外取而削之，上取而吐之，下取而下之，从而补之，逆而泻之，久病新病，同一正取之法也。
帝曰∶病在中，而不实不坚，且聚且散，奈何？
因消削吐下之言，复为此问。
岐伯曰∶悉乎哉问也！无积者，求其藏，虚则补之，药以祛之，
食以随之，引水渍之，和其中外，可使毕已。
内外之病，求之于经，上下之病，求之于府。若病在中，不实不坚，且聚且散，而无积者，当求之藏，
藏虚则补之，或先用药以祛其邪，随用食以养其正，或行水渍之，以取其汗，则中外皆和，虚中有邪，可毕已。
帝曰∶有毒无毒，服有约乎？
约，规则也。上文云，能毒以浓药，不胜毒以薄药，是浓药有
毒，薄药无毒，因问有毒无毒之药，服之其有规则乎？
岐伯曰∶病有久新，方有大小，有毒无毒，固宜常制矣。大毒
治病，十去其六，常毒治病，十去其七，小毒治病，十去其八，无
毒治病，十去其九，谷肉果菜，食养尽之，无使过之，伤其正也。不尽，行复如法。
必先岁气，无伐天和。无盛盛，无虚虚，而遇人夭殃。无致邪，无失正，绝人长命。
食，音嗣，凡病有久新，处方有大小，因病处方，用有毒无毒之药，固宜有经常之制矣。是以大毒
治病十去其六而止，常毒治病，十去其七而止，小毒治病，十去其八而止，无毒治病十去其九而
止，服药之外，更兼谷肉果菜，为之谷养，使病尽除去之。毒药攻邪，中病即止，无使过之，伤其正也。
谷肉果菜，食养之而病不尽，复欲治之，其行复如前法。然必先知岁气之太过不及，无过用
毒药，伐其天和，太过而补，是盛盛也，不以而消，是虚虚也，故无盛盛，无虚虚，而遗人夭殃，盛
盛则致邪，虚虚则失正，故无致邪，无失正，而绝人长命，斯可矣。
帝曰∶其久病者，有气从不康，病去而瘠，奈何？
气从而顺，此身宜康，其病已去，此形宜强，其有久病者，气从，而身反不康，病已去，而身
反瘠，其故何也？
岐伯曰∶昭乎昭圣人之问也。化不可代，时不可违，夫经络以
通；血气以从。复其不足。与众齐同，养之和之，静以待，谨守其气，无使倾移，其形丹彰，
生气以长，命曰圣王。故《大要》曰∶无代化，无违时，必养必和，待其来复。此之谓也。
帝曰∶善。
天之气化，即人之气化也，故化不可代，天之四时，即人之四时也，故时不可违。病则经络不通，
血气不从，病去则经络以通，血气以从。病则正气不足，不与众同，病去，则复其不足，与众齐
同。然病虽去，尤必养之和之，静以待时，谨守其气，无使倾移，然后其形乃彰，生气以长，命曰寿世之
圣王。化不可代，时不可违，养之和之，静以待时，故《大要》曰∶无代化，无违时，必养必
和，待其来复。此即帝问之谓也。帝故善之。此一节，言阴阳太少
之异，五类盛衰之理，五运六气，根中根外，皆为五常之政也。
向外取邪而用削法，向上取邪而用吐法，向下取邪而用下法，顺其病势而用补法，逆其病势而用泻法。无论是久病还是新病，都采用这一种正确的治疗法则。
黄帝问：病位在中焦，但按之不实不坚，且症状时聚时散，该怎么办？
这是承接上文关于消、削、吐、下的论述，再次提出这个问题。
岐伯说：问得详尽啊！对于没有积滞的病症，要探求病变所在的脏腑。如果是虚证就予以补益，用药来祛除病邪，用食物来调养正气，或用温水浸渍身体以发汗，使体内和体表调和，就可以使疾病痊愈。
所谓内外之病，向经络中寻求病因；上下之病，向六腑中寻求病因。如果病在中焦，按之不实不坚，时聚时散，且没有积滞，应当探求五脏。若脏气虚弱则予以补益，或者先用药祛除邪气，随后用食物养护正气，或者通过行水浸渍身体来取其汗液，这样体内和体外都能调和，虚证兼有邪气的情况，就可以痊愈。
黄帝问：有毒和无毒的药物，服用时有规则吗？
“约”即规则。上文说，能耐受毒性的人可以用浓药，不能耐受毒性的人要用薄药，这意味着浓药有毒，薄药无毒。因此询问有毒和无毒的药物，服用它们是否有固定的规则？
岐伯说：疾病有久病和新病的区别，方剂有大方和小方的区别，药物有毒性和无毒性的区别，这些本来就应该有常规的法度。用大毒药物治疗疾病，病去十分之六就停药；用常毒药物治疗疾病，病去十分之七就停药；用小毒药物治疗疾病，病去十分之八就停药；用无毒药物治疗疾病，病去十分之九就停药。剩下的病邪，通过谷物、肉类、水果、蔬菜的饮食调养来彻底清除，不要让治疗过度，以免损伤人体的正气。如果病邪未尽，再按照上述方法重复治疗。
必须首先了解当年的岁气（气候特点），不要违背自然的和谐之气。不要使实证更实，不要使虚证更虚，从而避免给人带来早夭的灾祸。不要助长邪气，不要丧失正气，从而断送人的寿命。
“食”音同“嗣”。凡是疾病有久病和新病的区别，处方有大方和小方的区别，因病开具处方，使用有毒或无毒的药物，本来就应该有经常性的法度。因此，用大毒药物治疗疾病，病去十分之六就停止；用常毒药物治疗疾病，病去十分之七就停止；用小毒药物治疗疾病，病去十分之八就停止；用无毒药物治疗疾病，病去十分之九就停止。在服药之外，还要配合谷物、肉类、水果、蔬菜进行饮食调养，使病邪完全去除。毒药攻伐邪气，中病即止，不要过度，以免损伤正气。如果经过谷肉果菜的饮食调养后病仍未愈，想要继续治疗，其做法应像前面所述的方法一样。然而必须预先知道当年岁气的太过与不及，不要过用毒药，伐害人体的天和之气。病情本已亢盛却再用补法，这就是“盛盛”（使实证更盛）；病情本已虚弱却再用攻法，这就是“虚虚”（使虚证更虚）。所以，不要造成“盛盛”，不要造成“虚虚”，以免给人留下早夭的祸患。“盛盛”会导致邪气滋生，“虚虚”会导致正气丧失，所以不要助长邪气，不要丧失正气，这样才能保全人的寿命，这才是正确的。
黄帝问：那些患有久病的人，虽然气机已经顺畅，身体却不康复；病邪虽然已去，身体反而消瘦，该怎么办？
气机既然顺畅，身体理应康复；病邪既然已去，形体理应强壮。为什么有些久病患者，气机虽顺，身体反而不康复；病邪虽去，身体反而消瘦呢？原因是什么？
岐伯说：问得真高明啊，真是圣人的提问啊！自然的化生作用不能由人来替代，四时的时序不可违背。要使经络通畅，血气调和。恢复人体不足的正气，使其与众人相同。通过调养使之平和，安静地等待时机，谨慎地守护正气，不让正气倾覆移位，那么形体就会彰显，生气得以生长，这就称为圣王之道。所以《大要》中说：不要替代自然化生，不要违背四时时序，一定要调养、一定要平和，等待正气自行恢复。说的就是这个道理。
黄帝说：好。
天的气化作用，就是人的气化作用，所以说化生作用不能由人来替代。天的四时变化，就是人的四时变化，所以说时序不可违背。生病时经络不通畅，血气不调和；病好后经络通畅，血气调和。生病时正气不足，不同于常人；病好后，恢复其不足，与众人相同。然而病虽然已去，尤其必须调养使之平和，安静地等待时机，谨慎地守护正气，不让正气倾覆移位，然后形体才能彰显，生气得以生长，这被称为长寿世间的圣王之道。“化不可代，时不可违，养之和之，静以待时”，所以《大要》中说：“无代化，无违时，必养必和，待其来复。”这就是对黄帝问题的回答。黄帝因此称赞它。这一段文字，阐述了阴阳太少（少阴、少阳等）的差异，五类事物盛衰的道理，五运六气，无论根于中还是根于外，都属于五常（五行）的政令范畴。
Exterior pathogens are removed by scraping (scraping therapy), superior pathogens are expelled by emesis (vomiting therapy), inferior pathogens are purged by catharsis (purging therapy). Following the disease trend, tonification is applied; opposing the disease trend, sedation is applied. Whether for chronic diseases or acute diseases, this constitutes a single correct method of treatment.
The Yellow Emperor asked: When the disease is located in the middle jiao (Middle Burner), but feels neither solid nor firm upon palpation, and symptoms gather and disperse intermittently, what should be done?
This question follows the discussion on scraping, emesis, and purging, reiterating the inquiry.
Qibo replied: Your question is indeed thorough! For conditions without accumulation, seek the affected Zang organs (Solid Organs). If deficiency exists, apply tonification. Use medicinal herbs to dispel pathogens, use food to follow up with nourishment, and use warm water immersion to induce sweating. Harmonize the interior and exterior, and the disease can be completely resolved.
For diseases of the interior and exterior, seek their cause in the meridians (Meridians and Collaterals); for diseases of the upper and lower parts, seek their cause in the Fu organs (Hollow Organs). If the disease is in the middle, feeling neither solid nor firm, gathering and dispersing intermittently, and without accumulation, one should seek the Zang organs. If the Zang organs are deficient, tonify them. Alternatively, first use medicine to dispel the pathogen, then use food to nourish the righteous qi (Healthy Qi). Or, perform water immersion to induce sweating. Thus, both interior and exterior will be harmonized, and conditions of deficiency with retained pathogens can be completely resolved.
The Yellow Emperor asked: Regarding toxic and non-toxic medicines, is there a rule for their administration?
"Yue" (Rule) refers to regulations. The previous text stated that those who can tolerate toxicity may take strong/concentrated medicines, while those who cannot tolerate toxicity should take weak/thin medicines. This implies that concentrated medicines are toxic, while thin medicines are non-toxic. Therefore, it is asked whether there are rules for administering toxic and non-toxic medicines.
Qibo replied: Diseases vary between chronic and acute, prescriptions vary between large and small formulas, and medicines vary between toxic and non-toxic. These inherently require standard regulations. When using highly toxic medicines to treat disease, stop when six-tenths of the disease has been eliminated. When using moderately toxic medicines, stop when seven-tenths have been eliminated. When using slightly toxic medicines, stop when eight-tenths have been eliminated. When using non-toxic medicines, stop when nine-tenths have been eliminated. The remaining disease is cleared through dietary nourishment from grains, meats, fruits, and vegetables. Do not allow treatment to exceed this limit, lest it injure the righteous qi (Healthy Qi). If the disease is not fully eliminated, repeat the process according to these methods.
One must first consider the annual climate qi (Annual Climate Qi) and not violate the harmony of heaven (Natural Harmony). Do not exacerbate excess conditions ("Sheng Sheng"), and do not worsen deficiency conditions ("Xu Xu"), thereby avoiding bringing premature death upon people. Do not aid the pathogenic factors, and do not lose the righteous qi, thereby preserving human longevity.
"Food" is pronounced "si". For all diseases, whether chronic or acute, and prescriptions, whether large or small, when prescribing based on the disease and using toxic or non-toxic medicines, there must inherently be consistent regulations. Therefore, when treating with highly toxic medicines, stop after eliminating six-tenths of the disease; with moderately toxic medicines, stop after eliminating seven-tenths; with slightly toxic medicines, stop after eliminating eight-tenths; with non-toxic medicines, stop after eliminating nine-tenths. Beyond taking medicine, combine grain, meat, fruit, and vegetable dietary nourishment to ensure the disease is completely removed. Toxic medicines attack pathogens; cease when the disease is addressed, do not overdo it, lest it injure the righteous qi (Healthy Qi). If the disease persists even after dietary nourishment with grains, meats, fruits, and vegetables, and further treatment is desired, proceed as described previously. However, one must first know whether the annual climate qi is excessive or insufficient. Do not overuse toxic medicines to damage the harmony of heaven. If the condition is already excessive and tonification is applied, this is "Sheng Sheng" (making excess more excessive). If the condition is already deficient and reduction/attack is applied, this is "Xu Xu" (making deficiency more deficient). Thus, do not create "Sheng Sheng," do not create "Xu Xu," to avoid leaving people with the calamity of premature death. "Sheng Sheng" leads to the generation of pathogenic factors; "Xu Xu" leads to the loss of righteous qi. Therefore, do not generate pathogenic factors, do not lose righteous qi, so as not to cut short human life. This is the proper approach.
The Yellow Emperor asked: For those with chronic diseases, although the qi mechanism has become smooth, the body does not recover; although the disease has passed, the body becomes emaciated. What should be done?
If the qi mechanism is smooth, the body should be healthy. If the disease has passed, the form should be robust. Why do some patients with chronic diseases, despite having smooth qi mechanisms, fail to recover healthfully, and despite the disease passing, become emaciated? What is the reason?
Qibo replied: Indeed profound! It is truly the question of a sage. Natural transformation (Metabolism/Transformation) cannot be substituted by human intervention, and the timing of seasons cannot be violated. Ensure the meridians (Meridians and Collaterals) are unobstructed and the blood and qi (Blood and Qi) flow smoothly. Restore insufficiency, making it equal to that of others. Nourish and harmonize, wait quietly, carefully guard the qi, preventing it from collapsing or shifting. Then the physical form will manifest clearly, and the vital qi (Vital Qi) will grow. This is called the way of the Sage King. Therefore, the *Da Yao* (Great Essentials) states: Do not substitute natural transformation, do not violate seasonal timing, must nourish and must harmonize, wait for recovery to come. This is what is meant.
The Yellow Emperor said: Excellent.
The heavenly qi transformation is the same as human qi transformation; thus, transformation cannot be substituted. The four seasons of heaven are the four seasons of humans; thus, timing cannot be violated. When diseased, meridians are obstructed, and blood and qi are discordant. When the disease passes, meridians become unobstructed, and blood and qi flow smoothly. When diseased, righteous qi is insufficient and differs from others. When the disease passes, insufficiency is restored, becoming equal to others. However, even after the disease passes, one must still nourish and harmonize, wait quietly for the appropriate time, and carefully guard the qi, preventing collapse or shifting. Only then will the physical form manifest clearly, and the vital qi (Vital Qi) grow. This is referred to as the Sage King of longevity in the world. "Transformation cannot be substituted, timing cannot be violated; must nourish and must harmonize, wait for recovery to come." Thus, the *Da Yao* states: "Do not substitute transformation, do not violate timing, must nourish and must harmonize, wait for recovery to come." This refers to the Emperor's question. The Emperor praised it. This section discusses the differences between Yin and Yang (specifically Shaoyin and Shaoyang), the principles of prosperity and decline among the five categories, the Five Movements and Six Qi (Five Movements and Six Qi), whether rooted internally or externally, all belong to the governance of the Five Constants (Five Elements).