灵枢·四时气 Miraculous Pivot · Four-Season Qi
黄帝问于岐伯曰：夫四时之气，各不同形，百病之起，皆有所生，灸刺之道，何者为定？The Yellow Emperor asked Qi Bo, "The climates of the four seasons are all different, and the causes of various diseases are also distinct. What determines the method of acupuncture and moxibustion treatment?"
黄帝问岐伯说：四季的气候，各不相同，百病的生成，各有不同的原因，针灸治疗的方法根据什么来决定呢？
岐伯答曰：“四时之气，各有所在，灸刺之道，得气穴为定。Qi Bo replied: "The qi of the four seasons each has its location. The methods of acupuncture and moxibustion treatment should be determined according to the characteristics of the qi of the four seasons and the acupoints.
岐伯回答说：四季之气对人的影响，反映在身体上为各有一定的发病部位，针灸治疗的方法，要根据四季之气和经穴的特点来决定。
故春取经、血脉、分肉之间，甚者深刺之；间者浅刺之。夏取盛经孙络，取分间绝皮肤。Therefore, in spring, acupuncture is applied among the channels, blood vessels, and the spaces between muscles. In severe cases, insert the needle deeply; in mild cases, insert it shallowly. In summer, select the abundant channels and their collateral vessels, and puncture the spaces between the muscles just beneath the skin.
因此，春季针灸治病，可取用络脉、分肉之间的穴位，病重的深刺，病轻的浅刺；夏季可取用阳经、孙络上的穴位，或取分肉之间的经脉，用穿过皮肤的浅刺法；
秋取经俞，邪在腑，取之合。冬取井荥，必深以留之。”In autumn, select the acupoints on the channels and their associated points. If the pathogen is in the fu-organs, select the confluent points. In winter, select the well and spring points and retain the needles for a long time with deep insertion."
秋季可取用各经的腧穴，如果病邪在六腑，可取用手足阳明经的合穴；冬季可取用各经的井穴和荥穴，一定要深刺并且留针。
温疟汗不出，为五十九痏。For warm malaria with no sweating, perform fifty-nine needling procedures.
温疟病，没有汗出症状的，可用热病的五十九个腧穴进行治疗。
风㽷肤胀，为五十（七）痏。取皮肤之血者，尽取之。For wind edema with skin distension, perform fifty-seven needling procedures. When taking blood from the skin, take it all.
患风水病肌肤肿胀的，可以用五十七个治疗水病的腧穴治疗。如果是使用针刺放血的治疗方法，就应该将该穴位的恶血放干净。
飧泄，补三阴之，上补阴陵泉，皆久留之，热行乃止。For the condition of diarrhea (sunxie), reinforce the Sanyinjiao point and then reinforce the Yinlingquan point above it. Both points should be retained with needles for an extended period, and the needles should not be removed until a warm sensation is felt, indicating the flow of qi has been activated.
脾胃虚寒所致的飧泄证，应该使用补的手法，先取三阴交穴，再向上取阴陵泉穴，都要久留针，直至针下有热感的时候才能起针。
转筋于阳治其阳，转筋于阴治其阴，皆卒（《医部全录》：同焠）刺之。For muscle spasms on the yang aspect, treat the yang aspect; for muscle spasms on the yin aspect, treat the yin aspect. All are treated with quick needling (In "Complete Records of the Medical Department": same as "cui" - a type of needling).
手足外侧转筋，取手足外廉的阳经刺治，手足内侧转筋，取手足内廉的阴经刺治，都用焠针。
徒㽷，先取环谷（《医药科技》：当是脐中）下三寸，以铍针针之，已刺而筩之，而内之，入而复之，以尽其㽷，必坚（束之）。For simple edema, first select the point three cun below Huangu (In "Medical and Pharmaceutical Science and Technology": it should be the umbilicus). Puncture it with a beryllium needle. After puncturing, insert a tube into it, then insert it again to drain the edema completely. It must be firmly bound (In some versions: "shu" means to bind).
患水肿病，针治先取脐下三寸关元穴，用铍针针刺它，针刺后用竹管插入针孔放水，反复进行，使水排尽。针刺时，一定要急刺。
来（别本作束）缓则烦悗，来（别本作束）急则安静。If the arrival (In some versions: "shu" means to bind) is slow, there will be restlessness; if the arrival (In some versions: "shu" means to bind) is rapid, there will be calmness.
间日一刺之，㽷尽乃止。饮闭药，方刺之时徒饮之，方饮无食，方食无饮，无食他食，百三十五日。Puncture once every other day until the edema disappears. Drink the diuretic medicine. Drink it only when puncturing, do not eat when drinking, do not drink when eating, and do not eat other foods for one hundred and thirty-five days.
刺得缓慢，病人就会觉得烦闷不安，刺得快，病人就会很平静。每隔一天针刺放水一次，直到水尽为止。同时配合服补药，在针灸开始时服用，刚吃完补药不要进食，刚进完食也不要服补药，还要不吃水肿病禁忌的食物一百三十五天。
着痹不去，久寒不已，卒取其三里。骨为干。（读注：此句为衍文。）For fixed bi-syndrome that does not go away and persistent cold that does not cease, suddenly puncture Zusanli. (Annotation: This sentence is redundant.)
患湿邪的著痹病，经久不愈，常感寒冷不已，治疗用焠针刺里骨。
肠中不便，取三里，盛泻之，虚补之。For constipation in the intestines, select Zusanli. If there is excess, drain it; if there is deficiency, reinforce it.
湿邪在肠中造成肠胃不调的病证，治疗取足三里穴，邪气盛的用泻法，正气虚的用补法。
疠风者，素刺其肿上。已刺，以锐针针其处，按出其恶气，肿尽乃止。常食方食，无食他食。For leprosy, usually puncture on the swelling. After puncturing, use a sharp needle to puncture the area again, press to expel the pathogenic qi until the swelling disappears completely. Always eat the usual diet and do not eat other foods.
患麻风病，应多次用针刺其肿胀部位。刺后，用手挤压针刺处，挤出其中的邪毒之气，直到肿消尽为止。平时应吃适宜的食物，不吃禁忌的食物。
腹中常鸣，气上冲胸，喘不能久立，邪在大肠，刺肓之原、巨虚上廉、三里。For constant rumbling in the abdomen, qi rushing up to the chest, and being unable to stand for long due to panting, when the pathogen is in the large intestine, puncture the origin of Huang, Shanglian of Julu, and Zusanli.
腹中经常鸣响，气向上冲顶胸部，气喘而不能长久站立，这些症状表明病邪在肠，应针刺气海穴、上巨虚穴和足三里穴。
小腹控睪，引腰脊，上冲心，邪在小肠者，连睪系，属于脊，贯肝肺，络心系。For the lower abdomen pulling the testicles, leading to pain in the lumbar spine and rushing up to the heart, when the pathogen is in the small intestine, it is connected to the testicle system, belongs to the spine, penetrates the liver and lungs, and connects to the heart system.
小腹牵控睾丸，连及腰脊疼痛，上冲心胸，这些症状是邪在小肠的表现。小肠连及睾丸神经，附着于脊椎，贯通肝肺，联络心系。
气盛则厥逆，上冲肠胃，熏肝，散于肓，结于脐，故取之肓原以散之，刺太阴以予之，取厥阴以下之，取巨虚下廉以去之，按其所过之经以调之。When qi is excessive, there will be reverse flow, rushing up to the stomach and intestines, fumigating the liver, dispersing in Huang, and knotting at the umbilicus. Therefore, select the origin of Huang to disperse it, puncture the Taiyin to supplement it, select the Jueyin to descend it, select the Xialian of Julu to remove it, and press the channels it passes through to regulate it.
邪气盛则厥气上逆，冲及肠胃，影响肝脏，扩散于肓膜，聚结在脐部。因此，治疗应取气海穴来散邪气，针刺手太阳经的穴位来上散邪气，取足厥阴经的穴位来下泄邪气，取巨虚下廉穴来除去病邪，根据邪气所经的经络来调治。
善呕，呕有苦，长太息，心中憺憺，恐人将捕之，邪在胆，逆在胃，胆液泄则口苦，胃气逆则呕苦，故曰呕胆。For those who are prone to vomiting, with bitter taste in the vomit, long sighing, restlessness in the heart, and fearing that others will arrest them, when the pathogen is in the gallbladder and the reverse flow is in the stomach, the leakage of gallbladder fluid leads to bitter taste in the mouth, and the reverse flow of stomach qi leads to bitter vomiting. Therefore, it is called vomiting of bile.
病人往常呕吐，常常吐出苦水，常叹气，心中感觉空荡不安，就象害怕有人将要抓捕他似的感觉，这是病邪在胆，气逆于胃的症状。吐出胆汁就会感觉口苦，胃气上逆就会导致吐出苦水，所以称这种症状为呕胆。
取三里以下。胃气逆，则刺少阳血络以闭胆逆，却调其虚实，以去其邪。Select Zusanli to descend it. When the stomach qi is in reverse flow, puncture the blood vessels of the Shaoyang to block the reverse flow of the gallbladder, and then regulate its excess and deficiency to remove the pathogen.
治疗应取足三里穴，使上逆的胃气下降，刺足少阳的血络来抑制胆气上逆，根据病症的虚实情况来祛除病邪。
饮食不下，膈塞不通，邪在胃脘，在上脘则刺抑而下之，在下脘则散而去之。For inability to eat and drink, with blockage and obstruction in the diaphragm, when the pathogen is in the stomach cavity, if it is in the upper part of the stomach cavity, puncture to suppress and descend it; if it is in the lower part of the stomach cavity, disperse and remove it.
如果病人饮食不入，隔膜阻塞不通，这是病邪在胃脘的症状。病邪在上脘则刺上脘之穴，抑制病邪而使上逆之气下降；若病邪在下脘，则刺下脘之穴来消散祛除病邪。
小腹痛肿，不得小便，邪在三焦约，取之太阳大络。视其络脉与厥阴小络结而血者。肿上及胃脘，取三里。For swelling and pain in the lower abdomen with inability to urinate, when the pathogen is in the Sanjiao constraint, select the large collateral of the Taiyang. Examine the collateral vessels and the small collateral of the Jueyin that are knotted and have blood stasis. For swelling extending to the stomach cavity, select Zusanli.
小腹肿痛，不能小便，这是病邪在膀胱的症状，治疗应取足太阳经的大络委阳穴。如果观察到足太阳经大络与足厥阴经小络有聚结淤血现象，而且肿势向上延及胃脘，应取三里穴针治。
睹其色，察其以，知其散复者，视其目色，以知病之存亡也。By observing the complexion and examining the manifestations, one can know the dissipation and recurrence of the disease. By observing the color of the eyes, one can know the existence and disappearance of the disease.
诊断疾病时看病人的面色，观察患者的眼神，就能知道正气的散失或恢复的情况。观察眼睛的颜色，可以知道病邪是存在还是已经消失。
一其形，听其动静者，持气口、人迎以视其脉，坚且盛且滑者病日进，脉软者病将下，诸经实者病三日已。气口候阴，人迎候阳也。By observing the body shape and listening to the movement and stillness, hold the Qikou and Renying to examine the pulse. If the pulse is firm, full, and slippery, the disease will progress daily; if the pulse is soft, the disease will subside. If the channels are excessive, the disease will be cured in three days. The Qikou reflects the yin, and the Renying reflects the yang.
审查病人的形态、动静，再诊察气口、人迎的脉象，脉象坚实、滑利且洪大的，是病证日渐加重的表现；如果脉象软弱和缓，就是病邪将要衰退的表现；如果各经脉诊候的部位实而有力的，是正气旺盛的表现，三天左右就能痊愈了。气口之脉候阴，人迎之脉候阳。
