《阴阳应象大论》曰∶阴阳者，天地之道也，万物之纲纪，变化之父母，生杀之本始，神明之府
也，治病必求其本（此明天地万物，变化生杀，总不出于阴阳，察乎此者可以当神明矣。故治病者万绪纷然，
必求于本，或本于阴，或本于阳，阴阳既得，病祟焉逃。芩连姜附，尽可回春，参术硝黄，并能起死。此之未
辨，畏攻畏补，忧热忧寒，两岐必至于误生。广络遗讥于圣哲，本顾可弗求乎哉）。
《至真要大论》曰∶谨守病机，各司其属，有者求之，无者求之，盛者责之，虚者责之，必先五胜，疏其
血气，令其调达而致和平。此言病状繁多，各宜细察，然总不外于虚实也。谨守者，防其变动也。病而曰机者，
状其所因之不齐，而治之不可不圆活也。属者，有五脏之异、六腑之异、七情之异，六气之异、贵贱之异、老
少之异，禀畀有虚实之异，受病有标本之异，风气有五方之异，运气有胜复之异，情性有缓急之异，有尝贵后
贱之脱营，尝富后贫之气离守，各审其所属而司其治也。有者求之二句，言一遇病症，盒饭审其所属之有无也。
盛者责之二句是一章之大纲，于各属有无之间分别虚实而处治也。然至虚似实，大实似虚，此又不可不详为之
辨也。必先五胜者，如木欲实，金当平之之类是也。疏其血气，非专以攻伐为事。或补之而血气方行，或温之
而血气方和，或清之而血气方治，或通之而血气方调，正须随机应变，不得执一定之法，以应无穷之变也。此治
虚实之大法，一部《内经》之关要也。
君一臣二，奇之制也，君二臣四，偶之制也；君二臣三，奇之制也；君二臣六，偶之制也（君者，品味少
而分两多。臣者，品味多而分两少。奇制从阳，偶制从阴）。故曰∶近者奇之，远者偶之；汗者不以偶，下者
不以奇（病在上者为近，属阳，故用奇方，取其轻而缓也。病在下者为远，属阴，故用偶方，取其重而急也。
汗者不以偶，阴沉不能达表也。下者不以奇，阳升不能降下也）；补上治上制以缓，补下治下制以急，急则气味
浓，缓则气味薄。适其至所，此之谓也（上药宜缓，欲其曲留上部；下药宜急，欲其直达下焦。欲急者，须气
味之浓，欲缓者，须气味之薄。缓急得宜，浓薄合度，则适其病至之所，何患剂之弗灵乎）。病所远而中道气味之
者，食而过之，无越其制度也（病之所在远，而药则必由于胃，用之无
法则未达病所，则中道先受其气味矣。当于食为度，而使远近适宜，是过之也，过，犹达也。欲其近者，药在
食后，则食载药而留止于上，欲其远者，药在食前，则食坠药而疾走于下。服药有疾徐，根梢有升降，气味有
缓急，药剂有汤丸膏散，各须合法，无越其度也）。是故平气之道，近而奇偶，制小其服也。远而奇偶，制大其服
也。大则数少，小则数多，多则九之，少则二之（近病远病，各有阴阳表里之分，故远方近方，各有奇偶相兼
之法，或方奇而分两偶，或方偶而分两奇，此奇偶互用也。近而奇偶，制小其服，小则数多而尽于九。盖数多则
分两轻，性力缓而仅及近病也。远而奇偶，制大其服，大则数少，而止于二。盖数少则分两重，性力专而直达
远病也。是皆奇偶互用法之变也），奇之不去则偶之，是谓重方。偶之不去，则反佐以取之，所谓寒热温凉，
反从其病也（此变通之法也。始用药奇而病不去，变而为偶，奇偶迭用，是曰重方。重者，复也。若偶之而又
不去，则当求其微甚真假，反佐以取之。反佐者，顺其性也，如以热治寒而寒拒热，则反佐以寒而入之∶以寒
治热而热格寒，则反佐以热而入之。又如寒药热服，热药冷服，皆变通之妙用也。王太仆曰∶热与寒背，寒与
热违，微小之热为寒所折，微小之冷为热所消，大寒大热必能与违性者争，与异气者格，是以圣人反其佐以同其
气，令声应气求也）。
辛甘发散为阳，酸苦涌泄为阴，咸味涌泄为阴，淡味渗泄为阳，六者或收或散，或缓或急，或燥或润，或
软或坚，以所利而行之，调其气使其平也（涌，吐也。泄，泻也。渗泄，利小便也。辛主散主润，甘主缓，酸主
收主急，苦主燥主坚，咸主软，淡主渗泄，各因其利而行之，气可平矣）。
寒者热之，热者寒之，微者逆之，甚者从之（义见上），坚者削之，客者除之，劳者温之，结者散之，
留者攻之，燥者濡之，急者缓之，散者收之，损者益之，逸者行之，惊者平之，上之下之，摩之浴之，薄之劫
之，开之发之，适事为故（温之，甘温能除大热也，逸，即安逸也。饥饱劳逸皆能成病，过于逸则气脉凝滞，
故须行之。上者，吐也。摩者，按摩也。薄者，即薄兵城下之义。适事为故，犹云中病为度，适可而止，毋太过
以伤正，毋不及以留邪也）。
逆者正治，从者反治，从少从多，观其事也（从少谓一从而二逆，从多为二从而一逆也。事即病也，观
其病之轻重，而为之多少也）。
热因寒用，寒因热用，塞因塞用，通因通用，必伏其所主，而先其所因，其始则同，其终则异，可使破
积，可使溃坚，可使气和，可使必已（寒病宜热，然寒甚者格热，须热药冷服。此热因寒用也，热病宜寒，然
热甚者格寒，须寒药热服，此寒因热用也。塞因塞用者，如下气虚乏，中焦气壅，欲散满则更虚其下，欲补下
则满甚于中，治不知本而先攻其满，药入或减，药过依然，气必更虚，病必转甚，不知少服则壅滞，多服则宣
通，峻补其下则下自实，中满自除矣。通因通用者，或挟热而利，或凝寒而泄，寒者以热下之，热者以寒下之，
伏其所主，利病之本也。先其所因者，求病之由也。其始则同，言正治也。其终则异，言反治也，明于反治，
何病不愈）。
诸寒之而热者取之阴，热之而寒者取之阳，所谓求其属也（用寒药治热病，而热反增，非火有余，乃阴不
足也，阴不足则火亢，故当取之阴，但补阴则阳自退耳。用热药治寒症，而寒反增，非寒有余，乃阳不足也，阳
不足则阴寒，故当取之阳，但补水中之火，则寒自消耳。求其属者，求于本也。一水一火，皆于肾中求之，
故王太仆曰∶益火之源以消阴翳，壮水之主以制阳光，六味、八味二丸是也）。
夫五味入胃，各归所喜攻，酸先入肝，苦先入心，甘先入脾∶辛先入肺，咸先入肾。久而增气，物化之常也，气
增而久，夭之由也（增气者，助其气也。如黄连之苦，
本入心泻火，多服黄连，反助心火。故五味各归，久而增气，气增必夭折，可不慎欤）。
《阴阳应象大论》曰∶因其轻而扬之，因其重而减之，因其衰而彰之（轻者在表，宜扬而散之。重者在内，
宜减而泻之。衰者不补，则幽潜沉冤矣，补则再生，故曰彰）。形不足者，温之以气∶精不足者，补之以味（此
彰之之法也。阳气衰微则形不足，温之以气，则形渐复也。阴髓枯竭则精不足，补之以味，则精渐旺也）。其
高者，因而越之（高者，病在上焦。越者，吐也，越于高者之上也），其下者，引而竭之（下者，病在下焦，竭
者，下也，引其气液就下也，通利二便皆是也。或云引者，蜜导、胆导之类。竭者，承气、抵当之类），中满
者，泻之于内（中满，非气虚中满也，如胀满而有水有积，伤寒而结胸便闭是也。内字与中字照应）。其有邪
者，渍形以为汗（渍，浸也，如布桃枝以取汗，或煎汤液以熏蒸，或表清邪重，药不能汗，或冬月天寒，发
散无功，非渍形之法不能汗也）；其在皮者，汗而发之（邪在皮则浅矣，但分经汗之可也）；其 悍者，按而
收之（ 者，急也。悍者，猛也，怒气伤肝之症也，按者，制伏酸收，如芍药之类是也），其实者，散而泻
之（阴实者，以丁、姜、桂、附散其寒。阳实者，以芩、连、栀、柏泻其火），审其阴阳，以别柔刚（审病之
阴阳，施药之柔刚），阳病治阴，阴病治阳（阳胜者阴伤，治其阴者，补水之主也；阴胜者阳伤，治其阳者，
补水中之火也），定其血气，各守其乡（或血或气，用治攸分，各不可紊也）。血实宜决之（导之下流，如决
江河也），气虚宜掣引之（提其上升，如手掣物也）。
《五常政大论》曰∶病有久新，方有大小，有毒无毒，固宜常制矣（病久者，宜大剂；病新者，宜小剂。
无毒者，宜多用；有毒者，宜少用）。大毒治病，十去其六，常毒治病，十去其七，小毒治病，十去其八，无毒治病，十
去其九（药不及则病不痊，
药太过则正乃伤，大毒治病。十去其六，盒饭止矣。毒轻则可任，无毒则可久任也），谷肉果菜，食养尽之，
无使过之，伤其正也（病虽去而有未尽去者，当以饮食养正，而余邪自尽。若药饵太过，便伤正气）。必先岁
气，毋伐天和（五运有纪，六气有序，四时有令，阴阳有节，皆岁气也。人气应之以生长收藏，此天和也。于
此未明，则犯岁气、伐天和矣）。
《六元正纪大论》黄帝问曰∶妇人重身，毒之何如？岐伯曰∶有故无殒，亦无殒也（有孕曰重身。毒之。
用毒药也。故者，如下文大积大聚之故。有是故而用是药，所谓有病则病当之，故孕妇不殒，胎亦不殒也）。
帝曰∶愿闻其故何谓也？岐伯曰∶大积大聚，其可犯也，衰其大半而止（大积大聚，非毒药不能攻，然但宜衰
其大半，盒饭禁止，所谓大毒治病，十去其六者是也）。
愚按，论治之则，载由经籍，圆通之用，妙出吾心，如必按图索骥，则后先易辙，未有不出者矣。子舆氏
曰∶梓匠轮舆，能与人以规矩，不能使人巧。故夫揆度阴阳，奇恒五中，决以明堂，审于终始，其亦巧于规矩
者乎。
《阴阳应象大论》说：阴阳，是天地运行的规律，万物的总纲，变化的根源，生死的本始，神机变化的府库。治病必须探求根本（这里阐明天地万物、变化生死，总离不开阴阳，能洞察这一点的人就可以达到神明的境界。所以治病时虽然头绪纷繁，但必须探求根本，有的根本在阴，有的根本在阳，只要掌握了阴阳，病邪哪里能逃脱呢？黄芩、黄连、干姜、附子，都可以挽回生机；人参、白术、芒硝、大黄，都能起死回生。如果不辨明这些，既害怕攻下又害怕补益，既担忧热证又担忧寒证，必然导致误治，被圣哲所讥笑，根本难道可以不探求吗？）。
《至真要大论》说：谨慎地把握病机，分别归属其相应的脏腑或因素，有这种现象要探究其原因，没有这种现象也要探究其潜在原因，邪气盛的责之于邪盛，正气虚的责之于正虚，必须先分析五行相克的胜复关系，疏通气血，使其调和通达而恢复平衡。这是说病症繁多，各自应当仔细察辨，但总不外乎虚实两个方面。“谨守”，是为了防止病情变动。“病机”一词，是描述病因的不齐整，因此治疗不可不圆活变通。“属”，是指五脏不同、六腑不同、七情不同、六气不同、地位贵贱不同、年龄老少不同、禀赋虚实不同、受病标本不同、风气五方不同、运气胜复不同、性情缓急不同，以及曾经尊贵后变贫贱导致的“脱营”，曾经富裕后变贫穷导致的“气离守”，都要审察其所属类别而分别施治。“有者求之，无者求之”两句，是说一遇到病症，必须审察其所属性质的有无。“盛者责之，虚者责之”这两句是一章的大纲，在于区分各属性中虚实的情况而进行处置。然而极度虚弱看似实证，极度实滞看似虚证，这又不可不详细辨别。“必先五胜”，比如木气过实，金气应当平抑它之类。“疏其血气”，并不是专门以攻伐为事。或者通过补益使气血运行，或者通过温煦使气血调和，或者通过清解使气血治理，或者通过通利使气血调畅，正需要随机应变，不能拘执于固定的方法，来应对无穷的变化。这是治疗虚实的大法，也是整部《内经》的关键所在。
君药一味、臣药二味，是奇方的制度；君药二味、臣药四味，是偶方的制度；君药二味、臣药三味，是奇方的制度；君药二味、臣药六味，是偶方的制度（君药，药味少而分量重；臣药，药味多而分量轻。奇制顺应阳气，偶制顺应阴气）。所以说：病位近的用奇方，病位远的用偶方；发汗不用偶方，攻下不用奇方（病在上部者为近，属阳，所以用奇方，取其药力轻而缓和；病在下部者为远，属阴，所以用偶方，取其药力重而急猛。发汗不用偶方，因为阴气沉潜不能达表；攻下不用奇方，因为阳气升浮不能降下）；补上焦或治上部病证用缓剂，补下焦或治下部病证用急剂，急则药气味浓厚，缓则药气味淡薄。使药力恰好到达病所，说的就是这个道理（上部的药宜缓，希望它在上部停留曲折；下部的药宜急，希望它直达下焦。想要急效，须药气味浓厚；想要缓效，须药气味淡薄。缓急得当，浓薄合度，就能使药力适达病所，何必担心药剂不灵验呢）。如果病位深远而药物在中途就被胃气吸收，可以通过进食来控制药力，不要超越这个法度（病位所在遥远，而药物必须经过胃，如果没有法则，药力未到达病所，中途就先受到药味的影响了。应当以饮食为限度，使远近适宜，这就是“过”的意思，“过”就是到达的意思。想要药力在近处，药在食后服用，食物承载药物而停留在上部；想要药力在远处，药在食前服用，食物推动药物而快速走向下部。服药有快慢之分，药材根梢有升降之别，气味有缓急之异，药剂有汤、丸、膏、散的不同，都必须合乎法度，不要超越限度）。所以平调气机的原则是：病位近的用奇方或偶方，制成小剂量服用；病位远的用奇方或偶方，制成大剂量服用。大剂量则药味少，小剂量则药味多，多的不超过九味，少的不少于二味（近病和远病，各有阴阳表里的区别，所以远方和近方，各有奇偶配合的方法，或者方剂药味为奇而分量为偶，或者方剂药味为偶而分量为奇，这是奇偶互用。病位近而用奇偶方，制成小剂量，小则药味多而尽于九。因为药味多则分量轻，药性缓和，仅能到达近处的病。病位远而用奇偶方，制成大剂量，大则药味少，止于二。因为药味少则分量重，药性专一，能直达远处的病。这些都是奇偶互用法的变化），如果奇方无效就用偶方，这叫重方。如果偶方也无效，就用反佐法来取效，所谓寒热温凉，顺从病性而治（这是变通的方法。起初用药用奇方而病不去，改为偶方，奇偶交替使用，叫重方。重，就是重复。如果用偶方还不去，就应当探求病情的微甚真假，用反佐法来取效。反佐，就是顺从其病性，比如用热药治寒病而寒邪拒热，就反佐少量寒药进入；用寒药治热病而热邪格拒寒药，就反佐少量热药进入。又如寒药热服，热药冷服，都是变通的妙用。王太仆说：热与寒背道而驰，寒与热违背，微小的热会被寒折服，微小的冷会被热消除，大寒大热必然会与违性的药物抗争，与异气的药物格拒，所以圣人用反佐来同其气，使声相应，气相求）。
辛味和甘味能发散，属于阳；酸味和苦味能涌吐泄下，属于阴；咸味能涌吐泄下，属于阴；淡味能渗湿泄浊，属于阳。这六种味道，有的收敛有的发散，有的缓急有的燥润，有的软坚有的坚固，根据其所利的方面而施用，调理气机使其平和（涌，就是吐；泄，就是泻；渗泄，就是利小便。辛主散主润，甘主缓，酸主收主急，苦主燥主坚，咸主软，淡主渗泄，各依其有利的一面而施用，气机就可以平和了）。
寒证用热药治疗，热证用寒药治疗，病轻微的逆其病性治疗，病严重的顺其病性治疗（含义见上文），坚硬的要削磨它，外邪的要去除它，劳损的要温补它，郁结的要消散它，留滞的要攻逐它，干燥的要滋润它，拘急的要舒缓它，耗散的要收敛它，亏损的要补益它，安逸过度的要行气导引它，惊悸的要平复它，病在上部的用吐法或降法，按摩它，洗浴它，迫逐它，劫夺它，开泄它，发越它，以适合病情为准则（温之，指甘温能除大热；逸，即安逸。饥饱劳逸都能致病，过于安逸则气脉凝滞，所以需要行气导引。上，指吐法。摩，指按摩。薄，即兵临城下的意思。适事为故，犹如说中病为度，适可而止，不要太过伤及正气，也不要不及留下病邪）。
逆着病性治疗叫正治，顺着病性治疗叫反治，顺从的少或顺从的多，要看具体病情（从少指一个顺从而两个逆，从多指两个顺从而一个逆。事即病，观察病的轻重，来决定顺逆多少）。
热因寒用，寒因热用，塞因塞用，通因通用，必须制服其主要矛盾，先探求其病因，开始用药性质相同，最终效果不同，可以破除积滞，可以溃散坚块，可以使气和，可以使病必愈（寒病宜用热药，但如果寒邪极盛格拒热药，须将热药冷服，这叫热因寒用；热病宜用寒药，但如果热邪极盛格拒寒药，须将寒药热服，这叫寒因热用。塞因塞用，如下焦气虚匮乏，中焦气机壅滞，想消散胀满则会更虚下焦，想补下焦则中满更甚，治疗不知根本而先攻其胀满，药入可能暂时减轻，药过依然如故，气必更虚，病必转重，不知道少服则壅滞，多服则宣通，峻补下焦则下焦自实，中满自然消除了。通因通用，比如挟热而利，或凝寒而泄，寒者用热药攻下，热者用寒药攻下，伏其所主，是治病的根本。先其所因，是探求病的由来。其始则同，说的是正治。其终则异，说的是反治，明白反治，什么病不能痊愈呢）。
各种寒凉药治疗而热不退的，要取法于滋阴；温热药治疗而寒不除的，要取法于助阳，这就叫探求其本源（用寒药治热病，而热反而加重，不是火有余，而是阴不足，阴不足则火亢，所以应当补阴，只要补阴则阳自然退却。用热药治寒症，而寒反而加重，不是寒有余，而是阳不足，阳不足则阴寒，所以应当补阳，只要补水中之火，则寒自然消除。求其属，就是探求根本。一水一火，都在肾中探求，所以王太仆说：益火之源以消阴翳，壮水之主以制阳光，六味地黄丸、八味肾气丸就是这类药）。
五味进入胃中，各归其所喜的脏腑，酸味先入肝，苦味先入心，甘味先入脾；辛味先入肺，咸味先入肾。长期食用会增强相应脏腑之气，这是事物变化的常态，但气偏增久了，就会成为夭折的原因（增气，就是助长其气。比如黄连之苦，本入心泻火，多服黄连，反而助长心火。所以五味各归其经，久服则增气，气增久必夭折，能不谨慎吗？）。
《阴阳应象大论》说：因为病势轻扬的就用发散法，因为病势沉重的就用减损法，因为正气衰弱的就用彰显（补益）法（轻者在表，宜发散；重者在里，宜泻下；衰弱不补，则幽潜沉冤，补则再生，所以叫彰）。形体不足的，用气来温养；精髓不足的，用味来滋补（这是彰显的方法。阳气衰微则形不足，用气温养，则形体逐渐恢复；阴髓枯竭则精不足，用味滋补，则精髓逐渐旺盛）。病位在上的，用吐法使之越出；病位在下的，用通利法使之竭尽（高者，病在上焦。越，就是吐，使病邪越出于上部之上。下者，病在下焦，竭，就是下，引导气液向下，通利大小便都是。或者说引，指蜜导、胆导之类；竭，指承气汤、抵当汤之类）。中焦胀满的，从内部泻除（中满，不是气虚的中满，比如胀满而有水饮积滞，伤寒结胸便秘等。内字与中字呼应）。如果有邪气侵袭，浸渍身体以取汗（渍，浸，比如用桃枝沐浴取汗，或煎汤液熏蒸，或者表邪重，药不能发汗，或者冬天天寒，发散无功，非浸渍身体的方法不能取汗）；邪在皮肤的，用发汗法发散（邪在皮则浅，只需分经发汗即可）；邪气急悍的，按压并收敛它（悍，急也。悍者，猛也，怒气伤肝的病症，按，制约，酸收，比如芍药之类）。实证，用发散和泻下法（阴实，用丁香、干姜、肉桂、附子散其寒；阳实，用黄芩、黄连、栀子、黄柏泻其火），审察阴阳，以区别柔刚（审察病的阴阳，施用药的柔刚），阳病治阴，阴病治阳（阳胜则阴伤，治其阴，是补水之主；阴胜则阳伤，治其阳，是补水中之火），安定血气，各守其位（或血或气，治疗有所区分，各自不可紊乱）。血实的，宜决破疏导（导之下流，像决江河一样）；气虚的，宜提举引伸（提其上升，像手牵引物体一样）。
《五常政大论》说：有病有久有新，方有大有小，药有毒无毒，本来就有常规制度（病久的，宜大剂；病新的，宜小剂。无毒的药，宜多用；有毒的药，宜少用）。用大毒的药物治病，病去十分之六就停止；常用毒性的药物治病，病去十分之七就停止；小毒的药物治病，病去十分之八就停止；无毒的药物治病，病去十分之九就停止（药力不够则病不愈，药力太过则正气受伤，大毒治病，去其六分，就应该停止了。毒性轻的可以承受，无毒的可以久服）。用谷肉果菜，饮食调养来清除余邪，不要使药力过度，损伤正气（病虽去而有未尽者，应当以饮食养正，余邪自然尽除。若药饵太过，便伤正气）。必须首先考虑岁气，不要侵犯天和（五运有纪，六气有序，四时有令，阴阳有节，这都是岁气。人气顺应它们生长收藏，这就是天和。对此不明白，就会犯岁气、伐天和）。
《六元正纪大论》黄帝问：妇人怀孕，用毒药怎么样？岐伯说：有病则不会伤害母体，也不会伤害胎儿（怀孕叫重身。毒之，是用毒药。故，如下文大积大聚的缘故。有这种病因而用这种药，所谓有病则病邪承受药力，所以孕妇不伤，胎也不伤）。帝说：我想听听其中的道理，什么叫这样？岐伯说：大积大聚，可以触犯（使用猛药），但病去大半就停止（大积大聚，非毒药不能攻，但只宜去其大半，就应该禁止，所谓大毒治病，十去其六是同样的道理）。
我按语：论述治疗的法则，记载于经典之中，圆通的应用，妙出于吾心，如果一定要按图索骥，那么先后容易颠倒，没有不出现偏差的。孟子说：工匠师傅，能给人规矩，但不能使人巧妙。所以揣度阴阳，奇恒五中，决断于明堂，审察于终始，这也是善于运用规矩的人吧。
The *Yin Yang Ying Xiang Da Lun* (Great Treatise on Yin and Yang Corresponding to Phenomena) states: Yin and Yang are the way of heaven and earth, the general principles of all things, the parents of change, the origin of life and death, and the residence of spiritual transformation. In treating disease, one must seek the root (This clarifies that the changes and life/death of all things in heaven and earth do not go beyond Yin and Yang. Those who observe this can attain spiritual clarity. Therefore, when treating disease, although there are myriad complexities, one must seek the root, which may be in Yin or in Yang. Once Yin and Yang are understood, where can the pathogenic factors escape? Huangqin Lian (Scutellariae Radix and Coptidis Rhizoma), Jiang Fu (Zingiberis Rhizoma Preparatum and Aconiti Lateralis Radix Preparata) can all restore vitality; Renshen Shu (Ginseng Radix and Atractylodis Macrocephalae Rhizoma), Xiao Huang (Mangxiao and Rheum Palmatum) can all raise the dying. If these are not distinguished, fearing attack or tonification, worrying about heat or cold, one will inevitably err and be ridiculed by the sages. Can the root really be ignored?).
The *Zhi Zhen Yao Da Lun* (Great Treatise on the Most Essential Truths) states: Carefully guard the disease mechanism (Bing Ji, the critical point of disease pathology), assign each to its corresponding category. For what exists, investigate it; for what does not exist, investigate it. For excess, hold it accountable; for deficiency, hold it accountable. One must first understand the mutual overcoming among the Five Elements (Wu Sheng), unblock the blood and Qi, make them harmonious and unobstructed, thereby achieving peace. This says that although symptoms are numerous, each should be carefully observed, but they ultimately do not go beyond deficiency and excess. "Carefully guarding" refers to preventing changes. The term "mechanism" describes the unevenness of causes, so treatment cannot be rigid. "Category" refers to differences among the Five Zang organs, Six Fu organs, Seven Emotions, Six Qi, social status, age, constitution (deficiency/excess), disease origin (root/branch), wind from five directions, luck cycles (overcoming/rebounding), and temperament (slow/hasty). It also includes conditions like "Tuo Ying" (loss of nourishment due to falling from nobility to poverty) and "Qi Li Shou" (departure of Qi due to falling from wealth to poverty). One must examine their respective categories and manage treatment accordingly. The phrases "For what exists, investigate it; for what does not exist, investigate it" mean that upon encountering a symptom, one must examine the presence or absence of its corresponding nature. The phrases "For excess, hold it accountable; for deficiency, hold it accountable" are the main outline of this chapter, distinguishing deficiency and excess among various categories for treatment. However, extreme deficiency may resemble excess, and extreme excess may resemble deficiency, so detailed differentiation is essential. "First understand Wu Sheng" means, for example, if Wood is excessive, Metal should level it. "Unblocking blood and Qi" does not solely rely on attacking methods. Tonification may make blood and Qi flow; warming may harmonize them; clearing may regulate them; unblocking may adjust them. One must adapt to circumstances, not sticking to fixed methods to respond to infinite changes. This is the great method for treating deficiency and excess, and the key to the entire *Nei Jing*.
One sovereign herb and two minister herbs constitute the Odd (Ji) system; two sovereign and four minister herbs constitute the Even (Ou) system; two sovereign and three minister herbs constitute the Odd system; two sovereign and six minister herbs constitute the Even system (Sovereign herbs have few types but heavy doses; minister herbs have many types but light doses. Odd systems follow Yang; Even systems follow Yin). Thus it is said: Diseases near use Odd formulas; diseases far use Even formulas. Sweating does not use Even formulas; purging does not use Odd formulas (Diseases in the upper part are near, belong to Yang, so Odd formulas are used for their light and slow action. Diseases in the lower part are far, belong to Yin, so Even formulas are used for their heavy and rapid action. Sweating does not use Even formulas because Yin is deep and cannot reach the exterior. Purging does not use Odd formulas because Yang rises and cannot descend). Tonifying the upper or treating upper diseases uses slow preparations; tonifying the lower or treating lower diseases uses rapid preparations. Rapid preparations have strong flavors and odors; slow preparations have weak flavors and odors. Making the medicinal effect reach precisely where needed is called this (Upper medicines should be slow, to linger in the upper part; lower medicines should be rapid, to reach the lower Jiao directly. To be rapid, flavors and odors must be strong; to be slow, they must be weak. Proper balance of speed and strength ensures the medicine reaches the disease site, ensuring efficacy). If the disease is distant and the medicine's flavor is absorbed mid-way, control it with food intake without exceeding regulations (If the disease site is far, the medicine must pass through the Stomach. Without regulation, the medicine's effect might be consumed before reaching the disease site. Food intake serves as the limit to ensure appropriate distance. "Guo" means to reach. To keep medicine near, take it after meals so food carries it to stay upper; to send it far, take it before meals so food drives it quickly downward. Medication has speed variations, root/tip has ascending/descending properties, flavors have slow/fast effects, and formulations vary (decoction, pill, paste, powder). All must comply with rules, not exceeding limits). Therefore, the way to balance Qi is: For near diseases using Odd or Even formulas, make small doses. For far diseases using Odd or Even formulas, make large doses. Large doses have fewer ingredients; small doses have more ingredients. More than nine; less than two (Near and far diseases have Yin/Yang and Exterior/Interior distinctions, so Near and Far formulas have Odd/Even combinations. Either Odd formula with Even dosage, or Even formula with Odd dosage, this is Odd/Even interplay. Near diseases with Odd/Even formulas use small doses, small means many ingredients up to nine. Many ingredients mean light dosage, slow nature, reaching only near diseases. Far diseases with Odd/Even formulas use large doses, large means few ingredients, stopping at two. Few ingredients mean heavy dosage, focused nature, reaching far diseases directly. These are variations of Odd/Even interplay). If the Odd formula fails, use the Even formula, this is called Chong Fang (Repeated Formula). If the Even formula fails, use counter-assistance to achieve the result, meaning Cold/Hot/Warm/Cool follow the disease nature (This is a flexible method. Initially using Odd formula fails, change to Even, alternating Odd and Even is Chong Fang. Chong means repetition. If Even also fails, seek subtle truth/falsehood, use counter-assistance. Counter-assistance follows disease nature, e.g., treating Cold with Hot but Cold rejects Heat, add slight Cold to enter; treating Heat with Cold but Heat rejects Cold, add slight Hot to enter. E.g., Cold medicine taken hot, Hot medicine taken cold, all are flexible applications. Wang Taipu said: Heat opposes Cold, Cold opposes Heat. Slight Heat is overcome by Cold, slight Cold is eliminated by Heat. Great Cold and Great Heat struggle against opposing natures and repel different Qi. Thus the Sage uses counter-assistance to match Qi, making sound correspond to sound, Qi seek Qi).
Pungent and Sweet disperse and belong to Yang; Sour and Bitter induce vomiting/purging and belong to Yin; Salty induces vomiting/purging and belongs to Yin; Bland drains and belongs to Yang. These six flavors either astringe or disperse, either relax or tense, either dry or moisten, either soften or harden. Act according to their benefits, regulate Qi to achieve balance (Yong means vomit; Xie means purge; Shen Xie means promote urination. Pungent disperses/moistens; Sweet relaxes; Sour astringes/tenses; Bitter dries/hardens; Salty softens; Bland drains. Act according to benefit, Qi balances).
Cold treated with Heat; Heat treated with Cold. Minor cases treated oppositely (Ni); severe cases treated similarly (Cong) (Meaning seen above). Hardness reduced; invaders removed; exhaustion warmed; stagnation dispersed; retention attacked; dryness moistened; tension relieved; scattering gathered; loss benefited; leisure promoted; fright calmed; upper lowered; massaged/bathed; pressed/captured; opened/ventilated. Adapt to the situation (Wen means Sweet-Warm removes Great Heat; Yi means leisure. Hunger/fullness/overwork/leisure cause disease. Too much leisure stagnates Qi/Meridians, so promote movement. Shang means vomit. Mo means massage. Bo means besiege. Shi Shi Wei Gu means stop when appropriate, not too much to hurt Zheng Qi, not too little to leave Evil).
Opposite treatment is Zheng Zhi (Orthodox Treatment); Similar treatment is Fan Zhi (Reverse Treatment). Follow less or follow more, observe the case (Follow less: one similar, two opposite; Follow more: two similar, one opposite. Case refers to disease. Observe severity to determine ratio).
Heat caused by Cold usage; Cold caused by Heat usage. Blockage treated with blockage; Diarrhea treated with purgation. Subdue the master cause, address the original cause. Start same, end different. Break accumulations, dissolve hardness, harmonize Qi, ensure cure (Cold disease needs Hot, but severe Cold repels Hot, so take Hot medicine cold. This is Heat caused by Cold usage. Heat disease needs Cold, but severe Heat repels Cold, so take Cold medicine hot. This is Cold caused by Heat usage. Blockage treated with blockage: e.g., Lower Jiao Qi deficiency, Middle Jiao Qi stagnation. Dispersing fullness empties Lower further; tonifying Lower worsens Middle fullness. Not knowing root, attacking fullness first: medicine temporarily reduces, then returns, Qi emptier, disease worse. Not knowing small dose stagnates, large dose unblocks, harshly tonify Lower, Lower solidifies, Middle fullness clears. Diarrhea treated with purgation: e.g., Heat-diarrhea or Cold-diarrhea. Cold treated with Hot purgation, Heat treated with Cold purgation. Subduing master cause addresses root. Addressing original cause seeks etiology. Start same (Orthodox), End different (Reverse). Understanding Reverse Treatment cures all diseases).
Treatments with Cold that increase Heat: seek Yin. Treatments with Heat that increase Cold: seek Yang. This is seeking the category (Using Cold medicine for Heat disease increases Heat: not Fire excess, but Yin deficiency. Yin deficiency leads to Fire hyperactivity, so tonify Yin, Yang retreats. Using Hot medicine for Cold disease increases Cold: not Cold excess, but Yang deficiency. Yang deficiency leads to Yin Cold, so tonify Yang, warm Water-Fire, Cold dissipates. Seeking category means seeking root. Water and Fire sought in Kidney. Wang Taipu said: Enlarge Fire source to eliminate Yin shadow; Strengthen Water lord to control Sun brightness. Liu Wei Di Huang Wan and Ba Wei Di Huang Wan are examples).
Five Flavors enter Stomach, return to preferred organs. Sour enters Liver first; Bitter enters Heart first; Sweet enters Spleen first; Pungent enters Lung first; Salty enters Kidney first. Long-term use increases Qi, normal transformation. Increased Qi over time causes premature death (Increasing Qi aids its organ. E.g., Huanglian bitter enters Heart clears Fire, long-term use aids Heart Fire. Five flavors return to meridians, long-term use increases Qi, increased Qi leads to death, be cautious).
*Yin Yang Ying Xiang Da Lun* states: Lightness dispersed; heaviness reduced; decline manifested (Light in Exterior, disperse; Heavy in Interior, reduce/purge; Decline not tonified remains hidden, tonification restores life, hence "manifest"). Form deficiency warmed by Qi; Essence deficiency supplemented by Flavor (Method of manifestation. Yang Qi decline forms deficiency, warm with Qi restores form. Yin Marrow depletion essence deficiency, supplement with Flavor restores essence). High location, induce vomiting; Low location, drain thoroughly (High: Upper Jiao disease. Yong: vomit, push out high. Low: Lower Jiao disease. Jie: drain down, guide fluids down, promote urination/defecation. Or Yun: honey/gall bladder suppositories. Jie: Cheng Qi Tang, Di Dang Tang). Middle fullness, purge internally (Middle fullness not Qi deficiency, e.g., distension with fluid/stasis, Cold Damage chest binding constipation. Nei corresponds to Zhong). With Evil, soak body to sweat (Zi: soak, e.g., peach branch bath, decoction fumigation. Or exterior Evil heavy, medicine ineffective sweating, or winter cold, dispersion useless, soaking necessary). Skin level, sweat and release (Skin Evil shallow, meridian-specific sweating suffices). Fierce Evil, press and astringe (Han: urgent. Feng: fierce, anger injuring Liver. An: suppress, sour-astringent like Shaoyao). Excess, disperse and purge (Yin Excess: Ding, Jiang, Gui, Fu disperse Cold. Yang Excess: Qin, Lian, Zhi, Bai purge Fire). Examine Yin/Yang, distinguish Soft/Hard (Examine disease Yin/Yang, apply medicine Soft/Hard). Yang disease treat Yin; Yin disease treat Yang (Yang excess injures Yin, treat Yin water lord; Yin excess injures Yang, treat Yang water-fire). Stabilize Blood/Qi, keep in place (Blood/Qi treatment distinct, do not confuse). Blood excess, decant (Guide down like draining river). Qi deficiency, pull and guide (Lift up like pulling object).
*Wu Chang Zheng Ji Da Lun* states: Disease old/new, formula big/small, drug toxic/non-toxic, standard rules apply (Old disease big dose; new disease small dose. Non-toxic many use; toxic few use). Great toxicity treat disease, remove 60%; common toxicity remove 70%; slight toxicity remove 80%; non-toxic remove 90% (Insufficient medicine no cure; excessive medicine hurts Zheng Qi. Great toxicity remove 60%, stop. Light toxicity bearable, non-toxic long-term). Grains/meat/fruits/vegetables, diet nutrition finishes it, do not exceed, hurt Zheng Qi (Residual evil cleared by diet nutrition. Excessive medicine hurts Zheng Qi). First consider annual Qi, do not violate Heaven Harmony (Five Lucks ordered, Six Qi regular, Four Seasons commands, Yin/Yang rhythm, all Annual Qi. Human Qi responds growth/storage, this Heaven Harmony. Ignorance violates Annual Qi, harms Heaven Harmony).
*Liu Yuan Zheng Ji Da Lun* Yellow Emperor asks: Pregnant woman, how to use toxic drugs? Qibo says: With cause, no injury, no injury either (Pregnancy Chong Shen. Du Zhi use toxic drugs. Gu cause, e.g., large accumulation. Have cause use drug, disease bears drug, pregnant woman safe, fetus safe). Emperor asks reason. Qibo says: Large accumulation, can invade, reduce majority then stop (Large accumulation needs toxic drugs, but reduce majority then stop, same as Great toxicity remove 60%).
My commentary: Treatment rules recorded in classics, flexible application comes from heart. Following map loses horse, order reverses, errors occur. Mencius says: Craftsmen give rules, not skill. Measure Yin/Yang, Odd/Extraordinary, decide at Ming Tang, examine start/end, skilled in rules.