Suwen · Appraising Heat Illness

The text

The Yellow Emperor asked: There are those with a warm illness: sweat goes out, and heat returns at once; the pulse is restless and racing; it does not decline because of the sweat; there is wild speech and they cannot eat. What is the name of the illness? Qi Bo answered: The illness is named yin and yang crossing. Those who cross, die. The Emperor said: I wish to hear the account. Qi Bo said: That by which a person sweats is all born of grain; grain is born of jing. Now when pathogenic qi contends in the bones and flesh and sweat is obtained, this is the pathogen withdrawing and jing prevailing. When jing prevails, one should be able to eat and heat should not return. The returning heat is pathogenic qi; the sweat is jing-qi. Now if sweat goes out and heat returns at once, this is the pathogen prevailing. Not being able to eat means jing has nothing to supply it. When the illness stays, the years of life can be stood and watched as they tilt. Moreover the Discourse on Heat says: if sweat goes out and the pulse is still restless and abundant, there is death. Now the pulse does not answer the sweat; this is not prevailing over the illness; the death is already clear. Wild speech is loss of the will; one who has lost the will dies. Now three deaths are seen, and not one life. Though it seem to recover, there must be death. The Emperor said: There is bodily heat, sweat going out, and vexed fullness; the vexed fullness is not resolved by sweat. What illness is this? Qi Bo said: Sweat going out and the body hot — this is wind. Sweat going out and vexed fullness not resolving — this is reversal. The illness is named wind reversal. The Emperor said: I wish to hear this to the end. Qi Bo said: The Great Yang governs qi, and so receives the pathogen first. Shaoyin is inner and outer with it. Obtaining heat, it follows upward; following, there is reversal. The Emperor said: How does one treat it? Qi Bo said: Needle the inner and the outer; let them drink, and take a decoction. The Emperor said: What is taxation-wind like as an illness? Qi Bo said: Taxation-wind, by rule, is below the lung. As an illness it makes a person stiff above, with dimmed vision; what is spat is like snivel; there is aversion to wind and shivering cold. This is the illness of taxation-wind. The Emperor said: How does one treat it? Qi Bo said: Save the bending and looking-up. For those whose Great Yang still draws jing, three days; for those in middle years, five days; for those without jing, seven days. They cough out green-yellow snivel, its form like pus, as large as a pellet, coming from the mouth or from the nose. If it does not come out, it harms the lung; if it harms the lung, there is death. The Emperor said: There are those with kidney-wind: the face is puffy as if swollen, and speech is blocked and harmed. May one needle? Qi Bo said: In vacuity one should not needle. If one needles what should not be needled, after five days its qi must arrive. The Emperor said: What is the arrival like? Qi Bo said: When it arrives there must be little qi and heat at times. The heat at times goes from chest and back up to the head; sweat goes out; the hands are hot; the mouth is dry with bitter thirst; the urine is yellow; below the eyes there is swelling; there is sound in the belly; the body is heavy and hard to walk; the monthly affair does not come; there is vexation and one cannot eat; one cannot lie face-up; lying face-up, one coughs. The illness is named wind-water. The discourse is in the Needling Methods. The Emperor said: I wish to hear the account. Qi Bo said: Where the pathogen gathers, the qi there must be vacant. When yin is vacant, yang must gather there; therefore there is little qi, heat at times, and sweat going out. Yellow urine means there is heat in the lesser abdomen. Not being able to lie face-up means the stomach is not in accord. Lying face-up, the cough is extreme — it presses the lung from above. In all who have water-qi, a slight swelling is first seen below the eyes. The Emperor said: Why do you say this? Qi Bo said: Water is yin; below the eyes is also yin. The belly is where utmost yin dwells. Therefore water in the belly must make swelling below the eyes. True qi rising against its course: therefore the mouth is bitter and the tongue dry; in lying one cannot face up; facing up, one coughs out clear water. All who have water illness therefore cannot lie; lying, they startle; startling, the cough is extreme. Sound in the belly: the root of the illness is in the stomach. Pressing the spleen, there is vexation and one cannot eat; food that will not go down is a barrier at the stomach duct. The body heavy and hard to walk: the stomach vessel is in the feet. The monthly affair not coming: the womb vessel is closed. The womb vessel belongs to the heart and networks within the womb. Now qi presses the lung from above; heart-qi cannot pass downward; therefore the monthly affair does not come. The Emperor said: Good.

The line

The Yellow Emperor asked: There are those with a warm illness: sweat goes out, and heat returns at once; the pulse is restless and racing; it does not decline because of the sweat; there is wild speech and they cannot eat. What is the name of the illness?

The note

Sweat goes out and heat returns; the pulse is restless and racing. To appraise is to ask whether it is still at the surface. If the name is not yet right, the hand is already in disorder.