First Section on the Diseases and Symptoms of the Zang-Fu Organs and Meridians
Section 2
Human beings are endowed with the five constants, growing and thriving due to the influence of wind and qi. Although wind and qi can give rise to all things, they can also harm all things, just as water can float a boat or capsize it. If the true qi of the five organs is unobstructed, the person will be peaceful and harmonious; however, if external pathogenic wind invades, many will perish. There are myriad diseases, but they can be categorized into three types: first, when the meridians are invaded by pathogens, entering the Zang-Fu organs, which is an internal cause; second, when the limbs and nine orifices are obstructed, causing blood vessels to be blocked, which is an external cause; third, injuries from sexual activity, sharp instruments, or insects and beasts, which are neither internal nor external causes. If a person can cultivate and be cautious, preventing pathogenic wind from obstructing the meridians, and if the meridians are appropriately balanced and have not transmitted to the Zang-Fu organs, then treatment can be administered. If the limbs feel heavy and stagnant, one should practice Dao Yin (Guiding and Stretching), Tu Na (Breathing Exercises), acupuncture, and massage, ensuring that the nine orifices do not become blocked. Furthermore, one should avoid violating the laws of nature, prevent injuries from beasts, and not exhaust oneself in sexual activities. Dietary intake should be balanced in temperature and flavor, avoiding extremes that lead to bodily decline, thus preventing diseases from entering the cang li (skin pores). The cang refers to the area where the three jiao (three burners) connect with the true qi, where blood and qi are injected; the li refers to the texture of the skin and the Zang-Fu organs.
Introduction: The Classic of Difficult Issues is edited according to the classification method of Liu Duzhou’s Commentary on the Classic of Difficult Issues, marked by chapter and section. The annotations are primarily selected from the works of Qing Dynasty and modern medical practitioners, and due to personal understanding, there may be biases. Readers are encouraged to extract the essence and discard the dross, combining it with clinical practice and focusing on personal understanding. Comments and contributions of famous discussions or personal annotations are welcome!
Qing Dynasty, You Yi, Heart of the Classic of Difficult Issues
Human beings are endowed with the five elements of yin and yang, and their growth and longevity depend on wind and qi. Without the eight winds, there would be no movement and harmony; without the six qi, there would be no transformation and nourishment. However, where there is righteous qi, there is also pathogenic qi; where there is harmonious wind, there is also evil wind. The ability to give life and cause harm arises from a single mechanism, just as water can float a boat or capsize it. Therefore, when harmony is achieved, it is righteous qi; when harmony is lost, it is pathogenic qi; when righteousness is obtained, it is harmonious wind; when righteousness is lost, it is evil wind. The ability to give life is strong, and the ability to cause harm is also strong, which is why many perish. However, wind has varying weights, and diseases have varying depths. In summary, they can be categorized into three types: first, when evil enters the Zang-Fu organs through the meridians, which is an internal cause; second, when evil resides in the limbs and nine orifices, flowing along the blood vessels, which is a superficial external cause; third, when diseases arise from sexual activity, sharp instruments, or injuries from insects and beasts, which are neither internal nor external causes. If a person can cultivate and be cautious, preventing pathogenic wind and unusual qi from obstructing the meridians, there will be no disease; if it enters the meridians but has not yet entered the Zang-Fu organs, it can be treated through sweating, purging, or harmonizing. This corresponds to the previous internal cause. If the wind and qi invade the limbs and approach the nine orifices, then Tu Na, Dao Yin should be practiced to move the qi, acupuncture and massage should be used to expel the evil, thus relieving heaviness and stagnation, preventing blockage. Furthermore, one should avoid violating the laws of nature, prevent injuries from beasts, and ensure that sexual activities do not lead to exhaustion. Additionally, dietary intake should be balanced in temperature and flavor, avoiding extremes that lead to bodily decline, thus preventing diseases from entering the cang li. The cang refers to the area where the three jiao connect with the true qi, where blood and qi are injected; the li refers to the texture of the skin and the Zang-Fu organs.
Qing Dynasty, Wu Qian, Golden Mirror of Medicine
[Note] This section serves as the outline of the book, previously misclassified as a subsequent section, now placed at the beginning to clarify the main idea.
[Annotation] The five constants refer to the five elements. The qi of the five elements—wind, heat, dampness, dryness, and cold; the flavors of the five elements—sour, bitter, sweet, spicy, and salty. Human beings are endowed with these, thus the Zang-Fu organs communicate with the qi and flavors. It is not called the five qi, but rather the wind qi, which refers to other qi. Wind penetrates the four qi, just as benevolence penetrates the four virtues, hence it is said: they grow and thrive due to wind qi. However, while wind qi can give rise to all things, it can also harm all things, as it is the master of righteous wind, coming from its place of origin, and is the master of nourishing all things; pathogenic qi and evil wind come from behind, and are the masters of harming all things. When humans are in the midst of qi, their growth and harm are like water that can float a boat or capsize it. The five qi of heaven, when obtained by humans, become the true yuan qi of the five Zang organs. If they are unobstructed and mutually nourishing, even if there is pathogenic qi and evil wind, they cannot cause harm, and the person remains peaceful and harmonious; if they are obstructed, then pathogenic qi and evil wind can invade, leading to many deaths. The causes of death, although numerous, can be summarized into three main causes: first, when the center is deficient, and the meridians are invaded by evil, entering the Zang-Fu organs, which is an internal cause; second, when the center is strong, although affected by evil, the Zang-Fu organs are not affected, and only the external body, limbs, and nine orifices are obstructed, which is an external cause; third, injuries from sexual activity, sharp instruments, or insects and beasts, which are neither internal nor external causes. By detailing these three causes, all diseases can be understood. If a person can carefully cultivate their essence and qi, preventing pathogenic wind and evil qi from obstructing the meridians, there will be no disease; if it enters the meridians but has not yet entered the Zang-Fu organs, treatment can be administered to cure them. If the limbs and nine orifices feel heavy and stagnant, one should practice Dao Yin, Tu Na, acupuncture, and massage to prevent blockage. Furthermore, one should avoid violating the laws of nature, prevent injuries from beasts, and ensure that sexual activities do not lead to exhaustion. Dietary intake should be balanced in temperature and flavor, avoiding extremes that lead to bodily decline, thus preventing diseases from entering the cang li. The cang refers to the area where the three jiao connect with the true qi, where blood and qi are injected; the li refers to the texture of the skin and the Zang-Fu organs.
Qing Dynasty, Gao Xueshan, Commentary on the Classic of Difficult Issues
The five constants refer to the five elements, which originate from the Inner Canon and the discussion of the five constants. The eastern qi gives rise to movement and becomes wind; humans are endowed with the life-giving qi of the east, hence it is said to grow due to wind. Wind is also the leader of the six evils and the source of all diseases, hence it is said to also cause harm. The ability to give life and cause harm is evident, as humans cannot escape from the myriad things. Observing the water that can float a boat or capsize it, the principle becomes more credible. The true yuan refers to the true yang qi of the five Zang organs. This sentence is crucial for health preservation and disease treatment, and scholars should pay close attention. If the true yuan is unobstructed, the defensive qi is naturally solid, and the meridians will not be invaded by evil; how could they enter the Zang-Fu organs? This indicates there is no internal cause. Furthermore, if the true yuan is unobstructed, the spirit and mechanism flow through, and the limbs and nine orifices will not become obstructed, indicating there is no external cause. To avoid the harm of wind qi, one must cherish the true yuan; those who preserve their health can avoid disease, and those who treat diseases can save those who are already ill. This not only serves as an outline for the subsequent twenty-five sections but also as a major outline for this section’s seventeen clauses. Pathogenic qi refers to the qi that invades from the Five Constants and Six Evils; evil wind refers to the wind of the heavens and earth that is empty and harmful. These two sentences still relate to internal and external causes, indicating that if one does not know how to cherish the true yuan, the internal qi will not be sufficient externally, and external evils will penetrate internally, leading to certain death. The jing refers to the meridians, while the luo refers to the collaterals. The meridians connect externally to the skin and internally to the Zang-Fu organs. If the true yuan of the Zang organs is insufficient, evil will inevitably enter the organs. Hence, it is called an internal cause. The hands and feet are the four limbs, while the ears, eyes, mouth, nose, and the two lower orifices are the nine orifices. All must have unobstructed true yuan to ensure the blood vessels are interconnected. If the blood vessels are obstructed, it indicates the invasion of external evils, leading to the insufficiency of the true yuan, hence it is said to be an external cause. The term fang shi refers to sexual activity. The term jin ren does not refer to killing; it refers to injuries from sharp instruments, such as those from ancient palaces or foot amputations. The term chong shou refers to the injuries from insects and beasts, indicating that without the true yuan of the Zang organs, the blood vessels will not be interconnected, leading to the emergence of diseases that are neither internal nor external, hence it is said to not exceed three categories. Now, regarding internal causes, one should nourish the true yuan, be cautious in rising and resting, preventing evils from obstructing the meridians; next, even if one has already been affected by evils, they should be treated early to prevent transmission to the Zang organs. Regarding external causes, if evils invade, they must first enter through the limbs and gradually reach the nine orifices, feeling heavy and stagnant. One should practice Dao Yin to facilitate movement, Tu Na to clear the qi, acupuncture to release blood, moxibustion to strengthen fire, medicated plasters to activate stagnation, or massage to disperse blockages, allowing the evil to exit and the qi to flow, thus preventing the nine orifices from becoming blocked. Treatment for internal and external causes is as follows. The term wang fa refers to the previously mentioned sharp instruments, broadly referring to whips and sticks. The term qin shou refers to insects and beasts, such as the belief that peacock feces can cause miasma. The term zai shang refers to various injuries, indicating that even if it is said to be fate, one should still be cautious. If sexual activity is excessive, clothing and food are too hot or cold, and the five flavors are not balanced, although each has its preferences, they also have their aversions. If one has a preference, they will suffer decline; thus, if one can be cautious, how can diseases enter their cang li?
The term cang li refers to the gaps in the body, where blood and qi circulate; it is the pathway of the three jiao that connects the true yuan. The li refers to the texture of the skin and the Zang-Fu organs. Qing Dynasty, Shen Mingzong, Zhang Zhongjing’s Classic of Difficult Issues
This section is the main idea of the book, serving as the outline. Previous scholars misclassified it as a subsequent section, and it is now placed at the beginning to clarify the main points, preventing confusion. The Great Discussion on the Heavenly Origin states: the five movements of yin and yang are the principles of heaven and earth, the framework of all things, the parents of transformation, and the origin of life and death. In heaven, it is mysterious; in humans, it is the way; in the earth, it is transformation. Transformation gives rise to the five flavors, the way gives rise to wisdom, and the mysterious gives rise to spirit. The spirit in heaven corresponds to the five qi of wind, cold, heat, dampness, dryness, and fire; on earth, it corresponds to the five elements of wood, fire, earth, metal, and water; in humans, it corresponds to the five Zang organs of heart, liver, spleen, lung, and kidney. It is also said that in heaven, it is qi; on earth, it is form. The interaction of form and qi gives rise to the physical forms of all things. Therefore, Zhang Zhongjing states: humans are endowed with the five constants, which are the constant qi of heaven and earth, the five movements of yin and yang. Qi is wind, and wind is the primary qi of the east, which gives rise to the four seasons and the six qi. The qi of heaven transforms and nourishes all things, and must follow the movements of the eight winds to manifest. When it manifests, cold, heat, dampness, dryness, and fire follow accordingly, and humans are affected by this qi, thus they grow and thrive due to wind qi. However, wind has both righteous and evil aspects. Righteous wind is the gentle wind that nurtures all things, while evil wind is the harsh wind that destroys all things. Therefore, while wind qi can give rise to all things, it can also harm all things, just as water can float a boat or capsize it. The true yuan of the five organs is unobstructed, and the person is peaceful and harmonious, indicating that the internal qi is not deficient, thus they are not affected by evils and do not become ill. If the weather is cold and one reacts with heat, or if it is hot and one reacts with cold, this is pathogenic evil wind, leading to many deaths. The diseases of the human body do not exceed the categories of internal and external, yin and yang, internal causes, external causes, and neither internal nor external causes. Thus, it is said: myriad diseases can be categorized into three types: first, when the meridians are invaded by evil and enter the Zang-Fu organs, which is an internal cause, indicating a major evil affecting the exterior, such as a cold or flu that transmits through the meridians into the interior, leading to the disease of meridian invasion; second, when evil enters through the limbs and nine orifices, obstructing the blood vessels and muscles, leading to conditions such as spasms, paralysis, or wind bi, which are external skin conditions; third, when diseases arise from sexual activity, sharp instruments, or injuries from insects and beasts, which are neither internal nor external causes, indicating self-inflicted injuries. By detailing these three causes, all diseases can be understood. If a person can cultivate and be cautious, preventing pathogenic wind from obstructing the meridians, they will have no internal damage and thus no disease. If the meridians are affected but have not yet transmitted to the Zang-Fu organs, treatment can be administered to prevent the seven transmissions of disease, indicating that internal causes must be treated early. If the limbs feel heavy and stagnant, one should practice Dao Yin, Tu Na, acupuncture, and massage to prevent the nine orifices from becoming blocked, thus avoiding conditions such as spasms, weakness, pain, or paralysis, indicating that external causes must also be treated early. Furthermore, one should avoid violating the laws of nature, prevent injuries from beasts, and ensure that sexual activities do not lead to exhaustion. Dietary intake should be balanced in temperature and flavor, avoiding extremes that lead to bodily decline, thus preventing diseases from entering the cang li. The cang refers to the area where the three jiao connect with the true qi, where blood and qi are injected; the li refers to the texture of the skin and the Zang-Fu organs.
Liu Duzhou, Commentary on the Classic of Difficult Issues
This section discusses the unity of humans and the natural environment. “Humans are endowed with the five constants” refers to the five elements, and their growth and survival depend on wind and qi. Therefore, the phrase “growing due to wind qi” indicates that the conditions for life cannot be separated from air, which is wind qi. The seasonal wind qi flows in accordance with the climatic requirements of the natural world, allowing all things to grow; if the natural climate is abnormal, it can poison all things, becoming a pathogenic factor for humans. However, whether pathogenic factors can lead to disease also depends on the body’s ability to resist evils. As long as the true yuan qi of the five organs is sufficient and the defensive qi is unobstructed, the ability to resist disease is strong, allowing adaptation to abnormal climates without being affected by pathogenic qi. Conversely, if the pathogenic qi invades, it can harm the body, even leading to death. The causes of disease can be categorized into three types: first, when the righteous qi is deficient, and the meridians are invaded by evil, entering the Zang-Fu organs; second, when the righteous qi is not deficient, but pathogenic wind invades the skin, affecting the blood vessels and causing the limbs and nine orifices to become obstructed; third, due to excessive sexual activity, injuries from sharp instruments, or bites from insects and beasts, which are different pathogenic factors. If a person can cultivate their righteous qi, ensuring it is sufficient, pathogenic wind and cold will not invade the meridians. If one is careless and pathogenic qi enters the meridians before it has transmitted to the Zang-Fu organs, treatment should be administered promptly. For instance, if the meridians feel heavy and stagnant, one should practice Dao Yin, Tu Na, acupuncture, and massage to prevent blockage of the nine orifices. Furthermore, one should adhere to the laws of nature, avoid injuries from beasts, and not exhaust oneself in sexual activities. Dietary intake should be moderate in temperature, avoiding extremes, and the five flavors should be balanced to prevent decline in the body, thus preventing pathogenic factors from entering the cang li. The cang refers to the area where the three jiao connect with the true qi, where blood and qi are injected; the li refers to the texture of the skin and the Zang-Fu organs.
Hu Xishu, Lectures on the Classic of Difficult Issues
The second paragraph discusses the five elements and five movements. “Humans are endowed with the five constants” refers to the five elements and five movements. In heaven, it is wind; on earth, it is wood; in humans, it is the liver. Humans are endowed with the qi of heaven and earth, and the five qi of heaven and the five elements of earth are all constants. Metal, wood, water, fire, and earth, along with wind, heat, dampness, dryness, and cold, are the five qi of heaven. The term wind qi encompasses the five qi, as the five qi of heaven transform all things through wind qi.
While wind qi can give rise to all things, it can also harm all things. This statement has been made many times. The ancients said that not all winds harm people; only the unwholesome winds, the empty and evil winds, pose problems. Of course, it is unnecessary to criticize the ancients, but they held this view. They stated that the wind qi encompasses the five qi, and the five movements of heaven and earth allow all things and humans to grow due to wind qi. However, while wind qi can give rise to all things, unwholesome winds and unwholesome qi can also harm all things, just as water can float a boat or capsize it. The ability of wind qi to harm humans does not solely depend on the wind; it also requires issues within the body. This is a valid point.
The five organs each have their true yuan qi, which is referred to as organ qi. The ancients said that the true yuan refers to the original qi. If the true yuan of the five organs is unobstructed, even if one encounters pathogenic qi and evil wind, it will not harm them, and they will be peaceful and harmonious. The key lies within the person. Therefore, on one hand, those who are good at preserving their health will have unobstructed true yuan, and they will not become ill even if they encounter some evil wind; they will remain peaceful and harmonious, as the pathogenic qi and evil wind will not harm them. On the other hand, if one does not preserve their health and has many issues, then pathogenic qi and evil wind will surely find them, leading to many deaths. This is the meaning behind the statement that many perish.
From this perspective, a summary is made below.
Myriad diseases can be categorized into three types: first, when the meridians are invaded by evil and enter the Zang-Fu organs, which is an internal cause; second, when the limbs and nine orifices are obstructed, leading to blood vessel blockage, which is an external cause; third, when injuries arise from sexual activity, sharp instruments, or insects and beasts, which are neither internal nor external causes. By detailing these three causes, all diseases can be understood. If a person can cultivate and be cautious, preventing pathogenic wind from obstructing the meridians, they will have no internal damage and thus no disease. If the meridians are affected but have not yet transmitted to the Zang-Fu organs, treatment can be administered to prevent the seven transmissions of disease, indicating that internal causes must be treated early. If the limbs feel heavy and stagnant, one should practice Dao Yin, Tu Na, acupuncture, and massage to prevent the nine orifices from becoming blocked, thus avoiding conditions such as spasms, weakness, pain, or paralysis, indicating that external causes must also be treated early. Furthermore, one should avoid violating the laws of nature, prevent injuries from beasts, and ensure that sexual activities do not lead to exhaustion. Dietary intake should be balanced in temperature and flavor, avoiding extremes that lead to bodily decline, thus preventing diseases from entering the cang li. The cang refers to the area where the three jiao connect with the true qi, where blood and qi are injected; the li refers to the texture of the skin and the Zang-Fu organs.
Conclusion
Inheriting and promoting Traditional Chinese Medicine is our responsibility!
Copyright Notice
Copyright Notice: Some content of this article is excerpted from Commentary on the Classic of Difficult Issues, author/Liu Duzhou; Lectures on the Classic of Difficult Issues, speaker/Hu Xishu. The purpose of reprinting is to disseminate knowledge of Traditional Chinese Medicine culture, and the copyright belongs to the relevant rights holders. If there are any improper uses, please feel free to contact us for negotiation. The section titled Zi Heng Shi Zhu is original content, please indicate the source when reprinting.
Full Chapter Content
Section 1: Question: What does it mean to treat diseases before they occur? The Master said: To treat diseases before they occur means to recognize the disease of the liver and know that it transmits to the spleen, thus one should first strengthen the spleen. In the four seasons, if the spleen is strong and not affected by evils, there is no need to supplement it. The intermediate practitioner does not understand the transmission, sees the disease of the liver, and does not strengthen the spleen, only treating the liver. For liver diseases, sour herbs are used to supplement, bitter herbs are used to assist, and sweet herbs are used to adjust. Sour enters the liver, bitter enters the heart, and sweet enters the spleen. The spleen can harm the kidney; if the kidney qi is weak, water will not flow; if water does not flow, heart fire will be excessive, harming the lung; if the lung is harmed, metal qi will not flow; if metal qi does not flow, liver qi will be excessive, leading to self-healing of the liver. This is the key to treating liver by supplementing the spleen. If the liver is deficient, this method should be used; if it is not deficient, it should not be used. The classic states: Do not be deficient or excessive; supplement the insufficient and reduce the excessive. This is its meaning. The other organs follow this principle.
Section 2: Human beings are endowed with the five constants, growing and thriving due to the influence of wind and qi. Although wind and qi can give rise to all things, they can also harm all things, just as water can float a boat or capsize it. If the true qi of the five organs is unobstructed, the person will be peaceful and harmonious; however, if external pathogenic wind invades, many will perish. There are myriad diseases, but they can be categorized into three types: first, when the meridians are invaded by pathogens, entering the Zang-Fu organs, which is an internal cause; second, when the limbs and nine orifices are obstructed, causing blood vessels to be blocked, which is an external cause; third, injuries from sexual activity, sharp instruments, or insects and beasts, which are neither internal nor external causes. If a person can cultivate and be cautious, preventing pathogenic wind from obstructing the meridians, and if the meridians are appropriately balanced and have not transmitted to the Zang-Fu organs, then treatment can be administered. If the limbs feel heavy and stagnant, one should practice Dao Yin, Tu Na, acupuncture, and massage, ensuring that the nine orifices do not become blocked. Furthermore, one should avoid violating the laws of nature, prevent injuries from beasts, and not exhaust oneself in sexual activities. Dietary intake should be balanced in temperature and flavor, avoiding extremes that lead to bodily decline, thus preventing diseases from entering the cang li. The cang refers to the area where the three jiao connect with the true qi, where blood and qi are injected; the li refers to the texture of the skin and the Zang-Fu organs.
Section 3: Question: When a patient has a complexion that can be seen on the face, I would like to hear your explanation. The Master said: If the tip of the nose is blue, there is abdominal pain, and if it is cold, the person will die. If the tip of the nose is slightly black, there is water qi; if it is yellow, there is cold in the chest; if it is white, there is blood loss. If it is slightly red and out of season, the person will die. If the eyes are perfectly round, it indicates spasm, and it is untreatable. Furthermore, blue indicates pain, black indicates labor, red indicates wind, yellow indicates difficulty in defecation, and bright colors indicate retention of fluids.
Section 4: The Master said: If a patient speaks quietly and is prone to surprise, there is a disease in the joints; if the voice is hoarse and unclear, there is a disease in the heart; if the voice is high-pitched and long, there is a disease in the head.
Section 5: The Master said: If the breath shakes the shoulders, it indicates a hardened heart; if the breath is drawn from the chest, it indicates cough; if the breath is short and the mouth is open, it indicates lung atrophy and saliva.
Section 6: The Master said: If the breath is shallow and rapid, the disease is in the middle jiao, and if it is full, it should be purged immediately; if it is deficient, it should not be treated. If it is in the upper jiao, the breath is rapid; if it is in the lower jiao, the breath is distant; these are all difficult to treat. If the breath shakes and vibrates, it is untreatable.
Section 7: The Master said: If the pulse at the cun position is moving, it is due to the timing of the king; if the liver is associated with the color blue, each season corresponds to its color. If the liver is blue and turns white, it is not the correct pulse color, and the person is ill.
Section 8: Question: There are cases where something has not yet arrived but is about to arrive, and there are cases where something has arrived but does not arrive, and there are cases where something has arrived but does not leave, and there are cases where something has arrived too much; what does this mean? The Master said: After the winter solstice, at midnight of the Jiazi, the Shaoyang rises. During the time of Shaoyang, yang begins to be born, and the heavens become warm and gentle. If it has not yet reached Jiazi, the heavens are warm and gentle, this is what is meant by something not yet arriving but about to arrive; if it has reached Jiazi but the heavens are not warm and gentle, this is what is meant by something arriving but not arriving; if it has reached Jiazi but the heavens are extremely cold and do not resolve, this is what is meant by something arriving but not leaving; if it has reached Jiazi and the heavens are warm and gentle like in the summer months of May and June, this is what is meant by something arriving too much.
Section 9: The Master said: If the pulse is floating in the front, the disease is in the exterior; if it is floating in the back, the disease is in the interior. If there is pain in the waist and the back is stiff and unable to move, it must be short of breath and extreme.
Section 10: The Master said: The classic states: “The yang of the foot is alone,” what does this mean? The Master said: This refers to having yang without yin, hence it is called the yang of the foot.
Section 11: Question: If the pulse is deep, large, and slippery, deep indicates fullness, and slippery indicates qi. If the solid qi collides, blood qi enters the Zang organs, it leads to death; if it enters the Fu organs, it leads to recovery; this is called sudden collapse. What does this mean? The Master said: If the lips and mouth are blue, and the body is cold, it indicates entry into the Zang organs leading to death; if the body is warm and sweating, it indicates entry into the Fu organs leading to recovery.
Section 12: Question: If the pulse is weak, it indicates entry into the Zang organs leading to death; if it enters the Fu organs, it leads to recovery; what does this mean? The Master said: This is not a single disease; all diseases are like this. For example, if a sore is soaked and flows from the mouth to the limbs, it can be treated; if it flows from the limbs to the mouth, it cannot be treated; if the disease is external, it can be treated; if it enters the interior, it leads to death.
Section 13: Question: There are eighteen yang diseases; what does this mean? The Master said: Headache, neck, waist, spine, arm, and leg pain. There are eighteen yin diseases; what does this mean? The Master said: Cough, shortness of breath, wheezing, hiccups, throat sounds, intestinal sounds, bloating, heart pain, and rigidity. Each of the five Zang organs has eighteen diseases, totaling ninety diseases. There are also six subtle diseases, each with eighteen diseases, totaling one hundred and eight diseases. The five labors and seven injuries, and the thirty-six diseases of women are not included. Clear evils reside above, while turbid evils reside below; major evils are in the exterior, while minor evils are in the interior. The evils that enter through the mouth are from food. Each of the five evils has its own rules: wind affects the front, cold affects the evening, dampness harms the lower body, and mist harms the upper body; wind causes the pulse to float, cold causes the pulse to be rapid, mist harms the skin and pores, dampness flows into the joints, and extreme cold harms the meridians, while extreme heat harms the collaterals.
Section 14: Question: When a disease is urgent, should one save the interior or the exterior? The Master said: If the disease is treated and the lower part is relieved, and the clear fluids do not stop, causing body pain, one should urgently save the interior; if the body pain is relieved and the clear fluids adjust themselves, one should urgently save the exterior.
Section 15: If a chronic disease is added to an acute disease, one should first treat the acute disease, and then treat the chronic disease.
Section 16: The Master said: Each Zang organ disease has its own treatment; each Zang organ disease has its own aversions, and each should be treated according to what it dislikes. If a patient does not respond to food, but instead thinks about it excessively, they will surely develop a fever.
Section 17: For all diseases in the Zang organs, one should attack them according to their characteristics. For thirst, use zhi ren tang (Polygala Decoction), and the rest should be treated similarly.
Practice Makes Perfect
