西方生燥，天也。燥生金，金生辛，地也。辛生肺，肺生皮毛，人也。皮毛复有所生，故皮毛生肾。
肺脏复有所主，故肺主鼻。
其在天为燥，在地为金，在体为皮毛，在脏为肺，在色为白，
在音为商，在声为哭，在变动为咳，在窍为鼻，在味为辛，在志为忧。
神者，天之主也。其神在天为燥，则西方生燥，神之所在也。在地为金，则燥生金，神之所在也。
在体为皮毛，在脏为肺，则肺生皮毛，辛生肺，亦神之所在也，至于在色为白，在音为商，在声
为哭，在变动为咳，在窍为鼻，在味为辛，在志为忧，惟西方燥金之肺脏为然耳。
忧伤肺，喜胜忧，热伤皮毛，寒胜热，辛伤皮毛，苦胜辛。
忧伤肺，喜胜忧，伤于情者，情相胜也。热伤皮毛，寒胜热，伤于气者，气相胜也。辛伤皮毛，
苦胜辛，伤于味者，味相胜也。伤于气者，皆本气自伤，此热伤皮毛，则金受火刑，以明自伤受
伤，皆可伤也，热伤皮毛则寒胜其热，乃自然之理也。
北方生寒，寒生水，水生咸，咸生肾，肾生骨髓，髓生肝，肾主耳。
北方生寒，天也。寒生水，水生咸，地也。咸生肾，肾生骨髓，人也。骨髓复有所生，故髓生肝，
肾脏复有所主，故肾主耳。
其在天为寒，在地为水，在体为骨，在脏为肾，在色为黑，在音为羽，在声为呻，在变动为栗，
在窍为耳，在味为咸，在志为恐。
神者，天之主也。其神在天为寒，则北方生寒，神之所在也。
在地为水，则寒生水，神之所在也。在体为骨，在脏为肾，则肾生骨髓，咸生肾，亦神之所在也。至于在
色为黑，在音为羽，在声为呻，在变动为栗，在窍为耳，在味为咸，在志为恐，惟北方肾脏之寒水为然耳。
恐伤肾，思胜恐，寒伤血，燥胜寒，咸伤血，甘胜咸。
恐伤肾，思胜恐，伤于情者，情相胜也。肾脏五脏之精，而属于阴，故不言骨而言血，寒伤血，燥
胜寒，伤于气者，气相胜也。咸伤血，甘胜咸，伤于味者，味相胜也。土能胜水，当云湿胜寒，
今云燥胜，以明寒湿同类，燥土之气，以胜水气之寒也。此天之五方五气，地之五行五味，人之五脏五体，
而有阴阳之应象者如此。
故曰∶天地者，万物之上下也，阴阳者，血气之男女也，左右
者，阴阳之道路也，水火者，阴阳之征兆也。
此举天元纪大论之言，以明天地阴阳水火之义，上天下地，万物在其中，故天地者万物之上下也。血
阴气阳，男女籍以生，故阴阳者，血气之男女也。阴阳左右旋转，为血气循行之道，故左右者，阴阳之
道路也。天一生水，地二生火，为天地阴阳之应验，故水火者，阴阳之征兆也。
阴阳者，万物之能始也。
天地之阴阳，血气之阴阳，左右之阴阳，水火之阴阳，凡此阴阳者，乃万物之能始也，易曰∶坤以简
能，干知大始，此之谓也。
故曰∶阴在内，阳之守也，阳在外，阴之使也。
《生气通天论》岐伯曰∶阴者，藏精而起亟。即阴在内，而为阳之守也，阳者，卫外而为固，即阳
在外而为阴之使也。岐伯举此，以明阴阳为万物之能始，故内外相应如是也。
帝曰∶法阴阳奈何？
承岐伯阴阳应象之论，欲人取法阴阳而调治之，以合圣人论理人形之道，故问法阴阳奈何。
岐伯曰∶阳胜则身热，腠理开，喘粗为之俯仰，汗不出而热，
齿干以烦冤，腹满，死，能冬不能夏。
，犹俯也；冤，屈抑也。法阴阳者，阴阳不可偏胜，如阳胜则火热有余，而身热，热气在表，则腠
理开，热气在里则喘粗，表里皆病则为之俯仰，汗不出而内外皆热也，齿干，津液竭也，以烦
冤腹满死者，津液既竭，又心烦而屈抑不舒，腹满而土气内绝，故死。虽不即死也能冬不能夏。冬时寒冷，
阳胜可容，夏时炎暑，不堪煎厥矣。
阴胜，则身寒汗出、身常清，数栗而寒，寒则厥，厥则腹满，死；能夏不能冬。
数，音朔。阴胜则水寒有余，而身寒，寒气在表则汗出身常清，寒气在里则数栗而寒，表里不相接，
故寒则四肢厥，四肢厥者，生阳不达于外，厥则腹满死者，土气复绝于内，故死，虽不即
死，亦能夏不能冬。夏时炎暑，阴胜可容，冬时寒冷，不堪凛冽矣。
此阴阳更胜之变，病之形能也。
寒病而至于冬，则阴气更胜，热病而至于夏，则阳气更胜，故曰此阴阳更胜之变。或能冬而不能夏，
或能夏而不能冬，故曰病之形能也。是阴阳不可偏胜，偏胜则病也。
帝曰∶调此二者奈何？
承阴阳偏胜之意，复问调此二者奈何？
岐伯曰∶能知七损八益，则二者可调，不知用此，则早衰之节也。
阴阳二气本于天真，能知天真之七损八益，则阴阳二者可调。七损者，女子以七为纪，月事贵乎时下，
故曰损；八益者，男子以八为纪，精气贵乎充满，故曰益。知七损八益，则阴平阳秘，故二者
可调，不知用此损益之法，而调治之，则早衰之节也，节，犹候也。
年四十，而阴气自半也，起居衰矣。年五十，体重耳目不聪明矣。年六十，阴痿，气大衰，九
窍不利，下虚上实，涕泣俱出矣。故曰∶知之则强，不知则老。
试举早衰之节而略言之，年四十而阴精之气，自失其半也，故
起居衰矣，年五十，体重，则耳目不聪明矣，年六十，阴痿，则气大衰，九窍不利，下虚上实，涕泣俱出
矣。故曰∶知之则强。能知七损八益，则身强。不知则老，不知七损八益，则身老也。
故同出而名异耳。
同出于斯世之中，而强老之名则异耳。
智者察同，愚者察异，愚者不足，智者有余。有余则耳目聪明，身体轻强，老者复壮，壮者益治。
察同者，于同年未衰之日，而省察之。智者之事也。察异者，于强老各异之日而省察之，愚者之
事也。愚者察异，故愚者不足，智者察同，故智者有余。有余，则年五十体重，耳目不聪明者，今则耳目
聪明，而身体轻强。年六十，阴痿，气大衰者，今则老者复壮，年四十而阴气自半者，今则壮者益治矣。
是以圣人为无为之事，乐恬 之能，从欲快志于虚无之守，故
寿命无穷，与天地终，此圣人之治身也。
圣人治世，本无为而有为，恬 虚无，体同于天，故能论理人形，列别脏腑，端络经脉，会通六合，
而如帝之所问也。此言阴阳秉在天之神，而应象无方、惟圣人能取法而调治之。
天不足西北，故西北方，阴也，而人右耳目不如左明也。地不
满东南，故东南方，阳也，而人左手足不如右强也。
圣人寿命与天地终，则人之形体即天地之形体也。天为阳，人身耳目为阳，天不足于西北，是阳
体不足于阴方，故西北方，阴也，人身右为西北，而人右耳目，不如左耳目之明也。地为阴，人
身手足为阴，地不满东南，是阴体而不足于阳方，故东南方，阳也，人身左为东南，而人左手足，不如
右手足之强也。
帝曰∶何以然？
何以在左则耳目明，而手足不强，在右则手足强，而耳目不明。
岐伯曰∶东方，阳也。阳者，其精并于上，并于上，则上明而下虚。故使耳目聪明而
手足不便也，西方，阴也。阴者，其精并于下，并于下则下盛而上虚，故其耳目不聪明，而手足便也。
便，平声。人身南面而立，左东右西，左者乃东方阳也，阳者，其精并于上，并于上则上明而下虚，故
使左耳目聪明，而左手足不便也，右者乃西方阴也，阴者，其精并于下，并于下，则下盛而上
虚，故其右耳目不聪明，而右手足强便也。
故俱感于邪，其在上，则右甚，在下则左甚，此天地阴阳所不能全也，故邪居之。
一身形气，俱感于邪，其病在上，则上为阳，而右虚，故右甚，右甚即阳体而不足于阴方之义，其病
在下，则下为阴，而左虚，故左甚，左甚即阴体而不足于阳方之义，此天地阴阳之所不能
全，而人身有左右阴阳之不足也，故邪居之。
故天有精，地有形，天有八纪，地有五里，故能为万物之父母。清阳上天，浊阴归地，
是故天地之动静，神明为之纲纪。故能以生长收藏，终而复始。
里，理通。人身应天地者，以天地为万物之父母，而神明之所主也。精，精华也，故天有精。形，
形体也，故地有形。八纪，春夏秋冬，二分二至，八节之大纪也，故天有八纪。五里，东南西北
中，五方之道理也，故地有五里。既有精，有形，复有纪，有里，故能为万物之父母。清阳上天，天有精也，
浊阴归地，地有形也，动者天之纪，静者地之理，是故天地之动静，皆神明之纲纪，故能
以生长收藏，终而复始，所以能为万物之父母也。
惟贤人上配天，以养头，下象地，以养足，中傍人事，以养五脏。
圣人为无为之事，乐恬 之能，以欲快志于虚无之守，惟贤人则上配天，以养头，下象地，以养足，
中傍人事，以养五脏，盖圣人无为以合天地，贤人则有为以合天地也。
天气通于肺。
人身配天象地，而天地之气亦通于人，肺位居高，主周身之气，而天气与之相通。
地气通于嗌。
嗌，咽嗌也。嗌受水谷，下接胃口，而地气与之相通。
风气通于肝。
肝属木，其气风，故风动之气，与之相通。
雷气通于心。
心属火，火炎上，故雷气与之相通。
谷气通于脾。
脾土之气，灌于四旁，故四旁空谷之气，与之相通。
雨气通于肾。
雨气即水气，肾寒主水，故雨水之气与之相通。
六经为川。
三阴之经主五脏，三阳之经主六腑，六经为川者，三阴三阳之六经，如川之流而脉络贯通也。
肠胃为海。
人籍后天水谷以生，肠胃受盛水谷，如海之大，而众流所归也。
九窍为水注之气。
清阳出上窍，浊阴出下窍，耳目鼻口，前后阴，皆有水津以贯注，故九窍为水注之气。
以天地为之阴阳，阳之汗，以天地之雨名之，阳之气，以天地之疾风名之。暴气象雷，逆气象阳。
五脏六经，肠胃九窍，上合天地，有阴有阳，皆以天地为之阴阳，故人身阳气宣发之汗，可以天地
之雨名之，人身阳热营运之气，可以天地之疾风名之，其一时忿怒之暴气，可以象雷鸣之鼓
击，其暴气未平之逆气，可以象阳火之亢热。
故治不法天之纪，不用地之理，则灾害至矣。
天地之阴阳，即人身之阴阳也，人身之阴阳，即天地之阴阳也。故治身而不法天之八纪，不用地
之五里，则灾害至矣。
故邪风之至，疾如风雨。
灾害之至，将于瞬息，故邪风之至于人身而发病，则疾如风雨。
故善治者，治皮毛。
邪之中人，始伤皮毛，故善治者治皮毛。
其次治肌肤。
留而不去，则入于肌肤，故其次治肌肤。
其次治筋脉。
留而不去，则入于筋脉，故其次治筋脉。
其次治六腑。
留而不去，则入于腑，故其次治六腑。
其次治五脏。治五脏者，半死半生也。
留而不去，则入于脏，故其次治五脏，治及五脏，则半死半生，可不慎欤。
故天之邪气，感则害人五脏，水谷之寒热，感则害于六腑，地之湿气，感则害皮肉筋脉。
上文皮肌筋脉腑脏之病，有因于天者，有因于地者，有因于人者，故天之邪气，感于人身，则害人五
脏。邪气，风寒暑湿燥火也。人之水谷之寒热，感于人身，则害六腑。水谷寒热，饮食失宜，或寒或热也。
地之湿气，感于人身，则害皮肉筋脉，因于湿者，下先受之，故曰地之湿气。
故善用针者，从阴引阳，从阳引阴，以右治左，以左治右，以
我知彼，以表知里，以观过与不及之理，见微得过，用之不殆。
承上文感害之意而言，故善用针以治之者，知阳病必行于阴也，当从阴以引之，而出于阳。知阴病必
行于阳也，当从阳以引之，而离于阴。以右治左，以左治右，缪刺之法也。以我知彼，以我之神，会彼之神
也。以表知里，视其表阳，知其里阴也。以观过与不及之理，言以我知彼，以表知里，所以观其太过与不及
之理，而为用针之法也。故必见微得过，过，失也，病始于微萌，而得其
过失之所在，然后用针以治之，而不至于危殆也。
善诊者，察色按脉，先别阴阳，审清浊，而知部分，视喘息，听音声，而知所苦，观权衡规矩，
而知病所主，按尺寸，观浮沉滑
涩，而知病所生，以治无过，以诊则不失矣。
分，去声。未针之先，必以脉诊，故善诊者，察色脉，别阴阳，审色之清浊，而知面王之部分，视气之
喘息，听言之音声，而知脏腑之所苦，观权衡规矩，脉应四时，而知病之所主，按下尺上寸，以观三部
之浮沉滑涩，而知病之所生，能如是也，以之施治，则无过愆，以之为诊，则不失矣。
故曰∶病之始起也，可刺而已，其盛可待衰而已，故因其轻而扬之，因其重而减之，因其衰而彰之。
言病之始起也，可刺之而已其病。方其盛也，可待其自衰，乃刺之，而已其病。故因其病轻之时，而
发扬之，乃始起刺已之意也，因其盛重之时，而衰减之，乃其盛待衰之意也，因其衰减而彰
明之，乃衰而刺已之意也，此善诊而为刺之之法也。
西方产生燥气，这是天的属性。燥气滋生金气，金气滋生辛味，这是地的属性。辛味滋养肺脏，肺脏滋养皮毛，这是人的形体。皮毛又有其相生关系，所以皮毛与肾相关联。
肺脏又有其所主的功能，所以肺开窍于鼻。
在天为燥，在地为金，在人体形体为皮毛，在内脏为肺，在五色为白，在五音为商，在五声为哭，在变动为咳嗽，在九窍为鼻，在五味为辛，在五志为忧。
神是天的主宰。其神在天表现为燥，所以西方生燥，这是神所在的地方。在地表现为金，所以燥生金，这也是神所在的地方。
在形体表现为皮毛，在内脏表现为肺，所以肺生皮毛，辛生肺，也是神所在的地方。至于在色为白，在音为商，在声为哭，在变动为咳，在窍为鼻，在味为辛，在志为忧，只有西方的燥金之肺脏才具备这些特征。
忧伤肺，喜能胜忧；热伤皮毛，寒能胜热；辛伤皮毛，苦能胜辛。
忧伤肺，喜胜忧，这是情志相克的关系。热伤皮毛，寒胜热，这是气机相克的关系。辛伤皮毛，苦胜辛，这是五味相克的关系。伤于气的，都是本气自伤，这里说热伤皮毛，是因为金受火刑，以说明自伤和受伤都是可以发生的，热伤皮毛则寒能胜其热，这是自然的道理。
北方产生寒气，寒气滋生水气，水气滋生咸味，咸味滋养肾脏，肾脏滋养骨髓，骨髓滋养肝脏，肾开窍于耳。
北方产生寒气，这是天的属性。寒气生水，水生咸，这是地的属性。咸生肾，肾生骨髓，这是人的形体。骨髓又有其相生关系，所以髓生肝，肾脏又有其所主的功能，所以肾主耳。
在天为寒，在地为水，在体为骨，在脏为肾，在色为黑，在音为羽，在声为呻，在变动为战栗，在窍为耳，在味为咸，在志为恐。
神是天的主宰。其神在天为寒，所以北方生寒，这是神所在的地方。
在地为水，所以寒生水，这是神所在的地方。在体为骨，在脏为肾，所以肾生骨髓，咸生肾，也是神所在的地方。至于在色为黑，在音为羽，在声为呻，在变动为栗，在窍为耳，在味为咸，在志为恐，只有北方的肾脏之寒水才具备这些特征。
恐伤肾，思能胜恐；寒伤血，燥能胜寒；咸伤血，甘能胜咸。
恐伤肾，思胜恐，这是情志相克的关系。肾脏藏五脏之精，属于阴，所以不说骨而说血，寒伤血，燥胜寒，这是气机相克的关系。咸伤血，甘胜咸，这是五味相克的关系。土能胜水，按理说应该是湿胜寒，这里说燥胜寒，是为了说明寒湿同类，用燥土之气来胜水气之寒。这就是天之五方五气、地之五行五味、人之五脏五体，以及阴阳应象的道理如此。
所以说：天在上，地在下，是万物的上下界限；阴阳，如同血与气的男女属性；左右，是阴阳运行的道路；水火，是阴阳的征兆。
这里引用《天元纪大论》的话，来阐明天地阴阳水火的含义。上天下地，万物在其中，所以天地是万物的上下。血属阴，气属阳，男女依靠它们生育，所以阴阳是血气的男女属性。阴阳左右旋转，是血气循行的道路，所以左右是阴阳的道路。天一生水，地二生火，是天地阴阳的应验，所以水火是阴阳的征兆。
阴阳，是万物产生的根本。
天地的阴阳，血气的阴阳，左右的阴阳，水火的阴阳，所有这些阴阳，都是万物产生的根本。《易经》说：“坤以简能，干知大始”，说的就是这个道理。
所以说：阴在内，是阳的守持者；阳在外，是阴的役使者。
《生气通天论》中岐伯说：阴，藏精而起急（频繁作用）。即阴在内，作为阳的守持者；阳，卫外而固密。即阳在外，作为阴的役使者。岐伯举此例，来说明阴阳是万物产生的根本，所以内外相应如此。
黄帝问：如何效法阴阳呢？
承接岐伯关于阴阳应象的论述，希望人们取法阴阳来调治身体，以符合圣人论述人体形体的道理，所以问如何效法阴阳。
岐伯说：阳偏胜则身体发热，腠理开泄，呼吸喘促粗重，身体俯仰不安，汗不出而身热，牙齿干燥且心烦冤屈，腹部胀满，预后不良，只能耐受冬天而不能耐受夏天。
“俯”同“俛”，指低头；“冤”，指屈抑。效法阴阳，意味着阴阳不可偏胜。如阳胜，则火热有余，导致身热；热气在表，则腠理开泄；热气在里，则喘促粗重；表里皆病，则身体俯仰不安；汗不出而内外皆热。牙齿干燥，是津液枯竭的表现。因心烦冤屈、腹部胀满而死，是因为津液既竭，又心烦屈抑不舒，腹满导致土气内绝，所以死亡。虽然不立即死亡，但能冬不能夏。冬天寒冷，阳胜尚可忍受；夏天炎热，无法承受煎熬厥逆。
阴偏胜，则身体寒冷，出汗，身体常觉清冷，多次战栗发冷，冷则四肢厥逆，厥逆则腹部胀满，预后不良，只能耐受夏天而不能耐受冬天。
“数”，读作朔。阴胜则水寒有余，导致身寒；寒气在表，则汗出、身体常觉清冷；寒气在里，则多次战栗发冷；表里不相接，所以冷则四肢厥逆。四肢厥逆，是生阳之气不达于外；厥逆则腹部胀满而死，是因为土气再次绝于内，所以死亡。虽然不立即死亡，但也只能夏不能冬。夏天炎热，阴胜尚可忍受；冬天寒冷，无法承受凛冽。
这是阴阳更替偏胜的变化，是疾病的形态和能力表现。
寒病到了冬天，则阴气更胜；热病到了夏天，则阳气更胜，所以说这是阴阳更胜的变化。有的能冬不能夏，有的能夏不能冬，所以说这是疾病的形态和能力。因此阴阳不可偏胜，偏胜就会生病。
黄帝问：如何调治这两者呢？
承接阴阳偏胜的意思，又问如何调治这两者？
岐伯说：能懂得七损八益的道理，就能调治这两者；不懂得运用这个原则，就是早衰的迹象。
阴阳二气源于天真之气，能懂得天真之气的七损八益，就能调治阴阳二者。“七损”，女子以七岁为周期，月经贵在按时来潮，故称损；“八益”，男子以八岁为周期，精气贵在充满，故称益。懂得七损八益，就能使阴平阳秘，所以二者可调；不懂得运用这种损益的方法来调治，就会出现早衰的迹象。“节”，通“候”，指征候。
人到四十岁，阴气自然减半，起居能力开始衰退。五十岁，身体沉重，耳目不聪明。六十岁，阳痿，气大衰，九窍不利，下虚上实，涕泪俱出。所以说：懂得这个道理就强壮，不懂就衰老。
试着列举早衰的征候略加说明：四十岁阴精之气，自然失去一半，所以起居衰退；五十岁，身体沉重，耳目就不聪明了；六十岁，阳痿，气大衰，九窍不利，下虚上实，涕泪俱出。所以说：懂得就强壮。能懂七损八益，身体就强壮。不懂就衰老，不懂七损八益，身体就衰老。
所以虽然同源而出，但名称不同。
同样生活在这个世界中，但强壮和衰老的名称却不同。
智者观察共同点，愚者观察差异点；愚者不足，智者有余。有余则耳目聪明，身体轻健，老年人恢复强壮，壮年人更加健康。
观察共同点，是在同年未衰老的时候进行省察，这是智者的做法。观察差异点，是在强壮和衰老不同的时候进行省察，这是愚者的做法。愚者观察差异，所以感到不足；智者观察共同，所以感到有余。有余，那么五十岁身体沉重、耳目不聪明的人，现在耳目就聪明了，身体也轻健了。六十岁阳痿、气大衰的人，现在老年人也恢复强壮了；四十岁阴气自半的人，现在壮年人也更加调理好了。
因此圣人从事无为的事业，乐于恬淡虚无的境界，顺应欲望，在虚无中保持快乐，所以寿命无穷，与天地同寿，这是圣人的修身之道。
圣人治理世间，本于无为而有为，恬淡虚无，体悟同于天道，所以能论述人体形体，分辨脏腑，梳理经脉，会通六合，就像黄帝所问的那样。这说明阴阳秉承于天的神灵，而应象没有固定模式，只有圣人能取法并调治它。
天不足于西北方，所以西北方属阴，人的右耳目不如左耳目明亮。地不满于东南方，所以东南方属阳，人的左手足不如右手足强健。
圣人的寿命与天地同终，那么人的形体就是天地的形体。天属阳，人身耳目属阳，天不足于西北，是阳体在阴方不足，所以西北方属阴，人身右侧对应西北，所以人的右耳目不如左耳目明亮。地属阴，人身手足属阴，地不满于东南，是阴体在阳方不足，所以东南方属阳，人身左侧对应东南，所以人的左手足不如右手足强健。
黄帝问：为什么这样呢？
为什么左边耳目明亮而手足不强，右边手足强而耳目不明亮？
岐伯说：东方属阳。阳气，其精华汇聚于上部，汇聚于上部，则上部明亮而下部虚弱。所以使人耳目聪明而手足不便。西方属阴。阴气，其精华汇聚于下部，汇聚于下部，则下部盛而上部虚，所以耳目不聪明而手足便利。
“便”，读平声。人身面向南站立，左为东，右为西。左侧乃东方阳位，阳气，其精华汇聚于上部，汇聚于上部则上部明亮而下部虚弱，所以左耳目聪明，而左手足不便。右侧乃西方阴位，阴气，其精华汇聚于下部，汇聚于下部则下部盛而上部虚，所以右耳目不聪明，而右手足强健便利。
所以如果同时感受邪气，病在上部，则右侧严重；病在下部，则左侧严重。这是天地阴阳不能周全的地方，所以邪气居于此处。
一身形气，同时感受邪气，病在上部，则上部为阳，而右侧虚，所以右侧严重，右侧严重即阳体在阴方不足的含义；病在下部，则下部为阴，而左侧虚，所以左侧严重，左侧严重即阴体在阳方不足的含义。这是天地阴阳不能周全，而人身左右阴阳有不足的地方，所以邪气居于此处。
所以天有精，地有形，天有八纪，地有五里，所以能成为万物的父母。清阳上升为天，浊阴下降归地，
因此天地的动静，由神明作为纲纪。所以能以生长收藏，循环往复，终而复始。
“里”，通“理”。人身应合天地，以天地为万物的父母，也是神明所主宰的。精，是精华，所以天有精。形，是形体，所以地有形。八纪，指春夏秋冬、二分二至，是八个节气的大纲，所以天有八纪。五里，指东南西北中五个方位的道理，所以地有五里。既有精，有形，又有纪，有理，所以能成为万物的父母。清阳上天，因为天有精；浊阴归地，因为地有形。动是天地的纲纪，静是天地的道理，因此天地的动静，都由神明作为纲纪，所以能以生长收藏，终而复始，因此能成为万物的父母。
只有贤人上配天，以养头，下象地，以养足，中傍人事，以养五脏。
圣人从事无为的事业，乐于恬淡虚无的境界，顺应欲望，在虚无中保持快乐。只有贤人上配天，以养头，下象地，以养足，中傍人事，以养五脏。大概圣人无为以合天地，贤人则有为以合天地。
天气通于肺。
人身配天象地，而天地之气也通于人。肺位居高，主周身之气，所以天气与之相通。
地气通于嗌。
嗌，即咽嗌。嗌受纳水谷，下接胃口，所以地气与之相通。
风气通于肝。
肝属木，其气为风，所以风动之气与之相通。
雷气通于心。
心属火，火炎上，所以雷气与之相通。
谷气通于脾。
脾土之气，灌注于四旁，所以四旁空谷之气与之相通。
雨气通于肾。
雨气即水气，肾寒主水，所以雨水之气与之相通。
六经为川。
三阴经主五脏，三阳经主六腑。六经为川，是指三阴三阳的六经，像河流一样流动而脉络贯通。
肠胃为海。
人依靠后天的水谷生存，肠胃受纳盛放水谷，像大海一样广大，是众流所归之处。
九窍为水注之气。
清阳出于上窍，浊阴出于下窍。耳目鼻口及前后阴，都有水津贯注，所以九窍是水注之气。
以天地为之阴阳，阳之汗，以天地之雨命名；阳之气，以天地之疾风命名。暴气象雷，逆气象阳。
五脏六经、肠胃九窍，上合天地，有阴有阳，都以天地作为阴阳参照。所以人身阳气宣发之汗，可以比作天地之雨；人身阳热营运之气，可以比作天地之疾风；一时忿怒之暴气，可以比作雷鸣之鼓击；暴气未平之逆气，可以比作阳火之亢热。
所以治疗如果不效法天的纲纪，不使用地的道理，灾害就会降临。
天地的阴阳，就是人身的阴阳；人身的阴阳，就是天地的阴阳。所以治身而不效法天的八纪，不使用地的五里，灾害就会降临。
所以邪风到来，快如风雨。
灾害的到来，就在瞬息之间，所以邪风至于人身而发病，就快如风雨。
所以善于治疗的人，在皮毛阶段就治疗。
邪气中人，首先损伤皮毛，所以善于治疗的人在皮毛阶段就治疗。
其次治疗肌肤。
邪气停留不去，则进入肌肤，所以其次治疗肌肤。
其次治疗筋脉。
邪气停留不去，则进入筋脉，所以其次治疗筋脉。
其次治疗六腑。
邪气停留不去，则进入腑，所以其次治疗六腑。
其次治疗五脏。治疗五脏的病，往往半死半生。
邪气停留不去，则进入脏，所以其次治疗五脏。治及五脏，则半死半生，能不谨慎吗？
所以天的邪气，感伤人则危害五脏；水谷的寒热，感伤人则危害六腑；地的湿气，感伤人则危害皮肉筋脉。
上文提到的皮肌筋脉腑脏的疾病，有的因于天，有的因于地，有的因于人。所以天的邪气，感于人身，则危害五脏。邪气，指风寒暑湿燥火。人的水谷寒热，感于人身，则危害六腑。水谷寒热，指饮食失宜，或寒或热。地的湿气，感于人身，则危害皮肉筋脉，因于湿者，下部先受之，所以说地的湿气。
所以善于用针的人，从阴引阳，从阳引阴，以右治左，以左治右，以我知彼，以表知里，观察过与不及的道理，见微知著，发现过失，使用这种方法就不会有危险。
承接上文感害的意思而言，所以善于用针治疗的人，知道阳病必行于阴，应当从阴引之，而出于阳。知道阴病必行于阳，应当从阳引之，而离于阴。以右治左，以左治右，是缪刺的方法。以我知彼，是用我的神气，去体会病人的神气。以表知里，是观察其表阳，从而了解其里阴。通过观察过与不及的道理，言外之意是通过以我知彼、以表知里，来观察其太过与不及的道理，从而制定用针的方法。所以必须见微知著，“过”指过失，病始于微小的萌芽，而找到其过失所在，然后用针治疗，就不会陷入危殆。
善于诊察的人，观察面色，按压脉搏，首先辨别阴阳，审察色的清浊，从而知道病变的部位，视喘息，听声音，从而知道痛苦所在，观察权衡规矩（脉象应四时），从而知道疾病的主宰脏腑，按尺寸（寸口脉），观察浮沉滑涩，从而知道疾病的发生原因，以此治疗就不会有过错，以此诊察就不会失误。
“分”，读去声。在未针刺之前，必须先进行脉诊，所以善于诊察的人，观察面色脉搏，辨别阴阳，审察色的清浊，从而知道面部王（旺）的部分，视气息的喘息，听语言的音声，从而知道脏腑的痛苦，观察权衡规矩（脉应四时），从而知道疾病的主宰，按下尺上寸，观察三部脉的浮沉滑涩，从而知道疾病的发生，如果能这样做，以此施治就没有过错，以此诊察就没有失误。
所以说：病刚开始起时，可以用针刺治愈；病势正盛时，可等待其衰退后再针刺。所以因病势轻扬而发散它，因病势重而削减它，因病势衰而彰明它（扶助正气）。
意思是病刚开始起时，可以用针刺而已其病。当病势正盛时，可等待其自行衰退，再针刺而已其病。所以因病轻之时，而发扬之，这是始起即刺的意思；因病盛重之时，而衰减之，这是待衰而刺的意思；因病衰减而彰明之，这是衰而刺已（扶助正气）的意思。这是善于诊察并进行针刺的方法。
The West generates Dryness, which is the attribute of Heaven. Dryness generates Metal, and Metal generates Pungent (Xin) flavor, which is the attribute of Earth. Pungent flavor nourishes the Lung organ, and the Lung nourishes the skin and hair, which constitutes the human form. The skin and hair have further generative relationships; thus, the skin and hair are associated with the Kidney.
The Lung organ has its specific governing function; therefore, the Lung opens into the nose.
In Heaven it is Dryness, on Earth it is Metal, in the body it is the skin and hair, in the internal organs it is the Lung, in colors it is White,
in musical tones it is Shang (Metal), in vocal sounds it is Crying, in pathological changes it is Coughing, orifices it is the Nose, in flavors it is Pungent, and in emotions it is Sorrow.
Shen (Spirit) is the master of Heaven. Its Shen manifests as Dryness in Heaven; thus, the West generates Dryness, which is where the Shen resides. On Earth it is Metal; thus, Dryness generates Metal, which is also where the Shen resides.
In the body it is the skin and hair, in the organs it is the Lung; thus, the Lung generates the skin and hair, and Pungent generates the Lung, which are also where the Shen resides. As for being White in color, Shang in tone, Crying in sound, Coughing in change, the Nose in orifice, Pungent in flavor, and Sorrow in emotion, these characteristics apply only to the Lung of Dryness-Metal in the West.
Sorrow injures the Lung, while Joy overcomes Sorrow; Heat injures the skin and hair, while Cold overcomes Heat; Pungent injures the skin and hair, while Bitter overcomes Pungent.
Sorrow injures the Lung, Joy overcomes Sorrow; this refers to the mutual overcoming of emotions. Heat injures the skin and hair, Cold overcomes Heat; this refers to the mutual overcoming of Qi. Pungent injures the skin and hair, Bitter overcomes Pungent; this refers to the mutual overcoming of flavors. Injuries caused by Qi are essentially self-injury of the original Qi. Here, stating that Heat injures the skin and hair illustrates that Metal suffers under Fire punishment, clarifying that both self-injury and external injury can occur. Heat injuring the skin and hair implies that Cold can overcome Heat, which is a natural principle.
The North generates Cold, Cold generates Water, Water generates Salty flavor, Salty flavor nourishes the Kidney, the Kidney nourishes Marrow, Marrow nourishes the Liver, and the Kidney opens into the Ear.
The North generates Cold, which is the attribute of Heaven. Cold generates Water, Water generates Salty, which is the attribute of Earth. Salty generates the Kidney, the Kidney generates Marrow, which constitutes the human form. Marrow has further generative relationships; thus, Marrow generates the Liver. The Kidney organ has its specific governing function; thus, the Kidney governs the Ear.
In Heaven it is Cold, on Earth it is Water, in the body it is Bone, in the internal organs it is the Kidney, in colors it is Black,
in musical tones it is Yu (Water), in vocal sounds it is Groaning, in pathological changes it is Shivering, orifices it is the Ear, in flavors it is Salty, and in emotions it is Fear.
Shen (Spirit) is the master of Heaven. Its Shen manifests as Cold in Heaven; thus, the North generates Cold, which is where the Shen resides.
On Earth it is Water; thus, Cold generates Water, which is where the Shen resides. In the body it is Bone, in the organs it is the Kidney; thus, the Kidney generates Marrow, and Salty generates the Kidney, which are also where the Shen resides. As for being Black in color, Yu in tone, Groaning in sound, Shivering in change, the Ear in orifice, Salty in flavor, and Fear in emotion, these characteristics apply only to the Cold-Water of the Kidney in the North.
Fear injures the Kidney, while Thought overcomes Fear; Cold injures Blood, while Dryness overcomes Cold; Salty injures Blood, while Sweet overcomes Salty.
Fear injures the Kidney, Thought overcomes Fear; this refers to the mutual overcoming of emotions. The Kidney stores the essence of the five Zang organs and belongs to Yin; therefore, it mentions Blood rather than Bone. Cold injures Blood, Dryness overcomes Cold; this refers to the mutual overcoming of Qi. Salty injures Blood, Sweet overcomes Salty; this refers to the mutual overcoming of flavors. Earth can overcome Water; logically, it should be Dampness overcoming Cold. However, it states Dryness overcomes Cold to clarify that Cold and Dampness are of the same category, using the Qi of Dry-Earth to overcome the Cold of Water-Qi. This illustrates how the Five Directions and Five Qi of Heaven, the Five Elements and Five Flavors of Earth, and the Five Zang organs and Five Body tissues of Man correspond through Yin and Yang.
Therefore it is said: Heaven and Earth are the upper and lower bounds of all things; Yin and Yang are like the male and female attributes of Blood and Qi; Left and Right are the pathways of Yin and Yang; Water and Fire are the omens of Yin and Yang.
This quotes from the *Tianyuan Ji Dalun* to clarify the meaning of Heaven, Earth, Yin, Yang, Water, and Fire. Heaven above, Earth below, all things exist within them; thus, Heaven and Earth are the upper and lower bounds of all things. Blood is Yin, Qi is Yang; males and females rely on them for reproduction; thus, Yin and Yang are the male and female attributes of Blood and Qi. Yin and Yang rotate left and right, serving as the pathway for the circulation of Blood and Qi; thus, Left and Right are the pathways of Yin and Yang. Heaven generates One Water, Earth generates Two Fire; these are the manifestations of Heaven and Earth's Yin and Yang; thus, Water and Fire are the omens of Yin and Yang.
Yin and Yang are the beginning of all things.
The Yin and Yang of Heaven and Earth, the Yin and Yang of Blood and Qi, the Yin and Yang of Left and Right, and the Yin and Yang of Water and Fire—all these Yin and Yangs are the beginnings of all things. The *I Ching* says: "Kun possesses simplicity and ability; Qian knows the great beginning." This refers to such principles.
Therefore it is said: Yin inside is the guardian of Yang; Yang outside is the servant of Yin.
In the *Shengqi Tongtian Lun*, Qibo stated: Yin stores Essence and acts urgently. That is, Yin inside serves as the guardian of Yang. Yang protects the exterior and maintains solidity. That is, Yang outside serves as the servant of Yin. Qibo cited this to explain that Yin and Yang are the beginnings of all things, hence their internal and external correspondence.
The Emperor asked: How does one emulate Yin and Yang?
Following Qibo's discussion on the correspondence of Yin and Yang, he wished for people to emulate Yin and Yang for regulation and treatment, aligning with the sage's principles of human anatomy. Thus, he asked how to emulate Yin and Yang.
Qibo answered: If Yang prevails, the body becomes hot, pores open, breathing becomes rapid and coarse, causing difficulty in bending and stretching. With no sweat but heat remaining, teeth become dry, accompanied by vexation and oppression, abdominal fullness, leading to death. Such patients can tolerate Winter but not Summer.
"Fu" is synonymous with "Mian" (bowing); "Yuan" means constrained or suppressed. Emulating Yin and Yang means Yin and Yang must not prevail excessively. If Yang prevails, there is excess fire-heat, causing body heat. If heat is in the exterior, pores open; if in the interior, breathing becomes rapid and coarse. If both exterior and interior are affected, the body bends and stretches involuntarily. No sweat indicates heat in both interior and exterior. Dry teeth indicate exhaustion of body fluids. Death due to vexation, oppression, and abdominal fullness occurs because, with exhausted fluids, mental vexation and constraint persist, and abdominal fullness leads to the internal extinction of Earth Qi. Although not immediately fatal, they can tolerate Winter but not Summer. In winter cold, Yang prevalence is bearable; in summer heat, they cannot withstand the frying and jue syndrome.
If Yin prevails, the body becomes cold, sweating occurs, the body feels constantly chilly, frequent shivering and coldness ensue. Cold leads to jue (cold extremities), and jue leads to abdominal fullness, resulting in death. Such patients can tolerate Summer but not Winter.
"Shuo" is the pronunciation. If Yin prevails, there is excess water-cold, causing body coldness. If cold is in the exterior, sweat occurs and the body feels chilly; if in the interior, frequent shivering and coldness occur. When exterior and interior do not connect, cold leads to jue of the four limbs. Jue of the four limbs means yang life Qi does not reach the exterior. Abdominal fullness during jue leads to death because Earth Qi again extinguishes internally. Although not immediately fatal, they can tolerate Summer but not Winter. In summer heat, Yin prevalence is bearable; in winter cold, they cannot withstand the biting chill.
These are the variations of alternating Yin and Yang prevalence, representing the forms and capacities of disease.
In cold diseases, arriving at Winter, Yin Qi prevails more; in heat diseases, arriving at Summer, Yang Qi prevails more. Hence, this is called the variation of alternating Yin and Yang prevalence. Some can tolerate Winter but not Summer, some Summer but not Winter; hence, this is called the form and capacity of disease. Therefore, Yin and Yang must not prevail excessively; excessive prevalence causes disease.
The Emperor asked: How can these two be regulated?
Continuing the theme of Yin-Yang excessive prevalence, he asked how to regulate these two?
Qibo answered: If one understands the Seven Losses and Eight Benefits, these two can be regulated. If one does not use this principle, it is the sign of premature aging.
Yin and Yang Qi originate from True Heaven Qi. Understanding the Seven Losses and Eight Benefits of True Heaven Qi allows for the regulation of Yin and Yang. "Seven Losses" refers to women, whose cycles are based on seven. Menstruation is precious when timely, hence termed "Loss." "Eight Benefits" refers to men, whose cycles are based on eight. Essence and Qi are precious when abundant, hence termed "Benefit." Understanding the Seven Losses and Eight Benefits ensures Yin is peaceful and Yang is secure, allowing regulation of these two. Not understanding and applying this method of loss and benefit leads to signs of premature aging. "Jie" here means sign or indicator.
At forty years old, Yin Qi naturally halves, and daily activities decline. At fifty, the body feels heavy, and hearing and vision become unclear. At sixty, impotence occurs, Qi greatly declines, the nine orifices become obstructed, deficiency below and excess above lead to flowing tears and snot. Thus it is said: Knowing this brings strength; not knowing leads to old age.
Briefly describing the signs of premature aging: At forty, Yin Essence and Qi naturally lose half, so daily activities decline. At fifty, body heaviness makes hearing and vision unclear. At sixty, impotence leads to great Qi decline, nine orifices obstruction, deficiency below and excess above, with tears and snot flowing. Thus it is said: Knowing brings strength. Understanding the Seven Losses and Eight Benefits makes the body strong. Not knowing leads to old age; not understanding the Seven Losses and Eight Benefits results in an aged body.
Thus, although originating from the same source, names differ.
Born in the same world, the names of strength and old age differ.
The wise observe similarities; the foolish observe differences. The foolish lack; the wise have surplus. Surplus brings clear hearing and vision, light and strong body; the old regain strength, the strong become healthier.
Observing similarities involves reflecting on oneself before aging sets in; this is the act of the wise. Observing differences involves reflecting on the distinct states of strength and old age; this is the act of the foolish. The foolish observe differences, hence they feel lacking. The wise observe similarities, hence they feel abundant. With abundance, those who were heavy-bodied and dull at fifty now have clear senses and a light, strong body. Those who were impotent and weak at sixty now see the old regain strength. Those whose Yin Qi halved at forty now see the strong become even healthier.
Therefore, the Sage engages in non-action, delights in tranquility and emptiness, follows desires to find joy in guarding the void. Thus, lifespan is infinite, ending with Heaven and Earth. This is the Sage's method of cultivating the body.
The Sage governs the world through non-action yet effective action, embracing tranquility and emptiness, embodying the Way of Heaven. Thus, he can discuss human anatomy, distinguish Zang-Fu organs, trace meridians, and integrate the Six Harmonies, answering the Emperor's questions. This shows that Yin and Yang inherit the Spirit of Heaven, responding without fixed patterns; only the Sage can emulate and regulate them.
Heaven is deficient in the Northwest; thus, the Northwest is Yin, and humans' right ear and eye are less acute than the left. Earth is incomplete in the Southeast; thus, the Southeast is Yang, and humans' left hand and foot are weaker than the right.
Since the Sage's lifespan ends with Heaven and Earth, the human form corresponds to Heaven and Earth. Heaven is Yang, human ears and eyes are Yang. Heaven is deficient in the Northwest, meaning Yang is deficient in the Yin direction. Thus, the Northwest is Yin, corresponding to the right side of the body; hence, the right ear and eye are less acute than the left. Earth is Yin, human hands and feet are Yin. Earth is incomplete in the Southeast, meaning Yin is deficient in the Yang direction. Thus, the Southeast is Yang, corresponding to the left side of the body; hence, the left hand and foot are weaker than the right.
The Emperor asked: Why is this so?
Why are ears and eyes acute on the left but hands and feet weak, while hands and feet are strong on the right but ears and eyes less acute?
Qibo answered: The East is Yang. Yang Qi, its essence gathers upward. Gathering upward means the upper part is bright and the lower part is empty. Thus, ears and eyes are acute, but hands and feet are inconvenient. The West is Yin. Yin Qi, its essence gathers downward. Gathering downward means the lower part is full and the upper part is empty. Thus, ears and eyes are not acute, but hands and feet are convenient.
"Bian" is pronounced with the level tone. Facing south, the left is East (Yang). Yang Qi gathers upward; gathering upward makes the upper bright and lower empty, so the left ear and eye are acute, but the left hand and foot are inconvenient. The right is West (Yin). Yin Qi gathers downward; gathering downward makes the lower full and upper empty, so the right ear and eye are not acute, but the right hand and foot are strong and convenient.
Therefore, if simultaneously affected by pathogenic factors, diseases in the upper part are worse on the right; diseases in the lower part are worse on the left. This is because Heaven and Earth's Yin and Yang are not complete, so pathogens reside there.
When the entire body's form and Qi are affected by pathogens, if the disease is in the upper part, the upper is Yang, and the right is deficient, so the right is worse. This reflects the concept of Yang deficiency in the Yin direction. If the disease is in the lower part, the lower is Yin, and the left is deficient, so the left is worse. This reflects the concept of Yin deficiency in the Yang direction. Since Heaven and Earth's Yin and Yang are incomplete, and human Yin and Yang on the left and right are deficient, pathogens reside there.
Therefore, Heaven has Jing (Essence), Earth has Xing (Form). Heaven has Ba Ji (Eight Disciplines/Seasons), Earth has Wu Li (Five Principles/Directions). Thus, they can serve as parents to all things. Clear Yang ascends to Heaven, Turbid Yin descends to Earth.
Therefore, the movement and stillness of Heaven and Earth are governed by Shen Ming (Divine Spirit). Thus, they can facilitate growth, flourishing, harvesting, and storage, cycling endlessly.
"Li" connects to "Li" (Principle). Humans correspond to Heaven and Earth, regarding them as parents of all things and masters of Shen Ming. Jing is essence, so Heaven has Jing. Xing is form, so Earth has Xing. Ba Ji refers to Spring, Summer, Autumn, Winter, and the two Equinoxes and two Solstices, the major eight solar terms, so Heaven has Ba Ji. Wu Li refers to the principles of the five directions (East, South, West, North, Center), so Earth has Wu Li. Having Jing, Xing, Ji, and Li, they become parents to all things. Clear Yang ascends to Heaven because Heaven has Jing; Turbid Yin returns to Earth because Earth has Xing. Movement is Heaven's discipline, stillness is Earth's principle. Thus, the movement and stillness of Heaven and Earth are governed by Shen Ming, enabling growth, flourishing, harvesting, and storage in endless cycles, making them parents to all things.
Only the Virtuous Man emulates Heaven above to nourish the head, imitates Earth below to nourish the feet, and aligns with human affairs in the middle to nourish the Five Zang organs.
The Sage engages in non-action, delights in tranquility and emptiness, finding joy in guarding the void. Only the Virtuous Man emulates Heaven above to nourish the head, imitates Earth below to nourish the feet, and aligns with human affairs in the middle to nourish the Five Zang organs. The Sage achieves harmony with Heaven and Earth through non-action, while the Virtuous Man achieves it through action.
Heavenly Qi connects with the Lung.
Humans correspond to Heaven and Earth, and Heavenly Qi connects with humans. The Lung sits high and governs Qi throughout the body, so Heavenly Qi connects with it.
Earthly Qi connects with the Yi (Throat).
Yi refers to the throat. The Yi receives food and drink and connects downward to the stomach, so Earthly Qi connects with it.
Wind Qi connects with the Liver.
The Liver belongs to Wood, and its Qi is Wind; thus, the moving Qi of Wind connects with it.
Thunder Qi connects with the Heart.
The Heart belongs to Fire, and Fire flares upward; thus, Thunder Qi connects with it.
Grain Qi connects with the Spleen.
Spleen Earth Qi irrigates the four peripheries; thus, the hollow Qi of the four peripheries connects with it.
Rain Qi connects with the Kidney.
Rain Qi is Water Qi. The Kidney is Cold and governs Water; thus, Rain/Water Qi connects with it.
The Six Meridians are like rivers.
The Three Yin Meridians govern the Five Zang organs, and the Three Yang Meridians govern the Six Fu organs. The Six Meridians as rivers mean the Six Meridians of Yin and Yang flow like rivers, connecting meridians and collaterals.
The Intestines and Stomach are like seas.
Humans rely on postnatal food and drink for life. The Intestines and Stomach receive and store food and drink, vast like the sea, where all streams converge.
The Nine Orifices are the Qi of Water Injection.
Clear Yang exits through the upper orifices, Turbid Yin exits through the lower orifices. Ears, eyes, nose, mouth, and anterior/posterior orifices are all irrigated by body fluids; thus, the Nine Orifices are the Qi of Water Injection.
Using Heaven and Earth as references for Yin and Yang, the sweat of Yang Qi is named after Heaven's rain, and the Qi of Yang is named after Heaven's fierce wind. Violent Qi resembles thunder, rebellious Qi resembles Yang fire.
The Five Zang organs, Six Meridians, Intestines, Stomach, and Nine Orifices all correspond to Heaven and Earth, possessing Yin and Yang, referenced by Heaven and Earth. Thus, the sweat released by Yang Qi can be likened to Heaven's rain; the Qi circulating with Yang heat can be likened to Heaven's fierce wind. The violent Qi of sudden anger can be likened to the drumming of thunder; the rebellious Qi of uncalmed violence can be likened to the excessive heat of Yang fire.
Therefore, if treatment does not emulate Heaven's disciplines or use Earth's principles, disasters will arrive.
Heaven and Earth's Yin and Yang are identical to human Yin and Yang; human Yin and Yang are identical to Heaven and Earth's Yin and Yang. Therefore, treating the body without emulating Heaven's Eight Disciplines or using Earth's Five Principles will result in disasters.
Thus, when evil wind arrives, it is swift as wind and rain.
Disasters arrive in an instant; thus, when evil wind reaches the human body and causes disease, it is swift as wind and rain.
Therefore, the skilled healer treats at the level of the skin and hair.
Pathogens first injure the skin and hair when entering the body; thus, the skilled healer treats at the skin and hair stage.
Next, treat the muscles and skin.
If pathogens remain and do not depart, they enter the muscles and skin; thus, next, treat the muscles and skin.
Next, treat the sinews and vessels.
If pathogens remain and do not depart, they enter the sinews and vessels; thus, next, treat the sinews and vessels.
Next, treat the Six Fu organs.
If pathogens remain and do not depart, they enter the Fu organs; thus, next, treat the Six Fu organs.
Next, treat the Five Zang organs. Treating diseases of the Five Zang organs often results in half-death and half-life.
If pathogens remain and do not depart, they enter the Zang organs; thus, next, treat the Five Zang organs. Once treatment reaches the Zang organs, the prognosis is often half-death and half-life. Can one not be cautious?
Therefore, Heavenly pathogenic Qi, upon affecting the body, harms the Five Zang organs. Cold and heat from food and drink, upon affecting the body, harm the Six Fu organs. Earthly dampness, upon affecting the body, harms the skin, flesh, sinews, and vessels.
The aforementioned diseases of skin, muscle, sinew, vessel, Fu, and Zang arise from Heaven, Earth, or Human factors. Thus, Heavenly pathogenic Qi affects the body and harms the Five Zang organs. Pathogenic Qi refers to Wind, Cold, Summer-heat, Dampness, Dryness, and Fire. Cold and heat from food and drink affect the body and harm the Six Fu organs. Food and drink cold and heat refer to improper diet, either cold or hot. Earthly dampness affects the body and harms skin, flesh, sinews, and vessels. Dampness injuries usually affect the lower part first; thus, it is called Earthly dampness.
Therefore, the skilled acupuncturist draws Yang from Yin, draws Yin from Yang, treats the right with the left, treats the left with the right, knows the other through oneself, knows the interior through the exterior, observes the principles of excess and deficiency, sees the subtle to detect faults, and uses this method without danger.
Continuing the theme of pathogenic harm, the skilled acupuncturist knows that Yang diseases must traverse Yin, so one should draw from Yin to bring it out to Yang. Knowing Yin diseases must traverse Yang, one should draw from Yang to separate it from Yin. Treating the right with the left and the left with the right is the Miao-stitching method. Knowing the other through oneself means using one's own Shen to resonate with the patient's Shen. Knowing the interior through the exterior means observing exterior Yang to understand interior Yin. Observing the principles of excess and deficiency implies using "knowing the other through oneself" and "knowing the interior through the exterior" to discern excess and deficiency, thereby formulating acupuncture methods. Thus, one must perceive the subtle to detect faults ("Guo" means fault). Disease begins subtly; finding the fault allows for acupuncture treatment without danger.
The skilled diagnostician observes complexion and palpates pulses, first distinguishing Yin and Yang, examining clarity and turbidity to know the location, observing breathing and listening to voice to know the suffering, observing the balance of rules (pulse corresponding to seasons) to know the dominant disease, pressing the Cun and Chi positions, observing floating, sinking, slippery, and choppy qualities to know the origin of disease. Treating accordingly avoids error; diagnosing accordingly avoids failure.
"Fen" is pronounced with the departing tone. Before acupuncture, pulse diagnosis is essential. Thus, the skilled diagnostician observes complexion and pulse, distinguishes Yin and Yang, examines clarity and turbidity of color to know the prosperous areas of the face, observes breathing to know the suffering of Zang-Fu organs, observes pulse rules corresponding to seasons to know the dominant disease, presses Chi (lower) and Cun (upper) to observe floating, sinking, slippery, and choppy qualities in the three positions to know the origin of disease. Doing so ensures treatment has no errors and diagnosis has no failures.
Therefore it is said: When a disease first begins, it can be cured by acupuncture. When it is at its peak, wait for it to subside before treating. Therefore, disperse mild conditions, reduce severe conditions, and manifest/support conditions that are declining.
This means when a disease first begins, it can be treated with acupuncture. When the disease is at its peak, wait for it to subside naturally before treating. Therefore, when the disease is mild, disperse it (reflecting early treatment); when severe, reduce it (reflecting waiting for subsidence); when declining, support/manifest it (reflecting treatment during decline). This is the method of skilled diagnosis and acupuncture.