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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 74 · The Essentials of Supreme Truth
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “I already know how the five qi join and how fullness and emptiness alternate. When the six qi divide their rule and govern heaven and earth, how do they arrive?”
Qi Bo bowed twice and replied: “How discerning the question! This is the great ordering of heaven and earth and its connected response in the human spirit.”
The Emperor said: “I wish to hear how one joins with the bright above and the dark below.”
Qi Bo said: “This is what the Way governs and what practitioners find doubtful.”
The Emperor said: “I wish to hear its Way.”
Qi Bo said: “When Jueyin governs heaven, its transformation is Wind.
“When Shaoyin governs heaven, its transformation is heat.
“When Taiyin governs heaven, its transformation is Damp.
“When Shaoyang governs heaven, its transformation is Fire.
“When Yangming governs heaven, its transformation is dryness.
“When Taiyang governs heaven, its transformation is cold.
“Illness is named according to the zang position upon which it bears.”
The Emperor said: “What of earth’s transformations?”
Qi Bo said: “Their manifestations are the same as those governing heaven. The intervening qi are all likewise.”
The Emperor said: “What is meant by intervening qi?”
Qi Bo said: “Those governing to left and right are called intervening qi.”
The Emperor said: “How are they distinguished?”
Qi Bo said: “What governs the year is reckoned by years; intervening qi are reckoned by steps.”
The Emperor said: “Good. What of the year’s governing influence?”
Qi Bo said: “Jueyin governing heaven produces Wind transformation; at the Spring, sour transformation; governing qi, blue-green transformation; as intervening qi, movement transformation.
“Shaoyin governing heaven produces heat transformation; at the Spring, bitter transformation. It does not govern qi transformation; where its qi dwells, there is scorching transformation.
“Taiyin governing heaven produces Damp transformation; at the Spring, sweet transformation; governing qi, yellow transformation; as intervening qi, softening transformation.
“Shaoyang governing heaven produces Fire transformation; at the Spring, bitter transformation; governing qi, red transformation; as intervening qi, bright transformation.
“Yangming governing heaven produces dryness transformation; at the Spring, acrid transformation; governing qi, white transformation; as intervening qi, cool-clarity transformation.
“Taiyang governing heaven produces cold transformation; at the Spring, salty transformation; governing qi, dark transformation; as intervening qi, storing transformation.
“Thus treating illness requires understanding the divided rule of the six transformations, what produces the five flavors and five colors, and what suits the five zang. Only then can one discuss fullness, emptiness and the beginnings of illness.”
The anomalous Taiyin color graph is read as yellow from the five-color sequence. Shaoyin’s distinct wording is retained rather than forced into the other rows’ pattern.
The Emperor said: “I know that when Jueyin is at the Spring, sour transformation leads. How does Wind transformation act?”
Qi Bo said: “Wind moves upon earth: this is what is called the root. The remaining qi follow the same rule. What is rooted in heaven is heaven’s qi; what is rooted in earth is earth’s qi. Heaven and earth join their qi, the six divisions are apportioned, and the myriad things transform and are born.”
“Thus it is said: ‘Carefully observe what suits the qi; do not miss the mechanism of illness.’ This is the meaning.”
The Emperor said: “What of their use in treating illness?”
Qi Bo said: “Observe the year’s governing influence and prepare its products; then none of the governing uses will be omitted.”
The Emperor said: “Why give the year’s products priority?”
The compressed opening is read as prioritizing or preparing the year’s products, rather than introducing an unmentioned earlier harvest.
Qi Bo said: “They are the concentrated essence of heaven and earth.”
The Emperor said: “What of those associated with governing qi?”
Qi Bo said: “Those associated with governing qi are like those governing the year, but there is excess or deficiency.”
The Emperor said: “What is meant by products not associated with the year’s governing influence?”
Qi Bo said: “Their influence is dispersed. Thus their substance is alike but their grades differ. Qi and flavor may be thin or thick; nature and action agitated or still; treatment and preservation may require more or less; transforming strength may be shallow or deep. This is the meaning.”
The Emperor said: “What is meant by the year’s governing influence harming a zang?”
Qi Bo said: “Naming it by what the zang cannot overcome gives the essential.”
The Emperor said: “How is it treated?”
Qi Bo said: “When an excess from above invades below, settle it with what overcomes it. When an excess from outside invades within, treat it with what overcomes it.”
The Emperor said: “Good. How is qi balanced?”
Qi Bo said: “Carefully examine where yin and yang are and regulate them, aiming at balance. Ordinary patterns receive ordinary treatment; contrary patterns receive contrary treatment.”
The Emperor said: “You speak of examining where yin and yang are and regulating them. The discourse says that Renying and Cunkou answer one another like a stretched cord, equal in size, and this is called balance. Where yin is situated, what happens at Cunkou?”
Qi Bo said: “It can be known by observing whether the year has northern or southern government.”
The Emperor said: “I wish to hear it fully.”
Qi Bo said: “In a year of northern government, if Shaoyin is at the Spring, Cunkou does not respond; if Jueyin is at the Spring, the right does not respond; if Taiyin is at the Spring, the left does not respond.
“In a year of southern government, if Shaoyin governs heaven, Cunkou does not respond; if Jueyin governs heaven, the right does not respond; if Taiyin governs heaven, the left does not respond. In all these nonresponses, reversing the examination makes the pulse appear.”
The Emperor said: “What of examining the chi position?”
Qi Bo said: “In years of northern government, when the three yin are below, cun does not respond; when the three yin are above, chi does not respond. In years of southern government, when the three yin are in heaven, cun does not respond; when they are at the Spring, chi does not respond. Left and right follow the same rule.”
Cun and chi here name pulse positions, not converted units of distance.
“Thus it is said: ‘One who knows the essential can finish in one statement; one who does not scatters into endless discussion.’ This is the meaning.”
The Emperor said: “Good. What illness results when the qi of heaven and earth invade within?”
Qi Bo said: “In a year with Jueyin at the Spring, when Wind excess prevails, earth’s qi is not bright and the plains are dim; plants flower early. People shiver with cold, frequently stretch and yawn, and suffer heart pain, propping fullness, internal tightness in both rib-sides, inability to take down food and drink, and blockage of diaphragm and throat. Eating brings vomiting. There are abdominal distension and frequent belching; after stool and gas pass, there is relief as though the illness has lessened. The whole body is heavy.”
The displayed rib-side graph is anomalous and is read from the bodily context.
“In a year with Shaoyin at the Spring, when heat excess prevails, shimmering heat floats over rivers and marshes and shaded places become bright instead. People suffer constant abdominal rumbling, qi rushing upward into the chest, panting and inability to stand long, cold and heat, painful skin, dim eyes, toothache and swelling. Aversion to cold and fever resemble intermittent fever; there are pain in the lower abdomen and abdominal enlargement. Hibernating creatures do not hide.”
The source’s swelling modifier is corrupt; no additional named disorder is supplied.
“In a year with Taiyin at the Spring, plants flourish early. When Damp excess prevails, haze darkens rocky valleys; yellow gives way to black at the meeting of deepest yin. People suffer accumulated fluids, heart pain, deafness, muddled and dull awareness, swollen pharynx, throat obstruction, illness of the private parts with blood appearing, painful swelling in the lower abdomen and inability to urinate. Illness rushes upward with headache: the eyes feel as if coming out, the neck as if pulled out and the lower back as if broken. The hips cannot turn, the hollows of the knees feel knotted and the calves as if torn apart.”
The final body-part graph is anomalous; “calves” follows the leg sequence rather than its literal bird sense.
“In a year with Shaoyang at the Spring, when Fire excess prevails, fiery brightness fills the outskirts and fields; cold and heat arrive by turns. People suffer red and white pouring diarrhea, lower abdominal pain and red urine, with bloody stools in severe cases. Shaoyin has the same manifestations.”
“In a year with Yangming at the Spring, when dryness excess prevails, mist is cool and dark. People vomit frequently, with bitterness in the vomit, and often sigh. The heart and rib-sides hurt so that they cannot turn over. In severe cases the throat is dry and the face dusty, the body lacks oily moisture and the outer feet are hot instead.”
“In a year with Taiyang at the Spring, when cold excess prevails, congealing austerity brings harsh shivering cold. People suffer lower abdominal pain drawing on the testicles and pulling into the lower back and spine, rushing upward as heart pain. Blood appears; the throat hurts and the jaw swells.”
The Emperor said: “Good. How is it treated?”
Qi Bo said: “For qi at the Spring:
“When Wind invades within, treat with acrid and cool, assist with bitter, relax with sweet and disperse with acrid.
“When heat invades within, treat with salty and cold, assist with sweet and bitter, gather with sour and release with bitter.
“When Damp invades within, treat with bitter and hot, assist with sour and bland, dry with bitter and drain with bland.
“When Fire invades within, treat with salty and cold, assist with bitter and acrid, gather with sour and release with bitter.
“When dryness invades within, treat with bitter and warm, assist with sweet and acrid, and send downward with bitter.
“When cold invades within, treat with sweet and hot, assist with bitter and acrid, drain with salty, moisten with acrid and firm with bitter.”
The Emperor said: “Good. What of changes in heaven’s qi?”
Qi Bo said: “When Jueyin governs heaven and Wind excess prevails, dust darkens the great sky and clouds are disturbed. Cold generates spring qi; flowing water does not freeze. People suffer pain at the stomach cavity opposite the heart, propping upward against both rib-sides, blockage of diaphragm and throat, inability to take down food and drink, stiffness at the tongue’s root and vomiting after eating. There are cold diarrhea, abdominal distension, loose stools, abdominal masses and blocked water. Hibernating creatures do not leave. The illness is rooted in the Spleen. If Chongyang is cut off, death follows and it cannot be treated.”
The unusual cold-and-spring wording is retained as supplied; the rib-side graph is read contextually.
“When Shaoyin governs heaven and heat excess prevails, pent-up heat arrives and Fire carries out its government. People suffer vexing heat in the chest, dry throat, right-side fullness, skin pain, cold and heat, cough and panting. Great rain is about to arrive. There are spitting blood, blood passing below, nasal discharge, nosebleeds, sneezing, vomiting and changed urine color. Severe cases bring sores, ulcers, swelling, pain in shoulders, back, arms, upper arms and the hollow above the collarbone, heart pain and Lung swelling. The abdomen is enlarged and full, resounding with distension, panting and cough. The illness is rooted in the Lung. If Chize is cut off, death follows and it cannot be treated.”
Lung swelling interprets the displayed obscure graph in its bodily context.
“When Taiyin governs heaven and Damp excess prevails, deep gloom spreads and rain changes things into withered dryness. There are swelling, bone pain and yin obstruction. Yin obstruction cannot be reached by pressing. The lower back, spine, head and neck hurt, with occasional dizziness. Stools are difficult; the genital qi does not function. There is hunger without desire to eat, blood with coughing and spitting, and a heart that feels suspended. The illness is rooted in the Kidney. If Taixi is cut off, death follows and it cannot be treated.”
“When Shaoyang governs heaven and Fire excess prevails, warm qi spreads and Metal’s government is unsettled. People suffer headache, fever and aversion to cold with intermittent fever, heat above and painful skin. The complexion changes to yellow and red; the illness transmits into water, with swelling of body and face, abdominal fullness and breathing with the face raised. There are red and white pouring diarrhea, sores, ulcers, coughing and spitting blood, a vexed Heart and heat in the chest. Severe cases bring nasal discharge and nosebleeds. The illness is rooted in the Lung. If Tianfu is cut off, death follows and it cannot be treated.”
“When Yangming governs heaven and dryness excess prevails, trees flourish late and grasses sprout late; sinews and bones change within. People suffer left-side and rib-side pain; clear cold within brings intermittent fever. Great coolness changes the season’s manifestations. There are cough, abdominal rumbling and pouring loose stools like duck droppings. Noted trees restrain their growth and are pent down below; grasses scorch at their upper tips. Sudden pain in the heart and rib-sides prevents turning over. There are dry throat, dusty face, lower-back pain, hernial disorder in men, lower abdominal pain in women, dim eyes, sores at the eye corners, eruptions, pimples and abscesses. Hibernating creatures emerge. The illness is rooted in the Liver. If Taichong is cut off, death follows and it cannot be treated.”
The displayed hernia modifier is corrupt and is not converted into a more specific diagnosis.
“When Taiyang governs heaven and cold excess prevails, cold qi arrives again and water is about to freeze. Blood changes within and breaks out as abscesses and ulcers. People suffer counterflow with heart pain, vomiting blood, blood passing below, nasal discharge and nosebleeds, frequent sorrow and occasional dizziness, collapse and whirling. Fire burns fiercely and sudden rain becomes hail. Chest and abdomen are full; hands are hot, elbows contracted and armpits swollen. The heart pounds greatly; chest, rib-sides and stomach cavity are uneasy. There are red face, yellow eyes, frequent belching and dry throat. Severe cases bring a drawn complexion and thirst with a desire to drink. The illness is rooted in the Heart. If Shenmen is cut off, death follows and it cannot be treated. By these stirring qi, their zang can be known.”
The Emperor said: “Good. How is it treated?”
Qi Bo said: “For the qi governing heaven:
“When Wind excess prevails, settle it with acrid and cool, assist with bitter and sweet, relax with sweet and drain with sour.
“When heat excess prevails, settle it with salty and cold, assist with bitter and sweet, and gather with sour.
“When Damp excess prevails, settle it with bitter and hot, assist with sour and acrid, dry with bitter and drain with bland. If Damp is severe above and hot, treat with bitter and warm, assist with sweet and acrid, and stop when sweating has served its purpose.
“When Fire excess prevails, settle it with sour and cold, assist with bitter and sweet, gather with sour, release with bitter and restore with sour. Heat excess follows the same rule.
“When dryness excess prevails, settle it with bitter and moist, assist with sour and acrid, and send downward with bitter.
“When cold excess prevails, settle it with acrid and hot, assist with sweet and bitter, and drain with salty.”
The dryness line reads “bitter and moist” in the displayed source; it is not silently changed to “bitter and warm.”
The Emperor said: “Good. If a harmful influence instead overcomes the governing qi, how is it treated?”
Qi Bo said: “When Wind governs earth but coolness overcomes it, treat with sour and warm, assist with bitter and sweet, and settle with acrid.
“When heat governs earth but cold overcomes it, treat with sweet and hot, assist with bitter and acrid, and settle with salty.
“When Damp governs earth but heat overcomes it, treat with bitter and cold, assist with salty and sweet, and settle with bitter.
“When Fire governs earth but cold overcomes it, treat with sweet and hot, assist with bitter and acrid, and settle with salty.
“When dryness governs earth but heat overcomes it, treat with balanced cold, assist with bitter and sweet, and settle with sour; harmony is beneficial.
“When cold governs earth but heat overcomes it, treat with salty and cold, assist with sweet and acrid, and settle with bitter.”
“Balanced cold” retains the unusual wording of the dryness row without inventing a missing flavor.
The Emperor said: “What if harmful influence overcomes the qi governing heaven?”
Qi Bo said: “When Wind transforms in heaven but coolness overcomes it, treat with sour and warm, assisting with sweet and bitter.
“When heat transforms in heaven but cold overcomes it, treat with sweet and warm, assisting with bitter, sour and acrid.
“When Damp transforms in heaven but heat overcomes it, treat with bitter and cold, assisting with bitter and sour.
“When Fire transforms in heaven but cold overcomes it, treat with sweet and hot, assisting with bitter and acrid.
“When dryness-Fire is in heaven but heat overcomes it, treat with acrid and cold, assisting with bitter and sweet.
“When cold transforms in heaven but heat overcomes it, treat with salty and cold, assisting with bitter and acrid.”
The fifth row reads “dryness-Fire” in the displayed source, rather than the “dryness transformation” pattern; the difference is retained.
The Emperor said: “How do the six qi overcome one another?”
Qi Bo said: “Jueyin’s overcoming brings ringing ears, dizziness, muddled awareness and a desire to vomit; stomach and diaphragm feel cold. Great Wind repeatedly rises and bare-bodied creatures do not thrive. Qi gathers in the sides and rib-sides, changing into heat. Urine is yellow-red; the stomach cavity hurts opposite the heart, propping upward against both rib-sides. There are intestinal rumbling, diarrhea with undigested food, lower abdominal pain and red and white pouring diarrhea. Severe cases bring vomiting and blockage of diaphragm and throat.”
The anomalous creature and rib-side graphs are read from their recurring contexts.
“Shaoyin’s overcoming brings heat below the heart, frequent hunger, movement below the navel instead, and qi roaming through the Triple Burner. Blazing summer heat arrives, trees exude sap and plants wither. There are vomiting with counterflow, agitation and vexation, abdominal fullness and pain, and loose stools, transmitting into red urinary discharge.”
“Taiyin’s overcoming constrains Fire qi within; sores form inside and spread outside. Illness lies in the sides and rib-sides; severe cases bring heart pain, heat blockage, headache, throat obstruction and stiff neck. If it alone prevails, Damp qi becomes constrained within and cold presses the lower burner. Pain stays at the crown and draws to the space between the eyebrows; the stomach is full. Rain arrives repeatedly and dryness transformation appears. There are lower abdominal fullness, heaviness and stiffness of lower back and buttocks, internal difficulty, frequent pouring diarrhea, warm soles, heavy head, swelling of feet and shins, retained fluids arising within and swelling above.”
“Shaoyang’s overcoming lodges heat in the Stomach. There are a vexed Heart, heart pain, red eyes, desire to vomit, sour vomiting, frequent hunger, ear pain, red urine, frequent alarm and delirium. Sudden heat wastes and scorches; grasses wither and waters dry, and armored creatures become subdued. There are lower abdominal pain and red and white discharge below.”
“Yangming’s overcoming generates coolness within, left-side and rib-side pain and loose stools. Internally the throat is blocked; externally hernial disorder appears. Great coolness kills austerely; flowers change their appearance and hairy creatures suffer calamity. The chest is uncomfortable, with a blocked throat and cough.”
The anomalous hernia modifier is retained at the general level rather than assigned a specific modern condition.
“Taiyang’s overcoming brings congealing, piercing cold. Water freezes out of season and feathered creatures transform late. Hemorrhoids, intermittent fever and cold counterflow arise. If it enters the Stomach, heart pain forms within. Sores appear in the private parts; hidden bodily functions are impaired and draw into the groin and inner thighs. Sinews and flesh contract painfully; blood vessels congeal and become rough, network vessels fill and color changes. There may be blood passing below, obstructed swelling of the skin, abdominal fullness and reduced eating. Heat instead moves upward, with pain in head, neck, fontanel, crown and the Brain Door region. Eyes feel as if coming out. Cold entering the lower burner transmits into watery diarrhea.”
The Emperor said: “How is it treated?”
Qi Bo said: “For Jueyin’s overcoming, treat with sweet and cool, assist with bitter and acrid, and drain with sour.
“For Shaoyin’s overcoming, treat with acrid and cold, assist with bitter and salty, and drain with sweet.
“For Taiyin’s overcoming, treat with salty and hot, assist with acrid and sweet, and drain with bitter.
“For Shaoyang’s overcoming, treat with acrid and cold, assist with sweet and salty, and drain with sweet.
“For Yangming’s overcoming, treat with sour and warm, assist with acrid and sweet, and discharge with bitter.
“For Taiyang’s overcoming, treat with sweet and hot, assist with acrid and sour, and drain with salty.”
The Emperor said: “What of the returning counteraction of the six qi?”
Qi Bo said: “How comprehensive the question! Jueyin’s return brings hard fullness of the lower abdomen, internal tightness and sudden pain. Trees bend and sand flies; bare-bodied creatures do not flourish. There are counterflow with heart pain, sweating, vomiting, inability to take in food and drink, or bringing back out what enters. Sinews and bones shake, with dizziness and cold counterflow. Severe cases enter the Spleen: food is obstructed and vomited. If Chongyang is cut off, death follows and it cannot be treated.”
“Shaoyin’s return generates oppressive heat within, vexation, agitation, nasal discharge, sneezing and twisting lower abdominal pain. Fire appears with burning weariness and dry throat; discharge comes in portions and stops at times. Qi stirs on the left and travels upward on the right. There are cough, skin pain, sudden loss of voice, heart pain, clouded oppression and failure to recognize people. Shivery aversion to cold, trembling and delirium follow. After cold ceases there is heat, with thirst and desire to drink, scant qi, bone wilting and obstruction of diaphragm and intestines. Outside there is puffy swelling, with hiccups and belching. Red qi transforms afterward; flowing water does not freeze and heat qi acts greatly. Armored creatures do not recover. There are heat rash, eruptions, sores, ulcers, abscesses, deep sores, pimples and hemorrhoids. Severe cases enter the Lung, with cough and copious nasal discharge. If Tianfu is cut off, death follows and it cannot be treated.”
“Taiyin’s return raises abnormal Damp transformation. The body is heavy, the middle full, food and drink fail to transform, and yin qi counterflows upward. The chest is uncomfortable; retained fluids arise within, with noisy cough and panting. Great rain falls at times and scaled creatures appear on land. Head and crown are painfully heavy; shaking and spasms are especially severe. There are vomiting, silence and spitting clear fluids. Severe cases enter the Kidney’s opening, with unbounded diarrhea. If Taixi is cut off, death follows and it cannot be treated.”
“Shaoyang’s return heralds great heat, with withering, dryness and burning; armored creatures are depleted. There are fright, spasms, cough, nosebleeds, Heart heat, vexation, agitation, frequent stools and aversion to Wind. Counterflow qi ascends; the face looks dusty and the eyes become clouded and twitch. Fire qi erupts within, producing erosion in the mouth above, vomiting with counterflow, overflowing blood and blood passing below. It breaks out as intermittent fever, with aversion to cold and chattering tremors; extreme cold turns to heat. Throat networks scorch dry; thirst seeks water and liquids. Color changes to yellow and red; qi is scant and vessels wilt. It changes into water and transmits into swelling. Severe cases enter the Lung, with cough and blood passing below. If Chize is cut off, death follows and it cannot be treated.”
The eye phrase contains an anomalous graph, read from its clouding-and-spasm context.
“Yangming’s return greatly raises cool qi. Dense woods turn gray-green and dry; hairy creatures suffer harm. Illness arises in the sides and rib-sides; qi turns left, with frequent sighing. Severe cases bring heart pain, focal fullness, abdominal distension and diarrhea, bitter vomiting, cough, hiccups and vexation of the Heart. Illness lies in the diaphragm, with headache. Severe cases enter the Liver, bringing alarm and contracted sinews. If Taichong is cut off, death follows and it cannot be treated.”
“Taiyang’s return sends counterflow qi upward. Water congeals, rain becomes ice and feathered creatures die. Cold develops in the Heart and Stomach; chest and diaphragm are impaired. There are heart pain, focal fullness, headache, frequent sorrow, occasional dizziness and collapse, reduced eating, pain instead in lower back and buttocks, and difficulty bending and stretching. Earth cracks and ice hardens; sunlight does not govern. The lower abdomen pulls on the testicles, draws into the lower back and spine and rushes upward to the heart. Clear water is spat out, with hiccups and belching. Severe cases enter the Heart, bringing frequent forgetfulness and sorrow. If Shenmen is cut off, death follows and it cannot be treated.”
The Emperor said: “Good. How is it treated?”
Qi Bo said: “For Jueyin’s return, treat with sour and cold, assist with sweet and acrid, drain with sour and relax with sweet.
“For Shaoyin’s return, treat with salty and cold, assist with bitter and acrid, drain with sweet, gather with sour, release with acrid and bitter, and soften with salty.
“For Taiyin’s return, treat with bitter and hot, assist with sour and acrid, drain with bitter, dry it and discharge it.
“For Shaoyang’s return, treat with salty and cold, assist with bitter and acrid, soften with salty, gather with sour and release with acrid and bitter. For release, do not avoid heat, but do not encroach upon warmth or coolness. Shaoyin follows the same method.
“For Yangming’s return, treat with acrid and warm, assist with bitter and sweet, discharge with bitter, send downward with bitter and supplement with sour.
“For Taiyang’s return, treat with salty and hot, assist with sweet and acrid, and firm with bitter.
“In treating all overcoming and returning influences: warm the cold; cool the hot; clear the warm; warm the cool; gather the scattered; disperse the suppressed; moisten the dry; relax the tense; soften the hard; firm the brittle; supplement the declining; drain the strong. Settle each qi, bringing clarity and stillness. Then illness qi declines and leaves, returning to its root. This is the broad form of treatment.”
The Emperor said: “Good. What is meant by qi above and below?”
Qi Bo said: “Above the body’s midpoint there are three qi: this is heaven’s division, governed by heaven’s qi. Below the midpoint there are three qi: this is earth’s division, governed by earth’s qi. Name the qi, use the qi to identify its place, and then describe its illness. The midpoint is what is called the Celestial Pivot.
“If the upper prevails and the lower is also ill, name it by earth; if the lower prevails and the upper is also ill, name it by heaven. When overcoming arrives, its answering qi is bent and hidden, not yet released. When return arrives, its name is not distinguished by heaven and earth: all follow the returning qi’s rule.”
The Emperor said: “Do the movements of overcoming and return have fixed times? Must the qi necessarily occur?”
Qi Bo said: “Time has constant positions, but qi is not inevitable.”
The Emperor said: “I wish to hear its principle.”
Qi Bo said: “From the first qi through the end of the third, heaven’s qi governs: this is the ordinary time of overcoming. From the fourth qi through the final qi, earth’s qi governs: this is the ordinary time of return. Where there is overcoming, there is return; without overcoming, there is none.”
The Emperor said: “Good. What if overcoming follows after return?”
Qi Bo said: “Overcoming brings return, with no fixed number. It stops only when the qi declines. If overcoming follows a return and no return answers it, harm results: this injures life.”
The Emperor said: “Why does returning qi instead cause illness?”
Qi Bo said: “It occupies a position that is not its own and does not accord with it. If its return greatly exceeds the overcoming it answers, the host overcomes it. Thus illness results instead, as in what is called Fire, dryness and heat.”
The Emperor said: “How is it treated?”
Qi Bo said: “For overcoming qi, follow it if slight and restrain it if severe. For returning qi, settle it if moderate and remove it if violent. In all cases follow the overcoming qi and settle what is bent and hidden. Do not ask for a fixed number: aim at balance. This is the Way.”
The Emperor said: “Good. What of overcoming and return between host and guest?”
Qi Bo said: “The qi of host and guest have overcoming but no return.”
The Emperor said: “How do they follow or oppose the order?”
Qi Bo said: “The host prevailing opposes the order; the guest prevailing follows it. This is heaven’s Way.”
The Emperor said: “What illnesses do they produce?”
Qi Bo said: “With Jueyin governing heaven, a prevailing guest brings ringing ears, shaking and dizziness, with cough in severe cases. A prevailing host brings chest and rib-side pain and a tongue that finds speech difficult.
“With Shaoyin governing heaven, a prevailing guest brings nasal discharge, sneezing, stiff neck, oppressive heat in shoulders and back, headache, scant qi, fever, deafness and dim eyes. Severe cases bring swelling, overflowing blood, sores, ulcers, cough and panting. A prevailing host brings Heart heat, vexation and agitation, with rib-side pain and propping fullness in severe cases.
“With Taiyin governing heaven, a prevailing guest brings swelling of head and face and panting breath. A prevailing host brings chest and abdominal fullness and clouded awareness after eating.
“With Shaoyang governing heaven, a prevailing guest brings red eruptions, fiery red sores and ulcers, vomiting with counterflow, throat obstruction, headache, swollen pharynx, deafness and overflowing blood, with spasms within. A prevailing host brings chest fullness, cough and breathing with the face raised; severe cases have blood and hot hands.
“With Yangming governing heaven, if returning coolness remains excessive within, there are cough, nosebleeds, blocked throat and heat in the heart and diaphragm. Unceasing cough with ‘white blood’ coming out leads to death.
“With Taiyang governing heaven, a prevailing guest brings chest discomfort, clear nasal discharge and cough upon exposure to cold. A prevailing host brings sounds within the throat and pharynx.”
“White blood” is retained as the source’s historical expression, without a modern blood-cell diagnosis. The Yangming row’s distinct returning-coolness wording is not recast as a host/guest pair.
“With Jueyin at the Spring, a prevailing guest impairs the large joints: internally there are rigidity, contraction and spasms, externally impaired movement. A prevailing host brings shaking and drawing together of sinews and bones, with occasional pain in lower back and abdomen.
“With Shaoyin at the Spring, a prevailing guest brings lower-back pain and illness in buttocks, thighs, knees, hips, calves, shins and feet; oppressive heat with aching, swelling and inability to stand long, and changed urine and stools. A prevailing host sends counterflow qi upward, with heart pain, fever and obstruction at the diaphragm. Many obstructions arise in the sides and rib-sides; po-sweat is not contained, and counterflow of the four limbs arises.
“With Taiyin at the Spring, a prevailing guest brings wilting feet, heaviness below and untimely bowel movements and urination. Damp lodges in the lower burner, producing watery diarrhea, swelling and illness of hidden bodily functions. A prevailing host brings cold qi counterflow with fullness and inability to take down food and drink, becoming hernial disorder in severe cases.
“With Shaoyang at the Spring, a prevailing guest brings lower-back and abdominal pain with aversion to cold instead; severe cases bring white discharge below and white urine. A prevailing host sends heat upward instead, lodging in the Heart and bringing heart pain and fever, blockage in the middle and vomiting. Shaoyin has the same manifestations.
“With Yangming at the Spring, a prevailing guest stirs cool qi below, producing hard fullness of the lower abdomen and frequent diarrhea. A prevailing host brings heavy lower back, abdominal pain and cold in the lower abdomen, with loose stools like duck droppings below. Cold counterflows in the intestines and rushes upward into the chest; severe cases bring panting and inability to stand long.
“With Taiyang at the Spring, if returning cold remains excessive within, lower back and buttocks hurt, bending and stretching are impaired, and pain occurs in thighs, shins, feet and knees.”
The calf and shin readings follow the bodily sequence where the source has anomalous bird graphs. Po-sweat retains the source’s soul-aspect expression rather than supplying a new physiological mechanism.
The Emperor said: “Good. How is it treated?”
Qi Bo said: “Restrain what is high; lift what is low; check excess; supplement deficiency. Assist with what benefits it and harmonize with what suits it. Settle host and guest, adjust their cold and warmth, oppose what is the same and follow what is different.”
The Emperor said: “I already know treating cold with heat and heat with cold, opposing qi that accords and following qi that does not accord. What of the proper flavors?”
Qi Bo said: “For the host of the Wood position, sour drains and acrid supplements.
“For the host of the Fire position, sweet drains and salty supplements.
“For the host of the Earth position, bitter drains and sweet supplements.
“For the host of the Metal position, acrid drains and sour supplements.
“For the host of the Water position, salty drains and bitter supplements.”
“For the Jueyin guest, supplement with acrid, drain with sour and relax with sweet.
“For the Shaoyin guest, supplement with salty, drain with sweet and gather with salty.
“For the Taiyin guest, supplement with sweet, drain with bitter and relax with sweet.
“For the Shaoyang guest, supplement with salty, drain with sweet and soften with salty.
“For the Yangming guest, supplement with sour, drain with acrid and discharge with bitter.
“For the Taiyang guest, supplement with bitter, drain with salty, firm with bitter and moisten with acrid, opening the interstices, bringing fluids and freeing qi.”
The Emperor said: “Good. I wish to hear what is meant by the three divisions of yin and yang.”
Qi Bo said: “Qi has greater and lesser amounts, with differing uses.”
The Emperor said: “What does Yangming mean?”
Qi Bo said: “The two yang join in brightness.”
The Emperor said: “What does Jueyin mean?”
Qi Bo said: “The two yin meet at their limit.”
The Emperor said: “Qi has greater and lesser amounts; illness has strength and decline; treatment has gradual and urgent forms; formulas have large and small forms. I wish to hear the concise principles.”
Qi Bo said: “Qi lies high or low; illness is far or near; manifestations are within or outside; treatment is light or heavy. Its purpose is to reach the appropriate place.”
“The Great Essentials says: ‘One sovereign and two ministers form an odd formulation; two sovereigns and four ministers an even formulation; two sovereigns and three ministers an odd formulation; three sovereigns and six ministers an even formulation.’”
The odd/even names and all counts are retained as supplied, without recalculating or changing their categories.
“Thus it is said: ‘For near illness, use odd; for far illness, use even. Sweating does not use odd; downward treatment does not use even.’ To supplement or treat above, formulate gradually; to supplement or treat below, formulate urgently. Urgency uses thick qi and flavor; gradual action uses thin qi and flavor. This is what it means to reach the appropriate place.
“If illness lies far away and qi and flavor fail midway, administer with food to carry it past, without exceeding the formulation’s rule. Thus in balancing qi, whether odd or even, near illness uses a small administration and far illness a large administration. Large administrations are fewer; small administrations more numerous. More means nine; fewer means two. If odd does not remove it, use even: this is called a compounded formula. If even does not remove it, take it with contrary assistance. This refers to cold, hot, warm or cool following the illness contrariwise.”
The midway qi-and-flavor clause is elliptical; failure to reach the distant site is its contextual reading. The source’s counts are preserved without conversion into a modern dose or interval.
The Emperor said: “Good. I know illness arising at the root. How is illness arising at the branch treated?”
Qi Bo said: “When illness departs from its root and takes on a branch illness, treatment departs from its root and obtains a branch formula.”
The Emperor said: “Good. How is the overcoming of the six qi observed?”
Qi Bo said: “Observe what takes advantage upon its arrival. When cool qi arrives greatly, dryness prevails; Wind Wood receives harmful influence and Liver illness arises. When heat qi arrives greatly, Fire prevails; Metal dryness receives harmful influence and Lung illness arises. When cold qi arrives greatly, Water prevails; Fire heat receives harmful influence and Heart illness arises. When Damp qi arrives greatly, Earth prevails; cold Water receives harmful influence and Kidney illness arises. When Wind qi arrives greatly, Wood prevails; Earth Damp receives harmful influence and Spleen illness arises. This is what is meant by receiving harmful influence and developing illness.
“If it takes advantage of the year’s emptiness, the harmful influence is severe. If harmony with the season is lost, it is also severe. If it meets the moon’s emptiness, it is also severe. Repeated exposure makes illness dangerous. Where overcoming qi occurs, returning counteraction must come.”
The Emperor said: “What are their arriving pulses like?”
Qi Bo said: “At Jueyin’s arrival, the pulse is string-like.
“At Shaoyin’s arrival, the pulse is hooked.
“At Taiyin’s arrival, the pulse is sinking.
“At Shaoyang’s arrival, it is large and floating.
“At Yangming’s arrival, it is short and rough.
“At Taiyang’s arrival, it is large and long.
“If its arrival is harmonious, there is balance. If excessive, there is illness. A contrary arrival is illness; failure to arrive when due is illness; arrival before it is due is illness. Exchange of yin and yang is dangerous.”
The Emperor said: “The six qi follow branch and root differently. How is this so?”
Qi Bo said: “Some qi follow the root; some follow branch and root; some follow neither branch nor root.”
The Emperor said: “I wish to hear it fully.”
Qi Bo said: “Shaoyang and Taiyin follow the root. Shaoyin and Taiyang follow both root and branch. Yangming and Jueyin follow neither branch nor root, but follow the middle.
“For what follows the root, transformation arises from the root. What follows branch and root has the transformations of both. What follows the middle transforms according to middle qi.”
The Emperor said: “When the pulse follows but the illness is contrary, how is it examined?”
Qi Bo said: “The arriving pulse follows, but under pressure it does not beat forcefully. All the yang are like this.”
The Emperor said: “What are the pulses like in contrary yin patterns?”
Qi Bo said: “The arriving pulse follows, but under pressure it beats very strongly and abundantly. Thus among the many illnesses, some arise from the root, some from the branch and some from middle qi. Some are resolved by addressing the root, some the branch, some middle qi, some both branch and root, some by opposing and some by following. Opposing is proper following; what seems to follow is opposing.
“Thus it is said: ‘Know branch and root, and their use brings no peril. Clearly know opposing and following, and proper action has no doubt.’ Without this knowledge, one is unfit to discuss diagnosis and can only disorder the channels. The Great Essentials says: ‘The crude practitioner laughs, thinking it easily known. Before the talk of heat is finished, cold illness has begun again. The same qi has differing forms: diagnosis is confused and the channels disordered.’ This is the meaning.
“The Way of branch and root is concise yet broad, small yet great. One principle can disclose the harms of a hundred illnesses. Speak of branch and root and change without damage; examine root and branch and qi can be regulated. Clearly know overcoming and return and become a model for all people. Heaven’s Way is complete.”
The Emperor said: “How early or late are the changes of overcoming and return?”
Qi Bo said: “For what is overcome, illness already exists when the overcoming arrives. While the illness still smolders, return has already begun to sprout. Returning qi rises when the overcoming is exhausted and becomes severe when it obtains its position. Overcoming may be slight or severe; return may be lesser or greater. If overcoming is moderate, return is moderate; if overcoming is empty, return is empty. This is heaven’s constant rule.”
The Emperor said: “Why do overcoming and return sometimes act outside their proper positions or arrive after their time?”
Qi Bo said: “The birth of qi differs from the strength and decline of its transformation. The functions of cold, summer heat, warmth and coolness, in strength and decline, lie in the four boundaries. Yang begins to move in warmth and flourishes in summer heat; yin begins to move in coolness and flourishes in cold. Spring, summer, autumn and winter each differ by their allotted share.”
“Thus the Great Essentials says: ‘Spring’s warmth becomes summer’s heat; autumn’s displeasure becomes winter’s anger. Carefully examine the four boundaries. The scouting signs all return to them: their ending can be seen and their beginning known.’ This is the meaning.”
The Emperor said: “Does the difference have a number?”
Qi Bo said: “A further thirty measures in all.”
The calendrical measure is retained without supplying an unmentioned remainder.
The Emperor said: “What are all their pulse responses like?”
Qi Bo said: “The displacement follows the ordinary rule; it awaits its time to depart.”
“The Pulse Essentials says: ‘In spring, not sinking; in summer, not string-like; in winter, not rough; in autumn, not rapid. These are called the four barriers. Excessive sinking is illness; excessive string-like quality is illness; excessive roughness is illness; the rapid condition is illness. Their mixed appearance is illness; their reappearance is illness. Departure before it is due is illness; failure to depart when due is illness. A contrary condition means death.’”
The source’s compressed seasonal negatives and its anomalous qualifier after “rapid” are retained without silently rewriting the pulse rules.
“Thus it is said: ‘Qi keeps mutual guard and command as the scale and steelyard must not lose one another.’ When yin and yang qi are clear and still, generation and transformation are ordered; when disturbed, severe illnesses arise. This is the meaning.”
The Emperor said: “What of darkness and brightness?”
Qi Bo said: “The two yin meet at their limit, so it is called darkness. The two yang join in brightness, so it is called brightness. Their pairing is the difference between cold and summer heat.”
The Emperor said: “What of division and arrival?”
Qi Bo said: “Qi arriving is called arrival; qi dividing is called division. At arrival the qi is alike; at division it differs. This is what is called the proper ordering of heaven and earth.”
The Emperor said: “You have said that spring and autumn qi begin before, winter and summer qi afterward. I know this. But the six qi come and go and do not govern the same years constantly. How are they supplemented and drained?”
Qi Bo said: “For what governs above and below, follow what benefits it and correct its flavors: this is the essential. Left and right use the same rule.
“The Great Essentials says: ‘For Shaoyang’s government, sweet first and salty afterward.
“‘For Yangming’s government, acrid first and sour afterward.
“‘For Taiyang’s government, salty first and bitter afterward.
“‘For Jueyin’s government, sour first and acrid afterward.
“‘For Shaoyin’s government, sweet first and salty afterward.
“‘For Taiyin’s government, bitter first and sweet afterward.’
“Assist with what benefits it and support with what generates it. This is called obtaining the qi.”
The Emperor said: “Good. The many illnesses all arise from the transformations and changes of Wind, cold, summer heat, Damp, dryness and Fire. The classic says: ‘Drain what is abundant; supplement what is empty.’ I have bestowed this on practitioners, yet their use of it is still not wholly successful. I wish the essential Way to act reliably, like drumstick answering drum, like drawing out a thorn or wiping away sweat, with the skill and insight of the accomplished. May I hear it?”
Qi Bo said: “Carefully examine the mechanism of illness and do not miss what suits the qi. This is the meaning.”
The Emperor said: “I wish to hear what the mechanisms of illness are.”
Qi Bo said: “All Wind with shaking and dizziness belongs to the Liver.
“All cold with drawing inward and contraction belongs to the Kidney.
“All qi with oppressive fullness and constraint belongs to the Lung.
“All Damp with swelling and fullness belongs to the Spleen.
“All heat with clouding and spasms belongs to Fire.
“All pain, itching and sores belong to the Heart.
“All counterflow, retention and discharge belong below.
“All wilting, panting and vomiting belong above.
“All clenching, trembling and shivering as though spirit has lost its guard belong to Fire.
“All rigidity and stiff neck belong to Damp.
“All counterflow rushing upward belongs to Fire.
“All distension and abdominal enlargement belong to heat.
“All agitation, frenzy and wild behavior belong to Fire.
“All illnesses making sounds and resounding like a drum when struck belong to heat.
“All illnesses with swelling, pain, aching and alarm belong to Fire.
“All twisting and contortion, with turbid fluids, belong to heat.
“All illnesses with clear, transparent and cold fluids belong to cold.
“All sour vomiting, sudden pouring diarrhea and pressure to evacuate belong to heat.
“Thus the Great Essentials says: ‘Carefully hold to the illness mechanism, each governing its affiliation. Seek it where present and where absent; investigate it in abundance and in emptiness. First establish the five overcoming relations, examine blood and qi, and make them regulated and freely reaching, bringing harmony and balance.’ This is the meaning.”
The list contains the source’s nineteen statements, with retention and discharge sharing one lower affiliation. The obscure graph before “blood and qi” is read contextually as examination.
The Emperor said: “Good. How do the five flavors function as yin and yang?”
Qi Bo said: “Acrid and sweet release and disperse: they are yang. Sour and bitter surge and discharge: they are yin. Salty flavor surges and discharges: it is yin. Bland flavor seeps and drains: it is yang. These six may gather or disperse, relax or tighten, dry or moisten, soften or firm. Act according to what benefits, regulating qi and bringing it to balance.”
The Emperor said: “When regulation of qi alone does not obtain the result, how is it treated? What comes first or afterward among potent and nonpotent medicinals? I wish to hear the Way.”
Qi Bo said: “Whether potent or nonpotent, what is treated governs the choice. Formulate in an appropriate large or small form.”
The source’s du distinction includes potency and toxicity; it is not converted into a claim that a substance is safe.
The Emperor said: “Please explain the formulations.”
Qi Bo said: “One sovereign and two ministers form a small formulation; one sovereign, three ministers and five assistants a medium formulation; one sovereign, three ministers and nine assistants a large formulation.
“Warm the cold; cool the hot. Oppose what is slight; follow what is severe. Cut away the hard, remove the lodged, warm the exhausted, disperse the bound, attack what remains, moisten the dry, relax the tense, gather the scattered, warm the damaged, move the idle and settle the frightened. Raise it or send it down; massage or bathe it; apply externally or seize it away; open or release it. Let what suits the matter be the purpose.”
The Emperor said: “What is meant by opposing and following?”
Qi Bo said: “Opposing is ordinary treatment; following is contrary treatment. Whether to follow a little or much depends on observing the situation.”
The Emperor said: “What is meant by contrary treatment?”
Qi Bo said: “Heat is used through cold; cold through heat; blockage through blockage; passage through passage. Subdue what governs the illness and first use what it follows. At the beginning they are alike; at the end they differ. Thus accumulations can be broken, hardness dissolved, qi harmonized and illness brought to an end.”
The Emperor said: “Good. What of obtaining the result through regulating qi?”
Qi Bo said: “Oppose it or follow it; oppose and then follow, or follow and then oppose. Examine qi and make it regulated: this is the Way.”
The displayed graph before “qi” is obscure and is read from the regulating context.
The Emperor said: “Good. What of illness within and outside?”
Qi Bo said: “What moves from within to outside requires regulation within; what moves from outside to within requires treatment outside. If it moves from within outward and is abundant outside, first regulate within, then treat outside. If it moves from outside inward and is abundant within, first treat outside, then regulate within. If inside and outside do not reach one another, treat the principal illness.”
The Emperor said: “Good. When Fire and heat return, aversion to cold and fever resemble intermittent fever. Some attacks occur daily, others after several days. Why?”
Qi Bo said: “The overcoming and returning qi meet in greater or lesser amounts. More yin qi and less yang qi put the days of attacks farther apart; more yang qi and less yin qi bring them closer. This is the measure of strength and decline as overcoming and return press against one another. Intermittent fever follows the same rule.”
The Emperor said: “The discourse says to treat cold with heat and heat with cold, yet practitioners cannot abandon the measuring line and change their approach. Some have heat illness and remain hot after cooling; others have cold illness and remain cold after warming. Both remain and new illness arises. How should this be treated?”
Qi Bo said: “For those still hot after cooling, address yin; for those still cold after warming, address yang. This is called seeking the affiliation.”
The Emperor said: “Good. Why does taking cold instead produce heat, and taking heat instead produce cold?”
Qi Bo said: “It treats the ruling qi; that is why the effect reverses.”
The Emperor said: “Why does this happen when the ruling qi is not treated?”
Qi Bo said: “How comprehensive the question! The affiliations of the five flavors have not been addressed. When the five flavors enter the Stomach, each returns to what it favors. Sour enters the Liver first; bitter the Heart; sweet the Spleen; acrid the Lung; salty the Kidney. Over time they increase the qi: this is the constant rule of things’ transformation. Prolonged increase of qi is a cause of shortened life.”
The displayed extra graph before “sour” is not treated as a sixth flavor or a new technique.
The Emperor said: “Good. What do sovereign and minister mean in a formula’s construction?”
Qi Bo said: “What governs the principal illness is the sovereign. What assists the sovereign is the minister. What answers to the minister is the envoy. These do not mean the three upper and lower grades.”
The Emperor said: “What do the three grades mean?”
Qi Bo said: “They clarify the distinct classes of beneficial and harmful qualities.”
The Emperor said: “Good. What of illness within and outside?”
Qi Bo said: “A formula for regulating qi must distinguish yin and yang, determine within and outside, and keep each to its domain. Treat the internal internally and the external externally. Regulate the slight; settle the next degree; remove the abundant. Use sweating or downward treatment, cold, hot, warm or cool, reducing it through its corresponding kind and following what benefits it. Carefully keep the Way according to the method. The text holds that every undertaking can then succeed, qi and blood become properly balanced, and heaven’s allotted life is long preserved.”
The Emperor said: “Good.”
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