《至真要大论》曰∶阴之所在寸口何如？（阴之所在，脉沉不应。）视岁南北，可知之矣。北
政之岁，少阴在泉，则寸口不应；（木火金水四运，面北受气。凡气之在泉者，脉息不见，惟其左右之气
脉可见之。在泉之气，善则不见，恶者可见，病以气疾客主淫胜名之。在天之气其亦然也。）厥阴
在泉，则右不应；少阴在石故。）太阴在泉，则左不应。（太阴在左故。）南政之岁，少阴司天，则寸
口不应。（土运之岁，面南行令，故少阴司天，则二手寸口不应也。）厥阴司天，则右不应；太阴司天，
则左不应。（变左右义也。）诸不应者，反其诊则见也。（不应皆谓脉沉，脉沉下者，抑手而沉，
复其手则沉为浮，细为大也。）帝曰∶尺候何如？伯曰∶北政之岁，三阴在下，则寸不应；三
阴在上，则尺不应。司天曰上，在泉曰下。）南政之岁，三阴在
天，则寸口不应；三阴在泉，则尺不应。左右同。（尺不应寸，左右悉同。言南北二政之司天在泉，
其尺寸之脉，各有所不应也。）天地之气，内淫而病何如？岁厥阴在泉，风淫所胜，则地气不
明，平野昧，草乃秀。民病洒洒振寒，善呻数欠，心痛支满，两胁里急，饮食不下，膈
咽不通，食则呕，腹胀善噫，年后与气，则快然如衰，身体皆重。（谓寅申岁也。洒洒振寡，善
呻数欠，为胃病。合则呕，腹胀善噫，得后与气，则快然如衰，身体皆重，为脾病。饮食不下，
膈咽不通，邪在胃脘也。盖厥阴在泉之岁，木干而克脾胃，故病如是。）岁少阴在泉，热淫所胜，则
焰浮川泽，阴处反明。民病腹中常鸣，气上冲胸，喘不能久立，寒热皮肤痛，目瞑齿痛 肿，恶寒发热
如疟，少腹中痛腹大，蜇虫不藏。（谓卯酉岁也。齿痛 肿，为大肠病。腹中雷鸣，气上冲胸，喘不
能久立，邪在大肠也。盖少阴在泉之岁，火克金，故大肠病也。）岁太阴在泉，草乃早荣，湿淫所盛，
则埃昏岩石，黄反见黑，至阴之交。民病饮积，心痛，耳聋浑浑 ，咽肿喉痹，阴病血见，少腹
痛肿，不得小便，病冲头痛，目似脱，项似拔，腰似折，髀不可以回， 似结， 如别。（谓辰
戌岁也。太阴为土，色见应黄于中天，而反见于北方黑处也。水土同见，故曰至阴之交，合其气色也。
冲头痛，谓脑后眉间痛也。 ，谓膝后曲脚之中也。 ， 后软肉处也。耳聋浑浑 ，咽肿喉痹，
为三焦病。病冲头痛，目似脱，项似拨，腰似折，髀不可以回， 如结， 如别，为膀胱足太阳病。
又少腹肿痛，不得小便，邪在三焦，盖太阴在泉之岁，土旺克太阳，故病如是也。）岁少阳在泉，
火淫所胜，则焰明效野，寒热更至。民病注泄赤白，少腹痛溺赤，甚则血便。少阴同候。（谓乙亥
岁也。处寒之时，热更其气，热气既往，寒气后来，故云更至也。余候与少阴在泉同。）岁阳明在
泉，燥淫所胜，则 雾清瞑，民病喜呕，呕有苦，善太息，心胁痛，不能反侧，甚则咽干面尘，身无膏泽，
足外反热。（谓子午岁也。 雾谓暗不明，似雾也。言雾起 暗，不分形物而薄寒也。心胁痛、谓
心之傍，胁中痛也。面尘，谓面上如有触冒尘土之色也。呕有苦，善太息，心胁痛，不能反侧，甚则
面尘，身无膏泽，足外反热，为胆病。咽干面尘，为肝病。盖阳明在泉之岁，金王克木，故病如是。）
岁太阳在泉，寒淫所胜，则凝肃惨栗，民病少腹控睾，引腰脊，上冲心痛，血见，咽干颔肿。（
谓丑未岁也。凝肃，谓寒气霭空，凝而不动，万物静肃，其义形也。惨栗，寒甚也。控，引也。睾，
阴丸也。颔，颊车前牙之下也。咽痛颔肿，为小肠病，又少腹控睾，引腰脊，上冲心肺，邪在小
肠也。益太阳在泉之岁，水克火，故病如是。）诸气在泉，风淫于内，治以辛凉，佐以苦甘，以甘
缓之，以辛散之。热淫于内，治以咸寒，佐以甘苦，以酸收之，以苦发之。湿淫于内，治以苦热，佐
经酸淡，以苦燥之，以淡泄之。火淫于内，治以苦温，佐以甘辛，以苦下之。寒淫于内，治以甘热，
佐以苦辛，以咸泻之，以辛润之，以苦坚之。（此言六气之在泉，淫胜为病者，各有治之之法也。）天气
之变何如？厥阴司天，风淫所胜，则太虚埃昏，云物以扰，寒生春气，流水不冰。民病胃脘当心而
痛，上支两胁，膈咽不通，饮食不下，舌本强，食则呕，冷泄腹胀，溏泄瘕水闭，蛰虫不出，
病本于脾。（谓已亥岁也。是岁民病集于中也。风自天行，故太虚埃起风动飘荡，故云物扰也。埃，青尘
也。不分远物是为埃，是为昏埃。土之为病，其善泄利，若病水则水便闭而不下，若大泄利，则
经水亦多闭绝也。舌本强，食则呕，腹胀溏泄瘕水团，为脾病。又胃病者，腹脾胀，胃脘当心而痛，
上支两脸，膈咽不通，食饮不下。盖厥阴司天之岁，水胜土，故病如是。）
少阴司天，热淫所胜，怫热至，火行其政。民病胸中烦热，咽干，右 满，皮肤痛，寒热咳喘，
大雨且至，唾血血泄，鼽衄嚏呕，溺色变，甚则疮疡 肿，肩背臂 及缺盆中痛，心痛肺 ，腹大满，
膨膨而喘咳，病本于肺。（谓子午岁也。怫热至，是火行其政乃尔。是岁民病集于右，益以小肠通
心故也。病自肺生，故曰病本于肺也。盖病少阴司天之岁，火克金，故病如是也。）尺泽绝，死不治。
（尺泽在肘内 大纹中，动脉应手，肺之气也。火灼于金，承天之命，金气内绝，故必危亡。）太阴
司天，湿淫所胜，则沉阴且布，雨变枯槁， 肿骨痛阴痹，阴痹者，按之不得，腰脊头项痛，时弦，
大便难，阴气不用，饥不欲食，咳唾则有血，心如悬，病本于肾。（谓丑未岁也。沉，久也。）肾
气受邪，水无能润，下焦枯涸，故大便难也。饥不欲食，咳睡则有血，心悬如饥状，为肾病。又邪在
肾，则骨痛阴痹，阴痹者，按之不
得，腹胀腰痛，大便难，肩背颈项强痛，时弦。盖太阴司
天之岁，土克水，故病如是。）太溪绝，死不治。（太溪，在足内踝后跟骨上，动脉应手，肾之气也。
土邪胜水而肾气内绝。）少阳司天，火淫所胜，则温气流行，金政不平，民病头痛，发热恶寒而疟，
热上皮肤痛，色变黄赤，传而为水，身面 肿，腹满仰息，泄注赤白，疮疡咳唾血，烦心胸中热，
甚则鼽衄，病本乎肺。（谓寅审岁也。火来用事，则金气受邪，故曰金政不平也。火炎于上，金
肺受邪，客热内燔，水无能救，盖少阳司天之岁，火克金，故病如是。）天府绝，死不治。（天府，在肘
后内侧上腋下，同身寸之二寸，动脉应手，肺之气也。火胜而金肺绝，故死。）阳明司天，燥淫
所胜，则木乃晚荣，草乃晚生，筋骨内变，民病左 胁痛，寒清于中，感而疟，大凉革候，咳，腹
中鸣，注泻 溏，名木敛，生宛于下。草焦上首，心胁暴痛，不可反侧，咽干面尘腰痛，丈夫 疝，
妇人少腹痛，目昧 ，疡疮痤痈，蛰虫来见，病本于肝。（谓卯酉岁也。金胜，故草木晚荣也。配
于人身，则筋骨内应而不用也。大凉之气，变易时候，则人寒清发于中，内感寒气，则为 疟也。
大肠居右，肺气通之，今肺气内淫，肝居于左，故左 胁痛如刺割也。其岁民自注泄，则无淫胜之疾也。
大凉，次寒也。大凉且甚，阳气不行，故木容收敛，草容悉晚。生气已升，阳不布令，故行积生
气而 于下也。在人之应，则少腹之内，痛气居之，疮疡痤痈，腰痛不可俯仰，丈夫 疝，妇人
少腹痛，甚则咽干面尘，胸满洞泄，为肝病。又心胁痛不能反侧，目锐 痛，缺盆中肿痛，腋下肿
马刀，振寒疟，为胆病。盖阳明司天之岁，金克木，故病如是也。）太冲绝，死不治。（太冲在足大
指本节后二寸，脉动应手，肝之气也。金来代木，肝气内绝，正不胜邪，其死宜也。）太阳司天，寒淫
所胜，则寒气反至，水且冰，血变于中，发为痈疡，民病厥心痛，呕血血泄鼽衄，善悲，时眩仆。
运大炎烈，雨暴乃雹，胸腹病，手热肘挛掖肿，心澹澹大动，胸胁胃脘不安，面赤目黄，善噫嗌干，
甚则色 ，渴而欲饮，病本于心。（谓辰戌岁也。太阳司天，寒气布化，故水且冰，而血凝皮肤之间，
卫气结聚，故为痈也。若乘火运而火炎烈，与水交战，故豪雨半珠形雹也。是岁民病积于心胁之中
也。阳气内郁，湿气下蒸，故心厥痛而呕血，血泄鼽衄，面赤目黄，善噫手热，肘挛腋肿咽干，
甚则寒气胜阳，水行凌火，火气内郁，故渴而欲饮也。病始心生，为阴凌犯，故云病本于心也。盖
太阳司天之岁，水克火，故病如是。）神门绝，死不治。（神门在手之掌后锐骨之端，动脉应手，
真心气也。水行胜火，而心气内绝，神气已亡，不死何待？）所谓动气，知其脏也。（所以
诊视而知死者何？以皆是脏之经脉动气，知神藏之存亡尔。）司天之气，风淫所胜，平以辛凉，佐以
苦甘，以甘缓之，以酸泻之。热淫所胜，平以咸寒，佐以苦甘，以酸收之。湿淫所胜，平以苦热，
佐以酸辛，以苦燥之，以淡泄之。湿上甚而热，治以苦温，佐以甘辛，以汗为故而止。火淫所胜，平
以酸冷，佐以苦甘，以酸收之，以苦发之，以酸复之，热淫同。燥淫所胜，平以苦温，佐以酸辛，以苦
下之。寒淫所胜，平以辛热，佐以苦甘，以咸泻之，（此言六气之司天淫胜为病者，各有治之之法
也。）治诸胜复，寒者热之，热者寒之，温者清之，清者温之，散者收之，抑者散之，燥者润之，
急者缓之，坚者软之，脆者坚之，衰者补之，强者泻之，各安其气，必清必净，则病气衰去，归其
所宗，此治之大体也。（太阳气寒，少阴少阳气热、厥阴气温，阳明气清，太阴气湿，有胜复则各
倍其气以调之，故可使平也。宗，属也。调不失理，则余之气自归其所属，少阴之气自安其所居。
胜复衰已，则各补养而平定之，必清必净，无妄扰之，则六气循环，五神安泰，若运气之寒热，
治之平之，亦各归司天地气也。此总结言治胜复之大体也。）
身半以上其气三矣，天之分也，天气主之。身半以下，其气三也，地之分也，地气
主之。以名命气，以气命处，而言其病。半，所谓天枢也。（身之半，正谓脐中也。或以腰为
身半，当伸臂指天，舒足指地，以绳量之，中正当脐也，故又曰半，所谓天枢也。司天者其气三，
司地者其气三，故身半以上三气，身半以下三气也。以名言其气，以气言其处，以气处寒热，
而言其病之形证也。欲知病诊，尝随气所在以言之，当阴之分，冷病归之，当阳之分，热病归
之，故胜复之作，先言病生寒热者，必根据此物理也。《六微旨大论》曰∶天枢之上，天气主之，
天枢之下，地气主之，气交之分，人气从之。）
夫气之胜也。微者随之，甚者制之。气之复也，和者平之，暴者夺之，皆随其胜气，安其屈
伏，无问其数，以平其期，此其道也。（随，谓随之，安之。制，谓止制。平，谓平调。
夺，谓夺其胜气也。治此者，不以数之多少，但以气平和为准度耳。此言复之，所以反病而有治之
之法也。高者抑之，下者举之，有余者折之，不足者补之，佐以所利，或以所宜，必安其主客，适
其寒温，同者逆之，异者从之。（高者抑之，制其盛也。下者举之，济其落也。有余者折之，
屈其类也。不足者补之，全其气也。虽制胜扶弱，而客主须安，一其失所、内淫外并，而危败之由
作矣。同。谓寒热温清，气相比和者，异，谓木火土金水，不比和者，气相得者，则逆所胜之
气以治之。不相得者，则顺所不胜气以治之。此其治主客之大体也。）气有高下，病有远近，证有
中外，治有轻重，适其至所为故也。（脏位有高下，腑气有远近，病症有表里。药用有轻重，
调其多少，和其紧慢，令药气至病所为故，勿太过不及也。）大要曰∶君一臣二，奇之制也；君二
臣四，偶之制也；君二臣三，奇之制也；君三臣六，偶之制也。（奇，谓古之单方。偶，谓古之复
方。单复一制，皆有大小，故奇方云∶君一臣二，君二臣三。偶方云∶君二臣四，君三臣六也。病
有大小，气有远近，制有轻重所宜，故云制也。）故曰∶近者奇之，远者偶之，汗者不以奇，
下者不以偶，补上治上制以缓，补下治下制以急，急则气味浓，锾则气味薄，适其所至，此之
谓也。（汗药不以偶方，气不可以外发泄，下药不以奇制，药毒攻而致过。治上补上，方迅急则
止不住而迫下。治下补下，方缓慢则湿道路而力又微。制急方而气味薄，则力与缓等。制缓方
而气味浓，则势与急同。如是谓为缓不能缓，急不能急，浓而不浓，薄而不薄，大小非制，轻重
无度，则虚实寒热，脏腑纷挠，无由致理，岂神灵而可望安哉！）近而奇偶，制小其服也。远而
奇偶，制大其服也。大则数少，小则数多，多则九之，少则二之。（汤丸多少，凡如此也。近远，
The *Zhi Zhen Yao Da Lun* (Great Treatise on the Most Essential and Important Principles) states: What is the manifestation of Yin pulses at the Cun Kou (Cun position, radial artery pulse point)? (The term "Yin" here refers to the pulse being deep and unpalpable.) By observing the North and South political years of the annual cycle, this can be known.
In a **North Political Year** (Bei Zheng), when **Shao Yin** (Lesser Yin/Ministerial Fire) is in the Spring (ruling the latter half of the year), the Cun Kou pulses are unpalpable. (The Qi of Wood, Fire, Metal, and Water receives energy facing North. For Qi located in the Spring, the pulse is often invisible; only the Qi of the Left and Right positions is visible. When the Qi in the Spring is harmonious, the pulse is not seen; when pathological, it is visible. Diseases are named based on the guest Qi overcoming the host Qi or mutual invasion. The same applies to Qi in the Heaven position.) When **Jue Yin** (Greater Yin/Wind Wood) is in the Spring, the right Cun Kou pulse is unpalalpable. (Because Jue Yin is on the right.) When **Tai Yin** (Grand Yin/Damp Earth) is in the Spring, the left Cun Kou pulse is unpalpable. (Because Tai Yin is on the left.)
In a **South Political Year** (Nan Zheng), when **Shao Yin** is in the Heaven (ruling the first half of the year), the Cun Kou pulses are unpalpable. (In years of Earth transport, ruling facing South, when Shao Yin is in Heaven, both hands' Cun Kou pulses are unpalpable.) When **Jue Yin** is in Heaven, the right Cun Kou pulse is unpalpable; when **Tai Yin** is in Heaven, the left Cun Kou pulse is unpalpable. (This changes the meaning of left and right correspondence.)
Regarding all "unpalpable" cases, reversing the diagnostic method reveals them. (Unpalpable refers to deep pulses. Deep pulses are felt by pressing down; if hand pressure is reduced, the deep pulse becomes superficial, and the thin pulse becomes large.)
The Yellow Emperor asked: How about the Chi (Chi position, radial artery pulse point distal to Cun) pulse? The Master replied: In a North Political Year, when the Three Yin channels are below (in the Spring), the Cun Kou pulse is unpalpable; when the Three Yin channels are above (in Heaven), the Chi pulse is unpalpable. (Heaven is called Above, Spring is called Below.) In a South Political Year, when the Three Yin channels are in Heaven, the Cun Kou pulse is unpalpable; when the Three Yin channels are in the Spring, the Chi pulse is unpalpable. The situation is the same for the left and right sides. (If the Chi is unpalpable, the Cun is also unpalpable; left and right are identical. This means that for both North and South political years, regarding Heaven and Spring positions, the Cun and Chi pulses each have their respective unpalpable states.)
How do Heaven and Earth Qi invade internally causing disease?
In a year where **Jue Yin** is in the Spring, with excessive Wind Qi, the ground mist becomes dim, plains are obscure, and grass flourishes. People suffer from shivering chills, frequent yawning and groaning, heart pain with limb fullness, tightness in the hypochondrium, inability to swallow food, obstruction in the diaphragm and throat, vomiting after eating, abdominal distension with frequent belching. After defecation or passing gas, they feel relieved as if the illness has subsided, and the body feels heavy. (Refers to Yin-Shen years. Shivering chills, yawning, and groaning indicate Stomach disease. Combined with vomiting, abdominal distension, belching, relief after defecation/gas, and heaviness, this indicates Spleen disease. Inability to eat and throat obstruction indicate pathogen in the stomach region. Generally, in Jue Yin Spring years, Wood overacts on the Spleen and Stomach, hence these symptoms.)
In a year where **Shao Yin** is in the Spring, with excessive Heat Qi, flames float on rivers and marshes, and dark places appear bright. People suffer from borborygmus in the abdomen, Qi rushing up to the chest, asthma unable to stand for long, alternating chills and fever with skin pain, eye dimness and tooth swelling/pain, chills and fever resembling malaria, lower abdominal pain and distension, and hibernating insects failing to hide. (Refers to Mao-You years. Tooth swelling/pain indicates Large Intestine disease. Borborygmus, Qi rushing to chest, asthma, indicate pathogen in the Large Intestine. Generally, in Shao Yin Spring years, Fire overacts on Metal, hence Large Intestine disease.)
In a year where **Tai Yin** is in the Spring, grass flourishes early, with excessive Damp Qi, dust obscures rocks, yellow appears mixed with black, marking the intersection of Extreme Yin. People suffer from fluid retention accumulation, heart pain, deafness with muffled hearing, swollen throat and pharyngeal obstruction, bleeding from lower jiao disorders, lower abdominal pain and swelling, inability to urinate, Qi rushing upward causing headache, eyes feeling like they will fall out, neck feeling like it is being pulled, waist feeling like it is broken, thighs unable to move, knees feeling bound, and popliteal fossa feeling torn. (Refers to Chen-Xu years. Tai Yin is Earth, color corresponds to Yellow in the center heaven, but appears in the North Black area. Water and Earth colors appearing together is called the intersection of Extreme Yin. Rushing headache refers to pain between the eyebrows and back of the head. Guo refers to the back of the knee. Chan refers to the calf muscle. Deafness and throat swelling indicate San Jiao disease. Rushing headache, eye protrusion sensation, neck pull, waist break, thigh immobility, knee binding, and popliteal tearing indicate Bladder Tai Yang channel disease. Additionally, lower abdominal pain and urinary retention indicate pathogen in the San Jiao. Generally, in Tai Yin Spring years, Earth overacts on Tai Yang, hence these symptoms.)
In a year where **Shao Yang** is in the Spring, with excessive Fire Qi, fields shine brightly, and chills and fever alternate. People suffer from dysentery (red and white discharge), lower abdominal pain, red urine, and severe cases may have bloody stools. The pulse presentation is similar to Shao Yin in the Spring. (Refers to Yi-Hai year. During cold times, heat replaces the Qi; after heat passes, cold follows, hence "alternating." Other symptoms are the same as Shao Yin in the Spring.)
In a year where **Yang Ming** is in the Spring, with excessive Dryness Qi, fog makes things dim and unclear. People suffer from frequent vomiting with bitter taste, frequent sighing, heart and hypochondriac pain, inability to turn side to side, severe dry throat and dusty complexion, body lacking luster, and reverse heat in the outer foot. (Refers to Zi-Wu years. Fog implies obscurity. Heart/hypochondriac pain refers to pain beside the heart in the ribs. Dusty complexion means face looks soiled. Bitter vomiting, sighing, heart/hypochondriac pain, inability to turn, dusty face, lack of luster, and foot heat indicate Gallbladder disease. Dry throat and dusty face indicate Liver disease. Generally, in Yang Ming Spring years, Metal overacts on Wood, hence these symptoms.)
In a year where **Tai Yang** is in the Spring, with excessive Cold Qi, the atmosphere becomes condensed, solemn, and chilling. People suffer from lower abdominal pain radiating to the testicles, pulling into the lumbar spine, upward rushing heart pain, bleeding, dry throat, and submandibular swelling. (Refers to Chou-Wei years. Condensed solemnity means cold air fills the sky, stagnant and motionless. Chilling means extreme cold. Kong means pulling. Gao means testicle. Han refers to the area below the jaw near the teeth. Throat pain and submandibular swelling indicate Small Intestine disease. Lower abdominal pain radiating to testicles, pulling spine, and rushing to heart/lungs indicate pathogen in the Small Intestine. Generally, in Tai Yang Spring years, Water overacts on Fire, hence these symptoms.)
For various Qi in the Spring, if Wind invades excessively, treat with Acrid-Cool herbs, assist with Bitter-Sweet herbs, use Sweet to relax, and Acrid to disperse. If Heat invades excessively, treat with Salty-Cold herbs, assist with Bitter-Sweet herbs, use Sour to astringe, and Bitter to vent. If Dampness invades excessively, treat with Bitter-Hot herbs, assist with Sour-Light herbs, use Bitter to dry, and Light to drain. If Fire invades excessively, treat with Bitter-Warm herbs, assist with Sweet-Acrid herbs, and use Bitter to purge. If Cold invades excessively, treat with Sweet-Hot herbs, assist with Bitter-Acrid herbs, use Salty to purge, Acrid to moisten, and Bitter to consolidate. (This describes the treatment methods for diseases caused by the excessive influence of the Six Qi in the Spring.)
What are the changes in Heaven Qi?
When **Jue Yin** is in Heaven, with excessive Wind Qi, the vast sky becomes dusty and dim, clouds and objects are disturbed, cold generates spring Qi, and flowing water does not freeze. People suffer from epigastric pain at the heart center, radiation to both hypochondria, obstruction in diaphragm/throat, inability to eat, stiff tongue root, vomiting after eating, cold diarrhea with abdominal distension, loose stools, masses, edema, urinary retention, hibernating insects not emerging, with the disease rooted in the Spleen. (Refers to Si-Hai years. Wind comes from Heaven, causing dust and disturbance. Earth pathology favors diarrhea; if water disease, urine/stool is retained; if severe diarrhea, menstruation stops. Stiff tongue, vomiting, distension, loose stools, masses, edema indicate Spleen disease. Epigastric pain, hypochondriac radiation, throat obstruction indicate Stomach disease. Generally, in Jue Yin Heaven years, Water overacts on Earth, hence these symptoms.)
When **Shao Yin** is in Heaven, with excessive Heat Qi, stifling heat arrives, Fire exercises its administration. People suffer from chest irritability and heat, dry throat, right hypochondriac fullness, skin pain, chills/fever/cough/asthma, heavy rain approaching, hemoptysis, hematochezia, epistaxis, sneezing/vomiting, urine color changes, severe sores/swelling, shoulder/back/arm/clavicle pain, heart pain, lung distension, abdominal fullness, bloating with cough/asthma, with the disease rooted in the Lung. (Refers to Zi-Wu years. Stifling heat indicates Fire's rule. Disease concentrates on the right because Small Intestine connects to Heart. Disease originates from Lung, hence "rooted in Lung." Generally, in Shao Yin Heaven years, Fire overacts on Metal, hence these symptoms.) If Chi Ze pulse vanishes, death is incurable. (Chi Ze is in the elbow crease, pulsating, representing Lung Qi. Fire burns Metal, fulfilling Heaven's mandate, Metal Qi internally perishes, leading to fatal outcome.)
When **Tai Yin** is in Heaven, with excessive Dampness Qi, deep Yin spreads, rain causes withering. Edema, bone pain, Yin Bi (deep bi-syndrome). Yin Bi is characterized by insensitivity to pressure, pain in waist/spine/head/neck, intermittent wiry pulse, difficulty defecating, impotence, hunger without desire to eat, blood in sputum, heart feeling suspended, with the disease rooted in the Kidney. (Refers to Chou-Wei years. Shen means long-lasting. Kidney Qi is invaded, Water cannot moisten, Lower Jiao dries up, causing constipation. Hunger without appetite, bloody sputum, suspended heart sensation indicate Kidney disease. Pathogen in Kidney causes bone pain, Yin Bi, abdominal distension, back pain, constipation, shoulder/neck stiffness, wiry pulse. Generally, in Tai Yin Heaven years, Earth overacts on Water, hence these symptoms.) If Tai Xi pulse vanishes, death is incurable. (Tai Xi is behind the medial malleolus, pulsating, representing Kidney Qi. Earth evil overcomes Water, Kidney Qi internally perishes.)
When **Shao Yang** is in Heaven, with excessive Fire Qi, warm Qi circulates, Metal administration is uneven. People suffer from headache, fever/chills/malaria, heat attacking skin causing pain, yellow/red complexion changes, progression to water disease, facial/body edema, abdominal fullness with orthopnea, dysentery, sores, hemoptysis, chest heat, severe epistaxis, with the disease rooted in the Lung. (Refers to Yin-Shen years. Fire dominates, injuring Metal, hence "Metal administration uneven." Fire flares up, injuring Lung/Metal, internal heat burns, Water cannot save. Generally, in Shao Yang Heaven years, Fire overacts on Metal, hence these symptoms.) If Tian Fu pulse vanishes, death is incurable. (Tian Fu is in the upper inner arm, pulsating, representing Lung Qi. Fire overcomes Metal, Lung Qi perishes, hence death.)
When **Yang Ming** is in Heaven, with excessive Dryness Qi, trees fruit late, grass grows late, internal changes in sinews/bones. People suffer from left hypochondriac pain, central cold, malaria upon infection, great coolness changing seasons, cough, borborygmus, watery diarrhea, trees contracting, vitality stagnating below, grass withering at tips, sudden heart/hypochondriac pain, inability to turn, dry throat, dusty face, lower back pain, hernia in men, lower abdominal pain in women, eye dimness, sores/acne/abscesses, hibernating insects appearing, with the disease rooted in the Liver. (Refers to Mao-You years. Metal dominates, delaying plant growth. Corresponds to sinews/bones in body. Great coolness changes season, inducing cold/malaria. Large Intestine is on right, connected to Lung; now Lung Qi invades internally, Liver is on left, hence left hypochondriac stabbing pain. If people have diarrhea, no excessive pathogen disease. Great coolness is secondary to cold. Extreme coolness stops Yang Qi, so Wood contracts, grass delays. Vital Qi rises but Yang doesn't distribute, so accumulated Qi stays below. In body, lower abdominal pain, sores, back pain, hernia, female abdominal pain, dry throat, chest fullness/diarrhea indicate Liver disease. Heart/hypochondriac pain, eye corner pain, clavicle/armpit swelling, chills/malaria indicate Gallbladder disease. Generally, in Yang Ming Heaven years, Metal overacts on Wood, hence these symptoms.) If Tai Chong pulse vanishes, death is incurable. (Tai Chong is 2 cun behind big toe joint, pulsating, representing Liver Qi. Metal replaces Wood, Liver Qi internally perishes, righteous Qi cannot overcome evil, death is inevitable.)
When **Tai Yang** is in Heaven, with excessive Cold Qi, cold Qi returns, water freezes, blood changes internally, developing abscesses. People suffer from Jue Xin Tong (extreme heart pain), hematemesis, hematochezia, epistaxis, sadness, vertigo/fainting. If transport is extremely hot, violent rain produces hail. Chest/abdominal pain, hot hands, contracted elbows, swollen axillae, palpitations, chest/hypochondriac/epigastric discomfort, red face/yellow eyes, frequent belching, dry throat, severe dark complexion, thirst/drinking desire, with the disease rooted in the Heart. (Refers to Chen-Xu years. Tai Yang Heaven spreads cold, freezing water, coagulating blood/skin, Wei Qi aggregates forming abscesses. If coinciding with Fire transport, fire fights water, causing hail. Disease accumulates in chest/heart. Internal Yang depression, damp steaming downward cause heart pain, bleeding, red face/yellow eyes, belching, heat, elbow contraction, armpit swelling, dry throat. Severe cold overcomes Yang, Water overwhelms Fire, internal Fire depression causes thirst. Disease starts in Heart, Yin invades, hence "rooted in Heart." Generally, in Tai Yang Heaven years, Water overacts on Fire, hence these symptoms.) If Shen Men pulse vanishes, death is incurable. (Shen Men is at the end of the radial styloid, pulsating, representing True Heart Qi. Water overcomes Fire, Heart Qi perishes, Spirit departs, death is certain.)
The presence of moving Qi allows one to know the affected Zang organ. (Thus, diagnosis determines death by observing the moving Qi of the Zang meridians, knowing the survival of the Spirit Stores.)
For Heaven Qi, if Wind is excessive, level with Acrid-Cool, assist with Bitter-Sweet, Sweet to relax, Sour to drain. If Heat is excessive, level with Salty-Cold, assist with Bitter-Sweet, Sour to astringe. If Dampness is excessive, level with Bitter-Hot, assist with Sour-Acrid, Bitter to dry, Light to drain. If Dampness is high and hot, treat with Bitter-Warm, assist with Sweet-Acrid, stop when sweating occurs. If Fire is excessive, level with Acid-Cold, assist with Bitter-Sweet, Sour to astringe, Bitter to vent, Sour to restore. Same for Heat. If Dryness is excessive, level with Bitter-Warm, assist with Sour-Acrid, Bitter to purge. If Cold is excessive, level with Acrid-Hot, assist with Bitter-Sweet, Salty to purge. (This describes treatment for Six Qi in Heaven causing excessive disease.)
To treat all Victory and Repayment (Winning and Retaliating) Qi: Cold treat with Heat, Heat treat with Cold, Warm treat with Clear, Clear treat with Warm, Scattered treat with Astringent, Suppressed treat with Dispersing, Dry treat with Moistening, Tense treat with Relaxing, Hard treat with Softening, Brittle treat with Firming, Deficient treat with Tonifying, Excessive treat with Draining. Stabilize Qi, ensure clarity and purity, then disease Qi declines, returning to its source. This is the general principle of treatment. (Tai Yang is Cold, Shao Yin/Shao Yang are Hot, Jue Yin is Warm, Yang Ming is Clear, Tai Yin is Damp. With victory/repayment, double the Qi to adjust, thus achieving balance. Zong means belonging. Proper adjustment returns residual Qi to its owner, Shao Yin rests in its place. After victory/repayment subsides, nourish and calm. Clarity and purity prevent disturbance, allowing Six Qi circulation and Five Spirits peace. Treatment of transport cold/heat returns to Heaven/Earth Qi. This summarizes the general principle of treating victory/repayment.)
Above the middle of the body, there are three Qi, the domain of Heaven, governed by Heaven Qi. Below the middle of the body, there are three Qi, the domain of Earth, governed by Earth Qi. Name the Qi by its title, locate the Qi by its position, and describe the disease. The midpoint is called Tian Shu. (Body midpoint is the umbilicus. Some say waist, but measuring from raised arm to extended foot aligns with the umbilicus. Thus, midpoint is Tian Shu. Heaven Qi governs three Qi above, Earth Qi governs three Qi below. Naming Qi by title, locating by position, determining cold/heat by Qi, describing disease manifestations. To diagnose, follow Qi location: Yin areas attract cold diseases, Yang areas attract heat diseases. Hence, discussing cold/heat in victory/repayment relies on this physics. *Liu Wei Zhi Da Lun* states: Above Tian Shu, Heaven Qi rules; below Tian Shu, Earth Qi rules; at the Qi intersection, Human Qi follows.)
Regarding Qi Victory: Minor victories are followed/accommodated, major victories are controlled/restrained. Regarding Qi Repayment: Harmonious repayments are balanced, violent repayments are seized/removed. All follow the Victory Qi, pacify the suppressed Qi, regardless of number, aiming for balance. This is the Dao. (Follow means accommodate/peace. Control means restrain. Balance means regulate. Seize means remove Victory Qi. Treatment depends on Qi harmony, not numbers. This explains treatment for Repayment causing reverse disease. High suppress, Low elevate, Excessive reduce, Deficient tonify, assist with beneficial/appropriate methods, stabilize Host/Guest, adapt to cold/warm. High suppress excess. Low elevates deficiency. Excessive reduces category. Deficient tonifies Qi. Though conquering evil and supporting weakness, Host/Guest must be stabilized. Loss of proper location/internal invasion leads to danger. "Same" means compatible Qi (cold/warm etc.); "Different" means incompatible Five Elements. Compatible Qi: treat against the winning Qi. Incompatible Qi: follow the non-winning Qi. This is the general principle of Host/Guest treatment.)
Qi has high/low, disease has far/near, symptoms have exterior/interior, treatment has light/heavy. Adapt to reach the target. (Zang positions vary, Fu Qi distances vary, symptoms vary by interior/exterior. Medication weight varies. Adjust quantity, harmonize tension/speed, let medicinal Qi reach the disease, avoiding excess or insufficiency.)
The General Rule states: Monarch 1, Minister 2, Odd formula structure; Monarch 2, Minister 4, Even formula structure; Monarch 2, Minister 3, Odd formula structure; Monarch 3, Minister 6, Even formula structure. (Odd refers to ancient single formulas; Even refers to ancient compound formulas. Both have sizes. Odd formulas: Monarch 1 Minister 2, Monarch 2 Minister 3. Even formulas: Monarch 2 Minister 4, Monarch 3 Minister 6. Disease size, Qi distance, treatment weight determine structure.)
Therefore: Near diseases use Odd formulas, Far diseases use Even formulas. Diaphoretics do not use Odd formulas, Purgatives do not use Even formulas. Tonifying/Treating Upper uses Slow formulas, Tonifying/Treating Lower uses Rapid formulas. Rapid formulas have strong flavor/odor, Slow formulas have weak flavor/odor. Adapt to reach the target. (Diaphoretics avoid Even formulas to prevent excessive outward dispersal. Purgatives avoid Odd formulas to prevent toxic overattack. Treating Upper with rapid formulas causes them to pass through too quickly. Treating Lower with slow formulas causes stagnation and weak efficacy. Making Rapid formulas weak makes them equal to Slow. Making Slow formulas strong makes them equal to Rapid. If Slow cannot relax, Rapid cannot accelerate, Strong is not strong, Weak is not weak, Size is not structured, Weight is unlimited, then Deficiency/Excess/Cold/Heat and Zang/Fu become chaotic, order cannot be achieved, how can spirits find peace?)
Near diseases using Odd/Even, make dosage small. Far diseases using Odd/Even, make dosage large. Large means few items, Small means many items. Many up to nine, Few down to two. (Decoctions/pills vary accordingly. Near/Far...)