive Yang damaging Blood causes convulsions. Although both belong to Fire, there are deficiency and excess distinctions. Zhu Danxi said: Excess Fire can be purged using herbs like Coptis Chinensis Rhizoma (Huanglian); Deficient Fire can be tonified using herbs like Ginseng Radix et Rhizoma (Renshen). These are words of a benevolent person.
All pain, itching, and sores belong to the Heart (Xin). Severe Heat causes sore pain; mild Heat causes itching. The Heart governs the transformation of Hot Fire, so all pain, itching, and sores belong to the Heart.
All Jue syndromes, retention, and incontinence belong to the Lower Jiao. "Jue" refers to Qi reversing upward from below. Yin deficiency in the lower Jiao leads to Heat Jue; Yang deficiency in the lower Jiao leads to Cold Jue. "Gu" refers to retention of urine and feces. Yang deficiency results in lack of Qi, preventing the separation of clear and turbid, indicating Cold. Excessive Fire depletes Water, drying up essence and fluids, indicating Heat. "Xie" refers to incontinence. Decline of Mingmen Fire leads to Yang deficiency and incontinence (Cold). Depletion of Kidney Water leads to Fire forcing leakage (Heat). The Kidney opens into the two yin orifices and governs urination and defecation, residing in the lower Jiao.
All Wei syndromes, asthma, and vomiting belong to the Upper Jiao. Why does Wei (flaccidity), typically associated with the lower body, belong to the Upper? Because Lung Heat scorches the leaves, leading to Wei syndrome. "Chuan" (asthma/panting) indicates pathology in the Lung. "Ou" (vomiting without substance) is governed by the Lung and Stomach, collectively representing Upper Jiao disorders.
All conditions involving locked jaws, shivering chattering teeth, and tremors, resembling a loss of spiritual control, belong to Fire. "Jin" is synonymous with "Jin" (locked jaw), occurring in Cold Jue when teeth are clenched. "Gu" refers to shivering of the jaw. "Li" refers to tremors. Shivering with loss of spiritual mastery is caused by Fire. Hyperactive Heart Fire may manifest as the transformation of the overcoming element, indicating Excess Fire. Yang deficiency with Yin excess, failing to defend the exterior, causes shivering, indicating Deficient Fire.
All spasms and neck stiffness belong to Dampness. "Jing" refers to wind-damp causing difficulty in flexion and extension. The neck belongs to the Foot Taiyang Bladder Meridian of Cold Water; Water is Dampness, so these belong to Dampness.
All rebellious upward rushing Qi belongs to Fire. Asthma, cough, vomiting, abdominal fullness, and urgent reversal are all rebellious symptoms. Fire has a nature of flaming upward, so these belong to Fire.
All distension and abdominal enlargement belong to Heat. Internal invasion by Heat Qi transforms into vexation and fullness, hence "belonging to Heat." However, modern practitioners who rigidly apply this rule have harmed countless patients. Have they not read: "When Water Qi is excessive, abdominal distension and leg swelling occur"? "When Fire Qi is insufficient, hypochondriac fullness and abdominal distension occur"? In years of Liu Yan, distension occurs. When Water is depressed, distension is common. When Taiyang prevails, abdominal fullness occurs. When Yangming rebounds, abdominal distension occurs. It also says: "Distension arises from adapting to cold." "Internal cold generates fullness diseases." "Cold in the Stomach causes distension." These nine instances all describe Cold distension. Thus, Li Dongyuan stated that Cold distension is more common than Heat distension, which is well-founded.
All restlessness, mania, and transgression of norms belong to Fire. "Zao" is restlessness. "Kuang" is madness/confusion. "Yue" refers to behaviors like singing while climbing high. Fire entering the Lung causes vexation; Fire entering the Kidney causes restlessness. There is also restlessness caused by Yin excess. Cheng Wuji said: "Yin restlessness desires sitting in a well, wanting to drink but unable to swallow." Li Dongyuan said: "Yin restlessness desires sitting in a well; Yang has already perished. If doctors do not realize this and administer cold medicines, death is inevitable." Therefore, internal heat with restlessness is pathogenic Heat belonging to Fire; external heat with restlessness is rootless Fire belonging to Cold. The Classics frequently discuss mania, with four cases attributed to deficiency-cold, proving mania must be differentiated by heat and cold.
All sudden stiffness and rigidity belong to Wind. "Bao" means sudden. "Qiang" means sinew stiffness. "Zhi" means straight body unable to flex or extend. The Liver governs sinews and its transformation is Wind, so it belongs to Wind, not exogenous Wind. Internal Wind is often dry; using wind-dispersing agents increases dryness. Hence the saying: "To treat Wind, first nourish Blood; when Blood moves, Wind extinguishes itself." Light use of wind-dispersing agents increases dryness and opens pores, inviting Wind.
All diseases with sounds, where percussion yields a drum-like sound, belong to Heat. "You sheng" refers to borborygmus (intestinal rumbling). "Gu zhi ru gu" refers to abdominal distension. These result from rebellious and obstructed Yang Qi, hence belonging to Heat. However, many such cases belong to Cold. Blind faith in texts is worse than having no books at all.
All edema, pain, soreness, fright, and alarm belong to Fire. Edema is swelling. Pain and soreness indicate Fire in the meridians. Fright and alarm indicate Fire in the zang organs. However, edema and soreness are often due to Cold-Damp; fright and unrest are often due to deficiency.
All tendon twisting, opisthotonos, and turbid urine belong to Fire. Tendon twisting and spasms are caused by dryness-heat. Turbid urine results from inadequate clearing and transforming functions, hence belonging to Heat. However, Cold causes sinew stiffness, like the severe rigidity of opisthotonos in winter. Kidney and Heart deficiency often cause turbid urine. The Classic states: "Deficiency of Middle Qi causes changes in urination and defecation." Readers should understand this.
All body fluids that are clear, transparent, and cold belong to Cold. Clear and cold fluids are the natural state of Cold Water, hence belonging to Cold.
All vomiting, acid regurgitation, acute diarrhea, and tenesmus belong to Heat. Vomiting and rebellion reflect the flaming nature of Fire. Acid regurgitation reflects Excess of Liver Wood. Acute diarrhea reflects the speed of Fire. Tenesmus reflects Fire's drying nature. This describes the norm; however, deficiency-cold variations often present these symptoms and must be recognized.
Note: The nineteen clauses in the Classic describe the norm. I cite the exceptions to exhaust the variations. Wang Bing (Wai Po) deeply understood the variability of pathogenesis; his annotations are truly the finishing touch on the *Neijing*. Qixuanzi (Wang Bing's pseudonym) said: "If severe cold does not respond to hot therapy, there is no Fire; one must assist Heart Yang. If severe heat does not respond to cold therapy, there is no Water; if heat fluctuates rapidly, stopping and starting intermittently, there is no Water; one must assist Kidney Yin. Internal blockage with vomiting and inability to eat indicates Fire. Vomiting and regurgitating food after eating indicates no Fire. Sudden profuse diarrhea with undigested food indicates no Water. Chronic loose stools with irregular onset and cessation indicate no Water. Thus, Heart excess causes Heat; Kidney excess causes Cold. Kidney deficiency causes internal Cold movement; Heart deficiency causes internal Heat retention. Heat cannot be cooled by cold alone if there is no Water; Cold cannot be warmed by heat alone if there is no Fire. Failure to cool heat blames Water deficiency; failure to warm cold blames Fire deficiency. Short-lived effect of heat therapy blames Heart deficiency; short-lived effect of cold therapy blames Kidney insufficiency. Formulas using cold to treat heat may fail if Fire consumes intake; formulas using heat to attack cold may cause confusion and restlessness if Qi is not unobstructed and stagnation persists. I consider Wang Taipu's words a divine transmission of Qi and Huang, often reciting them and encouraging colleagues."
The *Sheng Qi Tong Tian Lun* (Treatise on Vital Energy Communicating with Heaven) states: Due to Cold, [Yang Qi] should move like a door pivot; if daily activities are erratic like being startled, Shen Qi will float outward (Yang Qi is not secure, allowing seasonal pathogens to invade. The Classic says: The three months of Winter are called 'Closing and Storage.' Ice forms on water, earth cracks; do not disturb Yang. It also says: In Winter, cold reaches the bones, insects hibernate closely, and gentlemen keep warm indoors. All emphasize Winter suitability for storage. 'Yin' here means etiology. Movement due to Cold involves internal妄动 (wild movement) like an unceasing pivot, and external irregular起居 (daily life) like startling qi. This contradicts heavenly timing, preventing Shen Qi from inward storage, causing it to float outward).
Due to Summer-Heat, sweating occurs; if vexed, there is panting and loud breathing; if quiet, there is excessive talking (This describes 'obtained through activity,' a sign of Zhong Re [Middle Heat]. Scorching labor causes Yang pathology, leading to sweating and vexation, high Qi, and panting. Even mild cases that remain quiet suffer internal spiritual chaos and incoherent speech).
Body feels like burning charcoal; sweating disperses the heat (This describes 'obtained through rest,' a sign of Zhong Shu [Summer Stroke]. Seeking coolness and drinking cold makes the pathology Yin-type. Heat is suppressed and constrained, making the body feel like burning charcoal. Sweating is required to dissipate the Yin depression. Moslae Herba (Xiangru) is a key diaphoretic for Summer, being warm and hot in nature, suitable only for Summer Stroke. Misuse in Middle Heat causes great harm, unknown to the world).
Due to Dampness, the head feels wrapped/heavy; if Damp-Heat is not removed, large sinews become soft and short, small sinews become lax and long; soft/short leads to constraint, lax/long leads to flaccidity (Earth prospers at the end of each season, with unpredictable onset. 'Head wrapped' means Damp injury causes heaviness in head and face. Long-standing Damp turns to Heat; medication is needed to remove it. If not removed, Heat injures Yin Blood, depriving sinews of nourishment. Large sinews become contracted and unable to extend; small sinews become lax and weak).
Due to Qi disorders, swelling occurs; if the four limbs take turns swelling, Yang Qi is exhausted (Lung Metal governs Qi; Qi disorders are Autumn pathogens. Swelling results from improper Qi transformation. 'Si wei' refers to the four limbs. 'Xiang dai' means feet swell and cannot walk, so hands are used for support. Qi fails to regulate, ultimately leading to exhaustion).
Yang Qi, when subjected to excessive mental/physical labor, becomes hyperactive; essence is depleted. Accumulating into Summer causes Jian Jue (Frying Jue) (Spring governs generating Qi. This describes Spring pathogens. If Qi is generating but labor is excessive, Qi expands outward, essence depletes inward. Spring pathogenic Qi accumulates; if unresolved by Summer, Fire becomes hyperactive, frying True Yin, and Fire flares with rebellious Xu Qi, called Jian Jue. According to *Mai Jie Pian*, Liver Qi dysfunction with irritability is called Jian Jue, confirming this refers to Spring. Old commentaries missed this, perhaps a gain from thousand reflections).
Great anger causes form and Qi to sever; Blood stagnates above, causing Bo Jue (Thinning Jue) (Anger injures Liver; Liver is the Sea of Blood. Anger causes Qi to rise; rebellious Qi severs connection, causing Blood to stagnate in the Upper Jiao. Mutual pressure is 'Bo'; Qi rebellion is 'Jue'. Blood and Qi chaos causes Bo Jue. Accumulation above inevitably leads to Jue and vomiting. Bo Jue represents abundant and excessive Blood/Qi).
Injury to sinews causes flaccidity, as if uncontrollable (Anger injuring to Blood Jue deprives sinews of nourishment, causing relaxation and inability to hold posture).
Sweating on one side only causes Pi Ku (Hemiplegia) (Pi means left or right, sweating on half the body. Ju means blockage on the other side. Prolonged, Wei Qi becomes insecure, Ying Qi loses control, leading to Pi Ku, i.e., hemiplegia).
Sweating exposed to dampness produces Cuo Fei (Acne and Prickly Heat) (When sweating, pores open; bathing in cold water constitutes exposure to dampness. Retention in skin/fascia causes Cuo (severe) or Fei (mild). Cuo is a small boil; Fei is summer prickly heat).
Excessive consumption of rich foods leads to large Ding (Carbuncles); susceptibility is like holding an empty vessel (Gao Liang refers to fatty/sweet foods. Bian means disease. Zu implies ability/ease. Unregulated rich flavors accumulate as scorching heat, easily generating large carbuncles. Over time, infection is easy, like receiving objects in an empty vessel).
Labor-induced sweat exposed to wind: Cold pressing creates Za (Pimples); stagnation leads to Cuo (Acne) (Physical labor with sweat, sitting/lying in wind, Cold presses, condensing fluids into Za (pimples). If stagnation worsens, it resembles small boils, named Cuo).
Failure of opening/closing allows Cold Qi to enter, producing Da Lou (Severe Kyphosis) (Summer pores open for release; Winter pores close for storage, following seasons. If opening/closing is inappropriate, Cold attacks, lodging in sinews/vessels, causing weakness/stiffness and kyphotic posture).
Cold sinking into vessels creates Shu Lou (Scrofula); lingering in flesh-fascia (Xian Mai means Cold sinking from sinews into vessels. Shu Lou refers to scrofula-like conditions. Persistent pathogen deepens).
Shu acupoint Qi transformation weakens, transmitting to fear and fright (Deepening Cold flows from vessels to meridians/acupoints, invading zang-fu, causing fear and fright).
Ying Qi does not follow course, rebels in muscle tissue, producing Yong Zhong (Abscess/Swelling) (Ying Qi runs in vessels. Pathogen sinking into vessels disrupts Ying Qi, causing rebellion in flesh and abscess formation).
Incomplete魄汗 (Po Han - Sweat governed by Lung/Hun), physical weakness, Qi depletion, acupoints closed, developing Feng Nue (Wind Malaria) (Lung governs skin/hair, pores of sweat. Lung stores Po, hence Po Han. Incomplete sweating traps Heat internally, consuming form and Qi, closing acupoints. Retained pathogen becomes Wind Malaria).
Spring injury by Wind, pathogen lingers, causing Dong Xie (Profuse Diarrhea) (Spring Wind injures Liver Wood, insulting Earth, causing profuse diarrhea).
Summer injury by Summer-Heat, Autumn develops Nu E Nue (Intermittent Fever/Malaria) (Summer Summer-Heat lies dormant; Autumn收束 (consolidation) traps Cold turning to Heat, causing alternating chills and fever. Nu E is a general term for malaria).
Autumn injury by Dampness, Qi rebels upward causing cough, developing Wei Jue (Flaccidity-Jue) (Earth prospers late in seasons; late Autumn Damp injury affects Lung. Damp turns to Heat, attacking Lung Metal, causing rebellious cough. 'Upward' because Damp enters from below).
Winter injury by Cold, Spring必然 Wen Bing (Warm Disease) (Winter Cold toxin hides in Yin divisions, emerging in Spring as Warm Disease, named by season. If emerging in Summer, it is called Heat Disease).
Taste overly sour: Liver Qi overflows, Spleen Qi perishes (Sour corresponds to Liver Wood. Excess sour intake increases Wood Qi, insulting Earth, destroying Spleen Qi).
Taste overly salty: Great bones Qi labors, muscles shorten, Heart Qi depressed (Salty corresponds to Kidney Water. Excess salts injure Kidneys; Kidneys govern bones, causing bone Qi labor. Salty enters Blood; blood injury shortens muscles. Water overacting confines Fire, depressing Heart Qi).
Taste overly sweet: Heart Qi pants/full, complexion black, Kidney Qi unbalanced (Sweet corresponds to Earth. Excess sweet causes stagnation in Upper Jiao, Heart Qi panting/full. Earth overacting injures Water, causing black complexion and Kidney Qi imbalance. Heng means balance).
Taste overly bitter: Spleen Qi not moistened, Stomach Qi becomes dense/thick (Excess bitter injures Heart, depriving Spleen. Bitter is dry, thus Spleen not moistened. *Wu Wei Lun* states: Bitter enters stomach, Grain Qi cannot overcome it, blocking Sanjiao pathways, causing vomiting. Bitter-Cold damages Middle, Spleen Zheng Qi not moistened, Stomach Xie Qi becomes dense (fullness)).
Taste overly pungent: Sinews/vessels flaccid, Spirit/Essence damaged (Excess pungent allows Lung Metal to insult Liver; Liver governs sinews, causing flaccidity. Pungent disperses,耗 Jing Shang Shen (depleting Essence damaging Spirit). Yang means disaster).
The *Yin Yang Bie Lun* (Treatise on Differentiating Yin and Yang) states: Diseases of Er Yang (Stomach/Large Intestine) originate in Xin Pi (Heart/Spleen), featuring hidden difficulties, women missing menstruation (Yangming is Er Yang. Stomach injury affects Heart/Spleen. Spleen/Stomach are husband/wife; husband injured, wife suffers. Heart/Stomach are mother/son; son injured, mother affected. 'Hidden difficulties' refers to sexual dysfunction. Stomach is Sea of Water/Grain, generating Ying/Wei, moistening Zong Jin. *Jue Lun*: Anterior yin is gathering of Zong Jin, combining Taiyin/Yangming. *Wei Lun*: Yin-Yang gather at Zong Jin, Yangming leads. Stomach disease causes sexual decline. Women's amenorrhea: Heart governs Blood, Spleen controls Blood, Stomach is Sea of Blood/Qi. Three meridians diseased, Blood closes).
Transmission to Feng Xiao (Wind Emaciation) or Xi Ben (Breath Rush) indicates death, untreatable (Stomach disease transmits over time; Liver Wood insults Earth, Wind emaciates muscles. Stomach disease deprives Lung of nourishment, causing breath urgency. Hidden injury damages Essence; Essence damage allows Fire to insult Metal, Yuan Ben fails, Zevil rises, death is inevitable).
San Yang (Bladder/Small Intestine) diseases present with chills/fever, lower body abscesses, Wei Jue (Flaccidity/Jue), transmitting to Su Ze (Loss of Luster) or Tui Shan (Genital Hernia) (Taiyang is San Yang, exterior, causing chills/fever/abscesses. Foot Taiyang meridian descends back/buttocks to foot; weakness/cold/pain in calves causes Wei/Jue. Exterior chills/fever deplete lubricating Qi. Tui Shan is lower abdominal pain radiating to testicles).
Yi Yang (Gallbladder/Sanjiao) onset: Shortness of Qi, frequent cough, frequent diarrhea, transmitting to Xin Che (Heart Palpitation/Tugging) or Ge (Regurgitation/Blockage) (Shaoyang is Yi Yang. Gallbladder Wood, Sanjiao Fire. Vigorous Fire consumes Qi, Minister Fire insults Metal, causing shortness of Qi/cough. Wood insults Earth, causing diarrhea. Sanjiao Fire agitates Heart (Che). Gallbladder Qi insults Spleen, causing blockage).
Er Yang (Stomach/Large Intestine) and Yi Yin (Liver/Pericardium) onset: Fright/back pain, belching, yawning, named Feng Jue (Wind Jue) (Er Yang: Stomach/Large Intestine. Yi Yin: Liver/Pericardium. Both govern fright. Classic: East connects to Liver, disease starts with fright. Yangming disease fears wood sounds. Hand Yangming tendons flank spine, causing back pain. Belching originates in Heart. Classic: Upward movement to Heart causes belching; Yin excess moves to Yangming, connecting to Heart. Yawning mainly Kidney, but Yangming disease causes yawning too. Liver governs Wind, Pericardium Fire; Wind-Heat clash causes Feng Jue).
Er Yin (Heart/Kidney) and Yi Yang (Gallbladder/Sanjiao) onset: Distension, chest fullness, sighing (Er Yin: Heart/Kidney. Yi Yang: Gallbladder/Sanjiao. Gallbladder insults Heart causing distension; Kidney insults Heart causing fullness. Sanjiao disease blocks upper/lower, causing sighing).
San Yang (Bladder/Small Intestine) and San Yin (Spleen/Lung) onset: Hemiplegia, flaccidity changes, limbs immobile (San Yang: Bladder/Small Intestine. San Yin: Spleen/Lung. Bladder meridian descends to feet; Small Intestine ascends to shoulders. Spleen governs limbs, Lung governs Qi. Four meridians diseased cause hemiplegia etc. Yi means change. Strength changes to flaccidity).
Regarding Sheng Yang (Life Yang) and Si Yin (Death Yin): Liver to Heart is Sheng Yang (Wood generates Fire, gaining Life Qi, heals in 4 days). Heart to Lung is Si Yin (Fire insults Metal, dies in 3 days). Lung to Kidney is Chong Yin (Heavy Yin, Metal/Water both diseased, Yang severed). Kidney to Spleen is Bi Yin (Reversed Yin), death, untreatable (Earth originally...