断。虚故不决。）气上溢（胆热上逆。）而口为之苦。（吴鹤皋改胆虚作胆嘘。欠通。气上溢。即嘘字之义。）有癃者。一
日数十溲。此不足也。身热如炭。头膺如格。人迎躁盛。（经曰。人迎者。胃脉也。）喘息气逆。此有余也。太阴脉微细
如发者。此不足也。病在太阴。（右手气口。太阴肺脉反微细。病有余而脉不足。是脉与病相反也。）其盛在胃。（左寸口
人迎躁盛。热如炭。颈膺格。所谓三盛。病在阳明也。）颇在肺。（喘息气逆。偏颇在肺。）病名曰厥。死不治。此所谓得
五有余。（身如炭。颈膺格。人迎盛。喘息。气逆。）二不足也。（溲数。脉微。）外得五有余。内得二不足。此其身不表
不里。亦正死明矣。（欲泻则里虚。欲补则表盛。）人生而有病巅疾者。此得之在母腹中时。其母有所大惊。气上而不下。
精气并居。故令子发为巅疾也。（王注作头首之疾。昂按。病由惊起。巅当作癫。若云巅顶。不知是何病也。）（奇病论）
【素】人病胃脘痈者。当候胃脉。沉细者气逆。（右关阳明。多血多气。不当沉细。）逆者人迎甚盛。甚盛则热。（右
关胃本脉沉细。而左寸人迎反盛。所谓三盛。病在阳明也。）人迎者。胃脉也。（王注。结喉旁人迎穴动脉属胃经。今作
左寸口脉。）逆而盛则热聚于胃口而不行。故胃脘为痈也。人之不得偃卧者何也。肺者脏之盖也。（灵枢九针篇。五脏之
应天者肺。肺者。五脏六腑之盖也。）肺气盛则脉大。脉大则不得偃卧。（肺火盛则喘促奔迫。）有病怒狂者。生于阳也。
治之奈何。夺其食即已。夫食入于阴。长气于阳。故夺其食即已。（病能论）
【灵】夫百病之始生也。皆生于风雨寒暑阴阳。喜怒饮食居处。大惊卒恐。则血气分离。阴阳破散。经络厥绝。脉
道不通。阴阳相逆。卫气稽留。经脉虚空。血气不次。乃失其常。人之欠者。（俗名呵欠。）何气使然。卫气昼日行于阳。
夜半则行于阴。阴者主夜。夜者卧。阳者主上。阴者主下。故阴气积于下。阳气未尽。（夜卧之余。阳气未尽得上。）阳
引而上。阴引而下。阴阳相引。故数欠。阳气尽。阴气盛。则目瞑。阴气尽而阳气盛。则寤矣。人之哕者。何气使然。
（说
文曰。哕。气牾也。辨者谓是呃逆。东垣以哕为干呕之甚者。人或非之。按素问宝命全角篇曰。病深者。其声哕。哕主
声言。则非呕吐明矣。古方书无呃字。或作咳逆。俗名呃忒。）谷入于胃。胃气上注于肺。今有故寒气。与新谷气。俱还
入于胃。新故相乱。真邪相攻。气并相逆。复出于胃。故为哕。（昂按。呃逆有实有虚。有寒有热。病原病候。种种不同。
此特言其一端耳。若以哕作呕吐。则呃逆亦病中要症。二经岂漫无一字及之哉。）人之噫者。何气使然。（俗作嗳。气阻
而嗳以通之。）寒气客于胃。厥逆。从下上散。复出于胃。故为噫。（经曰。心为噫。阳明络属心。阴气盛而上走阳明。
故噫。）人之嚏者。何气使然。阳气和利。满于心。出于鼻。故为嚏。（鼻为肺窍。心脉入肺。嚏则肺气通。）人之哀而泣
涕出者。何气使然。心者五脏六腑之主也。目者宗脉之所聚也。（耳目皆宗脉之所聚。）上液之道也。（液上升之道路。）
口鼻者。气之门户也。故悲哀愁忧则心动。心动则五脏六腑皆摇。摇则宗脉感。感则液道开。开故泣涕出焉。液者所以
灌精濡空（孔。）窍者也。故上液之道开则泣。泣不止则液竭。液竭则精不灌。精不灌则目无所见矣。故命曰夺精。（素
问言泣涕。见后解精微论。）人之太息者。何气使然。忧思则心系急。急则气道约。约则不利。故太息以伸出之。人之涎
下者。何气使然。饮食者。皆入于胃。胃中有热则虫动。虫动则胃缓。胃缓则廉泉开。故涎下。（廉泉。舌本穴名。阴维
任脉之会。昂按。风中舌本则舌纵难言。廉泉开而流涎沫。此云虫动。尚有未该。）人之耳中鸣者。何气使然。耳者宗脉
之所聚也。（此论他书不载。仅见于此。昂按。人夜卧之时。五官皆不用事。惟耳能听。岂非以宗脉所聚。故能有所警觉
也乎。又人在母腹中。仅一血胚。闻雷霆火爆之声。则惊而跳。此时五官未备。而闻性已与外物相通。故楞严二十五圆
通。独重耳根。孔子亦言。六十而耳顺。则耳之异于诸官也明矣。）故胃中空则宗脉虚。虚则下溜。（流。）脉有所竭者。
故耳鸣。（即下文上气不足。耳为之苦鸣之义。）人之自啮舌者。何气使然。此厥逆走上。（火气上逆。）脉气使然也。（使
然。一作辈至。）少阴气至则啮舌。（舌为手少阴心之窍。）少阳气至则啮颊。（手少阳三焦脉下颊。足少阳胆脉加颊车。）
阳明气至则啮唇矣。（手阳明大肠脉挟口。足阳明胃脉环唇。）故邪之所在皆为不足。故上气不足。脑为之不满。耳为之
苦鸣。头为之苦倾。目为之眩。中气不足。溲便为之变。（按内经无遗精白浊之文。但云出白溲白自淫。溲便变。又云水
液混浊。皆属于热。）肠为之苦鸣。下气不足。则乃为痿厥心 。（字汇。 。废忘也。音懑。）（口问）
【灵】人之善忘者。何气使然。上气不足。下气有余。肠胃实而心肺虚。虚则营卫留于下。久之不以时上。故善忘
也。（素问调经篇。血并于下。气并于上。乱而善忘。）人之善饥而不嗜食者。何气使然。（饥当嗜食。）精气并于脾。热
气留于胃。胃热则消谷。谷消故善饥。胃气逆上。则胃脘寒。故不嗜食也。（上脘热。故善消谷。中脘寒。故不嗜食。）
（大
惑论）
【灵】人之卒然忧恚而言无音者。何道之塞。曰。咽喉者。水谷之道也。（食喉管在后。通于胃。）喉咙者。气之所
以上下者也。（气喉管在前。通于肺。）会厌者。音声之户也。（气喉之蔽。以掩饮食。使不错入气喉。）口唇者。音声之
扇也。舌者。音声之机也。悬雍垂者。（上 。）音声之关也。颃颡者。（颃颈也。又咽也。）分气之所泄也。横骨者。（未
详。）神气所使。主发舌者也。故人之鼻洞。涕出不收者。颃颡不开。分气失也。（气无所分。）是故厌小而疾薄。则发气
疾。其开阖利。其出气易。其厌大而浓。则开阖难。其气出迟。故重言也。人卒然无音者。寒气客于厌。则厌不能发。
发不能下。至其开阖不致。故无音。（忧恚无言论）
【素】诊得心脉而急。病名心疝。（诸急为寒。寒气积而为疝。）少腹当有形也。心为牡脏。（金匮真言。阳中之阳心
也。）小肠为之使。故曰少腹当有形也。（心君不易受邪。故脏病而见形于腑。）胃脉病形何如。胃脉实则胀。虚则泄。病
成而变何谓。风成为寒热。（生气通天论。因于露风。乃生寒热。）瘅成为消中。（邪热在胃。则善食而饥。）厥成为巅疾。
（藏气下虚。厥逆而上。则巅顶眩运。忽然颠仆。）久风为飧泄。（肝风贼胃土。则食不化而泄利。）脉风成为疠。（音癞。
脉为血府。受风邪久。则血肉瘀坏而为癞。）病之变化。不可胜数。（不特此数端。）诸痈肿筋挛骨痛。此寒气之肿。八风
之变也。（皆风寒为病。灵枢九宫八风篇。风从南方来。名大弱风。伤人内舍于心。外在于脉。从西南方来。名谋风。伤
人内舍于脾。外在于肌。从西方来。名刚风。伤人内舍于肺。外在于皮肤。从西北方来。名折风。伤人内舍于小肠。外
在于手太阳脉。从北方来。名大刚风。伤人内舍于肾。外在于骨。与肩背之膂筋。从东北方来。名凶风。伤人内舍于大
肠。外在于两胁腋骨下及肢节。从东方来。名婴儿风。伤人内舍于肝。外在于筋纽。从东南方来。名弱风。伤入内舍于
胃。外在于肌肉。）（脉要精微论）
【灵】足之阳明手之太阳筋急。则口目为 。 急不能卒视。（本篇云。足阳明之筋。上颈挟口。腹筋急。引缺盆及
颊。卒口僻。急者目不合。热则筋纵。目不开。寒则急引颈移口。手太阳之筋。属目外 。应耳中鸣痛。引颔目瞑。良
久乃得视。）（经筋篇）
【灵】手屈而不伸者。其病在筋。（筋挛。）伸而不屈者。其病在骨。（骨痹。）（终始）
【灵】人有八虚。各何以候。曰以候五脏。肺心有邪。其气留于两肘。（肺脉自胸之中府。入肘之侠白等穴。心脉自
腋之极泉。行肘之少海等穴。）肝有邪。其气流于两腋。（肝脉布胁肋。行腋下期门等穴。此独作流。余皆留字。）脾有邪。
其气留于两髀。（脾脉上膝股内前廉。经筋篇。上循阴股。结于髀。）肾有邪。其气留于两 。（膝后曲处。肾脉上 。出
内廉。）凡此八虚者。皆机关之室。真气之所过。血络之所游。邪气恶血。固不得住留。住留则伤经络。骨节机关不得
屈伸。故病挛也。（邪客）
【灵】诊目痛。赤脉从上下者。太阳病。从下上者。阳明病。（火热则有赤脉。经筋篇。太阳为目上网。阳明为目下
网。）从外走内者。少阳病。（少阳脉行目外 。瞳子 之分。）婴儿病。其头毛皆逆上者。必死。（血不能濡。如草木将
死。枝叶先枯也。）（论病诊尺）
【素】阴盛则梦涉大水恐惧。阳盛则梦大火燔灼。阴阳俱盛。则梦相杀毁伤。（阴阳交争。）上盛则梦飞。下盛则梦
堕。甚饱则梦与。甚饥则梦取。（按饥饱梦饮食者多。亦犹便急而梦溺也。人之心劳者梦作苦。足酸者梦急行。亦其类也。）
肝气盛则梦怒。肺气盛则梦哭。（肝志为怒。肺志为悲。此皆病梦也。乐广论梦。为想为因。尚未尽梦之变。凡人之梦。
病梦为多也。灵枢淫邪发梦篇。与此略同。本篇下文仍有一段。于义无当。故删之。方盛衰论。亦有说梦一段。不录。）
（脉要精微论）
【灵】五脏身有五部。伏兔一。（足阳明胃经穴。膝上六寸起肉。一曰膝盖上七寸。以左右各三指按捺。上有肉起如
兔状。）腓二。腓者 也。（足肚。一名 肠。足太阳膀胱经。）背三。（中督脉。左右四行皆膀胱经脉。）五脏之 四。（心
肝脾肺肾五俞。皆膀胱经穴。膀胱虽主表。而十二俞内通于五脏六腑。）项五。（亦督脉。足太阳经。）此五部。有痈疽者
死。（昂按。阳毒起发者尚可治。若阴毒不起者。断难治也。）（寒热病）
【灵】夫胀者。皆在于脏腑之外。排脏腑而郭胸胁。胀皮肤。营气循脉。卫气逆。为脉胀。卫气并脉循分。为肤胀。
（马注。营气阴性精专。随宗脉行。不能为胀。惟卫气逆行。并脉循分肉。能为脉胀肤胀。）心胀者。烦心短气。卧不安。
肺胀者。虚满而喘咳。肝胀者。胁下满而痛引小腹。脾胀者。善哕。四肢烦 。体重不能胜衣。卧不安。肾胀者。腹满
引背。央央然腰髀痛。胃胀者。腹满胃脘痛。鼻闻焦臭。（心为焦火。气也。）妨于食。大便难。大肠胀者。肠鸣而痛濯
濯。冬日重感于寒。则飧泄不化。小肠胀者。少腹 胀。引腰而痛。膀胱胀者。少腹满而气癃。（闭淋。）三焦胀者。气
满于皮肤中。轻轻然而不坚。胆胀者。胁下痛胀。口中苦。善太息。（胀论）
【灵】水与肤胀鼓胀肠覃石瘕石水。何以别之。曰水始起也。目窠上微肿。如新卧起之状。其颈脉动。时咳。阴股
间寒。足胫肿。腹乃大。其水已成矣。以手按其腹。随手而起。如裹水之状。此其候也。（五癃津液论曰。阴阳气道不通。
四海闭塞。三焦不泻。津液不化。水谷并于肠胃之中。别于回肠。留于下焦。不得入膀胱。则下焦胀。水溢则为水胀。）
肤胀者。寒气客于皮肤之间。 然不坚。腹大身尽肿。皮浓。按其腹 而不起。腹色不变。此其候也。鼓胀何如。腹
胀身皆大。大与肤胀等也。色苍黄。腹筋起。此其候也。（以腹筋起。与肤胀异。）肠覃何如。寒气客于肠外。与卫气相
搏。气不得营。因有所系。癖而内着。恶气乃起。息肉乃生。其始生也。大如鸡卵。稍以益大。至其成。如怀子之状。
久者离岁。（历岁。）按之则坚。推之则移。月事以时下。（覃客肠外。为气病。故月事时下。）石瘕生于胞中。寒气客于
子门。子门闭塞。气不得通。恶血当泻不泻。 以留止。（ 。音胚。凝血也。）日以益大。状如怀子。月事不以时下。
（瘕
在胞中。为血病。故月事不下。）皆生于女子。可导而下。（石水。经无明文。）（水胀）
【素】今夫热病者。皆伤寒之类也。（冬月感风寒而即发者。为正伤寒。或寒毒郁积于内。至春变为温病。至夏变为
热病。然其始皆自伤寒致之。故曰伤寒之类。）或愈或死。其死皆以六七日之间。其愈皆以十日以上者何也。曰。巨阳者。
诸阳之属也。（太阳为诸阳之所宗属。）其脉连于风府。故为诸阳主气也。（风府。督脉穴。在脑后。督脉总督诸阳。）人
之伤于寒也。则为病热。（寒气怫郁。反发为热。）热虽甚不死。（热甚为在表。为阳症。）其两感于寒而病者。必不免于
死。（一阴一阳。一脏一腑。表里俱病。故死。）伤寒一日巨阳受之。（太阳主表。伤寒必由表传里。若郁久而成温病。则
（断句：虚故不决。）气上溢（胆热上逆。）而口为之苦。（吴鹤皋将“胆虚”改为“胆嘘”，欠通。“气上溢”即“嘘”字的含义。）有癃闭症的人，一天排尿数十次。这是正气不足的表现。身体发热像火炭一样，头颈和胸膺部感觉像被木格阻隔不通，人迎脉躁动盛大。（经文说：人迎脉，是胃的经脉。）喘息气逆。这是邪气有余的表现。太阴脉微细如发丝一般，这是正气不足的表现。病在太阴。（右手气口，太阴肺脉反而微细，病证表现为有余而脉象却不足，这是脉与病证相反。）其盛实在于胃。（左寸口人迎脉躁动盛大，身热如炭，颈膺格塞，这就是所谓的“三盛”，病在阳明经。）偏颇在肺。（喘息气逆，病势偏颇在肺。）病名叫做厥。死症，难以治愈。这就是所谓的得五有余证。（身热如炭，颈膺格塞，人迎脉盛，喘息，气逆。）和二不足证。（小便频数，脉微。）外见五有余证，内见二不足证。这属于表里俱病，也是明显的死症。（想泻邪则里气更虚，想补正则表邪更盛。）人生下来就有巅顶疾病（癫痫），这是因为在母腹中时，母亲受到大惊吓，导致气机上逆而不能下行，精气并聚于上，所以让孩子发作为癫疾。（王冰注解说这是头首部的疾病，汪昂按语认为：病由惊起，“巅”应当作“癫”。如果说只是巅顶的病，不知道是什么病呢？）（出自《奇病论》）
【素问】人患胃脘痈肿的，应当诊察胃脉。如果脉象沉细，说明气机逆乱。（右关脉属阳明胃，多血多气，不应当出现沉细脉。）气逆的人人迎脉非常盛大，盛大则生热。（右关胃本脉应当沉细，而左寸口人迎脉反而盛大，这就是所谓的“三盛”，病在阳明经。）人迎脉，就是胃的经脉。（王冰注解说：结喉旁的人迎穴动脉属于胃经，这里指左寸口脉。）气逆且盛大，则热邪聚集在胃口而不流通，所以胃脘发生痈肿。人不能仰卧是什么原因呢？肺是五脏的华盖。（《灵枢·九针篇》说：五脏对应天的是肺，肺是五脏六腑的华盖。）肺气盛则脉大，脉大则不能仰卧。（肺火盛则喘促奔迫。）有发怒狂病的人，是由于阳邪所致。怎么治疗呢？减少他的饮食即可痊愈。食物进入体内化生阴精，助长阳气，所以减少饮食即可痊愈。（出自《病能论》）
【灵枢】各种疾病的发生，都源于风雨寒暑、阴阳失调、喜怒无常、饮食起居不当、大惊卒恐等。大惊卒恐会导致血气分离，阴阳破散，经络厥绝，脉道不通，阴阳相逆，卫气稽留，经脉虚空，血气运行失去次序，从而失去常态。人打呵欠，是怎么回事呢？（俗名呵欠。）是什么气导致的？卫气白天行于阳分，夜半则行于阴分。阴分主夜间，夜间主睡眠。阳分主上，阴分主下。所以阴气积聚在下，阳气未尽。（夜间卧床休息时，阳气未尽能上行。）阳气牵引向上，阴气牵引向下，阴阳相互牵引，所以频频打呵欠。阳气尽，阴气盛，则眼睛闭合入睡。阴气尽而阳气盛，则醒来。人呃逆（哕），是怎么回事呢？（《说文解字》说：哕，气逆也。辨者认为是呃逆，李东垣认为哕是严重的干呕，有人非议他。按《素问·宝命全角篇》说：病深重的人，声音会哕。哕主要指声音，那么就不是呕吐了。古方书中没有“呃”字，有的写作“咳逆”，俗名呃忒。）谷物进入胃中，胃气上注于肺。现在如果有旧的寒气，与新入的谷气，一起返还入胃，新气与旧气相乱，真气与邪气相攻，气机并逆，再出于胃，所以发生呃逆。（汪昂按语：呃逆有实有虚，有寒有热，病原病候种种不同，这里只说了一种情况。如果把哕当作呕吐，那么呃逆也是病症中的重要症状，两经难道完全没有提及吗？）人嗳气（噫），是怎么回事呢？（俗写作嗳，气阻而嗳以通之。）寒气客居在胃，厥逆之气从下向上散发，再出于胃，所以发生嗳气。（经文说：心主嗳气。足阳明胃经络属于心，阴气盛而上走阳明，所以嗳气。）人打喷嚏（嚏），是怎么回事呢？阳气调和畅利，充满于心，出于鼻，所以打喷嚏。（鼻为肺窍，心脉入肺，打喷嚏则肺气通畅。）人悲哀哭泣流泪涕，是怎么回事呢？心是五脏六腑的主宰，目是宗脉汇聚的地方。（耳目都是宗脉汇聚之处。）是津液上升的道路。（液上升的路径。）口鼻是气的门户。所以悲哀愁忧则心动，心动则五脏六腑皆摇动，摇动则宗脉感应，感应则液道开启，开启所以流泪涕出。津液是用来灌溉精髓、濡润孔窍的。所以上液之道开启则流泪，泪不止则津液枯竭，津液枯竭则精髓得不到灌溉，精髓得不到灌溉则眼睛看不见东西了。所以叫做夺精。（《素问》言泣涕，见后文《解精微论》。）人长叹息（太息），是怎么回事呢？忧思则心系紧急，紧急则气道约束，约束则不利，所以长叹息来舒展它。人流涎（涎下），是怎么回事呢？饮食都进入胃中，胃中有热则虫动，虫动则胃缓，胃缓则廉泉穴开，所以流涎。（廉泉，舌根部穴位名，阴维脉与任脉交会处。汪昂按语：风邪中于舌本则舌纵难言，廉泉开而流涎沫，这里说是虫动，还有未周全之处。）人耳中鸣响，是怎么回事呢？耳是宗脉汇聚的地方。（此论其他书不载，仅见于此。汪昂按语：人夜间卧睡时，五官都不使用，只有耳朵能听，岂不是因为宗脉汇聚，所以能有所警觉吗？另外人在母腹中，只是一个血胚，听到雷霆火爆之声，则惊跳。此时五官未备，而闻性已与外物相通，所以《楞严经》二十五圆通，独重耳根，孔子也说六十而耳顺，则耳不同于其他器官是很明显的了。）所以胃中空虚则宗脉虚，虚则下溜。（流。）脉有所竭者，所以耳鸣。（即下文上气不足，耳为之苦鸣的意思。）人自己咬舌头，是怎么回事呢？这是厥逆之气走上。（火气上逆。）脉气使然也。（使然，一作辈至。）少阴气至则咬舌。（舌为手少阴心之窍。）少阳气至则咬颊。（手少阳三焦脉下颊，足少阳胆脉加颊车。）阳明气至则咬唇矣。（手阳明大肠脉挟口，足阳明胃脉环唇。）所以邪气所在的地方都是因为正气不足。所以上气不足，脑为之不满，耳为之苦鸣，头为之苦倾，目为之眩。中气不足，大小便为之改变。（按《内经》无遗精白浊之文，但云出白溲白自淫，溲便变，又云水液混浊，皆属于热。）肠为之苦鸣，下气不足，则发生痿厥心 。（《字汇》： ，废忘也，音懑。）（出自《口问》）
【灵枢】人容易健忘，是怎么回事呢？上气不足，下气有余，肠胃实而心肺虚。虚则营卫之气留滞于下，久而久之不能按时上行，所以容易健忘。（《素问·调经篇》说：血并于下，气并于上，乱而善忘。）人容易饥饿但不想吃东西，是怎么回事呢？（饥饿时应当想吃东西。）精气并于脾，热气留于胃，胃热则消谷，谷消所以容易饥饿。胃气逆上，则胃脘寒，所以不想吃东西。（上脘热，所以善于消化谷食；中脘寒，所以不想吃东西。）（出自《大惑论》）
【灵枢】人突然因忧愁愤怒而说不出话，是什么通道阻塞了呢？回答说：咽喉是水谷通行的道路。（食管在后，通于胃。）喉咙是气上下通行的地方。（气管在前，通于肺。）会厌是声音的门户。（气喉的遮蔽物，用来掩盖饮食，使其不错入气喉。）口唇是声音的扇叶。舌是声音的机关。悬雍垂是声音的关卡。颃颡是分流气的地方。横骨是神气所驱使，主管发动舌头的。所以人鼻孔洞开，鼻涕不收的，是因为颃颡不开，分气失职。（气无所分。）所以会厌小而薄，则发声快，开阖便利，出气容易；会厌大而厚，则开阖困难，出气迟缓，所以说话重复。人突然失音，是寒气客居于会厌，则会厌不能发，发不能下，至于开阖不致，所以失音。（出自《忧恚无言》）
【素问】诊得心脉急迫，病名叫心疝。（诸急脉为寒，寒气积结而为疝。）少腹部应当有形块。心为牡脏。（《金匮真言论》：阳中之阳心也。）小肠为之使，所以说少腹部应当有形块。（心君不易受邪，所以脏病而见形于腑。）胃脉病的表现怎么样？胃脉实则腹胀，虚则泄泻。病成而变化的原因是什么？风邪成为寒热。（《生气通天论》：因于露风，乃生寒热。）瘅热成为消中。（邪热在胃，则善食而饥。）厥逆成为巅疾。（藏气下虚，厥逆而上，则巅顶眩晕，忽然颠仆。）久风成为飧泄。（肝风贼害胃土，则食不化而泄利。）脉风成为疠。（音癞。脉为血府，受风邪久，则血肉瘀坏而为癞。）病的变化，不可胜数。（不只是这几端。）各种痈肿筋挛骨痛，这是寒气之肿，八风之变也。（都是风寒为病，《灵枢·九宫八风篇》：风从南方来，名大弱风，伤人内舍于心，外在于脉；从西南方来，名谋风，伤人内舍于脾，外在于肌；从西方来，名刚风，伤人内舍于肺，外在于皮肤；从西北方来，名折风，伤人内舍于小肠，外在于手太阳脉；从北方来，名大刚风，伤人内舍于肾，外在于骨，与肩背之膂筋；从东北方来，名凶风，伤人内舍于大肠，外在于两胁腋骨下及肢节；从东方来，名婴儿风，伤人内舍于肝，外在于筋纽；从东南方来，名弱风，伤入内舍于胃，外在于肌肉。）（出自《脉要精微论》）
【灵枢】足阳明经和手太阳经的筋急，则口眼歪斜。（ 急不能卒视。）（本篇说：足阳明之筋，上颈挟口，腹筋急，引缺盆及颊，卒口僻，急者目不合，热则筋纵，目不开，寒则急引颈移口。手太阳之筋，属目外眦，应耳中鸣痛，引颔目瞑，良久乃得视。）（出自《经筋篇》）
【灵枢】手屈曲不能伸展的，病在筋。（筋挛。）伸展不能屈曲的，病在骨。（骨痹。）（出自《终始》）
【灵枢】人有八虚，各用什么来诊察呢？回答说：用来诊察五脏。肺心有邪，其气留于两肘。（肺脉自胸之中府，入肘之侠白等穴，心脉自腋之极泉，行肘之少海等穴。）肝有邪，其气流于两腋。（肝脉布胁肋，行腋下期门等穴，此处独用“流”字，其余都用“留”字。）脾有邪，其气留于两髀。（脾脉上膝股内前廉，《经筋篇》：上循阴股，结于髀。）肾有邪，其气留于两腘。（膝后曲处，肾脉上腘，出内廉。）凡这八虚，都是关节枢纽之所，真气经过的地方，血络游行的地方。邪气恶血，本来不得停留，停留则损伤经络，骨节机关不得屈伸，所以发生拘挛。（出自《邪客》）
【灵枢】诊察目痛，赤脉从上往下的，是太阳病，从下往上的，是阳明病。（火热则有赤脉，《经筋篇》：太阳为目上网，阳明为目下网。）从外向内的，是少阳病。（少阳脉行目外眦，瞳子髎之分。）婴儿生病，头毛都逆上的，必死。（血不能濡养，如草木将死，枝叶先枯也。）（出自《论病诊尺》）
【素问】阴盛则梦见渡大水恐惧，阳盛则梦见大火燃烧灼烧，阴阳俱盛，则梦见互相杀戮毁伤。（阴阳交争。）上盛则梦见飞翔，下盛则梦见坠落。吃得很饱则梦见给予，很饿则梦见索取。（按：饥饱梦饮食者多，也就像便急而梦溺一样。人心劳者梦劳作辛苦，足酸者梦急行，也是这一类。）肝气盛则梦见发怒，肺气盛则梦见哭泣。（肝志为怒，肺志为悲，这都是病梦。乐广论梦，说是想说是因，尚未尽知梦的变化。凡人的梦，病梦为多。《灵枢·淫邪发梦篇》，与此略同。本篇下文仍有一段，于义无当，所以删去。《方盛衰论》也有说梦一段，不录。）（出自《脉要精微论》）
【灵枢】五脏在体表有五部。伏兔一穴。（足阳明胃经穴，膝上六寸起肉，一说膝盖上七寸，以左右各三指按捺，上有肉起如兔状。）腓二穴。（腓者，腨也。足肚，一名腨肠，足太阳膀胱经。）背三穴。（中督脉，左右四行皆膀胱经脉。）五脏之腧四穴。（心肝脾肺肾五俞，皆膀胱经穴，膀胱虽主表，而十二俞内通于五脏六腑。）项五穴。（亦督脉，足太阳经。）这五部，如果有痈疽的会死。（汪昂按语：阳毒起发的还可以治，若阴毒不起的，断难治也。）（出自《寒热病》）
【灵枢】胀病，都在脏腑之外，排挤脏腑而扩张胸胁，胀满皮肤。营气循脉而行，卫气逆乱，形成脉胀。卫气并脉循分肉而行，形成肤胀。（马莳注：营气阴性精专，随宗脉行，不能为胀，惟卫气逆行，并脉循分肉，能为脉胀肤胀。）心胀，烦心短气，卧不安。肺胀，虚满而喘咳。肝胀，胁下满而痛引小腹。脾胀，善哕，四肢烦 ，体重不能胜衣，卧不安。肾胀，腹满引背，央央然腰髀痛。胃胀，腹满胃脘痛，鼻闻焦臭。（心为焦火，气也。）妨于食，大便难。大肠胀，肠鸣而痛濯濯，冬日重感于寒，则飧泄不化。小肠胀，少腹 胀，引腰而痛。膀胱胀，少腹满而气癃。（闭淋。）三焦胀，气满于皮肤中，轻轻然而不坚。胆胀，胁下痛胀，口中苦，善太息。（出自《胀论》）
【灵枢】水胀、肤胀、鼓胀、肠覃、石瘕、石水，如何区别呢？回答说：水胀刚开始时，眼睑微微肿胀，像刚起床的样子，颈部脉搏跳动，时常咳嗽，大腿内侧寒冷，足胫肿，腹部才大，这时水已成。用手按压腹部，随手而起，像裹着水的样子。这是它的征候。（《五癃津液论》说：阴阳气道不通，四海闭塞，三焦不泻，津液不化，水谷并于肠胃之中，别于回肠，留于下焦，不得入膀胱，则下焦胀，水溢则为水胀。）肤胀，寒气客于皮肤之间，窅然不坚，腹部大全身尽肿，皮厚，按其腹窅而不起，腹色不变。这是它的征候。鼓胀怎么样？腹胀全身皆大，大与肤胀相等，色苍黄，腹筋起。这是它的征候。（以腹筋起，与肤胀异。）肠覃怎么样？寒气客于肠外，与卫气相搏，气不得营，因有所系，癖而内着，恶气乃起，息肉乃生。它刚开始生成时，大如鸡卵，逐渐增大，到成熟时，像怀孕的样子，久的超过一年。（历岁。）按之则坚，推之则移，月经按时来潮。（覃客肠外，为气病，故月事时下。）石瘕生于胞中，寒气客于子门，子门闭塞，气不得通，恶血当泻不泻，衃以留止。（衃，音胚，凝血也。）日以益大，状如怀子，月经不来潮。（瘕在胞中，为血病，故月事不下。）都发生在女子身上，可以用导法而下。（石水，经文无明文。）（出自《水胀》）
【素问】现在的热病，都属于伤寒一类。（冬月感风寒而即发的，为正伤寒，或寒毒郁积于内，至春变为温病，至夏变为热病，然而其始皆自伤寒致之，所以说伤寒之类。）有的痊愈有的死亡，死亡的都在六七天之间，痊愈的都在十日以上，为什么呢？回答说：巨阳，是诸阳的所属。（太阳为诸阳之所宗属。）其脉连于风府，所以为诸阳主气。（风府，督脉穴，在脑后，督脉总督诸阳。）人受寒邪，就变成热病。（寒气怫郁，反发为热。）热即使很严重也不会死。（热甚为在表，为阳症。）如果两感于寒而发病的，必定不免于死。（一阴一阳，一脏一腑，表里俱病，所以死。）伤寒第一天巨阳经受之。（太阳主表，伤寒必由表传里，若郁久而成温病，则
(Break: Deficiency, therefore indecisive.) Qi overflows upward (due to Gallbladder heat reversing upward), causing bitterness in the mouth. (Wu Hegao changed "Gallbladder deficiency" to "Gallbladder sighing," which is inappropriate. "Qi overflowing upward" is the meaning of the character "sigh.") Those with strangury (strangury) urinate dozens of times a day. This indicates insufficiency. The body feels hot like charcoal, the head and chest feel blocked like a lattice, and the Renying pulse (Renying pulse, stomach meridian pulse) is rapid and vigorous. (The classic states: The Renying pulse is the stomach meridian.) There is panting and rebellious Qi. This indicates excess. The Taiyin pulse is minute and fine like a hair; this indicates insufficiency. The disease is in the Taiyin. (On the right wrist, the Taiyin Lung pulse is reversely minute and fine; the disease presents as excess while the pulse shows insufficiency; this is a contradiction between pulse and disease.) The excess lies in the Stomach. (On the left cun position, the Renying pulse is rapid and vigorous; body heat like charcoal; neck and chest blockage; this is called "three excesses," indicating disease in the Yangming meridian.) It leans towards the Lung. (Panting and rebellious Qi; the pathological tendency is in the Lung.) The disease is named Jue (Jue syndrome). It is a fatal condition, untreatable. This is what is meant by obtaining five excess signs. (Body heat like charcoal, neck/chest blockage, vigorous Renying pulse, panting, rebellious Qi.) And two insufficiency signs. (Frequent urination, minute pulse.) Externally presenting five excess signs, internally presenting two insufficiency signs. This belongs to both exterior and interior pathology, clearly indicating death. (To purge would further weaken the interior; to tonify would further exacerbate the exterior.) A person born with Dian disease (Dian disease, epilepsy) contracted it while in the womb. Their mother suffered a great fright, causing Qi to reverse upward and not descend, with Essence and Qi gathering together, thus causing the child to develop Dian disease. (Wang Bing's commentary interprets this as a disease of the head. Wang Ang notes: Since the disease arises from fright, "Dian" should be read as "Dian" (epilepsy). If it referred only to the vertex, one would not know what disease it was.) (From *Qi Bing Lun*)
[Su Wen] When a person suffers from a carbuncle in the epigastrium, one should examine the Stomach pulse. If the pulse is deep and fine, it indicates rebellious Qi. (The right Guan position belongs to Yangming Stomach, which is rich in blood and Qi, so a deep and fine pulse is abnormal.) In cases of rebellious Qi, the Renying pulse is very vigorous; when very vigorous, heat is generated. (The Stomach pulse at the Guan position should be deep and fine, but the Renying pulse at the left Cun position is reversely vigorous; this is the "three excesses," indicating disease in the Yangming meridian.) The Renying pulse is the Stomach meridian. (Wang Bing's commentary: The arterial movement at the Renying acupoint beside the larynx belongs to the Stomach meridian; here it refers to the left Cun position pulse.) Rebellious and vigorous Qi causes heat to gather at the stomach opening without circulating, thus forming a carbuncle in the epigastrium. Why can some people not lie on their backs? The Lung is the canopy of the Zang organs. (In *Ling Shu: Nine Needles*, it is stated: Among the five Zang organs corresponding to Heaven is the Lung; the Lung is the canopy of the five Zang and six Fu organs.) When Lung Qi is excessive, the pulse becomes large; when the pulse is large, one cannot lie on their back. (Excessive Lung fire causes panting and urgency.) For those suffering from anger-induced mania, it arises from Yang pathogens. How should it be treated? Depriving them of food will cure it. Food enters and transforms into Yin, thereby nourishing Yang. Thus, depriving them of food cures it. (From *Bing Neng Lun*)
[Ling Shu] All diseases originate from wind, rain, cold, heat, yin-yang imbalance, excessive emotions, improper diet, living conditions, sudden fright, or terror. Sudden fright or terror causes separation of Blood and Qi, disruption of Yin and Yang, severance of collaterals, obstruction of vessel pathways, reversal of Yin and Yang, stagnation of Wei Qi, emptiness of meridians, disorder of Blood and Qi, and loss of normal function. Why do people yawn? (Commonly known as yawning.) What Qi causes this? Wei Qi travels through the Yang aspects during the day and enters the Yin aspects at midnight. Yin governs night, and night governs sleep. Yang governs the upper, and Yin governs the lower. Therefore, Yin Qi accumulates below, while Yang Qi is not yet exhausted. (During nighttime rest, Yang Qi has not fully ascended.) Yang pulls upward, Yin pulls downward; Yin and Yang pull each other, causing frequent yawning. When Yang Qi is exhausted and Yin Qi is abundant, the eyes close for sleep. When Yin Qi is exhausted and Yang Qi is abundant, one awakens. Why does a person hiccup (Yue)? (According to *Shuo Wen*, "Yue" means Qi rebellion. Some argue it refers to hiccups; Li Dongyuan considered Yue as severe dry heaving, which others dispute. According to *Su Wen: Bao Ming Quan Jiao Pian*: "When disease is deep, the sound is Yue." Since Yue primarily refers to sound, it is clearly not vomiting. Ancient medical texts did not use the character "E"; some wrote "Ke Ni," commonly known as "E Te".) Grain enters the Stomach, and Stomach Qi flows upward to the Lung. If old cold Qi remains and mixes with new grain Qi, both returning to the Stomach, the new and old Qi confuse each other, Zheng Qi and pathogenic factors attack each other, Qi rebels together, and re-emerges from the Stomach, causing hiccups. (Wang Ang notes: Hiccups can be excess or deficiency, cold or heat, with various etiologies and symptoms; this text describes only one aspect. If Yue were equated with vomiting, then hiccups would also be an important symptom; why would the classics omit them entirely?) Why does a person belch (Yi)? (Commonly written as Ai, where Qi is blocked and belched to relieve it.) Cold Qi lodges in the Stomach, causing rebellious Qi to scatter upward from below and emerge from the Stomach, causing belching. (The classic states: The Heart governs belching. The Foot-Yangming Stomach meridian connects to the Heart; when Yin Qi is excessive and moves upward to Yangming, belching occurs.) Why does a person sneeze (Ti)? When Yang Qi is harmonious and smooth, filling the Heart and emerging from the nose, sneezing occurs. (The nose is the orifice of the Lung; the Heart meridian enters the Lung; sneezing indicates unobstructed Lung Qi.) Why does a person cry and shed tears and mucus due to sorrow? The Heart is the master of the five Zang and six Fu organs. The eyes are the convergence point of the Zong vessels. (Both ears and eyes are convergence points of Zong vessels.) They are the pathways for fluid ascent. (The pathway for fluid rising.) The mouth and nose are the portals of Qi. Therefore, sorrow and worry move the Heart; when the Heart moves, all five Zang and six Fu organs tremble. Trembling stimulates the Zong vessels; stimulation opens the fluid pathways; once opened, tears and mucus flow out. Fluids are used to irrigate essence and moisten orifices. Thus, when the fluid pathway opens, tears flow; if tears do not stop, fluids are depleted. When fluids are depleted, essence is not irrigated. When essence is not irrigated, vision is lost. This is called "depleting essence." (*Su Wen* discusses tears and mucus in *Xie Jing Wei Lun*.) Why does a person sigh deeply (Tai Xi)? Worry and thought cause the Heart ties to tighten; tightening constricts the Qi pathway; constriction causes obstruction; thus, deep sighing is used to release it. Why does a person drool (Xian Xia)? Food and drink enter the Stomach. If there is heat in the Stomach, parasites move; parasite movement relaxes the Stomach; relaxation opens the Lianquan acupoint; thus, drooling occurs. (Lianquan is an acupoint at the base of the tongue, intersection of Yin Linking and Conception Vessels. Wang Ang notes: Wind striking the tongue base causes tongue flaccidity and speech difficulty, opening Lianquan and causing drool; mentioning parasites here is incomplete.) Why does a person hear ringing in the ears? The ear is the convergence point of Zong vessels. (This discussion is found only here. Wang Ang notes: At night, when the five senses are inactive, only the ears function, likely because they converge Zong vessels, allowing alertness. Also, in the womb, as a single blood embryo, hearing thunder or explosions causes jumping. At this stage, sensory organs are undeveloped, yet hearing connects with external objects. Hence, in *Surangama Sutra*'s twenty-five Perfections, the ear root is emphasized; Confucius said at sixty his ear was compliant. Thus, the ear's uniqueness is clear.) When the Stomach is empty, Zong vessels become deficient; deficiency leads to sinking. (Flow.) When vessels are exhausted, tinnitus occurs. (Meaning the same as "insufficiency of upper Qi causing bitter ringing in the ears" mentioned later.) Why does a person accidentally bite their own tongue? This is caused by rebellious Qi ascending. (Fire Qi rebelling upward.) Caused by vessel Qi. ("Caused by" may also be read as "arriving in succession".) When Shaoyin Qi arrives, the tongue is bitten. (The tongue is the orifice of Hand-Shaoyin Heart.) When Shaoyang Qi arrives, the cheek is bitten. (Hand-Shaoyang Sanjiao meridian descends along the cheek; Foot-Shaoyang Gallbladder meridian passes through Jiache.) When Yangming Qi arrives, the lip is bitten. (Hand-Yangming Large Intestine meridian flanks the mouth; Foot-Yangming Stomach meridian circles the lips.) Therefore, wherever pathogenic factors reside, it is due to insufficiency. Insufficiency of upper Qi causes brain fullness to decrease, bitter ringing in ears, heaviness of the head, and dizziness. Insufficiency of middle Qi causes changes in urination and defecation. (Note: *Nei Jing* has no mention of seminal emission or white turbid urine, but mentions white discharge and white urine from spontaneous emission; changes in urination/defecation also refer to turbid fluids, all belonging to heat.) Bitter ringing in intestines. Insufficiency of lower Qi leads to Wei (flaccidity) and Jue (cold extremities) and mental confusion. (*Zi Hui*: , meaning forgetfulness, pronounced Men.) (From *Kou Wen*)
[Ling Shu] Why are some people prone to forgetfulness? Insufficiency of upper Qi, excess of lower Qi; solid intestines and stomach but deficient heart and lungs. Deficiency causes Ying and Wei Qi to remain below, failing to ascend in time, leading to forgetfulness. (*Su Wen: Tiao Jing Pian*: Blood pooling below, Qi pooling above, chaos leads to forgetfulness.) Why are some people hungry but lack appetite? (Hunger should imply desire to eat.) Essence and Qi pool in the Spleen; heat Qi remains in the Stomach. Stomach heat digests grain quickly, causing hunger. Rebellious Stomach Qi causes cold in the epigastrium, hence lack of appetite. (Upper Guan heat aids digestion; middle Guan cold reduces appetite.) (From *Da Huo Lun*)
[Ling Shu] Why does a person suddenly lose their voice due to grief or anger? Which pathway is blocked? The throat is the passage for water and food. (Esophagus is posterior, connecting to Stomach.) The larynx is the passage for Qi. (Trachea is anterior, connecting to Lung.) The epiglottis is the door of sound. (Covers the larynx to prevent food entering airway.) Lips are the fan of sound. Tongue is the mechanism of sound. The uvula is the gate of sound. The pharynx (Hang Sang) is the outlet for distributing Qi. The transverse bone (Heng Gu) is driven by Shen Qi and controls tongue movement. Therefore, nasal leakage and uncontrollable runny nose indicate failure of the pharynx to open and dysfunction of Qi distribution. (Qi has nowhere to distribute.) Thus, a small and thin epiglottis allows rapid airflow, easy opening/closing, and easy voice production; a large and thick epiglottis makes opening/closing difficult, slowing airflow, causing stuttering. Sudden loss of voice is caused by cold Qi lodging in the epiglottis, preventing it from moving up or down, resulting in inability to open/close properly, hence loss of voice. (From *You Hui Wu Yan*)
[Su Wen] Diagnosing a rapid Heart pulse indicates Xin Han (Heart Hernia). (Rapid pulses indicate cold; accumulation of cold forms hernia.) There should be a palpable mass in the lower abdomen. The Heart is a Yang organ. (*Jin Gui Zhen Yan Lun*: Heart is Yang within Yang.) The Small Intestine acts as its envoy; thus, a mass appears in the lower abdomen. (The Heart Monarch is hard to invade directly; thus, Zang disease manifests in the Fu organ.) What are the manifestations of Stomach meridian disease? Excess in Stomach pulse causes distension; deficiency causes diarrhea. What are the transformations of disease progression? Wind transforming into cold-heat. (*Sheng Qi Tong Tian Lun*: Exposure to wind generates cold-heat.) Dan heat transforming into Xiao Zhong (middle-jiao diabetes). (Heat in Stomach causes polyphagia.) Jue reversing transforming into Dian Ji (vertex disease). (Deficiency of lower Zang Qi with rebellious Qi ascending causes vertigo and sudden collapse.) Long-standing wind transforming into Sun Xie (undigested diarrhea). (Liver wind attacks Spleen/Stomach earth, causing undigested food in stool.) Pulse wind transforming into Li (leprous disease). (Li sounds like Lai. Pulses are houses of Blood; long-term wind invasion causes blood/flesh corruption leading to leprosy.) Disease transformations are countless. (Not limited to these examples.) Various carbuncles, tendon spasms, and bone pain are caused by cold swelling and variations of Eight Winds. (All caused by wind-cold. *Ling Shu: Jiu Gong Ba Feng Pian*: Wind from South is Da Ruo Feng, affecting Heart and vessels; Southwest is Mou Feng, affecting Spleen and muscles; West is Gang Feng, affecting Lung and skin; Northwest is Zhe Feng, affecting Small Intestine and Hand-Taiyang vessels; North is Da Gang Feng, affecting Kidney, bones, and back muscles; Northeast is Xiong Feng, affecting Large Intestine and lateral ribs/joints; East is Ying Er Feng, affecting Liver and tendons; Southeast is Ruo Feng, affecting Stomach and muscles.) (From *Mai Yao Jing Wei Lun*)
[Ling Shu] Spasm of Foot-Yangming and Hand-Taiyang tendons causes facial deviation. (Cannot see suddenly.) (This chapter states: Foot-Yangming tendons ascend neck and flank mouth; abdominal tendon spasm pulls Jinmen and cheek, causing sudden facial deviation; acute cases have eyes unable to close; heat causes tendon flaccidity and eyes unable to open; cold causes neck pulling and mouth deviation. Hand-Taiyang tendons connect to outer canthus, correspond to ear ringing/pain, pull jaw and close eyes; vision returns after a while.) (From *Jing Jin Pian*)
[Ling Shu] Flexion without extension indicates tendon disease. (Tendon spasm.) Extension without flexion indicates bone disease. (Bone Bi.) (From *Zhong Shi*)
[Ling Shu] How should the Eight Xu (Eight Empties) be examined? To examine the five Zang organs. Pathogens in Lung and Heart stay in the elbows. (Lung meridian enters Xiabai in elbow; Heart meridian runs through Shaohai in elbow.) Pathogens in Liver flow to the axillae. (Liver meridian spreads to hypochondrium and axilla Qimen; here "flow" is used instead of "stay".) Pathogens in Spleen stay in the thighs. (Spleen meridian ascends inner thigh; *Jing Jin Pian*: ascends yin thigh, knots at hip.) Pathogens in Kidney stay in the popliteal fossae. (Popliteal fossa; Kidney meridian ascends popliteal, emerges medial side.) These eight xu are chambers of joints, passages of True Qi, and routes of blood collaterals. Pathogenic Qi and evil blood cannot lodge there; if they lodge, they damage collaterals, preventing joint flexion/extension, causing spasms. (From *Xie Ke*)
[Ling Shu] Diagnosing eye pain: Red vessels descending from above indicate Taiyang disease; ascending from below indicate Yangming disease. (Heat causes red vessels. *Jing Jin Pian*: Taiyang covers upper eyelid; Yangming covers lower eyelid.) Moving from outside inward indicates Shaoyang disease. (Shaoyang meridian runs outside outer canthus and Tongziliao.) If an infant's illness causes hair to stand on end, death is certain. (Blood fails to nourish; like dying plants, branches wither first.) (From *Lun Bing Zhen Chi*)
[Su Wen] Excess Yin dreams of crossing large waters and fear; Excess Yang dreams of large fires burning; Excess Yin and Yang dream of killing and destruction. (Yin-Yang conflict.) Excess upper dreams of flying; Excess lower dreams of falling. Full stomach dreams of giving; Empty stomach dreams of taking. (Note: Dreams of eating/drinking due to hunger/fullness are common, similar to dreaming of urination when bladder is full. Mental labor causes dreams of toil; sore feet cause dreams of running; these are similar.) Excess Liver Qi dreams of anger; Excess Lung Qi dreams of crying. (Liver emotion is anger; Lung emotion is grief; these are pathological dreams. Le Guang argued dreams arise from thought/causes, but didn't cover all dream variations. Most dreams are pathological. *Ling Shu: Yin Xie Fa Meng Pian* is similar. The following paragraph in this chapter is irrelevant, so deleted. *Fang Sheng Shuai Lun* also discusses dreams, omitted here.) (From *Mai Yao Jing Wei Lun*)
[Ling Shu] The five parts of the body corresponding to the five Zang organs. Futu (1). (Foot-Yangming Stomach meridian point, 6 cun above knee, fleshy prominence. One says 7 cun above knee; press with three fingers, flesh rises like a rabbit.) Fei/Calf (2). (Fei is Chun. Calf muscle, also called Chun Chang, Foot-Taiyang Bladder meridian.) Back (3). (Mid-Du meridian; four rows on either side are Bladder meridian.) Five Shu points of Zang (4). (Five Shu points of Heart, Liver, Spleen, Lung, Kidney, all Bladder meridian points. Though Bladder governs exterior, twelve Back-Shu points connect internally to five Zang and six Fu organs.) Neck (5). (Also Du meridian, Foot-Taiyang meridian.) Carbuncles/sores in these five parts are fatal. (Wang Ang notes: Yang toxins that erupt can be treated; Yin toxins that do not erupt are untreatable.) (From *Han Re Bing*)
[Ling Shu) Distension diseases occur outside the Zang-Fu, pushing against organs, expanding chest/hypochondrium, and swelling skin. Ying Qi follows vessels; Wei Qi rebels, causing Mai Zhang (Vessel Distension). Wei Qi merges with vessels along muscle spaces, causing Fu Zhang (Skin Distension). (Ma Shi's note: Ying Qi is pure and follows major vessels, cannot cause distension; only rebellious Wei Qi merging with vessels along muscles causes Mai Zhang and Fu Zhang.) Heart Distension: vexation, shortness of breath, restless sleep. Lung Distension: empty fullness, panting, cough. Liver Distension: fullness and pain under hypochondrium radiating to lower abdomen. Spleen Distension: frequent hiccups, limb irritability, heavy body unable to bear clothes, restless sleep. Kidney Distension: abdominal fullness pulling to back, aching waist and hips. Stomach Distension: abdominal fullness, epigastric pain, smelling burnt odor in nose. (Heart is burnt fire/Qi.) Difficulty eating, constipation. Large Intestine Distension: borborygmus and pain, undigested diarrhea in winter upon re-exposure to cold. Small Intestine Distension: lower abdominal distension pulling to waist and pain. Bladder Distension: lower abdominal fullness and strangury. (Strangury/retention.) Sanjiao Distension: Qi fullness in skin, light but not firm. Gallbladder Distension: pain and fullness under hypochondrium, bitter taste, frequent sighing. (From *Zhang Lun*)
[Ling Shu] How to distinguish Water Distension, Skin Distension, Drum Distension, Intestinal Polyp (Chang Tan), Uterine Mass (Shi Xia), and Stone Water? Water Distension begins with slight swelling of eye sockets, like waking up; pulsation in neck veins; occasional cough; cold sensation in inner thighs; edema in calves; then abdominal enlargement. Water is formed. Pressing abdomen leaves indentation that rebounds slowly, like wrapping water. This is the sign. (*Wu Long Jin Ye Lun*: Obstruction of Yin-Yang Qi pathways, closure of Four Seas, failure of Sanjiao to drain, failure to transform fluids, water/grain pooling in intestines, separating in ileum, staying in lower jiao, unable to enter bladder, causing lower jiao distension; water overflow causes Water Distension.) Skin Distension: Cold Qi lodges between skin; hollow and not firm; large abdomen, whole body swollen, thick skin; pressing abdomen leaves indentation that does not rebound; abdominal color unchanged. This is the sign. Drum Distension? Abdominal distension, whole body large, equal to Skin Distension; pale yellow color, visible abdominal veins. This is the sign. (Visible veins distinguish it from Skin Distension.) Intestinal Polyp (Chang Tan)? Cold Qi lodges outside intestines, combats Wei Qi, Qi fails to circulate, binds internally, bad Qi arises, polyps form. Initially egg-sized, gradually enlarges to pregnancy-like size, lasting over a year. Firm to touch, movable. Menstruation continues normally. (Cold outside intestine is Qi pathology, so menstruation is regular.) Shi Xia (Stone Mass) arises in uterus. Cold Qi lodges in cervical os, blocking Qi, preventing expulsion of evil blood, which stagnates. Gradually enlarges like pregnancy. Menstruation stops. (Mass in uterus is Blood pathology, so menstruation stops.) All occur in women; treatable by guiding downward. (Stone Water has no explicit text in classics.) (From *Shui Zhang*)
[Su Wen] Heat diseases today belong to the category of Shang Han (Cold Damage). (Contracting wind-cold in winter and immediate onset is true Shang Han; or cold toxin accumulates internally, becoming Wen Bing in spring, Re Bing in summer; however, all start from Shang Han, hence "category of Shang Han.") Some recover, some die; deaths occur within 6-7 days; recoveries take over 10 days. Why? Ju Yang (Greater Yang/Taiyang) is the chief of all Yang meridians. (Taiyang is the leader of Yang.) Its vessels connect to Fengfu, making it the master of Yang Qi. (Fengfu is a Du meridian point behind the head; Du meridian governs all Yang.) Contracting cold causes heat disease. (Cold stagnation generates heat.) Even severe heat is not fatal. (Severe heat indicates exterior/Yang syndrome.) However, "Two-Gan" (simultaneous contraction of exterior and interior) is fatal. (One Yin-One Yang, one Zang-one Fu, simultaneous exterior-interior disease leads to death.) On the first day of Shang Han, Taiyang receives it. (Taiyang governs exterior; Shang Han transmits from exterior to interior; if stagnant and transformed into Wen Bing, then