上 工 中 工 之 治 病 treatment of diseases by highest and mediocre doctors
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七 十 七 難 77th difficulty
Qī shí qī nán 論 上 工 中 工 之 治 病 explains as high and middle doctors manage diseases Lùn shàng gōng zhōng gōng zhī zhì bìng 七 十 七 難 曰 ：77th difficulty says Qī shí qī nán yuē: 經 言 ：treatise says Jīng yán 上 工 治 未 病 ，Highest doctor treats not disease before it started Shàng gōng zhì wèi bìng 中 工 治 已 病 」 者 ，middle doctor treats disease when it already started Zhōng gōng zhì yǐ bìng zhě 何 謂 也 ？ 然 ： how does it happen? Explanation Héwèi yě? Rán 所 謂 治 未 病 者 ，when they say treat disease before it started Suǒ wèi zhì wèi bìng zhě 見 肝 之 病 ， refer to disease of liver Jiàn gān zhī bìng 則 知 肝 當 傳 之與 脾 ， as liver pass it’s disease to spleen 故 先 實 其 脾 氣 ， so first qi of spleen is affected Gù xiān shí qí pí qì 無 令 得 受 肝 之 邪 ，but evil is not moved from liver yet Wú lìng de shòu gān zhī xié 故 曰 治 未 病 焉。 It is how they say to treat disease before it started Gù yuē zhì wèi bìng yān 中 工 者 見 肝 之 病 ， middle doctor see disease of liver Zhōng gōng zhě jiàn gān zhī bìng 不 曉 相 傳 ，without knowing mutual exchanges 但 一 心 治 肝 ，only thinking to treat a liver Dàn yīxīn zhì gān 故 曰 治 已病 也 。so they say treat disease when it already started Gù yuē zhì yǐ bìng yě ere to edit. |
77th difficulty explains that when liver is in excess, it should not be treated, disease will move through ko connection to the spleen. This difficulty is linked to the treatment explained in difficulty 69. Excess should be treated through the heart meridian. It is explained in difficulty 53, when disease moves through shen cycle instead of ko. In this case heart is a son for the liver, puncturing the heart will deplete excess of liver, it's disease. Heart is a mother of spleen, puncturing the heart will supplement the spleen. Difficulty 69 explains this treatment
虛 者 補 其 母 ， emptiness should be supplemented by mother
實 者 瀉 其 子， excess should be depleted by son
當 先 補 乏 ，first treat repleting deficient
然 後 瀉 之 。 afterwards treat depleting excess
In our case of liver excess disease will move to spleen, when spleen will become deficient. Treating the heart we fulfill emptiness of the spleen and deplete excess of liver. Heart is a meridian without excess or deficiency
不 虛 if there is no deficiency
不 實 ，neither excess
以 經 取 之 者 ， so this one meridian should be used
是 正 經 used the meridian
自 生 病 ， since diseases started
不 中 他 邪 也 ， not evil will come from other place
當 自 取 其 經 ， treat same chosen meridian
故 言 以 經 取 之 。it is why they say treat same meridian
Practitioner of archaic acupuncture treats pulse as it is said in difficulty 48, preventing disease from movement in ko cycles, moving it through shen cycle. Pulse is the principal guidance for archaic acupuncture treatment and prevention
虛 者 補 其 母 ， emptiness should be supplemented by mother
實 者 瀉 其 子， excess should be depleted by son
當 先 補 乏 ，first treat repleting deficient
然 後 瀉 之 。 afterwards treat depleting excess
In our case of liver excess disease will move to spleen, when spleen will become deficient. Treating the heart we fulfill emptiness of the spleen and deplete excess of liver. Heart is a meridian without excess or deficiency
不 虛 if there is no deficiency
不 實 ，neither excess
以 經 取 之 者 ， so this one meridian should be used
是 正 經 used the meridian
自 生 病 ， since diseases started
不 中 他 邪 也 ， not evil will come from other place
當 自 取 其 經 ， treat same chosen meridian
故 言 以 經 取 之 。it is why they say treat same meridian
Practitioner of archaic acupuncture treats pulse as it is said in difficulty 48, preventing disease from movement in ko cycles, moving it through shen cycle. Pulse is the principal guidance for archaic acupuncture treatment and prevention