而脉先变易，是先天而至，故病。）阴阳易者危。（不应天常，气见交错，失其恒位，更易见之，阴位见阳脉，
阳位见阴脉，是易位而见也，二气之乱故危。）
帝曰∶六气标本所从不同奈何？岐伯曰∶气有从本者，有从标本者，有不从标本者也。帝曰∶愿卒闻之。岐
伯曰∶少阳太阴从本，少阴太阳从本从标，阳明厥阴不从标本，从乎中也。（少阳之本火，太阴之本湿，本末同，
故从本也。少阴之本热，其标阴，太阳之本寒，其标阳，本末异，故从本从标。阳明之中太阴，厥阴之中少阳，
本末与中不同，故不从标本，从乎中也。从本从标从中，皆以其为化主之用也。）故从本者化生于本，从标本
者有标本之化，从中者以中气为化也。（化谓气化之元主也。有病，以元主气，用寒热药治之。按∶六微旨大
论曰∶“所谓本也。本之下，中之见也。见之下，气之标也。本标不同，
气应异象。”此之谓也。）
帝曰∶脉从而病反者，其诊何如？岐伯曰∶脉至而从，按之不鼓，诸阳皆然。（言病热而脉数，按之不动，
乃寒盛格阳而致之，非热也。）帝曰∶诸阴之反，其脉何如？岐伯曰∶脉至而从，按之鼓甚而盛也。（形证是寒，
按之而脉气鼓击于手下盛者，此为热盛拒阴而生病，非寒也。按∶反者，谓阳病脉当浮数而反沉迟，阴病脉当沉
迟而反浮数，如阳证似阴，阴证似阳之类是也。证阳脉阴，久病得之，为阳虚气弱，真元太亏，法宜温补；暴病
得之，为气虚邪陷，为阴盛阳微，多致危殆。证阴脉阳，初病得之，为暴怒呕衄，为虚火上升，犹可滋补；久病得之，
为阴竭阳浮，为精血干槁，劳瘵成矣。凡若此者，病为本，反为标，诊者不可不辨也。注言似是而尚未明确。）
是故百病之起，有生于本者，有生于标者，有生于中气者，有取本而得者，有取标而得者，有取中气而得者，
有取标本而得者，有逆取而得者，有从取而得者。逆，正顺也；若顺，逆也。（按∶本寒标热而即以热药治热，
本热标寒而即以寒药治寒，于标诚逆，于本正顺，此从治之妙法也。俗工不知此理，但泥外迹，若本寒标热而
直以寒治热，本热标寒而直以热治寒，于标似顺，于本则逆矣，可不慎乎。）故曰∶知标与本，用之不殆，明知
逆顺，正行无间。此之谓也。……大要曰∶粗工嘻嘻，以为可知，言热未已，寒病复始，同气异形，迷诊乱经。
此之谓也。（……按∶此反复嗟叹本标之不可不明也。盖本标不明，则寒热误施矣。）
帝曰∶胜复之变，早晏何如？岐伯曰∶夫所胜者，胜至已病，病已愠，愠而复已萌也。夫所复者，胜尽而起，
得位而甚。（按∶天地之道，消息盈虚，循环不已，有胜必复，自然之理也。胜至则病，既病而复之机已萌，是
复即复于胜极
之时，胜尽复起，复气得令，循致于甚，复仍胜矣，仍胜仍复，如环无端。）胜有微甚，复有少多，胜和而和，
胜虚而虚，天之常也。（按∶复常视胜也。）帝曰∶胜复之作，动不当位，或后时而至，其故何也？（按∶谓
四时有应胜应复之期，而时有不应者何故。）岐伯曰∶夫气之生与其化，衰盛异也，寒暑温凉盛衰之用，其在四
维。故阳之动，始于温，盛于暑，阴之动，始于清，盛于寒，春夏秋冬各差其分。（言春夏秋冬四正之气，在于四
维之分也。按∶四序推移，时至气换，一岁之中，盖自然之胜复也。四维乃交换之际，盛则先时，衰则后至，于
交换之际见之，故曰在四维也。此言胜复之常，以时序言；前言胜复之变，以病气言。然则胜复有二乎？曰∶惟
时序之胜复有衰盛之殊，故病之胜复有微甚之分，二而一者也。差，七赐切。）故大要曰∶彼春之暖，为夏之暑，
彼秋之忿，为冬之怒，谨按四维，斥候皆归，其终可见，其始可知。此之谓也。（按∶暖极则暑，忿极则怒，其始其终，
断可识矣。）帝曰∶差有数乎？岐伯曰∶又凡三十度也。（度者，日也。按∶新校正云∶“六元正纪大论曰∶‘差
有数乎？曰∶后皆三十度而有奇也。’此云三十度也者，此文为略。”）帝曰∶其脉应皆何如？岐伯曰∶差同正法，
待时而去也。（按∶待时而去，义未详。）脉要曰∶春不沉，夏不弦，冬不涩，秋不数，是谓四塞。（按∶塞，
闭固不通也。人之经脉，外应四时，则有春弦夏数秋涩冬沉之殊，然其气常周流贯通于上下前后之际。如春脉宜
弦，而其气则上承于冬，下流于夏，故春脉弦而兼沉，夏脉数中带弦，是上下之气相通也。若由冬交春，脉止见
弦，是上下气隔，闭塞不通矣。故春宜弦而沉，夏宜数而弦，秋宜涩而数，冬宜沉而涩，否则谓之四塞也。王注
但解塞字意，而不沉不弦等义全未发明。愚谓此节之义，当与四气调神论参看。）沉甚曰病，弦甚曰病，涩
甚曰病，数甚曰病，（按∶前节言四时之气不相接续而为患，此言四时之脉太过，则气极而为病也。）参见曰病，
复见曰病，未去而去曰病，去而不去曰病，（参见谓参和诸气来见，复见谓再见已衰已死之气也，去谓王已而去
者也。日行之度未出于差，是谓天气未出，日度过差，是谓天气已去，而脉尚在，既非得应，故曰病也。按∶参见，
注解太混。复见，注谓再见已衰已死之气，夫死脉初见，便已可危，若果再见，岂止为病而已。盖参者不一也，
谓一部之内见数脉也，脉象不纯，焉得不病。复见者，谓前以某脉而病，厥后小瘥，前脉又见，病根未拔，故
如是也。去未去义，诚如王注。）反者死。（……夏见沉，秋见数，冬见缓，春见涩，是谓反也。违犯天命，其能
久乎。按∶新校正云∶“详上文秋不数是谓四塞，此注云秋见数是谓反。盖以脉差只在仲月，差之度尽而数不去，
若秋之季月而脉尚数，则为反也。”此辨最为明确。）夫阴阳之气，清静则生化治，动则苛疾起，此之谓也。
（按∶六微旨大论曰∶“成败倚伏生乎动，动而不已则变作矣。”）
帝曰∶幽明何如？岐伯曰∶两阴交尽故曰幽，两阳合明故曰明，幽明之配，寒暑之异也。（两阴交尽于戌
亥，两阳合明于辰巳。灵枢系日月论云∶“亥十月左足之厥阴，戌九月右足之厥阴，此两阴交尽，故曰厥阴。辰三月左足
之阳明，巳四月右足之阳明，此两阳合于前，故曰阳明。”然阴交则幽，阳合则明，幽明之象当如是也。
寒暑位西南、东北，幽明位西北、东南，幽明之配，寒暑之位，诚斯异也。）帝曰∶分至何如？岐伯曰∶气至之
谓至，气分之谓分，至则气同，分则气异，所谓天地之正纪也。（因幽明之问而形斯义也，言冬夏二至是天地气，
主岁至其所在也。春秋二分是间气，初、二、四、五，四气各分其政于主岁左右也。）
帝曰∶夫子言春秋气始于前，冬夏气始于后，余已知之矣。然六气往复，主岁不常也，其补泻奈何？
（以分至明六气分位，则初气四气始于立春立秋前各一十五日为纪法，三气六气始于立夏立冬后各一十五日为纪法。
由是四气前后之纪，则三气六气之中，正当二至日也。故曰∶春秋气始于前，冬夏气始于后也。然以三百六十五日
易一气，一岁已往，气则改新，新气既来，旧气复去，所宜之味，天地不同，补泻之方，应知先后，故复以问也。）
岐伯曰∶……少阳之主，先甘后咸；阳明之主，先辛后酸；太阳之主，先咸后苦；厥阴之主，先酸后辛；少阴之主，
先甘后咸；太阴之主，先苦后甘。佐以所利，资以所生，是谓得气。（主谓主岁，得谓得其性用也。得其性用
则舒卷由人，不得性用则动生乖忤，岂祛邪之可望乎。）
帝曰∶善！夫百病之生也，皆生于风寒暑湿燥火，以之化之变也。（风寒暑湿燥火，天之六气也。静而顺者为
化，动而变者为变，故曰之化之变也。）经言盛者泻之，虚者补之。余锡以方士，而方士用之尚未能十全，余欲
令要道必行，桴鼓相应，犹拔刺雪污，工巧神圣，可得闻乎？（针曰工巧，药曰神圣。按∶难经云∶“望而知之
谓之神，闻而知之谓之圣，问而知之谓之工，切脉而知之谓之巧，以外知之曰圣，以内知之曰神。”）岐伯曰∶审
察病机，无失气宜。此之谓也。（按∶人之致病，各有其机，机之所动，气类分焉，审切其宜，斯无失矣。张景岳
曰∶“按气交变、五常政、至真要等论，皆详言五运六气各有太过不及，而天时民病变必因之，故有淫胜反胜客胜
主胜之异。盖气太过则亢极而实，气不及则被侮而虚，此阴阳盛衰自然之理也。此节于本篇之末统论病机，谓脏五
气六各有所主，或实或虚，无不从气之变而病有不同也。即如诸风掉眩皆属于肝矣，若木胜则四肢强直而为掉，
风动于上而为眩，脾土受邪，肝之实也；木衰则血不养筋而为掉，气虚于上而为眩，金邪乘木，肝之虚也。又如
诸痛痒疮皆属于心矣，若火盛则炽热为痈，心之实也；阳衰则阴胜为疽，心之虚也。五脏六气虚实皆然，故本篇首言
盛者泻之，虚者补之；末言有者求之，无者求之，盛者责之，虚者责之。盖既以气宜言病机矣，又特以盛虚有无
四字贯一篇之首尾以尽其义，此正先圣心传，精妙所在，最为吃紧纲领。奈何刘河间未之详审，略其颠末，独
取其中一十九条演为原病式，皆偏言盛气实邪，且于十九条中，凡归重于火者十之七八，至于不及虚邪，则全不
相顾。又曰∶‘其为治者，但当泻其过甚之气以为病本，不可反误治其兼化也。’立言若此，虚者何堪，故楼
氏指其治法之偏，诚非过也。夫病机为入道之门，为跬步之法，法既不善，局人耳目，初学得之，多致终身不能
超脱，习染已久，流弊日深，所以近代医家，举动皆河间遗风，其于泻假热，伐真虚，复人于反掌间者，比比然
也。或讳之曰∶河间当胡元之世，其风声气习本有不同，因时制宜，故为是论。即或有之，乃世变风移，今非昔
比，设欲率由其旧，恐冰炭钩绳不相符也，心切悯之，不容不辨。”谨按河间谈理自是明彻，但嫌原病式所言，
惟顺文解释，都说向实热一边而无所发明，所以滋后人之议，立言之家贵中正，有以也。景岳此辨，原本虚实，
考验真假，病机气宜，两得之矣。但其大意又似侧重虚寒上去，使后人迹而泥之，必致矫枉过直，吾恐将来之乌附
桂姜，亦犹昔日之芩连栀柏，其受诬也，不诚冤哉。阴阳应象论曰∶“善诊者，察色按脉，先别阴阳。”医不细
心体认，诚能如经之所言，则色脉混淆，阴阳倒置，宗河间者既虚虚，遵景岳者必实实，甚矣医家之不可有成见
也。）帝曰∶愿闻病机何如？岐伯曰∶诸风掉眩，皆属于肝。（按∶张景岳曰∶“风类不一，故曰诸风。掉，摇也。
眩，运也。风主动摇，木之化也，故属于肝。其虚其实，皆能致此。如发生之纪，其动掉眩巅疾，厥阴之复，筋
骨掉眩之类者，肝之实也。又如阳明司天，掉振鼓栗，筋痿不能久立者，燥金之盛，肝受邪也。太阴之复，头顶
痛重而掉螈尤甚者，木不制土，湿气反胜，皆肝之虚也。故卫气篇曰∶‘下虚则厥，上虚则眩。’亦此之谓。凡
实者宜凉宜泻，虚则宜温宜补，反而为之，祸不旋踵矣。余治仿此。”）诸寒收引，皆属于肾。（“收，敛也。
引，急也。肾属水，其化寒，凡阳气不达，则营卫凝聚，形体拘挛，皆收引之谓。如太阳之胜，为筋肉拘苛，血
脉凝泣，岁水太过，为阴厥，为上下中寒，水之
实也。岁水不及，为足痿清厥，涸流之纪，其病癃闭，水之虚也。水之虚实皆本于肾。”）诸气 郁，皆属于
肺。（“ ，喘急也。郁，痞闷也。肺属金，其化燥，燥金盛，则清邪在肺而肺病有余，如岁金太过，甚则喘
咳逆气之类是也。金气衰，则火邪胜之而肺病不足，如从革之纪，其发喘咳之类是也。肺主气，故诸气 郁者，
其虚其实皆属于肺。”谨按景岳言化燥，误矣。夫肺与大肠为表里，并属金，然肺主辛，阴金耳。阳明大肠属
庚，阳金也，其化乃得谓之燥。六气燥金居其一，正指大肠，非肺也。曰∶然则肺金独无化乎？曰∶清肃是矣。
音愤。）诸湿肿满，皆属于脾。（“脾属土，其化湿，土气实，则湿气盛行，如岁土太过，则饮发中满食减，
四肢不举之类是也。土气虚，则风木乘之，寒水侮之，如岁木太过，脾土受邪，民病肠鸣腹支满，卑监之纪，其
病留满痞塞，岁水太过，甚则腹大胫肿之类是也。脾主肌肉，故诸湿肿满等证，其虚实皆属于脾也。”）诸痛
痒疮，皆属于心。（“热甚则疮痛，热微则疮痒。心属火，其化热，故诸痛痒疮，皆属心也。然赫曦之纪，其
病疮疡，心邪盛也。太阳司天，亦发为痈疡，寒水胜也。火盛则心实，水胜则心虚，于此可见。”按此条古本
在诸热瞀螈之下，今挈置于此，合上文也。）诸热瞀螈，皆属于火。（“瞀，昏闷也。螈，抽掣也。邪热伤神
则瞀，亢阳伤血则螈，故皆属于火。然岁火不及，则民病两臂内痛，郁冒 昧。岁水太过，则民病身热烦心躁
（脉象先发生变异，这是先天之气已至的表现，所以会发病。）阴阳易位则病情危重。（不应合于天时的常态，气机出现交错，失去了其固定的位置，相互更替显现。阴位见到阳脉，阳位见到阴脉，这就是易位而见，由于阴阳二气混乱，所以危险。）
黄帝说：六气的标本所从不同，为什么呢？岐伯说：六气有从本化的，有从标本化的，有不从标本而从中的。黄帝说：希望听您详细讲讲。岐伯说：少阳和太阴从本化，少阴和太阳从本化也兼从标化，阳明和厥阴不从标本，而从其中气化。（少阳的本是火，太阴的本是湿，本与末相同，所以从本化。少阴的本是热，其标是阴；太阳的本是寒，其标是阳，本与末不同，所以既从本也从标。阳明的中气是太阴，厥阴的中气是少阳，本、末与中气都不同，所以不从标本，而从其中气化。无论是从本、从标还是从中，都是依据气化主导的作用。）所以从本的，气化生于本；从标本的，有本和标的两种气化；从中的，以中气为气化主宰。（“化”指气化的元主。有病时，根据元主之气，用寒性或热性药物治疗。按：《六微旨大论》说：“所谓本。在本之下，是中气的表现。在中气之下，是气的标。本和标不同，气应的征象也不同。”说的就是这个道理。）
黄帝说：脉象顺从病证但症状相反，诊断是怎样的？岐伯说：脉象看似顺从，但重按之下不鼓动，所有阳证都是这样。（意思是病表现为热，脉象数，但重按时脉搏不动，这是寒盛格拒阳气所致，并非真热。）黄帝说：所有阴证的反常情况，脉象是怎样的？岐伯说：脉象看似顺从，但重按时鼓动非常强劲盛大。（形体症状是寒，但重按时脉气在手下鼓击盛大，这是热盛拒阴而生病，并非真寒。按：所谓“反”，是指阳病脉应当浮数反而沉迟，阴病脉应当沉迟反而浮数，如阳证似阴、阴证似阳之类。证候属阳而脉象属阴，久病得此，是阳虚气弱，真元大亏，法当温补；暴病得此，是气虚邪陷，阴盛阳微，多导致危殆。证候属阴而脉象属阳，初病得此，是暴怒呕血或虚火上炎，尚可滋补；久病得此，是阴竭阳浮，精血干枯，已成劳瘵。凡是这种情况，病证为本，脉象之反为标，诊者不可不辨别。注解说似是而非，尚未明确。）
因此百病的发生，有的生于本，有的生于标，有的生于中气；治疗上，有取本而愈的，有取标而愈的，有取中气而愈的，有标本同治而愈的，有逆治而愈的，有从治而愈的。逆治，对于本质来说是正顺；如果顺从表象，反而是逆治。（按：本寒标热却用热药治热症，本热标寒却用寒药治寒症，对于标症确实是逆治，但对于本却是正顺，这是从治的妙法。庸医不懂这个道理，只拘泥于外在表象，若本寒标热直接用寒药治热，本热标寒直接用热药治寒，对于标症似乎顺从，对于本却是逆治了，能不谨慎吗？）所以说：知悉标与本，运用起来就不会危险；明晓逆与顺，行事就能没有差错。说的就是这个道理。……《大要》说：粗工嘻嘻哈哈，自以为知道，谈论热病还没完，寒病又发作，同气异形，迷惑诊断，扰乱经脉。说的就是这种人。（……按：这里反复感叹本标不可不明。因为本标不明，就会误施寒热药物。）
黄帝说：胜气和复气的变化，早晚如何？岐伯说：所谓的胜气，胜气一到就发病，病势酝酿，酝酿之后复气又开始萌生。所谓的复气，胜气尽时才兴起，得令时最严重。（按：天地之道，消长盈虚，循环不已，有胜必有复，这是自然之理。胜气至则病，既病之后复气的机制已萌生，所以复气即在胜气极盛之时，胜气尽复气起，复气得令，逐渐发展到严重，复气仍像胜气一样强盛，胜而复，复又胜，如环无端。）胜气有轻微和严重之分，复气有多和少之别，胜气平和则复气平和，胜气虚弱则复气虚弱，这是天的常态。（按：复气通常视胜气而定。）黄帝说：胜气和复气的发作，动作不当位，或者迟到，这是什么原因？（按：谓四时有应胜应复的时期，但有时不应期，是什么缘故。）岐伯说：气的生成与其变化，衰盛是不同的。寒暑温凉盛衰的运用，在于四维（四季之交）。所以阳气的发动，始于温和，盛于暑热；阴气的发动，始于清凉，盛于严寒。春夏秋冬各有其差别。（言春夏秋冬四正之气，存在于四维之分。按：四序推移，时至气换，一年之中，大概是自然的胜复。四维乃是交换之际，盛则先时，衰则后至，在交换之际可见，所以说在四维。此言胜复之常，以时序言；前言胜复之变，以病气言。那么胜复有两个吗？回答说：只有时序的胜复有衰盛之殊，所以病的胜复有微甚之分，二者是一回事。差，音七赐切。）所以《大要》说：那春天的温暖，成为夏天的暑热；那秋天的严厉，成为冬天的愤怒。谨慎观察四维，斥候（气象观测）皆归于此，其终结可见，其开始可知。说的就是这个道理。（按：暖极则暑，厉极则怒，其始其终，断然可识。）黄帝说：差别有定数吗？岐伯说：又是三十度。（度，指日。按：新校正说：“《六元正纪大论》说：‘差别有定数吗？回答说：之后都有三十度有余。’这里说三十度，此文较为简略。”）黄帝说：其脉象反应都是怎样的？岐伯说：差别同于正法，等待时令过去而消退。（按：待时而去，含义不详。）《脉要》说：春不见沉脉，夏不见弦脉，冬不见涩脉，秋不见数脉，这叫四塞。（按：塞，闭固不通。人的经脉，外应四时，则有春弦、夏数、秋涩、冬沉的不同，然而其气常周流贯通于上下前后之间。如春脉宜弦，但其气则上承于冬，下流于夏，所以春脉弦而兼沉，夏脉数中带弦，是上下之气相通。若由冬交春，脉只见弦，是上下气隔，闭塞不通了。所以春宜弦而沉，夏宜数而弦，秋宜涩而数，冬宜沉而涩，否则叫四塞。王冰注只解塞字意，而不沉不弦等义全未发明。我认为这一节的意思，应当与《四气调神大论》参看。）沉脉太过叫病，弦脉太过叫病，涩脉太过叫病，数脉太过叫病，（按：前节言四时之气不相接续而为患，此言四时之脉太过，则气极而为病。）参杂出现叫病，重复出现叫病，未去而去叫病，去而不去叫病，（参见谓参和诸气来见，复见谓再见已衰已死之气也，去谓旺气已去也。日行之度未出于差，是谓天气未出，日度过差，是谓天气已去，而脉尚在，既然不得应期，故曰病。按：参见，注解太混。复见，注谓再见已衰已死之气，夫死脉初见，便已可危，若果再见，岂止为病而已。盖参者不一也，谓一部之内见数脉也，脉象不纯，焉得不病。复见者，谓前以某脉而病，厥后小瘥，前脉又见，病根未拔，故如是也。去未去义，诚如王注。）相反的叫死。（……夏见沉脉，秋见数脉，冬见缓脉，春见涩脉，这叫反。违犯天命，能长久吗。按：新校正说：“详上文秋不数是谓四塞，此注云秋见数是谓反。盖以脉差只在仲月，差之度尽而数不去，若秋之季月而脉尚数，则为反也。”此辨最为明确。）阴阳之气，清静则生化有序，躁动则苛疾兴起，说的就是这个道理。（按：《六微旨大论》说：“成败倚伏生乎动，动而不已则变作矣。”）
黄帝说：幽和明是怎么回事？岐伯说：两阴交尽所以叫幽，两阳合明所以叫明，幽明的配合，就是寒暑的区别。（两阴交尽于戌亥，两阳合明于辰巳。《灵枢·系日月论》说：“亥十月左足之厥阴，戌九月右足之厥阴，此两阴交尽，故曰厥阴。辰三月左足之阳明，巳四月右足之阳明，此两阳合于前，故曰阳明。”然阴交则幽，阳合则明，幽明之象应当如此。寒暑位于西南、东北，幽明位于西北、东南，幽明的配合，寒暑的位置，确实有此区别。）黄帝说：分至是怎么回事？岐伯说：气至叫做至，气分叫做分，至则气同，分则气异，这就是天地的正纪。（因幽明之问而引出此义，言冬夏二至是天地气主岁至其所在也。春秋二分是间气，初、二、四、五，四气各分其政于主岁左右也。）
黄帝说：先生讲春秋气始于前，冬夏气始于后，我已经知道了。然而六气往复，主岁之气不固定，补泻该如何？（以分至明六气分位，则初气四气始于立春立秋前各一十五日为纪法，三气六气始于立夏立冬后各一十五日为纪法。由是四气前后之纪，则三气六气之中，正当二至日也。故曰∶春秋气始于前，冬夏气始于后也。然以三百六十五日易一气，一岁已往，气则改新，新气既来，旧气复去，所宜之味，天地不同，补泻之方，应知先后，故复以问也。）岐伯说：……少阳之主，先甘后咸；阳明之主，先辛后酸；太阳之主，先咸后苦；厥阴之主，先酸后辛；少阴之主，先甘后咸；太阴之主，先苦后甘。佐以所利，资以所生，这就叫得气。（主谓主岁，得谓得其性用也。得其性用则舒卷由人，不得性用则动生乖忤，岂祛邪之可望乎。）
黄帝说：好！各种疾病的发生，都生于风寒暑湿燥火，这是天之六气，静而顺者为化，动而变者为变，所以说“之化之变”。经文说盛者泻之，虚者补之。我赐予方士，而方士使用还不能十全十美，我想让要道必行，如桴鼓相应，犹拔刺雪污，工巧神圣，可以告诉我吗？（针曰工巧，药曰神圣。按：《难经》说：“望而知之谓之神，闻而知之谓之圣，问而知之谓之工，切脉而知之谓之巧，以外知之曰圣，以内知之曰神。”）岐伯说：审察病机，不要违背气宜。说的就是这个道理。（按：人之致病，各有其机，机之所动，气类分焉，审切其宜，斯无失矣。张景岳说：“按《气交变大论》、《五常政大论》、《至真要大论》等篇，都详细论述五运六气各有太过不及，而天时民病变必因之，故有淫胜、反胜、客胜、主胜之异。盖气太过则亢极而实，气不及则被侮而虚，这是阴阳盛衰自然之理。此节于本篇之末统论病机，谓脏五气六各有所主，或实或虚，无不从气之变而病有不同也。即如‘诸风掉眩皆属于肝’，若木胜则四肢强直而为掉，风动于上而为眩，脾土受邪，肝之实也；木衰则血不养筋而为掉，气虚于上而为眩，金邪乘木，肝之虚也。又如‘诸痛痒疮皆属于心’，若火盛则炽热为痈，心之实也；阳衰则阴胜为疽，心之虚也。五脏六气虚实皆然，故本篇首言‘盛者泻之，虚者补之’；末言‘有者求之，无者求之，盛者责之，虚者责之’。盖既以气宜言病机矣，又特以盛虚有无四字贯一篇之首尾以尽其义，此正先圣心传，精妙所在，最为吃紧纲领。奈何刘河间未之详审，略其颠末，独取其中一十九条演为《原病式》，皆偏言盛气实邪，且于十九条中，凡归重于火者十之七八，至于不及虚邪，则全不相顾。又曰：‘其为治者，但当泻其过甚之气以为病本，不可反误治其兼化也。’立言若此，虚者何堪，故楼氏指其治法之偏，诚非过也。夫病机为入道之门，为跬步之法，法既不善，局人耳目，初学得之，多致终身不能超脱，习染已久，流弊日深，所以近代医家，举动皆河间遗风，其于泻假热，伐真虚，复人于反掌间者，比比然也。或讳之曰：河间当胡元之世，其风声气习本有不同，因时制宜，故为是论。即或有之，乃世变风移，今非昔比，设欲率由其旧，恐冰炭钩绳不相符也，心切悯之，不容不辨。”谨按河间谈理自是明彻，但嫌《原病式》所言，惟顺文解释，都说向实热一边而无所发明，所以滋后人之议，立言之家贵中正，有以也。景岳此辨，原本虚实，考验真假，病机气宜，两得之矣。但其大意又似侧重虚寒上去，使后人迹而泥之，必致矫枉过直，吾恐将来之乌附桂姜，亦犹昔日之芩连栀柏，其受诬也，不诚冤哉。《阴阳应象大论》说：“善诊者，察色按脉，先别阴阳。”医不细心体认，诚能如经之所言，则色脉混淆，阴阳倒置，宗河间者既虚虚，遵景岳者必实实，甚矣医家之不可有成见也。）黄帝说：希望听听病机是怎样的？岐伯说：诸风掉眩，皆属于肝。（按：张景岳说：“风类不一，故曰诸风。掉，摇也。眩，运也。风主动摇，木之化也，故属于肝。其虚其实，皆能致此。如发生之纪，其动掉眩巅疾，厥阴之复，筋骨掉眩之类者，肝之实也。又如阳明司天，掉振鼓栗，筋痿不能久立者，燥金之盛，肝受邪也。太阴之复，头顶痛重而掉螈尤甚者，木不制土，湿气反胜，皆肝之虚也。故《卫气论》说：‘下虚则厥，上虚则眩。’亦此之谓。凡实者宜凉宜泻，虚则宜温宜补，反而为之，祸不旋踵矣。余治仿此。”）诸寒收引，皆属于肾。（“收，敛也。引，急也。肾属水，其化寒，凡阳气不达，则营卫凝聚，形体拘挛，皆收引之谓。如太阳之胜，为筋肉拘苛，血脉凝泣，岁水太过，为阴厥，为上下中寒，水之实也。岁水不及，为足痿清厥，涸流之纪，其病癃闭，水之虚也。水之虚实皆本于肾。”）诸气 郁，皆属于肺。（“ ，喘急也。郁，痞闷也。肺属金，其化燥，燥金盛，则清邪在肺而肺病有余，如岁金太过，甚则喘咳逆气之类是也。金气衰，则火邪胜之而肺病不足，如从革之纪，其发喘咳之类是也。肺主气，故诸气 郁者，其虚其实皆属于肺。”谨按景岳言化燥，误矣。夫肺与大肠为表里，并属金，然肺主辛，阴金耳。阳明大肠属庚，阳金也，其化乃得谓之燥。六气燥金居其一，正指大肠，非肺也。曰：然则肺金独无化乎？曰：清肃是矣。音愤。）诸湿肿满，皆属于脾。（“脾属土，其化湿，土气实，则湿气盛行，如岁土太过，则饮发中满食减，四肢不举之类是也。土气虚，则风木乘之，寒水侮之，如岁木太过，脾土受邪，民病肠鸣腹支满，卑监之纪，其病留满痞塞，岁水太过，甚则腹大胫肿之类是也。脾主肌肉，故诸湿肿满等证，其虚实皆属于脾也。”）诸痛痒疮，皆属于心。（“热甚则疮痛，热微则疮痒。心属火，其化热，故诸痛痒疮，皆属心也。然赫曦之纪，其病疮疡，心邪盛也。太阳司天，亦发为痈疡，寒水胜也。火盛则心实，水胜则心虚，于此可见。”按此条古本在诸热瞀螈之下，今挈置于此，合上文也。）诸热瞀螈，皆属于火。（“瞀，昏闷也。螈，抽掣也。邪热伤神则瞀，亢阳伤血则螈，故皆属于火。然岁火不及，则民病两臂内痛，郁冒 昧。岁水太过，则民病身热烦心躁
(When the pulse changes first, this indicates that the congenital Qi has arrived, thus disease occurs.) When Yin and Yang exchange positions, the condition is critical. (This does not conform to the normal pattern of Heaven; Qi appears in a disordered manner, losing its fixed position and exchanging places. When Yin positions show Yang pulses, and Yang positions show Yin pulses, this is called exchanging positions. Due to the chaos of Yin and Yang Qi, it is dangerous.)
The Yellow Emperor said: Why do the Ben (Root) and Biao (Branch) of the Six Qi differ? Qibo said: Some Qi follow the Ben, some follow both Ben and Biao, and some do not follow either but follow the Zhong Qi (Middle Qi). The Yellow Emperor said: I wish to hear this in detail. Qibo said: Shaoyang (Lesser Yang) and Taiyin (Greater Yin) follow the Ben; Shaoyin (Lesser Yin) and Taiyang (Greater Yang) follow both the Ben and the Biao; Yangming (Bright Yang) and Jueyin (Terminal Yin) do not follow the Ben or Biao but follow the Zhong Qi. (The Ben of Shaoyang is Fire, and the Ben of Taiyin is Dampness; since the Ben and End are the same, they follow the Ben. The Ben of Shaoyin is Heat, and its Biao is Yin; the Ben of Taiyang is Cold, and its Biao is Yang; since the Ben and End differ, they follow both the Ben and the Biao. The Zhong Qi of Yangming is Taiyin, and the Zhong Qi of Jueyin is Shaoyang; since the Ben, End, and Middle Qi are all different, they do not follow the Ben or Biao but follow the Zhong Qi. Whether following the Ben, Biao, or Zhong Qi, it is all due to the function of the master of transformation.) Therefore, those following the Ben have transformation born from the Ben; those following the Ben and Biao have transformations of both Ben and Biao; those following the Zhong Qi have transformation governed by the Middle Qi. ("Transformation" refers to the primary master of Qi transformation. In disease treatment, one treats according to the primary Qi, using Cold or Hot medicines. Note: *Liu Wei Zhi Da Lun* states: "What is called the Ben. Below the Ben is the manifestation of the Middle Qi. Below the Middle Qi is the Biao of the Qi. When Ben and Biao differ, the Qi responds with different phenomena." This is what is meant.)
The Yellow Emperor said: What is the diagnosis when the pulse conforms to the disease but the symptoms are contrary? Qibo said: The pulse may appear to conform, but upon deep pressure, it does not throb; this applies to all Yang conditions. (This means that although the disease presents as Heat with a rapid pulse, the pulse does not move upon deep pressure. This is caused by severe Cold repelling Yang, not true Heat.) The Yellow Emperor said: What about the contrary pulses in all Yin conditions? Qibo said: The pulse may appear to conform, but upon deep pressure, it throbs strongly and vigorously. (Although the physical signs indicate Cold, if the pulse qi beats strongly under the fingers upon deep pressure, this is caused by severe Heat repelling Yin, not true Cold. Note: "Contrary" refers to Yang diseases having pulses that should be Floating and Rapid but are instead Deep and Slow, or Yin diseases having pulses that should be Deep and Slow but are instead Floating and Rapid, such as Yang syndromes resembling Yin, or Yin syndromes resembling Yang. If the syndrome is Yang but the pulse is Yin, and this occurs in chronic illness, it indicates Yang deficiency and Qi weakness, with severe depletion of True Yuan; the method should be warming and tonifying. If this occurs in acute illness, it indicates Qi deficiency with pathogen sinking, Yin excess and Yang decline, often leading to critical danger. If the syndrome is Yin but the pulse is Yang, and this occurs in early illness, it may be due to sudden anger, vomiting blood, or floating deficient Fire; it can still be treated with nourishment. If this occurs in chronic illness, it indicates exhaustion of Yin with floating Yang, and dryness of essence and blood, resulting in consumptive disease. In all such cases, the syndrome is the Ben, and the contrary pulse is the Biao; the diagnostician must distinguish them clearly. The commentary notes that this is ambiguous and not yet clear.)
Therefore, the onset of all diseases arises from the Ben, from the Biao, or from the Zhong Qi. Treatment may cure by targeting the Ben, by targeting the Biao, by targeting the Zhong Qi, by treating both Ben and Biao, by counter-treatment (Ni), or by compliance treatment (Cong). Counter-treatment is actually correct compliance with the nature; compliance with the appearance is actually counter-treatment. (Note: Treating Heat symptoms with Hot medicine for a condition with Cold Ben and Heat Biao, or treating Cold symptoms with Cold medicine for a condition with Heat Ben and Cold Biao, is indeed counter-treatment for the Biao but correct compliance for the Ben; this is the subtle method of compliance treatment. Unskilled physicians do not understand this principle and stick only to external appearances. If they treat Heat with Cold for Cold-Ben/Heat-Biao, or Heat with Hot for Heat-Ben/Cold-Biao, it seems compliant for the Biao but counter for the Ben. Can one not be cautious?) Thus it is said: Knowing the Ben and Biao, one uses them without peril; clearly understanding Ni and Cong, one acts without error. This is what is meant. ... *Da Yao* says: The crude physician laughs, thinking he knows everything; before discussing Heat, Cold diseases reappear. Same Qi, different forms, confusing diagnosis and disordering the meridians. This refers to such people. (...Note: This repeatedly sighs that the Ben and Biao must be understood. If Ben and Biao are unclear, Cold and Heat will be misapplied.)
The Yellow Emperor said: How early or late are the changes of Sheng (Overcoming) and Fu (Rebounding)? Qibo said: Regarding Sheng, once the Sheng Qi arrives, disease occurs; as the disease brews, the Fu Qi begins to sprout. Regarding Fu, it rises after the Sheng Qi is exhausted and becomes severe when it attains its position. (Note: The way of Heaven and Earth involves waxing and waning, fullness and emptiness, cycling endlessly. Where there is Sheng, there must be Fu; this is natural law. When Sheng arrives, disease occurs, and the mechanism for Fu is already brewing. Thus, Fu rebounds at the peak of Sheng. When Sheng exhausts, Fu rises; when Fu Qi takes command, it develops to severity, and Fu again resembles Sheng. Sheng then Fu, Fu then Sheng, like a circle without end.) Sheng has slight and severe degrees; Fu has few and many degrees. If Sheng is mild, Fu is mild; if Sheng is weak, Fu is weak; this is the constant way of Heaven. (Note: Fu usually corresponds to Sheng.) The Yellow Emperor said: Why do Sheng and Fu sometimes act out of position or arrive late? (Note: This asks why the expected periods of Sheng and Fu in the four seasons sometimes do not occur.) Qibo said: The generation and transformation of Qi differ in decline and abundance. The use of Cold, Heat, Warmth, and Coolness in their abundance lies in the Four Corners (Si Wei). Thus, the movement of Yang begins with Warmth and peaks in Summer Heat; the movement of Yin begins with Coolness and peaks in Winter Cold. Spring, Summer, Autumn, and Winter each have their differences. (Referring to the four regular Qi of Spring, Summer, Autumn, and Winter, located in the divisions of the Four Corners. Note: The sequence shifts, time comes, and Qi changes. Within a year, this is roughly natural Sheng and Fu. The Four Corners are the moments of transition. Abundance comes early, decline comes late; seen at the transition, hence "in the Four Corners." This discusses the norm of Sheng and Fu by seasonal order; the previous discussion discussed the variation of Sheng and Fu by pathogenic Qi. Are there two types of Sheng and Fu? Answer: Only the seasonal Sheng and Fu have differences in decline and abundance, so the pathological Sheng and Fu have distinctions of slight and severe; the two are one. "Cha" is pronounced "qi".) Thus *Da Yao* says: The warmth of that spring becomes the heat of summer; the severity of that autumn becomes the anger of winter. Carefully observe the Four Corners; all observations return here. The end is visible, the beginning is known. This is what is meant. (Note: Extreme warmth leads to heat; extreme severity leads to anger. The beginning and end can certainly be recognized.) The Yellow Emperor said: Is there a specific number for these differences? Qibo said: It is thirty du. (Du refers to days. Note: Xin Zheng Jiao says: "*Liu Yuan Zheng Ji Da Lun* states: 'Is there a specific number for the difference? Answer: Afterward, there are always thirty du plus fractions.' Here it says thirty du; this text is abbreviated.") The Yellow Emperor said: How do the pulse responses correspond? Qibo said: The differences follow the standard method, waiting for the time to pass and then subsiding. (Note: "Waiting for the time to pass" is unclear. *Mai Yao* says: In Spring, no Deep pulse; in Summer, no Wiry pulse; in Winter, no Choppy pulse; in Autumn, no Rapid pulse. This is called Si Sai (Four Obstructions). (Note: Sai means closed and blocked. Human meridians respond externally to the four seasons, showing Wiry in Spring, Rapid in Summer, Choppy in Autumn, and Deep in Winter. However, their Qi constantly flows through upper/lower and front/back. For example, Spring pulse should be Wiry, but its Qi connects upward to Winter and flows downward to Summer, so the Spring pulse is Wiry and slightly Deep; Summer pulse is Rapid and contains Wiry qualities, indicating connection between upper and lower Qi. If transitioning from Winter to Spring, the pulse shows only Wiry, it means upper and lower Qi are separated and blocked. Thus, Spring should be Wiry and Deep, Summer Rapid and Wiry, Autumn Choppy and Rapid, Winter Deep and Choppy; otherwise, it is called Si Sai. Wang Bing's commentary only explains the meaning of Sai but fails to explain the non-Deep/non-Wiry etc. meanings. I believe this section should be cross-referenced with *Si Qi Tiao Shen Da Lun*.) Excessive Deep is disease; excessive Wiry is disease; excessive Choppy is disease; excessive Rapid is disease. (Note: The previous section discussed harm from discontinuous seasonal Qi; this section discusses harm from excessive seasonal pulses, where Qi extremity causes disease.) Concurrent appearance is disease; repeated appearance is disease; absent yet gone is disease; gone yet remaining is disease. (Concurrent appearance refers to mixed Qi appearing together; repeated appearance refers to seeing again the Qi of decay and death. "Gone" refers to the ruling Qi having passed. If the sun's degree has not exceeded the difference, it is called Heaven's Qi not yet emerged; if the sun's degree exceeds the difference, it is called Heaven's Qi already gone, yet the pulse remains. Since it does not match the expectation, it is called disease. Note: Commentary on concurrent appearance is too vague. Repeated appearance: commentary says seeing again decaying/dead Qi. If a dead pulse appears once, it is already critical; if seen again, how can it be merely disease? "Can" implies variety, meaning multiple pulses in one region; impure pulse images inevitably cause disease. "Repeated appearance" means previously diseased with a certain pulse, after slight improvement, the old pulse returns, indicating the root of disease is not removed. The meaning of "gone/not gone" is indeed as Wang Bing noted.) Contrary [pulse] indicates death. (...Seeing Deep in Summer, Rapid in Autumn, Moderate in Winter, Choppy in Spring is called Contrary. Violating the mandate of Heaven, how can one last long? Note: Xin Zheng Jiao says: "Examining the above, 'Autumn no Rapid' is Si Sai; this note says 'Autumn sees Rapid' is Contrary. Since pulse difference is only in the second month, if the Rapid pulse does not cease after the difference ends, and in the third month of Autumn the pulse is still Rapid, it is Contrary." This distinction is very clear.) The Qi of Yin and Yang, if quiet and pure, generates and transforms orderly; if agitated, severe diseases arise. This is what is meant. (Note: *Liu Wei Zhi Da Lun* states: "Success and failure lie hidden in movement; continuous movement leads to transformation.")
The Yellow Emperor said: What are You (Dark) and Ming (Bright)? Qibo said: When two Yins intersect and exhaust, it is called You; when two Yangs combine and brighten, it is called Ming. The pairing of You and Ming corresponds to the distinction between Cold and Heat. (Two Yins exhaust at Xu and Hai; Two Yangs combine at Chen and Si. *Ling Shu: Xi Ri Yue Lun* states: "Hai (10th lunar month) Left Foot Jueyin, Xu (9th lunar month) Right Foot Jueyin; these two Yins exhaust, hence Jueyin. Chen (3rd lunar month) Left Foot Yangming, Si (4th lunar month) Right Foot Yangming; these two Yangs combine anteriorly, hence Yangming." Thus Yin intersection is You, Yang combination is Ming; the imagery of You and Ming should be so. Cold and Heat are positioned Southwest and Northeast; You and Ming are positioned Northwest and Southeast. The pairing of You and Ming, and the positions of Cold and Heat, are indeed distinct.) The Yellow Emperor said: What are Fen (Equinox) and Zhi (Solstice)? Qibo said: Qi arriving is called Zhi; Qi dividing is called Fen. At Zhi, Qi is the same; at Fen, Qi differs. This is called the Correct Chronicle of Heaven and Earth. (Arising from the question of You and Ming, this meaning is formed. It says Winter and Summer Solstices are where Heaven and Earth Qi govern the year. Spring and Autumn Equinoxes are intermediate Qi; Chu, Er, Si, Wu, the four Qi each divide governance around the ruling Qi of the year.)
The Yellow Emperor said: The Master spoke of Spring and Autumn Qi starting earlier, and Winter and Summer Qi starting later; I know this now. However, the six Qi cycle back and forth, and the ruling Qi is not constant. How should tonification and sedation be applied? (Using Equinoxes and Solstices to clarify the positions of the six Qi, the first and fourth Qi start 15 days before Lichun and Liqiu respectively as the standard; the third and sixth Qi start 15 days after Lixia and Lidong respectively as the standard. From this, the standards of the first and fourth Qi being ahead and behind mean that within the third and sixth Qi, the Solstices fall exactly. Hence: Spring/Autumn Qi starts earlier, Winter/Summer Qi starts later. However, changing one Qi every 365 days, as one year passes, the Qi changes to new. When new Qi comes, old Qi goes. The suitable flavors differ between Heaven and Earth; the methods of tonification and sedation should know priority and sequence, hence the question.) Qibo said: ... The ruler of Shaoyang: First Sweet, then Salty; The ruler of Yangming: First Pungent, then Sour; The ruler of Taiyang: First Salty, then Bitter; The ruler of Jueyin: First Sour, then Pungent; The ruler of Shaoyin: First Sweet, then Salty; The ruler of Taiyin: First Bitter, then Sweet. Assist with what is beneficial, nourish with what generates; this is called De Qi (Obtaining Qi). (Ruler refers to the ruling Qi of the year; Obtaining means obtaining its nature and function. Obtaining its nature and function allows flexibility; failing to obtain it leads to conflict and deviation. How can one expect to dispel pathogens?)
The Yellow Emperor said: Excellent! The generation of all diseases arises from Wind, Cold, Summer Heat, Dampness, Dryness, and Fire. These are the Six Qi of Heaven. Quiet and compliant is Hua (Transformation); agitated and changing is Bian (Variation). Hence "Zhi Hua Zhi Bian". The Classics say: Sedate the Excess, Tonify the Deficiency. I bestowed formulas on physicians, yet their use is not perfect. I desire that the essential Dao be practiced, responding like a drumstick to a drum, pulling out thorns and washing away filth. Can you tell me how to achieve skill and sacredness? (Acupuncture is Skill; Medicine is Sacred. Note: *Nan Jing* states: "Knowing by observation is Divine; knowing by listening/smelling is Sage; knowing by inquiry is Worker; knowing by palpation is Skilled. Knowing externally is Sage; knowing internally is Divine.") Qibo said: Examine the Bing Ji (Pathogenesis) carefully, do not lose the Qi Yi (Appropriateness of Qi). This is what is meant. (Note: Diseases have their own mechanisms; when the mechanism moves, Qi categories separate. Examining appropriateness prevents error. Zhang Jingyue said: "In *Qi Jiao Bian*, *Wu Chang Zheng*, and *Zhi Yao Yao Lun*, the excess and deficiency of the Five Movements and Six Qi are detailed, and heavenly times and human diseases change accordingly, leading to differences in淫胜 (Excessive Overcoming), Fan Sheng (Reverse Overcoming), Ke Sheng (Guest Overcoming), and Zhu Sheng (Host Overcoming). Excess Qi becomes hyperactive and Excess; Deficient Qi is bullied and Deficient. This is the natural law of Yin/Yang excess/deficiency. This section at the end summarizes Pathogenesis, stating the five Zang and six Qi each have rulers, whether Excess or Deficient, all vary with Qi changes causing different diseases. For example, 'All wind, tremors, and dizziness belong to Liver.' If Wood overcomes, limbs stiffen causing tremor, wind moves upward causing dizziness; Spleen Earth is affected, this is Liver Excess. If Wood declines, blood fails to nourish tendons causing tremor, Qi is deficient upward causing dizziness; Metal evil attacks Wood, this is Liver Deficiency. Similarly, 'All pain, itching, and sores belong to Heart.' If Fire is abundant, intense heat causes abscesses, Heart Excess; if Yang declines, Yin prevails causing gangrene, Heart Deficiency. This applies to all Zang and Qi. Thus the chapter begins with 'Sedate Excess, Tonify Deficiency' and ends with 'Seek the Present, Seek the Absent, Blame the Excess, Blame the Deficiency.' Having discussed Pathogenesis via Qi Appropriateness, it specifically uses the four characters Excess, Deficiency, Present, Absent to connect the beginning and end, exhausting the meaning. This is the heart transmission of the Sages, the essence, and the most crucial guideline. Alas, Liu Hejian did not examine this carefully, omitting the beginning and end, taking only the nineteen clauses to write *Yuan Bing Shi*, focusing only on Excess Qi and Evil, and among the nineteen clauses, seven or eight attribute to Fire, ignoring Deficient/Evil Qi. He also said: 'In treatment, one should only sedate the excessive Qi as the root of disease, not mistakenly treat the accompanying transformations.' Such statements are unbearable for the Deficient. Thus Lou pointed out his bias in treatment, which is not an exaggeration. Pathogenesis is the gateway to the Way and the step-by-step method. If the method is flawed, it confines the mind. Beginners who learn it often cannot transcend it in life; with long practice, the弊端 deepen. So modern physicians act with Hejian's legacy, easily draining false Heat and attacking true Deficiency. Some excuse him: He lived in the Yuan dynasty, customs differed, adapting to times, hence this theory. Even if true, times have changed. To follow it blindly would be like mixing ice and charcoal. I pity this and must clarify." I respectfully note: Hejian's theory is clear, but *Yuan Bing Shi* only explains the text literally, leaning towards Excess-Heat without innovation, inviting criticism. Speakers should be impartial. Jingyue's debate restores Balance, tests truth, and captures both Pathogenesis and Qi Appropriateness. However, his main emphasis seems to lean towards Deficient-Cold. If later doctors follow this rigidly, they will overcorrect. I fear future use of Aconite, Asarum, Cinnamon, and Ginger will be like the past use of Scutellaria, Phellodendron, Gardenia, and Platycodon, wrongly accused. *Yin Yang Ying Xiang Da Lun* states: "Good diagnosticians observe color and pulse, first distinguishing Yin and Yang." If physicians do not carefully recognize, and colors/pulses are confused, Yin/Yang inverted, those following Hejian will further Deficiency, and those following Jingyue will further Excess. How terrible it is for physicians to have preconceptions!) The Yellow Emperor said: I wish to hear about Pathogenesis. Qibo said: All wind, tremors, and dizziness belong to the Liver. (Note: Zhang Jingyue says: "Wind varies, hence 'All Wind'. Tremor is shaking. Dizziness is spinning. Wind moves, transformation of Wood, hence belongs to Liver. Both Deficiency and Excess can cause this. In the Ji of Generation, movement includes tremors/dizziness/head disease; in Jueyin rebound, tendon/bone tremors/dizziness, these are Liver Excess. E.g., Yangming ruling Heaven, tremors/shivering, tendon flaccidity unable to stand long, Dryness Metal is strong, Liver is attacked. In Taieyin rebound, heavy head pain with severe tremors/spasms, Wood fails to control Earth, Dampness overcomes, these are Liver Deficiency. Thus *Wei Qi Lun* says: 'Lower deficiency causes reversal, upper deficiency causes dizziness.' This is what is meant. Excess should be cooled and sedated; Deficiency should be warmed and tonified. Reversing this brings disaster quickly. My treatments follow this.") All cold, contraction, and drawing-in belong to the Kidney. ("Contraction" is gathering. "Drawing-in" is tightening. Kidney belongs to Water, its transformation is Cold. Whenever Yang Qi does not reach, Ying and Wei condense, body contracts; all are called contraction. E.g., Taiyang overcoming causes muscle stiffness, blood vessels stagnating; Year Water Excess causes Yin reversal, cold in upper/lower/middle, Water Excess. Year Water Deficiency causes foot flaccidity/cold reversal, He Liu Ji, disease is stranguria, Water Deficiency. Water Excess/Deficiency both originate in Kidney.) All Qi [asthma] and depression belong to the Lung. ("[Asthma] is panting. Depression is stuffiness. Lung belongs to Metal, its transformation is Dryness. Dryness Metal excess, Clear Evil in Lung, Lung disease is Excess, e.g., Year Metal Excess, severe asthma/cough/reverse Qi. Metal Qi decline, Fire Evil overcomes, Lung disease is Deficient, e.g., Cong Ge Ji, asthma/cough. Lung governs Qi, hence all Qi [asthma] and depression, whether Deficient or Excess, belong to Lung." Note: Jingyue's claim of Dryness transformation is mistaken. Lung and Large Intestine are interior-exterior, both Metal. But Lung governs Pungent, Yin Metal. Yangming Large Intestine belongs to Geng, Yang Metal, its transformation is called Dryness. Among the Six Qi, Dryness Metal is one, referring to Large Intestine, not Lung. Question: Does Lung Metal have no transformation? Answer: Clear and肃 (Solemn) is it. Pronounced "fen".) All dampness, swelling, and fullness belong to the Spleen. ("Spleen belongs to Earth, its transformation is Dampness. Earth Qi Excess, Dampness prevails, e.g., Year Earth Excess, fluid retention, middle fullness, reduced appetite, limbs unable to lift. Earth Qi Deficient, Wind Wood overcomes, Cold Water insults, e.g., Year Wood Excess, Spleen Earth attacked, people have borborygmus, abdominal distension; Bei Jian Ji, disease is lingering fullness/blockage; Year Water Excess, severe abdominal swelling, leg edema. Spleen governs muscles, hence all dampness/swelling/fullness, whether Deficient or Excess, belong to Spleen.") All pain, itching, and sores belong to the Heart. ("Severe Heat causes sore pain; mild Heat causes sore itching. Heart belongs to Fire, its transformation is Heat, hence all pain/itching/sores belong to Heart. However, He Xi Ji, disease is sores/ulcers, Heart Evil Excess. Taiyang ruling Heaven, also causes abscesses, Cold Water overcomes. Fire Excess is Heart Excess; Water Excess is Heart Deficiency, visible here." Note: In ancient texts, this clause was below "All Heat, confusion, and spasms"; now placed here to match the preceding text.) All Heat, confusion, and spasms belong to Fire. ("Confusion" is mental clouding. "Spasms" are convulsions. Evil Heat damages Spirit causing confusion; Hyperactive Yang damages Blood causing spasms, hence all belong to Fire. However, Year Fire Deficiency, people suffer inner arm pain, depression/cloudiness. Year Water Excess, people suffer body heat, vexation, irritability...