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Combined with Junhuo (Ministerial Fire), thus fire appears and burns, causing dryness of the throat. When hot qi reverses downward, it distributes into branches, causing the water and fluids of urination to flow out through the large intestine like a torrent. Intermittent cessation means flowing intermittently and stopping, stopping and then flowing again. Qi movement on the left is the kidney qi of Shaoyin (Lesser Yin). Ascending to the right, it overcomes the lung. Overcoming the lung causes cough and skin pain. The lung governs voice; lung disease causes sudden aphonia (sudden loss of voice). The heart belongs to Shaoyin; excess heat causes heart pain; extreme pain leads to depression, vertigo, and unconsciousness. Internal stagnation of heat generates external cold, causing aversion to cold with shivering externally, and tremors with delirium internally. If cold subsides and heat arises, thirst and desire for drinking occur; if delirium ceases, shortness of qi results; if tremors cease, bone wasting occurs. If yin and yang, water and fire do not intersect in the middle jiao (Middle Burner), there will be obstruction of the diaphragm and intestines, leading to edema externally. With severe deficiency of earth qi, hiccups or belching may occur. The qi of Shaoyin first stagnates and then recovers; during stagnation, red qi transforms later; during recovery, flowing water does not freeze, and heat qi prevails greatly, causing shell-bearing insects of the metal category to perish. Heat moving outward causes febrile rashes, sores, ulcers, carbuncles, furuncles, acne, and hemorrhoids. Severe heat entering the lung causes cough and nasal sinusitis (nasal discharge of thick pus). If fire is excessive and metal is deficient, death is incurable when the Tianfu (LU3) pulse of the lung vanishes.

When Taiyin (Greater Yin) recovers, dampness transformations arise, causing heavy body and epigastric fullness, indigestion, upward reversal of yin qi, chest discomfort, internal fluid retention with coughing and wheezing sounds. Heavy rain occurs frequently, fish appear on land, the head feels heavy and painful, and convulsions are severe. Vomiting occurs with muteness, and clear fluid is expectorated. If severe, it enters the kidney, causing uncontrolled diarrhea through the orifices. Death is incurable when the Taixi (KI3) pulse vanishes.

When Taiyin is controlled, dampness does not transform or arise. Now that Taiyin recovers, dampness transformations arise because it was controlled and is now recovering, but the meridians are not yet harmonized, hence heavy body and fullness, and indigestion. Dampness is yin qi; upward reversal of yin qi causes chest discomfort. "Bian" (bowel movement/urination) implies smooth passage. Chest discomfort leads to internal fluid retention and coughing with wheezing sounds. Frequent heavy rain represents earth dampness; fish appearing on land indicates earth dampness and water signals. Dampness damaging the Taiyang (Greater Yang) meridian causes heavy head pain and severe convulsions. Dampness damaging the Yangming (Bright Yang) meridian causes vomiting, muteness, and expectoration of clear fluid. If severe, dampness evil enters the kidney, causing uncontrolled diarrhea through the orifices. The anterior and posterior orifices are the apertures of the kidney; the anterior water aperture exits via the stool, hence called "orifice diarrhea." If earth is excessive and water is deficient, death is incurable when the Taixi (KI3) pulse of the kidney vanishes.

When Shaoyang (Lesser Yang) recovers, great heat approaches, causing dryness and burning, and shell-bearing insects perish. Symptoms include惊骇 (startle/fright), convulsions, cough, and epistaxis (nosebleed); internal heart heat with irritability; frequent urination with aversion to wind; upward reversal of jue qi (rebellious qi) causing a face covered like floating dust, and eye convulsions. Internal emission of fire causes mouth ulcers above, vomiting and regurgitation in the middle, and blood overflow or bleeding below. It manifests as malaria with chills and trembling. Extreme cold reverses to heat, causing scorched throat collaterals, thirst for fluids, yellow-red urine, shortness of qi, and atrophied pulses. It transforms into water retention, transmitting to edema. If severe, it enters the lung, causing cough and hemoptysis. Death is incurable when the Chize (LU5) pulse vanishes.

"Bian" is taken literally. When Shaoyang is controlled, heat qi does not move. Now that Shaoyang recovers, great heat approaches. Approaching heat causes dryness and burning. Metal suffering from fire punishment causes shell-bearing insects to perish. People suffer from startle, convulsions, cough, and epistaxis, which is fire punishing lung metal. Heart heat and irritability is fire attacking the heart. Disharmony of Shaoyang Sanjiao (Triple Burner) qi causes frequent urination and external aversion to wind. Frequent urination and aversion to wind lead to upward reversal of jue qi. Upward reversal of jue qi causes a face like floating dust and eye convulsions, indicating that Shaoyang jue qi ascending prevents sheng yang (generating yang) qi from nourishing the face and eyes. Internal emission of fire causes mouth ulcers above, vomiting in the middle, and blood bleeding below, indicating Shaoyang fire emitting internally and Sanjiao qi disharmonizing in the upper, middle, and lower parts. Shaoyang qi manifesting as malaria causes chills and trembling. Extreme cold reversing to heat scorches throat collaterals, causes thirst, and turns urine yellow-red, representing Shaoyang malaria. Shortness of qi and atrophied pulses transforming into water retention and edema indicate internal deficiency of Shaoyang yuan zhen (original true) qi. If severe, evil fire enters the lung, causing cough and hemoptysis, leading to fire excess and metal deficiency, making the Chize (LU5) pulse vanish, resulting in incurable death.

When Yangming (Bright Yang) recovers, clear qi arises, trees become sparse and branches gray, hair-bearing animals suffer illness. Illness arises in the hypochondrium, qi gathers on the left, sighing is frequent. If severe, heart pain, epigastric fullness, abdominal distension, and diarrhea occur. Bitter vomiting, cough, hiccups, and heart vexation occur, with illness in the diaphragm and headache. If severe, it enters the liver, causing fright and tendon spasms. Death is incurable when the Taichong (LR3) pulse vanishes.

When Yangming is controlled, clear qi does not rise. Now that Yangming recovers, clear qi rises greatly. Wood suffering from metal punishment causes trees to become sparse and branches gray, and hair-bearing animals to suffer. "Li" means illness. Illness in the hypochondrium and qi gathering on the left is liver wood pathology. Frequent sighing is gallbladder wood pathology. If severe, excessive clear qi causes heart pain, epigastric fullness, abdominal distension, and diarrhea. Yangming qi rebellion causes bitter vomiting; lung-stomach disharmony causes cough; fixed cold in the chest causes hiccups; stomach collaterals not connecting to the heart cause heart vexation and diaphragmatic illness. The Jueyin (Terminal Yin) liver meridian ascends to the forehead and meets the Du vessel at the vertex; liver meridian disease causes headache. If severe, metal qi enters the liver, causing fright and tendon spasms. If metal is excessive and wood is deficient, death is incurable when the Taichong (LR3) pulse vanishes.

When Taiyang (Greater Yang) recovers, jue qi ascends, water freezes and rain turns to ice, feather-bearing animals die. Cold arises in the heart and stomach, diaphragmatic obstruction occurs, heart pain and epigastric fullness arise, headache with frequent sadness, occasional dizziness and fainting, reduced food intake, lumbar and back pain with inability to bend or extend, ground cracking and ice hardening, sunlight obscured. Lower abdomen pain radiating to the testicles, pulling the waist and spine, rising to strike the heart, expectoration of clear fluid, and hiccups/belching occur. If severe, it enters the heart, causing forgetfulness and frequent sadness. Death is incurable when the Shenmen (HT7) pulse vanishes.

Jue qi refers to cold qi. When Taiyang is controlled, cold qi does not move. Now that Taiyang recovers, cold qi ascends. Ascending cold qi causes water to freeze and rain to turn to ice. Water overcoming fire extinguishes it, so feather-bearing animals (fire category) die. Excessive cold causes cold in the heart and stomach. Cold in the heart and stomach causes diaphragmatic obstruction. Diaphragmatic obstruction causes heart pain and epigastric fullness. The Taiyang meridian ascends to the head, causing headache. Excessive yin qi causes frequent sadness; headache causes occasional dizziness and fainting. Middle earth deficiency-cold causes reduced food intake. Taiyang meridian disharmony causes lumbar/back pain and inability to bend/extend. Extreme cold causes ground cracking and ice hardening, obscuring sunlight. Cold below causes lower abdomen pain radiating to testicles; from below to middle, it pulls the waist/spine; from middle to above, it strikes the heart. Ascending cold causes expectoration of clear fluid, hiccups, and belching. Hiccups and belching indicate fire and earth not generating each other. If severe, cold enters the heart, causing forgetfulness and sadness. If water is excessive and fire is deficient, death is incurable when the Shenmen (HT7) pulse vanishes.

The Yellow Emperor said: Excellent. How to treat?

How to treat the recovery of the six qi?

Qibo said: For Jueyin recovery, treat with sour-cold herbs, assist with sweet-acrid herbs, drain with sour, and relax with sweet.

The method for treating recovery is to assist the root qi. Only when heat-dry qi is excessive should it be restrained or assisted. Sour is the flavor of wood; cold is the nature of water. Treating with sour-cold assists wood qi. To prevent excessive cold, assist with sweet; to prevent excessive sour, assist with acrid. Treating with sour-cold drains with sour. "Drain" here means to soothe/unblock. Assist with sweet-acrid relaxes with sweet. "Sour-cold" mentions only sour, "sweet-acrid" mentions only sweet, due to ellipsis. This treats Jueyin recovery by assisting without restraining.

For Shaoyin recovery, treat with salty-cold herbs, assist with bitter-acrid herbs, drain with sweet, astringe with sour, release with bitter-acrid, and restrain with salty.

Salty is the flavor of water; cold is the nature of water. Treating with salty-cold restrains fire qi. If fire qi is too deficient, assist with bitter (flavor of fire) to aid fire. If fire qi is too excessive, assist with acrid (flavor of metal) to generate water. Alternatively, drain with sweet to calm water, or astringe with sour to generate fire. Assisting with bitter-acrid releases; treating with salty-cold restrains. This treats Shaoyin heat recovery by either assisting or restraining.

For Taiyin recovery, treat with bitter-hot herbs, assist with sour-acrid herbs, drain with bitter, dry dampness, and purge turbidity.

Bitter is the flavor of fire; hot is the nature of fire. Treating with bitter-hot assists earth qi. If fire qi is insufficient, assist with sour (wood generates fire). If fire qi is excessive, assist with acrid (metal generates water). Treating with bitter-hot drains with bitter, dries with heat. Earth dampness is dried; earth dryness is purged. This treats Taiyin recovery by assisting without restraining.

For Shaoyang recovery, treat with salty-cool herbs, assist with bitter-acrid herbs, restrain with salty, astringe with sour, release with bitter-acrid. Release should not be far from heat; do not violate warm/cool methods. Shaoyin follows the same method.

Treating with salty-cool restrains fire qi. If fire qi is deficient, assist with bitter; if excessive, assist with acrid. Either restrain with salty to drain fire, or astringe with sour to generate fire. Assisting with bitter-acrid releases. Acrid is metal flavor; bitter is fire flavor. Clarifying "release with bitter-acrid" means "release not far from heat," using heat to aid fire. Do not use warm/cool methods. Since Shaoyang and Shaoyin both belong to fire, this assistance method is the same as Shaoyin.

For Yangming recovery, treat with acrid-warm herbs, assist with bitter-sweet herbs, purge with bitter, descend with bitter, and tonify with sweet.

"Sweet" in "tonify with sweet" was erroneously "sour" in old texts, corrected here. Acrid is metal flavor to aid metal. Warm is fire nature to restrain metal. Treating with acrid-warm balances metal qi. Bitter is fire flavor to restrain metal; sweet is earth flavor to generate metal. Assisting with bitter-sweet balances metal qi. If metal qi is excessive, purge/descend with bitter. If metal qi is deficient, tonify with sweet. This treats Yangming dryness recovery by either restraining or assisting.

For Taiyang recovery, treat with salty-hot herbs, assist with sweet-acrid herbs, firm with bitter.

Salty is water flavor to aid water; hot is fire nature to warm cold. Treating with salty-hot aids water qi. If water qi is excessive, assist with sweet; if deficient, assist with acrid. When water is balanced, no tonification/draining is needed; just firm with bitter. Water-cold aided by fire-flavor achieves water-fire intersection and firmness. This treats Taiyang recovery by assisting without restraining.

To treat all excess-recovery patterns: Cold is treated with heat; heat with cold; warmth with clearing; coolness with warming; dispersion with astringing; suppression with dispersing; dryness with moistening; tension with relaxing; hardness with softening; fragility with firming; deficiency with tonifying; excess with draining. Each stabilizes its qi, ensuring clarity and stillness, so pathogenic qi declines and returns to its origin. This is the general principle of treatment.

"Strong" is taken literally. Summarizing previous treatments of excess-recovery, this is the general principle.

The Yellow Emperor said: Excellent. What is meant by the up and down of qi?

Continuing from excess-recovery, asking about excess qi residing above and recovery qi residing below, and how their up/down movement in the human body causes disease.

Qibo said: Above the midpoint of the body, there are three qi, belonging to Heaven, governed by heavenly qi. Below the midpoint, there are three qi, belonging to Earth, governed by earthly qi. Name the qi by its designation, designate the location by the qi, and discuss the disease. The midpoint is known as Tianshu (CV12). If excess is above and disease is below, name it by Earth. If excess is below and disease is above, name it by Heaven. When excess arrives, the retaliatory qi is suppressed and not yet emitted. When recovery arrives, it is not named differently by Heaven/Earth, but follows the recovery pattern.

"Fen" is pronounced with falling tone. *Yin Yang Xi Ri Yue* states: Waist above is Heaven, waist below is Earth. Heaven is Yang, Earth is Yin. Months 1 & 6 govern Foot Shaoyang; Months 2 & 5 govern Foot Taiyang; Months 3 & 4 govern Foot Yangming. These three yang qi govern the first half of the year, hence "above midpoint, three qi." Heaven is Yang, the domain of Heaven, governed by heavenly qi. Months 7 & 12 govern Foot Shaoyin; Months 8 & 11 govern Foot Taiyin; Months 9 & 10 govern Foot Jueyin. These three yin qi govern the second half of the year, hence "below midpoint, three qi." Earth is Yin, the domain of Earth, governed by earthly qi. The three qi above are Shaoyang, Taiyang, Yangming; below are Shaoyin, Taiyin, Jueyin. Thus, the names of Three Yin/Yang designate the qi above and below the midpoint. Foot Shaoyang starts at the outer canthus; Foot Taiyang at the inner canthus; Foot Yangming at the nose. These three yang are Heaven's domain, their qi starting above. Foot Shaoyin starts below the little toe; Foot Taiyin at the tip of the big toe; Foot Jueyin at the hairy margin of the big toe. These three yin are Earth's domain, their qi starting below. Thus, qi above and below designates meridian pathways. By naming qi and locating it, one can discuss internal/external/up/down diseases. Tianshu (CV12) is above the navel, opposite the waist midpoint, defining the "half." If yang qi above excesses and disease occurs below, the disease is in Earth, named by Earth. If yin qi below excesses and disease occurs above, the disease is in Heaven, named by Heaven. When qi exceeds, recovery qi is suppressed and not yet emitted. When recovery arrives, there is no distinction between Heaven/Earth, following recovery rules. As stated later, "Excess brings recovery; no excess means stagnation," meaning recovery has fixed rules.

The Yellow Emperor said: Does the movement of excess-recovery have constant timing? Is the qi inevitable?

Continuing from recovery rules, asking if the movement of excess-recovery has constant numbers in the six periods of a year, and if the overcome qi is inevitable.

Qibo said: Timing has constant positions, but qi is not inevitable.

The six periods of a year start with Jueyin and end with Taiyang. Timing has constant positions, but excess-recovery depends on excess to trigger recovery, so it is not inevitable.

The Yellow Emperor said: I wish to hear the way.

Constant timing implies constant excess. Constant excess implies constant recovery, so I wish to hear the constant way of excess-recovery.

Qibo said: From the first period to the third, heavenly qi governs, which is the norm of excess. From the fourth period to the final, earthly qi governs, which is the norm of recovery. There is recovery if there is excess; no excess means no recovery.

Spring/Summer are Yang, representing heavenly qi. Thus, periods 1-3 are governed by heavenly qi, with excess preceding recovery, and excess qi usually in the first half of the year, hence the norm of excess. Autumn/Winter are Yin, representing earthly qi. Thus, periods 4-6 are governed by earthly qi, with recovery qi usually in the second half of the year, hence the norm of recovery. Excess brings recovery; no excess means no recovery. This is the norm of excess-recovery, but variations cannot be predicted.

The Yellow Emperor said: Excellent. After recovery ends, another excess occurs. What happens?

Excess brings recovery, a normal principle. After recovery ends, if another excess occurs, what then?

Qibo said: When excess arrives, recovery occurs, with no fixed number; it stops only when it declines. If recovery ends and excess occurs again, failure to recover causes harm, injuring life.

"Shu" is taken literally. "Zhi" means extreme. Recovery occurs when excess is extreme, with no fixed number. Recovery stops only when it declines. Once declined, recovery ends, and if excess occurs again, failure to recover causes harm. This injures life. E.g., if water excess suppresses fire, fire recovery damages metal. If fire qi ends, metal should recover excess; if not, metal suffers fire damage and cannot generate, others follow this example.

The Yellow Emperor said: Recovery causes contrary disease. Why?

Failure to recover causes harm; recovery causing contrary disease, why?

Qibo said: Residing in the wrong position, they do not harmonize. Greatly recovering the excess makes the ruling qi overcome it, hence contrary disease, referred to as fire-dry-heat.

Excess qi is in the first half of the year; recovery qi in the second. E.g., dryness recovery occurs in the 4th period (Shaoyang Ministerial Fire); wind recovery in the 5th period (Yangming Dry Metal); fire/heat recovery in the final period (Taiyang Cold Water). All reside in wrong positions. Wrong position means lack of harmony. Starting with excess and ending with recovery, even if greatly recovering the excess, the ruling qi of that time overcomes it, causing contrary disease. Fire/heat resides in Taiyang Cold Water position; dryness in Shaoyang Ministerial Fire position. Referring to "fire-dry-heat," wind-wood qi in Yangming Dry Metal position is also included. Earth-damp qi governs four seasons, so it is excluded.

The Yellow Emperor said: How to treat?

Recovery causing contrary disease, how to treat?

Qibo said: For qi excess, mild cases follow it; severe cases control it. For qi recovery, harmonious cases balance it; violent cases deprive it. Follow the excess qi, stabilize the suppressed qi, regardless of quantity, aiming for balance. This is the way.

Six qi excesses vary in severity; six qi recoveries vary in harmony/violence. For excess qi, mild cases are treated by following; severe cases by controlling. For recovery qi, harmonious cases are balanced; violent cases are deprived. Even if excess qi wins, if recovery qi still wins, the treatment follows the excess qi to stabilize the suppressed, regardless of quantity, aiming for balance. This is the treatment principle.

The Yellow Emperor said: Excellent. What about guest-host excess-recovery?

In a year, there is superimposed Guest Qi and Six Positions of Host Qi. If Host Qi overcomes Guest Qi, or Guest Qi overcomes Host Qi, excess brings recovery, hence the question.

Qibo said: Guest-host qi, excess without recovery.

Considering six qi, excess brings recovery. But guest-host qi are simultaneous and in the same position; Host Qi is fixed, Guest Qi changes, so there is excess but no recovery.

The Yellow Emperor said: How does the adverse reaction come from?

Host and Guest Qi overcome each other; some overcoming is adverse, some is compliant. Asking how adversity comes.

Qibo said: Host overcoming is adverse; Guest overcoming is compliant. This is the Way of Heaven.

Six qi governing the year are constant every year, the norm of qi. Superimposed Guest Qi shifts with Si Tian (Heavenly Ruler) and Zai Quan (Earthly Sovereign), the temporary state of qi. The constant can yield, but the temporary cannot. Thus, Host overcoming Guest is adverse; Guest overcoming Host is compliant. This Guest Qi victory due to Si Tian is called the Way of Heaven.

The Yellow Emperor said: How does disease arise?

Guest-host qi have excess but no recovery, yet all cause human disease, so asking how disease arises.

Qibo said: When Jueyin governs Heaven, Guest excess causes tinnitus, tremors, vertigo, and severe cough. Host excess causes chest/hypochondriac pain and tongue stiffness with difficulty speaking.