先病而后逆者治其本。先逆而后病者治其本。先寒而后生病者治其本。先病而后生寒者治其本。
先热而后生病者治其本。
此承前数章之义。分别标本外内先后之治法焉。先逆先寒先热者。先病天之六气也。先病者。
先病患之经气也。先病而后逆者。人之形体先病。而后致气之厥逆。故当先治其本病。先逆而后病
者。先感天之六气。病吾身之阴阳。以致气逆而为病者。故当先治其天之本气。先寒而后生病者。
先感天之寒邪。而致生六经之病。故当先治其本寒。先病而后生寒者。吾身中先有其病。而后生寒
者。当先治其本病。先热而后生病者。先感天之热邪。而致生形身之病。故当先治其天之本热。天
之六气。风寒热湿燥火也。人之六气六经。三阴三阳也。人之阴阳。与天之六气相合。故有病本而
及标者。有病标而及本者。此节以先病为本。后病为标。莫云从曰。先病后逆。先逆后病。总论天
之六气。与吾身之阴阳。先寒而后生病。先病而后生寒。先热而后生病。先病而后生热。分论天有
此寒热。而吾身中亦有此寒热也。
先泄而后生他病者治其本。必且调之。乃治其他病。先病而后中满者治其标。先病而后泄者治
其本。先中满而后烦心者治其本。
泄者。脾胃之病也。脾属四肢而主肌肉。此病者。因脾病于内。而生四肢形体之病。故当先治
其本病。必且调
其脾胃。而后治其他病焉。中满者。腹中胀满。脾胃之所生也。先病而后中满者。因病而致中满也。
则当先治中满之标病。而后治其本病。先病而后泄者。因病而致飧泄也。当先治其本病。而泄自止
矣。脾所生病者。上走心为噫。先中满而后烦心者。脾病上逆于心也。故当治其本病。夫人之脏腑
形骸经脉血气。皆本于脾胃之所生。上节论天之客气。与人之阴阳。外内交感而为病。此论人之本
气为病。又当以脾胃为根本也。
有客气。有同气。大小便不利治其标。大小便利治其本。
此承上文而言。所谓先病先逆。先寒先热。先泄中满之为病。有客气而有同气者也。客气者。天
之六气也。同气者。吾身中亦有此六气。与天气之相同也。有客气之为病者。有本气之为病者。皆
伤人之正气。伤则气不化。而二便不利矣。故大小便不利者治其标。大小便利者治其本。莫云从
曰。客气之病。从外而内。本气之病。从内而外。大小便不利者。病气皆入于内。故当治其标而从
下解。大小便利者。病气皆在于外。故当治其外之本病。
病发而有余。本而标之。先治其本。后治其标。病发而不足。标而本之。先治其标。后治其本。
谨详察间甚。以意调之。间者并行。甚为独行。先大小便不利而后生他病者。治其本也。（间去声）
此论阴阳六气之标本也。六微旨论曰。少阳之上。火气治之。阳明之上。燥气治之。太阳之上。
寒气治之。厥阴之上。风气治之。少阴之上。热气治之。太阴之上。湿气治之。所谓本也。本之下。
气之标也。盖以风寒暑湿燥火六气为本。以三阴三阳六气为标。有余者。邪气之有余。不足者。正
气之不足。故病发而有余。本而标之。先治
其风寒暑湿之本气。而后调其三阴三阳之标。谓当先散其邪。而后调其正气。如病发而不足。标而
本之。当先调其阴阳。而后治其本气。此标本邪正虚实之治要也。再当谨察其间甚。以意调之。间者。
邪正虚实之相间。故当并行其治。盖以散邪之中。兼补其正。补正之内。兼散其邪。甚者。谓邪气
独盛。或正气独虚。又当独行其治。如邪气甚者。独泻其邪。正虚甚者。独补其正。此补泻间甚之
要法也。如先大小便不利而后生他病者。当治其二便之本病。又无论其邪正之间甚矣。按、此篇列
于厥证之间。无问答之辞。乃承上启下。以申明厥逆之义。盖人秉天地阴阳五运六气而成此形。此
身中亦有五运六气。应天道环转之不息。若感天之客气。则为客邪所逆而成病矣。若喜怒暴发。志
意不调。饮食失节。居处失宜。则此身中之气运厥逆而为病矣。故病客气者。自外而内。病同气者。
自内而外。有标本外内之出入。有邪正虚实之后先。故曰标本之道。要而博。小而大。可一言而知
百病之害。言标与本。易而勿损。察本与标。气令可调。明知胜复。为万民式。天之道毕矣。
The differentiation of Jingqi (Meridian Qi) among the Five Zang Organs, Yin-Yang, and Pathogenic vs. Upright factors.
When illness occurs first followed by Qi rebellion (reversal of Qi flow), treat the Root (Ben). When Qi rebellion occurs first followed by illness, treat the Root. When cold sensation occurs first followed by illness, treat the Root. When illness occurs first followed by cold sensation, treat the Root.
When heat sensation occurs first followed by illness, treat the Root.
This continues the meaning of the preceding chapters, distinguishing the treatment methods regarding Root and Branch (Biao), interior and exterior, and sequence. The terms "first rebellion," "first cold," and "first heat" refer to initially contracting the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) of Heaven. The term "first illness" refers to initially contracting the Jingqi (Qi of the Twelve Meridians) of Man.
When illness occurs first followed by Qi rebellion, it means the human body's form is first diseased, leading subsequently to Qi Jue-ni (rebellious Qi). Therefore, one should first treat the primary disease (Root).
When Qi rebellion occurs first followed by illness, it means one initially contracts the Six Qi of Heaven, damaging the Yin-Yang of one's own body, thereby causing Qi rebellion and subsequent illness. Therefore, one should first treat the fundamental Qi of Heaven.
When cold sensation occurs first followed by illness, it means one initially contracts the Cold pathogen of Heaven, leading to illness in the Six Meridians. Therefore, one should first treat the fundamental Cold.
When illness occurs first followed by cold sensation, it means there is a pre-existing disease within the body, which then generates a sensation of cold. One should first treat the primary disease (Root).
When heat sensation occurs first followed by illness, it means one initially contracts the Heat pathogen of Heaven, leading to illness in the physical form. Therefore, one should first treat the fundamental Heat of Heaven.
The Six Qi of Heaven are Wind, Cold, Heat, Dampness, Dryness, and Fire. The Six Qi and Six Meridians of Man correspond to the Three Yin and Three Yang. Human Yin-Yang combines with the Six Qi of Heaven; thus, there are cases where disease proceeds from Root to Branch, and cases where disease proceeds from Branch to Root. In this section, the initial illness is considered the Root, and the subsequent illness is considered the Branch. Mo Yuncong stated: "Illness followed by rebellion, and rebellion followed by illness" generally discusses the relationship between the Six Qi of Heaven and the Yin-Yang of the body. "Cold before illness, illness before cold, heat before illness, illness before heat" specifically discusses how Heaven possesses these colds and heats, and the body also possesses corresponding colds and heats.
When diarrhea occurs first followed by other illnesses, treat the Root. It is necessary to first regulate the Spleen and Stomach before treating other diseases. When illness occurs first followed by abdominal fullness, treat the Branch. When illness occurs first followed by diarrhea, treat the Root. When abdominal fullness occurs first followed by vexation in the heart, treat the Root.
Diarrhea is a disease of the Spleen and Stomach. The Spleen governs the four limbs and muscles. This type of illness arises because the Spleen is diseased internally, generating illness in the limbs and physical form. Therefore, one should first treat the primary disease (Root), necessarily regulating the Spleen and Stomach first, and then treating other diseases.
"Zhong-man" (central fullness) refers to abdominal distension, which is generated by the Spleen and Stomach. When illness occurs first followed by Zhong-man, it is due to an existing disease causing central fullness. In this case, one should first treat the Branch illness of central fullness, and then treat the Root disease.
When illness occurs first followed by diarrhea, it is due to an existing disease causing Sundiarrhea (diarrhea with undigested food). One should first treat the Root disease, and the diarrhea will cease naturally.
Diseases generated by the Spleen, when moving upward to affect the Heart, manifest as belching. When abdominal fullness occurs first followed by heart vexation, it is because Spleen disease rebels upward to the Heart. Therefore, one should treat the Root disease. The Zang-Fu organs, physical form, meridians, and blood-Qi of humans all originate from the Spleen and Stomach. The previous section discussed Heavenly Keqi (Guest Qi) interacting with Human Yin-Yang, causing disease through internal-external interaction. This section discusses illness caused by Human Benqi (Host Qi), emphasizing that the Spleen and Stomach must be regarded as the foundation.
There is Guest Qi (Keqi) and Host Qi (Tongqi). When urination and defecation are obstructed, treat the Branch. When urination and defecation are unobstructed, treat the Root.
This follows the previous text, stating that illnesses such as initial illness, initial rebellion, initial cold, initial heat, initial diarrhea, and initial fullness involve both Guest Qi and Host Qi. "Guest Qi" refers to the Six Qi of Heaven. "Host Qi" refers to the fact that the human body also contains these six Qi, identical to those of Heaven. There are illnesses caused by Guest Qi and illnesses caused by Host Qi; both damage the upright Qi of humans. Damage leads to failure of Qi transformation, resulting in obstruction of urination and defecation. Therefore, when urination and defecation are obstructed, treat the Branch; when they are unobstructed, treat the Root. Mo Yuncong stated: Illness from Guest Qi moves from exterior to interior; illness from Host Qi moves from interior to exterior. In cases of obstructed urination and defecation, pathogenic Qi enters inward, so one should treat the Branch and resolve it from below. In cases of unobstructed urination and defecation, pathogenic Qi remains external, so one should treat the Root disease of the exterior.
When a disease manifests as Excess (Yu), treat the Root first and the Branch second. When a disease manifests as Deficiency (Zu), treat the Branch first and the Root second.
Carefully observe the severity and mildness of the condition, and adjust treatment according to judgment. In mild cases, treat both Root and Branch simultaneously; in severe cases, treat either Root or Branch exclusively. If obstruction of urination and defecation occurs first followed by other illnesses, treat the Root. (Note: "Jian" is pronounced with the falling tone.)
This section discusses the Root and Branch of Yin-Yang and the Six Qi. The *Suwen: Liu Wei Zhi Da Lun* states: Above Shaoyang, Fire Qi governs; above Yangming, Dryness Qi governs; above Taiyang, Cold Qi governs; above Jueyin, Wind Qi governs; above Shaoyin, Heat Qi governs; above Taiyin, Dampness Qi governs. This is called the "Root." Below the Root is the "Branch" of Qi. Generally, the Six Qi of Wind, Cold, Summer-heat, Dampness, Dryness, and Fire constitute the Root, while the Three Yin and Three Yang constitute the Branch.
"Excess" refers to the excess of pathogenic Qi; "Deficiency" refers to the deficiency of upright Qi. Thus, when a disease manifests as Excess, one treats the Root first and the Branch second: first treating the fundamental Qi of Wind, Cold, Summer-heat, and Dampness, and then harmonizing their Branches of Three Yin and Three Yang. This implies dispersing the pathogen first, then harmonizing the upright Qi. Conversely, when a disease manifests as Deficiency, one treats the Branch first and the Root second: first harmonizing Yin-Yang, then treating the fundamental Qi. These are the key principles for treating Root/Branch, Pathogen/Upright, and Excess/Deficiency.
Furthermore, one must carefully observe the severity ("Jian" vs. "Shen") and adjust accordingly. "Mild" (Jian) indicates a mixture of pathogen and upright, excess and deficiency; therefore, simultaneous treatment is required—dispersing pathogens while tonifying upright Qi, and tonifying upright Qi while dispersing pathogens. "Severe" (Shen) indicates either exclusive excess of pathogen or exclusive deficiency of upright Qi; therefore, exclusive treatment is required. For extreme excess, exclusively purge the pathogen; for extreme deficiency, exclusively tonify the upright Qi. This is the essential method for tonification, purgation, and managing severity.
If obstruction of urination and defecation occurs first followed by other illnesses, treat the Root disease of the two bowels, regardless of the state of pathogen/upright or severity/mildness.
Note: This chapter is placed among the Jue syndrome chapters without Q&A format; it serves as a transition to clarify the meaning of Jue-ni (rebellious Qi). Humans are formed by inheriting the Yin-Yang, Five Movements, and Six Qi of Heaven and Earth. The body also contains Five Movements and Six Qi, responding to the continuous rotation of Heavenly Dao. If one contracts Heavenly Guest Qi, one becomes ill due to reversal by guest pathogens. If one experiences sudden anger or joy, disordered will/intent, irregular diet, or improper living conditions, the Qi dynamics within the body rebel and cause illness. Thus, illness from Guest Qi proceeds from exterior to interior; illness from Host Qi proceeds from interior to exterior. There are movements of Root/Branch and Interior/Exterior, and sequences of Pathogen/Upright and Excess/Deficiency. Hence it is said: The Way of Root and Branch is concise yet comprehensive, small yet great; one word can reveal the harm of a hundred diseases. Speaking of Branch and Root is easy and non-damaging; observing Root and Branch allows Qi regulation. Understanding Sheng-Fu (Overcoming and Repaying) makes one a model for the people; the Way of Heaven is complete.