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(Su Wen, Chapter 53: Da Wu Zheng Da Lun)
The Yellow Emperor asked: In some years, people do not fall ill, yet the Qi of the Zang organs does not respond or function as it should. What is the reason for this?
Qibo replied: This is because the Heavenly Qi exerts control over it, and the Qi follows a certain direction. (The phrase "years without illness where organs do not respond or function" refers to situations where the annual movement suggests illness should occur but does not, and where organ Qi should respond to the season but fails to do so. The phrase "Heavenly Qi controls, and Qi follows" means that the Si Tian (Heavenly Ruling) Qi restricts it, causing it to follow the Heavenly Qi, thus resulting in a mismatch with the annual movement. "Control" here means restriction.)
The Yellow Emperor said: I wish to hear this in detail.

Qibo said: When Shaoyang (Ministerial Fire) rules the Si Tian position, Fire Qi descends upon the earth, causing Lung Qi to ascend and follow. White appears, and Metal is utilized by Fire; grasses and trees suffer disaster. Flames burn fiercely, altering the nature of Metal and depleting it. Great heat prevails, leading to coughing, sneezing, rhinorrhea, epistaxis, nasal obstruction, sores and ulcers, alternating chills and fever, and edema. (Shaoyang Ministerial Fire ruling Si Tian corresponds to Yin and Shen years. Fire descending is feared by Metal, so Lung Qi ascends to follow. "Following" means responding and moving. When Metal moves, white appears, and Metal is used by Fire, so grasses and trees suffer disaster. However, fierce fire alters the nature of Metal and causes depletion; "Metal follows transformation" refers to this. If disease occurs, such as coughing, sneezing, rhinorrhea, epistaxis, nasal obstruction, and sores, these are caused by excessive Fire injuring the Lung. Cold Metal and hot Fire clash, causing alternating chills and fever. The Lung governs skin and hair; when pathogenic heat gathers there, edema results. All these arise from changes generated by Heavenly Qi. Fan sounds like 'fan'; sounds like 'rui'; Ti sounds like 'di'; Qiu sounds like 'qiu'; Nu sounds like 'nu'; Zhi sounds like 'zhi'). Wind qi circulates on the ground, raising dust and sand. Symptoms include heart pain, epigastric pain, cold limbs (Jue Ni), and blockage at the diaphragm. Its onset is sudden and rapid. (Whenever Shaoyang rules Si Tian, Jueyin rules the Zai Quan position, so wind circulates on the ground, raising dust. Excessive wind affects the Jueyin Liver channel, which runs along the stomach, connects to the liver, and pierces the diaphragm, causing such symptoms. Since nothing is swifter than wind, the onset is sudden and rapid. These arise from changes generated by Earthly Qi).

When Yangming (Dryness/Metal) rules the Si Tian position, Dryness Qi descends upon the earth, causing Liver Qi to ascend and follow. Blue/Green appears, and Wood is utilized by Metal; Earth suffers disaster. Chill and desolation arrive frequently; trees are felled and grass withers. Symptoms include hypochondriac pain, red eyes, tremors and shivering, tendon wasting, and inability to stand for long periods. (Yangming Dryness/Metal ruling Si Tian corresponds to Mao and You years. Dryness descending is feared by Wood, so Liver Qi responds and ascends to follow. When Wood responds, blue/green appears, and Wood is used by Metal, so Earth must be injured. When Metal is prosperous, chill and desolation arrive frequently, so trees are felled and grass withers, and disease affects the Liver. The Liver channel runs through the hypochondrium, causing pain. The Liver opens into the eyes, causing redness. The Liver governs wind, causing tremors. The Liver governs tendons, causing wasting and inability to stand. All these arise from changes generated by Heavenly Qi). Sudden heat arrives, making the earth feel like midsummer. Yang Qi stagnates and erupts. Urine color changes. Chills and fever resemble malaria. Severe cases involve heart pain. Fire acts on dry matter. Flowing water does not freeze. Hibernating insects appear. (Whenever Yangming rules Si Tian, Shaoyin Sovereign Fire rules the Zai Quan position, so heat circulates on the ground, causing such climate phenomena. Fire in the Yin aspect causes clashing of cold and heat, resembling malaria. Stagnant Fire cannot extend, causing heart pain. Fire adheres to dryness, acting on dry matter. "Gao" means dry. These arise from changes generated by Earthly Qi).

When Taiyang (Cold/Water) rules the Si Tian position, Cold Qi descends upon the earth, causing Heart Qi to ascend and follow. Fire appears bright, Red/Dan color emerges, and Metal suffers disaster. Cold and clear air rises frequently. Victory leads to water freezing. Fire Qi is high and bright. Symptoms include heart heat, irritability, dry throat, frequent thirst, rhinorrhea, sneezing, tendency toward sadness, frequent yawning. Wild heat flows, cold returns, frost falls irregularly. Memory loss occurs. Severe cases involve heart pain. (Taiyang Cold/Water ruling Si Tian corresponds to Chen and Xu years. Cold descending is feared by Fire, so Heart Qi responds and ascends to follow. When Fire responds, it becomes bright and Dan color emerges, so Metal suffers disaster. Water victory brings cold, hence such climate phenomena. Fire response brings heat, hence such symptoms. All these arise from changes generated by Heavenly Qi). Earth becomes moist, Water becomes abundant. Cold invades, deep Yin transforms. Dampness alters things. Internal retention of fluids causes abdominal fullness and anorexia. Skin feels heavy and numb. Tendons and vessels are unresponsive. Severe cases involve edema and carbuncles on the back and buttocks. (Whenever Taiyang rules Si Tian, Taiyin Dampness/Earth rules the Zai Quan position, so dampness circulates on the ground, causing such climate and disease phenomena. means bi-syndrome heaviness. Rou Ke means insensitivity and immobility. See Disease Category 45 for details. Back/buttock carbuncles occur because heavy, numb, swollen muscles prevent movement, leading to prolonged pressure sores on the back and buttocks. These are Spleen/Earth syndromes arising from changes generated by Earthly Qi).

When Jueyin (Wind/Wood) rules the Si Tian position, Wind Qi descends upon the earth, causing Spleen Qi to ascend and follow. Earth Qi becomes prominent, Yellow appears, and Water suffers disaster. Earth's function changes. Body weight increases, muscles waste. Appetite decreases, taste becomes bland. Wind circulates in the sky, clouds and objects shake. Vertigo and tinnitus occur. (Jueyin Wind/Wood ruling Si Tian corresponds to Si and Hai years. Wind descending is feared by Earth, so Spleen Qi responds and ascends to follow. When Earth responds, Qi becomes prominent and yellow appears, so Water suffers disaster. Earth is controlled by Wood, so its function changes, affecting the Spleen channel, causing wind and cloud movement. All these arise from changes generated by Heavenly Qi). Fire releases its violence. The earth becomes hot. Intense heat scorches. Red rain falls. Hibernating insects appear frequently. Flowing water does not freeze. Onset is rapid. (Whenever Jueyin rules Si Tian, Shaoyang Ministerial Fire rules the Zai Quan position, so Ministerial Fire descends, causing such climate phenomena. "Chi Wo Xia" means warm rains falling under red influence. Rapid onset is due to the violent and swift nature of Ministerial Fire. These arise from changes generated by Earthly Qi).

When Shaoyin (Sovereign Fire) rules the Si Tian position, Heat Qi descends upon the earth, causing Lung Qi to ascend and follow. White appears, Metal is utilized by Heat; grasses and trees suffer disaster. Asthma and vomiting occur. Chills and fever, sneezing, rhinorrhea, epistaxis, and nasal obstruction appear. Great heat prevails. Severe cases involve burning sores. Metal melts and stones flow. (Shaoyin Sovereign Fire ruling Si Tian corresponds to Zi and Wu years. Fire descending is feared by Metal, so climate and diseases are largely similar to Shaoyang Si Tian, all arising from changes generated by Heavenly Qi). The earth becomes dry. Chill and desolation arrive frequently. Hypochondriac pain and frequent sighing occur. Desolate energy moves. Grasses and trees change color. (Whenever Shaoyin rules Si Tian, Yangming Dryness/Metal rules the Zai Quan position, so dryness circulates on the ground, causing such climate phenomena. Liver Wood is injured, causing hypochondriac pain. Lung Metal is excessive, causing frequent sighing. These arise from changes generated by Earthly Qi).

When Taiyin (Dampness/Earth) rules the Si Tian position, Dampness Qi descends upon the earth, causing Kidney Qi to ascend and follow. Black appears, Water changes. Dust obscures, clouds and rain cover. Chest discomfort occurs. Impotence, severe Qi decline, and failure to function occur. At this time, lower back pain occurs, making movement difficult. Cold limbs (Jue Ni) appear. (Taiyin Dampness/Earth ruling Si Tian corresponds to Chou and Wei years. Wet Earth descending is feared by Water, so Kidney Qi responds and ascends to follow. When Water responds, black appears as a change. Heart Fire is constrained, causing chest discomfort. Earth victory injures Water, causing impotence and other diseases. "At this time" refers to when Earth is prosperous. All these diseases belong to the Kidney channel and arise from changes generated by Heavenly Qi). The earth stores Yin. Great cold arrives. Hibernating insects settle early. Epigastric stuffiness and pain occur. Earth cracks, ice hardens. Lower abdominal pain occurs. Eating is often impaired. If Metal overcomes, stagnant water increases, taste becomes salty, flowing water decreases. (Whenever Taiyin rules Si Tian, Taiyang Cold/Water rules the Zai Quan position, so cold circulates on the ground, causing storage of Yin and symptoms like epigastric stuffiness. This is Cold Water insulting Fire. "Cheng Jin" refers to years with Yi stems (Metal Movement) or times with Dryness/Metal Qi. Water born from Metal has severe cold congealment, so stagnant water increases, taste becomes salty, and flowing water decreases. This is Yin overcoming Yang and stillness overcoming motion. These arise from changes generated by Earthly Qi. Note: In the transformation of Luck, one victory brings one defeat, one prosperity brings one decline; this is normal logic. Observing the Six Qi of Si Tian in this chapter, such as Shaoyang and Shaoyin Fire descending causing Lung Qi to ascend and Metal to be utilized, these are restrained organs rising to function. Why? Each of the Five Movements has its own control. When controlling Qi adds up, the controlled must respond. Responding, it follows the transformation to function. The logic and signs are obvious but unknown to many. Thus, extreme heat brings dryness (Metal follows Fire); extreme dryness brings wind (Wood follows Metal); extreme wind brings dust (Earth follows Wood); extreme dampness brings rain (Water follows Earth); extreme Yin condensation brings thunder/lightning (Fire follows Water). Hence, the I Ching says: "Clouds follow the Dragon, Wind follows the Tiger." The Dragon obtains East Wood Qi, so clouds follow; clouds are Earth Qi. The Tiger obtains West Metal Qi, so wind follows; wind is Wood Qi. This illustrates the meaning of this chapter. Observing the changes of Five Movements and the deficiency/excess of Zang images, it is known that they cannot be discussed with partiality.)

The Yellow Emperor said: Qi begins to generate transformations, Qi scatters to form shapes, Qi spreads to multiply, and Qi ends with image changes; their origin is one. However, the resources for the five flavors vary. Transformations have thickness and thinness. Maturation has scarcity and abundance. Start and end differ. What is the reason? (This section details the Zai Quan Six Transformations and differences in five flavors and grains. "Start" initiates life potential. "Scatter" disperses into ten thousand things. "Spread" distributes lushness. "End" collects success. This states that the beginning, end, scattering, and spreading of all things originate from one Qi. Upon maturation, differences in thickness and abundance arise.)
Qibo replied: Earthly Qi controls it. It is not that Heaven does not generate and Earth does not grow. (Earthly Qi refers to the Zai Quan Qi. Controlling it refers to what it accomplishes. The Six Transformations of Zai Quan have varying prosperity and decline. Things born on Earth must respond to Qi. Thus, thin Qi yields thin transformation, not because Heaven does not generate; scarce Qi yields scarce growth, not because Earth does not grow. Wang Bing said: Although Heaven and Earth are indifferent to generation, the Qi of generation has similarities and differences. Why? Because within the body of Earth there are six entrances. Qi has similarities and differences, so there is generation and transformation, non-generation and non-transformation, little generation/transformation, and extensive generation/transformation. Therefore, between Heaven and Earth, there is no absolute generation, non-generation, little generation, or extensive generation. Each follows its Qi, dividing into likes/dislikes, differences/similarities.)
The Yellow Emperor said: I wish to hear the principle.
Qibo said: Cold, Heat, Dryness, and Moisture have different transformations. (Qi has six types, but only four are mentioned to highlight the general essentials.)

Therefore, when Shaoyang (Ministerial Fire) rules the Zai Quan position, Cold Poisons do not grow. The flavor is Pungent. Treatment uses Bitter and Sour. Grains are Green/Cyan and Red/Dan. (Shaoyang Ministerial Fire ruling Zai Quan corresponds to Si and Hai years. "Poison" refers to violent Qi of the Five Elements, each transforming differently. Fire in the earth prevents cold-poisonous things from growing. Fire controls Metal, so Pungent flavors correspond. Above Shaoyang, Jueyin rules. Below Fire, above Wood, so treatment uses Bitter and Sour. Grains are Green/Cyan and Red/Dan. Bitter/Dan belongs to Fire, transformed by Earthly Qi. Sour/Green belongs to Wood, generated by Heavenly Qi. Note: Among Zai Quan treatments, only Shaoyang and Jueyin do not mention intermediate flavors because Wood and Fire generate each other, leaving no gap. Other transformations have upper/lower conquest, so intermediate flavors are necessary.)

When Yangming (Dryness/Metal) rules the Zai Quan position, Wet Poisons do not grow. The flavor is Sour. The Qi is Damp. Treatment uses Pungent, Bitter, and Sweet. Grains are Red/Dan and White/Pure. (Yangming Dryness/Metal ruling Zai Quan corresponds to Zi and Wu years. Dryness in the earth prevents wet-poisonous things from growing. Metal conquers Wood, so Sour flavors correspond. Dryness overcomes Dampness, so Damp Qi corresponds. Above Yangming, Shaoyin rules. Below Metal, above Fire, so treatment uses Pungent and Bitter. Grains are Red/Dan and White/Pure. Pungent/White belongs to Metal, transformed by Earthly Qi. Bitter/Dan belongs to Fire, generated by Heavenly Qi. Sweet is added as an intermediate flavor between Fire and Metal. Sweet belongs to Earth, son of Fire, mother of Metal, thus harmonizing the two.)

When Taiyang (Cold/Water) rules the Zai Quan position, Heat Poisons do not grow. The flavor is Bitter. Treatment uses Bland and Salty. Grains are . (Taiyang Cold/Water ruling Zai Quan corresponds to Chou and Wei years. Cold in the earth prevents heat-poisonous things from growing. Water conquers Fire, so Bitter flavors correspond. Above Taiyang, Taiyin rules. Above Earth, below Water, so treatment uses Bland and Salty. Grains are . Bland is a thin Sweet taste. is black millet. Bland belongs to Earth, generated by Heaven. Salty belongs to Water, transformed by Earth. Taiyang intermediate flavor meaning is detailed in Taiyin Zai Quan below. Note: Wang Bing said: Taiyin Earth Qi rules Heaven from above; Qi is distant and high, so Sweet transformation is thin, becoming Bland. Thus Bland is a type of Sweet. Seeing Taiyin Zai Quan treats Sweet and Salty confirms Wang Bing. )

When Jueyin (Wind/Wood) rules the Zai Quan position, Clear Poisons do not grow. The flavor is Sweet. Treatment uses Sour and Bitter. Grains are Green/Cyan and Red. (Jueyin Wind/Wood ruling Zai Quan corresponds to Yin and Shen years. Wind moves in the earth, differing from Clear nature, so clear-poisonous things do not grow. Wood conquers Earth, so Sweet flavors correspond. Above Jueyin, Shaoyang rules. Above Fire, below Wood, so treatment uses Sour and Bitter. Grains are Green/Cyan and Red. Bitter/Red belongs to Fire, generated by Heaven. Sour/Green belongs to Wood, transformed by Earth.) Its Qi is specialized/unified. Its flavor is pure/correct. (When Jueyin rules Zai Quan, Shaoyang rules Si Tian. Upper Yang, Lower Yin. Wood and Fire combine, so Qi transformation is unified and flavor is pure. Other year Qi has upper/lower conquest, so Qi is not unified, hence mixed intermediate flavors.)

When Shaoyin (Sovereign Fire) rules the Zai Quan position, Cold Poisons do not grow. The flavor is Pungent. Treatment uses Pungent, Bitter, and Sweet. Grains are White and Red/Dan. (Shaoyin Sovereign Fire ruling Zai Quan corresponds to Mao and You years. Heat in the earth prevents cold-poisonous things from growing. Fire conquers Metal, so Pungent flavors correspond. Above Shaoyin, Yangming rules. Above Metal, below Fire, so treatment uses Pungent and Bitter. Grains are White and Red/Dan. Pungent/White belongs to Metal, transformed by Heaven. Bitter/Dan belongs to Fire, transformed by Earth. Meaning of Sweet is seen under Yangming Zai Quan above.)

When Taiyin (Dampness/Earth) rules the Zai Quan position, Dry Poisons do not grow. The flavor is Salty. The Qi is Hot. Treatment uses Sweet and Salty. Grains are . (Taiyin Dampness/Earth ruling Zai Quan corresponds to Chen and Xu years. Dampness in the earth prevents dry-poisonous things from growing. Earth conquers Water, so Salty flavors correspond. Dampness is not far from Cold, so Hot Qi things do not form. Above Taiyin, Taiyang rules. Below Damp, above Cold, so treatment uses Sweet and Salty. Grains are . Salty belongs to Water, generated by Heaven. Sweet belongs to Earth, governed by Earthly Qi.) Transformation is pure/thick, so Salty remains stable. Qi is specialized, so Pungent transforms and is treated together. (Among Six Qi, only Taiyin belongs to Earth. Taiyin rules Earth, Earth is in position, so transformation is pure/thick. Chun means thick. Among Five Flavors, only Salty belongs to Water, its nature is purging. Pure Earth controls it, allowing stability. Earth in Earth position is called Specialized Qi. Earth prosperity generates Metal, so it transforms with Pungent and is treated together. "Treated together" means Pungent, Sweet, and Salty are used jointly. Pungent belongs to Metal, son of Earth, mother of Water, harmonizing Water and Earth. This is the intermediate flavor of Taiyin Zai Quan treating Sweet and Salty. However, Taiyin and Taiyang are upper/lower pairs, both should be used; but Taiyin Zai Quan Pungent transformation is thick, while Taiyang Zai Quan Pungent transformation is thin.)

Therefore, it is said: To tonify Upper and Lower, follow the Qi. To treat Upper and Lower, oppose the Qi. Adjust according to the excess/deficiency of Cold and Heat in the respective locations. (This section discusses treatment methods. Tonify means supplement deficiency. Treat means address excess. Upper refers to Si Tian, Lower refers to Zai Quan. Following means using same-nature Qi, e.g., Pungent to tonify Lung, Sweet to tonify Spleed. Opposing means using contrary-nature Qi, e.g., Bitter to treat Lung, Sour to treat Spleen. Adjust based on disease location and appropriate Cold/Heat/Excess/Deficiency.) Therefore, it is said: Take from Above and Below, Inside and Outside, to seek the fault. Those capable of toxicity use strong medicine. Those incapable of toxicity use weak medicine. This is the principle. (Above/Below seeks disease in Upper/Lower. Inside/Outside seeks disease in Interior/Exterior. Seek the fault in these four aspects, then apply strong/weak treatment based on strength/weakness. Thick stomach, dark complexion, large bones, fat flesh = capable of toxicity, use strong medicine. Thin stomach, floating complexion, small bones, thin flesh = incapable of toxicity, use weak medicine. Neng means Nai/endure.) For reversed Qi: Disease in Upper, take from Below. Disease in Lower, take from Above. Disease in Middle, take from Sides. (Reversed Qi means root is here but branch is there. Since disease is reversed, treatment should be reversed. Disease in Upper, take from Below: e.g., treat Yin for Yang disease, drain below for upper congestion. Disease in Lower, take from Above: e.g., treat Yang for Yin disease, vent above for lower stagnation. Disease in Middle, take from Sides: disease originates internally but meridians connect externally; use acupuncture, moxibustion, warming, or massage according to location.) Treat Heat with Cold, administer warm. Treat Cold with Heat, administer cool. Treat Warmth with Clearing, administer cold. Treat Coolness with Warming, administer hot. (This is the meaning of "Use Cold with Heat" and "Use Heat with Cold" from Su Wen Chapter 74. When medicine opposes disease nature, fear incompatibility, so follow the Qi to administer, a method of borrowing.) Therefore, Dissolve and Cut down, Vomit and Purge, Tonify and Drain. Old and New diseases use the same methods. (Dissolve removes stagnation. Cut down attacks hardness. Upper excess requires vomiting. Lower excess requires purging. Tonify due to righteous deficiency. Drain due to pathogenic excess. Usage has urgency, treatment has sequence, but old/new diseases share methods.)