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Those who lose their proper position (i.e., when it is not the time of their ruling Qi, yet they are overcome or insulted) cause their original position to become deficient and thus lose control. For example, in the first Qi phase, Jueyin Wind-Wood prevails. If Dryness-Metal Qi takes advantage of its inability to be overcome (Metal overcomes Wood) to insult it, then Metal loses its position. When Yangming Dryness-Metal becomes the ruling Qi, it cannot flourish on its own due to deficiency, leading to danger. "Danger" means being unable to stand independently.

If there is a reversal between the Cun (inch) and Chi (cubit) pulses (Cun-Chi Fan), death ensues.

If Shaoyin Ministerial Fire does not govern Qi transformation, in the Northern and Southern regimes of the Five Movements, the Qi of Si Tian (Heavenly Sovereign) and Zai Quan (Earthly Spring) should not manifest in the pulse. If it does respond, it deviates from the norm, hence death.

Yin-Yang Jiao (intermingling of Yin and Yang pathogenic factors) leads to death.
The *Ping Re Bing Lun* (Treatise on Evaluating Heat Diseases) states: "In cases of warm diseases, if sweating is followed immediately by recurrent fever, with a rapid and restless pulse that does not subside with sweat, accompanied by delirious speech and inability to eat, this disease is named 'Yin-Yang Jiao'. Intermingling implies death."

First, establish the year's stem-branch to know the Qi, observe the corresponding manifestations on the left and right, and only then can one discuss the favorable or unfavorable outcomes regarding life and death.
"Ying" (respond) is pronounced with the level tone.
This summarizes the preceding text regarding the superposition of Left and Right Intermediary Qi. One must first establish the year of the Main Qi to know the corresponding Left and Right movements of the Intermediary Qi, thereby enabling the discussion of life and death reversals.

The Yellow Emperor asked: How do Cold, Heat, Dryness, Dampness, Wind, and Fire combine with humans? How do they generate all things?
Heaven, Earth, humans, and all things possess the Six Qi of Cold, Heat, Dryness, Dampness, Wind, and Fire. Thus, the Emperor raised the question of how these Six Qi combine with humans and generate all things.

Qibo replied: The East generates Wind; Wind generates Wood; Wood generates Sour taste; Sour nourishes the Liver; Liver nourishes Sinews; Sinews nourish the Heart. In Heaven, it is profound (Xuan); in Humans, it is the Dao; on Earth, it is transformation (Hua). Transformation generates the Five Flavors; Dao generates Wisdom; Profoundness generates Spirit (Shen). Spirit manifests as Wind in Heaven, as Wood on Earth, as Sinews in the body, as Softness in Qi, and as the Liver in the Zang organs.
The following sections elaborate on the meaning that the Six Qi combine with the human body to generate all things. The text is identical to the *Yin Yang Ying Xiang Da Lun*, with explanations found in this chapter. Here, "generates Qi" refers to the Qi that generates the Five Flavors; "manifests as Softness in Qi" indicates that Wind-Wood Qi is soft and gentle.
Its nature is warm/noisy (Xuan); its virtue is harmony (He); its function is movement (Dong).
Warmth of the sun is called Xuan; in spring, the weather begins to warm, so its nature is Xuan. Yang Harmony begins to spread, so its virtue is He. With a nature of warmth and virtue of harmony, the mechanism of Qi rotates, so its function is movement.
Its color is Cang (bluish-green); its transformation is flourishing (Rong); its insects are Hairy ones (Mao).
That which is Cang is Heaven, referring to the color green. Its transformation is Rong, meaning things begin to grow. Its insects are Mao, representing the image of dense hair/fur.
Its governance is dispersal (San); its command is dissemination (Xuan Fa); its alteration is destruction/collapse (Cui La); its disaster is falling/collapsing (Yun).
San means spreading out. Its governance spreads out, so its command disseminates. Cui La means disintegration. Yun means collapsing. San denotes disaster. Its alteration is Cui La, so its disaster is Yun.
Its flavor is Sour; its emotion is Anger (Nu). Anger injures the Liver; Grief (Bei) overcomes Anger; Wind injures the Liver; Dryness overcomes Wind; Sour injures Sinews; Pungent (Xin) overcomes Sour.
Things that are straight or crooked produce Sour, so its flavor is Sour. The Liver's emotion tends toward Anger, so its emotion is Anger, and Anger injures the Liver. Grief belongs to Sorrow, which is the emotion of the Lung; Metal calms Wood, so Grief overcomes Anger. Wind Qi injures the Liver, but Dryness overcomes Wind; Sour flavor injures Sinews, but Pungent overcomes Sour. All these reflect the principle of Metal calming Wood.

The South generates Heat; Heat generates Fire; Fire generates Bitter taste; Bitter nourishes the Heart; Heart nourishes Blood; Blood nourishes the Spleen. In Heaven, it is Heat; on Earth, it is Fire; in the body, it is Vessels (Mai); in Qi, it is Respiration/Breath (Xi); in the Zang organs, it is the Heart.
Explanation seen in *Yin Yang Ying Xiang Da Lun*. Here, "manifests as Xi in Qi" refers to the breath of respiration, which is Yang Heat Qi.
Its nature is Summer Heat (Shu); its virtue is manifestation/clarity (Xian); its function is restlessness/agitation (Zao).
Hot summer days are called Shu; the South is Fire-Heat, so its nature is Shu. Fire Qi is prominent and clear, so its virtue is Xian. With a nature of heat and virtue of clarity, the Qi mechanism is swift, so its function is Zao.
Its color is Red (Chi); its transformation is lush/proliferation (Mao); its insects are Feathered ones (Yu).
Qi of the Vermilion Heaven has the color Red. Its transformation is Mao, meaning things are abundant. Its insects are Yu, representing the image of flying/movement.
Its governance is brightness/clarity (Ming); its command is stifling heat/steaming (Yu Zheng); its alteration is scorching fire (Yan Shuo); its disaster is burning/incineration (Fan Zhuo).
Ming is like Xian. Yu Zheng means intense heat. Its governance is Ming, so its command is intense heat. Yan Shuo means fiery heat. Fan Zhuo means extreme heat. Its alteration is Yan Shuo, so its disaster is Fan Zhuo.
Its flavor is Bitter; its emotion is Joy (Xi). Joy injures the Heart; Fear (Kong) overcomes Joy; Heat injures Qi; Cold overcomes Heat; Bitter injures Qi; Salty (Xian) overcomes Bitter.
Things that burn upward produce Bitter, so its flavor is Bitter. The Heart's emotion tends toward Joy, so its emotion is Joy, and Joy injures the Heart. Fear is the emotion of the Kidney; Water controls Fire, so Fear overcomes Joy. Heat injures Heart Qi, but Cold overcomes Heat; Bitter injures Heart Qi, but Salty overcomes Bitter. All these reflect the principle of Water controlling Fire.

The Center generates Dampness; Dampness generates Earth; Earth generates Sweet taste; Sweet nourishes the Spleen; Spleen nourishes Flesh (Rou); Flesh nourishes the Lung. In Heaven, it is Dampness; on Earth, it is Earth; in the body, it is Flesh; in Qi, it is fullness/plenitude (Chong); in the Zang organs, it is the Spleen.
Explanation seen in *Yin Yang Ying Xiang Da Lun*. Here, "manifests as Chong in Qi" means Earth Qi fills the four directions.
Its nature is quiet and inclusive (Jing Jian); its virtue is moistening/nourishing (Ru); its function is transformation (Hua).
Earth resides in the center and spreads outward. Residing in the center implies stillness; spreading outward implies inclusiveness, so its nature is Jing Jian. All things rely on it for nourishment, so its virtue is Ru. Being still, inclusive, and moistening allows for infinite generation, so its function is Hua.
Its color is Yellow; its transformation is abundance/plenitude (Ying); its insects are Naked ones (Luo).
The Qi of Heaven has the color Yellow. Its transformation is Ying, meaning things are filled. Its insects are Luo, representing the image of flesh-bodied animals.
Its governance is tranquility (Mi); its command is clouds and rain (Yun Yu); its alteration is pouring/heavy rain (Dong Zhu); its disaster is flooding/ulceration (Yin Kui).
Mi, pronounced Mi, same as in other chapters.
Mi means quiet. The earth's body is quiet, so its governance is Mi. Dampness rises to form clouds and rain, so its command is Yun Yu. Clouds move and rain falls, so its alteration is Dong Zhu. Continuous pouring leads to disasters of flooding and ulceration.
Its flavor is Sweet; its emotion is Pensiveness/Overthinking (Si). Pensiveness injures the Spleen; Anger overcomes Pensiveness; Dampness injures Flesh; Wind overcomes Dampness; Sweet injures the Spleen; Sour overcomes Sweet.
Crops sown and harvested produce Sweet, so its flavor is Sweet. The Spleen's emotion tends toward Pensiveness, so its emotion is Pensiveness, and Pensiveness injures the Spleen. Anger is the emotion of the Liver; Wood penalizes Earth, so Anger overcomes Pensiveness. Dampness injures Flesh, but Wind overcomes Dampness; Sweet flavor injures the Spleen, but Sour overcomes Sweet. All these reflect the principle of Wood penalizing Earth.

The West generates Dryness; Dryness generates Metal; Metal generates Pungent taste; Pungent nourishes the Lung; Lung nourishes Skin and Hair (Pi Mao); Skin and Hair nourish the Kidney. In Heaven, it is Dryness; on Earth, it is Metal; in the body, it is Skin and Hair; in Qi, it is completion/accomplishment (Cheng); in the Zang organs, it is the Lung.
Explanation seen in *Yin Yang Ying Xiang Da Lun*. "Manifests as Cheng in Qi" means perceiving Autumn Qi, all things achieve completion.
Its nature is Cool (Liang); its virtue is clear/pure (Qing); its function is consolidation/astringency (Gu).
Autumn Qi is balanced and calm, so its nature is Liang. The Qi mechanism converges, so its virtue is Qing. All things bear fruit/seeds, so its function is Gu.
Its color is White; its transformation is gathering/restraining (Lian); its insects are Armored ones (Jie).
Qi of the Plain Heaven has the color White. Its transformation is Lian, meaning things are gathered. Its insects are Jie, representing the image of metallic shells/carapaces.
Its governance is firm/sharp (Jin); its command is fog and dew (Wu Lu); its alteration is solemn killing/withering (Su Sha); its disaster is withering/falling leaves (Cang Luo).
Jin means firm and sharp; Metal substance is firm and sharp, so its governance is Jin. White Dew descends, so its command is Wu Lu.
Summer reaches its peak and Autumn begins to decline, so its alteration is Su Sha (solemn killing), causing all things to wither, hence its disaster is Cang Luo.
Its flavor is Pungent; its emotion is Sorrow/Worry (You). Sorrow injures the Lung; Joy overcomes Sorrow; Heat injures Skin and Hair; Cold overcomes Heat; Pungent injures Skin and Hair; Bitter overcomes Pungent.
Things that change/reform produce Pungent, so its flavor is Pungent. The Lung's emotion tends toward Sorrow, so its emotion is Sorrow, and Sorrow injures the Lung. Joy is the emotion of the Heart; Fire conquers Metal, so Joy overcomes Sorrow. Heat Qi injures Skin and Hair, but Cold overcomes Heat; Pungent flavor injures Skin and Hair, but Bitter overcomes Pungent. All these reflect the principle of Fire conquering Metal.
Note: In Spring, Wind injures the Liver; in Summer, Heat injures Qi; in Late Summer, Dampness injures Flesh; in Winter, Cold injures Blood. These are injuries caused by the primary Qi of the four seasons themselves. Here in Autumn, it says Heat injures Skin and Hair, which is an injury caused by the conquered Qi (Fire conquers Metal, Heat belongs to Fire). This shows that among the Five Zang organs, some are injured by the primary Qi of the four seasons, while others are injured by the conquering Guest Qi. By citing the differences in one Zang organ, one can infer the situation for all five.

The North generates Cold; Cold generates Water; Water generates Salty taste; Salty nourishes the Kidney; Kidney nourishes Marrow (Sui); Marrow nourishes the Liver. In Heaven, it is Cold; on Earth, it is Water; in the body, it is Bones; in Qi, it is hardness/firmness (Jian); in the Zang organs, it is the Kidney.
Explanation seen in *Yin Yang Ying Xiang Da Lun*. "Manifests as Jian in Qi" means perceiving Winter Qi, all things become solidified.
Its nature is biting cold/severe (Lin); its virtue is cold (Han); its function is holding firm/steadfastness (Cao).
Cao was originally missing, now supplemented.
Lin means severe. Winter Qi is severe and cold, so its nature is Lin. With a nature of Lin, its virtue is Han. With a nature of Lin and virtue of Han, its function is Cao. Cao means steadfastness.
Its color is Black; its transformation is solemnity/hiding (Su); its insects are Scaled ones (Lin).
Qi of the Dark Heaven has the color Black. Its transformation is Su, meaning things are hidden/stored. Its insects are Lin, representing aquatic creatures.
Its governance is stillness (Jing); its command is strict steadfastness (Yan Zhen); its alteration is freezing/biting cold (Ning Lie); its disaster is hail (Bing Bao).
Yan Zhen was originally missing, now supplemented. Bao, pronounced Bo, same as in other chapters.
Winter Qi is stable, so its governance is Jing. Severe cold and steadfastness, so its command is Yan Zhen. Ning Lie means extreme cold. Bing Bao represents the hardness of water. Its alteration is Ning Lie, so its disaster is Bing Bao.
Its flavor is Salty; its emotion is Fear (Kong). Fear injures the Kidney; Pensiveness overcomes Fear; Cold injures Blood; Dryness overcomes Cold; Salty injures Blood; Sweet overcomes Salty.
Things that moisten and flow downward produce Salty, so its flavor is Salty. The Kidney's emotion tends toward Fear, so its emotion is Fear, and Fear injures the Kidney. Pensiveness is the emotion of the Spleen; Earth overcomes Water, so Pensiveness overcomes Fear. Cold Water injures Yin Blood, but Earth Dryness overcomes Cold; Salty flavor injures Yin Blood, but Sweet flavor overcomes Salty. All these reflect the principle of Earth overcoming Water.

The Five Qi alternate in standing, each having its precedence. If not in its proper position, it is Evil Qi; if in its proper position, it is Correct Qi.
"Geng" is pronounced with the level tone.
Summarizing the above, the Qi of the Five Directions alternates through the four seasons: Spring Wind, Summer Heat, Autumn Dryness, Winter Cold, each having its prior arrival. Qi present outside its main position constitutes Evil Qi. Qi present within its main position constitutes Correct Qi.

The Yellow Emperor asked: How do diseases undergo changes?
Since Qi outside its position is Evil, he asks how disease changes occur.

Qibo replied: When Qi is compatible, the illness is mild; when incompatible, the illness is severe.
The Qi of the four seasons can all cause disease. If disease occurs with compatible Qi, the changes are mild. If disease occurs with incompatible Qi, the changes are severe.

The Yellow Emperor asked: What about the ruling Qi of the year (Excess and Deficiency)?
Since compatible Qi leads to mild illness and incompatible Qi to severe illness, and since the Qi of the four seasons can all cause disease, he asks about the excess and deficiency of the ruling Qi of the year.

Qibo replied: When Qi is in excess, it controls what it normally overcomes and insults what it cannot overcome. When Qi is deficient, what it cannot overcome insults and exploits it, and what it normally overcomes lightly insults it.
The alternating Five Qi are the ruling Qi of the times. The Five Movements in the middle are the ruling Qi of the year. For example, if Jia-Ji Earth Movement rules the year, and Earth Qi is in excess, it controls the Water Qi it normally overcomes and insults the Wood Qi it cannot overcome. If Earth Qi is deficient, the Wood Qi it cannot overcome insults and exploits it, and the Water Qi it normally overcomes also lightly insults it. Both excess and deficiency lead to disease; this applies to all Five Qi.

Being harmed by the very Qi one previously insulted happens because one lacked fear/respect initially.
Yearly Qi values balance; it should not be excessive nor deficient. Initially, one exploits and insults the other, but subsequently, one suffers harm from the insult. For instance, if Yearly Earth is in excess, it controls Water Qi, causing Earth to become deficient in its own position. When Chang Xia (Late Summer) Earth Qi rules, unable to flourish on its own, the son of Water (Wood) counter-controls Earth. This is "being harmed by the insult." It reiterates that suffering harm from insulting others stems from initially failing to respect one's position and lacking caution, applying to all Five Qi.

The Yellow Emperor said: Excellent.
When Qi is in excess and exploits/insults, it eventually suffers harm from the insult. If Qi is deficient and suffers insult, stagnation will eventually resolve. Therefore, the Emperor praised this explanation.