素问·五常政大论 Great Treatise on the Five Constant Governances
黄帝问曰：太虚寥廓，五运回薄，衰盛不同，损益相从，愿闻平气何如而名，何如而纪也。歧伯对曰：昭乎哉问也。木曰敷和，火曰升明，土曰备化，金曰审平，水曰静顺。帝曰：其不及，奈何。歧伯曰：木曰委和，火曰伏明，土曰卑监，金曰从革，水曰涸流。帝曰：太过何谓。歧伯曰：木曰发生，火曰赫曦，上曰敦阜，金曰坚成，水曰流衍。帝曰：三气之纪，愿闻其候。歧伯曰：悉乎哉问也。敷和之纪，木德周行，阳舒阴布，五化宣平，其气端，其性随，其用曲直，其化生荣，其类草木，其政发散，其候温和，其令风，其藏肝，肝其畏清，其主目，其谷麻，其果李，其实核，其应春，其虫毛，其畜犬，其色苍，其养筋，其病里急支满，其味酸，其音角，其物中坚，其数八。升明之纪，正阳而治，德施周普，五化均衡，其气高，其性速，其用燔灼，其化蕃茂，其类火，其政明曜，其候炎暑，其令热，其藏心，心其畏寒，其主舌，其谷麦，其果杏，其实络，其应夏，其虫羽，其畜马，其色赤，其养血，其病瞤瘛，其味苦，其音徵，其物脉，其数七。备化之纪，气协天休，德流四政，五化齐修，其气平，其性顺，其用高下，其化丰满，其类土，其政安静，其候溽蒸，其令湿，其藏脾，脾其畏风，其主口，其谷稷，其果枣，其实肉，其应长夏，其虫倮，其畜牛，其色黄，其养肉，其病否，其味甘，其音宫，其物肤，其数五。审平之纪，收而不争，杀而无犯，五化宣明，其气洁，其性刚，其用散落，其化坚敛，其类金，其政劲肃，其候清切，其令燥，其藏肺，肺其畏热，其主鼻，其谷稻，其果桃，其实壳，其应秋，其虫介，其畜难，其色白，其养皮毛，其病咳，其味辛，其音商，其物外坚，其数九。静顺之纪，藏而勿害，治而善下，五化咸整，其气明，其性下，其用沃衍，其化凝坚，其类水，其政流演，其候凝肃，其令寒，其藏肾，肾其畏湿，其主二阴，其谷豆，其果栗，其实濡，其应冬，其虫鳞，其畜彘，其色黑，其养骨髓，其病厥，其味咸，其音羽，其物濡，其数六。故生而勿杀，长而勿罚，化而勿制，收而勿害，藏而勿抑，是谓平气。
委和之纪，是谓胜生，生气不政，化气乃扬，长气自平，收令乃早，凉雨时降，风云并兴，草木晚荣，苍乾凋落，物秀而实，肤肉内充，其气敛，其用聚，其动緛戾拘缓，其发惊骇，其藏肝，其果枣李，其实核壳，其谷稷稻，其味酸辛，其色白苍，其畜犬鸡，其虫毛介，其主雾露凄沧，其声角商，其病摇动注恐，从金化也，少角与判商同，上角与正角同，上商与正商同，其病支废痈肿疮疡，其甘虫，邪伤肝也，上宫与正宫同，萧飋肃杀，则炎赫沸腾，眚于三，所谓复也，其主飞蠹蛆雉，乃为雷霆。伏明之纪，是谓胜长，长气不宣，藏气反布，收气自政，化令乃衡，寒清数举，暑令乃薄，承化物生，生而不长，成实而稚，遇化已老，阳气屈伏，蛰虫早藏，其气郁，其用暴，其动彰伏变易，其发痛，其藏心，其果栗桃，其实络濡，其谷豆稻，其味苦咸，其色玄丹，其畜马彘，其虫羽鳞，其主冰雪霜寒，其声徵羽，其病昏惑悲忘，从水化也，少徵与少羽同，上商与正商同，邪伤心也，凝惨凓冽，则暴雨霖霪，眚于九，其主骤注雷霆震惊，沉霠淫雨。卑监之纪，是谓减化，化气不令，生政独彰，长气整，雨乃愆，收气平，风寒并兴，草木荣美，秀而不实，成而粃也，其气散，其用静定，其动疡涌分溃痈肿，其发濡滞，其藏脾，其果李栗，其实濡核，其谷豆麻，其味酸甘，其色苍黄，其畜牛犬，其虫倮毛，其主飘怒振发，其声宫角，其病留满否塞，从木化也，少宫与少角同，上宫与正宫同，上角与正角同，其病飱泄，邪伤脾也，振拉飘扬，则苍乾散落，其眚四维，其主败折虎狼，清气乃用，生政西辱。从革之纪，是谓折收，收气乃后，生气乃扬，长化合德，火政乃宣，庶类以蕃，其气扬，其用躁切，其动铿禁瞀厥，其发咳喘，其藏肺，其果李杏，其实壳络，其谷麻麦，其味苦辛，其色白丹，其畜鸡羊，其虫介羽，其主明曜炎烁，其声商徵，其病嚏咳鼽衂，从火化也，少商与少徵同，上商与正商同，上角与正角同，邪伤肺也，炎光赫烈，则冰雪霜雹，眚于七，其主鳞伏彘鼠，岁气早至，乃生大寒。涸流之纪，是谓反阳，藏令不举，化气乃昌，长气宣布，蛰虫不藏，土润水泉减，草木条茂，荣秀满盛，其气滞，其用渗泄，其动坚止，其发燥槁，其藏肾，其果枣杏，其实濡肉，其谷黍稷，其味甘咸，其色黅玄，其畜彘牛，其虫鳞倮，其主埃郁昏翳，其声羽宫，其病痿厥坚下，从土化也，少羽与少宫同，上宫与正宫同，其病癃閟，邪伤肾也，埃昏骤雨，则振拉摧拔，眚于一，其主毛显狐狢，变化不藏，故乘危而行，不速而至，暴虐无德，灾反及之，微者复微，甚者复甚，气之常也。
发生之纪，是谓启𢽬，土踈泄，苍气达，阳和布化，阴气乃随，生气淳化，万物以荣，其化生，其气美，其政散，其令条舒，其动掉眩巅疾，其德鸣靡启坼，其变振拉摧拔，其谷麻稻，其畜鸡犬，其果李桃，其色青黄白，其味酸甘辛，其象春，其经足厥阴少阳，其藏肝脾，其虫毛介，其物中坚外坚，其病怒，太角与上商同，上徵则其气逆，其病吐利，不务其德，则收气复，秋气劲切，甚则肃杀，清气大至，草木凋零，邪乃伤肝。赫曦之纪，是谓蕃茂，阴气内化，阳气外荣，炎暑施化，物得以昌，其化长，其气高，其政动，其令鸣显，其动炎灼妄扰，其德暄暑郁蒸，其变炎烈沸腾，其谷麦豆，其畜羊彘，其果杏栗，其色赤白玄，其味苦辛咸，其象夏，其经手少阴太阳，手厥阴少阳，其藏心肺，其虫羽鳞，其物脉濡，其病笑疟疮疡血流狂妄目赤，上羽与正徵同，其收齐，其病痓，上徵而收气后也，暴烈其政，藏气乃复，时见凝惨，甚则雨水霜雹切寒，邪伤心也。敦阜之纪，是谓广化，厚德清静，顺长以盈，至阴内实，物化充成，烟埃朦郁，见于厚土，大雨时行，湿气乃用，燥政乃辟，其化圆，其气丰，其政静，其令周备，其动濡积并蓄，其德柔润重淖，其变震惊飘骤崩溃，其谷稷麻，其畜牛犬，其果枣李，其色黅玄苍，其味甘咸酸，其象长夏，其经足太阴阳明，其藏脾肾，其虫倮毛，其物肌核，其病腹满，四支不举，大风迅至，邪伤脾也，坚成之纪，是谓收引，天气洁，地气明，阳气随，阴治化，燥行其政，物以司成，收气繁布，化洽不终，其化成，其气削，其政肃，其令锐切，其动暴折疡疰，其德雾露萧飋，其变肃杀凋零，其谷稻黍，其畜鸡马，其果桃杏，其色白青丹，其味辛酸苦，其象秋，其经手太阴阳明，其藏肺肝，其虫介羽，其物壳络，其病喘喝胸凭仰息，上徵与正商同，其生齐，其病咳，政暴变，则名木不荣，柔脆焦首，长气斯救，大火流，炎烁且至，蔓将槁，邪伤肺也。流衍之纪，是谓封藏，寒司物化，天地严凝，藏政以布，长令不扬，其化凛，其气坚，其政谧，其令流注，其动漂泄沃涌，其德凝惨寒氛，其变冰雪霜雹，其谷豆稷，其畜彘牛，其果栗枣，其色黑丹黅，其味咸苦甘，其象冬，其经足少阴太阳，其藏肾心，其虫鳞倮，其物濡满，其病胀，上羽而长气不化也，政过则化气大举而埃昏气交，大雨时降，邪伤肾也。故曰：不恒其德，则所胜来复，政恒其理，则所胜同化，此之谓也。
帝曰：天不足西北，左寒而右凉，地不满东南，右热而左温，其故何也。歧伯曰：阴阳之气，高下之理，太少之异也。东南方，阳也，阳者其精降于下，故右热而左温。西北方，阴也，阴者其精奉于上，故左寒而右凉。是以地有高下，气有温凉，高者气寒，下者气热。故适寒凉者胀之，温热者疮，下之则胀已，汗之则疮已，此凑理开闭之常，太少之异耳。帝曰：其于寿夭何如。歧伯曰：阴精所奉其人寿，阳精所降其人夭。帝曰：善。其病也，治之柰何。歧伯曰：西北之气散而寒之，东南之气收而温之，所谓同病异治也。故曰：气寒气凉，治以寒凉，行水渍之。气温气热，治以温热，强其内守。必同其气，可使平也，假者反之。
帝曰：善。一州之气生化寿夭不同，其故何也。歧伯曰：高下之理地势使然也。崇高则阴气治之，污下则阳气治之，阳胜者先天，阴胜者后天，此地理之常，生化之道也。帝曰：其有寿夭乎。歧伯曰：高者其气寿，下者其气夭，地之小大异也，小者小异，大者大异。故治病者，必明天道地理，阴阳更胜，气之先后，人之寿夭，生化之期，乃可以知人之形气矣。
帝曰：善。其岁有不病，而藏气不应不用者，何也。歧伯曰：天气制之，气有所从也。帝曰：愿卒闻之。歧伯曰：少阳司天，火气下临，肺气上从，白起金用，草木眚，火见燔焫，革金且耗，大暑以行，咳嚏鼽衂鼻窒，曰疡，寒热胕肿。风行于地，尘沙飞扬，心痛胃脘痛，厥逆鬲不通，其主暴速。阳明司天，燥气下临，肝气上从，苍起木用而立，土乃眚，凄沧数至，木伐草萎，脇痛目赤，掉振鼓栗，筋痿不能久立。暴热至，土乃暑，阳气郁发痛，小便变，寒热如疟，甚则心痛，火行于稿，流水不冰，蛰虫乃见。太阳司天，寒气下临，心气上从，而火且明，丹起金乃眚，寒清时举，胜则水冰，火气高明，心热烦嗌乾，善渴鼽嚏，喜悲数欠，热气妄行，寒乃复，霜不时降，善忘甚则心痛。土乃润，水丰衍，寒客至，沈阴化湿，气变物水饮内蓄，中满不食，皮𤸷肉苛，筋脉不利，甚则胕肿身后痈。厥阴司天，风气下临，脾气上从，而土且隆，黄起水乃眚，土用革，体重肌肉萎，食减口爽，风行太虚，云物摇动，目转耳鸣。火纵其暴，地乃暑，大热消烁，赤沃下，蛰虫数见，流水不冰，其发机速。少阴司天，热气下临，肺气上从，白起金用，草木眚，喘呕寒热嚏鼽衂鼻窒，大暑流行，甚则疮疡燔灼，金烁石流。地乃燥清，凄沧数至，脇痛善太息，肃杀行，草木变。太阴司天，湿气下临，肾气上从，黑起水变，埃冒云雨，胸中不利，阴痿气大衰而不起不用。当其时反腰脽痛，动转不便也。厥逆，地乃藏阴，大寒且至，蛰虫早附，心下否痛，地裂冰坚，少腹痛时害于食，乘金则止水增，味乃咸，行水减也。
帝曰：岁有胎孕不育，治之不全，何气使然。歧伯曰：六气五类，有相胜制也，同者盛之，异者衰之，此天地之道，生化之常也。故厥阴司天，毛虫静，羽虫育，介虫不成，在泉，毛虫育，倮虫耗，羽虫不育。少阴司天，羽虫静，介虫育，毛虫不成，在泉，羽虫育，介虫耗不育。太阴司天，倮虫静，鳞虫育，羽虫不成，在泉，倮虫育，鳞虫不成。少阳司天，羽虫静，毛虫育，倮虫不成，在泉，羽虫育，介虫耗，毛虫不育。阳明司天，介虫静，羽虫育，介虫不成，在泉，介虫育，毛虫耗，羽虫不成。太阳司天，鳞虫静，倮虫育，在泉，鳞虫耗，倮虫不育。诸乘所不成之运，则甚也。故气主有所制，岁立有所生，地气制己胜，天气制胜己，天制色，地制形，五类衰盛，各随其气之所宜也。故有胎孕不育治之不全，此气之常也，所谓中根也。根于外者亦五，故生化之别，有五气五味五色五类五宜也。帝曰：何谓也。歧伯曰：根于中者，命曰神机，神去则机息根于外者，命曰气立，气止则化绝。故各有制，各有胜，各有生，各有成。故曰：不知年之所加，气之同异，不足以言生化，此之谓也。
帝曰：气始而生化，气散而有形，气布而蕃育，气终而象变，其致一也。然而五味所资，生化有薄厚，成熟有少多，终始不同，其故何也。歧伯曰：地气制之也，非天不生，地不长也。帝曰：愿闻其道。歧伯曰：寒热燥湿，不同其化也。故少阳在泉，寒毒不生，其味辛，其治苦酸，其谷苍丹。阳明在泉，湿毒不生，其味酸，其气湿，其治辛苦甘，其谷丹素。太阳在泉，热毒不生，其味苦，其治淡咸，其谷黅秬。厥阴在泉，清毒不生，其味甘，其治酸苦，其谷苍赤，其气专，其味正。少阴在泉，寒毒不生，其味辛，其治辛苦甘，其谷白丹。太阴在泉，燥毒不生，其味咸，其其气热，其治甘咸，其榖黅秬。化淳则咸守，气专则辛化而俱治。
故曰：补上下者从之，治上下者逆之，以所在寒热盛衰而调之。故曰：上取下取，内取外取，以求其过。能毒者以厚药，不胜毒者以薄药，此之谓也。气反者，病在上，取之下，病在下，取之上，病在中，傍取之。治热以寒，温而行之，治寒以热，凉而行之，治温以清，冷而行之，治清以温，热而行之。故消之削之，吐之下之，补之写之，久新同法。帝曰：病在中，而不实不坚，且聚且散，柰何。歧伯曰：悉乎哉问也。无积者求其藏，虚则补之，药以袪之，食以随之，行水渍之，和其中外，可使毕已。帝曰：有毒无毒，服有约乎。歧伯曰：病有久新，方有大小，有毒无毒，固宜常制矣。大毒治病，十去其六，常毒治病，十去其七，小毒治病，十去其八，无毒治病，十去其九。谷肉果菜，食养尽之，无使过之，伤其正也。不尽，行复如法，必先岁气，无伐天和，无盛盛，无虚虚，而遗人天殃，无致邪，无失正，绝人长命。帝曰：其久病者，有气从不康，病去而瘠，柰何。歧伯曰：昭乎哉圣人之问也。化不可代，时不可违。夫经络以通，血气以从，复其不足，与众齐同，养之和之，静以待时，谨守其气，无使倾移，其形乃彰，生气以长，命曰圣王。故大要曰：无代化，无违时，必养必和，待其来复，此之谓也。帝曰：善。
Huangdi asked: The great void is vast and empty; the five movements circulate and press upon one another, waning and waxing unequally, diminishing and increasing in mutual succession. I wish to hear how the balanced qi is named, and how it is classified. Qibo replied: How illuminating is this question! Wood, in balance, is called Spreading Harmony; fire is called Ascending Brightness; earth is called Comprehensive Transformation; metal is called Discerning Balance; water is called Tranquil Compliance. Huangdi said: What of when they are insufficient? Qibo said: Wood, when insufficient, is called Diminished Harmony; fire is called Suppressed Brightness; earth is called Debased Oversight; metal is called Compliant Change; water is called Dried-up Flow. Huangdi said: What is meant by excess? Qibo said: Wood, when excessive, is called Bursting Forth Life; fire is called Blazing Brilliance; earth is called Abundant Elevation; metal is called Firm Completion; water is called Overflowing Abundance. Huangdi said: I wish to hear the signs of these three levels of qi in their categories. Qibo said: How thorough is this question! In the category of Spreading Harmony, the virtue of wood circulates everywhere; yang unfolds and yin spreads, and the five transformations are proclaimed in balance. Its qi is upright; its nature is compliant; its function is bending and straightening; its transformation is engendering flourishing growth; its class is grasses and trees; its governance is outward release; its climatic sign is mild warmth; its seasonal command is wind; its viscus is the liver — the liver fears clear coolness; its ruling orifice is the eye; its grain is hemp; its fruit is the plum; its seed-body is the pit; its correspondence is spring; its creatures are the furred kind; its domestic animal is the dog; its color is blue-green; its nourishment is the sinews; its disease is urgent tension and distension of the flanks; its flavor is sour; its note is jue; its substance is hard at the core; its number is eight. In the category of Ascending Brightness, true yang governs; its virtue is bestowed everywhere and universally, and the five transformations are evenly balanced. Its qi is lofty; its nature is swift; its function is scorching and blazing; its transformation is luxuriant flourishing; its class is fire; its governance is bright radiance; its climatic sign is blazing heat; its seasonal command is heat; its viscus is the heart — the heart fears cold; its ruling orifice is the tongue; its grain is wheat; its fruit is the apricot; its seed-body is net-veined; its correspondence is summer; its creatures are the feathered kind; its domestic animal is the horse; its color is red; its nourishment is the blood; its disease is twitching and spasm; its flavor is bitter; its note is zhi; its substance is the pulse-vessel; its number is seven. In the category of Comprehensive Transformation, its qi harmonizes with heaven's blessing; its virtue flows through the governance of all four others, and the five transformations are equally cultivated. Its qi is level; its nature is compliant; its function acts on the high and the low alike; its transformation is fullness and abundance; its class is earth; its governance is calm stillness; its climatic sign is moist, steaming heat; its seasonal command is dampness; its viscus is the spleen — the spleen fears wind; its ruling orifice is the mouth; its grain is millet; its fruit is the jujube; its seed-body is flesh; its correspondence is late summer; its creatures are the bare-skinned kind; its domestic animal is the ox; its color is yellow; its nourishment is the flesh; its disease is blockage and fullness; its flavor is sweet; its note is gong; its substance is the flesh; its number is five. In the category of Discerning Balance, it gathers in without contention and kills without transgression; the five transformations are proclaimed clearly. Its qi is pure; its nature is firm; its function is scattering and shedding; its transformation is hardening and constraining; its class is metal; its governance is forceful sternness; its climatic sign is clear sharpness; its seasonal command is dryness; its viscus is the lung — the lung fears heat; its ruling orifice is the nose; its grain is rice; its fruit is the peach; its seed-body is the husk; its correspondence is autumn; its creatures are the shelled kind; its domestic animal is the fowl; its color is white; its nourishment is the skin and body hair; its disease is coughing; its flavor is pungent; its note is shang; its substance is hard on the outside; its number is nine. In the category of Tranquil Compliance, it stores away without causing harm, and governs by favoring descent; the five transformations are all put in order. Its qi is clear; its nature is downward; its function is to irrigate abundantly; its transformation is congealing and hardening; its class is water; its governance is flowing and spreading; its climatic sign is congealing sternness; its seasonal command is cold; its viscus is the kidney — the kidney fears dampness; its ruling orifice is the two lower orifices; its grain is beans; its fruit is the chestnut; its seed-body is moist; its correspondence is winter; its creatures are the scaled kind; its domestic animal is the pig; its color is black; its nourishment is the bones and marrow; its disease is reversal; its flavor is salty; its note is yu; its substance is moist; its number is six. Therefore: engender life without killing it; foster growth without punishing it; transform without controlling it; gather in without harming it; store away without suppressing it — this is called the balanced qi.
In the category of Diminished Harmony, this is called 'the overcoming of engendering.' The qi of engendering fails to govern, so the transforming qi of earth rises up; the qi of growth settles into its own balance, while the command of harvesting arrives early. Cool rains fall in their season; wind and clouds arise together. Grasses and trees flourish late, their blue-green stalks wither and shed; yet things that bloom still bear fruit, the skin and flesh filling within. Its qi is constrained; its function is gathering inward; its pathological movement is cramping, twisting, and slackened contraction; its outbreak brings fright and alarm. Its viscus is the liver; its fruits are the jujube and plum; its seed-bodies are pits and husks; its grains are millet and rice; its flavors are sour and pungent; its colors are white and blue-green; its domestic animals are the dog and fowl; its creatures are the furred and shelled kinds; its characteristic weather is fog, dew, and bleak chill; its notes are jue and shang; its disease is trembling, unsteadiness, and anxious fear, following the transformation of metal. When the minor jue coincides with the intercalated shang, when the ascending jue matches the true jue, and when the ascending shang matches the true shang, its disease is limb paralysis, welling-abscess, swelling, and sores, with sweet-craving parasites — evil has injured the liver. When the ascending gong matches the true gong, and withering desolation sets in, then blazing heat surges and boils over; the calamity falls at the third number — this is what is called the 'revenge.' Its governing creatures are flying insects, wood-borers, maggots, and pheasants, and it manifests as thunder and lightning. In the category of Suppressed Brightness, this is called 'the overcoming of growth.' The qi of growth fails to spread; the storing qi of water instead prevails; the harvesting qi governs on its own; the transforming command achieves balance. Cold and clear chill arise repeatedly; the command of summer heat grows thin. Sustained by transformation, things are engendered yet fail to grow; they reach completion while still immature, and by the time transformation arrives they have already aged. Yang qi is bent and suppressed; hibernating creatures retreat into dormancy early. Its qi is stagnant; its function is sudden and violent; its pathological movement alternates between manifest and hidden, ever-changing; its outbreak brings pain. Its viscus is the heart; its fruits are the chestnut and peach; its seed-bodies are net-veined and moist; its grains are beans and rice; its flavors are bitter and salty; its colors are black and vermilion; its domestic animals are the horse and pig; its creatures are the feathered and scaled kinds; its characteristic weather is ice, snow, frost, and cold; its notes are zhi and yu; its disease is confusion, delusion, sorrow, and forgetfulness, following the transformation of water. When the minor zhi matches the minor yu, and the ascending shang matches the true shang, evil has injured the heart. When congealing bleakness and biting cold prevail, torrential rains and prolonged downpours follow; the calamity falls at the ninth number; its governing signs are sudden cloudbursts, startling thunder and lightning, and deep overcast with excessive rain. In the category of Debased Oversight, this is called 'diminished transformation.' The transforming qi fails to issue its command; the governance of engendering alone flourishes; the qi of growth is orderly, the rains fall irregularly, and the harvesting qi is balanced. Wind and cold arise together; grasses and trees flourish beautifully, blooming but not bearing fruit, and what they complete is mere chaff. Its qi is dispersed; its function is quiet stillness; its pathological movement is ulceration, welling swelling, splitting, and abscess-collapse; its outbreak is dampness and stagnation. Its viscus is the spleen; its fruits are the plum and chestnut; its seed-bodies are moist and pitted; its grains are beans and hemp; its flavors are sour and sweet; its colors are blue-green and yellow; its domestic animals are the ox and dog; its creatures are the bare-skinned and furred kinds; its characteristic weather is whirling gusts and violent gales; its notes are gong and jue; its disease is retention, fullness, and blockage, following the transformation of wood. When the minor gong matches the minor jue, when the ascending gong matches the true gong, and the ascending jue matches the true jue, its disease is undigested-food diarrhea — evil has injured the spleen. When shaking gales and whirling winds prevail, the blue-green foliage withers and scatters; its calamity falls at the four cardinal corners; its governing sign is destruction by tigers and wolves; clear metal qi then takes effect, and the governance of engendering is humbled. In the category of Compliant Change, this is called 'broken harvest.' The harvesting qi falls behind; the engendering qi rises up; the qi of growth and transformation combine their virtues; the governance of fire is proclaimed, and the multitude of creatures thereby flourish. Its qi is expansive; its function is agitated and urgent; its pathological movement is clanging spasm, blockage, and fainting reversal; its outbreak is coughing and panting. Its viscus is the lung; its fruits are the plum and apricot; its seed-bodies are husk and net-fiber; its grains are hemp and wheat; its flavors are bitter and pungent; its colors are white and vermilion; its domestic animals are the fowl and sheep; its creatures are the shelled and feathered kinds; its characteristic weather is bright radiance and searing heat; its notes are shang and zhi; its disease is sneezing, coughing, and nasal congestion with bleeding, following the transformation of fire. When the minor shang matches the minor zhi, when the ascending shang matches the true shang, and the ascending jue matches the true jue, evil has injured the lung. When blazing brilliance grows fierce and intense, ice, snow, frost, and hail follow; the calamity falls at the seventh number; its governing creatures are the scaled and hibernating kinds, pigs and rats. The seasonal qi arrives early, and great cold is thereby engendered. In the category of Dried-up Flow, this is called 'the reversal of yang.' The storing command fails to be raised; the transforming qi of earth flourishes; the growth qi is proclaimed and spread; hibernating creatures fail to retreat into dormancy. The soil is moist yet the springs diminish; grasses and trees grow luxuriant in their branches, blooming in full abundance. Its qi is stagnant; its function is seeping and draining; its pathological movement is hardening and blockage; its outbreak is dryness and desiccation. Its viscus is the kidney; its fruits are the jujube and apricot; its seed-bodies are moist flesh; its grains are broomcorn and millet; its flavors are sweet and salty; its colors are yellow and black; its domestic animals are the pig and ox; its creatures are the scaled and bare-skinned kinds; its characteristic weather is murky dust and gloom-shrouded haze; its notes are yu and gong; its disease is wilting, reversal, and hardened stool, following the transformation of earth. When the minor yu matches the minor gong, and the ascending gong matches the true gong, its disease is urinary blockage — evil has injured the kidney. When dust-laden gloom brings sudden downpours, shaking, uprooting gales follow; the calamity falls at the first number; its governing creatures are conspicuous furred ones, foxes and raccoon-dogs. Change occurs without proper storage; thus the counter-qi rides upon the vulnerable moment and moves, arriving unsummoned, violent and tyrannical, devoid of virtue, and disaster in turn befalls it. When the deficiency is slight, the revenge is slight; when severe, the revenge is severe — this is the constancy of qi.
In the category of Bursting Forth Life, this is called 'opening and unfurling.' The soil is loosened and drained; the blue-green qi of wood reaches through; harmonious yang spreads its transforming influence, and yin qi follows along. The qi of engendering is pure and transforming, and the myriad things thereby flourish. Its transformation is engendering; its qi is lush; its governance is dispersal; its command is unfolding and stretching; its pathological movement is dizziness, vertigo, and disorders of the vertex; its virtue manifests as rustling wind and the opening and splitting of buds; its calamitous change is shaking, uprooting, destructive gales. Its grains are hemp and rice; its domestic animals are the fowl and dog; its fruits are the plum and peach; its colors are blue-green, yellow, and white; its flavors are sour, sweet, and pungent; its season-symbol is spring; its channels are the foot jueyin and shaoyang; its viscera are the liver and spleen; its creatures are the furred and shelled kinds; its substances are hard at the core and hard on the outside; its disease is anger. When the greater jue matches the ascending shang, and when the ascending zhi prevails so that its qi turns rebellious, its disease is vomiting and diarrhea. If wood fails to attend to its virtue, then the harvesting qi of metal takes revenge: the autumn qi grows forceful and keen, and in severe cases turns to killing severity; clear metal qi arrives in full force, grasses and trees wither and fall, and evil then injures the liver. In the category of Blazing Brilliance, this is called 'luxuriant flourishing.' Yin qi transforms within, yang qi flourishes without; blazing summer heat carries out its transformation, and things thereby prosper. Its transformation is growth; its qi is lofty; its governance is movement; its command is resounding and manifest; its pathological movement is scorching heat and reckless disturbance; its virtue manifests as warmth, heat, and steaming humidity; its calamitous change is fierce blazing and seething boil-over. Its grains are wheat and beans; its domestic animals are the sheep and pig; its fruits are the apricot and chestnut; its colors are red, white, and black; its flavors are bitter, pungent, and salty; its season-symbol is summer; its channels are the hand shaoyin and taiyang, and the hand jueyin and shaoyang; its viscera are the heart and lung; its creatures are the feathered and scaled kinds; its substances are the pulse-vessel and moist flesh; its disease is manic laughter, malarial disorders, sores and ulcers, blood flowing freely, wild delirium, and reddened eyes. When the ascending yu matches the true zhi, its harvest phase proceeds evenly, yet its disease is tetanic rigidity, for when the ascending zhi prevails the harvesting qi of metal lags behind. When its governance grows violently intense, the storing qi of water takes revenge, and congealing bleakness appears out of season; in severe cases rain, frost, and hail bring biting cold, and evil injures the heart. In the category of Abundant Elevation, this is called 'broad transformation.' Its generous virtue is pure and still; it follows growth so as to become full; the utmost yin is replete within, and things are transformed to fullness and completion. Smoke-like haze and dust hang thick and murky, appearing over the deep soil; heavy rains fall in season; damp qi thereby takes effect, and the governance of dryness is held in check. Its transformation is fullness; its qi is abundant; its governance is stillness; its command is all-encompassing; its pathological movement is dampness accumulating and pooling; its virtue manifests as softness, moistness, and heavy sodden wetness; its calamitous change is shock, sudden gales, and collapse. Its grains are millet and hemp; its domestic animals are the ox and dog; its fruits are the jujube and plum; its colors are yellow, black, and blue-green; its flavors are sweet, salty, and sour; its season-symbol is late summer; its channels are the foot taiyin and yangming; its viscera are the spleen and kidney; its creatures are the bare-skinned and furred kinds; its substances are the flesh and the pit; its disease is abdominal fullness and inability to raise the four limbs. When great winds arrive suddenly, evil injures the spleen. In the category of Firm Completion, this is called 'gathering and contracting.' Heaven's qi is pure; earth's qi is bright; yang qi follows along; yin governs the transformation; dryness carries out its governance, and things are thereby brought to completion. The harvesting qi spreads abundantly, yet the transformation of growth does not reach its end. Its transformation is completion; its qi is pared and sharp; its governance is stern; its command is keen and cutting; its pathological movement is sudden fractures, sores, and chronic ailments; its virtue manifests as fog, dew, and rustling wind; its calamitous change is killing severity and withering desolation. Its grains are rice and broomcorn millet; its domestic animals are the fowl and horse; its fruits are the peach and apricot; its colors are white, blue-green, and vermilion; its flavors are pungent, sour, and bitter; its season-symbol is autumn; its channels are the hand taiyin and yangming; its viscera are the lung and liver; its creatures are the shelled and feathered kinds; its substances are shell and net-fiber; its disease is panting, wheezing, chest oppression, and having to sit upright to breathe. When the ascending zhi matches the true shang, its engendering phase proceeds evenly, yet its disease is coughing. When its governance changes violently, even the great trees fail to flourish and the tender, brittle growth scorches at the tip; the growth qi of fire then comes to the rescue — a great fire spreads, searing heat arrives, and the vines will wither; evil injures the lung. In the category of Overflowing Abundance, this is called 'sealing and storing.' Cold governs the transformation of things; heaven and earth are stern and frozen; the governance of storage spreads abroad, and the command of growth fails to be raised. Its transformation is bitter cold; its qi is hard; its governance is quiet stillness; its command is flowing and pouring; its pathological movement is drifting discharge, drenching, and welling up; its virtue manifests as congealing bleakness and cold mist; its calamitous change is ice, snow, frost, and hail. Its grains are beans and millet; its domestic animals are the pig and ox; its fruits are the chestnut and jujube; its colors are black, vermilion, and yellow; its flavors are salty, bitter, and sweet; its season-symbol is winter; its channels are the foot shaoyin and taiyang; its viscera are the kidney and heart; its creatures are the scaled and bare-skinned kinds; its substances are moist and full; its disease is distension. When the ascending yu prevails, the growth qi of fire fails to transform. When its governance goes to excess, the transforming qi of earth rises up greatly and dust-laden haze fills the exchange of qi; heavy rains fall in season, and evil injures the kidney. Hence it is said: when a phase fails to maintain its constant virtue, the one it overcomes comes to take revenge; when its governance constantly upholds its proper order, the one it overcomes is transformed in accordance with it. This is what is meant.
Huangdi said: Heaven is insufficient in the northwest, where the left is cold and the right is cool; earth is not full in the southeast, where the right is hot and the left is warm. What is the reason for this? Qibo said: This is a matter of yin and yang qi, of the principle of high and low, and of the difference between the great and the lesser. The southeast is yang, and yang's essence descends downward, so the right is hot and the left is warm there. The northwest is yin, and yin's essence is offered upward, so the left is cold and the right is cool there. Thus the land has its heights and depths, and the qi has its warmth and coolness: where the land is high, the qi is cold; where the land is low, the qi is hot. Therefore those who dwell amid cold and coolness develop distension, and those who dwell amid warmth and heat develop sores; purging relieves the distension, and inducing sweat relieves the sores. This is the constant principle of the opening and closing of the striae and pores, and merely reflects the difference between the great and the lesser degrees of yin and yang. Huangdi said: How does this bear upon longevity and early death? Qibo said: Where yin essence is offered upward, people live long; where yang essence descends, people die young. Huangdi said: Good. When people there fall ill, how should they be treated? Qibo said: For the qi of the northwest, disperse it and cool it; for the qi of the southeast, gather it in and warm it. This is what is meant by 'the same disease treated differently.' Hence it is said: where the qi is cold or cool, treat with cold and cooling methods, applying water to soak the body; where the qi is warm or hot, treat with warming and heating methods, strengthening what is guarded within. One must match the treatment to the local qi, and balance can thereby be achieved. In false, counterfeit presentations, do the reverse.
Huangdi said: Good. Within a single region, the qi's engendering and transformation, and people's longevity and early death, differ — what is the reason? Qibo said: This follows the principle of high and low; it is caused by the lay of the land. Where the land is lofty, yin qi governs it; where the land is low-lying, yang qi governs it. Where yang prevails, things mature before their allotted time; where yin prevails, things mature after their time. This is the constant principle of terrestrial pattern, and the way of engendering and transformation. Huangdi said: Does this also govern longevity and early death? Qibo said: Where the land is high, its qi favors long life; where the land is low, its qi favors early death — and this varies with the size of the land, small differences in elevation producing small differences, great differences producing great differences. Therefore one who treats disease must clearly understand the way of heaven and the pattern of earth, the alternating prevalence of yin and yang, the precedence and sequence of qi, the longevity and early death of people, and the timing of engendering and transformation — only then can one truly know a person's bodily form and qi.
Huangdi said: Good. In certain years, people do not fall ill, yet the qi of a viscus fails to respond or to function as expected — why is this? Qibo said: Heaven's qi controls it; the viscus qi has something it follows. Huangdi said: I wish to hear this in full. Qibo said: When shaoyang governs heaven, fire qi descends and presides below, and lung qi rises to follow it; whiteness arises and metal takes effect, while grasses and trees suffer calamity. Fire appears and scorches, subduing and consuming metal; great heat then prevails, causing coughing, sneezing, nasal congestion with bleeding, and stuffed nose; there are sores, alternating cold and heat, and swelling of the flesh. Wind moves over the earth, dust and sand fly up; there is heart pain and stomach-duct pain, reversal-counterflow, and blockage of the diaphragm. Its onset is sudden and rapid. When yangming governs heaven, dryness qi descends and presides below, and liver qi rises to follow it; blue-green arises and the function of wood is established, while earth suffers calamity. Bleak chill arrives repeatedly, wood is felled and grasses wither; there is rib-side pain, reddened eyes, trembling and shivering with chattering teeth, and sinew wilting that prevents long standing. Sudden heat arrives, earth then grows hot; yang qi is pent up and bursts forth as pain; urination changes; there is alternating cold and heat resembling malarial disorder, and in severe cases heart pain. Fire spreads over dried grass, flowing water does not freeze, and hibernating creatures appear out of season. When taiyang governs heaven, cold qi descends and presides below, and heart qi rises to follow it, so that fire also grows bright; vermilion arises, and metal thereby suffers calamity. Cold and clear chill arise from time to time, and when they prevail, water freezes. Fire qi is lofty and bright: there is heat in the heart, vexation, dryness of the throat, frequent thirst, sneezing and nasal congestion, tendency to sorrow, and frequent yawning. When heat qi moves recklessly, cold then takes revenge: frost falls out of season, there is forgetfulness, and in severe cases heart pain. The soil becomes moist, water grows abundant, cold invades, and deep yin transforms into dampness; the qi changes and things become water and fluid retained internally — there is fullness in the middle and inability to eat, numbness of the skin and heaviness of the flesh, and impaired function of the sinews and vessels; in severe cases there is swelling of the instep and abscess on the back of the body. When jueyin governs heaven, wind qi descends and presides below, and spleen qi rises to follow it, so that earth also grows abundant; yellow arises, and water thereby suffers calamity. The function of earth is altered: there is heaviness of the body, wilting of the muscles and flesh, reduced appetite, and blandness in the mouth. Wind sweeps through the great void, clouds and objects sway and shake, the eyes spin and the ears ring. Fire indulges its violence, the earth then grows hot, great heat consumes and sears, red discharge flows downward, hibernating creatures appear repeatedly, flowing water does not freeze — its onset is swift and sudden. When shaoyin governs heaven, heat qi descends and presides below, and lung qi rises to follow it; whiteness arises and metal takes effect, while grasses and trees suffer calamity. There is panting, vomiting, alternating cold and heat, sneezing, nasal congestion with bleeding, and stuffed nose; great heat prevails widely, and in severe cases there are burning sores and ulcers, heat so fierce as to melt metal and liquefy stone. The earth then grows dry and clear, bleak chill arrives repeatedly; there is rib-side pain and frequent sighing, killing severity prevails, and grasses and trees are transformed. When taiyin governs heaven, damp qi descends and presides below, and kidney qi rises to follow it; blackness arises and water is transformed; dust-laden haze, clouds, and rain appear; there is discomfort in the chest, impotence, and the qi is greatly weakened so that it cannot rise and cannot function. At such times there is, on the contrary, pain in the lower back and buttocks, and difficulty in movement and turning. There is cold-limb reversal; the earth then stores yin, great cold is about to arrive, and hibernating creatures retreat early. There is oppressive pain below the heart; the earth cracks and ice hardens; there is pain in the lower abdomen that at times interferes with eating. When water overrides metal, the stored water increases, the flavor that dominates is then salty, and the flow of water diminishes.
Huangdi said: In certain years, pregnancies fail to come to term, and treatment does not reach completion — what qi causes this? Qibo said: Among the six qi and the five categories of creatures, there is mutual overcoming and control: those that share the same phase as the governing qi flourish, while those that differ decline. This is the way of heaven and earth, the constancy of engendering and transformation. Thus, when jueyin governs heaven, the furred creatures are quiescent, the feathered creatures thrive, and the shelled creatures fail to reach completion; when jueyin governs the earth below, the furred creatures thrive, the bare-skinned creatures are depleted, and the feathered creatures fail to reproduce. When shaoyin governs heaven, the feathered creatures are quiescent, the shelled creatures thrive, and the furred creatures fail to reach completion; when shaoyin governs the earth below, the feathered creatures thrive, and the shelled creatures are depleted and fail to reproduce. When taiyin governs heaven, the bare-skinned creatures are quiescent, the scaled creatures thrive, and the feathered creatures fail to reach completion; when taiyin governs the earth below, the bare-skinned creatures thrive, and the scaled creatures fail to reach completion. When shaoyang governs heaven, the feathered creatures are quiescent, the furred creatures thrive, and the bare-skinned creatures fail to reach completion; when shaoyang governs the earth below, the feathered creatures thrive, the shelled creatures are depleted, and the furred creatures fail to reproduce. When yangming governs heaven, the shelled creatures are quiescent, the feathered creatures thrive, and the shelled creatures fail to reach completion; when yangming governs the earth below, the shelled creatures thrive, the furred creatures are depleted, and the feathered creatures fail to reach completion. When taiyang governs heaven, the scaled creatures are quiescent and the bare-skinned creatures thrive; when taiyang governs the earth below, the scaled creatures are depleted and the bare-skinned creatures fail to reproduce. In every case, when a creature-category is overridden during the movement in which it fails to reach completion, its failure is severe. Thus the governing qi has that which it controls, and the established year has that which it generates; earth's qi controls what it overcomes, and heaven's qi controls what overcomes it. Heaven governs color, earth governs form; the decline and flourishing of the five categories each follow what is suitable to their qi. Hence there are years when pregnancies fail to come to term and treatment does not reach completion — this is the constancy of qi, what is called 'rooted within.' What is rooted without is likewise fivefold; thus the distinctions of engendering and transformation comprise five qi, five flavors, five colors, five categories, and five suitabilities. Huangdi said: What does this mean? Qibo said: What is rooted within is called the pivot of spirit — when spirit departs, the pivot ceases. What is rooted without is called the establishment of qi — when qi stops, transformation is severed. Thus each has its controls, each has its overcoming, each has its engendering, and each has its completion. Hence it is said: one who does not understand what influence the year adds, and the sameness or difference of qi, is not fit to speak of engendering and transformation. This is what is meant.
Huangdi said: When qi begins, engendering and transformation occur; when qi disperses, form comes into being; when qi spreads, multiplication and nurture occur; when qi ends, the outward image changes — in this, all things arrive at the same principle. And yet, in what the five flavors provide, engendering and transformation may be thin or thick, and maturation may be scant or abundant, so that the end and beginning differ — what is the reason for this? Qibo said: It is controlled by earth's qi. It is not that heaven fails to engender — it is that earth fails to foster growth uniformly. Huangdi said: I wish to hear this principle. Qibo said: Cold, heat, dryness, and dampness produce different transformations. Thus, when shaoyang governs the earth below, cold-toxin fails to arise; its flavor is pungent; it is treated with bitter and sour; its grains are blue-green and vermilion. When yangming governs the earth below, damp-toxin fails to arise; its flavor is sour; its qi is damp; it is treated with pungent, bitter, and sweet; its grains are vermilion and white. When taiyang governs the earth below, heat-toxin fails to arise; its flavor is bitter; it is treated with bland and salty; its grains are yellow and black. When jueyin governs the earth below, clear-cold-toxin fails to arise; its flavor is sweet; it is treated with sour and bitter; its grains are blue-green and red; its qi is concentrated and its flavor is pure. When shaoyin governs the earth below, cold-toxin fails to arise; its flavor is pungent; it is treated with pungent, bitter, and sweet; its grains are white and vermilion. When taiyin governs the earth below, dryness-toxin fails to arise; its flavor is salty; its qi is hot; it is treated with sweet and salty; its grains are yellow and black. When transformation is pure, the salty flavor holds firm; when qi is concentrated, the pungent flavor transforms and both are brought into balance.
Hence it is said: in supplementing the upper or lower body, follow along with the qi; in treating the upper or lower, go against the qi — regulate according to the location and the prevalence or decline of cold and heat. Hence it is said: take the treatment from above or from below, from within or from without, in order to seek out the fault. Those who can tolerate toxicity are treated with potent medicines; those who cannot withstand toxicity are treated with mild medicines. This is what is meant. When the qi is contrary to the location of disease: if the disease is above, treat from below; if the disease is below, treat from above; if the disease is in the middle, treat from the sides. Treat heat with cold, but administer it warm; treat cold with heat, but administer it cool; treat warmth with clearing coolness, but administer it cold; treat clear coolness with warmth, but administer it hot. Thus, whether dissolving or paring away, inducing vomiting or purging, supplementing or draining, the same method applies whether the disease is chronic or recent. Huangdi said: When disease is in the middle, yet is neither excess nor hard, now gathering and now dispersing, what then? Qibo said: How thorough is this question! Where there is no fixed accumulation, seek out the affected viscus; if it is deficient, supplement it — expel the pathogen with medicine, follow up with diet, and apply water-soaking therapy; harmonize the interior and exterior, and the disease can be brought to complete resolution. Huangdi said: For medicines with toxicity and without toxicity, is there a rule for their administration? Qibo said: Disease may be chronic or recent, prescriptions may be large or small, and medicines may be toxic or non-toxic — there is indeed a constant rule to be observed. When treating disease with highly toxic medicine, stop when six-tenths of the pathogen is removed; with ordinarily toxic medicine, stop at seven-tenths removed; with mildly toxic medicine, stop at eight-tenths removed; with non-toxic medicine, stop at nine-tenths removed. Thereafter, grains, meats, fruits, and vegetables should be used to nourish and complete the recovery — do not overdo it, lest one injure the correct qi. If the disease is not yet eliminated, resume treatment according to the same method. One must always take the year's qi into account first, and never assault the harmony of heaven; do not further fill what is already full, do not further deplete what is already deficient, thereby bringing calamity upon a person from heaven itself; do not induce evil qi, and do not lose the correct qi — these errors would cut short a person's long life. Huangdi said: In those with chronic illness, whose qi, though following treatment, does not regain health, and who remain emaciated even after the disease has left — what then? Qibo said: How illuminating is this question of the sage! Transformation cannot be replaced by artificial means, and the proper season cannot be defied. Once the channels and network vessels are opened and the blood and qi made compliant, restore what is insufficient until it is equal with the rest of the body; nourish it and harmonize it, remain still and await the proper time, carefully guard the qi and do not let it be displaced — then the bodily form will become manifest and the qi of life will grow and flourish. This is called the way of the sage-king. Hence the Great Essentials say: do not replace transformation, do not defy the season; one must nourish, one must harmonize, and await its natural return. This is what is meant. Huangdi said: Good.