脉之界分，兼见腰痛，少腹满，小便数，如癃状，气不足，意恐惧，腹中悒悒然之经化证者，
不亟正治，或早加禁截，必注之经而溜之藏，当病腰胁痛，不可俯仰，丈夫 疝，妇人少腹
肿，甚则嗌干，面尘脱色，胸满呕逆，飧泄狐疝，四肢满闭，淋溲便难而转筋；如或暑藏营
舍，舍属肺募之界分，兼见心寒，寒甚热，热间善惊，如有所见之藏化证者，不亟正治，或
早加禁截，邪干肺脏矣，当病发咳上气，甚则大骨枯槁，大肉陷下，胸中气满，喘息不便，
其气动形，期六月死；如或暑藏营舍，舍属心募之界分，兼见烦心，甚欲得饮清水，反寒少
热不甚之藏化证者，不亟正治，或早加禁截，邪干心脏矣，当病筋脉相引而急，甚则大骨枯
槁，大肉陷下，胸中气满，腹内痛，心中不便，肩项身热，破 脱肉，目匡陷，真藏见，目
不见人立死，其见人者，至其所不胜之时则死；如或暑藏营舍，舍属脾募之界分，兼见寒甚，
腹中痛，热则肠鸣，鸣已汗出之藏化证者，不亟正治，或早加禁截，邪干脾脏矣，当病发瘅，
腹中热，烦心，出黄，甚则大骨枯槁，大肉陷下，胸中气满，喘息不便，内痛引肩项，身热，
脱肉破 ，真藏见，十日之内死；如或暑藏营舍，舍属肝募之界分，兼见色苍苍然，善太息，
其状若死之藏化证者，不亟正治，或早加禁截，邪干肝藏矣，当病胁痛，出食，甚则大骨枯
槁，大肉陷下，胸中气满，喘息不便，内痛引肩项，期一月死；如或暑藏营舍，舍属肾募之
界分，兼见洒洒然，腰脊痛，宛转，大便难，目 然，手足寒之藏化证者，不亟正治，或
早加禁截，邪干肾脏矣，当病少腹冤热而痛，出白，甚则大骨枯槁，大肉陷下，肩髓内消，
动作益衰，真藏未见，期一岁死，见其真藏，乃与之期日；如或暑藏营舍，舍属胃府之界分，
兼见善饥，不能食，食则腹支满之府化证者，不亟正治，或早加禁截，邪入胃府矣，当病留
饮，吐沫，关格，蛔结，天癸竭，精气衰少，甚则羸瘦短气，胃络脉绝，阳络伤则吐血，阴
络伤则便血，见血即死；如或暑藏营舍，次复风寒两袭，而作先热后寒之温疟者，不亟正治，
或早加禁截，多致痹气血而成风痹，以次乘传，所谓痹伤形，移皆有次也，或致风郁成黄。
或致邪逆胸腹而成蛊也。更有一种，冬中寒风藏于骨髓，次遇大暑邪气与汗皆出，证见骨髓
消，肌肉烁，亦先热后寒，同名温疟者，不亟正治或早加禁截，多致形藏损，至皮聚而毛落，
至骨痿不能起于床者死；或骨痿不能起于床，至皮聚而毛落者死，所谓至从下上，损从上下
也。如或暑藏营舍，次遇夏气凄沧之水寒，更中秋气降肃之风化，而作先寒后热之寒疟者，
不亟正治，或早加禁截，亦致痹气血而成痛痹；或致水闭成疸；或致水饮溢出肌肤肠胃之外
而成肿也。如或阴气先绝，阳气独发，证见少气烦冤，手足热而欲呕，而作但热不寒之瘅疟
者，不亟正治，或早加禁截，多致身体灼热，目盲狂走；或致热气所过则为痈脓；或致胃疽
肠腐，其人死身色赤，腋下温，心下热也。更有一种，肺素有热，厥逆上冲，中气实而不泄，
因有所用力，腠理开，风寒舍于皮肤之肉，分肉之间而发，证见肌肉消烁，亦但热不寒，同
名瘅疟者，不亟正治，或早加禁截，多致喘咳血溢，毛发焦折，或致肺痿肺痈，吐涎沫及脓
血也。
如或暑藏营舍，风并冲居，独表气微虚，不能挈阴自下而上，而作但寒不热之牝疟者，
不亟正治，或早加禁截，多致阴阳离决，血菀于上；或致重阴则癫，脱阳见鬼，其人死身色
青，胫先寒，唇先黑也；如或春病者恶风，夏病者多汗，冬病者寒不甚，不亟正治，或早加
禁截，其变生形证，此则因时之序，以显经藏之化；或已兼经藏之化，此又因经藏界分，转
生变承矣。至于间日发，或间数日发者，不亟正治，或早加禁截，其变生形证，以其舍深，
横连募原，内薄六腑，则易干脏腑，多致病死不治也。然则夏令暑热之气，为致病之本因，
人身营气之舍，为奉本之标见。秋气降肃之风，沐浴之水，凄沧之寒，为成病之宗乘。若卫
气三阳，此则作病之关机。经藏界分，此又营舍之畛畦也。故寒热间作，及兼经藏之化曰常，
注经溜府，及见乘胜之证曰变。是以一岁之中，长幼之病多相似者，以暑为时序对待所必有
之气故尔。乃若五运六气，亦作 疟，宜应别论。以五岁六期，始一再见，为流行相袭加临
之化故尔。如岁火太过，炎暑流行民病疟，其兼证喘咳少气，血溢血泄，耳聋嗌燥，中热，
肩背热；如岁木不及，复则炎暑流火，民病寒热，其兼证痱疹痈痤；如赫曦之纪，炎暑施化
，民病KT 疟，其兼证疮疡血流，狂妄目赤；如阳明司天，燥气下临，暴热乃至，民病寒
热，其兼证心痛。如少阴司天，热气下临，大暑流行，民病寒热，其兼证，喘呕嚏鼽，吐衄
鼻窒。如阳明之政，炎暑大行，民病寒热，其兼证咳逆嗌塞，振栗癃 ；三之气，燥热交合，
民病寒热，其兼证喘咳气上；四之气，寒雨降，民病疟寒之疾，其兼证骨痿血便，暴仆振栗，
谵妄少气、嗌干引饮，及为心痛，痈肿疮疡。如少阳之政，炎火乃流，民病寒热疟，其兼证
，聋，瞑，色变。如太阴之政，四之气，溽暑蒸化民病疟，其兼证，腠理热、血暴溢、心腹
胪满而热，甚则 肿。如少阴之政，三之气，大火行，民病寒热更作，其兼证，咳喘，目赤
，气厥，心痛；四之气，溽暑至，民病寒热，其兼证，嗌干，黄瘅，鼽衄、饮发。如火郁之
发，大暑至，民病温疟，其兼证，螈 、骨痛、四肢 愤，疡痱，呕逆，腹暴痛，血溢流注，
目赤，心热，甚则瞀闷懊 ，温汗濡玄府，善暴死也。如厥阴在泉，风淫所胜，民病洒淅振
寒，其兼证，欠呻，两胁里急，心腹支满，膈咽不通，食则呕逆，腹胀，善噫，得后气乃快
然，身体皆重。如少阴在泉，热胜则焰，民病寒热如疟，其兼证，皮肤痛，目瞑，齿痛，
肿，肠鸣，气上，喘，不能久立，少腹中痛而腹大。如少阴司天，热淫所胜，民病寒热，其
兼证，咳，喘，气中唾血，鼽衄，溺色变，甚则疮、疡、 肿，肩背、臂 、缺盆中痛，肺
胀满膨膨而喘咳。如少阳司天，火淫所胜，民病头痛，发热恶寒而成疟，其兼证，皮肤热痛，
色变黄赤，咳唾血溢，热中，仰息，传而为水，身面跗肿。如阳明司天，燥淫所胜，寒清于
中，感而成疟，其兼证，左股胁痛，咳而腹鸣，注泄，骛溏，甚则心暴痛，不可反侧，嗌干，
面尘。如太阳之胜，凝溧且至，民病疟，其兼证，寒厥入胃，内生心痛，阴中乃疡，隐曲不
利，筋肉拘苛，血脉凝泣，目如脱，寒入下焦，传为濡泻。如少阴之复，燠热内作，民病寒
热，其兼证，振栗、 妄，寒已而热，肤痛，暴喑，少气，骨痿，膈肠不便，外作浮肿。如
少阳之复，大热将至，民病疟，其兼证，鼓栗寒极，寒极乃热，血溢，血泄，少气，脉萎，
嗌络焦枯，渴饮水浆，上为口糜，下为跗肿，赤黄色变，小便数而欠也。顾营运之相袭，及
主客之加临，亦莫不以暑热为本因，营舍为剽见。但所显证形，皆属藏化，所谓病所胜之藏，
承所不胜之气故也。制方施治，各有宜忌，高则抑之，下则举之，有余折之，不足补之，佐
以所利，和以所宜，同则异之，异则从之，治寒以热，治热以寒，所以顺流行，安主客，而
适寒温也。设不察时令，与流行主客之差别而概治之，甚至早加禁截，多令暴亡。所谓中运
行者十全五，中天刑者无一生，行伤藏故也，可不慎欤。（颐）性生木鲁，不敢强作臆说，
以资观听，谨从经论，详别因证之常变，衍疏成编，聊备 考。岂漫云着述乎！
况未尽实多，千里比肩，端祈指驳。
脉象的界限分布，如果同时出现腰痛、小腹胀满、小便频数、像癃闭（排尿困难）一样的症状，气虚，心中恐惧，腹部中郁闷不舒的经络化证，如果不迅速进行正规治疗，或者过早地加以截断疟疾发作，病邪必然传入经络并流注于脏腑，将会导致腰胁部疼痛，身体不能俯仰，男子患疝气，女子小腹部肿胀，严重时咽喉干燥，面色如蒙尘且失去光泽，胸部胀满、呕吐逆气，完谷不化的泄泻，狐疝，四肢胀满闭塞，淋证、小便困难以及转筋；如果暑热之邪藏匿于营分，停留在属于肺募穴的界限区域，同时伴有心寒、极度寒冷后发热、发热期间容易惊恐、好像看到了幻象的脏腑化证，如果不迅速进行正规治疗，或者过早地加以截断，邪气就会侵犯肺脏，将会导致咳嗽、气逆上冲，严重时大骨枯槁、大块肌肉陷下，胸中气满，呼吸喘息不畅，气息扰动形体，预计六个月死亡；如果暑热之邪藏匿于营分，停留在属于心募穴的界限区域，同时伴有烦闷心痛，非常想喝冷水，反而感觉寒冷而热度不高，热度也不严重的脏腑化证，如果不迅速进行正规治疗，或者过早地加以截断，邪气就会侵犯心脏，将会导致筋脉相互牵引而拘急，严重时大骨枯槁、大块肌肉陷下，胸中气满，腹内疼痛，心中不适，肩颈背部发热，肌肉消瘦剥脱，眼眶凹陷，真脏脉现，眼睛看不见人则立即死亡，如果还能看见人，到了它不胜克的时辰就会死亡；如果暑热之邪藏匿于营分，停留在属于脾募穴的界限区域，同时伴有极度寒冷，腹部疼痛，发热时肠鸣，肠鸣之后出汗的脏腑化证，如果不迅速进行正规治疗，或者过早地加以截断，邪气就会侵犯脾脏，将会导致发生疸病，腹中热，烦闷心痛，排出黄色尿液，严重时大骨枯槁、大块肌肉陷下，胸中气满，呼吸喘息不畅，内部疼痛牵引肩颈背部，身体发热，肌肉消瘦剥脱，真脏脉现，十天之内死亡；如果暑热之邪藏匿于营分，停留在属于肝募穴的界限区域，同时伴有面色青苍，喜欢叹气，状态好像死人的脏腑化证，如果不迅速进行正规治疗，或者过早地加以截断，邪气就会侵犯肝脏，将会导致胁肋疼痛，呕吐食物，严重时大骨枯槁、大块肌肉陷下，胸中气满，呼吸喘息不畅，内部疼痛牵引肩颈背部，预计一个月死亡；如果暑热之邪藏匿于营分，停留在属于肾募穴的界限区域，同时伴有战栗发抖，腰脊疼痛，身体辗转反侧，大便困难，眼睛昏花不明，手足寒冷的脏腑化证，如果不迅速进行正规治疗，或者过早地加以截断，邪气就会侵犯肾脏，将会导致小腹部冤屈郁热而疼痛，排出白色浊物，严重时大骨枯槁、大块肌肉陷下，肩髓内部消减，动作日益衰弱，真脏脉尚未出现，预计一年死亡，如果见到真脏脉，就给予具体的死期预测；如果暑热之邪藏匿于营分，停留在属于胃腑的界限区域，同时伴有容易饥饿但不能进食，进食后腹部支撑胀满的腑化证，如果不迅速进行正规治疗，或者过早地加以截断，邪气就会进入胃腑，将会导致留饮，吐沫，关格（大小便不通），蛔虫结聚，天癸枯竭，精气衰少，严重时身体消瘦、气短，胃络脉绝断，阳络受伤则吐血，阴络受伤则便血，见血即死；如果暑热之邪藏匿于营分，接着又遭受风寒两邪侵袭，从而产生先热后寒的温疟，如果不迅速进行正规治疗，或者过早地加以截断，多会导致气血痹阻而形成风痹，依次传变，这就是所谓的痹症损伤形体，转移都有次序，或者导致风邪郁结变成黄疸。或者导致邪气逆乱于胸腹而形成蛊病。还有一种情况，冬天感受寒风藏于骨髓，接着遇到大暑邪气与汗一起外出，证候表现为骨髓消减，肌肉消瘦，也是先热后寒，同样称为温疟的，如果不迅速进行正规治疗或过早加以截断，多导致形脏受损，发展到皮肤聚集而毛发脱落，发展到骨痿不能起床的就会死亡；或者骨痿不能起床，发展到皮肤聚集而毛发脱落的就会死亡，这就是所说的病势从下向上发展，损害从上向下蔓延。如果暑热之邪藏匿于营分，接着遇到夏季凄清寒冷的水寒之气，再遇上秋季肃降的风化，从而产生先寒后热的寒疟，如果不迅速进行正规治疗，或者过早地加以截断，也会导致气血痹阻而形成痛痹；或者导致水液闭塞形成黄疸；或者导致水饮溢出肌肤肠胃之外而形成水肿。如果阴气先绝，阳气独发，证候表现为气短烦闷冤屈，手足发热并且想呕吐，从而产生只有热没有寒的瘅疟，如果不迅速进行正规治疗，或者过早地加以截断，多导致身体灼热，目盲狂走；或者导致热气经过的地方形成痈脓；或者导致胃疽肠腐，其人死后身体颜色赤红，腋下温暖，心下部发热。还有一种情况，肺素来有热，厥逆之气上冲，中气充实而不能宣泄，因为用力过度，腠理开放，风寒停留在皮肤的肉分、分肉之间而发病，证候表现为肌肉消烁，也是只有热没有寒，同样称为瘅疟的，如果不迅速进行正规治疗，或者过早地加以截断，多导致喘咳吐血溢血，毛发焦枯折断，或者导致肺痿肺痈，吐出涎沫及脓血。
如果暑热之邪藏匿于营分，风邪并冲居其中，唯独表气轻微虚弱，不能牵引阴气自下而上，从而产生只有寒没有热的牝疟，如果不迅速进行正规治疗，或者过早地加以截断，多导致阴阳离决，血液郁积于上部；或者导致重阴则癫狂，脱阳则见鬼，其人死后身体颜色青黑，小腿先冷，嘴唇先黑；如果春季患病者恶风，夏季患病者多汗，冬季患病者寒冷不明显，如果不迅速进行正规治疗，或者过早地加以截断，其产生的变形证候，这是因季节时序的不同，以显现经络脏腑的变化；或者已经兼有经络脏腑的变化，这又是因经络脏腑的界限分布，转而生成变承关系了。至于每隔一天发作，或者每隔几天发作的，如果不迅速进行正规治疗，或者过早地加以截断，其产生的变形证候，因为其病位深，横向连及募原，向内迫近六腑，就容易侵犯脏腑，多导致病死且无法治愈。那么夏令暑热之气，是致病的根本原因，人身营气的停留处，是奉承本因的表现。秋气肃降的风，沐浴之水，凄清的寒冷，是形成疾病的宗乘（基础）。如果卫气在三阳经，这是发病的关键机关。经络脏腑的界限分布，这是营气停留区域的畛畦（边界）。所以寒热交替发作，以及兼有经络脏腑的变化称为常，病邪注入经络流注腑脏，以及见到乘胜的证候称为变。因此在一岁之中，老少病人的病症大多相似，是因为暑热是时序对待所必有的气候缘故。至于五运六气，也会产生疟疾，应当另外讨论。因为五年六年一个周期，始一再见，是流行相袭加临的变化缘故。比如岁火太过，炎暑流行，民众患疟疾，其兼证有喘咳气短，血溢血泄，耳聋咽喉干燥，体内发热，肩背发热；比如岁木不及，复气则为炎暑流火，民众患寒热往来，其兼证有痱疹痈痤；比如赫曦之纪，炎暑施化，民众患疟疾，其兼证有疮疡血流，狂妄目赤；比如阳明司天，燥气下临，暴热乃至，民众患寒热往来，其兼证有心痛。比如少阴司天，热气下临，大暑流行，民众患寒热往来，其兼证有喘呕喷嚏鼻流涕，吐血鼻衄鼻塞。比如阳明之政，炎暑大行，民众患寒热往来，其兼证有咳逆咽喉阻塞，战栗癃闭；三之气，燥热交合，民众患寒热往来，其兼证有喘咳气上；四之气，寒雨下降，民众患疟寒之疾，其兼证有骨痿便血，突然仆倒战栗，谵语气短、咽喉干燥想喝水，以及发生心痛，痈肿疮疡。比如少阳之政，炎火乃流，民众患寒热疟疾，其兼证有耳聋，视物不清，面色改变。比如太阴之政，四之气，溽暑蒸化，民众患疟疾，其兼证有腠理热、血液暴溢、心腹胪满而热，严重时浮肿。比如少阴之政，三之气，大火行，民众患寒热交替发作，其兼证有咳喘，目赤，气厥，心痛；四之气，溽暑至，民众患寒热往来，其兼证有咽喉干燥，黄疸，鼻渊鼻衄、水饮发作。如火郁之发，大暑至，民众患温疟，其兼证有抽搐、骨痛、四肢愤懑，疡痱，呕吐逆气，腹部暴痛，血溢流注，目赤，心热，严重时瞀闷懊恼，温汗濡润玄府，善于突然死亡。比如厥阴在泉，风淫所胜，民众患战栗振寒，其兼证有呵欠伸腰，两胁里急，心腹支撑胀满，膈咽不通，进食则呕吐逆气，腹胀，喜欢打嗝，得后气放屁后才舒服，身体皆沉重。比如少阴在泉，热胜则焰，民众患寒热如疟，其兼证有皮肤痛，视物不清，齿痛，肿胀，肠鸣，气上冲，喘，不能久立，小腹部中痛而腹部肿大。比如少阴司天，热淫所胜，民众患寒热往来，其兼证有咳，喘，气中唾血，鼻渊鼻衄，尿色改变，严重时疮疡浮肿，肩背、手臂、缺盆中痛，肺胀满膨膨而喘咳。比如少阳司天，火淫所胜，民众患头痛，发热恶寒而成疟疾，其兼证有皮肤热痛，面色变黄赤，咳唾血溢，热中，仰面呼吸，传变为水病，身面跗肿。比如阳明司天，燥淫所胜，寒清于中，感而成疟，其兼证有左股胁痛，咳而腹鸣，泄泻，稀便，严重时心暴痛，不能翻身侧卧，咽喉干燥，面色如蒙尘。比如太阳之胜，凝溧且至，民众患疟疾，其兼证有寒厥入胃，内生心痛，阴部生溃疡，隐曲不利，筋肉拘挛苛急，血脉凝涩，眼睛像要脱出，寒入下焦，传为濡泻。比如少阴之复，燠热内作，民众患寒热往来，其兼证有战栗妄动，寒已而热，肤痛，突然失音，气短，骨痿，膈肠不便，外作浮肿。比如少阳之复，大热将至，民众患疟疾，其兼证有鼓栗寒极，寒极乃热，血溢，血泄，气短，脉萎，咽喉脉络焦枯，渴饮水浆，上为口糜，下为跗肿，赤黄色变，小便频数且欠伸。顾营运的相袭，以及主客的加临，也没有不以暑热为本因，营舍为表现。但所显示的证候形态，都属于脏化，所谓病克胜之脏，承受所不胜之气的原因。制定方剂施行治疗，各有适宜和禁忌，高则抑之，下则举之，有余折之，不足补之，佐以所利，和以所宜，同则异之，异则从之，治寒以热，治热以寒，所以顺应流行，安定主客，而适应寒温。如果不考察时令，以及流行主客的区别而一概治疗，甚至过早地加以截断，多导致突然死亡。所谓中运行者十全五，中天刑者无一生，是因为行伤脏的缘故，能不谨慎吗？（卢之颐）本性生于木鲁，不敢强行发表臆说，以资观赏听闻，谨从经典论述，详细辨别病因证候的常变，演绎疏解成编，聊备参考。难道是随意著述吗！况且未尽之处实多，千里比肩，恳请指正驳斥。
The boundaries of the pulse, if accompanied by lower back pain, fullness in the lower abdomen, frequent urination resembling strangury (difficulty in urination), deficiency of Qi, fearfulness, and a depressed feeling in the abdomen, representing the transformation syndrome of the meridians: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will inevitably enter the meridians and flow into the zang organs. The disease should manifest as pain in the waist and hypochondrium, inability to bend or extend the body, hernia in men, and swelling in the lower abdomen of women. In severe cases, there may be dryness of the throat, a dusty complexion with loss of luster, chest fullness, vomiting and regurgitation, undigested food diarrhea, fox hernia, fullness and obstruction of the four limbs, strangury, difficult urination, and muscle cramps; if the summer-heat pathogen lodges in the Ying (Nutritive) level and stays within the boundary of the Lung's front-mu point, accompanied by cold sensation in the heart, severe cold with mild heat, susceptibility to fright after fever subsides, and visual hallucinations, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Lung organ. The disease should manifest as cough and rebellious Qi, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, dyspnea and difficulty breathing, agitation of Qi affecting the form, with death expected within six months; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Heart's front-mu point, accompanied by vexation in the heart, strong desire to drink cold water, yet feeling cold with mild heat, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Heart organ. The disease should manifest as contraction and tension of sinews and vessels, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, abdominal pain, mental discomfort, heat in the shoulders, neck, and body, wasting of flesh, sunken eye sockets, appearance of Zang-pulse, immediate death upon loss of consciousness, or death at the time of its overcoming element if consciousness is retained; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Spleen's front-mu point, accompanied by severe cold, abdominal pain, bowel sounds during fever, and sweating after bowel sounds, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Spleen organ. The disease should manifest as dan-fever (febrile disease), heat in the abdomen, vexation, yellow urine, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, dyspnea and difficulty breathing, internal pain radiating to shoulders and neck, body heat, wasting of flesh, appearance of Zang-pulse, with death within ten days; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Liver's front-mu point, accompanied by a pale greenish complexion, frequent sighing, and a state resembling death, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Liver organ. The disease should manifest as hypochondriac pain, vomiting of food, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, dyspnea and difficulty breathing, internal pain radiating to shoulders and neck, with death expected within one month; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Kidney's front-mu point, accompanied by shivering, lower back and spine pain, restlessness, difficulty in defecation, blurred vision, and cold hands and feet, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Kidney organ. The disease should manifest as painful heat in the lower abdomen, discharge of white turbid matter, and in severe cases, emaciation of the large bones, sinking of the large muscles, depletion of marrow in the shoulders, declining physical activity, absence of Zang-pulse with death expected within one year, or specific prediction of death date if Zang-pulse appears; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Stomach fu organ, accompanied by hunger but inability to eat, abdominal distension after eating, representing the transformation syndrome of the fu organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will enter the Stomach fu organ. The disease should manifest as retained fluid, spitting of saliva, guan-ge (obstruction of upper and lower orifices), accumulation of roundworms, exhaustion of Tian-gui, decline of essence and Qi, and in severe cases, emaciation and shortness of Qi, severance of Stomach collaterals, hematemesis from injury to Yang collaterals, hematochezia from injury to Yin collaterals, and immediate death upon bleeding; if the summer-heat pathogen lodges in the Ying level and is subsequently attacked by wind-cold, resulting in warm malaria characterized by initial heat followed by chills: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to Bi syndrome of Qi and blood becoming wind-Bi, transmitting sequentially, where Bi damages the form and shifts in order, or leads to jaundice from wind stagnation, or gu-poison from pathogenic rebellion in the chest and abdomen. Another type involves winter wind-cold lodging in the bone marrow, followed by exposure to intense summer-heat causing sweat to exit, presenting with bone marrow depletion and muscle wasting, also initial heat followed by chills, named warm malaria: if not treated promptly with standard methods or if antimalarial interventions are applied too early, it often damages the form organs, leading to skin aggregation and hair loss, or bone-withering unable to rise from bed, which is fatal; or bone-withering unable to rise from bed leading to skin aggregation and hair loss is fatal, known as disease ascending from below and damage descending from above. If the summer-heat pathogen lodges in the Ying level, then encounters cool water-cold of summer and descending wind of autumn, resulting in cold malaria characterized by initial chills followed by heat: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it also leads to Bi syndrome of Qi and blood becoming pain-Bi, or water closure causing jaundice, or water-fluid overflowing outside skin and intestines causing edema. If Yin Qi is exhausted first and Yang Qi acts alone, presenting with shortness of Qi, vexation, hot hands and feet, and desire to vomit, resulting in dan malaria characterized by heat without chills: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to burning body heat, blindness, and狂走 (mad running); or abscess and pus formation where heat passes; or stomach疽 (abscess) and intestinal rot, where the person dies with red body color, warm armpits, and heat in the epigastrium. Another type involves pre-existing lung heat, rebellious Qi rushing upward, excess Zhong-Qi not draining, triggered by exertion opening pores, with wind-cold lodging between skin and muscles, presenting with muscle wasting, also heat without chills, named dan malaria: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to coughing and hemoptysis, scorched and broken hair, or lung-withering and lung-abscess with expectoration of saliva and purulent blood.
If the summer-heat pathogen lodges in the Ying level, wind combines and rushes, with only slight deficiency of Wei-Qi failing to lift Yin from below, resulting in pin malaria characterized by chills without heat: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to separation of Yin and Yang, blood stagnating upwards; or heavy Yin causing mania, Yang depletion causing seeing ghosts, where the person dies with blue body color, cold calves, and black lips; if spring-onset malaria features aversion to wind, summer-onset features excessive sweating, winter-onset features mild cold, and these are not treated promptly with standard methods, or if antimalarial interventions are applied too early, the resulting morphological changes manifest according to seasonal sequences, revealing meridian-zang transformations; or having already combined meridian-zang transformations, further generating variable succession based on meridian-zang boundaries. For intermittent fever or multi-day intervals, if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the resulting morphological changes occur because the lodging is deep, horizontally connecting to Mu-yuan, internally pressing the Six Fu organs, easily invading Zang-Fu organs, often leading to untreatable fatal disease. Thus, summer heat is the root cause of disease, while the lodging of Ying-Qi in the body is the superficial manifestation. Autumn's descending wind, bathing waters, and chilling cold are the foundational factors for disease formation. If Wei-Qi is in the Three Yang meridians, this is the mechanism of disease onset. Meridian-zang boundaries are the fields of Ying-lodging. Therefore, alternating chills and heat, along with meridian-zang transformations, are normal; pathogen injection into meridians and flowing into Fu organs, along with victorious syndromes, are variations. Hence, diseases among all ages in a year are similar due to the necessary presence of summer heat in seasonal cycles. Regarding Wu-Yun Liu-Qi, malaria also occurs, requiring separate discussion, as five-year and six-period cycles involve recurring influences. For example, excessive Fire year with prevalent heat causes malaria with accompanying cough, shortness of Qi, bleeding, deafness, dry throat, central heat, shoulder/back heat; deficient Wood year with rebound heat/fire causes chills/fever with accompanying rashes and sores; He-Xi era with heat transformation causes malaria with accompanying ulcers, bleeding, madness, red eyes; Yang-Min ruling Heaven with dryness descending causes sudden heat with chills/fever and accompanying heart pain; Shao-Yin ruling Heaven with heat descending causes prevalent heat with chills/fever and accompanying cough, vomiting, sneezing, nasal discharge, epistaxis, nasal obstruction; Yang-Min administration with great heat causes chills/fever with accompanying cough, throat obstruction, shivering, strangury; Third Qi, dry-heat combination causes chills/fever with accompanying cough, rebellious Qi; Fourth Qi, cold rain causes cold malaria with accompanying bone-withering, bloody stool, sudden collapse, shivering, delirium, shortness of Qi, dry throat with thirst, heart pain, sores; Shao-Yang administration with flowing fire causes chills/fever/malaria with accompanying deafness, blindness, color change; Tai-Yin administration, Fourth Qi, humid heat causes malaria with accompanying pore heat, sudden bleeding, abdominal fullness/heat, severe edema; Shao-Yin administration, Third Qi, great fire causes alternating chills/fever with accompanying cough, asthma, red eyes, Qi reversal, heart pain; Fourth Qi, humidity causes chills/fever with accompanying dry throat, jaundice, rhinorrhea/epistaxis, fluid retention; Fire depression eruption with great heat causes warm malaria with accompanying convulsions, bone pain, limb resentment, sores/rashes, vomiting, acute abdominal pain, bleeding, red eyes, heart heat, severe dizziness/oppression, sweating through Xuan-fu, sudden death; Jue-Yin in Earth with wind excess causes shivering/chills with accompanying yawning/sighing, hypochondriac tightness, abdominal fullness, diaphragm/throat blockage, vomiting after eating, abdominal distension, belching, relief after flatus, heavy body; Shao-Yin in Earth with heat excess causes malaria-like chills/fever with accompanying skin pain, blindness, toothache, swelling, bowel sounds, rising Qi, asthma, inability to stand long, lower abdominal pain/distension; Shao-Yin ruling Heaven with heat excess causes chills/fever with accompanying cough, asthma, bloody sputum, rhinorrhea/epistaxis, urine color change, severe ulcers/swelling, shoulder/back/arm/clavicle pain, lung fullness/asthma; Shao-Yang ruling Heaven with fire excess causes headache, fever/chills forming malaria with accompanying skin heat/pain, yellow/red color change, bloody sputum, internal heat, orthopnea, transmission to water, facial/foot edema; Yang-Min ruling Heaven with dryness excess causes cold/clearness internally, infection forming malaria with accompanying left thigh/hypochondriac pain, cough/bowel sounds, diarrhea/watery stool, severe sudden heart pain, inability to turn, dry throat, dusty face; Tai-Yang victory with condensation/dampness causes malaria with accompanying cold reversal entering stomach, internal heart pain, genital ulcers, difficulty in private functions, muscle spasms, stagnant blood, protruding eyes, cold entering Lower-Jiao transforming into damp diarrhea; Shao-Yin recovery with internal warmth causes chills/fever with accompanying shivering, delirium, post-chill heat, skin pain, sudden aphonia, shortness of Qi, bone-withering, diaphragm/intestinal obstruction, external edema; Shao-Yang recovery with approaching great heat causes malaria with accompanying shivering/extreme cold, post-cold heat, bleeding, shortness of Qi, atrophic pulse, scorched throat collaterals, thirst for fluids, oral ulcers, foot edema, red/yellow color change, frequent urination with stretching. Reviewing operational succession and host/guest influence, all use summer heat as root and Ying-lodging as surface sign. Manifested forms belong to Zang-transformation, meaning disease in the overcoming Zang accepts the non-overcoming Qi. Prescription and treatment have specific indications and contraindications: suppress high, elevate low, reduce excess, tonify deficiency, assist with beneficial agents, harmonize with suitable ones, treat same with difference, follow difference, treat cold with heat, treat heat with cold, to comply with circulation, stabilize host/guest, and adapt to cold/heat. Failure to observe seasonality and host/guest differences, leading to general treatment or early antimalarial intervention, often causes sudden death. Those affected by Central Movement survive half; those affected by Heavenly Punishment do not survive, due to movement damaging Zang organs. Is this not worthy of caution? (Lu Yi) Born in Mu-Lu, dare not force speculative theories for public consumption, strictly following classic discussions, detailing common and variable etiologies and syndromes, compiling annotations for reference. Is this merely casual writing? Indeed, many imperfections remain, seeking correction from distant scholars.