上燔金受火炙故内痛肩背此心之藏也）大骨枯槁大肉陷下胸中气满腹内痛心中不便肩项（前后喘息不便内痛引肩项此段
云心中不便肩项不成文理当亦欠内痛引三字）身热破 脱肉目眶陷真脏见目不见人立死其见人者至其所不胜之时则死（续
肝主目故目眶陷及不见人立死也不胜之时谓庚辛之月此肝之藏滑云此五者肺心脾肾肝玉机真藏论）五脏者中之守也中盛
藏满（中盛谓腹中气盛藏于肺脏）气胜伤恐者（者当作也气胜谓胜于呼吸而喘变易也腹中气盛肺脏充满气胜息变善伤于
恐）声如从室中言是中气之湿也（言声不发如在室中者腹中有湿气也）言而微终日乃复言者此夺气也（续言音微细声断
不续乃夺气然也）衣被不敛言语善恶不辟亲疏者此神明之乱也仓廪不藏者是门户不要也（续仓廪谓脾胃门户谓魄门魄门
即肛门要谓禁要经曰魄门亦为五脏使水谷不得久藏也）水泉不止者是膀胱不藏也（续水泉谓前阴之流注也）得守者生失
守者死五脏者身之强也头者精明之府头倾视深精神将夺矣背者胸之府背曲肩垂府将坏矣腰者肾之府转摇不能肾将惫矣膝
者筋之府屈伸不能行则偻附（一作俯）筋将惫矣骨者髓之府不能久立行则振掉骨将惫矣（续皆以所居所由而为之府也）
得强则生失强则死（五脏者中之守谓五脏之气为人身中之守得守则生失守则死若今所言皆失守者也五脏者身之强也谓五
脏之气为人身中之强得强则生失强则死若今所言皆失强者也盖五脏之气内属本脏外循各经故为守为强有如是者脉要精微
论）帝曰愿闻虚实以决死生岐伯曰五实死五虚死（实谓五脏邪气盛实虚谓五脏真气不足）脉盛（心也）皮热（肺也）腹
胀（脾也）前后不通（肾也）闷瞀（肝也）此谓五实脉细（心也）皮寒（肺也）气少（肝也）泄利前后（肾也）饮食不
下（脾也）此谓五虚曰其时有生者何也曰浆粥入胃泄注止则虚者活身汗得后利则实者活此其候也（玉机真藏论）头痛巅
疾下虚上实过在足少阴巨阳甚则入肾（续膀胱脉从巅络脑挟脊抵腰中循膂络肾属膀胱然肾虚不能引巨阳之气故头痛而为
上巅之疾也经病甚已则入于脏） 蒙招尤（当作 蒙招摇 蒙谓目瞬动而蒙昧下文目冥是也招摇谓头振掉而不定也
声相近摇徭古通用故误 为徇繇为无也）目冥耳聋下实上虚过在足少阳厥阴甚则入肝腹满 胀支膈 胁（ 胁上也愚谓
支执持也谓胸 胁皆执持不利也）下厥上胃（谓气从下逆上而胃于目也）过在足太阴阳明咳嗽上气厥在胸中过在手阳明
太阴（愚谓厥者逆也咳嗽上气乃厥逆之病在胸中也）心烦头痛病在膈中过在手巨阳少阴（以上论手足阴阳者五而无手少
阳厥阴岂君相火为病同耶○雪斋云此言五决为纪故不及手少阳厥阴五脏生成论）帝曰足阳明之脉病恶人与火闻木音则惕
然而惊钟鼓不为动闻木音而惊何也岐伯曰阳明者胃脉也胃者土也故闻木音而惊者土恶木也曰其恶火何也曰阳明主肉其脉
血气盛邪客之则热热则恶火曰其恶人何也曰阳明厥则喘而惋惋则恶人（惋热郁内也阳明之气厥逆则为喘而惋惋热内郁故
恶人烦）曰或喘而死者或喘而生者何也曰厥逆连脏则死连经则生（续经谓经脉脏谓五神脏若喘逆肝连于脏者死神去故也）
曰病甚则弃衣而走登高而歌或至不食数日逾垣上屋所上之处皆非其素能也病反能者何也曰四肢者诸阳之本也（续阳受气
于四肢故四肢为诸阳之本也）阳盛则四肢实实则能登高也曰其弃衣而走者何也曰热盛于身（续阴阳争而外并于阳故热盛
于身）故弃衣而欲走也曰其妄言骂詈不避亲疏而歌者何也曰阳盛则使人妄言骂詈不避亲疏而不欲食不欲食故妄走也（此
处疑有缺误阳明脉解论）二阳之病发心脾有不得隐曲（隐蔽委曲之事）女子不月（王安道曰释者谓男子则脾受之而味不
化故少精女子则心受之而血不流故不月分心脾为男女各受立说殊不知二阳阳明也胃与大肠之脉也脾胃有病心脾受之发心
脾犹言延及于心脾也脾胃为合胃病而及脾理固宜矣大肠与心本非合也今大肠而及心何哉盖胃为受纳之腑大肠为传化之腑
食
入于胃浊气归心饮入于胃输精于脾者以胃能纳大肠能化耳肠胃既病则不能受不能化心脾何所资乎心脾既无所资则无运化
而生精血矣故肠胃有病心脾受之则男为少精女为不月矣心脾当总言男女不当分说至隐曲不月方可分说耳盖男女之精血皆
由五脏六腑之相养而后成其可谓男精资于脾女血资于心乎经本谓男女皆有心脾之病但在男则隐曲不利在女则月事不来耳
○心脾青田老人谓当作肺脾引证下文风消者脾病息贲者肺病深为有理王注亦云胃传脾则为风热而消削大肠传肺则为喘息
而上贲是也有不得隐曲者肺受之则气不化然气化则精生今气不化则精不生矣脾受之则味不化味不化则精无所异是以男子
有不得隐曲也女子不月者肺受之则血不流经曰月事不来者胞脉闭也胞脉者属于心而络于胞中今气上迫肺心气不得下通故
也脾受之则味不化味不化则血无所资所以女子不月）其传为风消其传为息贲者死不治（续胃病深久传入于脾故为风热以
消削大肠病甚传入于肺为喘息而上贲然肠胃脾肺兼及于心二脏二腑互相克薄故死）三阳为病发寒热下为痈肿及为痿厥
（续三阳谓太阳小肠膀胱脉也小肠之脉从手上头膀胱之脉从头下足故在上为病则发寒热在下为病则为痈肿 痿厥也
酸疼也痿无力也厥足冷即气逆也）其传为索泽（谓润泽之气消索也）其传为颓疝（续热甚则精血枯涸故皮肤润泽之气
索然矣然阳气下坠阴脉上争上争则寒多下坠则筋缓故睾垂纵缓内作颓疝）一阳发病少气善咳善泄（续一阳谓少阳胆三焦
脉也胆气乘胃故善泄三焦内病故少气阳上熏肺故善咳何故心火内应而然）其传为心掣其传为膈（续膈气乘心心热故阳气
内掣三焦内结中热故隔塞不便）二阳（阳明）一阴（厥阴心主）发病主惊骇背痛善噫善欠名为风厥（续王注一阴谓厥阴
心主及肝脉也经云心病膺背肩脾间痛又在气为噫故背痛善噫心气不足则肾气乘之肝主惊骇故惊骇善欠夫肝气为风肾气陵
逆既风又厥故名风厥○按此背阴发痛不叙二阳恐缺误也）二阴（少阴心肾）一阳（少阳）发病善胀心满善气（续肾胆同
逆三焦不行气蓄于上故心满下虚上盛故气泄出）三阳（太阳）三阴（太阴）发病为偏枯痿易四肢不举（三阴不足则发偏
枯三阳有余则为痿易易变易常用痿弱无力也）结阴者便血一升（阴生血故）再结（二盛）二升三结（三盛）三升阴阳结
斜多阴少阳曰石水腹肿二阳结谓之消（二阳谓胃与大肠俱热结也肠胃藏热故善消水谷）三阳结谓之隔（谓小肠膀胱热结
也小肠热则血脉燥膀胱热则津液涸故隔塞而不便泻）三阴结谓之水（续谓脾肺俱寒结也脾肺寒结则气化为水）一阴一阳
结谓之喉痹（续三焦心主脉并络喉气热内结故为喉痹）阴搏阳别谓之有子（尺脉搏击与寸口殊别则为有妊滑云尺脉搏手
以阴中别有阳也）阴阳虚肠辟死（续辟利也胃气不留肠开勿禁阴中不廪是阳气竭绝故死）阳加于阴谓之汗（续阳在下阴
在上阳气上搏阴能同之则蒸而为汗）阴虚阳搏谓之崩（续阴脉不足阳脉盛搏则内崩而血流下阴阳别论）帝曰人之居处动
静勇怯脉亦为之变乎岐伯曰凡人之惊巩恚劳动静皆为变也（续变易常候）是以夜行则喘出于肾（续肾主于夜气合齿冥故
夜行则喘息内从肾出也）淫气病肺（续夜行肾劳因而喘息气淫不次则病肺也）有所堕恐喘出于肝淫气害脾（续恐生于肝
堕损筋血因而奔喘故出于肝肝木妄淫害脾土也）有所惊恐喘出于肺淫气伤心（惊则心无所根据神无所归气乱胸中故喘出于
肺也惊则神越故气淫反伤心也）度水跌仆喘出于肾与骨（续湿气通肾骨肾主之故度水跌仆喘出肾骨矣跌足跌仆身倒也）
当是之时勇者气行则已怯者则着而为病也故曰诊病之道观人勇怯骨肉皮肤能知其情以为诊法也故饮食饱甚汗出于胃（续
惊夺心精神气浮越阳内薄之故汗出于胃）持重远行汗出于肾（续骨劳气越肾复过疲故持重远行汗出于肾）疾走恐惧汗出
于肝（续暴役于筋肝气罢极故汗出于肝）摇体劳苦汗出于脾（续动作用力则谷精四布脾化水谷故汗出于脾）故春秋冬夏
四时阴阳生病起于过用此为常也（续不适其性而强云为过则病生此其常理五脏受气盖有常分用而遏耗是以病生经脉别
论）百病之始生也必先于皮毛邪中之则腠理开开则入客于络脉留而不去传入于经留而不去传入于腑廪积聚于肠胃邪之始
入于皮也 然起毫毛开腠理（续 然恶寒也起毛起竖也腠理谓皮空及文理也）其入于络也则络脉盛色变（续盛谓盛满变
谓易其常也）其入客于经也则感虚乃陷下（续经虚邪入故曰感虚脉虚气少故陷下也）其留于筋骨之间寒多则筋挛骨痛热
多则筋弛骨消肉烁 破毛直而败（续经曰寒则筋急热则筋缓寒胜为痛热胜为气消 者肉之标故肉消则 破毛直而败也皮
部论）帝曰人有逆气不得卧而息有音者有不得卧而息无音者有起如故而息有音者有得卧行而喘者有不得卧不（滑云多一
不字）能行而喘者有不得卧卧而喘者皆何脏使然（以上六问而下但三答亦脱简也）岐伯曰不得卧而息有音者是阳明之逆
也足三阳者下行今逆而上行故息有音也阴阳者胃脉也胃者六腑之海（水谷海也）其气亦下行阳明逆不得从其道故不得卧
也下经曰（上古经也）胃不和则卧不安此之谓也夫起居如故而息有音者此肺之络脉逆也络脉不得随经上下故留经而不行
络脉之病患也微故起居如故而息有音者也夫不得卧卧则喘者是水气之客也夫水者循津液而流也肾者水脏主津液主卧与喘
也（不得卧而息无音有得卧行而喘有不得卧能行而喘三义俱无所答逆调论）帝曰人之不得偃（仰也）卧者何也岐伯曰肺
者脏之盖也肺气盛则脉大（脉谓脉隧也）脉大则不得偃卧（续肺气盛满仰卧则气促喘奔故也）帝曰人有卧而有所不能安
者何也岐伯曰脏有所伤及精有所之寄则安（甲乙经作情有所倚则不安）故人不能悬其病也（续五脏有所伤损及之水谷精
气有所之寄扶其下则卧安以伤及于脏故人不能悬其病处于空中也病能论）帝曰有病肾风者面 庞然壅害于言可刺否（续
庞然肿起貌壅谓目下壅如卧蚕形肾脉入肺中循喉咙挟舌本故妨害于言语）岐伯曰虚不当刺不当刺而刺后五日其气必至（续
至谓病气来至也然一脏配一日五日至肾肾已不足风内薄之谓肿为实以针大泻反伤脏气真气不足不可复故刺后五日其气必
至也）曰其至何如曰至必少气时热时热从胸背上至头汗出手热口干善渴小便黄目下肿腹中鸣身重难以行月事不来烦而不
能正偃正偃则咳病名曰风水（始为肝风因不当刺亦为风水肝当作肾亦当作变）帝曰愿闻其说岐伯曰邪之所凑其气必虚阴
虚者阳必凑之故少气时热而汗出也小便黄者少腹中有热也不能正偃者胃中不和也正偃则咳甚上迫肺也诸有水气者微肿先
见于目下也其气上逆故口苦舌干卧不得正偃正偃则咳出清水也诸水病者故不得卧卧则惊惊则咳甚也腹中鸣者病本于胃也
薄脾则烦不能食食则不能下者胃脘膈也身重难以行者胃脉在足也月事不来者胞脉闭也胞脉者属心而络于胞中今气上迫肺
心气不得下通故月事不来也（续考上文所释之义未解热从胸背上至头汗出手热口干苦渴之义应古论简脱而此差谬之耳如
是者何肾脉从肾上贯肝膈入肺循喉咙挟舌本膀胱脉从巅络脑还出别下项循肩膊内挟脊抵腰循中膂今阴不足而阳有余故热
从胸背上至头而汗退场门干苦渴也然心者阳脏也其脉行于臂手肾者阴脏也其脉循于胸足肾不足则心气有余故手热矣又心肾
之脉俱少阴也评热论）帝曰少阴何以主肾肾何以主水岐伯曰肾者至阴也至阴者盛水也肺者太阴也少阴者冬脉也故其本在
肾其末在肺皆积水也（续阴者谓寒也冬月至寒肾气合应故云肾者至阴也水旺于冬故云至阴者盛水也肾少阴脉从肾上贯肝
膈入肺中故云其本在肾其末在肺也肾气上逆则水气客于肺中故云皆积水也）曰肾何以能聚水而生病曰肾者胃之关也关门
不利故聚水而从其类也（续关者所以司出入也肾主下焦膀胱为腑主其分注关窍二阴故肾气化则二阴通二阴闭则胃 满故
云肾者肾之关也关闭则水积水积则气停气停则水生水生积则气溢气水同类故云关闭不利聚水而从其类也经曰下焦溢为水
此之谓也）上下溢于皮肤故为 肿 肿者聚水而生病也（续上谓肺下谓肾肺肾俱溢故聚水于腹中而生病）曰诸水皆生于
肾乎曰肾者牝脏也（续牝阴也亦主阴位故云牝脏）地气上者属于肾而生水液也故曰至阴勇而劳甚则肾汗出肾汗出逢于风
内不得入于脏腑外不得越于皮肤客于玄府行于皮里传于 肿本之于肾名曰风水（续勇劳汗出谓力房汗出则玄府开汗出逢
风则玄府复闭玄府闭已则余汗未出内伏皮肤传化为水从风而水故名风水）所谓玄府者汗空也（续汗液色玄从空而出以汗
聚于里故谓之府府聚也）故水病下为 肿大腹上为喘呼（续水下居于肾则腹至足而 肿上入行肺则喘息奔疾而大呼也）
（这段文字主要论述了五脏精气衰竭的征象、虚实死生之候、六经病变及水气病的机理。）
大骨枯槁，大肉陷下，胸中气满，腹内痛，心中不便，肩项（前后）喘息不便，内痛引肩项。此段云“心中不便肩项”不成文理，当亦欠“内痛引”三字。身热，破䐃脱肉，目眶陷，真脏见，目不见人，立死；其见人者，至其所不胜之时则死。（续：肝主目，故目眶陷及不见人立死也。不胜之时谓庚辛之月。此肝之藏。滑云：此五者肺心脾肾肝玉机真藏论。）
五脏者，中之守也。中盛藏满，气胜伤恐者（者当作也，气胜谓胜于呼吸而喘变易也。腹中气盛，肺脏充满，气胜息变，善伤于恐）。声如从室中言，是中气之湿也（言声不发，如在室中者，腹中有湿气也）。言而微，终日乃复言者，此夺气也（续：言音微细，声断不续，乃夺气然也）。衣被不敛，言语善恶不辟亲疏者，此神明之乱也。仓廪不藏者，是门户不要也（续：仓廪谓脾胃，门户谓魄门，魄门即肛门，要谓禁要。经曰：魄门亦为五脏使，水谷不得久藏也）。水泉不止者，是膀胱不藏也（续：水泉谓前阴之流注也）。得守者生，失守者死。
五脏者，身之强也。头者，精明之府，头倾视深，精神将夺矣。背者，胸之府，背曲肩垂，府将坏矣。腰者，肾之府，转摇不能，肾将惫矣。膝者，筋之府，屈伸不能，行则偻附（一作俯），筋将惫矣。骨者，髓之府，不能久立，行则振掉，骨将惫矣（续：皆以所居、所由而为之府也）。得强则生，失强则死（五脏者中之守，谓五脏之气为人身中之守，得守则生，失守则死。若今所言，皆失守者也。五脏者身之强也，谓五脏之气为人身中之强，得强则生，失强则死。若今所言，皆失强者也。盖五脏之气内属本脏，外循各经，故为守为强，有如是者。脉要精微论）。
帝曰：愿闻虚实以决死生。岐伯曰：五实死，五虚死（实谓五脏邪气盛实，虚谓五脏真气不足）。脉盛（心也），皮热（肺也），腹胀（脾也），前后不通（肾也），闷瞀（肝也），此谓五实。脉细（心也），皮寒（肺也），气少（肝也），泄利前后（肾也），饮食不下（脾也），此谓五虚。曰：其时有生者何也？曰：浆粥入胃，泄注止，则虚者活；身汗得后利，则实者活。此其候也（玉机真藏论）。
头痛巅疾，下虚上实，过在足少阴、巨阳，甚则入肾（续：膀胱脉从巅络脑，挟脊抵腰中，循膂络肾，属膀胱。然肾虚不能引巨阳之气，故头痛而为上巅之疾也。经病甚已，则入于脏）。蒙招尤（当作蒙招摇，蒙谓目瞬动而蒙昧，下文目冥是也。招摇谓头振掉而不定也。声相近，摇、徭古通用，故误为徇、繇为无也），目冥耳聋，下实上虚，过在足少阳、厥阴，甚则入肝。腹满胀，支膈胁（胁上也。愚谓支执持也，谓胸胁皆执持不利也）。下厥上冒（谓气从下逆上而冒于目也）。过在足太阴、阳明。咳嗽上气，厥在胸中，过在手阳明、太阴（愚谓厥者逆也，咳嗽上气乃厥逆之病，在胸中也）。心烦头痛，病在膈中，过在手巨阳、少阴（以上论手足阴阳者五，而无手少阳、厥阴，岂君相火为病同耶？○雪斋云：此言五决为纪，故不及手少阳、厥阴。五脏生成论）。
帝曰：足阳明之脉病，恶人与火，闻木音则惕然而惊，钟鼓不为动，闻木音而惊，何也？岐伯曰：阳明者，胃脉也。胃者，土也，故闻木音而惊者，土恶木也。曰：其恶火何也？曰：阳明主肉，其脉血气盛，邪客之则热，热则恶火。曰：其恶人何也？曰：阳明厥则喘而惋，惋则恶人（惋，热郁内也。阳明之气厥逆，则为喘而惋，惋热内郁，故恶人烦）。曰：或喘而死者，或喘而生者，何也？曰：厥逆连脏则死，连经则生（续：经谓经脉，脏谓五神脏。若喘逆肝连于脏者，死神去故也）。曰：病甚则弃衣而走，登高而歌，或至不食数日，逾垣上屋，所上之处皆非其素能也，病反能者，何也？曰：四肢者，诸阳之本也（续：阳受气于四肢，故四肢为诸阳之本也）。阳盛则四肢实，实则能登高也。曰：其弃衣而走者，何也？曰：热盛于身（续：阴阳争而外并于阳，故热盛于身），故弃衣而欲走也。曰：其妄言骂詈，不避亲疏而歌者，何也？曰：阳盛则使人妄言骂詈，不避亲疏，而不欲食，不欲食故妄走也（此处疑有缺误。阳明脉解论）。
二阳之病发心脾，有不得隐曲（隐蔽委曲之事），女子不月（王安道曰：释者谓男子则脾受之而味不化，故少精；女子则心受之而血不流，故不月。分心脾为男女各受，立说殊不知二阳阳明也，胃与大肠之脉也。脾胃有病，心脾受之，发心脾犹言延及于心脾也。脾胃为合，胃病而及脾，理固宜矣。大肠与心本非合也，今大肠而及心何哉？盖胃为受纳之腑，大肠为传化之腑，食入于胃，浊气归心；饮入于胃，输精于脾者，以胃能纳，大肠能化耳。肠胃既病，则不能受，不能化，心脾何所资乎？心脾既无所资，则无运化而生精血矣。故肠胃有病，心脾受之，则男为少精，女为不月矣。心脾当总言男女，不当分说。至隐曲、不月方可分说耳。盖男女之精血，皆由五脏六腑之相养而后成，其可谓男精资于脾，女血资于心乎？经本谓男女皆有心脾之病，但在男则隐曲不利，在女则月事不来耳。○心脾青田老人谓当作肺脾，引证下文风消者脾病，息贲者肺病，深为有理。王注亦云：胃传脾则为风热而消削，大肠传肺则为喘息而上贲是也。有不得隐曲者，肺受之则气不化，然气化则精生，今气不化则精不生矣。脾受之则味不化，味不化则精无所异，是以男子有不得隐曲也。女子不月者，肺受之则血不流，经曰：月事不来者，胞脉闭也。胞脉者属于心而络于胞中，今气上迫肺，心气不得下通，故也。脾受之则味不化，味不化则血无所资，所以女子不月）。其传为风消，其传为息贲者，死不治（续：胃病深久，传入于脾，故为风热以消削；大肠病甚，传入于肺，为喘息而上贲。然肠胃脾肺兼及于心二脏二腑，互相克薄，故死）。
三阳为病，发寒热，下为痈肿，及为痿厥酸疼也（痿无力也，厥足冷，即气逆也）。其传为索泽（谓润泽之气消索也）。其传为颓疝（续：热甚则精血枯涸，故皮肤润泽之气索然矣。然阳气下坠，阴脉上争，上争则寒多，下坠则筋缓，故睾垂纵缓，内作颓疝）。
一阳发病，少气，善咳，善泄（续：一阳谓少阳胆、三焦脉也。胆气乘胃，故善泄；三焦内病，故少气；阳上熏肺，故善咳。何故心火内应而然？）。其传为心掣，其传为膈（续：膈气乘心，心热，故阳气内掣；三焦内结，中热，故隔塞不便）。
二阳（阳明）、一阴（厥阴心主）发病，主惊骇，背痛，善噫，善欠，名为风厥（续：王注一阴谓厥阴心主及肝脉也。经云：心病膺背肩脾间痛，又在气为噫，故背痛善噫。心气不足，则肾气乘之。肝主惊骇，故惊骇善欠。夫肝气为风，肾气陵逆，既风又厥，故名风厥。○按：此背阴发痛，不叙二阳，恐缺误也）。
二阴（少阴心肾）、一阳（少阳）发病，善胀，心满，善气（续：肾胆同逆，三焦不行气，蓄于上，故心满；下虚上盛，故气泄出）。
三阳（太阳）、三阴（太阴）发病，为偏枯，痿易，四肢不举（三阴不足，则发偏枯；三阳有余，则为痿易。易，变易常用，痿弱无力也）。
结阴者，便血一升（阴生血故）。再结（二盛），二升。三结（三盛），三升。阴阳结斜，多阴少阳，曰石水，腹肿。二阳结谓之消（二阳谓胃与大肠俱热结也。肠胃藏热，故善消水谷）。三阳结谓之隔（谓小肠、膀胱热结也。小肠热则血脉燥，膀胱热则津液涸，故隔塞而不便泻）。三阴结谓之水（续：谓脾肺俱寒结也。脾肺寒结，则气化为水）。一阴一阳结谓之喉痹（续：三焦、心主脉并络喉，气热内结，故为喉痹）。
阴搏阳别，谓之有子（尺脉搏击与寸口殊别，则为有妊。滑云：尺脉搏手，以阴中别有阳也）。阴阳虚，肠辟死（续：辟利也。胃气不留，肠开勿禁，阴中不廪，是阳气竭绝，故死）。阳加于阴，谓之汗（续：阳在下，阴在上，阳气上搏，阴能同之，则蒸而为汗）。阴虚阳搏，谓之崩（续：阴脉不足，阳脉盛搏，则内崩而血流下。阴阳别论）。
帝曰：人之居处动静勇怯，脉亦为之变乎？岐伯曰：凡人之惊巩恚劳，动静皆为变也（续：变易常候）。是以夜行则喘出于肾（续：肾主于夜，气合齿冥，故夜行则喘息内从肾出也）。淫气病肺（续：夜行肾劳，因而喘息，气淫不次，则病肺也）。有所堕恐，喘出于肝，淫气害脾（续：恐生于肝，堕损筋血，因而奔喘，故出于肝。肝木妄淫，害脾土也）。有所惊恐，喘出于肺，淫气伤心（惊则心无所根据，神无所归，气乱胸中，故喘出于肺也。惊则神越，故气淫反伤心也）。度水跌仆，喘出于肾与骨（续：湿气通肾，骨肾主之，故度水跌仆，喘出肾骨矣。跌，足跌；仆，身倒也）。当是之时，勇者气行则已，怯者则着而为病也。故曰：诊病之道，观人勇怯、骨肉、皮肤，能知其情，以为诊法也。
故饮食饱甚，汗出于胃（续：惊夺心精神，气浮越，阳内薄之，故汗出于胃）。持重远行，汗出于肾（续：骨劳，气越，肾复过疲，故持重远行，汗出于肾）。疾走恐惧，汗出于肝（续：暴役于筋，肝气罢极，故汗出于肝）。摇体劳苦，汗出于脾（续：动作用力，则谷精四布，脾化水谷，故汗出于脾）。故春秋冬夏，四时阴阳，生病起于过用，此为常也（续：不适其性而强云为过，则病生，此其常理。五脏受气，盖有常分，用而遏耗，是以病生。经脉别论）。
百病之始生也，必先于皮毛，邪中之则腠理开，开则入客于络脉，留而不去，传入于经，留而不去，传入于腑，廪积聚于肠胃。邪之始入于皮也，泝然起毫毛，开腠理（续：泝然，恶寒也。起毛起竖也。腠理谓皮空及文理也）。其入于络也，则络脉盛色变（续：盛谓盛满，变谓易其常也）。其入客于经也，则感虚乃陷下（续：经虚，邪入，故曰感虚。脉虚气少，故陷下也）。其留于筋骨之间，寒多则筋挛骨痛，热多则筋弛骨消，肉烁㾗破，毛直而败（续：经曰：寒则筋急，热则筋缓。寒胜为痛，热胜为气消。㾗者，肉之标，故肉消则㾗破。毛直而败也。皮部论）。
帝曰：人有逆气不得卧而息有音者，有不得卧而息无音者，有起如故而息有音者，有得卧行而喘者，有不得卧不能行而喘者，有不得卧卧而喘者，皆何脏使然（以上六问而下但三答，亦脱简也）？岐伯曰：不得卧而息有音者，是阳明之逆也。足三阳者下行，今逆而上行，故息有音也。阴阳者，胃脉也。胃者，六腑之海（水谷海也），其气亦下行。阳明逆，不得从其道，故不得卧也。下经曰（上古经也）：胃不和则卧不安，此之谓也。夫起居如故而息有音者，此肺之络脉逆也。络脉不得随经上下，故留经而不行。络脉之病患也微，故起居如故而息有音者也。夫不得卧，卧则喘者，是水气之客也。夫水者，循津液而流也。肾者，水脏，主津液，主卧与喘也（不得卧而息无音，有得卧行而喘，有不得卧能行而喘，三义俱无所答。逆调论）。
帝曰：人之不得偃（仰也）卧者，何也？岐伯曰：肺者，脏之盖也。肺气盛则脉大（脉谓脉隧也）。脉大则不得偃卧（续：肺气盛满，仰卧则气促喘奔，故也）。帝曰：人有卧而有所不能安者，何也？岐伯曰：脏有所伤及，精有所之寄则安（甲乙经作情有所倚则不安）。故人不能悬其病也（续：五脏有所伤损，及之水谷精气有所之寄，扶其下则卧安。以伤及于脏，故人不能悬其病处于空中也。病能论）。
帝曰：有病肾风者，面胕庞然壅，害于言，可刺否？（续：庞然肿起貌。壅谓目下壅如卧蚕形。肾脉入肺中，循喉咙，挟舌本，故妨害于言语。）岐伯曰：虚不当刺，不当刺而刺，后五日其气必至（续：至谓病气来至也。然一脏配一日，五日至肾。肾已不足，风内薄之，谓肿为实，以针大泻，反伤脏气，真气不足，不可复，故刺后五日其气必至也）。曰：其至何如？曰：至必少气，时热，时热从胸背上至头，汗出手热，口干善渴，小便黄，目下肿，腹中鸣，身重难以行，月事不来，烦而不能正偃，正偃则咳。病名曰风水（始为肝风，因不当刺，亦为风水。肝当作肾，亦当作变）。帝曰：愿闻其说。岐伯曰：邪之所凑，其气必虚。阴虚者，阳必凑之，故少气时热而汗出也。小便黄者，少腹中有热也。不能正偃者，胃中不和也。正偃则咳甚，上迫肺也。诸有水气者，微肿先见于目下也。其气上逆，故口苦舌干，卧不得正偃，正偃则咳出清水也。诸水病者，故不得卧。卧则惊，惊则咳甚也。腹中鸣者，病本于胃也。薄脾则烦不能食，食则不能下者，胃脘膈也。身重难以行者，胃脉在足也。月事不来者，胞脉闭也。胞脉者，属心而络于胞中。今气上迫肺，心气不得下通，故月事不来也（续：考上文所释之义未解，热从胸背上至头，汗出，手热口干苦渴之义，应古论简脱而此差谬之耳。如是者何？肾脉从肾上贯肝膈入肺，循喉咙，挟舌本。膀胱脉从巅络脑，还出别下项，循肩膊内挟脊抵腰，循中膂。今阴不足而阳有余，故热从胸背上至头而汗退场门干苦渴也。然心者阳脏也，其脉行于臂手；肾者阴脏也，其脉循于胸足。肾不足则心气有余，故手热矣。又心肾之脉俱少阴也。评热论）。
帝曰：少阴何以主肾？肾何以主水？岐伯曰：肾者，至阴也。至阴者，盛水也。肺者，太阴也。少阴者，冬脉也。故其本在肾，其末在肺，皆积水也（续：阴者谓寒也。冬月至寒，肾气合应，故云肾者至阴也。水旺于冬，故云至阴者盛水也。肾少阴脉从肾上贯肝膈入肺中，故云其本在肾，其末在肺也。肾气上逆，则水气客于肺中，故云皆积水也）。曰：肾何以能聚水而生病？曰：肾者，胃之关也。关门不利，故聚水而从其类也（续：关者，所以司出入也。肾主下焦，膀胱为腑，主其分注关窍二阴。故肾气化则二阴通，二阴闭则胃 满。故云肾者肾之关也。关闭则水积，水积则气停，气停则水生，水生积则气溢。气水同类，故云关闭不利，聚水而从其类也。经曰：下焦溢为水，此之谓也）。上下溢于皮肤，故为 肿。 肿者，聚水而生病也（续：上谓肺，下谓肾。肺肾俱溢，故聚水于腹中而生病）。曰：诸水皆生于肾乎？曰：肾者，牝脏也（续：牝，阴也。亦主阴位，故云牝脏）。地气上者属于肾，而生水液也。故曰：至阴勇而劳甚则肾汗出，肾汗出逢于风，内不得入于脏腑，外不得越于皮肤，客于玄府，行于皮里，传于 肿。本之于肾，名曰风水（续：勇劳汗出，谓力房汗出，则玄府开。汗出逢风，则玄府复闭。玄府闭已，则余汗未出，内伏皮肤，传化为水，从风而水，故名风水）。所谓玄府者，汗空也（续：汗液色玄，从空而出，以汗聚于里，故谓之府。府，聚也）。故水病下为 肿大腹，上为喘呼（续：水下居于肾，则腹至足而 肿；上入行肺，则喘息奔疾而大呼也）。
(The following text discusses the signs of exhaustion of the five zang organs' essence and qi, the prognosis of death and life based on excess and deficiency patterns, the pathologies of the six meridians, and the mechanisms of water-dampness diseases.)
When the large bones are withered and the large muscles are sunken, there is fullness in the chest, internal pain in the abdomen, discomfort in the heart region, and difficulty in breathing from the shoulders and neck. The internal pain radiates to the shoulders and neck. (Note: The phrase "discomfort in the heart region and shoulders/neck" lacks logical coherence; it likely omits the characters "internal pain radiates".) There is fever, destruction of the flesh, sunken eye orbits, appearance of the true zang pulse, and inability to recognize people. Death occurs immediately; if the patient can still recognize people, death will occur during the time when their element is overcome by another (e.g., Geng-Xin months for Liver). (Continuation: The Liver governs the eyes, so sunken eye orbits and inability to recognize people lead to immediate death. The "time of being overcome" refers to the Geng-Xin months. This describes the Liver's condition. Hua Shou notes: These five conditions correspond to the Lung, Heart, Spleen, Kidney, and Liver as described in the *Yu Ji Zhen Zang Lun*.)
The Five Zang organs are the guardians within the body. When there is excessive fullness in the center (abdomen) and the zang organs, and excessive qi leading to fear (the character 'zhe' should be 'ye'; excessive qi means surpassing normal respiration and causing panting. Abdominal qi is excessive, lung qi is full, rapid breathing easily injures the fear aspect), the voice sounds as if coming from inside a room (this indicates dampness in the middle jiao; the voice is muffled as if speaking indoors due to abdominal dampness). Speaking faintly and only repeating words throughout the day indicates depletion of qi (voice is thin and intermittent, signifying qi depletion). Inability to control clothing, and speech that does not distinguish between good/bad or close/distant relatives, indicates chaos of the spirit-mind. Inability to store food and fluids ("granaries") indicates failure of the gatekeeper ("doorway", referring to the Po Men or anus, which controls excretion. The Classics state: The Po Men serves the five zang organs and does not allow food and fluids to remain long). Uncontrollable urination ("water springs") indicates the Bladder's failure to store urine (urinary flow from the anterior yin). Those who retain these functions live; those who lose them die.
The Five Zang organs determine the strength of the body. The head is the mansion of clarity and spirit; if the head tilts and vision is deep/dull, the spirit is about to be depleted. The back is the mansion of the chest; if the back is curved and shoulders droop, the mansion is failing. The waist is the mansion of the Kidneys; if turning and shaking are difficult, the Kidneys are exhausted. The knees are the mansion of the sinews; if flexion and extension are impossible and walking requires stooping, the sinews are exhausted. The bones are the mansion of the marrow; if one cannot stand for long and trembles while walking, the bones are exhausted (Continuation: These are called mansions because they reside in and derive from these structures). Retaining strength leads to life; losing strength leads to death. (The Five Zang as internal guardians means their qi guards the body; retaining this guard ensures life. Losing it ensures death. As stated above, all describe loss of guarding. The Five Zang as bodily strength means their qi provides physical robustness; retaining strength ensures life. Losing it ensures death. The qi of the five zang internally belongs to the respective zang and externally circulates through the meridians, thus acting as guardians and sources of strength. See *Mai Yao Jing Wei Lun*.)
The Emperor asked: I wish to hear how to distinguish excess and deficiency to determine life and death. Qibo replied: Five Excesses lead to death, and Five Deficiencies lead to death (Excess refers to flourishing evil qi in the five zang; Deficiency refers to insufficiency of true qi in the five zang). Pulse is surging (Heart), skin is hot (Lung), abdomen is distended (Spleen), front and rear orifices are blocked (Kidney), oppression and dizziness (Liver); this is called Five Excesses. Pulse is fine (Heart), skin is cold (Lung), qi is scanty (Liver), diarrhea and incontinence of front and rear orifices (Kidney), inability to eat or drink (Spleen); this is called Five Deficiencies. The Emperor asked: Is there any case where survival is possible? Qibo replied: If gruel and porridge enter the stomach and diarrhea stops, the deficient patient lives; if sweat appears and bowel movements become unblocked, the excess patient lives. These are the prognostic signs (See *Yu Ji Zhen Zang Lun*).
Headache affecting the vertex, caused by deficiency below and excess above, involves the Foot Shaoyin and Taiyang meridians; if severe, it enters the Kidney (Continuation: The Bladder meridian connects to the brain at the vertex, runs along the spine to the waist, links to the Kidney, and belongs to the Bladder. However, Kidney deficiency fails to guide Taiyang qi upward, causing headache at the vertex. When channel disease becomes severe, it enters the zang organ). Dizziness and trembling (should read Meng Zhao Yao; Meng refers to blurred vision and eye twitching, as mentioned later in "blindness"; Zhao Yao refers to head trembling and instability. Due to phonetic similarity, Yao and Yao were interchangeable in ancient texts, leading to errors like Xun or You meaning nothing), blindness, and deafness, caused by excess below and deficiency above, involve the Foot Shaoyang and Jueyin meridians; if severe, it enters the Liver. Abdominal fullness and distension, support-like obstruction in the chest and hypochondrium (above the ribs. Note: Zhi means holding/stiffness, implying stiffness and discomfort in the chest and hypochondrium). Reversal of qi from below rising to cover the head (qi reverses from below upwards to obscure the eyes). Involves the Foot Taiyin and Yangming meridians. Coughing and rebellious qi, rebellion located in the chest, involves the Hand Yangming and Taiyin meridians (Note: Jue means reversal. Coughing and rebellious qi are disorders of reversal located in the chest). Heart vexation and headache, disease located in the diaphragm, involves the Hand Taiyang and Shaoyin meridians (Above discusses five hand-foot yin-yang pairs, omitting Hand Shaoyang and Jueyin; perhaps Ministerial Fire diseases are similar? ○ Xuezhai says: This states the principles of the Five Decisions, hence Hand Shaoyang and Jueyin are omitted. See *Wu Zang Sheng Cheng Lun*).
The Emperor asked: When the Foot Yangming meridian is diseased, the patient fears people and fire, startles at the sound of wood but is unmoved by bells and drums. Why does the sound of wood cause startling? Qibo replied: Yangming is the Stomach meridian. The Stomach is Earth, and Earth fears Wood, hence the startle at the sound of wood. The Emperor asked: Why does he fear fire? Qibo replied: Yangming governs the flesh, and its channels are rich in blood and qi. When evil invades, heat arises, and heat causes aversion to fire. The Emperor asked: Why does he fear people? Qibo replied: When Yangming qi rebels, panting and inner distress occur, and inner distress causes aversion to people (Wan means internal heat stagnation. Yangming qi rebellion causes panting and distress; internal heat stagnation leads to aversion to people). The Emperor asked: Why do some die from panting while others survive? Qibo replied: If rebellion connects to the zang organs, death ensues; if it connects only to the channels, survival is possible (Continuation: Channels refer to the meridians; zang organs refer to the Five Spirit Zang. If panting/rebellion affects the Liver connected to the zang, death occurs because the spirit departs). The Emperor asked: In severe cases, patients discard clothes and run, climb high and sing, may go without food for days, jump over walls and roofs—places they could never reach before. How can they perform feats beyond their usual ability? Qibo replied: The four limbs are the root of all yang qi (Continuation: Yang qi receives nourishment in the four limbs, so they are the root of yang). When yang is excessive, the four limbs become solid/full, enabling climbing. The Emperor asked: Why discard clothes and run? Qibo replied: Heat is excessive in the body (Continuation: Yin and yang contend, and yang externalizes, causing excessive heat in the body), so they discard clothes and wish to run. The Emperor asked: Why do they speak wildly, curse, ignore kinship ties, and sing? Qibo replied: Yang excess causes wild speech, cursing, ignoring social boundaries, and lack of appetite. Lack of appetite leads to wandering (There may be missing text here. See *Yang Ming Mai Jie Lun*).
Diseases of Er Yang (Yangming) originate in the Heart and Spleen, involving hidden difficulties (private matters), and women experience amenorrhea. (Wang Andao explains: Some say men suffer Spleen issues leading to poor transformation of flavors and scanty essence; women suffer Heart issues leading to poor blood flow and amenorrhea. Dividing Heart/Spleen by gender is incorrect. Er Yang refers to Yangming, the Stomach and Large Intestine meridians. Spleen/Stomach diseases affect the Heart and Spleen, meaning the disease extends to them. Stomach and Spleen are interior-exterior pairs; Stomach disease affecting Spleen is logical. But Large Intestine and Heart are not paired. Why does Large Intestine affect Heart? The Stomach is the receiving vessel, Large Intestine the transforming vessel. Food entering the Stomach sends turbid qi to the Heart; drinks entering the Stomach send refined essence to the Spleen. Because the Stomach receives and Large Intestine transforms. If intestines/stomach are diseased, they cannot receive or transform, leaving no resources for Heart and Spleen. Without resources, Heart and Spleen cannot transform and generate essence/blood. Thus, intestinal/stomach disease affecting Heart/Spleen causes scanty essence in men and amenorrhea in women. Heart and Spleen should be discussed generally for both genders; only specific symptoms like hidden difficulties and amenorrhea should be differentiated. Essence and blood for both genders rely on mutual nourishment of the six fu and five zang organs. Can we say male essence relies on Spleen and female blood on Heart? The Classic implies both genders have Heart/Spleen disease, but men present with sexual dysfunction and women with amenorrhea. ○ Qing Tian Laoren suggests reading "Lung-Spleen" instead of "Heart-Spleen", citing later text: Wind-consumption is Spleen disease, Xi Ben is Lung disease. Wang Bing also notes: Stomach transmitting to Spleen causes wind-heat consumption; Large Intestine transmitting to Lung causes panting and rising qi. For hidden difficulties, if Lung is affected, qi fails to transform; transformation generates essence, so lack of transformation means no essence. If Spleen is affected, flavors fail to transform; lack of flavor transformation means no resource for essence, causing sexual dysfunction in men. For amenorrhea, if Lung is affected, blood fails to flow. The Classics state: Amenorrhea results from closure of the Bao Mai (Conception Vessel network). The Bao Mai belongs to the Heart and connects to the Bao (Uterus). Now, qi presses upward on the Lung, preventing Heart qi from descending, hence amenorrhea. If Spleen is affected, flavors fail to transform; lack of flavor transformation means no resource for blood, hence amenorrhea). If transmitted as Wind Consumption or Xi Ben (Panting and Rising Qi), death is inevitable and untreatable (Continuation: Long-standing Stomach disease transmits to Spleen, causing wind-heat consumption. Severe Large Intestine disease transmits to Lung, causing panting and rising qi. Since Stomach/Intestines/Spleen/Lung involve Heart and Liver, mutual overcoming leads to death).
Diseases of San Yang (Taiyang) manifest as alternating chills and fever, abscesses/swellings below, and flaccidity/cold limbs (Wei means weakness; Jue means cold feet, i.e., qi reversal). If transmitted as Suo Ze (loss of skin luster/moisture) or Tui Shan (scrotal hernia/relaxation) (Continuation: Severe heat exhausts essence and blood, causing loss of skin moisture. Yang qi sinks downward, yin pulses compete upward. Upward competition causes cold; downward sinking causes tendon laxity, leading to relaxed scrotum and internal hernia).
Diseases of Yi Yang (Shaoyang) manifest as shortness of breath, frequent coughing, and frequent diarrhea (Continuation: Yi Yang refers to Shaoyang Gallbladder and Sanjiao meridians. Gallbladder qi invading Stomach causes diarrhea; internal Sanjiao disease causes shortness of breath; yang ascending steams Lung causing cough. Why does Heart Fire respond internally?). If transmitted as Xin Che (heart pulling/tugging) or Ge (diaphragmatic obstruction) (Continuation: Diaphragm qi invades Heart, causing heart heat and internal pulling of yang qi; internal Sanjiao knotting and middle heat cause diaphragmatic obstruction).
Diseases of Er Yang (Yangming) and Yi Yin (Jueyin Pericardium) manifest primarily with fright, back pain, frequent belching, and yawning, named Feng Jue (Wind Jue) (Continuation: Wang Bing notes Yi Yin refers to Jueyin Pericardium and Liver. Classics state: Heart disease causes pain in chest, back, shoulder, and spleen area; in qi it manifests as belching, hence back pain and belching. Heart qi deficiency allows Kidney qi to invade. Liver governs fright, hence fright and yawning. Liver qi is Wind, Kidney qi is rebellious; thus Wind and Jue, named Feng Jue. ○ Note: Back yin pain is mentioned, but Er Yang is omitted, suggesting missing text).
Diseases of Er Yin (Shaoyin Heart/Kidney) and Yi Yang (Shaoyang) manifest with frequent distension, chest fullness, and frequent sighing (Continuation: Kidney and Gallbladder rebel together; Sanjiao fails to move qi, accumulating above causing chest fullness; lower deficiency and upper excess cause qi leakage/sighing).
Diseases of San Yang (Taiyang) and San Yin (Taiyin) manifest as hemiplegia, flaccidity with change, and inability to move the four limbs (San Yin deficiency causes hemiplegia; San Yang excess causes flaccidity/change. Yi means change/transformation; Wei means weak/powerless).
Jie Yin (Knotting of Yin) results in bloody stool: one sheng initially (Yin generates blood), two sheng upon second knotting (double excess), three sheng upon third knotting (triple excess). Knotting of Yin and Yang obliquely, with much Yin and little Yang, is called Shi Shui (Stone Water), characterized by abdominal swelling. Knotting of Er Yang (Stomach and Large Intestine heat) is called Xiao (Consumption/Wasting-Thirst). Knotting of San Yang (Small Intestine and Bladder heat) is called Ge (Obstruction/Dysphagia) (Small Intestine heat dries blood vessels; Bladder heat dries fluids, causing obstruction). Knotting of San Yin (Spleen and Lung cold) is called Shui (Water-Dampness) (Spleen and Lung cold-knotting transforms qi into water). Knotting of Yi Yin and Yi Yang (Pericardium and Sanjiao) is called Hou Bi (Throat Bi/Occlusion) (Sanjiao and Pericardium meridians connect to the throat; internal heat knotting causes throat occlusion).
Yin Bo Yang Bie (Pulse striking strongly at Yin position, distinct from Yang position) indicates pregnancy (Slippery pulse at Cun/Kou indicates pregnancy. Hua Shou notes: Slippery pulse at Chi indicates yang distinct within yin). Yin and Yang deficiency with Chang Pi (dysentery/diarrhea) leads to death (Pi means dysentery. Stomach qi fails to retain, intestines open uncontrollably, yin lacks containment, indicating exhaustion of yang qi, hence death). Yang added to Yin is called Sweat (Yang below, Yin above; yang qi rises and interacts with yin, steaming into sweat). Yin deficiency with Yang Bo (surging) is called Beng (Metrorrhagia/Uterine Bleeding) (Yin pulse insufficient, yang pulse surging, causing internal collapse and bleeding. See *Yin Yang Bie Lun*).
The Emperor asked: Do living conditions, activity/rest, courage/fearfulness also cause pulse variations? Qibo replied: All fright, anger, labor, movement, and rest cause variations (altering normal patterns). Therefore, night walking causes panting originating from the Kidney (Kidney governs night; qi combines with darkness, so night walking causes panting from Kidney). Excessive qi damages the Lung (Night walking tires Kidney, causing panting; excessive/disordered qi then damages Lung). Falling or fear causes panting from the Liver, and excessive qi harms the Spleen (Fear originates in Liver; falling injures sinews/blood, causing running panting from Liver. Liver Wood excessively invades Spleen Earth). Fright causes panting from the Lung, and excessive qi damages the Heart (Fright leaves Heart without foundation, spirit without return, qi chaotic in chest, causing panting from Lung. Fright scatters spirit, so excessive qi damages Heart). Wading through water or falling causes panting from Kidney and Bone (Dampness communicates with Kidney; Bone is governed by Kidney, so wading/falling causes panting from Kidney/Bone. Die means foot stumble; Pu means body fall). At such times, courageous people's qi flows and recovers; timid people's qi stagnates and causes disease. Thus, the way to diagnose is to observe courage, bone/muscle structure, and skin to understand the condition.
Therefore, eating until very full causes sweat from the Stomach (Fright/scattering of Heart spirit makes qi float; yang presses inward, causing sweat from Stomach). Carrying heavy loads or traveling far causes sweat from the Kidney (Bone labor, qi escapes, Kidney over-fatigued, so carrying/traveling causes sweat from Kidney). Running fast or fearing causes sweat from the Liver (Sudden strain on sinews, Liver qi exhausted, so sweating from Liver). Body twisting and hard labor causes sweat from the Spleen (Movement and effort distribute grain essence; Spleen transforms water/grain, so sweating from Spleen). Thus, illnesses arising in Spring, Summer, Autumn, Winter due to yin/yang imbalances stem from overuse; this is the constant rule (Forcing actions against nature causes disease. Five Zang qi has limits; overuse depletes them, causing disease. See *Jing Mai Bie Lun*).
All diseases begin in the skin and hair. Evil invades, pores open, allowing entry into Luo vessels. If lingering, it enters Jing meridians; if still lingering, it enters Fu organs, accumulating in the intestines/stomach. Initially, evil enters skin, causing goosebumps and opening pores. Entering Luo vessels causes vessel fullness and color change. Entering Jing meridians requires deficiency to sink in (Channel deficiency allows evil entry; pulse/qi deficiency causes sinking). Lingering in sinews/bones: cold causes cramping/pain; heat causes relaxation/wasting, muscle wasting, skin cracking, straight/hair loss, and decay (Cold tightens sinews, heat relaxes them. Cold excess causes pain, heat excess causes qi/waste. Cracks are skin markers; muscle wasting leads to skin cracks. Hair straightening and decay. See *Pi Bu Lun*).
The Emperor asked: People have rebellious qi preventing sleep with noisy breathing, preventing sleep without noisy breathing, waking normally with noisy breathing, sleeping but panting when moving, unable to sleep and unable to move but panting, and unable to sleep but panting when lying down. Which zang organs cause these? (Six questions, but only three answers provided, suggesting missing bamboo slips). Qibo replied: Unable to sleep with noisy breathing is Yangming rebellion. Foot Three Yang descend; now rebelling upward, causing noisy breathing. Yin/Yang refers to Stomach meridian. Stomach is the Sea of Six Fu Organs (food/grain sea), its qi descends. Yangming rebellion prevents following the path, causing insomnia. The Lower Classic says: "Stomach disharmony leads to restless sleep." Regarding waking normally with noisy breathing, this is Lung Luo vessel rebellion. Luo vessels cannot follow Jing up/down, lingering in Jing. Luo vessel disease is minor, so waking is normal but breathing is noisy. Unable to sleep, panting when lying down, is caused by Water Qi invasion. Water follows fluids. Kidney is the Water Organ, governing fluids, sleep, and panting (No answer for silent breathing or moving while sleeping. See *Ni Diao Lun*).
The Emperor asked: Why can some not lie flat? Qibo replied: Lung is the canopy of the zang organs. Lung qi excess causes large pulses (pulse tunnels). Large pulses prevent lying flat (Lung qi fullness causes dyspnea when supine). The Emperor asked: Why can some not sleep comfortably? Qibo replied: If zang organs are injured and essence has nowhere to lodge, sleep is disturbed (Jia Yi Jing reads: "Emotion leaning causes unrest"). Thus, one cannot suspend the disease in mid-air (Zang injury and essence lodging support sleep; injury to zang prevents suspending disease. See *Bing Neng Lun*).
The Emperor asked: A patient with Kidney Wind has swollen face, obstructed speech. Can acupuncture be used? (Pangran means swelling. Yong means lower eyelid swelling like a silkworm. Kidney meridian enters Lung, circles throat, binds tongue root, hindering speech.) Qibo replied: Deficiency should not be needled. If needled incorrectly, qi will arrive in five days (One zang corresponds to one day; five days reach Kidney. Kidney already deficient, wind invades internally. Swelling seen as excess, but strong draining needle injures true qi, making recovery impossible. Hence qi arrives in five days). The Emperor asked: How will it arrive? Qibo replied: It will bring shortness of breath, intermittent fever (from chest/back to head), sweaty hot hands, dry mouth/thirst, yellow urine, swollen lower eyelids, borborygmus, heaviness, difficulty walking, amenorrhea, vexation, inability to lie flat, and coughing when lying flat. Disease name: Feng Shui (Initially Liver Wind, but due to improper needling, becomes Feng Shui. Liver should be Kidney, Bian should be Bianhua/Change). The Emperor asked: Explain. Qibo replied: Where evil gathers, qi must be deficient. Yin deficiency allows Yang to gather, causing shortness of breath, fever, sweating. Yellow urine indicates lower abdominal heat. Inability to lie flat indicates Stomach disharmony. Lying flat worsens cough, pressing on Lung. All water diseases show slight swelling first in lower eyelids. Qi rebels upward, causing bitter taste, dry tongue, inability to lie flat, coughing clear fluid. Water patients cannot sleep; sleeping causes fright, worsening cough. Borborygmus originates in Stomach. Pressing Spleen causes vexation/anorexia; food stuck in epigastrium/diaphragm. Heaviness/difficulty walking relates to Stomach meridian in legs. Amenorrhea results from Bao Mai closure. Bao Mai belongs to Heart, connects to Uterus. Qi presses Lung, Heart qi cannot descend, hence amenorrhea (Continuation: Previous explanation unclear regarding fever from chest/head, sweaty hands, thirst. Likely ancient text omission/error. Why? Kidney meridian goes up Liver/Diaphragm to Lung, circles throat. Bladder meridian from vertex to brain, down neck, shoulder, spine, waist. Yin deficiency, Yang excess causes heat from chest/head to sweat, dry mouth/thirst. Heart is Yang organ, pulse on arms/hands; Kidney is Yin organ, pulse on chest/legs. Kidney deficiency leads to Heart excess, hence hot hands. Both Heart/Kidney meridians are Shaoyin. See *Ping Re Lun*).
The Emperor asked: Why does Shaoyin govern Kidney? Why does Kidney govern water? Qibo replied: Kidney is Zhi Yin (Ultimate Yin). Zhi Yin stores water. Lung is Tai Yin. Shaoyin is Winter pulse. Root in Kidney, branch in Lung, both accumulate water (Yin means cold. Winter is coldest, Kidney qi corresponds, hence Zhi Yin. Water flourishes in winter, hence Zhi Yin stores water. Kidney Shaoyin meridian goes up Liver/Diaphragm to Lung, hence root Kidney, branch Lung. Kidney qi rebellion allows water qi to invade Lung, hence water accumulation). The Emperor asked: How can Kidney gather water to cause disease? Qibo replied: Kidney is the Gate of Stomach. If the gate is dysfunctional, water accumulates according to its kind (Gate controls entry/exit. Kidney governs lower jiao, Bladder is Fu, manages orifices. Kidney qi transformation opens/closes orifices. Closure leads to water accumulation, qi stagnation, water generation, overflow. Water/Qi are same kind, hence gate dysfunction gathers water. Classics: Lower jiao overflow becomes water). Overflowing up and down into skin causes edema. Edema is disease from accumulated water (Upper Lung, Lower Kidney. Both overflow, accumulating water in abdomen causing disease). The Emperor asked: Do all water diseases originate in Kidney? Qibo replied: Kidney is Pin Zang (Yin Organ/Female Organ). Earth qi ascending belongs to Kidney, generating water fluids. Thus: Zhi Yin, exertion/labor causes Kidney sweat. Sweat encountering wind, unable to enter zang, unable to exit skin, stays in Xuancuo, moves under skin, transmits to edema. Rooted in Kidney, named Feng Shui (Xuancuo is sweat pore. Sweat is dark/xuan, exits pore, gathers inside, hence Fu. Fu means gathering. Labor/exertion opens Xuancuo; wind closes it. Remaining sweat trapped under skin transforms to water, named Feng Shui). Thus water disease causes lower edema/abdominal swelling, upper panting/breathing difficulty (Water accumulates in Kidney, swelling from abdomen to feet; ascends to Lung, causing panting. See *Shui Ke Lun*).