帝与岐伯，论脉之大要，着之玉版。藏之脏腑，每旦读之，名曰玉机，故名《玉机真脏论》。玉机者，
心之神机，真脏者，藏之元真，神机转而不回，藏真脏而不见，若回则不转，真脏脉见，则
死。帝反复申详，以明玉机真脏之义。
黄帝问曰∶春脉如弦，何如而弦？
承上编弦钩毛石，而问所以致弦之故。
岐伯对曰∶春脉者，肝也，东方木也，万物之所以始生也。故其气来，软弱轻唐而滑，端直以长，
故曰弦，反此者病。
帝曰∶何如而反？
春时反脉何如？
岐伯曰∶其气来突而强，此谓太过，病在外，其气来不实而微，此谓不及病在中。
气，脉气也，太过则外强。故病在外。不及则内虚，故病在中。
帝曰∶春脉太过与不及，其病皆何如？
太过在外，不及在中，皆为何病？
岐伯曰∶太过则令人善忘，忽忽眩冒而巅疾。其不及，则令人胸痛引背，下则两胁 满。
肝脉太过，则令人善忘。伤寒论云∶本有久瘀血，故令喜忘。
忽忽眩冒者，风木上乘也。巅疾者。肝合督脉会于巅顶也。其肝脉不及，不能贯膈注肺，则令人胸痛引背，
不能合少肠而枢转，下则两胁 满。
帝曰∶善。夏脉如钩，何如而钩？岐伯曰∶夏脉者，心也，南方
火也，万物之所以盛长也，故其气来盛去衰，故曰钩，反此者病。
长，上声下同。来盛者，夏火之有余也；去衰者，如钩环转，
稍末轻微也。此胃而有钩，故名曰钩。若夏时而反此脉者病。
帝曰∶何如而反，岐伯曰∶其气来盛，去亦盛，此谓太过，病在外；其气来不盛，
去反盛，此谓不及，病对中。
来盛去亦盛，则脉气太过，故病在外；来不盛，则里气内虚，去反盛，则胃气不谐，此脉气不及，故病在中。
帝曰∶夏脉太过与不及，其病皆如何？岐伯曰∶太过，则令人
身热而肤痛，为浸淫；其不及，则令人烦心，上见咳唾，下为气泄。
心脉太过，则火气外浮，故令人身热而肤痛，热伤肤表，故为浸泾而成疮；其心脉不及，则心气内
虚，故令人烦心，虚于上，则见咳唾，咳唾，咳唾涎沫也；虚于下，则为气泄，气泄者，后气下泄也。
帝曰∶善。秋脉如浮，何如而浮？岐伯曰∶秋脉者，肺也，西
方金也，万物之所以收成也。故其气来轻虚以浮，来急去散，故曰浮，反此者病。
轻虚以浮，毛而浮也，来急去散，则从内而毛浮于外，胃而有毛，故名曰浮。若秋时而反此脉者病。
帝曰∶何如而反？岐伯曰∶其气来毛，而中央坚，两旁虚，此
谓太过，病在外；其气来毛而微，此谓不及，病在中。
毛脉而中央坚，两旁虚，则脉气太过，故病在外，毛脉而复微，此脉气不及，故病在中。
帝曰∶秋脉太过与不及，其病皆何如？岐伯曰∶太过刚令人逆
气而背痛，愠愠然，其不及，则令人喘，呼吸少气而咳，上气见血，
下闻病音。
肺俞在背，肺脉太过，故令人逆气而背痛，肺气内郁，故愠愠然；肺脉不及，则内虚，故令人喘，
其呼出吸入皆少气，而咳，咳伤肺络，则上气见血，气上不下，则下闻病音。病音，呻吟声也。呻吟者，下虚也。
帝曰∶善。冬脉如营，何如而营？岐伯曰∶冬脉者，肾也，北
方水也，万物之所以合藏也。故其气来沉以转，故曰营，反此者病。
藏，如字。营，犹石也，深藏之义也。转，转聚也。沉以转，此胃而有营，故名曰营。若冬时而
反此脉者病。
帝曰∶何如而反？岐伯曰∶其气来如弹石者，此谓太过，病在外。其去如数者，此谓不及，病在中。
数，音朔。来如弹石者，上下有力而强硬也，此脉气太过，故病在外，其去如数者，弹石一至而即去，
去之疾也，此脉气不及，故病在中。
帝曰∶冬脉太过与不及，其病皆何如？岐伯曰∶太过则令人解 ，春脉痛，而少气，不欲言，其
不及，则令人心悬，如病饥，眇中清，春中痛，少腹满，小便变。帝曰∶善。
眇，抄同，音渺，余篇仿此。解 ，犹懈怠也。眇中，胁骨之未，助稍处也。清，微冷也。肾脉太
过，则水寒之气外盛，故令人解 。春脉痛，水寒有余，火气不足，故少气不欲言。其肾脉不及，
则水不济火，故令人心悬如病饥，火不济水，故眇中清，春中痛，少腹满，小便变。
帝曰∶四时之序，逆从之变异也。然脾脉独何主？
总承上文而言，春夏秋冬四时之序，逆其所从，而有脉病之变
异也，然四时之脉，止合四脏，而脾脉独何至？
岐伯曰∶脾脉者，土也，孤脏以灌四旁者也。
土至四时，各十八日，脾脉属土，位居中央，不得独主于时，故为孤脏，以灌四旁者也。
帝曰∶然则脾善恶，可得见之乎？岐伯曰∶善者不可得见，恶者可见。
脾脉之善，在于各脏，故善者不可得见，脾脉不濡，则诸脏有太过不及，故恶者可见。
帝曰∶恶者如何可见？岐伯曰∶其来如水之流者，此谓太过，病在外；如鸟之喙者，此谓不及。病在中。
灌溉太过，脾气之来，如水之流者，则湿气浸淫，此谓土湿太过，病当在外；灌溉不及，脾气不舒，
如鸟之喙者，则坚劲自止，此谓土气不及，病当在中，凡其皆可见也。
帝曰∶夫子言脾为孤脏，中央土，以灌四旁。其太过与不及，其病皆何如？
上文岐伯云∶脾脉者土也，孤脏以灌四旁，帝举其言，问太过不及之病，其病在脾者，皆何如？
岐伯曰∶太过，则令人四肢不举；其不及，则令人九窍不通，名曰重强。
重，平声。强，去声。脾脉太过，湿气浸淫，流于四末，则令人四肢不举，脾脉不及，坚劲自止，不
能灌溉，则令人九窍不通，脾脉不和，而四肢不举，脾脉不和而九窍不通，是脾病而上下四旁
皆病，故名曰重强。强，不和也。
帝瞿然而起，再拜而稽首曰∶善。吾得脉之大要，天下至数，五色脉变，揆度奇恒，道在于一，神
转不回，回则不转，乃失其机，至数之要，迫近以微，着之玉版、藏之脏腑，每旦读之，名曰玉机。
度，入声。上藏，如字。瞿然，惊顾貌。脏腑，密室也。帝闻岐伯之言，瞿然惊顾而起，再拜稽
首，而善其说，谓吾今乃得脉之大要，因举《玉版论要》之言，以发明之，天下至数，道之广也，五
色脉变，理之微也，揆度奇恒，治之善也。道在于一，神相守也。神机营运，左旋右起，是神转不回。
若右旋左起，是回则不转，不转乃失其营运不息之机，而有下文之病死也。然此至数，无容外
求。故曰至数之要，迫近以微。迫近，色脉也；以微，神机也。史臣复记黄帝以脉之大要而着之玉版，
藏之脏腑，每旦读之，名曰玉机。机，神机也；着之玉版，故曰玉机。此一节，言以脉之大要，
着之玉版，所以名为玉机也。
黄帝曰∶五脏受气于其所生，传之于其所胜。气舍于其所生，死于其所不胜，病之且死，必先传
行，至其所不胜，病乃死。此言气之逆行也，故死。
“黄帝曰”三字，旧本在五脏相通上，今改正于此。受当作授，下同。脉之大要，有正脉、病脉、
死脉。五脏之气，有正气、病气、死气。故帝举五脏而复论之。五脏授气于其所生者，五脏正
气，授于所生之子也，传之于其所胜者，五脏病气，传于己所胜之脏也。我生生我，皆为所生，气舍于其
所生者，五脏正气，舍于所生之母也。死于其所不胜者，五脏死气，死于受克，乃己所不胜之
脏也。凡此四者，下文复申详之，而病之且死，不遽死也。必先传行于诸脏，后至其所不胜之脏，则病
乃死。又申明此之传行，乃言气之逆行也，故死。
肝受气于心，传之于脾，气舍于肾，至肺而死。心受气于脾，传之于肺，气舍于肝，至肾而死。
脾受气于肺，传之于肾，气舍于心，至肝而死。肺受气于肾，传之于肝，气舍于脾，至心而死。肾
受气于肝，传之于心，气舍于肺，至脾而死。此皆逆死也。一日一夜五分之。此所以占死生之早暮也。
此承上文而申言之。五脏授气于其所生者，如肝授气于心，是授气于我生之子也。传之于其所胜者，肝
传之于脾，是传于己所胜之土也。气舍于其所生者，肝气舍于肾，舍于生我之母也。死于其
所不胜者，肝至肺而死，死于己所受克之脏也。心授气于脾，授气于我生之子也，心传之于肺，传之于其所
胜也，心气舍于肝，舍于生我之母也，心至肾而死，死于其所不胜也。脾授气于肺，授气于所生之子也，
传之于肾，传之于其所胜也，气舍于心，舍于所生之母也，至肝而死，死于其所不胜也。肺授气于肾，
授气于所生之子
也，传之于肝，传之于其所胜也，气舍于脾，舍于所生之母也，至心而死，死于其所不胜也。肾授气于肝，
授气于所生之子也，传之于心，传之于其所胜也，气舍于肺，舍于所生之母也，至脾而死，
死于其所不胜也。上文云，此言气之逆行也，故死。故曰∶此皆逆死也。一日一夜，气合四时，以五行而
五分之，可以占死生之早暮也。五分者，寅卯主木，巳午主火，申酉主金，亥子主水，辰戌丑
未主土。肝至肺而死，死于申酉；心至肾而死，死于亥子；脾至肝而死，死于寅卯；肺至心而死，死于巳
午；肾至脾而死，死于辰戌丑未也。
五脏相通，移皆有次。五脏有病，则各传其所胜，不治，法三月，若六月，若三日，若六日，传
五脏而当死，是顺传所胜之次。
此亦申明上文之义，言顺传所胜，亦死也。上文五脏授气其所生，气舍于其所生者，乃五脏相通，而
移皆有次也，肝心脾肺肾，以次相通，相通而授气之所在，即气舍之所在也。上文传之于其所
胜者，乃五脏有病，则各传其所胜也。木土水火金，相胜而传，传之为所胜，则受传即为所不胜也。上文
病之且死，必先传行，是当治之，若不治，则法三月，若六月，若三日，若六日，传五脏而当
死。法三月者，病在于肝，越夏三月，至秋则金克木而死。若六月者，病在于肝，剧于孟春，越春夏六月，
至秋，则金克木而死。五脏仿此，可以类推。若三日者，肝病土虚，剧于戊巳，从戊至庚，
三日也，至辛则肺金克脾，故三日乃死，若六日者，肝病木虚，剧于甲乙，从甲至己，六日也，至庚则
木受金刑，故六日乃死，五脏仿此，亦可类推。夫四时之五行，十干之五行，皆木火土金水，以
次相生，此三月六月，三日六日，传五脏而死，是顺传而有所胜之次，不若上文气之逆行而死也。
故曰∶别于阳者，知病从来，别于阴者，知死生之期，言知至其所困，乃死。
引《阴阳别论》之言，以明上文病死，言当知至其所困乃死。困，受克也。
是故风者，百病之长也。今风寒客于人，使人毫毛毕直，皮肤闭而为热，当是之时，可汗而发也。
病之从来，由外而内；是故风者，百病之长也。今风寒客于人，从毫毛而入于皮肤，故使人毫毛毕直，
然后皮肤闭拒而为热，当是之时，知病从来，可汗而发散其风寒也。
或痹不仁，肿痛，当是之时，可汤熨，及火灸刺，而去之。
痹，痿痹。不仁，强急。肿，痛肿也。或痹不仁，邪入于经脉也。肿痛，邪伤其肌肉也。当是之时，
知病从来，可汤熨，及火灸刺，而散去之。
弗治，病入舍于肺，名曰肺痹，发咳上气。
病腑弗治，则入于脏∶故病入舍于肺，名曰肺痹。言邪入于肺，而为痹也。肺痹，则发咳上气。
弗治，肺即传而行之肝，病名曰肝痹。一名曰，厥胁痛，出食。当是之时，可按，若刺耳。
病肺弗治，肺即传所胜而行之肝，病名曰肝痹，肝脉布胁肋，肝气厥逆，故一名曰厥胁痛。食气入胃，
散精于肝，肝气逆，故出食，当病肝之时，气血不和，则可按摩，若针刺耳。
弗治，肝传之脾，病名曰脾风、发瘅，腹中热，烦心，出黄，当此之时，可按、可药、可浴。
病肝弗治，肝即传所胜而行之脾，风木伤脾，火气乃生，故病名曰脾风发瘅。腹中热，热邪上蒸，则
烦心，热邪下泄，则溺出黄。当病脾之时，脾络不通，可按摩以通之。脾气内虚，可甘药以
补之。脾湿不行，可汤浴以散之。
弗治，脾传之肾，病名曰疝瘕。少腹冤热而痛，出白，一名曰蛊，当此之时，可按、可药。
病脾弗治，脾即传所胜而行之肾。水湿下凝，故病名曰疝瘕，疝瘕在少腹之处，故少腹冤热而痛。
冤热，热极无伸也。少腹热痛，内则虚寒，故溺出白，此疝瘕之病，外实，内虚。故一名曰蛊。当
脾病传肾之时，亦可按而可药。
弗治，肾传之心，病筋脉相引而急，病名日 。当此之时，可灸、可药。弗治，满十日，法当死。
，音炽，余篇同。病肾弗治，肾即传所胜而行之心，心主血脉，血不荣筋，故病筋脉相引而急。
引急者，拘牵之意，故病名曰 。 ，搐搦也。当肾病传心之时，亦可灸、可药。若失而弗治，满十日，法当
死。十日则十干尽，而五脏周，故死。
肾因传之心，心即复反感而行之肺，发寒热，法当三岁死，此病之次也。
黄帝与岐伯讨论脉象的要领，将其记载在玉版上，收藏于脏腑之中，每天早晨诵读，命名为《玉机》，因此篇名为《玉机真脏论》。所谓“玉机”，是指心脏的神机（生命活动的内在动力）；所谓“真脏”，是指脏腑的元气。神机运转而不逆转，脏腑的真气不显露于外；如果神机逆转则无法运转，当真脏脉出现时，病人就会死亡。黄帝反复陈述并详细说明，以阐明玉机和真脏的含义。
黄帝问道：春季的脉象像琴弦一样，怎样的脉象才算是弦脉？
这是承接上文关于弦、钩、毛、石四种脉象的论述，询问导致弦脉的原因。
岐伯回答说：春季的脉象对应肝脏，属于东方五行中的木，是万物开始生长的季节。所以其脉气来时，软弱轻虚而滑利，端正且长，所以称为弦脉；与此相反的则是病脉。
岐伯说：如果脉气来势急促而强劲，这叫做“太过”，病邪在体表；如果脉气来势不实而微弱，这叫做“不及”，病邪在体内。
这里所说的“气”指脉气。太过则体表强盛，所以病在表；不及则内部虚弱，所以病在里。
黄帝问：春季脉象的太过和不及，分别会导致什么疾病？
太过在表，不及在里，分别是什么病症？
岐伯说：脉气太过，会让人容易健忘，恍惚眩晕甚至头部疾病。如果脉气不及，会让人胸痛牵引背部，向下则两胁胀满。
肝脉太过，会导致健忘。《伤寒论》中说：因为原本有久瘀血，所以让人喜欢健忘。
恍惚眩晕，是因为风木之气上乘头目。头部疾病，是因为肝经与督脉会合于头顶。如果肝脉不及，不能贯穿膈肌注入肺脏，就会导致胸痛牵引背部；不能与少阳枢机相合而转输气机，向下则导致两胁胀满。
黄帝说：好。夏季的脉象像钩子一样，怎样的脉象才算是钩脉？
岐伯说：夏季的脉象对应心脏，属于南方五行中的火，是万物盛大生长的季节。所以其脉气来时旺盛而去时衰弱，所以称为钩脉；与此相反的则是病脉。
“长”读上声，以下同。来势旺盛，是夏季火气有余的表现；去势衰弱，就像钩环旋转，末端轻微。这是胃气兼有钩象，所以名叫钩脉。如果在夏季出现相反的脉象，就是病态。
黄帝问：怎样才是相反的情况？
岐伯说：如果脉气来势旺盛，去势也旺盛，这叫做“太过”，病邪在体表；如果脉气来势不旺盛，去势反而旺盛，这叫做“不及”，病邪在体内。
来势旺盛去势也旺盛，说明脉气太过，所以病在表；来势不旺盛，说明里气内虚，去势反而旺盛，说明胃气不协调，这是脉气不及，所以病在里。
黄帝问：夏季脉象的太过和不及，分别会导致什么疾病？
岐伯说：脉气太过，会让人身体发热且皮肤疼痛，发展为浸淫疮疡；如果脉气不及，会让人心烦，向上表现为咳嗽吐痰，向下表现为气泄（如二便失禁或气短下陷）。
心脉太过，则火气外浮，所以让人身体发热且皮肤疼痛，热邪损伤肤表，所以发展为浸淫疮疡；如果心脉不及，则心气内虚，所以让人心烦。虚于上部，则见咳嗽吐痰（咳唾涎沫）；虚于下部，则为气泄（后气下泄）。
黄帝说：好。秋季的脉象像浮毛一样，怎样的脉象才算是浮脉？
岐伯说：秋季的脉象对应肺脏，属于西方五行中的金，是万物收获的季节。所以其脉气来时轻虚而浮，来势急而去势散，所以称为浮脉；与此相反的则是病脉。
轻虚而浮，即毛脉而浮。来势急而去势散，是从内部向外发散，兼有胃气的毛象，所以名叫浮脉。如果在秋季出现相反的脉象，就是病态。
黄帝问：怎样才是相反的情况？
岐伯说：如果脉气像毛一样，但中间坚实两边空虚，这叫做“太过”，病邪在体表；如果脉气像毛一样但微弱，这叫做“不及”，病邪在体内。
毛脉而中间坚实两边空虚，说明脉气太过，所以病在表；毛脉而又微弱，说明脉气不及，所以病在里。
黄帝问：秋季脉象的太过和不及，分别会导致什么疾病？
岐伯说：脉气太过，会让人气逆而背痛，心中郁闷不快；如果脉气不及，会让人气喘，呼吸短促而咳嗽，气逆吐血，下部能听到呻吟声。
肺俞穴在背部，肺脉太过，所以让人气逆而背痛，肺气内郁，所以心中郁闷；肺脉不及，则内部虚弱，所以让人气喘，呼气和吸气都气短，并且咳嗽，咳嗽伤及肺络，则气逆吐血，气上不下，所以下部能听到呻吟声。呻吟声，是由于下部虚弱所致。
黄帝说：好。冬季的脉象像营室星（或深藏之象）一样，怎样的脉象才算是营脉？
岐伯说：冬季的脉象对应肾脏，属于北方五行中的水，是万物闭藏的季节。所以其脉气来时沉而圆滑，所以称为营脉；与此相反的则是病脉。
“藏”字照原字读。“营”通“石”，意为深藏。转，指圆转聚积。沉而圆转，兼有胃气的营象，所以名叫营脉。如果在冬季出现相反的脉象，就是病态。
黄帝问：怎样才是相反的情况？
岐伯说：如果脉气来时像弹石一样坚硬，这叫做“太过”，病邪在体表；如果脉气去时急促，这叫做“不及”，病邪在体内。
“数”读朔音。来势像弹石，上下有力且强硬，这是脉气太过，所以病在表；去势像数脉，弹石一下即去，去势疾速，这是脉气不及，所以病在里。
黄帝问：冬季脉象的太过和不及，分别会导致什么疾病？
岐伯说：脉气太过，会让人肢体懈怠无力，春季脉痛，气少不想说话；如果脉气不及，会让人心里空虚感像饥饿一样，胁肋间清冷，脐中疼痛，小腹胀满，小便异常。
“眇”通“抄”，音渺，其他篇章仿此。“解㑊”，犹言懈怠。“眇中”，指肋骨尽头，季胁稍处。“清”，微冷。肾脉太过，则水寒之气外盛，所以让人肢体懈怠。春季脉痛，是因为水寒有余，火气不足，所以气少不想说话。如果肾脉不及，则水不能济火，所以让人心里空虚像生病饥饿；火不能济水，所以胁肋间清冷，脐中疼痛，小腹胀满，小便异常。
黄帝说：四季的顺序，有顺逆变异。然而脾脉独自主司什么？
总括上文而言，春夏秋冬四季的顺序，违背其所从属的规律，就有脉象和疾病的变异。然而四时的脉象只对应四脏，脾脉独自对应什么？
岐伯说：脾脉属于土，是孤独的脏器，用来灌溉四方（其他四脏）。
土行旺于四季之末各十八日，脾脉属土，位居中央，不能单独主宰一个季节，所以称为孤脏，用来灌溉四方。
黄帝问：那么脾脉的好坏，可以看出来吗？
岐伯说：好的脾脉看不出来，坏的脾脉可以看出来。
脾脉的好，体现在其他各脏的功能正常上，所以好的脾脉不可见；如果脾脉不濡润，则其他各脏会出现太过或不及，所以坏的脾脉可见。
黄帝问：坏的脾脉如何看出来？
岐伯说：如果脉气像水流一样奔涌，这叫做“太过”，病邪在体表；如果脉气像鸟嘴一样坚劲，这叫做“不及”，病邪在体内。
灌溉太过，脾气来势像水流，则湿气浸淫，这叫土湿太过，病在表；灌溉不及，脾气不舒展，像鸟嘴一样坚劲自止，这叫土气不及，病在里。这些情况都是可见的。
黄帝问：先生曾说脾为孤脏，居中央属土，用来灌溉四方。它的太过和不及，分别会导致什么疾病？
上文岐伯说：脾脉属土，是孤脏以灌溉四方。黄帝引用他的话，问太过不及的疾病，如果是脾本身的病变，是怎样的？
岐伯说：脉气太过，会让人四肢不能举动；如果脉气不及，会让人九窍不通，名叫“重强”。
“重”读平声，“强”读去声。脾脉太过，湿气浸淫，流注于四肢末端，所以让人四肢不能举动；脾脉不及，坚劲自止，不能灌溉，所以让人九窍不通。脾脉不和，导致四肢不能举动，脾脉不和导致九窍不通，这是脾病而上下四方都受累，所以名叫“重强”。强，指不和。
黄帝惊讶地起身，再拜叩头说：好。我得到了脉象的要领，这是天下的至理，观察五色和脉象的变化，衡量正常与异常，道理在于一个“神”字。神机运转而不逆转，逆转则不运转，这样就失去了生机。至理的要点，迫近而微妙，记载在玉版上，收藏于脏腑，每天早晨诵读，名叫玉机。
“度”读入声。“上藏”照原字读。“瞿然”，惊顾的样子。“脏腑”，此处指密室。黄帝听了岐伯的话，惊顾而起，再拜叩头，称赞他的学说，说我现在才得到脉象的要领，于是引用《玉版论要》的话加以阐发。天下的至理，道的广博；五色脉变，理的微妙；衡量奇恒，治疗的善法。道理在于一个“一”字，神相守持。神机营运，左旋右起，这就是神转不回。如果右旋左起，就是回则不转，不转就失去了营运不息的生机，从而有下文所述的病死。然而这个至理，不需要向外寻求。所以说至理的要点，迫近而微妙。迫近，指色脉；微妙，指神机。史官再次记录黄帝将脉象的要领记载在玉版上，收藏于脏腑，每天早晨诵读，名叫玉机。机，指神机；记载在玉版上，所以叫玉机。这一节，是说将脉象的要领记载在玉版上，所以命名为玉机。
黄帝说：五脏接受气于它所生的脏（子），传送给它所克的脏（胜）。气停留于生它的脏（母），死于它所不胜的脏（克我者）。病情快要死亡时，必定先传行，到达它所不胜的脏，病人才会死。这是说的气的逆行，所以致死。
“黄帝曰”三字，旧本在“五脏相通”之上，现在改正到这里。“受”当作“授”，以下同。脉象的要领，有正脉、病脉、死脉。五脏之气，有正气、病气、死气。所以黄帝列举五脏又加以论述。五脏将气授予它所生的脏，是五脏的正气授予所生的子脏；传送给它所克的脏，是五脏的病气传给它所克的脏。我生者和生我者，都称为“所生”。气停留于生它的脏，是五脏的正气停留在生它的母脏。死于它所不胜的脏，是五脏的死气死于受克，即死于它自己所不胜的脏。以上四种情况，下文再详细陈述，而病情快要死亡时，不会立即死亡，必定先传行于各脏，最后到达它所不胜的脏，病人才会死。又申明这种传行，是气的逆行，所以致死。
肝接受气于心，传送给脾，气停留于肾，到肺而死。心接受气于脾，传送给肺，气停留于肝，到肾而死。脾接受气于肺，传送给肾，气停留于心，到肝而死。肺接受气于肾，传送给肝，气停留于脾，到心而死。肾接受气于肝，传送给心，气停留于肺，到脾而死。这些都是逆死。一天一夜分为五段。借此可以占测死亡的早晚。
这是承接上文进一步说明。五脏将气授予它所生的脏，如肝将气授予心，是授予我生的子脏。传送给它所克的脏，肝传送给脾，是传给己所克的土脏。气停留于生它的脏，肝气停留于肾，是停留在生我的母脏。死于它所不胜的脏，肝到肺而死，是死于己所受克的脏。心将气授予脾，是授予我生的子脏；心传送给肺，是传给它所克的脏；心气停留于肝，是停留在生我的母脏；心到肾而死，是死于它所不胜的脏。脾将气授予肺，是授予所生的子脏；传送给肾，是传给它所克的脏；气停留于心，是停留在所生的母脏；到肝而死，是死于它所不胜的脏。肺将气授予肾，是授予所生的子脏；传送给肝，是传给它所克的脏；气停留于脾，是停留在所生的母脏；到心而死，是死于它所不胜的脏。肾将气授予肝，是授予所生的子脏；传送给心，是传给它所克的脏；气停留于肺，是停留在所生的母脏；到脾而死，是死于它所不胜的脏。上文说，这是气的逆行，所以致死。所以说：这些都是逆死。一天一夜，气结合四时，按五行分为五段，可以占测死亡的早晚。五分者，寅卯主木，巳午主火，申酉主金，亥子主水，辰戌丑未主土。肝传到肺而死，死于申酉时；心传到肾而死，死于亥子时；脾传到肝而死，死于寅卯时；肺传到心而死，死于巳午时；肾传到脾而死，死于辰戌丑未时。
五脏相通，转移都有次序。五脏有病，则各自传送给它所克的脏，如果不治疗，按照规律三个月，或者六个月，或者三天，或者六天，传遍五脏就会死，这是顺传所克的次序。
这也是申明上文的意思，说顺传所克也会死。上文五脏将气授予它所生的脏，气停留于生它的脏，乃是五脏相通，而转移都有次序。肝心脾肺肾，依次相通，相通而授气的所在，就是气停留的所在。上文传送给它所克的脏，乃是五脏有病，则各自传送给它所克的脏。木土水火金，相克而传，传为所克，则受传者即为所不胜者。上文说病情快要死亡时，必定先传行，应当治疗，如果不治疗，则按照规律三个月，或者六个月，或者三天，或者六天，传遍五脏就会死。所谓三个月，病在肝，越过夏季三个月，到秋天则金克木而死。所谓六个月，病在肝，剧烈于孟春，越过春夏六个月，到秋天，则金克木而死。五脏仿此类推。所谓三天，肝病土虚，剧烈于戊己日，从戊到庚，是三天，到辛日则肺金克脾，所以三天乃死。所谓六天，肝病木虚，剧烈于甲乙日，从甲到己，是六天，到庚日则木受金刑，所以六天乃死，五脏仿此类推。四时的五行，十天干的五行，都是木火土金水，依次相生。这三个月、六个月、三天、六天，传遍五脏而死，是顺传而有所克的次序，不如上文气的逆行而死那样严重。
所以说：辨别阳分，知道病的来源；辨别阴分，知道死生的期限，意思是知道病发展到它所困顿（受克）的地方，就会死。
引用《阴阳别论》的话，来说明上文病死，说要等到病发展到它所困顿的地方才会死。困，指受克。
所以风邪，是百病的先导。如今风寒侵入人体，使人毫毛全部竖立，皮肤闭塞而发热，在这个时候，可以用发汗的方法治疗。
病的来源，由外而内；所以风邪是百病的先导。如今风寒侵入人体，从毫毛进入皮肤，所以使人毫毛全部竖立，然后皮肤闭拒而发热，在这个时候，知道病的来源，可以用发汗法发散风寒。
或者出现痹症、麻木不仁、肿痛，在这个时候，可以用汤药热敷，以及火灸针刺，来去除病邪。
痹，指痿痹。不仁，指强急麻木。肿，指痛肿。或者痹症不仁，是邪气进入经脉。肿痛，是邪气伤害肌肉。在这个时候，知道病的来源，可以用汤药热敷，以及火灸针刺，来散去病邪。
如果不治疗，病邪进入肺脏，名叫肺痹，发作咳嗽和气逆。
病在腑不治疗，则进入脏；所以病邪进入肺脏，名叫肺痹。意思是邪气进入肺，形成痹证。肺痹，则发作咳嗽和气逆。
如果不治疗，肺脏随即传送给肝脏，病名叫肝痹。又名厥，胁痛，呕吐食物。在这个时候，可以进行按摩，或者针刺耳部穴位。
病在肺不治疗，肺随即传送给它所克的肝，病名叫肝痹。肝脉布于胁肋，肝气厥逆，所以又名厥，胁痛。饮食之气进入胃，散布精气于肝，肝气逆乱，所以呕吐食物。当患肝病时，气血不和，可以按摩，或者针刺耳部穴位。
如果不治疗，肝脏传送给脾脏，病名叫脾风，发作黄疸，腹中热，心烦，尿黄。在这个时候，可以按摩，可以服药，可以洗浴。
病在肝不治疗，肝随即传送给它所克的脾，风木伤害脾，火气乃生，所以病名叫脾风发作黄疸。腹中热，热邪上蒸，则心烦；热邪下泄，则尿黄。当患脾病时，脾络不通，可以按摩以疏通它。脾气内虚，可以用甘味药物补益。脾湿不行，可以用汤浴来散发它。
如果不治疗，脾脏传送给肾脏，病名叫疝瘕。小腹部冤热而痛，尿出白色液体，又名蛊。在这个时候，可以按摩，可以服药。
病在脾不治疗，脾随即传送给它所克的肾。水湿下凝，所以病名叫疝瘕。疝瘕在小腹部，所以小腹部冤热而痛。冤热，指热极无法伸展。小腹痛，内则虚寒，所以尿出白色液体。这是疝瘕的病，外实内虚。所以又名蛊。当脾病传肾时，也可以按摩和服药。
如果不治疗，肾脏传送给心脏，病名筋脉牵引拘急，名叫痓。在这个时候，可以艾灸，可以服药。如果不治疗，满十天，按规定应当死亡。
“痓”音炽，其他篇章同。病在肾不治疗，肾随即传送给它所克的心。心主血脉，血不能荣养筋脉，所以病名筋脉牵引拘急。引急，指拘牵之意，所以病名叫痓。痓，指抽搐。当肾病传心时，也可以艾灸和服药。如果失治不治疗，满十天，按规定应当死亡。十天则十天干尽，而五脏周遍，所以死。
The Yellow Emperor and Qibo discussed the essentials of pulse diagnosis, recorded them on jade tablets, stored them within the Zang-Fu organs, and read them every morning. They named it "Yu Ji" (Jade Machine), hence the chapter title "Treatise on the Jade Machine and True Visceral Pulses" (Yùjī Zhēnzàng Lùn). The term "Yu Ji" refers to the Shen Ji (Divine Mechanism, the intrinsic dynamic of life) of the Heart; "Zhen Zang" (True Viscera) refers to the Yuan Zhen (Primordial Truth/Essence) of the viscera. The Divine Mechanism rotates without reversing; the True Essence of the viscera does not appear externally. If it reverses, rotation ceases; when the True Visceral Pulse appears, death ensues. The Yellow Emperor repeatedly elaborated to clarify the meaning of the Jade Machine and True Visceral Pulses.
The Yellow Emperor asked: "The spring pulse is like a string. What constitutes a string-like pulse?"
This follows the previous discussion on the four pulses (string, hook, hair, stone) and asks for the cause of the string-like pulse.
Qibo replied: "The spring pulse corresponds to the Liver, which belongs to Wood in the East, and is the season when all things begin to grow. Therefore, its qi comes soft, light, deficient yet slippery, straight and long, so it is called 'string'. The opposite of this indicates disease."
The Yellow Emperor asked: "What constitutes the opposite?"
i.e., what does an abnormal pulse look like in spring?
Qibo said: "If the qi comes rapid and strong, this is called 'Excess' (Tai Guo), with disease located externally; if the qi comes weak and faint, this is called 'Deficiency' (Bu Ji), with disease located internally."
Here, 'qi' refers to pulse qi. Excess implies external strength, hence disease is external; Deficiency implies internal weakness, hence disease is internal.
The Yellow Emperor asked: "For the spring pulse, what diseases result from Excess and Deficiency respectively?"
Excess is external, Deficiency is internal; what are the specific diseases?
Qibo said: "Excess causes forgetfulness, dizziness, vertigo, and head disorders. Deficiency causes chest pain radiating to the back, and distension in both hypochondriac regions below."
Liver pulse Excess leads to forgetfulness. As stated in the *Shanghan Lun* (Treatise on Cold Damage): "Due to longstanding blood stasis, one tends to forget."
Dizziness and vertigo occur because Wind-Wood qi attacks upward. Head disorders occur because the Liver channel connects with the Du Mai (Governing Vessel) at the vertex. If the Liver pulse is Deficient, it cannot penetrate the diaphragm to nourish the Lungs, causing chest pain radiating to the back; it fails to coordinate with the Shaoyang pivot mechanism, leading to hypochondriac distension below.
The Yellow Emperor said: "Excellent. The summer pulse is like a hook. What constitutes a hook-like pulse?"
Qibo said: "The summer pulse corresponds to the Heart, which belongs to Fire in the South, and is the season when all things flourish and grow. Therefore, its qi comes vigorous and goes declining, so it is called 'hook'. The opposite indicates disease."
'Chang' (long/growing) is pronounced with the rising tone. Vigorous coming reflects surplus Summer Fire; declining going resembles the curve of a hook, slightly lighter at the end. This possesses the Stomach Qi along with the Hook quality, hence named 'Hook'. An opposite pulse in summer indicates disease.
The Yellow Emperor asked: "What constitutes the opposite?"
Qibo said: "If the qi comes vigorous and goes also vigorous, this is called 'Excess', with disease external; if the qi comes not vigorous but goes vigorous, this is called 'Deficiency', with disease internal."
Vigorous coming and going indicates pulse Excess, hence disease is external; not vigorous coming indicates internal deficiency; vigorous going indicates disharmony of Stomach Qi. This is pulse Deficiency, hence disease is internal.
The Yellow Emperor asked: "What diseases result from Summer pulse Excess and Deficiency?"
Qibo said: "Excess causes body heat and skin pain, developing into spreading sores (Jin Yin). Deficiency causes vexation, coughing and expectoration above, and Qi leakage below."
Heart pulse Excess causes Fire Qi to float outward, resulting in body heat and skin pain; heat damaging the skin surface leads to spreading sores. Heart pulse Deficiency causes internal Heart Qi deficiency, leading to vexation. Deficiency above manifests as coughing and expectoration of saliva; deficiency below manifests as Qi leakage (downward expulsion of Qi).
The Yellow Emperor said: "Excellent. The autumn pulse is like floating hair. What constitutes a floating pulse?"
Qibo said: "The autumn pulse corresponds to the Lungs, which belong to Metal in the West, and is the season when all things are harvested. Therefore, its qi comes light, empty, and floating, rapid in arrival and scattered in departure, so it is called 'floating'. The opposite indicates disease."
Light, empty, and floating is the Hair pulse floating. Rapid arrival and scattered departure indicate dispersal from interior to exterior. Possessing Stomach Qi with the Hair quality, it is named 'Floating'. An opposite pulse in autumn indicates disease.
The Yellow Emperor asked: "What constitutes the opposite?"
Qibo said: "If the qi feels like hair but is firm in the center and empty on the sides, this is called 'Excess', with disease external; if the qi feels like hair but is faint, this is called 'Deficiency', with disease internal."
Hair-like pulse with firm center and empty sides indicates pulse Excess, hence disease is external; Hair-like pulse that is faint indicates pulse Deficiency, hence disease is internal.
The Yellow Emperor asked: "What diseases result from Autumn pulse Excess and Deficiency?"
Qibo said: "Excess causes rebellious Qi and back pain, with a feeling of oppression. Deficiency causes panting, shortness of breath, cough, hemoptysis due to ascending Qi, and audible groaning from below."
The Lung Shu points are on the back. Lung pulse Excess causes rebellious Qi and back pain; internal stagnation of Lung Qi causes oppression. Lung pulse Deficiency causes internal weakness, leading to panting. Both exhalation and inhalation show shortness of breath and cough; cough damaging Lung collaterals causes hemoptysis. Ascending Qi failing to descend causes audible groaning below. Groaning indicates lower deficiency.
The Yellow Emperor said: "Excellent. The winter pulse is like Ying (stored/deep). What constitutes a Ying pulse?"
Qibo said: "The winter pulse corresponds to the Kidneys, which belong to Water in the North, and is the season when all things are stored. Therefore, its qi comes deep and turning/round, so it is called 'Ying'. The opposite indicates disease."
'Cang' (store) is read as written. 'Ying' is akin to 'Stone', implying deep storage. 'Zhuan' means turning/gathering. Deep and turning, possessing Stomach Qi with the Ying quality, is named 'Ying'. An opposite pulse in winter indicates disease.
The Yellow Emperor asked: "What constitutes the opposite?"
Qibo said: "If the qi comes like striking stones, this is called 'Excess', with disease external; if the qi goes rapid/sharp, this is called 'Deficiency', with disease internal."
'Shuo' (rapid) is pronounced 'shuo'. Coming like striking stones indicates strength and rigidity in both directions, indicating pulse Excess, hence disease is external. Going rapid/sharp means leaving immediately after one strike, indicating pulse Deficiency, hence disease is internal.
The Yellow Emperor asked: "What diseases result from Winter pulse Excess and Deficiency?"
Qibo said: "Excess causes flaccidity and weakness, spring pulse pain, shortness of breath, and reluctance to speak. Deficiency causes a feeling of emptiness in the heart as if hungry, coldness in the hypochondrium, umbilical pain, abdominal fullness, and abnormal urination."
'Miao' is synonymous with 'Chao', pronounced 'miao'. 'Xie Xie' means flaccidity/weakness. 'Miao Zhong' refers to the end of the ribs, near the costal margin. 'Qing' means slight cold. Kidney pulse Excess causes external prevalence of Cold-Water Qi, leading to flaccidity. Spring pulse pain occurs because Cold-Water is excessive and Fire is insufficient, causing shortness of breath and reluctance to speak. Kidney pulse Deficiency means Water fails to nourish Fire, causing cardiac emptiness resembling hunger; Fire fails to warm Water, causing coldness in the hypochondrium, umbilical pain, abdominal fullness, and urinary abnormalities.
The Yellow Emperor said: "The sequence of the four seasons involves deviations of compliance and rebellion. However, what does the Spleen pulse alone govern?"
Summarizing the above: The sequence of Spring, Summer, Autumn, and Winter involves deviations if contrary to their nature, leading to pulse and disease changes. Yet the four seasonal pulses correspond only to four Zang organs; what does the Spleen pulse correspond to?
Qibo said: "The Spleen pulse belongs to Earth. It is the solitary organ that irrigates the four directions (the other four organs)."
Earth thrives for eighteen days at the end of each season. The Spleen pulse belongs to Earth, positioned centrally, and cannot solely govern one season, thus it is the 'Solitary Organ', irrigating the four directions.
The Yellow Emperor asked: "Can the good or bad state of the Spleen pulse be seen?"
Qibo said: "The good state cannot be seen; the bad state can be seen."
The goodness of the Spleen pulse lies in the proper function of the other organs, so the good state is invisible. If the Spleen pulse is not moist/nourishing, the other organs will show Excess or Deficiency, so the bad state is visible.
The Yellow Emperor asked: "How can the bad state be seen?"
Qibo said: "If the qi comes flowing like water, this is called 'Excess', with disease external; if the qi comes like a bird's beak, this is called 'Deficiency', with disease internal."
Irrigation Excess, with Spleen Qi coming like flowing water, indicates dampness permeating, termed Earth-Damp Excess, disease external. Irrigation Deficiency, with Spleen Qi unrelaxed, coming like a bird's beak (firm and stopping), indicates Earth-Qi Deficiency, disease internal. These conditions are visible.
The Yellow Emperor asked: "You said the Spleen is the solitary organ, central Earth, irrigating the four directions. What diseases result from its Excess and Deficiency?"
Qibo previously said: "Spleen pulse is Earth, solitary organ irrigating four directions." The Yellow Emperor cites this to ask about diseases of Excess and Deficiency, specifically those affecting the Spleen itself.
Qibo said: "Excess causes inability to move the four limbs. Deficiency causes obstruction of the nine orifices, named 'Chong Qiang' (Heavy Rigidity)."
'Chong' is level tone; 'Qiang' is departing tone. Spleen pulse Excess allows dampness to permeate to the extremities, causing inability to move limbs. Spleen pulse Deficiency becomes rigid and stops, failing to irrigate, causing obstruction of the nine orifices. Disharmony of Spleen pulse leads to limb immobility and orifice obstruction; Spleen disease affects upper, lower, and four directions, hence named 'Chong Qiang'. 'Qiang' means disharmony/rigidity.
The Yellow Emperor rose startled, bowed twice, and kowtowed, saying: "Excellent. I have obtained the essence of pulse diagnosis, the supreme numbers of the world. Observing changes in five colors and pulses, measuring normal and abnormal, the Dao lies in One. The Divine Mechanism turns without reversing; reversing means no turning, thus losing its mechanism. The essence of these supreme numbers is proximate and subtle. Recorded on jade tablets, stored in viscera, read every morning, named Jade Machine."
'Du' is entered tone. 'Shang Cang' read as written. 'Qu Ran' means startled gaze. 'Zang Fu' here refers to a secret chamber. Startled by Qibo's words, the Yellow Emperor rose, bowed, and praised the teaching. He now understands the pulse essence, citing the *Yu Ban Lun Yao* to elaborate. The supreme numbers of the world represent the breadth of Dao; changes in color and pulse represent subtlety of principle; measuring odd and constant represents skill in treatment. The Dao lies in 'One', where Spirit remains united. The Divine Mechanism operates rotating left and right; this is turning without reversing. Rotating right then left is reversing, leading to loss of continuous operation and subsequent death. However, this supreme number requires no external seeking. Thus, the essence is proximate (color/pulse) and subtle (Divine Mechanism). The historian records that the Yellow Emperor inscribed the pulse essence on jade tablets, stored them in viscera, and read them daily, naming it Jade Machine. 'Ji' is the Divine Mechanism; inscribed on jade, hence 'Jade Machine'. This section explains why the pulse essence is named Jade Machine.
The Yellow Emperor said: "The Five Zang receive qi from the Zang they generate (Son), transmit it to the Zang they overcome (Controlled). Qi stays in the Zang that generates them (Mother), and dies at the Zang that overcomes them (Controlling). When death is imminent, transmission must first occur to the Controlling Zang before death ensues. This describes reverse qi movement, hence death."
"The words 'Yellow Emperor said'" were originally placed before 'Five Zang mutually connected'; corrected here. 'Shou' should be 'Shou' (grant/transmit), same below. Pulse essentials include Normal, Disease, and Death pulses. Zang Qi includes Righteous, Disease, and Death Qi. The Yellow Emperor lists the Zang to discuss this. Granting qi to the generated Zang: Righteous Qi grants to the Son. Transmitting to the overcoming Zang: Disease Qi transmits to the Controlled. 'Generated' includes both generating and being generated. Qi staying in the generating Zang: Righteous Qi stays in the Mother. Dying at the overcoming Zang: Death Qi dies from being controlled, i.e., by the Controlling Zang. These four aspects are detailed below. Death is not immediate; transmission occurs through various Zang, finally reaching the Controlling Zang, then death occurs. This transmission is reverse qi movement, hence fatal.
Liver receives qi from Heart, transmits to Spleen, qi stays in Kidney, dies at Lung. Heart receives qi from Spleen, transmits to Lung, qi stays in Liver, dies at Kidney. Spleen receives qi from Lung, transmits to Kidney, qi stays in Heart, dies at Liver. Lung receives qi from Kidney, transmits to Liver, qi stays in Spleen, dies at Heart. Kidney receives qi from Liver, transmits to Heart, qi stays in Lung, dies at Spleen. All are reverse deaths. Dividing day and night into five parts allows predicting early or late death.
Elaborating above: Granting qi to generated Zang: Liver grants to Heart (Son). Transmitting to overcoming Zang: Liver transmits to Spleen (Earth). Qi staying in generating Zang: Liver qi stays in Kidney (Mother). Dying at overcoming Zang: Liver dies at Lung (Metal controls Wood). Heart grants to Spleen (Son); transmits to Lung (Controlled); qi stays in Liver (Mother); dies at Kidney (Water controls Fire). Spleen grants to Lung (Son); transmits to Kidney (Controlled); qi stays in Heart (Mother); dies at Liver (Wood controls Earth). Lung grants to Kidney (Son); transmits to Liver (Controlled); qi stays in Spleen (Mother); dies at Heart (Fire controls Metal). Kidney grants to Liver (Son); transmits to Heart (Controlled); qi stays in Lung (Mother); dies at Spleen (Earth controls Water). Above stated: reverse qi movement causes death. Hence, all are reverse deaths. Day and night combine with seasons, divided into five by Wu Xing, allowing prediction of death timing. Five parts: Yin-Mao govern Wood, Si-Wu govern Fire, Shen-You govern Metal, Hai-Zi govern Water, Chen-Xu-Chou-Wei govern Earth. Liver dying at Lung dies at Shen-You; Heart dying at Kidney dies at Hai-Zi; Spleen dying at Liver dies at Yin-Mao; Lung dying at Heart dies at Si-Wu; Kidney dying at Spleen dies at Chen-Xu-Chou-Wei.
The Five Zang are interconnected, with transfers having order. When diseased, each transmits to the Zang it overcomes. If untreated, according to rules, in three months, six months, three days, or six days, transmitting through all Five Zang leads to death. This is forward transmission following the overcoming order.
Elaborating above: Forward transmission to the controlled Zang also leads to death. Granting qi to generated Zang and staying in generating Zang shows Zang interconnection and ordered transfer. Liver-Heart-Spleen-Lung-Kidney connect in order; the site of granting qi is where qi stays. Transmitting to overcoming Zang means disease transmits to the controlled Zang. Wood-Earth-Water-Fire-Metal overcome and transmit; transmission to the controlled makes the recipient the controlling Zang for the next step. Disease impending death requires prior transmission. Treatment is needed; if untreated, death occurs in 3 months, 6 months, 3 days, or 6 days via forward transmission. Three months: Liver disease passes Summer (3 months), dies in Autumn when Metal controls Wood. Six months: Liver disease peaks in early Spring, passes Spring-Summer (6 months), dies in Autumn when Metal controls Wood. Other Zang follow suit. Three days: Liver disease worsens on Wu-Ji days; from Wu to Geng is 3 days; on Xin day, Lung Metal controls Spleen Earth, so death in 3 days. Six days: Liver disease worsens on Jia-Yi days; from Jia to Ji is 6 days; on Geng day, Wood suffers Metal punishment, so death in 6 days. Other Zang follow suit. Seasonal and Heavenly Stem Wu Xing are Wood-Fire-Earth-Metal-Water, generating in order. Transmission death in 3 months/6 months/3 days/6 days follows forward overcoming order, less severe than reverse qi death.
Thus: Differentiating Yang reveals disease origin; differentiating Yin reveals death/life timing, meaning knowing the point of confinement (control) indicates death.
Citing *Yin Yang Bie Lun*: To understand death, know the point of confinement (being controlled).
Wind is the leader of hundred diseases. Now, if Wind-Cold invades, causing all hairs to stand erect and skin pores to close leading to fever, at this time, sweating therapy can be used.
Disease originates externally and moves inward; thus Wind is the leader of diseases. Wind-Cold enters via hairs and skin, causing erect hairs and closed pores with fever. Knowing the origin, sweating disperses Wind-Cold.
Or Bi syndrome, numbness, swelling, and pain occur. At this time, hot compresses, moxibustion, and acupuncture can remove it.
Bi refers to flaccid Bi. Numbness refers to stiffness. Swelling refers to painful swelling. Bi and numbness indicate pathogen entering meridians. Swelling and pain indicate pathogen damaging muscles. Knowing the origin, hot compresses, moxibustion, and acupuncture disperse the pathogen.
If untreated, pathogen enters Lung, named Lung Bi, manifesting as cough and rebellious Qi.
Untreated腑 disease enters Zang; pathogen enters Lung, named Lung Bi. Pathogen in Lung causes Bi, leading to cough and rebellious Qi.
If untreated, Lung transmits to Liver, named Liver Bi. Also called Jue, hypochondriac pain, vomiting food. At this time, massage or ear acupuncture can be used.
Untreated Lung disease transmits to controlled Liver, named Liver Bi. Liver channel spreads over hypochondrium; Liver Qi rebels, hence also called Jue, hypochondriac pain. Food Qi enters Stomach, distributes essence to Liver; Liver Qi rebels, causing vomiting. During Liver disease, Qi-Blood disharmony allows massage or ear acupuncture.
If untreated, Liver transmits to Spleen, named Spleen Feng, manifesting as Jaundice, abdominal heat, vexation, yellow urine. At this time, massage, herbs, or bathing can be used.
Untreated Liver disease transmits to controlled Spleen. Wind-Wood damages Spleen, generating Fire, named Spleen Feng with Jaundice. Abdominal heat steams upward causing vexation; downward leakage causes yellow urine. During Spleen disease, meridian blockage allows massage for unblocking. Internal Spleen Qi deficiency allows sweet herbs for tonification. Spleen Dampness stagnation allows herbal baths for dispersion.
If untreated, Spleen transmits to Kidney, named Shan Jia. Lower abdomen feels oppressed heat and pain, white discharge, also named Gu. At this time, massage or herbs can be used.
Untreated Spleen disease transmits to controlled Kidney. Water-Damp condenses downward, named Shan Jia. Located in lower abdomen, causing oppressed heat and pain. Oppressed heat means extreme heat unable to extend. Lower abdominal heat/pain with internal deficiency/cold causes white discharge. Shan Jia is exterior excess, interior deficiency, hence also named Gu. During Spleen-Kidney transmission, massage and herbs are applicable.
If untreated, Kidney transmits to Heart, causing tendon and vessel traction and spasm, named Chi. At this time, moxibustion or herbs can be used. If untreated, after ten days, death is expected.
'Chi' pronounced 'chi'. Untreated Kidney disease transmits to controlled Heart. Heart governs Blood vessels; Blood fails to nourish tendons, causing traction and spasm. Traction/spasm means constraint, hence named Chi. Chi means convulsion. During Kidney-Heart transmission, moxibustion and herbs apply. If neglected, after ten days (completion of Ten Heavenly Stems and cycle of Five Zang), death ensues.
Kidney transmits to Heart; Heart reverses and transmits to Lung, manifesting as chills and fever. According to rules, death occurs in three years. This is the sequence of disease transmission.