中。故引腰脊。肾脉络心。故上冲心痛。心主血。而寒气逼之。故血见。按经脉篇嗌痛颔肿。乃小肠经病。小肠者。心
之府也。亦水邪上侮火脏火腑而然。）帝曰。善。治之奈何。岐伯曰。诸气在泉。风淫于内。治以辛凉。佐以苦甘。以甘
缓之。以辛散之。（风乃木气。金能胜之。故治以辛凉。过于辛。恐反伤其气。故佐以苦甘。苦胜辛而甘益气也。木性急。
故以甘缓之。风邪胜。故以辛散之。脏气法时论曰。肝苦急。急食甘以缓之。肝欲散。急食辛以散之。）热淫于内。治以
咸寒。佐以甘苦。以酸收之。以苦发之。（热乃火气。水能胜之。故宜治以咸寒。佐以苦甘。甘胜咸。所以防咸之过。苦
能泄。所以去热之实也。酸乃木味。火生于木。以酸收之者。收火归原也。热郁于内而不解者。以苦发之。）湿淫于内。
治以苦热。佐以酸淡。以苦燥之。以淡泄之。（湿乃阴土之气。故宜治以苦热。苦能胜湿。热以和阴也。酸从木化。故佐
以酸淡。以苦燥之者。苦从火化也。卦传曰。燥万物者。莫 乎火。以淡泄之者。淡味渗泄为阳也。）火淫于内。治以咸
冷。佐以苦辛。以酸收之。以苦发之。（火淫于内。故宜治以咸冷。苦能泄辛能散。故当佐以苦辛。以酸收之。以苦发之。
与上文同义。）燥淫于内。治以苦温。佐以甘辛。以苦下之。（燥乃清凉之金气。故当治以苦温。燥则气结于内。故当佐
以辛甘发散。以苦下之。）寒淫于内。治以甘热。佐以苦辛。以咸泻之。以辛润之。以苦坚之。（寒乃水气。土能胜水。
热能胜寒。故宜治以甘热。脏气法时论曰。肾苦燥。急食辛以润之。肾欲坚。急食苦以坚之。以苦补之。以咸泻之。）帝
曰。善。天气之变何如。岐伯曰。厥阴司天。风淫所胜。则太虚埃昏。云物以扰。寒生春气。流水不冰。民病胃脘当心
而痛。上肢两胁。膈咽不通。饮食不下。舌本强。食则呕。冷泄腹胀。溏泄瘕水闭。蛰虫不去。病本于脾。冲阳绝。死
不治。（厥阴司天。巳亥岁也。风淫于上。故太虚埃昏。云物扰乱。寒生于春气。是以流水不冰。按经脉篇。舌本强。食
则呕。胃脘痛腹胀。饮食不下。溏瘕泄水闭。皆脾经之病。盖风木淫胜。故病本于脾。蛰虫藏于土中。因风气外淫。故
不去也。卫阳、足阳明胃脉。在足跗上。动脉应手。胃气已绝。故死不治。）少阴司天。热淫所胜。怫热至。火行其政。
民病胸中烦热。嗌干。右 满。皮肤痛。寒热咳喘。大雨且至。唾血。血泄。鼽衄。嚏呕。溺色变。甚则疮疡 肿。肩
背臂 及缺盆中痛。心痛。肺 。腹大满。膨膨而喘咳。病本于肺。尺泽绝。死不治。（少阴司天。子午岁也。怫、郁也。
盖少阴之火。发于阴中。故为怫热。少阴太阳。阴中有阳。阳中有阴。阴阳相从。标本互换。是以火热甚而大雨至。水
寒极而运火炎。民病胸中烦热嗌干。右 满。皮肤痛。肺受火热而津液不生也。唾血血泄。热淫而迫血妄行也。按经脉
篇。溺色变。肩背臂 痛。烦心胸满。肺胀膨膨而喘咳。皆肺经之病。盖火淫则金气受伤。故病本于肺。尺泽、在肘内
廉大交中。动脉应手。肺之合穴脉也。肺气已绝。故死不治。）太阴司天。湿淫所胜。则沉阴且布。雨变枯槁。 肿骨痛。
阴痹。阴痹者。按之不得。腰脊头项痛。时眩。大便难。阴气不用。饥不欲食。咳唾则有血。心如悬。病本于肾。太溪
绝。死不治。（太阴司天。丑未岁也。湿淫于上。是以沉阴且布。草木枯槁。得化气之雨而变生。 肿阴痹。皆感寒湿之
气。病在阴者名曰痹。故按之不得也。肾主骨而膀胱为之府。故腰脊头项骨痛。肾开窍于二阴。故大便难也。阴气不用
者。不能上交于心也。上下不交。则上焦之火热留于胃。胃热则消谷。故善饥。胃气上逆。故不欲食也。咳唾有血者。
心火在上。而不得上下之相济也。经脉篇曰。肾是动病。目KT KT 无所见。心如悬若饥。盖心肾不交。故虚悬于上
而若饥也。此土淫胜水。故病本于肾。太溪、肾之动脉。在足内踝外。踝骨上。太溪脉不至。则肾气已绝。故死不治。）
少阳司天。火淫所胜。则温气流行。金政不平。民病头痛。发热恶寒而疟。热上皮肤痛。色变黄赤。传而为水。身面
肿。腹满仰息。泄注赤白。疮疡。咳。唾血烦心。胸中热。甚则鼽衄。病本于肺。天府绝。死不治。（少阳司天。寅申岁
也。火淫所胜。故金政不平。少阳之火。在天为暑。故民病头痛。寒热而疟。热上皮肤。色变黄赤。火上淫于肺也。肺
者。太阴。皆积水也。传为水者。逼其金水外溢。故为肿满之水病也。仰息、肺气逆而不得偃息也。泄注赤白。疮疡唾
血烦心。火热盛也。鼽衄。甚而及于肺也。此火淫胜金。故病本于肺。天府、肺脉。在腋下三寸。动脉应手。肺气已绝。
故死不治。）阳明司天。燥淫所胜。则木乃晚荣。草乃晚生。筋骨内变。民病左 胁痛。寒清于中。感而疟。大凉革候。
咳。腹中鸣。注泄 溏。名木敛。生菀于下。草焦上首。心胁暴痛。不可反侧。嗌干。面尘。腰痛。丈夫 疝。妇人少
腹痛。目昧 伤。疮痤痈。蛰虫来见。病本于肝。太冲绝。死不治。（阳明司天。卯酉岁也。燥金淫胜于上。则木受其制。
故草木生荣俱晚。肝血伤而不能荣养筋骨。故生内变。左 胁痛。肝经病也。感寒清而成疟者。秋成 疟也。大凉革候
者。夏秋之交。变炎暑而为清凉也。腹中鸣。注泄惊溏。寒清于中也。菀、茂也。名木敛于上而生菀于下。草焦上首。
肃杀之气淫于上也。心胁暴痛。不可反侧。嗌干面尘。 疝 疡。皆肝经之病。盖金淫于上。故病本于肝。太冲、在足
大指本节后二寸。动脉应手。肝经之俞穴脉也。肝气已绝。故死不治。）太阳司天。寒淫所胜。则寒气反至。水且冰。血
变于中。发为痈疡。民病厥心痛。呕血血泄。鼽衄善悲。时眩仆。运火炎烈。雨暴乃雹。胸腹满。手热肘挛。掖肿。心
澹澹大动。胸胁胃脘不安。面赤目黄。善噫嗌干。甚则色 。渴而欲饮。病本于心。神门绝。死不治。所谓动气。知其
脏也。（曰寒气反至者。谓太阳为诸阳之首。即君火之阳也。然本于在下之寒水。今寒气反从上而至。是上下皆寒。而太
阳运居于中。故曰。运火炎烈。夫寒临于上。如阳能胜之。即所谓凡伤于寒。则为病热。乃病反其本。中标之病矣。故
治反其本。中标之方。此太阳从本从标。寒热更胜之气也。是以痈疡呕血。鼽衄腹满。乃阳热中盛之证。如心痛眩仆。
面赤目黄。色 善噫。乃寒凌心火。逼其火热上炎。水火寒热交争。而神门脉绝。心气灭矣。神门、心之俞穴。在手掌
后锐骨端。动脉应手。故所谓候脉之动气。则知其五脏之存亡矣。灵枢经曰。邪在心。心痛。善悲。时眩仆。又曰。上
走心为噫。）帝曰。善。治之奈何。（此章论司天之六气淫胜。而以所胜之气味平之。）岐伯曰。司天之气。风淫所胜。平
以辛凉。佐以苦甘。以甘缓之。以酸泻之。（按在泉之气曰淫于内而曰治。司天之气曰所胜而曰平。盖天气在外而地气在
内也。故曰治者。治其内而使之外也。曰平者。平其上而使之下也。是以在在泉曰以辛散之。在司天曰以酸泻之。）热淫
所胜。平以咸寒。佐以苦甘。以酸收之。（此与在泉之治法相同。但少以苦发之。盖自下而上淫于内者。宜从之而发散于
外也。）湿淫所胜。平以苦热。佐以酸辛。以苦燥之。以淡泄之。湿上甚而热。治以苦温。佐以甘辛。以汗为故而止。（湿
乃土之湿气。故上甚而热者。亦宜用辛温发散。以汗为故而止。金匮要略曰。腰以下肿。当利小便。腰以上肿。当发汗
乃愈。此皆治水湿之要法。）火淫所胜。平以酸冷。佐以苦甘。以酸收之。以苦发之。以酸复之。热淫同。（少阳之火。
乃地火也。如平之而未平者。淫于内也。故当以苦发之。此即三焦之元气。宜复以酸收之。勿使其过于发散世。夫少阴
之热。君主之火也。淫甚则外内相合。亦当以苦发之。）燥淫所胜。平以苦温。佐以酸辛。以苦下之。（苦温能胜清金。
辛能润燥。燥必内结。故以酸苦泄之。）寒淫所胜。平以辛热。佐以甘苦。以咸泻之。（夫淫于内。则干涉于脏气。故上
文曰。以辛润之。以苦坚之。此胜于外。止宜平之泻之而已。）帝曰。善。邪气反胜。治之奈何。岐伯曰。风司于地。清
反胜之。治以酸温。左以苦甘。以辛平之。热司于地。寒反胜之。治以甘热。佐以苦辛。以咸平之。湿司于地。热反胜
之。治以苦冷。佐以在咸甘。以苦平之。火司于地。寒反胜之。治以甘热。佐以苦辛。以咸平之。燥司于地。热反胜之。
治以平寒。佐以苦甘。以辛平之。以和为利。寒司于地。热反胜之。治以咸冷。佐以甘辛。以苦平之。（邪气反胜者。不
正之气。反胜在泉主岁之气。又当用胜邪之气味以平治之。上章曰。天气反时。则可根据时。此之谓也。）帝曰。其司天邪
胜何如。岐伯曰。风化于天。清反胜之。治以酸温。佐以甘苦。热化于天。寒反胜之。治以甘温。佐以苦酸辛。湿化于
天。热反胜之。治以苦寒。佐以苦酸。火化于天。寒反胜之。治以甘热。佐以苦辛。燥化于天。热反胜之。治以辛寒。
佐以苦甘。寒化于天。热反胜之。治以咸冷。佐以苦辛。（此论六气司天。邪气反胜。宜以所胜之气味平之。）帝曰。六
气相胜奈何。岐伯曰。厥阴之胜。耳鸣头眩。愦愦欲吐。胃膈如寒。大风数举。 虫不滋。 胁气并。化而为热。小便
黄赤。胃脘当心而痛。上肢两胁。肠鸣飧泄。少腹痛。注下赤白。甚则呕吐。膈咽不通。（此论三阴三阳主岁之气。淫胜
而为民病者。宜以所胜之气味平之。耳鸣头眩。木淫于上也。大风数举。淫于下而上也。愦愦欲吐。胃气如寒。胃土病
也。 虫不滋。木制之也。 胁气并。肝气聚也。化而为热。小便黄赤。木淫而生火也。风木气胜。则脾胃受伤。故风
气淫于上。则胃脘当心而痛。上肢两胁。甚则呕吐。膈咽不通。淫而下。则肠鸣飧泄。少腹痛。注下赤白。所谓风之伤
人也。善淫而数变。）少阴之胜。心下热。善饥。脐下反动。气游三焦。炎暑至。木乃津。草乃萎。呕逆躁烦。腹满痛溏
泄。传为赤沃。（心下热善饥。外淫之火。交于内也。脐下反动。少阴之标阴。发于下也。气游三焦。谓本标之气。游于
上下。而交于中也。炎暑至者。与少阳气交之时。木乃津者。得少阴阴水之所资养也。草乃萎者。受君相二火之暑热也。
呕逆、阴气上逆也。烦躁、阴阳寒热之征也。复满溏泄。阴寒在下也。传为赤沃、君火下淫也。）太阴之胜。火气内郁。
疮疡于中。流散于外。病在 胁。甚则心痛。热格。头痛喉痹。项强。独胜则湿气内郁。寒迫下焦。痛留顶。互引眉间。
胃满。雨数至。燥化乃见。少腹满。腰 重强。内不便。善注泄。足下温。头重。足胫 肿。饮发于中。 肿于上。（阴
湿之气淫于外。则火气内郁。而疮疡于中矣。湿热之气。流散于外。则及于风木。而病在 胁。甚则心痛者。木甚而传
于火也。热格头痛喉痹项强者。风火之气。与湿气相离。从颈项而上于巅顶也。此言太阴之气。火土相合。而淫于岁半
以前。独胜者。阴湿之气。复胜于岁半以后也。湿气在中。故内郁而迫于下焦。痛留顶而互引眉间者。风火之气。留于
巅顶。传于阳明之经。而下及于胃满也。雨数至。燥化乃见者。至四气五气之交。而后见此证也。少腹满腰 重者。湿
气下淫。而及于肾也。足下温头重者。风火之气。复流于下也。足胫 肿者。土淫而水泛也。饮发于中。 肿于上者。
水邪之从下而中。中而上也。此节论土胜于四时。从中而外。外而上。上而中。中而下。同四时之气。外内出入。环转
一身。大有关于病机。学人宜体认无忽。）少阳之胜。热客于胃。烦心。心痛目赤。欲呕。呕酸善饥。耳痛溺赤。善惊谵
妄。暴热消铄。草萎水涸。介虫乃屈。少腹痛。下沃赤白。（少阳之气。合于三焦。故热客于胃。盖三焦之原。皆出于胃
间也。三焦与心主包络相合。故烦心心痛。三焦之脉。上入耳中。络目锐 。故淫上则为耳痛目赤。淫于中则为呕饥。
淫于下则为溺赤少腹痛。下沃赤白也。善惊谵妄暴热者。阳明胃经热也。三焦之气。蒸津液。化营血。消铄者。热盛而
血液伤也。草萎者。暑热在上也。水涸者。火气在下也。介虫乃屈者。暑热在于气交之中。人与天地参也。王子律曰。
少阴与少阳君相相合。在少阴反提出三焦二字。又曰。炎暑至。在少阳止微露其端。皆经义微妙处。）阳明之胜。清发于
中。左 胁痛。溏泄。内为嗌塞。外发 疝。大凉肃杀。华英改容。毛虫乃殃。胸中不便。嗌塞而咳。（金气寒肃。故清
发于中。金胜。则木气受亏。故为胁痛 疝。清气在下。则为溏泄。在上则为嗌塞。大凉肃杀。淫胜极也。是以华英改
(Continuing from the previous text.) ...Therefore, it pulls and causes pain in the waist and spine. The Kidney meridian connects with the Heart, so Qi rushes upward causing heart pain. The Heart governs Blood vessels, and when Cold forces the Blood, hematochezia (blood in stool) occurs. (According to the *Ling Shu: Jing Mai* chapter, sore throat and submandibular swelling are diseases of the Small Intestine meridian. The Small Intestine is the Fu organ of the Heart; this is also caused by Water pathogen attacking the Fire Zang and Fu organs.) The Yellow Emperor said: Excellent. How should it be treated? Qibo said: For all Qi ruling the Earthly Station (Zai Quan), if Wind excess affects the interior, treat with Pungent-Cool herbs, assist with Bitter-Sweet herbs. Use Sweet herbs to relax tension, and Pungent herbs to disperse. (Wind belongs to Wood Qi; Metal can overcome it, hence treatment with Pungent-Cool. If too pungent, it may damage Qi, so assist with Bitter-Sweet. Bitter controls Pungent, and Sweet tonifies Qi. Wood nature is urgent, so use Sweet to relax it. Wind pathogen excess, so use Pungent to disperse. The *Su Wen: Zang Qi Fa Shi Lun* states: Liver suffers from urgency, eat Sweet food to relax it; Liver desires dispersion, eat Pungent food to disperse it.) If Heat excess affects the interior, treat with Salty-Cold herbs, assist with Sweet-Bitter herbs. Use Sour herbs to astringe, and Bitter herbs to vent. (Heat belongs to Fire Qi; Water can overcome it, hence suitable treatment with Salty-Cold. Assist with Sweet-Bitter; Sweet controls Salty to prevent excess, and Bitter can drain to remove Heat excess. Sour belongs to Wood flavor; Fire is born from Wood. Using Sour to astringe is to return Fire to its origin. If Heat is stagnant internally and unresolved, use Bitter herbs to vent it.) If Dampness excess affects the interior, treat with Bitter-Hot herbs, assist with Sour-Insipid herbs. Use Bitter herbs to dry Dampness, and Insipid herbs to leach out. (Dampness belongs to Yin Earth Qi, hence suitable treatment with Bitter-Hot. Bitter can overcome Dampness, and Hot harmonizes Yin. Sour transforms into Wood, so assist with Sour-Insipid. Using Bitter to dry Dampness is because Bitter transforms into Fire. The *I Ching* states: Nothing dries things more than Fire. Using Insipid to leach is because Insipid flavor has leaching properties, belonging to Yang.) If Fire excess affects the interior, treat with Salty-Cold herbs, assist with Bitter-Pungent herbs. Use Sour herbs to astringe, and Bitter herbs to vent. (Fire excess affects the interior, hence suitable treatment with Salty-Cold. Bitter drains, Pungent disperses, so assist with Bitter-Pungent. Use Sour to astringe, Bitter to vent, same meaning as above.) If Dryness excess affects the interior, treat with Bitter-Warm herbs, assist with Sweet-Pungent herbs. Use Bitter herbs to purge downward. (Dryness belongs to Cool Metal Qi, hence treatment with Bitter-Warm. Dryness causes Qi stagnation internally, so assist with Pungent-Sweet to disperse, and use Bitter herbs to purge downward.) If Cold excess affects the interior, treat with Sweet-Hot herbs, assist with Bitter-Pungent herbs. Use Salty herbs to purge, Pungent herbs to moisten, and Bitter herbs to firm. (Cold belongs to Water Qi; Earth can overcome Water, and Heat overcomes Cold, hence suitable treatment with Sweet-Hot. The *Su Wen: Zang Qi Fa Shi Lun* states: Kidney suffers from dryness, eat Pungent food to moisten it; Kidney desires firmness, eat Bitter food to firm it. Use Bitter to tonify, Salty to purge.)
The Yellow Emperor said: Excellent. What are the changes of Heavenly Qi? Qibo said: When Jue Yin rules Heaven, Wind excess prevails, the sky becomes dusty and dim, clouds and objects are disturbed. Cold arises within Spring Qi, flowing water does not freeze. People suffer from epigastric pain at the heart region, radiating to both hypochondria, obstruction in the diaphragm and pharynx, difficulty swallowing, stiff tongue root, vomiting after eating, cold diarrhea, abdominal distension, loose stools or masses, urinary retention, and hibernating insects do not emerge. The disease originates in the Spleen. If the Chongyang pulse is absent, death is inevitable and untreatable. (Jue Yin ruling Heaven corresponds to Si and Hai years. Wind excess above causes the sky to be dusty and dim, clouds disturbed. Cold arising from Spring Qi means flowing water does not freeze. According to the *Ling Shu: Jing Mai*, stiff tongue root, vomiting after eating, epigastric pain, abdominal distension, difficulty swallowing, loose stools, masses, and urinary retention are all Spleen meridian diseases. Because Wind-Wood excess prevails, the disease originates in the Spleen. Hibernating insects hide in the soil; due to external Wind invasion, they do not emerge. Weiyang acupoint, which is the Foot-Yangming Stomach meridian pulse, is located on the dorsum of the foot where the pulse is palpable. If Stomach Qi is exhausted, death is inevitable and untreatable.) When Shao Yin rules Heaven, Heat excess prevails, stifling heat arrives, Fire exercises its administration. People suffer from chest vexation and heat, dry throat, right hypochondriac fullness, skin pain, aversion to cold with fever, cough and wheezing, heavy rain is imminent, spitting blood, bloody diarrhea, rhinorrhea and epistaxis, sneezing and vomiting, change in urine color, severe cases develop sores and edema, pain in shoulders, back, arms, and supr clavicular fossa, heart pain, Lung distension, large abdominal fullness, bloating with cough and wheezing. The disease originates in the Lung. If the Chize pulse is absent, death is inevitable and untreatable. (Shao Yin ruling Heaven corresponds to Zi and Wu years. Fu means stagnation. Shao Yin Fire emerges from Yin, hence stifling heat. Shao Yin and Tai Yang have Yin within Yang and Yang within Yin; Yin and Yang follow each other, exchanging Biao and Ben, so intense Heat brings heavy rain, extreme Cold moves Fire. People suffer from chest vexation, dry throat, right hypochondriac fullness, skin pain; Lung receives Heat and fluids are not generated. Spitting and passing blood is Heat forcing blood to move recklessly. According to the *Ling Shu: Jing Mai*, change in urine color, shoulder/back/arm pain, chest vexation/fullness, Lung distension with bloating/cough/wheezing are all Lung meridian diseases. Because Fire excess injures Metal Qi, the disease originates in the Lung. Chize acupoint is at the medial elbow crease where the pulse is palpable; it is the He-Sea point of the Lung meridian. If Lung Qi is exhausted, death is inevitable and untreatable.) When Tai Yin rules Heaven, Dampness excess prevails, deep Yin spreads, rain changes causing withering. Edema and bone pain occur, Yin Bi (obstruction). Yin Bi is characterized by lack of sensation upon pressure, pain in waist, spine, head, and neck, occasional vertigo, difficulty defecating, dysfunction of Yin Qi, hunger without desire to eat, blood in sputum, feeling of emptiness in the heart like hanging. The disease originates in the Kidney. If the Taixi pulse is absent, death is inevitable and untreatable. (Tai Yin ruling Heaven corresponds to Chou and Wei years. Dampness excess above causes deep Yin to spread, grass and trees wither, but grow upon receiving transforming rain. Edema and Yin Bi are caused by Cold-Damp pathogen. Disease in Yin is called Bi, hence no sensation on pressure. Kidney governs bones, Bladder is its Fu, hence bone pain in waist/spine/head/neck. Kidney opens into two orifices, hence difficulty defecating. Dysfunction of Yin Qi means failure to ascend to Heart. Upper and lower do not communicate, so Upper Jiao Heat stays in Stomach; Stomach Heat digests quickly causing hunger. Stomach Qi rebels causing lack of appetite. Blood in sputum is because Heart Fire is above but cannot communicate上下. The *Ling Shu: Jing Mai* states: Kidney moving disease involves blurred vision and heart feeling empty/hungry. Because Heart-Kidney non-interaction, it feels empty above like hunger. This is Earth excess overcoming Water, so disease originates in Kidney. Taixi acupoint is the Kidney artery, behind the medial malleolus. If Taixi pulse is absent, Kidney Qi is exhausted, death is inevitable and untreatable.) When Shao Yang rules Heaven, Fire excess prevails, warm Qi circulates, Metal administration is uneven. People suffer from headache, fever with aversion to cold and malaria, skin pain from rising heat, yellow-red complexion, progression to water disease, body/facial edema, abdominal fullness with orthopnea, dysentery (red and white), sores, cough, blood in sputum, vexation, chest heat, severe cases have rhinorrhea and epistaxis. The disease originates in the Lung. If the Tianfu pulse is absent, death is inevitable and untreatable. (Shao Yang ruling Heaven corresponds to Yin and Shen years. Fire excess makes Metal administration uneven. Shao Yang Fire is Summer heat in Heaven, hence headache, chills/fever/malaria. Rising heat causes skin pain and yellow-red complexion, Fire invading Lung. Lung belongs to Tai Yin and accumulates water. Progression to water disease is forcing Metal/Water to overflow externally, causing edema/fullness. Orthopnea is Lung Qi rebellion preventing supination. Dysentery, sores, blood in sputum, vexation indicate intense Fire. Rhinorrhea/epistaxis indicates severity reaching Lung. This is Fire excess overcoming Metal, so disease originates in Lung. Tianfu acupoint is Lung pulse, 3 cun below axilla, pulse palpable. If Lung Qi is exhausted, death is inevitable and untreatable.) When Yang Ming rules Heaven, Dryness excess prevails, trees bloom late, grass grows late, internal changes in sinews and bones. People suffer from left hypochondriac pain, cold/clarity in middle, malaria upon infection. Great coolness changes the season, cough, borborygmus, watery diarrhea. Tall trees contract, plants flourish below, grass withers at top. Sudden pain in heart/hypochondrium, inability to turn side-to-side, dry throat, dusty face, lower back pain, hernia in men, lower abdominal pain in women, blurred vision, acne and abscesses, hibernating insects appear. The disease originates in the Liver. If the Taichong pulse is absent, death is inevitable and untreatable. (Yang Ming ruling Heaven corresponds to Mao and You years. Dry-Metal excess above constrains Wood, hence late blooming/growing. Liver Blood injured fails to nourish sinews/bones, causing internal changes. Left hypochondriac pain is Liver meridian disease. Malaria from cold/clarity is Autumn Cheng malaria. Great coolness changing season is transition from summer heat to coolness. Borborygmus/watery diarrhea is cold/clarity in middle. Wan means flourishing. Trees contracting above/plants flourishing below/grass withering top is肃杀 (killing/drying) Qi excess above. Sudden heart/hypochondriac pain, inability to turn, dry throat, dusty face, hernia/acne are Liver meridian diseases. Because Metal excess above, disease originates in Liver. Taichong acupoint is 2 cun behind big toe metatarsophalangeal joint, pulse palpable, Liver meridian Shu point. If Liver Qi is exhausted, death is inevitable and untreatable.) When Tai Yang rules Heaven, Cold excess prevails, Cold Qi returns, water freezes, blood changes internally, developing sores. People suffer from jue heart pain, vomiting/passing blood, rhinorrhea/epistaxis, frequent sadness, occasional vertigo and collapse. Operating Fire is fierce, violent rain or hail. Chest/abdominal fullness, hot hands, contracted elbows, armpit swelling, palpitations, chest/hypochondrium/epigastrium discomfort, red face, yellow eyes, frequent belching, dry throat, severe cases have dark complexion, thirst wanting drink. The disease originates in the Heart. If the Shenmen pulse is absent, death is inevitable and untreatable. To know the pulsating Qi reveals the Zang. (Saying Cold returns means Tai Yang is head of all Yang, i.e., Minister Fire Yang. But rooted in Lower Cold Water. Now Cold returns from above, meaning upper/lower are Cold, Tai Yang operates in middle, hence Operating Fire is fierce. Cold above, if Yang overcomes it, becomes Heat disease (contrary to original), a Zhong Biao disease. Thus treatment reverses original, targeting Zhong Biao formula. This is Tai Yang following Ben/Biao, alternating Cold/Heat. So sores, vomiting blood, rhinorrhea, abdominal fullness are Yang-Heat excess signs. Heart pain, vertigo, red face, yellow eyes, dark complexion, belching are Cold suppressing Heart Fire, forcing Heat upward. Water/Fire/Cold/Heat contend, Shenmen pulse absent, Heart Qi extinguished. Shenmen acupoint is Heart Shu, at radial end of wrist, pulse palpable. Thus observing pulsating Qi knows Zang survival. *Ling Shu* says: Evil in Heart causes heart pain, sadness, vertigo/collapse. Also: Qi going up to Heart causes belching.)
The Yellow Emperor said: Excellent. How to treat? (This chapter discusses Six Qi excess ruling Heaven, balancing with overcoming flavors.) Qibo said: For Heaven-ruling Qi, Wind excess, balance with Pungent-Cool, assist with Bitter-Sweet, relax with Sweet, purge with Sour. (Note: Earth-ruling Qi says "excess inside" and "treat"; Heaven-ruling Qi says "overcoming" and "balance". Heaven Qi is outside, Earth Qi is inside. "Treat" means treat inside to push out; "Balance" means balance above to push down. Hence Earth-ruling uses Pungent to disperse, Heaven-ruling uses Sour to purge.) Heat excess, balance with Salty-Cold, assist with Bitter-Sweet, astringe with Sour. (Same as Earth-ruling treatment, but less Bitter venting. Rising from below to inside should be followed and dispersed outward.) Dampness excess, balance with Bitter-Hot, assist with Sour-Pungent, dry with Bitter, leach with Insipid. If Dampness is severe above with Heat, treat with Bitter-Warm, assist with Sweet-Pungent, stop when sweating occurs. (Damp is Earth moisture; severe above with Heat suits Pungent-Warm dispersal, stopping at sweat. *Jin Gui Yao Lue* says: Swelling below waist, promote urination; swelling above waist, induce sweat. These are key methods for Water-Damp.) Fire excess, balance with Acid-Cold, assist with Bitter-Sweet, astringe with Sour, vent with Bitter, restore with Sour. Heat excess follows same method. (Shao Yang Fire is Earth Fire. If unbalanced, it invades inside, so vent with Bitter. This is San Jiao Yuan Qi, restore with Sour to prevent excessive dispersion. Shao Yin Heat is Sovereign Fire. Excessive invasion combines inside/outside, also vent with Bitter.) Dryness excess, balance with Bitter-Warm, assist with Sour-Pungent, purge with Bitter. (Bitter-Warm overcomes Cool Metal, Pungent moistens Dryness. Dryness knots internally, so purge with Sour-Bitter.) Cold excess, balance with Pungent-Hot, assist with Sweet-Bitter, purge with Salty. (Excess inside interferes with Zang Qi, hence earlier texts say moisten with Pungent, firm with Bitter. This excess outside only needs balancing and purging.)
The Yellow Emperor said: Excellent. How to treat reverse winning by Evil Qi? Qibo said: If Wind rules Earth but Clearness wins in reverse, treat with Acid-Warm, assist with Bitter-Sweet, balance with Pungent. If Heat rules Earth but Cold wins in reverse, treat with Sweet-Hot, assist with Bitter-Sweet, balance with Salty. If Dampness rules Earth but Heat wins in reverse, treat with Bitter-Cold, assist with Salty-Sweet, balance with Bitter. If Fire rules Earth but Cold wins in reverse, treat with Sweet-Hot, assist with Bitter-Sweet, balance with Salty. If Dryness rules Earth but Heat wins in reverse, treat with Neutral-Cold, assist with Bitter-Sweet, balance with Pungent, harmony is beneficial. If Cold rules Earth but Heat wins in reverse, treat with Salty-Cold, assist with Sweet-Pungent, balance with Bitter. (Reverse winning means irregular Qi wins against the ruling Earth Qi. Use overcoming flavors to balance. Previous chapter: if Heaven Qi opposes time, follow time. This is what it means.)
The Yellow Emperor said: How about Heaven-ruling reverse winning? Qibo said: If Wind transformation in Heaven is reversed by Clearness, treat with Acid-Warm, assist with Sweet-Bitter. If Heat transformation in Heaven is reversed by Cold, treat with Sweet-Warm, assist with Bitter-Acid-Pungent. If Dampness transformation in Heaven is reversed by Heat, treat with Bitter-Cold, assist with Bitter-Acid. If Fire transformation in Heaven is reversed by Cold, treat with Sweet-Hot, assist with Bitter-Pungent. If Dryness transformation in Heaven is reversed by Heat, treat with Pungent-Cold, assist with Bitter-Sweet. If Cold transformation in Heaven is reversed by Heat, treat with Salty-Cold, assist with Bitter-Pungent. (Discusses Six Qi ruling Heaven, reverse winning by evil, balance with overcoming flavors.)
The Yellow Emperor said: How about Six Qi mutual overcoming? Qibo said: Jue Yin overcoming: tinnitus, vertigo, confusion wanting to vomit, stomach/diaphragm feels cold, frequent strong winds, hibernating insects do not multiply, hypochondriac Qi merging, transforming into Heat, yellow-red urine, epigastric pain at heart region, radiating to hypochondria, borborygmus and undigested stool diarrhea, lower abdominal pain, dysentery (red/white), severe vomiting, diaphragm/pharynx obstruction. (Discusses Three Yin/Yang ruling year Qi, excess causing people's disease, balance with overcoming flavors. Tinnitus/vertigo: Wood excess above. Strong winds: excess below ascending. Confusion/vomiting, cold stomach: Stomach Earth disease. Insects not multiplying: Wood controls them. Hypochondriac Qi merging: Liver Qi gathering. Transforming to Heat/yellow urine: Wood excess generating Fire. Wind-Wood excess injures Spleen/Stomach. Wind excess above causes epigastric pain/radiation/vomiting/obstruction; excess descending causes borborygmus/diarrhea/lower pain/dysentery. Wind harms people, prone to excess and rapid change.)
Shao Yin overcoming: heat below heart, frequent hunger, movement below umbilicus, Qi roaming San Jiao, summer heat arrives, Wood becomes juicy, grass withers, vomiting/reversal, restlessness/vexation, abdominal fullness/pain/loose stool, progressing to red discharge. (Heat below heart/hunger: external Fire interacting inside. Movement below umbilicus: Shao Yin Biao Yin emerging below. Qi roaming San Jiao: Ben/Biao Qi roaming up/down/center. Summer heat arrival: interaction with Shao Yang. Wood juicy: nourished by Shao Yin Yin Water. Grass withers: affected by Sovereign/Minister Fire heat. Vomiting: Yin Qi rebelling upward. Restlessness: sign of Yin/Yang/Cold/Heat. Abdominal fullness/loose stool: Yin Cold below. Red discharge: Sovereign Fire descending.)
Tai Yin overcoming: Fire Qi stagnant inside, sores inside spreading outside, disease in hypochondria, severe heart pain, heat blockage, headache, throat bi, neck stiffness. Exclusive excess causes internal Damp stagnation, Cold pressing Lower Jiao, pain staying at vertex radiating to glabella, full stomach, frequent rain, Dryness transformation appears, lower abdominal fullness, heavy/stiff waist, internal difficulty, frequent watery diarrhea, warm soles, heavy head, swollen calves/shins, fluid retention inside, edema above. (Yin-Damp excess outside causes internal Fire stagnation and sores. Damp-Heat spreading outside affects Wind-Wood, disease in hypochondria. Severe heart pain: Wood excess transmitting to Fire. Heat blockage/headache/throat bi/neck stiffness: Wind-Fire separating from Damp, ascending neck to vertex. Tai Yin Qi, Fire-Earth combine, excess first half of year. Exclusive excess: Yin-Damp excess second half. Damp in middle stagnates pressing Lower Jiao. Pain at vertex/glabella: Wind-Fire at vertex transmitting to Yang Ming/Stomach. Frequent rain/Dryness appearance: transition of 4th/5th Qi. Lower fullness/heavy waist: Damp excess descending to Kidney. Warm soles/heavy head: Wind-Fire flowing down. Swollen calves: Earth excess flooding Water. Fluid retention/edema: Water pathogen rising from lower/middle/upper. This section discusses Earth exceeding Four Seasons, circulating through body, crucial for pathology, students must recognize carefully.)
Shao Yang overcoming: Heat guest in Stomach, vexation, heart pain, red eyes, desire to vomit, sour vomiting, frequent hunger, ear pain, red urine, frequent fright, delirium, sudden heat wasting, grass withers, water dries, shell creatures submit, lower abdominal pain, dysentery red/white. (Shao Yang Qi combines with San Jiao, Heat guests Stomach. San Jiao origin emerges from Stomach. San Jiao combines with Pericardium, hence vexation/heart pain. San Jiao meridian enters ear, connects eye corner, excess above causes ear/eye symptoms. Excess middle causes vomiting/hunger. Excess below causes red urine/lower pain/dysentery. Fright/delirium/sudden heat: Yang Ming Stomach Heat. San Jiao steams fluids, transforms Ying Blood, wasting indicates Heat injuring Blood. Grass withers: Summer heat above. Water dries: Fire below. Shell creatures submit: Summer heat in Qi intersection, man and heaven correspond. Wang Zilu says: Shao Yin/Shao Yang Sovereign/Minister combine, Shao Yin mentions San Jiao. Summer heat, Shao Yang hints slightly. Subtle meanings.)
Yang Ming overcoming: Clearness emerges inside, left hypochondriac pain, loose stool, internal throat obstruction, external hernia. Great coolness killing, flowers change appearance, hair creatures suffer, chest discomfort, throat obstruction and cough. (Metal Qi cold/severe, Clearness emerges inside. Metal excess injures Wood, hence hypochondriac pain/hernia. Clear Qi below causes loose stool. Above causes throat obstruction. Great coolness killing is extreme excess. Flowers change, hair creatures suffer. Chest discomfort, throat obstruction, cough...)