如梗状，甚则咽肿喉痹（心脉上挟于咽，故喉中如梗，至于痹则痛矣）。肝咳之状，咳则两胁下痛，甚则不可
以转，转则两 下满（肝之脉布胁肋，故胁下痛。 ，胁之下也）。脾咳之状，咳则右 下痛，阴阴引肩背，甚则不可以
动，动则咳剧（脾脉上膈挟咽，其支
者复从胃别上膈，脾处右，故右 下痛，痛引肩背也。脾土喜静，动则违其性，故增剧也）。肾咳之状，咳则
腰背相引而痛，甚则咳涎（肾脉贯脊，系于腰背。故相引而痛。肾属水，主涎，故为咳涎也）。
五脏之久咳，乃移于六腑。脾咳不已，则胃受之，胃咳之状，咳而呕，呕甚则长虫出（胃者，脾之妻也，
故脾咳必传于胃而为呕唾。长虫处于胃，呕甚则随气而出也）。肝咳不已，则胆受之，胆咳之状，咳呕胆汁（胆
汁者，苦汁也）。肺咳不已，则大肠受之，大肠咳状，咳而遗矢（遗矢者，大便不禁也）。心咳不已，则小肠
受之，小肠咳状，咳而失气，气与咳俱失（大肠之气由于小肠之化，故小肠咳则气达于大肠，而转失气也）。
肾咳不已，则膀胱受之，膀胱咳状，咳而遗溺（膀胱为津液之府，故遗溺）。久咳不已，则三焦受之，三焦咳
状，咳而腹满，不欲食饮（久咳，则上中下三焦俱病，一身之气皆逆，故腹满不能食饮也）。此皆聚于胃，关于
肺，使人多涕唾而面浮肿气逆也（聚于胃者，胃为五脏六腑之本也。关于肺者，肺为皮毛之合也。涕唾者，肺
与胃司之。面浮肿者，气上逆而急也）。
《经脉别论》曰∶夜行则喘出于肾，淫气病肺（夜属于阴。行则劳其身半以下，且夜行多恐，故喘出于肾
也。肾水伤，则无以禁火之炎，而肺金受贼矣）。有所堕恐，喘出于肝，淫气害脾（堕而恐者，伤筋损血，故
喘出于肝，肝木伐土，故害脾也）。有所惊恐，喘出于肺，淫气伤心（且惊且恐，则气衰而神乱。肺主气，心
藏神，故二脏受伤也）。度水跌仆，喘出于肾与骨（水气通于肾，跌仆伤其骨，故喘出焉）。当是之时，勇者气行则
已，怯者着而为病也（勇者气足神全，故一时所动之气，旋即平复，不足之人随所受而成病矣）。
《腹中论》曰∶心腹满，旦食则不能暮食……名为鼓胀（胀甚则腹皮绷急，中空无物，鼓之如鼓，故名鼓胀）
……治之以鸡矢醴，一剂知，二剂已（鸡胃能消金石，其矢之性等于巴豆，通利二便，消积下气。但宜于壮实
之人，虚者服之，祸不旋踵。即经云一剂便知其效，二剂便已其病。亦状其猛利也。用干羯鸡矢一升，炒微焦，
入无灰酒三碗，煎至减半，取清汁，五更热饮即腹鸣，辰巳时行二三次，皆黑水也。饮一剂，觉足有皱纹，饮
二次即愈矣）。
《灵枢·胀论》曰∶夫心胀者，烦心短气，卧不安；肺胀者，虚满而喘咳；肝胀者，胁下满而痛引小腹；
脾胀者，善哕，四肢烦 ，体重不能胜衣、卧不安；肾胀者，腹满引背央央然，腰髀痛（此五脏之胀也。闷乱
曰，央央者，困苦之貌）。
胃胀者，腹满，胃脘痛，鼻闻焦臭，妨于食，大便难；大肠胀者，肠鸣而痛濯濯，冬日重感于寒，则飧泄
不化；小肠胀者，小腹 胀，引腰而痛∶膀胱胀者，少腹满而气癃；三焦胀者，气满于皮肤中，轻轻然而不坚；
胆胀者，胁下痛胀，口中苦，善太息（此六腑之胀也。濯濯，肠鸣水声也。飧泄，完谷不化也。气癃者，小便不
利也）。
厥气在下，营卫留止，寒气逆上，真邪相攻，两气相搏，乃合为胀也（厥逆之气自下而上，则营卫之行失
其常度，真气与邪气相攻，合而为胀也）。
《灵枢·水胀》篇曰∶目窠上微肿，如新卧起之状（目之下为目窠，如新卧起者，形如卧蚕也），其颈脉动，
时咳（颈脉。足阳明人迎也。阳明之脉自人迎下循腹里，而
水邪乘之，故为颈脉动，水之标在肺，故时咳），阴股间寒，足胫肿，腹乃大，其水已成矣。以手按其腹，随
手而起，如裹水之状，此其候也（此上皆言水肿之候）。
肤胀者，寒气客于皮肤之间， 然不坚，腹大，身尽肿，皮浓（ ，鼓声也。寒气客于皮肤，阳气不
行，病在气分，故有声如鼓。气本无形，故不坚。气无所不至。故腹大、身尽肿而皮浓也），按其腹， 而
不起，腹色不变，此其候也（气在肤间，按散者不能猝复，故 而不起。皮浓，故腹色不变也）。
〔鼓胀者〕腹胀身皆大，大与肤胀等也，色苍黄，腹筋起，此其候也（鼓胀、肤胀，大同小异，只色苍黄、
腹筋起为别耳）。
〔夫肠覃者〕寒气客于肠外，与卫气相搏，气不得荣，因有所系，癖而内着，恶气乃起， 肉乃生（覃之为
义，延布而深也。寒气薄卫，滞而不行，留于肠外，故癖积起、 肉生也）。其始生也，大如鸡卵，稍以益大，
至其成如怀子之状，久者离岁，按之则坚，推之则移，月事以时下，此其候也（离岁，越岁也。邪在肠外，不
在胞中，故无妨于月事。皆由汁沫所聚，非血病可知也）。
石瘕生于胞中，寒气客于子门，子门闭塞，气不得通，恶血当泻不泻， （音不）以留止，日以益大，状如怀
子，月事不以时下，皆生于女子，可导而下（ ，
败血凝聚也。子门闭塞， 血留止，其坚如石，故名石瘕。月事不以时下，无经可至也，可以导血之剂下之。
按肠覃、石瘕皆言月事，则此二症惟女人有之，故曰皆生于女子也）。
《平人气象论》曰∶颈脉动，喘疾咳。曰水（颈脉，乃结喉旁动脉，足阳明之人迎也。水气上逆，则侵犯阳
明，故颈脉动。水溢于肺，则喘而咳）。目裹微肿，如卧蚕起之状，曰水（目之下胞曰目裹，胃脉之所至，脾脉
之所主。若微肿如卧蚕状，是水气犯脾胃也）。溺黄赤安卧者，黄胆（溺色黄赤而安卧自如，必成黄胆也）。
已食如饥者，胃疸（胃热善消谷，故虽食常饥，此名胃疸）。面肿曰风（风为阳邪，故曰高巅之上，惟风
可到，此面肿所以属风也）。足胫肿曰水（水为阴邪，润下之品，故足肿，肿者为水也）。目黄者黄胆（诸经
有热皆上熏于目，故黄胆者目黄）。
《举痛论》曰∶经脉流行不止，环周不休，寒气入经而稽迟，泣而不行，客于脉外则血少，客于脉中则气
不通，故卒然而痛（泣者，涩而不利也）。
寒气客于脉外则脉寒，脉寒则缩 ，缩 则脉绌急，绌急则外引小络，故卒然而痛，得炅则痛立止（经脉
受寒则缩，缩则急，故卒痛。然客于脉外者，其邪浅，故才得炅气则立止也）。因重中于寒，则痛久矣（重者，
重复受寒也。伤之深，故不易愈也）。寒气客于经脉之中，与炅气相薄则脉满，满则痛而不可按也。营行脉中，血
不足者，脉中常热，新寒与故热相薄，
则邪实而脉满，按之则痛愈甚，故不可按也。……寒气客于肠胃之间，膜原之下，血不得散，小络急引故痛。
按之则血气散，故按之痛止（膜，脂膜与筋膜也。原者，肓之原，即腹中空隙之处。血凝则小络急痛，按着空
处，则寒散络缓，故痛止。非若经脉之无罅隙者，按之愈痛也）。寒气客于挟脊之脉则深，按之不能及，故按
之无益也（挟脊者，足太阳经也。其最深者。则伏冲、伏膂之脉；故手按不能及其处也）。寒气客于冲脉，冲脉
起于关元，随腹直上，寒气客则脉不通，脉不通则气因之，故喘动应手矣（冲脉起于胞中，即关元也，其脉并
足少阴肾经夹脐上行，会于咽喉，而肾脉上连于肺，犯寒则脉不通，而气因以逆，故喘。曰应手者，动之甚
也）。寒气客于背俞之脉脉泣，脉泣则血虚，血虚则痛，其俞注于心，故相引而痛。按之则热气至，热气至则
痛止矣（背俞，五脏俞也，皆足太阳经穴。太阳之脉循膂当心，上出于项，故寒气客之则脉泣血虚，背与心相引
而痛，因其俞注于心也。血虚而痛，故按之而痛止）。寒气客于厥阴之脉，厥阴之脉者，络阴器，系于肝，寒气
客于脉中，则血泣脉急，故胁肋与少腹相引痛矣（少腹，胁肋，皆肝之部分也）。厥气客于阴股，寒气上及少
腹，血泣在下相引，故腹痛引阴股（厥气，寒而上逆之气也。阴股、少腹，乃足三阴。冲脉所由行也）。寒气
客于小肠膜原之间，络血之中，血泣不得注于大经，血气稽留不得行，故宿昔而成积矣（小肠为受盛之府，化
物出焉，寒气客于膜原及小络，则血涩不得注于大经，化物失职，久而成积矣）。寒气客于五脏，厥逆上泄，阴气竭，阳
气未入，故卒然痛死不知人，气复反则生矣（五脏皆受邪；厥逆而泄越
于上，阴气暴竭，阳气未能遽入，故卒然痛死，或得炅，则气复反而生矣），寒气客于肠胃，厥逆上出，故痛
而呕也（胃为水谷之海，肠为水谷之道，皆主行下者也。寒邪伤之，则逆而上出，故痛而呕）。寒气客于小
肠，小肠不得成聚，故后泄腹痛矣（小肠与丙火为表里，成聚，即受盛之义也。则失其受盛之常，故泄而腹痛。）
热气留于小肠，肠中痛，瘅热焦渴则坚干而不得出，故痛而闭不通矣（大抵营卫脏腑之间，得热即行，遇冷即
凝，故痛皆因于寒也。此一条独言热痛。却由于便闭不通，故痛。仍非火之自为痛也，故曰通则不痛，痛则不通）。
《痹论》曰，风寒湿三气杂至。合而为痹也（痹者，闭也，不仁也。六气之中，风寒湿为阴邪。阴气合
病，则闭塞成冬之象。故血气不流。经络壅闭而痹斯作矣）。其风气胜者为行痹（风属阴中之阳，善行而数变，
故为行痹。凡走注历节疼痛之类，俗名流火是也），寒气胜者为痛痹（阴寒之气乘于肌肉筋骨，则凝泣稽留，
闭而不通，故为痛痹，即痛风也）。湿气胜者为着痹也（着痹者，重着不移，湿从土化，故病在肌肉，不在筋
骨也）。
肺痹者，烦满喘而呕（肺在上焦，脉循胃口，故为烦满，喘而且呕）。心痹者，脉不通，烦则心下鼓，暴上
气而喘，嗌干善噫，厥气上则恐（脉者，心之合也，心受病则脉不通，心脉支者上挟咽，直者却上肺，故其病
如此，厥逆则水邪侮火，故神伤而恐。恐者，肾志也）肝痹者，夜卧则惊，多饮数小便，上为引如怀（肝受邪则
魂不安宁，故夜卧多惊，闭而为热，故多饮数小便也。上为引者，引饮也。如怀者，腹大如怀物也。木邪侮土，
故为病如此）。肾痹者，善胀，尻以代踵，脊以代头（肾者胃之关，肾痹则邪并及胃，故腹善胀，尻以代踵者，足
不能伸也。脊以代头者，身偻不能直也）。脾痹者，
四肢解惰，发咳呕汁，上为大塞（脾主四肢，又主困倦，故为解惰，土伤则金亦伤，故咳，妻病故夫亦病，故
呕。坤已不升，干金不降，大塞之象也）。肠痹者，数饮而出不得，中气喘争，时发飧泄（肠痹则下焦之气闭而
不行，故数饮而溺不得出，气化不及州都，返而上逆，故喘争也。小便不利，则水液混于大肠，故飧泄也）。胞
痹者，少腹膀胱按之内痛，若沃以汤，涩于小便，上为清涕（胞，溺之脬也。膀胱气闭则水液壅满，故按之内
痛也，气闭则热如汤之沃也。膀胱之脉从巅络脑，故小便下涩，清涕上出也）。
痛者，寒气多也，有寒故痛也（寒则血气凝泣，故痛。《终始》篇曰∶病痛者，阴也）。……病久入深，营
卫之行涩，经络时疏，故不痛（此言病则营卫涩而必痛，其不痛者经络有疏散之时，则不涩，故不痛也）。皮
肤不营，故为不仁（皮肤之间，无血以和之，故不仁也）。……阳气少，阴气多，与病相益，故寒也（痹病本属
阴寒，若阳气不足之人，则寒从内起，与外病相助益，故寒也）。……阳气多，阴气少，病气胜，阳遭阴，故为
痹热（其人阳气素盛，而遭阴寒之气，病气反为阳气胜矣，故为热痹）。其多汗而濡者，此其逢湿甚也，阳气
少，阴气盛，两气相感，故汗出而濡也（两气者，身中之气与外客之气。两气皆阴，互相感召，故汗出。《脉
要精微论》曰阴气有余为多汗身寒是也）。
凡痹之类，逢寒则急，逢热则纵（寒则筋挛，故急。热则筋弛，故纵）。
《痿论》曰∶肺热叶焦，则皮毛虚弱急薄，着则生痿 也（火来乘金，在内为肺叶焦枯，在外为皮毛虚
薄。热气着而不去，则为痿 ， 者，足不能行也）。心气热，则下脉厥而上，上则下脉虚，虚则生脉痿，
枢折挈，胫纵而不任地也（心火上炎，则三阴在下之脉亦厥逆而上，上盛则下虚，乃生脉痿。四肢关节之处如
枢纽之折，而不能提挈。足肿纵缓而不能任地也）。肝气热，则胆泄口苦，筋膜干，筋膜干则筋急而挛，发为
筋痿（肝热则胆亦热，故汁溢而口苦。血海干枯，筋无以荣，则挛急而痿）。脾气热，则胃干而渴，肌肉不仁，
发为肉痿（脾与胃为夫妻，而开窍于口，故脾热则胃干而渴，脾主肌肉，热淫于内，则脾阴耗损，故肉不仁而
为痿）。肾气热，则腰脊不举，骨枯而髓减，发为骨痿（腰者肾之府，脊者肾之所贯也，肾主骨。故骨枯为痿）。
肺者，脏之长也，为心之盖也（肺位至高，故谓之长。覆于心上，故谓之盖），有所失亡，所求不得，则
像有异物梗塞一样，严重时咽喉肿痛、喉痹（手少阴心经的脉气上行挟持咽喉，所以喉咙感觉像被梗塞，到了痹证阶段就会疼痛）。肝咳的症状，咳嗽时两侧胁肋下疼痛，严重时身体不能转动，一转动两侧胁下就胀满（足厥阴肝经的经脉分布在胁肋部，所以胁下疼痛。 ，指胁肋之下）。脾咳的症状，咳嗽时右侧胁下疼痛，隐隐地牵引到肩背部，严重时不能活动，一动就咳嗽加剧（足太阴脾经的脉气上行穿过膈肌并挟持咽喉，它的支脉又从胃部分出上行穿过膈肌，脾脏位于右侧，所以右侧胁下疼痛，疼痛牵引肩背。脾属土，喜静，活动则违背其本性，所以症状加重）。肾咳的症状，咳嗽时腰部和背部相互牵引而痛，严重时咳嗽吐出涎沫（足少阴肾经的经脉贯穿脊柱，联系着腰背，所以相互牵引而痛。肾属水，主管涎液，所以出现咳嗽吐涎的现象）。
五脏久咳不愈，病邪就会传变到六腑。脾咳不止，就会传到胃，形成胃咳，症状是咳嗽伴有呕吐，呕吐严重时会有蛔虫吐出（胃与脾相表里，如同夫妻关系，所以脾咳必然传于胃而导致呕吐痰涎。蛔虫居住在胃中，呕吐剧烈时就会随着气机逆乱而出）。肝咳不止，就会传到胆，形成胆咳，症状是咳嗽并呕吐胆汁（胆汁是苦味的液体）。肺咳不止，就会传到大肠，形成大肠咳，症状是咳嗽时大便失禁（大便失禁是指无法控制排便）。心咳不止，就会传到小肠，形成小肠咳，症状是咳嗽时放屁，气体随着咳嗽一起排出（大肠的气来源于小肠的消化转化，所以小肠咳时气机会通达大肠，导致排气）。肾咳不止，就会传到膀胱，形成膀胱咳，症状是咳嗽时小便失禁（膀胱是贮存津液的器官，所以会出现遗尿）。久咳不愈，就会传到三焦，形成三焦咳，症状是咳嗽伴腹部胀满，不想饮食（久咳会导致上、中、下三焦都患病，全身的气机都逆乱，所以腹部胀满，不能进食饮水）。这些病症都是病邪聚集在胃，关联于肺，使人多涕唾且面部浮肿、气机上逆（病邪聚集在胃，是因为胃是五脏六腑的根本。关联于肺，是因为肺主皮毛。涕唾是由肺和胃所主管的。面部浮肿，是因为气机上逆急促所致）。
《素问·经脉别论》说：夜间行走，喘息之气出于肾，淫溢的病气会伤害肺（夜间属于阴。行走会劳累下半身，且夜间行走多伴有恐惧，所以喘息之气出于肾。肾水受伤，就无法制约心火的炎上，导致肺金受到克制）。如果有坠落惊恐的经历，喘息之气出于肝，淫溢的病气会伤害脾（坠落伤筋损血，惊恐伤神，所以喘息出于肝，肝木克伐脾土，所以伤害脾）。如果有受惊恐惧，喘息之气出于肺，淫溢的病气会伤害心（既惊又恐，会导致气衰神乱。肺主气，心藏神，所以这两脏受伤）。如果渡水跌倒，喘息之气出于肾和骨（水性通于肾，跌仆损伤骨骼，所以喘息由此产生）。在这个时候，体质强健的人气机运行通畅病就好了，体质虚弱的人病邪停留就成为疾病（体质强健的人气血充足、精神健全，所以一时扰动的气机很快就能平复；气血不足的人，随其所受的邪气而成为疾病）。
《素问·腹中论》说：心腹胀满，早上吃了饭晚上就不能再吃……这种病叫做鼓胀（胀得厉害时腹皮绷急，中间空虚没有实物，敲击声音像敲鼓，所以叫鼓胀）……用鸡矢醴治疗，服一剂见效，服两剂痊愈（鸡的胃能消化金石，鸡屎的药性等同于巴豆，能通利二便，消除积滞、降气。但只适合身体壮实的人，虚人服用，灾祸立刻降临。即经文所说的一剂便知有效，两剂便治愈疾病。这也是形容药力猛烈。用法是用干鸡屎一升，炒至微焦，加入无灰酒三碗，煎至减半，取清汁，五更天热饮，就会腹鸣，辰时巳时排出两三次，都是黑水。喝一剂，觉得脚上有皱纹，喝两剂就痊愈了）。
《灵枢·胀论》说：心胀的症状，心烦短气，睡不安稳；肺胀的症状，胸部虚满而喘咳；肝胀的症状，胁下胀满且疼痛牵引小腹；脾胀的症状，容易呃逆，四肢烦闷沉重，身体重得连衣服都穿不动，睡不安稳；肾胀的症状，腹部胀满牵引背部感到困苦不堪，腰部和髋部疼痛（这是五脏的胀病。闷乱称为“ ”，央央是困苦的样子）。
胃胀的症状，腹部胀满，胃脘疼痛，鼻子闻到焦臭味，妨碍进食，大便困难；大肠胀的症状，肠鸣且疼痛如水声，冬天再次感受寒邪，就会发生完谷不化的泄泻；小肠胀的症状，小腹胀满，牵引腰部疼痛；膀胱胀的症状，小腹胀满且小便不通畅；三焦胀的症状，气充满在皮肤之中，轻轻按之但不坚硬；胆胀的症状，胁下疼痛胀满，口苦，喜欢叹气（这是六腑的胀病。濯濯是肠鸣的水声。飧泄是完谷不化。气癃是小便不利）。
厥逆之气在下，营卫之气留滞不行，寒气逆上，真气与邪气相互攻击，两气相搏结，于是合而为胀病（厥逆之气自下而上，导致营卫运行的常规失去节制，真气与邪气相攻，结合而成胀病）。
《灵枢·水胀》篇说：眼睑微微肿胀，像刚睡醒的样子（眼睛下面称为目窠，像刚睡醒者，形状像卧蚕），颈部脉搏跳动，时常咳嗽（颈脉指足阳明胃经的人迎穴。阳明经脉从人迎向下沿腹部内侧，水邪乘袭于此，所以颈脉跳动；水的标象在肺，所以时常咳嗽），大腿内侧发冷，小腿肿胀，腹部才变大，这时水病已经形成。用手按压腹部，随手而起，像包裹着水一样的状态，这是水肿的征候（以上都在讲述水肿的征候）。
肤胀的病，寒气客居在皮肤之间，鼓鼓然但不坚硬，腹部大，全身都肿，皮肤厚（ 是鼓声。寒气客居在皮肤间，阳气不能运行，病在气分，所以有声如鼓。气本来无形，所以不坚硬。气无所不到，所以腹部大、全身肿且皮肤厚），按压腹部，凹陷不起，腹部颜色不变，这是肤胀的征候（气在皮肤之间，按压散开不能立刻恢复，所以凹陷不起。皮肤厚，所以腹部颜色不变）。
〔鼓胀〕腹部胀大，全身也都大，大小与肤胀相等，面色苍黄，腹部青筋暴露，这是鼓胀的征候（鼓胀和肤胀大同小异，只有面色苍黄、腹部青筋暴露作为区别）。
〔肠覃〕寒气客居在肠外，与卫气相搏结，气不能正常营养，因而有所系结，癖积内着，恶气乃生，息肉乃生（覃的意思是延伸分布且深。寒气迫近卫气，停滞不行，留在肠外，所以癖积兴起、息肉生长）。它刚开始生成时，大小像鸡蛋，逐渐增大，直到长成像怀孕的样子，久的超过一年，按压它则坚硬，推动它则移动，月经按时来潮，这是肠覃的征候（离岁是越年的意思。邪气在肠外，不在胞宫，所以不影响月经。这都是由汁沫积聚而成，不是血病，可以知道）。
石瘕生于胞宫中，寒气客居在子门，子门闭塞，气不得通行，恶血应当排泄而不能排泄，瘀血留止，一天天增大，形状像怀孕，月经不能按时来潮，都发生在女子身上，可以用导下法治疗（ 音bù，败血凝聚。子门闭塞，败血留止，其坚如石，所以名叫石瘕。月经不能按时来潮，是没有经血可至，可以用导血的下法。按肠覃、石瘕都提到月经，那么这两个病症只有女人有，所以说都发生在女子身上）。
《素问·平人气象论》说：颈部脉搏跳动，喘息急促咳嗽，这叫做水病（颈脉，是结喉旁边的动脉，足阳明胃经的人迎穴。水气上逆，侵犯阳明，所以颈脉跳动。水溢于肺，所以喘而咳）。眼睑微微肿胀，像卧蚕起的样子，这叫做水病（眼睛下面的肉胞叫做目裹，是胃脉所到达的地方，脾脉所主管的。如果微肿像卧蚕状，是水气侵犯脾胃）。小便黄赤且安卧的，是黄疸（小便色黄赤且安卧自如，必定形成黄疸）。吃完饭却像饿了一样，是胃疸（胃热善于消化食物，所以虽然吃了常常觉得饿，这叫胃疸）。面部浮肿叫做风（风为阳邪，所以说高巅之上，只有风能到达，这就是面肿属于风的原因）。小腿浮肿叫做水（水为阴邪，性质润下，所以足肿，肿的是水）。眼睛发黄是黄疸（各条经络有热都会向上熏蒸于眼睛，所以黄疸病患者眼睛发黄）。
《素问·举痛论》说：经脉流行不止，环周不休，寒气进入经脉导致运行迟缓，涩滞而不行，客居在脉外则血少，客居在脉中则气不通，所以突然疼痛（泣，意思是涩滞而不流利）。
寒气客居在脉外则脉寒，脉寒则收缩拘急，收缩拘急则脉道屈曲紧急，屈曲紧急则向外牵引细小的络脉，所以突然疼痛，得到温热则疼痛立即停止（经脉受寒则收缩，收缩则紧急，所以突然疼痛。然而客居在脉外的，邪气较浅，所以刚得到热气就立即停止）。因为重复受寒，所以疼痛持久（重，是重复受寒的意思。伤得深，所以不容易痊愈）。寒气客居在经脉之中，与热气相搏结则脉满，脉满则疼痛且不可按压。营气行于脉中，血不足的人，脉中常热，新寒与旧热相搏结，则邪气实而脉满，按压则疼痛更甚，所以不可按压。……寒气客居在肠胃之间，膜原之下，血液不得散行，小络紧急牵引所以疼痛。按压则血气散开，所以按压后疼痛停止（膜，指脂膜和筋膜。原，指肓之原，即腹中空隙之处。血凝则小络急痛，按着空处，则寒散络缓，所以疼痛停止。不像经脉那样没有缝隙，按压会更痛）。寒气客居在挟脊的经脉则位置深，按压不能达到，所以按压没有益处（挟脊的是足太阳膀胱经。其中最深的是伏冲、伏膂之脉；所以手按不能触及那里）。寒气客居在冲脉，冲脉起于关元，沿腹部直上，寒气客居则脉不通，脉不通则气随之逆乱，所以喘息且应手可触（冲脉起于胞中，即关元处，其脉并足少阴肾经夹脐上行，会于咽喉，而肾脉上连于肺，受寒则脉不通，气随之逆乱，所以喘息。说“应手”，是因为跳动非常明显）。寒气客居在背俞的经脉，脉道涩滞，脉道涩滞则血虚，血虚则痛，背俞之气注于心，所以相互牵引而痛。按压则热气到达，热气到达则疼痛停止（背俞，是五脏的俞穴，都属于足太阳经穴。太阳经脉循行脊背当心，上出于项，所以寒气客居则脉涩血虚，背与心相互牵引而痛，因为俞穴注于心。血虚而痛，所以按压后疼痛停止）。寒气客居在厥阴经脉，厥阴经脉联络阴器，系于肝脏，寒气客居在脉中，则血涩脉急，所以胁肋与小腹相互牵引疼痛（小腹、胁肋，都是肝的部位）。厥气客居在大腿内侧，寒气上行及于小腹，血液涩滞在下方相互牵引，所以腹痛牵引大腿内侧（厥气，是寒而上逆的气。阴股、小腹，是足三阴经和冲脉经过的地方）。寒气客居在小肠膜原之间，络脉之中，血液涩滞不能注入大经，血气稽留不能运行，所以久而久之形成积块（小肠是受盛之府，化物出焉，寒气客居在膜原及小络，则血涩不能注入大经，化物失职，久而成积）。寒气客居在五脏，厥逆上泄，阴气竭绝，阳气未入，所以突然疼痛昏死不知人，气机回复则生（五脏都受邪气；厥逆而泄越于上，阴气暴竭，阳气未能随即进入，所以突然痛死，或者得到温热，则气机回复而生存）。寒气客居在肠胃，厥逆上出，所以疼痛且呕吐（胃是水谷之海，肠是水谷之道，都主下行。寒邪伤害它们，则逆而上出，所以疼痛且呕吐）。寒气客居在小肠，小肠不能完成受盛的功能，所以后泄腹痛（小肠与丙火为表里，成聚，就是受盛的意思。如果失去受盛的常态，所以泄泻且腹痛）。热气留于小肠，肠中疼痛，湿热焦渴则大便坚硬干燥而不能排出，所以疼痛且闭塞不通（大抵营卫脏腑之间，得热即行，遇冷即凝，所以疼痛多因于寒。这一条唯独言热痛，却是由于便秘不通导致的疼痛，仍然不是火热自行为痛，所以说通则不痛，痛则不通）。
《素问·痹论》说，风寒湿三气杂至，合而为痹病（痹，是闭阻、麻木的意思。六气之中，风寒湿为阴邪。阴气合病，则闭塞成冬季之象。所以血气不流，经络壅闭而痹病产生）。风气胜的叫行痹（风属阴中之阳，善行而数变，所以叫行痹。凡是走注历节疼痛之类的，俗名流火），寒气胜的叫痛痹（阴寒之气乘于肌肉筋骨，则凝涩稽留，闭而不通，所以叫痛痹，即痛风），湿气胜的叫着痹（着痹，重着不移，湿从土化，所以病在肌肉，不在筋骨）。
肺痹的症状，烦闷喘促且呕吐（肺在上焦，经脉循胃口，所以烦闷，喘而且呕）。心痹的症状，脉道不通，心烦则心下悸动，突然上气而喘，咽干喜欢嗳气，厥气上逆则恐惧（脉是心的合应，心受病则脉不通，心脉的支脉上挟咽喉，直行者上连肺，所以病症如此，厥逆则水邪侮火，所以神伤而恐。恐，是肾的情志）。肝痹的症状，夜间睡觉则惊骇，多饮且小便频数，上部牵引如怀物感（肝受邪则魂不安宁，所以夜间多惊，闭而为热，所以多饮频尿。上部牵引，指引饮。如怀，指腹部大如怀物。木邪侮土，所以病症如此）。肾痹的症状，容易腹胀，臀部代替脚跟走路，脊背代替头部直立（肾是胃的关口，肾痹则邪气波及胃，所以腹部易胀。臀部代踵，是脚不能伸直。脊背代头，是身体弯曲不能直立）。脾痹的症状，四肢懈怠，发作咳嗽呕吐涎汁，上部严重痞塞（脾主四肢，又主困倦，所以懈怠，土伤则金亦伤，所以咳，妻病故夫亦病，所以呕。坤土不升，乾金不降，是大痞塞之象）。肠痹的症状，多次饮水而小便排不出，腹中气喘争鸣，时常发生完谷不化的泄泻（肠痹则下焦之气闭而不行，所以多次饮水而溺不得出，气化不及膀胱，反而上逆，所以气喘争鸣。小便不利，则水液混于大肠，所以飧泄）。胞痹的症状，小腹部膀胱部位按压内部疼痛，像被热水浇灌，小便涩滞，上部流出清涕（胞，是尿脬。膀胱气闭则水液壅满，所以按压内部疼痛。气闭则热如热水浇灌。膀胱的经脉从头顶络脑，所以小便下涩，清涕上出）。
疼痛，是因为寒气多，有寒所以痛（寒则血气凝涩，所以痛。《终始》篇说：病痛者，属阴）。……病久入深，营卫运行涩滞，经络有时疏懈，所以不痛（这是说痹病则营卫涩滞而必痛，其不痛的，是因为经络有疏散的时候，就不涩滞，所以不痛）。皮肤得不到营血濡养，所以麻木不仁（皮肤之间，没有血液调和，所以不仁）。……阳气少，阴气多，与病邪相助益，所以寒冷（痹病本属阴寒，若阳气不足的人，则寒从内起，与外病相助益，所以寒冷）。……阳气多，阴气少，病气胜，阳遭阴，所以是热痹（其人阳气素盛，而遭受阴寒之气，病气反为阳气胜，所以是热痹）。那些多汗且湿润的，这是因为逢湿邪严重，阳气少，阴气盛，两气相感，所以汗出而湿润（两气，指体内的气与外客的气。两气皆阴，互相感召，所以汗出。《脉要精微论》说阴气有余为多汗身寒）。
凡是痹病之类，逢寒则筋脉拘急，逢热则筋脉弛纵（寒则筋挛，所以急。热则筋弛，所以纵）。
《素问·痿论》说：肺热叶焦，则皮毛虚弱急薄，附着则生痿躄（火来乘金，在内为肺叶焦枯，在外为皮毛虚薄。热气附着不去，则为痿躄，躄，是脚不能行走）。心气热，则下部脉厥逆而上，上部盛下部虚，下部虚则生脉痿，关节枢纽折断提挈无力，小腿纵缓不能承重（心火上炎，则三阴在下之脉也厥逆而上，上盛则下虚，乃生脉痿。四肢关节之处如枢纽之折，而不能提挈。足肿纵缓而不能承重）。肝气热，则胆汁外泄口苦，筋膜干枯，筋膜干枯则筋脉拘急挛缩，发为筋痿（肝热则胆亦热，所以胆汁溢出而口苦。血海干枯，筋无以荣养，则挛急而痿）。脾气热，则胃干而渴，肌肉麻木不仁，发为肉痿（脾与胃相表里，且开窍于口，所以脾热则胃干而渴，脾主肌肉，热淫于内，则脾阴耗损，所以肉不仁而为痿）。肾气热，则腰脊不能举动，骨骼枯槁而髓减少，发为骨痿（腰是肾之府，脊是肾所贯穿的，肾主骨。所以骨枯为痿）。肺，是五脏之长，为心的盖（肺位至高，所以叫长。覆盖在心上面，所以叫盖），如果有丧失亡失，所求不得，则
Like having a foreign body stuck in the throat, and in severe cases, the throat becomes swollen and painful (Throat Bi / Yan Zhong Hou Bi). The meridians of the Heart ascend and flank the throat, hence the sensation of obstruction in the throat; when it progresses to Bi syndrome, pain occurs.
The manifestation of Liver Cough involves pain in both hypochondriac regions upon coughing, and in severe cases, the body cannot turn; turning causes fullness in the hypochondriac regions. The Liver meridian distributes over the costal and hypochondriac areas, hence the pain under the ribs. "Xia" refers to below the hypochondrium.
The manifestation of Spleen Cough involves pain in the right hypochondriac region upon coughing, with dull pain radiating to the shoulder and back, and in severe cases, movement is restricted; moving exacerbates the cough. The Spleen meridian ascends through the diaphragm and flanks the throat; its branch arises from the stomach, ascends through the diaphragm again. As the Spleen is located on the right, pain occurs in the right hypochondrium, radiating to the shoulder and back. Spleen Earth prefers stillness; movement violates its nature, thus aggravating the condition.
The manifestation of Kidney Cough involves pain in the lower back and back mutually radiating upon coughing, and in severe cases, coughing produces saliva. The Kidney meridian penetrates the spine and connects to the lower back and back, hence the mutual radiation of pain. Kidney belongs to Water and governs saliva, hence coughing with saliva.
When Cough of the Five Zang organs persists for a long time, the pathogen transfers to the Six Fu organs. If Spleen Cough does not cease, the Stomach receives it, resulting in Stomach Cough. Its manifestation is coughing accompanied by vomiting; if vomiting is severe, roundworms may be expelled. The Stomach is the wife of the Spleen (in terms of interior-exterior relationship), so Spleen Cough inevitably transmits to the Stomach, causing vomiting of phlegm-saliva. Roundworms reside in the Stomach and are expelled with the rebellious Qi during severe vomiting.
If Liver Cough does not cease, the Gallbladder receives it, resulting in Gallbladder Cough. Its manifestation is coughing and vomiting bile. Bile is a bitter fluid.
If Lung Cough does not cease, the Large Intestine receives it, resulting in Large Intestine Cough. Its manifestation is coughing with involuntary defecation. "Involuntary defecation" refers to the inability to control bowel movements.
If Heart Cough does not cease, the Small Intestine receives it, resulting in Small Intestine Cough. Its manifestation is coughing with flatus, where gas is expelled simultaneously with the cough. The Qi of the Large Intestine derives from the transformation by the Small Intestine; thus, Small Intestine Cough allows Qi to reach the Large Intestine, leading to flatus.
If Kidney Cough does not cease, the Bladder receives it, resulting in Bladder Cough. Its manifestation is coughing with urinary incontinence. The Bladder is the mansion of fluids, hence urinary incontinence.
If prolonged Cough does not cease, the San Jiao receives it, resulting in San Jiao Cough. Its manifestation is coughing with abdominal fullness and loss of appetite. Prolonged Cough affects the Upper, Middle, and Lower San Jiao, causing rebellion of all Qi in the body, leading to abdominal fullness and inability to eat or drink.
All these conditions gather in the Stomach and relate to the Lung, causing excessive nasal discharge and saliva, facial edema, and rebellious Qi. Gathering in the Stomach occurs because the Stomach is the root of the Five Zang and Six Fu organs. Relating to the Lung occurs because the Lung governs the skin and hair. Nasal discharge and saliva are governed by the Lung and Stomach. Facial edema results from rapid upward rebellion of Qi.
The *Jing Mai Bie Lun* chapter states: Night walking causes panting originating from the Kidney, and excess pathogenic Qi damages the Lung. Night belongs to Yin. Walking fatigues the lower half of the body, and night walking often involves fear, hence panting originates from the Kidney. If Kidney Water is injured, it cannot control the flaming fire, and Lung Metal suffers attack.
Falling and fear cause panting originating from the Liver, and excess pathogenic Qi harms the Spleen. Falling injures sinews and blood, and fear disturbs the spirit, hence panting originates from the Liver. Liver Wood attacks Spleen Earth, hence harming the Spleen.
Fear and fright cause panting originating from the Lung, and excess pathogenic Qi damages the Heart. Both fright and fear cause Qi deficiency and spiritual chaos. The Lung governs Qi, and the Heart stores the Spirit, hence these two organs are injured.
Wading through water and falling cause panting originating from the Kidney and bones. Water energy communicates with the Kidney, and falling injures the bones, hence panting arises here.
At such times, those who are courageous have their Qi flow smoothly and recover, while those who are timid have the pathogen linger and become diseased. Courageous individuals have sufficient Qi and complete Spirit, so the temporarily disturbed Qi quickly returns to normal. Those with insufficiency develop disease according to the pathogen they receive.
The *Fu Zhong Lun* chapter states: Fullness in the heart and abdomen, where one can eat in the morning but not in the evening... is named Drum Distension (Gu Zhang). When distension is severe, the abdominal skin is tight, the center is empty without solid matter, and it sounds like a drum when struck, hence the name Drum Distension. ... It is treated with Ji Shi Li (Chicken Dropping Fermented Liquid). One dose brings noticeable effect, two doses cure. The chicken's stomach can digest metal and stone; its droppings have properties similar to Radix Euphorbiae Humifusae (Ba Dou), promoting urination and defecation, resolving accumulation, and descending Qi. However, it is suitable only for robust individuals; if taken by the deficient, disaster follows immediately. This corresponds to the classic saying that one dose shows efficacy and two doses cure, describing its potency. Usage: Use one sheng of dried chicken droppings, stir-fry until slightly charred, add three bowls of pure wine, decoct until reduced by half, take the clear juice hot at dawn. Abdominal borborygmus will occur, and two to three episodes of black watery stool will pass during Chen and Si hours. After one dose, wrinkles appear on the feet; after two doses, recovery occurs.
The *Ling Shu · Zhang Lun* chapter states: For Heart Distension, there is mental restlessness, shortness of breath, and restless sleep. For Lung Distension, there is empty fullness with panting and cough. For Liver Distension, there is fullness and pain in the hypochondrium radiating to the lower abdomen. For Spleen Distension, there is frequent hiccups, irritability and heaviness in the four limbs, weight such that clothes feel unbearable, and restless sleep. For Kidney Distension, there is abdominal fullness radiating to the back with a sense of distress, and pain in the waist and thighs. These are the distensions of the Five Zang organs. "Man luan" refers to mental confusion; "Yang yang" describes a state of distress.
For Stomach Distension, there is abdominal fullness, epigastric pain, smelling burnt odors in the nose, difficulty eating, and difficult defecation. For Large Intestine Distension, there is borborygmus and gurgling pain; if exposed to cold in winter, there is undigested food diarrhea. For Small Intestine Distension, there is lower abdominal distension radiating to the back with pain. For Bladder Distension, there is lower abdominal fullness and strangury (difficulty urinating). For San Jiao Distension, Qi fills the skin, feeling light but not firm. For Gallbladder Distension, there is pain and distension in the hypochondrium, bitter taste in the mouth, and frequent sighing. These are the distensions of the Six Fu organs. "Zhuo zhuo" refers to the sound of water in the intestines. "Sun xie" refers to undigested food diarrhea. "Qi long" refers to difficult urination.
Jue Qi (Rebellious Cold Qi) stays below, Ying and Wei Qi stagnate, Cold Qi rebels upward, True Qi and Pathogenic Qi attack each other, and the two energies collide, forming Distension. Rebellious Qi rising from below disrupts the normal course of Ying and Wei Qi; True Qi and Pathogenic Qi clash, combining to form Distension.
The *Ling Shu · Shui Zhang* chapter states: Slight swelling above the eyes, resembling the appearance after waking up (the area below the eye is called Mu Ke; resembling post-waking sleep, the shape resembles a silkworm lying down), pulsation of the neck vessels, and occasional coughing. The neck vessel refers to Ren Ying, an acupoint of Foot Yangming Stomach Meridian. The Yangming meridian descends from Ren Ying along the inside of the abdomen; Water Evil attacks here, causing neck vessel pulsation. The exterior sign of Water is in the Lung, hence occasional coughing. Coldness in the inner thigh, swelling of the calves, and subsequent abdominal enlargement indicate that Water Disease has formed. Pressing the abdomen causes the skin to rise immediately, resembling a bag of water; this is its sign. All the above describe signs of Edema.
Skin Distension (Fu Zhang) occurs when Cold Evil lodges between the skin. The abdomen is distended but not firm, the whole body is swollen, and the skin is thick. " " denotes a drum-like sound. Cold Evil lodging in the skin prevents Yang Qi from circulating; the disease is in the Qi level, hence drum-like sounds. Qi is inherently formless, hence not firm. Qi reaches everywhere, hence abdominal distension, whole-body swelling, and thick skin. Pressing the abdomen leaves an indentation that does not rebound immediately, and the abdominal color remains unchanged; this is its sign. Qi between the skin disperses upon pressure and cannot quickly restore, hence the indentation persists. Thick skin keeps the abdominal color unchanged.
[Drum Distension] Abdominal distension and general bodily enlargement are equal to Skin Distension, but the complexion is greenish-yellow, and abdominal veins are prominent; this is its sign. Drum Distension and Skin Distension are largely similar, distinguished only by greenish-yellow complexion and prominent abdominal veins.
[Intestinal Polyp (Chang Tan)] Cold Evil lodges outside the intestines, colliding with Wei Qi. Qi fails to nourish, becoming bound, leading to fixed masses and internal adherence. Evil Qi arises, and flesh polyps grow. "Tan" implies extending deeply. Cold Evil presses on Wei Qi, stagnating and failing to move, remaining outside the intestines, hence masses arise and polyps grow. Initially, it is as large as a chicken egg, gradually enlarging until it resembles pregnancy. Long-standing cases exceed a year. Pressing makes it hard; pushing moves it. Menstruation proceeds on time; this is its sign. "Li sui" means exceeding a year. The pathogen is outside the intestines, not in the uterus, so menstruation is unaffected. This is clearly due to the accumulation of juices, not blood disease.
Stone Mass (Shi Xia) arises in the uterus. Cold Evil lodges in the Zi Men (cervical os), blocking it. Qi cannot pass, and evil blood should be discharged but is retained. The mass grows daily, resembling pregnancy. Menstruation does not proceed on time. It occurs only in women and can be treated with draining methods. "Bu" refers to coagulated败血 (decayed blood). Zi Men blockage causes blood retention, hard as stone, hence Stone Mass. Menstrual irregularity indicates no menses are present; blood-draining agents can be used to purge it. Since Chang Tan and Shi Xia both mention menstruation, these two syndromes occur only in women, hence "arising in women."
The *Ping Ren Qi Xiang Lun* chapter states: Pulsation of the neck vessels, rapid panting, and urgent cough indicate Water Disease. The neck vessel is the arterial pulse beside the thyroid cartilage, Ren Ying of Foot Yangming Stomach Meridian. Water Qi rebelling upward invades Yangming, causing neck pulsation. Water overflowing into the Lung causes panting and cough. Slight swelling of the eye bags, resembling silkworms, indicates Water Disease. The lower eyelid is called Mu Guo, where Stomach Meridian arrives and Spleen Meridian governs. Slight swelling like silkworms indicates Water Evil invading Spleen and Stomach. Yellow-red urine with preference for lying down indicates Jaundice. Urine yellow-red with comfortable lying down indicates Jaundice formation. Feeling hungry after eating indicates Stomach Jaundice. Stomach heat digests food rapidly, causing hunger despite eating. Swelling of the face indicates Wind. Wind is a Yang pathogen; thus, "only Wind can reach the high summit," explaining facial swelling as Wind-related. Swelling of the calves indicates Water. Water is a Yin pathogen with moistening and downward-flowing nature; hence foot swelling is Water. Yellow eyes indicate Jaundice. Heat in all meridions steams upward to the eyes, hence jaundiced eyes.
The *Ju Tong Lun* chapter states: Meridian Qi flows endlessly in cycles. Cold Evil entering meridians causes delay and stagnation. Lodging outside meridians reduces Blood; lodging inside blocks Qi, causing sudden pain. "Qi" means sluggish and unsmooth.
Cold Evil lodging outside meridians causes meridian cold, contraction, and cramping. Contraction leads to tension, pulling small collaterals, causing sudden pain. Pain stops immediately with warmth. Meridians contracting from cold cause sudden pain. Since the pathogen is superficial (outside meridians), pain stops upon receiving warmth. Repeated exposure to Cold causes prolonged pain. "Chong" means repeated Cold injury. Deep injury is hard to cure.
Cold Evil lodging inside meridians clashes with Warmth, causing fullness. Fullness causes pain that cannot be pressed. Ying Qi flows in meridians; in Blood-deficient persons, meridians are often hot. New Cold clashing with old Heat creates Excess and Meridian Fullness. Pressing worsens pain, hence it cannot be pressed.
Cold Evil lodging between the stomach/intestines and Mo Yuan (membranous origin) prevents Blood dispersion. Tight small collaterals cause pain. Pressing disperses Qi and Blood, stopping pain. "Mo" refers to fatty membranes and fascia. "Yuan" is the source of Huang (tri-jiao cavity), i.e., hollow spaces in the abdomen. Blood coagulation causes collateral tension and pain. Pressing hollow areas dissipates Cold and relaxes collaterals, stopping pain. Unlike meridians without gaps, pressing here relieves pain.
Cold Evil lodging in the paraspinal meridians is deep; pressing cannot reach it, so pressing is ineffective. Paraspinal refers to Foot Taiyang Bladder Meridian. The deepest are Fu Chong and Fu Lv meridians; hand pressing cannot reach them.
Cold Evil lodging in the Chong Mai (Penetrating Vessel), which originates at Guan Yuan and ascends straight up the abdomen, blocks the vessel. Blockage causes Qi rebellion, leading to panting palpable to the touch. Chong Mai originates in the uterus (Guan Yuan), runs alongside Foot Shaoyin Kidney Meridian up the umbilicus, meets at the throat, and Kidney Meridian connects to the Lung. Cold blocks the vessel, causing Qi rebellion and panting. "Palpable" indicates strong pulsation.
Cold Evil lodging in Back-Shu meridians causes stagnation and Blood deficiency, leading to pain. Shu points connect to the Heart, causing mutual radiation of pain. Pressing brings Heat, stopping pain. Back-Shu points are Foot Taiyang acupoints corresponding to the Five Zang. Taiyang meridian follows the spine, passes the heart, and emerges at the nape. Cold causes stagnation and Blood deficiency, leading to back-heart pain via Shu connection. Blood deficiency pain stops with pressing-induced Heat.
Cold Evil lodging in Jueyin Meridian (Liver Pericardium), which connects to genitalia and anchors in the Liver, causes Blood stagnation and meridian tension. This leads to mutual radiation of pain between the hypochondrium and lower abdomen. Hypochondrium and lower abdomen are Liver territories.
Jue Qi lodges in the inner thigh. Cold Qi ascends to the lower abdomen. Blood stagnation below causes mutual radiation, leading to abdominal pain radiating to the inner thigh. Jue Qi is Cold rebelling upward. Inner thigh and lower abdomen are Foot Three Yin and Chong Mai pathways.
Cold Evil lodging in Small Intestine Mo Yuan and collaterals causes Blood stagnation, preventing entry into major meridians. Qi and Blood stagnate, forming masses over time. Small Intestine is the mansion of reception and transformation. Cold in Mo Yuan and small collaterals causes Blood stagnation, impairing transformation, leading to masses.
Cold Evil lodging in the Five Zang causes Jue rebellion and upper leakage. Yin Qi exhausts, Yang Qi fails to enter, causing sudden pain, death-like coma, and unconsciousness. Recovery of Qi leads to survival. All Five Zang suffer pathogens; Jue rebellion leaks upward, causing sudden Yin exhaustion and delayed Yang entry, leading to coma. Warmth restores Qi and life.
Cold Evil lodging in Stomach/Intestines causes Jue rebellion upward, leading to pain and vomiting. Stomach is the sea of water/grain; Intestines are the channels. Both govern downward movement. Cold injury causes upward rebellion, hence pain and vomiting.
Cold Evil lodging in Small Intestine prevents "Cheng Ju" (completion/reception), causing diarrhea and abdominal pain. Small Intestine pairs with Bing Fire. "Cheng Ju" means reception/transformation. Loss of function causes diarrhea and pain.
Heat staying in Small Intestine causes intestinal pain. Damp-heat scorching and thirst lead to dry, hard stool impaction, causing pain and constipation. Generally, Qi/Blood/Zang/Fu move with Heat and congeal with Cold, so pain is usually Cold-related. This case is Heat pain due to constipation, not Fire self-pain. Hence, "Unblocked means no pain; pain means blockage."
The *Bi Lun* chapter states: Wind, Cold, and Dampness mix to form Bi Syndrome. "Bi" means closure and numbness. Among Six Qi, Wind, Cold, Damp are Yin pathogens. Yin combination creates Winter-like closure, stopping Blood/Qi flow, obstructing collaterals, and generating Bi.
Wind predominance causes Moving Bi (Xing Bi). Wind is Yin-within-Yang, agile and changing, hence Moving Bi. This includes wandering joint pain, commonly called "Flowing Fire."
Cold predominance causes Painful Bi (Tong Bi). Yin-Cold attacking muscles/sinews/bones causes stagnation and closure, hence Painful Bi, i.e., Gout.
Damp predominance causes Fixed Bi (Zhuo Bi). Fixed Bi is heavy and immobile. Damp transforms from Earth, affecting muscles rather than sinews/bones.
Lung Bi manifests as chest fullness, panting, and vomiting. Lung is in Upper Jiao; meridian circles the stomach, causing fullness, panting, and vomiting.
Heart Bi manifests as blocked meridians. Mental agitation causes palpitations below the heart. Sudden upward Qi and panting, dry throat, frequent belching. Jue Qi rebellion causes fear. Pulse reflects Heart; Heart disease blocks pulses. Branches flank throat and connect to Lung, causing these symptoms. Jue rebellion (Water insulting Fire) damages Spirit, causing fear. Fear is Kidney emotion.
Liver Bi manifests as nightmares/fright during sleep, polydipsia, and frequent urination. Upper牵引 (radiation) resembles pregnancy. Liver邪 disturbs Hun (Ethereal Soul), causing night frights. Closure generates Heat, causing thirst and frequent urination. "Upper radiation" refers to drinking desire. "Ru huai" means abdominal distension like pregnancy. Wood insulting Earth causes these symptoms.
Kidney Bi manifests as frequent abdominal distension. The sacrum replaces the heels, and the spine replaces the head. Kidney is the gate of Stomach; Bi spreads to Stomach, causing distension. "Sacrum replacing heels" means inability to extend legs. "Spine replacing head" means kyphosis/inability to stand straight.
Spleen Bi manifests as limb flaccidity, coughing, vomiting of juices, and severe upper obstruction. Spleen governs limbs and fatigue, hence flaccidity. Earth injury injures Metal, causing cough. Wife illness affects husband (Stomach), causing vomiting. Kun Earth fails to ascend, Qian Metal fails to descend, causing severe obstruction.
Intestinal Bi manifests as frequent drinking but inability to urinate, mid-abdominal wheezing/conflict, and intermittent undigested food diarrhea. Intestinal Bi closes Lower Jiao Qi, preventing urination. Qi fails to transform in Bladder, rebelling upward, causing wheezing. Urinary difficulty mixes fluids with Large Intestine, causing diarrhea.
Bladder Bi (Bao Bi) manifests as internal pain upon pressing lower abdomen/Bladder, feeling like hot water pouring, dysuria, and clear nasal discharge above. Bao is the bladder sac. Qi closure causes fluid stasis and internal pain. Heat feels like boiling water. Bladder meridian connects brain to vertex; lower dysuria causes upper clear discharge.
Pain is caused by excess Cold; presence of Cold causes pain. Cold coagulates Blood/Qi, causing pain. *Zhong Shi* chapter says: Painful diseases are Yin.
Long-standing disease enters deep; Ying/Wei flow becomes sluggish. Collaterals occasionally loosen, so pain ceases. Bi disease usually causes pain due to sluggish Ying/Wei. Lack of pain occurs when collaterals loosen, preventing stagnation.
Skin lacking nourishment causes numbness (Bu Ren). Lack of Blood harmony in skin causes numbness.
Yang deficiency and Yin excess compound the disease, causing Cold. Bi is inherently Yin-Cold. In Yang-deficient persons, internal Cold aids external pathology, causing Cold sensations.
Yang excess and Yin deficiency, with Pathogenic Qi prevailing, create Heat Bi. Person with inherent Yang excess encounters Yin-Cold; Pathogenic Qi becomes Yang-dominant, causing Heat Bi.
Profuse sweating and dampness occur when encountering severe Dampness. Yang deficiency and Yin excess cause mutual induction, leading to sweating and dampness. "Two Qi" refers to internal Qi and external pathogen. Both Yin induce each other, causing sweat. *Mai Yao Jing Wei Lun* states: Excess Yin causes profuse sweating and body cold.
Generally, Bi syndromes contract with Cold and relax with Heat. Cold causes sinew spasm (contraction); Heat causes sinew relaxation.
The *Wei Lun* chapter states: Lung Heat scorches leaves, weakening skin/hair, leading to Wei Bi (paralysis). Fire insulting Metal scorches Lung internally and weakens skin/hair externally. Lingering Heat causes Wei Bi. "Bi" means inability to walk.
Heart Heat causes lower meridians to rebel upward, creating upper excess and lower deficiency, leading to Mai Bi (vessel paralysis). Joint hinges break, unable to lift; calves relax, unable to bear weight. Heart Fire flares, reversing Three Yin meridians upward. Upper excess/lower deficiency causes Mai Bi. Limb joints break like hinges; feet relax, unable to support weight.
Liver Heat causes Gallbladder bile leakage and bitter taste. Sinews dry, becoming tense and contracted, leading to Jin Wei (sinew paralysis). Liver Heat heats Gallbladder, leaking bile (bitter taste). Blood Sea dries, sinews lose nourishment, becoming tense and paralyzed.
Spleen Heat causes Stomach dryness and thirst. Muscles become numb, leading to Rou Wei (muscle paralysis). Spleen/Stomach are paired, opening at mouth. Spleen Heat dries Stomach (thirst). Spleen governs muscles; internal Heat consumes Yin, causing muscle numbness and paralysis.
Kidney Heat causes inability to raise waist/spine. Bones wither, Marrow decreases, leading to Gu Wei (bone paralysis). Waist is Kidney mansion; spine is penetrated by Kidney. Kidney governs bones; bone withering causes paralysis.
Lung is the Chief of Zang organs and Cover of Heart. Lung is highest, hence "Chief." Covers Heart, hence "Cover." If losses occur or desires remain unfulfilled, then