篇中专论脉色，而末则归重于一。一者，神也。谓色为外候，脉为内候，神则摄乎内外之间，脉色得之则
善，失之则凶，治病之要，惟此而已。篇中以移精变气为名者，盖由帝问古用祝由治病以移易精气，而即以引
端之辞为名也。景岳注解明畅，故采录之。
黄帝问曰∶余闻古之治病，惟其移精变气，可祝由而已。今世治病，毒药治其内，针石治其外，或愈或
不愈，何也？（移谓移易，变谓变改，皆使邪不伤正，精神复强而内守也。按∶张景岳曰∶“上古以全德之世，
邪不能侵，故凡有疾
病，惟用祝由而已，以其病不甚而治亦易也。按明制医术十三科∶曰大方脉，曰小方脉，曰妇人，曰伤寒，曰
疮疡，曰针灸，曰眼，曰口齿，曰咽喉，曰接骨，曰金镞，曰按摩，曰祝由。今按摩、祝由二科失其传，惟民
间尚有之。祝，之救切。”）岐伯对曰∶往古人居禽兽之间，动作以避寒，阴居以避暑，内无眷慕之累，外无
伸宦之形，此恬 之世，邪不能深入也。故毒药不能治其内，针石不能治其外，故可移精祝由而已。（古者巢
居穴处，夕隐朝游，禽兽之间，断可知矣。然动躁阳盛，故身热足以御寒∶凉气生寒，故阴居可以避暑。夫志
捐思想，则内无眷慕之累；心亡愿欲，故外无伸宦之形。静保天真，自无邪胜。是以移精变气，无假毒药，祝
说病由，不劳针石而已。按∶张景岳曰∶“伸，屈伸之情。宦，名利之累。内无眷慕，外无趋求，故曰恬 之
世。祝，咒同。由，病所从生也。故曰祝由。”）当今之世不然，忧患缘其内，苦形伤其外，又失四时之逆从，
寒暑之宜，贼风数至，虚邪朝夕，内至五脏骨髓，外伤孔窍肌肤，所以小病必甚，大病必死，故祝由不能已也。
帝曰∶善！余欲临病患，观死生，决嫌疑，欲知其要，如日月光，可得闻乎？（按∶日月之光，有目共见，
此问治病之要，欲求显而易见也。）岐伯曰∶色脉者，上帝之所贵，先师之所传也。（上帝，上古之帝。先师，
岐伯祖世之师僦贷季也。）上古使僦贷季，理脉色而通神明，合之金木水火土，四时八风六合，不离其常。
（按∶张景岳曰∶“理色脉，察内外之精微也。通神明，色脉辨而神明见也。色脉之应，无往不合，如五行之
衰王，四时之往来，八风之变，六合之广，消长相根据，无不有常度也。”）变化相移以观其妙，以知其要。欲知
其要，则色脉是矣。（按∶张景岳曰∶“五行四时八风之气，迭有盛衰，则变
化相移，色脉随之而应，故可以观其妙，知其要。凡人之五脏六腑，百骸九窍，脉必由乎气，气必合乎天，虽
其深微难测，而惟于色脉足以察之，故曰欲知其要，则色脉是矣。”）色以应日，脉以应月，常求其要，则其
要也。（按∶张景岳曰∶“色分五行，而明晦是其变，日有十二干，而阴晴是其变，故色以应日。脉有十二经，
而虚实是其变，月有十二建，而盈缩是其变，故脉以应月。常求色脉之要，则明如日月，而得其变化之要矣。”）
夫色之变化，以应四时之脉，此上帝之所贵，以合于神明也。所以远死而近生，生道以长，命曰圣王。（按∶
脉随时而应于内，色应脉而形于外，色脉相应，死可远而生自近矣。惟古帝知之，故能却老全角，动合神明，
而养生之道独全也。）中古之治，病至而治之汤液，十日以去八风五痹之病，十日不已，治以草苏草 之枝，
本末为助，标本已得，邪气乃服。（八风，八方之风。五痹，谓皮肉筋骨脉之痹也。按∶张景岳曰∶“中古之
治病，必病至而后治之，其治也先以汤液。汤液者，五谷所制而非药也。服之十日而八风五痹之病可以去矣。
使十日不已，则治以草苏草 之枝。苏，叶也。 ，根也。枝，茎也。根枝相佐，故云本末为助，即后世之汤
剂也。病原为本，病变为标，得其标本，邪无不服。此中古之治，虽不若上古之见于未然，而犹未若后世之误
也。 音该。”）暮世之治病也则不然，治不本四时，不知日月。不审逆从。（四时之气各有所在，不本其处
而即妄攻，是反古也。四时刺逆从论曰∶“春气在经脉，夏气在孙络，长夏气在肌肉，秋气在皮肤，冬气在骨
髓。”当各随其所在而辟伏其邪尔。不知日月者，谓日有寒温明晦，月有空满盈亏也。八正神明论曰∶“凡刺之
法，必候日月星辰四时八正之气，气定乃刺之。是故天温日明，则人血淖液而卫气浮，故血易泻，气易行；天
寒日阴，则人血凝泣而卫气沉。月始生，则血气始精，卫气始行；月廓满，则血气盛，肌肉坚；月廓空，则肌
肉减，经络虚，卫气去，形独居。是以因天时而调血气也。是故天寒无
刺，天温无疑，月生无泻，月满无补，月廓空无治，是谓得时而调之。”此之谓也。不审逆从者，谓不审量其
病可治与不可治也。按∶张景岳曰∶“按太仆引经注此，其说虽是，而殊有未尽者。如不本四时，则有不知运气
之盛衰，阴阳之消长。故好用温热者，忘天地之赫曦；专用寒凉者，昧主客之流衍。五音皆有宜忌，胡可视为
泛常。故五常政大论曰∶‘必先岁气，无伐无和。’设不知此而犯之，如抱薪救火，因雪加霜矣。如不知日月，
王注即以日月为解。然本篇所言，原在色脉。故不知色脉，则心无参伍之妙，诊无表里之明。色脉不合者，孰
当舍证而从脉；缓急相碍者，孰当先此而后彼。理趣不明，其妄孰甚。此色脉之参合，必不可少，故云日月也。
又若不审逆从，则有气色之逆从，如玉版论要曰∶‘色见上下左右，各在其要。上为逆，下为从；女子右为逆，
左为从∶男子左为逆，右为从。’有四时脉息之逆从，如平人气象论曰∶‘脉有逆从四时，未有脏形，春夏而
脉瘦，秋冬而脉浮大，命曰逆四时也。’玉机真脏论曰∶‘所谓逆四时者，春得肺脉，夏得肾脉，秋得心脉，
冬得脾脉，其至皆悬绝沉涩者，命曰逆四时也。’有脉证之逆从，如平人气象论曰∶‘风热而脉静，泄而脱血
脉实，病在中脉虚，病在外脉涩坚者，皆难治，命曰反四时也。’又玉机真脏论曰∶‘病热脉静，泄而脉大，
脱血而脉实，病在中脉实坚，病在外脉不实坚者，皆难治也。’有治法之逆从，如至真要大论曰∶‘有逆取而
得者，有从取而得者。逆，正顺也。若顺，逆也。’又曰∶‘微者逆之，甚者从之。’又曰∶‘逆者正治，从
者反治，从少从多，观其事也。’五常政大论曰∶‘强其内守，必同其气，可使平也，假者反之。’是皆逆从之
道，医所最当潜心者。若不明四时脉证之逆从，则不识生死之理，而病必多失。不明论治之逆从，则必致妄投
而绝人长命，是真医杀之耳。此暮世之通弊也，宜详察之。”）病形已成，乃欲微针治其外，汤液治其内，粗工
凶凶，以为可攻，故病未已，新病复起。（……按∶张景岳曰∶“既不能防于未然，又不能察其见在，心粗
且浅，针药乱施。若辈者，意其为实而攻之，则假实未去而真虚至，意其为热而寒之，则故热未去而新寒起，
是不足以治人而适足以害人耳。”）
帝曰∶余闻其要于夫子矣，夫子言不离色脉，此余之所知也。岐伯曰∶治之极于一。（按∶张景岳曰∶“一
之为道大矣，万事万物之原也。易曰∶‘天一生水。’尧曰∶‘惟精唯一，允执厥中。’老子曰∶‘道生一，
一生二，二生三，三生万物。’又曰∶‘天得一以清，地得一以宁，神得一以灵，谷得一以盈，万物得一以
生，侯王得一以为天下贞。’孔子曰∶‘吾道一以贯之。’释氏曰∶‘万法归一。’庄子曰∶‘通于一而万事毕。’
邵子曰∶‘天向一中分造化。’至真要等论曰∶‘知其要者，一言而终；不知其要，流散无穷。’此曰治之
极于一，其道皆同也。故人能得一，则宇宙在乎手，人能知一，则万化归乎心矣。”）帝曰∶何谓一？岐伯曰∶
一者因得之。（按∶天地万物本于一，则一者统辞也，合之于病将何如？盖凡病之初起，莫不有因，随其因而
推求之，则一可得矣。欲得其一，诚如下文是矣。）帝曰∶奈何？（按∶谓何如可得也。）岐伯曰∶闭户塞牖，
系之病者，数问其情，以从其意，得神者昌，失神者亡。帝曰∶善！（按∶此正求因得一之法也。一者神而已
矣，神之得失未易遽窥也，必使病者静居一室之中，耳无所闻，目无所见，然后委婉曲折，叩问其衷情，因事
致宜，顺适其心意，以观其神明之得失，则存亡可以立辨，所谓治之极于一也，如是而已。景岳通论一字之义
甚确，而以神与一分解，似尚未之思也。）
本篇专门论述脉象与面色，而结尾则归结于“一”。“一”，指的是神。面色是外在的征候，脉象是内在的征候，神则统摄于内外之间，掌握了脉色就能治好病，失去了就会凶险，治病的要领，仅此而已。篇名取为《移精变气论》，大概是因为黄帝询问古人用祝由（一种通过咒语、祈祷来治病的方法）治病以改变精气，所以以此作为引端的辞句来命名。张景岳的注解清晰流畅，因此采纳收录。
黄帝问道：我听说古时候治病，只要转移精神、改变气机，用祝由的方法就可以了。现在的人治病，用药物在内调理，用针石在外治疗，有的痊愈，有的不愈，这是为什么呢？（“移”指移易，“变”指变改，都是为了使邪气不伤害正气，使精神重新强大并内守。按：张景岳说：“上古是道德完备的时代，邪气不能侵入，所以凡是疾病，只用祝由即可，因为病情不重且治疗也容易。按照明朝的制度，医术分为十三科：大方脉、小方脉、妇人、伤寒、疮疡、针灸、眼、口齿、咽喉、接骨、金镞、按摩、祝由。如今按摩和祝由两科失传了，只有民间还有。祝，音‘之救切’。”）
岐伯回答说：远古时候，人们居住在禽兽之间，活动以躲避寒冷，居住在阴凉处以躲避暑热，内心没有眷恋思慕的劳累，外表没有奔走仕途的劳形，这是一个恬淡虚无的时代，邪气不能深入。所以药物不能从内治疗，针石不能从外治疗，因此只需转移精神、用祝由即可。（古代人巢居穴处，晚上隐蔽早上出游，在禽兽之间，断然可知。然而动作躁动阳气旺盛，所以身体发热足以抵御寒冷；凉气产生寒凉，所以居住在阴凉处可以避暑。如果志向抛弃思想杂念，那么内心就没有眷恋思慕的劳累；心中没有愿望欲望，所以外表没有奔走求名的劳形。安静地保全天真之气，自然没有被邪气战胜的情况。因此转移精神改变气机，不需要借助药物，只是诉说病因，不劳烦针石即可。按：张景岳说：“伸，指屈伸之情状。宦，指名利的拖累。内心没有眷恋，外部没有趋附追求，所以称为恬淡虚无的时代。祝，同咒字。由，指病产生的原因。所以叫祝由。”）
当今的时代就不是这样了，忧患缠绕在内心，苦累的身体损伤在外部，又违背了四时气候的顺逆规律，不适应寒暑的变化，贼风频繁到来，虚邪贼风早晚侵袭，向内深入五脏骨髓，向外损伤孔窍肌肤，所以小病必定加重，大病必定死亡，因此祝由也不能治愈了。
黄帝说：好！我想要面对病患，观察生死，决断疑难，想要知道其中的要领，像日月之光一样明亮，可以讲给我听吗？（按：日月的光芒，有眼睛的人都能看见，这个问的是治病的要领，想要寻求显而易见的答案。）
岐伯说：面色和脉象，是上帝所重视的，是先师所传承的。（上帝，指上古的帝王。先师，指岐伯祖辈的老师僦贷季。）上古时代让僦贷季，整理脉色并通晓神明，结合金木水火土五行，以及四时、八风、六合，都不离开其常规。（按：张景岳说：“理色脉，是察究内外的精微之处。通神明，是脉色辨明后神明显现。色脉的应验，无处不合，就像五行的衰旺，四时的往来，八风的变幻，六合的广阔，消长都有依据，无不有一定的法度。”）观察变化相互推移以知晓奥妙，从而掌握要领。想要掌握要领，就看面色和脉象了。（按：张景岳说：“五行、四时、八风的气，交替有盛衰，那么变化相互推移，色脉随之而应，所以可以观察其奥妙，知晓其要领。大凡人的五脏六腑，百骸九窍，脉必然由气决定，气必然合乎天道，虽然深微难测，但唯有通过色脉足以察知，所以说想要掌握要领，就看色脉了。”）面色对应日，脉象对应月，经常探求其要领，那么要领就清楚了。（按：张景岳说：“色分五行，明晦是其变化，日有十二干，阴晴是其变化，所以色对应日。脉有十二经，虚实是其变化，月有十二建，盈缩是其变化，所以脉对应月。经常探求色脉的要领，那么就明如日月，得到变化的要领了。”）
色的变化，以应合四时的脉象，这是上帝所重视的，用来合于神明。所以远离死亡而接近生存，生命之道得以长久，这叫做圣王。（按：脉随时间而在内应合，色应合脉而显于外，色脉相应，死亡可远而生存自近。只有上古帝王知道这一点，所以能抗拒衰老保全形体，行动合于神明，而养生之道独全。）
中古时代的治理，病来了就用汤液治疗，十天以去除八风五痹的病，十天不好，就用草苏草荄（草根）的枝茎治疗，根茎相佐，标本兼顾，标本已得，邪气乃服。（八风，指八方之风。五痹，指皮、肉、筋、骨、脉的痹症。按：张景岳说：“中古治病，必须病来了才治疗，治疗时先用汤液。汤液，是用五谷制成的而非草药。服用十天八风五痹的病就可以去除了。如果十天不好，就用草苏草荄的枝茎治疗。苏，指叶。荄，指根。枝，指茎。根枝相助，所以说本末为助，就是后世的汤剂。病原为本，病变为标，得到标本，邪气没有不服的。这是中古的治疗，虽然不像上古那样见于未病之时，但也还未像后世那样错误。荄，音‘该’。”）
末世治病就不是这样了，治疗不根据四时，不知道日月。不审察逆从。（四时之气各有所在，不根据其所处位置就妄加攻伐，这是反古。《四时刺逆从论》说：“春气在经脉，夏气在孙络，长夏气在肌肉，秋气在皮肤，冬气在骨髓。”应当各自随着它们所在的位置来避开伏藏的邪气。不知道日月，是说日有寒温明晦，月有空满盈亏。《八正神明论》说：“凡针刺之法，必须等候日月星辰四时八正之气，气定然后针刺。所以天温日明，则人血淖泽而卫气浮，所以血易泻，气易行；天寒日阴，则人血凝涩而卫气沉。月亮初生，则血气始精，卫气始行；月亮圆满，则血气盛，肌肉坚；月亮亏空，则肌肉减，经络虚，卫气去，形体独存。因此顺应天时来调养血气。所以天寒不要刺，天温不要犹豫，月生不要泻，月满不要补，月廓空不要治，这叫顺应时节调治。”说的就是这个。不审察逆从，是指不审量病是否可以治疗。按：张景岳说：“引用太仆的经注解释此段，说法虽对，但殊有未尽。比如不根据四时，就有不知道运气盛衰、阴阳消长的情况。所以好用温热药的人，忘记了天地的大热；专用寒凉药的人，不明白主客气的流衍。五音都有宜忌，怎么可以视为平常。所以《五常政大论》说：‘必先岁气，无伐无和。’假如不知道这些而触犯它，就像抱薪救火，因雪加霜。假如不知道日月，王冰注即以日月为解。然而本篇所言，原本在色脉。所以不知道色脉，则心中没有参伍比较的妙用，诊察没有表里的明晰。色脉不合的，谁应当舍证从脉；缓急相碍的，谁应当先此而后彼。理趣不明，狂妄莫过于此。这种色脉的参合，必不可少，所以称其为日月。另外如果不审察逆从，则有气色的逆从，如《玉版论要》说：‘色见上下左右，各在其要。上为逆，下为从；女子右为逆，左为从；男子左为逆，右为从。’有四时脉息的逆从，如《平人气象论》说：‘脉有逆从四时，未有脏形，春夏而脉瘦，秋冬而脉浮大，命曰逆四时也。’《玉机真脏论》说：‘所谓逆四时者，春得肺脉，夏得肾脉，秋得心脉，冬得脾脉，其至皆悬绝沉涩者，命曰逆四时也。’有脉证的逆从，如《平人气象论》说：‘风热而脉静，泄而脱血脉实，病在中脉虚，病在外脉涩坚者，皆难治，命曰反四时也。’又《玉机真脏论》说：‘病热脉静，泄而脉大，脱血而脉实，病在中脉实坚，病在外脉不实坚者，皆难治也。’有治法的逆从，如《至真要大论》说：‘有逆取得者，有从取得者。逆，正顺也。若顺，逆也。’又说：‘微者逆之，甚者从之。’又说：‘逆者正治，从者反治，从少从多，观其事也。’《五常政大论》说：‘强其内守，必同其气，可使平也，假者反之。’这些都是逆从之道，医生最应当潜心研究的。如果不明白四时脉证的逆从，就不识生死之理，而病必定多失误。不明白论治的逆从，就必定导致妄投药物而断人寿命，真是医生杀之。这是末世的通病，应当详细考察。”）
病形已经形成，才想用微针治其外，汤液治其内，粗劣的医生惊慌失措，以为可以攻伐，所以旧病未去，新病又起。（……按：张景岳说：“既然不能在未病时预防，又不能察知现有的病情，心粗且浅，针药乱施。这类人，心里以为是实证而攻伐，则假实未去而真虚到来；心里以为是热证而寒凉，则故热未去而新寒兴起，这不足以治人，恰恰足以害人。”）
黄帝说：我从夫子那里听到了要领，夫子说不离色脉，这是我已知的。岐伯说：治疗的极致在于“一”。（按：张景岳说：“一的道理很大，是万事万物的本源。《易经》说：‘天一生水。’尧说：‘惟精唯一，允执厥中。’老子说：‘道生一，一生二，二生三，三生万物。’又说：‘天得一以清，地得一以宁，神得一以灵，谷得一以盈，万物得一以生，侯王得一以为天下贞。’孔子说：‘吾道一以贯之。’佛家说：‘万法归一。’庄子说：‘通于一而万事毕。’邵雍说：‘天向一中分造化。’《至真要等论》说：‘知其要者，一言而终；不知其要，流散无穷。’这里说治疗的极致在于一，道理都是一样的。所以人能得一，则宇宙在手；人能知一，则万化归心。”）
黄帝说：什么是“一”？岐伯说：“一”是通过探究病因得到的。（按：天地万物本于一，那么“一”是总括的词，合到病症上怎么样呢？大凡病之初起，莫不有因，顺着病因推求，那么“一”就可以得到了。想要得到这个“一”，确实像下文所说的那样。）
黄帝说：怎么做？（按：指如何可以得到。）
岐伯说：关上门窗，专注于病人，细致询问他的情志，顺从他的心意，得到神的则昌盛，失去神的则死亡。
黄帝说：好！（按：这正是求因得一的方法。“一”就是神罢了，神的得失不容易立刻窥探，必须让病人在安静的房间里，耳无所闻，目无所见，然后委婉曲折地叩问他的衷情，因事制宜，顺适其心意，以观察其神明的得失，那么存亡就可以立即辨别，所谓治疗的极致在于一，就是这样而已。张景岳对“一”字的义理解释很确切，但把神与一分开解释，似乎还没考虑到这一点。）
This chapter specifically discusses pulse and complexion, but concludes by emphasizing "One." "One" refers to Shen (Spirit). Complexion is an external sign, pulse is an internal sign, while Spirit governs both internal and external. Mastering pulse and complexion leads to good outcomes, losing them leads to misfortune; the key to treating disease lies solely in this. The chapter is named *Yi Jing Bian Qi* (Shifting Spirit and Changing Qi) because the Yellow Emperor asked about ancient healing using Zhu You (a method of healing through incantation and prayer) to shift and change Jing-Qi (Essence-Qi), thus using this phrase as an introductory topic. Zhang Jingyue's commentary is clear and fluent, so it has been adopted.
The Yellow Emperor asked: I have heard that in ancient times, diseases were treated only by shifting spirit and changing qi, sufficient with Zhu You alone. Today, diseases are treated internally with medicinal herbs and externally with acupuncture and stone therapy, yet some recover and others do not. Why is this? ("Shift" means to alter, "Change" means to transform, both aiming to prevent pathogenic factors from harming healthy Qi, allowing Spirit to become strong and remain inwardly guarded. Note: Zhang Jingyue stated, "In the ancient era of perfect virtue, pathogenic factors could not invade. Thus, for any illness, only Zhu You was used, as the disease was mild and treatment easy. According to Ming dynasty regulations, medicine was divided into thirteen departments: Internal Medicine for Adults, Internal Medicine for Children, Gynecology, Cold Damage Disorders, Surgery/Traumatology, Acupuncture, Ophthalmology, Stomatology, Otolaryngology, Orthopedics, Foreign Body Extraction, Massage, and Zhu You. Currently, Massage and Zhu You have been lost, existing only in folk practice. 'Zhu' is pronounced 'zhi jiu qie'.")
Qibo replied: In ancient times, people lived among birds and beasts, moving to avoid cold, dwelling in shaded areas to avoid heat. Internally, they had no burden of longing or attachment; externally, they had no form of servitude or official striving. This was an era of tranquility and emptiness, where pathogenic factors could not penetrate deeply. Therefore, medicinal herbs could not treat internally, nor acupuncture and stone therapy externally; thus, shifting spirit and using Zhu You sufficed. (In ancient times, people nested in trees or dwelt in caves, hiding at night and roaming by day, clearly living among beasts. However, active movement generates abundant Yang-Heat, keeping the body warm enough to resist cold; cool air brings chill, so dwelling in shade allows one to avoid heat. If desires and thoughts are discarded, there is no internal burden of longing; if the heart lacks wishes and cravings, there is no external strain of seeking fame or office. Preserving natural innocence through stillness naturally prevents pathogenic victory. Hence, shifting spirit and changing qi requires no medicinal herbs, and explaining the origin of illness via incantations requires no acupuncture or stone therapy. Note: Zhang Jingyue said, "'Shen' refers to the state of flexion and extension. 'Huan' refers to the burden of fame and profit. With no internal longing and no external pursuit, it is called an era of tranquility. 'Zhu' is synonymous with 'Zhou' (curse/incantation). 'You' refers to the origin of the disease. Hence, it is called Zhu You.")
Today's world is different. Worries and anxieties entangle the interior, physical hardship damages the exterior, and one loses compliance with the reversals and adherence of the four seasons, failing to adapt to cold and heat. Treacherous winds arrive frequently, and empty pathogens attack morning and night, penetrating inward to the five Zang organs and bone marrow, and outwardly damaging pores, skin, and muscles. Consequently, minor illnesses inevitably worsen, and major illnesses inevitably lead to death; thus, Zhu You cannot cure them.
The Yellow Emperor said: Excellent! I wish to face patients, observe life and death, resolve doubts, and understand the essentials, seeing them clearly like the sun and moon. May I hear this? (Note: The light of the sun and moon is visible to all who have eyes. This question seeks the essential principle of treatment, desiring an answer that is obvious and clear.)
Qibo replied: Complexion and pulse are highly valued by the Supreme Emperor and transmitted by the Ancient Masters. (Supreme Emperor refers to the emperors of antiquity. Ancient Masters refer to Qibo's ancestral teacher, Jiu Daiji.) In antiquity, the Supreme Emperor appointed Jiu Daiji to organize and analyze pulse and complexion, attaining understanding of Shen-Ming (Spiritual Illumination), integrating them with the Five Elements (Metal, Wood, Water, Fire, Earth), the Four Seasons, Eight Winds, and Six Directions, without deviating from their constants. (Note: Zhang Jingyue said, "Organizing complexion and pulse involves examining the subtleties of the interior and exterior. Attaining spiritual illumination means that once complexion and pulse are distinguished, the spiritual essence becomes manifest. The correspondence of complexion and pulse aligns everywhere, just as the waning and waxing of the Five Elements, the passage of the Four Seasons, the changes of the Eight Winds, and the expanse of the Six Directions follow consistent laws of increase and decrease.") By observing how changes shift and interact, one perceives their wonder and grasps their essence. To grasp the essence, one must look to complexion and pulse. (Note: Zhang Jingyue said, "The Qi of the Five Elements, Four Seasons, and Eight Winds alternates in abundance and deficiency, causing shifts in transformation. Complexion and pulse respond accordingly, allowing one to perceive their wonder and grasp their essence. For all the five Zang and six Fu organs, hundred bones, and nine orifices, pulses are determined by Qi, and Qi conforms to Heaven. Although profound and difficult to measure, only through complexion and pulse can they be examined. Thus, it is said that to grasp the essence, one looks to complexion and pulse.") Complexion corresponds to the Sun, and pulse corresponds to the Moon. Constantly seeking their essence reveals the essence itself. (Note: Zhang Jingyue said, "Complexion divides into the Five Elements, with brightness and darkness as its variations; the Sun has twelve stems, with cloudy and clear skies as its variations, hence complexion corresponds to the Sun. Pulse has twelve meridians, with deficiency and excess as its variations; the Moon has twelve stations, with waxing and waning as its variations, hence pulse corresponds to the Moon. Constantly seeking the essence of complexion and pulse makes one bright as the sun and moon, obtaining the essence of their transformations.")
The changes in complexion correspond to the pulses of the four seasons. This is what the Supreme Emperor values, aligning with spiritual illumination. Thus, one stays far from death and close to life, prolonging the way of life, which is called the Sage King. (Note: Pulses respond internally according to time, and complexion manifests externally corresponding to pulses. When complexion and pulse correspond, death is kept at bay and life draws near. Only the ancient emperors understood this, enabling them to ward off aging and preserve their physical form, acting in accordance with spiritual illumination, thereby fully mastering the way of health preservation.)
In the middle ancient era, when disease arrived, treatment involved decoctions (Tang Ye). After ten days, the diseases of Eight Winds and Five Obstructions (Bi) would be eliminated. If not cured after ten days, treatment involved the branches of grass leaves (Su) and grass roots (Gai), using root and branch together for mutual assistance. Once the root and branch aspects were addressed, the pathogenic factor submitted. (Eight Winds refer to winds from eight directions. Five Bi refer to obstruction in skin, flesh, sinew, bone, and vessels. Note: Zhang Jingyue said, "In the middle ancient era, treatment began only after disease arrival, initially using Tang Ye. Tang Ye is made from grains, not medicinal herbs. Taking it for ten days eliminates Eight Wind and Five Bi diseases. If not cured after ten days, treatment uses grass leaves and roots. 'Su' means leaf. 'Gai' means root. 'Zhi' means stem. Roots and stems assist each other, hence 'root and branch assist,' which is the later-era decoction. The disease source is the root, the disease manifestation is the branch. Grasping both ensures pathogenic submission. This middle-ancient treatment, while not foreseeing disease before onset like the upper ancient era, was still not erroneous like later eras. 'Gai' is pronounced 'gai'.")
In the late era, treatment is different. Treatment does not follow the four seasons, ignores the sun and moon, and fails to examine reversal and adherence. (Each season's Qi resides in specific locations; attacking blindly without considering these locations is contrary to antiquity. *Si Shi Ni Cong Lun* states: "Spring Qi is in the channels, Summer Qi in collateral vessels, Late Summer Qi in muscles, Autumn Qi in skin, Winter Qi in bone marrow." One should expel hidden pathogens according to their location. Ignoring the sun and moon means ignoring daily temperature/light changes and lunar fullness/emptiness. *Ba Zheng Shen Ming Lun* states: "Acupuncture methods must await the Qi of sun, moon, stars, four seasons, and eight correct periods. Only when Qi is stable should one needle. Thus, on warm sunny days, human blood is fluid and Wei-Qi floats, making blood easy to drain and Qi easy to move; on cold cloudy days, blood coagulates and Wei-Qi sinks. At moon birth, blood and Qi begin to refine and flow; at moon fullness, blood and Qi are abundant, muscles firm; at moon emptiness, muscles diminish, channels deficient, Wei-Qi departs, leaving only the form. Therefore, adjust blood and Qi according to heavenly timing. Do not needle on cold days, hesitate not on warm days, do not drain at moon birth, do not tonify at moon fullness, do not treat at moon emptiness. This is adjusting according to time." This refers to this. Failing to examine reversal and adherence means failing to assess whether a disease is treatable. Note: Zhang Jingyue said, "Citing the Grand Tutor's commentary, the explanation is correct but incomplete. For instance, ignoring the four seasons implies ignorance of the prosperity/decline of Luck (Yun) and the waxing/waning of Yin/Yang. Those overusing warm/hot herbs forget the blazing heat of heaven and earth; those exclusively using cold/cool herbs miss the flow of host and guest Qi. All five tones have appropriate taboos; how can they be treated as ordinary? *Wu Chang Zheng Da Lun* says: 'First know the annual Qi, do not violate or harmonize improperly.' If one violates this despite ignorance, it is like carrying firewood to save a fire or adding frost to snow. Regarding ignoring the sun and moon, Wang Bing interpreted them literally. However, this chapter focuses on complexion and pulse. Thus, lacking knowledge of complexion and pulse means lacking the subtlety of tripartite comparison and clarity of interior/exterior diagnosis. When complexion and pulse disagree, whom should one abandon symptoms for pulse? When urgency and slackness conflict, whom should one treat first? Without clear principles, recklessness knows no bounds. This integration of complexion and pulse is indispensable, hence called 'sun and moon.' Furthermore, failing to examine reversal/adherence involves Qi and color reversal/adherence. *Yu Ban Lun Yao* says: 'Color appearing up/down/left/right has its critical point. Up is reversal, down is adherence; for women, right is reversal, left is adherence; for men, left is reversal, right is adherence.' There is also pulse reversal/adherence across four seasons. *Ping Ren Qi Xiang Lun* says: 'Pulses have reversal/adherence to four seasons. Without organ shape, thin pulses in spring/summer and floating-large pulses in autumn/winter are named reversal to four seasons.' *Yu Ji Zhen Zang Lun* says: 'Reversal to four seasons means: Spring getting Lung pulse, Summer getting Kidney pulse, Autumn getting Heart pulse, Winter getting Spleen pulse, all hanging, isolated, deep, and choppy, is named reversal to four seasons.' There is also pulse-symptom reversal/adherence. *Ping Ren Qi Xiang Lun* says: 'Wind-heat with quiet pulse, diarrhea with excessive bleeding and solid pulse, interior disease with deficient pulse, exterior disease with choppy/firm pulse—all are difficult to treat, named reverse to four seasons.' *Yu Ji Zhen Zang Lun* says: 'Hot disease with quiet pulse, diarrhea with large pulse, bleeding with solid pulse, interior disease with solid/firm pulse, exterior disease with non-solid/non-firm pulse—all are difficult to treat.' There is also treatment method reversal/adherence. *Zhi Yao Yao Da Lun* says: 'Some are obtained by reversal, some by adherence. Reversal is proper adherence. If adherent, it is reversal.' It also says: 'For mild cases, use reversal; for severe cases, use adherence.' And: 'Reversal is direct treatment, adherence is contrary treatment. Follow less or more, observing the situation.' *Wu Chang Zheng Da Lun* says: 'Strengthen internal guarding, align with Qi, peace can be achieved; for false conditions, do the opposite.' These are all ways of reversal and adherence, which doctors must study diligently. If one does not understand the reversal/adherence of seasonal pulses and symptoms, one does not recognize the principles of life and death, leading to many errors in treating disease. If one does not understand the reversal/adherence of therapeutic discussion, one will inevitably prescribe recklessly, cutting off long life—this is truly doctors killing patients. This is a common flaw of the late era, worthy of detailed examination.")
When the disease form has already manifested, one attempts to treat externally with fine needles and internally with decoctions. Crude practitioners act frantically, believing they can attack, so the old disease remains, and new diseases arise. (... Note: Zhang Jingyue said, "Unable to prevent before onset and unable to observe current status, their hearts are coarse and shallow, administering needles and drugs randomly. These individuals, assuming excess and attacking, leave false excess unremoved while true deficiency arrives; assuming heat and cooling, leave original heat unremoved while new cold arises. Such methods are insufficient to heal humans and merely sufficient to harm them.")
The Yellow Emperor said: I have heard the essentials from the Master. The Master speaks of nothing but complexion and pulse, which is what I know. Qibo said: The ultimate limit of treatment lies in "One." (Note: Zhang Jingyue said, "The Dao of One is great, the origin of all things. The *I Ching* says: 'Heaven generates One, Water.' Yao said: 'Be precise and unified, sincerely hold the Mean.' Laozi said: 'Dao generates One, One generates Two, Two generates Three, Three generates Ten Thousand Things.' He also said: 'Heaven obtains One to be clear, Earth obtains One to be tranquil, Spirit obtains One to be spiritual, Valley obtains One to be full, Ten Thousand Things obtain One to live, Lords and Kings obtain One to be the rectitude of the world.' Confucius said: 'My Dao is penetrated by One.' Buddhists say: 'All Dharmas return to One.' Zhuangzi said: 'Connect with One and all matters are completed.' Shao Yong said: 'Heaven divides creation from within One.' *Zhi Yao Yao Lun* etc. say: 'Knowing the essence, one word ends it; not knowing the essence, one scatters infinitely.' Here it says the ultimate of treatment is One; the Dao is the same. Thus, if a person obtains One, the universe is in their hands; if a person knows One, all transformations return to the heart.")
The Yellow Emperor said: What is meant by "One"? Qibo said: "One" is obtained through investigating the cause. (Note: Heaven and Earth and all things originate from One, so "One" is a comprehensive term. How does this apply to disease? Generally, at the onset of any disease, there is always a cause. Following the cause to deduce, "One" can be obtained. To obtain this "One," it is indeed as described below.)
The Yellow Emperor said: How? (Note: Meaning, how can it be obtained?)
Qibo said: Close the doors and windows, focus on the patient, ask carefully about their emotional state, and follow their intentions. Obtaining Spirit leads to prosperity; losing Spirit leads to death.
The Yellow Emperor said: Excellent! (Note: This is precisely the method of seeking the cause to obtain One. "One" is Spirit. The gain or loss of Spirit is not easily glimpsed. One must ensure the patient rests quietly in a room, hearing nothing and seeing nothing. Then, gently and tactfully, inquire into their inner feelings, adapting to circumstances and soothing their mind to observe the gain or loss of their Spirit. Then, life and death can be immediately distinguished. This is what is meant by the ultimate of treatment being One. That is all. Zhang Jingyue's interpretation of the meaning of "One" is very accurate, but separating Spirit and One seems to overlook this connection.)