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The *Liu Yuan Zheng Ji Da Lun* states: The rhythm (referring to the regularity of climatic changes) originates from above and concludes below. In the first half of the year, the Heavenly Qi (Tian Qi, 天气) dominates; in the second half of the year, the Earthly Qi (Di Qi, 地气) dominates. ("Half a year" refers to the day of Liqiu, Start of Autumn.) When Heaven and Earth interact, the Qi Intersection (Qi Jiao, 气交) dominates, thus completing the annual cycle. (The interaction of Heaven and Earth corresponds to the third and fourth Qi phases, dominated by the intersection of Heaven and Earth Qi, marking the completion of the annual cycle.) Spring Qi moves westward, Summer Qi moves northward, Autumn Qi moves southward, and Winter Qi moves eastward. (Observing the growth and storage of all things confirms this statement.) Therefore, Spring Qi begins below, Autumn Qi begins above, Summer Qi begins in the middle, and Winter Qi begins at the periphery. Spring Qi begins on the left, Autumn Qi begins on the right, Winter Qi begins at the back, and Summer Qi begins at the front. This is the normal pattern of seasonal transformation. (This can be understood by observing phenomena.) Thus, in extremely high places, Winter Qi always exists; in extremely low places, Spring Qi always exists. (On mountain peaks, ice and snow persist even in midsummer; in low, muddy marshes, grass grows even in severe winter, illustrating the meaning of "always existing." Spring and Summer Qi originally govern Winter and the South, but their energy descends to the Northwest. Autumn and Winter Qi originally govern the Northwest, but their energy arises from the Southeast. Therefore, Spring Qi originates from the Qi below in the previous year; Autumn Qi results from the descent of the Qi above in the current year; Summer Qi arises from the ascent of the Central Qi in the current year.) These patterns must be carefully observed.

When Jueyin (Liver/Gallbladder) Wind-Wood Qi arrives, it manifests as internal tension (tendon spasms and contraction, hence the urgency). When Shaoyin (Heart/Pericardium) Ministerial Fire Qi arrives, it manifests as sores, rashes, and fever (as Fire Qi governs). When Taiyin (Spleen/Stomach) Damp-Earth Qi arrives, it manifests as fluid retention, epigastric fullness, and rebellious Qi. When Shaoyang (Sanjiao/Gallbladder) Ministerial Fire Qi arrives, it manifests as sneezing, vomiting, and sores (also governed by Fire Qi). When Yangming (Large Intestine/Stomach) Dry-Metal Qi arrives, it manifests as flaccid edema (flaccid swelling that rebounds quickly upon pressure). When Taiyang (Bladder/Kidney) Cold-Water Qi arrives, it manifests as difficulty in flexion and extension of joints, which is the normal pattern of disease.

When Jueyin Wind-Wood Qi arrives, it manifests as distending pain in the hypochondrium (Zhi, meaning obstruction or interference). When Shaoyin Ministerial Fire Qi arrives, it manifests as fright, confusion, aversion to cold, tremors, and delirium (Zhan, referring to incoherent speech due to mental disorder). When Taiyin Damp-Earth Qi arrives, it manifests as convulsions and fullness. When Shaoyang Ministerial Fire Qi arrives, it manifests as fright, irritability, visual blurring, and sudden illness. When Yangming Dry-Metal Qi arrives, it manifests as nasal congestion, and diseases of the inner thigh, knee, thigh, calf, and foot. When Taiyang Cold-Water Qi arrives, it manifests as lower back pain, which is the normal pattern of disease.

When Jueyin Wind-Wood Qi arrives, it manifests as tendon laxity and cramping. When Shaoyin Ministerial Fire Qi arrives, it manifests as sorrowful delirium and epistaxis or subcutaneous bleeding (Mie, referring to turbid blood). When Taiyin Damp-Earth Qi arrives, it manifests as abdominal fullness, Huoluan (cholera-like syndrome with vomiting and diarrhea), and vomiting/diarrhea. When Shaoyang Ministerial Fire Qi arrives, it manifests as throat bi (obstruction), tinnitus, and gurgling vomiting (Yong, referring to food regurgitation where swallowing is difficult). When Yangming Dry-Metal Qi arrives, it manifests as hypochondriac pain and skin wrinkling/cracking (like bran). When Taiyang Cold-Water Qi arrives, it manifests in sleep sweating and spasms (Qin Han, referring to sweating in the chest, throat, neck, and axilla during sleep, commonly known as night sweats), which is the normal pattern of disease.

When Jueyin Wind-Wood Qi arrives, it manifests as hypochondriac pain, vomiting, and diarrhea (Xie, referring to purging). When Shaoyin Ministerial Fire Qi arrives, it manifests as excessive talking and laughing. When Taiyin Damp-Earth Qi arrives, it manifests as severe edema (Zhong, referring to soft muscle tissue that remains depressed after pressure). When Shaoyin Ministerial Fire Qi arrives, it manifests as acute diarrhea, convulsions, and sudden death. When Yangming Dry-Metal Qi arrives, it manifests as nasal congestion and sneezing. When Taiyang Cold-Water Qi arrives, it manifests as uncontrolled diarrhea or constipation/inability to urinate, which is the normal pattern of disease.

These twelve variations are reciprocal responses of Virtue (De, 德), Transformation (Hua, 化), Administration (Zheng, 政), and Decree (Ling, 令). If Qi is high, the disease is high; if Qi is low, the disease is low; if Qi is posterior, the disease is posterior; if Qi is anterior, the disease is anterior; if Qi is central, the disease is central; if Qi is external, the disease is external. This is the normal order of position. (The reciprocity of Virtue and Transformation refers to Heaven and Earth Qi. High, low, anterior, posterior, central, and external refer to the locations of disease. Hand Yin-Yang Qi is high, Foot Yin-Yang Qi is low. Foot Taiyang Qi is at the back, Foot Yangming Qi is at the front, Foot Shaoyang, Taiyin, and Jueyin Qi are in the center, and Foot Shaoyang Qi is on the side. Each follows its location, describing how Qi changes cause disease manifestations. The mentions of Jueyin, Shaoyin, Taiyin, etc., in the main text primarily discuss annual cycles, while human diseases align with these cycles. These twelve variations refer to the aforementioned Virtue, Transformation, Administration, Decree, disease changes, and the twelve solar terms' climatic features. If not arriving in the proper annual sequence, but through the interaction of Host and Guest Qi, they belong to variable Qi, manifesting as Yong Fu (using recurrence). In cases of Sheng Fu (victory and retaliation), when the Sheng Qi (excess Qi) arrives, if its De is altered, it is retaliated with De; if its Hua is altered, it is retaliated with Hua; if its Zheng/Ling is altered, it is retaliated with Zheng/Ling. The reciprocation of Qi cannot shift positions. Qi that is high is retaliated at a high level; Qi that is low is retaliated at a low level; Qi that is posterior is retaliated posteriorly; Qi that is anterior is retaliated anteriorly; Qi that is central is retaliated centrally; Qi that is external is retaliated externally. Their positional hierarchy also cannot shift. Thus, the normal variations of wind, cold, heat, dampness, dryness, and fire in the world cannot be identical.)

Therefore, if Wind prevails, there is movement (restlessness); if Heat prevails, there is swelling (Heat prevailing in Qi causes Dan poison [erysipelas], prevailing in Blood causes abscesses/swelling, prevailing in bone/flesh causes edema that does not rise upon pressure); if Dryness is abundant, there is dryness (Dryness on the exterior causes skin wrinkling; Dryness on the interior causes exhaustion of essence and blood; Dryness in Qi and fluids causes muscles to dry and skin adhere to bones); if Cold prevails, there is floating/edema (Fu, referring to depression upon pressure); if Dampness prevails, there is Ru Xie (damp diarrhea/watery stool), and severely, water closure and edema (muscle depression that does not rise, closure leads to fluid accumulation in the skin). Depending on the location of the Qi, corresponding variations occur.

If Heavenly Qi is insufficient, Earthly Qi follows it; if Earthly Qi is insufficient, Heavenly Qi follows it. The Five Movements (Wu Yun, 五运) reside in the middle and often arrive first. (Yun refers to Wood, Fire, Earth, Metal, Water, each governing the year's climate. When Earthly Qi is strong, the annual Yun rises; when Heavenly Qi is strong, the annual Yun descends. Rising and descending, the Yun often migrates first.) It dislikes what it cannot overcome (the element that controls it) and returns to what is similar. Following the Yun's return and submission, disease arises. (If the position is incorrect, changes arise; if changes arise, disease occurs.) Therefore, if the upper part prevails, Heavenly Qi descends; if the lower part prevails, Earthly Qi migrates upward. (Sheng means excess. Excess above leads to self-descent; excess below leads to self-migration. The shifting of more and less is the normal state of Qi.) The difference is determined by the degree of excess (More excess leads to greater migration/descent; less excess leads to lesser migration/descent. The response of more and less varies between mild and severe). Mild differences are small; severe differences are large. If severe, positions and Qi exchanges occur, leading to major changes and the onset of disease.

The general principle states: The standard cycle is five parts, the minor cycle is seven parts; the deviation is visible. This is what is meant. (Through five and seven parts, one can know the excessive deviation of Heaven and Earth Yin-Yang.) Why should one not use cold to attack heat, or heat to attack cold? (For releasing the exterior, do not avoid heat; for attacking the interior, do not avoid cold. (Since sweating requires heat, one does not avoid heat; since purging requires cold, one does not avoid cold. These refer to situations where one has no choice but to use them.))

For pregnant women, how should toxic drugs be used? If there is an underlying pathogen, there will be no damage to the mother, nor will the fetus perish. (Refers to large, hard masses like Zheng Jia [masses]. If pain is unbearable, treat with drugs that break accumulations and increase pain temporarily. This is called "saving the major aspect." There is no injury above, meaning one need not worry about total loss; the fetus will survive.) For large accumulations, attack is permissible. However, stop when the pathogen has diminished by more than half. Over-treatment leads to death. (Diminishing by half is not enough to harm life. Thus, stop medication when half is reduced. If one waits for complete elimination through over-restriction, residual toxins remain inside. Attacking without disease using toxic drugs damages the body's harmonious balance, so over-treatment leads to death.)

If Wood Qi is stagnant, resolve it with dispersing methods; if Fire Qi is stagnant, resolve it with venting methods; if Earth Qi is stagnant, resolve it with purging methods; if Metal Qi is stagnant, resolve it with draining methods; if Water Qi is stagnant, resolve it with restraining methods. However, regulate the Qi. (Da means using emesis to allow smooth flow; Fa means using diaphoresis to allow dispersion; Duo means using purgatives to remove obstruction; Xie means using渗泄 (percolation/drainage), releasing the exterior, and promoting urination; Zhe means suppressing it to control rebellious Qi. Understanding these five methods allows for regulating Qi, followed by observation of deficiency/excess for further regulation. Excess is treated with suppression because it fears being drained, hence called "draining." Guo means excess. For excess, use flavors to drain: Salty drains Kidney, Sour drains Liver, Pungent drains Lung, Sweet drains Spleen, Bitter drains Heart. Excess fears draining, hence draining is called "fear".)