谨守病机，〔谨守者防其变动也，病而曰机者，状其所因之不齐，而治之不可不圆活也。〕各司
其属。〔属者有五脏六腑之异，有七情六气之异，各审其属，而司其治。〕有者求之，无者求之，〔
言一遇病症，盒饭审其所属之有无。〕盛者责之，虚者责之。〔言于各属有无之间，分别虚实而处
治也。〕先必五胜，〔如木欲实，金当平之之类是也。〕疏其血气，令其调达，而致和平。〔或补之
而血气方行，或温之而血气方和，或清之而血气方治，或通之而血气方调，须随机应变，不得执一定
之治。〕补上治上，治以缓，补下治下。治以急；急则气味浓，缓则气味薄。寒者热之，热者寒
之。〔此正治法。〕微者逆之，〔即正治法。〕甚者从之，〔此反治法。〕客者除之，坚者削之
，留者攻之，逸者行之，〔过于安逸，则气脉凝滞，故须行之。〕结者散之，散者收之，急者
缓之，惊者平之，〔安之也。〕燥者濡之，劳者温之，〔温养之也。〕损者益之。热因寒用，〔寒甚格
热，热不得前，须热药冷服，所谓治寒以热凉而行之也。〕寒因热用，〔寒药热服，所谓治热以寒
温而行之也。〕塞因塞用，〔如补脾得而胀自消。〕通因通用，〔如积滞泄利，必通下之也。〕必伏
其所主，而先其所因，其始则同，其终则异，可使破积，可使溃坚，可使气和，可使必已。诸寒
之而热者，取之阴，〔谓以苦寒治热，而热反增，非火有余，乃阴不足也，故宜补阴壮水，则热自退
矣。〕热之而寒者，取之阳，〔谓以辛热治寒，而寒反甚，非寒有余，乃阳不足也，故宜补水中之火，
则寒自消矣。〕所谓求其属也。〔言求其本，一水一火，皆肾中求之。〕形不足者，〔阳气衰也。
〕温之以气，〔非气不足以达表而温之。〕精不足者，〔阴髓亏也。〕补之以味。〔非味不足以实中
而补之。〕其高者因而越之，〔病在上焦宜升散之，吐涌之也，〕其下者引而竭之，〔病在下焦，宜荡
涤之，疏利之也。或云引者，蜜导胆导之类，竭者承气抵当之类。〕中满者泻之于内，〔中满非气虚中
满，如胀满而有水有积，伤寒而结胸、便闭是也。〕其有邪者，渍形以为汗，〔渍，浸也，言其汗出如
浸，或用药熏汤蒸之，浴洗之，皆法也。〕其在皮者，汗而发之，〔前言有邪者，兼经络而言，言其
深也，此在皮者，言其浅也，故为表症宜汗。〕其 悍者，按而收之，〔 者，急也，悍者，猛也
，怒气伤肝之症也。按者制伏酸
收，如芍药之类是也〕。其实者散而泻之。〔阳实宜散之，阴实宜泻之。〕审其阴阳，以别柔刚。〔审
病之阴阳，施药之柔刚〕。阳病治阴，阴病治阳。〔阳盛者阴伤，治其阴者，补水之主也；阴盛者阳
伤，治其阳者，补水中之火也。〕定其血气，各守其乡。〔或血或气，用治收分，各不可紊也。〕血实宜
决之，〔谓决去其血，如决水之义。〕气虚宜掣引之。〔掣，挽也，挽回其气而引之使复也。如上气虚
者，升而柔之，中气虚者。温而补之，下气虚者。纳而归之。〕阴阳俱不足，〔脉细小也。〕补阳则阴
竭，泻阴则阳脱，如是者，可将以甘药，〔故补虚羸者，非用甘不可，土为万物之母也。〕不可以饮以
至剂。〔刚毒之剂也。并不可针灸。〕形苦志苦，〔必多忧思，忧则伤肺，思则伤脾。〕病生于咽嗌，
〔脾肺脉俱循咽溢，气伤而虚，则不可行而滞，试观悲忧过度，则喉咙哽咽，饮食难进，思虑过度，则
上焦痞膈，咽中核梗塞，即其征也。〕治之以甘药。〔因损其脏，故甘药调补之。〕形数惊恐，经络不
通，病生于不仁，〔惊则气乱，恐则气下，因数惊恐，则气血散乱，而经络不通，故病不仁，即麻木也。
〕治之以按摩醪药。〔醪药，药酒也，按摩以导气行血，醪药以养正除邪。〕欲令脾实，气无滞，饱无久
坐，食无大酸，无食一切生物，宜甘宜淡。木郁达之，〔达，畅达也，木喜调畅，但使气得通行，便谓
之达。〕火郁发之，〔发，发越也，因其势而解之，散之升之，如开其窗，揭其被，皆谓之发。〕土郁
夺之，〔夺、直取之也，滞在上者吐之，滞在中者伐之，滞在下者泻之，皆谓之夺。〕金郁泄之，〔泄
，疏利也。或解其表，或破其气，或通其便，皆谓之泄。〕水郁折之。〔折，调治也。如
养气可以化水，治在肺也；实土可以制水，治在脾也；自强可以帅水，治在肾也∶分利可以泄水，
治在膀胱也。凡此皆谓之折。〕病在中，而不实不坚，且聚且散，奈何？曰∶无积者求其脏虚则补
之，〔有积在中，则坚实不散矣，今则无积，可知病在中者，脏之虚也，故当取其何脏之虚以补之。〕
药以祛之，〔去其病也。〕食以随之，〔养其气也。〕行水渍之，〔浸洗以通其经也。〕和其中外
，可使毕已。病有久新，方有大小，有毒无毒，固宜常制矣。〔病重者宜大剂，病轻者宜小剂，无毒
者宜多用，有毒者宜少用〕。大毒治病，十去其六；常毒治病，十去其七；小毒治病，十去其
八，无毒治病，十去其九；〔药不及则病不痊，药太过则正乃伤，故大毒治病，十去其六，盒饭知止
，毒轻则可任，无毒则可久任也。〕谷肉果菜食养尽之，勿使过之，伤其正也。〔病虽去而有未尽
去者，当以饮食养正，而余邪自尽，若药饵太过，则伤正气。〕不尽，行复如法。〔食养而犹不
尽者，直用药如前法以治之〕。必先岁气，〔如少阴司天，热淫所胜，则无犯热之类也。〕无伐天和，
〔用药当顺天时。〕无盛盛，〔邪盛复助之也。〕无虚虚，〔正虚复攻之也，〕而遣人夭殃；勿致邪，
〔盛其盛，是致邪也，〕勿失正，〔虚其虚，是失正也。〕绝人长命。凡未诊病，必问常贵后贱，虽不中
邪，病从内生，名曰脱营。〔心志不舒，则血无以生，脉日以竭，故为营脱。〕常富后贫，名曰失
精。〔忧煎日迫，奉养日廉，故其五脏之积，日加消败，故为失精。〕凡欲诊病者，必问饮食居处，
〔饮食有膏粱藜藿之殊，居处有寒温燥湿之异。〕暴乐暴苦，始乐后苦，皆伤精气，精气竭绝，形体毁
沮。〔苦乐失常，皆伤精气，甚至
竭绝，则形体毁坏。〕诊有三常，〔即常贵贱，常贫富，常苦乐之义。〕必问贵贱，封君败伤，〔
追悔已往也。〕及欲侯王，〔妄想将来也，皆致病之因。〕故贵脱势，虽不中邪，精神内伤，身必
败亡。〔抑郁不伸，故精神内伤，迷而不达，不亡不已也。〕始富后贫，虽不伤邪，皮焦筋屈，痿
为挛。〔忧愁思虑，则心肺俱伤，气血俱损，故为是病。〕凡诊者必知终始，〔谓原其始要其终
也。〕有知余绪，〔谓察其本知其末也。〕切脉问名，〔欲得其素履之详也。〕当合男女，〔脉有顺逆
之别。〕离绝郁结，〔离者失其所爱，绝者断其所怀，郁者思虑抑郁，结者深情难解。〕忧恐喜怒，〔
忧则气沉，恐则气怯，喜则气缓，怒则气逆。〕五脏空虚，血气离守，〔凡此皆伤其内故也。〕工不能
知，何术之语。常富大伤，〔谓甚劳甚苦也。〕斩筋绝脉，〔其筋如斩，其脉如绝。〕身体复行，令泽
不息。〔泽，津液也。息，生长也。言身虽复旧能行，然令泽不息矣。〕故伤败结，留薄归阳，脓积寒
热。〔言旧之所侮有所败结，血气留薄不散，则郁而成热归于阳分，故脓血蓄积，令人寒热交作也。〕
粗工治之，亟刺阴阳，身体解散，四股转筋，死日有期。〔不知脓积以劳伤所致，刺则气血复伤而死
矣。〕喜伤心，恐胜喜，忧伤肺，喜胜忧，思伤脾，怒胜思，怒伤肝，悲胜怒，恐伤肾，〔恐则足不能
行，恐则遗尿，恐则阳痿，是其征也。〕思胜恐。病生于本，〔言受病之根原。〕余知之矣，生于标者
，〔言目前之多变。〕治之奈何？曰∶病反其本，中标之病，〔谓病有标本，但反求其所致之本，则现下
之标病，可得其阴阳表里之的矣。〕治反其本，中标之方。〔治有本末，但反求其拔本之道，则治标之
运用，
可得其七方十剂之妙矣。〕治有取标而得者，有取本而得者，〔病之先受者为本，病之后变者为标。
〕有逆取而得者，有从取而得者。〔各有所宜也。〕故知逆与从，正行无问，〔正理而行，无所疑问。
〕知标本者，万举万当，不知标本，是谓妄行。粗工嘻嘻，以为可知，言热未已，寒病复始。〔假热
未已，真寒复起。〕粗工凶凶，以为可攻，故病未已，新病复起。〔假实未去，真虚更至。〕血之与气。
异名同类，〔以血化于液，液化于气也。〕故夺血者无汗，夺汗者无血。〔血与汗亦同类，但血主营
，为阴为里，汗属卫，为阳为表，若表里俱夺，则不脱于阴，即脱于阳。〕故人有两死，〔脱阳亦死，脱
阴亦死。〕而无两生，〔孤阳不能生，孤阴亦不能生。〕形肉已夺，是一夺也；大夺血之后，是二夺
也∶大汗出之后，是三夺也；大泄之后，是四夺也；新产及大血之后，是五夺也，此皆不可泻。妇人重身，
毒之如何，〔有孕曰重身。毒之谓峻利药也。〕曰∶有故无殒，亦无殒也，〔有是故而用是药，所谓有
病则病当之，故孕妇不殒，胎亦不殒也。〕大积大聚，其可犯也，衰其大半而止。〔大积大聚，非毒药不
可攻，但大毒治病，十去其六七即止。〕过者死。〔过用则伤胎致死。〕
Adhere strictly to the pathogenesis, (carefully grasp the mechanism of disease to prevent changes; the term "pathogenesis" describes the complexity and variability of etiology, thus treatment must be flexible and adaptable.) Each category has its specific attributes. (Attributes include differences among the Zang-Fu organs and variations in the Seven Emotions and Six Qi; carefully examine the specific category to formulate appropriate treatments.) Investigate those that exist, investigate those that do not exist. (This means upon encountering a disease, one must examine the presence or absence of pathological factors in the relevant categories.) Reprimand (address) excess, reprimand deficiency. (This means distinguishing between excess and deficiency within each category for treatment.) First, understand the mutual overcoming among the Five Elements, (for example, if Wood is excessive, Metal should be used to level it.) Unblock the Qi and Blood, make them smooth and unobstructed, thereby achieving harmony. (Tonify to promote circulation, warm to harmonize, clear to regulate, or unblock to adjust; one must adapt to circumstances and not adhere to fixed methods.) For upper body tonification and treatment, use mild methods; for lower body tonification and treatment, use urgent/strong methods; urgent methods involve strong flavors and aromas, while mild methods involve weak flavors and aromas. Treat cold with heat, treat heat with cold. (These are direct treatment methods.) For minor conditions, oppose them, (i.e., direct treatment.) For severe conditions, follow them, (i.e., contrary treatment.) Eliminate exogenous pathogens, reduce hardness, attack stagnation, promote movement for lethargy, (excessive leisure leads to Qi and vessel stagnation, so promotion is required.) Disperse consolidations, astringe scatterings, relieve urgency, calm fright, (to stabilize them.) Moisten dryness, warm exhaustion, (meaning to warm and nourish.) Benefit depletion. Use hot natured drugs with cold administration, (when Cold is extreme and repels Hot drugs, preventing entry, administer hot drugs cold; this is treating cold with heat but administering coolly.) Use cold natured drugs with hot administration, (administer cold drugs hot; this is treating heat with cold but administering warmly.) Treat obstruction with obstructing methods, (e.g., tonifying Spleen resolves distension.) Treat diarrhea with purging methods, (e.g., purgatives for stagnation-induced diarrhea.) One must subdue the primary factor and address the root cause first; although they start similarly, they end differently; this can break accumulations, dissolve hardness, harmonize Qi, and ensure cure. When cooling measures fail to resolve heat, seek the Yin, (if bitter-cold herbs increase heat, it indicates Yin deficiency rather than Fire excess; thus, tonify Yin and strengthen Water to resolve heat.) When heating measures fail to resolve cold, seek the Yang, (if acrid-hot herbs worsen cold, it indicates Yang deficiency rather than Cold excess; thus, tonify the Fire within Water to resolve cold.) This is called seeking the root. (Seek the origin; Water and Fire are both sought from the Kidney.) For insufficiency of form, (Yang Qi decline,) warm it with Qi, (Qi alone cannot reach the exterior to warm.) For insufficiency of essence, (Yin Marrow deficit,) supplement it with flavor/substance. (Substance alone cannot fill the interior to tonify.) For high locations, induce vomiting/vomiting upward, (diseases in the Upper Jiao benefit from ascending and dispersing methods like emesis.) For low locations, guide and exhaust, (diseases in the Lower Jiao benefit from purging and draining methods. Some interpret "guide" as honey suppositories or gallbladder suppositories, and "exhaust" as Chengqi Tang or Didang Tang.) For fullness in the middle, purge internally, (middle fullness here refers not to Qi deficiency but to water/damp accumulation, such as chest binding or constipation in Shaoyang diseases.) For those with pathogens, soak the body to induce sweat, (soak implies immersion; inducing sweat through fumigation, herbal baths, etc., is valid.) For pathogens in the skin, induce sweating to release them, (previous mention of pathogens referred to deep meridian levels; skin-level pathogens are superficial, hence diaphoresis is indicated for exterior syndromes.) For fierce/aggressive symptoms, press and astringe, (fierce refers to urgency/intensity, often Liver injury from anger; pressing/astringing uses sour-astringent herbs like Paeonia.) For excess conditions, disperse and purge. (Yang excess requires dispersion, Yin excess requires purging.) Examine Yin and Yang to distinguish soft and hard/rigid. (Assess Yin-Yang pathology to select soft-rigid herbs.) Treat Yin diseases by addressing Yang, treat Yang diseases by addressing Yin. (Yang excess injures Yin, so treating Yin involves tonifying the source of Water; Yin excess injures Yang, so treating Yang involves tonifying the Fire within Water.) Stabilize Qi and Blood, let each remain in its domain. (Whether treating Qi or Blood, dosage and method must not be chaotic.) For blood excess, drain it, (like draining water.) For Qi deficiency, pull and guide it. ("Pull" means to retrieve and guide Qi back to normal; e.g., ascend and soften Upper Qi deficiency, warm and tonify Middle Qi deficiency, store and return Lower Qi deficiency.) If both Yin and Yang are insufficient, (pulse is fine and small,) tonifying Yang causes Yin exhaustion, purging Yin causes Yang collapse; in such cases, use sweet/herbal medicines, (sweet herbs are essential for tonifying weakness as Earth is the mother of all things.) Do not use harsh/toxic agents. (Harsh toxic agents are contraindicated; acupuncture/moxibustion are also not suitable.) For physical hardship and mental anguish, (likely involving much worry and thought; worry injures Lung, thought injures Spleen.) Diseases arising in the throat/pharynx, (Spleen and Lung meridians traverse the throat; Qi deficiency leads to stagnation; excessive grief causes choking, excessive thought causes globus sensation.) Treat with sweet/herbal medicines. (Since internal organs are damaged, sweet herbs regulate and tonify.) For frequent fright and fear causing meridian blockage, diseases manifesting as numbness/anesthesia, (Fright scatters Qi, Fear sinks Qi; frequent fright/fear causes Qi-Blood chaos and meridian blockage, leading to numbness.) Treat with massage and medicinal wine. (Medicinal wine nourishes righteousness and expels evil; massage guides Qi and moves Blood.) To strengthen the Spleen, avoid Qi stagnation, do not sit long after eating, avoid overly sour foods, avoid raw/uncooked foods; prefer sweet and bland flavors. If Wood is depressed, promote its free flow, (promote means smooth flow; allowing Qi to move freely constitutes promotion.) If Fire is depressed, vent it, (vent means to disperse and ascend according to its nature, like opening windows or removing blankets.) If Earth is depressed, seize/drastically remove it, (drastic removal: vomit if stagnant above, purge if stagnant in middle, drain if stagnant below.) If Metal is depressed, drain it, (drain means to disperse and promote; release exterior, break Qi stagnation, or open bowels.) If Water is depressed, restrain/regulate it. (Regulation: nourish Lung Qi to transform Water, fortify Spleen Earth to control Water, strengthen Kidney Qi to command Water, or promote urination to drain Water.) If disease is in the middle, neither solid nor hard, fluctuating and gathering/scattering, what then? Answer: If there is no accumulation, seek organ deficiency and tonify it, (absence of firm accumulation suggests organ deficiency; identify which Zang is deficient and tonify it.) Use drugs to eliminate pathogens, (remove disease.) Use food to follow/support, (nourish Qi.) Use water soaking/bathing to circulate fluids, (immersion to unblock meridians.) Harmonize interior and exterior, and the disease can be cured. Diseases vary in duration (old/new), formulas vary in size (large/small), and toxicity varies (toxic/non-toxic); these should follow standard regulations. (Severe disease needs large doses, mild disease needs small doses; non-toxic herbs can be used more, toxic herbs less.) For highly toxic drugs, stop when 60% of the disease is removed; for commonly toxic drugs, stop at 70%; for slightly toxic drugs, stop at 80%; for non-toxic drugs, stop at 90%. (Insufficient potency fails to cure; excessive potency damages healthy Qi. Thus, stop early for toxic drugs; lighter toxicity allows longer use, non-toxicity allows prolonged use.) Complete recovery through dietary therapy of grains, meats, fruits, and vegetables; do not overdo it, lest it damage healthy Qi. (If residual pathogens remain after drug therapy, use diet to nourish righteous Qi; excessive drug use harms healthy Qi.) If not fully resolved, repeat the method. (If dietary therapy fails, resume drug therapy as previously described.) First, consider the annual Qi/climate, (e.g., if Shao Yin governs the year and Heat prevails, avoid violating heat-related prohibitions.) Do not violate the Harmony of Heaven, (medication should accord with seasonal timing.) Do not exacerbate excess, (adding to existing pathogenic excess.) Do not aggravate deficiency, (attacking existing healthy deficiency,) thereby avoiding premature death; do not invite pathogens, (exacerbating excess invites pathogens,) do not lose healthy Qi, (aggravating deficiency loses healthy Qi,) cutting off longevity. Before diagnosing, always ask about past status of nobility vs. baseness; even without external pathogens, disease arises internally, named "Tuoying" (Loss of Ying). (Unfulfilled aspirations hinder Blood generation, depleting vessels, causing Ying loss.) Ask about past wealth vs. poverty, named "Shijing" (Loss of Jing/Essence). (Persistent worry and reduced sustenance cause gradual depletion of Zang-Jing.) To diagnose properly, always ask about diet and living environment. (Diet varies from rich to plain; residence varies in cold/warmth and dryness/dampness.) Sudden joy followed by sudden sorrow, or initial joy ending in sorrow, all damage Essence-Qi; if Essence-Qi is exhausted, the physique deteriorates. (Irregular emotional states damage Essence-Qi; exhaustion leads to physical decay.) The Three Constants of diagnosis refer to constant status regarding nobility/poverty and suffering/joy. Always ask about social status; ruin of a noble title (regretting the past) or desire for lordship (fantasizing about the future) are causes of disease. Thus, loss of power for the noble, though not due to external pathogens, causes internal spiritual injury and inevitable physical decline. (Depression causes internal spiritual injury, leading to demise.) Initial wealth followed by poverty, though not injuring with pathogens, causes dry skin, contracted sinews, flaccidity, and spasms. (Worry and thought injure Heart/Lung, damaging Qi/Blood.) A physician must know the beginning and end of disease, (trace origin and outcome.) Understand the threads/details, (know the root and branch.) Pulse taking and inquiry into name/background, (to understand lifestyle details.) Correlate with male/female differences, (pulses have favorable/unfavorable patterns.) Separation, severance, depression, and knotting, (separation: losing loved ones; severance: cutting ties; depression: brooding; knotting: unresolved deep emotions.) Worry, fear, joy, anger, (worry sinks Qi, fear makes Qi timid, joy relaxes Qi, anger reverses Qi.) These empty the Five Zang, causing Qi and Blood to abandon their posts. (All these damage the interior.) If a practitioner does not know these, how can they speak of technique? Severe damage from former wealth (extreme labor/suffering) severs sinews and cuts pulses, (sinews feel severed, pulses feel cut.) Though the body may recover mobility, fluid/nutrient production ceases. (Fluids/Nutrients do not regenerate.) Thus, injury and stagnation, lingering and thinning, turning to Yang, lead to pus accumulation and alternating chills/fever. (Old injuries cause Qi-Blood stagnation, transforming into Heat in the Yang aspect, causing pus/chills-fever.) Crude practitioners treat this by urgently needling Yin/Yang meridians, causing body dissolution, leg cramps, and eventual death. (Not recognizing劳伤 [labor injury] as the cause, needling further damages Qi-Blood.) Joy injures the Heart, Fear overcomes Joy; Sorrow injures the Lung, Joy overcomes Sorrow; Thought injures the Spleen, Anger overcomes Thought; Anger injures the Liver, Grief overcomes Anger; Fear injures the Kidney, (Fear causes inability to walk, enuresis, impotence.) Thought overcomes Fear. Disease originates from the Root, (the fundamental cause.) I know this; but what of disease originating from the Branch? (current variable symptoms.) How to treat? Answer: Reverse the disease to find the Root, identifying the Branch disease. (By tracing the Root, the Yin-Yang/Exterior-Interior nature of the current Branch becomes clear.) Treat by reversing to the Root, applying Branch formulas. (By addressing the Root, the application of Branch treatments reveals the subtleties of the Seven Formulas and Ten Categories.) Treatment can succeed by targeting the Branch or the Root. (Primary cause is Root, secondary change is Branch.) It can succeed by contrary treatment or following treatment. (Each has its appropriateness.) Knowing contrary and following, proceed correctly without doubt. (Following correct principles leaves no doubt.) Knowing Root and Branch ensures success in ten thousand attempts; ignoring them is reckless action. Crude physicians laughingly think they know, claiming heat persists while cold disease restarts. (False heat remains, true cold returns.) Crude physicians aggressively think they can attack, so old disease persists while new disease arises. (False excess remains, true deficiency arrives.) Blood and Qi are different names but same category, (Blood transforms from Fluids, Fluids from Qi.) Therefore, those who lose Blood should not sweat, and those who lose Sweat should not lose Blood. (Blood and Sweat are similar; Blood manages Ying, is Yin/Interior; Sweat belongs to Wei, is Yang/Exterior. Loss of both Exterior/Interior leads to Yin or Yang collapse.) Thus, humans can die two deaths (collapse of Yang or Yin) but cannot have two lives (isolated Yang or Yin cannot generate life.) Depletion of flesh/form is the first depletion; massive blood loss is the second; profuse sweating is the third; severe diarrhea is the fourth; postpartum or major hemorrhage is the fifth. All these are contraindications for purging. For pregnant women, how to use toxic/harsh drugs? (Pregnancy is "heavy body." Toxic drugs refer to harsh purgatives.) Answer: If there is a cause/pathology, there will be no harm to the mother, nor to the fetus. (Using appropriate drugs for specific pathology means the disease bears the brunt, sparing mother and fetus.) Large accumulations and masses can be attacked, but stop when half to two-thirds are reduced. (Large accumulations require toxic drugs, but stop after reducing 60-70%.) Overuse leads to death. (Overuse damages the fetus and causes death.)