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20. When pathogenic qi is in excess, there must be a retaliatory response; as the disease of dominance (Sheng Bing) is about to subside, the disease of retaliation (Fu Bing) begins to sprout. After the retaliation subsides, dominance arises again, and this cycle continues until both sides' qi decline, at which point it stops. The presence or absence, and the slightness or severity, are balanced like a steelyard. Although seasons have fixed positions, the movement of qi is not absolute. Dominance occurs during the three phases governed by the Si Tian (Heavenly Sovereign), and retaliation concludes during the phase governed by the Zai Quan (Earthly Ruler). Between the Principal Qi (Zhu Qi) and Guest Qi (Ke Qi), there is dominance but no retaliation. If the Principal Qi dominates the Guest Qi, it is considered "Rebellious" (Ni); if the Guest Qi dominates the Principal Qi, it is considered "Compliant" (Cong).

[Annotation] If the Six Qi have dominance, there must be retaliation; this is the way of the cycle of Yin and Yang. As the disease of dominance subsides, the disease of retaliation sprouts; this is the mechanism of the advance and retreat of pathogenic and righteous qi. After dominance comes retaliation, and after retaliation comes dominance; there is no fixed number, and it naturally stops only when the qi of both parties declines. There is retaliation only when there is dominance; if dominance is slight, retaliation is slight; if dominance is severe, retaliation is severe, just as the counterweight and beam of a scale do not exceed each other excessively. However, although the timing of the movement of dominance and retaliation has fixed positions, the qi itself is not inevitable. "Qi is not inevitable" means that in a year where dominance should occur, it does not. "Seasons have fixed positions" means that the time of dominance is in the front, governed by the position of Si Tian; from the First Phase to the Third Phase, this is the norm for dominance. The time of retaliation is in the back, governed by the position of Zai Quan; from the Fourth Phase to the Final Phase, this is the norm for retaliation. This is what is meant by the mutual dominance and retaliation of the Six Qi. Regarding the Principal and Guest Qi of the Six Phases, there is dominance but no retaliation. The reason for having dominance but no retaliation is that the Guest Qi executes the commands of Heaven, and when the season passes, it ends; the Principal Qi guards its position and follows the mandate of Heaven. If the Principal Qi dominates the Guest Qi, it violates the mandate of Heaven, and the transformation of qi cannot proceed, hence it is called "Rebellious." If the Guest Qi dominates the Principal Qi, the superior oversees and the inferior serves, and the administration is thus implemented, hence it is called "Compliant."

21. The stagnation of Fire, Earth, and Metal waits for the appropriate time to erupt; Water erupts following Fire, while Wood has no constant timing. The eruption of Water manifests as hail and snow; Earth as violent winds and sudden storms; Wood as destruction and breaking; Metal as clear and cold austerity; Fire as obscurity and dimness, with varying degrees of severity. Slight cases involve only the affected meridian, while severe cases involve meridians that mutually punish each other. Treatment for Wood stagnation involves promoting free flow (Da); for Fire, dispersing (Fa); for Metal, draining and descending (Xie); for Water, restraining and redirecting (Zhe); and for Earth, purging (Duo), thereby restoring balance.

[Annotation] The eruption of the Five Stagnations (Wu Yu) each has its specific timing. Fire stagnation erupts during the Third Phase (Shaoyang Ministerial Fire); Earth stagnation erupts during the Fourth Phase (Taiyin Damp Earth); Metal stagnation erupts during the Fifth Phase (Yangming Dryness Metal). These each wait for their respective prosperous phases to erupt. Water stagnation does not wait for the Final Phase (Taiyang Cold Water) but often erupts during the Second and Third Phases (Fire phases) because Water nature is yin and treacherous; seeing the initial retreat of Yang, it advances to take advantage, so it does not wait for Water to be prosperous. Wood stagnation has no fixed timing because Wood generates Wind, and Wind moves swiftly and changes frequently, making its qi unpredictable; thus, Wood eruptions have no constant time. Having determined the timing of the Five Eruptions, one must also know their signs, the slightness or severity of the Five Qi, the weather conditions, and the diseases affecting the people. The sign of Water eruption: slight is cold, severe is hail and snow (hail and snow indicate extreme cold). The sign of Earth eruption: slight is dampness, severe is violent wind and rain (piao zhou refers to storms). The sign of Wood eruption: slight is wind, severe is destruction and breaking (hui zhe refers to uprooting and snapping). The sign of Metal eruption: slight is dryness, severe is clear and cold austerity (qing ming refers to cold solemnity). The sign of Fire eruption: slight is heat, severe is obscurity (xun mei refers to dimness/blurry vision). "More or less" refers to Excess (Tai Guo) and Deficiency (Bu Ji). Deficiency leads to mild disease; Excess leads to severe disease. "Slight disease involves only the meridian" means the meridian affects itself. "Severe disease involves mutual punishment" means involving meridians that either punish me or are punished by me. For example, if Wood qi is excessive, Earth is punished by me, and Metal punishes me. Earth fears being overcome by me to harmonize its transformation; Metal fears being dominated by me to align with its transformation; thus, these three meridians show concurrent disease. The same logic applies to the other Qi. "Wood Da" refers to "promoting the free flow of Wood stagnation"; Da means smooth and unimpeded flow. For any Wood stagnation disease, where wind and cold constrict, use Acrid herbs to disperse and unblock, Sweet herbs to harmonize and relax, and Bitter herbs to purge or calm, ensuring the Wood qi flows smoothly—this is the method for treating Wood stagnation. "Fire Fa" refers to "dispersing Fire stagnation"; Fa means uplifting and dissolving. For any Fire stagnation disease, constrained by Cold, use Acrid-Warm herbs to disperse, Acrid-Sweet herbs to uplift, Acrid-Cool herbs to resolve, and Acrid-Bitter herbs to scatter, ensuring the Fire qi is uplifted and dissolved—this is the method for treating Fire stagnation. "Metal Xie" refers to "draining Metal stagnation"; Xie means draining, unblocking, and descending. For any Metal stagnation disease, where dryness is trapped by Fire, use Acrid herbs to diffuse and moisten, and Bitter herbs to drain and clear, ensuring the Dryness qi is diffused and unblocked—this is the method for treating Metal stagnation. "Water Zhe" refers to "restraining Water stagnation"; Zhe means driving out, guiding, permeating, and unblocking. For any Water stagnation disease, where water is stagnant due to dampness, use Acrid-Bitter herbs to drive and guide, and Acrid-Neutral herbs to permeate and unblock, ensuring Water qi flows freely without accumulation—this is the method for treating Water stagnation. "Earth Duo" refers to "purging Earth stagnation"; Duo means sweating, vomiting, and purging. For any Earth stagnation disease, where dampness is blocked by Wind, use sweating for exterior cases, purging for interior cases, vomiting for upper jiao cases, and purgatives for lower jiao cases, ensuring Earth qi is not obstructed—this is the method for treating Earth stagnation.