能犹言情状,盖言病之情状也。凡七则,有精义,有阙误,有衍文,洵缀集成篇者。
黄帝问曰∶人病胃脘痈者,诊当何如?岐伯对曰∶诊此者当候胃脉,其脉当沉细,沉细者气逆,逆者人迎
甚盛,甚盛则热,人迎者胃脉也。(胃为水谷之海,其血盛气壮,今反脉沉细,是逆常平也。人迎谓结喉旁脉
动应手者。按∶胃痈乃实热之证,脉当沉细有力。有力者,实热也。沉细者,毒蓄于内也。经虽但言沉细,其
为有力无疑也。王注直以沉细为虚,误矣。凡诊脉者,内见沉细有力之脉,形于右关,外则人迎动脉,盛于结
喉旁,诊候若此,其为胃痈无疑矣。)逆而盛,则热聚于胃口而不行,故胃脘为痈也。(血气壮盛而热内薄之,
两气相合,故结为痈也。)
帝曰∶善!人有卧而有所不安者,何也?岐伯曰∶脏有所伤及情有所倚则卧不安,故人不能悬其病也。
(按∶王本精有所之,寄则安。文义难通。甲乙经作情有所倚则卧不安,是也,今改从之。上古天真论曰∶“恬
虚无,真气从之,精神内守,病安从来。”生气通天论曰∶“苍天之气清净则志意治。”盖心无所慕,则情
无所钟,坦然而卧,帖然而安矣。彼夫功名之士,驰驱于荣禄,逐臭之夫,权 夫泉刀,以至酒色之徒,朝拥
匏樽,暮寻窬窦,心望望兮四驰,神摇摇而靡定,日维不足,夜以继之,卧不即安,皆情有所倚之为害也。
是故欲保命者,先须却病;欲却病者,须断妄想;欲断妄想,先用清心。心清则妄去,妄去则神定,神定矣,
卧云乎哉。是知枯禅之断六根,直是祛病良法。悬,犹远也。)
帝曰∶人之不得偃卧者,何也?(按∶偃,仰也。)岐伯曰∶肺者脏之盖也,(居高布叶,四脏下之,故
云。)肺气盛则脉大,脉大则不得偃卧。(肺气盛满,偃卧则气促喘奔故也。)
帝曰∶有病厥者,诊右脉沉而紧,左脉浮而迟,不然病主安在?(按∶甲乙经不然作不知。)岐伯曰∶冬
诊之,右脉固当沉紧,此应四时,左脉浮而迟,此逆四时,在左当主病在肾,颇关在肺,当腰痛也。(浮为肺脉,
故言颇关在肺也。腰者肾之府,故肾受病则腰痛也。)帝曰∶何以言之?岐伯曰∶少阴脉贯肾络肺,今得肺脉,
肾为之病,故肾为腰痛之病也。(左脉浮迟,非肺来见,以左肾不足而脉不能沉,故得肺脉,肾为病也。)
帝曰∶善!
有病颈痈者,或石治之,或针灸治之,而皆已,其真安在?(言所攻则异,所愈则同,欲闻真法何在也。)
岐伯曰∶此同名异等者也。夫痈气之息者,宜以针开除去之。夫气盛血聚者,宜石而泻之。此所谓同病异治也。
(息, 也,死肉也。石,砭石,用以破大痈出脓。按∶治之有异者,以痈原各有所宜故也。)
帝曰∶有病怒狂者,此病安生?岐伯曰∶生于阳也。帝曰∶阳何以使人狂?岐伯曰∶阳气者,因暴折而难
决,故善怒也。病名曰阳厥。(言阳气被折郁不散也。此人多怒,亦曾因暴折而心不疏畅故尔。皆阳逆躁极所
生,故病名阳厥。)帝曰∶何以知之?岐伯曰∶阳明者常动,巨阳、少阳不动,不动而动,大疾,此其候也。
(不应常动而反动甚者,动当病也。按∶此就脉之动于颈项者而言也。阳明人迎脉,动于
结喉旁。太阳天窗脉,动于项两旁大筋前陷者中。少阳天容脉,动于曲颊下。然阳明常多气多血,其动显,
故云常动。巨阳常少气,少阳常少血,其动隐,故云不动。今阳厥之证,三阳并动,是不特动者动,而不动者
亦动,其为疾也,讵不大哉。)帝曰∶治之奈何?岐伯曰∶夺其食即已。夫食入于阴,长气于阳,故夺其食
即已。使之服以生铁落为饮,夫生铁落者,下气疾也。帝曰∶善!(按∶食以养人,多食则能害人。无病之时,
尚须节慎,若既病矣,而仍自纵恣,则生痰助火,乏胃牵邪,养人者反以害人矣,故阳厥之证,尤当夺食也。
盖食之为道,精则变化气血,粗则增长虚骄。人之有邪,必根据卫气而发发者,卫为水谷之悍气故也。阳盛善食,
禁勿令食,故云夺也。铁落,金属,欲制火先须平木也。洛,甲乙作落,是也,从之。)
有病身热解堕,汗出如浴,恶风少气,此为何病?岐伯曰∶病名酒风。帝曰∶治之奈何?岐伯曰∶以泽泻、
术各十分,麋御五分,合以三指撮为后饭。……饮酒中风者也。风论曰∶“饮酒中风则为漏风。”是亦名漏风
也。夫极饮者,阳气盛而腠理疏,玄府开发。阳盛则痿弱,故身体解堕也。腠理疏则风内攻,玄府发则气外泄,
故汗出如浴也。风气外薄,肤腠复开,汗多内虚,瘅热熏肺,故恶风少气也。因酒而病,故曰酒风。术味苦温
平,主治大风止汗。麋含味苦寒平,主治风湿筋痿。泽泻味甘寒平,主治风湿益气。饭后药先,谓之后饭。
帝曰∶妇人重身,毒之何如?岐伯曰∶有故无殒,亦无殒也。(上无殒言母必全,下无殒言子亦不死也。
按∶毒之谓妇人怀妊而病积聚,可用毒药治否。有故无殒,谓既有病,虽用重剂,母子俱可无害也。)帝曰∶
愿闻其故何谓也?岐伯曰∶大积大聚,其可犯也,衰其大半而止,过者死。(过禁待尽,毒瓦斯内余,无病可攻,
以当毒药,毒攻不已,则败损中和,故过则死。按∶人之所以致有积聚者,多由正气内虚,不能运化,故欲去
积聚,必顾正气。盖攻积之药,尽属驶剂,得去大半,势自难留,元气日增,积聚渐减矣。若攻之不已,必伤
元气,而积聚益横,且至胀满而死,不可不慎也。此一段,王本原刻在六元正纪大论中,因与上下文义不合,
故移置于此。)
“能”字在这里是形容情状的意思,大概是指描述疾病的情状。这段文字共有七则内容,其中有精妙的义理,也有残缺错误之处,还有衍文(多余的文字),确实是拼凑集成的一篇。
黄帝问道:人患胃脘痈(胃部化脓性炎症)病,诊察时应当如何?岐伯回答说:诊察这种病应当观察胃脉,其脉象应当沉细,脉象沉细说明气机逆乱,气机逆乱则人迎脉(结喉旁动脉)特别盛大,特别盛大则表示有热,人迎脉属于胃经的脉。(胃为水谷之海,气血旺盛,现在反而出现沉细的脉象,这是违背了正常的平人脉象。人迎脉是指结喉旁边脉搏跳动应手的部位。按语:胃痈属于实热证,脉象应当沉细而有力。有力代表实热,沉细代表毒邪蓄积在体内。经文虽然只说沉细,但其中必然有力无疑。王冰注直接认为沉细是虚证,这是错误的。凡是诊脉的人,如果在右关部见到沉细有力的脉象,而在体外结喉旁出现人迎脉动盛大,诊候如此,这肯定是胃痈无疑。)气机逆乱且盛大,则热气聚集在胃口处而不能运行,所以胃脘形成痈肿。(血气壮盛而热邪内迫,两气相合,所以结成痈肿。)
黄帝说:好!有人睡觉时感到不安稳,是什么原因呢?岐伯说:脏腑受到损伤以及情志有所偏倚就会导致睡眠不安,所以人不能脱离这些病因来单独谈论病情。(按语:王冰注本中作“精有所之,寄则安”,文义难以通顺。《甲乙经》作“情有所倚则卧不安”,是正确的,现在改正并遵从它。《上古天真论》说:“恬淡虚无,真气从之,精神内守,病安从来。”《生气通天论》说:“苍天之气清净则志意治。”大概心里没有所羡慕的事物,那么情感就没有所专注的对象,坦然地躺下,安稳地入睡。那些追求功名的人,在荣华禄位中奔波;追逐臭味的人(指贪利者),在金钱财富中钻营;以至于沉迷酒色之徒,早晨拥抱着酒杯,晚上寻找偷香窃玉的机会,心神恍惚四处驰散,精神摇荡不定,白天觉得时间不够用,夜晚接着继续,睡觉自然不能立即安宁,这都是因为情感有所偏倚造成的危害。所以想要保命的人,必须先祛除疾病;想要祛除疾病的人,必须断绝妄想;想要断绝妄想,先用清心法。心清则妄想去除,妄想去除则神志安定,神志安定了,睡觉还有什么困难呢。由此可知枯坐禅定以断绝六根,确实是祛病的良方。悬,就是远离的意思。)
黄帝说:人不能仰卧(偃卧,即仰面躺卧),是什么原因呢?(按语:偃,就是仰的意思。)岐伯说:肺是五脏的华盖(覆盖在其他脏器之上),(位置高如伞盖,覆盖四脏之下,所以说华盖。)肺气盛满则脉象大,脉象大就不能仰卧。(肺气盛满,仰卧时会导致气促喘息奔涌的缘故。)
黄帝说:有的人患厥逆病,诊察右手脉象沉而紧,左手脉象浮而迟,不知这个病主要在哪里?(按语:《甲乙经》中“不然”作“不知”。)岐伯说:冬季诊察,右手脉象本来应当沉紧,这顺应四季变化;左手脉象浮而迟,这违背了四季变化,左手脉异常主病在肾,同时也关联到肺,应当出现腰痛的症状。(浮脉是肺的脉象,所以说也关联到肺。腰是肾的外府,所以肾受病则腰痛。)黄帝说:为什么这样说?岐伯说:足少阴肾经贯穿肾脏联络肺脏,现在诊得肺脉,是因为肾病导致的,所以肾是腰痛病的根源。(左手脉浮迟,并非肺脉传来,而是因为左肾不足导致脉象不能沉,所以表现出肺脉的特征,这是肾病。)
黄帝说:好!
有的人患颈痈(颈部化脓性炎症),有的用砭石治疗,有的用针灸治疗,都痊愈了,其中的真谛在哪里呢?(意思是攻治的方法不同,但痊愈的结果相同,想听真正的道理在哪里。)岐伯说:这是同名但病情等级不同的病。如果是痈气消散停滞(息,腐肉),适宜用针挑开除去。如果是气盛血聚的情况,适宜用砭石刺破泻出脓血。这就是所说的同病异治。(息,是腐肉的意思。石,指砭石,用来刺破大痈排出脓液。按语:治疗方法之所以不同,是因为痈肿的成因各有适宜的治疗方法。)
黄帝说:有的人患怒狂病,这种病是怎么产生的?岐伯说:产生于阳分。黄帝说:阳气怎么使人发狂?岐伯说:阳气因为突然受挫而难以决断疏导,所以容易发怒。这种病名叫阳厥。(意思是阳气被折郁结而不散发。这种人大多易怒,也是因为突然受挫而心胸不舒畅所致。都是阳气逆乱躁极所生,所以病名叫阳厥。)黄帝说:怎么知道呢?岐伯说:阳明经的脉通常是常动的,太阳经、少阳经的脉通常不动,如果不该动的反而动,而且跳动非常急疾,这就是征候。(不应该常动反而动得很厉害,说明有病。按语:这里指的是颈项部位跳动的脉。阳明经的人迎脉,跳动在结喉旁。太阳经的天窗脉,跳动在项部两旁大筋前的凹陷中。少阳经的天容脉,跳动在曲颊下方。然而阳明经多气多血,其跳动明显,所以说常动。太阳经常少气,少阳经常少血,其跳动隐蔽,所以说不动。现在的阳厥证,三阳经同时跳动,不仅该动的在动,不该动的也在动,这个病难道不大吗?)黄帝说:怎么治疗?岐伯说:剥夺他的饮食就能痊愈。食物进入人体滋养阴分,助长阳气,所以剥夺饮食就能痊愈。让他服用生铁落煎成的汤剂,生铁落具有迅速降气的作用。黄帝说:好!(按语:饮食供养人,多吃则会害人。没病的时候,尚且需要节制谨慎,如果已经病了,还放纵恣意,就会生痰助火,拖累脾胃引邪深入,养人的东西反而害人了,所以阳厥证,尤其应当剥夺饮食。大概饮食的道理,精华部分转化为气血,粗糙部分增长虚骄之气。人有邪气,必定依附卫气而发作,发作时,卫气是水谷中剽悍的气。阳盛的人善于进食,禁止他进食,所以叫夺食。铁落是金属,想要制约火邪必须先平抑木气。洛,《甲乙经》作落,是正确的,遵从它。)
有的人身体发热、肢体松懈无力,出汗像洗澡一样,怕风、气短,这是什么病?岐伯说:病名叫酒风。黄帝说:怎么治疗?岐伯说:用泽泻、白术各十分,麋衔五分,混合后每次取三指撮的量,在饭后服用。……这是饮酒后感受风邪的病。《风论》说:“饮酒后中风则为漏风。”这也名叫漏风。极度饮酒的人,阳气盛而腠理疏松,汗孔开发。阳盛则痿弱,所以身体松懈无力。腠理疏松则风邪内攻,汗孔开发则气外泄,所以出汗像洗澡一样。风气外迫,肤腠再次张开,汗多导致内部虚弱,湿热熏蒸肺部,所以怕风、气短。因为喝酒而生病,所以叫酒风。白术味苦、温、平,主治大风止汗。麋衔味苦、寒、平,主治风湿筋痿。泽泻味甘、寒、平,主治风湿益气。饭后服药先吃,叫做后饭。
黄帝说:妇女怀孕期间,如果用毒药治疗会怎样?岐伯说:如果有病邪存在就不会伤害母体,也不会伤害胎儿。(上面的“无殒”指母亲一定保全,下面的“无殒”指胎儿也不死亡。按语:所谓“毒之”是指妇人怀胎而有积聚病,可以用毒药治疗吗?“有故无殒”是说既然有病,即使使用重剂,母子都可以无害。)黄帝说:希望听听其中的原因,什么叫这样呢?岐伯说:大的积聚病,可以攻伐,但病势消退大半时就停止,过度攻伐会导致死亡。(过度禁戒等待耗尽,毒气留在体内,没有病可攻,却用毒药去攻,毒药攻伐不止,就会败损中和之气,所以过度就会死。按语:人之所以导致积聚,多由正气内部虚弱,不能运化,所以想要去除积聚,必须顾护正气。攻积的药物都属于峻烈之剂,得到去掉大半,病势自然难留,元气日渐增加,积聚逐渐减少。如果攻伐不停止,必伤元气,而积聚更加猖獗,甚至导致胀满而死,不可不谨慎。这一段,王冰注本原本刻在《六元正纪大论》中,因为与上下文义不合,所以移置于此。)
"Neng" here refers to describing the condition, generally meaning the description of the disease's manifestations. There are seven clauses in total; some contain profound principles, others have omissions or errors, and there are also redundant texts. It is indeed a piece compiled from various sources.
The Yellow Emperor asked: "If a person suffers from a carbuncle in the stomach region (Wei Yuan Yong), how should the diagnosis be conducted?" Qibo replied: "When diagnosing this condition, one should observe the Stomach pulse. The pulse should be deep and fine. A deep and fine pulse indicates rebellious Qi. When Qi is rebellious, the Renying pulse (artery beside the Adam's apple) becomes excessively full. An excessively full pulse indicates heat. The Renying pulse belongs to the Stomach meridian. (The Stomach is the sea of water and grain, with abundant blood and strong Qi. Now, instead, the pulse is deep and fine, which goes against the normal healthy pulse state. The Renying pulse refers to the pulsation felt at the artery beside the Adam's apple. Note: Wei Yuan Yong is a syndrome of excess heat. The pulse should be deep, fine, and forceful. Forcefulness indicates excess heat; deepness and fineness indicate toxin accumulation within. Although the classic text only mentions 'deep and fine,' it is undoubtedly forceful. Wang Bing's commentary directly interprets 'deep and fine' as deficiency, which is erroneous. In pulse diagnosis, if a deep, fine, and forceful pulse is seen internally at the Right Guan position, and externally the Renying pulse at the side of the Adam's apple is excessively full, such diagnostic findings confirm Wei Yuan Yong without doubt.) Rebellious and excessive Qi causes heat to gather at the stomach opening and fail to circulate, thus forming a carbuncle in the stomach region. (When blood and Qi are vigorous and heat presses inward, the two energies combine, resulting in the formation of a carbuncle.)
The Yellow Emperor said: "Excellent! Why do some people feel restless when lying down?" Qibo said: "When internal organs are injured and emotions are attached to specific objects, sleep becomes uneasy. Therefore, one cannot discuss the illness in isolation from these factors. (Note: Wang Bing's edition reads 'Jing has its destination, where it resides, peace ensues,' which is difficult to understand. The *Jia Yi Jing* reads 'Qing (emotion) has its attachment, then sleep is uneasy,' which is correct. We now adopt this reading. The *Shanggu Tianzhen Lun* states: 'Tranquil and void, true Qi follows; spirit and essence guard within, how can disease arise?' The *Shengqi Tongtian Lun* states: 'The Qi of Heaven is pure and clear, so will and intent are regulated.' If the heart has no desires, emotions have no focus, one lies calmly and sleeps peacefully. Those pursuing fame and fortune rush through glory and wealth; those chasing profit delve into money and knives; even those indulging in wine and lust hold goblets in the morning and seek illicit encounters at night. Their minds wander aimlessly, their spirits unstable. Daytime feels insufficient, night continues it, so sleep is not immediately peaceful. All these harms stem from emotional attachment. Thus, those wishing to preserve life must first eliminate disease; those wishing to eliminate disease must cut off delusions; those wishing to cut off delusions must first clear the heart. A clear heart removes delusions; removed delusions stabilize the spirit. With stabilized spirit, what difficulty is there in sleeping? Hence, Zen meditation severing the six senses is indeed an excellent method for curing disease. 'Xuan' means far away.)
The Yellow Emperor said: "Why can some people not lie on their backs (Yanwo)?" (Note: Yan means supine.) Qibo said: "The Lung is the canopy of the five zang organs (positioned high, covering the four lower organs, hence called the canopy). When Lung Qi is excessive, the pulse becomes large. A large pulse prevents lying on the back. (When Lung Qi is full, lying supine causes shortness of breath and panting.)
The Yellow Emperor said: "A patient suffers from Jue (cold reversal). The right pulse is deep and tight, while the left pulse is floating and slow. Where is the disease primarily located?" (Note: *Jia Yi Jing* reads 'Bu Ran' as 'Bu Zhi' [do not know].) Qibo said: "In winter diagnosis, the right pulse should naturally be deep and tight, conforming to the seasons. The left pulse being floating and slow violates the seasonal pattern. Abnormality in the left pulse indicates disease in the Kidney, closely involving the Lung, manifesting as lower back pain. (Floating is the Lung pulse, hence it involves the Lung. The waist is the mansion of the Kidney; thus, Kidney disease causes lower back pain.) The Yellow Emperor said: "Why do you say so?" Qibo said: "The Shaoyin meridian passes through the Kidney and connects to the Lung. Now, obtaining the Lung pulse indicates Kidney disease; therefore, the Kidney is the source of the lower back pain. (The left floating and slow pulse is not transmitted from the Lung but results from Left Kidney deficiency causing the pulse to fail to sink, thus presenting Lung pulse characteristics, indicating Kidney disease.)
The Yellow Emperor said: "Excellent!
"Some patients with neck carbuncles are treated with Bian stones (lithotripsy/lancing), while others are treated with acupuncture, yet both recover. What is the truth behind this?" (Meaning: The methods of attack differ, but the cure is the same. I wish to hear the true principle.) Qibo said: "These are diseases with the same name but different stages/severity. For carbuncles where Qi stagnates and flesh dies (Xi), it is suitable to use needles to open and remove them. For cases where Qi is excessive and blood gathers, it is suitable to use Bian stones to drain them. This is what is called treating the same disease differently. (Xi refers to dead/fleshy tissue. Shi refers to Bian stones, used to break large carbuncles and discharge pus. Note: Treatments differ because the origins of carbuncles have different appropriate therapies.)
The Yellow Emperor said: "Some suffer from Nukuang (rage-induced mania). How does this disease arise?" Qibo said: "It arises from Yang." The Yellow Emperor said: "How does Yang cause mania?" Qibo said: "Yang Qi, due to sudden frustration and inability to resolve, leads to frequent anger. This disease is named Yang Jue (Yang Reversal). (Meaning: Yang Qi is frustrated and depressed, failing to dissipate. Such individuals often get angry due to sudden setbacks and unsmoothed hearts. All result from extreme rebellion and agitation of Yang Qi, hence named Yang Jue.) The Yellow Emperor said: "How do we know?" Qibo said: "The Yangming meridian pulses constantly. The Taiyang and Shaoyang meridians do not normally pulse visibly. If the non-pulsating ones pulse vigorously and rapidly, this is the sign. (Pulsating when it shouldn't indicates disease. Note: This refers to pulses moving in the neck and throat area. The Yangming Renying pulse moves beside the Adam's apple. The Taiyang Tianchuang pulse moves in the depression before the large tendons on both sides of the neck. The Shaoyang Tianrong pulse moves below the cheekbone. However, Yangming has abundant Qi and blood, so its movement is obvious, hence 'constantly moving.' Taiyang has little Qi, Shaoyang has little blood, so their movement is hidden, hence 'not moving.' In the current Yang Jue syndrome, all three Yang meridians move. Not only do the moving ones move, but the non-moving ones also move. Is this not a major disease?) The Yellow Emperor said: "How to treat it?" Qibo said: "Deprive them of food, and it will cease. Food enters the Yin and generates Qi in the Yang; thus, depriving food stops it. Administer a decoction of Shengtie Luo (Iron Filings). Shengtie Luo descends Qi rapidly. The Yellow Emperor said: "Excellent!" (Note: Food nourishes humans, but overeating harms. Even when healthy, moderation is required. Once ill, indulgence generates phlegm and aids fire, burdens the Stomach, and attracts pathogens, turning nourishment into harm. Thus, for Yang Jue, food deprivation is especially necessary. Food transforms into Qi and Blood if refined, or increases arrogance/deficiency if coarse. Pathogens rely on Wei Qi to manifest; Wei Qi is the fierce Qi of water and grain. Excess Yang leads to good appetite; forbidding food is called 'deprivation.' Iron filings are metal; to control Fire, one must first calm Wood. 'Luo' in *Jia Yi Jing* is written as 'Luo', which is correct. We follow it.)
"Some have body heat, flaccidity, sweating profusely like bathing, aversion to wind, and shortness of Qi. What disease is this?" Qibo said: "The disease is named Jiu Feng (Wind-Damp caused by Wine)." The Yellow Emperor said: "How to treat it?" Qibo said: "Use Ze Xie (Alisma Rhizome) and Bai Zhu (Atractylodes Macrocephala Rhizome) each in 10 parts, and Mi Xian (Dendrobium nobile stem, historically referred to as Mi Yu/Mi Han in some contexts, though modern identification varies) in 5 parts. Mix them. Take three finger-widths amount after meals. ... This is wind-stroke following alcohol consumption. The *Feng Lun* states: 'Wind striking after drinking is called Lou Feng (Leaking Wind).' This is also named Lou Feng. Extreme drinkers have excessive Yang and loose interstices (Cou Li), with open pores. Excess Yang causes flaccidity, hence body weakness. Loose interstices allow wind to attack inward; open pores cause Qi to leak outward, hence profuse sweating. External wind pressure and reopened pores lead to massive sweating and internal deficiency. Damp-heat steams the Lung, causing aversion to wind and shortness of Qi. Since it arises from wine, it is called Jiu Feng. Bai Zhu is bitter, warm, and neutral, treating severe wind and stopping sweat. Mi Xian is bitter, cold, and neutral, treating wind-damp and tendon flaccidity. Ze Xie is sweet, cold, and neutral, treating wind-damp and benefiting Qi. Taking medicine after eating is called 'Hou Fan' (Late Meal/Taking after meal)."
The Yellow Emperor said: "For a pregnant woman, what happens if toxic drugs are used?" Qibo said: "If there is a pathogen (Gu), there will be no injury [to the mother], nor injury [to the fetus]." (The upper 'wu yun' means the mother remains safe; the lower 'wu yun' means the fetus does not die. Note: 'Du zhi' refers to whether toxic drugs can be used for a pregnant woman with accumulations/masses. 'You gu wu yun' means since there is disease, even heavy doses will not harm mother or child.) The Yellow Emperor said: "I wish to hear the reason. What does this mean?" Qibo said: "For large accumulations and masses, they can be attacked, but stop when more than half has subsided. Over-treatment leads to death. (Over-restriction waiting for exhaustion leaves toxins inside; attacking without disease with toxic drugs damages the harmonious middle Qi, so excess leads to death. Note: Accumulations often arise from internal deficiency of Zheng Qi failing to transform. To remove accumulations, one must protect Zheng Qi. Accumulation-dispelling drugs are harsh. Removing more than half makes the pathogen hard to sustain; as Yuan Qi increases, accumulations gradually decrease. If treatment continues, Yuan Qi is damaged, accumulations worsen, leading to distension and death. Caution is essential. This section was originally in the *Liuyuan Zhengji Dalun* in Wang Bing's edition but was moved here due to contextual mismatch.)"