汤液醪醴，作自上古，备而弗服。中古之世，服之万全。当今之世，虽有汤醪，不能已病，故有病起于极
微，而即不可治者，有病于五脏，而疏涤以愈者。时世不同，治病亦异。所以追维上古，而重上古之全神也。
黄帝问曰∶为五谷汤液及醪醴，奈何？
上编移精变气论曰，汤液十日，以去八风五痹之病。帝承上编之意。问上古为五谷汤液以及醪醴，其
义奈何∶
岐伯对曰，必以稻米，炊之稻薪，稻米者完，稻薪者坚。
汤液醪醴，黍、稷、稻、麦、豆，皆可为之。而秋成之稻壳尤
佳，故必以稻米，炊之即以稻薪。盖稻米者，其质完备，稻薪者，其质坚劲也。
帝曰∶何以然？
稻米何以完？稻薪何以坚？
岐伯曰∶此得天地之和，高下之宜，故能至完，伐取得时，故能至坚也。
《六元正纪大论》云，岁半之前，天气主之；岁半之后，地气主之。稻米夏长秋成，此得天地之和。
天体至高，地体至下，得天地之和，便得高下之宜。故稻米之质，能至完也。稻薪深秋而刈，
色白似金，其时天气收，地气肃，伐取得时，故稻薪之质，能至坚也。
帝曰∶上古圣人，作汤液醪醴，为而不用，何也？
汤液醪醴，古圣作之，为而不用，其故何也？
岐伯曰∶自古圣人之作汤液醪醴者，以为备耳。夫上古作汤液，故为而弗服也。中古之世，
道德稍衰，邪气时至，服之万全。
古圣作汤液醪醴，以备不虞。夫上古之世，恬 虚无，真气从之，故为而弗服也。中古之世，道德
稍衰，真气不从，邪气时至，故汤液醪醴，有病服之，可以万全。
帝曰∶今之世，不必已，何也？
服之万全，其病必已。当今之世，服汤液醪醴，病不必已，其故何也。
岐伯曰∶当今之世，必齐毒药攻其中， 石针艾治其外也。
当今之世，忧患缘其内，苦形伤其外，故必齐毒药攻其中， 石针艾治其外，但用汤液醪醴无裨也。
帝曰∶形敝血尽，而功不立者何？
汤液、醪醴、毒药、针艾，并用而病不愈，直至形敝血尽，而功不立者何？
岐伯曰∶神不使也。
使，去声，下同。人之一身，神气游行，内外传使，功不立
者，神不使也。
帝曰∶何谓神不使？
神气在内，何谓不使？
岐伯曰∶针石道也，精神不进，志意不治，故病不可愈。
针石之为道也，工之精神，与病之精神，工之志意，与病之志意，两相合也。今工之精神不进，志
意不治，工与病违，故病不可愈。此工失其神，不相使也。
今精坏神去，荣卫不可复收，何者？嗜欲无穷，而忧患不止，
精气弛坏，荣泣卫除，故神去之，而病不愈也。
泣，作涩。今时之人，精坏神去，则荣卫不可复收。何以精坏神去，盖嗜欲无穷，而忧患不止也。
夫嗜欲无穷，则精气弛坏，忧患不止，则荣涩卫除。精气弛坏，荣涩卫除，故神去之，而病不愈
也。此病失其神，不相使也。此一节，言汤液醪醴不能治病者，神去而不相使也。所以今时不得同于中古，
而大远于上古也。
帝曰∶夫病之始生也，极微极精，必先入结于皮肤，今良工皆称曰病成，名曰逆。则针石不能
治，良药不能及也。今良工皆得其法，守其数，亲戚兄弟远近，音声日闻于耳，五色日见于目，而病
不愈者，亦何暇不早乎？
病至不愈，病形已成，若夫病之始生也。起于极微极精，微犹轻也，精犹细也。必先入结于皮肤
之毫毛，今良工治之，皆称曰病成，名之曰逆。则虽针石不能为治，则虽良药不能相及也。且今之
良工，皆得其治病之法，守其常变之数，病者非亲戚则兄弟。亲戚兄弟或相疏而远，或相亲而近，其音声
可以日闻于耳，五色可以日见于目，而病至不愈者，亦何其闲暇之甚，而不早为之计，以至病成而逆乎。
岐伯曰∶病为本，工为标，标本不得，邪气不服，此之谓也。
病之始生，虽起于微，然有可治者；有不可治者，人身有病，则病为本，医工治之，则工为标。
标本相得，则病可愈。标本不得，邪气则不服。邪气不服，是以不愈。即此始结皮肤，而病不愈
之谓也。所以申明病虽始生，治之而不愈也。
帝曰∶其有不从毫毛而生，五脏阳已竭也。津液充郭，其魄独居，精孤于内，气耗于外，形不可
与衣相保，此四极急而动中，是气拒于内，而形弛于外，治之奈何？
郭，廓同。廓，空廓。四极，即四肢。急，胀急也。病生皮肤，即不能治，其有不从毫毛而生，则
五脏之阳已竭也。津液充塞于空廓之间，为凝聚胀满之病。肺藏魄，为五脏之长，通调水道，
下输四布，其魄独居，不能下输四布矣。肺主气，肾藏精，精气相交，今精孤于内，气耗于外，水天上下，
不相通矣。形不可与衣相保者，形体浮肿不可与衣相为保合也，形不保衣，此四肢所以胀急，而喘动于中，
是水气拒格于内，形体废弛于外，内外相失，阴阳不和，治之奈何？
岐伯曰∶平治于权衡，去宛陈 ，微动器极，温衣，缪刺其处，以复其形。开鬼门，洁净
府，精以时服。五阳已布，疏涤五脏，故精自生，形自盛，骨肉相保，巨气乃平。
缪，平声，余篇仿此。权，秤锤也。衡，平也。腐秽充塞，五脏不和，故当平治于权衡。如秤物而得其
平也。宛，积也。陈，久也。 ，腐也。去宛陈 ，谓津液充廓，则去其积久之腐秽，以平之也。微动四极
，乃助其阳热之气，使四肢温和，而微动也。谓四极急而动中，则微动，四极以和之也。温衣，缪
刺其处，以复其形，乃温浓其衣，左右交刺，以复其自然之形体也。谓形不与衣相保，则温衣缪刺以复
其形也。开鬼门，乃开发毛腠而汗出也。洁净府，乃小便利而中渎之府清洁也。谓其魄独居，则开鬼门、
洁净府，使肺魄外达于皮毛，下通于净府也。精以时服，五阳已布，乃肺气通调，则肾脏之精亦以时服。
不致孤精于内，气耗于外矣，肺气通调，则五脏之阳亦已输布，不致五脏之阳已竭矣。凡此施治，所以
疏涤五脏也。五脏疏涤，则正气来复，故精自生，形自盛，骨肉相保，而巨气乃平，始之气拒于内，而形
弛于外者，至此则内外安和，形气调摄矣，所以申明病干五脏，治之而可愈也。
帝曰∶善。
病生皮肤，标本不得，即不能治。病干五脏，平其权衡，犹为可治，轻重死生，神变莫测，故帝曰善。
此一节言暮世之病，与古不同，精神志意无所施也。
Jiangji (fermented grain beverages), prepared since ancient times, were kept in reserve but not consumed. In the middle antiquity, consuming them ensured complete efficacy. In the present age, even with Jiangji, diseases cannot be cured. Thus, some diseases arise from extremely subtle causes and become incurable immediately; others originate in the Zang organs and are healed by purging and cleansing. Times differ, so treatments differ. Therefore, we trace back to ancient times to emphasize preserving the complete Shen (Spirit) of antiquity.
The Yellow Emperor asked: How should Tangye (grain decoctions) and Jiangji be prepared?
In the previous chapter "Yi Jing Bian Qi Lun" (Discourse on Shifting Spirit and Transforming Qi), it is stated that Tangye boiled for ten days can eliminate diseases caused by the Eight Winds and Five Bi syndromes. The Yellow Emperor, following the intent of the previous chapter, asks about the rationale behind preparing Tangye and Jiangji from the five grains in ancient times.
Qibo replied: One must use rice grains and burn rice straw as fuel. Rice grains possess a complete nature, and rice straw possesses a firm nature.
Tangye and Jiangji can be made from millet, foxtail millet, rice, wheat, and beans. However, rice husks harvested in autumn are particularly excellent, hence one must use rice grains and burn rice straw. This is because rice grains have a complete substance, and rice straw has a firm and tough substance.
The Yellow Emperor asked: Why is this?
Why are rice grains complete? Why is rice straw firm?
Qibo said: This is because they obtain the harmony of Heaven and Earth and the suitability of high and low positions, thus achieving completeness. They are harvested at the proper time, thus achieving firmness.
"Liu Yuan Zheng Ji Da Lun" states: In the first half of the year, Heavenly Qi dominates; in the second half, Earthly Qi dominates. Rice grows in summer and matures in autumn, obtaining the harmony of Heaven and Earth. Heaven is highest, Earth is lowest; obtaining the harmony of Heaven and Earth means obtaining the suitability of high and low. Thus, the nature of rice grains achieves completeness. Rice straw is cut in late autumn, white like metal; at this time, Heavenly Qi contracts and Earthly Qi肃 (solemnizes). Harvested at the proper time, the nature of rice straw achieves firmness.
The Yellow Emperor asked: Why did the sages of ancient times prepare Tangye and Jiangji but not use them?
The sages of old prepared Tangye and Jiangji but did not use them. What is the reason?
Qibo said: Since ancient times, the sages prepared Tangye and Jiangji merely as a precaution. In ancient times, people were tranquil and empty of desires, their True Qi followed naturally, so they prepared them but did not consume them. In the middle antiquity, virtue declined slightly, pathogenic factors frequently occurred, and consuming them ensured complete efficacy.
The ancient sages prepared Tangye and Jiangji to guard against unforeseen circumstances. In ancient times, minds were tranquil and void, True Qi followed suit, so they prepared them but did not consume them. In the middle antiquity, virtue declined slightly, True Qi did not follow, and pathogenic factors frequently invaded, so Tangye and Jiangji could be used when ill to ensure complete efficacy.
The Yellow Emperor asked: In the present age, why does consumption not necessarily cure the disease?
If consumed, the disease must be cured. In the present age, consuming Tangye and Jiangji does not necessarily cure the disease. Why?
Qibo said: In the present age, one must use medicinal drugs to attack internally, and use bian stones, needles, and moxibustion to treat externally.
In the present age, worries and anxieties entangle the interior, and physical hardship damages the exterior. Therefore, one must use medicinal drugs to attack internally and bian stones, needles, and moxibustion to treat externally; using only Tangye and Jiangji is of no benefit.
The Yellow Emperor asked: Why is there no therapeutic effect when the form is exhausted and blood is depleted?
Even when Tangye, Jiangji, medicinal drugs, needles, and moxibustion are all used, if the disease is not cured, until the form is ruined and blood is exhausted, why is there no therapeutic effect?
Qibo said: Because the Shen (Spirit) no longer responds or functions.
"Shi" is pronounced with the departing tone, same as below. In the human body, Shen Qi circulates and transmits commands internally and externally. The lack of therapeutic effect is due to the Shen not functioning.
The Yellow Emperor asked: What is meant by "the Shen not functioning"?
The Shen Qi is within; what does it mean that it does not function?
Qibo said: The way of needles and stones relies on the alignment of spirits. If the patient's spirit does not advance and their will is not regulated, the disease cannot be cured.
The method of needles and stones requires the practitioner's spirit and will to align with the patient's spirit and will. Now, the practitioner's spirit does not enter the patient's state, and their will does not regulate the patient's condition; the practitioner and patient are discordant, so the disease cannot be cured. This is because the practitioner has lost their Shen and cannot interact effectively.
Now, essence is damaged and Shen departs, making Ying (Nutritive) and Wei (Defensive) Qi irrecoverable. Why? Because desires are endless, and worries are unceasing. Essence becomes lax and damaged, Ying Qi becomes stagnant, and Wei Qi dissipates. Thus, Shen departs, and the disease is not cured.
"Qi" here acts as "Se" (stagnant). People today have damaged essence and departed Shen, making Ying and Wei Qi irrecoverable. Why is essence damaged and Shen departed? Because desires are endless, and worries are unceasing.
Endless desires cause essence to become lax and damaged; unceasing worries cause Ying Qi to stagnate and Wei Qi to dissipate. With damaged essence and stagnant/dissipated Ying-Wei Qi, Shen departs, and the disease is not cured. This is because the patient has lost their Shen and cannot interact effectively. This section explains that Tangye and Jiangji cannot cure diseases because Shen has departed and does not respond. Hence, people today cannot be equated with those of the middle antiquity, nor with the ancient times.
The Yellow Emperor asked: When a disease first arises, it is extremely subtle and fine, initially binding in the skin and hair. Now, skilled physicians call it "disease established" or "adverse." Then needles and stones cannot treat it, and good medicines cannot reach it. Skilled physicians today master the methods and observe the patterns. Relatives and brothers, near or far, hear their voices daily and see their complexions daily. Yet, if the disease is not cured, why do they not plan early enough to avoid it becoming established and adverse?
When the disease is uncured, its form is established. Regarding the initial onset, it arises from extreme subtlety and fineness ("wei" implies lightness, "jing" implies minuteness). It initially binds in the skin and hair follicles. Now, skilled physicians treat it, calling it "disease established" and naming it "adverse." Thus, even needles and stones cannot treat it, and even good medicines cannot reach it. Moreover, skilled physicians today master treatment methods and observe variations. Patients are relatives or brothers. Some relatives are distant, some close; their voices are heard daily, and complexions seen daily. Yet, if the disease remains uncured, why are they so leisurely as not to plan early, allowing the disease to become established and adverse?
Qibo said: The disease is the root (Ben), and the physician is the branch (Biao). If the root and branch do not match, pathogenic Qi cannot be subdued. This is what is meant.
Although the disease begins subtly, some are curable, some are not. When the body has a disease, the disease is the Ben; when the physician treats it, the physician is the Biao. If Ben and Biao match, the disease can be cured. If they do not match, pathogenic Qi is not subdued. Because pathogenic Qi is not subdued, the disease is not cured. This refers to the initial binding in the skin where the disease is not cured. Thus, it clarifies that even though the disease just began, treatment may fail.
The Yellow Emperor asked: There are diseases not arising from the hair and skin, where the Yang Qi of the Zang organs is already exhausted. Fluids fill the cavities, Po (Lung Spirit) resides alone, Jing (Essence) is isolated internally, Qi is depleted externally, the form is too swollen to fit clothes. This causes distension in the four limbs and internal movement/wheezing. Qi is rejected internally, and the form is flaccid externally. How should this be treated?
"Guo" is synonymous with "Kuo" (cavity/hollow). "Si Ji" refers to the four limbs. "Ji" refers to distension/tightness. If a disease arising in the skin is untreatable, it means the Yang Qi of the five Zang organs is exhausted. Fluids fill the cavities, causing condensation and distension. The Lung stores Po and is the leader of the five Zang organs, regulating water passages and distributing downwards. Now, Po resides alone, unable to distribute downwards. The Lung governs Qi, the Kidney stores Jing. Jing and Qi should interact. Now, Jing is isolated internally, and Qi is depleted externally; Water and Heaven (Qi) do not communicate. The form cannot fit clothes indicates severe edema. This distension in the limbs and internal wheezing is due to Water Qi rejecting internally and the form being flaccid externally. Interior and exterior are disconnected, Yin and Yang are disharmonious. How should this be treated?
Qibo said: Balance and weigh appropriately, remove accumulated stale pathogens, gently move the limbs to exertion, wear warm clothing, and use Miu Ci (lateral needling) at the affected areas to restore the form. Open the Ghost Gates (sweat pores), cleanse the Net House (bladder), and allow Jing to function regularly. Once the five Yang Qi are distributed, dredge and cleanse the five Zang organs. Thus, Jing generates spontaneously, the form becomes robust, bone and flesh protect each other, and the Great Qi becomes peaceful.
"Miu" is pronounced with the level tone, similar in other chapters. "Quan" is the weight, "Heng" is balance. With foul turbidity blocking and five Zang organs disharmonious, one must balance and weigh appropriately, like weighing objects to find balance. "Wan" means accumulation, "Chen" means long-standing, "Chen" (distension) means decay. Removing Wan-Chen-Chen means removing long-standing stagnant fluids and decay to restore balance. Gently moving the four limbs aids Yang-heat Qi, warming the limbs and inducing slight movement. For distended limbs and internal wheezing, gentle movement harmonizes them. Wearing warm clothing and using lateral needling restores the natural form. For forms that do not fit clothes, warm clothing and lateral needling restore the form. Opening Ghost Gates means inducing sweating through opening hair follicles. Cleansing the Net House means promoting urination to clean the lower jiao. For Po residing alone, opening Ghost Gates and cleansing the Net House allows Lung Po to reach the skin externally and flow to the bladder internally. Jing functions regularly once the five Yang Qi are distributed, meaning Lung Qi regulates, and Kidney Jing functions regularly, preventing isolation of Jing and depletion of Qi. Lung regulation distributes Yang Qi of the five Zang organs, preventing exhaustion. These treatments dredge and cleanse the five Zang organs. Once cleansed, Righteous Qi returns, Jing generates spontaneously, the form becomes robust, bone and flesh protect each other, and Great Qi becomes peaceful. The initial rejection of Qi internally and flaccidity externally are resolved into interior-exterior harmony and form-Qi regulation. Thus, it clarifies that diseases affecting the five Zang organs can be cured.
The Yellow Emperor said: Excellent.
Diseases arising in the skin, if Ben and Biao do not match, are untreatable. Diseases affecting the five Zang organs, if balanced and weighed, are still treatable. The severity, life and death, and spiritual transformations are unfathomable. Thus, the Yellow Emperor said "Excellent." This section discusses diseases of the late era differing from antiquity, where Spirit and Will have no place to function.