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The *Liu Yuan Zheng Ji Da Lun* states: The beginning of the numerical sequence starts from above and connects to below. In the first half of the year, the Qi of Heaven (Tian Qi) dominates; in the second half of the year, the Qi of Earth (Di Qi) dominates. ("Half of the year" refers to the day of Liqiu, Start of Autumn.) When Heaven and Earth interact, the Qi intersection (Qi Jiao) dominates, marking the completion of the annual cycle. (The interaction of upper and lower refers to the transition between the Third and Fourth Qi phases. That is, the intersection of Heaven and Earth Qi dominates, which marks the end of the annual cycle.) The Qi of Spring moves westward, the Qi of Summer moves northward, the Qi of Autumn moves eastward, and the Qi of Winter moves southward. (Observing the growth, flourishing, harvest, and storage of all things confirms this statement.) Therefore, the Qi of Spring begins at the bottom, the Qi of Autumn begins at the top, the Qi of Summer begins in the middle, and the Qi of Winter begins at the periphery/biao. The Qi of Spring begins on the left, the Qi of Autumn begins on the right, the Qi of Winter begins at the back, and the Qi of Summer begins at the front. These are the normal patterns of the four seasons' transformation. (This can be understood by observing phenomena.) Thus, in extremely high places, the Qi of Winter is always present; in extremely low places, the Qi of Spring is always present. (On the peaks of high mountains, ice and snow persist even in midsummer; in low, muddy river marshes, grass grows even in harsh winter, clearly illustrating the meaning of "always present." The Qi of Spring and Summer originally governs the southeast, but its energy descends toward the northwest. The Qi of Autumn and Winter originally governs the northwest, but its energy ascends toward the southeast. Therefore, the Qi of Spring originates from the previous year, rising from the lower Qi; the Qi of Autumn arises from the current year, descending from the upper Qi; the Qi of Summer originates from the current year, rising from the central Qi.) One must carefully observe these principles.

When Jueyin (Liver/Gallbladder) arrives, it manifests as abdominal urgency and pain (tendons become soft and contracted, causing urgency). When Shaoyin (Heart/Small Intestine) arrives, it manifests as sores, macules/rashes, and fever (due to the generation of Fire Qi). When Taiyin (Spleen/Stomach) arrives, it manifests as accumulation of fluids and obstruction/blockage (due to Earth Qi). When Shaoyang (Sanjiao/Gallbladder) arrives, it manifests as sneezing, vomiting, and sores/ulcers (due to the generation of Fire Qi). When Yangming (Large Intestine/Stomach) arrives, it manifests as floating emptiness/swelling (floating emptiness refers to thin swelling that rebounds quickly upon pressure). When Taiyang (Bladder/Kidney) arrives, it manifests as difficulty in flexion and extension, which is a common pattern of disease.

When Jueyin arrives, it manifests as supporting pain in the hypochondrium (obstruction/hindrance). When Shaoyin arrives, it manifests as fright, confusion, aversion to cold, tremors, and delirious speech (delirium refers to confused talking due to mental disorder). When Taiyin arrives, it manifests as abdominal fullness. When Shaoyang arrives, it manifests as fright, irritability, visual blurring/dizziness, and sudden illness. When Yangming arrives, it manifests as nasal congestion/runny nose, and diseases of the sacrum, yin organs, thighs, knees, calves, and feet. When Taiyang arrives, it manifests as lower back pain, which is a common pattern of disease.

When Jueyin arrives, it manifests as flaccidity and spasms. When Shaoyin arrives, it manifests as sadness,妄语 (delusional speech), epistaxis, and subcutaneous bleeding (mie refers to dark blood). When Taiyin arrives, it manifests as central fullness, cholera-like vomiting and diarrhea. When Shaoyang arrives, it manifests as throat bi (obstruction), tinnitus, and vomiting with regurgitation (yong refers to food overflowing, inability to swallow). When Yangming arrives, it manifests as hypochondriac pain and skin cracking/scaling (skin resembling bran). When Taiyang arrives, it manifests in nocturnal sweating and spasms (nocturnal sweating refers to sweat occurring during sleep in the chest, throat, neck, and axilla regions; commonly known as night sweats). This is a common pattern of disease.

When Jueyin arrives, it manifests as hypochondriac pain, vomiting, and diarrhea (xie refers to purging). When Shaoyin arrives, it manifests as excessive talking and laughing. When Taiyin arrives, it manifests in heavy edema (heavy edema refers to pitting edema where the depression does not rebound). When Shaoyang arrives, it manifests as acute watery diarrhea, convulsions, and sudden death. When Yangming arrives, it manifests as nasal congestion and sneezing. When Taiyang arrives, it manifests as diarrhea or constipation/obstruction, which is a common pattern of disease.

These twelve transformations respond to virtue with virtue, to transformation with transformation, to governance with governance, and to orders with orders. If the Qi is high, the pathology is high; if the Qi is low, the pathology is low; if the Qi is posterior, the pathology is posterior; if the Qi is anterior, the pathology is anterior; if the Qi is central, the pathology is central; if the Qi is external, the pathology is external. This is the normal order of position. (Responding to virtue and transformation refers to the Qi of Heaven and Earth. High, low, anterior, posterior, central, and external refer to the locations of disease. The Yin and Yang of the hands have Qi that is high; the Yin and Yang of the feet have Qi that is low. The Qi of Foot-Taiyang is at the back of the body; the Qi of Foot-Yangming is at the front; the Qi of Foot-Shaoyang, Foot-Taiyin, and Foot-Jueyin is in the center; the Qi of Foot-Shaoyang is on the side. Each describes the pathological manifestations arising from Qi changes according to their location. All mentions of Jueyin, Shaoyin, Taiyin, etc., in the main text primarily refer to the annual cycle, while human diseases correspond to this cycle. These twelve transformations refer to the preceding virtues, transformations, governance, orders, pathological changes, and the twelve solar terms' indicators. If they arrive not according to the annual step or host/guest positions, they belong to changing Qi, manifesting as excess-rebound (Sheng-Fu) patterns. Regarding Sheng-Fu indicators: when the excess Qi arrives, if virtue changes, it is repaid with virtue; if transformation changes, it is repaid with transformation; if governance/orders change, they are repaid with governance/orders. The reciprocation of Qi cannot shift positions. Changed Qi, if high, is repaid high; if low, repaid low; if posterior, repaid posterior; if anterior, repaid anterior; if central, repaid central; if external, repaid external. Their positional height and depth also cannot shift. Thus, the variations of wind, cold, summer-heat, dampness, dryness, and fire in the world often do not conform uniformly.)

Therefore, if Wind prevails, there is movement/tremor (restlessness). If Heat prevails, there is swelling (Heat prevailing in Qi causes erysipelas; prevailing in Blood causes abscesses/swellings; prevailing in bone and muscle causes edema that does not rebound). If Dryness prevails, there is dryness (Dryness externally causes skin cracking; internally causes depletion of essence and blood; affecting Qi and fluids causes muscles to dry and skin to adhere to bones). If Cold prevails, there is floating/swelling (floating refers to swelling that rises, leaving an indentation upon pressure). If Dampness prevails, there is loose stool/watery diarrhea (ru xie refers to watery bowel movements); severely, there is urinary retention and edema (heavy edema refers to pitting edema; water retention refers to fluid escaping into the skin). Describing these variations depends on the location of the Qi.

When Heaven's Qi is insufficient, Earth's Qi follows to supplement it; when Earth's Qi is insufficient, Heaven's Qi follows to support it. The Movement (Yun) resides in the middle and often acts first. (Movement refers to Wood, Fire, Earth, Metal, and Water governing each year respectively. If Earth Qi prevails, the annual Movement rises; if Heaven Qi prevails, the annual Movement descends. Rising and descending, the Movement and Qi often migrate and descend first.) It dislikes what it cannot overcome and returns to what harmonizes with it, generating disease following the Movement's return. (If not in its proper position, variation occurs; variation leads to disease.) Therefore, if the Upper prevails, Heaven's Qi descends; if the Lower prevails, Earth's Qi migrates upward. (Prevailing means excessive. Excess above causes self-descent; excess below causes self-migration. The shifting of more and less is the norm 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. Responses vary from mild to severe). Mild differences are small deviations; severe differences are large deviations. If severe, positions and Qi exchanges occur, leading to major variations and disease onset. The *Da Yao* states: Severe deviations are five parts, mild deviations are seven parts; these differences are visible. This is what is meant. (Through these five and seven parts, one knows the excessive deviation of Heaven and Earth Yin and Yang.)

In hot weather, do not violate by using hot remedies; in cold weather, do not violate by using cold remedies. Why? For releasing the exterior, do not stay away from hot remedies; for attacking the interior, do not stay away from cold remedies. (Sweating requires heat, hence using heat without avoiding heat; purging requires cold, hence using cold without avoiding cold; these are used only when unavoidable.) Timing must be followed; violations are treated by overcoming them. (Spring suits coolness, Summer suits cold, Autumn suits warmth, Winter suits heat. This is the appropriateness of time; medication must not disobey. However, violating heat is treated with cold, violating cold with heat, violating Spring [needing cool] with cool, violating Autumn [needing warm] with warm; this is using the overcoming method.)

For pregnant women, how should toxic drugs be used? If there is a pathogen, there will be no miscarriage/mother's harm, nor fetal harm. (Refers to large, hard masses/zhen, with unbearable pain, treated with drugs that break accumulations and relieve pain. This means if untreated, both die; treating preserves the greater good. "No mother's harm" means the mother need not necessarily perish. "No fetal harm" means the fetus will not die either.) Large accumulations may be treated with contraindicated drugs, but stop when the condition has diminished by more than half; exceeding this limit causes death. (Diminishing by half is insufficient to harm life, so stop medication after half is reduced. If one waits for total elimination through over-prohibition, residual toxic qi remains internally; attacking non-existent disease with toxic drugs damages the harmonious balance, causing death.)

Wood stagnation is resolved by dispersing/venting; Fire stagnation is resolved by emitting/sweating; Earth stagnation is resolved by seizing/purging; Metal stagnation is resolved by draining/releasing; Water stagnation is resolved by restraining/modulating. However, regulate the Qi. (Venting refers to emesis, making it smooth and unobstructed. Emitting refers to diaphoresis, making it dispersed. Seizing refers to purgation, removing obstruction. Draining refers to leeching/diuresis and releasing the exterior. Restraining refers to suppressing, controlling rebellious Qi. Mastering these five methods allows Qi regulation, followed by observation of deficiency/excess for further conditioning.) Excess is restrained by what it fears, which is called purging. (Excess means hyperactivity. Hyperactivity is purged by flavor: Salty purges Kidney, Sour purges Liver, Pungent purges Lung, Sweet purges Spleen, Bitter purges Heart. Excess fears purging, hence purging is termed fear.)