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(From "Suwen: Chapter on the Great Discussion of the Five Regular Administrations")

The Yellow Emperor asked: The Heaven's Yang Qi is insufficient in the Northwest, making the left side cold and the right side cool; the Earth's Yin Qi is incomplete in the Southeast, making the right side hot and the left side warm. What is the reason for this? (Note: Since Heaven is insufficient in the Northwest, the Northwest is called the Gate of Heaven. Since Earth is incomplete in the Southeast, the Southeast is called the Gate of Earth. The "Great Discussion of the Five Regular Administrations" states: The so-called boundary of Wu and Ji, where the stars Kui, Bi, Jiao, and Zhen are located, are the gates of Heaven and Earth. This meaning is consistent with the present section. This section discusses from the perspective of facing South towards Xun and having the back to Qian. Qian is located in the Northwest, so the left is North and the right is West, hence cold on the left and cool on the right; Xun is located in the Southeast, so the right is South and the left is East, hence hot on the right and warm on the left, corresponding to the Qi of the four seasons.)

Qibo replied: This is due to the differences in Yin and Yang Qi, as well as the principles of elevation and depression, and the variations in size. (The following text all discusses geographical differences. Elevation and depression refer to the terrain of the Central Plains, which is high in the Northwest and low in the Southeast. Size refers to the mountains, rivers, and territories, each having different extents. Therefore, the Yin and Yang Qi are not uniform, and cold, heat, warmth, and coolness vary according to the local environment.) The Southeast belongs to Yang; the essence of Yang descends, so the right is hot and the left is warm. The Northwest belongs to Yin; the essence of Yin ascends, so the left is cold and the right is cool. (Yang Qi descends from above. Since the Southeast is low, the East is warm and the South is hot; Yang begins in the East and peaks in the South. Yin Qi ascends from below. Since the Northwest is high, the West is cool and the North is cold; Yin begins in the West and peaks in the North.) Thus, the ground has elevations and depressions, and the climate has warmth and coolness. High places have cold Qi, and low places have hot Qi. (The "Great Discussion of the Six Yuan and Correct Chronicles" states: In the highest lands, Winter Qi prevails; in the lowest lands, Spring Qi prevails. This is exactly what is meant here.) Therefore, those who go to cold and cool places tend to suffer from distension, while those who go to hot and warm places tend to develop sores. Distension can be cured by purgation, and sores can be cured by diaphoresis. This is the normal pattern of the opening and closing of the interstices (Cou Li), reflecting the differences in regional scale. ("Zhi" also means "to adapt to". Adapting to cold and cool places causes the interstices to close tightly, preventing Qi from circulating freely, leading to internal distension. Adapting to hot and warm places causes the interstices to open frequently, allowing pathogenic Yang Qi to enter easily, leading to sores. Distension is internal, so purgation cures it. Sores are external, so diaphoresis cures it. Although these patterns of distension and sores are normal responses to the opening and closing of interstices, severe cold or heat leads to severe disease, and mild cold or heat leads to mild disease, representing the difference in magnitude. Wang Bing said: Northwest and Southeast refer to the general trends. Verifying with climate, in the Central Plains terrain, living at a height results in cold, while living in a depression results in heat. Observing carefully, high mountains have much snow and are cold, while plains have much rain and are hot, thus confirming the relationship between elevation and temperature. In China, areas with significant elevation differences are divided into three parts along the East-West and North-South axes. Part 1: From the Han River and Shu River southwards to the sea. Part 2: From the Han River northwards to Pingyao County. Part 3: From the northern mountains of Pingyao northwards to the Northern Sea of the Fan borders. Thus, the southern part is characterized by intense heat, the middle part by mixed cold and heat, and the northern part by intense cold. Beyond the North-South divisions, cold and heat are extreme. In the intensely hot division, cold is slight; in the intensely cold division, heat is slight. However, climbing to the peak of extremely high mountains reveals a stark contrast in cold and heat between the south and north faces, with double the difference in vegetation vitality. Similarly, there are three types of East-West elevation differences. Type 1: From Kunyuan County westwards to Shazhou. Type 2: From Kaifeng County westwards to Kunyuan County. Type 3: From Kaifeng County eastwards to the vast ocean. Thus, the eastern part is characterized by great warmth, the middle part by mixed warmth and coolness, and the western part by great coolness. In the greatly warm division, cold accounts for two-fifths; in the greatly cool division, heat accounts for two-fifths. Beyond warmth and coolness, they become extreme, turning into great heat and great cold. Generally speaking, this is the case. However, among the nine divisions, cold is most extreme in the Northwest, and heat is most extreme in the Southeast. Among these nine divisions, there are differences in elevation; high places are dry, and low places are humid, which are minor differences within a region. Speaking generally, these are the two aspects of elevation and depression. Why? The terrain of the Central Plains is high in the West and North, and low in the East and South. Now, all rivers converge and flow eastward into the Pacific Ocean, revealing the elevation differences of the Southeast, Northwest, Southwest, and Northeast. First, terrain elevation causes different temperatures; second, the abundance or scarcity of Yin and Yang Qi causes differences in warmth and coolness. Verifying with climate now, Spring Qi moves west, Autumn Qi moves east, Winter Qi moves south, and Summer Qi moves north. Comparing with the central region, from Kaifeng to Kunyuan, the climate matches the calendar predictions. Comparing eastward movement, from Kaifeng to the ocean, every hundred li, Autumn Qi arrives one day late, and Spring Qi emerges one day early. Comparing westward movement, from Kunyuan County west to the Fan border desert, for south-facing and northwest/southeast orientations, every forty li, Spring Qi emerges one day late, and Autumn Qi arrives one day early; for north-facing and northeast/southwest orientations, every fifteen li, Spring Qi emerges one day late, and Autumn Qi arrives one day early. Comparing southward movement, for river shapes facing north/northeast/southwest, every fifteen li, Yang Qi lags one day, and Yin Qi advances one day; for south-facing and southeast/northwest rivers, every fifteen li, Heat arrives one day early, and Cold arrives one day late; for flat lands, every fifty li, Yang Qi emerges one day early, and Cold arrives one day late. Comparing northward movement, for river shapes facing south/southeast/northwest, every twenty-five li, Yang Qi lags one day, and Yin Qi advances one day; for north-facing and northeast/southwest rivers, every fifteen li, Cold arrives one day early, and Heat arrives one day late; for flat lands, every twenty li, Heat lags one day, and Cold arrives one day early. Generally, this is the case. However, in high and steep places, Winter Qi prevails; in flat and low places, Summer Qi prevails. Observing snow melting and grass flourishing confirms this. Furthermore, landforms naturally include bow-shaped, snake-shaped, and moon-shaped valleys, with different terrains affecting growth, death, prosperity, and decay. Even with similar earth, heaven varies. In such places, facing Li, Bing, Xun, Yi, or Zhen directions causes Spring Qi to arrive early and Autumn Qi late, differing by fifteen days; facing Ding, Kun, Geng, Dui, Xin, Qian, Kan, or Gen directions causes Autumn Qi to arrive early and Spring Qi late, differing by twenty days. These are known as mountain-adjacent lands; observing orientation reveals the climate. In cold and cool places, interstices open less and close more; frequent closing prevents Yang Qi from dissipating, causing abdominal distension in cold/cool regions. In hot and humid places, interstices open more and close less; frequent opening causes Yang Qi to scatter, leading to skin sores in hot/warm regions. The subsequent text mentions that if Middle Qi is insufficient, distension resolves. Diaphoresis causes Yang Qi to escape externally, resolving sores. Note: Wang Bing's theory divides China into Nine Palaces, further subdividing directions within each palace, distinguishing Yin/Yang and cold/heat, which must be examined. Detailed check: Han Shu River is the Yangtze River. From the river to the South Sea is the Li Palace. From the river to Pingyao County is the Center Palace (now in Fenzhou, Shanxi). From north of Pingyao to the Northern Fan border is the Kan Palace. This describes the North-South division. Kunyuan County is Kunyang County, now in Fengxiang Prefecture, Shaanxi. From Kunyuan west to Shazhou is the Dui Palace. From Kaifeng west to Kunyuan is the Center Palace. From Kaifeng east to the ocean is the Zhen Palace. This describes the East-West division. Understanding the five main palaces allows observation of the four corner energies.)

The Yellow Emperor asked: How does this affect human longevity? (Since the Qi of the land differs, human longevity also varies.)

Qibo replied: People in places where Yin Essence is offered up live long; people in places where Yang Essence descends die young. (In places where Yin Essence is offered up, Yang Qi is solid, so people tend to live long. This refers to elevated areas. In places where Yang Essence descends, Yang Qi leaks easily, so people tend to die young. This refers to depressed areas.)

The Yellow Emperor said: Excellent. If illness occurs, how should it be treated?

Qibo replied: For the Qi of the Northwest, use dispersing and cooling methods; for the Qi of the Southeast, use gathering and warming methods. This is called treating the same disease differently based on location. (Northwest Qi is cold; Wei Qi is consolidated externally, causing Heat to stagnate internally. Thus, it is appropriate to disperse external cold and clear internal heat. Southeast Qi is hot; Wei Qi leaks externally, causing Cold to generate internally. Thus, it is appropriate to consolidate external leakage and warm internal cold. Although the disease may be the same, the treatment differs.) Therefore, it is said: In cold and cool climates, treat with cold and cool remedies, and use herbal foot baths. In warm and hot climates, treat with warm and hot remedies, and strengthen internal retention. One must align with the local Qi to bring the condition to balance; if the presentation is false, reverse the treatment. (In the cold and cool Northwest, people often eat hot foods, leading to abundant internal fire; thus, cold/cool treatments and herbal baths are suitable to disperse external cold. In the warm and hot Southeast, people often eat cool foods, leading to internal cold; thus, warm/hot treatments are suitable, and strengthening internal retention is necessary to prevent Yang Qi leakage and secure the interior. Heavenly and earthly Qi have Yin-Yang ascending/descending dynamics, and disease treatment also involves Yin-Yang dynamics. Aligning medication with climatic suitability brings balance. However, the Northwest may have false heat, and the Southeast may have false cold. False conditions require contrary treatment, meaning the Northwest might need hot medicine, and the Southeast might need cold medicine. Having traveled extensively north and south, I find that hot regions have more heat diseases, and cold regions have more cold diseases, which cannot be ignored. Details on true/false distinctions are found in the fourth chapter of Treatment Theory.)

The Yellow Emperor said: Excellent. Within one province, the generation, transformation, longevity, and shortness of life differ. What is the reason?

Qibo replied: The principle of elevation and depression is determined by terrain. Elevated areas are governed by Yin Qi, and depressed areas are governed by Yang Qi. Those dominated by Yang develop earlier (Xiantian), and those dominated by Yin develop later (Houtian). This is the constant law of geography and the way of generation and transformation. (Within one province, unlike the vastness of the world, there are still differences in generation, transformation, longevity, and shortness due to terrain elevation. High places are governed by ascending Yin Qi; Yin nature is slow, so flora and fauna flourish and wither later. Later development implies slower flourishing and withering, hence longer life. Low places are governed by descending Yang Qi; Yang nature is fast, so things succeed and fail earlier. Early success/failure implies rapid growth and decline, hence shorter life. Sun Simiao stated: For infants aged three to ten, observing their temperament and constitution can predict longevity. Generally, children who are exceptionally smart in early childhood tend to have shorter lives, like Xiang Tuo and Yan Hui. Children whose bone structure matures slowly and whose demeanor is dignified and relaxed, requiring some effort to refine, tend to live long. Those who anticipate others' thoughts and react quickly tend to have shorter lives, like Yang Xiu and Kong Rong. Thus, longevity can be roughly predicted. This is akin to plum blossoms blooming early and missing the harsh winter, while chrysanthemums bloom late and fulfill their natural lifespan. Late completion is a sign of longevity. This illustrates the meaning of Xiantian and Houtian.)

The Yellow Emperor asked: Is there really a difference in longevity there?

Qibo replied: People in high places have longer lifespans, and people in low places have shorter lifespans. This varies by the size of the region; small regions have small differences, and large regions have large differences. (Elevation determines Yin and Yang Qi, which dictates longevity. However, on a large scale like the whole country, differences exist over thousands of li; on a small scale like a province, differences exist over tens of li. Thus, small regions have small variations, and large regions have large variations.)

Therefore, healers must understand the Way of Heaven and Geography, the alternation and dominance of Yin and Yang, the sequence of Qi, human longevity, and the periods of generation and transformation, in order to comprehend human form and Qi. (Not understanding the Way of Heaven means not knowing the changes of Luck. Not understanding Geography means not knowing the suitability of local environments. Not understanding the alternation of Yin and Yang means losing both root and branch. Not understanding the sequence of Qi means reversing urgency and slackness. Not understanding the periods of longevity and transformation means lacking firm insight and acting rashly, inviting blame. All these factors are indispensable. Only then can one, beyond observing form to inspect externals, observe Qi to know internals, ensuring that the path of healing remains comprehensive and safe.)