脏气，五脏之气也。法时，法天之四时也。天行四时，地生百物。人备五脏，皆合五行。天有一岁之五
行，有十干之五行，有一日之五行；地有五谷五果五畜五菜百药，各具五味，各有五行；人
之五脏五行，合于天地。合天，则有五色六气之上承，合地，则有五苦五欲之下应，故曰脏气法时也。
黄帝问曰∶合人形以法四时、五行而治，何如而从？何如而逆？得失之意，愿闻其事。
合人形通体经脉，外而皮毛，内而腑脏，以法天地之四时五行而延医之，何如？则法天地而从，何如？
则不法天地而逆，反逆为从则得，反从为逆则失，愿闻从逆得失之事，而探诸岐伯也。
岐伯对曰∶五行者，金木水火土也。更贵更贱，以知死生，以决成败，而定五脏之气，间甚之时，死
生之期也。
更，平声，间，去声，下间甚同。四时之气，不外五行，五行
者，金木水火土也。贵者，水旺于春，火旺于夏；贱者，水败于秋，火灭于冬。更贵更贱者，生化叠乘，
寒暑往来也。以更贵更贱之理，以知病之死生，以决治之成败，而五脏之旺气可定，病之间甚，死生
之期，皆可定也。
帝曰∶愿卒闻之。
卒，犹尽也。
岐伯曰∶肝主春，足厥阴少阳主治，其日甲乙。肝苦急，急食甘以缓之。
肝心脾肺肾，人之五脏也。于脏为肝，于时为春，故肝主春。足厥阴，乙木也，足少阳，甲木也，故春
时而足厥阴少阳主治，其日甲乙。肝主春木有生阳渐长之机，若急而不和，肝所苦也，治之
之法，当急食甘味以缓之。
心主夏，手少阴太阳主治，其日丙丁。心苦缓，急食酸以收之。
手少阴，丁火也，手太阳，丙火也，故夏时而手少阴太阳主治，其日丙丁。心主夏火，有炎上迅速之
机，若缓而不速，心所苦也，治之之法，当急食酸味以收之。酸收者，助心气而使之上炎也。
脾主长夏，足太阴阳明主治，其日戊己。脾苦湿，急食苦以燥之。
足太阴，己土也，足阳明，戊土也，故长夏而足太阴阳明主治，其日戊己，脾属阴土，籍阳明燥气
以相资，若湿而不燥，脾所苦也，治之之法，当急食苦味以燥之，苦为火味，故能燥也。
肺主秋，手太阴阳明主治，其日庚辛。肺苦气上逆，急食苦以泄之。
手太阴，辛金也，手阳明，庚金也，故秋时而手太阴阳明主治，其日庚辛，肺主秋金，有收敛清肃之
机，若气上逆，肺所苦也，治之之法，当急食苦味以泄之，苦寒注下，故能泄也。上文言苦燥，
此言苦泄，盖禀君火之气而味苦，则燥，禀寒水之气而味苦，则泄，于物性之运气推之，则得矣。
肾主冬，足少阴太阳主治，其日壬癸。肾苦燥，急食辛以润之，开腠理，致津液通气也。
足少阴，癸水也，足太阳，壬水也。故冬时而足少阴太阳主治，其日壬癸。水王于冬，肾气主之，
燥而不润，肾所苦也，治之之法，当急食辛味以润之，夫辛主发散，何以能润？以辛能开腠
理，致在内之津液而通气于外，在下之津液而通气于上，故能润也。
病在肝，愈于夏，夏不愈，甚于秋，秋不死，持于冬，起于春，禁当风。
肝，木也，夏，火也，火为木之子，故病在肝，愈于夏。子气王而病不愈，至秋则金克木而病甚矣。秋
不死，持于冬，水生木也。至春则木气复王，故起于春。风气通于肝，故禁当风。此藏气法一岁之四时也。
肝病者，愈在丙丁，丙丁不愈，加于庚辛，庚辛不死，持于壬癸，起于甲乙。
肝病愈在丙丁，即上文病在肝愈于夏也。丙丁不愈，加于庚辛，即上文夏不愈甚于秋也。庚辛不死，
持于壬癸，即上文秋不死，持于冬也。起于甲乙，即上文起于春也。此藏气法十干之四时也。
肝病者，平旦慧，下晡甚，夜半静。
慧，爽慧也。静，安静也。平旦乃木王之时，平旦慧，即上文起于春、起于甲乙之意也。下晡乃金
王之时，金克木，故下晡甚，即上文甚于秋，加于庚辛之意也。夜半乃水王之时，水生木，故夜
半静，即上文持于冬、持于壬癸之意也。此藏气法一日之四时也。
肝欲散，急食辛以散之，用辛补之，酸泻之。
肝病则木郁，故肝欲散，治之之法，当急食辛味以散之，辛主散也。肝气郁而欲散，散之即所以补之，
故用辛补之。夫辛散为补，则酸收为泻，故酸泻之。此藏气法地之五味也。
病在心，愈在长夏。长夏不愈，甚于冬，冬不死，持于春，起于夏，禁温食，热衣。
心，火也。长夏，土也。土为火之子，故病在心，愈在长夏。子气王而病不愈，至冬则水克火，而
病甚矣。冬不死，持于春，木生火也。至夏则火气复王，故起于夏。火气通于心，故禁温食热衣。
此藏气法一岁之四时也。
心病者，愈在戊己。戊己不愈，加于壬癸。壬癸不死，持于甲乙，起于丙丁。
心病愈在戊己，即病在心，愈在长夏也。戊己不愈，加于壬癸，即长夏不愈，甚于冬也。壬癸不死，持
于甲乙，即冬不死，持于春也。起于丙丁，即起于夏也。此藏气法十干之四时也。
心病者，日中慧，夜半甚，平旦静。
日中乃火王之时，故日中慧，即起于夏，起于丙丁也。夜半乃水王之时，水克火，故夜半甚，即甚
于冬，加于壬癸也。平旦乃木王之时，木生火，故平旦静，即持于春、持于甲乙也。此脏气法一日之四时也。
心欲软，急食咸以 之，用咸补之，甘泻之。
心病则火炎，故心欲 。治之之法，当急食咸味以 之，咸能 坚也。心气炎而欲 ， 之即所以
补之，故用咸补之。咸 为补，则甘缓为泻，故甘泻之。此藏气法地之五味也。
病在脾，愈在秋，秋不愈，甚于春。春不死，持于夏，起于长夏。禁湿食饱食、湿地濡衣。
湿食，旧本误温食，今改。湿食，水湿也。濡衣，濡润之衣也。脾，土也，秋，金也。金为土之子，
故病在脾，愈在秋。子气王而病不愈，至春则木克土，而病甚矣。春不死，持于夏，火生土也，
至长夏则土气复王。故起于长夏。湿气通于脾，故禁湿食饱食，湿地濡衣。此藏气法一岁之四时也。
脾病者，愈在庚辛。庚辛不愈，加于甲乙。甲乙不死，持于丙丁，起于戊己。
脾病愈在庚辛，即病在脾，愈在秋也。庚辛不愈加于甲乙，即
春不死持于夏也。起于戊己，即起于长夏也。此藏气法十干之四时
也。
脾病者，日 慧，日出甚，下晡静。
，音迪。 ，昃也。日 乃午后未分，土王之时，故曰 慧，即起于长夏，起于戊己也。日出乃
木王之时，木克土，故日出甚，即甚于春，加于甲乙。下晡乃申酉金王之时，土生金，故下晡静。
以肝心为例，当日中火王而静，今下晡静者，以明子母气王，皆能静也。此藏气法一日之四时也。
脾欲缓，急食甘以缓之，用苦泻之，甘补之。
脾病则土不柔和，故脾欲缓。治之之法，当急食甘味以缓之，甘能缓中也。脾气欲缓，苦泄则泻，故
用苦泻之。苦泄为泻，则甘缓为补，故甘补之。此藏气法地之五味也。
病在肺，愈在冬。冬不愈，甚于夏。夏不死，持于长夏，起于秋。禁寒饮食寒衣。
肺，金也，冬，水也，水为金之子，故病在肺，愈在冬。子气王而病不愈，至夏，则火克金而病甚矣。
夏不死，持于长夏，土生金也。至秋而金气复王，故起于秋。饮冷形寒则伤肺，故禁寒饮食
寒衣。此藏气法一岁之四时也。
肺病者，愈在壬癸。壬癸不愈，加于丙丁。丙丁不死，持于戊己。起于庚辛。
肺病愈在壬癸，即病在肺，愈在冬也。壬癸不愈，加于丙丁，即冬不愈，甚于夏也。丙丁不死，持
于戊己，即不死，持于长夏也。起于庚辛，即起于秋也。此藏气法十干之四时也。
肺病者，下晡慧，日中甚，夜半静。
下晡，乃金王之时，故下晡慧，即起于秋，起于庚辛也。日中乃火王之时，火克金，故日中甚，即
甚于夏，加于丙丁也。夜半，乃水王之时，金生水，故夜半静，亦子气王而安静也。此藏气法一日之四时也。
肺欲收，急食酸以收之，用酸补之，辛泻之。
肺病则气散，故肺欲收，治之之法，当急食酸味以收之。酸主
收也，肺气散而欲收，收之即所以补之，故用酸补之。酸收为补，则辛散为泻，故辛泻之。此藏气法
地之五味也。
病在肾，愈在春。春不愈，甚于长夏。长夏之死，持于秋。起于冬。禁犯淬HT 热食、温炙衣。
淬，音翠，余篇同。HT ，音衰。淬HT 热食，火燔之食也。温炙衣，火焙之衣也。肾，水也，春，
木也，木为水之子，故病在肾，愈在春。子气王而病不愈，至长夏，则土克水而病甚矣。长夏不
死，持于秋，金生水也。至冬，则水气乘王，故起于冬。肾为水脏，燥而不润，肾所苦也，故禁犯 HT 热
食，温炙衣。此藏气法一岁之四时也。
肾病者，愈在甲乙。甲乙不愈，加于戊己。戊己不死，持于庚辛。起于壬癸。
肾病愈在甲乙，即病在肾，愈在春也。甲乙不愈，加于戊己，即春不愈，甚于长夏也。戊己不死持
于庚辛，即长夏不死，持于秋也。起于壬癸，即起于冬也。此藏气法十干之四时也。
肾病者，夜半慧，四季甚，下晡静。
夜半，乃水王之时，故夜半慧，即起于冬，起于壬癸也。四季，乃辰戌丑未，土王之时，土克水，
故四季甚，即甚于长夏，加于戊己也。下晡，乃金王之时，金生水，故下晡静，即持于秋，持
于庚辛也。此藏气法一日之四时也。
肾欲坚，急食苦以坚之，用苦补之，咸泻之。
肾病则水汛，故肾欲坚，治之之法，当急食苦味以坚之，苦为火味，故能坚也。肾濡欲坚，坚之即所
以补之，故用苦补之。苦坚为补，则咸 为泻，故咸泻之。此藏气法地之五味也。
夫邪气之客于身也，以胜相加，至其所生而愈，至其所不胜而甚，至于所生而持，自得其位而
起。必先定五脏之脉，乃可言间甚之时，死生之期也。
总结上文之义，上文病肝心脾肺肾，皆邪气之客于身，故曰∶夫邪气之客于身也，乃以胜相加。如燥
金伤肝，寒水凌心，风木
乘脾，火热烁肺，濡湿侵肾是也。上文病五脏而能愈，皆至其所生而愈也。病五脏而致甚，皆至其所不胜
而甚也。五脏病甚而能持，皆至于所生而持也。持而能起，皆自得其位而起也。决其间甚死
生，必诊脉而知之，故必先定五脏之脉，乃可言其间甚之时，以及死生之期。有如上文之所云尔。
此一节，言五脏之气，法天之四时，地之五味也。
肝病者，两胁下痛引少腹，令人善怒，虚则目 无所见，耳
无所闻，善恐，如人将捕之。取其经，厥阴与少阳。气逆则头痛，耳聋不聪，颊肿取血者。
，音荒，余篇同。厥阴肝脉布胁肋、抵小腹，故肝病者两胁下痛引少腹。怒者肝之情，肝病故令
人善怒。若肝气内虚，不能上升，则目 无所见，耳无所闻。生气不达，则善恐，如人将捕
之，而有惊骇之状，取其厥阴与少阳之经，而治之。盖少阳者，厥阴中见之气也。若肝气上逆，则头痛
颊肿，耳聋不聪，当取厥阴少阳之经而出其血者。
心病者，胸中痛，膺背肩甲间痛，两臂内痛。虚则胸腹大，胁下与腰相引而痛，取其经，少阴太阳，
舌下血者。其变病，刺 中血者。
甲，胛同。此论心病，而言心包之经脉，以明心不受病也。《灵枢·经脉》论云∶心主包络之脉，起
于胸中，循胸出胁，故心病者，胸中痛，胁支满，胁下痛。又云∶循 内，行太阴少阴之间。太阴，
肺也，少阴，心也，故膺背痛而病心，肩胛痛而病肺。又云∶入肘中，下臂，故两臂内痛。心火内虚，土
无所生，则腹大连胸，故虚则胸腹大。经脉不能循胸出胁，循胁出背，故胁下与腰相引而痛。
取其少阴太阳之经而治之，少阴者心也，心气和，则心包亦和，太阳者，心为阳中之太阳也。舌下血者，取
心之开窍，而刺出其血也。其变病者，言始病心包之经脉，今变病太阳之孙络。当刺
中，而取其血者， 中，足太阳之委中，乃 中央之合穴也。
脾病者，身重，善肌肉痿，足不收，行善 ，脚下痛。虚则腹
满，肠鸣飧泄，食不化。取其经，太阴阳明少阴血者。
周身肌肉，脾土主之，故脾病者，身重，善肌肉痿。痿，犹痹也。脾足太阴之经脉，起于足大趾，循经
上膝，脾病，故足不收，行善 ，脚下痛。脾土内虚，不能四布，则腹满。土气虚寒，则肠
鸣飧泄，食不化。取其经脉而治之，则在太阴阳明。兼及少阴者，火土相生之火。血者，通其经脉也。
肺病者，喘咳逆气，肩背痛，汗出，尻阴股膝髀 足皆痛。虚则少气，不能报息，耳
聋嗌干。取其经，太阴，足太阳之外，厥阴内血者。
尻，考平声，余篇仿此。肺气不利，则喘咳逆气。肺之经脉不和，则肩背痛、汗出。太阳合肺，行于
皮毛，太阳经脉，从腰脊，贯臀入 ，至端抵足，今太阳之气，不和于肺，故尻阴股膝髀
足皆痛。厥阴之脉，贯膈注肺，今肝气内虚，不能贯膈注肺，故少气不能报息。息，呼吸也。从厥阴而出
五脏之气，即肝、心、脾、肺、肾五脏的功能活动。法时，即效法自然界四季的变化规律。天体运行体现四季更替，大地孕育各类生物。人体具备五脏，均与五行相对应。天有年度的五行变化，有十天干的五行属性，有一日十二时辰的五行分布；地有五谷、五果、五畜、五菜及各类药物，各自具有五味，且蕴含五行特性；人的五脏五行，与天地相应。顺应天时，则有五色、六气在上承接；顺应地利，则有五苦、五欲在下呼应，所以说五脏之气的变化规律是效法四时的。
黄帝问道：结合人的形体结构，效法四季和五行来进行治疗，怎样算是顺从（正确），怎样算是违背（错误）？其中的得失原理，希望听您详细讲解。
所谓结合人的形体全身经脉，外至皮毛，内至脏腑，以效法天地四时五行来延请医生诊治，如果如何呢？那就是效法天地而顺从；如果如何呢？那就是不效法天地而违背。反而将违背当作顺从就是得，将顺从当作违背就是失，希望听闻关于顺从与违背、得与失的具体事例，并向岐伯请教。
岐伯回答说：五行，是指金、木、水、火、土。它们轮流旺盛与衰退，借此可以判断疾病的生死，决定治疗的成败，并确定五脏之气的盛衰、病情的轻重以及死亡或痊愈的时间。
“更”读平声，“间”读去声，下文中的“间甚”同理。四季的气候变化，不出五行范畴。五行，就是金、木、水、火、土。所谓“贵”，指水在春季旺盛，火在夏季旺盛；所谓“贱”，指水在秋季败退，火在冬季熄灭。“更贵更贱”指的是生化过程的交替重叠，寒暑气候的往来循环。根据这种更替贵贱的道理，可以预知病人的生死，决断治疗的成败，从而确定五脏的旺气，病情的轻重以及死生的期限都可以确定了。
黄帝说：希望能详尽地听取这些道理。
“卒”，通“尽”，意为完全、详尽。
岐伯说：肝脏对应春季，由足厥阴肝经和足少阳胆经主司，对应的天干日是甲日和乙日。肝气容易拘急，遇到这种情况应紧急食用甘味食物来缓和它。
肝、心、脾、肺、肾是人体的五脏。在脏为肝，在时为春，所以肝主春季。足厥阴属乙木，足少阳属甲木，所以在春季时节，足厥阴经和足少阳经主事，对应的日子是甲日和乙日。肝主春季木气，具有生发阳气逐渐生长的机能，如果出现拘急而不调和的情况，这是肝所痛苦的症状，治疗的方法，应当紧急食用甘味食物来缓和它。
心脏对应夏季，由手少阴心经和手太阳小肠经主司，对应的天干日是丙日和丁日。心气容易涣散，遇到这种情况应紧急食用酸味食物来收敛它。
手少阴属丁火，手太阳属丙火，所以在夏季时节，手少阴经和手太阳经主事，对应的日子是丙日和丁日。心主夏季火气，具有炎上迅速的特性，如果出现弛缓而不迅速的情况，这是心所痛苦的症状，治疗的方法，应当紧急食用酸味食物来收敛它。酸味具有收敛作用，能助长心气使其向上炎升。
脾脏对应长夏（夏秋之交），由足太阴脾经和足阳明胃经主司，对应的天干日是戊日和己日。脾气容易受湿邪困扰，遇到这种情况应紧急食用苦味食物来燥湿。
足太阴属己土，足阳明属戊土，所以在长夏时节，足太阴经和足阳明经主事，对应的日子是戊日和己日。脾属阴土，依赖阳明胃的燥气来资助，如果出现湿滞而不干燥的情况，这是脾所痛苦的症状，治疗的方法，应当紧急食用苦味食物来燥湿。苦味属于火味，所以具有燥湿的作用。
肺脏对应秋季，由手太阴肺经和手阳明大肠经主司，对应的天干日是庚日和辛日。肺气容易上逆，遇到这种情况应紧急食用苦味食物来泄降。
手太阴属辛金，手阳明属庚金，所以在秋季时节，手太阴经和手阳明经主事，对应的日子是庚日和辛日。肺主秋季金气，具有收敛清肃的特性，如果出现气机上逆的情况，这是肺所痛苦的症状，治疗的方法，应当紧急食用苦味食物来泄降。苦寒之性下行，所以能够泄降。上文提到苦味能燥湿，这里说苦味能泄降，大概是因为禀受君火之气而味苦的，就能燥湿；禀受寒水之气而味苦的，就能泄降，从事物的性质和运气来推究，就能明白了。
肾脏对应冬季，由足少阴肾经和足太阳膀胱经主司，对应的天干日是壬日和癸日。肾气容易干燥，遇到这种情况应紧急食用辛味食物来滋润，通过开发腠理，促使津液流通，使气机通畅。
足少阴属癸水，足太阳属壬水。所以在冬季时节，足少阴经和足太阳经主事，对应的日子是壬日和癸日。水气在冬季旺盛，由肾气主司，如果出现干燥而不滋润的情况，这是肾所痛苦的症状，治疗的方法，应当紧急食用辛味食物来滋润。辛味主要主发散，怎么能滋润呢？因为辛味能开发腠理，使体内的津液通达于外，下部的津液通达于上，所以能起到滋润的作用。
疾病在肝脏，会在夏季痊愈；如果夏季不愈，病情会在秋季加重；如果秋季不死，病情会在冬季维持稳定；到了春季就会好转。此时应当禁忌吹风。
肝属木，夏属火，火是木之子，所以肝病在夏季痊愈。如果子气（火）旺盛而病不愈，到了秋季则金克木，病情就会加重。如果秋季不死，病情在冬季维持，是因为水生木。到了春季木气重新旺盛，所以病情在春季好转。风气通应于肝，所以要禁忌当风。这是五脏之气效法一年中四季变化的规律。
肝病者，痊愈的日子在丙日和丁日；如果丙丁日不愈，病情会在庚日和辛日加重；如果庚辛日不死，病情会在壬日和癸日维持稳定；到了甲日和乙日就会好转。
肝病痊愈在丙丁日，即上文所说的病在肝愈于夏季。丙丁日不愈，病情在庚辛日加重，即上文所说的夏季不愈则在秋季加重。庚辛日不死，病情在壬癸日维持，即上文所说的秋季不死则在冬季维持。病情在甲乙日好转，即上文所说的起于春季。这是五脏之气效法十天干四季变化的规律。
肝病患者，清晨时感觉清爽舒适，傍晚时分病情加重，半夜时分安静平稳。
“慧”，指神志清爽。“静”，指病情安静。清晨是木气旺盛的时候，清晨感觉清爽，即上文所说的起于春季、起于甲乙日的意思。傍晚是金气旺盛的时候，金克木，所以傍晚病情加重，即上文所说的甚于秋季、加于庚辛日的意思。半夜是水气旺盛的时候，水生木，所以半夜病情安静，即上文所说的持于冬季、持于壬癸日的意思。这是五脏之气效法一日中四季（时辰）变化的规律。
肝喜条达疏散，遇到这种情况应紧急食用辛味食物来疏散，用辛味补益肝气，用酸味泻除肝气。
肝病则木气郁结，所以肝喜疏散。治疗的方法，应当紧急食用辛味食物来疏散它，辛味主散。肝气郁结而欲疏散，疏散它就是补益，所以用辛味补之。既然辛散为补，那么酸收就为泻，所以用酸味泻之。这是五脏之气效法地面万物五味的规律。
疾病在心脏，会在长夏痊愈；如果长夏不愈，病情会在冬季加重；如果冬季不死，病情会在春季维持稳定；到了夏季就会好转。此时应当禁忌温热饮食和厚暖衣物。
心属火，长夏属土，土是火之子，所以心病在长夏痊愈。如果子气（土）旺盛而病不愈，到了冬季则水克火，病情就会加重。如果冬季不死，病情在春季维持，是因为木生火。到了夏季火气重新旺盛，所以病情在夏季好转。火气通应于心，所以要禁忌温热饮食和厚暖衣物。这是五脏之气效法一年中四季变化的规律。
心病者，痊愈的日子在戊日和己日；如果戊己日不愈，病情会在壬日和癸日加重；如果壬癸日不死，病情会在甲日和乙日维持稳定；到了丙日和丁日就会好转。
心病痊愈在戊己日，即病在心愈于长夏。戊己日不愈，病情在壬癸日加重，即长夏不愈则在冬季加重。壬癸日不死，病情在甲乙日维持，即冬季不死则在春季维持。病情在丙丁日好转，即起于夏季。这是五脏之气效法十天干四季变化的规律。
心病患者，中午时感觉清爽舒适，半夜时分病情加重，清晨时分安静平稳。
中午是火气旺盛的时候，所以中午感觉清爽，即起于夏季、起于丙丁日。半夜是水气旺盛的时候，水克火，所以半夜病情加重，即甚于冬季、加于壬癸日。清晨是木气旺盛的时候，木生火，所以清晨病情安静，即持于春季、持于甲乙日。这是五脏之气效法一日中四季变化的规律。
心喜柔软，遇到这种情况应紧急食用咸味食物来软化它，用咸味补益心气，用甘味泻除心气。
心病则火气炎上，所以心喜软化。治疗的方法，应当紧急食用咸味食物来软化它，咸味能软坚。心气炎上而欲软化，软化它就是补益，所以用咸味补之。咸软为补，那么甘缓为泻，所以用甘味泻之。这是五脏之气效法地面万物五味的规律。
疾病在脾脏，会在秋季痊愈；如果秋季不愈，病情会在春季加重；如果春季不死，病情会在夏季维持稳定；到了长夏就会好转。此时应当禁忌潮湿饮食、过饱饮食、潮湿环境及湿润衣物。
“湿食”，旧本误作“温食”，今改正。湿食，指水湿之物。“濡衣”，指湿润的衣服。脾属土，秋属金，金是土之子，所以脾病在秋季痊愈。如果子气（金）旺盛而病不愈，到了春季则木克土，病情就会加重。如果春季不死，病情在夏季维持，是因为火生土，到了长夏土气重新旺盛，所以病情在长夏好转。湿气通应于脾，所以要禁忌湿食、饱食、湿地和濡衣。这是五脏之气效法一年中四季变化的规律。
脾病者，痊愈的日子在庚日和辛日；如果庚辛日不愈，病情会在甲日和乙日加重；如果甲乙日不死，病情会在丙日和丁日维持稳定；到了戊日和己日就会好转。
脾病痊愈在庚辛日，即病在脾愈于秋季。庚辛日不愈，病情在甲乙日加重，即春季不死则在夏季维持（注：此处原文逻辑似有跳跃，通常应为甚于春，持于夏，但依原文翻译）。病情在戊己日好转，即起于长夏。这是五脏之气效法十天干四季变化的规律。
脾病患者，午后未时分感觉清爽舒适，日出时分病情加重，傍晚时分安静平稳。
“晡”，音迪，意为偏西、下午。午后未分是土气旺盛的时候，所以感觉清爽，即起于长夏、起于戊己日。日出是木气旺盛的时候，木克土，所以日出时病情加重，即甚于春季、加于甲乙日。傍晚是申酉金气旺盛的时候，土生金，所以傍晚病情安静。以肝心为例，中午火气旺盛时病情安静，现在傍晚安静，是为了说明子母气旺盛时，病情都能安静。这是五脏之气效法一日中四季变化的规律。
脾喜缓和，遇到这种情况应紧急食用甘味食物来缓和它，用苦味泻除脾气，用甘味补益脾气。
脾病则土气不柔和，所以脾喜缓和。治疗的方法，应当紧急食用甘味食物来缓和它，甘味能缓和中焦。脾气欲缓和，苦味泄降则为泻，所以用苦味泻之。苦泄为泻，那么甘缓为补，所以用甘味补之。这是五脏之气效法地面万物五味的规律。
疾病在肺脏，会在冬季痊愈；如果冬季不愈，病情会在夏季加重；如果夏季不死，病情会在长夏维持稳定；到了秋季就会好转。此时应当禁忌寒冷饮食和寒冷衣物。
肺属金，冬属水，水是金之子，所以肺病在冬季痊愈。如果子气（水）旺盛而病不愈，到了夏季则火克金，病情就会加重。如果夏季不死，病情在长夏维持，是因为土生金。到了秋季金气重新旺盛，所以病情在秋季好转。饮用冷物、身体受寒都会伤肺，所以要禁忌寒冷饮食和寒冷衣物。这是五脏之气效法一年中四季变化的规律。
肺病者，痊愈的日子在壬日和癸日；如果壬癸日不愈，病情会在丙日和丁日加重；如果丙丁日不死，病情会在戊日和己日维持稳定；到了庚日和辛日就会好转。
肺病痊愈在壬癸日，即病在肺愈于冬季。壬癸日不愈，病情在丙丁日加重，即冬季不愈则在夏季加重。丙丁日不死，病情在戊己日维持，即不死则在长夏维持。病情在庚辛日好转，即起于秋季。这是五脏之气效法十天干四季变化的规律。
肺病患者，傍晚时分感觉清爽舒适，中午时分病情加重，半夜时分安静平稳。
傍晚是金气旺盛的时候，所以傍晚感觉清爽，即起于秋季、起于庚辛日。中午是火气旺盛的时候，火克金，所以中午病情加重，即甚于夏季、加于丙丁日。半夜是水气旺盛的时候，金生水，所以半夜病情安静，也是子气旺盛而安静的表现。这是五脏之气效法一日中四季变化的规律。
肺喜收敛，遇到这种情况应紧急食用酸味食物来收敛它，用酸味补益肺气，用辛味泻除肺气。
肺病则气机涣散，所以肺喜收敛。治疗的方法，应当紧急食用酸味食物来收敛它。酸味主收敛，肺气涣散而欲收敛，收敛它就是补益，所以用酸味补之。酸收为补，那么辛散为泻，所以用辛味泻之。这是五脏之气效法地面万物五味的规律。
疾病在肾脏，会在春季痊愈；如果春季不愈，病情会在长夏加重；如果长夏不死，病情会在秋季维持稳定；到了冬季就会好转。此时应当禁忌火烤的热食和火焙的暖衣。
“淬”，音翠，其他篇章同此读音。“煑”，音衰。淬煑热食，指用火烧烤的食物。温炙衣，指用火烘干的衣物。肾属水，春属木，木是水之子，所以肾病在春季痊愈。如果子气（木）旺盛而病不愈，到了长夏则土克水，病情就会加重。如果长夏不死，病情在秋季维持，是因为金生水。到了冬季，水气乘势旺盛，所以病情在冬季好转。肾为水脏，若干燥而不滋润，是肾所痛苦的症状，所以要禁忌火烤热食和火焙暖衣。这是五脏之气效法一年中四季变化的规律。
肾病者，痊愈的日子在甲日和乙日；如果甲乙日不愈，病情会在戊日和己日加重；如果戊己日不死，病情会在庚日和辛日维持稳定；到了壬日和癸日就会好转。
肾病痊愈在甲乙日，即病在肾愈于春季。甲乙日不愈，病情在戊己日加重，即春季不愈则在长夏加重。戊己日不死，病情在庚辛日维持，即长夏不死则在秋季维持。病情在壬癸日好转，即起于冬季。这是五脏之气效法十天干四季变化的规律。
肾病者，半夜时分感觉清爽舒适，四季末月（辰戌丑未月）病情加重，傍晚时分安静平稳。
半夜是水气旺盛的时候，所以半夜感觉清爽，即起于冬季、起于壬癸日。四季末月，即辰、戌、丑、未月，是土气旺盛的时候，土克水，所以四季末月病情加重，即甚于长夏、加于戊己日。傍晚是金气旺盛的时候，金生水，所以傍晚病情安静，即持于秋季、持于庚辛日。这是五脏之气效法一日中四季变化的规律。
肾喜坚固，遇到这种情况应紧急食用苦味食物来坚固它，用苦味补益肾气，用咸味泻除肾气。
肾病则水气泛滥，所以肾喜坚固。治疗的方法，应当紧急食用苦味食物来坚固它，苦味属火，所以能坚阴。肾气濡润而欲坚固，坚固它就是补益，所以用苦味补之。苦坚为补，那么咸软为泻，所以用咸味泻之。这是五脏之气效法地面万物五味的规律。
邪气侵犯人体，是以相克的关系相加害的。疾病传到其所生的脏器就会痊愈，传到其所不胜的脏器就会加重，传到所生的脏器就会维持稳定，回到本脏当令的时期就会好转。必须先确定五脏的脉象，才能谈论病情轻重的时间以及死生的期限。
总结上文的意义，上文所述肝、心、脾、肺、肾的疾病，都是邪气客居体内，所以说“邪气之客于身也，以胜相加”。例如燥金伤害肝，寒水凌犯心，风木乘袭脾，火热灼伤肺，湿邪侵扰肾，就是这样。上文所述五脏病能痊愈，都是因为传到了其所生的脏器而痊愈。五脏病导致加重，都是因为传到了其所不胜的脏器而加重。五脏病重而能维持，都是因为传到了所生的脏器而维持。维持后能好转，都是因为回到了本脏当令的时期而好转。决断病情的轻重和死生，必须诊察脉象才能知道，所以必须先确定五脏的脉象，才能谈论病情轻重的时间以及死生的期限，就像上文所说的那样。
肝病患者的症状，两胁下疼痛牵引至小腹，使人容易发怒；如果是虚证，则视力模糊看不清东西，听力下降听不见声音，容易恐惧，好像有人要抓捕他一样。治疗时应取足厥阴肝经和足少阳胆经的穴位。如果肝气上逆，出现头痛、耳聋耳鸣、面颊肿胀，应当刺破经络出血治疗。
“荒”，音荒，其他篇章同此读音。厥阴肝经分布于胁肋，抵于小腹，所以肝病表现为两胁下疼痛牵引小腹。怒是肝的情志，肝病所以使人容易发怒。如果肝气内虚，不能上升，则视力模糊、听力下降。生气不达，则容易恐惧，像被人抓捕一样，表现出惊骇的样子。治疗应取厥阴经和少阳经的穴位。因为少阳是厥阴的中见之气。如果肝气上逆，则出现头痛、面颊肿胀、耳聋耳鸣，应当取厥阴、少阳经穴刺血治疗。
心病患者的症状，胸中疼痛，膺部、背部、肩胛间疼痛，双臂内侧疼痛。如果是虚证，则胸腹部胀大，胁下与腰部相互牵引疼痛。治疗时应取手少阴心经和手太阳小肠经的穴位，舌下出血治疗。如果有变病，应刺委中穴出血。
“甲”，同“胛”。此处论述心病，却提到了心包络的经脉，以说明心本身不受病。《灵枢·经脉》篇论述道：心主包络的经脉，起于胸中，沿胸部出于胁部，所以心病表现为胸中痛，胁部支撑满闷，胁下痛。又说：沿腋下，行于手太阴肺经和手少阴心经之间。太阴指肺，少阴指心，所以膺背痛与心病有关，肩胛痛与肺病有关。又说：进入肘中，下行手臂，所以双臂内侧疼痛。心火内虚，土无所生（火不生土），则腹部胀大连及胸部，所以虚证表现为胸腹大。经脉不能循行于胸胁背腰，所以胁下与腰部相互牵引疼痛。
取手少阴和手太阳经治疗，少阴即心，心气和则心包亦和；太阳即心为阳中之太阳。舌下出血，是取心的开窍，刺出其血。所谓变病，是指起初病在手厥阴心包络的经脉，现在变为手太阳小肠经的孙络病变。应当刺委中穴，取其血。委中，是足太阳膀胱经的合穴，位于膝腘窝中央。
脾病患者的症状，身体沉重，肌肉萎缩无力，脚部松弛不收，行走困难，脚下疼痛。如果是虚证，则腹部胀满，肠鸣，完谷不化的腹泻，食物不消化。治疗时应取足太阴脾经、足阳明胃经及足少阴肾经的血分穴位。
周身肌肉由脾土主管，所以脾病表现为身体沉重，肌肉萎缩。痿，类似于痹症。脾足太阴经脉，起于足大趾，沿经上行至膝，脾病则足部松弛不收，行走困难，脚下痛。脾土内虚，不能布散精微，则腹部胀满。土气虚寒，则肠鸣，完谷不化，食物不消化。取经脉治疗，主要在太阴和阳明。兼及少阴，是因为火土相生（火为土之母）。血者，指疏通经脉。
肺病患者的症状，气喘咳嗽，气逆，肩背疼痛，出汗，尻部、阴部、大腿、膝盖、髀部、小腿及足部都疼痛。如果是虚证，则气短，呼吸急促无法接续，耳聋，咽喉干燥。治疗时应取手太阴肺经，足太阳膀胱经之外侧，以及足厥阴肝经内侧的血分穴位。
“尻”，考平声，其他篇章仿此。肺气不利，则气喘咳嗽气逆。肺的经脉不和，则肩背痛、出汗。太阳经合于肺，行于皮毛，太阳经脉从腰脊贯穿臀部入腘，至足端抵足，现在太阳之气与肺不和，所以尻、阴、股、膝、髀、足皆痛。厥阴经脉，贯穿膈肌注入肺，现在肝气内虚，不能贯穿膈肌注入肺，所以气短，呼吸无法接续。息，指呼吸。从厥阴而出……
The Qi of the Zang organs refers to the functional activities of the five Zang organs: Liver, Heart, Spleen, Lung, and Kidney. "Fa Shi" (following the seasons) means modeling after the changes of the four seasons in nature. The movement of the heavens manifests the alternation of the four seasons, and the earth gives birth to all living things. The human body possesses five Zang organs, all corresponding to the Five Elements (Wu Xing). Heaven has the Five Elements of the year, the Five Elements of the Ten Heavenly Stems, and the Five Elements of the twelve two-hour periods of a day; the earth has the five grains, five fruits, five domestic animals, five vegetables, and various medicines, each possessing the Five Flavors and containing Five Element characteristics; the Five Elements of the human five Zang organs correspond with Heaven and Earth. Aligning with Heaven, there is the reception of the Five Colors and Six Qi from above; aligning with Earth, there is the response of the Five Bitternesses and Five Desires from below. Thus it is said that the laws of the Zang organ Qi follow the seasons.
Yellow Emperor asked: Combining the human form, modeling the treatment after the Four Seasons and Five Elements, how should one proceed in accordance (conformity)? How should one proceed in opposition? I wish to hear about the principles of gain and loss in this matter.
By combining the meridians of the entire human body, extending from the skin and hair externally to the Fu and Zang organs internally, and employing doctors who model their practice after the Four Seasons and Five Elements of Heaven and Earth, what would be the result? If one models after Heaven and Earth, it is conformity; if one does not model after Heaven and Earth, it is opposition. Treating opposition as conformity results in gain (success), while treating conformity as opposition results in loss (failure). I wish to hear about the matters of conformity and opposition, gain and loss, and inquire further from Qibo.
Qibo replied: The Five Elements are Metal, Wood, Water, Fire, and Earth. Their alternating prosperity and decline allow us to know life and death, to decide success and failure in treatment, and to determine the Qi of the five Zang organs, the times of remission and exacerbation, and the periods of life and death.
"Geng" is pronounced with a level tone, "Jian" with a departing tone; "Jian Shen" below follows the same pronunciation. The Qi of the four seasons does not exceed the Five Elements. The Five Elements are Metal, Wood, Water, Fire, and Earth. "Gui" (noble/prosperous) refers to Water prospering in Spring and Fire prospering in Summer; "Jian" (base/declining) refers to Water declining in Autumn and Fire extinguishing in Winter. "Geng Gui Geng Jian" refers to the overlapping succession of generation and transformation, and the coming and going of cold and heat. By understanding the principle of alternating prosperity and decline, one can predict life and death in disease, decide the success or failure of treatment, determine the prosperous Qi of the five Zang organs, and ascertain the severity of illness and the timing of life and death.
The Yellow Emperor said: I wish to hear this completely.
"Cu" means "exhaustively" or "fully."
Qibo said: The Liver governs Spring. The Foot Jueyin (Liver Meridian) and Foot Shaoyang (Gallbladder Meridian) are in charge, corresponding to the days of Jia and Yi. The Liver suffers from tension/spasm; in such cases, urgently consume Sweet flavors to relax it.
The Liver, Heart, Spleen, Lung, and Kidney are the five Zang organs of humans. Among the Zang organs, it is the Liver; among the seasons, it is Spring. Therefore, the Liver governs Spring. Foot Jueyin corresponds to Yi Wood, and Foot Shaoyang corresponds to Jia Wood. Thus, during Spring, the Foot Jueyin and Foot Shaoyang meridians are in charge, corresponding to the days of Jia and Yi. The Liver governs the Wood element of Spring, which has the mechanism of generating Yang Qi and gradual growth. If there is tension without harmony, this is what the Liver suffers from. The method of treatment is to urgently consume Sweet flavors to relax it.
The Heart governs Summer. The Hand Shaoyin (Heart Meridian) and Hand Taiyang (Small Intestine Meridian) are in charge, corresponding to the days of Bing and Ding. The Heart suffers from laxity/flaccidity; in such cases, urgently consume Sour flavors to astringe it.
Hand Shaoyin corresponds to Ding Fire, and Hand Taiyang corresponds to Bing Fire. Thus, during Summer, the Hand Shaoyin and Hand Taiyang meridians are in charge, corresponding to the days of Bing and Ding. The Heart governs the Fire element of Summer, which has the mechanism of flaming upward and rapid movement. If there is flaccidity without speed, this is what the Heart suffers from. The method of treatment is to urgently consume Sour flavors to astringe it. Sour flavors have an astringent effect, assisting Heart Qi to flame upward.
The Spleen governs Late Summer (the transition between Summer and Autumn). The Foot Taiyin (Spleen Meridian) and Foot Yangming (Stomach Meridian) are in charge, corresponding to the days of Wu and Ji. The Spleen suffers from dampness; in such cases, urgently consume Bitter flavors to dry it.
Foot Taiyin corresponds to Ji Earth, and Foot Yangming corresponds to Wu Earth. Thus, during Late Summer, the Foot Taiyin and Foot Yangming meridians are in charge, corresponding to the days of Wu and Ji. The Spleen belongs to Yin Earth and relies on the drying Qi of the Yangming Stomach for support. If there is dampness without dryness, this is what the Spleen suffers from. The method of treatment is to urgently consume Bitter flavors to dry it. Bitter flavor belongs to Fire, so it has the ability to dry.
The Lung governs Autumn. The Hand Taiyin (Lung Meridian) and Hand Yangming (Large Intestine Meridian) are in charge, corresponding to the days of Geng and Xin. The Lung suffers from rebellious Qi ascending; in such cases, urgently consume Bitter flavors to drain/descend it.
Hand Taiyin corresponds to Xin Metal, and Hand Yangming corresponds to Geng Metal. Thus, during Autumn, the Hand Taiyin and Hand Yangming meridians are in charge, corresponding to the days of Geng and Xin. The Lung governs the Metal element of Autumn, which has the mechanism of convergence and clearing/purifying. If Qi rebels upward, this is what the Lung suffers from. The method of treatment is to urgently consume Bitter flavors to drain/descend it. Bitter-Cold properties descend, so they can drain/descend. The previous text mentioned Bitter flavors drying dampness; here it says Bitter flavors drain/descend. This is because receiving the Qi of Sovereign Fire and having a Bitter taste leads to drying; receiving the Qi of Cold Water and having a Bitter taste leads to draining/descending. Inferring from the nature and movement of substances, this can be understood.
The Kidney governs Winter. The Foot Shaoyin (Kidney Meridian) and Foot Taiyang (Bladder Meridian) are in charge, corresponding to the days of Ren and Gui. The Kidney suffers from dryness; in such cases, urgently consume Pungent flavors to moisten it, by opening the interstices (cou li), promoting the flow of body fluids, and unblocking Qi.
Foot Shaoyin corresponds to Gui Water, and Foot Taiyang corresponds to Ren Water. Thus, during Winter, the Foot Shaoyin and Foot Taiyang meridians are in charge, corresponding to the days of Ren and Gui. Water is prosperous in Winter, governed by Kidney Qi. If there is dryness without moisture, this is what the Kidney suffers from. The method of treatment is to urgently consume Pungent flavors to moisten it. Pungent flavor mainly promotes dispersion; how can it moisten? Because Pungent flavor opens the interstices, allowing internal body fluids to circulate outward, and lower body fluids to circulate upward, thus achieving moistening.
Diseases in the Liver will heal in Summer. If not healed in Summer, they will worsen in Autumn. If not fatal in Autumn, they will stabilize in Winter, and recover in Spring. Wind exposure should be avoided.
The Liver belongs to Wood, and Summer belongs to Fire. Fire is the child of Wood, so Liver diseases heal in Summer. If the Child Qi (Fire) is prosperous but the disease does not heal, by Autumn, Metal overcomes Wood, and the disease worsens. If not fatal in Autumn, it stabilizes in Winter because Water generates Wood. By Spring, Wood Qi becomes prosperous again, so recovery occurs in Spring. Wind Qi communicates with the Liver, so wind exposure must be avoided. This describes how Zang organ Qi follows the four seasons of the year.
In Liver diseases, healing occurs on Bing and Ding days. If not healed on Bing and Ding days, exacerbation occurs on Geng and Xin days. If not fatal on Geng and Xin days, stabilization occurs on Ren and Gui days, and recovery occurs on Jia and Yi days.
Healing in Bing and Ding days corresponds to healing in Summer as mentioned above. Exacerbation in Geng and Xin days corresponds to worsening in Autumn if not healed in Summer. Stabilization in Ren and Gui days corresponds to stabilization in Winter if not fatal in Autumn. Recovery in Jia and Yi days corresponds to recovery in Spring. This describes how Zang organ Qi follows the four seasons of the Ten Heavenly Stems.
Patients with Liver diseases feel clear-headed (Hui) at dawn, symptoms worsen in the late afternoon (Xia Pu), and become quiet/stable at midnight.
"Hui" means clear-minded. "Jing" means quiet/stable. Dawn is when Wood Qi is prosperous; feeling clear-headed at dawn corresponds to the meaning of recovering in Spring and on Jia/Yi days. Late afternoon is when Metal Qi is prosperous; Metal overcomes Wood, so symptoms worsen then, corresponding to worsening in Autumn and on Geng/Xin days. Midnight is when Water Qi is prosperous; Water generates Wood, so symptoms become quiet then, corresponding to stabilization in Winter and on Ren/Gui days. This describes how Zang organ Qi follows the four seasons (time periods) of a day.
The Liver desires dispersion. In such cases, urgently consume Pungent flavors to disperse it. Use Pungent flavors to tonify, and Sour flavors to drain.
Liver disease causes Wood stagnation, so the Liver desires dispersion. The method of treatment is to urgently consume Pungent flavors to disperse it, as Pungent flavors promote dispersion. When Liver Qi is stagnant and desires dispersion, dispersing it is equivalent to tonifying it, so use Pungent flavors to tonify. Since Pungent dispersion is tonification, Sour astringency is drainage, so use Sour flavors to drain. This describes how Zang organ Qi follows the Five Flavors of the Earth.
Diseases in the Heart will heal in Late Summer. If not healed in Late Summer, they will worsen in Winter. If not fatal in Winter, they will stabilize in Spring, and recover in Summer. Warm food and hot clothing should be avoided.
The Heart belongs to Fire, and Late Summer belongs to Earth. Earth is the child of Fire, so Heart diseases heal in Late Summer. If the Child Qi (Earth) is prosperous but the disease does not heal, by Winter, Water overcomes Fire, and the disease worsens. If not fatal in Winter, it stabilizes in Spring because Wood generates Fire. By Summer, Fire Qi becomes prosperous again, so recovery occurs in Summer. Fire Qi communicates with the Heart, so warm food and hot clothing must be avoided. This describes how Zang organ Qi follows the four seasons of the year.
In Heart diseases, healing occurs on Wu and Ji days. If not healed on Wu and Ji days, exacerbation occurs on Ren and Gui days. If not fatal on Ren and Gui days, stabilization occurs on Jia and Yi days, and recovery occurs on Bing and Ding days.
Healing in Wu and Ji days corresponds to healing in Late Summer. Exacerbation in Ren and Gui days corresponds to worsening in Winter if not healed in Late Summer. Stabilization in Jia and Yi days corresponds to stabilization in Spring if not fatal in Winter. Recovery in Bing and Ding days corresponds to recovery in Summer. This describes how Zang organ Qi follows the four seasons of the Ten Heavenly Stems.
Patients with Heart diseases feel clear-headed at noon, symptoms worsen at midnight, and become quiet/stable at dawn.
Noon is when Fire Qi is prosperous, so patients feel clear-headed at noon, corresponding to recovery in Summer and on Bing/Ding days. Midnight is when Water Qi is prosperous; Water overcomes Fire, so symptoms worsen then, corresponding to worsening in Winter and on Ren/Gui days. Dawn is when Wood Qi is prosperous; Wood generates Fire, so symptoms become quiet then, corresponding to stabilization in Spring and on Jia/Yi days. This describes how Zang organ Qi follows the four seasons of a day.
The Heart desires softness/pliability. In such cases, urgently consume Salty flavors to soften it. Use Salty flavors to tonify, and Sweet flavors to drain.
Heart disease causes Fire to flame upward, so the Heart desires softening. The method of treatment is to urgently consume Salty flavors to soften it, as Salty flavors can soften hardness. When Heart Qi flames upward and desires softening, softening it is equivalent to tonifying it, so use Salty flavors to tonify. Since Salty softening is tonification, Sweet relaxation is drainage, so use Sweet flavors to drain. This describes how Zang organ Qi follows the Five Flavors of the Earth.
Diseases in the Spleen will heal in Autumn. If not healed in Autumn, they will worsen in Spring. If not fatal in Spring, they will stabilize in Summer, and recover in Late Summer. Damp food, overeating, damp environments, and wet clothing should be avoided.
"Damp food" was mistakenly written as "warm food" in old editions and is corrected here. It refers to water-damp substances. "Ru yi" refers to wet clothing. The Spleen belongs to Earth, and Autumn belongs to Metal. Metal is the child of Earth, so Spleen diseases heal in Autumn. If the Child Qi (Metal) is prosperous but the disease does not heal, by Spring, Wood overcomes Earth, and the disease worsens. If not fatal in Spring, it stabilizes in Summer because Fire generates Earth. By Late Summer, Earth Qi becomes prosperous again, so recovery occurs in Late Summer. Dampness Qi communicates with the Spleen, so damp food, overeating, damp ground, and wet clothing must be avoided. This describes how Zang organ Qi follows the four seasons of the year.
In Spleen diseases, healing occurs on Geng and Xin days. If not healed on Geng and Xin days, exacerbation occurs on Jia and Yi days. If not fatal on Jia and Yi days, stabilization occurs on Bing and Ding days, and recovery occurs on Wu and Ji days.
Healing in Geng and Xin days corresponds to healing in Autumn. Exacerbation in Jia and Yi days corresponds to... [Note: Text implies worsening in Spring, stabilization in Summer]. Recovery in Wu and Ji days corresponds to recovery in Late Summer. This describes how Zang organ Qi follows the four seasons of the Ten Heavenly Stems.
Patients with Spleen diseases feel clear-headed in the late afternoon (Wei hour), symptoms worsen at sunrise, and become quiet/stable in the late afternoon.
"Bu" (referring to time) sounds like "Di," meaning afternoon. The period after noon (Wei hour) is when Earth Qi is prosperous, so patients feel clear-headed, corresponding to recovery in Late Summer and on Wu/Ji days. Sunrise is when Wood Qi is prosperous; Wood overcomes Earth, so symptoms worsen then, corresponding to worsening in Spring and on Jia/Yi days. Late afternoon (Shen/You hours) is when Metal Qi is prosperous; Earth generates Metal, so symptoms become quiet then. Taking Liver and Heart as examples, symptoms are quiet when Fire Qi is prosperous at noon; now they are quiet in the late afternoon, illustrating that when Child and Mother Qi are prosperous, symptoms become quiet. This describes how Zang organ Qi follows the four seasons of a day.
The Spleen desires relaxation. In such cases, urgently consume Sweet flavors to relax it. Use Bitter flavors to drain, and Sweet flavors to tonify.
Spleen disease causes Earth to lose its gentleness, so the Spleen desires relaxation. The method of treatment is to urgently consume Sweet flavors to relax it, as Sweet flavors can moderate the Middle Jiao. When Spleen Qi desires relaxation, Bitter drainage constitutes drainage, so use Bitter flavors to drain. Since Bitter drainage is drainage, Sweet relaxation is tonification, so use Sweet flavors to tonify. This describes how Zang organ Qi follows the Five Flavors of the Earth.
Diseases in the Lung will heal in Winter. If not healed in Winter, they will worsen in Summer. If not fatal in Summer, they will stabilize in Late Summer, and recover in Autumn. Cold food and cold clothing should be avoided.
The Lung belongs to Metal, and Winter belongs to Water. Water is the child of Metal, so Lung diseases heal in Winter. If the Child Qi (Water) is prosperous but the disease does not heal, by Summer, Fire overcomes Metal, and the disease worsens. If not fatal in Summer, it stabilizes in Late Summer because Earth generates Metal. By Autumn, Metal Qi becomes prosperous again, so recovery occurs in Autumn. Drinking cold liquids and physical cold damage the Lung, so cold food and cold clothing must be avoided. This describes how Zang organ Qi follows the four seasons of the year.
In Lung diseases, healing occurs on Ren and Gui days. If not healed on Ren and Gui days, exacerbation occurs on Bing and Ding days. If not fatal on Bing and Ding days, stabilization occurs on Wu and Ji days, and recovery occurs on Geng and Xin days.
Healing in Ren and Gui days corresponds to healing in Winter. Exacerbation in Bing and Ding days corresponds to worsening in Summer if not healed in Winter. Stabilization in Wu and Ji days corresponds to stabilization in Late Summer if not fatal. Recovery in Geng and Xin days corresponds to recovery in Autumn. This describes how Zang organ Qi follows the four seasons of the Ten Heavenly Stems.
Patients with Lung diseases feel clear-headed in the late afternoon, symptoms worsen at noon, and become quiet/stable at midnight.
Late afternoon is when Metal Qi is prosperous, so patients feel clear-headed then, corresponding to recovery in Autumn and on Geng/Xin days. Noon is when Fire Qi is prosperous; Fire overcomes Metal, so symptoms worsen then, corresponding to worsening in Summer and on Bing/Ding days. Midnight is when Water Qi is prosperous; Metal generates Water, so symptoms become quiet then, also reflecting the quietness when Child Qi is prosperous. This describes how Zang organ Qi follows the four seasons of a day.
The Lung desires convergence. In such cases, urgently consume Sour flavors to converge it. Use Sour flavors to tonify, and Pungent flavors to drain.
Lung disease causes Qi to scatter, so the Lung desires convergence. The method of treatment is to urgently consume Sour flavors to converge it. Sour flavors primarily converge. When Lung Qi scatters and desires convergence, converging it is equivalent to tonifying it, so use Sour flavors to tonify. Since Sour convergence is tonification, Pungent dispersion is drainage, so use Pungent flavors to drain. This describes how Zang organ Qi follows the Five Flavors of the Earth.
Diseases in the Kidney will heal in Spring. If not healed in Spring, they will worsen in Late Summer. If not fatal in Late Summer, they will stabilize in Autumn, and recover in Winter. Avoid roasted hot foods and fire-dried warm clothes.
"Cui" sounds like "Cui," same as in other chapters. "Zhu" sounds like "Shuai." Cui Zhu hot food refers to food roasted by fire. Wen Zhi clothes refer to clothes dried by fire. The Kidney belongs to Water, and Spring belongs to Wood. Wood is the child of Water, so Kidney diseases heal in Spring. If the Child Qi (Wood) is prosperous but the disease does not heal, by Late Summer, Earth overcomes Water, and the disease worsens. If not fatal in Late Summer, it stabilizes in Autumn because Metal generates Water. By Winter, Water Qi becomes prosperous, so recovery occurs in Winter. The Kidney is a Water organ; if dry and not moist, it suffers. Therefore, avoid roasted hot foods and fire-dried warm clothes. This describes how Zang organ Qi follows the four seasons of the year.
In Kidney diseases, healing occurs on Jia and Yi days. If not healed on Jia and Yi days, exacerbation occurs on Wu and Ji days. If not fatal on Wu and Ji days, stabilization occurs on Geng and Xin days, and recovery occurs on Ren and Gui days.
Healing in Jia and Yi days corresponds to healing in Spring. Exacerbation in Wu and Ji days corresponds to worsening in Late Summer if not healed in Spring. Stabilization in Geng and Xin days corresponds to stabilization in Autumn if not fatal in Late Summer. Recovery in Ren and Gui days corresponds to recovery in Winter. This describes how Zang organ Qi follows the four seasons of the Ten Heavenly Stems.
Patients with Kidney diseases feel clear-headed at midnight, symptoms worsen in the four seasonal months (Chen, Xu, Chou, Wei), and become quiet/stable in the late afternoon.
Midnight is when Water Qi is prosperous, so patients feel clear-headed then, corresponding to recovery in Winter and on Ren/Gui days. The four seasonal months (Chen, Xu, Chou, Wei) are when Earth Qi is prosperous; Earth overcomes Water, so symptoms worsen then, corresponding to worsening in Late Summer and on Wu/Ji days. Late afternoon is when Metal Qi is prosperous; Metal generates Water, so symptoms become quiet then, corresponding to stabilization in Autumn and on Geng/Xin days. This describes how Zang organ Qi follows the four seasons of a day.
The Kidney desires firmness/solidity. In such cases, urgently consume Bitter flavors to firm it. Use Bitter flavors to tonify, and Salty flavors to drain.
Kidney disease causes Water to flood, so the Kidney desires firmness. The method of treatment is to urgently consume Bitter flavors to firm it. Bitter flavor belongs to Fire, so it can firm (Yin). When Kidney Qi is moist and desires firmness, firming it is equivalent to tonifying it, so use Bitter flavors to tonify. Since Bitter firming is tonification, Salty softening is drainage, so use Salty flavors to drain. This describes how Zang organ Qi follows the Five Flavors of the Earth.
When pathogenic Qi invades the body, it acts according to the cycle of overcoming. Diseases heal when transmitted to the organ it generates, worsen when transmitted to the organ that overcomes it, stabilize when reaching the organ it generates, and recover when returning to its own dominant position. One must first determine the pulses of the five Zang organs before discussing the times of remission and exacerbation, and the periods of life and death.
Summarizing the above meaning, the diseases of the Liver, Heart, Spleen, Lung, and Kidney mentioned above are all due to pathogenic Qi lodging in the body. Thus it is said: "When pathogenic Qi invades the body, it acts according to the cycle of overcoming." For example, Dry Metal injures the Liver, Cold Water overwhelms the Heart, Wind Wood attacks the Spleen, Hot Fire scorches the Lung, and Dampness invades the Kidney. The fact that diseases of the five Zang organs heal is because they reach the organ they generate. The fact that diseases of the five Zang organs worsen is because they reach the organ that overcomes them. The fact that severe diseases of the five Zang organs stabilize is because they reach the organ they generate. The fact that they recover after stabilizing is because they return to their own dominant position. To decide between remission/exacerbation and life/death, one must diagnose the pulse to know. Therefore, one must first determine the pulses of the five Zang organs before discussing the times of remission and exacerbation, and the periods of life and death, as mentioned above.
This section discusses how the Qi of the five Zang organs follows the Four Seasons of Heaven and the Five Flavors of Earth.
Patients with Liver diseases experience pain in both hypochondriac regions radiating to the lower abdomen, making them prone to anger. In deficiency patterns, they suffer from blurred vision and hearing loss, excessive fear, and a sensation as if someone is about to capture them. Treatment should involve the Jueyin and Shaoyang meridians. If Liver Qi rebels, causing headache, deafness/tinnitus, and cheek swelling, bloodletting should be performed on these meridians.
"Huang" sounds like "Huang," same as in other chapters. The Jueyin Liver meridian distributes along the costal and hypochondriac regions and reaches the lower abdomen, so Liver disease presents as pain in both hypochondriac regions radiating to the lower abdomen. Anger is the emotion of the Liver, so Liver disease makes people prone to anger. If Liver Qi is internally deficient and cannot ascend, vision becomes blurred and hearing diminishes. If vital Qi fails to reach, fear arises, resembling being hunted, with a startled appearance. Treatment should take the Jueyin and Shaoyang meridians. This is because Shaoyang is the Zhongjian (intermediate) Qi of Jueyin. If Liver Qi rebels upward, causing headache, cheek swelling, and deafness/tinnitus, blood should be drawn from the Jueyin and Shaoyang meridians.
Patients with Heart diseases experience pain in the chest, pain in the anterior chest, back, and interscapular region, and pain in the inner aspect of both arms. In deficiency patterns, the chest and abdomen become distended, and there is pulling pain between the hypochondrium and the waist. Treatment should involve the Shaoyin and Taiyang meridians, and bloodletting under the tongue. For altered conditions, bloodletting at Weizhong (BL40) should be performed.
"Jia" is the same as "Jia" (scapula). This discussion of Heart disease mentions the Pericardium meridian to clarify that the Heart itself does not receive disease. The *Ling Shu: Jing Mai* chapter states: The meridian of the Heart Master (Pericardium) originates in the chest, runs along the chest and out to the hypochondrium. Therefore, Heart disease presents with chest pain, fullness and pain in the hypochondrium. It also states: Running along the axilla, between the Taiyin (Lung) and Shaoyin (Heart) meridians. Taiyin is Lung, Shaoyin is Heart, so anterior chest/back pain relates to Heart disease, and scapular pain relates to Lung disease. It also states: Entering the elbow, descending the arm, so pain in the inner aspect of both arms occurs. Internal deficiency of Heart Fire leads to Earth lacking generation (Fire does not generate Earth), resulting in abdominal distension extending to the chest, hence deficiency presents with large chest and abdomen. The meridians cannot circulate through the chest, hypochondrium, and back, causing pulling pain between the hypochondrium and waist.
Treatment involves the Shaoyin and Taiyang meridians. Shaoyin is the Heart; when Heart Qi is harmonious, the Pericardium is also harmonious. Taiyang refers to the Heart as the Great Yang within Yang. Bloodletting under the tongue takes the opening of the Heart orifice to刺出 (puncture and release) blood. "Altered conditions" refers to initial disease in the Pericardium meridian changing to the Luo collateral branches of the Taiyang meridian. One should puncture Weizhong (BL40) and draw blood. Weizhong is the He-Sea point of the Foot Taiyang Bladder Meridian, located in the center of the popliteal fossa.
Patients with Spleen diseases experience heavy body, frequent muscle atrophy/wasting, inability to flex the feet, difficulty walking, and pain in the soles of the feet. In deficiency patterns, there is abdominal fullness, borborygmus, undigested stool diarrhea (Sun Xie), and food not transforming. Treatment should involve the Taiyin, Yangming, and Shaoyin meridians, focusing on blood.
The muscles of the whole body are governed by Spleen Earth, so Spleen disease presents with heavy body and muscle wasting. "Wei" is similar to Bi syndrome. The Foot Taiyin Spleen meridian originates at the big toe and ascends to the knee. Spleen disease causes the foot to be flaccid and unable to hold, leading to difficult walking and sole pain. Internal deficiency of Spleen Earth prevents the distribution of essence, causing abdominal fullness. Deficiency-cold of Earth Qi causes borborygmus and undigested stool diarrhea. Treatment involves taking the meridians, primarily Taiyin and Yangming. Including Shaoyin is because Fire and Earth generate each other (Fire is the mother of Earth). "Blood" refers to unblocking the meridians.
Patients with Lung diseases experience wheezing, coughing, rebellious Qi, shoulder and back pain, sweating, and pain in the sacrum, yin region, thigh, knee, thigh bone, calf, and foot. In deficiency patterns, there is shortness of breath, inability to complete inhalation/exhalation cycles, deafness, and dry throat. Treatment should involve the Taiyin meridian, outside the Taiyang meridian, and inside the Jueyin meridian, focusing on blood.
"Kao" is pronounced with a level tone, following this pattern for other chapters. Dysfunction of Lung Qi causes wheezing, coughing, and rebellious Qi. Disharmony of the Lung meridian causes shoulder/back pain and sweating. The Taiyang meridian combines with the Lung and runs through the skin and hair. The Taiyang meridian runs from the lumbar spine, through the buttocks into the popliteal fossa, to the end of the foot. Now, Taiyang Qi is disharmonious with the Lung, causing pain in the sacrum, yin region, thigh, knee, thigh bone, calf, and foot. The Jueyin meridian passes through the diaphragm and injects into the Lung. Now, internal deficiency of Liver Qi prevents it from passing through the diaphragm to inject into the Lung, causing shortness of breath and inability to complete breathing cycles. "Xi" refers to respiration. From Jueyin out...