寒温疫，多起于冬不藏精，及辛苦饥饿之人。盖冬不藏精，则邪能深入，而辛苦之人，其身常暖，其衣常薄，暖时窍开，
薄时忍寒，兼以饥饿劳倦，致伤中气，则寒邪易入，待春而发，此所以大荒之后，必有大疫，正为此也。但此辈疫气既
盛，势必传染，又必于虚者先受其气，则有不必冬寒而病者矣。避之之法，必节欲节劳，仍勿忍饥而近其气，自可无虑。）
春伤于风，夏生飧泄；（春伤于风，木气通于肝胆，即病者乃为外感，若不即病而留连于夏，脾土当令，木邪相侮，变为
飧泄也。飧音孙，完谷而泄也。）夏伤于暑，秋必 疟；（夏伤于暑，金气受邪，即病者乃为暑证，若不即病而暑汗不出，
延至于秋，新凉外束，邪郁成热，金火相拒，寒热交争，故病为 疟。 音皆。）秋伤于湿，冬生咳嗽。（夏秋之交，土
金用事，秋伤于湿，其即病者，湿气通脾，故为濡泄等证，若不即病，而湿蓄金藏，久之变热，至冬则外寒内热，相搏
乘肺，病为咳嗽。生气通天论亦云∶秋伤于湿，上逆而咳。按此四节，春夏以木火伤人而病反寒，秋冬以寒湿伤人而病
反热，是即上文重阴必阳、重阳必阴之义。）故曰∶天地者，万物之上下也；（天覆物，故在上。地载物，故在下。五运
寒温疫病，多因冬季未能固藏精气，以及过度劳累、饥饿的人群所引发。因为冬季不藏精，邪气便能深入体内；而辛苦劳作之人，身体常感温暖，衣着单薄，在温暖时腠理（汗孔）开泄，在寒冷时又强忍受寒，再加上饥饿和疲劳损伤了中焦脾胃之气，导致寒邪容易侵入，潜伏至春季发作，这就是为什么大荒灾年之后必然伴随大瘟疫的原因。但是，这类疫气既然已经盛行，势必会相互传染，且必定先侵袭那些正气虚弱的人，因此就会出现并非因冬季严寒而发病的情况。预防的方法，必须节制房事和劳倦，不要强忍饥饿并远离疫气，自然就可以没有忧虑了。）春天伤于风邪，夏天就会发生完谷不化的泄泻；（春天伤于风邪，木气与肝胆相通，如果立即发病就是外感病；如果不立即发病而拖延到夏季，此时脾土当令，木邪反侮脾土，从而变为飧泄。飧音孙，指大便中含有未消化的食物残渣而泄泻。）夏天伤于暑邪，秋天必定发生疟疾；（夏天伤于暑邪，金气受邪，如果立即发病就是暑证；如果不立即发病且暑天出汗不畅，拖延到秋季，新凉之邪从外部束缚肌表，邪气郁结化热，金与火相互抗拒，寒热交争，所以病发为疟疾。疟音皆。）秋天伤于湿邪，冬天就会发生咳嗽。（夏秋之交，土气和金气主事，秋天伤于湿邪，如果立即发病，湿气通于脾，所以会出现濡泄等证候；如果不立即发病，而湿气蓄积于肺脏，久而久之化热，到了冬天则外有寒邪内有热邪，相互搏结侵犯肺脏，病发为咳嗽。《生气通天论》也说：秋天伤于湿邪，气机上逆而咳嗽。按这四段经文，春夏季节以木火伤人而病症反而表现为寒，秋冬季节以寒湿伤人而病症反而表现为热，这正是上文“重阴必阳、重阳必阴”的道理。）所以说：天和地，是万物的上下方位；（天覆盖万物，所以在上。大地承载万物，所以在下。五运
Cold, warm, and epidemic diseases often originate from the failure to conserve essence during winter, as well as in individuals who are overworked or hungry. This is because failing to conserve essence in winter allows pathogenic factors to penetrate deeply; meanwhile, those engaged in arduous labor often feel warm and wear thin clothing. When warm, their pores (sweat apertures) open; when cold, they endure the chill. Combined with hunger and fatigue damaging the Middle Jiao (Middle Burner, primarily referring to the Spleen and Stomach) Qi, cold pathogens easily invade. They may lie dormant until spring to manifest, which explains why major epidemics inevitably follow years of great famine. However, once such epidemic Qi becomes prevalent, it will inevitably spread contagiously, and it must first affect those who are deficient in Zheng Qi (Upright Qi). Thus, illness can occur without the necessity of severe winter cold. The method of prevention requires regulating sexual activity and avoiding overexertion, not enduring hunger, and staying away from the source of the epidemic Qi, thereby ensuring peace of mind.) If Wind is injured in Spring, Diarrhea with undigested food (Sun Xie) will arise in Summer; (Injury by Wind in Spring involves Wood Qi communicating with the Liver and Gallbladder. If disease manifests immediately, it is an External Contraction. If it does not manifest immediately but lingers into Summer, when Earth Qi governs, Wood Pathogen insults Earth, transforming into Sun Xie. "Sun" refers to diarrhea containing undigested food remnants.) If Heat is injured in Summer, Malaria (Nue) will definitely occur in Autumn; (Injury by Heat in Summer affects Metal Qi. If disease manifests immediately, it is a Heat Syndrome. If it does not manifest immediately and sweat does not discharge freely during summer heat, lingering into Autumn, new coolness binds externally, causing pathogenic factors to stagnate and transform into heat. Metal and Fire resist each other, leading to alternating chills and fever, thus resulting in Malaria. "Nue" is pronounced "jie".) If Dampness is injured in Autumn, Cough will arise in Winter. (At the transition between Summer and Autumn, Earth and Metal Qi are active. Injury by Dampness in Autumn: if disease manifests immediately, Dampness communicates with the Spleen, resulting in conditions like Ru Xie (soft/watery diarrhea). If it does not manifest immediately, Dampness accumulates in the Lung storage, eventually transforming into heat over time. By Winter, external Cold and internal Heat struggle and attack the Lung, resulting in Cough. The *Su Wen: Sheng Qi Tong Tian Lun* also states: Injury by Dampness in Autumn causes Qi to rebel upward, leading to cough. Regarding these four sections: In Spring and Summer, Wood and Fire injure the body, yet the pathology manifests as Cold; in Autumn and Winter, Cold and Dampness injure the body, yet the pathology manifests as Heat. This illustrates the principle mentioned earlier: "Extreme Yin transforms into Yang, Extreme Yang transforms into Yin.") Therefore it is said: Heaven and Earth are the upper and lower positions of all things; (Heaven covers all things, hence it is above. Earth carries all things, hence it is below. The Five Movements...)