形弱而气烁 马云。魄汗未尽。穴 未闭。形体弱而气消烁。乃外感风寒。致穴 已闭。当发为风疟。
疟论。言疟之为证。非独至秋有之。四时皆能成疟也。简按王注有至于
秋秋阳复收之言。故论及之。
风疟 此即疟耳。必非有一种风疟者。金匮真言云。秋善病风疟。又云。夏暑汗不出者。秋成风疟。
刺疟云。风疟。发则汗出恶风。疟论云。夫 疟皆生于风。俱可证也。
故风者百病之始也 张云。凡邪伤卫气。如上文寒暑湿气风者。莫不缘风气以入。故风为百病之始。
上下不并 吴云。阳谓之上。阴谓之下。阳中有阴。阴中有阳。谓之并。言风寒为病之久。则邪气
传变。阳自上而阴自下。谓之不并。是水火不相济。阴阳相离。简按王解并字为交通。与吴之意符焉。
良医 王充论衡云。医能治一病。谓之巧。能治百病。谓之良。故良医服百病之方。治百人之疾。
阳气当隔 马云。隔者。乖隔不通之谓也。简按隔。非噎隔之隔。王马并引三阳结谓之隔。恐非也。
反此三时 志云。平旦日中日西也。
形乃困薄 马云。未免困窘而衰薄矣。
起亟也 吴。改为守也。马云。营气藏五脏之精。随宗气以营运于经脉中。而外与卫气相表里。卫
气有所应于外。营气即随之而起。夫是之谓起亟也。张云。亟。即气也。阴阳应象曰。精化为气。即此藏精起
气之谓。亟。音气。志云。阴者主藏精。而阴中之气。亟起以外应。阳者主卫外。而为阴之固也。汪云。起者。
起而应也。外有所召。则内数起以应也。如外以顺召。则心以喜起而应之。外以逆召。则肝以怒起而应之之类
也。简按数说未知孰是。汪解似易晓焉。且王意亦似当然。
并乃狂 张云。并者。阳邪入于阳分。谓重阳也。简按与王注异义同意。
阳不胜其阴 高云。阴寒盛也。阴寒盛则五脏气争。争。彼此不和也。
陈阴阳 张云。犹言铺设得所。不使偏胜也。吴云。陈。设也。简按王陈读循。未详所据。
气立如故 张云。人受天地之气以立命。故曰气立。然必阴阳调和。而后气立如故。首节所谓生之本
于阴阳者。正此两节之谓。简按王云。真气独立。似明切焉。
风客淫气 王注痹论云。淫气。谓气之妄行者。简按说文。淫。浸淫随理也。徐云。随其脉理。而浸
渍也。马云。风来客之。浸淫以乱营卫之气。则风薄而热起。似不妥贴。
因而饱食 张云。此下三节。皆兼上文风客淫气而言也。风气既淫于外。因而饱食。则随客阳明云云。
简按下文有三因字。故有此说。
肠 为痔 吴云。肠中 沫。壅而为痔。简按续字汇。 。肠间水。盖本于本篇而释者。窃考 本是
癖。以其肠间辟积之水。故从水作 。外台癖饮。或作 饮。与庄子 之 义迥别。肠 二字。素灵中凡
十见。多指赤白滞痢而言。唯本篇云。肠 为痔。盖古肠垢脓血。出从谷道之总称。王下一而字。云肠 而为
痔。吴乃扩其意以释之。固是也。张云。为肠 为痔。而下痢脓血也。此似卤莽读去者。马云。其肠日常 积。
渐出肛门而为痔。此岂以 为襞之义乎。难从。
因而强力 吴张并从王注。而为强力入房。马志高则为强用其力。简按下文云。肾气乃伤。则王注
似为得矣。
阳密乃固 巢源。作阴密阳固。（出十二卷冷热病候）考下文云。阳强不能密。阴气乃绝。则巢源
误。志云。此总结上文之义。而归重于阳焉。
是谓圣度 高云。上文云。圣人陈阴阳。内外调和。故复言因而和之。志云。是谓圣人调养之法度。
因于露风 马云。此上文见雾露之谓。王注以露为裸体者。非。志云。露。阴邪也。风。阳邪也。
在天阴阳之邪。伤吾身之阴阳。而为寒热病矣。张云。因露于风者。寒邪外侵。阳气内拒。阴阳相薄。故生寒
热。简按张注与王意稍同。
洞泄 阴阳应象。作飧泄。论疾诊尺。作后泄肠 。知洞泄即是飧泄。邪气脏腑病形云。洞者。食
不化。下嗌还出。甲乙作洞泄。盖洞筒同。说文。筒。通箫也。徐云。通洞无底。汉元帝吹洞箫。注。与筒同。
水谷不化。如空洞无底。故谓之洞泄。巢源。洞泄者。痢无度也。水谷痢候。引本篇文详论之。当参考。又见
小儿洞泄下利候。王氏准绳云。餐泄。水谷不化而完出。是也。史记仓公传。 风。（太平御览。作洞风。）
即此也。或饮食太过。肠胃所伤。亦致米谷不化。此俗呼水谷利也。邪气留连。盖至夏之谓。高云。邪气留连。
至夏乃为洞泄。
疟 千金。作HT 疟。（说具于疟论。）
秋伤于湿上逆而咳 张云。湿土用事于长夏之末。故秋伤于湿也。秋气通于肺。湿郁成热。则上乘
肺金。故气逆而为咳嗽。简按溯洄集云。湿乃长夏之令。何于秋言。盖春夏冬。每一时各有三月。故其令亦各
就其本时而行也。若长夏则寄旺于六月之一月耳。秋虽亦有三月。然长夏之湿令。每侵过于秋而行。故曰秋伤
于湿。（秋令为燥。然秋之三月。前近于长夏。其不及则为湿所胜。其太过则同于火化。其平气则又不伤人。
此经所以于伤人。止言风暑湿寒。而不言燥也。或问余曰。五运六气七篇所叙。燥之为病甚多。何哉。余曰。
运气七篇。与素问诸篇。自是两书。作于二人之手。其立意各有所主。不可混言。王冰以为七篇参入素问中。
本非素问元文也。余今所推之义。乃是素问本旨。当自作一意看。）此当只以
秋发病为论。湿从下受。故于肺为咳。谓之上逆。夫肺为诸气之主。今既有病。则气不外运。又湿滞经络。故
四肢痿弱无力。而或厥冷也。阴阳应象大论。所谓冬生咳嗽。既言过时。则与本篇之义。颇不同矣。（简按安
道此论极精。兹揭其要。当熟玩全篇。）
痿厥 张云。太阴阳明论曰。伤于湿者。下先受之。上文言因于湿者。大筋 短。小筋 长。 短为
拘。弛长为痿。所以湿气在下。则为痿为厥。痿多属热。厥则因寒也。
温病 论疾诊尺。作瘅热。溯洄集云。寒者。冬之令也。冬感之偶不即发。而至春其身中之阳。虽始
为寒邪所郁。不得顺其渐升之性。然亦必欲应时而出。故发为温病也。又云。春为温病者。盖因寒毒中人肌肤。
阳受所郁。至春天地之阳气外发。其人身受郁之阳。亦不能出。故病作也。（韩祗和曰。冬时感寒郁阳。至春
时再有感。而后发。余谓此止可论温病之有恶寒者耳。其不恶寒者。则亦不为再感而论发也。故仲景曰。太阳
病发热而渴。不恶寒者。为温病。是也。）马云。热论曰。凡病伤寒而成温者。先夏至者。为病暑。阴阳应象
大论云。冬伤于寒。春必病温。伤寒论云。冬感于寒。至春变为温病。则温之为义明矣。杨玄操释五十八难之
温病。以为是疫疠之气者。非也。
肝气以津 马云。肝气津淫而木盛。张云。津。溢也。
脾气乃绝 志云。肝多津液。津溢于肝。则脾气乃绝其转输矣。简按即是本王注意。
大骨气劳 马云。即上节之所谓高骨也。玉机真藏论。亦谓之大骨。汪昂云。高骨。腰间命门穴上
有骨高起。张云。劳困剧也。
喘满 汉石显传。忧满不食。注。满。懑同。王注。令人心闷。盖满读为懑也。
胃气乃浓 简按王注。脾气不濡。胃气强浓。此盖脾约证。伤寒论曰。趺阳脉浮而涩。浮则胃气强。
涩则小便数。浮涩相搏。大便则坚。其脾为约。麻子仁丸主之。是也。张云。脾气不濡。则胃气留滞。故曰乃
浓。浓者。胀满之谓。已觉欠理。汪昂云。按酸咸甘辛。言其害。而不及其利也。味苦。言其利。而未及其害
也。古文不拘一例。不必穿凿强解。是以胃气浓为利。甚误。
沮弛 张云。沮。坏也。志云。遏抑也。简按王训润。恐非是。
精神乃央 新校正云。央。乃殃也。马云。央者。半也。四气调神论。有未央绝灭。此言精神仅可
至半也。简按二说并通。王训久。恐误。又按五味偏过生疾。其例不一。言脾气者二。言心气者亦二。肝气。
肾气。胃气。各一。而不及肺气。未详何理。抑古文误邪。
凑理 广雅。凑。聚也。汲冢周书。周于中土。以为天下之大凑。盖会聚元真之处。故谓之凑。以
其在肌肉中。又从肉作腠。文心雕龙。凑理无滞。吴注举痛论云。腠。汗孔也。理。肉纹也。疟论。汗空疏腠
理开。知是以腠为汗孔者误。
气骨以精 宋本。作骨气。高云。五味和。则肾主之骨以正。肝主之筋以柔。肺主之气。心主之血
以流。脾主之凑理以密。诚如是也。则有形之骨。无形之气。皆以精粹。可谓谨道如法。生气通天。而长有天命矣。
形体虚弱而气机消烁。马云：魄汗未尽，腠理未闭。形体虚弱而气机消烁，乃是外感风寒，导致腠理闭塞。应当发为风疟。
《疟论》说，疟疾这种病证，并非只有秋季才有，四季都能形成疟疾。简按：王冰注中有“至于秋阳复收”的说法，所以论及此事。
风疟：这就是疟疾罢了。必定不是有一种专门叫风疟的病。《金匮真言论》说：“秋季容易患风疟。”又说：“夏季暑热时不出汗的人，秋天会形成风疟。”《刺疟篇》说：“风疟发作时出汗且怕风。”《疟论》说：“各种疟疾都生于风邪。”都可以证明这一点。
所以风是百病的开端。张云：凡是邪气伤害卫气，像上文所说的寒、暑、湿、气、风等，没有不借着风气侵入的。所以风是百病的开端。
上下不并：吴云：阳称为上，阴称为下。阳中有阴，阴中有阳，叫做“并”。意思是风寒致病日久，邪气传变，阳气从上而下，阴气从下而上，这就叫“不并”。这是水火不相济，阴阳分离。简按：王冰解释“并”字为交通，与吴氏的意思相符。
良医：王充《论衡》说：“医生能治一种病，叫做巧；能治百种病，叫做良。”所以良医掌握百种疾病的方剂，治疗百人的疾病。
阳气当隔：马云：隔，就是乖隔不通的意思。简按：这里的“隔”，不是噎膈的“隔”。王冰和马云都引用《素问·六节藏象论》中“三阳结谓之隔”的说法，恐怕不对。
反此三时：志云：指平旦、日中、日西这三个时辰。
形乃困薄：马云：未免困窘而衰薄了。
起亟也：吴氏改为“守也”。马云：营气藏于五脏之精，随着宗气在经脉中营运，并且在外与卫气互为表里。卫气在外有所感应，营气就随即起来响应。这就叫“起亟”。张云：亟，就是气的意思。《阴阳应象大论》说：“精化为气。”就是这种藏精而起气的意思。亟，读音同“气”。志云：阴主藏精，而阴中之气，迅速起来在外响应。阳主卫护于外，并为阴的固护。汪云：起，就是起来响应。外面有召唤，内部就多次起来响应。比如外面以顺境召唤，心就以喜悦起来响应它；外面以逆境召唤，肝就以愤怒起来响应它之类。简按：以上几种说法不知哪种正确。汪氏的解释似乎容易理解。而且王冰的意思也似乎是合理的。
并乃狂：张云：并，是指阳邪进入阳分，称为重阳。简按：这与王注意义不同但用意相同。
阳不胜其阴：高云：阴寒盛极。阴寒盛则五脏之气争竞。争竞，就是彼此不和。
陈阴阳：张云：犹言铺设得当，不让偏胜。吴云：陈，就是设。简按：王冰将“陈”读作“循”，不详依据所在。
气立如故：张云：人受天地之气以确立生命，所以说“气立”。但必须阴阳调和，然后气立才能如常。首节所谓“生之本于阴阳者”，正是这两节的意思。简按：王冰说“真气独立”，似乎明白贴切。
风客淫气：王冰注《痹论》说：“淫气，谓气之妄行者。”简按：《说文解字》说：“淫，浸淫随理也。”徐锴说：“随其脉理，而浸渍也。”马云：风邪来客居其中，浸淫从而扰乱营卫之气，那么风邪迫近而热势兴起，似乎不妥帖。
因而饱食：张云：以下三节，都兼带上文“风客淫气”来说。风气既然淫乱于外，如果接着饱食，那么（邪气）就会随客于阳明经……简按：下文有三个“因”字，所以有此说法。
肠澼为痔：吴云：肠中汁沫，壅塞而成痔疮。简按：《续字汇》解释“澼”为肠间水，大概是基于本篇而解释的。我考察“澼”本意是癖积，因为肠间积聚的水液，所以从水旁作“澼”。《外台秘要》中的癖饮，有时写作“澼饮”，与庄子“澼洸”的意义截然不同。“肠澼”二字，在《素问》和《灵枢》中凡出现十次，多指赤白滞痢而言。唯独本篇说：“肠澼为痔。”大概是古代对肠垢脓血，从肛门排出的总称。王冰加了一个“而”字，说“肠澼而为痔”。吴氏扩大其意来解释，固然也是对的。张云：为肠澼为痔，而下痢脓血。这似乎是鲁莽地读过去。马云：他的肠道日常积聚，渐渐排出肛门成为痔疮。这难道是把“澼”当作褶皱的意思吗？难以采纳。
因而强力：吴、张二人遵从王冰注，认为是强力入房。马、志、高三人则是强用其力。简按：下文说“肾气乃伤”，那么王冰的注释似乎更恰当。
阳密乃固：巢元方《诸病源候论》作“阴密阳固”（出自第十二卷冷热病候）。考下文说：“阳强不能密，阴气乃绝。”那么巢元方是错误的。志云：这是总结上文的意思，而归重于阳气。
是谓圣度：高云：上文说“圣人陈阴阳，内外调和”，所以又说“因而和之”。志云：这叫作圣人调养的法度。
因于露风：马云：这是上文提到的见雾露的意思。王冰注把“露”解释为裸体，不对。志云：露，是阴邪；风，是阳邪。在天之阴阳邪气，损伤我们身上的阴阳，从而产生寒热病。张云：因暴露于风中，寒邪外侵，阳气内拒，阴阳相搏，所以产生寒热。简按：张注与王意稍同。
洞泄：《阴阳应象大论》作“飧泄”。《论疾诊尺》作“后泄肠澼”。知道洞泄即是飧泄。《邪气脏腑病形》说：“洞，指食物不消化，咽下后又吐出。”《甲乙经》作“洞泄”。大概“洞”、“筒”同音。《说文解字》说：“筒，通箫也。”徐锴说：“通洞无底。”汉元帝吹洞箫，注解说与“筒”同。水谷不化，如同空洞无底，所以叫作洞泄。《诸病源候论》说：洞泄，是痢疾无度。《水谷痢候》引用本篇文字详细论述它，应当参考。又见于《小儿洞泄下利候》。王焘《千金翼方》引《准绳》说：餐泄，水谷不化而完出，就是这个意思。《史记·仓公传》中的“ 风”（《太平御览》作“洞风”），就是此病。或者是饮食太过，肠胃受伤，也导致米谷不化。这就是俗话说的水谷利。邪气留连，大概是指到夏天的时候。高云：邪气留连，到夏天才成为洞泄。
风疟：《千金方》作“风疟”（说明详见《疟论》）。
秋伤于湿上逆而咳：张云：湿土在长夏之末当令，所以秋季伤于湿。秋气通于肺，湿气郁结成热，于是上乘肺金，所以气逆而咳嗽。简按：《溯洄集》说：湿是长夏的时令，为什么在秋季说呢？大概春夏冬，每一时各有三个月，所以它们的时令也各自在本时运行。若长夏则寄旺于六月这一个月而已。秋季虽然有三个月，但长夏的湿令，常常侵犯超过秋季而行。所以说“秋伤于湿”。（秋令为燥，然而秋季的前三个月，靠近长夏，其不及则为湿所胜，其太过则同于火化，其平气则又不伤人。这部经典之所以在谈伤人时，只说风暑湿寒，而不说燥。）或者有人问我：五运六气七篇所叙述的，燥之为病很多，为什么呢？我说：运气七篇，与《素问》其他篇章，本是两本书，由两人所作，立意各有所主，不可混为一谈。王冰认为七篇参入《素问》中，本非《素问》原文。我现在所推演的义理，乃是《素问》本旨，应当单独作为一个意思来看待。这里只应以秋季发病来讨论。湿从下部受邪，所以在肺表现为咳嗽，称为上逆。肺是诸气之主，现在既有病，则气不外运，加上湿滞经络，所以四肢痿弱无力，或者厥冷。《阴阳应象大论》所谓“冬生咳嗽”，既然说过时，则与本篇的意思，颇不相同。（简按：安道这个论述极其精妙，这里揭示其要点，应当熟读玩味全篇。）
痿厥：张云：《太阴阳明论》说：“伤于湿者，下先受之。”上文说“因于湿者，大筋软短，小筋弛长”。软短为拘挛，弛长为痿废。所以湿气在下，则成为痿和厥。痿多属热，厥则因寒。
温病：《论疾诊尺》作“瘅热”。《溯洄集》说：寒，是冬季的时令。冬季感受寒邪，偶然没有立即发作，到了春天，身体中的阳气，虽然开始被寒邪郁遏，不顺从其逐渐升发的本性，但也一定要应时而出。所以发为温病。又说：春季得温病，是因为寒毒中人肌肤，阳受其所郁，到了春天天地阳气外发，人身受郁之阳，也不能出，所以病发作。（韩祗和说：冬季感受寒邪郁遏阳气，到了春季再次感受邪气，而后发作。我认为这只可以论述温病中有恶寒的情况。那些不恶寒的，也不作为再次感受而论述发作。所以张仲景说：“太阳病发热而渴，不恶寒者，为温病。”就是这个意思。）马云：《热论》说：“凡病伤寒而成温者，先夏至者为病暑。”《阴阳应象大论》说：“冬伤于寒，春必病温。”《伤寒论》说：“冬感于寒，至春变为温病。”那么温的含义就很明白了。杨玄操解释《难经》第五十八难的温病，认为是疫疠之气，是不对的。
肝气以津：马云：肝气津淫而木盛。张云：津，溢也。
脾气乃绝：志云：肝多津液，津溢于肝，则脾气乃绝其转输。简按：这正是王冰注的意思。
大骨气劳：马云：就是上一节所说的高骨。《玉机真脏论》也称其为“大骨”。汪昂说：高骨，腰间命门穴上有骨高起。张云：劳困剧也。
喘满：《汉书·石显传》：“忧满不食。”注：满，懑同。王冰注：令人心闷。大概“满”读为“懑”。
胃气乃浓：简按：王冰注：“脾气不濡，胃气强浓。”这大概是脾约证。《伤寒论》说：“趺阳脉浮而涩，浮则胃气强，涩则小便数。浮涩相搏，大便则坚，其脾为约。麻子仁丸主之。”就是这个。张云：脾气不濡，则胃气留滞，所以说“乃浓”。浓，就是胀满的意思。已经觉得欠妥。汪昂说：按酸咸甘辛，说的是它的害处，而没有提到它的益处。味苦，说的是它的益处，而没有提到它的害处。古文不拘泥于一种体例，不必穿凿附会强行解释。因此把“胃气浓”理解为有利，非常错误。
沮弛：张云：沮，坏也。志云：遏抑也。简按：王冰训为润，恐怕不对。
精神乃央：新校正说：央，乃殃也。马云：央，是一半的意思。《四气调神大论》有“未央绝灭”，这里说精神仅可至一半。简按：两种说法都通。王冰训为久，恐怕错误。又按：五味偏过生疾，其例子不一。讲脾气的有两处，讲心气的也有两处。肝气、肾气、胃气，各一处，而没有提到肺气，不详是什么道理。或许是古文有误吧。
凑理：《广雅》：凑，聚也。《汲冢周书》：“周于中土，以为天下之大凑。”大概是汇聚元真之处，所以叫作凑。因为它在肌肉中，又从肉旁作“腠”。《文心雕龙》：“凑理无滞。”吴崑注《举痛论》说：“腠，汗孔也。理，肉纹也。”《疟论》：“汗空疏腠理开。”知道以腠为汗孔是错误的。
气骨以精：宋本作“骨气”。高云：五味调和，则肾主之骨以正，肝主之筋以柔，肺主之气，心主之血以流，脾主之凑理以密。诚然如此，则有形的骨，无形的气，都以精粹。可以说是谨守道法，生气通天，而长久享有天命了。
When the physical form is weak and the vital energy (Qi) is consumed, as noted by Ma Yun: The sweat from the soul (Po-han) has not yet ceased, and the interstices (Cou-Li) are not yet closed. The physical form is weak and the vital energy is consumed; this is due to external contraction of wind-cold, causing the interstices to close. It should manifest as Wind Malaria.
The *Malaria Chapter* states that malaria, as a syndrome, does not occur only in autumn; it can develop in all four seasons. Briefly noted: Wang Bing's commentary mentions "when autumn arrives, the autumn sun returns," hence this discussion.
Wind Malaria: This is simply malaria. It certainly does not refer to a specific type of disease called "Wind Malaria." The *Jin Gui Zhen Yan Lun* says, "In autumn, one is prone to Wind Malaria." It also says, "Those who do not sweat during summer heat will develop Wind Malaria in autumn." The *Ci Malaria Chapter* says, "Wind Malaria manifests with sweating and aversion to wind." The *Malaria Chapter* says, "All malaria arises from wind." All these can serve as evidence.
Therefore, wind is the beginning of a hundred diseases. Zhang Yun: Whenever pathogenic factors injure the Defensive Qi, such as the cold, heat, dampness, qi, and wind mentioned above, none enter without relying on wind qi. Thus, wind is the beginning of a hundred diseases.
Upper and lower do not combine: Wu Yun: Yang is referred to as upper, Yin as lower. When Yang contains Yin and Yin contains Yang, it is called "combine" (Bing). It means that after wind-cold illness persists for a long time, the pathogenic factor transforms; Yang descends from above and Yin ascends from below, which is called "not combining." This indicates that water and fire do not interact, and Yin and Yang separate. Briefly noted: Wang Bing interprets "Bing" as communication, which aligns with Wu's meaning.
Excellent Physician: Wang Chong's *Lun Heng* states, "A physician who can cure one disease is called skillful; one who can cure a hundred diseases is called excellent." Therefore, an excellent physician masters prescriptions for a hundred diseases and treats illnesses of a hundred people.
Yang Qi should be obstructed: Ma Yun: "Ge" refers to obstruction and lack of free flow. Briefly noted: Here, "Ge" does not refer to dysphagia (Ye-Ge). Both Wang Bing and Ma Yun cite the phrase "Three Yang knotting is called Ge," which is likely incorrect.
Reversing these three times: Zhi Yun: Refers to dawn (Pingdan), noon (Rizhong), and afternoon (Rixi).
The form becomes exhausted and thin: Ma Yun: Unavoidably becoming distressed and emaciated.
Arising urgently (Qi Ji): Wu changed it to "Shou" (guard). Ma Yun: Ying Qi stores the essence of the five zang organs and circulates within the meridians along with Zong Qi, while externally having a exterior-interior relationship with Wei Qi. When Wei Qi responds externally, Ying Qi immediately arises to respond. This is called "Qi Ji." Zhang Yun: "Ji" is synonymous with Qi. The *Yin Yang Ying Xiang Da Lun* states, "Essence transforms into Qi." This refers to storing essence and arising Qi. "Ji" is pronounced like "Qi." Zhi Yun: Yin governs storing essence, and the Qi within Yin arises quickly to respond externally. Yang governs defending the exterior and solidifying Yin. Wang Yun: "Qi" means arising to respond. If there is a call from outside, the interior rises frequently to respond. For example, if summoned by favorable conditions externally, the Heart arises with joy to respond; if summoned by adverse conditions externally, the Liver arises with anger to respond, and so on. Briefly noted: Among these explanations, it is unknown which is correct. Wang's explanation seems easier to understand. Moreover, Wang Bing's intent also seems reasonable.
Combining leads to mania: Zhang Yun: "Bing" refers to Yang pathogenic factors entering the Yang aspect, known as Double Yang. Briefly noted: Although different in meaning from Wang Bing's note, the underlying intent is similar.
Yang cannot overcome Yin: Gao Yun: Yin-cold is excessive. When Yin-cold is excessive, the Qi of the five zang organs contends. Contention means mutual disharmony.
Arrange the Yin and Yang: Zhang Yun: Similar to saying arranging them properly so that neither dominates excessively. Wu Yun: "Chen" means to set or arrange. Briefly noted: Wang Bing reads "Chen" as "Xun" (follow), but the basis is unclear.
Qi establishment remains as before: Zhang Yun: Humans receive the Qi of Heaven and Earth to establish life, hence it is called "Qi establishment." However, only when Yin and Yang are harmonious can Qi establishment remain normal. The first section's statement that "the root of life lies in Yin and Yang" precisely refers to these two sections. Briefly noted: Wang Bing's statement that "True Qi stands alone" seems clear and apt.
Wind guests invade and disorder Qi: Wang Bing's commentary on the *Bi Lun* states: "Yin Qi refers to Qi moving recklessly." Briefly noted: The *Shuo Wen Jie Zi* states: "Yin means soaking and spreading according to the grain." Xu Kai says: "Following its meridian lines, it soaks and permeates." Ma Yun: When wind comes to lodge within, soaking and thereby disturbing Ying and Wei Qi, wind presses inward and heat arises. This seems inappropriate.
Consequently eating full: Zhang Yun: The following three sections all relate back to the previous text "Wind guests invade and disorder Qi." Since wind qi has become disordered externally, if one subsequently eats until full, then [pathogens] follow to guest the Yangming channel... Briefly noted: The word "yin" (consequently/because of) appears three times in the following text, hence this interpretation.
Intestinal Pi leads to hemorrhoids: Wu Yun: Fluids in the intestines accumulate and obstruct, leading to hemorrhoids. Briefly noted: The *Xu Zi Hui* explains "Pi" as water between the intestines, likely based on this chapter. I have examined that "Pi" originally refers to accumulation; because of water accumulating between the intestines, it takes the water radical. In *Waitai Miyao*, Pi Yin is sometimes written as Pi Yin, which is completely different from the meaning in Zhuangzi. The term "Chang Pi" appears ten times in the *Suwen* and *Lingshu*, mostly referring to bloody and white dysentery. Only this chapter says, "Chang Pi leads to hemorrhoids." It is likely an ancient general term for intestinal filth, pus, and blood exiting from the anus. Wang Bing added the character "er" (and), saying "Chang Pi leads to hemorrhoids." Wu expanded the meaning to explain it, which is acceptable. Zhang Yun: Having Chang Pi and hemorrhoids, accompanied by dysentery with pus and blood. This seems like a careless reading. Ma Yun: His intestines daily accumulate, gradually expelling out through the anus to become hemorrhoids. Does this interpret "Pi" as folds? It is difficult to accept.
Consequently exerting strength forcefully: Wu and Zhang follow Wang Bing's note, interpreting it as sexual intercourse involving forceful exertion. Ma, Zhi, and Gao interpret it as using physical strength forcibly. Briefly noted: The following text says, "Kidney Qi is injured," so Wang Bing's note seems more appropriate.
Yang being dense leads to solidity: Chao Yuanfang's *Zhu Bing Yuan Hou Lun* writes "Yin dense, Yang solid" (from Volume 12, Cold and Heat Disease Syndromes). Examining the following text: "If Yang is strong but cannot be dense, Yin Qi will perish." Thus, Chao Yuanfang is mistaken. Zhi Yun: This summarizes the meaning of the preceding text and emphasizes Yang.
This is called the standard of the Sage: Gao Yun: The preceding text says, "The Sage arranges Yin and Yang, harmonizing internal and external," hence it again says "harmonize accordingly." Zhi Yun: This is called the method of regulation by the Sage.
Contracted due to exposure to wind: Ma Yun: This refers to encountering mist and dew mentioned earlier. Wang Bing's note interprets "Lu" (dew/exposure) as nakedness, which is incorrect. Zhi Yun: Dew is Yin pathogen; wind is Yang pathogen. The Yin and Yang pathogens in heaven damage the Yin and Yang of our body, resulting in cold and heat diseases. Zhang Yun: Being exposed to wind causes cold pathogen to invade externally and Yang Qi to resist internally; Yin and Yang contend, thus generating cold and heat. Briefly noted: Zhang's note is slightly similar to Wang's intent.
Hole diarrhea (Dong Xie): The *Yin Yang Ying Xiang Da Lun* writes "Sun Xie" (undigested stool diarrhea). The *Lun Ji Zhen Chi* writes "Hou Xie Chang Pi." Knowing that Dong Xie is Sun Xie. The *Xie Qi Zang Fu Bing Xing* states: "Dong means food is not digested; upon swallowing, it comes back out." The *Jia Yi Jing* writes "Dong Xie." Probably "Dong" and "Tong" are homophones. The *Shuo Wen Jie Zi* states: "Tong is a flute." Xu Kai says: "Open and hollow without bottom." Emperor Yuan of Han played the Dong Xiao, annotated as same as Tong. Water and grain do not digest, like a hollow void without bottom, hence called Dong Xie. *Zhu Bing Yuan Hou Lun* states: Dong Xie is dysentery without limit. The *Shui Gu Li Hou* cites this chapter's text for detailed discussion; reference is advised. Also seen in *Xiao Er Dong Xie Xia Li Hou*. Wang Ang's *Zhun Sheng* states: Can Xie, water and grain do not digest and exit intact; this is it. The *Shiji - Cang Gong Zhuan* mentions "Feng" (*Taiping Yulan* writes "Dong Feng"), which is this condition. Or, excessive diet damages the stomach and intestines, also causing undigested rice and grain. This is colloquially called water-grain diarrhea. Pathogenic factors lingering, likely referring to summer. Gao Yun: Pathogenic factors linger, becoming Dong Xie in summer.
Wind Malaria: *Qian Jin Fang* writes "Feng Nue" (Explanation provided in *Malaria Chapter*).
Autumn injury by dampness leads to upward reversal and cough: Zhang Yun: Damp-earth rules at the end of late summer, hence autumn injury by dampness. Autumn Qi connects to the Lung. Dampness stagnates and turns into heat, ascending to attack Lung Metal, hence Qi reverses causing cough. Briefly noted: *Suhui Ji* states: Dampness is the command of late summer, why speak of it in autumn? Generally, spring, summer, and winter each have three months, so their commands operate within their respective seasons. Late summer resides prosperously only in the sixth month. Although autumn has three months, the damp command of late summer often invades and exceeds into autumn. Hence it says "Autumn injury by dampness." (Autumn command is dryness, but the first three months of autumn are close to late summer; deficiency allows dampness to dominate, excess matches fire transformation, and balanced state does not harm people. This classic only mentions wind, heat, dampness, and cold as harming agents, not dryness.) Someone asked me: Why are there many descriptions of dryness diseases in the Seven Chapters of Five Movements and Six Qi? I said: The Seven Chapters of Five Movements and Six Qi and other chapters of *Suwen* are two different books authored by different people, with different intentions, and should not be mixed. Wang Bing believed the seven chapters were inserted into *Suwen* and were not original *Suwen* text. My current deduction follows the original intent of *Suwen* and should be viewed independently. Here, we should only discuss autumn onset. Dampness enters from below, hence manifests as cough in the Lung, termed upward reversal. The Lung is the master of all Qi. Now diseased, Qi does not circulate outward. Additionally, dampness stagnates in collaterals, hence limbs become flaccid and weak, or cold. The *Yin Yang Ying Xiang Da Lun* mentions "Winter generates cough"; since it mentions passing the time, it differs significantly from this chapter's meaning. (Briefly noted: Andao's argument is extremely refined; highlighting the key points here, one should study the whole chapter carefully.)
Flaccidity and cold extremities (Wei Jue): Zhang Yun: The *Tai Yin Yang Ming Lun* states, "Those injured by dampness, the lower part receives it first." The preceding text says, "Due to dampness, large tendons become short and soft, small tendons become long and slack." Short and soft causes contracture; long and slack causes flaccidity. Thus, dampness below leads to flaccidity and cold extremities. Flaccidity mostly belongs to heat; cold extremities are due to cold.
Warm disease (Wen Bing): *Lun Ji Zhen Chi* writes "Dan Re" (feverish heat). *Suhui Ji* states: Cold is the command of winter. Winter cold infection occasionally does not manifest immediately. By spring, the Yang Qi within the body, although initially constrained by cold pathogen and unable to rise gradually, must still emerge according to the season. Hence it manifests as Warm disease. It also states: Spring Warm disease occurs because cold toxin invades human skin and muscles; Yang is constrained. By spring, heavenly and earthly Yang Qi emerges externally; the constrained Yang Qi within the person also cannot exit, hence the disease acts up. (Han Zhihe said: Winter cold constrains Yang; by spring, secondary infection triggers onset. I believe this only applies to Warm diseases with aversion to cold. Those without aversion to cold do not require secondary infection to manifest. Thus Zhang Zhongjing said: 'Taiyang disease with fever, thirst, and no aversion to cold is Warm disease.' This is correct.) Ma Yun: The *Re Lun* states, "All diseases contracting Shanghan and becoming Wen, before Summer Solstice are Bing Shu (Heat disease)." The *Yin Yang Ying Xiang Da Lun* states, "Winter injury by cold leads to Wen disease in spring." The *Shanghan Lun* states, "Winter contraction of cold transforms into Wen disease in spring." Thus the meaning of Wen is clear. Yang Xuancao's explanation of Wen Bing in Difficulty 58 of *Nan Jing*, identifying it as epidemic pestilence Qi, is incorrect.
Liver Qi overflows: Ma Yun: Liver Qi overflows and Wood becomes excessive. Zhang Yun: Jin means overflow.
Spleen Qi perishes: Zhi Yun: The Liver has much fluid; when fluid overflows into the Liver, Spleen Qi perishes in its transportation function. Briefly noted: This is exactly Wang Bing's note.
Great bone Qi labor: Ma Yun: Refers to the high bone mentioned in the previous section. The *Yu Ji Zhen Zang Lun* also calls it "Great Bone." Wang Ang says: High bone, the bone protruding above the Mingmen acupoint in the waist. Zhang Yun: Severe fatigue and exhaustion.
Panting and fullness: *Han Shu - Shi Xian Zhuan*: "Worried and full, not eating." Annotation: Man is same as Men. Wang Bing's note: Causes heart stuffiness. Probably "Man" is read as "Men."
Stomach Qi becomes thick/congested: Briefly noted: Wang Bing's note: "Spleen Qi not moist, Stomach Qi strong and thick." This is likely Pi Yue (Spleen Constriction) syndrome. The *Shanghan Lun* states: "Fuyang pulse floating and choppy; floating indicates strong Stomach Qi; choppy indicates frequent urination. Floating and chopping struggle together, feces become hard, the Spleen is constricted. Hemp Seed Pill governs it." This is it. Zhang Yun: Spleen Qi not moist, thus Stomach Qi stagnates, hence called "becomes thick." Thick means distension and fullness. Already feels inadequate. Wang Ang says: Sour, salty, sweet, pungent describe harms, omitting benefits. Bitter describes benefits, omitting harms. Ancient texts do not adhere to a single style; one should not force interpretations. Therefore, interpreting "Stomach Qi thick" as beneficial is very erroneous.
Weakened and relaxed: Zhang Yun: Ju means damaged. Zhi Yun: Suppressed. Briefly noted: Wang Bing defines as moistening, which is likely incorrect.
Spirit and Essence suffer disaster: Xin Zheng Xiao notes: Yang is Yan (disaster). Ma Yun: Yang means half. The *Si Qi Tiao Shen Da Lun* has "Wei Yang Jue Mie" (not yet exhausted/extinguished); here it says Spirit can only reach half. Briefly noted: Both explanations are valid. Wang Bing defining as long-lasting is likely wrong. Also, excessive flavors cause disease, examples vary. Two mentions of Spleen Qi, two of Heart Qi. Liver, Kidney, Stomach Qi, each one mention. No mention of Lung Qi; reason unknown. Perhaps an error in the ancient text?
Cou Li (interstices): *Guang Ya*: Cou means gather. *Ji Zhong Zhou Shu*: "Surrounding central lands, considered the great gathering place of the world." Likely the place where primordial Qi gathers, hence called Cou. Because it is in the muscles, it also uses the flesh radical to write "Cou." *Wen Xin Diao Long*: "Cou Li without stagnation." Wu Kun's note on *Ju Tong Lun*: "Cou is sweat pore; Li is muscle grain." The *Nu Lun* states: "Sweat pores sparse, Cou Li open." Knowing that interpreting Cou solely as sweat pore is mistaken.
Bone and Qi are refined: Song edition writes "Gu Qi." Gao Yun: With harmonized five flavors, the Kidney-governed bones are upright, Liver-governed tendons are flexible, Lung-governed Qi flows, Heart-governed Blood flows smoothly, Spleen-governed Cou Li are dense. Truly thus,有形 (form-based) bones and intangible Qi both become refined. One can be said to strictly follow the Dao, let Sheng Qi connect with Heaven, and long possess the Mandate of Life.