（《素问·至真要大论》）
帝曰∶气之上下何谓也？岐伯曰∶身半以上，其气三矣，天之分也，天气主之；身半以下，其气三矣，地之分也，
地气主之。（气之上下，司天在泉也，而人身应之，则身半以上，阳气三，阴气亦三，是为手之六经，应天之分，故天气
主之。身半以下，亦阳气三，阴气三，是为足之六经，应地之气，故地气主之。《六节藏象论》亦云其气三，三而成天，
三而成地，三而成人，亦是三阴三阳之义。）以名命气，以气命处，而言其病。半，所谓天枢也。（以名命气，谓正其名
则气有所属，如三阴三阳者名也，名既立则六气各有所主矣。以气命处，谓六经之气各有其位。察其气则中外前后上下
左右病处可知矣。半，身半也，上下之中也。以人身言之，则前及于脐，后及于腰，故脐旁二寸名天枢穴，正取身半之
义。又天枢详义，见本类前九。）故上胜而下俱病者，以地名之；下胜而上俱病者，以天名之。（上胜则下虚而下俱病者，
即名地气也。下胜则上虚而上俱病者，即名天气也，《六元正纪大论》曰∶天气不足，地气随之，地气不足，天气从之。
亦此之谓。）所谓胜至，报气屈伏而未发也，复至则不以天地异名，皆如复气为法也。（凡胜至为病者，以报气未发也，
故病在上则求乎天，病在下则求乎地。若复气已至，则不以天地异名，但求复气所居，随微甚以为治法也。如前章治六
气之复，及下文云气之复也，和者平之，暴者夺之，皆治复之法。）帝曰∶胜复之动，时有常乎？气有必乎？岐伯曰∶时
有常位而气无必也。（时有常，气无必，义如下文。）帝曰∶愿闻其道也。岐伯曰∶初气终三气，天气主之，胜之常也；
四气尽终气，地气主之，复之常也。（岁半之前，天气主之，岁半之后，地气主之，胜在前，复在后，故自初气以至三气，
乃司天所主之时，太过则胜其不胜，不及则胜者来胜。此胜之常也。自四气以至终气，乃在泉所主之时，太过则承者起
而制之，不及则子为母而复之，此复之常也。故曰时有常位。）有胜则复，无胜则否。（在胜必有复，无胜则无复。《五常
政大论》曰∶微者复微，甚者复甚。可见胜复之气，或有或无，或微或甚，其变不一，故曰气无必也。）帝曰∶善。复已
而胜何如？岐伯曰∶胜至则复，无常数也，衰乃止耳。（复已而胜，谓既复之后而又胜也。胜至则复，言再胜则再复，本
无常数也。胜复之变，本由乎气，若气有余而胜复微，则气有未尽，故不免再胜再复。若胜复甚，则彼此气尽而已，故
衰乃止耳。）复已而胜，不复则害，此伤生也。（若有胜无复，则亢而为害，故伤生也。）帝曰∶复而反病何也？岐伯曰∶
居非其位，不相得也。大复其胜，则主胜之，故反病也。（复而反病，谓复反自病也。复气居非其位，则客主之气不相得，
气不相得而大复其胜，力极必虚，虚则主气乘之，故反受病也。）所谓火燥热也。（此即居非其位也，火，少阳也。燥，
阳明也。热，少阴也。少阳少阴在泉，以客之火气，而居主之水位，火气大复，则水主胜之。阳明司天，以客之金气，
而居主之火位，金气大复，则火主胜之。余气胜复，则无主胜之反病，故曰所谓火燥热也。按∶此以复气反病为言，然
燥在三气之前，本非复之时也，但言复则胜可知矣，故胜气不相得者亦当反病，天地之气皆然也。）帝曰∶治之奈何？岐
伯曰∶夫气之胜也，微者随之，甚者制之，气之复也，和者平之，暴者夺之。皆随胜气，安其屈伏，无问其数，以平为
期，此其道也。（此总言胜复微甚之治也。微者随之，顺其气以安之也。甚者制之，制以所畏也。和者平之，调其微邪也。
暴者夺之，泻其强盛也。但随胜气以治，则屈伏之气可安矣。然不必计其数之多少，但以得平为期，乃气胜之道。此言
皆随胜气者，非单以胜气为言，而复气之至，气亦胜矣，盖兼言之也。本节治法，乃与前章治诸气复相参阅。）帝曰∶善。
黄帝问道：气的上下分布是指什么？岐伯回答说：身体上半部，其气分为三类，属于天的分野，由天气所主；身体下半部，其气也分为三类，属于地的分野，由地气所主。（气的上下，指的是司天和在泉之气，而人身与之相应，则身体上半部，阳气有三，阴气也有三，这就是手六经，对应天的分野，所以由天气所主。身体下半部，同样是阳气有三，阴气有三，这就是足六经，对应地气，所以由地气所主。《素问·六节藏象论》也说“其气三”，三而成天，三而成地，三而成人，这也是三阴三阳的道理。）用名称来界定气，用气来界定部位，从而论述疾病。所谓“半”，指的就是天枢穴。（用名称来界定气，是说确立名称后，气就有归属，如三阴三阳是名称，名称确立后，六气各自有所主管。用气来界定部位，是说六经之气各有其位置。观察气的变化，就可以知道内外、前后、上下、左右病变的部位。“半”即身半，也就是身体的中间部分。从人体正面看，前至脐部，后至腰部，所以脐旁两寸处的穴位名为天枢穴，正是取身体一半的含义。另外关于天枢的详细含义，见本类前面的第九条。）所以上方胜气盛而下部都发病的，用地气来命名；下方胜气盛而上部都发病的，用天气来命名。（上方胜气盛则下部虚而全部发病，这就称为地气病。下方胜气盛则上部虚而全部发病，这就称为天气病。《素问·六元正纪大论》说：“天气不足，地气随之；地气不足，天气从之。”也是这个意思。）所谓胜气到来时，报复之气尚屈伏而未发；等到报复之气到来时，就不再用天地异名来区分，都按照报复之气的规律来处理。（凡是胜气致病，是因为报复之气尚未发出，所以病在上部就求之于天，病在下部就求之于地。如果报复之气已经到来，就不再用天地不同的名称，只根据报复之气所在的位置，根据其程度的轻重来确定治疗方法。如前一章治疗六气之复，以及下文所说“气之复也，和者平之，暴者夺之”，都是治疗复气的方法。）黄帝道：胜气和复气的变动，时间上有固定规律吗？气有必然性吗？岐伯回答说：时间上有固定的位次，但气没有必然的定数。（时间有固定规律，气没有必然定数，道理如下文所述。）黄帝道：希望听听其中的道理。岐伯回答说：初气到三气，由天气主管，这是胜气的常规；四气到终气，由地气主管，这是复气的常规。（岁半之前，天气主管；岁半之后，地气主管。胜气在前，复气在后，所以从初气到三气，是司天之气主管的时候，太过则胜其所不胜之气，不及则胜气来克。这是胜气的常规。从四气到终气，是在泉之气主管的时候，太过则承制之气兴起而制约它，不及则子气为母气而复气。这是复气的常规。所以说时间有固定的位次。）有胜气就会有复气，没有胜气就没有复气。（在胜气中必有复气，没有胜气就没有复气。《素问·五常政大论》说：“微者复微，甚者复甚。”可见胜复之气，或有或无，或轻或重，变化不一，所以说气没有必然的定数。）黄帝道：讲得好。复气之后又出现胜气怎么样？岐伯回答说：胜气到来就会有复气，次数没有固定，直到气衰才会停止。（复气之后又出现胜气，是说既已发生复气之后又再次发生胜气。胜气到来就有复气，意思是再胜就再复，本来没有固定的次数。胜复的变化，原本取决于气，如果气有余而胜复轻微，说明气未尽，所以不免再次胜、再次复。如果胜复剧烈，那么彼此的气都会耗尽，所以气衰就会停止。）复气之后又出现胜气，如果不复气就会造成危害，这会损伤生命。（如果有胜气而无复气，就会亢盛而为害，所以损伤生命。）黄帝道：复气反而导致生病是怎么回事？岐伯回答说：因为复气居于非其本位，与主气不相协调。如果大力恢复以克制胜气，则主气会反过来克制它，所以反而生病。（复气反而生病，是说复气反而自伤。复气居于非其本位，则客气与主气不相协调，气不相协调且大力恢复以克制胜气，力量极尽必致虚弱，虚弱则主气乘虚而入，所以反而受病。）这主要发生在火、燥、热这三种情况。（这就是所说的“居于非其本位”。火，指少阳；燥，指阳明；热，指少阴。少阳、少阴在泉，以客居的火气，占据主气的水位，火气大复，则水之主气反胜之。阳明司天，以客居的金气，占据主气的火位，金气大复，则火之主气反胜之。其余气机的胜复，则没有主气反胜导致的反病，所以说主要是火、燥、热这三种情况。按：这里是以复气导致反病来说明，但燥气在三气之前，本来不是复气的时候，只是说复气则可知胜气，所以胜气不相协调的情况也会反病，天地之气都是如此。）黄帝道：如何治疗？岐伯回答说：对于胜气，轻微的顺从其势，严重的加以制约；对于复气，平和的予以调和，剧烈的予以攻泻。都要随着胜气，安抚其屈伏之气，不问次数多少，以平衡为目的，这就是治疗的原则。（这里总述胜复之气微甚的治疗原则。轻微的顺从其势，是顺应其气以安定它。严重的加以制约，是用其所畏之物来制约。平和的予以调和，是调理轻微的邪气。剧烈的予以攻泻，是泻除强盛的邪气。只要顺着胜气来治疗，屈伏之气就能安定。然而不必计较次数多少，只要达到平衡即可，这才是处理气胜之道。这里所说的“皆随胜气”，并非单指胜气而言，复气到来时，气也是胜的，这里是兼而言之。本节的治疗原则，可与前一章治疗各种气复的内容参照阅读。）黄帝道：讲得好。
Huangdi asked: What is meant by the distribution of Qi in the upper and lower parts? Qibo replied: The upper half of the body, its Qi is divided into three categories, belonging to the domain of Heaven, governed by Heavenly Qi; the lower half of the body, its Qi is also divided into three categories, belonging to the domain of Earth, governed by Earthly Qi. (The upper and lower aspects of Qi refer to the Si Tian [Supreme Sovereign] and Zai Quan [Inferior Sovereign] influences, which correspond to the human body. Thus, in the upper half, there are three Yang Qi and three Yin Qi, corresponding to the Six Hand Meridians [Six Hand Jueyin, Shaoyang, Taiyang, Yangming, Shaoyin, Taiyin], aligning with the domain of Heaven, hence governed by Heavenly Qi. In the lower half, similarly, there are three Yang Qi and three Yin Qi, corresponding to the Six Foot Meridians [Six Foot Jueyin, Shaoyang, Taiyang, Yangming, Shaoyin, Taiyin], aligning with Earthly Qi, hence governed by Earthly Qi. The *Suwen: Liujie Cangxiang Lun* also states "its Qi is three"; three constitute Heaven, three constitute Earth, and three constitute Humanity, reflecting the principle of Three Yin and Three Yang.) By naming, we define the Qi; by Qi, we define the location, thereby discussing disease. The term "half" refers to the Tianshu point (ST25) (Tianshu [Heavenly Pivot]). (Naming defines Qi, meaning that once a name is established, Qi has its affiliation; for example, Three Yin and Three Yang are names, and once established, each of the Six Qi has its specific governance. Defining location by Qi means that the Qi of the Six Meridians each has its own position. Observing the Qi allows one to know the locations of disease internally/externally, anterior/posterior, superior/inferior, and lateral. "Half" refers to the midpoint of the body. From the perspective of the human body, this extends anteriorly to the umbilicus and posteriorly to the waist. Therefore, the acupoint located two cun lateral to the umbilicus is named Tianshu [Heavenly Pivot], precisely taking the meaning of the body's midpoint. For further details on Tianshu, see Item 9 in this category earlier.) When the superior part experiences excessive Qi causing disease throughout the inferior part, it is named according to Earthly Qi; when the inferior part experiences excessive Qi causing disease throughout the superior part, it is named according to Heavenly Qi. (When superior Qi is excessive, the inferior becomes deficient and diseased, which is termed Earthly Qi pathology. When inferior Qi is excessive, the superior becomes deficient and diseased, which is termed Heavenly Qi pathology. The *Suwen: Liuyuan Zhengji Dalun* states: "When Heavenly Qi is insufficient, Earthly Qi follows; when Earthly Qi is insufficient, Heavenly Qi follows." This is what is meant here.) When the pathogenic factor of excess (Sheng) arrives, the retaliatory factor (Fu) remains suppressed and unmanifested. When the retaliatory factor arrives, it is no longer distinguished by different names of Heaven and Earth, but is treated according to the principles of the retaliatory factor. (Whenever disease arises from an excess factor, it is because the retaliatory factor has not yet emerged. Thus, if the disease is in the upper part, treatment seeks the influence of Heaven; if in the lower part, it seeks the influence of Earth. If the retaliatory factor has already arrived, one does not use different names for Heaven and Earth, but only seeks the location of the retaliatory factor and determines treatment based on its severity. As discussed in the previous chapter regarding the treatment of the six Qi retaliations, and as stated below: "Regarding the retaliation of Qi, if mild, level it; if violent, drain it." These are methods for treating retaliatory Qi.) Huangdi said: Do the movements of excess and retaliation follow fixed temporal patterns? Is there a necessity to the Qi? Qibo replied: There are fixed temporal positions, but the Qi itself is not fixed/necessary. (Time has fixed regularity, but Qi does not have absolute necessity, as explained below.) Huangdi said: I wish to hear the principle. Qibo replied: From the First Qi to the Third Qi, Heavenly Qi governs, which is the normal pattern of excess; from the Fourth Qi to the Final Qi, Earthly Qi governs, which is the normal pattern of retaliation. (Before the middle of the year, Heavenly Qi governs; after the middle of the year, Earthly Qi governs. Excess comes first, retaliation follows. Thus, from the First Qi to the Third Qi is the period governed by Si Tian [Supreme Sovereign]. If excessive, it overcomes what it does not overcome; if deficient, the excess factor comes to overcome. This is the normal pattern of excess. From the Fourth Qi to the Final Qi is the period governed by Zai Quan [Inferior Sovereign]. If excessive, the controlling factor rises to restrain it; if deficient, the child Qi retaliates for the mother Qi. This is the normal pattern of retaliation. Hence, it is said that time has fixed positions.) Where there is excess, there is retaliation; where there is no excess, there is no retaliation. (Where there is excess, there must be retaliation; where there is no excess, there is no retaliation. The *Suwen: Wuchang Zheng Dalun* states: "Mild excess leads to mild retaliation; severe excess leads to severe retaliation." This shows that excess and retaliatory Qi may or may not exist, and may be mild or severe, with varied changes; hence, it is said that Qi is not fixed/necessary.) Huangdi said: Excellent. What happens if excess occurs after retaliation? Qibo replied: When excess arrives, retaliation follows. There is no fixed number; it stops only when the Qi declines. (Excess after retaliation means that after retaliation has occurred, excess arises again. When excess arrives, retaliation follows, meaning another excess leads to another retaliation, with no fixed number originally. The variation of excess and retaliation depends on Qi. If Qi is abundant but excess and retaliation are mild, it indicates Qi is not exhausted, so it inevitably undergoes further excess and retaliation. If excess and retaliation are severe, both sides' Qi will be exhausted, so it stops when Qi declines.) If excess occurs after retaliation and there is no retaliation, harm will result, damaging life. (If there is excess without retaliation, it will become hyperactive and harmful, thus damaging life.) Huangdi said: Why does retaliation sometimes cause illness instead? Qibo replied: Because the retaliatory Qi resides in a position that is not its own, and they do not harmonize. If one vigorously restores to overcome the excess, the host Qi will overcome it, causing illness instead. (Retaliation causing illness means the retaliatory Qi harms itself. If the retaliatory Qi resides in a non-appropriate position, the guest and host Qi do not harmonize. If one vigorously retaliates against the excess, strength is exhausted leading to deficiency, allowing the Host Qi to take advantage of the deficiency, thus suffering illness instead.) This specifically refers to Fire, Dryness, and Heat. (This refers to residing in a non-appropriate position. Fire refers to Shaoyang [Lesser Yang]; Dryness refers to Yangming [Greater Yang]; Heat refers to Shaoyin [Lesser Yin]. When Shaoyang and Shaoyin are Zai Quan [Inferior Sovereign], the guest Fire Qi occupies the host Water position. If Fire Qi retaliates strongly, the host Water Qi overcomes it. When Yangming is Si Tian [Supreme Sovereign], the guest Metal Qi occupies the host Fire position. If Metal Qi retaliates strongly, the host Fire Qi overcomes it. For other Qi excess/retaliation, there is no such counter-illness caused by host Qi overcoming, hence it is said that this applies to Fire, Dryness, and Heat. Note: This discusses illness caused by retaliation, although Dryness precedes the Third Qi and is not normally the time for retaliation. However, stating retaliation implies excess can be known. Thus, when excess Qi is incompatible, counter-illness may also occur; this applies to both Heaven and Earth Qi.) Huangdi said: How should it be treated? Qibo replied: Regarding excess Qi, if mild, follow its trend; if severe, control it. Regarding retaliatory Qi, if mild, balance it; if violent, drain it. All treatments should follow the excess Qi, pacify the suppressed Qi, regardless of the number of occurrences, aiming for balance. This is the principle. (This summarizes the treatment for mild and severe excess and retaliation. Following the trend of the mild means accommodating the Qi to stabilize it. Controlling the severe means restraining it with what it fears. Balancing the mild means regulating slight pathogenic factors. Draining the violent means purging strong excess. By treating according to the excess Qi, the suppressed Qi can be stabilized. One need not count the number of times, but aim for balance, which is the way of handling Qi excess. The phrase "all follow the excess Qi" does not refer solely to excess Qi; when retaliatory Qi arrives, it is also excessive, so this includes both. The treatment principles in this section should be read in conjunction with the previous chapter on treating various Qi retaliations.) Huangdi said: Excellent.