治外感,必知邪气之变态;治内伤,必知脏腑之情性。治六淫之病,如逐外寇,攻其客
,毋
伤及其主,主弱则客不退矣;治七情之病,如抚乱民,暴其罪,必兼矜其情,情失则乱不正
矣。
营道者,知其雄,守其雌;制方者,知其奇,守其正。
攻除陈积之药,可峻而不可 ,宜专而不宜泛; 则急过病所,泛则搏击罕中,由是坚垒
如故,而破残已多,岂徒无益而已哉?
母之与子,气本相通。母旺则及其子,子旺亦气感于母。故《删繁论》云∶肝劳病者,
补心气以益之。余脏皆然。则不特“虚则补其母”一说已也。
阳与阴反,然无阴则阳不见矣;邪与正反,然无正则邪不显矣。是以热病饮沸汤而不知
热,痿痹手足反无痛者,阴盛而无与阳忤,正衰而不与邪争也。如是者,多不可治。
木、火有相通之妙,金、水有相涵之益。故不特木能生火,而火亦生木;不特金能生水
,而水亦生金。水之生金,如珠之在渊;火之生木,如花之含日。
脾与胃合,肝与胆合,肾与膀胱合,皆足经也。其脏腑皆相根据附,则其诊候亦应同在一
部。
如左关候肝、胆,右关候脾、胃,左尺候肾与膀胱是已。肺与大肠合,心与小肠合,心包络
与三焦合,皆手经也。其脏腑不相根据附,则其诊候亦不必同在一部。按《内经》云∶尺外以
候
肾,尺里以候腹。又云∶前以候前,后以候后;上竟上者,胸喉中事。是以大肠当候于右尺
之里,小肠当候于左尺之里,三焦分立上、中、下三部。如此,则左心、小肠,右肺、大肠
之谬,可不辨而自着矣。
治疗外感病,必须了解邪气的变化规律;治疗内伤病,必须了解脏腑的生理特性。治疗六淫(风、寒、暑、湿、燥、火六种外感病邪)引起的疾病,就像驱逐外来的敌人,要攻击入侵者,不要伤害作为主体的正气,如果正气虚弱,那么邪气就无法退去;治疗七情(喜、怒、忧、思、悲、恐、惊七种情志因素)引起的疾病,就像安抚作乱的百姓,揭露他们的罪行时,必须同时怜悯他们的情状,如果忽视了人的情感需求,动乱就无法平息。
善于养生的人,懂得刚强的道理,却坚守柔弱的原则;制定方剂的人,懂得奇数的妙用,却坚守正数的法度。
攻逐清除陈旧积滞的药物,药性可以猛烈但不宜过于峻急,用药应当专一而不宜广泛分散;如果药性过于峻急,就会迅速通过病灶部位,如果用药过于广泛分散,就很少能击中要害,因此坚硬的病邪堡垒依然如故,而人体正气已经受损众多,这难道仅仅是没有益处而已吗?
母脏与子脏,气机本是相通的。母脏旺盛时,其气会波及子脏;子脏旺盛时,其气也会感应母脏。所以《删繁论》说:肝劳损生病的人,可以通过补益心气来辅助它。其他脏腑的情况也是如此。这就不仅仅局限于“虚则补其母”这一说法了。
阳与阴是相反的,但是没有阴,阳就无法显现;邪气与正气是对立的,但是没有正气,邪气就无法显露。所以在热病中,有人喝滚烫的水却不知道烫,痿痹导致手足反而不疼痛的人,是因为阴气过盛而没有与阳气相冲突,正气衰弱而没有与邪气相争斗。像这样的情况,大多难以治疗。
木与火有相互通感的奥妙,金与水有相互涵养的益处。所以不仅仅是木能生火,而且火也能生木;不仅仅是金能生水,而且水也能生金。水的滋生金,就像珍珠在深渊中一样;火的滋生木,就像花朵含着太阳一样。
脾与胃相合,肝与胆相合,肾与膀胱相合,这些都是足经所属的脏腑。它们的脏腑彼此依附关联,所以它们的诊候部位也应该同在一部。比如左关脉候察肝和胆,右关脉候察脾和胃,左尺脉候察肾和膀胱,就是这种情况。肺与大肠相合,心与小肠相合,心包络与三焦相合,这些都是手经所属的脏腑。它们的脏腑不彼此依附关联,所以它们的诊候部位也不必同在一部。按照《内经》所说:尺部外侧以候察肾,尺部内侧以候察腹部。又说:前部以候察身体前侧的疾病,后部以候察身体后侧的疾病;上尽于上者,是胸喉中的事情。因此大肠应当在右尺部的内侧候察,小肠应当在左尺部的内侧候察,三焦分别立位于上、中、下三部。这样,关于左心、小肠,右肺、大肠的错误观点,就可以不辨自明地显露出来了。
In treating exogenous diseases, one must understand the transformations of pathogenic factors; in treating endogenous injuries, one must understand the physiological characteristics of the Zang-Fu organs. Treating diseases caused by the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) is like driving away external invaders: attack the intruder without injuring the host; if the host's Qi is weak, the invader will not retreat. Treating diseases caused by the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright) is like pacifying rebellious subjects: when exposing their crimes, one must also show compassion for their circumstances; if human emotions are neglected, disorder cannot be rectified.
Those who cultivate the Dao know the masculine but abide by the feminine; those who formulate prescriptions know the odd numbers but abide by the even numbers.
Medicines that attack and eliminate chronic accumulations may be potent but should not be overly harsh; they should be specific rather than broad. If too harsh, they rush past the disease site; if too broad, they rarely hit the target accurately. Consequently, the fortress of the disease remains intact while the body's healthy Qi is severely depleted. Is this merely a lack of benefit?
The Mother organ and the Child organ have inherently connected Qi. When the Mother is prosperous, its Qi extends to the Child; when the Child is prosperous, its Qi resonates with the Mother. Thus, *Shan Fan Lun* states: "For Liver exhaustion causing disease, tonify Heart Qi to benefit it." The same applies to other Zang organs. This goes beyond just the principle of "tonify the Mother when deficient."
Yang and Yin are opposite, yet without Yin, Yang cannot manifest; Pathogen and Healthy Qi are opposing, yet without Healthy Qi, the Pathogen cannot become apparent. Therefore, in heat diseases, some drink boiling water without feeling the heat; in flaccidity and numbness, hands and feet feel no pain. These occur because Yin is excessive and does not conflict with Yang, or Healthy Qi is weak and does not contend with the Pathogen. Such cases are often incurable.
Wood and Fire have the subtlety of mutual connection; Metal and Water have the benefit of mutual containment. Thus, not only does Wood generate Fire, but Fire also generates Wood; not only does Metal generate Water, but Water also generates Metal. Water generating Metal is like pearls in an abyss; Fire generating Wood is like flowers holding the sun.
Spleen and Stomach combine, Liver and Gallbladder combine, Kidney and Bladder combine; these all belong to the Foot meridians. Since these Zang-Fu pairs are closely attached, their pulse diagnoses should correspond to the same position. For example, the Left Guan position observes the Liver and Gallbladder, the Right Guan position observes the Spleen and Stomach, and the Left Chi position observes the Kidney and Bladder. Lung and Large Intestine combine, Heart and Small Intestine combine, Pericardium and Sanjiao combine; these all belong to the Hand meridians. Since these Zang-Fu pairs are not closely attached, their pulse diagnoses need not be at the same position. According to *Nei Jing*: "The outer part of the Chi position observes the Kidney, and the inner part observes the abdomen." It also says: "The anterior part observes anterior ailments, and the posterior part observes posterior ailments; the upper extreme corresponds to matters of the chest and throat." Therefore, the Large Intestine should be observed at the inner part of the Right Chi position, and the Small Intestine at the inner part of the Left Chi position, while Sanjiao is separately located in the Upper, Middle, and Lower sections. In this way, the fallacy of associating the Left Heart/Small Intestine and Right Lung/Large Intestine becomes self-evident without further debate.