五运之气，岁有天气，抑而怫之，郁极乃发，待时而作也。故经曰土郁之发，岩谷振惊，雷
殷气交，（云之分也。）埃昏黄黑，化为白气，飘骤高深，击石飞空，洪水乃从，川流漫衍，田
牧土驹，（大水去已，石土危然，若群驹散牧于田野。）化气乃敷，善为时雨，物之始生始长，
始化始成。故民病心腹胀，肠鸣而为数后，甚则心痛胁 ，呕吐霍乱，饮发注下， 肿身重。（脾
热之生也。）云奔雨府，霞拥朝阳，山泽埃昏，其乃发也。其气四，云横天山，浮游生减，怫之
先兆。（王冰云∶天际云横，山犹冠带，岩谷丛薄，乍减乍生，有土之见，怫兆已彰，皆平明占
之浮游，以午前候望也。）金郁之发，天洁地明，风清劲切，大凉乃举，草树浮烟，燥气以行，
雾数起，（丑后辰前。）杀气来至，草木苍干，（其色黄赤黑而杂而至。物不胜杀，故草木苍
干。）金乃有声，故民病咳逆，心胁痛引少腹，善暴痛，不可反侧，嗌干，面尘，色恶。（金胜
而木病也。）山泽焦枯，土
凝霜卤，怫乃发也。（王冰云。）其气五，夜寒白露，林莽声凄，怫之兆也。水郁之发，阳气乃
辟，阴气暴举，大寒乃至，川泽岩凝，寒 结为霜雪，甚则黄黑昏翳，流行气交，霜乃为杀，水
乃见祥，故民病寒客心痛，腰 痛，大关节不利，屈伸不便，善厥逆，痞坚腹满。（阴胜阳，则
故也。）阳光不治，空积沉阴，白埃昏瞑，而乃发也。太虚深玄，气犹麻散，微见而隐，色黑微
黄，怫之先兆也。（王冰云∶寅至辰分，可候也矣。）木郁之发，太虚昏埃，云物以扰，大风乃
至，发屋折木，木有变。（土生异木，奇状也。）故民病胃脘当心而痛，上支两胁，膈咽不通，
食饮不下，甚则耳鸣眩转，目不识人，善暴僵仆。（是谓筋骨强直而不用，卒倒无所知也。）太
虚苍埃，天山一色，或气浊色黄黑，郁若横云不雨，而乃发也。其气无常，长川草偃，（无风而
自低。）柔叶呈阴，（白杨叶也，无风而叶皆背见。）松吟高山，虎啸岩岫，怫之先兆。（王冰
云∶甚者发速，微者发徐也。山行之候，以松虎期之，原行以麻黄为候，秋冬以梧桐、蝉叶候之。）火郁之发，
太虚昏翳，（而空见赤气也。）大明不彰，（而昏暗是也。）炎火行，大暑至，山泽燔燎，材木流津，广
厦腾烟，土浮霜卤，止水乃减，蔓草呈黄，风行惑言，（南风行令，惑言雨而不作。）湿化乃后，
故民病少气，疮疡痈肿，胁腹胸背面首四肢 愤，胪胀，疡痱呕逆，螈 骨痛，节乃有动，注下，
温疟，腹中暴痛，血溢流注，精液乃少，目赤心热，甚则瞀闷懊 ，善暴死，刻终大温，汗濡玄
府，而乃发也。其气四，〔（新添）郁极乃发，待时而作者，天气不足，地气随之，地气不足，
天气从之，运居其中，木气欲升，金气郁之，火气欲升，水气郁之，土气欲升，木气郁之，金气
欲升，火气郁之，丁酉、己亥、己巳、庚午、辛丑、庚寅。假令庚午，金气欲升，天气抑之，又
逢三之气，上下火郁，不能升降。故曰天气下降，气流于地，地气上升，气腾于天。故高下相台，
升降相因，而变作矣。多少而差其分，微者小差，甚者大差，甚则位易，气变易则大变生而病作
矣。《大要》曰∶甚纪五分，微纪七分。甚纪者速，微纪者缓。一纪者十五日，甚纪者七十五日，
而待时而发也，微纪者缓，一百五日而发也，所以知天地阴阳过差矣。〕动复则静，阳极反阴，
湿令乃化乃成，华发水凝，山川冰雪，焰阳午泽，怫之先兆也。
有怫之应，而后报也，皆观其极，而乃发也。木发无时，水随火也。其发无时者，示发无常。
水随二火之位，水火发于四气，金发五气。然有多少，发有微甚，微则当其气而不兼他气，甚则
兼其己所不胜。故水发而冰雹，土发而飘骤，木发而毁折，金发而清明，火发而曛昧。其所不胜
之气，推其下承，而可知也。然下承者，所谓实盛过极，则有承袭之害也。故经曰∶相火之下，
水气承之，水位之下，土气承之，土位之下，风气承之，风位之下，金气承之，金位之下，火气
承之，君水之下，阴精承之，皆所以制其胜也，视其物而明也。如人物热极，而体流津，以火炼
金，热极反化为水，是知火热过极，而兼水气下承之也。又，水气寒极，则物坚水凝如地，是知
水气过极，而兼土气下承也。又，雨湿极盛，则为骤注烈风而淫溃，是知土气过极，而兼风气下
承之也。又，风大则反凉，而草木散落，是知风气过极，而兼金气下承之也。又，秋气大凉，而
物皆干燥，是兼火气下承之象也。然万事不可过，太过者必有胜己者来承而制之也。故经曰∶亢
则害，承乃制，制则生化，外列盛衰，害则败乱，生化大病。然亢者，过极也，物恶其极，故曰
物生谓之化，物极谓之变。又，俗云物极则反，皆斯道也。
（新添）善。郁之甚者，治之奈何？木郁达之，（达者，在上涌之，吐令条达。）火郁发之，
（解表发汗，令其疏散。）土郁夺之，（夺谓宣下之，令无拥碍也。）金郁泄之，（渗泄、解表、
利小便也。）水郁折之。（抑制其盛气，折其冲逆也。）过者折之，以其畏也。
五运之气，每年都有天气的压制而使其郁结，郁积到极点就会发作，等待特定时机才发生。所以医经说：土气郁结发作时，山岩山谷震动惊骇，雷声轰鸣于天地气交之中，（这是云气分散的现象。）尘土飞扬使天色昏黄黑浊，化为白色的雾气，狂风暴雨在高深之间飘骤，击打岩石飞散于空中，洪水随之而来，河流泛滥漫延，田野牧场中大水退去后，石头和泥土高耸突兀，就像群马在田野间散落放牧一样。（此时）化气（长养之气）得以敷布，善于降下适时之雨，万物开始生长、发育、变化、成形。因此百姓容易患心腹胀满，肠鸣且频繁腹泻，严重则心痛胁痛，呕吐霍乱，饮邪发作为泄泻不止，浮肿身体沉重。（这是脾热的表现。）乌云奔涌向雨府，霞光拥抱着朝阳，山泽间尘土昏暗，这就是土气郁结发作的景象。其气数对应四，云层横亘天山，浮游之气忽生忽灭，这是土气郁结的先兆。（王冰说：天际云层横亘，山峦如同戴着帽带，岩谷丛生的草木，乍减乍生，显露出土气的迹象，郁结的征兆已经明显，都在平明时分观察浮游之气，以午前时刻候望为准。）
金气郁结发作时，天空洁净大地明朗，风清劲切，大凉之气兴起，草树笼罩在烟雾中，燥气盛行，雾多起于丑时后至辰时前，肃杀之气到来，草木枯黄干裂，（颜色黄赤黑混杂而至。事物不能承受肃杀，所以草木苍老干枯。）金属发出声响，因此百姓患病咳嗽气逆，心胁痛牵引少腹，容易突发剧痛，不能翻身侧卧，咽喉干燥，面色如蒙尘垢，色泽恶浊。（这是金气胜而肝木病的原因。）山泽焦枯，土壤凝结成霜卤，这就是金气郁结发作的景象。（王冰说。）其气数对应五，夜间寒冷白露降，树林莽原声音凄厉，这是金气郁结的先兆。
水气郁结发作时，阳气退避，阴气暴起，大寒降临，河川沼泽岩石凝结，寒气结成霜雪，严重时黄黑色昏暗遮蔽，流行于天地气交之中，霜成为肃杀之象，水显现出祥瑞之兆，因此百姓患病寒气客居导致心痛，腰痛，大关节不利，屈伸不便，容易四肢厥冷，痞块坚硬腹部胀满。（这是阴胜阳衰的缘故。）阳光不能治理光明，空虚积聚沉阴，白色尘埃昏暗不明，这就是水气郁结发作的景象。太虚深远玄妙，气像麻散一样微弱可见又隐没，颜色黑微黄，这是水气郁结的先兆。（王冰说：寅时至辰时这段时间，可以候望了。）
木气郁结发作时，太虚昏暗尘埃，云物扰乱，大风到来，掀翻房屋折断树木，树木有变异。（土生异木，形状奇特。）因此百姓患病胃脘当心而痛，向上支撑两胁，膈咽不通，饮食不下，严重时耳鸣眩晕，看不清人，容易突发僵仆。（这叫做筋骨强直而不能用，突然倒下无知觉。）太虚苍色尘埃，天山一色，或者气浊色黄黑，郁结像横云不雨，这就是木气郁结发作的景象。其气无常，长河边的草倒伏，（无风而自然低垂。）柔叶呈现背面，（白杨树叶，无风而叶子都背面向上。）松吟高山，虎啸岩岫，这是木气郁结的先兆。（王冰说：严重的发作快，轻微的发作慢。在山行走的时候，以松树老虎来预测，在原野行走以麻黄为预测，秋冬以梧桐、蝉叶来预测。）
火气郁结发作时，太虚昏暗遮蔽，（而空中出现赤气。）大明不显，（而是昏暗。）炎火运行，大暑到来，山泽燃烧，木材流汁，大厦腾烟，土面浮起霜卤，止水减少，蔓草变黄，风行惑言，（南风行使命令，迷惑言语指下雨而不作雨。）湿化推迟，因此百姓患病少气，疮疡痈肿，胁腹胸背头面四肢肿胀，胪胀，疡痱呕逆，抽搐骨痛，关节动摇，泄泻，温疟，腹中突发疼痛，血溢流注，精液减少，目赤心热，严重时神志昏闷懊恼，容易突发死亡，刻终之时大温，汗濡玄府，这就是火气郁结发作的景象。其气数对应四，〔（新添）郁积到极点才发作，等待时机发生的，是天气不足，地气随之；地气不足，天气从之，运气居于其中。木气欲升，被金气郁结；火气欲升，被水气郁结；土气欲升，被木气郁结；金气欲升，被火气郁结。丁酉、己亥、己巳、庚午、辛丑、庚寅年。例如庚午年，金气欲升，天气抑制它，又逢三之气，上下火气郁结，不能升降。所以说天气下降，气流于地；地气上升，气腾于天。所以高下相台，升降相因，而变化产生。多少而有差异，轻微的差小，严重的差大，甚则位置改变，气变易则大变生而疾病发作。《大要》说：甚纪五分，微纪七分。甚纪者速，微纪者缓。一纪者十五日，甚纪者七十五日，等待时机而发；微纪者缓，一百零五日而发。所以知道天地阴阳过差。〕动复则静，阳极反阴，湿令乃化乃成，华发水凝，山川冰雪，焰阳午泽，这是郁结的先兆。
有郁结的应验，而后才有报复，都是观察其极点，然后才发作。木气发作没有固定时间，水随火也。其发作没有固定时间的，显示发作无常。水随二火之位，水火发于四气，金发五气。然而有多少之分，发作有轻微严重，轻微则只当本气而不兼他气，严重则兼其所不胜之气。所以水发作而有冰雹，土发作而有飘骤，木发作而有毁折，金发作而清明，火发作而曛昧。其所不胜之气，推究其下承之气，就可以知道了。然而下承者，所谓实盛过极，则有承袭之害。所以医经说：相火之下，水气承之；水位之下，土气承之；土位之下，风气承之；风位之下，金气承之；金位之下，火气承之；君水之下，阴精承之，都是为了制约其胜气，观察物体而明白。如人物热极，而身体流津，以火炼金，热极反化为水，是知道火热过极，而兼水气下承之。又，水气寒极，则物体坚水凝如地，是知道水气过极，而兼土气下承。又，雨湿极盛，则为骤注烈风而淫溃，是知道土气过极，而兼风气下承。又，风大则反凉，而草木散落，是知道风气过极，而兼金气下承。又，秋气大凉，而物体皆干燥，是兼火气下承之象。然而万事不可过，太过者必有胜己者来承而制之。所以医经说：亢则害，承乃制，制则生化，外列盛衰，害则败乱，生化大病。然而亢者，过极也，物体厌恶其极，所以说物体生长叫做化，物体极叫做变。又，俗话物体极则反，都是这个道理。
（新添）问：郁结严重的，治疗怎么办？答：木郁达之，（达者，在上涌之，吐令条达。）火郁发之，（解表发汗，令其疏散。）土郁夺之，（夺谓宣下之，令无拥碍也。）金郁泄之，（渗泄、解表、利小便也。）水郁折之。（抑制其盛气，折其冲逆也。）过者折之，以其畏也。
The Qi of the Five Movements (Wu Yun) has, each year, the Heavenly Qi suppressing and stagnating it; when stagnation reaches its extreme, it erupts, waiting for the appropriate time to act. Thus, the Classics state: When Earth Qi is stagnant and erupts, cliffs and valleys tremble in alarm, thunder roars at the intersection of Heaven and Earth Qi (this is the dispersal of clouds), dust obscures the sky with yellow-black hues, transforming into white Qi, drifting and storming between high and deep depths, striking rocks and flying in the air, floodwaters then follow, river flows overflow and spread, fields and pastures [after the great waters recede] show stones and earth standing precariously, as if a herd of foals scattered grazing in the fields. The Transformation Qi (Qi of growth and nourishment) then spreads, aptly providing timely rains, allowing things to begin to grow, lengthen, transform, and mature. Therefore, the people suffer from heart and abdominal distension and fullness, borborygmus and frequent diarrhea; severely, they experience heart pain, hypochondriac pain, vomiting, Huoluan (cholera-like syndrome), fluid retention with profuse diarrhea, edema, and heavy body. (This arises from Spleen Heat.) Clouds rush to the Rain Mansion, rosy clouds embrace the morning sun, mist and dust obscure mountains and marshes; this is the eruption of Earth Qi. Its number corresponds to Four; clouds hang across the Heavenly Mountain, floating Qi fluctuates in generation and decline, which is the omen of stagnation. (Wang Bing says: Clouds hanging across the horizon, mountains like wearing hats and belts, dense vegetation in valleys appearing and disappearing, revealing Earth's presence, the signs of stagnation are manifest; all are observed at dawn, watching the floating Qi before noon.)
When Metal Qi is stagnant and erupts, the sky is clean and the earth bright, winds are clear and piercing, great coolness rises, grass and trees float in smoke, Dryness Qi prevails, fog frequently rises (between Chou and Chen hours), killing Qi arrives, grass and trees turn pale and dry (their colors are mixed yellow, red, and black; things cannot withstand the killing force, thus grass and trees become pale and dry). Metal makes sound, therefore the people suffer from cough and rebellious Qi, heart and hypochondriac pain radiating to the lower abdomen, prone to sudden severe pain, inability to turn over or lie on side, dry throat, dusty complexion, and foul color. (This is due to Metal excess causing Liver Wood disease.) Mountains and marshes are scorched and dry, soil condenses into frost and salt; this is the eruption of Metal Qi. (Wang Bing says.) Its number corresponds to Five; night cold and white dew fall, forests and wilds sound desolate, which is the omen of Metal Qi stagnation.
When Water Qi is stagnant and erupts, Yang Qi retreats, Yin Qi rises violently, great cold arrives, rivers, marshes, and rocks freeze, cold condenses into frost and snow; severely, yellow-black darkness obscures, flowing through the Qi intersection of Heaven and Earth, frost becomes the sign of killing, Water shows auspicious signs. Therefore, the people suffer from cold invading causing heart pain, lumbar pain, stiffness and difficulty in movement of large joints, prone to reversal cold (Jue Ni), palpitations, hardness, and abdominal fullness. (This is due to Yin excess overcoming Yang.) Solar light fails to govern brightness, emptiness accumulates sinking Yin, white dust obscures vision; this is the eruption of Water Qi. The Great Void is deep and profound, Qi scatters like hemp fibers, faintly visible then hidden, color black slightly yellow, which is the omen of Water Qi stagnation. (Wang Bing says: From Yin to Chen hours, observation is possible.)
When Wood Qi is stagnant and erupts, the Great Void is dim with dust, clouds and phenomena are disturbed, great winds arrive, overturning houses and breaking trees, Wood undergoes change. (Earth generates strange Wood, with unusual shapes.) Therefore, the people suffer from epigastric pain centered behind the heart, radiating upward to support both hypochondria, obstruction of diaphragm and pharynx, inability to swallow food and drink; severely, tinnitus, vertigo, inability to recognize people, prone to sudden rigidity and collapse. (This is called strong and rigid sinews and bones unable to function, sudden falling without consciousness.) The Great Void is gray with dust, mountain and sky one color, or Qi turbid with yellow-black color, stagnation resembling horizontal clouds without rain; this is the eruption of Wood Qi. Its Qi is unpredictable; long rivers' grass bends (naturally low without wind), soft leaves show their undersides (White Poplar leaves, showing backs without wind), pines chant on high mountains, tigers roar in rock peaks, which is the omen of Wood Qi stagnation. (Wang Bing says: Severe eruptions are fast, mild ones slow. For travel in mountains, predict by pines and tigers; for plains, predict by Ephedrae Herba (Mahuang); in autumn and winter, predict by Firmiana Seedling Bark (Fuzi) and Cicada Slough (Chanyijin).)
When Fire Qi is stagnant and erupts, the Great Void is dim and obscured (with red Qi visible in the void), the Great Brightness is not manifest (but rather dim), Blazing Fire moves, Great Heat arrives, mountains and marshes burn, timber flows with sap, grand mansions rise with smoke, soil floats with frost and salt, still water decreases, creeping grass turns yellow, wind blows confusing words (Southern Wind issues orders, confusing words indicate rain will not come), Humidification lags. Therefore, the people suffer from shortness of breath, sores, ulcers, carbuncles and swelling, distension of hypochondrium, abdomen, chest, back, head, face, limbs, and trunk, ulcerative flaccidity, vomiting and rebellious Qi, convulsions, bone pain, joint movement, profuse diarrhea, Warm Malaria (Wen Nue), sudden abdominal pain, blood extravasation and flow, depletion of essence and fluid, red eyes and hot Heart, severely, mental confusion and restlessness, prone to sudden death. At the end of the Ke period, great warmth occurs, sweat moistens the Xuanfu (pores); this is the eruption of Fire Qi. Its number corresponds to Four. [Added: When stagnation reaches its extreme, it erupts, waiting for the time; this happens when Heavenly Qi is insufficient, Earth Qi follows; when Earth Qi is insufficient, Heavenly Qi follows, with Movement occupying the center. Wood Qi desires to ascend, but is stagnated by Metal Qi; Fire Qi desires to ascend, but is stagnated by Water Qi; Earth Qi desires to ascend, but is stagnated by Wood Qi; Metal Qi desires to ascend, but is stagnated by Fire Qi. Ding You, Ji Hai, Ji Si, Geng Wu, Xin Chou, Geng Yin years. For example, in Geng Wu year, Metal Qi desires to ascend, but Heavenly Qi suppresses it, and encountering the Third Qi, upper and lower Fire Qi is stagnated, unable to ascend or descend. Thus it is said: Heavenly Qi descends, Qi flows into Earth; Earth Qi ascends, Qi rises to Heaven. Thus high and low interact, ascending and descending cause each other, and changes arise. Differences vary in degree; slight differences are small, severe differences are large; severely, positions change, Qi transformation leads to major changes and disease onset. The Da Yao states: Severe cycles are five parts, mild cycles are seven parts. Severe cycles are fast, mild cycles are slow. One cycle is fifteen days; severe cycles take seventy-five days to erupt after waiting for the time; mild cycles are slow, taking one hundred and five days to erupt. Thus, one knows the excess and deficiency of Heaven and Earth Yin and Yang.] Movement returns to stillness, Extreme Yang reverses to Yin, Humid Command transforms and forms, flowers emerge while water freezes, mountains and rivers hold ice and snow, blazing sun at midday marshes, which is the omen of stagnation.
There is an response to stagnation, followed by retaliation; all observe the extreme, then erupt. Wood eruption has no fixed time, Water follows Fire. Its eruption having no fixed time indicates irregular eruption. Water follows the position of the two Fires, Water and Fire erupt in the Four Commands, Metal erupts in the Fifth Command. However, there are degrees of abundance and scarcity, eruptions have mild and severe aspects. Mild cases correspond only to their own Qi without involving other Qi; severe cases involve the Qi they cannot overcome. Thus, Water eruption brings hail, Earth eruption brings gusty storms, Wood eruption brings destruction, Metal eruption brings clarity, Fire eruption brings obscurity. The Qi they cannot overcome can be known by deducing the supporting Qi below. The supporting Qi refers to what happens when excess and extremity lead to destructive succession. Thus, the Classics say: Below Ministerial Fire, Water Qi supports; below Water position, Earth Qi supports; below Earth position, Wind Qi supports; below Wind position, Metal Qi supports; below Metal position, Fire Qi supports; below Sovereign Water, Yin Essence supports; all serve to restrain their overcoming Qi, made clear by observing objects. For instance, when human/animal heat is extreme, body fluids flow; using fire to refine metal, extreme heat transforms back into water; thus we know that extreme Heat involves Water Qi supporting from below. Again, when Water Qi is extremely cold, objects harden and water freezes like earth; thus we know extreme Water involves Earth Qi supporting from below. Again, when rain and dampness are extremely abundant, there are sudden torrential winds and overflowing floods; thus we know excessive Earth involves Wind Qi supporting from below. Again, when wind is great, it turns cool and grass/trees scatter; thus we know excessive Wind involves Metal Qi supporting from below. Again, when Autumn Qi is greatly cool and objects are dry, it is the image of Fire Qi supporting from below. However, nothing should go to extremes; excess must be met by the Qi that overcomes it to restrain it. Thus, the Classics say: Excess causes harm, support leads to restraint, restraint allows transformation and generation, external manifestation shows prosperity and decline, harm leads to disorder, transformation and generation lead to major disease. Excess means reaching the extreme; things abhor the extreme, thus "growth of things is called Transformation, extremity of things is called Change." Also, common saying "things reverse at the extreme," all follow this Dao.
(Added) Question: How to treat severe stagnation? Answer: Wood stagnation is resolved by unblocking (Da), (Unblocking means inducing vomiting for those above to promote smooth flow.) Fire stagnation is resolved by venting (Fa), (Releasing the exterior and inducing sweating to allow dispersion.) Earth stagnation is resolved by seizing/drainage (Duo), (Seizing means purging downward to remove obstruction.) Metal stagnation is resolved by draining/releasing (Xie), (Percolating, releasing the exterior, promoting urination.) Water stagnation is resolved by restraining (Zhe), (Restraining its excessive Qi, checking its rebellious surge.) Excess is restrained by what it fears.