【Original Text】
The Yellow Emperor asked: In cases of febrile disease, when sweating occurs, the body becomes hot again and the pulse is rapid and agitated, not due to the decline of sweat, and the patient speaks deliriously and cannot eat, what is the name of this disease?
Qi Bo replied: This disease is called Yin-Yang交 (Yin-Yang Jiao), which signifies death.
The Emperor said: I wish to hear the explanation.
Qi Bo said: The reason for sweating in humans is that it originates from the grain, and the grain is produced from essence. Now, when the evil qi contends within the bones and flesh and causes sweating, it indicates that the evil has been repelled and the essence has triumphed. If the essence triumphs, one should be able to eat without becoming hot again; the return of heat indicates the presence of evil qi, while sweating indicates the presence of essence. Now, if sweating occurs and heat returns, it indicates that the evil has triumphed, and if one cannot eat, it means the essence is lacking. If the disease persists, the patient’s life is in imminent danger. Moreover, the “Treatise on Heat” states: If sweating occurs and the pulse is still rapid and strong, death is imminent. Now, if the pulse does not correspond with the sweat, this indicates that the essence cannot overcome the disease, and death is evident. Delirium indicates a loss of will, and a loss of will leads to death. Now, we see three signs of death and not one sign of life; even if recovery occurs, death is certain.
The Emperor said: There are cases of body heat, sweating, and restlessness, where restlessness is not alleviated by sweating; what disease is this?
Qi Bo said: Sweating and body heat indicate wind; sweating and restlessness that is not alleviated indicate a condition called wind-constraint (风厥, Feng Jue).
The Emperor said: I wish to hear the conclusion.
Qi Bo said: The Taiyang (Greater Yang) governs qi, hence it is the first to receive the evil; the Shaoyin (Lesser Yin) is its interior counterpart, and if it receives heat, it will ascend with it, leading to constraint.
The Emperor said: How should it be treated?
Qi Bo said: Acupuncture at the exterior and interior points, and administer decoctions.
The Emperor said: What about the disease of labor wind (劳风, Lao Feng)?
Qi Bo said: Labor wind affects the area below the lungs, causing symptoms such as stiffness in the neck, blurred vision, expectoration of thick phlegm, and sensitivity to wind with chills; this is the disease of labor wind.
The Emperor said: How should it be treated?
Qi Bo said: By resting and avoiding exertion. The Taiyang (Greater Yang) should be stimulated for three days for young adults, five days for middle-aged individuals, and seven days for those lacking essence. If the patient coughs up phlegm that is yellow and thick, resembling pus and the size of a bullet, it should be expelled from the mouth or nose; if not expelled, it will harm the lungs, and lung damage will lead to death.
The Emperor said: In cases of kidney wind (肾风, Shen Feng), where the face is swollen and the eyelids are puffy, can acupuncture be performed?
Qi Bo said: If the kidney is deficient, acupuncture should not be performed; if it is performed, the evil qi will surely return in five days.
The Emperor said: What will happen when it returns?
Qi Bo said: When the evil qi returns, there will be shortness of breath, intermittent fever, sweating, hot hands, excessive thirst, yellow urine, swollen eyelids, abdominal rumbling, heaviness in the body, difficulty in movement, and in women, the menstrual cycle will cease, leading to restlessness and inability to eat. This condition is called wind-water (风水, Feng Shui), discussed in the “Needling Methods” section.
The Emperor said: I wish to hear the reasoning behind this.
Qi Bo said: The gathering of evil qi is due to the deficiency of righteous qi. When kidney yin is deficient, yang evil will gather, leading to shortness of breath, intermittent fever, and sweating. Yellow urine indicates heat in the lower abdomen. Inability to lie flat indicates disharmony in the stomach. Lying flat leads to severe coughing, as water qi presses upwards towards the lungs. Any patient with water qi will show slight swelling under the eyes.
The Emperor said: Why is that?
Qi Bo said: Water is yin, and the area under the eyes is also yin; the abdomen is the residence of the ultimate yin. Therefore, if there is water in the abdomen, it will cause swelling under the eyes. The true qi reverses upwards, leading to a bitter taste in the mouth and dryness of the tongue, making it impossible to lie flat. Lying flat will cause the expulsion of clear water. Patients with water qi cannot lie flat, as it will lead to anxiety, and anxiety will exacerbate coughing. Abdominal rumbling indicates that the disease originates from the stomach. If the spleen is weak, it leads to restlessness and inability to eat; if food cannot be ingested, it indicates obstruction in the stomach. Heaviness in the body and difficulty in movement is due to the stomach meridian running down to the feet. In women, the absence of menstruation is due to obstruction of the uterine vessels. The uterine vessels belong to the heart and connect to the uterus; now, if water qi presses upwards towards the lungs, the heart qi cannot descend, hence menstruation does not occur.
The Emperor said: Excellent.
【Notes】
①脉躁疾: Refers to a rapid and agitated pulse.
②阴阳交: Yang refers to the evil heat qi; Yin refers to the righteous essence.
③俾: Means to assist or supplement.
④三死: Refers to the three symptoms of sweating, returning heat, and inability to eat, rapid pulse, and delirium.
⑤风厥: Refers to a condition caused by wind invasion, deficiency of essence, and upward reversal of Shaoyin fire leading to fever and unrelieved restlessness.
⑥上从之: Refers to the upward reversal of Shaoyin deficiency heat following the Taiyang qi.
⑦劳风: Refers to a condition caused by labor leading to deficiency, where wind invasion causes chills, stiffness in the neck, and cough with thick phlegm.
⑧巨阳引: Refers to acupuncture at points on the Taiyang meridian to stimulate the meridian qi.
⑨肾风: Refers to kidney damage by wind heat, leading to water retention and edema.
⑩庞然: Refers to a swollen appearance.
（11）正偃: Refers to lying flat on the back.
（12）胞脉: Refers to the uterine vessels.
【Translation】
The Yellow Emperor asked: In cases of febrile disease, when sweating occurs, the body becomes hot again and the pulse is rapid and agitated, not due to the decline of sweat, and the patient speaks deliriously and cannot eat, what is the name of this disease?
Qi Bo replied: This disease is called Yin-Yang交 (Yin-Yang Jiao), which signifies death.
The Yellow Emperor said: I wish to hear the explanation.
Qi Bo said: The reason for sweating in humans is that it originates from the grain, and the grain is produced from essence. Now, when the evil qi contends within the bones and flesh and causes sweating, it indicates that the evil has been repelled and the essence has triumphed. If the essence triumphs, one should be able to eat without becoming hot again; the return of heat indicates the presence of evil qi, while sweating indicates the presence of essence. Now, if sweating occurs and heat returns, it indicates that the evil has triumphed, and if one cannot eat, it means the essence is lacking. If the disease persists, the patient’s life is in imminent danger. Moreover, the “Treatise on Heat” states: If sweating occurs and the pulse is still rapid and strong, death is imminent. Now, if the pulse does not correspond with the sweat, this indicates that the essence cannot overcome the disease, and death is evident. Delirium indicates a loss of will, and a loss of will leads to death. Now, we see three signs of death and not one sign of life; even if recovery occurs, death is certain.
The Yellow Emperor said: There are cases of body heat, sweating, and restlessness, where restlessness is not alleviated by sweating; what disease is this?
Qi Bo said: Sweating and body heat indicate wind; sweating and restlessness that is not alleviated indicate a condition called wind-constraint (风厥, Feng Jue).
The Yellow Emperor said: I wish to hear the conclusion.
Qi Bo said: The Taiyang (Greater Yang) governs qi, hence it is the first to receive the evil; the Shaoyin (Lesser Yin) is its interior counterpart, and if it receives heat, it will ascend with it, leading to constraint.
The Yellow Emperor said: How should it be treated?
Qi Bo said: Acupuncture at the exterior and interior points, and administer decoctions.
The Yellow Emperor said: What about the disease of labor wind (劳风, Lao Feng)?
Qi Bo said: Labor wind affects the area below the lungs, causing symptoms such as stiffness in the neck, blurred vision, expectoration of thick phlegm, and sensitivity to wind with chills; this is the disease of labor wind.
The Yellow Emperor said: How should it be treated?
Qi Bo said: By resting and avoiding exertion. The Taiyang (Greater Yang) should be stimulated for three days for young adults, five days for middle-aged individuals, and seven days for those lacking essence. If the patient coughs up phlegm that is yellow and thick, resembling pus and the size of a bullet, it should be expelled from the mouth or nose; if not expelled, it will harm the lungs, and lung damage will lead to death.
The Yellow Emperor said: In cases of kidney wind (肾风, Shen Feng), where the face is swollen and the eyelids are puffy, can acupuncture be performed?
Qi Bo said: If the kidney is deficient, acupuncture should not be performed; if it is performed, the evil qi will surely return in five days.
The Yellow Emperor said: What will happen when it returns?
Qi Bo said: When the evil qi returns, there will be shortness of breath, intermittent fever, sweating, hot hands, excessive thirst, yellow urine, swollen eyelids, abdominal rumbling, heaviness in the body, difficulty in movement, and in women, the menstrual cycle will cease, leading to restlessness and inability to eat. This condition is called wind-water (风水, Feng Shui), discussed in the “Needling Methods” section.
The Yellow Emperor said: I wish to hear the reasoning behind this.
Qi Bo said: The gathering of evil qi is due to the deficiency of righteous qi. When kidney yin is deficient, yang evil will gather, leading to shortness of breath, intermittent fever, and sweating. Yellow urine indicates heat in the lower abdomen. Inability to lie flat indicates disharmony in the stomach. Lying flat leads to severe coughing, as water qi presses upwards towards the lungs. Any patient with water qi will show slight swelling under the eyes.
The Yellow Emperor said: Why is that?
Qi Bo said: Water is yin, and the area under the eyes is also yin; the abdomen is the residence of the ultimate yin. Therefore, if there is water in the abdomen, it will cause swelling under the eyes. The true qi reverses upwards, leading to a bitter taste in the mouth and dryness of the tongue, making it impossible to lie flat. Lying flat will cause the expulsion of clear water. Patients with water qi cannot lie flat, as it will lead to anxiety, and anxiety will exacerbate coughing. Abdominal rumbling indicates that the disease originates from the stomach. If the spleen is weak, it leads to restlessness and inability to eat; if food cannot be ingested, it indicates obstruction in the stomach. Heaviness in the body and difficulty in movement is due to the stomach meridian running down to the feet. In women, the absence of menstruation is due to obstruction of the uterine vessels. The uterine vessels belong to the heart and connect to the uterus; now, if water qi presses upwards towards the lungs, the heart qi cannot descend, hence menstruation does not occur.
The Yellow Emperor said: Excellent.
