耳聋，目内陷者死，〔阳精脱矣。〕皮肤着者死，〔谓皮肤枯者着骨。〕脱肉身不去者死。〔不去者，身
重不能动摇来去也。〕乳子而病热，脉悬小者何如？曰∶手足温则生，〔四肢为诸阳之本，温则阳气犹
存。〕寒则死，〔邪胜其正，元阳去矣，故死。所谓从者，手足温也，所谓逆者，手足寒也。〕乳子中
风热，喘鸣息肩者，脉何如？曰∶脉实大也，缓则生，〔大而缓则胃气存。〕急则死。〔大而急则真脏见。〕
寒无犯寒，热无犯热，〔凡用寒者，无犯司气之寒，用热者，无犯司气之热。〕从者和，逆者病
。司气以寒，用寒无犯，司气以热，用热无犯，司气以温，用温无犯，司气以凉，用凉无犯。〔司气
，谓司天司地之气也。谓寒热温凉，俱当避忌，有应用者，亦无过用，恐犯岁气也。〕发表不远
热，〔寒邪中表，非温热不能发散，夏日亦然。〕攻里不远寒。〔郁热在里，非沉寒不能攻，隆冬亦然。
〕帝曰∶不发不攻，而犯寒犯热何如？〔言不因发表而犯热，不因攻里而犯寒，不当用而误用。病当何
如〕？岐伯曰∶寒热内贼，其病益甚。〔以水济水，以火济火也。〕帝曰∶愿闻无病者何如？岐伯曰∶无
者生之，〔无病犯之，则生寒生热。〕有者甚之。〔有病犯之，寒热反甚矣〕。厥阴司天，〔己亥年
也〕风淫所胜，〔司天主上半年，天气司之，故六淫谓之
所胜，上淫于下也。〕平以辛凉，〔风为木气，金能胜之，故平以辛凉。〕佐以苦甘，〔过于辛，
恐反伤其气，故佐以苦甘，苦胜辛，甘益气也。〕以甘缓之，〔木性急，故以甘缓之。〕以酸泻之
。〔木之正味，其泻以酸也。〕少阳在泉；〔己亥年也。〕火淫于内，〔在泉主下半年，地气司
之，故六淫谓之于内，外淫于内也。〕治以咸冷，佐以苦辛，〔苦能泻火，辛能散火故也。〕以酸收之
，〔火盛于经而不敛者，以酸收。〕以苦发之。〔火郁于内而不解者，以苦发之。〕风化于天，清反
胜之，〔凡己亥岁厥阴风木司天，而或气有不及，则金之清气反胜之。〕治以酸温，〔酸求木之同气，温
以制清也。〕佐以苦甘。〔苦以温金，甘以缓肝之急也。〕火司于地，寒反胜之，〔凡己亥岁，少阳相
火在泉，而气有不及，则水之寒气反胜也。〕治以甘热，〔甘能胜水，热能制寒。〕佐以苦辛，〔寒得苦
而温，得辛而散也。〕以咸平之。〔火之正味，其补以咸，水之正味，其泻以咸也。〕少阴司天，〔子午
年也。〕热淫所胜，平以咸寒，〔热为火气，水能胜之。〕佐以苦甘，〔苦能泻，所以去热之实，甘胜
咸，所以防咸之过。〕以酸收之。〔热胜于经而不敛，故以酸收之。〕阳明在泉，〔子午年也。〕燥
淫于内，治以苦温，〔燥为金气，火能胜之，治以苦温，苦从火化也。〕佐以甘辛，〔木受金伤，以甘缓
之，金之正味，以辛泻之。〕以苦下之。〔燥结不通，则邪实于内，故当以苦下之。〕热化于天，寒反胜
之，〔凡子午岁，少阴君火司天，而或气有不及，则水之寒气反胜也。〕治以甘温，〔甘能胜水，温能制
寒。〕佐以苦辛，〔火为水胜，则心苦缓，故宜食酸以收之。〕燥司于地，热反胜之，〔凡子午
岁，阳明燥金在泉，而气有不及，则火之热气反胜之。〕治以平寒，〔以金司于地，气本肃杀，若用
大寒，必助其惨，故但以平寒，以抑其热。〕佐以苦甘，〔所以泻火也。〕以酸平之，〔金之正味，其
补以酸也。〕以和为利。〔戒过用也，即平寒之意。〕太阴司天，〔丑未年也。〕湿淫所胜，平以苦热
，〔湿为土气，燥能除之。〕佐以酸辛，〔酸从木化，制土者也，辛胜酸，所以防酸之过也。〕以苦燥之，
〔苦从火化也。〕以淡泄之。〔淡能利窍也。〕湿上甚而热，〔湿郁于上而成热也。〕治以苦温，〔欲
其燥也。〕佐以辛甘，〔欲其散也。〕以汗为故而止。〔一燥一散，则湿热之在上者以汗之，故而止矣
。〕太阳在泉，〔丑未年也。〕寒淫于内。治以甘热，〔甘能胜水，热能制寒。〕佐以苦辛，以咸泻之，
以辛润之，以苦坚之。〔如经云∶肾苦燥，急食辛以润之，肾欲坚，急食苦以坚之，用苦补之，碱
泻之也。〕湿化于天，热反胜之，〔凡丑未岁，太阴湿土司天，而或气有不足，则火之热气反胜之。〕
治以苦寒，佐以苦酸，〔苦寒所以祛热，苦酸所以敛热。按此节与湿司于天，皆当言风反胜之，而俱言
热者，盖风火本属同气，内能胜湿者也，然佐以苦酸，则木之正味，其泻以酸，此虽治热而亦兼乎风
矣。〕寒司于地，热反胜之，〔凡丑未岁。太阳寒水在泉，而气有不及，则火之热气反胜之。〕治以咸冷，
〔抑火邪也。〕佐以甘辛，〔甘泻火而辛能散也。〕以苦平之。〔水之正味，其补以苦也。〕少阳司天，
〔寅申年也。〕火淫所胜，平以咸冷，〔水能胜火也。〕佐以苦甘，〔苦能泻火之实，甘能泻火之急。
〕以酸收之，〔火胜而散越者酸以收之。〕以苦发之，〔火郁而复留者，以苦发之。〕以
酸复之。〔以苦发火，未免伤气，故又当以酸复之。〕热淫同。〔火热二气同治也。〕厥阴在泉，〔
寅申年也。〕风淫于内，平以辛凉，佐以甘苦，以甘缓之，〔治同厥阴司天。〕以辛散之，〔风邪胜
，故以辛散之。〕火化于天，寒反胜之，〔凡寅申岁，少阳相火司天，而或气有不及，别水之寒气反
胜之。〕治以甘热，佐以苦辛。〔与火司于地同治，少以咸平之一句。〕风司于地，清反胜之，〔凡寅
申岁，厥阴风木在泉，而或气有不及，则金之清气反胜之。〕治以酸温，佐以苦甘，〔治同风化于天。
〕以辛平之。〔木之正味，其补以辛，金之正味，其泻以辛。〕阳明司天，〔卯酉年也。〕燥淫所胜，
平以苦温，佐以酸辛，以苦下之。〔与燥淫于内同治，但彼佐辛，此佐酸辛为异，〕少阴在泉，〔卯酉
年也，〕热淫于内，治以咸寒，佐以苦甘，以酸收之，以苦发之。〔治同少阳司天。〕燥化于天，热反胜之，
〔凡卯酉岁，阳明燥金司天，而或气有不及，则火之热气反胜之。〕治以辛寒，〔辛寒所以散热也。〕
佐以苦甘。〔苦甘所以泻火。〕热司于地，寒反胜之，〔凡卯酉岁，少阴君火在泉，而气有不及，则水之
寒气反胜之。〕治以甘热，佐以苦辛，以咸平之。〔治同火司于地。〕太阳司天，〔辰戌年也。〕寒淫所
胜，平以辛热，〔辛热足以散寒。〕佐以苦甘，〔苦甘可以胜水。〕以咸泻之。〔水之正味，其泻以
咸。〕太阴在泉，〔辰戌年也〕湿淫于内，治以苦热，佐以甘淡，以苦燥之，以淡泄之。〔治同太阴司天
，但彼佐酸辛，此佐酸淡为异。〕寒化于天，热反胜之，〔凡辰戌岁，太阳寒水司天，而或气有不及
，则火之热气反胜之。〕治以咸冷，佐以苦辛。〔治同寒司于地。〕湿司于地，而热
反胜之，〔凡辰戌岁，太阴湿土在泉，而或气有不足，财火之热气反胜之。〕治以苦冷，〔抑火邪
也。〕佐以咸甘，〔咸寒制热，甘辛补土。〕以苦平之。〔即苦冷之义。〕
耳聋，且目眶内陷的，属于死证，〔这是因为阳精已经脱失。〕皮肤干枯紧贴骨骼的，属于死证，〔所谓“着”，是指皮肤枯槁紧贴骨头。〕身体极度消瘦但身体沉重、无法移动转侧的，也属于死证。〔所谓“不去”，是指身体沉重，不能随意走动或转身。〕婴儿患热病，脉象悬细而小的，预后如何？回答说：如果手足温暖则能存活，〔四肢是诸阳经的根本，手足温说明阳气尚存。〕如果手足寒冷则会死亡，〔邪气胜过正气，元阳已去，所以致死。所谓“顺证”，就是手足温；所谓“逆证”，就是手足寒。〕婴儿感受风热之邪，出现气喘、喉间有声、抬肩呼吸的症状，脉象应当如何？回答说：脉象应当实大，若脉来缓和则生，〔脉大而缓，说明胃气尚存。〕若脉来急疾则死。〔脉大而急，说明真脏脉现，胃气已绝。〕
治疗原则：寒证不要用寒药犯其寒气，热证不要用热药犯其热气。〔凡是使用寒凉药的，不要触犯当令的寒气；使用温热药的，不要触犯当令的热气。〕顺应时令用药则病情和缓，违背时令用药则病情加重。司天之气为寒，用寒药时不可过度触犯岁气之寒；司天之气为热，用热药时不可过度触犯岁气之热；司天之气为温，用温药时不可过度触犯岁气之温；司天之气为凉，用凉药时不可过度触犯岁气之凉。〔所谓“司气”，是指司天和在泉之气。意思是寒、热、温、凉都应当避忌，即使有必须应用的药物，也不宜过用，恐怕触犯当年的岁气。〕发表解表不宜远离温热药，〔寒邪侵袭肌表，非温热药不能发散，即使是夏天也是如此。〕攻下里实不宜远离寒凉药。〔郁热结在体内，非沉寒之品不能攻下，即使是隆冬时节也是如此。〕黄帝问：如果不进行发表或攻里，却误用了寒药或热药，会怎样？〔意思是：不因发表而误用热药，不因攻里而误用寒药，在不该用的时候错误地使用了。〕岐伯说：寒热之邪会在体内侵害人体，使病情更加严重。〔这就好比以水救水，以火救火。〕黄帝问：希望听听没有生病的人误用寒热药物会怎样？岐伯说：没有病的人误用，会产生新的寒热病证；〔无病而误用寒热，就会生出寒热之病。〕有病的人误用，会使原有病情加重。〔有病而误用，寒热反而更严重。〕
厥阴风木司天（己亥年），风气淫盛，〔司天主管上半年，天气由它主宰，所以六淫称为“所胜”，即上临于下。〕治疗用辛凉之品平抑，〔风属木气，金能克木，所以用辛凉来平抑。〕辅以苦甘之品，〔过于辛散，恐怕反伤正气，所以辅以苦甘，苦能制辛，甘能益气。〕用甘味药来缓和肝急，〔木性急躁，所以用甘味来缓和它。〕用酸味药来泻木。〔酸是木的正味，泻木用酸。〕
少阳相火在泉（己亥年），火气淫盛于内，〔在泉主管下半年，地气由它主宰，所以六淫称为“于内”，即外入于内。〕治疗用咸冷之品，辅以苦辛之品，〔苦能泻火，辛能散火。〕用酸味药收敛，〔火盛于经脉而不收敛的，用酸味来收敛。〕用苦味药发散。〔火郁结于内而不解的，用苦味来发散。〕
风气司天，清气反而偏胜，〔凡是己亥年厥阴风木司天，如果运气有不及，那么金的清气就会反过来偏胜。〕治疗用酸温之品，〔酸味求同于木气，温性能制约清气。〕辅以苦甘之品。〔苦味能温金，甘味能缓解肝之急。〕
火气在泉，寒气反而偏胜，〔凡是己亥年，少阳相火在泉，如果运气有不及，那么水的寒气就会反过来偏胜。〕治疗用甘热之品，〔甘能胜水，热能制寒。〕辅以苦辛之品，〔寒气得苦味而温，得辛味而散。〕用咸味药平调。〔咸是火的正味，补火用咸；咸也是水正味，泻水用咸。〕
少阴君火司天（子午年），热气淫盛，治疗用咸寒之品平抑，〔热为火气，水能克火。〕辅以苦甘之品，〔苦能泻火，所以去除热的实证；甘能胜咸，所以防止咸味太过。〕用酸味药收敛。〔热胜于经脉而不收敛，所以用酸味收敛。〕
阳明燥金在泉（子午年），燥气淫盛于内，治疗用苦温之品，〔燥为金气，火能克金，治疗用苦温，苦味从火化。〕辅以甘辛之品，〔木受金伤，用甘味缓之，辛是金之正味，用辛泻之。〕用苦味药攻下。〔燥结不通，邪气实于内，所以应当用苦味攻下。〕
热气司天，寒气反而偏胜，〔凡是子午年，少阴君火司天，如果运气有不及，那么水的寒气就会反过来偏胜。〕治疗用甘温之品，〔甘能胜水，温能制寒。〕辅以苦辛之品，〔火被水胜，心气苦缓，所以适宜食酸以收敛。〕
燥气在泉，热气反而偏胜，〔凡是子午年，阳明燥金在泉，如果运气有不及，那么火的热气就会反过来偏胜。〕治疗用平寒之品，〔因为金气在泉，本性肃杀，如果用大寒药，必然助长其惨烈之气，所以只用平寒药来抑制热气。〕辅以苦甘之品，〔这是为了泻火。〕用酸味药平调，〔酸是金之正味，补金用酸。〕以调和为有利。〔告诫不要过用，也就是平寒的意思。〕
太阴湿土司天（丑未年），湿气淫盛，治疗用苦热之品平抑，〔湿为土气，燥能除湿。〕辅以酸辛之品，〔酸从木化，能制约土，辛能胜酸，所以防止酸味太过。〕用苦味药燥湿，〔苦从火化。〕用淡味药渗泄。〔淡能利窍。〕湿气在上部甚且伴有热，〔湿郁于上而成热。〕治疗用苦温之品，〔想要燥湿。〕辅以辛甘之品，〔想要散湿。〕以出汗后病愈为度而停药。〔一燥一散，则在上部的湿热通过发汗排出，病愈即止。〕
太阳寒水在泉（丑未年），寒气淫盛于内。治疗用甘热之品，〔甘能胜水，热能制寒。〕辅以苦辛之品，用咸味药泻之，用辛味药润之，用苦味药坚之。〔如经文所说：肾苦燥，急食辛以润之；肾欲坚，急食苦以坚之；用苦补之，咸泻之。〕
湿气司天，热气反而偏胜，〔凡是丑未年，太阴湿土司天，如果运气有不足，那么火的热气就会反过来偏胜。〕治疗用苦寒之品，辅以苦酸之品，〔苦寒用来祛热，苦酸用来敛热。按此节与湿司于天的情况，都应当说是风反胜，但这里都说热，是因为风火本属同气，风能胜湿。然而辅以苦酸，酸是木之正味，泻木用酸，这虽然是治热，但也兼治风了。〕
寒气在泉，热气反而偏胜，〔凡是丑未年，太阳寒水在泉，如果运气有不及，那么火的热气就会反过来偏胜。〕治疗用咸冷之品，〔抑制火邪。〕辅以甘辛之品，〔甘能泻火，辛能散火。〕用苦味药平调。〔苦是水之正味，补水用苦。〕
少阳相火司天（寅申年），火气淫盛，治疗用咸冷之品平抑，〔水能胜火。〕辅以苦甘之品，〔苦能泻火的实证，甘能泻火的急迫。〕用酸味药收敛，〔火胜而散越的，用酸味收敛。〕用苦味药发散，〔火郁结而复留的，用苦味发散。〕用酸味药恢复正气。〔用苦味发散火邪，未免伤气，所以又应当用酸味来恢复。〕热气淫盛的治疗与此相同。〔火热二气治疗方法相同。〕
厥阴风木在泉（寅申年），风气淫盛于内，治疗用辛凉之品平抑，辅以甘苦之品，用甘味药缓和，〔治疗同厥阴司天。〕用辛味药发散，〔风邪偏胜，所以用辛味发散。〕
火气司天，寒气反而偏胜，〔凡是寅申年，少阳相火司天，如果运气有不及，那么水的寒气就会反过来偏胜。〕治疗用甘热之品，辅以苦辛之品。〔与火在泉的治疗相同，只是少了一句“以咸平之”。〕
风气在泉，清气反而偏胜，〔凡是寅申年，厥阴风木在泉，如果运气有不及，那么金的清气就会反过来偏胜。〕治疗用酸温之品，辅以苦甘之品，〔治疗同风化于天。〕用辛味药平调。〔辛是木之正味，补木用辛；辛也是金之正味，泻金用辛。〕
阳明燥金司天（卯酉年），燥气淫盛，治疗用苦温之品平抑，辅以酸辛之品，用苦味药攻下。〔与燥淫于内的治疗相同，只是彼处佐以辛，此处佐以酸辛，这是不同之处。〕
少阴君火在泉（卯酉年），热气淫盛于内，治疗用咸寒之品，辅以苦甘之品，用酸味药收敛，用苦味药发散。〔治疗同少阳司天。〕
燥气司天，热气反而偏胜，〔凡是卯酉年，阳明燥金司天，如果运气有不及，那么火的热气就会反过来偏胜。〕治疗用辛寒之品，〔辛寒用来散热。〕辅以苦甘之品。〔苦甘用来泻火。〕
热气在泉，寒气反而偏胜，〔凡是卯酉年，少阴君火在泉，如果运气有不及，那么水的寒气就会反过来偏胜。〕治疗用甘热之品，辅以苦辛之品，用咸味药平调。〔治疗同火在泉。〕
太阳寒水司天（辰戌年），寒气淫盛，治疗用辛热之品平抑，〔辛热足以散寒。〕辅以苦甘之品，〔苦甘可以胜水。〕用咸味药泻之。〔咸是水之正味，泻水用咸。〕
太阴湿土在泉（辰戌年），湿气淫盛于内，治疗用苦热之品，辅以甘淡之品，用苦味药燥湿，用淡味药渗泄。〔治疗同太阴司天，只是彼处佐以酸辛，此处佐以甘淡，这是不同之处。〕
寒气司天，热气反而偏胜，〔凡是辰戌年，太阳寒水司天，如果运气有不及，那么火的热气就会反过来偏胜。〕治疗用咸冷之品，辅以苦辛之品。〔治疗同寒在泉。〕
湿气在泉，热气反而偏胜，〔凡是辰戌年，太阴湿土在泉，如果运气有不足，那么火的热气就会反过来偏胜。〕治疗用苦冷之品，〔抑制火邪。〕辅以咸甘之品，〔咸寒制热，甘辛补土。〕用苦味药平调。〔即苦冷的含义。〕
Deafness accompanied by sunken eyes indicates death, [due to the depletion of Yang essence.] Skin withering and adhering tightly to the bones indicates death. [The term "adhering" refers to emaciated skin clinging to the bone.] Extreme emaciation of the body coupled with heaviness and inability to move or turn over also indicates death. [The term "unable to go" refers to bodily heaviness preventing movement or turning.]
For an infant suffering from febrile disease with a pulse that is suspended and fine/small, what is the prognosis? It is said: Survival is indicated if the hands and feet are warm, [as the four limbs are the root of all Yang meridians; warmth suggests Yang Qi is still present.] Death is indicated if the hands and feet are cold, [as pathogenic factors overcome healthy Qi, leading to the loss of Primordial Yang.] This corresponds to the concept that "following" (favorable) means warm hands and feet, while "reversing" (unfavorable) means cold hands and feet.
If an infant contracts wind-heat, presenting with panting, wheezing, and shoulder lifting during respiration, what should the pulse be like? It is said: The pulse should be substantial and large. If it is slow/relaxed, survival is indicated, [a large yet relaxed pulse suggests the presence of Stomach Qi.] If it is rapid/tight, death is indicated. [A large and rapid pulse reveals the True Zang pulse, indicating exhaustion of Stomach Qi.]
Therapeutic Principle: In cold conditions, do not use cold herbs to violate the seasonal cold; in heat conditions, do not use hot herbs to violate the seasonal heat. [When using cold-natured herbs, avoid violating the prevailing seasonal cold; when using hot-natured herbs, avoid violating the prevailing seasonal heat.] Adhering to the season leads to harmony; violating it exacerbates the disease. If the ruling Qi (Si Qi) is cold, using cold herbs must not excessively offend the seasonal cold; if the ruling Qi is hot, using hot herbs must not excessively offend the seasonal heat; if the ruling Qi is warm, using warm herbs must not excessively offend the seasonal warmth; if the ruling Qi is cool, using cool herbs must not excessively offend the seasonal coolness. [The "Ruling Qi" refers to the Qi of the Sovereign Heaven (Si Tian) and Sovereign Earth (Zai Quan). It implies that cold, heat, warmth, and coolness should all be respected as constraints. Even if specific herbs are necessary, they should not be overused to avoid offending the annual Qi.] For releasing the exterior, one should not stray far from warm/hot herbs, [as cold pathogens invading the exterior require warm/hot herbs for dispersion, even in summer.] For purging the interior, one should not stray far from cold herbs, [as internal stagnation of heat requires heavy cold herbs for purging, even in deep winter.]
The Yellow Emperor asked: What happens if one violates cold or heat without indication for exterior release or interior purging? [Meaning: Using hot herbs without need for exterior release, or cold herbs without need for interior purging—misusing them when inappropriate.] Qibo replied: Internal invasion by cold and heat will cause the disease to worsen. [This is akin to adding water to water or fire to fire.] The Yellow Emperor asked: What about those who are not diseased? Qibo replied: For those without disease, misuse generates new cold or heat conditions. [Misusing cold/hot herbs in a healthy person induces cold/heat pathology.] For those with disease, misuse exacerbates the condition. [Misusing herbs in a sick person intensifies the existing cold or heat.]
**Jue Yin Wind Wood at Sovereign Heaven (Years of Ji Hai):** When wind excess prevails, [Sovereign Heaven governs the first half of the year; thus, the Six Excesses are termed "prevailing," meaning upper influences affecting the lower.] Treat with pungent-cool herbs to level it, [Wind belongs to Wood; Metal controls Wood, so pungent-cool properties are used.] Assist with bitter-sweet herbs, [Excessive pungency may damage Qi; thus, bitter-sweet herbs assist. Bitter controls pungency, and Sweet tonifies Qi.] Use sweet herbs to relax tension, [Wood nature is urgent, so sweet herbs relax it.] Use sour herbs to drain Wood. [Sour is the true flavor of Wood; draining Wood uses sour.]
**Shao Yang Minister Fire at Sovereign Earth:** Fire excess within, [Sovereign Earth governs the second half of the year; thus, the Six Excesses are termed "within," meaning external influences penetrating inward.] Treat with salty-cold herbs, assist with bitter-pungent herbs, [Bitter drains fire, Pungent disperses fire.] Use sour herbs to astringe, [When fire is excessive in the channels and uncontained, sour herbs astringe.] Use bitter herbs to vent, [When fire is depressed internally and unresolved, bitter herbs vent it.]
**Wind at Sovereign Heaven, with Cold Counter-Prevalence:** [In Ji Hai years, if Jue Yin Wind Wood is weak, Metal's clear/cold Qi counter-prevails.] Treat with acid-warm herbs, [Acid seeks the same Qi as Wood; Warmth controls Clear/Cold.] Assist with bitter-sweet herbs. [Bitter warms Metal; Sweet relieves Liver urgency.]
**Fire at Sovereign Earth, with Cold Counter-Prevalence:** [In Ji Hai years, if Shao Yang Minister Fire is weak, Water's cold Qi counter-prevails.] Treat with sweet-hot herbs, [Sweet controls Water; Heat controls Cold.] Assist with bitter-pungent herbs, [Cold becomes warm with Bitter; Cold becomes dispersed with Pungent.] Level with salty herbs. [Salty is the true flavor of Fire (tonifying); Salty is also the true flavor of Water (draining).]
**Shao Yin Ruler Fire at Sovereign Heaven (Years of Zi Wu):** Heat excess prevails. Treat with salty-cold herbs to level it, [Heat is Fire Qi; Water controls Fire.] Assist with bitter-sweet herbs, [Bitter drains to remove heat excess; Sweet controls Salt to prevent excess.] Use sour herbs to astringe. [When heat is excessive in the channels and uncontained, sour herbs astringe.]
**Yang Ming Dryness Metal at Sovereign Earth:** Dryness excess within. Treat with bitter-warm herbs, [Dryness is Metal Qi; Fire controls Metal. Treatment uses bitter-warm, where Bitter transforms via Fire.] Assist with sweet-pungent herbs, [Wood injured by Metal is relaxed by Sweet; Pungent is Metal's true flavor, used to drain Metal.] Use bitter herbs to purge downward. [Dryness constipation leads to internal excess, requiring bitter purgatives.]
**Heat at Sovereign Heaven, with Cold Counter-Prevalence:** [In Zi Wu years, if Shao Yin Ruler Fire is weak, Water's cold Qi counter-prevails.] Treat with sweet-warm herbs, [Sweet controls Water; Warmth controls Cold.] Assist with bitter-pungent herbs. [When Fire is defeated by Water, the Heart suffers from laxity, so Sour is suitable to astringe.]
**Dryness at Sovereign Earth, with Heat Counter-Prevalence:** [In Zi Wu years, if Yang Ming Dryness Metal is weak, Fire's heat Qi counter-prevails.] Treat with neutral-cold herbs, [Metal at Sovereign Earth has a肃杀 (severe/drying) nature; using major cold herbs would aid this severity, so neutral-cold is used to suppress heat.] Assist with bitter-sweet herbs, [To drain Fire.] Level with sour herbs, [Sour is Metal's true flavor, used to tonify Metal.] Harmony is beneficial. [Warning against overuse, implying the neutral-cold approach.]
**Tai Yin Damp Earth at Sovereign Heaven (Years of Chou Wei):** Dampness excess prevails. Treat with bitter-hot herbs to level it, [Dampness is Earth Qi; Dryness removes Dampness.] Assist with acid-pungent herbs, [Acid transforms via Wood to control Earth; Pungent controls Acid to prevent excess.] Use bitter herbs to dry dampness, [Bitter transforms via Fire.] Use bland herbs to drain/diurese. [Bland opens orifices.] If dampness is severe above with heat, [Dampness stagnating above generates heat.] Treat with bitter-warm herbs, [To dry.] Assist with sweet-pungent herbs, [To disperse.] Stop treatment once sweating occurs and the condition resolves. [One drying, one dispersing, allows damp-heat above to exit via sweat, stopping upon resolution.]
**Tai Yang Cold Water at Sovereign Earth:** Cold excess within. Treat with sweet-hot herbs, [Sweet controls Water; Heat controls Cold.] Assist with bitter-pungent herbs, use salty herbs to drain, pungent herbs to moisten, and bitter herbs to firm. [As stated in the classics: Kidney suffers from dryness, urgently eat pungent to moisten; Kidney desires firmness, urgently eat bitter to firm; Bitter tonifies, Salty drains.]
**Dampness at Sovereign Heaven, with Heat Counter-Prevalence:** [In Chou Wei years, if Tai Yin Damp Earth is weak, Fire's heat Qi counter-prevails.] Treat with bitter-cold herbs, assist with bitter-acid herbs, [Bitter-cold dispels heat; Bitter-acid consolidates heat. Note: This section and "Damp at Sovereign Heaven" should technically refer to Wind counter-prevalence, but mention Heat because Wind and Fire share similar Qi and can overcome Damp. However, assisting with bitter-acid involves Acid, the true flavor of Wood for draining, treating both Heat and Wind.]
**Cold at Sovereign Earth, with Heat Counter-Prevalence:** [In Chou Wei years, if Tai Yang Cold Water is weak, Fire's heat Qi counter-prevails.] Treat with salty-cold herbs, [To suppress Fire pathogen.] Assist with sweet-pungent herbs, [Sweet drains Fire; Pungent disperses.] Level with bitter herbs. [Bitter is Water's true flavor, used to tonify Water.]
**Shao Yang Minister Fire at Sovereign Heaven (Years of Yin Shen):** Fire excess prevails. Treat with salty-cold herbs to level it, [Water controls Fire.] Assist with bitter-sweet herbs, [Bitter drains Fire excess; Sweet drains Fire urgency.] Use sour herbs to astringe, [When Fire is excessive and dissipating, Sour astringes.] Use bitter herbs to vent, [When Fire is depressed and lingering, Bitter vents.] Use sour herbs to restore. [Venting Fire with Bitter may injure Qi, so Sour restores it.] Heat excess follows the same treatment. [Fire and Heat are treated similarly.]
**Jue Yin Wind Wood at Sovereign Earth:** Wind excess within. Treat with pungent-cool herbs to level it, assist with sweet-bitter herbs, use sweet herbs to relax, [Treatment same as Jue Yin at Sovereign Heaven.] Use pungent herbs to disperse, [Wind pathogen excess requires Pungent dispersion.]
**Fire at Sovereign Heaven, with Cold Counter-Prevalence:** [In Yin Shen years, if Shao Yang Minister Fire is weak, Water's cold Qi counter-prevails.] Treat with sweet-hot herbs, assist with bitter-pungent herbs. [Same treatment as Fire at Sovereign Earth, minus the phrase "level with salty."]
**Wind at Sovereign Earth, with Cold/Clear Counter-Prevalence:** [In Yin Shen years, if Jue Yin Wind Wood is weak, Metal's clear Qi counter-prevails.] Treat with acid-warm herbs, assist with bitter-sweet herbs, [Treatment same as Wind at Sovereign Heaven.] Level with pungent herbs. [Pungent is Wood's true flavor, used to tonify Wood; Pungent is also Metal's true flavor, used to drain Metal.]
**Yang Ming Dryness Metal at Sovereign Heaven (Years of Mao You):** Dryness excess prevails. Treat with bitter-warm herbs to level it, assist with acid-pungent herbs, use bitter herbs to purge downward. [Same as Dryness excess within, but differs in assistance: there it assists with Pungent, here with Acid-Pungent.]
**Shao Yin Ruler Fire at Sovereign Earth:** Heat excess within. Treat with salty-cold herbs, assist with bitter-sweet herbs, use sour herbs to astringe, use bitter herbs to vent. [Treatment same as Shao Yang at Sovereign Heaven.]
**Dryness at Sovereign Heaven, with Heat Counter-Prevalence:** [In Mao You years, if Yang Ming Dryness Metal is weak, Fire's heat Qi counter-prevails.] Treat with pungent-cold herbs, [Pungent-cold disperses heat.] Assist with bitter-sweet herbs. [Bitter-sweet drains Fire.]
**Heat at Sovereign Earth, with Cold Counter-Prevalence:** [In Mao You years, if Shao Yin Ruler Fire is weak, Water's cold Qi counter-prevails.] Treat with sweet-hot herbs, assist with bitter-pungent herbs, level with salty herbs. [Treatment same as Fire at Sovereign Earth.]
**Tai Yang Cold Water at Sovereign Heaven (Years of Chen Xu):** Cold excess prevails. Treat with pungent-hot herbs to level it, [Pungent-hot is sufficient to scatter cold.] Assist with bitter-sweet herbs, [Bitter-sweet can overcome Water.] Use salty herbs to drain. [Salty is Water's true flavor, used to drain Water.]
**Tai Yin Damp Earth at Sovereign Earth:** Dampness excess within. Treat with bitter-hot herbs, assist with sweet-bland herbs, use bitter herbs to dry, bland herbs to drain. [Treatment same as Tai Yin at Sovereign Heaven, but differs in assistance: there it assists with Acid-Pungent, here with Sweet-Bland.]
**Cold at Sovereign Heaven, with Heat Counter-Prevalence:** [In Chen Xu years, if Tai Yang Cold Water is weak, Fire's heat Qi counter-prevails.] Treat with salty-cold herbs, assist with bitter-pungent herbs. [Treatment same as Cold at Sovereign Earth.]
**Dampness at Sovereign Earth, with Heat Counter-Prevalence:** [In Chen Xu years, if Tai Yin Damp Earth is insufficient, Fire's heat Qi counter-prevails.] Treat with bitter-cold herbs, [To suppress Fire pathogen.] Assist with salty-sweet herbs, [Salty-cold controls heat; Sweet-Pungent tonifies Earth.] Level with bitter herbs. [Meaning of bitter-cold.]