《经》曰∶平，如何而名？木曰敷和，火曰升明、土曰备化，金曰审下，水曰静
顺。其不及奈何？木曰委和，火曰伏明，土曰卑监，金曰从革，水曰涸流。太过何谓？
木曰发生，火曰赫曦，土曰敦阜，金曰坚成、水曰流衍。不恒其德，（恃已而凌犯他位。）
则所胜来复。（所胜者，必来复仇。）政恒其理，则所胜同化。（若不肆威刑，政理和
恒则胜已，与已所胜者，皆同治化。由是言之，医道与治道亦有相通者矣。）
以木火土金水配心肝脾肺肾，相生相克，素知之矣。诸书有云∶五行唯一，独火
有二。此言似是而非。论五行俱各有二，奚独一火哉？若论其至，五行各有五，五五二
十五，五行各具一太极，此所以成变化而行鬼神也。今以五行之阴阳生死言之，木有甲
木属阳，乙木属阴。人身之胆，是甲木，属足少阳；肝是乙木，属足厥阴。甲木生于
亥，而死于午；乙木生于午，而死于亥。火有丙火属阳，丁火属阴，火身之相火属手少
阳，心火属手少阴，丙火生于寅，而死于酉，丁火生于酉，而死于寅。水有壬水属
阳，有癸水属阴，人身之肾水属足少阴，膀胱属足太阳，壬水生于申，而死于卯，癸水
生于卯而死于申。土有戊土属阳，已土属阴，人身之胃土属足阳明，脾土属足太阴，
戊土生于寅而死于酉，已土生于酉而死于寅。金有庚金，有辛金，庚金属阳，辛金属
阴，人身之肺金属手太阴，大肠金属于阳明，庚金生于已而死于子，辛金生于子而死
于已。欲察病情者，专以时日之生旺休囚，而验其阴阳之属，如胆火旺，则寅卯旺而午
未衰，肝火旺则午未甚而亥子衰，五行各以其类推之。
独土金随母寄生，故欲补土金者，从寄生处而补其母，是以东垣有隔二之治，是从
母也。有隔三之治，又从母之外家也。土金惟寄生，故其死为真死，惟水火从真生，故
其死不死，绝处逢生也。归库者，绝其生气而收藏也。返魂者，续其死气而变化也。水
火随处有生机，钻木可取，击石可取，圆珠可取。方诸取水，掘地取水。若金死不救，
土死不救，木死不救，是以五行中，独重水火，而其生克之妙用，又从先天之根也。
世人皆曰水克火，赵氏独曰水养火。世人皆曰金生水，赵氏独曰水生金。世人皆曰
土克水，而赵氏独于水中补土。世人皆曰木克土，而赵氏独曰升木以培土。若此之论，
颠倒拂常，谁则信之？讵知君相二火，以肾为宫。水克火者，后天有形之水火也。水养
火者，先天无形之水火也。海中之金，未出
沙土，不经锻炼、不畏火，不克木，此黄钟根本。人之声音，出自肺金，清浊轻重，丹
田所系，不求其原，徒事于肺，抑末也。今之言补肺者，人参、黄 ；清肺者，黄芩、
麦冬；敛肺者五味、诃子；泻肺者、葶苈、根壳。病之轻者，岂无一效？若本源亏损，
毫不相干。盖肺金之气，夜卧则归脏于肾水之中，丹家谓之母藏子宫，子隐母胎。此一
脏名曰娇脏，畏热畏寒，肾中有火，则金畏火刑，而不敢归，肾中无火，则水冷金寒，
而不敢归，或为喘胀，或为咳哕，或为不寐，或为不食，如丧家之狗。斯时也，欲补
土母以益子，喘胀愈甚；清之泻之，肺气日消，死期迫矣。惟收敛者，仅似有理，然不
得其门，从何而入？《仁斋直指》云∶肺出气也，肾纳气也。肺为气之主，肾为气之
本。凡咳嗽暴重，动引百骸，自觉气从脐下逆奔而上者，此肾虚不能纳气归元也。毋徒
事于肺，或壮水之主，或益火之原，火向水中生矣。若夫土者，从火寄生，即当随火而
补。然而补火有至妙之理，阳明胃土，随少阴心火而生，故补胃土者补心火，而归脾汤
一方，又从火之外家益补之，俾木生火，火生土也。太阴脾土随少阳相火而生，故补脾
土者补相火，而八味丸一方，合水火既济而蒸腐之，此至理也。人所不知，盖混沌之
初，一气而已，何尝有土？自天一生水，而水之凝成处始为土，此后天卦仁，艮土居
坎，水之次也。其坚者为石，而最圣者为金，可见水土金，先天之一原也。又有补子
之义，盖肺为土之子，先补其子，食子不食母之乳，其母不衰，亦见金生土之人。又有
化生之妙，不可不知，甲木戊土所畏，畏其所胜，不得已以已妹嫁之，配为夫妇，此申
已化土。凡化物以龙为主。其间遇龙则化，不遇龙则不化，张仲景立建中汤。以建脾
土。木曰曲直，曲直作酸，芍药味酸，属甲木，土曰稼穑，稼穑作甘，甘草味甘，属已
土，酸甘相合，甲已化土。又如肉桂，盖桂属龙火，使助其化也。仲景立方之妙类如
此。又以见木生土之义，盖上无定位，旺于四季，四季俱有生理，故及之至于木也者，
以其克土。举世欲伐之，赵氏以为木藉土生，岂有反克之理？惟木郁于下。故其根下
克。盖木气者，乃主生之气，始于东方，盍不观之为政者，首重农事，先祀芒神。芒神
者木气也，春升之气也，阳气也，元气也，胃气也，同出而异名也。载培树木者，雨以
润之，风以散之，日以暄之，使得遂其发生长养之天耳。及其发达既久，生意已竭，又
当敛其主主之气，而归于水土之中，以为来春发生之本，此天地春生冬藏之义也，焉有
伐之之理？东垣《脾胃论》中，用升柴以疏木气，谆谆言之详也。申明五行之妙用，专
重水火耳。
《黄帝内经》说：平和的状态，如何命名？木称为敷和，火称为升明，土称为备化，金称为审下，水称为静顺。如果五行之气不足（不及）会怎样？木称为委和，火称为伏明，土称为卑监，金称为从革，水称为涸流。如果五行之气太过（亢盛）又是什么情况？木称为发生，火称为赫曦，土称为敦阜，金称为坚成，水称为流衍。如果德行不恒定（恃强凌弱侵犯其他方位），那么被克制的一方就会来报复（被克者必来复仇）。如果政令恒常合于规律，那么被克制的一方也会与之同化（如果不肆意施威，政令和谐恒定，则克制我者与我所克者，都共同治理化育。由此而言，医道与治国之道也有相通之处）。
将木、火、土、金、水分别配属于心、肝、脾、肺、肾，它们之间相生相克，这是大家熟知的。各种书籍中说：五行中只有一行是特殊的，唯独火有两类。这种说法看似有理实则错误。论述五行时，每一行都各有两类，为何唯独说火特殊呢？若论其极致，五行每行各有五种变化，五五二十五种，五行各自具备一个太极，这就是能够促成万物变化并运行鬼神般奥妙功能的原因。现在从阴阳生死角度论述五行：木有甲木属阳，乙木属阴。人体中的胆，属于甲木，归属于足少阳经；肝属于乙木，归属于足厥阴经。甲木生于亥时（月/日），死于午时；乙木生于午时，死于亥时。火有丙火属阳，丁火属阴。人体中的相火（三焦之火）属于手少阳经，心火属于手少阴经。丙火生于寅时，死于酉时；丁火生于酉时，死于寅时。水有壬水属阳，癸水属阴。人体中的肾水属于足少阴经，膀胱属于足太阳经。壬水生于申时，死于卯时；癸水生于卯时，死于申时。土有戊土属阳，己土属阴。人体中的胃土属于足阳明经，脾土属于足太阴经。戊土生于寅时，死于酉时；己土生于酉时，死于寅时。金有庚金属阳，辛金属阴。人体中的肺金属手太阴经，大肠金属手阳明经。庚金生于巳时，死于子时；辛金生于子时，死于巳时。想要观察病情的人，专门依据时日五行的生旺休囚状态，来验证其阴阳属性，例如胆火旺盛，则寅卯时旺盛而午未时衰弱；肝火旺盛，则午未时极盛而亥子时衰弱，五行都可以依此类推。
唯独土和金随着母亲（火）寄生，所以想要补益土和金的人，要从寄生的源头去补益其母（火），因此李东垣提出了“隔二之治”，这是从母脏入手治疗。还有“隔三之治”，则是从母脏的外家（即母之父母）入手治疗。因为土和金只有寄生关系，所以它们的死是真正的死；唯独水火是从真源而生，所以它们的死并非真死，是在绝境中逢生。所谓“归库”，是指断绝生气而进入收藏状态。所谓“返魂”，是指延续死气而使其发生变化。水火随处都有生机，钻木可以取火，击石可以取火，圆珠可以取火，方诸（古代取露器）可以取水，掘地也可以取水。如果金死了就无法救治，土死了无法救治，木死了无法救治，因此在五行之中，唯独重视水火，而它们生克的奥妙作用，又源于先天的根本。
世人都说水克火，唯独赵氏说水养火。世人都说金生水，唯独赵氏说水生金。世人都说土克水，而赵氏独自在水中补土。世人都说木克土，而赵氏却说升发木气以培补土。像这样的理论，颠倒违背常规，谁会相信呢？殊不知君火（心火）与相火（命门火）以肾为宫室。所谓水克火，指的是后天有形的水火。所谓水养火，指的是先天无形的水火。海中的金，尚未脱离沙土，未经过锻炼，不畏火，也不克木，这是黄钟律管的根本。人的声音出自肺金，清浊轻重，都与丹田有关，如果不探求本源，只在肺上做工夫，那是舍本逐末。现在谈论补肺的，用人参、黄芪；清肺的，用黄芩、麦冬；敛肺的，用五味子、诃子；泻肺的，用葶苈子、桑白皮。病情轻浅的，难道没有一点疗效吗？但如果本源亏损，就毫不相干了。大概肺金之气，夜间卧睡时回归藏纳于肾水之中，道家称之为母藏子宫，子隐母胎。这一脏器名为娇脏，畏热畏寒。如果肾中有火，则金畏惧火刑，不敢回归；如果肾中无火，则水冷金寒，也不敢回归。结果导致气喘胀满，或者咳嗽呃逆，或者失眠，或者食欲不振，如同丧家之狗。在这个时候，如果想通过补土母来益子（肺），喘胀会更加严重；如果用清热泻火的方法，肺气日渐消损，死亡期就近了。只有收敛的方法，看起来似乎有理，但如果不得其门而入，从何着手？《仁斋直指方》说：肺主呼气，肾主纳气。肺为气之主，肾为气之本。凡是咳嗽突然加重，牵动全身筋骨，自觉气从脐下逆冲而上者，这是肾虚不能纳气归元。不要只在肺上做工夫，或者壮水之主（滋补肾阴），或者益火之原（温补肾阳），火便在水中产生了。至于土，从火寄生，就应当随火而补。然而补火有极其精妙的道理，阳明胃土，随着少阴心火而生，所以补胃土要补心火，而归脾汤一方，又从火之外家（肝木生心火，故补肝以助心）进行增益补益，使得木生火，火生土。太阴脾土随着少阳相火而生，所以补脾土要补相火，而八味丸一方，结合水火既济的原理来蒸腐运化食物，这是至理。人们所不知道的，大概是混沌之初，只有一气罢了，何曾有土？自从天一生水，水凝聚的地方才形成土，这是后天卦象中，艮土居于坎水之位，是水之次级产物。其中坚硬的是石头，而最神圣的是金，可见水、土、金，源自先天的同一根源。又有补子的义理，肺是土之子，先补其子，就像吃子而不食母之乳，母亲也不会衰败，这也体现了金生土的道理。又有化生的奥妙，不可不知，甲木与戊土所畏惧的，是其所胜者，不得已将自己的妹妹嫁给它，配为夫妇，这就是甲己合化土。凡是用药物化生，以龙为主（指具有灵动变化之性的药物或药对）。其间遇到龙则化，不遇到龙则不化，张仲景创立建中汤，用以建立脾土。木曰曲直，曲直产生酸味，芍药味酸，属于甲木；土曰稼穑，稼穑产生甘味，甘草味甘，属于己土，酸甘相合，甲己化土。又如肉桂，桂属于龙火，用来辅助其化生。张仲景立方的奥妙大抵如此。这又体现了木生土的道理，因为土在上无固定位置，旺于四季，四季都有生理活动，所以提及于此。至于木之所以被提及，是因为它克土。举世都想砍伐它，赵氏认为木依靠土生长，哪有反而克制的道理？只是因为木郁结在下部，所以它的根向下克制。木气，乃是主宰生发的阳气，始于东方，何不观察执政者，首先重视农事，先祭祀芒神。芒神就是木气，也就是春升之气，阳气，元气，胃气，名称不同但本质相同。栽培树木，雨水滋润它，风散播它，阳光温暖它，让它得以遂其发生长养的天性罢了。等到发育长久，生意已竭，又应当收敛其主生之气，而归于水土之中，作为来年春季生发的根本，这是天地春生冬藏的意义，哪里有砍伐的道理？李东垣在《脾胃论》中，使用升麻、柴胡来疏泄木气，讲得非常详细。申明五行的奥妙作用，唯独重视水火罢了。
The *Classic* (Huangdi Neijing) states: What is the name for a state of balance? Wood is called "Fuhe" (Spreading Harmony), Fire is called "Shengming" (Ascending Brightness), Earth is called "Beihua" (Complete Transformation), Metal is called "Shenxia" (Judicious Submission), and Water is called "Jingshun" (Quiet Obedience). What happens when there is insufficiency (Buji)? Wood is called "Weihe" (Lax Harmony), Fire is called "Fuming" (Hidden Brightness), Earth is called "Beijian" (Low Supervision), Metal is called "Congge" (Following Change), and Water is called "Helou" (Dried-up Stream). What constitutes excess (Taiguo)? Wood is called "Fasheng" (Vigorous Growth), Fire is called "Hexi" (Blazing Heat), Earth is called "Dunfu" (Mounded Mound), Metal is called "Jiancheng" (Solid Formation), and Water is called "Liuyan" (Overflowing Flow). If virtue is not constant (relying on oneself to encroach upon other positions), then the conquered element will retaliate (the conquered must come to take revenge). If governance remains consistent with its principles, then the conquered element will transform in harmony (if one does not arbitrarily exert power, and governance is harmonious and constant, then both the conqueror and the conquered will share in the same transformative governance. From this perspective, the Way of Medicine shares commonalities with the Way of Governance).
By matching Wood, Fire, Earth, Metal, and Water to the Heart, Liver, Spleen, Lung, and Kidney respectively, their mutual generation and restriction are well known. Various texts claim that among the Five Elements, only one is unique, specifically Fire having two aspects. This statement is plausible but incorrect. When discussing the Five Elements, each has two aspects; why single out Fire? If discussing the ultimate reality, each of the Five Elements has five variations, totaling twenty-five (5x5). Each Element possesses a Taiji (Supreme Ultimate), which is how changes are accomplished and spiritual transformations occur. Now, speaking of Yin and Yang life and death within the Five Elements: Wood includes Jia Wood (Yang) and Yi Wood (Yin). In the human body, the Gallbladder belongs to Jia Wood and corresponds to the Foot Shaoyang channel; the Liver belongs to Yi Wood and corresponds to the Foot Jueyin channel. Jia Wood is born at Hai and dies at Wu; Yi Wood is born at Wu and dies at Hai. Fire includes Bing Fire (Yang) and Ding Fire (Yin). The Ministerial Fire (Sanjiao Fire) in the body belongs to the Hand Shaoyang channel, while Heart Fire belongs to the Hand Shaoyin channel. Bing Fire is born at Yin and dies at You; Ding Fire is born at You and dies at Yin. Water includes Ren Water (Yang) and Gui Water (Yin). Kidney Water in the body belongs to the Foot Shaoyin channel, and the Bladder belongs to the Foot Taiyang channel. Ren Water is born at Shen and dies at Mao; Gui Water is born at Mao and dies at Shen. Earth includes Wu Earth (Yang) and Ji Earth (Yin). Stomach Earth in the body belongs to the Foot Yangming channel, and Spleen Earth belongs to the Foot Taiyin channel. Wu Earth is born at Yin and dies at You; Ji Earth is born at You and dies at Yin. Metal includes Geng Metal (Yang) and Xin Metal (Yin). Lung Metal in the body belongs to the Hand Taiyin channel, and Large Intestine Metal belongs to the Yangming channel. Geng Metal is born at Si and dies at Zi; Xin Metal is born at Zi and dies at Si. To observe pathological conditions, one should focus on the birth, prosperity, rest, and imprisonment of time and day elements to verify their Yin-Yang attributes. For example, if Gallbladder Fire is prosperous, it is prosperous at Yin and Mao hours and weak at Wu and Wei hours; if Liver Fire is prosperous, it is peak at Wu and Wei hours and weak at Hai and Zi hours. The Five Elements can be inferred by analogy.
Only Earth and Metal parasitize according to their mother (Fire); therefore, those wishing to tonify Earth and Metal should tonify their mother from the point of parasitization. Thus, Li Dongyuan proposed the "Treatment Separated by Two" (Ge Er Zhi), which acts through the mother organ. There is also the "Treatment Separated by Three" (Ge San Zhi), which acts through the mother's external family (the mother's parents). Because Earth and Metal rely solely on parasitization, their "death" is true death. Only Water and Fire are born from the true source, so their "death" is not true death; they find life in despair. "Returning to the Storehouse" refers to cutting off vital energy and entering storage. "Returning the Soul" refers to continuing dead energy and transforming it. Water and Fire have vitality everywhere; fire can be obtained by drilling wood, striking stone, or using a pearl; water can be collected using Fangzhu (ancient dew collector) or by digging into the earth. If Metal dies, it cannot be saved; if Earth dies, it cannot be saved; if Wood dies, it cannot be saved. Therefore, among the Five Elements, Water and Fire are uniquely emphasized, and their subtle functions of generation and restriction stem from the congenital root.
People generally say Water restricts Fire, but Zhao Shi alone says Water nourishes Fire. People generally say Metal generates Water, but Zhao Shi alone says Water generates Metal. People generally say Earth restricts Water, but Zhao Shi alone supplements Earth within Water. People generally say Wood restricts Earth, but Zhao Shi alone says ascending Wood qi tonifies Earth. Such theories seem to reverse conventions; who would believe them? Yet, they do not realize that Sovereign Fire (Heart Fire) and Ministerial Fire (Mingmen Fire) use the Kidney as their palace. "Water restricts Fire" refers to postnatal, tangible Water and Fire. "Water nourishes Fire" refers to prenatal, intangible Water and Fire. Gold in the sea, not yet separated from sand and soil, unrefined, fears no fire, and restricts no wood; this is the fundamental basis of the Huangzhong pitch pipe. Human voice originates from Lung Metal; its clarity, turbidity, lightness, and heaviness are related to the Dantian. Not seeking the origin but merely working on the Lung is focusing on the branch rather than the root. Currently, those discussing Lung tonification use Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi); Lung clearing uses Scutellariae Radix (Huangqin) and Ophiopogonis Radix (Maidong); Lung astringing uses Schisandrae Fructus (Wuweizi) and Terminalia Chebulae Fructus (Hezi); Lung purging uses Thladianthae Fructus (Tinglizi) and Morus Cortex (Sangbaipi). For mild diseases, is there no effect? However, if the root source is deficient, it is irrelevant. Generally, Lung Metal Qi returns to Kidney Water during sleep, which Daoists call "Mother hides in the子宫 (uterus), Son hides in Mother's womb." This organ is called the Delicate Organ, fearing heat and cold. If there is Fire in the Kidney, Metal fears Fire punishment and dares not return; if there is no Fire in the Kidney, Water becomes cold and Metal becomes cold, and it dares not return. This results in wheezing and distension, or coughing and hiccups, or insomnia, or anorexia, like a dog without a home. At this time, attempting to tonify the Earth Mother to benefit the Child (Lung) will worsen wheezing and distension; clearing or purging will cause Lung Qi to diminish daily, approaching death. Only astringents seem reasonable, but without finding the door, how to enter? *Ren Zhai Zhi Zhi Fang* states: The Lung exudes Qi, the Kidney receives Qi. The Lung is the master of Qi, the Kidney is the root of Qi. Whenever coughing suddenly worsens, moving the whole body, with a sensation of Qi rushing upward from below the navel, this is Kidney deficiency failing to receive Qi and return it to the Yuan (Source). Do not merely work on the Lung; either strengthen the Master of Water (nourish Kidney Yin) or benefit the Origin of Fire (warm Kidney Yang), and Fire will generate within Water. As for Earth, it parasitizes from Fire, so it should be supplemented following Fire. However, supplementing Fire has profound principles. Yangming Stomach Earth is generated along with Shaoyin Heart Fire; thus, to tonify Stomach Earth, one tonifies Heart Fire. The Guipi Decoction (Guipi Tang) further supplements from the Fire's external family (Liver Wood generates Heart Fire, so tonifying Liver aids Heart), causing Wood to generate Fire and Fire to generate Earth. Taiyin Spleen Earth is generated along with Shaoyang Ministerial Fire; thus, to tonify Spleen Earth, one tonifies Ministerial Fire. The Bawei Wan (Eight-Ingredient Pill) combines Water and Fire achieving mutual interaction to steam and rot food, which is the supreme principle. What people do not know is that in the beginning of chaos, there was only One Qi; where was Earth? Since Heaven generates One Water, Earth forms where Water condenses. In the postnatal trigrams, Gen Earth resides in Kan Water position, being secondary to Water. The solid part is Stone, and the most sacred is Metal; thus, Water, Earth, and Metal share a congenital origin. There is also the meaning of tonifying the child: Lung is the child of Earth. Tonifying the child first is like eating the child's food instead of the mother's milk; the mother will not decline, illustrating Metal generating Earth. There is also the wonder of transformation to be aware of: Jia Wood and Wu Earth fear what they overcome. Reluctantly, the elder sister is married to her, forming a couple; this is Jia-Ji transforming into Earth. Transformations are primarily led by Dragon (referring to dynamic medicinal properties or pairs). Where Dragon meets, transformation occurs; where it does not meet, it does not transform. Zhang Zhongjing established Jianzhong Decoction (Jianzhong Tang) to establish Spleen Earth. Wood is described as "Quzhi" (Bending and Straightening), producing Sour flavor; Paeoniae Radix Alba (Shaoyao) is sour and belongs to Jia Wood. Earth is described as "Jiashe" (Sowing and Reaping), producing Sweet flavor; Glycyrrhizae Radix (Gancao) is sweet and belongs to Ji Earth. Sour and Sweet combine, and Jia-Ji transforms into Earth. Similarly, Cinnamomi Cortex (Rougui) belongs to Dragon Fire, assisting transformation. The subtlety of Zhang Zhongjing's prescriptions is like this. This also reveals the meaning of Wood generating Earth. Earth has no fixed position above, prospering in the Four Seasons, where all seasons have physiological activity, hence mentioned here. Regarding Wood, it is mentioned because it restricts Earth. The world wants to cut it down, but Zhao Shi believes Wood relies on Earth for growth; how can it restrict it in reverse? It is only because Wood is depressed below that its roots restrict downward. Wood Qi is the Qi of main generation, starting in the East. Why not observe rulers who prioritize agriculture and first sacrifice to Mangshen (God of Agriculture)? Mangshen is Wood Qi, which is Spring Ascending Qi, Yang Qi, Yuan Qi, and Stomach Qi; they are different names but the same essence. Cultivating trees involves rain moistening them, wind dispersing them, and sun warming them, allowing them to fulfill their natural growth. When development is prolonged and vitality exhausted, one should converge the generating Qi and return it to Water and Earth to serve as the root for next spring's generation. This is the meaning of Heaven and Earth's Spring Generation and Winter Storage; where is the logic in cutting it down? Li Dongyuan, in his *Pi Wei Lun* (Treatise on the Spleen and Stomach), uses Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) to vent Wood Qi, explaining in detail. Clarifying the subtle functions of the Five Elements focuses solely on Water and Fire.