肺最居上,气最清肃,苟无因以迫,何有咳嗽不宁之患乎?迫之者,不外乎外因风
寒,内因痰火,气而已然。初感风寒者,自作风寒正治,倘稍郁久成热,则娇脏易伤,
发散寒凉,俱宜禁用,盖每多肾水向已有亏,肺金久失滋养,借此传染之伤风新咳,
顿成紧急痨瘵之沉 ,倘识认不早,从标清理,后救无及。(张)常遇此症,其候壮热
憎寒,咳嗽频甚,痰唾稠粘,精神困倦,肌肤日瘦,六脉弦洪而数,久按无神。当此之
际,若欲消痰,适足助其燥槁之势,此痰乃水泛所生,非痰药所能消之者也。若欲清
火,适足以伤胃气,此火乃无形之火,非寒凉所能折之者也。若欲理气,适足以耗散真
元,此气乃丹田至宝之元气,曰无阴相济,不得已而上浮,非桑皮、桔红所能理者也。
津滋日耗,销烁日增,阴已亏而火愈盛,荣行脉中,故脉洪数无伦,亦迫于势也。水中
之真火上炎,彻骨之大热乃壮,火乘金候,焚灼难堪,苟非重用火中补水之方,奚堪涸
辙。燎原之势?每用或八味或去附子,倍加熟地,更入牛脉、麦冬、五味子作汤,大
剂,日二剂,食前温服,裨真火藏源,尤雷自熄。夏阴一得,焦烁稍回,渐见无汗之骨
蒸,为有汗而热解。然虚火一退,若真元虚
极者,倦怠必来,补气之功,便宜接续,真阴衰极者,真阳一复,燥涸难除,补水之功
又须倍加,当此热病而热药,势可骇人。然本病而本治,实切至理,每臻神效,敢具后方。
肺脏位于人体最上部,其气最为清肃。如果没有外邪逼迫,怎么会有咳嗽不安的祸患呢?逼迫肺气的因素,不外乎外感的风寒和内生的痰火,归根结底是“气”的问题。初感风寒者,自然应当采用治疗风寒的正法;倘若寒气郁积日久化热,则娇嫩的肺脏容易受伤,此时发散风寒和寒凉药物都应当禁用。因为往往患者肾水原本已有亏损,肺金长期失去滋养,借此传染性的伤风新咳,顿时演变成紧急严重的痨瘵重症。如果识别诊断不早些,只从表面症状清理,后来再想救治就来不及了。(张景岳)经常遇到这种病症,其表现为高热恶寒,咳嗽非常频繁严重,痰液稠厚粘腻,精神困倦,肌肤日渐消瘦,六脉弦、洪且数,久按缺乏神气。在这个时候,如果想要消除痰饮,恰好助长了其干燥枯槁的趋势,这痰是水湿泛滥所生,不是普通化痰药所能消除的。如果想要清泻火热,恰好会损伤胃气,这火是无形的虚火,不是寒凉药物所能折服的。如果想要调理气机,恰好会耗散真气,这气是丹田宝贵的元气,因为无阴相济,不得已而上浮,不是桑白皮、桔红所能调理的。津液日益消耗,销烁之象日益增加,阴已亏虚而火愈盛,营血行于脉中,所以脉象洪大数乱无比,也是被火势逼迫所致。水中的真火上炎,彻骨的大热因此壮盛,火克金(肺),焚烧灼热难以忍受,如果不是重用“火中补水”的方剂,怎能承受如涸辙之鲋、燎原之势般的危机?我常用八味丸或去掉附子,加倍加入熟地黄,再加入牛膝、麦冬、五味子煎汤,大剂量,每日两剂,饭前温服,使真火归藏于源,犹如雷火自熄。夏季的阴气一旦得到补充,焦灼干枯稍得缓解,逐渐见到原本无汗的骨蒸潮热,转变为有汗而热解。然而虚火一退,如果真气元气极度虚弱者,倦怠感必然出现,补气之功,便应接续进行;真阴衰败到极点者,真阳一旦恢复,燥涸难除,补水之功又须加倍。在这种情况下,用热药治疗热病,形势看似骇人听闻。但针对本病治本,确实切合至理,每每达到神奇疗效,现附上后方。
The Lung resides at the highest position in the body, and its Qi is the clearest and most purifying. If there were no external forces forcing it, how could there be the affliction of restless coughing? The factors forcing it are none other than external Wind-Cold (Wind-Cold), internal Phlegm-Fire (Phlegm-Fire), which ultimately boil down to Qi. For those initially contracting Wind-Cold, one should naturally adopt the orthodox treatment for Wind-Cold; however, if the cold stagnates for a long time and transforms into heat, the delicate Zang-organ (Lung) is easily injured. At this point, both dispersing methods for cold and cooling herbs should be strictly prohibited. This is because the Kidney Water (Kidney Yin) is often already deficient, and the Lung Metal (Lung Qi/Yin) has long lost nourishment. Borrowing this contagious common cold or new cough, it suddenly becomes an urgent and severe consumptive disease (Tuberculosis/Chronic Consumptive Disease). If recognition is not early, and treatment focuses only on superficial symptoms, later rescue will be futile. (Zhang Jingyue) Often encounters such cases, where the presentation includes high fever with aversion to cold, frequent and severe coughing, thick and sticky sputum, mental fatigue, daily emaciation of the skin and muscles, and six pulses that are wiry, surging, and rapid, lacking spirit upon prolonged pressing. At this moment, if one attempts to eliminate phlegm, it merely aids the trend of dryness and withering; this phlegm is generated from overflowing water and cannot be eliminated by ordinary phlegm-resolving drugs. If one attempts to clear fire, it merely damages Stomach Qi; this fire is formless deficiency fire, which cannot be subdued by cold and bitter herbs. If one attempts to regulate Qi, it merely dissipates true Yuan Qi; this Qi is the precious Yuan Qi of the Dantian, floating upward due to the lack of Yin to support it, and cannot be regulated by Cortex Morus Radicis (Sang Bai Pi) or Pericarpium Citri Reticulatae (Ju Hong). Body fluids are consumed day by day, and consumption increases day by day; Yin is deficient while Fire flourishes. Ying (Nutritive) blood circulates within the vessels, hence the pulse is surging, rapid, and chaotic without limit, also forced by the momentum of Fire. The True Fire within Water flares upward, causing the bone-deep great heat to become vigorous. Fire attacks Metal (Lung), making the burning and scorching unbearable. Unless one heavily employs formulas that "supplement Water within Fire" (nourish Yin to anchor Yang), how can one endure the crisis of a fish in a dried rut or a prairie fire? I often use Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) or remove Fu Zi (Aconite Root), double the dosage of Shu Di Huang (Prepared Rehmannia Root), and add Niu Xi (Achyranthes Root), Mai Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Fruit) to decoct. Administer large doses, two doses per day, taken warm before meals, so that the True Fire returns to its source, extinguishing itself like thunder and lightning. Once Summer Yin is obtained, the scorched and dried state slightly recovers, gradually transitioning from bone-steaming fever without sweat to sweating with heat resolution. However, once deficiency Fire retreats, if the True Yuan Qi is extremely deficient, fatigue will inevitably appear; the merit of tonifying Qi should then be continued. If True Yin is extremely depleted, once True Yang recovers, dryness and aridity remain difficult to remove; the merit of supplementing Water must be doubled. Under these circumstances, using hot herbs to treat heat diseases seems shocking. Yet, treating the root cause of the original disease truly aligns with profound principles, often achieving miraculous effects. I dare to present the following formula.