上编论六经脉之厥状病能，而病能未畅其旨，故复论之。十二经脉秉气于胃，故首论胃脘痈，其次有病
厥者，有病颈痈者，有病怒狂者，有病酒风者，举病气之合于四时者而论之，皆病能也。
黄帝问曰∶人病胃脘痈者，诊应何如？
十二经脉，秉气于胃，人病胃脘痈，则经脉之诊当何如？
岐伯对曰∶诊此者，当候胃脉，其脉当沉细。沉细者气逆。逆者人迎甚盛，甚
盛则热，人迎者，胃脉也。逆而盛，则热聚于胃口而不行，故胃脘为痈也。
胃脘有痈，故诊此者，当候胃脉，病在于胃，其脉当沉细。沉细者，由于正气之逆气逆则经脉不和，
故逆者人迎甚盛，甚盛则胃热也。申明人迎者，乃结候两旁之胃脉也。今气逆而热盛，则热聚
于胃口而不行，不行故胃脘为痈也。
所谓深之细者，其中手如针也，摩之切之，聚者坚也，搏者大也。
旧本在为后饭之下，今改正于此。中，去声。深，沉也。博，散也。上文云，其脉当沉细，所谓沉
之细者，其中手如针之微细深沉也。胃脘有痈，其外则当摩之切之，摩之切之而有所凝聚者，痈
之坚也。若不凝聚而博散者，痈之大也。
帝曰∶善。人有卧而有所不安者，何也？
候人迎而知胃痈，帝故善之。胃不和，则卧不安，故举以问。
岐伯曰∶脏有所伤，及精有所之，寄则安，故人不能悬其病也。
诸脏之气，归于胃土，卧不安者，乃脏气有所伤，及阴精有所之。之，去也。脏伤精去，卧不安
也。夫诸脏之气皆归于胃，而胃土之气寄于诸脏，是胃气相寄则安，今不寄则不安，故人不能悬绝其病也。
帝曰∶人之不得偃卧者，何也？
偃卧，正卧也。《评热论》云，不能正偃者，胃中不和也，故举而复问。
岐伯曰∶肺者脏之盖也。肺气盛则脉大，脉大则不得偃卧，论在奇恒阴阳中。
肺位居高，是肺者脏之盖也。盖者，如天复于上，其气下行。今肺气盛，则气上不下，气上不下则
肺部之脉大，脉大则不得偃卧矣，此失阴阳之常度，故论在奇恒阴阳中。奇恒阴阳，如下文所云是也。
《上经》者，言气之通天也。《下经》者，言病之变化也。《金
匮》者决死生也。《揆度》者切度之也。《奇恒》者言奇病也。所谓
奇者，使奇病不得以四时死也。恒者，得以四时死也。所谓揆者，方切求之也，言切求其脉理也。
度者，得其病处，以四时度之也。
旧本在篇末，今列于此。度，入声。处，去声。《示从容》论云，请诵《脉经》上下编。《脉经》疑
即《灵枢经》，此《上经》《下经》，即《脉经》上下经也。上经言气化之道，故上经者，言
人气之通天也。下经言疾病之生，故下经者，言民病之变化也。《灵枢》论篇有着之玉版，藏之兰室者，
即藏之金匮也。“金匮”者，所以通决死生也。疏五过论云上经下经，揆度阴阳，奇恒五
中，决以明堂，故申言揆度者，切其脉而度之也。奇恒者，言非常之奇病也。复申言所谓奇者，使奇病不得
以四时死也。恒者，得以四时死也。又申言所谓揆者，方切求之，言切求其脉理也。度者，
得其病处，而以四时之阴阳度之也。如是则知气之通天，病之变化，可以决人之死生矣。
帝曰∶有病厥者，诊右脉沉而紧，左脉浮而迟，不然，病主安在？
承上文切求脉理，得其病处之意，而问有病厥者，阳气不上，故诊右脉沉而紧，阴气不下，故左脉浮而
迟。病厥，则阴阳之气不相顺接，脉故如是，设病厥而脉不然，则病主安在？
岐伯曰∶各诊之，右脉固当沉紧，此应四时，左脉浮而迟，此
逆四时，在左当主病在肾，颇关在肺，当腰痛也。
切求脉理，得其病处，当以四时阴阳之理度之，春生夏长，秋收冬藏，如冬诊之，右脉固当沉紧，此冬
脉之应四时也。今左脉浮而迟，此冬脉之逆四时也。浮迟在左，当主病在肾，所以然者，肾
脉居于左尺也，肾上连肺，故颇关在肺，在肾关肺，当腰痛也。
帝曰∶何以言之？
在肾何以关肺，关肺何以腰痛？
岐伯曰∶少阴脉，贯肾络肺，今得肺脉，肾为之病，故肾为腰痛之病也。
少阴者肾脉也。少阴之脉，贯肾络肺，故在肾关肺也。浮迟者，肺脉也。今得浮迟之肺脉，而肾
为之病，腰者肾之府，故肾为腰痛之病也。
帝曰∶善。有病颈痈者，或石治之，或针灸治之，而皆已，其真安在？
论病厥而诊冬脉，诊冬脉而应四时，帝故善之，病厥为冬，则
颈痈为春，怒狂为夏，酒风为秋，故相继以问。
岐伯曰∶此同名异等者也。
等，类也，颈痈之名虽同，而在气在血，则异类也。
夫痈气之息者，宜以针开除去之，夫气盛血聚者，宜石而泻之，此所谓同病异治也。
息，止息也。颈痈而气之止末者，其病在气，宜以针开通其气而除去之，此气息成痈，而有针刺
之真法也。颈痈而气盛血聚者，其病在血，宜石刺出血而泻之，此血聚成痈，而有石刺之真法也。
此所以同病异治而皆已也。
帝曰∶有病怒狂者，此病安生？
颈痈为春，怒狂为夏，故举怒狂以向。
岐伯曰∶生于阳也。
阳气过盛，则狂，此之怒狂，生于阳也。
帝曰∶阳何以使人狂？
阳者正气也，何以使人狂。
岐伯曰∶阳气者，因暴折而难决，故善怒也，病名曰阳厥。
阳气直遂，不可屈抑，今阳气者，因暴折而难决。决，犹散
也。暴折难决，故善怒而狂也，此因阳气厥逆而成，故病名曰阳厥。
帝曰∶何以知之？
阳厥何以知之。
岐伯曰∶阳明者常动，巨阳少阳不动，不动而动大疾，此其候也。
太少合并而有阳明，是阳明有少阳之阳，复有太阳之阳，故阳
明者常动。巨阳者，阳之极也。阳极而其气反微。少阳者，阳之初
也。阳初而其气安静，故巨阳少阳不动，本当不动，而今也乃动之大疾，此其为阳厥之候也。
帝曰∶治之奈何？
未悉治法，故复问之。
岐伯曰∶夺其食即已，夫食入于阴，长气于阳，故夺其食即
已，使之服以生铁洛为饮。夫生铁洛者，下气疾也。
长，上声。洛，烙同。阳明者，胃也。胃者，阳气之所归也。阳气有余，须夺其食即已。夫食入于胃，
生其阴精，故食入于阴，阴精足则阳气盛，故长气于阳，夺其食则阳明土气少虚，故夺其食
即已。夺，犹损也。更使之服以生铁烙为饮。铁者金也。金能平木，可治少阳之气。烙饮者，转赤为乌也。
赤而乌，可以平巨阳之气，故曰下气疾也。
帝曰∶善。有病身热解堕，汗出如浴，恶风少气，此为何病？
恶，去声。阳厥有治，则阴厥亦有治，帝默会其意而善之，复举身热汗出恶风少气之病以问。
岐伯曰∶病名曰酒风。
酒气先行皮肤，先充络脉，故身热汗出恶风，不从中土而散精，故懈惰少气，岐伯曰酒风，盖秋病也。
帝曰∶治之奈何？岐伯曰∶以泽泻术各十分，糜衔五分，合以三指撮，为后饭。
分，去声。酒风之病，中土内虚，当以泽泻术二种十分为君，助其脾土，糜衔五分为臣，散其风邪，
合以三指而撮此药，先服其药，补中土而散邪风，为之后饭，以益其胃气焉。合胃痈病厥颈痈
怒狂酒风，以论病能，而揆度奇恒，未畅其旨，故下即有奇病、大奇之论。
上编论述了六经脉气厥逆的证候表现，但关于“病能”（疾病的功能与机理）的宗旨尚未阐发透彻，因此再次进行论述。十二经脉的气血禀受于胃，所以首先论述胃脘痈，其次论述有患厥证的、有患颈痈的、有患怒狂病的、有患酒风的，列举那些病气与四时气候相合的疾病来论述，这些都属于“病能”的范畴。
黄帝问道：人患胃脘痈的病，诊察脉象应当是怎样的？
十二经脉的气血禀受于胃，人如果患胃脘痈，那么经脉的诊察应当是怎样的呢？
岐伯回答说：诊察这种病，应当观察胃脉，其脉象应当是沉细的。脉象沉细说明气机逆乱。气机逆乱则人迎脉非常盛大，人迎脉盛大则表明有热。人迎脉，就是反映胃气的脉象。气机逆乱且盛大，则热气聚集在胃口而不能运行，所以胃脘形成痈肿。
胃脘有痈肿，所以诊察此病，应当观察胃脉。病位在胃，其脉象应当沉细。脉象沉细，是由于正气逆乱。气机逆乱则经脉不和，所以气逆则人迎脉非常盛大，人迎脉盛大则说明胃中有热。这里申明，人迎脉是位于结喉旁两侧的胃动脉搏动处。现在气机逆乱而热盛，则热气聚集在胃口而不能运行，不能运行故而在胃脘形成痈肿。
所谓深取时的细脉，指中指按下去感觉如针尖般微细深沉。抚摸和切按患处，如果有凝聚感的则是痈肿坚硬的表现；如果搏动范围宽大散漫的，则是痈肿较大的表现。
旧版将此段放在“为后饭”之后，现改正于此。“中”，读去声。“深”，即沉的意思。“博”，通“薄”，意为散漫。上文说，其脉应当沉细，所谓沉取时的细脉，是指中指按下去如针尖般微细深沉。胃脘有痈肿，外部则应当抚摸和切按，抚摸切按时若有凝聚感的，是痈肿坚硬的特征。如果不凝聚而呈散漫状的，是痈肿体积较大的特征。
黄帝说：好。有人躺卧时感到不安宁，这是为什么呢？
通过诊察人迎脉而知晓胃痈，黄帝对此表示赞许。胃气不和，则睡眠不安，所以举此问题来询问。
岐伯说：内脏有所损伤，以及阴精有所耗散流失，若胃气能够寄居调和，则能安宁，所以人不能脱离这种病理状态而单独存在疾病。
五脏之气，都归于胃土。躺卧不安，是因为脏气有所损伤，以及阴精有所流失。“之”，意为去、流失。脏气受伤、阴精流失，导致卧不安宁。因为五脏之气皆归于胃，而胃土之气寄寓于五脏，胃气相互寄寓调和则安宁，现在不寄寓调和则不安宁，所以人不能将这种病态完全孤立看待。
黄帝说：人不能仰卧，这是为什么呢？
“偃卧”，即正身仰卧。《评热论》中说，不能正身仰卧的，是因为胃中不和，所以再次提出询问。
岐伯说：肺位于五脏之上，如同盖子一样覆盖着其他脏腑。肺气旺盛则脉象变大，脉象变大则不能仰卧，这一理论记载在《奇恒阴阳》篇中。
肺的位置居高临下，所以说肺是五脏的盖子。“盖”，如同天覆盖在上，其气本应下行。现在肺气过盛，则气向上而不向下，气向上不下行则肺部对应的脉象变大，脉象变大则不能仰卧了。这违背了阴阳的正常规律，所以论述在《奇恒阴阳》中。《奇恒阴阳》，如下文所说是也。
《上经》，讲的是气与天相通的道理。《下经》，讲的是疾病的变化规律。《金匮》，是用来决断死生的。《揆度》，是通过切脉来揣度病情。《奇恒》，是论述奇异疾病的。所谓“奇”，是指使奇异疾病不因四时变化而死（即预后特殊）。所谓“恒”，是指普通疾病会随四时变化而死（即顺应常理）。所谓“揆”，是方切求索其意，意思是仔细推求脉理。“度”，是探得病位所在，并用四时规律来衡量它。
旧版在篇末，现列于此。“度”，读入声。“处”，读去声。《示从容》篇中说，请诵读《脉经》的上编和下编。《脉经》怀疑就是《灵枢经》，这里的《上经》《下经》，就是《脉经》的上、下两经。《上经》讲气化之道，所以《上经》说的是人气与天相通。《下经》讲疾病的发生，所以《下经》说的是百姓疾病的变化。《灵枢》论篇中提到刻在玉版上、藏在兰室中的内容，就是藏在金匮中。“金匮”，是用来通晓决断死生的。《疏五过论》中说：“上经、下经，揆度阴阳，奇恒五中，决以明堂”，所以重申“揆度”，是指切按其脉象而揣度病情。“奇恒”，是说非常见的奇异疾病。再次重申所谓“奇”，是指使奇异疾病不因四时常规而死。“恒”，是指普通疾病会随四时常规而死。又重申所谓“揆”，是方切求索，意思是仔细推求脉理。“度”，是探得病位所在，并用四时的阴阳规律来衡量它。这样就能知晓气与天相通、疾病变化的道理，从而可以决断人的死生了。
黄帝说：有人患厥证，诊察右脉沉而紧，左脉浮而迟，如果不是这样，病主在哪里？
承接上文仔细推求脉理、探得病位的意思，而询问患厥证的人。阳气不上升，所以诊察右脉沉而紧；阴气不下行，所以左脉浮而迟。患厥证，则阴阳之气不相顺接，脉象才会如此。假如患厥证而脉象不是这样，那么病主在哪里呢？
岐伯说：分别诊察左右脉。右脉本来应当沉紧，这是顺应四时规律的；左脉浮而迟，这是违背四时规律的。左脉出现这种情况，主要病位在肾，同时也关联到肺，应当表现为腰痛。
仔细推求脉理，探得病位，应当用四时阴阳的道理来衡量。春生、夏长、秋收、冬藏，如果在冬季诊察，右脉本来应当沉紧，这是冬季脉象顺应四时规律。现在左脉浮而迟，这是冬季脉象违背四时规律。浮迟脉出现在左侧，主要病位在肾。之所以如此，是因为肾脉位于左尺部。肾上行连接肺，所以也关联到肺，病在肾而关联肺，应当出现腰痛的症状。
黄帝说：为什么这样说呢？
病在肾为何关联肺？关联肺为何会导致腰痛？
岐伯说：少阴脉，贯穿肾脏并联络肺脏。现在诊得肺脉（浮迟），说明肾发生了病变，所以肾成为腰痛病的根源。
少阴脉就是肾脉。少阴之脉，贯穿肾脏并联络肺脏，所以在肾病时会关联肺。浮迟脉，是肺脉的特征。现在诊得浮迟的肺脉，却由肾引起病变，腰是肾的外府，所以肾成为腰痛病的根源。
黄帝说：好。有人患颈痈，有的用砭石治疗，有的用针灸治疗，都痊愈了，其中的真谛在哪里？
论述厥证时诊察冬季脉象，诊察冬季脉象时顺应四时规律，黄帝对此表示赞许。厥证对应冬季，那么颈痈对应春季，怒狂对应夏季，酒风对应秋季，所以相继提出问题。
岐伯说：这是同名但类别不同的疾病。
“等”，即类。颈痈的名称虽然相同，但在气分还是在血分，则属于不同类别。
如果是痈气停滞不行的，适宜用针具刺开除去邪气；如果是气盛血聚的，适宜用砭石刺破泻出血邪。这就是所说的“同病异治”。
“息”，指止息、停滞。颈痈如果是气机停滞未散的，病在气分，适宜用针具开通气机而除去病邪，这是气滞成痈而有针刺治疗的真法。颈痈如果是气盛血聚的，病在血分，适宜用砭石刺破出血而泻除邪气，这是血聚成痈而有砭石治疗的真法。这就是同一种病名却采用不同治疗方法都能痊愈的原因。
黄帝说：有人患怒狂病，这个病是怎么产生的？
颈痈对应春季，怒狂对应夏季，所以举怒狂病来询问。
岐伯说：生于阳分。
阳气过盛，就会发狂，这种怒狂病，就是生于阳分的。
黄帝说：阳气为什么使人发狂？
阳指的是正气，为什么会使人生病发狂？
岐伯说：阳气，因为突然受到挫折而难以宣泄，所以容易发怒，这种病名叫阳厥。
阳气直遂通畅，不可屈折压抑。现在的阳气，因为突然受到挫折而难以宣泄。“决”，通“泄”，意为发散。突然受挫难以宣泄，所以容易发怒发狂，这是因为阳气厥逆而形成的，所以病名叫阳厥。
黄帝说：怎么知道是阳厥呢？
如何判断是阳厥？
岐伯说：阳明脉经常跳动，太阳脉和少阳脉通常不跳动。原本不跳动的脉现在跳动且急促有力，这就是阳厥的征象。
太阴、少阳合并而有阳明，所以阳明脉既有少阳的阳气，又有太阳的阳气，因此阳明脉经常跳动。巨阳（太阳），是阳气的极点。阳极则其气反而微弱。少阳，是阳气的初生阶段。阳初生则其气安静，所以太阳和少阳脉通常不跳动。本来不应该跳动，现在却跳动得非常急疾，这就是阳厥的征象。
黄帝说：怎么治疗呢？
不了解治疗方法，所以再次询问。
岐伯说：限制其饮食即可痊愈。食物进入体内转化为阴精，助长阳气，所以限制饮食即可痊愈。让病人服用生铁洛制成的饮品。生铁洛，具有快速降气的作用。
“长”，读上声。“洛”，同“烙”。阳明经属于胃。胃，是阳气汇聚的地方。阳气有余，必须限制饮食才能痊愈。食物进入胃中，化生阴精，所以食物进入阴分，阴精充足则阳气更盛，从而助长阳气。限制饮食则阳明土气减少虚亢，所以限制饮食即可痊愈。“夺”，即损减之意。再让病人服用生铁烙制成的饮品。铁属金。金能克木，可以调节少阳之气。“烙饮”，是将红色转为黑色。红色转黑，可以平抑巨阳之气，所以说它能快速降气。
黄帝说：好。有人身体发热、肢体懈怠无力、出汗像洗澡一样多、怕风、气短，这是什么病？
“恶”，读去声。阳厥有了治法，那么阴厥也应该有治法，黄帝领会了其中的意思并表示赞许，再次提出身体发热、出汗、怕风、气短的病症来询问。
岐伯说：这种病名叫酒风。
酒气先行于皮肤，先充盈络脉，所以身体发热、出汗、怕风。酒气不从脾胃运化散精，所以身体懈怠无力、气短。岐伯称之为酒风，这大概是秋季发生的疾病。
黄帝说：怎么治疗呢？
岐伯说：用泽泻、白术各十分，麋衔五分，混合后用三指撮取药量，饭后服用。
“分”，读去声。酒风之病，中焦脾胃内虚，应当用泽泻、白术两种药各十分作为君药，以补助脾土；麋衔五分作为臣药，以疏散风邪。混合后用三指撮取此药，先服药，补益中焦脾胃并疏散邪风，然后再吃饭，以增益胃气。结合前面的胃痈、厥证、颈痈、怒狂、酒风，来论述“病能”，以及“揆度奇恒”的道理，宗旨尚未完全阐发，所以下面紧接着有关于奇病、大奇病的论述。
The upper section discussed the manifestations of Jue (reversal) in the six meridians, but the principles of "Bing Neng" (disease functions and mechanisms) were not fully elucidated; therefore, further discussion is presented. The twelve primary meridians derive their Qi from the Stomach. Thus, the discussion begins with Carbuncle of the Epigastrium (Stomach Abscess), followed by cases of Jue syndrome, Neck Carbuncle, Manic Delirium due to anger, and Jiufeng (Wine Wind). These conditions, where pathogenic Qi aligns with the Four Seasons, are all categorized under Bing Neng.
Huangdi asked: When a person suffers from Carbuncle of the Epigastrium, what should the pulse diagnosis reveal?
Since the twelve primary meridians derive their Qi from the Stomach, if a person suffers from Carbuncle of the Epigastrium, how should the pulse of the meridians be diagnosed?
Qibo replied: To diagnose this condition, one must observe the Stomach Pulse. The pulse should be Deep and Fine (Chen Xi). A Deep and Fine pulse indicates Rebellious Qi. When Qi is rebellious, the Renying (Human Welcome) pulse becomes extremely full. An extremely full Renying pulse indicates Heat. The Renying pulse reflects the Stomach Meridian. When Qi is rebellious and full, Heat accumulates at the stomach opening without circulating, resulting in a Carbuncle of the Epigastrium.
Because there is a carbuncle in the epigastrium, diagnosing this requires observing the Stomach Pulse. Since the disease is in the Stomach, the pulse should be Deep and Fine. The Deep and Fine quality arises from the rebellion of Healthy Qi. When Qi rebels, the meridians become disharmonious; thus, rebellion causes the Renying pulse to be extremely full, indicating Stomach Heat. It is clarified here that the Renying pulse refers to the Stomach artery located on both sides of the laryngeal prominence. Now, with rebellious Qi and excessive Heat, Heat accumulates at the stomach opening and fails to circulate. Due to this lack of circulation, a carbuncle forms in the epigastrium.
Regarding the fine pulse felt deeply: when pressing with the middle finger, it feels as fine and deep as a needle. Palpating and pressing the affected area, if there is a sense of aggregation, it indicates the hardness of the carbuncle; if the pulsation is broad and diffuse, it indicates a large carbuncle.
In older editions, this passage appeared after "taking medicine before meals"; it is now corrected here. "Zhong" (middle finger) is pronounced with the departing tone. "Shen" means deep. "Bo" means diffuse. As stated earlier, the pulse should be Deep and Fine. The "fine pulse felt deeply" refers to the sensation of being extremely fine and deep, like a needle, when pressed by the middle finger. For a carbuncle in the epigastrium, the exterior should be palpated and pressed. If aggregation is felt during palpation and pressing, it signifies the hardness of the carbuncle. If there is no aggregation but rather a diffuse spread, it signifies the largeness of the carbuncle.
Huangdi said: Excellent. Why do some people feel uneasy when lying down?
Having understood the diagnosis of Stomach Carbuncle through the Renying pulse, Huangdi praised this insight. Disharmony of the Stomach leads to restlessness during sleep; hence, this question was raised.
Qibo said: When the Zang organs are injured, and Jing (Essence) is lost or scattered, if Wei Qi (Stomach Qi) can reside and harmonize, then peace is achieved. Therefore, one cannot isolate the disease from this physiological connection.
The Qi of the five Zang organs returns to the Spleen-Stomach Earth. Restlessness during sleep occurs due to injury to Zang Qi and the loss of Yin Essence. "Zhi" means departure or loss. Injury to Zang Qi and loss of Essence lead to unrest during sleep. Since the Qi of all Zang organs returns to the Stomach, and Stomach Earth Qi resides within the Zang organs, mutual residence and harmony bring peace. Without this residence, there is unrest. Thus, one cannot view the pathology in isolation.
Huangdi asked: Why can some people not lie flat on their backs?
"Yanwo" refers to lying flat on the back. The *Ping Re Lun* (Discourse on Fever Evaluation) states that inability to lie flat is due to disharmony in the Stomach. Hence, this question is raised again.
Qibo said: The Lung is the canopy of the Zang organs. When Lung Qi is excessive, the pulse becomes large. A large pulse prevents lying flat. This theory is found in the *Qi Heng Yin Yang* chapter.
The Lung resides in a high position, acting as a canopy covering the other Zang organs. Like the sky covering above, its Qi should descend. Currently, if Lung Qi is excessive, it ascends and does not descend. Ascending without descending causes the pulse associated with the Lung to become large. A large pulse makes lying flat impossible. This violates the normal balance of Yin and Yang, hence it is discussed in the *Qi Heng Yin Yang* chapter. "Qi Heng Yin Yang" refers to what follows below.
The *Shang Jing* (Upper Classic) discusses the communication of Qi with Heaven. The *Xia Jing* (Lower Classic) discusses the changes of diseases. The *Jin Gui* (Golden Cabinet) determines life and death. The *Kui Du* (Measure and Estimate) involves palpating and estimating. The *Qi Heng* (Extraordinary and Constant) discusses extraordinary diseases. "Qi" (extraordinary) means such diseases do not die according to the four seasons' norms. "Heng" (constant) means ordinary diseases die according to the four seasons' norms. "Kui" means to square and seek, referring to carefully investigating the pulse mechanism. "Du" means to locate the disease site and estimate it according to the four seasons.
In older editions, this was at the end of the chapter; it is listed here now. "Du" is pronounced with the entering tone. "Chu" is pronounced with the departing tone. The *Shi Cong Rong* discourse says, "Please recite the Upper and Lower sections of the *Mai Jing*." The *Mai Jing* is suspected to be the *Ling Shu Jing*. Here, the *Shang Jing* and *Xia Jing* refer to the upper and lower sections of the *Mai Jing*. The *Shang Jing* discusses the way of Qi transformation, so it speaks of human Qi communicating with Heaven. The *Xia Jing* discusses the generation of diseases, so it speaks of the changes in people's illnesses. The *Ling Shu* mentions inscribing on jade plates and storing in orchid chambers, which is equivalent to storing in the Golden Cabinet. The "Golden Cabinet" is used to determine life and death. The *Shu Wu Guo Lun* states: "Shang Jing, Xia Jing, Kui Du Yin Yang, Qi Heng Wu Zhong, decided by Ming Tang." Thus, reiterating "Kui Du" means palpating the pulse to estimate the condition. "Qi Heng" refers to unusual, extraordinary diseases. Reiterating "Qi," it means extraordinary diseases do not follow the seasonal pattern of death. "Heng" means they do follow the seasonal pattern. Reiterating "Kui," it means to square and seek, i.e., carefully investigate the pulse logic. "Du" means finding the disease location and estimating it via the Yin-Yang of the four seasons. In this way, one understands the communication of Qi with Heaven and the changes of disease, thereby determining life and death.
Huangdi asked: In cases of Jue syndrome, if the right pulse is Deep and Tight, and the left pulse is Floating and Slow, but if this is not the case, where is the primary disease located?
Continuing the theme of carefully investigating pulse logic to locate the disease, he asks about Jue syndrome. Yang Qi failing to ascend results in a Right pulse that is Deep and Tight. Yin Qi failing to descend results in a Left pulse that is Floating and Slow. In Jue syndrome, Yin and Yang Qi fail to connect smoothly, resulting in such pulses. If one has Jue syndrome but the pulse is different, where is the primary disease?
Qibo said: Diagnose each side separately. The Right pulse should naturally be Deep and Tight; this corresponds to the Four Seasons. The Left pulse being Floating and Slow contradicts the Four Seasons. On the left, the disease primarily resides in the Kidney, significantly involving the Lung, and should manifest as lower back pain.
Investigating pulse logic to locate the disease requires estimation based on the Yin-Yang of the Four Seasons: Spring generates, Summer grows, Autumn harvests, Winter stores. If diagnosed in Winter, the Right pulse should naturally be Deep and Tight; this is the Winter pulse corresponding to the seasons. However, the Left pulse being Floating and Slow contradicts the seasonal pattern. Floating and Slow on the left primarily indicates disease in the Kidney. This is because the Kidney pulse resides in the Left Chi position. The Kidney connects upward to the Lung; thus, it significantly involves the Lung. Disease in the Kidney involving the Lung manifests as lower back pain.
Huangdi asked: Why do you say so?
Why does Kidney disease involve the Lung? Why does Lung involvement cause lower back pain?
Qibo said: The Shaoyin Meridian passes through the Kidney and links to the Lung. Now, obtaining the Lung pulse indicates the Kidney is diseased. Therefore, the Kidney is the source of the lower back pain.
Shaoyin refers to the Kidney pulse. The Shaoyin meridian passes through the Kidney and links to the Lung, hence Kidney disease involves the Lung. Floating and Slow is the characteristic of the Lung pulse. Obtaining the Floating and Slow Lung pulse while the Kidney is the root of the illness: since the waist is the mansion of the Kidney, the Kidney becomes the source of the lower back pain.
Huangdi said: Excellent. Some suffer from Neck Carbuncle. Some are treated with stone needles (bian shi), others with acupuncture, and all recover. What is the truth behind this?
Having discussed Jue syndrome and winter pulses corresponding to the seasons, Huangdi praised this. Jue corresponds to Winter, Neck Carbuncle to Spring, Manic Delirium to Summer, and Wine Wind to Autumn. Thus, questions follow sequentially.
Qibo said: These share the same name but belong to different categories.
"Deng" means category. Although named Neck Carbuncle, they differ in whether the pathology lies in Qi or Blood.
If the carbuncle is caused by stagnant Qi, it is suitable to use needles to open and remove it. If it is caused by excessive Qi and aggregated Blood, it is suitable to use stone needles to drain it. This is called "treating the same disease differently."
"Xi" means stagnation or cessation. If the Neck Carbuncle is due to Qi stagnation, the disease is in the Qi level. Needles should be used to unblock Qi and remove the pathogen. This is the true method for carbuncles formed by Qi stagnation using acupuncture. If the Neck Carbuncle is due to excessive Qi and aggregated Blood, the disease is in the Blood level. Stone needles should be used to pierce and bleed to drain the pathogen. This is the true method for carbuncles formed by Blood aggregation using stone therapy. This explains why treating the same-named disease differently leads to recovery in both cases.
Huangdi asked: Some suffer from Manic Delirium due to anger. How does this disease arise?
Neck Carbuncle corresponds to Spring; Manic Delirium corresponds to Summer. Hence, this is asked next.
Qibo said: It arises from Yang.
Excessive Yang Qi leads to mania. This type of manic delirium arises from Yang.
Huangdi asked: How does Yang cause mania?
Yang refers to Healthy Qi. How does it cause mania?
Qibo said: Yang Qi, when suddenly frustrated and difficult to resolve, leads to frequent anger. This disease is named Yang Jue (Yang Reversal).
Yang Qi flows freely and should not be suppressed. When Yang Qi is suddenly frustrated and difficult to dissipate ("Jue" implies dissipation/resolution), it leads to anger and mania. This results from the reversal of Yang Qi, hence named Yang Jue.
Huangdi asked: How do we know this?
How do we identify Yang Jue?
Qibo said: The Yangming pulse is constantly active. The Taiyang and Shaoyang pulses are normally inactive. If the normally inactive pulses become active and rapid, this is the sign of Yang Jue.
Taiyang and Shaoyang combine to form Yangming. Yangming possesses the Yang of Shaoyang and the Yang of Taiyang, so the Yangming pulse is constantly active. Juyang (Taiyang) is the extreme of Yang. At the extreme, its Qi becomes weak. Shaoyang is the beginning of Yang. At the beginning, its Qi is quiet. Thus, Taiyang and Shaoyang pulses are normally inactive. If they become active and rapid, this is the sign of Yang Jue.
Huangdi asked: How should it be treated?
Unfamiliar with the treatment method, he asks again.
Qibo said: Depriving them of food will cure it. Food enters the Yin and nourishes/grows Yang. Therefore, depriving them of food cures it. Have them drink Sheng Tie Luo (Iron Filings Decoction). Sheng Tie Luo rapidly descends Qi.
"Zhang" is pronounced with the rising tone. "Luo" is synonymous with "Lao." Yangming belongs to the Stomach. The Stomach is the gathering place of Yang Qi. With excess Yang Qi, restricting food intake is necessary for recovery. Food enters the Stomach, generating Yin Essence. Thus, food enters Yin; sufficient Yin Essence strengthens Yang, thereby "growing" Yang. Restricting food reduces the hyperactivity of Yangming Earth Qi, so restriction cures it. "Duo" means to diminish. Additionally, have them drink Sheng Tie Lao (Iron Filings Drink). Iron belongs to Metal. Metal controls Wood, regulating Shaoyang Qi. "Lao Yin" (drinking the red-hot iron quenched liquid) turns red to black. Red turning to black can calm Juyang Qi, hence it is said to rapidly descend Qi.
Huangdi said: Excellent. Some suffer from body heat, flaccidity, sweating profusely as if bathing, aversion to wind, and shortness of breath. What disease is this?
"E" is pronounced with the departing tone. Having established treatment for Yang Jue, Yin Jue should also have treatment. Huangdi grasped the implication and praised it, then asked about the disease characterized by heat, sweating, aversion to wind, and shortness of breath.
Qibo said: This disease is named Jiufeng (Wine Wind).
Wine Qi acts first on the skin and fills the collaterals, causing body heat, sweating, and aversion to wind. It does not distribute essence through the central Earth (Spleen/Stomach), leading to flaccidity and shortness of breath. Qibo calls this Jiufeng, likely an autumn disease.
Huangdi asked: How should it be treated?
Qibo said: Use Ze Xie (Alisma Rhizome) and Bai Zhu (Atractylodes Macrocephala Rhizome) each in 10 parts, and Mi Xian (Elsholtzia Spica) in 5 parts. Mix and take three fingers' worth as a dose, taken before meals.
"Fen" is pronounced with the departing tone. Jiufeng disease involves deficiency in the central Earth. Ze Xie and Bai Zhu, each 10 parts, serve as the Sovereign herbs to tonify Spleen Earth. Mi Xian, 5 parts, serves as the Minister herb to dispel wind pathogens. Mix these and take a dose held between three fingers. Take the medicine first, tonify the center, dispel wind pathogens, and then eat, to benefit Stomach Qi. Combining Carbuncle of the Epigastrium, Jue syndrome, Neck Carbuncle, Manic Delirium, and Wine Wind illustrates "Bing Neng" and the principles of "Kui Du Qi Heng." Since the主旨 (main purport) was not fully expounded, the following text discusses Extraordinary Diseases and Great Extraordinary Diseases.