黄帝问曰。为五谷汤液。及醪醴奈何。（此承上章而复问也。五谷、黍稷稻麦菽。五行之谷。以养五脏者也。醪醴、
甘旨之酒。熟谷之液也。帝以五谷为问。是五谷皆可为汤液醪醴。以养五脏。而伯答以中央之稻米稻薪。盖谓中谷之液。
可以灌养四脏故也。）岐伯对曰。必以稻米。炊之稻薪。稻米者完。稻薪者坚。帝曰。何以然。岐伯曰。此得天地之和。
高下之宜。故能至完。伐取得时。故能至坚也。（夫天地有四时之阴阳。五方之异域。稻得春生夏长秋收冬藏之气。具天
地阴阳之和者也。为中央之土谷。得五方高下之宜。故能至完。以养五脏。天地之政令。春生秋杀。稻薪至秋而刈。故
伐取得时。金曰坚成。故能至坚也。炊以稻薪者。取丙辛化水之义。以化生五脏之津。上章云。移精变气以通神明。论
神气生于先天之精也。此章复论精气。又藉后天水谷之所资生。盖五谷之液。以养五气。气和津成。神乃自生。是以上
古之人。能完其天真者。虽有汤液醪醴。为而勿服。以其神全故也。中古之时。道德稍衰。邪气时至。服之万全。以稻
米之液。能生养精气神也。今世之人。止知毒药攻内。针石治外。不知精气坏弛。其功不立者。以神去故也。是以上章
曰移精变气。得神者昌。此章曰故精自生。巨气乃平。凡治病心先求其本也。）帝曰。上古圣人。作汤液醪醴。为而不用。
何也。岐伯曰。自古圣人之作汤液醪醴者。以为备耳。夫上古作汤液。故为而弗服也。（伯言上古圣人之作汤液醪醴者。
恐为邪气所伤。故以为备耳。然上古之人。多能完其天真。虽有贼邪。勿之能害。故虽为而勿服也。）中古之世。道德稍
衰。邪气时至。服之万全。（天真论曰。夫道者。能却老而全角。所以年度百岁。而动作不衰者。以其德全不危也。言中
古之人。道德虽衰。而不致于精神坏弛。故服之万全。）帝曰。今之世。不必已。何也。（不能必其邪已而获万全也。）岐
伯曰。当今之世。必齐毒药攻其中。 石针艾治其外也。（齐、疾也。 、锐也。针有九式。一曰 针。言当今之世。止
知攻疾。而不知调养其正气也。）帝曰。形弊血尽。而功不立者何。岐伯曰。神不使也。（经曰。针石之道。在皮肉筋脉
骨。各有所处。病各有所宜。各不同形。各以任其所宜。弊、止也。形弊者在皮肉筋骨。刺已止矣。血尽者在血脉。亦
已尽其疏通矣。而不能奏功者。用针之工。神不使也。灵枢经曰。粗守形。上守神。神乎神。客在门。）帝曰。何谓神不
使。岐伯曰。针石道也。精神不进。志意不治。故病不可愈。（此申明工不守神也。经曰。神在秋毫。属意病者。神属勿
去。知病存亡。又曰。凡刺之真。必先治神。静意治义。观适之义。浅深在志。远近若一。如临深渊。手如握虎。神无
营于众物。今粗环知针石之道。精神不进。志意不治。故病不可愈也。）今精坏神去。荣卫不可复收。何者。嗜欲无穷。
而忧患不止。精气弛坏。荣泣卫除。故神去之。而病不愈也。（此论病者之精神坏弛。而病不能愈也。夫气生于精。精阳
之气。化水谷之精微。而后生此荣卫。精坏神去。故荣卫不可复收。此论荣卫之生于精气也。或者嗜欲无穷。则坏其精
矣。忧患不止。则伤其气矣。精气坏弛则荣血凝泣。而卫气除去矣。故神去之而病不愈。此言神由荣卫精气之所生也。
生于精气者。先天所生之神也。神生于荣卫者。后天谷液之所生也。）帝曰。夫病之始生也。极微极精。必先入结于皮肤。
今良工皆称曰病成。名曰逆。则针石不能治。良药不能及也。今良工皆得其法。守其数。亲戚兄弟远近。音声日闻于耳。
五色日见于目。而病不愈者。亦何暇不早乎。岐伯曰。病为本。工为标。标本不得。邪气不服。此之谓也。（此节论汤液
治病之当有法也。夫察色听声。问其情。从其意。此良工得其法矣。如汤液不得其法。而病亦不愈。故详设此问焉。帝
曰。病之始生。极微极细。必先留结于皮肤。如十日不已。良工皆称曰病已成。名曰逆。虽针石不能治。而良药不能及
也。今良工皆得其审证之法。守其数。问其情。亲戚兄弟。或远或近。系之病者。可谓从其意。得其情矣。音声日闻于
耳。五色日见于目。可谓察其色。知其声矣。而病不愈者。亦何暇不早治而使病成乎。伯言病为本。工为标。盖以工之
治法为标也。言不得草苏草 。本末为助之法治之。是以邪气之不服也。上节论针石治病。重在得神。此节论汤液治病。
贵在得法。下节论汤液治病。重在调复精气。此三者。良工之不可缺一者也。夫审证辨脉。得病之情。固良工之首务。
而治病之汤液。又不可不得其法也。金西铭曰。此之谓也句。乃引标本已得。邪气乃服而言也。）帝曰。其有不从毫毛而
生。五脏阳已竭也。津液充郭。其魄独居。孤精于内。气耗于外。形不可与衣相保。此四极急而动中。是气拒于内。而
形施于外。治之奈何。（此节论气生于精。精由气化。欲治病者。当究其原。原本既清。则生机自盛。精生气平。邪气自
服。不可徒以攻疾为首务也。夫阳气主于皮毛。不从毫毛而生。五脏阳已竭者。不因外邪伤于表阳。而五脏之元真已竭
于内也。肺主气而外主皮毛。气化则水津四布。而下输膀胱。气耗于外。不能布化水液。是以津液充溢于郛郭。而肺藏
之阴魄孤精。独居于内也。水液充于皮肤则身体肿胀。而不可与衣相保。四肢为诸阳之本。阳虚于外。是以四极肿急。
喘而动中。是气逆于内。而形肿施于外。为治之法奈何。）岐伯曰。平治以权衡。去菀陈 。微动四极。温衣。缪刺其处。
以复其形。开鬼门。洁净府。精以时服。五阳已布。疏涤五脏。故精自生。形自盛。骨肉相保。巨气乃平。帝曰。善。
（此谓腐秽去而形复。形复而气布。气化而水行。水行而精生。精生而气平。所谓形归气。气归精也。平权衡者。平治
其脉。即缪刺也。肺朝百脉。输精于皮毛。毛脉合精。而后行气于脏腑。故先平治其权衡。权衡已平。则气血和而水津
散矣。积者谓之菀。久者谓之陈。腐者为之 。夫脾主为胃行其津液。灌于四脏。行于四肢。充于肌肉。脾家实。则不
能行其津液而下输膀胱。是以腐秽当去。而后形复也。微动四肢。运脾气也。温衣。暖肺气也。缪刺、调气血也。肌肉
血脉和调。则肿满消而复其旧日之形矣。鬼门、毛孔也。开鬼门。发表汗也。洁净府。泻膀胱也。鬼门开。则肺窍通而
水津布。所谓外窍开则里窍通。上窍通则下窍泄矣。膀胱者。津液之所藏。都府洁净。则精以时复矣。巨阳为诸阳主气。
而生于膀胱。精已复则气自生。而五脏之阳和已布矣。夫肠胃膀胱。受五脏浊气。名传化之府。陈 去。都府洁。则五
脏之浊。得以疏涤矣。夫水谷入胃。津液各走其道。五脏疏涤。故精自生而形自盛矣。精主骨。气主肉。精气足则骨肉
相保。而巨气乃平。巨气者。太阳主气也。夫膀胱精复。而五脏布阳者。太阳为诸阳主气也。五脏精生。而巨气乃平者。
州都之精。五脏之所生也。此章言上古之圣。能完其先天之真。中古以来。当养其后天之气。故曰。必以稻米。炊以稻
薪。盖后天之精气。由中胃水谷之所生也。高士宗曰。腹者。肠胃之郛郭。足太阴脾土之所主也。津液充郭者。胀满于
腹也。形不可与衣相保。四急极而动中者。肿胀于皮肤四肢也。是以去菀陈 。消其腹满也。开鬼门。洁净府者。行泄
皮肤之水也。先治其权衡者。脾土之运输。必由肺气之通调也。金西铭曰。四肢者。井荥经输之所出入。十二经脉。交
相贯通。胸中为气之海。宗气积于胸中。出喉咙以司呼吸。同荣气行于十二经脉之中。气行则脉行。气拒于内。则脉泣
于外矣。外内气血。交相拒逆。是以四肢胀急。而喘动于中矣。此节为治胀满水肿之要法。王子方曰。当知上古之法。
又非止于针石治外汤药治内而已。）
黄帝问道：制作五谷的汤液和醪醴，应当如何操作？（这是承接上一章的内容再次发问。五谷，指黍、稷、稻、麦、菽，是五行对应的谷物，用来滋养五脏。醪醴，是指甘甜醇厚的酒，是由熟谷发酵而成的液体。黄帝以五谷为提问对象，意思是五谷都可以用来制作汤液和醪醴，以滋养五脏，但岐伯回答强调要用中央之地的稻米和稻秆作为燃料，大概是认为中谷的汁液可以灌溉滋养其他四脏的缘故。）
岐伯回答说：必须用稻米，并用稻秆来炊煮。因为稻米性质完备，稻秆质地坚实。（天地有四季的阴阳变化，五方有不同的地理环境，稻米具备了春生、夏长、秋收、冬藏的气机，具有天地阴阳调和的特性。它属于中央土德的谷物，符合五方高下不同的地势适宜性，所以性质最为完备，能滋养五脏。天地的政令规律是春生秋杀，稻秆在秋天收割，所以采伐收获得时，金气主收敛坚固，因此质地坚实。用稻秆炊煮，是取“丙辛化水”的道理，用以化生五脏的津液。上一章说“移精变气以通神明”，论述神气生于先天的精气；这一章又论述精气，借助后天水谷的精微来资生。大概五谷的汁液用来滋养五气，气机和顺则津液生成，神气自然产生。所以上古的人，能够保全其先天天真之气，即使制作了汤液醪醴，也是备而不用，因为他们神气完整。中古时期，道德稍微衰退，邪气不时侵袭，服用汤液醪醴就能获得万全的效果，因为稻米的汁液能生化滋养精气神。当今时代的人，只知道用毒药攻治内脏，用针石治疗体表，不知道如果精气衰败松弛，治疗效果就无法建立，这是因为神气离去的原因。所以上一章说“移精变气，得神者昌”，这一章说“故精自生，巨气乃平”。凡是治病，心法首先要探求根本。）
黄帝道：上古的圣人，制作汤液醪醴，为什么做了却不使用呢？
岐伯道：自古圣人制作汤液醪醴，是为了防备疾病之用。上古之人制作汤液，所以只是备着而不服用。（岐伯说上古圣人制作汤液醪醴，是担心被邪气伤害，所以作为预备。然而上古之人，大多能保全其先天天真之气，即使有贼邪侵害，也不能伤害他们，所以虽然制作了却不服用。）
中古的时代，道德稍微衰退，邪气时常侵袭，服用汤液醪醴就能获得万全的效果。（《上古天真论》说：“懂得养生之道的人，能延缓衰老而保全形体，所以活到百岁而动作不衰退，是因为他们的道德完备而没有危险。”这里说的是中古之人，虽然道德衰退，但不至于导致精神衰败松弛，所以服用汤液能获得万全效果。）
黄帝道：当今时代，病情不一定能痊愈，为什么呢？（不能保证邪气去除而获得万全的效果。）
岐伯道：当今时代，必须用齐整的毒药攻治其内部，用砭石、针具和艾灸治疗其外部。（“齐”通“疾”，意为急迫；“砭”是用石针刺破皮肤排脓或放血的工具。针具有九种式样，第一种叫“砭针”。意思是当今时代，只知道攻逐疾病，而不知道调养正气。）
黄帝道：形体衰败，血液耗竭，而治疗效果不显著，是什么原因呢？
岐伯道：这是因为神气不再发挥作用了。（《内经》说：针石的治疗之道，在于皮、肉、筋、脉、骨，各有其适用的部位，病症各有其适宜的治疗方法，形态各不相同，各自顺应其适宜的方法。“弊”即止息之意。形体衰败表现在皮肉筋骨，针刺已经停止作用了；血液耗竭表现在血脉，疏通也已经尽力了。但不能奏效，是因为施针的技术层面，神气不再驱使响应。《灵枢经》说：“粗工守形，上工守神。神啊神，病客在门。”）
岐伯道：这是指针石治疗的道理。如果患者的精神不能进入接受状态，意志不能调摄治理，那么病就不能治愈。（这是在阐明医生如果不注重守神。经文说：“神在秋毫之末，意念要集中在病人身上，神志不要离开，才能知晓病的存亡。”又说：“凡刺的真谛，必先治神。静心用意，观察适应的道理，深浅在意念中把握，远近如一，如同面临深渊，手如握虎，神志不被众物干扰。现在粗疏的医生只知道针石的形式，患者精神不能进入，意志不能调摄，所以病不能治愈。”）
如今精气坏乱，神气离去，营卫之气无法再恢复，为什么呢？因为嗜欲没有穷尽，而忧患不停止，导致精气弛缓坏乱，营血凝涩，卫气消散，所以神气离去，病就不愈。（这是在论述病人的精神衰败松弛，导致病不能痊愈。气生于精，精中的阳气化生水谷的精微，然后产生营卫。精气坏乱、神气离去，所以营卫无法再恢复。这是在论述营卫生于精气。有人嗜欲无穷，就会损坏其精；忧患不止，就会损伤其气。精气弛缓坏乱，则荣血凝涩，卫气除去。所以神气离去而病不愈。这是在说神由荣卫精气所产生。生于精气的，是先天主宰的神；生于荣卫的，是后天水谷汁液所生的神。）
黄帝道：疾病刚开始产生的时候，极其微小精细，必定先侵入并结聚在皮肤。现在优秀的医生都称这已经是病已成，名叫“逆”，那么针石不能治疗，良药也不能达到病所了。现在的优秀医生都掌握了正确的方法，遵守诊察的法则，亲戚兄弟无论远近，声音每天在耳边听到，五色每天在眼前看到，但病仍不愈，这难道不是因为没有及早治疗吗？
岐伯道：病人为本，医生为标。标本不相契合，邪气就不能被制服，说的就是这个意思。（这一节论述用汤液治病应当有法度。观察面色、听取声音、询问病情、顺从意愿，这是优秀医生掌握了方法。如果汤液不得其法，病也不会好，所以详细提出这个问题。黄帝说：疾病初生，极微极细，必定留结在皮肤。如果十天不好，优秀医生都称病已成形，名叫“逆”，虽然针石不能治，良药也不能及。现在优秀医生都掌握了审证的方法，遵守法则，询问病情，亲戚兄弟无论远近，牵挂病人，可以说是顺从其意，得其情了。声音每天听到，五色每天看到，可以说是察其色，知其声了。但病仍不愈，这难道是没时间早治而使病成形的吗？岐伯说病为本，医生为标。是以医生的治法为标。意思是如果不采用草苏、草荄等本末相助的法度来治疗，所以邪气不服。上一节论述针石治病，重在得神；这一节论述汤液治病，贵在得法；下一节论述汤液治病，重在调复精气。这三者是优秀医生不可缺少的。审证辨脉，了解病情，固然是优秀医生的首要任务，但治病的汤液，又不可不得其法。金西铭说：“此之谓也”这句话，是引用标本已得，邪气乃服而言。）
黄帝道：如果有不从毫毛外表受邪而生，而是五脏阳气已经衰竭，津液充满胸腹廓廓，只有阴魄独自居留，孤精在内，气耗于外，形体肿胀以至于衣服都穿不下，四肢浮肿急促且伴有内脏喘动，这是气拒逆于内，而形体肿胀表现于外。治疗该怎么办？（这一节论述气生于精，精由气化。想要治病，应当探究其本源。本源既清，生机自然旺盛，精生气平，邪气自然服从，不能仅仅把攻逐疾病当作首要任务。阳气主要主管皮毛，如果不从毫毛受邪，而是五脏阳气已经衰竭，不是因为外邪伤害表阳，而是五脏的元气已经在内部枯竭。肺主气而外部主管皮毛，气能化行则水津四处布散，并向下输送到膀胱。气耗于外，不能布化水液，所以津液充满胸腹廓廓，而肺藏的阴魄孤精，独自居留于内。水液充满皮肤则身体肿胀，以至于衣服都穿不下。四肢是诸阳之本，阳气虚于外，所以四肢浮肿急促，气喘且震动内脏。这是气逆于内，而形体肿胀表现于外。治疗的方法该怎么办？）
岐伯道：用权衡之法来平治，去除郁积的陈腐之物，轻微活动四肢，穿着温暖衣物，用缪刺法在其相应部位施治，以恢复其形体。开泄汗孔（鬼门），洁净膀胱（净府），精气按时复常，五脏阳气得以布散，疏通涤荡五脏。所以精气自然产生，形体自然强盛，骨肉相互保护，大气（巨气）于是平和。
黄帝道：好。（这是说腐秽去除而形体恢复，形体恢复而气机布散，气机通畅而水液运行，水液运行而精气产生，精气产生而气机平和。所谓形归气，气归精。平权衡，就是平治其脉象，即缪刺法。肺朝百脉，输精于皮毛，毛脉合精，然后行气于脏腑。所以先平治其权衡。权衡已平，则气血和调而水津散布。积聚称为“菀”，久留称为“陈”，腐败称为“莝”。脾主为胃运行津液，灌注于四脏，运行于四肢，充盈于肌肉。脾家实，则不能运行津液而下输膀胱，所以腐秽应当去除，而后形体才能恢复。轻微活动四肢，是运脾气；穿着温暖衣物，是暖肺气；缪刺，是调气血。肌肉血脉和调，则肿满消退而恢复旧日形体。鬼门，即毛孔。开鬼门，即发表发汗；洁净府，即泻膀胱。鬼门开，则肺窍通而水津布散，所谓外窍开则里窍通，上窍通则下窍泄。膀胱是津液收藏之处，都府洁净，则精气按时恢复。巨阳为诸阳主气，而生于膀胱。精气已复则气自生，而五脏之阳和已布散。肠胃膀胱，受纳五脏浊气，名为传化之府。陈莝去除，都府洁净，则五脏的浊气得以下行疏涤。水谷入胃，津液各走其道，五脏疏涤，所以精气自然产生而形体自然强盛。精主骨，气主肉，精气充足则骨肉相保，而巨气乃平。巨气，即太阳主气。膀胱精复，而五脏布阳，是因为太阳为诸阳主气。五脏精生，而巨气乃平，是因为州都之精，由五脏所生。这一章讲上古圣人能保全先天之真，中古以来，应当养护后天之气，所以说“必以稻米，炊以稻薪”，大概后天的精气，是由中焦胃的水谷所产生。高士宗说：腹部，是肠胃的廓郭，由足太阴脾土所主。津液充郭，是指胀满于腹部。形不可与衣相保，四极急而动中，是指肿胀于皮肤四肢。所以去菀陈莝，是为了消除腹满。开鬼门，洁净府，是为了排泄皮肤之水。先治其权衡，是因为脾土的运输，必由肺气的通调来实现。金西铭说：四肢，是井、荥、经、输穴出入的地方，十二经脉交相贯通。胸中为气之海，宗气积于胸中，出喉咙以司呼吸，同营气行于十二经脉之中。气行则脉行，气拒于内，则脉涩于外。内外气血，交相拒逆，所以四肢胀急，而气喘震动于中。这一节是治疗胀满水肿的要法。王子方说：应当知道上古的方法，又不止于针石治外、汤药治内而已。）
Yellow Emperor asked, saying: How should one prepare the decoctions and fermented wines made from the five grains? (This follows up on the previous chapter with another question. The five grains refer to millet, broomcorn millet, rice, wheat, and beans; these are the grains corresponding to the Five Elements, used to nourish the five Zang organs. Lao Li refers to sweet and mellow wine, a liquid derived from cooked grains. By asking about the five grains, the Emperor implies that all five grains can be used to make decoctions and fermented wines to nourish the five Zang organs. However, Qi Bo's answer emphasizes using rice from the Central region and rice straw as fuel, suggesting that the essence of central grains can irrigate and nourish the other four Zang organs.)
Qi Bo replied, saying: One must use rice and cook it with rice straw. Rice is complete in nature, and rice straw is firm in quality. (Heaven and Earth have the Yin and Yang of the four seasons, and the five directions have different geographical environments. Rice possesses the qi of spring birth, summer growth, autumn harvest, and winter storage, embodying the harmony of Heaven and Earth's Yin and Yang. As a grain of the Central Earth virtue, it suits the varying altitudes and terrains of the five directions, making its nature most complete for nourishing the five Zang organs. The laws of Heaven and Earth dictate spring birth and autumn killing; rice straw is harvested in autumn, so it is gathered at the proper time. Metal governs solidity and completion, hence its firmness. Cooking with rice straw takes the principle of "Bing-Xin transforming into Water" to generate the fluids of the five Zang organs. The previous chapter stated "Shifting Jing and altering Qi to communicate with Spirit," discussing how Spirit arises from congenital Jing. This chapter discusses Jing again, relying on postnatal water and grain essence for generation. Essentially, the juices of the five grains nourish the five Qi; when Qi is harmonious, fluids form, and Spirit naturally arises. Thus, people in ancient times, who could preserve their congenital True Qi, would prepare decoctions and fermented wines but not consume them, because their Spirit was whole. In middle antiquity, virtue declined slightly, and pathogenic factors frequently invaded; consuming these preparations ensured complete recovery, as rice juice could generate and nourish Jing, Qi, and Spirit. People in the present age only know to use toxic medicines to attack internally and needles/stones to treat externally, failing to realize that if Jing and Qi are depleted and lax, treatment will fail because Spirit has departed. Hence, the previous chapter said "Shift Jing and alter Qi; he who obtains Spirit prospers," and this chapter says "Thus Jing generates itself, and the Great Qi becomes balanced." In treating disease, one must first seek the root in the mind.)
The Yellow Emperor asked, saying: Why did the sages of ancient times prepare decoctions and fermented wines but not use them?
Qi Bo replied, saying: Since ancient times, the sages prepared decoctions and fermented wines merely as a precaution. Those in antiquity prepared them but did not consume them. (Qi Bo explained that the sages prepared these preparations fearing injury from pathogenic factors, keeping them as reserves. However, people of antiquity mostly preserved their congenital True Qi; even if attacked by harmful pathogens, they could not be harmed. Therefore, although prepared, they were not consumed.)
In the era of middle antiquity, virtue declined slightly, and pathogenic factors frequently invaded; consuming [the preparations] ensured complete recovery. (The *Su Wen: Shanggu Tianzhen Lun* states: "Those who understand the Dao can delay aging and preserve their form, living to a hundred years without physical decline, because their virtue is complete and they face no danger." This means that although people of middle antiquity saw a decline in virtue, their spirit did not become depleted and lax, so consuming the preparations yielded complete results.)
The Yellow Emperor asked, saying: In the present age, why is it not certain that the disease will be cured? (One cannot guarantee the removal of pathogens to achieve complete recovery.)
Qi Bo replied, saying: In the present age, one must necessarily use potent medicines to attack internally and utilize Bian stones, needles, and moxibustion to treat externally. ("Qi" is a homophone for "Ji," meaning urgent; "Bian" refers to stone needles used to puncture skin for draining pus or blood. There are nine types of needles, the first being the Bian needle. This implies that in the present age, people only know to attack diseases and neglect to nourish righteous Qi.)
The Yellow Emperor asked, saying: When the body is debilitated and blood is exhausted, yet therapeutic effects are not established, what is the reason?
Qi Bo replied, saying: It is because the Spirit no longer responds. (The Classics state: The method of needles and stones lies in the skin, flesh, sinews, vessels, and bones, each having specific locations; diseases have specific indications, differing in form, each requiring appropriate treatment. "Bi" means cessation. When the body is debilitated in skin, flesh, sinews, and bones, needling has ceased to act; when blood is exhausted in the vessels, dredging has been maximized. Yet efficacy fails because, at the technical level of needling, the Spirit does not drive the response. The *Ling Shu* states: "Crude practitioners guard form; superior practitioners guard Spirit. Oh Spirit, Spirit, the guest is at the door.")
The Yellow Emperor asked, saying: What is meant by "the Spirit no longer responds"?
Qi Bo replied, saying: This refers to the principle of needle and stone therapy. If the patient's Spirit does not advance into a receptive state, and their Will is not regulated, then the disease cannot be cured. (This clarifies that if the practitioner does not guard the Spirit. The Classics state: "Spirit resides in the finest details; focus your intent on the patient. Do not let your Spirit depart, so you may know the survival or demise of the disease." It also states: "The true essence of needling requires first regulating the Spirit. Calm your mind and intent, observe the appropriateness of the situation. Depth depends on your will; distance feels uniform. Approach like standing at the edge of an abyss; hold the hand like grasping a tiger. Let your Spirit not be distracted by myriad objects." Now, crude practitioners only know the form of needles and stones; the patient's Spirit does not advance, and their Will is unregulated, so the disease cannot be cured.)
Now, if Jing is ruined and Spirit has departed, and Ying and Wei Qi cannot be recovered, why is this? Because desires are endless, and worries and distress do not cease. Jing and Qi become lax and ruined, Ying Blood becomes stagnant, and Wei Qi dissipates. Thus, Spirit departs, and the disease is not cured. (This discusses how the patient's spiritual depletion leads to incurability. Qi is generated from Jing; the Yang Qi within Jing transforms the essence of water and grain to produce Ying and Wei. With Jing ruined and Spirit departed, Ying and Wei cannot be restored. This explains that Ying and Wei arise from Jing and Qi. Endless desires damage Jing; incessant worries injure Qi. Lax and ruined Jing and Qi cause Ying Blood to stagnate and Wei Qi to vanish. Thus, Spirit departs, and the disease persists. This indicates that Spirit is generated by Ying, Wei, Jing, and Qi. Generated from Jing and Qi is the congenital Spirit; generated from Ying and Wei is the postnatal Spirit produced by grain fluids.)
The Yellow Emperor asked, saying: When a disease first begins, it is extremely subtle and refined, inevitably entering and knotting in the skin. Now, skilled physicians call this "Disease Established," named "Ni" (Rebellious/Adverse), stating that needles and stones cannot treat it, and good medicines cannot reach it. Skilled physicians today possess the correct methods and adhere to the numbers [of diagnosis]. Relatives and brothers, near or far, hear voices daily and see colors daily, yet the disease remains uncured. Is this not due to a failure to treat early enough?
Qi Bo replied, saying: The disease is the root (Ben); the physician is the branch (Biao). If root and branch do not match, the pathogenic factor will not submit. This is what is meant. (This section discusses the necessity of method in treating with decoctions. Observing complexion, listening to sounds, asking about circumstances, and following intentions—this is how skilled physicians master the method. If decoctions lack proper method, the disease will not heal, hence this detailed inquiry. The Emperor said: Disease begins subtly, knotting in the skin. If unresolved for ten days, skilled physicians call it "Disease Established," named "Ni," where needles and stones fail and medicines cannot reach. Today, skilled physicians grasp diagnostic methods and adhere to principles, caring for relatives regardless of distance, hearing voices and seeing colors daily—thus observing color, knowing sound, following intent, and obtaining circumstance. Yet the disease remains uncured. Is this truly a lack of time to treat early? Qi Bo replies: Disease is the root, physician is the branch. The physician's treatment method is the branch. Without employing methods that assist root and branch (such as grass roots and stems), the pathogen will not submit. The previous section emphasized guarding Spirit in needle therapy; this section emphasizes mastering method in decoction therapy; the next section emphasizes restoring Jing and Qi. These three are indispensable for skilled physicians. Examining signs and pulse to understand disease condition is the primary task, but decoctions must also follow proper method. Jin Ximing notes that "This is what is meant" refers to the concept that once root and branch align, the pathogen submits.)
The Yellow Emperor asked, saying: What if the disease does not originate from the hair and skin, but rather the Yang Qi of the five Zang organs is already exhausted? Fluids fill the torso/cavity, the Po (Corporeal Soul) dwells alone, isolated Jing remains inside while Qi耗 (depletes) outside. The body is too swollen to fit into clothes. The four extremities are tight and swollen, causing internal palpitations/movement. This is Qi rejecting/rebelling inside, while the form swells outside. How should this be treated? (This section discusses that Qi is born from Jing, and Jing is transformed by Qi. To treat disease, one must investigate the origin. Once the origin is clear, vitality flourishes; when Jing and Qi are balanced, pathogens submit. One should not solely focus on attacking disease. Yang Qi primarily governs the skin and hair. If not affected externally via hair/skin, but the Yang Qi of the five Zang is exhausted, it is not external pathogens injuring the exterior Yang, but the primal Yuan Qi of the five Zang exhausted internally. The Lung governs Qi and externally governs skin/hair. When Qi transforms, water fluids distribute widely and flow down to the Bladder. With Qi depleted externally, it cannot transform fluids, causing fluids to fill the torso cavity. The Yin Po of the Lung dwells alone inside. Fluids filling the skin cause bodily swelling, making clothes unwearable. The four extremities are the root of all Yang; Yang deficiency externally causes extremity swelling/tightness and panting/internal movement. This is Qi rebelling internally and form swelling externally. How should this be treated?)
Qi Bo replied, saying: Balance and regulate using weights and measures. Remove accumulated decay and old stagnation. Slightly move the four extremities. Wear warm clothing. Apply Miu Ci (twisted needling) at corresponding sites to restore the form. Open the Ghost Gates (sweat pores), purify the Clean House (Bladder). Essence will return in due time. The five Yangs will be distributed. Dredge and cleanse the five Zang organs. Thus, essence generates itself, form becomes robust, bone and flesh protect each other, and the Great Qi becomes balanced.
The Yellow Emperor said: Excellent. (This means removing filth restores form; restored form allows Qi distribution; distributed Qi moves water; moving water generates essence; generated essence balances Qi. Form returns to Qi, Qi returns to Essence. Balancing weights and measures refers to balancing the pulses, i.e., Miu Ci. The Lung directs all vessels, transmitting essence to skin/hair. Skin and vessel essence combine, then Qi moves to Zang-Fu. Thus, balance the weights/measures first. Once balanced, Qi and Blood harmonize, and water fluids scatter. Accumulation is called "Wan"; long-standing is called "Chen"; rotten is called "Cuo". The Spleen transports fluids for the Stomach, pouring into the four Zang, moving through limbs, filling muscles. If Spleen is full/excess, it cannot transport fluids to the Bladder, so filth must be removed to restore form. Slight limb movement moves Spleen Qi; warm clothing warms Lung Qi; Miu Ci regulates Qi and Blood. Harmonized muscles and vessels reduce swelling and restore former form. Ghost Gate refers to sweat pores. Opening Ghost Gate means inducing sweating. Purifying Clean House means draining the Bladder. Opening Ghost Gate opens Lung orifices and distributes fluids; opening external orifices opens internal ones, upper opens lower drains. The Bladder stores fluids; a clean capital house allows essence to return timely. Grand Yang (Taiyang) is the master of all Yang, born from the Bladder. Returned essence generates Qi, distributing Harmony of Yang in five Zang. Intestines and Bladder receive turbid Qi from five Zang, named Fu organs of transmission. Removing Chen/Cuo cleans the capital house, allowing turbidity of five Zang to drain. Water and grain enter the Stomach, fluids take their paths. Five Zang are cleansed, so essence generates and form strengthens. Essence governs bone; Qi governs flesh. Abundant essence and Qi ensure bone-flesh protection, and Great Qi balances. Great Qi is Taiyang governing Qi. Bladder essence returns, five Zang distribute Yang because Taiyang masters Yang. Five Zang essence generates, Great Qi balances because Zhou Du essence is produced by five Zang. This chapter states ancient sages preserved congenital Truth; since middle antiquity, one must nurture postnatal Qi. Hence, "Must use rice, cook with rice straw," implying postnatal essence/Qi arises from Middle Jiao/Stomach water/grain. Gao Shizong says: The abdomen is the casing of intestines/stomach, governed by Foot-Taiyin Spleen Earth. Fluids filling the casing means abdominal distension. Form unfit for clothes, extremities tight/internal movement means swelling of skin/limbs. Thus, removing Wan-Chen-Cuo eliminates abdominal fullness. Opening Ghost Gate, purifying Clean House expels skin water. Balancing weights/measures first is because Spleen transport relies on Lung regulation. Jin Ximing says: Limbs are entry/exit points of Jing-Ying-Jing-Shu acupoints; twelve meridians interconnect. Chest is Sea of Qi; Zong Qi accumulates there, exits throat for respiration, travels with Ying Qi in twelve meridians. Qi moves, vessels move. Qi rebels inside, vessels stagnate outside. Internal/external Qi-Blood rebel against each other, causing limb swelling/tightness and internal panting. This section is the key method for treating distension and edema. Wang Zifang says: One must know ancient methods extend beyond just external needles/stones and internal herbs.)