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Huangdi asked, "I have heard that in ancient times, the treatment of diseases relied solely on 'Yi Jing Bian Qi' (Shifting Spirit and Changing Qi) and could be cured through 'Zhu You' (Divination Therapy). Today, people treat diseases internally with medicinal herbs and externally with acupuncture and stone tools. Some recover, while others do not. Why is this?"

(Note: 'Yi Jing Bian Qi' refers to enhancing one's essence and transforming one's Qi. Addressing deities is called 'Zhu', and 'You' means following. It implies communicating with divine spirits so that the disease follows and can be healed. In this chapter, Huangdi mentions shifting spirit and changing Qi, and Bibo states that those who possess Shen (Spirit) prosper, while those who lose it perish. This means that those who can nourish their Jing (Essence), Qi, and Shen can be cured by Zhu You therapy; herbal decoctions and acupuncture can also treat them. However, if the spirit dissipates, even miraculous pills are ineffective. Hence, some recover and others do not.)

Qibo replied, "In ancient times, people lived among birds and beasts. They moved about to avoid cold and dwelled in shady places to avoid heat. Internally, they had no burdens of attachment and longing; externally, they did not suffer the physical strain of serving in official capacities. This was an era of tranquility and emptiness, where pathogenic factors could not penetrate deeply. Therefore, toxic medicines were not needed internally, nor were acupuncture and stone tools externally. Thus, shifting spirit, changing Qi, and Zhu You therapy were sufficient."

(Bibo stated that ancients had solid and complete spirits, so Zhu You therapy alone sufficed. Only when the spirit is connected can one communicate with the divine. Living among beasts, they were not afraid of external objects. Cold and heat were appropriate, and the Qi of the four seasons was harmonious. Without the burden of attachment, Jing was nourished; without the strain of official duties, Shen was not exhausted. Living in a tranquil era, their wills were naturally comfortable. Pathogens did not enter the five Zang organs or bone marrow, so toxic medicines were unnecessary internally; they did not damage the orifices and skin externally, so acupuncture and stone tools were unnecessary. Thus, one could shift spirit and change Qi to connect with the divine. The unpredictable changes of Yin and Yang are called Shen; the unbounded application of Shen is called Sheng. With abundant Jing and Qi, one connects with the divine, achieving harmony of Yin and Yang and smooth flow of Shen Qi, leaving no room for harm from treacherous winds.)

"In today's world, it is different. Worries and anxieties trouble from within, and hard labor damages from without. People fail to follow the four seasons and go against the appropriateness of cold and heat. Treacherous winds arrive frequently, and empty pathogens invade day and night, penetrating inward to the five Zang organs and bone marrow, and outwardly damaging the orifices and skin. Consequently, minor illnesses become severe, and major illnesses lead to death. Therefore, Zhu You therapy cannot cure them."

Huangdi said, "Well said." (Note: 'Shuo' is the pronunciation here. Anxiety injures Shen; bodily hardship injures Jing; violating the four seasons injures Qi. Treacherous wind refers to harmful winds; empty pathogens refer to incorrect pathogens from false directions. Internal deficiency of Jing and Shen causes minor illnesses to worsen; lack of Zheng Qi (Upright Qi) to overcome pathogens leads to death in major illnesses.)

"I wish to examine patients, observe life and death, and resolve doubts. I want to grasp the essentials clearly, like the light of the sun and moon. May I ask how?"

(Doubts refer to the inability to determine life and death. Essentials refer to the key principles. Facial complexion corresponds to the Sun, and pulse corresponds to the Moon. This means the key principles of complexion and pulse are as clear and recognizable as the brightness of the sun and moon.)

Qibo said, "The way of complexion and pulse is highly valued by the Supreme Deity and transmitted by ancient masters."

(The principles of complexion and pulse are secrets of the Supreme Deity, taught only to worthy individuals and true disciples. The ancient master referred to is Jiu Daiji.)

"In ancient times, [the emperor] ordered Jiu Daiji to organize the study of complexion and pulse to understand the divine, integrating them with the Five Elements (Metal, Wood, Water, Fire, Earth), the four seasons, the Eight Winds, and the Six Directions, adhering to constant principles."

(The Eight Winds refer to winds from eight directions; in humans, they correspond to winds affecting the five meridians, treating pathogens in the five pulses. Six Directions refer to Heaven and Earth in all spatial orientations. This means ancient masters managed complexion and pulse to understand the divine, encompassing the constant principles of Heaven and Earth, Yin and Yang, four seasons, and Five Elements.)

"By observing shifts and changes, one can perceive their subtleties and grasp their essentials. To grasp the essentials, one must look at complexion and pulse."

(Complexion is the splendor of Qi; the pulse is the fluid of Jing. Shifts and changes refer to shifting spirit and changing Qi. By observing this process to connect with the divine subtleties, and seeking the essential way, one relies on complexion and pulse. Managing complexion and pulse to understand the divine allows one to know the abundance or deficiency of Jing and Qi.)

"Complexion corresponds to the Sun, and pulse corresponds to the Moon. Constantly seeking their essence reveals the essence itself."

(Sun and Moon are the essence of Yin and Yang in Heaven and Earth. Complexion belongs to Yang, and pulse belongs to Yin. Constantly seeking the essence of complexion and pulse ultimately returns to Yin and Yang. Knowing that complexion corresponds to the Sun and pulse to the Moon reveals the core principle. The previous section discussed how complexion and pulse align with the Five Elements, four seasons, Eight Winds, and Six Directions, but the essence ultimately converges on Yin and Yang.)

"The changes in complexion should correspond to the pulses of the four seasons. This is what the Supreme Deity values, aligning with the divine. Thus, one avoids death and approaches life, prolonging the way of life, which is called the Sage King."

(This reiterates the alignment of Yin, Yang, complexion, and pulse. The five colors of complexion changes correspond to the pulses of the four seasons, as complexion arises from the pulse. Valuing complexion and pulse to align with the divine allows one to avoid death and approach life, extending longevity. This is termed the Sage King, referring to ancient sages who cultivated the way of health and returned to the state of True Humans.)

"In the middle antiquity, treating diseases involved acting when illness arrived, using herbal decoctions for ten days to eliminate diseases caused by the Eight Winds and Five Bi Syndromes."

(This describes people of middle antiquity who could not shift spirit and change Qi to connect with the divine, thus using herbal medicine. There was a method: treating upon arrival. Unlike the era of tranquility where pathogens could not cause harm even if present, if illness arrived, herbal decoctions were used immediately. The Eight Winds refer to winds from eight directions triggering pathogens in the five Zang organs. The Five Bi Syndromes refer to Bi syndromes of the five Zang organs. For example, injury by wind in spring (Jia/Yi days) affects the Liver Bi; summer (Bing/Ding) affects Heart Bi; autumn (Geng/Xin) affects Lung Bi; winter (Ren/Gui) affects Kidney Bi; and transition periods (Wu/Ji) affect Spleen Bi. The five Zang organs correspond to the Five Elements of Earth and the Ten Heavenly Stems, generating the Five Elements. Thus, ten days of decoction cover the cycle of the Ten Stems, eliminating the Five Bi Syndromes.)

"If not cured after ten days, treatment switches to branches of grass stems and roots. Using both root and branch assists each other; when both root and branch are addressed, the pathogenic factor submits."

(Note: 'Gai' is the pronunciation here. This discusses the root and branch of disease and the root and branch of herbs. 'Su' refers to stems; 'Rou' refers to roots. Branches of grass stems are lateral shoots; branches of grass roots are lateral roots. Generally, stems and roots are the root, and lateral branches are the branch. The Five Bi Syndromes are disorders of the five Zang organs. The Zang organs have external manifestations in the meridians and acupoints, and external connections to sinews, vessels, skin, and flesh. The Zang organs are the root; meridians, acupoints, sinews, and bones are the branch. Herbs generate five flavors to nourish Zang Qi. Thus, for Zang diseases, stems and roots are used. If pathogens are in the external connections of meridians, branches of grass stems and roots are used. This treats the root with the root and the branch with the branch. Heart and Lung reside above (Yang) and are treated with grass stems (proximity to upper); Liver and Kidney reside below (Yin) and are treated with grass roots (proximity to lower). Using herb roots and branches assists in addressing disease root and branch, ensuring submission of pathogens. This demonstrates the methodical use of medicine in middle antiquity.)

"In late antiquity, treatment is different. Treatment does not follow the four seasons, ignores the Sun and Moon (Yin and Yang), and fails to examine reversal and compliance (root and branch,順逆)."

(Not following four seasons means ignoring the Qi of five directions. Ignoring Sun and Moon means failing to recognize Yin-Yang, complexion, and pulse. Failing to examine reversal and compliance means distinguishing neither root/branch nor順/逆.)

"When the disease form has already established, they attempt to treat externally with fine needles and internally with herbal decoctions. Incompetent doctors act frantically, believing aggressive treatment is possible. Thus, the old disease persists, and new diseases arise."

(Ancient sages treated disease before it occurred. Treating after establishment is like digging a well when thirsty—too late. Incompetent doctors, acting frantically, attack wrongly. Thus, pathogens remain, and wrongful attacks cause new diseases. These modern doctors fail to examine the excess or deficiency of complexion, pulse, Jing, and Shen, and do not understand the methods of root and branch.)

Huangdi said, "I wish to hear the essential way."

Qibo said, "The ultimate point of treatment is not to lose sight of complexion and pulse. Applying them without confusion is the great principle of treatment."

(Complexion and pulse are the way of Yin and Yang. Examining them allows determination of life and death without doubt. The great method of treatment lies herein. This summarizes the previous section.)

"If reversal and compliance are inverted, and root and branch are confused, one loses Shen and loses the state."

(Inverted reversal and compliance mean failing to follow the four seasons and going against cold and heat. Confused root and branch means not understanding disease root/branch and misapplying herb root/branch. Late-era people, unable to regulate according to time and expel pathogens, inevitably lose Shen and form. The Heart houses Shen and is the master of the body. If the master is clear, the twelve officials are at peace; governing the world brings prosperity. Losing Shen leads to losing the state. *Su Wen: Shanggu Tianzhen Lun* states: When form and Shen coexist, one completes their natural lifespan. Daoist texts say: Where Shen moves, Qi moves; where Shen stays, Qi stays. Knowing Shen and Qi can prolong life, this chapter emphasizes Shen.)

"Abandoning the old and embracing the new allows one to attain the True Human."

(Abandoning old pathological stains and embracing new spiritual transformations allows one to attain the Way of the True Human and return to that state. This suggests that modern people, by cultivating Jing and Qi and emulating antiquity, can also extend life.)

Huangdi said, "I have heard the essentials from my teacher. He said it does not depart from complexion and pulse, which I know."

(Huangdi knew only that the essential way does not depart from complexion and pulse.)

Qibo said, "The ultimate point of treatment lies in 'One'. Since Huangdi knows the essence lies in complexion and pulse, Qibo adds: The essential way originates from the ultimate, returning to 'One'. 'One' is Shen. Obtaining Shen means obtaining complexion, pulse, Jing, and Qi."

Huangdi asked, "What is meant by 'One'?"

Qibo replied, "'One' is obtained through inquiry."

(Obtained through understanding the patient's emotional state.)

Huangdi asked, "How?"

Qibo said, "Close the doors and windows, focus on the patient, repeatedly inquire about their feelings, and follow their intentions. Those who obtain Shen prosper; those who lose Shen perish."

Huangdi said, "Well said."

(Note: 'Shuo' is the pronunciation here. Closing doors and windows prevents external distractions. Shen resides in the Heart; movement of heart-mind is called Qing (emotion). Zhi (Will) controls Shen, gathers Hun and Po, adapts to temperature, and harmonizes joy and anger. By preventing distraction and repeatedly inquiring about emotions to follow intent, one discerns the presence or absence of Shen. Loss of Shen leads to death; acquisition of Shen leads to life. The first chapter discussed ancient True Humans breathing essence and guarding Shen independently. This chapter says ancients shifted spirit and changed Qi to connect with the divine, called Sage Kings. Modern people, abandoning old and embracing new, can become True Humans. If spirit is solid, all can return to True Human status. If Shen Qi dissipates, even skilled doctors are powerless. Should clinicians neglect complexion, pulse, and Shen Qi, relying solely on acupuncture and herbs?)