凡六气,数起于上而终于下。岁半之前,自大寒后,天气主之;岁半之后,自大暑之后
,地气主之;上下交互,气交主之。司气以热,用热无犯;司气以寒,用寒无犯;司气以凉
,用凉无犯;司气以温,用温无犯。司气同其主,亦无犯;异主,则少犯之,是谓四畏。
若天气反时,可根据时,及胜其主,则可犯,以平为期,不可过也。
夫疫病者,四时皆有不正之气,春夏有寒清时,秋冬亦有暄热时,一方之内,长幼患状
,率皆相类者,谓之天行是也。若春时应暖,而清气折之,则责邪在肝,病曰青筋牵;夏时
应暑,而寒气折之,则责邪在心,病曰赤脉KT ;秋时应凉,而热气抑之,则责邪在肺,
病曰白气狸;冬时应寒,而暖气抑之,则责邪在肾,病曰黑骨温;土无正形,因火而名,故
附金木水火而变,病曰黄肉随。其天行之病,大则流毒天下,次则一方一乡,或偏着一家,
悉由民庶同业所召,故天地灵祗,假斯不正之气而责罚。且人命有遭逢,时有否泰,故有偏
着一家者。天地既有斯害气,还以天地所生之物而防备之,命曰贤人知方。
病者发热,腰痛强急,脚缩不伸, 中欲折,目中生花,或涩涩憎寒复热,颈中双
筋牵,不得屈伸,项直背强,眼赤黄,欲转动合目回侧,病名青筋牵者,由春三月,其源从
厥阴涉足少阳,少阳之气始发,少阴之气始衰,阴阳怫郁于腠理,脏腑受厉而生。若腑虚,
则为阴邪所伤,故发热;若脏实,则为阳毒所损,故憎寒。
凡是六气(风、寒、暑、湿、燥、火),其数理起于天而终于地。一年的一半之前,从大寒节气之后开始,由天气主导;一年的一半之后,自大暑节气之后开始,由地气主导;天气与地气交互作用,由“气交”(天地之气交汇之处)主导。当司天之气表现为热时,用药不宜用热药以免触犯;当司天之气表现为寒时,用药不宜用寒药以免触犯;当司天之气表现为凉时,用药不宜用凉药以免触犯;当司天之气表现为温时,用药不宜用温药以免触犯。如果司天之气与主气相同,也不宜触犯;如果不同,则应少量触犯,这被称为“四畏”。如果天气违背了时令规律,可以根据实际时令,以及克制主气的情况,适当使用相应的药物,以身体平衡为准则,不可过度。
所谓疫病,是四季中出现的非正常气候。春夏季节出现寒冷清冽之时,秋冬季节出现温暖炎热之时,在一个地区内,无论长幼患病症状,大多相似,这就叫做“天行”(流行性传染病)。如果春季本该温暖,却被清气(寒气)所折损,那么致病邪气责在于肝,这种病称为“青筋牵”;夏季本该暑热,却被寒气所折损,那么致病邪气责在于心,这种病称为“赤脉KT”(注:原文“KT”疑为衍文或异体字,此处保留原意,通常指血脉病变);秋季本该凉爽,却被热气所抑制,那么致病邪气责在于肺,这种病称为“白气狸”;冬季本该寒冷,却被暖气(热气)所抑制,那么致病邪气责在于肾,这种病称为“黑骨温”;土没有固定的形态,因火而得名,所以依附于金、木、水、火的变化而变化,这种病称为“黄肉随”。这种天行疫病,严重的会流毒天下,较轻的波及一个地区或一个乡里,或者只集中在一户人家,这都是由于百姓共同的行为所感召,因此天地神灵借助这些不正之气进行责罚。况且人的命运有遭遇的不同,时运有顺逆之分,所以有的病只集中在一家。既然天地产生了这种有害之气,就用天地所生的万物来防备它,这就叫作“贤人知方”(明智的人懂得应对的方法)。
患者出现发热、腰部疼痛且僵硬拘急、双脚收缩不能伸展、腹部像要折断一样疼痛、眼睛视物模糊或有闪光感,或者感到阵阵恶寒随后发热、颈部两侧筋脉牵引、不能屈伸、颈部僵硬背部强直、眼睛发红发黄、想要转动眼球却只能闭眼侧视,这种病名为“青筋牵”的,是由于在春季三个月期间,病源从足厥阴肝经涉足足少阳胆经,此时少阳之气刚开始生发,少阴之气刚开始衰退,阴阳之气郁结在腠理(皮肤肌肉的间隙),导致脏腑受邪而生病。如果腑气虚弱,就会被阴邪所伤,所以出现发热;如果脏气充实,就会被阳毒所损伤,所以出现憎寒(极度怕冷)。
Regarding the Six Qi (Wind, Cold, Summer Heat, Dampness, Dryness, Fire), their numerical sequence begins from Heaven and ends on Earth. In the first half of the year, starting after the Great Cold solar term, the Heavenly Qi dominates; in the second half of the year, starting after the Great Heat solar term, the Earthly Qi dominates; the interaction between Heaven and Earth is governed by the "Qi Jiao" (the intersection of Heavenly and Earthly Qi). When the ruling Qi is Hot, one should not use Hot remedies to avoid offending it; when the ruling Qi is Cold, one should not use Cold remedies; when the ruling Qi is Cool, one should not use Cool remedies; when the ruling Qi is Warm, one should not use Warm remedies. If the ruling Qi matches the Principal Qi, one should also not offend it; if it differs, one should offend it only slightly. This is referred to as the "Four Feared Things." However, if the Heavenly Qi contradicts the seasonal norm, one may follow the actual season and the factors overcoming the Principal Qi, allowing for appropriate intervention, aiming for balance without excess.
The so-called Epidemic Diseases are caused by abnormal Qi present in all four seasons. In spring and summer, there may be times of cold and chill; in autumn and winter, there may be times of warmth and heat. Within a certain region, if people of all ages suffer from similar symptoms, this is called "Tian Xing" (Heavenly Transmission/Contagious Disease). If spring should be warm but is restrained by Clear/Cold Qi, the pathogenic factor is attributed to the Liver, and the disease is named "Qing Jin Qian" (Green Tendon Pulling); if summer should be hot but is restrained by Cold Qi, the pathogenic factor is attributed to the Heart, and the disease is named "Chi Mai KT" (Red Vessel [Condition]); if autumn should be cool but is suppressed by Hot Qi, the pathogenic factor is attributed to the Lung, and the disease is named "Bai Qi Li" (White Qi Fox-like); if winter should be cold but is suppressed by Warm Qi, the pathogenic factor is attributed to the Kidney, and the disease is named "Hei Gu Wen" (Black Bone Warmth); Earth has no fixed form and is named due to Fire, thus varying with Metal, Wood, Water, and Fire, and the disease is named "Huang Rou Sui" (Yellow Flesh Following). Such Tian Xing diseases, if severe, spread poison throughout the world; if moderate, they affect one region or village; if minor, they concentrate on one family. All are summoned by the collective conduct of the common people. Therefore, the spirits of Heaven and Earth utilize this abnormal Qi to inflict punishment. Moreover, human fate involves different encounters, and fortune varies between smooth and obstructed periods, hence some diseases concentrate on a single family. Since Heaven and Earth generate such harmful Qi, they also provide things born from Heaven and Earth to guard against it, which is called "Xian Ren Zhi Fang" (The Wise Know the Method).
Patients exhibit fever, lower back pain with stiffness and urgency, legs curled up and unable to extend, abdominal pain as if breaking, visual disturbances such as seeing flowers/sparks, or alternating chills and fever, traction of the bilateral tendons in the neck preventing flexion and extension, stiff neck and strong back, red and yellow eyes, desire to turn the eyes but only able to close them and look sideways. This disease, named "Qing Jin Qian," originates in the three months of spring. The source moves from the Foot-Jueyin Liver Meridian to the Foot-Shaoyang Gallbladder Meridian. At this time, Shaoyang Qi begins to emerge, and Shaoyin Qi begins to decline. Yin and Yang become stagnant in the Cou Li (interstices of skin and muscles), causing the Zang-Fu organs to receive harsh pathogens and become diseased. If the Fu organs are deficient, they are injured by Yin pathogens, resulting in fever; if the Zang organs are excessive, they are damaged by Yang toxins, resulting in aversion to cold.