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**Treating Disease Before It Occurs (Preventive Treatment)**

Rather than seeking to cure after illness has arisen, it is better to nurture health before disease appears. For if one waits until the disease is formed to apply medicine, it is merely a futile effort. Therefore, preventing the formation of disease is the principle of medical practice; intervening before disease manifests elucidates the principles of life preservation. In this way, by contemplating potential troubles and preventing them in advance, what trouble could there be? This embodies the sage's intent of "treating disease before it occurs, not after."

This is like using earth to hold back water: if one does not block the trickling streams, the overwhelming flood cannot be restrained. Similarly, using water to fight fire: if one does not extinguish the faint glow, the raging flame cannot be stopped. If one cannot stop water or fire once they have become mighty, how much less can one treat a disease that has already taken form?

Therefore, in spring when nature renews itself, one should sleep late and rise early; in summer when vegetation flourishes, one should rise early and sleep late. This allows for relaxing the body, avoiding anger, and fulfilling one's will, while consuming cool and cold foods to nourish Yang Qi. Thus do sages prevent disease in spring and summer. In autumn when nature gathers and calms, one should rise with the rooster; in winter when nature stores and hides, one should wait for sunlight to rise. This allows for gathering the spirit, concealing intentions, and regulating desires, while consuming warm and hot foods to nourish Yin Essence. Thus do sages prevent disease in autumn and winter.

One might ask: "Seeing liver disease, first strengthen the spleen to prevent wood from overacting on earth; seeing redness on the right cheek, first clear lung heat to prevent metal from becoming excessive. This is the method of treating pre-disease. Now you speak of harmonizing with the four seasons and nurturing the spirit as the method of preventive treatment. What is the meaning?"

Preserving the body intact for longevity is the Way of the Sage; achieving perfect cures is the skill of the Superior Physician. The saying "treat disease before it occurs" is recorded in the *Suwen: Treatise on Regulating the Spirit According to the Four Seasons*, holding profound significance.

In the ancient dialogues between the Yellow Emperor and the Heavenly Master, nourishment was always prioritized. First discussing innate Heaven-endowed Qi, then regulating the spirit, following the laws of Yin and Yang, and adjusting to the four seasons. Emphasizing regulated diet and regular daily routines, the urgency of health preservation was stressed to treat diseases before they arise, preventing them from becoming difficult to manage.

Later, Qin Que (Bian Que) understood this. Seeing the Duke of Jin’s disease had reached the *gaohuang* (area between the heart and diaphragm), he said, "It cannot be treated." Understanding this fully, when Bian Que saw the Duke of Qi’s disease had penetrated to the bone marrow, he declared, "It cannot be saved." Alas! How unfortunate that the Dukes of Qi and Jin did not understand this.

**Excess Leads to Harm, Reception Leads to Restraint**

When Qi arrives and reaches its extreme, it becomes a disaster. When Qi attacks, it must be countered by a restorative force to achieve balance. When things reach an extreme, they reverse; this is the natural law.

Generally, the six Qi (Cold, Heat, Dryness, Dampness, Wind, Fire) and the Five Phases (Wood, Fire, Earth, Metal, Water) cause harm when they reach their peak excess. They are restrained when they receive counter-balancing forces. Thus, reaching an extreme leads to disaster, while being countered leads to balance. The subtlety of Qi dynamics is thus clearly revealed. This is the meaning of "Excess leads to harm, reception leads to restraint."

Investigating the mechanism of Heaven and Earth Yin-Yang, extreme cold generates heat, and extreme heat generates cold. These changes are divine and unfathomable, rotating and governing within. Thus, Wood at its extreme resembles Metal; Fire at its extreme resembles Water; Earth at its extreme resembles Wood; Metal at its extreme resembles Fire; Water at its extreme resembles Earth. Because when Qi is excessively strong, the force receiving and restraining it surpasses itself. Only by receiving the excess and restraining its harm can the work of creation be completed.

Currently, below Xiang Huo (Ministerial Fire), Shui Qi (Water Qi) receives it, so Fire does not mutate. Below the position of Water, Tu Qi (Earth Qi) receives it, so Water does not cause disaster. Below the position of Earth, Mu Qi (Wood Qi) receives it, so Earth remains compliant. Below the position of Wind, Jin Qi (Metal Qi) attacks, so Wind subsides. Heat and Fire create Dry Metal, naturally belonging to Metal disorders. Yin Jing (Essence) receives Jun Huo (Monarch Fire), naturally belonging to Fire conditions. Such is the meaning of "Excess causes harm, reception brings restraint."

I have examined the *Liuyuan Zhengji Dalun* (Great Treatise on the Six Origins and Correct Records), which states: "Where Shaoyang reaches, it manifests as Fire generation, ending in steaming dampness." (Fire transformation generates Fire; Yang is above, hence ending in steaming dampness.) This indicates Water transformation receiving Ministerial Fire. "Where Taiyang reaches, it manifests as cold snow, hail, and white dust," indicating Earth transformation receiving Cold Water. "Where Taiyin reaches, it manifests as thunder, sudden rain, and fierce wind," indicating Thunder/Rain (Earth) receiving Wood Qi below. "Where Jueyin reaches, it manifests as Wind generation, ending in solemnity/stillness," indicating Wind generation ending in stillness. "Where Yangming reaches, it manifests as scattering and warmth," indicating Metal scattering receiving Fire Qi below. "Where Shaoyin reaches, it manifests as Heat generation, intermediate Cold," indicating Heat generation with Yin Essence receiving from above, hence intermediate Cold. Is this not the principle that excess causes harm and reception brings restraint?

Previously, the Yellow Emperor and Qibo explored heaven and earth, distant objects and the human body, questioning each other to create the *Neijing*. In the *Liweizhi Dalun*, it mentions the succession of the Six Qi, stating that restraint allows for growth and transformation, displaying prosperity and decline externally; harm leads to disorder and severe disease. All cases where the conquering Qi receives from below serve to curb the superficial excess. Otherwise, why does Water emergence bring lightning and snow, Earth emergence bring sudden winds, Wood emergence bring destruction, Metal emergence bring clarity, and Fire emergence bring smoke and darkness? These are all manifestations of depression reaching an extreme and then erupting, serving to receive the excessive Qi.

Ah! One who understands Heaven, Earth, and Humanity is called a physician. Is it only to treat diseases? One must examine the pathogenesis without losing sight of the Qi suitability.

**Examining Pathogenesis Without Losing Sight of Qi Suitability**

Pathogenic factors have specific affiliations; one must investigate their essence beforehand. Therapeutic methods have specific destinations; one must prevent errors afterwards. The key to treatment lies in investigating the affiliation first. If one does not know the destination of the method, errors are inevitable. Thus, although diseases are numerous, their affiliations fall within the Five Movements and Six Qi. If one examines this thoroughly and grasps the essentials, then treats accordingly, ensuring alignment with the suitability of Qi and Movements, avoiding even the slightest error, then the path of seeking the root in treatment would be impeccable. The *Zhenshi Yao Da Lun* states: "Examine the pathogenesis; do not lose the suitability of Qi." The implication is here.

I believe there is one phrase that summarizes the essence of medicine: Qi and Movements (Yunqi). Heaven is Yang, Earth is Yin. Yin and Yang each divide into three categories, known as Three Yin and Three Yang. Yet Heaven is not purely Yang, containing Three Yin; Earth is not purely Yin, containing Three Yang. Thus, above and below Heaven and Earth exist the Six Qi (Wind, Heat, Fire, Dampness, Dryness, Cold), rotating between them, along with the Five Movements (Wood, Fire, Earth, Metal, Water). Humans live within this, and their Zang-Fu organs and acupoints circulate with Heaven and Earth. Thus, the origin of all diseases lies here. How should physicians treat? By observing this, ensuring no loss of suitability.

For instance, all wind-induced tremors and dizziness belong to Liver Wood; all pain, itching, and sores belong to Heart Fire; all dampness, swelling, and fullness belong to Spleen Earth; all Qi stagnation and depression belong to Lung Metal; all cold and contraction belong to Kidney Water. These are pathogeneses belonging to the Five Movements. All sudden stiffness and rigidity belong to Wind; all vomiting and acid regurgitation belong to Heat; all restlessness and mania belong to Fire; all spasms and rigidity belong to Dampness; all dryness and withering belong to Dryness; all clear and cold fluids belong to Cold. These are pathogeneses belonging to the Six Qi.

Although pathogenesis is examined, treatment must also be detailed. One must distinguish Yin and Yang in ambiguous situations and differentiate Root (Ben) and Branch (Biao) in subtle moments. Investigate the reasons for differences in Existence/Non-existence and Deficiency/Excess. Use sweating, vomiting, or purging appropriately; apply Cold, Heat, Warm, or Cool therapies correctly. Counter minor evils or follow major ones. Upward to avoid invading Qi, middle to judge annual movements, downward to assess north-south suitability. Ensuring moderation and proper timing prevents errors.

The *Liuyuan Zhengji Dalun* says: "Do not lose heavenly trust; do not oppose Qi suitability." The *Wuchang Zheng Dalun* says: "First know the annual Qi; do not damage Heavenly Harmony." These reflect the meaning of not losing Qi suitability. The *Suwen* and *Lingshu* constantly discuss Qi and Movements. "Establish the year first to clarify the Qi." Warns: "To treat disease, one must understand Heavenly Dao, Earthly Geography, and Yin-Yang alternation." States: "Not knowing the addition of years, the prosperity/decline of Qi, and the origin of deficiency/excess, one cannot be a skilled practitioner." This earnestness is not the Sage's excessive worry, but because the essence of medicine lies here. The book *Yuan Bing Shi* classifies phenomena, deeply clarifying the wonders of Qi and Movement creation, leaving no room for improvement in understanding pathogenesis and Qi suitability.

**Combining Color and Pulse Can Ensure Total Success**

To know the interior, observe the exterior; to diagnose the exterior is to know the interior. What exists inside manifests outside. Without cross-referencing, one cannot determine the reversal or smoothness of pathogens. Physicians must deeply understand this principle. Observe the Five Colors (Green, Yellow, Red, White, Black) and combine them with the pulses of the Five Zang organs to determine correspondence. Palpate the five pulse qualities (Rapid, Large, Slow, Choppy, Deep) and combine them with the colors of the Five Zang to judge compliance. If one can observe subtle colors and diagnose subtle pulses, combining interior and exterior for treatment, total success can be achieved effortlessly. The *Suwen* states: "Able to combine color and pulse, one can achieve total success." This is the meaning.

The One Qi of the Dao divides into Yin and Yang and scatters into the Five Phases, which humans possess. The five pulses are Heaven's truth, circulating blood and Qi, connecting Yin and Yang, nourishing the body. The five colors are the brilliance of Qi, corresponding to the Five Phases and four seasons, manifesting on the face. Only by observing color and palpating pulse without bias can one grasp the pathogenesis, judge Cold/Heat, assign to Zang-Fu, and treat according to symptoms, achieving complete recovery based on combining color and pulse.

For example, Liver color like green kingfisher feathers, with a slightly wiry and rapid pulse, indicates life. If floating, choppy, and short, with color like dead grass, survival is unlikely. Heart color like chicken comb red, with a floating, large, and scattered pulse, indicates compliance. If deep, soft, and slippery, with color like clotted blood, compliance is unlikely. Spleen color like crab belly yellow, with a moderate, slow, and large pulse, indicates following. If slightly wiry and rapid, with color like immature orange, following is unlikely. Lung color like pig fat white, with a floating, choppy, and short pulse, indicates auspiciousness. If floating, large, and scattered, with color like dry bones, auspiciousness is unlikely. Kidney color like crow feather black, with a deep, soft, and slippery pulse, indicates life. If slow and large, with color like soot, death ensues. Life and death depend on the combination of diagnosis and observation. With this, if herbs match the syndrome, failure to cure is unheard of.

I have discussed: Facial regions correspond to locations; pulse positions (Cun, Guan, Chi) correspond to sites. Left cheek corresponds to Liver, matching the left Guan position; Liver/Gallbladder relates to Wind-Wood, the first Qi. Forehead corresponds to Heart, matching the left Cun position; Heart/Small Intestine relates to Monarch Fire, the second Qi. Nose corresponds to Spleen, matching the right Guan position; Spleen/Stomach relates to Damp-Earth, the fourth Qi. Right cheek corresponds to Lung, matching the right Cun position; Lung/Large Intestine relates to Dry-Metal, the fifth Qi. Chin corresponds to Kidney, matching the left Chi position; Kidney/Bladder relates to Cold-Water, the final Qi. Ministerial Fire is the third Qi, relating to the right Mingmen and Sanjiao. The principles of Yin-Yang and Five Phases generation and restriction should be deduced by combining color and pulse. Thus, the *Maiyao Jingwei Lun* states: "Color combines with Five Phases, pulse combines with Yin-Yang." The *Nanjing Thirteen Difficulty* states: "Color and pulse should correspond." Total success in treatment requires combining color and pulse. The *Wuzang Shengcheng* chapter states: "Heart matches pulse, its luster is color." Pulse size, slipperiness, depth can be felt; color subtleties seen. Combining color and pulse ensures total success. E.g., Red pulse arriving is panting and firm; White pulse is panting and floating; Green pulse is long and vibrating; Yellow pulse is large and empty; Black pulse is hard and large above. This lists colors then pulses, teaching future students to inspect and palpate together. Later, Bian Que stated: "Knowing by observation is Divine; knowing by pulse is Skillful." This deeply captures the *Neijing* logic. Later generations called prescriptions "Divine and Skillful Total Success," having profound meaning.

**Treating Disease Must Seek the Root**

To apply treatment, one must investigate the source of the disease. The source of disease lies in Yin and Yang pathogens. Investigating this leads to cure. Skilled physicians know this: Wind, Heat, and Fire diseases belong to Yang pathogens. If the root is Yang and not treated at the root, Yang pathogens spread and become uncontrollable. Dampness, Dryness, and Cold diseases belong to Yin pathogens. If the root is Yin and not treated at the root, Yin pathogens spread and become unmanageable. Investigating the source and treating accordingly ensures total success.

"Treating disease must seek the root" is found in the *Yinyang Yingxiang Dalun*. Pathogens change over time, creating numerous variations. Like water with a source becoming vast, or grass with roots growing stems and leaves, disease with a root has infinite changes. Without seeking the root, removing deep-seated afflictions is impossible.

Jueyin is the branch, Wind-Wood is the root. Wind pathogen causes tremors, dizziness, convulsions, and sudden stiffness. Shaoyin is the branch, Monarch Fire is the root. Heat pathogen causes sores, itching, sudden diarrhea, and turbid fluids. Shaoyang is the branch, Ministerial Fire is the root. Fire pathogen causes fever, confusion, convulsions, restlessness, and mania. Good practitioners use Pungent-Cool for Wind excess, Salty-Cold for Heat excess, and Salty-Cold for Fire excess. Since the root is Yang, treating Yang ensures cure.

Taiyin is the branch, Damp-Earth is the root. Damp pathogen causes abdominal fullness, edema, and stiffness. Yangming is the branch, Dry-Metal is the root. Dry pathogen causes Qi stagnation, depression, and wrinkled skin. Taiyang is the branch, Cold-Water is the root. Cold pathogen causes vomiting, diarrhea, foul smells, and clear/cold fluids. Good practitioners use Bitter-Hot for Damp excess, Bitter-Warm for Dry excess, and Pungent-Hot for Cold excess. Since the root is Yin, treating Yin ensures cure. This confirms that treatment must investigate the source.

Pathogens have specific signs and treatments have specific keys. Exterior: sweat to release. Interior: purge to drain. High: induce vomiting. Fierce: press to gather. Cold deficiency: moxibustion. Spasm/bi: acupuncture. Blood stasis/swelling: stone needles. Qi stagnation/paralysis: Qigong/Daoyin. Meridian obstruction/numbness: medicinal wine. Blood/Qi stagnation/tendons: warming therapy. Seeking the root initially and eliminating pathogens finally covers all these methods.

Alas! The Yellow Emperor, learning from Qibo and Lei Gong, stated: "Yin and Yang are the Way of Heaven and Earth, the纲纪 (guiding principle) of all changes, birth, and death. Unfathomable spirits govern them." Human illness stems from Yin and Yang. Physicians must seek the root in Yin and Yang. The *Zhenshi Yao Da Lun* says: "Seek what exists, seek what does not exist." This seeking of pathogenesis aligns with seeking the root.

Generally, the Four Seasons rely on Stomach Qi as the root. Diagnosis of the six pulses must show Stomach Qi. Even with severe external symptoms, if Stom stomach Qi is present, the disease is treatable. If Stomach Qi is not exhausted, medicinal power circulates to skin and meridians, making cure easy. If Stomach Qi is exhausted, even correct herbs cannot circulate nutrients. True Zang pulses appear alone, and medicine fails, leading to untreatable conditions. Li Dongyuan said: "Pulses value Shen (Spirit)." Shen means Stomach Qi. Thus, classics advise early treatment to prevent deep invasion. This is precisely why sages treat pre-disease, not post-disease.