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(Suwen: Zhensuo Yao Dalun)
The Yellow Emperor asked: What is the condition of diseases caused by the internal invasion of Heaven and Earth Qi? (Yin refers to excessive evil. Not adhering to its virtue is called Yin. Internal Yin means pathogenic factors enter from outside, and Qi overflows internally, referring to diseases caused by changes in the Zai Quan [Earthly Branch] Qi.) Qibo replied: When Jueyin Wind Wood is Zai Quan, and Wind overcomes excessively, the Earth Qi becomes unclear, the plains become dim, and grasses and trees sprout early; (Jueyin Zai Quan corresponds to Yin and Shen years. Wind overcoming on the ground causes Wood to overcome Earth, and Wind to overcome Dampness, raising dust, thus Earth Qi is unclear and plains are dim. Excess Wood Qi causes early sprouting.) People suffer from shivering chills, frequent groaning and yawning, heart pain, limb distension, tightness in both hypochondria, inability to swallow food, obstruction in the diaphragm and throat, vomiting after eating, abdominal distension with frequent belching. After defecation or passing gas, they feel relieved as if symptoms have subsided, but the body remains heavy. (According to the Jingmai Chapter, from shivering chills to frequent yawning belongs to Yangming Stomach disease; from vomiting after eating to heaviness of the body belongs to Taiyin Spleen disease. Moreover, the Jueyin Liver meridian passes through the diaphragm and spreads over the hypochondria, hence heart pain and limb distension etc., all due to Wood evil overcoming excessively and injuring the Spleen and Stomach.)

When Shaoyin Ministerial Fire is Zai Quan, Heat overcomes excessively, flames seem to float on rivers and marshes, dark places appear bright, and hibernating insects do not hide; (Shaoyin Zai Quan corresponds to Mao and You years. Ministerial Fire overcoming below causes flames to float on water bodies, dark places to appear bright, and hibernating insects not to hide.) People suffer from constant borborygmus in the abdomen, Qi rushing up to the chest, asthma unable to stand for long, alternating chills and fever, skin pain, closed eyes, toothache and swelling, chills and fever like malaria, lower abdominal pain, and abdominal enlargement. (Constant borborygmus is due to the movement of Fire Qi. Qi rushing to the chest is due to the flaming nature of Fire. Asthma and skin pain are due to Fire evil attacking the Lung. Closed eyes are due to severe heat and Yin deficiency, fearing sunlight. Loose teeth and swelling are due to Heat attacking the Yangming Meridian. Chills and fever like malaria indicate injury to Metal and Water, with struggle between Yin and Yang. Heat in the Lower Jiao causes lower abdominal pain. Heat in the Middle Jiao causes abdominal enlargement.)

When Taiyin Damp Earth is Zai Quan, grasses flourish early, and Dampness overcomes excessively, causing mist and gloom in rocky valleys, yellow appearing black, at the intersection of Extreme Yin; (Taiyin Zai Quan corresponds to Chen and Xu years. Earth is the basis for plants, so grasses flourish early. Rocky valleys are places of thick Earth, hence misty. Yellow is Earth color, Black is Water color. Earth overcoming Dampness makes yellow appear black. The Wuchang Zheng Dalun says: When Taiyin rules Heaven, Dampness descends, Kidney Qi ascends, and Black rises like Water change. This is the meaning of Earth confronting Water. Intersection of Extreme Yin refers to between the 3rd and 4th Qi periods, when Earth rules.) People suffer from fluid accumulation and heart pain, deafness, muffled voice, swollen throat, sore throat, bleeding from the lower part, lower abdominal pain and swelling, inability to urinate, Qi rushing causing headache, eyes feeling like popping out, neck feeling like being pulled, waist feeling like breaking, thighs unable to bend, knees feeling knotted, hips feeling separated. (Fluid accumulation and heart pain are Cold-Damp attacking the Heart. From deafness to sore throat belongs to Sanjiao Meridian disease according to Jingmai Chapter. From lower bleeding to inability to urinate is Yin Deficiency Kidney disease due to Dampness flowing downward. From headache to separation feeling belongs to Bladder Meridian disease. This is because Earth evil overcomes Water, and Kidney combines with Sanjiao and Bladder, all Water organs, so diseases affect them.)

When Shaoyang Ministerial Fire is Zai Quan, Fire overcomes excessively, flames shine brightly in suburbs, and chills and fever alternate; (Shaoyang Zai Quan corresponds to Si and Hai years. Ministerial Fire overcoming below causes bright flames. Extreme heat generates cold, hence alternating chills and fever.) People suffer from dysentery with red and white discharge, lower abdominal pain, red urine, and severely bloody stools, with pulse signs same as Shaoyin Zai Quan. (Heat injuring Blood leads to red discharge; Heat injuring Qi leads to white discharge. Heat in Lower Jiao causes lower abdominal pain, red urine, and bloody stools. Other diseases are same as Shaoyin Zai Quan.)

When Yangming Dryness Metal is Zai Quan, Dryness overcomes excessively, causing foggy, clear, and dim conditions; (Yangming Zai Quan corresponds to Zi and Wu years. Metal overcoming below causes dimness like fog, cold and obscure.) People suffer from frequent vomiting, bitter vomit, frequent sighing, heart and hypochondriac pain unable to turn sides, severely dry throat, dusty face, lack of luster on body, and heat on the outer side of feet. (According to Jingmai Chapter, bitter taste, sighing, heart/hypochondriac pain, dusty face, lack of luster, and foot heat belong to Foot-Shaoyang Gallbladder Meridian. Dry throat and dusty face belong to Jueyin Liver Meridian. This is because Metal evil overcomes, injuring Liver and Gallbladder.)

When Taiyang Cold Water is Zai Quan, Cold overcomes excessively, causing condensation, solemnity, and chilling fear; (Taiyang Zai Quan corresponds to Chou and Wei years. Water overcoming below causes chilling cold.) People suffer from lower abdominal pain pulling to testicles, connecting to waist and spine, rushing up to cause heart pain, bleeding, sore throat, and chin swelling. (Cold below injures its own kind, affecting Bladder and Kidney. Bladder is in abdomen, causing lower abdominal pain. Kidney governs yin organs, causing testicular pulling. Taiyang meridian runs along spine to waist, causing back pain. Kidney meridian connects to Heart, causing heart pain. Heart governs blood, Cold forces it, causing bleeding. Sore throat and chin swelling belong to Small Intestine Meridian, also due to Water evil insulting Fire.)

The Yellow Emperor said: Excellent. How to treat? (Below discusses treatment for Zai Quan excess.) Qibo said: For all Zai Quan Qi: If Wind overcomes internally, treat with Acrid-Cool, assist with Bitter-Sweet, use Sweet to relax, use Acrid to disperse; (Wind is Wood Qi, Metal overcomes it, so treat with Acrid-Cool. Too much Acrid may damage Qi, so assist with Bitter-Sweet. Bitter controls Acrid, Sweet tonifies Qi. Wood is urgent, so Sweet relaxes. Wind excess, so Acrid disperses. Zangqi Fashi Lun says: Liver suffers urgency, eat Sweet to relax. Liver desires dispersion, eat Acrid to disperse.) If Heat overcomes internally, treat with Salty-Cold, assist with Sweet-Bitter, use Sour to astringe, use Bitter to vent; (Heat is Fire Qi, Water overcomes it, so treat with Salty-Cold. Assist with Sweet-Bitter, Sweet controls Salty to prevent excess; Bitter drains to remove Heat excess. Heat in meridians not gathering, use Sour to astringe. Heat stagnated inside not resolving, use Bitter to vent.) If Dampness overcomes internally, treat with Bitter-Hot, assist with Sour-Light, use Bitter to dry, use Light to drain; (Dampness is Earth Qi, Dryness removes it, so treat with Bitter-Hot. Sour transforms from Wood, controlling Earth, so assist with Sour-Light. Bitter dries because it transforms from Fire. Light drains because it opens orifices. Zangqi Fashi Lun says: Spleen suffers Dampness, eat Bitter to dry.) If Fire overcomes internally, treat with Salty-Cold; assist with Bitter-Acrid, use Sour to astringe, use Bitter to vent; (Ministerial Fire fears Fire, so treat with Salty-Cold. Bitter drains Fire, Acrid disperses Fire, so used as assistance. Astringe with Sour, vent with Bitter, same principle as Heat treatment above.) If Dryness overcomes internally, treat with Bitter-Warm, assist with Sweet-Acrid, use Bitter to purge; (Dryness is Metal Qi, Fire overcomes it, treat with Bitter-Warm, Bitter transforms from Fire. Assist with Sweet-Acrid, Wood injured by Metal, Sweet relaxes; Metal's true flavor is Acrid, Acrid purges. Dryness blockage means excess inside, so purge with Bitter. Note: Below Dryness excess assists with Sour-Acrid, different from here Sweet-Acrid. Also Liuyuan Zhengji Dalun Zi/Wu year Yangming Zai Quan says purge with Sour-Warm, all different. Check Zangqi Fashi Lun: Lung suffers Qi rebellion, eat Bitter to drain. Use Sour to tonify, Acrid to purge. This is the distinction.) If Cold overcomes internally, treat with Sweet-Hot, assist with Bitter-Acrid, use Salty to purge, use Acrid to moisten, use Bitter to firm. (Cold is Water Qi, Earth overcomes Water, Heat overcomes Cold, so treat with Sweet-Hot, Sweet transforms from Earth, Hot from Fire. Assist with Bitter-Acrid etc., as Zangqi Fashi Lun says: Kidney suffers Dryness, eat Acrid to moisten. Kidney desires firmness, eat Bitter to firm. Use Bitter to tonify, Salty to purge.)

The Yellow Emperor said: Excellent. What about changes in Heavenly Qi? (Below discusses Bian Bing [diseases] from Si Tian [Heavenly Branch] excess.) Qibo said: When Jueyin Wind Wood rules Heaven, Wind overcomes excessively, the sky becomes dusty and dim, clouds and objects disturb, cold arises in Spring Qi, flowing water does not freeze, hibernating insects do not emerge; (Si-Hai years. Wind overcoming above causes sky dimness and cloud disturbance. Wind-Wood governs warmth, so cold arises in Spring and water doesn't freeze. However, Wind excess brings Metal control, Clear-Solid Qi acts, so insects don't emerge.) People suffer from epigastric pain at the heart center, extending to both hypochondria, obstruction in diaphragm/throat, inability to eat, stiff tongue root, vomiting after eating, cold diarrhea, abdominal distension, loose stool, mass formation, water retention, disease rooted in Spleen; (Epigastric pain etc. are Spleen diseases. According to Jingmai Chapter, stiff tongue, vomiting, epigastric pain, distension, loose stool/mass/water retention belong to Foot-Taiyin Spleen Meridian. This is Wood evil attacking Earth, so diseases root in Spleen.) Chongyang pulse vanishes, death untreatable. (Chongyang is Foot-Yangming Stomach pulse, on dorsal foot artery. Earth cannot overcome Wood, Spleen/Stomach Qi exhausts, Chongyang vanishes, hence death.)

When Shaoyin Ministerial Fire rules Heaven, Heat overcomes excessively, stifling heat arrives, Fire executes its administration, heavy rain approaches; (Zi-Wu years. Heat overcoming above causes Fire administration. Below Ministerial Fire, Yin Essence supports, so heavy rain approaches. Fu sound Fo, means stagnation.) People suffer from chest irritability and heat, dry throat, right-side fullness, skin pain, chills/fever cough/asthma, spitting blood/bloody stool, nasal congestion/sneezing/vomiting, urine color change, severely sores/swelling, shoulder/back/arm/clavicle pain, heart pain, Lung distension, abdominal fullness/bloating with cough/asthma, disease rooted in Lung; (Chest heat/dry throat etc. are Ministerial Fire flaming up, injuring Lung Metal. Metal governs Right, so right fullness. According to Jingmai Chapter, urine color change, shoulder/back/arm/clavicle pain, Lung distension/cough/asthma belong to Hand-Taiyin Lung Meridian. Nasal congestion, shoulder front pain belong to Hand-Yangming Large Intestine Meridian. Lung/Large Intestine are exterior-interior, Metal injured by Fire, so diseases root in Lung. Peng sound Peng.) Rize pulse vanishes, death untreatable. (Rize is Hand-Taiyin Lung pulse, in elbow crease artery. Metal cannot overcome Fire, Lung Qi exhausts, Rize vanishes, hence death.)

When Taiyin Damp Earth rules Heaven, Dampness overcomes excessively, deep Yin spreads at dawn, rain changes cause withering; Chou-Wei years. (Dampness overcoming above causes deep Yin spreading. Deep means deep. Deep Yin rain changes soak and harm, so things wither.) People suffer from edema, bone pain, Yin Bi. Yin Bi is pain unresponsive to pressure, with waist/spine/head/neck pain, occasional dizziness, difficult defecation, Yin Qi dysfunction, hunger without desire to eat, coughing/spitting blood, heart hanging sensation, disease rooted in Kidney; (Edema/bone pain etc. are Kidney Meridian diseases. According to Jingmai Chapter, waist/spine/head/neck pain belongs to Foot-Taiyang Bladder Meridian; hunger/no appetite, coughing blood, heart hanging belongs to Foot-Shaoyin Kidney Meridian. Kidney/Bladder are exterior-interior, Water overcome by Earth, so diseases root in Kidney. Wuxie Pian Yin Bi is similar, see Acupuncture Class 25.) Taixi pulse vanishes, death untreatable. (Taixi is Foot-Shaoyin Kidney pulse, behind medial malleolus artery. Water cannot overcome Earth, Kidney Qi exhausts, Taixi vanishes, hence death.)

When Shaoyang Ministerial Fire rules Heaven, Fire overcomes excessively, warm Qi circulates, Metal administration is uneven; (Yin-Shen years. Ministerial Fire overcoming above controls Metal, so warm Qi circulates, Metal administration uneven.) People suffer from headache, fever/chills like malaria, heat rising causing skin pain, yellow/red complexion, transmission to water disease, body/facial edema, abdominal fullness with仰息 (breathing with head thrown back), dysentery red/white, sores/coughing blood, vexation/chest heat, severely nasal congestion, disease rooted in Lung; (Ministerial Fire active, Metal Qi injured, guest heat burns inside, Water cannot control, hence these diseases, all root in Lung.) Tianfu pulse vanishes, death untreatable. (Tianfu is Hand-Taiyin Lung pulse, inner arm, 3 cun below axilla artery. Metal cannot overcome Fire, Lung Qi exhausts, Tianfu vanishes, hence death.)

When Yangming Dryness Metal rules Heaven, Dryness overcomes excessively, Trees flourish late, Grasses grow late, sinews/bones change internally, Great Cool changes climate, tall trees gather life below, grass tips wither, hibernating insects appear; (Mao-You years. Dryness Metal overcoming above controls Wood, so plant growth late. In humans, Liver Blood injured, cannot nourish sinews/bones, so internal changes. Metal Qi Great Cool changes generation climate, so plants react this way. Yangming Metal above, Shaoyin Fire below, so insects appear. Last four sentences moved from below Malaria section.) People suffer from left hypochondriac pain, cold clearing in middle, catching pathogen causing malaria, cough, borborygmus, dysentery loose stool, sudden heart/hypochondriac pain, unable to turn sides, dry throat, dusty face, waist pain, men's hernia, women's lower abdominal pain, eye ulcers, acne/abscesses, disease rooted in Liver; (Left hypochondriac pain etc. are Liver Meridian diseases, Wood governs Left. According to Jingmai Chapter, heart/hypochondriac pain unable to turn, dusty face belong to Foot-Shaoyang Gallbladder; waist pain unable to bend/extend, men's hernia, women's lower abdominal pain, dry throat/dusty face/sundried stool belong to Foot-Jueyin Liver. Liver/Gallbladder exterior-interior, Wood injured by Metal, so diseases root in Liver. Mu/Wu sounds. Tui sound Tui. Cuo sound He.) Taichong pulse vanishes, death untreatable. (Taichong is Foot-Jueyin Liver pulse, 2 cun behind big toe joint artery. Wood cannot overcome Metal, Liver Qi exhausts, Taichong vanishes, hence death.)

When Taiyang Cold Water rules Heaven, Cold overcomes excessively, Cold Qi returns, water freezes, if Fire transport is blazing, violent rain becomes hail; (Chen-Xu years, Cold overcoming above, Cold returns, water freezes. If meeting Fire transport blazing, Water/Fire clash, violent rain hail. These two sections old text seems inverted. Adjusted now.) People suffer from blood changes inside, developing abscesses, Juexin pain, vomiting blood/bloody stool/nasal congestion, frequent sadness, occasional dizziness/fainting, chest/abdominal fullness, hand heat/elbow cramping/armpit swelling, heart palpitations, chest/hypochondrium/epigastrium unrest, red face/yellow eyes, frequent belching/dry throat, severely dark complexion, thirst wanting drink, disease rooted in Heart. (Cold Water excess evil attacks Heart, hence blood changes/abscesses etc. According to Jingmai Chapter, hand heat, arm/elbow cramping, armpit swelling, chest/hypochondrium fullness, heart palpitations, red face/yellow eyes belong to Hand-Jueyin Pericardium Meridian. Fire injured by Cold, so diseases root in Heart. Dan same as Dan. Tai sound Tai, scorched black.) Shenmen pulse vanishes, death untreatable. (Shenmen is Hand-Shaoyin Heart pulse, end of sharp bone on palm artery. Fire cannot overcome Water, Heart Qi exhausts, Shenmen vanishes, hence death.) So-called Dong Qi (Moving Qi), know the Zang. (Dong Qi means Qi arrival pulse movement. Observing presence/absence of moving pulse knows Zang Qi survival/death. This summarizes six Qi disease changes.)

The Yellow Emperor said: Excellent. How to treat? (Below discusses Si Tian excess treatment.) Qibo said: Si Tian Qi: If Wind overcomes excessively, level with Acrid-Cool, assist with Sweet-Bitter, use Sweet to relax, use Sour to purge; (Wind above, level Acrid-Cool, assist Bitter-Sweet, Sweet relax, same as Zai Quan above. Sour purge, Wood's true flavor, purge with Sour. Meaning seen later.) If Heat overcomes excessively, level with Salty-Cold, assist with Bitter-Sweet, use Sour to astringe; (Same as Zai Quan above, but lacks "vent with Bitter", later Fire excess mentions it, so meaning same.) If Dampness overcomes excessively, level with Bitter-Hot, assist with Sour-Acrid, use Bitter to dry, use Light to drain; (Same as Zai Quan above, only assist Sour-Acrid differs from Sour-Light, Acrid controls Sour to prevent excess, so used as assist.) If Dampness is high/severe and hot, treat with Bitter-Warm, assist with Sweet-Acrid, stop when sweating occurs; (Damp high/severe hot is Damp stagnating above becoming Heat, treat Bitter-Warm to dry. Assist Sweet-Acrid to disperse. Dry and disperse, so upper Damp-Heat stops with sweat.) If Fire overcomes excessively, level with Salty-Cold, assist with Sweet-Bitter, use Sour to astringe, use Bitter to vent, use Sour to restore, Heat excess same; (Same as Zai Quan Heat. Water overcomes Fire, level Salty-Cold. Bitter drains Fire excess, Sweet relieves Fire urgency, assist Bitter-Sweet. Fire excess scattering, Sour astringes. Fire stagnated hidden, Bitter vents. But venting Fire damages Qi, so Sour restores. Fire/Heat treated together.) If Dryness overcomes excessively, level with Bitter-Warm (Text error Bitter-Wet should be Bitter-Warm), assist with Sour-Acrid, use Bitter to purge; (Same as Dryness inside above, but there Sweet-Acrid, here Sour-Acrid differs, see note before Dryness excess. Bitter-Wet error, should be Bitter-Warm.) If Cold overcomes excessively, level with Acrid-Hot, assist with Bitter-Sweet, use Salty to purge. (Acrid-Hot sufficient to scatter Cold, Bitter-Sweet can overcome Water. Salty purge, Water's true flavor, purge with Salty. Same as Zai Quan, text inverted, see Cold inside note.)