（《素问·六元正纪大论》）
帝曰∶夫子言用寒远寒，用热远热，未知其然也，愿闻何谓远？岐伯曰∶热无犯热，寒无犯寒，（远，避忌之谓，即
无犯也。凡用热者，无犯司气之热，用寒者，无犯司气之寒，是谓热无犯热，寒无犯寒。）从者和，逆者病，不可不敬畏
而远之，所谓时与六位也。（时，谓四时，即主气也。位谓六步，即客气也。主客之气，皆当敬畏，不犯为从，犯则为逆
矣。）帝曰∶温凉何如？（谓温凉稍次于寒热，亦可犯否？）岐伯曰∶司气以热，用热无犯，司气以寒，用寒无犯，司气
以凉，用凉无犯，司气以温，用温无犯，（司气者，司天司地之气也。用热无犯等四句，谓寒热温凉俱当避，即有应用者，
亦无过用，恐犯岁气也。）间气同其主无犯，异其主则小犯之，（间气，左右四间之客气也。主，主气也。同者，同热同
寒，其气甚，故不可犯。异者主寒客热，主热客寒，其气分，其邪不一，故可因其势而小犯之。上节言司气，此节言间
气，如《至真要大论》曰∶主岁者纪岁，间气者纪步也。）是谓四畏，必谨察之。（四畏，寒热温凉也。）帝曰∶善。其犯
者何如？（言有必不得已而犯之者，将何如也。）岐伯曰∶天气反时，则可根据时，（天气即客气，时即主气，客不合主，
是谓反时，反时者则可根据时，以主气之循环有常，客气之显微无定，故姑从乎主也。）及胜其主则可犯，（胜其主者，客
气太过也。如夏而寒甚，客水胜也。冬而热甚，客火胜也。春凉秋温，其气皆然。故可以热犯热，以寒犯寒，以温犯温、
以凉犯凉而从其变，乃所谓从治也。）以平为期而不可过，（过则伤正气而增病矣。）是谓邪气反胜者。（邪气反胜则非时
而至，如应热反寒，应寒反热，应温反凉，应凉反温，皆邪气反胜也。反胜者，故当反其气以平之。）故曰无失天信，无
逆气宜，（客主气运，至必应时，天之信也；不知时气，失天信 矣。寒热温凉，用之必当，气之宜也；不知逆从，逆气
宜矣。）无翼其胜，无赞其复，是谓至治。（翼其胜，赞其复，皆助邪也。知而弗犯，是谓至妙之治。）
帝曰∶善。论言热无犯热，寒无犯寒，余欲不远寒，不远热奈何？（同前《六元正纪大论》。不远寒、不远热，谓有
不可远寒、不可远热者，其治当何如也。）岐伯曰∶悉乎哉问也！发表不远热，攻里不远寒。（中于表者多寒邪，故发表
之治不能远热，夏月亦然。郁于里者多热邪，故攻里之治，不能远寒，冬月亦然。愚按∶此二句大意，全在发攻二字。
发者，逐之于外也。攻者，逐之于内也。寒邪在表，非温热之气不能散，故发表者不远热；热郁在内，非沉寒之物不能
除，故攻里者不远寒，此必然之理也。然亦有用小柴、白虎、益元、冷水之类而取汗愈病者何也？此因表里俱热，故当
凉解，非发之之谓也。又有用理中、四逆、回阳之类而除痛去积者何也？此因阴寒留滞，故当温中，非攻之之谓也。所
谓发者，开其外之固也。攻者，伐其内之实也。今之昧者，但见外感发热等病，不能察人伤于寒而传为热者有本寒标热
之义，辄用芩连等药以清其标；亦焉知邪寒在表，药寒在里，以寒得寒，气求声应，致使内外合邪，遂不可解，此发表
用寒之害也。其于春秋冬三季，及土金水三气治令，阴胜阳微之时为尤甚。故凡寒邪在表未散，外虽炽热而内无热证者，
正以火不在里，最忌寒凉，此而误人，是不知当发者不可远热也。又如内伤喘痛胀满等证，多有三阴亏损者，今人但见
此类，不辨虚寒，便用硝黄之属，且云先去其邪，然后固本，若近乎理；亦焉知有假实真虚之病而复伐之，则病未去而
元气不能支矣，此而误人，是不知当攻者方不远寒也。二者之害，余见之多矣，不得不特表出之，以为当事者之戒。）帝
曰∶不发不攻而犯寒犯热何如？（言不因发表而犯热，不因攻里而犯寒，则其病当何如？犯，谓不当用而误用也。）岐伯
曰∶寒热内贼，其病益甚。（以水济水，以火济火，则寒热内贼而病益甚矣。）帝曰∶愿闻无病者何如？岐伯曰∶无者生
之，有者甚之。（无病而犯寒热者，则生寒生热。有病而犯寒热者，则寒热反甚。）帝曰∶生者何如？岐伯曰∶不远热则
热至，不远寒则寒至。寒至则坚否腹满、痛急下利之病生矣。（寒至则阳衰不能运化，故为是病。）热至则身热吐下霍乱、
痈疽疮疡、瞀郁注下、 螈肿胀、呕鼽衄头痛、骨节变肉痛、血溢血泄、淋 之病生矣。（热至则火灼诸经，故为是病。
瞀，茂、务二音。 ，如云切。螈音翅。）帝曰∶治之奈何？ 岐伯曰∶时必顺之，犯者治以胜也。（时必顺之，治当顺时
也。若有所误犯，则当治之以胜，如犯热者胜以咸寒，犯寒者胜以甘热，犯凉者胜以苦温，犯温者胜以辛凉，治以所胜
则可解也。）
（出自《素问·六元正纪大论》）
黄帝问道：先生曾说“用寒远寒，用热远热”，我不明白其中的道理，希望听听什么是“远”？岐伯回答说：热天不要使用热药，寒天不要使用寒药。（所谓“远”，就是避忌的意思，即不要触犯。凡是使用热性药物时，不要触犯当令的司天之热气；使用寒性药物时，不要触犯当令的司地寒气，这就叫作“热无犯热，寒无犯寒”。）顺应四时气候的为顺，违背四时气候的为逆，对此不可不敬畏并加以避忌，这就是所说的顺应时令与六步客气变化。（“时”，指四季，即主气；“位”指六步，即客气。主气和客气都应当敬畏，不触犯为顺，触犯则为逆。）
黄帝问道：温气和凉气又该如何处理呢？（意思是温凉稍次于寒热，是否可以触犯？）岐伯回答说：当令之气为热，使用热药不可触犯；当令之气为寒，使用寒药不可触犯；当令之气为凉，使用凉药不可触犯；当令之气为温，使用温药不可触犯。（所谓“司气”，是指司天和司地之气。前面提到的“用热无犯”等四句，是说寒、热、温、凉都应当避忌，即使有必须应用的，也不宜过度使用，恐怕触犯岁气。）间气与主气相同则不可触犯，与主气不同则可以轻微触犯。（间气，指左右四间之客气。主，指主气。相同，指客气与主气同热或同寒，其气盛，所以不可触犯。不同，指主寒客热或主热客寒，其气分，邪气不一，所以可以顺应病势而轻微触犯。上一节讲的是司气，这一节讲的是间气，如《至真要大论》所说：“主管一年的称为主岁，主管一步的称为间气。”）这就叫作“四畏”，必须谨慎观察。（“四畏”，指寒、热、温、凉四种气。）黄帝说：好。如果触犯了会怎样呢？（意思是如果有不得已而触犯的情况，该怎么办呢？）岐伯回答说：如果客气反常不合时令，就可以根据主气来治疗。（客气即客气，时即主气。客气与主气不合，叫做“反时”。反时的情况，可以根据主气治疗，因为主气的循环是有规律的，而客气的显现是不固定的，所以暂时顺从主气。）等到客气胜过主气时就可以触犯（胜其主者，指客气太过。例如夏天却寒冷得很，是客水胜过主火；冬天却炎热得很，是客火胜过主水。春秋两季的凉温也是如此。因此可以用热药犯热天，用寒药犯寒天，用温药犯温天，用凉药犯凉天，从而顺应变化，这叫做“从治”。），以平定为准则，不可过度。（过度就会损伤正气而增加病情。）这就叫作“邪气反胜”。（邪气反胜是指非时而至的气，如该热反寒，该寒反热，该温反凉，该凉反温，都是邪气反胜。既然是反胜，就应当反向使用药物来平衡它。）所以说，不要违背天时的信约，不要逆乱气机的适宜。（客气和主气的运气，到来必然应合时令，这是天的信约；不了解时令之气，就违背了天的信约。寒热温凉的使用必须得当，这是气机的适宜；不了解逆从关系，就逆乱了气机的适宜。）不要助长邪气的亢盛，不要赞助邪气的报复，这就叫作最高明的治疗。（助长邪气的亢盛，赞助邪气的报复，都是帮助邪气。知道这些而不触犯，就叫作最精妙的治疗。）
黄帝说：好。经论中说“热无犯热，寒无犯寒”，我想既不避寒，也不避热，该怎么办呢？（同前《六元正纪大论》。不远寒、不远热，意思是存在不能避寒、不能避热的情况，此时治疗应当如何？）岐伯回答说：你问得非常详尽！发表（解表散邪）不避热，攻里（泻下积滞）不避寒。（外感表证多由寒邪引起，所以发表的治疗不能避开热药，即使是夏天也是这样。邪气郁结在体内多由热邪引起，所以攻里的治疗不能避开寒药，即使是冬天也是这样。我按语认为：这两句话的大意，全在于“发”和“攻”两个字。“发”，是将邪气驱逐于体外。“攻”，是将邪气驱逐于体内。寒邪在体表，没有温热之气不能发散，所以发表者不避热；热邪郁结在内，没有沉寒之物不能清除，所以攻里者不避寒，这是必然的道理。然而也有用小柴胡汤、白虎汤、益元散、冷水之类而取汗治愈疾病的，为什么呢？这是因为表里俱热，所以应当用凉法解表，这不是“发”的意思。又有用理中汤、四逆汤、回阳救逆之类来消除疼痛去除积滞的，为什么呢？这是因为阴寒留滞，所以应当温中，这不是“攻”的意思。所谓的“发”，是打开体表的固闭；所谓的“攻”，是攻伐体内的实邪。现在的庸医，只看到外感发热等疾病，不能洞察病人伤于寒邪后传变为热证的本寒标热之义，就随意使用黄芩、黄连等药物清解表面的热象；哪里知道邪寒在表，药寒在里，以寒遇寒，气求声应，致使内外合邪，最终无法解散，这是发表时用寒药的害处。这在春秋冬三季，以及土、金、水三气主令，阴胜阳微的时候尤为严重。所以凡是寒邪在表未散，虽然外表炽热但内部没有热证的，正因为火不在里，最忌讳寒凉，这样误治害人，就是不知道应当发表时不可避热。又如内伤引起的喘促、疼痛、胀满等证，多有太阴、少阴、厥阴亏损的情况，现在的人只见到这类症状，不辨别虚寒，就使用芒硝、大黄之类的药物，还说先祛除邪气，然后固护根本，似乎合乎情理；哪里知道如果是假实真虚的病证反而去攻伐，那么病邪未去而元气已经支撑不住了，这样误治害人，就是不知道应当攻里时才不避寒。这两种害处，我见得很多了，不得不特别指出，作为医生的警戒。）
黄帝问道：如果不发表、不攻里而触犯寒热会怎样呢？（意思是不因发表而犯热，不因攻里而犯寒，那么病情会怎样？犯，指不当用而误用。）岐伯回答说：寒热之气在体内侵害脏腑，病情会更加严重。（用水济水，用火济火，则寒热在体内侵害脏腑，病情更加严重。）
黄帝问道：请问没有生病的人触犯寒热会怎样？岐伯回答说：原本无病而触犯寒热，就会产生寒热病；原本有病而触犯寒热，原有的寒热症状就会加重。
黄帝问道：产生寒热病会怎样？岐伯回答说：不避热则热邪至，不避寒则寒邪至。寒邪至则会出现腹部坚硬痞满、疼痛紧急、腹泻等病。（寒邪至则阳气衰败不能运化，所以出现这些病。）热邪至则会出现身体发热、呕吐、泄泻、霍乱、痈疽疮疡、神志昏蒙郁闷、痢疾不止、抽搐、肿胀、呕吐、鼻塞、鼻衄、头痛、骨节改变、肌肉疼痛、出血、泄血、淋证等病。（热邪至则火热灼烧各条经脉，所以出现这些病。瞀，音茂、务； ，音如云切；螈，音翅。）
黄帝问道：治疗它们该怎么办？岐伯回答说：治疗时必须顺应时令，如果有所误犯，则用能克制它的药物治疗。（治疗必须顺应时令。如果有所误犯，则应当用相克的方法治疗，如犯热者用咸寒药克制，犯寒者用甘热药克制，犯凉者用苦温药克制，犯温者用辛凉药克制，用所胜之法治疗就可以解除。）
(From *Suwen: Liuyuan Zhengji Dalun*)
The Yellow Emperor asked: The Master said, "When using cold [medicines], avoid the cold [season]; when using heat [medicines], avoid the heat [season]." I do not understand this principle. May I ask what is meant by "avoid"? Qibo replied: Do not use hot [medicines] in hot [conditions/seasons]; do not use cold [medicines] in cold [conditions/seasons]. ("Avoid" means to shun or refrain from, i.e., do not infringe upon. When using hot medicines, do not infringe upon the heat of the ruling Qi (Siqi); when using cold medicines, do not infringe upon the cold of the ruling Qi. This is called "do not use hot in hot, do not use cold in cold.".) Those who follow [the seasons] will be harmonious; those who oppose [them] will become ill. One must not fail to revere and avoid them, which is referred to as respecting the time and the six positions. ("Time" refers to the four seasons, i.e., the Principal Qi (Zhuzhi). "Position" refers to the six steps, i.e., the Guest Qi (Keqi). Both the Principal and Guest Qi should be revered; not infringing upon them is following [the order], while infringing is opposing [it].)
The Yellow Emperor asked: What about warm and cool [conditions]? (Meaning: Warm and cool are slightly inferior to heat and cold; can they be infringed upon?) Qibo replied: When the ruling Qi is hot, do not use hot [medicines] to infringe; when the ruling Qi is cold, do not use cold [medicines] to infringe; when the ruling Qi is cool, do not use cool [medicines] to infringe; when the ruling Qi is warm, do not use warm [medicines] to infringe. (The "ruling Qi" refers to the Qi of the Sovereign Heaven and Sovereign Earth. The four sentences "do not use hot..." etc., mean that cold, heat, warmth, and coolness should all be avoided. Even if application is necessary, one should not overuse them, for fear of infringing upon the annual Qi.) If the Guest Qi (Jianqi) is the same as the Principal Qi, do not infringe; if it differs from the Principal Qi, a slight infringement is permissible. (Guest Qi refers to the Guest Qi of the four intermediate positions on the left and right. Principal refers to the Principal Qi. "Same" means the Guest and Principal Qi are both hot or both cold; their Qi is strong, so infringement is not allowed. "Different" means the Principal is cold and Guest is hot, or Principal is hot and Guest is cold; their Qi is divided, and the pathogenic factors are not uniform, so one may slightly infringe according to the momentum. The previous section discussed the Ruling Qi; this section discusses the Guest Qi. As stated in *Zhi Zhen Yao Da Lun*: "Those governing the year record the year; those governing the step record the step.") This is called the "Four Feared Ones," and one must carefully observe them. (The "Four Feared Ones" refer to cold, heat, warmth, and coolness.) The Yellow Emperor said: Excellent. What happens if one infringes? (Meaning: If there is an unavoidable infringement, what then?) Qibo replied: If the Heavenly Qi (Guest Qi) opposes the season, one may follow the season. (Heavenly Qi refers to Guest Qi; season refers to Principal Qi. When Guest does not match Principal, it is called "opposing the season." In cases of opposing season, one may follow the Principal, because the cycle of Principal Qi is constant, while the manifestation of Guest Qi is indeterminate; thus, one temporarily follows the Principal.) When the Guest Qi overcomes the Principal Qi, infringement is permissible. (Overcoming the Principal means the Guest Qi is excessive. For example, extreme cold in summer indicates Guest Water overcoming; extreme heat in winter indicates Guest Fire overcoming. The same applies to coolness in spring and warmth in autumn. Thus, one may use hot to infringe upon heat, cold to infringe upon cold, warm to infringe upon warmth, and cool to infringe upon coolness, thereby adapting to changes. This is called "following treatment".) Aim for balance and do not exceed limits. (Exceeding limits damages the Healthy Qi (Zhengqi) and increases illness.) This is called "pathogenic Qi counteracting victory." (Counteracting victory refers to non-seasonal Qi appearing, such as heat turning to cold, cold turning to heat, warmth turning to coolness, and coolness turning to warmth; these are all instances of pathogenic Qi counteracting victory. Since it is counteracting, one should use opposite Qi to balance it.) Therefore, it is said: Do not lose the trust of Heaven (the regularity of Guest and Principal Qi arrival), do not oppose the suitability of Qi (proper use of cold, heat, warmth, coolness). Do not assist the victory [of pathogenic Qi], do not praise the recovery [of pathogenic Qi]. This is called supreme governance. (Assisting victory and praising recovery both aid pathogenic Qi. Knowing this and not infringing is called the most subtle treatment.)
The Yellow Emperor said: Excellent. The treatise says "do not use hot in hot, do not use cold in cold." I wish to neither avoid cold nor avoid heat. How should this be handled? (Same as *Liuyuan Zhengji Dalun*. Not avoiding cold or heat means there are situations where one cannot avoid cold or heat; how should treatment proceed?) Qibo replied: Your question is very thorough! To release the exterior (Fa Biao), do not avoid heat; to attack the interior (Gong Li), do not avoid cold. (Exterior contraction often involves cold pathogens, so treatment to release the exterior cannot avoid hot medicines, even in summer. Pathogens stagnating in the interior often involve heat pathogens, so treatment to attack the interior cannot avoid cold medicines, even in winter. My commentary: The main point of these two sentences lies entirely in the characters "release" and "attack." "Release" means driving out externally. "Attack" means driving out internally. Cold pathogens in the exterior cannot be dispersed without warm-hot Qi; thus, releasing the exterior does not avoid heat. Heat stagnating internally cannot be eliminated without heavy-cold substances; thus, attacking the interior does not avoid cold. This is an inevitable principle. However, why are diseases cured by sweating after using Xiao Chai Hu Tang (Minor Chest Bi Decoction), Bai Hu Tang (White Tiger Decoction), Yi Yuan San, or cold water? This is because both exterior and interior are hot, so cooling resolution is indicated; this is not "releasing." Why are pain and accumulation removed using Li Zhong Tang (Regulate the Middle Decoction), Si Ni Tang (Frigid Extremities Decoction), or Yang-restoring methods? This is because Yin-cold is stagnant, so warming the middle is indicated; this is not "attacking." "Releasing" means opening the external constriction. "Attacking" means subduing internal excess. Modern ignorant physicians only see external contraction with fever and other diseases, failing to discern that injury by cold transforms into heat (root cold, branch heat), and casually use Huang Qin (Scutellariae Radix) and Lian Zi (Loti Semen) to clear superficial heat. They do not realize that with cold pathogens in the exterior and cold medicines in the interior, cold meets cold, and Qi responds to Qi, causing internal and external pathogens to combine, making the condition impossible to resolve. This is the harm of using cold medicines to release the exterior. This is especially severe in spring, autumn, and winter, and during the periods governed by Earth, Metal, and Water Qi, when Yin prevails and Yang is weak. Therefore, whenever cold pathogens remain in the exterior un-dispersed, even if the exterior appears blazing hot but there are no internal heat signs, one must strictly avoid cold-cooling agents because fire is not in the interior. Misusing them harms people, showing ignorance that when release is needed, heat should not be avoided. Similarly, for internal injuries presenting with wheezing, pain, and distension, there are often deficiencies of the Three Yin (Taiyin, Shaoyin, Jueyin). Modern physicians, seeing such symptoms without distinguishing deficiency-cold, immediately use Xie Shi (Natrii Sulfas) and Da Huang (Rhei Radix et Rhizoma), claiming to first eliminate pathogens and then tonify the root, which seems reasonable. They do not realize that if the disease is false-excess and true-deficiency, attacking it will leave the pathology unresolved while the Original Qi (Yuanqi) collapses. Misusing them harms people, showing ignorance that when attack is needed, cold should not be avoided. I have seen the harms of these two approaches many times and must highlight them as a warning to practitioners.)
The Yellow Emperor asked: What if one infringes upon cold and heat without releasing the exterior or attacking the interior? (Meaning: If one does not infringe upon heat due to releasing the exterior, nor infringe upon cold due to attacking the interior, what will happen? "Infringe" means using inappropriately and erroneously.) Qibo replied: Cold and heat will act as thieves within, and the illness will worsen. (Using water to help water, or fire to help fire, causes cold and heat to invade internally, worsening the illness.)
The Yellow Emperor asked: What happens to those without illness? Qibo replied: For those without illness, it generates illness; for those with illness, it exacerbates it. (If those without illness infringe upon cold and heat, they generate cold and heat conditions. If those with illness infringe upon cold and heat, their existing cold and heat symptoms intensify.)
The Yellow Emperor asked: What happens when illness is generated? Qibo replied: Not avoiding heat leads to heat arrival; not avoiding cold leads to cold arrival. When cold arrives, diseases such as abdominal hardness, fullness, urgent pain, and diarrhea arise. (Cold arrival causes Yang Qi decline and failure of transformation and transportation, leading to these diseases.) When heat arrives, diseases such as body heat, vomiting, diarrhea, cholera, carbuncles, sores, ulcers, mental confusion and depression, dysentery, convulsions, swelling, vomiting, nasal congestion, epistaxis, headache, joint deformity, muscle pain, hemorrhage, bloody diarrhea, and strangury arise. (Heat arrival causes fire to scorch the meridians, leading to these diseases. Mao sounds like mao/wu; sounds like yun; chuang sounds like chi.)
The Yellow Emperor asked: How should they be treated? Qibo replied: Treatment must conform to the season. If infringement occurs, treat with what overcomes it. (Treatment must conform to the season. If infringement occurs, treat with the overcoming element: for heat infringement, use salty-cold to overcome; for cold infringement, use sweet-hot to overcome; for cool infringement, use bitter-warm to overcome; for warm infringement, use pungent-cool to overcome. Treating with the overcoming method allows for resolution.)