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Wang Bing stated: If the pathogenic factor acting in opposition to the season causes severe disease, treatment should be based on the current season. Wu Kun explained that "season" refers to the Host Qi (Zhu Qi), which corresponds to the four seasons. Zhang Zhicong clarified that "Heavenly Qi contrary to the season" means, for example, if the ruling Qi is hot but the weather turns cool, one should use warm herbs according to the season.

When the Guest Qi (Ke Qi) overcomes the Host Qi, counteractive measures may be taken.

Wang Bing stated: In summer, if cold is extreme, heat can be used to treat it; if cold is not severe, one must not offend the Host Qi's heat. Zhang Zhicong stated: For instance, if the ruling Qi is hot but cold invades and prevails, heat may again be used to confront the Host Qi's heat. Zhang Jiebin stated: That which overcomes the Host Qi is excessive Guest Qi. For example, extreme cold in summer indicates an excess of Guest Water; excessive heat in winter indicates an excess of Guest Fire. The same applies to coolness in spring and warmth in autumn. Therefore, one may use heat to treat heat, cold to treat cold, warmth to treat warmth, and coolness to treat coolness. Following these variations is what is called "Following Treatment" (Cong Zhi).

The goal is balance, and one must not go to extremes.

Wang Bing stated: Stop when qi reaches balance; going beyond this leads to disease. "Disease arising from excess" is similar to "offending." Wu Kun stated: Excess will reverse-injure the Healthy Qi (Zheng Qi) and cause disease. Zhang Zhicong stated: Take balance as the limit; do not overuse so as to injure the primordial true Qi of the Ruling Qi. Zhang Jiebin stated: Excess injures Healthy Qi and exacerbates disease.

This is referred to as "Pathogenic Qi Prevailing in Opposition."

Wang Bing stated: When qi movement has a prevailing aspect, it is called Pathogenic Guest Qi overcoming the Host Qi, which must not be ignored. In the six phases of qi, within their respective positions, if cold should appear but heat does, or heat should appear but cold does, or warmth should appear but coolness does, or coolness should appear but warmth does, this is called the prevalence of pathogenic qi in the six phases. If winter is unusually warm, summer unusually cold, autumn unusually hot, or spring unusually cool, this is called the prevalence of pathogenic qi in the four seasons. When there is prevalence, one uses the opposite nature of qi to bring about balance. Zhang Zhicong stated: This is what is meant by "Pathogenic Qi Prevailing in Opposition"; in such cases, counteractive treatment is permissible. Zhang Jiebin stated: Pathogenic Qi prevailing in opposition refers to qi arriving out of season, such as heat expected but cold appearing, cold expected but heat appearing, warmth expected but coolness appearing, or coolness expected but warmth appearing. All these are examples of Pathogenic Qi prevailing in opposition. Since it is an oppositional prevalence, one should use the opposite nature of qi to achieve balance.

Therefore, it is said: Do not lose sight of the Trust of Heaven (Tian Xin); do not violate the appropriateness of Qi; do not assist the prevailing force; do not endorse the retaliatory force. This is called the highest form of governance.

Wang Bing stated: "Trust of Heaven" refers to the certainty of climate at the proper time. "Yi" and "Zan" both mean to assist. Strictly observing the Trust of Heaven is called the profound principle of Supreme Truth. Zhang Zhicong stated: "Trust of Heaven" refers to qi arriving in accordance with the season without error or妄 interference. Each of the Six Qi has its propriety and must not be violated. When there is a prevailing force, it is appropriate to curb it, but do not assist its prevalence. When there is a retaliatory force, it is appropriate to suppress it, but do not endorse its recurrence. Harmonize the correct flavors of herbs so that upper and lower harmonize in virtue, without interfering with each other's order. Keep the Five Movements (Wu Yun) in peace, ensuring they do not deviate from their administration. This is called the highest form of governance. Zhang Jiebin stated: When Guest, Host, and Movement-Qi arrive, they must correspond to the season; this is the Trust of Heaven. To not know the seasonal qi is to lose the Trust of Heaven. The use of cold, heat, warmth, and coolness must be appropriate to the qi. To not understand reversal and following is to violate the appropriateness of qi. Assisting the prevailing force and endorsing the retaliatory force are all aiding the pathogen. To know this and yet not interfere is called the most subtle form of treatment.