不荣，柔脆焦首，长气斯救，大火流，炎烁且至，蔓将槁，邪伤脾也。
金运太过曰坚成。金主秋收，故是谓收引。秋时天气清洁，天气清洁，则地气光明。夏为阳，秋为
阴，至秋则阳热之气，随阴治化。金在天为燥，故燥行其政。夏长秋成，故物以司成。金气太
过，故秋收之气繁盛舒布，至夏长之气化洽不终。化洽者，化气洽于万物。秋气早至，故化洽不终。其
化成，秋之收成也。其气削，金之削物也。其政肃，金之清肃也。其令锐切，金之刚劲也。其动
暴折疡疰，金之刑辟也。其德雾露萧瑟，金之柔润也。其变肃杀凋零，金之清锐也。金虽太过，太过而
往，不及随之。故金火木三气，并主其事。其谷稻黍，其畜鸡马，其果桃杏，金与火也。其色
白青丹，其味辛酸苦，金木火也。其象秋，秋属金也，其经手太阴阳明，盖手太阴主肺金，而手阳明大肠
为之府也。其脏肺肝，金与木也。其虫介羽，其物壳络，金与火也。其病喘喝，胸凭仰息，皆
肺病也。金气太过，当庚子庚午庚寅庚申之岁，上见少阴少阳司
天，谓之上征，金太过而火司天，则金气自平，故与正商同。木主生，金气已平，故其生齐，齐者，逐
其生也。其病咳，肺病也。金气太过，暴变其政，则坚刚之名木不荣。柔脆之草类焦首，始则金
淫，继则火胜，火主夏长，故长气斯救，救，犹复也。长气斯救，
则大火以流，大火流，则炎烁且至，藤蔓将槁，金受火刑，邪伤肺也。
流衍之纪，是谓封藏。寒司物化，天地严凝，藏政以布，长令不
扬，其化凛，其气坚，其政谧，其令流注，其动漂泄沃涌，其德凝
惨寒 ，其变冰雪霜雹，其谷豆稷，其畜彘牛，其果栗枣，其色黑
丹 ，其味咸苦甘，其象冬，其经足少阴太阳，其藏肾心，其虫鳞 ，其物濡满，其病
胀，上羽，而长气不化也。政过，则化气大举，而埃昏气交，大雨时降，邪伤肾也。
首二藏，如字。水运太过曰流衍，水主冬令，气机闭密，故是谓封藏。水在天为寒，故寒司物化，而
天地严凝，冬令之藏政以布，则水胜其火，故长令不扬。其化凛，水之凛冽也。其气坚，水之坚
凝也。其政谧，水之安静也。其令流注，水之滋灌也。其动漂泄沃涌，水之泛溢也。其德凝惨寒 ，水
之聚而能散也。 ，雪飞貌。其变冰雪霜雹，水淫太过，转柔为刚也。水虽太过。太过而往，不及
随之，故水土火三气，并主其事。其畜彘牛，其果栗枣，水与土也。其色黑丹 ，其味咸苦甘，水火土也。
其象冬，冬属水也，其经足少阴太阳，盖足少阴主肾水，而足太阳膀胱为之府。其脏肾心，水与火也，其虫
鳞，其物濡满，水与土也。其病胀，脾土之病也。水运太过，当丙辰丙戌之岁，太阳寒水上临，谓之上
羽，水太过而水上临，则长气不能施化。长气，火气也。水政太过，始则水淫，继则土胜，故化气大举，而埃
昏气交，埃昏气交，地气上升也，地气上升，故大雨时降，土气有余，则邪伤肾也。
故曰∶不恒其德，则所胜来复。政恒其理，则所胜同化。此之谓也。
暴烈其政，不务其德，是不恒其德也。化气政令，是政恒其理
也。承上文意而总结之。言不恒其德，则所胜来复，如木之收气复，火之藏气乃复，土之大风至，金之大
火流，水之化气大举者是也。政恒其理，则所胜同化，如谷畜果虫，皆胜气同化，五色五
味，则兼三气者是也。即此岁运太过不及，而有淫复之谓也。
此一节论五行平气，并不及太过之政也。
帝曰∶天不足西北，左寒而右凉，地不满东南，右热而左温，其故何也？
承上文五运太过不及之意，问天地四方亦有太过不及也。天为阳，阳气温热，地为阴，阴气寒凉。天
不足西北，则西北方之阳气少，故左右寒凉。地不满东南，则东南方之阴气少，故左右温热，
所以不足不满者，其故何也？
岐伯曰∶阴阳之气，高下之理，太少之异也。东南方，阳也，
阳者，其精降于下，故右热而左温。西北方，阴也，阴者，其精奉
于上，故左寒而右凉。是以地有高下，气有温凉，高者气寒，下者
气热，故适寒凉者胀，之温热者疮，下之则胀已，汗之则疮已，此腠理开闭之常，太少之异耳。
太，有余也。少，不足也。天不足西北，地不满东南，乃阴阳之天气，高下之地理，其中有太少之异
也。东南为阳，故东南方阳也，阳者，阳气有余，其阴精之气，则降于下，阴精下降，阳气有
余，故右热而左温。西北为阴，故西北方阴也，阴者，阴气有余，阴精之气奉于上，阴精上奉，阳气不足，
故左寒而右凉。又西北地高，东南地下，西北地凉，东南地温，是以地有高下，气有温凉。
温，犹热也，凉，犹寒也。故高者气寒，下者气热。适，往也，故往西北寒凉之方者，阴气有余，则病胀。
之，亦往也，往东南温热之方者，阳气有余，则生疮，下之者，天气下降之意，阴寒而得阳
热，则胀已。汗之者，地气上升之意，阳热而得阴液，则疮已。西北寒凉，腠理多闭少开，东南温热，腠
理多开少闭。故曰此腠理开闭之常，其中有太少之异耳。
帝曰∶其于寿夭何如？
阴阳高下，其中有太少之异，则太为有余，有余则寿，少为不足，不足夭则，故问其于寿夭何如。
岐伯曰∶阴精所奉，其人寿，阳精所降，其人夭。
西北方阴也，其精奉于上，东南方阳也，其精降于下。故阴精
所奉之方，其人寿，阳精所降之方，其人夭，是西北寿而东南夭也。
帝曰∶善。其病也，治之奈何？
阴精所奉之方，其人寿，阳精所降之方，其人夭，是以西北病
少，东南病多，帝故善之而探治病之法也。
岐伯曰∶西北之气，散而寒之，东南之气收而温之，所谓同病
异治也。故曰气寒气凉，治以寒凉，行水渍之。气温气热，治之温
热，强其内守，必同其气，可使平也，假者反之。
西北腠理常闭，其气有余，故治西北之病气，当散而寒之。东南腠理常开，其气不足，故治东南之
病气，当收而温之。一散一收，一寒一温，所谓同病异治也。西北之人，外虽寒闭，内则有余
而热。东南之人，外虽温开，内则不足而寒。故曰西北气寒气凉，复当治以寒凉，行水渍之，以开其闭，此
散而寒之之法也。东南气温气热，复当治以温热，强其内守，必内外和同其气，然后可使平
也。此收而温之之法也。如西北之人，外寒凉而内不热，亦当治以温热，东南之人，外温热而内不寒，
亦当治以寒凉，故曰假者反之。
帝曰∶善。一州之气，生化寿夭不同，其故何也？
西北之气，外寒凉而内有余，东南之气，外温热而内不足。假者反之，则西北寒凉，其内亦有不足。东
南温热，其内亦有有余，帝故善之，复问一州之气，亦有生化寿夭之不同，不必东南西北之殊，其故何也。
岐伯曰∶高下之理，地势使然也。崇高，则阴气治之，污下，
则阳气治之。阳胜者，先天，阴胜者，后天，此地理之常，生化之道也。
一州之中，亦有四方高下之理，乃地势使然也。地势崇高，则阴气治之，地势污下，则阳气治之。
阳气治之而阳胜者，四时之气
常先天。阴气治之而阴胜者，四时之气常后天。先天，则生化早，
后天，则生化迟，此地理阴阳高下之常，而有生化迟早之道也。
帝曰∶其有寿夭乎？
帝问生化寿夭，故复问生化之中，其有寿夭乎？
岐伯曰∶高者其气寿，下者其气夭。地之小大异也。小者小异，大者大异，故治病
者，必明天道地理，阴阳更胜，气之先后，人之寿夭，生化之期，乃可以知人之形气矣。
更，平声。地高者，阴气治之，阴精所奉，其人寿，故高者，其气寿。地下者，阳气治之，阳精所降，
其人夭，故下者其气夭。高则气大，下则气小，高者下者，乃地之小大异也。略高略下，高下
之小者，其寿夭小异。极高极下，高下之大者，其寿夭大异。故治病者，必明上天之道，下地之理，其中
有阴阳之更胜，有时气之先后，以此决人之寿夭，及生化之期，乃可以知人之形气矣。《灵枢》
寿夭篇云∶形与气相任则寿，不相任则夭。立形定气，而视寿夭者是也。
帝曰∶善。其岁有不病，而藏气不应不用者，何也？
生化寿夭之理既明，帝故善之。谓西北东南，同病异治，其终
岁有不病，而人身脏气，不应阴阳之气，不用高下之理，则无有太少之异者，其故何也？
岐伯曰∶天气制之，气有所从也。
制，犹御也。岁有不病，而脏气不应不用者，乃司天之气御于上，天气合于人身，气有所从，故不病也。
帝曰∶愿卒闻之。
天气制之，气有所从之道，愿尽闻之。
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，鼻窒口疡，寒热 肿，
风行于地，尘沙飞扬，心痛，胃脘痛，厥逆，膈不通，其主暴速。
凡寅申之岁，少阳司天。少阳，相火也，故火气下临，司天之
气，制于人身，人受其制，故肺气上从。肺色白而属金，故白起金用。白起金用，则草木乃眚，金刑木也，火
见燔 ，少阳之气也，革金且耗，金受火刑，则金变革而虚耗也。火气盛，故大暑以行，咳嚏鼽衄鼻窒，
肺病也。口疡寒热 肿，火病也，少阳司天，则厥阴在泉。厥阴，风气也，故风行于地。风行于地，则尘
沙飞扬。厥阴经脉属心包，故心痛。胃络上通心包，故胃脘痛，心痛，胃脘痛，则阴阳之气不相顺接，故厥
逆而膈不通。风气急疾，故其主暴速，有司天，则有在泉，故并论之。
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。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，蛰乃见。
数，音朔，下同。凡卯酉之岁，阳明司天，阳明，燥金也，故燥气下临。司天之气，制于人身，人受
其制，故肝气上从。肝色苍而属木，故苍起木用而立。苍起木用，则土乃眚，木刑土也。凄沧数
至，金气胜也。木伐草萎，金刑木也，胁痛目赤，肝木病也。掉振鼓栗，肝虚病也，筋痿不能久立，肝主筋
也。阳明司天，则少阴在泉，少阴，热气也，故暴热至。暴热至，则土乃暑，而阳气郁发，
热入于内，则小便变，热行于外，则寒热如疟，甚则热气自伤而心痛。客气加临，则君火加于六气，故火
气行于草木枯槁之时，致冬令流水不冰，蛰虫乃见而不藏。
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，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。
，音群。凡辰戌之岁，太阳司天，太阳，寒水也，故寒气下临。司天之气，制于人身，人受
其制，故心气上从。心属火，其色丹，而今火且明，丹起。火明丹起，则金乃眚，火刑金也。寒清时
举，胜则水冰，司天之气也。火气高明，上从之气也。心热烦，嗌干善渴，火病也。鼽嚏喜悲，火刑金也。
数欠，阴阳相引也。始病热气妄行，既则寒乃复，复则寒气盛，故霜不时降。心火虚，故善
忘，甚则心痛。太阳司天，则太阴在泉，太阴，湿气也，故土乃润。湿者水之类，故水丰衍。水湿则寒，故
寒客至，寒湿为阴，其性下沉而属土，故沉阴化，而湿气变物。湿气变物，则水饮内搐，致民病中满不食。
，痹也，苛，不安也，皮痹而肉不安，则筋脉亦不利，甚则 肿。上文少阳司天，寒热 肿，因于热也，
此太阴 肿，因于寒也。身后痈，谓痈发于背，不能上承太阳，盖太阳分部于背也。
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，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。
凡巳亥之岁，厥阴司天，厥阴，风气也，故风气下临。司天之气，制于人身，人受其制，故脾气上从。
脾属土，其色黄，而今土且隆，黄起，上隆黄起，则水乃眚，土刑水也。风木气盛，故土用
革，革，变革也。体重肌肉萎，脾病也；食减口爽，言所食减少，则口中乃爽，以明饱食，则口中不和，亦
脾病也。风气在上，则风行太虚，云物摇动。其在于人，则目转耳鸣。厥阴司天，则少阳在泉。少阳，火气
也，故火纵其暴，而地乃暑，暑，犹热也，地暑，则大热消烁，津液受热，则赤沃下。火气主开，故蛰虫
数见，火性温热，故流水不冰，火体急暴，故其发机速。
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，地乃燥
清，凄沧数至，胁痛，善太息，肃杀行，草木变。
不能得到滋养，（草木）柔脆且枯焦，生长之气得以救助。大火运行，炎热灼烧即将到达，藤蔓将要枯槁，这是邪气伤害脾脏。
金运太过称为“坚成”。金主管秋季的收敛，所以称为收引。秋季时天气清洁，天气清洁，则地气光明。夏季为阳，秋季为阴，到了秋季，阳热之气随着阴气的治理而转化。金在天上表现为燥，所以燥行使它的政令。夏长秋成，所以万物由金来主持成就。金气太过，所以秋季收敛之气繁盛舒布，导致夏季生长的气化不能完成。化洽，是指化气与万物相合。秋气早至，所以化气不能完成。其化成，是秋季的收成。其气削，是金的肃杀作用。其政肃，是金的清肃。其令锐切，是金的刚劲。其变动为暴折、疡疰，是金的刑罚。其德为雾露萧瑟，是金的柔润。其变为肃杀凋零，是金的清锐。金虽然太过，但太过之后，不及随之而来。所以金、火、木三气，共同主持其事。对应的谷物是稻、黍，对应的牲畜是鸡、马，对应的果实是桃、杏，这是金与火的配合。对应的颜色是白、青、丹，对应的味道是辛、酸、苦，这是金、木、火的配合。对应的是秋季，秋属金，对应的经脉是手太阴肺经和手阳明大肠经，因为手太阴主肺金，而手阳明大肠为之腑。对应的脏腑是肺、肝，这是金与木的配合。对应的虫类是介壳类和羽翅类，对应的物体是有壳和有络脉的，这是金与火的配合。对应的疾病是喘喝、胸凭仰息，都是肺病。金气太过，应当出现在庚子、庚午、庚寅、庚申之年，如果上见少阴君火或少阳相火司天，称为上征，金太过而火司天，则金气自然平和，所以与正商（金之平气）相同。木主生发，金气已平和，所以其生发整齐，齐者，是驱逐其生发之气。其病咳，是肺病。金气太过，突然改变其政令，则坚硬刚劲的名木不得滋养。柔脆的草类枯焦头部，起初是金气淫溢，继而是火气胜复，火主夏季生长，所以生长之气得以救助，救，就是恢复的意思。生长之气得以救助，则大火流动，大火流动，则炎热灼烧即将到达，藤蔓将要枯槁，金受火刑，邪气伤害肺脏。
流衍之纪，称为封藏。寒主宰万物的变化，天地严凝，收藏的政令布散，生长的命令不扬，其化凛冽，其气坚凝，其政静谧，其令如水流注，其动为漂泄沃涌，其德为凝惨寒冷，其变为冰雪霜雹，对应的谷物是豆、稷，对应的牲畜是猪、牛，对应的果实是栗、枣，对应的颜色是黑、丹，对应的味道是咸、苦、甘，对应的是冬季，对应的经脉是足少阴肾经和足太阳膀胱经，对应的脏腑是肾、心，对应的虫类是鳞甲类，对应的物体是濡满，对应的疾病是胀，这是上羽（水运太过），而生长之气不能施化。政令过甚，则化气大举，埃昏之气交争，大雨时常降下，邪气伤害肾脏。
首二藏，按字面理解。水运太过称为流衍，水主冬令，气机闭密，所以称为封藏。水在天上为寒，所以寒主宰万物的变化，天地严凝，冬令的收藏政令布散，则水胜火，所以生长命令不扬。其化凛，是水的凛冽。其气坚，是水的坚凝。其政谧，是水的安静。其令流注，是水的滋灌。其动漂泄沃涌，是水的泛溢。其德凝惨寒，是水聚而能散。 ，雪飞的样子。其变为冰雪霜雹，是水淫太过，转柔为刚。水虽然太过，但太过之后，不及随之而来，所以水、土、火三气，共同主持其事。对应的牲畜是猪、牛，对应的果实是栗、枣，这是水与土的配合。对应的颜色是黑、丹，对应的味道是咸、苦、甘，这是水、火、土的配合。对应的是冬季，冬属水，对应的经脉是足少阴肾经和足太阳膀胱经，因为足少阴主肾水，而足太阳膀胱为之腑。对应的脏腑是肾、心，这是水与火的配合，对应的虫类是鳞甲类，对应的物体是濡满，这是水与土的配合。对应的疾病是胀，是脾土的病。水运太过，当丙辰、丙戌之年，太阳寒水上临，称为上羽，水太过而水上临，则生长之气不能施化。长气，就是火气。水政太过，起初是水淫，继而是土胜，所以化气大举，埃昏之气交争，埃昏气交，是地气上升，地气上升，所以大雨时常降下，土气有余，则邪气伤害肾脏。
所以说：不恒常其德，则所胜之气来复。政令恒常其理，则所胜之气同化。说的就是这个道理。
暴烈其政，不务其德，就是不恒常其德。化气政令，就是政恒常其理。承接上文意思进行总结。说不恒常其德，则所胜来复，如木的收气复，火的藏气乃复，土的大风至，金的大火流，水的化气大举等就是这样。政恒常其理，则所胜同化，如谷畜果虫，都是胜气同化，五色五味，则是兼有三气。即由此岁运太过不及，而有淫复的说法。
黄帝说：天不足于西北，左边寒右边凉；地不满于东南，右边热左边温，这是什么缘故？
承接上文五运太过不及的意思，询问天地四方是否也有太过不及。天为阳，阳气温热；地为阴，阴气寒凉。天不足于西北，则西北方的阳气少，所以左右寒凉。地不满于东南，则东南方的阴气少，所以左右温热，之所以不足不满，是什么缘故呢？
岐伯说：阴阳之气，高下之理，太少（有余和不足）的差异。东南方属阳，阳者，其精降于下，所以右热左温。西北方属阴，阴者，其精奉于上，所以左寒右凉。因此地有高下，气有温凉，高处气寒，低处气热，所以去寒凉之地易患胀病，去温热之地易患疮病，用泻法则胀病愈，用汗法则疮病愈，这是腠理开闭的常态，是太少差异所致。
太，是有余。少，是不足。天不足西北，地不满东南，是阴阳的天气，高下的地理，其中有太少的差异。东南为阳，故东南方属阳，阳者，阳气有余，其阴精之气，则降于下，阴精下降，阳气有余，所以右热左温。西北为阴，故西北方属阴，阴者，阴气有余，阴精之气奉于上，阴精上奉，阳气不足，所以左寒右凉。又西北地高，东南地下，西北地凉，东南地温，因此地有高下，气有温凉。温，犹热也；凉，犹寒也。所以高处气寒，低处气热。适，往也，所以去西北寒凉之地，阴气有余，则病胀。之，亦往也，去东南温热之地，阳气有余，则生疮。下之者，是天气下降之意，阴寒得阳热，则胀已。汗之者，是地气上升之意，阳热得阴液，则疮已。西北寒凉，腠理多闭少开；东南温热，腠理多开少闭。所以说这是腠理开闭的常态，其中有太少的差异。
黄帝说：对于寿夭有什么影响？
阴阳高下，其中有太少的差异，太为有余，有余则寿；少为不足，不足则夭，所以问其对寿夭有何影响。
岐伯说：阴精所奉之地，其人长寿；阳精所降之地，其人短命。
西北方属阴，其精奉于上；东南方属阳，其精降于下。所以阴精所奉之地，其人长寿；阳精所降之地，其人短命，这就是西北寿而东南夭。
黄帝说：好。如果有病，如何治疗？
阴精所奉之地，其人长寿；阳精所降之地，其人短命，因此西北病少，东南病多，黄帝所以称赞并探求治病之法。
岐伯说：西北之气，宜散而寒之；东南之气，宜收而温之，这就是所谓的同病异治。所以说气寒气凉，治以寒凉，行水渍之。气温气热，治以温热，强其内守，必同其气，可使平和，假者反之。
西北腠理常闭，其气有余，所以治西北之病气，当散而寒之。东南腠理常开，其气不足，所以治东南之病气，当收而温之。一散一收，一寒一温，这就是同病异治。西北之人，外虽寒闭，内则有余而热。东南之人，外虽温开，内则不足而寒。所以说西北气寒气凉，复当治以寒凉，行水渍之，以开其闭，这是散而寒之的方法。东南气温气热，复当治以温热，强其内守，必内外和同其气，然后可使平和。这是收而温之的方法。如西北之人，外寒凉而内不热，亦当治以温热；东南之人，外温热而内不寒，亦当治以寒凉，所以说假者反之。
黄帝说：好。一州之气，生化寿夭不同，这是什么缘故？
西北之气，外寒凉而内有余；东南之气，外温热而内不足。假者反之，则西北寒凉，其内亦有不足；东南温热，其内亦有有余，黄帝所以称赞，再问一州之气，亦有生化寿夭的不同，不必限于东南西北的差异，是什么缘故？
岐伯说：高下之理，地势使然。崇高，则阴气治之；污下，则阳气治之。阳胜者先天，阴胜者后天，这是地理的常态，生化的道理。
一州之中，亦有四方高下之理，乃地势使然。地势崇高，则阴气治之；地势污下，则阳气治之。阳气治之而阳胜者，四时之气常先天。阴气治之而阴胜者，四时之气常后天。先天，则生化早；后天，则生化迟，这是地理阴阳高下的常态，而有生化迟早的道理。
黄帝说：其中有寿夭吗？
黄帝问生化寿夭，所以再问生化之中，是否有寿夭？
岐伯说：高者其气寿，下者其气夭。地的大小不同。小者小异，大者大异，所以治病者，必须明天道地理，阴阳更胜，气之先后，人之寿夭，生化之期，才可以知人的形气。
更，读平声。地高者，阴气治之，阴精所奉，其人长寿，所以高者其气寿。地下者，阳气治之，阳精所降，其人短命，所以下者其气夭。高则气大，下则气小，高者下者，乃地的大小差异。略高略下，高下之小者，其寿夭小异。极高极下，高下之大者，其寿夭大异。所以治病者，必须明上天之道，下地之理，其中有阴阳的更胜，有时气的先后，以此决断人的寿夭，及生化之期，才可以知人的形气。《灵枢》寿夭篇说：形与气相任则寿，不相任则夭。立形定气，而视寿夭者是也。
黄帝说：好。有的年份没有病，而脏气不应或不用的情况，是什么原因？
生化寿夭之理既明，黄帝所以称赞。谓西北东南，同病异治，终岁有不病，而人身脏气，不应阴阳之气，不用高下之理，则无有太少的差异，是什么缘故？
岐伯说：天气制之，气有所从。
制，犹御也。岁有不病，而脏气不应不用，乃司天之气御于上，天气合于人身，气有所从，所以不病。
黄帝说：愿尽闻之。
天气制之，气有所从之道，愿尽闻之。
岐伯说：少阳司天，火气下临，肺气上从，白起金用，草木眚，火见燔焫，革金且耗。大暑以行，咳嚏鼽衄，鼻窒口疡，寒热痈肿，风行于地，尘沙飞扬，心痛，胃脘痛，厥逆，膈不通，其主暴速。
凡是寅申之年，少阳司天。少阳，相火也，所以火气下临。司天之气，制于人身，人受其制，所以肺气上从。肺色白而属金，所以白起金用。白起金用，则草木乃眚，金刑木也。火见燔焫，少阳之气也，革金且耗，金受火刑，则金变革而虚耗也。火气盛，所以大暑以行。咳嚏鼽衄鼻窒，肺病也。口疡寒热痈肿，火病也。少阳司天，则厥阴在泉。厥阴，风气也，所以风行于地。风行于地，则尘沙飞扬。厥阴经脉属心包，所以心痛。胃络上通心包，所以胃脘痛。心痛，胃脘痛，则阴阳之气不相顺接，所以厥逆而膈不通。风气急疾，所以其主暴速。有司天，则有在泉，所以并论之。
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。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，蛰乃见。
数，音朔，下同。凡是卯酉之年，阳明司天，阳明，燥金也，所以燥气下临。司天之气，制于人身，人受其制，所以肝气上从。肝色苍而属木，所以苍起木用而立。苍起木用，则土乃眚，木刑土也。凄沧数至，金气胜也。木伐草萎，金刑木也。胁痛目赤，肝木病也。掉振鼓栗，肝虚病也。筋痿不能久立，肝主筋也。阳明司天，则少阴在泉，少阴，热气也，所以暴热至。暴热至，则土乃暑，而阳气郁发，热入于内，则小便变，热行于外，则寒热如疟，甚则热气自伤而心痛。客气加临，则君火加于六气，所以火气行于草木枯槁之时，致冬令流水不冰，蛰虫乃见而不藏。
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，土乃润，水丰衍，寒客至，沉阴化，湿气变物，水饮内搐，中满不食，皮痹肉苛，筋脉不利，甚则胕肿，身后痈。
群，音群。凡是辰戌之年，太阳司天，太阳，寒水也，所以寒气下临。司天之气，制于人身，人受其制，所以心气上从。心属火，其色丹，而今火且明，丹起。火明丹起，则金乃眚，火刑金也。寒清时举，胜则水冰，司天之气也。火气高明，上从之气也。心热烦，嗌干善渴，火病也。鼽嚏喜悲，火刑金也。数欠，阴阳相引也。始病热气妄行，既则寒乃复，复则寒气盛，所以霜不时降。心火虚，所以善忘，甚则心痛。太阳司天，则太阴在泉，太阴，湿气也，所以土乃润。湿者水之类，所以水丰衍。水湿则寒，所以寒客至，寒湿为阴，其性下沉而属土，所以沉阴化，而湿气变物。湿气变物，则水饮内搐，致民病中满不食。痹，痹也，苛，不安也，皮痹而肉不安，则筋脉亦不利，甚则胕肿。上文少阳司天，寒热痈肿，因于热也，此太阴胕肿，因于寒也。身后痈，谓痈发于背，不能上承太阳，盖太阳分部于背也。
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，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。
凡是巳亥之年，厥阴司天，厥阴，风气也，所以风气下临。司天之气，制于人身，人受其制，所以脾气上从。脾属土，其色黄，而今土且隆，黄起，上隆黄起，则水乃眚，土刑水也。风木气盛，所以土用革，革，变革也。体重肌肉萎，脾病也；食减口爽，言所食减少，则口中乃爽，以明饱食，则口中不和，亦脾病也。风气在上，则风行太虚，云物摇动。其在于人，则目转耳鸣。厥阴司天，则少阳在泉。少阳，火气也，所以火纵其暴，而地乃暑，暑，犹热也，地暑，则大热消烁，津液受热，则赤沃下。火气主开，所以蛰虫数见，火性温热，所以流水不冰，火体急暴，所以其发机速。
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，地乃燥清，凄沧数至，胁痛，善太息，肃杀行，草木变。
Lack of nourishment leads to softness, brittleness, and scorched tips. The Qi of growth is thereby rescued. The Great Fire flows, scorching heat arrives; vines wither. This is pathogenic factors injuring the Spleen (Spleen).
Excessive Metal Movement is called "Jian Cheng" (Firm Completion). Metal governs autumnal harvest, hence it is termed "Shou Yin" (Gathering and Pulling In). In autumn, the Heaven Qi is clean and pure; when Heaven Qi is clean and pure, Earth Qi shines bright. Summer is Yang, Autumn is Yin. Upon reaching autumn, the Yang-heat Qi transforms according to Yin governance. Metal in Heaven manifests as Dryness (Zao), so Dryness exercises its administration. Summer promotes growth, Autumn completes formation; thus, things are governed by completion. When Metal Qi is excessive, the Qi of autumnal harvest flourishes and spreads, causing the Qi of summer growth to fail to complete. "Hua Qia" means transformation Qi harmonizes with all things. Early arrival of Autumn Qi causes incomplete harmonization. Its completion is the autumn harvest. Its reduction is Metal's thinning of things. Its administration is solemn, representing Metal's clearing and肃 (solemn) nature. Its order is sharp and cutting, representing Metal's rigidity. Its movement involves violent breaking, ulcers, and lingering diseases, representing Metal's penal laws. Its virtue is misty dew and bleakness, representing Metal's softness and moistening. Its change is desolation and withering, representing Metal's clear sharpness. Although Metal is excessive, after excess comes deficiency. Thus, Metal, Fire, and Wood Qi jointly govern affairs. Corresponding grains are Rice and Millet; corresponding animals are Chicken and Horse; corresponding fruits are Peach and Apricot; these correspond to Metal and Fire. Corresponding colors are White, Cyan, and Vermilion; corresponding tastes are Pungent, Sour, and Bitter; these correspond to Metal, Wood, and Fire. Corresponding season is Autumn, which belongs to Metal. Corresponding meridians are Hand-Taiyin Lung Meridian and Hand-Mingyang Large Intestine Meridian, because Hand-Taiyin governs Lung Metal, while Hand-Mingyang Large Intestine serves as its Fu organ. Corresponding Zang organs are Lung and Liver, corresponding to Metal and Wood. Corresponding insects are those with shells and feathers; corresponding objects are those with shells and networks, corresponding to Metal and Fire. Corresponding diseases are wheezing and gasping, chest fullness requiring upright breathing, all being Lung diseases. Excessive Metal Qi occurs in years of Geng Zi, Geng Wu, Geng Yin, and Geng Shen. If Shaoyin (Lesser Yang) or Shaoyang (Lesser Yang) governs Heaven, it is called "Shang Zheng". Excessive Metal with Fire governing Heaven balances Metal Qi, making it equivalent to Zheng Shang (Standard Metal Equilibrium). Wood governs generation; with balanced Metal Qi, generation is uniform. "Qi" means driving away generation. Disease is cough, a Lung disease. Excessive Metal Qi abruptly changes its administration, causing hard and rigid famous trees to lack nourishment. Soft and brittle grasses scorch at the head. Initially, Metal Qi overflows; subsequently, Fire prevails. Fire governs summer growth, so Growth Qi rescues. "Rescue" implies restoration. With restored Growth Qi, Great Fire flows; with flowing Great Fire, scorching heat arrives; vines wither. Metal suffers Fire punishment, and pathogenic factors injure the Lung.
The era of Liu Yan is called "Feng Cang" (Sealing and Storing). Cold governs transformation; Heaven and Earth are strict and condensed. Storage administration spreads; growth orders do not rise. Its transformation is chilling; its Qi is firm and solid. Its administration is quiet; its order flows like water. Its movement is floating, draining, surging, and gushing. Its virtue is condensed, grim cold. Its change is ice, snow, frost, and hail. Corresponding grains are Beans and Foxtail Millet; corresponding animals are Pig and Ox; corresponding fruits are Chestnut and Jujube; corresponding colors are Black and Vermilion; corresponding tastes are Salty, Bitter, and Sweet; corresponding season is Winter. Corresponding meridians are Foot-Shaoyin Kidney Meridian and Foot-Taiyang Bladder Meridian. Corresponding Zang organs are Kidney and Heart. Corresponding insects are scaled creatures; corresponding objects are moist and full. Corresponding disease is distension. This is "Shang Yu" (Upper Feather/Water Excess), where Growth Qi fails to transform. If administration exceeds limits, Transformation Qi rises greatly, turbid Earth Qi intersects, and heavy rain falls frequently, injuring the Kidney.
"Shou Er Zang" refers to the characters literally. Water Movement Excess is called "Liu Yan". Water governs winter; Qi mechanism is closed and dense, hence "Feng Cang". Water in Heaven is Cold, so Cold governs transformation, making Heaven and Earth strict and condensed. Winter storage administration spreads, Water overcomes Fire, so Growth Order does not rise. "Its transformation is chilling" is Water's chilliness. "Its Qi is firm" is Water's solidity. "Its administration is quiet" is Water's tranquility. "Its order flows" is Water's irrigation. "Its movement floats and drains" is Water's overflow. "Its virtue is condensed cold" is Water gathering and dispersing. " , " describes flying snow. "Its change is ice, snow, frost, hail" is Water excess turning from soft to hard. Although Water is excessive, excess is followed by deficiency. Thus, Water, Earth, and Fire Qi jointly govern. Corresponding animals are Pig and Ox; fruits are Chestnut and Jujube, corresponding to Water and Earth. Colors are Black and Vermilion; tastes are Salty, Bitter, and Sweet, corresponding to Water, Fire, and Earth. Season is Winter, belonging to Water. Meridians are Foot-Shaoyin and Foot-Taiyang, as Foot-Shaoyin governs Kidney Water, with Foot-Taiyang Bladder as its Fu. Zang organs are Kidney and Heart, Water and Fire. Insects are scaled; objects are moist and full, Water and Earth. Disease is distension, a Spleen Earth disease. Water Excess occurs in Bing Chen and Bing Xu years. Taiyang Cold Water descends, called "Shang Yu". Water excess with Water governing Heaven prevents Growth Qi from transforming. "Growth Qi" is Fire Qi. Water administration excess initially causes Water overflow, then Earth prevails. Transformation Qi rises greatly, turbid Earth Qi intersects (Earth Qi rising), causing frequent heavy rain. Earth Qi surplus injures the Kidney.
Thus it is said: If virtue is not constant, the overcome element retaliates. If administration maintains its principle, the overcome element transforms together. This is what is meant. Violent administration without virtue is non-constant virtue. Transformation Qi and administration are constant principle. This summarizes the preceding text. Non-constant virtue leads to retaliation of the overcome element, e.g., Wood's harvesting Qi retaliates, Fire's storing Qi retaliates, Earth's great wind arrives, Metal's Great Fire flows, Water's Transformation Qi rises. Constant principle leads to co-transformation, e.g., grains, animals, fruits, insects all transform with the prevailing Qi; colors and tastes involve three Qi. This refers to excess and deficiency of annual movements causing overflow and retaliation. This section discusses Five Elements equilibrium, not excessive administration.
Emperor Wen asked: Heaven is deficient in the northwest, cold on the left, cool on the right; Earth is incomplete in the southeast, hot on the right, warm on the left. Why? Continuing the theme of excess/deficiency of Five Movements, he asks if directions also have excess/deficiency. Heaven is Yang, warm/hot; Earth is Yin, cold/cool. Deficient Heaven in Northwest means less Yang Qi there, hence cold/cool. Incomplete Earth in Southeast means less Yin Qi there, hence warm/hot. Why this deficiency/incompleteness?
Qibo answered: It is the principle of Yin/Yang Qi, high/low terrain, and difference between Tai (excess) and Shao (deficiency). Southeast is Yang. Yang Qi's essence descends, hence right hot, left warm. Northwest is Yin. Yin Qi's essence ascends, hence left cold, right cool. Therefore, land has height/depth, Qi has warmth/coolness. High places are cold; low places are hot. Going to cold/cool places causes distension; going to warm/hot places causes sores. Purging cures distension; sweating cures sores. This is the normal opening/closing of Cou Li (skin pores), due to Tai/Shao differences. "Tai" means excess; "Shao" means deficiency. Heaven deficient in NW, Earth incomplete in SE reflects Yin/Yang weather and high/low geography, involving Tai/Shao differences. Southeast is Yang, Yang Qi excess causes Yin Essence to descend, resulting in right hot/left warm. Northwest is Yin, Yin Qi excess causes Yin Essence to ascend, resulting in left cold/right cool. NW land is high/cool; SE land is low/warm. High = cold Qi; Low = hot Qi. "Shi" means go. Going NW (cold/cool), Yin excess causes distension. "Zhi" means go. Going SE (warm/hot), Yang excess causes sores. Purging represents Heaven Qi descending (Yin cold meets Yang heat, curing distension). Sweating represents Earth Qi ascending (Yang heat meets Yin fluid, curing sores). NW cold/cool closes Cou Li; SE warm/hot opens Cou Li. Hence, normal pore dynamics reflect Tai/Shao differences.
Emperor asked: What about longevity and premature death?
With Tai/Shao differences in Yin/Yang high/low, Tai (excess) brings longevity; Shao (deficiency) brings premature death. He asks about their impact.
Qibo answered: Where Yin Essence ascends, people live long. Where Yang Essence descends, people die young.
NW is Yin, essence ascends. SE is Yang, essence descends. Places where Yin Essence ascends have long-lived people; places where Yang Essence descends have short-lived people. NW is long-lived, SE is short-lived.
Emperor asked: Good. If disease occurs, how to treat it?
NW has few diseases (long life); SE has many diseases (short life). Emperor praises and seeks treatment methods.
Qibo answered: NW Qi should be dispersed and cooled; SE Qi should be gathered and warmed. This is "Same Disease, Different Treatment". Cold/Cool Qi treated with Cold/Cool methods, using water soaking. Warm/Hot Qi treated with Warm/Hot methods, strengthening internal retention, harmonizing Qi to achieve balance. Reverse for false conditions.
NW Cou Li usually closed, Qi excess; treat by dispersing and cooling. SE Cou Li usually open, Qi deficiency; treat by gathering and warming. Disperse/Gather, Cool/Warm constitute Same Disease, Different Treatment. NW people: exterior cold-closed, interior excess-heat. SE people: exterior warm-open, interior deficiency-cold. NW cold/cool treated with cold/cool (water soak) to open closure (Disperse/Cool method). SE warm/hot treated with warm/hot to strengthen internal retention and harmony (Gather/Warm method). If NW is cold/exterior but not hot/interior, use warm/hot. If SE is warm/exterior but not cold/interior, use cold/cool. Hence, reverse for false cases.
Emperor asked: Good. Within one province, growth/transformation and longevity differ. Why?
NW: exterior cold, interior excess. SE: exterior warm, interior deficiency. Reversing false cases implies NW interior may be deficient, SE interior may be excess. Emperor asks why growth/longevity differs within one province, not just N/S/E/W.
Qibo answered: High/low principles are determined by terrain. Elevated areas governed by Yin Qi; depressed areas governed by Yang Qi. Yang dominance precedes heaven (seasons arrive early); Yin dominance follows heaven (seasons arrive late). This is geographical norm and way of growth/transformation.
Within a province, high/low terrain dictates that elevated areas are governed by Yin Qi, depressed by Yang Qi. Yang dominance makes seasons arrive early (Xian Tian); Yin dominance makes them arrive late (Hou Tian). Early = fast growth; Late = slow growth. This is the norm of geographical Yin/Yang high/low affecting growth timing.
Emperor asked: Is there longevity/death variation?
Asking about growth/longevity, he asks if there is variation within growth.
Qibo answered: High places have long-lived Qi; low places have short-lived Qi. Land size varies. Small differences yield small variations; large differences yield large variations. Healers must understand Heaven's Way and Earth's Principle, Yin/Yang mutual overcoming, Qi sequence, human longevity, and growth periods to know human form and Qi.
High land governed by Yin, Yin Essence ascends, people live long (High = Long Qi). Low land governed by Yang, Yang Essence descends, people die young (Low = Short Qi). High = large Qi; Low = small Qi. Height/depth differences vary by land size. Slight height/depth = slight longevity difference. Extreme height/depth = large longevity difference. Healers must understand Heaven/Earth, Yin/Yang overcoming, seasonal sequence, to determine longevity and growth periods, knowing human form/Qi. *Ling Shu* Chapter on Longevity/Death states: Form and Qi in balance = longevity; imbalance = death. Establishing form and fixing Qi determines longevity.
Emperor asked: Good. Some years have no disease, yet Zang Qi does not respond or function. Why?
After clarifying growth/longevity, and noting NW/SE same-disease-different-treatment, he asks why some years have no disease despite Zang Qi not responding to Yin/Yang or high/low principles (no Tai/Shao difference).
Qibo answered: Heaven Qi controls it; Qi follows.
"Control" means govern. No disease despite Zang Qi non-response is due to Si Tian (Heaven Governing) Qi controlling from above, aligning Heaven Qi with Human Qi, so Qi follows, preventing disease.
Emperor asked: I wish to hear it fully.
I wish to hear fully the way Heaven Qi controls and Qi follows.
Qibo answered: When Shaoyang governs Heaven, Fire Qi descends, Lung Qi ascends to follow. White appears, Metal functions. Grasses/trees suffer. Fire blazing transforms Metal, exhausting it. Great heat prevails. Cough, sneezing, runny/bloody nose, nasal obstruction, mouth ulcers, cold/heat, carbuncles/swelling. Wind moves on Earth, dust/sand fly. Heart pain, epigastric pain, reversal cold, diaphragm blockage. Its master is sudden and rapid.
In Yin/Shen years, Shaoyang governs Heaven. Shaoyang is Minister Fire, so Fire Qi descends. Si Tian Qi controls humans; humans comply, so Lung Qi ascends. Lung color is white, belongs to Metal, so White/Metal function arises. Metal function suppresses Wood, harming grasses/trees. Fire blazing is Shaoyang Qi. Transforming Metal exhausts it (Metal suffers Fire punishment). Fire excess causes Great Heat. Cough etc. are Lung diseases. Mouth ulcers etc. are Fire diseases. Shaoyang Heaven governs, Jueyin Earth rules. Jueyin is Wind, so Wind moves on Earth, flying dust. Jueyin meridian connects to Pericardium, causing heart pain. Stomach meridian connects to Pericardium, causing epigastric pain. Heart/Stomach pain blocks Yin/Yang connection, causing reversal cold and diaphragm blockage. Wind is rapid, so manifestation is sudden. Heaven/Earth rulers discussed together.
When Yangming governs Heaven, Dryness Qi descends, Liver Qi ascends to follow. Cyan appears, Wood stands. Earth suffers. Bleakness frequently arrives. Wood cut, grass withers. Hypochondriac pain, red eyes, trembling/shivering, tendon wasting, inability to stand long. Sudden heat arrives, Earth becomes hot. Yang Qi stagnates and erupts. Urine changes. Chills/fever like malaria. Severe heart pain. Fire moves through dryness, flowing water doesn't freeze, hibernating insects appear.
Shuo sound. In Mao/You years, Yangming governs Heaven. Yangming is Dry Metal, so Dryness descends. Humans comply, Liver Qi ascends. Liver color cyan, belongs to Wood, so Cyan/Wood stands. Wood standing harms Earth (Wood overcomes Earth). Bleakness is Metal victory. Wood cut/grass withered is Metal punishing Wood. Hypochondriac pain/red eyes are Liver Wood disease. Trembling is Liver deficiency. Tendon wasting is Liver governing tendons. Yangming Heaven governs, Shaoyin Earth rules. Shaoyin is Heat, so sudden heat arrives. Sudden heat makes Earth hot, Yang Qi erupts. Internal heat changes urine; external heat causes chills/fever. Severe heat injures self, causing heart pain. Guest Qi adds Ruler Fire to Six Qi, so Fire acts during withering, preventing winter freezing, revealing hibernating insects.
When Taiyang governs Heaven, Cold Qi descends, Heart Qi ascends to follow. Fire shines, Vermilion appears. Metal suffers. Cold/clarity often rises. Victory causes water freezing. Fire Qi high/bright. Heart heat/irritation, throat dry, thirsty, runny/bloody nose, sneezing, sadness, yawning. Heat Qi wanders. Cold returns. Frost falls irregularly. Forgetfulness. Severe heart pain. Earth becomes moist. Water abundant. Cold guest arrives. Deep Yin transforms. Dampness changes things. Internal water retention, middle fullness, loss of appetite. Skin bi, flesh discomfort. Sinews/vessels unsmooth. Severe edema. Back abscess.
Qun sound. In Chen/Xu years, Taiyang governs Heaven. Taiyang is Cold Water, so Cold descends. Humans comply, Heart Qi ascends. Heart is Fire, color Vermilion. Fire shines/Vermilion appears. Metal suffers (Fire punishes Metal). Cold/clarity rising is Si Tian Qi. Victory freezes water. Fire high/bright is Ascending Qi. Heart heat/thirst is Fire disease. Runny nose/sadness is Fire punishing Metal. Yawning is Yin/Yang attraction. Initial heat wandering, then Cold returns (Cold excess), causing irregular frost. Heart Fire deficiency causes forgetfulness/severe heart pain. Taiyang Heaven governs, Taiyin Earth rules. Taiyin is Dampness, so Earth moistens. Damp is Water type, so Water abundant. Water/Damp is Cold. Cold guest arrives. Cold/Damp is Yin, sinks, belongs to Earth, so Deep Yin transforms, Dampness changes things. Dampness causes internal water retention, middle fullness/appetite loss. Bi is numbness, Ke is discomfort. Skin bi/flesh discomfort leads to vessel issues. Edema here is due to Cold (unlike Heat-induced swelling earlier). Back abscess is on back, connecting to Taiyang which governs back.
When Jueyin governs Heaven, Wind Qi descends, Spleen Qi ascends to follow. Earth隆 (rises), Yellow appears. Water suffers. Earth function changes. Heavy body, muscle wasting, reduced food intake, mouth taste disorder. Wind moves in Void, clouds/objects shake. Eyes spin, ears ring. Fire releases violence. Earth becomes hot. Great heat melts. Red fluids flow down. Hibernating insects appear frequently. Flowing water doesn't freeze. Onset is rapid.
In Si/Hai years, Jueyin governs Heaven. Jueyin is Wind, so Wind descends. Humans comply, Spleen Qi ascends. Spleen is Earth, color Yellow. Earth rises/Yellow appears. Water suffers (Earth overcomes Water). Wind/Wood excess changes Earth function ("Ge" means change). Heavy body/muscle wasting is Spleen disease. Reduced food/mouth disorder is Spleen disease. Wind in upper part shakes clouds/objects. In humans, eye spinning/ear ringing. Jueyin Heaven governs, Shaoyang Earth rules. Shaoyang is Fire, so Fire releases violence, Earth becomes hot. Heat melts fluids, causing red discharge. Fire opens, revealing insects. Fire warms, preventing freezing. Fire is violent, causing rapid onset.
When Shaoyin governs Heaven, Heat Qi descends, Lung Qi ascends to follow. White appears, Metal functions. Grasses/trees suffer. Wheezing/vomiting, cold/heat, sneezing, runny/bloody nose, nasal obstruction. Great heat prevails. Severe sores burning. Metal melts stone. Earth becomes dry/clear. Bleakness arrives. Hypochondriac pain, sighing. Desolation acts, plants change.