之气方同清也少阴等司天上下胜同法○六元正已论云上胜则天气降而下下胜则地气迁而上此谓之也）所谓胜至报气屈伏
而未发也复至则不以天地异名皆如复气为法（续胜至未复而病生以天地异名为贰复气已发则所生无问上胜下胜悉皆根据复
气为病寒热之主也至真要论）帝曰天地之气何以候之岐伯曰天地之气胜复之作不形于诊也（言平气及胜复皆以形症观察
不以诊知也）脉法曰天地之变无以脉诊此之谓也（天地以气不以位故不当以脉知五营运论）厥阴之至其脉弦（软虚而滑
端直以长是谓弦实而弦则病不实而微亦病不端长宜亦病不当其位亦病位不能弦亦病）少阴之至其脉钩（来盛去衰如偃带
钩是谓钩来不盛去反盛则病来盛去盛亦病来不盛去不盛亦病不当其位亦病位不能钩亦病）太阴之至其脉沉（沉下者按之
乃得下诸下脉也沉甚则病不沉亦病不当其位亦病位不能沉亦病）少阳之至大而浮（浮高也大谓稍大诸位脉也大浮甚则病
浮而不大亦大病而不浮亦病浮大不浮亦病不当其位亦病不能大浮亦病）阳明之至短而涩（往来不利是谓涩往来不远是谓
短短甚则病涩甚则病不短不涩亦病不当其位亦病位不能短涩亦病）太阳之至大而长（往来远是谓长大甚则病长甚则病长
而不大亦病大而不长亦病不当其位亦病位不能长大亦病）至而和则平（不大甚则为平调不弱不强是为平）至而甚则病（弦
似张弓弦滑如连珠沉而附骨浮高于皮涩而止住短如麻黍大如帽簪长如弓绳皆谓至而大甚也）至而反者病（应弦反涩应大
反细应浮反沉应沉反浮应短涩反长滑应 虚反强实应细反大是皆为气反常平之候有病乃如此见也）至而不至者病（气位
已至而脉气不应也）未至而至者病（按历古法凡得节气当年六位之分当如南北之岁脉象改易而应之气序未移而脉先变易
是先天而至故病）阴阳易者危（不应天常气见交错失其常位更易见之阴位见阳脉阳位见阴脉是易位而见也二气交错故病
危○六微旨论云至而至者和至而不至来气不及也未至而至来气有余也曰至而不至未至而至何也曰应则顺否则逆逆则变生
变生则病曰请言其应曰物生其应也气脉其应也所谓脉应即此脉应也至真要论）厥阴所至为里急（筋软缩故急）为支痛为
软戾为胁痛呕泄（利也）少阳所至为疡疹身热（火气生也）为惊惑恶寒战栗谵（乱言也）妄为悲妄衄 （污血亦脂也）
为语笑太阴所至为积饮痞膈（土气也）为 满为中满霍乱吐下为重 肿（ 肿谓肉泥按之不起也）少阳所至为 呕为疮
疡（火气生也）为惊躁瞀昧暴病为喉痹耳鸣呕涌（溢气不下）为暴注 螈暴死阳明所至为浮虚（薄肿按之复起）为鼽尻
阴股膝髀 足病为胁痛皴揭（身皮 象）为鼽 太阳所至为屈伸不和为腰痛为寝汗（睡中汗发于胸嗌颈腋之间）痉流
泄禁止病之常也（六元正纪论○或问五运六气内经讲论诸方所略其理奥妙未易造入原发明焉）丹溪曰翳李之初宜须识病
机
之变化论人形而处治若便攻于气运恐流于马宗素之徒而去其生人于某日病属其经用某乐治之之类也○又问人之五脏六腑
外应天地司气司运八风动静之变人应气焉岂不切当苟不知此为医未造其理何以调之曰杨太受尝云五运六气须每日候之记
其风雨晦明而有应时作病者有伏气后时而有病者故病冲而动者体认纯熟久久自能造其至极○王安道曰运气七篇与素问诸
篇自是两书作于二人之手其立意各有所主不可混言王冰以为七篇参入素问之中本非素问原文也○又运气之说褚澄尝议
之矣曰大桡作甲子纪岁年耳非言病也夫天地五行寒暑风雨仓卒而变人婴斯气作疾于身气难预期故疾难预定气非人为故疾
难人测推验多乖拯救易误俞扁弗议淳华弗稽运气之书岂非后人托名于圣哲耶○黄仲理曰南北二政三阴司天在泉寸尺不应
交反脉图并面解运气面说出刘温舒运气论奥又六气上下加临补泻病症面并 差棺墓面歌括出浦云运气精华又五运六气加
临转移面并面说出刘河间原病式后人采附仲景伤寒论中夫温舒浦云守真三家之说岂敢附于仲景之篇特后人好学人为之耳
又曰运气之说仲景三百九十七法无一言及之者非略之也盖有所不取也
读素问钞若干卷乃祁门汪石山先生之所续注者也予以孱弱有志于医术未之能尝服先生药辄获奇效先生究心于素难
诸书久矣凡就治于先生者百发百中与时医尝试者相去殊远然则先生之医诚有本哉观于此注亦可见矣禀于家君敬刊首卷及
此卷以倡之刻完因 识岁月于未简以谂观者如此
嘉靖五年岁次丙戌重阳日后学休宁程从迁谨识
六气之气方同于清肃。少阴等司天，上下胜复之法相同。《六元正纪大论》说：“上胜则天气降而下，下胜则地气迁而上，这叫做‘胜’。”所谓“胜至”，是指报复之气屈伏而未发；若“复气”到来，则不以天地异名区分，都按照复气的规律来处理。（续胜至未复而病生，以天地异名为贰；复气已发，则所生无问上胜下胜，悉皆根据复气为病，寒热之主也。见《至真要大论》）
黄帝问：天地之气如何候察？岐伯答：天地之气的胜复变化，不表现在脉诊上。（意思是平气及胜复都以形症观察，不以诊知。）《脉法》说：“天地之变，无以脉诊”，说的就是这个意思。（天地以气不以位，故不当以脉知。见《五运行大论》）
厥阴之气至，其脉弦。（软虚而滑，端直以长，是谓弦；实而弦则病；不实而微亦病；不端长宜亦病；不当其位亦病；位不能弦亦病。）
少阴之气至，其脉钩。（来盛去衰，如偃带钩，是谓钩；来不盛，去反盛则病；来盛去盛亦病；来不盛去不盛亦病；不当其位亦病；位不能钩亦病。）
太阴之气至，其脉沉。（沉下者，按之乃得；下诸下脉也；沉甚则病；不沉亦病；不当其位亦病；位不能沉亦病。）
少阳之气至，其脉大而浮。（浮高也；大谓稍大；诸位脉也；大浮甚则病；浮而不大亦病；大而不浮亦病；浮大不浮亦病；不当其位亦病；不能大浮亦病。）
阳明之气至，其脉短而涩。（往来不利是谓涩；往来不远是谓短；短甚则病；涩甚则病；不短不涩亦病；不当其位亦病；位不能短涩亦病。）
太阳之气至，其脉大而长。（往来远是谓长；大甚则病；长甚则病；长而不大亦病；大而不长亦病；不当其位亦病；位不能长大亦病。）
至而和则平。（不大甚则为平调，不弱不强是为平。）
至而甚则病。（弦似张弓弦，滑如连珠，沉而附骨，浮高于皮，涩而止住，短如麻黍，大如帽簪，长如弓绳，皆谓至而大甚也。）
至而反者病。（应弦反涩，应大反细，应浮反沉，应沉反浮，应短涩反长滑，应虚反强实，应细反大，是皆为气反常，平之候有病乃如此见也。）
至而不至者病。（气位已至而脉气不应也。）
未至而至者病。（按历古法，凡得节气当年六位之分，当如南北之岁，脉象改易而应。之气序未移而脉先变易，是先天而至，故病。）
阴阳易者危。（不应天常，气见交错，失其常位，更易见之。阴位见阳脉，阳位见阴脉，是易位而见也。二气交错，故病危。见《六微旨大论》云：“至而至者和；至而不至，来气不及也；未至而至，来气有余也。”曰：“至而不至，未至而至，何也？”曰：“应则顺，否则逆，逆则变生，变生则病。”曰：“请言其应。”曰：“物生其应也，气脉其应也。”所谓脉应即此脉应也。见《至真要大论》）
厥阴所至，为里急（筋软缩故急），为支痛，为软戾，为胁痛，呕泄（利也）。
少阳所至，为疡疹，身热（火气生也），为惊惑，恶寒战栗，谵妄（乱言也），为悲妄，衄（污血亦脂也），为语笑。
太阴所至，为积饮痞膈（土气也），为胀满，为中满，霍乱吐下，为重胕肿（胕肿谓肉泥，按之不起也）。
少阳所至，为哕呕，为疮疡（火气生也），为惊躁，瞀昧，暴病，为喉痹，耳鸣，呕涌（溢气不下），为暴注瘛疭，暴死。
阳明所至，为浮虚（薄肿，按之复起），为鼽，尻、阴、股、膝、髀、腨、足病，为胁痛，皴揭（身皮皴象），为鼽嚏。
太阳所至，为屈伸不和，为腰痛，为寝汗（睡中汗发于胸嗌颈腋之间），痉，流泄，禁止。病之常也。（见《六元正纪大论》）
或问：五运六气，《内经》讲论诸方所略，其理奥妙，未易造入，原发明焉。
丹溪曰：翳李之初，宜须识病机之变化，论人形而处治。若便攻于气运，恐流于马宗素之徒，而去其生人于某日病属其经，用某乐治之之类也。
又问：人之五脏六腑，外应天地司气司运，八风动静之变，人应气焉，岂不切当？苟不知此为医，未造其理，何以调之？
曰：杨太受尝云：五运六气，须每日候之，记其风雨晦明。而有应时作病者，有伏气后时而有病者。故病冲而动者，体认纯熟，久久自能造其至极。
王安道曰：运气七篇与《素问》诸篇，自是两书，作于二人之手，其立意各有所主，不可混言。王冰以为七篇参入《素问》之中，本非《素问》原文也。
又运气之说，褚澄尝议之矣，曰：大桡作甲子，纪岁年耳，非言病也。夫天地五行，寒暑风雨，仓卒而变，人婴斯气，作疾于身，气难预期，故疾难预定。气非人为，故疾难人测。推验多乖，拯救易误。俞扁弗议，淳华弗稽，运气之书，岂非后人托名于圣哲耶？
黄仲理曰：南北二政，三阴司天在泉，寸尺不应。交反脉图并面解运气面，说出刘温舒《运气论奥》。又六气上下加临补泻病症面，并差棺墓面歌括出浦云《运气精华》。又五运六气加临转移面，并面说出刘河间《原病式》。后人采附仲景《伤寒论》中。夫温舒、浦云、守真三家之说，岂敢附于仲景之篇？特后人好学人为之耳。又曰：运气之说，仲景三百九十七法，无一言及之者，非略之也，盖有所不取也。
《读素问钞》若干卷，乃祁门汪石山先生之所续注者也。予以孱弱，有志于医术，未之能尝服先生药，辄获奇效。先生究心于《素》《难》诸书久矣，凡就治于先生者，百发百中，与时医尝试者相去殊远。然则先生之医，诚有本哉！观于此注，亦可见矣。禀于家君，敬刊首卷及此卷，以倡之。刻完，因识岁月于未简，以谂观者如此。
嘉靖五年岁次丙戌重阳日后学休宁程从迁谨识
The Qi of the six periods is consistent with clear and crisp (Qing). For Shaoyin and others ruling as Tianqi (Heavenly Qi), the methods for Sheng (Superiority/Excess) and Fu (Rebound/Counteraction) above and below are the same. The *Liu Yuan Zheng Ji Lun* states: "When Superiority occurs from above, Heavenly Qi descends; when Superiority occurs from below, Earthly Qi migrates upward. This is called 'Sheng' (Superiority)." When "Sheng arrives," it refers to the state where the Rebounding Qi (Fu Qi) is suppressed and has not yet erupted. When "Fu Qi arrives," there is no distinction by names of Heaven or Earth; all follow the laws of Fu Qi. (If illness arises before Fu Qi erupts due to continued Sheng, distinguishing by Heaven/Earth names creates error; once Fu Qi erupts, regardless of whether Sheng was above or below, all illnesses follow the pattern of Fu Qi, which governs cold and heat. See *Zhi Zhen Yao Da Lun*).
Huangdi asked: How can one observe the Qi of Heaven and Earth? Qibo answered: The changes of Sheng and Fu in the Qi of Heaven and Earth do not manifest in pulse diagnosis. (Meaning: Normal Qi and Sheng/Fu variations are observed through symptoms and signs, not known solely through pulse diagnosis.) The *Mai Fa* states: "Changes of Heaven and Earth cannot be diagnosed by pulses," which refers to this principle. (Heaven and Earth rely on Qi rather than position, so they should not be known through pulses. See *Wu Yun Xing Da Lun*).
When Jueyin Qi arrives, its pulse is Xian (Wiry). (Soft, empty, and slippery, straight and long is called Xian; if solid and wiry, it indicates disease; if weak and slight, it also indicates disease; if not straight and long, it indicates disease; if not at its proper position, it indicates disease; if the position cannot produce a Xian pulse, it indicates disease.)
When Shaoyin Qi arrives, its pulse is Gou (Hooked). (Coming vigorously and departing weakly, like an inverted belt hook, is called Gou; if coming weakly but departing strongly, it indicates disease; if both coming and departing strongly, it indicates disease; if both coming and departing weakly, it indicates disease; if not at its proper position, it indicates disease; if the position cannot produce a Gou pulse, it indicates disease.)
When Taiyin Qi arrives, its pulse is Chen (Deep). (Pressing down to obtain it characterizes deep pulses among lower pulses; if very deep, it indicates disease; if not deep, it also indicates disease; if not at its proper position, it indicates disease; if the position cannot produce a Chen pulse, it indicates disease.)
When Shaoyang Qi arrives, its pulse is Da (Large) and Fu (Floating). (High and floating; Da means slightly large; among various pulses, if Large and Floating excessively, it indicates disease; if Floating but not Large, it indicates disease; if Large but not Floating, it indicates disease; if Large and Floating but not truly Floating, it indicates disease; if not at its proper position, it indicates disease; if unable to produce a Large and Floating pulse, it indicates disease.)
When Yangming Qi arrives, its pulse is Duan (Short) and Se (Choppy). (Unsmooth flow is called Se; short range of flow is called Duan; if very short, it indicates disease; if very choppy, it indicates disease; if neither short nor choppy, it indicates disease; if not at its proper position, it indicates disease; if the position cannot produce a Short and Choppy pulse, it indicates disease.)
When Taiyang Qi arrives, its pulse is Da (Large) and Chang (Long). (Far-reaching flow is called Chang; if very large, it indicates disease; if very long, it indicates disease; if Long but not Large, it indicates disease; if Large but not Long, it indicates disease; if not at its proper position, it indicates disease; if the position cannot produce a Large and Long pulse, it indicates disease.)
Arriving harmoniously indicates normalcy. (Not excessively large constitutes harmonious regulation; neither weak nor strong constitutes normalcy.)
Arriving excessively indicates disease. (Xian resembling a drawn bowstring, Hua [Slippery] like connected pearls, Chen adhering to bone, Fu higher than skin, Se stopping abruptly, Duan like hemp seeds, Da like a hat pin, Chang like a bowstring—all are considered arriving excessively.)
Arriving oppositely indicates disease. (Should be Xian but is Se; should be Da but is Xi [Fine]; should be Fu but is Chen; should be Chen but is Fu; should be Duan/Se but is Chang/Hua; should be Xu [Empty] but is Qiang/Shi [Strong/Solid]; should be Xi but is Da—all these are Qi contrary to normal. Normal conditions show disease only in such manifestations.)
Arriving but not reaching indicates disease. (The time/position has arrived, but the pulse Qi does not correspond.)
Not yet arrived but already arrived indicates disease. (According to ancient calendrical methods, upon obtaining solar terms corresponding to the six positions of the year, similar to Southern/Northern years, pulse images change to respond. If the sequence of Qi has not shifted but the pulse changes first, this is arriving prematurely, hence disease.)
Exchange of Yin and Yang indicates critical condition. (Not conforming to heavenly norms, Qi appearances intermingle, losing their regular positions. Yin positions showing Yang pulses, Yang positions showing Yin pulses—this is exchange of positions. Interference of two Qi leads to critical danger. See *Liu Wei Zhi Da Lun*: "Arriving when it should arrive is harmony; arriving when it should not have arrived means insufficient incoming Qi; not yet arrived but already arrived means excessive incoming Qi." Asked: "Why arriving when it shouldn't, or not arriving when it should?" Answered: "Correspondence is smooth, non-correspondence is adverse; adversity generates transformation; transformation generates disease." Asked: "Please explain correspondence." Answered: "Things generate their response; Qi and pulses generate their response." This pulse response is what is meant. See *Zhi Zhen Yao Da Lun*.)
Jueyin corresponds to Li Ji (abdominal tension/cramping due to soft/tense tendons), Zhi Tong (lateral pain), Ruan Li (muscle spasms/contractions), Xie Tong (hypochondriac pain), Ou Xie (vomiting and diarrhea).
Shaoyang corresponds to Yang Zhen (sores and rashes), Shen Re (body fever due to Fire Qi), Jing Huo (fright and confusion), E Han Zhan Li (aversion to cold and trembling), Chan Wang (delirious speech), Bei Wang (sadness and delusion), Nu (epistaxis/nosebleed), Yu Xiao (talking and laughing).
Taiyin corresponds to Ji Yin Pi Ge (accumulation of fluids, fullness, and obstruction due to Earth Qi), Man Zhong Man (generalized distension and abdominal fullness), Huo Luan Tu Xia (cholera-like vomiting and purging), Chong Zu Zhong (severe edema where pressing leaves an indentation that does not rebound).
Shaoyang corresponds to Yue Ou (hiccups and vomiting), Chuang Yang (sores and ulcers due to Fire Qi), Jing Zao (fright and restlessness), Mao Mei (blurred vision and stupor), Bao Bing (sudden illness), Hou Bi (sore throat), Er Ming (tinnitus), Yong (surging vomit due to trapped Qi failing to descend), Bao Zhu Chi Zhong (sudden diarrhea and convulsions), Bao Si (sudden death).
Yangming corresponds to Fu Xu (pitting edema that rebounds upon pressure), Qiu (nasal congestion), diseases of Kao (buttocks), Yin (genitals), Gu (thigh), Xi (knee), Bi (thigh), Shuan (calf), Zu (foot), Xie Tong (hypochondriac pain), Cun Jie (skin cracking/shriveling), Qiu Ti (sneezing).
Taiyang corresponds to Qu Shen Bu He (difficulty in flexion and extension), Yao Tong (lower back pain), Qin Han (night sweats occurring during sleep, emanating from chest, throat, neck, and axilla), Jing (stiffness/spasms), Liu Xie (profuse discharge), Jin Zhi (urinary retention/inability to void). These are the constants of disease. (See *Liu Yuan Zheng Ji Da Lun*)
Question: The Five Movements and Six Qi are briefly discussed in various chapters of the *Neijing*; their principles are profound and difficult to master. I seek to clarify them.
Danxi said: At the beginning of learning medicine, one must understand the changes of pathogenesis and treat based on the patient's constitution. If one merely attacks according to Qi movements, one risks falling into the error of Ma Zongsu’s followers, who claimed that on certain days, diseases belong to specific meridians and should be treated with specific musical tones or rituals.
Another question: Do the five Zang and six Fu organs not externally correspond to Heaven and Earth, ruling Qi and movements, and the changes of the eight winds? Does man not respond to Qi? Is this not precise? If one does not know this, how can one practice medicine effectively without grasping its principles? How can one regulate it?
Answer: Yang Taishou once said: One must monitor the Five Movements and Six Qi daily, recording wind, rain, darkness, and brightness. Some illnesses arise in accordance with the season; some arise later due to latent Qi. Therefore, those whose illness moves and stirs must cultivate pure understanding through experience; over time, one will naturally reach the pinnacle of mastery.
Wang Andao said: The Seven Chapters on Qi Movements and the other chapters of the *Suwen* were originally two separate books written by different authors, each with distinct intentions. They should not be conflated. Wang Bing believed the seven chapters were inserted into the *Suwen*, but they were not original text of the *Suwen*.
Furthermore, Chu Cheng had previously criticized the theory of Qi Movements, stating: Da Nao created the Sexagenary Cycle (Jiazi) to record years, not to discuss disease. Heaven and Earth, Five Elements, cold, heat, wind, and rain change suddenly. Humans contract these Qi, causing illness. Since Qi is hard to predict, disease is hard to fix in advance. Qi is not human-made, so disease is hard for humans to measure. Deductions often err, and rescue efforts easily fail. Yu and Bian did not discuss it; Chun and Hua did not verify it. Are books on Qi Movements merely later forgeries attributed to sages?
Huang Zhongli said: Regarding Northern and Southern Politics, when Three Yin rule as Tianqi or Quanqi, the Cun and Chi pulses do not respond. The diagram of reversed pulses and facial interpretations of Qi Movements come from Liu Wenshu’s *Yun Qi Lun Ao*. The diagrams of supplementation and reduction for diseases caused by the addition and臨 (Lin) of the Six Qi above and below, along with coffin/tomb facial rhyme schemes, come from Pu Yun’s *Yun Qi Jing Hua*. The diagrams of transfer and shift in the addition and 臨 of Five Movements and Six Qi come from Liu Hejian’s *Yuan Bing Shi*. Later scholars appended these to Zhang Zhongjing’s *Shanghan Lun*. Could the theories of Wenshu, Pu Yun, and Shouzhen dare to be attached to Zhang Zhongjing’s chapters? It is merely the work of later diligent learners. Furthermore, regarding the theory of Qi Movements, Zhang Zhongjing’s 397 methods mention it not at all. This is not omission, but rather deliberate exclusion.
*Du Suwen Chao*, consisting of several volumes, is the continued annotation by Mr. Wang Shishan of Qimen. I, being frail, aspired to medical arts but lacked proficiency. Whenever I took Mr. Wang’s medicine, miraculous effects were achieved. Mr. Wang had devoted himself to the *Suwen* and *Nanjing* for a long time. Those who sought treatment from him succeeded hundred percent, far surpassing contemporary physicians who relied on trial and error. Thus, Mr. Wang’s medicine certainly has a foundation! Observing this annotation confirms this. With my father’s permission, I respectfully printed the first volume and this volume to promote it. Upon completion of printing, I record the date here to inform readers.
In the fifth year of Jiajing, Bingxu year, Double Ninth Festival, humble student Cheng Congqian of Xiuning respectfully recorded this.