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Chapter 1: The Sequence of Diseases of the Zang-Fu Organs and Meridians – Section 16
Diseases of the Zang-Fu Organs and Meridians
Section 16
The Master said: Each of the five Zang organs has its own ailments that can be cured; each has its own aversions, and diseases arise according to what they dislike. If a patient who usually cannot eat suddenly craves food, it will surely lead to fever.
Introduction: The “Jin Kui Yao Lue” is edited according to the classification method in Liu Du Zhou’s commentary, 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 should extract the essence and discard the dross, combining it with clinical practice and focusing on self-understanding. Everyone is welcome to leave comments to supplement famous discussions or share their own annotations!
Notes by Zi Heng
The teacher said: The recovery from diseases of the five Zang organs relies on proper care in diet and daily activities. A diet and lifestyle that suit the condition will benefit recovery. Each Zang organ has its aversions: the heart dislikes heat, the lungs dislike cold, the liver dislikes wind, the spleen dislikes dampness, and the kidneys dislike dryness. What they dislike and do not prefer can accelerate the deterioration of the disease. For example, if a patient who usually cannot eat suddenly can eat or overeats, similar to the condition of “excessive thoughts,” it is a manifestation of weakness trying to save itself. Combined with Section 332 of the “Shang Han Lun,” if accompanied by fever, it indicates that the stomach Qi has been lost, and the prognosis is poor.
Qing Dynasty, You Yi, “Jin Kui Yao Lue Xin Dian”
What is gained, what is disliked, and what is not preferred should be considered in terms of diet and living conditions. As stated in the “Zang Qi Fa Shi Lun”: The liver is associated with the color green, so it should consume sweet foods; the heart is associated with red, so it should consume sour foods; the lungs are associated with white, so it should consume bitter foods; the kidneys are associated with black, so it should consume spicy foods; the spleen is associated with yellow, so it should consume salty foods. Additionally, heart diseases should avoid warm foods and hot clothing, spleen diseases should avoid warm foods, overeating, damp environments, and wet clothing; lung diseases should avoid cold foods and cold clothing; kidney diseases should avoid excessively hot foods and warm roasted clothing. The “Xuan Ming Wu Qi Pian” states that the heart dislikes heat, the lungs dislike cold, the liver dislikes wind, the spleen dislikes dampness, and the kidneys dislike dryness. The “Ling Shu Wu Wei Pian” states that liver diseases should avoid spicy foods, heart diseases should avoid salty foods, spleen diseases should avoid sour foods, lung diseases should avoid bitter foods, and kidney diseases should avoid sweet foods. Each Zang organ has its own gains that lead to recovery, meaning they obtain the appropriate Qi and flavors that stabilize the Zang Qi and dispel the pathogenic Qi. What they dislike leads to disease, meaning they obtain the forbidden Qi and flavors that disturb the Zang Qi and assist the pathogenic factors. If a patient who usually cannot eat suddenly craves food, it indicates a change in the Zang Qi due to pathogenic Qi, and consuming such food will exacerbate the pathogenic Qi and increase fever.
Qing Dynasty, Wu Qian, “Yi Zong Jin Jian”
[Note]
This indicates that each Zang organ has its own gains that lead to recovery, as emotions can counteract each other. For example, anger harms the liver, but if one experiences sadness, it can lead to recovery, as sadness overcomes anger. There are also cases where recovery occurs after a certain period; for instance, if the disease is in the liver, it recovers in summer, as it benefits from the Qi of the season, overcoming what is stronger than it; if it does not recover in summer, it is overpowered in autumn, indicating aversion to what is stronger than it, and it benefits from the abundant Qi; if it does not die in autumn, it holds on until winter, benefiting from the maternal Qi that nourishes it; if it arises in spring, it is happy to regain its position and Qi is abundant, and the other organs follow this pattern. When a patient craves food that they usually dislike, it indicates a change in the Zang Qi due to pathogenic Qi, hence even if they crave food, consuming it will surely lead to fever.
[Collected Annotations]
Cheng Lin said: The “Nei Jing” states: The liver is associated with the color green, so it should consume sweet foods; the heart is associated with red, so it should consume sour foods; the lungs are associated with white, so it should consume bitter foods; the spleen is associated with yellow, so it should consume sour foods; the kidneys are associated with black, so it should consume spicy foods. These are the foods that help the recovery of the five Zang organs. Liver diseases recover in the years of Bing and Ding, arising in the years of Jia and Yi; heart diseases recover in the years of Wu and Ji, arising in the years of Bing and Ding; spleen diseases recover in the years of Geng and Xin, arising in the years of Wu and Ji; lung diseases recover in the years of Ren and Gui, arising in the years of Geng and Xin; kidney diseases recover in the years of Jia and Ding, arising in the years of Ren and Gui. These are the recoveries of the five Zang organs when they regain their positions. Each Zang organ has its aversions: the heart dislikes heat, the lungs dislike cold, the liver dislikes wind, the spleen dislikes dampness, and the kidneys dislike dryness. Each disease arises according to what they dislike. If a patient who usually does not eat suddenly overeats, it will lead to an imbalance, increasing Yang and causing fever.
Qing Dynasty, Gao Xue Shan, “Gao Zhu Jin Kui Yao Lue”
Each organ has its gains; heart diseases gain liver Qi, liver diseases gain kidney Qi, kidney diseases gain lung Qi, and lung diseases gain spleen Qi. Spleen diseases gain heart Qi; this is one aspect; each Zang organ has its time of dominance; this is the second aspect; each of the heart, liver, spleen, lungs, and kidneys has its preferences; this is the third aspect. This refers specifically to what is preferred; recovery occurs when one obtains what is preferred. The “Shang Han Lun” states that if one is thirsty and desires water, give a little to them, and when the stomach Qi is harmonized, they will recover; this is the meaning. What is disliked refers to the heart’s aversion to heat, the lungs’ aversion to cold, the liver’s aversion to wind, the spleen’s aversion to dampness, and the kidneys’ aversion to dryness, and what each organ cannot withstand is what they dislike, which is what they think about. If the heart thinks of heat, it will be harmed by it, leading to heart disease; if the heart cannot withstand the kidneys, the kidneys will overpower it, leading to a critical condition. The other organs follow this pattern. What should not be eaten refers to the five flavors. People have their preferences among the five flavors, and if they are weak in the Zang Qi, they will crave what they usually dislike. If they suddenly crave it, it indicates that the Zang organ is affected by pathogenic Qi, hence it will surely lead to fever. The first statement indicates that the nature of the five Zang organs leads to recovery; the second statement indicates that losing the nature of the five Zang organs leads to illness; the last statement indicates that changing what one usually likes to an extreme dislike is not a trivial matter.
Qing Dynasty, Huang Yuan Yu, “Jin Kui Xuan Jie”
Each Zang organ disease has its gains; for example, a liver deficiency recovers in spring, a heart deficiency recovers in summer, dryness recovers with dampness, and dampness recovers with dryness. Each Zang organ disease has its aversions; what is disliked leads to illness. If a patient who usually cannot eat suddenly craves food, it indicates that the food is what they dislike, and if they suddenly crave it, it will surely lead to internal heat in the Zang organs.
Qing Dynasty, Cao Ying Fu, “Jin Kui Fa Wei”
Each Zang organ disease has its gains, and the five flavors are the closest. This section provides clear examples: for liver deficiency, sour foods are beneficial, hence the use of Wu Mei Wan (Mume Pill) as the monarch herb. If the liver is deficient and affects the spleen, it leads to acute abdominal pain. Acute pain occurs when the liver is dry and presses on the spleen, causing spleen Qi to be obstructed, leading to pain in the abdomen; hence sweet foods are used to strengthen the spleen, as in Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) with honey as the monarch herb. Bitter enters the heart, hence the use of Xie Xin Tang (Drain the Heart Decoction) with Huang Lian (Coptis) as the monarch herb. Spicy enters the lungs, hence the use of Shi Zao Tang (Ten Jujube Decoction) to drain phlegm and water with Yuan Hua (Genkwa) as the monarch herb (recently, people use mustard brine to treat lung abscesses, and white mustard seeds to treat phlegm and fluid, which follows this example). Salty enters the kidneys, hence the use of Pu Huai San (Calamus Ash Powder) for urinary difficulties with calamus ash as the monarch herb (this is the ash of calamus burned in water; recently, people mistakenly think that calamus pollen is used). The Fu Ling Rong Yan Tang (Poria and Salt Decoction) treats urinary difficulties, which also follows this principle. This is a general overview of how each Zang organ disease has its gains for recovery. The lungs dislike cold and govern the skin; cold invading the skin harms the lungs, leading to cold damage. If sweating does not fully resolve, water accumulates in the diaphragm, leading to cough and wheezing. The spleen dislikes dampness and governs the muscles; external wind can condense the muscles, leading to wind stroke, which lingers and penetrates the joints, causing joint pain. Dampness and water Qi coexist, leading to phlegm and fluid accumulation. If it descends to the large intestine, it leads to diarrhea. If it floods and fills, it leads to edema. The heart dislikes dryness and also dislikes water; if the gallbladder and stomach Qi are dry, it leads to insufficient heart Qi, resulting in vomiting blood and nosebleeds, which is the symptom of Xie Xin Tang. If water Qi invades the heart, it leads to palpitations, which is the symptom of Xiao Qing Long Tang. The liver dislikes dryness; dryness leads to excessive gallfire and causes thirst. The liver dislikes stagnation; if there is a reversal, it affects the spleen, leading to acute abdominal pain. The liver also dislikes dampness; if dampness prevails, blood fails, and filth accumulates, leading to parasitic diseases. The kidneys dislike cold; cold water leads to blood failure, resulting in blood in the stool. The kidneys also dislike dryness; if the storage is dry, essence is depleted, and tendons and vessels do not relax, leading to atrophy. This is a general overview of what each Zang organ dislikes. The spleen prefers dryness and dislikes dampness; excessive drinking of tea and alcohol leads to damp phlegm. Lying in damp places leads to wind and pain. The lungs prefer warmth and dislike cold; cold foods and drinks lead to cold and fluid accumulation. Wind and cold invade the lungs, and if the skin is not open, it leads to wind dampness. The kidneys prefer warmth and dislike water; if water accumulates under the ribs, it leads to urinary difficulties, and if not, it leads to abdominal fullness or back pain. The liver prefers coolness and dislikes heat; blood deficiency leads to dryness, resulting in irritability and Qi rising to the heart (the heart is the sovereign organ, and it has no preferences or aversions. Its issues are merely influenced by other organs. The heart prefers tranquility and dislikes disturbance, which is true for everyone, but it is not discussed in the context of disease). Blood heat injures the collaterals, leading to blood and pus in the stool. This is a general overview of the Qi of the five Zang organs, which leads to disease according to what they dislike. In summary, the spleen stores dampness, hence it dislikes dampness. The lungs store coolness, hence they dislike cold. The heart stores heat, hence it dislikes heat. The kidneys store excess water, hence they dislike water. The liver stores gallfire, hence it dislikes dryness. This is the excess Qi of the organs leading to disease. However, excessive sweating can lead to spleen essence not being nourished, resulting in spasms. Dryness in the intestines and stomach can lead to lung heat and cause atrophy. If heart Yang is not vigorous, the pulse changes to knotty and intermittent. Kidney cold and essence deficiency can lead to infertility. Liver blood cold can lead to counterflow. However, insufficient Qi in the organs can also lead to disease! In treating diseases, one must seek the root cause; there are no fixed patterns to adhere to. Readers of the “Jin Kui” should also observe its coherence.
(If a patient who usually cannot eat suddenly craves food, it will surely lead to fever.)
This section should be treated as a separate segment. The ancient text mixed the diseases of the five Zang organs into one, making it difficult to interpret. Chen Xiu Yuan believed that the Zang Qi was transformed by pathogenic Qi, which is merely a conjecture. The statement “usually cannot eat” does not mean “usually dislikes food”; it refers to the initial state of the disease where the patient does not want to eat. This symptom may arise after the disease or as the disease is about to recover. The auspicious and inauspicious signs of pathogenic Qi are based on the presence or absence of stomach Qi. If the disease has both exterior and interior symptoms and the patient cannot ingest food, it leads to death; this is a clear indication that with stomach Qi, life is sustained, and without it, death occurs. The transformation of stomach Qi is the life force of the patient, similar to the pulse returning to normal. A sudden pulse indicates death, while a gradual pulse indicates life; hence the transformation of stomach Qi should also be gradual for recovery, while a sudden onset indicates excessive conditions. The stomach governs the muscles; if a person endures hunger for too long, they will feel cold. After eating to fullness, the body gradually warms. Hence, in the Jue Yin chapter, if one desires food and eats a plain cake, it leads to fever, indicating a sign of survival. However, if the stomach fire is too strong after illness, there may be an urgent desire for food, and eating will lead to intense heat; I have seen this in family members. There are also cases of Yangming dryness and heat, where after eating, there is no bowel movement for several days, and upon fever, the hands and feet cramp; I have seen this in Shen Song Tao, which is why in the “Zhong Zhang” chapter, large doses of Da Huang (Rhubarb) are used, as the “Nei Jing” treats atrophy by specifically targeting Yangming.
Qing Dynasty, Shen Ming Zong, “Zhang Zhong Jing Jin Kui Yao Lue”
This discusses the gains and aversions of the five Zang organs, distinguishing between deficiency and excess diseases. The five Zang organs are associated with the five Qi of cold, heat, warmth, coolness, and dampness, and the five uses of slow, dispersing, softening, gathering, and hardening, as well as the five flavors of bitter, sour, spicy, sweet, and salty, and the five odors of burnt, rancid, fragrant, fishy, and rotten, and the five colors of green, yellow, red, white, and black. However, all things also have specific Qi and flavors, but they are not as comprehensive as those of the human body. If the Zang Qi is insufficient, the Qi of other organs will disturb it, leading to a desire for external Qi and flavors for self-rescue, hence the recovery of each Zang organ disease is based on what they gain. For instance, the liver desires sour, and the kidneys desire salty, which is due to the deficiency of Zang Qi. If the Zang organs are affected by external pathogens, internal stagnation transforms into heat, leading to aversions to external Qi and flavors, hence each Zang organ has its aversions, such as the heart disliking heat and the lungs disliking cold. This should be followed according to what each organ dislikes, as it is the site of receiving pathogens, and what is considered “disliked” is due to the Zang Qi being affected by pathogens. If the Zang Qi is insufficient and the pathogenic Qi disturbs the original Qi, it leads to a desire for external Qi and flavors for self-rescue, hence the craving for food that is usually not preferred will surely lead to fever, as fever is caused by the stagnation of Zang organ Qi leading to internal heat. The “Nan Jing” states that diet and labor harm the spleen; one should prefer flavors. Although Zhong Jing does not mention it, diseases related to Qi and flavors must arise from diet and labor, and should be compared with the “Nan Jing” for completeness.
Qing Dynasty, Chen Xiu Yuan, “Jin Kui Yao Lue Qian Zhu”
The teacher said: Diseases of the five Zang organs can be cured by obtaining what is preferred; if one is given what they like, it can help their righteousness and quell the evil, and the disease can be cured. Each Zang organ disease has its aversions; if one is given what they dislike, it can harm their righteousness and benefit the evil, and the disease will worsen. This nature of disease also reflects the nature of the person; each person has their own preferences, and this applies to all matters, especially food, which is easy to observe. If a patient usually cannot eat, it means they dislike that food; if they suddenly crave it due to illness, it indicates that hunger and thirst are harming them. If they consume it, it will not be suitable for their Zang organs, and it will surely lead to fever, which is not beneficial for Qi and blood, but will only exacerbate the pathogenic factors. It is evident that what is preferred should be given, while what is disliked should be avoided.
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