不治已病治未病
与其救疗于有疾之后，不若摄养于无疾之先，盖疾成而后药者，徒劳而
已。是故已疾而不治，所以为医家之法，未病而先治，所以明摄生之理。夫如是则思患而预
防之者，何患之有哉？此圣人不治已病治未病之意也。尝谓备土以防水也，苟不以闭塞其涓
涓之流，则滔天之势不能遏；备水以防火也，若不以扑灭其荧荧之光，则燎燎之焰不能止。
其水火既盛尚不能止遏，况病已成，岂能治欤？故宜夜卧早起于发陈之春，早起夜卧于蕃莠
之夏，以之缓形无怒而遂其志，以之食凉食寒而养其阳，圣人春夏治未病者如此。与鸡俱兴
于容平之秋，必待日光于闭藏之冬，以之敛神匿志而私其意，以之食温食热而养其阴，圣人
秋冬治未病者如此。或曰∶见肝之病，先实其脾脏之虚，则木邪不能传，见右颊之赤，先泻
其肺金之热，则金邪不能盛，此乃治未病之法。今以顺四时调养神志而为治未病者，是何意
耶？盖保身长全者，所以为圣人之道，治病十全者，所以为上工术，不治已病治未病之说，
着于“四气调神大论”，厥有旨哉！昔黄帝与天师难疑答问之书，未尝不以摄养为先，始论
乎
天真，次论乎调神，既以法于阴阳，而继之以调于四气，既曰食饮有节，而又继之以起居有
常，谆谆然以养生为急务者，意欲治未然之病，无使至于已病难图也。厥后秦缓达乎此，见
晋候病在膏肓，语之曰∶不可为也。扁鹊明乎此，见齐侯病至骨髓，断之曰∶不可救也。噫！
惜齐晋之候，不知
亢则害承乃制
气之来也，既以极而成灾，则气之乘也，必以复而得平。物极则反，理之
自然也。大抵寒、暑、燥、湿、风、火之气，木、火、土、金、水之形，亢极则所以害其物，
承乘则所以制其极。然则，极而成灾，复而得平，气运之妙，灼然而明矣。此亢则害承乃制
之意。原夫天地阴阳之机，寒极生热，热极生寒，至神不测，有以斡旋宰制于其间也。故木
极而似金，火极而似水，土极而似木，金极而似火，水极而似土。盖气之亢极，所以承之者，
反胜于已也。夫惟承其亢而制其害者，造化之功可得而成也。今夫相火之下，水气承而火无
其变；水位之下，土气承而水无其灾；土位之下，木承而土顺；风位之下，金乘而风平。火
热成其燥金，自然金家之疾；阴精承其君火，自然火家之候。所谓亢而为害，承而乃制者，
如斯而已。且尝考之《六元正纪大论》云∶少阳所至为火生，终为蒸溽。（火化以生，则火
生也。阳在上，故终为蒸溽。）是水化以承相火之意。太阳所至为寒雪、冰雹、白埃，是土
化以承寒水之意也。（霜雪冰雹，水也。白埃下承土也。）以至太阴所至为雷霆骤注烈风，（雷
霆骤注，土也。烈风下承之木气也。）厥阴所至为风生，终为肃，（风化以生，则风生也。肃，
静也。）阳明所至为散落温，（散落，金也。温下承之火气也。）少阴所至为热生，中为寒。（热
化以生，则热生也。阴精承上，故中为寒也。）岂非亢为害则承乃制者欤？昔者黄帝与岐伯
上穷天纪，下极地理，远取诸物，近取诸身，更相问难，以作《内经》，至于《六微旨大论》
有及于六气相承之言，以为制则生化，外列盛衰，害则败乱，生化大病。诸以所胜之气承于
下者，皆折其标盛也，不然曷以水发而电雪，土发而骤飘，木发而毁折，金发而清明，火发
而熏昧。此皆郁极乃发，以承所亢之意也。呜呼！通天地人，曰僵医家者流，岂止治疾而已，
当
审察病机无失气宜
邪气各有所属也，当穷其要于前；治法各有所归也，当防其差于后。盖治病之要，从穷
其所属为先。苟不知法之所归，未免于无差尔。是故疾病之生，不胜其众，要其所属，不出
乎五运六气而已。诚能于此审察而得其机要，然后为之治，又必使之各应于运气之宜，而不
至有一毫差误之失。若然，则治病求属之道庶乎其无愧矣。《至真要大论》曰∶审察病机，
无失气宜。意蕴诸此。尝谓医道有一言而可以尽其要者，运气是也。天为阳，地为阴。阴阳
二气各分三品，谓之三阴三阳。然天非纯阳，而亦有三阴；地非纯阴，而亦有三阳。故天地
上下，各有风热火湿燥寒之六气，其斡旋运动乎两间者，而又有木火土金水之五运，人生其
中，脏腑气穴亦与天地相为流通，是知众疾之作，而所属之机无出乎是也。然而医之为治，
当如何哉？惟当察乎此，使无失其宜而后可。若夫诸风掉眩，皆属肝木；诸痛痒疮，皆属心
火；诸湿肿满，皆属脾土；诸气恚郁，皆属肺金；诸寒收引，皆属肾水；此病机属于五运者
也。诸暴强直，皆属于风；诸呕吐酸，皆属于热；诸躁扰狂越，皆属于火；诸痉强直，皆属
于湿；诸涩枯涸，皆属于燥；诸病水液，澄彻清冷，皆属于寒；此病机属于六气者也。夫惟
病机之察，虽曰既审，而治病之施亦不可不详。故必别阴阳于疑似之间，辨标本于隐微之际。
有无之殊者，求其有无之所以殊；虚实之异者，责其虚实之所以异。为汗吐下，投其所当投，
寒热温凉，用其所当用。或逆之以制其微，或从之以导其甚。上焉以远司气之犯，中焉以辨
岁运之化，下焉以审南北之宜，使大小适中，先后合度，以是为治，又岂有差殊乖乱之失耶？
又
六元正纪大论》曰∶无失天信，无逆气宜。《五常政大论》曰∶必先岁气，无伐天和。此皆
无失气宜之意也。故《素问》、《灵枢》之经，未尝不以气运为言。既曰∶先立其年，以明
其气。复有以戒之曰∶治病者必明天道地理，阴阳更胜。既曰∶不知年之所加，气之盛衰，
虚实之所起，不可以为工矣。谆谆然若有不能自已者，是岂圣人私忧过计哉？以医道之要，
悉在乎此也。观乎《原病式》一书，比类物象，深明乎气运造化之妙，其于病机气宜之理不
可以有加矣。
能合色脉可以万全
欲知其内者，当以观乎外，诊于外者，斯以知其内。盖有诸内者形诸
外，苟不以相参而断其病邪之逆顺，不可得也。为工者，深烛厥理。故望其五色以青黄赤白
黑，以合于五脏之脉，穷其应与不应。切其五脉急大缓涩沉，以合其五脏之色顺与不顺。诚
能察其精微之色，诊其微妙之脉，内外相参而治之，则万举万全之功可坐而致矣。《素问》
曰∶能合色脉，可以万全，其意如此。原夫道之一气，判而为阴阳，散而为五行，而人之所
禀皆备焉。夫五脉者，天之真，行血气，通阴阳，以营于身。五色者，气之华，应五行，合
四时，以彰于面。惟其察色按脉而不偏废，然后察病之机，断之以寒热，归之以脏腑，随证
而疗之，而获全济之效者，本于能合色脉而已。假令肝色如翠羽之青，其脉微弦而急，所以
为生，若浮涩而短，色见如草滋者，岂能生乎？心色如鸡冠之赤，其脉当浮大而散，所以为
顺，若沉濡而滑，色见如 血者，岂能顺乎？脾色如蟹腹之黄，其脉当中缓而大，所以为从；
若微弦而急，色见如枳实者，岂能从乎？肺色如豕膏之白，其脉当浮涩而短，所以为吉；若
浮大而散，色见如枯骨者，岂能吉乎？从至肾色见如乌羽之黑，其脉沉濡而滑，所以为生，
或脉来缓而大，色见如炱者死。死生之理，夫惟诊视相参。既以如此，则药证相对，厥疾弗
瘳者，未之有也。抑尝论之∶容色所见，左右上下各有其部，脉息所动，寸关尺中皆有其位。
左颊者，肝之部，以合左手关位；肝胆之分，应于风木，为初之气。颜为心之部，以合于左
手寸口，心与小肠之分，应于君火，为二之气。鼻为脾之部，合于右手关脉，脾胃之分，应
于湿土，为四之气。右颊肺之部，合于右手寸口，肺与大肠之分，应于燥金，为五之气。
颐为肾之部，以合于左手尺中，肾与膀胱之分，应于寒水，为终之气。至于相火，为
三之气，应于右手命门、三焦之分也。若夫阴阳五行相生相胜之理，当以合之于色脉而推之
也。是故《脉要精微论》曰∶色合五行，脉合阴阳。《十三难》曰∶色之与脉，当参相应。
然而治病万全之功，苟非合于色脉者，莫之能也。《五脏生成》篇云∶心之合脉也，其营色
也。夫脉之大小、滑涩、沉浮，可以指别；五色微诊，可以目察。继之以能合色脉，可以万
全。谓夫赤脉之至也，喘而坚；白脉之至也，喘而浮；青脉之至也，长而左右弹；黄脉之至
也，大而虚；黑脉之至也，上坚而大。此先言五色，次言五脉。欲后之学人，望而切之，以
相合也。厥后，扁鹊明乎此，述之曰∶望而知之谓之神，切脉而知之谓之巧。深得《内经》
之理也。下迨后世，有立方者，目之曰神巧万全，厥有旨哉！
治病必求于本
将以施其疗疾之法，当以穷其受病之源。盖疾源之源，不离于阴阳二邪也，穷此而疗之，
厥疾勿瘳者鲜矣。良工知其然，谓夫风热火之病，所以属乎阳邪之所客，病既本于阳，苟不
求其本而治之，则阳邪滋蔓而难制。湿燥寒之病，所以属乎阴邪之所客，病既本于阴，苟
不求其本而治之，则阴邪滋蔓而难图。诚能穷原疗疾，各得其法，万举万全之功可坐而致也。
治病必求于本见于《素问·阴阳应象大论》者如此。夫邪气之基，久而传化，其变证不胜其
众也。譬如水之有本，故能荐至汪洋浩瀚，派而趋下以渐大。草之有本，故能荐生茎叶，实
秀而在上以渐蕃。若病之有本，变化无穷，苟非必求其本而治之，欲去深感之患，不可得也。
今夫厥阴为标，风木为本，其风邪伤于人也，掉摇而眩转， 动而螈 ，猝暴强直之病生矣。
少阴为标，君火为本，其热邪伤于人也，疮疡而痛痒，暴注而下迫，水液浑混之病生矣。少
阳为标，相火为本，其火邪伤于人也，为热而瞀螈，躁扰而狂越，如丧神守之病生矣。善为
治者，风淫所胜，平以辛凉。热淫所胜，平以咸寒。火淫所胜，平以咸冷。以其病本于阳，
必求其阳而疗之，病之不愈者未之有也。太阴为标，湿土为本，其湿邪伤于人也，腹满而身
肿，按之而没指，诸 强直之病生矣。阳明为标，燥金为本，其燥邪伤于人也，气滞而恚郁，
皮肤以皱揭，诸涩枯涸之病生矣。太阳为标，寒水为本，其寒邪伤于人也，吐利而腥秽，水
液以清冷，诸寒收引之病生矣。善为治者，湿淫所胜，平以苦热。燥淫所胜，平以苦温。寒
淫所胜，平以辛热。以其病本于阴，必求其阴而治之，病之不愈者未之有也。岂非将以施其
疗疾之法当以穷其受病之源者哉？抑尝论之邪气为病，各有其候，治之之法，各有其要，亦
岂止于一端而已。其在表者，汗而发之；其入里者，下而夺之；其在高者，因而越之，谓可
吐也；剽悍者，按而收之，谓按摩也。脏寒虚夺者，治以灸 ；脉病挛痹者，治以针刺；血
实蓄结肿热者，治之砭石；气滞痿厥寒热者，治以导引；经络不通，病生于不仁者，治以醪
醴；血气凝泣，病生于筋脉者，治以熨药。始焉求其受病之本，终焉蠲其为病之邪者，无出
于此也。噫！昔黄帝处于法宫之中，坐于明堂之上，受业于歧伯，传道于雷公，曰∶阴阳者
，天地之道也，纲纪万物变化生杀之妙。盖有不测之神，斡旋宰制于其间也。人或受邪生病
，不离于阴阳也。病既本于此，为工者岂可他求哉？必求于阴阳可也。《至真要大论》曰∶
有者求之，无者求之。此求其病机之说，与夫求于本其理一也。
大抵四时以胃气为本，然治病必须先诊六脉，皆有胃气，外证虽重，病亦可治。胃气未
绝，则药力营运而输散于皮毛经络，故易治而生。胃气既绝，则药虽对证，不能使其运用以
输精于皮毛经络。真脏独见而药不及矣，遂成不治之证也。东垣曰∶脉贵有神。有神者，有
胃气之谓也。故诸经方论皆曰有病早治疗，不令邪气深入。所以圣人治未病，不治已病，正
谓此也。
**不治已病治未病**
与其在疾病发生后再去救治，不如在尚未患病时先进行调养。因为疾病形成后才用药治疗，只是徒劳无功罢了。因此，对于已经形成的疾病而不予治疗（指通过预防避免其发生），是医家的法则；在疾病未发之前先进行干预，是为了阐明养生的道理。如果能这样思虑祸患并预先防范，还有什么祸患呢？这正是圣人“不治已病，只治未病”的深意。
这就好比用土来防水，如果不堵塞那涓涓细流，滔天的水势就无法遏制；又比如用水来防火，如果不扑灭那微弱的火光，燎原的大火就无法停止。当水火之势已经盛大时尚且不能阻止，何况疾病已经形成，又怎么能治愈呢？
所以，在万物生发的春季，应当晚睡早起；在万物繁茂的夏季，应当早起晚睡；以此来舒展形体、控制怒气、顺遂心意，食用清凉寒凉的食物以保养阳气。圣人春夏季节防治未病的方法就是这样。在万物收敛的秋季，应当与鸡鸣同时起床；在万物闭藏的冬季，应当等到日出才起床；以此来收敛神志、隐藏意念、节制欲望，食用温热食物以保养阴气。圣人秋冬季节防治未病的方法就是这样。
有人问：看到肝脏有病，先充实脾脏的虚弱，那么肝木之邪就不能传变；看到右脸颊发红，先清泻肺金的火热，那么肺金之邪就不会亢盛，这是治疗未病的法则。现在您却把顺应四时调养神志作为治未病的方法，这是什么意思呢？
大概保全身体长久完整，是圣人的道；治病十全十美，是上工的技术。“不治已病治未病”的说法，记载于《素问·四气调神大论》中，其中确实有深刻的旨意啊！
从前黄帝与天师问答的书信中，未曾不以调养为先，首先论述天真之气，其次论述调摄神志，接着效法阴阳，继而又调理四时之气，既说饮食要有节制，又说起居要有规律，谆谆教导以养生为急务，意图在于治疗尚未发生的疾病，不让它发展到难以医治的地步。
后来秦越人（扁鹊）通达这个道理，看到晋侯的病在膏肓，告诉他说：“不可治了。”扁鹊明白这个道理，看到齐侯的病深入骨髓，断言说：“无法挽救了。”唉！可惜齐侯和晋侯不知道这一点。
**亢则害承乃制**
气的到来，既然到了极点就会成为灾害，那么气的乘袭，必然通过报复（制约）来达到平衡。事物发展到极端就会向反面转化，这是自然的道理。
大致来说，寒、暑、燥、湿、风、火六气，木、火、土、金、水五行，亢盛到极点就会伤害万物，受到承接和乘袭就能制约这种极端。既然如此，达到极端就成灾祸，得到报复制约就恢复平衡，气运的奥妙，明显可见了。这就是“亢则害，承乃制”的意思。
推究天地阴阳的机理，寒极生热，热极生寒，变化神妙莫测，在其中起着运转主宰的作用。所以木气极盛时似金，火气极盛时似水，土气极盛时似木，金气极盛时似火，水气极盛时似土。这是因为气亢盛到极点，承接制约它的力量反而胜过它自己。只有承接亢盛之气并制约其危害，造化的功能才能完成。
如今，相火之下，有水气承接，所以火没有变异；水位之下，有土气承接，所以水没有灾害；土位之下，有木气承接，所以土气顺遂；风位之下，有金气乘袭，所以风气平息。火热成就燥金，自然属于金家的病症；阴精承接君火，自然属于火家的症候。所谓亢盛成为危害，承接从而制约，就是这样的。
我曾考察《素问·六元正纪大论》说：少阳所至表现为火生，最终表现为蒸腾潮湿。（火化以生，即火生。阳气在上，所以最终表现为蒸腾潮湿。）这是水化以承接相火的意思。太阳所至表现为寒雪、冰雹、白埃，这是土化以承接寒水的意思。（霜雪冰雹属水，白埃在下承接土气。）以至于太阴所至表现为雷霆骤雨烈风，（雷霆骤雨属土，烈风在下承接木气。）厥阴所至表现为风生，最终表现为肃杀静敛，（风化以生，即风生。肃，意为静。）阳明所至表现为散落温和，（散落属金，温和在下承接火气。）少阴所至表现为热生，中间表现为寒。（热化以生，即热生。阴精在上承接，所以中间表现为寒。）这难道不是亢盛为害则承接制约的道理吗？
从前黄帝与岐伯上穷天纪，下极地理，远取诸物，近取诸身，互相问难，以此作成《内经》，到了《素问·六微旨大论》中提到六气相承的话，认为制约则生化，外部列示盛衰，危害则败乱，生化大病。所有以所胜之气承接在下的，都是折损其标盛的势头，否则为什么水发作时有闪电积雪，土发作时有暴风骤起，木发作时有树木摧折，金发作时有天空清明，火发作时有烟雾熏昧？这些都是郁结至极而后发作，以承接所亢盛之气的意思啊。
唉！通晓天地人三才的人，称为医家流派，岂止是治疗疾病而已，应当审察病机不违背气宜。
**审察病机无失气宜**
邪气各有归属，应当在前面探究其关键；治法各有归依，应当在后面防止差错。大概治病的关键，从探究其所属为先。如果不知道法的归依，难免会有差错。所以疾病的产生，不胜枚举，追究其所属，不出乎五运六气之外。如果真的能在此审察并得其机要，然后进行治疗，又必须使各对应运气之宜，不至于有一毫差误的失误。如果是这样，那么治病求属的道理，差不多可以无愧了。《素问·至真要大论》说：审察病机，无失气宜。意蕴就在这里。
我曾认为医道有一句话可以尽括其要点，就是运气。天为阳，地为阴。阴阳二气各分三品，称为三阴三阳。然而天并非纯阳，也有三阴；地并非纯阴，也有三阳。所以天地上下，各有风、热、火、湿、燥、寒六气，它们在两间运转运动，而又有木、火、土、金、水五运。人生在其中，脏腑气穴也与天地相互流通，由此可知众疾之作，其所属之机无出乎此。然而医者的治疗，应当如何呢？只应当察知于此，使其不失其宜才可以。
至于各种风病导致摇动眩晕，都归属于肝木；各种疼痛瘙痒疮疡，都归属于心火；各种湿肿胀满，都归属于脾土；各种气滞愤郁，都归属于肺金；各种寒冷收引，都归属于肾水；这是病机归属于五运的情况。各种暴烈的强直拘挛，都归属于风；各种呕吐酸水，都归属于热；各种躁扰狂越，都归属于火；各种痉强直，都归属于湿；各种涩枯干涸，都归属于燥；各种水液排泄物澄澈清冷，都归属于寒；这是病机归属于六气的情况。
虽然病机的审察已经详尽，但施治也不可不详。所以必须在疑似之间辨别阴阳，在隐微之际分辨标本。有无不同的，探求其之所以不同；虚实有异的，责求其之所以有异。使用汗、吐、下法，投其所当投；使用寒、热、温、凉药，用其所当用。或者逆其势以制约轻微之邪，或者从其势以引导严重之邪。向上以远离司天之气的侵犯，中间以辨别岁运的变化，向下以审察南北的适宜，使大小适中，先后合度，以此进行治疗，又怎么会有差错乖乱的失误呢？
另外，《素问·六元正纪大论》说：无失天信，无逆气宜。《素问·五常政大论》说：必先岁气，无伐天和。这都是无失气宜的意思。所以《素问》、《灵枢》的经典，未曾不以气运而言。既说：先立其年，以明其气。又有告诫说：治病者必明天道地理，阴阳更胜。既说：不知年之所加，气之盛衰，虚实之所起，不可以为工矣。谆谆教导好像不能自已，这难道是圣人私心忧虑过度吗？因为医道的关键，全在于此。观察《原病式》一书，比类物象，深明气运造化的奥妙，其在病机气宜的道理上不能再增加了。
**能合色脉可以万全**
想要知道体内的情况，应当观察外表；诊察外表，就能知道体内。大概内部有什么，就会表现在外部，如果不加以参验来判断病邪的逆顺，是不可能做到的。医者应深刻洞察此理。所以观察五色（青黄赤白黑），结合五脏之脉，穷尽其相应与否。切按五脉（急大缓涩沉），结合五脏之色，辨其顺与不顺。如果能察知精微之色，诊察微妙之脉，内外参合而治疗，那么万举万全的功效就可以坐而致之了。《素问》说：能合色脉，可以万全，意思就是这样。
推究道的一气，判分为阴阳，散开为五行，人所禀受皆具备于此。五脉是天之真，运行血气，通调阴阳，以营养全身。五色是气之华彩，应合五行，配合四时，以彰显于面部。只有察色按脉而不偏废，然后察知病机，断之以寒热，归之于脏腑，随证而疗之，获得全济功效的，根本在于能合色脉罢了。
举例来说，肝色如翠羽之青，其脉微弦而急，所以为生；若脉浮涩而短，面色如草滋（枯草），怎能生存呢？心色如鸡冠之赤，其脉当浮大而散，所以为顺；若脉沉濡而滑，面色如衃血（凝血），怎能顺呢？脾色如蟹腹之黄，其脉当中缓而大，所以为从；若脉微弦而急，面色如枳实（枯黄），怎能从呢？肺色如豕膏之白，其脉当浮涩而短，所以为吉；若脉浮大而散，面色如枯骨，怎能吉呢？肾色见如乌羽之黑，其脉沉濡而滑，所以为生；或脉来缓而大，面色如烟炱（黑灰），主死。死生之理，唯有诊视相参。既然如此，那么药证相对，疾病不愈的情况，从未有过。
我曾论述：容色所见，左右上下各有其部，脉息所动，寸关尺中皆有其位。左颊是肝之部，合于左手关位；肝胆之分，应于风木，为初之气。颜面是心之部，合于左手寸口；心与小肠之分，应于君火，为二之气。鼻部是脾之部，合于右手关脉；脾胃之分，应于湿土，为四之气。右颊是肺之部，合于右手寸口；肺与大肠之分，应于燥金，为五之气。颐部是肾之部，合于左手尺中；肾与膀胱之分，应于寒水，为终之气。至于相火，为三之气，应于右手命门、三焦之分也。至于阴阳五行相生相胜的道理，应当结合色脉来推究。所以《素问·脉要精微论》说：色合五行，脉合阴阳。《难经·十三难》说：色之与脉，当参相应。然而治病万全的功效，如果不是合于色脉的，没有人能做到。《素问·五脏生成》篇说：心之合脉也，其荣色也。脉的大小、滑涩、沉浮，可以用手指辨别；五色的微诊，可以用眼睛观察。继之以能合色脉，可以万全。谓如赤脉至，喘而坚；白脉至，喘而浮；青脉至，长而左右弹；黄脉至，大而虚；黑脉至，上坚而大。这是先言五色，次言五脉。欲使后之学人，望而切之，以相合也。后来，扁鹊明白此理，阐述说：望而知之谓之神，切脉而知之谓之巧。深得《内经》之理。下至后世，有立方者，称之为神巧万全，确实有深意啊！
**治病必求于本**
将要施行治疗疾病的方法，应当穷究其受病的根源。大概疾病的源头，不离于阴阳二邪，穷究此而治疗，疾病不愈的情况很少了。良医知道这样，认为风、热、火之病，属于阳邪所客，病既本于阳，如果不求其本而治之，则阳邪滋蔓而难制。湿、燥、寒之病，属于阴邪所客，病既本于阴，如果不求其本而治之，则阴邪滋蔓而难图。如果能穷源疗疾，各得其法，万举万全的功效就可以坐而致之。
“治病必求于本”见于《素问·阴阳应象大论》者如此。邪气的基础，久而传化，其变证不胜枚举。譬如水有本源，所以能荐至汪洋浩瀚，派流趋下逐渐变大。草有根，所以能荐生茎叶，结实秀穗而在上逐渐繁茂。如果病有本源，变化无穷，如果不必求其本而治之，想要去除深重的病患，是不可能的。
如今厥阴为标，风木为本，其风邪伤人，出现摇动眩晕、抽搐、猝暴强直的病。少阴为标，君火为本，其热邪伤人，出现疮疡痛痒、暴注下迫、水液浑混的病。少阳为标，相火为本，其火邪伤人，出现发热瞀闷抽搐、躁扰狂越、如丧神守的病。善于治疗的人，风淫所胜，平以辛凉。热淫所胜，平以咸寒。火淫所胜，平以咸冷。因为其病本于阳，必求其阳而疗之，病不愈的情况从未有过。
太阴为标，湿土为本，其湿邪伤人，出现腹满身肿、按之没指、诸强直病。阳明为标，燥金为本，其燥邪伤人，出现气滞愤郁、皮肤皱揭、诸涩枯涸病。太阳为标，寒水为本，其寒邪伤人，出现吐利腥秽、水液清冷、诸寒收引病。善于治疗的人，湿淫所胜，平以苦热。燥淫所胜，平以苦温。寒淫所胜，平以辛热。因为其病本于阴，必求其阴而治之，病不愈的情况从未有过。这难道不是说要施行疗疾之法，应当穷究受病之源吗？
我曾论述：邪气为病，各有其候，治之之法，各有其要，岂止一端而已。在表的，汗而发之；入里的，下而夺之；在高的，因而越之，即吐法；剽悍的，按而收之，即按摩。脏寒虚夺者，治以灸；脉病挛痹者，治以针刺；血实蓄结肿热者，治以砭石；气滞痿厥寒热者，治以导引；经络不通，病生于不仁者，治以醪醴；血气凝泣，病生于筋脉者，治以熨药。始焉求其受病之本，终焉蠲其为病之邪者，无出于此也。
唉！从前黄帝处于法宫之中，坐于明堂之上，受业于歧伯，传道于雷公，说：阴阳者，天地之道也，纲纪万物变化生杀之妙。盖有不测之神，斡旋宰制于其间也。人若受邪生病，不离于阴阳。病既本于此，医者岂可他求哉？必求于阴阳可也。《素问·至真要大论》说：有者求之，无者求之。这是求病机的说法，与夫求于本其理一也。
大致四季以胃气为本，然而治病必须先诊六脉，皆有胃气，外证虽重，病亦可治。胃气未绝，则药力营运而输散于皮毛经络，故易治而生。胃气既绝，则药虽对证，不能使其运用以输精于皮毛经络。真脏独见而药不及矣，遂成不治之证也。李东垣说：脉贵有神。有神者，有胃气之谓也。所以诸经方论皆曰有病早治疗，不令邪气深入。所以圣人治未病，不治已病，正谓此也。
**Treating Disease Before It Occurs (Preventive Treatment)**
Rather than seeking to cure after illness has arisen, it is better to nurture health before disease appears. For if one waits until the disease is formed to apply medicine, it is merely a futile effort. Therefore, preventing the formation of disease is the principle of medical practice; intervening before disease manifests elucidates the principles of life preservation. In this way, by contemplating potential troubles and preventing them in advance, what trouble could there be? This embodies the sage's intent of "treating disease before it occurs, not after."
This is like using earth to hold back water: if one does not block the trickling streams, the overwhelming flood cannot be restrained. Similarly, using water to fight fire: if one does not extinguish the faint glow, the raging flame cannot be stopped. If one cannot stop water or fire once they have become mighty, how much less can one treat a disease that has already taken form?
Therefore, in spring when nature renews itself, one should sleep late and rise early; in summer when vegetation flourishes, one should rise early and sleep late. This allows for relaxing the body, avoiding anger, and fulfilling one's will, while consuming cool and cold foods to nourish Yang Qi. Thus do sages prevent disease in spring and summer. In autumn when nature gathers and calms, one should rise with the rooster; in winter when nature stores and hides, one should wait for sunlight to rise. This allows for gathering the spirit, concealing intentions, and regulating desires, while consuming warm and hot foods to nourish Yin Essence. Thus do sages prevent disease in autumn and winter.
One might ask: "Seeing liver disease, first strengthen the spleen to prevent wood from overacting on earth; seeing redness on the right cheek, first clear lung heat to prevent metal from becoming excessive. This is the method of treating pre-disease. Now you speak of harmonizing with the four seasons and nurturing the spirit as the method of preventive treatment. What is the meaning?"
Preserving the body intact for longevity is the Way of the Sage; achieving perfect cures is the skill of the Superior Physician. The saying "treat disease before it occurs" is recorded in the *Suwen: Treatise on Regulating the Spirit According to the Four Seasons*, holding profound significance.
In the ancient dialogues between the Yellow Emperor and the Heavenly Master, nourishment was always prioritized. First discussing innate Heaven-endowed Qi, then regulating the spirit, following the laws of Yin and Yang, and adjusting to the four seasons. Emphasizing regulated diet and regular daily routines, the urgency of health preservation was stressed to treat diseases before they arise, preventing them from becoming difficult to manage.
Later, Qin Que (Bian Que) understood this. Seeing the Duke of Jin’s disease had reached the *gaohuang* (area between the heart and diaphragm), he said, "It cannot be treated." Understanding this fully, when Bian Que saw the Duke of Qi’s disease had penetrated to the bone marrow, he declared, "It cannot be saved." Alas! How unfortunate that the Dukes of Qi and Jin did not understand this.
**Excess Leads to Harm, Reception Leads to Restraint**
When Qi arrives and reaches its extreme, it becomes a disaster. When Qi attacks, it must be countered by a restorative force to achieve balance. When things reach an extreme, they reverse; this is the natural law.
Generally, the six Qi (Cold, Heat, Dryness, Dampness, Wind, Fire) and the Five Phases (Wood, Fire, Earth, Metal, Water) cause harm when they reach their peak excess. They are restrained when they receive counter-balancing forces. Thus, reaching an extreme leads to disaster, while being countered leads to balance. The subtlety of Qi dynamics is thus clearly revealed. This is the meaning of "Excess leads to harm, reception leads to restraint."
Investigating the mechanism of Heaven and Earth Yin-Yang, extreme cold generates heat, and extreme heat generates cold. These changes are divine and unfathomable, rotating and governing within. Thus, Wood at its extreme resembles Metal; Fire at its extreme resembles Water; Earth at its extreme resembles Wood; Metal at its extreme resembles Fire; Water at its extreme resembles Earth. Because when Qi is excessively strong, the force receiving and restraining it surpasses itself. Only by receiving the excess and restraining its harm can the work of creation be completed.
Currently, below Xiang Huo (Ministerial Fire), Shui Qi (Water Qi) receives it, so Fire does not mutate. Below the position of Water, Tu Qi (Earth Qi) receives it, so Water does not cause disaster. Below the position of Earth, Mu Qi (Wood Qi) receives it, so Earth remains compliant. Below the position of Wind, Jin Qi (Metal Qi) attacks, so Wind subsides. Heat and Fire create Dry Metal, naturally belonging to Metal disorders. Yin Jing (Essence) receives Jun Huo (Monarch Fire), naturally belonging to Fire conditions. Such is the meaning of "Excess causes harm, reception brings restraint."
I have examined the *Liuyuan Zhengji Dalun* (Great Treatise on the Six Origins and Correct Records), which states: "Where Shaoyang reaches, it manifests as Fire generation, ending in steaming dampness." (Fire transformation generates Fire; Yang is above, hence ending in steaming dampness.) This indicates Water transformation receiving Ministerial Fire. "Where Taiyang reaches, it manifests as cold snow, hail, and white dust," indicating Earth transformation receiving Cold Water. "Where Taiyin reaches, it manifests as thunder, sudden rain, and fierce wind," indicating Thunder/Rain (Earth) receiving Wood Qi below. "Where Jueyin reaches, it manifests as Wind generation, ending in solemnity/stillness," indicating Wind generation ending in stillness. "Where Yangming reaches, it manifests as scattering and warmth," indicating Metal scattering receiving Fire Qi below. "Where Shaoyin reaches, it manifests as Heat generation, intermediate Cold," indicating Heat generation with Yin Essence receiving from above, hence intermediate Cold. Is this not the principle that excess causes harm and reception brings restraint?
Previously, the Yellow Emperor and Qibo explored heaven and earth, distant objects and the human body, questioning each other to create the *Neijing*. In the *Liweizhi Dalun*, it mentions the succession of the Six Qi, stating that restraint allows for growth and transformation, displaying prosperity and decline externally; harm leads to disorder and severe disease. All cases where the conquering Qi receives from below serve to curb the superficial excess. Otherwise, why does Water emergence bring lightning and snow, Earth emergence bring sudden winds, Wood emergence bring destruction, Metal emergence bring clarity, and Fire emergence bring smoke and darkness? These are all manifestations of depression reaching an extreme and then erupting, serving to receive the excessive Qi.
Ah! One who understands Heaven, Earth, and Humanity is called a physician. Is it only to treat diseases? One must examine the pathogenesis without losing sight of the Qi suitability.
**Examining Pathogenesis Without Losing Sight of Qi Suitability**
Pathogenic factors have specific affiliations; one must investigate their essence beforehand. Therapeutic methods have specific destinations; one must prevent errors afterwards. The key to treatment lies in investigating the affiliation first. If one does not know the destination of the method, errors are inevitable. Thus, although diseases are numerous, their affiliations fall within the Five Movements and Six Qi. If one examines this thoroughly and grasps the essentials, then treats accordingly, ensuring alignment with the suitability of Qi and Movements, avoiding even the slightest error, then the path of seeking the root in treatment would be impeccable. The *Zhenshi Yao Da Lun* states: "Examine the pathogenesis; do not lose the suitability of Qi." The implication is here.
I believe there is one phrase that summarizes the essence of medicine: Qi and Movements (Yunqi). Heaven is Yang, Earth is Yin. Yin and Yang each divide into three categories, known as Three Yin and Three Yang. Yet Heaven is not purely Yang, containing Three Yin; Earth is not purely Yin, containing Three Yang. Thus, above and below Heaven and Earth exist the Six Qi (Wind, Heat, Fire, Dampness, Dryness, Cold), rotating between them, along with the Five Movements (Wood, Fire, Earth, Metal, Water). Humans live within this, and their Zang-Fu organs and acupoints circulate with Heaven and Earth. Thus, the origin of all diseases lies here. How should physicians treat? By observing this, ensuring no loss of suitability.
For instance, all wind-induced tremors and dizziness belong to Liver Wood; all pain, itching, and sores belong to Heart Fire; all dampness, swelling, and fullness belong to Spleen Earth; all Qi stagnation and depression belong to Lung Metal; all cold and contraction belong to Kidney Water. These are pathogeneses belonging to the Five Movements. All sudden stiffness and rigidity belong to Wind; all vomiting and acid regurgitation belong to Heat; all restlessness and mania belong to Fire; all spasms and rigidity belong to Dampness; all dryness and withering belong to Dryness; all clear and cold fluids belong to Cold. These are pathogeneses belonging to the Six Qi.
Although pathogenesis is examined, treatment must also be detailed. One must distinguish Yin and Yang in ambiguous situations and differentiate Root (Ben) and Branch (Biao) in subtle moments. Investigate the reasons for differences in Existence/Non-existence and Deficiency/Excess. Use sweating, vomiting, or purging appropriately; apply Cold, Heat, Warm, or Cool therapies correctly. Counter minor evils or follow major ones. Upward to avoid invading Qi, middle to judge annual movements, downward to assess north-south suitability. Ensuring moderation and proper timing prevents errors.
The *Liuyuan Zhengji Dalun* says: "Do not lose heavenly trust; do not oppose Qi suitability." The *Wuchang Zheng Dalun* says: "First know the annual Qi; do not damage Heavenly Harmony." These reflect the meaning of not losing Qi suitability. The *Suwen* and *Lingshu* constantly discuss Qi and Movements. "Establish the year first to clarify the Qi." Warns: "To treat disease, one must understand Heavenly Dao, Earthly Geography, and Yin-Yang alternation." States: "Not knowing the addition of years, the prosperity/decline of Qi, and the origin of deficiency/excess, one cannot be a skilled practitioner." This earnestness is not the Sage's excessive worry, but because the essence of medicine lies here. The book *Yuan Bing Shi* classifies phenomena, deeply clarifying the wonders of Qi and Movement creation, leaving no room for improvement in understanding pathogenesis and Qi suitability.
**Combining Color and Pulse Can Ensure Total Success**
To know the interior, observe the exterior; to diagnose the exterior is to know the interior. What exists inside manifests outside. Without cross-referencing, one cannot determine the reversal or smoothness of pathogens. Physicians must deeply understand this principle. Observe the Five Colors (Green, Yellow, Red, White, Black) and combine them with the pulses of the Five Zang organs to determine correspondence. Palpate the five pulse qualities (Rapid, Large, Slow, Choppy, Deep) and combine them with the colors of the Five Zang to judge compliance. If one can observe subtle colors and diagnose subtle pulses, combining interior and exterior for treatment, total success can be achieved effortlessly. The *Suwen* states: "Able to combine color and pulse, one can achieve total success." This is the meaning.
The One Qi of the Dao divides into Yin and Yang and scatters into the Five Phases, which humans possess. The five pulses are Heaven's truth, circulating blood and Qi, connecting Yin and Yang, nourishing the body. The five colors are the brilliance of Qi, corresponding to the Five Phases and four seasons, manifesting on the face. Only by observing color and palpating pulse without bias can one grasp the pathogenesis, judge Cold/Heat, assign to Zang-Fu, and treat according to symptoms, achieving complete recovery based on combining color and pulse.
For example, Liver color like green kingfisher feathers, with a slightly wiry and rapid pulse, indicates life. If floating, choppy, and short, with color like dead grass, survival is unlikely. Heart color like chicken comb red, with a floating, large, and scattered pulse, indicates compliance. If deep, soft, and slippery, with color like clotted blood, compliance is unlikely. Spleen color like crab belly yellow, with a moderate, slow, and large pulse, indicates following. If slightly wiry and rapid, with color like immature orange, following is unlikely. Lung color like pig fat white, with a floating, choppy, and short pulse, indicates auspiciousness. If floating, large, and scattered, with color like dry bones, auspiciousness is unlikely. Kidney color like crow feather black, with a deep, soft, and slippery pulse, indicates life. If slow and large, with color like soot, death ensues. Life and death depend on the combination of diagnosis and observation. With this, if herbs match the syndrome, failure to cure is unheard of.
I have discussed: Facial regions correspond to locations; pulse positions (Cun, Guan, Chi) correspond to sites. Left cheek corresponds to Liver, matching the left Guan position; Liver/Gallbladder relates to Wind-Wood, the first Qi. Forehead corresponds to Heart, matching the left Cun position; Heart/Small Intestine relates to Monarch Fire, the second Qi. Nose corresponds to Spleen, matching the right Guan position; Spleen/Stomach relates to Damp-Earth, the fourth Qi. Right cheek corresponds to Lung, matching the right Cun position; Lung/Large Intestine relates to Dry-Metal, the fifth Qi. Chin corresponds to Kidney, matching the left Chi position; Kidney/Bladder relates to Cold-Water, the final Qi. Ministerial Fire is the third Qi, relating to the right Mingmen and Sanjiao. The principles of Yin-Yang and Five Phases generation and restriction should be deduced by combining color and pulse. Thus, the *Maiyao Jingwei Lun* states: "Color combines with Five Phases, pulse combines with Yin-Yang." The *Nanjing Thirteen Difficulty* states: "Color and pulse should correspond." Total success in treatment requires combining color and pulse. The *Wuzang Shengcheng* chapter states: "Heart matches pulse, its luster is color." Pulse size, slipperiness, depth can be felt; color subtleties seen. Combining color and pulse ensures total success. E.g., Red pulse arriving is panting and firm; White pulse is panting and floating; Green pulse is long and vibrating; Yellow pulse is large and empty; Black pulse is hard and large above. This lists colors then pulses, teaching future students to inspect and palpate together. Later, Bian Que stated: "Knowing by observation is Divine; knowing by pulse is Skillful." This deeply captures the *Neijing* logic. Later generations called prescriptions "Divine and Skillful Total Success," having profound meaning.
**Treating Disease Must Seek the Root**
To apply treatment, one must investigate the source of the disease. The source of disease lies in Yin and Yang pathogens. Investigating this leads to cure. Skilled physicians know this: Wind, Heat, and Fire diseases belong to Yang pathogens. If the root is Yang and not treated at the root, Yang pathogens spread and become uncontrollable. Dampness, Dryness, and Cold diseases belong to Yin pathogens. If the root is Yin and not treated at the root, Yin pathogens spread and become unmanageable. Investigating the source and treating accordingly ensures total success.
"Treating disease must seek the root" is found in the *Yinyang Yingxiang Dalun*. Pathogens change over time, creating numerous variations. Like water with a source becoming vast, or grass with roots growing stems and leaves, disease with a root has infinite changes. Without seeking the root, removing deep-seated afflictions is impossible.
Jueyin is the branch, Wind-Wood is the root. Wind pathogen causes tremors, dizziness, convulsions, and sudden stiffness. Shaoyin is the branch, Monarch Fire is the root. Heat pathogen causes sores, itching, sudden diarrhea, and turbid fluids. Shaoyang is the branch, Ministerial Fire is the root. Fire pathogen causes fever, confusion, convulsions, restlessness, and mania. Good practitioners use Pungent-Cool for Wind excess, Salty-Cold for Heat excess, and Salty-Cold for Fire excess. Since the root is Yang, treating Yang ensures cure.
Taiyin is the branch, Damp-Earth is the root. Damp pathogen causes abdominal fullness, edema, and stiffness. Yangming is the branch, Dry-Metal is the root. Dry pathogen causes Qi stagnation, depression, and wrinkled skin. Taiyang is the branch, Cold-Water is the root. Cold pathogen causes vomiting, diarrhea, foul smells, and clear/cold fluids. Good practitioners use Bitter-Hot for Damp excess, Bitter-Warm for Dry excess, and Pungent-Hot for Cold excess. Since the root is Yin, treating Yin ensures cure. This confirms that treatment must investigate the source.
Pathogens have specific signs and treatments have specific keys. Exterior: sweat to release. Interior: purge to drain. High: induce vomiting. Fierce: press to gather. Cold deficiency: moxibustion. Spasm/bi: acupuncture. Blood stasis/swelling: stone needles. Qi stagnation/paralysis: Qigong/Daoyin. Meridian obstruction/numbness: medicinal wine. Blood/Qi stagnation/tendons: warming therapy. Seeking the root initially and eliminating pathogens finally covers all these methods.
Alas! The Yellow Emperor, learning from Qibo and Lei Gong, stated: "Yin and Yang are the Way of Heaven and Earth, the纲纪 (guiding principle) of all changes, birth, and death. Unfathomable spirits govern them." Human illness stems from Yin and Yang. Physicians must seek the root in Yin and Yang. The *Zhenshi Yao Da Lun* says: "Seek what exists, seek what does not exist." This seeking of pathogenesis aligns with seeking the root.
Generally, the Four Seasons rely on Stomach Qi as the root. Diagnosis of the six pulses must show Stomach Qi. Even with severe external symptoms, if Stom stomach Qi is present, the disease is treatable. If Stomach Qi is not exhausted, medicinal power circulates to skin and meridians, making cure easy. If Stomach Qi is exhausted, even correct herbs cannot circulate nutrients. True Zang pulses appear alone, and medicine fails, leading to untreatable conditions. Li Dongyuan said: "Pulses value Shen (Spirit)." Shen means Stomach Qi. Thus, classics advise early treatment to prevent deep invasion. This is precisely why sages treat pre-disease, not post-disease.