岁少阴在泉，热淫所胜，则焰浮川泽，阴处反明。民病腹中常鸣，气上冲胸，喘不能久立，寒
热皮肤痛，目瞑齿痛 肿，恶寒发热如疟，少腹中痛，腹大，蛰虫不藏。
处，去声，下命处之处同； ，音拙；恶，去声，下同；藏，如字。少阴在泉，卯酉岁也。少阴主热，
热淫所胜，则焰浮川泽。焰浮川泽，则阴处反明。《灵枢·四时气》论云∶腹中常鸣，气上冲
胸，喘不能久立，邪在大肠。寒热皮肤痛者，肺病也。目瞑齿痛 肿，恶寒发热如疟者，阳明病也。少腹
中痛腹大，蛰虫不藏者，少阴火热之气也。民病如是，火淫金病也。
岁太阴在泉，草乃早荣，湿所胜，则埃昏岩谷，黄反见黑，至
阴之交。民病饮积心痛，耳聋浑浑 ，嗌肿喉痹，阴病见血，少
腹痛肿，不得小便，病冲头痛，目似脱，项似拔，腰似折，髀不可
以回， 如结， 如别。
，音纯；折，音舌；见，音现，下见同。回，犹曲也。太阴在泉，辰戌岁也。太阴，土
也，土生万物，故草乃早荣。太阴主湿，湿淫所胜，则埃昏岩谷，谓尘埃岩谷，皆昏昧也。湿淫水溢，故土
色之黄，反见其黑，水土皆为至阴，黄反见黑，乃至阴之交。民病饮积心痛，土湿而火寒也。经脉论云∶三焦
是动，则病耳聋浑浑 ，咽肿喉痹。此三焦火气虚也。阴病见血，脾络虚也。少腹痛肿，不得小便，水道不
行也。又云∶膀胱是动，则病冲头痛，目似脱，项如拔，腰似折，髀不可以曲， 如结， 如裂。此太阳水寒
病也。民病如是，乃土湿火寒，土胜水病也。
岁少阳在泉，火淫所胜，则焰明郊野，寒热更至。民病注泄赤
白，少腹痛，溺赤，甚则血便。少阴同候。
溺，鸟去声，下同。少阳在泉，巳亥岁也。少阳主火，火淫所胜，则焰明郊野。火胜则热，热极生寒，故
寒热更至。民病注泄赤白，少腹痛，溺赤，甚则血液，皆少阳三焦火热病也。少阳少阴，
皆属于火，火淫金病，与少阴同候。
岁阳明在泉，燥淫所胜，则 雾清瞑。民病喜呕，呕有苦，善
太息，心胁痛，不能反侧，甚则嗌干面尘，身无膏泽，足外反热。
阳明在泉，子午岁也。阳明主燥，燥淫所胜，则 雾清瞑。 雾清瞑秋金之气也。胆病者呕宿汁。《经脉》
论云∶胆是动，则病口苦，善太息，心胁痛，不能转侧，甚者面微有尘，体无膏泽，足外反热。
民病如是，乃金淫木病，胆属木也。
岁太阳在泉，寒淫所胜，则凝肃惨栗。民病少腹控睾，引腰脊，上冲心痛，血见，嗌痛颔肿。
睾，音高，下同；见，如字。太阳在泉，丑未岁也。太阳主寒，寒淫所胜，则凝肃惨栗。《邪气脏
腑病形论》云，小肠病者，小腹痛，腰脊控睾而痛。《经脉》论云∶小肠是动则病嗌痛颔肿。小肠者，
心之腑，故上肿心痛，血见。民病如是，水淫火病也。
帝曰∶善。治之奈何？
六气淫胜，发为民病，治之奈何。
岐伯曰∶诸气在泉，风淫于内，治以辛凉，佐以苦甘，以甘缓之，以辛散之。
上文诸气在泉，如风淫于内，木气胜也，金能平之，故治以辛凉。辛凉太过，则佐以苦，辛凉不及，
则佐以甘。盖苦胜金而甘生金也。木气急而虚，则以甘缓之，风邪胜而实，则以辛散之。
热淫于内，治以咸寒，佐以甘苦，以酸收之，以苦发之。
热淫于内，火气胜也。水能平之，故治以咸寒。咸寒太过，则以甘苦；咸寒不及，则佐以苦。盖甘胜
水而苦助寒也。火气急而虚，则以酸收之，火生于木，补其母也。火邪胜而实，则以苦发之，
苦性，虽寒，本于火味，故曰发。发，犹散也。
湿淫于内，治以苦热，佐以酸淡，以苦燥之，以淡泄之。
湿淫于内，土气胜也。湿为阴，故治以火味之苦热。苦热不及，则佐以酸；苦热太过，则佐以淡。盖
酸生火而淡泄火也。土气虚而阴湿，则以苦燥之。土气滞而不行，则以淡泄之。
火淫于内，治以咸冷，佐以苦辛，以酸收之，以苦发之。
火淫于内，热气胜也。水能平之，故治以咸冷。冷，犹寒也。咸冷太过，则佐以苦；咸冷不及，则佐
以辛。盖苦味生土，能制其水，而辛能生水也。以酸收之，以苦发之，与上文热淫于内，同一义也。
燥淫于内，治以苦温，佐以甘辛，以苦下之。
燥淫于内，金气胜也。火能平之，故治以苦温。苦温太过，金气不足，则佐以甘辛，盖甘
生金而辛助金也。苦温不及，金气犹盛，更以苦下之。下，犹制也。
寒淫于内，治以甘热，佐以苦辛，以咸泻之，以辛润之，以苦坚之。
寒淫于内，水气胜也。土能平之，火能温之，故治以甘热。甘热太过，水气不足，则佐以苦辛，盖
苦性寒而助水，辛属金而生水也。甘热不及，水气犹盛，则以咸泻之。申明佐以苦辛，辛为金味
以生水，乃以辛润之，苦为寒性以助水，乃以苦坚之。凡此佐治之
法，义各不同，学人当随其所宜，以为佐治可也。
帝曰∶善。天气之变何如？
上文论在泉之气，此复问天气之变何如？
岐伯曰∶厥阴司天，风淫所胜，则太虚埃昏，云物以扰，寒生
春气，流水不冰。民病胃脘当心而痛，上支两胁，膈咽不通，饮食
不下，舌本强，食则呕，冷泄腹胀，溏泄瘕水闭，蛰虫不去，病本于脾。冲阳绝，死不治。
强，去声，下同。厥阴司天，巳亥岁也。风淫所胜，则太虚如尘埃之昏昧，云物以扰而不宁。冬寒
春风，寒生春气，本于寒而生春气之风也。风性挠动，故流水不冰。《经脉》论云∶脾脉属脾
络胃，上膈挟咽，其支者别上膈，注心中。是动则病舌本强，食则呕，胃脘痛，腹胀，食不下，心下急痛，
溏泄瘕水闭。民病如是，乃风淫木胜，脾土病也。蛰虫不去者，蛰虫藏于中土，土气不舒，故不去也。去，
犹出也。凡此皆病本于脾。若阳明胃脉之冲阳绝，则死不治。冲阳，在足跗上动脉应手者是也。
少阴司天，热淫所胜，怫热至，火行其政。民病胸中烦热，嗌干，右 满，皮肤痛，
寒热咳喘，大雨且至，唾血血泄，鼽衄嚏呕，溺色变。甚则疮疡 肿，肩背
臂 及缺盆中痛，心痛，肺 ，腹大满，膨胀而咳喘，病本于肺。尺泽绝，死不治。
少阴司天，子午岁也。热淫所胜，则怫热至，而火行其政。怫，犹郁也。民病胸中烦热嗌干，右 满，
皮肤痛，寒热咳喘，火盛而肺金病也。大雨且至，言怫热之时，且有大雨之至，雨虽至而
火气盛，故唾血血泄鼽衄，火淫其血液也。嚏呕溺色变，火淫其水津也。甚则疮疡 肿，火淫其肌肉也。
《经脉》论云∶肺脉起于中焦，循 臂内。是动则病肺胀满，膨膨而喘咳，缺盆中痛，气盛则肩背
痛，风寒汗出，气虚则肩背痛寒，溺色变也。凡此民病，皆本于肺。若肺脉之尺泽绝，则死不治。尺泽，
在时内廉大纹中，肺之合穴也。
太阴司天，湿淫所胜，则沉阴且布，雨变枯槁， 肿骨痛阴
痹，阴痹者，按之不得，腰脊头项痛时眩，大便难，阴气不用，饥不
欲食，咳唾则有血，心如悬，病本于肾。太溪绝，死不治。
太阴司天，丑未岁也。湿淫所胜，则沉阴且布，沉阴布而雨降，则雨变。枯槁，言草之枯槁，因雨湿
而滋润也。《灵枢·五邪》篇云∶邪在肾，则病骨痛阴痹。阴痹者，按之不得，腹胀腰痛，大便
难，肩背颈项痛，时眩。又《经脉》篇云∶肾是动，则病饥不饮食，咳唾则有血，心如悬也。凡此， 肿骨
痛诸病，皆本于肾。若肾之太溪脉绝，则死不治。太溪，在足内踝后跟骨上陷中之动脉也。
少阳司天，火淫所胜，则温气流行，金政不平。民病头痛，发
热恶寒而疟，热上皮肤痛，色变黄赤，传而为水，身面 肿，腹满
仰息，泄注赤白，疮疡，咳唾血，烦心胸中热，甚则鼽衄，病本于肺。天府绝，死不治。
恶，去声。少阳司天，寅申岁也。火淫所胜，则温气流行，金受火淫，故金政不平。民病头痛，发热
恶寒而疟，热上皮肤痛，火淫肺金也。五邪篇云∶邪在肺，则病皮肤痛，寒热者是也。色变
黄赤，即上文溺色变也。传而为水，言色变黄赤，乃火淫水热，传为水病也。身面 肿，腹满喘息，泄注
赤白，疮疡，咳唾血，烦心，胸中热，甚则鼽衄，即上文疮疡 肿，咳喘唾血，血泄鼽衄，胸中热烦之病，故
病亦本于肺，火淫金病也。若肺脉之天府绝，则死不治。天府，在腋下三寸，动脉应手者是也。
阳明司天，燥淫所胜，则木乃晚荣，草乃晚生，筋骨内变，民
病左 胁痛，寒清于中，感而疟，大凉革候，咳，腹中鸣，注泄
溏，名木敛，生菀于下，草焦上首，心胁暴痛，不可反侧，嗌干面
尘，腰痛，丈夫 疝，妇人少腹痛，目昧 疡，疮痤痈，蛰虫未见，病本于肺。太冲绝，死不治。
未，旧本讹来，今改。阳明司天，卯酉岁也。燥淫所胜，金胜木虚，则木乃晚荣，草乃晚生。肝血不
荣养其筋骨，而筋骨内变，则民病左 胁痛。寒清之金气客于中，则感而为疟。春行秋令，则
大凉革候，革候则病咳，腹中鸣，注泄 溏矣。木乃晚荣，则名木敛而生气郁于下，草乃晚生，则草焦上首
而瘁于上。经脉论云∶胆是动，则病心胁痛，不能转侧。肝是动，则病嗌干面尘，腰痛，丈夫 疝，妇人
少腹肿也。目为肝窍，故目昧。胆脉起于目锐 ，故 疡。疮疵痈者，肝血虚也。蛰虫未见者，蛰虫见于春，
今草木晚发，故蛰虫未见。而病本于肝，若肝脉之太冲绝，则死不治。太
冲，在足大趾本节后二寸，肝经之俞穴也。
太阳司天，寒淫所胜，则寒气反至，水且冰，血变于中，发为
痈疡，民病厥心痛，呕血血泄鼽衄，善悲，时眩仆。运火炎烈，雨暴乃雹，胸腹满，手热时
挛腋肿，心 大动，胸胁胃脘不安，面
赤目黄，善噫嗌干，甚则色 ，渴而欲饮，病本于心。神门绝，死不治。
太阳司天，辰戊岁也。寒淫所胜，则寒气反至。反至者，非其时也。水且冰者，冻已解而水冰也。寒气凝
敛则血变于中，而发为痈疡。民病厥心痛，善悲，时眩仆者，《五邪》篇云∶邪在心，则病心
痛喜悲时眩仆也。血变于中，外不发为痈疡，则内呕血，而血泄鼽衄，此寒胜火郁之病也。若运火炎烈，
而寒气上淫，则雨暴乃雹。火受水制，则胸腹满。经脉论云∶心主包络是动，则病手心热，臂
时挛急，腋肿，甚则胸胁支满，心中 大动，面赤目黄。又云∶心是动，则病嗌干心痛，渴而欲饮，
甚则色 ，火从水色也。凡此诸病，乃水淫火郁，皆本于心。若心脉之神门绝，死不治。神门，
在掌后锐骨端，心之俞穴也。
所谓动气，知其脏也。
总结上文而言脾之冲阳，肺之尺泽、天府，肾之太溪，肝之太
冲，心之神门，皆动脉应手。所谓动气，诊其动气，而知其五脏之死生也。
帝曰。善。治之奈何？
司天气胜，发为民病，治之奈何？
岐伯曰∶司天之气，风淫所胜，平以辛凉，佐以苦甘，以甘缓
之，以酸泻之。
外淫于内，所胜治之，故上文在泉曰治，上淫于下，所胜平之，故此司天曰平。平，犹治也。风淫所
胜，木气胜也，金能治之，故平以辛凉。辛凉太过，则佐以苦，辛凉不及，则佐以甘，盖
苦胜金而甘生金也。木气急而虚，则以甘缓之，风邪胜而实，则以酸泻之，以明不但金味能泻，而木之
本味，亦能泻也。泻，犹达也，达之所以散之也。
热淫所胜，平以咸寒，佐以苦甘，以酸收之。
热淫所胜，火气胜也，水能治之，故平以咸寒。咸寒太过，则佐以苦甘，甘为土味以胜水，苦为火
味以平寒也。咸寒不及，则以酸收之，收之而助其咸寒也。
湿淫所胜，平以苦热，佐以酸辛，以苦燥之，以淡泄之，湿上
甚而热，治以苦温，佐以甘辛，以汗为故而止。
湿淫所胜，土气胜也，湿气为阴，火能治之，故平以火味之苦热。苦热不及，则佐以酸苦热太过则佐
以辛，盖酸为木味以生火，辛为全味以生水也。土气寒湿，以苦燥之，土气炎燥，以淡泄之。
泄，渗泄也。寒类于湿，燥类于热，湿上甚而热，是寒热相兼，既湿且燥，宜从外解，故治以苦温，苦温所以
散寒湿也。佐以甘辛，甘辛所以滋燥热也。必以汗，为复其故，而病可止。此土淫所胜，而有寒湿燥热之气也。
火淫所胜，平以咸冷，佐以苦甘，以酸收之，以苦发之，以酸复之，热淫同。
咸冷，旧本讹酸冷，今改。火淫所胜，热气胜也，水能治之，故平以咸冷。咸冷太过，则佐以苦甘，
苦为火味以平冷，甘为土味以胜水也。咸冷不及，则以酸收之，收之而助其咸冷也。火淫而热
气过盛，以苦发之，发之而热气内减，仍以酸复之。此以苦发之，
以酸复之，上文热淫所胜，未之言也，故复言热淫同。
燥淫所胜，平以苦温，佐以酸辛，以苦下之。
燥淫所胜，金气胜也，火能治之，故平以苦温。苦温不及，则
佐以酸，苦温太过，则佐以辛，盖酸生火而辛生水也。燥淫而全气过盛，则以苦下之。
寒淫所胜，平以辛热，佐以甘苦，以咸泻之。
When Shaoyin (Ministerial Fire) governs the lower half of the year, if Heat is excessively prevalent, flames seem to float on rivers and marshes, and dark places appear unexpectedly bright. The people suffer from constant borborygmus in the abdomen, Qi rushing upward to the chest, panting unable to stand for long, aversion to cold and fever with skin pain, eyes closing, toothache and swelling, aversion to cold and fever resembling malaria, pain in the lower abdomen, abdominal distension, and hibernating insects failing to hide.
"Chu" is pronounced with the departing tone, same as "chu" in "ming chu"; "Zhuo" is pronounced Zhuo; "Wu" is pronounced with the departing tone, same below; "Cang" is read as written. When Shaoyin governs the lower half, it corresponds to Mao and You years. Shaoyin governs Heat. If Heat is excessively prevalent, flames seem to float on rivers and marshes. Flames floating on rivers and marshes mean dark places appear bright. The *Lingshu · Sixi Qi* chapter states: Constant borborygmus in the abdomen, Qi rushing upward to the chest, panting unable to stand for long—this indicates pathogen in the Large Intestine. Aversion to cold and fever with skin pain indicates Lung disease. Eyes closing, toothache and swelling, aversion to cold and fever resembling malaria indicate Yangming disease. Pain in the lower abdomen, abdominal distension, hibernating insects failing to hide indicate Shaoyin Fire-Heat Qi. When the people suffer thus, it is Fire excess causing Metal (Lung) disease.
When Taiyin (Dampness/Earth) governs the lower half, grass and trees flourish early. If Dampness is excessively prevalent, dust obscures cliffs and valleys, yellow appears mixed with black, marking the intersection of Supreme Yin. The people suffer from fluid accumulation and heart pain, deafness with muffled hearing, throat swelling and obstruction, bleeding from yin disorders, lower abdominal pain and swelling, inability to urinate, rebellious Qi rushing to cause headache, eyes feeling as if popping out, neck feeling as if pulled, waist feeling as if broken, thighs unable to bend, tendons in the popliteal fossa bound like a knot, and tendons in the groin severed like a break.
"Chun" is pronounced Chun; "Zhe" is pronounced She; "Xian" is pronounced Xian, same below. "Hui" means bending. When Taiyin governs the lower half, it corresponds to Chen and Xu years. Taiyin is Earth; Earth generates all things, so grass and trees flourish early. Taiyin governs Dampness. If Dampness is excessively prevalent, dust obscures cliffs and valleys, meaning dust and cliffs become dim. Dampness overflows like water, so the yellow color of Earth appears mixed with the black of Water. Both Earth and Water belong to Supreme Yin; yellow appearing with black marks the intersection of Supreme Yin. Fluid accumulation and heart pain indicate Earth Dampness and Heart Fire Cold. The *Jingmai Lun* states: When Sanjiao moves, it causes deafness with muffled hearing, throat swelling and obstruction. This indicates deficiency of Sanjiao Fire Qi. Bleeding from yin disorders indicates deficiency of Spleen collaterals. Lower abdominal pain and swelling, inability to urinate indicate failure of water pathways to flow. It also states: When Bladder moves, it causes rebellious Qi rushing to headache, eyes feeling as if popping out, neck feeling as if pulled, waist feeling as if broken, thighs unable to bend, tendons in the popliteal fossa bound like a knot, and tendons in the groin severed like a break. This indicates Taiyang Water-Cold disease. When the people suffer thus, it is Earth Dampness and Fire Cold, Earth excess causing Water disease.
When Shaoyang (Ministerial Fire) governs the lower half, if Fire is excessively prevalent, flames shine brightly in suburbs and fields, and cold and heat alternate. The people suffer from profuse diarrhea with red and white discharge, lower abdominal pain, red urine, and in severe cases, bloody stools. The pulse presentation is the same as Shaoyin.
"Niao" is pronounced Niao (departing tone), same below. When Shaoyang governs the lower half, it corresponds to Si and Hai years. Shaoyang governs Fire. If Fire is excessively prevalent, flames shine brightly in suburbs and fields. Fire excess brings heat; extreme heat generates cold, hence cold and heat alternate. Profuse diarrhea with red and white discharge, lower abdominal pain, red urine, and severe bloody stools are all Shaoyang Sanjiao Fire-Heat diseases. Shaoyang and Shaoyin both belong to Fire; Fire excess causing Metal disease presents similarly to Shaoyin.
When Yangming (Dryness/Metal) governs the lower half, if Dryness is excessively prevalent, mist is clear and dim. The people suffer from frequent vomiting, bitter vomit, frequent sighing, heart and hypochondriac pain, inability to turn sideways, and in severe cases, dry throat, dusty complexion, lack of body luster, and heat on the outer aspect of the feet.
When Yangming governs the lower half, it corresponds to Zi and Wu years. Yangming governs Dryness. If Dryness is excessively prevalent, mist is clear and dim. Clear and dim mist is Autumn Metal Qi. Gallbladder disease causes vomiting of old bile. The *Jingmai Lun* states: When Gallbladder moves, it causes bitter taste, frequent sighing, heart and hypochondriac pain, inability to turn sides, and in severe cases, slightly dusty face, lack of body luster, and heat on the outer aspect of the feet. When the people suffer thus, it is Metal excess causing Wood (Liver/Gallbladder) disease, as Gallbladder belongs to Wood.
When Taiyang (Cold/Water) governs the lower half, if Cold is excessively prevalent, condensation and solemnity bring chilling misery. The people suffer from lower abdominal pain radiating to the testicles, pulling on the waist and spine, upward rushing heart pain, bleeding, throat pain, and submandibular swelling.
"Gao" is pronounced Gao, same below; "Xian" is read as written. When Taiyang governs the lower half, it corresponds to Chou and Wei years. Taiyang governs Cold. If Cold is excessively prevalent, condensation and solemnity bring chilling misery. The *Xieqi Zangfu Bingxing Lun* states: Small Intestine disease causes lower abdominal pain, waist and spine pain radiating to the testicles. The *Jingmai Lun* states: When Small Intestine moves, it causes throat pain and submandibular swelling. The Small Intestine is the Fu organ of the Heart, hence upper swelling, heart pain, and bleeding. When the people suffer thus, it is Water excess causing Fire (Heart) disease.
The Yellow Emperor said: Excellent. How should they be treated?
When the six Qi excessively prevail and cause disease in the people, how should they be treated?
Qibo said: For all Qi governing the lower half, if Wind excessively prevails internally, treat with Pungent-Cool, assist with Bitter-Sweet, use Sweet to relax tension, and use Pungent to disperse.
Regarding the previous text on Qi governing the lower half, such as Wind prevailing internally, this indicates Wood excess. Metal can level it, so treat with Pungent-Cool. If Pungent-Cool is excessive, assist with Bitter; if insufficient, assist with Sweet. Bitter conquers Metal, and Sweet generates Metal. Wood Qi is urgent and deficient, so use Sweet to relax it; Wind pathogen is excessive and excess, so use Pungent to disperse it.
If Heat excessively prevails internally, treat with Salty-Cold, assist with Sweet-Bitter, use Sour to astringe, and use Bitter to disperse.
Heat excessively prevailing internally indicates Fire excess. Water can level it, so treat with Salty-Cold. If Salty-Cold is excessive, assist with Sweet-Bitter; if insufficient, assist with Bitter. Sweet conquers Water, and Bitter assists Cold. Fire Qi is urgent and deficient, so use Sour to astringe it (Fire is born from Wood, supplementing the mother). Fire pathogen is excessive and excess, so use Bitter to disperse it. Although Bitter is cold, its origin is Fire flavor, hence called dispersing. Dispersing means scattering.
If Dampness excessively prevails internally, treat with Bitter-Hot, assist with Sour-Light, use Bitter to dry Dampness, and use Light to drain.
Dampness excessively prevailing internally indicates Earth excess. Dampness is Yin, so treat with Fire-flavor Bitter-Hot. If Bitter-Hot is insufficient, assist with Sour; if excessive, assist with Light. Sour generates Fire, and Light drains Fire. Earth Qi is deficient with Yin-Dampness, so use Bitter to dry it. Earth Qi is stagnant and not flowing, so use Light to drain it.
If Fire excessively prevails internally, treat with Salty-Cold, assist with Bitter-Pungent, use Sour to astringe, and use Bitter to disperse.
Fire excessively prevailing internally indicates Heat excess. Water can level it, so treat with Salty-Cold. Cold means Cold. If Salty-Cold is excessive, assist with Bitter; if insufficient, assist with Pungent. Bitter flavor generates Earth, controlling Water, while Pungent generates Water. Using Sour to astringe and Bitter to disperse has the same meaning as Heat excessively prevailing internally mentioned earlier.
If Dryness excessively prevails internally, treat with Bitter-Warm, assist with Sweet-Pungent, use Bitter to purge downward.
Dryness excessively prevailing internally indicates Metal excess. Fire can level it, so treat with Bitter-Warm. If Bitter-Warm is excessive leading to Metal deficiency, assist with Sweet-Pungent (Sweet generates Metal, Pungent assists Metal). If Bitter-Warm is insufficient and Metal remains strong, further use Bitter to purge downward. Purging means controlling.
If Cold excessively prevails internally, treat with Sweet-Hot, assist with Bitter-Pungent, use Salty to purge, use Pungent to moisten, and use Bitter to firm.
Cold excessively prevailing internally indicates Water excess. Earth can level it, Fire can warm it, so treat with Sweet-Hot. If Sweet-Hot is excessive leading to Water deficiency, assist with Bitter-Pungent (Bitter is cold nature assisting Water, Pungent is Metal generating Water). If Sweet-Hot is insufficient and Water remains strong, use Salty to purge. This clarifies assisting with Bitter-Pungent: Pungent is Metal flavor generating Water, hence used to moisten; Bitter is cold nature assisting Water, hence used to firm. All these assisting methods have different meanings; learners should choose according to appropriateness.
The Yellow Emperor said: Excellent. What about changes in Heavenly Qi?
The previous text discussed Earthly Qi; now asking about changes in Heavenly Qi.
Qibo said: When Jueyin governs Heaven, if Wind excessively prevails, the great void becomes dusty and dim, clouds and objects are disturbed, Cold generates Spring Qi, and flowing water does not freeze. The people suffer from epigastric pain at the heart center, supporting up to both hypochondria, obstruction of diaphragm and pharynx, inability to swallow food, stiffness of the tongue root, vomiting after eating, cold diarrhea, abdominal distension, loose stool, mass formation, water retention, hibernating insects not hiding, with the disease rooted in the Spleen. If Chongyang pulse vanishes, death is incurable.
"Qiang" is pronounced Qiang (departing tone), same below. When Jueyin governs Heaven, it corresponds to Si and Hai years. Wind excessively prevailing makes the sky dusty and dim, clouds and objects restless. Winter Cold combined with Spring Wind, Cold generates Spring Qi, originating from Cold producing Spring Wind. Wind nature is disturbing, hence flowing water does not freeze. The *Jingmai Lun* states: Spleen meridian belongs to Spleen, connects to Stomach, goes up through diaphragm, flanks pharynx; branch goes up through diaphragm, enters Heart. Movement causes tongue stiffness, vomiting after eating, epigastric pain, abdominal distension, inability to eat, urgency and pain below heart, loose stool, mass formation, water retention. When people suffer thus, it is Wind excess, Wood excess causing Spleen Earth disease. Hibernating insects not hiding is because they hide in Central Earth; Earth Qi is not comfortable, so they do not hide. Qu means exit. All these diseases root in Spleen. If Yangming Stomach meridian's Chongyang pulse vanishes, death is incurable. Chongyang is the pulsating artery on the dorsum of the foot.
When Shaoyin governs Heaven, if Heat excessively prevails, stifling heat arrives, Fire executes its administration. The people suffer from vexation and heat in the chest, dry throat, fullness in the right hypochondrium, skin pain, aversion to cold and fever with cough and wheezing, heavy rain approaching, spitting blood, bloody diarrhea, rhinorrhea, epistaxis, sneezing, vomiting, and change in urine color. In severe cases, sores and swellings, pain in shoulders, back, arms, and clavicular fossa, heart pain, lung distension, abdominal fullness, bloating with cough and wheezing, with the disease rooted in the Lung. If ChiZe pulse vanishes, death is incurable.
When Shaoyin governs Heaven, it corresponds to Zi and Wu years. Heat excessively prevailing means stifling heat arrives and Fire executes administration. Fu means stagnation. Vexation and heat in chest, dry throat, right hypochondriac fullness, skin pain, aversion to cold and fever with cough and wheezing indicate Fire excess causing Lung Metal disease. Heavy rain approaching means during stifling heat, heavy rain will arrive; although rain comes, Fire Qi remains strong, hence spitting blood, bloody diarrhea, rhinorrhea, epistaxis, indicating Fire excess affecting blood vessels. Sneezing, vomiting, urine color change indicate Fire excess affecting water fluids. Severe sores and swellings indicate Fire excess affecting muscles. The *Jingmai Lun* states: Lung meridian starts at middle jiao, follows arm interior. Movement causes lung distension, bloating with cough and wheezing, clavicular pain, Qi excess causes shoulder/back pain, wind-cold sweating, Qi deficiency causes shoulder/back pain cold, urine color change. All these diseases root in Lung. If Lung meridian's ChiZe pulse vanishes, death is incurable. ChiZe is in the large crease on the medial side of the elbow, the He-Sea point of Lung.
When Taiyin governs Heaven, if Dampness excessively prevails, deep Yin spreads, rain changes causing withering, edema, bone pain, Yin Bi. Yin Bi means pressing finds no specific tender point, accompanied by waist/spine/head/neck pain, dizziness, difficulty defecating, dysfunction of Yin Qi, hunger without desire to eat, coughing/spitting blood, heart feeling suspended, with the disease rooted in the Kidney. If TaiXi pulse vanishes, death is incurable.
When Taiyin governs Heaven, it corresponds to Chou and Wei years. Dampness excessively prevailing means deep Yin spreads. Deep Yin spreading causes rain, changing into withering. Withering refers to grass becoming withered due to rain dampness nourishment. *Lingshu · Wuxie* chapter states: Pathogen in Kidney causes bone pain and Yin Bi. Yin Bi means pressing finds no tender point, abdominal distension, waist pain, difficulty defecating, shoulder/back/neck pain, dizziness. *Jingmai* chapter states: Kidney movement causes hunger without eating, coughing/spitting blood, heart feeling suspended. All these edema, bone pain diseases root in Kidney. If Kidney meridian's TaiXi pulse vanishes, death is incurable. TaiXi is the pulsating artery behind the medial malleolus.
When Shaoyang governs Heaven, if Fire excessively prevails, warm Qi circulates, Metal administration is uneven. The people suffer from headache, fever with aversion to cold resembling malaria, heat attacking skin causing pain, yellow-red complexion changes, transmission to water disease, body/facial edema, abdominal fullness with仰息 (breathing with head extended), profuse red/white diarrhea, sores, coughing/spitting blood, vexation and heat in chest, severe rhinorrhea/epistaxis, with the disease rooted in the Lung. If TianFu pulse vanishes, death is incurable.
"E" is pronounced E (departing tone). When Shaoyang governs Heaven, it corresponds to Yin and Shen years. Fire excessively prevailing means warm Qi circulates; Metal suffers Fire excess, so Metal administration is uneven. Headache, fever with aversion to cold resembling malaria, heat attacking skin causing pain indicate Fire excess invading Lung Metal. *Wuxie* chapter states: Pathogen in Lung causes skin pain, aversion to cold/fever. Yellow-red complexion change is the urine color change mentioned earlier. Transmission to water disease means yellow-red complexion is Fire excess Water-Heat transmitting to water disease. Body/facial edema, abdominal fullness, panting, profuse red/white diarrhea, sores, coughing/spitting blood, vexation, chest heat, severe rhinorrhea/epistaxis are the sores/swelling, cough/wheeze/spitting blood, bloody diarrhea/epistaxis, chest heat/vexation mentioned earlier, so disease roots in Lung, Fire excess Metal disease. If Lung meridian's TianFu pulse vanishes, death is incurable. TianFu is three cun below the axilla, pulsating artery.
When Yangming governs Heaven, if Dryness excessively prevails, trees flourish late, grass grows late, internal changes in sinews and bones, left hypochondriac pain, cold/clear Qi in middle, contracting malaria, great coolness changing seasons, cough, borborygmus, profuse loose stool, famous trees contract, life Qi stagnates below, grass withers above, sudden heart/hypochondriac pain, inability to turn sides, dry throat, dusty face, waist pain, men's hernia, women's lower abdominal pain, blurred vision and canthus ulcers, acne/boils, hibernating insects not seen, with the disease rooted in the Lung. If TaiChong pulse vanishes, death is incurable.
"Wei", old text error "Lai", corrected. When Yangming governs Heaven, it corresponds to Mao and You years. Dryness excessively prevailing, Metal excess Wood deficiency, trees flourish late, grass grows late. Liver Blood fails to nourish sinews/bones, internal changes occur, causing left hypochondriac pain. Cold/Clear Metal Qi invades middle, contracting malaria. Spring acting as Autumn, great coolness changes season, causing cough, borborygmus, profuse loose stool. Trees flourishing late means famous trees contract, Life Qi stagnates below; grass growing late means grass withers above. *Jingmai Lun* states: Gallbladder movement causes heart/hypochondriac pain, inability to turn sides. Liver movement causes dry throat, dusty face, waist pain, men's hernia, women's lower abdominal swelling. Eyes are Liver orifices, hence blurred vision. Gallbladder meridian starts at outer canthus, hence canthus ulcers. Acne/boils indicate Liver Blood deficiency. Hibernating insects not seen because they appear in Spring, but plants grow late, so insects not seen. Disease roots in Liver. If Liver meridian's TaiChong pulse vanishes, death is incurable. TaiChong is two cun distal to the base of the big toe, Shu-Stream point of Liver meridian.
When Taiyang governs Heaven, if Cold excessively prevails, Cold Qi returns contrary, water freezes, blood changes internally, causing sores/ulcers. The people suffer from Jue Heart pain, vomiting blood, bloody diarrhea, rhinorrhea, epistaxis, frequent sadness, occasional dizziness and fainting. If annual運 Fire burns fiercely, violent rain turns to hail, chest/abdominal fullness, hand heat with occasional spasms, axillary swelling, Pericardium palpitation, chest/hypochondrium/stomach discomfort, red face yellow eyes, frequent belching, dry throat, severe black complexion, thirst desiring drink, with the disease rooted in the Heart. If ShenMen pulse vanishes, death is incurable.
When Taiyang governs Heaven, it corresponds to Chen and Xu years. Cold excessively prevailing means Cold Qi returns contrary. Contrary return means arriving out of season. Water freezing means thawed water refreezes. Cold condensing causes blood changes internally, causing sores/ulcers. Jue Heart pain, sadness, dizziness/fainting: *Wuxie* chapter states: Pathogen in Heart causes heart pain, liking sadness, dizziness/fainting. Blood changes internally, not manifesting externally as sores, causes internal vomiting blood, bloody diarrhea, rhinorrhea, epistaxis, this is Cold excess suppressing Fire stagnation. If annual運 Fire burns fiercely and Cold Qi invades upwards, violent rain turns to hail. Fire controlled by Water causes chest/abdominal fullness. *Jingmai Lun* states: Pericardium movement causes hot palms, arm spasms, axillary swelling, severe chest/hypochondrium fullness, heart palpitations, red face yellow eyes. Also: Heart movement causes dry throat, heart pain, thirst desiring drink, severe black complexion, Fire from Water color. All these diseases are Water excess Fire stagnation, rooting in Heart. If Heart meridian's ShenMen pulse vanishes, death is incurable. ShenMen is at the end of the radial styloid process, Shu-Stream point of Heart.
Saying "Moving Qi" allows knowing the Zang organs.
Summarizing above, Spleen's Chongyang, Lung's ChiZe and TianFu, Kidney's TaiXi, Liver's TaiChong, Heart's ShenMen are all pulsating arteries. Saying "Moving Qi," diagnosing these moving Qi knows the life/death of the five Zang.
The Yellow Emperor said: Excellent. How to treat?
Heavenly Qi excess causing disease in people, how to treat?
Qibo said: Heavenly Qi, if Wind excessively prevails, level with Pungent-Cool, assist with Bitter-Sweet, use Sweet to relax, use Sour to purge.
External invading internal, treated by what conquers it. Hence Earthly Qi said "Treat," Upper invading Lower, conquered levels it. Hence Heavenly Qi says "Level." Level means Treat. Wind excessively prevailing is Wood excess, Metal can treat it, so level with Pungent-Cool. Pungent-Cool excessive, assist with Bitter; insufficient, assist with Sweet. Bitter conquers Metal, Sweet generates Metal. Wood Qi urgent/deficient, use Sweet to relax; Wind pathogen excess/excess, use Sour to purge, showing not only Metal flavor purges, but Wood's own flavor purges. Purge means reach/disperse.
If Heat excessively prevails, level with Salty-Cold, assist with Bitter-Sweet, use Sour to astringe.
Heat excessively prevailing is Fire excess, Water can treat it, so level with Salty-Cold. Salty-Cold excessive, assist with Bitter-Sweet (Sweet is Earth flavor conquering Water, Bitter is Fire flavor leveling Cold). Salty-Cold insufficient, use Sour to astringe, aiding Salty-Cold.
If Dampness excessively prevails, level with Bitter-Hot, assist with Sour-Pungent, use Bitter to dry, use Light to drain. If Dampness is severe above with Heat, treat with Bitter-Warm, assist with Sweet-Pungent, stop when sweating occurs.
Dampness excessively prevailing is Earth excess, Dampness is Yin, Fire can treat it, so level with Fire-flavor Bitter-Hot. Bitter-Hot insufficient, assist with Sour; excessive, assist with Pungent (Sour is Wood flavor generating Fire, Pungent is Metal flavor generating Water). Earth Cold-Damp, use Bitter to dry; Earth Hot-Dry, use Light to drain. Drain means seep-drain. Cold resembles Damp, Dry resembles Heat. Damp severe above with Heat is Cold-Heat mixed, both Damp and Dry, should resolve from exterior, so treat with Bitter-Warm (dispels Cold-Damp). Assist with Sweet-Pungent (nourishes Dry-Heat). Must sweat to restore normal state, then disease stops. This is Earth excess with Cold-Damp-Dry-Heat Qi.
If Fire excessively prevails, level with Salty-Cold, assist with Bitter-Sweet, use Sour to astringe, use Bitter to disperse, use Sour to restore. Heat excess is same.
Salty-Cold, old text error "Salty-Cold" (should be Salty-Cold), corrected. Fire excessively prevailing is Heat excess, Water can treat it, so level with Salty-Cold. Salty-Cold excessive, assist with Bitter-Sweet (Bitter is Fire flavor leveling Cold, Sweet is Earth flavor conquering Water). Salty-Cold insufficient, use Sour to astringe, aiding Salty-Cold. Fire excess and Heat extremely strong, use Bitter to disperse; after dispersing, Heat reduces internally, still use Sour to restore. Using Bitter to disperse and Sour to restore was not mentioned in previous Heat excess, so reiterate Heat excess is same.
If Dryness excessively prevails, level with Bitter-Warm, assist with Sour-Pungent, use Bitter to purge downward.
Dryness excessively prevailing is Metal excess, Fire can treat it, so level with Bitter-Warm. Bitter-Warm insufficient, assist with Sour; excessive, assist with Pungent (Sour generates Fire, Pungent generates Water). Dryness excess and Metal Qi extremely strong, use Bitter to purge downward.
If Cold excessively prevails, level with Pungent-Hot, assist with Sweet-Bitter, use Salty to purge.