问曰。太阴病治宜主温乎。答曰。此不可执一而论。寒邪直中太阴。而本经自病者。是
当急
温无疑矣。其有阳经之邪。热过寒生。而转入太阴者。亦当主温。若属热邪陷入太阴。而见
吐利满痛等证者。纯温非宜。纯清亦不可。则惟有和之一法。如所谓太阳病。脉浮者可发汗
。宜
桂枝汤。此逆挽其陷入之邪。仍从外解。而方中甘芍姜枣。亦足以奠安太阴。是和法也。若
本太阳病。因误下而腹满时痛。转属太阴者。用桂枝加芍药汤。此仍用桂枝升举阳邪。但倍
芍药以收太阴之逆气。是亦和法也。若大实痛者。不下则痛势须臾难缓。峻下又恐脾阴随下
利而尽泄。故仍用桂枝升举阳邪但加大黄以微和胃气。是亦和法也。三阴经中。以少阴厥阴。
尚有实热之证。可用大寒大下者。太阴湿土。位处中州。全赖阳气布护
。以资健运转输之力。病在太阴。虽属热因。切不可用寒凉直折。遏抑阳气。阴邪愈锢。故
仲景又谓太阴为病。设当行大黄芍药者宜减之。以其人胃气弱。易动故也。观此则太阴病之
治当主温。可知矣。而治太阴之病不可呆执温法。又可知矣。不知温法者。不可与议太阴
本脏虚寒之病。徒执温法者
。不可与议太阴他经传变之病。仲景治太阴病法。大约以升举阳气为主。或当急温。或宜兼
清兼下。随证变通。后世李东垣脾胃论。殆能觑破此旨。其处方似甚夹杂。而于阴阳升降之
机。庶乎其得之矣。
问：太阴病的治疗是否应当以温法为主？
答：这个问题不能一概而论。如果是寒邪直接侵入太阴，导致本经自病的，当然应当紧急使用温法，这是毫无疑问的。如果有来自阳经的病邪，因热极生寒而转入太阴的，也应当以温法为主。如果属于热邪陷入太阴，并出现呕吐、腹泻、腹部胀满疼痛等症状的，单纯使用温法并不适宜，单纯使用清法也不可行，那么只有采用“和法”这一种方法。比如所谓太阳病，脉象浮的可以用发汗法，适宜用桂枝汤（Cinnamon Twig Decoction）。这是逆挽其陷入之邪，使其仍从体表解除，而方中的甘草、芍药、生姜、大枣，也足以安定太阴脾胃之气，这就是和法。如果是原本患太阳病，因误用下法而导致腹部胀满、时时作痛，转而归属于太阴的，使用桂枝加芍药汤（Cinnamon Twig and Peony Decoction）。这仍然是用桂枝升举阳气以驱散邪气，只是加倍使用芍药来收敛太阴上逆之气，这也是和法。如果是大实痛的情况，如果不通下，疼痛之势片刻难以缓解；但若峻猛攻下，又恐怕脾阴随着下利而完全泄尽。所以仍然使用桂枝升举阳气，但加大黄（Rhubarb Root）以轻微调和胃气，这也是和法。在三阴经中，只有少阴和厥阴还有实热证候，可以使用大寒或峻下的药物。太阴属湿土，位居中焦，完全依赖阳气的布散护卫，以资助其健运和转输的功能。病在太阴，虽然属于热邪所致，但切不可使用寒凉药物直折其势，以免遏制压抑阳气，导致阴邪更加固结难解。所以张仲景又说，治疗太阴病，如果应当使用大黄或芍药的，应当减量，因为病人的胃气虚弱，容易受药物影响而动荡。由此看来，太阴病的治疗应当以温法为主，这是显而易见的。而治疗太阴病不可死板地拘执于温法，这也是显而易见的。不懂温法的人，不可以与他讨论太阴本脏虚寒的病证；只知死守温法的人，不可以与他讨论太阴由他经传变而来的病证。张仲景治疗太阴病的方法，大致以升举阳气为主，或者应当紧急温补，或者适宜兼用清法或下法，随证候变化而灵活变通。后世的李东垣（Li Dongyuan）在《脾胃论》中，大概能洞察到这一宗旨。他的处方看起来似乎很杂乱，但在阴阳升降的机理方面，差不多是得法的了。
Q: Should the treatment of Taiyin disease (Taiyin Syndrome) primarily involve warming methods?
A: This cannot be discussed in a rigid, one-size-fits-all manner. If cold pathogenic factors directly invade the Taiyin channel, causing disease originating within the channel itself, urgent warming is undoubtedly indicated. However, if pathogens from Yang channels transform into heat and then enter the Taiyin channel due to extreme heat generating cold-like symptoms, warming should also be the primary approach. If, on the other hand, heat pathogens sink into the Taiyin channel, presenting with symptoms such as vomiting, diarrhea, abdominal fullness, and pain, using purely warming methods is inappropriate, and using purely clearing methods is also not feasible; thus, only the "harmonizing method" (He Fa) is suitable. For instance, regarding what is called Shaoyang disease [Note: Text says Shaoyang but context implies Shaoyang or general exterior syndrome often treated with Guizhi Tang for harmonizing Ying-Wei], where the pulse is floating, sweating can be induced, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate. This reverses the sinking of pathogens, allowing them to resolve from the exterior, while the Licorice, Peony, Ginger, and Jujube in the formula are sufficient to stabilize the Qi of the Taiyin Spleen-Stomach; this is the harmonizing method. If a patient originally had Shaoyang disease [Note: Text says Shaoyang but context implies Taiyang] and suffered from abdominal fullness and intermittent pain due to erroneous purgation, shifting the condition to Taiyin, Guizhi Jia Shaoyao Tang (Cinnamon Twig and Peony Decoction) should be used. This still employs Cinnamon Twig to raise Yang Qi and dispel pathogens, but doubles the Peony to subdue the rebellious Qi of Taiyin; this is also the harmonizing method. In cases of severe excess pain, failure to purge will make the pain unbearable in moments, yet harsh purgation risks exhausting Spleen Yin through diarrhea. Therefore, Cinnamon Twig is still used to raise Yang Qi, but Rhubarb Root (Da Huang) is added to mildly harmonize Stomach Qi; this is also the harmonizing method. Among the Three Yin channels, only Shaoyin and Jueyin may present with excess-heat syndromes treatable with major cold or drastic purgative methods. Taiyin, associated with Damp Earth and located in the Central Region, relies entirely on the distribution and protection of Yang Qi to support its transformative and transportive functions. Even if the etiology of Taiyin disease involves heat, one must absolutely avoid using cold-cooling herbs to directly suppress it, as this would inhibit Yang Qi and cause Yin pathogens to become more entrenched. Thus, Zhang Zhongjing stated that in treating Taiyin disease, if Da Huang or Bai Shao are indicated, their dosages should be reduced because the patient's Stomach Qi is weak and easily disturbed. From this, it is evident that the treatment of Taiyin disease should primarily emphasize warming. It is also evident that treating Taiyin disease requires avoiding a rigid adherence to warming methods alone. Those who do not understand warming methods cannot discuss diseases of the Taiyin organ characterized by deficiency-cold; those who rigidly adhere to warming methods cannot discuss Taiyin diseases resulting from transmission from other channels. Zhang Zhongjing’s methods for treating Taiyin disease generally focus on raising Yang Qi, whether requiring urgent warming or necessitating combined clearing or purging, adapting flexibly to the specific presentation. Li Dongyuan of later generations, in his *Pi Wei Lun* (Treatise on the Spleen and Stomach), seemingly grasped this principle. Although his prescriptions appear complex, they essentially align with the mechanism of the ascending and descending of Yin and Yang.