病之有标本,犹草之有根苗。拔茅须连其茹,治病必求其本。标本不明,处方何据?所谓瞑目
夜行,无途路而可见矣。原夫六气为本,三阴三阳经为标。病气为本,脏腑经络受病为标。先受病
为本,次受病为标。且如尺寸俱浮者,太阳受病也。其经标本,膀胱、小肠也。膀胱寒水为本,其
脉循脊上连风府,故头疼脊强。小肠为标,主发热。其正冬月时,在本者麻黄汤,在标者桂枝汤,
余月改用冲和汤也。尺寸俱长者,阳明受病也。其经标本,大肠与胃也。大肠为标,燥金为本,大
肠与
肺为表里。但发热,解肌汤。本脉络鼻循目,故目痛鼻干,不眠,虚则汗解,实则大柴胡、承气选
用。尺寸俱弦者,少阳受病也。其经标本,三焦与胆也。三焦相火,本也,游行乎一身,故微热。
足胆,标也,其脉循胁络耳,故耳聋胁痛,寒热,呕而口苦。缘胆无出入之路,故从中治证,用小
柴胡和解散而愈。其经有三禁,汗、下、吐是也。尺寸俱沉者,太阴受病也。其经标本,肺与脾也。
肺标,脉循咽。脾本,湿土。故腹满咽干,当得本治,宜泄,大柴胡、承气也。尺寸俱微沉者,少
阴受病也。其经标本,心与肾。君火为本,心苗舌,故舌燥。标肾,脉循肺,主口干,故口干舌燥。
故在标者,因身冷,治主姜附也。在本者,宜下,三乙承气,看微甚而用之。尺寸俱微缓,厥阴受
病也。其经标本,肝与心包络也。风木为本,下循阴器,故囊缩;标心包络,系舌,故舌卷。大抵
温之,四逆辈。其四经并前三经中,若有阳分传来者,下之,庶不误也。
疾病有本与标之分,就像草木有根与苗的区别。拔茅草时必须连同其根须一起拔出,治疗疾病必须探求其根本。如果不明白本与标的关系,开方用药依据何在?这就像闭着眼睛在黑夜中行走,没有道路却想看清方向一样。
六气是根本,三阴三阳经络是标象。病邪之气是根本,脏腑经络受邪发病是标象。先感受的病邪是根本,后感受的病邪是标象。
例如,寸脉和尺脉都呈现浮象的,是太阳经受病。这条经络的本与标,对应膀胱和小肠。膀胱属寒水,为根本;其经脉沿脊柱上行连接风府穴,所以出现头痛、脊背强直的症状。小肠为标象,主发热。如果是冬季时令发病,病在本(膀胱)的用麻黄汤,病在标(小肠)的用桂枝汤;其他月份则改用冲和汤。
寸脉和尺脉都呈现长象的,是阳明经受病。这条经络的本与标,对应大肠和胃。大肠为标象,燥金为根本,大肠与肺互为表里。主要症状是发热,用解肌汤治疗。本经脉络通鼻部并经过眼部,所以出现目痛、鼻干、失眠等症状;正气虚弱时用发汗法使病邪从体表解除,实证则选用大柴胡汤或承气汤类方剂。
寸脉和尺脉都呈现弦象的,是少阳经受病。这条经络的本与标,对应三焦和胆。三焦属相火,是根本,游行于全身,所以表现为轻微发热。足少阳胆经为标象,其经脉沿胁肋分布并联络耳部,所以出现耳聋、胁痛、寒热往来、呕吐且口苦的症状。因为胆没有直接出入的路径,所以从中焦进行治疗,使用小柴胡和解散即可痊愈。这条经络的治疗有三项禁忌:发汗、攻下、催吐。
寸脉和尺脉都呈现沉象的,是太阴经受病。这条经络的本与标,对应肺和脾。肺为标象,经脉循行咽喉;脾为根本,属湿土。所以出现腹部胀满、咽喉干燥的症状,应当治本,宜用泄法,可选用大柴胡汤或承气汤。
寸脉和尺脉都呈现微沉象的,是少阴经受病。这条经络的本与标,对应心和肾。君火为根本,心开窍于舌,所以出现舌燥;标象为肾,经脉循行肺部,主司口干,所以出现口干舌燥的症状。因此,病在标象者,因身体寒冷,治疗主要以姜、附子为主;病在根本者,宜用下法,选用三乙承气汤,根据病情的轻重来决定使用。
寸脉和尺脉都呈现微缓象的,是厥阴经受病。这条经络的本与标,对应肝和心包络。风木为根本,经脉向下循行经过阴器,所以出现睾丸收缩的症状;标象为心包络,系连于舌,所以出现舌头卷曲的症状。大体上采用温补法,使用四逆汤类方剂。在这六经病变中,如果有阳气分传来的病证,应当使用下法,这样才不会误治。
The disease having root and branch is like grass having root and shoot. When pulling reeds, one must pull up the roots along with them; when treating a disease, one must seek its root. If root and branch are not understood, what is the basis for prescribing? It is like walking blindfolded at night, seeing no path yet trying to see clearly.
The Six Qi (Six Atmospheric Influences) constitute the root, while the Three Yin and Three Yang meridians constitute the branch. The pathogenic qi is the root, while the organs and meridians suffering from the disease are the branch. The initially affected condition is the root, and the subsequently affected condition is the branch.
For instance, if both the Cun (inch) and Chi (cubit) pulses are floating, it indicates that the Taiyang Meridian (Greater Yang Meridian) is affected. The root and branch of this meridian correspond to the Bladder and Small Intestine. The Bladder, belonging to Cold Water, is the root; its meridian runs along the spine and connects to the Fengfu point (GV16), thus causing headache and stiffness of the spine. The Small Intestine is the branch, governing fever. In winter season, if the disease is in the root (Bladder), Mahuang Tang (Ephedra Decoction) is used; if in the branch (Small Intestine), Guizhi Tang (Cinnamon Twig Decoction) is used; in other months, Chonghe Tang (Harmonizing Decoction) is substituted.
If both pulses are long, it indicates that the Yangming Meridian (Yang Brightness Meridian) is affected. The root and branch correspond to the Large Intestine and Stomach. The Large Intestine is the branch, Dry Metal is the root, and the Large Intestine and Lung are exterior-interior partners. The main symptom is fever, treated with Jieji Tang (Muscle-Releasing Decoction). The meridian network passes through the nose and eyes, thus causing eye pain, dry nose, and insomnia. If deficiency, sweating resolves the pathogen; if excess, Dazhaihu Tang (Major Bupleurum Decoction) or Chengqi Tang (Purgative Decoction) are selected.
If both pulses are wiry, it indicates that the Shaoyang Meridian (Lesser Yang Meridian) is affected. The root and branch correspond to the Sanjiao (Triple Burner) and Gallbladder. The Sanjiao, belonging to Ministerial Fire, is the root, circulating throughout the body, thus causing slight fever. The Foot-Shaoyang Gallbladder Meridian is the branch; its vessel runs along the hypochondrium and links to the ear, thus causing deafness, hypochondriac pain, alternating chills and fever, vomiting, and bitter taste in the mouth. Since the Gallbladder has no direct exit or entry path, treatment is conducted from the middle jiao, using Xiaochaihu Hejie San (Minor Bupleurum Harmonizing Powder) for recovery. This meridian has three prohibitions: sweating, purging, and emesis.
If both pulses are deep, it indicates that the Taiyin Meridian (Greater Yin Meridian) is affected. The root and branch correspond to the Lung and Spleen. The Lung is the branch, its vessel running along the pharynx; the Spleen is the root, belonging to Damp Earth. Thus, abdominal fullness and dry throat occur. One should treat the root, employing draining methods, such as Dazhaihu Tang or Chengqi Tang.
If both pulses are slightly deep, it indicates that the Shaoyin Meridian (Lesser Yin Meridian) is affected. The root and branch correspond to the Heart and Kidney. Sovereign Fire is the root, the Heart opens into the tongue, thus causing dry tongue. The branch is the Kidney, its vessel running along the Lung, governing dry mouth, thus causing dry mouth and tongue. Therefore, for disease in the branch, due to cold body, treatment primarily uses Ginger and Aconite. For disease in the root, purging is appropriate, using Sanyi Chengqi Tang (Three Yi Purgative Decoction), applied according to severity.
If both pulses are slightly slow, it indicates that the Jueyin Meridian (Terminal Yin Meridian) is affected. The root and branch correspond to the Liver and Pericardium. Wind-Wood is the root, the vessel descends to the genitalia, thus causing contraction of the scrotum; the branch is the Pericardium, linked to the tongue, thus causing tongue curling. Generally, warming is employed, using Sini Tang (Recovery from Collapse Decoction) and similar formulas. Among these six meridians, if there is transmission from the Yang aspect, purging should be used to avoid error.