藏象抄（注曰膀胱位当孤腑言他腑皆无所待而自能出惟膀胱必待气化而后能出与他腑不同故曰孤腑同则为类异则为
孤）脉候抄（从阳阴始按阴阳即仲景所谓浮洪长滑为阳沉细短涩为阴之类欤○和柔相离者缓也若接续不离则数矣故病脾
脉来实而益数也○厌厌和调不变乱也摄摄连属不止代也榆荚轻浮和软也借之以形容秋脉之轻浮和适而相属也○来如弹石
弹石强硬也平则沉软病则强硬与沉软反也与前弹石不同前弹石兼促此只则强硬也○脾为孤脏言他脏各主一时惟脾不正主
四时与他脏异故曰孤○长夏胃微软弱曰平按前二条皆言胃而毛胃而石此言软弱软弱即胃也下仿此弱多胃少曰脾病但代无
胃死软弱有石曰冬病弱甚曰今病按此节与前条夏胃微钩曰平之旨同○毛而有弦曰春病弦甚曰今病按前条春兼秋脉知秋乃
病此条秋兼春脉知春乃病不过对举互言别无他后意脉仿此○如水之流浮盛也如鸟之啄细小也浮盛太过细小不及○浊气归
心浊气阴气也淫精于脉精者阳精也脉非动脉乃经脉也即前阴气阳精也○毛脉合精一节言皮毛之精与脉气流经之精相合而
行气于气海气海则流布于曰脏由是中外上下各得其所而平均也留当作留后节揆度节此权衡之义○不间脏传曰脏已间脏传
如心病传肝之类不间脏传如心病传肺之类然间脏虽传所生至于七传则一经不能再受邪矣○凡阳有五盖五者土数也五脏皆
以胃气为主故曰五五二十五阳○不能极于天地之精气盖极中者也不适中乎精气也○诸阳皆然谓诸阴在内格拒其阳于外故
病似阳而诚属阴不可作阳病治下仿此○阳气有余身热无汗汗者阴气也阴胜阳虚故热无汗）能病抄（秋冬夺于所用至手足
为之寒也一节用用力也争者不和也邪气阴邪也气因于中四字疑衍之从上者阴邪从逆上之阳而上也秋冬阳衰阴盛人于秋冬
耗夺其阳精之气则上焦阳气愈衰为盛阴迫之而上不和矣阳既上而不下则下焦愈见阳虚而阴愈盛阴盛充溢为阴邪矣阴邪而
从微阳逆上是寒自下逆上而厥也手足寒者四肢诸阳之本阳衰阴旺故手足寒也○气聚于脾中谷气聚也○疟皆生于风后言疟
因于暑盖疟皆先伤暑后感风寒而发也○注曰阳气下行极而上阴气上行极而下故曰阴阳上下交争此指外邪所伤言汇粹抄阳
病者上行极而下阴病者下行极而上此指本气自病言按风暑阳邪喜伤于阳阳经而受阳邪则阳极矣和则阳气下降极则反上与
阴争水寒阴邪喜伤于阴阴经而受阴邪则阴极矣和则阴气上升极则反下与阳争此亦各经之阴阳如某经气血多少之谓非营行
脉中卫行脉外之阴阳也○皮肤之内肠胃之外此营气所舍暑热藏于皮肤之内乃舍于营气中也后言皮肤之内卫气所舍风水客
于皮肤乃客于卫气中也可见皮肤之内乃营卫并居此亦各经之营卫其气和柔故能受邪向之暑热伤营今之风寒伤卫营卫俱受
邪而并居故因卫气外出而入于阳分则与阳争阳虚而寒因卫气内行而入于阴分则与阴争阴虚而热此指昼行阳夜行阴之卫气
也后段并于阳则阳胜并于阴则阴胜又与前阴阳上下交争互相发明○病极则复者物极则衰故阳中之邪极则寒止阴中之邪极
则热止且卫气越其受邪之经而行于他经则邪正相离而寒热亦止○疟但热不寒盖因只感暑与风之阳邪不感水邪之阴寒故如
是也○寒而鼓颔颔乃胃脉所经热而多渴乃胃热所致故知疟属于胃者多○胜复之气盖言或胜气为病或复气为病非先胜后复
之谓如阳邪胜阴邪复也徇蒙招尤至甚则入肝许学士云上虚者肝虚也肝虚则头晕徇蒙者如以物蒙其首招摇不定目弦耳聋皆
晕之状也名曰肝厥头晕○结阴者便血宝鉴曰阴气内不结得外行无所禀渗入肠间故便血也）论治抄（按而收之谓按摩以收
摄之○假者何如谓冬月用寒药不以冬寒为禁也高者抑之一节总解上文制之夺之之义○夫气之胜也一节与后运气抄夫气之
胜也文同必安其主客即六气加临之主客同逆之指六气言异者从之指五运言○病所远而中道气味之者一节中道者气味薄之
药也病病在肾肝其道远或用气味薄药治之必须大剂顿服亦合义方之制注曰食而令足剂大而多也然急过之乃顿服之○以所
利行之如辛利于散之类○惊者平之或使其平心易气以先之而后药此因外惊而治也若内气动其神者又当以药平其阴阳之盛
衰则神可安志可定矣○必伏其所主一节伏 伏也今欲 伏其邪使之不为害当先知热因寒用等法如同谓以热治寒始皆同也
终异谓热药寒服则气异热药寒服而无格拒之患必破积溃坚而服□□□□□□□□者宜也或内治或外治或衰之以属各随
其所宜也○）色诊抄（合于神明谓合于天地神明之变化也）针刺抄（观适之变谓须静意视义而观察之化调适其病变也○
无逢其冲而泻之谓水下一刻三刻五刻七刻人气在三阳二刻四刻六刻八刻人气在阴分气在阳三则阳分独盛气在阴分则阴分
独盛见其独盛指以为邪以针泻之反伤真气故下文云云王注言水下一刻人气在太阳三刻在少阳三刻在阳明四刻在阴分若然
则气一昼一夜只行得二十五周于身与灵枢篇首人气一昼一夜五十度周于身之说不合其误可知且分阴者乃三阳之阴分非内
脏阴分午时水下一刻人气在三阳之刻在阳分亦三阴之阳分非外腑阳分故曰腑有阴阳脏亦有阴阳此专指卫气言也○七节之
旁中有小心按经度篇心经注曰心系有二其一上与肺相连入肺两大叶间其一由肺系而下曲折向后并脊膂细络相连贯脊髓与
肾相通正当七节之间经之所云其指此欤○从阴引阳从阳引阴谓头阳足阴热阳寒阴头有病下取之足有病上取之阳病之引热
阴使凉阴病寒引之阳使温皆是也此与论治抄阳病气反者病在上取之下病在下取之上病在中旁义取之并同）阴阳抄（万物
之能如谓万物之生初固由之死之初亦由之○味归形形食味气生形形气食言不特味生形气亦生形○气归精精归化化生精精
食气此言气不特生形又能生精○味伤形气伤精此言味虽生形而形伤形气虽生精而亦伤精○精化为气此言气不特生精生化
而精化亦能生气故曰交相益也○气伤于味此言不特形伤味而气亦伤于故曰互相损也○天运当以日光明谓之天营运不息者
由日光明而阳气盛也如人固守其阳则寿若伤耗其阳则夭○暮而收拒一节示人以养阳也○脉流薄疾并乃狂薄疾阴气虚也并
者阳气盛实也）标本抄（治得为从得者顺也如以热治热为顺其病也）运气抄（气数气指阴阳气言数指三阴三阳言注曰气
数者生成之气谓天一地六之九数也○所胜则微所不胜则甚盖直年之气胜气也胜气为邪所于则直年之气为胜而邪不胜故病
微直年之气不胜不胜不足也为邪所于则甚○非其时则微者如木年而火气至是直年木气胜故火气虽至乃非其时故后二年乃
病者微也○当其时则甚如木直之年木气胜也今为邪中是木气虚而受邪故曰所不胜则甚不胜者木气虚也又曰当其时则甚谓
木直之年而木为邪所病其病为甚故曰当其时则甚○安其屈复如胜气和则平之胜气甚则夺之谓随胜气之微甚或平或夺以安
静之使其屈伏耳）汇粹抄（故圣人传精神一节谓身中精神传而承袭之不毁天之真气服而顺从之不逆则神明流通而无内壅
外壅之失○其色必夭前言察脉此言亦当察色○如参春者病参春谓重轻疾徐自等也中部之候独调谓中部虽不大不数然上下
二部皆大数者亦死或上下二部大数独中部脉小者亦死○一候后则病后则胜脉有大小迟数大谓者前小者后数者前迟者后也
○独小者病独者于凡候中举一候言也如前一候后则候之义）岐伯曰肾移寒于脾痈肿少气（肾伤于寒而传而脾胃主肉寒主
于肉则结为坚坚化为脓故为痈也血伤故少故曰少气）脾移寒于肝痈肿筋挛（脾主肉肝主筋肉温则筋舒肉冷则筋急故筋挛
也肉寒则卫气结聚故为肿痈）肝寒移于心狂隔中（心为阳脏神处其中寒薄之则仲乱离故狂也阳气寒相薄故隔塞而中不通）
心移寒于肺肺消肺消者饮一溲二死不治（心为阳脏反受诸寒气寒不清郁而为热内烁于金金受火邪故中消也肺脏消烁气无
所持故饮一溲二金火相贼死不可治）肺移寒于肾为涌水涌水者按腹不坚水气客于大肠疾行则鸣濯濯如囊裹浆水之病也（夫
肺寒入肾肾气有余则上奔于肺故云涌水大肠为肺之府为水客于大肠也肾受凝结不能化能化液大肠积水而不流通故病行则
不）脾移热于肝则为惊衄（肝藏血主惊故热薄之则惊而鼻血）肝移热于心则死（夫两阳和合火木相烁故肝热入心则当死
也已）心移热于肺传为膈消（心府两间中有斜膈膜膈膜下际内连于横膈膜故心热入肺久久传化内传膈热消渴而多饮也）
肺移热于肾传为柔 （柔谓筋柔 谓骨强气骨皆热髓不内充故骨 强而不举筋柔而缓无力也）肾移热于脾传为虚肠 死
不可治（脾土制木肾反移热以与之是土不能制木而受病故久久传为虚损也肠 死者肾主下焦象水而冷今乃移热是精气内
消下焦无主以守持故肠 除而气不禁止也）胞移热于膀胱则癃溺血（膀胱为津液之府胞为受纳之司胞热移于膀胱则阴络
内溢故不得小便而溺血）膀胱移热于小肠膈肠不便上而口糜（小肠脉络心咽循下膈抵胃属小肠故受热则下令肠膈塞而不
便上则令口生疮而糜烂也）小移移热于大肠必 瘕为沉（小肠移热大肠两热相藏则血溢而为伏瘕也血满不利则月事成滞
不行故云为伏瘕为沉也 与伏同）大肠移热于胃善食而瘦又谓之食亦（胃为水谷之海其气外养肌肉热消水谷又燥肌肉故
善食而瘦食亦者谓食人移易而过不生肌肤也亦易也）胃移热于胆亦曰食亦（义同上）胆移热于脑则辛额鼻渊鼻渊者浊涕
下不止也传为衄 瞑目（脑液下渗则为浊涕涕下不止如彼水泉故曰鼻渊 谓鼻 足太阳脉起目内 上额交颠络脑阳明脉
起于鼻交 中旁约太阳之脉令脑热则足太阳逆与阳明之脉俱盛薄于 中故鼻辛辛 谓醉痛也热盛则阳络溢阳络溢则衄出
汗血也 谓汗血血出甚阳明太阳脉衰不能荣养于目故目瞑瞑暗也）故得之气厥也（厥者气逆也皆由气逆而得之出气厥论）
帝曰始生有病癫者病名为何曰病名胎病此得之在母腹中时其母有所大惊气上而不下精气并居故令子发癫疾（精气谓阳之
精气○出奇病论）岐伯曰阳虚则外寒者阳受气于上焦以温皮肤分肉之间今寒气在外则上焦不通上焦不通则寒气独留于外
故寒 （ 战 也）阴虚生内热者所有劳倦形气衰少谷气不盛上焦不行下脘不通胃气热热气熏胸中故内热（王安道曰此
阴字指人身之阴与水谷之味也夫有所劳倦者过动属火也形气衰少者壮火食气也谷气不盛者劳伤元气则少食而气衰也上焦
不行者清阳不升也下脘不通者浊阴不降也夫胃受水谷则清阳升而浊阴降以传化出入滋养一身也今胃不能纳而谷气衰少则
清无升浊无降矣故曰上不行下不通非绝不行不通但比无病时谓之不行不通耳上不行下不通则郁矣郁则少火皆成壮火胃居
上焦下脘之间故胃气热热则上炎熏胸中为内热也斯东垣所谓劳伤形体饮食失节而致热者乎内伤之说盖原于此）阳盛生外
热者上焦不通则皮肤致密腠理闭塞玄府不通卫气不得泄越故外热（外伤寒毒内薄诸阳寒外盛则皮肤收皮肤收则腠理密故
卫气蓄聚无所流行矣寒气外薄阳气内争积火内燔故生外热）阴盛生内寒者厥气上逆寒气积于胸中而不泻不泻则温气去寒
独留则血凝泣凝则脉不通其脉盛大以涩故中寒（温气阳气也阴逆内满则阳气去于皮外也○出调经论）灵枢（病传篇曰七
传当作次传谓传其所胜如心传肺肺传肝之类间传谓间脏传所不胜如心传肝肝传肾之类○根结篇曰形气不足病气有余思泻
之形谓皮肉筋骨血脉也气谓口鼻中喘息也形胜者为有余消瘦者为不足审口鼻中气劳役如故为气有余若喘息气促气短或不
足以息者为不足当称当泻全不在此但病来潮作之时病气精神增添者是病气有余乃邪气胜也急泻以寒凉酸苦之剂如潮作之
时精神困弱语言无力及懒语者为病气不足乃真气不足也急补以辛耳湿热之利若病患形气不足病也来之时病气亦不足此阴
俱不足禁用针针宜补以其药不可尽剂不已取脐不气悔穴）○有病头痛数岁不已者当有所犯大寒内至骨髓髓者以脑为主脑
逆故令头痛齿亦痛（出奇病论）○有癃者一日数十溲（后条脉细微如发）此不足也身热如炭颈膺如格人迎躁盛喘息气逆
此有余也太阴脉细微如发此不足也（外有余者五内不足者二）名为何病岐伯曰病在太阴其盛在胃颇在肺病名曰厥死不治
（外有阴者五皆手太阴脉当洪大而数今微细如发是脉与症相反也以肺气逆凌于胃故上使人迎躁盛也故曰其病在太阴其盛
在胃也以喘息气逆又云颇在于肺病相气逆症不相应故死不治何也谓其病在表则内有二不足谓其病在里则外有五有余表里
既不可凭补泻因难为用其死明矣）○有病癫者曰胎病此得之在母腹中时其母有所大惊气上而不得下精气并居故令子发为
癫疾也（精气阳之精气○出奇病论）○有病庞然如水状切其脉大紧身无痛形不瘦不能食食少何病也曰病生在肾名曰肾风
（脉如弓弦大而且紧大则为气紧则为寒寒气内薄而反无痛故问之盖以劳气内蓄寒复内争劳气薄寒故化为风风胜于胃故曰
【脉候抄】（注释说：膀胱位于孤腑，是说其他腑都无所依赖而能自行排泄，只有膀胱必须等待气化作用后才能排出，与其他腑不同，所以称为孤腑。同类为类，异类为孤。）
脉象诊察（阴阳起始于何处？按阴阳来说，即仲景所说的浮、洪、长、滑属于阳，沉、细、短、涩属于阴这一类吧。○脉象和柔相离是缓脉；如果接续不离则是数脉，所以脾病脉来实而更加快速。○“厌厌”指和调不变乱；“摄摄”指连属不止，即代脉；“榆荚”形容轻浮和软，借以描述秋脉的轻浮和适且相互连接。○脉来如弹石，弹石指强硬，平人脉象沉软，病脉则强硬，与沉软相反，这与前文提到的“弹石”不同，前文的弹石兼有急促之意，这里仅指强硬。○脾为孤脏，说其他脏各主一个季节，只有脾不单独主宰一时，而是寄旺于四季，与其他脏不同，所以称为孤。○长夏时节，胃气微软弱为平脉。按前两条都言胃，毛脉之胃、石脉之胃，这里说软弱，软弱即胃气的表现，下文仿照此例。弱多胃少为脾病，但见代脉而无胃气则为死证；软弱中兼见石脉为冬病；弱甚为今病。按此节与前条“夏胃微钩曰平”的宗旨相同。○毛脉中带有弦象为春病，弦象甚为今病。按前条春兼秋脉知秋乃病，此条秋兼春脉知春乃病，不过是对举互言，别无他意，脉象仿照此理。○如水之流，指浮盛；如鸟之啄，指细小。浮盛太过，细小不及。○浊气归心，浊气即阴气；淫精于脉，精者即阳精。脉非动脉，乃是经脉，即前文所说的阴气阳精。○“毛脉合精”一节，是说皮毛之精与脉气流经之精相合，而行气于气海，气海则流布于五脏，由此中外上下各得其所而平均。“留”字应当作“流”。后节“揆度”，节取权衡之义。○“不间脏传”，指脏已间脏传，如心病传肝之类；“间脏传”，如心病传肺之类。然而间脏虽传，所生至于七传，则一经不能再受邪了。○凡阳有五，盖五者土数也，五脏皆以胃气为主，所以说五五二十五阳。○不能极于天地之精气，盖极中者，不适中乎精气也。○诸阳皆然，谓诸阴在内格拒其阳于外，故病似阳而诚属阴，不可作阳病治，下文仿照此理。○阳气有余，身热无汗，汗者阴气也，阴胜阳虚故热无汗。）
【能病抄】秋冬夺于所用，以至于手足为之寒也。一节用用力也，争者不和也，邪气阴邪也。气因于中四字疑衍。从上者，阴邪从逆上之阳而上也。秋冬阳衰阴盛，人于秋冬耗夺其阳精之气，则上焦阳气愈衰，为盛阴迫之而上不和矣。阳既上而不下，则下焦愈见阳虚而阴愈盛，阴盛充溢为阴邪矣。阴邪而从微阳逆上，是寒自下逆上而厥也。手足寒者，四肢诸阳之本，阳衰阴旺，故手足寒也。○气聚于脾中，谷气聚也。○疟皆生于风后，言疟因于暑，盖疟皆先伤暑后感风寒而发也。○注曰：阳气下行极而上，阴气上行极而下，故曰阴阳上下交争。此指外邪所伤而言。汇粹抄：阳病者上行极而下，阴病者下行极而上，此指本气自病而言。按风暑阳邪喜伤于阳阳经，而受阳邪则阳极矣，和则阳气下降，极则反上与阴争；水寒阴邪喜伤于阴阴经，而受阴邪则阴极矣，和则阴气上升，极则反下与阳争。此亦各经之阴阳，如某经气血多少之谓，非营行脉中、卫行脉外之阴阳也。○皮肤之内，肠胃之外，此营气所舍。暑热藏于皮肤之内，乃舍于营气中也。后言皮肤之内，卫气所舍，风水客于皮肤，乃客于卫气中也。可见皮肤之内乃营卫并居，此亦各经之营卫，其气和柔，故能受邪。向之暑热伤营，今之风寒伤卫，营卫俱受邪而并居，故因卫气外出而入于阳分，则与阳争，阳虚而寒；因卫气内行而入于阴分，则与阴争，阴虚而热。此指昼行阳、夜行阴之卫气也。后段并于阳则阳胜，并于阴则阴胜，又与前阴阳上下交争互相发明。○病极则复者，物极则衰，故阳中之邪极则寒止，阴中之邪极则热止。且卫气越其受邪之经而行于他经，则邪正相离，而寒热亦止。○疟但热不寒，盖因只感暑与风之阳邪，不感水邪之阴寒，故如是也。○寒而鼓颔，颔乃胃脉所经；热而多渴，乃胃热所致，故知疟属于胃者多。○胜复之气，盖言或胜气为病，或复气为病，非先胜后复之谓，如阳邪胜阴邪复也。徇蒙招尤至甚则入肝，许学士云：上虚者肝虚也，肝虚则头晕。徇蒙者如以物蒙其首，招摇不定，目弦耳聋，皆晕之状也，名曰肝厥头晕。○结阴者便血，《宝鉴》曰：阴气内不结，得外行无所禀，渗入肠间，故便血也。）
【论治抄】按而收之，谓按摩以收摄之。○假者何如？谓冬月用寒药，不以冬寒为禁也。高者抑之一节，总解上文制之夺之之义。○夫气之胜也一节，与后运气抄“夫气之胜也”文同。必安其主客，即六气加临之主客同；逆之指六气言，异者从之指五运言。○病所远而中道气味之者一节，中道者气味薄之药也。病在肾肝，其道远，或用气味薄药治之，必须大剂顿服，亦合义方之制。注曰：食而令足，剂大而多也。然急过之，乃顿服之。○以所利行之，如辛利于散之类。○惊者平之，或使其平心易气以先之，而后药，此因外惊而治也。若内气动其神者，又当以药平其阴阳之盛衰，则神可安，志可定矣。○必伏其所主一节，伏，伏也。今欲伏其邪，使之不为害，当先知热因寒用等法。如同谓以热治寒，始皆同也；终异谓热药寒服，则气异。热药寒服而无格拒之患，必破积溃坚而服……者宜也。或内治或外治，或衰之以属，各随其所宜也。○）
【色诊抄】合于神明，谓合于天地神明之变化也。
【针刺抄】观适之变，谓须静意视义而观察之，化调适其病变也。○无逢其冲而泻之，谓水下一刻、三刻、五刻、七刻，人气在三阳；二刻、四刻、六刻、八刻，人气在阴分。气在阳三则阳分独盛，气在阴分则阴分独盛。见其独盛指以为邪，以针泻之，反伤真气，故下文云云。王注言水下一刻人气在太阳，三刻在少阳，三刻在阳明，四刻在阴分。若然，则气一昼一夜只行得二十五周于身，与《灵枢》篇首“人气一昼一夜五十度周于身”之说不合，其误可知。且分阴者乃三阳之阴分，非内脏阴分；午时水下一刻人气在三阳之刻，在阳分亦三阴之阳分，非外腑阳分，故曰腑有阴阳，脏亦有阴阳。此专指卫气言也。○七节之旁中有小心，按《经度篇》心经注曰：心系有二，其一上与肺相连，入肺两大叶间；其一由肺系而下，曲折向后，并脊膂细络相连，贯脊髓与肾相通，正当七节之间，经之所云，其指此欤？○从阴引阳，从阳引阴，谓头阳足阴，热阳寒阴。头有病下取之，足有病上取之，阳病之引热阴使凉，阴病寒引之阳使温，皆是也。此与《论治抄》“阳病气反者，病在上取之下，病在下取之上，病在中旁取之”并同。）
【阴阳抄】万物之能如，谓万物之生初固由之，死之初亦由之。○味归形，形食味；气生形，形气食。言不特味生形，气亦生形。○气归精，精归化，化生精，精食气。此言气不特生形，又能生精。○味伤形，气伤精。此言味虽生形，而形伤形；气虽生精，而亦伤精。○精化为气。此言气不特生精生化，而精化亦能生气，故曰交相益也。○气伤于味。此言不特形伤味，而气亦伤于味，故曰互相损也。○天运当以日光明，谓之天营运不息者，由日光明而阳气盛也。如人固守其阳则寿，若伤耗其阳则夭。○暮而收拒一节，示人以养阳也。○脉流薄疾，并乃狂。薄疾，阴气虚也；并者，阳气盛实也。）
【标本抄】治得为从，得者顺也。如以热治热为顺其病也。
【运气抄】气数，气指阴阳气言，数指三阴三阳言。注曰：气数者生成之气，谓天一地六之九数也。○所胜则微，所不胜则甚。盖直年之气胜气也。胜气为邪所干，则直年之气为胜而邪不胜，故病微；直年之气不胜，不胜不足也，为邪所干，则甚。○非其时则微者，如木年而火气至，是直年木气胜，故火气虽至，乃非其时，故后二年乃病者微也。○当其时则甚，如木直之年，木气胜也。今为邪中，是木气虚而受邪，故曰所不胜则甚，不胜者木气虚也。又曰当其时则甚，谓木直之年而木为邪所病，其病为甚，故曰当其时则甚。○安其屈复，如胜气和则平之，胜气甚则夺之，谓随胜气之微甚，或平或夺，以安静之，使其屈伏耳。）
【汇粹抄】故圣人传精神一节，谓身中精神传而承袭之不毁，天之真气服而顺从之不逆，则神明流通而无内壅外壅之失。○其色必夭，前言察脉，此言亦当察色。○如参春者病，参春谓重轻疾徐自等也。中部之候独调，谓中部虽不大不数，然上下二部皆大数者亦死，或上下二部大数，独中部脉小者亦死。○一候后则病，后则胜。脉有大小迟数，大谓者前小者后，数者前迟者后也。○独小者病，独者于凡候中举一候言也，如前一候后则候之义。）
岐伯曰：肾移寒于脾，痈肿少气。（肾伤于寒而传之，脾胃主肉，寒主于肉则结为坚，坚化为脓，故为痈也。血伤故少，故曰少气。）脾移寒于肝，痈肿筋挛。（脾主肉，肝主筋，肉温则筋舒，肉冷则筋急，故筋挛也。肉寒则卫气结聚，故为肿痈。）肝寒移于心，狂隔中。（心为阳脏，神处其中，寒薄之则神乱离，故狂也。阳气寒相薄，故隔塞而中不通。）心移寒于肺，肺消。肺消者，饮一溲二，死不治。（心为阳脏，反受诸寒气，寒不清郁而为热，内烁于金，金受火邪，故中消也。肺脏消烁，气无所持，故饮一溲二，金火相贼，死不可治。）肺移寒于肾，为涌水。涌水者，按腹不坚，水气客于大肠，疾行则鸣濯濯，如囊裹浆，水之病也。（夫肺寒入肾，肾气有余则上奔于肺，故云涌水。大肠为肺之府，水客于大肠也。肾受凝结，不能化液，大肠积水而不流通，故病行则不……）脾移热于肝，则为惊衄。（肝藏血，主惊，故热薄之则惊而鼻血。）肝移热于心则死。（夫两阳和合，火木相烁，故肝热入心则当死也已。）心移热于肺，传为膈消。（心府两间中有斜膈膜，膈膜下际内连于横膈膜，故心热入肺，久久传化，内传膈热，消渴而多饮也。）肺移热于肾，传为柔（柔谓筋柔，谓骨强，气骨皆热，髓不内充，故骨强而不举，筋柔而缓无力也。）肾移热于脾，传为虚肠 死，不可治。（脾土制木，肾反移热以与之，是土不能制木而受病，故久久传为虚损也。肠 死者，肾主下焦，象水而冷，今乃移热，是精气内消，下焦无主以守持，故肠 除而气不禁止也。）胞移热于膀胱则癃溺血。（膀胱为津液之府，胞为受纳之司，胞热移于膀胱，则阴络内溢，故不得小便而溺血。）膀胱移热于小肠，膈肠不便，上而口糜。（小肠脉络心，咽循下膈抵胃，属小肠，故受热则下令肠膈塞而不便，上则令口生疮而糜烂也。）小移移热于大肠，必 瘕为沉。（小肠移热大肠，两热相藏，则血溢而为伏瘕也。血满不利，则月事成滞不行，故云为伏瘕为沉也。 与伏同。）大肠移热于胃，善食而瘦，又谓之食亦。（胃为水谷之海，其气外养肌肉，热消水谷，又燥肌肉，故善食而瘦。食亦者，谓食人移易而过，不生肌肤也。亦，易也。）胃移热于胆，亦曰食亦。（义同上。）胆移热于脑，则辛额，鼻渊。鼻渊者，浊涕下不止也。传为衄 瞑目。（脑液下渗则为浊涕，涕下不止，如彼水泉，故曰鼻渊。 谓鼻 ，足太阳脉起目内 ，上额交颠，络脑。阳明脉起于鼻，交 中，旁约太阳之脉。令脑热，则足太阳逆，与阳明之脉俱盛，薄于 中，故鼻辛。辛 谓醉痛也。热盛则阳络溢，阳络溢则衄，出汗血也。 谓汗血，血出甚。阳明太阳脉衰，不能荣养于目，故目瞑瞑暗也。）故得之气厥也。（厥者，气逆也，皆由气逆而得之，出气厥论。）
帝曰：始生有病癫者，病名为何？曰：病名胎病，此得之在母腹中时，其母有所大惊，气上而不下，精气并居，故令子发癫疾。（精气，谓阳之精气。○出奇病论。）
岐伯曰：阳虚则外寒者，阳受气于上焦，以温皮肤分肉之间。今寒气在外，则上焦不通，上焦不通，则寒气独留于外，故寒 （ 战 也）。阴虚生内热者，所有劳倦，形气衰少，谷气不盛，上焦不行，下脘不通，胃气热，热气熏胸中，故内热。（王安道曰：此阴字指人身之阴与水谷之味也。夫有所劳倦者，过动属火也；形气衰少者，壮火食气也；谷气不盛者，劳伤元气则少食而气衰也；上焦不行者，清阳不升也；下脘不通者，浊阴不降也。夫胃受水谷，则清阳升而浊阴降，以传化出入，滋养一身也。今胃不能纳，而谷气衰少，则清无升，浊无降矣。故曰上不行，下不通，非绝不行不通，但比无病时谓之不行不通耳。上不行，下不通，则郁矣。郁则少火皆成壮火。胃居上焦下脘之间，故胃气热，热则上炎熏胸中，为内热也。斯东垣所谓劳伤形体、饮食失节而致热者乎？内伤之说，盖原于此。）
阳盛生外热者，上焦不通，则皮肤致密，腠理闭塞，玄府不通，卫气不得泄越，故外热。（外伤寒毒，内薄诸阳，寒外盛则皮肤收，皮肤收则腠理密，故卫气蓄聚，无所流行矣。寒气外薄，阳气内争，积火内燔，故生外热。）
阴盛生内寒者，厥气上逆，寒气积于胸中而不泻，不泻则温气去，寒独留，则血凝泣，凝则脉不通，其脉盛大以涩，故中寒。（温气，阳气也。阴逆内满，则阳气去于皮外也。○出调经论。）
《灵枢》（《病传篇》曰：七传当作次传，谓传其所胜，如心传肺、肺传肝之类；间传，谓间脏传所不胜，如心传肝、肝传肾之类。○《根结篇》曰：形气不足，病气有余，思泻之。形谓皮肉筋骨血脉也，气谓口鼻中喘息也。形胜者为有余，消瘦者为不足。审口鼻中气，劳役如故为气有余，若喘息气促、气短或不足以息者为不足。当称当泻，全不在此，但病来潮作之时，病气精神增添者是病气有余，乃邪气胜也，急泻以寒凉酸苦之剂；如潮作之时精神困弱、语言无力及懒语者为病气不足，乃真气不足也，急补以辛耳湿热之利。若病患形气不足，病来之时病气亦不足，此阴俱不足，禁用针，针宜补以其药，不可尽剂不已，取脐不气悔穴。）
○有病头痛数岁不已者，当有所犯大寒，内至骨髓。髓者以脑为主，脑逆故令头痛，齿亦痛。（出奇病论）
○有癃者一日数十溲（后条脉细微如发），此不足也。身热如炭，颈膺如格，人迎躁盛，喘息气逆，此有余也。太阴脉细微如发，此不足也（外有余者五，内不足者二）。名为何病？岐伯曰：病在太阴，其盛在胃，颇在肺，病名曰厥，死不治。（外有阴者五，皆手太阴脉当洪大而数，今微细如发，是脉与症相反也。以肺气逆凌于胃，故上使人迎躁盛也。故曰其病在太阴，其盛在胃也。以喘息气逆，又云颇在于肺，病相气逆，症不相应，故死不治。何也？谓其病在表则内有二不足，谓其病在里则外有五有余，表里既不可凭，补泻因难为用，其死明矣。）
○有病癫者，曰胎病，此得之在母腹中时，其母有所大惊，气上而不得下，精气并居，故令子发为癫疾也。（精气，阳之精气。○出奇病论）
○有病庞然如水状，切其脉大紧，身无痛，形不瘦，不能食，食少，何病也？曰：病生在肾，名曰肾风。（脉如弓弦，大而且紧，大则为气，紧则为寒，寒气内薄而反无痛，故问之。盖以劳气内蓄，寒复内争，劳气薄寒，故化为风，风胜于胃，故曰……）
[Excerpts on Pulse Diagnosis] (The annotation states: The bladder is located in the "Gu Fu" (Solitary Vessel). This means that while other fu organs can discharge their contents independently without reliance, the bladder must wait for qi transformation to expel urine. Thus, it differs from other fu organs and is called the Solitary Vessel. Similarity constitutes a category; difference constitutes solitude.)
Pulse Observation (Where do Yin and Yang begin? In terms of Yin and Yang, these correspond to Zhang Zhongjing's classification where floating, surging, long, and slippery pulses are Yang, while deep, fine, short, and choppy pulses are Yin. ○ A pulse that is gentle and separated indicates a slow rate; if it connects continuously without separation, it indicates a rapid rate. Therefore, in Spleen disease, the pulse comes solid and becomes more rapid. ○ "Yan Yan" describes a harmonious and unchaotic quality; "She She" describes continuous connection without stopping, known as the Dai (intermittent) pulse; "Elm Catkins" describes lightness, floating, softness, and gentleness, used to describe the autumn pulse which is light, floating, harmonious, and connected. ○ A pulse coming like a bouncing stone indicates rigidity. In health, the pulse is deep and soft; in disease, it becomes rigid, contrary to the deep and soft state. This differs from the previously mentioned "bouncing stone," which combined urgency with rigidity; here, it refers only to rigidity. ○ The Spleen is the solitary Zang organ. Other Zang organs each govern one season, whereas the Spleen does not govern a single season exclusively but influences all four seasons, differing from other Zang organs, hence called solitary. ○ During late summer, a stomach Qi that is slightly soft and weak indicates a normal pulse. According to the previous two sections discussing the stomach, both the Mao (feather-like) and Shi (stone-like) pulses relate to the stomach; here, "soft and weak" refers to the presence of Stomach Qi, following this pattern. If weakness exceeds Stomach Qi, it indicates Spleen disease; if an intermittent pulse appears without Stomach Qi, it indicates death; if softness/weakness combines with a stone-like quality, it indicates winter disease; if weakness is severe, it indicates current illness. This section aligns with the principle stated earlier: "A slight hook quality in the summer stomach Qi indicates health." ○ A hair-like pulse containing a string-like quality indicates spring disease; a severe string-like quality indicates current illness. As the previous section noted that spring combining with autumn pulse implies autumn disease, this section notes that autumn combining with spring pulse implies spring disease. These are merely paired statements for mutual explanation, with no other meaning; pulse diagnosis follows this logic. ○ "Flowing like water" refers to floating and abundant qualities; "pecking like a bird" refers to fine and small qualities. Floating and abundance are excessive, while fineness and smallness are insufficient. ○ "Turbid Qi returns to the Heart." Turbid Qi refers to Yin Qi; "excessive essence enters the vessels." Essence here refers to Yang Essence. The vessel referred to is not the arterial pulse but the Jing-Luo vessels, referring to the Yin Qi and Yang Essence mentioned previously. ○ The section "Mao and Mai combine essence" discusses how the essence of the skin/hair combines with the essence of the Qi flowing through the vessels, moving Qi into the Qi Sea (Lower Dantian), which then distributes to the five Zang organs, allowing internal/external and upper/lower aspects to find their proper places and achieve balance. The character "Liu" should be read as "Liu" (flow). The subsequent section "Kui Du" takes the meaning of weighing/balancing. ○ "Transmission without passing through intervening Zang" refers to transmission skipping an intervening Zang, such as Heart transmitting to Liver. "Intervening Zang transmission" refers to transmission passing through an intervening Zang, such as Heart transmitting to Lung. However, even with intervening transmission, after seven transmissions, a meridian can no longer receive pathogenic factors. ○ There are five types of Yang. Five is the number associated with Earth. Since all five Zang organs rely on Stomach Qi, it is said that five times five equals twenty-five Yangs. ○ "Cannot reach the extreme of Heaven and Earth's essence." "Ji" (extreme/reach) here means centering or appropriateness; it fails to center appropriately regarding essence and Qi. ○ "All Yangs are thus." This means that when Yin internally blocks and repels Yang externally, the symptoms resemble Yang excess but actually belong to Yin deficiency. It cannot be treated as a Yang disease; the following text follows this logic. ○ Excess Yang causes body heat and absence of sweating. Sweat is Yin Qi. When Yin prevails and Yang is deficient, heat occurs without sweat.)
[Excerpts on Pathogenesis] Depriving oneself of physical exertion during autumn and winter leads to cold hands and feet. "Yong" means exerting force; "Zheng" means disharmony; pathogenic Qi here refers to Yin pathogens. The phrase "Qi becomes trapped in the middle" is suspected to be a textual error. "Ascending from below" refers to Yin pathogens ascending along counter-flowing Yang Qi. In autumn and winter, Yang declines and Yin flourishes. If one depletes Yang essence and Qi during these seasons, Upper Jiao Yang Qi further declines, becoming oppressed by flourishing Yin and rising upward in disharmony. Once Yang rises and does not descend, Lower Jiao shows increased Yang deficiency and Yin excess. Flourishing Yin overflows to become Yin pathogens. Yin pathogens counter-flowing with微弱 Yang cause cold to reverse from below upwards, resulting in Jue (reversal cold). Hands and feet are cold because they are the root of all Yang limbs; Yang deficiency and Yin prosperity cause cold hands and feet. ○ Qi gathers in the Spleen, representing the accumulation of Gu Qi (Grain Qi). ○ Malaria arises from wind lastly, implying malaria originates from Heat/Shu. Malaria typically results from initial Summer-Heat injury followed by Wind-Cold contraction. ○ Annotation: "Yang Qi descends to its extreme and then ascends; Yin Qi ascends to its extreme and then descends," hence "Yin and Yang contend above and below." This refers to external pathogenic invasion. Huicui excerpts: "Yang diseases ascend to their extreme and then descend; Yin diseases descend to their extreme and then ascend." This refers to intrinsic Qi pathology. Wind and Shu are Yang pathogens that preferentially injure Yang meridians. Receiving Yang pathogens leads to Yang extremity; when harmonious, Yang Qi descends, but at its extreme, it reverses to contend with Yin. Water and Cold are Yin pathogens that preferentially injure Yin meridians. Receiving Yin pathogens leads to Yin extremity; when harmonious, Yin Qi ascends, but at its extreme, it reverses to contend with Yang. This refers to the Yin/Yang of specific meridians (e.g., varying amounts of Qi and Blood in certain meridians), not the Ying (Nutrient) Qi within vessels and Wei (Defensive) Qi outside vessels. ○ Inside the skin and outside the intestines/stomach is where Ying Qi resides. Summer-Heat hides inside the skin, residing in Ying Qi. Later, inside the skin and outside the intestines/stomach is where Wei Qi resides. Wind-Water lodges in the skin, affecting Wei Qi. Thus, inside the skin is where Ying and Wei coexist. This also refers to the Ying/Wei of specific meridians. Their Qi is gentle and harmonious, making them susceptible to pathogens. Previously, Summer-Heat injured Ying; now, Wind-Cold injures Wei. Both Ying and Wei are injured and coexist. When Wei Qi moves outward into Yang branches, it contends with Yang; Yang deficiency causes cold. When Wei Qi moves inward into Yin branches, it contends with Yin; Yin deficiency causes heat. This refers to Wei Qi traveling through Yang during the day and Yin at night. The later section states "converging on Yang makes Yang prevail; converging on Yin makes Yin prevail," further elucidating the previous point about Yin/Yang contention above and below. ○ When disease reaches its extreme, it reverses. Things reverse when they reach their extreme. Thus, when Yang pathogens reach their extreme, cold stops; when Yin pathogens reach their extreme, heat stops. Moreover, when Wei Qi leaves the meridian where it received the pathogen and travels to another meridian, pathogen and righteous Qi separate, and cold/heat cease. ○ Malaria with only heat and no chills occurs because only Yang pathogens (Summer-Heat and Wind) were contracted, without Yin-Cold pathogens (Water/Cold). ○ Chills with jaw trembling occur because the jaw is traversed by the Stomach meridian; thirst and frequent drinking occur due to Stomach Heat. Thus, malaria often belongs to the Stomach. ○ Sheng (Overcoming) and Fu (Rebounding) Qi refers to either Overcoming Qi causing disease or Rebounding Qi causing disease, not necessarily a sequence of overcoming then rebounding (e.g., Yang pathogen overcoming, Yin pathogen rebounding). Xun Meng Zhao You (dizziness and instability) reaching severity enters the Liver. Scholar Xu states: Upper deficiency indicates Liver deficiency. Liver deficiency causes dizziness. Xun Meng feels like having something covering the head, swaying uncertainly; dizzy eyes, deaf ears are all signs of dizziness, named Gan Jue (Liver Jue) dizziness. ○ Jie Yin (Knotted Yin) causes hematochezia. *Baodian* states: If Yin Qi does not knot internally but flows externally without receiving support, it seeps into the intestines, causing hematochezia.)
[Excerpts on Treatment Principles] "An Er Shou Zhi" means massage to gather and secure. ○ What is meant by "Jia" (false)? It refers to using cold herbs in winter without being prohibited by winter cold. "Gao Zhe Yi Zhi" (Suppress what is high) generally explains the meaning of controlling and depriving mentioned earlier. ○ The section "When Qi Prevails" is identical to the later Yunqi excerpt "When Qi Prevails." One must stabilize the Host and Guest, referring to the Host and Guest of the Six Qi additions. "Ni" (Reverse) refers to the Six Qi; "Cong" (Follow) refers to the Five Movements. ○ "Disease is distant, but treat via the middle path with subtle flavors/aromas." The "middle path" refers to medicines with subtle flavors/aromas. If the disease is in the Kidney or Liver, the distance is far. Using medicines with subtle flavors/aromas requires large doses administered at once, conforming to the principles of Yi Fang. Annotation: "Shi Er Ling Zu" means sufficient food, i.e., large and numerous doses. However, "Ji Guo Zhi" means administering at once. ○ "Proceed according to what is beneficial," e.g., Pungent flavors benefit dispersion. ○ "Calm palpitations." Calm the mind and regulate Qi first, then administer medicine. This treats external fright. If internal movement agitates the Spirit, one must use medicine to balance the excess/deficiency of Yin/Yang so the Spirit can be安定 (stable) and Will determined. ○ "Must subdue that which dominates." "Fu" means to subdue. To subdue pathogens and prevent harm, one must first know methods like "treat heat with cold administration." Tong (Same) means treating cold with heat initially seems the same; Zhong (End/Different) means taking hot medicine cold changes its nature. Taking hot medicine cold avoids rejection. Breaking accumulations and dissipating hardness... is appropriate. Internal or external treatment, or reducing by affiliation, each follows what is suitable. ○)
[Excerpts on Color Diagnosis] "He Yu Shen Ming" means aligning with the changes of Heaven and Earth's divine spirit.
[Excerpts on Acupuncture] "Guan Shi Zhi Bian" means observing changes with a quiet mind and understanding, transforming and adjusting pathological changes. ○ Do not puncture and drain when encountering the peak. At water mark 1, 3, 5, 7, Qi is in the Three Yang meridians; at marks 2, 4, 6, 8, Qi is in the Yin divisions. When Qi is in Yang, Yang division is exclusively prosperous; when Qi is in Yin, Yin division is exclusively prosperous. Seeing exclusive prosperity and identifying it as evil to drain with needles harms True Qi, hence the following text. Wang's commentary says at water mark 1, Qi is in Taiyang; mark 3, Shaoyang; mark 3, Yangming; mark 4, Yin division. If so, Qi circulates only 25 cycles in a day/night, contradicting *Ling Shu* stating 50 cycles. This error is evident. Furthermore, "Fen Yin" refers to the Yin division of the Three Yang meridians, not the inner Zang Yin divisions. At noon, water mark 1, Qi is in the Three Yang cycle; in the Yang division, it is also the Yang division of the Three Yin meridians, not the outer Fu Yang divisions. Thus, Fu have Yin/Yang, and Zang have Yin/Yang. This specifically refers to Wei Qi. ○ "Beside the seventh vertebra lies the Xiao Xin (Lesser Heart)." According to *Jing Du Pian* commentary on the Heart meridian: The Heart connections are two. One connects upward to the lungs, entering between the two large lung lobes. The other descends from the lung connection, curving backward, connecting finely along the spine and diaphragm, penetrating the spinal cord and communicating with the Kidneys, right at the seventh vertebra. Does the scripture refer to this? ○ "Draw from Yin to lead Yang, draw from Yang to lead Yin." Head is Yang, Feet are Yin; Heat is Yang, Cold is Yin. Disease in the head is treated by lower points; disease in the feet by upper points. For Yang diseases leading heat to Yin to cool, and Yin diseases leading cold to Yang to warm, all are correct. This aligns with *Lun Zhi Chao*: "For Yang diseases with reversed Qi, disease above is treated below, disease below is treated above, disease in the middle is treated laterally.")
[Excerpts on Yin and Yang] The ability of all things, meaning the beginning of life depends on it, and the beginning of death also depends on it. ○ Flavor returns to Form; Form consumes Flavor. Qi generates Form; Form/Qi consume [Flavor/Qi]. Not only does Flavor generate Form, but Qi also generates Form. ○ Qi returns to Essence; Essence returns to Transformation; Transformation generates Essence; Essence consumes Qi. This states Qi not only generates Form but also Essence. ○ Flavor injures Form; Qi injures Essence. Although Flavor generates Form, Form can be injured by Flavor; although Qi generates Essence, Essence can be injured by Qi. ○ Essence transforms into Qi. Qi not only generates Essence through transformation, but Essence can also generate Qi, hence "mutually benefiting." ○ Qi is injured by Flavor. Not only is Form injured by Flavor, but Qi is also injured by Flavor, hence "mutually damaging." ○ Heavenly movements depend on sunlight. Heavenly movements are incessant because sunlight makes Yang Qi prosperous. If humans preserve their Yang, they live long; if they deplete Yang, they die early. ○ "Evening gathering and rejecting" section instructs on nourishing Yang. ○ Pulse flow is thin and rapid; convergence leads to mania. "Bo Ji" indicates Yin deficiency; "Bing" indicates Yang excess and solidity.)
[Excerpts on Root and Branch] Successful treatment is "Cong" (following/compliance). "De" means compliance. Treating heat with heat is compliant with the disease.
[Excerpts on Climate and Movement] Qi Shu: Qi refers to Yin/Yang Qi; Shu refers to Three Yin/Three Yang. Annotation: Qi Shu refers to generative Qi, the numbers Nine of Tian 1 and Di 6. ○ "What is overcome is mild; what overcomes is severe." This refers to the Direct Year's Qi as the Overcoming Qi. If the Overcoming Qi is interfered with by pathogens, the Direct Year's Qi remains victorious and pathogens are not victorious, so disease is mild. If the Direct Year's Qi is not victorious (insufficient), and is interfered with by pathogens, it is severe. ○ "Not in its season is mild." E.g., Wood year but Fire Qi arrives. Direct Year Wood Qi is strong, so although Fire Qi arrives, it is out of season, so disease manifests mildly two years later. ○ "In its season is severe." E.g., Direct Wood year, Wood Qi is strong. Now intercepted by pathogens, Wood Qi is deficient and receives pathogens, hence "what overcomes is severe" (Wood Qi is deficient). Also "in its season is severe" means in a Direct Wood year, Wood is diseased by pathogens, so disease is severe. ○ "Stabilize屈复 (Quiescence and Rebound)." If Overcoming Qi is harmonious, calm it; if Overcoming Qi is severe, deprive it. Follow the severity of Overcoming Qi to calm or deprive, stabilizing it to make it quiescent.)
[Excerpts on Compilation] "Thus the Sage transmits Spirit" means inheriting internal Spirit without destruction, accepting Heavenly True Qi without opposition, so Divine Spirit flows freely without internal/external obstruction. ○ "Its color must be wan." Previous text discussed pulse; this says color should also be observed. ○ "Like Can Chun" indicates disease. Can Chun means heavy/light, fast/slow are equal. If only the Middle position pulse is harmonious (not large/rapid), but Upper/Lower positions are large/rapid, death ensues. Or if Upper/Lower are large/rapid but Middle is small, death ensues. ○ "One Hou later indicates disease; later indicates victory." Pulses vary in size and speed. Large refers to former/small refers to latter; rapid refers to former/slow refers to latter. ○ "Uniquely small indicates disease." Unique refers to highlighting one Hou among all observations, similar to the meaning of "one Hou later." )
Qi Bo said: Kidney transfers Cold to Spleen, causing abscesses/swelling and shortness of breath. (Kidney injured by Cold transmits to Spleen. Spleen governs flesh; Cold governs flesh, condensing into hardness, hardening into pus, causing abscesses. Blood injury causes shortage, hence shortness of breath.) Spleen transfers Cold to Liver, causing abscesses/swelling and tendon spasms. (Spleen governs flesh, Liver governs tendons. Warm flesh relaxes tendons; cold flesh tightens tendons, causing spasms. Cold flesh causes Wei Qi aggregation, causing swelling/abscesses.) Liver transfers Cold to Heart, causing madness and chest blockage. (Heart is a Yang Zang housing Spirit. Cold oppression confuses Spirit, causing madness. Yang Qi and Cold oppose each other, causing blockage and mid-body obstruction.) Heart transfers Cold to Lung, causing Lung Xiao (Consumption). Lung Xiao involves drinking one unit and urinating two units; death is incurable. (Heart is Yang Zang but receives Cold. Cold stagnates and transforms into Heat, scorching Metal internally. Metal receives Fire evil, causing Middle Xiao. Lung consumption destroys Qi support, leading to drinking one and urinating two. Metal and Fire destroy each other; death is incurable.) Lung transfers Cold to Kidney, causing Yong Shui (Surging Water). Yong Shui presents as non-tender abdomen upon pressure. Water Qi lodges in Large Intestine; rapid walking causes gurgling sounds like a bag wrapping浆 (paste). (Lung Cold enters Kidney; Kidney Qi surplus rushes to Lung, hence Surging Water. Large Intestine is Lung's Fu. Water lodges in Large Intestine. Kidney receives condensation, failing to transform fluids; Large Intestine accumulates water without circulation, causing disease...) Spleen transfers Heat to Liver, causing fright and epistaxis. (Liver stores Blood and governs fright. Heat oppression causes fright and nosebleed.) Liver transfers Heat to Heart, leading to death. (Two Yangs combine, Fire and Wood scorch each other. Liver Heat entering Heart leads to death.) Heart transfers Heat to Lung, transmitting to Ge Xiao (Diaphragm Consumption). (Between Heart Fu layers lies a diagonal diaphragm membrane, connecting internally to the horizontal diaphragm. Heart Heat entering Lung, over time transforms, internally transmitting Diaphragm Heat, causing thirst and polydipsia.) Lung transfers Heat to Kidney, transmitting to Rou Gu (Soft Tendons/Hard Bones). (Rou means soft tendons; Gu Qiang means hard bones. Qi and Bone are hot, Marrow does not fill internally, so bones are hard/unlifted, tendons are soft/weak.) Kidney transfers Heat to Spleen, transmitting to Xu Chang ... Death is incurable. (Spleen Earth controls Wood. Kidney transferring Heat to it means Earth cannot control Wood and becomes diseased, leading to chronic deficiency. ... Death occurs because Kidney governs Lower Jiao, symbolizing Water/Cold. Transferring Heat means Essence dissipates internally; Lower Jiao has no master to guard, causing ... expulsion and uncontrolled Qi.) Bao (Uterus/Bladder) transfers Heat to Bladder, causing Lin (Strangury) and bloody urine. (Bladder is Treasury of Fluids; Bao is repository of reception. Bao Heat transfers to Bladder, causing Yin collaterals to overflow internally, preventing urination and causing bloody urine.) Bladder transfers Heat to Small Intestine, causing intestinal blockage/inconvenience and mouth ulcers above. (Small Intestine meridian connects to Heart, passes throat, crosses diaphragm to Stomach. Heat causes intestinal/diaphragmatic blockage/inconvenience; above, it causes mouth sores/ulcers.) Small Intestine transfers Heat to Large Intestine, causing ... Zha (Masses) and Chen (Depression/Sinking). (Small Intestine Heat transfers to Large Intestine; two Heats combine, causing blood overflow forming Fu Zha (hidden masses). Blood fullness and obstruction cause menstrual stagnation, hence Fu Zha and Chen. ... is synonymous with Fu.) Large Intestine transfers Heat to Stomach, causing polyphagia with emaciation, also called Shi Yi (Eating and Changing). (Stomach is Sea of Water/Grain, nourishing muscles externally. Heat consumes Water/Grain and dries muscles, causing polyphagia/emaciation. Shi Yi means food passes through without generating flesh. Yi means change.) Stomach transfers Heat to Gallbladder, also called Shi Yi. (Meaning same as above.) Gallbladder transfers Heat to Brain, causing sinus pain and Bi Yuan (Nasal Spring). Bi Yuan is continuous dripping of turbid mucus. Transmitting to ... Mn Mu (Epistaxis/Closed Eyes). (Brain fluid seeps down as turbid mucus, dripping endlessly like a spring, hence Bi Yuan. ... refers to nasal bridge. Foot Taiyang meridian starts at inner eye, crosses forehead, connects to brain. Yangming meridian starts at nose, crosses nasal bridge, encircles Taiyang. Brain heat causes Taiyang reversal, combining with Yangming at nasal bridge, causing nasal pain. ... refers to drunken pain. Heat excess causes Yang collaterals to overflow, causing epistaxis/sweating blood. ... refers to sweating blood. Severe blood loss causes Yangming/Taiyang decline, failing to nourish eyes, causing dark/closed eyes.) Thus, these arise from Qi Jue (Qi Reversal). (Jue means Qi reversal; all result from Qi reversal, from Qi Jue Lun.)
Emperor said: Initially developing Dian disease, what is its name? Qi Bo said: Named Tai Bing (Fetal Disease). It is acquired in the womb when the mother suffers great fright. Qi ascends and does not descend; Essence and Qi congregate, causing the child to develop Dian disease. (Essence/Qi refers to Yang Essence. ○ From Chu Qi Bing Lun.)
Qi Bo said: Yang deficiency causes exterior cold. Yang receives Qi from Upper Jiao to warm skin and muscle intervals. Now Cold is external, blocking Upper Jiao. Upper Jiao blockage causes Cold to remain solely externally, hence chills/shivering. Yin deficiency generates interior Heat. Labor/fatigue causes Form/Qi depletion and insufficient Gu Qi. Upper Jiao fails to move; Lower Wan is blocked. Stomach Qi becomes hot, steaming the chest, causing interior Heat. (Wang Andao states: This "Yin" refers to bodily Yin and Grain flavors. Labor/fatigue involves excessive movement belonging to Fire. Form/Qi depletion means Strong Fire consumes Qi. Insufficient Gu Qi means labor damages Yuan Qi, reducing food intake and Qi. Upper Jiao failure means Clear Yang does not ascend. Lower Wan blockage means Turbid Yin does not descend. Stomach receives grains, ascending Clear Yang and descending Turbid Yin to transmit/nourish the body. Now Stomach cannot accept, Gu Qi declines, Clear Yang has nothing to ascend, Turbid Yin has nothing to descend. Hence "Upper fails, Lower blocked," not absolute blockage but relative to health. Failure/blockage leads to stagnation. Stagnation turns Mild Fire into Strong Fire. Stomach is between Upper Jiao and Lower Wan. Stomach Qi heats, rising to steam chest, causing interior Heat. This is Dong Yuan's theory of labor-damage and diet irregularity causing heat. The concept of internal injury originates here.)
Yang excess generates exterior heat. Upper Jiao blockage makes skin dense, pores closed, Xuan Fu blocked. Wei Qi cannot vent, causing exterior heat. (External Cold toxicity presses internal Yang. External Cold excess causes skin contraction, pore density, Wei Qi accumulation without flow. External Cold presses, internal Yang contends, accumulated fire burns internally, generating exterior heat.)
Yin excess generates interior cold. Jue Qi reverses upward; Cold accumulates in Chest/Middle without discharge. Without discharge, Warm Qi departs, Cold remains alone. Blood coagulates, vessels obstruct. Pulse is large and choppy, hence interior cold. (Warm Qi is Yang Qi. Yin reversal fills internally, driving Yang Qi to skin exterior. ○ From Tiao Jing Lun.)
*Ling Shu* (*Bing Chuan Pian*): "Seven transmissions" should be "Sequential transmission," transmitting to what it overcomes (e.g., Heart to Lung, Lung to Liver). "Inter-transmission" refers to skipping Zangs to transmit to what overcomes it (e.g., Heart to Liver, Liver to Kidney). ○ *Gen Jie Pian*: If Form/Qi are deficient but Disease Qi is excessive, consider draining. Form refers to skin/flesh/bones/blood/vessels; Qi refers to nasal/oral breathing. Form excess is robust; deficiency is emaciated. Assess nasal/oral Qi: unchanged by labor means Qi excess; panting/shortness of breath means Qi deficiency. Drain/tonify depends not just on this, but on whether Disease Qi/Spirit increases during paroxysms (excess/Evil wins, drain with cold/bitter/sour); or decreases (deficiency/True Qi wins, tonify with pungent/warm/damp-draining). If Form/Qi deficient and Disease Qi deficient at onset, this is total Yin deficiency. Needles are contraindicated; tonify with medicine. If medicine fails, take... umbilical points.)
○ Headache lasting years without relief suggests major Cold invasion reaching marrow. Marrow is governed by Brain. Brain reversal causes headache and toothache. (From Chu Qi Bing Lun)
○ Frequent urination (dozens of times daily) indicates deficiency (later pulse fine as hair). Body heat like charcoal, neck/chest like a barrier, Renying pulse restless/rapid, panting/reverse Qi indicate excess. Taiyin pulse fine as hair indicates deficiency (Five exterior excesses, Two interior deficiencies). What disease? Qi Bo said: Disease in Taiyin, excess in Stomach, partly in Lung. Named Jue, death is incurable. (Five exterior Yin [symptoms] but Hand Taiyin pulse should be surging/rapid, now fine as hair. Pulse contradicts symptoms. Lung Qi rebellion oppresses Stomach, causing Renying rapidity. Disease in Taiyin, excess in Stomach. Panting/reverse Qi partly in Lung. Disease/Qi/Symptoms mismatch leads to death. Why? Exterior disease has two interior deficiencies; Interior disease has five exterior excesses. Exterior/Interior cannot guide treatment; tonification/draining difficult. Death is clear.)
○ Dian disease named Tai Bing, acquired in womb from maternal fright. Qi ascends, Essence/Qi congregate, causing fetal Dian. (Yang Essence. ○ From Chu Qi Bing Lun)
○ Swollen like water, pulse large/tight, body painless, form not emaciated, unable to eat/eats little. Disease originates in Kidney, named Ren Feng (Wind of Kidney). (Pulse like bowstring, large/tight. Large indicates Qi, Tight indicates Cold. Cold presses internally but painless. Labor Qi accumulates internally, Cold contends, Labor/Cold transform into Wind, Wind overcomes Stomach...)