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Chapter 32 To Pierce Heat 32-186-8 When the liver has a heat disease, the urine turns yellow first.1 The abdomen has pain; [the patient] lies down often and the body is hot.2 When the heat is fought [by the proper qi], [the patient] talks crazily and is frightened. The flanks are full and have pain. The hands and the feet move restlessly. [The patient] cannot sleep peacefully.3 be cured by [letting the patient] sweat. one must not do the contrary and let [the heat] stop [in the body]. This would result in a severe [disease].” lin yi et al.: “yang shangshan states: ‘If one was slightly harmed by cold in winter, this will develop into a warmth disease before summer arrives. If one was severely harmed by cold in winter, this will develop into a summerheat disease after summer has arrived.” Guo Tian: “The evil is concealed in the interior and should be dispersed through sweating. one must not stop the sweating. otherwise, the evil could not be removed [from the body].” Zhang Qi: “In the eight character [passage]暑當与汗... there must be an erroneous omission.” 1 Tanba: “on the basis of the wording in connection with the four depots further below, the character 先 should precede [the characters] 小便.” 2 Wang Bing: “The liver vessel encircles the private organ, touches the lower abdomen , and rises [from there]. Hence [in the case of heat disease in this vessel] the urine does not pass and is yellow first, the abdomen has pain and one lies down a lot. When cold accumulates,it creates cold.Hence the body is hot.”Zhang Qi: “The lower abdomen is the liver region. When the lower abdomen has heat, the urine is yellow as a result. Wood subdues the spleen; hence the abdomen has pain. The liver and the gallbladder share the same qi.When the gallbladder has heat, [the patient] loves to lie down.The minister fire rises to pour out. Hence the entire body is hot.The heat of the five depots is obviously emitted internally; it is not identical with an affection by heat from the outside.”Zhang Zhicong: “ ‘first’ is to say: first there is this or that internally caused heat and first this or that pathocondition appears.” 3 Wang Bing: “even though the conduit and the network [vessels] have received heat, the spirit depots have not taken in an evil yet. The evil and the proper [qi] fight each other. Hence [the text] states 爭. also, the liver vessel rises from the lower abdomen , passes by the stomach, penetrates the diaphragm, spreads into the flanks, follows the throat and then encloses the base of the tongue.Hence [the patient] speaks crazily, the flanks are full and have pain.The nature of the liver is quiet and it masters fright. Hence in the case of a disease [in the liver, the patient] is frightened, hands and feet 500 Huang Di nei jing su wen on geng and xin [days] this is severe; on jia and yi [days the patient] sweats profusely.4 When the qi moves contrary [to its regular course], then death occurs on geng and xin [days].5 Pierce the foot ceasing yin and the [foot] minor yang [conduits].6 {When ‘it moves contrary [to its regular course],’ then [the patient] has headache and is dizzy.7 The vessel pulls on and rushes against the head.}8 are restless, [the patient] lies down, but cannot find peace.” Zhang Jiebin: “When the [heat] qi fights against the liver, then the liver qi turns into disorder. Hence [the patient] talks crazily and is frightened. .. extreme heat generates wind. Wind excess moves into the four limbs. Hence hands and feet are restless.When wood evil invades the soil, it will proceed to the stomach. When the stomach loses its harmony, one’s sleep is not peaceful.”Wu Kun: “When the heat is extreme, then it strikes against the qi of the depots. evil and proper [qi] fight each other.” Zhang Zhicong: “When man sleeps, then the blood returns to the liver. When the liver qi has received harm and cannot take in the blood, [the patient] cannot find sleep.”Cheng shide et al.: “熱爭 is to say: the evil and the proper [qi] fight each other.” 4 Zhang Zhicong: “ ‘Profuse sweating’ is to say: the proper overcomes the evil and [the evil] leaves [the body] to the outside.” 5 Wang Bing: “The liver rules the wood; geng and xin [days] are metal. Metal...

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