Suwen · On Heat

The text

The Yellow Emperor asked: Heat illnesses now are all of the kind that was harmed by cold. Some recover, some die. Those who die all do so in the space of six or seven days; those who recover all do so after ten days or more. Why? I do not know the explanation; I wish to hear the reason. Qi Bo answered: The Great Yang belongs to all the yang; its vessel joins the Wind Mansion, and so it governs qi for all the yang. When a person is harmed by cold, it becomes a heat illness. Though the heat be extreme, there is no death. Those who are doubly struck by cold and fall ill cannot escape death. The Emperor said: I wish to hear their forms. Qi Bo said: On the first day of harm by cold, the Great Yang receives it; therefore the head and nape ache, and the low back and spine are stiff. On the second day Yangming receives it. Yangming governs the flesh; its vessel flanks the nose and networks the eyes; therefore the body is hot, the eyes ache, the nose is dry, and one cannot lie down. On the third day Shaoyang receives it. Shaoyang governs the gallbladder; its vessel follows the flanks and networks the ear; therefore the chest and flanks ache, and the ears are deaf. When the channels and collaterals of the three yang have all received the illness, and it has not yet entered the zang, sweat can end it. On the fourth day Taiyin receives it. The Taiyin vessel spreads in the stomach and networks the gullet; therefore the belly is full and the gullet is dry. On the fifth day Shaoyin receives it. The Shaoyin vessel pierces the kidney, networks the lung, and ties to the root of the tongue; therefore the mouth is parched, the tongue is dry, and there is thirst. On the sixth day Jueyin receives it. The Jueyin vessel follows the yin organs and networks the liver; therefore there is vexed fullness and the scrotum draws in. When the three yin and three yang, the five zang and six fu, have all received the illness, ying and wei do not travel, the five zang do not pass through — then there is death. In those not doubly struck by cold: on the seventh day the Great Yang illness declines, and the headache is a little better. On the eighth day the Yangming illness declines, and the bodily heat is a little better. On the ninth day the Shaoyang illness declines, and in the deafness one faintly hears. On the tenth day the Taiyin illness declines; the belly reduces as before, and one thinks of drink and food. On the eleventh day the Shaoyin illness declines; thirst stops, there is no fullness; the dry tongue has ended, and one sneezes. On the twelfth day the Jueyin illness declines; the scrotum loosens, the lower belly sinks a little; the great qi has all gone, and the illness is ending day by day. The Emperor said: How does one treat it? Qi Bo said: Treat each by opening its zang vessel; the illness declines and ends, day by day. If it has not yet filled three days, sweat can end it. If it has filled three days, draining below can end it. The Emperor said: When a heat illness has already recovered, and at times something is left behind — why? Qi Bo said: All that is left behind comes from eating by force while the heat was still extreme; therefore something remains. In such cases the illness has already declined, yet heat is still stored; because the grain-qi presses against it, the two heats join, and so something is left behind. The Emperor said: Good. How does one treat what is left behind? Qi Bo said: Watch its vacuity and repletion; regulate what is against and what follows; it can be made to end, of necessity. The Emperor said: In a heat illness, what must be forbidden? Qi Bo said: When a heat illness is a little better, eating meat brings it back; eating much leaves something behind. These are its forbiddens. The Emperor said: In those doubly struck by cold, what are the pulse and the form of the illness like? Qi Bo said: In those doubly struck by cold: on the first day of illness, Great Yang and Shaoyin are both ill — headache, dry mouth, and vexed fullness. On the second day, Yangming and Taiyin are both ill — belly full, body hot, no wish to eat, and delirious speech. On the third day, Shaoyang and Jueyin are both ill — ears deaf, scrotum drawn in, and reversal; water and broth will not go in; they do not know people. On the sixth day, death. The Emperor said: The five zang are already harmed, the six fu do not pass through, ying and wei do not travel — and after this, three more days until death. Why? Qi Bo said: Yangming is the eldest of the twelve channel vessels; its blood and qi are abundant; therefore they do not know people. In three days that qi is then exhausted, and so there is death. Of all who are harmed by cold and become warm: those before the summer solstice are warm illness; those after the summer solstice are summer-heat illness. Summer-heat should go out together with the sweat; do not stop it.

The line

The Yellow Emperor asked: Heat illnesses now are all of the kind that was harmed by cold. Some recover, some die. Those who die all do so in the space of six or seven days; those who recover all do so after ten days or more. Why?

The note

Heat illnesses are all of the kind that was harmed by cold. Harmed by cold, here, is being wounded by cold — not a modern disease name. The six-channel passage is watching how heat changes its seat, day by day.