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Chapter 46 Discourse on Disease Manifestations1 46-256-2 Huang Di asked: “When someone suffers from stomach duct2 yong-abscess, how is this to be diagnosed?”3 Qi Bo responded: “To diagnose this [disease] one must examine the [movement in the] stomach vessel.4 [The movement in] this vessel should be in the depth and fine. When it is in the depth and fine, the qi moves contrary [to its normal course].5 When it moves contrary [to its normal course], the [movement in the vessel at] man‘s facing is extremely abundant. When it is extremely abundant, then there is heat.6 {Man’s facing is [associated with] the stomach vessel.} 1 139/27: “病能 is equivalent to 病態, ‘manifestation of a disease.’ ” see also 1401/66. 2 The Tai su has 胃管, “stomach tube”, for both occurrences of 胃脘. 3 Wu Kun: “Below the respiration gate (i.e., the epiglottis) and above the strong gate (i.e., the cardia), the duct which receives water and grains is called ‘stomach duct.’ 癰 is 毒, ‘poison.’ ”Zhang Zhicong: “The camp [qi] and the guard [qi], the blood and the qi, they are generated by the yang brilliance. In case the blood and the qi are blocked and move contrary [to their normal direction], then this is a disease of abscess-swelling . It is unlike an affection from the outside by the six excessives of the four seasons, or any internal harm by the five states of mind and seven emotions.” 4 The Tai su has 得, “grasp”, instead of 候. 5 Wang Bing: “The stomach is the sea of water and grains. It abounds with blood and its qi is strong. Here now, in contrast, the [movement in the] vessels is in the depth and fine.This is contrary to a normal state.”yao shaoyu: “a stomach abscess is a sign of repletion heat; the [movement in the] vessels should be deep, fine, and strong. a strong [movement] is [a sign of] repletion heat. a deep and fine [movement indicates that] poison has accumulated internally.even though the classic speaks only of a deep and fine [movement], it is without any doubt also a strong one.” 6 Wang Bing: “‘Deep and fine’ are [signs of] cold. When cold qi blocks the yang, the vessel at man’s facing abounds [with qi]. [The vessel at] man’s facing is the yang brilliance vessel. Hence, when it abounds [with qi], then this is [a sign of] heat. ‘Man’s facing’ is the designation of the vessel movement that can be felt on [both] sides of the throat.”Zhang Qi: “The yang brilliance qi moves from the head to the feet.When [the movement] at the instep (fu-yang section/point) is deep and rough while at man’s 678 Huang Di nei jing su wen once there is a movement contrary [to its normal course] and abundance, then heat assembles at the stomach opening and does not move. Hence, the stomach duct develops a yong-abscess.”7 [Huang] Di: “Good! someone lies down to sleep and there is something which does not let him rest. Why is that so?” Qi Bo: “When the depots had been harmed and the essence has [once again its] place it moves to to lean on, then [the patient] finds rest.8 facing it is extremely abundant,then [this is a sign indicating that] the conduit qi does not descend. Hence, one knows that heat accumulates in the stomach.” 7 Wang Bing: “When blood and qi are strong and abound and are hit against by heat internally, the two qi combine their heat. Hence, they form an abscess.” Zhang Jiebin: “When yang brilliance qi moves contrary [to its normal course] and abounds [at man’s facing], then heat evil has gathered in the stomach duct. Hence, it forms abscesses where it stays.” 8 These three lines do not appear to respond to Huang Di’s question. In partial agreement with the Tai su version (see below) one could read: 藏有所傷,及精有所之,倚則 不安, “The depots have been harmed somewhere and the essence has a place to move to. [Patients] lean on something and cannot find rest.” Wang Bing interpreted the character 及 verbally as 及之, “to reach”: “When the five depots are reached by something causing harm, the essence qi of water and grain have somewhere to move to and to settle [there]. If it supports them from below, then one lies down to sleep and finds rest. Because the harm has reached the depots, man cannot suspend the location of...

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