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Diseases mostly manifest as peaceful. However, since its qi is pure and unified, there is also the fear that hyperactivity will cause harm; therefore, it is said that changes in movement have more or less, disease manifestations have mild or severe degrees, and life and death have early or late timings. Observing the twenty-four years mentioned in the classic text, only in the eight years of Suihui (Year Meeting) is it stated: "What is called Suihui is the peace of qi," from which the imbalance of other years can be known. Thus, it is said that "restriction leads to generation and transformation"; consequently, what lacks restriction becomes harmful. Therefore, there are variations such as arriving when not due, or being due but not arriving, all of which are deviations of qi. One cannot assume that because it is peaceful, it is normal and thus neglect observation."

The Yellow Emperor said: The Master spoke of avoiding cold when using cold remedies, and avoiding heat when using heat remedies. I do not understand this principle; I wish to hear what "avoiding" means. Qibo said: Do not offend heat with heat, and do not offend cold with cold. ("Avoiding" refers to shunning taboos, i.e., not offending. Whenever using heat remedies, do not offend the heat of the ruling qi; whenever using cold remedies, do not offend the cold of the ruling qi. This is called "do not offend heat with heat, do not offend cold with cold.") Following the climate brings harmony; opposing it causes disease. One must not fail to revere and avoid it; this is referred to as Time and the Six Positions. ("Time refers to the Four Seasons, i.e., the Dominant Qi. Position refers to the Six Steps, i.e., the Guest Qi. Both Dominant and Guest Qi should be revered; not offending is following, while offending is opposing.") The Yellow Emperor asked: What about Warmth and Coolness? ("Does this mean that since Warmth and Coolness are slightly inferior to Heat and Cold, can they be offended?") Qibo replied: If the ruling qi is Heat, do not use Heat remedies to offend it; if the ruling qi is Cold, do not use Cold remedies to offend it; if the ruling qi is Coolness, do not use Coolness remedies to offend it; if the ruling qi is Warmth, do not use Warmth remedies to offend it. (Note: Ruling Qi refers to the Qi governing Heaven and Earth. It means that although Heat and Cold should certainly not be offended, Warmth and Coolness should also be avoided. The influence of the Year's Qi is extremely significant; even slight offense can cause harm.) For the Intermittent Qi (Jianqi), if it is the same as the Dominant Qi, do not offend it; if it differs from the Dominant Qi, a slight offense is permissible. ("Intermittent Qi refers to the Guest Qi of the four left and right positions. Dominant Qi refers to the Dominant Qi. 'Same' means sharing the same Heat or Cold, where the qi is very strong, so it cannot be offended. 'Different' means Dominant Cold with Guest Heat, or Dominant Heat with Guest Cold, where the qi is dispersed and the pathogenic factors differ, so one may slightly offend according to the trend. The previous section discussed Ruling Qi, this section discusses Intermittent Qi. As stated in *Zhi Zhen Yao Da Lun*: 'Those governing the year record the year; those governing steps record the step.'") This is called the Four Fears, which must be carefully examined. ("The Four Fears are Cold, Heat, Warmth, and Coolness.") The Yellow Emperor said: Excellent! What happens if one offends them? ("This asks what to do if one must inevitably offend them.") Qibo said: If the Heavenly Qi (Guest Qi) goes against the seasonal timing, one may follow the seasonal timing (Dominant Qi). ("Heavenly Qi refers to Guest Qi, and Time refers to Dominant Qi. When Guest does not match Dominant, it is called 'against time.' In cases of 'against time,' one should follow the Dominant Qi, because the cycle of Dominant Qi has regularity, while the manifestation of Guest Qi is indefinite; thus, one temporarily follows the Dominant.") And if the Guest Qi overcomes the Dominant Qi, one may offend it. ("Overcoming the Dominant Qi means the Guest Qi is excessive. For example, extreme cold in summer indicates Guest Water overcoming Master Fire. Extreme heat in winter indicates Guest Fire overcoming Master Water. The coolness of spring and warmth of autumn are similar. Thus, one may use Heat remedies to offend Heat times, Cold remedies to offend Cold times, Coolness remedies to offend Coolness times, and Warmth remedies to offend Warmth times, thereby adapting to changes. This is called 'Following Treatment'.") Aim for balance and do not exceed limits. (... "Exceeding limits damages Righteous Qi and increases disease.") Therefore, it is said: Do not lose the trust of Heaven (seasonal certainty), do not oppose the appropriateness of Qi, do not assist Winning Qi, do not praise Repaying Qi. This is called Supreme Governance. ("When Guest and Dominant Qi arrive at their proper times, it is the Trust of Heaven; failing to know seasonal Qi loses this trust. Using Cold, Heat, Warmth, and Coolness appropriately is the Appropriateness of Qi; failing to recognize Following or Opposing opposes this appropriateness. Assisting Winning Qi and praising Repaying Qi both aid Pathogenic factors. Knowing this and not offending is the subtlety of Supreme Governance.")

The Yellow Emperor said: Excellent! Does the Qi of the Five Movements also have Repayment? ("Repayment refers to retaliation. This asks if the Qi of the Five Movements, like the Winning and Repaying of the Six Qi, appears annually.") Qibo said: Only when stagnation reaches its extreme does it erupt, waiting for the appropriate time to act. (When the Five Movements are excessively overcome, their stagnation must reach an extreme; once extreme, they erupt, each having its specific timing. See below for details.) The Yellow Emperor asked: Please explain what this means. Qibo said: The Qi of the Five Constants, whether excessive or deficient, manifests differently. The Yellow Emperor said: I wish to hear the complete explanation. Qibo said: Excess manifests violently/suddenly, deficiency manifests slowly/gently. Violent manifestations lead to severe disease, while slow manifestations lead to lingering disease. ("Lingering refers to advancing and retreating in a tangle, holding out for a long time. Excess qi is violent, deficiency qi is slow; this is the natural order. However, the text later says 'The Great arrives slowly and constantly, the Small arrives violently and perishes,' which seems contrary. One must realize that the violence of the Great is due to unbridled strength, while the perish of the Small is due to injury. Unbridled strength can still be controlled, but injury cannot be sustained. Thus, these two sections complement each other to elucidate the meaning of subtle versus severe.") The Yellow Emperor asked: What are the numbers for excess and deficiency? Qibo said: Excess uses Completion Numbers, deficiency uses Generation Numbers. Earth always uses Generation Numbers. ("Excess uses Completion Numbers, representing abundant qi. Deficiency uses Generation Numbers, representing weak qi. Earth's qi is born/long-lived in the four seasons, so it always uses Generation Numbers without needing Completion Numbers. These numbers having generation and completion likely reflect the concept of qi within the state! All sixty-year cycles of luck and governance numbers, such as 'Cold Transformation 1, Cold Transformation 6,' refer to this." Note: "Earth always uses Generation" means Earth occupies the Central Palace, and its number stops at five. Wherever the text mentions Humidity Transformation or Rain Transformation as five, this is the case. Seeking the deeper meaning, Earth has no Completion Number and only speaks of the Generation Number five because Earth is the mother of all things, generating endlessly, reigning successively in time, taking generation as constant. Unlike deficient movements where qi can be added, excessive movements are so full that they cannot generate things.)

The Yellow Emperor asked: How do they manifest? Qibo said: When Earth Stagnation erupts, cliffs and valleys shake and startle, ("Wood overcomes Earth, causing Earth stagnation. When stagnation reaches extremity, it becomes angry; anger moves, then it erupts. Cliffs and valleys represent deep Earth. Shaking and startling represent the eruption of Earth Qi.") Thunder roars in the intersection of Qi, ("Roaring means盛大. Intersection of Qi is in the middle of ascending and descending, also between the Third and Fourth Qi. Fire and Dampness combine to form Qi, erupting as thunder, hence it is prosperous during the Fire and Dampness commands.") Dust haze dims yellow and black, ("Dust and smog obscure the sun.") transforming into white Qi, ("Vaporized dampness, belonging to mountain mist.") drifting storms strike high and deep, ("Drifting winds and sudden rains break through high and deep places.") striking stones flying in the air, floods then follow, ("Rockslides and rolling stones, floods emerge accordingly.") rivers overflow, fields and pastures resemble scattered foals of earth, ("Rivers overflow, submerbing suburbs and plains. Fields and pastures resembling foals refers to after the flood, only towering earth and stones remain, looking like a herd of foals grazing in the fields.") Transformation Qi spreads, good at bringing timely rain, ("Earth Dampness transformation, released from stagnation.") beginning to grow, beginning to lengthen, beginning to transform, beginning to complete. ("Earth Qi being stagnant delays all transformations. However, Earth Stagnation erupts between the Third and Fourth Qi, so it can still grow and complete, not losing its season.") Thus, the people suffer from heart and abdominal distension, intestinal murmurs and frequent diarrhea, and in severe cases, heart pain, hypochondriac fullness, vomiting, Huoluan (cholera-like syndrome), fluid retention with projectile diarrhea, edema, and heavy body. ("These are all diseases caused by Damp Earth. Dampness in the Upper and Middle Jiao causes heart and abdominal distension. Dampness in the Lower Jiao causes frequent diarrhea and dysentery. Heart affected by Dampness causes heart pain. Liver insulted by Dampness causes hypochondriac distension. Sound without matter is Ou (retching), matter expelled is Tu (vomiting). Huoluan involves simultaneous vomiting and diarrhea, with confusion of mind and eyes. Yin refers to Phlegm-Fluid. Zhu Xia refers to sudden profuse diarrhea. Dampness injuring flesh causes edema and heaviness. These are all signs of Earth erupting Damp Pathogens.") Clouds rush to the Rain Mansion, morning glow embraces the rising sun, mountains and marshes are dim with dust haze; this is the eruption, occurring in the Fourth Qi. ("Rain Mansion is where Taiyin Dampness gathers. Morning glow embracing the sun appears at dawn. Dust haze is the turbidity of Earth Qi. Earth governs the Fourth Qi, after Major Heat in mid-June, lasting over sixty days. Thus, Earth Stagnation erupts in the Fourth Qi.") Clouds cross Tian Mountain, mayflies appear and disappear; this is the omen of impending stagnation. ("Mayfly refers to ephemera, born in the morning, dying at night, appearing in yin weather. Here, large clouds crossing Tian Mountain and small mayflies appearing/disappearing indicate that Earth Stagnation is about to erupt, making the omen clear. Fu refers to stagnation, pronounced Fo.")

When Metal Stagnation erupts, the sky is clean and the earth bright, the air is clear and piercing, ("Fire overcomes Metal, causing Metal stagnation. Metal Qi is clear and urgent, so its eruption appears thus.") great coolness arises, grass and trees float with smoke, (Note: Coolness is Metal Qi, smoke is Fire Qi. Metal reigns in Autumn, when it is greatly cool; Fire retreats from command, and its Qi floats among grass and trees. Jing Yue mistakenly considered floating smoke as Metal's condensing Qi.) dryness Qi flows, dense fog rises frequently, ("When Metal Qi arrives, Dryness Qi flows; when Yin Qi condenses, dense fog rises. , refers to dense fog, pronounced Mao.") killing Qi arrives, grass and trees become pale and dry, Metal produces sound. (Note: Autumn Qi is肃杀 (solemn and killing), hence called Killing Qi, not Yin Qi. Grass and trees wither here; the Qi is dry and vigorous, producing a clear and sharp sound, called Autumn Sound, which is Metal Sound.) Thus, the people suffer from cough and reverse Qi, chest and hypochondriac fullness, pulling to the lower abdomen, prone to sudden pain making turning difficult, dry throat, and dark, foul complexion. (Cough and reverse Qi, dry throat, indicate Lung disease with Dryness. Chest/hypochondriac fullness pulling to lower abdomen, sudden pain preventing turning, indicates Metal Qi overcoming and injuring Liver. Chen means dusk/dark; Metal Qi is solemn and killing, hence face is dark and foul.) Mountains and marshes scorch and wither, soil congeals with frost and salt; this is the eruption, occurring in the Fifth Qi. (Dryness Qi flows, hence mountains/marshes scorch, soil surface turns white, salt crystallizes as frost. Metal reigns in the Fifth Qi, governing after Autumn Equinox in mid-August, lasting over sixty days. Thus, its eruption occurs in the Fifth Qi. Lu pronounced Lu.) Night snow and White Dew, forests and thickets sound desolate; this is the omen. (Note: Frost in late autumn follows White Dew. Xue implies leaking. Desolate sound in forests is Metal Wind moving. This is the omen of Autumn.)

When Water Stagnation erupts, Yang Qi retreats, ("Earth overcomes Water, causing Water stagnation. When Water stagnates and erupts, Cold transformation prevails, so Yang Qi retreats. Pi is synonymous with Bi/avoid.") Yin Qi rises violently, great cold arrives, rivers and marshes freeze severely, cold vapor condenses into frost and snow, ("Cold vapor refers to cold Qi like mist.") in severe cases, yellow and black dimness obscures, flowing through the intersection of Qi, becoming frost-killing, Water shows omens. ("Yellow is Earth color. Black is Water color. Water erupts due to Earth stagnation, so both colors appear in the Qi intersection. Xiang refers to disaster/omen; all auspicious or inauspicious signs are called Xiang.") Thus, the people suffer from cold invading causing heart pain, waist and knee pain, immobility of large joints, difficulty bending and stretching, prone to cold limbs, epigastric hardness, and abdominal fullness. ("These are all diseases caused by Cold Water Qi. Fire fears Water, hence heart pain. Cold enters Kidney, hence waist/knee pain. Cold causes blood/qi stagnation and tendon contraction, hence joint immobility. Yin Qi prevailing, Yang Qi not moving, hence cold limbs, epigastric hardness, abdominal fullness.") Sunlight fails to govern, empty space accumulates heavy Yin, white haze dims then erupts, occurring before and after the Two Fires. ("Before and after Two Fires refers to Minister Fire Second Qi and Duke Fire Third Qi, from Spring Equinox mid-March to Minor Heat June, totaling 120 days, all governed by Two Fires. Water reigns in Winter, its Qi stagnates, so it erupts during Fire command, Yin supporting Yang. Wang Shi said: Yin Essence and Water both support Fire, before and after Minister and Duke Fire.") The great void is deep and dark, Qi scatters like hemp seeds, faintly visible then hidden, color black with slight yellow; this is the omen of Water Stagnation. (Deep dark is black. Hemp scatter means visible yet scattered, faintly seen then hidden. Generally, observing Qi methods should be done at dawn; color black with slight yellow: yellow is Earth, black is Water; slight yellow mixed with black is the omen of impending Water Stagnation.)

When Wood Stagnation erupts, the great void is dusty and dim, clouds and objects are disturbed, great wind arrives, roofs are blown off and trees broken, Wood undergoes change. ("Metal overcomes Wood, causing Wood stagnation. When Wood Stagnation erupts, Wind Qi prevails greatly, hence dust, cloud disturbance, roof blowing, tree breaking, etc., all are Wood's changes.") Thus, the people suffer from epigastric pain centering on the heart, extending upward to support both hypochondria, blockage of diaphragm and throat, inability to eat or drink, and in severe cases, tinnitus, vertigo, blindness/confusion, and prone to sudden stiff collapse. ("These are all diseases caused by Wind-Wood Liver Pathogen. Jueyin Meridian夹胃贯膈 (clamps stomach and pierces diaphragm), hence epigastric pain centering on heart, diaphragm/throat blockage, inability to eat/drink. Extending to hypochondria is Liver Qi reversing. Liver Meridian circulates through throat, enters Ying-Sang, connects to Eye System, meets at vertex, hence tinnitus, vertigo, blindness. Wind-Wood is strong, most injures Stomach Qi, hence sudden stiff collapse.") Great void grey haze, sky and mountain one color, or turbid color, yellow-black oppressive; horizontal clouds do not bring rain, then it erupts, its timing is irregular. ("Grey haze, turbid color, yellow-black oppression are all wind-dust. Wind overcomes Dampness, hence clouds horizontal but no rain. Wind Qi arrival is dynamic and changing, hence its eruption has no fixed time.") Long rivers bend grass, soft leaves show shade, pines chant on high mountains, tigers roar in rock peaks; this is the omen of impending Wood Stagnation. (Bending grass means grass bends with wind. Showing shade means soft leaves hang down, revealing undersides when flipped by wind. Pine chant means sound in trees. Tiger roar generates wind, wind comes from tiger. Seeing these are all omens of impending Wood Stagnation.)

When Fire Stagnation erupts, the great void swells and obscures, the Great Brightness does not shine, ("Water overcomes Fire, causing Fire stagnation. 'Swelling' is an error, should be 'Xun' (dusk/haze). Fire Stagnation erupting, Heat transformation prevails, hence great void hazy and dim, Great Brightness fails to shine.") blazing fire moves, great heat arrives, mountains and marshes burn, timber flows with sap, wide mansions rise with smoke, earth floats with frost-salt, standing water decreases, creeping grass scorches yellow, wind blows confusing words, Dampness transformation lags. ("Burning/smoke rising means intense heat. Timber flowing sap means juice melting/flowing. Frost-salt means springs dry up and salt becomes frost. Standing water means accumulated water. Wind blowing confusing words means extreme heat generates wind, wind-heat intensify causing confused speech. Dampness transformation lags means rain does not come. Xia pronounced Xia.") Thus, the people suffer from shortness of Qi, sores, itching, carbuncles and swelling, hypochondriac/abdominal/chest/back/head/limb congestion and distension, lumbar distension, ulcers, vomiting and reverse Qi, convulsions, bone pain, joint movement, projectile diarrhea with Warm Malaria, sudden abdominal pain, blood extravasation and flow, scarcity of essence/fluids, red eyes, hot heart, and in severe cases, mental confusion, restlessness, and prone to sudden death. ("These are all diseases caused by Fire Prosperity. Vigorous Fire consumes Qi, hence shortness of breath. Fire rots matter, hence sores/carbuncles. Yang Pathogen excess, hence congestion, distension, ulcers, toxins. Fire Qi rushing up, hence vomiting/reverse Qi. Fire injuring tendons, hence convulsions. Fire injuring bones, hence bone pain. Fire lodged in joints, hence joint movement. Fire in intestines/stomach, hence projectile diarrhea. Fire in Shaoyang, hence Warm Malaria. Fire solid in abdomen, hence sudden pain. Fire entering Blood level, hence blood extravasation. Fire scorching Yin level, hence scarce fluids. Fire entering Liver, hence red eyes. Fire entering Heart, hence hot heart. Fire flaming Upper Jiao, hence confusion. Fire stagnating Danzhong, hence restlessness. Fire nature is rapid, destroying True Yin, hence sudden death. Lu pronounced Lu/Ao. Ao pronounced Ao. , pronounced Bao.") End of ke (time unit) brings great warmth, sweat moistens Xuanku (sweat pores); this is the eruption, occurring in the Fourth Qi. ("End of Ke is the end of 100 Ke. Day Ke starts at Yin Chu, ends at Chou Mo, this is Yin Extreme time. Hence daily Qi is coolest here. Great warmth at end of Ke and sweat moistening Xuanku indicates other heats. Xuanku is sweat pore. Fire reigns in Summer, its Qi stagnates, so it erupts in Wei-Shen Fourth Qi. Fourth Qi is remainder of Yang Extreme.") Movement returns to stillness, Yang Extreme reverses to Yin, Damp Command transforms and completes. ("Previous text said Dampness transformation lags; now Fire reigns generating Earth, hence movement returns to stillness, Yang Extreme reverses to Yin, Earth Qi acts, Damp Command returns, hence all things can transform and complete.") Flowers bloom, water freezes, mountains/rivers ice/snow, flame-Yang Wuze; this is the omen of impending Fire Stagnation. ("Blooming flowers are Duke Fire Second Qi period. Wuze is southern marsh. Ice/snow blooming at flower time shows Fire Qi stagnation. Flame/Yang Qi appearing at southern marsh is omen of impending Fire Stagnation.") There is response to Fu (stagnation) then repayment; all observe the extreme then erupt. ("Below summarizes the meaning of Stagnation Eruption above. All responses have omens, repayments follow. Matter reaches extremity then changes, hence stagnation extreme then erupts.") Wood erupts without fixed time, Water follows Fire. ("Earth/Metal/Fire Stagnation eruptions have times; only Wind-Wood changes quickly, text says 'timing irregular', i.e., Wood erupts without time. Water overcomes Fire, text says 'before/after Two Fires', i.e., Water follows Fire.") Carefully await its time, disease can be predicted; missing time and reversing year, Five Qi do not move, generation/transformation/storage/harvest, governance has no constancy. ("Knowing seasonal Qi, disease Qi can be predicted. Missing seasonal Qi, Five Qi movement cannot be known, how can one know constants of generation/storage?")

The Yellow Emperor said: Water erupts causing hail/snow, Earth erupts causing gusts/storms, Wood erupts causing destruction/breaking, Metal erupts causing clarity/brightness, Fire erupts causing haze/darkness. What Qi causes this? Qibo said: Qi has abundance and scarcity, eruption has subtlety and severity. Subtle matches its own Qi, severe combines with its subordinate Qi. Observe the subordinate Qi to know the manifestation. ("Elucidates Meaning of Controlling/Subordinating. Abundance/scarcity refers to Excess/Deficiency. Severity/subtlety: subtle stagnation erupts subtly, severe stagnation erupts severely. Subtle matches its own Qi, appearance of original Qi. Severe combines with subordinate Qi, appearance of Controlling Qi. e.g., below Water position, Earth Qi controls; below Earth position, Wood Qi controls; below Wood position, Metal Qi controls; below Metal position, Fire Qi controls; below Fire position, Water Qi controls. Thus, Water eruption subtle is Cold, severe is Hail/Snow, combining with Earth (hail/snow like Earth). Earth eruption subtle is Dampness, severe is Gusts/Storms, combining with Wood (wind governs gusts). Wood eruption subtle is Wind, severe is Destruction, combining with Metal (Metal governs killing). Metal eruption subtle is Dryness, severe is Clarity, combining with Fire (Fire governs brightness). Fire eruption subtle is Heat, severe is Haze, combining with Water (Water governs darkness). Zheng means evidence; obtaining evidence from subordinate Controlling Qi reveals subtlety/severity of eruption.")

The Yellow Emperor said: Excellent! Why do Five Qi eruptions occur out of position? ("Out of position means not corresponding to time.") Qibo said: Call it difference. ("Qi has prosperity/decline, hence arrival has priority/later, hence called difference. Difference means not in proper position. As *Zhi Zhen Yao Da Lun* says: 'Winning/Repaying actions, movement out of position, or arriving late.' That text discusses Winning/Repaying out of position; this discusses Five Qi eruption out of position. Though seemingly different topics, the meaning is one.") The Yellow Emperor said: Does difference have numbers? ("Asking about day counts