天地一倾轧之宇也，阴阳一摩荡之气也，五行一倚伏之数也，万物一推移之象也，四时
一更
代之纪也。此之谓日新，此之谓不息。不制则不生，不胜则不复，而天地之机息矣，人物之
类灭矣。其机不激则不动，不动则钝而不灵，而阴阳五行积于无用之地矣，天地万物有不摧
裂破坏者乎?《内经·六微旨大论》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；君火之下，阴精承之。亢则
害，承乃制，制则生化，外列盛衰，害则败乱，生化大病。夫曰下曰承云者，此以六气之步
言，其措词不得不如此。若推究万物之体，则所谓下者，非本体之外，别有所为下也，乃本
体之中，自有此气浑于无间者也。所谓承者，非从其外而附之，乃具其中而存之者也。何
者?
天下无一物不备五行，四时无一刻不备五行之气，但有多寡之数，盛衰之宜。一或营运有差
，
则胜者亢，而不胜者害矣。其所以不终于害者，以有制之者也。其制也，非制于既亢之后也
。火承以水，则火自有所涵而不越；水承以土，则水自有所防而不滥；土承以木，则土自有
所动而不郁；木承以金，则木自有所裁而不横；金承以火，则金自有所成而不顽。承者，隐
制
于未然，斯不待其亢而害，消于不觉矣。至于制之云者，世皆以为抑其生之过，而不知制者
，正以助其生之机也。木得金制，则不致横溢而力专于火矣；火得水制，则不致涣散而精聚
于土矣。此言生也。木亢不成火，以其湿也，得金制之，则木燥而火成矣；火亢不成土，以
其燥也，得水制之，则火湿而土成矣。此言化也。制也者，万物之所以成始而成终也，既防
亢害之后，而又开生化之先，其诸乾坤合辟阴阳不测之妙乎!明斯义也，其于病气胜复倚伏
之机，治法气味合和之道，豁然贯通矣乎!谨采先哲之名谈，一得之管见，有关于运气之旨
，病机之变，治法之要者，条列于下，以备观览焉。
夫以四时、五行、运气之变也 ，其机甚微。亢之害也，木亢则土害，土害则水肆而火
熄，
土愈失发生之源矣；火亢则金害，金害则木横而土微，金愈乏资生之本矣。土、金、水仿此
。此亢之害，害乃于他者也。亦有亢之害，害反及于身者。史载之曰∶经言，天火下临，则
肺金上从，白起金用，而草乃眚；燥气下临，则肝气上从，苍起木用，而土乃眚。以常所胜
论之，则火至而肺病，金至而肝病。今也天火下临，则金以从天之气，而白乃用，故病反生
于肝；天金下临，则木以从天之气，而苍乃用，故病反生于脾。举此类推，则厥阴司天，脾
气上从，而水斯眚；太阳司天，心气上从，而金斯眚；太阴司天，肾气上从，而火斯眚。皆
可知矣。此天度之尊，独异于他。经言∶天能制色，以其能制胜己，而使不为害。至于司地
，则气化之正，各随其证矣。惟胜复之候不同，亦随其气之多寡以求之。胜之为病轻，复之
为病重；胜则所不胜者，顺受其克，复加报怨仇焉，此不可不知也。如木之受病，本于肺金
所制，则不过肺气有余，凌犯于肝，生眼昏、 痒、耳无所闻、胸痛、体重诸病耳!若乃木
化
之盛，肝气妄行，大伤于脾，则金必相救，邪反伤肝，能使人体重、烦冤、胸痛引背、两胁
满痛引少腹∶故经言上应太白星者，谓金之复也。载之之论如此。所谓胜者，亢之害也；所
谓复者，承之制也。经曰∶风伤肝，燥胜风；热伤气，寒胜热；湿伤肉，风胜湿；燥伤皮毛
，热胜燥；寒伤血，湿胜寒。此胜之气也。又曰∶风胜则动，热胜则肿，燥胜则干，寒胜则
浮，湿胜则濡泻，甚则水闭 肿。此胜之证也。又曰∶有余而往，不足随之；不足而往，有
余随之。此复之机也。又曰∶胜复盛衰，不能相多也；往来小大，不能相过也；用之升降，
不能相无也。又曰∶气有余，则制己所胜，而侮所不胜；其不及，则己所不胜，侮而乘之，
己所胜，轻而侮之。侮反受邪，侮而受邪，寡于畏也。此胜复之大数也。所以然者，如木亢
害土，则土气无所泄而专精于金矣；土亢害水，则水气无所用而积力于木矣。金反报木，而
土气得伸矣；木反报土，而水气得伸矣。不但此也，今日之亢，即是前日之制，而今日之制
，又为来日之亢，制之不已，则又亢矣，经曰∶侮反受邪。史载之曰∶复之病重者，复之气
以积久而力浓，胜之气以发泄而无余也。故经曰∶所谓胜至，报气屈伏而未发也，胜至而复
，复已而胜，无常数也。故经又曰∶无翼其胜，无赞其复。谓治胜气者，宜预安其屈伏，无
令复气之反侮也。呜呼!圣人之教深矣。此亢之害，害反及于身者，所谓不戢自焚也。所谓
制也，所谓复也，此皆承制之实也。更有承制之虚。实者能生能化，虚者不能生化也。何以
言之?承制之实者，木亢而金来制木，实已生化金气来复也；金亢而火来制金，实已生化火
气来复也。虚者，乃木亢极，而见金之幻象，其金不但不能制木，而实害土之极也；金亢极
，而见火之幻象，其火不但不能制金，而实害木之极也。刘河间曰∶疮疡属火，而反腐出脓
水者，犹谷、果、肉、菜，热极则腐烂，而溃为污水也。溃而腐烂者，水之化也。所谓五行
之理过极，则胜己者反来制之，故火热过极，则反兼于水化也。又曰∶诸暴强直，支痛 戾
，里急筋缩，皆属于风者，燥金主于紧敛，短缩劲切，风木为病，反见燥金之化，由亢则害
，承乃制也。况风能胜湿而为燥也，一部《原病式》，其论皆如此。此承制之虚也。其承制
乃亢害，非生化也。易老《保命集》中，所谓兼化之虚象者也。而刘氏乃曰∶经云亢，则害
，承乃制者，谓亢过极，反兼胜己之化，制其甚也。如以火炼金，热极则反为水。五行之理
，微则当其本化，甚则兼其鬼贼。如此，是直以亢极之幻象，误为承制之实用矣。认似作是
，岂不谬乎?(河间所论，乃承制之虚，此辨最精透，自古无人见及。)
治病者，于承制之实，必能安其屈伏，而始有防微之功；于承制之虚，必能察其本原，
而后
为见真之智也。且夫五行之相生相制也，万物由此而成，万法由此而出。故张隐庵有曰∶枣
色黄味甘，脾家果也。凡木末之实，而为心家果者，生化之道也；(木生心火。)木末之实，
而为脾家果者，制化之道也。(木制脾土。)盖天地所生之万物，咸感五运六气之生化，明乎
阴阳生克之理，则凡物之性，皆可用之而生化于五脏六腑之气矣。故桃为肺之果，核主利肝
血；杏为心之果，核主利肺气。皆制化之理然也。本草述大黄条，引卢不远曰∶大黄味大苦
，气大寒，似得寒水正化，而炎上作苦，苦性走下，不相反乎?《参同》云∶五行相克，更
为父母。《素问》曰∶制则生化。是故五行之体，以克为用。其润下者，正炎上之用乎!则
凡心用有所不行，变生痰疾者，舍同类之苦，巽以入之，不能彰其用而复其常也。夫是说也
，即六元正纪曰∶六气之用，各归不胜而为化。故太阴雨化，施于太阳；太阳寒化，施于少
阴、少阳；少阴、少阳热化，施于阳明；阳明燥化，施于厥阴；厥阴风化，施于太阴。此有
所施，则彼有所奉。所谓太阴雨化，施于太阳者，太阳寒水之用，必受太阴雨化之施，而其
用乃成；而太阴雨化之用，亦必受太阳寒水之奉，而其用乃成也。故制也者，六气之所以成
己而成物也。卢氏不引《内经》而引《参同》，舍近取远，非引掖后学之道也。此生物之体
性也。
至于制方之法，则柯韵伯论四神丸方义，有曰∶鸡鸣至平旦，天之阴，阴中之阳也。阳
气当
至不至，虚邪得以留而不去，故作泻于黎明。其由有四∶一为脾虚不能制水；一为肾虚不能
行水。故二神丸君补骨脂之辛燥者，入肾以制水；佐肉豆蔻之辛温者，入脾以暖土；丸以枣
肉，又辛甘发散为阳也。一为命门火衰，不能生土；一为少阳气虚，无以发陈。故五味子散
。君五味子之酸温，以收坎宫耗散之火，少火生气，以培土也；佐吴茱萸之辛温，以顺肝木
欲散之势，为水气开滋生之路，以奉春生也。此四者，病因虽异，而见症则同，皆水亢为害
。二神丸是承制之剂，五味散是化生之剂也。二方理不同而用则同，故可互用以助效，亦可
合用以建功。合为四神丸，是制生之剂也，制生则化，久泄自瘳矣。此制方之法，必本于五
行承制生化之理也。若此者，皆往哲之名论，或论运气，或论物性，或论病机，或论方法，
亦云备矣。
至于平日读书之管见，则有论五行体性、功用，与病机吉凶、缓急之篇。曰∶肝主东
方风
木，其体温润，是土气也。木克土，即为土所供奉也。其性疏泄，是木之正气也。其用燥，
凡湿得风则干，是金气也。金克木，木含金气即为金所制伏，不使疏泄太过也。心主南方火
热，其体干燥，凡物必干燥始能着火，又物得火则坚，是金气也。火克金，即为金所供奉也
。其性大热，是火之正气也。其用蒸，凡物为火所逼则潮，是水气也。水克火，火含水气即
为水所制伏，不使炎热太过也。脾主中央湿土，其体淖泽，是水气也。土克水，水为土之奴
，当供奉夫土者也。其性镇静，是土之正气也。静则易郁，必借木气以疏之，土为万物所归
，四气具备，而求助于水与木者尤亟。何者?土不可燥，亦不可郁，故脾之用主于动，是木
气也。肺主西方燥金，其体劲洁，是木气也。其性清肃，是金之正气也。其用酷烈，酷暑烈
火，火使人畏，金亦使人畏，是金中有火神也。火有光明，金亦有光明者也。肾主北方寒水
，其体流动，是火气也。其性沉下，是水之正气也。其用温润，是土气也。由是观之，五行
之中，各有五行，不待外求，而本体自足。此天地相生相成，自然之数，当然之常也。停停
匀匀，不偏不倚，至于有变，则为病矣。变者，谓自病而所不胜者乘之，与自病而乘所胜者
，皆是也。二者吉凶缓急，前人皆混统立说，未曾分析。今吾思之，凡自病而所不胜者乘之
，其吉凶未可知，而其势必缓也；自病而乘
所胜者，其势急而必凶矣。何以言之?自病则本当为人所乘，其势顺；自病而反能乘人，其
势逆也。其顺逆奈何?正虚与邪实之别也。正虚者，脾土虚则肝木盛，心火虚则肾水盛，肝
、肾本无邪，本无意来克脾、克心，不过五脏之气，此亏则彼溢，有互相挹注之势，故土虚
不运，则木气满闷；火气不扬，则水气寒凝耳!其病在自虚之脏，而不在来乘之脏也。其吉
凶
不可知者，何也?谓自虚之脏气微，则相生之力微，但以药助之，而可复矣，并无事泻来乘
之脏也。是其治最易，而无待辗转斡旋也。必自虚之脏气竭，而后相生之力竭，而不可为矣
，故曰其势缓也。邪实者，肝邪实则克土，不必土脏之虚也，而径克之。肾邪实则克火，不
必火脏之虚也，而径克之。克之则传之，七传
而生气绝矣。其绝也，不待其七传而知也，当其初传，而预决之矣。何也?有病之脏，本不
当力能乘人，今其力能乘人者，邪盛而本脏之元气已绝，不能自主，惟邪气之所欲为而肆行
无忌也。若本脏元气未绝，则自能监制邪气，不使横溢至此矣。本脏气绝，则生生之源竭，
而所胜之脏失其所恃，故克而传之易易也。如肝
邪实，则肝之正气不能生火，而土之化源已虚。肝邪来逼，略无救援，既经传脾，肝脾合气
，邪力愈大，正气愈微，势如破竹。初或数日而传一脏，继则一日而传一脏，或一日而传数
脏矣。当其初传，化源已绝，用药补泻，皆穷于无可施，故曰其势凶而急也。何也?所谓邪
实者，以其得母气之生助也。肝挟水邪而克土，则火不能生；脾挟火邪以克水，则金不能助
故也。是同一相乘相克，而其吉凶缓急，如是悬隔，临诊决病，视人生死，其可不尽心乎?
故越人、仲景论治未病，皆曰见肝之病，必先实脾，是当其未传而急防之也。急防云者，抑
木
之亢，扶土之衰，仍资火气，以导木之去路，培土之来源。其法攻补兼施，辗转斡旋，如隔
二隔三，泻南补北，良工心苦，正为此耳!至如薛立斋、张景岳辈，每曰补正则邪自去。此
乃自虚而为人所乘者，变因自虚，人本无邪，故直补本宫，无事诛伐也。
又尝论寒者热之，热者寒之，微者逆之，甚者从之，假者反之之义，曰∶前贤有言，实
热以
苦寒折之，虚热以甘温除之。用苦寒者，是热者寒之、微者逆之之义也；用甘温者，是假者
反之之义也。又言阴盛格阳，阳盛格阴，则先其所主，伏其所因，或寒药而热服，或热剂而
寒佐，是甚者从之之义也，所谓反佐是也。此三者，逆之义为最显，从之义前贤发之为最详
，独所谓假者反之，自昔未有笃论，而又往往混于甚者从之之中，漫无分别。不揣狂愚，聊
天地是一个不断倾斜挤压的空间，阴阳是一种相互摩擦激荡的气，五行是一种相互依存潜伏的规律，万物是一种不断推移变化的现象，四季是一种交替更迭的法则。这就叫做日新月异，这就叫做永不停息。如果没有制约就不能生长，如果不能克制就不能恢复，那么天地的生机就会停止，万物的种类就会灭绝。其机理如果不被激发就不会运动，不运动就会迟钝而不灵验，那么阴阳五行就会堆积在无用的地方，天地万物难道没有遭受摧残破坏的吗？《内经·六微旨大论》说：相火之下，有水气来承接制约；水位之下，有土气来承接制约；土位之下，有风气来承接制约；风位之下，有金气来承接制约；金位之下，有火气来承接制约；君火之下，有阴精来承接制约。亢盛就会产生危害，有承接才能制约，有制约才能生化，外在表现出盛衰的变化；产生危害就会导致败坏混乱，生化功能就会发生大病。所谓“下”和“承”，这是从六气运行的步骤来说的，措辞不得不如此。如果推究万物的本体，那么所谓的“下”，并不是在本体之外另外有一个向下的作用，而是本体之中，自然就有这股气浑然存在于无间之处。所谓的“承”，并不是从外面依附过来，而是具备在内部而存在着的。为什么呢？天下没有一样东西不具备五行，四季没有一刻钟不具备五行之气，只是有多寡的数量、盛衰的适宜程度罢了。一旦运行出现偏差，那么胜者就会亢盛，不胜者就会受害。之所以最终不至于受害，是因为有制约的缘故。这种制约，并不是在已经亢盛之后才去制约它。火由水来承接，那么火自然有所涵养而不越界；水由土来承接，那么水自然有所防范而不泛滥；土由木来承接，那么土自然有所松动而不郁结；木由金来承接，那么木自然有所裁制而不横溢；金由火来承接，那么金自然有所成就而不顽固。承接，是在事情尚未发生时隐蔽地制约，这样就不必等到亢盛而产生危害，危害就在不知不觉中消除了。至于说到制约，世人都认为是抑制过度的生机，却不知道制约，正是为了帮助生机的运作。木得到金的制约，就不会横溢而力量专注于火；火得到水的制约，就不会涣散而精华聚集于土。这是说的“生”。木亢盛不能化生火，是因为湿气的影响，得到金的制约，那么木变得干燥而火就形成了；火亢盛不能化生土，是因为燥气的影响，得到水的制约，那么火变得湿润而土就形成了。这是说的“化”。制约，是万物所以能成始又能成终的原因，既防止了亢盛后的危害，又开启了生化的先河，这大概是乾坤开合、阴阳不可测度的奥妙吧！明白了这个道理，对于病气胜复倚伏的机理，治法气味调和的道理，就能豁然贯通了！谨采集先哲的名言，加上自己的一点管见，关于运气宗旨、病机变化、治法要点的内容，分条列在下面，以备阅览。
以四时、五行、运气的变化来看，其机理非常微妙。亢盛的危害，木亢则伤害土，土受伤则水肆行而火熄灭，土更加失去生发的源头；火亢则伤害金，金受伤则木横逆而土微弱，金更加缺乏资助的根本。土、金、水仿照此类情况。这种亢盛的危害，伤害的是其他脏腑。也有亢盛的危害，反而伤害自身的。史载之说：经书说，天火在下临，则肺金在上顺从，白色起而金用事，草木就会受灾；燥气在下临，则肝气在上顺从，青色起而木用事，土就会受灾。按照通常的相克理论来说，则是火至而肺病，金至而肝病。现在天火在下临，则金因为顺从天之气，而白色用事，所以病反而生在肝；天金在下临，则木因为顺从天之气，而青色用事，所以病反而生在脾。举此类推，则厥阴司天时，脾气上顺从，而水受灾；太阳司天时，心气上顺从，而金受灾；太阴司天时，肾气上顺从，而火受灾。都可以知道了。这是天度尊贵，唯独与其他不同。经书说：天能控制颜色，因为它能制胜己所不胜之气，而使不为害。至于地气，则是气化的正常表现，各自随着证候而定。只有胜复的征候不同，也随着气的多少来探求。胜气致病轻，复气致病重；胜气是所不胜者顺受其克，复气则是报复仇怨，这些是不可不知道的。比如木受病，本于肺金所制约，则不过是肺气有余，凌犯于肝，产生眼昏、痒、耳无所闻、胸痛、体重诸病罢了！如果是木化之盛，肝气妄行，大伤于脾，则金必然相救，邪气反而伤肝，能使人体重、烦冤、胸痛引背、两胁满痛引少腹：所以经书说上应太白星，说的是金的复气。载之的论述就是这样。所谓胜，就是亢盛的危害；所谓复，就是承接的制约。经书说：风伤肝，燥胜风；热伤气，寒胜热；湿伤肉，风胜湿；燥伤皮毛，热胜燥；寒伤血，湿胜寒。这是胜气。又说：风胜则动，热胜则肿，燥胜则干，寒胜则浮，湿胜则濡泻，甚则水闭浮肿。这是胜证的征候。又说：有余而来，不足随之；不足而来，有余随之。这是复的机理。又说：胜复盛衰，不能相差太多；往来大小，不能超过限度；运用的升降，不能互相缺失。又说：气有余，则制约己所胜，而侮慢己所不胜；气不及，则己所不胜，侮慢而乘袭之，己所胜，轻微而侮慢之。侮慢反过来受邪，受邪是因为缺乏敬畏。这是胜复的大致规律。之所以这样，比如木亢害土，则土气无处发泄而专精于金；土亢害水，则水气无处使用而积力于木。金反过来报复木，而土气得伸展；木反过来报复土，而水气得伸展。不仅如此，今天的亢盛，就是昨天的制约，而今天的制约，又成为明天的亢盛，制约不止，就又亢盛了，经书说：侮慢反过来受邪。史载之说：复气致病重的，复气因为积累久而力量浓厚，胜气因为发泄而无余。所以经书说：所谓胜至，报气屈伏而未发，胜至而复，复已而胜，没有固定的次数。所以经书又说：不要助长胜气，不要赞助复气。说的是治疗胜气，应该预先安抚屈伏之气，不让复气反侮。唉！圣人的教诲深远啊。这种亢盛的危害，反而伤害自身，所谓的不收敛自焚。所谓制约，所谓复气，这都是承接制约的实象。更有承接制约的虚象。实象能生能化，虚象不能生化。为什么这么说？承接制约的实象，木亢而金来制木，实际上是生化金气来复；金亢而火来制金，实际上是生化火气来复。虚象，乃是木亢极，而出现金的幻象，这金不但不能制木，反而是害土到了极点；金亢极，而出现火的幻象，这火不但不能制金，反而是害木到了极点。刘河间说：疮疡属火，而腐败出脓水的，就像谷物、水果、肉类、蔬菜，热极则腐烂，而溃烂为污水。溃烂腐烂，是水的气化。所谓五行的道理过极，则胜己者反而来制约，所以火热过极，则反而兼有水的气化。又说：各种暴烈的强直，肢体疼痛扭曲，里急筋缩，都归属于风，燥金主于紧敛，短缩劲切，风木为病，反而见到燥金的气化，由亢则害，承乃制。况且风能胜湿而为燥，《原病式》一书，其论述都是如此。这就是承接制约的虚象。这种承接制约乃是亢害，不是生化。易老《保命集》中，所谓兼化的虚象。而刘氏却说：经书说亢，则害，承乃制，是说亢过极，反而兼有胜己的气化，来制约其甚。比如用火炼金，热极则反为水。五行的道理，微则当其本化，甚则兼其鬼贼。如此，是直接以亢极的幻象，误认为承接制约的实用。（河间所论，乃是承接制约的虚象，此辨析最精透，自古无人见到。）
治病的人，对于承接制约的实象，必须能安抚屈伏之气，才有防微杜渐的功效；对于承接制约的虚象，必须能察知本源，才是见真知的智慧。况且五行的相生相制，万物由此而成，万法由此而出。所以张隐庵说：枣色黄味甘，是脾家的果实。凡是木末的果实，而成为心家果实的，是生化的道理（木生心火）；木末的果实，而成为脾家果实的，是制化的道理（木制脾土）。大概天地所生的万物，都感受五运六气的生化，明白阴阳生克的道理，那么凡物的性质，都可以用来生化于五脏六腑之气了。所以桃是肺的果实，核主要利肝血；杏是心的果实，核主要利肺气。都是制化的道理使然。本草述大黄条，引用卢不远说：大黄味大苦，气大寒，似乎得寒水正化，而炎上作苦，苦性走下，不相反吗？《参同契》说：五行相克，互为父母。《素问》说：制则生化。所以五行的本体，以克为用。那润下的，正是炎上的作用吗！那么凡是心用有所不行，变生痰疾的，舍弃同类之苦，巽以入之，不能彰显其用而恢复常态。这个说法，即六元正纪说：六气之用，各归不胜而为化。所以太阴雨化，施于太阳；太阳寒化，施于少阴、少阳；少阴、少阳热化，施于阳明；阳明燥化，施于厥阴；厥阴风化，施于太阴。这有所施，则彼有所奉。所谓太阴雨化，施于太阳者，太阳寒水之用，必须接受太阴雨化的施予，而其用乃成；而太阴雨化之用，也必须接受太阳寒水的奉承，而其用乃成。所以制约，是六气所以成己而成物的原因。卢氏不引《内经》而引《参同》，舍近取远，不是引导后学的道义。这是生物的体性。
至于制方的方法，柯韵伯论述四神丸方义，有说：鸡鸣至平旦，是天的阴，阴中之阳。阳气应当至而不至，虚邪得以停留而去不掉，所以在黎明作泻。其原因有四个：一是脾虚不能制水；一是肾虚不能行水。所以二神丸以补骨脂的辛燥为君药，入肾以制水；佐以肉豆蔻的辛温，入脾以暖土；丸以枣肉，又是辛甘发散为阳。一是命门火衰，不能生土；一是少阳气虚，无以发陈。所以五味子散。以五味子的酸温为君药，以收坎宫耗散之火，少火生气，以培土；佐以吴茱萸的辛温，以顺肝木欲散之势，为水气开滋生之路，以奉春生。这四者，病因虽异，而见症则同，都是水亢为害。二神丸是承接制约的剂型，五味散是化生的剂型。两方理不同而用则同，所以可互用以助效，也可合用以建功。合为四神丸，是制生之剂，制生则化，久泄自然痊愈。这是制方的方法，必须基于五行承接制约生化的道理。像这样的，都是往哲的名论，有的论运气，有的论物性，有的论病机，有的论方法，也算完备了。
至于平日读书的管见，则有论五行体性、功用，与病机吉凶、缓急的篇章。说：肝主东方风木，其体温润，是土气。木克土，即为土所供奉。其性疏泄，是木的正气。其用燥，凡湿得风则干，是金气。金克木，木含金气即为金所制伏，不使疏泄太过。心主南方火热，其体干燥，凡物必干燥始能着火，又物得火则坚，是金气。火克金，即为金所供奉。其性大热，是火的正气。其用蒸，凡物为火所逼则潮，是水气。水克火，火含水气即为水所制伏，不使炎热太过。脾主中央湿土，其体淖泽，是水气。土克水，水为土之奴，当供奉夫土。其性镇静，是土的正气。静则易郁，必借木气以疏之，土为万物所归，四气具备，而求助于水与木者尤亟。为什么？土不可燥，亦不可郁，所以脾之用主于动，是木气。肺主西方燥金，其体劲洁，是木气。其性清肃，是金的正气。其用酷烈，酷暑烈火，火使人畏，金亦使人畏，是金中有火神。火有光明，金亦有光明。肾主北方寒水，其体流动，是火气。其性沉下，是水的正气。其用温润，是土气。由此看来，五行之中，各有五行，不待外求，而本体自足。这是天地相生相成，自然的数，当然的常。停停匀匀，不偏不倚，至于有变，则为病。变者，谓自病而所不胜者乘之，与自病而乘所胜者，皆是。二者吉凶缓急，前人皆混统立说，未曾分析。现在我思考，凡是自病而所不胜者乘之，其吉凶未可知，而其势必缓；自病而乘所胜者，其势急而必凶。为什么这么说？自病则本当为人所乘，其势顺；自病而反能乘人，其势逆。其顺逆如何？正虚与邪实的区别。正虚者，脾土虚则肝木盛，心火虚则肾水盛，肝、肾本无邪，本无意来克脾、克心，不过五脏之气，此亏则彼溢，有互相挹注之势，所以土虚不运，则木气满闷；火气不扬，则水气寒凝！其病在自虚之脏，而不在来乘之脏。其吉凶不可知，为什么呢？谓自虚之脏气微，则相生之力微，但以药助之，而可复矣，并无事泻来乘之脏。是其治最易，而无待辗转斡旋。必自虚之脏气竭，而后相生之力竭，而不可为矣，所以说其势缓。邪实者，肝邪实则克土，不必土脏之虚，而径克之。肾邪实则克火，不必火脏之虚，而径克之。克之则传之，七传而生气绝。其绝，不待其七传而知，当其初传，而预决之。为什么？有病之脏，本不当力能乘人，今其力能乘人者，邪盛而本脏之元气已绝，不能自主，惟邪气之所欲为而肆行无忌。若本脏元气未绝，则自能监制邪气，不使横溢至此。本脏气绝，则生生之源竭，而所胜之脏失其所恃，故克而传之易易。如肝邪实，则肝之正气不能生火，而土之化源已虚。肝邪来逼，略无救援，既经传脾，肝脾合气，邪力愈大，正气愈微，势如破竹。初或数日而传一脏，继则一日而传一脏，或一日而传数脏。当其初传，化源已绝，用药补泻，皆穷于无可施，所以说其势凶而急。为什么？所谓邪实，以其得母气之生助。肝挟水邪而克土，则火不能生；脾挟火邪以克水，则金不能助。是同一相乘相克，而其吉凶缓急，如是悬隔，临诊决病，视人生死，其可不尽心乎？所以越人、仲景论治未病，都说见肝之病，必先实脾，是当其未传而急防之。急防云者，抑木之亢，扶土之衰，仍资火气，以导木之去路，培土之来源。其法攻补兼施，辗转斡旋，如隔二隔三，泻南补北，良工心苦，正为此耳！至于薛立斋、张景岳辈，每曰补正则邪自去。这是自虚而为人所乘者，变因自虚，人本无邪，故直补本宫，无事诛伐。
又曾论寒者热之，热者寒之，微者逆之，甚者从之，假者反之的意义，说：前贤有言，实热以苦寒折之，虚热以甘温除之。用苦寒者，是热者寒之、微者逆之义；用甘温者，是假者反之之义。又说阴盛格阳，阳盛格阴，则先其所主，伏其所因，或寒药而热服，或热剂而寒佐，是甚者从之义，所谓反佐。这三者，逆之义为最显，从之义前贤发之为最详，独所谓假者反之，自昔未有笃论，而又往往混于甚者从之之中，漫无分别。不揣狂愚，聊
The heaven and earth constitute a space of continuous tilting and pressing; yin and yang are qi that rub against and激荡 (agitate) each other; the Five Phases are numbers of mutual dependence and latent potential; all things are phenomena of constant推移 (shifting); the four seasons are laws of alternating succession. This is called daily renewal, this is called ceaseless motion. Without restraint, there can be no growth; without overcoming, there can be no recovery, and then the mechanism of heaven and earth would cease, and the species of beings would perish. If its mechanism is not激 (stimulated), it will not move; if it does not move, it becomes dull and unresponsive, and yin, yang, and the Five Phases accumulate in places of uselessness. Would not heaven, earth, and all things suffer destruction and damage? The *Neijing · Liù Wēi Zhǐ Dà Lùn* (Great Treatise on the Six Subtle Principles) states: Below Xiāng Huǒ (Ministerial Fire), Shuǐ Qì (Water Qi) assumes control; below the position of Water, Tǔ Qì (Earth Qi) assumes control; below the position of Earth, Fēng Qì (Wind Qi) assumes control; below the position of Wind, Jīn Qì (Metal Qi) assumes control; below the position of Metal, Huǒ Qì (Fire Qi) assumes control; below Jūn Huǒ (Monarch Fire), Yīn Jīng (Yin Essence) assumes control. When there is excessive flourishing (Kàng 亢), harm ensues; when there is assumption of control (Chéng 承), there is restraint (Zhì 制); with restraint, there is generation and transformation (Shēng Huà 生化), manifesting externally as prosperity and decline; when harm occurs, disorder prevails, and generation and transformation become major diseases. The terms "below" and "assume control" are used here to describe the steps of the Six Qi; thus, the wording is necessarily so. However, if we investigate the substance of all things, what is meant by "below" is not something external to the substance acting downwards, but rather this Qi naturally exists within the substance itself, blending seamlessly. What is meant by "assume control" is not attaching from the outside, but existing within. Why? Because there is not a single thing in the world that does not contain the Five Phases, nor a moment in the four seasons that lacks the Qi of the Five Phases; there are only differences in quantity and degrees of flourishing and decline. If operation deviates slightly, the victorious phase becomes excessive, and the defeated phase suffers harm. The reason it does not ultimately result in harm is because of restraint. This restraint is not applied after excess has already occurred. Fire is restrained by Water, so Fire naturally has containment and does not overstep; Water is restrained by Earth, so Water naturally has prevention and does not flood; Earth is restrained by Wood, so Earth naturally has movement and does not stagnate; Wood is restrained by Metal, so Wood naturally has pruning and does not grow wildly; Metal is restrained by Fire, so Metal naturally has refinement and does not become stubborn. "Assuming control" implies hidden restraint before the event, so that one need not wait for excess to cause harm; harm is eliminated imperceptibly. As for the term "restraint," the world generally believes it means suppressing excessive vitality, not realizing that restraint actually assists the mechanism of generation. When Wood is restrained by Metal, it does not overflow, and its force concentrates on Fire; when Fire is restrained by Water, it does not dissipate, and its essence gathers in Earth. This refers to "generation." If Wood is excessive and cannot generate Fire, it is due to dampness; restrained by Metal, Wood becomes dry, and Fire is formed. If Fire is excessive and cannot generate Earth, it is due to dryness; restrained by Water, Fire becomes moist, and Earth is formed. This refers to "transformation." Restraint is how all things begin and end; it prevents harm after excess and initiates generation. Is this not the profound mystery of the opening and closing of Heaven and Earth, and the unfathomable nature of Yin and Yang? Understanding this principle allows one to clearly grasp the mechanisms of disease Qi's victory and retaliation, and the way of harmonizing therapeutic flavors and properties. I have carefully collected the famous discourses of former sages, along with my own humble insights, regarding the principles of Yun Qi (Luck/Qi Movement), variations in disease mechanisms, and essentials of treatment methods, listed below for review.
Considering the changes of the four seasons, Five Phases, and Yun Qi, the mechanism is very subtle. In the harm of excess: Wood excess harms Earth; if Earth is harmed, Water acts recklessly and Fire extinguishes, causing Earth to lose its source of generation. Fire excess harms Metal; if Metal is harmed, Wood grows wild and Earth weakens, causing Metal to lack its root of nourishment. Earth, Metal, and Water follow similar patterns. This harm of excess harms others. There is also harm of excess that rebounds upon oneself. Shi Zaizhi stated: The classics say, when Heavenly Fire descends, Lung Metal follows upward; Bai (White/Metal) takes effect, and grasses suffer. When Dryness descends, Liver Qi follows upward; Cang (Green/Wood) takes effect, and Earth suffers. According to normal controlling relationships, Fire arriving causes Lung disease, and Metal arriving causes Liver disease. Now, with Heavenly Fire descending, Metal follows the Heavenly Qi, and White takes effect, so disease arises in the Liver. With Heavenly Metal descending, Wood follows the Heavenly Qi, and Green takes effect, so disease arises in the Spleen. By analogy, when Jueyin governs the year, Spleen Qi follows upward, and Water suffers; when Taiyang governs the year, Heart Qi follows upward, and Metal suffers; when Taiyin governs the year, Kidney Qi follows upward, and Fire suffers. All these can be known. This dignity of Heavenly measures is unique. The classics state: Heaven can control colors because it can overcome what conquers itself, preventing harm. Regarding Earthly governance, it is the normal气化 (Qi transformation), varying with symptoms. Only the signs of victory and retaliation differ, sought according to the abundance or scarcity of Qi. Disease caused by Victory Qi is mild; disease caused by Retaliation Qi is severe. Victory involves the unconquered accepting control; Retaliation involves seeking revenge. These must be understood. For example, if Wood is diseased due to restraint by Lung Metal, it is merely excessive Lung Qi invading the Liver, causing dizziness, itching, deafness, chest pain, and heaviness. But if Wood's transformation is excessive, and Liver Qi acts recklessly, severely harming the Spleen, Metal must rescue, and the pathogen injures the Liver, causing heaviness, vexation, chest pain radiating to the back, and fullness/pain in the hypochondrium radiating to the lower abdomen. Thus, the classics mention correspondence to the Star Taibai (Venus), indicating Metal's retaliation. This is Shi Zaizhi's argument. "Victory" refers to the harm of excess; "Retaliation" refers to the restraint of assumption. The classics say: Wind injures the Liver, Dryness overcomes Wind; Heat injures Qi, Cold overcomes Heat; Dampness injures Flesh, Wind overcomes Dampness; Dryness injures Skin/Hair, Heat overcomes Dryness; Cold injures Blood, Dampness overcomes Cold. These are Victory Qi. It also says: Wind excess causes movement; Heat excess causes swelling; Dryness excess causes dryness; Cold excess causes edema; Dampness excess causes loose stools; severe cases cause water retention and edema. These are signs of Victory. It also says: Where there is surplus, deficiency follows; where there is deficiency, surplus follows. This is the mechanism of Retaliation. It also says: The fluctuation of victory and retaliation cannot exceed limits; their coming and going cannot surpass bounds; their use of ascending and descending cannot be absent. It also says: When Qi is in excess, it controls what it normally conquers and insults what normally conquers it. When Qi is deficient, what normally conquers it insults and exploits it, and what it normally conquers lightly insults it. Insulting leads to receiving pathogens; receiving pathogens is due to lack of fear. This is the general rule of victory and retaliation. Why? If Wood excess harms Earth, Earth Qi has nowhere to vent and concentrates on Metal. If Earth excess harms Water, Water Qi has nowhere to use and accumulates force in Wood. Metal retaliates against Wood, allowing Earth Qi to extend. Wood retaliates against Earth, allowing Water Qi to extend. Moreover, today's excess is yesterday's restraint, and today's restraint becomes tomorrow's excess. Restraint without end leads to excess again. The classics say: Insulting leads to receiving pathogens. Shi Zaizhi said: Severe retaliation disease occurs because Retaliation Qi accumulates strength over time, while Victory Qi is exhausted through venting. Thus, the classics say: When Victory arrives, the Retaliation Qi lies dormant. When Victory arrives, Retaliation follows; when Retaliation ends, Victory returns. There is no fixed number. Thus, the classics further say: Do not aid Victory, do not assist Retaliation. Treating Victory Qi requires pacifying the dormant Qi to prevent Retaliation Qi from insulting back. Alas! The teachings of the sages are profound. This harm of excess rebounding upon oneself is called "burning oneself by not sheathing the sword." Restraint and Retaliation are the substantial manifestations of assumption and restraint. There is also the virtual manifestation of assumption and restraint. The substantial can generate and transform; the virtual cannot. Why? In the substantial case, Wood excess is controlled by Metal, which actually generates Metal Qi for retaliation. Metal excess is controlled by Fire, which actually generates Fire Qi for retaliation. In the virtual case, Wood reaches extreme excess and presents an illusion of Metal. This Metal cannot control Wood but instead severely harms Earth. Metal reaches extreme excess and presents an illusion of Fire. This Fire cannot control Metal but instead severely harms Wood. Liu Hejian said: Sores and ulcers belong to Fire, but those rotting and discharging pus/water are like grains, fruits, meat, and vegetables rotting under extreme heat into sewage. Rotting is the transformation of Water. The principle of the Five Phases is that at extremes, the conqueror comes to restrain. Thus, extreme Fire transforms into Water. He also said: All sudden stiffness, limb pain, twisting, interior urgency, and tendon contraction belong to Wind. Dryness/Metal governs tightness and shortening. Wind-Wood disease presenting Dryness-Metal transformation is due to excess causing harm and assumption bringing restraint. Furthermore, Wind overcomes Dampness to create Dryness. The entire *Yuan Bing Shi* discusses this. This is the virtual aspect of assumption and restraint. Here, assumption and restraint are excess and harm, not generation and transformation. Yi Lao's *Bao Ming Ji* calls this the virtual image of mixed transformation. Liu claimed: The classics say "excess causes harm, assumption brings restraint," meaning extreme excess assumes the transformation of its conqueror to restrain the severity. Like using fire to smelt metal; extreme heat turns it to water. The principle of Five Phases: subtle cases follow original transformation; severe cases assume the ghost/killer phase. Thus, mistaking the virtual image of extreme excess for the practical use of assumption and restraint is erroneous. Recognizing similarity as truth is indeed absurd! (Liu's discussion concerns the virtual aspect of assumption/restraint; this critique is most penetrating, unseen since antiquity.)
In treating diseases, for the substantial aspect of assumption and restraint, one must pacify the dormant Qi to achieve preventive efficacy; for the virtual aspect, one must observe the origin to gain true wisdom. The mutual generation and restraint of the Five Phases form all things and yield all methods. Zhang Yin'an said: Dates are yellow and sweet, fruits of the Spleen. Fruits at the tips of Wood that become Heart fruits illustrate the way of generation (Wood generates Heart Fire). Fruits at the tips of Wood that become Spleen fruits illustrate the way of restraint (Wood restrains Spleen Earth). All things born of heaven and earth feel the generation and transformation of the Five Movements and Six Qi. Understanding Yin-Yang generation and control allows the nature of all things to be used to generate and transform the Qi of the Zang-Fu organs. Thus, peaches are Lung fruits; pits benefit Liver blood. Apricots are Heart fruits; pits benefit Lung Qi. All follow the logic of restraint and transformation. The *Bencao Shu* entry on Da Huang cites Lu Bu Yuan: Da Huang is extremely bitter and cold, seemingly obtaining the correct transformation of Cold Water, yet rising heat produces bitterness, and bitterness moves downward—is this not contradictory? The *Cantong Qi* says: Five Phases control each other, becoming parents to one another. The *Suwen* says: Restraint leads to generation and transformation. Thus, the substance of the Five Phases uses control as function. That which moistens and flows down is the function of that which flares up. Therefore, for any Heart dysfunction producing phlegm-disease, using bitter substances of the same category to enter via Xun (obedience/subtlety) cannot manifest its function and restore normalcy. This view aligns with the *Liuyuan Zhengji*: The functions of the Six Qi return to what they do not conquer to transform. Thus, Taiyin's Rain Transformation applies to Taiyang; Taiyang's Cold Transformation applies to Shaoyin and Shaoyang; Shaoyin/Shaoyang's Heat Transformation applies to Yangming; Yangming's Dryness Transformation applies to Jueyin; Jueyin's Wind Transformation applies to Taiyin. Where there is application, there is reception. Taiyin's Rain Transformation applying to Taiyang means Taiyang's Cold Water function must receive Taiyin's Rain Transformation to complete its use; conversely, Taiyin's Rain Transformation must receive Taiyang's Cold Water reception to complete its use. Thus, restraint is how the Six Qi complete themselves and things. Lu citing the *Cantong Qi* instead of the *Neijing*, seeking far sources near home, is not the way to guide students. This is the nature of living things.
Regarding prescription formulation, Ke Yunbo discussed the rationale of Sishen Wan: From cockcrow to dawn, it is Heaven's Yin, Yang within Yin. Yang Qi should arrive but does not; empty pathogens remain, causing diarrhea at dawn. Causes include: 1. Spleen deficiency failing to control Water; 2. Kidney deficiency failing to move Water. Thus, Ershen Wan uses Gubuzhi (Psoralea Fructus), pungent and dry, as sovereign to enter Kidney and control Water; Rou Doukou (Nutmeg), pungent and warm, as assistant to enter Spleen and warm Earth; pills made with Jujube flesh, pungent-sweet dispersing to generate Yang. 3. Mingmen Fire decline failing to generate Earth; 4. Shaoyang Qi deficiency failing to initiate growth. Thus, Wuweizi San. Wuweizi (Schisandra Berry), sour and warm, as sovereign to gather dissipating Fire in Kan Palace; Sheng Huo Qi Sheng generates Qi to cultivate Earth; Wuzhuyu (Evodia Fruit), pungent and warm, as assistant to smooth Liver Wood's desire to scatter, opening paths for Water Qi generation to serve Spring growth. Though etiologies differ, symptoms are the same: all involve Water excess causing harm. Ershen Wan is an assumption-restraint formula; Wuweizi San is a generation-transformation formula. Different theories, same usage; they can be used interchangeably or combined. Combined as Sishen Wan, it is a restraint-generation formula. Restraint generates transformation; chronic diarrhea heals. This method is based on the principle of Five Phase assumption, restraint, generation, and transformation. Such discussions by past sages cover luck, material nature, disease mechanisms, and methods comprehensively.
My humble insights from reading discuss the substance/function of Five Phases and the auspicious/inauspicious, slow/fast nature of disease mechanisms. Liver governs East Wind-Wood; its substance is moist, containing Earth Qi. Wood controls Earth, thus Earth serves it. Its nature is dispersing, the upright Qi of Wood. Its function is dryness; dampness becomes dry with wind, representing Metal Qi. Metal controls Wood; Wood contains Metal Qi, restrained by Metal to prevent excessive dispersion. Heart governs South Fire-Heat; its substance is dry (things must be dry to catch fire, and harden in fire), representing Metal Qi. Fire controls Metal, thus Metal serves it. Its nature is hot, the upright Qi of Fire. Its function is steaming; things forced by fire become moist, representing Water Qi. Water controls Fire; Fire contains Water Qi, restrained by Water to prevent excessive heat. Spleen governs Central Wet Earth; its substance is muddy/moist, representing Water Qi. Earth controls Water; Water is Earth's servant, serving Earth. Its nature is calm/still, the upright Qi of Earth. Stillness easily stagnates, needing Wood Qi to disperse. Earth is the归宿 (destination) of all things, possessing four Qi, urgently seeking help from Water and Wood. Why? Earth must not be dry nor stagnant. Thus, Spleen's function is movement, representing Wood Qi. Lung governs West Dryness-Metal; its substance is tough/clean, representing Wood Qi. Its nature is clear/descending, the upright Qi of Metal. Its function is fierce/severe; summer heat/fire frightens people, so does Metal; Metal contains Fire Spirit. Fire has light; Metal has light too. Kidney governs North Cold Water; its substance is flowing, representing Fire Qi. Its nature is sinking/lowering, the upright Qi of Water. Its function is moist/warm, representing Earth Qi. Thus, within the Five Phases, each contains the Five Phases, self-sufficient without external seeking. This is the natural number of heaven and earth generating each other, the constant norm. Balanced, unbiased, deviation leads to disease. Deviation means self-disease exploited by what conquers it, or self-disease exploiting what it conquers. Both exist. Past scholars conflated their auspicious/inauspicious and slow/fast natures. I analyze: Self-disease exploited by the conqueror is uncertain in outcome but slow in progression. Self-disease exploiting the conquered is fast and fatal. Why? Self-disease normally allows exploitation (smooth/natural); self-disease exploiting others is reverse/abnormal. Smooth vs. Reverse depends on Deficiency of Righteous Qi vs. Excess of Pathogenic Qi. In Deficiency: Spleen Earth deficiency leads to Liver Wood excess; Heart Fire deficiency leads to Kidney Water excess. Liver/Kidney have no pathogen, no intent to attack Spleen/Heart. It is merely that when one Zang is deficient, another overflows, creating mutual suction. Spleen deficiency fails to transport, causing Wood Qi fullness; Heart Qi fails to rise, causing Water Qi cold coagulation. The disease is in the deficient Zang, not the attacking Zang. Outcome is uncertain because if Qi is slight, generation power is slight; medication can restore it without purging the attacker. Treatment is easy, requiring no complex maneuvering. Only when the deficient Zang's Qi is exhausted, and generation power ceases, is it hopeless—hence "slow." In Excess: Liver Pathogen Excess attacks Earth, regardless of Spleen deficiency. Kidney Pathogen Excess attacks Fire, regardless of Heart deficiency. Attack leads to transmission; seven transmissions lead to exhaustion of Life Qi. Death is predictable at initial transmission. Why? The diseased Zang normally shouldn't attack others. If it can, Pathogen is strong, and Original Qi is exhausted, unable to control itself, letting Pathogen run rampant. If Original Qi remains, it controls the Pathogen. Exhaustion of Original Qi cuts off the source of life; the conquered Zang loses support, making transmission easy. E.g., Liver Pathogen Excess: Liver Righteous Qi cannot generate Fire, weakening Earth's transformation source. Liver Pathogen presses, no rescue. After transmitting to Spleen, Liver-Spleen combine, Pathogen strengthens, Righteous Qi weakens, momentum like splitting bamboo. Initially days per Zang, then one day per Zang, or multiple Zangs in a day. At initial transmission, transformation source is cut; tonification/purging is futile. Hence "fast and fatal." Why? Pathogen Excess gains maternal support. Liver carrying Water Pathogen attacks Earth, blocking Fire generation; Spleen carrying Fire Pathogen attacks Water, blocking Metal assistance. Same mutual attack, yet outcomes vary vastly. Clinicians must strive diligently. Yuè Rén (Yue Jingyuan) and Zhòng Jǐng (Zhang Zhongjing) discussed treating disease before onset: "Seeing Liver disease, first solidify Spleen." This is urgent prevention before transmission. Urgent prevention means suppressing Wood excess, supporting Earth deficiency, utilizing Fire Qi to guide Wood's exit and cultivate Earth's source. Methods combine attack and tonification, complex maneuvering, such as separating two/three layers, draining South, supplementing North. Skilled physicians toil for this. Xue Lizhai and Zhāng Jǐngyuè often said: "Tonify Righteous Qi, Pathogen leaves spontaneously." This applies to self-deficiency exploited by others. Etiology is self-deficiency; originally no pathogen. Thus, directly tonify the palace, no need to purge.
I also discussed the meanings of "Cold treat with Heat, Heat treat with Cold," "Mild treat oppositely, Severe treat similarly," and "Fake treat reversely." Former sages said: Excess Heat broken by Bitter-Cold; Deficient Heat removed by Sweet-Warm. Using Bitter-Cold follows "Heat treat with Cold, Mild treat oppositely." Using Sweet-Warm follows "Fake treat reversely." Also, Yin Excess repelling Yang, Yang Excess repelling Yin: treat the primary cause, subdue the origin; take Cold medicine hot, or Hot medicine with Cold assistants. This is "Severe treat similarly," i.e., counter-assistance. Among these, "Opposite" is most obvious; "Similar" was detailed by former sages. "Fake treat reversely" lacked firm theory and was often confused with "Severe treat similarly." Presuming ignorance, I briefly discuss...