三阴三阳者,天之六气也。五脏六腑者,有形之五行也。胃属土,而阳明主秋令之燥。阳明者,胃之
悍气,别走阳明,犹膀胱乃津液之府,而太阳之气为巨阳,五行六气之有别也。夫两阳合明,故曰阳明,
阳盛之气也,故胃土之气柔和,(土主柔顺。)而阳明之气燥热,是以阳明得中见少阴之湿化,则阴阳相和矣。
胃土得戊癸之合,则火土之气盛矣。故阳明之气宜于和柔,胃土之气宜于强盛,如火土之气弱,而又秉太阴
之湿,则水谷不消而为虚泄矣。此宜人参、橘皮、甘草、半夏之类以助胃,白术、苍术、浓朴、茯苓、姜、
枣之类以益脾,甚者加附子以助癸中之火。若阳明悍热之气盛,而不得太阴之化,则阳与阴绝,渐能食而
瘦矣。此又宜黄连、枳实之类以抑胃, 、术、姜、枣之类以扶脾。易老、东垣以枳术丸为半补半消之法,
皆不得五行六气之理、先圣立方之意。
余于南轩临窗注书,十有余岁矣。自晨至暮,未尝离此。窗前阶砌虽小,而甚清洁,每于夏月大风雨
后,即有蜒蚰如拇指大者,蜗牛如田螺者,生长极易,此感天地之风湿而生,所谓四生中之湿生也。人
秉天地之五行六气而生,身中亦具此六气。如伤寒病在厥阴,感厥阴之风气,而蛔生于中土。盖亦因风湿
所生,一时即能长大,亦如蚰、蜗之易生易大者也。又常闻人之脏腑,与猪相似。余因见剖猪处,稍住足
观之,偶见一猪小肠内,有蛔虫长尺许,盘旋于内,与人之蛔虫无异。要知人病蛔厥作痛,或常吐蛔、便
蛔,多因脾胃湿热而生,无病之人,未常有蛔也。俗人相沿云∶胃中有蛔,故能消食。谬矣!
三阴三阳,对应的是天地的六气。五脏六腑,是有形的五行物质基础。胃属于土,而阳明经主管秋季的燥气。阳明经,是胃中剽悍滑疾之气,别行于阳明经;这就好比膀胱是津液汇聚之府,而太阳经之气称为巨阳,这是五行与六气各有区别的缘故。所谓“两阳合明”,所以称为阳明,它是阳气极盛的气化表现,因此胃土之气应当柔和(土性主柔顺),而阳明之气则偏于燥热,所以阳明经得到中见少阴的湿化作用,阴阳才能调和。胃土得到戊癸相合(化火),则火土之气旺盛。因此,阳明之气适宜和柔,胃土之气适宜强盛;如果火土之气虚弱,又禀受太阴的湿气,就会导致水谷不消化而出现虚寒泄泻。这种情况适宜用人参、橘皮、甘草、半夏等药物来辅助胃气,用白术、苍术、厚朴、茯苓、生姜、大枣等药物来补益脾气,病情严重的加附子以助益命门之火。如果阳明剽悍燥热之气过盛,而不能得到太阴的湿化制约,就会导致阳与阴隔绝,出现虽然能吃但身体消瘦的症状。这种情况又适宜用黄连、枳实等药物来抑制胃火,用白术、生姜、大枣等药物来扶持脾气。李东垣等人将枳术丸作为半补半消的方法,都没有掌握五行六气的道理,也不符合先圣创立方剂的宗旨。
我在南轩临窗读书,已经有十多年了。从早晨到晚上,未曾离开这里。窗前台阶虽小,但非常清洁,每逢夏月大雨风雨之后,就有像拇指大的蜒蚰(蜗牛类软体动物)、像田螺一样的蜗牛生长,极易繁殖,这是因为感应了天地间的风湿之气而生,这就是所谓的“四生”中的湿生。人秉承天地的五行六气而生,体内也具备这六气。比如伤寒病在厥阴经,感受了厥阴的风气,蛔虫就会生于中焦脾胃。大概也是因为风湿所生,短时间内就能长大,也像蜒蚰、蜗牛一样容易生长变大。我又常听人说人的脏腑与猪相似。我曾因在宰猪处稍驻足观看,偶然看见一头猪的小肠内,有长约一尺的蛔虫,盘旋其中,与人的蛔虫没有不同。要知道人患蛔厥作痛,或者经常吐蛔虫、便蛔虫,多是因为脾胃湿热而生,没有生病的人,体内通常不会有蛔虫。世俗之人沿袭说法:认为胃中有蛔虫,所以能消化食物。这是错误的!
The Three Yin and Three Yang correspond to the Six Qi of Heaven. The Five Zang and Six Fu organs are the有形 (tangible) basis of the Five Elements. The Stomach belongs to Earth, while the Yangming channel governs the Dryness of Autumn. Yangming is the vigorous Qi of the Stomach, which branches off to the Yangming channel; this is analogous to the Bladder being the mansion of fluids, while the Qi of the Taiyang channel is called Ju Yang (Great Yang). This illustrates the distinction between the Five Elements and the Six Qi. Because two Yangs combine to illuminate, it is called Yangming, representing the Qi of extreme Yang abundance. Therefore, the Qi of Stomach Earth should be gentle and soft (Earth governs gentleness), whereas the Qi of Yangming tends toward dryness and heat. Thus, when Yangming receives the damp transformation from its interior counterpart Shaoyin, Yin and Yang achieve harmony. When Stomach Earth combines with Wu and Gui (transforming into Fire), the Qi of Fire and Earth becomes prosperous. Consequently, the Qi of Yangming should be harmonious and gentle, and the Qi of Stomach Earth should be strong and robust. If the Qi of Fire and Earth is weak and additionally influenced by the Dampness of Taiyin, water and grain will fail to digest, leading to deficiency-type diarrhea. In such cases, it is appropriate to use herbs such as Renshen (Ginseng Radix et Rhizoma), Jupi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), and Banxia (Pinelliae Rhizoma) to assist the Stomach, and Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling (Poria), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus) to benefit the Spleen. For severe cases, Fuzi (Aconiti Lateralis Radix Praeparata) may be added to assist the Fire within Gui. Conversely, if the vigorous and hot Qi of Yangming is excessive and cannot be transformed by Taiyin, Yang and Yin become severed, resulting in increased appetite but emaciation. In such instances, it is appropriate to use herbs such as Huanglian (Coptidis Rhizoma) and Zhishi (Aurantii Fructus Immaturus) to suppress Stomach Heat, and Baizhu, Shengjiang, and Dazao to support the Spleen. Li Dongyuan and others regarded Zhizhu Wan (Bitter Orange and Atractylodes Macrocephala Pill) as a method of half-tonifying and half-resolving, failing to grasp the principles of the Five Elements and Six Qi, and missing the intent of the ancient sages in formulating prescriptions.
I have been studying by the window at Nanxuan for over ten years. From morning till night, I have never left this spot. Although the steps before the window are small, they are kept very clean. Every summer after heavy rainstorms, creatures like thumb-sized slugs (Yanyou) and snails resembling field snails grow easily. These arise from sensing the Wind-Dampness of Heaven and Earth, known as "damp-born" among the four types of generation. Humans are born inheriting the Five Elements and Six Qi of Heaven and Earth, and our bodies also possess these Six Qi. For instance, when a Shanghan (Cold Damage) disease affects the Jueyin channel, and one contracts the Wind Qi of Jueyin, roundworms (Hui Chong) may develop in the central Earth (Spleen/Stomach). This is likely due to Wind-Dampness generating them, allowing them to grow large quickly, similar to how slugs and snails grow easily. I have often heard that human internal organs resemble those of pigs. Once, while pausing briefly at a pig-slaughtering site, I happened to observe a pig's small intestine containing a roundworm about one chi long, coiling inside, indistinguishable from human roundworms. It must be understood that when humans suffer from Hui Jue (roundworm colic) with pain, or frequently vomit or pass roundworms, it is mostly due to Damp-Heat in the Spleen and Stomach. Healthy individuals typically do not harbor roundworms. The common folk erroneously persist in the belief that having roundworms in the stomach aids digestion. This is false!