五运有太过有不及。太过者，甲丙戊庚壬五阳干也。不及者，乙丁己辛癸五阴干
也。王冰曰∶苍天布气，尚不越乎五行，人在气中，岂不应乎天道？故随气运阴阳之盛
衰，理之自然也。《经》曰∶不知年之所加，气之盛衰，虚实之所起，不可以为工。虽然
运气之理，亦不可泥，又有内外两因，随时感触，虽当太过之运，亦有不足之时，不及
之运，亦多有余之患。倘专泥运气，能无实实虚虚，损不足而益有余乎？况岁气之在天
地，亦有气常之时，故冬有非常之温，夏有非时之寒，春有非时之燥，秋有非时之暖，
犯之者病。又如春气西行，秋气东行，夏气北行。冬气南行。卑下之地，春气常行，高
阜之境，冬气常在。天不足西北而多风，地不满东南而多湿。百里之内，晴雨不同。千
里之外，寒暄各别。方主不齐，而病亦因之。虽然，西北固浓，安能人人皆实？东南
固薄，安能人人皆虚？且如久旱则亢阳，久雨则亢阴，阳盛人耐秋冬而不耐春夏，喜阴
寒而恶阳暄，阴盛人耐春夏而不耐秋冬，喜晴明而恶阴雨，此乃天气变常。人禀各异。
又为法外之遗也。善言运气者，随机观变，方得古人未发之旨。缪仲醇曰∶五运六气
者，虚位也。岁有是气至则算，无是气至则不算，既无其气，焉得有其药乎？无益于治
疗，有误乎来学。将以施之治病，譬如指算法之稀奇，谓事物之实有，岂不误哉！其
云∶必先岁气者，谓此年多肖雨，民病多湿，药类用二木，苦寒以燥之，佐以风药，
风能胜湿，此即必先岁气之谓也。其云∶毋伐天和者，即春夏养阴，秋冬养阳，春夏禁
用麻黄、桂枝，秋冬禁用石膏、知母、芩、连、芍药，此即毋伐天和之谓。然尚有舍时
从症之时也。谓不明五运六气，检偏方书何济者，正指后人不明五运六气之所以，而误
于方册所载，根据而用之，动辙成过，则虽检偏方书，亦何益哉！故张仲景、华元化、越
人、叔和，并未尝载有是说，即六经治法之中，亦并无一字及之，且见性理所载，元儒
草芦吴氏，天之气运之中，亦备载之，益信其为天运气数之法，而非独医家治疗之书
也。况传流既久，天地人物气化转薄，亦难可以同年而语矣。故宜知之者，以明天气岁
气立法之常也；不可执之者，以处天气岁气法外之变也。天有寒暄早晚不同，人有盛衰
时刻迥别，岂可以千支司岁，一定之数，以定无穷时刻盛衰之受哉！
五运有太过和不及之分。太过者，是指甲、丙、戊、庚、壬这五个阳干。不及者，是指乙、丁、己、辛、癸这五个阴干。王冰说：苍天布散气候之气，尚且不超出五行范围，人生活在气之中，难道不应顺应天道吗？因此随着运气中阴阳的盛衰变化，这是理所当然的自然规律。《内经》说：不知道每年干支加临的情况，不了解气候的盛衰以及虚实产生的原因，就不能成为合格的医生。虽然如此，对于运气之理也不可拘泥固执，因为还有内因和外因两种因素，随时可能感触致病。即使是处于太过之运的时候，也会出现不足的情况；处于不及之运的时候，也常有多余（过盛）的病患。如果专门拘泥于运气理论，难道不会犯“实其实、虚其虚”的错误，即损害不足的正气而增加有余的邪气吗？况且岁气在天地之间，也有气候反常的时候，所以冬天会有不正常的温暖，夏天会有不合时节的寒冷，春天会有不合时节的干燥，秋天会有不合时节的暖热，触犯这些异常气候就会生病。又如春气向西运行，秋气向东运行，夏气向北运行，冬气向南运行。低洼卑下的地方，春气常常流行；高峻山阜之地，冬气常常存在。西北方天体不足，所以多风；东南方大地不满，所以多湿。百里之内，晴雨情况不同；千里之外，寒暖各自有别。地域主气不一致，疾病也因此而异。虽然如此，西北地区气候固然浓厚，怎么能保证人人都体质充实呢？东南地区气候固然薄弱，怎么能保证人人都体质虚弱呢？况且如久旱则导致亢盛的阳气，久雨则导致亢盛的阴气。阳气偏盛的人耐受秋冬而不耐受春夏，喜欢阴寒而厌恶阳热；阴气偏盛的人耐受春夏而不耐受秋冬，喜欢晴朗明亮而厌恶阴雨天气，这是天气变化失常，人的禀赋各不相同，这也是常规法则之外的遗留情况。善于谈论运气的人，能够随机观察变化，才能领悟古人未曾阐发的深意。缪仲醇说：五运六气是虚设的位置。岁中有这种气到来就计算，没有这种气到来就不计算，既然没有那种气，哪里会有针对那种气的药呢？这对治疗无益，反而误导后来的学者。如果要将其应用于治病，就像指着算法的稀奇古怪，说是事物的实有，这难道不是错误吗！他说“必先了解当年的岁气”，意思是这一年多雨，百姓多患湿病，药物类别选用木类药材，用苦寒药来燥湿，佐以风药，风能胜湿，这就是“必先了解当年岁气”的意思。他说“不要伐害天和”，即春夏保养阴气，秋冬保养阳气，春夏禁用麻黄、桂枝，秋冬禁用石膏、知母、黄芩、黄连、芍药，这就是“不要伐害天和”的意思。然而还有舍弃时令而从症状论治的时候。那些说不通晓五运六气，去查阅偏方书籍有什么用处的人，正是指后人不明五运六气的原理，而误信方书所载，依据而使用，动辄造成过失，那么即使查阅偏方书籍，又有什么益处呢！所以张仲景、华元化、扁鹊（越人）、王叔和，都未曾记载这种说法，即使在六经治法之中，也没有一个字提到它。而且见性理所载，元代儒生草庐吴氏，在天之气运之中，也详细记载了它，更加相信它是关于天运气数的方法，而不是专门供医家治疗的书籍。况且流传既已久远，天地人物的气化逐渐变薄，也难以与古代相提并论了。所以应当知道的是，用来明白天气和岁气立法的常规；不可固执的是，用来处理天气和岁气常规之外的变化。天有寒暖早晚的不同，人有盛衰时刻的巨大差异，怎么可以用干支司岁的固定数目，来确定无穷时刻中盛衰受病的状况呢！
The Five Movements (Wu Yun) have aspects of Excess (Tai Guo) and Deficiency (Bu Ji). Excess refers to the five Yang Heavenly Stems: Jia, Bing, Wu, Geng, and Ren. Deficiency refers to the five Yin Heavenly Stems: Yi, Ding, Ji, Xin, and Gui. Wang Bing stated: "The Heaven distributes Qi, not exceeding the Five Elements (Wu Xing). Humans exist within this Qi; how could they fail to correspond with the Way of Heaven? Therefore, following the waxing and waning of Yin and Yang in the movements is a matter of natural principle." The Classic (Jing) states: "One who does not know the annual addition of stems and branches, the prosperity and decline of Qi, and the origin of deficiency and excess, cannot be a qualified physician." Nevertheless, one must not rigidly adhere to the principles of movements and Qi. There are also internal and external causes that can be contacted at any time. Even during an Excess movement, there may be times of deficiency; even during a Deficiency movement, there are often cases of excess. If one strictly adheres to movements and Qi, will one not commit the error of reinforcing the excess and depleting the deficiency, thereby damaging what is insufficient and benefiting what is already excessive? Moreover, the annual Qi in heaven and earth also has periods of abnormality. Thus, winter may have unusual warmth, summer may have untimely cold, spring may have untimely dryness, and autumn may have untimely warmth. Those exposed to these become ill. For instance, Spring Qi moves westward, Autumn Qi moves eastward, Summer Qi moves northward, and Winter Qi moves southward. In low-lying areas, Spring Qi is prevalent; in high mountainous regions, Winter Qi persists. The northwest is deficient in heaven and thus windy; the southeast is incomplete in earth and thus damp. Within a hundred li, sunny and rainy conditions differ; beyond a thousand li, cold and warm climates vary. Since regional dominant Qi differs, diseases arise accordingly. Although the northwest climate is indeed dense, can everyone be constitutionally solid? Although the southeast climate is indeed thin, can everyone be constitutionally weak? Furthermore, prolonged drought leads to hyperactive Yang, while prolonged rain leads to hyperactive Yin. Individuals with Yang excess tolerate winter and autumn but not spring and summer; they prefer cold and dislike heat. Individuals with Yin excess tolerate spring and summer but not winter and autumn; they prefer clear weather and dislike rain. These are abnormalities of heavenly Qi and variations in human endowment, representing circumstances outside standard rules. One skilled in discussing movements and Qi observes changes flexibly, thereby grasping the profound insights unexpressed by ancients. Miao Zhongchun said: "Five Movements and Six Qi are virtual positions. If the Qi of the year arrives, it is calculated; if not, it is not. Without such Qi, how can there be corresponding medicine? This is of no benefit to treatment but misleads future scholars." To apply this to treating disease is like pointing to the intricacies of calculation and claiming them as physical realities—would this not be erroneous! When he says "First understand the annual Qi," he means that if the year is rainy and people suffer from dampness, one uses Wood-category herbs, bitter-cold herbs to dry dampness, assisted by Wind-dispelling herbs, as wind overcomes dampness. This is the meaning of "first understanding the annual Qi." When he says "Do not harm the Harmony of Heaven," he means nourishing Yin in spring and summer, and nourishing Yang in autumn and winter; forbidding Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) in spring and summer, and forbidding Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Shaoyao (Paeoniae Radix) in autumn and winter. This is the meaning of "not harming the Harmony of Heaven." However, there are times when one abandons the season and treats according to symptoms. Those who say "Without understanding Five Movements and Six Qi, what use is consulting prescription books?" refer to later generations who do not understand the rationale of movements and Qi, mistakenly relying on recorded prescriptions, leading to frequent errors. In such cases, even consulting prescription books is of no benefit. Therefore, Zhang Zhongjing, Hua Yuanhua, Yue Ren (Bian Que), and Shuhe (Wang Huhe) never recorded such theories. Not even in the treatment methods of the Six Channels (Liu Jing) is there a single word mentioning them. Furthermore, Wushi of Caolu, a Confucian scholar of the Yuan Dynasty, detailed this in his writings on heavenly Qi movements, confirming that it is a method of heavenly cycles rather than a book solely for medical treatment. Moreover, as transmission continues for a long time, the Qi transformation of heaven, earth, humans, and things becomes thinner, making it difficult to compare with ancient times. Thus, one should know the regularities of heavenly and annual Qi legislation; one should not rigidly apply it to handle variations outside these regulations. Heaven has differences in cold/warmth and early/late timing; humans have distinct differences in prosperity/decline at different moments. How can one use the fixed numbers of stems and branches governing years to determine the endless variations in human susceptibility to prosperity and decline?