不以为次。）因而喜，大虚，则肾气乘矣，（喜则气下，故伤心。心伤而大虚，则肾气乘之，水
胜火也。）怒则肝气乘矣，（怒则气逆于肝而乘于脾，木胜土也。）悲则肺气乘矣，（悲则气并于肺而乘于
肝，金胜木也。）恐则脾气乘也，（恐伤肾则肾气虚而脾气乘之，土胜水也。）忧则心气乘也。（忧伤肺则
心气乘之，火胜金也。）此其道也。（或以有余而乘彼，或以不足而被乘。皆乘所不胜，此不次之道也。）
故病有五，五五二十五变，及其传化传乘之名也。（脏惟五，而五脏之传又能各兼五脏，则有二十五变。
传者以此传彼，乘者以强凌弱，故有曰“传”、曰“乘”之异名耳。）
有病身热、汗出、烦满，烦满不为汗解。（不为汗解，谓汗后烦热不散也。）夫汗出而身热者风也，汗
出而烦满不解者厥也，病名“风厥”。巨阳主气，故先受邪，少阴与其为表里也，得热则上从之，从之则厥
也。（风为阳邪，故汗虽出而身仍热也。巨阳主气，气言表也。表病则里应，故少阴得热，则阴分之气亦从
阳而上逆，逆则厥矣，故名“风厥”。风厥之义不一，此言太阳。少阴病也，又有二阳
一阴发病，名曰“风厥”，言胃与肝也。人之善病风厥漉汗者，肉不坚，腠理疏也。）劳风为病，法在肺下。（
劳风者，因劳伤风也。肺下者，在内则胸膈之间，在外则四椎、五椎之间也。风受于外，则病应于内，凡人
之因于劳者必气喘，此劳能动肺可知。）其为病也，使人强上冥视，（邪在肺下则为喘逆，故令人强上不能俯
首。风热上壅，则畏风羞明，故令人冥目而视。）唾出若涕，恶风而振寒，此为“劳风”。（风热伤阴则津液
稠浊，故唾出若涕。肺主皮毛，卫气受伤故恶风振寒。）治之以救俯仰。（风之微甚，证在俯仰之间也，
故当先救之。然救此者必先温肺，温肺则风散，风散则俯仰安矣。若温散不愈，郁久成热，然后可以清解。温
清失宜。病必延甚。）巨阳引精者三日，中年者五日，不精者七日。（风邪
之病肺者，必由足太阳膀胱经风门、肺俞等穴内入于脏。大肠者，水之腑，三阳之表也，故当引精上行，则
风从咳散。若巨阳气盛，引精速者应在三日，中年精衰者应在五日，衰年不精者应在七日，当咳出青黄痰涕而
愈，如下文者，是即“引精”之谓。）咳出青黄涕，其状如脓，大如弹丸，从口中若鼻中出，不出则伤肺，伤
肺则死也。（咳涕不出者。即今人所谓干咳嗽也，甚至金水亏竭，虚劳之候，故死。肾气劳竭，肺气
内虚，阳气迫之，故不出则伤肺而死也。）
有病肾风者，面 然，壅害于言，（ ，浮肿也。 然，失色貌。壅，重浊不清也。肾脉循喉咙，挟
舌本，病风则肾脉不利，故壅害于言语。）少气时热，时热从胸背上至头，汗出手热，口干苦
渴，小便黄，目下肿，腹中鸣，身重难以行，月事不来，烦而不能食，不能正偃，正偃则咳，病名“风水”。
（肾主水，风在肾经，即名“风水”。）盖因邪之所凑，其气必虚。（邪必因虚而入，故
邪之所凑，其气必虚。）阴虚者阳必凑之，故少气时热而汗出也。（阴虚则无气，故为少气时热。阳主散而
凑于阴分，故汗出。）小便黄者，少腹中有热也。（少腹有热，邪在阴也，故小便黄。）不能正偃者，胃
中不和也。正偃则咳甚，上迫肺也。（正偃，仰卧也。肾脉贯肝膈，入肺中，其支者注胸中，肾邪自下而上，
则胃气逆而不和，故正偃则咳甚而上迫于肺。）诸有水气者，微肿先见于目下也。水者，阴也；
目下，亦阴也。腹者，至阴之所居，故水在腹者，必使目下肿也。（目下肿如卧蚕者，其腹必有水气也。）
真气上逆，故口苦舌干，卧不得正偃，正偃则咳出清水也。诸水病者，故不得卧，卧
则惊，惊则咳甚也。（水邪留滞于脏，故为气逆。气逆则不得正卧，故惊而咳甚。）腹中鸣者，病本于胃
也。薄脾则烦不能食，食不能下者，胃脘隔也。身重难以行者，胃脉在足也。（脾胃属土，所
以制水，土弱则寒水反侮之，故腹中鸣而食不下，胃主肌肉，其脉行于足。
水气居于肉中，故身重不能行。）月事不来者，胞脉闭也。胞脉者，属心而络于胞中。今气上迫肺，心气不得
下通，故月事不来也。（胞即子宫，相火之所在也；心主血脉，君火之所居也。阳气上下交通，故胞胳属心而
络于胞中，以通月事。今气上迫肺，则阴邪遏绝阳道，心气不得下行，故胞脉闭，月事断矣。） 然如有水
状，切其脉大紧，身无痛者，形不瘦，不能食，食少，病生在肾，名为“肾风”。（如有水状，谓其 然浮
肿，似水而实非水也。脉大者，阴虚也；脉紧者，寒气也。身无痛，形不瘦者，邪气。在脏不在表也。风挟
肾邪，反伤脾胃，故不能食。所以风有内外之分，不可不辨。八风自外而入，必先有发热恶
寒、头疼身痛等证。此因于外者，显然有可察也。五风由内而病，则绝无外证，而忽病如风，其由内伤可知
也，如“诸暴强直，皆属于风”，“诸风掉眩，皆属于肝”之类。盖言有所中者，谓之中外感也；无所中者，
谓之属内伤也。外感者邪袭肌表，故多阳实；内伤者由于酒色劳倦，七情口腹，致伤脏气，故由阴虚。凡脏
气受伤，脾败者病在肢体，或多痰饮；肾病者或在骨髓，或在二阴；心病者或在血脉，或在神志；肺病者
或在营卫，或在声音；肝病者或在筋爪，或在胁肋，此五脏之类风，未有不由阴虚而然者，惟东垣独得其义，
曰有中风者卒然昏愦，不省人事，此非外来风邪，乃本气自病也。人年逾四旬，气衰者多有此疾。盖人年四
十而阴气自半，故多犯之，岂非阴虚之病乎？夫人生于阳而根于阴，根本衰则人必病，根本败则人必危矣。
所谓根本者，即真阴也。人知阴虚唯一，而不知阴虚有二，如阴中之水虚，则病在精血；阴中之火虚，则病
在神气。盖阳衰则气去，故神志为之昏乱，非火虚乎？阴亏则形坏，故肢体为之废弛，非水虚
乎？今以神离形坏之症，乃不求水火之源，而犹以风治，鲜不危矣。故凡治类风者，专宜培补真阴，以救根
本，使阴气复则风燥自除矣。然外感者，非曰绝无虚证，气虚则虚也；内伤者非曰必无实症，有滞则实也。
治虚者，当察其在阴在阳而直补之；治实者，但察其因痰因气而暂开之，此于
内伤外感及虚实攻补之间，最当察其有无微甚而酌其治也。甚至有元气素亏，猝然仆倒。上无痰，下失禁，
瞑目昏沉，此厥竭症，尤与风邪无涉。使非大剂参、熟或七年之艾破格挽回，又安望其复真气于将绝之顷哉！倘
不能察其表里，又不能辨其虚实，但以风之为名，多用风药，不知风药皆燥，燥复伤阴，风药皆散，散复伤
气，以内伤作外感，以不足为有余，是促人之死也。）肾风而不能食，善惊，惊已心气痿者死，（风生于
肾，则反克脾土，故不能食。肾邪犯心则神气失守，故善惊。惊后而心气痿弱不能复者，心肾俱败，水火俱
困也，故死。）有病身热解惰，汗出如浴，恶风少气，病名“酒风”。（此即前所谓“漏风”也。酒性本热，
过饮而病，故令身热。湿热伤于筋，故懈惰。湿热蒸于肤腠，故汗出如浴。汗多则卫虚，故恶风。卫虚则
气泄，故少气。因酒得风而病，故曰“酒风”。）治以泽泻、术各十分，麋衔五分，合以三指撮，为后饭。（
泽泻味甘淡，性微寒，能渗利湿热。白术味甘苦，气温，能补中，燥湿。止汗。麋衔，即薇衔，一名无心草，
南人呼为吴风草，味苦平，微寒，主治风湿。十分者，倍之也。五分者，减半也。合以三指，用三指撮合，以
约其数而为煎剂也。饭后药先，故曰“后饭”。）
贼风邪气之伤人也，令人病焉。有不离屏蔽，不出室穴之中卒然病者，非不离贼风邪气，此皆尝有
所伤于湿气，藏于血脉之中，分肉之间，久留而不去，若有所堕坠，恶血在内而不去，卒然喜怒不节，饮食
不适，寒温不时，腠理闭而不通。（凡此者，皆所谓“故邪”也。）其开而遇风寒，则血气凝结，
与故邪相袭，则为“寒痹”。（其开者，谓冒露于风寒也。故邪在前。风寒继之，二者相值，则血气凝结，故
为寒痹；寒气胜者，为痛痹也。）其有热则汗出，汗出则受风，虽不遇贼风邪气，必有因加而
发焉。（其或有因热汗出而受风者，虽非贼风邪气，亦为外感。必有因加而发者，谓因于故而加以新也，
新故合邪，故病发矣。）皆病患所自知
也。其毋所遇邪气，又毋怵惕之所志，卒然而病者，唯有因鬼神之事乎？（鬼神之事，盖自古惑之矣。）
非也，此亦有故邪留而未发，因而志有所恶，及有所慕，血气内乱，两气相搏，其所从来者微，视之不见，
听而不闻，故似鬼神。（故邪者，如上文“留而未发”之谓也，恶者，恶其所憎也。慕者，慕其所好也。故
邪未发而新邪复触之，则五志为邪所凭，血气因而内乱，邪正先后，两气相搏，而邪妄之病生矣。但病所从
来者，其机甚微，有非闻见可及。故人以鬼神为疑，不知迹似鬼神，而实非鬼神之所为也。）其祝而已者，
巫知百病之胜，先知其病之所从生者，可祝而已也。（祝者，巫咒之属，即祝由也。胜者，凡百病五行之道，
必有所以胜之者。然必先知其病所从生之由，而后以胜法胜之，则可移精变气，祛其邪矣。病有药石所不及，
非此不可者，惟先巫知之，故可祝而已也。然则先巫用祝之妙，正不在祝，其机在胜之而已。祝、咒同。）
（不将其列为常规次序。）如果因为喜悦导致心气大虚，那么肾气就会乘虚侵袭。（喜悦会使气机下陷，从而损伤心脏。心脏受损且极度虚弱时，肾气便会乘虚而入，这是水克火的表现。）愤怒会导致肝气乘袭脾土。（愤怒使气机上逆于肝脏，进而侵犯脾脏，这是木克土的表现。）悲伤会导致肺气乘袭肝脏。（悲伤使气机汇聚于肺，进而侵犯肝脏，这是金克木的表现。）恐惧会导致脾气乘袭肾脏。（恐惧损伤肾脏导致肾气虚弱，脾气便乘虚侵袭，这是土克水的表现。）忧虑会导致心气乘袭肺脏。（忧伤肺导致肺气虚弱，心气便乘虚侵袭，这是火克金的表现。）这就是五行相乘的规律。（有的是因邪气有余而乘袭他脏，有的是因正气不足而被他脏乘袭。都是乘袭其所不胜的一行，这就是不按正常次序传变的规律。）所以疾病有五种基本类型，五脏之间相互传变可产生二十五种变化，这就是所谓的“传”和“乘”。（脏腑只有五个，但五脏之间的传变又能各自兼涉其他四脏，因此有二十五种变化。所谓“传”，是指病气由此脏传到彼脏；所谓“乘”，是指强盛之气欺凌虚弱之气，因此有不同的名称。）
有一种病症表现为身体发热、出汗、心中烦闷胀满，且这种烦满不因出汗而缓解。（“不为汗解”指出汗后烦热依然不散。）凡是出汗而身体仍热的，属于风邪致病；出汗而烦满不解的，属于厥证，这种病名为“风厥”。足太阳膀胱经主一身之表气，所以首先受邪；足少阴肾经与太阳经互为表里，当受到热邪时，少阴之气也会随之向上从阳化热，气机上逆则形成厥证。（风为阳邪，所以虽然出汗但身体仍然发热。巨阳即太阳经，主司体表之气。表病则里应，所以少阴经受热，阴分之气也随阳气上逆，逆乱则成厥，故命名为“风厥”。关于“风厥”的含义有多种解释，此处指的是太阳与少阴同病的情况。还有另一种情况是阳明与厥阴发病，也称为“风厥”，涉及胃与肝。人之所以容易患风厥并大量出汗，是因为肌肉不坚实，腠理疏松。）劳风病，病位通常在肺部下方。（劳风是由于劳累后感受风邪所致。肺下在内指胸膈之间，在外指第四、第五胸椎之间。风邪从外侵入，病气反映于内，凡是因为劳累的人必然气喘，这说明劳倦能伤肺。）它的症状使人颈项强直、视物昏暗模糊，（邪气在肺下导致气喘逆乱，所以使人颈项强直不能低头。风热上壅，使人畏风羞明，所以让人闭目视物。）咳唾如鼻涕般的粘稠痰液，怕风且伴有寒战，这称为“劳风”。（风热损伤阴液导致津液稠浊，所以咳出的痰像鼻涕一样。肺主皮毛，卫气受伤所以怕风且寒战。）治疗应当先解决俯仰困难的问题。（风的轻重，体现在患者俯仰动作是否受限，所以应当先救治此症。然而救治此症必须先温补肺气，肺气温暖则风邪消散，风散则俯仰自如。如果温散无效，郁久化热，然后才可以清热解表。若温法与清法使用不当，病情必定加重。）对于能引精气上行者，三天可愈；中年精气稍衰者，五天可愈；年老精气亏虚者，七天可愈。（风邪伤肺，必由足太阳膀胱经的风门、肺俞等穴内传入脏。大肠为水之腑，是三阳经的表，所以应当引导精气上行，风邪便可随咳嗽排出。如果太阳经气旺盛，引精迅速者应在三天内痊愈；中年精气衰退者应在五天内痊愈；老年精气枯竭者应在七天内痊愈，应当咳出青黄色的痰涕而病愈，如下文所述，这就是“引精”的意思。）咳出青黄色鼻涕状脓痰，形状像脓，大小如弹丸，从口中或鼻中排出，如果不排出则会损伤肺脏，损伤肺脏就会导致死亡。（咳不出痰涕，即今人所说的干咳，甚至发展到金水亏竭，出现虚劳征象，所以致死。肾气劳竭，肺气内虚，阳气逼迫痰浊，所以排不出则损伤肺而死。）
患有肾风病的患者，面部浮肿，面色晦暗无光，言语重浊不清，（浮肿。面色晦暗。重浊不清。肾脉循行喉咙，夹持舌根，患风邪则肾脉不利，所以言语重浊不清。）气短且时常发热，热气有时从胸背上升至头部，手心发热，口干口苦渴饮，小便黄赤，眼下浮肿，腹中肠鸣，身体沉重难以行走，月经停止，心烦不能进食，不能仰卧，仰卧则咳嗽，这种病名为“风水”。（肾主水，风邪在肾经，所以称为“风水”。）这是因为邪气聚集之处，正气必然虚弱。（邪气必定趁着正气虚弱而入侵，所以说邪气聚集的地方，正气一定虚弱。）阴虚则阳邪必凑集于阴分，所以会出现气短、时常发热和出汗的症状。（阴虚则无气，所以气短且时常发热。阳主发散并凑集于阴分，所以出汗。）小便黄赤，说明小腹中有热。（小腹有热，邪气在阴分，所以小便黄赤。）不能仰卧，是因为胃气不和。仰卧则咳嗽加剧，是因为气机上逆压迫肺脏。（正偃即仰卧。肾脉贯穿肝脏和膈肌，进入肺中，其支脉注入胸中，肾邪自下而上，导致胃气上逆而不和，所以仰卧时咳嗽加剧并上迫于肺。）所有有水气病的患者，轻微浮肿首先见于眼下。水属阴；眼下也属阴。腹部是至阴之所居，所以腹部有水气，必然导致眼下浮肿。（眼下浮肿如卧蚕者，腹部必有水气。）真气上逆，所以口苦舌干，不能仰卧，仰卧则咳出清水。所有水病患者，所以不能安卧，卧则惊恐，惊恐则咳嗽加剧。（水邪留滞于脏腑，导致气机逆乱。气逆则不能平卧，所以惊恐且咳嗽加剧。）腹中肠鸣，病本在于胃。邪气薄犯脾脏则心烦不能进食，食物无法下行，是因为胃脘阻隔。身体沉重难以行走，是因为胃脉行于足部。（脾胃属土，用以制约水湿，土弱则寒水反侮，所以腹中肠鸣且饮食不下。胃主肌肉，其经脉行于足部。水气居于肌肉之中，所以身体沉重不能行走。）月经不来，是因为胞脉闭塞。胞脉属于心并联络于子宫。如今气机上逆压迫肺脏，心气不得下行通达，所以月经不来。（胞即子宫，是相火所在之处；心主血脉，是君火所居之地。阳气上下交通，所以胞脉属心并联络于子宫，以通调月经。如今气机上逆压迫肺脏，阴邪遏绝阳道，心气不得下行，所以胞脉闭塞，月经断绝。）
如果看起来像水肿，切脉发现脉象大而紧，身体没有疼痛，形体不消瘦，不能进食或食量很少，病位在肾，名为“肾风”。（看起来像水肿，是指面部浮肿，似水而非真水。脉大表示阴虚；脉紧表示寒气。身体无痛、形体不瘦，说明邪气在脏不在表。风挟带肾邪，反而损伤脾胃，所以不能进食。因此风邪有内外之分，不可不辨别。八风从外侵入，必然先有发热恶寒、头痛身痛等症状。这是外感，显然可以察觉。五风由内而生，则完全没有外证，突然发病如同中风，可知是由内伤引起，如“诸暴强直，皆属于风”，“诸风掉眩，皆属于肝”之类。大概有所感受的，称为中外感；无所感受的，称为属内伤。外感是邪气侵袭肌表，所以多表现为阳实证；内伤是由于酒色劳倦、七情饮食，导致脏气受伤，所以由阴虚引起。凡是脏气受伤，脾败的病在肢体，或多痰饮；肾病者在骨髓或在二阴；心病者在血脉或神志；肺病者在营卫或声音；肝病者在筋爪或胁肋，这些五脏类风病，没有不是由阴虚引起的。只有李东垣独自领悟了这一义理，他说有中风者突然昏倒，不省人事，这不是外来风邪，而是本气自病。人年过四十，气衰者多有此疾。大概人到了四十岁阴气自然减半，所以多犯此病，难道不是阴虚之病吗？人生于阳而根于阴，根本衰弱则人必病，根本败坏则人必危。所谓根本，即真阴。人们知道阴虚只有一种，却不知道阴虚有两种：如阴中之水虚，则病在精血；阴中之火虚，则病在神气。大概阳衰则气去，所以神志昏乱，这不是火虚吗？阴亏则形坏，所以肢体废弛，这不是水虚吗？现在面对神离形坏的病症，却不探究水火之源，仍然用治风的方法治疗，很少有不危险的。所以凡是治疗类似风证的，专门应当培补真阴，以救根本，使阴气恢复则风燥自然消除。然而外感并非绝无虚证，气虚即为虚；内伤并非绝无实证，有停滞即为实。治疗虚证，应当察其在阴在阳而直接补益；治疗实证，只需察其因痰因气而暂时开泄，这在处理内伤外感及虚实攻补之间，最应当考察有无微甚而斟酌治疗方法。甚至有元气素来亏虚，突然仆倒，上部无痰，下部失禁，闭目昏沉，这是厥竭症，尤其与风邪无关。如果不是大剂量人参、熟地黄或七年之陈艾破格挽回，又怎能指望在真气将绝之时恢复真气呢！如果不能察辨表里，又不能分辨虚实，仅仅因为名字里有“风”字，就多用风药，不知道风药皆燥，燥复伤阴；风药皆散，散复伤气。以内伤当作外感，以不足当作有余，这是促使人死亡啊。）肾风而不能进食，容易惊恐，惊恐之后心气痿弱不能恢复的会死亡，（风生于肾，则反克脾土，所以不能进食。肾邪侵犯心脏则神气失守，所以容易惊恐。惊恐后心气痿弱不能恢复的，是心肾俱败，水火俱困，所以死亡。）
有一种病症表现为身体发热、肢体懈怠无力，出汗如洗澡般，怕风且气短，病名为“酒风”。（这就是前面所说的“漏风”。酒性本热，过度饮酒致病，所以导致身体发热。湿热伤害筋脉，所以懈怠无力。湿热蒸腾于皮肤腠理，所以出汗如浴。汗多则卫气虚弱，所以怕风。卫虚则气泄，所以气短。因饮酒后感风而病，所以叫“酒风”。）治疗用泽泻、白术各十分，麋衔五分，混合后用三指撮取，作为饭后服用的药剂。（泽泻味甘淡，性微寒，能渗利湿热。白术味甘苦，气温，能补中气，燥湿止汗。麋衔，即薇衔，一名无心草，南方人称为吴风草，味苦平，微寒，主治风湿。十分是加倍的意思，五分是减半的意思。合以三指，是用三指撮合，以约略数量作为煎剂。饭后服药在先，所以叫“后饭”。）
贼风邪气伤人，使人患病。有的人并不离开遮蔽物，也不走出居室，却突然生病，这并不是因为没有遇到贼风邪气，这都是因为曾经受过湿气伤害，湿气藏在血脉之中、分肉之间，长久停留不去；或者曾经有堕坠受伤，恶血留在体内不去；或者突然喜怒不节制，饮食不适，寒温不调，腠理闭塞不通。（以上这些，都称为“故邪”。）当腠理开泄时遇到风寒，则血气凝结，与故邪相合，就成为“寒痹”。（其开者，指冒露于风寒之中。故邪在前，风寒继之，二者相遇，则血气凝结，所以成为寒痹；寒气胜者为痛痹。）如果有热则出汗，出汗则受风，即使没有遇到贼风邪气，也一定有因旧邪引发新病的情况。（如果有因热出汗而受风者，虽然不是贼风邪气，也是外感。一定有因加而发者，指因于旧邪再加上新的诱因，新旧邪气结合，所以发病了。）这些都是病人自己知道的。如果没有遇到邪气，又没有惊恐忧虑的情志刺激，却突然生病，难道是鬼神作祟吗？（鬼神之事，大概是自古以来迷惑人的说法。）不是这样的，这也是因为有故邪留滞而未发作，因而情志有所厌恶，或有所贪慕，导致血气内乱，新旧两气相搏，病邪来的机理很细微，看也看不见，听也听不见，所以好像鬼神。（故邪，如上文中“留而未发”所说。恶，指厌恶所憎恨的事物。慕，指贪慕所喜爱的事物。故邪未发而新邪又触动它，则五志被邪气凭借，血气因而内乱，邪正先后，两气相搏，妄病就产生了。但病邪来源的机理非常微妙，非闻见所能触及。所以人怀疑是鬼神，不知道迹象似鬼神，而实际上并非鬼神所为。）那些通过祝由治愈的，是因为巫师懂得百病相胜的道理，预先知道病邪产生的根源，可以用祝由法治愈。（祝，是巫咒一类，即祝由。胜，指凡百病五行之道，必有所以胜之的方法。然而必须预先知道病邪产生的缘由，然后用胜法克制它，就可以移精变气，祛除邪气。有病是药物针石所不及的，非此法不可，只有古代巫师知道，所以可以用祝由治愈。既然如此，古代巫师用祝由的妙处，正不在于祝咒本身，其关键在于“胜”的原理而已。祝、咒同义。）
(Not listed in the regular sequence.) If joy causes a severe deficiency of Heart Qi, then Kidney Qi will take advantage of this to invade. (Joy causes Qi to sink downward, thereby damaging the Heart. When the Heart is damaged and severely deficient, Kidney Qi invades; this represents Water overcoming Fire.) Anger causes Liver Qi to overact upon the Spleen. (Anger causes Qi to rebel upward in the Liver and attack the Spleen; this represents Wood overcoming Earth.) Grief causes Lung Qi to overact upon the Liver. (Grief causes Qi to gather in the Lungs and attack the Liver; this represents Metal overcoming Wood.) Fear causes Spleen Qi to overact upon the Kidneys. (Fear damages the Kidneys, causing Kidney Qi to become deficient, allowing Spleen Qi to invade; this represents Earth overcoming Water.) Worry causes Heart Qi to overact upon the Lungs. (Worry damages the Lungs, causing Lung Qi to become deficient, allowing Heart Qi to invade; this represents Fire overcoming Metal.) This is the principle of mutual overacting. (Some cases involve excess pathogenic factors attacking another organ, while others involve deficiency allowing another organ to attack. In all cases, the attack occurs on the organ that one cannot overcome in the normal cycle; this is the rule of irregular transmission.) Therefore, there are five basic types of diseases, and the mutual transmission among the five Zang organs can produce twenty-five variations; these are named "transmission" (Chuan) and "overacting" (Cheng). (There are only five Zang organs, but the transmission between them can involve each of the other four, resulting in twenty-five variations. "Transmission" refers to disease moving from one organ to another, while "overacting" refers to strong pathogenic factors bullying weak ones; hence the different names.)
There is a condition characterized by fever, sweating, and vexation with fullness, where the vexation does not resolve with sweating. ("Does not resolve with sweating" means that the vexation and heat persist after sweating.) Fever accompanied by sweating indicates Wind pathogen; sweating accompanied by unresolved vexation and fullness indicates Jue syndrome. This disease is named "Wind-Jue". The Taiyang (Greater Yang) channel governs the exterior Qi and is thus the first to be affected by pathogens; the Shaoyin (Lesser Yin) channel is interior-exterior paired with it. When heat affects the Taiyang, the Shaoyin Qi follows it upward, transforming into heat; when Qi rebels upward, it forms Jue. (Wind is a Yang pathogen, so although sweating occurs, the body remains hot. Taiyang governs the exterior Qi. Exterior disease prompts interior response; thus, when Shaoyin receives heat, the Yin Qi also follows the Yang upward and rebels, forming Jue. Hence the name "Wind-Jue". Note: "Wind-Jue" has multiple meanings; here it refers to simultaneous disease of Taiyang and Shaoyin. Another form involves Yangming and Jueyin channels, affecting the Stomach and Liver. People prone to Wind-Jue with profuse sweating have insecure flesh and loose interstices.) Laofeng (Labor-induced Wind) disease typically manifests below the Lungs. (Laofeng results from wind invasion following physical exhaustion. "Below the Lungs" refers internally to the chest and diaphragm region, and externally to the area between the fourth and fifth thoracic vertebrae. Wind enters from the exterior and manifests internally; those exhausted by labor inevitably pant, indicating that labor injures the Lungs.) Symptoms include stiffness of the neck and upper back, and dim vision. (Pathogens below the Lungs cause panting and rebellion, leading to neck stiffness preventing bowing. Wind-heat obstructs upward, causing photophobia, leading to closing eyes to see.) The patient expectorates thick sputum resembling phlegm, feels aversion to wind, and experiences chills. This is called "Laofeng". (Wind-heat damages Yin fluids, making secretions thick and turbid, hence sputum like phlegm. The Lungs govern skin and hair; damage to Wei Qi causes aversion to wind and chills.) Treatment should prioritize resolving difficulty in flexion and extension. (The severity of Wind is reflected in the limitation of flexion and extension movements; thus, relief must be sought first. However, treating this requires warming the Lung Qi first; warming dissipates Wind, and once Wind dissipates, movement returns to normal. If warming and dispersing fail, stagnation may turn into heat, requiring clearing and resolving methods thereafter. Improper use of warming or clearing will worsen the condition.) For patients who can guide Essence upward, recovery occurs in three days; for middle-aged patients with declining Essence, five days; for elderly patients with depleted Essence, seven days. (Wind pathogens injuring the Lungs enter via the Fengmen and Feishu acupoints of the Foot-Taiyang Bladder channel into the Zang organs. The Large Intestine is the Fu organ of Water and the exterior of the Three Yang channels; thus, guiding Essence upward allows Wind to be expelled through coughing. If Taiyang Qi is vigorous, guiding Essence is rapid, with recovery in three days; middle-aged patients with declining Essence recover in five days; elderly patients with depleted Essence recover in seven days, expectorating green-yellow sputum and nasal discharge, as described below. This is what is meant by "guiding Essence".) Expectoration of green-yellow purulent sputum, resembling pus and sized like a bullet, expelled from the mouth or nose, is critical. If not expelled, it damages the Lungs, leading to death. (Inability to cough up sputum, known today as dry cough, can progress to depletion of Metal and Water, presenting as consumptive disease, leading to death. Exhaustion of Kidney Qi and internal deficiency of Lung Qi, combined with forcing Yang Qi, prevents expulsion, damaging the Lungs and causing death.)
Patients with Shenfeng (Kidney Wind) present with facial edema, a pale and lusterless complexion, and heavy, unclear speech. (Edema. Pale/lusterless appearance. Heavy/unclear. The Kidney meridian circulates along the throat and flanks the tongue root; Wind pathology impedes the Kidney meridian, causing heavy and unclear speech.) They experience shortness of breath, intermittent fever, heat rising from the chest and back to the head, hot palms, dry mouth with bitter taste and thirst, yellow urine, edema under the eyes, borborygmus, heaviness of the body making movement difficult, amenorrhea, irritability preventing eating, inability to lie supine (supine position aggravates coughing). This disease is named "Fengshui" (Wind-Water). (The Kidneys govern Water; Wind in the Kidney meridian is named "Fengshui".) This occurs because where pathogens gather, Qi must be deficient. (Pathogens invade due to deficiency; thus, where pathogens gather, Qi is necessarily deficient.) Yin deficiency leads to Yang pathogens gathering in the Yin aspect, causing shortness of breath, intermittent fever, and sweating. (Yin deficiency results in lack of Qi, causing shortness of breath and intermittent fever. Yang tends to scatter and gather in the Yin aspect, causing sweating.) Yellow urine indicates heat in the lower abdomen. (Heat in the lower abdomen implies pathogen in the Yin aspect, hence yellow urine.) Inability to lie supine is due to disharmony in the Stomach. Supine position aggravates coughing because Qi rebels upward and presses on the Lungs. (Supine means lying flat. The Kidney meridian passes through the liver and diaphragm, enters the Lungs, and its branch enters the chest. Kidney pathogens move upward, causing Stomach Qi to rebel and become disordered, so supine position aggravates coughing and presses on the Lungs.) In all cases of fluid retention, slight edema appears first under the eyes. Water is Yin; the area under the eyes is also Yin. The abdomen is the residence of Supreme Yin; thus, fluid in the abdomen causes edema under the eyes. (Edema under the eyes resembling a sleeping silkworm indicates fluid retention in the abdomen.) Rebellion of True Qi causes bitter taste and dry tongue, inability to lie supine, and expectoration of clear water when supine. All water-disease patients cannot lie flat; lying down causes fright, which aggravates coughing. (Water pathogens stagnate in the Zang organs, causing Qi rebellion. Qi rebellion prevents lying flat, causing fright and severe coughing.) Borborygmus originates in the Stomach. Pathogens pressing on the Spleen cause irritability and anorexia; food impaction is due to obstruction in the epigastrium. Heaviness and difficulty walking relate to the Stomach meridian running on the feet. (Spleen and Stomach belong to Earth, controlling Water. If Earth is weak, Cold Water insults it, causing borborygmus and food impaction. The Stomach governs muscles, and its meridian runs on the feet. Fluid retention in muscles causes heaviness and immobility.) Amenorrhea is due to closure of the Bao Mai (Uterine Vessels). The Bao Mai belongs to the Heart and connects to the Bao (Uterus). Currently, Qi rebels upward pressing on the Lungs, preventing Heart Qi from descending, thus causing amenorrhea. (Bao is the Uterus, seat of Ministerial Fire; the Heart governs Blood vessels, seat of Sovereign Fire. Yang Qi communicates上下, so Bao Mai belongs to the Heart and connects to the Uterus to regulate menstruation. Now, Qi rebels upward, Yin pathogens block Yang pathways, Heart Qi cannot descend, Bao Mai closes, and menstruation stops.)
If the appearance resembles edema, but the pulse is large and tight, the body has no pain, the form is not emaciated, and the patient cannot eat or eats little, the disease is located in the Kidneys and is named "Shenfeng". (Resembling edema refers to facial swelling that looks like water but is not true water retention. A large pulse indicates Yin deficiency; a tight pulse indicates Cold. No pain and non-emaciation indicate the pathogen is in the Zang, not the exterior. Wind carrying Kidney pathogens injures the Spleen and Stomach, causing anorexia. Thus, Wind has external and internal distinctions that must be recognized. Eight Winds enter from outside, initially presenting with fever, aversion to cold, headache, and body pain. These external infections are clearly observable. Five Winds arise internally, presenting without external signs, suddenly appearing like Wind, indicating internal injury, such as "all sudden stiffness belongs to Wind" and "all Wind tremors and dizziness belong to the Liver." Generally, having been struck by something is called external infection; having no external strike is called internal injury. External infection attacks the muscle-surface, often presenting as Yang Excess; internal injury results from alcohol, sex, labor, fatigue, emotions, and diet, damaging Zang Qi, often presenting as Yin Deficiency. When Zang Qi is injured: Spleen failure manifests in limbs or phlegm-fluids; Kidney disease manifests in marrow or two yin openings; Heart disease manifests in blood vessels or spirit/mind; Lung disease manifests in Ying-Wei or voice; Liver disease manifests in sinews/claws or hypochondrium. All these Zang-type Wind diseases stem from Yin Deficiency. Only Li Dongguan grasped this principle: he stated that stroke-like sudden fainting and loss of consciousness is not external Wind pathogen, but self-disease of the Root Qi. People over forty with declining Qi often suffer this. At forty, Yin Qi naturally halves, making them prone to this; is it not Yin Deficiency? Humans are born from Yang but rooted in Yin. If the root declines, illness ensues; if the root fails, danger looms. The root is True Yin. People know Yin Deficiency as one category, but do not know there are two: Water deficiency within Yin affects Essence and Blood; Fire deficiency within Yin affects Spirit and Qi. Yang decline leads to Qi departure, causing mental confusion—is this not Fire deficiency? Yin depletion leads to physical deterioration, causing limb flaccidity—is this not Water deficiency? Now, facing symptoms of spirit separation and physical decay, if one does not seek the source of Water and Fire but treats with Wind-dispelling methods, danger is inevitable. Therefore, treating pseudo-Wind conditions requires specifically tonifying True Yin to save the root; restoring Yin eliminates Wind and Dryness. However, external infections are not devoid of deficiency (Qi deficiency is deficiency); internal injuries are not devoid of excess (stagnation is excess). Treating deficiency requires observing whether it is Yin or Yang and directly tonifying; treating excess requires observing if it is due to Phlegm or Qi and temporarily opening/resolving. In handling internal vs. external and deficiency vs. excess, one must carefully assess the presence and severity of subtle differences to adjust treatment. Even cases of inherent Yuan Qi deficiency presenting with sudden collapse, no phlegm above, incontinence below, closed eyes, and lethargy are Jue-Jie (Collapse) syndromes, unrelated to Wind pathogen. Without large doses of Ginseng, Rehmannia, or seven-year-old Mugwort to drastically rescue, how can one hope to restore Qi at the brink of extinction! If one cannot distinguish exterior-interior or deficiency-excess, and merely uses Wind-dispelling herbs because of the name "Wind," one ignores that Wind herbs are drying (injuring Yin) and dispersing (injuring Qi). Treating internal injury as external infection, and insufficiency as excess, hastens death.) If Shenfeng prevents eating, causes frequent fright, and leads to Heart Qi atrophy after fright, death occurs. (Wind generated in the Kidneys insults Earth, causing anorexia. Kidney pathogens invading the Heart cause loss of Spirit control, leading to fright. If Heart Qi remains atrophic and unable to recover after fright, both Heart and Kidney fail, and Water and Fire are trapped, leading to death.)
A condition characterized by fever, lassitude, profuse sweating like bathing, aversion to wind, and shortness of breath is named "Jiufeng" (Alcohol Wind). (This is the "Loufeng" mentioned earlier. Alcohol is inherently hot; excessive consumption causes fever. Damp-heat injures sinews, causing lassitude. Damp-heat steams the skin and pores, causing profuse sweating. Profuse sweating weakens Wei Qi, causing aversion to wind. Wei deficiency leads to Qi leakage, causing shortness of breath. Disease acquired from alcohol followed by Wind exposure is called "Alcohol Wind".) Treatment uses Ze Xie (Alisma Rhizome) and Bai Zhu (Atractylodes Macrocephala Rhizome), ten parts each, and Mi Xian (Dendranthemi Indici Herba), five parts. Mix and take three finger-widths as a dose, administered after meals. (Ze Xie is sweet, bland, slightly cold, promoting damp-heat drainage. Bai Zhu is sweet, bitter, warm, tonifying the Middle, drying dampness, and stopping sweating. Mi Xian, also known as Wei Xian or Wu Feng Cao, is bitter, neutral, slightly cold, treating Wind-Damp. Ten parts means double; five parts means half. Mixing with three fingers approximates the quantity for decoction. Taking medicine after food is called "Hou Fan".)
Zei Feng (Thieving Wind) pathogens injure humans, causing disease. Some people do not leave shelter or exit their rooms yet fall ill suddenly. This is not because they avoided Zei Feng pathogens; rather, they previously suffered moisture injury, which lodged in the blood vessels and between muscle layers, lingering long-term. Or they had previous falls causing blood stasis retained internally. Or they experienced uncontrolled anger/joy, improper diet, or temperature dysregulation, leading to closed and blocked interstices. (All these are called "Gu Xie" / Old Pathogens.) When the interstices open and encounter Wind-Cold, blood and Qi coagulate, combining with old pathogens to form "Han Bi" (Cold Bi). (Opening refers to exposure to Wind-Cold. Old pathogens are present; Wind-Cold follows. Their collision causes coagulation, forming Cold Bi; if Cold dominates, it is Painful Bi.) If there is heat, sweating occurs; sweating invites Wind. Even without encountering Zei Feng pathogens, new manifestations will arise from old triggers. (Sweating from heat invites Wind. Although not Zei Feng, it is still external contraction. New manifestations arise from old triggers, meaning old pathogens combine with new inducements, causing disease onset.) Patients are aware of these themselves. If no pathogen was encountered, nor any fright or anxiety, yet sudden illness occurs, is it due to ghosts and spirits? (Ghost/spirit stories have confused people since ancient times.) No. This is also due to old pathogens lingering unmanifested. Emotional aversion or obsession disturbs blood and Qi, causing internal chaos and conflict between pathogenic and healthy Qi. The origin is subtle, invisible and inaudible, seeming like ghosts/spirits. (Old pathogens refer to those "lingering unmanifested." Aversion refers to hating something; obsession refers to desiring something. Unmanifested old pathogens triggered by new stimuli allow Five Emotions to be possessed by pathogens, disturbing blood and Qi. Pathogenic and healthy Qi clash, generating false illness. The mechanism is too subtle for senses, leading to suspicion of ghosts/spirits, though it is not actually supernatural.) Those cured by Zhu You (Incantation Therapy) are healed because the shaman understands the mutual overcoming of the Five Elements in diseases, knowing the origin of the disease, and using incantations to shift spirit and change Qi, expelling pathogens. (Zhu refers to shamanic incantations, i.e., Zhu You therapy. Overcoming refers to the Five Element principles governing disease cure. One must first know the disease origin to apply the overcoming method, shifting spirit/Qi and expelling pathogens. Some diseases are beyond herbal/acupuncture reach, requiring this method. Ancient shamans knew this, so Zhu You works. The subtlety of Zhu You lies not in the incantation itself, but in the principle of "overcoming." Zhu and Zhou are synonymous.)