生之德。而为凉为肃。德之化也。）厥阴所至为毛化。少阴所至为羽化。太阴所至为 化。少阳所至为羽化。阳明所至为
介化。太阳所至为鳞化。德化之常也。（五类之虫。感五运六气而生育。故为德化之常也。）厥阴所至为生化。少阴所至
为荣化。太阴所至为濡化。少阳所至为茂化。阳明所至为坚化。太阳所至为藏化。布政之常也。（生茂坚藏。乃六气之政。
而宣布于四时。）厥阴所至为飘怒大凉。少阴所至为太暄寒。太阴所至为雷霆骤注。列风。少阳所至为飘风。燔燎霜凝。
阳明所至为散落温。太阳所至为寒雪冰雹。白埃。气变之常也。（飘怒、风之变。凉乃金气承之。大暄、火之甚。寒乃阴
精承之。雷霆骤注。湿土之变。极则风气承之。飘风者。风自火出也。燔燎、炎之甚。极则水气承之。散落、肃杀之甚。
温乃火气承之。寒雪冰雹、寒之甚也。极则土气承之。盖气极则变。变则害。承乃制。）厥阴所至为挠动。为迎随。少阴
所至为高明。焰为曛。太阴所至为沉阴。为白埃。为晦瞑。少阴所至为光显。为彤云。为曛。阳明所至为烟埃。为霜。
为劲切。为凄鸣。太阳所至为刚固。为坚芒。为立。令行之常也。（迎随、往来也。彤云者。泽气上蒸而为云也。凄鸣、
金有声也。刚固坚芒。乃寒凝冰坚之象。此六气之令。行于四时之常也。）厥阴所至为里急。少阴所至为疡胗。身热。太
阴所至。为积饮痞隔。少阳所至为嚏呕。为疮疡。阳明所至为浮虚。太阳所至为屈伸不利。病之常也。（此春病之常也。
里急、逆气上升也。厥阴主春。春气始于下而上。故为里急。阳明主秋。秋气始于上。故为浮虚。火生于木。风火相煽。
故为身热疮疡。土位中央。而分旺于四季。故四时为痞 中满之病。太阳主筋。为风气所伤。故 短而屈伸不利。）厥阴
所至为支痛。少阴所至为惊惑。恶寒战栗谵妄。太阴所至为 满。少阳所至为惊躁。瞀昧暴病。阳明所至为鼽。尻阴股
膝髀 足病。太阳所至为腰痛。病之常也。（ 音畜瞀音务尻音敲。此夏病之常也。）厥阴所至为 戾。少阴所至为悲
妄衄 。太阴所至为中满。霍乱吐下。少阳所至为喉痹。耳鸣呕涌。阳明所至为胁痛皴揭。太阳所至为寝汗痉。病之常
也。（ 音软戾叶利 音蔑皴音逡。此秋病之常也。 、缩也。戾、了戾也。即转出小便之关戾。厥阴主利前阴。而脉络
阴器。为燥金所伤。故戾 不利。皴、皱也。以燥而遇燥。故皮为皴揭。）厥阴所至为胁痛呕泄。少阴所至为语笑。太阴
所至为重 肿。少阳所至为暴注。 螈暴死。阳明所至为鼽嚏。太阳所至为流泄。禁止。病之常也。（此冬病之常也。心
主言而喜为心志。君火为冬令之寒水所迫。则心气实而语笑不休。以上四时诸病。有因于六气者。有因于四时者。学人
引而伸之。以意会之。其义自得。此论四时之五运六气。有德有化。有政有令。有变有病。）凡此十二变者。报德以德。
报化以化。报政以政。报令以令。气高则高。气下则下。气后则后。气前则前。气中则中。气外则外。位之常也。（报德
以德。报化以化者。即所谓春有鸣条律畅之化。则秋有雾露清凉之政。盖无胜则无复也。气高则高。气下则下者。谓春
气始于下。则五运六气。皆主厥阴之风木。秋气始于上。则五运六气。皆属阳明之燥金。夏气始于前。则五运六气。皆
主少阳之炎暑。冬气始于后。则五运六气。皆属太阳之凝寒。此四时六气。皆有定位之常。非若客气之环转也。此复结
上文之义。）故风胜则动。火胜则肿。燥胜则干。寒胜则浮。湿胜则濡泄。甚则水闭 肿。随气所在。以言其变耳。（首
问五运六气之应。而上章独论六气之变。故复论其五运焉。风热燥寒。四时之气也。以湿土而列于四时之后者。谓土旺
四季。先春夏而后秋冬也。随气所在者。随四时之气。而言五运之胜耳。在者。言风气在春。热气在夏。燥气在秋。寒
气在冬。湿气在于四季。各主七十二日有奇。）帝曰。愿闻其用也。岐伯曰。夫六气之用。各归不胜而为化。故太阴雨化。
施于太阳。太阳寒化。施于少阴。少阴热化。施于阳明。阳明燥化。施于厥阴。厥阴风化。施于太阴。各命其所在以征
之也。（此论五行胜化之为用也。命其所在而征之者。太阴之气。在于长夏。太阳之气在于冬。少阴之气在于夏。阳明之
气在于秋。厥阴之气在于春。如冬有雨化。以征太阴之胜。夏有寒化。以征太阳之胜。此与春胜长夏。长夏胜冬之义相
同。徐振公曰。此即帝所问之有胜有复。在六气为胜复。在四时为胜化。）帝曰。自得其位。何如。岐伯曰。自得其位。
常化也。帝曰。愿闻所在也。岐伯曰。命其位而方月可知也。（自得其位者。四时之六气。各自司其本位。此时化之常也。
厥阴位于正月二月。少阴位于三月四月。各命其位而方之月。则可知六气之所在矣。）帝曰。六位之气。盈虚何如。岐伯
曰。太少异也。太者之至徐而常。少者暴而亡。（此言主时之六气。亦有盛有虚。乃随岁运之太少也。岁运太过。则六位
之气盈。岁运不及。则六位之气虚。盖太过之气。来徐而长。不及之气。来疾而短。故曰少者暴而亡。金西铭曰。太过
之气。先天时而至。故徐而长。不及之气。后天时而至。故暴而短。譬如人之后至。则疾行而趋走矣。）帝曰。天地之气。
盈虚何如。岐伯曰。天气不足。地气随之。地气不足。天气从之。运居其中而常先也。恶所不胜。归所同和。随运归从。
而生其病也。故上胜则天气降而下。下胜则地气迁而上。多少而差其分。微者小差。甚者大差。甚则位易气交。易则大
变生而病作矣。大要曰。甚纪五分。微纪七分。其差可见。此之谓也。（恶去声差叶雌。此论主时之六气。亦有天地盈虚
之分。而上下相胜也。岁半以上。天气主之。岁半以下。地气主之。运居于天地之中。常先天地之气而为之胜。故曰。
随运归从。而生其病。谓天地之气。归从运气。而彼此相胜也。气交、谓三气四气之交。如天气不足。地气随之。则四
之土气。先交于三气之火。如地气不足。天气随之。则三之火气。先交于四气之土。此火土子母相合。谓之归所同和。
乃胜之微者也。微者小差。小差者。在天之纪。仍居七分。而三分交于地。在地之纪。仍居七分。而三分交于天。此上
下气交。不为民病者也。恶所不胜者。恶己所不胜之气也。太阳寒化。施于少阴。阳明燥化。施于厥阴。此下胜则地气
迁而上。厥阴风化。施于太阴。少阴火化。施于阳明。此上胜则天气降而下。乃胜之甚者也。甚者大差。大差者。在天
之纪居五分。而五分直降于下。在地之纪居五分。而五分反迁于上。故曰。甚则位易。气交易。则大变生而病作矣。位
易者。谓越三气四气之位。而初气二气。行于五位六位。五气六气。行于初位二位。此所不胜之气胜之。故曰恶所不胜。
越其位而加之。故曰大变。如归所同和。则不越位矣。）帝曰。善。论言热无犯热。寒无犯寒。余欲不远寒。不远热。奈
何。岐伯曰。悉乎哉问也。发表不远热。攻里不远寒。帝曰。不发不攻。而犯寒犯热。何如。岐伯曰。寒热内贼。其病
益甚。帝曰。愿闻无病者何如。岐伯曰。无者生之。有者甚之。帝曰。生者何如。岐伯曰。不远热。则热至。不远寒。
则寒至。寒至则坚痞腹满。痛急下利之病生矣。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。帝曰。治之奈何。岐伯曰。时必顺之。犯者。治以胜也。（此言主时之六气亦
当远寒而远热者也。按前章之所谓热无犯热。寒无犯寒者。论司天在泉。及加临之六气。此章论主时之六气。亦有寒热
温凉之分。故帝复有此问。辛甘发散为阳。故有病而应发散者。即当远热而不远热矣。酸苦涌泄为阴。如有病而应攻里
者。即当远寒而不远寒矣。如虽病而不宜发表攻里。若妄犯之。则寒热内贼。其病益甚。若无病而不远热。不远寒者。
则坚痞腹满。身热吐下之病生矣。时、谓四时。治以胜者。如犯热则以所胜之寒治之。如犯寒则以所胜之热治之。张玉
师曰。后之病生。与前章之客气。总论亦可。）黄帝问曰。妇人重身。毒之何如。岐伯曰。有故无殒。亦无殒也。帝曰。
愿闻其故何谓也。岐伯曰。大积大聚。其可犯也。衰其大半而止。过者死。（此言胎孕积聚。亦有阴阳寒热之分。所当远
寒而远热者也。重身、谓妊娠而身重。毒者。大寒大热之药也。娠妇始结胎之一月二月。乃木气司养。三月四月主火。
五月六月主土。七月八月主金。九月十月主水。至太阳而五行已周。阴阳水火分。而成后天之形身矣。然未生之前。五
行之气。各有盛有虚。有胜有郁。宜以寒热温凉顺逆而调之。设或有病。而欲不远寒。不远热。亦无伤于胎气。所谓有
故无殒。然亦无过之而致殒也。即如大积大聚。乃属脏腑之五行。尚其可犯寒而犯热者也。若过犯之则死。寒热温凉。
是谓四畏。可不慎诸。此节大有关于治道。学人宜细心体会。附论。七月所生小儿能育。而亦多长寿者。盖七月乃肺藏
司养。肺属天而主气主血。天一生水。感天地之气而生。故育。九月十月。乃少阴太阳所主。皆感阴阳水火而生。若夫
八月乃阳明大肠主气。感阳明之府气而生。故虽生而不育。）帝曰。善。郁之甚者。治之奈何。岐伯曰。木郁达之。火郁
发之。土郁夺之。金郁泄之。水郁折之。然调其气。过者折之。以其畏也。所谓泻之。帝曰。假者何如。岐伯曰。有假
其气。则无禁也。所谓主气不足。客气胜也。（此言四时之郁。而有调治之法也。郁之甚者。太阴施于太阳。则水郁矣。
太阳施于少阴。则火郁矣。少阴施于阳明。则金郁矣。阳明施于厥阴。则木郁矣。厥阴施于太阴。则土郁矣。调治之法。
木郁则舒达之。火郁则发散之。土郁则疏夺之。金郁则泄利之。水郁则折流之。然调其所胜之气。太过者折之。以其畏
而无复也。所谓泻之。谓泻其胜气也。假者。非长夏胜冬。冬胜夏。夏胜秋。秋胜春。春胜长夏。乃主气不足。客气胜
也。如厥阴风木主春。而值阳明金气加临。君相二火主夏。而值太阳寒水加临。长夏湿土主气。而值厥阴风木加临。阳
明金气主秋。而值二火之气加临。太阳寒水主冬。而值太阴土气加临。有假其气。竟以寒热治客气之胜。而主气之寒热。
则无禁也。按此篇所谓六元正纪大论者。六气谓之六元。五运亦感天元而化。首数章论六气之主岁。而五运化于其中。
各有盛有虚。有胜有复。末章论六气之主时。随运归从。上下胜制。有胜有郁而无复。善养生者。皆当随时调养。以参
天地之和。施于天下。流于无穷。乃调变之大关目也。）帝曰。至哉圣人之道。天地大化。营运之节。临御之纪。阴阳之
政。寒暑之令。非夫子孰能通之。请藏之灵兰之室。署曰六元正纪。非斋戒不敢。示慎传也。
（这是五运六气所展现的生养之德。）表现为清凉与肃杀，这是德性的化育。（五类昆虫，感应五运六气的变化而生长发育，所以称为德化的常态。）厥阴风木之气到来时，万物化为毛虫类；少阴君火之气到来时，万物化为羽虫类；太阴湿土之气到来时，万物化为倮虫类（无毛羽鳞介之虫）；少阳相火之气到来时，万物化为羽虫类；阳明燥金之气到来时，万物化为介虫类（有甲壳之虫）；太阳寒水之气到来时，万物化为鳞虫类。这是德化运行的常规规律。（生发、茂盛、坚固、闭藏，是六气的政令，而在四季中宣布施行。）厥阴风木之气到来时，表现为生发之机；少阴君火之气到来时，表现为繁荣之象；太阴湿土之气到来时，表现为湿润之态；少阳相火之气到来时，表现为茂密生长；阳明燥金之气到来时，表现为坚硬收敛；太阳寒水之气到来时，表现为闭藏蓄积。这是政令施行的常规。（飘动愤怒的大凉，是风的变化，凉气由金气承接制约；大热，是火的极盛，寒气由阴精承接制约；雷霆骤雨，是湿土的变异，极则风气承接制约；飘风，风自火出；燔燎霜凝，炎之极盛，极则水气承接制约；散落温，肃杀之极，温热由火气承接制约；寒雪冰雹白埃，是寒冷的极盛，极则土气承接制约。大概气极则变，变则生害，承接才能制约。）厥阴风木之气到来时，表现为动摇不定，往来顺随；少阴君火之气到来时，表现为光明高亢，火焰昏暗；太阴湿土之气到来时，表现为阴沉，白埃弥漫，天色晦暗；少阳相火之气到来时，表现为光明显著，彤云密布，昏暗不明；阳明燥金之气到来时，表现为烟埃飞扬，降霜，劲急切厉，凄厉鸣响；太阳寒水之气到来时，表现为刚强坚固，坚利如芒，挺立不动。这是时令施行的常规。（迎随，指往来流动。彤云，是水泽之气上蒸形成的云。凄鸣，是金气发出的声音。刚固坚芒，是寒凝冰坚的景象。这是六气的时令，在四季中正常施行。）
厥阴风木之气到来时，病证多见腹中拘急疼痛；少阴君火之气到来时，病证多见疮疡疹子，身体发热；太阴湿土之气到来时，病证多见痰饮积聚、痞塞阻隔；少阳相火之气到来时，病证多见喷嚏、呕吐、疮疡；阳明燥金之气到来时，病证多见浮肿虚软；太阳寒水之气到来时，病证多见关节屈伸不利。这是春季疾病的常规规律。（里急，是逆气上升所致。厥阴主春，春气始于下而上行，所以出现里急。阳明主秋，秋气始于上，所以出现浮虚。火生于木，风火相煽，所以出现身热疮疡。土位居中，旺于四季，所以四季都有痞满中满的病证。太阳主筋，为风气所伤，所以出现短缩而屈伸不利。）
少阴君火之气到来时，病证多见惊恐迷惑，恶寒战栗，胡言乱语；太阴湿土之气到来时，病证多见腹部胀满；少阳相火之气到来时，病证多见惊悸烦躁，视物模糊昏蒙，突发疾病；阳明燥金之气到来时，病证多见鼻塞流涕，尻、阴部、股、膝、髀、足等部位发病；太阳寒水之气到来时，病证多见腰痛。这是夏季疾病的常规规律。（“畜”音同“畜”，“瞀”音同“务”，“尻”音同“敲”。）
少阴君火之气到来时，病证多见悲伤妄语、鼻出血；太阴湿土之气到来时，病证多见胸腹满闷，霍乱吐泻；少阳相火之气到来时，病证多见喉痹，耳鸣，呕吐涌溢；阳明燥金之气到来时，病证多见胁痛，皮肤皲裂；太阳寒水之气到来时，病证多见睡中出汗，痉挛。这是秋季疾病的常规规律。（“ 音软”，“戾”叶音“利”，“ ”音蔑，“皴”音逡。“ ”指收缩，“戾”指了戾，即小便排泄关窍的阻滞。厥阴主管前阴，脉络阴器，被燥金所伤，所以出现小便不利。皴，即皱纹。因燥遇燥，所以皮肤皲裂。）
太阴湿土之气到来时，病证多见身体沉重浮肿；少阳相火之气到来时，病证多见暴注下迫，抽搐猝死；阳明燥金之气到来时，病证多见鼻塞喷嚏；太阳寒水之气到来时，病证多见泄泻不禁。这是冬季疾病的常规规律。（心主言语，喜笑是心的情志表现。君火被冬令的寒水逼迫，则心气实而语笑不休。以上四季的各种病证，有的因六气引起，有的因四时引起。学者应引申推演，用心领会，其中的道理自然明了。这里论述的是四时的五运六气，有德、有化、有政、有令、有变、有病。）
这十二种变化，以德报德，以化报化，以政报政，以令报令。气在高处则反应在高处，气在低处则反应在低处，气在后则反应在后，气在前则反应在前，气在中则反应在中，气在外则反应在外。这是位置运行的常规。（以德报德，以化报化，就是说所谓春天有鸣条律畅的化育，秋天就有雾露清凉的政令。没有克制就没有报复。气高则高，气下则下，是说春气始于下，则五运六气都主厥阴的风木；秋气始于上，则五运六气都属于阳明的燥金；夏气始于前，则五运六气都主少阳的炎暑；冬气始于后，则五运六气都属于太阳的凝寒。这四时六气，都有固定的位置常规，不像客气那样环转不息。这是总结上文的意思。）
所以风胜则动摇，火胜则肿胀，燥胜则干燥，寒胜则浮肿，湿胜则濡泄，严重则导致小便闭塞、水肿。随着气所在的不同，来陈述其变化罢了。（首问五运六气的相应，而上章专门论述六气的变化，所以这里再论述五运。风、热、燥、寒，是四时之气。将湿土列在四时之后，是因为土旺于四季，先春夏而后秋冬。随气所在，是随着四时之气而言五运的胜复。在者，是说风气在春，热气在夏，燥气在秋，寒气在冬，湿气在于四季，各自主管七十二天多一点。）
黄帝说：希望听听它的应用。岐伯说：六气的作用，各自归于其所不胜而产生化育。所以太阴的雨化，施加于太阳；太阳的寒化，施加于少阴；少阴的热化，施加于阳明；阳明的燥化，施加于厥阴；厥阴的风化，施加于太阴。各自指定其所在的位置来验证它。（这里论述五行胜化的作用。命其所在而征之，是指太阴之气在长夏，太阳之气在冬天，少阴之气在夏天，阳明之气在秋天，厥阴之气在春天。如冬天有雨化，以此验证太阴的胜气；夏天有寒化，以此验证太阳的胜气。这与春胜长夏、长夏胜冬的道理相同。徐振公说：这就是黄帝所问的有胜有复。在六气方面叫胜复，在四时方面叫胜化。）
黄帝说：如果得到自身的位置，会怎样？岐伯说：得到自身的位置，就是正常的化育。黄帝说：希望听听它们所在的位置。岐伯说：指定其位置，就可以知道对应的方和月份了。（自得其位，是指四时的六气，各自掌管其本位，这是时令化育的常规。厥阴位于正月二月，少阴位于三月四月。各自指定其位置及相应的方月，就可以知道六气所在了。）
黄帝说：六位的运气，盈虚情况如何？岐伯说：太过和不及是不同的。太过的到来缓慢而持久，不及的到来猛烈而短暂。（这里说主时的六气，也有盛有虚，是随着岁运的太过或不及而变化。岁运太过，则六位之气充盈；岁运不及，则六位之气虚弱。大概太过之气，来得慢而且长；不及之气，来得快而且短。所以说不及之气猛烈而短暂。金西铭说：太过之气，先于天时到达，所以慢而长；不及之气，后于天时到达，所以猛烈而短。就像人迟到，就会疾行快走一样。）
黄帝说：天地之气，盈虚情况如何？岐伯说：天气不足，地气随之；地气不足，天气从之。运居于其中，常常先于天地之气。厌恶所不胜之气，归向与之和谐之气，随着运气的归从，而产生疾病。所以上方胜则天气下降，下方胜则地气迁升。多少而有差异，轻微的差异小，严重的差异大。严重到极点则位置改变，气交发生变动，变动则产生大变，疾病也就发作了。大体上说，严重的差异占五分，轻微的差异占七分，这种差异是可以看到的。这就是所说的。（“恶”读去声，“差”叶音“雌”。这里论述主时的六气，也有天地盈虚的区别，以及上下相胜的情况。岁半以上，天气主事；岁半以下，地气主事。运居于天地之中，常常先于天地之气而成为胜气。所以说“随运归从，而生其病”，意思是天地之气归从运气，而彼此相胜。气交，指三气和四气的交接。如天气不足，地气随之，则四之气（土气）先交于三之气（火气）；如地气不足，天气随之，则三之气（火气）先交于四之气（土气）。这是火土子母相合，叫做归所同和，属于胜气轻微的情况。微者小差，小差者，在天之纪仍居七分，而三分交于地；在地之纪仍居七分，而三分交于天。这是上下气交，不会造成民病。恶所不胜，是厌恶自己不能承受的气。太阳寒化施加于少阴，阳明燥化施加于厥阴，这是下胜则地气迁升；厥阴风化施加于太阴，少阴火化施加于阳明，这是上胜则天气下降，属于胜气严重的情况。甚者大差，大差者，在天之纪居五分，而五分直接降于下；在地之纪居五分，而五分反迁于上。所以说严重则位置改变。气交易，则大变生而疾病发作。位易，是指越过三气四气的位置，初气二气运行于五位六位，五气六气运行于初位二位。这是所不胜之气取胜，所以叫恶所不胜。越过其位置而加之，所以叫大变。如果归所同和，就不会越位了。）
黄帝说：好。论中说热无犯热，寒无犯寒，我想既不远离寒也不远离热，该怎么办？岐伯说：问得真详细啊！发表不远热，攻里不远寒。黄帝说：如果不发表不攻里，却犯寒犯热，会怎样？岐伯说：寒热内侵为贼，病情会更加严重。黄帝说：希望听听没有病的人怎么样？岐伯说：没病的会生病，有病的会更重。黄帝说：没病而生病是怎样的？岐伯说：不远热，则热邪至；不远寒，则寒邪至。寒邪至则出现坚硬痞块、腹满、急痛、下利等疾病；热邪至则出现身体发热、呕吐、霍乱、痈疽疮疡、视物模糊郁闷、腹泻不止、抽搐肿胀、呕吐、鼻塞、鼻出血、头痛、骨节变形、肌肉疼痛、出血、淋证等疾病。黄帝说：治疗怎么办？岐伯说：必须顺应时节。违犯的，用能克制它的药来治。（这里说主时的六气也应当远寒远热。按前章所谓热无犯热、寒无犯寒，是论述司天在泉及加临的六气。此章论述主时的六气，也有寒热温凉之分，所以黄帝有此问。辛甘发散为阳，所以有病需要发散者，就应当远热而不远热。酸苦涌泄为阴，如有病需要攻里者，就应当远寒而不远寒。如果虽病但不宜发表攻里，若妄犯之，则寒热内侵为贼，病情加重。若无病而不远热、不远寒，则会产生坚硬痞块、腹满、身热吐下等疾病。时，指四时。治以胜，如犯热则以所胜之寒治之，如犯寒则以所胜之热治之。张玉师说：后来产生的病，与前章的客气总论也可以相通。）
黄帝问道：妇女怀孕，用毒药治疗怎么样？岐伯说：有病则无损伤，胎儿也无损伤。黄帝说：希望听听这是什么意思。岐伯说：有大积大聚，可以触犯（使用猛药），但病势衰去大半就要停止，过度使用会导致死亡。（这里说胎孕积聚，也有阴阳寒热的区分，应当远寒远热。重身，指妊娠身重。毒，指大寒大热的药物。孕妇始结胎的一月二月，由木气司养；三月四月主火；五月六月主土；七月八月主金；九月十月主水。到了太阳，五行已周，阴阳水火分开，形成后天的形身。然而未生之前，五行之气各有盛有虚，有胜有郁，适宜以寒热温凉顺逆来调治。假使有病，想要不远寒、不远热，也不会伤害胎气，所谓有故无殒。但也绝不能过度而导致殒命。就像大积大聚，属于脏腑的五行，尚且可以犯寒犯热。如果过度使用则会致死。寒热温凉，称为四畏，能不谨慎吗？这一节大有关于治道，学者应细心体会。附论：七月出生的小儿能养育，而且多长寿，因为七月是肺脏司养，肺属天而主气主血，天一生水，感天地之气而生，所以能养育。九月十月，由少阴太阳所主，皆感阴阳水火而生。至于八月，由阳明大肠主气，感阳明之腑气而生，所以虽然出生但不能养育。）
黄帝说：好。郁结严重的，怎么治疗？岐伯说：木郁达之，火郁发之，土郁夺之，金郁泄之，水郁折之。然而要调理其气。过盛的予以折损，因为它畏惧克制，这就叫泻法。黄帝说：如果是假象怎么办？岐伯说：如果有假借其气，就没有禁忌。所谓主气不足，客气胜。（这里说四时的郁结，而有调治的方法。郁结严重的，太阴施加于太阳，则水郁；太阳施加于少阴，则火郁；少阴施加于阳明，则金郁；阳明施加于厥阴，则木郁；厥阴施加于太阴，则土郁。调治方法，木郁则舒达之，火郁则发散之，土郁则疏夺之，金郁则泄利之，水郁则折流之。然而要调治其所胜之气，太过者折之，因为它畏惧而没有报复，这就叫泻。谓泻其胜气。假者，不是长夏胜冬、冬胜夏、夏胜秋、秋胜春、春胜长夏，而是主气不足，客气胜。如厥阴风木主春，而值阳明金气加临；君相二火主夏，而值太阳寒水加临；长夏湿土主气，而值厥阴风木加临；阳明金气主秋，而值二火之气加临；太阳寒水主冬，而值太阴土气加临。有假借其气，竟以寒热治疗客气的胜气，而主气的寒热就没有禁忌了。按此篇所谓六元正纪大论，六气叫六元，五运也感天元而化。首数章论六气之主岁，而五运化于其中，各有盛有虚，有胜有复。末章论六气之主时，随运归从，上下胜制，有胜有郁而无复。善于养生的人，都应当随时调养，以参天地之和，施于天下，流于无穷，这是调变的大关键。）
黄帝说：真是伟大啊，圣人的道！天地的大化，营运的节律，临御的纲纪，阴阳的政令，寒暑的命令，如果不是先生谁能通晓？请藏在灵兰之室，题名为六元正纪，不斋戒不敢示人，以示慎重传授。
(The virtue of generation.) Manifesting as coolness and肃ness (solemnity/restriction), this is the transformation of virtue. (The five categories of insects, sensing the changes of the Five Movements and Six Qi, grow and reproduce; thus it is called the constant pattern of virtuous transformation.) When Jueyin (Liver/Gallbladder) arrives, transformation into hairy creatures occurs. When Shaoyin (Heart/Pericardium) arrives, transformation into feathered creatures occurs. When Taiyin (Spleen/Stomach) arrives, transformation into naked creatures (those without hair, feathers, scales, or shells) occurs. When Shaoyang (Sanjiao/Gallbladder) arrives, transformation into feathered creatures occurs. When Yangming (Large Intestine/Lung) arrives, transformation into shelled creatures occurs. When Taiyang (Bladder/Kidney) arrives, transformation into scaled creatures occurs. This is the constant pattern of virtuous transformation. (Generation, flourishing, firmness, and storage are the administration of the Six Qi, announced across the four seasons.) When Jueyin arrives, it brings the transformation of generation. When Shaoyin arrives, it brings the transformation of flourishing. When Taiyin arrives, it brings the transformation of moistening. When Shaoyang arrives, it brings the transformation of lushness. When Yangming arrives, it brings the transformation of firmness. When Taiyang arrives, it brings the transformation of storage. This is the constant pattern of administration. (Drifting anger and great coolness represent the variation of wind, with coolness being controlled by Metal Qi. Great heat represents the excess of Fire, with coldness being controlled by Yin Essence. Thunder and sudden rain represent the variation of Wet Earth, where at the extreme, Wind Qi takes control. Drifting wind arises from Fire. Blazing fires and frost condensation represent the excess of flame, where at the extreme, Water Qi takes control. Scattering and warmth represent the excess of desiccation, with warmth being controlled by Fire Qi. Cold snow, hail, and white dust represent the excess of cold, where at the extreme, Earth Qi takes control. Generally, when Qi reaches its extreme, it transforms; transformation leads to harm; control through succession prevents disaster.) When Jueyin arrives, it manifests as agitation and following. When Shaoyin arrives, it manifests as brightness and height, flames dimming. When Taiyin arrives, it manifests as deep yin, white dust, and obscurity. When Shaoyang arrives, it manifests as radiance, red clouds, and dimness. When Yangming arrives, it manifests as smoke and dust, frost, sharpness, and mournful sounds. When Taiyang arrives, it manifests as rigidity, hardness like thorns, and standing still. This is the constant pattern of commands. (Following refers to coming and going. Red clouds are formed by the evaporation of moisture rising into clouds. Mournful sounds are the voice of Metal Qi. Rigidity, firmness, and sharpness are images of cold coagulation and ice hardening. These are the commands of the Six Qi, operating constantly in the four seasons.)
When Jueyin arrives, diseases often present as abdominal urgency. When Shaoyin arrives, diseases often present as sores and rashes, with body heat. When Taiyin arrives, diseases often present as accumulation of fluids, stagnation, and obstruction. When Shaoyang arrives, diseases often present as sneezing, vomiting, and sores. When Yangming arrives, diseases often present as floating emptiness. When Taiyang arrives, diseases often present as difficulty in flexion and extension. This is the constant pattern of spring diseases. (Abdominal urgency is caused by rebellious Qi rising upward. Jueyin governs Spring; Spring Qi begins below and moves upward, hence abdominal urgency. Yangming governs Autumn; Autumn Qi begins above, hence floating emptiness. Fire is born from Wood; wind and fire fan each other, hence body heat and sores. Earth resides in the center and prospers in all four seasons, hence diseases of fullness and middle-jiao distension in all seasons. Taiyang governs tendons; injured by wind Qi, hence shortening and difficulty in flexion and extension.)
When Shaoyin arrives, diseases often present as fright, confusion, aversion to cold, trembling, and delirium. When Taiyin arrives, diseases often present as abdominal fullness. When Shaoyang arrives, diseases often present as fright and restlessness, visual obscuration, and sudden illness. When Yangming arrives, diseases often present as nasal congestion, and ailments of the sacrum, yin region, thighs, knees, hips, and feet. When Taiyang arrives, diseases often present as lower back pain. This is the constant pattern of summer diseases. ("Xu" sounds like "xu"; "Mao" sounds like "wu"; "Qiao" sounds like "qiao".)
When Shaoyin arrives, diseases often present as sorrow, delirium, and epistaxis. When Taiyin arrives, diseases often present as central fullness, cholera-like vomiting and diarrhea. When Shaoyang arrives, diseases often present as throat bi, tinnitus, and surging vomiting. When Yangming arrives, diseases often present as hypochondriac pain and skin cracking. When Taiyang arrives, diseases often present as nocturnal sweating and spasms. This is the constant pattern of autumn diseases. ("Ruan", "Li" rhymes with "li", "Min" sounds like "mie", "Cun" sounds like "qun". "Ruan" means contraction; "Li" means obstruction, specifically of the urinary passage. Jueyin governs the anterior yin and meridians of the genitalia; injured by Dryness Metal, hence urinary obstruction. Cun means wrinkles. Due to dryness meeting dryness, the skin cracks.)
When Taiyin arrives, diseases often present as heavy swelling. When Shaoyang arrives, diseases often present as sudden diarrhea, convulsions, and sudden death. When Yangming arrives, diseases often present as nasal congestion and sneezing. When Taiyang arrives, diseases often present as uncontrolled discharge. This is the constant pattern of winter diseases. (The Heart governs speech; laughter is the emotion of the Heart. When Ministerial Fire is pressured by the cold water of Winter, Heart Qi becomes excessive, leading to incessant speech and laughter. The aforementioned diseases of the four seasons arise either from the Six Qi or the Four Seasons. Scholars should extend and infer, understanding the meaning through contemplation. This discusses the Five Movements and Six Qi of the four seasons, possessing virtue, transformation, administration, command, variation, and disease.)
These twelve variations respond to virtue with virtue, to transformation with transformation, to administration with administration, and to command with command. Qi high responds high; Qi low responds low; Qi rear responds rear; Qi front responds front; Qi center responds center; Qi exterior responds exterior. This is the constant pattern of position. (Responding to virtue with virtue... implies that if Spring has the transformation of rustling branches and smooth flow, Autumn will have the administration of fog, dew, coolness, and clarity. Without overcoming, there is no retaliation. Qi high responds high... means Spring Qi begins below, so the Five Movements and Six Qi are governed by Jueyin's Wind-Wood; Autumn Qi begins above, so they belong to Yangming's Dryness-Metal; Summer Qi begins forward, so they are governed by Shaoyang's Heat-Scorch; Winter Qi begins backward, so they belong to Taiyang's Congealed-Cold. These four seasons' Six Qi have fixed positional constants, unlike the circulating Guest Qi. This reiterates the previous text.)
Therefore, Wind excess causes movement; Fire excess causes swelling; Dryness excess causes dryness; Cold excess causes edema; Dampness excess causes loose stools; severely, it causes water retention and edema. Speaking of variations according to where the Qi resides. (The initial question concerns the response of the Five Movements and Six Qi; the previous chapter discussed only the variations of Six Qi; thus, the Five Movements are discussed here again. Wind, Heat, Dryness, and Cold are the Qi of the four seasons. Wet Earth is listed after the four seasons because Earth prospers in all four seasons, prioritizing Spring/Summer then Autumn/Winter. "Where the Qi resides" refers to speaking of the overcoming of the Five Movements according to the Qi of the four seasons. "Resides" means Wind Qi in Spring, Heat Qi in Summer, Dryness Qi in Autumn, Cold Qi in Winter, and Dampness Qi in the four seasons, each governing slightly more than 72 days.)
The Emperor said: I wish to hear about their application. Qibo said: The function of the Six Qi returns to what it cannot overcome to produce transformation. Thus, Taiyin's Rain Transformation applies to Taiyang; Taiyang's Cold Transformation applies to Shaoyin; Shaoyin's Heat Transformation applies to Yangming; Yangming's Dryness Transformation applies to Jueyin; Jueyin's Wind Transformation applies to Taiyin. Assign their respective positions to verify them. (This discusses the function of the Five Elements' overcoming transformation. Assigning positions to verify means: Taiyin Qi is in Late Summer, Taiyang Qi in Winter, Shaoyin Qi in Summer, Yangming Qi in Autumn, Jueyin Qi in Spring. If Winter has Rain Transformation, it verifies Taiyin's overcoming; if Summer has Cold Transformation, it verifies Taiyang's overcoming. This is consistent with the principle of Spring overcoming Late Summer and Late Summer overcoming Winter. Xu Zhen Gong said: This is exactly what the Emperor asked about—overcoming and retaliation. In Six Qi, it is called overcoming and retaliation; in Four Seasons, it is called overcoming transformation.)
The Emperor said: What happens when one obtains their own position? Qibo said: Obtaining one's own position is the normal transformation. The Emperor said: I wish to know their locations. Qibo said: By assigning their positions, the directions and months can be known. (Obtaining one's own position means the Six Qi of the four seasons each manage their original positions; this is the constant of seasonal transformation. Jueyin is located in the first and second months; Shaoyin in the third and fourth months. By assigning their positions and corresponding directions/months, the location of the Six Qi can be known.)
The Emperor said: How do the Six Positions of Qi fluctuate between fullness and deficiency? Qibo said: Excess and insufficiency are different. The arrival of Excess is slow and constant; the arrival of Insufficiency is violent and brief. (This states that the Six Qi governing the seasons also have prosperity and deficiency, following the year's movement of Excess or Insufficiency. Yearly Movement Excess leads to full Qi in the six positions; Yearly Movement Insufficiency leads to deficient Qi. Excess Qi arrives slowly and lasts long; Insufficient Qi arrives quickly and is short. Hence, Insufficiency is violent and brief. Jin Ximing said: Excess Qi arrives before the season, hence slow and long; Insufficient Qi arrives after the season, hence violent and short. Like a person arriving late, running fast.)
The Emperor said: How do Heaven and Earth Qi fluctuate? Qibo said: When Heaven Qi is insufficient, Earth Qi follows; when Earth Qi is insufficient, Heaven Qi follows. Movement resides in the middle and is always prior. It dislikes what it cannot overcome and returns to what harmonizes with it. Following the Movement's return generates disease. Therefore, upper overcoming causes Heaven Qi to descend; lower overcoming causes Earth Qi to ascend. There are differences in degree. Minor differences are small; major differences are large. Extreme cases lead to positional exchange and Qi intersection; exchange leads to major changes and disease onset. Generally, major differences account for five parts, minor differences for seven parts; these differences are visible. This is what is meant. ("E" pronounced as falling tone; "Cha" rhymes with "ci". This discusses the Six Qi governing seasons having Heaven/Earth fullness/deficiency and upper/lower overcoming. First half of the year, Heaven Qi governs; second half, Earth Qi governs. Movement resides between Heaven and Earth, always preceding Heaven/Earth Qi as the overcoming force. "Returning to Movement...": Heaven/Earth Qi return to Movement Qi, overcoming each other. Qi Intersection refers to the junction of Third and Fourth Qi. If Heaven Qi is insufficient, Earth Qi follows, so Fourth Qi (Earth) intersects Third Qi (Fire) first. If Earth Qi is insufficient, Heaven Qi follows, so Third Qi (Fire) intersects Fourth Qi (Earth) first. This Fire-Earth mother-child harmony is called returning to harmony, a minor overcoming. Minor difference: In Heaven's record, it remains seven parts, three intersect Earth; in Earth's record, it remains seven parts, three intersect Heaven. This upper-lower intersection does not cause public disease. Disliking what it cannot overcome: Disliking the Qi one cannot withstand. Taiyang Cold applies to Shaoyin, Yangming Dryness applies to Jueyin—this is lower overcoming causing Earth Qi to ascend. Jueyin Wind applies to Taiyin, Shaoyin Fire applies to Yangming—this is upper overcoming causing Heaven Qi to descend. This is severe overcoming. Major difference: In Heaven's record, five parts remain, five directly descend; in Earth's record, five parts remain, five reverse ascend. Hence, severe cases involve positional exchange. Positional exchange means exceeding the positions of Third/Fourth Qi; First/Second Qi operate in Fifth/Sixth positions; Fifth/Sixth Qi operate in First/Second positions. This is the Qi one cannot overcome winning, hence "disliking what it cannot overcome." Exceeding position is called major change. Returning to harmony avoids exceeding position.)
The Emperor said: Excellent. The theory says "Do not violate Heat with Heat, do not violate Cold with Cold." I wish to neither distance myself from Cold nor from Heat. What should I do? Qibo said: Your inquiry is thorough. For releasing the exterior, do not distance from Heat; for attacking the interior, do not distance from Cold. The Emperor said: What if neither releasing nor attacking, but violating Cold and Heat? Qibo said: Cold and Heat invade internally as thieves, and the disease worsens. The Emperor said: What about those without disease? Qibo said: Those without disease will develop it; those with disease will worsen. The Emperor said: How does developing disease occur? Qibo said: Not distancing from Heat leads to Heat arrival; not distancing from Cold leads to Cold arrival. Cold arrival causes hard masses, abdominal fullness, urgent pain, and diarrhea. Heat arrival causes body heat, vomiting, cholera, carbuncles, sores, visual obscuration, diarrhea, convulsions, swelling, vomiting, nasal congestion, epistaxis, headache, joint deformation, muscle pain, bleeding, and strangury. The Emperor said: How to treat? Qibo said: One must conform to the time. Violators are treated by what overcomes them. (This states that the Six Qi governing seasons should also avoid Cold and Heat. The previous chapter's "Do not violate..." referred to Sovereign/Guest Qi and added Qi. This chapter refers to governing Qi, which has Cold/Heat/Warm/Cool distinctions, hence the Emperor's question. Pungent/Sweet dispersing is Yang; for diseases requiring dispersion, one should avoid Heat but not Cold. Sour/B bitter draining is Yin; for diseases requiring purgation, one should avoid Cold but not Heat. If diseased but inappropriate for dispersion/purgation, violating them causes internal invasion, worsening disease. If healthy and not avoiding Cold/Heat, diseases like hard masses, fullness, heat, vomiting arise. "Time" refers to four seasons. Treating by overcoming: if violating Heat, use Cold (what overcomes Heat); if violating Cold, use Heat. Yu Zhishi said: Subsequent diseases relate to the previous chapter's Guest Qi general discussion.)
The Yellow Emperor asked: If a woman is pregnant, how should toxic drugs be used? Qibo said: If there is pathology, there is no injury [to the mother], and no injury [to the fetus]. The Emperor said: Explain this. Qibo said: For large accumulations and masses, they can be attacked, but stop when more than half is reduced; exceeding this leads to death. (This states pregnancy/masses have Yin/Yang/Cold/Heat distinctions, requiring avoidance of Cold/Heat. "Heavy body" means pregnancy. "Toxic" refers to extreme Cold/Hot drugs. Months 1-2 of conception are governed by Wood; 3-4 by Fire; 5-6 by Earth; 7-8 by Metal; 9-10 by Water. By Taiyang, the Five Elements cycle completes, Yin/Yang and Water/Fire separate, forming the postnatal body. Before birth, Five Element Qi varies in excess/deficiency and overcoming/stagnation, suitable for regulation via Cold/Heat/Warm/Cool and reversal/compliance. If diseased and needing non-avoidance of Cold/Heat, it won't harm fetal Qi—"if there is pathology, no injury." But do not exceed to cause injury. Even large masses, belonging to Zang-Fu elements, can be attacked with Cold/Heat. Overdoing it causes death. Cold/Heat/Warm/Cool are the Four Feared things; caution is needed. This section is crucial for medical practice; scholars should reflect carefully. Appendix: Infants born in the 7th month survive and live long because Lung governs then; Lung belongs to Heaven, governs Qi and Blood; Heaven generates Water, sensing Heaven/Earth Qi, hence survival. Months 9-10 are governed by Shaoyin/Taiyang, sensing Yin/Yang/Water/Fire, hence survival. Month 8 is governed by Yangming Large Intestine; sensing Yangming Fu Qi, hence birth without survival.)
The Emperor said: Excellent. For severe stagnation, how to treat? Qibo said: Stagnation of Wood, reach it; Stagnation of Fire, emit it; Stagnation of Earth, seize it; Stagnation of Metal, drain it; Stagnation of Water, restrain it. However, regulate the Qi. Excess is restrained because it fears control; this is called purging. The Emperor said: What about false conditions? Qibo said: If there is false Qi, there are no prohibitions. This refers to insufficient Host Qi and victorious Guest Qi. (This discusses methods for regulating seasonal stagnation. Severe stagnation: Taiyin applies to Taiyang, causing Water stagnation; Taiyang applies to Shaoyin, causing Fire stagnation; Shaoyin applies to Yangming, causing Metal stagnation; Yangming applies to Jueyin, causing Wood stagnation; Jueyin applies to Taiyin, causing Earth stagnation. Regulation: Wood stagnation—expand; Fire stagnation—disperse; Earth stagnation—purge; Metal stagnation—drain; Water stagnation—restrain. Regulate the overcoming Qi. Excess is restrained because it fears control without retaliation; this is purging the overcoming Qi. False conditions refer to Host Qi insufficiency and Guest Qi victory, e.g., Jueyin Wind in Spring met by Yangming Metal; Ministerial Fire in Summer met by Taiyang Cold; Late Summer Wet Earth met by Jueyin Wind; Yangming Metal in Autumn met by Two Fires; Taiyang Cold in Winter met by Taiyin Earth. With false Qi, treat Guest Qi victory with Cold/Heat, while Host Qi Cold/Heat has no prohibition. Note: "Six Yuan Zheng Ji Da Lun" means Six Qi are Six Origins; Five Movements also transform via Heavenly Origin. Early chapters discuss Six Qi governing years, with Five Movements transforming within, having excess/deficiency and overcoming/retaliation. Final chapter discusses Six Qi governing seasons, following Movement return, upper/lower overcoming, having overcoming/stagnation but no retaliation. Good health preservation requires seasonal adjustment to participate in Heaven/Earth harmony, applied to the world, infinite. This is the key to regulation.)
The Emperor said: Great is the Way of the Sages! The great transformation of Heaven and Earth, the rhythm of operation, the discipline of governance, the policy of Yin and Yang, the order of Cold and Heat—who but you, Master, could understand it? Please store it in the Linglan Chamber, titled "Six Yuan Zheng Ji," and I will not show it without fasting and purification, showing cautious transmission.