《至真要大论》曰∶阴之所在寸口何如？（阴之所在，脉沉不应。）视岁南北，可知之矣。北
政之岁，少阴在泉，则寸口不应；（木火金水四运，面北受气。凡气之在泉者，脉息不见，惟其左
右之气脉可见之。在泉之气，善则不见，恶者可见，病以气及客主淫胜名之。在天之气，其亦然矣。）厥阴在
泉，则右不应；（少阴在右故。）太阴在泉，则左不应。（太阴在左故。）南政之岁，少阴司天，则
寸口不应。（土运之岁，面南行令，故少阴司天，则二手寸口不应也。）厥阴司天，则右不应；太阴司
天，则左不应。（亦左右义也。）诸不应者，反其
诊则见矣。（不应皆谓脉沉，脉沉下者抑手而沉，复其手则沉为浮，细为大也。）帝曰∶尺候何如？伯曰∶
北政之岁，三阴在下，则寸不应；三阴在上，则尺不应。（司天曰上，在泉曰下。）南政之岁，
三阴在天，则寸不应；三阴在泉，则尺不应。左右同。（尺不应寸，左右悉同。此言南北二政
之司天在泉其尺寸之脉，各有所不应也。）天地之气，内淫而病如何？岁厥阴在泉，风淫所胜，则
地气不明，平野昧，草乃早秀。民病洒洒振寒，善呻数欠，心痛支满，两胁里急，饮
食不下，鬲咽不通，食则呕，腹胀善噫，得后与气，则快然如衰，身体皆重。（谓寅申岁也。
洒洒振寒，善呻数欠，为胃病。食则呕，腹胀善噫，得后与气，则快然如衰，身体皆重，为脾病。饮食不下，鬲
咽不通，邪在胃脘也。盖厥阴在泉之岁，木王而克脾胃，故病如是。）岁少阴在泉，热淫所胜，则焰浮川
泽，阴处反明。民病腹中常鸣，气上冲胸，喘不能久立，寒热皮肤痛，目瞑齿痛 肿，
恶寒发热如疟，少腹中痛腹大，蛰虫不藏。（谓卯酉岁也。齿痛 肿，为大肠病。腹中雷鸣，气上冲
胸，喘不能久立，邪在大肠也。盖少阴在泉之岁，火克金，故大肠病也。）岁太阴在泉，草乃早荣，湿
淫所胜，则埃昏岩谷，黄反见黑，至阴之交。民病饮积，心痛，耳聋浑浑 ，咽
肿喉痹，阴病血见，少腹痛肿，不得小便，病冲头痛，目似脱，项似拔，腰拟折，髀
不可以回， 如结， 如别。（谓辰戌岁也。太阴为土，色见应黄于天中，而反见于北方黑处也。水土
同见，故曰至阴之交，合其颜色也。冲头痛，谓脑后眉间痛也。 ，谓膝后曲脚之中也。 ， 后软肉处也。耳
聋浑浑 ，咽肿喉痹，为三焦病。病冲头痛，目似脱，项似拔，腰似折，髀不可以回， 如结， 如别，为膀
胱足太阳病。又少腹肿痛，不得小便，邪在三焦。盖太阴在泉之岁，土王克太阳，故病如是也。）岁少阳在
泉，火淫所胜，则焰明郊野，寒热更至。民病注泄赤白，少腹痛溺赤，甚则血便。少
阴同候。（谓巳亥岁也。处寒之时，热更其气，热气既往，寒气后来，故云更至也。余候与少阴在泉同。）岁阳
明在泉，燥淫所胜，则 雾清瞑，民病喜
呕，呕有苦，善太息，心胁痛不能反侧，甚则嗌干面尘，身无膏泽，足外反热。（谓子午
岁也。 雾，谓雾暗不分，似雾也。清，薄寒也。言雾起瞀暗，不分物形而薄寒也。心胁痛，谓心之傍，胁中
痛也。面尘，谓面上如有触冒尘土之色也。呕有苦，善太息，心胁痛不能反侧，甚则面尘，身无膏泽，足外反
热，为胆病。嗌干面尘，为肝病。阳明在泉之岁，金王克木，故病如是。）岁太阳在泉，寒淫所胜，则凝肃惨
栗，民病少腹控睾，引腰脊，上冲心痛，血见，咽痛颔肿。（谓丑未岁也。凝肃，谓寒气霭空，凝而不动，万
物静肃其仪形也。惨栗，寒甚也。控，引也。睾，阴丸也。颔，颊车前牙之下也。咽痛颔肿，为小肠病。又少
腹控睾，引腰，上冲心肺，邪在小肠也。盖太阳在泉之岁，水克火，故病如是。）诸气在泉，风淫于内，治以
辛凉，佐以苦甘，以甘缓之，以辛散之。热淫于内，治以咸寒，佐以甘苦，以酸收之，以苦发之。湿淫于内，
治以苦热，佐以酸淡，以苦燥之，以淡泄之。火淫于内，治以咸冷，佐以苦辛，以酸收之，以苦发之。燥淫于
内，治以苦温，佐以甘辛，以苦下之。寒淫于内，治以甘热，佐以苦辛，以咸泻之，以辛润之，以苦坚之。
（此言六气之在泉，淫胜在病者，各有治之之法也。）天气之变何如？厥阴司天，风淫所胜，则太虚埃昏，
云物以扰，寒生春气，流水不冰。民病胃脘当心而痛，上支两胁，鬲咽不通，饮食不下，舌本强，食则呕，
冷泄腹胀，溏泄瘕水闭，蛰虫不出，病本于脾。（谓巳亥岁也。是岁民病集于中也。风自天行，故太虚埃起。
风动飘荡，故云物扰也。埃，青尘也。不分远物，是为埃昏。土之为病，其善泄利。若病水，则小便闭而不下。
若大泄利，则经水亦多闭绝也。舌本强，食则呕，腹胀溏泄瘕水闭，为脾病。又胃病者，腹脾胀，胃脘当心痛，
上支两胁，鬲咽不通，食饮不下。盖厥阴司天之岁，木胜土，故病如是。）冲阳绝，死不治。（冲阳在足跗上
动脉应手，胃之气也。冲阳脉微则食饮减少，绝则药食不入，亦下咽还出也。攻之不入，养之不生，则邪气日
强，真气内绝，故死。）少阴司天，热淫所胜，怫热至，火行其政。民病胸中烦热，嗌干，右 满，皮肤痛，
寒热咳喘，大雨且至，唾血血泄，鼽衄嚏呕，溺色变，甚则疮疡 肿，肩背臂 及缺盆中痛，心痛肺 ，腹
大满，膨膨而喘咳，病本于肺。（谓子午岁也。
怫热至，是火行其政乃尔。是岁民病集于右，盖以小肠通心故也。病自肺生，故曰病本肺也。盖少阴司天之岁，
火克金，故病如是也。）尺泽绝，死不治。（尺泽在肘内廉大纹中，动脉应手，肺之气也。火灼于金，承天之
命，金气内绝，故必危亡。）太阴司天，湿淫所胜，则沉阴且布，雨变枯槁， 肿骨痛阴痹，阴痹者按之不得，
腰脊头项痛，时眩，大便难，阴气不用，饥不欲食，咳唾则有血，心如悬，病本于肾。（谓丑未岁也。沉，久
也。肾气受邪，水不能润，下焦枯涸，故大便难也。饥不欲食，咳唾则有血，心悬如饥状，为肾病。又邪在
肾，则骨痛阴痹，阴痹者按之而不得，腹胀腰痛，大便难，肩背颈项强痛，时眩。盖太阴司天之岁，土克水，
故病如是。）太溪绝，死不治。（太溪在足内踝后跟骨上，动脉应手，肾之气也。土邪胜水而肾气内绝。）少
阳司天，火淫所胜，则温气流行，金政不平。民病头痛，发热恶寒而疟，热上皮肤痛，色变黄赤，传而为水，
身面 肿，腹满仰息，泄注赤白，疮疡咳唾血，烦心胸中热，甚则鼽衄，病本于肺。（谓寅申岁也。火来用
事，则金气受邪，故曰金政不平也。火炎于上，金肺受邪，客热内灼，水无能救，盖少阳司天之气，火克金，
故病如是。）天府绝，死不治。（天府在肘后内侧上，腋下同身寸之二寸，动脉应手，肺之气也。火胜而金肺
绝，故死。）阳明司天，燥淫所胜，则木乃晚荣，草乃晚生，筋骨内变，民病左 胁痛，寒清于中，感而疟，
大凉革候，咳，腹中鸣，注泻 溏，名木敛，生菀于下，草焦上首，心胁暴痛，不可反侧，嗌干面尘腰痛，丈
夫疝，妇人少腹痛，目 ，疡疮痤痈，蛰虫来见，病本于肝。（谓卯酉岁也。金胜，故草木晚荣也。配于
人身，则筋骨内应而不用也。大凉之气，变易时候，则人寒清发于中，内感寒气，则为 疟也。大肠居右，肺
气通之，今肺气内淫，肝居下左，故左 胁痛，如刺割也。其岁民自注泄，则无淫胜之疾也。大凉，次寒也。
大凉且甚，阳气不行，故木容收敛，草容悉晚。生气已升，阳不布令，故行积生气而 于下也。在人之应，则
少腹之内，痛气居之。疮疡痤痈，腰痛不可以俯仰，丈夫 疝，妇人少腹痛，甚则咽面尘，胸满洞泄，为肝
病。又心胁痛不能反侧，目锐 痛，缺盆中肿痛，腋下肿马刀，振寒疟，为胆病。盖阳明司天之岁，金克木，
故病如是。）太冲绝，死不治。（太冲在足大指本节后二寸，脉动应手，肝之气也。金来伐木，肝气内绝，真
不胜邪，故死。）太阳司天，寒淫所胜，则寒气反至，水且
冰，血变于中，发为痈疡，民病厥心痛，呕血血泄鼽衄，善悲，时眩仆。运火炎烈，雨暴乃雹，胸腹满，手热
肘挛掖肿，心澹澹大动，胸胁胃脘不安，面赤目黄，善噫嗌干，甚则色 ，渴而欲饮，病本于心。（谓辰戌岁
也。太阳司天，寒气布化，故水且冰，而血凝皮肤之间，卫气结聚，故为痈也。若乘火运而火炎烈，与水交
战，故豪雨半珠形雹也。是岁民病集于心胁之中也。阳气内郁，温气下蒸，故心厥痛而呕血，血泄鼽衄，面赤
目黄，善噫，手热肘挛腋肿，嗌干。甚则寒气胜阳，水行凌火，火气内郁，故渴而欲饮也。病始心生，为阴凌
犯，故云病本于心也。盖太阳司天之岁，水克火，故病如是。）神门绝，死不治。（神门在手之掌后锐骨之
端，动脉应手，真心气也。水行胜火，而心气内绝，神气已亡，不死何待？）所谓动气，知其脏也。（所以
诊视而知其死者何？以皆是脏之经脉动气，知神脏之存亡耳。）司天之气；风淫所胜，平以辛凉，佐以苦甘，
以甘缓之，以酸泻之。热淫所胜，平以咸寒，佐以苦甘，以酸收之。湿淫所胜，平以苦热，佐以酸辛，以苦燥
之，以淡泄之。湿上甚而热，治以苦温，佐以甘辛，以汗为故而止。火淫所胜，平以酸冷，佐以苦甘，以酸收
之，以苦发之，以酸复之，热淫同。燥淫所胜，平以苦温，佐以酸辛，以苦下之。寒淫所胜，平以辛热，佐以
苦甘，以咸泻之。（此言六气之司天、淫胜为病者，各有治之之法也。）治诸胜复，寒者热之，热者寒之，温
者清之，清者温之，散者收之，抑者散之，燥者润之，急者缓之，坚者软之，脆者坚之，衰者补之，强者泻
之，各安其气，必清必静，则病气衰去，归其所宗，此治之大体也。（太阳气寒，少阴少阳气热，厥阴气温，
阳明气清，太阴气湿，有胜复则各倍其气调之也，故可使平也。宗，属也。调不失理，则余之气自归其所属，
少之气自安其所居。胜复衰已，则各补养而平定之，必清必静，无妄挠之，则六气循环，五神安泰。若运气之
寒热，治之平之，亦各归司天地气也。此总结言治胜复之大体者也。）
身半以上，其气三矣，天之分也，天气主之。身半以下，其气三矣，地之分也，地气主之。以名命气，以
气命处，而言其病。半，谓天枢也。（身之半，正谓脐中也。或以腰为身半，当伸臂指天，舒足指地，以绳量
之，中正当脐
也，故又曰半，所谓天枢也。司天者其气三，司地者其气三，故身半以上三气，身半以下三气也。以名言其气，
以气言其处，以气处寒热，而言其病之形证也。欲知病诊，常随气所在以言之，当阴之分，冷病归之，当阳之
分，热病归之，故胜复之作，先言病生寒热者，必根据此物理也。《六微旨大论》云∶天枢之上，天气主之。天枢
之下，地气主之。气交之分，人气从之。）
夫气之胜也，微者随之，甚者制之。气之复也，和者平之，暴者夺之。皆随胜气，
安其屈伏，无问其数，以平为期，此其道也。（随，谓随之，安之。制，谓止制。平，谓平谓。夺，
谓夺其胜气也。治此者，不以数之多少，但以气平和为准度耳。此言复之，所以反病而有治之之法也。）高者
抑之，下者举之，有余者折之，不足者补之，佐以所利，和以所宜，必安其主客，适
其寒温，同者逆之，异者从之。（高者抑之，制其胜也。下者举之，济其弱也。有余者折之，屈其锐也。
不足者补之，全其气也。虽制胜扶弱，而客主须安。一气失所，内淫外并，而危败之由作矣。同，谓寒热温清，
气相比和者。异，谓水火木金土，不比和者，气相得者，则逆所胜之气以治之。不相得者，则顺所不胜气以治之。
此其治主客之大体也。）
气有高下，病有远近，证有中外，治有轻重，适其至所为故也。（脏位有高下，腑气有
远近，病证有表里，药用有轻重，调其多少，和其紧慢，令药气至病所为故，勿太过不及也。）《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；君三臣六，偶之制
也。（奇，谓古之单方。偶，谓古之复方。单复一制皆有大小，故奇方云君一臣二君二臣三，偶方云君二臣四君
三臣六也。病有大小，气有远近，治有轻重所宜，故云制者也。）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。（汗药不以偶方，气不可以外发泄。下药不以奇制，药毒攻而致过。治上补上，方
迅急则止不住而迫下。治下补下，方缓慢则湿道路而力又微。制急方而气味薄，则力与缓等。制缓方而气味浓，
则势与急同。如是为缓不能缓，急不能急，浓而不浓，薄而不薄。大小非制，轻重无度。则虚实寒热，脏腑纷挠，
《至真要大论》说：阴脉在寸口（手腕桡动脉搏动处，候上焦及心肺之气）的表现是怎样的？（所谓“不应”，指脉搏沉伏摸不到。）观察岁运的南北政，就可以知道了。
北政之年，少阴君火在泉（主管下半年气候），则双侧寸口脉搏沉伏摸不到；（木、火、金、水四气运行，面向北方接受地气。凡是位于在泉的气，其脉象往往隐伏不见，只有左右其他气的脉象可见。在泉之气，若平和则脉不见，若偏胜为病则可见，疾病根据客气与主客之气的淫胜情况命名。在天之气，也是如此。）厥阴风木在泉，则右侧寸口脉搏沉伏摸不到；（因为少阴在右侧的缘故。）太阴湿土在泉，则左侧寸口脉搏沉伏摸不到。（因为太阴在左侧的缘故。）
南政之年，少阴君火司天（主管上半年气候），则双侧寸口脉搏沉伏摸不到；（土运之年，面向南方行令，所以少阴司天时，双手寸口脉搏都沉伏摸不到。）厥阴风木司天，则右侧寸口脉搏沉伏摸不到；太阴湿土司天，则左侧寸口脉搏沉伏摸不到。（也是依据左右对应的道理。）
所有出现“不应”（脉搏沉伏摸不到）的情况，如果反过来诊察（如将手指用力按压或改变体位），就能显现出来。（所谓的“不应”都是指脉象沉伏，脉沉时向下按手觉得沉，恢复手部位置后，沉脉变为浮脉，细微的脉象变得粗大。）
黄帝问：尺部（手腕桡动脉远端，候下焦及肾命之气）的脉象表现如何？岐伯回答：北政之年，三阴经位于下方（在泉），则寸口脉搏沉伏摸不到；三阴经位于上方（司天），则尺部脉搏沉伏摸不到。（司天称为上，在泉称为下。）南政之年，三阴经在司天，则寸口脉搏沉伏摸不到；三阴经在在泉，则尺部脉搏沉伏摸不到。左右侧的情况相同。（尺部不应、寸部不应，左右两侧完全一样。这是说南北二政的司天和在泉，其寸部和尺部的脉象，各有其不应（沉伏摸不到）的部位。）
天地之气，内部淫溢而致病会怎样？
岁逢厥阴风木在泉，风气淫胜，则地面雾气昏暗，原野迷茫，草木提前开花。百姓发病表现为战栗恶寒，喜欢呻吟，频繁打哈欠，心痛且肢体胀满，两胁内部拘急，饮食难以下咽，膈喉阻塞不通，进食则呕吐，腹部胀满且喜欢嗳气，大小便排气后，症状暂时减轻，身体沉重。（这指的是寅申年。战栗恶寒、喜欢呻吟、频繁打哈欠，是胃病。进食呕吐、腹胀喜嗳、得二便后缓解、身体沉重，是脾病。饮食不下、膈咽不通，邪气在胃脘。因为厥阴在泉之年，木气旺盛克制脾胃，所以出现上述病症。）
岁逢少阴君火在泉，热气淫胜，则山川沼泽如火焰般蒸腾，阴暗之处反而明亮。百姓发病表现为腹中肠鸣，气向上冲撞胸部，气喘不能久立，寒热交替且皮肤疼痛，眼睛闭合齿痛腮肿，恶寒发热像疟疾一样，小腹痛且腹部肿大，冬眠昆虫不藏匿。（这指的是卯酉年。齿痛腮肿，是大肠病。腹中雷鸣、气上冲胸、气喘不能久立，邪气在大肠。因为少阴在泉之年，火克金，所以大肠生病。）
岁逢太阴湿土在泉，草木提前繁荣，湿气淫胜，则山谷岩石间尘埃昏暗，黄色反现黑色，这是至阴之气交接的时候。百姓发病表现为饮食物积聚停滞，心痛，耳聋听力模糊，咽喉肿痛闭塞，下部出血，小腹痛肿，小便不通，头痛剧烈如冲撞，眼睛感觉要脱出，颈部感觉僵硬如被拔起，腰部感觉像折断，大腿无法转动，膝后腘窝部位感觉像被捆绑，小腿肚感觉像撕裂。（这指的是辰戌年。太阴属土，颜色应黄于天空中央，却反而出现在北方的黑色区域。水土之色同见，所以叫至阴之交，指颜色的混合。冲头痛，指脑后和眉间疼痛。腘，指膝盖后方弯曲处的脚中间。腨，指小腿后方的软肉处。耳聋听力模糊、咽喉肿痛闭塞，是三焦病。头痛剧烈、眼欲脱、项似拔、腰似折、髀不可回、腘如结、腨如别，是膀胱足太阳经病。另外小腹痛肿、小便不通，邪在三焦。因为太阴在泉之年，土气旺盛克制太阳，所以出现上述病症。）
岁逢少阳相火在泉，火气淫胜，则郊野火光通明，寒热交替到来。百姓发病表现为痢疾赤白相间，小腹痛、尿色红，严重时便血。脉象表现与少阴在泉相同。（这指的是巳亥年。处在寒冷之时，热气更替其气，热气过去后寒气随后到来，所以说交替到来。其余症状与少阴在泉相同。）
岁逢阳明燥金在泉，燥气淫胜，则雾气昏暗不清，百姓发病喜欢呕吐，呕吐物有苦味，喜欢长叹气，心肋疼痛不能翻身侧卧，严重时咽喉干燥、面色如蒙尘土、身体缺乏润泽、足外侧发热。（这指的是子午年。雾暗不分，似雾非雾。清，指薄寒。说雾气升起昏暗，看不清物体形状且有薄寒。心胁痛，指心脏旁边、胁中疼痛。面尘，指脸上像沾了尘土的颜色。呕吐有苦味、喜欢长叹气、心胁痛不能翻身、严重时面尘、身无膏泽、足外反热，是胆病。咽喉干燥、面尘，是肝病。阳明在泉之年，金气旺盛克制木，所以出现上述病症。）
岁逢太阳寒水在泉，寒气淫胜，则环境凝结肃杀、凄惨凛冽，百姓发病表现为小腹牵引睾丸疼痛，牵连腰脊，向上冲撞心痛，出血，咽喉痛、下巴肿胀。（这指的是丑未年。凝肃，指寒气弥漫空中，凝结不动，万物静肃其形态。惨栗，指寒气极重。控，牵引。睾，阴囊。颔，颊车穴前方牙齿下方。咽喉痛、下巴肿胀，是小肠病。另外小腹牵引睾丸、牵连腰部、向上冲撞心肺，邪在小肠。因为太阳在泉之年，水克火，所以出现上述病症。）
各种气在泉，风气淫溢在内，用辛凉药治疗，辅以苦甘药，用甘味药缓急，用辛味药发散。热气淫溢在内，用咸寒药治疗，辅以甘苦药，用酸味药收敛，用苦味药发散。湿气淫溢在内，用苦热药治疗，辅以酸淡药，用苦味药燥湿，用淡味药渗泄。火气淫溢在内，用咸冷药治疗，辅以苦辛药，用酸味药收敛，用苦味药发散。燥气淫溢在内，用苦温药治疗，辅以甘辛药，用苦味药通便。寒气淫溢在内，用甘热药治疗，辅以苦辛药，用咸味药泻下，用辛味药润燥，用苦味药坚阴。（这是说六气在泉，淫胜致病，各有治疗方法。）
天气的变化如何？
厥阴风木司天，风气淫胜，则天空尘埃昏暗，云物扰动，寒气生出春气，流水不结冰。百姓发病表现为胃脘当心处疼痛，向上支撑两胁，膈咽不通，饮食不下，舌根强硬，进食则呕吐，冷性泄泻、腹胀、溏泄、瘕积、水闭，冬眠昆虫不出，病本在于脾。（这指的是巳亥年。这一年百姓的病集中在中部。风从天而行，所以天空扬起灰尘。风动飘荡，所以云物扰动。埃，指青色的尘土。看不清远处物体，这叫埃昏。土受病，容易泄利。如果生病导致水液代谢障碍，则小便闭而不通。如果严重泄利，则经血也多闭绝。舌根强硬、进食呕吐、腹胀溏泄、瘕水闭，是脾病。另外胃病，表现为腹部胀满、胃脘当心痛、向上支撑两胁、膈咽不通、饮食不下。因为厥阴司天之岁，木胜克土，所以出现上述病症。）冲阳脉绝，死症不可治。（冲阳穴在足背动脉应手处，是胃气所在。冲阳脉微弱则饮食减少，绝则药食不入，甚至咽下即吐。攻邪不进，补养不生，则邪气日益强盛，真气内部断绝，所以死亡。）
少阴君火司天，热气淫胜，郁热至极，火气行使政令。百姓发病表现为胸中烦热，咽喉干燥，右胁胀满，皮肤疼痛，寒热咳嗽气喘，大雨将至，唾血、便血、鼻衄、打喷嚏、呕吐，尿液颜色改变，严重时疮疡肿胀，肩背手臂及缺盆中疼痛，心痛肺胀，腹部大满，膨隆且喘咳，病本在于肺。（这指的是子午年。郁热至极，是火行使政令如此。这一年百姓的病集中在右侧，因为小肠通于心。病从肺生，所以说病本在肺。因为少阴司天之岁，火克金，所以出现上述病症。）尺泽脉绝，死症不可治。（尺泽穴在肘内侧大纹中，动脉应手，是肺气所在。火灼伤金，承受天命，金气内部断绝，所以必然危亡。）
太阴湿土司天，湿气淫胜，则深沉的阴气散布，雨水变化导致枯槁，浮肿骨痛、阴痹（深部疼痛）。阴痹的特点是按压找不到痛点，腰脊头项疼痛，时常眩晕，大便困难，性功能减退，饥饿但不想进食，咳唾带血，心里像悬空一样难受，病本在于肾。（这指的是丑未年。沉，指长久。肾气受邪，水不能滋润，下焦枯涸，所以大便困难。饥饿不想进食、咳唾带血、心悬如饥状，是肾病。另外邪在肾，则骨痛阴痹，阴痹按压不得，腹胀腰痛，大便困难，肩背颈项强痛，时常眩晕。因为太阴司天之岁，土克水，所以出现上述病症。）太溪脉绝，死症不可治。（太溪穴在足内踝后跟骨上，动脉应手，是肾气所在。土邪胜水而肾气内部断绝。）
少阳相火司天，火气淫胜，则温热之气流行，金气政令不平。百姓发病表现为头痛，发热恶寒且像疟疾，热气上行皮肤疼痛，肤色变黄赤，传变为水肿，身面浮肿，腹部胀满仰面呼吸，痢疾赤白，疮疡咳唾血，心烦胸中热，严重时鼻衄，病本在于肺。（这指的是寅申年。火来用事，则金气受邪，所以说金政不平。火炎于上，金肺受邪，客热内灼，水不能救，因为少阳司天之气，火克金，所以出现上述病症。）天府脉绝，死症不可治。（天府穴在肘后内侧上，腋下同身寸二寸处，动脉应手，是肺气所在。火胜而金肺绝，所以死亡。）
阳明燥金司天，燥气淫胜，则树木晚荣，草木晚生，筋骨内部病变，百姓发病表现为左侧胁肋疼痛，心中寒冷清冷，感邪则发疟疾，大凉改变气候，咳嗽，腹中鸣响，痢疾溏泄，名木收敛，生机郁结于下，草枯萎于上，心胁突发疼痛，不能翻身侧卧，咽喉干燥、面色如尘、腰痛，男子疝气，女子小腹痛，眼睛视物不明，疮疡痤疮痈疽，冬眠昆虫出现，病本在于肝。（这指的是卯酉年。金胜，所以草木晚荣。配于人身，则筋骨内部相应而不能使用。大凉之气，改变时候，人心中发寒清，内感寒气，则为疟疾。大肠居右，肺气通之，今肺气内淫，肝居左下，所以左侧胁肋痛，如刺割。这一年百姓自注泄，则无淫胜之疾。大凉，次于寒。大凉且甚，阳气不行，所以木容收敛，草容悉晚。生气已升，阳不布令，所以行积生气而郁于下。在人体的对应，则少腹之内，痛气居之。疮疡痤痈、腰痛不可以俯仰、男子疝气、妇人小腹痛，严重时咽面尘、胸满洞泄，为肝病。另外心胁痛不能反侧、目锐眦痛、缺盆中肿痛、腋下肿马刀、振寒疟，为胆病。因为阳明司天之岁，金克木，所以出现上述病症。）太冲脉绝，死症不可治。（太冲穴在足大趾本节后二寸，脉动应手，是肝气所在。金来伐木，肝气内部断绝，真气不胜邪气，所以死亡。）
太阳寒水司天，寒气淫胜，则寒气反常到来，水且结冰，血液在体内变色，发为痈疡，百姓发病表现为厥心痛，呕血、便血、鼻衄，容易悲伤，时常眩晕仆倒。若岁运火炎烈，暴雨乃成冰雹，胸腹满，手热肘挛腋肿，心跳悸动不安，胸胁胃脘不安，面色红赤、目黄，喜欢嗳气、咽喉干燥，严重时面色黑，口渴想喝水，病本在于心。（这指的是辰戌年。太阳司天，寒气布化，所以水且冰，而血凝在皮肤之间，卫气结聚，所以为痈。如果乘火运而火炎烈，与水交战，所以豪雨半珠形雹。这一年百姓的病集中于心胁之中。阳气内郁，温气下蒸，所以心厥痛而呕血，血泄鼻衄，面赤目黄，善噫，手热肘挛腋肿，咽干。严重时寒气胜阳，水行凌火，火气内郁，所以渴而欲饮。病始心生，为阴凌犯，所以说病本在心。因为太阳司天之岁，水克火，所以出现上述病症。）神门脉绝，死症不可治。（神门穴在手掌后锐骨之端，动脉应手，是真心气所在。水行胜火，而心气内部断绝，神气已亡，不死还等什么？）
所谓动气，可以知道是哪一脏病变。（所以诊视而知其死亡的缘故是什么？因为这些皆是脏之经脉动气，以此知晓神脏的存亡罢了。）
司天之气：风气淫胜，用辛凉药平调，辅以苦甘药，用甘味药缓急，用酸味药泻之。热气淫胜，用咸寒药平调，辅以苦甘药，用酸味药收敛。湿气淫胜，用苦热药平调，辅以酸辛药，用苦味药燥湿，用淡味药渗泄。湿气上部严重且热，用苦温药治疗，辅以甘辛药，以出汗为痊愈标准停止。火气淫胜，用酸冷药平调，辅以苦甘药，用酸味药收敛，用苦味药发散，用酸味药复元，热气淫胜同理。燥气淫胜，用苦温药平调，辅以酸辛药，用苦味药通便。寒气淫胜，用辛热药平调，辅以苦甘药，用咸味药泻下。（这是说六气司天，淫胜致病，各有治疗方法。）
治疗各种胜复之气，寒者用热药，热者用寒药，温者用清药，清者用温药，散者用收药，抑者用散药，燥者用润药，急者用缓药，坚者用软药，脆者用坚药，衰者用补药，强者用泻药，使各安其气，必须清静，则病气衰退去除，回归其所宗属，这是治疗的总体原则。（太阳气寒，少阴阳气热，厥阴气温，阳明气清，太阴气湿，有胜复则各加倍其气来调和，所以可以使平和。宗，属也。调理不失理，则其余之气自然回归其所属，少之气自然安守其居所。胜复衰退后，则各自补养而平定，必须清静，不要妄加干扰，则六气循环，五神安泰。若运气之寒热，治疗平调，也各自归司天地之气。这是总结言治胜复的大体原则。）
身半以上，其气有三，属于天的部分，由天气主导。身半以下，其气有三，属于地的部分，由地气主导。以名称命气，以气命处，从而论述疾病。半，指的是天枢穴。（身体的半，正指脐中。有人以腰为身半，应当伸臂指天，舒足指地，用绳子量之，中正当脐，所以又叫半，所谓天枢。司天者其气三，司地者其气三，所以身半以上三气，身半以下三气。以名言其气，以气言其处，以气处寒热，而言其病的形证。想要知道病诊，常随气所在而言，当阴之分，冷病归之，当阳之分，热病归之，所以胜复之作，先言病生寒热者，必根据此物理。《六微旨大论》说：天枢之上，天气主之。天枢之下，地气主之。气交之分，人气从之。）
气的胜复，轻微的顺从其势，严重的制约它。气的复，平和的平调它，暴烈的夺其势。都随着胜气，安抚其屈伏，不问其数，以平和为期，这就是其道。（随，谓顺从安抚。制，谓制止。平，谓平调。夺，谓夺取胜气。治疗这些，不以数的多少，但以气平和为准度。这是说复之，所以反病而有治之法。）
高的抑制它，低的提升它，有余的折损它，不足的补益它，辅以有利的药物，调和适宜的药性，必须安定主客之气，适应寒温，同气逆治，异气顺治。（高的抑制，是制约胜气。低的提升，是济助弱气。有余折损，是屈其锐气。不足补益，是全其气。虽然制胜扶弱，但客主须安。一气失所，内淫外并，而危败之由作矣。同，谓寒热温清气相比和。异，谓水火木金土不比和，气相得者，则逆所胜之气以治之。不相得者，则顺所不胜气以治之。这是治主客的大体。）
气有高下，病有远近，证有中外，治有轻重，适其至所为故也。（脏位有高下，腑气有远近，病证有表里，药用有轻重，调其多少，和其紧慢，令药气至病所为故，勿太过不及也。）《大要》说：君一臣二，是奇方制度；君二臣四，是偶方制度；君二臣三，是奇方制度；君三臣六，是偶方制度。（奇，谓古之单方。偶，谓古之复方。单复一制皆有大小，故奇方云君一臣二君二臣三，偶方云君二臣四君三臣六也。病有大小，气有远近，治有轻重所宜，故云制者也。）所以说：近病用奇方，远病用偶方，发汗不用奇方，攻下不用偶方，补上治上制以缓剂，补下治下制以急剂，急则气味浓，缓则气味薄，适其至所，这就叫作恰当。（发汗药不用偶方，气不可以向外发泄过度。下药不用奇制，药毒攻伐会导致过害。治上补上，方迅急则止不住而迫下。治下补下，方缓慢则湿道路而力又微。制急方而气味薄，则力与缓等。制缓方而气味浓，则势与急同。如是为缓不能缓，急不能急，浓而不浓，薄而不薄。大小非制，轻重无度。则虚实寒热，脏腑纷挠，）
The *Zhi Zhen Yao Da Lun* (Great Treatise on the Most Essential Principles) states: What is the manifestation of Yin pulses at the Cun Kou (Cun position, radial artery pulse point reflecting upper jiao and heart/lung qi)? (The term "Ying" refers to a pulse that is deep and imperceptible.) By observing whether the year's governing Qi is North or South, this can be known.
In years of Northern Governance, when Shao Yin (Ministerial Fire) is in Quan (ruling the second half of the year), the Cun Kou pulses are deep and imperceptible; (Wood, Fire, Metal, and Water undergo four cycles of transformation, receiving Qi facing North. For any Qi located in Quan, its pulse often remains hidden and unseen, while the pulses of other Qi on the left and right may be visible. When the Qi in Quan is harmonious, the pulse is not seen; when it is pathogenic, it is visible. Diseases are named based on the excess of Guest Qi or Host-Guest interactions. The same applies to Qi in Si Tian.) When Jue Yin (Wind Wood) is in Quan, the right Cun Kou pulse is deep and imperceptible; (Because Shao Yin is on the right.) When Tai Yin (Damp Earth) is in Quan, the left Cun Kou pulse is deep and imperceptible. (Because Tai Yin is on the left.)
In years of Southern Governance, when Shao Yin (Ministerial Fire) is in Si Tian (ruling the first half of the year), the Cun Kou pulses are deep and imperceptible; (In years of Earth Cycle, commanding facing South, so when Shao Yin is in Si Tian, both hands' Cun Kou pulses are deep and imperceptible.) When Jue Yin (Wind Wood) is in Si Tian, the right Cun Kou pulse is deep and imperceptible; when Tai Yin (Damp Earth) is in Si Tian, the left Cun Kou pulse is deep and imperceptible. (This also follows the principle of left-right correspondence.)
All instances of "Ying" (imperceptibility) become visible if the diagnostic method is reversed (e.g., by applying deeper pressure or changing posture). (The term "Ying" refers to deep pulses; when pressing down, the pulse feels deep, but upon releasing or adjusting the hand, a deep pulse may appear superficial, and a fine pulse may appear coarse.)
The Yellow Emperor asked: How do the Chi positions (Chi position, distal radial artery pulse point reflecting lower jiao and kidney/mandate qi) manifest? The Master replied: In years of Northern Governance, when the Three Yin meridians are below (in Quan), the Cun Kou pulses are deep and imperceptible; when the Three Yin meridians are above (in Si Tian), the Chi pulses are deep and imperceptible. (Si Tian is referred to as "above," and Quan as "below.") In years of Southern Governance, when the Three Yin meridians are in Si Tian, the Cun Kou pulses are deep and imperceptible; when the Three Yin meridians are in Quan, the Chi pulses are deep and imperceptible. The situation is the same for the left and right sides. (Whether Chi or Cun is imperceptible, it is identical on both sides. This explains that for Northern and Southern governance, the Si Tian and Quan positions have specific locations where the Cun and Chi pulses are imperceptible.)
How does the internal excess of Heaven and Earth Qi cause disease?
In years where Jue Yin (Wind Wood) is in Quan, with Wind excess prevailing, the ground atmosphere becomes obscure, plains are shrouded in mist, and grasses flower early. The people suffer from chills and trembling, frequent groaning and yawning, heart pain with limb fullness, tightness in the hypochondrium, difficulty swallowing food, obstruction in the diaphragm and throat, vomiting after eating, abdominal distension with frequent belching. After defecation or passing gas, symptoms temporarily alleviate, but the body feels heavy. (This refers to Yin-Shen years. Chills, groaning, and yawning indicate Stomach disease. Vomiting, distension, belching, relief after bowel movement, and heaviness indicate Spleen disease. Difficulty swallowing and throat obstruction indicate pathogen in the stomach cavity. Since Jue Yin is in Quan, Wood Qi is strong and overacts on the Spleen and Stomach, causing these symptoms.)
In years where Shao Yin (Ministerial Fire) is in Quan, with Heat excess prevailing, rivers and marshes appear to boil like flames, and dark places seem bright. The people suffer from borborygmus (abdominal rumbling), Qi rushing up to the chest, asthma unable to stand for long, alternating chills and fever with skin pain, eye closure with toothache and swelling, chills and fever resembling malaria, lower abdominal pain and distension, and hibernating insects failing to hide. (This refers to Mao-You years. Toothache and swelling indicate Large Intestine disease. Borborygmus, Qi rushing to chest, and asthma indicate pathogen in the Large Intestine. Since Shao Yin is in Quan, Fire overacts on Metal, causing Large Intestine disease.)
In years where Tai Yin (Damp Earth) is in Quan, grasses flourish early. With Dampness excess prevailing, valleys and rocks are obscured by dust, yellow color appears black, marking the intersection of Extreme Yin. The people suffer from fluid accumulation, heart pain, deafness with muffled hearing, sore throat and obstruction, bleeding from lower orifices, lower abdominal pain and swelling, inability to urinate, severe headache as if bursting, eyes feeling as if protruding, neck feeling stiff as if pulled, waist feeling as if broken, thighs unable to move, popliteal fossa feeling bound, and calf muscles feeling torn. (This refers to Chen-Xu years. Tai Yin is Earth; its color should be yellow in the central sky, but instead appears in the northern black region. Water and Earth colors appearing together is called the intersection of Extreme Yin. Severe headache refers to pain in the back of the head and between eyebrows. Popliteal fossa is the bend behind the knee. Calf muscle is the soft flesh behind the leg. Deafness and sore throat indicate San Jiao disease. Headache, eye protrusion sensation, neck stiffness, waist breakage, thigh immobility, bound popliteal fossa, and torn calves indicate Bladder Foot-Taiyang meridian disease. Lower abdominal pain and urinary retention indicate pathogen in the San Jiao. Since Tai Yin is in Quan, Earth Qi overacts on Taiyang, causing these symptoms.)
In years where Shao Yang (Ministerial Fire) is in Quan, with Fire excess prevailing, the suburbs shine brightly, and cold and heat alternate. The people suffer from dysentery with red and white discharge, lower abdominal pain, red urine, and in severe cases, bloody stools. The pulse presentation is the same as in Shao Yin in Quan. (This refers to Si-Hai years. During cold periods, heat replaces it; after heat passes, cold returns, hence "alternating." Other symptoms are the same as Shao Yin in Quan.)
In years where Yang Ming (Dryness Metal) is in Quan, with Dryness excess prevailing, fog is dim and unclear. The people suffer from frequent vomiting with bitter taste, frequent sighing, heart and hypochondriac pain preventing turning over, severe dry throat, dusty complexion, lack of skin luster, and heat on the outer foot. (This refers to Zi-Wu years. Dim fog obscures shapes and brings slight cold. Heart-hypochondriac pain refers to pain beside the heart in the ribs. Dusty complexion means the face looks covered in dust. Bitter vomiting, sighing, pain preventing turning, dusty face, lack of luster, and foot heat indicate Gallbladder disease. Dry throat and dusty face indicate Liver disease. Since Yang Ming is in Quan, Metal Qi overacts on Wood, causing these symptoms.)
In years where Tai Yang (Cold Water) is in Quan, with Cold excess prevailing, the environment becomes condensed, solemn, and chilling. The people suffer from lower abdominal pain radiating to the testicles, pulling into the lumbar spine and shooting up to the heart with pain, bleeding, sore throat, and submandibular swelling. (This refers to Chou-Wei years. Condensed solemnity means cold air fills the sky, stagnant and motionless, making all things still. Chilling means extreme cold. "Kong" means radiating/pulling. "Gao" means testicle. "Han" is below the jawline near the teeth. Sore throat and submandibular swelling indicate Small Intestine disease. Lower abdominal pain radiating to testicles, pulling to waist, and shooting to heart/lungs indicates pathogen in the Small Intestine. Since Tai Yang is in Quan, Water overacts on Fire, causing these symptoms.)
For various Qi in Quan, if Wind excesses internally, treat with Pungent-Cold herbs, assist with Bitter-Sweet herbs, use Sweet to relax tension, and use Pungent to disperse. If Heat excesses internally, treat with Salty-Cold herbs, assist with Sweet-Bitter herbs, use Sour to astringe, and use Bitter to disperse. If Dampness excesses internally, treat with Bitter-Hot herbs, assist with Sour-Light herbs, use Bitter to dry dampness, and use Light to drain. If Fire excesses internally, treat with Salty-Cold herbs, assist with Bitter-Pungent herbs, use Sour to astringe, and use Bitter to disperse. If Dryness excesses internally, treat with Bitter-Warm herbs, assist with Sweet-Pungent herbs, use Bitter to purge. If Cold excesses internally, treat with Sweet-Hot herbs, assist with Bitter-Pungent herbs, use Salty to purge, use Pungent to moisten, and use Bitter to consolidate. (This describes the treatment methods for diseases caused by the excess of the Six Qi in Quan.)
How do changes in Heaven's Qi manifest?
When Jue Yin (Wind Wood) is in Si Tian, with Wind excess prevailing, the sky becomes dusty and obscure, clouds and objects are disturbed, cold generates spring-like Qi, and flowing water does not freeze. The people suffer from epigastric pain at the heart center, upward support to the hypochondrium, obstruction in the diaphragm and throat, difficulty swallowing, stiff tongue root, vomiting after eating, cold diarrhea, abdominal distension, loose stools, masses, and fluid retention. Hibernating insects do not emerge. The disease originates in the Spleen. (This refers to Si-Hai years. Wind comes from heaven, raising dust. Wind movement disturbs clouds. "Ai" is green dust. Obscuring distant objects is "Ai Hun." Earth disease tends toward diarrhea. If water pathology occurs, urine stops. If severe diarrhea occurs, menstruation stops. Stiff tongue, vomiting, distension, loose stools, and masses indicate Spleen disease. Epigastric pain, hypochondriac support, throat obstruction, and swallowing difficulty indicate Stomach disease. Since Jue Yin is in Si Tian, Wood overacts on Earth, causing these symptoms.) If the Chong Yang pulse vanishes, death is incurable. (Chong Yang is on the dorsum of the foot where the artery beats, representing Stomach Qi. A weak Chong Yang pulse reduces intake; a vanished pulse prevents ingestion or causes immediate regurgitation. If attack fails and nourishment fails, evil grows strong while true Qi perishes internally, leading to death.)
When Shao Yin (Ministerial Fire) is in Si Tian, with Heat excess prevailing, stifling heat arrives, and Fire exercises its administration. The people suffer from chest irritability and heat, dry throat, right hypochondriac fullness, skin pain, chills/fever, cough, and asthma. Heavy rain approaches. Hemoptysis, hematochezia, epistaxis, sneezing, vomiting, and urine color changes occur. In severe cases, sores swell, shoulder/back/arm/clavicle pain, heart pain, lung distension, abdominal fullness, bloating, cough, and asthma occur. The disease originates in the Lung. (This refers to Zi-Wu years. Stifling heat indicates Fire's dominance. Disease concentrates on the right because the Small Intestine connects to the Heart. Disease arises from the Lung, hence "originates in Lung." Since Shao Yin is in Si Tian, Fire overacts on Metal, causing these symptoms.) If the Chi Ze pulse vanishes, death is incurable. (Chi Ze is in the elbow crease where the artery beats, representing Lung Qi. Fire burns Metal, fulfilling heavenly mandate; internal Metal Qi perishes, leading to critical danger.)
When Tai Yin (Damp Earth) is in Si Tian, with Dampness excess prevailing, deep Yin spreads, rain causes withering. Edema, bone pain, and Yin Bi (deep pain unresponsive to pressure) occur. Yin Bi involves pain in the waist, spine, head, and neck, dizziness, difficult defecation, impotence, hunger without desire to eat, blood in sputum, and a sensation of the heart hanging empty. The disease originates in the Kidney. (This refers to Chou-Wei years. "Chen" means long-lasting. Kidney Qi is pathogenic, Water cannot moisten, lower Jiao dries, causing constipation. Hunger without appetite, bloody sputum, and hanging heart sensation indicate Kidney disease. Pathogen in Kidney causes bone pain, Yin Bi, abdominal distension, back pain, constipation, neck stiffness, and dizziness. Since Tai Yin is in Si Tian, Earth overacts on Water, causing these symptoms.) If the Tai Xi pulse vanishes, death is incurable. (Tai Xi is behind the medial malleolus where the artery beats, representing Kidney Qi. Earth evil overcomes Water, and Kidney Qi perishes internally.)
When Shao Yang (Ministerial Fire) is in Si Tian, with Fire excess prevailing, warm Qi flows freely, and Metal's administration is uneven. The people suffer from headache, fever/chills resembling malaria, heat rising causing skin pain, yellow-red complexion changes, progression to edema, facial/body swelling, abdominal fullness with仰息 (breathing with head tilted back), dysentery with red/white discharge, sores, bloody sputum,心烦 (vexation) and chest heat, and severe epistaxis. The disease originates in the Lung. (This refers to Yin-Shen years. Fire dominance injures Metal, so "Metal administration is uneven." Fire flares up, injuring Metal/Lung; guest heat burns internally, Water cannot save. Since Shao Yang is in Si Tian, Fire overacts on Metal, causing these symptoms.) If the Tian Fu pulse vanishes, death is incurable. (Tian Fu is two cun below the axilla on the inner arm where the artery beats, representing Lung Qi. Fire dominance causes Metal/Lung perishing, leading to death.)
When Yang Ming (Dryness Metal) is in Si Tian, with Dryness excess prevailing, trees bloom late, grasses grow late, bones and sinews undergo internal changes. The people suffer from left hypochondriac pain, coldness in the middle, malaria upon contraction, drastic cooling altering seasons, cough, borborygmus, loose dysentery, trees敛 (contracting), vitality stagnating below, grasses withering above, sudden heart/hypochondriac pain preventing turning, dry throat, dusty face, back pain, hernia in men, lower abdominal pain in women, visual impairment, sores/acne/abscesses, and emergence of hibernating insects. The disease originates in the Liver. (This refers to Mao-You years. Metal dominance causes late blooming. Corresponding to the body, bones/sinews fail. Drastic cooling alters seasons, causing internal cold/malaria. Large Intestine is on the right, connected to Lung Qi; now Lung Qi invades internally, Liver is on the left/bottom, causing left hypochondriac stabbing pain. If people have diarrhea, there is no excess disease. Drastic cooling is secondary to cold. Extreme cold stops Yang Qi, so Wood contracts and grasses delay. Rising Sheng Qi lacks Yang distribution, stagnating below. In the body, pain Qi resides in the lower abdomen. Sores, back pain, hernia, female abdominal pain, dusty face, chest fullness, and洞泄 (profuse diarrhea) indicate Liver disease. Heart/hypochondriac pain, eye corner pain, clavicle/armpit swelling, chills/malaria indicate Gallbladder disease. Since Yang Ming is in Si Tian, Metal overacts on Wood, causing these symptoms.) If the Tai Chong pulse vanishes, death is incurable. (Tai Chong is two cun proximal to the big toe joint where the pulse beats, representing Liver Qi. Metal attacks Wood, Liver Qi perishes internally, True Qi cannot overcome evil, leading to death.)
When Tai Yang (Cold Water) is in Si Tian, with Cold excess prevailing, cold Qi returns abnormally, water freezes, blood changes internally, causing abscesses. The people suffer from Jue Xin Tong (cold heart pain), hematemesis, hematochezia, epistaxis, sadness, dizziness, and fainting. If the annual cycle has intense Fire, violent rain forms hail. Chest/abdominal fullness, hot hands, elbow spasms, armpit swelling, palpitations, chest/hypochondriac/epigastric discomfort, red face, yellow eyes, belching, dry throat, and in severe cases, black complexion and thirst with desire to drink occur. The disease originates in the Heart. (This refers to Chen-Xu years. Tai Yang Si Tian spreads Cold, freezing water and coagulating blood in skin, causing abscesses via Wei Qi stagnation. If Fire cycle is intense, it battles Water, forming hail. Disease concentrates in heart/hypochondrium. Internal Yang stagnation steams Warm Qi, causing cold heart pain, bleeding, red/yellow face, belching, hot hands, spasms, swelling, dry throat. Severe Cold overcomes Yang, Water overacts on Fire, internal Fire stagnation causes thirst. Disease starts in Heart, Yin invading, hence "originates in Heart." Since Tai Yang is in Si Tian, Water overacts on Fire, causing these symptoms.) If the Shen Men pulse vanishes, death is incurable. (Shen Men is at the end of the transverse wrist crease where the artery beats, representing True Heart Qi. Water overcomes Fire, Heart Qi perishes internally, Spirit departs, death is inevitable.)
The presence of moving Qi allows one to know which Zang organ is affected. (Why do we diagnose death? Because these are the moving Qi of the Zang meridians, revealing the survival or demise of the Spirit Zangs.)
For Qi in Si Tian: If Wind excesses, level with Pungent-Cold, assist with Bitter-Sweet, use Sweet to relax, use Sour to purge. If Heat excesses, level with Salty-Cold, assist with Bitter-Sweet, use Sour to astringe. If Dampness excesses, level with Bitter-Hot, assist with Sour-Pungent, use Bitter to dry, use Light to drain. If Dampness is severe above with Heat, treat with Bitter-Warm, assist with Sweet-Pungent, stop when sweating occurs. If Fire excesses, level with Acid-Cold, assist with Bitter-Sweet, use Sour to astringe, use Bitter to disperse, use Sour to restore. Heat excess follows the same. If Dryness excesses, level with Bitter-Warm, assist with Acid-Pungent, use Bitter to purge. If Cold excesses, level with Pungent-Hot, assist with Bitter-Sweet, use Salty to purge. (This describes treatment for Six Qi in Si Tian causing excess diseases.)
To treat all Victory and Repayment (Sheng Fu) patterns: Cold is treated with Heat, Heat with Cold, Warm with Cool, Cool with Warm, Scattered with Astringent, Suppressed with Dispersing, Dry with Moistening, Urgent with Relieving, Hard with Softening, Fragile with Firming, Deficient with Tonifying, Excess with Purging. Calm each Qi, ensure clarity and stillness, then disease Qi declines and returns to its source. This is the general principle of treatment. (Tai Yang is Cold, Shao Yin/Shao Yang are Hot, Jue Yin is Warm, Yang Ming is Clear/Cool, Tai Yin is Damp. With Sheng Fu, double the respective Qi to regulate, achieving balance. "Zong" means belonging. Proper regulation returns residual Qi to its source. After Sheng Fu subsides, nourish and calm. Clarity and stillness prevent interference, allowing Six Qi circulation and Five Spirits peace. Treating climatic heat/cold returns them to their Si Tian/Quan sources. This summarizes the general principle of treating Sheng Fu.)
Above the midpoint of the body, there are three Qi, belonging to Heaven, governed by Heaven Qi. Below the midpoint, there are three Qi, belonging to Earth, governed by Earth Qi. Name the Qi by its designation, designate the location by the Qi, and discuss the disease. The midpoint refers to the Tianshu acupoint. (The body's midpoint is the umbilicus. Some say the waist, but measuring from raised arm to extended foot aligns with the umbilicus, hence "midpoint" or Tianshu. Si Tian has three Qi, Di (Earth) has three Qi, so upper body has three Qi, lower body has three Qi. Naming Qi by name, location by Qi, cold/heat by Qi location determines disease signs. To know diagnosis, follow Qi location: Yin areas attract Cold diseases, Yang areas attract Heat diseases. Thus, discussing Sheng Fu begins with cold/heat based on this physics. *Liu Wei Zhi Da Lun* states: Above Tianshu, Heaven Qi governs. Below Tianshu, Earth Qi governs. At the Qi intersection, Human Qi follows.)
Regarding Qi Victory: Minor victories are followed; major victories are controlled. Regarding Qi Repayment: Harmonious repays are leveled; violent repays are deprived. All follow the Victory Qi, pacify the suppressed, regardless of number, aiming for harmony. This is the Dao. (Follow means to soothe. Control means to stop. Level means to balance. Deprive means to take away Victory Qi. Treatment depends on Qi harmony, not numbers. This explains the treatment for Repayment causing reverse disease.)
High is suppressed, low is lifted, excess is reduced, deficient is tonified. Assist with beneficial agents, harmonize with appropriate ones. Secure the Host and Guest, adapt to cold/heat. Same Qi is treated inversely, different Qi is treated conformingly. (Suppress high to control victory. Lift low to aid weakness. Reduce excess to blunt sharpness. Tonify deficient to preserve Qi. Though controlling victory and aiding weakness, Host/Guest must be secured. One Qi out of place causes internal invasion and external merging, leading to crisis. "Same" means harmonious Cold/Heat/Warm/Cool. "Different" means non-harmonious Water/Fire/Wood/Metal/Earth. If Qi agrees, treat inversely against the victorious Qi. If Qi disagrees, treat conformingly to the non-victorious Qi. This is the general principle of treating Host/Guest.)
Qi has high and low; disease has far and near; symptoms have interior and exterior; treatment has light and heavy. Adapt to reach the target. (Zang positions have height/depth; Fu Qi has distance; symptoms have exterior/interior; medicines have potency. Adjust quantity and speed so medicinal Qi reaches the disease site, avoiding excess or deficiency.) The *Da Yao* states: One Sovereign, two Ministers, is the Odd Formula system; Two Sovereigns, four Ministers, is the Even Formula system; Two Sovereigns, three Ministers, is the Odd Formula system; Three Sovereigns, six Ministers, is the Even Formula system. (Odd refers to ancient single-agent formulas; Even refers to compound formulas. Both have sizes. Odd formulas: 1-2, 2-3. Even formulas: 2-4, 3-6. Diseases vary in size, Qi in distance, treatment in weight/appropriateness, hence "systems.") Therefore: Near diseases use Odd formulas; Far diseases use Even formulas. Sweating does not use Odd formulas; Purging does not use Even formulas. Tonifying upper/treating upper uses Slow formulas; Tonifying lower/treating lower uses Rapid formulas. Rapid formulas have strong flavor/odor; Slow formulas have weak flavor/odor. Reach the target appropriately. This is correctness. (Sweating with Even formulas causes excessive outward dispersal. Purging with Odd formulas causes toxic over-attack. Upper treatment with Rapid formulas fails to stay upper. Lower treatment with Slow formulas gets stuck in transit and loses power. Making Rapid formulas weak makes them equal to Slow. Making Slow formulas strong makes them equal to Rapid. This results in neither truly slow nor rapid, neither strong nor weak. Size is not system, weight is not measure. Deficiency/excess, cold/heat, Zang/Fu become chaotic.)