【闡釋】鄭氏此條採取問答形式，說明薑附之功用，並斥服薑附燒幹腎水之說。仲景傷寒論113方中，用附子者有33方，蓋附子純陽之性，能補坎中真陽。《醫理真傳》一書中，有坎卦解、離卦解、氣血兩字作一卦解，君相二火解等，都是說明氣血周流五臟六腑，以及全身，必須相應平衡，始能健康長壽。如有偏盛，必發而為病。“氣有餘便是火，氣不足便是寒”。“火旺者陰必虧，寒甚者陽必衰”。此陽虛陰虛之所由來也。姜附乃陰症主藥，用之以扶少火而生氣者，凡一切陽虛諸症，皆可服之。附子為熱藥之冠，能扶欲絕之火種，又必佐乾薑之辛散，以蕩盡陰邪，迎陽歸舍，故曰回陽。凡陽虛陰盛為病，皆可放膽使用，能早用善用，即不致釀成危候。蓋邪火始能傷陰，真火實能生陰，火盛則水盛，火衰則水衰，故燒幹腎水之說，實屬無稽。筆者臨證數十年來，以善用姜桂附聞於世，用附片少則數十克，多則達二三百克，從未發生任何副作用，蓋即本諸邪火始能傷陰，真火實能生陰之理論。又曰：“然則世之用大黃，芒硝以治病，其故何也＂？蓋硝、黃乃治壯火食氣之藥也，食氣者，食盡元陰之氣也。若不急為撲滅，頃刻將真陰灼盡而命不永。至其所現症狀，如氣粗口熱，大渴飲冷等，非但薑附不可用，即一切辛燥之品，皆當禁服，此又白虎、承氣之用矣。
或問：俗雲小兒純陽之體，不宜服薑附，是耶？非耶？
答曰：小兒者，稚陽也，如初生之萌芽，其質嬌嫩，用藥稍差，即禍生不測，便釀出陽虛種種危候，非姜附何能扶少火而生氣，以助先天危亡之機乎？世人動曰純陽，豈非見之左耶。總之用薑附亦必究其虛實，相其陰陽，觀其神色，當涼則涼，當熱則熱，何拘拘以薑附為咎哉？
【闡釋】俗說“小兒純陽之體，有熱無寒”。其實此語非是。有初生小兒，生下後其身體即為陽虛者，由其母在妊娠期中，喜食生冷；或因營養不良，以致胎兒在母腹中，即未健康成長，發育不好，其面容皎白，額上顯出青紋，口唇青白，哭時聲不洪亮，舌質淡紅，苔白膩等。亦有小兒患病，注射青鏈黴素，或過服寒涼之劑，有如鄭氏所說：“用藥稍差，即禍生不測，便釀出陽虛種種危候。”
上述兩種症狀，則非用薑附以扶少火而生氣，以救危亡不可。總之用薑附必辨其陰陽虛實，何能拘泥于小兒純陽之體，不宜服薑附哉！筆者曾治患兒戴某，生下後三月，即患咳嗽，病勢嚴重，送醫院治療，經注射青黴素半月，病癒出院。在一年中，咳喘斷續發作，住醫院四次。最後一次診斷為肺氣腫，雖注射針藥及輸液治療，未見減輕，已下病危通知書。患兒面容烏黑，咳時頭傾胸曲，氣喘促，出冷汗，手足冰涼，舌質淡紅，苔白膩。其母在妊娠期中，喜吃生冷瓜果以及冰糕汽水等飲料。根據上述診斷，胎兒在母體內即受損傷，生下後即現陽虛之象。加之三月即住醫院治療，共有五次，注射青黴素及輸液，損傷陽氣。現已見種種危候，非用薑附以扶陽止咳喘不可。先用四逆湯加麻黃治之；繼用真武湯，最後以理中湯善其後，共服藥三十劑而痊癒。今十年，小孩健康成長，已讀小學矣。
或問：俗雲小兒初生，先服開口藥，以下胎毒，免生瘡症，用藥不外大黃、銀花、勾藤、防風、巴豆、大棗等，果可服否？
答雲：小兒下地，定要服開口藥，以下胎毒，免生瘡、風症，此皆不經之論。夫小兒居母腹中，母呼一呼，母吸一吸，十月功圓，破衣而出，此時一團真氣養成，有何胎毒？如果有毒，小兒尚可活乎？既經下地，如初出土萌芽，此則一身真氣，本是並無一毫外邪，何得即以戕伐生氣之藥而施之，則無疾反生有疾，不生風因而生風，故有四六風、七天風，十有九死，難以枚舉。此千古之流弊，實千古小兒之大厄也。噫！何世人之不講究理法耶？
【闡釋】鄭氏認為小兒初生下地，不可妄施藥品，力斥世俗用大黃、銀花等藥以下胎毒之非是，並指出其流弊，在當時是很有見地的。現今產科醫院林立，婦女生育小孩多在醫院，此種陋習，已隨之而消失矣。
附錄
《傷寒論》原文，有《傷寒恒論》中所無者，補上備考。
6.太陽病，發熱而渴，不惡寒者，為溫病。若發汗已，身灼熱者，名風溫。風溫為病，脈陰陽俱浮，自汗出，身重，多眠睡，鼻息必鼾，語言難出。若被下者，小便不利，直視失溲。若被火者，微發黃色，劇則如驚癇，時瘈疭。若火熏之，一逆尚引日，再逆促命期。
30.問曰：症象陽旦，按法治之而增劇，厥逆，咽中幹，兩脛拘急而譫語。師曰：夜半手足當溫，兩腳當伸。後如師言，何以知此？
答曰：寸口脈浮而大，浮為風，大為虛，風則生微熱，虛則兩脛攣，病形象桂枝，因加附子參其間。增桂令汗出，附子溫經，亡陽故也。
厥逆，咽中幹，煩躁，陽明內結，譫語煩亂，更飲甘草乾薑湯。夜半陽氣還，兩足當熱，脛尚微拘急，重與芍藥甘草湯，爾乃脛伸；以承氣湯微溏，則止其譫語，故知病可愈。
37.太陽病，十日以去，脈浮細而嗜臥者，外已解也，設胸滿脅痛者，與小柴胡湯；脈但浮者，與麻黃湯。
92.病發熱頭痛，脈反沉，若不差，身體疼痛，當救其裏，宜四逆湯。
98.得病六七日，脈遲浮弱，惡風寒，手足溫，醫二三下之，不能食，而脅下滿痛，面目及身黃，頸項強，小便難者，與柴胡湯，後必下重，本渴飲水而嘔者，柴胡不中與也，食穀者噦。
101.條前段。傷寒中風，有柴胡證，但見一證便是，不必悉具。
113.形作傷寒，其脈不弦緊而弱，弱者必渴，被火必譫語，弱者發熱脈浮，解之當汗出愈。
115.脈浮熱甚，而反炙之，此為實，實以虛治，因火而動，必咽燥吐血。
122.病人脈數，數為熱，當消穀引食，而反吐者，此以發汗，令陽氣微，膈氣虛，脈乃數也。數為客熱，不能消穀，以胃中虛冷，故吐也。
141.病在陽，應以汗解之，反以冷水潠之，若灌之，其熱被劫不得去，彌更益煩，肉上粟起，意欲飲水，反不渴者，服文蛤散。若不差者，與五苓散。寒實結胸，無熱證者，與三物小陷胸湯，白散亦可服。
171.太陽少陽並病，心下鞭，頸項強而弦者，當刺大椎、肺俞、肝俞，慎勿下之。
224.陽明病，汗出多而渴者，不可與豬苓湯，以汗多胃中燥，豬苓湯複利其小便故也。
342.傷寒厥四日，熱反三日，複厥五日，其病為進，寒多熱少，陽氣退，故為進也。
380.傷寒大吐大下之，極虛，複極汗者，其人外氣怫鬱，複與之水，以發其汗，因得噦。所以然者，胃中寒冷故也。
辨霍亂病脈症並治篇382.問曰：病有霍亂者何？答曰：嘔吐而利，此名霍亂。
384.傷寒，其脈微澀者，本是霍亂，今是傷寒，卻四五日至陰經上，轉入陰必利，本嘔下利者，不可治也。欲似大便而反失氣，仍不利者，此屬陽明也，便必鞭，十三日愈，所以然者，經盡故也。下利後，當便鞭，鞭則能食者愈。今反不能食，到後經中，頗能食，複過一經能食，過之一日當愈，不愈者，不屬陽明也。
四逆加人參湯方甘草二兩（炙）附子一枚（生、去皮，破八片）乾薑一兩半人參一兩上四味，以水三升，煮取一升二合，去渣，分溫再服。
386.霍亂，頭痛發熱，身疼痛，熱多欲飲水者，五苓散主之。寒多不用水者，理中丸主之。
387.吐利止，而身痛不休者，當消息和解其外，宜桂枝湯小和之。
388.吐利汗出，發熱惡寒，四肢拘急，手足厥冷者，四逆湯主之。
389.既吐且利，小便複利，而大汗出，下利清穀，內寒外熱，脈微欲絕者，四逆湯主之。
390.吐已下斷，汗出而厥，四肢拘急不解，脈微欲絕者，通脈四逆加豬膽湯主之。
通脈四逆加豬膽湯方甘草二兩（炙）乾薑三兩強人可四兩附子大者一枚（生去皮，破八片）豬膽汁半合上四味，以水三升，煮取一升二合，去渣，內豬膽汁，分溫再服，其脈即來。無豬膽，以羊膽代之。
編後記
鄭欽安氏為近代傑出的、具有代表性的傷寒學家，其所著《醫理真傳》、《醫法圓通》和《傷寒恒論》三書，從元陰元陽立論，互相發明，渾然一體，為推廣運用傷寒理法方藥於各種雜病之辮治的獨特經驗總結，對治療慢性疾病，獨闢蹊徑，自成一家，實為繼承和發揮仲景學術傳世之作。我服膺其學，潛心揣習，用幹臨床，效如桴鼓，故多年來致力於三書之闡釋，承巴蜀書社以弘揚中華民族優秀傳統文化為己任，鼎力支持，業已先後出版。出版後頗獲海內外好評，其中《醫理真傳》、《醫法圓通》再版均已售罄。現應讀者要求，乃將三書重排，合訂為一冊，改為大32開精裝出版，定名為《鄭欽安醫書闡釋》。三書內容，沒有增減，僅由責任編輯調整統一全書體例，刪除、合併三書序、跋、附記中的冗贅篇章，重編總目，並對原版個別訛錯字加以訂正。
十餘年來，我雖竭盡全力為闡釋三書作了很多工作，因個人水準有限，兼之資料不足，於其所不知者，付諸闕如；所幸鄭氏三書，原文俱在，深望中醫界高明之士，不斷豐富發展，以匡不逮，庶使鄭氏之學，得以發揚光大，則我抛磚引玉的宿願也就得償了。
承全國人民代表大會副委員長，中國科學院主席團成員、院士，中國醫學科學院名譽院長，中華醫學會名譽會長，國際知名泌尿科專家，我九三學社主席吳階平同志為《鄭欽安醫書闡釋》題簽，敬致謝忱。
唐步祺于成都槐樹齋
1995年3月
【阐释】郑氏这一条采用问答的形式，说明干姜、附子的功效，并驳斥服用干姜、附子会烧干肾水的说法。在《伤寒论》113首方剂中，使用附子的有33首，这是因为附子具有纯阳的性质，能够补益坎卦中的真阳（肾阳）。《医理真传》一书中，有对坎卦的解析、离卦的解析、将气和血两字作为一卦来解析、君火与相火二火的解析等，这些都是为了说明气血在五脏六腑以及全身周流运行，必须保持相应的平衡，才能健康长寿。如果有偏盛的情况，必然引发疾病。“气有余便是火，气不足便是寒”。“火旺者阴必亏，寒甚者阳必衰”。这就是阳虚和阴虚产生的原因。干姜、附子是阴证的主药，用来扶持少火（生理之火）以生发元气，凡是各种阳虚病症，都可以服用。附子是热性药物的冠首，能够扶持即将熄灭的火种，又必须佐以干姜的辛散之性，以荡尽阴邪，引导阳气回归本位，所以称为回阳。凡是阳虚阴盛导致的疾病，都可以大胆使用，如果能早用、善用，就不会酿成危重证候。因为邪火才能损伤阴液，真火实际上能滋生阴液，火盛则水盛，火衰则水衰，所以说烧干肾水的说法，实在属于无稽之谈。笔者临证数十年来，因善于使用干姜、桂枝、附子而闻名于世，使用附片最少几十克，多则达到二三百克，从未发生任何副作用，这正是因为基于“邪火始能伤阴，真火实能生阴”的理论。又说：“那么世间使用大黄、芒硝来治病，其中的缘故是什么呢？”原来硝石、大黄是治疗壮火（病理之火）消耗元气的药物，所谓食气，就是耗尽了元阴之气。如果不急于扑灭，顷刻间就会将真阴灼烧殆尽而寿命不永。至于其所出现的症状，如气粗口热、大渴饮冷等，不仅干姜、附子不可用，就是一切辛燥的药物，都应当禁止服用，这就是白虎汤、承气汤的应用之处了。
有人问：俗话常说小儿是纯阳之体，不宜服用干姜、附子，是这样吗？不是这样吗？
回答说：小儿是稚阳之体，就像初生的萌芽一样，其体质娇嫩，用药稍有差错，就会祸患丛生，便酿出阳虚的各种危重证候，除了干姜、附子，还有什么能扶持少火以生发元气，以救助先天元气危亡之机呢？世人动不动就说纯阳，岂不是见识偏颇了吗？总之，使用干姜、附子也必须究查其虚实，观察其阴阳，审视其神色，该凉则凉，该热则热，何必拘泥于认为干姜、附子有害呢？
【阐释】俗话说“小儿纯阳之体，有热无寒”。其实这句话是不对的。有的初生小儿，出生后身体即为阳虚，这是由于母亲在妊娠期间，喜欢吃生冷食物；或者因营养不良，导致胎儿在母腹中未能健康成长，发育不良，其面容皎白，额上显现青纹，口唇青白，哭时声音不洪亮，舌质淡红，苔白腻等。也有小儿患病，注射青霉素、链霉素，或过服寒凉的药物，正如郑氏所说：“用药稍有差错，就会祸患丛生，便酿出阳虚的各种危重证候。”
上述两种情况，则非要用干姜、附子来扶持少火以生发元气，以挽救危亡不可。总之，使用干姜、附子必须辨别阴阳虚实，怎么能拘泥于小儿是纯阳之体，就不宜服用干姜、附子呢！笔者曾治疗患儿戴某，出生后三个月，就患上咳嗽，病势严重，送医院治疗，经注射青霉素半个月，病愈出院。在一年中，咳喘断续发作，住院四次。最后一次诊断为肺气肿，虽然注射针药及输液治疗，未见减轻，已下达病危通知书。患儿面容乌黑，咳嗽时头倾胸曲，气喘急促，出冷汗，手足冰凉，舌质淡红，苔白腻。其母在妊娠期间，喜欢吃生冷瓜果以及冰糕汽水等饮料。根据上述诊断，胎儿在母体内即受到损伤，出生后即现阳虚之象。加之三个月内即住院五次，注射青霉素及输液，损伤阳气。现已出现种种危重证候，非用干姜、附子来扶阳止咳喘不可。先用四逆汤加麻黄治疗；继用真武汤，最后以理中汤善后，共服药三十剂而痊愈。如今十年过去了，小孩健康成长，已读小学了。
有人问：俗话常说小儿初生，先服开口药，以排出胎毒，避免生疮症，用药不外乎大黄、金银花、钩藤、防风、巴豆、大枣等，果真可以服用吗？
回答说：小儿落地，一定要服开口药，以排出胎毒，避免生疮、风症，这都是不经之论。夫小儿居住在母腹中，母亲呼一口气，母亲吸一口气，十月功夫圆满，破衣而出，此时一团真气养成，有什么胎毒？如果真的有毒素，小儿还能存活吗？既然已经落地，就像刚出土的萌芽，这一身真气，本来并无丝毫外邪，怎么可以用戕伐生气的药物来施治呢？这样就会导致无疾反生有疾，不生风因而生风，所以有四六风、七天风，十有九死，难以一一列举。这是千古流传的弊端，实在是千古小儿的大灾难啊。唉！为什么世人不讲究医理法则呢？
【阐释】郑氏认为小儿初生下地，不可妄施药品，极力驳斥世俗用大黄、金银花等药物来下胎毒的错误观点，并指出其流弊，在当时是很有见地的。现今产科医院林立，妇女生育小孩多在医院，这种陋习，已随之而消失了。
附录
《伤寒论》原文中，有《伤寒恒论》中所没有的，补充在此作为备考。
6. 太阳病，发热而渴，不恶寒者，为温病。如果发汗后，身体灼热的，名叫风温。风温这种病，脉象阴阳俱浮，自汗出，身体沉重，嗜睡，鼻息必定鼾声，语言困难。如果被误用攻下法，小便不利，直视失禁。如果被误用火疗，轻微的发黄色，严重的如同惊痫，时时抽搐。如果用火熏法，一次误治尚且拖延时日，再次误治就会加速死亡。
30. 问曰：症状像阳旦证，按照常规法治后反而加重，出现四肢厥逆，咽喉干燥，两小腿拘急而且谵语。老师说：半夜手足应当变暖，两脚应当伸直。后来果然像老师所说，凭什么知道这一点？
回答说：寸口脉浮而大，浮表示风邪，大表示虚损，风邪则产生微热，虚损则两小腿拘挛，病形象似桂枝汤证，因此加入附子参合其间。增加桂枝令其出汗，附子温经，这是因为亡阳的缘故。
出现四肢厥逆，咽喉干燥，烦躁，阳明内结，谵语烦乱，再饮用甘草干姜汤。半夜阳气恢复，两足应当发热，小腿仍然轻微拘急，再次给予芍药甘草汤，然后小腿伸直；用承气汤轻微通便，则停止其谵语，所以知道病可痊愈。
37. 太阳病，十天以上，脉浮细而想睡觉的，表证已解，如果胸部满闷胁肋疼痛的，给予小柴胡汤；脉只浮的，给予麻黄汤。
92. 病发热头痛，脉反而沉，如果不愈，身体疼痛，应当救其里，适宜四逆汤。
98. 得病六七日，脉迟浮弱，恶风寒，手足温，医生二三度攻下，不能进食，而且胁下满痛，面目及全身发黄，颈项强直，小便困难的，给予柴胡汤，之后必定有下重感，原本口渴饮水却呕吐的，柴胡汤不适合使用，进食则呃逆。
101. 条文前段。伤寒中风，有柴胡证，但见到一个证候就可以，不必全部具备。
113. 外形像伤寒，其脉不弦紧而弱，弱则必定口渴，被火疗必定谵语，弱而发热脉浮，解表应当汗出而愈。
115. 脉浮热甚，反而用艾灸，这是实证，以虚证治法对待实证，因火而动，必定咽喉干燥吐血。
122. 病人脉数，数为热，应当消谷引食，反而呕吐的，这是因为发汗，令阳气微弱，膈气虚，脉才数。数为客热，不能消谷，因为胃中虚冷，所以呕吐。
141. 病在阳分，应当以汗法解之，反而用冷水喷灌，如果灌之，其热被劫持不得去除，更加烦闷，皮肤起粟粒，想要喝水，反而不渴的，服用文蛤散。如果不愈的，给予五苓散。寒实结胸，无热证的，给予三物小陷胸汤，白散也可以服用。
171. 太阳少阳并病，心下硬满，颈项强而弦的，应当刺大椎、肺俞、肝俞，千万不要攻下。
224. 阳明病，汗出多而渴的，不可与猪苓汤，因为汗多胃中燥，猪苓汤再次利其小便的缘故。
331. 伤寒先厥冷，后发热而腹泻的，必定自行停止，见到厥冷又腹泻。
342. 伤寒厥冷四天，发热反而三天，又厥冷五天，病情为进展，寒多热少，阳气退却，所以为进展。
380. 伤寒大吐大下的，极度虚弱，又极汗出的，其人外气怫郁，又给水以发其汗，因而得呃逆。之所以这样，是因为胃中寒冷。
381. 伤寒，呃逆而腹满，看其前后二便，知道哪部不利，通利即愈。
辨霍乱病脉症并治篇 382. 问曰：病有霍乱的，是什么？回答说：呕吐而腹泻，这叫霍乱。
383. 问曰：病发热头痛，身疼恶寒，吐利的，这属于什么病？
384. 伤寒，其脉微涩的，本是霍乱，现在是伤寒，却四五日至阴经上，转入阴必利，原本呕吐下利的，不可治。想要大便反而失气，仍不利的，这属于阳明，大便必定硬，十三日愈，之所以这样，因为经尽的缘故。下利后，应当大便硬，硬则能食的愈。现在反而不能食，到后经中，颇能食，又过一经能食，过之一日当愈，不愈的，不属于阳明。
四逆加人参汤方 甘草二两（炙） 附子一枚（生、去皮，破八片） 干姜一两半 人参一两 上四味，以水三升，煮取一升二合，去渣，分温再服。
386. 霍乱，头痛发热，身疼痛，热多欲饮水的，五苓散主之。寒多不用水的，理中丸主之。
387. 吐利止，而身痛不休的，应当斟酌和解其外，适宜桂枝汤小和之。
388. 吐利汗出，发热恶寒，四肢拘急，手足厥冷的，四逆汤主之。
389. 既吐且利，小便复利，而大汗出，下利清谷，内寒外热，脉微欲绝的，四逆汤主之。
390. 吐已下断，汗出而厥，四肢拘急不解，脉微欲绝的，通脉四逆加猪胆汁汤主之。
通脉四逆加猪胆汁汤方 甘草二两（炙） 干姜三两 强人可四两 附子大者一枚（生去皮，破八片） 猪胆汁半合 上四味，以水三升，煮取一升二合，去渣，内猪胆汁，分温再服，其脉即来。无猪胆，以羊胆代之。
编后记
郑钦安氏为近代杰出的、具有代表性的伤寒学家，其所著《医理真传》、《医法圆通》和《伤寒恒论》三书，从元阴元阳立论，互相发明，浑然一体，为推广运用伤寒理法方药于各种杂病的辨证治疗的独特经验总结，对治疗慢性疾病，独辟蹊径，自成一家，实为继承和发挥仲景学术传世之作。我佩服其学说，潜心研习，用于临床，效如桴鼓，故多年来致力于三书的阐释，承巴蜀书社以弘扬中华民族优秀传统文化为己任，鼎力支持，业已先后出版。出版后颇获海内外好评，其中《医理真传》、《医法圆通》再版均已售罄。现应读者要求，乃将三书重排，合订为一册，改为大32开精装出版，定名为《郑钦安医书阐释》。三书内容，没有增减，仅由责任编辑调整统一全书体例，删除、合并三书序、跋、附记中的冗赘篇章，重编总目，并对原版个别讹错字加以订正。
十多年来，我虽竭尽全力为阐释三书作了很多工作，因个人水平有限，加之资料不足，对于所不知者，付诸阙如；所幸郑氏三书，原文俱在，深望中医界高明之士，不断丰富发展，以匡不逮，庶使郑氏之学，得以发扬光大，则我抛砖引玉的宿愿也就得偿了。
承全国人民代表大会常务委员会副委员长，中国科学院主席团成员、院士，中国医学科学院名誉院长，中华医学会名誉会长，国际知名泌尿科专家，我九三学社主席吴阶平同志为《郑钦安医书阐释》题签，敬致谢忱。
唐步祺于成都槐树斋
1995年3月
[Explanation] Zheng's commentary on this clause adopts a question-and-answer format to explain the functions of dried ginger (Ganjiang) and prepared aconite root (Fuzi), and refutes the claim that taking dried ginger and prepared aconite root will "burn up kidney water." Among the 113 formulas in Zhang Zhongjing's *Treatise on Cold Pathogenic Diseases* (*Shanghan Lun*), 33 formulas use prepared aconite root. This is because prepared aconite root possesses the nature of pure yang, capable of tonifying the true yang within the Kan trigram (Kidney Yang). The book *Yi Li Zhen Chuan* (True Transmission of Medical Principles) contains interpretations of the Kan trigram, the Li trigram, interpreting Qi and Blood as one trigram, and the explanation of Ministerial Fire and Sovereign Fire. These all illustrate that the circulation of Qi and Blood throughout the five zang organs, six fu organs, and the entire body must maintain corresponding balance to ensure health and longevity. If there is an excess in any aspect, disease will inevitably arise. "Excess Qi becomes fire; deficient Qi becomes cold." "When fire is flourishing, yin must be deficient; when cold is severe, yang must decline." These are the origins of yang deficiency and yin deficiency. Dried ginger and prepared aconite root are the principal medicines for yin syndromes. They are used to support the "lesser fire" (physiological fire) to generate qi. For all kinds of yang deficiency syndromes, they can be taken. Prepared aconite root is the foremost among hot-natured medicines; it can support the dying embers of fire. It must be assisted by the acrid-dispersing property of dried ginger to sweep away yin pathogens and guide yang back to its residence, hence termed "returning yang." For diseases caused by yang deficiency and yin excess, they can be used boldly. If used early and skillfully, critical conditions will not develop. This is because pathogenic fire damages yin fluids, whereas true fire actually generates yin fluids. When fire is abundant, water is abundant; when fire declines, water declines. Therefore, the claim that dried ginger and prepared aconite root burn up kidney water is truly baseless. In my decades of clinical practice, I have been known for my adept use of dried ginger, cinnamon twig (Guizhi), and prepared aconite root. I use prepared aconite slices ranging from dozens of grams to two or three hundred grams, without ever encountering any side effects. This is precisely based on the theory that "pathogenic fire damages yin, while true fire generates yin." He further asks: "Then why do people use rhubarb (Dahuang) and mirabilite (Mangxiao) to treat diseases?" Mirabilite and rhubarb are medicines used to treat "vigorous fire" (pathological fire) consuming qi. Consuming qi means exhausting the primordial yin qi. If not urgently extinguished, the true yin will be scorched away in an instant, leading to a shortened lifespan. As for the symptoms presented, such as coarse breathing, hot mouth, excessive thirst with desire for cold drinks, not only are dried ginger and prepared aconite root contraindicated, but all acrid-dry substances should also be prohibited. This is the application of Baihu Tang and Chengqi Tang.
Question: Commonly, it is said that children have a "pure yang constitution" and should not take dried ginger and prepared aconite root. Is this correct? Or incorrect?
Answer: Children possess a "tender yang" constitution, similar to a newly sprouted seedling. Their physical quality is delicate; if medication is slightly inaccurate, unforeseen disasters may occur, leading to various critical conditions of yang deficiency. Besides dried ginger and prepared aconite root, what else can support the lesser fire to generate qi and rescue the precarious state of congenital vitality? People often speak of "pure yang," which is indeed a biased view. In summary, when using dried ginger and prepared aconite root, one must investigate deficiency and excess, observe yin and yang, examine the complexion and spirit. If cooling is indicated, cool; if heating is indicated, heat. Why rigidly condemn dried ginger and prepared aconite root?
[Explanation] The common saying "children have a pure yang constitution, having only heat and no cold" is incorrect. Some newborns exhibit yang deficiency immediately after birth due to the mother's preference for raw and cold foods during pregnancy, or due to malnutrition, resulting in poor fetal growth and development in the womb. Such infants may have a fair complexion, blue veins visible on the forehead, cyanotic-white lips, weak crying voice, pale-red tongue coating, and white-greasy tongue fur. Other children may suffer from illness requiring penicillin-streptomycin injections or overuse of cold-natured medicines, just as Zheng stated: "Slight medication errors lead to unforeseen disasters,酿成 (brewing) various critical conditions of yang deficiency."
In either of the above two scenarios, it is imperative to use dried ginger and prepared aconite root to support the lesser fire to generate qi and save the critical condition. One must distinguish yin-yang deficiency and excess when using these herbs; how can one rigidly adhere to the notion that children, being of pure yang constitution, should not take them? I once treated a pediatric patient, Xiao Dai, who developed severe coughing at three months old. After half a month of penicillin injection therapy in the hospital, he was discharged cured. However, within a year, his cough and asthma recurred intermittently, requiring four hospitalizations. The final diagnosis was pulmonary emphysema. Despite intravenous injections and fluid therapy, there was no improvement, and a critical condition notice was issued. The child had a dark complexion, bent head and chest while coughing, rapid panting, cold sweat, and ice-cold hands and feet. His tongue was pale-red with a white-greasy coating. His mother had consumed raw fruits, melons, ice cream, and carbonated beverages during pregnancy. Based on this diagnosis, the fetus was damaged in utero, manifesting yang deficiency signs after birth. Furthermore, five hospital visits within three months, along with penicillin injections and fluid therapy, damaged the yang qi. With various critical signs present, it was necessary to use dried ginger and prepared aconite root to tonify yang and stop coughing and wheezing. Initially, Sini Tang added with Ephedrae Herba (Mahuang) was used; subsequently, Zhenwu Tang was administered; finally, Lizhong Tang was used for recovery. After thirty doses, he recovered. Ten years later, the child has grown up healthily and attends primary school.
Question: It is commonly said that newborns should first take "opening medicine" to expel fetal toxins and prevent sores and wind disorders. Medicines typically include rhubarb, honeysuckle flower (Yinhua), uncaria hook (Gouteng), saposhnikovia root (Fangfeng), croton seed (Badou), and jujube (Dazao). Is it really advisable to administer them?
Answer: The idea that newborns must take opening medicine to expel fetal toxins and prevent sores and wind disorders is unfounded. While in the mother's womb, the fetus breathes with the mother's inhalation and exhalation. After ten months of gestation, upon breaking the membranes, a mass of true qi is formed. What fetal toxin could there be? If there were toxins, could the infant survive? Once born, like a sprout emerging from soil, the body's true qi is free from external pathogens. How can one administer drugs that damage vital energy? Doing so would create disease where there was none, and induce wind disorders where there were none, leading to conditions like "four-six wind" or "seven-day wind," with nine out of ten deaths, too numerous to list. This is a long-standing malpractice and a great calamity for children throughout history. Alas! Why do people fail to study medical principles and methods?
[Explanation] Zheng believed that newborns should not be recklessly medicated. He strongly refuted the secular practice of using rhubarb, honeysuckle, etc., to expel fetal toxins, pointing out its detrimental consequences. This was highly insightful for his time. Today, with obstetric hospitals everywhere and most births occurring in hospitals, this bad habit has disappeared.
Appendix
The following are original texts from *Shanghan Lun* missing from *Shanghan Heng Lun*, added here for reference.
6. Taiyang disease, characterized by fever, thirst, and aversion to cold absence, is Warm Disease. If sweating therapy is applied and the body becomes burning hot, it is named Wind-Warmth. In Wind-Warmth disease, pulse is floating and large on both cun and chi positions, spontaneous sweating occurs, the body feels heavy, drowsiness is prevalent, snoring is heard in nasal breathing, and speech is difficult. If purgatives are wrongly used, urination becomes difficult, eyes stare fixedly, and incontinence occurs. If fire therapy is wrongly applied, slight jaundice may appear; severely, it resembles convulsions with occasional spasms. If moxibustion or scalding is used, one error prolongs the illness; a second error accelerates death.
30. Question: Symptoms resemble Yangdan syndrome. Following standard treatment worsens the condition, causing cold extremities, dry throat, cramped calves, and delirium. The Master said: "By midnight, hands and feet will warm, and legs will extend." Later, this happened exactly as predicted. How did you know this?
Answer: The pulse at Cun Kou is floating and large. Floating indicates wind; large indicates deficiency. Wind generates slight heat; deficiency causes calf cramping. The presentation resembles Guizhi Tang syndrome, so Fuzi is added. Increasing Guizhi promotes sweating; Fuzi warms the meridians, addressing yang collapse.
For cold extremities, dry throat, irritability, yangming internal binding, and delirious confusion, drink Gancao Ganjiang Tang again. By midnight, yang qi returns, feet become warm. If calves remain slightly cramped, administer Shaoyao Gancao Tang again, then legs extend. Use Chengqi Tang to induce mild stooling to stop delirium, indicating recovery.
37. Taiyang disease lasting more than ten days, with a fine floating pulse and desire to sleep, indicates exterior resolution. If chest fullness and hypochondriac pain persist, give Xiaochaihu Tang. If only the pulse is floating, give Mahuang Tang.
92. Disease with fever, headache, and a sinking pulse contrary to expectation. If unresolved and accompanied by body pain, rescue the interior with Sini Tang.
98. Six or seven days into illness, pulse is slow, floating, and weak; aversion to wind and cold; warm hands and feet. After two or three erroneous purgations, inability to eat, hypochondriac fullness and pain, yellowing of face and body, neck stiffness, and difficulty urinating occur. Giving Chaihu Tang will likely cause a sensation of heaviness in the rectum. If originally thirsty for water but vomiting, Chaihu Tang is inappropriate; eating triggers hiccups.
101. Regarding the first part of the clause: In Shanghan or Zhongfeng, if Chaihu syndrome exists, observing one symptom suffices; all need not be present.
113. Appearance resembles Shanghan, but pulse is not wiry-tight; instead, it is weak. Weakness implies thirst. Fire therapy will cause delirium. Weakness with fever and floating pulse resolves with sweating.
115. Pulse is floating with intense heat. Moxibustion is wrongly applied. This is an excess pattern treated as deficiency. Fire agitation causes dry throat and hemoptysis.
122. Patient has a rapid pulse, indicating heat, which should aid digestion and appetite. Instead, vomiting occurs. This results from sweating depleting yang qi, leaving diaphragm qi deficient, causing the rapid pulse. Rapid pulse here indicates transient heat, unable to digest food, due to cold stomach. Hence vomiting.
141. Exterior disease should be resolved by sweating. Using cold water spray or irrigation traps heat, increasing irritability and causing gooseflesh. Desire to drink but no thirst indicates Wenli San is appropriate. If ineffective, Wuling San is given. Cold-excess Jiechu without heat signs is treated with Sanwu Xiaoxiongtang; Baisan is also acceptable.
171. Concurrent Taiyang and Shaoyang disease with epigastric hardness, stiff and wiry neck. Acupuncture at Dazhui, Feishu, Ganshu is indicated. Avoid purgation.
224. Yangming disease with profuse sweating and thirst. Zhuling Tang is contraindicated because sweating causes stomach dryness, and Zhuling Tang further promotes urination.
331. Shanghan begins with cold limbs. If fever follows with diarrhea, diarrhea stops spontaneously. If cold limbs return, diarrhea recurs.
342. Shanghan with four days of cold limbs followed by three days of fever, then five days of cold limbs indicates progression. More cold than heat signifies yang retreat, marking disease progression.
380. Severe vomiting and purging in Shanghan cause extreme weakness. Profuse sweating follows. External qi stagnation occurs. Giving water to induce sweating leads to hiccups due to cold stomach.
381. Shanghan with hiccups and abdominal fullness. Check anterior and posterior orifices. Identify obstruction and relieve it for cure.
Chapter on Differentiating Huoluan Disease Pulses and Symptoms
382. Question: What is Huoluan? Answer: Vomiting and diarrhea constitute Huoluan.
383. Question: Fever, headache, body ache, aversion to cold, vomiting, and diarrhea—what disease is this? Answer: This is Huoluan. Huoluan involves spontaneous vomiting and diarrhea. Even if diarrhea stops, fever may recur.
384. Shanghan with faint and choppy pulse was originally Huoluan, now Shanghan. After four or five days, pathogen enters yin meridians, turning inward causes diarrhea. Original vomiting and diarrhea are incurable. Desire to defecate but passing gas without stool indicates Yangming. Stool becomes hard; recovery in thirteen days due to meridian cycle completion. Post-diarrhea hard stool allows eating, indicating recovery. Inability to eat suggests non-Yangming involvement.
385. Aversion to cold, faint pulse, and recurrent diarrhea. Diarrhea cessation indicates blood loss. Sini Tang plus Renshen Tang governs.
Formula for Sini Tang plus Renshen Tang: Zhi Gancao 2 liang, Sheng Fuzi 1 piece (peeled, broken into 8), Ganjiang 1.5 liang, Renshen 1 liang. Boil in 3 sheng water to obtain 1.2 sheng. Strain. Divide into two warm doses.
386. Huoluan with headache, fever, body ache. Heat predominance with desire for water: Wuling San governs. Cold predominance without desire for water: Lizhong Wan governs.
387. Vomiting and diarrhea cease, but body pain persists. Harmonize the exterior moderately with Guizhi Tang.
388. Vomiting, diarrhea, sweating, fever, aversion to cold, limb cramping, and cold extremities: Sini Tang governs.
389. Vomiting and diarrhea, frequent urination, profuse sweating, undigested food in stool, internal cold with external heat, faint pulse nearly imperceptible: Sini Tang governs.
390. Vomiting and diarrhea stop, sweating with cold extremities, persistent limb cramping, faint pulse nearly imperceptible: Tongmai Sini Tang plus Zhu Danzhi governs.
Formula for Tongmai Sini Tang plus Zhu Danzhi: Zhi Gancao 2 liang, Ganjiang 3 liang (4 liang for strong constitutions), large Sheng Fuzi 1 piece (peeled, broken into 8), Zhu Danzhi 0.5 he. Boil in 3 sheng water to obtain 1.2 sheng. Strain. Add Zhu Danzhi. Divide into two warm doses. Pulse returns. If pig gallbladder unavailable, use sheep gallbladder.
391. Vomiting, diarrhea, sweating, normal pulse with slight irritability: Due to new deficiency unable to handle grain qi.
Postscript
Zheng Qin'an was a prominent modern scholar of Shanghan. His works *Yi Li Zhen Chuan*, *Yi Fa Yuan Tong*, and *Shanghan Heng Lun* establish theories on primordial yin and yang, mutually illuminating each other as a cohesive whole. They summarize unique experiences in applying Shanghan principles, methods, formulas, and herbs to miscellaneous diseases, offering innovative approaches for chronic conditions. This constitutes a valuable inheritance and development of Zhang Zhongjing's academic legacy. Admiring his scholarship, I studied it diligently and applied it clinically with excellent results. Thus, I dedicated years to explaining these three books. Bashu Book Society, committed to promoting Chinese traditional culture, supported their publication. They received acclaim domestically and internationally, with reprints of *Yi Li Zhen Chuan* and *Yi Fa Yuan Tong* selling out. Responding to reader demand, these three books are now republished together in a single volume, large 32-size hardcover, titled *Zheng Qin'an Yishu Chanshi*. Content remains unchanged; editorial adjustments unified formatting, removed redundant prefaces/postscripts, revised the table of contents, and corrected typographical errors.
Despite my efforts over ten years to explain these books, limited personal ability and insufficient resources left some gaps. Fortunately, the original texts remain. I hope eminent TCM practitioners will enrich and develop this knowledge to compensate for my shortcomings, allowing Zheng's learning to flourish, fulfilling my wish to throw a brick to attract jade.
I extend gratitude to Comrade Wu Jieping, Vice Chairman of the Standing Committee of the National People's Congress, Member of the Presidium and Academician of the Chinese Academy of Sciences, Honorary President of the Chinese Academy of Medical Sciences, Honorary President of the Chinese Medical Association, International Renowned Urologist, and Chairman of China Jiusan Society, for inscribing the title for *Zheng Qin'an Yishu Chanshi*.
Tang Buqi at Huaishu Studio, Chengdu
March 1995
Shanghan Heng Lun Upper Volume | Shanghan Heng Lun Lower Volume