3．四时主气相互感应每年都有春温、夏暑、长夏湿、秋燥、冬寒和春生、夏长、长夏化、秋收、冬藏的变化，所以通过相似相应发生不同季节的时令病和诸种时令疾病的改变。正如《时病论》说：“春伤于风，谓当春厥阴行令，风木司权之候，伤乎风也。夫风邪之为病，有轻重之分焉，轻则日冒，重则日伤，又重则日中。如寒热有汗，是风伤卫分，久日伤风病也；鼻塞咳嗽，是风冒于表，名日冒风病也；突然昏倒，不省人事，是风中于里，名日中风病也。”“夏伤于暑者，谓夏季小暑大暑之令，伤于暑也，其时天暑地热，人在其中，感之皆称暑病。夫暑邪伤人，有伤暑，冒暑、中暑之分，且有暑风、暑温、暑咳、暑瘵之异。伤暑者，静而得之为伤阴暑，动而得之为伤阳暑；冒暑者，较伤暑为轻，不过邪冒肌表而已；中暑者，即中喝也，忽然昏倒，如中风状；暑风者，须臾昏倒，手足遂抽；暑温者，较阳暑略微轻可；暑咳者，暑热袭肺而咳逆；暑瘵者，暑热劫络而吐血。又有霍乱之证，因暑气夹风寒湿食扰乱于中。”“大暑至白露，正值湿土司权，是故谓之秋伤于湿……因湿为病者有六，一日伤湿，一日中湿，一日冒湿，一日湿热，一日寒湿，一日湿温。盖伤湿者，有表里之分焉，在表由于居湿涉水，雨露沾衣，从外而受者也；在里由于喜饮茶酒，多食瓜果，从内而生者也。中湿者，卒然昏倒，颇与中风相似；冒湿者，因冒早晨雾露，或冒云瘴山岚；湿热者，夏末秋初感受为多，他时为少；寒湿者，先伤于湿，后伤于冷；湿温者，湿酿成温，温未化热，最难速愈。”“冬伤于寒，谓交立冬之后，寒气伤人，其能周密者何伤之有!一有不谨，则寒遂伤于寒水之经，即病寒热无汗，脉来浮紧，名日伤寒是也。一交春令，便不可以伤寒名之。然冬令受寒，有浅深之别焉，深者为中，浅者为冒。盖中寒者，寒邪直中于三阴之里，故有吐泻腹痛，急宜热剂祛寒；冒寒者，寒邪冒于躯壳之外，则有寒热身痛，不难一汗而愈。”俞根初说：“秋深初凉，西风肃杀，感之者多病风燥，此属凉燥，较严冬风寒为轻；若秋晴无雨，秋阳以曝，感之者多病温燥，此属燥热，较暮春风温为重。”《素问·脏气法时论》说：“肝主春，足厥阴，少阳主治……心主夏，手少阴、太阳主治……脾主长夏，足太阴、阳明主治……肾主冬，足少阴、太阳主治……。病在肝，愈在夏，夏不愈，甚于秋，秋不死，持于冬，起于春……；病在心，愈在长夏，长夏不愈，甚于冬，冬不死，持于春，起于夏……；病在脾，愈在秋，秋不愈，甚于春，春不死，持于夏，起于长夏……；病在肺，愈在冬，冬不愈，甚于夏，夏不死，持于长夏，起于秋……；病在肾，愈在春，春不愈，甚于长夏，长夏不死，持于秋，起于冬。”
4．六气的太过不及相互感应一年四季各有其所主的风寒暑湿燥火，一日昼夜各有其所主的风寒暑湿燥火，这些风寒暑湿燥火在正常的范围内可以通过相似相应的关系促进人体的生长发育，假若太过和不及，或因正气不能适应这种变化时，就变成了致病的条件，故《内经》说：“虚邪贼风，避之有时”，“正气存内，邪不可干。”
5．昼夜阴阳、五行相互感应昼夜的阴阳、五行变化，使“昼为阳，夜为阴，”“平旦人气生，日中而阳气隆，日西而阳气已虚。”木旺于寅卯平旦时，火旺于巳午中午时，金旺于申酉日入时，水旺于亥子夜半时，土旺于未申日西时，故其通过相似相应可以引起相似系统、相似运动的病理、生理、症状的改变。
三、天人相应学说临床应用举隅
1．诸年运气相似相应案1984年适逢甲子，在门诊过程中，经常遇见一些久治不愈的所谓感冒患者，症见身热乏力，咳嗽，舌苔薄白，脉浮紧。因思甲子中运湿土，少阴君火司天。予化湿祛痰，稍佐祛暑之品治之，均见二三剂愈。
2．异气相似相应案雍正癸丑，疫气流行，抚吴使者，属叶天士制方救之。叶日：时毒疫气，必应司天，癸丑湿土气化运行，气交阳光不治，疫气大行，故凡人之脾胃虚者，乃应其疠气，邪从口鼻皮毛而入，病从湿化者，发热目黄，胸满丹疹，泄泻，当察其舌色，或淡白，或舌心干焦者，邪犹在气分，甘露消毒丹治之；若壮热旬日不解，神昏谵语斑疹，当察其舌绛干光圆硬，津涸液枯，是寒从火化，邪已人营矣，用神犀丹治之。
3．四时主气相似相应案
(1)四时主气相应发病案
苏××，女，成。
一个多月来，身热乏力，头晕，口渴喜饮，纳呆食减，汗多。医诊为感冒。先予感冒清热冲剂、感冒通等不解，继又以输液、抗生素、病毒唑治之仍不效。审之，神疲乏力尤甚，脉弦大紧。思之：病发于夏天暑热之季，乃暑病也。东垣主用清暑益气汤，鞠通亦列于《温病条辨》中，应宗之。清暑益气汤原方2剂，果愈。
(2)四时主气相应加重案
李××，男，成。
20多年来，每到冬天则发生呕吐，其他季节自然消失。每次发病，少则每日呕吐数口，多则每日数次，一次即盈盆盈碗。医诊神经性呕吐。始用西药治疗不效，继又用中药降逆止呕亦不效。此次发病虽然已经一个多月，但始终不见其效。细审其舌苔薄白，脉弦大紧。综合脉证。思之：冬季阳虚寒盛之令，复遇脾胃阳虚，寒饮中阻之体，两寒相应，胃失和降，故而呕吐频作。治宜温中化饮，桂附理中合五苓散。处方：附子10克，肉桂10克，党参10克，干姜10克，甘草10克，白术10克，泽泻10克，茯苓10克，猪苓10克。
服药2剂，呕吐即止。次年冬季又复发，但程度较轻，继服6剂，愈。
邢××，女，成。
20多年来，每至春季则颜面出疹，如小米大，奇痒，其他季节自然消退。遍用中、西药物治疗不效。思之：春季者，肝木所主之时也，肝藏血，血虚则风动，风动则痒，此即痒为泄风之意。拟用养血清热祛风。处方：丹参15克，当归10克，川芎10克，生地10克，白芍10克，银花10克，连翘10克，元参10克，薄荷3克。服药30剂，瘳。
苏××，女，成。
崩漏数年，夏轻冬重。今年入冬以来，经血大下，腹痛拘急，饮食全废。医者或以固涩收敛，或以归脾摄血，然均无功。某院除用西药外，仅仅输血即达1500毫升，但仍不止。察其脉虚大弦紧，面色咣白而微透黄色，神疲乏力，言语低微，腹痛喜按，指趾厥冷。证脉合参。因思：冬主闭藏，其主在肾，命门火衰，则闭藏失职。又肾者主水，受五脏六腑之精而藏之，肾火不足，脾土失养，则统血不能。此必脾肾两脏亏虚所致耳。治拟补脾益肾，以助先后二天。处方：黄芪15克，当归10克，川芎10克，熟地10克，党参10克，白术10克，茯苓10克，麦冬10克，半夏10克，附子10克，炙甘草10克，淡大芸15克，肉桂10克，鹿角胶10克(烊化)，芡实10克，生姜10克，大枣5枚阿胶lO克(烊化)。服药4剂，经血止，继服20剂，愈。
4．昼夜六气相似相应案
(1)昼夜六气发病案
王××，女，55岁。
四天来恶寒发热，头痛身痛。予西药和中药感冒清、银黄口服液等不效。察其除体温在38．9℃外，舌苔薄白，脉弦紧。思之：病虽发生于暑热之季，然脉证均风寒客表之象，宜宗有是证用是药，疏散风寒，九味羌活汤l剂，愈。
李××，男，15岁。
吃冰糕后，突然发现腹部剧痛不止，时而包块起伏。急至某院诊治。医云：肠梗阻。先予复方大承气汤一剂，不效，继又予萝卜芒硝汤一剂仍不效。不得已而欲手术治疗，但家属拒绝手术，而再恳服中药。察其除上述诸证外，并见其腹痛得温而稍减，脉弦紧。综合脉证。思之：《素问·举痛论》云：“寒气客于脉外，则脉寒，脉寒则缩蜷，缩蜷则脉绌急，则外引小络，故卒然而痛，得炅则痛立止。”此病发于吃冷食之后，必寒邪直中之证也。急予温中散寒。处方：丁香10克，小茴香10克，川椒10克，肉桂10克，木香10克，良姜10克。药刚入腹约10分钟，腹痛即减，半小时后痛减六七，两小时后疼痛全失，愈。
(2)昼夜六气相应加剧案
耿××，女，成。
8个多月来，低热乏力。某院除查其有结核菌素试验阳性外，余无任何阳性发现。先予抗痨药治疗三个多月无效，继又以中药养阴清热治疗两个多月仍不见好转。询之：发热甚于午后，至夜反减，每次发热之前先感心胸烦热，继而全身发热无力，热甚之时体温可达38．6℃，上午与夜间一般最高不超过37．3℃，而且精神较好，脉弦而滑。思之：阴虚之热虽午后较甚，而前半夜应更甚，而此证反前半夜发热减轻。又思：午后日晡乃脾湿所主之时，脉又见弦滑而非细数，则非阴虚而乃心胸湿热郁滞也。治宜栀子豉汤解郁热。处方：栀子10克，豆豉10克。药进6剂，发热尽解，愈。
刘××，女，50岁。
突然全身奇痒难忍。医予消风散三剂治之，其痒更剧。至某院皮科诊治，云：皮炎，治疗十余天非但无功，反更严重。细询其证：夜间奇痒，白天即减，每次发痒非抓至到处出血不得稍减，脉弦细。思之：痒发于夜间，夜为阴，昼为阳，营为阴，卫为阳，营血不足，燥热生风，乃痒也。治宜养血活血，凉血散风。处方：生地30克，熟地10克，生何首乌10克，当归10克，丹皮lO克，元参30克，白蒺藜6克，僵蚕6克，红花lO克，甘草6克。
服药1剂痒即大减，继服6剂，愈。
苏××，女，26岁。
6年多来，月经不调，有时提前十几天，月经至后经常淋漓不断10—30天才止，经量时多时少，此次月经虽已10天．但仍淋漓不断。细审前医所用之方，有云肝郁化火予丹栀逍遥散者，有云瘀血阻滞予失笑散加味者，有予芩连四物、胶艾四物、归脾汤者，然均无效。细审其脉弦涩不调，少腹满痛，午后至夜间加剧，胸胁苦满，乳房胀痛，头晕头痛，五心烦热，尿热尿痛。证脉合参，诊为肝郁血虚，郁而化火，热迫血行。又思：午后至夜间腹满尤甚，乃脾肾虚寒，湿郁不化之证。若但予泻火清热则寒湿更甚，非温肾散寒相佐而难解。因拟丹栀逍遥散养血疏肝，清热泻火，去生姜，加炮姜、肉桂以温肾散寒。2剂后月经量减少，6剂后经血止，他证亦减大半。
四、结语
天人相应学说是在中医相似论的指导下形成的气象、医学相关学说，因此它的思维方法也是相似论的思维方法。
天人相应学说是中医进行辨证论治时的重要依据之一，它所应用的方法主要有诸年运气相互感应，诸年异气相互感应、四时主气相互感应、六气太过不及相互感应、昼夜阴阳五行相互感应法五种。
天人相应式的辨证论治方法常常补充我们辨证论治时的思路不足，所以我们治疗疑难复杂疾病时，应该结合天人相应的观点去进行，并把天人相应学说中的几个规律作为重要的论证去研究。
能冬不能夏能夏不能冬
在我进入疑难病辨证论治规律性的实质性研究时，发现疑难病的大量症状改变与季节性的变化有关。例如：感冒病，有的患者一到冬季即反复感冒，至夏季则诸证全然不作；而另有一部分患者则与此截然相反，每到夏季即反复感冒，一到冬季则全然不作。咳嗽病，有的患者一到冬季即不断地咳嗽，虽治难愈，但在夏季则全然不作；而另一部分患者则与此相反，患者一到夏季即反复咳嗽，一到冬季则不治亦愈。哮喘病，有的患者一到冬季则哮喘发作，虽治难效，而到夏季则不治自愈；但有的患者与此恰恰相反，一到夏季则哮喘大作，虽治难效，而一到冬季则不治亦愈。胃痛病，有的患者一到冬季则必然反复疼痛，而一到夏季则不治亦愈；另一部分患者则与此相反，每到夏季则疼痛必发，冬季自愈。如此等等，不胜枚举。
这些症状的出现有没有一个共同的规律性呢?可不可以应用这一规律性去认识疾病的病机，并应用这一规律性去辨证论治呢?
当我读至《素问·阴阳应象大论》中的一段按照阴阳法则辨证论治的论述时，始而稍有所悟，它说，“能冬不能夏”是由于“阳盛”，“能夏不能冬”是由于“阴盛”。但是怎么应用于临床仍甚渺渺。及至详读王冰所注“阳胜故能冬，热甚故不能夏。”“阴胜故能夏，寒甚故不能冬。”始知辨体质的阳胜、阴胜时，凡能耐受冬季之气候者为阳盛体质的人，治疗时应很好地考虑阳胜，予以清热泻火；而凡能耐受夏季气候者为阴胜体质的人，治疗时应多考虑阴胜，予以温阳散寒。但是从临床上看，真正阳胜、阴胜者少，所以很难指导临床实践。及至读到张介宾《类经》所注，始而大有所悟。他说：“阴竭者，得冬之助犹可支持，遇夏之热，不能耐受矣。”“阳衰者，喜暖恶寒，故耐夏而不能冬也。”言疑难之病，若阴虚者则夏甚冬止，阳虚者则夏止冬剧。验之临床其效果然大增。
3．四时主气相互感应
每年都有春温、夏暑、长夏湿、秋燥、冬寒以及春生、夏长、长夏化、秋收、冬藏的变化，因此通过相似相应的关系，发生不同季节的时令病和各类时令疾病的演变。正如《时病论》所说：“春伤于风，是指正值春季厥阴风木当令，风气司权之时，人体感受了风邪。风邪致病有轻重的区别：轻的称为‘日冒’，重的称为‘日伤’，更重的称为‘日中’。如出现寒热有汗的症状，是风邪伤了卫分，日久形成伤风病；鼻塞咳嗽，是风邪侵袭体表，称为冒风病；突然昏倒，不省人事，是风邪深入体内，称为中风病。”“夏伤于暑，是指正值夏季小暑、大暑当令，人体感受了暑邪。此时天气炎热，地热蒸腾，人处于其中，感受的都称为暑病。暑邪伤人，有伤暑、冒暑、中暑的区别，还有暑风、暑温、暑咳、暑瘵的不同。静而得之的为伤阴暑，动而得之的为伤阳暑；冒暑比伤暑轻，仅是邪气侵犯肌表而已；中暑即中暍，突然昏倒，像中风的样子；暑风，须臾间昏倒，手足随即抽搐；暑温比阳暑略微轻些；暑咳，是暑热袭肺导致咳嗽气逆；暑瘵，是暑热劫伤络脉导致吐血。又有霍乱的证候，是因暑气夹杂风寒湿食扰乱于中焦。”“从大暑到白露，正值湿土当令，所以称为秋伤于湿……因湿邪致病的有六种：一是伤湿，二是中湿，三是冒湿，四是湿热，五是寒湿，六是湿温。伤湿有表里之分：在表的由于居住潮湿、涉水、雨露沾衣，是从外感受的；在里的由于喜欢饮茶酒、多吃瓜果，是从内产生的。中湿，突然昏倒，颇与中风相似；冒湿，因为早晨冒雾露，或冒云瘴山岚；湿热，多在夏末秋初感受，其他时候较少；寒湿，先伤于湿，后受冷；湿温，湿酿成温，温未化热，最难迅速痊愈。”“冬伤于寒，是指立冬之后，寒气伤人，如果能周密防护，有什么可伤害的呢？一旦不慎，寒邪就伤了寒水之经（足太阳膀胱经），立即发病表现为寒热无汗，脉象浮紧，称为伤寒。一进入春季，便不可以再称为伤寒。然而冬季受寒，有深浅之别：深者为中寒，浅者为冒寒。中寒，寒邪直接侵入三阴经的里部，所以有吐泻腹痛，急需热剂祛寒；冒寒，寒邪侵袭躯壳之外，则有寒热身痛，不难通过发汗而愈。”俞根初说：“深秋初凉，西风肃杀，感受的人多患风燥病，这属于凉燥，比严冬的风寒为轻；如果秋晴无雨，秋阳暴晒，感受的人多患温燥病，这属于燥热，比暮春风温为重。”《素问·脏气法时论》说：“肝主春，足厥阴肝经、足少阳胆经主治……心主夏，手少阴心经、手太阳小肠经主治……脾主长夏，足太阴脾经、足阳明胃经主治……肾主冬，足少阴肾经、足太阳膀胱经主治……。病在肝，痊愈在夏季，夏季不愈，病情加重在秋季，秋季不死，维持于冬季，起色在春季……；病在心，痊愈在长夏，长夏不愈，病情加重在冬季，冬季不死，维持于春季，起色在夏季……；病在脾，痊愈在秋季，秋季不愈，病情加重在春季，春季不死，维持于夏季，起色在长夏……；病在肺，痊愈在冬季，冬季不愈，病情加重在夏季，夏季不死，维持于长夏，起色在秋季……；病在肾，痊愈在春季，春季不愈，病情加重在长夏，长夏不死，维持于秋季，起色在冬季。”
4．六气的太过不及相互感应
一年四季各有其所主的风、寒、暑、湿、燥、火，一日之中昼夜也各有其所主的风、寒、暑、湿、燥、火。这些风寒暑湿燥火在正常范围内，可以通过相似相应的关系促进人体的生长发育；假若太过或不及，或因正气不能适应这种变化时，就变成了致病的条件，所以《内经》说：“虚邪贼风，避之有时”，“正气存内，邪不可干。”
5．昼夜阴阳、五行相互感应
昼夜的阴阳、五行变化，使“昼为阳，夜为阴”，“平旦人气生，日中而阳气隆，日西而阳气已虚”。木旺于寅卯时（平旦），火旺于巳午时（中午），金旺于申酉时（日落），水旺于亥子时（夜半），土旺于未申时（日西），因此通过相似相应可以引起相似系统、相似运动的病理、生理、症状的改变。
三、天人相应学说临床应用举隅
1．诸年运气相似相应案
1984年适逢甲子年，在门诊过程中，经常遇见一些久治不愈的所谓感冒患者，症见身热乏力，咳嗽，舌苔薄白，脉浮紧。思考甲子年中运为湿土，少阴君火司天。给予化湿祛痰，稍佐祛暑之品治疗，均见二三剂即愈。
2．异气相似相应案
雍正癸丑年，疫气流行，抚吴使者，属意叶天士制方救治。叶天士说：时毒疫气，必应司天之气。癸丑年湿土气化运行，气交阳光不治，疫气大行，所以凡是脾胃虚弱的人，乃应其疠气，邪从口鼻皮毛而入，病从湿化的，发热目黄，胸满丹疹，泄泻，应当察其舌色，或淡白，或舌心干焦者，邪犹在气分，用甘露消毒丹治疗；如果壮热旬日不解，神昏谵语斑疹，应当察其舌绛干光圆硬，津涸液枯，这是寒从火化，邪已入营分，用神犀丹治疗。
3．四时主气相似相应案
(1) 四时主气相应发病案
苏××，女，成人。
一个多月来，身热乏力，头晕，口渴喜饮，纳呆食减，汗多。医生诊断为感冒。先予感冒清热冲剂、感冒通等药不解，继而又以输液、抗生素、病毒唑治疗仍不效。审察病情，神疲乏力尤甚，脉弦大紧。思考：病发于夏天暑热之季，乃是暑病。李东垣主张用清暑益气汤，吴鞠通也列于《温病条辨》中，应当遵循此法。给予清暑益气汤原方2剂，果然痊愈。
(2) 四时主气相应加重案
李××，男，成人。
20多年来，每到冬天则发生呕吐，其他季节自然消失。每次发病，少则每日呕吐数口，多则每日数次，一次即盈盆盈碗。医生诊断为神经性呕吐。始用西药治疗不效，继而又用中药降逆止呕亦不效。此次发病虽然已经一个多月，但始终不见其效。细审其舌苔薄白，脉弦大紧。综合脉证思考：冬季是阳虚寒盛的季节，又遇脾胃阳虚、寒饮中阻的体质，两寒相应，胃失和降，故而呕吐频作。治宜温中化饮，桂附理中汤合五苓散。处方：附子10克，肉桂10克，党参10克，干姜10克，甘草10克，白术10克，泽泻10克，茯苓10克，猪苓10克。
服药2剂，呕吐即止。次年冬季又复发，但程度较轻，继服6剂，痊愈。
邢××，女，成人。
20多年来，每至春季则颜面出疹，如小米大，奇痒，其他季节自然消退。遍用中、西药物治疗不效。思考：春季是肝木所主之时，肝藏血，血虚则风动，风动则痒，这就是“痒为泄风”的意思。拟用养血清热祛风。处方：丹参15克，当归10克，川芎10克，生地10克，白芍10克，银花10克，连翘10克，元参10克，薄荷3克。服药30剂，痊愈。
苏××，女，成人。
崩漏数年，夏轻冬重。今年入冬以来，经血大下，腹痛拘急，饮食全废。医者或以固涩收敛，或以归脾摄血，然均无功。某院除用西药外，仅仅输血即达1500毫升，但仍不止。察其脉虚大弦紧，面色㿠白而微透黄色，神疲乏力，言语低微，腹痛喜按，指趾厥冷。证脉合参。思考：冬主闭藏，其主在肾，命门火衰，则闭藏失职。又肾者主水，受五脏六腑之精而藏之，肾火不足，脾土失养，则统血不能。此必脾肾两脏亏虚所致耳。治拟补脾益肾，以助先后二天。处方：黄芪15克，当归10克，川芎10克，熟地10克，党参10克，白术10克，茯苓10克，麦冬10克，半夏10克，附子10克，炙甘草10克，淡大芸15克，肉桂10克，鹿角胶10克(烊化)，芡实10克，生姜10克，大枣5枚，阿胶10克(烊化)。服药4剂，经血止，继服20剂，痊愈。
4．昼夜六气相似相应案
(1) 昼夜六气发病案
王××，女，55岁。
四天来恶寒发热，头痛身痛。予西药和中药感冒清、银黄口服液等不效。察其除体温在38.9℃外，舌苔薄白，脉弦紧。思考：病虽发生于暑热之季，然脉证均呈风寒客表之象，宜宗“有是证用是药”，疏散风寒，九味羌活汤1剂，痊愈。
李××，男，15岁。
吃冰糕后，突然发现腹部剧痛不止，时而包块起伏。急至某院诊治。医云：肠梗阻。先予复方大承气汤一剂，不效，继又予萝卜芒硝汤一剂仍不效。不得已而欲手术治疗，但家属拒绝手术，而再恳服中药。察其除上述诸证外，并见其腹痛得温而稍减，脉弦紧。综合脉证思考：《素问·举痛论》云：“寒气客于脉外，则脉寒，脉寒则缩蜷，缩蜷则脉绌急，则外引小络，故卒然而痛，得炅则痛立止。”此病发于吃冷食之后，必寒邪直中之证也。急予温中散寒。处方：丁香10克，小茴香10克，川椒10克，肉桂10克，木香10克，良姜10克。药刚入腹约10分钟，腹痛即减，半小时后痛减六七，两小时后疼痛全失，痊愈。
(2) 昼夜六气相应加剧案
耿××，女，成人。
8个多月来，低热乏力。某院除查其有结核菌素试验阳性外，余无任何阳性发现。先予抗痨药治疗三个多月无效，继又以中药养阴清热治疗两个多月仍不见好转。询之：发热甚于午后，至夜反减，每次发热之前先感心胸烦热，继而全身发热无力，热甚之时体温可达38.6℃，上午与夜间一般最高不超过37.3℃，而且精神较好，脉弦而滑。思考：阴虚之热虽午后较甚，而前半夜应更甚，而此证反前半夜发热减轻。又思：午后日晡乃脾湿所主之时，脉又见弦滑而非细数，则非阴虚而乃心胸湿热郁滞也。治宜栀子豉汤解郁热。处方：栀子10克，豆豉10克。药进6剂，发热尽解，痊愈。
刘××，女，50岁。
突然全身奇痒难忍。医予消风散三剂治之，其痒更剧。至某院皮科诊治，云：皮炎，治疗十余天非但无功，反更严重。细询其证：夜间奇痒，白天即减，每次发痒非抓至到处出血不得稍减，脉弦细。思考：痒发于夜间，夜为阴，昼为阳，营为阴，卫为阳，营血不足，燥热生风，乃痒也。治宜养血活血，凉血散风。处方：生地30克，熟地10克，生何首乌10克，当归10克，丹皮10克，元参30克，白蒺藜6克，僵蚕6克，红花10克，甘草6克。
服药1剂痒即大减，继服6剂，痊愈。
苏××，女，26岁。
6年多来，月经不调，有时提前十几天，月经至后经常淋漓不断10—30天才止，经量时多时少，此次月经虽已10天，但仍淋漓不断。细审前医所用之方，有云肝郁化火予丹栀逍遥散者，有云瘀血阻滞予失笑散加味者，有予芩连四物、胶艾四物、归脾汤者，然均无效。细审其脉弦涩不调，少腹满痛，午后至夜间加剧，胸胁苦满，乳房胀痛，头晕头痛，五心烦热，尿热尿痛。证脉合参，诊为肝郁血虚，郁而化火，热迫血行。又思：午后至夜间腹满尤甚，乃脾肾虚寒，湿郁不化之证。若但予泻火清热则寒湿更甚，非温肾散寒相佐而难解。因拟丹栀逍遥散养血疏肝，清热泻火，去生姜，加炮姜、肉桂以温肾散寒。2剂后月经量减少，6剂后经血止，他证亦减大半。
四、结语
天人相应学说是在中医相似论的指导下形成的气象、医学相关学说，因此它的思维方法也是相似论的思维方法。
天人相应学说是中医进行辨证论治时的重要依据之一，它所应用的方法主要有诸年运气相互感应，诸年异气相互感应、四时主气相互感应、六气太过不及相互感应、昼夜阴阳五行相互感应法五种。
天人相应式的辨证论治方法常常补充我们辨证论治时的思路不足，所以我们治疗疑难复杂疾病时，应该结合天人相应的观点去进行，并把天人相应学说中的几个规律作为重要的论证去研究。
能冬不能夏 能夏不能冬
在我进入疑难病辨证论治规律性的实质性研究时，发现疑难病的大量症状改变与季节性的变化有关。例如：感冒病，有的患者一到冬季即反复感冒，至夏季则诸证全然不作；而另有一部分患者则与此截然相反，每到夏季即反复感冒，一到冬季则全然不作。咳嗽病，有的患者一到冬季即不断地咳嗽，虽治难愈，但在夏季则全然不作；而另一部分患者则与此相反，患者一到夏季即反复咳嗽，一到冬季则不治亦愈。哮喘病，有的患者一到冬季则哮喘发作，虽治难效，而到夏季则不治自愈；但有的患者与此恰恰相反，一到夏季则哮喘大作，虽治难效，而一到冬季则不治亦愈。胃痛病，有的患者一到冬季则必然反复疼痛，而一到夏季则不治亦愈；另一部分患者则与此相反，每到夏季则疼痛必发，冬季自愈。如此等等，不胜枚举。
这些症状的出现有没有一个共同的规律性呢?可不可以应用这一规律性去认识疾病的病机，并应用这一规律性去辨证论治呢?
当我读至《素问·阴阳应象大论》中的一段按照阴阳法则辨证论治的论述时，始而稍有所悟，它说，“能冬不能夏”是由于“阳盛”，“能夏不能冬”是由于“阴盛”。但是怎么应用于临床仍甚渺渺。及至详读王冰所注“阳胜故能冬，热甚故不能夏。”“阴胜故能夏，寒甚故不能冬。”始知辨体质的阳胜、阴胜时，凡能耐受冬季之气候者为阳盛体质的人，治疗时应很好地考虑阳胜，予以清热泻火；而凡能耐受夏季气候者为阴胜体质的人，治疗时应多考虑阴胜，予以温阳散寒。但是从临床上看，真正阳胜、阴胜者少，所以很难指导临床实践。及至读到张介宾《类经》所注，始而大有所悟。他说：“阴竭者，得冬之助犹可支持，遇夏之热，不能耐受矣。”“阳衰者，喜暖恶寒，故耐夏而不能冬也。”言疑难之病，若阴虚者则夏甚冬止，阳虚者则夏止冬剧。验之临床其效果然大增。
3. Mutual Induction of the Dominant Qi of the Four Seasons
Every year, there are changes of spring warmth, summer heat, late summer dampness, autumn dryness, and winter cold, as well as spring growth, summer flourishing, late summer transformation, autumn harvesting, and winter storage. Therefore, through the relationship of similarity and correspondence, seasonal diseases (seasonal illnesses) and various alterations of these seasonal diseases occur. As stated in *Shi Bing Lun* (Treatise on Seasonal Diseases): "Injury by wind in spring refers to the time when the Jueyin Liver Wood governs and wind qi holds authority, during which the human body is injured by wind pathogen. The disease caused by wind pathogen has degrees of severity: mild cases are called 'Ri Mao' (daily invasion), severe cases are called 'Ri Shang' (daily injury), and even more severe cases are called 'Ri Zhong' (daily penetration). For instance, aversion to cold with fever and sweating indicates that wind has injured the Wei (Defensive) level, resulting in a chronic wind-injury disease; nasal congestion and cough indicate that wind has invaded the exterior, named wind-invasion disease; sudden fainting and loss of consciousness indicate that wind has penetrated into the interior, named wind-stroke disease." "Injury by summer-heat in summer refers to the period of Minor Heat and Major Heat when the body is injured by summer-heat pathogen. At this time, the sky is hot and the earth is warm; humans within it all contract what is termed summer-heat disease. Injury by summer-heat pathogen varies into summer-heat injury, summer-heat invasion, and summer-heat stroke, and also differs into summer-wind, summer-warmth, summer-cough, and summer-consumption. Summer-heat injury obtained while resting is Yin summer-heat injury; that obtained while active is Yang summer-heat injury. Summer-heat invasion is milder than summer-heat injury, merely affecting the muscle-surface. Summer-heat stroke, also known as heatstroke, involves sudden fainting resembling wind-stroke. Summer-wind involves sudden fainting followed by convulsions of the limbs. Summer-warmth is slightly milder than Yang summer-heat. Summer-cough results from summer-heat invading the Lung causing cough and counterflow qi. Summer-consumption results from summer-heat damaging collaterals causing hematemesis. There is also cholera-like syndrome, caused by summer-qi mixing with wind-cold-dampness and food stagnation to disrupt the Middle Jiao." "From Great Heat to White Dew, Wet Earth holds authority, hence it is called 'Autumn injury by dampness.' ... Diseases caused by dampness include six types: one is dampness injury, two is dampness stroke, three is dampness invasion, four is damp-heat, five is cold-dampness, and six is damp-warmth. Dampness injury has exterior and interior distinctions: exterior dampness arises from living in damp places, wading in water, or clothes wetted by rain and dew, contracted from outside; interior dampness arises from liking tea and alcohol, eating too many melons and fruits, generated from inside. Dampness stroke involves sudden fainting, similar to wind-stroke. Dampness invasion occurs from exposure to morning fog and dew, or mountain miasma. Damp-heat is mostly contracted at the end of summer and beginning of autumn, rarely at other times. Cold-dampness occurs after initial dampness injury followed by cold exposure. Damp-warmth is dampness fermenting into warmth, where warmth has not yet transformed into heat, making it difficult to cure quickly." "Winter injury by cold refers to the period after Start of Winter, when cold qi injures the body. If one is careful and protective, what harm can be done? If careless, cold pathogen injures the Bladder Meridian of Foot-Taiyang (Cold Water Meridian), immediately manifesting as aversion to cold, fever, anhidrosis, and a floating-tight pulse, named Cold Damage (Shanghan). Once Spring arrives, it can no longer be called Cold Damage. However, winter cold injury has depth differences: deep injury is Cold Stroke, shallow injury is Cold Invasion. Cold Stroke means cold pathogen directly enters the interior of the Three Yin meridians, causing vomiting, diarrhea, and abdominal pain, requiring urgent warming agents to dispel cold. Cold Invasion means cold pathogen invades the exterior of the body, causing aversion to cold, fever, and body ache, easily cured by inducing sweating." Yu Genchu said: "Late autumn and early coolness, with the solemn killing effect of west winds, those who contract it often suffer from wind-dryness, which belongs to Cool-Dryness, milder than the wind-cold of severe winter. If autumn is clear and rainless, with the sun baking, those who contract it often suffer from Warm-Dryness, which belongs to Dry-Heat, heavier than the Wind-Warmth of late spring." *Su Wen: Zang Qi Fa Shi Lun* states: "The Liver governs Spring, with the Foot-Jueyin Liver and Foot-Shaoyang Gallbladder meridians governing... The Heart governs Summer, with the Hand-Shaoyin Heart and Hand-Taiyang Small Intestine meridians governing... The Spleen governs Late Summer, with the Foot-Taiyin Spleen and Foot-Yangming Stomach meridians governing... The Kidney governs Winter, with the Foot-Shaoyin Kidney and Foot-Taiyang Bladder meridians governing... Disease in the Liver heals in Summer; if not healed in Summer, it worsens in Autumn; if not fatal in Autumn, it stabilizes in Winter, and improves in Spring... Disease in the Heart heals in Late Summer; if not healed in Late Summer, it worsens in Winter; if not fatal in Winter, it stabilizes in Spring, and improves in Summer... Disease in the Spleen heals in Autumn; if not healed in Autumn, it worsens in Spring; if not fatal in Spring, it stabilizes in Summer, and improves in Late Summer... Disease in the Lung heals in Winter; if not healed in Winter, it worsens in Summer; if not fatal in Summer, it stabilizes in Late Summer, and improves in Autumn... Disease in the Kidney heals in Spring; if not healed in Spring, it worsens in Late Summer; if not fatal in Late Summer, it stabilizes in Autumn, and improves in Winter."
4. Mutual Induction of Excess and Deficiency of the Six Qi
Each of the four seasons has its governing Wind, Cold, Summer-heat, Dampness, Dryness, and Fire. Each day and night also has its governing Wind, Cold, Summer-heat, Dampness, Dryness, and Fire. When these pathogens are within normal limits, they promote human growth and development through similarity and correspondence. If they are excessive or deficient, or if the Healthy Qi cannot adapt to these changes, they become conditions for disease. Thus, *Nei Jing* states: "Avoid empty evil and thief wind in due time," and "When Healthy Qi exists within, evil cannot interfere."
5. Mutual Induction of Yin-Yang and Five Elements of Day and Night
The changes of Yin-Yang and Five Elements during day and night make "day Yang, night Yin," "at dawn, Human Qi generates; at noon, Yang Qi is exuberant; at sunset, Yang Qi is already deficient." Wood is prosperous at Yin-Mao hours (dawn), Fire at Si-Wu hours (noon), Metal at Shen-You hours (sunset), Water at Hai-Zi hours (midnight), and Earth at Wei-Shen hours (afternoon). Therefore, through similarity and correspondence, pathological, physiological, and symptomatic changes in similar systems and movements can be induced.
III. Examples of Clinical Application of the Theory of Heaven-Human Correspondence
1. Case of Similar Correspondence of Annual Luck (Yun)
In 1984, corresponding to the Jiazi year, in outpatient practice, I frequently encountered patients with so-called colds that were refractory to treatment. Symptoms included feverish sensation, fatigue, cough, thin white tongue coating, and floating-tight pulse. Considering that the Central Luck of Jiazi is Wet Earth, with Shaoyin Junfire ruling the Heaven, I prescribed damp-resolving and phlegm-dispelling herbs, slightly supplemented with summer-heat-resolving agents. All patients recovered within two to three doses.
2. Case of Similar Correspondence of Heterogeneous Qi
In the Gui Chou year of the Yongzheng reign, epidemic qi prevailed. The Envoy of Wu requested Ye Tianshi to formulate prescriptions for rescue. Ye said: "Seasonal toxic epidemic qi must correspond to the ruling Heaven Qi. In the Gui Chou year, Wet Earth Qi operates; sunlight fails to regulate the qi intersection, causing epidemic qi to spread widely. Thus, those with weak Spleen and Stomach respond to this pestilential qi. Pathogens enter via mouth, nose, skin, and hair. Diseases transforming from dampness present with fever, yellow eyes, chest fullness, erythema, and diarrhea. One must observe the tongue color; if pale white or with a dry, scorched center, the pathogen remains in the Qi Level, treat with Ganlu Xiaodu Dan (Sweet Dew Detoxifying Powder). If high fever persists for ten days without resolution, accompanied by delirium and macules/rashes, observe if the tongue is crimson, dry, smooth, round, and hard, indicating depleted fluids and essence. This means cold has transformed into fire, and the pathogen has entered the Ying (Nutritive) Level, treat with Shenxi Dan (Divine Rhinoceros Horn Pill)."
3. Case of Similar Correspondence of Dominant Qi of the Four Seasons
(1) Case of Onset Corresponding to Dominant Qi
Patient Su XX, Female, Adult.
For over a month, she suffered from feverish sensation, fatigue, dizziness, thirst with desire to drink, poor appetite, reduced food intake, and profuse sweating. Diagnosed as a cold. Initial treatment with Ganmao Qingre Granules and Ganmaotong was ineffective. Subsequent intravenous therapy, antibiotics, and Ribavirin were also ineffective. Examination revealed extreme fatigue and a string-large-tight pulse. Reflection: The illness began in the hot summer season, thus it is a Summer-Heat disease. Li Dongyuan advocated Qing Shu Yi Qi Tang, and Wu Juzhong included it in *Wen Bing Tiao Bian*. We should follow this method. Prescribed original formula of Qing Shu Yi Qi Tang for 2 doses, resulting in recovery.
(2) Case of Aggravation Corresponding to Dominant Qi
Patient Li XX, Male, Adult.
For over 20 years, vomiting occurred every winter, disappearing naturally in other seasons. Each episode involved vomiting a few mouthfuls daily at minimum, or several times daily at maximum, filling basins and bowls. Diagnosed as nervous vomiting. Western medicine was ineffective initially, followed by Chinese medicine for descending rebellious Qi and stopping vomiting, also ineffective. Although this episode lasted over a month, there was no improvement. Detailed examination showed thin white tongue coating and string-large-tight pulse. Comprehensive analysis: Winter is the season of Yang deficiency and abundant cold. Encountering a constitution of Spleen-Stomach Yang deficiency and middle-jiao obstruction by cold-fluid, the two colds correspond, causing the Stomach to lose its harmonizing and descending function, leading to frequent vomiting. Treatment should warm the middle and transform fluids. Guifu Lizhong Tang combined with Wuling San. Prescription: Fuzi 10g, Rougui 10g, Dangshen 10g, Ganjiang 10g, Gancao 10g, Baizhu 10g, Zexie 10g, Fuling 10g, Zhuling 10g.
After 2 doses, vomiting stopped. It recurred the following winter but was milder. After continuing for 6 doses, she recovered.
Patient Xing XX, Female, Adult.
For over 20 years, facial rashes appeared every spring, size of millet seeds, with intense itching, resolving naturally in other seasons. Extensive use of Chinese and Western medicines was ineffective. Reflection: Spring is the time governed by Liver Wood. The Liver stores Blood; blood deficiency leads to wind stirring, and wind stirring causes itching. This is the meaning of "itching is venting wind." Plan to nourish blood, clear heat, and dispel wind. Prescription: Danshen 15g, Danggui 10g, Chuanxiong 10g, Shengdi 10g, Baishao 10g, Yinhua 10g, Lianqiao 10g, Xuanshen 10g, Bohe 3g. After 30 doses, she recovered.
Patient Su XX, Female, Adult.
Metrorrhagia and metrorrhaxis for several years, lighter in summer, heavier in winter. Since entering winter this year, heavy menstrual bleeding, abdominal cramping pain, total loss of appetite. Physicians used astringents or Guipi Tang to control bleeding, all without effect. A certain hospital used Western medicine and transfused 1500ml of blood, but bleeding did not stop. Pulse was deficient-large-string-tight. Complexion was sallow-white with a slight yellow tint, spirit fatigued, voice low, abdominal pain relieved by pressure, cold fingers and toes. Combining symptoms and pulse: Winter governs closure and storage, dominated by the Kidney. Decline of Mingmen Fire leads to failure of closure and storage. The Kidney governs Water, receiving and storing essence from the five Zang and six Fu organs. Insufficient Kidney Fire fails to nourish Spleen Earth, leading to inability to control blood. This must be due to deficiency of both Spleen and Kidney. Treatment aims to tonify Spleen and benefit Kidney, aiding the Pre- and Post-Heaven sources. Prescription: Huangqi 15g, Danggui 10g, Chuanxiong 10g, Shudi 10g, Dangshen 10g, Baizhu 10g, Fuling 10g, Maimendong 10g, Banxia 10g, Fuzi 10g, Zhigancao 10g, Roudongsong (Cistanche) 15g, Rougui 10g, Lujiaojiao 10g (melted), Qianshi 10g, Shengjiang 10g, Dazao 5 pieces, Ejiao 10g (melted). After 4 doses, menstruation stopped. After continuing for 20 doses, she recovered.
4. Case of Similar Correspondence of Six Qi of Day and Night
(1) Case of Onset Corresponding to Six Qi of Day and Night
Patient Wang XX, Female, 55 years old.
For four days, aversion to cold, fever, headache, and body ache. Western medicine and Chinese medicines like Ganmaoqing and Yinhuang Oral Liquid were ineffective. Examination showed temperature 38.9°C, thin white tongue coating, and string-tight pulse. Reflection: Although the illness occurred in the hot summer season, the pulse and symptoms all indicate Wind-Cold attacking the exterior. Follow "treat according to the syndrome." Dispel Wind and Cold. Jiwei Qianghuo Tang for 1 dose, recovered.
Patient Li XX, Male, 15 years old.
After eating ice cream, sudden severe abdominal pain persisted, with intermittent rising and falling masses. Urgently treated at a hospital. Diagnosis: Intestinal obstruction. First prescribed Compound Dachengqi Tang for 1 dose, ineffective. Then Radish and Mirabilite Decoction for 1 dose, still ineffective. Surgery was considered, but family refused, requesting Chinese medicine again. Examination showed abdominal pain slightly relieved by warmth, and string-tight pulse. Comprehensive analysis: *Su Wen: Ju Tong Lun* states: "When cold pathogen lodges outside the vessels, the vessels become cold. Vessel cold causes contraction and curling. Contraction causes vessel tension and urgency, pulling on small collaterals, thus sudden pain. Pain stops immediately upon obtaining heat." This illness started after eating cold food,必定 a case of direct invasion by cold pathogen. Urgently warm the middle and dispel cold. Prescription: Dingxiang 10g, Xiaohuixiang 10g, Chuanjiao 10g, Rougui 10g, Muxiang 10g, Liangjiang 10g. About 10 minutes after ingestion, abdominal pain decreased. Half an hour later, pain reduced by 60-70%. Two hours later, pain completely disappeared, recovered.
(2) Case of Aggravation Corresponding to Six Qi of Day and Night
Patient Geng XX, Female, Adult.
For over 8 months, low-grade fever and fatigue. A hospital found positive tuberculin test, otherwise no positive findings. Anti-tuberculosis drugs for over 3 months were ineffective. Nourishing Yin and clearing heat Chinese medicine for over 2 months showed no improvement. Inquiry: Fever is worse in the afternoon, decreases at night. Before each fever, there is vexation and heat in the heart/chest, followed by whole-body fever and weakness. Max temperature reaches 38.6°C during peak fever. Morning and night generally do not exceed 37.3°C. Spirit is relatively good. Pulse is string-slippery. Reflection: Yin-deficiency heat is indeed worse in the afternoon, but should be worse in the first half of the night. Here, fever decreases in the first half of the night. Furthermore, afternoon (Shen/You hours) is governed by Spleen Dampness. The pulse is string-slippery, not fine-rapid, indicating not Yin deficiency but rather stagnation of Damp-Heat in the Heart/Chest. Treatment should use Zhizi Chi Tang to resolve stagnant heat. Prescription: Zhizi 10g, Chidouchi 10g. After 6 doses, fever completely resolved, recovered.
Patient Liu XX, Female, 50 years old.
Sudden unbearable whole-body itching. Physician prescribed Xiaofeng San for 3 doses, but itching worsened. Dermatology department diagnosed dermatitis. Treatment for over 10 days was ineffective and condition worsened. Detailed inquiry: Intense itching at night, decreasing during day. Scratching until bleeding everywhere provides slight relief. Pulse is string-fine. Reflection: Itching occurs at night. Night is Yin, Day is Yang. Ying (Nutritive) is Yin, Wei (Defensive) is Yang. Ying-Blood deficiency leads to dryness-heat generating wind, causing itching. Treatment should nourish and invigorate blood, cool blood, and scatter wind. Prescription: Shengdi 30g, Shudi 10g, Sheng Heshouwu 10g, Danggui 10g, Danpi 10g, Xuanshen 30g, Baijili 6g, Jiangcan 6g, Honghua 10g, Gancao 6g.
After 1 dose, itching greatly reduced. After continuing for 6 doses, recovered.
Patient Su XX, Female, 26 years old.
For over 6 years, irregular menstruation, sometimes advancing by ten days. After menstruation, spotting often lasts 10-30 days. Flow volume varies. This time, menstruation has lasted 10 days, still spotting. Reviewing previous prescriptions: Some attributed to Liver Depression transforming into Fire, prescribing Danzhi Xiaoyao San. Some attributed to Blood Stasis obstruction, prescribing Shixiao San plus modifications. Others prescribed Qinlian Siwu Tang, Jiao'ai Siwu Tang, or Guipi Tang, all ineffective. Detailed pulse is string-choppy and irregular. Lower abdomen full and painful, worsening from afternoon to night. Chest and hypochondrium bitter-fullness, breast distension and pain, dizziness, headache, five-palm heat, hot and painful urination. Combining symptoms and pulse: Diagnosed as Liver Depression and Blood Deficiency, stagnating into Fire, Heat forcing blood movement. Further reflection: Lower abdominal fullness is especially severe from afternoon to night, indicating Spleen-Kidney deficiency-cold and stagnant dampness not transforming. If only using fire-clearing and heat-resolving, cold-dampness will worsen. Difficult to resolve without assisting with Kidney-warming and cold-dispelling. Thus, plan Danzhi Xiaoyao San to nourish blood, soothe Liver, clear heat, and drain fire. Remove Shengjiang, add Paojiang and Rougui to warm Kidney and dispel cold. After 2 doses, menstrual flow decreased. After 6 doses, bleeding stopped, other symptoms largely reduced.
IV. Conclusion
The theory of Heaven-Human Correspondence is a meteorological and medical related theory formed under the guidance of the TCM Theory of Similarity. Therefore, its thinking method is also the thinking method of the Theory of Similarity.
The theory of Heaven-Human Correspondence is one of the important bases for TCM syndrome differentiation and treatment. Its applied methods mainly include: mutual induction of annual luck, mutual induction of heterogeneous qi of different years, mutual induction of dominant qi of the four seasons, mutual induction of excess and deficiency of the six qi, and mutual induction of Yin-Yang and Five Elements of day and night.
The syndrome differentiation and treatment method of Heaven-Human Correspondence often supplements deficiencies in our thinking during standard syndrome differentiation. Therefore, when treating difficult and complex diseases, we should integrate the perspective of Heaven-Human Correspondence and study the several laws within this theory as important arguments.
"Capable of Winter, Not Summer; Capable of Summer, Not Winter"
When I entered substantive research on the regularities of syndrome differentiation and treatment for difficult diseases, I found that a large number of symptom changes in difficult diseases are related to seasonal variations. For example: In colds, some patients repeatedly catch colds every winter, while all symptoms completely cease in summer; another part of patients is exactly the opposite, repeatedly catching colds every summer, while completely ceasing in winter. In coughs, some patients constantly cough every winter, difficult to cure despite treatment, but completely cease in summer; another part is opposite, repeatedly coughing every summer, curing spontaneously in winter. In asthma, some patients have asthma attacks every winter, difficult to treat effectively, but heal spontaneously in summer; others are exactly opposite, severe asthma every summer, difficult to treat effectively, but heal spontaneously in winter. In stomach pain, some patients inevitably have recurrent pain every winter, healing spontaneously in summer; another part is opposite, pain must occur every summer, healing spontaneously in winter. And so on, too numerous to mention.
Is there a common regularity in the appearance of these symptoms? Can this regularity be applied to understand the pathogenesis of diseases and to guide syndrome differentiation and treatment?
When I read a passage in *Su Wen: Yin Yang Ying Xiang Da Lun* regarding syndrome differentiation and treatment according to Yin-Yang rules, I had a slight realization. It says, "Capable of Winter, Not Summer" is due to "Yang Exuberance," and "Capable of Summer, Not Winter" is due to "Yin Exuberance." However, how to apply this clinically remained obscure. Upon detailed reading of Wang Bing's annotation: "Yang victory allows endurance of Winter, excessive heat prevents endurance of Summer." "Yin victory allows endurance of Summer, excessive cold prevents endurance of Winter." I then understood that when distinguishing constitutions of Yang Victory and Yin Victory, those capable of enduring winter climate are people with Yang-exuberant constitutions; treatment should consider Yang victory, applying heat-clearing and fire-draining. Those capable of enduring summer climate are people with Yin-exuberant constitutions; treatment should consider Yin victory, applying Yang-warming and cold-dispelling. However, clinically, true Yang or Yin victory is rare, so it is difficult to guide clinical practice. Upon reading Zhang Jiebin's annotation in *Lei Jing*, I had a great realization. He said: "Those with Yin exhaustion can still support themselves with the help of Winter, but cannot endure the heat of Summer." "Those with Yang decline prefer warmth and dislike cold, thus enduring Summer but not Winter." Regarding difficult diseases, those with Yin deficiency worsen in Summer and stop in Winter; those with Yang deficiency stop in Summer and worsen in Winter. Verification in clinical practice significantly increased effectiveness.