既知四时之色。须知四时之病。知四时之病。以察四时之色。夫而后可按四时之色。以言四时之病。其病
维何。玉机真藏论曰。春脉如弦。太过则令人善忘。忽忽眩冒而巅疾。其不及则令人胸痛。引背下则两胁
满。夏脉如钩。太过则令人身热。而肤痛为浸淫。其不及则令人烦心。上见咳唾。下为气泄。秋脉如浮。太
过则令人逆气而背痛愠愠然。其不及则令人喘。呼吸少气而咳。上气见血。下闻病音。冬脉如营。太过则
令人解 。脊脉痛而少气不欲言。其不及。则令人心悬如病饥。 中清。脊中痛。少腹满。小便变。脾脉者。中
央土。孤脏以灌四旁者也。太过则令人四肢不举。其不及则令人九窍不通。名曰重强。此皆四时之病也。
然此四时之病。内经以脉言。而吾以色言者何哉。盖尝读内经而有悟于岐黄之言焉。岐伯曰。夫色脉与
尺脉之相应也。如桴鼓影响之相应也。不得相失也。色之变化。以应四时之脉。此上帝之所贵。以合于神
明也。黄帝曰。吾得脉之大要。天下至数。五色脉变。揆度奇恒。道在于一。由此观之。四时气色之生克。亦可
以脏腑经脉之病症比例而推矣。何也。五脏之病。四时之色。推之以五行之理。太过则薄所胜。而乘所不
胜。其不及则所胜妄行。而所生受病。所不胜薄之也。设或知病而不知诊。或知诊而不知病。则虽能知诊。
虽能知病。而究不知诊病。即能知诊病。而尚不知治病。而况尚不知诊。尚不知病耶。呜呼。灵素之书。若此
其详也。延医之法。若此其备也。然而无有乎尔。则亦无有乎尔。（善忘之忘。宋林亿等较正千金素问。皆云
当作怒。今考素问气交变大论。亦作怒。宜从之。）
Having understood the complexions corresponding to the four seasons, one must also understand the diseases prevalent in the four seasons. Understanding the diseases of the four seasons allows one to examine the complexions of the four seasons. Only then can one speak of the diseases of the four seasons by observing their complexions. What are these diseases? The *Jade Machine True Viscera Discourse* (Yùjī Zhēnzàng Lùn) states: The pulse of Spring is like a string (xián). If excessive, it causes forgetfulness, dizziness, and vertigo, leading to disorders at the vertex (diān jí). If deficient, it causes chest pain radiating to the back, and below, fullness in both hypochondria. The pulse of Summer is like a hook (gōu). If excessive, it causes feverish sensation in the body and skin pain manifesting as spreading sores (jìnyín). If deficient, it causes vexation in the heart, with coughing and expectoration appearing above, and qi leakage (qì xiè) below. The pulse of Autumn is like floating (fú). If excessive, it causes rebellious qi and dull back pain. If deficient, it causes panting, shortness of breath, and coughing, with blood appearing from above (hemoptysis) and pathological sounds heard below. The pulse of Winter is like a camp (yíng), meaning deep and firm. If excessive, it causes flaccidity of the limbs, pain in the spinal vessels, shortness of breath, and reluctance to speak. If deficient, it causes a feeling of emptiness in the heart as if hungry, coldness in the epigastrium, pain in the middle of the spine, fullness of the lower abdomen, and abnormal urination. The Spleen pulse corresponds to Earth in the Center; it is the solitary viscera that nourishes the four peripheries. If excessive, it causes inability to lift the limbs. If deficient, it causes obstruction of the nine orifices, a condition named "heavy stiffness" (zhòng qiáng). These are all the diseases related to the four seasons. However, the *Nei Jing* discusses these four-season diseases in terms of pulses, whereas I discuss them in terms of complexion. Why is this? Having studied the *Nei Jing*, I have gained insight into the words of Qibo and Huangdi. Qibo said: The correspondence between complexion, pulse, and Cun-Che-Fu (radial artery palpation) is like the striking of a drum with a drumstick, the shadow following the object, and the echo responding to the sound; they cannot be inconsistent. Changes in complexion should correspond to the pulses of the four seasons. This is highly valued by Heaven, aligning with divine illumination. Huangdi said: I have grasped the essentials of pulse diagnosis, which is the greatest principle under heaven. The changes of the five colors and pulses, measured by Kuidu (comparing normal and abnormal), lie in unity. From this perspective, the generation and restriction among the qi and complexions of the four seasons can be inferred by analogy with the pathological conditions of the zang-fu organs and meridians. Why? The diseases of the five zang organs and the complexions of the four seasons can be deduced using the principles of the Five Elements. Excess leads to attacking what it overcomes and bullying what it cannot overcome; deficiency leads to what it overcomes acting recklessly, what it generates suffering disease, and what cannot overcome it encroaching upon it. If one knows the disease but not the diagnostic methods, or knows the diagnostic methods but not the disease, then although one may know diagnostics and disease, one ultimately does not know how to diagnose illness. Even if one knows how to diagnose illness, one still does not know how to treat it, let alone knowing diagnostics and disease. Alas, the books of *Lingshu* and *Suwen* are so detailed. The methods for engaging physicians are so comprehensive. Yet, there is none; indeed, there is none. (Note: Regarding "forgetfulness" (wàng), Song dynasty scholar Lin Yi and others corrected the *Qianjin Suwen*, stating it should be read as "anger" (nù). Current examination of the *Suwen · Qi Jiao Bian Da Lun* also writes "anger," so this reading should be followed.)