道之大原出于天。圣人以天道教化于人。故篇名著至教。
黄帝坐明堂。召雷公而问之曰。子知医之道乎。（王冰曰。明堂、布政之宫也。八窗四达。上圆下方。在国之南。故
称明堂。夫求民之瘼。恤民之隐。大圣之用心。故召引雷公。问拯济生灵之道。愚按岐伯乃帝王之师。故称伯曰天师。
是以七十四篇。皆咨访于伯。然帝之神灵敦敏。具生知之质。乃上古继天立极。传道教化之至圣。其访咨于伯者。盖以
证明斯道也。是以末后七篇。乃帝之所以复教化于臣僚。闵士先曰。首篇亦帝与伯论毕。而即归于帝论。）雷公对曰。诵
而颇能解。解而未能别。别而未能明。明而未能彰。足以治群僚。不足知侯王。（由诵而解。解而别。别而明。明而彰。
皆渐积日进之功。盖天纵之圣。自能先知先觉。以明此道。在群僚之贤者。非讲习讨论。不能贯通于心。故止可主于臣
僚之位。而不能至圣人之聪明睿智也。）愿得受树天之度。四时阴阳。合之别星辰。与日月光。以彰经术。后世益明。（树
天之度者。所谓立端于始。表正于中。盖立端表以测天之四时阴阳。星辰日月之度。以着于经书。乃传于后世。倪仲玉
曰。此即量天尺璇玑玉衡之类。）上通神农。着至教。疑于二皇。（二皇、谓伏羲神农。言能通天之道。可以上通于神农。
以彰着至教。而疑于二皇。易系曰。神农氏没。黄帝尧舜氏作。通其变。使民不倦。神而化之。使民宜之。易穷则变。
变则通。通则久。是以自天佑之。吉无不利。黄帝尧舜。垂衣裳而天下治。盖取诸乾坤。故曰疑于二皇者。谓上合于伏
羲神农。取天地之道。以垂教后世。）帝曰。善。无失之。此皆阴阳表里。上下雌雄相输应也。而道上知天文。下知地理。
中知人事。可以常久。以教众庶。亦不疑殆。医道论篇。可传后世。可以为宝。（上下、谓天运之环转于上下。以应人之
腰以上为天。腰以下为地。表里、中外也。即所谓根于中而运于外也。雌雄、阴阳之相合也。言明乎阴阳之道。则上知
天文。下知地理。中知人事。可以垂永久。以教众庶。合于医道论篇。可传于后世。以为保命养生之大宝。）雷公曰。请
受道。讽诵用解。（意言非生知之圣。必讽诵讲解。而后能明此道。）帝曰。子不闻阴阳传乎。曰。不知。（乃上古传论阴
阳之书。）曰。夫三阳天为业。上下无常。合而病至。偏害阴阳。（三阳者。至阳也。至阳者。天之阳也。富有之谓业。
言天之大而无外也。上下无常。天行健也。合而病至者。以天之阴阳不和。合于人之病至。则有阴阳偏害之大患矣。此
言天为阳。地为阴。在上为阳。泉下为阴。日为阳。夜为阴。一昼一夜。天道绕地一周。阴阳相贯。上下气交。昼夜环
转之不息。而人亦应之。气为阳。血为阴。火为阳。水为阴。亦昼夜环转之不息也。一阴一阳。雌雄相应。少阴与太阳
相合。太阴与阳明相合。厥阴与少阳相合。故气从太阴出注阳明。阳明行于太阳。太阳合于少阴。少阴行于少阳。少阳
合于厥阴。厥阴复出于太阴。阴阳相贯。如环无端。若三阳并至则为偏害之患。）雷公曰。三阳莫当。请闻其解。（莫当
者。言人之阴气。不能当三阳之并至。）帝曰。三阳独至者。是三阳并至。并至如风雨。上为巅疾。下为漏泄。（独至者。
三阳合并而为一阳也。天之风气为阳。雨水为阴。三阳并至。则阳气上行而为巅疾。下行而为漏泄。犹天之阳气独盛。
而在下之泉水竭也。）外无期。内无正。不中经纪。诊无上下以书别。（阴阳离合论曰。阳予之正。阴为之主。阴阳离合。
不相失也。言三阳并至。外无阴阳出入之可期。内无生阳之阴正。不中经脉之纪纲。故不能以脉经上下编之书别。盖言
此在气并。而不形于血脉之诊也。玉师曰。不形于诊。是以大奇篇之肠 下血。阳甚而脉反沉小滑涩。）雷公曰。臣治疏
愈。说意而已。（治、理数也。言于天地阴阳之理甚疏。止可闻其大意而已。）帝曰。三阳者。至阳也。积并则为惊。病
起疾风。至如 砺。九窍皆塞。阳气滂溢。干嗌喉塞。并于阴。则上下无常。薄为肠 。（至阳者。谓阳之至盛而无极。
有如天之疾风。若 砺之雷火骤至。阳盛则为惊也。九窍为水注之气。使九窍之水气皆竭。而阳气溢于窍中。夫肺属天
而主气。与肾水上下交通。阳独盛而水液竭。故使嗌干喉塞也。并于阴。则使阴气之上下无常。搏于阴液。则为肠 下
痢。盖阳甚而血液将绝。即所谓下为漏泄也。）此谓三阳直心。坐不得起卧者。便身全三阳之病。（三阳者。太阳也。太
阳者。巨阳也。为诸阳主气。而与少阴标本相合。故心为阳中之太阳。是太阳之气。在表而合于天之气。在上而合于君
火之阳。直、当也。谓三阳并至。正当于心。是三阳之合并于太阳也。夫三阳之离合也。合则为一。离则有三。太阳为
开。阳明为阖。少阳为枢。起者。太阳之主开也。卧者。阳明之主阖也。坐者。不起不卧。少阳中枢之象也。盖言三阳
之气合。则正当于心。分出于形身。则为坐不得起卧之象。便身全三阳之病矣。此申明三阳者。乃二阳合并于太阳。有
离而有合也。上节论三阳之气。滂溢于外窍。而内薄于阴。此言太阳之气。正当于心。而分出于形身之外。）且以知天下。
何以别阴阳。应四时。合之五行。（天下者。谓人居天之下。何以别阴阳。以应天之四时。合地之五行。闵士先曰。此乃
承上启下之文。）雷公曰。阳言不别。阴言不理。请起受解。以为至道。（此言知天之道。而后能理别阴阳。至道。即所
谓至诚无息之道。）帝曰。子若受传。不知合至道。以惑师教。语子至道之要。病伤五脏。筋骨以消。子言不明不别。是
世主学尽矣。（合至道者。谓人合天地之道也。人之阴阳。合天之四时水火。人之五脏。合天之五方五行。五脏之气。外
合于皮肉筋骨。如病伤五脏。则在外之筋骨以消。是以不明别阴阳之气。五脏所合之皮肉筋骨。则传世之主学尽矣。盖
言阴阳五行。各有分别。此论阴阳水火之气。而不病五脏之有形。如所谓肾且绝。是肾之水液。阴气并绝。非脏伤之骨
消也。莫子瑜曰。人有病气而不病形者。有病形而不病气者。有形气之兼病者。此二篇论病阴阳水火之气。故当以明别
之。）肾且绝。惋惋日暮。从容不出。人事不殷。（夫天一生水。在上为天。在下为泉。天包乎地。水通乎天。阴阳相贯。
上下循环。在人则太阳在上。精水在下。如三阳并至。并于阴而上下无常。薄为肠 。则肾之精气且绝矣。惋惋、惊叹
貌。殷、盛也。古者日中为市。人事正殷。至日暮阳尽而阴受气。则万民皆卧。盖言在天之道。阳气为阳。精水为阴。
昼为阳。夜为阴。在人之道。三阳为阳。精液为阴。昼出为阳。夜入为阴。盖以比天之阴阳。昼出夜卧。阴阳和平。可
常保其天年。若能和于阴阳。调于四时。亦可寿敝天地。如有阳无阴。有阴无阳。且毙在旦夕。又焉能如天之常。地之
久乎。是以天下万民应天之道。至阳尽而阴受气之时。惊叹其日暮。则从容不出。人事不殷。盖以天之阴阳。比类人之
阴阳。绝者绝而生者生。在天之道。不过阴阳亢极。岂至于有阳无阴。有昼无夜哉。灵枢经曰。日暮阳尽而阴受气。万
民皆卧。平旦阴尽而阳受气。如是无已。与天地同纪。朱永年曰。肾且绝三字当节断。）
The great origin of the Dao stems from Heaven. The Sages use the Way of Heaven to educate humanity. Therefore, this chapter is titled "Zhe Zhi Jiao Lun" (Treatise on Establishing Supreme Teachings).
Huangdi sat in the Mingtang (Hall of Brightness) and summoned Leigong, asking him, "Do you understand the principles of medicine?" (Wang Bing stated: The Mingtang is a palace for issuing administrative decrees. It has eight windows opening to all directions, round above and square below, located south of the capital, hence called Mingtang. To seek the people's ailments and pity their hidden sufferings is the intent of a Great Sage; thus, he summoned Leigong to inquire about the way to save living beings. I believe Qibo was the teacher of emperors, hence addressed as Tian Shi (Heavenly Master). Therefore, in Chapter 74, consultations were made with Qibo. However, Huangdi possessed divine spirit and keen intelligence, endowed with innate knowledge, being the Supreme Sage who succeeded Heaven to establish the ultimate standard and transmit teachings in ancient times. His consultation with Qibo was likely to verify this Great Dao. Thus, the final seven chapters represent Huangdi re-educating his officials. Min Shixian noted: The first chapter also concluded with Huangdi and Qibo discussing, then returning to Huangdi's discourse.) Leigong replied, "I can recite it and roughly understand it; having understood, I cannot yet distinguish it clearly; having distinguished it, I cannot yet elucidate it thoroughly; having elucidated it, I cannot yet manifest it brightly. This is sufficient to govern officials but insufficient to comprehend the ways of feudal lords." (From recitation to understanding, from understanding to distinguishing, from distinguishing to elucidating, and from elucidating to manifesting are all gradual processes of accumulation and daily progress. Presumably, a sage endowed by Heaven naturally knows beforehand and perceives early to clarify this Dao. Among worthy officials, without study and discussion, one cannot penetrate the mind internally; thus, they can only preside over official positions but cannot attain the wisdom and insight of a Sage.) I wish to receive the measurement of Heaven, combine the Yin and Yang of the four seasons, differentiate stars, and unite with the light of the sun and moon, to illuminate medical classics, making them clearer for future generations. (Establishing the measurement of Heaven refers to setting the beginning at the start and marking correctness in the middle. Generally, setting endpoints and markers to measure the Yin and Yang of the four seasons, and the measures of stars and sun/moon, recorded in classics, thereby transmitted to posterity. Ni Zhongyu said: This is akin to the measuring ruler or Xuanji Yuheng [armillary sphere].) Reaching up to Shennong, establishing supreme teachings, comparable to the Two Emperors. (The Two Emperors refer to Fuxi and Shennong. It means connecting with the Way of Heaven, reaching up to Shennong, to establish supreme teachings, and being comparable to the Two Emperors. The *Yijing* Commentary states: After Shennong passed away, Huangdi, Yao, and Shun arose, facilitating changes so people would not grow weary, transforming spiritually so people would adapt. When things reach an extreme, they change; when they change, they flow; when they flow, they endure. Thus, Heaven blesses them, bringing auspiciousness without disadvantage. Huangdi and Shun wore robes and caps, and the world was governed, likely drawing inspiration from Qian and Kun. Hence, 'comparable to the Two Emperors' means aligning with Fuxi and Shennong, taking the Way of Heaven and Earth to teach future generations.) Huangdi said, "Excellent. Do not lose this. These are all matters of Yin and Yang, exterior and interior, upper and lower, male and female interacting and responding. The Dao involves knowing astronomy above, geography below, and human affairs in the middle. It can last forever, teaching the masses, without doubt or danger. The Treatise on Medical Principles can be passed to future generations and treasured." (Upper and lower refer to the cyclical movement of Heaven's operations corresponding to the waist-up as Heaven and waist-down as Earth. Exterior and interior refer to outside and inside, i.e., rooted internally and operating externally. Male and female refer to the union of Yin and Yang. Understanding the Way of Yin and Yang allows one to know astronomy above, geography below, and human affairs in the middle, lasting eternally to teach the masses, aligning with the Treatise on Medical Principles, which can be passed down as a precious treasure for preserving life and nurturing health.) Leigong said, "Please let me accept the Dao, reciting and applying my mind to understand." (Meaning that those not born with innate knowledge must recite and explain to eventually grasp this Dao.) Huangdi said, "Have you not heard of the *Yin Yang Zhuan* (Transmission of Yin and Yang)?" Leigong said, "I do not know." (This refers to ancient texts transmitting discussions on Yin and Yang.) Huangdi said, "San Yang (Three Yangs) take Heaven as their domain. Their movements are irregular; when they merge and arrive together, disease occurs, causing partial harm to Yin and Yang." (San Yang represents Extreme Yang. Extreme Yang is the Yang of Heaven. 'Abundance is called Ye (business/domain),' describing Heaven's vastness without boundary. Irregular movements reflect Heaven's vigorous action. Merging to cause disease implies that disharmony between Heavenly Yin and Yang leads to severe harm to human Yin and Yang. Here, Heaven is Yang, Earth is Yin; above is Yang, springs below are Yin; day is Yang, night is Yin. In one day and night, Heaven circles the Earth once, Yin and Yang interpenetrate, Qi intersects above and below, rotating endlessly through day and night, and humans respond accordingly. Qi is Yang, Blood is Yin; Fire is Yang, Water is Yin; these also rotate endlessly. One Yin and one Yang correspond like male and female: Shaoyin combines with Taiyang, Taiyin combines with Yangming, Jueyin combines with Shaoyang. Thus, Qi exits Taiyin and enters Yangming; Yangming flows into Taiyang; Taiyang combines with Shaoyin; Shaoyin flows into Shaoyang; Shaoyang combines with Jueyin; Jueyin returns to Taiyin. Yin and Yang interpenetrate like a circle without end. If San Yang arrives together, it causes partial harm.) Leigong said, "San Yang is unstoppable; please explain." ('Unstoppable' means human Yin Qi cannot withstand the simultaneous arrival of San Yang.) Huangdi said, "When San Yang arrives alone, it is actually San Yang merging. This merger is like wind and rain. Above, it causes diseases of the vertex (head); below, it causes leakage/diarrhea." ('Arriving alone' means San Yang merges into one Yang. Heavenly wind is Yang, rain is Yin. When San Yang merges, Yang Qi ascends causing vertex diseases, and descends causing leakage, similar to Heavenly Yang becoming excessive while underground springs dry up.) Externally, there is no regular pattern; internally, there is no righteous Qi; it does not conform to meridian guidelines, so diagnosis cannot distinguish upper and lower via written pulse texts. (*Yin Yang Li He Lun* states: Yang provides righteousness, Yin acts as master; Yin and Yang separate and join without loss. Meaning when San Yang merges, there is no expectation of Yin-Yang entry/exit externally, nor righteous Yin generating Yang internally, failing to meet meridian standards. Thus, it cannot be distinguished by writing pulse texts of upper and lower meridians. This indicates the pathology lies in Qi merging, not manifesting in blood vessel diagnosis. Master Yu said: Since it doesn't manifest in diagnosis, *Da Qi Pian* mentions intestinal discharge with blood where Yang is excessive but the pulse is instead deep, small, slippery, and choppy.) Leigong said, "My treatments are sparse and only slightly effective; I merely discuss the general idea." ('Treatment' here refers to reasoning/logic. Meaning his understanding of Heavenly and Earthly Yin-Yang principles is superficial, able only to hear the general gist.) Huangdi said, "San Yang is Extreme Yang. Accumulation and merging cause fright. Diseases arise like sudden winds, urgent as grinding stones. All nine orifices become blocked. Yang Qi surges excessively, drying the throat and causing obstruction. If merging into Yin, movements become irregular, pressing into the intestines causing dysentery." (Extreme Yang means Yang reaches its peak without limit, like sudden heavenly winds or thunder/fire sounding like grinding stones. Excessive Yang causes fright. The nine orifices are passages for water Qi; if water Qi in the nine orifices dries up while Yang Qi overflows into them, Lung (associated with Heaven, governing Qi) fails to communicate with Kidney Water. With Yang excessive and fluids depleted, the throat becomes dry and obstructed. Merging into Yin makes Yin Qi irregular, clashing with Yin fluids, causing intestinal dysentery. Essentially, extreme Yang depletes blood, known as 'leakage below'.) This is called San Yang striking the Heart directly. Patients sit but cannot stand or lie down, suffering fully from San Yang diseases. (San Yang refers to Taiyang. Taiyang is the Great Yang, master of all Yang Qi, combining with Shaoyin as root and branch. Thus, the Heart is the Taiyang within Yang. Taiyang Qi is exterior, combining with Heavenly Qi, and superior, combining with Sovereign Fire Yang. 'Directly' means 'upon'. When San Yang merges, it strikes the Heart, meaning San Yang merges into Taiyang. Regarding separation and joining of San Yang: joined, they are one; separated, they are three. Taiyang is Opening, Yangming is Closing, Shaoyang is Pivot. Standing relates to Taiyang's Opening; lying relates to Yangming's Closing; sitting (neither standing nor lying) symbolizes Shaoyang's Pivot. Essentially, when San Yang Qi joins, it strikes the Heart; when distributed to the body, it manifests as inability to stand or lie down, fully afflicted by San Yang diseases. This clarifies that San Yang is actually Er Yang merging into Taiyang, having separation yet unity. The previous section discussed San Yang Qi overflowing into external orifices and pressing internally into Yin; this section discusses Taiyang Qi striking the Heart and distributing outward.) Furthermore, use this to understand the world. How to distinguish Yin and Yang? How to respond to the Four Seasons? How to integrate with the Five Elements? ('World' refers to humans under Heaven. How to distinguish Yin and Yang to align with Heavenly Four Seasons and Earthly Five Elements? Min Shixian said: This is transitional text connecting preceding and following sections.) Leigong said, "Yang statements are undistinguished, Yin statements are unreasoned. Please rise and accept explanations to regard them as the Supreme Dao." (This means knowing the Way of Heaven enables one to reason and distinguish Yin and Yang. Supreme Dao refers to the path of utmost sincerity without cessation.) Huangdi said, "If you accept transmission but do not integrate with the Supreme Dao, you will confuse your teacher's instruction. I will tell you the essence of the Supreme Dao: Disease injures the Five Zang organs, causing muscles and bones to waste. Your statements are unclear and undistinguished; this shows worldly learning is exhausted." (Integrating with Supreme Dao means humans align with the Way of Heaven and Earth. Human Yin/Yang align with Heavenly Four Seasons and Water/Fire; Human Five Zang align with Heavenly Five Directions and Five Elements. Qi of Five Zang externally connects to skin, flesh, sinews, and bones. If disease injures Five Zang, external sinews and bones waste. Thus, failing to clearly distinguish Yin/Yang Qi and the skin/flesh/sinews/bones combined with Five Zang results in exhaustion of principal worldly learning. Basically, Yin/Yang and Five Elements have distinct categories. This discussion focuses on Yin/Yang and Water/Fire Qi, not the physical form of Five Zang. For instance, 'Kidney nearly perished' refers to depletion of Kidney fluid and Yin Qi, not bone wasting from organ injury. Mo Ziyu said: Some have Qi pathology without Form pathology, some have Form pathology without Qi pathology, some have both. These two chapters discuss Yin/Yang/Water/Fire Qi pathology, so clear distinction is required.) When Kidney Qi is nearly perished, one feels alarmed at dusk. Remaining calm, one does not go out; human affairs cease to flourish." (Heaven generates Water in One. Above is Heaven, below is spring. Heaven envelops Earth; Water connects to Heaven. Yin and Yang interpenetrate, circulating up and down. In humans, Taiyang is above, Essence-Water is below. If San Yang merges, presses into Yin, moves irregularly, and causes intestinal dysentery, Kidney Essence-Qi is nearly perished. 'Wanwan' describes an alarmed expression. 'Yin' means flourishing. In ancient times, markets were held at noon when human affairs flourished. At dusk, Yang ends and Yin receives Qi, so all people sleep. Essentially, in Heavenly Dao, Yang Qi is Yang, Essence-Water is Yin; Day is Yang, Night is Yin. In Human Dao, San Yang is Yang, Essence-Fluid is Yin; Day activity is Yang, Night rest is Yin. Comparing Heavenly Yin/Yang, day activity and night rest maintain Yin/Yang harmony, preserving natural lifespan. If one harmonizes with Yin/Yang and adjusts to Four Seasons, one may live as long as Heaven and Earth. But with Yang without Yin, or Yin without Yang, death comes soon, unable to match Heaven's constancy or Earth's longevity. Thus, all people under Heaven follow Heavenly Dao. When Yang ends and Yin receives Qi, fearing the dusk, one remains calm and does not go out; human affairs cease to flourish. Using Heavenly Yin/Yang to analogize Human Yin/Yang, what perishes perishes and what lives lives. In Heavenly Dao, it is merely Yin/Yang hyperactivity, not reaching Yang without Yin or Day without Night. *Ling Shu Jing* states: At dusk, Yang ends and Yin receives Qi, all people sleep; at dawn, Yin ends and Yang receives Qi. Without end, this follows the rhythm of Heaven and Earth. Zhu Yongnian said: The phrase 'Kidney nearly perished' should be punctuated separately.)