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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 31 · Discourse on Heat
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “Heat illnesses all belong to the class of cold damage. Some recover and some die. Death comes within six or seven days, while recovery takes more than ten days. Why? I do not understand and wish to hear the reason.”
Qi Bo replied: “Greater Yang is the gathering of the yang influences. Its vessel connects with the Wind Palace, so it governs their qi. When a person is injured by cold, heat illness follows. Though the heat is severe, death need not follow. But one doubly afflicted by cold cannot escape death.”
The Emperor said: “I wish to hear its manifestations.”
Qi Bo said: “On the first day of cold damage, Greater Yang receives it, causing pain in head and nape and stiffness of waist and spine. On the second day Yangming receives it. Yangming governs flesh; its vessel runs beside the nose and networks with the eyes, so the body is hot, eyes painful and nose dry, and lying down is impossible.
On the third day Shaoyang receives it. Shaoyang governs Gallbladder; its vessel follows the flanks and networks with the ears, so chest and flanks are painful and hearing is lost. When all three yang channels and networks are ill but the zang organs have not been entered, sweating can end it.
On the fourth day Taiyin receives it. Its vessel spreads within Stomach and networks with the throat, so the abdomen is full and throat dry. On the fifth day Shaoyin receives it. Its vessel passes through Kidney, networks with Lung and connects to the tongue’s root, so mouth and tongue are dry and there is thirst.
On the sixth day Jueyin receives it. Its vessel follows the private parts and networks with Liver, so there is vexation and fullness and the scrotum contracts. When the three yin and three yang, five zang and six fu organs are all ill, nutritive and defensive qi fail to move and the five zang organs lose communication: death follows.”
For those not doubly afflicted by cold, Greater Yang illness declines on the seventh day and headache eases somewhat. On the eighth, Yangming illness declines and bodily heat eases somewhat. On the ninth, Shaoyang illness declines and the deaf ears hear faintly. On the tenth, Taiyin illness declines; the abdomen subsides to its former state and food and drink are desired.
On the eleventh, Shaoyin illness declines: thirst ends, fullness ceases, tongue dryness stops and sneezing occurs. On the twelfth, Jueyin illness declines: the scrotum relaxes and the lower abdomen settles slightly. The great pathogenic qi departs entirely, and the illness ends day by day.
The Emperor asked: “How is it treated?”
Qi Bo said: “In treatment, free the vessels of each affected zang organ; the illness then declines and ends day by day. Before three full days have passed, sweating can end it. Once three days are complete, discharging can end it.”
The Emperor asked: “Why does something sometimes remain after heat illness has recovered?”
Qi Bo said: “What remains does so because eating is forced while heat is severe. The illness has declined, but some heat remains hidden. Grain qi then presses against it; the two heats combine, leaving illness behind.”
The Emperor said: “Good. How is what remains treated?”
Qi Bo said: “Observe deficiency and repletion and regulate the contrary and following courses. In this way it can be made to end.”
The Emperor asked: “What should be forbidden in heat illness?”
Qi Bo said: “When heat illness has eased only slightly, eating meat causes relapse and eating too much leaves illness behind. These are its restrictions.”
The Emperor asked: “In double affliction by cold, what are the pulse responses and the form of illness?”
Qi Bo said: “In double affliction by cold, Greater Yang and Shaoyin are both ill on the first day, causing headache, dry mouth, vexation and fullness. On the second, Yangming and Taiyin are both ill, causing abdominal fullness, bodily heat, lack of appetite and delirious speech. On the third, Shaoyang and Jueyin are both ill, causing deafness, contracted scrotum and counterflow. Water and thin drinks cannot enter; the person recognizes no one. Death comes on the sixth day.”
The Emperor asked: “The five zang organs are already injured, the six fu organs obstructed, and nutritive and defensive qi not moving. Why is death delayed a further three days?”
Qi Bo said: “Yangming is chief of the twelve channel vessels and has abundant blood and qi. Thus, after the person ceases to recognize others, three days pass before its qi is exhausted and death follows.
When cold damage develops into warm illness, onset before the summer solstice is called warm illness; onset after the summer solstice is called summer-heat illness. Summer heat should leave together with sweat: do not stop it.”
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