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Huangdi asked: What is meant by the distribution of Qi in the upper and lower parts? Qibo replied: The upper half of the body, its Qi is divided into three categories, belonging to the domain of Heaven, governed by Heavenly Qi; the lower half of the body, its Qi is also divided into three categories, belonging to the domain of Earth, governed by Earthly Qi. (The upper and lower aspects of Qi refer to the Si Tian [Supreme Sovereign] and Zai Quan [Inferior Sovereign] influences, which correspond to the human body. Thus, in the upper half, there are three Yang Qi and three Yin Qi, corresponding to the Six Hand Meridians [Six Hand Jueyin, Shaoyang, Taiyang, Yangming, Shaoyin, Taiyin], aligning with the domain of Heaven, hence governed by Heavenly Qi. In the lower half, similarly, there are three Yang Qi and three Yin Qi, corresponding to the Six Foot Meridians [Six Foot Jueyin, Shaoyang, Taiyang, Yangming, Shaoyin, Taiyin], aligning with Earthly Qi, hence governed by Earthly Qi. The *Suwen: Liujie Cangxiang Lun* also states "its Qi is three"; three constitute Heaven, three constitute Earth, and three constitute Humanity, reflecting the principle of Three Yin and Three Yang.) By naming, we define the Qi; by Qi, we define the location, thereby discussing disease. The term "half" refers to the Tianshu point (ST25) (Tianshu [Heavenly Pivot]). (Naming defines Qi, meaning that once a name is established, Qi has its affiliation; for example, Three Yin and Three Yang are names, and once established, each of the Six Qi has its specific governance. Defining location by Qi means that the Qi of the Six Meridians each has its own position. Observing the Qi allows one to know the locations of disease internally/externally, anterior/posterior, superior/inferior, and lateral. "Half" refers to the midpoint of the body. From the perspective of the human body, this extends anteriorly to the umbilicus and posteriorly to the waist. Therefore, the acupoint located two cun lateral to the umbilicus is named Tianshu [Heavenly Pivot], precisely taking the meaning of the body's midpoint. For further details on Tianshu, see Item 9 in this category earlier.) When the superior part experiences excessive Qi causing disease throughout the inferior part, it is named according to Earthly Qi; when the inferior part experiences excessive Qi causing disease throughout the superior part, it is named according to Heavenly Qi. (When superior Qi is excessive, the inferior becomes deficient and diseased, which is termed Earthly Qi pathology. When inferior Qi is excessive, the superior becomes deficient and diseased, which is termed Heavenly Qi pathology. The *Suwen: Liuyuan Zhengji Dalun* states: "When Heavenly Qi is insufficient, Earthly Qi follows; when Earthly Qi is insufficient, Heavenly Qi follows." This is what is meant here.) When the pathogenic factor of excess (Sheng) arrives, the retaliatory factor (Fu) remains suppressed and unmanifested. When the retaliatory factor arrives, it is no longer distinguished by different names of Heaven and Earth, but is treated according to the principles of the retaliatory factor. (Whenever disease arises from an excess factor, it is because the retaliatory factor has not yet emerged. Thus, if the disease is in the upper part, treatment seeks the influence of Heaven; if in the lower part, it seeks the influence of Earth. If the retaliatory factor has already arrived, one does not use different names for Heaven and Earth, but only seeks the location of the retaliatory factor and determines treatment based on its severity. As discussed in the previous chapter regarding the treatment of the six Qi retaliations, and as stated below: "Regarding the retaliation of Qi, if mild, level it; if violent, drain it." These are methods for treating retaliatory Qi.) Huangdi said: Do the movements of excess and retaliation follow fixed temporal patterns? Is there a necessity to the Qi? Qibo replied: There are fixed temporal positions, but the Qi itself is not fixed/necessary. (Time has fixed regularity, but Qi does not have absolute necessity, as explained below.) Huangdi said: I wish to hear the principle. Qibo replied: From the First Qi to the Third Qi, Heavenly Qi governs, which is the normal pattern of excess; from the Fourth Qi to the Final Qi, Earthly Qi governs, which is the normal pattern of retaliation. (Before the middle of the year, Heavenly Qi governs; after the middle of the year, Earthly Qi governs. Excess comes first, retaliation follows. Thus, from the First Qi to the Third Qi is the period governed by Si Tian [Supreme Sovereign]. If excessive, it overcomes what it does not overcome; if deficient, the excess factor comes to overcome. This is the normal pattern of excess. From the Fourth Qi to the Final Qi is the period governed by Zai Quan [Inferior Sovereign]. If excessive, the controlling factor rises to restrain it; if deficient, the child Qi retaliates for the mother Qi. This is the normal pattern of retaliation. Hence, it is said that time has fixed positions.) Where there is excess, there is retaliation; where there is no excess, there is no retaliation. (Where there is excess, there must be retaliation; where there is no excess, there is no retaliation. The *Suwen: Wuchang Zheng Dalun* states: "Mild excess leads to mild retaliation; severe excess leads to severe retaliation." This shows that excess and retaliatory Qi may or may not exist, and may be mild or severe, with varied changes; hence, it is said that Qi is not fixed/necessary.) Huangdi said: Excellent. What happens if excess occurs after retaliation? Qibo replied: When excess arrives, retaliation follows. There is no fixed number; it stops only when the Qi declines. (Excess after retaliation means that after retaliation has occurred, excess arises again. When excess arrives, retaliation follows, meaning another excess leads to another retaliation, with no fixed number originally. The variation of excess and retaliation depends on Qi. If Qi is abundant but excess and retaliation are mild, it indicates Qi is not exhausted, so it inevitably undergoes further excess and retaliation. If excess and retaliation are severe, both sides' Qi will be exhausted, so it stops when Qi declines.) If excess occurs after retaliation and there is no retaliation, harm will result, damaging life. (If there is excess without retaliation, it will become hyperactive and harmful, thus damaging life.) Huangdi said: Why does retaliation sometimes cause illness instead? Qibo replied: Because the retaliatory Qi resides in a position that is not its own, and they do not harmonize. If one vigorously restores to overcome the excess, the host Qi will overcome it, causing illness instead. (Retaliation causing illness means the retaliatory Qi harms itself. If the retaliatory Qi resides in a non-appropriate position, the guest and host Qi do not harmonize. If one vigorously retaliates against the excess, strength is exhausted leading to deficiency, allowing the Host Qi to take advantage of the deficiency, thus suffering illness instead.) This specifically refers to Fire, Dryness, and Heat. (This refers to residing in a non-appropriate position. Fire refers to Shaoyang [Lesser Yang]; Dryness refers to Yangming [Greater Yang]; Heat refers to Shaoyin [Lesser Yin]. When Shaoyang and Shaoyin are Zai Quan [Inferior Sovereign], the guest Fire Qi occupies the host Water position. If Fire Qi retaliates strongly, the host Water Qi overcomes it. When Yangming is Si Tian [Supreme Sovereign], the guest Metal Qi occupies the host Fire position. If Metal Qi retaliates strongly, the host Fire Qi overcomes it. For other Qi excess/retaliation, there is no such counter-illness caused by host Qi overcoming, hence it is said that this applies to Fire, Dryness, and Heat. Note: This discusses illness caused by retaliation, although Dryness precedes the Third Qi and is not normally the time for retaliation. However, stating retaliation implies excess can be known. Thus, when excess Qi is incompatible, counter-illness may also occur; this applies to both Heaven and Earth Qi.) Huangdi said: How should it be treated? Qibo replied: Regarding excess Qi, if mild, follow its trend; if severe, control it. Regarding retaliatory Qi, if mild, balance it; if violent, drain it. All treatments should follow the excess Qi, pacify the suppressed Qi, regardless of the number of occurrences, aiming for balance. This is the principle. (This summarizes the treatment for mild and severe excess and retaliation. Following the trend of the mild means accommodating the Qi to stabilize it. Controlling the severe means restraining it with what it fears. Balancing the mild means regulating slight pathogenic factors. Draining the violent means purging strong excess. By treating according to the excess Qi, the suppressed Qi can be stabilized. One need not count the number of times, but aim for balance, which is the way of handling Qi excess. The phrase "all follow the excess Qi" does not refer solely to excess Qi; when retaliatory Qi arrives, it is also excessive, so this includes both. The treatment principles in this section should be read in conjunction with the previous chapter on treating various Qi retaliations.) Huangdi said: Excellent.