也。”)岐伯曰∶后皆三十度而有奇也。(……“后者,自始及终也。度,日
也。三十度而有奇,一月之数也。奇,谓四十三刻七分半也。盖气有先至后至之差,不过三十度耳。即如气盈
朔虚节序置闰之法,早至者先十五日有奇,迟至者后十五日有奇,或前或后,总不出一月有奇之数,正此义也。”
按∶此段问答,详味语气,是单论先后之差,未曾说到所以先后处。景岳谓气有盛衰,则至有先后,误矣。下
文方是论所以先后。)
帝曰∶善!气有非时而化者何也?岐伯曰∶太过者当其时,不及者归其己胜也,(……按∶己胜,谓已被胜
也。己气不及,则力弱而权归于胜己者,故非其时而有其气,如注云春凉夏寒秋热冬雨之类是也。)
帝曰∶愿闻其行何谓也?(按∶谓气化营运之次序也。)岐伯曰∶春气西行,夏气北行,秋气东行,冬气南
行。(按∶春主东,而其气常由东而西;秋主西,而其气常由西而东∶夏主南,而其气常由南而北;冬主北,而
其气常由北而南也。)故春气始于下,秋气始于上,夏气始于中,冬气始于标。(按∶春主发散,而其气则本
于秋冬之收藏,故云始于下。秋主收敛,而其气则本于春夏之长养,故云始于上。夏主长茂,而其气则本于中
土之敦培,故云始于中。冬主归藏,而其气则本于岁半以前之所生所长所收而成,故云始于标。盖言气各有所
自起也。)春气始于左,秋气始于右,冬气始于后,夏气始于前,此四时正化之常。(按∶左,东也;右,西
也;后,北也;前,南也。言四气之正位也。)故至高之地,冬气常在,至下之地,春气常在。(按∶注云∶
“高山之巅,盛夏冰雪,污下川泽,严冬草生,常在之义足明矣。”又五常政大论云∶“地有高下,气有温凉,
高者气寒,下者气热。”皆言气各有所互藏也。)必谨察之。帝曰∶善!黄帝曰∶五运六气之应见,六化之正,
六变之纪,何如?岐伯对曰∶夫六气正纪,有化有变,有胜有复,有用有病,不同其候,帝欲何
问乎?帝曰∶愿尽闻之。岐伯曰∶请遂言之。夫气之所至也,厥阴所至为和平,(初之气,木之化。)少阴所至
为暄,(二之气,君火也。)太阴所至为埃溽,(四之气,土之化。)少阳所至为炎暑,(三之气,相火也。)阳
明所至为清劲,(五之气,金之化。)太阳所至为寒 ,(终之气,水之化。)时化之常也。(“三阴三阳之
次,厥阴,一阴也;少阴,二阴也;太阴,三阴也。少阳,一阳也;阳明,二阳也;太阳,三阳也。皆因次为
序,下文十二化皆然,此客气之常也。”按∶时化者,随时变化,乃客气也,非四时之正化。注作主气,误矣。)
厥阴所至为风府,为璺启;(“微裂未破曰璺,开拆曰启,皆风化之所致。”按∶府,犹藏也,会聚也。璺音
问。)少阴所至为大火府,为舒荣;(按∶少阴,君火也,故云大火府。物得阳气,气渐舒而色渐荣。)太阴
所至为雨府,为员盈;(“太阴化湿,故为雨府。物得土气而后充盈,故为员盈。员,周也。”)少阳所至为
热府,为行出;(按∶少阳相火,相火为用,其热更甚,故曰热府。阳盛之极,气尽外达,故又曰行出也。)
阳明所至为司杀府,为庚苍;(“庚,更也。苍,木化也。物得发生之化者,遇金气而更易也。”按∶
金主肃杀,故为司杀府。)太阳所至为寒府,为归藏。(按∶寒盛之时,万物收敛而归藏。)司化之常也。(按
司,主也。六气之化,各有专主,乃有六府之名也。)
厥阴所至为生,为风摇;(“木气升,故主生。风性动,故为摇。”)少阴所至为荣,为形见;(按∶阳
气渐盛,万物荣美而庶类之形毕见也。)太阴所至为化,为云雨;(“土能化生万物,云雨其气也。”)少阳所
至为长,为蕃鲜;(按∶阳气盛长,万物蕃茂而鲜妍。)阳明所至为收,为雾露;(按∶秋时收敛,故气凝结
而为雾露也。)太阳所至为藏,为周密。(按∶藏者,敛之深。周密者,
藏之固也。)气化之常也。(按∶有气则有化,六者之常也。)
厥阴所至为风生,终为肃;(按∶六微旨大论曰∶“风位之下,金气承之。”故厥阴风生而终为整肃是也。)
少阴所至为热生,中为寒;(“六微旨大论曰∶‘少阴之上,热气治之,中见太阳。’故少阴热生而终为寒也。
又云∶‘君火之下,阴精承之。’亦为寒之义。”)太阴所至为湿生,终为注雨;(“土位之下,风气承之,
故太阴湿生而终为注雨,即飘骤之谓。”)少阳所至为火生,终为蒸溽;(“相火之下,水气承之,故少阳火
生而终为蒸溽也。”)阳明所至为燥生,终为凉;(“此燥凉二字,当互更之。盖金位之下,火气承之,故阳
明凉生而终为燥也。”)太阳所至为寒生,中为温。(“太阳之上,寒气治之,中见少阴,故太阳寒生而中为
温也。”按∶上文六化厥阴太阴少阳阳明俱言终,惟少阴太阳言中者,何也?盖六气之道,阴阳而已;阴阳征
兆,水火而已。少阴者,君火也;太阳者,寒水也。阳胜则阴复,故少阴所至为热生,中为寒,此离象之外阳
内阴也。阴胜则阳复,故太阳所至为寒生,中为温,此坎象之外阴内阳也。故惟此二气言中者,乃阴阳互藏之
妙;其他言终者,则皆下承之义耳。)德化之常也。(按∶正化之下,承者继之,虽六气相制之自然,而实则
天地相生之德也。)
厥阴所至为毛化,(按,毛属木化。)少阴所至为羽化,(有羽翼飞行之类也。按∶羽属火化。)太阴所
至为 化,(无毛羽鳞甲之类也。按∶ 属土化。)少阳所至为羽化,(薄明羽翼蜂蝉之类,非翎羽之羽也。)
阳明所至为介化,(按∶甲属金化。)太阳所至为鳞化,(按∶鳞属水化。)德化之常也。(按∶动物之生,禀
之以化,六气之德也。)
厥阴所至为生化,(按,万物之生,木所化也。)少阴所至为荣化,(按∶万物荣美,火所化也。)太阴
所至为濡化,(按∶濡
润万物,湿土所化。)少阳所至为茂化,(按∶万物畅茂,相火之化。)阳明所至为坚化,(按∶物敛而坚,
金燥所化。)太阳所至为藏化,(按∶万物收藏,寒水之化。)布政之常也,(“气布则物从其化,故谓之政。”)
厥阴所至为飘怒,大凉;(“飘怒,木亢之变;大凉,金之承制也。”)少阴所至为大暄,寒;(“大暄,
火亢之变;寒,阴精之承制也。”)太阴所至为雷霆骤注,烈风,(“雷霆骤注,土亢之变;烈风,木之承
制也。”)少阳所至为瓢风燔燎,霜凝;(“飘风燔燎,热亢之变;霜凝,水之承制之。”)阳明所至为散落,
温;(“散落,金亢之变;温,火之承制也。”)太阳所至为寒雪冰雹,白埃;(“寒雪冰雹,水亢之变;白
埃,土之承制也。”)气变之常也。(“变者,变乎常也。六气亢极,则承者制之,因胜而复,皆非和平正气,
故谓之变。”)
厥阴所至为挠动,为迎随;(“挠动,风之性。迎随,木之性。”)少阴所至为高明焰,为曛;(按∶焰者,
火之光。高明焰者,火炽盛而其光四达也。)太阴所至为沉阴,为白埃,为晦暝,(按∶埃,尘也。白埃者,
土飞扬而色白也。晦暝者,尘埃蔽日而昏昧,皆土气之所化也。)少阳所至为光显,为彤云,为曛;(“光显,虹电
火光之属也。彤云,赤云也。”按∶曛者,火热之气,少阴少阳俱火,故并言曛也。彤音同。)阳明所至为烟
埃,为霜,为劲切,为凄鸣;(按∶烟埃者,秋寒气肃,如烟之袅空,如埃之蔽日也。)太阳所至为刚固,
为坚芒,为立。(按∶此皆冬寒水冱之象也。)令行之常也。(“气行而物无敢违,故谓之令。”)
厥阴所至为里急,(按∶木主肝,病则气抑郁而里急。)少阴所主为疡胗身热,(按∶疡,疮属。胗,
类。是皆君火外达于肌肤而然也。)太阴所至为积饮痞隔,(湿土用事,则脾多湿
滞,故为积饮痞隔。)少阳所至为嚏呕,为疮疡,(按∶相火上炎,故为嚏呕。热留肌肉,故为疮疡。)阳明
所至为浮虚,(“阳明用事而浮虚,皮毛为金之合也。”)太阳所至为屈伸不利,(按∶寒水用事则病在肾,
肾主骨,故令屈伸不利。)病之常也。
厥阴所至为支痛;(按∶支,胁也。厥阴主肝而部在两胁,故病则胁支痛。)少阴所至为惊惑,恶寒战栗,
谵妄;(“少阴主心,故为惊惑。热极反兼寒化,故恶寒战栗。阳亢伤阴,心神迷乱,故谵妄。”)太阴所至
为满;(“太阴主脾,病在中焦,故 满。 音蓄。”)少阳所至为惊躁,瞀昧,暴病;(按∶少阳相火,属
三焦而以火为用,故病则惊躁。火外阳而内阴,故瞀昧。相火急疾,故为暴病。景岳以为主胆,盖误以手少阳
为足少阳也。夫足少阳胆本属木,安得谓之相火。)阳明所至为鼽,尻阴股膝髀 足病;(按∶阳明燥金,主
大肠而合于肺,肺开窍于鼻,肺感寒则鼻鼽。鼽,鼻塞也。尻阴股足等,肾之病也。大肠之经而见肾病,义未
通。景岳又以阳明为主胃,误矣。盖胃者,土也,足阳明也。六气之阳明,乃手阳明大肠经,大肠属庚主金,
故谓之燥金也。)太阳所至为腰痛。(“太阳膀胱之脉,挟脊抵腰中,故为腰痛。”)病之常也。
厥阴所至为 戾;(按∶风木为病,则筋 缩而乖戾。戾,不柔也。 音软。)少阴所至为悲妄,衄 ;
(“火病于心而并于肺,故为悲妄。火逼血而妄行,故鼻血为衄,污血为 。 音灭。”)太阴所至为中满,
霍乱,吐下;(按∶此土湿伤脾而及胃也。)少阳所至为喉痹,耳鸣,呕涌;(“相火上炎也。”)阳明所至为
胁痛皴揭;(“燥金用事,则肝木受伤,故胁痛。皮肤甲错而起,为皴揭,皆燥病也。皴,取钧切。”)太阳
所至为寝汗,痉。(“寒水用事,故为寝汗,脉要精微论曰阴气有余为多汗身寒者是也。肢体强直、筋急反戾
曰痉,阴寒凝滞而阳气不行也。痉音敬。”)病之常也。
厥阴所至为胁痛呕泄,(“木为自病,故胁痛。肝乘脾胃,故呕泄。”)少阴所至为语笑,(按∶少阴主
心与火,火盛则心不能静,故多言而善笑也。)太阴所至为重, 肿;(按∶土过于湿则身重,肢体浮肿名曰
肿也。)少阳所至为暴注, 螈,暴死;(“相火乘金,大肠受之,则为暴注而下。乘脾,则肌肉 动。
乘肝,则肢体筋脉抽螈。相火急暴,故为暴死。”)阳明所至为鼽嚏;(“金气寒肃而敛,故为鼽为嚏。”)
太阳所至为流泄禁止。(按∶流泄兼津液便溺言,阴寒气闭,则津液收敛,汗不达空,二便难通,故曰流泄禁
止也。)病之常也。
凡此十二变者,报德以德,报化以化,报政以政,报令以令,气高则高,气下则下,气后则后,气前则前,
气中则中,气外则外,位之常也。(气报德报化,谓天地气也。高下前后中外,谓生病所也。手之阴阳其气高,
足之阴阳其气下,足太阳气在身后,足阳明气在身前,足太阴少阴厥阴气在身中,足少阳气在身侧,各随所在
言之,气变生病象也。按∶此总结上文胜复为病之次,言各因其气之所至而为报也。王注论手足阴阳部位,自
是不易。但本篇所言,专指六气。六气之内,少阳相火,乃是手少阳三焦,非足少阳胆;阳明燥金,乃是手阳
明大肠,非足阳明胃。盖胃属土,非属金;胆属木,非属火也。吾乡张景岳、马玄HT 及诸名公,并仍王氏之误。
岂知相火燥金居六气之二,名义既乖,施治必谬,可不辨乎。然则三焦大肠之位应在何所?曰∶大肠主传道变化,
亦当如足三阴之气,行于身中。三焦包括一身,总统脏腑,理应属身之外。王注泛论脏腑之位则可,若为本篇
此节之注则非也。)
故风胜则动,(按∶风善行而数变,以动为性,故风胜则动也。又按以下六句,已见于阴阳应象大论,而
此篇亦载之者,以此篇正专论六气,谓六气偏胜,则病应于外也。)热胜则肿,(“疮疡痈肿,火之病也。”)燥胜则干,(“精
血津液枯竭于内,皮肤肌肉皴揭于外,皆燥之病也。”)寒胜则浮,(“腹满身浮,阳不足而寒为病也。”湿胜则濡泄,甚则
水闭 肿,“濡泄,水利也。水闭 肿,水道不利而肌肉肿胀,按之如泥不起者是也。”)随气所在以言其变耳。(“气有
高下前后中外之异,人之为病,其气亦然。故气胜于高,则病在头顶,气胜于下,则病在足膝;气胜于前,则病在面腹
手臂;气胜于后,则病在肩背腰臀;气胜于中,则病在脏腑筋骨;气胜于外,则病在经络皮毛。而凡风胜则动、热胜则
肿、燥胜则干、寒胜则浮、湿胜则濡泄 肿之类,无不随气所在而为病变也。”)
帝曰∶愿闻其用也。(“此言施化之用也。”)岐伯曰∶夫六气之用,各归不胜而为化。(“各归不胜,
谓必从可克者而施其化也。”)故太阴雨化,施于太阳;太阳寒化,施于少阴;少阴热化,施于阳明;阳明燥
也。”)岐伯说:此后都经过三十个日度还有余数。(……“后,指从开始到结束。度,指日行度数。三十度有余,是一个月的数量。余数,指四十三刻七分半。大概气有先到和晚到的差异,不超过三十度罢了。就像气盈、朔虚、节气序置闰的方法,早到的先十五天有余,晚到的后十五天有余,或前或后,总不出一个月有余的数量,正是这个意思。”)按:这段问答,仔细品味语气,是专门论述先后的差异,没有说到之所以先后的原因。张景岳认为气有盛衰,所以至有先后,这是错误的。下文才是论述之所以先后的原因。)
黄帝说:好!气在非正常时节发生变化的原因是什么?岐伯说:太过的气在当令的时节出现,不及的气则归属于被它克制的一方(即胜己者),(……按:己胜,指已被克制的状态。己气不及,则力量弱小,权力归于胜己者,所以在非其时而有其气,如春天凉、夏天寒、秋天热、冬天雨之类就是这种情况。)
黄帝说:愿意听您讲讲气化运行的次序是什么意思?(按:指气化营运的次序。)岐伯说:春气向西运行,夏气向北运行,秋气向东运行,冬气向南运行。(按:春主东方,但其气常由东向西;秋主西方,但其气常由西向东;夏主南方,但其气常由南向北;冬主北方,但其气常由北向南。)所以春气始于下,秋气始于上,夏气始于中,冬气始于标。(按:春主发散,但其气本源于秋冬的收藏,所以说始于下。秋主收敛,但其气本源于春夏的生长养育,所以说始于上。夏主长茂,但其气本源于中土的敦培,所以说始于中。冬主归藏,但其气本源于岁半以前所生、所长、所收而成的结果,所以说始于标。意思是说气各自有所起始的地方。)春气始于左,秋气始于右,冬气始于后,夏气始于前,这是四时正化的常态。(按:左,指东方;右,指西方;后,指北方;前,指南方。说的是四气的正位。)所以在极高的地方,冬气常在;在极低的地方,春气常在。(按:注解说:“高山之巅,盛夏仍有冰雪;低洼川泽,严冬草木生长,‘常在’的意思就很明白了。”又《五常政大论》说:“地有高下,气有温凉,高处气寒,低处气热。”都是说气各有互藏的道理。)一定要仔细考察。黄帝说:好!黄帝问:五运六气的相应显现,六化的正纪,六变的纲纪,是怎样的?岐伯回答说:六气正纪,有化有变,有胜有复,有用有病,表现不同,陛下想问什么呢?黄帝说:愿意全部听您讲。岐伯说:请允许我接着讲。气所至的情况,厥阴所至表现为和平,(初之气,木的化气。)少阴所至表现为温暖,(二之气,君火。)太阴所至表现为尘湿,(四之气,土的化气。)少阳所至表现为炎热暑气,(三之气,相火。)阳明所至表现为清凉劲急,(五之气,金的化气。)太阳所至表现为寒冷凝滞,(终之气,水的化气。)这是随时变化的常态。(“三阴三阳的顺序,厥阴是一阴;少阴是二阴;太阴是三阴。少阳是一阳;阳明是二阳;太阳是三阳。都依顺序排列,下文十二化都是这样,这是客气之常。”按:时化,指随时间变化,乃是客气,不是四时的正化。注解说作主气,是错误的。)
厥阴所至表现为风府,表现为裂缝开启;(“微裂未破叫璺,开拆叫启,都是风化所致。”按:府,犹言藏,会聚。璺音问。)少阴所至表现为大火府,表现为舒展繁荣;(按:少阴,是君火,所以叫大火府。万物得到阳气,气逐渐舒展而颜色逐渐繁荣。)太阴所至表现为雨府,表现为圆满充盈;(“太阴化湿,所以为雨府。万物得到土气后才充盈,所以为员盈。员,通周。”)少阳所至表现为热府,表现为外达流行;(按:少阳相火,相火为用,其热更甚,所以叫热府。阳盛之极,气完全外达,所以又叫行出。)阳明所至表现为司杀府,表现为庚苍;(“庚,更替。苍,木的化气。万物得到发生之化,遇到金气而更易。”按:金主肃杀,所以为司杀府。)太阳所至表现为寒府,表现为归藏。(按:寒盛之时,万物收敛而归藏。)这是司化的常态。(按司,主也。六气的化,各有专主,所以有六府之名。)
厥阴所至表现为生,表现为风摇;(“木气升,所以主生。风性动,所以为摇。”)少阴所至表现为荣,表现为形见;(按:阳气渐盛,万物荣美而各类形态毕现。)太阴所至表现为化,表现为云雨;(“土能化生万物,云雨是其气。”)少阳所至表现为长,表现为蕃鲜;(按:阳气盛长,万物繁茂而鲜妍。)阳明所至表现为收,表现为雾露;(按:秋时收敛,所以气凝结而为雾露。)太阳所至表现为藏,表现为周密。(按:藏,是敛之深。周密,是藏之固。)这是气化的常态。(按:有气则有化,这是六者的常态。)
厥阴所至表现为风生,最终表现为肃;(按:《六微旨大论》说:“风位之下,金气承之。”所以厥阴风生而最终为整肃。)少阴所至表现为热生,中间表现为寒;(“《六微旨大论》说:‘少阴之上,热气治之,中见太阳。’所以少阴热生而最终为寒。又说:‘君火之下,阴精承之。’也是寒的意思。”)太阴所至表现为湿生,最终表现为注雨;(“土位之下,风气承之,所以太阴湿生而最终为注雨,即飘骤的意思。”)少阳所至表现为火生,最终表现为蒸溽;(“相火之下,水气承之,所以少阳火生而最终为蒸溽。”)阳明所至表现为燥生,最终表现为凉;(“这燥凉二字,应当互换。因为金位之下,火气承之,所以阳明凉生而最终为燥。”)太阳所至表现为寒生,中间表现为温。(“太阳之上,寒气治之,中见少阴,所以太阳寒生而中间为温。”按:上文六化中厥阴、太阴、少阳、阳明都说终,只有少阴、太阳说中,为什么呢?大概六气的道理,不过是阴阳而已;阴阳的征兆,不过是水火而已。少阴,是君火;太阳,是寒水。阳胜则阴复,所以少阴所至为热生,中间为寒,这是离卦之外阳内阴之象。阴胜则阳复,所以太阳所至为寒生,中间为温,这是坎卦之外阴内阳之象。所以只有这两气说中,乃是阴阳互藏的奥妙;其他说终的,则是下承的意思罢了。)这是德化的常态。(按:正化之下,承者继之,虽然是六气相制的自然规律,但实则是天地相生之德。)
厥阴所至表现为毛化,(按,毛属木化。)少阴所至表现为羽化,(有羽翼飞行之类。按:羽属火化。)太阴所至表现为倮化,(无毛羽鳞甲之类。按:倮属土化。)少阳所至表现为羽化,(薄明羽翼蜂蝉之类,不是翎羽的羽。)阳明所至表现为介化,(按:甲属金化。)太阳所至表现为鳞化,(按:鳞属水化。)这是德化的常态。(按:动物的生成,禀受六气之化,这是六气的德。)
厥阴所至表现为生化,(按,万物的生,是木所化。)少阴所至表现为荣化,(按:万物荣美,是火所化。)太阴所至表现为濡化,(按:濡润万物,是湿土所化。)少阳所至表现为茂化,(按:万物畅茂,是相火之化。)阳明所至表现为坚化,(按:物敛而坚,是金燥所化。)太阳所至表现为藏化,(按:万物收藏,是寒水之化。)这是布政的常态,(“气布则物从其化,所以叫政。”)
厥阴所至表现为飘怒,大凉;(“飘怒,是木亢之变;大凉,是金之承制。”)少阴所至表现为大暄,寒;(“大暄,是火亢之变;寒,是阴精之承制。”)太阴所至表现为雷霆骤注,烈风,(“雷霆骤注,是土亢之变;烈风,是木之承制。”)少阳所至表现为瓢风燔燎,霜凝;(“飘风燔燎,是热亢之变;霜凝,是水之承制。”)阳明所至表现为散落,温;(“散落,是金亢之变;温,是火之承制。”)太阳所至表现为寒雪冰雹,白埃;(“寒雪冰雹,是水亢之变;白埃,是土之承制。”)这是气变的常态。(“变,是变乎常。六气亢极,则承者制之,因胜而复,都不是和平正气,所以叫变。”)
厥阴所至表现为挠动,表现为迎随;(“挠动,是风的本性。迎随,是木的本性。”)少阴所至表现为高明焰,表现为曛;(按:焰,是火的光。高明焰,是火炽盛而其光四达。)太阴所至表现为沉阴,表现为白埃,表现为晦暝,(按:埃,是尘。白埃,是土飞扬而色白。晦暝,是尘埃蔽日而昏昧,都是土气所化。)少阳所至表现为光显,表现为彤云,表现为曛;(“光显,是虹电火光之类。彤云,是赤云。”按:曛,是火热之气,少阴少阳俱为火,所以并言曛。彤音同。)阳明所至表现为烟埃,表现为霜,表现为劲切,表现为凄鸣;(按:烟埃,是秋寒气肃,如烟之袅空,如埃之蔽日。)太阳所至表现为刚固,表现为坚芒,表现为立。(按:这都是冬寒水冱之象。)这是令行的常态。(“气行而物无敢违,所以叫令。”)
厥阴所至表现为里急,(按:木主肝,病则气抑郁而里急。)少阴所主表现为疡胗身热,(按:疡,疮属。胗,疹类。这些都是君火外达于肌肤所致。)太阴所至表现为积饮痞隔,(湿土用事,则脾多湿滞,所以为积饮痞隔。)少阳所至表现为嚏呕,表现为疮疡,(按:相火上炎,所以为嚏呕。热留肌肉,所以为疮疡。)阳明所至表现为浮虚,(“阳明用事而浮虚,皮毛为金之合。”)太阳所至表现为屈伸不利,(按:寒水用事则病在肾,肾主骨,所以令屈伸不利。)这是病的常态。
厥阴所至表现为支痛;(按:支,胁也。厥阴主肝而部在两胁,所以病则胁支痛。)少阴所至表现为惊惑,恶寒战栗,谵妄;(“少阴主心,所以为惊惑。热极反兼寒化,所以恶寒战栗。阳亢伤阴,心神迷乱,所以谵妄。”)太阴所至表现为满;(“太阴主脾,病在中焦,所以满。 音蓄。”)少阳所至表现为惊躁,瞀昧,暴病;(按:少阳相火,属三焦而以火为用,所以病则惊躁。火外阳而内阴,所以瞀昧。相火急疾,所以为暴病。张景岳以为主胆,大概是误以手少阳为足少阳。足少阳胆本属木,怎么能叫相火呢?)阳明所至表现为鼽,尻阴股膝髀 足病;(按:阳明燥金,主大肠而合于肺,肺开窍于鼻,肺感寒则鼻鼽。鼽,鼻塞也。尻阴股足等,是肾的病。大肠经而见肾病,义理不通。张景岳又以阳明为主胃,也是错误的。盖胃者,土也,足阳明也。六气之阳明,乃手阳明大肠经,大肠属庚主金,所以叫燥金。)太阳所至表现为腰痛。(“太阳膀胱之脉,挟脊抵腰中,所以为腰痛。”)这是病的常态。
厥阴所至表现为 戾;(按:风木为病,则筋 缩而乖戾。戾,不柔也。 音软。)少阴所至表现为悲妄,衄 ;(“火病于心而并于肺,所以为悲妄。火逼血而妄行,所以鼻血为衄,污血为 。 音灭。”)太阴所至表现为中满,霍乱,吐下;(按:这是土湿伤脾而及胃。)少阳所至表现为喉痹,耳鸣,呕涌;(“相火上炎。”)阳明所至表现为胁痛皴揭;(“燥金用事,则肝木受伤,所以胁痛。皮肤甲错而起,为皴揭,都是燥病。皴,取钧切。”)太阳所至表现为寝汗,痉。(“寒水用事,所以为寝汗,《脉要精微论》说阴气有余为多汗身寒者是也。肢体强直、筋急反戾曰痉,阴寒凝滞而阳气不行也。痉音敬。”)这是病的常态。
厥阴所至表现为胁痛呕泄,(“木为自病,所以胁痛。肝乘脾胃,所以呕泄。”)少阴所至表现为语笑,(按:少阴主心与火,火盛则心不能静,所以多言而善笑。)太阴所至表现为重, 肿;(按:土过于湿则身重,肢体浮肿名叫肿。)少阳所至表现为暴注, 螈,暴死;(“相火乘金,大肠受之,则为暴注而下。乘脾,则肌肉 动。乘肝,则肢体筋脉抽螈。相火急暴,所以为暴死。”)阳明所至表现为鼽嚏;(“金气寒肃而敛,所以为鼽为嚏。”)太阳所至表现为流泄禁止。(按:流泄兼津液便溺言,阴寒气闭,则津液收敛,汗不达空,二便难通,所以叫流泄禁止。)这是病的常态。
凡是这十二种变化,以德报德,以化报化,以政报政,以令报令,气高则高,气下则下,气后则后,气前则前,气中则中,气外则外,这是位的常态。(气报德报化,指天地气。高下前后中外,指生病所在。手之阴阳其气高,足之阴阳其气下,足太阳气在身后,足阳明气在身前,足太阴少阴厥阴气在身中,足少阳气在身侧,各随所在而言,气变生病之象。按:这是总结上文胜复为病的次序,说各因其气之所至而为报。王冰注论手足阴阳部位,自是不易。但本篇所言,专指六气。六气之内,少阳相火,乃是手少阳三焦,非足少阳胆;阳明燥金,乃是手阳明大肠,非足阳明胃。盖胃属土,非属金;胆属木,非属火。吾乡张景岳、马玄台及诸名公,仍沿王氏之误。岂知相火燥金居六气之二,名义既乖,施治必谬,可不辨乎。然而三焦大肠之位应在何处?答:大肠主传道变化,亦当如足三阴之气,行于身中。三焦包括一身,总统脏腑,理应属身之外。王注泛论脏腑之位则可,若为本篇此节之注则非也。)
所以风胜则动,(按:风善行而数变,以动为性,所以风胜则动。又按以下六句,已见于《阴阳应象大论》,而此篇亦载之者,以此篇正专论六气,谓六气偏胜,则病应于外也。)热胜则肿,(“疮疡痈肿,是火的病。”)燥胜则干,(“精血津液枯竭于内,皮肤肌肉皴揭于外,都是燥的病。”)寒胜则浮,(“腹满身浮,阳不足而寒为病也。”湿胜则濡泄,甚则水闭 肿,“濡泄,水利也。水闭 肿,水道不利而肌肉肿胀,按之如泥不起者是也。”)随气所在以言其变耳。(“气有高下前后中外之异,人之生病,其气亦然。故气胜于高,则病在头顶,气胜于下,则病在足膝;气胜于前,则病在面腹手臂;气胜于后,则病在肩背腰臀;气胜于中,则病在脏腑筋骨;气胜于外,则病在经络皮毛。而凡风胜则动、热胜则肿、燥胜则干、寒胜则浮、湿胜则濡泄 肿之类,无不随气所在而为病变也。”)
黄帝说:愿意听您讲讲用的情况。(“此言施化之用。”)岐伯说:六气之用,各归不胜而为化。(“各归不胜,谓必从可克者而施其化也。”)所以太阴雨化,施于太阳;太阳寒化,施于少阴;少阴热化,施于阳明;阳明燥
"..." Qibo said: "Thereafter, it takes thirty degrees plus a remainder. (...'Later' refers to from the beginning to the end. 'Degree' refers to the sun's daily movement. Thirty degrees plus a remainder constitutes one month. The remainder refers to forty-three ke and seven-and-a-half fen. Generally, there is a difference between the early arrival and late arrival of Qi, not exceeding thirty degrees. Just as in the method of intercalation for Qi surplus,朔 deficiency, and seasonal order, those arriving early arrive fifteen days plus a remainder ahead, and those arriving late arrive fifteen days plus a remainder behind. Whether earlier or later, it never exceeds the number of one month plus a remainder; this is precisely the meaning." [Commentary]: In this dialogue, carefully savoring the tone, it solely discusses the difference in timing (early vs. late) without addressing the reasons for these differences. Zhang Jingyue's assertion that Qi has prosperity and decline, thus leading to early and late arrivals, is incorrect. The following text discusses the reasons for the early and late arrivals.)
The Yellow Emperor said: "Excellent! What is the reason for Qi transforming at non-standard times?" Qibo replied: "When Qi is excessive, it manifests during its proper season; when Qi is deficient, it yields to the element that overcomes it. ([Commentary]: 'Ji Sheng' refers to being overcome by another. When one's own Qi is deficient, its strength is weak, and authority shifts to the element that overcomes it. Thus, Qi appears out of season, such as coolness in spring, cold in summer, heat in autumn, and rain in winter.)
The Yellow Emperor said: "I wish to hear what is meant by the sequence of Qi's movement." ([Commentary]: Refers to the sequence of Qi transformation and operation.) Qibo said: "Spring Qi moves westward, Summer Qi moves northward, Autumn Qi moves eastward, and Winter Qi moves southward. ([Commentary]: Spring governs the East, but its Qi often moves from East to West; Autumn governs the West, but its Qi often moves from West to East; Summer governs the South, but its Qi often moves from South to North; Winter governs the North, but its Qi often moves from North to South.) Therefore, Spring Qi begins from below, Autumn Qi begins from above, Summer Qi begins from the middle, and Winter Qi begins from the extremity/biao. ([Commentary]: Spring governs dispersion, but its Qi originates from the storage of Autumn and Winter, hence 'begins from below.' Autumn governs gathering, but its Qi originates from the growth and nourishment of Spring and Summer, hence 'begins from above.' Summer governs flourishing, but its Qi originates from the nurturing of Central Earth, hence 'begins from the middle.' Winter governs returning and storing, but its Qi originates from what was generated, grown, and harvested before mid-year, hence 'begins from the biao/extremity.' This means each Qi has its own starting point.) Spring Qi begins on the left, Autumn Qi begins on the right, Winter Qi begins at the back, and Summer Qi begins at the front. This is the normal pattern of the four seasons' orthodox transformations. ([Commentary]: Left is East; Right is West; Back is North; Front is South. This refers to the correct positions of the four Qi.) Therefore, in extremely high places, Winter Qi is always present; in extremely low places, Spring Qi is always present. ([Commentary]: The commentary states: 'On the peaks of high mountains, ice and snow persist even in midsummer; in low-lying rivers and marshes, grass grows even in severe winter.' This sufficiently clarifies the meaning of 'always present.' Also, *Wu Chang Zheng Da Lun* says: 'Earth has high and low points, Qi has warm and cool temperatures. High places have cold Qi, low places have hot Qi.' All indicate that Qi contains mutual intermingling.) One must observe this carefully. The Yellow Emperor said: "Excellent!" The Yellow Emperor asked: "How do the responses of the Five Movements and Six Qi manifest? What are the orthodox records of the Six Transformations and the chronicles of the Six Variations?" Qibo replied: "In the orthodox record of the Six Qi, there are transformations and variations, excesses and reprisals, functions and diseases. Their manifestations differ. What does Your Majesty wish to ask?" The Yellow Emperor said: "I wish to hear everything." Qibo said: "Please allow me to continue. Regarding the arrival of Qi: At Jueyin, it manifests as peace and harmony. (First Qi, Wood transformation.) At Shaoyin, it manifests as warmth. (Second Qi, Ministerial Fire.) At Taiyin, it manifests as dusty humidity. (Fourth Qi, Earth transformation.) At Shaoyang, it manifests as scorching heat. (Third Qi, Ministerial Fire.) At Yangming, it manifests as coolness and crispness. (Fifth Qi, Metal transformation.) At Taiyang, it manifests as cold and stagnation. (Final Qi, Water transformation.) These are the normal patterns of seasonal transformations. ('The sequence of Three Yin and Three Yang: Jueyin is First Yin; Shaoyin is Second Yin; Taiyin is Third Yin. Shaoyang is First Yang; Yangming is Second Yang; Taiyang is Third Yang. They follow this sequence. The subsequent twelve transformations are all like this; this is the normal state of Guest Qi.' [Commentary]: 'Seasonal transformation' refers to changes according to time, which is Guest Qi, not the orthodox transformation of the Four Seasons. The commentary incorrectly identifies it as Host Qi.)
At Jueyin, it manifests as the 'House of Wind,' causing fissures and openings. ('A micro-crack not yet broken is called 'Wen'; opening and splitting is called 'Qi'. Both are caused by wind transformation.' [Commentary]: 'Fu' implies storage or gathering. 'Wen' is pronounced 'wen'.) At Shaoyin, it manifests as the Great Fire House, causing expansion and flourishing. ([Commentary]: Shaoyin is Ministerial Fire, hence 'Great Fire House.' When things receive Yang Qi, the Qi gradually expands and color flourishes.) At Taiyin, it manifests as the Rain House, causing fullness and roundness. ('Taiyin transforms dampness, hence the Rain House. Things become full only after receiving Earth Qi, hence 'Yuan Ying' (round/full). 'Yuan' means circumference/complete.') At Shaoyang, it manifests as the Heat House, causing outward flow and emergence. ([Commentary]: Shaoyang is Ministerial Fire. As Ministerial Fire functions, its heat is more intense, hence 'Heat House.' When Yang is extremely abundant, Qi reaches the exterior completely, hence 'Xing Chu' (flow/emergence).) At Yangming, it manifests as the House of Killing, causing 'Geng Cang' (replacement and greenness). ('Geng' means change/replacement. 'Cang' refers to Wood transformation. Things that received generating transformation encounter Metal Qi and undergo change.' [Commentary]: Metal governs肃杀 (solemn killing), hence 'House of Killing'.) At Taiyang, it manifests as the Cold House, causing return and storage. ([Commentary]: During extreme cold, all things gather and return to storage.) These are the normal patterns of governing transformations. ([Commentary]: 'Si' means govern. Each of the Six Qi transformations has a specific governor, hence the name 'Six Houses'.)
At Jueyin, it manifests as generation and wind shaking. ('Wood Qi rises, hence governing generation. Wind nature is moving, hence shaking.') At Shaoyin, it manifests as flourishing and visible forms. ([Commentary]: Yang Qi gradually increases, all things flourish beautifully, and various forms appear.) At Taiyin, it manifests as transformation and cloud/rain. ('Earth can transform/generate all things; clouds and rain are its Qi.') At Shaoyang, it manifests as growth and lush freshness. ([Commentary]: Yang Qi grows vigorously, all things flourish and are fresh/beautiful.) At Yangming, it manifests as harvesting and fog/dew. ([Commentary]: In autumn, things harvest, so Qi condenses into fog and dew.) At Taiyang, it manifests as storage and thoroughness. ([Commentary]: Storage means deep gathering. Thoroughness means secure storage.) These are the normal patterns of Qi transformation. ([Commentary]: Where there is Qi, there is transformation; these are the constants of the six.]
At Jueyin, it manifests as wind generation, ultimately resulting in肃 (solemnity/crispness). ([Commentary]: *Liu Wei Zhi Da Lun* says: 'Below the position of Wind, Metal Qi succeeds it.' Thus, Jueyin wind generates and ultimately becomes solemn/crisp.) At Shaoyin, it manifests as heat generation, with cold in the middle. ('*Liu Wei Zhi Da Lun* says: 'Above Shaoyin, Hot Qi governs, revealing Taiyang.' Thus, Shaoyin heat generates and ultimately becomes cold. It also says: 'Below Ministerial Fire, Yin Essence succeeds it.' This also implies cold.') At Taiyin, it manifests as dampness generation, ultimately resulting in pouring rain. ('Below the position of Earth, Wind Qi succeeds it. Thus, Taiyin dampness generates and ultimately results in pouring rain, i.e., sudden storms.') At Shaoyang, it manifests as fire generation, ultimately resulting in steaming humidity. ('Below Ministerial Fire, Water Qi succeeds it. Thus, Shaoyang fire generates and ultimately results in steaming humidity.') At Yangming, it manifests as dryness generation, ultimately resulting in coolness. ('These two characters, Dryness and Coolness, should be swapped. Because below the position of Metal, Fire Qi succeeds it. Thus, Yangming coolness generates and ultimately becomes dryness.') At Taiyang, it manifests as cold generation, with warmth in the middle. ('Above Taiyang, Cold Qi governs, revealing Shaoyin. Thus, Taiyang cold generates and has warmth in the middle.' [Commentary]: In the previous six transformations, Jueyin, Taiyin, Shaoyang, and Yangming all mention 'ultimately,' while only Shaoyin and Taiyang mention 'middle.' Why? The way of the Six Qi is merely Yin and Yang; the signs of Yin and Yang are merely Water and Fire. Shaoyin is Ministerial Fire; Taiyang is Cold Water. When Yang prevails, Yin retaliates; thus, Shaoyin manifests heat generation with cold in the middle, resembling the Li trigram (Yang outside, Yin inside). When Yin prevails, Yang retaliates; thus, Taiyang manifests cold generation with warmth in the middle, resembling the Kan trigram (Yin outside, Yang inside). Hence, only these two Qi mention 'middle,' representing the subtlety of mutual Yin-Yang containment; the others mentioning 'ultimately' refer to the meaning of succeeding from below.) These are the normal patterns of Virtue Transformation. ([Commentary]: Below the orthodox transformation, the succeeding element continues it. Although this is the natural mutual restriction of the Six Qi, it is essentially the Virtue of Heaven and Earth generating each other.)
At Jueyin, it manifests as hair transformation. ([Commentary: Hair belongs to Wood transformation.]) At Shaoyin, it manifests as feather transformation. ([Things with wings for flight. [Commentary: Feathers belong to Fire transformation.]) At Taiyin, it manifests as naked transformation. ([Things without hair, feathers, scales, or shells. [Commentary: Naked belongs to Earth transformation.]) At Shaoyang, it manifests as feather transformation. ([Thin-winged insects like bees and cicadas, not large flight feathers.]) At Yangming, it manifests as shell/hard covering transformation. ([Commentary: Shells/Hard coverings belong to Metal transformation.]) At Taiyang, it manifests as scale transformation. ([Commentary: Scales belong to Water transformation.]) These are the normal patterns of Virtue Transformation. ([Commentary: The birth of animals is endowed with transformation by the Six Qi; this is the Virtue of the Six Qi.])
At Jueyin, it manifests as generative transformation. ([Commentary: The generation of all things is transformed by Wood.]) At Shaoyin, it manifests as flourishing transformation. ([Commentary: The flourishing beauty of all things is transformed by Fire.]) At Taiyin, it manifests as moistening transformation. ([Commentary: Moistening all things is transformed by Damp Earth.]) At Shaoyang, it manifests as luxuriant transformation. ([Commentary: The vigorous growth of all things is transformed by Ministerial Fire.]) At Yangming, it manifests as hardening transformation. ([Commentary: Things contract and harden, transformed by Metal Dryness.]) At Taiyang, it manifests as storing transformation. ([Commentary: The storage of all things is transformed by Cold Water.]) These are the normal patterns of Administrative Policy. ('When Qi distributes, things follow its transformation, hence called Policy.')
At Jueyin, it manifests as violent anger and great coolness. ('Violent anger is the variation of Wood excess; great coolness is the controlling force of Metal.') At Shaoyin, it manifests as extreme warmth and cold. ('Extreme warmth is the variation of Fire excess; cold is the controlling force of Yin Essence.') At Taiyin, it manifests as thunderstorms and fierce winds. ('Thunderstorms are the variation of Earth excess; fierce winds are the controlling force of Wood.') At Shaoyang, it manifests as whirlwinds and burning fires, with frost condensation. ('Whirlwinds and burning fires are the variation of Heat excess; frost condensation is the controlling force of Water.') At Yangming, it manifests as scattering and warmth. ('Scattering is the variation of Metal excess; warmth is the controlling force of Fire.') At Taiyang, it manifests in cold snow, hail, and white dust. ('Cold snow and hail are the variation of Water excess; white dust is the controlling force of Earth.') These are the normal patterns of Qi Variation. ('Variation means deviation from the norm. When the Six Qi reach extreme excess, the succeeding element controls them, leading to victory and reprisal. None of these are peaceful, righteous Qi, hence called Variation.')
At Jueyin, it manifests as trembling and following/accompanying. ('Trembling is the nature of Wind. Following/accompanying is the nature of Wood.') At Shaoyin, it manifests as bright flames and dusk-like heat. ([Commentary: Yan is the light of fire. Bright flame means fire is blazing and its light radiates in all directions.]) At Taiyin, it manifests as heavy yin, white dust, and darkness. ([Commentary: Ai is dust. White dust is earth flying up with white color. Darkness is dust obscuring the sun, causing gloom. All are transformed by Earth Qi.]) At Shaoyang, it manifests as brilliance, red clouds, and dusk-like heat. ('Brilliance refers to rainbows, lightning, and firelight. Red clouds are crimson clouds.' [Commentary]: Xun refers to hot air. Both Shaoyin and Shaoyang are Fire, hence both mention Xun. Tong is pronounced 'tong'.) At Yangming, it manifests as smoke and dust, frost, sharpness, and mournful sounds. ([Commentary: Smoke and dust refer to the solemnity of autumn cold air, curling through the sky like smoke, obscuring the sun like dust.]) At Taiyang, it manifests as rigidity, hardness/spikes, and standing. ([Commentary: These are all images of winter cold freezing water.]) These are the normal patterns of Order Execution. ('When Qi moves, nothing dares to disobey, hence called Order.')
At Jueyin, it manifests as internal tension. ([Commentary: Wood governs the Liver. Disease causes Qi depression and internal tension.]) At Shaoyin, it manifests as ulcers, rashes, and body heat. ([Commentary: Yang is ulcer/sores. Zhen is rash type. These are caused by Ministerial Fire reaching the skin and muscles.]) At Taiyin, it manifests as fluid accumulation, epigastric fullness, and obstruction. ([Commentary: When Damp Earth functions, the Spleen suffers from damp stagnation, hence fluid accumulation, epigastric fullness, and obstruction.]) At Shaoyang, it manifests as sneezing and vomiting, and sores/ulcers. ([Commentary: Ministerial Fire flares upward, hence sneezing and vomiting. Heat remains in muscles, hence sores/ulcers.]) At Yangming, it manifests as floating emptiness. ('When Yangming functions, floating emptiness occurs because the skin and hair correspond to Metal.') At Taiyang, it manifests in difficulty bending and stretching. ([Commentary: When Cold Water functions, disease affects the Kidney. The Kidney governs bones, hence difficulty bending and stretching.]) These are the normal patterns of Disease.
At Jueyin, it manifests as flank pain. ([Commentary: Zhi refers to the hypochondrium/flank. Jueyin governs the Liver and is located in the bilateral flanks, hence disease causes flank pain.]) At Shaoyin, it manifests as fright/confusion, aversion to cold with shivering, and delirium. ('Shaoyin governs the Heart, hence fright/confusion. Extreme heat reversely combines with Cold transformation, hence aversion to cold and shivering. Yang excess injures Yin, confusing the Heart Spirit, hence delirium.') At Taiyin, it manifests in fullness. ('Taiyin governs the Spleen. Disease in the Middle Jiao causes fullness. [Character] is pronounced 'xu'.') At Shaoyang, it manifests as fright/restlessness, visual impairment/confusion, and sudden disease. ([Commentary: Shaoyang Ministerial Fire belongs to the Sanjiao and uses Fire. Hence disease causes fright/restlessness. Fire is Yang outside and Yin inside, hence visual impairment/confusion. Ministerial Fire is rapid, hence sudden disease. Zhang Jingyue believed it governed the Gallbladder, likely confusing Hand Shaoyang with Foot Shaoyang. Foot Shaoyang Gallbladder inherently belongs to Wood, how can it be called Ministerial Fire?]) At Yangming, it manifests as rhinitis (blocked nose), and diseases of the sacrum, yin, thighs, knees, thighs, and feet. ([Commentary: Yangming Dry Metal governs the Large Intestine and connects with the Lung. The Lung opens into the nose. Lung cold causes rhinitis. Rhinitis means blocked nose. Sacrum, yin, thighs, feet, etc., are Kidney diseases. Seeing Kidney disease in the Large Intestine meridian makes no logical sense. Zhang Jingyue also mistakenly identified Yangming as governing the Stomach. The Stomach is Earth, Foot Yangming. The Yangming of the Six Qi is actually the Hand Yangming Large Intestine Meridian. The Large Intestine belongs to Geng and governs Metal, hence called Dry Metal.]) At Taiyang, it manifests as lower back pain. ('The Taiyang Bladder meridian runs along the spine to the waist, hence lower back pain.') These are the normal patterns of Disease.
At Jueyin, it manifests as deformity/distortion. ([Commentary: Wind-Wood disease causes sinew contraction and distortion. Li means not flexible. [Character] is pronounced 'ruan'.]) At Shaoyin, it manifests as sorrow/wantonness, nasal bleeding, and bloody vomit/stool. ('Fire disease in the Heart spreads to the Lung, hence sorrow/wantonness. Fire forces blood to move recklessly, hence nasal bleeding is Nu, and dirty blood is . [Character] is pronounced 'mie'.') At Taiyin, it manifests as central fullness, cholera, vomiting, and diarrhea. ([Commentary: This is Earth dampness injuring the Spleen and affecting the Stomach.]) At Shaoyang, it manifests as throat obstruction, tinnitus, and surging vomiting. ('Ministerial Fire flares upward.') At Yangming, it manifests as flank pain and skin cracking/fissuring. ('When Dry Metal functions, Liver Wood is injured, hence flank pain. Skin becomes rough and cracks, called Cun Jie. All are Dryness diseases. Cun is pronounced 'qu jun qie'.') At Taiyang, it manifests in night sweats and spasms. ('Cold Water functions, hence night sweats. *Mai Yao Jing Wei Lun* says: Excess Yin leads to excessive sweating and body cold. Spasms refer to stiff limbs and reversed tendon cramps. Yin-Cold stagnation prevents Yang Qi from flowing. Jing is pronounced 'jing'.') These are the normal patterns of Disease.
At Jueyin, it manifests as flank pain, vomiting, and diarrhea. ('Wood self-diseases, hence flank pain. Liver attacks Spleen/Stomach, hence vomiting and diarrhea.') At Shaoyin, it manifests in talking and laughing. ([Commentary: Shaoyin governs the Heart and Fire. When Fire is excessive, the Heart cannot remain quiet, hence excessive talking and frequent laughter.]) At Taiyin, it manifests in heaviness and edema. ([Commentary: Excess Earth dampness causes body heaviness. Limb swelling is called edema.]) At Shaoyang, it manifests as sudden diarrhea, convulsions/twitching, and sudden death. ('Ministerial Fire attacks Metal; the Large Intestine receives it, causing sudden diarrhea. Attacking Spleen causes muscle twitching. Attacking Liver causes limb/tendon convulsions. Ministerial Fire is sudden and violent, hence sudden death.') At Yangming, it manifests as rhinitis and sneezing. ('Metal Qi is cold, solemn, and contracting, hence rhinitis and sneezing.') At Taiyang, it manifests in the prohibition of discharge/excretion. ([Commentary: Discharge/excretion includes fluids, urine, and stool. Yin-Cold Qi closure causes fluid retention, sweat cannot reach the pores, and urination/defecation is difficult, hence 'prohibition of discharge/excretion'.]) These are the normal patterns of Disease.
All these twelve variations repay Virtue with Virtue, Transformation with Transformation, Policy with Policy, and Order with Order. High Qi responds with high, Low Qi responds with low, Back Qi responds with back, Front Qi responds with front, Middle Qi responds with middle, Exterior Qi responds with exterior. This is the normal pattern of Position. (Qi repaying Virtue/Transformation refers to Heaven and Earth Qi. High/Low/Front/Back/Middle/Exterior refer to the location of disease. Hand Yin/Yang Qi is high; Foot Yin/Yang Qi is low. Foot Taiyang Qi is at the back; Foot Yangming Qi is at the front; Foot Taiyin, Shaoyin, and Jueyin Qi are in the middle; Foot Shaoyang Qi is at the side. Speaking according to their respective locations describes the image of Qi variation causing disease. [Commentary]: This summarizes the sequence of disease caused by excess and reprisal mentioned above, stating that each responds according to the arrival of its Qi. Wang Bing's commentary on the positions of Hand/Foot Yin/Yang is irrefutable. However, this chapter specifically refers to the Six Qi. Within the Six Qi, Shaoyang Ministerial Fire is the Hand Shaoyang Sanjiao, not the Foot Shaoyang Gallbladder; Yangming Dry Metal is the Hand Yangming Large Intestine, not the Foot Yangming Stomach. The Stomach belongs to Earth, not Metal; the Gallbladder belongs to Wood, not Fire. My fellow townsman Zhang Jingyue, Ma Xuantai, and other famous physicians still followed Wang Bing's error. How could they know that if Ministerial Fire and Dry Metal occupy the second positions of the Six Qi, their names and meanings are wrong, and treatment will inevitably be erroneous? Must we not distinguish this? Then where should the positions of Sanjiao and Large Intestine be? Answer: The Large Intestine governs transmission and transformation, just like the Qi of the Foot Three Yin, it travels within the body. The Sanjiao encompasses the whole body and commands the Zang-Fu organs, so it should logically belong to the exterior of the body. Wang Bing's general discussion of Zang-Fu positions is acceptable, but as a commentary for this section of this chapter, it is incorrect.)
Therefore, when Wind prevails, there is movement. ([Commentary: Wind moves swiftly and changes frequently; movement is its nature, hence Wind excess causes movement. Also, the following six sentences already appeared in *Yin Yang Ying Xiang Da Lun*, and are included here because this chapter specifically discusses the Six Qi, stating that when the Six Qi are excessively biased, disease manifests externally.]) When Heat prevails, there is swelling. ('Ulcers and carbuncles/swelling are diseases of Fire.') When Dryness prevails, there is dryness. ('Essence, blood, and body fluids are depleted internally; skin and muscles crack externally. All are diseases of Dryness.') When Cold prevails, there is floating/edema. ('Abdominal fullness and body floating are due to Yang insufficiency and Cold disease.') When Dampness prevails, there is loose stool; severely, there is water closure and swelling. ('Loose stool is watery diarrhea. Water closure and swelling refer to unfavorable water pathways causing muscle swelling, which feels like mud when pressed and does not rise.' ) The variations are described according to where the Qi resides. ('Qi has differences in high/low, front/back, middle/exterior. Human disease Qi is also like this. Thus, if Qi prevails in high places, disease is in the crown of the head; if in low places, disease is in the feet/knees; if in front, disease is in the face/abdomen/arms; if in back, disease is in the shoulders/back/waist/hips; if in middle, disease is in the Zang-Fu/organs/tendons/bones; if in exterior, disease is in the meridians/skin/hair. And all cases of Wind excess causing movement, Heat excess causing swelling, Dryness excess causing dryness, Cold excess causing floating, Damp excess causing loose stool/swelling, etc., all undergo pathological changes according to where the Qi resides.')
The Yellow Emperor said: "I wish to hear about their Functions/Uses." ('This speaks of the function of applying transformation.') Qibo said: "The Function of the Six Qi each returns to the unconquerable to effect transformation. ('Each returns to the unconquerable' means it must apply its transformation through the element that can be conquered by it.") Thus, Taiyin's Rain Transformation applies to Taiyang; Taiyang's Cold Transformation applies to Shaoyin; Shaoyin's Heat Transformation applies to Yangming; Yangming's Dryness