将以施其疗病之法,当以穷其受病之源。盖疾 不离阴阳二邪,风热火病属阳,湿燥寒病属阴。苟不求而
治之,则阴阳邪气滋蔓而难制矣。(久而传变,不胜其众。)今夫厥阴为标,风木为本,风邪伤人,掉摇螈 ,
卒露强直之病生焉。少阴为标,君火为本,热邪伤人,疮疡暴下,水液混浊之病生焉。少阳为标,相火为本,
火邪伤人,躁扰狂越,如丧神守之病生焉。善为治者,风淫所胜,平以辛凉;热淫所胜,平以咸寒;火淫所胜,
平以咸冷。以其病本于阳,故必求其阳而疗之。太阴为标,湿土为本,湿邪伤人,腹满身肿,诸痉强直之病生
焉。阳明为标,燥金为本,燥邪伤人, 郁皴揭,诸涩枯涸之病生焉。太阳为标,寒水为本,寒邪伤人,吐
利腥秽,诸寒收引之病生焉。善为治者,湿淫所胜,平以苦热;燥淫所胜,平以苦温;寒淫所胜,平以辛热。
以其病本于阴,故必求其阴而治之。如是而病之不愈者,未之有也。
六气为本,三阴三阳为标。盖天之三气,其气自上而下,在人足三阳经受之;地之三气,其气自下而上,
在人足三阴经受之。太阳寒水证,其脉浮而紧。紧者寒水之本也,浮者太阳标也。发于三阳经,急以辛热之药,
攻本之紧,估以甘寒轻剂,解标之浮。由经入腑,又当审脉之浮紧。若紧去浮在,是浮入腑也,以寒药解之;
浮去紧在,是紧入腑也,以热药攻之;浮紧不去,是浮紧俱入也,仍以热药攻其本,寒药解其标。发于三阴经,
急以辛热之药,攻本之紧,佐以甘寒重剂,解标之浮。由经之藏,又当审脉之浮紧。若紧去浮在,是浮入脏
也,以寒药解之;浮去紧在,是紧入脏也;以热药攻之;浮紧不去,是浮紧俱入也,仍以热药攻其本,寒药解其
表。少阴君火证,其脉沉而大。大者君火本也,沉者少阴标也。发于三阳经,则以辛寒之药,攻本之火;佐
以甘温轻
剂,解标之沉。发于三阴经,则以辛寒之药攻本之火,佐以甘温重剂解标之沉,少阳相火证,其脉浮而数;
太阴湿土证,其脉沉而缓。本末同,故从本也。厥阴风木症,其脉沉而弦。阳明燥金证,其脉浮而短。本末
与中不同,故不从标本从乎中也。
抑论治法,各有其要,岂止于一端而已!其在表者,汗以发之;其在里者,下之夺之;其在高者,因而
越之,谓可吐也; 悍者,按而收之,谓按摩也;脏寒虚夺者,治以灸 ;脉病挛痹者,治以针刺;血实蓄结肿
热者,治以砭石;气滞痿厥寒热者,治以导引;经络不通,病生于不仁者,治以醪醴;血气凝泣,病生于筋脉
者,治以熨药。始焉求其受病之本,终焉蠲其为病之邪者,无出于此也。昔者黄帝坐于明堂,受业于岐伯,传
通于雷公,曰∶阴阳者,天地之道也。纲纪万物,变化杀生,盖有不测之神,斡旋宰制于其间。病既本于此,
为工者,奚可他求哉!又曰∶有者求之,无者求之。此求病机之说,与夫必求其本之理一也。
打算实施治疗疾病的方法,应当探究导致疾病的根源。大抵疾病离不开阴和阳两种邪气,风、热、火这类病证属于阳,湿、燥、寒这类病证属于阴。如果不加探究就进行治疗,那么阴阳邪气就会蔓延滋长而难以控制。(病情拖延日久发生传变,就无法承受其众多变化。)如今厥阴经以三阴为标,风木为本,风邪伤人,会出现肢体摇动抽搐、突然僵硬强直的病证。少阴经以二阴为标,君火为本,热邪伤人,会出现疮疡、暴泻、水液混浊的病证。少阳经以一阳为标,相火为本,火邪伤人,会出现烦躁扰乱、狂乱超越、如同丧失神志控制的病证。善于治疗的人,对于风邪过胜的病证,用辛凉的药物来平抑;对于热邪过胜的病证,用咸寒的药物来平抑;对于火邪过胜的病证,用咸冷的药物来平抑。因为病本源于阳,所以必须探究阳邪并加以治疗。太阴经以三阴为标,湿土为本,湿邪伤人,会出现腹部胀满、全身浮肿、各种痉挛强直的病证。阳明经以二阳为标,燥金为本,燥邪伤人,会出现皮肤郁结皲裂脱屑、各种干涩枯涸的病证。太阳经以一阳为标,寒水为本,寒邪伤人,会出现呕吐下利腥臭秽浊、各种寒冷收缩牵引的病证。善于治疗的人,对于湿邪过胜的病证,用苦热的药物来平抑;对于燥邪过胜的病证,用苦温的药物来平抑;对于寒邪过胜的病证,用辛热的药物来平抑。因为病本源于阴,所以必须探究阴邪并加以治疗。像这样,如果病还不痊愈的,是从来没有过的。
六气是本,三阴三阳是标。大概天的三种气,其气自上而下,在人足部的三阳经受纳;地的三种气,其气自下而上,在人足部的三阴经受纳。太阳寒水证,脉象浮而紧。紧脉代表寒水的本气,浮脉代表太阳的标气。病发于三阳经,急需用辛热的药物,攻逐本气的紧脉,辅以甘寒轻剂,解除标气的浮脉。病由经传入腑,又应当审察脉象的浮紧情况。如果紧脉消失而浮脉仍在,说明浮脉入腑,用寒药解除;如果浮脉消失而紧脉仍在,说明紧脉入腑,用热药攻逐;如果浮紧脉都不消失,说明浮紧两气都入腑,仍然用热药攻逐本气,用寒药解除标气。病发于三阴经,急需用辛热的药物,攻逐本气的紧脉,佐以甘寒重剂,解除标气的浮脉。病由经传入脏,又应当审察脉象的浮紧情况。如果紧脉消失而浮脉仍在,说明浮脉入脏,用寒药解除;如果浮脉消失而紧脉仍在,说明紧脉入脏,用热药攻逐;如果浮紧脉都不消失,说明浮紧两气都入脏,仍然用热药攻逐本气,用寒药解除标气(此处原文“表”疑为“标”之误,依理译为标)。少阴君火证,脉象沉而大。大脉代表君火的本气,沉脉代表少阴的标气。病发于三阳经,就用辛寒的药物,攻逐本气之火;佐以甘温轻剂,解除标气之沉。病发于三阴经,就用辛寒的药物攻逐本气之火,佐以甘温重剂解除标气之沉。少阳相火证,脉象浮而数;太阴湿土证,脉象沉而缓。本气和标气属性相同,所以从本气论治。厥阴风木证,脉象沉而弦。阳明燥金证,脉象浮而短。本气、标气与中气不同,所以不从标本而从乎中气论治。
再者论述治疗方法,各有其要点,岂止局限于一端呢!病在体表的,用发汗法发散它;病在体内的,用泻下法攻夺它;病位高的,顺势使其向上涌吐,这就是吐法;病势急悍的,按压收敛它,这就是按摩法;脏腑虚寒正气亏损的,用灸法治疗;脉病导致筋脉挛急痹阻的,用针刺治疗;血实瘀结肿胀发热的,用砭石放血治疗;气滞痿软厥冷或寒热往来的,用导引术治疗;经络不通、病生麻木不仁的,用酒剂(醪醴)治疗;气血凝滞、病生在筋脉的,用热敷药熨治疗。开始探究受病的根本,最终祛除致病的邪气,没有超出这些方法的。从前黄帝坐在明堂,向岐伯求学,传承给雷公,说:阴阳,是天地运行的规律。它是万物的纲纪,主宰着万物的变化和生死,其中有着不可测度的神妙力量,在其中斡旋宰制。既然病根源于此,作为医生,还有什么可另外寻求的呢!又说:有的病要探求其成因,无征象的病也要探求其机理。这种探求病机的说法,与必须探究疾病根本的道理是一致的。
To implement methods for treating diseases, one must investigate the source of the disease. Generally, diseases do not deviate from Yin and Yang pathogenic factors. Wind, heat, and fire belong to Yang; dampness, dryness, and cold belong to Yin. If treatment is undertaken without investigation, the pathogenic factors of Yin and Yang will spread and become difficult to control. (After a long time, transmission and transformation occur, making it impossible to handle the multitude of changes.) Now, Jueyin (Liver/Pericardium) has San Yin (Three Yin) as its Biao (Manifestation/Exterior aspect) and Wind-Wood as its Ben (Root/Internal aspect). When wind pathogen injures the human body, diseases such as tremors, convulsions, sudden stiffness, and rigidity arise. Shaoyin (Heart/Kidney) has Er Yin (Two Yin) as its Biao and Jun Huo (Ministerial Fire/Emperor Fire) as its Ben. When heat pathogen injures the human body, diseases such as sores, ulcers, sudden diarrhea, and turbid fluids arise. Shaoyang (Gallbladder/Triple Burner) has Yi Yang (One Yang) as its Biao and Xiang Huo (Ministerial Fire) as its Ben. When fire pathogen injures the human body, diseases such as restlessness, agitation, mania, and loss of mental control arise. Skilled practitioners treat excessive wind with pungent-cool herbs to pacify it; excessive heat with salty-cold herbs to pacify it; excessive fire with salty-cold herbs to pacify it. Since the disease originates in Yang, one must seek out the Yang pathogen and treat it. Taiyin (Spleen/Lung) has San Yin as its Biao and Damp-Earth as its Ben. When damp pathogen injures the human body, diseases such as abdominal fullness, generalized edema, and various spasms and rigidity arise. Yangming (Stomach/Large Intestine) has Er Yang as its Biao and Dryness-Metal as its Ben. When dryness pathogen injures the human body, diseases such as skin郁结 (stagnation), cracking, peeling, and various dryness and withering arise. Taiyang (Bladder/Small Intestine) has Yi Yang as its Biao and Cold-Water as its Ben. When cold pathogen injures the human body, diseases such as vomiting and purging of foul odors, and various cold contraction and pulling arise. Skilled practitioners treat excessive dampness with bitter-hot herbs to pacify it; excessive dryness with bitter-warm herbs to pacify it; excessive cold with pungent-hot herbs to pacify it. Since the disease originates in Yin, one must seek out the Yin pathogen and treat it. In this manner, if a disease does not heal, it has never happened.
The Six Qi are the Ben (Root), and the Three Yin and Three Yang are the Biao (Manifestation). The three Qi of Heaven descend from above and are received by the Foot Yang Meridians in the human body; the three Qi of Earth ascend from below and are received by the Foot Yin Meridians in the human body. In Taiyang Cold-Water syndrome, the pulse is floating and tight. Tightness represents the Ben of Cold-Water; floating represents the Biao of Taiyang. When arising in the Three Yang Meridians, urgently use pungent-hot herbs to attack the tightness of the Ben, assisted by mild sweet-cold agents to resolve the floating of the Biao. When entering the Fu Organs from the Meridians, examine the pulse for floating and tightness again. If the tightness disappears but the floating remains, the floating has entered the Fu; use cold herbs to resolve it. If the floating disappears but the tightness remains, the tightness has entered the Fu; use hot herbs to attack it. If neither floating nor tightness disappears, both have entered the Fu; still use hot herbs to attack the Ben and cold herbs to resolve the Biao. When arising in the Three Yin Meridians, urgently use pungent-hot herbs to attack the tightness of the Ben, assisted by heavy sweet-cold agents to resolve the floating of the Biao. When entering the Zang Organs from the Meridians, examine the pulse for floating and tightness again. If the tightness disappears but the floating remains, the floating has entered the Zang; use cold herbs to resolve it. If the floating disappears but the tightness remains, the tightness has entered the Zang; use hot herbs to attack it. If neither floating nor tightness disappears, both have entered the Zang; still use hot herbs to attack the Ben and cold herbs to resolve the Biao. In Shaoyin Jun Huo syndrome, the pulse is deep and large. Largeness represents the Ben of Jun Huo; depth represents the Biao of Shaoyin. When arising in the Three Yang Meridians, use pungent-cold herbs to attack the fire of the Ben, assisted by mild sweet-warm agents to resolve the depth of the Biao. When arising in the Three Yin Meridians, use pungent-cold herbs to attack the fire of the Ben, assisted by heavy sweet-warm agents to resolve the depth of the Biao. In Shaoyang Xiang Huo syndrome, the pulse is floating and rapid; in Taiyin Damp-Earth syndrome, the pulse is deep and slow. Since the Ben and Biao are identical in nature, treatment follows the Ben. In Jueyin Wind-Wood syndrome, the pulse is deep and wiry. In Yangming Dryness-Metal syndrome, the pulse is floating and short. Since the Ben, Biao, and Zhong Qi (Middle Qi) differ, treatment does not follow the Ben or Biao but follows the Zhong Qi.
Furthermore, regarding therapeutic methods, each has its key points, not limited to just one aspect! For pathogens in the exterior, disperse them through sweating; for pathogens in the interior, purge and drain them; for pathogens located high, induce vomiting by following their upward trend; for fierce pathogens, press and restrain them (massage); for deficiency and cold in the Zang Organs, treat with moxibustion; for pulse diseases causing spasms and bi-syndrome, treat with acupuncture; for blood excess with stasis, swelling, and heat, treat with Bian stone (bloodletting); for Qi stagnation, flaccidity, cold limbs, and alternating chills and fever, treat with Daoyin (guiding and pulling exercises); for blocked meridians and numbness, treat with medicinal wine; for coagulated Qi and Blood affecting sinews and vessels, treat with warming plasters. To seek the root of the disease at the beginning and eliminate the pathogenic factor at the end, nothing exceeds these methods. In ancient times, Emperor Huangdi sat in the Ming Tang, studied under Qibo, and transmitted knowledge to Leigong, saying: Yin and Yang are the Way of Heaven and Earth. They are the guidelines for all things, governing changes, life, and death, containing unmeasurable divine power that rotates and controls within. Since disease originates from this, what else can a physician seek? It is also said: Seek those that exist, seek those that do not. This theory of seeking the disease mechanism is consistent with the principle of necessarily seeking the root.