三阴结。谓之水。三阴为六经之主。三阴邪结。是坤土不能运精矣。土不运精。则二阴之水气益甚。势必反来侮土。
且水气盛则阳不得入。阳不得入则肺气不得通调。斯寒水不行而为壅。故为水也。盖中州结则气壅而关门不利。不利则
聚水而从其类。类者。本在肾。末在肺也。
一阴一阳结。谓之喉痹。厥阴。少阳。一主风木。一主相火。胆肝心胞三焦皆所共也。均为热化而风煽之。四结之
脉。皆络于喉。风火逆上而不得发。必于喉乎结之。是成喉痹也。
有并病者。凡人之阴阳内外雌雄。必相输应。是以阴阳相致。得其和平。若既两病。则各经之阴阳。必错迕违逆。
相遇则搏而败。必并于胜。故不谓之合病。而谓之并病。并者有所归也。
二阳一阴。阳明主病。不胜一阴。脉 而动。九窍皆沉。阳明全有谷神营卫之盛气。厥阴则任独使而布行之。合两
家同病。而中州气馁。是阳明主病矣。乃中州气馁。而风木失和。将厥阴之戾。反克于中州。嗣此阳明之脉不复搏大而
见。气不昌而内郁见动。则所以宣之九窍无俾也。故皆沉。此则阳明之病甚矣。是谓并病也。
三阳一阴。太阳脉胜。一阴不能止。内乱五脏。外为惊骇。一阴主筋膜之气。又主三阴之阖。能为太阳之守。莫一
阴若也。乃三阳一阴俱病。而太阳之脉且胜。夫太阳之病。在脉浮。病而脉胜。则浮大中空。无阴可知。无阴则太阳之
上下无常方。风雨并至而为病。而岂无气之一阴能止之乎。于是内气不守。则内乱五脏。本脏神怯。则外为惊骇也。
二阴二阳。病在肺。少阴脉沉。胜肺伤脾。外伤四肢。二阴主里而藏精。病则真精内虚。二阳起谷神而朝津液。病则津
液枯竭。于是气逆火盛。必伤于肺。故曰病在肺。若见少阴脉沉者。是谓肾气不衡。而无根之浮火逆而上乘。则上胜于
肺。中州不能遏其逆。则热燥伤脾脾病则不能授气于四关。故并外伤四肢也。
二阴二阳皆交至。病在肾。骂詈妄行。颠疾为狂。前证明阳气虚内热。肾气不衡。故有胜肺伤脾之见。今内伤之气
皆交至。而定为病在肾者。此系肾家水空火不守。而上发与阳明热邪相并。使心无所主。故神惑志失。而骂詈妄行。太
阳无内。故颠疾。神明内乱。故为病狂。此症之见。似宜皆在阳明。然实肾精不守。不能主里。使心火自焚。与阳明并
也。
二阴一阳。病出于肾。阴气客游于心脘下。空窍堤闭不通。四肢别离。一阳连肾。上至肺。外连脾胃。然其根本出
于二阴。今二阴肾家寒虚。少阳不足。故病出于肾。肾与胆气皆寒虚。是以阴气客游于心脘下。阴气既盛于中脘。则所
以行津液出营卫以灌溉四末者。皆空窍堤闭不通矣。不通者。无阳则不通也。不通则四肢乃别离矣。此证近于单腹胀。
而四肢如削者也。一阴一阳。代绝。此阴气至心上下无常。出入不知。喉咽干燥。病在脾土。一阴之阴。为作朔之阴。
一阳之阳。为生生之阳。二脉皆代绝。是阴不为阳根。阳不为阴生矣。两俱失职。则所以为游部。为独使者。皆无根之
阴气也。心之下。自膻中至三焦。皆少阳生发游行上下之位。二部之生气既已无根。故阴气至心而上下无常。出入不知
也。咽喉胆之使也。故干。脾土之冲和。亦赖胆肝之舒达。若脉皆代绝。是以死气乘脾矣。其为中气不续。中土衰败可
知。
二阳三阴。至阴皆病。阴不过阳。阳气不能止阴。阴阳并绝。沉为血瘕。浮为脓 。二阳三阴。本脾胃也。而后云
至阴者。以明此三阴属于太阴肺。故分别言之。夫阳明居二阳中州气盛。太阴脾常为之行气于三阴。而阳明亦自能达气
于三阳。则手太阴肺常能为治节于其间。是以阴阳和同。阳倡阴随。阴守阳中。阳指阴使。今二阳三阴至阴皆病。其病
气皆见于其脉。则其象为阳浮而不能沉。阴沉而不能浮。是以阴不过阳。阳亦不能止阴。是阴阳离绝也。如是则沉伏于
内者。有阴寒之病。血聚为瘕。浮显于外者。有阳毒之病。壅盛脓 。旧文作沉为脓 。浮为血瘕。有吴鹤皋正之。
按内经无并病之文。然阴阳不和。两戾相遇。势必相战。战有胜负。则其病更有所归。或归胜。或归负。必有为之主者。
终非合病之条也。故另出言之。乃内经举一隅耳。此阴阳之错迕。脏腑之乘除。可不辨明乎。
三阴经邪气郁结，称为水病。三阴经是六经的主宰。若三阴经受邪气郁结，就是脾土（坤土）不能运化精微物质了。脾土不能运化精微，那么二阴（少阴、厥阴）的水气就会更加旺盛，势必反过来克制脾土。
况且水气旺盛则阳气无法进入，阳气无法进入则肺气的通调功能失常。这样寒水之气停滞不行而成为壅塞，所以形成水病。大概中焦脾胃郁结则气机壅滞，导致关门（指排泄孔窍或下焦水道）不利。不利则水液聚集并同类相从。所谓“类”，根本在于肾，末梢在于肺。
一阴（厥阴）与一阳（少阳）邪气郁结，称为喉痹。厥阴和少阳，一个主风木，一个主相火。胆、肝、心包、三焦都与此相关。它们都表现为热化，而风邪煽动火势。这四条经脉（此处指涉及喉部的经络）都联络于咽喉。风火之气逆上而不能发散，必然在咽喉处郁结，从而形成喉痹。
有并病这种情况。凡是人的阴阳、内外、雌雄，必定相互感应呼应。因此阴阳相交致，达到和平状态。如果同时患两种病，那么各经的阴阳之气必定交错违逆。相遇时互相搏结而导致败坏，必定合并于胜者一方。所以不叫合病，而叫并病。“并”意味着有所归附。
二阳（阳明）与一阴（厥阴）同病，以阳明为主病。因为不胜过一阴，脉象躁动，九窍皆沉陷。阳明本具有谷气、神气以及营卫的盛壮之气，厥阴则独自行使职能并布散运行。两经同病，导致中焦脾胃之气衰弱，这就是阳明主病的表现。既然中焦脾胃之气衰弱，而风木之气失去调和，那么厥阴的戾气反而克制中焦脾胃。此后阳明的脉象不再呈现搏大而有力的特征，气机不昌盛而内郁出现躁动之象，这就导致宣发至九窍的气血无力支持。所以九窍皆沉陷。这是阳明的病证非常严重了，这叫做并病。
三阳（太阳）与一阴（厥阴）同病，太阳脉象偏胜，一阴不能制约。内部扰乱五脏，外部表现为惊骇。一阴主司筋膜之气，又主司三阴经的闭合功能，能够作为太阳经的守卫，没有比一阴更合适的了。如今三阳和一阴都发病，而且太阳脉象偏胜。太阳的病，脉象应浮。病而脉象偏胜，则脉象浮大中空，可知无阴液涵养。无阴液则太阳经上下无常定之处，风雨邪气一同来袭而致病，难道仅凭微弱的一阴之气能制止吗？于是内部正气不能固守，导致内部扰乱五脏；本脏神气怯弱，所以外部表现为惊骇。
二阴（少阴、厥阴）与二阳（阳明、太阴）同病，病位在肺。少阴脉沉。这是胜气伤肺、损伤脾脏，外伤四肢。二阴主里而藏精，发病则真精在内空虚。二阳（主要指阳明）依靠谷气产生神气并汇聚津液，发病则津液枯竭。于是气逆火盛，必然伤害肺脏。所以说病在肺。如果见到少阴脉沉，这是肾气不平衡，无根的浮火逆而上乘，则上部胜过肺脏，中焦脾胃不能遏制其逆气，则燥热损伤脾脏。脾病则不能将气输送到四肢关节，所以同时外伤四肢。
二阴和二阳的邪气都交杂而至，病位在肾。患者骂人、胡乱行动，癫疾发作变为狂症。前文证明阳气虚衰而生内热，肾气不平衡，所以有胜肺伤脾的表现。如今内伤之气都交杂而至，而定为病在肾，这是因为肾家水亏火不守，而上发的邪气与阳明热邪相合并，使心神无所主宰，所以神志迷惑、意志丧失，从而骂人、胡乱行动。太阳经内部空虚，所以发生癫疾。神明内部混乱，所以变为狂症。这种症状的出现，似乎都应该在阳明经，但实际上是肾精不守，不能主里，使心火自焚，并与阳明经邪气相并。
二阴与一阳同病，病出于肾。阴气客居游荡于心脘之下，空窍堤防闭塞不通，四肢消瘦分离。一阳（少阳）连接肾脏，上至肺脏，外连脾胃。然而其根本出于二阴。如今二阴肾家寒虚，少阳不足，所以病出于肾。肾与胆气都寒虚，因此阴气客居游荡于心脘之下。阴气既在中脘旺盛，那么用来行津液、出营卫以灌溉四肢末端的通道，都因空窍堤防闭塞而不通。不通是因为没有阳气推动。不通则四肢乃消瘦分离。此证接近于单腹胀，而四肢如削瘦一般。
一阴与一阳脉象代绝（间歇性停跳）。这是阴气至心，上下无常，出入不知，咽喉干燥，病在脾土。一阴之阴，是作朔（新月/阴始生）之阴；一阳之阳，是生生不息之阳。这两部脉象都出现代绝，说明阴不为阳之根，阳不为阴所生。两者都失职，那么所谓的游部、独使者，都成了无根的阴气。心之下，自膻中至三焦，都是少阳生发游行上下的部位。两部脉的生气既然已经无根，所以阴气至心而上下无常，出入不知。咽喉是胆的使道，所以干燥。脾土的冲和之气，也依赖胆肝的舒达。如果脉象都代绝，那就是死气侵犯脾土了。由此可知是中气不续，中土衰败。
二阳与三阴同病，至阴（太阴）皆病。阴气不能超过阳气，阳气不能制止阴气，阴阳脉气皆绝。脉沉为血瘕（腹内结块），脉浮为脓疡。二阳和三阴，本来是指脾胃。但后来说“至阴”，是为了明确这三阴属于太阴肺，所以分别言之。夫阳明居于二阳之中，中州气盛。太阴脾常为之在三阴中运行气机，而阳明也能自行通达气机于三阳。这样手太阴肺常能在其间治理调节。因此阴阳和谐，阳倡阴随，阴守阳中，阳指挥阴使用。如今二阳和三阴的至阴都发病，其病气都表现在脉象上，那么象表现为阳浮而不能沉，阴沉而不能浮。因此阴气不能超过阳气，阳气也不能制止阴气，这是阴阳离绝。像这样，则沉伏于内的，有阴寒之病，血液凝聚形成瘕块；浮显于外的，有阳毒之病，壅盛形成脓疡。旧文写作“沉为脓疡，浮为血瘕”，被吴鹤皋纠正。
按《内经》原文并没有“并病”这一术语。然而阴阳不和，两股戾气相遇，势必互相战斗。战斗有胜负，那么病势就更有所归附。或者归附于胜者，或者归附于负者，必定有一个主导者。终究不是合病的条目。所以单独提出来说明。这是《内经》举一反三的例子罢了。这种阴阳的交错违逆，脏腑的乘侮关系，怎能不辨明呢？
When the Three Yin meridians are knotted, it is called Water Disease. The Three Yin meridians are the masters of the Six Meridians. When the Three Yin meridians are knotted by pathogenic factors, it means that Kun Earth (Spleen/Stomach) fails to transport and transform essential substances. If Earth fails to transport essentials, then the Water Qi of the Two Yin (Shao Yin and Jue Yin) becomes even more excessive, inevitably coming to insult Earth in return.
Moreover, when Water Qi is abundant, Yang cannot enter. If Yang cannot enter, the Lung's function of diffusing and descending cannot be regulated. Thus, Cold Water stagnates and becomes obstructed, resulting in Water Disease. Generally, when the Middle Jiao is knotted, Qi becomes congested and the "gates" (excretory orifices or lower jiao water passages) fail to open properly. When they fail to open, water accumulates and follows its kind. The "kind" refers to the root being in the Kidney and the branch being in the Lung.
When One Yin (Jue Yin) and One Yang (Shao Yang) are knotted, it is called Throat Bi (Obstruction). Jue Yin and Shao Yang, one governs Wind-Wood and the other governs Ministerial Fire. The Gallbladder, Liver, Pericardium, and San Jiao all share these attributes. Both tend toward Heat transformation, with Wind fanning the flames. The four meridians involved all connect to the throat. When Wind and Fire rebel upward and cannot disperse, they must knot at the throat, thereby forming Throat Bi.
There is a condition known as Bing Bing (Concurrent Disease). In humans, Yin and Yang, interior and exterior, male and female principles must correspond and interact. Therefore, when Yin and Yang converge harmoniously, peace is achieved. If two diseases occur simultaneously, the Yin and Yang of each meridian will inevitably clash and contradict. Upon meeting, they contend and deteriorate, ultimately merging into the side that prevails. Hence, it is not called He Bing (Combined Disease), but Bing Bing (Concurrent Disease). "Bing" implies a tendency toward a specific outcome.
In the case of Two Yang (Yang Ming) and One Yin (Jue Yin) concurrent disease, Yang Ming is primarily affected because it cannot overcome One Yin. The pulse is restless, and all nine orifices appear sunken. Yang Ming originally possesses the robust Qi of Grain Essence, Shen Spirit, Ying, and Wei. Jue Yin acts independently to distribute and circulate. When both meridians are diseased, the Qi of the Middle Jiao weakens, making Yang Ming the primary site of pathology. Since the Middle Jiao Qi is weak and Wind-Wood loses harmony, the rebellious nature of Jue Yin counter-attacks the Middle Jiao. Consequently, the Yang Ming pulse no longer appears forceful and large; instead, due to deficient and internally constrained Qi, restlessness manifests. This lack of strength prevents the proper dissemination to the nine orifices, causing them to sink. This indicates severe Yang Ming disease, termed Concurrent Disease.
In the case of Three Yang (Tai Yang) and One Yin (Jue Yin) concurrent disease, the Tai Yang pulse is dominant, and One Yin cannot restrain it. Internally, it disrupts the Five Zang organs; externally, it causes fright and palpitations. One Yin governs the Qi of the sinews and membranes and controls the closing function of the Three Yin meridians, serving as the guard for Tai Yang, with no better candidate than One Yin. However, when both Three Yang and One Yin are diseased, and the Tai Yang pulse is still dominant: Tai Yang disease typically presents with a floating pulse. A dominant pulse in this context suggests a floating, large, and hollow quality, indicating a lack of Yin. Without Yin, Tai Yang lacks stability, allowing Wind and Rain pathogens to strike simultaneously. Can such a weak One Yin restrain this? Internal Qi fails to hold fast, disrupting the Five Zang organs. Due to weakness of the organ's Shen spirit, external manifestations include fright and palpitations.
In the case of Two Yin (Shao Yin, Jue Yin) and Two Yang (Yang Ming, Tai Yin) concurrent disease, the pathology lies in the Lung. The Shao Yin pulse is deep. This represents an excess condition injuring the Lung and Spleen, with external injury to the four limbs. Two Yin govern the interior and store essence; disease here implies internal deficiency of true essence. Two Yang (primarily Yang Ming) generates Shen Qi from Grain Essence and gathers body fluids; disease here implies depletion of body fluids. Thus, rebellious Qi and flourishing Fire inevitably damage the Lung, hence "pathology lies in the Lung." If the Shao Yin pulse is seen as deep, it signifies unbalanced Kidney Qi, with rootless floating Fire rebelling upward and overwhelming the Lung. The Middle Jiao cannot curb this rebellion, so heat and dryness injure the Spleen. Spleen disease prevents the transmission of Qi to the four joints, resulting in external injury to the limbs.
When the pathogenic factors of Two Yin and Two Yang intersect and arrive together, the pathology lies in the Kidney. Symptoms include cursing, erratic behavior, mania arising from epilepsy. Previous texts established that Yang Qi deficiency leads to internal heat and unbalanced Kidney Qi, causing injuries to the Lung and Spleen. Now, with internal injured Qi intersecting, the pathology is defined as lying in the Kidney. This is because Kidney Water is empty and Fire does not stay put, rising to merge with Yang Ming Heat Pathogens. This leaves the Heart without a master, causing confusion of Shen and loss of Zhi, leading to cursing and erratic behavior. With Tai Yang lacking internal support, mania ensues. Internal disorder of Shen results in Kuang (madness). Although these symptoms seem related to Yang Ming, the root is actually Kidney Essence failing to secure the interior, allowing Heart Fire to burn itself out and merge with Yang Ming.
In the case of Two Yin and One Yang concurrent disease, the pathology originates from the Kidney. Yin Qi wanders below the heart and epigastrium, blocking the orifices and barriers, causing the limbs to waste away. One Yang (Shao Yang) connects to the Kidney, ascends to the Lung, and extends externally to the Spleen and Stomach. However, its root lies in Two Yin. Currently, the Kidney family of Two Yin is cold and deficient, and Shao Yang is insufficient, so the pathology originates from the Kidney. Both Kidney and Gallbladder Qi are cold and deficient, allowing Yin Qi to wander below the heart and epigastrium. Once Yin Qi is abundant in the middle epigastrium, the channels responsible for distributing fluids, generating Ying and Wei, and irrigating the four extremities become blocked by closed orifices and barriers. Blockage occurs due to the absence of Yang. Blockage leads to the wasting of the limbs. This condition resembles single-abdominal distension with emaciated limbs.
When One Yin and One Yang pulses show Dai Jue (intermittent cessation), Yin Qi reaches the Heart, moving up and down irregularly, entering and exiting unknowingly, accompanied by dryness of the throat and tongue. The pathology lies in Spleen Earth. The Yin of One Yin is the Yin of the new moon (beginning of Yin generation); the Yang of One Yang is the Yang of continuous generation. If both pulses show Dai Jue, it means Yin is not the root of Yang, and Yang is not generated by Yin. Both have failed in their duties. The wandering parts and independent messengers become rootless Yin Qi. Below the Heart, from Dan Zhong to San Jiao, are the positions where Shao Yang generates, rises, and circulates. Since the Sheng Qi of these two regions has lost its root, Yin Qi reaches the Heart with irregular movement and unknown entry/exit. The throat is the envoy of the Gallbladder, hence dryness. The harmonious nature of Spleen Earth also relies on the soothing and dispersing actions of the Gallbladder and Liver. If the pulses both show Dai Jue, it indicates that Dead Qi invades the Spleen. It can be known that the Middle Qi is discontinuous and the Central Earth is declining.
In the case of Two Yang and Three Yin concurrent disease, the Zhi Yin (Tai Yin) is diseased. Yin cannot exceed Yang, and Yang cannot restrain Yin. If Yin and Yang pulses both cease, a deep pulse indicates Blood Xi (abdominal mass), while a floating pulse indicates Nong Chuang (abscess). Two Yang and Three Yin originally refer to the Spleen and Stomach. However, mentioning "Zhi Yin" clarifies that these Three Yin belong to the Tai Yin Lung, hence they are discussed separately. Yang Ming resides within Two Yang, possessing strong Middle Jiao Qi. Tai Yin Spleen often transports Qi among the Three Yin, while Yang Ming can naturally reach Qi to the Three Yang. Thus, Hand Tai Yin Lung often regulates the balance between them. Therefore, Yin and Yang are harmonious: Yang initiates and Yin follows; Yin guards within Yang; Yang directs and Yin serves. Now, if Two Yang and the Zhi Yin of Three Yin are all diseased, their pathological Qi manifests in the pulses. The image is Yang floating but unable to sink, and Yin sinking but unable to float. Thus, Yin cannot exceed Yang, nor can Yang restrain Yin. This is the separation and extinction of Yin and Yang. In such cases, what sinks internally involves Yin-Cold pathology, with blood coagulating to form Xi masses. What floats externally involves Yang-Toxin pathology, with congestion and swelling forming abscesses. Old texts read "deep indicates abscess, floating indicates blood mass," which was corrected by Wu Hegao.
Note: The Nei Jing does not explicitly use the term "Bing Bing" (Concurrent Disease). However, when Yin and Yang are disharmonious and conflicting forces meet, they inevitably battle. Victory or defeat determines where the pathology settles—either归于 the victor or the vanquished. There must be a dominant factor. It is fundamentally different from He Bing (Combined Disease). Thus, it is mentioned separately. This is an example of the Nei Jing using one instance to illustrate others. Such contradictions of Yin and Yang, and the mutual overcoming of Zang-Fu organs, must be clearly distinguished.