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When the Qi of Shaoyin (Lesser Yang) fails to retire on time, if the Si Tian (Heavenly Qi) above is lost and the Di Zhi (Earthly Branch) below is also lost. Moreover, Yi and Geng cannot harmonize their virtues; specifically, the lower Yi Wei year fails to migrate to its proper position, meaning the Yin (soft) stem loses the support of the Yang (firm) stem, which is also a slight deficiency in Metal Qi. A slight deficiency leads to a slight excess, and after the slight excess, there may be no retaliatory Qi. Three years later, it transforms into a Plague Qi called Jin Li (Metal Plague), with symptoms similar to Metal Epidemic, treated as described in the previous chapter.

Suppose it is a Ren Wu Yang year with excessive Qi. If the preceding Xin Si year had surplus days (meaning the previous year's Ke Qi did not retreat), although the Ren Wu year has entered, Jueyin Wind Wood still governs the Si Tian. The Earth Qi has already migrated to its proper position, with Yangming Dry Metal in Quan (Earth). Last year, Bing Shen Shaoyang Ministerial Fire served as the Right Intercalary Qi, resulting in Heaven being Jueyin and Earth being Yangming, thus Earth does not obey Heaven. Ding and Xin meet, causing Wood Qi to be excessively deficient, thereby suffering from Metal's control, so it is not excessive. At this time, the Rubin pipe (corresponding to the 5th month) does not resonate with the Taijiao tone; Metal's dryness prevails, and Fire's heat retaliates. Severe cases manifest quickly, mild cases slowly. The severity and nature of the epidemic are determined by calculating the days of the year when the epidemic arrives and the position of Taiyi. Similarly, in the Ren Wu year, which should govern according to the exchange, if the lower Ding You year fails to migrate, meaning the lower Bing Shen Shaoyang Qi has not retired, we see that Ding and Ren do not harmonize. Ding, as a soft stem, loses firmness, indicating a slight deficiency in Wood Qi, with slight excess and retaliation. Three years later, it transforms into a Plague Qi called Mu Li (Wood Plague), resembling Wind Epidemic, treated as before.

In the Ren Wu year, Yang Qi is excessive. If the preceding Xin Si year had surplus days, even though the Ren Wu year has begun, the Jueyin Wind Wood of Xin Si still governs Si Tian, representing a loss of Si Tian Qi. In the Wu year, Shaoyin君Fire governs Si Tian, and Yangming Dry Metal should be in Quan. If Earth Qi has migrated, Yangming is in Quan. Last year, Bing Shen Shaoyang was in Quan, serving as the Right Intercalary Qi this year. Heaven is last year's Jueyin, Earth is this year's Yangming. Yangming Metal Qi punishes Wood Qi upwards, so Earth does not serve Heaven. Last year's Xin Si had not yet retired; Ding and Ren govern Wood, so Ding and Xin meet. Ding is Yin, so Wood Qi is excessively deficient, suffering from Metal's control due to Wood's deficiency and Metal's excess, hence not excessive. This discusses Ding in relation to Ren. Ren governs Wood Qi, called Taijiao. Loss of Si Tian causes the Taijiao tone in the Rubin pipe to fail to resonate. Wood loses control and falls short, allowing Metal's dryness to prevail. When Wood Qi returns to its proper position, Wood generates Fire, and Fire's heat retaliates to overcome Metal. Severe victory leads to rapid onset; mild victory leads to slow onset. The arrival of the epidemic depends on these factors. The severity and nature are known by推算 (calculating) the days of the year of arrival and Taiyi. Again, in the Ren Wu year, Ren reaches Wu, and they should govern together. Ren and Ding combine for Wood Qi; Shaoyin Wu is above, Yangming You is below. Extending this, the lower Ding You year fails to migrate, meaning the lower Bing Shen Shaoyang has not retired. Above, Ren fails to migrate; below, Ding fails to migrate, showing Ding and Ren do not harmonize. Ding, a soft stem, loses firmness (failure to migrate), indicating a slight deficiency in Wood Qi. With slight deficiency comes slight excess and retaliation. Three years later, it becomes Mu Li (Wood Plague), like Wind Epidemic, treated as before.

Suppose it is a Wu Shen Yang year with excessive Qi. If the Ding Wei year had excessive days, although the Wu Shen year has entered, Taiyin Wet Earth still governs Si Tian. Earth Qi has migrated, with Jueyin Wind Wood in Quan. Last year, Ren Xu Taiyang Cold Water retired to become the Right Intercalary Qi. Heaven is Ding Wei, Earth is Gui Hai, so Earth does not obey Heaven's transformation. Ding and Gui meet, causing Fire Qi to be excessively deficient, suffering from Water's control, so it is not excessive. The Yize pipe's Shang Taiwei tone does not resonate. This is Wu and Gui losing their meeting. Three years later, an epidemic transforms, arriving quickly in Geng Xu. The severity and nature are determined by the days of the year of arrival and Taiyi. Similarly, in the Wu Shen year, Wu reaches Shen, and they should govern Heaven. The lower Gui Hai year fails to migrate, meaning the lower Ren Xu Taiyang has not retired, showing Wu and Gui do not harmonize. The lower Gui, a soft stem, loses firmness, showing a slight deficiency in Fire Qi, with slight excess or no retaliation. Three years later, it becomes Huo Li (Fire Plague), treated as before, using methods to block and drain.

In the Wu Shen year, Yang Qi is excessive. If the preceding Ding Wei year had excessive days, although the Wu Shen year has entered, last year's Ding Wei Taiyin Wet Earth still governs Si Tian, a loss of Si Tian Qi. In the Shen year, Shaoyang Ministerial Fire governs Si Tian, and Jueyin Wind Wood should be on Earth. If Earth Qi has migrated, Jueyin is in Quan. Last year, Ren Xu Taiyang was in Quan, retiring this year to become the Right Intercalary Qi. Heaven is last year's Ding Wei Taiyin, Earth is Gui Hai Jueyin. Jueyin Wood Qi overcomes Earth's Soil, so Earth does not obey Heaven. Wu and Gui both relate to Fire Qi. Last year's Ding Wei retired, so Ding and Gui meet. Gui's Fire Qi is excessively deficient, suffering from Water's control due to Fire's deficiency and Water's excess, hence not excessive. This discusses Gui in relation to Wu. Wu governs Fire Qi, called Taiwei. Loss of Si Tian causes the Taiwei tone in the Yize pipe to fail to resonate. This is Wu and Gui losing their meeting. Three years later, an epidemic transforms, connecting to Geng Xu. Wu Shen, Ji You, Geng Xu span three years. The severity and nature of the epidemic are known by the year of arrival, days, and Taiyi. Similarly, in Wu Shen, Wu Fire Qi is central, Shen Shaoyang governs Si Tian. Wu reaches Shen, governing Heaven. Wu and Gui combine; Shaoyang is above, Jueyin Hai is below. The lower Jueyin fails to migrate, meaning the lower Ren Xu Taiyang has not retired. Above, Wu fails to migrate; below, Gui fails to migrate, showing Wu and Gui do not harmonize. The lower Gui, a soft stem, loses firmness and fails to migrate, showing a slight deficiency in Fire Qi. Slight deficiency brings slight excess, or no retaliation. Three years later, it becomes Huo Li (Fire Plague), treated as before. It is said that treatment can involve cooling and draining, clarifying that cooling and draining methods treat Fire Plague. Extending this, Earth, Metal, Water, and Wood can also be treated similarly, not just as in the previous chapter. This section clarifies the meaning of the previous chapter regarding the loss of Gang and Rou stems and the transformation into epidemics after three years.

Yellow Emperor said: When human Qi is insufficient and Heavenly Qi is empty, and Human Spirit loses its guard, with Spiritual Light not gathering, evil ghosts invade people, causing sudden death. Can you explain this?
The Emperor asked based on the concept of "Three Deficiencies" from the previous chapter.

Qibo said: When one of the five Zang organs is deficient, and it coincides with Heavenly deficiency, pathogenic Qi invades.
Organ deficiency is the first deficiency; Heavenly deficiency is the second; contracting pathogenic Qi is the third. As described below.

Worry and overthinking damage the Heart. If Shaoyin governs Si Tian and Heavenly days are insufficient, Taiyin acts as the intercalary Qi, this is called Heavenly deficiency. This is simultaneous deficiency of Human and Heavenly Qi. If startled, essence is stolen, sweat issues from the Heart, forming three deficiencies. The Spirit and Ming lose their guard. The Heart is the Monarch Official, where Spirit and Ming originate. If Spirit loses its position, it wanders to the Upper Dantian, under the Emperor Taiyi in the Newan Palace. With Spirit lost and Spiritual Light not gathering, if encountering a year of Fire deficiency, Black Corpse Ghosts appear, causing sudden death.
After Zi-Wu years, Chou-Wei follow. Thus, Zi-Wu Shaoyin lacks days, and Chou-Wei Taiyin acts as intercalary Qi. Similarly for lower Shaoyang and Shaoyin acting as intercalary Qi. Human and Heavenly Qi are deficient. If startled, essence is stolen, sweat from Heart, this is three deficiencies. Heart is Fire organ; Black Corpse Ghosts appearing means Water controls Fire. These three deficiencies combined cause sudden death.

Diet and fatigue damage the Spleen. If Taiyin governs Si Tian and Heavenly days are insufficient, Shaoyang acts as intercalary Qi, this is called deficiency. This is deficiency of both Human and Heavenly Qi. If eating too much, sweat issues from Stomach; drinking and having sex while full, sweat issues from Spleen, forming three deficiencies. Spleen Spirit loses guard. Spleen is the Advisory Official, where Wisdom originates. With Spirit lost and Spiritual Light scattered, if encountering a year of Earth deficiency, or Ji year, or Jia year loss, or Taiyin Heavenly deficiency, Green Corpse Ghosts appear, causing sudden death.
Spleen and Stomach are connected by membrane, so discussing Spleen includes Stomach.

Sitting long in damp places or forcing entry into water damages the Kidney. Kidney is the Official of Strength, where Skill originates. Forming three deficiencies, Kidney Spirit loses guard, Will loses position, Spiritual Light not gathering. If encountering a year of Water deficiency, or Xin year failing to match, or Bing year loss, or Taiyang Si Tian deficiency, Yellow Corpse Ghosts appear, causing sudden death.
Fu means match. Not matching Fu means not harmonizing, also implying loss of guard.

Anger rising upward and not descending damages the Liver. If Jueyin governs Si Tian and Heavenly days are insufficient, Shaoyin acts as intercalary Qi, this is Heavenly deficiency. This is Heavenly and Human deficiency. If running fast or fearing, sweat issues from Liver. Liver is the General Official, where Strategy originates. Spirit position lost, Spiritual Light not gathering. If encountering a year of Wood deficiency, or Ding year not matching, or Ren year loss, or Jueyin Si Tian deficiency, White Corpse Ghosts appear, causing sudden death.
Heart, Spleen, Stomach, Liver were discussed; Lung can be inferred by analogy.

These five losses of guard are Heavenly and Human deficiency, with Spirit wandering and losing its position. Five Corpse Ghosts invade people, causing sudden death, called Shi Jue (Corpse Coma). When humans disrupt the five Spirits' positions, Spiritual Light is not round. Not only Corpse Ghosts, but all pathogenic invasions are due to Spirit losing its guard. This means those who keep guard live, those who lose guard die; those who have Spirit prosper, those who lose Spirit perish.
This section clarifies the previous chapter's meaning on sudden death from three deficiencies and the necessity of the twelve Zang organs not losing each other.