（本篇尽出素问。末附灵枢一则。）
诸风掉眩。皆属于肝。（风木动摇。）诸寒收引。皆属于肾。（寒性缩急。）诸气 郁。皆属于肺。（肺主气。）诸湿肿
满。皆属于脾。（脾不营运。）诸痛痒疮。皆属于心。（疮疡皆属心火。火微则痒。火甚则痛。）诸厥固泄。皆属于下。（吴
注。下谓肾也。兼水火之司。阴精水衰。则有热厥。命门火衰。则有寒厥。肾开窍于二阴。水衰火实。则二便不通而为
固。火衰水实。则二便不禁而为泄。）诸痿喘呕。皆属于上。（上。谓肺也。肺主气。肺热叶焦。则诸脏无所禀气。故有
肺痿。及筋脉骨肉诸痿。喘呕亦属上焦。）诸热瞀（音茂。）螈。（昏乱抽掣。）皆属于火。诸禁（HT 。）鼓栗。如丧神
守。
皆属于火。（内热而外反寒。盖火性就燥。内热既甚。卫外之阳。皆凑入内。故外反鼓栗也。）诸逆冲上。皆属于火。诸
躁狂越。皆属于火。诸病 肿。（热盛于内。水随水溢。）酸痛惊骇。皆属于火。诸胀腹大。皆属于热。（热郁于内为热胀。
亦有寒郁而生寒胀者。东垣曰。大抵热胀少。寒胀多。故立中满分消丸治热胀。中满分消汤治寒胀。）诸病有声。（肠鸣。）
鼓之如鼓。（鼓胀。）皆属于热。（李士材曰。二病多有属寒者。）诸转反戾。（转筋之类。）水液混浊。（小便。）皆属于热。
诸呕吐酸。暴注下迫。（火泻里急。）皆属于热。诸痉项强。皆属于湿。（湿甚而兼风木之化。）诸暴强直。皆属于风。（风
性劲急。二证相类。而一属湿。一属风。）诸病水液。澄彻清冷。（吐溺。）皆属于寒。故大要曰。谨守病机。各司其属。
有者求之。（或有热有湿。或有风有寒。）无者求之。（或无水。或无火。或非热。或非寒。）盛者责之。虚者责之。（河间
着原病式。用病机十九条。而未及十六字。似属缺典。）必先五胜。（五行胜气。）疏其血气。令其调达。而致和平。此之
谓也。（此段次序稍易。以火从火。以热从热。用便观览。因于文义无害。故敢尔也。昂按。病机十九条。而火居其五。
热居其四。可见诸病火热为多。盖风寒暑湿。皆能为火为热也。宇宙间天地万物。皆赖此阳火。以为生发之本。若无此
火。则天地或几乎息矣。庄子所谓火传不知其尽。而释氏相宗。亦以暖与议并举也。但平则为恩。亢则为害。生杀之机。
互相倚伏。凡物皆然。故火能生人。而亦能杀人也。）诸气在泉。（司天略同。稍有异者。详本注中。经文在泉。每居司
天之前。）风淫于内。治以辛凉。佐以苦甘。（旧本无甘字。司天有甘字。）以甘缓之。以辛散之。（金能胜木。故治以辛
凉。辛过甚。恐伤气。故佐以苦甘。苦胜辛。甘益气也。木性急。故甘以缓之。木喜条达。故辛以散之。司天多酸以泻
之。无辛散句。）热淫于内。治以咸寒。佐以甘苦。以酸收之。以苦发之。（水胜火。故治以咸寒。甘胜咸。佐之所以防
其过也。心苦缓。故以酸收之。热郁于内。故以苦发之。司天无苦发句。）湿淫于内。治以苦热。佐以酸淡。（司天作酸
辛。又云湿上甚而热。治以苦温。佐以甘辛。以汗为故而止。）以苦燥之。以淡泄之。（苦热能燥湿。酸木能制土。淡能
利水。吴注。使酸而非淡。则味浓滋湿矣。泄。渗与汗也。）火淫于内。治以咸冷。佐以苦辛。（司天作苦甘。相火畏火
也。故治以咸冷。苦能泄热。辛能散能润。）以酸收之。以苦发之。（与治热淫同。）燥淫于内。治以苦温。佐以甘辛。（司
天作酸辛。）以苦下之。（火能胜金。故治以苦温。甘辛能润燥。燥热内结。以苦泻之可也。）寒淫于内。治以甘热。佐以
苦辛。（司天作平以辛热。佐以甘苦。）以咸泻之。以辛润之。以苦坚之。（土能制水。热能胜寒。故治以甘热。苦而辛。
亦热品也。伤寒内热者。以咸泻之。肾苦燥。以辛润之。肾欲坚。以苦坚之。）治诸胜复。寒者热之。热者寒之。温者清
（凉。）之。清者温之。散者收之。抑（郁。）者散之。燥者润之。急者缓之。坚者 （软。）之。脆者坚之。衰者补之。
强者泻之。各安其气。必清必静。则病气衰去。归其所宗。此治之大体也。气之胜也。微者随之。甚者制之。气之复也。
和者平之。暴者温之。皆随胜气。（胜复之气。）安其屈伏。（屈伏之气。）无问其数。以平为期。此其道也。寒者热之。
热者寒之。微者逆之。甚者从之。（王注。微者犹人火也。可以湿伏。可以水折。甚者犹龙火也。激则愈焰。当顺其性而
散之。按此与上文微者随之甚者制之相反。而各有其妙。）坚者削之。客者除之。劳者温之。（温养。）结者散之。留者攻
之。燥者濡之。急者缓之。散者收之。损者益之。逸者行之。惊者平之。上之（吐。）下之。（泻。）摩之浴之。薄之（渐
磨。）劫之。开之发之。适事为故。何谓逆从。（申明上文逆之从之二义。）曰。逆者正治。从者反治。（以寒治热。以热
治寒。逆病气者。谓之正治。以寒治热而佐以热药。以热治寒而佐以寒药。顺病气者。谓之反治。）从少从多。观其事也。
（视病之轻重。为药之多少。）反治何谓。（反治为治法玄微。故再三辨诘。）曰。热因寒用。寒因热用。塞因塞用。通因
通用。必伏其所主。（所主之病。）而先其所因。（所因之法。）其始则同。其终则异。可使破积。可使溃坚。可使气和。
可使必已。（王林注曰。热因寒用者。如大寒内结。以热攻除。寒甚格热。热不得前。则以热药冷服。下嗌之后。冷体既
消。热性便发。情且不违。而致大益。是热因寒用之例也。寒因热用者。如大热在中。以寒攻治则不入。以热攻治则病
增。乃以寒药热服。入腹之后。热气既消。寒性遂行。情且协和。而病以减。是寒因热用之例也。五常政大论。治热以
寒。温而行之。治寒以热。凉而行之。即此义也。塞因塞用者。如下焦虚乏。中焦气壅。 胁满盛。欲散满则益虚其下。
欲补下则满甚于中。病患告急。不救其虚。且攻其满。药入则减。药过依然。故中满下虚。其病益甚。不知疏启其中。
峻补其下。少服则资壅。多服则宣通。下虚既实。中满自除。此塞因塞用也。通因通用者。如大热内结。注泻不止。以
热涩之。结复未除。以寒下之。结散利止。此通因通用也。其积寒久泻。以热下之。同此法。）平气何如。曰。谨察阴阳
所在而调之。以平为期。正者正治。反者反治。（王注。阴病阳不病。阳病阴不病。是为正病。则以寒治热。以热治寒。
正治也。如阴位见阳脉。阳位见阴脉。是谓反病。则以寒治寒。以热治热。此反治也。）论言治寒以热。治热以寒。方士
不能废绳墨而更其道也。有病热者。寒之而热。有病寒者。热之而寒。二者皆在。新病复起。（寒热二症皆在。因服寒热
之药。反增新病。）奈何治。（欲根据标格。则病势不除。若废绳墨。则更无新法。）曰。诸寒之而热者取之阴。热之而寒者
取之阳。所谓求其属也。（王注。言益火之原。以消阴翳。壮水之主。以制阳光。故曰求其属也。又曰。脏腑之源。有寒
热温凉之主。取心者不必齐以热。取肾者不必齐以寒。但益心之阳。寒亦通行。强肾之阴。热之犹可。观斯之故。或治
热以热。治寒以寒。万举万全。孰知其意。）服寒而反热。服热而反寒。其故何也。曰。治其旺气。是以反也。（气当旺
之时。而复补助之。马注。或热太过而水不生。故虽用寒药而热不去。或寒太过而火不生。故虽用热药而寒不去。）不治
旺而然者。何也。曰。不治五味属也。（五味各有所属。）夫五味入胃。各归其所喜攻。酸先入肝。苦先入心。甘先入脾。
辛先入肺。咸先入肾。久而增气。（助其藏气。）物化之常也。气增而久。夭之由也。（久而增气。王注云。如久服黄连苦
参反热之类。气增不已。则脏有偏胜。偏胜则脏有偏绝。故致暴夭。生气通天论所谓味过于酸。肝气以津。脾气乃绝。
即其义也。）方制君臣。何谓也。主病之谓君。（主治是病者。为君药。）佐君之谓臣。应臣之谓使。（佐应者。为臣使药。）
非上下三品之谓也。（神农制本草。以上药一百二十品为君。中药一百二十品为臣。下药一百二十五品为佐使。）气有多
少。病有盛衰。治有缓急。方有大小。奈何。曰。气有高下。（马注。司天在泉。观下文补上治上二句。当属上部下部。）
病有远近。（久病新病。位远位近。）证有中外。（内伤。外感。）治有轻重。（轻剂。重剂。）适其至所为故也。（治以适至
其所为节。如病高而治下。病远而治近。病中而治外。病重而治轻。皆为药病不相当也。）大要曰。君一臣二。奇之制也。
君二臣四。偶之制也。君二臣三。奇之制也。君二臣六。偶之制也。（王注。奇。古之单方。偶。古之复方。）故曰。近
者奇之。远者偶之。汗者不以奇。下者不以偶。补上治上制以缓。（恐其下迫。）补下治下制以急。（恐其力微。）急则气
味浓。（用气浓味浓之药。）缓则气味薄。（用气薄味薄之药。）适其至所。此之谓也。是故平气之道。近而奇偶。制小其
服也。（心肺位近。或补或汗。宜小其服。）远而奇偶。制大其服也。（肝肾位远。或补或下。宜大其服。）大则数少。小
则数多。多则九之。（味多而分两轻。）少则二之。（味少而分两重。）奇之不去则偶之。是谓重方。（即复方。不能少而奇，
宁多而偶。所谓逆者正治也。）偶之不去则反佐以取之。所谓寒热温凉。反从其病也。（马注。取药味之寒热温凉。反同
于病之寒热温凉者以佐之。乃因其性而利导之。所谓从者反治也。）病之中外何如。曰。调气之方。必别阴阳。定其中外。
各守其乡。内者内治。（阴经里证。）外者外治。（阳经表证。）微者调之。其次平之。盛者夺之。汗者（者当作之。）下之。
寒热温凉。衰之以属。随其攸利。（王注。假如小寒之气。温以和之。大寒之气。热以取之。甚寒之气。则下夺之。夺之
不已。则逆折之。折之不尽。则求其属以衰之。小热之气。凉以和之。大热之气。寒以取之。甚热之气。则汗发之。发
之不尽。则逆制之。制之不尽。则求其属以衰之。）病之中外何如。曰。从内之外者调其内。（皆先治其本。后治其标。）
从外之内者治其外。从内之外而盛于外者。先调其内而后治其外。从外之内而盛于内者。先治其外而后调其内。中外不
相及。则治主病。（中不出外。外不入中。则治其本病。）五味阴阳之用何如。辛甘发散为阳。酸苦涌泄。（涌吐。泄下。）
为阴。咸味涌泄为阴。淡味渗泄为阳。（利小便。）六者或收（酸。）或散。（辛。）或缓（甘。）或急。（咸苦。）或燥。（苦。）
或润。（辛。）或 。（咸。）或坚。（苦。）以所利而行之。调其气使其平也。（至真要大论）
补上下者从之。治上下者逆之。（王注。上下谓司天在泉也。气不及。则顺其味以和之。气太过。则逆其味以折之。）
以所在寒热盛衰而调之。（地有寒热异宜。人有盛衰异质。）故曰。上取（涌吐。一曰头面胸喉。）下取。（泄利。一曰少
腹胫足。一曰二便通塞。）内取（药饵。一曰切脉虚实。一曰沉以候里。）外取。（形色。一曰按摩针灸。一曰渍形为汗。
一曰浮以候表。）以求其过。能（耐。）毒者以浓药。不胜毒者以薄药。（视其人之强弱。）气反者。病在上。取之下。（通
其下而上病愈。）病在下。取之上。（升其上而下病愈。）病在中。旁取之。（病在中。而经脉行于左右。针灸熨药而旁取
之。灵枢终始篇。病在上者下取之。病在下者高取之。病在头者取之足。病在腰者取之 。此言刺法。然药饵亦有此理。
李东垣曰。灵枢曰。头有疾。取之足。谓阳病取阴也。足有疾。取之上。是阴病取阳也。中有疾。旁取之。中者。脾胃
也。旁者。少阳甲胆也。甲胆风木也。东方春也。胃中谷气者。便是风化也。胃中湿胜而成泄泻。宜助甲胆。风胜以克
之。又是升阳。助清气上行之法也。）治热以寒。温而行之。（寒药热服。）治寒以热。凉而行之。（热药凉服。二者为反
治。）治温以清。冷而行之。（清药冷服。）治清以温。热而行之。（温药热服。二者为正治。）故消之削之。吐之下之。补
之泻之。久新同法。病有久新。方有大小。有毒无毒。（药之有毒无毒者。）固宜常制（度。）矣。大毒治病。十去其六。
（过之则伤正气。）常毒治病。十去其七。小毒治病。十去其八。无毒治病。十去其九。（张子和曰。凡药皆毒也。虽苦
参甘草。不可不谓之毒。久服必偏胜为害。）谷肉果菜。食养尽之。（饮食调养。以尽病邪。藏气法时论。毒药攻邪。五
谷为养。五果为助。五畜为益。五菜为充。）无使过之。伤其正也。不尽。行复如法。（余邪未尽。复行前法。）必先岁气。
(The content of this chapter is entirely derived from the *Suwen*. At the end, one passage from the *Lingshu* is appended.)
All wind diseases manifesting as tremors and dizziness belong to the Liver. (Wind and Wood qi cause shaking.) All cold diseases manifesting as contraction and pulling belong to the Kidney. (Cold nature causes shrinking and urgency.) All qi disorders manifesting as stagnation and depression belong to the Lung. (The Lung governs Qi.) All dampness diseases manifesting as edema and fullness belong to the Spleen. (The Spleen fails in transportation and transformation.) All pain, itching, and sores belong to the Heart. (Sores generally belong to Heart Fire; mild fire causes itching, severe fire causes pain.) All Jue (reversal) conditions, constipation, and diarrhea belong to the Lower Jiao. (Wu's commentary: The Lower Jiao refers to the Kidney, which manages both Water and Fire. Deficiency of Yin essence/Water leads to Heat Jue; deficiency of Mingmen Fire leads to Cold Jue. The Kidney opens into the two yin orifices. When Water is deficient and Fire is excessive, the two bowels are blocked causing retention; when Fire is deficient and Water is excessive, the two bowels are uncontrolled causing diarrhea.) All Wei (wasting) syndromes, asthma, and vomiting belong to the Upper Jiao. (Upper Jiao refers to the Lung. The Lung governs Qi. If Lung heat scorches the leaves, other Zang organs cannot receive Qi, leading to Lung Wei and wasting of sinews, vessels, bones, and flesh; asthma and vomiting also belong to Upper Jiao disorders.) All heat diseases manifesting as mental confusion and convulsions belong to Fire. (Mao: confusion; Yuan: convulsions.) All conditions with mouth closure, abdominal distension like a drum, and shivering, as if losing spiritual control, belong to Fire. (Internal heat with external cold. Since Fire nature follows dryness, when internal heat is severe, defensive Yang gathers internally, causing external shivering and distension.) All rebellious Qi rushing upward belong to Fire. All restlessness, mania, and transgression belong to Fire. All diseases manifesting as swelling, soreness, pain, fright, and horror belong to Fire. (Heat excess internally, water overflows with heat.) All abdominal distension and enlargement belong to Heat. (Heat stagnating internally causes heat distension; there are also cold distensions caused by cold stagnation. Li Dongyuan said: Generally, heat distension is rare, cold distension is common. Thus, Zhongman Fenxiao Wan treats heat distension, and Zhongman Fenxiao Tang treats cold distension.) All diseases manifesting with bowel sounds (borborygmus) and abdominal distension like a drum belong to Heat. (Li Shicai said: These two diseases often belong to Cold.) All tendon contractions and twisting, and turbid urine belong to Heat. All vomiting of sour fluid, sudden diarrhea with tenesmus belong to Heat. All spasm and neck stiffness belong to Dampness. (Severe dampness combined with Wind-Wood transformation.) All sudden stiffness and rigidity belong to Wind. (Wind nature is forceful and urgent; these two syndromes are similar but one belongs to Dampness and the other to Wind.) All bodily fluids that are clear and cold (vomit, urine) belong to Cold. Therefore, the Great Principle states: Carefully observe the pathogenesis and assign each to its category. Investigate what is present (there may be heat, dampness, wind, or cold). Investigate what is absent (there may be no water, no fire, not heat, not cold). For excess, blame the excess pathogen; for deficiency, blame the deficiency of healthy Qi. (He Jian wrote *Yuan Bing Shi*, citing the Nineteen Pathogenesis Formulas, but did not mention these sixteen characters, which seems like an omission.) First analyze the Five Elements' winning and retaliating qi. Unblock their Blood and Qi, make them harmonious and smooth, and achieve peace. This is what is meant. (The order of this paragraph is slightly changed to group Fire with Fire and Heat with Heat for easier reading, as it does not harm the meaning, so I dare to do so. Wang Ang notes: Among the Nineteen Pathogenesis Formulas, Fire accounts for five and Heat accounts for four, showing that most diseases involve Fire and Heat. Generally, Wind, Cold, Summerheat, and Dampness can all transform into Fire and Heat. All things in the universe rely on this Yang Fire as the root of generation. Without this Fire, Heaven and Earth would almost cease. As Zhuangzi said, "Fire is passed on without knowing its end," and Buddhist Abhidharma also pairs warmth with consciousness. However, when balanced it is grace, when excessive it is harm; the mechanism of life and death relies on each other, as do all things. Thus, Fire can nourish humans but also kill them.)
Regarding Qi at the Spring (Si Tian is similar, with slight differences detailed in the original note. In the text, Qi at the Spring usually precedes Qi at the Ground). When Wind dominates internally, treat with Pungent-Cool, assist with Bitter-Sweet. (Old texts lack "Sweet"; Si Tian has "Sweet".) Use Sweet to relax, use Pungent to disperse. (Metal conquers Wood, so treat with Pungent-Cool. Excessive Pungent may damage Qi, so assist with Bitter-Sweet. Bitter controls Pungent, Sweet tonifies Qi. Wood nature is urgent, so Sweet relaxes it. Wood likes free flow, so Pungent disperses it. Si Tian uses Sour to drain, without the Pungent dispersal phrase.) When Heat dominates internally, treat with Salty-Cold, assist with Sweet-Bitter. Use Sour to astringe, use Bitter to vent. (Water conquers Fire, so treat with Salty-Cold. Sweet controls Salty, assisting prevents excess. Heart dislikes slackness, so Sour astringes. Heat stagnates internally, so Bitter vents. Si Tian lacks the "Bitter vent" phrase.) When Dampness dominates internally, treat with Bitter-Hot, assist with Sour-Neutral. (Si Tian makes it Sour-Pungent; also says if Dampness is severe above with Heat, treat with Bitter-Warm, assist with Sweet-Pungent, stop when sweating occurs.) Use Bitter to dry, use Neutral to drain. (Bitter-Hot dries Dampness; Sour-Wood controls Earth; Neutral promotes urination. Wu's note: Using Sour instead of Neutral results in thick flavors that generate Dampness. Drain refers to渗利 and sweating.) When Fire dominates internally, treat with Salty-Cold, assist with Bitter-Pungent. (Si Tian makes it Bitter-Sweet; Ministerial Fire fears Water, so treat with Salty-Cold. Bitter drains Heat, Pungent disperses and moistens.) Use Sour to astringe, use Bitter to vent. (Same as treating Heat dominance.) When Dryness dominates internally, treat with Bitter-Warm, assist with Sweet-Pungent. (Si Tian makes it Sour-Pungent.) Use Bitter to purge downward. (Fire conquers Metal, so treat with Bitter-Warm. Sweet-Pungent moistens dryness; Dryness-Heat knots internally, purging with Bitter is appropriate.) When Cold dominates internally, treat with Sweet-Hot, assist with Bitter-Pungent. (Si Tian makes it Flat with Pungent-Hot, assist with Sweet-Bitter.) Use Salty to purge, use Pungent to moisten, use Bitter to firm. (Earth controls Water, Heat conquers Cold, so treat with Sweet-Hot. Bitter and Pungent are also hot agents. For Cold injury with internal Heat, use Salty to purge; Kidney dislikes dryness, use Pungent to moisten; Kidney desires firmness, use Bitter to firm.)
To treat various winning and retaliating Qi: Treat Cold with Hot, Heat with Cold, Warm with Cool, Cool with Warm, Scattered with Astringent, Stagnant with Dispersing, Dry with Moistening, Urgent with Relaxing, Hard with Softening, Fragile with Firming, Weak with Tonifying, Strong with Draining. Calm their Qi, ensure clarity and stillness, then the pathogenic Qi will decline and return to its source. This is the general principle of treatment. For winning Qi, follow the minor ones, restrain the severe ones. For retaliating Qi, level the moderate ones, warm the violent ones. Always follow the winning Qi, settle the suppressed Qi, regardless of number, aiming for balance. This is the way. Treat Cold with Hot, Heat with Cold. Minor cases reverse the disease (Orthodox Treatment), severe cases follow the disease (Counter Treatment). (Wang Bing's note: Minor is like human fire, can be subdued by wetness or water. Severe is like dragon fire, provoking it increases flames; one should follow its nature to dissipate it. Note: This contradicts "minor follow, severe restrain" above, but both have their merits.) Harden by reducing, guests by removing, labor by warming, knots by dispersing, retention by attacking, dryness by moistening, urgency by relaxing, scattering by astringing, loss by benefiting, leisure by moving, fright by calming. Elevate those above, descend those below, massage, bathe, gradually grind,劫夺 (rob/seize), open, vent. Suit the method to the situation. What is Reverse and Follow? (Clarifying the two meanings of reverse and follow above.) Answer: Reverse is Orthodox Treatment, Follow is Counter Treatment. (Using Cold to treat Heat, Hot to treat Cold, reversing the disease Qi is Orthodox Treatment. Using Cold to treat Heat but assisting with Hot herbs, or Hot to treat Cold but assisting with Cold herbs, following the disease Qi is Counter Treatment.) Follow few or many, observe the case. (View severity to determine drug quantity.) What is Counter Treatment? (Counter treatment is subtle, hence repeated questioning.) Answer: Heat due to Cold usage, Cold due to Heat usage, Blockage due to Blockage usage, Flow due to Flow usage. Must subdue the main pathology, first address the cause. Initially same, finally different. Can break accumulations, dissolve hardness, harmonize Qi, ensure cure. (Wang Lin's note: Heat due to Cold usage: e.g., severe internal cold treated with Hot drugs, but cold repels heat. Take Hot drugs cold; after swallowing, cold body dissipates, Hot nature activates, complying with sentiment while achieving benefit. This is the example. Cold due to Heat usage: e.g., severe internal heat, Cold drugs don't enter, Hot drugs worsen condition. Take Cold drugs hot; after entering abdomen, heat dissipates, Cold nature acts, harmonizing sentiment and reducing disease. This is the example. *Wu Chang Zheng Da Lun* says: Treat Heat with Cold, administer warm; Treat Cold with Hot, administer cool. This is the meaning. Blockage due to Blockage usage: e.g., lower Jiao deficiency, middle Jiao Qi obstruction, flank fullness. To disperse fullness worsens lower deficiency; to tonify lower worsens middle fullness. Patient urgent. If not saving deficiency but attacking fullness, drug reduces temporarily but returns. So middle fullness and lower deficiency worsen. Not knowing to open middle and tonify lower heavily. Small dose aids stagnation, large dose promotes flow. Once lower is solid, middle fullness removes itself. This is Blockage due to Blockage usage. Flow due to Flow usage: e.g., severe internal heat, continuous diarrhea. Heat-astringent doesn't remove knot. Cold-purgative removes knot, stops flow. This is Flow due to Flow usage. Also chronic cold diarrhea treated with Hot purgatives follows this method.)
What is Leveling Qi? Answer: Carefully observe Yin and Yang locations and regulate them, aiming for balance. Correct disease gets correct treatment, reversed disease gets reversed treatment. (Wang Bing's note: Yin disease without Yang disease, Yang disease without Yin disease is correct disease; treat Heat with Cold, Cold with Hot, this is correct treatment. If Yin position shows Yang pulse, Yang position shows Yin pulse, this is reversed disease; treat Cold with Cold, Hot with Hot, this is reversed treatment.) Text says treat Cold with Hot, Heat with Cold. Physicians cannot abandon rules and change the path. But some heat patients treated with Cold get hotter; some cold patients treated with Hot get colder. Both exist, new diseases arise. How to treat? (Following rules leaves disease unchecked; abandoning rules leaves no new method.) Answer: Those treated with Cold who get hotter, take from Yin; those treated with Hot who get colder, take from Yang. This is called seeking their affiliation. (Wang Bing's note: Enlarge Fire source to eliminate Yin shadows; strengthen Water master to control Sunlight. Hence seek affiliation. Also: Zang-Fu sources have Cold/Hot/Warm/Cool masters. Treating Heart need not always be Hot; treating Kidney need not always be Cold. Just benefit Heart Yang, Cold can circulate; strengthen Kidney Yin, Heat can work. Observing this, some treat Heat with Hot, Cold with Cold, perfectly successful. Who knows the intent?) Taking Cold but getting Heat, taking Hot but getting Cold, why? Answer: Treating the prosperous Qi, thus reversal. (When Qi is prosperous, aiding it again. Ma's note: Or Heat too much and Water not born, so Cold drugs don't remove Heat; or Cold too much and Fire not born, so Hot drugs don't remove Cold.) Why not treating prosperous Qi but happening so? Answer: Not treating the Five Flavors' affiliation. (Five Flavors each have affiliations.) When Five Flavors enter Stomach, they go to their preferred targets. Sour enters Liver first, Bitter enters Heart first, Sweet enters Spleen first, Pungent enters Lung first, Salty enters Kidney first. Long-term use increases Qi (assists Zang Qi). This is the constant of transformation. Increased Qi for long time is the cause of premature death. (Long-term increase of Qi, Wang Bing notes: e.g., long-term Coptis/Polygala use causing Heat. Qi increase indefinitely leads to Zang excess, excess leads to Zang extinction, causing sudden death. *Sheng Qi Tong Tian Lun* says: Flavor too Sour, Liver Qi overflows, Spleen Qi perishes. This is the meaning.)
Formula Sovereign-Minister system, what is it? Sovereign treats the disease. (Treating the disease is Sovereign herb.) Minister assists Sovereign. Envoy responds to Minister. (Assisting/responding are Minister-Envoy herbs.) Not referring to Upper/Middle/Lower categories. (Shennong categorized 120 Upper herbs as Sovereign, 120 Middle as Minister, 125 Lower as Assistant-Envoy.) Qi has amounts, disease has excess/deficiency, treatment has slow/fast, formula has big/small. How? Answer: Qi has high/low (Ma's note: Si Tian/Spring, see below tonify upper/treat upper sentences, belongs to upper/lower parts). Disease has near/far (chronic/new, distant/near location). Syndrome has inside/outside (internal injury, external contraction). Treatment has light/heavy (light agent, heavy agent). Suit reaching the target. (Treatment suits reaching the target. E.g., disease high treat low, disease far treat near, disease middle treat outside, disease heavy treat light, all mismatched.) Great Principle says: Sovereign 1 Minister 2 is Odd system. Sovereign 2 Minister 4 is Even system. Sovereign 2 Minister 3 is Odd system. Sovereign 2 Minister 6 is Even system. (Wang Bing's note: Odd is ancient single formula; Even is ancient compound formula.) Thus say: Near use Odd, Far use Even. Sweating not necessarily Odd, Purging not necessarily Even. Tonify upper/treat upper make slow (fear downward pressure). Tonify lower/treat lower make fast (fear weak power). Fast means strong flavor/odor (use strong odor/flavor drugs). Slow means weak flavor/odor (use weak odor/flavor drugs). Suit reaching target, this is it. Therefore, leveling Qi path: Near with Odd/Even, make small dosage (Heart/Lung near, tonify/sweat, small dosage). Far with Odd/Even, make large dosage (Liver/Kidney far, tonify/purge, large dosage). Large means few items, Small means many items. Many is nine (many flavors, light weight). Few is two (few flavors, heavy weight). If Odd fails, use Even, called Heavy Formula (i.e., Compound. Better many-even than few-odd. Reverse is Orthodox). If Even fails, use counter-assistant to take effect, called Cold/Hot/Warm/Cool, counter-following disease (Ma's note: Take drug flavors Cold/Hot/Warm/Cool, opposite to disease's Cold/Hot/Warm/Cool to assist, guiding by nature. Follow is Counter Treatment).
Disease inside/outside how? Answer: Regulating Qi formulas must distinguish Yin/Yang, fix inside/outside, keep respective villages. Inside treat inside (Yin meridian interior syndrome). Outside treat outside (Yang meridian exterior syndrome). Minor adjust, next level level, excess seize. Sweat, purge, Cold/Hot/Warm/Cool, decay by affiliation, follow benefits. (Wang Bing's note: Small Cold air, warm to harmonize; Large Cold air, hot to take; Severe Cold air, purge to seize. If purge insufficient, reverse to cut. If cutting insufficient, seek affiliation to decay. Small Heat air, cool to harmonize; Large Heat air, cold to take; Severe Heat air, sweat to emit. If sweating insufficient, reverse to control. If controlling insufficient, seek affiliation to decay.) Disease inside/outside how? Answer: From inside to outside, treat inside (treat root first, branch later). From outside to inside, treat outside. From inside to outside and severe outside, first regulate inside then treat outside. From outside to inside and severe inside, first treat outside then regulate inside. Inside/Outside unrelated, treat main disease (Inside doesn't go out, Outside doesn't enter inside, treat root disease).
Five Flavors Yin/Yang usage how? Pungent/Sweet disperse/yang, Sour/Bitter涌泄 (vomit/purge) yin. Salty涌泄 yin, Neutral渗泄 yang (promote urination). Six types: some astringe (Sour), some disperse (Pungent), some relax (Sweet), some urgent (Salty/Bitter), some dry (Bitter), some moisten (Pungent), some soften (Salty), some firm (Bitter). Act by benefit, regulate Qi to peace. (*Zhi Zhen Yao Da Lun*)
Tonify upper/follow, treat upper/reverse. (Wang Bing's note: Upper/Lower refer to Si Tian/Spring. Qi insufficient, follow flavor to harmonize; Qi excessive, reverse flavor to cut.) Regulate by location Cold/Heat excess/deficiency. (Earth has Cold/Heat suitability, Humans have Excess/Deficiency constitution.) Thus say: Upper take (vomit, or head/chest/throat), Lower take (purge/drain, or lower abdomen/shins/feet, or two bowels open/close), Inside take (medicine, or pulse void/solid, or deep to hear inside), Outside take (color/form, or massage/acupuncture, or soak form for sweat, or floating to hear outside), seek fault. Endure poison use strong drug, cannot endure poison use thin drug (view person strength). Qi reversal: Disease above, take below (unblock below, above disease cures). Disease below, take above (lift above, below disease cures). Disease middle, take side (Disease middle, meridians run left/right, acupuncture/warming/drugs take side. *Lingshu Zhong Shi*: Disease above take below, Disease below take high, Disease head take foot, Disease waist take popliteal. This refers to needling, but medicine has this logic too. Li Dongyuan says: *Lingshu* says: Head disease take foot, Yang disease take Yin; Foot disease take above, Yin disease take Yang; Middle disease take side, Middle is Spleen/Stomach, Side is Shaoyang Gallbladder, Gallbladder Wind-Wood, East Spring, Grain Qi in Stomach is Wind transformation, Stomach Dampness causes diarrhea, assist Gallbladder, Wind conquers, also lifting Yang assisting Clear Qi ascending method.) Treat Heat with Cold, administer warm (Cold drugs hot take). Treat Cold with Hot, administer cool (Hot drugs cold take. These two are Counter Treatment). Treat Warm with Clear, administer cold (Clear drugs cold take). Treat Clear with Warm, administer hot (Warm drugs hot take. These two are Orthodox Treatment). Thus reduce, shave, vomit, purge, tonify, drain, old/new same method. Disease old/new, formula big/small, drug toxic/non-toxic (drugs toxic/non-toxic), should have constant measure. Great toxicity treat disease, remove ten of six (excess damages healthy Qi). Common toxicity treat disease, remove ten of seven. Small toxicity treat disease, remove ten of eight. Non-toxicity treat disease, remove ten of nine. (Zhang Hezi says: All drugs are toxic, even Polygala/Glycyrrhiza cannot be called non-toxic, long-term use causes excess harm.) Grain/Meat/Fruit/Vegetable, food nourishment exhausts it (dietary nourishment exhausts pathogen. *Zang Qi Fa Shi Lun*: Toxic drugs attack pathogen, Five Grains nourish, Five Fruits assist, Five Livestock benefit, Five Vegetables fill.) Do not exceed, damage Zheng Qi. Not exhausted, repeat method. First must year Qi.