生气通天者，人身阴阳五行之气，生生不已，上通于天也。气为阳，主生。故帝论阳气内藏，则承上
卫外，可以上通于天。伯谓阳主外，阴主内。阳外，而复秘密；阴内，而能起亟，则精固于内，气立于外，
可以上通于天，长有天命，故名《生气通天论》。
黄帝曰∶夫自古通天昔，生之本，本于阴阳；天地之间，六合之内，其气九州，九窍、五脏、
十二节，皆通乎天气。
帝论人之生气，上通于天，追溯孕含未剖，太虚寥廓之时，故曰自古通天者，乃有生之本，本于人身
之阴阳。凡天地之间，六合之内，其地气之九州，人气之九窍、五脏、十二节，皆通乎天气，此
生气之所以通天也。六合，四方上下也。九州，冀、兖、青、徐、梁、荆、雍、豫、杨也。九窍，两目、
两耳、两鼻、口、前后阴也。五脏，肝、心、脾、肺、肾也。十二节，两手、两肘、两臂、
两足、两 、两髀，皆神气之游行出入也。
其生五，其气三，数犯此者，则邪气伤人，此寿命之本也。
数，音朔。凡人之生，各具五行，故其生五。五行之理，通贯三才，故其气三。人之一身，三才具备，
以人身三才之气，数犯此五行者，则木有风邪，火有热邪，土有湿邪，金有燥邪，水有寒
邪，故邪气伤人。邪气伤人，寿命不保，此生五气三，乃人身寿命之本也。
苍天之气，清净则志意治，顺之，则阳气固，虽有贼邪，弗能害也。此因时之序。故圣
人传精神，服天气而通神明，失之则内闭九窍，外壅肌肉，卫气散解，此谓自伤，气之削也。
散，上声。解，作懈。下同。清净者，苍天之气也。天气清净，则人之志意亦治，是天气之通于
人也。顺之者，顺此清净之气也。故顺之则阳气外固，虽有贼邪，弗能害也。所谓顺之者，此因
时之序，言因四时之次序而清净也。惟圣人能顺之，故圣人传精神。所谓传精神者，乃服天清净之气，而通
吾身之神明，若人不能顺而失之，则阳气不从内以达外，故内闭九窍，外雍肌肉，不从肌肉
而充皮肤，故卫气散解，此人不服天气，谓之自伤。阳气不固，故曰气之削也。
阳气者，若天与日，失其所。则折寿而不彰。
人身阳气，如天如日。盖营运通体之阳气，若天旋转。经脉之阳气，若日也。通体之气，经脉之气，各
有其所，若失其所，则营运者，不周于通体，施转者，不循于经脉，故短折其寿而不彰着于人世矣。
故天运当以日光明，是故阳因而上，卫外者也。
天气清净，明德惟藏。故天之默运于上也，当以日光明。是故人身之阳气，因之而上。阳因而上，
其体如天；卫外者也，其体如日，此阳气之若天与日也。
因于寒，欲如运枢，起居如惊，神气乃浮。
清净之气，天人之正气也。寒暑燥火湿风之气，天人之淫气也。若因于寒，则欲如运枢。运枢者，寒
邪卒至，则起居如惊，神气乃外浮以应之也。由是而知，因于寒，乃阳因而上也，欲如运枢，卫外者也。
因于暑，汗，烦则喘喝，静则多言；体若燔炭，汗出而散。
若因于暑，夏月皮毛开发，故汗；烦则喘喝，暑邪伤阳也。静则多言，暑邪伤阴也。若伤暑无汗，
则病燥火之气，故体若燔炭。燔炭，燥火也。故必汗出而散。言阴液出于皮毛，则暑邪燥火始散。
由是而知，因于暑，乃阳因而上也。汗出而散，卫外者也。
因于湿，首如裹，湿热不攘。大筋 短，小筋弛长， 短为拘，弛长为痿。
，软同，全篇仿此。若因于湿，湿气重着，故首如裹。阳热之气，逢湿则滞，故湿热不攘。不攘者，
不外拒于皮毛，不如因寒之乃浮，不如因暑之汗出也。湿伤肌肉，不从肌肉而外出，则内入
于筋骨之间，故大筋 弱而短，小筋弛纵而长。大筋连于骨内， 短，则屈而不伸，故 短为拘。拘，挛
也。小筋络于骨外，弛长则伸而不屈，故弛长为痿。痿，痿痹也。此阳因而上，湿热不攘，不能卫外者也。
因于气，为肿，四维相代，阳气乃竭。
气，犹风也。《阴阳应象大论》云∶阳之气，以天地之疾风名之，故不言风而言气。因于气为肿者，
风淫末疾，四肢肿也。四维相代者，四肢行动，不能彼此借力而相代也。四肢者，诸阳之本，
今四维相代，则阳气乃竭，此阳因而上，阳气竭，而不能卫外者也。
阳气者，烦劳则张，精绝，辟积于夏，使人煎厥，目盲不可以视，耳闭不可以听，溃溃乎若
坏都， 乎不可止。
，音骨，余篇同。阳气者，由内而外，根于阴精，如烦劳则阳气外张，阴精内绝，阴不交阳，故精
绝。辟积，重复也。辟积于夏者，冬时受病，病不能愈，重复时日，至于夏也，夏月火盛，内
亡其精，故使人煎厥。煎厥，如火之焚而热极也。精气不注于目，故目盲不可以视；精气不充于耳，故耳
闭不可以听。溃溃，乱貌，溃溃乎若坏都，言耳目昏乱，神失其守，若国都之败坏也。 ，
流貌， 乎不可止，言神气散驰，流而不返，不可挽回而止之也。此烦劳伤精，而神气内乱也。
阳气者，大怒则形气绝，而血菀于上，使人薄厥。有伤筋，纵，其若不容。
阳气者，自下而上，本于阴血，如大怒则逆气上形。形者，悻悻然见于其面也。气绝者，怒则气上
不接于下也。血随气行，气逆则血郁于上，气血皆逆，则使人薄厥。薄厥，虚极而厥逆也。血不
养筋，则有伤于筋，筋伤则纵。所谓纵者，转动不能，其若不容者然。此大怒气逆而血不荣筋也。
汗出偏沮，使人偏枯。汗出见湿，乃生痤痱。高梁之变，足生大疔，受如持虚。劳汗当
风，寒薄为 ，郁乃痤。
痤，坐，平声。高梁，即膏梁，余篇同。 ，音渣。沮，犹湿也。阳气内通精血，复从中土，而外出
于皮肤，故假汗出膏梁以明之。汗者，水谷之精，从内出外，若汗出偏沮，则气血不周于身，故使
人偏枯。若夏日汗出，而见水湿之气，则皮肤湿热生疖如痤，生疹如痱。若膏梁浓味，伤其中土，因膏梁而
变病，则足生大疔。受如持虚，言疔从内以出外，如持虚器而受毒也。若劳碌汗出而当风。
风，寒气也。故寒薄为 ，郁乃痤，言寒薄于皮肤而上行，则为 。 ，赤鼻也。寒郁于皮肤而外泄，则
为痤。痤，小疖也。此言阳气加阴乃为汗，从中土而外出于皮肤也。
阳气者，精则养神，柔则养筋。
精，精粹也。柔，柔和也。上文烦劳精绝至目盲耳闭，而神气散乱，故曰，阳气者，精则养神，所以
申明上文阳气不精而神无所养也。上文大怒气绝，至血菀而伤筋。故曰阳气者，柔则养筋，所以
申明上文，阳气不柔而筋无所养也。
开阖不得，寒气从之，乃生大偻。陷脉为 ，留连肉腠。俞气化薄，传为善畏，及为惊骇，荣气
不从，逆于肉理，乃生痈肿。魄汗未尽，形弱而气烁，穴俞以闭，发为风疟。
俞，音输，余篇同。上文假汗出膏梁，以明阳气从中土而出于皮肤，此假开阖，以明阳气由阖而开，
由开而阖，不但从内以出外也。开阖者，外内之枢机，开则外出，阖则内入；今开阖不得，则太
阳之寒气从之。背为阳，主开；腹为阴，主阖。开阖不得，寒气从之，则背突胸窝，乃生大偻。偻，伛偻也，
此言阳气之不能开阖也。陷脉为 ，留连肉腠，言寒邪陷于脉，则肉腠或空或突，而如嵝，留连肉腠而
难愈也。俞气化薄，言寒邪入于穴俞，则俞气变化而内薄。薄，泊也。传为善畏，及为惊骇，言薄心气，
则善畏，薄肝气，则惊骇也。荣气不从，逆于肉理，乃生痈肿，言寒邪入于肉，则荣血之气不从肌
肉以外出，但逆于肉理，而生痈肿也。此阳气不能由阖而开也。魄汗未尽阳气外虚也，形弱而气烁，形体
虚弱，而热气外烁也。穴俞以闭，不能内入也，身汗而热，内外不和，
故发为风疟，此阳气不能由开而阖也。上文言阳气外出于皮肤；此言阳气更从内以出外，从外以入内，所
以承上文而补其未尽之义也。
故风者，百病之始也。清静，则肉腠闭拒，虽有大风苛毒，弗之能害，此因时之序也。故
病久则传化，上下不并，良医弗为。
承上文风疟之意，言风为百病之始，宜顺天时而避之也。六淫之气，风居其首，故风者，百病之始也。
身心清静，则肉腠闭拒，虽有大风苛毒，弗之能害，此因四时之序也。若不因时序，受大风苛毒而
为病，必至从表入里，由浅入深，故病久则传化。传化，传经变化也。病久传化，则上下阴阳不相交并，
虽有良医，弗能为也。
故阳蓄积病死，而阳气当隔，隔者当泻，不亟正治，粗乃败之。
病久传化，其所由来者渐矣。故阳蓄积病死，言亢阳蓄积，至病久弗为而死也。而阳气当隔，言亢阳之气
当与腑脏相隔也。申明当隔者，若既病则当泻，苟不亟泻而正治之，犹粗工之败乃事，不得云良医弗为也。
故阳气者，一日而主外，平旦人气生，日中而阳气隆，日西而阳气已虚，气门乃收。
是故暮而闭拒，无扰筋骨，无见雾露，反此三时，形乃困薄。
旧本，收讹闭，闭讹收，今改正。治于既病之后，不若顺于未病之先。故阳气者，一日而主外，一
日三时，人身阳气之所主也。平旦人气生，寅卯辰平旦之时，主人身春生之气也。日中阳气隆，己
午末日中之时，主人身夏长之气也。日西阳气已虚，气门乃收，申酉戌日西之时，主人身秋收之气也。是
故暮而闭拒，亥子丑暮夜之时，主人身冬藏之气也；暮夜闭拒，当无扰筋骨，无见雾露，安静
以养微阳。若不安静，反如平旦日中日西三时之动作，则形乃困顿，虚薄而为病。所以教人因时序，而养
阳气者如此。此一节，论阳气之内外出入，以明生阳之气，上通于天也。
岐伯曰∶阴者，藏精而起亟也，阳者，卫外而为固也。
藏，如字，亟，去声。阳生于阴，由静而动。故岐伯曰∶阴者，藏精而起亟也。精藏于阴而起亟，阴
中有阳矣。阳者，卫外而为固也；阳卫外，为阴之固，阳中有阴矣。
阴不胜其阳，则脉流薄疾，并乃狂。
薄，虚；疾，急也。阴不胜其阳，阳热盛也，阳热盛，则经脉流行，虚薄急疾，经脉薄疾，阳热
相并，则并乃狂。
阳不胜其阴，则五脏气争，九窍不通。
阳不胜其阴，阴寒盛也。阴寒盛则五脏气争。争，彼此不和也。五脏气争，则九窍不通。盖两目者，
肝之窍；两耳者，心之窍；两鼻者，肺之窍；口者脾之窍；前后阴者，肾之窍也。
是以圣人陈阴阳，筋脉和同，骨髓坚固，气血皆从。如是，则
内外调和，邪不能害，耳目聪明，气立如故。
陈，敷布也，上文阴阳不和而为病，是以圣人敷布阴阳，使周身之筋脉协议，通体之骨髓坚固。阳主
之气，阴主之血，皆顺而从之，能如是也，则内外调和，而邪不能害。邪不能害，则耳目聪
明，而气立如故。《五常政大论》云∶“根于外者，命曰气立”。气立如故，可以防御其外邪矣。
风客淫气，精乃亡，邪伤肝也。因而饱食，筋脉横解，肠 为
痔。因而大饮，则气逆。因而强力，肾气乃伤，高骨乃坏。
强，腔，上声。气立不如故，不能防御其邪，则风客淫气，言风邪客于人身，而为淫乱之气也。
风为阳邪，风客淫气，则阴精消烁，故精乃亡。风木之邪，内通于肝，故邪伤肝也。因而饱食者，
风邪未去而饱食也。筋脉横解者，肝主之筋，心主之脉，不循经上下，而横散懈弛也，《经脉别论》云∶
食气入于胃，散精于肝，淫气于筋，食气入胃，浊气归心，淫精于脉。故饱食而筋脉横懈也。肠
为痔者，水谷之精，不荣筋脉，大肠积 ，湿热下注而为痔也。因而大饮，风邪未去而过饮也。酒气，
先行肺主之皮毛，不由脾气之散精。脾肺不交，则气逆也。因而强力，风邪未去而强用其力也。过
劳伤精故肾气乃伤。肾主骨，故高骨乃坏，腰高之骨，不能动摇而败坏也。此风木之邪，始伤肝气，因饱
食大饮强力而病及五脏也。
凡阴阳之要，阳密乃固。
上文云，阳者，卫外而为固，故复言凡阴阳之要，阳密乃固。言阳虽卫外，复当藏密，乃能为阴之固也。
两者不和，若春无秋，若冬无夏。
上文言阴不胜其阳，又言阳不胜其阴，故复言两者不和。如阴不胜其阳，而阳气胜，若春无秋矣；
阳不胜其阴，而阴气胜，若冬无夏矣。
因而和之，是谓圣度。
上文云，圣人陈阴阳内外调和，故复言因而和之，是谓圣度。
故阳强不能密，阴气乃绝。
上文云，阴者藏精而起亟，故复言若阳强不能密，则阴亦不能藏精起亟，而阴气乃绝。
阴平阳秘，精神乃治，阴阳离决，精气乃绝。
是必阴平和，阳秘密，则精神乃治。若阴不平和，阳不秘密，而阴阳离决，则精气乃绝。既言阴气
乃绝，又言精气乃绝者，所以申明阴不藏精而皆绝也。
因于露风，乃生寒热。
上文云，风客淫气，故复言因于露风，乃生寒热。寒热，淫气也。
是以春伤于风，邪气留连，乃为洞泄。夏伤于暑，秋为 疟。秋伤于湿，上逆而咳，发为痿
"Shengqi Tongtian" (Vital Energy Connecting with Heaven) refers to the vital energy of Yin and Yang and the Five Elements in the human body, which generates endlessly and connects upward with Heaven. Qi belongs to Yang and governs growth. Therefore, the Yellow Emperor discusses how Yang Qi, when stored internally and guarding the exterior, can connect upward with Heaven. Bo Gao stated that Yang governs the exterior and Yin governs the interior. If Yang is external yet secure; and Yin is internal yet responsive (Qi Ji), then Essence can be secured internally, and Qi can stand externally, thereby connecting upward with Heaven, allowing one to long enjoy their heavenly mandate. Hence, it is named "Treatise on Vital Energy Connecting with Heaven".
The Yellow Emperor said: Since ancient times, humans have connected with Heaven. The root of life lies in Yin and Yang. Within the universe, inside the Six Directions (Six He), the Earth's Qi corresponds to the Nine Provinces, while human Qi corresponds to the Nine Orifices, Five Zang Organs, and Twelve Joints, all connecting with Heavenly Qi.
The Yellow Emperor discusses how human vital energy connects upward with Heaven, tracing back to the time before conception, when the Great Void was vast and empty. Thus, it is said that since ancient times, connecting with Heaven is the root of life, rooted in the Yin and Yang of the human body. Within the universe, inside the Six Directions, the Earth's Qi of the Nine Provinces, and the human Qi of the Nine Orifices, Five Zang Organs, and Twelve Joints, all connect with Heavenly Qi. This is why vital energy can connect with Heaven. The Six Directions refer to the four cardinal directions and up and down. The Nine Provinces refer to Ji, Yan, Qing, Xu, Liang, Jing, Yong, Yu, and Yang. The Nine Orifices refer to two eyes, two ears, two nostrils, mouth, anterior yin, and posterior yin. The Five Zang Organs refer to Liver, Heart, Spleen, Lung, and Kidney. The Twelve Joints refer to two hands, two elbows, two arms, two feet, two knees, and two thighs, which are places where Shen (Spirit) and Qi travel in and out.
Life possesses attributes of the Five Elements, and its Qi is divided into the Three Powers (Heaven, Earth, Human). Frequently violating these principles allows pathogenic factors to harm the person; this is the root of lifespan.
'Shuo' is pronounced as 'shuo'. Generally, upon birth, everyone possesses the Five Elements, hence their life is five. The principle of the Five Elements penetrates the Three Powers, hence their Qi is three. The human body possesses the Three Powers. If the Qi of the Three Powers in the human body frequently violates the laws of the Five Elements, then Wood has Wind Pathogen, Fire has Heat Pathogen, Earth has Dampness Pathogen, Metal has Dryness Pathogen, and Water has Cold Pathogen. Thus, pathogenic factors harm the person. When pathogenic factors harm the person, lifespan cannot be preserved. These Five Qi and the Qi of the Three Powers are the root of human lifespan.
The Qi of the Azure Heaven, if pure and quiet, keeps the will and intention stable. Complying with it makes Yang Qi solid; even if there are thief pathogens, they cannot harm. This is because one complies with the sequence of seasons. Therefore, the sages preserve their spirit, ingest Heavenly Qi, and connect with divine intelligence. If one fails to comply and loses this state, the nine orifices close internally, muscles become obstructed externally, and Wei Qi (Defensive Qi) scatters and relaxes. This is called self-injury, a depletion of Qi.
'San' is pronounced with the rising tone. 'Jie' means laxity. The same applies below. Pure and quiet refers to the Qi of Heaven. When Heavenly Qi is pure and quiet, human will and intention are also stable; this is the connection between Heavenly Qi and humans. To comply means to comply with this pure and quiet Qi. Therefore, complying with it makes Yang Qi secure externally, so even if there are thief pathogens, they cannot harm. What is meant by complying is complying with the sequence of the four seasons, maintaining purity and quietness according to the seasonal order. Only the sages can comply with this, so the sages preserve their spirit. Preserving spirit means ingesting the pure and quiet Qi of Heaven and Earth to connect with one's own divine intelligence. If humans fail to comply and lose this state, Yang Qi cannot reach the exterior from the interior. Thus, the nine orifices close internally, and muscles are obstructed externally. Yang Qi does not fill the skin from the muscles, so Wei Qi scatters and relaxes. This is failing to ingest Heavenly Qi, called self-injury. Because Yang Qi is not secure, it is called the depletion of Qi.
Human Yang Qi is like the sky and the sun. If it loses its proper position, lifespan is shortened and not manifest.
Human Yang Qi is like the sky and the sun. The Yang Qi circulating the whole body is like the rotating sky. The Yang Qi in the meridians is like the sun. The Qi of the whole body and the Qi of the meridians each have their proper positions. If they lose their positions, the circulating Qi does not flow throughout the body, and the rotating Qi does not follow the meridians. Thus, lifespan is shortened and not manifest in the world.
Therefore, the movement of Heaven relies on the brightness of the Sun. Thus, Yang Qi moves upward and guards the exterior.
Heavenly Qi is pure and quiet, and bright virtue is hidden. Therefore, Heaven's silent operation above relies on the brightness of the Sun. Thus, human Yang Qi follows upward. Yang Qi moves upward; its form is like Heaven; it guards the exterior, its form is like the Sun. This is why Yang Qi is like Heaven and the Sun.
When affected by Cold, Yang Qi should rotate like a door pivot. If daily activities are startled, Shen Qi floats outward.
Pure and quiet Qi is the righteous Qi of Heaven and Humans. Cold, Heat, Dryness, Fire, Dampness, and Wind are the excessive Qi of Heaven and Humans. If affected by Cold, Yang Qi should rotate like a door pivot. Rotating pivot means when Cold Pathogen arrives suddenly, daily activities are startled, and Shen Qi floats outward to respond. From this, we know that being affected by Cold is Yang Qi moving upward, desiring to rotate like a pivot, guarding the exterior.
When affected by Summer-Heat, there is sweating. If vexed, there is panting and loud breathing; if quiet, there is excessive talking. The body feels like burning charcoal; sweating dissipates the pathogen.
If affected by Summer-Heat, in summer the skin pores open, so there is sweating. Vexation leads to panting and loud breathing because Summer-Heat damages Yang. Quietness leads to excessive talking because Summer-Heat damages Yin. If heatstroke occurs without sweating, it is due to Dryness-Fire Qi, so the body feels like burning charcoal. Fan Tan refers to Dryness-Fire. Therefore, sweating must occur for dissipation. This means when Yin fluids exit through the skin, Summer-Heat and Dryness-Fire dissipate. From this, we know that being affected by Summer-Heat is Yang Qi moving upward. Sweating and dissipating is guarding the exterior.
When affected by Dampness, the head feels wrapped. If Damp-Heat is not removed, large tendons shorten and small tendons elongate. Shortening causes spasms; elongation causes flaccidity.
Ruan sounds like 'ruan', following this pattern throughout the text. If affected by Dampness, Dampness is heavy and sticky, so the head feels wrapped. Yang-Heat Qi stagnates when meeting Dampness, so Damp-Heat is not removed. Not removing means not repelling it at the skin and hair follicles, unlike being affected by Cold where Qi floats, or being affected by Summer-Heat where sweat exits. Dampness damages muscles. If it does not exit from muscles, it enters between sinews and bones. Thus, large tendons become weak and short, and small tendons become lax and long. Large tendons connect inside the bone; shortening means flexion without extension, so shortening causes spasms. Spasm means contraction. Small tendons connect outside the bone; laxity and length mean extension without flexion, so laxity and length cause flaccidity. Flaccidity refers to Wei Bi (flaccid obstruction). This is Yang Qi moving upward, Damp-Heat not removed, unable to guard the exterior.
When affected by Qi (Wind), swelling occurs. If the four limbs alternate in dysfunction, Yang Qi is exhausted.
Qi here refers to Wind. In "Treatise on Yin-Yang and Correspondences of the Five Phases", it says: The Qi of Yang is named after the swift wind of Heaven and Earth, so it is not called Wind but Qi. Being affected by Qi causes swelling; Wind excessively affects the extremities, causing limb swelling. Si Wei Xiang Dai means the four limbs move, unable to borrow strength from each other to compensate. The four limbs are the root of all Yang. Now, if the four limbs alternate in dysfunction, Yang Qi is exhausted. This is Yang Qi moving upward, Yang Qi exhausted, unable to guard the exterior.
Yang Qi, when subjected to excessive labor, becomes hyperactive. Essence is depleted. Accumulating repeatedly in summer causes Jian Jue (Frying Syncope). Eyes become blind and cannot see; ears become closed and cannot hear. It is chaotic like a collapsing capital; scattered like an unstoppable flow.
Gu sounds like 'gu', same for subsequent chapters. Yang Qi originates from within and extends outward, rooted in Yin Essence. Excessive labor causes Yang Qi to expand outward and Yin Essence to deplete internally. Yin does not interact with Yang, so Essence is depleted. Pi Ji means repetition. Accumulating in summer means illness contracted in winter does not heal, repeating over time until summer. In summer, Fire is abundant, and internal Essence is lost, causing Jian Jue. Jian Jue is like fire burning and extreme heat. Essence Qi does not pour into the eyes, so eyes become blind and cannot see; Essence Qi does not fill the ears, so ears become closed and cannot hear. Kui Kui describes chaos. Kui Kui hu ruo huai du means eyes and ears are confused, Spirit loses its guard, like a capital falling apart. Liu describes flowing. Hu bu ke zhi means Shen Qi scatters and flows without returning, impossible to stop. This is excessive labor damaging Essence, causing internal chaos of Shen Qi.
Yang Qi, when angered greatly, causes Form Qi to sever, and Blood stagnates in the upper part, causing Bo Jue (Thrusting Syncope). If sinews are damaged, they become lax, and movement is impaired.
Yang Qi rises from below to above, rooted in Yin Blood. Great anger causes rebellious Qi to ascend. Xing refers to the angry expression on the face. Qi Jue means Qi ascends and does not connect downward. Blood follows Qi; when Qi rebels, Blood stagnates upward. When both Qi and Blood rebel, Bo Jue occurs. Bo Jue is syncope due to extreme deficiency. Blood does not nourish sinews, causing damage to sinews. Damaged sinews become lax. Laxity means inability to rotate, as if the body cannot accommodate movement. This is great anger causing Qi rebellion and Blood failing to nourish sinews.
Sweating on only one side causes Pian Ku (Hemiplegia). Sweating while exposed to dampness causes Cuo Fei (acne and miliaria). Changes from rich food and drink lead to Da Ding (large carbuncles); receiving pathogens is easy like holding an empty vessel. Labor sweat exposed to wind, cold presses to form Zha, stagnation forms Cuo.
Cuo is pronounced 'zuo', level tone. Gao Liang refers to rich food and drink, same for subsequent chapters. Zha sounds like 'zha'. Ju means dampness. Yang Qi connects internally with Essence and Blood, passes through the Middle Jiao, and exits externally to the skin. Thus, sweating and rich food are used to illustrate. Sweat is the essence of water and grain, exiting from inside to outside. If sweating occurs on only one side, Qi and Blood do not circulate the body, causing Pian Ku. If sweating in summer exposes one to water-dampness Qi, skin Damp-Heat produces boils like Cuo and rashes like Fei. Rich food and strong flavors damage the Middle Jiao; changes due to rich food lead to Da Ding. Shou Ru Chi Xu means carbuncles emerge from inside to outside, like holding an empty vessel to receive poison. If labor sweat is exposed to wind, Wind is Cold Qi. Thus, cold pressing forms Zha, and stagnation forms Cuo. Zha refers to red nose. Cold stagnating in skin and exiting externally forms Cuo. Cuo is a small boil. This states that Yang Qi plus Yin creates sweat, exiting from Middle Jiao to skin.
Yang Qi, when refined, nourishes Shen (Spirit); when soft, nourishes sinews.
Jing means refined essence. Rou means softness. Previously, excessive labor depleted Essence leading to blindness and deafness, and Shen Qi scattered. Thus, it is said: Yang Qi, when refined, nourishes Shen. This clarifies that when Yang Qi is not refined, Shen has no nourishment. Previously, great anger caused Qi severance, Blood stagnation, and sinew damage. Thus, it is said: Yang Qi, when soft, nourishes sinews. This clarifies that when Yang Qi is not soft, sinews have no nourishment.
If opening and closing are dysfunctional, Cold Qi follows, causing severe kyphosis. Cold sinking into meridians forms Lou, lingering in flesh and interstices. Shu Qi transforms and presses inward, transmitting as fearfulness and fright. Ying Qi does not follow, reverses in muscle texture, causing abscesses. Po Han (sweat) is not finished, form is weak and Qi is scorched, acupoints close, developing Feng Nue (Wind Malaria).
Shu is pronounced 'shu', same for subsequent chapters. Previously, sweating and rich food illustrated Yang Qi exiting skin from Middle Jiao. Here, opening and closing illustrate Yang Qi opening from closing and closing from opening, not just exiting inward to outward. Opening and closing are the pivots of interior and exterior. Opening exits outward; closing enters inward. Now, if opening and closing are dysfunctional, Taiyang Cold Qi follows. Back is Yang, governing opening; abdomen is Yin, governing closing. If opening and closing are dysfunctional, Cold Qi follows, causing protruding back and sunken chest, resulting in severe kyphosis. Lou means hunchback. This states Yang Qi's inability to open and close. Xian Mai Wei Lou, Lian Lian Rou Cou means Cold Pathogen sinks into meridians, so flesh interstices are hollow or protruding, like Lou, lingering in flesh interstices and hard to heal. Shu Qi Hua Bo means Cold Pathogen enters acupoints, so Shu Qi transforms and presses inward. Bo means泊 (moor/press). Chuan Wei Shan Wei, Ji Wei Jing Hai means pressing Heart Qi causes fearfulness; pressing Liver Qi causes fright. Ying Qi Bu Cong, Ni Yu Rou Li, Nai Sheng Yong Zhong means Cold Pathogen enters flesh, so Ying Blood Qi does not exit from muscles but reverses in muscle texture, causing abscesses. This states Yang Qi's inability to open from closing. Po Han Wei Jin means Yang Qi is externally deficient. Xing Ruo Er Qi Shuo means form is weak and heat scorches externally. Xue Shu Yi Bi means inability to enter inward. Body sweats and is hot, interior and exterior are discordant, thus developing Feng Nue. This states Yang Qi's inability to close from opening. Previously, Yang Qi exited to skin; now, Yang Qi goes from interior to exterior and exterior to interior, continuing the previous text and supplementing its unfinished meaning.
Therefore, Wind is the beginning of all diseases. Purity and quietness close and reject flesh interstices; even with great wind and harsh toxins, they cannot harm. This is complying with the sequence of seasons. Therefore, prolonged disease transmits and transforms; if Upper and Lower do not merge, even good doctors cannot help.
Continuing the meaning of Wind Malaria, Wind is the beginning of all diseases, and one should avoid it by complying with Heavenly timing. Among the Six Excesses, Wind is first, so Wind is the beginning of all diseases. Physical and mental purity and quietness close and reject flesh interstices; even with great wind and harsh toxins, they cannot harm. This is complying with the four-season sequence. If one does not comply with seasonal order, receives great wind and harsh toxins, and becomes ill, it must progress from exterior to interior, shallow to deep. Thus, prolonged disease transmits and transforms. Chuan Hua means transmission and transformation of meridians. Prolonged disease transmission and transformation mean Upper and Lower Yin and Yang do not intersect and merge. Even with good doctors, they cannot help.
Therefore, Yang accumulation leads to death, and Yang Qi should be separated. Separated Qi should be drained. If not urgently treated correctly, incompetent doctors will ruin it.
Prolonged disease transmission and transformation develop gradually. So Yang accumulation causes death, meaning hyperactive Yang accumulates, and prolonged illness without treatment leads to death. And Yang Qi should be separated, meaning hyperactive Yang Qi should be separated from Zang-Fu organs. Clarifying those that should be separated: once ill, it should be drained. If not urgently drained and correctly treated, it is like incompetent doctors ruining matters, not saying good doctors cannot help.
Therefore, Yang Qi governs the exterior for one day. At dawn, Ren Qi (Human Qi) arises; at noon, Yang Qi is robust; at sunset, Yang Qi is already deficient, and Qi Gates collect.
Therefore, at dusk, close and reject; do not disturb sinews and bones; do not expose to fog and dew. Reversing these three times, form becomes exhausted and thin.
Old editions had errors: 'collect' mistaken for 'close', 'close' mistaken for 'collect', now corrected. Treating after illness is not as good as complying before illness. Therefore, Yang Qi governs the exterior for one day. The three times of the day govern human Yang Qi. Ping Dan (Dawn) Ren Qi arises: Yin-Mao-Chen dawn times govern Spring Birth Qi of the body. Ri Zhong (Noon) Yang Qi is robust: Ji-Wu-Wei noon times govern Summer Growth Qi of the body. Ri Xi (Sunset) Yang Qi is deficient, Qi Gates collect: Shen-You-Xu sunset times govern Autumn Harvest Qi of the body. Therefore, Mu (Dusk) closes and rejects: Hai-Zi-Chou night times govern Winter Storage Qi of the body; Night closure and rejection should not disturb sinews and bones, nor expose to fog and dew, keeping quiet to nourish slight Yang. If not quiet, acting like Dawn, Noon, and Sunset movements, form becomes exhausted, thin, and ill. Thus, teaching people to comply with seasonal order to nourish Yang Qi. This section discusses Yang Qi entering and exiting internally and externally, clarifying that Sheng Yang Qi connects upward with Heaven.
Qi Bo said: Yin stores Essence and responds rapidly (Qi Ji); Yang guards the exterior and secures.
Cang is read as is. Ji is pronounced with departing tone. Yang is born from Yin, moving from stillness to motion. Thus, Qi Bo said: Yin stores Essence and responds rapidly. Essence is stored in Yin and responds rapidly; Yin contains Yang. Yang guards the exterior and secures; Yang guards exterior, securing Yin; Yang contains Yin.
If Yin cannot overcome Yang, pulses flow thinly and rapidly; merging causes madness.
Bo means thin; Ji means rapid. If Yin cannot overcome Yang, Yang-Heat is abundant. Abundant Yang-Heat makes pulse circulation thin, rapid, and urgent. Pulse thinness and rapidity, Yang-Heat merging, cause madness.
If Yang cannot overcome Yin, Five Zang Qi contend, and Nine Orifices are blocked.
If Yang cannot overcome Yin, Yin-Cold is abundant. Abundant Yin-Cold causes Five Zang Qi to contend. Contend means discord. Five Zang Qi discord causes Nine Orifices blockage. Two eyes are Liver orifices; two ears are Heart orifices; two nostrils are Lung orifices; mouth is Spleen orifice; anterior and posterior yins are Kidney orifices.
Therefore, sages arrange Yin and Yang, sinews and pulses harmonize, marrow strengthens, Qi and Blood follow. Thus, interior and exterior harmonize, pathogens cannot harm, eyes and ears are clear, Qi stands as usual.
Chen means spreading. Previously, Yin-Yang discord caused disease. Thus, sages spread Yin and Yang, making body sinews and pulses agree, whole-body marrow strengthen. Yang governs Qi, Yin governs Blood, both follow smoothly. If so, interior and exterior harmonize, pathogens cannot harm. Pathogens cannot harm, so eyes and ears are clear, and Qi stands as usual. "Treatise on Five Regular Policies" says: "Rooted externally, it is called Qi Li." Qi Li standing as usual can defend against external pathogens.
Wind pathogens lodge in excessive Qi, Essence perishes, pathogens damage Liver. Eating full afterward, sinews and pulses loosen transversely, intestines produce hemorrhoids. Drinking heavily afterward, Qi rebels. Straining force afterward, Kidney Qi is injured, high bones deteriorate.
Qiang sounds like 'qiang'. Qi Li not as usual, unable to defend pathogens, so Wind lodges in excessive Qi, meaning Wind Pathogen lodges in human body, becoming chaotic Qi. Wind is Yang Pathogen. Wind lodging in excessive Qi consumes Yin Essence, so Essence perishes. Wind-Wood Pathogen connects internally to Liver, so pathogens damage Liver. Eating full afterward means eating full while Wind Pathogen remains. Sinews and pulses loosening transversely means Liver-governed sinews and Heart-governed pulses do not follow meridians up and down but scatter and relax. "Treatise on Meridian Differences" says: Food Qi enters Stomach, scatters essence to Liver, excessive Qi to sinews; Food Qi enters Stomach, turbid Qi returns to Heart, excessive essence to pulses. Thus, eating full causes sinews and pulses to loosen. Intestines producing hemorrhoids means water-grain essence does not nourish sinews and pulses; Large Intestine accumulates, Damp-Heat pours downward causing hemorrhoids. Drinking heavily afterward means drinking excessively while Wind Pathogen remains. Wine Qi first travels Lung-governed skin and hair, not by Spleen Qi scattering essence. Spleen-Lung non-interaction causes Qi rebellion. Straining force afterward means using force strongly while Wind Pathogen remains. Over-labor damages Essence, so Kidney Qi is injured. Kidney governs bones, so high bones deteriorate. High waist bones cannot move and deteriorate. This Wind-Wood Pathogen initially damages Liver Qi, and due to overeating, heavy drinking, and straining, disease affects Five Zang Organs.
The key of Yin and Yang is that Yang must be dense to secure.
Previously said: Yang guards exterior and secures. Thus, again stating: The key of Yin and Yang is Yang density secures. Although Yang guards exterior, it must also store densely to secure Yin.
If the two do not harmonize, it is like Spring without Autumn, or Winter without Summer.
Previously stated Yin cannot overcome Yang, and Yang cannot overcome Yin. Thus, again stating the two do not harmonize. If Yin cannot overcome Yang and Yang wins, it is like Spring without Autumn; if Yang cannot overcome Yin and Yin wins, it is like Winter without Summer.
Harmonizing them accordingly is called the Sage's standard.
Previously said: Sages arrange Yin and Yang, interior and exterior harmonize. Thus, again stating harmonizing them accordingly is called the Sage's standard.
Therefore, if Yang is strong but not dense, Yin Qi perishes.
Previously said: Yin stores Essence and responds rapidly. Thus, again stating: If Yang is strong but not dense, Yin cannot store Essence and respond rapidly, so Yin Qi perishes.
When Yin is peaceful and Yang is secret, Spirit is governed. When Yin and Yang separate and decide, Essence and Qi perish.
It must be that Yin is peaceful and Yang is secret, then Spirit is governed. If Yin is not peaceful and Yang is not secret, and Yin and Yang separate and decide, then Essence and Qi perish. Stating both Yin Qi perishes and Essence and Qi perishes clarifies that Yin not storing Essence leads to total perishing.
Affected by exposure to Wind, Cold-Heat develops.
Previously said: Wind lodges in excessive Qi. Thus, again stating: Affected by exposure to Wind, Cold-Heat develops. Cold-Heat is excessive Qi.
Therefore, injuring Wind in Spring, pathogen lingers, causing Dong Xie (profuse diarrhea). Injuring Summer-Heat in Summer, developing Nue (Malaria) in Autumn. Injuring Dampness in Autumn, Qi rebels upward causing cough, developing Wei (Flaccidity).