(《素问·至真要大论》)
帝曰∶邪气反胜,治之奈何?(反胜者,以天地气有不足,则间气乘虚为邪而反胜之也。)岐伯曰∶风司于地,清反
胜之,治以酸温,佐以苦甘,以辛平之。(凡寅申岁厥阴风木在泉而或气有不及,则金之清气反胜之,故当治以酸温,酸
求木之同气,温以制清也。佐以苦甘,苦以温金,甘以缓肝之急也。以辛平之,木之正味,其补以辛;金之正味,其泻
以辛也。)热司于地,寒反胜之,治以甘热,佐以苦辛,以咸平之。(凡卯酉岁少阴君火在泉而或气有不及,则水之寒气
反胜之,故当治以甘热,甘能胜水,热能制寒也。佐以苦辛,寒得苦而温,得辛而散也。以咸平之,火之正味,其补以
咸;水之正味,其泻以咸也,)湿司于地,热反胜之,治以苦冷,佐以咸甘,以苦平之。(凡辰戌岁太阴湿土在泉而或气
有不及,则火之热气反胜之,故当治以苦冷,抑火邪也。佐以咸甘,咸寒制热,甘湿补土也。以苦平之,即苦冷之义。)
火司于地,寒反胜之,治以甘热,佐以苦辛,以咸平之。(凡巳亥岁少阳相火在泉而气有不及,与上文热司于地者同其治。)
燥司于地,热反胜之,治以平寒,佐以苦甘,以酸平之,以和为利。(凡子午岁阳明燥金在泉而气有不及,则热反胜之,
治以平寒,以金司于地,气本肃杀,若用大寒,必助其惨,故但宜平寒,抑其热耳。佐以苦甘,所以泻火也。以酸平之,
金之正味,其补以酸也。以和为利,戒过用也,即平寒之意。)寒司于地,热反胜之,治以咸冷,佐以甘辛,以苦平之。
(凡丑未岁太阳寒水在泉而气有不及,则热反胜之,故治以咸冷,抑火邪也。佐以甘辛,甘泻火而辛能散也。以苦平之,
水之正味,其补以苦也。王氏曰∶此六气方治,与前淫胜法殊贯。其云治者,泻客邪之胜气也。云佐者,皆所利所宜也。
云平者,补已弱之正气也。)
帝曰∶其司天邪胜何如?(言司天反胜也。)岐伯曰∶风化于天,清反胜之,治以酸温,佐以甘苦。(巳亥岁也。治
与上文风同于地大同。)热化于天,寒反胜之,治以甘温,佐以苦酸辛。(子午岁也。治与上文热司于地稍同,但少一咸
味,多一酸味,盖火为水胜则心苦缓,故宜食酸以收之。)湿化于天,热反胜之,治以苦寒,佐以苦酸。(丑未岁也。苦
寒所以祛热,苦酸所以敛热。按∶此与上文湿司于地,皆当言风反胜之,而俱言热者,盖风火本属同气,均能胜湿故也。
然佐以苦酸,则木之正味,其泻以酸,此虽治热,而亦兼乎风矣。)火化于天,寒反胜之,治以甘热,佐以苦辛。(寅申
岁也。治与上文热司于地大同。)燥化于天,热反胜之,治以辛寒,佐以苦甘。(卯酉岁也,辛寒所以散热,苦甘所以泻
火。)寒化于天,热反胜之,治以咸冷,佐以苦辛。(辰戌岁也。治与上文寒司于地大同。)
(《素问·至真要大论》)
黄帝问道:当邪气反向克制正气时,应当如何治疗?(所谓反胜,是指由于天地之气有所不足,导致间气乘虚而入成为邪气,从而反向克制主气。)岐伯回答说:如果风气主司在泉之位,而清凉之气反而偏胜,治疗应用酸温的药物为主,辅以苦甘味的药物,再用辛味药来调和。(凡是寅申年,厥阴风木在泉,若运气有不及,则金之清气反向偏胜,所以应当用酸温之法治疗。酸味能顺应木气的同类属性,温性能制约清冷之气。辅以苦甘,苦味能温煦肺金,甘味能缓解肝木之急迫。用辛味来平调,因为辛是木的正味,用于补益木气;也是金的正味,用于泻除金气。)
如果热气主司在泉之位,而寒气反而偏胜,治疗应用甘热的药物为主,辅以苦辛味的药物,再用咸味药来调和。(凡是卯酉年,少阴君火在泉,若运气有不及,则水之寒气反向偏胜,所以应当用甘热之法治疗。甘味能制伏水气,热能驱散寒邪。辅以苦辛,寒邪遇苦则温,遇辛则散。用咸味来平调,因为咸是火的正味,用于补益心火;也是水的正味,用于泻除肾水。)
如果湿气主司在泉之位,而热气反而偏胜,治疗应用苦冷的药物为主,辅以咸甘味的药物,再用苦味药来调和。(凡是辰戌年,太阴湿土在泉,若运气有不及,则火之热气反向偏胜,所以应当用苦冷之法,以抑制火热邪气。辅以咸甘,咸寒能制约热邪,甘味能补益湿土。用苦味来平调,即苦冷之意。)
如果火气主司在泉之位,而寒气反而偏胜,治疗应用甘热的药物为主,辅以苦辛味的药物,再用咸味药来调和。(凡是巳亥年,少阳相火在泉,若运气有不及,其治法与上文“热气在泉”的情况相同。)
如果燥气主司在泉之位,而热气反而偏胜,治疗应用平寒的药物为主,辅以苦甘味的药物,再用酸味药来调和,以平和为有利。(凡主子午年,阳明燥金在泉,若运气有不及,则热气反向偏胜。治疗用平寒之品,是因为金气主司在泉,其气本属肃杀,如果使用大寒之药,必然助长其惨烈之气,所以只宜用平寒之药,以抑制热气即可。辅以苦甘,是为了泻除火邪。用酸味来平调,因为酸是金的正味,用于补益肺气。以和为利,是告诫不要过度用药,也就是平寒的本意。)
如果寒气主司在泉之位,而热气反而偏胜,治疗应用咸冷的药物为主,辅以甘辛味的药物,再用苦味药来调和。(凡是丑未年,太阳寒水在泉,若运气有不及,则热气反向偏胜,所以治疗用咸冷之法,以抑制火热邪气。辅以甘辛,甘味能泻火,辛味能发散。用苦味来平调,因为苦是水的主味,用于补益肾水。)王冰注解说:这六气的治疗方剂,与前文淫胜的治疗方法有所不同。文中说“治”,是指泻除客邪的偏胜之气;说“佐”,都是指所适宜有利的辅助药物;说“平”,是指补益已经虚弱的正气。)
黄帝问道:如果是司天之气受到邪气反向克制,情况又是怎样的呢?(这里说的是司天之气的反胜情况。)岐伯回答说:如果风化主司于天,而清凉之气反而偏胜,治疗应用酸温的药物为主,辅以甘苦味的药物。(这是巳亥年的情况。治法与上文风气在泉的情况大致相同。)
如果热化主司于天,而寒气反而偏胜,治疗应用甘温的药物为主,辅以苦酸辛味的药物。(这是子午年的情况。治法与上文热气在泉稍同,只是少了一味咸药,多了一味酸药。大概是因为火被水克制则心气易缓,所以适宜食用酸味药以收敛心气。)
如果湿化主司于天,而热气反而偏胜,治疗应用苦寒的药物为主,辅以苦酸味的药物。(这是丑未年的情况。苦寒用来祛除热邪,苦酸用来收敛热邪。按:这与上文湿气在泉的情况,都应当说是风气反向偏胜,但这里都说热气,大概是因为风火本属同气,都能胜湿的缘故。然而辅以苦酸,酸是木的正味,用于泻除木气,这虽然是治疗热邪,但也兼治了风邪。)
如果火化主司于天,而寒气反而偏胜,治疗应用甘热的药物为主,辅以苦辛味的药物。(这是寅申年的情况。治法与上文热气在泉的情况大致相同。)
如果燥化主司于天,而热气反而偏胜,治疗应用辛寒的药物为主,辅以苦甘味的药物。(这是卯酉年的情况。辛寒用来散发热邪,苦甘用来泻除火邪。)
如果寒化主司于天,而热气反而偏胜,治疗应用咸冷的药物为主,辅以苦辛味的药物。(这是辰戌年的情况。治法与上文寒气在泉的情况大致相同。)
(Su Wen, Chapter 74: The Most Important and Essential Questions)
The Yellow Emperor asked: How should one treat conditions where pathogenic factors counteract the normal physiological qi? (Counteracting victory refers to a situation where, due to insufficiency in the heavenly and earthly qi, interstitial qi takes advantage of the deficiency to become pathogenic and counteracts the dominant qi.) Qibo replied: When wind governs at the position of Earthly Qi (Zai Quan), but coldness counteracts it, treatment should employ sour-warm substances as the principal agents, assisted by bitter-sweet substances, and balanced with pungent substances. (In years of Yin-Shen, when Jueyin Wind-Wood is at the position of Earthly Qi, if the qi is insufficient, the clear-cold qi of Metal counteracts it. Therefore, treatment should use sour-warm methods. Sour flavor seeks the same qi as Wood; warmth controls coldness. Assisting with bitter and sweet: Bitter warms Metal; Sweet relieves the urgency of Liver Wood. Balancing with Pungent: Pungent is the true flavor of Wood, used for tonification; it is also the true flavor of Metal, used for purgation.)
When heat governs at the position of Earthly Qi, but coldness counteracts it, treatment should employ sweet-hot substances as the principal agents, assisted by bitter-pungent substances, and balanced with salty substances. (In years of Mao-You, when Shaoyin Ministerial Fire is at the position of Earthly Qi, if the qi is insufficient, the cold water qi counteracts it. Therefore, treatment should use sweet-hot methods. Sweet overcomes Water; Heat controls Cold. Assisting with bitter and pungent: Cold becomes warm upon encountering Bitter; Cold disperses upon encountering Pungent. Balancing with Salty: Salty is the true flavor of Fire, used for tonification; it is also the true flavor of Water, used for purgation.)
When dampness governs at the position of Earthly Qi, but heat counteracts it, treatment should employ bitter-cold substances as the principal agents, assisted by salty-sweet substances, and balanced with bitter substances. (In years of Chen-Xu, when Taiyin Damp-Earth is at the position of Earthly Qi, if the qi is insufficient, the hot fire qi counteracts it. Therefore, treatment should use bitter-cold methods to suppress the Fire pathogen. Assisting with salty and sweet: Salty-Cold controls Heat; Sweet nourishes Earth. Balancing with Bitter: This implies the meaning of Bitter-Cold.)
When Fire governs at the position of Earthly Qi, but coldness counteracts it, treatment should employ sweet-hot substances as the principal agents, assisted by bitter-pungent substances, and balanced with salty substances. (In years of Si-Hai, when Shaoyang Ministerial Fire is at the position of Earthly Qi, if the qi is insufficient, the treatment is the same as described above for Heat governing at the position of Earthly Qi.)
When dryness governs at the position of Earthly Qi, but heat counteracts it, treatment should employ neutral-cold substances as the principal agents, assisted by bitter-sweet substances, and balanced with sour substances, aiming for harmony. (In years of Zi-Wu, when Yangming Dryness-Metal is at the position of Earthly Qi, if the qi is insufficient, heat counteracts it. Treatment uses neutral-cold because Metal governing at the position of Earthly Qi has an inherent肃杀 (severing/drying) nature. Using extreme cold would exacerbate this severity, so only neutral-cold should be used to suppress heat. Assisting with bitter and sweet serves to purge Fire. Balancing with Sour: Sour is the true flavor of Metal, used for tonification. Aiming for harmony warns against excessive use, which is the essence of neutral-cold.)
When cold governs at the position of Earthly Qi, but heat counteracts it, treatment should employ salty-cold substances as the principal agents, assisted by sweet-pungent substances, and balanced with bitter substances. (In years of Chou-Wei, when Taiyang Cold-Water is at the position of Earthly Qi, if the qi is insufficient, heat counteracts it. Therefore, treatment uses salty-cold methods to suppress the Fire pathogen. Assisting with sweet and pungent: Sweet purges Fire; Pungent disperses. Balancing with Bitter: Bitter is the true flavor of Water, used for tonification.) Wang Bing noted: These six qi prescriptions differ from the previous methods for excessive influence. "Treatment" refers to purging the excessive qi of the guest pathogen. "Assistance" refers to what is beneficial and appropriate. "Balancing" refers to tonifying the already weakened righteous qi.
The Yellow Emperor asked: What about when Heavenly Qi (Si Tian) is counteracted by pathogenic excess? (This refers to counteracting victory in Heavenly Qi.) Qibo replied: When wind transformation governs Heaven, but coldness counteracts it, treatment should employ sour-warm substances as the principal agents, assisted by sweet-bitter substances. (This applies to Yin-Hai years. The treatment is largely the same as wind governing at the position of Earthly Qi mentioned earlier.)
When heat transformation governs Heaven, but coldness counteracts it, treatment should employ sweet-warm substances as the principal agents, assisted by bitter-sour-pungent substances. (This applies to Zi-Wu years. The treatment is slightly similar to heat governing at the position of Earthly Qi, but lacks one salty ingredient and adds one sour ingredient. This is because when Fire is overcome by Water, the Heart suffers from flaccidity, so it is suitable to consume sour substances to astringe.)
When dampness transformation governs Heaven, but heat counteracts it, treatment should employ bitter-cold substances as the principal agents, assisted by bitter-sour substances. (This applies to Chou-Wei years. Bitter-cold dispels heat; bitter-sour astringes heat. Note: In both the cases of dampness governing Heaven and dampness governing Earth, it should theoretically be stated that wind counteracts them, yet heat is mentioned here. This is likely because Wind and Fire share the same qi and can both overcome dampness. However, assisting with bitter and sour: Sour is the true flavor of Wood, used for purgation. Although this treats heat, it also addresses wind.)
When fire transformation governs Heaven, but coldness counteracts it, treatment should employ sweet-hot substances as the principal agents, assisted by bitter-pungent substances. (This applies to Yin-Shen years. The treatment is largely the same as heat governing at the position of Earthly Qi mentioned earlier.)
When dryness transformation governs Heaven, but heat counteracts it, treatment should employ pungent-cold substances as the principal agents, assisted by bitter-sweet substances. (This applies to Mao-You years. Pungent-cold dissipates heat; bitter-sweet purges fire.)
When cold transformation governs Heaven, but heat counteracts it, treatment should employ salty-cold substances as the principal agents, assisted by bitter-pungent substances. (This applies to Chen-Xu years. The treatment is largely the same as cold governing at the position of Earthly Qi mentioned earlier.)