《天元纪大论》鬼臾区曰∶谨奉天道，请言真要。此篇论六气司天，六气在泉，有正化，有胜复，
有标本寒热，有调治逆从，五味阴阳，制方奇偶，谨奉天道，合于人身，故曰《至真要大论》。
黄帝问曰∶五气交合，盈虚更作，余知之矣。六气分治，司天地者，其至何如？
更，平声，下同。盈虚，即太少也。五运与六气交合，甲、丙、戊、庚、壬为太，主盈；乙、丁、
己、辛、癸为少，主虚；子、寅、辰、午、申、戌为太，主盈；丑、卯、巳、未、酉、亥为少，
主虚。五气交合，盈虚更作，《六元正纪》详论之，故曰余知之矣。
其六气不与五运交合，分治以司天地者，其至何如？此承上编六十岁之纪，而问一岁之六气也。
岐伯再拜对曰∶明乎哉问也！天地之大纪，人神之通应也。
六气分治，以司天地，此天地之大纪，至神之理，通于人身，乃人神之通应也。
帝曰∶愿闻上合昭昭，下合冥冥，奈何？
天地大纪，人神通应，故愿闻人之上合天之昭昭，下合地之冥冥。
岐伯曰∶此道之所主，工之所疑也。
天地之理，备于人身，此道之所主，而为工之所疑也。
帝曰∶愿闻其道也。
愿闻上下相合之道。
岐伯曰∶厥阴司天，其化以风，少阴司天，其化以热；太阴司天，其化以湿；少阳司天，其
化以火；阳明司天，其化以燥；太阳司天，其化以寒。以所临藏位，命其病者也。
三阴三阳六气司天，各有风热湿火燥寒之化也。以所临藏位者，天气之所临。合于人之形藏，各有其
位也。如厥阴合肝，少阴合心肾，太阴合肺脾，少阳合三焦、胆，阳明合大肠、胃，太阳合小肠、膀
胱，各有上下形藏之位。以所临藏位命其病者，天气所临，合于形藏，而有风热湿火燥寒之病也。
帝曰∶地化奈何？
六气本化上临，乃司天之化，故问地化奈何？
岐伯曰∶司天同候，间气皆然。
间，去声，下同。地化与司天同候，其左右之间气，亦同候也。
帝曰∶间气何谓？
间气同候，何谓？
岐伯曰∶司左右者，是谓间气也。
《五营运大论》云∶随气所在，期于左右。故司上下之左右者，
是谓间气也。间气司上下之左右，当与司天在泉同候矣。
帝曰∶何以异之？
间气与司天在泉之气，何以异之？
岐伯曰∶主岁者纪岁，间气者纪步也。
主岁者，司天在泉之气也，司天在泉，主一岁之气，故主岁者纪岁。间气者，上下左右之气也。上下左
右，分主六十日之一气，故间气者纪步也。《六微旨大论》云∶步者，六十度而有奇。六十度，即六十日也。
帝曰∶善。岁主奈何？
主岁者纪岁，故问岁主奈何？
岐伯曰∶厥阴司天为风化，在泉为酸化，司气为苍化，间气为
动化。
司天在泉，司气间气，皆为岁主，伯故类举以对。阳为气，司天为阳，故厥阴司天为风化。厥阴司天，
巳亥岁也。阴为味，在泉为阴，故厥阴在泉为酸化。厥阴在泉，寅申岁也。司气，司岁之运气也。丁壬木运，
本于天之苍气，故司气为苍化。间气，上下左右之气也。《五营运大论》云∶上见太阳，则左厥阴，上
见少阴，则右厥阴；太阳在下，左厥阴，少阴在下，右厥阴。辰戌子午，厥阴居司
天之左右，丑未卯酉，厥阴居在泉之左右，故间气为动化。动，风之摇动也。
少阴司天为热化，在泉为苦化，不司气化，居气为灼化。
子午之岁，少阴司天为热化。卯酉之岁，少阴在泉为苦化。戊癸化火，少阳司气，少阴君火，不司
气化。所以然者，六气之中有二火。少阳相火，合司气之化，而君火之尊不与也。少阴不司气化，
而间气则居，故居气为灼化。灼，火之灼燔也。盖上见厥阴，左少阴；上见太阴，右少阴；厥阴在下，左少
阴；太阴在下，右少阴。巳亥丑未，少阴居司天之左右；寅申辰戌，少阴居在泉之左右也。
太阴司天为湿化，在泉为甘化，司气为 化，间气为柔化。
丑未之岁，太阴司天为湿化，辰戌之岁，太阴在泉为甘化。甲己化土，本于天之 化，故司气为 化。
盖上见少阴，左太阴；上见少阳，右太阴；少阴在下，左太阴；少阳在下，右太阴。子午寅
申，太阴居司天之左右；卯酉巳亥，太阴居在泉之左右，故间气为柔化。柔，土之濡弱也。
少阳司天为火化，在泉为苦化，司气为丹化，间气为明化。
寅申之岁，少阳司天为火化，巳亥之岁，少阳在泉为苦化。戊癸化火，本于天之丹气，故司气为丹化。
上见太阴，左少阳；上见阳明，右少阳；太阴在下，左少阳；阳明在下，右少阳。丑未卯酉，
少阳居司天之左右；辰戌子午，少阳居在泉之左右，故间气为明化。明，火之光明也。
阳明司天为燥化，在泉为辛化，司气为素化，间气为清化。
卯酉之岁，阳明司天为燥化；子午之岁，阳明在泉为辛化。乙庚化金，本于天之素气，故司气为素化。
上见少阳，左阳明；上见太阳，右阳明；少阳在下，左阳明；太阳在下，右阳明。寅申辰戌，
阳明居司天之左右，巳亥丑未，阳明居在泉之左右，故间气为清化。清，金之清肃也。
太阳司天为寒化，在泉为咸化，司气为玄化，间气为藏化。
藏，如字。辰戌之岁，太阳司天为寒化，丑未之岁，太阳在泉为咸化。丙辛化水，本于天之玄气，故
司气为玄化。上见阳明，左太阳；上见厥阴，右太阳；阳明在下，左太阳；厥阴在下，右太阳。
卯酉巳亥，太阳居司天之左右；子午寅申，太阳居在泉之左右，故间气为藏化。藏，寒之凝敛也。
故治病者，必明六化分治，五味五色所生，五脏所宜，乃可以言盈虚，病生之绪也。
六气各有所化，故治病者必明六化之分治，其中复有酸苦甘辛咸五味，苍 丹素玄五色，故必明五味
五色所生，而合于五脏之所宜，然后乃可以言六气化之盈虚，病生之端绪也。
帝曰∶厥阴在泉而酸化，先余知之矣。同化之行也何如？
上文岐伯云∶地化与司天同候。是厥阴司天，其化以风，厥阴在泉，其化亦以风也，帝故举而问之。
岐伯曰∶风行于地。所谓本也，余气同法。本乎天者，天之气也，本乎地者，地之
气也。天地合气，六节分，而万物化生矣。故曰∶谨候气宜，无失病机，此之谓也。
厥阴在泉，故风行于地。六气为本，故所谓本也。不但风气为然，其热湿火燥寒之气皆然，故余气
同法。六气司天而本乎天者，即天之气也。六气在泉而本乎地者，即地之气也。司天在泉，皆本
六气。故天地合气，一岁六分之，故六节分，而万物化生矣。六节之气，各有所宜，不宜则病，故曰∶谨
候气宜，无失病机。即此六节分而万物化生之谓也。
帝曰∶其主病何如？
谨候气宜，无失病机，是六气为万物之主，不宜则病，故问主病何如？
岐伯曰∶司岁备物，则无遗主矣。
司岁，五运五行主岁也；备物，随五行所主之运，备五行所属之物也。随司岁之气以备物，则
谨候气宜，无失病机，故无遗主矣。
帝曰∶先岁物，何也？
五运五行，六岁始复，先备其物，以候其用，故问先岁物何也？
岐伯曰∶天地之专精也。
万物之性，不外五行，五行之气，各主一岁，随五行所主之气，备五行所属之物，乃得天地之专精也。
帝曰∶司气者何如？
五运五行，六气亦五行，故问司气者何如？
岐伯曰∶司气者，主岁同，然有余不足也。
六气合五运。司气者，必与主岁同，谓之专精。然司气者，多不能尽与主岁同，而有有余不足也。
六十年中惟乙卯乙酉，丙辰丙戌，丁巳丁亥，戊子戊午，戊寅戊申，己丑己未十二年，司气与主岁同。
帝曰∶非司岁物，何谓也？
非司岁所备之物，何以不专精，故又问之。
岐伯曰∶散也，故质同而异等也，气味有薄浓，性用有躁静，
治保有多少，力化有浅深，此之谓也。
非司岁所备之物，其气散也，故秉质同而等级异也。所谓异等者，气味有薄浓，薄则不足，浓则有余；
性用有躁静，躁则劣，静则优。自气味薄浓性用躁静推之，则治保有多少，力化有浅深，即此质同异等之谓也。
帝曰∶岁主藏害，何谓？
害，犹病也。五运五行，谓之岁主。五运五行，合于五脏，不
和则病，故问岁主藏害何谓？
岐伯曰∶以所不胜命之，则其要也。
水火金土木，相为胜制，受制则不胜，不胜则病，故以所不胜命之，则其藏害之大要也。
帝曰∶治之奈何？
藏害，而治之奈何？
岐伯曰∶上淫于下，所胜平之；外淫于内，所胜治之。
司天在泉之理，备于人身，故举上下外内，以明藏害之治。上淫于下，谓司天之气，淫胜其在下
之运气，当以所胜平之。如少商金运，火热司天，平以咸寒之类。外淫于内，谓在泉之气，淫胜其
在内之运气，当以所胜治之。如少宫土运，风木在泉，治以辛凉之类。曰平曰治，言治之而得其平，平之
而得其治也。
帝曰∶善。平气如何？
无上下外内之胜制，谓之平气，平气何如？
岐伯曰∶谨察阴阳所在而调之，以平为期，正者正治，反者反治。
人身之气，合于天地，故当谨察阴阳所在而调和之，大要以平为期。正者正治，言阳盛治阳，阴盛
治阴，正治而得其平也。反者反治，言阳虚而阳反盛，阴虚而阴反盛，无容正治，当反治而得其平也。
帝曰∶夫子言察阴阳所在而调之，论言人迎与寸口，相应若引
绳，小大齐等，命曰平。阴之所在寸口何如？
上文岐伯云∶察阴阳所在而调之，以平为期。《灵枢·禁服》论云∶人迎主中，寸口主外，两者相应若
引绳，小大齐等。如是者名曰平人。帝并举其言，谓寸口，乃脉之大会，而阴之所在寸口何如？阴，少阴也。
岐伯曰∶视岁南北，可知之矣。
五运之中，戊癸化火，以戊癸之岁为南政，甲乙丙丁己庚辛壬之岁为北政。故视岁之南北，可知其政矣。
帝曰∶愿卒闻之。岐伯曰∶北政之岁，少阴在泉，则寸口不应，
厥阴在泉，则右不应，太阴在泉，则左不应。南政之岁，少阴司天，
则寸口不应；厥阴司天，则右不应；太阴司天，则左不应。诸不应者，反其诊则见矣。
甲乙丙丁己庚辛壬北政之岁，如卯酉阳明司天，而少阴在泉，少阴君火不司气化，则不与岁运相通，
故寸口之脉，不应君火之气也。少阴不司气化，而左右之间气则居。如当厥阴在泉，则少阴居厥阴之右，故
右不应，言右位之少阴，不应于寸口；当太阴在泉，则少阴居太阴之左，故左不应，言左位之少阴，不应于
寸口也。戊癸配地支，南政之岁，如子午少阴司天，少阴君火不司气化，故寸口之脉，不应于君火之气也，如
居左右之间气，而厥阴司天，则右位之少阴，不应于寸口；太阴司天，则左位之少阴，不应于寸口。
《六微旨大论》云∶厥阴之右，少阴治之，少阴之右，太阴治之。是少阴居厥阴之右，太阴之左，故厥阴
则右不应，太阴则左不应也。不应者，少阳相火，应在中之运，而少阴君火之尊，不司气化。不司
气化，故不见于寸口也。《五营运大论》云∶脉法曰∶天地之变，无以脉诊。故申明诸不应者，不当求之于
诊，若反其诊而求之，则可见矣。反，犹离也。由此观之，则阴之所在寸口，当明其义，而不诊其脉也。
帝曰∶尺候何如？
因寸而问及于尺也。
岐伯曰∶北政之岁，三阴在下，则寸不应；三阴在上，则尺不应。南政之岁，
三阴在天，则寸不应；三阴在泉，则尺不应。左右同。故曰∶知其要者，一
言而终，不知其要，流散无穷。此之谓也。
上文北政之岁，三阴在泉，则寸不应，故曰北政之岁，三阴在下，则寸不应也。以寸推尺，如三阴在
上，则尺不应，一如其寸也。上文南政之岁，三阴司天，则寸不应，故曰南政之岁，三阴在天，则寸不
应也。以寸推尺，如三阴在泉，则尺不应，一如其寸也。凡
此不应，但论少阴。今曰三阴，以少阴居厥阴之右，少阴居太阴之左，是左右同。左右同者，以太厥之左右而
论少阴也。故引《六元正纪大论》之言，谓知其要者，举一可以类推，故一言而终，不知其
要，则流散无穷，即此尺候之谓也。
帝曰∶善。天地之气，内淫而病何如？
上天下地之气，胜其运气，内淫而发为民病，何如？承岐伯上
淫于下，外淫于内之意，而复问也。
岐伯曰∶岁厥阴在泉，风淫所胜，则地气不明，平野昧，草乃早秀。民病
洒洒振寒，善申数欠，心痛支满，两胁里急，饮食不下，
膈咽不通，食则呕，腹胀善噫，得后与气，则快然如衰，身体皆重。
数，音朔，下同。厥阴在泉，寅申岁也。厥阴主风，风淫所胜，则尘土飞扬，故地气不明。地气不明，则
平野昏昧。风动发陈，故草乃早秀。《灵枢·经脉》论云∶胃是动，则病洒洒振寒，善申数欠。脾脉上
膈挟咽。病则食不下，食则呕，腹胀善噫，得后与气则快然如衰，身体皆重。乎厥阴之脉，循胸出胁，病则
胸胁支满心痛，此厥阴风胜，而胃土脾土受病也。
In the *Tianyuanji Dalun* (Great Discourse on the Great Origin and Cycle), Gui Yuzhou said: "I respectfully follow the Heavenly Dao and request to speak of the essential truths." This chapter discusses the Six Qi (Wind, Heat, Wetness, Fire, Dryness, Cold) presiding over Heaven (governing the first half of the year) and Earth (governing the second half of the year), including proper transformation (Zhenghua), winning and retaliating (Shengfu), root and branch (Benbiao), cold and heat attributes, and the principles of contrary and compliant treatment. It involves the Yin-Yang of the Five Flavors, and the odd-even composition of prescriptions. Respectfully aligning with the Heavenly Dao and harmonizing with the human body, it is thus called the *Zhi Zhen Yao Da Lun* (Great Discourse on the Utmost Truths and Essentials).
The Yellow Emperor asked: "The Five Qi interact and combine, alternating between fullness and emptiness; I am aware of this. However, regarding the Six Qi governing separately, those presiding over Heaven and Earth, what is their arrival like?"
"Geng" is pronounced with the level tone, as below. "Fullness and emptiness" refer to Tai (Excess) and Shao (Deficiency). The Five Movements and Six Qi interact and combine. Jia, Bing, Wu, Geng, Ren are Tai (Excess), governing fullness; Yi, Ding, Ji, Xin, Gui are Shao (Deficiency), governing emptiness; Zi, Yin, Chen, Wu, Shen, Xu are Tai, governing fullness; Chou, Mao, Si, Wei, You, Hai are Shao, governing emptiness. The interaction of the Five Qi and the alternation of fullness and emptiness are discussed in detail in the *Liuyuan Zhengji Dalun*, hence it is said, "I am aware of this."
What about when the Six Qi do not interact with the Five Movements, but govern separately to preside over Heaven and Earth? What is their arrival like? This follows the previous discussion of the sixty-year cycle and asks about the Six Qi within a single year.
Qibo bowed twice and replied: "How clear your question is! This is the great law of Heaven and Earth, and the universal correspondence between humans and the Divine."
The separate governance of the Six Qi to preside over Heaven and Earth is the great law of Heaven and Earth, the most subtle principle, corresponding to the human body, which is the universal correspondence between humans and the Divine.
The Emperor said: "I wish to hear how it corresponds above to the manifest Heaven and below to the hidden Earth. How does this work?"
The great law of Heaven and Earth and the correspondence between humans and the Divine lead me to wish to hear how humanity corresponds above to the manifest Heaven and below to the hidden Earth.
Qibo said: "This is what the Dao governs, and what skilled physicians often doubt."
The principles of Heaven and Earth are complete within the human body. This is governed by the Dao, yet remains a source of doubt for physicians.
The Emperor said: "I wish to hear this principle."
I wish to hear the principle of the mutual correspondence of above and below.
Qibo said: "When Jueyin presides over Heaven, its transformation is Wind; Shaoyin presides over Heaven, its transformation is Heat; Taiyin presides over Heaven, its transformation is Wetness; Shaoyang presides over Heaven, its transformation is Fire; Yangming presides over Heaven, its transformation is Dryness; Taiyang presides over Heaven, its transformation is Cold. Diseases are named according to the zang-fu positions they influence."
The Three Yin and Three Yang Six Qi presiding over Heaven each have transformations of Wind, Heat, Wetness, Fire, Dryness, and Cold. "According to the zang-fu positions they influence" refers to the position where Heavenly Qi descends. It corresponds to the physical zang organs in the human body, each having its specific location. For example, Jueyin corresponds to the Liver, Shaoyin to the Heart and Kidney, Taiyin to the Lung and Spleen, Shaoyang to the Sanjiao and Gallbladder, Yangming to the Large Intestine and Stomach, and Taiyang to the Small Intestine and Bladder, each having upper and lower physical zang positions. "Naming diseases according to the influenced zang positions" means that when Heavenly Qi descends and corresponds to the physical zang, diseases of Wind, Heat, Wetness, Fire, Dryness, or Cold arise.
The Emperor said: "What is the transformation of Earth?"
The original transformation of the Six Qi descending from above is the transformation of Heaven presiding. Therefore, you ask what the transformation of Earth is?
Qibo said: "The signs of Earth's transformation are the same as those of Heaven presiding, and the Intermediary Qi (Jianqi) are also the same."
"Jian" is pronounced with the departing tone, as below. The transformation of Earth has the same signs as Heaven presiding, and its left and right Intermediary Qi also have the same signs.
The Emperor said: "What is meant by Intermediary Qi?"
The signs of Intermediary Qi are the same, what does this mean?
Qibo said: "Those who govern the left and right [of Heaven and Earth] are called Intermediary Qi."
The *Wuyunxing Dalun* (Great Discourse on the Five Movements and Six Qi) states: "Following the location of the Qi, expect it on the left and right." Thus, those who govern the left and right of above and below are called Intermediary Qi. Intermediary Qi governs the left and right of above and below, and should have the same signs as Heaven presiding and Earth presiding.
The Emperor said: "How are they distinguished?"
How are Intermediary Qi distinguished from Heaven-presiding and Earth-presiding Qi?
Qibo said: "Those governing the year record the year; Intermediary Qi record the step."
Those governing the year refer to Heaven-presiding and Earth-presiding Qi, which govern the Qi of the entire year, so they record the year. Intermediary Qi refer to the Qi of above, below, left, and right. Above, below, left, and right each govern one Qi of sixty days, so Intermediary Qi record one step. The *Liuweizhi Dalun* (Great Discourse on the Six Subtle Principles) states: "A step is sixty du with some remainder." Sixty du equals sixty days.
The Emperor said: "Good. How does the year's governance work?"
Since those governing the year record the year, I ask how the year's governance works?
Qibo said: "When Jueyin presides over Heaven, it is Wind transformation; when in Earth, it is Sour transformation; when governing Qi, it is Azure transformation; as Intermediary Qi, it is Movement transformation."
Heaven-presiding, Earth-presiding, Qi-governing, and Intermediary Qi are all governors of the year, so I list them categorically to answer. Yang is Qi, and Heaven-presiding is Yang, so when Jueyin presides over Heaven, it is Wind transformation. Jueyin presiding over Heaven corresponds to Si and Hai years. Yin is Flavor, and Earth-presiding is Yin, so when Jueyin is in Earth, it is Sour transformation. Jueyin in Earth corresponds to Yin and Shen years. Qi-governing refers to the ruling movement of the year. Ding and Ren Wood movements originate from the Azure Qi of Heaven, so Qi-governing is Azure transformation. Intermediary Qi are the Qi of above, below, left, and right. The *Wuyunxing Dalun* states: "If Taiyang is above, Jueyin is on the left; if Shaoyin is above, Jueyin is on the right; if Taiyang is below, Jueyin is on the left; if Shaoyin is below, Jueyin is on the right." In Chen, Xu, Zi, and Wu years, Jueyin is at the left and right of Heaven-presiding; in Chou, Wei, Mao, and You years, Jueyin is at the left and right of Earth-presiding, so Intermediary Qi is Movement transformation. Movement refers to the swaying of Wind.
When Shaoyin presides over Heaven, it is Heat transformation; when in Earth, it is Bitter transformation; it does not govern Qi; as Intermediary Qi, it is Scorching transformation.
In Zi and Wu years, Shaoyin presides over Heaven with Heat transformation. In Mao and You years, Shaoyin is in Earth with Bitter transformation. Wu and Gui transform into Fire, with Shaoyang governing Qi. Shaoyin Ministerial Fire does not govern Qi. The reason is that among the Six Qi there are two Fires. Shaoyang Ministerial Fire combines with the Qi-governing transformation, while the dignity of Ruler Fire (Shaoyin) does not participate. Since Shaoyin does not govern Qi, but Intermediary Qi occupy positions, Intermediary Qi is Scorching transformation. Scorching refers to the burning of Fire. If Jueyin is above, Shaoyin is on the left; if Taiyin is above, Shaoyin is on the right; if Jueyin is below, Shaoyin is on the left; if Taiyin is below, Shaoyin is on the right. In Si, Hai, Chou, and Wei years, Shaoyin is at the left and right of Heaven-presiding; in Yin, Shen, Chen, and Xu years, Shaoyin is at the left and right of Earth-presiding.
When Taiyin presides over Heaven, it is Wet transformation; when in Earth, it is Sweet transformation; when governing Qi, it is Yellow transformation; as Intermediary Qi, it is Soft transformation.
In Chou and Wei years, Taiyin presides over Heaven with Wet transformation; in Chen and Xu years, Taiyin is in Earth with Sweet transformation. Jia and Ji transform into Earth, originating from the Yellow Qi of Heaven, so Qi-governing is Yellow transformation.
If Shaoyin is above, Taiyin is on the left; if Shaoyang is above, Taiyin is on the right; if Shaoyin is below, Taiyin is on the left; if Shaoyang is below, Taiyin is on the right. In Zi, Wu, Yin, and Shen years, Taiyin is at the left and right of Heaven-presiding; in Mao, You, Si, and Hai years, Taiyin is at the left and right of Earth-presiding, so Intermediary Qi is Soft transformation. Soft refers to the moist weakness of Earth.
When Shaoyang presides over Heaven, it is Fire transformation; when in Earth, it is Bitter transformation; when governing Qi, it is Cinnabar transformation; as Intermediary Qi, it is Bright transformation.
In Yin and Shen years, Shaoyang presides over Heaven with Fire transformation; in Si and Hai years, Shaoyang is in Earth with Bitter transformation. Wu and Gui transform into Fire, originating from the Cinnabar Qi of Heaven, so Qi-governing is Cinnabar transformation.
If Taiyin is above, Shaoyang is on the left; if Yangming is above, Shaoyang is on the right; if Taiyin is below, Shaoyang is on the left; if Yangming is below, Shaoyang is on the right. In Chou, Wei, Mao, and You years, Shaoyang is at the left and right of Heaven-presiding; in Chen, Xu, Zi, and Wu years, Shaoyang is at the left and right of Earth-presiding, so Intermediary Qi is Bright transformation. Bright refers to the luminosity of Fire.
When Yangming presides over Heaven, it is Dry transformation; when in Earth, it is Pungent transformation; when governing Qi, it is White transformation; as Intermediary Qi, it is Clear transformation.
In Mao and You years, Yangming presides over Heaven with Dry transformation; in Zi and Wu years, Yangming is in Earth with Pungent transformation. Yi and Geng transform into Metal, originating from the White Qi of Heaven, so Qi-governing is White transformation.
If Shaoyang is above, Yangming is on the left; if Taiyang is above, Yangming is on the right; if Shaoyang is below, Yangming is on the left; if Taiyang is below, Yangming is on the right. In Yin, Shen, Chen, and Xu years, Yangming is at the left and right of Heaven-presiding; in Si, Hai, Chou, and Wei years, Yangming is at the left and right of Earth-presiding, so Intermediary Qi is Clear transformation. Clear refers to the crisp肃 (solemnity/clearing) of Metal.
When Taiyang presides over Heaven, it is Cold transformation; when in Earth, it is Salty transformation; when governing Qi, it is Dark transformation; as Intermediary Qi, it is Storage transformation.
Storage is read as written. In Chen and Xu years, Taiyang presides over Heaven with Cold transformation; in Chou and Wei years, Taiyang is in Earth with Salty transformation. Bing and Xin transform into Water, originating from the Dark Qi of Heaven, so Qi-governing is Dark transformation. If Yangming is above, Taiyang is on the left; if Jueyin is above, Taiyang is on the right; if Yangming is below, Taiyang is on the left; if Jueyin is below, Taiyang is on the right. In Mao, You, Si, and Hai years, Taiyang is at the left and right of Heaven-presiding; in Zi, Wu, Yin, and Shen years, Taiyang is at the left and right of Earth-presiding, so Intermediary Qi is Storage transformation. Storage refers to the condensing nature of Cold.
Therefore, those who treat diseases must understand the distinct governance of the Six Transformations, the generation of the Five Flavors and Five Colors, and the suitability for the Five Zang. Only then can one discuss fullness and emptiness, and the origins of disease generation.
Each of the Six Qi has its own transformation. Therefore, those who treat diseases must understand the distinct governance of the Six Transformations. Within this, there are the Five Flavors (Sour, Bitter, Sweet, Pungent, Salty) and Five Colors (Azure, Yellow, Cinnabar, White, Dark). One must understand the generation of these flavors and colors and their harmony with the Five Zang. Only then can one discuss the fullness and emptiness of the Six Qi transformations and the beginnings of disease generation.
The Emperor said: "Jueyin in Earth results in Sour transformation, which I knew before. How does the operation of similar transformations work?"
Earlier, Qibo stated: "The transformation of Earth has the same signs as Heaven presiding." Thus, when Jueyin presides over Heaven, its transformation is Wind; when Jueyin is in Earth, its transformation is also Wind. The Emperor raises this to ask.
Qibo said: "Wind moves upon the Earth. This is called the Root. The other Qi follow the same pattern. That which originates from Heaven is the Qi of Heaven; that which originates from Earth is the Qi of Earth. When Heaven and Earth combine their Qi, the Six Steps divide, and all things are generated. Therefore, it is said: 'Carefully observe the appropriateness of the Qi, and do not miss the pathogenesis.' This is what is meant."
Jueyin is in Earth, so Wind moves upon the Earth. The Six Qi are the Root, hence it is called the Root. This applies not only to Wind but also to Heat, Wetness, Fire, Dryness, and Cold; thus, the other Qi follow the same pattern. The Six Qi presiding over Heaven and originating from Heaven are the Qi of Heaven. The Six Qi in Earth and originating from Earth are the Qi of Earth. Heaven-presiding and Earth-presiding both originate from the Six Qi. Therefore, when Heaven and Earth combine their Qi, the year is divided into six steps, so the Six Steps divide, and all things are generated. Each of the Six Steps' Qi has its appropriateness; if inappropriate, disease arises. Hence, "Carefully observe the appropriateness of the Qi, and do not miss the pathogenesis." This refers to the division of the Six Steps and the generation of all things.
The Emperor said: "What are the primary diseases?"
Carefully observing the appropriateness of the Qi and not missing the pathogenesis implies that the Six Qi are the masters of all things. If inappropriate, disease arises. Therefore, I ask what the primary diseases are?
Qibo said: "Prepare medicinal materials according to the year's Qi, and no primary treatment will be missed."
"Sui" (Year) refers to the Five Movements and Five Elements governing the year. "Bei wu" (Preparing materials) refers to preparing substances belonging to the Five Elements according to the movement they govern. By preparing materials according to the Qi governing the year, one carefully observes the appropriateness of the Qi and does not miss the pathogenesis, so no primary treatment is missed.
The Emperor said: "What is meant by 'prior year materials'?"
The Five Movements and Five Elements repeat every six years. Materials are prepared in advance to await their use. Therefore, I ask what "prior year materials" means?
Qibo said: "They are the essence and purity of Heaven and Earth."
The nature of all things does not exceed the Five Elements. The Qi of the Five Elements each governs one year. By preparing substances belonging to the Five Elements according to the Qi they govern, one obtains the essence and purity of Heaven and Earth.
The Emperor said: "What is Qi-governing?"
The Five Movements and Five Elements, and the Six Qi are also Five Elements. Therefore, I ask what Qi-governing is?
Qibo said: "Qi-governing is the same as the year's governance, but there may be excess and deficiency."
The Six Qi combine with the Five Movements. Qi-governing must be the same as the year's governance, called "essence and purity." However, Qi-governing often cannot fully match the year's governance, resulting in excess and deficiency.
In the sixty-year cycle, only in the twelve years of Yi-Mao, Yi-You, Bing-Chen, Bing-Xu, Ding-Si, Ding-Hai, Wu-Zi, Wu-Wu, Wu-Yin, Wu-Shen, Ji-Chou, and Ji-Wei do Qi-governing and year-governance coincide.
The Emperor said: "What is meant by 'non-year-governing materials'?"
Materials not prepared according to the year's Qi are not of essence and purity. Therefore, I ask again.
Qibo said: "Their Qi is scattered. Thus, although their substance is the same, their grade differs. Their flavor and aroma vary in thinness and density; their nature and function vary in agitation and stillness. There are differences in treatment and preservation, and in the depth of their therapeutic power. This is what is meant."
Materials not prepared according to the year's Qi have scattered Qi. Thus, although their substance is the same, their grade differs. "Different grades" means flavor and aroma vary in thinness and density; thinness indicates deficiency, density indicates excess. Nature and function vary in agitation and stillness; agitation is inferior, stillness is superior. Inferring from the thinness/density of flavor/aroma and agitation/stillness of nature/function, there are differences in treatment/preservation and in the depth of therapeutic power. This is what is meant by "same substance, different grade."
The Emperor said: "What is meant by 'Year-Governing Organ Harm'?"
"Harm" is synonymous with disease. The Five Movements and Five Elements are called Year-Governing. They correspond to the Five Zang. Disharmony leads to disease. Therefore, I ask what "Year-Governing Organ Harm" means?
Qibo said: "Naming it by what it cannot overcome is the key."
Water, Fire, Metal, Wood, and Earth mutually overcome and control each other. If controlled, one cannot overcome; if one cannot overcome, disease arises. Therefore, naming it by what it cannot overcome reveals the main principle of organ harm.
The Emperor said: "How should it be treated?"
Regarding organ harm, how should it be treated?
Qibo said: "If excessive Qi invades from above downwards, pacify it with what overcomes it. If external excessive Qi invades internally, treat it with what overcomes it."
The principles of Heaven-presiding and Earth-presiding are complete in the human body. Thus, citing above/below and outside/inside clarifies the treatment of organ harm. "Excessive Qi invading from above downwards" refers to Heaven-presiding Qi excessively overcoming the Earth-presiding Qi below. It should be pacified with what overcomes it. For example, if Shaoshang Metal movement is present and Fire/Heat presides over Heaven, pacify it with salty-cold substances. "External excessive Qi invading internally" refers to Earth-presiding Qi excessively overcoming the internal movement Qi. It should be treated with what overcomes it. For example, if Shaogong Earth movement is present and Wind/Wood presides in Earth, treat it with pungent-cool substances. "Pacify" and "Treat" imply achieving balance through treatment and achieving cure through pacification.
The Emperor said: "Good. What is Ping Qi (Balanced Qi)?"
Ping Qi refers to the absence of excessive overcoming between above/below or outside/inside. What is Ping Qi?
Qibo said: "Carefully observe the location of Yin and Yang and regulate them, aiming for balance. Direct treatment uses direct methods; contrary treatment uses contrary methods."
Human Qi corresponds to Heaven and Earth. Therefore, one must carefully observe the location of Yin and Yang and regulate them, aiming generally for balance. "Direct treatment uses direct methods" means treating Yang excess with Yang-reducing methods and Yin excess with Yin-reducing methods, achieving balance through direct treatment. "Contrary treatment uses contrary methods" means when Yang deficiency presents with apparent Yang excess, or Yin deficiency presents with apparent Yin excess, direct treatment is not applicable. Instead, contrary treatment should be used to achieve balance.
The Emperor said: "You mentioned observing the location of Yin and Yang to regulate them. The classics state that the Renying and Cun Kou pulses should respond like a drawn rope, equal in size, called 'Ping' (Normal). What is the situation with Yin at the Cun Kou?"
Earlier, Qibo said: "Observe the location of Yin and Yang and regulate them, aiming for balance." The *Lingshu · Jin Fu* chapter states: "Renying governs the interior, Cun Kou governs the exterior. If they respond like a drawn rope and are equal in size, the person is called 'Ping Ren' (Normal Person)." The Emperor cites this, noting that Cun Kou is the meeting place of pulses. What is the situation with Yin (specifically Shaoyin) at the Cun Kou?
Qibo said: "By observing whether the year is South or North Polarity, this can be known."
Among the Five Movements, Wu and Gui transform into Fire. Years of Wu and Gui are South Polarity (Nanzheng); years of Jia, Yi, Bing, Ding, Ji, Geng, Xin, Ren are North Polarity (Beizheng). Thus, by observing the year's polarity, its governance can be known.
The Emperor said: "I wish to hear this in detail." Qibo said: "In North Polarity years, if Shaoyin is in Earth, the Cun Kou pulse will not respond; if Jueyin is in Earth, the right side will not respond; if Taiyin is in Earth, the left side will not respond. In South Polarity years, if Shaoyin presides over Heaven, the Cun Kou pulse will not respond; if Jueyin presides over Heaven, the right side will not respond; if Taiyin presides over Heaven, the left side will not respond. In cases of non-response, reversing the diagnostic approach will reveal the truth."
In North Polarity years (Jia, Yi, Bing, Ding, Ji, Geng, Xin, Ren), for example, if Yangming presides over Heaven in Mao/You years and Shaoyin is in Earth, Shaoyin Ruler Fire does not govern Qi. Thus, it does not connect with the annual movement, and the Cun Kou pulse does not respond to Ruler Fire Qi. Although Shaoyin does not govern Qi, its Intermediary Qi occupy positions. If Jueyin is in Earth, Shaoyin is on the right of Jueyin, so the right side does not respond (meaning the Shaoyin on the right does not respond at the Cun Kou). If Taiyin is in Earth, Shaoyin is on the left of Taiyin, so the left side does not respond (meaning the Shaoyin on the left does not respond at the Cun Kou).
In South Polarity years (Wu, Gui paired with Earthly Branches), for example, if Shaoyin presides over Heaven in Zi/Wu years, Shaoyin Ruler Fire does not govern Qi. Thus, the Cun Kou pulse does not respond to Ruler Fire Qi. If occupying the left/right Intermediary positions, and Jueyin presides over Heaven, the Shaoyin on the right does not respond at the Cun Kou; if Taiyin presides over Heaven, the Shaoyin on the left does not respond at the Cun Kou.
The *Liuweizhi Dalun* states: "On the right of Jueyin, Shaoyin governs; on the right of Shaoyin, Taiyin governs." Thus, Shaoyin is on the right of Jueyin and on the left of Taiyin. Hence, if Jueyin, the right does not respond; if Taiyin, the left does not respond. Non-response occurs because Shaoyang Ministerial Fire should govern the central movement, but Shaoyin Ruler Fire, due to its dignity, does not govern Qi. Not governing Qi, it does not appear at the Cun Kou.
The *Wuyunxing Dalun* states: "The pulse method says: Changes of Heaven and Earth cannot be diagnosed by pulse alone." Thus, it clarifies that for non-responses, one should not seek diagnosis via pulse. If one reverses the diagnostic approach (looks beyond the pulse), the truth becomes visible. "Reverse" here means to depart from. From this, we see that regarding Yin at the Cun Kou, one must understand the principle rather than diagnose solely by pulse.
The Emperor said: "What is the situation with the Chi (Cubit) pulse?"
Asking about the Chi pulse following the Cun pulse.
Qibo said: "In North Polarity years, if the Three Yin are below, the Cun pulse will not respond; if the Three Yin are above, the Chi pulse will not respond. In South Polarity years, if the Three Yin are at Heaven, the Cun pulse will not respond; if the Three Yin are in Earth, the Chi pulse will not respond. The left and right are the same. Therefore, it is said: 'One who knows the essentials concludes in one word; one who does not know the essentials wanders infinitely.' This is what is meant."
Earlier, in North Polarity years, if Three Yin are in Earth, the Cun pulse does not respond. Hence, "In North Polarity years, if Three Yin are below, the Cun pulse does not respond." Inferring Chi from Cun, if Three Yin are above, the Chi pulse does not respond, just as with Cun.
Earlier, in South Polarity years, if Three Yin preside over Heaven, the Cun pulse does not respond. Hence, "In South Polarity years, if Three Yin are at Heaven, the Cun pulse does not respond." Inferring Chi from Cun, if Three Yin are in Earth, the Chi pulse does not respond, just as with Cun.
All such non-responses primarily discuss Shaoyin. Now mentioning "Three Yin" is because Shaoyin is on the right of Jueyin and on the left of Taiyin, making left and right consistent. "Left and right consistent" means discussing Shaoyin based on the left/right positions of Tai and Jueyin. Thus, citing the *Liuyuan Zhengji Dalun*: "One who knows the essentials can infer from one example, concluding in one word. One who does not know the essentials wanders infinitely." This refers to the Chi pulse observation.
The Emperor said: "Good. How do Heaven and Earth Qi invade internally and cause disease?"
Heavenly and Earthly Qi, overcoming the movement Qi, invade internally and cause common diseases. How is this? This continues the meaning of "excessive Qi invading from above downwards" and "external excessive Qi invading internally" mentioned earlier, asking again.
Qibo said: "In years when Jueyin is in Earth, if Wind excessively prevails, the Earth Qi becomes unclear, the plains become dim, and grass blooms early. People suffer from shivering chills, frequent stretching and yawning, heart pain, chest and flank distension and tightness, difficulty swallowing food, obstruction in the diaphragm and throat, vomiting after eating, abdominal distension with frequent belching. After passing stool or gas, they feel relieved as if the symptoms have subsided, and the whole body feels heavy."
"Shuo" is the pronunciation for "shu," as below. Jueyin in Earth corresponds to Yin and Shen years. Jueyin governs Wind. If Wind excessively prevails, dust flies, so Earth Qi becomes unclear. If Earth Qi is unclear, the plains become dim. Wind stirs and promotes growth, so grass blooms early.
The *Lingshu · Jing Mai* chapter states: "If the Stomach channel is affected, disease manifests as shivering chills, frequent stretching and yawning." The Spleen channel ascends through the diaphragm and flanks the throat. Disease manifests as difficulty swallowing, vomiting after eating, abdominal distension with frequent belching. After passing stool or gas, relief is felt as if symptoms have subsided, and the whole body feels heavy.
The Jueyin channel circulates through the chest and emerges at the flanks. Disease manifests as chest/flank distension and heart pain. This is Jueyin Wind excess causing disease in the Stomach Earth and Spleen Earth.