言其变病之所也。六气之用，各归不胜而为化者，谓各归不胜之方月施化也。方月者，假如厥阴司天之岁，
则阳明之位在泉左间，其方月东北，初之气也；太阳之位右间，其方月东南，二之气也；厥阴之位司天，
其方月正南，三之气也；少阴之位在天左间，其方月西南，四之气也；太阴之位在泉右间，其方月西北，
五之气也；少阳之位在泉，其方月正北，终之气也。故其岁施用太阴雨化，施于东南二之气太阳之位；太
阳寒化，施于西南四之气少阴之位；少阴热化，施于东北初之气阳明之位；阳明燥化，施于正南三之气厥
阴之位；厥阴风化，施于西北五之气太阴之位，皆各命其所在之化，以征验其所施之化，于岁同法推之也。
自得其位，在本位之方月施化也。如厥阴之岁，则太阴自得于西北五之气本位施雨化，太阳自得于东南二
之气本位施寒化，少阴自得于西南四之气本位施热化，少阳自得于正北终之气本位施火化，阳明自得于东
北初之气本位施燥化，厥阴自得于正南三之气本位施风化，于岁同法推之也。大者之至徐而常者，六气之
盈者为病，则其势反徐而微，治法当逆之也。少者之至暴而亡，六气之虚者为病，则其势反暴而甚，治法
当从之也。人见其气暴烈，骤用峻剂攻之，则热病未已，寒病复始，殊不知大者之气反微，少者之气反甚也。
帝曰∶愿闻阴阳之三也何谓？岐伯曰∶气有多少异用也。帝曰∶阳明何谓也？岐伯曰∶两阳合明也。帝
曰∶厥阴何也？岐伯曰∶两阴交尽也。帝曰∶幽明何如？岐伯曰∶雨阴交尽故曰幽，两阳合明故曰明，幽明之
配，寒暑之异也。帝曰∶分至何如？岐伯曰∶气至之谓至，气分之谓分，至则气同，分则气异，所谓天地之正
纪也。帝曰∶夫百病之始生也，皆生于风、寒、暑、湿、燥、火，以之化之变也。经言盛者泻之，虚者补之，
余锡以方士，而方士用之，尚未能十全，余欲令要道必行，桴鼓相应，犹拔刺雪污，工巧神圣，可得闻乎？
岐伯曰∶审察病机，无失气宜，此之谓也。帝曰∶愿闻病机何如？岐伯曰∶诸风掉眩，皆属于肝。诸寒收引，
皆属于肾。诸气 郁，皆属于肺。诸湿肿满，皆属于脾。诸热瞀 ，皆属于火。诸痛痒疮，皆属于心。诸厥固
泄，皆属于下。诸痿喘呕，皆属于上。诸禁鼓栗，如丧神守，皆属于火。诸痉项强，皆属于湿。诸逆冲上，皆
属于火。诸胀腹大，皆属于热。诸躁狂越，皆属于火。诸暴强直，皆属于风。诸病有声，鼓之如鼓，皆属于热。
诸病 肿，疼酸惊骇，皆属于火。诸转反戾，水液混浊，皆属于热。诸病水液，澄澈清冷，皆属于寒。诸呕吐
酸，暴注下迫，皆属于热。故《大要》曰∶谨守病机，各司其属，有者求之，无者求之，盛者责之，虚者责之，
必先五胜，疏其血气，令其调达，而至和平，此之谓也。（至真要大论）
此一章，论五运六气之为病治法也。病机一十九条实察病之要旨。而“有者求之，无者求之，盛者责之，
虚者责之”一十六字，乃答篇首盛者泻之，虚者补之之旨，而总结一十九条之义，又其要旨中之要旨也。
河间《原病式》但用病机一十九条立言，而遗此十六字，犹有舟无操舟之工，有兵无将兵之帅，今负 窃
之罪以补之。夫诸风病皆属于肝也，风木盛则肝太过而病化风，如木太过，发生之纪病掉眩之类，俗谓之
阳急惊等病，治以凉剂是也。燥金盛则肝为邪攻而病亦化风，如阳明司天，燥金下临，病掉振之类，俗
谓之阴 慢惊等病，治以温剂是也。诸火热病，皆属于心也，火热甚则心太过而病化火热，如岁火太过，
诸谵妄狂越之类，俗谓之阳躁谵语等病，治以攻剂是也。寒水胜则心为邪攻，而病亦化火热，如岁水太过，
病躁悸烦心谵妄之类，俗谓之阴躁郑声等病，治以补剂是也。诸湿病皆属于脾也，湿土甚则脾太过而病化
湿，如湿胜则濡泄之类，仲景用五苓等剂去湿是也。风木胜则脾为邪攻而病亦化湿，如岁木太过，病飧泄
之类，钱氏用宣风等剂去风是也。诸气 郁，皆属于肺也，燥金甚则肺太过而病化 郁，如岁金太过，甚
则咳喘之类，东垣谓之寒喘，治以热剂是也。火热胜则肺为邪攻，而病亦化 郁，如岁火太过，病咳喘之
类，东垣谓之热喘，治以寒剂是也。诸寒病皆属于肾也，寒水甚则肾太过，而病化寒，如太阳所至为屈伸
不利之类，仲景用乌头汤等剂是也。湿土胜则肾为邪攻，而病亦化寒，如湿气变物，病筋脉不利之类，东
垣用复煎、健步等剂是也。其在太过 所化之物为盛，盛者真气也；其在受攻，所化之病为虚，虚者假气
也。故有其病化者，恐其气之假，故有者亦必求之。无其病化者，恐其邪隐于中，如寒胜化火，燥胜化风，
及寒伏反躁，热伏反厥之类，故无者亦必求之。其病之化似盛者，恐其盛之未的，故盛者亦必责之。其病
之化似虚者，恐其虚之未真，故虚者亦必责之。凡一十九条病机皆用此一十六字为法求之，庶几补泻不瘥
也。今河间损此一十六字，但以病化有者为盛，无者为虚，而不复求其假者虚者，为未备，故引经传以证
其得失也。
帝曰∶五味阴阳之用何如？岐伯曰∶辛甘发散为阳，酸苦涌泄为阴，咸味涌泄为阴，淡味渗泄为阳。
六者或收或散？或缓或急，或燥或润，或 或坚，以所利行之，调气使平。帝曰∶非调气而得者，治之
奈何？有毒无毒，何先何后？愿闻其道。岐伯曰∶有毒无毒，所治为主，适大小为制也。帝曰∶请言其
制？岐伯曰∶君一臣二，制之小也；君一臣三佐五，制之中也；君一臣三佐九，制之大也。寒者热之，热
者寒之，微者逆之，甚者从之，坚者削之，客者除之，劳者温之，结者散之，留者攻之，燥者濡之，急
者缓之，散者收之，损者益之，逸者行之，惊者平之，上之下之，摩之浴之，薄之劫之，开之发之，
适事为故。帝曰∶何谓逆从？岐伯曰∶逆者正治，从者反治，从少从多，观其事也。帝曰∶反治何谓？
岐伯曰∶热因寒用，寒因热用，塞因塞用，通因通用，必伏其所主，而先其所因，其始则同，其终则异，
可使破积，可使溃坚，可使气和，可使必已。（至真要大论）
此一章论内气不调得病者之治法也。盖内气不调而得病，故所病寒热之邪，但可于其气之微者逆治之。
如气甚而逆治之，则正邪格拒，不能胜邪，命将难全，故但当从其寒热之邪于外，伏其所主之剂于中，然
后正邪相入，而邪就擒矣。东垣所谓姜附寒饮，承气热服，及仲景于白通汤加尿胆治少阴，丹溪于苓柏汤
皆熟炒治色目妇人恶寒之类是也。
帝曰∶气调而得者何如？岐伯曰∶逆之从之，逆而从之，从而逆之，疏气令调，则其道也。（至真要大论）
此一章，论内气本调，因外邪得病者之治法也。盖内气调而得病，故不分寒热之微甚，或逆治之，或从
治之皆可，更不须惧其正邪格拒，正固则邪自退矣。
帝曰∶病之中外何如？岐伯曰∶从内之外者，调其内；从外之内者，治其外；从内之外而盛于外者，先调
其内而后治其外；从外之内而盛于内者，先治其外而后调其内；中外不相及，则治主病。帝曰∶善。火热复，
恶寒发热，有如疟状，或一日发，或间数日发，其故何也？岐伯曰∶胜复之气，会遇之时，有多少也。阴气多
而阳气少，则其发日远；阳气多而阴气少，则其发日近。此胜复相搏，盛衰之节，疟亦同法。帝曰∶论言治寒
以热，治热以寒，而方士不能废绳墨而更其道也。有病热者寒之而热，有病寒者热之而寒，二者皆在，新病复
起奈何治？岐伯曰∶诸寒之而热者取之阴，热之而寒者取之阳，所谓求其属也。帝曰∶善。服寒而反热，服
热而反寒，其故何也？岐伯曰∶治其王气，是以反也。
帝曰∶不治王而然者何也？岐伯曰∶悉乎哉问也！不治五味属也。夫五味入胃，各归所喜，故酸先入肝，
苦先入心，甘先入脾，辛先入肺，咸先入肾，久而增气，物化之常也。气增而久，夭之由也。帝曰∶善。方制
君臣何谓也？岐伯曰∶主病之谓君，佐君之谓臣，应臣之谓使，非上下三品之谓也。帝曰∶三品何谓？岐
伯曰∶所以明善恶之殊贯也。帝曰∶善。病之中外何如？岐伯曰∶调气之方，必别阴阳，定其中外，各守其
乡，内者内治，外者外治，微者调之，其次平之，盛者夺之，汗之下之，寒热温凉，衰之以属，随其攸利，
谨道如法，万举万全，气血正平，长有天命。帝曰∶善。（“不治五味属也”，一本“五味”二字作“王
气”二字。至真要大论）
岐伯曰∶寒热燥湿，不同其化也。故少阳在泉，寒毒不生，其味辛，其治苦酸，其谷苍丹。阳明
在泉，湿毒不生，其味酸，其气温，其治辛苦甘，其谷丹素。太阳在泉，热毒不生，其味苦，其治淡咸，其谷
。厥阴在泉，清毒不生，其味甘，其治酸苦，其谷苍赤，其气专，其味正。少阴在泉，寒毒不生，其味
辛，其治辛苦甘，其谷白丹。太阴在泉，燥毒不生，其味咸，其气热，其治甘咸，其谷 。化淳
则咸守，气专则辛化而俱治。故曰∶补上下者从之，治上下者逆之，以所在寒热盛衰而调之。故曰∶
上取下取，内取外取，以求其过。能毒者以浓药，不胜毒者以薄药，此之谓也。
气反者，病在上，取之下；病在下，取之上；病在中，旁取之。治热以寒，温而行之；治寒以热，
凉而行之；治温以清，冷而行之；治清以温，热而行之。故消之削之，吐之下之，补之泻之，久新同法。
帝曰∶病在中而不实不坚，且聚且散，奈何？岐伯曰∶无积者求其藏，虚则补之，药以祛之，食
以随之，行水渍之，和其中外。可使毕已。
帝曰∶有毒无毒，服有约乎？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，而遗人夭殃，无致邪，无失正，绝人长命。帝曰∶其久
病者，有气从不康，病去而瘠，奈何？岐伯曰∶昭乎哉圣人之问也！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，静以待时，谨守其气，无使倾移，其形乃彰，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。（五常政大论）
帝曰∶气有多少，病有盛衰，治有缓急，方有大小，愿闻其约奈何？岐伯曰∶气有高下；病有远近，证有
中外，治有轻重，适其至所为故也。大要曰∶君一臣二，奇之制也；君二臣四，偶之制也；君二臣三，
奇之制也；君二臣六，偶之制也。故曰∶近者奇之，远者偶之，汗者不以奇，下者不以偶，补上治上制以缓，补下
治下制以急，急则气味浓，缓则气味薄，适其至所，此之谓也。病所远而中道气味之者，食而过之，无越其制
度也。是故平气之道，近而奇偶，制小其服也。远而奇偶，制大其服也。大则数少，小则数多，多则九之，少
则二之，奇之不去则偶之，是谓重方。偶之不去，则反佐以取之，所谓寒热温凉，反从其病也。帝曰∶善。病
生于本，余知之矣。生于标者，治之奈何？岐伯曰∶病反其本，中标之病，治反其本，中标之方。（至真要大论）
帝问曰∶妇人重身，毒之何如？岐伯曰∶有故无殒，亦无殒也。帝曰∶愿闻其故何谓也？岐伯曰∶大积大
聚，其可犯也，衰其太半而止，过者死。（六元正纪大论）
阐述疾病变化的发生部位。六气的作用，各自归于其所不胜（即克制它的五行）的一方而发生变化，是指各气在其所不胜的方位和月份施行其气化作用。所谓方位和月份，例如厥阴风木司天的年份，则阳明燥金位于在泉的左间位，其方位在东北，对应初之气；太阳寒水位于右间位，其方位在东南，对应二之气；厥阴风木位于司天位，其方位在正南，对应三之气；少阴君火位于天左间位，其方位在西南，对应四之气；太阴湿土位于在泉右间位，其方位在西北，对应五之气；少阳相火位于在泉位，其方位在正北，对应终之气。因此，在这一年中施用的太阴雨化，施加于东南方二之气所在的太阳寒水位；太阳寒化，施加于西南方四之气所在的少阴君火位；少阴热化，施加于东北方初之气所在的阳明燥金位；阳明燥化，施加于正南方三之气所在的厥阴风木位；厥阴风化，施加于西北方五之气所在的太阴湿土位，这都是各自命名其所在的气化，以验证其所施行的气化，对其它年份也采用同样的方法推算。
如果各气处于其本位，则在本位的方位和月份施行气化。例如厥阴风木司天的年份，太阴湿土自得于西北方五之气的本位施行雨化，太阳寒水自得于东南方二之气的本位施行寒化，少阴君火自得于西南方四之气的本位施行热化，少阳相火自得于正北方终之气的本位施行火化，阳明燥金自得于东北方初之气的本位施行燥化，厥阴风木自得于正南方三之气的本位施行风化，对其他年份也采用同样的方法推算。
气势宏大者到来缓慢且持久，若六气过盛致病，其势头反而缓慢微弱，治疗方法应当逆其势而行。气势微小者到来暴烈且短暂，若六气虚弱致病，其势头反而暴烈严重，治疗方法应当顺其势而行。人们看到气机暴烈，就立即使用峻猛的药剂攻伐，结果热病未愈，寒病又起，殊不知气势宏大者其表现反而微弱，气势微小者其表现反而剧烈。
黄帝说：我想了解阴阳分为三类的含义是什么？岐伯说：这是因为气的多少不同，用法也不同。黄帝说：为什么称阳明？岐伯说：两阳合明称为阳明。黄帝说：为什么称厥阴？岐伯说：两阴交尽称为厥阴。黄帝说：幽和明是什么意思？岐伯说：两阴交尽故称为幽，两阳合明故称为明，幽与明的配合，代表了寒与暑的区别。黄帝说：分至是什么意思？岐伯说：气至称为至，气分称为分，至时气相同，分时气不同，这就是天地正常的纲纪。
黄帝说：各种疾病的产生，都源于风、寒、暑、湿、燥、火，这是由它们的气化和变化引起的。经文说：实证用泻法，虚证用补法。我赐予你们这些方术，但方士们使用它，还不能做到十全十美。我希望重要的道理能够切实执行，疗效像鼓槌击鼓那样迅速相应，如同拔刺雪污一样彻底，这种工巧神圣的技术，可以讲给我听吗？岐伯说：审察病机，不违背气宜，说的就是这个道理。黄帝说：我想听听什么是病机？岐伯说：凡是风病导致的震颤眩晕，都属于肝。凡是寒病导致的筋脉收缩牵引，都属于肾。凡是气病导致的郁结不畅，都属于肺。凡是湿病导致的水肿胀满，都属于脾。凡是热病导致的昏昧不清，都属于火。凡是痛痒疮疡，都属于心。凡是厥逆、二便闭塞或泄泻，都属于下焦。凡是痿证、喘促、呕吐，都属于上焦。凡是口噤、鼓颔战栗，如同丧失神志守护，都属于火。凡是痉挛项强，都属于湿。凡是气逆冲上，都属于火。凡是腹胀大，都属于热。凡是躁动狂乱越常，都属于火。凡是突然发生的强直，都属于风。凡是病有声响，叩之如鼓声，都属于热。凡是病见肿胀，疼痛酸楚惊骇，都属于火。凡是转筋反折，津液混浊，都属于热。凡是病见水液排泄物澄澈清冷，都属于寒。凡是呕吐酸水，急骤腹泻伴有里急后重，都属于热。所以《大要》说：谨慎地守住病机，分别归属其脏腑，有的求其因，无的求其隐，盛的责其邪，虚的责其正，必须先分析五脏胜复关系，疏通气血，使其调达平和，达到平衡，说的就是这个道理。（出自《素问·至真要大论》）
这一章，论述五运六气致病及治疗方法。病机十九条确实考察了疾病的要害。“有的求其因，无的求其隐，盛的责其邪，虚的责其正”这十六个字，是回答篇首“实证用泻法，虚证用补法”的宗旨，并总结了十九条病机的意义，更是其中的核心要点。河间氏的《原病式》仅用病机十九条立论，而遗漏了这十六字，就像有船没有划船工人，有军队没有统帅，今天我承担窃取经典的罪名来补充它。
凡风病都属于肝。风木过盛则肝太过而病化为风，如木气太过，发生之纪出现的震颤眩晕等病，俗称阳急惊等病，治疗用凉剂。燥金过盛则肝受邪攻击而病也化为风，如阳明司天，燥金下临，出现震颤等病，俗称阴慢惊等病，治疗用温剂。
凡火热病都属于心。火热甚则心太过而病化为火热，如岁火太过，出现谵语妄言狂乱等病，俗称阳躁谵语等病，治疗用攻剂。寒水过盛则心受邪攻击，病也化为火热，如岁水太过，出现躁动心悸烦心谵妄等病，俗称阴躁郑声等病，治疗用补剂。
凡湿病都属于脾。湿土甚则脾太过而病化为湿，如湿胜则濡泄等病，张仲景用五苓散等剂祛湿。风木过盛则脾受邪攻击而病也化为湿，如岁木太过，出现飧泄等病，钱乙用宣风散等剂去风。
凡气郁病都属于肺。燥金甚则肺太过而病化为气郁，如岁金太过，严重时咳嗽气喘等病，李东垣称之为寒喘，治疗用热剂。火热过盛则肺受邪攻击，病也化为气郁，如岁火太过，出现咳嗽气喘等病，李东垣称之为热喘，治疗用寒剂。
凡寒病都属于肾。寒水甚则肾太过，而病化为寒，如太阳所至出现屈伸不利等病，张仲景用乌头汤等剂治疗。湿土过盛则肾受邪攻击，病也化为寒，如湿气改变物体，出现筋脉不利等病，李东垣用复煎汤、健步丸等剂治疗。
在太过之气所化的事物表现为盛，盛的是真气；在受邪攻击所化的病表现为虚，虚的是假气。所以有病象转化的，担心其气是假的，所以“有者”也必须探求其因。没有病象转化的，担心邪气潜伏在中，如寒胜化火，燥胜化风，以及寒伏反躁，热伏反厥等情况，所以“无者”也必须探求其因。病象转化看似盛的，担心其盛不确切，所以“盛者”也必须追究其实质。病象转化看似虚的，担心其虚不真实，所以“虚者”也必须追究其实质。凡十九条病机都用这十六字作为法则去探求，差不多就不会补泻失误了。现在河间氏损毁了这十六字，仅仅以病象有者为盛，无者为虚，而不进一步探求假者和虚者，是不完备的，所以引用经典传记来证明其得失。
黄帝说：五味中阴阳的作用是怎样的？岐伯说：辛味和甘味能发散，属于阳；酸味和苦味能涌吐泄下，属于阴；咸味能涌吐泄下，属于阴；淡味能渗利泄下，属于阳。这六种味道有的收敛有的发散，有的缓和有的紧急，有的燥湿有的滋润，有的软坚有的坚硬，根据其对机体有利的方面来运用，调和气机使之平复。
黄帝说：如果不是通过调气而治愈的，怎么治疗呢？有毒无毒的药物，先用哪个后用哪个？我想听听其中的道理。岐伯说：有毒无毒，以治疗的疾病为主，根据病情大小来制定剂量。黄帝说：请讲讲制定的规则？岐伯说：君药一味，臣药二味，是小制；君药一味，臣药三味，佐药五味，是中制；君药一味，臣药三味，佐药九味，是大制。寒性病用热药治，热性病用寒药治，病轻者逆其病性治疗，病重者顺其病性治疗，坚积者削之，客邪者除之，劳倦者温之，结聚者散之，留滞者攻之，干燥者润之，拘急者缓之，涣散者收之，亏损者补之，安逸者行之，惊恐者平之，在上者使之降，在下者使之升，按摩沐浴，迫劫之法，开泄发汗，根据事情适宜为原则。
黄帝说：什么叫逆治和从治？岐伯说：逆治是正治，从治是反治，从少还是从多，观察具体情况而定。黄帝说：什么叫反治？岐伯说：热因寒用，寒因热用，塞因塞用，通因通用，必须制服其主要病邪，先探究其病因，开始用药性质相同，最终效果不同，这样可以破除积滞，溃散坚块，使气和顺，使病必愈。（出自《素问·至真要大论》）
这一章论述内气不调导致疾病的治法。因为内气不调而得病，所以对于寒热之邪，只可在其气微小时逆治。如果气盛而逆治，则正气与邪气格拒，不能战胜邪气，性命难保，所以应当顺从其外部的寒热之邪，而在内部伏藏主要治疗的药剂，然后正气与邪气相入，邪气就被擒获了。李东垣所说的姜附寒饮（热药冷服），承气汤热服，以及张仲景在白通汤中加入尿胆治疗少阴病，朱丹溪在苓柏汤中都炒熟治疗色目妇人恶寒等情况，都是这个道理。
黄帝说：气调而得病的情况是怎样的？岐伯说：逆治或从治，逆而从之，从而逆之，疏理气机使其调和，就是这种方法。（出自《素问·至真要大论》）
这一章，论述内气原本调和，因外邪导致疾病的治法。因为内气调和而得病，所以不分寒热的轻重，或者逆治，或者从治都可以，更不需要担心正气与邪气格拒，正气固守则邪气自然退却。
黄帝说：疾病涉及内外是怎么回事？岐伯说：病从内生而表现于外的，调理其内部；病从外生而传入内部的，治疗其外部；病从内生而外部症状严重的，先调理内部而后治疗外部；病从外生而内部症状严重的，先治疗外部而后调理内部；内外互不影响，则治疗主病。黄帝说：好。火热复气发作，恶寒发热，像疟疾的样子，有时一天发作，有时隔几天发作，这是什么原因？岐伯说：胜复之气相遇的时间，有多有少。阴气多而阳气少，则发作间隔远；阳气多而阴气少，则发作间隔近。这是胜复之气相互搏击，盛衰的节律，疟疾也遵循同样的规律。黄帝说：经论说治寒用热药，治热用寒药，但方士不能废除常规而改变其道。如果有患热病用寒药治反而更热，患寒病用热药治反而更寒，这两种情况都存在，又有新病兴起，怎么治疗？岐伯说：凡是寒药治热病而反热的，取治其阴；热药治寒病而反寒的，取治其阳，这就叫求其所属的本脏。黄帝说：好。服用寒药反而发热，服用热药反而发寒，这是什么原因？岐伯说：因为只治疗了其王气（当令之气），所以反而加重。
黄帝说：不治疗王气而痊愈是怎么回事？岐伯说：问得真详细啊！是因为不治疗五味所属的本脏。五味进入胃中，各自归入它所喜好的脏腑，所以酸味先入肝，苦味先入心，甘味先入脾，辛味先入肺，咸味先入肾，长久服用会增加该脏之气，这是物化的常态。气增加久了，就会成为夭折的原因。黄帝说：好。方剂的君臣制度是什么意思？岐伯说：主治疾病的称为君，辅助君的称为臣，配合臣的称为使，不是指上中下三品药材的分类。黄帝说：三品是什么意思？岐伯说：是为了说明善恶不同的类别。黄帝说：好。疾病涉及内外是怎么回事？岐伯说：调气的方剂，必须辨别阴阳，确定其中外位置，各守其乡，内的病在内治，外的病在外治，病轻的调治，其次平复，病盛的攻夺，汗法下法，寒热温凉，根据其所属脏腑衰减，随其便利，谨慎遵循道法，万举万全，气血平和，长寿天命。黄帝说：好。（注：“不治五味属也”，另一版本“五味”二字作“王气”二字。出自《素问·至真要大论》）
岐伯说：寒热燥湿，其气化作用不同。所以少阳相火在泉，寒毒不生，其味辛，治疗用苦酸，谷物用苍色和丹色。阳明燥金在泉，湿毒不生，其味酸，其气温，治疗用辛苦甘，谷物用丹色和素色。太阳寒水在泉，热毒不生，其味苦，治疗用淡咸，谷物用……（原文缺）。厥阴风木在泉，清毒不生，其味甘，治疗用酸苦，谷物用苍赤色，其气专一，其味纯正。少阴君火在泉，寒毒不生，其味辛，治疗用辛苦甘，谷物用白色和丹色。太阴湿土在泉，燥毒不生，其味咸，其气热，治疗用甘咸，谷物用……（原文缺）。气化淳厚则咸味守之，气专一则辛味化之且共同治理。所以说：补益上下者顺从其性，治疗上下者逆其性，根据所在部位的寒热盛衰来调节。所以说：上病取下，下病取上，内病取外，外病取内，以求其过错。能耐受药力的人用浓药，不能耐受药力的人用薄药，说的就是这个道理。
气机反逆的，病在上，取之下；病在下，取之上；病在中，旁取之。治热用寒药，温着服用；治寒用热药，凉着服用；治温用清药，冷着服用；治清用温药，热着服用。所以消导、削积、催吐、泻下、补益、泻实，久病新病治疗方法相同。
黄帝说：病在中部，不实不坚，且聚且散，怎么办？岐伯说：没有积滞的，求之于脏腑，虚则补之，药物祛除病邪，食物随之调养，行水渍浴，调和其中外。可以使病痊愈。
黄帝说：有毒无毒的药物，服用有定规吗？岐伯说：病有久新，方有大小，有毒无毒，本来就有常规制度。大毒治病，去掉十分之六；常毒治病，去掉十分之七；小毒治病，去掉十分之八；无毒治病，去掉十分之九，用谷肉果菜，食养来尽除余邪，不要过度，以免损伤正气。如果不愈，再按此法进行。
必须先考虑当年的岁气，不要破坏天和之气，不要使实证更盛，不要使虚证更虚，从而给人带来夭折的灾殃，不要招致邪气，不要失掉正气，断绝人的寿命。黄帝说：对于久病的人，有气机不顺而不能康复，病去而身体消瘦，怎么办？岐伯说：圣人问得真高明啊！气化不可代替，时令不可违背。经络通畅，血气顺行，恢复其不足，与众人相同，养育调和它，安静等待时机，谨慎守住其气，不让倾移，形体才能彰显，生气得以增长，这叫圣王。所以《大要》说：不要代替气化，不要违背时令，必须养育调和，等待其来复，说的就是这个道理。（出自《素问·五常政大论》）
黄帝说：气有多少，病有盛衰，治有缓急，方有大小，我想听听它们的概要是什么？岐伯说：气有高下之分；病有远近之别，证有中外之异，治有轻重之差，只要使药力到达病所即可。大要说：君药一味，臣药二味，是奇方制；君药二味，臣药四味，是偶方制；君药二味，臣药三位，是奇方制；君药二味，臣药六位，是偶方制。所以说：病近的用奇方，病远的用偶方，发汗不用奇方，泻下不用偶方，补上治上制方宜缓，补下治下制方宜急，急则气味浓厚，缓则气味淡薄，使药力到达病所，说的就是这个道理。病所遥远而中途被中焦气味阻隔的，用食物送服以引导药力，不要超越制度。所以平气之道，病近而有奇偶，制小其服。病远而有奇偶，制大其服。大方则药味少，小方则药味多，多则九味，少则二味，奇方不去病则用偶方，这叫重方。偶方不去病，则反佐以取之，所谓寒热温凉，反从其病性。黄帝说：好。病生于本，我知道了。病生于标，怎么治疗？岐伯说：病反其本，中标之病，治反其本，中标之方。（出自《素问·至真要大论》）
黄帝问：妇女怀孕，可以用毒药吗？岐伯说：有故无殒，亦无殒也（因为有病邪存在，所以不会伤害母体，也不会伤害胎儿）。黄帝说：我想听听这是什么意思？岐伯说：有大积大聚，可以犯之（使用攻伐药），但病势衰减半以上就要停止，超过这个限度会导致死亡。（出自《素问·六元正纪大论》）
Describes the location where disease changes occur. The function of the Six Qi acts by returning to its unconquered (i.e., the element that controls it) direction and transforming there. This means each Qi performs its transformation in the direction and month that is unconquered by it. By "direction and month," for example, in a year when Jueyin Wind Wood governs the Heaven position, Yangming Dryness Metal occupies the Left Interstitial position at the Earth level; its direction is Northeast, corresponding to the First Qi; Taiyang Cold Water occupies the Right Interstitial position; its direction is Southeast, corresponding to the Second Qi; Jueyin Wind Wood occupies the Heaven position; its direction is Due South, corresponding to the Third Qi; Shaoyin Ministerial Fire occupies the Left Interstitial position at Heaven; its direction is Southwest, corresponding to the Fourth Qi; Taiyin Damp Earth occupies the Right Interstitial position at Earth; its direction is Northwest, corresponding to the Fifth Qi; Shaoyang Ministerial Fire occupies the Earth position; its direction is Due North, corresponding to the Final Qi. Therefore, the Taiyin Rain Transformation applied in this year is exerted on the Taiyang Cold position in the Southeast during the Second Qi; the Taiyang Cold Transformation is exerted on the Shaoyin Heat position in the Southwest during the Fourth Qi; the Shaoyin Heat Transformation is exerted on the Yangming Dryness position in the Northeast during the First Qi; the Yangming Dryness Transformation is exerted on the Jueyin Wind position in the Due South during the Third Qi; the Jueyin Wind Transformation is exerted on the Taiyin Damp position in the Northwest during the Fifth Qi. Each names its respective transformation based on its location, verifying the transformation exerted, applying the same method to deduce for other years.
If each Qi resides in its own position, it performs transformation in the direction and month of its original position. For instance, in a year governed by Jueyin Wind Wood, Taiyin Damp Earth naturally exerts Rain Transformation in its original position of Northwest during the Fifth Qi; Taiyang Cold Water naturally exerts Cold Transformation in its original position of Southeast during the Second Qi; Shaoyin Ministerial Fire naturally exerts Heat Transformation in its original position of Southwest during the Fourth Qi; Shaoyang Ministerial Fire naturally exerts Fire Transformation in its original position of Due North during the Final Qi; Yangming Dryness Metal naturally exerts Dryness Transformation in its original position of Northeast during the First Qi; Jueyin Wind Wood naturally exerts Wind Transformation in its original position of Due South during the Third Qi. The same deduction method applies to other years.
When the momentum is grand, arrival is slow and constant. If illness arises from an excess of the Six Qi, the momentum appears instead slow and slight; the treatment method should oppose it. When the momentum is slight, arrival is violent and fleeting. If illness arises from a deficiency of the Six Qi, the momentum appears instead violent and severe; the treatment method should follow it. Observing violent Qi, people immediately use harsh drugs to attack, resulting in unhealed heat diseases and newly started cold diseases. They do not realize that grand Qi manifests as slight, while slight Qi manifests as intense.
The Yellow Emperor said: I wish to hear what is meant by the division of Yin and Yang into three categories. Qibo replied: It is because the quantity of Qi differs, leading to different applications. The Yellow Emperor asked: Why is it called Yangming? Qibo replied: Two Yangs combined and brightened is called Yangming. The Yellow Emperor asked: Why is it called Jueyin? Qibo replied: Two Yins intersecting and ending is called Jueyin. The Yellow Emperor asked: What are You (Darkness) and Ming (Brightness)? Qibo replied: Two Yins intersecting and ending is called You; Two Yangs combined and brightened is called Ming. The pairing of You and Ming represents the difference between Cold and Summer Heat. The Yellow Emperor asked: What are Fen (Division) and Zhi (Arrival)? Qibo replied: Arrival of Qi is called Zhi; Division of Qi is called Fen. At Zhi, Qi is the same; at Fen, Qi is different. This is the normal order of Heaven and Earth.
The Yellow Emperor said: All diseases originate from Wind, Cold, Summer Heat, Dampness, Dryness, and Fire, due to their transformations and variations. The Classics state: Excess is drained, deficiency is tonified. I have bestowed these formulas upon you, but practitioners using them cannot yet achieve perfect results. I desire that essential principles be implemented effectively, with efficacy as immediate as a drumstick striking a drum, thorough as removing a thorn or cleaning dirt. May I hear about such skillful and divine techniques? Qibo replied: Carefully examine the pathogenesis without violating the suitability of Qi; this is what is meant. The Yellow Emperor said: I wish to hear about pathogenesis. Qibo replied: All wind diseases causing tremors and dizziness belong to the Liver. All cold diseases causing contraction and pulling belong to the Kidney. All Qi diseases causing stagnation and depression belong to the Lung. All damp diseases causing edema and fullness belong to the Spleen. All heat diseases causing confusion and obscuration belong to Fire. All pain, itching, and sores belong to the Heart. All jue conditions, constipation, or diarrhea belong to the Lower Jiao. All flaccidity, wheezing, and vomiting belong to the Upper Jiao. All locking, shivering, and loss of spiritual control belong to Fire. All spasms and neck stiffness belong to Dampness. All rebellious Qi rushing upward belong to Fire. All abdominal distension and enlargement belong to Heat. All restlessness, mania, and deviation belong to Fire. All sudden rigidity belongs to Wind. All diseases with sounds, sounding like drums when tapped, belong to Heat. All diseases with swelling, pain, soreness, fright, and alarm belong to Fire. All twisting and convulsions with turbid fluids belong to Heat. All diseases involving clear and cold fluids belong to Cold. All vomiting of sour fluid, sudden diarrhea with tenesmus belong to Heat. Thus, the *Da Yao* says: Strictly observe the pathogenesis, assign each to its category. Seek the cause where symptoms exist; seek the hidden cause where symptoms are absent. Blame the excess on evil; blame the deficiency on weakness. First analyze the five-element victories, dredge blood and Qi, make them smooth and reaching peace. This is what is meant. (From *Suwen: Zhizhen Yao Da Lun*)
This chapter discusses the pathology and treatment methods of Five Movements and Six Qi. The Nineteen Pathogeneses truly capture the essence of disease. The sixteen characters "Seek the cause where symptoms exist; seek the hidden cause where symptoms are absent; blame the excess on evil; blame the deficiency on weakness" answer the chapter's opening principle of "Excess is drained, deficiency is tonified," summarizing the meaning of the nineteen pathogeneses, and are the core among cores. Hejian's *Yuan Bing Shi* uses only the Nineteen Pathogeneses for discussion, omitting these sixteen characters. It is like having a boat without a rower, or an army without a commander. Today, I assume the罪 of stealing classics to supplement this.
All wind diseases belong to the Liver. Excessive Wind Wood causes Liver excess, transforming into wind diseases, such as tremors and dizziness in the Ji of Generation when Wood is excessive. Commonly known as Yang Acute Convulsion, treated with cooling agents. Excessive Dryness Metal attacks the Liver, also transforming into wind diseases, such as tremors under Yangming governing Heaven with Dryness Metal descending. Commonly known as Yin Slow Convulsion, treated with warming agents.
All fire-heat diseases belong to the Heart. Extreme Fire-Heat causes Heart excess, transforming into fire-heat diseases, such as delirium and mania when Year Fire is excessive. Commonly known as Yang Restless Delirium, treated with purgative agents. Excessive Cold Water attacks the Heart, also transforming into fire-heat diseases, such as restlessness, palpitations, vexation, and delirium when Year Water is excessive. Commonly known as Yin Restlessness Zhengsheng, treated with tonifying agents.
All damp diseases belong to the Spleen. Extreme Damp Earth causes Spleen excess, transforming into damp diseases, such as loose stools when Dampness prevails. Zhang Zhongjing used Wu Ling San to remove dampness. Excessive Wind Wood attacks the Spleen, also transforming into damp diseases, such as undigested food diarrhea when Year Wood is excessive. Qian Yi used Xuan Feng San to remove wind.
All Qi stagnation diseases belong to the Lung. Extreme Dryness Metal causes Lung excess, transforming into Qi stagnation, such as cough and asthma when Year Metal is excessive. Li Dongyuan called this Cold Asthma, treated with hot agents. Excessive Fire-Heat attacks the Lung, also transforming into Qi stagnation, such as cough and asthma when Year Fire is excessive. Li Dongyuan called this Heat Asthma, treated with cold agents.
All cold diseases belong to the Kidney. Extreme Cold Water causes Kidney excess, transforming into cold diseases, such as difficulty bending and stretching when Taiyang arrives. Zhang Zhongjing used Wu Tou Tang. Excessive Damp Earth attacks the Kidney, also transforming into cold diseases, such as tendon and vessel dysfunction caused by dampness changing objects. Li Dongyuan used Fu Jian Decoction and Jian Bu Wan.
What transforms from excessive Qi appearing as excess is True Qi; what transforms from being attacked appearing as deficiency is False Qi. Therefore, where transformation exists, fearing the Qi is false, one must seek the cause even in "existence." Where no transformation exists, fearing hidden evil, such as Cold transforming into Fire, Dryness transforming into Wind, Cold hiding causing restlessness, or Heat hiding causing jue, one must seek the cause even in "non-existence." Where transformation seems excessive, fearing the excess is inaccurate, one must investigate "excess." Where transformation seems deficient, fearing the deficiency is not genuine, one must investigate "deficiency." All nineteen pathogeneses use these sixteen characters as the method of inquiry, avoiding incorrect tonification and draining. Now, Hejian damaged these sixteen characters, simply equating existence with excess and non-existence with deficiency, failing to seek false and deficient aspects, making it incomplete. Thus, citing classics to prove gains and losses.
The Yellow Emperor said: How are the Yin-Yang uses of the Five Flavors? Qibo replied: Pungent and Sweet flavors disperse and emit, belonging to Yang; Sour and Bitter flavors induce vomiting and drainage, belonging to Yin; Salty flavor induces vomiting and drainage, belonging to Yin; Bland flavor渗利 and drains, belonging to Yang. These six flavors either collect or disperse, either relax or tense, either dry or moisten, either soften or harden. Act according to what benefits, harmonize Qi to achieve balance.
The Yellow Emperor said: If not cured by harmonizing Qi, how to treat? Which comes first, toxic or non-toxic drugs? May I hear the way? Qibo replied: Toxic or non-toxic, the treatment target is primary; adjust size and dosage accordingly. The Yellow Emperor said: Please speak of the system. Qibo replied: One Sovereign, two Ministers, is small system; One Sovereign, three Ministers, five Assistants, is medium system; One Sovereign, three Ministers, nine Assistants, is large system. Cold is treated with Heat; Heat is treated with Cold. Minor cases are treated oppositely (Ni); major cases are treated similarly (Cong). Hardness is reduced; guests (pathogens) are removed; fatigue is warmed; knots are scattered; retention is attacked; dryness is moistened; urgency is eased; scattering is gathered; loss is benefited; leisure is moved; fright is calmed. Upper is lowered; lower is raised; massage and bathing; pressing and劫 (coercion); opening and emitting. Adapt to the matter as the goal.
The Yellow Emperor said: What are Ni (Opposite) and Cong (Following)? Qibo replied: Ni is Zheng Zhi (Orthodox Treatment); Cong is Fan Zhi (Reverse Treatment). Follow less or follow more, observing the situation. The Yellow Emperor said: What is Fan Zhi? Qibo replied: Heat treated with Cold usage; Cold treated with Heat usage; Obstruction treated with Obstruction usage; Diarrhea treated with Purging usage. Must subdue the master, first address the cause. Initially same, finally different. Can break accumulations, dissolve hardness, harmonize Qi, ensure cure. (From *Suwen: Zhizhen Yao Da Lun*)
This chapter discusses treatment for diseases caused by internal Qi disharmony. Since internal Qi is disharmonious, external cold/heat pathogens can only be treated oppositely when Qi is minor. If Qi is excessive and treated oppositely, Zheng and Xie repel each other, unable to defeat evil, life endangered. Thus, one should follow external cold/heat, while hiding main treatment agents internally. Then Zheng and Xie enter, and evil is captured. Examples include Li Dongyuan's Ginger/Aconite taken cold, Chengqi Decoction taken hot, Zhang Zhongjing adding urine/bile to Bai Tong Decoction for Shaoyin, and Zhu Danxi frying Lingbai Decoction thoroughly for women with cold aversion.
The Yellow Emperor said: What about diseases where Qi is harmonious? Qibo replied: Opposite or following treatment, opposite then following, following then opposite, dredging Qi to make it harmonious is the way. (From *Suwen: Zhizhen Yao Da Lun*)
This chapter discusses treatment for diseases where internal Qi was originally harmonious but affected by external pathogens. Since internal Qi is harmonious, whether treating oppositely or following is acceptable regardless of cold/heat severity. No need to fear Zheng-Xie repulsion; if Zheng is solid, Xie retreats naturally.
The Yellow Emperor said: How about diseases involving interior and exterior? Qibo replied: From interior to exterior, regulate interior; from exterior to interior, treat exterior. From interior to exterior but severe externally, first regulate interior then treat exterior. From exterior to interior but severe internally, first treat exterior then regulate interior. If interior and exterior are unrelated, treat the main disease. The Yellow Emperor said: Good. Fire-heat recurrence with chills and fever, resembling malaria, occurring daily or every few days, why? Qibo replied: Time of encounter between Sheng (Victory) and Fu (Rebound) Qi varies. More Yin and less Yang means distant intervals; more Yang and less Yin means close intervals. This is Sheng-Fu combat, rhythm of excess and deficiency; Malaria follows the same law. The Yellow Emperor said: Classics say treat cold with heat, treat heat with cold, but practitioners cannot abandon rules. If heat treated with cold becomes hotter, cold treated with heat becomes colder, both present, new disease arises, how to treat? Qibo replied: For those treated with cold becoming hotter, treat Yin; for those treated with heat becoming colder, treat Yang. This is seeking the affiliation. The Yellow Emperor said: Good. Taking cold drugs causes heat, taking heat drugs causes cold, why? Qibo replied: Treating Wang Qi (Dominant Qi) causes reversal.
The Yellow Emperor said: What if not treating Wang Qi cures it? Qibo replied: Excellent question! It is not treating the Five Flavors' affiliation. Five Flavors enter the stomach, each returning to its preference: Sour enters Liver first, Bitter enters Heart first, Sweet enters Spleen first, Pungent enters Lung first, Salty enters Kidney first. Long-term use increases Qi, which is the norm of transformation. Increasing Qi for too long causes premature death. The Yellow Emperor said: Good. What is the Sovereign-Minister system? Qibo replied: Main disease is Sovereign; assisting Sovereign is Minister; responding to Minister is Envoy. Not referring to Upper/Middle/Lower grades. The Yellow Emperor said: What are the three grades? Qibo replied: To clarify distinct categories of good and evil. The Yellow Emperor said: Good. How about diseases involving interior and exterior? Qibo replied: Formulas for regulating Qi must distinguish Yin-Yang, determine interior/exterior, keep to their places. Interior treated internally, exterior treated externally. Minor cases regulated, next level balanced, excessive cases seized, sweating or purging. Cold, Heat, Warm, Cool, attenuate by affiliation, follow benefit. Strictly follow the Dao, ten thousand attempts ten thousand complete, Qi and Blood peaceful, long life destiny. The Yellow Emperor said: Good. ("Not treating Five Flavors affiliation," another version reads "Wang Qi". From *Suwen: Zhizhen Yao Da Lun*)
Qibo replied: Cold, Heat, Dryness, Dampness have different transformations. Thus, when Shaoyang is at Earth, Cold poison does not grow; flavor is Pungent, treatment uses Bitter/Sour, grains are Green/Red. When Yangming is at Earth, Damp poison does not grow; flavor is Sour, temperature is Warm, treatment uses Pungent/Bitter/Sweet, grains are Red/White. When Taiyang is at Earth, Heat poison does not grow; flavor is Bitter, treatment uses Bland/Salty, grains are... (Original text missing). When Jueyin is at Earth, Clear poison does not grow; flavor is Sweet, treatment uses Sour/Bitter, grains are Green/Red, Qi is specialized, flavor is correct. When Shaoyin is at Earth, Cold poison does not grow; flavor is Pungent, treatment uses Pungent/Bitter/Sweet, grains are White/Red. When Taiyin is at Earth, Dryness poison does not grow; flavor is Salty, Qi is Hot, treatment uses Sweet/Salty, grains are... (Original text missing). When transformation is pure, Salty guards; when Qi is specialized, Pungent transforms and treats together. Thus: Tonify upper/lower by following; treat upper/lower by opposing. Regulate based on location's cold/heat excess/deficiency. Thus: Upper take from lower, lower take from upper, inner take from outer, outer take from inner, to find fault. Those who can tolerate poison use strong medicine; those who cannot use weak medicine. This is it.
Qi reversal: Disease above, take below; disease below, take above; disease in middle, take sides. Treat heat with cold, administer warm; treat cold with heat, administer cool; treat warm with clear, administer cold; treat clear with warm, administer hot. Thus, dissipate, reduce, vomit, purge, tonify, drain. Old and new diseases follow the same method.
The Yellow Emperor said: Disease in middle, not solid, not firm, gathering and scattering, how? Qibo replied: No accumulation, seek Zang organs. Deficiency tonify. Drugs dispel, food follows, water walking, harmonize interior/exterior. Can be cured.
The Yellow Emperor said: Toxic/non-toxic drugs, is there a rule for administration? Qibo replied: Diseases have old/new, formulas have large/small, toxic/non-toxic, there are fixed systems. Great toxicity treats disease, remove 60%; common toxicity removes 70%; slight toxicity removes 80%; non-toxicity removes 90%. Grains, meats, fruits, vegetables, food nourishment completes it. Do not exceed, damaging Zheng Qi. If not complete, repeat method.
First consider annual Qi, do not violate Tian He (Heavenly Harmony). Do not make excess more excess, do not make deficiency more deficiency, leaving people to premature death. Do not attract evil, do not lose Zheng, cutting off long life. The Yellow Emperor said: For chronic patients, Qi does not conform, disease gone but emaciated, how? Qibo replied: Wise question of the Sage! Transformation cannot be replaced, time cannot be violated. Meridians pass, Blood-Qi flows, restore insufficiency, equal with others. Nourish and harmonize, wait quietly for time, guard Qi carefully, prevent collapse, form becomes manifest, Sheng Qi grows. Called Sage King. Thus *Da Yao* says: Do not replace transformation, do not violate time, must nourish and harmonize, wait for recovery. This is it. (From *Suwen: Wuchang Zheng Da Lun*)
The Yellow Emperor said: Qi has quantity, disease has excess/deficiency, treatment has urgency, formula has size. May I hear the summary? Qibo replied: Qi has high/low; disease has far/near; syndrome has interior/exterior; treatment has heavy/light. Just reach the destination. *Da Yao* says: One Sovereign, two Ministers, is Odd system; Two Sovereigns, four Ministers, is Even system; Two Sovereigns, three Ministers, is Odd system; Two Sovereigns, six Ministers, is Even system. Thus: Near use Odd; Far use Even. Sweating does not use Odd; Purging does not use Even. Tonify upper/treat upper, system slow; tonify lower/treat lower, system fast. Fast means strong flavor; slow means weak flavor. Reach destination, this is it. Disease far, mid-body blocks flavor, use food to guide, do not exceed system. Thus, balancing Qi: Near with Odd/Even, make small dose. Far with Odd/Even, make large dose. Large means few doses; small means many doses. Many up to nine; few down to two. If Odd fails, use Even, called Chong Fang (Repeated Formula). If Even fails, use Fan Zuo (Reverse Assistant), meaning Cold/Heat/Warm/Cool, reverse-follow disease. The Yellow Emperor said: Good. Disease born from Ben (Root), I know. Born from Biao (Branch), how to treat? Qibo replied: Disease reverses Ben, mark Biao disease; treat reverses Ben, mark Biao formula. (From *Suwen: Zhizhen Yao Da Lun*)
The Yellow Emperor asked: Pregnant woman, how to use poison? Qibo replied: You Gu Wu Yun, Yi Wu Yun Ye (Having cause, no injury; also no injury). The Yellow Emperor said: Explain. Qibo replied: Large accumulation/poly, can be invaded. Deplete more than half then stop. Exceeding leads to death. (From *Suwen: Liuyuan Zhengji Da Lun*)