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The entire text is roughly divided into twenty-eight sections: The first section discusses the transformations of Si Tian (Mastering Heaven), Zai Quan (Ruling Earth), and Jian Qi (Intermediary Qi); the second section explains that Earth's transformations originate from Heaven's Qi; the third section discusses how medicinal properties differ according to the ruling year; the fourth section states that when excessive pathogens damage the Zang organs, they invariably affect the organ that cannot overcome it; the fifth section discusses why the Cun Kou pulse does not respond when Shao Yin is in a specific position, distinguishing between Nan Zheng (Southern Polity) and Bei Zheng (Northern Polity); the sixth section covers treatment methods for diseases caused by Zai Quan and Si Tian; the seventh section addresses treatments for counter-reverse attacks by guest excessive pathogens and the mutual overcoming of the Six Qi; the eighth section discusses diseases caused by the rebound of the Six Qi and their treatments; the ninth section describes the human body's resonance with Si Tian and Zai Quan; the tenth section explains the principles of Overcoming (Sheng) and Rebound (Fu) along with their treatments; the eleventh section covers the overcoming and rebound of Host Qi (Zhu Qi) and Guest Qi (Ke Qi) and their treatments; the twelfth section details the correct flavors of the Five Zang organs and the principles of tonification and sedation for host and guest; the thirteenth section discusses the Three Yin and Three Yang; the fourteenth section explains the odd and even structures of prescriptions; the fifteenth section discusses formulas for treating the branch (symptoms); the sixteenth section describes how the Six Qi act as pathogens causing disease; the seventeenth section relates pulse arrival to disease manifestation; the eighteenth section explains the Biao (Root/Exterior) and Ben (Branch/Interior) theory of the Six Qi; the nineteenth section discusses reverse and compliant treatments when the pulse contradicts the disease; the twentieth section notes that the timing of overcoming and rebound affects the pulse; the twenty-first section discusses the distribution and convergence of Yin and Yang; the twenty-second section outlines the sequence of medication for the Six Channels; the twenty-third section presents the Nineteen Pathogenesis Formulas; the twenty-fourth section emphasizes that the formulation based on the Five Flavors, along with direct and reverse treatments, constitutes the core tenets of medical practice; the twenty-five section discusses the root and branch relationships of internal and external factors; the twenty-six section describes how misdiagnosis leads to reversed cold and heat conditions; the twenty-seventh section evaluates the efficacy and toxicity of medicines; finally, it reiterates questions regarding internal and external treatments. The gist of the entire classic is contained herein, representing truly essential and profound discourse that warrants deep contemplation and careful study.

Huang Di asked: I understand that the Five Qi interact, and their abundance and deficiency alternate. However, regarding the Six Qi governing distinct periods, what is the nature of the arrival of those governing Heaven and Earth? (...The Five Elements govern the years, which have periods of surplus and deficit, hence the term 'alternating abundance and deficiency'.) Qi Bo replied: This is governed by the Dao, yet it is a source of doubt for physicians. Huang Di said: I wish to hear the principle. Qi Bo said: When Jue Yin governs Heaven, its transformation is Wind; when Shao Yin governs Heaven, its transformation is Heat; when Tai Yin governs Heaven, its transformation is Dampness; when Shao Yang governs Heaven, its transformation is Fire; when Yang Ming governs Heaven, its transformation is Dryness; when Tai Yang governs Heaven, its transformation is Cold. Diseases are named according to the Zang organs corresponding to these positions. (Note: This refers to the transformation of Si Tian, meaning virtue and transformation, such as the orthodox and evil transformations mentioned in previous chapters. The Six Qi governing Heaven each disseminate their transformation; the human Zang organs resonate with them. Harmony results in health, disharmony in disease, and thus diseases are named accordingly.) Huang Di asked: How does Earth's transformation work? Qi Bo said: It follows the same pattern as Si Tian, and this applies to the Intermediary Qi as well. (The roots of the Six Qi possess constant natures; thus, although their positions change, their transformations and treatments remain similar. Note: Zhang Jingyue stated, "Earth's transformation refers to the transformation of Zai Quan. Intermediary Qi is explained below. Although the Six Steps have distinctions of upper/lower and left/right, their Qi transformations are similar, hence they share the same observational criteria as Si Tian.") Huang Di asked: What is meant by Intermediary Qi? Qi Bo said: Those located to the left and right of Si Tian and Zai Quan are called Intermediary Qi. (Note: The Six Qi govern the Six Steps. The upper is Si Tian, the lower is Zai Quan, and the remaining four are Intermediary Qi. Those on the left and right above are the Left and Right Intermediaries of Si Tian; those on the left and right below are the Left and Right Intermediaries of Zai Quan.) Huang Di asked: How can they be distinguished? (Note: Asking for the difference between Si Tian/Zai Quan and the Left/Right Intermediary Qi.) Qi Bo said: Those governing the year record the year; Intermediary Qi records the steps. (Note: Zhang Jingyue said, "Governing the year records the year: Si Tian governs the first half, Zai Quan the second half. Intermediary Qi records the steps: a year has six steps, each governing 60 days and 87.5 ke.") Huang Di said: Excellent! How is the Year Governor determined? (Note: This collectively discusses the differences in Qi transformation among upper, lower, left, and right.) Qi Bo said: When Jue Yin governs Heaven, it manifests as Wind Transformation; (Note: Jingyue said, "Wood Qi in Heaven is Wind Transformation, characterized by turbulence and movement, flying clouds and objects, as seen in Jue Yin governing Heaven in Yi-Hai years.") at Zai Quan, it manifests as Sour Transformation; ("When Wood Qi is in Earth, the flavor becomes Sour, as seen in Jue Yin at Zai Quan in Yin-Shen years.") in Si Qi, it manifests as Cyan Transformation; ("Si Qi refers to the Qi of the Five Movements. When Wood Movement governs, the color transforms to Cyan/Green, as in Ding-Ren years.") and as Intermediary Qi, it manifests as Movement Transformation. ("At the position occupied by Jue Yin, the execution of Wind Transformation causes all things to stir, hence called Movement Transformation. For example, in Chou-Wei years, it is the Left Intermediary of Earth, governing the First Step; in Zi-Wu years, it is the Right Intermediary of Heaven, governing the Second Step; in Chen-Xu years, it is the Left Intermediary of Heaven, governing the Fourth Step; in Mao-You years, it is the Right Intermediary of Earth, governing the Fifth Step.") When Shao Yin governs Heaven, it manifests as Heat Transformation; (Note: Zhang Jingyue said, "Ministerial Fire in Heaven is Heat Transformation, characterized by bright sunlight and warmth nurturing all things, as seen in Shao Yin governing Heaven in Zi-Wu years.") at Zai Quan, it manifests as Bitter Transformation; ("When Fire Qi is in Earth, the flavor becomes Bitter, as seen in Shao Yin at Zai Quan in Mao-You years.") it does not govern Qi transformation; ("Ministerial Fire does not govern the Movements. The reason Five Movements and Six Qi differ is that Movements derive from Heavenly Stems, hence there are five; Qi derives from Earthly Branches, hence there are six. The five represent the Five Elements; the six divide Fire into Ministerial and Sovereign. Thus, among the Six Qi, there are distinctions between Sovereign and Ministerial Fire, whereas in the Five Movements, Fire is merely one. Among the six, one is missing; only Sovereign Fire alone does not govern the Qi transformation of the Five Movements. Precisely because Sovereign Fire is Solar Fire, the root of Yang Qi and the origin of all transformations, it governs all Qi without being governed itself, hence it does not singly govern Qi transformation. Note: Xin Zheng Jiao and various commentators state 'Sovereign Fire by name, Ministerial Fire by position,' aiming to show Sovereign Fire does not govern the Movements, but this view is erroneous. The original text of *Tian Yuan Ji Da Lun* says 'Sovereign Fire by brightness,' not 'by name.' Why change 'brightness' to 'name' and force an interpretation? This greatly misses the scriptural intent. They likely altered 'brightness' to 'name' solely to cite it here.") Its resident Qi manifests as Burning Transformation. ("Resident" refers to location. "Burning" means brightness. It is called Resident Qi rather than Intermediary Qi because the Sovereign's residence is revered everywhere, so it is not called 'intermediate.' For instance, in Yin-Shen years, it resides at the Left of Zai Quan, governing the First Step; in Chou-Wei years, at the Right of Si Tian, governing the Second Step; in Si-Hai years, at the Left of Si Tian, governing the Fourth Step; in Chen-Xu years, at the Right of Zai Quan, governing the Fifth Step.) When Tai Yin governs Heaven, it manifests as Damp Transformation; (Note: Jingyue said, "Earth Qi in Heaven is Damp Transformation, characterized by haze and obscurity, clouds, rain, and moisture, as seen in Tai Yin governing Heaven in Chou-Wei years.") at Zai Quan, it manifests as Sweet Transformation; ("When Earth Qi is in Earth, the flavor becomes Sweet, as seen in Tai Yin at Zai Quan in Chen-Xu years.") in Si Qi, it manifests as Yellow Transformation; ("When Earth Movement governs, the color transforms to Yellow, as in Jia-Ji years.") and as Intermediary Qi, it manifests as Softening Transformation. ("At the position occupied by Tai Yin, the execution of Damp Transformation makes all things soft. For example, in Mao-You years, it is the Left Intermediary of Earth, governing the First Step; in Yin-Shen years, the Right Intermediary of Heaven, governing the Second Step; in Zi-Wu years, the Left Intermediary of Heaven, governing the Fourth Step; in Si-Hai years, the Right Intermediary of Earth, governing the Fifth Step.") When Shao Yang governs Heaven, it manifests as Fire Transformation; (Note: Jingyue said, "Ministerial Fire in Heaven is Fire Transformation, characterized by intense heat and scorching, as seen in Shao Yang governing Heaven in Yin-Shen years.") at Zai Quan, it manifests as Bitter Transformation; ("When Fire Qi is in Earth, the flavor becomes Bitter, as seen in Shao Yang at Zai Quan in Si-Hai years.") in Si Qi, it manifests as Red Transformation; ("When Fire Movement governs, the color transforms to Vermilion/Red, as in Wu-Gui years.") and as Intermediary Qi, it manifests as Illumination Transformation. ("At the position occupied by Shao Yang, the execution of Fire Transformation makes all things bright. For example, in Chen-Xu years, it is the Left Intermediary of Earth, governing the First Step; in Mao-You years, the Right Intermediary of Heaven, governing the Second Step; in Chou-Wei years, the Left Intermediary of Heaven, governing the Fourth Step; in Zi-Wu years, the Right Intermediary of Earth, governing the Fifth Step.") When Yang Ming governs Heaven, it manifests as Dryness Transformation; (Note: Jingyue said, "Metal Qi in Heaven is Dryness Transformation, characterized by coolness and sharpness, mist and dew, as seen in Yang Ming governing Heaven in Mao-You years.") at Zai Quan, it manifests as Pungent Transformation; ("When Metal Qi is in Earth, the flavor becomes Pungent, as seen in Yang Ming at Zai Quan in Zi-Wu years.") in Si Qi, it manifests as White Transformation; ("When Metal Movement governs, the color transforms to White, as in Yi-Geng years.") and as Intermediary Qi, it manifests as Clear Transformation. ("At the position occupied by Yang Ming, the execution of Dryness Transformation brings coolness. For example, in Si-Hai years, it is the Left Intermediary of Earth, governing the First Step; in Chen-Xu years, the Right Intermediary of Heaven, governing the Second Step; in Yin-Shen years, the Left Intermediary of Heaven, governing the Fourth Step; in Chou-Wei years, the Right Intermediary of Earth, governing the Fifth Step.") When Tai Yang governs Heaven, it manifests as Cold Transformation; (Note: Jingyue said, "Water Qi in Heaven is Cold Transformation, characterized by solemnity and biting cold, gloom and solidity, as seen in Tai Yang governing Heaven in Chen-Xu years.") at Zai Quan, it manifests as Salty Transformation; ("When Water Qi is in Earth, the flavor becomes Salty, as seen in Tai Yang at Zai Quan in Chou-Wei years.") in Si Qi, it manifests as Dark Transformation; ("When Water Movement governs, the color transforms to Dark/Black, as in Bing-Xin years.") and as Intermediary Qi, it manifests as Storage Transformation. ("At the position occupied by Tai Yang, the execution of Cold Transformation causes all things to close and store. For example, in Zi-Wu years, it is the Left Intermediary of Earth, governing the First Step; in Si-Hai years, the Right Intermediary of Heaven, governing the Second Step; in Mao-You years, the Left Intermediary of Heaven, governing the Fourth Step; in Yin-Shen years, the Right Intermediary of Earth, governing the Fifth Step.") Therefore, those who treat diseases must understand the six transformations governing separately, the generation of the Five Flavors and Five Colors, and the suitability for the Five Zang organs, before they can discuss the origins of abundance, deficiency, and disease. (Note: Jingyue said, "In treating disease, one must seek the root, which is the Six Transformations; observe the form, which is the Five Colors; distinguish the governance, which is the Five Flavors; and discern suitability, which is the Five Zang Organs. Understanding these allows one to know where Qi is abundant or deficient, enabling discussion of the beginnings of abundance, deficiency, and disease, ensuring treatment is error-free.")

Huang Di asked: I previously knew that when Jue Yin is at Zai Quan, it manifests as Sour Transformation. How does the propagation of Wind occur? (Note: Jingyue said, "This asks: if Jue Yin at Zai Quan is Sour, and the previous text on Earth's transformation says 'same observation as Si Tian,' then Jue Yin at Zai Quan also involves Wind. So, what is the distinction between Sour and Wind?") Qi Bo said: Wind propagates on Earth; this is called the Root, and the other Qi follow the same principle. ("There is Wind Transformation before there is Sour Transformation; Wind is the root of Sour. The same logic applies to other Qi: Heat/Fire Transformation precedes Bitter, Damp Transformation precedes Sweet, Dryness Transformation precedes Pungent, and Cold Transformation precedes Salty. All Six Qi acting on Earth are the roots generating the Five Flavors. *Tian Yuan Ji Da Lun* states: 'What is called the Root is the Six Primal Sources.' The meaning of 'Root' here is identical.") That which originates from Heaven is the Qi of Heaven; that which originates from Earth is the Qi of Earth. (Note: Qi refers to the Six Qi.) When Heaven and Earth combine their Qi, the Six Periods divide, and all things are generated. ("Heavenly Qi descends, Earthly Qi ascends, meeting at the Qi intersection, called combined Qi. From this, the Qi of the Six Periods divides, and all things are endlessly generated.") Hence it is said: Carefully await the appropriateness of Qi, and do not miss the pathogenesis. This is what is meant. (Note: Qi originates from Heaven and Earth and has its own appropriateness; disease responds to the human body and has its own mechanism.) Huang Di asked: How does the governing disease manifest? ("Asking about the disease-managing properties of medicines.") Qi Bo said: Prepare medicines according to the ruling year, and no disease-managing herb will be omitted. ("The Qi of Heaven and Earth is governed differently each year. By preparing medicines according to the governing Qi, no herb managing the disease will be missed. For example, when Jue Yin governs the year, prepare Sour substances; when Shao Yin and Shao Yang govern, prepare Bitter substances; when Tai Yin governs, prepare Sweet substances; when Yang Ming governs, prepare Pungent substances; when Tai Yang governs, prepare Salty substances. These are called Year Substances. With Year Substances prepared, the use of the Five Flavors is complete.") Huang Di asked: What are the substances of the previous year? Qi Bo said: They are the concentrated essence of Heaven and Earth. ("Year Substances obtain the concentrated and exclusive transformation of Heaven and Earth; their Qi is strong and potent, hence they should be prepared first. This shares the same meaning as 'eating grain of the year to preserve one's true Qi' in *Liu Yuan Zheng Ji Da Lun*.") Huang Di asked: How is Si Qi? Qi Bo said: Si Qi is the same as governing the year, but there are differences of surplus and deficit. (Note: Jingyue said, "Si Qi refers to the Si Qi of the Five Movements mentioned earlier; governing the year refers to Si Tian and Zai Quan. The Movements and Qi govern similarly. However, the Five Tai movements are surplus, and the Five Shao movements are deficient, leading to variations in the density of material properties.") Huang Di asked: What is meant by non-year-substance materials? Qi Bo said: They are scattered. (Note: Jingyue said, "Non-year-substance materials refer to those not governing the year. Scattered means that although the order of the Six Qi does not govern Heaven and Earth, it governs the four intermediaries. Thus, the response of material generation also disperses according to Qi, appearing in the four directions with different endowments.") Hence, their substance is the same, but their grade differs. ("Since the Qi of Heaven and Earth changes constantly, although the physical constitution of generated materials may be the same, their functional potency varies.") Their aroma and taste vary in thinness and density; their nature and function vary in agitation and stillness; their therapeutic and preservative effects vary in quantity; their transformative power varies in depth. This is what is meant. (Note: This summarizes the above points, stating that the differences in year substances stem from differences in Si Qi, a matter physicians must attend to.)

Huang Di asked: What is meant by the Year Governor harming the Zang organs? Qi Bo said: Naming them by what they cannot overcome is the key. (Note: Jingyue said, "This states that Heaven has Year Qi, humans have Zang Qi, and when the Year Governor harms the Five Zang, it occurs in the organ that cannot overcome it. For example, if Wood Qi is excessive, Spleen cannot overcome it; if Fire Qi is excessive, Lung cannot overcome it; if Earth Qi is excessive, Kidney cannot overcome it; if Metal Qi is excessive, Liver cannot overcome it; if Water Qi is excessive, Heart cannot overcome it. These are the keys to Zang harm.") Huang Di asked: How to treat it? Qi Bo said: If excess invades from above, pacify it with what overcomes it; if excess invades from outside, treat it with what overcomes it. ("Excessive invasion causes harm. 'Invading from above' refers to Heaven's Six Qi affecting the Six Channels of humans; 'invading from outside' refers to Earth's Five Flavors injuring the Five Palaces of humans. When excessive pathogens cause harm, they should be pacified and treated using what overcomes them.") Huang Di said: Excellent! How is the Peaceful Qi treated? (Note: Jingyue said, "This asks how to treat disease when the Year Qi is peaceful.") Qi Bo said: Carefully observe the location of Yin and Yang and regulate it, aiming for balance. Treat orthodox diseases with orthodox methods, and reverse diseases with reverse methods. ("Yin and Yang exist in pulses, symptoms, flavors, meridians, and Zang images. Not knowing their location leads to confusing reverse with orthodox and contrary with compliant. Thus, one must carefully observe and regulate, aiming for balance without excess. If Yang Channel/Yang Symptom yields Yang Pulse, or Yin Channel/Yin Symptom yields Yin Pulse, this is an Orthodox Disease. Orthodox treatment means using Cold to treat Heat and Heat to treat Cold. If Yang Channel/Yang Symptom yields Yin Pulse, or Yin Channel/Yin Symptom yields Yang Pulse, this is a Reverse Disease. Reverse treatment means using Heat to treat Heat and Cold to treat Cold.")

Huang Di asked: You spoke of observing Yin and Yang location to regulate. The classics state that Ren Ying and Cun Kou correspond, equal in size like a drawn rope, named as Peace. Where Yin resides, how is the Cun Kou pulse? (Note: Jingyue said, "'The classics' refers to *Ling Shu: Jin Fu Pian*. This cites the observation of Yin and Yang from this classic, discussing Ren Ying and Cun Kou. Ren Ying is on the head, Cun Kou on the hand. If Yin and Yang correspond, sizes are equal, called Peace. 'Yin' refers to Shao Yin. Where Shao Yin resides, the pulse should not respond at Cun Kou; this must be observed.") Qi Bo said: Observe whether the year is Southern or Northern Polity, and you will know. ("Jia and Ji years are Southern Polity; Yi, Geng, Bing, Xin, Ding, Ren, Wu, Gui years (eight years) are Northern Polity. Southern Polity resides South, determining up/down/left/right; thus in human pulses, South corresponds to Cun, North to Chi. Northern Polity resides North, determining up/down/left/right; thus North corresponds to Cun, South to Chi. Since the Five Movements revere Earth, only Jia-Ji Earth Movements are Southern Polity; all other years are Northern Polity.") Huang Di said: I wish to hear it fully. Qi Bo said: In Northern Polity years, if Shao Yin is at Zai Quan, the Cun Kou pulse does not respond; ("Non-response means the pulse comes deep, fine, and hidden, not felt by the fingers. In Northern Polity years, Qi resides North, determining up/down; Chi governs Si Tian, Cun governs Zai Quan. Thus, if Shao Yin is at Zai Quan, residing in the center of North, both hands' Cun Kou do not respond. This occurs in Yi, Ding, Xin, Gui, Mao, You years.") if Jue Yin is at Zai Quan, the Right Cun does not respond; ("Right refers to Right Cun. In Northern Polity, if Jue Yin is at Zai Quan, Shao Yin is at Right Cun, hence no response. This occurs in Bing, Wu, Geng, Ren, Yin, Shen years.") if Tai Yin is at Zai Quan, the Left Cun does not respond. ("Left refers to Left Cun. In Northern Polity, if Tai Yin is at Zai Quan, Shao Yin is at Left Cun, hence no response. This occurs in Bing, Wu, Geng, Ren, Chen, Xu years.") In Southern Polity years, if Shao Yin governs Heaven, the Cun Kou pulse does not respond; ("In Southern Polity years, Qi resides South, determining up/down; Cun governs Si Tian, Chi governs Zai Quan. Thus, if Shao Yin governs Heaven, residing in the center of South, both hands' Cun Kou do not respond. This occurs in Jia-Zi, Jia-Wu years.") if Jue Yin governs Heaven, the Right Cun does not respond; ("Right refers to Right Cun. In Southern Polity, if Jue Yin governs Heaven, Shao Yin is at Right Cun, hence no response. This occurs in Ji-Si, Ji-Hai years.") if Tai Yin governs Heaven, the Left Cun does not respond. ("Left refers to Left Cun. In Southern Polity, if Tai Yin governs Heaven, Shao Yin is at Left Cun, hence no response. This occurs in Ji-Chou, Ji-Wei years.) For all non-responses, reversing the diagnosis reveals them. (Note: 'Reverse' does not mean opposite, but rather changing perspective. Whatever corresponds to Cun in Southern Polity corresponds to Chi in Northern Polity, and vice versa. Diagnosing with this reversal, non-responses at either Cun or Chi become visible.) Huang Di asked: How is the Chi pulse? (Note: Jingyue said, "The above discussed non-responses of both Cuns; now asking about the Chi pulses.") Qi Bo said: In Northern Polity years, if the Three Yin are below, the Cun does not respond; if the Three Yin are above, the Chi does not respond. ("Northern Polity reverses Southern Polity; thus 'below' governs Cun, 'above' governs Chi. Up/Down refers to Si Tian/Zai Quan.") In Southern Polity years, if the Three Yin are at Heaven, the Cun does not respond; if the Three Yin are at Earth, the Chi does not respond. ("Southern Polity reverses Northern Polity; thus 'at Heaven' governs Cun, 'at Earth' governs Chi.") Left and Right are the same. (Note: Ma Xuantai said, "Not only dimensions apply; the reversal of the Left and Right Intermediaries in both Northern and Southern Polities is the same as Cun and Chi." This is correct. Zhang Jingyue erred by speaking only of Cun and Chi. Zhang Jingyue stated, "Where Yin resides, the pulse does not respond. Commentators say the Six Qi regard Shao Yin as Sovereign; Sovereign image is non-action, not governing seasonal Qi, hence Shao Yin's arrival causes non-response. This view is very wrong. Since Shao Yin is one of the Six Qi, how could it not govern Qi? Only in *Tian Yuan Ji Da Lun*, 'Sovereign Fire by brightness, Ministerial Fire by...'"