Huangdi asked: I have heard that in ancient times, treating illnesses involved only the shifting of essence and altering of qi, which could be addressed through incantations. Nowadays, illnesses are treated with toxic medicines internally and acupuncture and stones externally, yet sometimes they are cured and sometimes not. Why is this? Qibo replied: In ancient times, people lived among animals, moving to avoid the cold and dwelling in shade to escape the heat. They had no internal burdens of attachment or external pressures of ambition. This was a tranquil era, and pathogenic factors could not penetrate deeply. Thus, toxic medicines were unnecessary internally, and acupuncture and stones were unnecessary externally. Shifting essence and incantations were sufficient. In the present era, it is different. Internal worries and external physical hardships, along with a disregard for the rhythms of the seasons and the proper responses to cold and heat, have led to frequent invasions of Zefeng, deficiency-type pathogens that affect the body day and night, reaching internally to the five organs and bone marrow, and externally harming the orifices and skin. Therefore, minor illnesses become severe, and major illnesses lead to death, making incantations ineffective.
Huangdi said: Good. I wish to observe patients, discern life and death, and resolve doubts. I want to understand the essentials, as clear as the light of Riyue (GB24). Can you explain? Qibo said: The observation of complexion and pulse is highly valued by the supreme ruler and passed down by ancient masters. In high antiquity, Jiudaiji used the principles of complexion and pulse to understand mental activity, aligning them with the five elements, the four seasons, and the six pairs of meridians. By adhering to these constants and observing their transformations, one could grasp the subtleties and essentials. To understand the essentials, focus on complexion and pulse. Complexion corresponds to the sun, and pulse corresponds to the moon. By constantly seeking the essentials, one finds them. The changes in complexion correspond to the seasonal pulses, a principle highly valued by the supreme ruler, aligning with mental activity to prolong life and avoid death. This is the way of the sage kings. In middle antiquity, illnesses were treated upon their onset. Decoctions were used for ten days to remove the five obstructions. If not cured, herbal concoctions were used, with branches and roots aiding each other, and pathogenic qi would subside. In recent times, treatment is different. It does not follow the seasons, ignores Riyue (GB24), and fails to discern compliance and opposition. By the time the illness is fully formed, minor acupuncture is used externally and decoctions internally. Crude methods are hastily applied, leading to unresolved illnesses and new complications.
Huangdi said: I wish to hear the essential principles. Qibo said: The ultimate principle of treatment is not to overlook complexion and pulse. Use them without confusion, as this is the great rule of treatment. Acting contrary to this leads to losing the branch and root, resulting in the loss of spirit and the state. Abandon the old and embrace the new to attain the true way. Huangdi said: I have heard the essentials from you, Master. You emphasize the importance of complexion and pulse, which I understand. Qibo said: The ultimate principle of treatment lies in unity. Huangdi asked: What is unity? Qibo replied: Unity is achieved through understanding. Huangdi asked: How? Qibo said: Close the doors and windows, focus on the patient, repeatedly inquire about their condition, and follow their will. Those who retain their spirit thrive; those who lose it perish. Huangdi said: Good.