（《素问·五常政大论》）
帝曰∶其岁有不病，而脏气不应不用者何也？岐伯曰∶天气制之，气有所从也。（岁有不病不应不用者，谓岁运当病
而有不病及脏气当应当用而有不应不用者也。天气制之气有所从者，谓司天制之则从乎天气，故有不应乎岁者矣。制，
禁制也。）帝曰∶愿卒闻之。
岐伯曰∶少阳司天，火气下临，肺气上从，白起金用，草木眚，火见燔 ，革金且耗，大暑以行，咳嚏鼽衄，鼻窒
疮疡，寒热 肿。（少阳相火司天，寅申岁也。火气下临，金之所畏，故肺气上从。从者，应而动也。金动则白色起而金
为火用，故草木受眚。然火见燔 必革易金性，且至于耗，金曰从革，即此之谓。若其为病则咳嚏鼽衄，鼻塞疮疡，皆
火盛伤肺而然。金寒火热，金火相搏，则为寒热。肺主皮毛，邪热凑之，故为 肿。皆天气之所生也。燔音烦。 ，如
瑞切。嚏音帝。鼽音求。衄，女六切。窒音质。）风行于地，尘沙飞扬，心痛胃脘痛，厥逆膈不通，其主暴速。（凡少阳
司天，则厥阴在泉，故风行于地，尘沙飞扬也。风淫所胜，病在厥阴，厥阴之脉，挟胃属肝贯膈，故其为病如此。然至
疾者莫如风，故又主于暴速。皆地气之所生也。）
阳明司天，燥气下临，肝气上从，苍起木用而立，土乃眚，凄沧数至，木伐草萎，胁痛目赤，掉振鼓栗，筋痿不能
久立。（阳明燥金司天，卯酉岁也。燥气下临，木之所畏，故肝气应而上从。木应则苍色起，而木为金用，故土必受伤。
然金盛则凄沧数至，故木伐草萎而病在肝。肝经行于胁，故胁痛。肝窍在目，故目赤。肝主风，故掉振鼓栗。肝主筋，
故筋痿不能久立。皆天气之所生也。）暴热至，土乃暑，阳气郁发，小便变，寒热如疟，甚则心痛，火行于槁，流水不冰，
蛰虫乃见。（凡阳明司天，则少阴君火在泉，热行于地，故其应候如此。火在阴分，则寒热交争，故令如疟。火郁不伸，
故心痛。火就燥，故行于槁。槁，干枯也。皆地气之所生者。）太阳司天，寒气下临，心气上从，而火且明，丹起金乃眚，
寒清时举，胜则水冰，火气高明，心热烦，嗌干善渴，鼽嚏，喜悲数欠，热气妄行，寒乃复，霜不时降，善忘，甚则心
痛。（太阳寒水司天，辰戌岁也。寒气下临，火之所畏，故心气应而上从。火应则明而丹色起，故金乃眚。然水胜则为寒，
故其候若此。火应则动热，故其病若此。皆天气之所生也。）土乃润，水丰衍，寒客至，沉阴化，湿气变物，水饮内 ，
中满不食，皮 肉苛，筋脉不利，甚则 肿身后痈。（凡太阳司天，则太阴在泉，湿行于地，故其为候为病如此。 ，痹
而重也。肉苛，不仁不用也，证详疾病类四十五。身后痈者，以肉苛 肿不能移，则久着枕席而身后臀背为痈疮也。皆
脾土之证，地气之所生也。）
厥阴司天，风气下临，脾气上从，而土且隆，黄起水乃眚，土用革，体重肌肉萎，食减口爽，风行太虚，云物摇动，
目转耳鸣。（厥阴风木司天，巳亥岁也。风气下临，土之所畏，故脾气应而上从。土应则气隆而黄色起，故水乃眚。然土
为木制，故土用受革，脾经为病，而风云动摇。皆天气之所生也。）火纵其暴，地乃暑，大热消烁，赤沃下，蛰虫数见，
流水不冰，其发机速。（凡厥阴司天，则少阳在泉，相火下行，故其气候如此。赤沃下者，霖雨多热，受赤气也。其发机
速，相火之发，暴而速也。皆此地气之所生者。）
少阴司天，热气下临，肺气上从，白起金用，草木眚，喘呕寒热，嚏鼽衄鼻窒，大暑流行，甚则疮疡燔灼，金烁石
流。（少阴君火司天，子午岁也。火气下临，金之所畏，故其气候疾病，与前少阳司天大同，皆天气之所生也。）地乃燥，
凄沧数至，胁痛善太息，肃杀行，草木变。（凡少阴司天，则阳明燥金在泉，燥行于地，故其气候如此。肝木受伤，故胁
痛。肺金太过，故善太息。皆地气之所生也。）
太阴司天，湿气下临，肾气上从，黑起水变，埃冒云雨，胸中不利，阴萎气大衰而不起不用，当其时反腰 痛，动
转不便也，厥逆。（太阴湿土司天，丑未岁也。湿土下临，水之所畏，故肾气应而上从。水应则黑起为变，心火受制，故
胸中不利。然土胜者水必伤，故为阴痿以下等疾。当其时者，当土王之时也。凡此诸病，俱属肾经，皆天气之所生也。）
地乃藏阴，大寒且至，蛰虫早附，心下痞痛，地裂冰坚，少腹痛，时害于食，乘金则止水增，味乃咸，行水减也。（凡太
阴司天，则太阳在泉，寒行于地，故为地乃藏阴等候，心下痞痛等疾，皆寒水侮火也。乘金者，如岁逢六乙，乘金运也；
时遇燥金，乘金气也。水得金生，寒凝尤甚，故止蓄之水增，味乃咸，流行之水减，以阴胜阳，以静胜动，皆地气之所
生也。愚按∶运气之化，凡一胜则一负，一盛则一衰，此理之常也。观本篇司天六气，如少阳少阴火气下临，则肺气上
从白起金用等义，皆被克之气，反起而用者何也？盖五运各有所制，制气相加，则受制者不得不应，应则反从其化而为
用，其理其征，本属显然，而实人所不知也。故如热甚者燥必随之，此金之从火也；燥甚者风必随之，此木之从金也；
风甚者尘霾随之，此土之从木也；湿蒸甚者霖注随之，此水之随土也；阴凝甚者雷电随之，此火之从水也。故易曰∶云
从龙，风从虎。夫龙得东方木气，故云从之，云者土气也。虎得西方金气，故风从之，风者木气也。即此篇之义。以观
五运之变化，脏象之虚实，其有不可以偏执论者类可知矣。）
帝曰∶气始而生化，气散而有形，气布而蕃育，气终而象变，其致一也；然而五味所资，生化有薄浓，成熟有少多，
终始不同，其故何也？（此以下详明在泉六化，五味五谷之有异也。始者肇其生几，散者散于万物，布者布其茂盛，终
者收于成功。此言万物之始终散布，本同一气，及其生化成熟，乃各有浓薄少多之异也。）岐伯曰∶地气制之也，非天不
生而地不长也。（地气者，即在泉也。制之者，由其所成也。在泉六化，各有盛衰，物生于地，气必应之，故气薄则薄，
非天之不生，气少则少，非地之不长也。王氏曰∶天地虽无情于生化，而生化之气自有异同尔。何者？以地体之中有六
入故也。气有同异，故有生有化，有不生有不化，有少生少化，有广生广化矣。故天地之间，无必生必化、必不生必不
化、必少生少化、必广生广化也，各随其气，分所好所恶、所异所同也。）帝曰∶愿闻其道。岐伯曰∶寒热燥湿，不同其
化也。（气有六而言其四，举大概之要耳。）
故少阳在泉，寒毒不生，其味辛，其治苦酸，其谷苍丹。（少阳相火在泉，巳亥岁也。所谓毒者，凡五行暴烈之气，
各有所化，故火在地中，则寒毒之物不生，火气制金，则味辛之物应之。少阳之上，厥阴主之，下火上木，故其治苦酸，
其谷苍丹。苦丹属火，地气所化；酸苍属木，天气所生也。按∶在泉六化之治，惟少阳、厥阴不言间味者，以木火相生，
气无所间也。其他生化皆有上下克伐，故间味不能无矣。）
阳明在泉，湿毒不生，其味酸，其气湿，其治辛苦甘，其谷丹素。（阳明燥金在泉，子午岁也。燥在地中，故湿毒之
物不生。金克木，故味酸者应之。燥胜湿，故气湿者应之。阳明之上，少阴主之，下金上火，故其治辛苦，其谷丹素。
辛素属金，地气所化；苦丹属火，天气所生。然治兼甘者，火金之间味也。甘属土，为火之子，为金之母，故能调和于
二者之间。）
太阳在泉，热毒不生，其味苦，其治淡咸，其谷 。（太阳寒水在泉，丑未岁也。寒在地中，故热毒之物不生。水
克火，故味苦者应之。太阳之上，太阴主之，上土下水，故其治淡咸，其谷 。淡，即甘之薄味也。 ，黑黍也。淡
属土，天之所生；咸 属水，地之所化也。太阳间味，义详下文太阴在泉。按∶王氏曰∶太阴土气，上主于天，气远
而高，故甘之化薄而为淡也，所以淡亦甘之类也。观下文太阴在泉，其治甘咸，则王氏之言益信。）
厥阴在泉，清毒不生，其味甘，其治酸苦，其谷苍赤，（厥阴风木在泉，寅申岁也。风行地中，与清殊性，故清毒之
物不生。木克土，故味甘者应之。厥阴之上，少阳主之，上火下木，故其治酸苦，其谷苍赤。苦赤属火，天之所生；酸
苍属木，地之所生也。）其气专，其味正。（厥阴在泉，则少阳司天，上阳下阴，木火相合，故其气化专一，味亦纯正。
其他岁气则上下各有胜制，气不专一，故皆兼夫间味也。）
少阴在泉，寒毒不生，其味辛，其治辛苦甘，其谷白丹。（少阴君火在泉，卯酉岁也。热在地中，故寒毒之物不生。
火克金，故味辛者应之。少阴之上，阳明主之，上金下火，故其治辛苦，其谷白丹。辛白属金，天之所化；苦丹属火，
地之所生也。甘字义见前阳明在泉下。）
太阴在泉，燥毒不生，其味咸，其气热，其治甘咸，其谷 。（太阴湿土在泉，辰戌岁也。湿在地中，故燥毒之物
不生。土克水，故味咸者应之。湿不远寒，故气热之物不成。太阴之上，太阳主之，下湿上寒，故其治甘咸，其谷 。
咸属水，天气所生；甘 属土，地气所主也。）化淳则咸守，气专则辛化而俱治。（六气惟太阴属土，太阴司地，土得
位也，故其化淳。淳，浓也。五味惟咸属水，其性善泄，淳土制之，庶得其守矣。土居土位，故曰气专。土盛生金，故
与辛化而俱治。俱治者，谓辛与甘咸兼用为治也。盖辛属金，为土之子，为水之母，能调和于水土之间，此即太阴在泉，
其治甘咸之间味也。然太阴、太阳相为上下，皆当用之；但太阴在泉辛化浓，太阳在泉辛化薄耳。）
故曰补上下者从之，治上下者逆之，以所在寒热盛衰而调之。（此下皆言治法也。补者补其不足，治者治其有余。上
谓司天，下谓在泉。从之谓同其气，如以辛补肺，以甘补脾之类是也。逆之谓反其气，如以苦治肺，以酸治脾之类是也。
当各以病之所在，随其寒热盛衰之宜而调之也。）故曰上取下取，内取外取，以求其过，能毒者以浓药，不胜毒者以薄药，
此之谓也。（上取下取，察其病之在上在下也。内取外取，察其病之在表在里也。于此四者而求其过之所在，然后因其强
弱，以施浓薄之治。若其人胃浓色黑，骨大肉肥，此能毒者也，宜治以浓药。若其胃薄色浮，骨小肉瘦，此不能毒者也，
宜治以薄药。能，耐同。）气反者，病在上，取之下；病在下，取之上；病在中，旁取之。（气反者，本在此而标在彼也。
其病既反，其治亦宜反。故病在上，取之下，谓如阳病者治其阴，上壅者疏其下也。病在下，取之上，谓如阴病者治其
阳，下滞者宣其上也。病在中，旁取之，谓病生于内而经连乎外，则或刺或灸，或熨或按，而随其所在也。）治热以寒，
温而行之；治寒以热，凉而行之；治温以清，冷而行之；治清以温，热而行之。（此即《至真要大论》寒因热用、热因寒
用之义。凡药与病逆者，恐不相投，故从其气以行之，假借之道也。）故消之削之，吐之下之，补之泻之，久新同法。（消
以去滞，削以攻坚，上实者宜吐，下实者宜下，补因正之不足，泻因邪之有余；但此中用有缓急，治有先后，而病之久
新同其法也。）
（《素问·五常政大论》）
黄帝问道：有的年份人们没有发生疾病，但脏腑之气却不应时而不发挥作用，这是什么原因呢？岐伯回答说：这是因为天气制约了它，气有所顺从。（所谓“岁有不病不应不用”，是指岁运应当发病而没有发病，以及脏腑之气应当应时而用却没有应时而用的情况。所谓“天气制之气有所从”，是指司天之气制约它，使其顺从于天气，所以出现了与岁运不相应的情况。“制”，就是禁制的意思。）黄帝说：我希望详尽地听听其中的道理。
岐伯说：少阳相火司天之年，火气下行临于地面，肺气上从于火，白色显现而金气被火所制用，草木遭受灾祸，烈火焚烧，变革金的性质且使之消耗，大暑流行，出现咳嗽、喷嚏、鼻流清涕、鼻衄、鼻塞、疮疡、寒热往来及浮肿等病症。（少阳相火司天，对应寅年和申年。火气下行，是金气所畏惧的，所以肺气上从。所谓“从”，就是顺应而动。金气动则白色显现，金被火所制用，所以草木受灾。然而火气炽盛必然改变金的性质，甚至使其耗损，“金曰从革”说的就是这个意思。如果因此致病，如咳嗽、喷嚏、鼻流清涕、鼻衄、鼻塞、疮疡，都是火盛伤肺所致。金寒火热，金火相搏，就产生寒热往来的症状。肺主皮毛，邪热凑集于皮毛，所以出现浮肿。这些都是由天气所产生的变化引起的。燔，音烦； ，音瑞切；嚏，音帝；鼽，音求；衄，女六切；窒，音质。）风气在地面流行，尘土飞扬，出现心痛、胃脘痛、四肢厥逆、膈部气机不通等症状，其发病特点是暴急迅速。（凡是少阳司天，则厥阴在泉，所以风气在地面流行，尘土飞扬。风淫胜复，病变在厥阴肝经，厥阴经脉挟胃、属肝、贯膈，所以出现上述病症。然而疾速莫过于风，所以说发病暴急迅速。这些都是由地气所产生的变化引起的。）
阳明燥金司天之年，燥气下行临于地面，肝气上从于燥，青色显现而木气被金所制用，土气遭受灾祸，凄冷肃杀之气频繁到来，树木被伐、草木枯萎，出现胁痛、目赤、震颤鼓栗、筋脉痿软不能久立等症状。（阳明燥金司天，对应卯年和酉年。燥气下行，是木气所畏惧的，所以肝气应时而上从。木气应则青色显现，木被金所制用，所以土气必受损伤。然而金气旺盛则凄冷肃杀之气频繁到来，所以树木被伐、草木枯萎，病变在肝。肝经行于胁肋，所以胁痛。肝窍在目，所以目赤。肝主风，所以震颤鼓栗。肝主筋，所以筋脉痿软不能久立。这些都是由天气所产生的变化引起的。）暴热突然到来，大地如同盛夏，阳气郁结而发，小便颜色改变，出现类似疟疾的寒热症状，严重的心痛，火气行于干枯之物，流水不结冰，冬眠的虫类出现。（凡是阳明司天，则少阴君火在泉，热气行于地面，所以气候现象如此。火在阴分，则寒热交争，所以使人出现类似疟疾的症状。火气郁结不得舒展，所以心痛。火性就燥，所以行于干枯之物。“槁”，指干枯。这些都是由地气所产生的变化引起的。）
太阳寒水司天之年，寒气下行临于地面，心气上从于寒，火气显得明亮，丹色显现而金气遭受灾祸，寒冷清肃之气时常兴起，胜复则水结冰，火气高明，出现心热烦躁、咽喉干燥、喜欢口渴、鼻流清涕、喷嚏、易悲伤、频频呵欠，热气妄行，寒气复至，霜不时下降，容易健忘，严重时心痛。（太阳寒水司天，对应辰年和戌年。寒气下行，是火气所畏惧的，所以心气应时而上从。火气应则明亮且丹色显现，所以金气遭受灾祸。然而水胜则为寒，所以气候现象如此。火气应则动热，所以病症如此。这些都是由天气所产生的变化引起的。）湿气滋润，水气丰盈漫溢，寒气客居体内，沉阴之气化生，湿气改变万物，水饮内停，腹部胀满、食欲不振，皮肤麻木沉重，筋脉不利，严重时浮肿，身后（臀部背部）生痈疽。（凡是太阳司天，则太阴湿土在泉，湿气行于地面，所以气候和病症如此。“ ”，指痹阻而沉重。“肉苛”，指肌肤麻木不知痛痒、肢体不用，证候详见疾病类第四十五篇。身后痈，是因为肌肉麻木沉重浮肿不能移动，长期卧着枕席，导致身后臀背生出痈疮。这些都是脾土的病症，由地气所产生的变化引起。）
厥阴风木司天之年，风气下行临于地面，脾气上从于风，土气显得隆盛，黄色显现而水气遭受灾祸，土气的作用发生改变，身体沉重、肌肉萎缩，食欲减退、口淡无味，风气在天空流行，云物摇动，出现头晕眼花、耳鸣等症状。（厥阴风木司天，对应巳年和亥年。风气下行，是土气所畏惧的，所以脾气应时而上从。土气应则气隆而黄色显现，所以水气遭受灾祸。然而土被木克制，所以土气的作用发生改变，脾经受病，风云动摇。这些都是由天气所产生的变化引起的。）火气放纵其暴烈，地面炎热，大热消烁万物，赤色雨水降下，冬眠的虫类频繁出现，流水不结冰，发病机制迅速。（凡是厥阴司天，则少阳相火在泉，相火下行，所以气候现象如此。“赤沃下”，指霖雨多热，受赤气影响。其发病机制迅速，是因为相火发作暴烈而迅速。这些都是由地气所产生的变化引起的。）
少阴君火司天之年，热气下行临于地面，肺气上从于热，白色显现而金气被热所制用，草木遭受灾祸，出现气喘、呕吐、寒热、喷嚏、鼻流清涕、鼻衄、鼻塞，大暑流行，严重时疮疡灼热，金石熔化。（少阴君火司天，对应子年和午年。火气下行，是金气所畏惧的，所以其气候和疾病，与前文少阳司天大同小异，都是由天气所产生的变化引起的。）地面干燥，凄冷肃杀之气频繁到来，胁痛、喜欢叹气，肃杀之气运行，草木变色。（凡是少阴司天，则阳明燥金在泉，燥气行于地面，所以气候现象如此。肝木受伤，所以胁痛。肺金太过，所以喜欢叹气。这些都是由地气所产生的变化引起的。）
太阴湿土司天之年，湿气下行临于地面，肾气上从于湿，黑色显现而水气发生变化，埃尘弥漫、云雨笼罩，胸中不畅，阳痿、气机大衰而不能勃起或发挥作用，到了这个时候反而腰痛，转动不便，四肢厥逆。（太阴湿土司天，对应丑年和未年。湿土下行，是水气所畏惧的，所以肾气应时而上从。水气应则黑色显现为变，心火受制，所以胸中不畅。然而土胜则水必伤，所以出现阳痿等疾患。“当其时者”，指当土旺之时。凡此诸病，都属于肾经，都是由天气所产生的变化引起的。）地面收藏阴气，大寒将至，冬眠的虫类早早潜伏，心下痞塞疼痛，地裂冰坚，小腹痛，时常影响进食，如果遇到金运克制，则止水增加，味道变咸，流动的水减少。（凡是太阴司天，则太阳寒水在泉，寒气行于地面，所以有地面收藏阴气等气候现象，心下痞痛等疾患，都是寒水侮火所致。“乘金者”，如岁逢六乙，即金运之年；时令遇燥金，即乘金气。水得金生，寒凝尤其严重，所以止蓄之水增加，味道变咸，流动的水减少，这是以阴胜阳，以静胜动，都是由地气所产生的变化引起的。我按语：运气之化，凡是一胜则一负，一盛则一衰，这是常理。观察本篇司天六气，如少阳、少阴火气下行，则肺气上从、白色显现、金气被用等义，都是被克制的脏气，反而兴起而发挥作用，为什么呢？大概五运各有所制，制气相加，则受制者不得不响应，响应则反而顺从其气化而发挥作用，其理其征，本属明显，但实际上人们并不知晓。所以如热甚则燥必随之，这是金从属于火；燥甚则风必随之，这是木从属于金；风甚则尘霾随之，这是土从属于木；湿蒸甚则霖注随之，这是水从属于土；阴凝甚则雷电随之，这是火从属于水。所以《易经》说：“云从龙，风从虎。”龙得东方木气，所以云跟随它，云是土气；虎得西方金气，所以风跟随它，风是木气。即以此篇的意义来观察五运的变化，脏象的虚实，那些不可以偏执理论来论述的情况，大致可以知道了。）
黄帝道：气开始而生化，气散布而有形，气布散而蕃育，气终结而形象变化，它们的根本是一致的；然而五味所资取，生化有厚薄，成熟有多寡，始终不同，这是什么缘故呢？（以下内容详细阐明在泉六化，五味五谷的差异。始，是肇始生机；散，是散布于万物；布，是布散茂盛；终，是收于成功。这是说万物的始终散布，本同一气，等到生化成熟，乃各有浓薄少多的差异。）岐伯说：地气制约它，并非天不生而地不长。（地气，就是在泉之气。制约它，是由其所成就的。在泉六化，各有盛衰，物生于地，气必相应，所以气薄则生化薄，并非天不生；气少则生化少，并非地不长。王冰说：天地虽然对生化无情意，但生化之气自有异同。为什么呢？因为地体中有六入的缘故。气有同异，所以有生有化，有不生不化，有少生少化，有广生广化。所以天地之间，没有必定生必定化、必定不生必定不化、必定少生少化、必定广生广化的情况，各随其气，分其所好所恶、所异所同。）黄帝说：我希望听听其中的道理。岐伯说：寒热燥湿，它们的化生是不同的。（气有六种而只言四种，是举出大概的要领罢了。）
所以少阳相火在泉，寒毒之物不生，其味辛，治疗用苦酸，谷物为苍色和丹色。（少阳相火在泉，对应巳年和亥年。所谓“毒”，凡是五行暴烈之气，各有所化，所以火在地中，则寒毒之物不生，火气制金，则味辛之物应之。少阳之上，厥阴主之，下火上木，所以治疗用苦酸，谷物为苍色和丹色。苦丹属火，由地气所化；酸苍属木，由天气所生。按：在泉六化之治，只有少阳、厥阴不言间味，因为木火相生，气无所间隔。其他生化皆有上下克伐，所以间味不能没有。）
阳明燥金在泉，湿毒之物不生，其味酸，其气湿，治疗用辛苦甘，谷物为丹色和素色。（阳明燥金在泉，对应子年和午年。燥在地中，所以湿毒之物不生。金克木，所以味酸者应之。燥胜湿，所以气湿者应之。阳明之上，少阴主之，下金上火，所以治疗用辛苦，谷物为丹色和素色。辛素属金，由地气所化；苦丹属火，由天气所生。然而治疗兼用甘味，是因为甘是火金之间的间味。甘属土，为火之子，为金之母，所以能调和于二者之间。）
太阳寒水在泉，热毒之物不生，其味苦，治疗用淡咸，谷物为 。（太阳寒水在泉，对应丑年和未年。寒在地中，所以热毒之物不生。水克火，所以味苦者应之。太阳之上，太阴主之，上土下水，所以治疗用淡咸，谷物为 。淡，即甘之薄味。 ，黑黍也。淡属土，由天之所生；咸 属水，由地之所化。太阳间味，意义详见下文太阴在泉。按：王冰说：太阴土气，上主于天，气远而高，所以甘之化薄而为淡，所以淡也是甘的一类。看下文太阴在泉，其治甘咸，则王冰的话更加可信。）
厥阴风木在泉，清毒之物不生，其味甘，治疗用酸苦，谷物为苍色和赤色，（厥阴风木在泉，对应寅年和申年。风行地中，与清殊性，所以清毒之物不生。木克土，所以味甘者应之。厥阴之上，少阳主之，上火下木，所以治疗用酸苦，谷物为苍色和赤色。苦赤属火，由天之所生；酸苍属木，由地之所生也。）其气专一，其味纯正。（厥阴在泉，则少阳司天，上阳下阴，木火相合，所以其气化专一，味亦纯正。其他岁气则上下各有胜制，气不专一，所以都兼有间味。）
少阴君火在泉，寒毒之物不生，其味辛，治疗用辛苦甘，谷物为白色和丹色。（少阴君火在泉，对应卯年和酉年。热在地中，所以寒毒之物不生。火克金，所以味辛者应之。少阴之上，阳明主之，上金下火，所以治疗用辛苦，谷物为白色和丹色。辛白属金，由天之所化；苦丹属火，由地之所生也。甘字的意义见前阳明在泉下。）
太阴湿土在泉，燥毒之物不生，其味咸，其气热，治疗用甘咸，谷物为 。（太阴湿土在泉，对应辰年和戌年。湿在地中，所以燥毒之物不生。土克水，所以味咸者应之。湿不远寒，所以气热之物不成。太阴之上，太阳主之，下湿上寒，所以治疗用甘咸，谷物为 。咸属水，由天气所生；甘 属土，由地气所主也。）化气淳厚则咸味守正，气专一则辛味化生而共同治疗。（六气中只有太阴属土，太阴司地，土得位，所以其化气淳厚。淳，浓也。五味中只有咸属水，其性善泄，淳土制之，才能得其守正。土居土位，所以叫气专。土盛生金，所以与辛化共同治疗。俱治，是说辛与甘咸兼用为治。盖辛属金，为土之子，为水之母，能调和于水土之间，这就是太阴在泉，其治甘咸之间的间味。然而太阴、太阳相为上下，都应当使用；只是太阴在泉辛化浓，太阳在泉辛化薄罢了。）
所以说，补上下的要顺从其气，治上下的要逆其气，根据所在部位的寒热盛衰来调治。（以下皆言治法。补，是补其不足；治，是治其有余。上指司天，下指在泉。从之，谓同其气，如以辛补肺，以甘补脾之类是也。逆之，谓反其气，如以苦治肺，以酸治脾之类是也。应当各根据病的所在，随其寒热盛衰的适宜而调治。）所以说，上取下取，内取外取，以求察其过错，体质能承受药毒的用浓药，不能承受药毒的用薄药，说的就是这个意思。（上取下取，是察病在上在下。内取外取，是察病在表在里。在这四个方面求察其过之所在，然后因其强弱，施以浓薄之治。若其人胃厚色黑，骨大肉肥，这是能承受药毒的人，宜用浓药治疗。若其人胃薄色浮，骨小肉瘦，这是不能承受药毒的人，宜用薄药治疗。能，通耐。）气反的，病在上，取之下；病在下，取之上；病在中，旁取之。（气反，是本在此而标在彼。其病既反，其治亦宜反。所以病在上，取之下，谓如阳病治其阴，上壅者疏其下。病在下，取之上，谓如阴病治其阳，下滞者宣其上。病在中，旁取之，谓病生于内而经络连乎外，则或刺或灸，或熨或按，而随其所在。）治热用寒药，温服；治寒用热药，凉服；治温用清药，冷服；治清用温药，热服。（这即是《至真要大论》寒因热用、热因寒用的意义。凡药性与病性相反的，恐怕不相投合，所以顺从其气而行，是假借之道。）所以消之削之，吐之下之，补之泻之，无论久病新病，方法相同。（消，以去除积滞；削，以攻坚块；上实者宜吐，下实者宜下；补，因正气不足；泻，因邪气有余；但这中间用法有缓急，治疗有先后，而病之久新治疗方法相同。）
(Su Wen, Chapter 53: Da Wu Zheng Da Lun)
The Yellow Emperor asked: In some years, people do not fall ill, yet the Qi of the Zang organs does not respond or function as it should. What is the reason for this?
Qibo replied: This is because the Heavenly Qi exerts control over it, and the Qi follows a certain direction. (The phrase "years without illness where organs do not respond or function" refers to situations where the annual movement suggests illness should occur but does not, and where organ Qi should respond to the season but fails to do so. The phrase "Heavenly Qi controls, and Qi follows" means that the Si Tian (Heavenly Ruling) Qi restricts it, causing it to follow the Heavenly Qi, thus resulting in a mismatch with the annual movement. "Control" here means restriction.)
The Yellow Emperor said: I wish to hear this in detail.
Qibo said: When Shaoyang (Ministerial Fire) rules the Si Tian position, Fire Qi descends upon the earth, causing Lung Qi to ascend and follow. White appears, and Metal is utilized by Fire; grasses and trees suffer disaster. Flames burn fiercely, altering the nature of Metal and depleting it. Great heat prevails, leading to coughing, sneezing, rhinorrhea, epistaxis, nasal obstruction, sores and ulcers, alternating chills and fever, and edema. (Shaoyang Ministerial Fire ruling Si Tian corresponds to Yin and Shen years. Fire descending is feared by Metal, so Lung Qi ascends to follow. "Following" means responding and moving. When Metal moves, white appears, and Metal is used by Fire, so grasses and trees suffer disaster. However, fierce fire alters the nature of Metal and causes depletion; "Metal follows transformation" refers to this. If disease occurs, such as coughing, sneezing, rhinorrhea, epistaxis, nasal obstruction, and sores, these are caused by excessive Fire injuring the Lung. Cold Metal and hot Fire clash, causing alternating chills and fever. The Lung governs skin and hair; when pathogenic heat gathers there, edema results. All these arise from changes generated by Heavenly Qi. Fan sounds like 'fan'; sounds like 'rui'; Ti sounds like 'di'; Qiu sounds like 'qiu'; Nu sounds like 'nu'; Zhi sounds like 'zhi'). Wind qi circulates on the ground, raising dust and sand. Symptoms include heart pain, epigastric pain, cold limbs (Jue Ni), and blockage at the diaphragm. Its onset is sudden and rapid. (Whenever Shaoyang rules Si Tian, Jueyin rules the Zai Quan position, so wind circulates on the ground, raising dust. Excessive wind affects the Jueyin Liver channel, which runs along the stomach, connects to the liver, and pierces the diaphragm, causing such symptoms. Since nothing is swifter than wind, the onset is sudden and rapid. These arise from changes generated by Earthly Qi).
When Yangming (Dryness/Metal) rules the Si Tian position, Dryness Qi descends upon the earth, causing Liver Qi to ascend and follow. Blue/Green appears, and Wood is utilized by Metal; Earth suffers disaster. Chill and desolation arrive frequently; trees are felled and grass withers. Symptoms include hypochondriac pain, red eyes, tremors and shivering, tendon wasting, and inability to stand for long periods. (Yangming Dryness/Metal ruling Si Tian corresponds to Mao and You years. Dryness descending is feared by Wood, so Liver Qi responds and ascends to follow. When Wood responds, blue/green appears, and Wood is used by Metal, so Earth must be injured. When Metal is prosperous, chill and desolation arrive frequently, so trees are felled and grass withers, and disease affects the Liver. The Liver channel runs through the hypochondrium, causing pain. The Liver opens into the eyes, causing redness. The Liver governs wind, causing tremors. The Liver governs tendons, causing wasting and inability to stand. All these arise from changes generated by Heavenly Qi). Sudden heat arrives, making the earth feel like midsummer. Yang Qi stagnates and erupts. Urine color changes. Chills and fever resemble malaria. Severe cases involve heart pain. Fire acts on dry matter. Flowing water does not freeze. Hibernating insects appear. (Whenever Yangming rules Si Tian, Shaoyin Sovereign Fire rules the Zai Quan position, so heat circulates on the ground, causing such climate phenomena. Fire in the Yin aspect causes clashing of cold and heat, resembling malaria. Stagnant Fire cannot extend, causing heart pain. Fire adheres to dryness, acting on dry matter. "Gao" means dry. These arise from changes generated by Earthly Qi).
When Taiyang (Cold/Water) rules the Si Tian position, Cold Qi descends upon the earth, causing Heart Qi to ascend and follow. Fire appears bright, Red/Dan color emerges, and Metal suffers disaster. Cold and clear air rises frequently. Victory leads to water freezing. Fire Qi is high and bright. Symptoms include heart heat, irritability, dry throat, frequent thirst, rhinorrhea, sneezing, tendency toward sadness, frequent yawning. Wild heat flows, cold returns, frost falls irregularly. Memory loss occurs. Severe cases involve heart pain. (Taiyang Cold/Water ruling Si Tian corresponds to Chen and Xu years. Cold descending is feared by Fire, so Heart Qi responds and ascends to follow. When Fire responds, it becomes bright and Dan color emerges, so Metal suffers disaster. Water victory brings cold, hence such climate phenomena. Fire response brings heat, hence such symptoms. All these arise from changes generated by Heavenly Qi). Earth becomes moist, Water becomes abundant. Cold invades, deep Yin transforms. Dampness alters things. Internal retention of fluids causes abdominal fullness and anorexia. Skin feels heavy and numb. Tendons and vessels are unresponsive. Severe cases involve edema and carbuncles on the back and buttocks. (Whenever Taiyang rules Si Tian, Taiyin Dampness/Earth rules the Zai Quan position, so dampness circulates on the ground, causing such climate and disease phenomena. means bi-syndrome heaviness. Rou Ke means insensitivity and immobility. See Disease Category 45 for details. Back/buttock carbuncles occur because heavy, numb, swollen muscles prevent movement, leading to prolonged pressure sores on the back and buttocks. These are Spleen/Earth syndromes arising from changes generated by Earthly Qi).
When Jueyin (Wind/Wood) rules the Si Tian position, Wind Qi descends upon the earth, causing Spleen Qi to ascend and follow. Earth Qi becomes prominent, Yellow appears, and Water suffers disaster. Earth's function changes. Body weight increases, muscles waste. Appetite decreases, taste becomes bland. Wind circulates in the sky, clouds and objects shake. Vertigo and tinnitus occur. (Jueyin Wind/Wood ruling Si Tian corresponds to Si and Hai years. Wind descending is feared by Earth, so Spleen Qi responds and ascends to follow. When Earth responds, Qi becomes prominent and yellow appears, so Water suffers disaster. Earth is controlled by Wood, so its function changes, affecting the Spleen channel, causing wind and cloud movement. All these arise from changes generated by Heavenly Qi). Fire releases its violence. The earth becomes hot. Intense heat scorches. Red rain falls. Hibernating insects appear frequently. Flowing water does not freeze. Onset is rapid. (Whenever Jueyin rules Si Tian, Shaoyang Ministerial Fire rules the Zai Quan position, so Ministerial Fire descends, causing such climate phenomena. "Chi Wo Xia" means warm rains falling under red influence. Rapid onset is due to the violent and swift nature of Ministerial Fire. These arise from changes generated by Earthly Qi).
When Shaoyin (Sovereign Fire) rules the Si Tian position, Heat Qi descends upon the earth, causing Lung Qi to ascend and follow. White appears, Metal is utilized by Heat; grasses and trees suffer disaster. Asthma and vomiting occur. Chills and fever, sneezing, rhinorrhea, epistaxis, and nasal obstruction appear. Great heat prevails. Severe cases involve burning sores. Metal melts and stones flow. (Shaoyin Sovereign Fire ruling Si Tian corresponds to Zi and Wu years. Fire descending is feared by Metal, so climate and diseases are largely similar to Shaoyang Si Tian, all arising from changes generated by Heavenly Qi). The earth becomes dry. Chill and desolation arrive frequently. Hypochondriac pain and frequent sighing occur. Desolate energy moves. Grasses and trees change color. (Whenever Shaoyin rules Si Tian, Yangming Dryness/Metal rules the Zai Quan position, so dryness circulates on the ground, causing such climate phenomena. Liver Wood is injured, causing hypochondriac pain. Lung Metal is excessive, causing frequent sighing. These arise from changes generated by Earthly Qi).
When Taiyin (Dampness/Earth) rules the Si Tian position, Dampness Qi descends upon the earth, causing Kidney Qi to ascend and follow. Black appears, Water changes. Dust obscures, clouds and rain cover. Chest discomfort occurs. Impotence, severe Qi decline, and failure to function occur. At this time, lower back pain occurs, making movement difficult. Cold limbs (Jue Ni) appear. (Taiyin Dampness/Earth ruling Si Tian corresponds to Chou and Wei years. Wet Earth descending is feared by Water, so Kidney Qi responds and ascends to follow. When Water responds, black appears as a change. Heart Fire is constrained, causing chest discomfort. Earth victory injures Water, causing impotence and other diseases. "At this time" refers to when Earth is prosperous. All these diseases belong to the Kidney channel and arise from changes generated by Heavenly Qi). The earth stores Yin. Great cold arrives. Hibernating insects settle early. Epigastric stuffiness and pain occur. Earth cracks, ice hardens. Lower abdominal pain occurs. Eating is often impaired. If Metal overcomes, stagnant water increases, taste becomes salty, flowing water decreases. (Whenever Taiyin rules Si Tian, Taiyang Cold/Water rules the Zai Quan position, so cold circulates on the ground, causing storage of Yin and symptoms like epigastric stuffiness. This is Cold Water insulting Fire. "Cheng Jin" refers to years with Yi stems (Metal Movement) or times with Dryness/Metal Qi. Water born from Metal has severe cold congealment, so stagnant water increases, taste becomes salty, and flowing water decreases. This is Yin overcoming Yang and stillness overcoming motion. These arise from changes generated by Earthly Qi. Note: In the transformation of Luck, one victory brings one defeat, one prosperity brings one decline; this is normal logic. Observing the Six Qi of Si Tian in this chapter, such as Shaoyang and Shaoyin Fire descending causing Lung Qi to ascend and Metal to be utilized, these are restrained organs rising to function. Why? Each of the Five Movements has its own control. When controlling Qi adds up, the controlled must respond. Responding, it follows the transformation to function. The logic and signs are obvious but unknown to many. Thus, extreme heat brings dryness (Metal follows Fire); extreme dryness brings wind (Wood follows Metal); extreme wind brings dust (Earth follows Wood); extreme dampness brings rain (Water follows Earth); extreme Yin condensation brings thunder/lightning (Fire follows Water). Hence, the I Ching says: "Clouds follow the Dragon, Wind follows the Tiger." The Dragon obtains East Wood Qi, so clouds follow; clouds are Earth Qi. The Tiger obtains West Metal Qi, so wind follows; wind is Wood Qi. This illustrates the meaning of this chapter. Observing the changes of Five Movements and the deficiency/excess of Zang images, it is known that they cannot be discussed with partiality.)
The Yellow Emperor said: Qi begins to generate transformations, Qi scatters to form shapes, Qi spreads to multiply, and Qi ends with image changes; their origin is one. However, the resources for the five flavors vary. Transformations have thickness and thinness. Maturation has scarcity and abundance. Start and end differ. What is the reason? (This section details the Zai Quan Six Transformations and differences in five flavors and grains. "Start" initiates life potential. "Scatter" disperses into ten thousand things. "Spread" distributes lushness. "End" collects success. This states that the beginning, end, scattering, and spreading of all things originate from one Qi. Upon maturation, differences in thickness and abundance arise.)
Qibo replied: Earthly Qi controls it. It is not that Heaven does not generate and Earth does not grow. (Earthly Qi refers to the Zai Quan Qi. Controlling it refers to what it accomplishes. The Six Transformations of Zai Quan have varying prosperity and decline. Things born on Earth must respond to Qi. Thus, thin Qi yields thin transformation, not because Heaven does not generate; scarce Qi yields scarce growth, not because Earth does not grow. Wang Bing said: Although Heaven and Earth are indifferent to generation, the Qi of generation has similarities and differences. Why? Because within the body of Earth there are six entrances. Qi has similarities and differences, so there is generation and transformation, non-generation and non-transformation, little generation/transformation, and extensive generation/transformation. Therefore, between Heaven and Earth, there is no absolute generation, non-generation, little generation, or extensive generation. Each follows its Qi, dividing into likes/dislikes, differences/similarities.)
The Yellow Emperor said: I wish to hear the principle.
Qibo said: Cold, Heat, Dryness, and Moisture have different transformations. (Qi has six types, but only four are mentioned to highlight the general essentials.)
Therefore, when Shaoyang (Ministerial Fire) rules the Zai Quan position, Cold Poisons do not grow. The flavor is Pungent. Treatment uses Bitter and Sour. Grains are Green/Cyan and Red/Dan. (Shaoyang Ministerial Fire ruling Zai Quan corresponds to Si and Hai years. "Poison" refers to violent Qi of the Five Elements, each transforming differently. Fire in the earth prevents cold-poisonous things from growing. Fire controls Metal, so Pungent flavors correspond. Above Shaoyang, Jueyin rules. Below Fire, above Wood, so treatment uses Bitter and Sour. Grains are Green/Cyan and Red/Dan. Bitter/Dan belongs to Fire, transformed by Earthly Qi. Sour/Green belongs to Wood, generated by Heavenly Qi. Note: Among Zai Quan treatments, only Shaoyang and Jueyin do not mention intermediate flavors because Wood and Fire generate each other, leaving no gap. Other transformations have upper/lower conquest, so intermediate flavors are necessary.)
When Yangming (Dryness/Metal) rules the Zai Quan position, Wet Poisons do not grow. The flavor is Sour. The Qi is Damp. Treatment uses Pungent, Bitter, and Sweet. Grains are Red/Dan and White/Pure. (Yangming Dryness/Metal ruling Zai Quan corresponds to Zi and Wu years. Dryness in the earth prevents wet-poisonous things from growing. Metal conquers Wood, so Sour flavors correspond. Dryness overcomes Dampness, so Damp Qi corresponds. Above Yangming, Shaoyin rules. Below Metal, above Fire, so treatment uses Pungent and Bitter. Grains are Red/Dan and White/Pure. Pungent/White belongs to Metal, transformed by Earthly Qi. Bitter/Dan belongs to Fire, generated by Heavenly Qi. Sweet is added as an intermediate flavor between Fire and Metal. Sweet belongs to Earth, son of Fire, mother of Metal, thus harmonizing the two.)
When Taiyang (Cold/Water) rules the Zai Quan position, Heat Poisons do not grow. The flavor is Bitter. Treatment uses Bland and Salty. Grains are . (Taiyang Cold/Water ruling Zai Quan corresponds to Chou and Wei years. Cold in the earth prevents heat-poisonous things from growing. Water conquers Fire, so Bitter flavors correspond. Above Taiyang, Taiyin rules. Above Earth, below Water, so treatment uses Bland and Salty. Grains are . Bland is a thin Sweet taste. is black millet. Bland belongs to Earth, generated by Heaven. Salty belongs to Water, transformed by Earth. Taiyang intermediate flavor meaning is detailed in Taiyin Zai Quan below. Note: Wang Bing said: Taiyin Earth Qi rules Heaven from above; Qi is distant and high, so Sweet transformation is thin, becoming Bland. Thus Bland is a type of Sweet. Seeing Taiyin Zai Quan treats Sweet and Salty confirms Wang Bing. )
When Jueyin (Wind/Wood) rules the Zai Quan position, Clear Poisons do not grow. The flavor is Sweet. Treatment uses Sour and Bitter. Grains are Green/Cyan and Red. (Jueyin Wind/Wood ruling Zai Quan corresponds to Yin and Shen years. Wind moves in the earth, differing from Clear nature, so clear-poisonous things do not grow. Wood conquers Earth, so Sweet flavors correspond. Above Jueyin, Shaoyang rules. Above Fire, below Wood, so treatment uses Sour and Bitter. Grains are Green/Cyan and Red. Bitter/Red belongs to Fire, generated by Heaven. Sour/Green belongs to Wood, transformed by Earth.) Its Qi is specialized/unified. Its flavor is pure/correct. (When Jueyin rules Zai Quan, Shaoyang rules Si Tian. Upper Yang, Lower Yin. Wood and Fire combine, so Qi transformation is unified and flavor is pure. Other year Qi has upper/lower conquest, so Qi is not unified, hence mixed intermediate flavors.)
When Shaoyin (Sovereign Fire) rules the Zai Quan position, Cold Poisons do not grow. The flavor is Pungent. Treatment uses Pungent, Bitter, and Sweet. Grains are White and Red/Dan. (Shaoyin Sovereign Fire ruling Zai Quan corresponds to Mao and You years. Heat in the earth prevents cold-poisonous things from growing. Fire conquers Metal, so Pungent flavors correspond. Above Shaoyin, Yangming rules. Above Metal, below Fire, so treatment uses Pungent and Bitter. Grains are White and Red/Dan. Pungent/White belongs to Metal, transformed by Heaven. Bitter/Dan belongs to Fire, transformed by Earth. Meaning of Sweet is seen under Yangming Zai Quan above.)
When Taiyin (Dampness/Earth) rules the Zai Quan position, Dry Poisons do not grow. The flavor is Salty. The Qi is Hot. Treatment uses Sweet and Salty. Grains are . (Taiyin Dampness/Earth ruling Zai Quan corresponds to Chen and Xu years. Dampness in the earth prevents dry-poisonous things from growing. Earth conquers Water, so Salty flavors correspond. Dampness is not far from Cold, so Hot Qi things do not form. Above Taiyin, Taiyang rules. Below Damp, above Cold, so treatment uses Sweet and Salty. Grains are . Salty belongs to Water, generated by Heaven. Sweet belongs to Earth, governed by Earthly Qi.) Transformation is pure/thick, so Salty remains stable. Qi is specialized, so Pungent transforms and is treated together. (Among Six Qi, only Taiyin belongs to Earth. Taiyin rules Earth, Earth is in position, so transformation is pure/thick. Chun means thick. Among Five Flavors, only Salty belongs to Water, its nature is purging. Pure Earth controls it, allowing stability. Earth in Earth position is called Specialized Qi. Earth prosperity generates Metal, so it transforms with Pungent and is treated together. "Treated together" means Pungent, Sweet, and Salty are used jointly. Pungent belongs to Metal, son of Earth, mother of Water, harmonizing Water and Earth. This is the intermediate flavor of Taiyin Zai Quan treating Sweet and Salty. However, Taiyin and Taiyang are upper/lower pairs, both should be used; but Taiyin Zai Quan Pungent transformation is thick, while Taiyang Zai Quan Pungent transformation is thin.)
Therefore, it is said: To tonify Upper and Lower, follow the Qi. To treat Upper and Lower, oppose the Qi. Adjust according to the excess/deficiency of Cold and Heat in the respective locations. (This section discusses treatment methods. Tonify means supplement deficiency. Treat means address excess. Upper refers to Si Tian, Lower refers to Zai Quan. Following means using same-nature Qi, e.g., Pungent to tonify Lung, Sweet to tonify Spleed. Opposing means using contrary-nature Qi, e.g., Bitter to treat Lung, Sour to treat Spleen. Adjust based on disease location and appropriate Cold/Heat/Excess/Deficiency.) Therefore, it is said: Take from Above and Below, Inside and Outside, to seek the fault. Those capable of toxicity use strong medicine. Those incapable of toxicity use weak medicine. This is the principle. (Above/Below seeks disease in Upper/Lower. Inside/Outside seeks disease in Interior/Exterior. Seek the fault in these four aspects, then apply strong/weak treatment based on strength/weakness. Thick stomach, dark complexion, large bones, fat flesh = capable of toxicity, use strong medicine. Thin stomach, floating complexion, small bones, thin flesh = incapable of toxicity, use weak medicine. Neng means Nai/endure.) For reversed Qi: Disease in Upper, take from Below. Disease in Lower, take from Above. Disease in Middle, take from Sides. (Reversed Qi means root is here but branch is there. Since disease is reversed, treatment should be reversed. Disease in Upper, take from Below: e.g., treat Yin for Yang disease, drain below for upper congestion. Disease in Lower, take from Above: e.g., treat Yang for Yin disease, vent above for lower stagnation. Disease in Middle, take from Sides: disease originates internally but meridians connect externally; use acupuncture, moxibustion, warming, or massage according to location.) Treat Heat with Cold, administer warm. Treat Cold with Heat, administer cool. Treat Warmth with Clearing, administer cold. Treat Coolness with Warming, administer hot. (This is the meaning of "Use Cold with Heat" and "Use Heat with Cold" from Su Wen Chapter 74. When medicine opposes disease nature, fear incompatibility, so follow the Qi to administer, a method of borrowing.) Therefore, Dissolve and Cut down, Vomit and Purge, Tonify and Drain. Old and New diseases use the same methods. (Dissolve removes stagnation. Cut down attacks hardness. Upper excess requires vomiting. Lower excess requires purging. Tonify due to righteous deficiency. Drain due to pathogenic excess. Usage has urgency, treatment has sequence, but old/new diseases share methods.)