治病之法。各有异同。五方之民。居处衣食。受病治疗。各有所宜。
黄帝问曰。医之治病也。一病而治各不同。皆愈何也。（不同。谓针石灸 。毒药导引也。）岐伯对曰。地势使然也。
（夫九州八方。皆通于天气。天有春夏秋冬之四时。地有生长化收藏之五气。而人亦应之。是以东方主春生之令。而人
气亦发生于外。故宜针石以治其外。南方主夏长之令。而人气更发越于外。故宜微针以治其皮毛。西方主秋收之令。人
气亦收藏于内。故宜毒药以治其内。北方主冬藏之令。而人之阳气亦沉潜于下。故宜艾 以起阳气于至阴。中央湿土主
生化之令。而人气亦守于中。故宜导引按跷。使灌通于四末。此地势有生长收藏之不同。而治法是亦有别也。）故东方之
域。天地之所始生也。（域、区界也。宇内也。言天地始生之气。由东方之九野。以及于宇内之九州也。金西铭曰。首言
地势使然。继言天地之所始生。地气通于天也。）鱼盐之地。海滨旁水。其民食鱼而嗜咸。皆安其处。美其食。鱼者使人
热中。盐者胜血。故其民皆黑色疏理。其病皆为痈疡。（此言五方之生物。所以养生。如偏于嗜食。皆能致病也。地不满
东南。故多旁水。海滨之地。利于鱼盐。旁水。故民多食鱼。近海。故嗜咸。得鱼盐之利。故居安食美也。鱼性属火。
故使人热中。心主血脉。故咸胜血也。嗜咸。故色黑。血弱。致肉理空疏也。五脏生成篇曰。多食咸。则脉凝泣而色变。
灵枢经曰。饮食不节。阴气不足。阳气有余。荣气不行。乃发为痈。又曰。血泣不通。则卫气归之。不得复反。故痈肿
也。）其治宜砭石。故砭石者。亦从东方来。（砭悲廉切叶边砭石、石针也。山海经曰。高氏之山。有石如玉。可以为
针。即此类也。东方之地。人气发生于外。故其治诸病。宜于砭石也。夫春生之气。从东方而普及于宇内。故砭石之法。
亦从东方而来。以施及于九州也。）西方者。金玉之域。砂石之处。天地之所收引也。（地之刚在西方。故多金玉砂石。
天地降收之气。从西北而及于东南。）其民陵居而多风。水土刚强。其民不衣而褐荐。其民华实而脂肥。故邪不能伤其形
体。其病生于内。（高平曰陆。大陆曰阜。大阜曰陵。根据山陵而居。故多风。金气坚肃。故水土刚强。不衣、不事服饰也。
褐、毛布也。荐茵褥也。华、浓浓也。谓酥酪膏肉之类。饮食华浓。故人多脂而肥。水土刚强。肤腠肥浓。是以外邪不
能伤其形。惟饮食七情之病生于内也。）其治宜毒药。故毒药者。亦从西方来。（毒药、有毒之药也。五常政大论曰。大
毒治病。十去其六。常毒治病。十去其七。小毒治病。十去其九。盖上古以神农之上品无毒者。谓可久服长生。而中品
下品有毒之药。以治病攻疾也。邪不外入。病从内生。故宜毒药治其内。天地秋收之气。从西以及于九州。故毒药治病
之法。亦从西方来也。）北方者。天地所闭藏之域也。（西北方、阴也。是以闭藏之气。惟北更甚。）其地高陵居。风寒
冰冽。其民乐野处而乳食。（地高陵居。西北之势也。风寒冰冽。阴气胜也。野处乳食。北人之性也。）脏寒生满病。其
治宜艾 。故艾 者。亦从北方来。（夫秋收之气收于内。冬藏之气。直闭藏于至阴之下。是以中土虚寒。而胸腹之间。
生胀满之病矣。艾名冰台。削冰令圆。举而向日。以艾承其影。则得火。夫阳生于阴。火生于水。艾能得水中之真阳者
也。北方阴寒独盛。阳气闭藏。用艾 灸之。能通接元阳于至阴之下。是以灸 之法。亦从北方而来也。夫人与天地参
也。天有寒暑之往来。人有阴阳之出入。经曰。陷下则灸之。即四方之民。阳气陷藏。亦宜艾 。故曰。艾 之法。亦
从北方来。董帷园曰。故凡虚寒胀满之病。治宜温补。启发元阳。不可误用寒凉克伐之剂。）南方者。天地所长养。阳
之所盛处也。（南方主夏长之气。是以为阳热所盛之处。）其地下。水土弱。雾露之所聚也。（地陷东南。故其地下而水土
弱。低下则湿。故雾露之所聚。）其民嗜酸而食 。故其民皆致理而赤色。其病挛痹。（ 、腐也。如豉 醯醢之类。物
之腐者也。致、密也。酸味收敛。故肉理致密。酸乃木味。故外见赤色。多雾露湿气。故其病挛痹也。金西铭曰。五方
之民。举东方之嗜咸者。则见本色之黑。南方之嗜酸者。则见所生之赤。盖色生于味也。夫气为阳。味为阴。东方主春
生之气。而民嗜藏下之咸。南方主浮长之气。而民嗜收敛之酸。有若阳鹿之嗜阴龟。潜龙之嗜飞燕。皆出于天性之自然
也。）其治宜微针。故九针者。亦从南方来。（南方之气。浮长于外。故宜微针以刺其皮。夫针有九式。微针者。其锋微
细。浅刺之针也。）中央者。其地平以湿。天地所以生万物也众。（中央、土之位也。地平、土之体也。湿者、土之气也。
化生万物。土之德也。位居中央。而气溉四方。是以所生万物之广众也。）其民食杂而不劳。故其病多痿厥寒热。（四方
辐辏。万物会聚。故民食纷杂。化养于中。故不劳其四体。四肢为诸阳之本。痿痹者。手足之气逆。而痿弱不用也。平
脉篇曰。阳脉不足。阴脉乘之。则洒淅恶寒。阴脉不足。阳往乘之。则发热。寒热者。手足三阴三阳之脉病也。盖言中
土之民。不劳其四体。而气血不能灌溉于四旁。是以多痿厥寒热之病矣。）其治宜导引按跷。故导引按跷者。亦从中央出
也。（导引者。擎手而引欠也。按跷者。乔足以按摩也。盖中央之化气。不能充达于四旁。故宜导按其四肢。以引血气之
流通也。夫中央之化气。由中而及于四方。故导引按跷之法。亦从中而四出也。莫子晋曰。由东南而及于西北。由西北
而及于东南。故曰来。由中央而及于四方。故曰出。）故圣人杂合以治。各得其所宜。（夫天有四时之气。地有五方之宜。
民有居处衣食之殊。治有针灸药饵之异。故圣人或随天之气。或合地之宜。或随人之病。或用针灸毒药。或以导引按摩。
杂合以治。各得其宜。）故治所以异。而病皆愈者。得病之情。知治之大体也。（所谓病同而异治者。如痈疡之热毒盛于
外者。治宜针砭。毒未尽出者。治以毒药。阴毒之内陷者。又宜于艾 也。又如湿邪之在四肢而病痿厥者。宜于针砭。
气血之不能疏通者。宜按跷导引。所以治异而病皆愈者。得病之情者。知病之因于天时。或因于地气。或因于人之嗜欲。
得病之因情也。或因五方之民。而治以五方之法。或因人气之生长收藏。而宜于针砭艾 。或宜于毒药按跷。是知治之
大体。而又不必胶执于东方之治宜砭石。西方之治宜毒药也。是以圣人杂合以治。而皆得其所宜。再按上古之民。动作
以避寒。则阳气不致陷藏。而无胀满之病矣。阴居以避暑。则元气不致外弛。而无挛痹之证矣。形劳而不倦。则气血得
以流通。而无痿厥寒热之疾矣。是以毒药不能治其内。针石不能治其外。此修养吾身中之精气。而能胜天地之阴阳者也。）
The methods of treating diseases vary and have their differences. The people residing in the five directions, due to their distinct living environments, clothing, and diet, suffer from different diseases and require appropriate treatments accordingly.
The Yellow Emperor asked: When physicians treat diseases, the same disease is treated with different methods, yet all result in recovery. Why is this? (The term "different" here refers to treatments such as Bian stone therapy, acupuncture, moxibustion, herbal medicine, and Daoyin.) Qibo replied: This is caused by geographical conditions.
(The nine provinces and eight directions are all connected to the Heavenly Qi. Heaven has the four seasons of Spring, Summer, Autumn, and Winter; Earth has the five Qi of Growth, Development, Transformation, Harvest, and Storage. Humans correspond to these changes. Therefore, the East governs the generating command of Spring, and human Qi also emerges outwardly; thus, Bian stone therapy is suitable for treating external conditions. The South governs the growing command of Summer, and human Qi becomes more expansive outwardly; thus, fine needles are suitable for treating the skin and hair follicles. The West governs the harvesting command of Autumn, and human Qi stores inwardly; thus, herbal medicines are suitable for treating internal conditions. The North governs the storing command of Winter, and human Yang Qi sinks and hides downwardly; thus, moxibustion is suitable to raise Yang Qi from the deepest Yin. The Central region belongs to damp Earth, governing the command of transformation and generation, and human Qi remains centered; thus, Daoyin and Anqiao (massage) are suitable to unblock and circulate Qi to the four extremities. This difference in geographical conditions regarding growth, development, transformation, and storage leads to differences in treatment methods.)
Therefore, the Eastern region is where the initial generating Qi of Heaven and Earth resides. (Region refers to boundaries or the universe. It means the initial generating Qi of Heaven and Earth spreads from the Nine Fields of the East to the Nine Provinces within the universe. Jin Ximing stated: First, it states that geographical conditions make it so; then it mentions the initial generating Qi of Heaven and Earth, indicating that Earth Qi connects with Heaven Qi.) This is a land of fish and salt, adjacent to the sea and waters. The people there eat fish and prefer salty flavors, content with their environment and food. Eating fish causes heat to accumulate internally; excessive salt consumption damages blood. Consequently, the people there tend to have dark skin and loose tissue texture. Their diseases are mostly carbuncles and ulcers. (This illustrates how the products of the five directions affect health; dietary preferences can lead to disease. The earth is incomplete in the southeast, hence many water bodies nearby. Coastal lands favor fish and salt production; proximity to water leads to fish consumption, and proximity to the sea leads to a preference for salt. Benefiting from fish and salt, they live securely and enjoy good food. Fish nature is Fire, causing internal heat; the Heart governs blood vessels, and Salt overcomes Blood. Preference for salt leads to dark complexion; weak blood results in loose muscle texture. *Suwen: Chapter on Generation of Five Zang Organs* states: Excessive salt intake causes blood stasis and color changes. *Ling Shu* states: Irregular diet leads to insufficient Yin Qi, excess Yang Qi, and impaired Ying Qi circulation, resulting in carbuncles. It also states: Blood stasis prevents Wei Qi from returning, causing swelling.) Their treatment is suitable for Bian stone therapy. Thus, Bian stone therapy originated from the East. (Bian, pronounced 'bian', refers to stone needles. *Classic of Mountains and Seas* states: On Gaoshi Mountain, there are stones like jade that can be made into needles; these are examples. In the East, human Qi emerges outwardly, making Bian stone suitable for various diseases. The Spring generating Qi spreads from the East to the universe; thus, Bian stone therapy also comes from the East to apply to the Nine Provinces.)
The Western region is an area of gold, jade, sand, and gravel, where the Heaven and Earth's harvesting and contracting Qi reside. (The firmness of Earth is in the West, hence abundant gold, jade, and gravel. The descending and contracting Qi of Heaven and Earth spreads from the northwest to the southeast.) The people there dwell on hills, exposed to wind, with hard and strong soil and water. They do not wear fine clothes but use coarse wool mats. Their diet is rich and fatty, and their bodies are plump. External pathogens cannot easily damage their physical form; their diseases arise internally. (Flat high ground is called Lu, large continents are called Fu, and large mounds are called Ling. Dwelling near hills exposes them to wind. Metal Qi is firm and austere, making soil and water strong. "Not wearing clothes" refers to neglecting adornment. He refers to wool cloth. Jian refers to mats. Hua refers to richness, such as butter, cheese, and meat. Rich and dense diet leads to fat accumulation. Strong soil and water result in thick skin and pores, preventing external pathogens from damaging the body; only diseases from diet and emotions arise internally.) Their treatment is suitable for herbal medicines. Thus, herbal medicine therapy also originated from the West. (Poisonous drugs refer to toxic herbs. *Chapter on Great Normality of Government* states: Great poison treats disease, removing six-tenths; common poison removes seven-tenths; slight poison removes nine-tenths. Ancient times considered non-toxic top-grade herbs from Shennong for long-term longevity, while mid- and lower-grade toxic herbs were used to treat diseases. Pathogens do not enter from outside; diseases arise from within, so internal treatment with herbs is suitable. The Autumn harvesting Qi spreads from the West to the Nine Provinces; thus, herbal medicine therapy also comes from the West.)
The Northern region is where the Heaven and Earth's closing and storing Qi reside. (The northwest is Yin; thus, the storing Qi is most intense in the North.) The terrain is high, people dwell on hills, and the wind and cold are biting. The people there prefer living in the wild and consuming dairy products. (High terrain and hill dwelling characterize the northwest. Biting wind and cold indicate prevailing Yin Qi. Wild living and dairy consumption reflect northern habits.) Cold organs lead to fullness diseases; their treatment is suitable for moxibustion. Thus, moxibustion therapy also originated from the North. (Autumn harvesting Qi stores inwardly; Winter storing Qi closes deeply at the lowest Yin, leading to middle Jiao deficiency-cold and abdominal distension. Mugwort is called Bingtai; melting ice into a circle and holding it toward the sun allows mugwort placed in the shadow to catch fire. Yang is born from Yin, fire is born from water; mugwort obtains the true Yang from water. The North is uniquely cold with Yin prevailing and Yang hidden; moxibustion can connect Yuan Yang at the deepest Yin. Thus, moxibustion comes from the North. Humans participate with Heaven and Earth; Heaven has cold and heat cycles, humans have Yin and Yang fluctuations. *Classic* states: For sinking pulse, use moxibustion. People of the four directions have sinking and hidden Yang Qi, suitable for moxibustion. Dong Weiyuan stated: For deficiency-cold and distension, warm tonification is suitable to inspire Yuan Yang; cold-purging agents should be avoided.)
The Southern region is where Heaven and Earth's nurturing Qi thrives and Yang Qi is abundant. (The South governs Summer growing Qi, making it a place of abundant Yang heat.) The terrain is low, soil and water are weak, and it is an aggregation point for fog and dew. (The earth sinks in the southeast, resulting in low terrain and weak soil/water. Low areas are damp, aggregating fog and dew.) The people there prefer sour flavors and fermented foods. Consequently, their skin texture is tight, and their complexion is reddish. Their diseases are mostly spasms and bi-syndrome. (Fu refers to fermented/rotten foods like douchi or vinegar sauces. Zhi means dense/tight. Sour flavor astringes, leading to tight muscle texture. Sour corresponds to Wood, manifesting as red color. Abundant fog and dew cause dampness, leading to spasms and bi-syndrome. Jin Ximing noted: Observing Easterners who prefer salt reveals black color; Southerners who prefer sour reveal red color. Color is generated by taste. Qi is Yang, taste is Yin. East governs Spring generating Qi, people prefer salty (Yin) taste; South governs floating/growing Qi, people prefer sour (astringent) taste. Like deer preferring turtles or dragons preferring swallows, this is natural instinct.) Their treatment is suitable for fine needles. Thus, the Nine Needles also originated from the South. (Southern Qi floats and grows outwardly, making fine needles suitable for superficial needling. There are nine types of needles; fine needles have sharp, thin tips for shallow insertion.)
The Central region is flat and damp, where Heaven and Earth generate numerous things. (Central is the position of Earth. Flatness is the form of Earth. Dampness is the Qi of Earth. Transforming and generating all things is the virtue of Earth. Positioned centrally, its Qi irrigates the four directions, producing abundant life.) The people there have mixed diets and do not engage in heavy labor. Consequently, their diseases are mostly wei-paralysis, jue-reversal, and alternating chills and fever. (Four directions converge, goods gather, leading to diverse diets. Nourishment occurs in the center, sparing the limbs. Limbs are the root of Yang meridians. Wei-bi involves qi reversal in hands and feet, causing weakness. *Ping Mai Pian* states: Insufficient Yang pulse with Yin invasion causes shivering chills; insufficient Yin pulse with Yang invasion causes fever. Chills and fever involve the three Yin and three Yang meridians of hands and feet. Central people, not laboring limbs, fail to irrigate extremities with Qi and Blood, leading to wei, jue, and chills/fever diseases.) Their treatment is suitable for Daoyin and Anqiao. Thus, Daoyin and Anqiao therapy also originated from the Center. (Daoyin involves stretching and yawning; Anqiao involves foot massage. Central transforming Qi fails to reach the periphery, so guiding and massaging limbs helps circulate Qi and Blood. Central transforming Qi spreads from center to four directions, so Daoyin/Anqiao also spreads outward. Mo Zijin stated: From southeast to northwest and vice versa is termed "coming"; from center to four directions is termed "going out".)
Therefore, the Sages combine all methods for treatment, each obtaining what is appropriate. (Heaven has four seasons, Earth has five directional advantages, people have diverse living/dietary habits, and treatments vary between acupuncture, herbs, etc. Sages adapt to Heaven's Qi, Earth's suitability, patients' conditions, using acupuncture, herbs, or Daoyin/massage, combining methods appropriately.) Thus, although treatments differ, all diseases recover because the physician understands the disease's reality and the general principles of treatment. (For example, external heat toxins in carbuncles are treated with Bian/needles; lingering toxins with herbs; internal Yin toxins with moxibustion. Dampness in limbs causing wei/jue is treated with needles/Bian; blocked Qi/Blood with Anqiao/Daoyin. Treating differently yet achieving recovery requires understanding disease etiology (Heaven, Earth, desires) and applying regional methods (Five Directions) based on human Qi dynamics (growth/storage). One must not rigidly adhere to "East only uses Bian" or "West only uses Herbs." Sages combine methods appropriately. Ancients moved to avoid cold, preserving Yang and preventing distension; lived indoors to avoid heat, preserving Yuan Qi and preventing spasms; exercised without exhaustion, ensuring Qi/Blood flow and preventing wei/jue/chills-fever. Thus, herbs and needles are not always needed; cultivating internal Jing-Qi allows overcoming Heaven and Earth's Yin-Yang changes.)