人身非常温也，非常热也。为之热而烦满者，（非素所有，故曰非常。）阴气少而阳气胜，故热而烦满
也。（阴虚者阳必凑之。阳邪实于阴分，故热而烦满。）人身非衣寒也，中非有寒气也。（寒
从中生者，无所因而寒者，寒生于中也。）是人多痹气也。阳气少，阴气多，故身寒如从水中出。（痹者，
正气不行也。阳少阴多，则荣卫不能充达，故寒从中生，所谓寒痹之属。）人有四肢热，逢风寒如灸
如火者，（凡有内热而风寒外束之，则热必愈盛，故如灸如火也。）是阴气虚，阳气盛。四肢者，阳也，两阳
相得而阴气虚少，少水不能灭盛火，而阳独治。（四肢者，诸阳之本也。风者，阳气也。以四
肢之热，而逢风于外，是谓两阳相得，况乎阴气衰少，则水不胜火，故病为阳独治，治言王也。）独治者，不
能生长也，独胜而止耳。（阳独治者，孤阳也，故不能生长而止能为热耳。）逢风而如灸如火者，是人
当肉烁也。（肉者，阴也。阳盛则伤阴，故令人肌肉消烁。）人有身寒，汤火不能热，浓衣不能温，然不冻
栗，是为肾气素胜，以水为事，太阳气衰，肾脂枯不长，一水不能胜两火。肾者水也，
而生于骨，肾不生则髓不能满，故寒甚至骨也。（肾气素胜者，必恃胜而多欲，故以水为事。太阳者，少
阴之表，阴中之阳也。欲多则精伤于肾而脂枯不长，脂枯则水不胜火，火胜则肾水愈虚，骨髓不充，气涸
于内，故寒甚至骨也。）所以不能冻栗者，肝，一阳也，心，二阳也，肾，孤脏也，一水不能胜二火，故不
能冻栗，病名曰“骨
痹”，是人当挛节也。（肝有少阳之相火，心为少阴之君火，肾，一水也。一水已竭，二火犹存，是阴气已
虚于中，而浮阳独胜于外，故身骨虽寒而不至冻栗，病名“骨痹”。然水不胜火，则筋骨皆失所滋，故肢节
当为拘挛。）人之肉苛者，虽近于衣絮，犹尚苛也，是谓何疾？（苛者，顽水沉重之谓。苛，音呵。）是为营
气虚，卫气实也。营气虚则不仁，卫气虚则不用，营卫俱虚则不仁且不用，肉如故也。人身与志不相有曰“
死”。（不仁，不知痛痒寒热也。不用，不能举动也。荣气者，阴气也，主里；卫气者，阳气也，主表，上
言卫气实者，言肌肉本无恙也；下言卫气虚者，正言卫气之病也。营卫俱虚，则血气俱病，
血虚故为不仁，气虚故为不用。人之身体在外，五志在内，虽肌肉如彼，而神气失守，则外虽有形而中已
无主，若彼此不相有也，故当死。）有病热而有所痛者也。病热者，阳脉也，以三阳之动也。（阳脉者，
火邪也。凡病热者必因于阳，故三阳之脉，其动甚也。）人迎─盛少阳，二盛太阳，三盛阳明。入阴也。（人
迎，足阳明脉，所以候阳也，人迎一盛，病在足少阳，一盛而躁，病在手少阳；人迎二盛，病在足太阳。
二盛而躁，病在手太阳；人迎三盛，病在足阳明，三盛而躁，病在手阳明也。凡邪热在表，三阳既毕，则入
于阴分矣。）夫阳入于阴，故病在头与腹，乃 胀而头痛也。（头主阳，腹主阴。阳邪在头则头痛，及其
入于阴分，则腹为 胀也。）
有五脏六腑寒热相移者也。（相移者，以此病而移于彼也。）肾移寒于脾，痈肿少气；（肾中寒气移于
脾者，乃为痈肿。凡痈肿之病，寒热皆能为之。热者为阳毒，寒者为阴毒。盖脾主肌肉，得寒则气聚而坚，
坚而不散，则为肿为痈也，曰“痈”者；壅也。肾以寒水之气，反传所胜，侵侮脾土，故壅为浮肿。少气者，
寒盛则阳虚于下，阳虚则无以化气也。）脾移寒于肝，痈肿筋挛；（脾中寒胜，则反传于肝。脾寒则肉寒，故
为痈肿。肝寒则筋寒，故为筋挛。）肝移寒于心，狂，膈中；（肝移寒
于心，传其所生也。心主火，其藏神。受肝邪之寒逆，故神乱而为狂。心脉出属心系，下膈，阳为阴抑则气
有不行，故隔寒不通也。）心移寒于肺，肺消，肺消者，饮一溲二，死不治；（心与肺，二阳脏也。心
移寒于肺者，君火之衰耳。火不足，则不能温养肺金，肺气不温，则不能行化津液，故饮虽一而溲则倍之。
夫肺者，水之母也，水去多则肺气从而索矣，故曰“肺消”。门户失守。本元日竭，故死不能治。）肺移寒于肾，
为涌水，涌水者，按腹不坚，水气客于大肠，疾行则鸣濯濯，如囊裹浆水之病也。（涌水者，水自下而上，
如泉之涌也。水者，阴气也，其本在肾，其末在肺。肺移寒于肾，则阳气不化于下，阳气不化则水
泛为邪而客于大肠，以大肠为肺之合也。但按腹不坚而肠中濯濯有声者，即是其候。）
脾移热于肝，则为惊衄；（上文言“移寒”，此下言“移热”也。脾热移于肝者，反传其胜，热之甚
也。肝藏血，病主惊骇，邪热薄之则风火交作，故为惊，为鼻中出血也。）肝移热于心，则死；（心本属火，
而肝以风热移之，木火相燔，犯及君主，故当死也。）心移热于肺，传为膈消；（肺属金，其化本燥，心复以
热移之，则燥愈甚而传为膈消。膈消者，膈上焦烦，饮水多而善消也。上文言肺消者因于寒，此言膈消者因
于热，可见消有阴阳二症，不可不辨。）肺移热于肾，传为柔 ；（柔，筋软无力也。 ，骨强直也。肺主
气，肾主骨，肺肾皆热，则真阴日消，故传为柔 。 ，音翅。）肾移热于脾，传为虚肠 ，死不可治；（肾移
热于脾者，阴火上炎也。邪热在下，真阴必亏，故传为虚损。肾本水脏，而挟热侮脾，故为肠 下利脓血。
阴虚反克，则水土俱败，故死不治也。）胞移热于膀胱，则癃溺血；（胞，子宫也，在男则为精室，在女则为
血室。膀胱，津液之府也，俗名谓之“溲胞”。命门火盛，则胞宫移热于膀胱，故小便不利为癃，甚则为溺
血。常见相火妄动，逆而不通，多患此者，即其证也，胞，包，脬二音。在“胞胎”之“胞”则音胞，“溲
胞”之“胞”则音
脬。）膀胱移热于小肠，膈肠不便，上为口糜；（膀胱之热上行，则移热于小肠。小肠之脉，循咽下膈，抵
胃，其支者循颈上颊，故受热为膈肠之病则痞塞不便，受热于咽颊之间则上为口糜。）小肠移热于大肠，
为瘕，为沉；（小肠之热下行，则移热于大肠，热结不散，或气或血，留聚于曲折之处，是为 瘕， 瘕
者，谓其隐伏秘匿，深沉不易取也。 、伏同。）大肠移热于胃，善食而瘦，又谓之“食亦”。（大肠移热于
胃，燥热之气上行也，故善于消谷。阳明主肌肉，而热烁之，则虽食亦病而瘦，所以谓之“食亦”。）胃移
热于胆，亦曰“食亦”；（阳明胃热而移于胆，则木火合邪，不生脾土，故亦当善食而瘦。）胆移热于脑，则辛
鼻渊，鼻渊者，浊涕下不止也，（胆经之脉，起于目锐 ，上抵头角，下耳后，曲折布于脑后，故胆移热于
脑，则为辛 鼻渊之病，辛，酸辛也。 ，音遏，鼻茎也。）传为衄蔑瞑目。（脑热不已，则传为此症。
衄、 ，皆为鼻血，但甚者为衄，微者为 。热伤阴血则目无所养，故令瞑目，以羞明不能开也。 ，音灭。）
故得之气厥也。（厥者，气逆也。此总结一篇之义，皆由气逆所致。）
乳子而病热，脉悬小者，手足温则生，寒则死。（乳子，婴儿也，病热脉悬小者，阳症阴脉，本为大
禁，但小而缓者，邪之微也，其愈则易，小而急者，邪之甚也，为可虑耳，以小儿稚阳之体，而加之病热。
脉不当小。若脉虽小而手足温者，以四肢为诸阳之本，阳犹在也，故生；若四肢寒冷，则邪胜其正，元阳去
矣，故死。谓从者手足温，逆者手足寒也。）乳子中风热，喘鸣肩息者，脉实大也，缓则生，急则死。（
此言小儿之外感也。风热中于阳分，为喘鸣肩息者，脉当实大。但大而缓则胃气存，邪渐退，故生；实而急
则真脏见，病日进，故死，此见古人之诊小儿者，未尝不重在脉也，即虽初脱胞胎，亦自有脉可辨，何后世
幼科如《水镜诀》及《全幼心鉴》等书，别有察三关之说，于脉则全置不问？夫三关乃手阳明之浮络，原
不足以候脏腑之气，且凡在小儿，无论病与不病，
此脉皆紫白而兼乎青红，虽时有浓淡之异，而四色常不相离也。何以辨其紫为风，红为寒，青为惊，白为疳？
又何以辨其雷惊、人惊、水惊、兽惊之的确乎？近代医家，习以为常，全不知脉，欲济其危，胡可得也？遍考
并无三关名目，惟经脉有察手鱼之色者，若乎近之。然乃概言诊法，亦非独为小儿也。则三关之说，特后世
之异端，不足凭也。故凡欲诊小儿者，在必察气口之脉，面部之色，呼吸之声，或兼察手鱼亦可也。且小儿之脉；
原非大方之比，不必多歧，但求于大、小、缓、急、虚、实六者之间，可
以尽之。诊得其真，取如反掌，既明且易，岂不愈于彼哉！）
人身并非恒定处于温热状态，也并非恒定处于寒冷状态。出现发热且伴有烦闷胀满症状的，（因为这不是身体原本就有的常态，所以称为“非常”。）这是由于阴气不足而阳气偏胜，所以出现发热和烦闷胀满。（阴虚则阳气必然乘袭。阳邪实盛于阴分，所以导致发热和烦闷胀满。）
人体并非因为穿衣少而感到寒冷，体内也没有寒气内生。（寒从内部产生的情况，是指没有外感诱因而产生的寒冷，即寒生于中。）这类人大多有痹气阻滞。由于阳气少、阴气多，所以身体寒冷，感觉像从水中出来一样。（痹，是指正气运行不畅。阳气少而阴气多，则营卫之气不能充盈通达，所以寒冷从内部产生，这属于寒痹一类。）
有的人四肢发热，遇到风寒时感觉像被火灸或火烧一样，（凡是体内有热而风寒在外部束缚，那么内热必定更加旺盛，所以感觉像被火灸或火烧一样。）这是阴气虚弱，阳气盛实。四肢属阳，两阳相合而阴气虚少，就像少量的水不能扑灭旺盛的火，导致阳气独旺。（四肢是诸阳之本。风也属阳。以四肢之热，再遭遇外来的风邪，这就叫“两阳相得”，何况阴气衰少，水不胜火，所以病表现为阳独治，“治”意为王、盛。）所谓“独治”，是不能生长化育的，只是单独的亢盛罢了。（阳独治就是孤阳，所以不能生长化育，只能表现为热。）遇到风邪就像被火灸火烧一样，这样的人肌肉会消烁。（肉属阴。阳盛则伤阴，所以使人肌肉消烁。）
有的人身体寒冷，喝热水、用火烧都不能使其温暖，穿厚衣服也不能使其暖和，但是并不发抖战栗，这是因为肾气素来强盛，从事耗损肾精的活动，导致太阳经气衰弱，肾脂枯竭不能生长。一水不能胜过两火。肾属水，主生骨，肾不生则骨髓不能充满，所以寒冷甚至深入骨髓。（肾气素胜的人，一定倚仗其强盛而多欲，所以从事耗损肾精的事。太阳经是少阴经的表，是阴中之阳。欲望多则肾精受伤而肾脂枯竭不长，肾脂枯竭则水不胜火，火胜则肾水更虚，骨髓不充，气枯竭于内，所以寒冷甚至深入骨髓。）之所以不冻栗，是因为肝是一阳，心是二阳，肾是孤脏，一水不能胜过二火，所以不能冻栗，这种病名叫“骨痹”，这样的人关节应当拘挛。（肝有少阳相火，心为少阴君火，肾为一水。一水已竭，二火犹存，这是阴气已在内部虚弱，而浮阳独胜于外部，所以身骨虽寒但不至于冻栗，病名“骨痹”。然而水不胜火，筋骨都失去滋养，所以肢节应当发生拘挛。）
人的肌肉沉重麻木，即使靠近棉絮，仍然感到沉重麻木，这是什么病？（苛，是指顽重沉重的意思。苛，音呵。）这是营气虚，卫气实。营气虚则感觉迟钝（不仁），卫气虚则运动障碍（不用），营卫俱虚则既感觉迟钝又运动障碍，肌肉依然如故。人身与神志不相维系叫做“死”。（不仁，是指不知痛痒寒热。不用，是指不能举动。营气是阴气，主里；卫气是阳气，主表。上文说卫气实，是说肌肉本身无病变；下文说卫气虚，正是说卫气的病变。营卫俱虚，则血气俱病，血虚故为不仁，气虚故为不用。人的身体在外，五志在内，虽然肌肉那样，但神气失守，则外虽有形而中已无主，若彼此不相拥有，所以当死。）
有病发热而且疼痛的。病发热的，脉象属阳，因为三阳经气发动。（阳脉，指火邪。凡病发热的必因于阳，所以三阳之脉，其搏动很剧烈。）人迎脉大一倍病在少阳，大二倍病在太阳，大三倍病在阳明。邪气入阴。（人迎穴，足阳明胃经动脉，用来候阳气。人迎脉大一倍，病在足少阳胆经，一倍而躁动，病在手少阳三焦经；人迎脉大二倍，病在足太阳膀胱经。二倍而躁动，病在手太阳小肠经；人迎脉大三倍，病在足阳明胃经，三倍而躁动，病在手阳明大肠经。凡邪热在表，三阳经病遍后，则进入阴分。）
阳气入于阴分，所以病在头部和腹部，于是腹胀而头痛。（头主阳，腹主阴。阳邪在头则头痛，等到它进入阴分，则腹部胀满。）
有五脏六腑寒热相互传移的病。（相移，是指以此病传到彼处。）肾将寒邪移于脾，出现痈肿、少气；（肾中寒气移于脾者，就成为痈肿。凡痈肿的病，寒热都能造成。热的是阳毒，寒的是阴毒。大概脾主肌肉，得到寒气则气聚而坚硬，坚硬而不散，就成为肿成为痈，叫“痈”；就是壅塞的意思。肾以寒水之气，反传所克制的脾土，侵侮脾土，所以壅塞成为浮肿。少气，是因为寒盛则下焦阳虚，阳虚则无法化生元气。）脾将寒邪移于肝，出现痈肿、筋挛；（脾中寒胜，则反传于肝。脾寒则肉寒，所以为痈肿。肝寒则筋寒，所以为筋挛。）肝将寒邪移于心，出现狂证、膈中寒阻；（肝将寒邪移于心，是传其所生的脏。心主火，藏神。受到肝邪之寒逆，所以神乱而为狂。心脉出属心系，下膈，阳为阴抑则气有不行，所以膈寒不通。）心将寒邪移于肺，出现肺消，肺消病，喝一份尿两份，死不治；（心与肺，都是阳脏。心移寒于肺者，是君火衰微。火不足，则不能温养肺金，肺气不温，则不能行化津液，所以喝一份水而尿两份。肺是水之母，水去多则肺气随之枯竭，所以叫“肺消”。门户失守，本元日竭，所以死不能治。）肺将寒邪移于肾，出现涌水，涌水病，按腹部不坚硬，水气客于大肠，快走时肠鸣濯濯，像囊裹浆水的病。（涌水，是水自下而上涌出，像泉水涌出一样。水是阴气，其本在肾，其末在肺。肺移寒于肾，则阳气不化于下，阳气不化则水泛为邪而客于大肠，因为大肠是肺的合腑。只要按腹部不坚硬而肠中濯濯有声，就是其征候。）
脾将热邪移于肝，则出现惊骇、鼻衄；（上文讲“移寒”，这里讲“移热”。脾热移于肝者，是反传其克制之脏，热势很盛。肝藏血，病主惊骇，邪热迫之则风火交作，所以为惊，为鼻出血。）肝将热邪移于心，则死；（心本属火，而肝以风热移之，木火相燔，侵犯君主之官，所以当死。）心将热邪移于肺，传变为膈消；（肺属金，其化本燥，心复以热移之，则燥更甚而传为膈消。膈消，是膈上焦烦，饮水多而善消。上文讲肺消是因于寒，这里讲膈消是因于热，可见消渴有阴阳两种病症，不可不辨别。）肺将热邪移于肾，传变为柔疰（柔痉）；（柔，指筋软无力。疰，指骨强直。肺主气，肾主骨，肺肾皆热，则真阴日消，所以传为柔疰。疰，音翅。）肾将热邪移于脾，传变为虚损肠澼，死不可治；（肾移热于脾者，是阴火上炎。邪热在下，真阴必亏，所以传为虚损。肾本是水脏，而挟热侮脾，所以为肠澼下利脓血。阴虚反克，则水土俱败，所以死不治也。）胞宫将热邪移于膀胱，则出现小便不利溺血；（胞，子宫也，在男性则为精室，在女性则为血室。膀胱，是津液之府，俗名叫做“溲胞”。命门火盛，则胞宫移热于膀胱，所以小便不利为癃，严重时则为溺血。常见相火妄动，逆而不通，多患此病，就是其证候。胞，包，脬三个音。在“胞胎”之“胞”则读胞，在“溲胞”之“胞”则读脬。）膀胱将热邪移于小肠，出现膈肠不便，上部出现口糜；（膀胱之热上行，则移热于小肠。小肠之脉，循咽下膈，抵胃，其支者循颈上颊，所以受热为膈肠之病则痞塞不便，受热于咽颊之间则上部出现口糜。）小肠将热邪移于大肠，出现瘕积、沉疝；（小肠之热下行，则移热于大肠，热结不散，或气或血，留聚于曲折之处，是为瘕积。瘕积，谓其隐伏秘匿，深沉不易取也。瘕、伏同义。）大肠将热邪移于胃，食欲旺盛但身体消瘦，又叫“食亦”。（大肠移热于胃，是燥热之气上行，所以善于消化谷物。阳明主肌肉，而热烁之，则虽然进食也多而消瘦，所以叫“食亦”。）胃将热邪移于胆，也叫“食亦”；（阳明胃热而移于胆，则木火合邪，不生脾土，所以也应当食欲旺盛而消瘦。）胆将热邪移于脑，则出现辛螫鼻渊，鼻渊病，是浊涕下流不止，（胆经之脉，起于目锐眦，上抵头角，下耳后，曲折布于脑后，所以胆移热于脑，则为辛螫鼻渊之病。辛，酸辛也。螫，音遏，鼻茎也。）传变为鼻衄、目盲瞑目。（脑热不已，则传为此症。衄、螫，皆为鼻血，但严重者为衄，轻微者为螫。热伤阴血则目无所养，所以令瞑目，因羞明不能睁开。螫，音灭。）
所以这些病都是由气厥引起的。（厥，是气逆的意思。这是总结全篇的意义，都是由气逆所致。）
婴儿患热病，脉象悬小的，手足温暖则生，手足寒冷则死。（乳子，婴儿也，病热脉悬小者，是阳症见阴脉，本来是大禁忌，但如果脉小而缓，说明邪气微，痊愈容易；如果脉小而急，说明邪气甚，值得忧虑。因为小儿是稚阳之体，又加上病热，脉不应当小。如果脉虽小而手足温，因为四肢是诸阳之本，阳气还在，所以生；如果四肢寒冷，则邪胜其正，元阳离去，所以死。谓顺证者手足温，逆证者手足寒。）
婴儿患风热，喘鸣肩息者，脉象实大，脉缓则生，脉急则死。（此言小儿之外感。风热中于阳分，为喘鸣肩息者，脉应当实大。但大而缓则胃气存，邪气渐退，所以生；实而急则真脏脉现，病日进，所以死。此见古人之诊小儿者，未尝不重在脉，即使刚脱离胞胎，也有脉可辨，为何后世幼科如《水镜诀》及《全幼心鉴》等书，别有察三关之说，对于脉诊完全置问不顾？夫三关乃是手阳明之浮络，原本不足以候脏腑之气，而且凡在小儿，无论病与不病，此脉皆紫白而兼乎青红，虽时有浓淡之异，而四色常不相离也。何以辨其紫为风，红为寒，青为惊，白为疳？又何以辨其雷惊、人惊、水惊、兽惊之的确乎？近代医家，习以为常，全不知脉，想要救济其危，怎么可能呢？遍考并无三关名目，惟经脉有察手鱼之色者，似乎接近。然乃概言诊法，亦非独为小儿也。则三关之说，特后世之异端，不足凭也。所以凡欲诊小儿者，在必察气口之脉，面部之色，呼吸之声，或兼察手鱼亦可也。且小儿之脉，原非大方之比，不必多歧，但求于大、小、缓、急、虚、实六者之间，可以尽之。诊得其真，取效如反掌，既明且易，岂不愈于彼哉！）
The human body is not constantly in a state of warmth, nor is it constantly in a state of cold. When heat arises accompanied by vexation and fullness, (because this is not the body's original constant state, it is termed "abnormal".) This occurs due to insufficient Yin Qi and an excess of Yang Qi, resulting in heat and vexation/fullness. (When Yin is deficient, Yang inevitably encroaches. When pathogenic Yang is excessive in the Yin aspect, it causes heat and vexation/fullness.)
The body does not feel cold merely from lack of clothing, nor is there internal cold generated within. (Cold generated from within refers to cold arising internally without external causative factors.) Such individuals often have Bi Qi (obstructive Qi). Because Yang Qi is scarce and Yin Qi is abundant, the body feels cold as if emerging from water. (Bi refers to the stagnation of healthy Qi. With little Yang and much Yin, Ying and Wei Qi cannot fill and reach the extremities, so cold generates from within; this belongs to the category of Cold Bi.)
Some individuals experience heat in the four limbs, feeling as if being moxibustioned or burned when encountering wind and cold. (Whenever there is internal heat constrained externally by wind and cold, the internal heat must become even more intense, hence the sensation of burning or moxibustion.) This indicates deficient Yin Qi and excessive Yang Qi. The four limbs belong to Yang; when two Yangs combine while Yin Qi is deficient, it is like a small amount of water failing to extinguish a raging fire, leading to Yang dominating exclusively. (The four limbs are the root of all Yang meridians. Wind also belongs to Yang. Heat in the four limbs combined with external wind constitutes "two Yangs combining." Given the deficiency of Yin, water cannot overcome fire, thus the pathology manifests as Yang dominating exclusively; "dominating" here means flourishing.) "Exclusive domination" implies an inability to generate and nourish; it is merely solitary hyperactivity. (Solitary Yang domination is isolated Yang, thus unable to generate and nourish, manifesting only as heat.) Encountering wind with sensations of burning or moxibustion indicates that the person's flesh will emaciate. (Flesh belongs to Yin. Excess Yang injures Yin, causing muscle emaciation.)
Some individuals suffer from body coldness that cannot be warmed by hot drinks or fire, nor by thick clothing, yet they do not shiver. This is because Kidney Qi was originally strong, but through excessive sexual activity ("engaging in water affairs"), the Taiyang Qi has declined, and Kidney essence/fluid is dried up and fails to grow. One water cannot overcome two fires. The Kidney belongs to Water and generates bone; if the Kidney fails to function, marrow will not fill, resulting in cold penetrating to the bone. (Those with originally strong Kidney Qi likely indulged excessively, damaging Kidney essence until fluid/essence dries up. Taiyang is the exterior of Shaoyin, Yang within Yin. Excessive desire damages Kidney essence, leading to dried-up essence where water cannot overcome fire. Fire excess further depletes Kidney Water, leaving marrow unfilled and Qi dried internally, causing cold to reach the bone.) The reason for not shivering is that the Liver is one Yang, the Heart is two Yangs, and the Kidney is a solitary organ; one water cannot overcome two fires, hence no shivering. This disease is named "Bone Bi," and such individuals should expect joint contracture. (The Liver contains Shaoyang Ministerial Fire, the Heart is Shaoyin Sovereign Fire, and the Kidney is one Water. With one Water exhausted and two Fires remaining, Yin is deficient internally while floating Yang dominates externally. Thus, although bones feel cold, shivering does not occur. Named "Bone Bi," since water cannot overcome fire, tendons and bones lose nourishment, leading to joint contracture.)
When a person's muscles feel heavy and numb, still feeling heavy even near cotton wadding, what disease is this? (He represents a sense of heaviness and numbness. He, pronounced 'he'.) This is due to deficient Ying Qi and solid/excess Wei Qi. Deficient Ying Qi leads to anesthesia (loss of sensation); deficient Wei Qi leads to paralysis (loss of movement); if both Ying and Wei are deficient, there is both anesthesia and paralysis, while the muscles remain unchanged. If the body and spirit are disconnected, it is termed "death." (Anesthesia means insensitivity to pain, itching, cold, and heat. Paralysis means inability to move. Ying Qi is Yin, governing the interior; Wei Qi is Yang, governing the exterior. The earlier mention of "solid Wei Qi" referred to the muscles themselves being unaffected; the later mention of "deficient Wei Qi" specifically addressed Wei Qi pathology. When both Ying and Wei are deficient, blood and Qi are both diseased; blood deficiency causes anesthesia, Qi deficiency causes paralysis. The body is external, the Five Wills are internal. Even if muscles appear normal, if Spirit/Qi loses its residence, the exterior has form but the interior lacks a master, appearing disconnected, thus leading to death.)
There are diseases involving heat accompanied by pain. Diseases with heat present involve Yang pulses, due to the activity of the Three Yang meridians. (Yang pulse indicates Fire pathogen. All heat diseases stem from Yang, hence the Three Yang pulses beat vigorously.) If the Renying pulse is one-fold larger, the disease is in Shaoyang; two-folds larger, in Taiyang; three-folds larger, in Yangming. It enters the Yin. (Renying is the artery of the Foot-Yangming Stomach meridian, used to observe Yang. One-fold enlargement indicates disease in Foot-Shaoyang Gallbladder; if rapid/agitated, Hand-Shaoyang Sanjiao. Two-folds indicates Foot-Taiyang Bladder; if agitated, Hand-Taiyang Small Intestine. Three-folds indicates Foot-Yangming Stomach; if agitated, Hand-Yangming Large Intestine. Once pathogenic heat traverses the Three Yang at the exterior, it enters the Yin aspect.) Since Yang enters Yin, the disease affects the head and abdomen, causing abdominal distension and headache. (Head governs Yang, Abdomen governs Yin. Yang pathogen in the head causes headache; upon entering Yin, the abdomen becomes distended.)
There are conditions where cold and heat transfer between the Zang and Fu organs. (Transfer means the disease moves from one organ to another.) If Kidney transfers cold to Spleen, carbuncles/swellings and shortness of breath occur. (Kidney cold transferring to Spleen causes carbuncles. Carbuncles can result from both cold and heat. Heat constitutes Yang toxin, cold constitutes Yin toxin. Spleen governs flesh; cold causes Qi to gather and harden. Hardness without dispersion results in swelling or carbuncle. "Carbuncle" implies obstruction. Kidney's cold water energy retrogressively attacks the conquered Spleen Earth, causing obstructive edema. Shortness of breath occurs because severe cold causes lower Jiao Yang deficiency, preventing Qi transformation.) If Spleen transfers cold to Liver, carbuncles and tendon spasms occur. (Spleen cold excess transfers to Liver. Spleen cold chills the flesh, causing carbuncles. Liver cold chills the tendons, causing spasms.) If Liver transfers cold to Heart, mania and chest obstruction occur. (Liver cold transferring to Heart is transmission to the generated organ. Heart governs Fire and houses Spirit. Receiving Liver's counter-flow cold disrupts Spirit, causing mania. Heart vessels connect to the heart system and pass through the diaphragm; Yang suppressed by Yin prevents Qi flow, causing cold obstruction in the chest.) If Heart transfers cold to Lung, Lung Xiao (Lung Consumption) occurs. In Lung Xiao, drinking one part results in urinating two parts; this is incurable and fatal. (Heart and Lung are both Yang organs. Heart transferring cold to Lung indicates decline of Sovereign Fire. Insufficient Fire fails to warm Lung Metal; unwarmed Lung Qi cannot transform fluids, so one drink yields double urine. Lung is the mother of Water; excessive fluid loss exhausts Lung Qi, hence "Lung Xiao." Loss of gatekeeping and daily depletion of Yuan Essence lead to death.) If Lung transfers cold to Kidney, Yong Shui (Gushing Water) occurs. In Yong Shui, pressing the abdomen reveals no hardness; water Qi lodges in the Large Intestine, making a gurgling sound when walking quickly, resembling a bag containing watery fluid. (Yong Shui is water surging upward like a spring. Water is Yin Qi, rooted in Kidney, ending in Lung. Lung cold transferring to Kidney prevents Yang Qi transformation below; untransformed Yang leads to water flooding as pathogen lodging in Large Intestine, which is the Interior-Exterior pair of Lung. Abdominal softness with intestinal gurgling confirms the diagnosis.)
If Spleen transfers heat to Liver,惊 (startle/fright) and epistaxis occur. (Previous text discussed "transferring cold"; this discusses "transferring heat." Spleen heat transferring to Liver is counter-transmission to the conquering organ, indicating intense heat. Liver stores Blood; pathology involves fright. Pathogenic heat provokes Wind-Fire interaction, causing startle and nosebleed.) If Liver transfers heat to Heart, death ensues. (Heart inherently belongs to Fire; Liver transferring Wind-Heat creates Wood-Fire combustion, attacking the Sovereign Organ, leading to death.) If Heart transfers heat to Lung, it transmits to Ge Xiao (Diaphragm Consumption). (Lung belongs to Metal, naturally dry. Heart transferring heat increases dryness, transmitting to Ge Xiao. Ge Xiao involves upper jiao vexation, excessive thirst, and rapid consumption. Earlier, Lung Xiao was caused by cold; here, Ge Xiao is caused by heat, showing Xiao Ke has Yin and Yang types requiring differentiation.) If Lung transfers heat to Kidney, it transmits to Rou Ji (Soft Spasm). (Rou means weak/tender tendons. Ji means stiff bones. Lung governs Qi, Kidney governs Bone. Heat in both Lung and Kidney consumes True Yin daily, transmitting to Rou Ji. Ji, pronounced 'chi'.) If Kidney transfers heat to Spleen, it transmits to Xu Chang Pi (Deficiency Intestinal Dysentery), which is fatal and incurable. (Kidney heat transferring to Spleen is Ministerial Fire flaring upward. Lower pathogenic heat depletes True Yin, causing deficiency. Kidney is Water organ but harasses Spleen with heat, causing bloody/purulent diarrhea. Yin deficiency counter-attacking leads to collapse of Water and Earth, hence fatal.) If Bao Gong (Uterus/Womb) transfers heat to Bladder, Long (difficulty urinating) and hematuria occur. (Bao Gong is uterus; in males, Jing Shi; in females, Xue Shi. Bladder is the mansion of fluids,俗称 "Su Pao". Mingmen Fire excess causes Bao Gong heat to transfer to Bladder, causing dysuria (Long) or hematuria. Commonly seen with reckless Ministerial Fire causing obstruction. Bao, Bao, Pao have different pronunciations. In "Bao Tai" it is 'bao'; in "Su Pao" it is 'pao'.) If Bladder transfers heat to Small Intestine, ge chang bu bian (diaphragmatic/intestinal obstruction) and kou mi (oral ulceration/mucosal erosion) occur above. (Bladder heat ascending transfers to Small Intestine. Small Intestine vessels follow the throat, pass through diaphragm, reach stomach, branch to neck/cheek. Heat causes obstruction/stagnation in diaphragm/intestines and oral mucosal erosion in throat/cheeks.) If Small Intestine transfers heat to Large Intestine, Zha (masses) and Chen (deep masses) occur. (Small Intestine heat descending transfers to Large Intestine. Heat accumulation persists, Qi or Blood stagnates in convoluted areas, forming Zha/Zhi masses. Zha implies hidden/deep masses difficult to retrieve. Zha/Fu share meaning.) If Large Intestine transfers heat to Stomach, polyphagia with emaciation occurs, called "Shi Yi". (Large Intestine heat transferring to Stomach is dry-heat ascending, promoting grain digestion. Yangming governs flesh; heat scorches it, causing eating yet wasting, hence "Shi Yi".) If Stomach transfers heat to Gallbladder, it is also called "Shi Yi". (Stomach Yangming heat transferring to Gallbladder combines Wood-Fire, failing to generate Spleen Earth, causing polyphagia and emaciation.) If Gallbladder transfers heat to Brain, Xin Bi Yuan (stinging nasal sinusitis) occurs. Bi Yuan is continuous discharge of turbid mucus. (Gallbladder vessels originate at outer eye corner, ascend to head angle, descend behind ear, spread around brain. Gallbladder heat transferring to brain causes stinging Bi Yuan. Xin means pungent/acrid. Yuan, pronounced 'e', refers to nasal cartilage.) Transmission leads to Nu Mie (nosebleed) and ming mu (blindness/dazzled eyes). (Unrelenting brain heat transmits to these symptoms. Nu and Mie are both nosebleeds; severe is Nu, mild is Mie. Heat injuring Yin blood deprives eyes of nourishment, causing dazzled eyes/unability to open due to photophobia. Mie, pronounced 'mie'.)
Thus, all these arise from Qi Jue. (Jue means Qi reversal. This summarizes the chapter: all result from Qi reversal.)
If an infant suffers from heat disease and the pulse is suspended and small, survival depends on warm hands and feet; cold hands and feet indicate death. (Infant with heat and suspended-small pulse presents Yang syndrome with Yin pulse, generally a major contraindication. However, small and slow indicates mild pathogen, easy recovery; small and rapid indicates severe pathogen, concerning. Infants have tender Yang bodies; heat disease should not present small pulse. If pulse is small but hands/feet are warm, since limbs are root of Yang, Yang remains, so life; if limbs cold, pathogen overcomes Zheng, Yuan Yang departs, so death. Warmth follows, coldness opposes.) If infant contracts Wind-Heat with wheezing and shoulder breathing, pulse should be substantial and large. Slow pulse indicates life; rapid pulse indicates death. (This addresses pediatric exterior contraction. Wind-Heat invading Yang causes wheezing/shoulder breathing, requiring substantial-large pulse. Large-slow indicates Stomach Qi remains, pathogen receding, so life; substantial-rapid indicates True Zang pulse appearing, disease progressing, so death. Ancient physicians emphasized pulse diagnosis in infants, even newborns. Why do later pediatric texts like *Shui Jing Jue* and *Quan You Xin Jian* rely solely on observing the Three Passages (San Guan) and ignore pulses? San Guan are superficial collaterals of Hand-Yangming, insufficient for observing Zang-Fu Qi. In infants, regardless of illness, these pulses are purple-white mixed with cyan-red, varying in intensity but always coexisting. How to distinguish purple as Wind, red as Cold, cyan as Fright, white as Malnutrition? Or specific fright types? Modern practitioners accept this habitually, ignoring pulse diagnosis, making crisis rescue impossible. No ancient texts mention "Three Passages"; only observing color at hand fish (Thenar eminence) is similar, but this is general diagnosis, not exclusive to pediatrics. Thus, San Guan theory is a later heterodoxy, unreliable. To diagnose infants, one must observe Qi Kou pulse, facial color, respiration sound, or optionally hand fish color. Infant pulses differ from adults; simplicity is key. Distinguishing Large/Small, Slow/Rapid, Deficient/Substantial covers all. Accurate diagnosis yields quick results, clear and easy, superior to other methods.)