热。感吾身之阴寒。则为病寒。感吾身之水湿。则为痰喘。感吾身之燥气。则为便难。如中于腑。则暴仆而卒不知人。
中于脏。舌即难言。而口唾涎沫。又如伤寒。天之阴邪也。或中于阴。或中于阳。有中于阳而反病寒者。有中于阴而反
病热者。是吾身之阴中有阳。阳中有阴。标本阴阳之气化也。如感吾身中之水湿。则为青龙五苓之证。如感吾身中之燥
热。又宜于白虎承气诸汤。此止受天之一邪。而吾身中有表里阴阳变化之不同也。又如夏月之病。有手足厥冷。而成姜
桂参附之证者。盖夏月之阳气。尽发越于外。而里气本虚。受天之风暑。而反变为阴寒。皆吾身之气化。非暑月之有伤
寒也。是以神巧之士。知标本之病生。则知有标本之气化。知标本之气化。则能用标本之治法矣。故知标与本。用之不
殆。明知顺逆。正行无间。此之谓也。逆者。以寒治热。以热治寒。故曰逆。正顺也。从者以热治热。以寒治寒。故曰
若顺。逆也。如阴阳寒热之中。又有病热而反寒者。如厥深热亦深之类是也。又有病寒而反热者。如揭去衣被。欲入水
中。此孤阳外脱。急救以参附之证。粗工嘻嘻。以为可知。言热未已。寒病复始。同气异形。迷诊乱经。此之谓也。）夫
标本之道。要而博。小而大。可以言一而知百病之害。言标与本。易而勿损。察本与标。气可令调。明知胜复。为万民
式。天之道毕矣。（此极言标本之用也。言标本之道。虽为要约。而其用则广博。虽为微小。而其用则弘大。可以言一而
知百病之害者。惟知标本故也。言标与本。则施治平易而无伤损。察本与标。则六气虽变。可使均调。明知标本胜复。
则足以为民式。六气在天之道毕矣。）帝曰。胜复之变。早晏何如。岐伯曰。夫所胜者。胜至已病。病已愠愠。面复已萌
也。夫所复者。胜尽而起。得位而甚。胜有微甚。复有少多。胜和而和。胜虚而虚。天之常也。帝曰。胜复之作。动不
当位。或后时而至。其故何也。岐伯曰。夫气之生与其化。衰盛异也。寒暑温凉。盛衰之用。其在四维。故阳之动。始
于温。盛于暑。阴之动。始于清。盛于寒。春夏秋冬。各差其分。故大要曰。彼春之暖。为夏之暑。彼秋之忿。为冬之
怒。谨按四维。斥候皆归。其终可见。其始可知。此之谓也。帝曰。差有数乎。岐伯曰。又凡三十度也。（此章言日月运
行。寒一暑。四时之气。由微而盛。由盛而微。从维而正。从正而维。寒温互换。凉暑气交。胜复之气。有盛有衰。随
时先后。是以有早有晏也。阳之动。始于温。盛于暑。阴之动。始于清。盛于寒。是由微而甚也。如春之沉。夏之弦。
秋之数。冬之涩。是冬之余气。尚交于春。春之余气。尚交于夏。夏之余气。尚交于秋。秋之余气。尚交于冬。是由盛
而微也。所谓正者。春夏秋冬之正方也。维者。春夏之交。夏秋之交。秋冬之交。冬春之交。四隅之四维也。四时之气。
从维而正。复从正而维。寒温气交。凉暑更互。环转之不息也。是以胜至已病。病已愠愠。而复已萌者。谓复气已发萌
于胜气之时也。如春有凄惨残贼之胜。是金气之胜木也。夏有炎暑燔烁之复。是火气之复金也。而火气已萌于胜。病愠
愠之时。是复气之早发于本位之三十度也。所复之气。俟胜尽而起。至炎夏所主之本位而甚。是胜气早。而复气将来亦
早也。是以胜气甚。则复气多。胜气微。则复气少。胜气和平。而复亦和平。胜气虚衰。而复亦虚衰。此天道之常也。
如胜复之作。动不当位。后时而至者。此胜复之晏也。夫气之生。生于前之气交。如夏气之生于季春也。气之化。化于
后之气交。如春气之流于孟夏也。胜复之气有盛衰。是以有早晏之异也。盖气之盛者。胜于本位以前所生之三十度。气
之衰者。流于本位以后所化之三十度。故不当其位也。如金气衰而胜于春夏之交。则复气亦衰而复于夏秋之交矣。是胜
虚而虚。后时而至也。此四时之气。前后互交。是以胜复之盛衰。随四时之气交。而或前或后也。故曰。盛衰之用。其
在四维。又曰。谨按四维。斥候皆归。其终可见。其始可知。谓胜复之早晏。皆归于四维之斥候。或早而在于始之前三
十度。或晏而在于终之后三十度也。）帝曰。其脉应皆何如。岐伯曰。差同正法。待时而去也。（此复以脉候而证明气化
之交通。故曰。是谓四塞。谓春夏秋冬之气。不相交通。则天地四时之气。皆闭塞矣。正者。四时之正位也。言脉同四
时之正法。而前后相交。待时而去者。待终三十度而去也。如春之沉。尚属冬之气交。终正月之三十日。而春气始独司
其令也。）脉要曰。春不沉。夏不弦。冬不涩。秋不数。是谓四塞。（春不沉。则冬气不交于春。夏不弦。则春气不交于
夏。秋不数。则夏气不交于秋。冬不涩。则秋气不交于冬。是四时之气。不相交通而闭塞矣。）沉甚曰病。弦甚曰病。涩
甚曰病。数甚曰病。参见曰病。复见曰病。未去而去曰病。去而不去曰病。反者死。故曰气之相守司也。如权衡之不得
相失也。夫阴阳之气。清静则生化治。动则苛疾起。此之谓也。（四时之气。盛于主位之时。而微于始生。衰于交化。是
以甚则病也。参见者。谓春初之沉弦并见。夏初之弦数并见也。复见者。已去而复见也。未去而去者。未及三十度而去
也。去而不去者。已至三十日。应去而不去也。反者。谓四时反见贼害之脉也。故曰。气之相守司也。如权衡之不得相
失也。言四时之气。守于本位。司于气交。犹权衡之不相离也。四时阴阳之气。清静则生化治。生化者。生于前而化于
后也。动者。气之乱也。）帝曰。幽明何如。岐伯曰。两阴交尽。故曰幽。两阳合明。故曰明。幽明之配。寒暑之异也。
（幽明者。阴阳也。两阴交尽。阴之极也。故曰幽。两阳合明。阳之极也。故曰明。阴极则阳生。阳极则阴生。寒往则
暑来。暑往则寒来。故幽明之配。寒暑之异也。此复申明阳之动始于温。盛于暑。阴之动始于清。盛于寒。四时之往来。
总属阴阳寒暑之二气耳。）帝曰。分至如何。岐伯曰。气至之谓至。气分之谓分。至则气同。分则气异。所谓天地之正纪
也。（气至、谓冬夏之二至。气分谓春秋之二分。此承上文以申明彼春之暖。为夏之暑。彼秋之忿。为冬之怒。言二至之
时。总属寒暑阴阳之二气。气分之时。则有温凉之不同也。）帝曰。夫子言春秋气始于前。冬夏气始于后。余已知之矣。
然六气往复。主岁不常也。其补泻奈何。岐伯曰。上下所主。随其攸利。正其味。则其要也。左右同法。大要曰。少阳
之主。先甘后咸。阳明之主。先辛后酸。太阳之主。先咸后苦。厥阴之主。先酸后辛。少阴之主。先甘后咸。太阴之主。
先苦后甘。佐以所利。资以所生。是谓得气。（春秋之气始于前者。言春在岁半以上之前。秋在岁半以下之前。夏冬之气。
在二气之后。谓四时之主气也。六气往复。主岁不常者。谓加临之客气。六期环转。无有常位也。此章论四时之主气。
前后交通。得气之清静者也。若受客胜以动之。又不能循序而苛疾起矣。是以上下所主。及左右之间气。当随其攸利。
正其味以调之。乃其要也。大要宜先泻而后补之。盖以佐主气之所利。资主气之所生。是谓得四时之气。生化而交通也。
按前章论客气之补泻。先补而后泻者。在客之本气而论也。此复以先泻而后补者。为四时之主气而言也。岁运七篇。圣
人反复详论。曲尽婆心。文有似乎雷同。而旨义各别。学人亦宜反复参阅。不可以其近而忽之。）帝曰。善。夫百病之生
也。皆生于风寒暑湿燥火。以之化之变也。经言盛者泻之。虚者补之。余锡以方士。而方士用之。尚未能十全。余欲令
要道必行。桴鼓相应。犹拔刺雪汗。工巧神圣。可得闻乎。（夫百病之始生也。皆生于风雨寒暑。阴阳喜怒。饮食居处。
大惊卒恐。则血气分离。阴阳破散。以上七篇。统论五运六气之邪。皆外感天地之气而为病。然人身之中。亦有五行六
气。或喜怒暴发。或居处失宜。或食饮不节。或卒恐暴惊。皆能伤五脏之气而为病。是以此经言锡之方士。而方士用之。
尚未能十全也。要道者。天地人三才之道也。桴鼓相应者。谓天地人之五行六气。如声气之感应也。拔刺者。谓天地阴
阳之邪。犹刺之从外入。宜拔而去之。雪汗者。谓在内所生之病机。使之如汗而发雪也。天地人三才之道并用。外内阴
阳之法并施。斯成工巧神圣之妙。盖天地之道。胜复之作。不形于诊。重在望闻。内因之病。偏于问切。）岐伯曰。审察
病机。无失气宜。此之谓也。（病机者。根于中而发于外者也。气宜者。五脏五行之气。各有所宜也。）帝曰。愿闻病机
何如。岐伯曰。诸风掉眩。皆属于肝。诸寒收引。皆属于肾。诸气忿郁。皆属于肺。诸湿肿满。皆属于脾。诸热瞀螈。
皆属于火。诸痛痒疮。皆属于心。（五脏内合五行。五内联生六气。是以五脏之气病于内。而六气之证见于外也。）诸厥
固泄。皆属于下。诸痿喘呕。皆属于上。（诸厥固泄。皆属于下者。从上而下也。诸痿喘呕。皆属于上者。从下而上也。
夫在上之阳气下逆。则为厥冷。在下之阴气上乘。则为痿痹。在上之水液下行。则为固泄。在下之水液上行。则为喘呕。
亦犹天地阴阳之气。上下相乘。而水随气之上下也。）诸禁鼓栗。如丧神守。皆属于火。诸痉项强。皆属于湿。诸逆冲上。
皆属于火。诸胀腹大。皆属于热。诸躁狂越。皆属于火。诸暴强直。皆属于风。诸病有声。鼓之如鼓。皆属于热。诸病
肿。疼酸惊骇。皆属于火。诸转反戾。水液混浊。皆属于热。诸病水液。澄澈清冷。皆属于寒。诸呕吐酸。暴注下迫。
皆属于热。（此五脏之气。而发见于形气也。火者。少阳包络之相火。热者。君火之气也。诸禁鼓栗。热极生寒也。如丧
神守。相火甚而心神不安也。风者。木火之气。皆能生风。反戾。了戾也。）故大要曰。谨守病机。各司其属。有者求之。
无者求之。盛者责之。虚者责之。必先五胜。疏其血气。令其调达。而致和平。此之谓也。（此言所发之病机。各有五脏
五行之所属。有者。谓五脏之病气有余。无者。谓五脏之精气不足。盛者。责其太甚。虚者。责其虚微。如火热之太过。
当责其无水也。故必先使五脏之精气皆胜。而后疏其血气。令其调达。致使五脏之气平和。此之谓神工也。）帝曰。善。
五味阴阳之用何如。岐伯曰。辛甘发散为阳。酸苦涌泄为阴。咸味涌泄为阴。淡味渗泄为阳。六者或收或散。或缓或急。
或燥或润。或 或坚。以所利而行之。调其气。使其平也。（五味阴阳之用调五脏者。有发有散。有涌有泄。六者之中。
或收或散。或缓或急。或燥或润。或 或坚。如肝苦急而欲散。心苦缓而欲 。脾苦湿而欲缓。肺苦逆而欲收。肾苦燥
而欲坚。各随其所利而行之。调其五脏之气。而使之平也。）帝曰。非调气而得者。治之奈何。有毒无毒。何先何后。愿
闻其道。岐伯曰。有毒无毒。所治为主。适大小为制也。帝曰。请言其制。岐伯曰。君一臣二。制之小也。君一臣三佐
五。制之中也。君一臣三佐九。制之大也。（帝言上文论调五脏之气而使之平。然五脏之病。又当以有毒无毒之药治之。
或调或治。何先何后。愿闻其道。岐伯曰。以有毒无毒所治病为主。然适其方之大小为制也。主病之谓君。佐君之谓臣。
应臣之谓使。盖病之甚者。制大其服。病之微者。制小其服。能毒者。制大其服。不能毒者。制小其服。）寒者热之。热
者寒之。微者逆之。甚者从之。坚者削之。客者除之。劳者温之。结者散之。留者攻之。燥者濡之。急者缓之。散者收
之。损者温之。逸者行之。惊者平之。上之下之。摩之浴之。薄之劫之。开之发之。适事为故。（温者。补也。盖补药多
属甘温。泻药多属苦寒。摩者。上古多用膏摩而取汗。浴者。用汤液浸渍也。薄。迫也。此皆治病之要法。各适其事而
用之。）帝曰。何谓逆从。岐伯曰。逆者正治。从者反治。从少从多。观其事也。（逆者。以寒治热。以热治寒。故为正
治。从者。热病从热。寒病从寒。故为反治。微者逆之。甚者从之。如病之过甚者从多。；不太甚者从少。观其从事之何
如耳。）帝曰。反治何谓。岐伯曰。热因寒用。寒因热用。塞因塞用。通因通用。必伏其所主。而先其所因。其始则同。
其终则异。可使破积。可使溃坚。可使气和。可使必已。（热因寒用。寒因热用者。治热以寒。温而行之。治寒以热。凉
而行之。其始则同。其终则异也。塞因塞用。通因通用者。如诸呕吐酸。乃热邪坚积于中。而壅塞于上。即从之而使之
上涌。所谓塞因塞用。而可使破积也。如暴注下迫。乃热邪坚积于中。而通泄于下。即从之而使之下泄。所谓通因通用。
Heat. When one feels the Yin-cold of one's own body, it manifests as a Cold disease; when one feels the Water-Dampness of one's own body, it manifests as Phlegm and wheezing; when one feels the Dryness of one's own body, it manifests as difficulty in defecation. If the pathogen invades the Fu organs (Yang organs), there will be sudden collapse and loss of consciousness.
If the pathogen invades the Zang organs (Yin organs), the tongue will become stiff and difficult to speak, and saliva will foam from the mouth. Take for example Shanghan (Cold Damage); this is a Yin pathogen from Heaven. It may invade the Yin or the Yang. There are cases where invasion of the Yang results in Cold symptoms, and cases where invasion of the Yin results in Heat symptoms. This is because within our body's Yin there is Yang, and within Yang there is Yin; it is the transformation of the Qi of Biao-Biao (Surface-Root) Yin-Yang. If one feels the Water-Dampness within one's body, it presents as patterns suitable for Qinglong Tang (Azure Dragon Decoction) or Wuling San (Five-Ling Powder). If one feels the Dryness-Heat within one's body, it is appropriate to use Baizhu Tang (White Tiger Decoction) or Chengqi Tang (Descending Qi Decoction). This involves only receiving one pathogen from Heaven, while within our body there are different changes of Biao-Li (Exterior-Interior) Yin-Yang. For example, in summer diseases, there are cases of cold extremities presenting as patterns requiring Jiangui Shenzhi (Ginger, Cinnamon, Ginseng, and Aconite). This is because in summer, the Yang Qi is entirely dispersed outward, leaving the Interior Qi inherently deficient. Upon receiving the Wind-Shu (Summerheat) from Heaven, it transforms into Yin-Cold. This is all due to the transformation of one's own Qi, not because there is Shanghan (Cold Damage) in the summer months. Therefore, skilled physicians, knowing the origin of the disease (Biao-Ben), know the transformation of Biao-Ben Qi; knowing the transformation of Biao-Ben Qi, they can apply the treatment methods of Biao-Ben. Thus, knowing Biao and Ben (Root), one uses them without danger; clearly understanding Shun and Ni (Following/Opposing), one walks the correct path without obstruction. This is what is meant. "Ni" (Opposing) refers to treating Heat with Cold and Cold with Heat; thus it is called "Ni". This is Zheng (Correct/Orthodox) treatment. "Cong" (Following) refers to treating Heat with Heat and Cold with Cold; thus it is called "Ruoshun" (Seeming Following), which is actually Fan (Reverse) treatment. Among Yin-Yang and Cold-Heat, there are cases of Heat disease manifesting as Cold, such as "the deeper the Jue (cold extremities), the deeper the Heat". There are also cases of Cold disease manifesting as Heat, such as removing clothes and blankets, desiring to enter water; this is Lone Yang escaping externally, requiring emergency treatment with Shenfu Tang (Ginseng and Aconite Decoction). Crude physicians laugh, thinking they understand, saying the Heat disease is not yet over, but the Cold disease has started again. Same Qi producing different forms, confusing diagnosis and disrupting meridians—this is what is meant.) The Way of Biao-Ben (Surface-Root) is concise yet extensive, small yet great. One can speak of one and know the harm of a hundred diseases. Speaking of Biao and Ben makes treatment easy and non-damaging; observing Ben and Biao allows Qi to be regulated. Clearly knowing Sheng-Fu (Overcoming-Rebounding), one serves as a model for all people; the Way of Heaven is complete. (This greatly expounds the utility of Biao-Ben. It says the Way of Biao-Ben, though concise, is extensive in application; though small, its effect is grand. One can speak of one and know the harm of a hundred diseases because one understands Biao-Ben. Speaking of Biao and Ben makes treatment gentle and harmless; observing Ben and Biao allows the Six Qi (Six Climatic Factors) to be balanced even if changed. Clearly knowing Biao-Ben Sheng-Fu suffices to be a model for the people; the Way of Six Qi in Heaven is complete.) The Emperor asked: How early or late are the changes of Sheng-Fu? Qibo replied: The so-called "Sheng" (Overcoming) is when the Sheng Qi arrives and causes disease, the disease is brewing, and the "Fu" (Rebounding) Qi has already sprouted. The so-called "Fu" begins when the Sheng Qi exhausts itself, becomes severe upon reaching its proper position. Sheng has slight and severe degrees; Fu has few and many degrees. If Sheng is peaceful, Fu is peaceful; if Sheng is deficient, Fu is deficient. This is the constant law of Heaven. The Emperor asked: Why do Sheng-Fu actions sometimes fail to reach their proper position or arrive late? Qibo replied: The generation and transformation of Qi differ in prosperity and decline. The applications of Cold, Heat, Warmth, and Coolness depend on the Four Corners (Siwei, the transitional periods between seasons). Thus, the movement of Yang begins with Warmth and peaks in Summerheat; the movement of Yin begins with Coolness and peaks in Cold. Spring, Summer, Autumn, and Winter each have their specific divisions. Thus, the *Da Yao* (Great Essentials) states: The warmth of that spring becomes the heat of that summer; the severity of that autumn becomes the anger of that winter. Carefully observing the Four Corners, all signs return; their end is visible, their beginning is known. This is what is meant. The Emperor asked: Is there a fixed number for these differences? Qibo replied: It is thirty du (days). (This chapter discusses the movement of sun and moon, the alternation of Cold and Heat, and how the Qi of the four seasons goes from slight to prosperous, from prosperous to slight, from Siwei to Zheng (Main), and from Zheng back to Siwei. Cold and Warmth interchange, Coolness and Heat intersect. Sheng-Fu Qi has prosperity and decline, following time sequentially, hence some are early and some late. Yang's movement begins with Warmth and peaks in Summerheat; Yin's movement begins with Coolness and peaks in Cold. This is from slight to severe. E.g., Sun pulse in Spring, String pulse in Summer, Rapid pulse in Autumn, Choppy pulse in Winter: Winter's residual Qi intersects with Spring; Spring's residual Qi intersects with Summer; Summer's residual Qi intersects with Autumn; Autumn's residual Qi intersects with Winter. This is from severe to slight. "Zheng" refers to the main positions of the four seasons. "Siwei" refers to the transitions: Spring-Summer, Summer-Autumn, Autumn-Winter, Winter-Spring—the four corners. The Qi of the four seasons moves from Siwei to Zheng, and from Zheng back to Siwei. Cold and Warmth intersect, Coolness and Heat alternate, rotating endlessly. Thus, when Sheng arrives causing disease, and the disease is brewing, Fu has already sprouted. This means Fu Qi sprouts during the time of Sheng Qi. E.g., in Spring, there is a Sheng of desolation and injury, which is Metal overcoming Wood; in Summer, there is a Fu of blazing heat, which is Fire rebelling against Metal. But Fire Qi had already sprouted during the Sheng, when the disease was brewing. This is Fu Qi appearing early at its proper position by thirty du. The Fu Qi waits for Sheng to exhaust before rising, becoming severe when reaching the proper position ruled by Summerheat. If Sheng is early, Fu will also be early. Thus, if Sheng is severe, Fu is numerous; if Sheng is slight, Fu is few; if Sheng is peaceful, Fu is peaceful; if Sheng is deficient, Fu is deficient. This is the constant law of Heaven. If Sheng-Fu actions fail to reach their proper position or arrive late, this is "Yan" (Late). The generation of Qi occurs in the Qi intersection preceding it, e.g., Summer Qi generates in late Spring. The transformation of Qi occurs in the Qi intersection following it, e.g., Spring Qi flows into early Summer. Sheng-Fu Qi has prosperity and decline, hence the difference between early and late. Prosperous Qi surpasses the thirty du generated before its proper position; deficient Qi flows into the thirty du transformed after its proper position. Hence it does not match its position. E.g., if Metal Qi is deficient and surpasses during the Spring-Summer transition, its Fu Qi will also be deficient and rebound during the Summer-Autumn transition. This is "Sheng deficient, Fu deficient," arriving late. The Qi of the four seasons intersects front and back, so the prosperity and decline of Sheng-Fu follow the intersection of seasonal Qi, appearing either earlier or later. Thus it is said: The application of prosperity and decline lies in the Four Corners. Also: Carefully observe the Four Corners, all signs return. Their end is visible, their beginning is known. This means the earliness or lateness of Sheng-Fu all returns to the signs of the Four Corners, either early by thirty du before the start, or late by thirty du after the end.) The Emperor asked: What are the corresponding pulses? Qibo replied: The differences are consistent with the normal method, departing when the time comes. (This reiterates using pulse signs to prove the communication of Qi transformation. Hence it is called "Si Sai" (Four Obstructions): if the Qi of Spring, Summer, Autumn, and Winter do not communicate, the Qi of Heaven, Earth, and the four seasons are all blocked. "Zheng" refers to the main positions of the four seasons. It means the pulse follows the normal method of the four seasons, intersecting front and back. "Departing when the time comes" means departing after thirty days. E.g., the Sun pulse in Spring still belongs to the Qi intersection of Winter; after thirty days of the first month, Spring Qi alone governs.) The *Mai Yao* (Pulse Essentials) states: No Sun pulse in Spring, no String pulse in Summer, no Choppy pulse in Winter, no Rapid pulse in Autumn—this is called "Si Sai". (No Sun pulse in Spring means Winter Qi does not intersect with Spring; no String pulse in Summer means Spring Qi does not intersect with Summer; no Rapid pulse in Autumn means Summer Qi does not intersect with Autumn; no Choppy pulse in Winter means Autumn Qi does not intersect with Winter. This means the Qi of the four seasons does not communicate and is blocked.) Excessive Sun pulse indicates disease; excessive String pulse indicates disease; excessive Choppy pulse indicates disease; excessive Rapid pulse indicates disease. Simultaneous appearance indicates disease; Recurrent appearance indicates disease. Departing before time indicates disease; Remaining past time indicates disease. Reversal leads to death. Thus it is said: Qi guarding and governing each other is like the balance beam never losing equilibrium. Yin and Yang Qi, if quiet and still, lead to generation and governance; if agitated, severe diseases arise. This is what is meant. (The Qi of the four seasons is prosperous at its main position, slight at generation, and declining at transformation. Hence excess leads to disease. "Simultaneous appearance" refers to Sun and String pulses appearing together in early Spring, String and Rapid pulses appearing together in early Summer. "Recurrent appearance" refers to returning after departure. "Departing before time" refers to departing before thirty days. "Remaining past time" refers to having reached thirty days but failing to depart. "Reversal" refers to seeing harmful pulses contrary to the four seasons. Thus it is said: Qi guarding and governing each other is like the balance beam never losing equilibrium. It means the Qi of the four seasons guards its proper position and governs at the Qi intersection, just as the balance beam cannot separate. The Yin and Yang Qi of the four seasons, if quiet and still, lead to generation and governance. Generation means generating in the front and transforming in the back. Agitation means disorder of Qi.) The Emperor asked: How are You and Ming? Qibo replied: When two Yins intersect and exhaust, it is called You (Dark/Nether); when two Yangs combine and brighten, it is called Ming (Bright/Luminous). The pairing of You and Ming corresponds to the difference between Cold and Heat. (You and Ming refer to Yin and Yang. Two Yins intersecting and exhausting is the extreme of Yin, hence You; two Yangs combining and brightening is the extreme of Yang, hence Ming. Extreme Yin generates Yang; extreme Yang generates Yin. Cold departs, Heat arrives; Heat departs, Cold arrives. Thus the pairing of You and Ming corresponds to the difference between Cold and Heat. This reiterates that Yang's movement begins with Warmth and peaks in Summerheat; Yin's movement begins with Coolness and peaks in Cold. The coming and going of the four seasons total belong to the two Qi of Yin-Yang and Cold-Heat.) The Emperor asked: How are Fen and Zhi (Equinoxes and Solstices)? Qibo replied: Qi arriving is called Zhi; Qi dividing is called Fen. At Zhi, Qi is the same; at Fen, Qi is different. This is called the regular record of Heaven and Earth. (Zhi refers to the Winter and Summer Solstices; Fen refers to the Spring and Autumn Equinoxes. This continues the previous text to reiterate that the warmth of spring becomes the heat of summer, and the severity of autumn becomes the anger of winter. It means at Zhi times, it totals the two Qi of Cold-Heat and Yin-Yang; at Fen times, there are differences in Warmth and Coolness.) The Emperor asked: The Master spoke of Spring and Autumn Qi starting from the front, and Winter and Summer Qi starting from the back. I already know this. However, the six Qi reciprocate, and the ruling Qi of the year is not constant. How should tonification and sedation be applied? Qibo replied: What is governed above and below follows its benefit. Rectify its flavor, and that is the key. The left and right follow the same method. The *Da Yao* states: The ruler of Shaoyang (Lesser Yang) prioritizes Sweet then Salty; the ruler of Yangming (Brightness Yang) prioritizes Pungent then Sour; the ruler of Taiyang (Greater Yang) prioritizes Salty then Bitter; the ruler of Jueyin (Terminal Yin) prioritizes Sour then Pungent; the ruler of Shaoyin (Lesser Yin) prioritizes Sweet then Salty; the ruler of Taiyin (Greater Yin) prioritizes Bitter then Sweet. Assist with what is beneficial, nourish with what generates. This is called obtaining Qi. (Spring and Autumn Qi starting from the front means Spring starts before the halfway point of the year, and Autumn starts before the second half. Winter and Summer Qi start after the two Qi, referring to the Main Qi of the four seasons. "Six Qi reciprocating, ruling Qi of the year not constant" refers to the Guest Qi superimposed, cycling through six periods without fixed position. This chapter discusses the Main Qi of the four seasons, communicating front and back, obtaining the quietness of Qi. If affected by Guest Overcoming and moved, and unable to proceed in order, severe diseases arise. Therefore, what is governed above and below, and the intermediate Qi on the left and right, should follow its benefit, rectify its flavor to regulate it, which is the key. The Great Essentials advocate sedation first then tonification, assisting the benefit of Main Qi and nourishing what Main Qi generates, thus obtaining the Qi of the four seasons, leading to generation and communication. In the previous chapter discussing Guest Qi tonification/sedation, tonifying first then sedating applies to the Root Qi of the Guest. Here, advocating sedation first then tonification applies to the Main Qi of the four seasons. The Seven Chapters of Annual Movement repeatedly discuss this by the Sages with utmost care. The text seems repetitive, but the meaning differs. Students should read repeatedly and not ignore it because it seems close.) The Emperor said: Good. All diseases arise from Wind, Cold, Summerheat, Dampness, Dryness, and Fire, through their transformation and variation. The Classics state: Sedate excess, Tonify deficiency. I bestowed this on physicians, but when they use it, it is not yet perfect. I wish for the essential Way to be practiced, responding like drum and stick, like removing thorns or melting snow. Can the skill of master physicians be heard? (All diseases originate from Wind, Rain, Cold, Heat, Yin-Yang, Joy/Anger, Diet, Dwelling, Great Fright/Sudden Fear, causing separation of Blood and Qi, and dispersion of Yin-Yang. The above seven chapters uniformly discuss pathogens of Five Movements and Six Qi, all external infections of Heaven and Earth Qi causing disease. However, within the human body, there are also Five Elements and Six Qi. Sudden outbursts of Joy/Anger, improper dwelling, irregular diet, or sudden fright/fear can all damage the Qi of the Five Zang organs and cause disease. Thus, although the Classic bestows this on physicians, their use is not yet perfect. The Essential Way refers to the Way of Heaven, Earth, and Man (Three Powers). "Responding like drum and stick" means the Five Elements and Six Qi of Heaven, Earth, and Man resonate like sound and echo. "Removing thorns" means pathogens of Heaven and Earth Yin-Yang are like thorns entering from outside, suitable for removal. "Melting snow" means internal pathological mechanisms are made to emerge like sweat or melt like snow. Using the Way of Three Powers together, and applying External/Internal Yin-Yang methods together, achieves the wonder of master physicians. The Way of Heaven, regarding Sheng-Fu actions, does not manifest in pulse diagnosis but relies on Observation and Listening; Internal cause diseases rely more on Inquiry and Palpation.) Qibo said: Examine the Pathogenesis carefully, do not lose the suitability of Qi. This is what is meant. (Pathogenesis is rooted internally and manifests externally. Suitability of Qi means each of the Five Zang and Five Elements Qi has its own suitability.) The Emperor said: I wish to hear about the Pathogenesis. Qibo said: All wind-induced tremors and dizziness belong to the Liver; all cold-induced contraction and pulling belong to the Kidney; all Qi-related depression and stagnation belong to the Lung; all dampness-induced swelling and fullness belong to the Spleen; all heat-induced blindness and convulsions belong to Fire; all pain, itching, and sores belong to the Heart. (The Five Zang internally correspond to the Five Elements, and the Five Internals generate the Six Qi. Thus, when the Qi of the Five Zang is diseased internally, the manifestations of the Six Qi appear externally.) All Jue (reversal/cold extremities), Bi (obstruction), and leakage belong to the Lower Jiao; all Wei (withering) asthma and vomiting belong to the Upper Jiao. (All Jue, Bi, and leakage belonging to the Lower Jiao means descending from above. All Wei, asthma, and vomiting belonging to the Upper Jiao means ascending from below. When Yang Qi above reverses downward, it becomes cold extremities; when Yin Qi below ascends upward, it becomes withering and numbness. When fluids above descend downward, they become obstruction and leakage; when fluids below ascend upward, they become asthma and vomiting. This is also like the Heaven and Earth Yin-Yang Qi interacting up and down, with water following the Qi's movement.) All locking, shivering, and trembling, as if losing spiritual control, belong to Fire; all spasms and neck stiffness belong to Dampness; all rebellious rushing upward belong to Fire; all distension and abdominal enlargement belong to Heat; all restlessness, mania, and running wild belong to Fire; all sudden rigidity and straightness belong to Wind; all diseases with sounds, drumming like a drum, belong to Heat; all diseases with swelling, pain, soreness, fright, and horror belong to Fire; all twisting and turning, with turbid body fluids, belong to Heat; all diseases with clear and cold body fluids belong to Cold; all vomiting and acid regurgitation, sudden diarrhea with tenesmus, belong to Heat. (This is the Qi of the Five Zang manifesting in form and Qi. Fire refers to the Minister Fire of Shaoyang Pericardium; Heat refers to the Qi of Sovereign Fire. All locking, shivering, and trembling result from extreme Heat generating Cold. Losing spiritual control means Minister Fire is excessive and Heart Spirit is unsettled. Wind refers to Wood and Fire Qi, both capable of generating Wind. "Fanli" refers to twisting.) Thus the *Da Yao* states: Carefully guard the Pathogenesis, each responsible for its category. Seek those that exist, seek those that do not. Blame excess, blame deficiency. First determine the Five Overcomings, unblock Blood and Qi, make them smooth and reaching, and achieve harmony. This is what is meant. (This states that the manifested Pathogenesis each belongs to the Five Zang and Five Elements. "Exist" means excess of Zang disease Qi; "Do not exist" means deficiency of Zang essence Qi. "Excess" blames it being too severe; "Deficiency" blames it being weak. E.g., excessive Fire-Heat should blame the lack of Water. Thus, one must first ensure the essence Qi of the Five Zang prevails, then unblock Blood and Qi, making them smooth and reaching, causing the Qi of the Five Zang to be peaceful. This is called divine work.) The Emperor said: Good. How are the uses of the Five Flavors and Yin-Yang? Qibo said: Pungent and Sweet dispersing and diffusing are Yang; Sour and Bitter inducing vomiting and purging are Yin; Salty flavor inducing vomiting and purging is Yin; Bland flavor渗泄 (percolating and draining) is Yang. These six either astringe or disperse, either relax or tense, either dry or moisten, either soften or harden. Act according to what is beneficial, regulate their Qi, and make them peaceful. (The use of Yin-Yang of the Five Flavors to regulate the Five Zang involves dispersing, diffusing, inducing vomiting, and purging. Among the six, either astringing or dispersing, relaxing or tensing, drying or moistening, softening or hardening. E.g., Liver suffers from tension and desires dispersing; Heart suffers from laxity and desires softening; Spleen suffers from Dampness and desires relaxation; Lung suffers from rebellion and desires astringing; Kidney suffers from dryness and desires hardening. Each acts according to its benefit, regulating the Qi of the Five Zang and making them peaceful.) The Emperor said: For those not obtained by regulating Qi, how to treat? Regarding toxic and non-toxic herbs, which comes first, which comes last? I wish to hear the Way. Qibo said: Toxic or non-toxic, the treated condition is primary; adjust the size accordingly. The Emperor said: Please speak of the system. Qibo said: One Sovereign, two Ministers, constitutes a small formula; one Sovereign, three Ministers, five assistants, constitutes a medium formula; one Sovereign, three Ministers, nine assistants, constitutes a large formula. (The Emperor said the above discussed regulating the Qi of the Five Zang to make them peaceful, but diseases of the Five Zang should also be treated with toxic and non-toxic herbs. Whether regulating or treating, which comes first? I wish to hear the Way. Qibo said: Based on the disease treated by toxic/non-toxic herbs, adjust the formula size. The herb mastering the disease is Sovereign; assisting the Sovereign is Minister; responding to the Minister is Envoy. For severe diseases, increase the dosage; for mild diseases, decrease the dosage. For those capable of tolerating toxicity, increase dosage; for those incapable, decrease dosage.) Treat Cold with Heat, treat Heat with Cold. For mild cases, oppose (Ni); for severe cases, follow (Cong). Harden by reducing, remove invaders. Warm laboring conditions, scatter knots. Attack retention, moisten dryness. Relax urgency, gather scattering. Warm depletion, promote leisure. Calm fright. Descend what is above, raise what is below. Massage and bathe. Press and劫 (force/expel). Open and diffuse. Adapt to the matter as the goal. (Warm refers to tonification. Tonifying herbs are mostly Sweet-Warm; purging herbs are mostly Bitter-Cold. Massage refers to ancient use of ointment massage to induce sweating; bathing refers to soaking in decoctions. "Bo" means pressing/forcing. These are all essential methods of treatment, each adapted to the situation.) The Emperor asked: What is Ni and Cong? Qibo said: Ni is Zheng (Orthodox) treatment; Cong is Fan (Reverse) treatment. Follow less or follow more, observe the case. (Ni, treating Heat with Cold and Cold with Heat, is Orthodox treatment. Cong, treating Heat disease with Heat and Cold disease with Cold, is Reverse treatment. Mild cases are opposed; severe cases are followed. If the disease is extremely severe, follow more; if not too severe, follow less. Observe how the treatment proceeds.) The Emperor asked: What is Fan treatment? Qibo said: Use Heat due to Cold usage, use Cold due to Heat usage. Use blockage for blockage, use patentting for patentting. Must subdue what dominates, and address the cause first. Initially they are the same, finally they differ. Can break accumulations, can dissolve hardness, can harmonize Qi, can ensure cure. (Use Heat due to Cold usage, use Cold due to Heat usage: Treating Heat with Cold, administered warm; treating Cold with Heat, administered cool. Initially same, finally different. Use blockage for blockage, use patentting for patentting: E.g., vomiting and acid regurgitation, where Heat pathogen firmly accumulates in the middle and blocks above, follow it to induce upward vomiting, called "use blockage for blockage," thereby breaking accumulations. E.g., sudden diarrhea with tenesmus, where Heat pathogen firmly accumulates in the middle and drains downward, follow it to induce downward drainage, called "use patentting for patentting.")