踵足跟也尻以代踵足挛急也脊以代头身蜷屈也肾脉起足小趾别入跟中上股内后廉贯脊属肾络膀胱气不足而受邪故不伸
展）脾痹者四肢懈惰发咳呕汁上为大塞（续脾主四肢又其脉入腹属脾络胃上膈挟咽故发咳呕汁脾气养肺胃复连咽故上为
大塞也）肠痹者数饮而出不得中气喘争时发飧泄（续大肠之脉络肺下膈属大肠小肠之脉络心循咽下膈抵胃属小肠今小肠
有邪则脉不下膈故肠不行化而胃气蓄热故多饮水不得下出也肠胃中阳气与邪气奔喘交争故时或通利以肠气不化则为飧
泄）胞痹者少腹膀胱按之内痛若沃以汤涩于小便上为清涕（续膀胱为津液之府胞内居之少腹处关元之中内藏胞器今胞受
风寒湿气则膀胱太阳之脉郁结不行故按之内痛若沃以汤涩于小便也小便既涩太阳之脉不得下行故上烁其脑而为清涕）淫
气喘息痹聚在肺淫气忧思痹聚在心淫气遗溺痹聚在肾淫气乏竭痹聚在肝淫气肌绝痹聚在脾（王注淫气谓气之妄行者各随
脏之所主入而为痹也今按如此则属内伤非风寒湿三气杂至而为外伤者宣明五气论云邪入于阴则为痹所谓邪者岂指淫气
而言邪）诸痹不已亦益内也（益深入于内也）其风胜者其入易已也（留皮肤间故也）曰痹其时有死者或痛久者或易已者
其故何也曰其入脏者死其留连筋骨间者疼久留皮肤间者易已（续入脏以神去也筋骨疼久以其定也皮肤易已以浮浅也）曰
其客于六腑者何也曰此亦其食饮居处为其病本也（续四方虽土地温凉高下不同物性刚柔飧居亦异但过动其分则六腑致伤
经曰水谷之寒热感则害六腑）六腑亦各有俞风寒湿气中其俞而食饮应之循俞而入各舍其腑也（续六腑俞谓背俞也并足太
阳脉气所发校正云六腑俞并在本椎下两旁王注言在椎之旁者文略也）曰针治之奈何曰五脏有俞六腑有合循脉之分各有所
发各随（一作治）其过则病瘳也（续肝俞太冲心俞大陵脾俞太白肺俞太渊肾俞太溪皆经脉之所注也胃合入于三里胆合入
于阳陵泉大肠合入于曲池小肠合入于小海三焦合入于天井膀胱合入于委中故经言循脉之分云云过谓脉所经过处）曰营卫
之气亦令人痹乎曰营者水谷之精气也和调于五脏洒陈于六腑乃能入于脉也（续正理论曰谷入于胃脉道乃行水入于精其血
乃成校正云谷入于胃气传与肺精专者上行经遂由此故水谷精气合营气营运而入于脉也）故循脉上下贯五脏络六腑也（续
营行脉内故无所不至）卫者水谷之悍气也其气 疾滑利不能入于脉也（续悍气谓浮盛之气也以其浮盛故 疾悍利不能入
于脉中也）故循皮肤之中分肉之间熏于肓膜散于胸腹（续皮肤分肉谓脉外也肓膜谓五脏之间膈中膜也以其浮盛故能布散
于胸腹之中空虚之处熏其肓膜令气宣通也）逆其气则病从其气则愈不与风寒湿气合故不为痹曰痹或痛或不痛或不仁或寒
或热或燥或湿其故何也曰痛者寒气多也有寒故痛也（续风寒湿气客于分肉之间迫切而为沫得寒则聚聚则排分肉肉裂则痛
故有寒则痛也）其不痛不仁者病久入深营卫之行涩经络时疏故不痛（续不痛与不仁两事后言不痛是载明不痛为重也）皮
肤不荣故为不仁（续皮顽不知有无也）其寒者阳气少阴气多与病相益故寒也（续病本生于风寒湿气故阴气益之也）其热
者阳气多阴气少病气胜阳遭（一作乘）阴故为痹热（续遭遇也言遇于阴气阴气不胜故为热○或热下有或燥问今此无答辞）
其多汗而濡者此其逢湿甚也阳气少阴气盛两气相感故汗出而濡也（续中表相应则相感也）曰夫痹之为病不痛何也曰痹在
于骨则重在于脉则血凝而不流在于筋则屈不伸在于肉则不仁在于皮则寒故具此五者则不痛也凡痹之类逢寒则虫（一作
急）逢热则纵（痹论）○帝曰五脏使人痿何也（续痿谓痿弱无力以运动）岐伯曰肺主身之皮毛心主身之血脉肝主身之筋
膜（续膜皮下肉上筋膜也）脾主身之肌肉肾主身之骨髓（续所主不同痿生亦各归其所主）故肺热叶焦则皮毛虚弱急薄者
则生痿 也（续肺热则肾受热气故足挛 不得伸以行也）心气热则下脉厥而上上则下脉虚虚则生脉痿枢折挈胫纵而不任
地也（续心热盛则火独光而上炎肾脉下行今火盛上炎用事故肾脉亦随火炎烁而逆上也阴气厥逆火复内燔阴上隔阳下不守
位心气通脉故生脉痿肾气主足故膝腕枢纽如折去而不相提挈胫筋纵缓而不能任用于地也）肝气热则胆泄口苦筋膜干则筋
急而挛发为筋痿（续肝热则胆液渗泄故口苦也肝主筋膜热则筋膜干而挛急发为筋痿）脾气热则胃干而渴肌肉不仁发为肉
痿（续脾与胃以膜相连脾气热则胃液渗泄故干而渴也脾主肌肉今热薄于内故肌肉不仁发为肉痿）肾气热则腰脊不举骨枯
而髓减发为骨痿（续腰为肾府又肾脉上股内贯脊属肾故肾气热则腰脊不举也肾主骨髓故热则骨枯髓减发为骨痿○滑注此
多从相火上说）曰何以得之曰肺者脏之长也为心之盖也（续位高而布叶于胸中故为脏之长心之盖）有所失亡所求不得则
发肺鸣鸣则肺热叶焦（续肺藏气志若不扬则气郁气郁不利故喘息有声而肺热叶焦也）故曰五脏因肺热叶焦发为痿痹此之
谓也（肺者所以行营卫治阴阳故也）悲哀太甚则胞络绝（杨上善云胞络心主包络之脉尤可见相火之义）胞络绝则阳气内
动发则心下崩数溲血也（续悲则心系急肺布叶举而上焦不通营卫不散热气在中故胞络绝而阳气内鼓动发则心下内崩而下
血也溲谓溺也）故本病曰大经空虚发为肌痹传为脉痿（续本病古经篇名也大经大经脉也以溺血故空虚脉虚则热内薄卫气
盛营气微故发为肌痹先见肌痹后渐脉痿故曰传为脉痿）思想无穷所愿不得意淫于外入房太甚宗筋驰纵发为筋痿及为白淫
（续思想所愿为祈欲也施泻劳损故为筋痿及白淫也白淫谓白物淫衍如精之状男则溺溲而下女则阴器中绵绵而下）故下经
曰筋痿者生于肝使内也（续下经古经名使内谓劳役筋力费竭精气也）有渐于湿以水为事若有所留居处相湿股肉濡溃痹而
不仁发为肉痿（续业惟近湿居处泽下皆水为事也平者久而犹殆感之者尤甚矣肉属于脾脾气恶湿湿着于内则卫气不荣故为
肉痿○滑注以脾则有热复渐于湿因发动而为痿也）故下经曰肉痿者得之湿地也（续经曰地之湿气感则害皮肉筋脉此则谓
害肉也）有所远行劳倦逢大热而渴渴则阳气内伐（谓伐腹中之阴气也）内伐则热舍于肾肾水脏也今水不胜火则骨枯而髓
虚故足不任身发为骨痿（以热舍于肾中）故下经曰骨痿者生于大热也曰何以别之曰肺热者色白而毛败心热者色赤而络脉
溢肝热者色苍而爪枯脾热者色黄而肉蠕动肾热者色黑而齿槁曰如夫子言可矣论言治痿者独取阳明何也曰阳明者五脏六腑
之海（续阳明胃脉也胃为水谷之海）主闰宗筋宗筋主束骨而利机关也（续宗筋谓阴毛中横骨上下脐两旁之竖筋也上络胸
膈下贯髋尻又经背腹上头项故云宗筋主束骨利机关然腰者肾之大关节所以司屈伸故曰机关）冲脉者经脉之海也（续十二
经之海）主渗灌溪谷与阳明合于宗筋（续冲脉循腹挟脐旁五分而上阳明脉亦挟脐旁一寸五分而上宗筋脉于中故曰与阳明
合于宗筋也以为十二经海故主渗灌溪谷也肉之大会为谷小会为溪）阴阳总宗筋之会会于气街而阳明为之长皆属于带脉而
络于督脉（续宗筋会聚于横骨之中从上而下故曰阴阳总宗筋之会宗筋挟脐下合于横骨阳明辅其外冲脉居其中故云会于气
街而阳明为之长气街则阴毛两旁脉动处也带脉起于季胁回身一周而络于督脉也○愚谓阴阳总宗筋之会此即厥论前阴者宗
筋之所聚太阴阳明之所合之义也）故阳明虚则宗筋纵带脉不引故足痿不用也（续引谓牵引）曰治之奈何曰各补其荥而通
其俞调其虚实和其逆顺筋脉骨肉各以其时受月则病已矣（时受月谓受气时月如肝王甲乙心王丙丁之类也痿论）○帝曰厥
之寒热者何也（续厥谓气逆上也○愚谓厥者冷也逆也非特气逆上也或热或寒从下逆上皆是也）岐伯曰阳气衰于下则为寒
厥阴气衰于下则为热厥（阳谓足之三阳脉阴谓足之三阴脉足谓下也）曰热厥之为热也必起于足下者何也（续阳主外厥在
内故问之）曰阳气起（一作走）于足五趾之表阴脉者集于足下而聚于足心故阳气胜则足下热也（续足三阳脉并出足五趾
之端俱循足阳而上肝脾肾脉集于足下聚于足心阴弱故足下热）曰寒厥之为寒也必从五趾而上于膝者何也（续阴主内厥在
外故问之）曰阴气起于五趾之里集于膝下而聚于膝上故阴气胜则从五趾至膝上寒其寒也不从外皆从内也（续足三阴之脉
俱出足五趾之里并犹足阴而上循股阴入腹故云集膝下聚膝上也）曰寒厥何失而然也曰前阴者宗筋之所聚太阴阳明之所合
也（续宗筋挟脐下合于阴器故云前阴者宗筋之所聚太阴者脾脉阳明者胃脉脾胃之脉皆辅近宗筋故云太阴阳明之所合）春
夏则阳气多而阴气少秋冬则阴气盛而阳气衰（续此乃天之常道）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（续质谓形质也夺于所用谓多欲而夺其精气也）气因于（一作所）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（愚按张子和曰秋冬阴壮阳衰人或时赖壮勇纵情嗜欲于秋冬之时则阳夺于内阴气下溢邪气上行阳
气既衰真精又竭阳不荣养阴气独行故手足寒发为寒厥也）曰热厥何如而然也曰酒入于胃则络脉满而经脉虚脾主为胃行其
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营其四肢也（续前阴谓太阴之所合故胃不和则精气
竭也内精不足故四肢无气以营之）此人必数醉若饱以入房气聚于脾中不得散酒气与谷气相薄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（续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○愚按人或醉饱而房气聚于脾胃主行津液阴气虚阳气入则胃不和胃不和则精气竭精气竭则四肢不荣酒气与谷气相薄
则内热而溺赤气壮而 悍肾气既衰阳气独胜故手足热发而为热厥也）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（续暴犹卒也言卒然冒闷不醒觉也不知人谓闷甚不知识人也或谓乃厥）曰阴气盛于上则下虚下虚则腹胀满
阳气盛于上（阳气盛于上五字当作腹满二字）则下气重上而邪气逆逆则阳气乱阳气乱则不知人也（续甲乙经云阳脉下坠
阴脉上争发尸厥张仲景云少阴脉不至肾气微少精血奔气促迫上入胸膈宗筋反聚血结心下阳气退下热归阴股与阴相动令身
不仁此为尸厥又王注阴谓足太阴按缪刺论云邪客于手足少阴太阴足阳明之络此五络皆会于耳中上络左角五络俱竭今人身
脉皆动而形无知其状若尸或曰尸厥安得专解阴为太阴也）曰愿闻六经脉之厥状病能也曰巨阳之厥则肿首头重足不能行发
为仆（续巨阳太阳也足太阳脉起目内 上额交巅上其支别者循髀外后廉下合 中以下贯 内出外踝后循京骨至小趾端
外侧由是厥逆外形斯症也○愚按此后诸病各随脉络所生病形而言也张子和曰厥者或寒或热皆从下起）阳明之厥则癫疾欲
走呼腹满不得卧面赤而热妄见而妄言少阳之厥则暴聋颊肿而热胁痛 不可以运太阴之厥则腹满 胀后不利不欲食食则呕
不得卧少阴之厥则口干溺赤腹满心痛厥阴之厥则少腹肿痛腹胀泾溲不利好卧屈膝阴缩肿 内热（一本作胫外热）盛则泻
之虚则补之不盛不虚以经取之（续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）太阴厥逆 急挛心
痛引腹治主病者（续太阴之脉行有左右候其有过者当发取之故言治主病者）少阴厥逆虚满呕变下泄清治主病者厥阴厥逆
挛腰痛虚满前闭谵（音 ）言（续谵言者气虚独言也）治主病者三阴俱逆不得前后使人手足寒三日死（续三阴绝故三日
死）太阳厥逆僵仆呕血善衄治主病者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（续发肠
痈则经气绝故不可治惊者死也）阳明厥逆喘咳身热善惊衄呕血手太阴厥逆虚满而咳善呕沫治主病者手心主少阴厥逆心痛
引喉身热死不可治手太阳厥逆耳聋泣出项不可以顾腰不可俯仰治主病者（续手太阳脉不属于腰经言腰不可俯仰恐古错简
文）手阳明少阳厥逆发喉痹嗌肿 治主病者（厥论）卧出而风吹之血凝于肤者为痹（续谓 痹也）凝于脉者为泣（续血
行不利）凝于足者为厥（续足逆冷）此三者血行而不得反其空（空血流之道大经隧也）故为痹厥也（五脏生成论）○帝
曰有病身热汗出烦满不为汗解此为何病岐伯曰汗出而身热者风也汗出而烦满不解者厥也病名曰风厥巨阳主气故先受邪少
阴与其为表里得热则上从之从之则厥也（续上从之谓少阴随太阳而上）治之奈何曰表里刺之饮之服汤（谓泻太阳补少阴
也饮之汤者谓止逆上之肾气也评热论）帝曰今大热病者皆伤寒之类也或愈或死其死皆以六七日之间其愈皆以十日以上者
何也（续其伤于四时之气皆能为病以伤寒为毒者最乘杀厉之气中而即病名曰伤寒不即病者寒毒藏于肌肤至夏至前变为温
足跟（脚后跟）僵硬，甚至以臀部着地行走代替足跟行走，这是因为足部筋脉拘挛急迫；脊柱弯曲，头部前倾仿佛用脊背代替头部，这是因为身体蜷缩屈曲。足少阴肾经的经脉起于足小趾下方，斜行进入足跟中，向上沿大腿内侧后缘，贯穿脊柱，归属于肾脏，联络膀胱。肾气不足而感受邪气，所以肢体不能伸展。
脾痹的症状是四肢懈怠无力，咳嗽并呕吐清水，上部出现严重的痞塞不通。脾主管四肢，其经脉入腹属于脾，联络胃，上行穿过膈肌，挟持咽喉，所以会引发咳嗽、呕吐清水。脾气滋养肺和胃，又连接咽喉，所以上部出现严重痞塞。
肠痹的症状是多饮水但小便排出不畅，腹部有气冲喘鸣之声，时常发生完谷不化的泄泻。大肠的经脉联络肺，下行穿过膈肌，归属于大肠；小肠的经脉联络心，沿咽喉下行穿过膈肌，抵住胃部，归属于小肠。现在小肠有邪气，导致经脉之气不能下行穿过膈肌，所以肠道运化功能失常，胃气蓄积热邪，因此多饮水但不能顺利排出。肠胃中的阳气与邪气奔冲喘逆、相互交争，所以有时会出现通利现象，但因为肠气不能正常运化，所以发生完谷不化的泄泻。
胞痹的症状是小腹和膀胱部位按压时内部疼痛，感觉像被热水浇灌一样，小便涩滞不畅，上部表现为流清鼻涕。膀胱是津液汇聚的府库，胞器居于其中，位于小腹关元穴所在区域，内部藏有胞器。现在胞器受到风寒湿气的侵袭，导致膀胱太阳经脉郁结不通，所以按压时内部疼痛，感觉像被热水浇灌，小便涩滞。小便既已涩滞，太阳经脉之气不能下行，反而上灼脑部，从而产生清涕。
淫乱之气导致喘息，痹证积聚在肺；淫乱之气导致忧思，痹证积聚在心；淫乱之气导致遗尿，痹证积聚在肾；淫乱之气导致精力衰竭，痹证积聚在肝；淫乱之气导致肌肉消瘦绝灭，痹证积聚在脾。（王冰注：淫气是指妄行的气，各自随着所属脏腑的主令而入成为痹证。如今按此理解，则属于内伤，而非风寒湿三气杂至造成的外伤。《宣明五气论》说：“邪入于阴则为痹”，所说的“邪”难道仅指淫气而言吗？）
各种痹证久治不愈，也会逐渐深入体内。其中风邪偏胜的，病邪容易痊愈。（因为病邪停留在皮肤之间。）有人说痹证有的导致死亡，有的疼痛持久，有的容易痊愈，这是什么原因呢？回答说：病邪侵入五脏的会死亡，病邪留连在筋骨之间的疼痛持久，病邪停留在皮肤之间的容易痊愈。（补充：侵入五脏是因为神气离散；筋骨疼痛持久是因为病位固定；皮肤容易痊愈是因为病位浮浅。）
有人说病邪客居在六腑，是什么原因呢？回答说：这也是因为饮食起居不当作为发病的根本。（补充：虽然四方土地温凉高低不同，物性刚柔、饮食居住也有差异，但只要过度损伤了分界界限，就会伤害六腑。经文说：“水谷的寒热，感受了就会伤害六腑”。）六腑也各有背俞穴，风寒湿气中伤这些俞穴，饮食不当与之相应，邪气沿着俞穴进入，各自停留在其对应的腑中。（补充：六腑俞穴指的是背俞穴，都是足太阳膀胱经脉气所发之处。校正说：六腑俞穴都在本椎骨下两旁。王冰注说在椎骨旁边，文字简略罢了。）
问：针刺治疗怎么样呢？答：五脏有输穴，六腑有合穴，顺着经脉的分布，各有所发，根据它们的病变部位进行治疗，病就能痊愈。（补充：肝俞、太冲，心俞、大陵，脾俞、太白，肺俞、太渊，肾俞、太溪，都是经脉气血灌注的地方。胃经合穴入于足三里，胆经合穴入于阳陵泉，大肠经合穴入于曲池，小肠经合穴入于小海，三焦经合穴入于天井，膀胱经合穴入于委中。所以经文说“顺着经脉的分布”等话。“过”指的是经脉经过的地方。）
问：营气和卫气也会让人得痹证吗？答：营气是水谷的精微精气，调和于五脏，散布于六腑，然后才能进入脉管中。（补充：《正理论》说：“谷物进入胃中，脉道才得以运行，水进入化为精，血液才形成。”校正说：“谷物进入胃中，气传输给肺，精专的部分上行于经络隧道，所以水谷精气结合营气营运进入脉管中。”）所以营气沿着脉管上下运行，贯穿五脏，联络六腑。（补充：营气行于脉内，所以无处不到。）
卫气是水谷的悍气，它的性质剽疾滑利，不能进入脉管中。（补充：悍气是指浮盛的气。因为它浮盛，所以剽疾悍利，不能进入脉管中。）所以卫气循行于皮肤之中、分肉之间，熏蒸于肓膜，散布于胸腹。（补充：皮肤、分肉指的是脉外部分。肓膜指的是五脏之间的膈中膜。因为它浮盛，所以能布散于胸腹之中的空虚之处，熏蒸肓膜使气机宣通。）违背卫气就会生病，顺应卫气就会痊愈，如果不与风寒湿气相合，就不会形成痹证。
问：痹证有的疼痛，有的不痛，有的麻木不仁，有的寒冷，有的发热，有的干燥，有的湿润，这是什么原因呢？答：疼痛是因为寒气多，因为有寒所以痛。（补充：风寒湿气客居在分肉之间，迫切挤压形成沫，遇到寒则凝聚，凝聚则排斥分肉，分肉裂开则痛，所以有寒则痛。）
那些不痛且麻木不仁的，是因为病久深入，营卫运行涩滞，经络时常空虚，所以不痛。（补充：不痛与不仁两件事，后面说“不痛”是为了明确强调不痛是主要的。）皮肤得不到荣养，所以麻木不仁。（补充：皮肤顽钝，不知有无。）
那些寒冷的，是因为阳气少，阴气多，与病邪相互助长，所以寒冷。（补充：病本来生于风寒湿气，所以阴气更加旺盛。）
那些发热的，是因为阳气多，阴气少，病气胜过阳气，遭遇（一作乘）阴气，所以产生痹热。（补充：遭遇的意思。言遇于阴气，阴气不胜，所以为热。○或者“热”字下有“或燥”二字，问今此处无答辞。）
那些多汗且湿润的，是因为逢受了甚重的湿气，阳气少，阴气盛，两气相互感应，所以汗出且湿润。（补充：表里相应则相互感应。）
问：痹证这种病，为什么不痛呢？答：痹证在骨则身体沉重，在脉则血液凝滞不流动，在筋则屈伸不利，在肉则麻木不仁，在皮则寒冷。如果具备这五种情况，就不痛了。大凡痹证之类，逢受寒邪则筋脉拘急（一作虫动），逢受热邪则筋脉弛纵。（引自《痹论》）
○黄帝问：五脏为什么会使人产生痿证呢？（补充：痿是指痿弱无力，无法运动。）岐伯回答：肺主管身体的皮毛，心主管身体的血脉，肝主管身体的筋膜（补充：膜是在皮下肉上的筋膜），脾主管身体的肌肉，肾主管身体的骨髓。（补充：所主管的不同，痿的产生也各自归于其所主管的部位。）
所以肺热叶焦，则皮毛虚弱、紧缩变薄，就会产生痿躄（足痿不行）。（补充：肺热则肾受热气，所以足部拘挛，不能伸展来行走。）
心气热，则下部脉气厥逆而上行，上行则下部脉气虚，虚则产生脉痿，关节枢纽折断，小腿纵缓而不能站立于地面。（补充：心热盛则火独光而上炎，肾脉下行，现在火盛上炎，所以肾脉也随火炎烁而逆上。阴气厥逆，火复内燔，阴在上隔阳，下不守位。心气通脉，所以生脉痿。肾气主足，所以膝腕枢纽如折断，不相提挈，胫筋纵缓而不能任用于地。）
肝气热，则胆汁外泄口苦，筋膜干枯，则筋脉拘急而挛缩，发为筋痿。（补充：肝热则胆液渗泄，所以口苦。肝主筋膜，热则筋膜干而挛急，发为筋痿。）
脾气热，则胃干而渴，肌肉麻木不仁，发为肉痿。（补充：脾与胃以膜相连，脾气热则胃液渗泄，所以干而渴。脾主肌肉，现在热邪薄于内，所以肌肉不仁，发为肉痿。）
肾气热，则腰脊不能举动，骨骼枯槁而髓液减少，发为骨痿。（补充：腰为肾之府，又肾脉上大腿内侧，贯穿脊柱，属于肾，所以肾气热则腰脊不能举动。肾主骨髓，所以热则骨枯髓减，发为骨痿。○滑寿注：这里大多从相火的角度来说。）
问：是怎么得的呢？答：肺是脏之长，为心的盖。（补充：位置高且布叶于胸中，所以为脏之长，心的盖。）如果有失亡、所求不得的情况，就会引发肺鸣，肺鸣则肺热叶焦。（补充：肺藏气志，如果不舒畅，则气郁，气郁不利，所以喘息有声而肺热叶焦。）所以说五脏因肺热叶焦，发为痿痹，说的就是这个道理。（肺是用来运行营卫、治理阴阳的。）
悲哀太甚，则胞络断绝。（杨上善说：胞络即心主包络之脉，尤其可见相火的意义。）胞络断绝，则阳气在内扰动，发作时心下崩漏，数溲血。（补充：悲则心系急，肺布叶举而上焦不通，营卫不散热气在中，所以胞络绝而阳气内鼓动，发作则心下内崩而下血。溲谓溺也。）所以本病篇说：大经空虚，发为肌痹，传变为脉痿。（补充：本病是古经篇名。大经是大经脉。因为溺血所以空虚，脉虚则热内迫，卫气盛，营气微，所以发为肌痹，先见肌痹，后渐变为脉痿，所以说传变为脉痿。）
思想无穷，所愿不得，意淫于外，入房太甚，宗筋弛纵，发为筋痿及为白淫。（补充：思想所愿为祈欲也，施泻劳损，所以为筋痿及白淫。白淫谓白物淫衍，如精之状，男则溺溲而下，女则阴器中绵绵而下。）所以下经说：筋痿者生于肝，使内（房事）也。（补充：下经是古经名。使内谓劳役筋力，费竭精气也。）
有渐进于湿，以水为事，若有所留，居处相湿，股肉濡溃，痹而不仁，发为肉痿。（补充：业惟近湿，居处泽下，皆水为事也。平者久而犹殆，感之者尤甚矣。肉属于脾，脾气恶湿，湿着于内则卫气不荣，故为肉痿。○滑寿注：以脾则有热，复渐于湿，因发动而为痿也。）所以下经说：肉痿者得之湿地也。（补充：经曰：地之湿气，感则害皮肉筋脉，此则谓害肉也。）
有所远行劳倦，逢大热而渴，渴则阳气内伐（谓伐腹中之阴气也）。内伐则热舍于肾，肾水脏也。今水不胜火，则骨枯而髓虚，故足不任身，发为骨痿。（以热舍于肾中。）所以下经说：骨痿者生于大热也。
问：怎么区别它们呢？答：肺热者色白而毛败，心热者色赤而络脉溢，肝热者色苍而爪枯，脾热者色黄而肉蠕动，肾热者色黑而齿槁。
问：像先生所说可以了。但论述说治痿者独取阳明，为什么呢？答：阳明是五脏六腑之海。（补充：阳明胃脉也，胃为水谷之海。）主要润宗筋，宗筋主要约束骨骼而利于关节。（补充：宗筋谓阴毛中横骨上下、脐两旁之竖筋也。上络胸膈，下贯髋尻，又经背腹上头项，故云宗筋主束骨利机关。然腰者肾之大关节，所以司屈伸，故曰机关。）冲脉是经脉之海。（补充：十二经之海。）主要渗灌溪谷，与阳明合于宗筋。（补充：冲脉循腹挟脐旁五分而上，阳明脉亦挟脐旁一寸五分而上，宗筋脉于中，故曰与阳明合于宗筋也。以为十二经海，故主渗灌溪谷也。肉之大会为谷，小会为溪。）阴阳总宗筋之会，会于气街，而阳明为之长，皆属于带脉而络于督脉。（补充：宗筋会聚于横骨之中，从上而下，故曰阴阳总宗筋之会。宗筋挟脐下合于横骨，阳明辅其外，冲脉居其中，故云会于气街而阳明为之长。气街则阴毛两旁脉动处也。带脉起于季胁，回身一周，而络于督脉也。○愚谓阴阳总宗筋之会，此即厥论前阴者宗筋之所聚，太阴阳明之所合之义也。）所以阳明虚则宗筋纵，带脉不引，故足痿不用也。（补充：引谓牵引。）
问：治疗怎么样呢？答：各补其荥穴而通其俞穴，调其虚实，和其逆顺，筋脉骨肉，各以其时受月，则病已矣。（时受月谓受气时月，如肝王甲乙，心王丙丁之类也。引自《痿论》）
○黄帝问：厥证的寒热是怎么回事呢？（补充：厥谓气逆上也。○愚谓厥者冷也，逆也，非特气逆上也，或热或寒，从下逆上皆是也。）岐伯回答：阳气衰于下则为寒厥，阴气衰于下则为热厥。（阳谓足之三阳脉，阴谓足之三阴脉，足谓下也。）
问：热厥之为热也，必起于足下者，为什么呢？（补充：阳主外，厥在内，故问之。）答：阳气起于足五趾之表，阴脉者集于足下而聚于足心，故阳气胜则足下热也。（补充：足三阳脉并出足五趾之端，俱循足阳而上，肝脾肾脉集于足下，聚于足心，阴弱故足下热。）
问：寒厥之为寒也，必从五趾而上于膝者，为什么呢？（补充：阴主内，厥在外，故问之。）答：阴气起于五趾之里，集于膝下而聚于膝上，故阴气胜则从五趾至膝上寒。其寒也不从外，皆从内也。（补充：足三阴之脉俱出足五趾之里，并犹足阴而上，循股阴入腹，故云集膝下，聚膝上也。）
问：寒厥是何种失误而导致的呢？答：前阴者，宗筋之所聚，太阴阳明之所合也。（补充：宗筋挟脐下合于阴器，故云前阴者宗筋之所聚。太阴者脾脉，阳明者胃脉，脾胃之脉皆辅近宗筋，故云太阴阳明之所合。）春夏则阳气多而阴气少，秋冬则阴气盛而阳气衰。（补充：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。（补充：质谓形质也。夺于所用谓多欲而夺其精气也。）气因于（一作所）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。（愚按张子和曰：秋冬阴壮阳衰，人或时赖壮勇，纵情嗜欲于秋冬之时，则阳夺于内，阴气下溢，邪气上行，阳气既衰，真精又竭，阳不荣养，阴气独行，故手足寒，发为寒厥也。）
问：热厥是如何而这样的呢？答：酒入于胃，则络脉满而经脉虚。脾主为胃行其津液者也。阴气虚则阳气入，阳气入则胃不和，胃不和则精气竭，精气竭则不营其四肢也。（补充：前阴谓太阴之所合，故胃不和则精气竭也。内精不足，故四肢无气以营之。）此人必数醉若饱以入房，气聚于脾中不得散，酒气与谷气相薄，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。（补充：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。○愚按人或醉饱而房，气聚于脾胃，主行津液，阴气虚，阳气入，则胃不和，胃不和则精气竭，精气竭则四肢不荣，酒气与谷气相薄，则内热而溺赤，气壮而 悍，肾气既衰，阳气独胜，故手足热，发而为热厥也。）
问：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，为什么呢？（补充：暴犹卒也，言卒然冒闷不醒觉也。不知人谓闷甚不识人也。或谓乃厥。）答：阴气盛于上则下虚，下虚则腹胀满。阳气盛于上（阳气盛于上五字当作腹满二字）则下气重上而邪气逆，逆则阳气乱，阳气乱则不知人也。（补充：甲乙经云：阳脉下坠，阴脉上争，发尸厥。张仲景云：少阴脉不至，肾气微少，精血奔气促迫，上入胸膈，宗筋反聚，血结心下，阳气退下，热归阴股，与阴相动，令身不仁，此为尸厥。又王注阴谓足太阴。按缪刺论云：邪客于手足少阴太阴足阳明之络，此五络皆会于耳中，上络左角，五络俱竭，今人身脉皆动而形无知，其状若尸，或曰尸厥。安得专解阴为太阴也。）
问：愿闻六经脉之厥状病能也。答：巨阳之厥，则肿首，头重，足不能行，发为仆。（补充：巨阳太阳也。足太阳脉起目内眦，上额交巅上，其支别者循髀外后廉，下合腘中，以下贯踹内，出外踝后，循京骨至小趾端外侧，由是厥逆，外形斯症也。○愚按此后诸病各随脉络所生病形而言也。张子和曰：厥者或寒或热，皆从下起。）
阳明之厥，则癫疾，欲走呼，腹满，不得卧，面赤而热，妄见而妄言。
厥阴之厥，则少腹肿痛，腹胀，泾溲不利，好卧屈膝，阴缩肿， 内热（一本作胫外热）。
盛则泻之，虚则补之，不盛不虚以经取之。（补充：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。）
太阴厥逆 ，急挛，心痛引腹，治主病者。（补充：太阴之脉行有左右，候其有过者当发取之，故言治主病者。）
三阴俱逆，不得前后，使人手足寒，三日死。（补充：三阴绝故三日死。）
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。（补充：发肠痈则经气绝，故不可治。惊者死也。）
手太阳厥逆，耳聋，泣出，项不可以顾，腰不可俯仰，治主病者。（补充：手太阳脉不属于腰，经言腰不可俯仰，恐古错简文。）
卧出而风吹之，血凝于肤者为痹，（补充：谓 痹也。）凝于脉者为泣（续血行不利），凝于足者为厥（续足逆冷）。此三者血行而不得反其空（空血流之道，大经隧也），故为痹厥也。（引自《五脏生成论》）
○帝曰：有病身热汗出烦满，不为汗解，此为何病？岐伯曰：汗出而身热者风也，汗出而烦满不解者厥也，病名曰风厥。巨阳主气，故先受邪，少阴与其为表里，得热则上从之，从之则厥也。（补充：上从之谓少阴随太阳而上。）治之奈何？曰：表里刺之，饮之服汤。（谓泻太阳补少阴也。饮之汤者谓止逆上之肾气也。引自《评热论》）
帝曰：今大热病者，皆伤寒之类也。或愈或死，其死皆以六七日之间，其愈皆以十日以上者，何也？（补充：其伤于四时之气，皆能为病，以伤寒为毒者，最乘杀厉之气，中而即病，名曰伤寒，不即病者，寒毒藏于肌肤，至夏至前变为温
The heel (calcaneus) is stiff, and one may walk with the buttocks on the ground instead of using the heels, due to spasmodic contraction of the tendons in the feet; the spine is curved, and the head leans forward as if the back were replacing the head, due to the body being curled up. The Foot-Shaoyin Kidney Meridian originates below the little toe, enters the heel obliquely, ascends along the posterior medial aspect of the thigh, penetrates the spine, connects with the Kidney, and links with the Bladder. When Kidney Qi is deficient and pathogenic factors invade, the limbs cannot extend.
Pi Bi (Spleen Bi Syndrome) presents with flaccidity and weakness of the four limbs, coughing, vomiting of clear fluid, and severe obstruction in the upper jiao. The Spleen governs the four limbs; its meridian enters the abdomen, belongs to the Spleen, links with the Stomach, ascends through the diaphragm, and flanks the throat, thus causing cough and vomiting of clear fluid. The Spleen Qi nourishes the Lungs and Stomach and connects with the throat, leading to severe obstruction in the upper jiao.
Chang Bi (Intestinal Bi Syndrome) is characterized by frequent drinking but difficulty urinating, abdominal qi rushing and wheezing sounds, and occasional diarrhea with undigested food. The Large Intestine meridian links with the Lung, descends through the diaphragm, and belongs to the Large Intestine; the Small Intestine meridian links with the Heart, follows the throat, descends through the diaphragm, reaches the Stomach, and belongs to the Small Intestine. Now, with pathogenic factors in the Small Intestine, the meridian qi cannot descend through the diaphragm, so intestinal transformation and transportation fail, and Stomach Qi accumulates heat, leading to excessive thirst and inability to excrete fluids smoothly. The Yang Qi in the intestines and stomach rushes and contends with the pathogenic factors, causing occasional relief, but because intestinal Qi fails to transform properly, diarrhea with undigested food occurs.
Bao Bi (Bladder/Reproductive Organ Bi Syndrome) involves internal pain upon pressing the lower abdomen and Bladder area, feeling as if scalded by hot water, dysuria, and running clear nasal discharge from above. The Bladder is the reservoir of body fluids, and the Bao (uterus/reproductive organ) resides within it, located at the Guan Yuan point in the lower abdomen. When the Bao is invaded by Wind-Cold-Dampness, the Taiyang Meridian of the Bladder becomes stagnant and blocked, causing internal pain upon pressure, a sensation of scalding, and dysuria. Since urine flow is obstructed, the Taiyang Meridian qi cannot descend but instead rises to scorch the brain, resulting in clear nasal discharge.
Excessive sexual activity or abnormal Qi movement causing panting indicates Bi accumulation in the Lung; excessive worry indicates Bi accumulation in the Heart; enuresis indicates Bi accumulation in the Kidney; exhaustion indicates Bi accumulation in the Liver; muscle wasting indicates Bi accumulation in the Spleen. (Wang Bing’s commentary: "Yin Qi" refers to erratic Qi moving abnormally, entering each Zang organ according to its dominance to form Bi. However, this interpretation suggests internal injury rather than external invasion by Wind, Cold, and Dampness. The *Xuan Ming Wu Qi Lun* states: "Pathogens entering Yin cause Bi." Does "pathogen" here refer only to Yin Qi?)
If various Bi syndromes persist, they will gradually penetrate inward. If Wind is predominant, recovery is easier because the pathogen remains superficial in the skin. Some ask why some Bi cases result in death, some involve prolonged pain, and others resolve easily. The answer is: invasion into the Zang organs leads to death; lingering in sinews and bones causes prolonged pain; remaining in the skin allows for easy recovery. (Supplement: Invasion into Zang organs leads to loss of Shen [Spirit]; pain in sinews/bones persists due to fixed location; skin Bi resolves easily due to superficiality.)
Regarding pathogens lodging in the Six Fu organs, the root cause lies in improper diet and lifestyle. Although geographical conditions vary, affecting constitution and habits, overindulgence damages the Fu organs. As stated in the classics: "Cold and heat from food and drink harm the Six Fu organs when contracted." Each Fu organ has Back-Shu points; Wind, Cold, and Dampness attacking these points, combined with dietary impropriety, allow pathogens to enter along the meridians and lodge in their respective Fu organs. (Supplement: The Back-Shu points of the Six Fu organs are located on both sides of the corresponding vertebrae, where the Foot-Taiyang Bladder Meridian qi emerges.)
How should acupuncture treatment be applied? The Five Zang organs have Shu points, and the Six Fu organs have He-Sea points. Following the distribution of the meridians, treat according to the specific pathology, and the disease will heal. (Supplement: Liver Shu, Taichong; Heart Shu, Daling; Spleen Shu, Taibai; Lung Shu, Taiyuan; Kidney Shu, Taixi are all points where meridian Qi gathers. Stomach He-Sea is Zusanli; Gallbladder He-Sea is Yanglingquan; Large Intestine He-Sea is Quchi; Small Intestine He-Sea is Xiaohai; Sanjiao He-Sea is Tianjing; Bladder He-Sea is Weizhong. The term "Guo" refers to the pathway of the meridian.)
Do Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) also cause Bi? Ying Qi is the refined essence of food and drink, harmonized among the Five Zang organs and distributed to the Six Fu organs before entering the vessels. (Supplement: According to *Zheng Li Lun*, grain enters the Stomach, meridians begin to flow, water transforms into essence, and blood forms. Correction: Grain enters the Stomach, Qi transmits to the Lung, the purest part ascends via the collaterals, so water-grain essence combines with Ying Qi to circulate in the vessels.) Thus, Ying Qi circulates up and down the vessels, penetrating the Five Zang and connecting the Six Fu. (Supplement: Ying Qi moves within the vessels, reaching everywhere.)
Wei Qi is the fierce Qi of food and drink; its nature is rapid and slippery, unable to enter the vessels. (Supplement: Fierce Qi refers to floating and vigorous Qi. Due to its floating nature, it is rapid and fierce, unable to enter the vessels.) Therefore, Wei Qi circulates between the skin and muscles, steams the Huang membrane (diaphragmatic fascia), and disperses in the chest and abdomen. (Supplement: Skin and muscles refer to areas outside the vessels. The Huang membrane refers to the fascia between the Zang organs. Being vigorous, it distributes to empty spaces in the chest and abdomen, steaming the Huang membrane to promote Qi circulation.) Violating Wei Qi causes illness; harmonizing it leads to recovery. Without combining with Wind, Cold, or Dampness, Bi does not form.
Why do some Bi syndromes hurt, while others do not? Why are some numb, cold, hot, dry, or damp? Pain is caused by excess Cold; Cold constricts and causes pain. (Supplement: Wind, Cold, and Dampness lodge between muscles, condensing into fluid droplets. Upon encountering Cold, they aggregate, pushing apart the muscles, causing tearing and pain.)
Non-painful numbness occurs when the disease is deep and chronic, Ying and Wei Qi flow is sluggish, and meridians are often empty. (Supplement: Non-pain and numbness are related; non-pain emphasizes severity.) Skin malnourishment leads to numbness. (Supplement: Skin becomes insensate.)
Cold sensations arise from deficiency of Yang Qi and excess of Yin Qi, which exacerbate each other. (Supplement: The disease originates from Wind-Cold-Dampness, increasing Yin.)
Heat sensations arise from excess Yang Qi and deficiency of Yin Qi, where pathogenic Yang encounters Yin, causing Bi-heat. (Supplement: "Encounter" implies interaction. If Yin cannot overcome Yang, heat results.)
Profuse sweating and wetness occur when Dampness is severe, Yang Qi is weak, and Yin Qi is strong, causing mutual induction and sweating. (Supplement: Interior and exterior correspond and induce each other.)
Why might Bi not hurt? If Bi affects bone, the body feels heavy; if in vessels, blood stagnates; if in sinews, flexion-extension is impaired; if in flesh, there is numbness; if in skin, there is cold. Possessing all five symptoms precludes pain. Generally, Bi worsens with Cold (causing spasm) and improves with Heat (causing relaxation). (From *Bi Lun*)
Emperor Wen asked: How do the Five Zang organs cause Wei syndrome (flaccidity)? Qi Bo answered: The Lung governs skin and hair; the Heart governs blood vessels; the Liver governs sinews and membranes; the Spleen governs muscles; the Kidney governs bone marrow. (Supplement: Different governance leads to different sites of Wei formation.)
Thus, Lung heat causing leaf-like desiccation leads to weak, thin skin and hair, resulting in Wei Bi (foot flaccidity). (Supplement: Lung heat transmits to the Kidney, causing leg spasms and inability to walk.)
Heart heat causes lower vessel Qi to rebel upward, depleting lower vessel Qi, leading to Mai Wei (vessel flaccidity), where joints break, calves relax, and standing is impossible. (Supplement: Heart fire flares up, reversing Kidney vessel flow. Yin rebels, fire burns internally, separating Yin and Yang. Heart governs vessels, causing Mai Wei. Kidney governs legs; joint failure leads to calf relaxation.)
Liver heat causes bitter taste from bile leakage, dry sinews, and tendon spasms, forming Jin Wei (sinew flaccidity). (Supplement: Liver heat causes bile secretion; Liver governs sinews, heat dries them, causing spasms.)
Spleen heat causes dry mouth/thirst from Stomach fluid leakage, muscle numbness, forming Rou Wei (flesh flaccidity). (Supplement: Spleen and Stomach are connected by membranes; Spleen heat dries Stomach fluids; Spleen governs muscles, heat causes numbness.)
Kidney heat causes inability to raise the waist/spine, dry bones, and reduced marrow, forming Gu Wei (bone flaccidity). (Supplement: Waist is the house of the Kidney; Kidney meridian runs through the spine. Heat prevents movement. Kidney governs marrow; heat dries bones and reduces marrow.)
How is this acquired? The Lung is the leader of the Zang organs and the canopy of the Heart. Emotional distress or unfulfilled desires cause Lung Qi stagnation and roaring sounds, leading to Lung heat and leaf-like desiccation. (Supplement: Lung houses Qi and emotion; stagnation causes noisy breathing and heat.) Thus, Zang Wei arises from Lung heat desiccation. (The Lung regulates Ying and Wei and balances Yin-Yang.)
Extreme grief severs the Bao Luo (pericardium collaterals), causing internal Yang agitation, heart bleeding, and frequent bloody urine. (Supplement: Grief tightens the Heart connection, raises Lung leaves, blocks upper Jiao, traps heat, severing Bao Luo and agitating Yang, causing bleeding. "Sou" means urination.) Thus, *Ben Bing* states: Major vessels become empty, causing Ji Bi (muscle Bi), transmitting to Mai Wei. (Supplement: *Ben Bing* is an ancient chapter. Hematuria empties vessels; vessel deficiency allows heat to press inward, Wei Qi becomes strong, Ying Qi weak, causing Ji Bi, which transmits to Mai Wei.)
Endless longing and unfulfilled desires, excessive sexual activity, cause Zong Jin (major sinews) to relax, leading to Jin Wei and Bai Yin (white discharge). (Supplement: Unfulfilled desires lead to sexual exertion, damaging sinews and essence. Bai Yin is white discharge resembling semen.) Thus, *Xia Jing* states: Jin Wei originates from the Liver and sexual indulgence. (Supplement: *Xia Jing* is an ancient text; "Shi Nei" means sexual exertion draining essence.)
Gradual exposure to dampness, living in wet areas, causes muscle rot and numbness, forming Rou Wei. (Supplement: Proximity to water/dampness harms the Spleen, which dislikes dampness. Dampness obstructs Wei Qi nourishment, causing Rou Wei.) Thus, *Xia Jing* states: Rou Wei comes from damp places. (Supplement: Dampness harms skin, muscle, sinews, and vessels, specifically muscles here.)
Long journeys, fatigue, extreme heat, and thirst cause Yang Qi to attack internally (devouring Yin Qi in the abdomen). Heat lodges in the Kidney (Water organ); if Water cannot control Fire, bones dry, marrow empties, and legs cannot support the body, forming Gu Wei. (Supplement: Heat lodges in the Kidney.) Thus, *Xia Jing* states: Gu Wei originates from extreme heat.
Differentiation: Lung heat shows pale complexion and brittle hair; Heart heat shows red complexion and overflowing collateral vessels; Liver heat shows dark complexion and brittle nails; Spleen heat shows yellow complexion and twitching muscles; Kidney heat shows black complexion and dry teeth.
Why treat Wei exclusively by regulating the Yangming? Yangming (Stomach) is the sea of the Five Zang and Six Fu organs. It moistens Zong Jin (major sinews), which bind bones and facilitate joint movement. (Supplement: Zong Jin refers to vertical tendons around the pubic bone and umbilicus, connecting to the chest, hips, and head. The waist is the major joint of the Kidney, governing flexion/extension, hence "Ji Guan".) The Chong Mai (Penetrating Vessel) is the sea of the twelve meridians, nourishing溪谷 (valleys/muscle spaces), merging with Yangming at Zong Jin. (Supplement: Chong Mai and Stomach meridian run parallel near the umbilicus, meeting at Zong Jin. Meat masses are "Gu", small masses are "Xi".) Yin and Yang converge at Zong Jin, meeting at Qi Chuan (groin pulse), with Yangming as the leader, connected to Dai Mai (Girdle Vessel) and Du Mai (Governor Vessel). (Supplement: Convergence at the pubic bone; Yangming supports externally, Chong Mai internally. Dai Mai circles the waist. This aligns with *Jue Lun*: "The anterior yin is the gathering of Zong Jin, combined by Taiyin and Yangming.") Thus, Yangming deficiency leads to Zong Jin laxity and Dai Mai failure to pull, causing foot flaccidity. (Supplement: "Yin" means traction.)
Treatment: Tonify Ying points, drain Shu points, regulate deficiency/excess, harmonize reversal/flow. Treat sinews, vessels, bones, and flesh according to their auspicious months. (Supplement: Auspicious months correspond to organ dominance, e.g., Liver in Jia/Yi days.)
Emperor Wen asked: What causes cold and heat in Jue syndrome? Qi Bo answered: Deficiency of Yang Qi below causes Han Jue (Cold Jue); deficiency of Yin Qi below causes Re Jue (Heat Jue). (Yang refers to Foot-Taiyang, Taiyang, Shaoyang; Yin refers to Foot-Taiyin, Shaoyin, Jueyin.)
Why does Re Jue heat start at the feet? Yang Qi originates at the lateral aspects of the five toes; Yin meridians gather at the sole. Excess Yang causes heat in the sole. (Supplement: Foot-Taiyang, Yangming, Shaoyang exit the toes; Foot-Jueyin, Taiyin, Shaoyin gather at the sole. Weak Yin allows heat.)
Why does Han Jue cold start at the toes and rise to the knees? Yin Qi originates at the medial aspects of the five toes, gathering below and above the knees. Excess Yin causes cold from toes to knees, originating internally. (Supplement: Foot-Taiyin, Shaoyin, Jueyin emerge medially, ascend thighs, enter abdomen.)
What error causes Han Jue? The anterior yin is the gathering of Zong Jin, combined by Taiyin and Yangming. (Supplement: Zong Jin connects to genitalia; Spleen and Stomach meridians support Zong Jin.) In Spring/Summer, Yang is abundant, Yin scarce; in Autumn/Winter, Yin is abundant, Yang scarce. A robust person who exhausts themselves sexually during Yin-dominant seasons causes lower Qi to struggle upward without replenishment, essence leaks downward, and pathogenic Qi rises. (Supplement: "Duo Yu Suo Yong" means excessive desire draining essence.) Qi stagnates internally, Yang Qi declines, failing to nourish meridians; Yang decreases daily, Yin remains alone, causing cold hands and feet. (Zhang Zihe notes: In autumn/winter, people indulge desires, draining internal Yang, allowing Yin to overflow and pathogenic Qi to rise, causing cold extremities.)
How does Re Jue occur? Wine enters the Stomach, filling collaterals but emptying main vessels. The Spleen transports fluids for the Stomach. Yin deficiency allows Yang to enter; Stomach disharmony leads to essence depletion, failing to nourish limbs. (Supplement: Stomach disharmony depletes essence; lack of internal essence leaves limbs starved.) Frequent drunkenness and post-coital activity cause Qi to accumulate in the Spleen, mixing wine and grain Qi, generating internal heat and red urine. Wine Qi is fierce; Kidney Qi declines daily; Yang dominates, causing hot hands and feet. (Supplement: Drunkenness/sex deplete essence, creating internal heat. Kidney declines, Yang dominates, causing heat.)
Why does Jue cause abdominal fullness or sudden unconsciousness? Excess Yin Qi above causes lower deficiency and abdominal fullness. (Note: "Yang Qi excess above" likely a textual error for "abdominal fullness"). Lower Qi presses upward, pathogenic Qi rebels, disturbing Yang Qi, causing unconsciousness. (Supplement: *Jia Yi Jing* mentions Yang sinking, Yin rising, causing "Shi Jue" (Corpse Jue). Zhang Zhongjing describes Shaoyin pulse absence, Kidney Qi weakness, and Qi rushing to chest/pericardium, causing numbness. *Miu Ci Lun* describes five collaterals converging at the ear/left temple, leading to corpse-like unconsciousness.)
Describe the Jue patterns of the six meridians:
Taiyang Jue: Head swelling, heaviness, inability to walk, collapse. (Foot-Taiyang starts at inner canthus, crosses vertex, descends back/thigh, calf, ankle, little toe. Rebellion causes these symptoms.)
Yangming Jue: Mania, running/crying, abdominal fullness, insomnia, red/hot face, hallucinations, delirium.
Shaoyang Jue: Sudden deafness, swollen/hot cheeks, flank pain, immobility.
Taiyin Jue: Abdominal fullness/distension, difficult defecation, anorexia, vomiting after eating, insomnia.
Shaoyin Jue: Dry mouth, red urine, abdominal fullness, heart pain.
Jueyin Jue: Lower abdominal swelling/pain, abdominal distension, difficult urination/stool, preference for lying with knees flexed, genital retraction/swelling, internal heat (or shin heat).
Excess: Drain. Deficiency: Tonify. Neither: Treat via the meridian itself. (Supplement: Use needle retention time based on meridian method.)
Taiyin Jue Ni: Spasms, heart pain radiating to abdomen. Treat the affected area.
Shaoyin Jue Ni: Empty fullness, vomiting, clear diarrhea. Treat the affected area.
Jueyin Jue Ni: Spasms, low back pain, empty fullness, urinary retention, delirium. Treat the affected area.
Three Yin Jue Ni: Inability to urinate/defecate, cold extremities, death in three days. (Three Yin exhausted.)
Taiyang Jue Ni: Rigidity, collapse, hematemesis, epistaxis. Treat the affected area.
Shaoyang Jue Ni: Joint dysfunction, inability to walk/turn neck, intestinal abscess (incurable), fright (fatal).
Yangming Jue Ni: Asthma/cough, fever, fright, epistaxis, hematemesis. Treat the affected area.
Hand-Taiyin Jue Ni: Empty fullness, cough, frothy vomiting. Treat the affected area.
Hand-Shaoyin/Jueyin Jue Ni: Heart pain radiating to throat, fever, fatal/incurable.
Hand-Taiyang Jue Ni: Deafness, weeping, inability to turn neck/walk. Treat the affected area. (Note: Hand-Taiyang does not connect to the waist; text may be corrupted.)
Hand-Yangming/Shaoyang Jue Ni: Throat bi, swollen throat. Treat the affected area. (From *Jue Lun*)
Sleeping outdoors exposed to wind causes blood coagulation in skin (Bi), vessels (Qi stagnation), or feet (Jue/Cold). These result from blood failing to return to its channels (large meridians). Hence Bi and Jue. (From *Wu Zang Sheng Cheng Lun*)
Emperor Wen asked: A patient has fever, sweating, irritability/fullness unrelieved by sweat. What is this? Qi Bo answered: Sweating with fever is Wind; sweating with persistent irritability/fullness is Jue. Named Feng Jue (Wind Jue). Taiyang governs exterior Qi and is first invaded; Shaoyin is its interior counterpart. Heat causes Shaoyin to follow Taiyang upward, causing Jue. (Supplement: Shaoyin follows Taiyang upward.) Treatment: Acupuncture exterior-interior pairs, administer decoctions. (Supplement: Drain Taiyang, tonify Shaoyin. Decoction stops rebellious Kidney Qi. From *Ping Re Lun*)
Emperor Wen asked: High fevers are types of Shang Han (Cold Damage). Some recover, some die within 6-7 days; survivors recover after 10+ days. Why? (Supplement: All seasonal pathogens cause disease, but Cold Damage is most toxic. Immediate illness is Shang Han; latent cold toxin transforms into Warm Disease before Summer Solstice...)