言其变病之所也。六气之用，各归不胜而为化者，谓各归不胜之方月施化也。方月者，假如厥阴司天之岁，
则阳明之位在泉左间，其方月东北，初之气也；太阳之位右间，其方月东南，二之气也；厥阴之位司天，
其方月正南，三之气也；少阴之位在天左间，其方月西南，四之气也；太阴之位在泉右间，其方月西北，
五之气也；少阳之位在泉，其方月正北，终之气也。故其岁施用太阴雨化，施于东南二之气太阳之位；太
阳寒化，施于西南四之气少阴之位；少阴热化，施于东北初之气阳明之位；阳明燥化，施于正南三之气厥
阴之位；厥阴风化，施于西北五之气太阴之位，皆各命其所在之化，以征验其所施之化，于岁同法推之也。
自得其位，在本位之方月施化也。如厥阴之岁，则太阴自得于西北五之气本位施雨化，太阳自得于东南二
之气本位施寒化，少阴自得于西南四之气本位施热化，少阳自得于正北终之气本位施火化，阳明自得于东
北初之气本位施燥化，厥阴自得于正南三之气本位施风化，于岁同法推之也。大者之至徐而常者，六气之
盈者为病，则其势反徐而微，治法当逆之也。少者之至暴而亡，六气之虚者为病，则其势反暴而甚，治法
当从之也。人见其气暴烈，骤用峻剂攻之，则热病未已，寒病复始，殊不知大者之气反微，少者之气反甚也。
帝曰∶愿闻阴阳之三也何谓？岐伯曰∶气有多少异用也。帝曰∶阳明何谓也？岐伯曰∶两阳合明也。帝
曰∶厥阴何也？岐伯曰∶两阴交尽也。帝曰∶幽明何如？岐伯曰∶雨阴交尽故曰幽，两阳合明故曰明，幽明之
配，寒暑之异也。帝曰∶分至何如？岐伯曰∶气至之谓至，气分之谓分，至则气同，分则气异，所谓天地之正
纪也。帝曰∶夫百病之始生也，皆生于风、寒、暑、湿、燥、火，以之化之变也。经言盛者泻之，虚者补之，
余锡以方士，而方士用之，尚未能十全，余欲令要道必行，桴鼓相应，犹拔刺雪污，工巧神圣，可得闻乎？
岐伯曰∶审察病机，无失气宜，此之谓也。帝曰∶愿闻病机何如？岐伯曰∶诸风掉眩，皆属于肝。诸寒收引，
皆属于肾。诸气 郁，皆属于肺。诸湿肿满，皆属于脾。诸热瞀 ，皆属于火。诸痛痒疮，皆属于心。诸厥固
泄，皆属于下。诸痿喘呕，皆属于上。诸禁鼓栗，如丧神守，皆属于火。诸痉项强，皆属于湿。诸逆冲上，皆
属于火。诸胀腹大，皆属于热。诸躁狂越，皆属于火。诸暴强直，皆属于风。诸病有声，鼓之如鼓，皆属于热。
诸病 肿，疼酸惊骇，皆属于火。诸转反戾，水液混浊，皆属于热。诸病水液，澄澈清冷，皆属于寒。诸呕吐
酸，暴注下迫，皆属于热。故《大要》曰∶谨守病机，各司其属，有者求之，无者求之，盛者责之，虚者责之，
必先五胜，疏其血气，令其调达，而至和平，此之谓也。（至真要大论）
此一章，论五运六气之为病治法也。病机一十九条实察病之要旨。而“有者求之，无者求之，盛者责之，
虚者责之”一十六字，乃答篇首盛者泻之，虚者补之之旨，而总结一十九条之义，又其要旨中之要旨也。
河间《原病式》但用病机一十九条立言，而遗此十六字，犹有舟无操舟之工，有兵无将兵之帅，今负 窃
之罪以补之。夫诸风病皆属于肝也，风木盛则肝太过而病化风，如木太过，发生之纪病掉眩之类，俗谓之
阳急惊等病，治以凉剂是也。燥金盛则肝为邪攻而病亦化风，如阳明司天，燥金下临，病掉振之类，俗
谓之阴 慢惊等病，治以温剂是也。诸火热病，皆属于心也，火热甚则心太过而病化火热，如岁火太过，
诸谵妄狂越之类，俗谓之阳躁谵语等病，治以攻剂是也。寒水胜则心为邪攻，而病亦化火热，如岁水太过，
病躁悸烦心谵妄之类，俗谓之阴躁郑声等病，治以补剂是也。诸湿病皆属于脾也，湿土甚则脾太过而病化
湿，如湿胜则濡泄之类，仲景用五苓等剂去湿是也。风木胜则脾为邪攻而病亦化湿，如岁木太过，病飧泄
之类，钱氏用宣风等剂去风是也。诸气 郁，皆属于肺也，燥金甚则肺太过而病化 郁，如岁金太过，甚
则咳喘之类，东垣谓之寒喘，治以热剂是也。火热胜则肺为邪攻，而病亦化 郁，如岁火太过，病咳喘之
类，东垣谓之热喘，治以寒剂是也。诸寒病皆属于肾也，寒水甚则肾太过，而病化寒，如太阳所至为屈伸
不利之类，仲景用乌头汤等剂是也。湿土胜则肾为邪攻，而病亦化寒，如湿气变物，病筋脉不利之类，东
垣用复煎、健步等剂是也。其在太过 所化之物为盛，盛者真气也；其在受攻，所化之病为虚，虚者假气
也。故有其病化者，恐其气之假，故有者亦必求之。无其病化者，恐其邪隐于中，如寒胜化火，燥胜化风，
及寒伏反躁，热伏反厥之类，故无者亦必求之。其病之化似盛者，恐其盛之未的，故盛者亦必责之。其病
之化似虚者，恐其虚之未真，故虚者亦必责之。凡一十九条病机皆用此一十六字为法求之，庶几补泻不瘥
也。今河间损此一十六字，但以病化有者为盛，无者为虚，而不复求其假者虚者，为未备，故引经传以证
其得失也。
帝曰∶五味阴阳之用何如？岐伯曰∶辛甘发散为阳，酸苦涌泄为阴，咸味涌泄为阴，淡味渗泄为阳。
六者或收或散？或缓或急，或燥或润，或 或坚，以所利行之，调气使平。帝曰∶非调气而得者，治之
奈何？有毒无毒，何先何后？愿闻其道。岐伯曰∶有毒无毒，所治为主，适大小为制也。帝曰∶请言其
制？岐伯曰∶君一臣二，制之小也；君一臣三佐五，制之中也；君一臣三佐九，制之大也。寒者热之，热
者寒之，微者逆之，甚者从之，坚者削之，客者除之，劳者温之，结者散之，留者攻之，燥者濡之，急
者缓之，散者收之，损者益之，逸者行之，惊者平之，上之下之，摩之浴之，薄之劫之，开之发之，
适事为故。帝曰∶何谓逆从？岐伯曰∶逆者正治，从者反治，从少从多，观其事也。帝曰∶反治何谓？
岐伯曰∶热因寒用，寒因热用，塞因塞用，通因通用，必伏其所主，而先其所因，其始则同，其终则异，
可使破积，可使溃坚，可使气和，可使必已。（至真要大论）
此一章论内气不调得病者之治法也。盖内气不调而得病，故所病寒热之邪，但可于其气之微者逆治之。
如气甚而逆治之，则正邪格拒，不能胜邪，命将难全，故但当从其寒热之邪于外，伏其所主之剂于中，然
后正邪相入，而邪就擒矣。东垣所谓姜附寒饮，承气热服，及仲景于白通汤加尿胆治少阴，丹溪于苓柏汤
皆熟炒治色目妇人恶寒之类是也。
帝曰∶气调而得者何如？岐伯曰∶逆之从之，逆而从之，从而逆之，疏气令调，则其道也。（至真要大论）
此一章，论内气本调，因外邪得病者之治法也。盖内气调而得病，故不分寒热之微甚，或逆治之，或从
治之皆可，更不须惧其正邪格拒，正固则邪自退矣。
帝曰∶病之中外何如？岐伯曰∶从内之外者，调其内；从外之内者，治其外；从内之外而盛于外者，先调
其内而后治其外；从外之内而盛于内者，先治其外而后调其内；中外不相及，则治主病。帝曰∶善。火热复，
恶寒发热，有如疟状，或一日发，或间数日发，其故何也？岐伯曰∶胜复之气，会遇之时，有多少也。阴气多
而阳气少，则其发日远；阳气多而阴气少，则其发日近。此胜复相搏，盛衰之节，疟亦同法。帝曰∶论言治寒
以热，治热以寒，而方士不能废绳墨而更其道也。有病热者寒之而热，有病寒者热之而寒，二者皆在，新病复
起奈何治？岐伯曰∶诸寒之而热者取之阴，热之而寒者取之阳，所谓求其属也。帝曰∶善。服寒而反热，服
热而反寒，其故何也？岐伯曰∶治其王气，是以反也。
帝曰∶不治王而然者何也？岐伯曰∶悉乎哉问也！不治五味属也。夫五味入胃，各归所喜，故酸先入肝，
苦先入心，甘先入脾，辛先入肺，咸先入肾，久而增气，物化之常也。气增而久，夭之由也。帝曰∶善。方制
君臣何谓也？岐伯曰∶主病之谓君，佐君之谓臣，应臣之谓使，非上下三品之谓也。帝曰∶三品何谓？岐
伯曰∶所以明善恶之殊贯也。帝曰∶善。病之中外何如？岐伯曰∶调气之方，必别阴阳，定其中外，各守其
乡，内者内治，外者外治，微者调之，其次平之，盛者夺之，汗之下之，寒热温凉，衰之以属，随其攸利，
谨道如法，万举万全，气血正平，长有天命。帝曰∶善。（“不治五味属也”，一本“五味”二字作“王
气”二字。至真要大论）
岐伯曰∶寒热燥湿，不同其化也。故少阳在泉，寒毒不生，其味辛，其治苦酸，其谷苍丹。阳明
在泉，湿毒不生，其味酸，其气温，其治辛苦甘，其谷丹素。太阳在泉，热毒不生，其味苦，其治淡咸，其谷
。厥阴在泉，清毒不生，其味甘，其治酸苦，其谷苍赤，其气专，其味正。少阴在泉，寒毒不生，其味
辛，其治辛苦甘，其谷白丹。太阴在泉，燥毒不生，其味咸，其气热，其治甘咸，其谷 。化淳
则咸守，气专则辛化而俱治。故曰∶补上下者从之，治上下者逆之，以所在寒热盛衰而调之。故曰∶
上取下取，内取外取，以求其过。能毒者以浓药，不胜毒者以薄药，此之谓也。
气反者，病在上，取之下；病在下，取之上；病在中，旁取之。治热以寒，温而行之；治寒以热，
凉而行之；治温以清，冷而行之；治清以温，热而行之。故消之削之，吐之下之，补之泻之，久新同法。
帝曰∶病在中而不实不坚，且聚且散，奈何？岐伯曰∶无积者求其藏，虚则补之，药以祛之，食
以随之，行水渍之，和其中外。可使毕已。
帝曰∶有毒无毒，服有约乎？岐伯曰∶病有久新，方有大小，有毒无毒，固宜常制矣。大毒治病，十去其
六；常毒治病，十去其七；小毒治病，十去其八；无毒治病，十去其九，谷肉果菜，食养尽之，无使过
之，伤其正也。不尽，行复如法。
必先岁气，无伐天和，无盛盛，无虚虚，而遗人夭殃，无致邪，无失正，绝人长命。帝曰∶其久
病者，有气从不康，病去而瘠，奈何？岐伯曰∶昭乎哉圣人之问也！化不可代，时不可违。夫经络以通，
血气以从，复其不足，与众齐同，养之和之，静以待时，谨守其气，无使倾移，其形乃彰，生气以长，
命曰圣王。故《大要》曰∶无代化，无违时，必养必和，待其来复，此之谓也。（五常政大论）
帝曰∶气有多少，病有盛衰，治有缓急，方有大小，愿闻其约奈何？岐伯曰∶气有高下；病有远近，证有
中外，治有轻重，适其至所为故也。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；君二臣六，偶之制也。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，缓则气味薄，适其至所，此之谓也。病所远而中道气味之者，食而过之，无越其制
度也。是故平气之道，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，奇之不去则偶之，是谓重方。偶之不去，则反佐以取之，所谓寒热温凉，反从其病也。帝曰∶善。病
生于本，余知之矣。生于标者，治之奈何？岐伯曰∶病反其本，中标之病，治反其本，中标之方。（至真要大论）
帝问曰∶妇人重身，毒之何如？岐伯曰∶有故无殒，亦无殒也。帝曰∶愿闻其故何谓也？岐伯曰∶大积大
聚，其可犯也，衰其太半而止，过者死。（六元正纪大论）
Describes the location where disease changes occur. The function of the Six Qi acts by returning to its unconquered (i.e., the element that controls it) direction and transforming there. This means each Qi performs its transformation in the direction and month that is unconquered by it. By "direction and month," for example, in a year when Jueyin Wind Wood governs the Heaven position, Yangming Dryness Metal occupies the Left Interstitial position at the Earth level; its direction is Northeast, corresponding to the First Qi; Taiyang Cold Water occupies the Right Interstitial position; its direction is Southeast, corresponding to the Second Qi; Jueyin Wind Wood occupies the Heaven position; its direction is Due South, corresponding to the Third Qi; Shaoyin Ministerial Fire occupies the Left Interstitial position at Heaven; its direction is Southwest, corresponding to the Fourth Qi; Taiyin Damp Earth occupies the Right Interstitial position at Earth; its direction is Northwest, corresponding to the Fifth Qi; Shaoyang Ministerial Fire occupies the Earth position; its direction is Due North, corresponding to the Final Qi. Therefore, the Taiyin Rain Transformation applied in this year is exerted on the Taiyang Cold position in the Southeast during the Second Qi; the Taiyang Cold Transformation is exerted on the Shaoyin Heat position in the Southwest during the Fourth Qi; the Shaoyin Heat Transformation is exerted on the Yangming Dryness position in the Northeast during the First Qi; the Yangming Dryness Transformation is exerted on the Jueyin Wind position in the Due South during the Third Qi; the Jueyin Wind Transformation is exerted on the Taiyin Damp position in the Northwest during the Fifth Qi. Each names its respective transformation based on its location, verifying the transformation exerted, applying the same method to deduce for other years.
If each Qi resides in its own position, it performs transformation in the direction and month of its original position. For instance, in a year governed by Jueyin Wind Wood, Taiyin Damp Earth naturally exerts Rain Transformation in its original position of Northwest during the Fifth Qi; Taiyang Cold Water naturally exerts Cold Transformation in its original position of Southeast during the Second Qi; Shaoyin Ministerial Fire naturally exerts Heat Transformation in its original position of Southwest during the Fourth Qi; Shaoyang Ministerial Fire naturally exerts Fire Transformation in its original position of Due North during the Final Qi; Yangming Dryness Metal naturally exerts Dryness Transformation in its original position of Northeast during the First Qi; Jueyin Wind Wood naturally exerts Wind Transformation in its original position of Due South during the Third Qi. The same deduction method applies to other years.
When the momentum is grand, arrival is slow and constant. If illness arises from an excess of the Six Qi, the momentum appears instead slow and slight; the treatment method should oppose it. When the momentum is slight, arrival is violent and fleeting. If illness arises from a deficiency of the Six Qi, the momentum appears instead violent and severe; the treatment method should follow it. Observing violent Qi, people immediately use harsh drugs to attack, resulting in unhealed heat diseases and newly started cold diseases. They do not realize that grand Qi manifests as slight, while slight Qi manifests as intense.
The Yellow Emperor said: I wish to hear what is meant by the division of Yin and Yang into three categories. Qibo replied: It is because the quantity of Qi differs, leading to different applications. The Yellow Emperor asked: Why is it called Yangming? Qibo replied: Two Yangs combined and brightened is called Yangming. The Yellow Emperor asked: Why is it called Jueyin? Qibo replied: Two Yins intersecting and ending is called Jueyin. The Yellow Emperor asked: What are You (Darkness) and Ming (Brightness)? Qibo replied: Two Yins intersecting and ending is called You; Two Yangs combined and brightened is called Ming. The pairing of You and Ming represents the difference between Cold and Summer Heat. The Yellow Emperor asked: What are Fen (Division) and Zhi (Arrival)? Qibo replied: Arrival of Qi is called Zhi; Division of Qi is called Fen. At Zhi, Qi is the same; at Fen, Qi is different. This is the normal order of Heaven and Earth.
The Yellow Emperor said: All diseases originate from Wind, Cold, Summer Heat, Dampness, Dryness, and Fire, due to their transformations and variations. The Classics state: Excess is drained, deficiency is tonified. I have bestowed these formulas upon you, but practitioners using them cannot yet achieve perfect results. I desire that essential principles be implemented effectively, with efficacy as immediate as a drumstick striking a drum, thorough as removing a thorn or cleaning dirt. May I hear about such skillful and divine techniques? Qibo replied: Carefully examine the pathogenesis without violating the suitability of Qi; this is what is meant. The Yellow Emperor said: I wish to hear about pathogenesis. Qibo replied: All wind diseases causing tremors and dizziness belong to the Liver. All cold diseases causing contraction and pulling belong to the Kidney. All Qi diseases causing stagnation and depression belong to the Lung. All damp diseases causing edema and fullness belong to the Spleen. All heat diseases causing confusion and obscuration belong to Fire. All pain, itching, and sores belong to the Heart. All jue conditions, constipation, or diarrhea belong to the Lower Jiao. All flaccidity, wheezing, and vomiting belong to the Upper Jiao. All locking, shivering, and loss of spiritual control belong to Fire. All spasms and neck stiffness belong to Dampness. All rebellious Qi rushing upward belong to Fire. All abdominal distension and enlargement belong to Heat. All restlessness, mania, and deviation belong to Fire. All sudden rigidity belongs to Wind. All diseases with sounds, sounding like drums when tapped, belong to Heat. All diseases with swelling, pain, soreness, fright, and alarm belong to Fire. All twisting and convulsions with turbid fluids belong to Heat. All diseases involving clear and cold fluids belong to Cold. All vomiting of sour fluid, sudden diarrhea with tenesmus belong to Heat. Thus, the *Da Yao* says: Strictly observe the pathogenesis, assign each to its category. Seek the cause where symptoms exist; seek the hidden cause where symptoms are absent. Blame the excess on evil; blame the deficiency on weakness. First analyze the five-element victories, dredge blood and Qi, make them smooth and reaching peace. This is what is meant. (From *Suwen: Zhizhen Yao Da Lun*)
This chapter discusses the pathology and treatment methods of Five Movements and Six Qi. The Nineteen Pathogeneses truly capture the essence of disease. The sixteen characters "Seek the cause where symptoms exist; seek the hidden cause where symptoms are absent; blame the excess on evil; blame the deficiency on weakness" answer the chapter's opening principle of "Excess is drained, deficiency is tonified," summarizing the meaning of the nineteen pathogeneses, and are the core among cores. Hejian's *Yuan Bing Shi* uses only the Nineteen Pathogeneses for discussion, omitting these sixteen characters. It is like having a boat without a rower, or an army without a commander. Today, I assume the罪 of stealing classics to supplement this.
All wind diseases belong to the Liver. Excessive Wind Wood causes Liver excess, transforming into wind diseases, such as tremors and dizziness in the Ji of Generation when Wood is excessive. Commonly known as Yang Acute Convulsion, treated with cooling agents. Excessive Dryness Metal attacks the Liver, also transforming into wind diseases, such as tremors under Yangming governing Heaven with Dryness Metal descending. Commonly known as Yin Slow Convulsion, treated with warming agents.
All fire-heat diseases belong to the Heart. Extreme Fire-Heat causes Heart excess, transforming into fire-heat diseases, such as delirium and mania when Year Fire is excessive. Commonly known as Yang Restless Delirium, treated with purgative agents. Excessive Cold Water attacks the Heart, also transforming into fire-heat diseases, such as restlessness, palpitations, vexation, and delirium when Year Water is excessive. Commonly known as Yin Restlessness Zhengsheng, treated with tonifying agents.
All damp diseases belong to the Spleen. Extreme Damp Earth causes Spleen excess, transforming into damp diseases, such as loose stools when Dampness prevails. Zhang Zhongjing used Wu Ling San to remove dampness. Excessive Wind Wood attacks the Spleen, also transforming into damp diseases, such as undigested food diarrhea when Year Wood is excessive. Qian Yi used Xuan Feng San to remove wind.
All Qi stagnation diseases belong to the Lung. Extreme Dryness Metal causes Lung excess, transforming into Qi stagnation, such as cough and asthma when Year Metal is excessive. Li Dongyuan called this Cold Asthma, treated with hot agents. Excessive Fire-Heat attacks the Lung, also transforming into Qi stagnation, such as cough and asthma when Year Fire is excessive. Li Dongyuan called this Heat Asthma, treated with cold agents.
All cold diseases belong to the Kidney. Extreme Cold Water causes Kidney excess, transforming into cold diseases, such as difficulty bending and stretching when Taiyang arrives. Zhang Zhongjing used Wu Tou Tang. Excessive Damp Earth attacks the Kidney, also transforming into cold diseases, such as tendon and vessel dysfunction caused by dampness changing objects. Li Dongyuan used Fu Jian Decoction and Jian Bu Wan.
What transforms from excessive Qi appearing as excess is True Qi; what transforms from being attacked appearing as deficiency is False Qi. Therefore, where transformation exists, fearing the Qi is false, one must seek the cause even in "existence." Where no transformation exists, fearing hidden evil, such as Cold transforming into Fire, Dryness transforming into Wind, Cold hiding causing restlessness, or Heat hiding causing jue, one must seek the cause even in "non-existence." Where transformation seems excessive, fearing the excess is inaccurate, one must investigate "excess." Where transformation seems deficient, fearing the deficiency is not genuine, one must investigate "deficiency." All nineteen pathogeneses use these sixteen characters as the method of inquiry, avoiding incorrect tonification and draining. Now, Hejian damaged these sixteen characters, simply equating existence with excess and non-existence with deficiency, failing to seek false and deficient aspects, making it incomplete. Thus, citing classics to prove gains and losses.
The Yellow Emperor said: How are the Yin-Yang uses of the Five Flavors? Qibo replied: Pungent and Sweet flavors disperse and emit, belonging to Yang; Sour and Bitter flavors induce vomiting and drainage, belonging to Yin; Salty flavor induces vomiting and drainage, belonging to Yin; Bland flavor渗利 and drains, belonging to Yang. These six flavors either collect or disperse, either relax or tense, either dry or moisten, either soften or harden. Act according to what benefits, harmonize Qi to achieve balance.
The Yellow Emperor said: If not cured by harmonizing Qi, how to treat? Which comes first, toxic or non-toxic drugs? May I hear the way? Qibo replied: Toxic or non-toxic, the treatment target is primary; adjust size and dosage accordingly. The Yellow Emperor said: Please speak of the system. Qibo replied: One Sovereign, two Ministers, is small system; One Sovereign, three Ministers, five Assistants, is medium system; One Sovereign, three Ministers, nine Assistants, is large system. Cold is treated with Heat; Heat is treated with Cold. Minor cases are treated oppositely (Ni); major cases are treated similarly (Cong). Hardness is reduced; guests (pathogens) are removed; fatigue is warmed; knots are scattered; retention is attacked; dryness is moistened; urgency is eased; scattering is gathered; loss is benefited; leisure is moved; fright is calmed. Upper is lowered; lower is raised; massage and bathing; pressing and劫 (coercion); opening and emitting. Adapt to the matter as the goal.
The Yellow Emperor said: What are Ni (Opposite) and Cong (Following)? Qibo replied: Ni is Zheng Zhi (Orthodox Treatment); Cong is Fan Zhi (Reverse Treatment). Follow less or follow more, observing the situation. The Yellow Emperor said: What is Fan Zhi? Qibo replied: Heat treated with Cold usage; Cold treated with Heat usage; Obstruction treated with Obstruction usage; Diarrhea treated with Purging usage. Must subdue the master, first address the cause. Initially same, finally different. Can break accumulations, dissolve hardness, harmonize Qi, ensure cure. (From *Suwen: Zhizhen Yao Da Lun*)
This chapter discusses treatment for diseases caused by internal Qi disharmony. Since internal Qi is disharmonious, external cold/heat pathogens can only be treated oppositely when Qi is minor. If Qi is excessive and treated oppositely, Zheng and Xie repel each other, unable to defeat evil, life endangered. Thus, one should follow external cold/heat, while hiding main treatment agents internally. Then Zheng and Xie enter, and evil is captured. Examples include Li Dongyuan's Ginger/Aconite taken cold, Chengqi Decoction taken hot, Zhang Zhongjing adding urine/bile to Bai Tong Decoction for Shaoyin, and Zhu Danxi frying Lingbai Decoction thoroughly for women with cold aversion.
The Yellow Emperor said: What about diseases where Qi is harmonious? Qibo replied: Opposite or following treatment, opposite then following, following then opposite, dredging Qi to make it harmonious is the way. (From *Suwen: Zhizhen Yao Da Lun*)
This chapter discusses treatment for diseases where internal Qi was originally harmonious but affected by external pathogens. Since internal Qi is harmonious, whether treating oppositely or following is acceptable regardless of cold/heat severity. No need to fear Zheng-Xie repulsion; if Zheng is solid, Xie retreats naturally.
The Yellow Emperor said: How about diseases involving interior and exterior? Qibo replied: From interior to exterior, regulate interior; from exterior to interior, treat exterior. From interior to exterior but severe externally, first regulate interior then treat exterior. From exterior to interior but severe internally, first treat exterior then regulate interior. If interior and exterior are unrelated, treat the main disease. The Yellow Emperor said: Good. Fire-heat recurrence with chills and fever, resembling malaria, occurring daily or every few days, why? Qibo replied: Time of encounter between Sheng (Victory) and Fu (Rebound) Qi varies. More Yin and less Yang means distant intervals; more Yang and less Yin means close intervals. This is Sheng-Fu combat, rhythm of excess and deficiency; Malaria follows the same law. The Yellow Emperor said: Classics say treat cold with heat, treat heat with cold, but practitioners cannot abandon rules. If heat treated with cold becomes hotter, cold treated with heat becomes colder, both present, new disease arises, how to treat? Qibo replied: For those treated with cold becoming hotter, treat Yin; for those treated with heat becoming colder, treat Yang. This is seeking the affiliation. The Yellow Emperor said: Good. Taking cold drugs causes heat, taking heat drugs causes cold, why? Qibo replied: Treating Wang Qi (Dominant Qi) causes reversal.
The Yellow Emperor said: What if not treating Wang Qi cures it? Qibo replied: Excellent question! It is not treating the Five Flavors' affiliation. Five Flavors enter the stomach, each returning to its preference: Sour enters Liver first, Bitter enters Heart first, Sweet enters Spleen first, Pungent enters Lung first, Salty enters Kidney first. Long-term use increases Qi, which is the norm of transformation. Increasing Qi for too long causes premature death. The Yellow Emperor said: Good. What is the Sovereign-Minister system? Qibo replied: Main disease is Sovereign; assisting Sovereign is Minister; responding to Minister is Envoy. Not referring to Upper/Middle/Lower grades. The Yellow Emperor said: What are the three grades? Qibo replied: To clarify distinct categories of good and evil. The Yellow Emperor said: Good. How about diseases involving interior and exterior? Qibo replied: Formulas for regulating Qi must distinguish Yin-Yang, determine interior/exterior, keep to their places. Interior treated internally, exterior treated externally. Minor cases regulated, next level balanced, excessive cases seized, sweating or purging. Cold, Heat, Warm, Cool, attenuate by affiliation, follow benefit. Strictly follow the Dao, ten thousand attempts ten thousand complete, Qi and Blood peaceful, long life destiny. The Yellow Emperor said: Good. ("Not treating Five Flavors affiliation," another version reads "Wang Qi". From *Suwen: Zhizhen Yao Da Lun*)
Qibo replied: Cold, Heat, Dryness, Dampness have different transformations. Thus, when Shaoyang is at Earth, Cold poison does not grow; flavor is Pungent, treatment uses Bitter/Sour, grains are Green/Red. When Yangming is at Earth, Damp poison does not grow; flavor is Sour, temperature is Warm, treatment uses Pungent/Bitter/Sweet, grains are Red/White. When Taiyang is at Earth, Heat poison does not grow; flavor is Bitter, treatment uses Bland/Salty, grains are... (Original text missing). When Jueyin is at Earth, Clear poison does not grow; flavor is Sweet, treatment uses Sour/Bitter, grains are Green/Red, Qi is specialized, flavor is correct. When Shaoyin is at Earth, Cold poison does not grow; flavor is Pungent, treatment uses Pungent/Bitter/Sweet, grains are White/Red. When Taiyin is at Earth, Dryness poison does not grow; flavor is Salty, Qi is Hot, treatment uses Sweet/Salty, grains are... (Original text missing). When transformation is pure, Salty guards; when Qi is specialized, Pungent transforms and treats together. Thus: Tonify upper/lower by following; treat upper/lower by opposing. Regulate based on location's cold/heat excess/deficiency. Thus: Upper take from lower, lower take from upper, inner take from outer, outer take from inner, to find fault. Those who can tolerate poison use strong medicine; those who cannot use weak medicine. This is it.
Qi reversal: Disease above, take below; disease below, take above; disease in middle, take sides. Treat heat with cold, administer warm; treat cold with heat, administer cool; treat warm with clear, administer cold; treat clear with warm, administer hot. Thus, dissipate, reduce, vomit, purge, tonify, drain. Old and new diseases follow the same method.
The Yellow Emperor said: Disease in middle, not solid, not firm, gathering and scattering, how? Qibo replied: No accumulation, seek Zang organs. Deficiency tonify. Drugs dispel, food follows, water walking, harmonize interior/exterior. Can be cured.
The Yellow Emperor said: Toxic/non-toxic drugs, is there a rule for administration? Qibo replied: Diseases have old/new, formulas have large/small, toxic/non-toxic, there are fixed systems. Great toxicity treats disease, remove 60%; common toxicity removes 70%; slight toxicity removes 80%; non-toxicity removes 90%. Grains, meats, fruits, vegetables, food nourishment completes it. Do not exceed, damaging Zheng Qi. If not complete, repeat method.
First consider annual Qi, do not violate Tian He (Heavenly Harmony). Do not make excess more excess, do not make deficiency more deficiency, leaving people to premature death. Do not attract evil, do not lose Zheng, cutting off long life. The Yellow Emperor said: For chronic patients, Qi does not conform, disease gone but emaciated, how? Qibo replied: Wise question of the Sage! Transformation cannot be replaced, time cannot be violated. Meridians pass, Blood-Qi flows, restore insufficiency, equal with others. Nourish and harmonize, wait quietly for time, guard Qi carefully, prevent collapse, form becomes manifest, Sheng Qi grows. Called Sage King. Thus *Da Yao* says: Do not replace transformation, do not violate time, must nourish and harmonize, wait for recovery. This is it. (From *Suwen: Wuchang Zheng Da Lun*)
The Yellow Emperor said: Qi has quantity, disease has excess/deficiency, treatment has urgency, formula has size. May I hear the summary? Qibo replied: Qi has high/low; disease has far/near; syndrome has interior/exterior; treatment has heavy/light. Just reach the destination. *Da Yao* says: One Sovereign, two Ministers, is Odd system; Two Sovereigns, four Ministers, is Even system; Two Sovereigns, three Ministers, is Odd system; Two Sovereigns, six Ministers, is Even system. Thus: Near use Odd; Far use Even. Sweating does not use Odd; Purging does not use Even. Tonify upper/treat upper, system slow; tonify lower/treat lower, system fast. Fast means strong flavor; slow means weak flavor. Reach destination, this is it. Disease far, mid-body blocks flavor, use food to guide, do not exceed system. Thus, balancing Qi: Near with Odd/Even, make small dose. Far with Odd/Even, make large dose. Large means few doses; small means many doses. Many up to nine; few down to two. If Odd fails, use Even, called Chong Fang (Repeated Formula). If Even fails, use Fan Zuo (Reverse Assistant), meaning Cold/Heat/Warm/Cool, reverse-follow disease. The Yellow Emperor said: Good. Disease born from Ben (Root), I know. Born from Biao (Branch), how to treat? Qibo replied: Disease reverses Ben, mark Biao disease; treat reverses Ben, mark Biao formula. (From *Suwen: Zhizhen Yao Da Lun*)
The Yellow Emperor asked: Pregnant woman, how to use poison? Qibo replied: You Gu Wu Yun, Yi Wu Yun Ye (Having cause, no injury; also no injury). The Yellow Emperor said: Explain. Qibo replied: Large accumulation/poly, can be invaded. Deplete more than half then stop. Exceeding leads to death. (From *Suwen: Liuyuan Zhengji Da Lun*)