问曰。上工治未病。何也。师曰。夫治未病者。见肝之病。知肝传脾。当先实脾。四季脾王不受
邪。即勿补之。中工不晓相传。见肝之病。不解实脾。惟治肝也。夫肝之病。补用酸。助用焦苦。益
用甘味之药调之。酸入肝。焦苦入心。甘入脾。脾能伤肾。肾气微弱。则水不行。水不行。则心火气
盛。则伤肺。肺被伤。则金气不行。金气不行。则肝气盛。则肝自愈。此治肝补脾之要妙也。肝虚则
用此法。实则不在用之。经曰。虚虚实实。补不足。损有余。是其义也。余脏准此。按、素问云。邪
气之客于身也。以胜相加。肝应木而胜脾土。以是知肝病当传脾也。实脾者。助令气王。使不受邪。所
谓治未病也。设不知而徒治其肝。则肝病未已。脾病复起。岂上工之事哉。肝之病补用酸者。肝不足。
则益之以其本味也。与内经以辛补之之说不同。然肝以阴脏而含生气。以辛补者所以助其
用。补用酸者。所以益其体。言虽异而理各当也。助用苦焦者。千金所谓心王则气感于肝也。益用甘
味之药调之者。越人所谓损其肝者缓其中也。酸入肝以下十五句。疑非仲景原文。类后人谬添注脚。
编书者误收之也。盖仲景治肝补脾之要。在脾实而不受肝邪。非补脾以伤肾。纵火以刑金之谓。果尔。
则是所全者少。而所伤者反多也。且脾得补而肺将自旺。肾受伤必虚及其子。何制金强木之有哉。细
按语意。见肝之病以下九句。是答上工治未病之辞。补用酸三句。乃别出肝虚正治之法。观下文云。
肝虚则用此法。实则不在用之。可以见矣。盖脏病惟虚者受之。而实者不受。脏邪惟实则能传。而虚
则不传。故治肝实者。先实脾土。以杜滋蔓之祸。治肝虚者。直补本宫。以防外侮之端。此仲景虚实
并举之要旨也。后人不察肝病缓中之理。谬执甘先入脾之语。遂略酸与焦苦。而独于甘味曲穷其说。以
为是即治肝补脾之要妙。昔贤云。 辞知其所蔽。此之谓耶。
夫人禀五常。因风气而生长。风气虽能
生万物。亦能害万物。如水能浮舟。亦能覆舟。若五脏元真通畅。人即安和。客气邪风。中人多死。
千般 难。不越三条。一者经络受邪入脏腑。为内所因也。二者四肢九窍。血脉相传。壅塞不通。为
外皮肤所中也。三者房室金刃虫兽所伤。以此详之。病由都尽。若人能养慎。不令邪风干忤经络。适
中经络。未流传腑脏。即医治之。四肢才觉重滞。即导引吐纳。针灸膏摩。勿令九窍闭塞。更能无犯
王法。禽兽灾伤。房室勿令竭乏。服食节其冷热。苦酸辛甘。不遗形体有衰。病则无由入其腠理。腠
者。是三焦通会元真之处。理者。是皮肤脏腑之文理也。
人禀阴阳五行之常。而其生其长。则实由风与气。盖非八风。则无以动荡而协和。非六气。则无以变
易而长养。然有正气。即有客气。有和风。即有邪风。其生物害物。并出一机。如浮舟覆舟。总为一
水。故得其和则为正气。失其和即为客气。得其正则为和风。失其正即为邪风。其生物有力。则其害
物亦有力。所以中人多死。然风有轻重。病有浅深。约而言之。不越三条。一者邪从经络入脏腑而深。
为内所因。二者邪在四肢九窍皮肤沿流血脉而浅。为外所因。三者病从王法房室金刃虫兽而生。为不
内外因。所谓病之由也。人于此慎养。不令邪风异气干忤经络。则无病。适入经络。未入脏腑。可汗
吐或和解而愈。所谓医治之也。此应前内因一段。若风气外侵四肢。将及九窍。即吐纳导引以行其
气。针灸膏摩以逐其邪。则重滞通快。而闭塞无由。此应前外因一段。更能不犯王法禽兽。则形体不
伤。又虽有房室而不令竭乏。则精神不敝。此应前房室一段。腠理云者。谓凡病纠缠于身。不止经络
血脉。势必充溢腠理。故必慎之使无由入。腠者。三焦与骨节相贯之处。此神气所往来。故曰元真通
会。理者。合皮肤脏腑。内外皆有其理。细而不紊。故曰文理。仲景此论。以风气中人为主。故以经
络入脏腑者。为深为内。自皮肤流血脉者。为浅为外。若房室金刃虫兽所伤。则非客气邪风中人之比。
与经络脏腑。无相干涉者。为不内外因也。（节徐氏）
按、陈无择三因方。以六淫邪气所触为外因。
五脏情志所感为内因。饮食房室跌扑金刃所伤。为不内外因。盖仲景之论。以客气邪风为主。故不从
内伤外感为内外。而以经络脏腑为内外。如徐氏所云是
也。无择合天人表里立论。故以病从外来者为外因。从内生者为内因。其不从邪气情志所生者。为不
内外因。亦最明晰。虽与仲景并传可也。
问曰。病患有气色见于面部。愿闻其说。师曰。鼻头色青。
腹中痛。苦冷者死。鼻头色微黑者。有水气。色黄者。胸上有寒。色白者。亡血也。设微赤非时者死。
其目正圆者痉不治。又色青为痛。色黑为劳。色赤为风。色黄者便难。色鲜明者有留饮。
此气色之辨。所谓望而知之者也。鼻头、脾之部。青肝之色。腹中痛者。土受木贼也。冷则阳亡
而寒水助邪。故死。肾者主水。黑、水之色。脾负而肾气胜之。故有水气。色黄者面黄也。其病在脾。
脾病则生饮。故胸上有寒。寒、寒饮也。色白亦面白也。亡血者不华于色。故白。血亡则阳不可更越。
设微赤而非火令之时。其为虚阳上泛无疑。故死。目正圆者阴之绝也。痉为风强病。阴绝阳强。故不
治。痛则血凝泣而不流。故色青。劳则伤肾。故色黑。经云。肾虚者面如漆柴也。风为阳邪。故色赤。
脾病则不运。故便难。色鲜明者有留饮。经云。水病患目下有卧蚕。面目鲜泽也。
师曰。病患语声寂
寂然喜惊呼者。骨节间病。语声喑喑然不彻者。心膈间病。语声啾啾然细而长者。头中病。
语声寂寂然喜惊呼者。病在肾肝。为筋髓寒而痛时作也。喑喑然不彻者。病在心肺。则气道塞而
音不彰也。啾啾然细而长者。痛在头中。则声不敢扬。而胸膈气道自如。故虽细而仍长也。此音声之
辨。闻而知之者也。然殊未备。学人一隅三反可矣。
师曰。息摇肩者心中坚。息引胸中上气者咳。息张口短气者。肺痿吐沫。
心中坚者。气实而出入阻。故息则摇肩。咳者气逆而肺失降。则息引胸中上气。肺痿吐沫者。气
伤而布息难。则张口短气。此因病而害于气者也。
师曰。吸而微数。其病在中焦实也。当下之则愈。虚者不治。在上焦者其吸促。在下焦者其吸远。
此皆难治。呼吸动摇振振者不治。
息兼呼吸而言。吸则专言入气也。中焦实。则气之入者。不得下行。故吸微数。数犹促也。下之
则实去气通而愈。若不系实而系虚。则为无根失守之气。顷将自散。故曰不治。或云。中焦实而元气虚
者。既不任受攻下。而又不能自和。故不治。亦通。其实在上焦者。气不得入而辄还。则吸促。促犹短
也。实在下焦者。气欲归而不骤及。则吸远。远犹长也。上下二病。并关脏气。非若中焦之实。可从
下而去者。故曰难治。呼吸动摇振振者。气盛而形衰。不能居矣。故亦不治。
师曰。寸口脉动者。因其王时而动。假令肝王色青。四时各随其色。肝色青而反色白。非其时。
色脉皆当病。王时。时至而气王。脉乘之而动。而色亦应之。如肝王于春。脉弦而色青。此其常也。
推之四时。无不皆然。若色当青而反白。为非其时而有其色。不特肝病。肺亦当病矣。犯其王气故也。
故曰。色脉皆当病。
问曰。有未至而至。有至而不至。有至而不去。有至而太过。何谓也。师曰。冬至之后。甲子夜
半少阳起。少阳
之时。阳始生。天得温和。以未得甲子天因温和。此为未至而至也。以得甲子而天未温和。为至而不
至也。以得甲子而天大寒不解。此为至而不去也。以得甲子而天温如盛夏五六月时。此为至而太过也。
上之至谓时至。下之至谓气至。盖时有常数而不移。气无定刻而或迁也。冬至之后甲子。谓冬至
后六十日也。盖古造历者。以十一月甲子朔夜半冬至为历元。根据此推之。则冬至后六十日。当复得甲
子。而气盈朔虚。每岁递迁。于是至日不必皆值甲子。当以冬至后六十日花甲一周。正当雨水之候为正。
雨水者。冰雪解散而为雨水。天气温和之始也。云少阳起者。阳方起而出地。阳始生者。阳始盛而生
物。非冬至一阳初生之谓也。窃尝论之矣。夏至一阴生。而后有小暑、大暑。冬至一阳生。而后有小
寒、大寒。非阴生而反热。阳生而反寒也。天地之道。否不极则不泰。阴阳之气。剥不极则不复。夏
至六阴尽于地上。而后一阴生于地下。是阴生之时。正阳极之时也。冬至六阳尽于地上。而后一阳生
于地下。是阳生之时。正阴极之时也。阳极而大热。阴极而大寒。自然之道也。则所谓阳始生天得温
和者。其不得与冬至阳生同论也审矣。至未得甲子而天已温。或已得甲子而天反未温。及已得甲子而
天大寒不解。或如盛夏五六月时。则气之有盈有缩。为候之或后或先。而人在气交之中者。往往因之
而病。惟至人为能与时消息而无忤耳。
师曰。病患脉浮者在前。其病在表。浮者在后。其病在里。腰痛背强不能行。必短气而极也。
前谓关前。后谓关后。关前为阳。关后为阴。关前脉浮者。以阳居阳。故病在表。关后脉浮者。以
阳居阴。故病在里。然虽在里而系阳脉。则为表之里。而非里之里。故其病不在肠肾。而在腰背膝胫。而及其至。
则必短气而极。所以然者。形伤不去。穷必及气。表病不除。久必归里也。
问曰。经云厥阳独行。何谓也。师曰。此为有阳无阴。故称厥阳。
厥阳独行者。孤阳之气。厥而上行。阳失阴则越。犹夫无妻则荡也。千金方云。阴脉且解。血散
不通。正阳遂厥。阴不往从。此即厥阳独行之旨欤。
问曰。寸脉沉大而滑。沉则为实。滑则为气。实气相搏。血气入脏即死。入腑即愈。此为卒厥。
何谓也。师曰。唇口青身冷。为入脏。即死。如身和汗自出。为入腑。即愈。
实谓血实。气谓气实。实气相搏者。血与气并而俱实也。五脏者。藏而不泻。血气入之。卒不得
还。神去机息。则唇青身冷而死。六腑者。传而不藏。血气入之。乍满乍泻。气还血行。则身和汗出
而愈。经云。血之与气。并走于上。则为大厥。厥则暴死。气复反则生。不返则死是也。
问曰。脉脱入脏即死。入腑即愈。何谓也。师曰。非为一病。百病皆然。譬如浸淫疮。从口起流
向四肢者可治。从四肢流来入口者不可治。病在外者可治。入里者即死。
脉脱者。邪气乍加。正气被遏。经隧不通。脉绝似脱。非真脱也。盖即暴厥之属。经曰。趺阳脉
不出。脾不上下。身冷肤硬。又曰。少阴脉不至。肾气微。少精血。为尸厥。即脉脱之谓也。厥病入
脏者。深而难出。气竭不复则死。入腑者浅而易通。气行脉出即愈。浸淫疮。疮之浸淫不已。外台所
谓转广有汁。流绕周身者也。
从口流向四肢者。病自内而之外。故可治。从四肢流来入口者。病自外而之里。故不可治。李玮西云。
病在外二句。概指诸病而言。即上文百病皆然之意。入里者死。如痹气入腹。香港脚冲心之类。
问曰。阳病十八。何谓也。师曰。头痛、项、腰、脊、臂、脚掣痛。阴病十八。何谓也。师曰。
咳、上气、喘、哕、咽、肠鸣、胀满、心痛、拘急。五脏病各有十八。合为九十病。人又有六微。微
有十八病。合为一百八病。五劳七伤六极。妇人三十六病。不在其中。清邪居上。浊邪居下。大邪中
表。小邪中里。谷 之邪。从口入者。宿食也。五邪中人。各有法度。风中于前。寒中于暮。湿伤于
下。雾伤于上。风令脉浮。寒令脉急。雾伤皮腠。湿流关节。食伤脾胃。极寒伤经。极热伤络。
头、项、腰、脊、臂、脚。六者病兼上下。而通谓之阳者。以其在躯壳之外也。咳、上气、喘、
哕、咽、肠鸣、胀满、心痛、拘急九者。病兼脏腑。而通谓之阴者。以其在躯壳之里也。在外者有营
病卫病。营卫交病之殊。是一病而有三也。三而六之。合则为十八。故曰阳病十八也。在里者有或虚
或实之异。是一病而有二也。九而二之。合则为十八。故曰阴病十八也。五脏病各有十八。六微病又
各有十八。则皆六淫邪气所生者也。盖邪气之中人者。有风、寒、暑、湿、燥、火之六种。而脏腑之
受邪者。又各有气分、血分、气血并受之三端。六而三之。则为十八病。以十八之数推之。则五脏合
得九十病。六微合得一百八病。至于五劳七伤六极。则起居饮食情志之所生也。妇人三十六病。则经
月产乳带下之疾也。均非六气外淫所致。故曰不在其中。清邪、风露之邪。故居于上。浊邪、水土之
邪。故居于下。大邪漫风。虽大而力散。故中于表小邪、户牖隙
风。虽小而气锐。故中于里。谷 、饮食之属。入于口而伤于胃者也。是故邪气有清浊大小之殊。人
问：高明的医生治疗未发生的疾病，这是为什么呢？
老师回答：所谓治疗未发生的疾病，就是看到肝脏有病，知道肝病会传变到脾脏，因此应当先充实脾脏。如果在四季中脾土当令旺盛时，脾脏不受邪气侵袭，就不必特意补益。中等水平的医生不懂这种传变规律，看到肝脏有病，不懂得先充实脾脏，只是单纯地治疗肝脏。对于肝脏的疾病，补法应用酸味药，辅助用焦苦味药，增益用甘味药来调和。酸味入肝，焦苦味入心，甘味入脾。脾脏功能强健能制约肾脏，肾气微弱则水液不能妄行；水液不妄行，则心火之气不会过盛；心火不过盛，就不会灼伤肺脏；肺脏不被损伤，则金气（肺气）正常运行；金气正常则能制约肝木，使肝气不至于过亢，这样肝脏的病就能自愈。这就是“治肝补脾”的奥妙所在。这种方法适用于肝虚证，如果是肝实证则不适用。医经说：“不要使虚证更虚，实证更实”，要补其不足，损其有余，就是这个道理。其他脏腑的疾病也依此类推。
按语：《素问》中说，邪气侵犯人体，是按照五行相克的规律相加侵害的。肝属木而克脾土，由此可知肝病应当传变到脾。所谓“实脾”，就是帮助脾土之气旺盛，使其不受邪气侵袭，这就是所谓的“治未病”。如果不知道这一点，仅仅治疗肝脏，那么肝病尚未痊愈，脾病又会兴起，这难道是高明医生的做法吗？治疗肝病用酸味药，是因为肝气不足，就用它本味的酸药来补益。这与《内经》中“辛散以补肝”的说法不同。然而，肝脏作为阴脏却含有生发之气，用辛味药是为了助长其功能（用），用酸味药是为了滋养其形体（体）。说法虽然不同，但道理各有所当。辅助用焦苦味药，正如《千金方》所说，心气旺盛则能感应于肝。增益用甘味药来调和，正如《难经》所说，损害肝脏的要法是缓和其中气（缓其中）。从“酸入肝”以下十五句，怀疑不是张仲景的原文，像是后人错误添加的注释，编书的人误将其收录进去了。大概张仲景“治肝补脾”的要旨，在于使脾实而不受肝邪侵犯，而不是通过补脾去伤害肾脏、纵容心火去克制肺金。如果真的那样，那么保全的少，伤害的反倒多。况且脾得到补益，肺将自然旺盛；肾脏受伤必然虚弱并波及它的子脏（肝），哪里有什么制约肺金、强壮肝木的道理呢？仔细推敲文意，“见肝之病”以下九句，是回答“上工治未病”的话；“补用酸”三句，则是另外提出肝虚证的正规治疗方法。看下文说：“肝虚则用此法，实则不在用之”，就可以明白了。大概脏腑的疾病只有虚证才接受补法，而实证不接受；脏腑的邪气只有实证才能传变，而虚证不能传变。所以治疗肝实证，先充实脾土，以杜绝蔓延滋生的祸患；治疗肝虚证，直接补益本脏，以防外邪侵犯。这是张仲景虚实并举的要旨。后世人不考察肝病需要“缓其中”的道理，错误地执着于“甘味先入脾”的说法，于是省略了酸味和焦苦味，只在甘味上曲折穷究其说，认为这就是“治肝补脾”的奥妙。古人说：“言辞可以显露出人的蔽塞之处”，说的正是这种情况。
人禀受五常之气，依靠风气和气候而生长。风气虽然能滋生万物，也能危害万物，就像水能浮起船，也能倾覆船一样。如果五脏的真气通畅，人就会平安和谐。客气邪风，一旦侵入人体，人往往会死亡。千般灾难性的疾病，不超过三条原因：一是经络受到邪气侵入脏腑，这是由内部因素引起的；二是四肢和九窍，血脉相传，壅塞不通，这是由外部皮肤受到的侵害；三是房事过度、金属利器创伤、虫兽咬伤等造成的伤害。详细分析这些，疾病的来源就完全清楚了。如果人能谨慎调养，不让邪风干扰经络，刚侵入经络，还未流传到脏腑，就及时医治；四肢刚觉得沉重滞涩，就采用导引、吐纳、针灸、膏摩等方法，不要让九窍闭塞。此外，还要不触犯王法，避免禽兽灾祸，房事不要过度导致精气枯竭，饮食调节冷热五味（苦、酸、辛、甘），不让形体衰弱，疾病就没有机会侵入腠理。腠理，是三焦通会元真之气（元气）的地方；纹理，是皮肤和脏腑的结构纹理。
人禀受阴阳五行的常态，而其生长变化，确实是由风与气决定的。如果不是八风，就无法动荡而协和；如果不是六气，就无法变易而长养。然而有正气就有客气，有和风就有邪风，它们生物和害物，都出于同一个机制，就像浮舟和覆舟，总归是水的作用。所以得其和谐就是正气，失去和谐就是客气；得其正就是和风，失去正就是邪风。它们生物的力量大，那么害物的力量也大。所以邪气中人往往致死。然而风有轻重，病有浅深，概括来说，不超过三条：一是邪气从经络进入脏腑而深入，称为内因；二是邪气在四肢、九窍、皮肤，沿着血脉流窜而浅表，称为外因；三是疾病从触犯王法、房室过度、金属利器、虫兽咬伤而产生，称为不内外因。这就是疾病的由来。人在这里要谨慎调养，不让邪风异气干扰经络，就不会生病。如果邪气刚侵入经络，还没进入脏腑，可以通过汗法、吐法或和解法治愈，这就是“及时医治”。这对应前面的内因一段。如果风气外侵四肢，即将波及九窍，就用吐纳导引来运行其气，用针灸膏摩来驱逐邪气，那么重滞就会通畅，闭塞也就无从发生。这对应前面的外因一段。此外，如果不触犯王法和禽兽，形体就不会受伤；即使有房事也不让它过度枯竭，精神就不会败坏。这对应前面的房室一段。所谓腠理，是说凡是疾病纠缠于身体，不仅限于经络血脉，势必充溢于腠理，所以必须谨慎防止其侵入。腠，是三焦与骨节相贯通的地方，这是神气往来的地方，所以说“元真通会”。理，是结合皮肤和脏腑，内外都有纹理，细密而不紊乱，所以说“文理”。张仲景这段论述，以风气中人为主，所以把从经络进入脏腑的，视为深、为内；从皮肤流入血脉的，视为浅、为外。至于房室、金刃、虫兽所伤，则不属于客气邪风中人的范畴，与经络脏腑没有相互干涉的关系，所以称为不内外因。（节选自徐氏注解）
按语：陈无择在《三因方》中，以六淫邪气接触为外因，五脏情志感受为内因，饮食、房室、跌扑、金刃所伤为不内外因。大概张仲景的论述，以客气邪风为主，所以不从内伤、外感分为内外，而是以经络、脏腑分为内外，就像徐氏所说的那样。陈无择结合天人、表里立论，所以把病从外来者称为外因，从内生者称为内因，那些不是从邪气、情志产生的，称为不内外因，这也最为清晰明了。虽然与张仲景的学说并行流传也是可以的。
问：病人面部出现气色变化，我想听听其中的道理。
老师说：鼻头颜色发青，腹中疼痛，如果伴有畏冷症状的，预后不良（主死）。鼻头颜色微黑的，有水气病。面色黄的，胸上有寒饮。面色白的，是失血。如果微微发红且不在夏季（非其时）出现的，预后不良（主死）。眼睛直视不能转动且固定的，是痉病，难以治愈。另外，青色主痛，黑色主劳损，红色主风邪，黄色主大便困难，面色鲜明润泽的，体内有留饮。
这是通过观察气色来辨别疾病，也就是所谓“望而知之”的方法。鼻头是脾的外候部位，青色是肝的颜色。腹中疼痛，说明脾土受到肝木的克制。如果伴有畏冷，说明阳气亡失，寒水助长邪气，所以主死。肾脏主水，黑色是水液的颜色。脾土虚弱而肾气胜之，所以产生水气。面色黄，是指面黄，病在脾脏。脾病则生饮，所以胸上有寒饮（寒指寒饮）。面色白，是指面白。失血的人面色不华，所以发白。血亡则阳气不可再外越，如果微微发红且不是在火旺之时，无疑是虚阳上浮，所以主死。眼睛直视固定，说明阴气绝竭。痉病是风强之病，阴绝阳强，所以难以治愈。疼痛则血液凝涩而不流动，所以面色青。劳损则伤肾，所以面色黑。医经说：“肾虚的人面色像漆柴一样黑。”风为阳邪，所以面色赤。脾病则运化失职，所以大便困难。面色鲜明润泽的，是有留饮。医经说：“水病患者眼下像卧蚕，面目鲜明光泽。”
老师说：病人说话声音寂静，喜欢突然惊呼的，是骨节间有病。说话声音低沉不清晰的，是心膈间有病。说话声音细小而长的，是头部有病。
说话声音寂静，喜欢突然惊呼的，病在肝肾，是因为筋髓寒冷而疼痛不时发作。声音低沉不清晰的，病在心肺，因为气道阻塞而声音不彰扬。声音细小而长的，疼痛在头部，因为不敢大声说话，而胸膈气道自如，所以虽然声音细小但仍然显得长。这是通过听声音来辨别疾病，也就是所谓“闻而知之”的方法。但这还不够完备，学者们可以举一反三。
老师说：呼吸时耸肩的，心中坚满。呼吸时牵引胸中气逆上冲的，是咳嗽。呼吸时张口短气的，是肺痿伴吐涎沫。
心中坚满，是因为气实而出入受阻，所以呼吸时耸肩。咳嗽是因为气逆而肺失肃降，所以呼吸牵引胸中气逆上冲。肺痿吐沫，是因为气伤而布息困难，所以张口短气。这是因病而损害了气机。
老师说：吸气轻微急促的，病在中焦，属于实证。用泻下法就可以痊愈。如果是虚证，则难以治愈。病在上焦的，吸气短促；病在下焦的，吸气深长。这些都难以治愈。呼吸时全身振颤动摇的，难以治愈。
“息”兼指呼吸而言，“吸”专指吸入气息。中焦实证，吸入的气息不能下行，所以吸气轻微急促。“数”通“促”。用泻下法，实邪去，气机通，病就好了。如果不是实证而是虚证，那就是无根失守之气，很快就会消散，所以说难以治愈。有人说，中焦实证而元气虚的人，既不能承受攻下，又不能自我调和，所以难以治愈，这也是通的。病实在上焦的，气不得入而立即返回，所以吸气短促。“促”即短的意思。病实在下焦的，气欲归而不能迅速到达，所以吸气深长。“远”即长的意思。上下两处的病，都关乎脏气，不像中焦之实，可以从下面去除，所以说难以治愈。呼吸时全身振颤动摇，是气盛而形衰，不能安居，所以也难以治愈。
老师说：寸口脉跳动，是因为随着当令季节的气旺而动。例如肝旺时面色青，四季各自随其对应的颜色。如果肝旺时面色本该青却反白，或者不在肝旺的季节却出现了相应的色脉，都是病的表现。当令之时，时令到了气就旺盛，脉象随之而动，面色也随之相应。如肝旺于春季，脉弦而色青，这是正常的。推及四季，无不如此。如果面色本该青却反白，是不合时令而有此色，不仅是肝病，肺也会生病，这是因为侵犯了当令的旺气。所以说，色脉都不正常，即为病。
问：有未到时节而气候先到的，有时令到了而气候没到的，有时令到了而气候不去的，有时令到了而气候太过的，这是什么意思？
老师说：冬至之后，甲子日的夜半，少阳之气始生。少阳之时，阳气开始生发，天气变得温和。如果在还没有到甲子日时，天气就已经温和，这叫“未至而至”（未到时节而气候先到）。如果已经到了甲子日，天气却没有变得温和，这叫“至而不至”（时令到了而气候没到）。如果已经到了甲子日，天气依然大寒不解，这叫“至而不去”（时令到了而气候不去）。如果已经到了甲子日，天气却像盛夏五六月份那样热，这叫“至而太过”（时令到了而气候太过）。上面的“至”指时令到了，下面的“至”指气候（气）到了。大概时令有固定的常数而不改变，气候没有固定的时刻而可能会迁移。冬至之后的甲子日，是指冬至后六十天。大概古代制定历法的人，以十一月甲子朔日夜半冬至作为历法的起点。根据这个推算，冬至后六十天，应当再次遇到甲子日。但由于气盈朔虚，每年依次迁移，所以至日不一定都值甲子日。应当以冬至后六十天花甲一周，正当雨水节气的时候为正。雨水，是冰雪解散化为雨水，天气温和的开始。说“少阳起”，是指阳气刚刚升起而出地；“阳始生”，是指阳气开始盛大而生养万物，并不是指冬至时初生的一阳。我曾讨论过这个问题：夏至一阴生，然后有小暑、大暑；冬至一阳生，然后有小寒、大寒。这并不是阴生反而热，阳生反而寒。天地之道，否极泰来，阴阳之气，剥尽则复。夏至时地上六阴尽，然后一阴生于地下，这是阴生之时，正是阳极之时。冬至时地上六阳尽，然后一阳生于地下，这是阳生之时，正是阴极之时。阳极则大热，阴极则大寒，这是自然的道理。那么所谓“阳始生，天得温和”，显然不能与冬至时的阳生混为一谈，这是很清楚的。如果在没有到甲子日时天气已温，或者已经到甲子日而天气反而未温，以及已到甲子日而天气大寒不解，或者像盛夏五六月份那样热，那么气候有过剩也有有不足，节候有先后，而处于气交之中的人，往往因此生病，只有圣人能够与时消长而没有抵触。
老师说：病人脉象浮，关前（寸部）浮，病在表；关后（尺部）浮，病在里，伴有腰痛、背强、不能行走，必定短气且极度疲乏。
“前”指关前，“后”指关后。关前为阳，关后为阴。关前脉浮，是因为阳脉居于阳位，所以病在表。关后脉浮，是因为阳脉居于阴位，所以病在里。然而虽然病在里，但因为是阳脉，所以是“表之里”，而不是“里之里”。所以病不在肠肾，而在腰背膝胫，等到病情严重时，必定短气且极度疲乏。之所以这样，是因为形体损伤不去除，穷极必累及气机；表病不解除，久必传入里。
问：医经说“厥阳独行”，是什么意思？
老师说：这是因为有阳无阴，所以称为厥阳。
厥阳独行，是指孤阳之气，厥逆而上行。阳气失去阴液的依附就会外越，就像没有妻子就会放荡一样。《千金方》说：“阴脉松弛，血液散乱不通，正阳遂厥，阴不往从。”这就是厥阳独行的旨意吧。
问：寸脉沉大而滑，沉代表实，滑代表气，实与气相互搏结，血气入脏即死，入腑即愈。这是卒厥，是什么意思？
老师说：嘴唇青紫，身体冰冷，是血气入脏，即死。如果身体温和，汗自出，是血气入腑，即愈。
“实”指血实，“气”指气实。实气相搏，是指血与气并聚而俱实。五脏藏而不泻，血气进入，突然不能返还，神气离去，机器停息，就会唇青身冷而死。六腑传而不藏，血气进入，乍满乍泻，气还血行，就会身和汗出而愈。医经说：“血与气，并走于上，则为大厥。厥则暴死，气复返则生，不返则死。”就是这个意思。
问：脉脱入脏即死，入腑即愈，是什么意思？
老师说：这不是针对某一种病，百种病都是这样的。譬如浸淫疮，从口部开始流向四肢的可以治愈，从四肢流回入口部的不可治愈。病在外部的可治愈，病入内部的即死。
“脉脱”，是指邪气突然加临，正气被遏制，经络隧道不通，脉象断绝似脱，并非真的脱失。这大概就是暴厥之类。医经说：“趺阳脉不出，脾不上下，身冷肤硬。”又说：“少阴脉不至，肾气微，少精血，为尸厥。”这就是所说的脉脱。厥病入脏的，病位深而难出，气竭不复则死；入腑的，病位浅而易通，气行脉出即愈。浸淫疮，是疮疡浸淫不已，《外台秘要》所说的转广有汁，流绕周身的那种。从口流向四肢，是病自内而之外，所以可治；从四肢流回入口，是病自外而之里，所以不可治。李玮西说：“病在外二句”，概指各种疾病而言，即上文“百病皆然”的意思。入里者死，如痹气入腹，脚气冲心之类。
问：阳病有十八种，是什么？
老师说：头痛、项强、腰痛、脊强、臂痛、脚掣痛。
阴病有十八种，是什么？
老师说：咳、上气、喘、哕、咽塞、肠鸣、胀满、心痛、拘急。
五脏病各有十八种，合为九十病。人又有六微，微病各有十八种，合为一百零八病。五劳、七伤、六极，妇人三十六病，不在此列。清邪居上，浊邪居下，大邪中表，小邪中里，谷食之邪，从口入者，是宿食。五邪中人，各有规律：风邪中于前方（午前），寒邪中于暮夜，湿邪伤于下部，雾邪伤于上部。风令脉浮，寒令脉急，雾伤皮腠，湿流关节，食伤脾胃，极寒伤经，极热伤络。
头、项、腰、脊、臂、脚，这六种病兼涉上下，而通称为阳病，是因为它们在躯壳之外。咳、上气、喘、哕、咽塞、肠鸣、胀满、心痛、拘急，这九种病兼涉脏腑，而通称为阴病，是因为它们在躯壳之内。在外的，有营病、卫病、营卫交病的区别，是一种病而有三种情况。三乘以六，合为十八，所以叫阳病十八。在里的，有虚或实的差异，是一种病而有两种情况。九乘以二，合为十八，所以叫阴病十八。五脏病各有十八，六微病又各有十八，这都是六淫邪气所产生的。大概邪气中人，有风、寒、暑、湿、燥、火六种，而脏腑受邪，又各有气分、血分、气血并受三种情况。六乘以三，则为十八病。以十八之数推算，五脏合得九十病，六微合得一百零八病。至于五劳七伤六极，则是起居、饮食、情志所生成的。妇人三十六病，则是经、月、产、乳、带下之疾。均非六气外淫所致，所以说不在其中。清邪，指风露之邪，所以居于上；浊邪，指水土之邪，所以居于下。大邪，指漫风，虽然气势大但力量分散，所以中于表；小邪，指户牖隙风，虽然气势小但气性锐利，所以中于里。谷食，指饮食之类，入于口而伤于胃。所以邪气有清浊、大小的区别，人……
Question: Why does a skilled physician treat disease before it arises?
The Master replied: To treat disease before it arises means that when one sees liver disease, one knows that the liver transmits to the spleen, and thus should first strengthen the spleen. If the spleen is prosperous in any of the four seasons and not susceptible to pathogenic factors, then no supplementation is needed. An average physician, unaware of this transmission, seeing liver disease, fails to strengthen the spleen and merely treats the liver. In treating liver disease, sour flavors are used for tonification, scorched bitter flavors for assistance, and sweet flavors for harmonization. Sour enters the liver, scorched bitter enters the heart, and sweet enters the spleen. A strong spleen can restrain the kidney; if kidney qi is weak, water metabolism is controlled. If water metabolism is controlled, heart fire does not become excessive. If heart fire is not excessive, it does not injure the lung. If the lung is not injured, metal qi (lung qi) functions normally. Normal metal qi restrains wood, preventing liver qi from becoming excessive, thus allowing the liver disease to heal. This is the subtlety of "treating the liver by supplementing the spleen." This method applies to liver deficiency; it is not used for liver excess. The Classics state: "Do not make deficiency more deficient or excess more excess"; tonify what is insufficient and reduce what is excessive. This is the principle. The same applies to other organs.
Note: The *Suwen* states that when pathogenic factors invade the body, they act according to the cycle of overcoming (Wu Xing). The liver corresponds to Wood and overcomes Spleen Earth; thus, liver disease should transmit to the spleen. "Strengthening the spleen" means assisting the spleen's qi to prosper so it is not susceptible to pathogens, which is the essence of "treating disease before it arises." If one ignores this and only treats the liver, the liver disease may not resolve, and spleen disease may arise. Is this the conduct of a skilled physician? Using sour flavors to tonify the liver is because liver insufficiency is supplemented with its native flavor. This differs from the *Neijing* statement that pungent flavors tonify the liver. However, the liver is a Yin organ containing Sheng Qi (vital generating energy); using pungent flavors assists its function (Yong), while using sour flavors nourishes its substance (Ti). Although the statements differ, both principles are appropriate. Assisting with scorched bitter flavors aligns with the *Qianjin Fang*, which states that when Heart Qi prospers, it influences the Liver. Supplementing with sweet flavors to harmonize aligns with the *Nanjing*, which says that to damage the liver, one must soothe its center (Huan Qi Zhong). The fifteen sentences starting from "Sour enters the liver" are suspected not to be Zhang Zhongjing's original text but rather erroneous annotations added by later authors and mistakenly included by compilers. Zhang Zhongjing's key point in "treating the liver by supplementing the spleen" lies in making the spleen solid so it does not receive liver pathogens, not in harming the kidney via spleen tonification or allowing heart fire to punish the lung. If that were the case, the benefit would be small and the harm great. Moreover, if the spleen is tonified, the lung will naturally prosper; if the kidney is injured, it will weaken and affect its child organ (Liver). Where is the logic of restraining metal to strengthen wood? Carefully analyzing the meaning, the nine sentences from "Seeing liver disease..." answer the question on "skilled physicians treating disease before it arises," while the three sentences "Tonify with sour..." present the standard treatment for liver deficiency. As stated later, "Use this method for liver deficiency, not for excess," this is clear. Generally, Zang diseases accept tonification only when deficient, not when excess; Zang pathogens transmit only when excess, not when deficient. Therefore, in treating liver excess, one first strengthens Spleen Earth to prevent spread; in treating liver deficiency, one directly tonifies the Liver Zang to prevent external invasion. This is Zhang Zhongjing's essential principle of addressing both deficiency and excess. Later scholars, failing to understand the principle of soothing the liver's center, erroneously clung to the saying that "sweet enters the spleen first," omitting sour and scorched bitter, and excessively interpreting the use of sweet flavors as the essence of "treating the liver by supplementing the spleen." As the ancients said, "Words reveal one's obscurations," which applies here.
Humans inherit the Five Constants and grow due to Wind and Qi. While Wind and Qi can generate all things, they can also harm them, just as water can float a boat or capsize it. If the Yuan Zhen (Original True Qi) of the Five Zang Organs flows smoothly, the person remains peaceful and harmonious. If Ke Qi (Guest Pathogens) and Xie Feng (Evil Winds) invade, death often follows. The myriad calamitous diseases do not exceed three categories: 1. Pathogens entering the meridians and transmitting to the Zang Organs, constituting an internal cause. 2. Pathogens affecting the limbs and nine orifices, spreading through blood vessels causing blockage, constituting an external skin invasion. 3. Injuries from sexual indiscretion, metal/blades, insects, or beasts. Analyzing these comprehensively, the origins of disease are exhausted. If one cultivates caution, preventing evil winds from violating the meridians, and treats them immediately upon meridian invasion but before reaching the Zang Organs; if one uses Daoyin (guiding and pulling), Tunai (breathing exercises), acupuncture, moxibustion, and massage at the first sign of limb heaviness, preventing the closure of the nine orifices; if one avoids legal punishments, animal disasters, and sexual exhaustion; and regulates diet regarding temperature and the five flavors (bitter, sour, pungent, sweet) without letting the physical form decline, then pathogens cannot enter the Cou Li (interstices). Cou Li are the places where the San Jiao (Triple Burner) meets and circulates Yuan Zhen. Li refers to the structural patterns of the skin and Zang Organs.
Humans inherit the norms of Yin-Yang and the Five Elements, and their growth depends on Wind and Qi. Without the Eight Winds, there is no movement and harmony; without the Six Qi, there is no transformation and nourishment. However, where there is Zheng Qi (Upright Qi), there is Ke Qi (Guest Qi); where there is He Feng (Harmonious Wind), there is Xie Feng (Evil Wind). Their ability to generate or harm stems from the same mechanism, like water floating or capsizing boats. When in harmony, it is Zheng Qi; out of harmony, it is Ke Qi. When correct, it is He Feng; incorrect, it is Xie Feng. The greater their power to generate, the greater their power to harm. Thus, invasion by pathogens often leads to death. Wind varies in severity, and disease in depth. Summarizing, there are three causes: 1. Pathogens entering deeply from meridians to Zang Organs (Internal Cause). 2. Pathogens remaining shallowly in limbs, orifices, skin, and blood vessels (External Cause). 3. Diseases arising from legal troubles, sexual excess, metal/blades, or insect/beast bites (Neither Internal nor External Cause). One must cultivate caution here, preventing evil winds from violating the meridians. If pathogens enter meridians but not Zang Organs, they can be cured by sweating, vomiting, or harmonizing methods. This corresponds to the internal cause section mentioned earlier. If wind invades the limbs and approaches the orifices, use breathing exercises to move Qi and acupuncture/massage to expel pathogens, clearing heaviness and preventing closure. This corresponds to the external cause section. Avoiding legal/animal dangers preserves the body; avoiding sexual excess preserves spirit. This corresponds to the sexual excess section. "Cou Li" implies that diseases entangling the body extend beyond meridians and vessels into the interstices, so one must guard against their entry. "Cou" is where the San Jiao connects with bone joints, the place of Shen Qi (Spirit Qi) circulation, hence "Yuan Zhen Hui Tong." "Li" refers to the intricate structures of skin and Zang Organs, hence "Wen Li." Zhang Zhongjing's discussion focuses on wind invading humans; thus, entry from meridians to Zang is deep/internal, while flow from skin to vessels is shallow/external. Injuries from sex, blades, or beasts are distinct from guest pathogens and have no direct interference with meridians/Zang, hence "Neither Internal nor External." (Excerpt from Xu's commentary)
Note: Chen Wuyue in *San Yin Fang* classifies Six Excesses as External Causes, Five Zang Emotions as Internal Causes, and diet/sex/falls/blades as Neither Internal nor External. Zhang Zhongjing's theory focuses on guest pathogens, distinguishing internal/external based on meridians/Zang, as Xu noted. Chen Wuyue distinguishes based on origin (outside vs. inside), which is also clear and can coexist with Zhang's theory.
Question: Patients show facial complexion changes. I wish to hear the explanation.
The Master said: A blue color on the nose tip indicates abdominal pain; if accompanied by cold intolerance, it indicates death. A slightly black nose tip indicates Water Qi (fluid retention). A yellow color indicates Cold in the Chest. A white color indicates Blood Loss. If slightly red and not during the summer season, it indicates death. Fixed, staring eyes indicate Spasm (Jing), which is incurable. Additionally, blue indicates Pain, black indicates Consumption (Lao), red indicates Wind, yellow indicates difficult defecation, and a bright/shiny complexion indicates Retained Fluid (Liu Yin).
This differentiation of Qi and Color is known as "Diagnosis by Observation." The nose tip is the area of the Spleen; blue is the color of the Liver. Abdominal pain indicates Earth being attacked by Wood. Cold indicates Yang depletion and Cold Water aiding the pathogen, hence death. The Kidney governs Water; black is the color of Water. If Spleen Earth is weak and Kidney Water dominates, Water Qi arises. Yellow face indicates Spleen disease; Spleen disease generates Phlegm-Fluid, leading to Cold-Fluid in the chest. White face indicates Blood Loss; loss of blood results in lack of luster. If slightly red outside the fire season, it is Deficient Yang floating upward, hence death. Fixed eyes indicate Yin exhaustion. Spasm is a Wind-Excess disease; Yin exhaustion and Yang excess make it incurable. Pain causes blood stasis, hence blue. Consumption damages the Kidney, hence black. The Classics say: "Kidney deficiency makes the face look like lacquered charcoal." Wind is a Yang pathogen, hence red. Spleen dysfunction causes difficult defecation. Bright/shiny complexion indicates Retained Fluid. The Classics say: "Water patients have puffiness under the eyes and a shiny face."
The Master said: A patient whose voice is quiet but who suddenly cries out in fear has disease in the joints. A patient whose voice is hoarse and indistinct has disease in the Heart and Diaphragm. A patient whose voice is fine and long has disease in the Head.
Quiet voice with sudden cries indicates Kidney/Liver disease, caused by cold in sinews/marrow triggering intermittent pain. Hoarse voice indicates Heart/Lung disease, where airways are blocked. Fine, long voice indicates head pain; the patient dares not raise their voice, but the chest/diaphragm airway is free, so the voice sounds long despite being fine. This is "Diagnosis by Listening." It is incomplete; students should infer the rest.
The Master said: Breathing with shoulder shrugging indicates fullness in the Heart. Breathing drawing Qi upward from the chest indicates Cough. Breathing with open mouth and shortness of breath indicates Lung萎 (Fei Wei) with frothy saliva.
Fullness in the Heart obstructs Qi entry/exit, causing shoulder shrugging during respiration. Cough involves rebellious Qi and Lung failure to descend. Lung Wei involves Qi injury and difficult respiration, causing open-mouthed shortness. This is disease damaging Qi.
The Master said: Slight rapidity in inhalation indicates Excess in the Middle Jiao; purgation cures it. Deficiency is incurable. Inhalation is rapid (Cu) in Upper Jiao disease; inhalation is distant/long (Yuan) in Lower Jiao disease. Both are difficult to treat. Trembling during respiration is incurable.
"Inhalation" refers specifically to incoming Qi. Middle Jiao Excess blocks downward movement, causing slight rapidity. Purgation removes excess and restores flow. If deficiency, the rootless Qi dissipates, hence incurable. Some say Middle Jiao Excess with Yuan Qi Deficiency cannot tolerate purgation nor self-regulate, hence incurable. Upper Jiao Excess prevents Qi entry, causing rapid inhalation. Lower Jiao Excess delays Qi return, causing long inhalation. These involve Zang Qi and are harder to treat than Middle Jiao Excess. Trembling indicates Excess Qi and Deficient Form, unable to sustain itself, hence incurable.
The Master said: Cun Kou pulse movements follow the prosperous season. For example, Liver prosperity brings Blue color. Each season has its corresponding color. If Liver prosperity (Spring) shows White instead of Blue, or colors/pulses appear out of season, disease is present. When the season arrives, Qi prospers, pulse moves, and color responds. Spring Liver: String-like pulse, Blue color—this is normal. If Blue should be present but White appears, it violates the ruling Qi. Thus, both Liver and Lung are diseased. Hence, "Color and Pulse both indicate disease."
Question: What are "Arriving before time," "Arriving late," "Not departing," and "Excessive arrival"?
The Master said: After Winter Solstice, on the Jia-Zi day at midnight, Shao Yang Qi begins. Shao Yang marks the beginning of Yang generation and mild weather. If weather is mild before Jia-Zi, it is "Arriving before time." If weather is not mild after Jia-Zi, it is "Arriving late." If severe cold persists after Jia-Zi, it is "Not departing." If weather is hot like midsummer after Jia-Zi, it is "Excessive arrival." "Arriving" refers to seasonal timing; "Qi arriving" refers to climatic change. Seasons are fixed; climate shifts. Ancient calendars set Winter Solstice on a Jia-Zi day. Sixty days later is another Jia-Zi, coinciding with Rain Water (Yu Shui), when ice melts and warmth begins. "Shao Yang rises" means Yang emerges from the earth. This is not the initial Yang at Winter Solstice. I argue: Summer Solstice generates Yin, followed by Heat; Winter Solstice generates Yang, followed by Cold. Yin/Yang generation follows extreme depletion. Summer Solstice: Yin generates underground when Yang peaks above. Winter Solstice: Yang generates underground when Yin peaks above. Extreme Yang brings heat; extreme Yin brings cold. Thus, "Yang generating brings warmth" differs from Winter Solstice Yang generation. Deviations in climate cause disease; only sages adapt perfectly.
The Master said: Floating pulse at Cun (Front) indicates Exterior disease. Floating pulse at Chi (Back) indicates Interior disease, accompanied by lower back pain, stiffness, inability to walk, shortness of breath, and exhaustion.
Cun is Front (Yang); Chi is Back (Yin). Floating at Cun (Yang in Yang position) indicates Exterior. Floating at Chi (Yang in Yin position) indicates Interior. However, since it is a Yang pulse in the Interior, it is "Exterior within Interior," not true Interior disease (Intestines/Kidneys). Thus, pathology affects waist/back/knees/calves. Eventually, it causes shortness of breath and exhaustion because chronic physical injury affects Qi, and lingering Exterior disease penetrates Interior.
Question: What is "Jue Yang moving alone"?
The Master said: This is Yang without Yin, called Jue Yang.
Jue Yang moving alone is solitary Yang Qi reversing upward. Yang without Yin wanders, like a man without a wife. *Qianjin Fang* states: "Yin pulses relax, blood scatters, True Yang reverses, Yin does not follow." This is the essence of Jue Yang.
Question: Cun pulse is Deep, Large, and Slippery. Deep indicates Excess (Blood); Slippery indicates Qi. Excess and Qi struggle. If Blood/Qi enters Zang, death; if enters Fu, recovery. This is Cu Jue (Sudden Syncope). Explain.
The Master said: Blue lips and cold body indicate entry into Zang (Death). Warm body and spontaneous sweat indicate entry into Fu (Recovery).
"Excess" is Blood Excess; "Qi" is Qi Excess. Struggle means Blood and Qi congregate. Zang store and do not drain; if invaded, Spirit leaves, Machine stops, leading to death. Fu transmit and do not store; if invaded, Qi returns, Blood flows, leading to recovery. The Classics say: "Blood and Qi rushing upward causes Great Jue... if Qi returns, life; if not, death."
Question: Pulse Tuō (Loss/Vanishing) entering Zang means death; entering Fu means recovery. Why?
The Master said: This applies to all diseases. Like Eczema (Jin Yin Chuang): flowing from mouth to limbs is curable (Inside to Outside); flowing from limbs to mouth is incurable (Outside to Inside). Disease outside is curable; entering Inside is fatal.
"Pulse Tuō" means pathogens suddenly oppress Zheng Qi, blocking meridians, making pulse seem absent. It is akin to暴厥 (Bao Jue). If Jue enters Zang (deep), Qi exhausts and dies. If enters Fu (shallow), Qi moves and recovers. Eczema flowing outward is Inside-to-Outside (curable); flowing inward is Outside-to-Inside (incurable). "Disease outside... entering inside" applies generally. Examples include Bi Qi entering abdomen or Gout attacking the Heart.
Question: What are the 18 Yang Diseases?
The Master said: Headache, Neck stiffness, Low back pain, Spine stiffness, Arm pain, Leg cramping pain.
What are the 18 Yin Diseases?
The Master said: Cough, Rebellious Qi, Wheezing, Hiccups, Throat obstruction, Bowel sounds, Distension, Heart pain, Cramping/Tension.
Each of the Five Zang has 18 diseases, totaling 90. Humans also have Six Minor (Wei) conditions, each with 18 diseases, totaling 108. Five Labors, Seven Injuries, Six Extremes, and Women's 36 Diseases are excluded. Clear Pathogens reside above, Turbid below. Major Pathogens strike the Exterior, Minor Pathogens strike the Interior. Grain/Food pathogens enter via the mouth (Retention of Food). The Five Pathogens attack humans with specific patterns: Wind strikes the front (morning), Cold strikes at dusk, Dampness injures the lower body, Fog injures the upper body. Wind makes pulse Floating, Cold makes pulse Tight. Fog injures skin/Cou Li, Dampness flows to joints. Food injures Spleen/Stomach. Extreme Cold injures Meridians, Extreme Heat injures Collaterals.
Head, neck, back, spine, arms, legs are external (Yang). Cough, etc., are internal (Yin). External diseases vary by Ying/Wei involvement (3 types x 6 locations = 18). Internal diseases vary by Deficiency/Excess (2 types x 9 symptoms = 18). Zang diseases (18 each) and Wei diseases (18 each) stem from Six Excesses (Wind, Cold, Summer-Heat, Damp, Dryness, Fire) affecting Qi/Blood combinations (3 types x 6 pathogens = 18). Total: 5 Zang x 18 = 90; 6 Wei x 18 = 108. Five Labors/Seven Injuries arise from lifestyle/emotions. Women's 36 Diseases relate to menstruation/birth/leukorrhea. These are not caused by external Six Qi, hence excluded. Clear Pathogens (Wind/Dew) are above; Turbid (Water/Earth) are below. Major Pathogens (General Wind) are diffuse, striking Exterior. Minor Pathogens (Gap Wind) are sharp, striking Interior. Grain/Food enters mouth and injures Stomach. Thus, pathogens vary in clarity/turbidity and size...