有或左或右，偏虚为跛者，应三阳不足于下也。足太阳下行之脉，循髀 ，下出外踝之后，故有是
证。跛，补火切。）所谓强上引背者，阳气大上而争，故强上也。（太阳之脉，下项挟背，若阳气大上而争，
则与三阳之气上升者同，故为强上引背也。）所谓耳鸣者，阳气万物，盛上而跃，故耳鸣也。
（太阳支者，从巅至耳上角，阳邪上盛，故为耳鸣也。）所谓甚则狂巅疾者，阳尽在上，而阴气从下，下
虚上实，故狂巅疾也。（巅，癫同。所谓甚者，言阳邪盛也。阳邪实于阳经则阳尽在上，阴气在下，上
实下虚，故当为狂癫之病。）所谓浮而聋者，皆在气也。（阳实于上则气壅为聋，亦以其脉至耳也。）
所谓入中为喑者，阳盛已衰，故为喑也。（声由气发，气者阳也。阳盛则声大，阳虚则声微。若阳盛已衰，
故喑 不能言也。）内夺而厥，则为喑俳，此肾虚也。（俳，废也。内夺者，夺其精也。精夺则气夺而厥，
故声喑于上，体废于下。元阳大亏，病本在肾，肾脉上挟舌本，下走足心，故为是病。俳，当作“痱”，音
沸。）少阴不至者厥也。（此释上文“内夺而厥”之义也。少阴者，肾脉也，与太阳为表里。若肾气内夺则
少阴不至。少阴不至者，以阴虚无气，无气则阳衰致厥之由也。）少阳所谓心胁痛者，言少阳盛也。盛者，心
之所表也。（少阳之脉，下胸中，循胁里，故心胁痛者，言少阳之邪盛
也，然少阳属木，木以生火，故邪之盛者其本在胆，其表在心。表者，标也。）九月阳气尽而阴气盛，故
心胁痛也。（胆有相火，心有君火，火墓在戌，阳不胜阴则心胁为痛，故应九月之气。）所谓不可反侧者，
阴气藏物也。物藏则不动，故不可反侧也。（阴邪凝滞，藏伏阳中，喜静恶动，故反侧则痛。）所谓甚则
跃者，九月万物尽衰，草木毕落而堕，则气去阳而之阴，气盛而阳之下长，故谓跃。
（九月万物尽衰，草木毕落，是天地之气去阳而之阴也。人身之气亦然，故盛于阴分则所长在下。其有病为
跳跃者，以足少阳脉下出足之外侧，阴覆于上，阳鼓于下也，故应九月之气。）阳明所谓洒洒振寒者，阳
明者，午也，五月，盛阳之阴也，阳盛而阴气加之，故洒洒振寒也。（五月阳气明盛，故曰“阳明”。夏至
一阴初生，加以阳极之候，故病洒洒振寒者，以阳明应五月之气也。）所谓胫肿而股不收者，是五月盛阳
之阴也。阳者衰于五月，而一阴气上，与阳始争，故胫肿而股不收也。（足阳明脉；下髀关，抵伏兔，下
膝胫足附，入中趾内间。若阴生于下，上与阳争，则为胫肿而股不收，亦应五月一阴之气。）所谓上
喘而为水者，阴气下而复上，上则邪客于脏腑间，故为水也。（阳明土病则不能制水，故阴邪自下而上，客
于脏腑之间，乃化为水。水之本在肾，末在肺，标本俱病，故为上喘也。）所谓胸痛少气者，水
气在脏腑也。水者，阴气也。阴气在中，故胸痛少气也。（邪气之阴，非真阴也。阴邪在中，故为胸痛；
阴盛则阳衰，故为少气，少气则气短而喘矣。）所谓盛则厥，恶人与火，闻木音则惕然而惊者，阳气与阴气相
薄，水火相恶，故惕然而惊也。（薄，气相迫也。阴阳之气，正则相和，邪则相恶。阴邪薄于阳明，故惕然
而惊也。）所谓欲夺闭户牖而处者，阴阳相薄也。阳尽而阴盛，故欲独闭户牖而居。（阴邪盛则阳明之衰，故
欲静也。）所谓病至则欲乘高而歌，弃衣而走者，阴阳复争而外并于阳，故使之弃衣而走也。
（寒邪外并阳，则身热多躁，故弃衣而走。）所谓客孙脉则头痛、鼻鼽、腹肿者，阳明并于上，上者，则其孙
络太阴也，故头痛、鼻鼽、腹肿也。（寒邪客于阳明，则在头为痛，在鼻为鼽，在腹为肿，以阴
气上行而并于本经之孙络，故为是病。此太阴者，言阴邪之盛，非太阴经之谓也。）太阴所谓病胀者，太阴，
子也，十一月万物气皆藏于中，故曰“病胀”。（阴极于子，万物皆藏，故曰∶“太阴，子也。”太
阴之经入腹，凡邪藏于中，则病为胀，故应十一月之气。）所谓上走心为噫者，阴盛而上走于阳明，阳明络属
心，故曰“上走心为噫”也。（脾脉络胃，故阴邪盛则上走于阳明，阳明之正，上通于心，故上走心为
噫。寒气客于胃，厥逆从下上散，复出于胃，故为噫。兼而言之，寒气犯于心、脾、胃三经，俱能为噫也。）
所谓食则呕者，物盛满而上溢，故呕也。（脾胃相为表里，胃受水谷，脾不能运，则物盛满而溢，故为
呕。）所谓得后与气，则快然如衰者，十一月阴气下衰，而阳气且出，故曰“得后与气，则快然如衰”也。（
后，谓大便。气，谓转失气。阳气出则阴邪散，故快然如衰。一阳下动，冬至候也，故应十
一月之气。）少阴所谓腰痛者，少阴者，肾也，十月万物阳气皆伤，故腰痛也。（腰者肾之府，寒邪入肾则
为腰痛，纯阴在下，故应十月之气。）所谓呕、咳、上气、喘者，阴气在下，阳气在上，诸阳气浮，
无所根据从，故呕、咳、上气、喘也。（阴阳互倚，若阴中无阳，沉而不升，则孤阳在上，浮而不降，无所
根据从，故为呕、咳、上气、喘也。肺主气，肾主精，精虚则气不归元也。）所谓邑邑不能久立，久坐，
起则目KT KT 无所见者，万物阴阳不定，未有主也。秋气始至，微霜始下，而方杀万物，阴阳内夺，故目
KTKT 无所见也。（邑邑，不安貌。秋气至，微霜下，万物俱衰，阴阳未定，故内无所主而坐
起不常，目则KT KT 无所见，以阴肃阳衰，精气内夺，故应深秋十月之候。）
所谓少气、善怒者，阳气不治，阳气不治则阳气不得出，肝
气当治而未得，故善怒。善怒者，名曰“煎厥”。（阳和不治，则肝气多逆，不能调达，故善怒而为煎厥。
所谓多阴者多怒也。按，煎厥有阴阳虚实二证，不似臂厥之以脉所经处同名也。）所谓恐，如人将捕
之者，秋气万物，未有毕去，阴气少，阳气入，阴阳相薄，故恐也。（阴气，言肾气也；阳气，言邪气也，阴气将藏
未藏，而阳邪入之，阴阳相薄，则伤肾而为恐，故亦应秋气。）所谓恶闻食臭者，胃无
气，故恶闻食臭也。（胃无气，胃气败也。胃气所以败者，肾为胃关，肾中真火不足，不能温养化原，故
胃气虚而恶闻食臭也。此即饥不欲食之义。）所谓面黑如地色者，秋气内夺，故变于色也。（色以应日，阳气
之华也。阴胜于阳则面黑色变，故应秋气，此即“面如漆柴”之义。）所谓咳则有血者，阳脉伤也。阳气
未盛于上而脉满，满则咳，故血见于鼻也。（阳脉伤者。上焦之脉伤也。阳气未盛于上而脉满，则所满
者皆寒邪也。盖肾脉上贯肝膈，入肺中，故咳则血见于口，衄则血见于鼻也。）厥阴所谓 疝，妇人少腹肿
者，厥阴者，辰也，三月阳中之阴邪在中，故曰“ 疝、少腹肿”也。（辰，季春也。五阳一阴，
阴气将尽，故属厥阴。阴邪居于阳末则为 疝、少腹肿，故应三月之气。）所谓腰脊痛，不可以俯仰者，
三月一振，荣华万物，一俯而不仰也。（三月一振，阳气振也，故荣华万物。然余寒尚在，若阴气或胜。
则阳屈俯而不仰，故病为腰脊痛，亦应三月之气。）所谓 、癃疝、肤胀者，曰阴亦盛而脉胀不通，故曰“ 、
癃疝”也。（此复明癃疝肿胀之由，在阴邪盛也。阴盛则阳气不行，故为此诸症。）所谓甚则嗌干、热中者
，阴阳相薄而热，故嗌干也。（所谓盛者，应三月之阳盛也。阳邪盛则薄于阴分，故为嗌干、热中等病。）
足阳明之脉病，恶人与火，闻木音则惕然而惊，钟鼓不为动。阳明者，胃脉也，胃者土也，故闻木音而
惊者，土恶木也。（脉即经也。木能克土，故恶之。）其恶火，阳明主肉，其脉血
气盛，邪客之则热，热甚则恶火。（阳明经多气多血，邪客之则血气壅而易为热，热则恶火也。）
其恶人，阳明厥则喘而惋，惋则恶人。（阳明气逆而厥，则为喘惋。惋，忧惊也，故恶人之烦扰。）或喘而
死者，或喘而生者，如厥逆连脏则死，连经则生也。（连脏者败及三阴，故死；连经则肌表之疾耳，故生。）
病甚则弃衣而走，登高而歌，或至不食数日，逾垣上屋，所上之处，皆非其素所能也，病反能者也。（
凡癫狂伤寒家多有此证。）四肢者，诸阳之本也，阳盛则四肢实，实则能登高也。其弃衣而走者，热甚于身，
故弃衣欲走也。（阳明主肌肉，故热甚于身。）其妄言骂詈，不避亲疏而歌者，阳盛则使人妄言骂詈，
不避亲疏而不欲食，不欲食，故妄走也。（阳盛者，阳邪盛也。阳明为多气多血之经，而阳邪实之，阳之
极也，阳气者，静则神藏，躁则消亡，故神明乱而病如是，詈，音利。）
太阴、阳明为表里，脾、胃脉也。生病而异者，由夫阴阳异位，更虚更实，更逆更从，或从内，或从外，
所从不同，故病异名。（脾为脏，阴也。胃为腑，阳也。阳主外，阴主内，阳主上，阴主下，是“阴阳异
位”也。阳虚则阴实，阴虚则阳实，是“更虚更实”也。病者为逆，不病者为从，是“更逆更从”也。凡
此者，皆所从不同，故病亦异名。）阳者，天气也，主外；阴者，地气也，主内。（胃属三阳，
故主天气；脾属三阴，故主地气。）阳道实，阴道虚。（阳刚阴柔也。又外邪多有余，故阳道实；内伤多
不足，故阴道虚。一曰阴道实则阳道虚矣，所谓“更虚更实”也。）故犯贼风虚邪者阳受之，饮食不节起居不时
者阴受之，阳受之则入六腑，阴受之则入五脏。（贼风虚邪，外伤也，故阳受之而入腑；饮食起居，内伤也，
故阴受之而入脏。）入六腑则身热，不时卧，上为喘呼；入五脏则 满闭塞，下为飧泄，久为肠 ，（不时卧，
不能以时卧也。阳邪在表在上，故为身热、不
卧、喘呼，阴邪在里在下，故为 满，飧泄、肠 。）喉主天气，咽主地气。（喉为肺系，所以受气，
上通于天；咽为胃系，所以受水谷，下通于地。）故阳受风气，阴受湿气。（风，阳气也，故阳分受之；湿，
阴气也，故阴分受之，各从其类也。）阴气从足上行至头，而下行循臂至指端；阳气从手上行至头，而下行
至足。（手之三阴，从脏走手；手之三阳，从手走头；足之三阳，从头走足∶足之三阴，从足走腹。
盖阴气在下，下者必升；阳气在上，上者必降。脾阴胃阳，气皆然也。）故阳病者，上行极而下；阴病者，
下行极而上。（阳病极则及于下，阴病极则及于上，极则变也。非惟上下，表里亦然。）伤于风者，上
先受之；伤于湿者，下先受之。（阳受风气，故上先受之；阴受湿气，故下先受之。然上非无湿，下非无
风，但受有先后耳。曰“先受之”，则后者可知矣。）脾病而四肢不用，四肢皆禀气于胃，而不得至
经，必因于脾，乃得禀也。（此下言胃气必因脾气乃得行也。）今脾病不能为胃行其津液，四肢不得禀
水谷气，气日以衰，脉道不利，筋骨肌肉皆无气以生，故不用焉。（四肢之举动，必赖胃气以
为用，然胃气不能自至于诸经，必因脾气之营运，则胃中水谷之气化为津液，乃得及于四肢也。若脾病则
胃气不行，故各经脉道日以衰微而四肢不为用矣。）盖脾与胃，以膜相连，而能为之行其津液故也。（此下
言三阴三阳之脉，皆禀于脾胃之气也。）足太阴者，三阴也。其脉贯胃，属脾，络嗌，故太阴为之行气
于三阴。（为之者，为胃也。脾脉贯胃属脾，足太阴也，故为之行气于三阴。三阴者，五脏之谓。）阳明
者，表也，五脏六腑之海也，亦为之行气于三阳。（阳明者，太阴之表也，主受水谷，以溉脏腑，故为五脏
六腑之海。虽阳明行气于三阳，然亦赖脾气而后行，故曰“亦”也。三阳者，即六腑也。）脏腑各因其经，
而受气于阳明，故为胃行其津液。（因其经，因脾经也。脏腑得禀于阳明者，以脾经贯胃，故能为胃行其津液也。
）四肢不得禀水谷气，
日以益衰，阴道不利，筋骨肌肉无气以生，故不用焉。（阴道，血脉也。此复明脾主四肢之义，至深切矣。）
诊病之始，五决为纪。（五决者，察五脏决死生，为诊病之纲纪也。）欲知其始，先建其母。（始，
病之始也。建，立也。母，病之因也。不得其因，则标本弗辨，故当先建其母，如下文“某脏”，“某经”
之谓。）所谓五决者，五脉也。（五脉者，五脏之脉也。）是以头痛巅疾，下虚上实，过在足少阴、巨阳，
甚则入肾。（头痛巅疾，实于上也。上实者因于下虚，其过在肾与膀胱二经，盖足太阳之脉从巅络脑，而肾
与膀胱为表里，阴虚阳实，故为是病，甚则腑病已而入于脏，则肾独受伤矣。） 蒙招尤，目瞑耳聋，下实
上虚，过在足少阳、厥阴，甚则入肝。（ ，当作“ ”。蒙，茫昧也。招，掉摇也。尤，无定也。目无光
则蒙昧不明，头眩动则招尤不定，甚至目瞑者不能视，耳聋者无所闻，其过在肝胆之气实于下而虚于上也。
有的患者出现身体左右偏侧虚弱导致跛行，这是由于三阳经（太阳、阳明、少阳）下部阳气不足所致。足太阳膀胱经下行至大腿后侧，向下经过外踝后方，因此会出现这种病症。（跛，补火切。）所谓头项强直牵引背部拘急，是因为阳气过度上逆并与阴气相争，所以导致头项强直。（足太阳经脉，下行至颈部并夹持脊柱两侧，如果阳气过度上逆相争，就会与三阳经之气上升的趋势相同，因此表现为头项强直牵引背部。）所谓耳鸣，是因为阳气像万物一样，旺盛向上跳跃，所以引起耳鸣。（足太阳经的支脉，从头顶行至耳上角，阳邪在上部盛实，所以导致耳鸣。）所谓病情严重发展为狂证或癫疾的，是因为阳气全部壅滞于上部，而阴气沉伏于下部，形成下虚上实的局面，所以发生狂证和癫疾。（“巅”通“癫”。所谓“甚”，是指阳邪盛实。阳邪实于阳经则阳气全部壅滞于上部，阴气在下部，上实下虚，所以应当发生狂证和癫疾。）所谓脉浮且耳聋的，都是由于气机壅滞所致。（阳气实于上部则气机壅塞导致耳聋，也是因为足太阳经脉上行至耳的缘故。）所谓邪气入里导致失音的，是因为阳气盛极之后衰退，所以导致失音。（声音由气发出，气属于阳。阳气盛则声音洪大，阳气虚则声音微弱。如果阳气盛极已衰，所以失音不能说话。）内部精气被夺损而导致厥逆，就会出现失音和下肢废用，这是肾虚的表现。（“俳”意为废用。内夺，是指耗夺肾精。精气被夺则气也随之衰竭而发生厥逆，所以上部声音嘶哑，下部肢体废用。元阳大亏，病本在肾，肾脉上行夹持舌根，下行至足心，所以发生这种病。“俳”应作“痱”，音同“沸”。）少阴经气不至就会导致厥逆。（这是对上文“内夺而厥”含义的解释。少阴即肾脉，与足太阳膀胱经互为表里。如果肾气内部被夺损，则少阴经气不至。少阴经气不至的原因，是阴虚无气，无气则导致阳气衰弱而发生厥逆。）少阳经所说的胁肋疼痛，是说少阳经邪气盛实。盛实，反映在心（因为心为少阳之表）。（足少阳胆经，下行穿过胸中，沿胁肋内部行走，所以胁肋疼痛，是说少阳邪气盛实。然而少阳属木，木能生火，所以邪气盛实的根本在胆，其标表在心。表，指标也。）九月时阳气尽而阴气盛，所以出现胁肋疼痛。（胆有相火，心有君火，火的墓库在戌月（农历九月），阳气不胜阴气则心胁部位疼痛，所以对应九月的节气。）所谓不能翻身侧卧的，是因为阴气具有收藏万物的特性。事物被收藏则不动，所以不能翻身侧卧。（阴邪凝滞，潜伏在阳气之中，喜静恶动，所以翻身侧卧时就会疼痛。）所谓病情严重时出现跳跃躁动的，是因为九月时万物凋零，草木凋落坠落，人气也从阳分转向阴分，阴气盛而阳气在下生长，所以称为“跃”。（九月万物凋零，草木凋落，这是天地之气从阳转向阴。人身之气也是如此，所以在阴分盛实时，阳气的作用表现在下部。如果有病表现为跳跃躁动，是因为足少阳经脉下行至足外侧，阴气覆盖于上，阳气鼓动于下，所以对应九月的节气。）阳明经所说的洒淅恶寒，阳明对应午时（中午）和五月，是盛阳中的阴气，阳气盛而阴气加之，所以出现洒淅恶寒。（五月阳气明盛，所以叫“阳明”。夏至一阴初生，加上阳极的时令，所以病见洒淅恶寒，是因为阳明对应五月的节气。）所谓小腿肿胀且大腿松弛不收的，这是五月盛阳中的阴气。阳气在五月开始衰退，而一阴之气上升，与阳气开始相争，所以小腿肿胀且大腿松弛不收。（足阳明胃经：下行至髀关，抵伏兔穴，下行至膝胫足背，进入中趾内侧间。如果阴气生于下，向上与阳气相争，就会导致小腿肿胀且大腿松弛不收，这也对应五月一阴之气的变化。）所谓上喘且水肿的，是因为阴气下沉后又反上逆，上逆则邪气客居于脏腑之间，所以产生水饮。（阳明土病则不能制约水湿，所以阴邪自下而上，客居于脏腑之间，化为水饮。水饮的根本在肾，末梢在肺，标本俱病，所以上气喘促。）所谓胸痛且气短的，是水气停留在脏腑中。水饮属于阴气。阴气停留在中焦，所以胸痛且气短。（这里的邪气之阴，不是真阴。阴邪在中焦，所以胸痛；阴盛则阳气衰弱，所以气短，气短则呼吸急促。）所谓脉盛则厥逆，厌恶人与火，听到木头敲击的声音就惊恐不安的，是因为阳气与阴气相互搏结，水火不相容，所以惊恐不安。（薄，指气机相互迫近。阴阳之气，正常则和谐，邪气则相恶。阴邪迫近阳明经，所以惊恐不安。）所谓想要关闭门窗独自居住的，是因为阴阳相互搏结。阳气耗尽而阴气盛实，所以想要独自关闭门窗居住。（阴邪盛实则阳明经气衰弱，所以喜欢安静。）所谓发病时想要登上高处唱歌，脱掉衣服奔跑的，是因为阴阳再次相争且阳气外并于体表，所以使他脱掉衣服奔跑。（寒邪外并于阳分，则身体发热多烦躁，所以脱掉衣服奔跑。）所谓邪气客于孙络则头痛、鼻流清涕、腹部肿胀的，是因为阳明经气并入上部，上部则涉及其孙络太阴（此处指阴邪之盛，非特指手太阴肺经），所以头痛、鼻流清涕、腹部肿胀。（寒邪客于阳明经，则在头部为痛，在鼻部为鼽，在腹部为肿，因为阴气上行并并入本经的孙络，所以发生这些病。这里说的太阴，是指阴邪的盛实，并非指手太阴肺经。）太阴经所说的腹胀病，太阴对应子时（半夜）和十一月，此时万物之气都收藏于体内，所以叫“病胀”。（阴极于子时，万物皆收藏，所以说：“太阴，子也。”太阴经脉入腹，凡是邪气藏于体内，则病发为胀，所以对应十一月的节气。）所谓气上走于心部导致嗳气的，是因为阴气盛而上走于阳明经，阳明经络属于心，所以叫“上走于心为嗳”。（脾脉络胃，所以阴邪盛则上走于阳明经，阳明经的正脉，上通于心，所以上走于心为嗳。寒气客于胃，厥逆之气从下向上散开，又出于胃，所以为嗳。综合来说，寒气侵犯心、脾、胃三经，都能导致嗳气。）所谓进食后呕吐的，是因为食物积聚满溢而上逆，所以呕吐。（脾胃互为表里，胃受纳水谷，如果脾不能运化，则食物积聚满溢而上逆，所以呕吐。）所谓大小便通畅后，感觉轻松如同病减的，是因为十一月阴气下衰，而阳气将要外出，所以叫“得后与气，则快然如衰”。（后，指大便。气，指矢气。阳气外出则阴邪消散，所以感觉轻松如同病减。一阳初动，是冬至的候象，所以对应十一月的节气。）少阴经所说的腰痛，少阴对应肾，十月时万物阳气皆受损，所以腰痛。（腰是肾的外府，寒邪入肾则为腰痛，纯阴在下，所以对应十月的节气。）所谓呕吐、咳嗽、气逆、喘息的，是因为阴气在下，阳气在上，诸阳之气浮越，无所依附，所以呕吐、咳嗽、气逆、喘息。（阴阳互相依存，如果阴中没有阳，沉潜而不升，则孤阳在上，浮越而不降，无所依附，所以发生呕吐、咳嗽、气逆、喘息。肺主气，肾主精，精虚则气不归元。）所谓心情抑郁不能久立，久坐后起身则眼前昏花看不清楚的，是因为万物阴阳不定，没有主宰。秋气刚到，微霜始降，正在肃杀万物，阴阳内部被夺损，所以眼前昏花看不清。（邑邑，是不安的样子。秋气至，微霜下，万物俱衰，阴阳未定，所以内心无所主而坐起不常，眼睛昏花看不清，因为阴气肃杀阳气衰弱，精气内部被夺损，所以对应深秋十月的候象。）所谓气短、容易发怒的，是因为阳气失调。阳气失调则阳气不能外出，肝气应当条达而未得条达，所以容易发怒。容易发怒，名叫“煎厥”。（阳和不调，则肝气多逆乱，不能调达，所以易怒而为煎厥。所谓多阴者多怒。按，煎厥有阴阳虚实两种证型，不像臂厥那样以经脉所过之处同名。）所谓恐惧，像被人追捕一样的，是因为秋气时万物尚未完全离去，阴气少，阳气入内，阴阳相互搏结，所以恐惧。（阴气，指肾气；阳气，指邪气，阴气将收藏而未收藏，而阳邪侵入，阴阳相搏，则伤肾而为恐，所以也对应秋气。）所谓厌恶闻到食物气味的，是因为胃无气，所以厌恶闻到食物气味。（胃无气，指胃气败坏。胃气之所以败坏，是因为肾为胃之关，肾中真火不足，不能温养化源，所以胃气虚而厌恶闻到食物气味。这就是“饥不欲食”的含义。）所谓面色黑得像泥土颜色的，是因为秋气内部被夺损，所以面色改变。（面色对应太阳，是阳气的荣华表现。阴胜于阳则面色变黑，所以对应秋气，这就是“面如漆柴”的含义。）所谓咳嗽带血的，是因为阳脉受伤。阳气未在上部盛实而脉道满盛，满盛则咳嗽，所以血液见于鼻部。（阳脉伤者，指上焦之脉受伤。阳气未在上部盛实而脉道满盛，则所满盛的皆是寒邪。因为肾脉上行贯穿肝膈，入肺中，所以咳嗽则血见于口，鼻衄则血见于鼻。）厥阴经所说的疝气，妇女小腹肿胀的，厥阴对应辰时（早晨七至九点）和三月，此时阳中之阴邪在中焦，所以叫“疝气、小腹肿胀”。（辰，是季春三月。五阳一阴，阴气将尽，所以属厥阴。阴邪居于阳气的末尾则为疝气、小腹肿胀，所以对应三月的节气。）所谓腰脊疼痛，不能俯仰的，是因为三月阳气振奋，使万物繁荣，但只能俯而不能仰。（三月阳气振奋，所以使万物繁荣。然而余寒尚在，如果阴气胜，则阳气屈曲只能俯而不能仰，所以病发为腰脊疼痛，也对应三月的节气。）所谓瘛疭、癃疝、肤胀的，说是阴气也盛实而脉道胀满不通，所以叫“瘛疭、癃疝”。（这是再次阐明癃疝肿胀的原因，在于阴邪盛实。阴盛则阳气不行，所以发生这些症状。）所谓病情严重时咽喉干燥、心中烦热的，是因为阴阳相搏而生热，所以咽喉干燥。（所谓盛，对应三月阳气盛实。阳邪盛则搏结于阴分，所以发生咽喉干燥、热中等病。）足阳明经的病证，厌恶人与火，听到木头敲击的声音就惊恐不安，但听到钟鼓声却不为所动。阳明经是胃脉，胃属土，所以听到木头声音而惊，是因为土恶木。（脉即经。木能克土，所以厌恶它。）其厌恶火，是因为阳明主肌肉，其经脉气血盛实，邪气客居则发热，热甚则厌恶火。（阳明经多气多血，邪气客居则血气壅滞而易发热，热则厌恶火。）其厌恶人，是因为阳明经气厥逆则喘息且忧闷，忧闷则厌恶人。（阳明经气逆而厥，则喘息且忧闷。惋，是忧惊的意思，所以厌恶人的烦扰。）有的喘息而死，有的喘息而活，如果厥逆连及内脏则死，连及经脉则生。（连及内脏则败坏三阴，所以死；连及经脉则是肌表的疾病，所以生。）病情严重时脱掉衣服奔跑，登上高处唱歌，或者几天不吃饭，翻墙越屋，所上的地方，都不是他平时所能做到的，这是病反常的能力。（凡癫狂伤寒病患者多有此证。）四肢是诸阳经的根本，阳气盛则四肢充实，充实就能登高。他脱掉衣服奔跑，是因为热甚于身，所以脱掉衣服想跑。（阳明主肌肉，所以热甚于身。）他胡言乱语、骂人，不分亲疏而唱歌，是因为阳气盛实使人胡言乱语骂人，不分亲疏且不欲饮食，不欲饮食，所以胡乱奔跑。（阳盛者，指阳邪盛实。阳明是多气多血的经脉，而阳邪实之，是阳气的极点。阳气者，静则神藏，躁则消亡，所以神明错乱而病成这样。詈，音利。）太阴和阳明互为表里，分别是脾和胃的经脉。生病表现不同，是因为阴阳位置不同，更虚更实，更逆更从，有的从内，有的从外，所从不同，所以病名各异。（脾为脏，属阴。胃为腑，属阳。阳主外，阴主内，阳主上，阴主下，这是“阴阳异位”。阳虚则阴实，阴虚则阳实，这是“更虚更实”。病者为逆，不病者为从，这是“更逆更从”。所有这些，都是因为所从不同，所以病名也不同。）阳，是天之气，主外；阴，是地之气，主内。（胃属三阳，故主天气；脾属三阴，故主地气。）阳道实，阴道虚。（阳刚阴柔。另外外邪多有余，故阳道实；内伤多不足，故阴道虚。另一种说法是阴道实则阳道虚，这就是所谓的“更虚更实”。）所以遭受贼风虚邪的人，阳经受之；饮食不节、起居不时的人，阴经受之。阳经受邪则传入六腑，阴经受邪则传入五脏。（贼风虚邪，是外伤，所以阳经受之而入腑；饮食起居，是内伤，所以阴经受之而入脏。）邪入六腑则身体发热，不能按时睡眠，向上表现为喘息呼叫；邪入五脏则腹部痞满闭塞，向下表现为完谷不化的泄泻，日久发展为肠澼（痢疾）。（不时卧，是不能按时睡眠。阳邪在表在上，所以为身热、不卧、喘呼；阴邪在里在下，所以为痞满、飧泄、肠澼。）喉主天气，咽主地气。（喉为肺系，所以受气，上通于天；咽为胃系，所以受水谷，下通于地。）所以阳经受风气，阴经受湿气。（风，是阳气，所以阳分受之；湿，是阴气，所以阴分受之，各从其类。）阴气从足上行至头，再下行沿手臂至手指端；阳气从手上行至头，再下行至足。（手之三阴经，从脏走手；手之三阳经，从手走头；足之三阳经，从头走足；足之三阴经，从足走腹。大概阴气在下，下者必升；阳气在上，上者必降。脾阴胃阳，气机运行都是如此。）所以阳病者，向上发展到极点则向下；阴病者，向下发展到极点则向上。（阳病极则波及于下，阴病极则波及于上，极则发生变化。不仅上下如此，表里也是这样。）伤于风邪的，上部先受之；伤于湿邪的，下部先受之。（阳受风气，所以上部先受之；阴受湿气，所以下部先受之。然而上并非无湿，下并非无风，只是受邪有先后罢了。说“先受之”，则后受的就可知了。）脾病则四肢不用，因为四肢都禀受胃气，但不能直接到达经脉，必须依靠脾的转输，才能禀受胃气。（这下面讲胃气必须依靠脾气才能运行。）现在脾病不能为胃传输津液，四肢得不到禀受水谷之气，气日益衰弱，脉道不利，筋骨肌肉都没有气来滋养，所以不能活动。（四肢的活动，必须依赖胃气作为动力，然而胃气不能自行到达各条经脉，必须依靠脾气的营运，则将胃中水谷之气化为津液，才能到达四肢。如果脾病则胃气不行，所以各条经脉之道日益衰微而四肢不能活动。）大概脾与胃，通过膜相连，所以脾能为胃传输津液。（这下面讲三阴三阳的经脉，都禀受于脾胃之气。）足太阴脾经，是三阴经之一。其经脉贯通胃，属脾，联络咽喉，所以太阴脾经为三阴经传输气机。（为之，是为胃。脾脉贯通胃属脾，是足太阴经，所以为胃在三阴经中传输气机。三阴，指五脏。）足阳明胃经，是表经，是五脏六腑的海，也为三阳经传输气机。（阳明经，是太阴经的表经，主受纳水谷，以灌溉脏腑，所以是五脏六腑的海。虽然阳明经为三阳经传输气机，但也依赖脾气后才能运行，所以说“亦”。三阳，即六腑。）脏腑各自通过其经脉，从阳明经接受气机，所以（脾）能为胃传输津液。（因其经，指因脾经。脏腑得以禀受于阳明，是因为脾经贯通胃，所以能为胃传输津液。）四肢得不到禀受水谷之气，日益衰弱，阴道（血脉）不利，筋骨肌肉没有气来滋养，所以不能活动。（阴道，指血脉。这里再次阐明脾主四肢的道理，说得非常深切。）诊断疾病的开始，以五脏脉象为纲纪。（五决，是察验五脏以决断死生，作为诊断疾病的纲纪。）想要知道疾病的起始，先确立其根本。（始，指病的起始。建，是确立。母，指病的病因。不得其因，则标本不辨，所以应当先确立其根本，如下文所说的“某脏”、“某经”等。）所谓五决，是指五脏的脉象。（五脉，指五脏的脉象。）所以头痛巅疾，下虚上实，病在足少阴肾经和足太阳膀胱经，严重时病邪入肾。（头痛巅疾，是实于上部。上实是由于下虚，其病在肾与膀胱二经，盖足太阳经脉从头顶络脑，而肾与膀胱互为表里，阴虚阳实，所以发生这种病，严重时腑病已深入脏，则肾单独受伤。）头目眩晕动摇，视物不明，耳聋，下实上虚，病在足少阳胆经和足厥阴肝经，严重时病邪入肝。（“ ”，当作“ ”。蒙，茫昧不清。招，掉摇不定。尤，无定。眼睛无光则蒙昧不明，头眩动则招尤不定，甚至目瞑者不能视，耳聋者无所闻，其病在肝胆之气实于下而虚于上。）
Some patients present with weakness on either the left or right side, leading to limping (Buo, Bu Huo Qie). This is due to the insufficiency of the San Yang (Triple Yang) meridians in the lower body. The descending channel of the Foot-Taiyang Bladder Meridian runs along the thigh, descends behind the lateral malleolus; hence, this condition arises. Regarding "stiff neck pulling on the back," it occurs because Yang Qi surges excessively upward and contends, resulting in stiffness of the neck and upper back. (The Taiyang channel descends to the nape and flanks the back; if Yang Qi surges excessively upward and contends, it aligns with the ascending Qi of the Triple Yang, causing stiff neck and back tension.) Regarding "tinnitus," it happens because Yang Qi, like all things, flourishes and leaps upward, causing tinnitus. (A branch of the Taiyang channel extends from the vertex to the supra-auricular angle; when Pathogenic Yang Qi is excessive at the upper part, tinnitus results.) When the condition becomes severe, developing into mania or epilepsy (Dian/Dian Ji), it is because Yang Qi is entirely congested in the upper body while Yin Qi sinks to the lower body, creating a pattern of deficiency below and excess above, thus leading to mania and epilepsy. ("Dian" is synonymous with "Dian." "Severe" refers to the excess of Pathogenic Yang. When Pathogenic Yang fills the Yang meridians, Yang Qi is entirely upper-congested, while Yin Qi remains below; upper-excess and lower-deficiency lead to mania and epilepsy.) Regarding "floating pulse with deafness," it is caused by Qi congestion. (Yang excess in the upper part causes Qi stagnation leading to deafness, also because the channel reaches the ear.) Regarding "pathogen entering the interior causing aphonia," it is because Yang Qi, after being excessive, has declined, leading to aphonia. (Voice is emitted by Qi, which belongs to Yang. Excess Yang produces loud voice; deficient Yang produces faint voice. If Yang was excessive but has now declined, aphonia and inability to speak occur.) Internal depletion leading to Jue (reversal cold/loss of consciousness) results in aphonia and paralysis (Fei/Pai); this is Kidney Deficiency. ("Pai" means dysfunction/depletion. Internal depletion refers to the loss of Essence. Loss of Essence leads to Qi depletion and Jue, causing aphonia above and limb dysfunction below. A great deficit of Yuan Yang makes the Kidney the root of the disease. The Kidney channel ascends to flank the base of the tongue and descends to the sole of the foot, causing this condition. "Pai" should be written as "Fei," pronounced "Fei.") When Shaoyin Qi does not reach, Jue occurs. (This explains "internal depletion leading to Jue." Shaoyin is the Kidney channel, exterior-interior related to Taiyang. If Kidney Qi is internally depleted, Shaoyin Qi fails to arrive. Shaoyin Qi failing to arrive is due to Yin deficiency lacking Qi; without Qi, Yang declines causing Jue.) Regarding Shaoyang's "chest and hypochondriac pain," it indicates Shaoyang pathogenic excess. Excess reflects the Heart (as the Heart is the exterior marker of Shaoyang). (The Shaoyang channel descends through the chest and follows the interior of the hypochondrium; thus, pain here indicates Shaoyang excess. However, Shaoyang belongs to Wood, and Wood generates Fire; thus, the root of excess lies in the Gallbladder, while its marker/biao is the Heart. Biao refers to the superficial aspect.) In the ninth lunar month, Yang Qi ends and Yin Qi becomes abundant, causing chest and hypochondriac pain. (The Gallbladder contains Ministerial Fire, and the Heart contains Sovereign Fire. The tomb of Fire is in Xu (9th month). When Yang cannot overcome Yin, pain occurs in the heart and hypochondrium, corresponding to the 9th-month Qi.) Regarding "inability to turn or roll over," it is because Yin Qi possesses the nature of storing. Things stored do not move; hence, turning is impossible. (Yin pathogen is stagnant and latent within Yang; it prefers stillness and dislikes movement, so turning causes pain.) Regarding "severe jumping/restlessness," it is because in the ninth month, all things wither, grass and trees fall, and human Qi shifts from Yang to Yin. Yin Qi becomes abundant while Yang grows downward, termed "jumping." (In the 9th month, things wither; heaven and earth Qi shift from Yang to Yin. Human Qi is the same; when Yin is abundant, Yang's function manifests downward. Disease manifesting as jumping occurs because the Foot-Shaoyang channel descends to the lateral foot, with Yin covering above and Yang stirring below, corresponding to the 9th-month Qi.) Regarding Yangming's "shivering chills," Yangming corresponds to Wu (noon) and the 5th month, representing Yin within abundant Yang. Yang is abundant, and Yin Qi adds to it, causing shivering chills. (In the 5th month, Yang Qi is bright and abundant, hence "Yangming." At Summer Solstice, one Yin begins to generate; combined with the peak of Yang, illness presenting as shivering chills corresponds to the 5th-month Qi.) Regarding "swollen shins and relaxed thighs," this is Yin within abundant Yang of the 5th month. Yang declines in the 5th month, and one Yin Qi ascends to contend with Yang, causing swollen shins and relaxed thighs. (Foot-Yangming channel: descends to Biguan, reaches Futu, goes down to knee/shin/foot, enters medial toe. If Yin generates below and contends upward with Yang, shins swell and thighs relax, corresponding to the one-Yin Qi of May.) Regarding "upper panting and edema," it is because Yin Qi sinks then reverses upward; upward reversal allows pathogen to lodge between organs, causing water retention. (Yangming Earth disease fails to control Water; thus, Yin pathogen rises from below, lodges between organs, transforming into water. Water's root is Kidney, tip is Lung; both root and tip diseased cause upper panting.) Regarding "chest pain and shortness of breath," it is because water-Qi resides in the organs. Water is Yin Qi. Yin Qi in the middle causes chest pain and shortness of breath. (This pathogenic Yin is not True Yin. Yin pathogen in the middle causes chest pain; Yin excess leads to Yang decline, causing shortness of breath/panting.) Regarding "excessive pulse leading to Jue, aversion to people and fire, startle at wood sound," it is because Yang and Yin Qi contend, water and fire dislike each other, causing startle. (Bo means Qi pressing against each other. Normal Yin/Yang harmonize; pathogenic Yin/Yang clash. Yin pathogen presses on Yangming, causing startle.) Regarding "desire to close doors/windows and stay alone," it is due to Yin-Yang contention. Yang is exhausted, Yin is abundant, so one desires solitude. (Yin pathogen abundance leads to Yangming decline, hence desire for quiet.) Regarding "climbing high and singing, discarding clothes and running," it is because Yin and Yang contend again, and Yang merges outwardly, causing discarding clothes and running. (Cold pathogen merging outwardly with Yang causes body heat and restlessness, hence discarding clothes and running.) Regarding "pathogen lodging in Sun collaterals causing headache, nasal discharge, abdominal swelling," it is because Yangming merges upward; the upper part involves its Sun collaterals (Taiyin), causing headache, rhinorrhea, and abdominal swelling. (Cold pathogen in Yangming causes head pain, nasal discharge, abdominal swelling because Yin Qi ascends and merges with the channel's Sun collaterals. Here "Taiyin" refers to Yin pathogen abundance, not specifically Hand-Taiyin Lung Meridian.) Regarding Taiyin's "abdominal distension," Taiyin corresponds to Zi (midnight) and the 11th month, when all Qi hides within, hence "distension." (Yin peaks at Zi; all things hide, hence "Taidyin is Zi." Taiyin channel enters abdomen; pathogen hiding inside causes distension, corresponding to 11th-month Qi.) Regarding "Qi moving upward to Heart causing belching," it is because Yin excess moves upward to Yangming, whose collaterals connect to Heart, hence "moving to Heart causes belching." (Spleen collateral connects to Stomach; Yin excess moves to Yangming. Yangming main channel connects to Heart, causing belching. Cold lodging in Stomach causes rebellious Qi to scatter upward and exit Stomach as belching. Generally, Cold invading Heart, Spleen, Stomach can all cause belching.) Regarding "vomiting after eating," it is because food accumulates full and overflows upward, causing vomiting. (Spleen and Stomach are exterior-interior. Stomach receives food; if Spleen fails to transport, food accumulates and overflows, causing vomiting.) Regarding "relief after defecation and passing gas," it is because in the 11th month, Yin Qi declines downward and Yang Qi prepares to emerge, hence "relief after bowel movement and gas." (Hou means stool; Qi means flatulence. Yang emergence disperses Yin pathogen, bringing relief. One Yang moving downward corresponds to Winter Solstice, matching 11th-month Qi.) Regarding Shaoyin's "lower back pain," Shaoyin is Kidney; in the 10th month, all Yang Qi is injured, causing lower back pain. (Waist is the mansion of Kidney; Cold entering Kidney causes pain. Pure Yin is below, corresponding to 10th-month Qi.) Regarding "vomiting, cough, rebellious Qi, panting," it is because Yin is below, Yang is above; all Yang Qi floats without foundation, causing these symptoms. (Yin and Yang rely on each other. If Yin lacks Yang and sinks without rising, solitary Yang floats above without descending/foundation, causing vomiting, cough, rebellious Qi, panting. Lung governs Qi, Kidney governs Essence; Essence deficiency leads to Qi failing to return to its source.) Regarding "depression, inability to stand long, dizziness upon rising from sitting," it is because Yin-Yang of all things is unsettled, lacking a master. Autumn Qi arrives, frost falls, killing all things; Yin-Yang is internally depleted, causing visual disturbance. (Yiyi means uneasy. Autumn arrival, frost falling, things withering, Yin-Yang unsettled, internal lack of mastery leads to restless sitting/standing and blurred vision. Yin肃 (solemn/cold) and Yang decline, Essence internally depleted, corresponding to late Autumn/10th month.) Regarding "shortness of breath and irritability," it is because Yang Qi is unregulated. Unregulated Yang cannot exit; Liver Qi should regulate but fails, causing irritability. Irritability is named "Jian Jue" (Frying Jue). (Yang harmony unregulated leads to Liver Qi rebellion and failure to flow freely, causing irritability and Jian Jue. Those with much Yin are prone to anger. Jian Jue has Yin/Yang and Deficiency/Excess types, unlike Bi Jue named after channel location.) Regarding "fear, as if being chased," it is because in Autumn, things have not fully departed; Yin is scant, Yang enters, Yin-Yang contend, causing fear. (Yin Qi refers to Kidney Qi; Yang Qi refers to Pathogen. Yin Qi is about to hide but hasn't; Yang pathogen enters. Contention injures Kidney causing fear, corresponding to Autumn.) Regarding "aversion to food odor," it is because Stomach lacks Qi, hence aversion to food smell. (Stomach lacks Qi means Stomach Qi is failing. Reason for failure: Kidney is Stomach's gate; insufficient True Fire in Kidney fails to warm/nourish transformation source, causing Stomach Qi deficiency and aversion to food smell. This is equivalent to "hunger but no desire to eat.") Regarding "face black like earth," it is because Autumn Qi depletes internally, changing complexion. (Complexion corresponds to Sun, glory of Yang. Yin exceeding Yang turns face black, corresponding to Autumn, meaning "face like lacquered charcoal.") Regarding "cough with blood," it is because Yang channels are injured. Yang Qi is not yet abundant above but vessels are full; fullness causes cough, blood appears in nose. (Yang channel injury refers to Upper Jiao vessel injury. If Yang is not abundant above but vessels are full, the fullness is Cold pathogen. Kidney channel passes through Liver/Diaphragm into Lung; cough causes blood from mouth, epistaxis causes blood from nose.) Regarding Jueyin's "hernia, women's lower abdominal swelling," Jueyin corresponds to Chen (7-9 AM) and 3rd month, where Yin pathogen of Yang is in the middle, hence "hernia, lower abdominal swelling." (Chen is late Spring. Five Yang, One Yin; Yin Qi is ending, belonging to Jueyin. Yin pathogen at end of Yang causes hernia/lower abdominal swelling, corresponding to 3rd-month Qi.) Regarding "lower back/spine pain, inability to bend/straighten," it is because in the 3rd month, Yang vibrates, flourishing all things, bending but not straightening. (3rd month Yang vibrates, flourishing things. Residual cold remains; if Yin wins, Yang bends only, not straightens, causing back pain, corresponding to 3rd-month Qi.) Regarding "spasms, strangury/hernia, skin distension," it is said that Yin is also abundant, vessels distended and blocked, hence "spasms, strangury." (Explains strangury/swelling is due to Yin pathogen abundance. Yin excess blocks Yang Qi, causing these symptoms.) Regarding "severe dry throat, internal heat," it is because Yin-Yang contention generates heat, causing dry throat. ("Abundant" corresponds to 3rd-month Yang abundance. Yang pathogen excess contends with Yin, causing dry throat/internal heat.) Foot-Yangming meridian disease: aversion to people/fire, startle at wood sound, but not moved by bells/drums. Yangming is Stomach channel; Stomach is Earth; startle at wood sound is because Earth fears Wood. (Channel equals Meridian. Wood controls Earth, hence aversion.) Aversion to fire: Yangming governs flesh, its vessels have abundant Qi/Blood; pathogen causes heat, severe heat causes aversion to fire. (Yangming has much Qi/Blood; pathogen causes stagnation/heat, hence aversion to fire.) Aversion to people: Yangming Jue causes panting and distress; distress causes aversion to people. (Yangming Qi rebellion/Jue causes panting/distress. Wan means sorrow/startle, hence aversion to disturbance.) Some die from panting, some live: if Jue connects to Zang, death; if connects to Jing, life. (Connecting to Zang ruins Three Yin, hence death; connecting to Jing is superficial, hence life.) Severe disease: discards clothes, runs, climbs high, sings, skips days without eating, climbs walls/roofs, doing what they couldn't before. (Common in manic/depressive or typhoid cases.) Limbs are root of all Yang; Yang excess makes limbs solid, enabling climbing. Discarding clothes/runs due to heat in body. (Yangming governs muscle, hence heat in body.) Delirious speech, cursing regardless of kinship, singing: Yang excess causes delirium/cursing, lack of appetite, aimless running. (Yang excess means Pathogenic Yang excess. Yangming is multi-Qi/Blood channel; Pathogenic Yang fills it, reaching Yang extreme. Yang Qi: stillness hides Spirit, agitation consumes Spirit; Spirit confusion causes such illness. Li means curse.) Taiyin and Yangming are exterior-interior, Spleen and Stomach channels. Diseases differ because Yin/Yang positions differ, alternating deficiency/excess, rebellion/compliance, internal/external origins, hence different names. (Spleen is Zang/Yin; Stomach is Fu/Yang. Yang exterior, Yin interior; Yang upper, Yin lower = "Different Positions." Yang deficiency leads to Yin excess, Yin deficiency leads to Yang excess = "Alternating Deficiency/Excess." Diseased is rebellion, healthy is compliance = "Alternating Rebellion/Compliance." Different origins cause different disease names.) Yang is Heaven Qi, governing exterior; Yin is Earth Qi, governing interior. (Stomach is Three Yang, governs Heaven Qi; Spleen is Three Yin, governs Earth Qi.) Yang Dao is Excess, Yin Dao is Deficient. (Yang firm, Yin soft. External pathogens often excess, hence Yang Dao Excess; Internal injuries often deficiency, hence Yin Dao Deficient. Alternatively, Yin Excess leads to Yang Deficiency, i.e., "Alternating Deficiency/Excess.") Thus, those harmed by thief-wind/empty-pathogens receive it in Yang; those harmed by irregular diet/lifestyle receive it in Yin. Yang reception enters Six Fu; Yin reception enters Five Zang. (Thief-wind/empty-pathogens are external, received by Yang entering Fu; diet/lifestyle are internal, received by Yin entering Zang.) Entering Six Fu causes fever, irregular sleep, upper panting/calling; entering Five Zang causes fullness/blockage, lower diarrhea (Sun Xie), long-term intestinal dysentery (Chang Pi). (Irregular sleep: inability to sleep on time. Yang pathogen exterior/upper causes fever, insomnia, panting; Yin pathogen interior/lower causes fullness, diarrhea, dysentery.) Throat governs Heaven Qi; Pharynx governs Earth Qi. (Throat is Lung system, receives Qi, connects to Heaven; Pharynx is Stomach system, receives food/water, connects to Earth.) Thus, Yang receives Wind; Yin receives Dampness. (Wind is Yang Qi, received by Yang; Dampness is Yin Qi, received by Yin, each following its kind.) Yin Qi ascends from foot to head, then descends arm to finger; Yang Qi ascends hand to head, then descends to foot. (Hand Three Yin: Zang to Hand; Hand Three Yang: Hand to Head; Foot Three Yang: Head to Foot; Foot Three Yin: Foot to Abdomen. Yin below must rise; Yang above must descend. Spleen Yin/Stomach Yang follow this.) Thus, Yang diseases go up to extreme then down; Yin diseases go down to extreme then up. (Yang extreme affects lower; Yin extreme affects upper; extreme implies change. Same for interior/exterior.) Wind injury affects upper first; Dampness injury affects lower first. (Yang receives Wind, upper affected first; Yin receives Dampness, lower affected first. Upper isn't devoid of Damp, lower devoid of Wind, just timing differs. "First" implies later is known.) Spleen disease causes limb immobility because limbs receive Qi from Stomach but cannot reach channels directly; must rely on Spleen to transmit. (Below explains Stomach Qi relies on Spleen Qi to move.) Now Spleen disease fails to transport fluids for Stomach; limbs don't receive Grain Qi; Qi declines daily, vessels obstruct, sinews/bones/muscles lack Qi to generate, hence immobile. (Limb movement relies on Stomach Qi, but Stomach Qi cannot reach channels alone; must rely on Spleen transport to transform Grain Qi into fluids reaching limbs. Spleen disease stops Stomach Qi, vessels decline, limbs immobile.) Spleen and Stomach connected by membrane, allowing Spleen to transport fluids for Stomach. (Below explains Three Yin/Three Yang channels all receive Qi from Spleen/Stomach.) Foot-Taiyin is Three Yin. Channel pierces Stomach, belongs to Spleen, connects to throat; thus Taiyin transmits Qi to Three Yin. (For Stomach. Spleen channel pierces Stomach/belongs to Spleen, Foot-Taiyin, thus transmits Qi to Three Yin for Stomach. Three Yin refers to Five Zang.) Yangming is Exterior, Sea of Five Zang/Six Fu, also transmits Qi to Three Yang. (Yangming is Taiyin's exterior, receives Grain, irrigates organs, hence Sea of Zang/Fu. Though Yangming transmits to Three Yang, it relies on Spleen Qi, hence "also." Three Yang refers to Six Fu.) Organs/channels receive Qi from Yangming via their channels; thus (Spleen) transports fluids for Stomach. (Via Spleen channel. Organs receive from Yangming because Spleen channel pierces Stomach, enabling fluid transport.) Limbs lack Grain Qi, decline daily, Yin Dao (vessels) obstruct, sinews/muscles lack Qi, hence immobile. (Yin Dao refers to blood vessels. Re-emphasizes Spleen governs limbs profoundly.) Diagnosis begins with Five Decisions as guideline. (Five Decisions: examine Five Zang pulses to decide life/death, guiding diagnosis.) To know origin, first establish Mother. (Origin: disease start. Jian: establish. Mother: disease cause. Without cause, root/branch unclear; must establish mother first, e.g., "Which Zang/Channel.") Five Decisions refer to Five Pulses. (Five Pulses: Five Zang pulses.) Thus, headache/dian disease, lower-deficient/upper-excess, fault in Foot-Shaoyin/Kidney and Foot-Taiyang/Bladder; severe enters Kidney. (Headache/dian is upper-excess. Upper-excess due to lower-deficiency; fault in Kidney/Bladder. Taiyang channel from vertex connects to brain; Kidney/Bladder exterior-interior. Yin-deficient/Yang-excess causes this; severe Fu disease enters Zang, injuring Kidney.) Dizziness/trembling, blurred vision, deafness, lower-excess/upper-deficient, fault in Foot-Shaoyang/Gallbladder and Foot-Jueyin/Liver; severe enters Liver. (" " should be " ". Meng: confused. Zhao: trembling. You: unstable. Eyes dim/confused, head dizzy/unstable, severe blindness/deafness. Fault is Liver/Gallbladder Qi excess below/deficient above.)