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(Suwen: Yi Jing Bian Qi Lun)

The Yellow Emperor said: I wish to face patients, observe their life and death prognoses, resolve doubtful cases, and grasp the essentials so that they are as clear and evident as the sun and moon. May I hear about this? (By "as clear as the sun and moon," it is desired that the diagnostic results be obvious and easy to perceive.) Qibo replied:

Observing complexion (Se, facial color) and palpating pulses (Mai, pulse) are highly valued by ancient sage-kings and transmitted by former masters. (This means that to achieve a state of clarity like the sun and moon, there is nothing more important than mastering complexion and pulse. "Shangdi" refers to the emperors of antiquity. "Former masters" refers to Jiudaiji mentioned later in the text.) In ancient times, [the emperor] sent Jiudaiji to study the laws of complexion and pulse and to comprehend the spirit-like functions of the body, integrating them with the Five Elements (Wu Xing: Metal, Wood, Water, Fire, Earth), the four seasons, the eight winds, and the six directions, without deviating from normal patterns. (Studying complexion and pulse is to inspect the subtle essence inside and outside the body; comprehending the spirit-like functions means that by distinguishing complexion and pulse, one can perceive the mysteries of life. The responses of complexion and pulse align everywhere with nature, just as the rise and fall of the Five Elements, the succession of seasons, the changes of the eight winds, and the vastness of the six directions all follow fixed laws of waxing and waning.) When these natural factors change and shift, we can observe their subtleties and grasp their essentials through the changes in complexion and pulse. To grasp the essentials, one must focus on complexion and pulse. (Because the qi of the Five Elements, four seasons, and eight winds alternately wax and wane, causing corresponding changes in the human body, complexion and pulse respond accordingly. Thus, one can observe the subtleties and grasp the essentials through them. For all the five zang organs, six fu organs, bones, joints, and orifices of the human body, the pulse is governed by qi, and qi conforms to Heaven. Although these are deep, subtle, and hard to fathom, only through complexion and pulse can they be inspected. Therefore, it is said that to grasp the essentials, one must focus on complexion and pulse.) Complexion corresponds to the Sun, and pulse corresponds to the Moon. By constantly seeking their essentials, one grasps the key points. (Complexion is divided into the Five Elements, with brightness and darkness representing its variations; the Sun has ten Heavenly Stems, with sunny and cloudy weather representing its variations; thus, complexion corresponds to the Sun. Pulse involves the twelve meridians, with excess and deficiency representing its variations; the Moon has twelve Earthly Branches, with waxing and waning representing its variations; thus, pulse corresponds to the Moon. By constantly seeking the essentials of complexion and pulse, one becomes as bright as the sun and moon, thereby mastering the essentials of change.) The changes in complexion should correspond to the pulses of the four seasons. This is what ancient sage-kings valued, aligning with the spirit-like functions, thereby moving away from death and toward life, allowing the Dao of life to flourish long-term. This is called the Sage-King. (Shangdi values the correspondence of complexion and pulse, thus being able to foresee signs and perceive subtleties, aligning with the spirit-like functions, often staying away from death and close to life, with the Dao of life prospering eternally. This is how sage-kings cultivated their bodies.)

In the middle-ancient era, treating diseases meant acting after the disease had manifested. One would use Tangye (Grain Decoctions) for ten days to eliminate diseases caused by the Eight Winds and Five Bi syndromes. If not cured after ten days, treatment would involve grass leaves, roots, and stems, with roots and stems assisting each other, addressing both root and branch. Once root and branch were understood, the pathogenic factor would be subdued. (In the middle-ancient era, treatment began only after the disease had formed. Initially, Tangye was used. Tangye refers to beverages made from grains, not medicinal herbs. Taking them for ten days could eliminate Eight Wind and Five Bi diseases. If not cured after ten days, grass Su [leaves], Gai [roots], and branches would be used. Su refers to leaves; Gai refers to roots; Zhi refers to stems. Roots and stems assist each other, hence "root and branch assist each other," which corresponds to the decoctions of later generations. The disease cause is the root, and the pathological manifestation is the branch. Grasping root and branch ensures the submission of pathogens. This was the treatment method of the middle-ancient era. Although it did not prevent disease before onset like the ancient era, it was still not as erroneous as later generations.)

In the late era, however, treatment was different. Treatment did not follow the four seasons, ignored the rhythms of the sun and moon, and failed to examine the principles of reversal and conformity. (Wang Bing noted: The qi of the four seasons resides in specific locations. Attacking blindly without considering these locations goes against ancient methods. *Si Shi Ci Ni Cong Lun* states: Spring qi resides in the channels, summer qi in the collateral vessels, late summer qi in the muscles, autumn qi in the skin, and winter qi in the bone marrow. Physicians should avoid latent pathogens according to where the qi resides. Ignoring the sun and moon refers to not knowing the daily changes in cold/warmth and light/darkness, and the lunar phases of fullness and emptiness. *Ba Zheng Shen Ming Lun* states: Acupuncture must wait for the movements of the sun, moon, stars, and the qi of the four seasons and eight directions. Only when the qi is stable should acupuncture be performed. Thus, when the weather is warm and sunny, human blood flows freely, and Wei Qi floats, making blood easy to drain and qi easy to move; when cold and dark, blood stagnates, and Wei Qi sinks. At the new moon, blood and qi begin to refine, and Wei Qi begins to move; at the full moon, blood and qi are abundant, and muscles are firm; at the empty moon, muscles diminish, meridians are deficient, Wei Qi departs, and only the form remains. Therefore, blood and qi must be regulated according to heavenly timing. Do not needle when cold, do not allow stagnation when warm, do not use draining methods at the new moon, do not use tonifying methods at the full moon, and do not treat at the empty moon. This is regulating according to time. This is the meaning. Failing to examine reversal and conformity means failing to judge whether a disease is treatable or not. I believe: Wang Taipu's citation of classics here is correct but incomplete. For instance, ignoring the four seasons leads to ignorance of the prosperity/decline of luck and the waxing/waning of Yin/Yang. Those who favor warm/hot herbs forget the scorching heat of heaven and earth; those who exclusively use cold/cool herbs ignore the flow of host and guest qi. The five tones have specific taboos; how can they be treated as ordinary? Thus, *Wu Chang Zheng Da Lun* states: First know the annual qi, do not violate the harmony of Heaven. If one violates this without understanding, it is like carrying firewood to save a fire or adding frost to snow, harming others and oneself while remaining unaware lifelong—truly lamentable! Regarding ignoring the sun and moon, Wang’s note explains it literally, but this chapter originally focuses on complexion and pulse. Therefore, not knowing complexion and pulse means lacking the subtlety of comparative analysis and clarity of interior/exterior diagnosis. When complexion and pulse do not match, who should discard symptoms to follow the pulse? When urgency and slowness conflict, who should address one before the other? Lack of understanding leads to such arrogance. This is why combining complexion and pulse is indispensable, hence the reference to the sun and moon. Furthermore, failing to examine reversal and conformity involves the reversal/conformity of qi and complexion. As *Yu Ban Lun Yao* states: Complexion appearing in upper/lower/left/right positions has specific meanings; upper is reversal, lower is conformity. For women, right is reversal, left is conformity; for men, left is reversal, right is conformity. *Wei Qi Shi Chang Pian* states: Examine excess and deficiency to regulate, knowing reversal and conformity. There is also the reversal/conformity of pulses across four seasons. *Ping Ren Qi Xiang Lun* states: Pulses have reversal/conformity to seasons. Without organ manifestations, thin pulses in spring/summer and floating-large pulses in autumn/winter are called reversing the four seasons. *Yu Ji Zhen Zang Lun* states: Reversing the four seasons means getting Lung pulse in spring, Kidney pulse in summer, Heart pulse in autumn, Spleen pulse in winter, especially if suspended, extreme, deep, or choppy. There is also the reversal/conformity of pulse and symptoms. *Ping Ren Qi Xiang Lun* states: Wind-heat with quiet pulse, diarrhea/dehydration with excessive pulse, internal disease with deficient pulse, external disease with choppy/firm pulse—all are difficult to treat, called reversing the four seasons. *Yu Ji Zhen Zang Lun* states: Heat disease with quiet pulse, diarrhea with large pulse, blood loss with excessive pulse, internal disease with firm pulse, external disease with non-firm pulse—all are difficult. There is also the reversal/conformity of treatment methods. *Zhi Yao Yao Da Lun* states: Some are cured by contrary methods, some by conforming methods. Contrary is actually proper conformity; if conforming, it is contrary. It also says: Mild cases are treated contrarily, severe cases conformingly. And: Contrary cases use standard treatment, conforming cases use reverse treatment, varying degrees depend on the situation. *Wu Chang Zheng Da Lun* states: Strengthen internal retention, align with qi, achieve balance; false conditions are opposite. These are the ways of reversal and conformity, which physicians must deeply study. If one does not understand the reversal/conformity of seasonal pulses and symptoms, one cannot recognize the principles of life and death, leading to many errors in treatment; if one does not understand the reversal/conformity of therapeutic discussion, one will recklessly administer treatments, cutting off people's lives. This is what is meant by "physicians killing," a common flaw of the late era, which should be carefully examined.) When the disease form has already developed, they attempt to treat externally with fine needles and internally with Tangye. (Since they cannot prevent it before onset nor perceive the current condition, their minds are coarse and vision shallow, indiscriminately applying needles and medicines.) Crude practitioners act frantically, believing attacks are necessary, so the old disease persists, and new diseases arise. (Crude practitioners lack profound learning and are mediocre/shallow. "Xiong xiong" describes their self-opinionated and reckless behavior. Such people, assuming excess and attacking, leave false excess unremoved while true deficiency arrives; assuming heat and cooling, the original heat remains while new cold arises. They are insufficient to treat people and merely sufficient to harm them.)

The Yellow Emperor said: I wish to hear the essential Dao. Qibo said: The ultimate principle of treatment is not to lose sight of complexion and pulse. Using them without confusion is the great rule of treatment. (The relationship between complexion/pulse and disease is like form and shadow, or sound and echo. Thus, the key to diagnosing lies in deeply understanding the subtleties of complexion and pulse without confusion, which is the great law as clear as the sun and moon.) If reversal and conformity are inverted, and root and branch are not distinguished, one loses spirit and endangers the state (metaphorically, endangering life). ("Reversal and conformity inverted" means treating conformity as reversal. "Root and branch not distinguished" means abandoning the root for the branch. Thus, spirit is lost and life endangered. "Dao" is identical to "Dao" [inverse].) Abandoning the old for the new allows one to attain the True Person. (This warns against advancing virtue and cultivating practice, avoiding the tracks of the late era and self-abandonment. "Abandoning the old" means discarding bad habits. "Attaining the new" means progressing with daily renewal. Renewal upon renewal allows one to learn from sages and attain the Dao of the True Person.)

The Yellow Emperor said: I have heard the essentials from you, Master. You say it revolves around complexion and pulse, which I know. Qibo said: The extreme of treatment lies in "One." The Yellow Emperor asked: What is "One"? Qibo replied: "One" is obtained through investigation/causality. (The Dao of "One" is great, the origin of all things. The *I Ching* says: Heaven generates One Water. Emperor Yao said: Be refined and unified, sincerely hold the center. Laozi said: Dao generates One, One generates Two, Two generates Three, Three generates Ten Thousand Things. He also said: Heaven obtains One to be clear, Earth obtains One to be tranquil, Spirit obtains One to be spiritual, Valley obtains One to be full, Ten Thousand Things obtain One to live, Lords/Kings obtain One to stabilize the world. Confucius said: My Dao is penetrated by One. Buddhism says: All Dharmas return to One. Zhuangzi said: Connecting with One completes all matters. Shao Yong said: Heaven divides creation from within One. *Zhi Yao Yao Lun* etc. state: Knowing the essence, one word suffices; not knowing, one wanders infinitely. Here it says the extreme of treatment is One; the Dao is the same. Thus, if one obtains One, the universe is in hand; if one knows One, all transformations return to the heart. "One" is the root; "Yin" (cause/reason) is what is investigated. Obtaining the cause, what cannot be obtained?) The Yellow Emperor asked: How? Qibo said: Close the doors and windows, focus on the patient, ask repeatedly about their condition, and follow their intent. (Closing doors and windows, focusing on the patient, aims for quietness without disturbance. Then, calmly inquire about their condition and tactfully follow their intent. One must gain their trust so that the asker feels no annoyance and the patient feels no disgust, thereby thoroughly understanding the root causes of the disease and ensuring accurate treatment. I believe: This chapter previously stated the ultimate principle is not losing complexion and pulse; here it states asking repeatedly and following intent. This aligns with *Xie Qi Zang Fu Bing Xing Pian*: Seeing complexion and knowing the disease is called Bright; palpating pulse and knowing the disease is called Divine; asking about disease and knowing the location is called Artisan. Knowing one makes one an Artisan, knowing two makes one Divine, knowing three makes one both Divine and Bright. This shares the same intent. If one seeks the root of the disease, one must combine these three aspects; otherwise, errors are inevitable.) Those who possess Spirit prosper; those who lose Spirit perish. The Yellow Emperor said: Excellent. (This summarizes the above to state the great root of life and death. *Tian Nian Pian* states: Losing Spirit means death, gaining Spirit means life. *Ben Bing Lun* also contains these two sentences, see Yun Qi Lei 44, which should be cross-referenced.)