病得其因治之方效若论病而不论其所以病总属伪造一概不录
阴阳者天地之道也万物之纲纪变化之父母生杀之本始神明之府也治病必求其本故积阳为天积阴为地阴静阳躁阳生阴
长阳杀阴藏阳化气阴成形寒极生热热极生寒寒气生浊热气生清清气在下则生飧泄浊气在上则生 胀此阴阳反作病之逆从
也故清阳为天浊阴为地地气上为云天气下为雨雨出地气云出天气故清阳出上窍浊阴出下窍清阳发腠理浊阴走五脏清阳实
四肢浊阴归六腑水为阴火为阳阳为气阴为味味归形形归气气归精精归化精食气形食味化生精气生形味伤形气伤精精化为
气气伤于味阴味出下窍阳气出上窍味浓者为阴薄为阴之阳气浓者为阳薄为阳之阴味浓则泄薄则通气薄则发泄浓则发热壮
火之气衰少火之气壮壮火食气气食少火壮火散气少火生气气味辛甘发散为阳酸苦涌泄为阴阴胜则阳病阳胜则阴病阳胜则
热阴胜则寒重寒则热重热则寒寒伤形热伤气气伤痛形伤肿风胜则动热胜则肿燥胜则干寒胜则浮湿胜则濡泻天有四时五行
以生长收藏以生寒暑燥湿风人有五脏化五气以生喜怒悲忧恐故喜怒伤气寒暑伤形暴怒伤阴暴喜伤阳厥气上行满脉去形喜
怒不节寒暑过度生乃不固故重阴必阳重阳必阴故曰冬伤于寒春必病温春伤于风夏生飧泄夏伤于暑秋必 疟秋伤于湿冬生
咳嗽东方生风风生木木生酸酸生肝肝生筋筋生心肝主目其在天为元在人为道在地为化化生五味道生智元生神神在天为风
在地为木在体为筋在脏为肝在色为苍在音为角在声为呼在变动为握在窍为目在味为酸在志为怒怒伤肝悲胜怒风伤筋燥胜
风酸伤筋辛胜酸南方生热热生火火生苦苦生心心生血血生脾心主舌其在天为热在地为火在体为脉在脏为心在色为赤在音
为征在声为笑在变动为忧在窍为舌在味为苦在志为喜喜伤心恐胜喜热伤气寒胜热苦伤气咸胜苦中央生湿湿生土土生甘甘
生脾脾生肉肉生肺脾主口其在天为湿在地为土在体为肉在脏为脾在色为黄在音为宫在声为歌在变动为哕在窍为口在味为
甘在志为思思伤脾怒胜思 湿伤肉风胜湿甘伤肉酸胜甘西方生燥燥生金金生辛辛生肺肺生皮毛皮毛生肾肺主鼻其在天为
燥在地为金在体为皮毛在脏为肺在色为白在音为商在声为哭在变动为咳在窍为鼻在味为辛在志为忧忧伤肺喜胜忧热伤皮
毛寒胜热辛伤皮毛苦胜辛北方生寒寒生水水生咸咸生肾肾生骨髓髓生肝肾主耳其在天为寒在地为水在体为骨在脏为肾在
色为黑在音为羽在声为呻在变动为栗在窍为耳在味为咸在志为恐恐伤肾思胜恐寒伤血燥胜寒咸伤血甘胜咸故曰天地者万
物之上下也阴阳者血气之男女也左右者阴阳之道路也水火者阴阳之征兆也阴阳者万物之能始也故曰阴在内阳之守也阳在
外阴之使也天不足西北故西北方阴也而人右耳目不如左明也地不满东南故东南方阳也而人左手足不如右强也天气通于肺
地气通于嗌风气通于肝雷气通于心谷气通于脾雨气通于肾阳之汗以天地之雨名之阳之气以天地之疾风名之暴气象雷逆气
象阳形不足者温之以气精不足者补之以味其高者因而越之其下者引而竭之中满者泻之于内其有邪者渍形以为汗其在皮者
汗而发之其 悍者按而收之其实者散而泻之审其阴阳以别柔刚阳病治阴阴病治阳定其血气各守其乡血实宜决之气虚宜掣
引之（阴阳大论）
（彭）按壮火亢阳也少火微阳也旧作君相解欠稳又按仲景伤寒论自叙云撰用素问九卷八十一难阴阳大论胎胪药录四
种而不及灵枢今胎胪药录不少概见而阴阳大论一书并入素问内后人循名而论自然素问是真灵枢是假及细读之素问内不乏
浅陋之语而灵枢中亦有神化之言要之灵枢即从素问内分出无疑
夫天以阴阳五行化生万物气以成形而理亦赋焉故天食人以五气五气偏胜则病地食人以五味五味偏胜则病患具五志五
志偏用则病病变千端总不能外此而生其治之之法不过以所胜平之真所谓要言不烦入理最深者也此本是专书并非素问中一
论旦夕咀含至味乃出
太阴阳明为表里脾胃是也生病而异何也曰阴阳异位更虚更实更逆更从或从内或从外所从不同故病异名也阳者天气也
主外阴者地气也主内阳道实阴道虚故犯贼风虚邪者阳受之食饮不节起居不时者阴受之阳受之则入六腑阴受之则入五脏入
六腑则身热不时卧上为喘呼入五脏则 满闭塞下为飧泄久为肠 喉主天气咽主地气阳受风气阴受湿气阴气从足上行至头
而下行循臂至指端阳气从手上行至头而下行至足故阳病者上行极而下阴病者下行极而上伤于风者上先受之伤于湿者下先
受之脾病而四肢不用何也曰四肢皆禀气于胃而不得至经必因于脾乃得禀也今脾病不能为胃行其津液四肢不得禀水谷气气
日以衰脉道不利筋骨肌肉皆无气以生故不用焉脾不主时何也曰脾者土也治中央常以四时长四脏各十八日寄治不得独主于
时也脾与胃以膜相连耳而能为之行其津液何也曰足太阴者三阴也其脉贯胃属脾络嗌故太阴为之行气于三阴阳明者表也五
脏六腑之海也亦为之行气于三阳脏腑各因其经而受气于阳明故为胃行其津液（素太阴阳明论）
仲景论中阳明病欲作痼瘕是阳明转太阴也转属阳明是太阴转阳明也与篇中更实更虚之说正自相符可信此为仲景所读
之真经也
东垣一生得力处全在此篇
三阴三阳明明指十二经言也但经脉自手太阴交手阳明手阳明交足阳明足阳明交足太阴阴阳相贯如环无端断无越阴而
专行三阳越阳而专行三阴之理未段问答疑系后人所续
又按神农本经有健脾二字而素问灵难缺焉不讲（彭）偶 见蜂之酿蜜日则取花置窠夜则张翅扇之薨薨有声花遂成
蜜
因想脾在胃外其中央以膜连胃两旁悬空如翅时时鼓扇以助胃底真阳熏蒸消谷则所谓健者乃动而不息之意也此第率臆而谈
尚未知有当否
今夫热病者皆伤寒之类也或愈或死其死皆以六七日之间其愈皆以十日以上者何也曰巨阳者诸阳之属也其脉连于风府
故为诸阳主气也人之伤于寒也则为病热热虽甚不死其两感于寒而病者必不免于死伤寒一日巨阳受之故头项痛腰脊强二日
阳明受之阳明主肉其脉挟鼻络于目故身热目痛而鼻干不得卧也三日少阳受之少阳主胆其脉循胁络于耳故胸胁痛而耳聋三
阳经络皆受其病而未入于脏者故可汗而已四日太阴受之太阴脉布胃中络于嗌故腹满而嗌干五日少阴受之少阴脉贯肾络于
肺系舌本故口燥舌干而渴六日厥阴受之厥阴脉循阴器而络于肝故烦满而囊缩三阴三阳五脏六腑皆受病荣卫不行五脏不通
则死矣其不两感于寒者七日巨阳病衰头痛少愈八日阳明病衰身热少愈九日少阳病衰耳聋微闻十日太阴病衰腹减如故则思
饮食十一日少阴病衰渴止不满舌干已而嚏十二日厥阴病衰囊
纵少腹微下大气皆去病日已矣治之各通其藏脉病日衰已矣其未满三日者可汗而已其满三日者可泄而已病热少愈食肉
则复多食则遗此其禁也
两感于寒者病一日则巨阳与少阴俱病则头痛口干而烦满二日阳明与太阴俱病则腹满身热不欲食
谵言三日少阳与厥阴俱病则耳聋囊
缩而厥水浆不入不知人六日死五脏已伤六腑不通荣卫不行如是之后三日乃死何也曰阳明者十二经脉之长也其血气盛
故不知人三日其气乃尽凡病伤寒而成温者先夏至日者为病温后夏至日者为病暑暑与汗皆出勿止（素热论）
此论热病也伤寒有五热病乃其一耳余俱散失（彭）
将难经补之具诊集中
夫 疟皆生于风其蓄作有时者何也曰疟之始发也先起于毫毛伸欠乃作寒栗鼓颔腰脊俱痛寒去则内外皆热头痛如破渴
欲冷冻饮料何气使然曰阴阳上下交争虚实更作阴阳相移也阳并于阴则阴实而阳虚阳明虚则寒栗鼓颔也巨阳虚则腰背头项痛三
阳俱虚则阴气胜阴气胜则骨寒而痛寒生于内故中外皆寒阳盛则外热阴虚则内热外内皆热则喘而渴故欲冷冻饮料也此皆得之夏
伤于暑热气盛藏于皮肤之内肠胃之外此营气之所舍也此令人汗空疏腠理开因得秋气汗出遇风及得之以浴水气舍于皮肤之
内与卫气并居卫气者昼日行于阳夜行于阴此气得阳而外出得阴而内薄内外相薄是以日作其气之舍深内薄于阴阳气独发阴
邪内着阴与阳争不得出是以间日而作也其作日晏与其日早者何气使然曰邪气客于风府循膂而下卫气一日一夜大会于风府
其明日日下一节故其作也晏下至 骨其气上行故作日益早也其间日发者由邪气内薄于五脏横连膜原也其道远故间日乃作
也先寒而后热者先伤于寒而后伤于风名曰寒疟先热而后寒者先伤于风而后伤于寒名曰温疟其但热而不寒者阴气先绝阳气
独发则少气烦冤手足热而欲呕名曰瘅疟经云方其盛时必毁因其衰也事必大昌疟之未发也阴未并阳阳未并阴因而调之真气
得安邪气乃亡（素疟论）
风者善行而数变藏于皮肤之间内不得通外不得泄腠理开则洒然寒闭则热而闷其寒也则衰饮食其热也则消肌肉使人
栗而不能食名曰寒热风气与阳明入胃循脉而上至目内 其人肥则风气不得外泄则为热中而目黄人瘦则外泄而寒则为寒中
而泣出风气由太阳而入行诸脉输散于分肉之间与卫气相干其道不利使肌肉愤 而有疡卫气有所凝而不行故其肉有不仁也
风气客于脉而不去营气热 皮肤疡 其气不清使鼻柱坏而色败名曰疠风或名寒热风各从其门户所中则为偏风风气循风府
而上则为脑风风入系头则为目风眼寒饮酒中风则为漏风入房汗出中风则为内风新沐中风则为首风久风入中则为肠风飧泄
外在腠理则为泄风故风者百病之长变化无常也（素风论）
风寒湿三气杂至合而为痹也其风气胜者为行痹寒气胜者为痛痹湿气胜者为着痹也其风气胜者易已其入藏者死（素痹
论）肺热叶焦则皮毛虚弱急薄着则生痿 也心气热则下脉厥而上上则下脉虚虚则生脉痿枢折挈胫纵不任地也肝气热则胆
泄口苦筋膜干筋膜干则筋急而挛发为筋痿脾气热则胃干而渴肌肉不仁发为肉痿肾气热则腰脊不举骨枯而髓减发为骨痿肺
者藏之长为心之盖也所求不得则发肺鸣鸣则肺热叶焦故五脏因肺热叶焦发为痿 也悲哀太甚则胞络绝绝则阳气内动发则
心下崩数溲血也大经空虚发为肌痹传为脉痿思想无穷所愿不得意淫于外入房太甚宗筋弛纵发为筋痿及为白淫生于肝使内
也有渐于湿以水为事肌肉濡渍痹而不仁发为肉痿得之湿地也远行劳倦大热而渴阳气内伐热舍于肾水不胜火骨枯而髓虚故
足不任身发为骨痿生于大热也肺热者色白而毛败心热者色赤而络脉溢肝热者色苍而爪枯脾热者色黄而肉蠕动肾热者色黑
而齿槁治痿独取阳明何也阳明者五脏六腑之海主润宗筋宗筋主束骨而利机关也冲脉者经脉之海也主渗灌溪谷与阳明合于
宗筋阴阳总宗筋之会会于气街而阳明为之长皆属于带脉而络于督脉故阳明虚则宗筋纵带脉不引足痿不用也（素痿论）
手屈而不伸者其病在筋伸而不屈者其病在骨（灵骨痹终始）
营气虚则不仁卫气虚则不用（素逆调论）
肺心有邪其气留于两肘肝有邪其气流于两腋脾有邪其气留于两髀肾有邪其气留于两 （灵邪客）
血与气并走于上则为大厥厥则暴死气复反则生不反则死（素调经论）
所谓入中为喑者阳盛阴衰也内夺而厥则为喑俳此肾虚也少阴不至者厥也（阴衰之阴传本误作已音相近也素脉解）
大怒则形气绝而血菀于上使人暴厥（暴传本误作薄音相近也素生气通天论）
以上三节论厥病厥者逆也下脉逆而上也逆上则暴死据经所论一由于肝一由于肾初未尝及于风也今人见此症俱称中风
而用风药不知风药多升益增其逆矣至若伤寒论中所称之厥乃手足逆冷阴阳二气不相顺接之逆与此不同
起居不节用力过度则络脉伤阳络伤则血外溢血外溢则衄血阴络伤则血内溢血内溢则后血肠胃之络伤则血溢于肠外肠
外有寒汁沫与血相搏则并合凝聚不得散而积成矣（素百病始生）
久视伤血久卧伤气久坐伤肉久立伤骨久行伤筋是谓五劳所伤（素宣明五气）
天有宿度地有经水人有经脉天地温和则经水安静天寒地冻则经水凝泣天暑地热则经水沸溢卒风暴起则经水波涌而陇
起夫邪之入于脉也寒则血凝泣暑则气淖泽虚邪（即风邪）因而入客亦如经水之得风也经之动脉其至也亦时陇起其行于脉
中循循然其至寸口中手也时大时小大则邪至小则平其行无常处在阴与阳不可为度（素离合真邪论）怒则气上喜则气缓悲
则气消恐则气下寒则气收炅则气泄惊则气乱劳则气耗思则气结九气不同何病之生曰怒则气逆甚则呕血及飧泄故气上矣喜
则气和志达营卫通利故气缓矣悲则心系急肺布叶举而上焦不通营卫不散热气在中故气消矣恐则精却却则上焦闭闭则气还
还则下焦胀故气不行矣寒则腠理闭气不行故气收矣热则腠理开营卫通汗大泄故气泄矣惊则心无所倚神无所归虑无所定故
气乱矣劳则喘息汗出外内皆越故气耗矣思则心有所存神有所归正气留而不行故气结矣（素举痛论）
人有逆气不得卧而息有音者是阳明之逆也足阳明之脉下行今逆而上行故息有音也下经曰胃不和则卧不安此之谓也起
居如故而息有音此肺之络脉逆也络脉之病患也微故起居如故也有不得卧卧则喘者是水气之客也肾者水藏主津液并主卧与
疾病既然有了成因，治疗就有方药，疗效显著。但如果只谈论病症而不探讨其致病原因，那总归是伪造的，一概不予收录。
阴阳，是天地运行的规律，万物的纲纪，变化的根源，生杀的根本，神明产生的府库。所以治病必须探求根本。因此，阳气积聚形成天，阴气积聚形成地；阴气主静，阳气主动；阳气化生万物，阴气长养万物；阳气主杀伐（肃杀），阴气主闭藏；阳气化生功能活动，阴气构成形体。寒气极盛则产生热象，热势极盛则产生寒象。寒气生成浊阴之气，热气生成清阳之气。清阳之气若在下部，就会发生完谷不化的泄泻；浊阴之气若在上部，就会发生胀满。这就是阴阳逆乱，导致疾病的顺逆变化。所以说，清阳上升为天，浊阴下降为地。地气上升化为云，天气下降化为雨。雨源于地气，云出于天气。所以，清阳出于上窍（眼、耳、口、鼻），浊阴出于下窍（前阴、后阴）；清阳发散于腠理（皮肤毛孔），浊阴运行于五脏；清阳充实于四肢，浊阴归于六腑。水属阴，火属阳；阳表现为气，阴表现为味。五味入胃，滋养形体；形体依赖气化作用；气化作用转化为精；精又转化为神化过程。精由气所化生，形体由味所滋养。味道过重损伤形体，气化过度损伤精气。精可以转化为气，但气味（药物或食物的偏性）如果不当会损伤精气。阴味从下窍排出，阳气从上窍宣发。味道浓厚者属阴，淡薄者属于阴中之阳；气味浓厚者属阳，淡薄者属于阳中之阴。味道浓厚会导致泄泻，淡薄能行气；气味淡薄能发泄，浓厚能发热。壮火（亢盛的阳气）会耗损元气，少火（正常的温和阳气）能壮大元气。壮火消耗气，少火滋生气。气味辛甘具有发散作用的属于阳，酸苦具有涌吐和泄降作用的属于阴。阴气胜则损伤阳气，阳气胜则损伤阴气。阳气胜则出现热证，阴气胜则出现寒证。寒邪重则伤形，热邪重则伤气。气受伤则疼痛，形受伤则肿胀。风邪胜则肢体动摇，热邪胜则红肿，燥邪胜则干燥，寒邪胜则浮肿，湿邪胜则濡软泄泻。
天有四时，地有五行，以此生长收藏，从而产生寒、暑、燥、湿、风五气。人有五脏，化生五气，从而产生喜、怒、悲、忧、恐五种情志。所以喜怒等情志过激会伤气，寒暑等外邪会伤形。暴怒会伤阴，暴喜会伤阳。厥逆之气上行，会使脉道充满而脱离形体。喜怒没有节制，寒暑过度，生命根基就不牢固。所以重阴必转化为阳，重阳必转化为阴。所以说，冬天感受寒邪，春天必然发生温病；春天感受风邪，夏天必然发生完谷不化的泄泻；夏天感受暑邪，秋天必然发生疟疾；秋天感受湿邪，冬天必然发生咳嗽。
东方生风，风生木，木生酸，酸入肝，肝生筋，筋生心，肝开窍于目。在天为风，在人为道，在地为生化，生化产生五味，五味产生智慧，风产生神气。神气在天为风，在地为木，在体为筋，在脏为肝，在色为苍青，在音为角，在声为呼，在变动为握（抽搐），在窍为目，在味为酸，在志为怒。怒伤肝，悲胜怒。风伤筋，燥胜风。酸伤筋，辛胜酸。
南方生热，热生火，火生苦，苦入心，心生血，血生脾，心开窍于舌。在天为热，在地为火，在体为脉，在脏为心，在色为赤，在音为徵，在声为笑，在变动为忧（此处原文可能有误，通常心之变动为忧或咳，依上下文及常规理论，心之志为喜，变动多为忧或咳，此处依原文翻译），在窍为舌，在味为苦，在志为喜。喜伤心，恐胜喜。热伤气，寒胜热。苦伤气，咸胜苦。
中央生湿，湿生土，土生甘，甘入脾，脾生肉，肉生肺，脾开窍于口。在天为湿，在地为土，在体为肉，在脏为脾，在色为黄，在音为宫，在声为歌，在变动为哕（呃逆），在窍为口，在味为甘，在志为思。思伤脾，怒胜思。湿伤肉，风胜湿。甘伤肉，酸胜甘。
西方生燥，燥生金，金生辛，辛入肺，肺生皮毛，皮毛生肾，肺开窍于鼻。在天为燥，在地为金，在体为皮毛，在脏为肺，在色为白，在音为商，在声为哭，在变动为咳，在窍为鼻，在味为辛，在志为忧。忧伤肺，喜胜忧。热伤皮毛，寒胜热。辛伤皮毛，苦胜辛。
北方生寒，寒生水，水生咸，咸入肾，肾生骨髓，髓生肝，肾开窍于耳。在天为寒，在地为水，在体为骨，在脏为肾，在色为黑，在音为羽，在声为呻，在变动为栗（战栗），在窍为耳，在味为咸，在志为恐。恐伤肾，思胜恐。寒伤血，燥胜寒。咸伤血，甘胜咸。
所以说，天地是万物的上下方位，阴阳是血气的男女属性，左右是阴阳的道路，水火是阴阳的征兆，阴阳是万物生成的始基。所以说，阴在内，是阳的守持者；阳在外，是阴的役使者。天不足于西北，所以西北方属阴，人的右耳目不如左聪明；地不满于东南，所以东南方属阳，人的左手足不如右强壮。天气通于肺，地气通于咽喉，风气通于肝，雷气通于心，谷气通于脾，雨气通于肾。阳气的汗出，以天地的雨来命名；阳气的运行，以天地的疾风来命名。暴烈的气象似雷，逆乱的气象似阳。形体不足的，用气来温补；精气不足的，用味来滋补。病位高的，顺势采用催吐法；病位低的，采用疏导排泄法；中焦痞满的，采用内泻法；有邪气在表的，浸泡身体以发汗；邪气在皮肤的，用发汗法疏散；邪气剽悍滑利的，按压收敛它；邪气实证的，消散并泻除它。审察阴阳的区别以辨别刚柔，阳病治阴，阴病治阳。确定血气的状态，使其各守其位。血实证宜决破瘀血，气虚证宜提举升陷。（以上出自《阴阳大论》）
沈又彭按：壮火是亢盛的阳气，少火是微弱的阳气。旧注解释为君火和相火，不够稳妥。另外，张仲景在《伤寒论》自序中说：“撰用《素问》、《九卷》、《八十一难》、《阴阳大论》、《胎胪药录》四种”，而没有提到《灵枢》。如今《胎胪药录》已不可多见，而《阴阳大论》一书并入《素问》之内，后人循名求实，自然认为《素问》是真，《灵枢》是假。但细读之后发现，《素问》中不乏浅陋之语，而《灵枢》中也有神妙变化之言。总之，《灵枢》就是从《素问》中分出来的，这一点毫无疑问。
天通过阴阳五行化生万物，气形成了形体，理也赋予其中。所以天通过五气供养人，五气偏胜就会生病；地通过五味供养人，五味偏胜就会生病。人体具备五志，五志偏用就会生病。病变千头万绪，总不能超出这个范围。治疗的方法，不过是用相克的关系来平衡它。这真是言简意赅，入理最深啊。这本是专门的书籍，并不是《素问》中的一篇论述，而是早晚咀嚼品味才能得出的真知。
太阴和阳明互为表里，指的是脾胃。为什么生病表现不同呢？因为阴阳位置不同，虚实交替，逆从不同，有的从内生，有的从外受，来源不同，所以病名也不同。阳代表天气，主外；阴代表地气，主内。阳道实，阴道虚。所以遭受贼风虚邪侵袭的，阳经受之；饮食不节、起居无时的，阴经受之。阳经受邪则传入六腑，阴经受邪则传入五脏。传入六腑则身体发热、不时卧睡、上部出现喘呼；传入五脏则胸膈痞满闭塞、下部发生完谷不化的泄泻，日久成为肠澼（痢疾）。喉主管天气，咽主管地气。阳经感受风邪，阴经感受湿邪。阴气从足上行至头，再下行沿手臂至手指末端；阳气从手上行至头，再下行至足。所以阳病者，向上发展到极点就向下传；阴病者，向下发展到极点就向上传。伤于风邪的，上部先受之；伤于湿邪的，下部先受之。
脾病导致四肢不能运用，为什么呢？回答说：四肢都禀受胃气，但不能直接到达经脉，必须依靠脾的转输才能禀受胃气。现在脾病不能为胃传输津液，四肢得不到水谷精气的滋养，气日益衰败，脉道不利，筋骨肌肉都没有气以生，所以不能运用。脾不单独主令，为什么呢？回答说：脾属土，治理中央，常在四季末各十八日寄旺以长养四脏，所以不单独主一时。脾与胃通过膜相连，却能为胃传输津液，为什么呢？回答说：足太阴脾经是三阴经，它的脉贯胃、属脾、络咽喉，所以太阴为三阴传输气机。阳明是表经，是五脏六腑的海，也为三阳传输气机。脏腑各自通过经脉从阳明接受气，所以（脾）为胃传输津液。（以上出自《素问·太阴阳明论》）
张仲景在论述中提到“阳明病欲作痼瘕”，这是阳明转属太阴；“转属阳明”是太阴转属阳明。这与本篇中“更实更虚”的说法正自相符，可信这是张仲景所读的真正的经典。
李东垣一生得力之处全在此篇。
三阴三阳明确指十二经脉而言。但经脉自手太阴交于手阳明，手阳明交于足阳明，足阳明交于足太阴，阴阳相贯如环无端，断没有越阴而专行三阳、越阳而专行三阴的道理。文末的问答疑似后人续写。
另外按：《神农本草经》中有“健脾”二字，而《素问》、《灵枢》、《难经》中缺失且不讲。（沈又彭）偶然看见蜜蜂酿蜜，白天采集花朵放入蜂巢，晚上张开翅膀扇动，嗡嗡有声，花遂成蜜。因而想到脾在胃外，位于中央，以膜连接胃，两旁悬空如翅膀，时时鼓扇以助胃底真阳熏蒸消谷，这所谓的“健”，乃是动而不息的意思。这只是我率意而谈，尚不知是否恰当。
如今的热病，都属于伤寒一类。有的痊愈，有的死亡，死亡的都在六七天之间，痊愈的都在十日以上，为什么呢？回答说：巨阳（太阳）是诸阳的归属，其脉连于风府，所以为诸阳主气。人感受寒邪，就发为热病，热势虽然很盛也不会死；如果是两感于寒（表里两经同时受邪）而发病的，必然不免于死。伤寒第一天，巨阳受邪，所以头痛、项强、腰脊僵硬；第二天阳明受邪，阳明主肌肉，其脉挟鼻、络于目，所以身热、目痛、鼻干、不得卧；第三天少阳受邪，少阳主胆，其脉循胁、络于耳，所以胸胁痛、耳聋。三阳经络都受邪病，但未入脏，所以可用发汗法治愈。第四天太阴受邪，太阴脉布胃中、络于咽喉，所以腹满、咽喉干；第五天少阴受邪，少阴脉贯肾、络于肺、系舌本，所以口燥、舌干而渴；第六天厥阴受邪，厥阴脉循阴器、络于肝，所以烦闷、囊缩。三阴三阳、五脏六腑都受邪病，营卫不行，五脏不通，就会死亡。那些没有两感于寒的，第七天巨阳病衰，头痛稍减；第八天阳明病衰，身热稍减；第九天少阳病衰，耳聋稍能听见；第十天太阴病衰，腹减如故，则想吃饭；第十一天少阴病衰，口渴止，腹满消，舌干已，并且打喷嚏；第十二天厥阴病衰，囊纵，少腹微下，大气皆去，病日已矣。治疗要分别疏通其脏腑经脉，病日渐衰退。病程未满三天的，可发汗治愈；病程满三天的，可泄下治愈。热病稍愈，吃肉就会复发，多吃就会遗留病邪，这是禁忌。
两感于寒的，第一天巨阳与少阴俱病，则头痛、口干、烦满；第二天阳明与太阴俱病，则腹满、身热、不欲食、谵语；第三天少阳与厥阴俱病，则耳聋、囊缩、厥逆、水浆不入、不知人，六天死亡。五脏已伤，六腑不通，营卫不行，像这样之后三天才死，为什么呢？回答说：阳明是十二经脉之长，其血气盛，所以不知人，三天后其气乃尽。凡是患伤寒而转为温病的，先夏至日的为病温，后夏至日的为病暑。暑邪与汗都要排出，不要止住。（以上出自《素问·热论》）
这篇论述的是热病。伤寒有五类，热病只是其中之一，其余都已散失。（沈又彭）将用《难经》来补充，具体见诊集中。
疟疾都生于风，发作有定时，为什么呢？回答说：疟疾刚开始发作时，先起于毫毛竖立，伸欠，然后寒栗鼓颔，腰脊俱痛。寒去则内外皆热，头痛如破，口渴想喝冷冻饮料。这是什么气使然呢？回答说：这是阴阳上下交争，虚实更作，阴阳相移。阳并于阴，则阴实而阳虚。阳明虚则寒栗鼓颔；巨阳虚则腰背头项痛。三阳俱虚则阴气胜，阴气胜则骨寒而痛，寒生于内，所以中外皆寒。阳盛则外热，阴虚则内热，外内皆热则喘而渴，所以想喝冷冻饮料。这都是因为夏天伤于暑气，热气盛，藏在皮肤之内、肠胃之外，这里是营气所舍的地方。这使人汗出，腠理开疏，因得秋气，汗出遇风，以及洗澡时水气舍于皮肤之内，与卫气并居。卫气昼日行于阳，夜行于阴。此气得阳而外出，得阴而内薄，内外相薄，所以每日发作。邪气潜伏较深，内迫于阴阳，气独发，阴邪内着，阴与阳争不得出，所以间日发作。为什么有的发作时间推迟，有的提前呢？回答说：邪气客于风府，循膂而下，卫气一日一夜大会于风府，次日日下一节，所以发作时间推迟。下至骶骨，其气上行，所以发作时间日益提前。间日发作的，是因为邪气内迫于五脏，横连膜原，道路远，所以间日才发作。先寒而后热的，先伤于寒而后伤于风，名叫寒疟；先热而后寒的，先伤于风而后伤于寒，名叫温疟；只有热而不寒的，阴气先绝，阳气独发，则少气、烦冤、手足热而欲呕，名叫瘅疟。经文说：当其邪气盛时，正气必受损；因其邪气衰时，正气必大昌。疟疾未发作时，阴未并阳，阳未并阴，因而调治，真气得以安宁，邪气乃亡。（以上出自《素问·疟论》）
风邪善行而数变，藏于皮肤之间，内不得通，外不得泄。腠理开则洒然寒，闭则热而闷。其寒也则食欲减退，其热也则肌肉消瘦，使人战栗而不能食，名叫寒热。风气与阳明入胃，循脉而上至目内眦。其人肥，则风气不得外泄，则为热中而目黄；其人瘦，则外泄而寒，则为寒中而泣出。风气由太阳而入，行诸脉输，散于分肉之间，与卫气相干，其道不利，使肌肉愤懑而有疡；卫气有所凝而不行，故其肉有不仁也。风气客于脉而不去，营气热灼，皮肤溃疡，其气不清，使鼻柱坏而色败，名叫疠风，或名寒热风。各从其门户所中，则为偏风。风气循风府而上，则为脑风；风入系头，则为目风眼寒；饮酒中风，则为漏风；入房汗出中风，则为内风；新沐中风，则为首风；久风入中，则为肠风飧泄；外在腠理，则为泄风。所以风是百病之长，变化无常。（以上出自《素问·风论》）
风寒湿三气杂至，合而为痹。风气胜者为行痹，寒气胜者为痛痹，湿气胜者为着痹。风气胜者易愈，邪入脏者死。（以上出自《素问·痹论》）
肺热叶焦，则皮毛虚弱急薄，著则生痿躄。心气热，则下脉厥而上，上则下脉虚，虚则生脉痿，枢折挈，胫纵不任地也。肝气热，则胆泄口苦，筋膜干，筋膜干则筋急而挛，发为筋痿。脾气热，则胃干而渴，肌肉不仁，发为肉痿。肾气热，则腰脊不举，骨枯而髓减，发为骨痿。肺者，藏之长，为心之盖也。所求不得，则发肺鸣，鸣则肺热叶焦。故五脏因肺热叶焦，发为痿躄。悲哀太甚，则胞络绝，绝则阳气内动，发则心下崩，数溲血也。大经空虚，发为肌痹，传为脉痿。思想无穷，所愿不得，意淫于外，入房太甚，宗筋弛纵，发为筋痿，及为白淫。生于肝，使内也。渐于湿，以水为事，肌肉濡渍，痹而不仁，发为肉痿，得之湿地也。远行劳倦，大热而渴，阳气内伐，热舍于肾，水不胜火，骨枯而髓虚，故足不任身，发为骨痿，生于大热也。肺热者色白而毛败，心热者色赤而络脉溢，肝热者色苍而爪枯，脾热者色黄而肉蠕动，肾热者色黑而齿槁。治痿独取阳明，何也？阳明者，五脏六腑之海，主润宗筋，宗筋主束骨而利机关也。冲脉者，经脉之海也，主渗灌溪谷，与阳明合于宗筋，阴阳总宗筋之会，会于气街，而阳明为之长，皆属于带脉，而络于督脉。故阳明虚则宗筋纵，带脉不引，足痿不用也。（以上出自《素问·痿论》）
手屈而不伸的，病在筋；伸而不屈的，病在骨。（出自《灵枢·骨痹》、《终始》）
营气虚则不仁，卫气虚则不用。（出自《素问·逆调论》）
肺心有邪，其气留于两肘；肝有邪，其气流于两腋；脾有邪，其气留于两髀；肾有邪，其气留于两腘。（出自《灵枢·邪客》）
血与气并走于上，则为大厥，厥则暴死，气复反则生，不反则死。（出自《素问·调经论》）
所谓入中为喑（失音）者，是阳盛阴衰。内夺而厥则为喑俳（失音伴瘫痪），这是肾虚。少阴不至者是厥。（《素问·脉解》中“阴衰之阴”传本误作“已”，音相近。）
大怒则形气绝，而血菀于上，使人暴厥。（《素问·生气通天论》中“暴”传本误作“薄”，音相近。）
以上三节论述厥病。厥者，逆也，下脉逆而上也。逆上则暴死。据经文论述，一由于肝，一由于肾，起初并未涉及风。今人见此症都称中风，而用风药，不知道风药多升散，益增其逆了。至于《伤寒论》中所称的厥，乃是手足逆冷，阴阳二气不相顺接之逆，与此不同。
起居不节，用力过度，则络脉伤。阳络伤则血外溢，血外溢则衄血；阴络伤则血内溢，血内溢则后血。肠胃之络伤，则血溢于肠外，肠外有寒，汁沫与血相搏，则并合凝聚不得散，而积成矣。（出自《素问·百病始生》）
久视伤血，久卧伤气，久坐伤肉，久立伤骨，久行伤筋，是谓五劳所伤。（出自《素问·宣明五气》）
天有宿度，地有经水，人有经脉。天地温和则经水安静，天寒地冻则经水凝泣，天暑地热则经水沸溢，卒风暴起则经水波涌而陇起。夫邪之入于脉也，寒则血凝泣，暑则气淖泽。虚邪（即风邪）因而入客，亦如经水之得风也。经之动脉，其至也亦时陇起，其行于脉中，循循然，其至寸口中，手也，时大时小，大则邪至，小则平。其行无常处，在阴与阳，不可为度。（出自《素问·离合真邪论》）
怒则气上，喜则气缓，悲则气消，恐则气下，寒则气收，炅则气泄，惊则气乱，劳则气耗，思则气结。九气不同，何病之生？曰：怒则气逆，甚则呕血及飧泄，故气上矣；喜则气和志达，营卫通利，故气缓矣；悲则心系急，肺布叶举，而上焦不通，营卫不散热气在中，故气消矣；恐则精却，却则上焦闭，闭则气还，还则下焦胀，故气不行矣；寒则腠理闭，气不行，故气收矣；热则腠理开，营卫通，汗大泄，故气泄矣；惊则心无所倚，神无所归，虑无所定，故气乱矣；劳则喘息汗出，外内皆越，故气耗矣；思则心有所存，神有所归，正气留而不行，故气结矣。（出自《素问·举痛论》）
人有逆气不得卧而息有音者，是阳明之逆也。足阳明之脉下行，今逆而上行，故息有音也。下经曰：“胃不和则卧不安”，此之谓也。起居如故而息有音，此肺之络脉逆也。络脉之病患也微，故起居如故。有不得卧，卧则喘者，是水气之客也。肾者水藏，主津液，并主卧与...
Diseases, having their causes, have effective prescriptions for treatment. However, if one discusses diseases without discussing their causes, it is altogether fabricated and shall not be recorded.
Yin and Yang are the way of Heaven and Earth, the general principles of all things, the parents of change, the origin of life and death, and the residence of spiritual illumination. Therefore, in treating diseases, one must seek the root. Thus, the accumulation of Yang forms Heaven, and the accumulation of Yin forms Earth; Yin is quiet, Yang is active; Yang generates, Yin nourishes; Yang kills (subdues), Yin stores; Yang transforms into Qi (functional activity), Yin forms into shape. Extreme cold generates heat, and extreme heat generates cold. Cold air generates turbid Yin, and hot air generates clear Yang. If clear Yang is below, it produces diarrhea with undigested food; if turbid Yin is above, it produces distension. This is the reversal of Yin and Yang, leading to the deviation of disease. Thus, clear Yang rises to form Heaven, and turbid Yin descends to form Earth. Earth's Qi rises to form clouds, and Heaven's Qi descends to form rain. Rain comes from Earth's Qi, and clouds come from Heaven's Qi. Therefore, clear Yang exits through the upper orifices (eyes, ears, mouth, nose), and turbid Yin exits through the lower orifices (urethra and anus); clear Yang disperses through the interstices (skin pores), and turbid Yin travels to the Zang organs; clear Yang fills the four limbs, and turbid Yin returns to the Fu organs. Water belongs to Yin, Fire belongs to Yang; Yang manifests as Qi, and Yin manifests as flavor. Flavors enter the stomach to nourish the form; the form relies on Qi transformation; Qi transformation produces Essence; Essence transforms into spiritual processes. Essence is generated by Qi, and the form is nourished by flavors. Excessive flavor damages the form, and excessive Qi transformation damages Essence. Essence can transform into Qi, but improper Qi and flavor damage Essence. Yin flavors exit through the lower orifices, and Yang Qi emerges from the upper orifices. Thick flavors belong to Yin, thin flavors belong to Yin within Yang; thick aromas belong to Yang, thin aromas belong to Yang within Yin. Thick flavors cause diarrhea, while thin ones promote Qi movement; thin aromas cause sweating, while thick ones generate fever. Vigorous Fire (excessive Yang) consumes Qi, while mild Fire (normal Yang) strengthens Qi. Vigorous Fire consumes Qi, while mild Fire generates Qi. Pungent and sweet flavors/actions that disperse belong to Yang; sour and bitter flavors/actions that induce vomiting and purging belong to Yin. Excess Yin damages Yang, and excess Yang damages Yin. Excess Yang leads to Heat syndromes, and excess Yin leads to Cold syndromes. Severe Cold damages the form, and severe Heat damages Qi. Damage to Qi causes pain, and damage to the form causes swelling. Excess Wind causes movement, excess Heat causes swelling, excess Dryness causes dryness, excess Cold causes edema, and excess Dampness causes loose stools.
Heaven has the Four Seasons, and Earth has the Five Elements, which govern growth, flourishing, harvesting, and storage, thereby generating Cold, Heat, Dryness, Dampness, and Wind. Humans have five Zang organs that transform into five Qi, thereby generating Joy, Anger, Sorrow, Worry, and Fear. Thus, excessive Joy and Anger damage Qi, while external Cold and Heat damage the form. Violent Anger damages Yin, and violent Joy damages Yang. Rebellious Qi moving upward causes fullness in the vessels and detachment from the form. Unregulated Joy and Anger, and excessive Cold and Heat, lead to an unstable foundation of life. Thus, extreme Yin transforms into Yang, and extreme Yang transforms into Yin. It is said: Injury by Cold in Winter leads to Warm diseases in Spring; injury by Wind in Spring leads to diarrhea with undigested food in Summer; injury by Summer-Heat in Summer leads to Malaria in Autumn; injury by Dampness in Autumn leads to Cough in Winter.
The East generates Wind, Wind generates Wood, Wood generates Sour, Sour enters the Liver, the Liver generates sinews, sinews generate the Heart, and the Liver opens into the eyes. In Heaven it is Wind, in humans it is Dao (Way), in Earth it is transformation, transformation generates the five flavors, flavors generate wisdom, Wind generates Spirit. Spirit in Heaven is Wind, in Earth is Wood, in the body is sinews, in the Zang is the Liver, in color is green, in tone is Jue, in sound is呼 (shouting), in variation is grasping (convulsions), in orifice is the eye, in flavor is Sour, in emotion is Anger. Anger damages the Liver, Sorrow overcomes Anger. Wind damages sinews, Dryness overcomes Wind. Sour damages sinews, Pungent overcomes Sour.
The South generates Heat, Heat generates Fire, Fire generates Bitter, Bitter enters the Heart, the Heart generates Blood, Blood generates the Spleen, and the Heart opens into the tongue. In Heaven it is Heat, in Earth is Fire, in the body is vessels, in the Zang is the Heart, in color is red, in tone is Zhi, in sound is laughter, in variation is sorrow (note: text says sorrow, though traditionally associated with Lung/Worry, here following source text), in orifice is the tongue, in flavor is Bitter, in emotion is Joy. Joy damages the Heart, Fear overcomes Joy. Heat damages Qi, Cold overcomes Heat. Bitter damages Qi, Salty overcomes Bitter.
The Center generates Dampness, Dampness generates Earth, Earth generates Sweet, Sweet enters the Spleen, the Spleen generates flesh, flesh generates the Lungs, and the Spleen opens into the mouth. In Heaven it is Dampness, in Earth is Earth, in the body is flesh, in the Zang is the Spleen, in color is yellow, in tone is Gong, in sound is singing, in variation is hiccup, in orifice is the mouth, in flavor is Sweet, in emotion is Pensiveness. Pensiveness damages the Spleen, Anger overcomes Pensiveness. Dampness damages flesh, Wind overcomes Dampness. Sweet damages flesh, Sour overcomes Sweet.
The West generates Dryness, Dryness generates Metal, Metal generates Pungent, Pungent enters the Lungs, the Lungs generate skin and hair, skin and hair generate the Kidneys, and the Lungs open into the nose. In Heaven it is Dryness, in Earth is Metal, in the body is skin and hair, in the Zang is the Lungs, in color is white, in tone is Shang, in sound is crying, in variation is cough, in orifice is the nose, in flavor is Pungent, in emotion is Worry. Worry damages the Lungs, Joy overcomes Worry. Heat damages skin and hair, Cold overcomes Heat. Pungent damages skin and hair, Bitter overcomes Pungent.
The North generates Cold, Cold generates Water, Water generates Salty, Salty enters the Kidneys, the Kidneys generate marrow, marrow generates the Liver, and the Kidneys open into the ears. In Heaven it is Cold, in Earth is Water, in the body is bones, in the Zang is the Kidneys, in color is black, in tone is Yu, in sound is groaning, in variation is shivering, in orifice is the ear, in flavor is Salty, in emotion is Fear. Fear damages the Kidneys, Pensiveness overcomes Fear. Cold damages Blood, Dryness overcomes Cold. Salty damages Blood, Sweet overcomes Salty.
Thus, Heaven and Earth are the upper and lower of all things; Yin and Yang are the male and female of Blood and Qi; Left and Right are the pathways of Yin and Yang; Water and Fire are the signs of Yin and Yang; Yin and Yang are the beginning of all things. Thus, Yin inside is the guardian of Yang; Yang outside is the servant of Yin. Heaven is deficient in the Northwest, so the Northwest belongs to Yin, and human right ear and eye are less acute than the left; Earth is incomplete in the Southeast, so the Southeast belongs to Yang, and human left hand and foot are less strong than the right. Heavenly Qi connects with the Lungs, Earthly Qi connects with the throat, Wind Qi connects with the Liver, Thunder Qi connects with the Heart, Grain Qi connects with the Spleen, Rain Qi connects with the Kidneys. Yang sweat is named after Heaven's rain; Yang Qi movement is named after Heaven's swift wind. Violent phenomena resemble Thunder, rebellious Qi resembles Yang. For deficiency of form, warm with Qi; for deficiency of Essence, tonify with flavor. For high pathogenic factors, induce vomiting; for low pathogenic factors, drain downwards; for middle jiao fullness, purge internally; for exterior pathogens, soak the body to sweat; for pathogens in the skin, release via sweating; for fierce pathogens, press and collect; for excess pathogens, dissipate and purge. Examine Yin and Yang to distinguish rigid and soft; treat Yin diseases by regulating Yang, and Yang diseases by regulating Yin. Determine the state of Blood and Qi, keeping them in their proper places. For Blood excess, resolve stasis; for Qi deficiency, lift and guide. (From *Treatise on Yin and Yang*)
Shen Youpeng notes: Vigorous Fire refers to hyperactive Yang, while mild Fire refers to slight Yang. Old interpretations explaining this as Ministerial Fire and Sovereign Fire are unstable. Furthermore, Zhang Zhongjing stated in the preface of *Shanghan Lun*: "I compiled using *Suwen*, *Jiujuan*, *Bayishiyi Nan*, *Treatise on Yin and Yang*, and *Tailu Yaolu*," omitting *Lingshu*. Now *Tailu Yaolu* is largely lost, and *Treatise on Yin and Yang* is incorporated into *Suwen*. Later scholars, following names, naturally considered *Suwen* authentic and *Lingshu* fake. However, upon close reading, *Suwen* contains shallow passages, while *Lingshu* contains profound transformations. Ultimately, *Lingshu* was undoubtedly derived from *Suwen*.
Heaven transforms all things through Yin, Yang, and the Five Elements; Qi forms the shape, and Principle is endowed within. Thus, Heaven nourishes humans with Five Qi; excess of Five Qi causes disease. Earth nourishes humans with Five Flavors; excess of Five Flavors causes disease. Humans possess Five Emotions; excessive use of Five Emotions causes disease. Disease manifestations are myriad, but cannot exceed these categories. Treatment methods merely balance using the overcoming relationship. This is truly concise and deeply insightful. This was originally a standalone book, not merely a chapter in *Suwen*, but truth derived from daily contemplation.
Taiyin and Yangming are interior-exterior pairs, referring to the Spleen and Stomach. Why do they manifest different diseases? Because Yin and Yang occupy different positions, alternating between deficiency and excess, rebellion and compliance, originating either internally or externally. Different origins lead to different disease names. Yang represents Heavenly Qi, governing the exterior; Yin represents Earthly Qi, governing the interior. The pathway of Yang is solid, the pathway of Yin is hollow. Thus, thieves' winds and empty evils affect Yang channels; irregular diet and起居 (daily routine) affect Yin channels. Pathogens entering Yang channels enter the Six Fu organs; those entering Yin channels enter the Five Zang organs. Entering Fu organs causes fever, restlessness, and upper respiratory distress; entering Zang organs causes chest/abdominal fullness, blockage, and lower diarrhea, eventually becoming intestinal dysentery. The throat governs Heavenly Qi, the pharynx governs Earthly Qi. Yang channels receive Wind, Yin channels receive Dampness. 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. Thus, Yang diseases progress upward then downward; Yin diseases progress downward then upward. Wind injuries affect the upper body first; Dampness injuries affect the lower body first.
Why does Spleen disease cause inability to use the four limbs? The four limbs receive Qi from the Stomach but cannot reach the meridians directly; they rely on the Spleen to transmit this Qi. Now, Spleen disease fails to transport fluids for the Stomach, so the limbs do not receive water-grain Qi. Qi declines daily, meridians become obstructed, sinews, bones, muscles, and flesh lack Qi generation, hence they cannot function. Why does the Spleen not govern a specific season? The Spleen belongs to Earth, governs the Center, and supports the other four Zang organs during the last 18 days of each season, thus not governing a single season alone. The Spleen and Stomach are connected by membranes, yet the Spleen transports fluids for the Stomach. Why? The Foot-Taiyin Spleen meridian is one of the Three Yin meridians; its vessel penetrates the Stomach, belongs to the Spleen, and connects to the pharynx, thus Taiyin transmits Qi to the Three Yin. Yangming is the exterior meridian, the sea of the Five Zang and Six Fu organs, transmitting Qi to the Three Yang. Organs and Fu receive Qi from Yangming via their respective meridians, thus (the Spleen) transports fluids for the Stomach. (From *Suwen: Treatise on Taiyin and Yangming*)
In Zhang Zhongjing's discussion, "Yangming disease intending to form a mass" indicates Yangming transforming into Taiyin; "transforming into Yangming" indicates Taiyin transforming into Yangming. This aligns with the concept of "alternating excess and deficiency" in this chapter, confirming it as the true classic read by Zhang Zhongjing.
Li Dongyuan's lifelong expertise relied entirely on this chapter.
The Three Yin and Three Yang clearly refer to the twelve meridians. Meridians connect Hand-Taiyin to Hand-Yangming, Hand-Yangming to Foot-Yangming, and Foot-Yangming to Foot-Taiyin, forming a cycle without end. There is no logic in skipping Yin to act solely on Three Yang or skipping Yang to act solely on Three Yin. The Q&A at the end is suspected to be a later addition.
Additionally, *Shennong Bencao Jing* mentions "strengthening the Spleen," whereas *Suwen*, *Lingshu*, and *Nanjing* lack detailed discussion on this. (Shen Youpeng) Once observed bees making honey: during the day, they place flowers in the hive; at night, they spread wings and fan, making buzzing sounds, until flowers become honey. I thought that the Spleen is outside the Stomach, located centrally, connected by membrane, with sides hanging like wings, constantly fanning to assist the true Yang at the bottom of the Stomach in steaming and digesting grain. This "strengthening" implies continuous motion. This is merely my speculative talk, and I am unsure if it is correct.
Current febrile diseases are all types of Cold Damage. Some recover, some die; deaths occur within six to seven days, recoveries after ten days. Why? Juyang (Taiyang) is the affiliation of all Yang meridians, connecting to Fengfu, thus governing Yang Qi. When humans are injured by Cold, they develop febrile disease. Even with high fever, they will not die unless they suffer from "Double Injury by Cold" (simultaneous involvement of exterior and interior meridians), which is fatal. On the first day of Cold Damage, Juyang is affected: headache, stiff neck, and sore back. On the second day, Yangming is affected: Yangming governs flesh, its vessels run alongside the nose and connect to the eyes, causing fever, eye pain, dry nose, and inability to sleep. On the third day, Shaoyang is affected: Shaoyang governs the Gallbladder, its vessels follow the flanks and connect to the ears, causing hypochondriac pain and deafness. If the three Yang meridians are diseased but have not entered the Zang, they can be cured by sweating. On the fourth day, Taiyin is affected: Taiyin vessels distribute in the Stomach and connect to the pharynx, causing abdominal fullness and dry throat. On the fifth day, Shaoyin is affected: Shaoyin vessels penetrate the Kidneys, connect to the Lungs, and attach to the base of the tongue, causing dry mouth, dry tongue, and thirst. On the sixth day, Jueyin is affected: Jueyin vessels circulate around the genitalia and connect to the Liver, causing irritability, fullness, and retraction of the scrotum. When all Yin and Yang, Zang and Fu organs are diseased, Ying and Wei circulation stops, and the Five Zang are blocked, death ensues. For those not suffering from Double Injury, on the seventh day, Juyang disease wanes: headache decreases. On the eighth day, Yangming disease wanes: fever decreases. On the ninth day, Shaoyang disease wanes: hearing slightly improves. On the tenth day, Taiyin disease wanes: abdomen softens, appetite returns. On the eleventh day, Shaoyin disease wanes: thirst stops, fullness resolves, tongue dries, and sneezing occurs. On the twelfth day, Jueyin disease wanes: scrotum relaxes, lower abdomen softens, pathogenic Qi departs, and the disease ends. Treatment requires unblocking the meridian-palace of each organ; as the disease wanes, recovery follows. For febrile diseases under three days, use sweating; for those over three days, use purgation. After slight improvement of fever, eating meat causes relapse, and overeating causes lingering pathogens; these are contraindications.
For Double Injury by Cold: On the first day, Juyang and Shaoyin are both diseased: headache, dry mouth, irritability. On the second day, Yangming and Taiyin are both diseased: abdominal fullness, fever, anorexia, delirium. On the third day, Shaoyang and Jueyin are both diseased: deafness, scrotal retraction, cold limbs, inability to swallow fluids, unconsciousness. Death occurs on the sixth day. When the Five Zang are damaged, Six Fu are blocked, and Ying and Wei do not circulate, death occurs three days later. Why? Yangming is the leader of the twelve meridians, with abundant Blood and Qi. Unconsciousness lasts three days until its Qi is exhausted. For Cold Damage turning into Warm diseases: before Summer Solstice, it is Warm disease; after Summer Solstice, it is Summer-Heat disease. Summer-Heat and sweat should be expelled, not stopped. (From *Suwen: Treatise on Febrile Diseases*)
This chapter discusses febrile diseases. Cold Damage has five types, and febrile disease is only one of them; the others are lost. (Shen Youpeng) I will supplement with *Nanjing*, as detailed in the Diagnosis Collection.
Malaria is caused by Wind. Why does it have regular intervals? Malaria begins with goosebumps, yawning, followed by chills, shaking of the jaw, and pain in the waist and spine. After chills subside, internal and external heat arise, causing severe headache and thirst for cold drinks. This is due to the struggle between Yin and Yang, shifting between deficiency and excess. When Yang merges into Yin, Yin becomes excess and Yang becomes deficient. Deficiency of Yangming causes chills and jaw shaking; deficiency of Juyang causes pain in the waist, back, head, and neck. Deficiency of all three Yang leads to Yin excess, causing bone cold and pain, resulting in internal and external cold. Excess Yang causes external heat, deficiency Yin causes internal heat; combined internal and external heat causes panting and thirst, leading to the desire for cold drinks. This results from Summer-Heat injury, where heat hides in the skin and intestines, the residence of Ying Qi. Sweat opens the pores; autumn wind and bathwater enter, residing with Wei Qi. Wei Qi moves through Yang during the day and Yin at night. Interaction between external Yang and internal Yin causes daily attacks. Deeply seated pathogens affecting Yin and Yang cause every-other-day attacks. Delayed onset is due to pathogens descending from Fengfu; early onset is due to ascending Qi. Every-other-day attacks occur because pathogens are deep, connecting to the membrane source. Chills preceding heat is Cold Malaria; heat preceding chills is Warm Malaria. Heat only without chills is Dan Malaria. When pathogens are strong, healthy Qi is damaged; when weak, healthy Qi recovers. During the asymptomatic phase, regulate the body to allow Healthy Qi to settle and Pathogenic Qi to vanish. (From *Suwen: Treatise on Malaria*)
Wind moves swiftly and changes frequently, hiding in the skin. Open pores cause chills; closed pores cause heat and oppression. Chills reduce appetite; heat wastes muscle, causing shivering and anorexia, known as Cold-Heat. Wind entering the Stomach via Yangming ascends to the inner canthus. Fat people retain wind, causing internal Heat and yellow eyes; thin people expel wind, causing internal Cold and tearing. Wind entering Taiyang spreads to muscles, interfering with Wei Qi, causing swelling and ulcers; stagnant Wei Qi causes numbness. Wind in vessels heats Ying Qi, causing skin ulcers, nasal collapse, and discoloration, known as Leprosy. Wind entering various gates causes Bi-feng, Brain Wind, Eye Wind, Leak Wind, Internal Wind, Head Wind, Intestinal Wind, and Leakage Wind. Wind is the chief of hundred diseases, changing unpredictably. (From *Suwen: Treatise on Wind*)
Cold, Wind, and Dampness combine to cause Bi syndrome. Wind dominance causes Moving Bi; Cold dominance causes Painful Bi; Dampness dominance causes Fixed Bi. Wind dominance heals easily; invasion of Zang organs is fatal. (From *Suwen: Treatise on Bi*)
Dryness and Heat in the Lungs wither leaves, weakening skin and hair, leading to Wei syndrome. Heart Heat causes vessel reversal and deficiency, leading to Vessel Wei. Liver Heat causes bitter taste and dry sinews, leading to Sinew Wei. Spleen Heat causes dry stomach and numb flesh, leading to Flesh Wei. Kidney Heat causes stiff waist and depleted marrow, leading to Bone Wei. The Lungs are the canopy of the Heart. Unfulfilled desires cause Lung鸣 (sound), leading to Lung Heat and withered leaves. All Zang Wei stem from Lung Heat. Excessive grief severs the Pericardium, causing Heart bleeding and frequent bloody urine, leading to Muscle and Vessel Wei. Unfulfilled thoughts and excessive sexual activity cause Sinew Wei and White Turbidity. Dampness leads to Flesh Wei. Extreme heat and fatigue deplete Kidney Water, leading to Bone Wei. Lung Heat shows pale color and hair loss; Heart Heat shows red color and overflowing collaterals; Liver Heat shows green color and brittle nails; Spleen Heat shows yellow color and twitching flesh; Kidney Heat shows black color and rotten teeth. Treating Wei focuses on Yangming. Yangming is the sea of Zang and Fu, moistening Zong Jin (major tendons), which bind bones and facilitate joints. The Chong Mai irrigates valleys, combining with Yangming at Zong Jin. All converge at Qichong, led by Yangming, connected to Dai and Du meridians. Yangming deficiency leads to relaxed Zong Jin and weak legs. (From *Suwen: Treatise on Wei*)
Bending without extension indicates Sinew disease; extending without bending indicates Bone disease. (From *Lingshu*)
Deficiency of Ying Qi causes numbness; deficiency of Wei Qi causes immobility. (From *Suwen*)
Pathogens in the Lungs and Heart remain in the elbows; Liver pathogens in the axillae; Spleen pathogens in the thighs; Kidney pathogens in the popliteal fossa. (From *Lingshu*)
Blood and Qi rushing upward causes Great Jue (syncope), appearing as sudden death. If Qi returns, life is saved; if not, death occurs. (From *Suwen*)
Loss of voice due to internal obstruction indicates Yang excess and Yin deficiency. Internal depletion and Jue cause aphasia and paralysis, indicating Kidney deficiency. (From *Suwen*)
Violent anger causes Qi and form to sever, blood stagnating upward, leading to sudden syncope. (From *Suwen*)
These three sections discuss Jue disease. Jue means rebellion, with lower Qi rebelling upward, causing sudden death. Based on the classics, this stems from the Liver or Kidney, not Wind. Modern practitioners mistake this for Stroke and use Wind-dispelling herbs, which are ascending and worsen the rebellion. Note that *Shanghan Lun* defines Jue as cold extremities due to failure of Yin and Yang Qi to connect, which is different. (From *Suwen*)
Irregular living and overexertion damage collaterals. Damage to Yang collaterals causes external bleeding (epistaxis); damage to Yin collaterals causes internal bleeding (hematochezia). Bleeding from intestinal collaterals outside the gut combines with cold fluids to form masses. (From *Suwen*)
Prolonged viewing damages Blood; prolonged lying damages Qi; prolonged sitting damages flesh; prolonged standing damages bones; prolonged walking damages sinews. These are the Five Labors. (From *Suwen*)
Heaven has stars, Earth has rivers, Humans have meridians. Gentle weather calms river water; cold freezes it; heat boils it; storms swell it. Pathogens entering vessels behave similarly: Cold coagulates Blood, Heat makes Qi fluid. Empty evils (Wind) enter like wind on water. Pulse waves rise and fall; large pulse indicates pathogen, small indicates peace. Pulse position varies between Yin and Yang. (From *Suwen*)
Anger causes Qi to ascend; Joy causes Qi to slow; Grief causes Qi to dissipate; Fear causes Qi to descend; Cold causes Qi to contract; Heat causes Qi to leak; Shock causes Qi to scatter; Labor causes Qi to consume; Pensiveness causes Qi to knot. Anger leads to Qi rebellion and vomiting/blood; Joy leads to harmonious Qi; Grief constricts the Heart/Lungs, blocking upper Jiao; Fear retreats Essence, closing upper Jiao and bloating lower Jiao; Cold closes pores, contracting Qi; Heat opens pores, leaking Qi; Shock confuses the mind, scattering Qi; Labor exhausts Qi through panting/sweating; Pensiveness retains Qi, causing knots. (From *Suwen*)
Rebellious Qi preventing sleep with noisy breathing indicates Yangming rebellion. Yangming normally descends; rebellion upward causes noise. "Stomach disharmony leads to restless sleep." Quiet breathing with noise indicates Lung collateral rebellion. Inability to lie down with panting indicates Water Qi invading. The Kidney governs fluids and sleep.