完固，气血坚实，邪不能入，故无事于毒药针石，但以祝由即可移易精气而愈其病也。祝、咒同；
由，病所由生也，故曰“祝由”。）今之世不然，忧患缘其内，苦形伤其外，又失四时之从，逆寒暑之宜，贼
风数至，虚邪朝夕，内至五脏骨髓，外伤空窍肌肤，所以小病必甚，大病必死，故祝由不能已也。（内伤五
脏，外逆四时，则表里俱伤，为病必甚，故不能以祝由治之也。）临病患，观死生，决嫌疑，知其要，如日月
之光，上古僦贷季，理色脉而通神明，合之金木水火土、四时、八风、六合，不离其常。（理色脉，察内外
之精微也。通神明，色脉辨而神明见也。色脉之应，无往不合，如五行之衰王，四时之往来，八
风之变，六合之气，消长相根据，无不有常度也。）变化相移，以观其妙，则色脉是矣。（五行、四时、八风
之气迭有盛衰，则变化相移，色脉随之而应，故可以观其妙。凡人之五脏六腑，百骸九窍，脉必由乎气，
气必合乎天，虽其深微难测，而惟于色脉足以察之，故曰∶“知其要，则色脉是矣”。）色以应日，脉
以应月，常求其要，则其要也。（色分五行，而明晦是其变，日有十干，而阴晴是其变，故色以应日。脉有十二
经，而虚实是其变，月有十二建，而盈缩是其变，故脉以应月。常求色脉之要，则明如日月而得其变化之要矣。）
夫色之变化，以应四时之脉，此上古之所以合于神明，远死而近生，生道以长。（上古知色脉之
应，故能见机察微，合于神明，常远于死，常近于生，生道永昌。）中古之治病，至而治之，汤液十日，
以去八风五痹之病；十日不已，治以草苏草 之枝，本末为助。标本已得，邪气乃服。（中古之治病，必病
至而后治之。其治也先以汤液，汤液者，五谷所制而非药也。服之十日，八风五痹之病可以去矣。使十日
不已，则治以草苏草 之枝。苏，叶也。 ，根也。枝，茎也。根枝相佐，故云“本末为助”，即
后世之煎剂也。病源为本，病变为标，得其标木，邪无不服，此中古之治，虽不若上古之见于未然，而犹
未若后世之误也。 ，音该。）莫世之治病也则不然，治不本四时，不知日月，不审逆从，病形已
成，乃欲微针治其外，汤液治其内，（既不能防于未然，又不能察其见在，心粗见浅，针药乱施也。）所谓粗
工凶凶，以为可攻，故病未已，新病复起。（粗工，学不精而庸浅也。凶凶，好自用而孟浪也。若
辈者，意其为实而攻之，则假实未去而真虚至；意其为热而寒之，则故热未除而新寒起。是不足以治人，
而适足以害人耳。）必也治之极于一，一者因得之。（因者，所因也。得其所因，又何所而不得哉！）凡诊病
者，必问尝贵后贱，虽不中邪，病从内生，名曰“脱营”。（尝贵后贱者，其心屈辱，神气不伸，虽不中邪，
而病生于内。营者，阴气也。营行脉中，心之所主，心志不舒则血无以生，脉日以竭，故为脱营。）
尝富后贫，名曰“失精”，五气留连，病有所并。（尝富后贫者，忧煎日切，奉养日廉，故其五脏之精日加
消败，是为失精。精失则气衰，气衰则不运，故为留聚而病有所并矣。）不在脏腑，不变躯形，诊之
而疑，不知病名。（如前二病者，求之内证，则脏腑无可凭，求之外证，则形躯无所据。诊者不明其故，
则未有不疑而莫识其为何病也。）身体
日减，气虚无精。（其病渐深，则体为瘦减；其气日虚，则精无以生。）病深无气，洒洒然时惊。（及其
病深，则真气消索，故曰“无气”。无气则阳虚，故洒然畏寒也。阳虚则神不足，故心怯而惊也。）
病深者，以其外耗于卫，内夺于荣。（精气俱损，则表里受困，故外耗于卫，内夺于荣，此其所以为深也。）
良工所失，不知病情，此亦治之一过也。（虽曰良工，而不能察此，则不得其情，焉知其本，此过误之一也。）
凡诊病者，必问饮食居处，（饮食有膏粱藜藿之殊，居处有寒温燥湿之异，因常知变，必详问而察之。）
暴乐暴苦，始乐后苦，皆伤精气。精气竭绝，形体毁沮。（乐则喜，喜则气缓；苦则悲，悲则气消。
故苦乐失常，皆伤精气，甚至竭绝，则形体毁沮。沮，坏也。）暴怒伤阴，暴喜伤阳。（怒伤肝，肝藏血，
故伤阴；喜伤心，心藏神，故伤阳。）厥气上行，满脉去形。（厥气，逆气化。凡喜怒过度而伤其精气
者，皆能令人气厥逆而上行。气逆于脉，故满脉；精脱于中，故去形。）愚医治之，不知补泻，不知病情，
精华日脱，邪气乃并，此治之二过也。（不明虚实，故不知补泻；不察所因，故不知病情；以致
阴阳败竭，故精华日脱。阳脱者，邪并于阴；阴脱者，邪并于阳，故曰“邪气乃并”。此愚医之所误过之二也。）
善为脉者，必以比类奇恒，从容知之。为工而不知道，此诊之不足贵，此治之三过也。（比类，比别例类也。
奇恒，异常也。从容，安详静察也。凡善诊者，必比类相求，故能因阴察阳，因表察里，因正察邪，因此
察彼，是以奇恒异常之脉证，皆自从容之法而知之矣。引而伸之，触类而长之，天下之能事
毕矣。工不知此，何证之有？此过误之三也。又如脾虚浮似肺，肾小浮似脾，肝急沉散似肾，此皆工之所时
乱也，惟从容而后得之。）诊有三常，必问贵贱，封君败伤，及欲侯王。（三常，即常贵贱，常贫富，常
苦乐之义。封君败伤者，追悔已往，及欲侯王者，妄想将来，皆致病之因。）
故贵脱势，虽不中邪，精神内伤，身必败亡。（抑郁不伸，故精
神内伤。迷而不达，不亡不已也。）始富后贫，虽不伤邪，皮焦筋屈，痿 为挛。（忧愁思虑则心肺俱伤，
气血俱损，故为是病。）医不能严，不能动神，外为柔弱，乱至失常，病不能移，则医事
不行，此治之四过也。（戒不严，则无以禁其欲；言不切，则无以动其神。又其词色外为柔弱而委随从顺，
任其好恶，则未有不乱而至失其常者。如是则病不能移，其于医也何有？此过误之四也。）凡诊者，必知
终始，有知余绪，切脉问名，当合男女。（“必知终始”，谓原其始，要其终也。“有知余绪”，谓察其本，
知其末也。切其脉必问其名，欲得其素履之详也。男女有阴阳之殊，脉色有逆顺之别，必辨男女而察其所
合也。）离绝菀结，忧恐喜怒，五脏空虚，血气离守，工不能知，何术之语？（离者，失其亲爱。绝者，断
其所怀。菀，谓思虑抑郁。结谓深情难解。忧则气沉，恐则气怯，喜则气缓，恚则气逆，凡此皆伤
其内，故令五脏空虚，血气离守。医不知此，何术之有？）尝富大伤，斩筋绝脉，身体复行，令泽不息。（
大伤，谓甚劳甚苦也，故其筋如斩，脉如绝，以耗伤之过也。虽身体犹能复旧而行，然令泽不息矣。
泽，精液也。息，生长也。）故伤败结，留薄归阳，脓积寒炅。（故，旧也。言旧之所伤，有所败结，血气
留薄不散，则郁而成热，归于阳分，故脓血蓄积，令人寒炅交作也。炅，居永切，热也。）粗工治之，
亟刺阴阳，身体解散，四肢转筋，死日有期。（粗工不知寒热为脓积所生，脓积以劳伤所致，乃治以常法，
急刺阴阳，夺而又夺，以致血气复伤，故身体解散，四肢转筋，则死日有期。谓非粗工之误之者耶？）
医不能明，不问所发，惟言死日，亦为粗工，此治之五过也。（但知死日而不知致死者，由于施治之不当，
此过误之五也。）凡此五者，皆受术不通，人事不明也。（不通者，不通于理也。物理不通，焉知
人事？以上五条，所不可不知也。）故治病也，必知天地阴阳，四时经纪，（阴阳气候之变，人身应
之以为消长，此天道之不可不知也。）五脏
六腑，雌雄表里，刺灸砭石，毒药所主。（脏腑有雌雄，经络有表里，刺灸石药，各有所宜，此脏象之不
可不知也。）从容人事，以明经道，贵贱贫富，各异品理，问年少长，勇怯之理。（经道，常道
也。不从容于人事，则不知常道。不能知常，焉能知变？人事有不齐，品类有同异，知之则随方就圆，因变
而施，此人事之不可不知也。）审于部分，知病本始，八正九候，诊必副矣。（八正，八节之正气也。
副，称也。能察形色于分部，则病之本始可知；能察邪正于九候，则脉之顺逆可据。明斯二者，诊必称矣。此
色脉之不可不知也。上言“五过”，未明“四德”。而此四节，一言天道，一言脏象，一言人事，一言脉色，
即“四德”也。明此四者，医道全矣，诚缺一不可也。）治病之道，气内为宝，循求其理，求之不得，过在
表里。（气内者，气之在内者也。即元气也。凡治病者，当先求元气之强弱。元气既明，大意见矣。求元气
之病而无所得，然后察其过之在表在里以治之，斯无误也。此下五节，亦皆四德内事。按气有外气，天地之
六气也；有内气，人身之元气也。气失其和，则为邪气；气得其和，则为正气，亦曰真气。但真气所在，其义
有三∶上有气海，曰膻中也，其治在肺；中有水谷气血之海，曰中气也，其治在脾胃；下有气海，曰丹田也，
其治在肾。人之所赖，惟此气耳。气聚则生，气散则死，故曰“气内为宝”，此诚最重之辞，医家最切之旨也。）
夫经脉十二，络脉三百六十五，此皆人之所明知，工之所循用也。（循，根据顺也。此言经络之略，人所知也。）
所以不十全者，精神不专，志意不理，外内相失，故时疑殆。不知阴阳逆从之理，此治之一失也；受师不卒，
妄作离术，谬言为道，更名自功，此治之二失也；（受师不卒者，学业未精，苟且自是也。妄作
离术者，不明正道，假借异端也。谬言为道，更名自功者，侈口妄谈，巧立名色以欺人也。）不适贫富贵贱之
居，坐之浓薄，形之寒温，不适饮食之宜，不别人之勇怯，不知比类，足以自乱，不足
以自明，此治之三失也；诊病不问其始。忧患饮食之失节，起居之过度，或伤于毒，不先言此，卒持寸口，
何病能中？妄言作名，为粗所穷，此治之四失也。世人之语，驰千里之外。（工之得失，则毁誉之远闻也。）
不明不中，弃术于市，自遗其咎。
五疫之至，皆相染易，无问大小，病状相似，不施救疗，如何可得不相移易？（五疫，即五运疫疠之气。
移易，传染也。）正气存内，邪不可干，避其毒瓦斯，天牝从来，复得其往，气出于脑，即不邪干。（疫疠乃
天之邪气，若吾身正气内固，则邪不可干，故不相染也。天牝，鼻也。鼻受天之气，故曰“天牝”。气自空虚而
来，亦欲其自空虚而去，故曰“避其毒瓦斯，天牝从来，复得其往”也，盖以气通于鼻，鼻连于脑中，流布
诸经，令人相染矣。气出于脑为嚏，或张鼻泄之，则邪从鼻出，毒瓦斯可令散也。）气出于脑，即先想心如日。
（日为太阳之气，应人之心。想心如日，即所以存吾之气，壮吾之神，使邪气不能犯也。）将欲入于疫室，
先想青气自肝而出，左行于东，化作林木；（心之所至，气必至焉，故存想之则神有所注而气可王矣，左
行于东，化作林木之状，所以壮肝气也。）次想白气自肺而出，右行于西，化作戈甲；（所以壮肺气也。）
次想赤气自心而出，南行于上，化作焰明；（所以壮心气也。）次想黑气自肾而出，北行于下，化
作水；（所以壮肾气也。）次想黄气自脾而出，存于中央，化作土。（所以壮脾气也。）五气护身之毕，
以想头上。如北斗之煌煌，然后可入于疫室。（煌煌，辉耀貌。天行疫疠，传染最速，凡入病家，男
病坐其床尾，女病坐其床头，盖疠气男从上出，女从下出也。故当谨避之耳。）
The body is complete and solid, Qi and Blood are firm, so pathogenic factors cannot enter; therefore, there is no need for toxic drugs or needles and stones, but only by Zhu You (a method of curing disease by transferring the patient's Jing-Qi through incantation regarding the origin of the illness) can the Jing-Qi be harmonized and the illness cured. ("Zhu" is synonymous with "Zhou" [incantation]; "You" refers to the cause from which the illness arises, hence it is called "Zhu You".) The world today is not like this; worries and anxieties originate internally, physical suffering damages the exterior, and one fails to follow the changes of the four seasons, going against the适宜ness of cold and heat. Treacherous winds arrive frequently, empty pathogens invade morning and night, penetrating inwardly to the five Zang organs and bone marrow, and damaging outwardly the hollow orifices and skin. Thus, minor illnesses must become severe, and major illnesses must lead to death, so Zhu You cannot cure them either. (Internal injury to the five Zang organs and external violation of the four seasons result in damage to both interior and exterior, making the illness severe, thus it cannot be treated by Zhu You.) When facing patients, observing life and death, resolving doubts, grasping the essentials is like the light of the sun and moon. In ancient times, Qiu Dai Ji regulated the complexion and pulse to understand the divine, integrating the Five Elements (Metal, Wood, Water, Fire, Earth), the four seasons, the eight winds, and the six directions, never departing from the constant principles. (Regulating complexion and pulse involves investigating the subtleties of the interior and exterior; understanding the divine means that through distinguishing complexion and pulse, the divine becomes manifest. The correspondence of complexion and pulse aligns everywhere, just as the waxing and waning of the Five Elements, the coming and going of the four seasons, the variations of the eight winds, and the increase and decrease of the Qi of the six directions all have fixed measures.) Changes shift mutually; by observing their mysteries, one relies on the complexion and pulse. (The Qi of the Five Elements, four seasons, and eight winds alternates in prosperity and decline, causing mutual shifts in change, and the complexion and pulse respond accordingly, allowing one to observe their mysteries. For all people, the five Zang and six Fu organs, hundred bones and nine orifices, the pulse is governed by Qi, and Qi conforms to Heaven. Although profound and difficult to measure, only through complexion and pulse can they be examined; hence it is said: "Grasping the essence, the complexion and pulse suffice.") Complexion corresponds to the Sun, and the pulse corresponds to the Moon; constantly seeking their essence allows one to grasp the key. (Complexion is divided into the Five Elements, with brightness and darkness as its variations; the Sun has ten Heavenly Stems, with cloudy and clear weather as its variations, so complexion corresponds to the Sun. The pulse has twelve Meridians, with deficiency and excess as its variations; the Moon has twelve Earthly Branches, with waxing and waning as its variations, so the pulse corresponds to the Moon. Constantly seeking the essence of complexion and pulse makes one bright as the sun and moon and able to grasp the key of their changes.) The changes of complexion correspond to the pulses of the four seasons; this is why the ancients could align with the divine, stay far from death and close to life, allowing the Way of Life to flourish long. (The ancients knew the correspondence of complexion and pulse, so they could perceive opportunities and observe subtleties, aligning with the divine, always staying far from death and close to life, ensuring the eternal prosperity of the Way of Life.) In middle antiquity, treating diseases involved waiting for the illness to arrive before treating it, using Tang Ye (grain-based decoctions) for ten days to eliminate diseases of the Eight Winds and Five Bi; if not cured after ten days, treatment would use branches of grass leaves and roots, assisting the root and the tip together. Once root and branch are obtained, the pathogenic factor submits. (In middle antiquity, treatment began only after the illness arrived. Initially, Tang Ye, made from grains rather than herbs, was taken for ten days to eliminate diseases of the Eight Winds and Five Bi. If not cured after ten days, grass leaves [Su] and grass roots [Gai] were used. Su refers to leaves; Gai refers to roots. Branch refers to stems. Roots and stems assist each other, hence "root and tip assist," which is the decoction of later generations. The disease source is the root, the disease manifestation is the branch; obtaining both ensures the submission of pathogens. This treatment of middle antiquity, while not as prophetic as that of high antiquity, was still not as erroneous as that of later generations. Gai is pronounced 'gai'.) Modern people treat diseases differently; treatment does not follow the four seasons, ignores the laws of the sun and moon, and fails to examine reversal and compliance. Only when the disease form has already formed do they attempt to treat the exterior with fine needles and the interior with Tang Ye. (Since they cannot prevent it before it occurs, nor observe the existing condition, their minds are coarse and vision shallow, indiscriminately applying needles and drugs.) Such are the crude physicians who act recklessly, believing attack is appropriate, so the old illness remains, and new illnesses arise. (Crude physicians are those with unrefined and mediocre skills. Reckless implies self-opinionated and rash behavior. These individuals, assuming excess and attacking it, leave false excess unresolved while true deficiency arrives; assuming heat and cooling it, leaving old heat unresolved while new cold arises. This is insufficient to heal people and merely sufficient to harm them.) One must trace the extreme of treatment back to a single origin; this origin lies in identifying the cause. (Cause refers to the etiology. Having found the cause, what else could be missed?) Whenever diagnosing an illness, one must ask about experiences of losing status from nobility to baseness. Even without contracting external pathogens, the illness arises internally, named "Tuo Ying" (Depletion of Ying). (Losing status from nobility to baseness causes mental humiliation and stifled Shen-Qi. Even without external pathogens, illness arises internally. Ying is Yin Qi. Ying circulates within the vessels, governed by the Heart. If the Heart's will is not舒展, blood cannot be generated, and vessels deplete daily, hence "Tuo Ying".) Experiencing wealth then poverty is named "Shi Jing" (Loss of Jing). The Qi of the five Zang organs lingers, and illnesses combine. (Experiencing wealth then poverty brings increasing worry and anxiety, while provisions decrease, causing the Jing of the five Zang organs to deteriorate daily, known as "Shi Jing". Loss of Jing leads to Qi deficiency; Qi deficiency leads to stagnation, causing lingering and combined illnesses.) These do not affect the Zang-Fu organs visibly, nor alter the body shape; diagnosis raises doubts, and the disease name is unknown. (For the aforementioned two illnesses, seeking internal signs yields no basis in the Zang-Fu organs; seeking external signs yields no basis in the body shape. If the physician does not understand the cause, doubt inevitably arises, and the disease remains unrecognized.) The body diminishes daily, Qi becomes deficient, and Jing is lost. (As the illness deepens, the body emaciates; as Qi becomes deficient daily, Jing cannot be generated.) In deep illness, there is no Qi, accompanied by shivering and occasional fright. (When the illness is deep, True Qi is exhausted, hence "no Qi". No Qi implies Yang deficiency, leading to aversion to cold. Yang deficiency implies insufficiency of Shen, leading to timidity and fright.) Deep illness occurs because the exterior consumes Wei Qi, and the interior deprives Ying Qi. (Both Jing and Qi are damaged, confining both interior and exterior; thus, the exterior consumes Wei Qi, and the interior deprives Ying Qi, which is why the illness is deep.) The error of a good physician lies in not knowing the condition of the illness; this is also one error in treatment. (Even if a good physician, failing to observe these aspects, cannot grasp the situation, how can they know the root? This is one error.) Whenever diagnosing, one must inquire about diet and dwelling. (Diet varies between rich foods and coarse grains; dwellings vary in cold, warmth, dryness, and dampness. To know change through constancy, one must ask in detail and observe.) Sudden joy followed by sudden sorrow, or initial joy turning to sorrow, all damage Jing-Qi. Exhaustion of Jing-Qi leads to the destruction of the形体 (body form). (Joy brings delight, delight relaxes Qi; sorrow brings grief, grief dissipates Qi. Thus, abnormal joy and sorrow damage Jing-Qi, even to the point of exhaustion, leading to bodily destruction. Ju means ruin.) Sudden anger injures Yin, sudden joy injures Yang. (Anger injures the Liver, which stores Blood, thus injuring Yin; Joy injures the Heart, which houses Shen, thus injuring Yang.) Jue Qi rises upward, filling the vessels and separating from the form. (Jue Qi is rebellious Qi. Any excessive anger or joy that damages Jing-Qi can cause Qi to rebel and rise. Qi rebelling in the vessels fills them; Jing depletion within separates it from the form.) Foolish physicians treat them without knowing tonification or purgation, and without understanding the condition; essence and brilliance deplete daily, and pathogenic factors combine; this is the second error in treatment. (Not understanding deficiency and excess, they do not know tonification or purgation; not examining the cause, they do not understand the condition; leading to the collapse of Yin and Yang, essence depletes daily. When Yang depletes, pathogens combine with Yin; when Yin depletes, pathogens combine with Yang, hence "pathogenic factors combine." This is the second error of foolish physicians.) Those skilled in pulse diagnosis must use analogy and comparison with the extraordinary (Qi Heng), knowing calmly. A physician who does not understand this Dao renders diagnosis worthless; this is the third error in treatment. (Analogy involves comparing and categorizing. Extraordinary refers to abnormalities. Calmly implies serene observation. Skilled diagnosticians compare similar cases to verify, allowing them to observe Yang through Yin, exterior through interior, normal through pathogenic, and one through another. Thus, extraordinary pulse and symptom patterns are understood through calm methods. Extending and applying these principles completes the art. Without this, what symptoms can be diagnosed? This is the third error. For example, Spleen deficiency floating resembles Lung; Kidney small floating resembles Spleen; Liver urgent, deep, and scattered resembles Kidney. These are often confused by physicians; only through calm observation can they be distinguished.) Diagnosis has three constants: one must ask about status (noble/base), loss of title/honor, and desires for lordship. (The three constants refer to constant noble/base, rich/poor, and joyful/sorrowful states. Loss of title involves regretting the past; desire for lordship involves delusions of the future; both are causes of disease.) Thus, when a noble loses power, even without external pathogens, internal spiritual injury occurs, and the body must perish. (Depression and stifling cause internal spiritual injury. Confusion and lack of clarity lead inexorably to death.) Starting rich then becoming poor, even without pathogenic injury, results in dry skin, contracted sinews, flaccidity, and contracture. (Worry and thought injure both Heart and Lung, damaging both Qi and Blood, causing these illnesses.) If the physician is not strict, cannot move the Shen, appears weak externally, and allows chaos to disrupt normalcy, the illness cannot be moved, and medical practice fails; this is the fourth error in treatment. (Without strict warnings, desires cannot be forbidden; without earnest words, Shen cannot be moved. Appearing weak and compliant externally, indulging preferences, leads to chaos and loss of normalcy. If the illness cannot be moved, what use is medicine? This is the fourth error.) All diagnosticians must know the beginning and end, understand residual threads, take pulses and ask names, considering male and female distinctions. ("Know beginning and end" means tracing the origin and summarizing the outcome. "Understand residual threads" means observing the root and knowing the branches. Taking the pulse requires asking the name to obtain detailed personal history. Males and females differ in Yin-Yang; pulses and complexions differ in reversal/compliance; one must distinguish gender and observe correspondences.) Separation, severance, depression, and knotting, along with worry, fear, joy, and anger, empty the five Zang organs and separate Blood and Qi. If the physician does not know this, what technique can be spoken of? (Separation is losing loved ones; severance is cutting off attachments. Depression refers to brooding; knotting refers to deep, hard-to-resolve emotions. Worry sinks Qi, fear makes Qi timid, joy relaxes Qi, anger reverses Qi. All these injure the interior, emptying the five Zang organs and separating Blood and Qi. If the physician does not know this, what technique exists?) Former wealth greatly damaged, tendons severed and vessels cut, the body may walk again, but fluids cease to grow. (Great damage refers to extreme labor and suffering, so tendons seem severed and vessels cut due to excessive consumption. Although the body may resume walking, fluids no longer grow. Ze refers to essences/fluids; Xi refers to growth.) Old injuries and败结 (decayed knots) linger and thin, returning to the Yang aspect, accumulating pus and alternating chills and heat. (Old injuries involve decayed knots where Qi and Blood linger and do not disperse,郁 transforming into heat, returning to the Yang aspect, accumulating pus and blood, causing alternating chills and heat. Jiong means heat.) Crude physicians treat this by urgently puncturing Yin and Yang; the body dissolves, limbs convulse, and the day of death is fixed. (Crude physicians do not know that chills and heat arise from pus accumulation caused by labor injury. Using standard methods, urgently puncturing Yin and Yang, depleting again and again, further damages Qi and Blood, causing body dissolution and limb convulsions, fixing the date of death. Is this not the error of crude physicians?) Physicians who fail to clarify, do not ask the cause, and only predict the day of death are also crude; this is the fifth error in treatment. (Knowing only the day of death without understanding the cause of death due to improper treatment is the fifth error.) All these five situations stem from不通 (lack of understanding) of techniques and ignorance of human affairs. (Lack of understanding means failure to comprehend principles. If physical principles are not understood, how can human affairs be known? The above five points must be known.) Therefore, treating illness requires knowing Heaven and Earth Yin-Yang and the regulations of the four seasons. (Changes in Yin-Yang climate cause corresponding fluctuations in the human body; this Heavenly Dao must be known.) It requires knowledge of the five Zang and six Fu organs, Yin-Yang pairing, interior-exterior relationships, and the indications for acupuncture, moxibustion, stone needles, and drugs. (Zang-Fu have Yin-Yang pairings; meridians have interior-exterior relationships; acupuncture, moxibustion, stones, and drugs have specific indications; this Zang-Xiang theory must be known.) One must calmly consider human affairs to clarify the constant Dao. Nobility and poverty, richness and poverty, have different categorical principles; asking about age and courage/weakness reveals their logic. (Constant Dao refers to regular principles. Not considering human affairs means not knowing the constant Dao. Without knowing the constant, how can change be known? Human affairs are uneven, categories have similarities and differences; knowing them allows adapting methods and changing treatments accordingly; human affairs must be known.) Examining the parts allows knowing the origin and beginning of the illness; the Eight Regularities and Nine Palpations ensure accurate diagnosis. (Eight Regularities refer to the correct Qi of the eight solar terms. Fu means matching. Observing color and shape in specific parts reveals the origin and beginning of illness; observing pathogenic and correct Qi in the Nine Palpations determines pulse compliance/reversal. Understanding these two ensures accurate diagnosis. This concerns complexion and pulse, which must be known. The previous section mentioned "Five Errors" but did not clarify the "Four Virtues". These four sections discuss Heavenly Dao, Zang-Xiang, Human Affairs, and Pulse-Complexion, constituting the "Four Virtues". Understanding these four completes the medical Dao; none can be omitted.) The way of treating illness holds Inner Qi as precious; following its principles, if not found, the error lies in exterior or interior. (Inner Qi refers to Qi within, i.e., Yuan Qi. In treating illness, one must first seek the strength of Yuan Qi. Once Yuan Qi is clear, the general idea is established. If searching for Yuan Qi pathology yields nothing, then examine whether the error lies in the exterior or interior to treat it, avoiding mistakes. The following five sections also belong to the Four Virtues. Qi includes External Qi (Six Qi of Heaven and Earth) and Internal Qi (Yuan Qi of the body). When Qi loses harmony, it becomes Pathogenic Qi; when it gains harmony, it becomes Correct Qi, also called True Qi. True Qi has three locations: Upper Qi Sea, called Dan Zhong, governed by the Lung; Middle Qi Sea of water and grain, called Middle Qi, governed by Spleen and Stomach; Lower Qi Sea, called Dan Tian, governed by the Kidney. Humans rely solely on this Qi. Qi gathering brings life; Qi scattering brings death, hence "Inner Qi is precious," truly the most important term and the closest intent of physicians.) There are twelve Main Meridians and 365 Collateral Vessels, all well-known to people and used by physicians. (Xun means following according to. This states the outline of meridians, which is known to people.) The reason for not achieving full success is lack of spiritual focus and unruly intention, causing interior-exterior disconnection, leading to frequent doubt and danger. Not knowing the principles of Yin-Yang reversal and compliance is the first failure in treatment; incomplete apprenticeship, reckless deviation from orthodoxy, false claims as Dao, renaming to claim credit is the second failure. (Incomplete apprenticeship means unrefined studies and arbitrary self-righteousness. Reckless deviation means ignoring the right path and borrowing heterodox methods. False claims and renaming mean boasting and inventing names to deceive.) Failing to adapt to the living conditions of nobility, poverty, wealth, and base status; seat thickness; body temperature; failing to adapt to dietary appropriateness; failing to distinguish courage and weakness; not knowing analogy, enough to confuse oneself, insufficient to clarify oneself, is the third failure in treatment. Diagnosing without asking the beginning—whether due to worry, dietary irregularities, excessive起居 (daily routine), or toxic injury—if these are not stated first, and suddenly holding the Cun Kou (radial artery), how can the illness be identified? Speaking falsely and creating names, being overwhelmed by crude methods, is the fourth failure. Words of the world travel a thousand miles. (Physician's gains and losses spread far through praise and blame.) Unclear and inaccurate, abandoning technique in the market, inviting blame upon oneself.
When the Five Epidemics arrive, they infect each other, regardless of age, with similar symptoms. Without rescue and treatment, how can transmission be prevented? (Five Epidemics refer to the epidemic Qi of the Five Movements. Yi means transmission/infection.) If Correct Qi resides within, pathogens cannot interfere; avoid the toxic miasma entering from the Tian Pin (nose), allowing it to exit as it came; Qi emerging from the brain prevents pathogenic interference. (Epidemic Qi is Heavenly pathogenic Qi. If our Correct Qi is solid internally, pathogens cannot interfere, hence no infection. Tian Pin refers to the nose. The nose receives Heavenly Qi, hence "Tian Pin". Qi comes from emptiness and should return to emptiness, hence "avoid toxic miasma coming from Tian Pin, returning to where it went," as Qi connects to the nose, the nose connects to the brain, circulating through meridians, causing infection. Qi emerging from the brain causes sneezing; opening the nose to vent it allows pathogens to exit and miasma to disperse.) Qi emerging from the brain begins with visualizing the Heart as the Sun. (The Sun represents Tai Yang Qi, corresponding to the Heart. Visualizing the Heart as the Sun preserves our Qi and strengthens our Shen, preventing pathogenic invasion.) Before entering an epidemic room, first visualize Green Qi emerging from the Liver, moving left to the East, transforming into forests and trees. (Wherever the mind goes, Qi follows; visualization focuses Shen and strengthens Qi. Moving left to the East, transforming into forests, strengthens Liver Qi.) Next, visualize White Qi emerging from the Lungs, moving right to the West, transforming into weapons and armor. (This strengthens Lung Qi.) Next, visualize Red Qi emerging from the Heart, moving south and upward, transforming into flames. (This strengthens Heart Qi.) Next, visualize Black Qi emerging from the Kidneys, moving north and downward, transforming into water. (This strengthens Kidney Qi.) Next, visualize Yellow Qi emerging from the Spleen, residing in the Center, transforming into earth. (This strengthens Spleen Qi.) After completing the protection of the five Qi, visualize it at the head, shining brightly like the Big Dipper, then one can enter the epidemic room. (Huang Huang means shining brightly. Heavenly epidemics transmit fastest. When entering a sickroom, sit at the foot of the bed for male patients and at the head for female patients, as epidemic Qi exits males from above and females from below. Thus, one must carefully avoid it.)