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。〕
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.]