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Wang Bing stated: This refers to the year of collecting medicinal materials. Zhang Zhicong explained: "Zhu bing" (Main disease treatment) refers to the herbs that primarily treat the disease. "Si sui bei wu" (Preparing yearly substances according to the ruling qi) means preparing medicinal materials in accordance with the Six Qi and Five Movements. For instance, when Shaoyin and Shaoyang (Lesser Yin and Lesser Yang) govern the fire element for the year, one should collect hot-natured substances like Fuzi (Prepared Aconite Root), Ganjiang (Dried Ginger), and Rougui (Cinnamon Bark). When Yangming (Bright Yang) governs dryness and metal, one should collect drying substances like Sangbaipi (Mulberry Root Bark) and Cangzhu (Atractylodes Rhizome). When Jueyin (Terminal Yin) governs wind, one should collect wind-dispelling substances like Fangfeng (Saposhnikovia Root) and Qianghuo (Notopterygium Rhizome). When Taiyang (Greater Yang) governs cold and water, one should collect cold-natured substances like Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Dahuang (Rhubarb Root). When Taiyin (Greater Yin) governs earth, one should collect sweet-ping or sweet-warm substances like Shanyao (Dioscorea Rhizome) and Huangjing (Polygonatum Rhizome), as well as Dan, Su, and Yuan grains; this is what is meant by the compatibility of medicine and food. Ma Shi stated: This passage discusses reserving "sui wu" (yearly produced substances) because they are the concentrated essence of heaven and earth, unlike substances governed by Si Tian Zai Quan (Dominant Heaven and Subterranean Qi), whose qi is biased. Non-yearly substances have scattered qi. The preceding text discussed observing the appropriateness of qi without violating the pathogenesis; thus, using medicine to treat disease requires a specific focus. Each year has its governing qi; one must reserve medicines based on the yearly governing qi so that no primary treatment principle is overlooked.

Qibo stated: Preparing yearly substances according to the ruling qi ensures that no primary treatment principle is overlooked.

Wang Bing stated: Carefully observe what heaven and earth generate; then the flavor of the medicine will be appropriate for that year. Therefore, those specialized in collecting medicines according to the yearly qi will not miss any indications over one or two years. Upon detailed examination, the character "zuo" (make/do) should be understood as "ze" (select). Zhang Zhicong stated: Collecting yearly substances first means preparing those governed by the yearly qi, which corresponds to the previous chapter's statement of "eating yearly grains to preserve true yuan," i.e., nourishing one's body's true yuan with the essence of heaven and earth. Ma Shi stated: Each year has its governing qi; one must reserve medicines based on the yearly governing qi so that no primary treatment principle is overlooked. Zhang Jiebin stated: For example, when Jueyin governs the year, prepare sour substances; when Shaoyang and Shaoyin govern, prepare bitter substances; when Taiyin governs, prepare sweet substances; when Yangming governs, prepare pungent substances; when Taiyang governs, prepare salty substances. These are called "sui wu" (yearly substances). When yearly substances are fully prepared, the application of the five flavors is complete. I (Zhang Ji) note: In the *Wu Chang Zheng Da Lun* (Great Treatise on the Normal State of the Five Movements), generation and transformation differ among the Five Qi, Five Flavors, Five Colors, Five Categories, and Five Appropriatenesses. The prosperity and decline of the five categories follow the appropriateness of their qi, such as Yu Chong (feathered creatures) breeding when Jueyin is Si Tian (Dominant Heaven) and Mao Chong (hairy creatures) breeding when it is Zai Quan (Subterranean Qi). The *Yuan He Ji Yong Jing* records that for Jueyin wind-fire years, Cheqianzi (Plantago Seed) and Rongyan (Halite) are suitable. Chen Wuyi's *San Yin Fang* uses Fuhe Tang (Harmonizing Decoction) for Jueyin Si Tian. Other examples include Sui Gu (Yearly Grains) and Jian Gu (Interim Grains) mentioned in the classics, all suitable for yearly substances, too numerous to list; the principles are detailed in respective sections. Furthermore, Li Dongyuan's *Yong Yao Xin Fa* states: "Si sui bei wu, tian di zhi zhuan jing" (Preparing yearly substances is the concentrated essence of heaven and earth). Medicines from a concentrated essence year are plump and rich, possessing their correct aroma and flavor at the time of use. If the Five Movements governing the year are insufficient, substances are thin; if excessive, substances are refined. Without concentrated essence, qi scatters; if qi scatters, substances are impure. Thus, although form and substance may be the same, their efficacy differs.

The Yellow Emperor asked: Why prioritize yearly substances? Qibo answered: Because they are the concentrated essence of heaven and earth.

Wang Bing stated: Medicines with concentrated essence are plump and rich, possessing their correct aroma and flavor at the time of use. The New Correction notes that "xian sui" (prioritize yearly) is likely a typo for "si sui" (govern yearly). Zhang Zhicong stated: Si qi (Governing Qi) refers to the Five Movements. Although the Five Movements correspond to the Main Year, there are distinctions between excess and deficiency. In years of excess, medicinal power is strong; in years of deficiency, medicinal power is weak. Ma Shi stated: The substances of each year's Si Tian and Zai Quan follow their transformation, storing the concentrated essence of heaven and earth; therefore, they must be prepared in advance. Zhang Jiebin stated: Yearly substances obtain the refined and concentrated transformation of heaven and earth, possessing strong qi and potent power, so they should be reserved first. This aligns with the meaning in the *Liu Yuan Zheng Ji Da Lun* regarding "eating yearly substances to preserve true yuan." I (Zhang Ji) note: Li Dongyuan's *Yong Yao Xin Fa* records a case in June of the Gengchen year treating Xu Bowei, who suffered from palpitations, incessant belching, greenish-yellow complexion, reduced spirit, reluctance to open eyes, fatigue, aversion to speech and laughter, and a pulse with intermittent pauses that sometimes recovered spontaneously—a Jie Mai (Knotted Pulse). Two doses of Zhigancao Tang (Licorice Decoction) were ineffective. Upon re-examination, matching pulse and symptoms, he said: "Could the medicine be old or rancid?" He purchased medicine with stronger aroma and flavor, halved the decoction dose, and after another dose, the patient recovered. All herbal and animal medicines have specific origins and harvesting times. Losing the origin alters nature and flavor slightly; losing the time results in incomplete aroma and flavor. Moreover, new and old, fine and coarse, differ greatly. Using them without selection leading to ineffectiveness is the physician's fault. Medicines value concentrated essence, as illustrated here.

The Yellow Emperor asked: What about non-sui wu (non-yearly substances)?

Wang Bing stated: They are governed by Yun Qi (Movement and Qi). Zhang Zhicong stated: If not sui wu substances, their qi is scattered and power is weak.

Qibo stated: Sui wu substances are the same as main year substances, but there are differences in excess and deficiency.

Wang Bing stated: The Five Movements governing the year have excess and deficiency; compared to sui wu, there may be thin or excessive qualities. Medicines from years of excess are concentrated. Zhang Zhicong stated: Although form and substance are the same, aroma and flavor vary in density. Ma Shi stated: Those referred to as "Si Qi" are indeed Si Yun (Governing Movement). For example, Jia and Ji years are Earth Movement, Yi and Geng years are Metal Movement. Excess leads to surplus, deficiency leads to insufficiency, resulting in biased qi. Zhang Jiebin stated: Main year refers to the Si Tian and Zai Quan governing movement mentioned earlier, which is the same as the qi governance. However, the five Excess movements are surplus, and the five Deficient movements are deficit, leading to variations in the density of substance properties. I (Zhang Ji) note: The *Wu Chang Zheng Da Lun* states that the Five Qi and Five Categories have mutual restriction; similar ones prosper, different ones decline. Qi governance has restrictions; yearly establishment has generation. Earth qi controls what it overcomes; Heaven qi controls what overcomes it; Heaven controls color; Earth controls form. Thus, there are restrictions, overcoming, generation, and completion. It is said that without knowing the year's qi similarity and difference, one cannot discuss generation and transformation. This excess and deficiency is deduced from these restrictions, leaving no omission of treatment principles.

The Yellow Emperor asked: What are non-sui wu substances called? Qibo answered: Scattered.

Wang Bing stated: Without concentration, qi scatters; if qi scatters, substances are impure. Zhang Zhicong stated: There are degrees in treating diseases and preserving truth, meaning some medicinal foods should be used in larger amounts and others in smaller amounts. In ancient times, when one could not prepare yearly substances, processing methods substituted for heaven and earth's assistance, such as roasting Fuzi or stir-frying Cangzhu and Sangbaipi, essentially using fire to assist fire and dryness to assist dryness. Recently, boiling Fuzi in water is called "self-made," and mixing Sangbaipi with honey is called "moistening dryness." This is like using hawks and dogs but removing their claws and teeth; driving them to catch cunning rabbits would fail, let alone achieve the skills of Han Lu (a famous hunting dog). Ma Shi stated: If non-yearly substances are used, their qi is scattered. Zhang Jiebin stated: Non-sui wu refers to non-main-year substances. "Scattered" means the sequence of Six Qi does not govern heaven and earth but rather the four interstitial periods; thus, the response of substance generation also scatters to the four directions with distinct endowments. I (Zhang Ji) note: The *Wu Chang Zheng Da Lun* states that qi begins generation, scatters into form, spreads for multiplication, and ends in transformation. Non-sui wu substances fall into the period of scattered qi and formed shape, where qi declines and flavor thins. As the *Analects* say, "Do not eat what is out of season." How can substances with incomplete nature and flavor be used for treating disease?

Thus, substances are identical in quality but differ in grade.

Wang Bing stated: Although form and substance are the same, efficacy differs; therefore, they are not esteemed. Ma Shi stated: One substance has the same quality, but its essence varies between complete and scattered. Zhang Jiebin stated: Heaven and earth's qi changes constantly; thus, although generated substances share the same constitution, their functional density varies.

Flavor has thin and dense qualities; nature and function have restless and quiet qualities; treatment and preservation have varying dosages; efficacy and transformation have shallow and deep levels. This is what is meant.

Wang Bing stated: Why do substances differ from the year? Ma Shi stated: Flavor has density; nature/function has restlessness/quietness; treatment/preservation has dosage variation; efficacy/transformation has depth variation. This is why yearly substances must be prepared. Zhang Jiebin stated: This refers to identical quality but different grades. Essentially, those governed by qi and those not governed by qi differ in this manner.

The Yellow Emperor asked: What is "Sui Zhu Zang Hai" (Yearly Master Organ Harm)? Qibo answered: Naming it by what it cannot overcome is the key.

Wang Bing stated: Wood cannot overcome Metal, Metal cannot overcome Fire, etc. Zhang Zhicong stated: This discusses how the Five Movements of the year are restricted by Si Tian and Zai Quan. "Sui Zhu" refers to the Six Qi governing the year; "Zang" refers to the Five Zang Organs. The Five Zang organs internally belong to the Five Elements and externally correlate with the Five Movements. When the qi of the Five Movements is injured by restriction, it harms the Five Zang organs. For example, Shaoshang Metal Movement encountering Fire ruling Si Tian, or Shaogong Earth Movement encountering Jueyin ruling Zai Quan. These are cases where the movement is overcome by the ruling qi. Thus, naming by what overcomes it reveals the key to yearly organ harm. Ma Shi stated: This explains that the harm to the Five Zang organs in a year occurs because they have something they cannot overcome, and there is a method to treat it. Yearly qi is in Heaven, Five Zang organs are in Man. Harm to the yearly master of the Five Zang organs arises because if Wood qi is excessive, Spleen cannot overcome it; if Fire qi is excessive, Lung cannot overcome it; if Earth qi is excessive, Kidney cannot overcome it; if Metal qi is excessive, Liver cannot overcome it; if Water qi is excessive, Heart cannot overcome it. Naming by what overcomes it reveals the key to harming organs.

The Yellow Emperor asked: How to treat it? Qibo answered: Upper excess affecting the lower, pacify with what overcomes it; external excess affecting the internal, treat with what overcomes it.

Wang Bing stated: "Yin" (Excess/Overflow) refers to moving against what it cannot overcome. Upper excess affecting the lower is Heaven's qi; external excess affecting the internal is Earth's qi. Pacify and treat according to what overcomes it. Overcoming refers to the five flavors, cold, heat, warm, and cool, detailed later. The New Correction notes: Although heavenly qi governing the year has excess and overcoming, it should only be balanced; hence, it says "pacify" not "treat." Zhang Zhicong stated: Upper excess affecting the lower means Si Tian qi excessively influences the underlying Yun Qi; pacify with what overcomes it. For example, Shaoshang Metal Movement with Fire/Heat descending should be pacified with Salty-Cold assisted by Bitter-Sweet. External excess affecting the internal means Zai Quan qi excessively influences the internal Five Movements; treat with what overcomes it. For example, Shaogong Earth Movement with Wind/Wood ascending should be treated with Pungent-Cool assisted by Bitter-Sweet. Si Tian and Zai Quan qi root externally; Five Movements transformation roots internally; hence, external excess affects internal. The next chapter says "pacify and treat" for heavenly qi and "treat" for Zai Quan, while other passages say Zai Quan qi "excesses internally." Ma Shi stated: When Si Tian qi excesses downward causing organ disease, pacify with what overcomes it, e.g., Wood excess controlled by Metal. When Zai Quan qi excesses inward causing organ disease, treat with what overcomes it, e.g., Wood excess controlled by Metal. "Overcoming" means using the five flavors and thermal natures according to what overcomes. Upper excess affects the first three qi phases, having overcoming without return; external excess affects the last four qi phases, having overcoming without return. Zhang Jiebin stated: Excessive Yin causes harm. Upper excess affecting the lower means Heaven's Six Qi descend causing disease in the Six Channels; external excess affecting the internal means Earth's Five Flavors damage the Five Orifices internally. Yin-Evil causing harm should be balanced and treated by what overcomes it. I (Zhang Ji) note: The *Wu Chang Zheng Da Lun* states that the five flavors' generation and transformation have density variations, maturity has quantity variations, and cold/hot/dry/wet have different transformations. Thus, Shaoyang Zai Quan: flavor Pungent, treatment Bitter-Acid; Yangming Zai Quan: flavor Acid, treatment Pungent-Sweet-Bitter; Taiyang Zai Quan: flavor Bitter, treatment Pale-Salty; Jueyin Zai Quan: flavor Sweet, treatment Sour-Bitter; Shaoyin Zai Quan: flavor Pungent, treatment Pungent-Sweet-Bitter; Taiyin Zai Quan: flavor Salty, treatment Sweet-Salty. Tonifying upper/lower follows; treating upper/lower opposes; adjust based on location, cold/heat, and excess/deficiency.

The Yellow Emperor asked: How to skillfully balance qi?

Wang Bing stated: "Ping" (Balance) refers to diagnosing peaceful qi. Zhang Zhicong stated: Ping Qi means no upper/lower overcoming, representing peaceful Yun Qi. Ma Shi stated: Even in peaceful years, disease occurs; one must view normal vs. abnormal and treat skillfully. The preceding text discussed disease from upper/excess downward and external/excess inward due to unbalanced yearly qi. Hence, asking about balancing qi for people's diseases.

Qibo answered: Carefully observe the location of Yin and Yang and regulate it, aiming for balance. Normal cases use standard treatment; reverse cases use reverse treatment.

Wang Bing stated: Knowing the location of Yin and Yang reveals whether the Cun and Chi pulses should respond or not. Not knowing leads to mistaking gain for loss and reversal for compliance; thus, careful observation is needed. Yin disease without Yang disease, or Yang disease without Yin disease, constitutes normal disease; treat normally, e.g., Cold treats Heat, Heat treats Cold. Yin position showing Yang pulse, or Yang position showing Yin pulse, constitutes reverse disease; treat reversely, e.g., Cold treats Cold, Heat treats Heat. Most prescriptions do not follow this reverse pattern; hence, "reverse cases use reverse treatment." Zhang Zhicong stated: Jia, Bing, Wu, Geng, Ren are Yang Movements; Yi, Ding, Ji, Xin, Gui are Yin Movements. Yin and Yang movements have excess and deficiency. Observe Yin/Yang location and regulate for balance. "Normal" means suppressing excess qi and supporting deficient qi in excess years. "Reverse" means assisting the overcoming qi in deficient years where the overcoming qi counter-attacks. Ma Shi stated: Yin and Yang refer to Cun/Chi positions, Yin/Yang pulses, Yin/Yang meridians. Observe and regulate for balance. If Yin Meridian diseased but Yang Meridian healthy, or vice versa, it is normal disease; treat normally (Cold for Heat, Heat for Cold). If Yin position shows Yang pulse or Yang position shows Yin pulse, it is reverse disease; treat reversely (Cold for Cold, Heat for Heat). Zhang Jiebin stated: Yin and Yang exist in pulses, syndromes, flavors, meridians, and organs. Not knowing their location leads to mistaking reverse for normal and inversion for compliance. Observe carefully and regulate for balance, avoiding excess. I (Zhang Ji) note: The *Wu Chang Zheng Da Lun* states: Nourish and harmonize, wait quietly for the time, guard the qi strictly, prevent collapse, manifest form, grow vital qi, called Sage King. Thus, the Great Principle says: Do not replace transformation, do not violate seasons, must nourish and harmonize, await recovery. This applies to balanced regulation cases.