素问·疏五过论 Discourse Elucidating the Five Errors
黄帝曰：呜呼远哉。闵闵乎若视深渊，若迎浮云，视深渊尚可测，迎浮云莫知其际。圣人之术，为万民式，论裁志意，必有法则，循经守数，按循医事，为万民副，故事有五过四德，汝知之乎。雷公避席再拜曰：臣年幼小，蒙愚以惑，不闻五过与四德，比类形名虚引其经，心无所对。
帝曰：凡未诊病者，必问尝贵后贱，虽不中邪，病从内生，名曰脱营。尝富后贫，名曰失精，五气留连，病有所并。医工诊之，不在藏府，不变躯形，诊之而疑，不知病名。身体日减，气虚无精，病深无气，洒洒然时惊，病深者，以其外耗于卫，内夺于荣。良工所失，不知病情，此亦治之一过也。凡欲诊病者，必问饮食居处，暴乐暴苦，始乐后苦，皆伤精气，精气竭绝，形体毁沮。暴怒伤阴，暴喜伤阳，厥气上行，满脉去形。愚医治之，不知补写，不知病情，精华日脱，邪气乃并，此治之二过也。善为脉者，必以比类奇恒从容知之，为工而不知道，此诊之不足贵，此治之三过也。诊有三常，必问贵贱，封君败伤，及欲侯王。故贵脱势，虽不中邪，精致神内伤，身必败亡。始富后贫，虽不伤邪，皮焦筋屈，痿躄为挛。医不能严，不能动神，外为柔弱，乱至失常，病不能移，则医事不行，此治之四过也。凡风诊者，必知终始，有知馀绪，切脉问名，当合男女。离绝菀结，忧恐喜怒，五藏空虚，血气离守，工不能知，何术之语。尝富大伤，斩筋绝脉，身体复行，令泽不息。故伤败结留，薄归阳，脓积寒炅。粗工治之，亟刺阴阳，身体解散，四支转筋，死日有期，医不能明，不问所发，唯言死日，亦为粗工，此治之五过也。
凡此五者，皆受术不通，人事不明也。故曰：圣人之治病也，必知天地阴阳四时经纪五藏六府雌雄表里刺灸砭石毒药所主，从容人事，以明经道，贵贱贫富，各异品理，问年少长，勇怯之理，审于分部，知病本始，八正九候，诊必副矣。治病之道，气内为宝，循求其理，求之不得，过在表里。守数据治，无失俞理，能行此术，终身不殆。不知俞理，五藏菀熟，痈发六府。诊病不审，是谓失常，谨守此治，与经相明，上经下经，揆度阴阳，奇恒五中，决以明堂，审于终始，可以横行。
Huangdi said: Ah, how far-reaching this is! How vast and obscure, as if gazing into a deep abyss, as if facing drifting clouds. Gazing into a deep abyss one can still fathom its depth, but facing drifting clouds one cannot know their limit. The art of the sage serves as a model for the myriad people; in judging and shaping his intent he must have laws and standards, following the classics and holding to their methods, conducting the affairs of medicine in accordance with them, so as to serve as a support for the myriad people. Now, in practice there are five errors and four virtues — do you know them? Lei Gong rose from his mat, bowed twice, and said: I am young in years, ignorant and confused; I have not heard of the five errors and the four virtues. In comparing categories and forms and names I have only vainly cited the classics without substance, and my mind has nothing with which to answer.
The Emperor said: Whenever one is about to diagnose a patient, one must always ask whether he was once noble and afterward became lowly. Even if he was not struck by an external pathogen, disease arises internally in such a case, and this is called 'desertion of the camp qi.' If he was once wealthy and afterward became poor, this is called 'loss of essence'; the five qi linger and stagnate, and disease develops from their accumulation. When the physician examines such a patient, the disease is not located in the viscera or bowels, nor does it alter the bodily form; on diagnosis he is puzzled and cannot name the disease. The body wastes day by day, the qi becomes deficient and essence is lacking; when the disease is deep there is no qi, and the patient is repeatedly startled as if chilled. When the disease is deep, it is because the defensive qi is exhausted externally and the nutritive qi is seized internally. This is what even a good physician may miss, failing to know the true nature of the disease — this is the first error in treatment. Whenever one wishes to diagnose a disease, one must always ask about diet and dwelling, about sudden joy and sudden suffering, about beginning in joy and ending in suffering — all of these injure the essential qi; when essential qi is exhausted and cut off, the bodily form is destroyed and ruined. Sudden rage injures yin, sudden joy injures yang; counterflow qi rises upward, filling the vessels and departing from the body. An ignorant physician treating such a case, not knowing whether to supplement or drain, and not knowing the true nature of the disease, allows the essential flower of qi to be lost day by day, so that pathogenic qi then gathers in — this is the second error in treatment. One who is skilled in pulse-taking must know it by comparing categories, the unusual and the constant, through unhurried deliberation. If one acts as a physician without knowing this Way, his diagnoses are not worth honoring — this is the third error in treatment. In diagnosis there are three constants: one must always ask about noble or lowly status, whether an enfeoffed lord has suffered ruin, and whether one aspires to be a marquis or a king. Thus, when the noble loses his position, even without being struck by an external pathogen, his essence is disturbed and his spirit is injured within, so that his body must decline and perish. When one begins wealthy and later becomes poor, even without injury from external pathogens, the skin becomes scorched and dry and the sinews contract, leading to wasting, lameness, and spasm. If the physician cannot be strict and cannot move the patient's spirit, but instead behaves outwardly with weak compliance, disorder arises and constancy is lost; the disease cannot be shifted, and so the physician's work does not succeed — this is the fourth error in treatment. Whenever diagnosing wind-conditions, one must know their beginning and end, and understand as well their subsidiary threads; feeling the pulse and asking the name of the disease, one must also consider whether the patient is male or female. Separation and severance, stagnation and knotting, worry and fear, joy and rage — these cause the five viscera to become empty and hollow, and blood and qi to lose their proper station. If the physician cannot know this, of what use is any technique he speaks of? Someone who was once wealthy and suffered great loss, with sinews severed and vessels cut off, whose body once again moves about while its depletion does not cease — thus injury and ruin accumulate and linger, pressing inward to return to yang, forming pus accumulations with cold and heat. A crude physician treating this hastily needles yin and yang; the body becomes dissolved and scattered, the four limbs cramp and twist, and the day of death has its appointed time. If the physician cannot make this clear, and without asking what brought on the disease merely pronounces the day of death, he too is but a crude physician — this is the fifth error in treatment.
In all these five, the physician has received the art without mastering it, and is not clear about human affairs. Hence it is said: when the sage treats disease, he must know Heaven and Earth, yin and yang, the order of the four seasons, the five viscera and six bowels, male and female, exterior and interior, and what governs needling, moxibustion, stone-lancing, and potent drugs. He deliberates unhurriedly on human affairs so as to clarify the Way of the channels. Noble and lowly, poor and rich, each have their own distinct nature and principle. He asks about age, whether young or old, and the principle of courage or timidity; he examines carefully the division of the body's regions, and knows the root and origin of the disease. With the eight rectitudes and nine indicators, his diagnosis will surely be confirmed. In the Way of treating disease, the qi within is treasured above all; one follows and seeks out its principle. If one seeks it and does not find it, the error lies in exterior and interior. Holding to the methods and treating accordingly, without losing the principle of the transport points, one who can practice this art will go through life without peril. If one does not know the principle of the transport points, the five viscera accumulate and turn to heat, and abscesses erupt in the six bowels. If diagnosis is not thorough, this is called losing the constant order. Carefully hold to this method of treatment, and let it be illuminated together with the classics — the Upper Canon and the Lower Canon, the weighing and measuring of yin and yang, the unusual and the constant of the five centers, judged by the Hall of Light, examined in its beginning and end — and one may then travel freely everywhere without hindrance.