肝热病者。小便先黄。腹痛。多卧身热。（此论五脏之热病。夫五脏者。五行之所生也。天之十干。化生地之五行。
人之十二经脉。上应天之六气。伤寒之邪。病三阴三阳之气。是以死于三日六日。而愈以十二日也。五脏之热病。病涉
于五行。是以死生皆系于十干也。病六气者。外因之邪。病在肌形。病五脏者。内因之病。伤五脏之神志。灵枢经之所
谓风寒伤形。忧恐忿怒伤气。气伤脏。乃病脏。寒伤形。乃病形也。曰先者。谓先有此内因之热。而先见是证也。肝主
疏泄。故小便赤黄。肝脉环阴器。抵少腹而上。故腹痛也。肝藏魂。魂伤。故多卧。木火主气。故身热也。此言内因之
病。始在气分。先下而上。内而外也。倪冲之曰。先者。谓先有此内热之证。而未与外热交争也。）热争则狂言及惊。胁
满痛。手足躁。不得安卧。（热争者。寒与热争也。此言外淫之邪。内干五脏。与内因之热。交争而为重病也。外因之邪。
内干五脏者。即阴阳应象论之所谓天之邪气。感则害人五脏是也。盖风寒之邪。始伤皮毛。留而不治。则入于肌腠。以
及于经脉。留而不治。则内干五脏。故曰。治五脏者。半死半生也。与内因之热。交争而为重病者。即玉机论之所谓传
化。有不以次入者。忧恐悲喜怒。令不得以其次。故令人有大病者是也。谓外感风寒之邪。内伤五脏。移皆有次。又因
五志内伤。故令不得以次相传。致令人有大病也。魂伤则狂言。东方肝木。其病发惊骇。肝脉布胁肋。故胁满痛。风木
之热甚。故淫于四末也。人卧则血归于肝。肝气伤而不能纳血。故不得卧也。王子方曰。寒已化热。故曰热争。）庚辛甚。
甲乙大汗。气逆则庚辛死。（病在肝。加于庚辛。庚辛不死。起于甲乙。大汗者。正胜邪而外出也。气逆者。热淫而反内
逆也。）刺足厥阴少阳。（黄帝曰。外因之病。难易之治。奈何。伯高答曰。形先病而未入脏者。刺之半其日。脏先病而
形乃应者。刺之倍其日。此外内难易之治也。夫形先病而未入脏者。谓外因之邪。未内入而与脏热交争也。脏先病而形
乃应者。谓五脏之热。出于形身。而与外热相应也。盖邪并而逆于内者难治。内热出而外合于形身之间。刺之易愈也。
杨
元如曰。此篇乃记述之书。是当复引君臣问答以证之。）其逆则头痛员员。脉引冲头也。（圆圆、周转也。此言肝脏之热
发于外。而与形热相应。热甚而上逆于头。故头痛而员转也。盖三阳之脉。上循于头。肝热与少阳交争。因脉引而上冲
于头也。当知病在气者关于脉。病在脉者关于气。脉气之道。大宜体会。）心热病者。先不乐。数日乃热。（心志在喜。
而恐胜之。先不乐者。为恐所伤也。夫心为君主之官。脏热乃神志之病。故独举心脏。以申明五脏之热。乃五志之为病
也。）热争则卒心痛。烦闷善呕。头痛面赤无汗。（外内交争。热干神脏。故卒然烦痛也。少阴病者。欲吐不吐。故善呕。
心为阳中之太阳。故头痛。心之华在面。故面赤。心主血。故无汗也。董帷园曰。论热争。当在内因外因之证兼看。）壬
癸甚。丙丁大汗。气逆则壬癸死。（心病者。加于壬癸。壬癸不死。起于丙丁。逆则无起色矣。）刺手少阴太阳。（手少阴
太阳。相为表里。故宜刺二经。以泻其热。）脾热病者。先头重颊痛。烦心。颜青。欲呕。身热。（阴气从足上行至头。
故先头重。阳明之脉巡颊。故颊痛也。脾络注心中。故心烦而颜青。热邪干胃。故欲呕。脾主肌肉。故身热也。）热争则
腰痛不可用俯仰。腹满泄。两颔痛。（经云。阳病者腰反折。不能俯。阴病者不能仰。阳者天气也。主外。阴者地气也。
主内。阴脏热于内。阳热甚于外。阴阳外内交争。故腰痛不可用俯仰也。腹者脾土之郛郭。故腹满泄。胃之悍气。上冲
头者。循牙车。下人迎。故颔下痛也。）甲乙甚。戊己大汗。气逆则甲乙死。（脾病者。加于甲乙。甲乙不死。起于戊己。
如反逆而内干于脏。则不能外出而汗解矣。）刺足太阴阳明。（足太阴阳明。相为表里。）肺热病者。先淅然。厥起毫毛。
恶风寒。舌上黄。身热。（皮毛者。肺之合。脏气热于内。故淅然寒栗于外而恶风寒。盖热盛则寒也。肺上连于喉嗌。故
舌黄。脏真高于肺。主行荣卫阴阳。故身热也。）热争则喘咳。痛走胸膺背。不得太息。头痛不堪。汗出而寒。（热干肺
脏。故喘咳不得太息。肺主胸中之气。气伤。故痛走胸背也。五脏之应天者肺。而手阳明之脉。上循于头。故头痛不堪。
热争于内。故汗出而生寒也。王冰曰。肺之络脉。上会于耳中。故头痛不堪。倪冲之曰。肺脏居于胸中。而俞在肩背。）
丙丁甚。庚辛大汗。气逆则丙丁死。（肺病者。加于丙丁。丙丁不死。起于庚辛。如气逆。则遇胜克之日即死矣。）刺手
太阴阳明。出血如大豆。立已。（此言六经之刺。皆宜泻而不宜补者也。肺乃五脏之长。故举肺以申明之。）肾热病者。
先腰痛 。苦渴数饮。身热。（腰者肾之府。故先腰痛。肾主骨。故 。肾为水脏。津液不能上资。故苦渴数饮也。
按五脏之热病。皆主身热。盖内因之热。从内而外也。五脏之热争。多主内证。盖外淫之热。交争于内也。）热争则项痛
而强。 寒且 。足下热。不欲言。（外热在太阳。则头痛而强。内热在肾。故 寒且 。足下热者。热流阴股也。不欲
言者。肾为生气之原也。）其逆则项痛员员淡淡然。（其争气上逆。则为项痛。员员淡淡。痛之微也。膀胱者肾之府。太
阳为诸阳主气。其气上升。肾藏之热。随太阳之气。而上冲于头也。此阴阳热气。外内交争。一随脉引。一随气升。皆
阴出之阳。故只头痛而不死。）戊己甚。壬癸大汗。气逆则戊己死。（肾病者。加于戊己。戊己不死。起于壬癸。从则外
出于形身故汗出。逆则内干于真脏。故死。）刺足少阴太阳。（足少阴太阳。相为表里。五脏六腑。经气之相通也。）诸
汗者。至其所胜日汗出也。（本气旺日。谓之所胜。汗出。则热随外泄而自愈矣。所谓自得其位而起也。按此节乃论经气
之兼证。故曰大汗。曰汗出。盖气分之汗大。经脉之汗微。）肝热病者。左颊先赤。（此言内因五志之热病者。必先见
于色也。五色之见。各有其部。肝属木而位居东方。故左颊先赤。夫精明五色者。气之华也。忧恐忿怒伤气。气伤脏。
乃病脏。今始见于色者。尚在气也。故曰治未病。未病者。病未及于脏也。）心热病者。颜先赤。（五色篇曰。阙者眉间
也。庭者颜也。首面上于阙庭。王宫在于下极。心合火而位居南方。故颜先赤。颜、额也。）脾热病者。鼻先赤。（土位
中央。故鼻先赤。）肺热病者。右颊先赤。（肺属金而位居西方。故右颊先赤。）肾热病者。颐先赤。（腮下谓之颐。肾属
水而位居北方。故颐先赤。此后天之卦象也。）病虽未发。见赤色者刺之。名曰治未病。（脏气热于内。必先见于色。病
虽未发者。谓虽病而未与外热交争也。见其色而即刺之。名曰刺未病。言脏气病而形未应者。当先刺之。勿使荣交而为
难治也。）热病从部所起者。至期而已。（此复申明五脏之热。先见于色者易愈也。部、面部也。从部所起者。如肝热病
左颊先赤。至甲乙大汗而病已矣。此病在五脏之本气。而不与外热交争。故至期而愈。如小便先黄。腹痛身热。是涉于
有形之形层。将与外热交争。而有反逆之危险矣。）其刺之反者。三周而已。重逆则死。（反者。谓反逆为顺也。言不能
治其未病。以致外内交争。其气反逆于内者。急当以刺取之。至三日而后已。如再不急治。使外内阴阳之热。重逆于内
则死矣。按伯高曰。风寒伤形。忧恐忿怒伤气。气伤脏。乃病脏。寒伤形。乃应形。此形气外内之相应也。帝曰。刺之
奈何。伯高答曰。病九日者。三刺而已。三刺者。三周也。九日者。病久而外内交争也。）诸当汗者。至其所胜日。汗大
出也。（此言热病从部所起者。至期当自大汗而病已也。胜日、谓本气胜旺之日。如肝之甲乙。心之丙丁。）诸治热病。
以饮之寒水。乃刺之。必寒衣之。居止寒处。身寒而止也。（诸热者。谓表之三阳。里之五脏。外内之热交争也。饮之寒
水。里之使寒也。寒衣寒处。表之使寒也。以刺取之。必俟其身寒而后止。）热病先胸胁痛。手足躁。刺足少阳。补足
太阴。（此言外因之热。病在三阳者。各有刺取之法也。先胸胁痛者。病发于少阳也。足少阳主筋。热甚则筋急。故手足
躁扰。灵枢经曰。热病手足躁。取之筋间。故当刺足少阳。以泻阳分之热。补足太阴。以御外入之邪。盖邪在少阳。三
阳为昼。太阴当受邪也。）病甚者。为五十九刺。（病甚者。阳热甚而及于内也。水热穴论曰。头上五行行五者。以越诸
阳之热也。大杼、膺俞、缺盆、背俞。此八者。以泻胸中之热也。气街、三里、巨虚上下廉。此八者。以泻胃中之热也。
云门、 骨、委中、髓空。此八者。以泻四肢之热也。五脏俞旁五。此十者。以泻五脏之热也。凡此五十九穴者。皆热
之左右也。帝曰。人伤于寒。而传为热。何也。伯曰。夫寒甚则生热也。此言凡伤于寒。则为病热。热甚于表阳。而入
于内者。当为五十九刺也。又按。孔穴圆经无 骨穴。有肩 穴。又腰俞穴。一名髓空。）热病始手臂痛者。刺手阳明
太阴而汗出止。（身半以上。手太阴阳明皆主之。热病始于手臂者。病在上而发于阳也。故当刺手阳明太阴。手太阴之主
表也。）热病始于头首者。刺项太阳而汗出止。（始于头首者。太阳之为病也。刺项者。刺风池风府也。太阳为诸阳主气。
其脉连于风府。故刺之而汗出乃止。）热病始于足胫者。刺足阳明而汗出止。（阳气起于足五趾之表。热病始于足胫者。
发于阳而始于下也。故当刺足阳明以取汗。）热病身先重。骨痛。耳聋好瞑。刺足少阴。病甚为五十九刺。（此病发于阴
而为热病者。当取足少阴也。肾主骨而为生气之原。气伤故身重。肾开窍于耳。故耳聋。少阴病但欲寐。故好瞑也。病
甚者。亦当为五十九刺。灵枢热病篇曰。热病身重骨痛。耳聋而好瞑。取之骨。以第四针。五十九刺骨。盖足少阴主骨。
故取之骨也。五十九刺骨者。取骨空之穴也。夫少阳少阴主枢。热在少阳者。可入于里阴。热在少阴者。可枢转而外出。
故在阴分阳分之病甚者。皆当为五十九刺也。张兆璜曰。少阳之上。火气治之。少阴之上。热气治之。故病在少阳少阴。
而皆为热甚。）热病先眩冒而热。胸胁满。刺足少阴少阳。（此言少阴少阳之二气相通也。夫阴阳出入。皆从枢转。热病
先眩冒而热。病发于少阳也。胸胁满。将入于里阴矣。故当刺足少阴少阳。从枢转而外出。按以上三节。用十六先字。
盖言有先于内者。有先于外者。有先从气分者。有先见于色者。皆当先治之。勿使其外内之交争也。张兆璜曰。首节
论热甚于少阳。上节论热甚于少阴。此论少阴与少阳相合。盖君火与相火之相合也。）太阳之脉。色荣颧骨。热病也。荣
未交日。今且得汗。待时而已。与厥阴脉争见者。死期不过三日。（此言外病六气之热。内有五脏之热。始在气分。而未
及于经荣者。当急取汗而解。勿使外内相交。而成不救也。伤寒论曰。太阳之为病。脉浮。见太阳之脉者。乃六气之病。
始在太阳之表阳。此外因之热病也。荣、华也。谓赤色之荣于颧颊之间。乃五脏之热。始病气而见于色。此内因之热病
也。曰骨者。谓尚在内而隐见于皮肤之间。当此之时。五脏之荣色。尚未与表阳之气相交。表阳之热。尚未与五脏之荣
气相交。故良工曰。病在太阳者。可从表汗而解。热在五脏者。病虽未发。见赤色者刺之。名曰治未病。今且得汗。是
可待时而已矣。若不急从汗解。则太阳之热。与脏热相交。而太阳与厥阴之脉争见者。死期不过三日矣。按此节与玉机
真藏论之所谓传化。有不以次入者。忧恐悲喜怒。令不得以其次。故令人有大病之义相同。盖表阳之邪。始病太阳。六
气相传。移皆有次。不以次入者。因五志内伤。而五脏内热。太阳之脉与厥阴脉争见者。是太阳之热。与肝热相交矣。
盖太阳为阳之始。厥阴为阴之终。举太阳与厥阴交争。是表阳之邪。不以次入。而与五脏之热。随所乘传。阳脉与阴脉
争见者。皆为死证。故不必备言五脏也。当知表阳之热。先气而经。经而脏。五脏之热。亦先从气而经。内而外也。外
内之热。交出于阳分者生。重逆于阴脏者死。首节论内热与外热交争。此论外热与内热交争。）其热内连肾。少阳之脉色
也。（此言表阳之热。与脏热交争。不以次入。惟少阳与肾脉相连耳。本输篇曰。少阳属肾。盖少阳之气。发原于肾。故
热病内连肾者。少阳之脉色也。）少阳之脉。色荣颊前。热病也。荣未交日。今且得汗。待时而已。与少阴脉争见者。死
肝热病，小便先变黄，腹痛，嗜睡，身体发热。（这是论述五脏的热病。五脏是五行之气所化生的。天的十天干，化生地之五行。人的十二经脉，上应合天的六气。伤寒的邪气，侵犯三阴三阳之气，所以死于三日或六日，而痊愈需要十二天。五脏的热病，病情涉及五行，所以生死都取决于天干之日。病在六气的，是外因的邪气，病在肌表形体；病在五脏的，是内因的病，损伤五脏的神志。《灵枢经》所说的风寒伤形体，忧恐忿怒伤气，气伤则脏，乃病于脏；寒伤形，乃病于形。所谓“先”，是指先有这种内因的热，而先出现这些证候。肝主疏泄，所以小便赤黄。肝脉环绕阴器，抵少腹而上行，所以腹痛。肝藏魂，魂受损，所以嗜睡。木火主气，所以身体发热。这是说内因的病，起初在气分，由下而上，由内而外。倪冲之说：所谓“先”，是指先有这种内热的证候，而尚未与外热交争。）若热邪与正气相争，则胡言乱语并惊骇，胁部胀满疼痛，手足躁动不安，不能安卧。（热争，是寒邪与热邪相争。这是说外来的淫邪，内犯五脏，与内因的热邪交争，从而形成重病。外来的邪气内犯五脏，就是《阴阳应象大论》所说的天之邪气，感受后伤害人五脏。大概风寒之邪，起初伤害皮毛，停留不治疗，就进入肌腠，进而到达经脉，停留不治疗，就内犯五脏。所以说：治疗五脏的病，一半能死，一半能生。与内因的热邪交争形成重病的，就是《玉机真脏论》所说的传化，有不按次序传入的，忧恐悲喜怒等情志，使得不能按次序相传，从而使人患大病。说是外感风寒之邪，内伤五脏，转移都有次序，又因为五志内伤，所以使得不能按次序相传，导致使人患大病。魂受伤则胡言乱语。东方肝木，其病发作时惊骇。肝脉布散于胁肋，所以胁部胀满疼痛。风木之热甚盛，所以淫溢于四肢末端。人卧则血归于肝，肝气受伤而不能纳血，所以不能安卧。王子方说：寒已化为热，所以叫热争。）逢庚辛日病情加重，逢甲乙日大汗出而愈，若气逆则逢庚辛日死亡。（病在肝，遇庚辛日加重，若庚辛日不死，到甲乙日可起。大汗出，是正气胜邪而向外排出。气逆，是热邪淫溢反而向内逆乱。）针刺足厥阴肝经和足少阳胆经。（黄帝问：外因的病，治疗的难易如何？伯高回答说：形体先病而未入脏的，针刺天数减半；脏先病而后形体反应的，针刺天数加倍。这是外内病难易的治疗原则。所谓形体先病而未入脏，是说外因的邪气，未内入而与脏热交争。脏先病而后形体反应，是说五脏的热，出于形体，而与外热相应。大概邪气并聚而逆于内的难治，内热出而外合于形体之间的，针刺容易痊愈。杨元如说：这篇是记述性的书，应当再引用君臣问答来证明它。）若气逆则头痛晕眩，脉气上冲头部。（员员，即周转。这是说肝脏的热发于外，而与形体之热相应，热甚而上逆于头，所以头痛且晕转。大概三阳经脉，上行循于头，肝热与少阳交争，因而脉气上冲于头。应当知道病在气者关系到脉，病在脉者关系到气，脉气之道，非常值得体会。）心热病，先心情不愉快，数日后才发热。（心的情志在喜，而恐胜之。先心情不乐，是被恐所伤。心为君主之官，脏热乃是神志的病，所以单独举心脏，以申明五脏的热，乃是五志导致的病。）若热邪与正气相争，则突然心痛，烦闷，喜欢呕吐，头痛，面红无汗。（外内交争，热邪干犯神脏，所以突然烦痛。少阴病，想吐吐不出，所以喜欢呕吐。心为阳中之太阳，所以头痛。心的荣华表现在面部，所以面红。心主血，所以无汗。董帷园说：论热争，应当结合内因外因的证候来看。）逢壬癸日病情加重，逢丙丁日大汗出而愈，若气逆则逢壬癸日死亡。（心病者，遇壬癸日加重，若壬癸日不死，到丙丁日可起。气逆则没有好转的迹象了。）针刺手少阴心经和手太阳小肠经。（手少阴和手太阳，互为表里，所以适宜刺这两条经，以泻其热。）脾热病，先头重，颊痛，心烦，面色发青，想呕吐，身体发热。（阴气从足上行至头，所以先头重。阳明经脉巡行于颊，所以颊痛。脾络注入心中，所以心烦而面色发青。热邪干犯胃，所以想呕吐。脾主肌肉，所以身体发热。）若热邪与正气相争，则腰痛不能俯仰，腹部胀满泄泻，两颔疼痛。（经文说：阳病者腰反折，不能俯；阴病者不能仰。阳是天气，主外；阴是地气，主内。阴脏热于内，阳热甚于外，阴阳内外交争，所以腰痛不能俯仰。腹部是脾土的廓郭，所以腹满泄。胃的悍气，上冲头部的，循行牙车，下行人迎，所以颔下痛。）逢甲乙日病情加重，逢戊己日大汗出而愈，若气逆则逢甲乙日死亡。（脾病者，遇甲乙日加重，若甲乙日不死，到戊己日可起。如果反逆而内干于脏，则不能外出而汗解了。）针刺足太阴脾经和足阳明胃经。（足太阴和足阳明，互为表里。）肺热病，先淅然恶寒，毫毛竖起，怕冷怕风，舌苔黄，身体发热。（皮毛是肺的合应，脏气热于内，所以体表淅然寒栗而怕冷怕风。大概热盛则表现为寒。肺上连于喉咽，所以舌黄。脏真高于肺，主行营卫阴阳，所以身体发热。）若热邪与正气相争，则喘咳，疼痛游走于胸膺背部，不能深吸气，头痛剧烈，汗出而恶寒。（热邪干犯肺脏，所以喘咳不能深吸气。肺主胸中之气，气受伤，所以疼痛游走于胸背。五脏中应天的是肺，而手阳明经脉，上行循于头，所以头痛剧烈。热争于内，所以汗出而生寒。王冰说：肺的络脉，上会于耳中，所以头痛剧烈。倪冲之说：肺脏居于胸中，而俞穴在肩背。）逢丙丁日病情加重，逢庚辛日大汗出而愈，若气逆则逢丙丁日死亡。（肺病者，遇丙丁日加重，若丙丁日不死，到庚辛日可起。如果气逆，则遇到被克制的日子就会死亡。）针刺手太阴肺经和手阳明大肠经，出血如大豆大小，立刻痊愈。（这是说六经的针刺，都适宜泻而不适宜补。肺是五脏之长，所以举肺以申明之。）肾热病，先腰痛，膝胫酸软无力，口渴多饮，身体发热。（腰是肾的府邸，所以先腰痛。肾主骨，所以膝胫酸软。肾为水脏，津液不能上滋，所以口渴多饮。按：五脏的热病，都主身热，大概是内因的热，从内而外。五脏的热争，多主内证，大概是外淫的热，交争于内。）若热邪与正气相争，则项痛而强直，恶寒且膝胫酸软，足下发热，不想说话。（外热在太阳，则头痛而强直。内热在肾，所以恶寒且膝胫酸软。足下发热，是热流注于阴股。不想说话，是因为肾为生气之源。）若气逆则项痛晕眩，隐隐作痛。（其争气上逆，则为项痛。员员淡淡，是痛势轻微。膀胱是肾的府邸，太阳为诸阳主气，其气上升，肾藏的热，随太阳之气，而上冲于头。这是阴阳热气，内外交争，一随脉引，一随气升，都是阴出之阳，所以只头痛而不死。）逢戊己日病情加重，逢壬癸日大汗出而愈，若气逆则逢戊己日死亡。（肾病者，遇戊己日加重，若戊己日不死，到壬癸日可起。顺则外出于形体故汗出，逆则内干于真脏，所以死。）针刺足少阴肾经和足太阳膀胱经。（足少阴和足太阳，互为表里。五脏六腑，经气是相通的。）凡是当汗出的，到了其所胜旺的日子就会汗出。（本气旺日，叫做所胜。汗出，则热随之外泄而自愈。所谓自得其位而起。按：这一节是论经气的兼证，所以说大汗，说汗出，大概是气分之汗大，经脉之汗微。）肝热病，左颊先发红。（这是说内因五志的热病，必先见于面色。五色的显现，各有其部位。肝属木而位居东方，所以左颊先红。精明的五色，是气的荣华。忧恐忿怒伤气，气伤脏，乃病于脏。现在刚见于色，尚在气分。所以说治未病。未病，是指病未及于脏。）心热病，额部先发红。（《五色篇》说：阙是眉间，庭是额部。首面上应于阙庭，王宫在于下极。心合火而位居南方，所以额部先红。颜，指额部。）脾热病，鼻部先发红。（土位中央，所以鼻部先红。）肺热病，右颊先发红。（肺属金而位居西方，所以右颊先红。）肾热病，下颌先发红。（腮下称为颐。肾属水而位居北方，所以下颌先红。这是后天的卦象。）病虽未发作，见到赤色的就针刺，这叫治未病。（脏气热于内，必先见于面色。病虽未发作，是指虽病而未与外热交争。见到其色就立即针刺，名叫刺未病。是说脏气病而形体未反应，应当先刺之，不要让营气交争而形成难治之症。）热病从面部所属部位发起的，到了相应的日期就会痊愈。（这是再次申明五脏的热，先见于面色的容易痊愈。部，指面部。从部所发起的，如肝热病左颊先红，到甲乙日大汗出而病愈。这是病在五脏的本气，而不与外热交争，所以到日期而愈。如小便先黄，腹痛身热，是涉及有形的形层，将与外热交争，而有反逆的危险了。）若针刺方法相反（误治），经过三个周期才能痊愈。若再次逆治则会死亡。（反，是指反逆为顺。是说不能治其未病，以致外内交争，其气反逆于内的，急当以针刺取之，到三天后才好。如再不紧急治疗，使外内阴阳之热，重逆于内则死。按：伯高说：风寒伤形，忧恐忿怒伤气，气伤脏，乃病脏。寒伤形，乃应形。这是形气外内的相应。帝问：如何针刺？伯高回答说：病九日的，针刺三次就好了。三刺，就是三周。九日，是病久而外内交争。）凡是应当汗出的，到了其所胜旺的日子，会大汗出。（这是说热病从面部所属部位发起的，到了日期应当自大汗而病愈。胜日，谓本气胜旺的日子，如肝之甲乙，心之丙丁。）凡是治疗热病，要喝冷水，然后针刺。必须穿凉衣服，居住在凉爽的地方，直到身体凉爽为止。（诸热者，谓表的三阳，里的五脏，外内之热交争。喝冷水，是使里寒。穿凉衣住凉处，是使表寒。用针刺取，必须等到身体凉爽后才停止。）热病先胸胁痛，手足躁动，针刺足少阳胆经，补足太阴脾经。（这是说外因的热，病在三阳的，各有针刺取法。先胸胁痛，是病发于少阳。足少阳主筋，热甚则筋急，所以手足躁扰。《灵枢经》说：热病手足躁，取之筋间，所以应当刺足少阳，以泻阳分之热。补足太阴，以御外入之邪。大概邪在少阳，三阳为昼，太阴当受邪。）病重的，用五十九刺法。（病重的，是阳热甚而波及于内。《水热穴论》说：头上五行行五者，以发散诸阳之热。大杼、膺俞、缺盆、背俞，这八个穴位，以泻胸中之热。气街、三里、巨虚上下廉，这八个穴位，以泻胃中之热。云门、髃骨、委中、髓空，这八个穴位，以泻四肢之热。五脏俞旁五，这十个穴位，以泻五脏之热。凡这五十九个穴位，都是治热的左右配穴。帝问：人伤于寒，而传变为热，为什么呢？伯高说：寒甚则生热。这是说凡是伤于寒，则为病热，热甚于表阳，而入于内的，应当用五十九刺法。又按：《孔穴圆经》无髃骨穴，有肩髃穴。又有腰俞穴，一名髓空。）热病始于手臂痛的，针刺手阳明大肠经和手太阴肺经，汗出而止。（身半以上，手太阴和手阳明皆主治。热病始于手臂，是病在上而发于阳。所以应当刺手阳明和手太阴，手太阴主表。）热病始于头首的，针刺项部太阳经，汗出而止。（始于头首，是太阳之为病。刺项，是刺风池和风府。太阳为诸阳主气，其脉连于风府，所以刺之而汗出乃止。）热病始于足胫的，针刺足阳明胃经，汗出而止。（阳气起于足五趾之表，热病始于足胫，是发于阳而始于下。所以应当刺足阳明以取汗。）热病身先沉重，骨痛，耳聋，喜闭目，针刺足少阴肾经，病重的用五十九刺法。（此病发于阴而为热病，应当取足少阴。肾主骨而为生气之源，气伤故身重。肾开窍于耳，故耳聋。少阴病但欲寐，故喜闭目。病重的，也应当用五十九刺法。《灵枢·热病篇》说：热病身重骨痛，耳聋而好瞑，取之骨，用第四针，五十九刺骨。盖足少阴主骨，所以取之骨。五十九刺骨，是取骨空的穴位。夫少阳少阴主枢，热在少阳者，可入于里阴；热在少阴者，可枢转而外出。所以在阴分阳分之病重的，都应当用五十九刺法。张兆璜说：少阳之上，火气治之；少阴之上，热气治之。所以病在少阳少阴，而皆为热甚。）热病先眩晕昏冒而发热，胸胁满，针刺足少阴肾经和足少阳胆经。（这是说少阴少阳之二气相通。夫阴阳出入，皆从枢转。热病先眩晕昏冒而发热，病发于少阳。胸胁满，将入于里阴了。所以应当刺足少阴和足少阳，从枢转而外出。按以上三节，用了十六个“先”字，大概是说有先于内的，有先于外的，有先从气分的，有先见于面色的，都应当先治之，不要让它们外内交争。张兆璜说：首节论热甚于少阳，上节论热甚于少阴，此论少阴与少阳相合，盖君火与相火之相合。）太阳经脉，色泽现于颧骨，是热病。色泽尚未交合之日，如今若能得汗，等待时日即可痊愈。若与厥阴经脉色泽同时出现，死期不超过三天。（这是说外病六气之热，内有五脏之热，起初在气分，而未及于经络色泽的，应当急取汗而解，不要让外内相交，而成不治之症。《伤寒论》说：太阳之为病，脉浮。见太阳之脉者，乃六气之病，起初在太阳之表阳，这是外因的热病。荣，通华。谓赤色之华现于颧颊之间，乃五脏之热，起初病气而见于色，这是内因的热病。曰骨，谓尚在内而隐见于皮肤之间。当此之时，五脏之荣色，尚未与表阳之气相交，表阳之热，尚未与五脏之荣气相交。所以良医说：病在太阳者，可从表汗而解。热在五脏者，病虽未发，见赤色者刺之，名叫治未病。如今若能得汗，是可以等待时日而已了。若不急从汗解，则太阳之热，与脏热相交，而太阳与厥阴之脉争见者，死期不过三天了。按：这一节与《玉机真脏论》所说的传化，有不按次序传入的，忧恐悲喜怒，使得不能按次序相传，从而使人患大病的意义相同。盖表阳之邪，起初病太阳，六气相传，转移都有次序，不以次入者，因五志内伤，而五脏内热。太阳之脉与厥阴脉争见者，是太阳之热，与肝热相交了。盖太阳为阳之始，厥阴为阴之终。举太阳与厥阴交争，是表阳之邪，不以次入，而与五脏之热，随所乘传。阳脉与阴脉争见者，皆为死证，所以不必备言五脏。应当知道表阳之热，先气而经，经而脏；五脏之热，亦先从气而经，内而外。外内之热，交出于阳分者生，重逆于阴脏者死。首节论内热与外热交争，此论外热与内热交争。）其热内连于肾，是少阳经脉的色泽。（这是说表阳之热，与脏热交争，不以次入，惟少阳与肾脉相连耳。《本输篇》说：少阳属肾。盖少阳之气，发原于肾，所以热病内连肾者，是少阳之脉色。）少阳经脉，色泽现于颊前，是热病。色泽尚未交合之日，如今若能得汗，等待时日即可痊愈。若与少阴经脉色泽同时出现，死
Liver Heat Disease: Urine turns yellow first, abdominal pain, excessive sleeping, and body heat. (This discusses heat diseases of the five Zang organs. The five Zang organs are generated by the Five Elements. The Ten Heavenly Stems transform into the Earthly Five Elements. The Twelve Meridians of Man correspond to the Six Qi of Heaven. Pathogenic factors of Cold Damage attack the Qi of the Three Yin and Three Yang meridians; thus, death occurs on the third or sixth day, and recovery takes twelve days. Heat diseases of the five Zang organs involve the Five Elements; therefore, life and death depend on the Heavenly Stems. Diseases involving the Six Qi are external pathogenic factors affecting the muscle and form; diseases of the five Zang organs are internal causes damaging the spirit and consciousness of the Zang organs. As stated in the *Ling Shu*: Wind and cold damage the form; worry, fear, anger, and resentment damage the Qi. When Qi is damaged, the Zang organs are affected, resulting in Zang disease; when cold damages the form, it results in form disease. "First" refers to having this internal heat prior to the appearance of these symptoms. The Liver governs free flow, so urine becomes red and yellow. The Liver meridian circles the genitalia, reaches the lower abdomen, and ascends, causing abdominal pain. The Liver stores the Hun (Ethereal Soul); when Hun is damaged, there is excessive sleeping. Wood and Fire govern the Qi, causing body heat. This describes an internal disease starting in the Qi level, moving from below to above, from inside to outside. Ni Chongzhi said: "First" means having this internal heat symptom before it contends with external heat.) If heat contends (Re Zheng), there is delirious speech and fright, fullness and pain in the hypochondrium, restlessness of the hands and feet, and inability to lie down peacefully. (Heat contention is the struggle between cold and heat. This describes external pathogenic factors invading the five Zang organs internally, contending with internal heat to form a severe disease. External pathogens invading the five Zang organs internally refer to what is stated in the *Yin Yang Ying Xiang Da Lun*: Heavenly pathogenic factors, upon invasion, harm the five Zang organs. Generally, wind and cold pathogens initially damage the skin and hair; if left untreated, they enter the muscle layers and then the meridians; if still untreated, they invade the five Zang organs internally. Thus it is said: Treating Zang organ diseases has a fifty-fifty chance of death or survival. Contending with internal heat to form severe disease refers to transmission and transformation mentioned in the *Yu Ji Zhen Zang Lun*, where entry does not follow the usual order. Worry, fear, grief, joy, and anger prevent orderly transmission, leading to major diseases. It means that while external wind-cold and internal Zang injury have a sequence, internal injury from the Five Emotions disrupts this order, causing major illness. Damage to Hun causes delirium. The East corresponds to Liver Wood; its disease manifests as fright and alarm. The Liver meridian spreads over the costal region, causing fullness and pain. Excessive wind-wood heat invades the four extremities. When one lies down, blood returns to the Liver; if Liver Qi is damaged and cannot store blood, one cannot sleep peacefully. Wang Zifang said: Cold transforms into heat, hence called heat contention.) Condition worsens on Geng-Xin days; profuse sweating on Jia-Yi days leads to recovery; if Qi rebels, death occurs on Geng-Xin days. (Disease in the Liver aggravates on Geng-Xin days. If not fatal on Geng-Xin, recovery begins on Jia-Yi days. Profuse sweating indicates righteous Qi overcoming pathogenic factors and expelling them outward. Qi rebellion indicates heat invading and reversing inward.) Needle the Foot-Jueyin (Liver) and Foot-Shaoyang (Gallbladder) meridians. (Huangdi asked: How difficult is the treatment of external diseases? Bogao answered: For diseases starting in the form without entering the Zang, reduce the needling days by half; for diseases starting in the Zang with subsequent form manifestation, double the needling days. This is the principle of treating external vs. internal difficulties. Form-first disease without Zang entry means external pathogens have not yet entered to contend with Zang heat. Zang-first disease with form response means Zang heat emerges to the form, corresponding to external heat. Pathogens aggregating and reversing inward are hard to treat; internal heat emerging to match the form is easy to cure with needling. Yang Yuanru said: This section is descriptive; it should be supported by sovereign-minister dialogues.) If Qi rebels, there is headache and dizziness, as if spinning, due to pulse Qi rushing to the head. (Yuan Yuan means rotation/spinning. This describes Liver heat manifesting externally, corresponding to form heat. Excessive heat reverses upward to the head, causing spinning headaches. Generally, the Three Yang meridians ascend to the head. Liver heat contends with Shaoyang, causing pulse Qi to rush upward. One must understand that disease in Qi relates to Pulse, and disease in Pulse relates to Qi; the pathway of Pulse and Qi requires deep contemplation.) Heart Heat Disease: First, unhappiness/melancholy; after several days, fever develops. (The emotion of the Heart is Joy, but Fear overcomes it. Initial unhappiness is due to Fear injury. The Heart is the Sovereign Official; Zang heat is a disorder of Spirit/Consciousness. Thus, the Heart is singled out to clarify that Zang heat diseases are disorders caused by the Five Emotions.) If heat contends, sudden heart pain, vexation, frequent vomiting, headache, red face, and absence of sweat occur. (External-internal contention, heat harassing the Spirit Zang, causes sudden pain. Shaoyin disease involves desire to vomit but inability, hence frequent vomiting. The Heart is Yang within Yang (Taiyang), causing headache. The Heart's brilliance manifests in the face, causing redness. The Heart governs Blood, hence no sweat. Dong Weiyuan said: Discussing heat contention requires viewing both internal and external symptoms.) Condition worsens on Ren-Gui days; profuse sweating on Bing-Ding days leads to recovery; if Qi rebels, death occurs on Ren-Gui days. (Heart disease aggravates on Ren-Gui days. If not fatal on Ren-Gui, recovery begins on Bing-Ding days. Rebellion means no improvement.) Needle the Hand-Shaoyin (Heart) and Hand-Taiyang (Small Intestine) meridians. (Hand-Shaoyin and Hand-Taiyang are exterior-interior pairs; needle both to drain heat.) Spleen Heat Disease: First, heavy head, cheek pain, heart vexation, blueish complexion, desire to vomit, and body heat. (Yin Qi ascends from the foot to the head, causing initial heaviness. the Yangming meridian traverses the cheeks, causing cheek pain. Spleen collaterals connect to the Heart, causing heart vexation and blueish complexion. Heat harasses the Stomach, causing desire to vomit. The Spleen governs muscles, causing body heat.) If heat contends, lower back pain preventing flexion and extension, abdominal fullness, diarrhea, and pain in both mandibles occur. (The Classic states: Yang diseases cause opisthotonos and inability to bend forward; Yin diseases cause inability to extend backward. Yang is Heaven Qi, governing exterior; Yin is Earth Qi, governing interior. Yin Zang heat inside, Yang heat outside, their contention causes lower back pain preventing movement. The abdomen is the enclosure of Spleen Earth, causing fullness and diarrhea. Stomach's fierce Qi rushes to the head, following the jaw to Renying, causing sub-mandibular pain.) Condition worsens on Jia-Yi days; profuse sweating on Wu-Ji days leads to recovery; if Qi rebels, death occurs on Jia-Yi days. (Spleen disease aggravates on Jia-Yi days. If not fatal on Jia-Yi, recovery begins on Wu-Ji days. Rebellion prevents outward expulsion via sweat.) Needle the Foot-Taiyin (Spleen) and Foot-Yangming (Stomach) meridians. (Foot-Taiyin and Foot-Yangming are exterior-interior pairs.) Lung Heat Disease: First, chills, erection of lanugo, aversion to wind and cold, yellow tongue coating, and body heat. (Skin and hair are the exterior of the Lung. Internal Zang heat causes external chills and aversion to wind/cold. Generally, extreme heat presents as cold. The Lung connects to the throat, causing yellow tongue. The True Qi of the Zang is high in the Lung, governing Ying and Wei Qi and Yin-Yang, causing body heat.) If heat contends, wheezing and coughing, pain radiating through the chest and back, inability to take deep breaths, unbearable headache, sweating with chills occur. (Heat harasses the Lung, causing wheezing, coughing, and dyspnea. The Lung governs Qi in the chest; Qi injury causes pain radiating through the chest and back. Among Zang organs, the Lung corresponds to Heaven. The Hand-Yangming meridian ascends to the head, causing unbearable headache. Heat contention inside causes sweating and subsequent chills. Wang Bing said: Lung collateral vessels connect to the ear, causing unbearable headache. Ni Chongzhi said: The Lung resides in the chest, with Shu points on the shoulder and back.) Condition worsens on Bing-Ding days; profuse sweating on Geng-Xin days leads to recovery; if Qi rebels, death occurs on Bing-Ding days. (Lung disease aggravates on Bing-Ding days. If not fatal on Bing-Ding, recovery begins on Geng-Xin days. Rebellion leads to death on the day of being overcome.) Needle the Hand-Taiyin (Lung) and Hand-Yangming (Large Intestine) meridians, bleed until the amount of blood is like a soybean, and it will stop immediately. (This states that needling the Six Meridians should always drain, never tonify. The Lung is the Chief of the Five Zang, used here to illustrate.) Kidney Heat Disease: First, lower back pain, soreness of the knees and shins, thirst with frequent drinking, and body heat. (The waist is the residence of the Kidney, causing initial back pain. The Kidney governs bones, causing knee/shin soreness. The Kidney is the Water Zang; fluids cannot nourish upwards, causing thirst and frequent drinking. Note: All five Zang heat diseases feature body heat, as internal heat moves from inside to outside. Zang heat contention mostly shows internal symptoms, as external heat contends inside.) If heat contends, neck pain and stiffness, aversion to cold with knee/shin soreness, heat in the soles of the feet, and reluctance to speak occur. (External heat in Taiyang causes headache and stiffness. Internal heat in the Kidney causes chills and knee/shin soreness. Heat in the soles is heat flowing into the Yin thigh. Reluctance to speak is because the Kidney is the source of generating Qi.) If Qi rebels, there is neck pain, dizziness, and dull, lingering pain. (Contending Qi rebelling upward causes neck pain. Dull and lingering pain is mild pain. The Bladder is the Kidney's residence; Taiyang is the master of all Yang Qi, ascending. Kidney heat follows Taiyang Qi to rush to the head. This is Yin-Yang heat contending internally and externally, following pulses and rising Qi, all Yin emerging to Yang, causing only headache without death.) Condition worsens on Wu-Ji days; profuse sweating on Ren-Gui days leads to recovery; if Qi rebels, death occurs on Wu-Ji days. (Kidney disease aggravates on Wu-Ji days. If not fatal on Wu-Ji, recovery begins on Ren-Gui days. Compliance leads to outward expulsion via sweat; rebellion leads to internal damage to the True Zang, causing death.) Needle the Foot-Shaoyin (Kidney) and Foot-Taiyang (Bladder) meridians. (Foot-Shaoyin and Foot-Taiyang are exterior-interior pairs. The Qi of the Five Zang and Six Fu organs is interconnected.) For all cases requiring sweating, sweating occurs on the day of their respective Overcoming (Sheng) phase. (The day the own Qi is prosperous is called the Overcoming day. Sweating allows heat to escape outward, leading to self-healing. This is "rising from its own position." Note: This section discusses combined syndromes of meridian Qi, hence "profuse sweating" and "sweating." Qi-level sweating is profuse; meridian-level sweating is slight.) Liver Heat Disease: Redness appears first on the left cheek. (This describes internal heat from the Five Emotions, which must first manifest in color. Each of the Five Colors has its location. Liver belongs to Wood and is located in the East, so redness appears first on the left cheek. Brightness and Five Colors are the brilliance of Qi. Worry, fear, anger, and resentment damage Qi; Qi damage harms the Zang, causing Zang disease. Since it is seen in color now, it is still at the Qi level. Hence, "Treat before disease arises." "Before disease" means the disease has not yet reached the Zang.) Heart Heat Disease: Redness appears first on the forehead. (The *Se Wu Pian* states: Que is between the eyebrows, Ting is the forehead. The head faces Que and Ting; the Royal Palace is at the lower pole. Heart combines with Fire and is located in the South, so redness appears first on the forehead. Yan refers to the forehead.) Spleen Heat Disease: Redness appears first on the nose. (Earth is located in the Center, so redness appears first on the nose.) Lung Heat Disease: Redness appears first on the right cheek. (Lung belongs to Metal and is located in the West, so redness appears first on the right cheek.) Kidney Heat Disease: Redness appears first on the chin. (The area below the cheeks is called Yi. Kidney belongs to Water and is located in the North, so redness appears first on the chin. This reflects post-heaven Bagua imagery.) Even if the disease has not fully manifested, if redness is seen, needle it. This is called "Treating Before Disease Arises." (Internal Zang heat must first manifest in color. "Disease not fully manifested" means sick but not yet contending with external heat. Seeing the color and immediately needle it is called "Needling Before Disease." It means when Zang Qi is diseased but the form has not responded, one should needle first to prevent Ying Qi contention and difficult-to-treat conditions.) Heat diseases arising from specific facial regions resolve by the expected time. (This reiterates that heat appearing first in color in the five Zang organs is easier to cure. "Region" refers to the face. Arising from the region, e.g., Liver heat with left cheek redness, resolves with profuse sweating on Jia-Yi days. This is disease in the fundamental Qi of the five Zang, not contending with external heat, so it resolves by the appointed time. In contrast, symptoms like yellow urine, abdominal pain, and body heat involve tangible form layers and may contend with external heat, posing risks of reversal.) If needling is done incorrectly (reversely), it takes three cycles (nine days) to resolve. Repeated reversal leads to death. ("Reverse" means turning reversal into compliance. If one fails to treat before disease arises, allowing internal-external contention and Qi reversal inward, urgent needling is required, resolving in three days. If not treated urgently, allowing internal-external Yin-Yang heat to heavily reverse inward leads to death. Note: Bogao said: Wind-cold damages form; emotions damage Qi; Qi damage harms Zang. Cold damages form, responding in form. This is the correspondence of form, Qi, exterior, and interior. Emperor asked: How to needle? Bogao answered: For nine-day diseases, three needleings suffice. Three needleings equal three cycles. Nine days indicate prolonged disease with internal-external contention.) For all cases requiring sweating, profuse sweating occurs on the Overcoming day. (This reiterates that heat diseases arising from facial regions resolve with profuse sweating by the appointed time. Overcoming day refers to the day the own Qi is prosperous, e.g., Jia-Yi for Liver, Bing-Ding for Heart.) For all treatments of heat diseases, drink cold water, then needle. Wear cold clothing, stay in cool places, and continue until the body feels cool. ("All heat" refers to the exterior Three Yang and interior Five Zang, with internal-external heat contention. Drinking cold water cools the interior. Cold clothing and places cool the exterior. Needling should continue until the body is cool.) Heat disease starting with chest/hypochondriac pain and hand/foot restlessness: Needle Foot-Shaoyang, Tonify Foot-Taiyin. (This outlines needling methods for external heat in the Three Yang. Chest/hypochondriac pain indicates Shaoyang onset. Foot-Shaoyang governs sinews; extreme heat causes spasm and restlessness. The *Ling Shu* states: For heat disease with restless limbs, select sinew areas. Thus, needle Foot-Shaoyang to drain Yang branch heat. Tonify Foot-Taiyin to resist incoming pathogens. When pathogens are in Shaoyang, the Three Yang represent daytime, and Taiyin is susceptible.) Severe cases: Use the Fifty-Nine Points. (Severe disease implies extreme Yang heat affecting the interior. The *Shui Re Xue Lun* states: Five rows of five points on the head disperse Yang heat. Dazhu, Ying Shu, Qianmen, Bei Shu (8 points) drain chest heat. Qichong, Zusanli, Shangjuxu, Xiajuxu (8 points) drain stomach heat. Yunmen, Guyu, Weizhong, Suikong (8 points) drain limb heat. Five points beside each Zang Shu (10 points) drain Zang heat. These 59 points are all related to treating heat. Emperor asked: Why does cold transform into heat? Bogao answered: Extreme cold generates heat. This means cold injuries become heat diseases; if heat is extreme in exterior Yang and enters the interior, use the 59 points. Note: *Kong Xue Yuan Jing* lacks Guyu point, has Jianyu point. Yaoshu is also named Suikong.) Heat disease starting with arm pain: Needle Hand-Yangming and Hand-Taiyin until sweating stops. (Upper body is governed by Hand-Taiyin and Hand-Yangming. Arm-onset heat is upper-body Yang disease. Thus, needle Hand-Yangming and Hand-Taiyin; Hand-Taiyin governs the exterior.) Heat disease starting with head pain: Needle Neck-Taiyang until sweating stops. (Head-onset is Taiyang disease. Needling the neck refers to Fengchi and Fengfu. Taiyang is master of Yang Qi, connected to Fengfu; needling induces sweating.) Heat disease starting with leg/calf pain: Needle Foot-Yangming until sweating stops. (Yang Qi originates from the exterior of the five toes. Leg-onset heat is Yang disease starting from below. Thus, needle Foot-Yangming to induce sweating.) Heat disease starting with heaviness, bone pain, deafness, and desire to close eyes: Needle Foot-Shaoyin. Severe cases: Use the Fifty-Nine Points. (This Yin-originating heat disease requires Foot-Shaoyin selection. Kidney governs bones and is the Qi source; Qi injury causes heaviness. Kidney opens into the ears, causing deafness. Shaoyin disease features drowsiness, causing desire to close eyes. Severe cases also use the 59 points. *Ling Shu* states: For heat disease with heaviness, bone pain, deafness, and drowsiness, select bones using the Fourth Needle (Five-Nine Bone Points). Foot-Shaoyin governs bones, so select bone points. Five-Nine Bone Points select empty bone acupoints. Shaoyang and Shaoyin govern pivots. Heat in Shaoyang can enter Yin interior; heat in Shaoyin can pivot outward. Thus, severe Yin/Yang branch diseases use the 59 points. Zhang Zhaohuang said: Shaoyang is governed by Fire Qi; Shaoyin by Heat Qi. Thus, diseases in Shaoyang/Shaoyin involve extreme heat.) Heat disease starting with dizziness, vertigo, fever, and chest/hypochondriac fullness: Needle Foot-Shaoyin and Foot-Shaoyang. (This describes the connection between Shaoyin and Shaoyang Qi. Yin-Yang exit/entry pivots. Dizziness/vertigo with fever indicates Shaoyang onset. Chest fullness suggests impending interior Yin entry. Thus, needle Foot-Shaoyin and Foot-Shaoyang to pivot outward. Note: The previous three sections use "first" sixteen times, indicating priority in treating internal, external, Qi-level, or color-manifested issues to prevent contention. Zhang Zhaohuang said: First section discusses Shaoyang heat; previous section Shaoyin heat; this section discusses Shaoyin-Shaoyang combination, i.e., Minister Fire and Sovereign Fire interaction.) Taiyang meridian color shining on the zygomatic bone indicates heat disease. If the color has not yet merged, and sweating is achieved now, wait for the appropriate time to resolve. If Taiyang and Jueyin meridian colors appear together, death will not exceed three days. (This discusses external Six Qi heat and internal five Zang heat, initially at the Qi level, not yet reaching the Collateral/Color level. Urgent sweating is needed to prevent internal-external merging. *Shang Han Lun* states: Taiyang disease features floating pulse. Taiyang pulse indicates Six Qi disease, starting in exterior Taiyang Yang, an external heat disease. Rong (Brilliance) refers to redness on the zygoma/cheeks, indicating internal five Zang heat manifesting in color. "Bone" means hidden in the skin. At this stage, Zang brilliance has not merged with exterior Yang Qi, nor has exterior heat merged with Zang Qi. Skilled physicians say: Taiyang disease can be resolved via exterior sweating. Internal Zang heat, even if unmanifested, if redness is seen, should be needle-treated ("Treat Before Disease"). If sweating is achieved now, waiting for the time suffices. If not resolved via sweating, Taiyang heat merges with Zang heat. If Taiyang and Jueyin pulses contend, death occurs within three days. Note: This aligns with *Yu Ji Zhen Zang Lun* on non-sequential transmission due to emotional injury. Exterior pathogens start in Taiyang, transmitting sequentially. Non-sequential entry is due to Five Emotions injuring the five Zang. Taiyang-Jueyin pulse contention indicates Taiyang heat merging with Liver heat. Taiyang is the beginning of Yang; Jueyin is the end of Yin. Their contention represents exterior pathogens entering non-sequentially with Zang heat. Yang-Yin pulse contention is a death sign, so all five Zangs need not be listed. Understand: Exterior Yang heat progresses Qi -> Meridian -> Zang; Zang heat progresses Qi -> Meridian -> Exterior. Heat exiting to Yang branch survives; heat heavily reversing to Yin Zang dies. First section: Internal heat contending with external; this section: External heat contending with internal.) If heat connects internally to the Kidney, it is the color of the Shaoyang meridian. (This describes exterior Yang heat contending with Zang heat, non-sequentially entering, specifically connecting Shaoyang and Kidney. *Ben Shu Pian* states: Shaoyang belongs to Kidney. Shaoyang Qi originates from the Kidney; thus, heat connecting to the Kidney manifests as Shaoyang meridian color.) Shaoyang meridian color shining on the front of the cheek indicates heat disease. If the color has not yet merged, and sweating is achieved now, wait for the appropriate time to resolve. If Shaoyang and Shaoyin meridian colors appear together, death [occurs].