（素问至真要大论）
帝曰∶论言治寒以热，治热以寒，而方士不能废绳墨而更其道也。有病热者寒之而热，有病寒者热之而寒，二者皆
在，新病复起，奈何治？（寒之而热，言治热以寒而热如故。热之而寒，言治寒以热而寒如故。及有以寒治热者，旧热
尚在而新寒生；以热攻寒者，旧寒未除而新热起。皆不得不求其详也。）岐伯曰∶诸寒之而热者取之阴，热之而寒者取之
阳，所谓求其属也。（诸寒之而热者，谓以苦寒治热而热反增，非火之有余，乃真阴之不足也。阴不足则阳有余而为热，
故当取之于阴，谓不宜治火也，只补阴以配其阳，则阴气复而热自退矣。热之而寒者，谓以辛热治寒而寒反甚，非寒之
有余，乃真阳之不足也。阳不足则阴有余而为寒，故当取之于阳，谓不宜攻寒也，但补水中之火，则阳气复而寒自消也。
故启玄子注曰∶益火之源，以消阴翳；壮水之主，以制阳光。又曰∶脏腑之原，有寒热温凉之主。取心者不必齐以热，
取肾者不必齐以寒；但益心之阳，寒亦通行，强肾之阴，热之犹可。故或治热以热，治寒以寒，万举万全，孰知其意？
此王氏之心得也。然求其所谓益与壮者，即温养阳气，填补真阴也。求其所谓源与主者，即所谓求其属也。属者根本之
谓，水火之本，则皆在命门之中耳。）帝曰∶善。服寒而反热，服热而反寒，其故何也？岐伯曰∶治其王气，是以反也（此
承上文而详求其服寒反热、服热反寒之所以然也。治其王气者，谓病有阴阳，气有衰王，不明衰王，则治之反甚。如阳
盛阴衰者，阴虚火王也，治之者不知补阴以配阳，而专用苦寒治火之王，岂知苦寒皆沉降，沉降皆亡阴，阴愈亡则火愈
盛，故服寒反热者，阴虚不宜降也。又如阳衰阴盛者，气弱生寒也，治之者不知补阳以消阴，而专用辛温治阴之王，岂
知辛温多耗散，耗散则亡阳，阳愈亡则寒愈甚，故服热反寒者，阳虚不宜耗也。此无他，皆以专治王气，故其病反如此。
又如夏令本热，而伏阴在内，故每多中寒，冬令本寒，而伏阳在内，故每多内热。设不知此而必欲用寒于夏，治火之王，
用热于冬，治寒之王，则有中寒隔阳者，服寒反热，中热隔阴者，服热反寒矣。是皆治王之谓，而病之所以反也。春秋
同法。）帝曰∶不治王而然者何也？岐伯曰∶悉乎哉问也。不治五味属也。夫五味入胃，各归所喜攻，酸先入肝，苦先入
心，甘先入脾，辛先入肺，咸先入肾，（此言不因治王而病不愈者，以五味之属，治有不当也。凡五味必先入胃，而后各
归所喜攻之脏。喜攻者，谓五味五脏各有所属也。如九针论曰∶病在筋，无食酸；病在气，无食辛；病在骨，无食咸；
病在血，无食苦；病在肉，无食甘。犯之者，即所谓不治五味属也。）久而增气，此物化之常也。气增而久，夭之由也。
（凡五味之性，各有所入，若味有偏用，则气有偏病，偏用即久，其气必增，此物化之常也。气增而久，则脏有偏胜，
脏有偏胜，则必有偏绝矣，此致夭之由也，如生气通天论曰，味过于酸，肝气以津，脾气乃绝，味过于咸，大骨气劳，
短肌心气抑之类是也。此篇前言寒热者，言病机也；后言五味者，言药饵也。药饵病机必审其真，设有谬误，鲜不害矣。）
黄帝问道：医论中说，治疗寒证用热药，治疗热证用寒药，这是不可违背的准则。但是遇到这样的病人：患热病的用寒凉药治疗后，发热症状反而不退；患寒病的用温热药治疗后，畏寒症状反而加重。这两种情况同时存在，且新的病症又出现了，应当如何治疗？（所谓“治热以寒而热如故”，是指用寒凉药治热病，但热象依旧；所谓“治寒以热而寒如故”，是指用温热药治寒病，但寒象依旧。此外，有用寒药治热病，旧的热邪未去，新的寒邪又生；有用热药攻寒邪，旧的寒邪未除，新的热邪又起。这些都不得不深入探究其详细机理。）
岐伯回答说：凡是使用寒凉药治疗热病而热势不退的，应当从滋阴入手；凡是使用温热药治疗寒病而寒势不减的，应当从补阳入手。这就是所谓的“求其属”（探求疾病的根本属性）。（所谓“诸寒之而热者”，是指用苦寒药治疗热病，热势反而增加，这并非火邪有余，而是真阴不足。阴不足则阳气相对偏亢而产生热，所以应当滋养阴液，即不宜单纯清泻火邪，只需补益阴液以制约阳气，那么阴气恢复，热自然消退。所谓“热之而寒者”，是指用辛热药治疗寒病，寒势反而加重，这并非寒邪有余，而是真阳不足。阳不足则阴气相对偏盛而产生寒，所以应当温补阳气，即不宜单纯攻逐寒邪，只需补益命门之火，那么阳气恢复，寒自然消除。所以王冰注解说：“益火之源，以消阴翳；壮水之主，以制阳光。”又说：脏腑的根本，有寒热温凉的主宰。治疗心病不必一概用热药，治疗肾病不必一概用寒药；只要补益心阳，即使用药偏寒也能通行；只要强固肾阴，即使用药偏热也可以。因此有时用热药治热病，用寒药治寒病，却能万无一失，谁能懂得其中的深意呢？这是王冰的心得体会。然而所谓“益”和“壮”，就是指温养阳气、填补真阴。所谓“源”和“主”，就是所说的“求其属”。属，指的是根本，水火之本，都在于命门之中。）
黄帝说：讲得好。服用寒药反而出现热象，服用热药反而出现寒象，这是什么缘故？
岐伯说：这是因为只治疗其旺盛之气（王气），所以导致病情相反。（这是承接上文详细探究服用寒药反热、服用热药反寒的原因。所谓“治其王气”，是指疾病有阴阳之分，正气有盛衰之别。如果不明辨盛衰，治疗就会使病情加重。例如阳盛阴虚者，是阴虚火旺，治疗时若不知补阴以配阳，而专用苦寒药直折火势，岂不知苦寒药多沉降，沉降易伤阴，阴愈伤则火愈盛，所以服用寒药反而更热，这是因为阴虚不宜用降法。又如阳虚阴盛者，是气弱生寒，治疗时若不知补阳以消阴，而专用辛温药直散阴寒，岂不知辛温药多耗散，耗散易伤阳，阳愈伤则寒愈甚，所以服用热药反而更寒，这是因为阳虚不宜用耗法。这没有别的原因，都是因为专门针对旺盛之气进行治疗，所以病情反而如此。再比如夏季本应炎热，但体内潜伏着阴寒，所以常患中寒症；冬季本应寒冷，但体内潜伏着阳热，所以常患内热症。如果不知道这一点，必定在夏天用寒药治火旺，在冬天用热药治寒旺，就会导致中寒隔阳者服寒药反热，中热隔阴者服热药反寒。这些都是针对“王气”进行治疗，从而导致病情反复的原因。春秋季节也遵循同样的法则。）
黄帝说：不针对旺盛之气治疗却出现这种情况，又是为什么呢？
岐伯说：问得真详尽啊！这是因为没有顾及五味的归属。五味进入胃后，各自归于其所喜攻的脏腑，酸味先入肝，苦味先入心，甘味先入脾，辛味先入肺，咸味先入肾。（这里说的是不因治疗王气而病不愈的原因，是因为五味的属性与治疗方法不当。凡五味必先入胃，然后各归其所喜攻的脏腑。所谓“喜攻”，是指五味与五脏各有对应的归属关系。如《九针论》所说：病在筋，不要吃酸；病在气，不要吃辛；病在骨，不要吃咸；病在血，不要吃苦；病在肉，不要吃甘。触犯这些禁忌，就是所谓的“不治五味属”。）长期偏食某种味道，会使相应脏腑之气增加，这是事物变化的常规。但如果气增加的时间久了，就会成为早夭的原因。（凡是五味的性质，各有其归属，如果味道偏用，则气也会偏病。偏用即长期使用，其气必然增加，这是事物变化的常规。气增加久了，则脏腑会有偏胜，脏腑偏胜，则必然导致偏绝，这是导致早夭的原因。如《生气通天论》所说：味过于酸，肝气过盛，脾气就会衰竭；味过于咸，大骨气劳损，肌肉短缩，心气受抑等，都是此类情况。本篇前面讲寒热，是讲病机；后面讲五味，是讲药饵。药饵治病必须审察其真假，如果有谬误，很少有不造成伤害的。）
Yellow Emperor asked: Medical theories state that cold syndromes are treated with hot remedies, and heat syndromes are treated with cold remedies; this is a standard that cannot be abandoned. However, there are cases where treating a heat syndrome with cold medicine fails to resolve the fever, and treating a cold syndrome with hot medicine fails to resolve the chills. When both conditions persist and new diseases arise, how should they be treated? (The phrase "treating heat with cold but heat remains" means using cold herbs for a heat syndrome, yet the heat signs persist. The phrase "treating cold with hot but cold remains" means using hot herbs for a cold syndrome, yet the cold signs persist. Furthermore, when cold herbs are used to treat heat, the old heat may remain while new cold arises; when hot herbs are used to attack cold, the old cold may not be eliminated while new heat arises. These situations require detailed investigation.)
Qibo replied: For those whose heat persists despite being treated with cold, one should tonify Yin; for those whose cold persists despite being treated with hot, one should tonify Yang. This is what is meant by "seeking their affiliation" (identifying the root nature of the disease). (When heat persists after treatment with cold, it implies that bitter-cold herbs were used, yet the heat increased. This is not due to excess Fire, but rather deficiency of True Yin. When Yin is deficient, Yang becomes relatively excessive, generating heat. Therefore, one should nourish Yin, meaning one should not merely clear Fire, but instead tonify Yin to harmonize with Yang. Once Yin Qi recovers, the heat will subside naturally. When cold persists after treatment with hot, it implies that acrid-hot herbs were used, yet the cold worsened. This is not due to excess Cold, but rather deficiency of True Yang. When Yang is deficient, Yin becomes relatively excessive, generating cold. Therefore, one should tonify Yang, meaning one should not merely purge Cold, but instead warm the Fire within Water. Once Yang Qi recovers, the cold will dissipate naturally. Thus, Wang Bing noted: "Enrich the source of Fire to eliminate shadows of Yin; strengthen the master of Water to control the brightness of Yang." He also stated: The origins of the Zang-Fu organs have masters of cold, heat, warmth, and coolness. Treating the Heart does not necessarily require hot herbs; treating the Kidney does not necessarily require cold herbs. If one enriches Heart Yang, even cold herbs can circulate freely; if one strengthens Kidney Yin, even hot herbs can be effective. Thus, sometimes treating heat with hot remedies or cold with cold remedies yields perfect results. Who understands this intent? This is Wang Bing's insight. However, what is meant by "enriching" and "strengthening" refers to warming and nourishing Yang Qi, and filling True Yin. What is meant by "source" and "master" refers to "seeking their affiliation." Affiliation refers to the root; the roots of Water and Fire lie within the Gate of Vitality (Mingmen).)
Yellow Emperor said: Excellent. Why do taking cold medicines result in heat, and taking hot medicines result in cold?
Qibo said: This occurs because one treats only the Exuberant Qi (Wang Qi), leading to an opposite reaction. (This continues the previous discussion to detail why taking cold medicines causes heat and hot medicines cause cold. "Treating Exuberant Qi" means that diseases involve Yin and Yang, and Qi has states of decline and exuberance. Failing to distinguish between decline and exuberance leads to treatments that exacerbate the condition. For example, in cases of Yang exuberance and Yin deficiency, there is Yin deficiency with Fire exuberance. If the practitioner does not know to tonify Yin to balance Yang, but instead uses bitter-cold herbs exclusively to suppress Fire, they fail to realize that bitter-cold herbs are descending and draining, which consumes Yin. As Yin is consumed, Fire becomes more exuberant, so taking cold medicines results in more heat; this is because Yin deficiency is unsuitable for descending methods. Similarly, in cases of Yang deficiency and Yin exuberance, Qi weakness generates cold. If the practitioner does not know to tonify Yang to dispel Yin, but instead uses acrid-warm herbs exclusively to scatter Yin Cold, they fail to realize that acrid-warm herbs are dispersing and consuming, which damages Yang. As Yang is damaged, cold becomes more severe, so taking hot medicines results in more cold; this is because Yang deficiency is unsuitable for dispersing methods. There is no other reason; the illness reacts this way because treatment focused solely on the Exuberant Qi. Consider summer: although externally hot, latent Yin resides internally, often causing middle-jiao cold. Winter: although externally cold, latent Yang resides internally, often causing interior heat. If one ignores this and insists on using cold herbs in summer to treat Fire exuberance, or hot herbs in winter to treat Cold exuberance, one may encounter middle-cold blocking Yang (where cold herbs cause heat) or middle-heat blocking Yin (where hot herbs cause cold). These are all consequences of treating the Exuberant Qi, causing the illness to react oppositely. Spring and autumn follow the same principles.)
Yellow Emperor asked: What if the condition manifests oppositely without treating the Exuberant Qi?
Qibo said: You ask very thoroughly! It is because the affiliations of the Five Flavors were not considered. When the five flavors enter the Stomach, they each go to the Zang organ they prefer to affect. Sour flavor enters the Liver first, Bitter flavor enters the Heart first, Sweet flavor enters the Spleen first, Acrid flavor enters the Lung first, and Salty flavor enters the Kidney first. (This explains why illness does not resolve even when not targeting the Exuberant Qi: it is due to inappropriate application of the affinities of the five flavors. All five flavors first enter the Stomach, then distribute to their preferred Zang organs. "Preferred to affect" means each flavor has an affinity with specific Zang organs. As stated in the *Nine Needles Treatise*: If the disease is in the sinews, avoid sour foods; if in Qi, avoid acrid foods; if in bones, avoid salty foods; if in blood, avoid bitter foods; if in flesh, avoid sweet foods. Violating these constitutes "not attending to the affiliations of the five flavors.") Long-term consumption increases the Qi of the corresponding organ, which is the normal transformation of substances. However, if this increase persists for a long time, it becomes a cause of premature death. (Each of the five flavors has a specific affinity. If flavors are used excessively, Qi becomes pathologically biased. Prolonged use inevitably increases Qi, which is the normal transformation. However, prolonged increase of Qi leads to Zang bias; Zang bias leads to extreme imbalance, which is the cause of premature death. As stated in the *Treatise on the Connection of Life and Heaven*: Excessive sour flavor causes Liver Qi to overflow and Spleen Qi to fail; excessive salty flavor causes labor in the large bones, shortening of muscles, and suppression of Heart Qi. The earlier part of this chapter discussed cold and heat regarding pathogenesis; the latter part discusses five flavors regarding medicinal administration. Medicinal administration must carefully assess the truth of the pathogenesis. Errors rarely fail to cause harm.)