未达天道之常变，反谓气运不相应，既识一定之常理，再审不定变化情，任尔百千
杂合病，要在天时地化中，知其要者一言毕，不得其旨散无穷。
【注】近世医者，皆谓五运六气与岁不应，置而不习，是未达天道之常变也。时之常者，
如春温、夏热、秋凉、冬寒也。日之常者，早凉、午热、暮温、夜寒也。时之变者，春不
温、夏不热、暑不蒸、秋不凉、冬不寒也。日之变者，早温、午寒、暮凉、夜热也。但学
医者，欲达常变之道，当先识一定主客之理，次审不定变化卒然之情，然后知百千杂合之
气为病，俱莫能逃天时地化之理也。虽或有不应，亦当审察与天时何时、地化何化、人
病何病相同，即同彼时、彼化、彼病而施治之，乃无差谬。此知其要者，一言而终也。为
医者可不于运气中一加意耶？
附∶冲阳诸脉穴位∶
冲阳穴──在足跗上五寸，去陷骨二寸骨间动脉。
太渊穴──在掌后内侧，横纹头动脉中。
太溪穴──在足内踝后五分，跟骨上动脉陷中。
太冲穴──在足大指本节二寸间，动脉应手陷中。
神门穴──在掌后锐骨端陷中。
附∶冲阳诸脉穴图
\r冲阳诸脉穴图\ps110-4a24.bmp\r
未能通晓天道中恒定与变化的规律，反而认为五运六气与实际年份不相符合；既然已经认识了确定的常理，就应当再审视那些不定的、变化无常的情况。无论遇到多少种复杂的合并病症，关键在于将其置于天时气候和地理环境的变化中去考量。懂得其中要领的人，用一句话就能概括完毕；不得其精髓的人，则会在无穷无尽的疑惑中迷失。
【注】近世的医生，都声称五运六气与当年的实际情况不相符，因此放置一旁不再学习，这是没有通达天道中恒定与变化的道理。时间的恒定规律，例如春季温暖、夏季炎热、秋季凉爽、冬季寒冷。一天的恒定规律，例如早晨凉快、中午炎热、傍晚温和、夜晚寒冷。时间的变化规律，例如春天不温暖、夏天不炎热、暑天不闷热、秋天不凉爽、冬天不寒冷。一天的变化规律，例如早晨温暖、中午寒冷、傍晚凉爽、夜晚炎热。凡是学医的人，想要通达恒定与变化的道理，应当先认识确定不移的主气与客气之理，其次审视不定且突然发生的变化情况，然后才能知道千百种复杂之气致病，都不能逃脱天时地理变化的规律。虽然有时会有不相符的情况，也应当审察其与何时天的气候、何地化的环境、何人的病症相同，就按照那时的气候、那里的环境、那样的病症来施治，这样就不会出现差错。这就是所谓“懂得要领的人，一句话就能终结（掌握）”。作为医生，难道不在运气学说上多加留意吗？
附：冲阳脉各穴位：
冲阳穴——位于足背上方五寸处，距离陷谷穴二寸的骨间动脉搏动处。
太渊穴——位于手腕后方内侧，腕横纹头处的动脉搏动中。
太溪穴——位于足内踝后方五分处，跟骨上方的动脉凹陷中。
太冲穴——位于足大趾本节（第一跖趾关节）后二寸之间，动脉应手的凹陷中。
神门穴——位于手腕后方锐骨（豌豆骨）端的凹陷中。
附：冲阳脉诸穴图
[图片文件：冲阳诸脉穴图]
Failure to comprehend the constancy and variability of the Heavenly Dao leads one to falsely claim that the Five Movements and Six Qi do not correspond to the year. Having recognized the fixed principles, one must further examine the uncertain and changing circumstances. Regardless of the myriad complex combined diseases, the key lies in understanding them within the context of celestial timing and earthly transformation. Those who grasp the essence can summarize it in a single statement; those who miss the point will be lost in infinite confusion.
[Annotation] Physicians in recent times often assert that the Five Movements and Six Qi do not correspond to the actual conditions of the year, and thus neglect studying them. This reflects a failure to understand the constancy and variability of the Heavenly Dao. The constancy of seasons includes: spring warmth, summer heat, autumn coolness, and winter cold. The constancy of daily cycles includes: morning coolness, midday heat, evening mildness, and nighttime cold. Variability in seasons includes: spring lacking warmth, summer lacking heat, summer heat failing to be stifling, autumn lacking coolness, and winter lacking cold. Variability in daily cycles includes: morning warmth, midday cold, evening coolness, and nighttime heat. Physicians seeking to master the way of constancy and variability must first understand the fixed principles of the Principal (Zhu) and Guest (Ke) Qi, then carefully observe sudden and unpredictable changes. Only then can they realize that diseases caused by hundreds or thousands of complex Qi combinations cannot escape the laws of celestial timing and earthly transformation. Even when discrepancies occur, one must investigate which celestial timing, earthly transformation, and human pathology align with the current situation, and treat accordingly based on that specific time, environment, and disease presentation, thereby avoiding errors. This is what is meant by "those who grasp the essence need but one word to conclude." Should physicians not pay close attention to the study of Movement and Qi?
Appendix: Acupoints of the Chongyang Meridian:
Chongyang (ST42) — Located five cun above the dorsum of the foot, two cun distal to Xiangu (ST43), in the depression where the arterial pulse is palpable between the bones.
Taiyuan (LU9) — Located at the radial end of the transverse crease of the wrist, on the medial side, in the depression where the arterial pulse is palpable.
Taixi (KI3) — Located five fen posterior to the medial malleolus, in the depression where the arterial pulse is palpable above the calcaneus.
Taichong (LR3) — Located two cun proximal to the metatarsophalangeal joint of the great toe, in the depression where the arterial pulse is palpable.
Shenmen (HT7) — Located in the depression at the ulnar end of the transverse crease of the wrist, adjacent to the pisiform bone.
Appendix: Diagram of Acupoints on the Chongyang Meridian
[Image file: Diagram of Acupoints on the Chongyang Meridian]