五者在内五中之情。而外见于色脉。
黄帝曰。呜呼远哉。闵闵乎若视深渊。若迎浮云。视深渊。尚可测。迎浮云。莫知其际。圣人之术。为万民式。论
裁志意。必有法则。循经守数。按循医事。为万民副。故事有五过四德。汝知之乎。雷公避席再拜曰。臣年幼小。蒙愚
以惑。不闻五过与四德。比类形名。虚引其经。心无以对。（此论诊道。亦当合于天道也。夫人之气为阳。精水为阴。卫
为阳。营血为阴。阴阳和平。而后血气乃行。经脉乃匀。故当先度其志意之得失。饮食居处。阴阳喜怒。然后察其色脉。
斯得万举万全。而无过失之咎。视深渊。尚可测。迎浮云。莫知其极。言天道之难明也。惟圣人从容得之。施于仁术。
垂于后世。为万民式。副、功也。四德、谓天之四时。有生长收藏之德化。如不知四时阴阳逆从之理。是谓四失矣。）帝
曰。凡未诊病者。必问尝贵后贱。虽不中邪。病从内生。名曰脱营。尝富后贫。名曰失精。五气留连。病有所并。医工
诊之。不在脏腑。不变躯形。诊之而疑。不知病名。身体日减。气虚无精。病深无气。洒洒然时惊。病深者。以其外耗
于卫。内夺于营。良工所失。不知病情。此亦治之一过也。（此病生于志意。而不因于外邪也。夫尝贵后贱。尝富后贫。
则伤其志意。故虽不中邪。而病从内生。夫脾藏营。营舍意。肾藏精。精舍志。是以志意失而精营脱也。五气留连。谓
五脏之神气。留郁于内而不能疏达。并者。谓并病于五脏也。五脏之气。外合于皮肉筋骨。是以身体日减。气虚无精。
病深无气。言气生于精。精生于气。精气之并伤也。洒洒、消索貌。盖以为久尝之富贵。不意失之。故时惊也。此病不
在脏腑。不在躯形。精气日虚。营卫日耗。即有良工。不知因名。此治之一过也。闵士先曰。病在情志。当以情志之法
治之。非药石之可能愈。）凡欲诊病者。必问饮食居处。暴乐暴苦。始乐后苦。皆伤精气。精气竭绝。形体毁沮。暴怒伤
阴。暴喜伤阳。厥气上行。满脉去形。愚医治之。不知补泻。不知病情。精华日脱。邪气乃并。此治之二过也。（此病生
于饮食居处。阴阳喜怒。而不因于外邪也。夫味归形。气归精。味伤形。气伤精。热伤气。寒伤形。乐者必过于温饱。
苦者必失于饥寒。是以饮食失节。寒温失宜。皆伤精气。精气竭绝。则形体毁沮矣。喜怒不中。则阴阳不和。而厥气上
行。脉满去形。盖身半以上为阳。身半以下为阴。肌腠气分为阳。经脉血分为阴。阴阳和平。则营卫血气。上下循环。
外出内入。如暴喜伤阳。则气并于阳而为厥逆。暴怒伤阴。则血并于阴而为脉满。盖肌形之血气。并于脉中。故谓脉满
去形也。盛者泻之。不足者补之。愚医治之。不知补泻。不知病情。致使精华日脱。阴阳寒热之邪气相并。此治之二过
也。）善为脉者。必以比类奇恒。从容知之。为工而不知道。此诊之不足贵。此治之三过也。（此病生于厥逆。而不因于
邪也。行奇恒之法。以太阴始。五脏相通。移皆有次。神转而不回者也。病则各逆传其所胜。回则不转。乃失其相生之
机。故善为脉者。必以比类奇恒。从容得之。为工不知。治之过也。闵士先曰。比类者。言候五脏脉气之顺逆。以比类
奇恒之脉。或顺或逆也。工以诊脉之顺逆。不必比类奇恒。故曰此诊之不足贵。）诊有三常。必问贵贱。封君败伤。及欲
侯王。故贵脱势。虽不中邪。精神内伤。身必败亡。始富后贫。虽不伤邪。皮焦筋屈。痿 为挛。医不能严。不能动神。
外为柔弱。乱至失常。病不能移。则医事不行。此治之四过也。（此言善诊者。当先察其精气神。而后切其血脉也。封君
败伤。故贵脱势。及欲侯王而不可得。此忧患缘于内。是以精神内伤。灵枢经曰。忧恐忿怒伤气。是三者皆不能守。而
失其常矣。始富后贫。则伤其志意。志意者。所以御精神。收魂魄。适寒温。和喜怒者也。是故荣卫调。志意和。则筋
骨健强。腠理致密。故伤其志意。则精神不能内守。外为筋骨挛 之病。荣卫不调。腠理不密。故外为柔弱。而三者亦
失其常矣。严、穷究也。动神、谓运动其神。移者。移精变气也。按上文曰。五气留连。气虚无精。病深无气。又曰。
外耗于卫。内夺于营。是故贵脱势。始富后贫。皆论伤于气。故此节止补出精神二字。莫子瑜曰。精气神三者互相资生。
故上节论伤气而精神自然并伤。此言伤精神而气亦在内。）凡诊者。必知终始。有知余绪。切脉问名。当合男女。（此阴
阳偏盛之为病。而不因于邪也。灵枢终始篇曰。谨奉天道。请言终始。终始者。经脉为纪。持其脉口人迎。以知阴阳有
余不足。平与不平。天道毕矣。所谓平人者不病。不病者。脉口人迎应四时也。上下相应。而俱往来也。六经之脉。不
结动也。本末之。寒温之。相守司也。形肉血气。必相称也。是谓平人。少气者。脉口人迎俱少。而不称尺寸也。如是
者。则阴阳俱不足。补阳则阴竭。泻阴则阳脱。如是者。可将以甘药。不可饮以至剂。如此者弗灸。不已者。因而泻之。
则五脏气坏矣。人迎一盛。病在足少阳。一盛而躁。病在手少阳。人迎二盛。病在足太阳。二盛而躁。病在手太阳。人
迎三盛。病在足阳明。三盛而躁。病在手阳明。人迎四盛。且大且数。名曰溢阳。溢阳为外格。脉口一盛。病在足厥阴。
一盛而躁。在手心主。脉口二盛。病在足少阴。二盛而躁。在手少阴。脉口三盛。病在足太阴。三盛而躁。在手太阴。
脉口四盛。且大且数者。名曰溢阴。溢阴为内关。人迎与脉口俱盛四部以上。命曰关格。关格者。与之短期。故凡诊者。
必知终始。余绪。谓更知灸刺补泻之绪端。当合男女。谓针刺之要。男内女外。坚拒勿出。谨守勿内。是谓得气。）离绝
菀结。忧恐喜怒。五脏空虚。血气离守。不人能知。何术之语。（菀音郁。此言左右血气之各有别也。左为人迎而主血。
右为气口而主气。离绝者。言阴阳血气。各有左右之分别也。是以血气皆病。则气郁于右。而血结于左。盖因忧恐伤右
部之肺肾。喜怒伤左部之心肝。以致五脏空虚。血气各离其所守之本位。工不知人迎气口。有阴阳气血之分。又何术之
语哉。）尝富大伤。斩筋绝脉。身体复行。令泽不息。故伤败结。留薄归阳。脓积寒炅。粗工治之。亟刺阴阳。身体解散。
四肢转筋。死日有期。医不能明。不问所发。唯言死日。亦为粗工。此治之五过也。凡此五者。皆受术不通。人事不明
也。（此言病在左而及于右。令其血气之相乘也。天一生水。肾水生肝木。肝木生心火。肾主藏精。肝主藏血。心主生血。
故左三部皆主血而为阴。地二生火。命门相火生脾土。脾土生肺金。火乃先天元气。脾胃主生气。肺主周身之气。故右
三部主气而为阳。如病在阴者。久则阴病极而归于阳。病在阳者。久则阳病极而归于阴。故终始篇曰。病先起于阴者。
先治其阴。而后治其阳。病先起于阳者。先治其阳。而后治其阴。此左右阴阳之相乘。而医之又不可不知也。如尝富而
一旦丧其资斧。则大伤其神魂。是以心主之脉。肝主之筋。有若斩绝。此伤左之血脉也。然右关之脾脏未伤。故身体尚
复能行。令、命也。泽、液也。谓肺肾所主之精气未伤。而尚生长之不息也。然病虽先起于阴。久则将及于阳。故伤败
心肝之血而结于左。则留薄于气分。而复归于阳。左右血气皆伤。而脓积寒炅也。灵枢经曰。夫痈疽之生。脓血之成也。
不从天下。不从地出。结微之所生也。又曰。寒气化为热。热胜则腐肉而为脓。此因伤阴而流薄归阳。是以脓积于阴阳
寒热之间。夫阴阳血气俱伤。补阳则阴竭。泻阴则阳脱。如是者。止可饮以甘药。而不宜灸刺。粗工不知。亟刺阴阳。
以致身体解散。则脾气伤矣。四肢转筋。则胃气绝矣。夫脾胃者。五脏之生原。生气已绝。丧无日矣。即有良医。不明
阴阳相乘之道。不问受病所发之因。止知阴阳坏而与之死期。此亦为粗工。盖不能审其因而施救治之法也。凡此五者。
皆发于五中。而不因于外感。医者当知天地阴阳之气。日用事物之常。莫不各有当然之理。顺之则志意和调。逆之则苛
疾暴起。此皆受术不通。人事不明。致有五者之责。）故曰。圣人之治病也。不知天地阴阳。四时经纪。五脏六腑。雌雄
表里。刺灸砭石。毒药所主。从容人事。以明经道。贵贱贫富。各异品理。问年少长。勇怯之理。审于分部。知病本始。
八正九候。诊必副矣。（此总结诊脉之道。当外合天地阴阳。四时经纪。内通五脏六腑。雌雄表里。或宜于灸刺砭石。或
当用药食所主。从容人事。以明经道。审贵贱贫富之情。察少长勇怯之理。脉各有分部。病发有原始。候四时八正之气。
明三部九候之理。诊道始备而必副矣。）治病之道。气内为宝。循求其理。与之不得。过在表里。守数据治。无失俞理。
能行此术。终身不殆。不知俞理。五脏菀热。痈发六腑。（内叶讷菀音郁。此论针刺之道。当以内气为宝。循求其脉理。
求之不得。其病在表里之气分矣。针经曰。在外者皮肤为阳。筋骨为阴。盖针刺之道。取皮脉肉筋骨之病而刺之。故求
之俞理不得其过在表里之皮肉筋骨矣。守数、谓血气之多少。及刺浅深之数也。针经曰。刺之害。中而不去则泄精。不
中而去则致气。泄精则病益甚而 。致气则生痈疡。又曰。疾浅针深。内伤良肉。皮肤为痈。病深针浅。病气不泻。支
大为脓。夫在内者。五脏为阴。六腑为阳。谓菀热在内。而痈发于在外之皮肉间也。）诊病不审。是谓失常。谨守此治。
与经相明。上经下经。揆度阴阳。奇恒五中。决以明堂。审于终始。可以横行。（诊病不审。谓不审病者之情。故为失常。
上经言气之通于天。下经言病之变化。揆者。方切求之。言切求其脉理也。度者。得其病处。以四时度之也。奇恒之病。
发于五中。五脏之色。见于明堂。审其脏腑经脉之始。三阴三阳已绝之终。谨守此法。则无往而非道矣。）
The five errors originate from the emotions within the five zang organs and manifest externally in the complexion and pulse.
Huangdi said: Alas, how profound! One must be cautious and careful, as if gazing into an abyss or welcoming floating clouds. Gazing into an abyss, one can still measure its depth; welcoming floating clouds, one cannot know their boundaries. The medical art of the sages serves as a model for all people. In discussing the regulation of patients' wills and intentions, there must be laws to follow; one must adhere to the meridians, observe medical constants, and act according to medical procedures, serving as an assistant to the people. Thus, there are five errors and four virtues in diagnosis and treatment. Do you know them? Leigong stepped back from his seat, bowed twice, and said: "I am young and small, covered by foolishness and confusion. I have never heard of the five errors and four virtues. Using analogy to analyze form and names, and citing classics vacuously, my mind cannot respond." (This discussion on the way of diagnosis should also conform to the Way of Heaven. Human qi belongs to Yang, essence and water belong to Yin; Wei Qi belongs to Yang, Ying Blood belongs to Yin. Only when Yin and Yang are peaceful can Qi and Blood circulate, and meridians become even. Therefore, one must first assess the gains and losses of the patient's will and intention, diet and residence, as well as Yin-Yang and joy-anger, before observing the complexion and pulse. This ensures success in every attempt and avoids the blame of errors. "Gazing into an abyss, one can measure it; welcoming floating clouds, one cannot know their limit" refers to the difficulty of understanding the Way of Heaven. Only sages can grasp it calmly, apply it to benevolent arts, and pass it down to posterity as a model for the people. "Fu" means merit. "Si De" (Four Virtues) refers to the four seasons of Heaven, possessing the transformative virtues of growth, flourishing, harvesting, and storing. If one does not understand the principles of the順逆 (smooth/reverse) of Yin-Yang in the four seasons, this is called "Si Shi" (Four Losses).)
Huangdi said: For those who have not yet diagnosed a disease, one must ask if the patient was once noble and later became humble. Even without invasion by external pathogens, the disease arises from within, named "Tuo Ying" (Depletion of Ying). Once wealthy and later poor, it is named "Shi Jing" (Loss of Jing). The Qi of the five zang organs lingers and connects, and pathogens combine. When physicians diagnose, they find the disease is not in the zang-fu organs, nor has the body shape changed. They feel doubtful after diagnosis and do not know the disease name. The patient's body decreases daily, Qi becomes empty and Jing is lost. In deep disease, Qi is exhausted, and the patient feels chilly and startled at times. The reason for deep disease is that Wei Qi is consumed externally and Ying is deprived internally. The error made by skilled physicians is failing to understand the condition of the disease. This is also one of the treatment errors. (This disease arises from will and intention, not from external pathogens. Being once noble and later humble, or once wealthy and later poor, damages will and intention. Thus, although not invaded by pathogens, the disease arises from within. The Spleen stores Ying, and Ying houses Yi (Intent); the Kidney stores Jing, and Jing houses Zhi (Will). Therefore, the loss of will and intention leads to the depletion of Jing and Ying. "Wu Qi Liu Lian" (Five Qi Lingering) refers to the divine Qi of the five zang organs lingering internally without being able to diffuse smoothly. "Bing" (Combining) refers to pathogens combining with the five zang organs. The Qi of the five zang organs corresponds externally to skin, flesh, sinews, and bones. Hence, the body decreases daily, Qi is empty and Jing is lost, and in deep disease, Qi is absent. This means Qi is born from Jing, and Jing is born from Qi; both Jing and Qi are damaged. "Sha Sha" describes a emaciated and cold appearance. It is likely due to having enjoyed wealth and honor for a long time and unexpectedly losing them, causing frequent startling. This disease is not in the zang-fu organs or body shape; Jing and Qi become increasingly deficient, and Ying and Wei become increasingly depleted. Even good physicians may not know the cause or name. This is one of the treatment errors. Min Shixian said: Diseases in emotions should be treated with methods for emotions, not merely with herbs or needles.)
For those wishing to diagnose diseases, one must ask about diet and residence. Sudden joy or sudden sorrow, starting with joy and ending with sorrow, all damage Essence-Qi. When Essence-Qi is exhausted, the body is ruined and depressed. Violent anger damages Yin, and violent joy damages Yang. Jue Qi (Rebellious Qi) moves upward, filling the vessels and separating from the form. Ignorant physicians, when treating, do not know tonification and sedation, nor do they understand the condition. The essence and brilliance are daily depleted, and pathogenic Qi combines. This is the second treatment error. (This disease arises from diet, residence, Yin-Yang, joy, and anger, not from external pathogens. Flavors nourish form, Qi nourishes essence; flavors damage form, Qi damages essence; heat damages Qi, cold damages form. Those who are joyful tend to overindulge in warmth and fullness; those who suffer tend to suffer from hunger and cold. Thus, irregular diet and inappropriate temperature all damage Essence-Qi. When Essence-Qi is exhausted, the body is ruined. Joy and anger not being moderate lead to Yin-Yang disharmony and Jue Qi moving upward, filling vessels and separating from form. Generally, the upper half of the body is Yang, the lower half is Yin; muscle intervals and Qi divisions are Yang, meridian blood divisions are Yin. When Yin and Yang are peaceful, Ying and Wei, Qi and Blood circulate up and down, out and in. If violent joy damages Yang, Qi combines with Yang leading to Jue Ni (Reversal); if violent anger damages Yin, Blood combines with Yin leading to vessel fullness. Generally, the Qi and Blood of muscles and form combine in the vessels, hence called "Vessel Fullness Separating from Form." Excess is sedated, deficiency is tonified. Ignorant physicians do not know tonification and sedation, nor understand the condition, causing essence to deplete daily and Yin-Yang cold-heat pathogens to combine. This is the second treatment error.)
Those skilled in pulse diagnosis must use analogy and comparison with abnormal conditions (Qi Heng) to understand the situation calmly. If a physician does not know this, such diagnosis is not worthy of respect. This is the third treatment error. (This disease arises from Jue Ni, not from pathogens. Practicing the method of Qi Heng starts with Tai Yin. The five zang organs are interconnected, and transmission follows a sequence; the Shen (Spirit) turns without reversing. Disease occurs when each reverses and transmits to what it overcomes. Reversal means no turning, resulting in the loss of the mechanism of mutual generation. Therefore, those skilled in pulse diagnosis must use analogy and Qi Heng to grasp it calmly. Physicians who do not know this commit a treatment error. Min Shixian said: Analogy refers to observing the smoothness or reversal of the five zang pulse Qi to compare with Qi Heng pulses, which may be smooth or reversed. Physicians rely only on the smoothness or reversal of pulse diagnosis and need not use Qi Heng analogy, hence saying such diagnosis is not worthy.)
There are three constants in diagnosis: one must ask about status (noble/base). Destruction of feudal lords, and desires to become marquises or kings that go unfulfilled. Thus, nobles losing power, even without pathogen invasion, suffer internal spiritual injury, and the body must perish. Starting wealthy and becoming poor, even without pathogen injury, results in scorched skin and bent sinews, leading to flaccidity and contracture. If the physician is not strict, cannot move the spirit, appears weak externally, disrupts until失常 (abnormal), and the disease cannot be shifted, then medical practice fails. This is the fourth treatment error. (This states that good diagnosticians should first observe Jing, Qi, and Shen, then palpate the vessels. Destruction of feudal lords and loss of noble status, or unfulfilled desires to become nobles, create worries originating internally, causing internal spiritual injury. The *Ling Shu* says: Worry, fear, and anger damage Qi. These three fail to maintain constancy. Starting wealthy and becoming poor damages will and intention. Will and intention are used to control spirit, gather soul, adapt to cold/heat, and harmonize joy/anger. Thus, when Ying and Wei are regulated and will is harmonious, sinews and bones are strong, and cou li (pores) are dense. Damaging will and intention causes spirit to fail to stay internal, leading to external sinew/bone contracture. Disharmonious Ying and Wei and loose cou li cause external weakness and loss of constancy. "Yan" means thorough investigation. "Dong Shen" means moving the spirit. "Yi" means shifting Jing and changing Qi. As stated earlier: Five Qi linger, Qi is empty and Jing is lost, deep disease lacks Qi; externally consumed by Wei, internally deprived of Ying. Thus, loss of noble status and wealth-to-poverty both discuss Qi injury. This section adds the words "Jing and Shen". Mo Ziyu said: Jing, Qi, and Shen mutually generate. The previous section discussed Qi injury, naturally injuring Jing and Shen; this section discusses Spirit injury, where Qi is also injured internally.)
In all diagnoses, one must know the beginning and end, understand the details, take pulses, ask for the name, and consider male/female differences. (This refers to diseases caused by Yin-Yang excess/deficiency, not pathogens. The *Ling Shu: Zhong Shi* chapter says: Respectfully following the Way of Heaven, let us speak of Beginning and End. Beginning and End take meridians as the guide. Holding the Pulse Kou and Ren Ying pulses, one knows if Yin-Yang has excess or deficiency, peace or imbalance, completing the Way of Heaven. A "Ping Ren" (Peaceful Person) is not sick. Not sick means Pulse Kou and Ren Ying correspond to the four seasons, match up and down, and come and go together. The six meridians do not knot or move abnormally. Roots and ends, cold and heat, guard and manage. Form, flesh, and Qi/Blood must correspond. This is a Peaceful Person. Those with little Qi have both Pulse Kou and Ren Ying deficient and disproportionate to Cun/Che. In such cases, both Yin and Yang are deficient. Tonifying Yang exhausts Yin; sedating Yang causes Yang collapse. Such cases can be treated with sweet medicines, not harsh formulas. Moxibustion should not be used; if ineffective, sedation causes destruction of five zang Qi. Ren Ying pulse 1x stronger indicates disease in Foot Shaoyang; 1x stronger and rapid indicates Hand Shaoyang. Ren Ying 2x stronger indicates Foot Taiyang; 2x stronger and rapid indicates Hand Taiyang. Ren Ying 3x stronger indicates Foot Yangming; 3x stronger and rapid indicates Hand Yangming. Ren Ying 4x stronger, large and rapid, is called "Yi Yang" (Overflowing Yang), leading to "Wai Ge" (External Grid). Pulse Kou 1x stronger indicates Foot Jueyin; 1x stronger and rapid indicates Hand Jueyin (Pericardium). Pulse Kou 2x stronger indicates Foot Shaoyin; 2x stronger and rapid indicates Hand Shaoyin. Pulse Kou 3x stronger indicates Foot Taiyin; 3x stronger and rapid indicates Hand Taiyin. Pulse Kou 4x stronger, large and rapid, is called "Yi Yin" (Overflowing Yin), leading to "Nei Guan" (Internal Lock). If both Ren Ying and Pulse Kou are 4x stronger in all positions, it is called "Guan Ge" (Grid/Lock). Guan Ge patients are given a short life expectancy. Thus, in diagnosis, one must know Beginning and End. "Yu Xu" (Remaining Threads) refers to knowing the details of moxibustion, acupuncture, tonification, and sedation. "He Nan Nu" (Combine Male/Female) refers to the key of acupuncture: Men internal, Women external; firmly reject exit, carefully guard entry. This is obtaining Qi.)
Separation and interruption, depression and knotting, worry, fear, joy, and anger cause the five zang to become empty and Qi/Blood to scatter and lose their posts. If one cannot understand this, what talk of technique is there? ("Wan" sounds like Yu. This discusses the distinction between left and right Qi/Blood. Left is Ren Ying governing Blood; Right is Qi Kou governing Qi. "Li Jue" means Yin/Yang Qi/Blood have left/right distinctions. Thus, if both Qi and Blood are diseased, Qi stagnates on the right, and Blood knots on the left. Likely due to worry/fear damaging Lung/Kidney on the right, and joy/anger damaging Heart/Liver on the left, causing five zang emptiness and Qi/Blood leaving their posts. Physicians who do not know the Yin/Yang/Qi/Blood distinction of Ren Ying and Qi Kou, what technique can they claim?)
Once wealthy but greatly injured, sinews and vessels severed, the body can still walk, but fluids cease. Injury and ruin knot, lingering and pressing towards Yang, accumulating pus, alternating cold and heat. Crude physicians treat by urgently needling Yin and Yang, causing the body to disintegrate, limbs to cramp, with a fixed death date. Physicians who do not clarify, do not ask the cause, and only speak of the death date are also crude. This is the fifth treatment error. All these five arise from incompetence in technique and ignorance of human affairs. (This discusses disease in the left affecting the right, causing Qi/Blood to attack each other. Heaven generates Water (1), Kidney Water generates Liver Wood, Liver Wood generates Heart Fire. Kidney stores Jing, Liver stores Blood, Heart generates Blood. Thus, the left three positions govern Blood and are Yin. Earth generates Fire (2), Mingmen Minister Fire generates Spleen Earth, Spleen Earth generates Lung Metal. Fire is Primordial Yuan Qi; Spleen/Stomach generate Qi; Lung governs whole-body Qi. Thus, the right three positions govern Qi and are Yang. If disease is in Yin, prolonged illness makes Yin extreme and returns to Yang; if in Yang, prolonged illness makes Yang extreme and returns to Yin. Thus, *Zhong Shi* says: Disease starting in Yin is treated in Yin first, then Yang; disease starting in Yang is treated in Yang first, then Yin. This is the mutual attack of left/right Yin/Yang, which physicians must know. If once wealthy and suddenly losing assets, the Shen/Hun are greatly injured. Thus, Heart vessels and Liver sinews seem severed. This injures left Blood/Vessels. However, the right Guan Spleen is not injured, so the body can still walk. "Ling" means "Ming" (Life/Destiny). "Ze" means "Ye" (Fluids), meaning Lung/Kidney Jing/Qi are not injured and continue to grow. Although disease starts in Yin, it eventually affects Yang. Thus, injuring Heart/Liver Blood and knotting on the left, it lingers in Qi division and returns to Yang. Both left/right Qi/Blood are injured, leading to pus accumulation and cold/heat. *Ling Shu* says: Carbuncles and sores, pus and blood, do not fall from heaven or rise from earth, but form from slight knotting. Cold transforms to Heat; Heat wins and rots flesh into pus. This is Yin injury flowing to Yang, so pus accumulates between Yin/Yang and Cold/Heat. If Yin/Yang Qi/Blood are both injured, tonifying Yang exhausts Yin, sedating Yin causes Yang collapse. Such cases should only use sweet medicines, not moxa/needle. Crude physicians do not know this, urgently needle Yin/Yang, causing body disintegration (Spleen Qi injured) and limb cramping (Stomach Qi exhausted). Spleen/Stomach are the source of the five zang; if Sheng Qi is exhausted, death is imminent. Even good physicians who do not understand Yin/Yang mutual attack, do not ask the cause, and only give a death date for broken Yin/Yang are crude. They fail to examine the cause and apply rescue methods. All five arise from the five internal organs, not external sensations. Physicians must know the Qi of Heaven/Earth Yin/Yang and the constants of daily things, which all have proper principles. Following them harmonizes will/intention; opposing them causes sudden severe disease. These are responsibilities arising from incompetent technique and ignorance of human affairs.)
Therefore it is said: The sage treats disease by understanding Heaven/Earth Yin/Yang, four seasons regulations, five zang/six fu organs, male/female exterior-interior relations, the indications for acupuncture, moxibustion, stone therapy, and drugs. By calmly handling human affairs, clarifying meridian paths, recognizing different principles of nobility/poverty, asking about age and courage/timidity, examining divisions, knowing the disease origin, using Eight Rectitudes and Nine Observations, the diagnosis will be accurate. (This summarizes the way of pulse diagnosis: externally combining with Heaven/Earth Yin/Yang and four seasons; internally connecting with five zang/six fu, male/female, exterior-interior. Suitable for moxa/needle/stone or drugs/food. Calmly handling human affairs clarifies meridian paths. Examining feelings of nobility/poverty, observing principles of age/courage. Pulses have divisions, diseases have origins. Observing Qi of four seasons/eight rectitudes, understanding theory of three parts/nine observations. Only then is the diagnostic way complete and accurate.)
The way of treating disease takes Internal Qi as the treasure. Seek its principle. If not found, the fault lies in Exterior/Interior. Follow numerical data for treatment, do not lose the principles of acupoints. Practicing this technique ensures lifelong safety. Not knowing acupoint principles leads to five zang stagnation-heat and carbuncles in six fu organs. ("Nei Ye Ne Wan" sounds like Yu. This discusses acupuncture: take Internal Qi as treasure, seek pulse principles. If not found, the disease is in Exterior/Interior Qi divisions. *Zhen Jing* says: Outside, skin is Yang, sinews/bones are Yin. Acupuncture targets diseases in skin, vessels, flesh, sinews, bones. Thus, seeking acupoint principles, if the fault in Exterior/Interior skin/flesh/sinews/bones is not found... "Shou Shu" (Keeping Numbers) refers to the quantity of Qi/Blood and depth of needling. *Zhen Jing* says: Harm of needling: hitting and not removing leaks Jing; missing and removing gathers Qi. Leaking Jing worsens disease; gathering Qi causes carbuncles. Also: Shallow disease, deep needle damages good flesh, skin becomes carbuncle; deep disease, shallow needle fails to drain pathogen, causing large swelling and pus. Inside, five zang are Yin, six fu are Yang. Stagnation-heat inside leads to carbuncles outside in skin/flesh.)
Failing to carefully examine disease is called失常 (Abnormality). Strictly adhering to this treatment clarifies with the Classics. Upper and Lower Classics, measuring Yin/Yang, Qi Heng and Wu Zhong, deciding via Ming Tang, examining Beginning and End, allows one to proceed freely. (Failing to carefully examine disease means not assessing the patient's emotions, thus Abnormal. Upper Classic speaks of Qi connecting to Heaven; Lower Classic speaks of disease changes. "Kui" means cutting and seeking, i.e., seeking pulse principles. "Du" means finding the disease location and measuring by four seasons. Qi Heng diseases arise from Wu Zhong; five zang colors appear at Ming Tang. Examining beginnings of zang-fu meridians and ends of Three Yin/Three Yang exhaustion. Strictly following this law leaves no path without Dao.)