内。乌得云出络也。此其支脉之行。即从入肺处。出络心包。注于膻中。正当心胸之间。以交于手厥阴经也。）
\r足少阴经脉之图\pt68a5.bmp\r
（琥）按足少阴之脉。上下左右分行。共六道其脉之起。自足小指之下云云。别入足跟云云。上股内后廉。贯脊。
还前而出于横骨穴。上至肓俞。内入而属肾。还下脐。而络膀胱者。二道。此为正经乃脉之本也。然其行多浅深屈曲之
处。活人书以入跟中者。为另一支别之脉。亦以其屈曲故也。其直者。由属肾处。接正经而上贯肝膈。云云。终于舌本
者。又二道。此亦正经之脉也。其支者。从肺出络心。注胸中者。又二道。此其内行之小支脉也。前热论中云。口燥舌
干而渴。此亦仅言其病之略耳。又按少阴之脉。上挟舌本而终。内经云。口燥者。此因舌本病热而干极。故并口亦燥也。
肝足厥阴之脉。起于大指丛毛之际。上循足跗上廉。去内踝一寸。上踝八寸。交出太阴之后。上 内廉。循股阴。
入毛中。过阴器。抵小腹。挟胃。属肝。络胆。上贯膈。布胁肋。循喉咙之后。上入颃颡。连目系。上出额。与督脉会
于巅。（愚按上贯膈以下文。当是另一大支之脉。盖足之三阴。从足上走入腹。其与督脉会于巅者。此借诸阳经之气。其
支脉始得上升于巅也。故属肝络胆句下。当增其支者三字。又丛字。当作聚。肋字。当作腋。聚毛。足大指后横纹处。
阴器。即前阴也。男女通称为器。脐下为小腹。目内深处为系。颃颡。咽颡也。此言足厥阴之脉。起于足大指后横纹处。
上循跗。抵本经之中封穴。以其穴远内踝前一寸。故云去也。上踝。过足太阴经三阴交穴。至中都。本经穴名。在内踝
上七寸 骨中。复上一寸。故云八寸。交出太阴之后。上循 与股内。入阴毛中。左右相交。环绕阴器。至小腹而上。
会任脉之中极。关元诸穴。复外而上循季肋端之章门穴。复上而至期门之所。俱本经穴名直两乳下。内行而挟胃属肝。
还下而络于胆也。其支者。复自期门穴而上贯膈。横布胁复上腋。此借足少阳之气也。复上循喉咙之后。此借手足阳明。
又手太阳与督脉之气也。复上入颃颡。此又借足阳明。手太阳之气也。上行于头。循足阳明之里。即借阳明之气。内行
连目。脉深处复上出额。行足少阳之里。又借少阳之气。上交于巅。与督脉相会于项中之百会穴而终也。百会。督脉穴
名。足太阳脉亦会于此。此可见厥阴支脉之行。必借诸阳经之气。始得上升于头者如此。）其支者从目系。下颊里环唇内。
（此言其一小支脉。即从目系处下行。循颊之里而下。左右交环于口唇之内也。）其支者。复从肝别贯膈。上注肺。（此
言交经之支。从期门属肝处。别上贯膈。注肺中。还下行。至中焦之分。以交于手太阴经也。）
\r足厥阴经脉之图\pt68a6.bmp\r
（琥）按足厥阴之脉。上下左右分行。共八道。其脉之起。自足大指聚毛之上云云。过阴器。至小腹循章门穴。复
上至期门穴之里。上而挟胃。下而属肝络胆者。二道。此为正经。乃脉之本也。其支者。自期门穴之里。上贯膈云云。
复上而内连目系。上出额。与督脉会于巅者。二道。此其支脉之大者也。（上二道支脉。诸家混注入正经之中。予特分出。
其说见前。）又其支之逆行者。从目系处。下颊里环唇内者。二道。此其支脉之小者也。又其支之交经者。从期门属肝之
处。
别贯膈。上注于肺者。二道。此由正经发出之支脉。从肺而交于手太阴经者也。前热论中云。烦满而囊缩。此亦仅
言其病之略耳。又按热论云。烦满而囊缩。仲景伤寒论皆宗之。考活人书别引经义云。肝者筋之合也。筋者。聚于阴器。
而脉络于舌本。脉弗营。则筋急。筋急。则引舌与卵。故唇青舌卷而卵缩。愚以病热之人。其唇色不至于青。所以世俗
之医。相传诊视热病法。但言舌卷卵缩。或云舌卷囊缩。为病热深极之候也。
（琥）总按上内经热病论中。辩伤寒。止分足六经证。汉张仲景推展内经热病原文。而着伤寒论云。从霜降以后。
至春分以前。凡有触冒霜露。体中寒。即病者。谓之伤寒。此是正伤寒病。寒气所伤。总不越足之六经。所以自古迄今。
注伤寒者。奚啻数百家。其辩脉证治法。亦但详足经。不及手经也。试以时令言之。霜降之时。湿土。王也。以后。则
寒水用事矣。春分以前。风木。王也。再推其前。则冬季之湿土用事矣。就六经言之。足太阳少阴。皆水也。三冬时实
主之。足少阳厥阴。皆木也。春分时实主之。足阳明太阴。皆土也。霜降与冬季之时。实主之。刘草 有云。水木土三
者。皆不胜寒气所伤。故水遇寒。则涸而冰。木遇寒。则叶落枝枯。土遇寒。则坼而不坚。此所以伤寒之病。在人身止
水木土三脏三腑受邪。其外见证。亦不过足之三阴三阳或以次受邪而为传病。或传不以次而为间病。或先后相传。前病
不去而为并病。或二阳三阳。一同受邪而为合病。或阴阳脏腑。表里受邪而为两感。凡此者。皆正伤寒之为病也。虽然
名为伤寒。而风湿之气亦在其中。要之风湿所伤总于足六经证见之。其他如春分以后。霜降以前。则暑热燥三气俱多。
其间但有非时之寒气着人。今医通谓之伤寒。然其病与冬时之正伤寒大异。其传变亦不但拘拘于足之六经也。有如四月
属巳。在天则暑气用事。在人则手厥阴心包络。手少阳三焦。二经应之。（以四月天气论之。人病无伤寒矣。不知天之六
气。巳与亥相冲。亥本北方水火极。则冲动水气而生寒。所以四月时。人亦不免有伤寒之病也。）五月属午。在天则热气
用事。在人则手少阴心。手太阳小肠。二经应之。（以五月天气本热。人不免有伤寒之病者。午冲子水而生寒也。）六月
属未。在天则湿气用事。湿本地气。土中有水。为热所蒸。在人则脾与胃应之。（夫脾胃系足经。无烦举也。人于六月中。
亦不免有伤寒者。以湿土中本有寒气故也。）七月属申。八月属酉。在天则燥气用事。（天之六气。申酉相对而冲者。寅
卯木也。寅申本相火。主大热之气。木火相煽。故卯亦从酉而成燥。）在人则手太阴肺。手阳明大肠。二经应之。（以七
八月天气论之。人病无伤寒矣。不知燥金之气本凉。凉之中。寒气居多。故人于秋时。亦有伤寒病也。）刘草 又云。手
经所属。皆金与火。金与火不畏寒。故金遇寒则愈坚。又火体极热。寒不能袭。殊不知火正畏水。寒能胜热。又不知夏
秋。非时之暂寒。终不及冬月之严寒。其气与暑热并行。夫暑热同一火气。火又为金之贼。若然。则是春分以后。霜降
以前。其间有非时之伤寒。其热邪所传。有连手经亦受病者。故予前言云。不可但拘拘于足之六经也。明洛阳进士孙应
奎。手集医方类选。自着伤寒论云。凡风寒暑湿热燥。天之六气。自外而中人五脏六腑。十二经络者。四时之中。皆得
谓之伤寒。要是言也。即河间刘守真伤寒直格中所云。手足经络。配天地四时之义。愚以四时之中。六气伤人。各不相
侔。其初。若不由寒气而得者。皆不得谓之伤寒。（谓伤风自是伤风。伤暑自是伤暑是也。）其初若由寒气而得者。皆得
谓之伤寒。（即如夏秋热燥之时。旦晚间偶着。雾露清凉之气是也。）大抵伤寒一病。在四时之中。不分何时。皆以寒为
标。热为本。其人病若标本皆寒者。此系中寒病。非伤寒病也。又正伤寒止传足经。类伤寒。间有传手经者。此非予一
人之私说。在昔贤已引其端。但无分经辩证。确然之论耳。据前热论中云。三阴三阳。五脏六腑。皆受病。夫五脏六腑。
皆受热所困而病极矣。则是三阴三阳经者。岂但言足而不言手邪。前人着书。每多引而不发。专待后人启悟。惜乎今时
之医。未有明言及手六经病者。子因不得已。而起辟其说。非故欲欺世而盗名也。
（手厥阴心包经的脉气）内行。怎么能说是出于络脉呢？这是它的支脉的运行路线，即从入肺的地方出来，联络心包，注入膻中穴，正当心胸之间，以此与手厥阴经相交。（足少阴经脉图 \pt68a5.bmp）
（王履）按：足少阴肾经的脉气，上下左右分行，共有六道。其脉气的起始，自足小趾之下云云，别行进入足跟云云，上行至大腿内侧后缘，贯穿脊柱，返回前方而出于横骨穴，上行至肓俞穴，向内进入并归属于肾，返回下行至脐部，并联络膀胱者，这是两道。此为正经，是脉气的根本。然而其运行多有浅深屈曲之处，《活人书》认为进入足跟中的是另一支别之脉，也是因其屈曲的缘故。其直行者，由归属于肾处接续正经而上行，贯穿肝和膈肌，云云，终于舌根者，又是两道。这也是正经的脉气。其支脉者，从肺出来联络心脏，注入胸中者，又是两道。这是其内行的小支脉。前文《热论》中说：“口燥、舌干而渴”，这也只是简略地言及其病症罢了。又按：少阴经的脉气，上行挟持舌根而终。《内经》说：“口燥”，这是因为舌根患病发热而极度干燥，所以连同口腔也干燥了。
足厥阴肝经的脉气，起始于足大趾丛毛之处，向上沿足背的上缘，距离内踝一寸，上至踝上八寸处，交出足太阴脾经之后，上行至小腿内侧，沿大腿内侧，进入阴毛中，经过生殖器，抵小腹，挟胃两旁，归属于肝，联络胆，上行贯穿膈肌，分布于胁肋，沿喉咙后方，上行进入颃颡（鼻咽部），连接目系（眼球连系脑部的脉络），上行出于额部，与督脉会合于头顶。（我按：从“上贯膈”以下这段文字，应当是另一条大支脉。因为足三阴经都是从足上行走入腹部，那些与督脉会合于头顶的，是借助诸阳经的气，其支脉才得以上升于头顶。所以在“属肝络胆”句下，应当增加“其支者”三个字。另外，“丛”字，应作“聚”。“肋”字，应作“腋”。聚毛，指足大趾后的横纹处。阴器，即前阴。男女通称为器。脐下为小腹。目内深处为系。颃颡，即咽颡。这里说的是足厥阴经的脉气，起始于足大趾后横纹处，向上沿足背，抵达本经的中封穴，因为其穴位距离内踝前一寸，所以说“去也”。上行过踝，经过足太阴经的三阴交穴，至中都穴，这是本经的穴位名，位于内踝上七寸胫骨中。再上一寸，所以说“八寸”。交出足太阴经之后，上行沿小腿与大腿内侧，进入阴毛中，左右相交，环绕生殖器，至小腹而上，会合任脉的中极、关元等穴，再向外而上沿季肋端的章门穴，再上行而至期门穴所在，都是本经的穴位名，直对两乳下方。内行而挟胃，归属于肝，返回下行而联络于胆。其支脉者，又从期门穴而上贯膈，横向布散于胁肋，复上行至腋下，这是借足少阳胆经的气。再上行沿喉咙后方，这是借手足阳明经以及手太阳经和督脉的气。再上行进入颃颡，这又借足阳明、手太阳的气。上行于头，沿足阳明经的里侧，即借阳明经的气。内行连接目系，脉气深处复上行出于额部，行于足少阳经的里侧，又借少阳经的气，上交于头顶，与督脉相会于项中的百会穴而终结。百会，是督脉的穴位名。足太阳经的脉气也会合于此。由此可见，厥阴经支脉的运行，必须借助诸阳经的气，才得以上升于头部，如此。）其支脉者，从目系处，下行至颊里，环绕唇内。（这里说的是其中一小支脉，即从目系处下行，沿颊的里侧而下，左右交环于口唇之内。）其支脉者，又从肝脏别出，贯穿膈肌，上行注入肺中。（这里说的是交接经脉的支脉，从期门穴归属于肝处，别出上行贯穿膈肌，注入肺中，还下行，至中焦之分，以与手太阴肺经相交。）
（足厥阴经脉图 \pt68a6.bmp）
（王履）按：足厥阴肝经的脉气，上下左右分行，共有八道。其脉气的起始，自足大趾聚毛之上云云，经过生殖器，至小腹循行章门穴，再上行至期门穴的里侧，上行而挟胃，下行而归属于肝、联络胆者，这是两道。此为正经，是脉气的根本。其支脉者，自期门穴的里侧，上行贯穿膈肌云云，再上行而内连目系，上行出于额部，与督脉会合于头顶者，这是两道。这是其支脉中较大的部分。（上述两道支脉，各家都混淆注入正经之中，我特意将其分出，其说法见前文。）又有其逆行方向的支脉，从目系处，下行至颊里，环绕唇内者，这是两道。这是其支脉中较小的部分。又有其交接经脉的支脉，从期门穴归属于肝处，别出贯穿膈肌，上行注入肺中者，这是两道。这是由正经发出之支脉，从肺而交接于手太阴肺经者。前文《热论》中说：“烦闷而阴囊收缩”，这也只是简略地言及其病症罢了。又按：《热论》说：“烦满而囊缩”，张仲景《伤寒论》都宗奉这一说法。考证《活人书》另外引用经文义理说：“肝主筋之合。筋，聚集于生殖器，而脉络连于舌根。脉气不能濡养，则筋急。筋急，则牵引舌与睾丸。所以嘴唇青紫、舌头卷曲而睾丸收缩。”我认为患热病的人，其嘴唇颜色不至于青紫，所以世俗的医生，相传诊断热病的方法，只说舌头卷曲、睾丸收缩，或者说舌头卷曲、阴囊收缩，认为是热病极深的征候。
（王履）总论：以上《内经·热病论》中，辨析伤寒，只分足六经证候。汉代张仲景推展《内经·热病论》原文，而著《伤寒论》说：“从霜降以后，至春分以前，凡有触犯冒犯霜露，体中寒冷，随即发病的，叫做伤寒。”这是正伤寒病。寒气所伤，总不出足之六经的范围。所以自古迄今，注解伤寒的，何止数百家，其辨析脉象、证候、治法，也只详于足经，不及手经。试以时令来说，霜降之时，湿土当令。此后，则寒水用事。春分以前，风木当令。再往前推，则是冬季的湿土用事。就六经而言，足太阳、足少阴，皆属水，三冬时节实际主宰它们。足少阳、足厥阴，皆属木，春分时实际主宰它们。足阳明、足太阴，皆属土，霜降与冬季之时实际主宰它们。刘草窗有话说：“水、木、土三者，都不能胜过寒气所伤。所以水遇寒，则枯竭结冰；木遇寒，则叶落枝枯；土遇寒，则裂开而不坚固。”这就是为什么伤寒病，在人身只有水、木、土三脏三腑受邪。其外在见证，也不过是足的三阴三阳或以次受邪而为传病，或传变不以次而为间病，或先后相传，前病未去而为并病，或二阳、三阳一同受邪而为合病，或阴阳脏腑、表里受邪而为两感。凡此种种，都是正伤寒的病证。虽然名为伤寒，而风湿之气也在其中。总之，风湿所伤，总见于足六经证候。其他如春分以后，霜降以前，则暑、热、燥三气俱多。其间只有非时之寒气着人，现今医生通称为伤寒。然而其病与冬季的正伤寒大不相同。其传变也不仅仅拘泥于足之六经。有如四月属巳，在天则暑气用事，在人则手厥阴心包络、手少阳三焦二经应之。（以四月天气而论，人病无伤寒了。不知天之六气，巳与亥相冲，亥本是北方水火之极，则冲动水气而生寒，所以四月时，人也不免有伤寒的病。）五月属午，在天则热气用事，在人则手少阴心、手太阳小肠二经应之。（以五月天气本热，人不免有伤寒的病，是因为午冲子水而生寒。）六月属未，在天则湿气用事，湿本地气，土中有水，为热所蒸，在人则脾与胃应之。（夫脾胃系足经，无需多举。人在六月中，也不免有伤寒，是因为湿土中本有寒气。）七月属申，八月属酉，在天则燥气用事。（天之六气，申酉相对而冲者是寅卯木。寅申本相火，主大热之气，木火相煽，故卯也从酉而成燥。）在人则手太阴肺、手阳明大肠二经应之。（以七八月天气而论，人病无伤寒了。不知燥金之气本凉，凉之中寒气居多，所以人在秋时，也有伤寒病。）刘草窗又说：“手经所属，皆金与火。金与火不畏寒，所以金遇寒则愈坚，又火体极热，寒不能袭。”殊不知火正畏水，寒能胜热。又不知夏秋非时之暂寒，终究不及冬月之严寒。其气与暑热并行，夫暑热同一火气，火又为金之贼。若然，则是春分以后，霜降以前，其间有非时之伤寒，其热邪所传，有连手经亦受病的。所以我前言说，不可仅仅拘泥于足之六经。明洛阳进士孙应奎，手集医方类选，自己著《伤寒论》说：“凡风寒暑湿热燥，天之六气，自外而中人五脏六腑、十二经络者，四时之中，皆得谓之伤寒。”要是这话，即河间刘守真《伤寒直格》中所云：“手足经络，配天地四时之义。”我认为四时之中，六气伤人，各不相侔。其初，若不由寒气而得的，都不得谓之伤寒。（谓伤风自是伤风，伤暑自是伤暑是也。）其初若由寒气而得的，都得以谓之伤寒。（即如夏秋热燥之时，旦晚间偶着雾露清凉之气是也。）大抵伤寒一病，在四时之中，不分何时，皆以寒为标，热为本。其人病若标本皆寒者，此系中寒病，非伤寒病也。又正伤寒只传足经，类伤寒间有传手经者，这不是我一人的私说，在昔贤已引其端，但无分经辨证确然之论耳。据前《热论》中说：“三阴三阳，五脏六腑，皆受病。”夫五脏六腑，皆受热所困而病极矣，则是三阴三阳经者，岂但言足而不言手邪？前人著书，每多引而不发，专待后人启悟，惜乎今时之医，未有明言及手六经病者。我因此不得已，而起辟其说，非故欲欺世而盗名也。
(The Qi of the Pericardium Meridian of Hand-Jueyin) Internally, how can it be said to emerge from the collaterals? This is the course of its branch meridian: emerging from where it enters the Lung, connecting with the Pericardium (Xinbao), and pouring into the Shanzhong (Chest Center) acupoint, located precisely between the heart and chest, thereby intersecting with the Hand-Jueyin Meridian. (Diagram of Foot-Shaoyin Meridian \pt68a5.bmp)
(Wang Lv) According to: The Qi of the Foot-Shaoyin Kidney Meridian divides and runs up, down, left, and right, totaling six pathways. Its origin starts below the little toe... diverges to enter the heel... ascends along the posterior medial aspect of the thigh, penetrates the spine, returns anteriorly, and emerges at the Henggu (Transverse Bone) acupoint, ascending to the Huangshu (Blind Water) acupoint, entering internally to connect with and belong to the Kidney, returning downward to the umbilicus, and connecting with the Bladder. These are two pathways. These constitute the main meridian, which is the root of the vessel's Qi. However, its course involves many areas of varying depth and curvature. *Huoren Shu* (Book of Vitality) considers the pathway entering the heel as a separate branch, due to its curvature. The straight pathway continues from where it belongs to the Kidney, joining the main meridian to ascend through the Liver and diaphragm... terminating at the root of the tongue. These are another two pathways. These are also part of the main meridian. The branch meridian emerges from the Lung, connects with the Heart, and pours into the chest. These are another two pathways. These are the small internal branches. As stated in the earlier *Re Lun* (Treatise on Heat): "dry mouth, dry tongue, and thirst." This merely briefly mentions the symptoms. Furthermore, the Shaoyin meridian ascends to flank the root of the tongue and terminates there. *Neijing* states: "dry mouth" occurs because the root of the tongue suffers from heat disease and becomes extremely dry, causing the mouth to become dry as well.
The Foot-Jueyin Liver Meridian originates at the pubic hair on the big toe, ascends along the upper margin of the dorsum of the foot, one cun away from the medial malleolus, eight cun above the ankle, crossing behind the Foot-Taiyin Spleen Meridian, ascending along the medial aspect of the leg and thigh, entering the pubic region, passing the external genitalia, reaching the lower abdomen, flanking the Stomach, belonging to the Liver, and connecting with the Gallbladder. It ascends through the diaphragm, spreads over the costal and hypochondriac regions, follows the posterior aspect of the throat, enters the nasopharynx (Hangsang), connects with the optic nerve system (Muxi), emerges above the forehead, and meets the Du Meridian at the vertex. (I note: The text from "ascends through the diaphragm" onwards should be considered a major branch. Since the three Yin meridians of the foot ascend from the foot into the abdomen, those meeting the Du Meridian at the vertex borrow Qi from the Yang meridians, allowing their branches to ascend to the vertex. Therefore, the phrase "belongs to the Liver and connects with the Gallbladder" should be followed by "its branch". Also, "cong" (cluster) should be read as "ju" (gather). "Lei" (rib) should be read as "ye" (axilla). "Ju Mao" refers to the transverse crease behind the big toe. "Yinqi" refers to the external genitalia, commonly called "qi" for both sexes. The area below the navel is the lower abdomen. The deep interior of the eye is the "xi" (system/attachment). "Hangsang" is the nasopharynx/pharynx. This describes the Foot-Jueyin meridian originating at the transverse crease behind the big toe, ascending along the dorsum to the Zhongfeng acupoint of this meridian; since it is one cun anterior to the medial malleolus, it is described as "away". Ascending past the ankle, it passes the Sanyinjiao acupoint of the Foot-Taiyin meridian, reaching the Zhongdu acupoint, named for this meridian, located seven cun above the medial malleolus within the tibia. One cun higher makes it "eight cun". Crossing behind the Taiyin meridian, it ascends along the leg and thigh, enters the pubic hair, crosses left and right, surrounds the genitalia, reaches the lower abdomen, and ascends to meet the Ren Meridian at the Zhongji and Guanyuan acupoints. Then moving outward and upward along the tip of the floating rib to the Zhangmen acupoint, and further up to the Qimen acupoint, all named points of this meridian, directly below the nipples. Internally, it flanks the Stomach, belongs to the Liver, returns downward to connect with the Gallbladder. Its branch again rises from the Qimen acupoint, penetrates the diaphragm, spreads horizontally across the ribs, and ascends to the axilla, borrowing Qi from the Foot-Shaoyang Gallbladder Meridian. Ascending further along the posterior throat, it borrows Qi from the Hand and Foot Yangming Meridians, as well as the Hand-Taiyang and Du Meridians. Entering the nasopharynx, it again borrows Qi from the Foot-Yangming and Hand-Taiyang. Ascending to the head, running inside the Foot-Yangming, borrowing Yangming Qi. Internally connecting to the eyes, rising from the deep pulse to the forehead, running inside the Foot-Shaoyang, borrowing Shaoyang Qi, and finally ascending to the vertex, meeting the Du Meridian at the Baihui acupoint in the neck to terminate. Baihui is a point on the Du Meridian, where the Foot-Taiyang meridian also converges. This shows that the Jueyin branch must borrow Qi from various Yang meridians to ascend to the head.) Another branch descends from the optic nerve system, travels through the inner cheek, and circles inside the lips. (This refers to a small branch descending from the optic nerve system, following the inner cheek downwards, crossing left and right to circle inside the lips.) Another branch diverges from the Liver, penetrates the diaphragm, and pours upward into the Lung. (This refers to the branch connecting meridians, diverging from the Qimen point belonging to the Liver, ascending through the diaphragm, pouring into the Lung, descending back to the middle jiao to intersect with the Hand-Taiyin Lung Meridian.)
(Diagram of Foot-Jueyin Meridian \pt68a6.bmp)
(Wang Lv) According to: The Qi of the Foot-Jueyin Liver Meridian divides and runs up, down, left, and right, totaling eight pathways. Its origin starts above the gathered hair on the big toe... passes the genitalia, reaches the lower abdomen, follows the Zhangmen acupoint, ascends to the interior of the Qimen acupoint, ascends to flank the Stomach, and descends to belong to the Liver and connect with the Gallbladder. These are two pathways. These constitute the main meridian, the root of the vessel. Its branch rises from the interior of the Qimen acupoint, penetrates the diaphragm... ascends to internally connect with the optic nerve system, emerges above the forehead, and meets the Du Meridian at the vertex. These are two pathways. These are the larger branches. (These two branch pathways were confused with the main meridian by previous scholars; I have specifically separated them, as explained previously.) There is also a reverse-flowing branch descending from the optic nerve system, traveling through the inner cheek, and circling inside the lips. These are two pathways. These are the smaller branches. There is also a branch connecting meridians, diverging from the Qimen point belonging to the Liver, penetrating the diaphragm, and pouring upward into the Lung. These are two pathways. These are branches issuing from the main meridian, connecting from the Lung to the Hand-Taiyin Lung Meridian. As stated in the earlier *Re Lun*: "restlessness, fullness, and retraction of the scrotum." This merely briefly mentions the symptoms. Furthermore, *Re Lun* states: "restlessness, fullness, and scrotal retraction." Zhang Zhongjing's *Shanghan Lun* follows this. Examining *Huoren Shu*, it cites other scriptural meanings: "The Liver governs the union of sinews. Sinews gather at the genitalia and connect via vessels to the root of the tongue. If the vessels do not nourish, sinews become tense. Tense sinews pull the tongue and testicles. Thus, blue lips, curled tongue, and retracted testicles." I believe that in patients with heat disease, lip color does not turn blue. Hence, secular doctors' traditional method for diagnosing heat disease only mentions curled tongue and retracted testicles, or curled tongue and retracted scrotum, considering it a sign of extreme heat disease.
(Wang Lv) General Note: In the above *Neijing Re Bing Lun* (Treatise on Heat Diseases), differentiation of Shanghan (Cold Damage) only distinguishes the Six Foot Meridians. Han Dynasty's Zhang Zhongjing expanded the original text of *Neijing Re Bing Lun* and wrote *Shanghan Lun*, stating: "From after Frost Descent until before Spring Equinox, anyone who is exposed to frost and cold dew, feels cold in the body, and immediately falls ill, is called suffering from Shanghan." This is True Shanghan. Injury by cold Qi generally does not exceed the Six Foot Meridians. Therefore, since ancient times to the present, hundreds of commentators on Shanghan have focused only on the Foot Meridians regarding pulse, symptom, and treatment differentiation, neglecting the Hand Meridians. Let us consider the seasons. At Frost Descent, Wet Earth is dominant. Afterwards, Cold Water takes charge. Before Spring Equinox, Wind Wood is dominant. Looking further back, it is the Wet Earth of Winter. Regarding the Six Meridians: Foot-Taiyang and Foot-Shaoyin belong to Water, governed by the three winter months. Foot-Shaoyang and Foot-Jueyin belong to Wood, governed at Spring Equinox. Foot-Yangming and Foot-Taiyin belong to Earth, governed at Frost Descent and Winter. Liu Caochuang said: "Water, Wood, and Earth cannot withstand cold injury. Water freezes when cold; leaves fall and branches wither when Wood is cold; earth cracks and loses firmness when Earth is cold." Thus, in Shanghan disease, only the Water, Wood, and Earth Zang-Fu organs suffer pathogenic invasion. External manifestations involve the Six Foot Yin and Yang meridians receiving pathogens sequentially (transmission disease), non-sequentially (intermittent disease), sequentially with lingering prior illness (combined disease), simultaneous attack on two or three Yang meridians (concurrent disease), or simultaneous attack on Yin/Yang, Zang/Fu, exterior/interior (dual infection). All these are True Shanghan diseases. Although named Shanghan, Wind-Dampness is included. Ultimately, Wind-Damp injuries manifest in the Six Foot Meridians. Other than that, after Spring Equinox and before Frost Descent, Summer-Heat, Heat, and Dryness are abundant. Only non-seasonal cold Qi affects people here, now commonly called Shanghan by physicians. However, this differs greatly from Winter True Shanghan, and its transmission is not confined to the Six Foot Meridians. For example, the fourth month corresponds to Si. In heaven, Summer-Heat Qi dominates; in humans, the Hand-Jueyin Pericardium and Hand-Shaoyang Sanjiao meridians correspond. (Considering April weather, one might think no Shanghan occurs. But knowing Heavenly Qi, Si clashes with Hai. Hai is the extreme of Water/Fire in the North, stirring Water Qi to generate cold. Thus, even in April, Shanghan can occur.) The fifth month corresponds to Wu. In heaven, Heat Qi dominates; in humans, Hand-Shaoyin Heart and Hand-Taiyang Small Intestine meridians correspond. (May is naturally hot, but Shanghan occurs because Wu clashes with Zi Water, generating cold.) The sixth month corresponds to Wei. In heaven, Dampness Qi dominates. Dampness is local Earth Qi; Earth contains Water, steamed by Heat. In humans, Spleen and Stomach correspond. (Spleen/Stomach are Foot Meridians, so no need to elaborate. People in June still get Shanghan because Damp Earth contains inherent cold.) July corresponds to Shen, August to You. In heaven, Dryness Qi dominates. (Heavenly Qi: Shen and You clash with Yin and Mao Wood. Yin-Shen is originally Xiang-Huo, governing great heat. Wood and Fire fan each other, so Mao also becomes Dryness with You.) In humans, Hand-Taiyin Lung and Hand-Yangming Large Intestine meridians correspond. (Considering July/August weather, one might think no Shanghan. But Dry Metal Qi is inherently cool, containing much cold within coolness. Thus, Autumn Shanghan exists.) Liu Caochuang also said: "Hand Meridians belong to Metal and Fire. Metal and Fire do not fear cold; Metal becomes harder with cold; Fire is extremely hot, immune to cold." Little do they know Fire fears Water, and Cold overcomes Heat. They fail to realize that transient cold in Summer/Autumn cannot match the severe cold of Winter. This Qi accompanies Summer-Heat. Summer-Heat and Heat share the same Fire Qi, and Fire is the enemy of Metal. Therefore, between Spring Equinox and Frost Descent, non-seasonal Shanghan exists. When Heat pathogens transmit, they may affect Hand Meridians too. Hence my previous statement: one cannot rigidly confine oneself to the Six Foot Meridians. Sun Yingkui, a Jinshi from Luoyang Ming Dynasty, compiled medical prescriptions and wrote his own *Shanghan Lun*, stating: "All Heavenly Six Qi—Wind, Cold, Summer-Heat, Dampness, Dryness, Heat—injuring the Five Zang, Six Fu, and Twelve Meridians from outside can be called Shanghan in any season." This aligns with Liu Shouzhen of Hejian's *Shanghan Zhige*: "Hand and Foot Meridians correspond to Heaven, Earth, and Four Seasons." I believe that in four seasons, Six Qi injure humans differently. Initially, if not caused by Cold Qi, it cannot be called Shanghan. (Wind injury is Wind injury; Summer-Heat injury is Summer-Heat injury.) Initially, if caused by Cold Qi, it can be called Shanghan. (e.g., occasional exposure to mist/dew coolness during hot/dry Summer/Autumn mornings/evenings.) Generally, Shanghan disease, regardless of season, uses Cold as the manifestation (Biao) and Heat as the root (Ben). If a patient presents with both Biao and Ben as Cold, it is Zhonghan (Mid-Cold) disease, not Shanghan. True Shanghan transmits only through Foot Meridians; similar Shanghan occasionally transmits through Hand Meridians. This is not my private theory; ancient sages hinted at it, but lacked precise meridian-based differentiation. According to the earlier *Re Lun*: "Three Yin and Three Yang, Five Zang and Six Fu, all receive disease." If Five Zang and Six Fu are exhausted by Heat, do the Three Yin and Three Yang refer only to Foot and not Hand? Previous authors often left things implicit, waiting for later generations to enlighten. Regrettably, modern physicians have not explicitly discussed Hand Six Meridian diseases. I am compelled to refute this view, not to deceive the world for fame.