病本十形，风、寒、燥、湿，暑、火二分内伤、外伤，内积、外、积，六气四因，病机以明。气固形实，
形虚中风，或为寒热，或为热中，或为寒中，或为厉风，或为偏枯，半身不遂。此率多痰，或属血虚，
在左死血，在右属痰。痰壅盛者，口眼 斜，不能言语，皆用吐法。气虚卒倒，降痰益气。火热而甚，燥热
潮热，治经随之。阴虚补阴，勿骤凉治。轻可降散，实则可泻。重者难疗，从治可施。中寒感寒，阴毒阴逆，
四肢厥冷，腹痛唇青，退阴正阳，急可温中。伤寒所致， 病有二∶发热恶寒，头项强痛，腰脊反张，口
噤而赤，螈 如痫，有汗柔暑，无汗名刚。春伤于风，夏必飧泄；复伤于暑，秋必 疟；秋伤于湿，冬必
咳嗽；冬伤于寒，春必温病。夏月身热，汗出恶寒，身重脉微，渴乃中 。春时病温，温疫、温
毒、温疟、风温，脉证分异，五种疾因。中湿风湿，暑成湿温。三种可别，湿热可分。寒痰、香港脚、食积、
劳烦，要知四证，乃似伤寒，伤寒之病，见中风脉；中风之病，得伤寒脉。大小青龙，治剂
必识，调卫调营，斯须两得。疟木伤寒，或痰，或食。老疟疟母，久则羸疲。三日一发，病经一岁；间日
发者，受病半年；一日一发，新病所以。连二日发，住一日者，气血俱病。或用截法，或随
经治。嗽多感寒，当分六气，六本一标，病机所秘。风热与寒。随证治之。暑燥清金，湿则利水。有声无
痰咳少。痰可降蠲，咳随本治。喘有气虚，或有痰壅，或因气逆。或倚息使。痢本湿热，或因
食致，腹痛下血，后重不利，治可通散，勿使涩住，湿热未消，成休息痢。泄泻多湿，热食气虚，如本脾泄，
胀而呕吐，洞泄不禁；肠泄则疼，瘕泄不便，后重茎痛；胃泄色黄，食饮不化。《太素》分
五∶溏泄、骛泄、飧濡、滑泄。渗闭阑门，泄实对证。瘅乃湿热；
曲相似。消渴热因，水肿气致。自汗阳亏，盗汗阴虚，东垣有法，对证可施。头风头痛，有痰者多。血虚与
热，分经可治。头旋眩晕，火积其痰，或本气虚，治痰为先。腰痛湿热，或本肾虚，或兼恶血。胁痛多气，或肝
火盛，或有死血，或痰流注。劳瘵阴虚，癫狂阳炽。呕吐略衄，气虚脉洪，火载血上，错经妄行。溺血便血，
病同所因。梦遗精滑，湿热之乘。便浊本热，有痰有虚。白浊属卫，赤浊属荣。热极成淋，气滞不通。血虚
惊悸，气虚耳聋。哕因胃病，疝本肝经，痿唯湿热，气弱少荣。厥多痰气，虚热所乘。手麻气虚，手木湿痰，
或死血病。霍乱吐泻，感风湿 。心痛脾疼，阴寒之说。气热烦劳，令人煎厥。气逆太甚，使人薄厥。浊气
在上，则生 胀，清气在下，则生飧泄。阴火之动，发为喉痹。阳水变病，飧泄方是。三阳病结，乃发寒热，
下体壅肿，及为痿厥。二阳之病，病发心脾，男子少精，女子不月。一阳发病，少气嗽泄，寒客在上，胃寒
阳热，水谷不化，痞胀而泄；热气居上，肠寒胃热，消谷善饥，腹胀便涩。蕴热怫郁，乃生
诸风。风寒与湿，合而为痹。膏粱之变，饶生大疔。荣气不从。逆于内里，乃生痈肿。疮疡凭脉，治乃不惑。
身重脉缓，湿胜除湿，身热脉大，躁热发肿，退热凉荣。眩晕动摇，痛而脉弦，降痰去风。气涩卫滞，躁渴
脉涩，补血泻气。食少恶寒，脉来紧细，宜泻寒水。辨经部分，详审为治。湿热生虫，水积痰饮。目痛赤肿，
精散荣热。牙痛龈宣，寒热亦别。五脏本病，热争重疸。六腑不和，留结为痈。五脏不和，九窍不通。脏
腑相移，传变为病，不可胜纪。间脏者存，传其所生；七传者死，传其所制。五脏有积，肝曰肥气，在左胁
下，大如覆杯，或有头足，久则变病，咳逆 疟，连岁不已；心积伏梁，病起脐上，其大如臂，上至心下，
如久不愈，令人烦心；脾积痞气，其在胃脘，复大如盘，久而不愈，四肢不
举，乃发黄瘅，虽食而瘦；肺积息 ，在右胁下，复大如杯，久而不愈，令人喘急，骨痿少气。鼓胀发蛊，
中满郁痞，开提其气，升降是宜。人身之本，脾胃为主。头痛耳鸣，九窍不利，肠胃所生。
胃气之虚，虚极变病，五乱互作。东垣所论∶王道之学，一虚一实，五实五虚。五劳七伤，六极乃痿；五
郁七情，九气所为。怒则气上，喜则气缓，悲则气消，恐则气下，寒则气收，暑则气泄，惊
则气乱，劳则气耗，思则气结。忧愁思虑，甚则伤心；形寒饮冷，过则伤肺；喜怒气逆，逆则伤肝；饮食劳
倦，甚乃伤脾；坐卧湿地，强力入水，故乃肾伤。皆因气动。形神自病，喜怒不节。劳形厥气，气血偏胜。阴
阳相乘，阳乘阴病，阴乘阳病。阳乘则热，阴乘则寒。重寒则热，重热则寒、寒则伤形，热则伤气。气伤则病，
形伤则肿。先痛后肿，气伤形也；先肿后痛，形伤气也。阴阳变病，标本寒热，如大寒甚，热之不热，是无
火也；热来复去，昼见夜伏，夜发昼见，时节而动，是无火也，当助其心。如大热甚，寒之不寒，是无水也；
热动复止，倏忽往来，时动时止，是无水也，当助其肾。内格呕逆，食不得入，是有火也；病呕而吐，食入
反出，是无火也。暴逆注下，食不及化，是有火也；溏泄而久，止发无常，是无水也。心盛生热，肾盛生寒。
又热不寒，是无火也，寒不得热，是无水也。寒之不寒，责其无水；热之不热，责其无火。
热之不久，责心之虚；寒之不久，责肾之少。审察病机，无失气宜，纪于水火，余气可知。室女病多，带下
赤白， 瘕 疝，气血为病。经闭不行，或漏不止，经过作痛，虚中有热。行而痛者，血
实之证，如不及期，血热乃结；过期血少，闭或血枯。淡者痰多，紫者热故。热极则黑，调荣降火，调理
妊娠，清热养血。一当产后，如无恶阻，大补气血，虽有他证，以末治之。大凡小儿，过暖
生热，热极生风，风痰积热，随病为治。生有胎恶，月里生惊，生
赤生呕，生黄不便。脐风撮口，变蒸发热，风痫癫痫，急慢惊
风，螈 惊愕，惊悸虚冒，暴急吐 ，腹胀 嗽，中恶天吊，鹅口重舌，木舌弄舌，客忤夜啼，脓耳鼻疳，
眉炼丹瘤，阴肿便浊，舌烂口臭，断蚀牙疳，虫痛吐蛔，疳瘦解颅，便青颊赤，食吐饮
水，吐泻青白，昏睡露睛，呵欠面黄，呷牙咬齿，泻痢脱肛，痈疡瘾疹，疮痘发斑，惊疳诸积。大率为病，
肝与脾经，脉治凭允。钱氏方论，男女病情，饮食起居，暴乐暴苦。始乐后苦；皆伤精气。
先富后贫，病曰失精；先贵后贱，虽不中邪，病从内生，名曰脱营。身体日减，气虚无精，良工勿失，
脉病证治，知微可已，举腹痛经，阴证治例，海藏所云，玄机之秘。
疾病的本源有十种形态，风、寒、燥、湿，暑、火分为内伤与外伤，内积与外积，六气与四因，病机由此明晰。
若正气固守、形体充实，则不易受邪；若形体虚弱而中风邪，可能表现为寒热往来，或为热中（热邪入里），或为寒中（寒邪入里），或为厉风（烈性风邪所致疾病），或为偏枯（半身不遂），导致半身瘫痪。这类病症大多伴有痰浊，或属于血虚。病位在左侧多为死血（瘀血），在右侧多属痰浊。若痰浊壅盛，出现口眼歪斜，不能言语，均应采用吐法治疗。若是气虚突然昏倒，应降痰并益气。若火热炽盛，出现燥热或潮热，治疗需根据经络随之调整。阴虚者补阴，不要骤然使用凉药治疗。病情轻浅可用轻清宣散之法，实证可用泻法。病情沉重者难治，可采用从治法（反治法）。若感受中寒或寒邪，出现阴毒、阴逆，四肢厥冷，腹痛唇青，应退阴扶阳，急温中焦。
伤寒所致的疾病，主要有两种情况：发热恶寒，头项强痛，腰脊反张，口噤面赤，抽搐如痫证，有汗称为柔痉，无汗称为刚痉。春季伤于风邪，夏季必然发生飧泄（完谷不化的腹泻）；若再伤于暑邪，秋季必然发生疟疾；秋季伤于湿邪，冬季必然发生咳嗽；冬季伤于寒邪，春季必然发生温病。夏季身体发热，出汗且恶寒，身体沉重脉象微弱，口渴则是中暑。春季发生的温病，包括温疫、温毒、温疟、风温，通过脉证区分，这是五种疾病的病因。中湿、风湿，暑气结合湿气形成湿温。这三种可以辨别，湿热也可以区分。寒痰、脚气、食积、劳烦，要知晓这四种证候，它们看似伤寒，但伤寒的病可见到中风脉象；中风的病可见到伤寒脉象。大青龙汤、小青龙汤等治疗方剂必须认识清楚，调和卫气与营气，片刻之间即可兼顾。
疟疾类似伤寒，或由痰引起，或由食积引起。老疟形成的疟母，日久会导致身体消瘦疲乏。三日发作一次的疟疾，病程经过一年；隔日发作的，受病半年；每日发作一次的，是新病。连续两天发作，休息一天再发的，是气血都患病了。可以采用截疟法，或根据经络进行治疗。咳嗽多因感寒，应当分辨六气，六气本于一标，这是病机的奥秘。风热与寒邪，随证治疗。暑燥宜清金（润肺），湿邪宜利水。有声无痰的咳少，有痰者可降蠲痰浊，咳嗽随根本治疗。喘证有气虚的，或有痰壅盛的，或因气逆引起的，或倚息而喘。痢疾本源是湿热，或因饮食不当导致，腹痛下血，里急后重不利，治疗可通散，不要使用涩滞药物使邪气留驻，若湿热未消，会形成休息痢。泄泻多由湿引起，也有热、食积、气虚之分。如脾泄，腹胀而呕吐，洞泄不禁；肠泄则疼痛，瘕泄排便不便，里急后重且茎中疼痛；胃泄大便色黄，饮食不化。《太素》将其分为五类：溏泄、骛泄、飧濡、滑泄。渗闭阑门，泄实是对证治疗。
疸病乃是湿热所致，曲相似（指黄疸色泽）。消渴由热引起，水肿由气引起。自汗是阳虚，盗汗是阴虚，李东垣有治疗方法，对证施治。头风头痛，多有痰浊。血虚与热，分经治疗。头旋眩晕，火积痰浊，或本源气虚，治疗以化痰为先。腰痛由湿热引起，或本源肾虚，或兼有瘀血。胁痛多由气滞引起，或肝火旺盛，或有瘀血，或痰流注。劳瘵（肺结核等慢性消耗性疾病）属阴虚，癫狂属阳热炽盛。呕吐伴轻微鼻衄，气虚脉洪大，火载血上行，错经妄行。溺血便血，病因相同。梦遗精滑，是湿热乘袭。便浊本源是热，有痰有虚。白浊属卫分，赤浊属营分。热极成淋，气滞不通。血虚致惊悸，气虚致耳聋。呃逆因胃病引起，疝气本源在肝经，痿证唯湿热引起，气弱则营血不足。厥证多由痰气引起，虚热乘袭。手麻是气虚，手木（麻木）是湿痰，或瘀血致病。霍乱吐泻，感受风湿。心痛脾疼，是阴寒之说。气热烦劳，令人煎厥。气逆太甚，使人薄厥。浊气在上，则生胀满，清气在下，则生飧泄。阴火之动，发为喉痹。阳水变病，飧泄方是。三阳病结，乃发寒热，下体壅肿，及为痿厥。二阳之病，病发心脾，男子少精，女子不月。一阳发病，少气嗽泄，寒客在上，胃寒阳热，水谷不化，痞胀而泄；热气居上，肠寒胃热，消谷善饥，腹胀便涩。蕴热怫郁，乃生诸风。风寒与湿，合而为痹。膏粱之变（饮食肥甘厚味过度），饶生大疔。荣气不从，逆于内里，乃生痈肿。疮疡凭脉诊断，治疗就不疑惑。
身重脉缓，湿胜除湿，身热脉大，躁热发肿，退热凉营。眩晕动摇，痛而脉弦，降痰去风。气涩卫滞，躁渴脉涩，补血泻气。食少恶寒，脉来紧细，宜泻寒水。辨经部分，详审为治。湿热生虫，水积痰饮。目痛赤肿，精散荣热。牙痛龈宣（牙龈肿痛出血），寒热亦别。五脏本病，热争重疸。六腑不和，留结为痈。五脏不和，九窍不通。脏腑相移，传变为病，不可胜纪。间脏者存，传其所生；七传者死，传其所制。
五脏有积，肝曰肥气，在左胁下，大如覆杯，或有头足，久则变病，咳逆疟，连岁不已；心积伏梁，病起脐上，其大如臂，上至心下，如久不愈，令人烦心；脾积痞气，其在胃脘，复大如盘，久而不愈，四肢不举，乃发黄瘅，虽食而瘦；肺积息贲，在右胁下，复大如杯，久而不愈，令人喘急，骨痿少气。鼓胀发蛊，中满郁痞，开提其气，升降是宜。人身之本，脾胃为主。头痛耳鸣，九窍不利，肠胃所生。胃气之虚，虚极变病，五乱互作。李东垣所论：王道之学，一虚一实，五实五虚。五劳七伤，六极乃痿；五郁七情，九气所为。怒则气上，喜则气缓，悲则气消，恐则气下，寒则气收，暑则气泄，惊则气乱，劳则气耗，思则气结。忧愁思虑，甚则伤心；形寒饮冷，过则伤肺；喜怒气逆，逆则伤肝；饮食劳倦，甚乃伤脾；坐卧湿地，强力入水，故乃肾伤。皆因气动。形神自病，喜怒不节。劳形厥气，气血偏胜。阴阳相乘，阳乘阴病，阴乘阳病。阳乘则热，阴乘则寒。重寒则热，重热则寒。寒则伤形，热则伤气。气伤则病，形伤则肿。先痛后肿，气伤形也；先肿后痛，形伤气也。
阴阳变病，标本寒热，如大寒甚，热之不热，是无火也；热来复去，昼见夜伏，夜发昼见，时节而动，是无火也，当助其心。如大热甚，寒之不寒，是无水也；热动复止，倏忽往来，时动时止，是无水也，当助其肾。内格呕逆，食不得入，是有火也；病呕而吐，食入反出，是无火也。暴逆注下，食不及化，是有火也；溏泄而久，止发无常，是无水也。心盛生热，肾盛生寒。又热不寒，是无火也，寒不得热，是无水也。寒之不寒，责其无水；热之不热，责其无火。热之不久，责心之虚；寒之不久，责肾之少。审察病机，无失气宜，纪于水火，余气可知。
室女病多，带下赤白，瘕疝，气血为病。经闭不行，或漏不止，经过作痛，虚中有热。行而痛者，血实之证，如不及期，血热乃结；过期血少，闭或血枯。淡者痰多，紫者热故。热极则黑，调营降火，调理妊娠，清热养血。一当产后，如无恶阻，大补气血，虽有他证，以末治之。大凡小儿，过暖生热，热极生风，风痰积热，随病为治。生有胎恶，月里生惊，生赤生呕，生黄不便。脐风撮口，变蒸发热，风痫癫痫，急慢惊风，螈惊愕，惊悸虚冒，暴急吐，腹胀嗽，中恶天吊，鹅口重舌，木舌弄舌，客忤夜啼，脓耳鼻疳，眉炼丹瘤，阴肿便浊，舌烂口臭，断蚀牙疳，虫痛吐蛔，疳瘦解颅，便青颊赤，食吐饮水，吐泻青白，昏睡露睛，呵欠面黄，呷牙咬齿，泻痢脱肛，痈疡瘾疹，疮痘发斑，惊疳诸积。大率为病，肝与脾经，脉治凭允。钱氏方论，男女病情，饮食起居，暴乐暴苦。始乐后苦；皆伤精气。先富后贫，病曰失精；先贵后贱，虽不中邪，病从内生，名曰脱营。身体日减，气虚无精，良工勿失，脉病证治，知微可已，举腹痛经，阴证治例，海藏所云，玄机之秘。
The origin of diseases encompasses ten forms: wind, cold, dryness, dampness, summerheat, and fire. These are categorized into internal and external injuries, internal and external accumulations, six qi (pathogenic factors) and four causes, thereby clarifying the pathogenesis.
When vital qi is solid and the physical form is robust, one resists pathogens; however, if the physical form is deficient and struck by wind pathogens, it may manifest as alternating chills and fever, or "Re Zhong" (Heat entering the interior), or "Han Zhong" (Cold entering the interior), or "Li Feng" (severe wind-induced disease), or "Pian Ku" (hemiplegia/paralysis of half the body). Such conditions are mostly associated with phlegm or blood deficiency. Lesions on the left side often indicate static blood (blood stasis), while those on the right side often indicate phlegm. In cases of severe phlegm obstruction causing facial paralysis (deviation of mouth and eyes) and aphasia, emetic therapy should be employed. For sudden collapse due to qi deficiency, descending phlegm and tonifying qi is indicated. If fire-heat is excessive, presenting as dry heat or tidal fever, treatment must follow the affected meridians. For yin deficiency, tonify yin; do not abruptly use cooling agents. Mild conditions can be treated with light dispersing methods, while excess conditions require purgation. Severe conditions are difficult to treat but may respond to contrary treatment (treating with methods opposite to the apparent symptoms). If struck by middle-cold or cold pathogens, leading to yin toxicity or yin reversal, with cold limbs, abdominal pain, and cyanotic lips, one must dispel yin and restore yang, urgently warming the middle jiao.
Diseases caused by Cold Damage (Shang Han) present in two main types: fever with aversion to cold, stiffness and pain in the head and neck, opisthotonos (arching of the back), trismus (lockjaw) with a red face, convulsions resembling epilepsy. With sweating, it is called "Rou Jing" (Flaccid Spasm); without sweating, it is called "Gang Jing" (Stiff Spasm). Injury by wind in spring leads to undigested diarrhea (Sun Xie) in summer; if additionally injured by summerheat, malaria occurs in autumn. Injury by dampness in autumn leads to cough in winter; injury by cold in winter leads to Warm Diseases (Wen Bing) in spring. In summer, body heat with sweating, aversion to cold, heaviness, faint pulse, and thirst indicates Heat Stroke (Zhong Shu). Warm diseases occurring in spring include Warm Epidemic, Warm Toxin, Warm Malaria, and Wind-Warmth; these five etiologies are distinguished by pulse and symptoms. Dampness and wind-dampness combine with summerheat to form Damp-Warmth. These three can be differentiated, as can dampness and heat. Cold-phlegm, beriberi (Hong Jiao), food stagnation, and labor-fatigue are four syndromes that resemble Cold Damage. However, Cold Damage may present with Wind Strike pulses, and Wind Strike may present with Cold Damage pulses. One must recognize formulas such as Da Qing Long Tang (Major Blue Green Dragon Decoction) and Xiao Qing Long Tang (Minor Blue Green Dragon Decoction) for treatment, balancing Wei (Defensive) and Ying (Nutritive) qi.
Malaria resembles Cold Damage and may be caused by phlegm or food stagnation. Chronic malaria forming a mass (Nu Mu) leads to emaciation over time. Malaria occurring every three days indicates a one-year duration; every other day indicates a six-month duration; daily occurrence indicates a new onset. Two consecutive days of fever followed by one day of remission indicates involvement of both qi and blood. Treatment may involve stopping malaria methods or treating according to the meridians. Coughs are often due to cold invasion and require differentiation of the six qi. The six qi originate from one root, which is the secret of pathogenesis. Wind-heat and cold are treated according to symptoms. Summerheat and dryness require clearing the Metal element (Lungs), while dampness requires promoting urination. Cough with sound but little phlegm differs from cough with phlegm, which is treated by descending and eliminating phlegm. Asthma may stem from qi deficiency, phlegm obstruction, or qi rebellion, sometimes requiring leaning forward to breathe. Dysentery originates from damp-heat or dietary indiscretion, presenting with abdominal pain, bloody stool, and tenesmus. Treatment involves draining and dispersing; avoid astringents while damp-heat persists, lest it become chronic dysentery (Xiuxi Li). Diarrhea is mostly due to dampness, but also heat, food stagnation, or qi deficiency. Spleen diarrhea presents with distension, vomiting, and uncontrollable watery stool; Intestine diarrhea involves pain and difficulty defecating with penile pain; Stomach diarrhea features yellow stool and undigested food. *Tai Su* classifies them into five types: loose stool, duck-like stool, undigested stool, and slippery stool. Obstruction at the Lanmen point requires treating excess based on syndrome.
Jaundice (Dan) is caused by damp-heat. Polydipsia (Xiao Ke) is caused by heat; edema is caused by qi dysfunction. Spontaneous sweating indicates yang deficiency; night sweats indicate yin deficiency. Li Dongyuan has methods for these, applied according to syndrome. Head wind and headache are often due to phlegm. Blood deficiency and heat are treated by meridian differentiation. Vertigo and dizziness are caused by fire accumulating phlegm or qi deficiency; treating phlegm is primary. Lower back pain is due to damp-heat, kidney deficiency, or blood stasis. Hypochondriac pain is mostly due to qi stagnation, liver fire, blood stasis, or phlegm migration. Consumption (Lai Zhai) is yin deficiency; mania and madness are excessive yang fire. Vomiting with slight epistaxis, with a large pulse, indicates fire carrying blood upward and erratic flow. Hematuria and hematochezia share similar causes. Nocturnal emission and spermatorrhea are caused by damp-heat invasion. Cloudy urine originates from heat, phlegm, or deficiency. White turbidity belongs to Wei level; red turbidity belongs to Ying level. Extreme heat causes strangury (Lin) due to qi stagnation. Blood deficiency causes palpitations; qi deficiency causes deafness. Hiccups stem from stomach disease; hernias originate in the Liver meridian. Flaccidity is solely due to damp-heat; qi weakness leads to insufficient nourishment. Reversal (Jue) is often due to phlegm-qi or deficiency-heat. Numbness in hands is qi deficiency; hand numbness/stiffness is damp-phlegm or blood stasis. Cholera with vomiting and diarrhea is caused by wind-dampness. Heart pain and spleen pain are attributed to yin-cold. Qi-heat and fatigue cause "Jian Jue" (Frying Reversal). Excessive qi rebellion causes "Bo Jue" (Thrusting Reversal). Turbid qi ascending causes distension; clear qi descending causes undigested diarrhea. Movement of yin-fire causes throat bi. Yang-water transformation leads to undigested diarrhea. Convergence of the three yang meridians causes chills and fever, lower body swelling, and flaccidity/reversal. Disease of the two yang meridians affects the heart and spleen, causing low sperm count in men and amenorrhea in women. Disease of the single yang meridian causes shortness of breath, cough, and diarrhea. Cold invading the upper jiao causes stomach cold and yang-heat, leading to indigestion, fullness, and diarrhea. Heat residing above and cold below causes rapid digestion with hunger, abdominal distension, and difficult bowel movements. Accumulated heat and depression generate various winds. Wind, cold, and dampness combine to form Bi syndrome. Changes from rich foods easily cause large carbuncles. When Ying qi does not flow smoothly and reverses internally, abscesses and swellings arise. Sores and ulcers are diagnosed by pulse, ensuring accurate treatment. Heavy body with slow pulse indicates dampness excess; treat by removing dampness. Body heat with large pulse indicates restless heat and swelling; treat by reducing heat and cooling Ying. Vertigo with tremors, pain with wiry pulse, requires descending phlegm and expelling wind. Qi stagnation and Wei obstruction with thirsty, choppy pulse require tonifying blood and draining qi. Poor appetite with aversion to cold and tight, thin pulse indicates cold-water excess; drain cold-water. Differentiate meridians and treat carefully. Damp-heat generates parasites; water accumulation and phlegm-fluid retention occur. Eye pain with redness and swelling indicates scattered essence and Ying heat. Toothache and swollen gums distinguish between cold and heat. Primary diseases of the five zang organs with heat contention lead to severe jaundice. Disharmony of the six fu organs leads to accumulation and abscesses. Disharmony of the five zang organs leads to obstruction of the nine orifices. Transmission between zang and fu organs creates endless variations. Transmission through intervening zang organs preserves life (transmitting to what it generates); seven-step transmission leads to death (transmitting to what controls it).
Accumulations in the five zang organs: Liver accumulation is called "Fei Qi," located under the left hypochondrium, size of an inverted cup, possibly with heads and feet; long-term it changes to cough, rebellion, and malaria, persisting for years. Heart accumulation is called "Fu Liang," starting above the navel, arm-sized, extending to the epigastrium; if untreated, it causes vexation. Spleen accumulation is called "Pi Qi," in the epigastrium, plate-sized; if untreated, limbs cannot move, turning into yellow jaundice, wasting despite eating. Lung accumulation is called "Xi Ben," under the right hypochondrium, cup-sized; if untreated, it causes panting, bone flaccidity, and shortness of breath. Drum distension and gu poisoning involve middle-fullness and depression; lifting qi and regulating ascending/descending is appropriate. The root of the human body is the Spleen and Stomach. Headache, tinnitus, and obstruction of the nine orifices are generated by the intestines and stomach. Deficiency of Stomach qi, when extreme, transforms into disease, with five disorders interacting. Li Dongyuan discussed: The Kingly Way of learning involves one deficiency and one excess, five excesses and five deficiencies. Five labors and seven injuries lead to the six extremes and flaccidity; five depressions and seven emotions are caused by nine qi movements. Anger causes qi to ascend; joy causes qi to slacken; grief causes qi to dissipate; fear causes qi to descend; cold causes qi to contract; summerheat causes qi to leak; shock causes qi to disorder; labor causes qi to consume; thought causes qi to knot. Worry and overthinking damage the Heart; cold form and cold drinks damage the Lungs; anger and qi rebellion damage the Liver; diet and labor fatigue damage the Spleen; sitting/lying in wet places or forcing entry into water damages the Kidney. All result from qi movement. Physical and spiritual illness arises from unregulated emotions. Labor damages the form and reverses qi, causing qi and blood imbalance. Yin and yang interact; yang invading yin causes yin disease, yin invading yang causes yang disease. Yang invasion brings heat; yin invasion brings cold. Extreme cold transforms to heat; extreme heat transforms to cold. Cold damages the form; heat damages qi. Qi damage causes disease; form damage causes swelling. Pain then swelling indicates qi damaging form; swelling then pain indicates form damaging qi.
Regarding yin-yang transformations and root/branch cold-heat: If severe cold is not relieved by heat, there is no fire; if heat comes and goes, appearing by day and hiding by night, moving with seasons, there is no fire; assist the Heart. If severe heat is not relieved by cold, there is no water; if heat moves and stops, coming suddenly and stopping intermittently, there is no water; assist the Kidney. Internal blockage with vomiting and inability to eat indicates fire; vomiting after eating indicates no fire. Sudden profuse diarrhea with undigested food indicates fire; chronic loose stools with irregular onset indicate no water. Excess heart generates heat; excess kidney generates cold. Again, heat without cold indicates no fire; cold without heat indicates no water. Failure to relieve cold with cold therapy blames lack of water; failure to relieve heat with heat therapy blames lack of fire. If heat relief is brief, blame heart deficiency; if cold relief is brief, blame kidney insufficiency. Examine pathogenesis, do not miss qi suitability, record in water and fire, and the rest of the qi can be known.
Women's diseases often involve leukorrhea (red and white), masses, and hernias, caused by qi and blood disorders. Amenorrhea or continuous bleeding, pain during menstruation, indicates deficiency with heat. Painful menstruation indicates blood excess; early periods indicate blood heat clotting; late periods indicate blood scarcity or exhaustion. Pale discharge indicates much phlegm; purple indicates heat; extreme heat turns black. Regulate Ying and descend fire. For pregnancy, clear heat and nourish blood. After childbirth, if no nausea/vomiting, greatly tonify qi and blood; treat other symptoms secondarily. Generally, children overheated by too much warmth develop heat; extreme heat generates wind; wind-phlegm and accumulated heat are treated according to the disease. Newborns may have fetal toxins,惊 (fright) within the month, redness, vomiting, or jaundice with constipation. Umbilical wind with mouth contraction, fever from transformation, wind-epilepsy, acute/chronic convulsions, convulsions with fright, palpitations with voidiness, sudden vomiting, abdominal distension with cough, evil invasion with upward gaze, goose-mouth tongue coating, wooden tongue, playing with tongue, guest fright with night crying, pus in ears/nose with caries, eyebrow dan lesions, scrotal swelling with cloudy urine, rotten tongue with bad breath, eroding tooth caries, worm pain with vomiting roundworms, malnutrition with fontanelle bulging, green stool with red cheeks, vomiting food/water, green/white vomit/diarrhea, deep sleep with exposed eyes, yawning with sallow face, grinding teeth, prolapse from diarrhea/dysentery, sores with hives, smallpox/chickenpox with macules, fright-malnutrition and various accumulations. Most diseases involve the Liver and Spleen meridians; diagnosis relies on pulse accuracy. Qian Yi's formula theories cover male and female conditions, diet, and daily life. Sudden joy followed by sorrow damages essence and qi. From wealth to poverty is called "Shi Jing" (Loss of Essence); from nobility to baseness, even without external pathogens, disease arises internally, called "Tuo Ying" (Depletion of Ying). The body diminishes daily, qi becomes deficient, and essence is lost. Skilled physicians must not miss this. Pulse, disease, syndrome, and treatment allow knowing the subtle signs to cure early. Examples of abdominal pain classics and yin syndrome treatments are mentioned by Hai Zang, secrets of profound mysteries.