李时珍曰∶《经》云∶必先岁气，毋伐天和。又曰∶升降浮沉则顺之，寒热温凉则逆之
。故春月宜加辛温之药，薄荷、荆芥之类，以顺春升之气；夏月宜加辛热之药，香薷、生姜
之类，以顺夏浮之气；长夏宜加甘苦辛温之药，人参、白术、苍术、黄柏之类，以顺化成之
气；秋月宜加酸温之药，芍药、乌梅之类，以顺秋降之气；冬月宜加苦寒之药，黄芩、知母
之类，以顺冬沉之气，所谓顺时气而养天和也。《经》又云∶春省酸、增甘以养脾气，夏省
苦、增辛以养肺气，长夏省甘、增咸以养肾气，秋省辛、增酸以养肝气，冬省咸、增苦以养
心气。此则既不伐天和，而又防其太过，所以体天地之大德也。昧者，舍本从标，春用辛凉
以伐木，夏用咸寒以抑火，秋用苦温以泄金，冬用辛热以涸水，谓之时药。殊背《素问》逆
顺之理，以夏月伏阴，冬月伏阳，推之可知矣。虽然月有四时，日有四时，或春得秋病，夏
得冬病，神而明之，机而行之，变通权宜，又不可泥一也。王好古曰∶四时总以芍药为脾剂，
苍术为胃剂，柴胡为时剂，十一脏皆取决于少阳，为发生之始故也。凡用纯寒、纯热之药，
及寒热相杂，并宜用甘草以调和之，惟中满者禁用甘尔。
厥阴司天（巳亥年），风淫所胜，平以辛凉，佐以苦甘，以甘缓之，以酸泻之（王注云∶
厥阴气未为盛热，故以凉药平之）。
清反胜之，治以酸温，佐以甘苦。
少阴司天（子午年），热淫所胜，平以咸寒，佐以苦甘，以酸收之。寒反胜之，治以甘
温，佐
太阴司天（丑未年），湿淫所胜，平以苦热，佐以酸辛，以苦燥之，以淡泄之。湿上甚
而
热，治以苦温，佐以甘辛，以汗为故（身半以上，湿气有余，火气复郁，则宜解表流汗而祛
之也）。
热反胜之，治以苦寒，佐以苦酸。
少阳司天（寅申年），火淫所胜，平以酸冷，佐以苦甘，以酸收之，以苦发之，以酸复
之（热气已退，时发动者，是为心虚气散不敛，以酸收之，仍兼寒助，乃能除根。热见太甚
，则以苦发之。汗已便凉，是邪气尽；汗已犹热，是邪未尽，则以酸收之；已汗又热，又
汗复热，是脏虚也，则补其心可也）。
寒反胜之，治以甘热，佐以苦辛。
阳明司天（卯酉年），燥淫所胜，平以苦温，佐以酸辛，以苦下之（制燥之法以苦温。
宜
下必以苦，宜补必以酸，宜泻必以辛）。
热
太阳司天（辰戌年），寒淫所胜，平以辛热，佐以苦甘，以咸泻之。
热反胜之，治以咸冷，佐以苦辛。
厥阴在泉（寅申年），风淫于内，治以辛凉，佐以苦，以甘缓之，以辛散之（风喜温而
恶清，故以辛凉胜之。估以苦，随所利也。木苦急，以甘缓之。木苦抑，以辛散之）。
清反胜之，治以酸温，佐以苦甘，以辛平之。
少阴在泉（卯酉年），热淫于内，治以咸寒，佐以甘苦，以酸收之，以苦发之（热性恶
寒
，故以咸寒。热甚于表，以苦发之；不尽，复寒制之；寒制不尽，复苦发之，以酸收之。甚
者再方，微者一方，可使必已。时发时止，亦以酸收之）。
寒反胜之，治以甘热，佐以苦辛，以咸平之。
太阴在泉（辰戌年），湿淫于内，治以苦热，佐以酸淡，以苦燥之，以淡泄之（湿与燥
反
，故以苦热。佐以酸淡，利窍也）。
热反胜之，治以苦冷，佐以咸甘，以苦平之。
少阳在泉（巳亥年），火淫于内，治以咸冷，佐以苦辛，以酸收之，以苦发之（火气大
行
于心腹，咸性柔软以制之。以酸收其散气。大法须汗者，以辛佐之）。
寒反胜之，治以甘热，佐以苦辛，以咸平之。
阳明在泉（子午年），燥淫于内，治以苦温，佐以甘辛，以苦下之（温利凉性，故以苦
下
之）。
热反胜之，治以平寒，佐以苦甘，以
太阳在泉（丑未年），寒淫于内，治以甘热，佐以苦辛，以咸泻之，以辛润之，以苦坚
之（以热治寒，是为摧胜，折其气也）。
热反胜之，治以咸冷，佐以甘辛，以苦平之。
李时珍曰∶司天主上半年，天气司之，故六淫谓之所胜，上淫于下也，故曰平之。在泉
主下半年，地气司之，故六淫谓之于内，外淫于内也，故曰治之。当其时而反得胜己之气者，
谓之反胜。六气之胜，何以征之？燥甚则地干，暑胜则地热，风胜则地动，湿胜则地泥，寒
胜则地裂，火胜则地涸是也。其六气胜复主客、证治病机甚详，见《素问·至真要大论》，
文多不载。
李时珍说：《黄帝内经》记载：必须首先顺应岁运的气候变化，不要破坏人体与自然的和谐平衡。又说：药物的升降浮沉特性应顺应运行的规律，寒热温凉的特性应逆治病邪的性质。因此，春季适宜加入辛温性质的药物，如薄荷、荆芥等，以顺应春季阳气升发之气；夏季适宜加入辛热性质的药物，如香薷、生姜等，以顺应夏季阳气浮越之气；长夏（夏秋之交）适宜加入甘、苦、辛、温性质的药物，如人参、白术、苍术、黄柏等，以顺应长夏化生万物之气；秋季适宜加入酸温性质的药物，如芍药、乌梅等，以顺应秋季阳气收敛下降之气；冬季适宜加入苦寒性质的药物，如黄芩、知母等，以顺应冬季阳气潜藏下沉之气，这就是所说的顺应时令之气来养护天地间的自然和谐。《黄帝内经》又说：春季减少酸味、增加甘味以滋养脾气；夏季减少苦味、增加辛味以滋养肺气；长夏减少甘味、增加咸味以滋养肾气；秋季减少辛味、增加酸味以滋养肝气；冬季减少咸味、增加苦味以滋养心气。这样做既没有破坏天地自然的和谐，又防止了气候变化的过度影响，体现了效法天地的大德。愚昧的人，舍弃根本而追求表象，春季用辛凉药物来克制木气，夏季用咸寒药物来抑制火气，秋季用苦温药物来泄金气，冬季用辛热药物来耗竭水气，称之为“时药”。这严重违背了《素问》中关于逆顺治疗的原理，根据夏季体内潜伏阴气、冬季体内潜伏阳气的道理，推演可知这是错误的。虽然月份有四时之分，日子也有四时之变，或者春天得了秋天的病，夏天得了冬天的病，需要神妙地明察事理，机敏地施行治疗，灵活变通，权宜处置，又不可拘泥于一种固定的模式。王好古说：四季总以芍药作为调理脾脏的药剂，苍术作为调理胃腑的药剂，柴胡作为顺应时气的药剂，因为十一脏腑的功能都取决于少阳胆经，它是生机发生的开始。凡是使用纯寒或纯热的药物，以及寒热混杂的药物，都适宜用甘草来调和它们，只有中焦胀满的病人禁用甘味药罢了。
厥阴风木司天（巳年、亥年），风气淫盛胜过正常气候，用辛凉性质的药物来平抑它，辅以苦甘性质的药物，用甘味来缓和急迫，用酸味来泻除风气（王冰注解说：厥阴之气尚未成为盛热，所以用凉性药物来平抑它）。
如果清气（凉气）反而偏胜，用酸温性质的药物来治疗，辅以甘苦性质的药物。
少阴君火司天（子年、午年），热气淫盛胜过正常气候，用咸寒性质的药物来平抑它，辅以苦甘性质的药物，用酸味来收敛热气。如果寒气反而偏胜，用甘温性质的药物来治疗，辅以……（原文此处似有缺漏，依文意补全逻辑）
太阴湿土司天（丑年、未年），湿气淫盛胜过正常气候，用苦热性质的药物来平抑它，辅以酸辛性质的药物，用苦味来燥湿，用淡味来渗泄湿气。如果湿气在上部特别严重并且伴有热象，用苦温性质的药物来治疗，辅以甘辛性质的药物，以出汗为治愈标准（身体上半部分湿气有余，火气郁结，则应当解表发汗以祛除病邪）。
如果热气反而偏胜，用苦寒性质的药物来治疗，辅以苦酸性质的药物。
少阳相火司天（寅年、申年），火气淫盛胜过正常气候，用酸冷性质的药物来平抑它，辅以苦甘性质的药物，用酸味来收敛，用苦味来发散，用酸味来恢复正气（热气已经消退，但时而发动，这是因为心气虚散不能收敛，用酸味来收敛它，仍然兼用寒性药物辅助，才能除根。如果热象过于严重，就用苦味来发散。出汗后体温转凉，说明邪气已尽；出汗后仍然发热，说明邪气未尽，就用酸味来收敛；已经出汗后又发热，再次出汗又发热，这是内脏虚弱，则可以补益心脏）。
如果寒气反而偏胜，用甘热性质的药物来治疗，辅以苦辛性质的药物。
阳明燥金司天（卯年、酉年），燥气淫盛胜过正常气候，用苦温性质的药物来平抑它，辅以酸辛性质的药物，用苦味来通下（制约燥气的方法是用苦温。适宜通下的必用苦味，适宜补益的必用酸味，适宜泻下的必用辛味）。
如果热气……（原文此处中断，通常接“热反胜之”）
太阳寒水司天（辰年、戌年），寒气淫盛胜过正常气候，用辛热性质的药物来平抑它，辅以苦甘性质的药物，用咸味来泻除寒气。
如果热气反而偏胜，用咸冷性质的药物来治疗，辅以苦辛性质的药物。
厥阴风木在泉（寅年、申年），风气内淫，用辛凉性质的药物来治疗，辅以苦味，用甘味来缓和，用辛味来疏散（风邪喜欢温暖而厌恶清凉，所以用辛凉来战胜它。估计用苦味，是随其有利的方面。肝木苦于急迫，用甘味来缓和；肝木苦于郁抑，用辛味来疏散）。
如果清气（凉气）反而偏胜，用酸温性质的药物来治疗，辅以苦甘性质，用辛味来平抑。
少阴君火在泉（卯年、酉年），热气内淫，用咸寒性质的药物来治疗，辅以甘苦性质，用酸味来收敛，用苦味来发散（热性厌恶寒冷，所以用咸寒。热邪在体表严重，用苦味发散；若未除尽，再用寒性制约；寒性制约未除尽，再用苦味发散，最后用酸味收敛。严重的用两个方剂，轻微的用一个方剂，可以使疾病痊愈。如果发作有时停止，也用酸味来收敛）。
如果寒气反而偏胜，用甘热性质的药物来治疗，辅以苦辛性质，用咸味来平抑。
太阴湿土在泉（辰年、戌年），湿气内淫，用苦热性质的药物来治疗，辅以酸淡性质，用苦味来燥湿，用淡味来渗泄（湿气与燥气相反，所以用苦热。辅以酸淡，是为了利窍）。
如果热气反而偏胜，用苦冷性质的药物来治疗，辅以咸甘性质，用苦味来平抑。
少阳相火在泉（巳年、亥年），火气内淫，用咸冷性质的药物来治疗，辅以苦辛性质，用酸味来收敛，用苦味来发散（火气在心腹大行，咸性柔软可以制约它。用酸味收敛散乱的气机。大法如果是需要发汗的，用辛味来辅助）。
如果寒气反而偏胜，用甘热性质的药物来治疗，辅以苦辛性质，用咸味来平抑。
阳明燥金在泉（子年、午年），燥气内淫，用苦温性质的药物来治疗，辅以甘辛性质，用苦味来通下（温性能利于凉性，所以用苦味来通下）。
如果热气反而偏胜，用平寒性质的药物来治疗，辅以苦甘性质，用……（原文此处中断）
太阳寒水在泉（丑年、未年），寒气内淫，用甘热性质的药物来治疗，辅以苦辛性质，用咸味来泻除，用辛味来润燥，用苦味来坚固（用热性治疗寒性，这叫摧折胜气，折损其气势）。
如果热气反而偏胜，用咸冷性质的药物来治疗，辅以甘辛性质，用苦味来平抑。
李时珍说：司天主管上半年，由天气主导，所以六淫称为“所胜”，是上部的邪气侵犯下部，所以称为“平之”。在泉主管下半年，由地气主导，所以六淫称为“于内”，是外部的邪气侵入内部，所以称为“治之”。当令之时却反而得到了克制自己的气候之气，称为“反胜”。六气偏胜的现象，如何验证呢？燥气甚则地面干燥，暑气胜则地面炎热，风气胜则地面震动，湿气胜则地面泥泞，寒气胜则地面开裂，火气胜则地面干涸，就是这样。关于六气胜复、主客、证候、治疗机理非常详细，见载于《素问·至真要大论》，因文字太多不再赘述。
Li Shizhen said: The *Classic* (Huangdi Neijing) states: "One must first observe the seasonal climate and not disrupt the harmony of Heaven and Humanity." It also states: "The ascending, descending, floating, and sinking properties of drugs should be followed according to their nature, while the cold, heat, warm, and cool properties should be counteracted against the disease." Therefore, in spring, it is appropriate to add acrid-warm herbs, such as Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Spica), etc., to accord with the ascending Qi of spring; in summer, it is appropriate to add acrid-hot herbs, such as Xiangru (Elsholtziae Herba), Shengjiang (Zingiberis Rhizoma Recens), etc., to accord with the floating Qi of summer; in late summer, it is appropriate to add sweet, bitter, acrid, and warm herbs, such as Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Huangbai (Phellodendri Cortex), etc., to accord with the transforming Qi; in autumn, it is appropriate to add sour-warm herbs, such as Shaoyao (Paeoniae Radix Alba), Wumei (Mume Fructus), etc., to accord with the descending Qi of autumn; in winter, it is appropriate to add bitter-cold herbs, such as Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), etc., to accord with the sinking Qi of winter. This is what is meant by following the seasonal Qi to nourish the natural harmony of Heaven and Earth. The *Classic* further states: "In spring, reduce sour and increase sweet to nourish Spleen Qi; in summer, reduce bitter and increase acrid to nourish Lung Qi; in late summer, reduce sweet and increase salty to nourish Kidney Qi; in autumn, reduce acrid and increase sour to nourish Liver Qi; in winter, reduce salty and increase bitter to nourish Heart Qi." This approach neither disrupts the natural harmony nor allows for excess, thereby embodying the great virtue of Heaven and Earth. Ignorant people, abandoning the root for the branch, use acrid-cool herbs in spring to suppress Wood, salty-cold herbs in summer to restrain Fire, bitter-warm herbs in autumn to drain Metal, and acrid-hot herbs in winter to dry up Water, calling them "seasonal medicines." This severely contradicts the principles of counteraction and compliance in the *Suwen*. By inferring from the fact that Yin hides in summer and Yang hides in winter, this error becomes evident. Although months have four seasons and days have four phases, one might encounter an autumn disease in spring or a winter disease in summer. One must apply divine insight and agile action, exercising flexibility and expediency, rather than adhering rigidly to a single pattern. Wang Haogu said: Throughout the four seasons, Shaoyao (Paeoniae Radix Alba) is generally used as the Spleen formula, Cangzhu (Atractylodis Rhizoma) as the Stomach formula, and Chaihu (Bupleuri Radix) as the seasonal formula, because all eleven Zang-Fu organs depend on Shaoyang (Gallbladder), which is the beginning of generation. Whenever pure cold or pure hot herbs are used, or a mixture of cold and hot, Gancao (Glycyrrhizae Radix et Rhizoma) should be used to harmonize them, except in cases of fullness in the middle jiao where sweet herbs are contraindicated.
When Jueyin Wind Wood governs the Heavenly Stem (Years of Si and Hai), if Wind prevails excessively, pacify it with Acrid-Cool herbs, assist with Bitter-Sweet herbs, soothe urgency with Sweet herbs, and drain wind with Sour herbs. (Wang Bing's commentary notes: Since the Qi of Jueyin has not yet become overly hot, cool herbs are used to pacify it.)
If Clear (Cool) Qi prevails reversely, treat with Sour-Warm herbs, assisting with Bitter-Sweet herbs.
When Shaoyin Ministerial Fire governs the Heavenly Stem (Years of Zi and Wu), if Heat prevails excessively, pacify it with Salty-Cold herbs, assist with Bitter-Sweet herbs, and astringe with Sour herbs. If Cold prevails reversely, treat with Sweet-Warm herbs... [Text fragment]
When Taiyin Damp Earth governs the Heavenly Stem (Years of Chou and Wei), if Dampness prevails excessively, pacify it with Bitter-Hot herbs, assist with Sour-Acrid herbs, dry dampness with Bitter herbs, and drain it with Pale (bland) herbs. If Dampness is severe in the upper part accompanied by Heat, treat with Bitter-Warm herbs, assisting with Sweet-Acrid herbs, aiming for sweating as the cure (Dampness excess in the upper half of the body with郁 Fire requires releasing the exterior and inducing sweat to dispel it).
If Heat prevails reversely, treat with Bitter-Cold herbs, assisting with Bitter-Sour herbs.
When Shaoyang Ministerial Fire governs the Heavenly Stem (Years of Yin and Shen), if Fire prevails excessively, pacify it with Sour-Cold herbs, assist with Bitter-Sweet herbs, astringe with Sour herbs, disperse with Bitter herbs, and restore with Sour herbs (After heat subsides, if it fluctuates, it indicates Heart Qi deficiency and dispersion; Sour herbs astringe it. Combined with cold herbs, it removes the root. If heat is extreme, Bitter herbs disperse it. If temperature normalizes after sweating, pathogens are exhausted; if heat persists, Sour herbs astringe; if fever recurs after sweating, it indicates organ deficiency, so tonify the Heart).
If Cold prevails reversely, treat with Sweet-Hot herbs, assisting with Bitter-Acrid herbs.
When Yangming Dryness Metal governs the Heavenly Stem (Years of Mao and You), if Dryness prevails excessively, pacify it with Bitter-Warm herbs, assist with Sour-Acrid herbs, and purge downward with Bitter herbs (The method to control dryness is Bitter-Warm. Purging requires Bitter, tonifying requires Sour, draining requires Acrid).
[Text fragment regarding Heat]
When Taiyang Cold Water governs the Heavenly Stem (Years of Chen and Xu), if Cold prevails excessively, pacify it with Acrid-Hot herbs, assist with Bitter-Sweet herbs, and drain with Salty herbs.
If Heat prevails reversely, treat with Salty-Cold herbs, assisting with Bitter-Acrid herbs.
When Jueyin Wind Wood governs the Earthly Branch (Years of Yin and Shen), if Wind invades internally, treat with Acrid-Cool herbs, assist with Bitter herbs, soothe with Sweet herbs, and disperse with Acrid herbs (Wind prefers warmth and dislikes coolness, so Acrid-Cool overcomes it. Using Bitter follows its beneficial aspects. Wood suffers from tension, so Sweet soothes it; Wood suffers from suppression, so Acrid disperses it).
If Clear (Cool) Qi prevails reversely, treat with Sour-Warm herbs, assisting with Bitter-Sweet, and level with Acrid herbs.
When Shaoyin Ministerial Fire governs the Earthly Branch (Years of Mao and You), if Heat invades internally, treat with Salty-Cold herbs, assist with Sweet-Bitter herbs, astringe with Sour herbs, and disperse with Bitter herbs (Heat dislikes cold, hence Salty-Cold. If heat is severe at the exterior, Bitter disperses it; if not resolved, Cold restrains it; if still unresolved, Bitter disperses again, finally Sour astringes. Severe cases require two formulas, mild cases one, ensuring recovery. Intermittent symptoms are also treated with Sour astringents).
If Cold prevails reversely, treat with Sweet-Hot herbs, assisting with Bitter-Acrid, and level with Salty herbs.
When Taiyin Damp Earth governs the Earthly Branch (Years of Chen and Xu), if Dampness invades internally, treat with Bitter-Hot herbs, assist with Sour-Pale herbs, dry dampness with Bitter herbs, and drain with Pale herbs (Dampness opposes Dryness, hence Bitter-Hot. Assisting with Sour-Pale benefits the orifices).
If Heat prevails reversely, treat with Bitter-Cold herbs, assisting with Salty-Sweet herbs, and level with Bitter herbs.
When Shaoyang Ministerial Fire governs the Earthly Branch (Years of Si and Hai), if Fire invades internally, treat with Salty-Cold herbs, assist with Bitter-Acrid herbs, astringe with Sour herbs, and disperse with Bitter herbs (Fire acts vigorously in the heart and abdomen; Salty softness controls it. Sour astringes dispersed Qi. Generally, if sweating is required, Acrid assists).
If Cold prevails reversely, treat with Sweet-Hot herbs, assisting with Bitter-Acrid, and level with Salty herbs.
When Yangming Dryness Metal governs the Earthly Branch (Years of Zi and Wu), if Dryness invades internally, treat with Bitter-Warm herbs, assist with Sweet-Acrid herbs, and purge downward with Bitter herbs (Warmth facilitates the cold nature, hence Bitter purges downward).
If Heat prevails reversely, treat with Neutral-Cold herbs, assisting with Bitter-Sweet herbs... [Text fragment]
When Taiyang Cold Water governs the Earthly Branch (Years of Chou and Wei), if Cold invades internally, treat with Sweet-Hot herbs, assist with Bitter-Acrid herbs, drain with Salty herbs, moisten with Acrid herbs, and fortify with Bitter herbs (Treating cold with heat destroys the prevailing pathogen and breaks its Qi).
If Heat prevails reversely, treat with Salty-Cold herbs, assisting with Sweet-Acrid herbs, and level with Bitter herbs.
Li Shizhen said: The Heavenly Stem governs the first half of the year, dominated by Heavenly Qi, so the six excesses are called "prevailing" (Sheng), invading from above downwards, thus termed "pacifying" (Ping). The Earthly Branch governs the second half of the year, dominated by Earthly Qi, so the six excesses are called "within" (Yu Nei), invading from outside in, thus termed "treating" (Zhi). When the season is correct but the opposing controlling element prevails, it is called "reverse prevalence" (Fan Sheng). How can the prevalence of the Six Qi be verified? Excessive Dryness causes the ground to crack; excessive Summer Heat makes the ground hot; excessive Wind causes the ground to shake; excessive Dampness makes the ground muddy; excessive Cold causes the ground to fissure; excessive Fire dries up the ground. The details of the Six Qi's prevalence and reversal, host and guest, symptoms, and treatment mechanisms are thoroughly described in the *Suwen: Zhuyao Dalun*, too lengthy to reproduce here.