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[Note]: The *Suwen* does not contain the character "zhe" (者).) All [cases] result in death. (These five colors all indicate being overcome by other elements, occurring out of season; without treatment, all result in death. However, observing color is difficult; for now, we understand this based on this single principle.) Ping An: In the *Suwen*, the character "ye" (也) follows the character "si" (死).)

[Ping An]: This section, from the beginning to the end of the chapter, appears in Volume 1, Chapter 4 ("Evil Qi, Zang-Fu Organs, and Disease Manifestations") of the *Lingshu*, and also in Volume 4, Part 2, Upper of the *Jiayi Jing*.

The Yellow Emperor asked: When evil qi invades a person, what are the manifestations of the disease? Qibo replied: When xu xie (deficient evil/evil wind from empty directions) invades the body, the blood vessels (xu) pulsate, and the form moves. When zheng xie (correct evil/normal seasonal wind) invades a person, it is subtle; it first manifests in the complexion, but is not felt in the body. It seems to exist yet not exist, to be present yet absent, to have form yet be formless; no one knows its true nature. The Yellow Emperor said: Excellent. (Xu xie refers to the evil winds from the eight empty directions. Zheng xie refers to the winds of the four seasons. The winds of the four seasons nourish all things, thus they are called "correct." The winds of the eight directions come from empty places and damage things, thus they are called "deficient." Both deficient and correct winds are not grain qi; because they enter when the couli (pores/cutaneous interstices) open, they are called "evil winds." When xu xie enters the body, it penetrates the couli, like water flowing backward in a ditch; the hair stands erect, and the form moves, thus causing disease in humans. When zheng xie enters the body, it is subtle and hard to recognize; it first appears in the complexion without being felt in the body, thus it is light and easy to dispel. Ping An: The *Jiayi Jing* lacks the sixteen characters from "Huangdi yue" to "Qibo da yue." "Xu" (洫) is written as "zhazhe" (洒浙) in the *Lingshu* and *Jiayi Jing*. The *Jiayi Jing* lacks the four characters "ruo you ruo wu" (若有若无).)

The Yellow Emperor asked Qibo: I have heard that observing the color to know the disease is called "ming" (clear/perceptive); palpating the pulse to know the disease is called "shen" (divine/profound); asking about the disease to know its location is called "gong" (skilled). I wish to hear how to observe and know, palpate and obtain, and ask and exhaust. How should this be done? (The clarity of observing color, the profundity of palpating the pulse, and the skillfulness of examining questions are the essentials of diagnosis, so I ask about them all. Ping An: The *Jiayi Jing* lacks this paragraph and the four characters "Qibo da yue" below it. "Wen qi bing" (ask his disease): The original copy writes "wen" (问) as "jian" (间); strictly following the *Lingshu* and this note, it is corrected to "wen".) Qibo replied: The correspondence between color, pulse, and chi skin (skin of the forearm) is like the correspondence between a drumstick striking a drum, a form casting a shadow, or a sound echoing; they must not be lost. (Fu, pronounced fú, is the drumstick. The answer mentions color, pulse, and chi, constituting three methods, excluding inquiry. Color refers to facial complexion. Pulse refers to the cunkou (radial artery at the wrist). Chi refers to the chi area (forearm skin). The good and evil qi of the zang and fu organs manifest in the color areas, cunkou, and chi. These three indicators correspond, like a stick hitting a drum, a form with its shadow, or a sound with its echo, without deviation. For example, if the liver color is green, the cunkou pulse is wiry, and the chi skin is abnormal, the internal and external do not deviate. Ping An: The *Jiayi Jing* adds the two characters "pi fu" (skin) after "chi".) This is also the manifestation of the root and branches; therefore, if the root dies, the leaves wither. (Here, the chi skin is regarded as the root and stem, while color and pulse are regarded as the branches and leaves; thus, if the root dies, the branches and leaves wither and change. Ping An: The *Jiayi Jing* lacks the character "gu" (therefore) before "gen" (root). In the note, "jing" (stem) is printed as "ji" (base) in the Yuan edition.) Color, pulse, and form/flesh (chi skin) must not deviate from each other. (Form/flesh refers to the chi skin. The three—color, pulse, and chi skin—must not deviate.) Therefore, knowing one makes one a gong (skilled), knowing two makes one shen (profound), and knowing three makes one shen qie ming (profound and clear). (Thus, knowing only one method [inquiry] allows one to be a gong; knowing two methods [inquiry and pulse] makes one shen; knowing inquiry, pulse, and being able to observe color is called shen ming. Ping An: In the note, "ke" (can) was originally "you" (have), corrected marginally to "ke"; the Yuan edition has both characters, which is incorrect.) The Yellow Emperor asked: I wish to hear this completely. Qibo replied: (Ping An: The *Jiayi Jing* lacks the thirty-nine characters from "se mai xing rou" to "Qibo da yue".) When the color is green, the pulse is xian (wiry); (Green is the color of the Liver; xian is the pulse of the Liver; thus, green and xian represent the Liver's exterior. Asking about the differences among color, pulse, and chi; now only answering color and pulse without mentioning chi, because chi changes are the same as the pulse.) When the color is red, the pulse is gou (hooked); (Red is the color of the Heart; gou is the pulse of the Heart; thus, red and gou represent the Heart's exterior.) When the color is yellow, the pulse is dai (modulated/interrupted); (Yellow is the color of the Spleen; dai is the pulse of the Spleen; thus, yellow and dai represent the Spleen's exterior.) When the color is white, the pulse is mao (feathery); (White is the color of the Lung; mao is the pulse of the Lung; thus, white and mao represent the Lung's exterior.) When the color is black, the pulse is shi (stone-like). (Black is the color of the Kidney; shi is the pulse of the Kidney; thus, black and shi represent the Kidney's exterior. Shi is also interpreted as jian (hard); jian is also shi.) If one sees the color but does not get the corresponding pulse, and instead gets a controlling (overcoming) pulse, death will occur; (For example, in Liver disease, if green is seen, the pulse should be xian; if a mao pulse is obtained instead, this is the Lung overcoming the Liver, thus death. The other organs follow this pattern.) If one gets a generating (nourishing) pulse, the disease will resolve. (For example, in Liver disease, if green is seen, even if the xian pulse is not present but a shi pulse is obtained, shi is the Kidney pulse; this is Water generating Wood, meaning a generating pulse is obtained, thus the disease resolves.) The Yellow Emperor asked Qibo: What are the disease manifestations generated and changed by the Five Zang organs? Qibo replied: One must first determine the correspondence of the five colors and five pulses, then the diseases can be distinguished. (To know the diseases generated and changed by the five zang organs, one must first determine the five colors of the face and the five pulses of the cunkou, then the disease can be known.) The Yellow Emperor asked: Once color and pulse are determined, how are they distinguished? Qibo replied: By adjusting/observing the six variations of the pulse—huan (slow/relaxed), ji (rapid/tense), xiao (small), da (large), hua (slippery), and se (rough)—the disease changes are determined. (Although one obtains the pulse of the primary organ, each pulse has six variations; observing these six variations reveals the disease manifestation. Ping An: "Xiao da" (small large) is written as "da xiao" (large small) in the *Jiayi Jing*; "bing bian" (disease change) is written as "bing xing" (disease manifestation). The character "yi" (particle indicating completion) is missing in the Yuan edition.) The Yellow Emperor asked: How is the adjustment/observation done? Qibo replied: When the pulse is ji (tense), the chi skin is also tense; (Pulse ji refers to the cunkou pulse being tense. Chi skin refers to the area from Chize to Guan; this is the chi division. Within the chi division, the arterial point one cun behind Guan is the site for diagnosing the chi pulse; from one cun behind to Chize is called the chi skin. Under the chi skin, the Hand Taiyin pulse qi comes from the zang to the fingertips and returns from the fingertips to the zang; thus, the skin under the chi corresponds to the six variations of the size and inch pulses. Palpating the chi skin with the hand shows tension consistent with the cunkou pulse.) When the pulse is huan (relaxed), the chi skin is also relaxed; (Cunkou pulse huan means palpating the chi skin reveals relaxation.) When the pulse is xiao (small), the chi skin is also diminished and lacks qi; (Cunkou pulse xiao means the chi skin is diminished and lacks qi.) When the pulse is da (large), the chi skin is also bulging and large; (Cunkou pulse da means the chi skin bulges and appears large. Another reading says "also large," suspected to be a correction to "da." Ping An: "Yi ben er qi" (also bulging and rising) is written as "yi da" (also large) in the *Jiayi Jing*.) When the pulse is hua (slippery), the chi skin is also slippery; (Palpating the cunkou pulse as hua means the chi skin is also slippery. Ping An: The *Jiayi Jing* adds nine characters before "mai hua": "Mai chen zhe, chi zhi pi fu yi chen" (When the pulse is deep, the chi skin is also deep).) When the pulse is se (rough), the chi skin is also rough. (The cunkou pulse comes in a hesitant and rough manner, and the chi skin is also rough and not slippery.) Regarding these six variations, there are slight and severe degrees. Therefore, one who is skilled at observing the chi skin does not need to wait for the cunkou; (Both cunkou and chi have six variations, and each variation has slight or severe degrees, which can be carefully examined. Previously, observing the six variations of the cunkou pulse and then the six variations in the chi region allows one to know the disease. If one can carefully observe the six variations of the chi skin, one can know the disease without needing to diagnose the cunkou. Ping An: The *Lingshu* and *Jiayi Jing* lack the character "liu" (six) before "bian" (variation) and the character "kou" (mouth/wrist) after "cun" (inch).) One who is skilled at observing the pulse does not need to wait for the color. (Being skilled at observing the cunkou pulse to know the disease also does not require observing the color to know.) One who can integrate and practice all three can be considered a Shang Gong (Superior Physician), whose cure rate is nine out of ten; one who practices two is a Zhong Gong (Medium Physician), whose cure rate is seven out of ten; one who practices one is a Xia Gong (Inferior Physician), whose cure rate is six out of ten. (Observing color, diagnosing pulse, and adjusting chi skin: integrating these three methods captures the subtleties of disease, hence nine out of ten cured, named Shang Gong. Knowing only two methods [chi and cunkou], curing seven out of ten, is Zhong Gong. Understanding only one method [chi], curing six out of ten, is Xia Gong. Ping An: In the *Jiayi Jing*, Shang Gong, Zhong Gong, and Xia Gong are not repeated; the character "qi" (its) follows "quan" (complete/all) in each case.)