素问：气交变大论篇第六十九

Overall Paraphrase

The Yellow Emperor asked: The five movements alternate in their course, corresponding above with the seasons of heaven. Yin and Yang cycle back and forth, cold and heat succeed one another. Right qi and pathogenic qi contend, separating internally and externally. The blood and qi of the six conduits are thrown into turmoil, and the qi of the five viscera shifts and tilts—some in excess, some in deficiency, some dominating alone, some combining with others. I wish to understand the origins of these changes and the constant laws that govern them. Could you please explain this?

Qibo bowed with his head to the ground, bowed again, and then replied: How penetrating is this question! This is a question that illuminates the Great Way. It is what the ancient emperors treasured, handed down generation after generation by the former masters. Although I am not particularly intelligent, I have been fortunate enough to have heard the essentials of it.

The Yellow Emperor said: I have heard that encountering the right person yet not transmitting it is called losing the Way; transmitting it to the wrong person is to recklessly divulge the precious gift of heaven. My virtue is indeed slight, insufficient to bear the supreme Way. However, I pity the common people of the world who cannot live out their natural lifespans. I hope you, Master, will preserve this Way in the inexhaustible and circulate it without end. I will take charge of this matter and act accordingly—what do you think? Qibo said: Allow me to explain in detail. The Upper Canon says: What is called the Way—above, one must understand astronomy; below, one must understand geography; in between, one must understand human affairs—only thus can it endure long. This is what is being spoken of. The Yellow Emperor asked: What does this mean? Qibo said: The key lies in the positions of qi—that which resides in heaven pertains to astronomy; that which resides on earth pertains to geography; that which threads through the transformations of human body qi pertains to human affairs. Therefore, excess (surpassing the normal level) arrives ahead of the heavenly season, and deficiency (falling below the normal level) arrives after the heavenly season. This is what is called the governing and transformation of heaven and earth, and the human body corresponds to it.

The Yellow Emperor asked: When the five movements undergo change, what happens when there is excess? Qibo said:

In years when Wood movement is in excess, wind qi prevails, and the Spleen Earth is attacked by pathogenic qi (Wood overcomes Earth). The people commonly suffer from sunsie (diarrhea with undigested food), loss of appetite, heaviness of body, oppression and depression, borborygmus, and abdominal distension and fullness. In heaven, this corresponds to the Year Star (Jupiter). In severe cases, there is mental confusion, irritability and anger, dizziness, and vertex headache. If the Transforming qi (Earth qi, the movement qi of the Spleen) cannot exercise its governance, and the Generating qi (Wood qi) alone holds sway, then clouds and fog fly about, grasses and trees cannot be at peace, and even toppling and shedding occurs. Conversely, there appears hypochondriac pain, severe vomiting. If the Chongyang pulse (the pulse position of the Foot-Yangming Stomach meridian) is severed, death ensues and cannot be treated. In heaven, this corresponds to the Tai Bai Star (Venus).

In years when Fire movement is in excess, heat and summer qi prevail, and the Lung Metal is attacked by pathogenic qi (Fire overcomes Metal). The people commonly suffer from malaria, shortness of breath, cough and wheezing, hemorrhage, blood diarrhea, severe watery discharge like a torrent, dry throat, deafness, chest heat and vexation, and heat in the shoulders and back. In heaven, this corresponds to the Ying Huo Star (Mars). In severe cases, there is chest pain, hypochondriac support and distension with pain, pain between the chest, back, and scapulae, pain in the medial aspect of both arms, body heat and bone pain, and heat toxin steeps and forms sores. If the Harvesting qi (Metal qi) cannot circulate, and the Growing qi (Fire qi) alone flourishes, then rain, frost, and cold appear abnormally. In heaven, this corresponds to the Chen Star (Mercury). If Upper-Overlap with Shaoyin Sovereign Fire or Shaoyang Minister Fire governs heaven, then the fire blazes fiercely, springs and waters dry up, the myriad things wither and scorch. The diseases instead manifest as delirious speech, mania, abnormal behavior, coughing and wheezing with sound, and incessant lower hemorrhage and discharge. If the Taiyuan pulse (the pulse position of the Hand-Taiyin Lung meridian) is severed, death ensues and cannot be treated. In heaven, this corresponds to the Ying Huo Star.

In years when Earth movement is in excess, rain and damp qi prevail, and the Kidney Water is attacked by pathogenic qi (Earth overcomes Water). The people commonly suffer from abdominal pain, coldness and reversal of the four limbs, emotional displeasure, heaviness of body, and oppression and depression. In heaven, this corresponds to the Zhen Star (Saturn). In severe cases, there is muscular atrophy, weakness of both feet unable to draw in and hold, easy cramping when walking, pain under the feet, water-rheum arising internally, abdominal distension and fullness, loss of appetite, and the four limbs unable to be lifted. If Earth qi gets its position and transforms, the Storing qi (Water qi) lies hidden, and the Transforming qi (Earth qi) rules alone, then springs gush forth, rivers overflow, dried marshlands give birth to fish, wind and rain rage greatly, earth collapses and water bursts forth, and fish appear on dry land. In disease, there is abdominal fullness, loose stool, borborygmus, and conversely, severe diarrhea. If the Taixi pulse (the pulse position of the Foot-Shaoyin Kidney meridian) is severed, death ensues and cannot be treated. In heaven, this corresponds to the Sui Star.

In years when Metal movement is in excess, dryness qi prevails, and the Liver Wood is attacked by pathogenic qi (Metal overcomes Wood). The people commonly suffer from pain in both hypochondria and the lower abdomen, red and painful eyes, ulceration at the canthi, and inability to hear sounds. If the killing and withering qi is excessive, then there is heaviness of the body, oppression and depression, chest pain pulling the back, and distension and pain in both hypochondria pulling the lower abdomen. In heaven, this corresponds to the Tai Bai Star. In severe cases, there is wheezing, coughing, counterflow of qi, pain in the shoulders and back, pain in the sacrococcygeal region, genitals, thighs, knees, calves, shin bones, and feet. In heaven, this corresponds to the Ying Huo Star. If the Harvesting qi (Metal qi) is harsh and severe, the Generating qi (Wood qi) is suppressed, grasses and trees converge and wither, become withered, dry, and falling. In disease, there is conversely sudden severe pain, hypochondriac pain so severe one cannot turn over, and severe coughing with qi counterflow and bleeding. If the Taichong pulse (the pulse position of the Foot-Jueyin Liver meridian) is severed, death ensues and cannot be treated. In heaven, this corresponds to the Tai Bai Star.

In years when Water movement is in excess, cold qi prevails, and pathogenic qi attacks the Heart Fire (Water overcomes Fire). The people commonly suffer from body heat, vexation, agitation with palpitations, yin reversal, cold in the upper, middle, and lower, delirious speech, mania, and heart pain. Cold arrives early. In heaven, this corresponds to the Chen Star. In severe cases, there is abdominal distension, edema of the lower legs, wheezing and coughing, sweating during sleep, and aversion to wind. Heavy rain arrives, and dust and mist are hazy and stagnant. In heaven, this corresponds to the Zhen Star. If Upper-Overlap with Taiyang Cold Water governs heaven, then rain, snow, hail, and frost descend untimely, and damp qi causes the myriad things to transform. In disease, there is conversely abdominal fullness, borborygmus, loose stool, undigested food in the stool, thirst, and clouded spirit with dizziness. If the Shenmen pulse (the pulse position of the Hand-Shaoyin Heart meridian) is severed, death ensues and cannot be treated. In heaven, this corresponds to the Ying Huo Star and the Chen Star.

The Yellow Emperor said: Very good. Then what about deficiency? Qibo said: How detailed is this question!

In years when Wood movement is deficient, dryness qi instead greatly prevails (Metal takes advantage of Wood), the Generating qi cannot arrive in due time, and grasses and trees flourish later than the season. If the killing and withering qi is excessive, then hard trees split and snap, and branches and leaves wither and dry. In heaven, this corresponds to the Tai Bai Star. The people commonly suffer from middle-jiao vacuity cold, pain in the flank and ribs, lower abdominal pain, borborygmus, and loose stool. Cool rain falls from time to time. In heaven, this corresponds to the Tai Bai Star, and the corresponding grain is green (dark green). If Upper-Overlap with Yangming Dryness Metal governs heaven, then the Generating qi loses its governance, and although grasses and trees flourish again, the Transforming qi is very urgent. In heaven, this corresponds to the Tai Bai Star and the Zhen Star, with the green grain ripening prematurely. When the Recovering qi arrives (the child avenging the mother, Fire coming to recover from Metal), heat and summer fire blaze, damp qi turns to dryness and heat, soft and brittle grasses and trees wither and scorch, and below they grow again, with flowering and fruiting occurring simultaneously. In disease, there is alternating cold and heat, sores, ulcers, prickly heat, rashes, swellings, and acne. In heaven, this corresponds to the Ying Huo Star and the Tai Bai Star, and its grain is white and firm. White dew descends early, the qi of killing and harvesting prevails, cold rain harms the myriad things, and insects gnaw on the sweet yellow grains. The Spleen Earth is attacked, the red qi (Fire qi) arrives later and transforms, and the Heart qi governs later than the season, overcoming the Lung Metal above. The white qi (Metal qi) is bent and subdued, and its grain cannot ripen. In disease, there is coughing and nasal congestion with discharge. In heaven, this corresponds to the Ying Huo Star and the Tai Bai Star.

In years when Fire movement is deficient, cold qi greatly prevails (Water takes advantage of Fire), the Growing qi cannot exercise its governance, and although the myriad things flourish, they tend toward decline. If the yin congealing and grimly cold qi is excessive, then yang qi cannot transform and give life, and the flourishing scenery is broken. In heaven, this corresponds to the Chen Star. The people commonly suffer from chest pain, hypochondriac support and distension, pain in both hypochondria, pain between the chest, back, and scapulae and the medial aspect of both arms, oppression, faintness, blurred vision, heart pain, sudden loss of voice, chest and abdominal distension, and pain pulling between the hypochondria and the lower back. In severe cases, the body curls up and cannot extend, and the hip bone and thigh bone seem separated. In heaven, this corresponds to the Ying Huo Star and the Chen Star, and its grain is red (cinnabar color). When the Recovering qi arrives (Earth coming to recover from Water), dust is stagnant and steaming, and heavy rain is about to arrive. The black qi (Water qi) is thwarted. In disease, there is loose stool, abdominal fullness, inability to eat and drink, cold arising from within, borborygmus, pouring diarrhea, abdominal pain, sudden cramping, wilting-flaccidity, impediment, and both feet unable to support the body. In heaven, this corresponds to the Zhen Star and the Chen Star, and the black grain cannot ripen.

In years when Earth movement is deficient, wind qi greatly prevails (Wood takes advantage of Earth), the Transforming qi cannot implement its governance, and although grasses and trees are lush and flourishing, they are blown about excessively, flowering but not fruiting. In heaven, this corresponds to the Sui Star. The people commonly suffer from sunsie, cholera, heaviness of body, abdominal pain, sinew and bone shaking and moving repeatedly, muscle twitching and soreness, and irritability with anger. The Storing qi (Water qi) instead takes charge of affairs, and hibernating creatures hide early. People mostly suffer from cold-within disease. In heaven, this corresponds to the Sui Star and the Zhen Star, and its grain is yellow (dark yellow). When the Recovering qi arrives (Metal coming to recover from Wood), the harvesting qi is severe, great trees wither and drop, and there is sudden severe pain in the chest and hypochondria, pulling downward to the lower abdomen, with frequent sighing. Insects gnaw on the sweet yellow grains, pathogenic qi lodges in the Spleen Earth, the yellow grain harvest is reduced, the people eat little and lose taste, and the green grain is damaged. In heaven, this corresponds to the Tai Bai Star and the Sui Star. If Upper-Overlap with Jueyin Wind Wood governs heaven, then flowing water does not freeze, hibernating creatures instead appear, the Storing qi cannot exert its function, and the white qi (Metal qi) cannot come to recover. In heaven, this corresponds to the Sui Star, yet the people are at peace and health.

In years when Metal movement is deficient, blazing fire qi prevails (Fire takes advantage of Metal), the Generating qi exerts its function, the Growing qi alone flourishes, the myriad things grow luxuriantly, and dry and scorching qi prevails. In heaven, this corresponds to the Ying Huo Star. The people commonly suffer from heaviness and oppression in the shoulders and back, nasal congestion with sneezing, blood in the stool, and pouring diarrhea. The Harvesting qi arrives late. In heaven, this corresponds to the Tai Bai Star, and its grain is hard and awned. When the Recovering qi arrives (Water coming to recover from Fire), cold rain suddenly descends, hail, frost, and snow kill the myriad things, yin cold and reversal repulse below, and yang qi instead moves upward. There is pain in the back of the head, extending to the vertex with fever. In heaven, this corresponds to the Chen Star. The red grain does not ripen, and the people commonly suffer from mouth sores; in severe cases, heart pain.

In years when Water movement is deficient, damp qi greatly prevails (Earth takes advantage of Water), the Growing qi instead exerts its function, transformation and generation accelerate, and summer rain falls frequently. In heaven, this corresponds to the Zhen Star. The people commonly suffer from abdominal fullness, heaviness of body, moist diarrhea, cold sores, discharge of clear water, pain attacks in the lumbus and thighs, difficulty in movement of the popliteal fossa, calf, thigh, and knee, oppression and depression, wilting and weakness of the feet, clear cold reversal, and pain under the feet. In severe cases, there is edema of the dorsum of the foot. The Storing qi cannot exercise its governance, and the Kidney qi loses its balance. In heaven, this corresponds to the Chen Star, and its grain is black millet. If Upper-Overlap with Taiyin Damp Earth governs heaven, then great cold comes frequently, hibernating creatures hide deep early, the earth accumulates hard ice, and yang light cannot exert its function. The people commonly suffer from lower body cold disease; in severe cases, abdominal fullness and edema. In heaven, this corresponds to the Zhen Star, and the yellow grain is associated. When the Recovering qi arrives (Wood coming to recover from Earth), great wind suddenly arises, grasses fall and trees snap, growth loses its freshness, the complexion changes from time to time, sinews and bones contract simultaneously, muscles twitch and cramp, both eyes see things blurrily, objects appear with cracks, muscles erupt in rashes, qi is blocked and stagnant in the diaphragm, heart and abdominal pain arise, the yellow qi is impaired, and its grain does not yield a bountiful harvest. In heaven, this corresponds to the Sui Star.

The Yellow Emperor said: Good. I wish to hear about the correspondence between deficient years and the four seasons. Qibo said: How detailed is this question!

In years when Wood movement is deficient, if in spring there is the normal transformation of gentle winds whistling through the branches, then in autumn there will be the normal governance of mist and dew, clear and cooling. If in spring there appears the victorious qi of dreary and destructive cold (Metal overcomes Wood), then in summer there will be the recovering qi of blazing heat and scorching fire (Fire coming to recover from Metal). The direction of its calamitous change is the East, the corresponding viscera is the Liver, and in disease it resides internally in the flank and rib region, and externally manifests at the joints.

In years when Fire movement is deficient, if in summer there is the normal transformation of bright and manifest brilliance, then in winter there will be the normal governance of severe frost and cold. If in summer there appears the victorious qi of grim and congealing cold (Water overcomes Fire), then from time to time there will be the recovering qi of dust, haze, darkness, and pouring rain (Earth coming to recover from Water). The direction of its calamitous change is the South, the corresponding viscera is the Heart, and in disease it resides internally in the chest and hypochondria, and externally manifests at the sinews and blood vessels.

In years when Earth movement is deficient, if in the four corners (the four diagonals, the months of Chen, Xu, Chou, and Wei) there is the normal transformation of dust, cloud, and fog with moistening, then in spring there will be the normal governance of whistling branches and stirring movement. If in the four corners there appears the abnormal change of shaking, pulling, and swirling flight (Wood overcomes Earth), then in autumn there will be the recovering qi of killing and drenching rain (Metal coming to recover from Wood). The direction of its calamitous change is the four corners, the corresponding viscera is the Spleen, and in disease it resides internally in the heart and abdomen, and externally manifests at the muscles and four limbs.

In years when Metal movement is deficient, if in summer there is the normal governance of brilliant brightness and steaming heat, then in winter there will be the normal response of severe cold and solemn order. If in summer there appears the abnormal change of blazing, scorching, and burning fire (Fire overcomes Metal), then in autumn there will be the recovering qi of hail and frost with snow (Water coming to recover from Fire). The direction of its calamitous change is the West, the corresponding viscera is the Lung, and in disease it resides internally in the chest, hypochondria, shoulders, and back, and externally manifests at the skin and body hair.

In years when Water movement is deficient, if in the four corners there is the normal transformation of swift moisture and dust clouds, then from time to time there will be the normal response of gentle winds blowing and generating the myriad things. If in the four corners there appears the abnormal change of dust and sudden rain (Earth overcomes Water), then from time to time there will be the recovering qi of drifting and pulling vibration (Wood coming to recover from Earth). The direction of its calamitous change is the North, the corresponding viscera is the Kidney, and in disease it resides internally in the lumbus, spine, and bone marrow, and externally manifests at the stream valleys, popliteal fossae, and knees.

The governance of the five movements is like a scale and its weights (a metaphor for nature's self-regulating mechanism)—what is too high is suppressed, what is too low is lifted up. Normal transformation, then the myriad things respond; abnormal change, then there must be recovering qi to retaliate. This is the principle of birth, growth, transformation, harvesting, and storing—the constant state of qi movement. If this constancy is lost, then the qi of heaven and earth will be blocked and impassable in all four directions. Therefore it is said: The movement and stillness of heaven and earth are governed by spirit intelligence; the returning and cycling of yin and yang are manifested by the signs of cold and heat. This is what is being spoken of.

The Yellow Emperor said: What you, Master, have spoken of regarding the changes of the five qi and the correspondence of the four seasons can be said to be extremely detailed. However, the turbulent disorder of qi movement arises from mutual collision, erupting without fixed opportunity, and suddenly disasters converge. How can this be predicted? Qibo said: The movement and change of qi is indeed not constant, but virtue (grace and beneficence), transformation (generation and change), governance (administration and order), seasonal orders (timely commands), calamity (disaster), and alteration (anomalous change)—each has its own distinct signs by which they can be discerned.

Huangdi asked: What does this mean? Qibo said: In the East arises wind, wind generates wood. Its virtue is spreading harmony (gentle diffusion), its transformation is growth and flourishing (nurturing vitality), its governance is unfolding and opening (relaxation and expansion), its command is wind, its change is stirring and arousal (agitation and stimulation), and its calamity is scattering and falling (dispersal and withering). In the South arises heat, heat generates fire. Its virtue is manifest brilliance (bright and evident), its transformation is luxuriant abundance (flourishing density), its governance is radiant illumination (bright shining), its command is heat, its change is melting and scorching (consuming blaze), and its calamity is burning and blazing (intense conflagration). In the Center arises dampness, dampness generates earth. Its virtue is moist evaporation (humid steaming), its transformation is rich completeness (abundant fullness), its governance is calm and stillness, its command is dampness, its change is sudden torrential downpour (abrupt heavy rain), and its calamity is prolonged flooding and rotting (incessant rain causing decay). In the West arises dryness, dryness generates metal. Its virtue is purity and clarity, its transformation is tight contraction (binding and constricting), its governance is vigorous urgency (forceful and incisive), its command is dryness, its change is killing and withering (austere destruction), and its calamity is fading and falling (aged decline and dropping). In the North arises cold, cold generates water. Its virtue is bitter chill (piercing cold), its transformation is clear tranquility (pure stillness), its governance is freezing solemnity (condensing dignity), its command is cold, its change is intense frostiness (severe bitterness), and its calamity is ice, snow, frost, and hail. Therefore, when observing the movements of qi-circumference, there are virtue, transformation, governance, command, change, and calamity. All myriad things follow these in their transformations, and the human body responds correspondingly.

Huangdi said: When you, Master, discuss the yearly seasons, you speak of insufficiency and excess, both corresponding above to the Five Stars. But virtue, transformation, governance, command, and calamitous aberrations and unusual changes are not constantly present—they arise abruptly. Do the Five Stars also change accordingly? Qibo said: The Five Stars uphold the movements of heavenly circumference and therefore do not move arbitrarily; there is nothing to which they do not respond. Abrupt changes, however, are intersections of qi-circumference alterations, and the Five Stars do not respond to them. Hence the saying: "They respond to the constant, not to the sudden" (The Five Stars respond to regular patterns, not to abrupt disturbances)—this is precisely its meaning. Huangdi asked: Then how do they manifest their responses? Qibo said: Each follows its own pattern of qi-transformation.

Huangdi asked: What about the speed, slowness, retrogression, and direct motion of the Five Stars? Qibo said: The Five Stars move along their orbital paths but linger long without departing; when they retrograde and remain, their radiance diminishes—this is called "inspecting below" (surveying the lower realm). Departing along the path and then swiftly returning, curving as they pass certain lodges—this is called "surveying omissions and faults" (examining neglected errors). Lingering long and orbiting around, sometimes leaving and sometimes approaching—this is called "deliberating calamity and virtue" (judging disasters and beneficent governance). When the response is near, the radiance is small; when the response is distant, the radiance is great. When radiance is double the normal magnitude, its qi-transformation is vigorous; when double again, calamitous aberrations are imminent; when reduced by half, its qi-transformation is diminished; when reduced to half again, it is called "overlooking inspection" (descending surveillance), which is examining the faults and virtues of the lower realm. Blessings are bestowed upon the virtuous, and punishments are exacted upon the faulty. Therefore, when stars appear, if positioned high and far they appear small; if positioned low and near they appear large. Hence, when star radiance is great, matters of joy and anger are near; when small, matters of fortune and misfortune are distant. In years of exuberant yearly-circumference, the star of this circumference deviates northward beyond its track (When yearly-circumference is excessive, its star departs from its normal course to the north). When circumference and qi are harmoniously aligned (annual circumference in harmony with annual qi), the Five Stars each follow their proper pathways. Thus, in years of exuberant yearly-circumference, the subdued star (the fearful star) loses its luster and concurrently takes on the color of its mother star. In years of insufficiency, the star of that circumference takes on the color of the star it cannot overcome. Those who observe celestial phenomena peer cautiously yet fail to grasp the profundity; fraught with anxiety in their deliberations, who indeed can be truly enlightened? To act baselessly without evidence and to speculate wildly is indeed a matter of dread for feudal lords and kings.

Huangdi asked: How do calamitous changes manifest their responses? Qibo said: They also each follow their own patterns of qi-transformation. Therefore, timeliness has prosperity and decline, transgressive encroachment has retrogression and directness, lingering presence has excess and deficiency, star manifestation has good and evil, constellation belonging has victory and defeat, and verification has auspiciousness and inauspiciousness.

Huangdi asked: What is meant by good and evil? Qibo said: Stars have joy, anger, sorrow, mourning, luster, and dryness—these are the constant states of stars and must be carefully observed. Huangdi asked: Do the high and low positions of these six star states differ? Qibo said: Although star manifestations may differ in height, their responses are consistent, and therefore the human body responds likewise.

Huangdi said: Excellent. What about the movements and rests, increases and decreases of virtue, transformation, governance, and command? Qibo said: Virtue, transformation, governance, and command with calamitous variations cannot be superposed upon one another; the prosperity and decline of victorious qi and recovering qi cannot augment one another; coming and going, small and great, cannot overstep one another; the ascent and descent of functions cannot cancel one another out. Each follows its own patterns of movement and cycles back and forth reciprocally.

Huangdi asked: How do diseases arise? Qibo said: Virtue and transformation are the auspicious signs of qi-circumference; governance and command are the regulatory frameworks of qi-circumference; variation is the governing principle of recovering qi; calamitous aberrations are the beginnings of harm. When qi and qi overcome one another and harmonize, the human body remains healthy; when they do not overcome harmoniously, illness arises; when external pathogens are repeatedly encountered, the condition is aggravated.

Huangdi said: Well spoken indeed! This is truly an exquisite and illuminating discourse, the great enterprise of the sages, proclaiming the great Way, penetrating to the boundless, exhausting to the limitless. I have heard that one skilled in discoursing on Heaven invariably verifies it through humanity; one skilled in discoursing on antiquity invariably confirms it through the present; one skilled in discoursing on qi-circumference invariably illuminates it through the myriad things; one skilled in discoursing on responses moves in synchrony with the transformations of Heaven and Earth; one skilled in discoursing on transformation and variation comprehends the principles of spiritual luminosity. Aside from you, Master, who could utter such supreme truth! Thereupon he selected an auspicious day, stored it in the sacred chamber, recited it every morning, and named it On Intersection and Variation of Qi. It was not to be opened except on days of fasting and purification, and was carefully transmitted to later generations.