生生子曰∶按鼻鼽一症，今人患者甚多，考诸古方，鲜有言其病因者，惟运气曰∶火攻肺虚，鼻鼽。少
阴司天，热气下临，肺气上从，鼽衄鼻窒。又云∶少阴司天，热淫所胜，民病鼽衄嚏呕。又云∶少阳司天，
火淫所胜，甚则鼽衄。又岁金不及，炎火乃行，民病鼽嚏。又曰∶阳明所至为鼽嚏。据运气，皆以火热司
令为言，火克金，热伤肺，盖以鼻为肺之窍也。虽云少阴、少阳热火司令之年为病，然亦只是肠胃素有痰
火积热者，乃有此感也。不然，火热主令之岁，三年之内，曷常无之，未尝人人有此病也，吾故曰，必
肠胃素有痰火积热者，然后有此感也。何者？大肠，肺之府也，胃、五脏之所受气者也。《内经》曰∶“
九窍不利，肠胃之所生也。”鼻主无形者，经曰∶清气通于天，又曰∶鼻主天气。愚谓肠胃设无痰火积热
，则其平常上升之气，皆清气也，纵火令之年，何豫
耶？若夫肠胃素有痰火积热，则其平常上升之气，皆氲而为浊耳。金职司降，喜清而恶浊，今受浊气
熏蒸，凝聚既久，壅遏郁结，而为痰涕。至于痔珠、 肉之类，皆由积久，燥火内燔，风寒外束，隧
道壅塞，气血升降，被其妨碍，浇培弥浓，犹积土而成阜也。据运气云云，纯以火热司令之岁，火气
下临，肺气上从，乃成鼻鼽嚏衄之症，假令水湿司令之岁，必无鼻鼽嚏衄，而鼻鼽嚏衄之证，必待火
热司天之岁而能成耶？噫！如斯而谈，则凿矣。观仲景《伤寒论》，太阳症，当与麻黄汤，不与者，
必成鼻衄。又见今人，每每感风寒，随时鼻塞浊涕，及素有郁热者，微触风寒，即鼻塞嚏涕。或调理
失宜，积年累月，竟成鼻鼽、鼻渊者，往往有之。《内经》曰∶“胆移热于脑，则辛 鼻渊，”又曷尝必
待火热司令而后始致此病耶。愚故曰∶必肠胃素有痰火积热，又值火热当权之年，内外之火夹攻，于
此时有甚耳。或曰∶子以运气之言为不足征欤，何今之按天时，占岁候，与夫验丰旱，及诸星卜家，
动辄取应，吾恐后之吹毛者，将藉此以非子矣，子曷逃乎？予曰∶愚亦深知僭逾为非，而无所逃也，愚
又奚敢谓运气为不足征也，夫运气云者，指岁运火令当权，所不胜者受邪，是大略以理该之也，否则咳嗽
吐血肺痈等症，又何莫而
非火克金之候耶？愚之所谓肠胃痰火积热者，即病因也，于运气有所核而无相悖戾焉，知我者，其鉴诸。
生生子说：考察鼻鼽（鼻涕清稀不止）这一病症，如今患病的人非常多。查阅古代医方，很少有关于其病因的论述，只有五运六气学说中提到：“火邪攻伐肺虚，导致鼻鼽。”“少阴君天之时，热气下行，肺气上从，出现鼻流清涕、鼻出血及鼻塞。”又说：“少阴司天，热邪过盛，百姓患鼻流清涕、鼻出血、打喷嚏和呕吐。”又说：“少阳司天，火邪过盛，严重时出现鼻流清涕、鼻出血。”又说：“岁金不及，炎火盛行，百姓患鼻流清涕、打喷嚏。”又说：“阳明之气所至，表现为鼻流清涕、打喷嚏。”根据运气学说，都是以火热当令来解释，火克金，热伤肺，大概是因为鼻子是肺的窍道。虽然说是少阴、少阳热火当令之年发病，但也只是肠胃中原本就有痰火积热的人，才会受到这种感应。不然的话，在火热主令的年份，三年内难道没有这种情况吗？为什么不是每个人都得这个病呢？所以我所以说，一定是肠胃中原本就有痰火积热的人，然后才会有这种感应。为什么呢？大肠是肺的腑，胃是五脏受气的地方。《内经》说：“九窍不利，是由肠胃产生的。”鼻子主管无形之气，经书说：“清气通于天”，又说：“鼻子主管天气”。我认为如果肠胃中没有痰火积热，那么它平常上升的气都是清气，即使是在火令之年，又有什么干扰呢？如果肠胃中原本就有痰火积热，那么它平常上升的气，都变成浑浊之气了。金的职能是肃降，喜欢清而厌恶浊，现在受到浊气的熏蒸，凝聚久了，壅塞郁结，形成痰涕。至于痔珠、息肉之类，都是由积累日久，燥火在内焚烧，风寒在外束缚，隧道壅塞，气血升降受到妨碍，浇灌培育更加浓稠，就像堆积泥土而成山丘一样。根据运气学说的说法，纯粹以火热当令的年份，火气下行，肺气上从，才形成鼻鼽、打喷嚏、鼻出血的症状，假如是水湿当令的年份，一定不会有鼻鼽、打喷嚏、鼻出血，而鼻鼽、打喷嚏、鼻出血的症状，一定要等到火热司天的年份才能形成吗？唉！像这样谈论，就太穿凿附会了。看张仲景的《伤寒论》，太阳病证，应当用麻黄汤治疗，如果不给用，一定会导致鼻出血。又看到现在的人，常常感受风寒，随时出现鼻塞、浊涕，以及素有郁热的人，轻微触动风寒，就出现鼻塞、打喷嚏、流涕。或者调理不当，积年累月，竟然成为鼻鼽、鼻渊的，往往有这种情况。《内经》说：“胆移热于脑，则辛螫鼻渊”，这又何尝一定要等到火热当令之后才开始导致这个病呢。我所以说：一定是肠胃中原本就有痰火积热，又正值火热当权的年份，内外的火气夹攻，在这个时候病情加重罢了。有人说：你认为运气学说的言论不足以验证吗？为什么现在按照天时，占测岁候，以及验证丰歉干旱，还有各种星象占卜家，动不动就应验，我恐怕后来吹毛求疵的人，将借此来非难您，您怎么能逃避呢？我说：我也深知越权行事是不对的，但无法逃避。我又怎么敢说运气学说不足以验证呢？所谓运气，是指岁运火令当权，所不胜者受邪，这是大致以理来概括的，否则咳嗽、吐血、肺痈等症，又哪一桩不是火克金的征候呢？我所说的肠胃痰火积热，就是病因，这与运气学说有所核实而没有违背冲突，了解我的人，请明鉴吧。
Shengshengzi said: Regarding the syndrome of Biqiu (rhinorrhea with clear discharge), many people suffer from it nowadays. Examining ancient prescriptions, few mention its etiology. Only the theory of Five Movements and Six Qi states: "Fire attacking lung deficiency leads to Biqiu." When Shaoyin governs the year, heat descends, lung qi ascends in response, resulting in rhinorrhea, epistaxis, and nasal obstruction. It also states: "When Shaoyin governs, excessive heat causes the people to suffer from rhinorrhea, epistaxis, sneezing, and vomiting." Furthermore: "When Shaoyang governs, excessive fire causes severe rhinorrhea and epistaxis." Additionally: "When Metal is deficient, blazing fire prevails, causing the people to suffer from rhinorrhea and sneezing." It is also said: "The arrival of Yangming manifests as rhinorrhea and sneezing." According to the theory of Five Movements and Six Qi, all explanations attribute this to Fire and Heat governing. Fire overcomes Metal; Heat injures the Lung, likely because the nose is the orifice of the Lung. Although it is stated that these diseases occur in years governed by Shaoyin and Shaoyang Fire and Heat, it is merely those who already have phlegm-fire and accumulated heat in the intestines and stomach who are susceptible. Otherwise, in years where Fire and Heat govern, such conditions do not appear every year, nor does everyone contract this disease. Therefore, I say that only those with pre-existing phlegm-fire and accumulated heat in the intestines and stomach will be affected. Why? The Large Intestine is the Fu organ of the Lung, and the Stomach is where the Qi of the Zang organs is received. The *Neijing* states: "Dysfunction of the nine orifices arises from the intestines and stomach." The nose governs formless Qi; the classics state: "Clear Qi connects with Heaven," and "The nose governs Heavenly Qi." I believe that if there were no phlegm-fire and accumulated heat in the intestines and stomach, the ascending Qi would normally be clear. Even in a year of Fire governance, what interference would there be? However, if there is pre-existing phlegm-fire and accumulated heat in the intestines and stomach, the normally ascending Qi becomes turbid. The function of Metal is to descend; it prefers clarity and abhors turbidity. Now, subjected to the steaming of turbid Qi, after long accumulation, it becomes obstructed and stagnant, forming phlegm and nasal discharge. As for conditions like hemorrhoidal beads or polyps, they result from long-term accumulation, internal burning by dry-fire, external constriction by wind-cold, blockage of the passages, hindrance of the ascent and descent of Qi and Blood, leading to thickening, much like soil piling up to form a mound. According to the theory of Five Movements and Six Qi, purely in years where Fire governs, Fire descends, Lung Qi ascends, forming symptoms of Biqiu, sneezing, and epistaxis. If Water and Dampness were to govern, surely there would be no Biqiu, sneezing, or epistaxis. Must the syndrome of Biqiu, sneezing, and epistaxis wait for a year governed by Fire and Heat to manifest? Alas! To discuss it thus is overly pedantic. Looking at Zhang Zhongjing's *Treatise on Cold Damage*, in Taiyang syndromes, Mahuang Tang should be administered; if not given, epistaxis will inevitably occur. Moreover, observing contemporary cases, people often contract wind-cold, leading to nasal congestion and turbid discharge at any time. Those with pre-existing stagnant heat, upon slight exposure to wind-cold, immediately develop nasal congestion, sneezing, and discharge. Or, due to improper regulation, over years and months, one may eventually develop Biqiu or Biyuan (nasal sinusitis). This is common. The *Neijing* states: "If Gallbladder heat transfers to the brain, it causes stinging pain and Biyuan." How can this disease necessarily wait for Fire and Heat to govern before arising? Thus, I say: it is necessary to have pre-existing phlegm-fire and accumulated heat in the intestines and stomach, combined with a year where Fire and Heat are dominant, so that internal and external Fire attack simultaneously, exacerbating the condition at that time. Someone might ask: Do you consider the statements on Five Movements and Six Qi insufficient for verification? Why do practitioners now follow heavenly timing, predict annual climates, verify harvests and droughts, and why do astrologers frequently achieve accurate predictions? I fear future critics will use this to refute you. How can you escape this? I reply: I am well aware that overstepping my bounds is wrong, yet I cannot escape. Nor do I dare claim that the theory of Five Movements and Six Qi is unverified. What is meant by Five Movements and Six Qi is that when the annual movement of Fire governs, the element overcome by Fire suffers pathology; this is a generalization based on principle. Otherwise, how can coughing, hemoptysis, and lung abscess not all be manifestations of Fire overcoming Metal? My concept of phlegm-fire and accumulated heat in the intestines and stomach is the etiology itself. This aligns with and does not contradict the theory of Five Movements and Six Qi. Those who understand me, please discern this.