暑者。季夏也季夏者。湿土也。君火持权不与之子。暑湿之令不行也。湿令不行。则土
亏矣
所胜妄行木气太过。少阳旺也。所生者受病则肺金不足。所不胜者侮之。故水得以乘之土分
。
土者坤也。坤土申之分。申为相火。水入于土。则水火相干。而阴阳交争。
故为寒热。兼木气终见三焦。是二少阳相
合也。少阳在湿土之分。故为寒热。肺金不足洒淅寒热此皆往来未定之气也。故为 疟。久
而不愈疟不发于夏而发于秋者。以湿热在酉之分。方得其权。故发于大暑以后也。
秋者清肃之气。收敛下行之体也为湿所伤。是长夏之气。不与秋令也。秋令不及。所胜
妄行
。故火得以炎上。而克金。心火既形于肺。故肺气逆而为咳。所不胜者侮之。木气上行与火
同。得动而不息也。所生者受病。故肾水亏也。长夏已亢。三焦之气盛也。命门（有三）焦之
舍也。故迫肾水上行。与脾土湿热相合为痰困。 而动于脾之湿也。是以咳嗽有声有痰咳
嗽
不发于秋。而发于冬者。以其六阴之极。肃杀始得其气。故肺不咳嗽于秋。而咳嗽于冬也。
咳嗽者。气逆行上也气上行而逆。故面目发微肿。极则身体皆肿。变为水气。
故曰浊气在上。则生 胀。又曰。诸气 郁。皆属肺金此之谓也。春伤于风夏伤于暑冬
伤于寒
辞理皆顺时字伤令字也。独秋伤于湿。作令字伤时字。读者不疑也。此四者皆无所亢。而害
其所乘之子也。邪从后至。言岁之主气。各差其分而为病。一定之法也。若说秋字伤湿字。其
文
与上三句相通。其理与法不相通大抵理与法通。不必拘于文也。故说诗者。不以文害辞。不
以辞害意。以意逆志为得之矣故曰。春伤于风说作人为风所伤非也。若是则止当头痛恶风自
汗何以言夏为飧泄哉。今言春伤于风。即是时伤令也明矣。经云。东方来者为婴儿风其伤
人也外在于筋。内舍于肝。又曰。春甲乙所伤。谓之肝风。用此二句。以较前文。则辞理自
通矣。
暑气，对应季夏（夏季的最后一个月）。季夏属于湿土当令。若君火（心火）持权而不让位于子（湿土），则暑湿的气候特征无法显现。湿令不显，导致土气亏虚。
此时，土所克制的木气就会妄行，表现为木气太过，少阳相火旺盛。土所生的肺金因此受病而不足。肺金不足，则克制它的水气会反过来侮之（反侮），导致水气得以侵犯土分。
土对应坤卦。在十二地支中，申月对应坤土之位，申时/申月又关联相火。若水气侵入土位，则水火相互干扰，阴阳发生交争。
因此出现寒热交替的症状。兼夹木气的终末表现可见于三焦，这是两个少阳（手少阳与足少阳）相合的结果。少阳处于湿土的分野，所以表现为寒热往来。肺金不足导致的洒淅恶寒发热，这些都是来去不定、未定之气。因此诊断为疟疾。
疟疾如果在夏天不发作而在秋天发作，是因为湿热之气在酉月（秋季第二个月）才获得主导权，所以在“大暑”节气之后才发作。
秋气是清肃之气，具有收敛和下行的特性。如果被湿气所伤，就是长夏的湿气干扰了秋令。秋令不及，则土所克制的木气妄行（此处原文逻辑似有跳跃，通常秋金克木，若秋不及则木反侮，或指前文土虚木旺延续至秋，但根据后文“火得以炎上”，此处应理解为秋金弱，不能制木，且前文提到火克金，故此处主要讲秋金受制）。实际上，根据后文“火得以炎上而克金”，这里是指秋金虚弱，无法制约，导致火气炎上克制肺金。心火既然在肺脏形成邪气，肺气就会上逆而咳嗽。
克制金的木气也会上行，与火气一同作用，得到动势而不停息。土所生的肾水因此受病而亏虚。长夏之气已经亢盛，三焦之气旺盛。命门是三焦的舍宅，因此逼迫肾水上行，与脾土的湿热相结合形成痰饮困阻，并扰动脾中的湿气。
因此咳嗽有声且有痰。咳嗽如果在秋天不发作而在冬天发作，是因为冬季是六阴之极，肃杀之气刚开始得其主导，所以肺不在秋天咳嗽，而在冬天咳嗽。
咳嗽，是气逆行向上。气上行且逆乱，所以面目微微浮肿；严重时全身都肿，转变为水气病。所以说“浊气在上，则生胀满”。又说“诸气膹郁，皆属于肺”，说的就是这个道理。
“春伤于风，夏伤于暑，冬伤于寒”，辞理顺畅，是因为“时”字和“伤令”字的用法一致。唯独“秋伤于湿”，将“湿”作“令”解，将“秋”作“时”解，读者对此不加怀疑。这四种情况都没有邪气亢盛到极点，而是伤害了其所能克制的下一季节对应的脏腑之子（此处王好古解释为：春木生夏火，春伤风则夏火受累；夏火生秋金，夏伤暑则秋金受累；秋金生冬水，秋伤湿... 等等，王好古此处是在解释《内经》“各以其时受病”及五行相生传变的关系，但他特别指出秋伤湿的特殊性在于湿土克水，或者湿土侮火等复杂关系，原文说“害其所乘之子”，即春伤风，风木生夏火，风邪害其子夏；夏伤暑，暑火生秋金，暑邪害其子秋；秋伤湿，湿土... 这里王好古的逻辑比较独特，他认为秋伤湿，湿土本克水，但他说“害其所乘之子”，可能是指湿土生金？不对，土生金。让我们仔细看原文：“此四者皆无所亢，而害其所乘之子也”。春伤风（木），木生火（夏），风邪害夏（子）；夏伤暑（火），火生土（长夏/中央）？不对，通常说是夏伤暑秋必疟。王好古认为夏伤暑，暑湿相关，害秋金？原文说“害其所乘之子”。春木生夏火，春伤风，风邪传入夏（子）；夏火生秋金，夏伤暑，暑邪传入秋（子）；秋金生冬水，秋伤湿... 这里有点矛盾，因为湿属土。王好古的意思是，这四个条文讲的是邪气潜伏，等到下一个季节对应的脏腑当令时才发病，且是通过五行相生关系传给“子”脏。但是秋伤湿，湿属土，土生金，金生水。如果秋伤湿，应该是湿邪伤肺（金）？或者湿邪伤脾（土）？原文后面解释咳嗽是肺气逆。所以秋伤湿，湿邪困脾，进而影响肺？或者湿邪直接伤肺？
让我们重新梳理王好古的逻辑：
1. 春伤于风 -> 风为木邪 -> 木生火 -> 夏伤暑（火）-> 这里的逻辑是春之风邪，到了夏天引发暑病？或者春伤风，邪留体内，到夏天发为暑病？原文说“夏伤于暑”，意思是夏天感受暑邪。王好古的解释重点在于“辞理”。
2. 他对比“春伤于风”、“夏伤于暑”、“冬伤于寒”与“秋伤于湿”。
3. 前三句都是“时+伤+令”，即春天伤于风令，夏天伤于暑令，冬天伤于寒令。
4. “秋伤于湿”，他把“湿”看作“令”（长夏之令），把“秋”看作“时”。意思是秋天的时候，受了长夏湿令的余气之邪。
5. 他认为这四者都不是邪气本身亢盛致病，而是邪气伤害了它所生的“子”脏（或者是被克者的子？）。
- 春伤风（木），木生火，夏为火，故害夏（子）。
- 夏伤暑（火），火生土？不对，夏伤暑，秋必疟（金）。火克金。这里是“害其所不胜”？
- 王好古原文：“此四者皆无所亢，而害其所乘之子也。”
- 让我们看他的具体例子：春伤风，风木也，夏暑火也，木生火，故春伤风，夏为飧泄（注：内经原文是“春伤于风，夏生飧泄”，飧泄属脾土？还是肝木？通常飧泄责之肝脾。王好古这里可能引用不同版本或有特定理解）。
- 其实王好古的核心观点是：不要拘泥于文字表面，要通晓医理。他说“经云：东方来者为婴儿风... 其伤人也外在于筋，内舍于肝... 春甲乙所伤，谓之肝风”。他用这个来证明“春伤于风”就是春季伤了风邪，风邪入肝。那么为什么夏天生病？因为母病及子？或者伏邪？
- 回到“秋伤于湿”。秋属金，湿属土。土生金。如果秋伤湿，是湿邪（母）伤肺金（子）？还是湿邪困脾，进而影响肺？
- 原文解释咳嗽：“心火既形于肺... 木气上行... 肾水亏... 迫肾水上行... 与脾土湿热相合为痰... 咳嗽”。
- 结论：王好古认为“秋伤于湿”这句话的语法结构与前三句不同，前三句是“季节+伤+该季节的主气”，而“秋伤于湿”是“季节+伤+非该季节的主气（而是上一季节的主气）”。但他认为这在医理上是通的，即长夏之湿邪， lingering into Autumn, affecting the Lungs (Metal), causing cough in Winter (Water, Metal's child? No, Metal generates Water. So Lung disease manifests in Kidney/Winter?).
- 原文最后说：“咳嗽不发于秋，而发于冬者... 故肺不咳嗽于秋，而咳嗽于冬也。” 这是因为冬为水，肺为金，金生水。母病及子？或者邪气潜伏，待时而发。
简化翻译，忠实于原文逻辑：
王好古认为，“春伤于风”等三句，是当令之时伤当令之气。“秋伤于湿”则是秋时伤了长夏之湿令。这四者都不是邪气亢盛直接致病，而是邪气通过五行关系伤害了其“子”脏（或相关联的脏腑）。邪气从后一个季节显现出来，说明岁主之气各有差分，这是固定的法则。如果说“秋伤于湿”的文法与前三句一样，那文理相通，但医理不通。大体上医理与法则相通，不必拘泥于文字。所以读诗的人，不因文字损害词句，不因词句损害意旨，以意逆志才能得之。因此说“春伤于风”解释为人被风所伤是不对的（如果是指广义的风邪，而非特指春令之风）。如果是那样，只会有头痛、恶风、自汗等症状，怎么会说夏天会发生飧泄呢？现在说“春伤于风”，就是当时伤了当时的令气，这是很明显的。经文说：“东方来的叫婴儿风，它伤人，外在伤筋，内在舍于肝。”又说：“春甲乙日所伤，叫做肝风。”用这两句话与前文对照，辞理自然就通了。
Heat (Shu) corresponds to the late summer (the last month of summer). Late summer is governed by damp-earth. If the Sovereign Fire (Heart Fire) holds authority and does not yield to its offspring (damp-earth), the climate characteristics of heat-dampness will not manifest. When the dampness mandate does not appear, the Earth Qi becomes deficient.
At this time, the Wood Qi, which Earth normally controls, acts recklessly, manifesting as excessive Wood Qi and prosperity of Shaoyang Ministerial Fire. The element generated by Earth, namely Lung Metal, suffers disease and becomes insufficient. Due to Lung Metal's insufficiency, the Water Qi, which normally controls Metal, rebels against it (reverse overcoming), allowing Water Qi to invade the Earth sector.
Earth corresponds to the Kun trigram. In the twelve Earthly Branches, Shen month corresponds to the position of Kun Earth, and Shen is also associated with Ministerial Fire. If Water Qi enters the Earth position, Water and Fire interfere with each other, leading to a struggle between Yin and Yang.
Therefore, alternating chills and fever occur. The terminal manifestation of combined Wood Qi can be seen in the Sanjiao (Triple Burner), which represents the combination of the two Shaoyangs (Hand Shaoyang and Foot Shaoyang). Since Shaoyang resides in the domain of damp-earth, it presents as alternating chills and fever. The chills and fever with a shivering sensation caused by Lung Metal insufficiency are all signs of unsettled, fluctuating Qi. Thus, it is diagnosed as Malaria.
If malaria does not manifest in summer but appears in autumn, it is because the Heat-Dampness Qi gains dominance in You month (the second month of autumn). Therefore, it manifests after the Great Heat solar term.
Autumn Qi is clear, crisp, and肃 (solemn/clear), possessing the nature of convergence and downward movement. If injured by dampness, it means the Qi of Long Summer (late summer) interferes with the Autumn mandate. When the Autumn mandate is insufficient, the Wood Qi, which Metal normally controls, acts recklessly (Note: The text implies a complex interaction where Autumn Metal fails to control Wood, or previous Wood excess continues). Consequently, Fire Qi flares upward and overcomes Metal. Once Heart Fire forms pathogenic influence in the Lung, Lung Qi rebels upward causing cough.
The Wood Qi, which overcomes Metal, also moves upward, acting together with Fire Qi, gaining momentum and ceasing not. The element generated by Metal, Kidney Water, suffers disease and becomes deficient. The Qi of Long Summer has already become hyperactive, and the Qi of the Sanjiao is vigorous. Mingmen (Gate of Life) is the residence of the Sanjiao; therefore, it forces Kidney Water to move upward, combining with the Damp-Heat of Spleen Earth to form Phlegm obstruction, disturbing the Dampness within the Spleen.
Thus, cough produces sound and phlegm. If cough does not manifest in autumn but appears in winter, it is because winter is the extreme of the Six Yin phases, and the Killing Qi (Cold/Autumnal energy) just begins to gain its dominant air. Therefore, the Lung does not cough in autumn but coughs in winter.
Cough is the rebellion of Qi moving upward. As Qi moves upward and rebels, the face and eyes may swell slightly; in severe cases, the whole body swells, transforming into Edema (Water Qi). Hence it is said, "Turbid Qi remaining above causes distension." It is also said, "All Qi stagnation and oppression belong to Lung Metal," which refers to this phenomenon.
"Spring injury by Wind, Summer injury by Heat, Winter injury by Cold" have smooth logic because the usage of "Time" and "Injuring Mandate" characters is consistent. Only "Autumn injury by Dampness" treats "Dampness" as the "Mandate" (of Long Summer) and "Autumn" as the "Time". Readers do not doubt this. These four conditions involve no extreme exuberance of the pathogen itself, but rather harm the "offspring" organ that it generates (or is related to via generation). The pathogen manifests from the subsequent season, indicating that the annual governing Qi has specific divisions for causing disease, which is a fixed law. If one interprets "Autumn injury by Dampness" as having the same textual structure as the preceding three sentences, the literary connection exists, but the medical theory and method do not align. Generally, theory and method must connect, without being bound by literal text. Therefore, when interpreting poetry, one should not let words obscure phrases, nor phrases obscure meaning, but seek the intent behind the words to truly understand. Thus, saying "Spring injury by Wind" simply means being injured by wind as a person is incorrect. If so, there would only be headache, aversion to wind, and spontaneous sweating; how could one speak of diarrhea (sun-xie) occurring in summer? Now, stating "Spring injury by Wind" clearly means injuring the mandate at the appropriate time. The Classic states: "Wind coming from the East is called Infant Wind; when it injures people, externally it affects tendons, internally it abides in the Liver." It also says: "Injury on Jia and Yi days in Spring is called Liver Wind." Using these two sentences to compare with the preceding text, the logic and rhetoric naturally become coherent.