（素问四气调神论 连前篇）
是故圣人不治已病治未病，不治已乱治未乱，此之谓也。（此承前篇而言圣人预防之道，治于未形，故用力少而成功
多，以见其安不忘危也。）夫病已成而后药之，乱已成而后治之，譬犹渴而穿井，斗而铸兵，不亦晚乎！（渴而穿井，无
及于饮，斗而铸兵，无济于战，诚哉晚矣，而病不早为之计者，亦犹是也。观扁鹊之初见齐桓侯曰∶君有疾，在腠理，
不治将深。后五日复见曰∶君有疾，在血脉，不治将深。又五日复见曰∶君有疾，在肠胃间，不治将深。而桓侯俱不能
用。再后五日复见，扁鹊望颜而退走曰∶疾之居腠理也，汤熨之所及也；在血脉，针石之所及也；在肠胃，酒醪之所及
也；其在骨髓，虽司命无奈之何矣。后五日桓侯疾作，使人召扁鹊，而扁鹊已去，桓侯遂死。夫桓侯不早用扁鹊之言，
及其病深而后召之，是即渴而穿井，斗而铸兵也。故在圣人则常用意于未病未乱之先，所以灾祸不侵，身命可保。今之
人多见病势已成，犹然隐讳，及至于不可为，则虽以扁鹊之神，亦云无奈之何，而医非扁鹊，又将若之何哉？嗟夫！祸
始于微，危因于易，能预此者，谓之治未病，不能预此者，谓之治已病，知命者其谨于微而已矣。）
（素问阴阳应象大论）
黄帝曰∶阴阳者，天地之道也，（道者，阴阳之理也。阴阳者，一分为二也。太极动而生阳，静而生阴，天生于动，
地生于静，故阴阳为天地之道。）万物之纲纪，（大曰纲，小曰纪，总之为纲，周之为纪，物无巨细，莫不由之，故为万
物之纲纪。王氏曰，滋生之用也，阳与之正气以生，阴为之主持以立者，亦是。）变化之父母，（天元纪大论曰∶物生谓
之化，物极谓之变。易曰∶在天成象，在地成形，变化见矣。朱子曰∶变者化之渐，化者变之成。阴可变为阳，阳可化
为阴。然而变化虽多，无非阴阳之所生，故为之父母。）生杀之本始，（生杀之道，阴阳而已，阳来则物生，阳去则物死。
凡日从冬至以后，自南而北谓之来，来则春为阳始，夏为阳盛，阳始则温，温则生物，阳盛则热，热则长物；日从夏至
以后，自北而南谓之去，去则秋为阴始，冬为阴盛，阴始则凉，凉则收物，阴盛则寒，寒则藏物，此阴阳生杀之道也。
然如下文曰∶阳生阴长，阳杀阴藏。则阳亦能杀，阴亦能长矣。六节藏象论曰∶生之本，本于阴阳。则阴亦能生矣。故
生于阳者，阴能杀之，生于阴者，阳能杀之，万物死生，皆由乎此，故谓之本始。本，根本也。始，终始也。）神明之府
也，（神，变化不测也。明，三光着象也。府，所以藏物也。神明出于阴阳，故阴阳为神明之府，此自首节阴阳二字，一
贯至此，义当联玩。天元纪大论亦有以上数句，见运气类第三。）治病必求于本。（本，致病之原也。人之疾病，或在表，
或在里，或为寒，或为热，或感于五运六气，或伤于脏腑经络，皆不外阴阳二气，必有所本。故或本于阴，或本于阳，
病变虽多，其本则一。知病所从生，知乱所由起，而直取之，是为得一之道。譬之伐木而引其柢，则千枝万叶，莫得弗
从矣。倘但知见病治病，而不求其致病之因，则流散无穷，此许学士所谓广络原野，以冀一人之获，诚哉疏矣。）故积阳
为天，积阴为地。（阴阳体象，大小不同，形气生成，不积不浓，故必积阳至大而为天，积阴至浓而为地。）阴静阳躁，（阴
性柔，阳性刚也。）阳生阴长，阳杀阴藏。（此即四象之义，阳生阴长，言阳中之阳阴也；阳杀阴藏，言阴中之阴阳也。
盖阳不独立，必得阴而后成，如发生赖于阳和，而长养由乎雨露，是阳生阴长也；阴不自专，必因阳而后行，如闭藏因
于寒冽，而肃杀出乎风霜，是阳杀阴藏也。此于对待之中，而复有互藏之道，所谓独阳不生，独阴不成也。如天元纪大
论曰∶天以阳生阴长，地以阳杀阴藏。实同此义。详运气类三，所当互考。一曰∶阳之和者为发生，阴之和者为成实，
故曰阳生阴长。阳之亢者为焦枯，阴之凝者为固闭，故曰阳杀阴藏。此以阴阳之淑慝言，于义亦通。）阳化气，阴成形。
（阳动而散，故化气。阴静而凝，故成形。）寒极生热，热极生寒。（阴寒阳热，乃阴阳之正气。寒极生热，阴变为阳也；
热极生寒，阳变为阴也。邵子曰∶动之始则阳生，动之极则阴生；静之始则柔生，静之极则刚生。此周易老变而少不变
之义。如人伤于寒，则病为热，本寒而变热也；内热已极，而反寒栗，本热而变寒也。故阴阳之理，极则必变。）寒气生
浊，热气生清。（寒气凝滞，故生浊阴。热气升散，故生清阳。）清气在下，则生飧泄；浊气在上，则生 胀。（清阳主升，
阳衰于下而不能升，故为飧泄；浊阴主降，阴滞于上而不能降，故为 胀。飧泄，完谷而泄也。 胀，胸膈满也。飧音
孙。 音嗔。）此阴阳反作，病之逆从也。（作，为也。此字，承上文治病必求其本以下而言。如阴云长，阳云杀，寒生
热，热生寒，清在下，浊在上，皆阴阳之反作，病之逆从也。顺则为从，反则为逆，逆从虽殊，皆有其本，故必求其本
而治之。）
故清阳为天，浊阴为地；地气上为云，天气下为雨；雨出地气，云出天气。（此下言阴阳精气之升降，以见天人一理
也。天地者，阴阳之形体也。云雨者，天地之精气也。阴在下者为精，精者水也，精升则化为气，云因雨而出也；阳在
上者为气，气者云也，气降则化为精，雨由云而生也。自下而上者，地交于天也，故地气上为云，又曰云出天气；自上
而下者，天交于地也，故天气下为雨，又曰雨出地气。六微旨大论曰∶升已而降，降者谓天；降已而升，升者谓地。天
气下降，气流于地；地气上升，气腾于天。可见天地之升降者，谓之云雨；人身之升降者，谓之精气。天人一理，此其
为最也。气水同类详义，有按在后第四章，所当参阅。）故清阳出上窍，浊阴出下窍；（本乎天者亲上，本乎地者亲下也。
上窍七，谓耳目口鼻。下窍二，谓前后二阴。）清阳发腠理，浊阴走五脏；（腠理，肌表也。阳发散于皮肤，故清阳归之。
阴受气于五脏，故浊阴走之。腠音凑。）清阳实四肢，浊阴归六腑。（四肢为诸阳之本，故清阳实之。六腑传化水谷，故
浊阴归之。）水为阴，火为阳，（水润下而寒，故为阴。火炎上而热，故为阳。水火者，即阴阳之征兆；阴阳者，即水火
之性情。凡天地万物之气，无往而非水火之运用，故天以日月为水火，易以坎离为水火，医以心肾为水火，丹以精气为
水火。夫肾者水也，水中生气，即真火也；心者火也，火中生液，即真水也。水火互藏，乃至道之所在，医家首宜省察。）
阳为气，阴为味。（气无形而升，故为阳。味有质而降，故为阴。此以药食气味言也。）味归形，形归气，（归，根据投也。
五味生精血以成形，故味归于形。形之存亡，由气之聚散，故形归于气。）气归精，（气者，真气也，所受于天，与谷气
并而充身者也。人身精血，由气而化，故气归于精。）精归化。（精者，坎水也，天一生水，为五行之最先。故物之初生，
其形皆水，由精以化气，由气以化神，是水为万化之原，故精归于化。）精食气，形食味，（食，如子食母乳之义。气归
精，故精食气。味归形，故形食味。）化生精，（万物化生，必从精始，故化生精。前言精归化者，言未化之前，由精为
化也。此言化生精者，言既化之后，由化生精也。）气生形。（气聚则形生，气散则形死也。）味伤形，气伤精，（味既归
形，而味有不节，必反伤形。气既归精，而气有失调，必反伤精。）精化为气，（精化为气，谓元气由精而化也。珠玉集
曰∶水是三才之祖，精为元气之根。其义即此。然上文既云气归精，是气生精也；而此又曰精化气，是精生气也。二者
似乎相反，而不知此正精气互根之妙，以应上文天地云雨之义也。夫阳化气。即云之类；阴成形，即雨之类。雨乃不生
于地而降于天之云，气归精也。云乃不出于天而升于地之气，精化为气也。人身精气，全是如此。故气聚则精盈，精盈
则气盛，精气充而形自强矣。帝所以先举云雨为言者，正欲示人以精气升降之如此耳。（气伤于味。）上文曰味伤形，则
未有形伤而气不伤者。如云味过于酸，肝气以津，脾气乃绝之类，是皆味伤气也。）阴味出下窍，阳气出上窍。（味为阴
故降，气为阳故升。）味浓者为阴，薄为阴之阳；气浓者为阳，薄为阳之阴。（此言气味之阴阳，而阴阳之中，复各有阴
阳也。味为阴矣，而浓者为纯阴，薄者为阴中之阳；气为阳矣，而浓者为纯阳，薄者为阳中之阴。）味浓则泄，薄则通；
气薄则发泄，浓则发热。（阴味下行，故味浓者能泄于下，薄者能通利；阳气上行，故气薄者能泄于表，浓者能发热也。）
壮火之气衰，少火之气壮。壮火食气，气食少火；壮火散气，少火生气。（火，天地之阳气也。天非此火，不能生物；人
非此火，不能有生。故万物之生，皆由阳气。但阳和之火则生物，亢烈之火反害物，故火太过则气反衰，火和平则气乃
壮。壮火散气，故云食气，犹言火食此气也。少火生气，故云食火，犹言气食此火也。此虽承气味而言，然造化之道，
少则壮，壮则衰，自是如此，不特专言气味者。）气味辛甘发散为阳，酸苦涌泄为阴。（此言正味之阴阳也。辛散甘缓，
故发肌表。酸收苦泄，故为吐泻。 涌， 同。）
阴胜则阳病，阳胜则阴病。（此下言阴阳偏胜之为病也。阴阳不和，则有胜有亏，故皆能为病。）阳胜则热，阴胜则
寒。（太过所致。）重寒则热，重热则寒。（物极则变也。此即上文寒极生热、热极生寒之义。盖阴阳之气，水极则似火，
火极则似水，阳盛则隔阴，阴盛则隔阳。故有真寒假热，真热假寒之辨，此而错认，则死生反掌。重，平声。）寒伤形，
热伤气。（寒为阴，形亦属阴，寒则形消故伤形。热为阳，气亦属阳，热则气散故伤气。）气伤痛，形伤肿。（气欲利，故
伤之则痛。形有质，故伤之则肿。）故先痛而后肿者，气伤形也；先肿而后痛者，形伤气也。（气先病而后及于形，因气
伤形也。形先病而后及于气，因形伤气也。）风胜则动，（风胜者，为振掉摇动之病，即医和云风淫末疾之类。）热胜则肿，
（热胜者，为丹毒痈肿之病，即医和云阳淫热疾之类。）燥胜则干，（燥胜者，为津液枯涸、内外干涩之病。）寒胜则浮，
（寒胜者阳气不行，为胀满浮虚之病，即医和云阴淫寒疾之类。）湿胜则濡泻。（脾恶湿而喜燥，湿胜者必侵脾胃，为水
谷不分濡泻之病，即医和云雨淫腹疾之类。濡音如，湿滞也。）天有四时五行，以生长收藏，以生寒暑燥湿风。（四时者，
春夏秋冬。五行者，木火土金水。合而言之，则春属木而主生，其化以风；夏属火而主长，其化以暑；长夏属土而主化，
其化以湿；秋属金而主收，其化以燥；冬属水而主藏，其化以寒。五行各一，惟火有君相之分。此言寒暑燥湿风者，即
五行之化也。五营运等论言寒暑燥湿风火者，是为六气也。）人有五脏，化五气，以生喜怒悲忧恐。（五脏者，心肺肝脾
肾也。五气者，五脏之气也。由五气以生五志。如本论及五营运大论，俱言心在志为喜，肝在志为怒，脾在志为思，肺
在志为忧，肾在志为恐。天元纪大论亦以悲作思。）故喜怒伤气，寒暑伤形。（喜怒伤内故伤气，寒暑伤外故伤形。举喜
怒言，则悲忧恐同矣。举寒暑言，则燥湿风同矣。上文言寒伤形、热伤气，与此二句似乎不同，盖彼以阴阳分形气，此
以内外分形气也。）暴怒伤阴，暴喜伤阳。（气为阳，血为阴。肝藏血，心藏神。暴怒则肝气逆而血乱，故伤阴。暴喜则
心气缓而神逸，故伤阳。如行针篇曰∶多阳者多喜，多阴者多怒。亦各从其类也。）厥气上行，满脉去形。（厥，逆也。
言寒暑喜怒之气，暴逆于上，则阳独实，故满脉。阳亢则阴离，故去形。此孤阳之象也。脉经曰∶诸浮脉无根者死。有
表无里者死。其斯之谓。）喜怒不节，寒暑过度，生乃不固。（固，坚也。）故重阴必阳，重阳必阴。（重者，重叠之义，
谓当阴时而复感寒，阳时而复感热，或以天之热气伤人阳分，天之寒气伤人阴分，皆谓之重。盖阴阳之道，同气相求，
故阳伤于阳，阴伤于阴；然而重阳必变为阴证，重阴必变为阳证，如以热水沐浴身反凉，凉水沐浴身反热，因小可以喻
大，下文八句，即其征验。此与上文重寒则热、寒极生热，义相上下，所当互求。重，平声。）故曰∶冬伤于寒，春必病
温；（冬伤于寒者，以类相求，其气入肾，其寒侵骨。其即病者，为直中阴经之伤寒；不即病者，至春夏则阳气发越，营
气渐虚，所藏寒毒，外合阳邪而变为温病。然其多从足太阳始者，正以肾与膀胱为表里，受于阴而发于阳也。愚按∶伤
(Su Wen: Si Qi Tiao Shen Da Lun, continuing from the previous chapter)
Therefore, the sage does not treat disease after it has formed, but prevents it before it forms; nor does he govern chaos after it has occurred, but prevents it before it occurs. This is what is meant by this. (This continues the previous chapter to discuss the preventive approach of the sage. Treating before symptoms manifest requires less effort and achieves more success, demonstrating that one remains vigilant against danger in times of peace.) If medication is administered only after illness has developed, or governance is applied only after disorder has arisen, it is akin to digging a well only when thirsty, or forging weapons only when battle begins. Is this not too late? (Digging a well when thirsty cannot quench the thirst; forging weapons during combat cannot aid the fight. Indeed, it is too late. Those who do not plan for illness early are no different. Consider Bian Que’s first meeting with Duke Huan of Qi: "You have an ailment, located in the skin and muscles (Cou Li). If untreated, it will deepen." Five days later, he returned: "Your ailment is now in the blood vessels. If untreated, it will deepen." Five days later again: "Your ailment is now in the intestines and stomach. If untreated, it will deepen." Yet Duke Huan ignored him. Five days later, upon seeing the Duke, Bian Que turned and fled, stating: "When the disease is in the skin and muscles, hot compresses can reach it; in the blood vessels, acupuncture and stone needles can reach it; in the intestines and stomach, medicinal wines can reach it; but if it reaches the bone marrow, even the God of Life cannot help." Five days later, Duke Huan fell ill and sent for Bian Que, but Bian Que had already left, and the Duke died. By not heeding Bian Que earlier and summoning him only when the disease was deep, Duke Huan exemplified digging a well when thirsty and forging weapons in battle. Thus, sages focus on preventing disease and disorder before they arise, ensuring disaster does not invade and life is preserved. Today, many people conceal their condition until it becomes incurable. Even with a divine healer like Bian Que, there would be nothing to be done, let alone ordinary physicians. Alas! Disaster begins in the minute, and danger arises from the slight. Those who can anticipate this are said to practice "treating undiseased" (Zhi Wei Bing); those who cannot are said to "treat diseased" (Zhi Yi Bing). Those who understand destiny are cautious in the minutiae.)
(Su Wen: Yin Yang Ying Xiang Da Lun)
The Yellow Emperor said: Yin and Yang are the principles of Heaven and Earth, (Dao refers to the logic of Yin and Yang. Yin and Yang represent division into two. Taiji moves to generate Yang, and rests to generate Yin. Heaven arises from movement, and Earth from stillness; thus, Yin and Yang are the principles of Heaven and Earth.) the general code of all things, (Large is called Gang [net rope], small is called Ji [threads]. Collectively, it is the net rope; universally, it is the threads. No matter how large or small, all things follow it, making it the general code of all things. Wang Shi stated it is the function of nourishment: Yang provides righteous Qi for growth, while Yin provides support for establishment.) the parents of change, (Tian Yuan Ji Da Lun states: Generation of things is called Hua [transformation]; extremity of things is called Bian [variation]. The I Ching says: Images form in Heaven, shapes form on Earth, and changes are revealed. Zhu Xi said: Bian is the gradual process of Hua, and Hua is the completion of Bian. Yin can transform into Yang, and Yang can transform into Yin. Although changes are manifold, they all originate from Yin and Yang, hence they are called parents.) the root and beginning of life and death, (The way of life and death is merely Yin and Yang. When Yang arrives, things live; when Yang departs, things die. After Winter Solstice, the sun moves from south to north, termed "arrival." Arrival brings Spring as the start of Yang, Summer as the peak of Yang. Start of Yang brings warmth, which generates life; peak of Yang brings heat, which promotes growth. After Summer Solstice, the sun moves from north to south, termed "departure." Departure brings Autumn as the start of Yin, Winter as the peak of Yin. Start of Yin brings coolness, which harvests things; peak of Yin brings cold, which stores things. This is the way of Yin and Yang regarding life and death. However, as stated below: "Yang generates, Yin grows; Yang kills, Yin stores." Thus, Yang can also kill, and Yin can also grow. Liu Jie Zang Xiang Lun states: The root of life lies in Yin and Yang. Thus, Yin can also generate. What is generated by Yang can be killed by Yin, and what is generated by Yin can be killed by Yang. All life and death depend on this, hence it is called the root and beginning. Ben means root; Shi means beginning and end.) the mansion of Spirit and Brilliance, (Shen refers to unpredictable changes. Ming refers to the visible phenomena of the three luminaries [sun, moon, stars]. Fu is a repository for storing things. Spirit and Brilliance emerge from Yin and Yang; therefore, Yin and Yang are the mansion of Spirit and Brilliance. From the opening words "Yin and Yang," the meaning runs continuously to here and should be studied integrally. Tian Yuan Ji Da Lun contains similar sentences, see Yun Qi Lei Chapter 3.) In treating disease, one must seek the root. (Ben refers to the origin of disease. Human diseases may be in the exterior or interior, cold or hot, caused by the Five Movements and Six Qi, or damaging the Zang-Fu organs and meridians. None escape the influence of Yin and Yang Qi, all having a root. Some root in Yin, some in Yang. Although manifestations vary, the root is one. Knowing where the disease originates and where the disorder arises, and directly targeting them, is the Way of Unity. It is like cutting wood by pulling its root; then thousands of branches and leaves will follow. If one only treats symptoms without seeking the cause, the flow will be endless. This is what Scholar Xu described as casting a wide net in the wilderness hoping to catch one person—indeed, too negligent.) Therefore, accumulated Yang becomes Heaven, and accumulated Yin becomes Earth. (The forms and images of Yin and Yang differ in size. Form and Qi generation require accumulation to become dense. Thus, Yang must accumulate to become vast and form Heaven; Yin must accumulate to become dense and form Earth.) Yin is quiet, Yang is restless, (Yin nature is soft; Yang nature is rigid.) Yang generates, Yin grows; Yang kills, Yin stores. (This is the meaning of the Four Images. "Yang generates, Yin grows" refers to Yin within Yang; "Yang kills, Yin stores" refers to Yang within Yin. Yang cannot stand alone; it requires Yin to complete it. For example, germination relies on Yang's harmony, while nourishment depends on rain and dew—this is Yang generates, Yin grows. Yin cannot act independently; it requires Yang to move. For example, storage is due to cold, while desiccation comes from wind and frost—this is Yang kills, Yin stores. Within this duality, there is mutual containment: solitary Yang does not generate, solitary Yin does not form. Tian Yuan Ji Da Lun states: "Heaven uses Yang to generate and Yin to grow; Earth uses Yang to kill and Yin to store." The meaning is identical. See Yun Qi Lei 3 for cross-reference. One interpretation: The harmonious aspect of Yang is germination; the harmonious aspect of Yin is fruition, hence "Yang generates, Yin grows." The excessive aspect of Yang is scorching and withering; the coagulating aspect of Yin is closure, hence "Yang kills, Yin stores." This discusses the benevolent and malevolent aspects of Yin and Yang, which is also valid.) Yang transforms into Qi, Yin forms into Shape. (Yang moves and disperses, thus transforming into Qi. Yin is still and coagulates, thus forming Shape.) Extreme cold generates heat; extreme heat generates cold. (Cold is Yin, Heat is Yang, which are the righteous energies of Yin and Yang. Extreme cold generating heat is Yin transforming into Yang; extreme heat generating cold is Yang transforming into Yin. Shao Zi said: At the beginning of movement, Yang is born; at the extremity of movement, Yin is born. At the beginning of stillness, softness is born; at the extremity of stillness, rigidity is born. This reflects the I Ching principle that old lines change while young lines remain static. For instance, contracting cold results in feverish illness—originally cold, transformed into heat. Internal heat becoming extreme leads to chills—originally heat, transformed into cold. Thus, the principle of Yin and Yang dictates transformation at extremes.) Cold Qi generates turbid Yin; Hot Qi generates clear Yang. (Cold Qi stagnates, thus generating turbid Yin. Hot Qi ascends and disperses, thus generating clear Yang.) If clear Yang stays below, Sunc Xie [diarrhea with undigested food] occurs; if turbid Yin stays above, Zhang Man [distension/fullness] occurs. (Clear Yang governs ascending. If Yang Qi is deficient below and cannot ascend, Sunc Xie results. Turbid Yin governs descending. If Yin Qi stagnates above and cannot descend, distension results. Sunc Xie refers to diarrhea with undigested food. Zhang Man refers to chest and diaphragm fullness. Sunc sounds like 'sun'. Zhang sounds like 'chen'.) This is the reversal of Yin and Yang, representing the deviation and compliance of disease. (Zuo means acting. This phrase connects to the preceding text on seeking the root in treatment. Such as Yin growing, Yang killing, cold generating heat, heat generating cold, clear below, turbid above—all are reversals of Yin and Yang, indicating deviation. Compliance is following the norm; deviation is opposing it. Though different, both have a root, so one must seek the root to treat.)
Thus, clear Yang is Heaven, turbid Yin is Earth; Earth Qi rises to become Clouds, Heaven Qi descends to become Rain; Rain emerges from Earth Qi, Clouds emerge from Heaven Qi. (This section discusses the ascending and descending of Yin-Yang essence to show the unity of Heaven and Humanity. Heaven and Earth are the physical forms of Yin and Yang. Clouds and Rain are the essence of Heaven and Earth. Yin below is Essence, which is Water. When Essence ascends, it transforms into Qi, and Clouds emerge from Rain. Yang above is Qi, which is Cloud. When Qi descends, it transforms into Essence, and Rain is born from Clouds. Ascending from below is Earth interacting with Heaven, hence Earth Qi rises to become Clouds, also said as Clouds emerge from Heaven Qi. Descending from above is Heaven interacting with Earth, hence Heaven Qi descends to become Rain, also said as Rain emerges from Earth Qi. Liu Wei Zhi Da Lun states: "After ascending, it descends; the descender is Heaven. After descending, it ascends; the ascender is Earth. Heaven Qi descends, Qi flows into Earth; Earth Qi ascends, Qi rises to Heaven." This shows that the ascending and descending of Heaven and Earth are called Clouds and Rain; the ascending and descending of the human body are called Essence and Qi. The unity of Heaven and Humanity is most evident here. See Chapter 4 for detailed meaning of Qi and Water being of the same category.) Thus, clear Yang exits through the upper orifices, turbid Yin exits through the lower orifices; (Things originating from Heaven tend upward; things originating from Earth tend downward. Upper orifices number seven: ears, eyes, mouth, nose. Lower orifices number two: anterior and posterior yin openings.) Clear Yang issues into the Cou Li [skin and interstices], turbid Yin travels to the Zang organs; (Cou Li refers to the muscular surface. Yang disperses into the skin, so clear Yang belongs there. Yin receives Qi from the Zang organs, so turbid Yin travels there. Cou sounds like 'cou'.) Clear Yang fills the four limbs, turbid Yin returns to the Fu organs. (The four limbs are the root of Yang, so clear Yang fills them. The six Fu organs transmit and transform water and grain, so turbid Yin returns to them.) Water is Yin, Fire is Yang, (Water flows downward and is cold, thus Yin. Fire flares upward and is hot, thus Yang. Water and Fire are the symbols of Yin and Yang; Yin and Yang are the nature of Water and Fire. The Qi of all things in Heaven and Earth is always the operation of Water and Fire. Thus, Heaven regards Sun and Moon as Water and Fire; I Ching regards Kan and Li as Water and Fire; Medicine regards Heart and Kidney as Water and Fire; Daoism regards Essence and Qi as Water and Fire. Kidney is Water; Qi generated within Water is True Fire. Heart is Fire; Fluid generated within Fire is True Water. Water and Fire mutually contain each other, which is the location of the Great Dao. Physicians must first examine this.) Yang is Qi, Yin is Flavor. (Qi is formless and ascends, thus Yang. Flavor has substance and descends, thus Yin. This refers to the aroma and flavor of medicine and food.) Flavor returns to Shape, Shape returns to Qi, (Gui means to rely on or conform to. The five flavors generate essence and blood to form Shape, thus Flavor returns to Shape. The survival or demise of Shape depends on the gathering or scattering of Qi, thus Shape returns to Qi.) Qi returns to Essence, (Qi refers to True Qi, received from Heaven and combined with Grain Qi to nourish the body. Human essence and blood are transformed from Qi, thus Qi returns to Essence.) Essence returns to Transformation. (Essence is Kan Water. Heaven generates Water as the first of the Five Elements. Thus, at the beginning of creation, forms are all Water. From Essence, Qi is transformed; from Qi, Spirit is transformed. Water is the source of all transformations, thus Essence returns to Transformation.) Essence feeds on Qi, Shape feeds on Flavor, (Shi means feeding, like a child nursing from milk. Qi returns to Essence, thus Essence feeds on Qi. Flavor returns to Shape, thus Shape feeds on Flavor.) Transformation generates Essence, (All things' transformation begins with Essence, thus Transformation generates Essence. The previous statement "Essence returns to Transformation" refers to Essence being the source before transformation. This statement "Transformation generates Essence" refers to Essence being generated after transformation.) Qi generates Shape. (When Qi gathers, Shape is born; when Qi scatters, Shape dies.) Flavor damages Shape, Qi damages Essence, (Since Flavor returns to Shape, unregulated Flavor will damage Shape. Since Qi returns to Essence, imbalanced Qi will damage Essence.) Essence transforms into Qi, (Essence transforming into Qi refers to Yuan Qi [Original Qi] being generated from Essence. Zhu Yu Ji states: Water is the ancestor of the Three Realms; Essence is the root of Yuan Qi. The meaning is as such. Although the text previously stated "Qi returns to Essence" (Qi generates Essence), and here states "Essence transforms into Qi" (Essence generates Qi), these seem opposite but actually reflect the mutual root of Essence and Qi, corresponding to the Heaven-Earth Cloud-Rain analogy. Yang transforms into Qi, analogous to Clouds; Yin forms into Shape, analogous to Rain. Rain falls from Heaven's clouds, not rising from Earth—this is Qi returning to Essence. Clouds rise to Heaven from Earth's Qi, not originating in Heaven—this is Essence transforming into Qi. Human Essence and Qi operate exactly thus. Thus, Qi gathering makes Essence abundant; Essence abundance makes Qi strong. When Essence and Qi are sufficient, Shape becomes strong. The Emperor mentioned Clouds and Rain first to demonstrate the ascending and descending of Essence and Qi. (Qi is damaged by Flavor.) As stated before, Flavor damages Shape; thus, when Shape is damaged, Qi is inevitably damaged. For example, excessive sour flavor causes Liver Qi to flood and Spleen Qi to cease—these are cases of Flavor damaging Qi.) Yin Flavor exits through the lower orifices, Yang Qi exits through the upper orifices. (Flavor is Yin, thus descends; Qi is Yang, thus ascends.) Strong Flavor is Yin, weak Flavor is Yang within Yin; Strong Qi is Yang, weak Qi is Yin within Yang. (This discusses the Yin-Yang of aroma and flavor, showing that within Yin and Yang, there are further Yin and Yang. Flavor is Yin, but strong flavor is Pure Yin, while weak flavor is Yang within Yin. Qi is Yang, but strong Qi is Pure Yang, while weak Qi is Yin within Yang.) Strong Flavor causes purgation, weak Flavor promotes circulation; Weak Qi causes sweating/dispersal, Strong Qi causes fever. (Yin Flavor moves downward, so strong Flavor can purge downwards, while weak Flavor can promote free flow. Yang Qi moves upward, so weak Qi can disperse outwardly, while strong Qi causes fever.) Vigorous Fire diminishes Qi, Mild Fire strengthens Qi. Vigorous Fire consumes Qi, Qi consumes Mild Fire; Vigorous Fire scatters Qi, Mild Fire generates Qi. (Fire is the Yang Qi of Heaven and Earth. Without this Fire, Heaven cannot generate things; without this Fire, humans cannot sustain life. Thus, all life stems from Yang Qi. However, harmonious Fire generates life, while excessive Fire harms life. Thus, excessive Fire causes Qi to decline, while balanced Fire allows Qi to strengthen. Vigorous Fire scatters Qi, hence it is said to "consume" Qi, meaning Fire eats Qi. Mild Fire generates Qi, hence it is said Qi "consumes" Fire, meaning Qi feeds on Fire. Although this follows the discussion of aroma and flavor, the principle of creation is that little leads to strength, and excess leads to decline, naturally so, not just regarding aroma and flavor.) Pungent and Sweet flavors that disperse and diffuse are Yang; Sour and Bitter flavors that induce vomiting and purgation are Yin. (This discusses the Yin-Yang of standard flavors. Pungent disperses, Sweet relaxes, thus affecting the muscle surface. Sour astringes, Bitter purges, thus causing vomiting or diarrhea. Yong [urge/vomit] is synonymous with...)
If Yin prevails, Yang becomes diseased; if Yang prevails, Yin becomes diseased. (This section discusses diseases caused by Yin-Yang excess. Disharmony between Yin and Yang leads to excess and deficiency, both capable of causing disease.) Yang excess results in Heat, Yin excess results in Cold. (Caused by excess.) Extreme Cold manifests as Heat, Extreme Heat manifests as Cold. (Extremes lead to transformation. This aligns with "Extreme cold generates heat, extreme heat generates cold." Yin and Yang Qi: Water extreme resembles Fire, Fire extreme resembles Water. Yang excess blocks Yin, Yin excess blocks Yang. Thus, there is true cold with false heat, and true heat with false cold. Misidentifying these leads to life or death instantly. Chong [extreme/repeated], pronounced flat tone.) Cold damages Shape, Heat damages Qi. (Cold is Yin, Shape is also Yin; Cold causes Shape to waste, thus damaging Shape. Heat is Yang, Qi is also Yang; Heat causes Qi to scatter, thus damaging Qi.) Qi injury causes Pain, Shape injury causes Swelling. (Qi desires smooth flow, so injury causes pain. Shape has substance, so injury causes swelling.) Therefore, pain followed by swelling indicates Qi damaging Shape; swelling followed by pain indicates Shape damaging Qi. (Qi disease precedes and affects Shape, hence Qi damages Shape. Shape disease precedes and affects Qi, hence Shape damages Qi.) Wind excess causes Tremors, (Wind excess causes shaking and trembling illnesses, such as Yi He's description of Wind invading the extremities.) Heat excess causes Swelling, (Heat excess causes erysipelas and abscesses, such as Yi He's description of Yang excess heat diseases.) Dryness excess causes Dryness, (Dryness excess causes withered fluids and internal/external dryness.) Cold excess causes Floating/Puffiness, (Cold excess impedes Yang Qi, causing distension and puffiness, such as Yi He's description of Yin excess cold diseases.) Dampness excess causes Loose Stools. (Spleen dislikes Dampness and prefers Dryness. Dampness excess invades Spleen and Stomach, causing indistinguishable water and grain loose stools, such as Yi He's description of Rain excess abdominal diseases. Ru sounds like 'ru', meaning damp stagnation.) Heaven has Four Seasons and Five Elements, which govern Growth, Flourishing, Harvesting, and Storage, generating Cold, Heat, Dryness, Dampness, and Wind. (Four Seasons: Spring, Summer, Autumn, Winter. Five Elements: Wood, Fire, Earth, Metal, Water. Combined: Spring belongs to Wood and governs Growth, transformed by Wind; Summer belongs to Fire and governs Flourishing, transformed by Heat; Late Summer belongs to Earth and governs Transformation, transformed by Dampness; Autumn belongs to Metal and governs Harvesting, transformed by Dryness; Winter belongs to Water and governs Storage, transformed by Cold. Each Element has one, except Fire which has Sovereign and Minister distinctions. The mention of Cold, Heat, Dryness, Dampness, and Wind refers to the transformations of the Five Elements. Wu Yun Yun Deng Lun mentions Cold, Heat, Dryness, Dampness, Wind, and Fire as the Six Qi.) Humans have Five Zang Organs, which transform Five Qi, generating Joy, Anger, Sorrow, Worry, and Fear. (Five Zang: Heart, Lung, Liver, Spleen, Kidney. Five Qi: Qi of the Five Zang. From Five Qi arise Five Emotions. As stated in this chapter and Wu Yun Yun Da Lun: Heart emotion is Joy, Liver emotion is Anger, Spleen emotion is Thought, Lung emotion is Worry, Kidney emotion is Fear. Tian Yuan Ji Da Lun also equates Sorrow with Thought.) Therefore, Joy and Anger damage Qi, Cold and Heat damage Shape. (Joy and Anger affect the interior, thus damaging Qi; Cold and Heat affect the exterior, thus damaging Shape. Mentioning Joy and Anger implies Sorrow, Worry, and Fear are similar. Mentioning Cold and Heat implies Dryness, Dampness, and Wind are similar. The previous text stated Cold damages Shape and Heat damages Qi, which seems different from these two sentences. That distinction separated Shape and Qi by Yin/Yang; this separates them by Interior/Exterior.) Violent Anger damages Yin, Violent Joy damages Yang. (Qi is Yang, Blood is Yin. Liver stores Blood, Heart stores Spirit. Violent Anger causes Liver Qi to rebel and Blood to become chaotic, thus damaging Yin. Violent Joy causes Heart Qi to slacken and Spirit to dissipate, thus damaging Yang. Xing Zhen Pian states: Those with much Yang are prone to Joy; those with much Yin are prone to Anger. Each follows its kind.) Jue Qi [Rebellious Qi] ascends, filling the vessels and separating from Shape. (Jue means rebellious. Rebellious Qi from Cold, Heat, Joy, and Anger surges upward, causing Yang to be exclusively excess, thus filling the vessels. Yang hyperactivity causes Yin to depart, thus separating from Shape. This is the image of solitary Yang. Mai Jing states: All floating pulses without root indicate death. Having exterior without interior indicates death. This is what is meant.) Unregulated Joy and Anger, Excessive Cold and Heat, and Life becomes unstable. (Gu means firm/stable.) Therefore, Double Yin must transform to Yang, Double Yang must transform to Yin. (Chong means overlapping. Refers to contracting Cold during Yin seasons or Heat during Yang seasons, or Heavenly Heat damaging Yang divisions, Heavenly Cold damaging Yin divisions. All are called Chong. The Way of Yin and Yang seeks similar energies; thus, Yang is damaged by Yang, Yin by Yin. However, Double Yang must transform into Yin syndrome, Double Yin into Yang syndrome. For example, bathing in hot water makes the body feel cool; bathing in cold water makes the body feel hot. Small examples illustrate large ones. The following eight sentences are evidence. This corresponds to the previous "Extreme cold generates heat, extreme cold generates heat," and meanings should be sought together. Chong, pronounced flat tone.) It is said: Injury to Cold in Winter leads to Warm Disease in Spring; (Injuring Cold in Winter, seeking similarity, the Qi enters the Kidney, and Cold invades the bones. Those who fall ill immediately suffer Direct Transmission Cold Damage to Yin Meridians. Those who do not fall ill immediately, when Spring and Summer arrive, Yang Qi expands, Ying Qi gradually depletes, and stored Cold Toxicity combines with external Yang Pathogens to transform into Warm Disease. However, it often starts from Foot Taiyang because Kidney and Bladder are interior-exterior pairs; receiving in Yin and manifesting in Yang. I note: Injury...)