（怒复伤肝，故当慎之。）又或在下地甲子，乙未失守者，即乙柔干，即上庚独治之，亦名失守者，即天运孤主之，三年
变疠，名曰金疠，（庚辰年在泉，太阴乙未之化也。若乙未不得迁正，而庚辰孤主于上，亦名失守，三年之后，必气变而
为金疠。）其至待时也，详其地数之等差，亦推其微甚，可知迟速尔。（疠之至也，其微甚迟速亦如天数。）诸位乙庚失守
刺法同。（凡乙庚之年上下失守者，刺法皆同前。）肝欲平，即勿怒。（保守肝气，防金胜也。）
假令壬午刚柔失守，（丁壬皆木运也。子午年少阴司天，必阳明在泉，以阳明配合木运，则丁卯丁酉为在泉之化。刚
柔不正，则皆失守矣。）上壬未迁正，下丁独然，即虽阳年，亏及不同，（若上年辛巳司天有余，厥阴不退位，则本年壬
丁不合，木运太虚，刚不正于上，柔孤立于下，虽曰阳年，亏则不同也。）上下失守，相招其有期，瘥之微甚，各有其数
也，（招，合也。得位之日，即其相招之期，微者远，甚者速，数有不同耳。）律吕二角，失而不和，同音有日，（阳律太
角，木音上管，阴吕少角，木音下管，壬丁失守，则二角不和。必上下迁正之日，其音乃同也。）微甚如见，三年大疫。
（微至乙酉，甚在甲申，木疫发也。）当刺脾之俞，（脾俞，在足太阳经。木疫之至，恐伤土脏，当先补之。旧注曰∶用
圆利针，令口中温暖而刺之，即咒曰∶五精智精，六甲玄灵，帝符元首，太始受真。诵之三遍。先想黄气于穴下，然后
刺之二分，得气至而次进之，又得动气次进之，二进各一分，留五呼，即徐徐出针，以手扪之，令其人闭息三遍而咽津
也。）次三日，可刺肝之所出也。（足厥阴经，大敦穴也。木邪之至，故当刺此所出，以泻木气。旧注曰∶用圆利针，令
口中温暖而刺之，即咒曰∶真灵至玄，天道冥然，五神各位，气守三田。诵之，然后可刺入同身寸之三分，留十呼，动
气至而出其针。）刺毕，静神七日，勿大醉歌乐，其气复散，又勿饱食，勿食生物，（皆防其伤脾也。）欲令脾实，气无滞
饱，无久坐，食无太酸，无食一切生物，宜甘宜淡。（畏木侵脾，故宜保之如此。）又或地下甲子，丁酉失守其位，未得
中司，即气不当位，下不与壬奉合者，亦名失守，非名合德，故柔不附刚，即地运不合，三年变疠，（本年丁酉未得迁正
于下，则不能上奉壬午，亦名失守，非合德也。三年之后，必气变而为木疠。）其刺法一如木疫之法。（凡诸丁壬之年，
上下失守，其刺法皆同前。）
假令戊申刚柔失守，（戊癸皆火运之年，寅申岁必少阳司天，厥阴在泉，以厥阴而配火运，刚癸亥为在泉之化。戊申
之刚在上，癸亥之柔在下，一有不正，俱失守矣。戊寅癸巳，其气皆同。）戊癸虽火运，阳年不太过也。（戊癸虽为火运，
若刚柔失守，即在阳年亦非太过也。）上失其刚。柔地独主，其气不正，故有邪干，（若上年丁未司天有余，太阴不退位，
则本年戊申失守于上，癸亥独主于下，火运不正，水必犯之，故有邪干。）迭移其位，差有浅深，欲至将合，音律先同，
（气有微甚，故差有浅深。若刚柔将合，故音律先同。盖戊申阳律，太征也。癸亥阴吕，少征也。其气和，其音叶矣。）
如此天运失时，三年之中，火疫至矣。（戊癸失守，故变火疫，速在庚戌，迟则辛亥当至矣。）当刺肺之俞。（肺俞，在足
太阳经。火疫之至，恐伤金脏，故当先补之。旧注曰∶用圆利针，令口中温暖，先以手按穴，乃刺之，咒曰∶真邪用搏，
气灌元神，帝符反本，位合其亲。诵之三遍。刺之二分，候气欲至，想白气在穴下，次进一分，得气至而徐徐出其针，
以手扪其穴。按∶此下当云次三日，可刺手厥阴之所流。必脱失也。）刺毕，静神七日，勿大悲伤也，悲伤即肺动，而真
气复散也，（用针补肺，故忌其伤。）人欲实肺者，要在息气也。（肺主气，息气乃可以补肺，即闭气存神之道。义见前。）
又或地下甲子，癸亥失守者，即柔失守位也，即上失其刚也，即亦名戊癸不相合德者也，即运与地虚，后三年变疠，名
曰火疠。（又若癸亥在泉不得迁正，下柔失位，上刚无合，戊虽阳火，亦失守矣，后之三年，发而为病，名曰火疠。）
是故立地五年，以明失守，以穷法刺，于是疫之与疠，即是上下刚柔之名也，穷归一体也，即刺疫法只有五法，即
总其诸位失守，故只归五行而统之也。（上文五年，言天即地在其中矣。虽疫自天来，疠从地至，若乎有辨；然不过上下
刚柔之分耳，其穷归于病，则一体也，故其刺法，亦惟此五者而已。此章以甲丙戊庚壬五阳年为例，阳刚失守，则阴柔
可知，故可以五行为言而统之也。此下有辟疗五疫法，见论治类二十。）
（愤怒再次损伤肝脏，因此应当谨慎对待。）又如果在地下甲子纪年中，乙未年失守，即乙为柔干，那么上位的庚金就会独自主事，这也称为失守，意味着天运孤立无援，三年后会变成疠气，称为金疠。（庚辰年在泉，是太阴乙未的化气。如果乙未年不能迁正，而庚辰年孤立于上位，也称为失守，三年之后，必然气化改变成为金疠。）疠气到来的时间有待观察，需详细考察地支数量的等差，也要推究其程度的轻重，从而可知其到来的迟速。（疠气到来时，其轻重的程度和迟速也如同天数规律一样。）各部位乙庚失守的刺法相同。（凡是乙庚之年上下失守的，刺法都同前文所述。）肝气喜好平和，所以不要发怒。（以此保养肝气，防止金气过胜。）
假如壬午年刚柔失守，（丁壬都是木运。子午年少阴君火司天，必定阳明燥金在泉，以阳明配合木运，则丁卯、丁酉年为在泉的化气。刚柔不正，就都失守了。）上位的壬水未能迁正，下位的丁火独自存在，即虽然是阳年，亏损的情况却不同，（如果上年辛巳司天有余，厥阴风木不退位，则本年壬丁不合，木运太虚，刚不在上位端正，柔在下位孤立，虽然说是阳年，但亏损的情形是不同的。）上下失守，相互招引是有期限的，病情的轻重，各有其定数。（招，即合。得位之日，就是它们相合的时期，病情轻的远，重的近，定数有所不同耳。）律吕二角音，失守而不和谐，等到相应的时候，声音就会相同，（阳律太角，是木音的上管；阴吕少角，是木音的下管。壬丁失守，则二角不和。必须等到上下迁正之日，其音才会相同。）轻重的表现如所见，三年后发生大疫。（轻的到乙酉年，重的在甲申年，这是木疫发作。）应当针刺脾俞穴，（脾俞穴，位于足太阳膀胱经。木疫到来，恐怕伤害土脏，应当先补益它。旧注说：用圆利针，让口中温暖然后刺入，随即念咒曰：五精智精，六甲玄灵，帝符元首，太始受真。诵读三遍。先在穴位下方想象黄气，然后刺入二分，得气后继续进针，再得动气后继续进针，每次进一分，留针五个呼吸时间，然后慢慢出针，用手按住穴位，让病人闭气三次并吞咽津液。）三天后，可以针刺肝经的井穴（所出穴）。（足厥阴肝经的大敦穴。木邪到来，所以应当刺这个所出穴，以泻除木气。旧注说：用圆利针，让口中温暖然后刺入，随即念咒曰：真灵至玄，天道冥然，五神各位，气守三田。诵读后，然后可刺入同身寸三分，留针十个呼吸时间，动气至而出针。）针刺完毕，静心调养七天，不要大醉唱歌娱乐，否则气会重新散乱，也不要饱食，不要吃生冷食物，（这都是为了防止伤害脾脏。）想要使脾实，气息不要滞塞饱胀，不要久坐，饮食不要太酸，不要吃一切生冷生物，适宜吃甘淡的食物。（畏惧木气侵犯脾脏，所以应当这样保护它。）又或者在地下甲子中，丁酉年失守其位，未能得到中司之气，即气不处于正确位置，下位不与壬水奉合，也称为失守，不叫合德，所以柔不依附刚，即地运不合，三年后变成疠气，（本年丁酉未能迁正在下位，则不能上奉壬午，也称为失守，不是合德。三年之后，必然气化改变成为木疠。）其刺法完全像木疫的方法。（凡是丁壬之年，上下失守，其刺法都同前文所述。）
假如戊申年刚柔失守，（戊癸都是火运之年，寅申岁必定少阳相火司天，厥阴风木在泉，以厥阴配合火运，刚癸亥为在泉的化气。戊申年的刚在上，癸亥年的柔在下，只要有一个不正，都失守了。戊寅、癸巳年，其气都是一样的。）戊癸虽然是火运，但如果是阳年并不算是太过。（戊癸虽为火运，如果刚柔失守，即使在阳年也不是太过。）上位失去了刚，下位柔地独自主事，其气不正，所以有邪气干扰，（如果上年丁未司天有余，太阴湿土不退位，则本年戊申失守于上位，癸亥独自主事于下位，火运不正，水气必定侵犯它，所以有邪气干扰。）位置交替移动，差错有浅深之分，将要相合之时，音律先相同，（气有轻重，所以差错有浅深。如果刚柔将要相合，所以音律先相同。盖戊申为阳律，太徵；癸亥为阴吕，少徵。其气和顺，其音协调了。）如此天运失去时机，三年之中，火疫就会到来。（戊癸失守，所以变为火疫，快的在庚戌年，慢的则在辛亥年应当到来。）应当针刺肺俞穴。（肺俞穴，位于足太阳膀胱经。火疫到来，恐怕伤害金脏，所以应当先补益它。旧注说：用圆利针，让口中温暖，先用手按压穴位，然后刺入，念咒曰：真邪用搏，气灌元神，帝符反本，位合其亲。诵读三遍。刺入二分，候气欲至，想象白气在穴位下方，再进一分，得气后慢慢出针，用手按住穴位。按：此处下面应当说三天后，可刺手厥阴心包经的荥穴。必定是脱漏了。）针刺完毕，静心调养七天，不要过度悲伤，悲伤就会触动肺脏，真气重新散乱，（因为用针补肺，所以忌讳伤悲。）人想要充实肺气，关键在于调息。（肺主气，调息才可以补肺，即闭气存神的道理。意义见前文。）又或者在地下甲子中，癸亥年失守，即柔失守了位置，即上位失去了刚，也叫做戊癸不相合德，即运与地皆虚，后三年变生疠气，称为火疠。（又如果癸亥在泉未能迁正，下位柔失位，上位刚无合，戊虽然是阳火，也失守了，之后的三年，发作成为疾病，称为火疠。）
因此确立地下五年，来阐明失守的道理，穷尽刺法的原理，于是疫与疠，就是上下刚柔的名称，最终归结为同一类，即刺治疫病的方法只有五种，即总括诸位失守的情况，所以只归五行来统辖。（上文说的五年，指天就在其中了。虽然疫自天来，疠从地至，似乎有区别；然而不过是上下刚柔的区分罢了，其最终归于病证，则是同一类，所以其刺法，也只有这五种而已。此章以甲、丙、戊、庚、壬五个阳年为例，阳刚失守，则阴柔可知，所以可以用五行而言并统辖之。此下有辟除五疫的方法，见论治类第二十。）
(If anger again injures the Liver, one must be cautious.) Furthermore, if in the Earthly Jiazi cycle, the Yi-Wei year is lost (Shi Shou), meaning Yi as the Yin (Rou) stem, then the Heaven's Geng metal will dominate alone. This is also called "loss of position" (Shi Shou), indicating that the Heavenly Qi operates in isolation. After three years, it transforms into a pestilence named Metal Pestilence (Jin Li). (In the Geng-Chen year, the Qi descends to the Earthly Branch (Zai Quan), corresponding to the transformation of Taiyin Yi-Wei. If Yi-Wei cannot assume its proper position, and Geng-Chen dominates alone above, it is also termed loss of position. Three years later, the Qi will inevitably change into Metal Pestilence.) The arrival of the pestilence awaits its time; one must carefully examine the numerical differences of the Earthly branches and deduce the severity to know whether it arrives early or late. (When the pestilence arrives, its severity and timing follow the laws of Heaven similarly.) For all cases where Yi and Geng are lost at various positions, the acupuncture method is the same. (For all Yi-Geng years with loss of position above and below, the acupuncture methods are identical to those described previously.) The Liver desires balance; therefore, do not become angry. (This preserves Liver Qi and prevents excessive Metal influence.)
Suppose Ren-Wu experiences loss of Yang (Gang) and Yin (Rou). (Ding and Ren both govern Wood Qi. In Zi-Wu years, Shaoyin (Ministerial Fire) governs from Heaven, implying Yangming (Metal) governs from Earth. With Yangming combining with Wood Qi, Ding-Mao and Ding-You represent the Earthly transformations. If Yang and Rou are improper, both are lost.) If the upper Ren does not assume its position, and the lower Ding stands alone, even though it is a Yang year, the deficiency differs. (If the previous year Xin-Si had excess Tian Qi, and Jueyin did not withdraw, then this year's Ren-Ding combination fails. Wood Qi becomes too deficient; Yang is not upright above, and Rou stands isolated below. Although called a Yang year, the nature of the deficiency is different.) When upper and lower positions are lost, their convergence has a set time; the severity of the disease varies according to specific numbers. ("Zhao" means convergence. The day they assume their positions is the time of convergence. Mild cases arrive later, severe cases sooner; the numbers differ.) The Lv-Lu (Pitch Pipes) Jiao tones lose harmony; there will come a day when the tones match. (Yang Lu Tai-Jiao is the upper pipe for Wood tone; Yin Lv Shao-Jiao is the lower pipe for Wood tone. Ren-Ding loss causes disharmony between the two Jiao tones. Only on the days they assume their positions will the tones align.) Depending on severity, a great epidemic occurs after three years. (Mild cases manifest by Yi-You; severe cases by Jia-Shen; this is the onset of Wood Epidemic.) One should puncture the Shu-stream point of the Spleen. (Spleen Shu is located on the Foot-Taiyang Bladder Meridian. Upon the arrival of Wood Epidemic, fear of injury to the Earth organ arises; thus, tonify it first. Old commentary states: Use a Yuanli needle, warm the mouth, then puncture while chanting: "Wu Jing Zhi Jing, Liu Jia Xuan Ling, Di Fu Yuan Shou, Tai Shi Shou Zhen." Recite three times. Visualize Yellow Qi beneath the acupoint, then insert 2 cun. Upon obtaining Deqi, advance further until Dongqi is felt, advancing another 1 cun each time. Retain for five breaths, then slowly withdraw the needle, covering the point with the hand, instructing the patient to hold their breath three times and swallow saliva.) Three days later, one may puncture the Jing-well point (point of origin) of the Liver. (The Dadun point of the Foot-Jueyin Liver Meridian. As Wood pathogen arrives, this origin point should be punctured to drain Wood Qi. Old commentary states: Use a Yuanli needle, warm the mouth, then puncture while chanting: "Zhen Ling Zhi Xuan, Tian Dao Ming Ran, Wu Shen Ge Wei, Qi Shou San Tian." Recite, then insert 3 cun (same body inch), retain for ten breaths, and withdraw upon feeling Dongqi.) After needling, calm the spirit for seven days. Avoid heavy intoxication, singing, or music, lest Qi scatter again. Avoid overeating or consuming raw/cold foods. (All these precautions prevent Spleen injury.) To strengthen the Spleen, avoid Qi stagnation and fullness, avoid prolonged sitting, avoid overly sour foods, and avoid all raw/cold biological matter. Prefer sweet and bland flavors. (Fearing Wood invasion of the Spleen, protection is necessary in this manner.)
Alternatively, in the Earthly Jiazi cycle, if Ding-You loses its position and fails to receive the Central Authority, the Qi is misplaced, and the lower does not combine with Ren. This is also called loss of position, not "combined virtue" (He De). Thus, Yin does not attach to Yang, Earthly Qi is discordant, and after three years, it transforms into a pestilence. (If Ding-You fails to assume position below, it cannot serve Ren-Wu above. This is loss of position, not combined virtue. Three years later, Qi changes into Wood Pestilence.) The acupuncture method is exactly like that for Wood Epidemic. (For all Ding-Ren years with loss of position above and below, the methods are identical to those described previously.)
Suppose Wu-Shen experiences loss of Yang and Yin. (Wu and Gui both govern Fire Qi. In Yin-Shen years, Shaoyang (Ministerial Fire) governs from Heaven, and Jueyin governs from Earth. With Jueyin combining with Fire Qi, the rigid Gui-Hai represents the Earthly transformation. Wu-Shen's Yang is above, Gui-Hai's Yin is below; if either is improper, both are lost. Wu-Yin and Gui-Si share the same Qi.) Although Wu and Gui govern Fire, if it is a Yang year, it is not necessarily an excess condition. (Although Wu-Gui govern Fire, if Yang and Rou are lost, even in a Yang year, it is not excessive.) If the upper loses its Yang, the lower Yin dominates alone, making the Qi improper, allowing evil to interfere. (If the previous year Ding-Wei had excess Tian Qi, and Taiyin did not withdraw, then Wu-Shen is lost above, and Gui-Hai dominates alone below. Fire Qi is improper, so Water attacks it, causing evil interference.) Positions shift alternately, with errors varying in depth. When they are about to converge, the pitch pipes sound alike first. (Qi varies in severity, hence errors vary in depth. When Yang and Rou are about to converge, the pitch pipes synchronize. Wu-Shen corresponds to Yang Lu Tai-Zheng; Gui-Hai to Yin Lv Shao-Zheng. Their Qi harmonizes, and their tones match.) Thus, if Heavenly Qi loses its timing, a Fire Epidemic will occur within three years. (Wu-Gui loss leads to Fire Epidemic; fast onset in Geng-Xu, slow onset in Xin-Hai.) One should puncture the Shu-stream point of the Lung. (Lung Shu is on the Foot-Taiyang Bladder Meridian. Upon Fire Epidemic, fear of injury to the Metal organ arises; thus, tonify it first. Old commentary states: Use a Yuanli needle, warm the mouth, press the point with the hand, then puncture while chanting: "Zhen Xie Yong Bo, Qi Guan Yuan Shen, Di Fu Fan Ben, Wei He Qi Qin." Recite three times. Insert 2 cun. Wait for Qi arrival, visualize White Qi beneath the point, advance 1 cun, obtain Deqi, and slowly withdraw the needle, covering the point with the hand. Note: The text below likely omitted: "Three days later, puncture the Ying-Spring point of the Hand-Jueyin Pericardium Meridian.") After needling, calm the spirit for seven days. Do not grieve excessively, as grief moves the Lung and scatters True Qi. (Since needles tonify the Lung, grief is contraindicated.) To solidify Lung Qi, one must regulate breathing. (The Lung governs Qi; regulating breath tonifies the Lung, which is the method of holding breath and preserving spirit. Meaning seen previously.)
Alternatively, in the Earthly Jiazi cycle, if Gui-Hai is lost, it means Yin has lost its position, the upper has lost its Yang, and it is named "Wu-Gui failing to combine virtue." With Qi and Earth both deficient, after three years, it transforms into a pestilence named Fire Pestilence. (If Gui-Hai in the Earthly branch fails to assume position, the lower Yin loses its place, and the upper Yang has no partner. Although Wu is Yang Fire, it is also lost. Three years later, it manifests as disease, named Fire Pestilence.)
Therefore, establishing the five-year Earthly cycle clarifies loss of position and exhausts the principles of acupuncture. Thus, Yi (Epidemic) and Li (Pestilence) are merely names for the upper/lower Yang/Yin imbalance, ultimately returning to a single entity. The acupuncture methods for epidemics consist only of five techniques, summarizing all positional losses under the Five Elements. (The "five years" mentioned above implies Heaven is included within Earth. Although Yi comes from Heaven and Li from Earth, seemingly distinct, they are merely divisions of upper/lower Yang/Yin. Ultimately returning to pathology, they are one entity; thus, acupuncture methods are limited to these five. This chapter uses the five Yang years—Jia, Bing, Wu, Geng, Ren—as examples. If Yang/Gang is lost, Yin/Rou can be inferred; thus, they can be unified under the Five Elements. Below, there are methods for averting the Five Epidemics, found in Category XX of Treatment Theory.)