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This chapter specifically discusses pulse and complexion, but concludes by emphasizing "One." "One" refers to Shen (Spirit). Complexion is an external sign, pulse is an internal sign, while Spirit governs both internal and external. Mastering pulse and complexion leads to good outcomes, losing them leads to misfortune; the key to treating disease lies solely in this. The chapter is named *Yi Jing Bian Qi* (Shifting Spirit and Changing Qi) because the Yellow Emperor asked about ancient healing using Zhu You (a method of healing through incantation and prayer) to shift and change Jing-Qi (Essence-Qi), thus using this phrase as an introductory topic. Zhang Jingyue's commentary is clear and fluent, so it has been adopted.

The Yellow Emperor asked: I have heard that in ancient times, diseases were treated only by shifting spirit and changing qi, sufficient with Zhu You alone. Today, diseases are treated internally with medicinal herbs and externally with acupuncture and stone therapy, yet some recover and others do not. Why is this? ("Shift" means to alter, "Change" means to transform, both aiming to prevent pathogenic factors from harming healthy Qi, allowing Spirit to become strong and remain inwardly guarded. Note: Zhang Jingyue stated, "In the ancient era of perfect virtue, pathogenic factors could not invade. Thus, for any illness, only Zhu You was used, as the disease was mild and treatment easy. According to Ming dynasty regulations, medicine was divided into thirteen departments: Internal Medicine for Adults, Internal Medicine for Children, Gynecology, Cold Damage Disorders, Surgery/Traumatology, Acupuncture, Ophthalmology, Stomatology, Otolaryngology, Orthopedics, Foreign Body Extraction, Massage, and Zhu You. Currently, Massage and Zhu You have been lost, existing only in folk practice. 'Zhu' is pronounced 'zhi jiu qie'.")

Qibo replied: In ancient times, people lived among birds and beasts, moving to avoid cold, dwelling in shaded areas to avoid heat. Internally, they had no burden of longing or attachment; externally, they had no form of servitude or official striving. This was an era of tranquility and emptiness, where pathogenic factors could not penetrate deeply. Therefore, medicinal herbs could not treat internally, nor acupuncture and stone therapy externally; thus, shifting spirit and using Zhu You sufficed. (In ancient times, people nested in trees or dwelt in caves, hiding at night and roaming by day, clearly living among beasts. However, active movement generates abundant Yang-Heat, keeping the body warm enough to resist cold; cool air brings chill, so dwelling in shade allows one to avoid heat. If desires and thoughts are discarded, there is no internal burden of longing; if the heart lacks wishes and cravings, there is no external strain of seeking fame or office. Preserving natural innocence through stillness naturally prevents pathogenic victory. Hence, shifting spirit and changing qi requires no medicinal herbs, and explaining the origin of illness via incantations requires no acupuncture or stone therapy. Note: Zhang Jingyue said, "'Shen' refers to the state of flexion and extension. 'Huan' refers to the burden of fame and profit. With no internal longing and no external pursuit, it is called an era of tranquility. 'Zhu' is synonymous with 'Zhou' (curse/incantation). 'You' refers to the origin of the disease. Hence, it is called Zhu You.")

Today's world is different. Worries and anxieties entangle the interior, physical hardship damages the exterior, and one loses compliance with the reversals and adherence of the four seasons, failing to adapt to cold and heat. Treacherous winds arrive frequently, and empty pathogens attack morning and night, penetrating inward to the five Zang organs and bone marrow, and outwardly damaging pores, skin, and muscles. Consequently, minor illnesses inevitably worsen, and major illnesses inevitably lead to death; thus, Zhu You cannot cure them.

The Yellow Emperor said: Excellent! I wish to face patients, observe life and death, resolve doubts, and understand the essentials, seeing them clearly like the sun and moon. May I hear this? (Note: The light of the sun and moon is visible to all who have eyes. This question seeks the essential principle of treatment, desiring an answer that is obvious and clear.)

Qibo replied: Complexion and pulse are highly valued by the Supreme Emperor and transmitted by the Ancient Masters. (Supreme Emperor refers to the emperors of antiquity. Ancient Masters refer to Qibo's ancestral teacher, Jiu Daiji.) In antiquity, the Supreme Emperor appointed Jiu Daiji to organize and analyze pulse and complexion, attaining understanding of Shen-Ming (Spiritual Illumination), integrating them with the Five Elements (Metal, Wood, Water, Fire, Earth), the Four Seasons, Eight Winds, and Six Directions, without deviating from their constants. (Note: Zhang Jingyue said, "Organizing complexion and pulse involves examining the subtleties of the interior and exterior. Attaining spiritual illumination means that once complexion and pulse are distinguished, the spiritual essence becomes manifest. The correspondence of complexion and pulse aligns everywhere, just as the waning and waxing of the Five Elements, the passage of the Four Seasons, the changes of the Eight Winds, and the expanse of the Six Directions follow consistent laws of increase and decrease.") By observing how changes shift and interact, one perceives their wonder and grasps their essence. To grasp the essence, one must look to complexion and pulse. (Note: Zhang Jingyue said, "The Qi of the Five Elements, Four Seasons, and Eight Winds alternates in abundance and deficiency, causing shifts in transformation. Complexion and pulse respond accordingly, allowing one to perceive their wonder and grasp their essence. For all the five Zang and six Fu organs, hundred bones, and nine orifices, pulses are determined by Qi, and Qi conforms to Heaven. Although profound and difficult to measure, only through complexion and pulse can they be examined. Thus, it is said that to grasp the essence, one looks to complexion and pulse.") Complexion corresponds to the Sun, and pulse corresponds to the Moon. Constantly seeking their essence reveals the essence itself. (Note: Zhang Jingyue said, "Complexion divides into the Five Elements, with brightness and darkness as its variations; the Sun has twelve stems, with cloudy and clear skies as its variations, hence complexion corresponds to the Sun. Pulse has twelve meridians, with deficiency and excess as its variations; the Moon has twelve stations, with waxing and waning as its variations, hence pulse corresponds to the Moon. Constantly seeking the essence of complexion and pulse makes one bright as the sun and moon, obtaining the essence of their transformations.")

The changes in complexion correspond to the pulses of the four seasons. This is what the Supreme Emperor values, aligning with spiritual illumination. Thus, one stays far from death and close to life, prolonging the way of life, which is called the Sage King. (Note: Pulses respond internally according to time, and complexion manifests externally corresponding to pulses. When complexion and pulse correspond, death is kept at bay and life draws near. Only the ancient emperors understood this, enabling them to ward off aging and preserve their physical form, acting in accordance with spiritual illumination, thereby fully mastering the way of health preservation.)

In the middle ancient era, when disease arrived, treatment involved decoctions (Tang Ye). After ten days, the diseases of Eight Winds and Five Obstructions (Bi) would be eliminated. If not cured after ten days, treatment involved the branches of grass leaves (Su) and grass roots (Gai), using root and branch together for mutual assistance. Once the root and branch aspects were addressed, the pathogenic factor submitted. (Eight Winds refer to winds from eight directions. Five Bi refer to obstruction in skin, flesh, sinew, bone, and vessels. Note: Zhang Jingyue said, "In the middle ancient era, treatment began only after disease arrival, initially using Tang Ye. Tang Ye is made from grains, not medicinal herbs. Taking it for ten days eliminates Eight Wind and Five Bi diseases. If not cured after ten days, treatment uses grass leaves and roots. 'Su' means leaf. 'Gai' means root. 'Zhi' means stem. Roots and stems assist each other, hence 'root and branch assist,' which is the later-era decoction. The disease source is the root, the disease manifestation is the branch. Grasping both ensures pathogenic submission. This middle-ancient treatment, while not foreseeing disease before onset like the upper ancient era, was still not erroneous like later eras. 'Gai' is pronounced 'gai'.")

In the late era, treatment is different. Treatment does not follow the four seasons, ignores the sun and moon, and fails to examine reversal and adherence. (Each season's Qi resides in specific locations; attacking blindly without considering these locations is contrary to antiquity. *Si Shi Ni Cong Lun* states: "Spring Qi is in the channels, Summer Qi in collateral vessels, Late Summer Qi in muscles, Autumn Qi in skin, Winter Qi in bone marrow." One should expel hidden pathogens according to their location. Ignoring the sun and moon means ignoring daily temperature/light changes and lunar fullness/emptiness. *Ba Zheng Shen Ming Lun* states: "Acupuncture methods must await the Qi of sun, moon, stars, four seasons, and eight correct periods. Only when Qi is stable should one needle. Thus, on warm sunny days, human blood is fluid and Wei-Qi floats, making blood easy to drain and Qi easy to move; on cold cloudy days, blood coagulates and Wei-Qi sinks. At moon birth, blood and Qi begin to refine and flow; at moon fullness, blood and Qi are abundant, muscles firm; at moon emptiness, muscles diminish, channels deficient, Wei-Qi departs, leaving only the form. Therefore, adjust blood and Qi according to heavenly timing. Do not needle on cold days, hesitate not on warm days, do not drain at moon birth, do not tonify at moon fullness, do not treat at moon emptiness. This is adjusting according to time." This refers to this. Failing to examine reversal and adherence means failing to assess whether a disease is treatable. Note: Zhang Jingyue said, "Citing the Grand Tutor's commentary, the explanation is correct but incomplete. For instance, ignoring the four seasons implies ignorance of the prosperity/decline of Luck (Yun) and the waxing/waning of Yin/Yang. Those overusing warm/hot herbs forget the blazing heat of heaven and earth; those exclusively using cold/cool herbs miss the flow of host and guest Qi. All five tones have appropriate taboos; how can they be treated as ordinary? *Wu Chang Zheng Da Lun* says: 'First know the annual Qi, do not violate or harmonize improperly.' If one violates this despite ignorance, it is like carrying firewood to save a fire or adding frost to snow. Regarding ignoring the sun and moon, Wang Bing interpreted them literally. However, this chapter focuses on complexion and pulse. Thus, lacking knowledge of complexion and pulse means lacking the subtlety of tripartite comparison and clarity of interior/exterior diagnosis. When complexion and pulse disagree, whom should one abandon symptoms for pulse? When urgency and slackness conflict, whom should one treat first? Without clear principles, recklessness knows no bounds. This integration of complexion and pulse is indispensable, hence called 'sun and moon.' Furthermore, failing to examine reversal/adherence involves Qi and color reversal/adherence. *Yu Ban Lun Yao* says: 'Color appearing up/down/left/right has its critical point. Up is reversal, down is adherence; for women, right is reversal, left is adherence; for men, left is reversal, right is adherence.' There is also pulse reversal/adherence across four seasons. *Ping Ren Qi Xiang Lun* says: 'Pulses have reversal/adherence to four seasons. Without organ shape, thin pulses in spring/summer and floating-large pulses in autumn/winter are named reversal to four seasons.' *Yu Ji Zhen Zang Lun* says: 'Reversal to four seasons means: Spring getting Lung pulse, Summer getting Kidney pulse, Autumn getting Heart pulse, Winter getting Spleen pulse, all hanging, isolated, deep, and choppy, is named reversal to four seasons.' There is also pulse-symptom reversal/adherence. *Ping Ren Qi Xiang Lun* says: 'Wind-heat with quiet pulse, diarrhea with excessive bleeding and solid pulse, interior disease with deficient pulse, exterior disease with choppy/firm pulse—all are difficult to treat, named reverse to four seasons.' *Yu Ji Zhen Zang Lun* says: 'Hot disease with quiet pulse, diarrhea with large pulse, bleeding with solid pulse, interior disease with solid/firm pulse, exterior disease with non-solid/non-firm pulse—all are difficult to treat.' There is also treatment method reversal/adherence. *Zhi Yao Yao Da Lun* says: 'Some are obtained by reversal, some by adherence. Reversal is proper adherence. If adherent, it is reversal.' It also says: 'For mild cases, use reversal; for severe cases, use adherence.' And: 'Reversal is direct treatment, adherence is contrary treatment. Follow less or more, observing the situation.' *Wu Chang Zheng Da Lun* says: 'Strengthen internal guarding, align with Qi, peace can be achieved; for false conditions, do the opposite.' These are all ways of reversal and adherence, which doctors must study diligently. If one does not understand the reversal/adherence of seasonal pulses and symptoms, one does not recognize the principles of life and death, leading to many errors in treating disease. If one does not understand the reversal/adherence of therapeutic discussion, one will inevitably prescribe recklessly, cutting off long life—this is truly doctors killing patients. This is a common flaw of the late era, worthy of detailed examination.")

When the disease form has already manifested, one attempts to treat externally with fine needles and internally with decoctions. Crude practitioners act frantically, believing they can attack, so the old disease remains, and new diseases arise. (... Note: Zhang Jingyue said, "Unable to prevent before onset and unable to observe current status, their hearts are coarse and shallow, administering needles and drugs randomly. These individuals, assuming excess and attacking, leave false excess unremoved while true deficiency arrives; assuming heat and cooling, leave original heat unremoved while new cold arises. Such methods are insufficient to heal humans and merely sufficient to harm them.")

The Yellow Emperor said: I have heard the essentials from the Master. The Master speaks of nothing but complexion and pulse, which is what I know. Qibo said: The ultimate limit of treatment lies in "One." (Note: Zhang Jingyue said, "The Dao of One is great, the origin of all things. The *I Ching* says: 'Heaven generates One, Water.' Yao said: 'Be precise and unified, sincerely hold the Mean.' 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 and Kings obtain One to be the rectitude of the world.' Confucius said: 'My Dao is penetrated by One.' Buddhists say: 'All Dharmas return to One.' Zhuangzi said: 'Connect with One and all matters are completed.' Shao Yong said: 'Heaven divides creation from within One.' *Zhi Yao Yao Lun* etc. say: 'Knowing the essence, one word ends it; not knowing the essence, one scatters infinitely.' Here it says the ultimate of treatment is One; the Dao is the same. Thus, if a person obtains One, the universe is in their hands; if a person knows One, all transformations return to the heart.")

The Yellow Emperor said: What is meant by "One"? Qibo said: "One" is obtained through investigating the cause. (Note: Heaven and Earth and all things originate from One, so "One" is a comprehensive term. How does this apply to disease? Generally, at the onset of any disease, there is always a cause. Following the cause to deduce, "One" can be obtained. To obtain this "One," it is indeed as described below.)

The Yellow Emperor said: How? (Note: Meaning, how can it be obtained?)

Qibo said: Close the doors and windows, focus on the patient, ask carefully about their emotional state, and follow their intentions. Obtaining Spirit leads to prosperity; losing Spirit leads to death.

The Yellow Emperor said: Excellent! (Note: This is precisely the method of seeking the cause to obtain One. "One" is Spirit. The gain or loss of Spirit is not easily glimpsed. One must ensure the patient rests quietly in a room, hearing nothing and seeing nothing. Then, gently and tactfully, inquire into their inner feelings, adapting to circumstances and soothing their mind to observe the gain or loss of their Spirit. Then, life and death can be immediately distinguished. This is what is meant by the ultimate of treatment being One. That is all. Zhang Jingyue's interpretation of the meaning of "One" is very accurate, but separating Spirit and One seems to overlook this connection.)