寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Pattern Differentiation

Byeonjeung

한글 변증  ·  Pinyin Bian Zheng

How an illness declares which way it is going — repletion against vacuity, yin against yang, and what the body does when the two are read the wrong way round

辨證

Forty-nine short sections on how to decide what kind of illness is in front of you. Where 審病 gave the methods of examination, this chapter gives the categories the findings are sorted into: the five repletions and five vacuities, where an illness begins, whether it came from outside or from within, whether it is moving slowly through the viscera or racing, whether the signs agree with the pulse, and what it means when they do not.

The chapter's centre of gravity is the warning it repeats in four different places: a yin illness can look exactly like a yang one, and a physician who treats the look of it does harm. At 3.21 it says so in the plainest language in the whole Bogam — that a case whose pulse and signs are all yin while the illness itself is yang goes unrecognized by the whole world, and that patients die of it in numbers. 3.23 gives the same lesson as four aphorisms, and 3.32 as a table of behaviour: whether the patient lies still or moves, keeps the eyes open or shut, wants light or dark, sleeps facing the wall or facing out.

The last thirteen sections are the Inner Classic's lists of fives — the five flavours' entries, the five qi's illnesses, the five viscera's aversions, the five fluids, the five taxations — set down one after another with almost no comment. They are the tradition's memory work, and they are worth reading as such rather than as doctrine: what each viscus is held to hate, to store, to govern and to turn fluid into is the frame every later discussion assumes.

3.1 The Five Repletions and the Five Vacuities 五實五虛

3.1.1
Source원문

黃帝曰, 願聞五實五虛. 歧伯對曰, 脉盛ㆍ皮熱ㆍ腹脹ㆍ前後不通ㆍ悶瞀, 此謂五實. 脉細ㆍ皮寒ㆍ氣少ㆍ泄利前後ㆍ飮食不入, 此謂五虛. 帝曰, 其時有生者何也. 歧伯曰, 漿粥入胃, 泄注止, 則虛者活; 身汗得後利, 則實者活. 此其候也. 《內經》

Translation영역
The Yellow Emperor said: I should like to hear of the five repletions and the five vacuities. Gibaek replied: a full pulse, hot skin, a distended abdomen, neither urine nor stool passing, and oppression with dim-sightedness — these are called the five repletions. A fine pulse, cold skin, scant qi, outflow of both urine and stool, and no food or drink taken — these are called the five vacuities. The Emperor said: and why is it that some of them live? Gibaek said: when gruel and congee go down into the stomach and the pouring diarrhoea stops, then the vacuous one lives; when the body sweats and the stool is got through, then the replete one lives. These are the signs of it.
Clinical note임상 주석
Five findings on each side, and the two sets are deliberately parallel: pulse, skin, abdomen or qi, the passage of urine and stool, and the state of the mind or appetite. Read together they are a severity score — the more of the five, the graver the case — and the Inner Classic's answer to the question of who survives is given in terms of only one of them each way: the vacuous patient who starts keeping food down, and the replete patient whose bowels open and who sweats. Both are judgments about whether the obstruction has broken, and both are what a modern clinician watches for at the same bedside.

Naegyeong 內經

3.1.2
Source원문

五虛之證, 予甞治數人, 在下則泄瀉不止, 在上則吐痰不止者, 皆死. 盖氣脫無所管攝故也. 早用參朮膏救之, 十活一二. 五實之證, 大承氣湯方見寒門加麻黃救之. 《綱目》

Translation영역
As to the pattern of the five vacuities, I have treated several such cases myself: where it lay below, the diarrhoea would not stop; where it lay above, the vomiting of phlegm would not stop; and all of them died. This is because the qi has deserted and there is nothing left to hold anything in. Giving Ginseng and Atractylodes Paste early to rescue them, one or two in ten live. For the pattern of the five repletions, rescue with Major Qi-Coordinating Decoctionthe formula is given in the Cold chapter plus ephedra.
Clinical note임상 주석
A case report, and an honest one: the author says plainly that all the patients he treated this way died, and that early treatment saves one or two in ten. 氣脫無所管攝 — the qi has deserted and nothing holds anything in — is a description of a patient losing fluid from both ends without the strength to stop it, and the modern reading is a decompensated patient in hypovolaemic shock. The judgment that it must be treated early or not at all is correct, and the treatment available in 1613 was not the one that works. **Ephedra added to Major Qi-Coordinating Decoction is a combination for the record, not for use.** Ephedra (麻黃) is a sympathomimetic and the decoction a strong purgative; given together to a patient with distension and obstruction they could do serious harm.

Gangmok 綱目

3.2 Yin and Yang Engendering Illness 陰陽生病

3.2.1
Source원문

內經曰, 夫邪之生也, 或生於陰, 或生於陽. 其生於陽者, 得之風雨寒暑; 其生於陰者, 得之飮食居處ㆍ陰陽喜怒.

Translation영역
The Inner Classic says: when an evil arises, it arises either in the yin or in the yang. What arises in the yang is got from wind and rain, cold and summerheat; what arises in the yin is got from food and drink, from where one lives, from sexual activity, and from joy and anger.
Clinical note임상 주석
The chapter's first division and the one everything else hangs from: outside or inside. The yang causes are the weather; the yin causes are diet, housing, sex and feeling. 居處, where one lives, is the oldest statement in the tradition of what would now be called environmental and social determinants of health, and the Bogam keeps it in the primary list rather than as an afterthought.

Naegyeong 內經

3.2.2
Source원문

風雨寒熱, 不得虛邪, 不能獨傷人. 此必因虛邪之風與其身形兩虛相得, 乃客其形. 虛邪之中人也, 始於皮膚. 皮膚緩則腠理開, 開則邪從毛髮入, 入則抵深, 深則毛髮立, 毛髮立則淅然, 故皮膚痛. 留而不去, 則傳舍於絡脉, 時痛肌肉. 留而不去, 傳舍於經, 洒淅善驚. 留而不去, 傳舍於輸, 六經不通, 四肢肢節痛, 腰脊乃強. 留而不去, 傳舍於伏衝之脉, 體重身痛. 留而不去, 傳舍於腸胃, 賁響腹脹. 多寒則腸鳴飱泄, 食不化; 多熱則溏出糜. 《靈樞》

Translation영역
Wind and rain, cold and heat cannot injure a person by themselves unless they meet a vacuity-evil. It must be that a vacuity-evil wind and the person's own body, the two vacuities, meet each other, and then it lodges in the form. When a vacuity-evil strikes a person it begins at the skin. When the skin is slack the interstices open; when they open the evil enters by way of the hairs; having entered it presses deeper; being deep the hairs stand up; when the hairs stand up there is a shivering, and so the skin aches. Staying and not departing, it is passed on to lodge in the network vessels, and the flesh aches from time to time. Staying and not departing, it is passed on to lodge in the channels, with chills and a tendency to startle. Staying and not departing, it is passed on to lodge in the transport points, the six channels are blocked, the limbs and joints ache, and the lumbus and spine grow stiff. Staying and not departing, it is passed on to lodge in the hidden thoroughfare vessel, with a heavy body and aching. Staying and not departing, it is passed on to lodge in the stomach and intestines, with rumbling and a distended abdomen. Where cold predominates there is borborygmus and food-shot diarrhoea, with food undigested; where heat predominates, a sloppy stool like gruel.
Clinical note임상 주석
兩虛相得 — the two vacuities meeting each other — is the proposition the whole aetiology rests on: weather alone does not make anyone ill, and a pathogen needs a host already weakened. It is the classical form of what a modern reader would call host susceptibility, and the Bogam states it as a necessary condition rather than a tendency. The rest of the passage is the tradition's model of progression, stated as a sequence of lodgings: skin, network vessels, channels, transport points, the thoroughfare vessel, stomach and intestines. Each stage has its own signs, and the repeated 留而不去 — staying and not departing — is the chapter's way of saying that an untreated illness does not stay where it started. The sequence is also a timetable for intervention, which is the point 3.17 makes explicitly.

Yeongchu 靈樞

3.2.3
Source원문

風雨之傷人也, 先客於皮膚, 傳入於孫脉. 孫脉滿則傳入于絡脉, 絡脉滿則輸于大經脉. 血氣與邪幷客於分腠之間, 其脉堅大, 故曰實. 實者外堅充滿, 不可按之, 按之則痛. 《內經》

Translation영역
When wind and rain injure a person they first lodge in the skin and are passed into the grandchild vessels. When the grandchild vessels are full they are passed into the network vessels; when the network vessels are full they are transported into the great channels. Blood and qi together with the evil lodge in the space of the interstices, and the pulse there is hard and large — hence it is called repletion. In repletion the outside is hard and full to bursting and cannot be pressed; press it and it hurts.

Naegyeong 內經

3.2.4
Source원문

寒濕之中人也, 皮膚不收, 肌肉堅緊, 榮血澁, 衛氣去, 故曰虛. 虛者聶辟聶謂皺, 辟謂疊, 氣不足, 按之則氣足以溫之, 故快然而不痛. 《內經》

Translation영역
When cold and damp strike a person the skin does not draw together, the flesh is hard and tight, the construction blood is rough and the defence qi has gone — hence it is called vacuity. In vacuity the skin is puckered and foldedseop means wrinkled, byeok means layered and the qi is insufficient; press it and the pressure is qi enough to warm it, so that it feels pleasant and does not hurt.
Clinical note임상 주석
The distinction is made by palpation and it still works: a swelling that cannot bear to be pressed is repletion, one that feels better for pressure is vacuity. 按之則痛 against 快然而不痛 is the single most used discrimination in Korean abdominal examination, and this is where it comes from.

Naegyeong 內經

3.2.5
Source원문

其生於陰者, 憂思傷心, 重寒傷肺, 忿怒傷肝, 醉以入房汗出當風傷脾, 用力過度若入房汗出浴水則傷腎. 《靈樞》

Translation영역
As for what arises in the yin: anxious thought injures the heart; redoubled cold injures the lung; indignant anger injures the liver; entering the bedchamber drunk and then sweating in a draught injures the spleen; using one's strength beyond measure, or entering the bedchamber and then bathing in cold water while sweating, injures the kidney.

Yeongchu 靈樞

3.3 Yin and Yang, Vacuous and Full 陰陽虛盛

3.3.1
Source원문

內經曰, 陽虛則外寒, 陰虛則內熱, 陽盛則外熱, 陰盛則內寒.

Translation영역
The Inner Classic says: when the yang is vacuous there is cold without; when the yin is vacuous there is heat within; when the yang is full there is heat without; when the yin is full there is cold within.
Clinical note임상 주석
The four-way table the chapter will use throughout: vacuity or repletion, crossed with yin or yang, giving cold or heat inside or outside. The four passages following explain each cell in turn by a mechanism, which is unusual — the Inner Classic normally asserts such tables without argument.

Naegyeong 內經

3.3.2
Source원문

陽虛生外寒者, 陽受氣於上焦, 以溫皮膚分肉之間. 今寒氣在外, 則上焦不通; 上焦不通, 則寒氣獨留於外, 故寒慄. 《內經》

Translation영역
Vacuous yang engendering cold without: the yang receives its qi at the upper burner and with it warms the skin and the spaces of the flesh. Now when cold qi is on the outside the upper burner does not pass through; when the upper burner does not pass through, the cold qi is left alone on the outside, and so there is shivering.

Naegyeong 內經

3.3.3
Source원문

陰虛生內熱者, 有所勞倦, 形氣衰少, 糓氣不盛, 上焦不行, 下脘不通, 胃氣熱, 熱氣熏胸中, 故內熱. 《內經》

Translation영역
Vacuous yin engendering heat within: there has been taxation fatigue, the build and the qi are worn down, the grain qi is not abundant, the upper burner does not move, the lower stomach duct does not pass through, the stomach qi grows hot, and the hot qi smokes up into the chest — and so there is heat within.
Clinical note임상 주석
The classical account of what later physicians called 陰虛火動, stirring of fire on a vacuous yin, and the chain it gives is worth following: overwork, then wasting, then poor nutrition, then stagnation in the upper and lower digestive tract, then heat. The symptom at the end of it — a burning sensation rising into the chest in an exhausted, underfed patient — is recognizable, and the Bogam's treatment of it is in the 內傷 and 虛勞 chapters.

Naegyeong 內經

3.3.4
Source원문

陽盛生外熱者, 上焦不通利, 則皮膚緻密, 腠理閉塞, 玄府不通, 衛氣不得泄越, 故外熱. 《內經》

Translation영역
Full yang engendering heat without: when the upper burner does not pass freely the skin becomes close and dense, the interstices are shut and blocked, the dark palaces do not open, and the defence qi cannot be discharged — and so there is heat without.
Clinical note임상 주석
玄府, the dark palaces, are the sweat pores, and the mechanism given is heat retained because sweating is obstructed. It is also the rationale for treating a fever by opening the exterior — the method the 傷寒 chapters use — and the physiology behind it is sound as far as it goes: a patient who cannot sweat cannot shed heat.

Naegyeong 內經

3.3.5
Source원문

陰盛生內寒者, 厥氣上逆, 寒氣積於胸中而不瀉. 不瀉則溫氣去, 寒獨留則血凝, 血凝則脉不通, 其脉盛大以澁, 故內寒. 《內經》

Translation영역
Full yin engendering cold within: reverting qi surges upward, and cold qi gathers in the chest and is not discharged. Not being discharged, the warm qi departs; the cold left alone, the blood congeals; the blood congealed, the vessels do not pass through, and the pulse is full and large but rough — and so there is cold within.
Clinical note임상 주석
血凝則脉不通 — congealed blood and vessels that will not pass — with a large but rough pulse and cold gathered in the chest. The description is the tradition's 寒凝血瘀, and the picture it covers includes what a modern clinician would recognize as cold-provoked angina and peripheral vasospasm. The 胸痛 and 心痛 sections treat it with warming rather than cooling, on this reasoning.

Naegyeong 內經

3.4 Inward Damage to the Essence-Spirit 內傷精神

3.4.1
Source원문

內經曰, 故貴脫勢, 雖不中邪, 精神內傷, 身必敗亡. 始富後貧, 雖不傷邪, 皮焦筋屈, 痿躄爲攣. 暴樂暴苦ㆍ始樂後苦, 皆傷精氣. 精氣竭絶, 形體毁沮.

Translation영역
The Inner Classic says: one once honoured who has lost his position, though no evil strike him, is damaged inwardly in the essence-spirit, and the body must come to ruin. One at first rich and afterwards poor, though no evil injure him, has scorched skin and bent sinews, and wilting lameness turns to cramping. Sudden joy and sudden grief, and joy at first followed by grief, all injure the essence qi; and when the essence qi is exhausted and cut off, the bodily form is wrecked and broken down.
Clinical note임상 주석
Loss of standing and loss of money named as causes of physical illness, with the explicit statement that no pathogen need be involved. The Inner Classic's claim is strong — that a fall in circumstances is sufficient on its own to waste the body — and the Bogam prints it in a chapter about how to classify illness rather than in a chapter about feelings, which is where the force of it lies: this is a differential diagnosis to be made at the bedside. The modern reading is the one the passage invites: a patient whose wasting, skin changes and contractures follow a social catastrophe rather than a disease. 始富後貧 — rich at first, poor afterwards — is the sharpest of the four, because it specifies that it is the change and not the condition that does the harm.

Naegyeong 內經

3.5 Cold and Heat Injuring the Form and the Qi 寒熱傷形氣

3.5.1
Source원문

內經曰, 寒傷形, 熱傷氣. 氣傷痛, 形傷腫. 故先痛而後腫者, 氣傷形也; 先腫而後痛者, 形傷氣也. 註曰, 氣傷則熱結於肉分, 故痛; 形傷則寒薄於皮腠, 故腫也.

Translation영역
The Inner Classic says: cold injures the form, heat injures the qi. Injured qi gives pain, injured form gives swelling. So where pain comes first and swelling after, it is the qi injuring the form; where swelling comes first and pain after, it is the form injuring the qi. The commentary says: when the qi is injured, heat binds in the divisions of the flesh, and so there is pain; when the form is injured, cold presses in at the skin and interstices, and so there is swelling.
Clinical note임상 주석
Which came first, the pain or the swelling: the question is asked for its own sake, and the answer decides whether the trouble began in the qi or in the tissue. It is a real clinical question in any soft-tissue or joint problem, and the order of onset is still the first thing a physician asks about a swollen painful limb.

Naegyeong 內經

3.5.2
Source원문

喜怒傷氣, 寒暑傷形. 《內經》

Translation영역
Joy and anger injure the qi; cold and summerheat injure the form.

Naegyeong 內經

3.6 The Method of Seeking the Category 求屬法

3.6.1
Source원문

黃帝曰, 有病熱者寒之而熱, 有病寒者熱之而寒, 二者皆在, 新病復起, 奈何. 歧伯對曰, 諸寒之而熱者取之陰, 熱之而寒者取之陽, 所謂求其屬也. 註曰, 言益火之源以消陰翳, 壯水之主以鎮陽光, 故曰求其屬也. 《內經》

Translation영역
The Yellow Emperor said: there are those ill with heat who are cooled and still have heat, and those ill with cold who are warmed and still have cold; both states persist and a new illness arises on top of them — what is to be done? Gibaek replied: in all cases cooled and still hot, take it from the yin; warmed and still cold, take it from the yang. This is what is meant by seeking its category. The commentary says: this means enriching the source of the fire to dispel the shadow of the yin, and strengthening the ruler of the water to quell the glare of the yang — and that is why it is called seeking its category.
Clinical note임상 주석
The most consequential passage in the chapter. The question is what to do when a correct treatment fails, and the answer is that the fault lies in the opposite half of the pair: heat that will not be cooled is not an excess of fire but a shortage of water, and cold that will not be warmed is not an excess of cold but a shortage of fire. The commentary's two phrases — 益火之源 and 壯水之主 — became the standing names for the two methods, and they are the theoretical ground of every yin-nourishing and yang-warming formula in the book: 六味地黃元 for the one, 八味丸 for the other. 審病 2.6 gives the same argument in Wang Bing's commentary on the nineteen mechanisms. Its appearance twice over, in two chapters, is a measure of how much weight the Bogam puts on it.

Naegyeong 內經

3.7 The Form of Treating Illness 療病式

3.7.1
Source원문

欲療病, 先察其源, 先候病機. 五藏未虛, 六府未竭, 血脉未亂, 精神未散, 服藥必活. 若病已成, 可得半愈. 病勢已過, 命將難痊. 《本草》

Translation영역
To treat an illness, first examine its source and first observe its mechanism. While the five viscera are not yet vacuous, the six bowels not yet exhausted, the blood and vessels not yet in disorder and the essence-spirit not yet scattered, the patient who takes medicine will certainly live. If the illness has already taken shape, half a cure may be got. If the force of the illness has already gone past, the life will be hard to make whole.
Clinical note임상 주석
Three stages and three prognoses: treat before the viscera are involved and the patient lives; treat once the illness has taken shape and half recover; treat after it has passed its height and the case is lost. It is the clearest statement in the Bogam of what would now be called the therapeutic window, and the practical advice in it — that the source and the mechanism are to be settled before anything is given — is the chapter's own method stated as a rule.

Boncho 本草

3.8 The Three and the Six That Cannot Be Treated 三不治六不治

3.8.1
Source원문

倉公有言曰, 病不肯服藥, 一死也; 信巫不信醫, 二死也; 輕身薄命, 不能將慎, 三死也. 《本草》

Translation영역
Master Chang said: a patient who will not take medicine, that is the first death; who trusts the shaman and not the physician, that is the second death; who holds his body cheap and his life of little account and cannot be careful of himself, that is the third death.

Boncho 本草

3.8.2
Source원문

扁鵲曰, 病有六不治. 驕恣不倫於理, 一不治也; 輕身重財, 二不治也; 衣食不能適, 三不治也; 陰陽幷ㆍ藏氣不定, 四不治也; 形羸不能服藥, 五不治也; 信巫不信醫, 六不治也. 《入門》

Translation영역
Pyeonjak said: there are six illnesses that cannot be treated. Arrogant and wilful, out of all reason — that is the first. Holding the body cheap and money dear — the second. Unable to manage clothing and food — the third. Yin and yang merged together with the visceral qi unsettled — the fourth. A body so wasted it cannot take medicine — the fifth. Trusting the shaman and not the physician — the sixth.
Clinical note임상 주석
Five of the nine between the two lists are about the patient rather than the illness, and only two — yin and yang merged with the visceral qi unsettled, and a body too wasted to take medicine — are clinical. The rest describe non-adherence, poverty, and a refusal to be treated, and they are listed as reasons a case will fail. A modern clinic would call three of them social determinants and two of them capacity, and would not call any of them untreatable; but the observation that these are what decide outcomes is not wrong. 衣食不能適 — unable to manage clothing and food — is the one that reads most strangely as a contraindication. Pyeonjak's point is that a patient who cannot keep themselves warm and fed cannot be carried through a course of treatment, which is a statement about circumstances and not about character.

Immun 入門

3.9 A Physician Is Valued at Three Generations 醫貴三世

3.9.1
Source원문

論語云, 人而無恒, 不可以作巫醫. 明此二法, 不可以權餙妄造. 所以醫不三世, 不服其藥. 九折臂者, 乃成良醫. 盖謂學功須深故也. 《本草》

Translation영역
The Analects says: a man without constancy cannot be made a shaman or a physician. This makes it clear that in these two arts one may not fabricate as expedience suggests. Hence the saying that if a physician is not of three generations one does not take his medicine; and that it is the man who has broken his arm nine times who becomes a good physician. The meaning is that the labour of learning must go deep.
Clinical note임상 주석
九折臂, the man who has broken his arm nine times, is the classical image for learning medicine by being ill — the phrase is from the Chu Ci and means a patient who has suffered the same injury so often that he knows its treatment better than any physician. Set beside the three-generations rule, the section is making two incompatible arguments at once: that medical competence is inherited and that it is earned by experience. The Bogam prints both, as it prints both facial maps at 審病 2.3.

Boncho 本草

3.10 The Four Seasons Engendering Illness 四時生病

3.10.1
Source원문

靈樞曰, 冬傷於寒, 春生癉熱; 春傷於風, 夏生飱泄腸澼; 夏傷於暑, 秋生痎瘧; 秋傷於濕, 冬生咳嗽.

Translation영역
The Yeongchu says: injured by cold in winter, one engenders scorching heat in spring; injured by wind in spring, food-shot diarrhoea and intestinal flux in summer; injured by summerheat in summer, intermittent malaria in autumn; injured by damp in autumn, cough in winter.

Yeongchu 靈樞

3.10.2
Source원문

內經曰, 春傷於風, 夏生飱泄; 夏傷於暑, 秋爲痎瘧; 秋傷於濕, 冬生咳嗽; 冬傷於寒, 春必病溫.

Translation영역
The Inner Classic says: injured by wind in spring, one engenders food-shot diarrhoea in summer; injured by summerheat in summer, there is intermittent malaria in autumn; injured by damp in autumn, cough in winter; injured by cold in winter, one must fall ill of warm disease in spring.

Naegyeong 內經

3.10.3
Source원문

又曰, 春傷於風, 邪氣留連, 乃爲洞泄; 夏傷於暑, 秋爲痎瘧; 秋傷於濕, 上逆而咳, 發爲痿厥; 冬傷寒, 春必病溫. 《內經》

Translation영역
It says again: injured by wind in spring, the evil qi lingers on and becomes a flooding diarrhoea; injured by summerheat in summer, there is intermittent malaria in autumn; injured by damp in autumn, there is upward counterflow with cough, breaking out as wilting and reversal; injured by cold in winter, one must fall ill of warm disease in spring.
Clinical note임상 주석
Three versions of the same four-part scheme, printed one after another with their differences intact — the Yeongchu's, the Inner Classic's, and a second Inner Classic passage. The claim is that an injury in one season produces a named illness two seasons later, and 冬傷於寒, 春必病溫 — injured by cold in winter, one falls ill of warm disease in spring — is the sentence the whole later doctrine of latent pathogens was built on. The regularities underneath are real seasonal ones: diarrhoeal illness in summer, malaria in autumn, respiratory illness in winter, epidemic fever in spring. What the scheme adds is the causal link backwards to the previous season, and that part has no support. It is worth knowing because the 瘧疾 and 瘟疫 chapters reason from it.

Naegyeong 內經

3.10.4
Source원문

脉盛身寒, 得之傷寒; 脉虛身熱, 得之傷暑. 《仲景》

Translation영역
A full pulse with a cold body: got by damage from cold. A vacuous pulse with a hot body: got by damage from summerheat.
Clinical note임상 주석
Two lines that are still used. The discrimination is between an illness in which the pulse is strong while the patient feels cold, and one in which the patient is hot while the pulse is weak — in modern terms between a vigorous febrile response and the exhausted circulation of heat illness. A patient who is hot with a thready pulse is the one in danger, and the Bogam's treatment of 中暑 turns on exactly this sign.

Junggyeong 仲景

3.11 How the Hundred Illnesses Begin 百病始生

3.11.1
Source원문

靈樞曰, 夫百病之始生也, 皆生風雨寒暑ㆍ淸濕ㆍ喜怒. 喜怒不節則傷藏, 風雨則傷上, 淸濕則傷下. 藏傷則病起於陰, 淸濕襲虛則病起於下, 風雨襲虛則病起於上.

Translation영역
The Yeongchu says: the beginnings of the hundred illnesses all arise from wind and rain, cold and summerheat, from chill and damp, and from joy and anger. Joy and anger unmoderated injure the viscera; wind and rain injure the upper body; chill and damp injure the lower. When the viscera are injured the illness starts in the yin; when chill and damp fall on a vacuity the illness starts below; when wind and rain fall on a vacuity the illness starts above.
Clinical note임상 주석
A rule about where to look. Weather from above lands on the upper body, wet and cold from the ground on the lower, feeling on the viscera. It is the reason the Bogam's chapters on cough and headache treat wind and those on diarrhoea and leg swelling treat damp, and the observation behind it — that exposure of the head and chest and exposure of the feet and legs produce different illnesses — is sound enough.

Yeongchu 靈樞

3.11.2
Source원문

內經曰, 凡消癉ㆍ仆擊ㆍ偏枯ㆍ痿厥ㆍ氣滿發逆, 肥貴人則膏粱之疾也.

Translation영역
The Inner Classic says: wasting-thirst, sudden collapse, hemiplegia, wilting and reversal, and fullness of qi breaking out as counterflow — in the fat and well-to-do these are the illnesses of rich food.
Clinical note임상 주석
The one passage in the chapter that a modern reader will find uncannily familiar. Diabetes, stroke, hemiplegia, limb weakness and breathlessness, grouped together, attributed to rich diet, and said to occur in the fat and the wealthy: that is the metabolic syndrome, named as a cluster with its cause and its social distribution, in a text of the first centuries BCE. 膏粱, fat and fine grain, is the classical term for the diet of the rich, and the Bogam's 消渴 and 中風 chapters both cite this line when they come to causes.

Naegyeong 內經

3.11.3
Source원문

隔則閉絶, 上下不通, 則暴憂之病也.

Translation영역
Where there is a barrier, so that it is shut off and cut through and above and below do not communicate, this is the illness of sudden grief.

Naegyeong 內經

3.11.4
Source원문

暴厥而聾ㆍ偏塞閉不通, 內氣暴薄也.

Translation영역
Sudden reversal with deafness, and a one-sided blockage shut and impassable: the qi within has suddenly been beaten down.

Naegyeong 內經

3.11.5
Source원문

不從內外中風之病, 故瘦留着也.

Translation영역
An illness of wind strike that follows neither the inner nor the outer course: hence the wasting and the lodging that remains.

Naegyeong 內經

3.11.6
Source원문

蹠跛, 寒風濕之病也.

Translation영역
A dragging, limping gait is an illness of cold, wind and damp.

Naegyeong 內經

3.11.7
Source원문

黃疸ㆍ暴痛ㆍ癲疾ㆍ厥狂, 久逆之所生也.

Translation영역
Yellow jaundice, sudden pain, epilepsy, reversal and mania are engendered by long-standing counterflow.

Naegyeong 內經

3.11.8
Source원문

五藏不平, 六府閉塞之所生也.

Translation영역
The five viscera out of their level state are engendered by the six bowels being shut and blocked.

Naegyeong 內經

3.11.9
Source원문

頭痛ㆍ耳鳴ㆍ九竅不利, 腸胃之所生也. 《內經》

Translation영역
Headache, ringing in the ears and the nine orifices not working freely are engendered by the intestines and stomach.
Clinical note임상 주석
Headache, tinnitus and malfunction of the orifices traced to the gut. The line is quoted constantly in later Korean practice to justify treating head and ear complaints through the digestion, and the Bogam's own 頭 and 耳 chapters both do so. Whatever its mechanism, the clinical habit it produces — asking about bowel function in a patient with chronic headache — is not a bad one.

Naegyeong 內經

3.11.10
Source원문

五邪中人, 各有法度. 風中於前口眼喎斜, 寒中於後頭項強痛, 霧傷於上, 濕傷於下. 風令脉浮, 寒令脉急, 霧傷皮腠, 濕流關節, 食傷脾胃, 極寒傷經, 極熱傷絡. 《難經》

Translation영역
The five evils strike a person each by its own rule. Wind strikes the frontwry mouth and eye, cold strikes the backstiff painful head and nape, fog injures above, damp injures below. Wind makes the pulse float, cold makes it tight; fog injures the skin and interstices, damp courses into the joints, food injures the spleen and stomach, extreme cold injures the channels, extreme heat injures the network vessels.
Clinical note임상 주석
The small-character glosses are in the base text and they name two familiar presentations: wind striking the front gives a wry mouth and eye — facial palsy — and cold striking the back gives a stiff, painful head and neck. The pairing of a one-sided facial weakness with exposure of the face, and of neck stiffness with a chill on the back of the neck, is as close as the classical literature comes to a localizing sign.

Nangyeong 難經

3.11.11
Source원문

無痰不成瘧, 無積不成痢. 《直指》

Translation영역
Without phlegm no malaria forms; without accumulation no dysentery forms.

Jikji 直指

3.12 The Hundred Illnesses Clear in the Morning and Worse at Evening 百病朝慧夕加

3.12.1
Source원문

黃帝問曰, 百病朝慧ㆍ晝安ㆍ夕加ㆍ夜甚, 何也. 歧伯對曰, 朝則人氣始生, 衛氣始行, 故朝慧. 日中人氣長, 長則勝邪, 故安. 夕則人氣始衰, 邪氣始生, 故加. 夜半人氣入藏, 邪氣獨居於身, 故甚也. 《靈樞》

Translation영역
The Yellow Emperor asked: in the hundred illnesses the patient is clear in the morning, at ease at midday, worse at evening and worst at night — why is this? Gibaek replied: in the morning the person's qi begins to be engendered and the defence qi begins to move, and so there is clarity. At midday the person's qi grows, and growing it overcomes the evil, and so there is ease. At evening the person's qi begins to wane and the evil qi begins to arise, and so it worsens. At midnight the person's qi enters the viscera and the evil qi is left alone in the body, and so it is worst.
Clinical note임상 주석
The daily curve that 審病 2.13 reasons from, stated here with its mechanism. Clearest in the morning, worst in the small hours, is the commonest shape of all, and the reason given — the defence qi withdrawing inward at night and leaving the evil unopposed — is the classical account of what a modern reader knows as circadian variation in symptoms and in immune function. 朝慧 … 夜甚 also describes the diurnal pattern of delirium and of dementia, which is why the phrase 夜甚 is used of those conditions throughout the Bogam.

Yeongchu 靈樞

3.13 Going Against the Norm Makes Illness 反常爲病

3.13.1
Source원문

內經曰, 氣實形實, 氣虛形虛, 此其常也, 反此者病.

Translation영역
The Inner Classic says: qi replete and the form replete, qi vacuous and the form vacuous — this is the norm; what goes against it is illness.

Naegyeong 內經

3.13.2
Source원문

糓盛氣盛, 糓虛氣虛, 此其常也, 反此者病.

Translation영역
Grain abundant and the qi abundant, grain scant and the qi scant — this is the norm; what goes against it is illness.

Naegyeong 內經

3.13.3
Source원문

脉實血實, 脉虛血虛, 此其常也, 反此者病.

Translation영역
The pulse replete and the blood replete, the pulse vacuous and the blood vacuous — this is the norm; what goes against it is illness.

Naegyeong 內經

3.13.4
Source원문

氣虛身熱, 此謂反也. 糓入多而氣少, 此謂反也. 糓不入而氣多, 此謂反也. 脉盛血少, 此謂反也. 脉少血多, 此謂反也.

Translation영역
Qi vacuous with a hot body — this is called going against. Much grain taken in and little qi — this is going against. No grain taken in and much qi — this is going against. A full pulse with scant blood — this is going against. A scant pulse with much blood — this is going against.
Clinical note임상 주석
Five mismatches, and the principle is the one 審病 2.5 applied to build and pulse: what matters is not whether a finding is high or low but whether it agrees with the others. A patient who eats well and has no strength, and one who eats nothing and is full of energy, are both abnormal; so is a bounding pulse in an anaemic patient. Each of the five would send a modern clinician looking for a cause, and that is precisely the use the Inner Classic puts them to in the next passage.

Naegyeong 內經

3.13.5
Source원문

糓入多而氣少者, 得之有所奪血ㆍ濕居下也. 糓入少而氣多者, 邪在胃及與肺也. 《內經》

Translation영역
One who takes in much grain and has little qi has got it from some loss of blood, or from damp settled below. One who takes in little grain and has much qi has the evil in the stomach and in the lung.
Clinical note임상 주석
The first of the two is the clinically useful one: a patient eating well and still weak, explained by blood loss or by fluid pooling in the lower body. Chronic occult bleeding with a good appetite is a common presentation of iron-deficiency anaemia, and a patient who eats normally while fluid collects in the legs is in heart or liver failure. Either one calls for investigation rather than for a tonic.

Naegyeong 內經

3.14 Preferring Cold and Preferring Heat 便寒便熱

3.14.1
Source원문

黃帝曰, 臨病人問所便, 奈何. 歧伯對曰, 夫中熱消癉則便寒, 寒中之屬則便熱. 胃中熱則消糓, 令人懸心善飢, 臍以上皮熱; 腸中熱則出黃如糜, 臍以下皮寒; 胃中寒則腹脹, 腸中寒則腸鳴飱泄; 胃中寒ㆍ腸中熱脹而且泄; 胃中熱ㆍ腸中寒則疾飢小腹痛脹. 《靈樞》

Translation영역
The Yellow Emperor said: when one comes before a patient and asks what he prefers, how is it to be taken? Gibaek replied: one with heat in the centre and wasting-thirst prefers cold; one of the cold-in-the-centre kind prefers heat. Heat in the stomach consumes the grain and makes the patient feel the heart hanging and often hungry, with the skin above the navel hot. Heat in the intestines brings out a yellow stool like gruel, with the skin below the navel cold. Cold in the stomach brings a distended abdomen; cold in the intestines brings borborygmus and food-shot diarrhoea. Cold in the stomach with heat in the intestines brings both distension and diarrhoea. Heat in the stomach with cold in the intestines brings quick hunger with pain and distension of the lower abdomen.
Clinical note임상 주석
The examination question is 問所便 — ask what the patient prefers — and the answer is taken as diagnostic: a patient who wants cold things has heat, one who wants warm things has cold. It is still the single most useful question in a Korean consultation, and it costs nothing. The second half makes a distinction the rest of the tradition rarely keeps: stomach and intestines can be hot and cold independently, giving four combinations, and the mixed pair — distension with diarrhoea, or quick hunger with lower abdominal pain — are recognizable presentations. The skin temperature above and below the navel is offered as the way to tell which is which, and that is a physical sign a modern examiner could check in a moment.

Yeongchu 靈樞

3.15 Fat and Thin in Judging the Signs of Illness 肥瘦辨病候

3.15.1
Source원문

靈樞曰, 肥而澤者, 血氣有餘; 肥而不澤者, 氣有餘血不足; 瘦而無澤者, 血氣俱不足. 審察其形氣有餘不足而調之, 可以知逆順矣.

Translation영역
The Yeongchu says: fat with a lustre to the skin means blood and qi both in surplus; fat without lustre means the qi in surplus and the blood insufficient; thin and without lustre means blood and qi both insufficient. Examine carefully whether the build and the qi are in surplus or insufficient and regulate accordingly, and one may know whether the case runs contrary or compliant.

Yeongchu 靈樞

3.15.2
Source원문

人黑瘦者易治, 肥大肉厚赤白者難愈. 黑人耐風濕, 赤白者不耐風濕. 瘦人肉硬, 肥人肉軟; 肉軟則受病難愈. 《千金》

Translation영역
A dark, thin person is easily treated; one who is big and fat, thick-fleshed and of a ruddy pallor, is hard to cure. A dark person bears wind and damp; one of a ruddy pallor does not. A thin person's flesh is firm, a fat person's soft; and where the flesh is soft an illness taken on is hard to cure.

Cheongeum 千金

3.15.3
Source원문

氣衰則身冷, 血衰則膚硬. 《入門》

Translation영역
When the qi wanes the body is cold; when the blood wanes the skin is hard.

Immun 入門

3.15.4
Source원문

肥人氣虛生寒, 寒生濕, 濕生痰; 瘦人血虛生熱, 熱生火, 火生燥. 故肥人多寒濕, 瘦人多熱燥也. 《丹心》

Translation영역
In a fat person the qi is vacuous and engenders cold, the cold engenders damp, and the damp engenders phlegm. In a thin person the blood is vacuous and engenders heat, the heat engenders fire, and the fire engenders dryness. So the fat have much cold damp and the thin much heat and dryness.
Clinical note임상 주석
The Dansim chain is the one later Korean practice actually uses: fat patients are treated for damp and phlegm, thin ones for heat and dryness. It is a crude rule and the chapter knows it — the Yeongchu passage above makes the finer distinction by lustre rather than by bulk — but as a starting assumption it matches what is seen often enough to be worth having. The Cheongeum passage is harder to read charitably. It makes skin colour a prognostic factor and holds a fat, pale, ruddy patient to be hard to cure, which is a judgment of its own time and place and has no clinical standing now.

Dansim 丹心

3.16 The Bold and the Timid Differ in Build 勇怯異形

3.16.1
Source원문

黃帝曰, 願聞勇怯之所由然. 少愈曰, 勇士者, 目深以固, 長衡直揚, 三焦理橫, 其心端直, 其肝大以堅, 其膽滿以傍. 怒則氣盛而胸脹, 肝擧而膽橫, 眥裂而目揚, 毛起而面蒼. 此勇士之由然也.

Translation영역
The Yellow Emperor said: I should like to hear how the bold and the timid come to be as they are. Soyu said: in a bold man the eyes are deep-set and steady, the brow long and straight and lifted, the grain of the three burners runs crosswise, his heart is upright, his liver large and firm, his gallbladder full and set to the side. When he is angry the qi swells and the chest distends, the liver lifts and the gallbladder turns crosswise, the canthi split and the eyes start, the hair rises and the face goes sallow. This is how a bold man comes to be as he is.

Yeongchu 靈樞

3.16.2
Source원문

帝曰, 願聞怯士之所由然. 少兪曰, 怯士者, 目大而不深, 陰陽相失, 三焦理縱, 𩩲𩨗短而小, 肝系緩, 其膽不滿而縱, 腸胃挺, 脇下空. 雖方大怒, 氣不能滿其胸, 肝肺雖擧, 氣衰復下, 故不能久怒. 此怯士之由然也.

Translation영역
The Emperor said: I should like to hear how a timid man comes to be as he is. Soyu said: in a timid man the eyes are large but not deep-set, yin and yang have lost each other, the grain of the three burners runs lengthwise, the breastbone is short and small, the liver's suspension is slack, his gallbladder is not full and hangs loose, the intestines and stomach are stretched straight, and below the flanks is empty. Even in the midst of a great rage the qi cannot fill his chest, and though liver and lung lift, the qi fails and they come down again — hence he cannot stay angry long. This is how a timid man comes to be as he is.
Clinical note임상 주석
A physiology of temperament, and one that locates courage in the gallbladder — 膽滿以傍 in the bold man, 膽不滿而縱 in the timid. It is why 膽 in Korean, as in English, carries the sense of nerve, and why the Bogam's 膽 chapter discusses fearfulness among the gallbladder's disorders. The anatomical claims are not observations: nobody had seen these livers and gallbladders. What the passage does record accurately is the physical display of anger — chest swelling, eyes starting, hair rising, face changing colour — and the fact that in some people it cannot be sustained.

Yeongchu 靈樞

3.16.3
Source원문

帝曰, 怯士之得酒, 怒不異勇士者, 何藏使然. 少兪曰, 酒者水糓之精, 熟糓之液也. 其氣慓悍, 其入于胃中則胃脹, 氣上逆滿于胸中, 肝浮膽橫. 當是之時, 固比于勇士, 氣衰則悔. 與勇士同類, 不知避之, 名曰酒悖也. 《靈樞》

Translation영역
The Emperor said: when a timid man gets drink and his anger is no different from a bold man's, which viscus brings this about? Soyu said: wine is the essence of water and grain, the liquor of cooked grain. Its qi is fierce and swift; entering the stomach it distends it, and the qi surges up and fills the chest, so that the liver floats and the gallbladder turns crosswise. At that moment he is indeed the equal of a bold man; and when the qi fails he is sorry for it. Being of a kind with the bold man and not knowing how to avoid it, this is called drunken violence.
Clinical note임상 주석
酒悖, drunken violence, named as a condition. The description is exact and needs no translation into modern terms: a timid man who becomes as aggressive as a bold one while drinking, and who regrets it when the effect wears off. The Inner Classic's explanation is mechanical — wine's fierce qi filling the chest — and its clinical point is the last clause, 不知避之, not knowing how to avoid it, which is where the Bogam's treatment of drinking in the 內傷 chapter begins.

Yeongchu 靈樞

3.17 The Slow Transmission of Visceral and Bowel Illness 臟腑病緩傳

3.17.1
Source원문

內經曰, 五藏相通, 移皆有次. 五藏有病則各傳其所勝. 不治, 法三月若六月ㆍ三日若六日, 傳五藏而當死. 註曰, 病有緩傳者, 有急傳者. 緩者或一歲二歲三歲而死, 其次或三月若六月而死; 急者一日二日三日四日或五六日而死.

Translation영역
The Inner Classic says: the five viscera communicate with one another, and the shifting always has its order. When one of the five viscera is ill it passes the illness on to the one it overcomes. Untreated, by rule in three months or six, in three days or six, it passes through the five viscera and death follows. The commentary says: some illnesses are transmitted slowly and some fast. Slowly transmitted, death comes in one, two or three years, or next after that in three months or six; fast transmitted, in one, two, three or four days, or in five or six.

Naegyeong 內經

3.17.2
Source원문

今風寒客於人, 使毫毛畢直, 皮膚閉而爲熱, 當是之時, 可汗而發也. 不治, 病入舍於肺, 名曰肺痺, 發咳上氣. 不治, 肺卽傳而行之肝, 病名曰肝痺, 脇痛出食, 當是之時, 可按若刺耳. 不治, 肝傳之脾, 病名曰脾風, 發癉, 腹中熱, 煩心出黃, 當此之時, 可按可藥可浴. 不治, 脾傳之腎, 病名曰疝瘕, 小腹寃熱而痛, 出白, 當此之時, 可灸可藥. 不治, 腎傳之心, 筋脉相引而急, 病名曰瘈, 當此之時, 可灸可藥. 不治, 滿十日法當死. 腎因傳之心, 心卽復反傳而行之肺, 發寒熱, 法當三歲死. 此病之次也.

Translation영역
Now when wind and cold lodge in a person, making every fine hair stand on end and the skin shut so that there is heat, at that moment it can be made to break out by sweating. Untreated, the illness goes in and lodges in the lung, and this is called lung impediment, which brings on cough and qi rising. Untreated, the lung passes it on at once to the liver, and the illness is called liver impediment, with pain in the flanks and vomiting of food; at that moment it can be treated only by pressing or needling. Untreated, the liver passes it to the spleen, and the illness is called spleen wind, breaking out as scorching heat, with heat in the abdomen, vexation of the heart and a yellow discharge; at that moment it can be treated by pressing, by medicine, or by bathing. Untreated, the spleen passes it to the kidney, and the illness is called hernial conglomeration, with a smouldering heat and pain in the lower abdomen and a white discharge; at that moment it can be treated by moxa or by medicine. Untreated, the kidney passes it to the heart, the sinews and vessels pull on each other and tighten, and the illness is called tugging spasm; at that moment it can be treated by moxa or by medicine. Untreated, when ten days are up death follows by rule. The kidney having passed it to the heart, the heart at once passes it back again to the lung, fever and chills break out, and by rule death comes in three years. This is the order of the illness.
Clinical note임상 주석
The passage is a treatment timetable disguised as a theory of transmission. At each stage it says not only where the illness has got to but what can still be done about it: sweating at the start, then pressing or needling only, then pressing and medicine and bathing, then moxa and medicine, and at last nothing. 當是之時, 可汗而發也 — at that moment it can be made to break out by sweating — is the governing idea of the whole 傷寒 tradition, that an illness has a window in which one method works and after which it does not. The named stages are the Inner Classic's and do not map onto modern entities; the structure does. An untreated acute illness that becomes a chronic one, with the options narrowing at each step, is a description any clinician would recognize.

Naegyeong 內經

3.17.3
Source원문

此邪初入表, 傳之緩也. 《內經》

Translation영역
This is an evil first entering the exterior, and its transmission is slow.

Naegyeong 內經

3.18 The Fast Transmission of Visceral and Bowel Illness 臟腑病急傳

3.18.1
Source원문

夫病傳者, 心病先心痛, 一日而咳心傳肺, 三日脇支滿肺傳肝, 五日閉塞不通ㆍ身痛體重肝傳脾, 三日不已死. 冬夜半, 夏日中.

Translation영역
As to the transmission of illness: in an illness of the heart there is first heart pain, in a day coughthe heart passing to the lung, in three days propping fullness of the flanksthe lung passing to the liver, in five days blockage with nothing passing through and aching and heaviness of the bodythe liver passing to the spleen; and if it is not ended in three more days, death. In winter at midnight, in summer at midday.
Clinical note임상 주석
The fast transmission, in days rather than years, with the small-character glosses in the base text naming each handover. Seven passages follow the same shape: an opening symptom, a chain of handovers with their intervals, a total, and the hour of death by season. The numbers are a scheme and the hours are the yin-yang cycle of 審病 2.15; neither is to be used. What the series does preserve is a set of sequences in which one organ's failure is followed by another's — heart pain then cough then congestion, kidney pain then retention then distension — and those sequences are real enough as descriptions of a patient decompensating. The Bogam's purpose in printing them is prognostic: to say, from the symptom that comes second, how fast the case is moving.

Naegyeong 內經

3.18.2
Source원문

肺病喘咳, 三日而脇支滿肺傳肝, 一日身重體痛, 五日而脹肝傳脾胃, 十日不已死. 冬日入, 夏日出.

Translation영역
In an illness of the lung there is panting and cough, in three days propping fullness of the flanksthe lung passing to the liver, in one day more heaviness and aching of the body, in five days distensionthe liver passing to the spleen and stomach; and if it is not ended in ten more days, death. In winter at sundown, in summer at sunrise.

Naegyeong 內經

3.18.3
Source원문

肝病頭目眩ㆍ脇支滿, 三日體重身痛, 五日而脹肝傳脾胃, 三日腰脊小腹痛ㆍ脛痠脾傳腎, 三日不已死. 冬日入, 夏早食.

Translation영역
In an illness of the liver there is dizziness of the head and eyes and propping fullness of the flanks, in three days heaviness and aching of the body, in five days distensionthe liver passing to the spleen and stomach, in three days pain in the lumbus, spine and lower abdomen with aching shinsthe spleen passing to the kidney; and if it is not ended in three more days, death. In winter at sundown, in summer at the early meal.

Naegyeong 內經

3.18.4
Source원문

脾病身重體痛, 一日而脹脾自傳胃, 二日小腹腰脊痛ㆍ脛痠, 三日背膂筋痛ㆍ小便閉脾傳腎膀胱, 十日不已死. 冬人定, 夏晏食.

Translation영역
In an illness of the spleen there is heaviness and aching of the body, in one day distensionthe spleen passing to the stomach of itself, in two days pain in the lower abdomen, lumbus and spine with aching shins, in three days pain in the sinews of the back and loin with urinary blockagethe spleen passing to the kidney and bladder; and if it is not ended in ten more days, death. In winter at the hour of retiring, in summer at the late meal.

Naegyeong 內經

3.18.5
Source원문

腎病小腹腰脊痛ㆍ䯒痠, 三日背膂筋痛ㆍ小便閉腎傳膀胱, 三日腹脹膀胱傳小腸, 三日兩脇支痛小腸傳心, 二日不已死. 冬大晨, 夏晏脯.

Translation영역
In an illness of the kidney there is pain in the lower abdomen, lumbus and spine with aching shinbones, in three days pain in the sinews of the back and loin with urinary blockagethe kidney passing to the bladder, in three days abdominal distensionthe bladder passing to the small intestine, in three days propping pain in both flanksthe small intestine passing to the heart; and if it is not ended in two more days, death. In winter at broad morning, in summer at late afternoon.

Naegyeong 內經

3.18.6
Source원문

胃病脹滿, 五日小腹腰脊痛ㆍ䯒痠胃傳腎, 三日背膂筋痛ㆍ小便閉腎傳膀胱, 五日身體重膀胱傳心, 六日不已死. 冬夜半後, 夏日胅.

Translation영역
In an illness of the stomach there is distension and fullness, in five days pain in the lower abdomen, lumbus and spine with aching shinbonesthe stomach passing to the kidney, in three days pain in the sinews of the back and loin with urinary blockagethe kidney passing to the bladder, in five days heaviness of the bodythe bladder passing to the heart; and if it is not ended in six more days, death. In winter after midnight, in summer at the sun's decline.

Naegyeong 內經

3.18.7
Source원문

膀胱病小便閉, 五日小腹脹ㆍ腰脊痛ㆍ䯒痠膀胱傳腎, 一日腹脹腎傳小腸, 二日身體痛小腸傳心, 三日不已死. 冬雞鳴, 夏下晡.

Translation영역
In an illness of the bladder there is urinary blockage, in five days distension of the lower abdomen with pain in the lumbus and spine and aching shinbonesthe bladder passing to the kidney, in one day abdominal distensionthe kidney passing to the small intestine, in two days aching of the bodythe small intestine passing to the heart; and if it is not ended in three more days, death. In winter at cockcrow, in summer at the late afternoon.
Clinical note임상 주석
The bladder sequence is the one a modern reader can follow straight through: urinary obstruction, then lower abdominal distension with loin pain, then generalized distension, then aching of the whole body, then death. That is obstructive uropathy going on to renal failure and uraemia, and the three-day terminal interval the passage gives is not far wrong for an untreated complete obstruction. **A patient who cannot pass urine needs catheterization and urgent assessment, not a prescription.**

Naegyeong 內經

3.18.8
Source원문

謂大氣入藏, 盖傳之急者也. 《內經》

Translation영역
This means the great qi entering the viscera, and it is the fast kind of transmission.

Naegyeong 內經

3.19 Evil and Essence, Vacuity and Repletion 邪精虛實

3.19.1
Source원문

內經曰, 邪之所湊, 其氣必虛. 許學士云, 留而不去, 其病則實.

Translation영역
The Inner Classic says: where an evil gathers, the qi there must be vacuous. The scholar Heo says: staying and not departing, the illness is then replete.
Clinical note임상 주석
The two halves are usually quoted apart and belong together. An evil can only settle where there was a weakness, so the beginning of every illness is a vacuity; but an evil that has settled and stayed makes a repletion. It follows that the same illness is to be supplemented at the start and drained later, which is the reasoning the Bogam uses whenever it changes method partway through a case.

Naegyeong 內經

3.19.2
Source원문

邪氣盛則實, 精氣奪則虛. 《內經》

Translation영역
When the evil qi is abundant there is repletion; when the essence qi is robbed away there is vacuity.

Naegyeong 內經

3.19.3
Source원문

重實ㆍ重虛者, 言大熱病, 氣熱脉滿, 是謂重實也; 脉虛ㆍ氣虛ㆍ尺虛, 是謂重虛也. 《內經》

Translation영역
Doubled repletion and doubled vacuity: in a great heat illness, with the qi hot and the pulse full, this is called doubled repletion; a vacuous pulse, vacuous qi and a vacuous cubit, this is called doubled vacuity.

Naegyeong 內經

3.20 The Three Vacuities and the Three Repletions 三虛三實

3.20.1
Source원문

人有三虛三實, 何謂也. 然有脉之虛實, 有病之虛實, 有診之虛實. 脉之虛實者, 濡者爲虛, 緊牢者爲實. 病之虛實者, 出者爲虛, 入者爲實; 言者爲虛, 不言者爲實; 緩者爲虛, 急者爲實. 診之虛實者, 濡者爲虛, 牢者爲實; 痒者爲虛, 痛者爲實; 外痛內快爲外實內虛, 內痛外快爲內實外虛. 《難經》

Translation영역
A person has three vacuities and three repletions — what does this mean? There is the vacuity or repletion of the pulse, of the illness, and of the examination. For the pulse: soggy is vacuous, tight and firm is replete. For the illness: what goes out is vacuous, what comes in is replete; one who talks is vacuous, one who does not is replete; slow is vacuous, urgent is replete. For the examination: soggy is vacuous, firm is replete; itching is vacuous, pain is replete; pain outside with ease within is repletion without and vacuity within, pain within with ease outside is repletion within and vacuity without.
Clinical note임상 주석
Three channels for the same judgment — the pulse, the course of the illness, and palpation — and the Nangyeong's point is that all three must be asked. The last pair is the practical one: where the pain is tells which layer is replete, and the test is whether pressing relieves or provokes it. 言者爲虛, 不言者爲實 — the talkative patient vacuous and the silent one replete — is the odd one out and is as much an observation of behaviour as of disease.

Nangyeong 難經

3.21 The Pulse Compliant but the Illness Contrary 脉從病反

3.21.1
Source원문

黃帝曰, 脉從而病反者何如. 歧伯曰, 脉至而從, 按之不鼓, 諸陽皆然. 帝曰, 諸陰之反何如. 歧伯曰, 脉至而從, 按之鼓甚而盛也. 註曰, 病熱而脉數, 按之不鼓動, 乃寒盛格陽而致之, 非熱也; 形證皆寒, 按之而脉氣鼓擊於指下而盛, 此爲熱盛拒陰而生病, 非寒也. 《內經》

Translation영역
The Yellow Emperor said: what of it when the pulse is compliant but the illness contrary? Gibaek said: the pulse arrives compliant, but pressed it does not drum; so it is with all the yang cases. The Emperor said: and what of the contrary cases among the yin? Gibaek said: the pulse arrives compliant, and pressed it drums hard and full. The commentary says: an illness of heat with a rapid pulse which, pressed, does not drum, is brought about by abundant cold barring the yang out, and is not heat. Where the build and the signs are all cold and the pulse qi, pressed, drums and strikes under the finger and is full, this is abundant heat shutting the yin out and so making illness, and is not cold.
Clinical note임상 주석
按之 — pressing harder — is the whole technique of this section. A rapid pulse that disappears under pressure is not a heat pulse; a slow or quiet one that drums harder under pressure is not a cold one. The sign the Inner Classic is pointing at is what a modern examiner would call the quality of the pulse under increasing pressure, and its significance is the same: the force behind the beat matters more than its rate. 格陽 and 拒陰 — the yang barred out, the yin shut out — are the terms for a patient who looks like the opposite of what they are, and this passage is the Bogam's authority for mistrusting the obvious reading.

Naegyeong 內經

3.21.2
Source원문

證似陽者, 脉亦從證似陽, 而其病反是寒也; 證似陰者, 脉亦從證似陰, 而其病反是熱也. 皆反其脉證施治. 如身熱煩躁ㆍ面赤, 其脉沉而微, 是陰證似陽也. 身熱者裏寒故也, 煩躁者陰盛故也, 面戴陽者下虛故也. 若誤謂實熱, 反與凉藥, 則氣消成大病矣. 四逆湯方見寒門加葱白治之. 如手足逆冷ㆍ大便秘ㆍ小便赤ㆍ脉沉而滑者, 陽證似陰也. 輕者白虎湯, 重者承氣湯二方並見寒門下之.

Translation영역
Where the signs resemble yang the pulse too follows the signs in resembling yang, and yet the illness is contrary to them and is cold; where the signs resemble yin the pulse too follows the signs in resembling yin, and yet the illness is contrary and is heat. In every such case treatment is given against the pulse and the signs. Thus fever with vexed agitation and a red face, with a pulse sunken and faint, is a yin pattern resembling yang. The fever is because of cold within; the vexed agitation because the yin is abundant; the face wearing the yang because the lower body is vacuous. If this is mistaken for a replete heat and cooling medicine given instead, the qi will be consumed and a grave illness will come of it. Treat it with Counterflow Cold Decoctionthe formula is given in the Cold chapter plus scallion white. Again, cold reversal of the hands and feet with constipation, red urine and a pulse sunken but slippery is a yang pattern resembling yin. In a light case precipitate it with White Tiger Decoction, in a grave one with Qi-Coordinating Decoctionboth formulas are given in the Cold chapter.
Clinical note임상 주석
The two presentations are the ones every clinician has to be able to tell apart, and they are set out with their mechanisms. A patient hot, flushed and agitated with a weak sunken pulse is cold inside; a patient with cold hands and feet, constipated and passing dark urine with a strong hidden pulse is hot inside. Both would be made worse by the treatment their appearance invites. **The formulas are recorded for the sake of the text: a patient in either state — shocked and flushed, or peripherally shut down with obstruction — needs assessment and resuscitation, not a decoction.** 面戴陽, the face wearing the yang, is the classical name for the flush of a patient whose circulation is failing — the same sign as 審病 2.4's malar flush — and the explanation offered, 下虛, vacuity below, is not far from a modern account of it.

Gangmok 綱目

3.21.3
Source원문

此二節言證似陽而脉病屬陰, 證似陰而脉病屬陽, 故反其證而治之. 盖證似陽而脉病屬陰者, 世尙能辨; 若脉證俱是陰而病獨屬陽者, 擧世莫辨, 而致夭折者滔滔皆是. 《綱目》

Translation영역
These two paragraphs speak of signs resembling yang while the pulse and the illness belong to yin, and of signs resembling yin while the pulse and the illness belong to yang; hence one treats against the signs. Now where the signs resemble yang while pulse and illness belong to yin, the world is still able to tell it; but where pulse and signs are both yin and the illness alone belongs to yang, the whole world fails to tell it, and those who are cut off untimely by this are past counting.
Clinical note임상 주석
The plainest warning in the Bogam, and it names its own profession as the danger: 擧世莫辨 — the whole world fails to tell it — of the case where every sign and the pulse itself say cold and the illness is heat. 滔滔皆是, past counting, is the author's estimate of how many patients died of the error. The modern equivalent is a patient who is shut down peripherally and looks cold while the process inside is a fulminant one — sepsis with cold extremities, an obstructed abdomen with a quiet surface. It is still the presentation most often misread, for the same reason: the surface is reassuring and the pulse agrees with it.

Gangmok 綱目

3.22 Branch and Root Contrary to Each Other 標本相反

3.22.1
Source원문

六氣之病, 標本相反者, 惟太陽ㆍ少陰之病爲最. 盖太陽標陽而本寒, 少陰標陰而本熱. 按之不鼓爲寒盛格陽者, 太陽寒水之本與標相反也; 按之鼓甚爲熱甚拒陰者, 少陰君火之本與標相反也. 不知相反者, 逆標氣之陰陽而正治, 則順本氣之寒熱而病加; 知相反者, 順標氣之陰陽而反治, 則逆本氣之寒熱而病愈矣. 《綱目》

Translation영역
Among the illnesses of the six qi, those whose branch and root are contrary to each other are greatest in greater yang and lesser yin. For greater yang is yang in its branch and cold in its root, and lesser yin is yin in its branch and hot in its root. A pulse that does not drum under pressure, from abundant cold barring the yang out, is the root of greater yang cold water contrary to its branch; one that drums hard under pressure, from severe heat shutting the yin out, is the root of lesser yin sovereign fire contrary to its branch. One who does not know of this contrariety goes against the yin or yang of the branch qi and treats straightforwardly, and so goes along with the cold or heat of the root qi and the illness worsens. One who knows of it goes along with the yin or yang of the branch qi and treats contrariwise, and so goes against the cold or heat of the root qi and the illness is cured.
Clinical note임상 주석
The theoretical account of what 3.21 described clinically. 標 and 本, branch and root, are the terms of 天地運氣 1.26: each of the six qi has a nature of its own and a position in the yin-yang scheme, and in greater yang and lesser yin the two disagree — greater yang is counted yang but is cold water, lesser yin is counted yin but is sovereign fire. That is why those two channels produce patients who look like the opposite of what they are. 正治 and 反治, straightforward and contrary treatment, are the two methods the passage turns on, and the paradox it ends with is deliberate: to treat the illness one must go along with the appearance and against the reality, because the medicine is chosen for the root while the dose and route follow the branch. It is the most abstract passage in the chapter and it is doing real work — it is the Bogam's justification for giving a hot medicine to a patient who is burning and a cold one to a patient who is shivering.

Gangmok 綱目

3.23 Aversion to Cold and Aversion to Heat 惡寒惡熱

3.23.1
Source원문

發熱惡寒者發於陽, 無熱惡寒者發於陰. 《仲景》

Translation영역
Where there is fever with aversion to cold, it has broken out in the yang; where there is aversion to cold without fever, it has broken out in the yin.

Junggyeong 仲景

3.23.2
Source원문

惡寒非寒, 明是熱證; 惡熱非熱, 明是虛證. 《丹心》

Translation영역
Aversion to cold is not cold — it is plainly a heat pattern; aversion to heat is not heat — it is plainly a vacuity pattern.
Clinical note임상 주석
A deliberate inversion, and the sharpest single sentence in the chapter. The patient who cannot bear cold is not cold but hot; the patient who cannot bear heat is not hot but depleted. Read against Junggyeong's line above, which says the opposite in the plain sense, the two make the chapter's point about appearances: a complaint is evidence about the patient, not a diagnosis. In practice the Dansim reading applies to the chronic case and Junggyeong's to the acute one. Shivering with a high fever is an exterior pattern; feeling cold all the time without fever, in a patient with a quick pulse and a dry mouth, is the heat pattern Dansim means.

Dansim 丹心

3.23.3
Source원문

久病非寒, 暴病非熱. 《綱目》

Translation영역
A long-standing illness is not cold; a sudden illness is not heat.

Gangmok 綱目

3.24 Construction and Defence Engendering Illness 榮衛生病

3.24.1
Source원문

黃帝問曰, 榮衛寒痺之爲病柰何. 伯高荅曰, 榮之所生也, 寒熱少氣ㆍ血上下行; 衛之生病也, 氣痛時來時去ㆍ怫愾賁響; 風寒客于腸胃之中, 寒痺之爲病也, 留而不去, 時痛而皮不仁也. 《靈樞》

Translation영역
The Yellow Emperor asked: what of illnesses of the construction, the defence, and cold impediment? Baekgo answered: what the construction engenders is cold and heat, scant qi, and blood running up and down. What the defence engenders is a shifting qi pain that comes and goes, with a pent-up fullness and rumbling. And when wind and cold lodge within the intestines and stomach, that is cold impediment as an illness: it stays and does not depart, with pain from time to time and numbness of the skin.

Yeongchu 靈樞

3.25 Able to Eat and Unable to Eat 能食不能食

3.25.1
Source원문

中風能食, 傷寒不能食. 《丹心》

Translation영역
In wind strike the patient can eat; in damage by cold the patient cannot.
Clinical note임상 주석
The shortest section in the Bogam, and a usable discrimination: an illness in which the appetite is preserved is not an acute febrile one. Appetite as the dividing line between an external contraction and everything else runs through the whole book — 審病 2.10's 有胃氣 and 2.13's 飮食不入 make the same judgment.

Dansim 丹心

3.26 Judging Surplus and Shortfall in Any Illness 凡病辨有餘不足

3.26.1
Source원문

凡病來潮作之時, 病氣精神增添者, 是爲病氣有餘, 乃邪氣勝也, 急瀉之以寒凉酸苦之劑.

Translation영역
In any illness, where at the time the illness comes on in its tide the illness qi and the spirit are both increased, this is a surplus of illness qi, the evil qi prevailing; drain it at once with cold, cool, sour and bitter preparations.

Dongwon 東垣

3.26.2
Source원문

若病來潮作之時, 神氣困弱者, 爲病氣不足, 乃眞氣不足也, 急補之以辛甘溫熱之劑.

Translation영역
If at the time the illness comes on in its tide the spirit qi is worn down and weak, this is a shortfall of illness qi, the true qi being insufficient; supplement it at once with acrid, sweet, warm and hot preparations.
Clinical note임상 주석
The test is what happens to the patient's energy when the symptom peaks. If they are more agitated and more present at the height of it, the illness has the upper hand and is to be drained; if they are flattened by it, the patient is depleted and is to be supplemented. It is a genuinely useful question, and it has the advantage of being answerable by the patient — what is being compared is the patient at the peak against the patient between peaks, not against anyone else.

Dongwon 東垣

3.26.3
Source원문

如病人形氣不足, 病來潮作之時, 病氣亦不足, 此乃陰陽俱不足也, 禁用鍼, 宜補之以甘藥, 又灸臍下氣海穴.

Translation영역
Where the patient's build and qi are insufficient and, at the time the illness comes on in its tide, the illness qi is insufficient too, this is yin and yang both insufficient: needling is forbidden, it should be supplemented with sweet medicines, and moxa given at the sea-of-qi point below the navel.
Clinical note임상 주석
禁用鍼 — needling forbidden — is a real contraindication and it is worth noting that the Bogam states one. A patient depleted in both build and symptom is held to have nothing to spare, and needling, which moves and disperses, is withheld in favour of sweet supplementing medicines and moxa at 氣海, CV-6, two finger-breadths below the navel.

Dongwon 東垣

3.26.4
Source원문

夫氣謂口鼻中氣息也, 形謂皮肉筋骨血脉也. 形勝者爲有餘, 消瘦者爲不足也. 氣者, 審口鼻中氣, 勞役如故爲氣有餘也; 若喘息氣促ㆍ氣短或不足以息者, 爲不足也. 故曰形氣也. 《東垣》

Translation영역
Qi here means the breath in the mouth and nose; form means the skin, flesh, sinews, bones, blood and vessels. Where the form prevails there is surplus; where it is wasted away there is shortfall. For the qi, examine the breath in the mouth and nose: if labour and exertion are as they were, the qi is in surplus; if there is panting, hurried breath, shortness of breath, or breath not sufficient to breathe with, there is shortfall. This is what is meant by form and qi.
Clinical note임상 주석
Dongwon defines his two terms by how to measure them, which is unusual. Form is assessed by the flesh and frame — present or wasted — and qi by the breath and by exercise tolerance: 勞役如故, able to work as before. Exertional breathlessness as the measure of the qi is exactly the modern approach to functional assessment, and the chapter's whole surplus-and-shortfall judgment rests on these two readings.

Dongwon 東垣

3.27 Whether an Illness Has a Form or None 凡病有形無形

3.27.1
Source원문

靈樞曰, 有形而不痛者, 陽之類也; 無形而痛者, 陰之類也. 無形而痛者, 陽完而陰傷之也, 急治其陰, 無攻其陽. 有形而不痛者, 其陰完而陽傷之也, 急治其陽, 無攻其陰. 陰陽俱動, 乍有形乍無形, 加以煩心, 命曰陰勝其陽, 此謂不表不裏, 其形不久也.

Translation영역
The Yeongchu says: what has a form and does not hurt is of the yang kind; what has no form and hurts is of the yin kind. Where there is no form and it hurts, the yang is whole and the yin is injured: treat the yin at once and do not attack the yang. Where there is a form and it does not hurt, the yin is whole and the yang is injured: treat the yang at once and do not attack the yin. Where yin and yang are both stirred, so that now there is a form and now there is none, with vexation of the heart besides, this is called the yin overcoming the yang; it is said to be neither exterior nor interior, and such a form does not last long.
Clinical note임상 주석
有形, having a form, means something palpable — a swelling, a mass, a lump; 無形 means a complaint with nothing to find. The Yeongchu's rule is that a palpable painless thing and an impalpable painful one are opposite in kind and opposite in treatment, and that the worst case is the one that comes and goes. A complaint that cannot be found on examination is not dismissed here; it is assigned to the yin and treated.

Yeongchu 靈樞

3.28 The Three Burners Not Returning to Their Places 三焦不歸

3.28.1
Source원문

寸口脉微而澁. 微者衛氣不行, 澁者榮氣不逮. 榮衛不能相將, 三焦無所仰, 身體痺不仁. 榮氣不足則煩疼ㆍ口難言, 衛氣虛則惡寒ㆍ數欠. 三焦不歸其部, 上焦不歸者噫而呑酢, 中焦不歸者不能消糓引食, 下焦不歸者則遺尿. 《仲景》

Translation영역
The pulse at the inch opening is faint and rough. Faint means the defence qi is not moving; rough means the construction qi does not keep up. Construction and defence cannot support each other, the three burners have nothing to lean on, and the body is numb and insensible. When the construction qi is insufficient there is vexing ache and difficulty in speaking; when the defence qi is vacuous there is aversion to cold and frequent yawning. When the three burners do not return to their places: the upper burner not returning gives belching and swallowing of sour fluid, the middle burner not returning an inability to digest grain and draw in food, the lower burner not returning incontinence of urine.
Clinical note임상 주석
Three localizing symptoms, each tied to one burner, and all three are still read that way: reflux and belching for the upper, indigestion and anorexia for the middle, urinary incontinence for the lower. 噫而呑酢 — belching with sour fluid coming up to be swallowed — is as good a description of gastro-oesophageal reflux as the classical literature contains.

Junggyeong 仲景

3.29 The Two Corpses, Four Oddities and Four Strange Illnesses 二尸四異四奇

3.29.1
Source원문

小兒魃病, 生者爲相繼, 死者爲傳尸也. 有脉而無氣謂之尸厥, 有氣而無脉謂之行尸.

Translation영역
In the child's wasting illness, where the child lives it is called succession, and where it dies it is called corpse transmission. Where there is a pulse but no breath it is called corpse reversal; where there is breath but no pulse it is called the walking corpse.
Clinical note임상 주석
尸厥 and 行尸, the two corpses, are states in which pulse and breath have come apart. A patient with a pulse and no breathing is in respiratory arrest; one breathing with no palpable pulse is in cardiac arrest or profound shock. Both are described accurately and both are now the subject of resuscitation rather than of diagnosis. **A patient in either state needs emergency resuscitation immediately.** 小兒魃病 is the wasting of an infant displaced by the next pregnancy — the classical term for what happens to a child weaned abruptly when a sibling arrives. The Bogam treats it in the 小兒 chapter.

Haejang 海藏

3.29.2
Source원문

丁奚ㆍ哺露ㆍ客忤ㆍ無辜, 四異病也.

Translation영역
Jeonghae, poro, gaego and muko are the four oddities among illnesses.
Clinical note임상 주석
Four paediatric conditions, all treated at length in the 小兒 chapter: 丁奚 and 哺露 are forms of severe infantile wasting, 客忤 the fright-illness of a small child after a stranger's visit, and 無辜 a wasting with glandular swellings. They are grouped here as 異, oddities, because they do not fit the adult categories the chapter has been building.

Haejang 海藏

3.29.3
Source원문

陽易ㆍ陰易ㆍ百合ㆍ狐惑, 四奇病也. 《海藏》

Translation영역
Yangyeok, eumyeok, baekhap and hohok are the four strange illnesses.
Clinical note임상 주석
陰陽易 is the relapse of a fever transmitted between husband and wife during convalescence; 百合病 a state of restless malaise after a fever, with the patient unable to lie, sit or eat settledly; 狐惑 an illness of ulceration at the mouth and the genitals with fever and changing eye signs. The last is the one modern readers notice: 狐惑 as the Jingui describes it is the clinical picture of Behçet's disease, and Korean and Japanese rheumatology literature still cites it as the earliest description.

Haejang 海藏

3.30 The Causes of Illness in Men and Women 男女病因

3.30.1
Source원문

凡病男子必審房勞, 女人先明經孕. 《入門》

Translation영역
In any illness, with a man one must examine into sexual taxation; with a woman one first makes clear the menses and pregnancy.
Clinical note임상 주석
One line, and it is a rule of history-taking: ask every man about sexual activity and every woman about her periods and whether she is pregnant, whatever the presenting complaint. The second half is still the first question in any clinic, for the same reason the Bogam gives it — the answer changes both the diagnosis and what may safely be given.

Immun 入門

3.31 Loss of the Normal Rise and Fall as Illness 升降失常爲病

3.31.1
Source원문

凡頭面上病, 皆百邪上攻; 胸膈間病, 皆百邪上衝; 腸胃間病, 皆百邪下流而傳入. 不然則血氣失升降之常, 陽當升而不升, 陰當降而不降. 識病機栝盡於此矣. 《入門》

Translation영역
All illnesses above, in the head and face, are the hundred evils attacking upward; all illnesses in the chest and diaphragm are the hundred evils surging upward; all illnesses in the intestines and stomach are the hundred evils flowing down and being passed in. Failing that, the blood and qi have lost the normal course of their rising and falling: the yang that ought to rise does not rise, the yin that ought to descend does not descend. Knowing the mechanism of illness is comprehended entirely in this.
Clinical note임상 주석
Two causes for everything: an evil driven to a place, or the normal circulation failing to move. 陽當升而不升, 陰當降而不降 — the yang that should rise not rising and the yin that should fall not falling — is the formula later Korean practice reaches for most often, and the Immun's claim that the whole mechanism of illness is comprehended in it is not far from how the tradition actually uses it.

Immun 入門

3.31.2
Source원문

陽病者, 上行極而下; 陰病者, 下行極而上. 上下必于中焦, 於是三焦溷亂, 內外氣塞. 《靈樞》

Translation영역
In a yang illness it runs upward to the limit and then downward; in a yin illness it runs downward to the limit and then upward. Up and down must both pass by the middle burner, and so the three burners fall into confusion and the qi within and without is blocked.

Yeongchu 靈樞

3.31.3
Source원문

手之三陽從手走頭, 足之三陽從頭走足, 是高能接下也; 足之三陰從足走腹, 手之三陰從腹走手, 是下能趨上也. 故上下升降而爲和. 易曰, 天道下濟而光明, 地道卑而上行. 難經曰, 氣主煦之, 升也; 血主濡之, 潤也. 夫唱則婦隨, 血隨氣而上行. 氣也者, 寄于辛, 用于寅, 平朝始從中焦注循天之紀, 左旋至丑而終, 晝夜通行五十度, 周流八百一十丈. 《東垣》

Translation영역
The three yang channels of the hand run from the hand to the head and the three yang of the foot from the head to the foot — this is the high being able to join the low. The three yin of the foot run from the foot to the abdomen and the three yin of the hand from the abdomen to the hand — this is the low being able to hasten upward. So up and down rise and fall and there is harmony. The Classic of Changes says: heaven's way comes down to help and is bright; earth's way is humble and moves upward. The Nangyeong says: the qi governs warming, which is rising; the blood governs moistening, which is wetting. As the husband leads the wife follows, and the blood goes up following the qi. The qi is lodged in the hour of sin and put to use in the hour of in; at daybreak it begins to pour from the middle burner and follow the ordering of heaven, turning leftward until it ends at the hour of chuk, travelling fifty circuits through day and night, and flowing round eight hundred and ten fathoms.
Clinical note임상 주석
The channel courses given as the anatomy of the rise and fall: hand yang up to the head, foot yang down to the feet, foot yin up to the abdomen, hand yin out to the hands, so that the circulation closes. The figures at the end are the Yeongchu's — fifty circuits in a day and night over eight hundred and ten 丈 of vessel — and they are the oldest quantitative statement about the circulation in the tradition. 夫唱則婦隨, the husband leading and the wife following, is Dongwon's image for blood moving after qi; the phrase is of its period, and the clinical rule it carries, that blood is moved by treating the qi, is the one every blood-moving formula in the book assumes.

Dongwon 東垣

3.32 Distinguishing the Two Patterns, Yin and Yang 辨陰陽二證

3.32.1
Source원문

凡病陰證, 則身靜重ㆍ語無聲ㆍ氣難布息ㆍ目睛不了了ㆍ鼻中呼不出吸不入ㆍ往來口與鼻中氣冷ㆍ水漿不入ㆍ大小便不禁ㆍ面上惡寒有如刀刮. 《東垣》

Translation영역
In any illness of the yin pattern the body is still and heavy, the speech without voice, the breath hard to spread out; the pupils are not clear; in the nose the breath neither comes out nor goes in; the air coming and going at the mouth and in the nose is cold; neither water nor gruel goes down; urine and stool are not held; and the face has an aversion to cold as though it were being scraped with a knife.

Dongwon 東垣

3.32.2
Source원문

陽證則身動輕ㆍ語有聲ㆍ目睛了了ㆍ鼻中呼吸出入能往而能來ㆍ口與鼻中氣皆然. 《東垣》

Translation영역
In the yang pattern the body moves and is light, the speech has voice, the pupils are clear, the breath in the nose goes out and in and can come and go freely, and the air at the mouth and in the nose is likewise.
Clinical note임상 주석
Dongwon's two columns, and what is being compared is not symptoms but bearing: whether the patient moves, whether the voice carries, whether the eyes are clear, whether the breath passes freely, whether the body still holds its contents. Every item is observable from the end of the bed, and the yin column taken together is a description of a patient collapsing. **The face cold as though scraped with a knife, with cold breath, inability to swallow and incontinence, is a medical emergency.**

Dongwon 東垣

3.32.3
Source원문

身表凉, 知在陰經也, 名曰陰證; 身表熱, 知在陽經也, 名曰陽證. 《入門》

Translation영역
When the body's surface is cool, one knows it is in the yin channels, and it is called a yin pattern; when the surface is hot, one knows it is in the yang channels, and it is called a yang pattern.

Immun 入門

3.32.4
Source원문

陽勝則身熱ㆍ腠理閉ㆍ喘麄爲之俛仰ㆍ汗不出而熱ㆍ齒乾以煩寃ㆍ腹滿死, 能冬不能夏能與耐同. 陰勝則身寒ㆍ汗出ㆍ身常凊ㆍ數慄而寒, 寒則厥, 厥則腹滿死, 能夏不能冬. 《內經》

Translation영역
When the yang prevails there is fever, the interstices shut, coarse panting that bends the patient forward and back, heat without sweating, dry teeth with vexed distress, and abdominal fullness and death; such a one can bear winter but not summer能 is the same as 耐, to bear. When the yin prevails there is coldness of the body, sweating, the body always cool, frequent shivering and cold; the cold brings reversal, and the reversal brings abdominal fullness and death; such a one can bear summer but not winter.
Clinical note임상 주석
Both columns end at 腹滿死, abdominal fullness and death, which is the Inner Classic's way of saying that either extreme kills by the same final route. The last clause of each is the constitutional one and it is the part that gets used: a patient who copes with winter and not summer is held to be yang in excess, and the reverse. The gloss 能與耐同 is in the base text, correcting 能 to the sense of bearing rather than ability.

Naegyeong 內經

3.32.5
Source원문

凡病人開目喜見人者屬陽也, 閉目不欲見人者屬陰也.

Translation영역
A patient who opens the eyes and is glad to see people belongs to the yang; one who keeps the eyes shut and does not wish to see people belongs to the yin.

Hoechun 回春

3.32.6
Source원문

多睡者, 陽虛陰盛也; 無睡者, 陰虛陽盛也.

Translation영역
One who sleeps much has vacuous yang and abundant yin; one who does not sleep has vacuous yin and abundant yang.

Hoechun 回春

3.32.7
Source원문

喜明者屬陽, 元氣實也; 喜暗者屬陰, 元氣虛也.

Translation영역
One who likes the light belongs to the yang, and the original qi is replete; one who likes the dark belongs to the yin, and the original qi is vacuous.

Hoechun 回春

3.32.8
Source원문

睡向壁者屬陰, 元氣虛也; 睡向外者屬陽, 元氣實也. 《回春》

Translation영역
One who sleeps facing the wall belongs to the yin, and the original qi is vacuous; one who sleeps facing outward belongs to the yang, and the original qi is replete.
Clinical note임상 주석
Four observations that need no instrument and no question: whether the patient meets your eye, how much they sleep, whether they want the curtains open, and which way they lie. The last — facing the wall or facing the room — is the one that has stayed in use, and what it reads is withdrawal. A clinician would now call the same cluster of findings low mood, fatigue and photophobia or its opposite, and would not disagree about which patient is the more depleted.

Hoechun 回春

3.33 Distinguishing Inward Damage from Outward Damage 辨內傷外傷

3.33.1
Source원문

詳見內傷.

Translation영역
This is treated in full in the chapter on Inward Damage.
Clinical note임상 주석
A cross-reference standing in for a section. The distinction between an illness contracted from outside and one arising from within is the central problem of Dongwon's medicine, and the Bogam gives it at length in 內傷 rather than here: fever, headache, aversion to cold and a surface pulse can belong either to a contraction or to exhaustion, and the two call for opposite treatment. The chapter marks the place and sends the reader on.

Donguibogam · Byeonjeung

3.34 The Eight Hollows as Signs of the Five Viscera 八虛候五臟

3.34.1
Source원문

黃帝問曰, 人有八虛, 各何以候. 歧伯對曰, 以候五藏也. 肺心有邪, 其氣流于兩肘; 肝有邪, 其氣流于兩脇一作腋; 脾有邪, 其氣流于兩髀一作股; 腎有邪, 其氣流于兩膕. 凡此八虛者, 皆機關之室ㆍ眞氣之所過ㆍ血絡之所遊, 邪氣惡血固不得留住; 留住則傷經絡骨節, 機關不得屈伸, 故病攣也. 《靈樞》

Translation영역
The Yellow Emperor asked: a person has eight hollows — what is each of them a sign of? Gibaek replied: they are signs of the five viscera. When lung or heart has an evil, its qi flows to the two elbows; when the liver has an evil, to the two flanksone text has armpits; when the spleen has an evil, to the two hipsone text has thighs; when the kidney has an evil, to the two popliteal hollows. All these eight hollows are chambers of the joint mechanism, places the true qi passes through and the blood network wanders in, and evil qi and foul blood must not be allowed to settle there; settling, they injure the channels, networks, bones and joints, the mechanism cannot bend and stretch, and so there is cramping illness.
Clinical note임상 주석
The eight hollows are the four paired flexures — elbows, axillae or flanks, hips, knees — and each is assigned to a viscus, so that a complaint in one points inward. The anatomy behind it is real: these are exactly the sites where the great vessels, nerves and lymph nodes lie close to the surface in a fold, which is why the Yeongchu calls them places the qi passes through and the blood wanders in, and why it says that anything settling there stiffens the joint. For a modern reader the useful inversion is that a persistent swelling or tenderness in a flexure is worth taking seriously as a sign of something deeper rather than as a local problem — the same reasoning that makes a clinician palpate the axillae and groins.

Yeongchu 靈樞

3.35 A Person Not Eating Dies in Seven Days 人不食七日死

3.35.1
Source원문

黃帝曰, 願聞人之不食七日而死何也. 角高對曰, 腸胃之中常留糓二斗ㆍ水一斗五升. 故平人日再後, 後二升半, 一日中五升, 七日則五七三斗五升, 而留水糓盡矣. 故平人不食飮七日而死者, 水糓精氣津液皆盡故也. 《靈樞》

Translation영역
The Yellow Emperor said: I should like to hear why a person who does not eat dies in seven days. Gakgo replied: within the intestines and stomach there are always two du of grain and one du five seung of water retained. Now an ordinary person passes stool twice a day, two and a half seung at a time, five seung in a day; and in seven days five times seven is three du five seung, and the retained water and grain are used up. So an ordinary person who neither eats nor drinks dies in seven days because the essence qi and the fluids of water and grain are all spent.
Clinical note임상 주석
An argument from arithmetic rather than from the five phases, and it is worth reading for its method. The Yeongchu posits a fixed store in the gut, measures the daily loss, divides, and gets seven days. The numbers are of their own system of measures and the conclusion is wrong for want of water — a person deprived of both food and drink dies in about three to four days, and of food alone survives for weeks — but the form of the reasoning, a balance between a reservoir and a rate of loss, is the form a modern physiologist would use. The practical content is the premise, 水糓精氣津液 — that it is the fluid and not the food that is critical. **A patient who cannot take fluids needs rehydration urgently; the figure of seven days is not a margin to rely on.**

Yeongchu 靈樞

3.36 Illness Has Five Contrary Cases 病有五逆

3.36.1
Source원문

黃帝曰, 何謂五逆. 歧伯曰, 熱病脉靜ㆍ汗已出脉盛躁, 是一逆也. 病泄脉洪大, 是二逆也. 着痺不移ㆍ䐃肉破ㆍ身熱ㆍ脉偏絶, 是三逆也. 淫而奪形ㆍ身熱ㆍ色夭白及後下血衃ㆍ血衃篤重, 是謂四逆也. 寒熱奪形ㆍ脉堅搏, 是謂五逆也. 《靈樞》

Translation영역
The Yellow Emperor said: what are the five contrary cases? Gibaek said: a heat illness with a quiet pulse, or the sweat already out and the pulse full and agitated — that is the first. An illness of diarrhoea with a surging large pulse — the second. A fixed impediment that does not shift, with the bulk of the flesh broken down, fever, and the pulse cut off on one side — the third. Excess that has robbed the build, with fever, a withered pale colour and clotted blood passed below, the clotted blood severe and heavy — the fourth. Cold and heat that have robbed the build, with a pulse hard and pounding — the fifth.
Clinical note임상 주석
逆, contrary, means a case in which the pulse and the illness point opposite ways, and each of the five is such a mismatch. A fever with a quiet pulse; diarrhoea with a bounding one; a wasting patient with a hard pounding pulse. In every instance the pulse fails to match the body's state, and that is the finding the Yeongchu treats as ominous — the same principle as 審病 2.5's 形氣相得者生. 䐃肉破, the bulk of the flesh broken down, with fever and a pulse absent on one side, is the one that reads most concretely: muscle wasting with fever and an absent limb pulse is critical limb ischaemia with infection, and it was beyond help in 1613.

Yeongchu 靈樞

3.36.2
Source원문

帝曰, 諸病皆有逆順, 可得聞乎. 歧伯曰, 腹脹ㆍ身熱ㆍ脉大, 是一逆也. 腹鳴而滿ㆍ四肢淸ㆍ泄ㆍ其脉大, 是二逆也. 衄而不止ㆍ脉大, 是三逆也. 咳且溲血ㆍ脫形ㆍ其脉小勁, 是四逆也. 咳ㆍ脫形ㆍ身熱ㆍ脉小以疾, 是謂五逆也. 如是者, 不過十五日而死矣. 《靈樞》

Translation영역
The Emperor said: all illnesses have their contrary and compliant cases — may I hear of them? Gibaek said: abdominal distension with fever and a large pulse — that is the first. Rumbling and fullness of the abdomen with cold limbs and diarrhoea and a large pulse — the second. A nosebleed that will not stop with a large pulse — the third. Cough with blood in the urine, the build stripped away, and a pulse small and taut — the fourth. Cough with the build stripped away, fever, and a pulse small and hurried — the fifth. Such cases die within fifteen days.

Yeongchu 靈樞

3.36.3
Source원문

腹大脹ㆍ四末淸ㆍ脫形ㆍ泄甚, 是一逆也. 腹脹ㆍ便血ㆍ其脉大時絶, 是二逆也. 咳ㆍ溲血ㆍ形肉脫ㆍ脉搏, 是三逆也. 嘔血ㆍ胸滿引背ㆍ脉小而疾, 是四逆也. 咳ㆍ嘔ㆍ腹脹且飱泄ㆍ其脉絶, 是五逆也. 如是者, 不及一時而死矣. 《靈樞》

Translation영역
Great distension of the abdomen with cold extremities, the build stripped away and severe diarrhoea — that is the first. Abdominal distension with blood in the stool and a pulse large and now and then cut off — the second. Cough with blood in the urine, the flesh of the body stripped away, and a pounding pulse — the third. Vomiting of blood with fullness of the chest drawing through to the back and a pulse small and hurried — the fourth. Cough and retching with abdominal distension and food-shot diarrhoea and the pulse cut off — the fifth. Such cases die within a single watch.
Clinical note임상 주석
Three graded lists: the first with no time attached, the second giving fifteen days, the third a single watch — about two hours. What distinguishes the third list is the combination of a failing circulation with active bleeding: cold extremities with profuse diarrhoea, blood in the stool with an intermittent pulse, haematemesis with chest pain radiating to the back. Each of the third list is recognizable as an emergency now. 嘔血ㆍ胸滿引背 — vomiting blood with chest fullness drawing through to the back — is either a ruptured oesophageal varix or a dissecting aorta, and the Yeongchu's estimate of the time available is not wrong. **Any of these presentations requires immediate emergency care.**

Yeongchu 靈樞

3.37 Where the Five Flavours Enter 五味所入

3.37.1
Source원문

酸入肝, 辛入肺, 苦入心, 鹹入腎, 甘入脾, 是謂五入. 《內經》

Translation영역
Sour enters the liver, acrid the lung, bitter the heart, salty the kidney, sweet the spleen: these are called the five entries.
Clinical note임상 주석
The first of the thirteen lists of fives that close the chapter. They are the tradition's memory work, and this one is the most used of them all: the flavour-to-viscus assignment is what decides which herbs are held to reach which organ, and every discussion of medicinal action in the 湯液篇 assumes it.

Naegyeong 內經

3.38 What the Five Qi Fall Ill With 五氣所病

3.38.1
Source원문

心爲噫, 肺爲咳, 肝爲語, 脾爲呑, 腎爲欠爲嚏, 胃爲氣逆爲噦爲恐, 大腸小腸爲泄, 下焦溢爲水, 膀胱不利爲癃ㆍ不約爲遺尿, 膽爲怒, 是謂五病. 《內經》

Translation영역
The heart gives belching, the lung cough, the liver talking, the spleen swallowing, the kidney yawning and sneezing; the stomach gives qi counterflow, hiccup and fear; the large and small intestine give diarrhoea; the lower burner overflowing gives water; the bladder not working freely gives dribbling retention, and not binding gives incontinence of urine; the gallbladder gives anger. These are called the five illnesses.
Clinical note임상 주석
Five viscera and then seven more organs, each with the symptom it is held to produce. Two of them are affect rather than symptom — fear from the stomach, anger from the gallbladder — and those two are the ones the Bogam actually reasons from: 膽爲怒 is why irritability is treated through the gallbladder, and 胃爲恐 why a frightened, anxious patient is asked about digestion.

Naegyeong 內經

3.39 What the Five Essences Merge Into 五精所幷

3.39.1
Source원문

精氣幷於心則喜, 幷於肺則悲, 幷於肝則憂, 幷於脾則畏, 幷於腎則恐, 是謂五幷, 虛而相幷者也. 註曰, 精氣謂火之精氣也. 肺虛而心精幷之則爲喜, 他藏倣此. 《內經》

Translation영역
When the essence qi merges into the heart there is joy; into the lung, grief; into the liver, anxiety; into the spleen, apprehension; into the kidney, fear. These are called the five mergings, and they are a merging upon vacuity. The commentary says: essence qi here means the essence qi of fire. When the lung is vacuous and the heart's essence merges into it there is joy, and the other viscera follow this pattern.
Clinical note임상 주석
虛而相幷 — merging upon vacuity — is the operative phrase: an emotion appears not because its own viscus is strong but because another's essence has flooded into a viscus that was empty. It is the classical account of affect as something that happens to a depleted patient, and it is why the Bogam treats inappropriate laughter, grief and fear as vacuity conditions rather than as excesses to be drained.

Naegyeong 內經

3.40 What the Five Viscera Hate 五臟所惡

3.40.1
Source원문

心惡熱, 肺惡寒, 肝惡風, 脾惡濕, 腎惡燥, 是謂五惡. 《內經》

Translation영역
The heart hates heat, the lung cold, the liver wind, the spleen damp, the kidney dryness: these are called the five hatreds.
Clinical note임상 주석
The list is a guide to what harms each organ and therefore to what must be avoided while treating it. Two of the five are good clinical sense on any account: a damaged lung does badly in cold air, and a failing kidney does badly in dehydration.

Naegyeong 內經

3.41 The Fluids the Five Viscera Turn Into 五臟化液

3.41.1
Source원문

心爲汗, 肺爲涕, 肝爲淚, 脾爲涎, 腎爲唾, 是謂五液. 《內經》

Translation영역
The heart gives sweat, the lung snivel, the liver tears, the spleen drool, the kidney spittle: these are called the five fluids.
Clinical note임상 주석
The assignment that makes sweating a matter of the heart — which is why the Bogam treats night sweats and spontaneous sweating in the 汗 chapter through the heart and its blood, and why 審病 2.16 reads oily sweat as the heart's failure.

Naegyeong 內經

3.42 What the Five Flavours Forbid 五味所禁

3.42.1
Source원문

辛走氣, 氣病無多食辛; 鹹走血, 血病無多食鹹; 苦走骨, 骨病無多食苦; 甘走肉, 肉病無多食甘; 酸走筋, 筋病無多食酸. 是謂五禁, 無令多食. 《內經》

Translation영역
Acrid runs to the qi, and in an illness of the qi one should not eat much that is acrid. Salty runs to the blood, and in an illness of the blood one should not eat much that is salty. Bitter runs to the bone, and in an illness of the bone one should not eat much that is bitter. Sweet runs to the flesh, and in an illness of the flesh one should not eat much that is sweet. Sour runs to the sinews, and in an illness of the sinews one should not eat much that is sour. These are called the five prohibitions, and one must not let them be eaten in quantity.
Clinical note임상 주석
Dietary restriction by flavour, and the reasoning is the reverse of 3.37's: a flavour reaches a tissue, so in a disease of that tissue the flavour is to be limited rather than used. 鹹走血, salty running to the blood, with the instruction to restrict salt in diseases of the blood, is the one a modern reader will stop at — salt restriction in hypertension and in heart failure rests on the same observed association, arrived at without any of the physiology.

Naegyeong 內經

3.43 Where the Five Illnesses Break Out 五病所發

3.43.1
Source원문

陰病發於骨, 陽病發於血, 陰病發於肉, 陽病發於冬, 陰病發於夏, 是謂五發. 《內經》

Translation영역
Yin illness breaks out in the bone, yang illness breaks out in the blood, yin illness breaks out in the flesh, yang illness breaks out in winter, yin illness breaks out in summer: these are called the five breakings-out.

Naegyeong 內經

3.44 What the Five Evils Throw Into Disorder 五邪所亂

3.44.1
Source원문

邪入於陽則狂, 邪入於陰則痺, 搏陽則爲巓疾, 搏陰則爲瘖, 陽入之陰則靜, 陰出之陽則怒, 是謂五亂. 《內經》

Translation영역
An evil entering the yang gives mania; entering the yin, impediment; striking the yang, illness of the crown; striking the yin, loss of voice. Yang entering into the yin gives stillness; yin coming out into the yang gives anger. These are called the five disorders.
Clinical note임상 주석
巓疾, illness of the crown, is the Inner Classic's term for epilepsy, and 瘖 is aphonia. Mania, epilepsy, loss of speech and rage are grouped here as disorders of where the evil has gone rather than as diseases in their own right, which is how the 癲狂 chapter frames them too.

Naegyeong 內經

3.45 How the Five Evils Show Themselves 五邪所見

3.45.1
Source원문

春得秋脉, 夏得冬脉, 長夏得春脉, 秋得夏脉, 冬得長夏脉, 是謂五邪, 皆同命死不治. 《內經》

Translation영역
Getting an autumn pulse in spring, a winter pulse in summer, a spring pulse in the long summer, a summer pulse in autumn, a long-summer pulse in winter: these are called the five evils, and all alike are declared fatal and not to be treated.
Clinical note임상 주석
The same judgment as 3.13 and 審病 2.10's 脉逆四時, here stated as a flat prognosis. In each case the pulse belongs to the season that restrains the present one, which is why the five are grouped as 邪 rather than as mere mismatches. 皆同命死不治 is the harshest verdict in the chapter and the Bogam prints it without softening.

Naegyeong 內經

3.46 What the Five Viscera Store 五臟所藏

3.46.1
Source원문

心藏神, 肺藏魄, 肝藏魂, 脾藏意, 腎藏志, 是謂五藏所藏. 《內經》

Translation영역
The heart stores the spirit, the lung the corporeal soul, the liver the ethereal soul, the spleen the intent, the kidney the will: these are what the five viscera store.
Clinical note임상 주석
The fivefold psychology the whole Bogam assumes, and the one place it is set down in a single line. 神ㆍ魄ㆍ魂ㆍ意ㆍ志 are not interchangeable words for mind: the spirit is awareness, the corporeal soul the bodily and instinctive side, the ethereal soul the imaginative and dreaming side, the intent the capacity to attend, the will the capacity to hold a purpose. The Bogam's 神 chapter treats disorders of each separately on this basis.

Naegyeong 內經

3.47 What the Five Viscera Govern 五臟所主

3.47.1
Source원문

心主脉, 肺主皮, 肝主筋, 脾主肉, 腎主骨, 是謂五主. 《內經》

Translation영역
The heart governs the vessels, the lung the skin, the liver the sinews, the spleen the flesh, the kidney the bones: these are called the five governings.

Naegyeong 內經

3.48 What the Five Taxations Injure 五勞所傷

3.48.1
Source원문

久視傷血, 久卧傷氣, 久坐傷肉, 久立傷骨, 久行傷筋, 是謂五勞所傷. 《內經》

Translation영역
Long looking injures the blood, long lying injures the qi, long sitting injures the flesh, long standing injures the bones, long walking injures the sinews: these are what the five taxations injure.
Clinical note임상 주석
Five postures held too long, and the list is the tradition's occupational health. 久坐傷肉 and 久立傷骨 — long sitting injuring the flesh, long standing injuring the bones — are the two a modern reader will recognize as the complaints of sedentary and of standing work, and 久視傷血, long looking injuring the blood, is cited in Korean clinics now for eye strain at a screen. The claim common to all five is that the harm is in the duration and not the activity, which is the right shape for an argument about posture.

Naegyeong 內經

3.49 The Five Pulses Answering to the Images 五脉應象

3.49.1
Source원문

肝脉弦, 心脉鉤, 脾脉代, 肺脉毛, 腎脉石, 是謂五藏之脉. 《內經》

Translation영역
The liver pulse is stringlike, the heart pulse hooked, the spleen pulse alternating, the lung pulse downy, the kidney pulse stony: these are called the pulses of the five viscera.
Clinical note임상 주석
The chapter ends by handing over to the next one. These five are the seasonal and visceral pulse images the 診脉 chapter works out at length, where the same list appears at 9.17 in the Inner Classic's own words. 鉤, hooked, and 毛, downy, are the archaic terms; the pulse chapter glosses them as the surging summer pulse and the floating autumn pulse.

Naegyeong 內經

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 1, Pattern Differentiation chapter. The Chinese text is collated against the Kyujanggak transcription of the 1613 edition; collation notes are given on the passages they concern. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.