（《素问·五常政大论》）
帝曰∶天不足西北，左寒而右凉，地不满东南，右热而左温，其故何也？（天不足西北，故西北为天门。地不满东
南，故东南为地户。《五常政大论》曰∶所谓戊己分者，奎壁角轸，则天地之门户也。义与此通。此节以背干面巽而言，
干居西北，则左为北，右为西，故左寒右凉；巽居东南，则右为南，左为东，故右热左温，而四季之气应之也。）岐伯曰∶
阴阳之气，高下之理，大小之异也。（此下皆言地理之异也。高下，谓中原地形，西北方高，东南方下也。大小，谓山河
疆域，各有大小也。故阴阳之气有不齐，而寒热温凉，亦各随其地而异矣。）东南方阳也，阳者其精降于下，故右热而左
温；西北方阴也，阴者其精奉于上，故左寒而右凉。（阳气自上而降下，东南方下，故东方温而南方热，阳始于东而盛于
南也。阴气自下而奉上，西北方高，故西方凉而北方寒，阴始于西而盛于北也。）是以地有高下，气有温凉，高者气寒，
下者气热。（《六元正纪大论》曰∶至高之地，冬气常在，至下之地，春气常在。正此谓也。）故适寒凉者胀，之温热者疮，
下之则胀已，汗之则疮已，此腠理开闭之常，大小之异耳。（之，亦适也。适寒凉之地，则腠理闭密，气多不达，故作内
胀。之温热之地，则腠理多开，阳邪易入，故为疮疡。胀在里，故下之则已。疮在表，故汗之则已。此其为胀为疮，虽
为腠理开闭之常，然寒热甚者病则甚，微者病则微，乃有大小之异耳。王氏曰∶西北、东南，言其大也。夫以气候验之，
中原地形，所居者悉以居高则寒，处下则热。尝试观之，高山多雪，平川多雨，高山多寒，平川多热，则高下寒热可征
见矣。中华之地，凡有高下之大者，东西、南北各三分也。其一者，自汉蜀江，南至海也；二者，自汉江，北至平遥县
也；三者，自平遥北山，北至蕃界北海也。故南分大热，中分寒热兼半，北分大寒。南北分外，寒热尤极。大热之分其
寒微，大寒之分其热微。然而登陟极高山顶，则南面北面；寒热悬殊，荣枯倍异也。又东西高下之别亦三矣，其一者，
自KT 源县，西至沙洲；二者，自开封县，西至KT 源县；三者，自开封县，东至沧海也。故东分大温，中分温凉兼
半，西分大凉。大温之分，其寒五分之二；大凉之分，其热五分之二。温凉分外，温凉尤极，变为大暄大寒也。约其大
凡如此。然九分之地，寒极于西北，热极于东南。九分之地，其中有高下不同，地高处则燥，下处则湿，此一方之中小
异也。若大而言之，是则高下之有二也。何者？中原地形，西高北高，东下南下。今百川满凑，东之沧海，则东南西北，
高下可知。一为地形高下，故寒热不同；二则阴阳之气有少有多，故表温凉之异尔。今以气候验之，乃春气西行，秋气
东行，冬气南行，夏气北行。以中分校之，自开封至KT 源，气候正与历候同。以东行校之，自开封至沧海，每一百里，
秋气至晚一日，春气发早一日。西行校之，自KT 源县西至蕃界碛石，其以南向及西北、东南者，每四十里，春气发晚
一日，秋气至早一日；北向及东北、西南者，每一十五里，春气发晚一日，秋气至早一日。南行校之，川形有北向及东
北西南者，每一十五里，阳气行晚一日，阴气行早一日；南向及东南西北川，每一十五里，热气至早一日，寒气至晚一
日；广平之地，则每五十里，阳气发早一日，寒气至晚一日。北行校之，川形有南向及东南、西北者，每二十五里，阳
气行晚一日，阴气行早一日；北向及东北、西南川，每一十五里，寒气至早一日，热气至晚一日；广平之地，则每二十
里，热气行晚一日，寒气至早一日。大率如此。然高处峻处，冬气常在，平处下处，夏气常在，观其雪零草茂，则可知
矣。然地土固有弓形川、蛇形川、月形川，地势不同，生杀荣枯，地同而天异。凡此之类，有离向、丙向、巽向、乙向、
震向处，则春气早至，秋气晚至，早晚校十五日；有丁向、坤向、庚向、兑向、辛向、干向、坎向、艮向处，则秋气早
至，春气晚至，早晚亦校二十日。是所谓带山之地也，审观向背，气候可知。寒凉之地，腠理开少而闭多，闭多则阳气
不散，故适寒凉腹必胀也。湿热之地，腠理开多而闭少，开多则阳气发散，故往温热皮必疮也。下文则中气不余，故胀
已。汗之则阳气外泄，故疮已。按∶王氏此论，以中国之地分为九宫，而九宫之中复分其东西南北之向，则阴阳寒热各
有其辨，不可不察也。详汉蜀江，即长江也。自江至南海，离宫也。自江至平遥县，中宫也。今属山西汾州界。自平遥
北至蕃界北海，坎宫也。此以南北三分为言也。KT 源县，即KT 阳县，今属陕西凤翔府。自KT 源西至沙洲，兑宫
也。自开封西至KT 源，中宫也。自开封东至沧海，震宫也。此以东西三分为言也。五正之宫得其详，则四隅之气可察
矣。）帝曰∶其于寿夭何如？（土地之气既不同，则人之寿夭亦有异也。）岐伯曰∶阴精所奉其人寿，阳精所降其人夭。（阴
精所奉之地，阳气坚固，故人多寿。谓崇高之处也。阳精所降之地，阳气易泄，故人多夭，谓污下之处也。）帝曰∶善。
其病者，治之奈何？岐伯曰∶西北之气，散而寒之，东南之气，收而温之，所谓同病异治也。（西北气寒，气固于外，则
热郁于内，故宜散其外寒，清其内热。东南气热，气泄于外，则寒生于中，故宜收其外泄，温其中寒。此其为病则同，
而治则有异也。）故曰∶气寒气凉，治以寒凉，行水渍之。气温气热，治以温热，强其内守。必同其气，可使平也，假者
反之。（西北气寒气凉，人多食热而内火盛，故宜治以寒凉，及行水渍之法，谓用汤液浸渍以散其外寒也。东南气温气热，
人多食凉而内寒生，故宜治以温热，又必强其内守，欲令阳气不泄，而固其中也。天气地气有阴阳升降，病治亦有阴阳
升降，用合气宜，是同其气而病可平矣。然西北未必无假热，东南未必无假寒，假者当反治，则西北有当热，东南有当
寒者矣。然余备历南北，还是热方多热病，寒方多寒病，又不可不知也。真假详义，有按在论治类四。）帝曰∶善。一州
之气，生化寿夭不同，其故何也？岐伯曰∶高下之理，地势使然也。崇高则阴气治之，污下则阳气治之，阳盛者先天，
阴胜者后天，此地理之常，生化之道也。（一州之地，非若天下之广，其中亦有生化寿夭之不同者，以地势有高下耳。高
者阴气升而治之，阴性迟，故物之荣枯皆后天而至。后天者，其荣迟，其枯亦迟，故多寿也。下者阳气降而治之，阳性
速，故物之成败皆先天而至。先天者，其成速，其败亦速，故多夭也。观孙真人曰∶婴儿三岁以上，十岁以下，观其性
气高下，即可知其寿夭。大略儿小时敏悟过人者多夭，则项橐、颜回之流是也。小儿骨法成就，威仪回转迟舒，稍费人
精神雕琢者寿。其预知人意，回旋敏速者亦夭，则杨修、孔融之流是也。由此言之，寿夭大略可知也。亦由梅花早发，
不睹岁寒，甘菊晚荣，终于年事，是知晚成者，寿之征也。此即先天后天之义。）帝曰∶其有寿夭乎？岐伯曰∶高者其气
寿，下者其气夭，地之小大异也，小者小异，大者大异。（地有高下，则气有阴阳，寿夭之所由也。然大而天下，则千万
里之遥，有所异也；小而一州，则数十里之近，亦有所异也。故小有小之异，大有大之异。）故治病者，必明天道地理，
阴阳更胜，气之先后，人之寿夭，生化之期，乃可以知人之形气矣。（不明天道，则不知运气之变。不明地理，则不知方
土之宜。不明阴阳更胜，则本末俱失。不明气之先后，则缓急倒施。不明寿夭生化之期，则中无确见而轻率招尤。凡此
数者，缺一不可，斯足因形以察人之外，因气以知人之内，而治病之道，庶保万全矣。
（出自《素问·五常政大论》）
黄帝问道：天的阳气在西北方不足，所以左边寒冷而右边凉爽；地的阴气在东南方不满，所以右边炎热而左边温暖，这是什么缘故呢？（注：天不足于西北，所以西北方称为天门。地不满于东南，所以东南方称为地户。《五常政大论》说：所谓戊己分界之处，即奎、壁、角、轸四星宿所在方位，就是天地之门户。此义与此相通。本节是以人背对乾卦面朝南巽卦而言，乾卦位于西北，则左侧为北，右侧为西，所以左寒右凉；巽卦位于东南，则右侧为南，左侧为东，所以右热左温，四季之气也随之相应。）
岐伯回答说：这是阴阳之气以及地势高下、疆域大小的差异所致。（以下皆论述地理环境的差异。高下，指中原地形，西北方高，东南方低。大小，指山河疆域，各有不同。因此阴阳之气不相齐一，寒热温凉也随各地环境而异。）东南方属阳，阳气其精华下降，所以右边热而左边温；西北方属阴，阴气其精华上奉，所以左边寒而右边凉。（阳气自上而降下，东南方地势低，所以东方温而南方热，阳气始于东方而盛于南方。阴气自下而奉上，西北方地势高，所以西方凉而北方寒，阴气始于西方而盛于北方。）因此地面有高下之分，气候有温凉之别，高处气寒，低处气热。（《六元正纪大论》说：最高之地，冬气常在；最低之地，春气常在。正是这个意思。）所以去往寒凉之地容易患胀病，去往温热之地容易患疮疡，用泻下法治疗胀病可愈，用发汗法治疗疮疡可愈，这是腠理开闭的常态，也是地域大小差异的表现。（“之”，也是“适”的意思。适应寒凉之地，则腠理密闭，气机多不能通达，所以发生内胀。适应温热之地，则腠理多开泄，阳邪易侵入，所以发生疮疡。胀病在里，所以用泻下法可愈。疮疡在表，所以用发汗法可愈。这虽然都是腠理开闭的常态，但寒热严重的病症就重，轻微的病症就轻，这就是大小的差异。王冰说：西北、东南，是言其大体。以气候验证，中原地形，居住在高处则寒，处在低处则热。试着观察，高山多雪，平原多雨，高山多寒，平原多热，那么高下寒热的情况就可以证实了。中华大地，凡是有高下之别的，东西南北各分为三部分。第一部分，从汉水蜀江以南直到大海；第二部分，从汉水以北直到平遥县；第三部分，从平遥北山以北直到蕃界北海。所以南部分属大热，中部分属寒热各半，北部分属大寒。南北分外，寒热尤为极端。大热之分，其寒气微弱；大寒之分，其热气微弱。然而登上极高山顶，则南北两面寒热悬殊，草木荣枯差异加倍。另外东西高下之别也有三种，第一种，从KT源县向西直到沙洲；第二种，从开封县向西直到KT源县；第三种，从开封县向东直到沧海。所以东部分属大温，中部分属温凉各半，西部分属大凉。大温之分，其寒气占五分之二；大凉之分，其热气占五分之二。温凉之外，温凉尤为极端，变为大暑和大寒。大致情况如此。然而九分之地中，寒气极于西北，热气极于东南。九分之地中，其中有高下不同，地处高处则燥，地处低处则湿，这是一方之中的微小差异。若从大体而言，这就是高下的两种区别。为什么呢？中原地形，西高北高，东低南低。如今百川汇聚，向东流入沧海，那么东南西北的高下情况就知道了。一是地形高下不同，所以寒热不同；二是阴阳之气有多有少，所以表现出温凉的差异。现在以气候验证，春季之气向西行，秋季之气向东行，冬季之气向南行，夏季之气向北行。以中部地区校验，从开封到KT源，气候与历法候应相同。以东行校验，从开封到沧海，每百里，秋气晚到一天，春气早发一天。西行校验，从KT源县西至蕃界碛石，其中南向及西北、东南方向，每四十里，春气晚发一天，秋气早到一天；北向及东北、西南方向，每十五里，春气晚发一天，秋气早到一天。南行校验，川形有北向及东北西南方向的，每十五里，阳气行迟一天，阴气行早一天；南向及东南西北川，每十五里，热气早到一天，寒气晚到一天；广平之地，则每五十里，阳气早发一天，寒气晚到一天。北行校验，川形有南向及东南、西北方向的，每二十五里，阳气行迟一天，阴气行早一天；北向及东北、西南川，每十五里，寒气早到一天，热气晚到一天；广平之地，则每二十里，热气行迟一天，寒气早到一天。大致如此。然而高处险峻之处，冬气常在；平坦低洼之处，夏气常在，看其积雪消融、草木茂盛，就可以知道了。然而地土固有弓形川、蛇形川、月形川等地势不同，生杀荣枯，地同而天异。凡是这类地方，有离向、丙向、巽向、乙向、震向处，则春气早至，秋气晚至，早晚相差十五日；有丁向、坤向、庚向、兑向、辛向、干向、坎向、艮向处，则秋气早至，春气晚至，早晚亦相差二十日。这就是所谓带山之地，审察朝向背向，气候可知。寒凉之地，腠理开少而闭多，闭多则阳气不散，所以去寒凉之地腹部必胀。湿热之地，腠理开多而闭少，开多则阳气发散，所以往温热之地皮肤必生疮疡。下文说中气不余，所以胀已。发汗则阳气外泄，所以疮已。按：王冰这一论述，将中国之地分为九宫，而在九宫之中又分其东西南北之向，则阴阳寒热各有辨别，不可不考察。详查汉蜀江，即长江也。自江至南海，是离宫。自江至平遥县，是中宫。今属山西汾州界。自平遥北至蕃界北海，是坎宫。这是以南北三分为言。KT源县，即KT阳县，今属陕西凤翔府。自KT源西至沙洲，是兑宫。自开封西至KT源，是中宫。自开封东至沧海，是震宫。这是以东西三分为言。五正之宫得其详细，则四隅之气可以察知了。）
黄帝问道：这对人的寿命长短有什么影响呢？（土地之气既然不同，那么人的寿命长短也有差异。）
岐伯回答说：阴精所奉之地的人长寿，阳精所降之地的人短命。（阴精所奉之地，阳气坚固，所以人多长寿。指崇高之处。阳精所降之地，阳气易泄，所以人多短命，指污下之处。）
黄帝道：好。如果生病了，怎么治疗呢？
岐伯回答说：西北方的气候特点，宜用发散和寒凉的方法治疗；东南方的气候特点，宜用收敛和温补的方法治疗，这就是所谓的同病异治。（西北气寒，卫气固守于外，则热郁结于内，所以适宜发散其外寒，清解其内热。东南气热，卫气泄越于外，则寒生于中，所以适宜收敛其外泄，温补其中寒。这虽然患病相同，但治疗方法却有差异。）所以说：气候寒冷凉爽的，用寒凉药治疗，并配合汤液浸渍法。气候温暖炎热的，用温热药治疗，以巩固内部正气。必须顺应其气候特点，才能使病情平和，如果是假象则相反。（西北气寒气凉，人多食热性食物而内火盛，所以适宜用寒凉药治疗，以及行水渍之法，即用汤液浸渍以散其外寒。东南气温气热，人多食凉性食物而内寒生，所以适宜用温热药治疗，又必须强固其内守，使阳气不泄，而固护其中。天气地气有阴阳升降，病治也有阴阳升降，用药合乎气候适宜，就是顺应其气而病可平复。然而西北未必没有假热，东南未必没有假寒，假象者应当反治，那么西北有当用热药，东南有当用寒药的情况。然而我遍游南北，还是热方多热病，寒方多寒病，这也是不可忽视的。真假详义，详见于论治类第四篇。）
岐伯回答说：高下的道理，是由地势决定的。崇高之处由阴气主事，低洼之处由阳气主事，阳气盛者发育在先（先天），阴气胜者发育在后（后天），这是地理的常理，也是化生的规律。（一个州的地域，不像天下那样广阔，其中也有生化寿夭的不同，是因为地势有高下罢了。高处阴气升而主事，阴性迟缓，所以万物荣枯都滞后而至。滞后者，其荣迟，其枯亦迟，所以多长寿。低处阳气降而主事，阳性迅速，所以万物成败都提前而至。提前者，其成速，其败亦速，所以多短命。看孙真人说：婴儿三岁以上，十岁以下，观察其性情气质的高下，就可以知道其寿命长短。大概幼儿小时聪明过人者多短命，如项橐、颜回之类。小儿骨相成就，威仪回转迟缓舒展，稍费人精神雕琢者长寿。那些预知人意，回旋敏捷快速者也多短命，如杨修、孔融之类。由此说来，寿命长短大致可知。这也像梅花早发，不见岁寒；甘菊晚荣，终其天年，可知晚成者是长寿的征兆。这就是先天后天的意义。）
黄帝问道：那里真的有寿命长短的差异吗？
岐伯回答说：高处的人气数长寿，低处的人气数短命，这是因地域大小不同而异，小区域有小差异，大区域有大差异。（地有高下，则气有阴阳，这是寿命长短的原因。然而大到天下，则千万里之遥，有所差异；小到一州，则数十里之近，也有所差异。所以小有小的差异，大有大的差异。）
所以说治病的人，必须明白天道地理，阴阳更替胜负，气运先后，人的寿夭，化生的时期，才可以了解人的形体和气机了。（不明白天道，就不知道运气变化。不明白地理，就不知道方土适宜。不明白阴阳更替胜负，就会本末俱失。不明白气运先后，就会缓急倒施。不明白寿夭化生的时期，心中就没有确见而轻率招致过失。这几方面缺一不可，这样才能足以在因形察人之外，因气知人之内，而治病之道，庶几保全万全了。）
(From "Suwen: Chapter on the Great Discussion of the Five Regular Administrations")
The Yellow Emperor asked: The Heaven's Yang Qi is insufficient in the Northwest, making the left side cold and the right side cool; the Earth's Yin Qi is incomplete in the Southeast, making the right side hot and the left side warm. What is the reason for this? (Note: Since Heaven is insufficient in the Northwest, the Northwest is called the Gate of Heaven. Since Earth is incomplete in the Southeast, the Southeast is called the Gate of Earth. The "Great Discussion of the Five Regular Administrations" states: The so-called boundary of Wu and Ji, where the stars Kui, Bi, Jiao, and Zhen are located, are the gates of Heaven and Earth. This meaning is consistent with the present section. This section discusses from the perspective of facing South towards Xun and having the back to Qian. Qian is located in the Northwest, so the left is North and the right is West, hence cold on the left and cool on the right; Xun is located in the Southeast, so the right is South and the left is East, hence hot on the right and warm on the left, corresponding to the Qi of the four seasons.)
Qibo replied: This is due to the differences in Yin and Yang Qi, as well as the principles of elevation and depression, and the variations in size. (The following text all discusses geographical differences. Elevation and depression refer to the terrain of the Central Plains, which is high in the Northwest and low in the Southeast. Size refers to the mountains, rivers, and territories, each having different extents. Therefore, the Yin and Yang Qi are not uniform, and cold, heat, warmth, and coolness vary according to the local environment.) The Southeast belongs to Yang; the essence of Yang descends, so the right is hot and the left is warm. The Northwest belongs to Yin; the essence of Yin ascends, so the left is cold and the right is cool. (Yang Qi descends from above. Since the Southeast is low, the East is warm and the South is hot; Yang begins in the East and peaks in the South. Yin Qi ascends from below. Since the Northwest is high, the West is cool and the North is cold; Yin begins in the West and peaks in the North.) Thus, the ground has elevations and depressions, and the climate has warmth and coolness. High places have cold Qi, and low places have hot Qi. (The "Great Discussion of the Six Yuan and Correct Chronicles" states: In the highest lands, Winter Qi prevails; in the lowest lands, Spring Qi prevails. This is exactly what is meant here.) Therefore, those who go to cold and cool places tend to suffer from distension, while those who go to hot and warm places tend to develop sores. Distension can be cured by purgation, and sores can be cured by diaphoresis. This is the normal pattern of the opening and closing of the interstices (Cou Li), reflecting the differences in regional scale. ("Zhi" also means "to adapt to". Adapting to cold and cool places causes the interstices to close tightly, preventing Qi from circulating freely, leading to internal distension. Adapting to hot and warm places causes the interstices to open frequently, allowing pathogenic Yang Qi to enter easily, leading to sores. Distension is internal, so purgation cures it. Sores are external, so diaphoresis cures it. Although these patterns of distension and sores are normal responses to the opening and closing of interstices, severe cold or heat leads to severe disease, and mild cold or heat leads to mild disease, representing the difference in magnitude. Wang Bing said: Northwest and Southeast refer to the general trends. Verifying with climate, in the Central Plains terrain, living at a height results in cold, while living in a depression results in heat. Observing carefully, high mountains have much snow and are cold, while plains have much rain and are hot, thus confirming the relationship between elevation and temperature. In China, areas with significant elevation differences are divided into three parts along the East-West and North-South axes. Part 1: From the Han River and Shu River southwards to the sea. Part 2: From the Han River northwards to Pingyao County. Part 3: From the northern mountains of Pingyao northwards to the Northern Sea of the Fan borders. Thus, the southern part is characterized by intense heat, the middle part by mixed cold and heat, and the northern part by intense cold. Beyond the North-South divisions, cold and heat are extreme. In the intensely hot division, cold is slight; in the intensely cold division, heat is slight. However, climbing to the peak of extremely high mountains reveals a stark contrast in cold and heat between the south and north faces, with double the difference in vegetation vitality. Similarly, there are three types of East-West elevation differences. Type 1: From Kunyuan County westwards to Shazhou. Type 2: From Kaifeng County westwards to Kunyuan County. Type 3: From Kaifeng County eastwards to the vast ocean. Thus, the eastern part is characterized by great warmth, the middle part by mixed warmth and coolness, and the western part by great coolness. In the greatly warm division, cold accounts for two-fifths; in the greatly cool division, heat accounts for two-fifths. Beyond warmth and coolness, they become extreme, turning into great heat and great cold. Generally speaking, this is the case. However, among the nine divisions, cold is most extreme in the Northwest, and heat is most extreme in the Southeast. Among these nine divisions, there are differences in elevation; high places are dry, and low places are humid, which are minor differences within a region. Speaking generally, these are the two aspects of elevation and depression. Why? The terrain of the Central Plains is high in the West and North, and low in the East and South. Now, all rivers converge and flow eastward into the Pacific Ocean, revealing the elevation differences of the Southeast, Northwest, Southwest, and Northeast. First, terrain elevation causes different temperatures; second, the abundance or scarcity of Yin and Yang Qi causes differences in warmth and coolness. Verifying with climate now, Spring Qi moves west, Autumn Qi moves east, Winter Qi moves south, and Summer Qi moves north. Comparing with the central region, from Kaifeng to Kunyuan, the climate matches the calendar predictions. Comparing eastward movement, from Kaifeng to the ocean, every hundred li, Autumn Qi arrives one day late, and Spring Qi emerges one day early. Comparing westward movement, from Kunyuan County west to the Fan border desert, for south-facing and northwest/southeast orientations, every forty li, Spring Qi emerges one day late, and Autumn Qi arrives one day early; for north-facing and northeast/southwest orientations, every fifteen li, Spring Qi emerges one day late, and Autumn Qi arrives one day early. Comparing southward movement, for river shapes facing north/northeast/southwest, every fifteen li, Yang Qi lags one day, and Yin Qi advances one day; for south-facing and southeast/northwest rivers, every fifteen li, Heat arrives one day early, and Cold arrives one day late; for flat lands, every fifty li, Yang Qi emerges one day early, and Cold arrives one day late. Comparing northward movement, for river shapes facing south/southeast/northwest, every twenty-five li, Yang Qi lags one day, and Yin Qi advances one day; for north-facing and northeast/southwest rivers, every fifteen li, Cold arrives one day early, and Heat arrives one day late; for flat lands, every twenty li, Heat lags one day, and Cold arrives one day early. Generally, this is the case. However, in high and steep places, Winter Qi prevails; in flat and low places, Summer Qi prevails. Observing snow melting and grass flourishing confirms this. Furthermore, landforms naturally include bow-shaped, snake-shaped, and moon-shaped valleys, with different terrains affecting growth, death, prosperity, and decay. Even with similar earth, heaven varies. In such places, facing Li, Bing, Xun, Yi, or Zhen directions causes Spring Qi to arrive early and Autumn Qi late, differing by fifteen days; facing Ding, Kun, Geng, Dui, Xin, Qian, Kan, or Gen directions causes Autumn Qi to arrive early and Spring Qi late, differing by twenty days. These are known as mountain-adjacent lands; observing orientation reveals the climate. In cold and cool places, interstices open less and close more; frequent closing prevents Yang Qi from dissipating, causing abdominal distension in cold/cool regions. In hot and humid places, interstices open more and close less; frequent opening causes Yang Qi to scatter, leading to skin sores in hot/warm regions. The subsequent text mentions that if Middle Qi is insufficient, distension resolves. Diaphoresis causes Yang Qi to escape externally, resolving sores. Note: Wang Bing's theory divides China into Nine Palaces, further subdividing directions within each palace, distinguishing Yin/Yang and cold/heat, which must be examined. Detailed check: Han Shu River is the Yangtze River. From the river to the South Sea is the Li Palace. From the river to Pingyao County is the Center Palace (now in Fenzhou, Shanxi). From north of Pingyao to the Northern Fan border is the Kan Palace. This describes the North-South division. Kunyuan County is Kunyang County, now in Fengxiang Prefecture, Shaanxi. From Kunyuan west to Shazhou is the Dui Palace. From Kaifeng west to Kunyuan is the Center Palace. From Kaifeng east to the ocean is the Zhen Palace. This describes the East-West division. Understanding the five main palaces allows observation of the four corner energies.)
The Yellow Emperor asked: How does this affect human longevity? (Since the Qi of the land differs, human longevity also varies.)
Qibo replied: People in places where Yin Essence is offered up live long; people in places where Yang Essence descends die young. (In places where Yin Essence is offered up, Yang Qi is solid, so people tend to live long. This refers to elevated areas. In places where Yang Essence descends, Yang Qi leaks easily, so people tend to die young. This refers to depressed areas.)
The Yellow Emperor said: Excellent. If illness occurs, how should it be treated?
Qibo replied: For the Qi of the Northwest, use dispersing and cooling methods; for the Qi of the Southeast, use gathering and warming methods. This is called treating the same disease differently based on location. (Northwest Qi is cold; Wei Qi is consolidated externally, causing Heat to stagnate internally. Thus, it is appropriate to disperse external cold and clear internal heat. Southeast Qi is hot; Wei Qi leaks externally, causing Cold to generate internally. Thus, it is appropriate to consolidate external leakage and warm internal cold. Although the disease may be the same, the treatment differs.) Therefore, it is said: In cold and cool climates, treat with cold and cool remedies, and use herbal foot baths. In warm and hot climates, treat with warm and hot remedies, and strengthen internal retention. One must align with the local Qi to bring the condition to balance; if the presentation is false, reverse the treatment. (In the cold and cool Northwest, people often eat hot foods, leading to abundant internal fire; thus, cold/cool treatments and herbal baths are suitable to disperse external cold. In the warm and hot Southeast, people often eat cool foods, leading to internal cold; thus, warm/hot treatments are suitable, and strengthening internal retention is necessary to prevent Yang Qi leakage and secure the interior. Heavenly and earthly Qi have Yin-Yang ascending/descending dynamics, and disease treatment also involves Yin-Yang dynamics. Aligning medication with climatic suitability brings balance. However, the Northwest may have false heat, and the Southeast may have false cold. False conditions require contrary treatment, meaning the Northwest might need hot medicine, and the Southeast might need cold medicine. Having traveled extensively north and south, I find that hot regions have more heat diseases, and cold regions have more cold diseases, which cannot be ignored. Details on true/false distinctions are found in the fourth chapter of Treatment Theory.)
The Yellow Emperor said: Excellent. Within one province, the generation, transformation, longevity, and shortness of life differ. What is the reason?
Qibo replied: The principle of elevation and depression is determined by terrain. Elevated areas are governed by Yin Qi, and depressed areas are governed by Yang Qi. Those dominated by Yang develop earlier (Xiantian), and those dominated by Yin develop later (Houtian). This is the constant law of geography and the way of generation and transformation. (Within one province, unlike the vastness of the world, there are still differences in generation, transformation, longevity, and shortness due to terrain elevation. High places are governed by ascending Yin Qi; Yin nature is slow, so flora and fauna flourish and wither later. Later development implies slower flourishing and withering, hence longer life. Low places are governed by descending Yang Qi; Yang nature is fast, so things succeed and fail earlier. Early success/failure implies rapid growth and decline, hence shorter life. Sun Simiao stated: For infants aged three to ten, observing their temperament and constitution can predict longevity. Generally, children who are exceptionally smart in early childhood tend to have shorter lives, like Xiang Tuo and Yan Hui. Children whose bone structure matures slowly and whose demeanor is dignified and relaxed, requiring some effort to refine, tend to live long. Those who anticipate others' thoughts and react quickly tend to have shorter lives, like Yang Xiu and Kong Rong. Thus, longevity can be roughly predicted. This is akin to plum blossoms blooming early and missing the harsh winter, while chrysanthemums bloom late and fulfill their natural lifespan. Late completion is a sign of longevity. This illustrates the meaning of Xiantian and Houtian.)
The Yellow Emperor asked: Is there really a difference in longevity there?
Qibo replied: People in high places have longer lifespans, and people in low places have shorter lifespans. This varies by the size of the region; small regions have small differences, and large regions have large differences. (Elevation determines Yin and Yang Qi, which dictates longevity. However, on a large scale like the whole country, differences exist over thousands of li; on a small scale like a province, differences exist over tens of li. Thus, small regions have small variations, and large regions have large variations.)
Therefore, healers must understand the Way of Heaven and Geography, the alternation and dominance of Yin and Yang, the sequence of Qi, human longevity, and the periods of generation and transformation, in order to comprehend human form and Qi. (Not understanding the Way of Heaven means not knowing the changes of Luck. Not understanding Geography means not knowing the suitability of local environments. Not understanding the alternation of Yin and Yang means losing both root and branch. Not understanding the sequence of Qi means reversing urgency and slackness. Not understanding the periods of longevity and transformation means lacking firm insight and acting rashly, inviting blame. All these factors are indispensable. Only then can one, beyond observing form to inspect externals, observe Qi to know internals, ensuring that the path of healing remains comprehensive and safe.)