厥凡三义∶一谓逆也，下气逆而上也，诸凡言厥逆是也；一谓极至也，本篇之热厥寒厥，盖言寒热之极也；一
谓昏迷不省人事也，本篇之言阴盛阳乱是也。乃世之云厥者，止以手足逆冷、不知人事为言，合之经旨，偏矣。
至于本篇帝问六经之厥，岐伯所对，前言六经之厥，次言六经之厥迷，终言手六经之厥逆。厥逆即厥，非有二
也。然详味所言，诸证纷纭，乃各经杂病之兼厥逆者。伯特为之敷陈，以尽厥之义。非厥之外有厥逆，且有诸厥
名目之不相同也。
黄帝问曰∶厥之寒热者，何也？岐伯对曰∶阳气衰于下则为寒厥，阴气衰于下则为热厥。（按∶阳虚则寒，
阴虚则热，厥亦犹然，况其他乎。）帝曰∶热厥之为热也，必起于足下者，何也？岐伯曰∶阳气起于足五指之
表，阴脉者，集于足下而聚于足心，故阳气胜则足下热也。（大约言之，足太阳脉，出于足小趾之端外侧，足
少阳脉出于足小趾次趾之端，足阳明脉，出于足中趾及大趾之端，并循足阳而上。肝脾肾脉集于足下，聚于足心。
阴弱故足下热也。按∶阴不故阳则阳胜，非真阳气有余也。）帝曰∶寒厥之为寒也，必从五指而上于膝者，
何也？岐伯曰∶阴气起于五指之里，集于膝下而聚于膝上，故阴气胜则从五指至膝上寒，其寒也，不从外，
皆从内也。（亦大约而言之也。足太阴脉起于足大趾之端内侧，足厥阴脉起于足大趾之端三毛中，足少阴脉起
于足小趾之下，斜趣足心。并循足阴而上，循股阴入腹，故云集于膝下而聚于膝之上也。按∶阳虚则阴胜，
阴胜则寒矣。然寒本于阳虚，故云从内。）
帝曰∶寒厥何失而然也？岐伯曰∶前阴者，宗筋之所聚，太阴、阳明之所合也。（宗筋挟脐下，合于阴器，
故云前阴者宗筋之所聚也。太阴脾脉，阳明胃脉，脾胃之脉，皆辅近宗筋，
故云太阴阳明之所合。按∶注盖以脉位言也。）岂知人身必借水谷以为养，前篇已言阳明主润宗筋，其云太阴阳
明之所合宜矣。春夏则阳气多而阴气少，秋冬则阴气盛而阳气衰。（此乃天之常道。）此人者质壮，以秋冬夺于
所用，下气上争不能复，精气溢下，邪气因从之而上也。气因于中，阳气衰不能渗营其经络，阳气日损，阴气
独在，故手足为之寒也。（夺于所用，谓多欲而夺其精气也。按∶秋冬宜养其阴，过用则阴虚而阳上浮，故上
争而精气泄，正亏邪动，真气因之而衰矣。四肢为诸阳之本，阳既衰则阴独盛，故手足不温而寒也。）
帝曰∶热厥何如而然也？岐伯曰∶酒入于胃，则络脉满而经脉虚。脾主为胃行津液者也，阴气虚则阳气入，
阳气入则胃不和，胃不和则精气竭，精气竭则不荣其四肢也。（按∶脉之正为经，旁为络，酒性暴悍，能动浮气而
善耗真气，故令络脉满而经脉虚也。然受之者胃，而为之营运者脾也，脾行则气动，乘虚入胃，胃不安而水谷
失所养，无以变化气血，四肢亦失所资荫矣。）此人必数醉若饱以入房，气聚于脾中不得散，酒气与谷气相搏，
热盛于中，故热遍于身，内热而溺赤也。夫酒气盛而 悍，肾气日衰，阳气独胜，故手足为之热也。（醉饱入
房，内亡精气，中虚热入，由是肾衰，阳盛阴虚，故热生于手足也。按∶醉饱入房，气何以聚于脾中耶？脾主
运化，然必资气于命门，而后能营运而不滞。今醉饱入房，则肾大虚，命门无气以资脾，故气聚而不散也。气
不散则热内壅而阳独胜，阳独胜则肾水枯而火用事，外走阳分，故又四肢尽热也。）
帝曰∶厥或令人腹满，或令人暴不知人，或至半日，远至一日，乃知人者，何也？岐伯曰∶阴气盛于上
则下虚，下虚则腹胀满，……腹满则下气重上而邪气
逆，逆则阳气乱，阳气乱则不知人也。（按∶阳清阴浊，清上升，浊下降，气自顺而不逆矣。厥而腹满不知人者，
是阴浊上升，阳气溃乱，故厥而不知人也。王本腹胀满下有“阳气盛于上”，五字，甲乙经作“腹满”二字，
是也，从之。又王注阴作足太阴气，误矣。）
帝曰∶善！愿闻六经脉之厥状病能也。岐伯曰∶巨阳之厥，则肿首头重，足不能行，发为 仆。（足太阳
脉，起于目内 ，上额交巅。其支别者，从巅至耳上角。其直行者，从巅入络脑，还出别下项，循肩 内，
挟脊抵腰中，入循膂，络肾，属膀胱。其支别者，从腰中下贯臀，入 中。其支别者，从 内左右，别下贯胂，
过髀枢，循髀外后廉，下合 中以下贯 内，出外踝之后，循京骨，至小趾之端外侧。由是厥逆，外形斯证也。）
阳明之厥，则癫疾欲走呼，腹满不得卧，面赤而热，妄见而妄言。（足阳明脉，起于鼻交 中，下循鼻外，
入上齿中，还出挟口环唇，下交承浆，却循颐后下廉，出大迎，循颊车，上耳前，过客主人，循发际，至额颅。
其支别者，从大迎前，下人迎，循喉咙，入缺盆，下膈，属胃，络脾。其直行者，从缺盆，下乳内廉，下挟脐，
入气街中。其支别者，起胃下口，循腹里，下至气街中而合，以下髀抵伏兔，下入膝膑中，下循 外廉，下足
，入中指内间。其支别者，下膝三寸而别，以下入中指外间。其支别者， 上入大趾间出其端。故厥如是也。）
少阳之厥，则暴聋颊肿而热，胁痛， 不可以运。（足少阳之脉，起于目锐 ，上抵头角，下耳后，循颈，
行手少阳之前，至肩上，交出手少阳之后，入缺盆。其支别者，从耳后，入耳中，出走耳前，至目锐 后。
其支别者，目锐 下大迎，合手少阳于 ，下加颊车，下颈合缺盆，以下胸中，贯膈络肝属胆，循胁里，出气
街，绕髦际，横入髀厌中。其直行者，从缺盆下腋，循胸过季胁，下合脾厌中，以下循髀阳，出膝外廉，下入
外辅骨之前，直下抵绝骨之端，下出外踝之前，循足 ，出小趾次指之端。故厥如是。）太阴之厥，则腹满
胀，后不利，不欲食，食则呕，不得卧。
足太阴脉，起于大趾之端，上膝股内前廉，入腹属脾络胃，上膈，挟咽，连
舌本，散舌下。其支别者，复从胃，别上膈，注心中。故厥如是。少阴之厥则口干溺赤，腹满心痛。（足少
阴脉，上股内后廉，贯脊，属肾，络膀胱。其直行者，从肾上贯肝膈，入肺中，循喉咙，挟舌本。其支别者，
从肺出，络心，注胸中。故厥如是。）厥阴之厥，则少腹肿痛，腹胀，泾溲不利，好卧，屈膝，阴缩肿， 内
热。足厥阴脉，去内踝一寸，上踝八寸，交出太阴之后，上 内廉，循股阴，入髦中，下环阴器，抵少腹，挟
胃，属肝，络胆，上贯膈。故厥如是。盛则泻之，虚则补之，不盛不虚，以经取之。（不盛不虚，谓邪气未盛，
真气未虚，如是则以穴俞经法留呼多少而取之。按∶自此以上，乃古本也。此下自太阴厥逆至篇末，全元起本
在第九卷，王氏移入于此。）
太阴厥逆， 急挛，心痛引腹。（……按。足太阴脉，自足大趾之端起，兼循 骨，又注心入腹，故病更
如是也。）少阴厥逆，虚满呕变，下泄清。（……按∶五脏之中，肾独有两。左为阴，右则阴中之阳也；左属
水，右则水中伏火焉。为气之根，为命之门，为胃之关。是故肾气充盈，少火蓄于丹田，周身之气自和洽而无
寒滞之患。今虚满，是气不能运也。呕变，是寒犯胃也。下泄清，是脾寒不摄也。总为肾虚命门火弱不能温养
丹田之所致。昧者不达，舍肾治脾，失其宜矣。）厥阴厥逆，挛，腰痛，虚满前闭，谵言。（……全元起云∶
“谵言者，气虚独言也。”按∶厥阴，肝也，肝主筋，肝病则筋拘挛。筋挛则屈伸不利，故腰痛。肝病则气
郁而不行，故虚满。肝脉环阴器，故前闭。肝伏风邪，故言谵也。）三阴俱逆，不得前后，使人手足寒，三日
死。（按∶凡病内寒，前后必自利。今反不利而手足厥冷，是阴凝痼闭，真气乏竭矣，焉得不死。）太阳厥逆，
僵仆，呕血善衄。（……按∶膀胱之经，既起目内 ，又循脊络脑，而其所主，惟气与火。气内闭，故僵仆。
火上炎，故呕衄。太阳主表，故
厥如是也。）少阳厥逆，机关不利，机关不利者，腰不可以行，项不可以顾，发肠痈，不可治，惊者死。（按∶
胆为肝之腑，肝主筋筋主束骨而利机关，肝胆病，故腰为之拘挛也。然此尚是半表里之病。若肠内发痈，则内外
皆病，其人必惊，神明已乱，焉得不死。）阳明厥逆，喘咳，身热，善惊、衄、呕血。（按∶阳明多气多血，胃
火盛则冲肺，故喘咳。走三阳，故身热。火性动，故善惊而诸血为之不宁。此热厥也。）手太阴厥逆，虚满而咳，
善呕沫。（……按∶肺主气，故病则虚满而咳。肺受寒，故呕沫也。沫音末，痰水之轻浮白色者。）手心主、
少阴厥逆，心痛引喉，身热死，不可治。（按∶心与心包属火，火上升则喉痛，是火，虚也。虚火上升而身又
发热，阴竭不能维阳矣，故死。）手太阳厥逆，耳聋，泣出，项不可以顾，腰不可以俯仰。（……按∶小肠属火，
火上逆，故耳聋。小肠脉至目内 ，故泣出。项不可顾二句，脉病俱不相应，疑仍前文重出也。）手阳明、少
阳厥逆，发喉痹，嗌肿，痉。（……按∶痉音劲，风病也。大肠、三焦脉俱由缺盆上颈项，故病如是。全元起
本作痉，王本误作 ，后人遂以痉为 ，盖仍此误也。）
厥病主要有三层含义：一是“逆”的意思，指下部的之气上逆，所有称为“厥逆”的都是这种情况；二是“极至”的意思，本篇中的热厥和寒厥，是说寒热到了极点；三是“昏迷不省人事”的意思，本篇中提到的阴盛阳乱导致的昏厥就是这种。然而世人所说的厥，仅仅局限于手足逆冷、不知人事这两点，这与《内经》的原意相比，就偏颇了。至于本篇中黄帝询问六经的厥病，岐伯的回答，先讲六经的厥病，接着讲六经厥病引起的昏迷，最后讲手六经的厥逆。厥逆就是厥，并没有两种区别。但是仔细品味文中所述，各种症状纷繁复杂，其实是各经杂病兼有厥逆的表现。伯特（注：此处疑为衍文或特定语境下的自称/误植，依原文保留）对此进行阐述，以穷尽“厥”的含义。并不是在厥之外还有厥逆，也不是说各种厥的名称互不相同。
黄帝问道：厥病有的表现为寒，有的表现为热，这是为什么呢？岐伯回答说：阳气在下部衰少就会发生寒厥，阴气在下部衰少就会发生热厥。（按语：阳虚则生寒，阴虚则生热，厥病也是如此，何况其他病症呢。）黄帝问：热厥的热感，一定从脚底开始，这是为什么呢？岐伯说：阳气起于足五指的外侧，阴脉汇聚于足下并聚集在足心，所以阳气胜则脚底发热。（大致来说，足太阳脉出于足小趾外侧端，足少阳脉出于足小趾次趾端，足阳明脉出于足中趾及大趾端，都沿足背向上行。肝、脾、肾三阴脉汇聚于足下，聚集在足心。因为阴气弱，所以脚底发热。按语：阴弱则阳胜，但这并非真正的阳气有余。）黄帝问：寒厥的寒冷感，一定从五个脚趾向上蔓延到膝盖，这是为什么呢？岐伯说：阴气起于足五指的里面，汇聚于膝下并聚集在膝上，所以阴气胜则从脚趾到膝盖感到寒冷，这种寒冷不是从外部感受得来的，都是从内部产生的。（这也是大致而言。足太阴脉起于足大趾内侧端，足厥阴脉起于足大趾末端丛毛处，足少阴脉起于足小趾之下，斜向足心。都沿足内侧向上行，沿大腿内侧进入腹部，所以说汇聚于膝下而聚集在膝上。按语：阳虚则阴胜，阴胜则寒。但寒的根本在于阳虚，所以说从内部产生。）
黄帝问：寒厥是因为什么失误才导致这样的呢？岐伯说：前阴部位，是宗筋汇聚的地方，也是太阴脉和阳明脉会合之处。（宗筋挟持脐下，会合于生殖器，所以说前阴是宗筋汇聚之地。太阴脾脉和阳明胃脉，脾胃之脉都靠近宗筋，所以说太阴和阳明在此会合。按语：注释大概是从经脉位置来说的。）哪里知道人身必须依靠水谷来滋养，前篇已经说过阳明主润宗筋，这里说太阴和阳明会合是合适的。春夏时节阳气多而阴气少，秋冬时节阴气盛而阳气衰。（这是天地的常道。）这种人体质强壮，如果在秋冬季节过度使用精气（如房事），会导致下部之气上争而不能恢复，精气外泄，邪气便随之而上行。气郁结在中焦，阳气衰少不能渗透濡养经络，阳气日渐损耗，只有阴气独存，所以手足因此发冷。（“夺于所用”，是指纵欲而耗损精气。按语：秋冬宜保养阴气，过度使用则阴虚而阳气上浮，所以上争而精气外泄，正气亏损邪气妄动，真气因此衰败。四肢是诸阳之本，阳气既衰则阴气独盛，所以手足不温而寒冷。）
黄帝问：热厥又是如何形成的呢？岐伯说：酒进入胃中，则络脉满盈而经脉空虚。脾主为胃传输津液，阴气虚则阳气内入，阳气内入则胃不和，胃不和则精气枯竭，精气枯竭则不能荣养四肢。（按语：脉的正支为经，旁支为络，酒性暴烈悍急，能扰动浮气且善于耗伤真气，所以使络脉满而经脉虚。然而受病的是胃，为之营运的是脾，脾运化则气动，乘虚入胃，胃不安宁而水谷失去滋养，无法变化为气血，四肢也失去了资荫。）这种人一定是经常醉酒或饱食后行房事，气聚在脾中不得疏散，酒气与谷气相互搏结，热盛于中，所以热遍全身，出现内热和小便赤黄的症状。酒的性质盛大而悍急，肾气日渐衰少，阳气独胜，所以手足因此发热。（醉饱后入房，体内精气亡失，中焦虚而热邪内入，由此肾气衰败，阳盛阴虚，所以热生于手足。按语：醉饱后入房，气为什么聚在脾中呢？脾主运化，但必须依赖命门之气资助，然后才能营运而不滞涩。现在醉饱入房，则肾大虚，命门无气以资助脾，所以气聚而不散。气不散则热在内壅塞而阳气独胜，阳气独胜则肾水枯涸而火气用事，向外走窜阳分，所以四肢都发热。）
黄帝问：厥病有的让人腹部胀满，有的让人突然昏迷不省人事，有的半天甚至一天后才苏醒，这是为什么呢？岐伯说：阴气盛于上部则下部虚，下部虚则腹胀满，……腹满则下部之气沉重上逆而邪气逆行，逆行则阳气紊乱，阳气紊乱则使人不知人事。（按语：阳清阴浊，清气上升，浊气下降，气机自然顺达而不逆。厥病出现腹满不知人，是阴浊上升，阳气溃乱，所以厥而不知人。王冰本在“腹胀满”下有“阳气盛于上”五字，《甲乙经》作“腹满”二字，是正确的，遵从它。另外王冰注中将“阴”解释为“足太阴气”，是错误的。）
黄帝说：好！我想听六经脉厥的症状和病态。岐伯说：太阳经厥逆，则头肿头重，脚不能行走，甚至跌倒。（足太阳脉，起于目内眦，上行额部交会于头顶。其分支，从头顶至耳上角。其直行者，从头顶入络脑，复出别下行项部，沿肩胛内侧，挟脊柱抵腰中，入循脊里，络肾，属膀胱。其分支，从腰中下行贯臀，入腘中。其分支，从腘内左右，别下行贯腓肠肌，过髀枢，沿大腿外后侧，下行合于腘中，以下贯腓肠肌，出外踝之后，沿京骨穴，至小趾外侧端。由此发生厥逆，外形出现这些症状。）
阳明经厥逆，则患癫狂病想奔跑呼喊，腹部胀满不能卧睡，面红发热，胡言乱语看到不存在的东西。（足阳明脉，起于鼻旁交颧骨中，下行沿鼻外侧，入上齿中，复出挟口环唇，下交承浆穴，却沿下颌后下廉，出大迎穴，沿颊车穴，上耳前，过客主人穴，沿发际，至额颅。其分支，从大迎前下行到人迎穴，沿喉咙，入缺盆，下膈，属胃，络脾。其直行者，从缺盆下乳内廉，下挟脐，入气街中。其分支，起于胃下口，循腹里，下至气街中而合，以下大腿抵伏兔穴，下行入膝膑中，下行沿小腿外廉，下足，入中指内间。其分支，下膝三寸处分出，以下入中指外间。其分支，上行入大趾间出其端。所以厥逆出现这些症状。）
少阳经厥逆，则突然耳聋，脸颊肿胀发热，胁痛，大腿不能运转。（足少阳脉，起于目锐眦，上抵头角，下耳后，循颈，行手少阳之前，至肩上，交出手少阳之后，入缺盆。其分支，从耳后入耳中，出走耳前，至目锐眦后。其分支，从目锐眦下大迎，合手少阳于䪼，下加颊车，下颈合缺盆，以下胸中，贯膈络肝属胆，循胁里，出气街，绕髦际，横入髀厌中。其直行者，从缺盆下腋，循胸过季胁，下合髀厌中，以下循髀阳，出膝外廉，下入外辅骨之前，直下抵绝骨之端，下出外踝之前，循足跗，出小趾次趾之端。所以厥逆出现这些症状。）
太阴经厥逆，则腹部胀满，大便不通利，不想吃东西，吃了就呕吐，不能卧睡。足太阴脉，起于大趾端，上膝股内前廉，入腹属脾络胃，上膈，挟咽，连舌本，散舌下。其分支，又从胃别出上膈，注心中。所以厥逆出现这些症状。
少阴经厥逆则口干小便赤，腹部胀满心痛。（足少阴脉，上股内后廉，贯脊，属肾，络膀胱。其直行者，从肾上贯肝膈，入肺中，循喉咙，挟舌本。其分支，从肺出，络心，注胸中。所以厥逆出现这些症状。）
厥阴经厥逆，则少腹肿痛，腹部胀满，大小便不利，喜欢躺卧，屈膝，生殖器收缩肿胀，阴中发热。足厥阴脉，去内踝一寸，上踝八寸，交出太阴之后，上膝内廉，循股阴，入髦中，下环阴器，抵少腹，挟胃，属肝，络胆，上贯膈。所以厥逆出现这些症状。实证用泻法，虚证用补法，不虚不实则取本经穴位治疗。（不虚不实，指邪气未盛，真气未虚，像这样则根据穴俞经法留针时间的长短来取穴。按语：自此以上，是古本的内容。此下自太阴厥逆至篇末，全元起本在第九卷，王冰将其移入于此。）
太阴经厥逆，腨部拘急挛缩，心痛牵引腹部。（……按：足太阴脉，自足大趾端起，兼循胫骨，又注心入腹，所以病情更如此。）
少阴经厥逆，虚满呕吐变易，下利清谷。（……按：五脏之中，肾独有两只。左为阴，右则为阴中之阳；左属水，右则水中伏藏火。它是气的根本，是生命之门，是胃的关口。所以肾气充盈，少火蓄于丹田，周身之气自然调和而没有寒滞的隐患。现在出现虚满，是气不能运化。呕吐变易，是寒邪犯胃。下利清谷，是脾寒不能固摄。总归是肾虚命门火弱不能温养丹田所致。愚昧的人不明白，舍弃治肾而去治脾，就不适宜了。）
厥阴经厥逆，筋脉拘挛，腰痛，虚满前阴闭塞，胡言乱语。（……全元起说：“谵言，是气虚独自说话。”按：厥阴对应肝脏，肝主筋，肝病则筋脉拘挛。筋挛则屈伸不利，所以腰痛。肝病则气郁而不行，所以虚满。肝脉环绕生殖器，所以前阴闭塞。肝伏风邪，所以言语错乱。）
三阴经同时厥逆，大小便不通，使人手足寒冷，三天死亡。（按：凡是病在内寒，大小便必然自利。现在反而不通利且手足厥冷，这是阴寒凝滞闭阻，真气乏竭了，怎么能不死呢？）
太阳经厥逆，僵仆倒地，呕血容易鼻衄。（……按：膀胱之经，既起于目内眦，又循脊络脑，而它所主的，只有气和火。气内闭，所以僵仆。火上炎，所以呕血鼻衄。太阳主表，所以厥逆出现这些症状。）
少阳经厥逆，关节活动不利，关节活动不利的人，腰不能行走，项不能回顾，如果并发肠痈，不可治愈，如果惊恐则死。（按：胆是肝的腑，肝主筋，筋主束骨而利关节，肝胆有病，所以腰为此拘挛。然而这还是半表里的病。如果肠内发痈，则内外皆病，其人必定惊恐，神明已乱，怎么能不死呢？）
阳明经厥逆，喘咳，身体发热，容易惊恐、鼻衄、呕血。（按：阳明多气多血，胃火盛则冲肺，所以喘咳。火走三阳，所以身热。火性主动，所以容易惊恐且各种血液不安宁。这是热厥。）
手太阴经厥逆，虚满而咳，容易呕吐痰沫。（……按：肺主气，所以生病则虚满而咳。肺受寒，所以呕吐痰沫。沫音末，指轻浮白色的痰水。）
手心主、少阴经厥逆，心痛牵引喉部，身体发热则死，不可治愈。（按：心与心包属火，火上升则喉痛，这是火，属于虚证。虚火上升而又身体发热，阴竭不能维系阳气了，所以死。）
手太阳经厥逆，耳聋，流泪，项不能回顾，腰不能俯仰。（……按：小肠属火，火上逆，所以耳聋。小肠脉至目内眦，所以流泪。“项不可以顾”两句，脉象与病症都不相应，怀疑仍是前文的重出。）
手阳明、少阳经厥逆，发生喉痹，咽喉肿胀，痉挛。（……按：痉音劲，是风病。大肠、三焦脉都由缺盆上颈项，所以病情如此。全元起本作“痉”，王本误作“瘖”，后人遂以“痉”为“瘖”，大概仍是由于这个错误。）
Jue (Reversal) has three main meanings: one refers to "reversal," meaning the Qi from the lower part reverses and moves upward; all instances referred to as "Jue Ni" (Reversal Cold/Numbness) fall into this category. The second refers to "extremity"; the Heat Jue and Cold Jue in this chapter refer to the extremities of cold and heat. The third refers to "coma or loss of consciousness"; the Yin excess and Yang disorder mentioned in this chapter leading to fainting fall into this category. However, what is commonly called Jue in later times is limited only to cold reversal of the hands and feet and loss of consciousness, which deviates from the original intent of the Classic. Regarding the Emperor's inquiry about the Jue of the Six Meridians in this chapter, Qibo's response first discusses the Jue of the Six Meridians, then the coma caused by Jue of the Six Meridians, and finally the Jue Ni of the Hand Six Meridians. Jue Ni is simply Jue; there are not two distinct entities. However, upon careful reading, the various symptoms described are actually miscellaneous diseases of each meridian complicated by Jue Ni. It elaborates to exhaust the meaning of Jue. It does not mean that outside of Jue there is Jue Ni, nor does it imply that the names of various Jues are different.
The Yellow Emperor asked: Why do some cases of Jue present with cold and others with heat? Qibo replied: When Yang Qi is deficient in the lower part, Cold Jue occurs; when Yin Qi is deficient in the lower part, Heat Jue occurs. (Note: Yang deficiency leads to cold, Yin deficiency leads to heat; Jue follows this principle as well, let alone other conditions.) The Emperor asked: Why does the heat sensation in Heat Jue always start from the soles of the feet? Qibo said: Yang Qi originates from the dorsal aspect of the five toes of the foot, while Yin meridians gather at the sole and converge at the center of the foot. Therefore, when Yang Qi prevails, the soles become hot. (Generally speaking, the Foot Taiyang Bladder Meridian emerges from the lateral end of the little toe, the Foot Shaoyang Gallbladder Meridian from the end of the second toe, and the Foot Yangming Stomach Meridian from the ends of the middle and big toes, all ascending along the dorsum of the foot. The Liver, Spleen, and Kidney Yin meridians gather at the sole and converge at the center of the foot. Due to Yin weakness, the soles feel hot. Note: Yin weakness allows Yang to prevail, but this is not a true excess of Yang Qi.) The Emperor asked: Why does the cold sensation in Cold Jue always spread from the five toes up to the knees? Qibo said: Yin Qi originates from the plantar aspect of the five toes, gathers below the knee, and converges above the knee. Therefore, when Yin Qi prevails, coldness spreads from the toes to the knees. This coldness does not come from the exterior but arises from within. (This is also a general description. The Foot Taiyin Spleen Meridian originates from the medial end of the big toe, the Foot Jueyin Liver Meridian from the hairline at the tip of the big toe, and the Foot Shaoyin Kidney Meridian from below the little toe, slanting toward the center of the foot. All ascend along the medial aspect of the foot, up the thigh interior into the abdomen, hence gathering below and converging above the knee. Note: Yang deficiency leads to Yin prevalence, and Yin prevalence leads to cold. Since the root of cold is Yang deficiency, it is said to arise from within.)
The Emperor asked: What mistake leads to Cold Jue? Qibo said: The anterior perineum is where the Zongjin (Tendon Sheath/Mass of Tendons) gathers, and it is the confluence of the Taiyin and Yangming meridians. (Zongjin supports the area below the navel and connects to the genitalia, hence it is said that the anterior perineum is where Zongjin gathers. The Taiyin Spleen Meridian and Yangming Stomach Meridian run close to Zongjin, hence they are said to converge here. Note: The commentary likely refers to the anatomical position of the meridians.) How could one not know that the human body relies on water and grain for nourishment? As stated in previous chapters, the Yangming governs moistening Zongjin, so mentioning the convergence of Taiyin and Yangming is appropriate. In spring and summer, Yang Qi is abundant and Yin Qi is scarce; in autumn and winter, Yin Qi is prevalent and Yang Qi declines. (This is the constant way of Heaven.) A person of robust constitution who overuses their essence during autumn and winter causes the lower Qi to contend upward without recovery, leading to the overflow of essence downwards. Pathogenic Qi then follows upward. Qi becomes stagnant in the middle, Yang Qi declines and cannot permeate and nourish the collaterals. Yang Qi diminishes day by day, leaving only Yin Qi. Thus, the hands and feet become cold. ("Overuse" refers to excessive sexual activity depleting essence. Note: Autumn and winter are suitable for nourishing Yin. Overuse leads to Yin deficiency and floating Yang, causing upward contention and essence leakage. Righteous Qi is depleted, pathogenic factors move, and True Qi declines. The four limbs are the root of all Yang. Once Yang declines, Yin prevails exclusively, so the hands and feet are unwarmed and cold.)
The Emperor asked: How is Heat Jue formed? Qibo said: When wine enters the stomach, the Luo (Collateral) vessels become full while the Jing (Main) meridians become empty. The Spleen governs transporting fluids for the Stomach. When Yin Qi is deficient, Yang Qi enters inward. When Yang Qi enters inward, the Stomach becomes disharmonious. When the Stomach is disharmonious, Essence and Qi are exhausted. When Essence and Qi are exhausted, the four limbs are not nourished. (Note: The main branch is the Jing, the side branches are the Luo. Wine is fierce and harsh, disturbing floating Qi and consuming True Qi, thus making Luo vessels full and Jing meridians empty. The Stomach receives it, but the Spleen operates it. Spleen transport activates Qi, which enters the Stomach vacuously. The Stomach is unsettled, water and grain lose nourishment, cannot transform into Qi and Blood, and the four limbs lose support.) Such a person must frequently engage in sexual intercourse after getting drunk or eating until full. Qi gathers in the Spleen and cannot disperse. Wine Qi and Grain Qi struggle against each other, creating intense heat in the center. Thus, heat pervades the body, causing internal heat and red urine. The nature of wine is vigorous and harsh, causing daily decline of Kidney Qi and exclusive prevalence of Yang Qi. Thus, the hands and feet become hot. (Sexual intercourse after drunkenness/fullness causes internal loss of essence, central deficiency allowing heat to enter, leading to Kidney decline, Yang excess and Yin deficiency, hence heat arises in the hands and feet. Note: Why does Qi gather in the Spleen after drunkenness and sex? The Spleen governs transformation and transportation but requires Qi from the Mingmen (Gate of Life) to operate without stagnation. Now, drunkenness and sex cause severe Kidney deficiency, leaving no Qi in Mingmen to assist the Spleen, so Qi gathers and does not disperse. Undispersed Qi causes internal heat obstruction and Yang excess. Yang excess dries up Kidney Water and allows Fire to act, moving outward to the Yang aspects, hence all four limbs become hot.)
The Emperor asked: Why does Jue sometimes cause abdominal fullness, or sudden unconsciousness, with recovery taking half a day to a day? Qibo said: When Yin Qi is excessive in the upper part, the lower part becomes deficient. Lower deficiency leads to abdominal fullness... Abdominal fullness causes lower Qi to weigh down and reverse upward, with pathogenic Qi reversing. Reversal leads to Yang Qi disorder. Yang Qi disorder leads to loss of consciousness. (Note: Yang is clear, Yin is turbid. Clear Qi ascends, turbid Qi descends, ensuring smooth flow without reversal. Jue with abdominal fullness and unconsciousness indicates turbid Yin rising and chaotic Yang, hence Jue and unconsciousness. Wang Bing's edition adds "Yang Qi excessive in the upper" after "abdominal fullness." The *Jia Yi Jing* uses only "abdominal fullness," which is correct. Follow this. Also, Wang Bing's note interpreting "Yin" as "Foot Taiyin Qi" is erroneous.)
The Emperor said: Excellent! I wish to hear the clinical manifestations and pathological states of Jue of the Six Meridians. Qibo said: Jue of the Greater Yang (Taiyang) presents with swelling of the head and heaviness, inability to walk, and falling down. (Foot Taiyang Bladder Meridian originates from the inner canthus, ascends to the forehead and vertex. Branches go to the supraorbital angle. The main trunk enters the brain, exits at the nape, runs along the shoulder medial to the spine, reaches the waist, enters the muscle layer, connects to the Kidney, and belongs to the Bladder. Branches descend through the buttocks into the popliteal fossa. Other branches descend through the calf, pass the hip joint, follow the posterior lateral thigh, merge in the popliteal fossa, descend through the calf, emerge behind the lateral malleolus, follow the Jinggu point, and end at the lateral side of the little toe. Thus, Jue manifests these external signs.)
Jue of the Yang Ming (Stomach) presents with manic epilepsy, desire to run and shout, abdominal fullness preventing sleep, flushed and hot face, hallucinations, and delirious speech. (Foot Yangming Stomach Meridian originates between the nose and cheekbones, descends along the lateral nose, enters the upper teeth, emerges around the lips, crosses the chin, follows the jawline to Daying, passes Jiache, ascends before the ear, passes Guest Master, follows the hairline to the forehead. Branches descend from Daying to Renying, follow the throat, enter the Supraclavicular Fossa, descend through the diaphragm, belong to the Stomach, and connect to the Spleen. The main trunk descends from the Supraclavicular Fossa along the medial breast, lateral to the navel, into the Qi Street. Branches originate from below the stomach, run inside the abdomen to the Qi Street, descend to the thigh, reach the Patella, follow the lateral leg, enter the foot, and reach the space between the middle toes. Branches diverge below the knee to the lateral side of the middle toe. Another branch enters the big toe. Thus, Jue manifests these signs.)
Jue of the Shaoyang (Gallbladder) presents with sudden deafness, swollen and hot cheeks, hypochondriac pain, and immobility of the thigh. (Foot Shaoyang Gallbladder Meridian originates from the outer canthus, ascends to the corner of the head, descends behind the ear, follows the neck anterior to the Hand Shaoyang, reaches the shoulder, crosses behind the Hand Shaoyang, enters the Supraclavicular Fossa. Branches enter the ear, exit before the ear, and reach the outer canthus. Branches descend from the outer canthus to Daying, merge with Hand Shaoyang at the temple, descend to Jiache, join the neck and Supraclavicular Fossa, descend into the chest, pierce the diaphragm, connect to the Liver, belong to the Gallbladder, follow the hypochondrium, emerge at the Qi Street, circle the pubic region, and enter the hip joint. The main trunk descends from the Supraclavicular Fossa under the axilla, follows the chest past the costal margin, merges in the hip joint, follows the lateral thigh, emerges at the lateral knee, descends anterior to the fibular head, reaches the end of the fibula, emerges anterior to the lateral malleolus, follows the dorsum of the foot, and ends at the second toe. Thus, Jue manifests these signs.)
Jue of the Taiyin (Spleen) presents with abdominal distension, difficulty defecating, anorexia, vomiting after eating, and inability to sleep. Foot Taiyin Spleen Meridian originates from the tip of the big toe, ascends along the medial knee and thigh, enters the abdomen, belongs to the Spleen, connects to the Stomach, ascends through the diaphragm, flanks the pharynx, connects to the root of the tongue, and scatters under the tongue. A branch rises from the Stomach through the diaphragm to the Heart. Thus, Jue manifests these signs.
Jue of the Shaoyin (Kidney) presents with dry mouth, red urine, abdominal fullness, and heart pain. Foot Shaoyin Kidney Meridian ascends along the medial thigh, penetrates the spine, belongs to the Kidney, and connects to the Bladder. The main trunk ascends from the Kidney through the Liver and Diaphragm, enters the Lung, follows the throat, and flanks the root of the tongue. A branch emerges from the Lung, connects to the Heart, and pours into the Chest. Thus, Jue manifests these signs.
Jue of the Jueyin (Liver) presents with swelling and pain in the lower abdomen, abdominal distension, difficulty urinating and defecating, preference for lying down, bent knees, contraction and swelling of the genitalia, and heat in the Yin aspect. Foot Jueyin Liver Meridian starts one cun above the medial malleolus, ascends eight cun crossing behind the Taiyin, follows the medial knee, travels along the medial thigh, enters the pubic region, circles the genitalia, reaches the lower abdomen, flanks the Stomach, belongs to the Liver, connects to the Gallbladder, and ascends through the Diaphragm. Thus, Jue manifests these signs. Excess is drained, deficiency is tonified, and neither excess nor deficiency is treated by selecting points from the affected meridian. (Neither excess nor deficiency means pathogenic Qi is not excessive and True Qi is not deficient; in such cases, needle retention time is adjusted according to meridian methods. Note: The above text is from the ancient version. From Taiyin Jue Ni to the end, Quanyuanqi's version was in Volume 9, moved here by Wang Bing.)
Taiyin Jue Ni presents with calf cramps and spasms, heart pain radiating to the abdomen. (Note: Foot Taiyin Meridian originates from the big toe, follows the tibia, enters the Heart and abdomen, hence these symptoms.)
Shaoyin Jue Ni presents with false fullness, vomiting and changes, and passage of clear watery stool. (Note: Among the Five Zang, the Kidneys are unique. The left is Yin, the right is Yang within Yin; the left belongs to Water, the right contains hidden Fire. It is the root of Qi, the Gate of Life, and the gate of the Stomach. When Kidney Qi is full, mild fire stores in the Dantian, harmonizing whole-body Qi without cold stagnation. False fullness indicates Qi failure to transport. Vomiting indicates Cold invading the Stomach. Clear stool indicates Spleen Cold failing to secure. This is due to Kidney deficiency and weak Mingmen Fire failing to warm the Dantian. Ignorant practitioners treat the Spleen instead of the Kidney, which is inappropriate.)
Jueyin Jue Ni presents with spasms, lower back pain, false fullness, urinary retention, and delirious speech. (Quanyuanqi said: "Delirious speech is talking alone due to Qi deficiency." Note: Jueyin corresponds to the Liver, which governs tendons. Liver disease causes tendon spasms, leading to limited movement and lower back pain. Liver Qi stagnation causes false fullness. The Liver Meridian circles the genitalia, causing urinary retention. Wind evil lurking in the Liver causes delirium.)
When all Three Yin meridians experience Jue Ni, resulting in inability to pass stool or urine, causing cold hands and feet, death occurs within three days. (Note: Internal cold usually causes diarrhea. Here, constipation and cold extremities indicate severe Yin coagulation and closure, with exhaustion of True Qi. How can one survive?)
Taiyang Jue Ni presents with stiffness and falling, hematemesis, and frequent epistaxis. (Note: The Bladder Meridian originates at the inner canthus, follows the spine to the brain. It governs Qi and Fire. Internal closure of Qi causes stiffness and falling. Ascending Fire causes bleeding. Taiyang governs the exterior, hence these Jue signs.)
Shaoyang Jue Ni presents with dysfunction of joints. Those with joint dysfunction cannot walk or turn their necks. If intestinal abscess develops, it is incurable. If fright occurs, death ensues. (Note: The Gallbladder is the Fu organ of the Liver. The Liver governs tendons, which bind bones and facilitate joints. Liver-Gallbladder disease causes lumbar spasm. This is a half-exterior/half-interior condition. Intestinal abscess involves both interior and exterior, causing mental confusion and death.)
Yangming Jue Ni presents with wheezing and cough, fever, fright, epistaxis, and hematemesis. (Note: Yangming has abundant Qi and Blood. Stomach Fire surging to the Lung causes cough. Fire moving through the Three Yang causes fever. Fire's active nature causes fright and blood instability. This is Heat Jue.)
Hand Taiyin Jue Ni presents with false fullness, cough, and frequent vomiting of froth. (Note: The Lung governs Qi, so disease causes false fullness and cough. Cold in the Lung causes vomiting of frothy sputum. Froth refers to light, white, floating phlegm-water.)
Hand Jueyin (Pericardium) and Shaoyin Jue Ni present with heart pain radiating to the throat. Fever indicates death and incurability. (Note: The Heart and Pericardium belong to Fire. Rising Fire causes throat pain (deficient fire). Deficient Fire rising with fever indicates Yin exhaustion failing to anchor Yang, hence death.)
Hand Taiyang Jue Ni presents with deafness, tearing, inability to turn the neck, and inability to bend or extend the waist. (Note: The Small Intestine belongs to Fire. Ascending Fire causes deafness. The Small Intestine Meridian reaches the inner canthus, causing tearing. The phrases "cannot turn neck" may be repetitions from earlier text as they do not match the meridian pathology.)
Hand Yangming and Shaoyang Jue Ni present with Bi syndrome of the throat, swollen pharynx, and spasms. (Note: Spasms refer to wind diseases. Large Intestine and Sanjiao meridians ascend from the Supraclavicular Fossa to the neck, hence these symptoms. Quanyuanqi wrote "spasms" (Jing), Wang Bing mistakenly wrote "aphonia" (Yin). Later generations confused the two due to this error.)