41.少阴司天热下临, 肺气上从病肺心, 燥行于地肝应病, 燥热交加
民病生, 喘咳血溢及血泻, 寒热鼽嚏涕流频, 疮疡目赤嗌干肿, 厥心
胁痛苦呻吟.
【注】上文统论主运、主气为病, 此则详言六气客气专主之病也. 少
阴君火司天, 子午岁也. 火气下临金之所畏, 故肺气上从而病肺心也
.凡少阴司天, 则阳明燥金在泉, 故燥行于地而病肝也. 是则知燥热
交加, 民病喘咳, 血上溢, 血下泄, 寒热, 塞鼽, 喷嚏, 流涕, 疮疡
,目赤, 嗌干, 肿痛, 心痛, 胁痛, 皆其证也.
42.太阴司天湿下临, 肾气上从病肾阴, 寒行于地心脾病, 寒湿交攻
内外淫, 民病身重足跗肿, 霍乱痞满腹胀??, 肢厥拘急脚下痛, 少腹
腰疼转动钝.
【注】太阴湿土司天, 丑未岁也. 湿气下临水之所畏, 故肾气上从而
病肾阴也. 凡太阴司天, 则太阳寒水在泉, 故寒行于地而病心脾也.
是知寒湿内外交攻, 民病身重, 足跗肿, 霍乱, 痞满, 腹胀, 四肢厥
逆拘急, 脚下痛, 少腹痛, 腰痛难于动转, 皆其证也.
43.少阳司天火下临, 肺气上从火刑金, 风行于地肝木胜, 风火为灾
是乃因, 民病热中咳失血, 目赤喉痹聋眩瞑, 疮疡心痛?? 瘛冒, 暴
死皆因臣犯君.
【注】少阳相火、司天, 寅申岁也. 火气下临金之所畏, 故肺气上从
而病肺也. 凡少阳司天, 则厥阴风木在泉, 故风行于地, 木胜则病在
肝.是则知风火为灾, 民病热中, 咳而失血, 目赤, 喉痹, 耳聋眩瞑
,疮疡, 心痛,?? 动, 瘛瘲, 昏冒, 皆其证也. 暴死者, 是三之客气
,相火加临君火, 以臣犯君故也.
44.阳明司天燥下临, 肝气上从病肝筋, 热行于地心肺害, 清燥风热
互交侵, 民病寒热咳膹郁, 掉振筋痿力难伸, 烦冤胁痛心热痛, 目痛
眦红小便绛.
【注】阳明燥金司天 , 卯酉岁也. 燥气下临木之所畏,故肝气上从而
病肝筋也. 凡阳明司天, 则少阴君火在泉, 故热行于地而病肺心也.
是则知清燥风热交侵, 民病寒热而咳, 胸郁膹满, 掉摇振动, 筋痿无
力,烦冤抑郁不伸, 两胁心中热痛, 目痛眦红, 小便绛色, 皆其证也
.
45.太阳司天寒下临, 心气上从病脉心, 湿行于地脾肉病, 寒湿热内
去推寻, 民病寒中终反热, 痈疽火郁病缠身, 皮?? 肉苛足痿软, 濡
泻满肿乃湿根.
【注】太阳寒水司天, 辰戌岁也. 寒气下临火之所畏, 故心气上从而
病心脉也. 凡太阳司天, 则太阴湿土在泉, 故湿行于地而病脾肉也.
是则知寒湿热气相合, 民病始为寒中终反变热, 如廱疽一切火郁之病
,皮?? 痹而重着, 肉苛不用不仁, 足痿无力, 湿泻腹满身肿, 皆其
证也.
46.厥阴司天风下临, 脾气上从脾病生, 火行于地冬温化, 风火寒湿
为病民, 耳鸣掉眩风化病, 支满肠鸣飧泻频, 体重食减肌肉痿, 温厉
为灾火化淫.
【注】厥阴风木司天、 巳亥岁也. 风气下临土之所畏,故脾气上从而
病脾也. 凡厥阴司天, 则少阳相火在泉, 故火行于地而病温也. 是则
知风火寒湿杂揉, 民病耳聋, 振掉, 眩晕, 腹满, 肠鸣, 完谷不化之
泻,体重食减, 肌肉痿瘦, 皆其证也.
41. 少阴君火司天，热气下行克制肺金，肺气上逆从之而致肺心病变；阳明燥金在泉，燥气流行于地，肝木受邪而发病。燥热二气交加，百姓易患疾病，表现为气喘咳嗽、吐血及便血，寒热往来、鼻塞喷嚏、流涕频繁，疮疡、眼睛发红、咽喉干燥肿痛，手足厥冷、心胸胁肋疼痛并痛苦呻吟。
【注】上文总论主运、主气致病，此处详细论述六气中客气专主之病。少阴君火司天，对应子年和午年。火气下行，是肺金所畏惧的，所以肺气上逆而从火化，导致肺心病变。凡是少阴君火司天，则阳明燥金在泉，所以燥气流行于地而伤肝。由此可知，燥热交加，百姓患病如气喘咳嗽，血从上溢或从下泄，寒热，鼻塞，喷嚏，流涕，疮疡，目赤，咽喉干痛，心痛，胁痛，都是其证候。
42. 太阴湿土司天，湿气下行克制肾水，肾气上逆从之而致肾阴病变；太阳寒水在泉，寒气流行于地，心脾受邪而发病。寒湿二气内外交攻，淫邪肆虐，百姓易患身体沉重、足背浮肿，霍乱、痞满、腹胀，四肢厥冷拘急、脚底疼痛，小腹及腰部疼痛且转动迟钝困难。
【注】太阴湿土司天，对应丑年和未年。湿气下行，是肾水所畏惧的，所以肾气上逆而从湿化，导致肾阴病变。凡是太阴湿土司天，则太阳寒水在泉，所以寒气流行于地而伤心脾。由此可知，寒湿内外交攻，百姓患病如身体沉重，足背浮肿，霍乱，痞满，腹胀，四肢厥冷拘急，脚下痛，小腹痛，腰痛难以转侧，都是其证候。
43. 少阳相火司天，热气下行克制肺金，肺气上逆从之而致火克金的病变；厥阴风木在泉，风气流行于地，肝木偏胜。风火为灾，这是其原因。百姓易患内热、咳嗽、咯血，眼睛发红、喉痹、耳聋、眩晕昏花，疮疡、心痛、抽搐、昏冒，突然死亡皆因臣（相火）犯君（君火）。
【注】少阳相火司天，对应寅年和申年。火气下行，是肺金所畏惧的，所以肺气上逆而从火化，导致肺病。凡是少阳相火司天，则厥阴风木在泉，所以风气流行于地，木气偏胜则病在肝。由此可知，风火为灾，百姓患病如内热，咳嗽而失血，目赤，喉痹，耳聋眩晕，疮疡，心痛，抽搐，瘛疭，昏冒，都是其证候。突然死亡的，是因为三之气客气，相火加临于君火之上，以臣犯君的缘故。
44. 阳明燥金司天，燥气下行克制肝木，肝气上逆从之而致肝筋病变；少阴君火在泉，热气流行于地，心肺受邪而受害。清燥与风热互相交侵，百姓易患寒热、咳嗽、胸膈郁满，肢体抖动震颤、筋脉痿软无力难伸展，烦闷抑郁、两胁心中热痛，眼睛疼痛、眼角发红、小便深红。
【注】阳明燥金司天，对应卯年和酉年。燥气下行，是肝木所畏惧的，所以肝气上逆而从燥化，导致肝筋病变。凡是阳明燥金司天，则少阴君火在泉，所以热气流行于地而伤肺心。由此可知，清燥风热交侵，百姓患病如寒热而咳，胸膈郁满，肢体抖动振动，筋痿无力，烦闷抑郁不伸，两胁心中热痛，目痛眦红，小便绛色，都是其证候。
45. 太阳寒水司天，寒气下行克制心火，心气上逆从之而致心脉病变；太阴湿土在泉，湿气流行于地，脾肉受邪而发病。寒湿热三气内在推求寻究，百姓易患始为寒中终反变热，痈疽等火郁之病缠绕全身，皮肤麻木不仁、肌肉顽厚、足部痿软无力，濡泻、腹满身肿乃是湿邪之根。
【注】太阳寒水司天，对应辰年和戌年。寒气下行，是心火所畏惧的，所以心气上逆而从寒化，导致心脉病变。凡是太阳寒水司天，则太阴湿土在泉，所以湿气流行于地而伤脾肉。由此可知，寒湿热气相合，百姓患病开始为寒中，最终反变为热，如痈疽一切火郁之病，皮肤痹阻而重着，肌肉顽厚不用不仁，足痿无力，湿泻腹满身肿，都是其证候。
46. 厥阴风木司天，风气下行克制脾土，脾气上逆从之而致脾病发生；少阳相火在泉，热气流行于地，冬季呈现温化之象。风火寒湿杂揉致病，百姓易患耳鸣、抖动、眩晕等风化之病，胁肋胀满、肠鸣、完谷不化的腹泻频繁，身体沉重、食欲减退、肌肉痿瘦，温热疫厉为灾，乃火气淫盛所致。
【注】厥阴风木司天，对应巳年和亥年。风气下行，是脾土所畏惧的，所以脾气上逆而从风化，导致脾病。凡是厥阴风木司天，则少阳相火在泉，所以热气流行于地而致温病。由此可知，风火寒湿杂揉，百姓患病如耳聋，振掉，眩晕，腹满，肠鸣，完谷不化之泻，体重食减，肌肉痿瘦，都是其证候。
41. When Shaoyin (Ministerial Fire) governs the year, heat descends to suppress Metal; Lung Qi ascends in compliance, leading to pathology of the Lung and Heart. Yangming (Dryness-Metal) is below, Dryness circulates on the earth, affecting the Liver. The combination of Dryness and Heat causes the people to suffer from wheezing and coughing, hematemesis and hematochezia, alternating chills and fever, nasal congestion, sneezing, frequent runny nose, sores and ulcers, red eyes, dry and swollen throat, cold extremities, and pain in the heart and hypochondrium accompanied by groaning.
[Note] The preceding text generally discusses diseases caused by the Main Movement and Main Qi; this section details diseases specifically governed by the Guest Qi of the Six Qi. When Shaoyin Junhuo (Monarchial Fire) governs the year, it corresponds to the Zi and Wu years. Fire qi descends, which is feared by Metal, so Lung Qi ascends and transforms with Fire, causing Lung and Heart pathology. Whenever Shaoyin Junhuo governs the year, Yangming Zaojin (Dryness-Metal) is below, so Dryness circulates on the earth and affects the Liver. Thus, it is known that the combination of Dryness and Heat causes the people to suffer from wheezing and coughing, bleeding from above or below, chills and fever, nasal congestion, sneezing, runny nose, sores and ulcers, red eyes, dry and painful throat, heart pain, and hypochondriac pain, all of which are its manifestations.
42. When Taiyin (Damp-Earth) governs the year, dampness descends to suppress Water; Kidney Qi ascends in compliance, leading to pathology of Kidney Yin. Taiyang (Cold-Water) is below, Cold circulates on the earth, affecting the Heart and Spleen. The attack of Cold and Dampness internally and externally causes the people to suffer from heavy body, edema of the dorsum of the foot, cholera-like disorder, fullness and distension, cold extremities with spasms, pain at the sole of the foot, and pain in the lower abdomen and lumbar region with difficulty in turning.
[Note] Taiyin Shitu (Damp-Earth) governs the year, corresponding to the Chou and Wei years. Dampness descends, which is feared by Water, so Kidney Qi ascends and transforms with Dampness, causing Kidney Yin pathology. Whenever Taiyin Shitu governs the year, Taiyang Han shui (Cold-Water) is below, so Cold circulates on the earth and affects the Heart and Spleen. Thus, it is known that the internal and external attack of Cold and Dampness causes the people to suffer from heavy body, edema of the dorsum of the foot, cholera-like disorder, fullness and distension, cold extremities with spasms, pain at the sole of the foot, lower abdominal pain, and lumbar pain with difficulty in movement, all of which are its manifestations.
43. When Shaoyang (Ministerial Fire) governs the year, fire descends to suppress Metal; Lung Qi ascends in compliance, leading to Fire insulting Metal pathology. Jueyin (Wind-Wood) is below, Wind circulates on the earth, and Wood prevails. Disaster caused by Wind and Fire is the cause. The people suffer from interior heat, cough, hemoptysis, red eyes, pharyngolaryngeal obstruction, deafness, dizziness, and blurred vision, sores and ulcers, heart pain, twitching, and fainting. Sudden death occurs because the Minister (Fire) insults the Monarch (Fire).
[Note] Shaoyang Xianghuo (Ministerial Fire) governs the year, corresponding to the Yin and Shen years. Fire descends, which is feared by Metal, so Lung Qi ascends and transforms with Fire, causing Lung pathology. Whenever Shaoyang Xianghuo governs the year, Jueyin Fengmu (Wind-Wood) is below, so Wind circulates on the earth, and when Wood prevails, the disease is in the Liver. Thus, it is known that disaster caused by Wind and Fire makes the people suffer from interior heat, cough with blood loss, red eyes, pharyngolaryngeal obstruction, deafness and dizziness, sores and ulcers, heart pain, twitching, convulsions, and fainting, all of which are its manifestations. Sudden death is due to the Guest Qi of the Third Qi, where Ministerial Fire overlays Monarchial Fire, insulting the Monarch.
44. When Yangming (Dryness-Metal) governs the year, dryness descends to suppress Wood; Liver Qi ascends in compliance, leading to pathology of Liver Sinews. Shaoyin (Monarchial Fire) is below, Heat circulates on the earth, harming the Lung and Heart. Clear Dryness and Wind-Heat mutually invade. The people suffer from chills and fever, cough, chest oppression and fullness, tremors and shaking, flaccidity of sinews with inability to extend, vexation and depression, heat and pain in the hypochondrium and heart, eye pain, red canthi, and dark red urine.
[Note] Yangming Zaojin (Dryness-Metal) governs the year, corresponding to the Mao and You years. Dryness descends, which is feared by Wood, so Liver Qi ascends and transforms with Dryness, causing Liver Sinew pathology. Whenever Yangming Zaojin governs the year, Shaoyin Junhuo (Monarchial Fire) is below, so Heat circulates on the earth and affects the Lung and Heart. Thus, it is known that the mutual invasion of Clear Dryness and Wind-Heat causes the people to suffer from chills and fever with cough, chest oppression and fullness, tremors and shaking, flaccidity of sinews with weakness, vexation and depression, heat and pain in the hypochondrium and heart, eye pain and red canthi, and dark red urine, all of which are its manifestations.
45. When Taiyang (Cold-Water) governs the year, cold descends to suppress Fire; Heart Qi ascends in compliance, leading to pathology of Heart Vessels. Taiyin (Damp-Earth) is below, Dampness circulates on the earth, affecting Spleen Flesh. Investigating internally, the combination of Cold, Dampness, and Heat causes the people to suffer initially from interior cold which eventually turns into heat, such as carbuncles and sores caused by Fire stagnation wrapping around the body, skin numbness and heaviness, muscle induration and insensitivity, leg flaccidity and weakness, damp diarrhea, abdominal fullness, and swelling, which stem from Dampness.
[Note] Taiyang Hanshui (Cold-Water) governs the year, corresponding to the Chen and Xu years. Cold descends, which is feared by Fire, so Heart Qi ascends and transforms with Cold, causing Heart Vessel pathology. Whenever Taiyang Hanshui governs the year, Taiyin Shitu (Damp-Earth) is below, so Dampness circulates on the earth and affects Spleen Flesh. Thus, it is known that the combination of Cold, Dampness, and Heat causes the people to suffer initially from interior cold which eventually turns into heat, such as carbuncles and sores of all Fire stagnation diseases, skin bi-syndrome with heaviness, muscle induration with lack of sensation, leg flaccidity and weakness, damp diarrhea with abdominal fullness and swelling, all of which are its manifestations.
46. When Jueyin (Wind-Wood) governs the year, wind descends to suppress Earth; Spleen Qi ascends in compliance, leading to Spleen pathology. Shaoyang (Ministerial Fire) is below, Fire circulates on the earth, transforming winter into warmth. The mixture of Wind, Fire, Cold, and Dampness causes disease. The people suffer from tinnitus, tremors, dizziness, and other wind-induced pathologies, flank fullness, borborygmus, frequent diarrhea with undigested food, heavy body, reduced appetite, and muscle emaciation. Warm epidemics occur as disasters due to the excess of Fire transformation.
[Note] Jueyin Fengmu (Wind-Wood) governs the year, corresponding to the Si and Hai years. Wind descends, which is feared by Earth, so Spleen Qi ascends and transforms with Wind, causing Spleen pathology. Whenever Jueyin Fengmu governs the year, Shaoyang Xianghuo (Ministerial Fire) is below, so Fire circulates on the earth and causes warm diseases. Thus, it is known that the mixture of Wind, Fire, Cold, and Dampness causes the people to suffer from deafness, tremors, dizziness, abdominal fullness, borborygmus, diarrhea with undigested food, heavy body, reduced appetite, and muscle emaciation, all of which are its manifestations.