医理真传
原著 清·郑钦安
转自民间中医网
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郑钦安原叙
医学一途，不难于用药，而难于识症。亦不难于识症，而难于识阴阳。阴阳化生五行，其中消长盈虚，发为疾病，万变万化，岂易窥测？诊候之际，犹多似是而非之处，辨察不明，鲜有不误人者也。余蜀南临邛人也，迁居于成都省城，学医于止唐刘太老夫子，指示《黄帝内经》、《周易》太极、仲景立方立法之旨。余沉潜于斯二十馀载，始知人身阴阳合一之道，仲景立方垂法之美。所览医书七十馀种，每多各逞己见，亦未尝不讲仲景之法，然或言病而不道其病之所以然，或言方而不探其用方之所以妙，参差间出，使人入于其中而茫然。近阅闽省陈修园医书一十三种，酌古准今，论深注浅，颇得仲景之微，亦且明透。其中分阴分阳之实据，用药活泼之机关，间有略而未详者。
余不揣鄙陋，以管窥之见，谨将乾坤化育，人身性命立极，与夫气机盈缩，内因、外因，阳虚、阴虚病情实据，用方用法，活泼圆通之妙，详言数十条，以明仲景立法垂方之苦心，亦足以补修园先生之未逮。
因志在活人，遂不知其言之妄也，高明谅之。
同治己巳菊月蜀南临邛钦安郑寿全书
医理真传卷一
乾坤大旨
乾为天，属金，纯阳也。称为老父、老阳、老子，又名曰龙。
坤为地，属土，纯阴也。称为老母、老阴。乾坤交媾，化生六子。
乾之初爻，乘于坤之初爻，而生长男，震也。乾之二爻，乘于坤之二爻，而生中男，坎也。乾之三爻，乘于坤之三爻，而生少男，艮也。
故曰：乾道成男（初爻、二爻、三爻，喻乾金真精真气发泄之次序也）。坤之初爻，乘于乾之初爻，而生长女，巽也。坤之二爻，乘于乾之二爻，而生中女，离也。坤之三爻，乘于乾之三爻，而生少女，兑也。故曰：坤道成女（初爻、二爻、三爻，喻坤土真阴流露之度数也）。乾坤六子，长少皆得乾坤性情之偏，惟中男中女，独得乾坤性情之正。人秉天地之正气而生，此坎离所以为人生立命之根也。
坎卦诗
天施地润水才通，一气含三造化工。
万物根基从此立，生生化化沐时中。
坎卦解
坎为水，属阴，血也，而真阳寓焉。中一爻，即天也。天一生水，在人身为肾，一点真阳，含于二阴之中，居于至阴之地，乃人立命之根，真种子也。诸书称为真阳。真阳二字，各处讲解字眼不同，恐初学看书，一时领悟不到，以致认症不清，今将各处字眼搜出，以便参究。真阳二字，一名相火，一名命门火，一名龙雷火，一名无根火，一名阴火，一名虚火。发而为病，一名元气不纳，一名元阳外越，一名真火沸腾，一名肾气不纳，一名气不归源，一名孤阳上浮，一名虚火上冲，种种名目，皆指坎中之一阳也。一阳本先天乾金所化，故有龙之名。一阳落于二阴之中，化而为水，立水之极（是阳为阴根也），水性下流，此后天坎卦定位，不易之理也。须知此际之龙，乃初生之龙（龙指坎中一阳也），不能飞腾而兴云布雨，惟潜于渊中，以水为家，以水为性，遂安其在下之位，而俯首于下也。若虚火上冲等症，明系水盛（水即阴也），水盛一分，龙亦盛一分（龙即火也），水高一尺，龙亦高一尺，是龙之因水盛而游，非龙之不潜而反其常。故经云：阴盛者，阳必衰，即此可悟用药之必扶阳抑阴也。乃市医一见虚火上冲等症，并不察其所以然之要，开口滋阴降火，自谓得其把握，独不思本原阴盛（阴盛二字，指肾水旺）阳虚（阳虚二字，指君火弱）,今不扶其阳，而更滋其阴，实不啻雪地加霜，非医中之庸手乎？余亦每见虚火上冲等症，病人多喜饮热汤，冷物全不受者，即此更足徵滋阴之误矣。又有称桂附为引火归源者，皆未识其指归，不知桂附干姜，纯是一团烈火，火旺则阴自消，如日烈而片云无。况桂附二物，力能补坎离中之阳，其性刚烈至极，足以消尽僭上之阴气。阴气消尽，太空为之（廊廊）〔廓朗〕，自然上下奠安，无偏盛也，岂真引火归源哉！历代注家，俱未将一阳潜于水中底蕴搜出，以致后学懵然无据，滋阴降火，杀人无算，真千古流弊，医门大憾也。
（虚火上冲之病最常见者，为现今医学所称之慢性咽炎、喉炎、口腔炎等，虽经清热解毒，滋阴降火等法治疗，如六神丸、喉炎丸等，而病终不愈。而用扶阳抑阴，如甘草干姜汤、附子理中汤等方剂施治，每获良效。）
离卦诗
地产天成号火王，阴阳互合隐维皇，神明出入真无定，箇里机关只伏藏。
离卦解
离为火，属阳，气也，而真阴寄焉。中二爻，即地也。地二生火，在人为心，一点真阴，藏于二阳之中，居于正南之位，有人君之象，为十二官之尊，万神之宰，人身之主也。故曰："心藏神。"坎中真阳，肇自乾元，一也；离中真阴，肇自坤元，二也。一而二，二而一，彼此互为其根，有夫妇之义。故子时一阳发动，起真水上交于心，午时一阴初生，降心火下交于肾。一升一降，往来不穷，性命于是乎立。
一合二而成，气无形而寓于血之中是也。二合一而成，血有形而藏于气之内是也（经云"气能统血"，即此意也）。气、血两字，作一坎卦解之也可，即作一离卦解之也可，即作坎离二卦解之也亦可。余恒曰："以脏腑分阴阳，论其末也。以一坎卦解之，推其极也。"又曰：人身一团血肉之躯，阴也，全赖一团真气运于其中而立命，亦可作一坎卦以解之。
君、相二火解
凡火居上以统乎阳，阳重而阴轻也，故居上为用（离卦二阳爻是也）；真火居下以统乎阴，阴重而阳轻也，故居下为体（坎卦一阳爻是也）。二火虽分，其实一气（离卦二阳爻，坎卦一阳爻，合之而成乾。人活一口气，即此乾元之气也。因乾分一气，落于坤宫，遂变出后天世界，此君、相二火之由来），诚阴阳之主宰也。如上之君火弱，即不能统上身之关窍精血，则清涕、口沫、目泪、漏睛、鼻齿出血，诸症作矣。如下之相火弱，即不能统下身之关窍精血，则遗尿、滑精、女子带下、二便不禁，诸症作矣。顾二火不可分，而二火亦不胜合，所以一往一来，化生中气（二火皆能生土，上者生凡土，即胃，下者生真土，即脾。二火化生中土，先后互相赖焉），遂分二气为三气也（故曰三元，又曰三焦。经云："无先天而后天不立，无后天而先天亦不生"，此先后三元之实义也）。如中宫不得二火之往来薰蒸，即不能腐熟谷水，则完谷不化，痰湿痞满诸症作矣（上中下三部，可见是一团火也）。如上下二火俱不足，则在上者，有反下趋之症，如心病移于小肠，肺病移于大肠是也；在下者，有反上腾之病，如虚火牙疼，咳血喘促，面目浮肿，喉痹之类是也。其中尤有至要者，有阴气上腾而真火不与之上腾者，有阴气上腾而真火即与之上腾者，此处便要留心。若上脱之机关已露，其脉浮空，气喘促，尚未见面赤、身热、汗出者，此阴气上腾，而真火尚未与之俱腾也。若见面赤、身热、汗出者，此阴气上腾，而真火亦与之俱腾矣。病至此际，真欲脱也。凡见阴气上腾诸症，不必延至脱时，而始用回阳，务见机于早，即以回阳镇纳诸方投之，万不致酿成脱症之候矣。亦有阳气下趋而君火未与之下趋者，有阳气下趋而君火即与之下趋者，此际不可玩忽。若下脱之机关已具，其脉细微欲绝，二便血下如注，或下利清谷益甚，四肢虽冷，尚觉未寒，二便之间，尚能禁者，此阳气下趋，而君火尚未与之俱趋也。若四肢寒甚，二便利甚，不自禁者，此阳气下趋，而君火亦与之俱趋也，病至此际，真欲脱也。
凡见阳气下趋诸症，不必定要见以上病情，而始用逆挽，务审机于先，即以逆挽益气之法救之，自可免脱症之祸矣。盖从下而竭于上者，为脱阳（坎中之阳，天体也，故脱从上），从上而竭于下者，为脱阴（离中之阴，地体也，故脱从下）。阳欲脱者，补阴以留之，如独参汤是也。阴欲脱者，补阳以挽之，如回阳饮是也。亦有阳欲脱者，不必养阴，阴盛而阳即灭。阴欲脱者，不必补阳，阳旺而阴立消，此皆阴阳之变也。学者务要细心体会，便得一元分合之义矣。
真龙约言
夫真龙者，乾为天是也（乾体属金，浑然一团，无一毫渣滓尘垢。古人以龙喻之，言其有变化莫测之妙）。乾分一气落于坤宫，化而为水，阴阳互根，变出后天坎离二卦，人身赖焉。二气往来，化生中土，万物生焉，二气亦赖焉。如坎宫之龙（坎中一爻，乾体所化），初生之龙也，养于坤土之中，故曰："见龙在田"，虽无飞腾之志，而有化育之功。是水也，无土而不停蓄，龙也，无土而不潜藏。故土覆水上，水在地中，水中有龙，而水不至寒极，地得龙潜，而地即能冲和，水土合德，世界大成矣。
窃思天开于子（子时一阳发动故也），而龙降焉。龙降于子，至巳而龙体浑全，飞腾已极（故五六月雨水多，龙亦出，皆是龙体浑全），极则生一阴。一阴始于午，至亥而龙体化为纯阴已极，极则生一阳。故曰：复一。一也者，真气也，天之体也，气虽在下，实无时而不发于上也。若离中真阴，地体也，虽居于上，实无时而不降于下也。故《易》曰："本乎天者亲上，本乎地者亲下"，此阴阳升降之要，万古不易之至理也。
业医者果能细心研究，即从真龙上领悟阴阳，便得人身一付全龙也。
三焦部位〔说〕
上焦统心肺之气，至膈膜；中焦统脾胃之气，自膈膜下起而至脐中；下焦统肝肾之气，自脐中起而至足。上焦天也（即上元），中焦地也（即中元），下焦水也（即下元）。天气下降于地，由地而入水；水气上升于地，由地而至于天。故曰：地也者，调和阴阳之枢机也。三焦之气，分而为三，合而为一，乃人身最关要之府，一气不舒，则三气不畅，此气机自然之理。学者即在这三焦气上探取化机，药品性味探取化机，便得调和阴阳之道也。
五运所化
甲己化土如甲己之岁，以土运统之，馀同推：乙庚化金丙辛化水丁壬化木戊癸化火
五行本体受病相传为病
天地化生五行，其中不无偏盛也。盖五行各秉一脏，各得一气，各主一方，各司一令，各有所生，各有所化，各有所制，各有所害。
所以东方生风木，司春令，在人为肝，肝气不舒，则发而为病，病有盛衰。南方生热火，司夏令，在人为心，心气不舒，则发而为病，病有盛衰。长夏生湿土，主四季，在人为脾，脾气不舒，则发而为病，病有盛衰。西方生燥金，司秋令，在人为肺，肺气不舒，则发而为病，病有盛衰。北方生寒水，司冬令，在人为肾，肾气不舒，则发而为病，病有盛衰。此五行本体之为病也。而更有母病及子者，如金病而移于肾是也；子病及母者，如肾病而移于肺是也。有妻病而乘于夫者，如土病而传于肝是也；有夫病而及于妻者，如肝病而传于土是也。有因相生而传为病者，如金病传水，水传木，木传火，火传土，土传金是也。有因相克而传为病者，如金病传木，木传土，土传水，水传火，火传金是也。学者能留心于此，而治病便不难矣。
人身虽云五脏六腑，总不外乎气血两字。学者即将气血两字，留心讨究，可无俟他求矣。夫气有馀便是火，火旺者阴必亏，如仲景人参白虎汤、三黄石膏汤，是灭火救阴法也；芍药甘草汤、黄连阿胶汤，是润燥扶阴法也；四苓滑石阿胶汤、六味地黄汤，是利水育阴法也。
气不足便是寒，寒盛者阳必衰，如仲景四逆汤、回阳饮，是温经救阳法也；理中汤、甘草干姜汤，是温中扶阳法也；附子细辛汤，真武汤，是温肾助阳法也。后贤改用滋阴降火之法，是套人参白虎润燥救阴诸法。而以之治气有余之症，法则可从；若用之于气不足之人，则失之远矣。
辨认一切阳虚证法
医理真传
原著 清·郑钦安
转自民间中医网
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郑钦安原序
医学这一门，难点不在于用药，而在于识别病证。也不难在于识别病证，而在于识别阴阳。阴阳化生五行，其中消长盈虚的变化，引发疾病，变化万千，岂容易窥测？在诊察候脉的时候，往往有很多似是而非的情况，辨别考察不清楚，很少有不误人的。我是四川南部临邛人，迁居到成都省城，向止唐刘太老夫子学习医术，他指示我《黄帝内经》、《周易》太极、张仲景创立方剂和确立法则的宗旨。我沉浸钻研于此二十多年，才知道人身阴阳合一的道理，张仲景创立方剂垂示法则的美妙之处。所阅读的医书七十多种，大多各自逞显己见，也未曾不讲张仲景的法则，然而有的只谈病却不讲病产生的原因，有的只谈方剂却不探究用方的奥妙，参差错出，使人进入其中而感到茫然。最近阅读福建省陈修园的十三种医书，斟酌古法以准今世，论述深刻而注解浅显，颇得张仲景的微妙之处，而且明白透彻。其中区分阴分和阳分的实际依据，用药灵活变化的机关，间或有简略而未详细的地方。
我不自量力，以管中窥豹的见解，恭敬地将乾坤化育万物，人身性命立极的根本，以及气机的盈缩，内因、外因，阳虚、阴虚病情的实际依据，用方用法的活泼圆通之妙，详细陈述几十条，以阐明张仲景立法创方的苦心，也足以弥补陈修园先生未及之处。
因为立志在于救人，所以不知道我的话是否荒谬，高明之士请谅解。
同治己巳年（1869年）九月 四川南部临邛 钦安 郑寿全 书写
医理真传卷一
乾坤大旨
乾象征天，属金，是纯阳的。称为老父、老阳、老子，又名龙。
坤象征地，属土，是纯阴的。称为老母、老阴。乾坤交媾，化生出六个子女。
乾卦的初爻，加于坤卦的初爻之上，而生出长男，即震卦。乾卦的二爻，加于坤卦的二爻之上，而生出中男，即坎卦。乾卦的三爻，加于坤卦的三爻之上，而生出少男，即艮卦。
所以说：乾道成男（初爻、二爻、三爻，比喻乾金真精真气发泄的次序）。坤卦的初爻，加于乾卦的初爻之上，而生出长女，即巽卦。坤卦的二爻，加于乾卦的二爻之上，而生出中女，即离卦。坤卦的三爻，加于乾卦的三爻之上，而生出少女，即兑卦。所以说：坤道成女（初爻、二爻、三爻，比喻坤土真阴流露的度数）。乾坤六子，长子和少女都得到乾坤性情的偏颇，只有中男和中女，独得乾坤性情的纯正。人秉承天地的正气而生，这就是坎卦和离卦所以成为人生立命的根本。
坎卦诗
天施地润水才通，一气含三造化工。
万物根基从此立，生生化化沐时中。
坎卦解
坎象征水，属阴，指血，而真阳寓存其中。中间的一爻，就是天。天一生水，在人体对应肾，一点真阳，含藏于两阴之中，居于至阴之地，这是人立命的根本，真正的种子。各种书籍称为真阳。真阳二字，各处讲解的字眼不同，恐怕初学者看书，一时领悟不到，以致辨认病证不清，现在将各处的字眼搜集出来，以便参考研究。真阳二字，一名相火，一名命门火，一名龙雷火，一名无根火，一名阴火，一名虚火。发作成为疾病，一名元气不纳，一名元阳外越，一名真火沸腾，一名肾气不纳，一名气不归源，一名孤阳上浮，一名虚火上冲，种种名目，都是指坎卦中间的那一个阳爻。这个阳爻本是先天乾金所化，所以有龙的名字。一阳落入两阴之中，化而为水，建立水的极致（这是阳为阴的根基），水性向下流，这是后天坎卦的定位，是不变的道理。须知此时的龙，乃是初生的龙（龙指坎卦中间的阳爻），不能飞腾而兴云布雨，只能潜藏在深渊中，以水为家，以水为性，于是安守在下之位，而俯首于下。如果是虚火上冲等症状，明显是水盛（水即阴），水盛一分，龙也盛一分（龙即火），水高一尺，龙也高一尺，这是龙因为水盛而游动，并非龙不潜藏反而违背常态。所以经文说：阴盛者，阳必衰，由此可以悟出用药必须扶阳抑阴。然而市井医生一见虚火上冲等症状，并不考察其所以然的要害，开口就滋阴降火，自以为抓住了要领，唯独不想本原是阴盛（阴盛二字，指肾水旺）阳虚（阳虚二字，指君火弱），现在不扶助其阳，反而更滋助其阴，实在无异于雪上加霜，不是医中的庸手吗？我也常常见到虚火上冲等症状的病人，大多喜欢喝热汤，完全不接受冷物，这就更加证明了滋阴的错误。又有称桂枝、附子为引火归源的，都没有认识其指向，不知道桂枝、附子、干姜，纯粹是一团烈火，火旺则阴自消，如太阳猛烈而片云无。况且桂枝、附子两味药，力量能补益坎卦和离卦中的阳，其性质刚烈至极，足以消尽僭越上行的阴气。阴气消尽，天空为之廓朗，自然上下安定，没有偏盛，难道真是引火归源吗！历代注家，都没有将一阳潜藏在水中的底蕴搜罗出来，以致后学懵懂没有依据，滋阴降火，杀人无数，真是千古流传的弊病，医门的大遗憾啊。
（虚火上冲的病最常见者，为现今医学所称之慢性咽炎、喉炎、口腔炎等，虽经清热解毒，滋阴降火等法治疗，如六神丸、喉炎丸等，而病终不愈。而用扶阳抑阴，如甘草干姜汤、附子理中汤等方剂施治，每获良效。）
离卦诗
地产天成号火王，阴阳互合隐维皇，神明出入真无定，箇里机关只伏藏。
离卦解
离象征火，属阳，指气，而真阴寄寓其中。中间的两爻，就是地。地二生火，在人体对应心，一点真阴，藏于两阳之中，居于正南之位，有人君的形象，为十二官的尊贵，万神的主宰，人身的主人。所以说：“心藏神。”坎卦中的真阳，肇始于乾元，是一；离卦中的真阴，肇始于坤元，是二。一分为二，二合为一，彼此互为根基，有夫妇的情义。所以子时一阳发动，起真水上交于心，午时一阴初生，降心火下交于肾。一升一降，往来无穷，性命于是确立。
一合二而成，气无形而寓存在血之中是这样。二合一而成，血有形而藏存在于气之内是这样（经文说“气能统血”，就是这个意思）。气、血两字，作一个坎卦来解也可以，即作一个离卦来解也可以，即作坎离二卦来解也可以。我常常说：“以脏腑分阴阳，是论其末节。以一个坎卦来解，是推究其极致。”又说：人身一团血肉之躯，是阴，全赖一团真气运化在其中而立命，也可以作一个坎卦来解。
君、相二火解
凡火居上以统率阳，阳重而阴轻，所以居上为用（离卦二阳爻即是）；真火居下以统率阴，阴重而阳轻，所以居下为体（坎卦一阳爻即是）。二火虽然分开，其实是一气（离卦二阳爻，坎卦一阳爻，合之而成乾卦。人活一口气，即此乾元之气。因乾分出一气，落于坤宫，遂变出后天世界，这就是君、相二火的由来），确实是阴阳的主宰。如果上面的君火弱，就不能统率上身关窍的精血，那么清涕、口沫、目泪、漏睛、鼻齿出血，诸症就会发作。如果下面的相火弱，就不能统率下身关窍的精血，那么遗尿、滑精、女子带下、大小便不禁，诸症就会发作。顾念二火不可分开，而二火也不能合并，所以一往一来，化生中气（二火都能生土，上面的生凡土，即胃，下面的生真土，即脾。二火化生中土，先后互相依赖），于是分二气为三气（所以说三元，又曰三焦。经文说：“无先天而后天不立，无后天而先天亦不生”，这是先后三元的实际意义）。如果中宫得不到二火的往来熏蒸，就不能腐熟谷水，那么完谷不化，痰湿痞满诸症就会发作（上中下三部，可见是一团火）。如果上下二火都不足，那么在上的，有反向下趋的症状，如心病移于小肠，肺病移于大肠是这样；在下的，有反向上腾的疾病，如虚火牙疼，咳血喘促，面目浮肿，喉痹之类是这样。其中尤为重要的是，有阴气上腾而真火不与之上腾的，有阴气上腾而真火即与之上腾的，这里就要留心。如果上脱的机关已经显露，其脉浮空，气喘急促，尚未见面赤、身热、汗出的，这是阴气上腾，而真火尚未与之俱腾。如果见面赤、身热、汗出的，这是阴气上腾，而真火也与之俱腾了。病到此时，真的要脱绝了。凡是见到阴气上腾诸症，不必拖延到脱绝时才用回阳之法，务必早见机，即以回阳镇纳诸方投之，万不至于酿成脱症的候象了。也有阳气下趋而君火未与之下趋的，有阳气下趋而君火即与之下趋的，此时不可玩忽。如果下脱的机关已经具备，其脉细微欲绝，大小便血下如注，或下利清谷更甚，四肢虽冷，尚觉未寒，大小便之间，尚能控制的，这是阳气下趋，而君火尚未与之俱趋。如果四肢寒甚，大小便利甚，不自禁的，这是阳气下趋，而君火也与之俱趋了，病到此时，真的要脱绝了。
凡是见到阳气下趋诸症，不必定要见到以上病情，才开始用逆挽之法，务必先审察机宜，即以逆挽益气之法救之，自然可免脱症的祸患。盖从下而竭于上的，为脱阳（坎中之阳，是天体，所以脱从上），从上而竭于下的，为脱阴（离中之阴，是地体，所以脱从下）。阳欲脱者，补阴以留住它，如独参汤是这样。阴欲脱者，补阳以挽回它，如回阳饮是这样。也有阳欲脱者，不必养阴，阴盛而阳即灭。阴欲脱者，不必补阳，阳旺而阴立消，这都是阴阳的变化。学者务必细心体会，就能得一元分合的意义了。
真龙约言
所谓真龙，就是乾为天（乾体属金，浑然一团，无一毫渣滓尘垢。古人以龙比喻它，说它有变化莫测的妙处）。乾分出一气落于坤宫，化而为水，阴阳互根，变出后天坎离二卦，人身依赖于此。二气往来，化生中土，万物生焉，二气也依赖于此。如坎宫的龙（坎中一爻，由乾体所化），是初生的龙，养于坤土之中，所以说：“见龙在田”，虽然没有飞腾的志向，而有化育的功效。是水，没有土就不停蓄；龙，没有土就不潜藏。所以土覆盖水上，水在地中，水中有龙，而水不至寒极，地得龙潜，而地即能冲和，水土合德，世界大成矣。
私下思考天开于子（子时一阳发动的缘故），而龙降焉。龙降于子，至巳而龙体浑全，飞腾已极（所以五六月雨水多，龙亦出，皆是龙体浑全），极则生一阴。一阴始于午，至亥而龙体化为纯阴已极，极则生一阳。所以说：复一。一是真气，天的本体，气虽在下，实无时而不发于上也。如果离中真阴，是地体，虽居于上，实无时而不降于下也。所以《易》说：“本乎天者亲上，本乎地者亲下”，这是阴阳升降的要诀，万古不易的至理。
业医者如果能细心研究，就从真龙上领悟阴阳，便得人身一副全龙也。
三焦部位〔说〕
上焦统辖心肺之气，至膈膜；中焦统辖脾胃之气，自膈膜下起而至脐中；下焦统辖肝肾之气，自脐中起而至足。上焦是天（即上元），中焦是地（即中元），下焦是水（即下元）。天气下降于地，由地而入水；水气上升于地，由地而至于天。所以说：地，是调和阴阳的枢机。三焦之气，分而为三，合而为一，是人身体最关要的府，一气不舒，则三气不畅，这是气机自然的道理。学者就在这三焦气上探取化机，药品性味探取化机，便得调和阴阳之道了。
五运所化
甲己化土如甲己之岁，以土运统之，其余同理推演：乙庚化金丙辛化水丁壬化木戊癸化火
五行本体受病相传为病
天地化生五行，其中不无偏盛。大概五行各秉赋一脏，各得一气，各主一方，各司一令，各有所生，各有所化，各有所制，各有所害。
所以东方生风木，司春令，在人体对应肝，肝气不舒，则发而为病，病有盛衰。南方生热火，司夏令，在人体对应心，心气不舒，则发而为病，病有盛衰。长夏生湿土，主四季，在人体对应脾，脾气不舒，则发而为病，病有盛衰。西方生燥金，司秋令，在人体对应肺，肺气不舒，则发而为病，病有盛衰。北方生寒水，司冬令，在人体对应肾，肾气不舒，则发而为病，病有盛衰。这是五行本体之为病。而更有母病及子的，如金病而移于肾是这样；子病及母的，如肾病而移于肺是这样。有妻病而乘于夫的，如土病而传于肝是这样；有夫病而及于妻的，如肝病而传于土是这样。有因相生而传为病的，如金病传水，水传木，木传火，火传土，土传金是这样。有因相克而传为病的，如金病传木，木传土，土传水，水传火，火传金是这样。学者能留心于此，而治病便不难了。
人身虽说五脏六腑，总不外乎气血两字。学者就将气血两字，留心讨究，可无俟他求了。夫气有余便是火，火旺者阴必亏，如张仲景人参白虎汤、三黄石膏汤，是灭火救阴法；芍药甘草汤、黄连阿胶汤，是润燥扶阴法；四苓滑石阿胶汤、六味地黄汤，是利水育阴法。
气不足便是寒，寒盛者阳必衰，如张仲景四逆汤、回阳饮，是温经救阳法；理中汤、甘草干姜汤，是温中扶阳法；附子细辛汤，真武汤，是温肾助阳法。后贤改用滋阴降火之法，是套用的人参白虎润燥救阴诸法。而以之治气有余之症，法则可从；若用之于气不足之人，则失之远矣。
辨认一切阳虚证法
Zhenyi Zhuan (True Transmission of Medical Principles)
Original Author: Zheng Qin'an (Qing Dynasty)
Translated from Folk TCM Network
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Preface by Zheng Qin'an
In the path of medicine, the difficulty does not lie in prescribing herbs, but in identifying symptoms. Nor is it difficult to identify symptoms, but rather in distinguishing Yin and Yang. Yin and Yang transform into the Five Phases (Wu Xing), within which waxing and waning, fullness and emptiness occur, giving rise to diseases with myriad variations; how can they be easily fathomed? During pulse diagnosis and symptom observation, there are often many cases that appear similar yet are fundamentally different. If differentiation and examination are unclear, few avoid harming patients. I am from Linqiong in southern Sichuan, having relocated to Chengdu city. I studied medicine under Master Liu Zhitang, who instructed me in the principles of the *Huangdi Neijing* (Yellow Emperor's Inner Canon), the Taiji of the *I Ching* (Book of Changes), and the purport of Zhang Zhongjing's formula creation and law establishment. After immersing myself in these studies for over twenty years, I came to understand the way of Yin-Yang unity in the human body and the beauty of Zhang Zhongjing's formulas and methods. Having read more than seventy medical texts, most displayed individual biases. Although none failed to discuss Zhang Zhongjing's methods, some discussed diseases without explaining their causes, and some discussed formulas without exploring the subtleties of their application. These inconsistencies left readers bewildered. Recently, I reviewed thirteen medical books by Mr. Chen Xiuyuan from Fujian Province. He balanced ancient wisdom with contemporary practice, offering profound discussions and shallow annotations, capturing the essence of Zhang Zhongjing with clarity and penetration. However, regarding the substantial evidence for distinguishing Yin and Yang divisions, and the flexible mechanisms of herb usage, there were occasional omissions or lack of detail.
Presuming my own limitations, with my narrow perspective, I respectfully elaborate on dozens of points concerning the creative transformation of Heaven and Earth, the fundamental basis of life in the human body, the expansion and contraction of Qi mechanism, internal and external factors, and the substantial evidence for Yang deficiency and Yin deficiency conditions. I also detail the flexibility and comprehensiveness of using formulas and methods, aiming to clarify the painstaking effort behind Zhang Zhongjing's law establishment and formula creation, thereby supplementing what Mr. Xiuyuan omitted.
With the sole intention of saving lives, I do not know if my words are presumptuous; I hope those with high understanding will forgive me.
Written by Zheng Shouquan (Zhen'an) from Linqiong, Southern Sichuan, in the ninth month of the Jisi Year of Tongzhi (1869).
Volume One of Zhenyi Zhuan
The General Principle of Qian and Kun
Qian symbolizes Heaven, belongs to Metal, and is Pure Yang. It is called the Old Father, Old Yang, or Laozi, and is also named Dragon.
Kun symbolizes Earth, belongs to Earth, and is Pure Yin. It is called the Old Mother, or Old Yin. When Qian and Kun interact, they generate six children.
When the first line of Qian overlays the first line of Kun, the Eldest Son is born, which is Zhen (Thunder). When the second line of Qian overlays the second line of Kun, the Middle Son is born, which is Kan (Water). When the third line of Qian overlays the third line of Kun, the Youngest Son is born, which is Gen (Mountain).
Thus it is said: The Way of Qian creates Men (The first, second, and third lines metaphorically represent the sequence of emission of the true essence and Qi of Qian Metal). When the first line of Kun overlays the first line of Qian, the Eldest Daughter is born, which is Xun (Wind). When the second line of Kun overlays the second line of Qian, the Middle Daughter is born, which is Li (Fire). When the third line of Kun overlays the third line of Qian, the Youngest Daughter is born, which is Dui (Lake). Thus it is said: The Way of Kun creates Women (The first, second, and third lines metaphorically represent the degree of flow of the true Yin of Kun Earth). Among the six children of Qian and Kun, the eldest and youngest possess biased aspects of Qian and Kun's nature, whereas only the Middle Son and Middle Daughter uniquely possess the upright nature of Qian and Kun. Humans are born inheriting the upright Qi of Heaven and Earth; this is why Kan and Li serve as the root for establishing life in humans.
Poem of the Kan Trigram
Heaven bestows, Earth moistens, Water flows freely;
One Qi contains Three, crafting divine workmanship.
From here, the foundation of all things stands firm,
Generating and transforming, bathed in seasonal harmony.
Explanation of the Kan Trigram
Kan symbolizes Water, belongs to Yin, refers to Blood, yet True Yang resides within it. The middle line represents Heaven. "Heaven generates One Water." In the human body, this corresponds to the Kidney. A spark of True Yang is contained within two Yin lines, residing in the place of extreme Yin. This is the root of life, the true seed. Various texts refer to it as True Yang. The term "True Yang" is explained differently across various sources, which may cause beginners to fail to grasp it quickly, leading to unclear symptom identification. Therefore, I have collected these terms for reference. "True Yang" is also known as Minister Fire, Mingmen Fire, Dragon-Thunder Fire, Rootless Fire, Yin Fire, or Deficiency Fire. When manifesting as disease, it is called Yuan Qi failing to be retained, Yuan Yang escaping outward, True Fire boiling, Kidney Qi failing to be retained, Qi failing to return to its source, Solitary Yang floating upward, or Deficiency Fire rushing upward. All these names refer to the single Yang line within the Kan trigram. This single Yang was originally transformed from the pre-Heaven Qian Metal, hence the name Dragon. When one Yang falls into two Yins, it transforms into Water, establishing the extreme of Water (Yang is the root of Yin). Water naturally flows downward; this is the fixed position of the post-Heaven Kan trigram, an unchangeable principle. It must be understood that the Dragon at this stage is a newborn Dragon (Dragon refers to the Yang line in Kan); it cannot soar to bring rain, but remains hidden in the abyss, making water its home and nature, thus content in its lower position, bowing down. Symptoms such as Deficiency Fire rushing upward clearly indicate Water excess (Water is Yin). For every unit of Water excess, the Dragon increases by one unit (Dragon is Fire). If water rises one foot, the dragon rises one foot. This is the Dragon swimming due to Water excess, not the Dragon failing to hide and acting contrary to its nature. Hence, the classic states: "When Yin is excessive, Yang must decline." From this, we can realize that medication must support Yang and suppress Yin. However, city doctors, upon seeing symptoms like Deficiency Fire rushing upward, fail to investigate the essential cause. They immediately prescribe Yin-nourishing and Fire-reducing methods, claiming mastery. They fail to consider that the root is Yin excess (Yin excess refers to旺盛 Kidney Water) and Yang deficiency (Yang deficiency refers to weak Jun Fire). Instead of supporting Yang, they further nourish Yin, which is akin to adding frost to snow—are they not mediocre physicians? I often see patients with Deficiency Fire rushing upward who prefer hot drinks and reject cold items entirely, further proving the error of Yin-nourishing. Some claim Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Prepared Aconite Root) guide fire back to its source. This misunderstands the direction. Guizhi, Fuzi, and Ganjiang (Dried Ginger) are pure blazing fire. When fire is strong, Yin naturally dissipates, just as intense sunlight leaves no clouds. Moreover, Guizhi and Fuzi can tonify the Yang in Kan and Li. Their nature is extremely pungent and warm, sufficient to eliminate rebellious Yin Qi ascending above. Once Yin Qi is eliminated, the sky becomes clear, and upper and lower parts settle in peace without excess or deficiency. Is this truly guiding fire back to its source?历代 commentators have failed to uncover the depth of one Yang hiding in water, causing later learners to be ignorant and baseless. Yin-nourishing and Fire-reducing methods have killed countless people, a千古 lingering malpractice and a great regret in the medical field.
(The most common diseases corresponding to Deficiency Fire rushing upward are chronic pharyngitis, laryngitis, stomatitis, etc., as termed in modern medicine. Despite treatment with clearing heat and detoxifying, or nourishing Yin and reducing fire methods such as Liushen Wan or Houyan Wan, the illness often persists. However, treating with supporting Yang and suppressing Yin methods, such as Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) or Fuzi Lizhong Tang (Aconite and Magnolia Bark Decoction), often yields good results.)
Poem of the Li Trigram
Earth produces, Heaven completes, named King of Fire;
Yin and Yang interlock, hiding the Divine Sovereign.
Spirit enters and exits, truly without fixed form;
The mechanism here lies only in concealment.
Explanation of the Li Trigram
Li symbolizes Fire, belongs to Yang, refers to Qi, yet True Yin resides within it. The middle two lines represent Earth. "Earth generates Two Fire." In humans, this corresponds to the Heart. A spark of True Yin is hidden within two Yang lines, residing in the South position, possessing the image of a ruler. It is the honor among the twelve organs, the master of ten thousand spirits, and the master of the human body. Thus it is said: "The Heart stores the Spirit." The True Yang in Kan originates from Qian Yuan (One); the True Yin in Li originates from Kun Yuan (Two). One becomes two, two becomes one; they mutually serve as roots, embodying the relationship of husband and wife. Thus, at Zi hour (11 PM - 1 AM), one Yang moves, raising True Water to intersect with the Heart. At Wu hour (11 AM - 1 PM), one Yin begins to generate, lowering Heart Fire to intersect with the Kidney. One ascends, one descends, endless in cycle; Life Nature is established here.
Interpreting Qi and Blood as One Trigram
The numbers of Heaven and Earth begin with One. One belongs to Yang, which is Qi. One generates Two; Two belongs to Yin, which is Blood.
One combines with Two to form unity: Qi is formless and resides within Blood. Two combines with One to form unity: Blood is formed and hides within Qi (The Classic says "Qi controls Blood," meaning this). Qi and Blood can be interpreted as one Kan trigram, or one Li trigram, or even both Kan and Li trigrams together. I often say: "Differentiating Yin and Yang by Zang-Fu organs discusses the branches. Interpreting via one Kan trigram explores the ultimate root." I also say: The human body is a mass of flesh and blood, which is Yin. It relies entirely on a cluster of True Qi circulating within to establish life; this can also be interpreted as one Kan trigram.
Explanation of Jun Fire and Minister Fire
Jun Fire is Ordinary Fire; Minister Fire is True Fire.
Ordinary Fire is the Heart; True Fire is the Yang within the Kidneys.
Ordinary Fire resides above to command Yang; Yang is heavy and Yin is light, so it resides above to function (represented by the two Yang lines of Li). True Fire resides below to command Yin; Yin is heavy and Yang is light, so it resides below to be the substance (represented by the single Yang line of Kan). Although the two fires are divided, they are essentially one Qi (The two Yang lines of Li and the single Yang line of Kan combine to form Qian. Humans live by one breath, which is this Qi of Qian Yuan. Because Qian divides one Qi and falls into the Kun Palace, the Post-Heaven world emerges. This is the origin of Jun and Minister Fires). They are indeed the masters of Yin and Yang. If the Jun Fire above is weak, it cannot control the essence and blood of the upper orifices, leading to clear nasal discharge, saliva, tears, leaking eyes, nosebleeds, and tooth bleeding. If the Minister Fire below is weak, it cannot control the essence and blood of the lower orifices, leading to enuresis, spermatorrhea, vaginal discharge in women, and incontinence of urine and feces. Note that the two fires cannot be separated, nor can they be fully merged. They move back and forth, generating Middle Qi (Both fires can generate Earth: the upper generates Ordinary Earth, i.e., Stomach; the lower generates True Earth, i.e., Spleen. The two fires generate Middle Earth, relying on each other sequentially). Thus, two Qi become three Qi (Hence the term San Yuan, or San Jiao. The Classic says: "Without Pre-Heaven, Post-Heaven cannot stand; without Post-Heaven, Pre-Heaven cannot generate." This is the true meaning of Pre- and Post-Heaven San Yuan). If the Central Palace fails to receive the mutual steaming of the two fires, it cannot rot and ripen grain and water, leading to undigested food in stool, phlegm-dampness, and fullness. (The Upper, Middle, and Lower sections reveal they are all one cluster of Fire). If both Upper and Lower fires are insufficient, the upper may trend downward, such as Heart disease transferring to the Small Intestine, or Lung disease transferring to the Large Intestine. The lower may trend upward, such as Deficiency Fire causing toothache, hemoptysis, asthma, facial edema, or throat obstruction. Most critically, there are cases where Yin Qi ascends but True Fire does not ascend with it, and cases where Yin Qi ascends and True Fire ascends with it. Here, one must pay attention. If the signs of Upper Collapse are emerging—pulse floating and empty, rapid breathing, but no red face, body heat, or sweating—this indicates Yin Qi is ascending, but True Fire has not yet ascended with it. If red face, body heat, and sweating appear, this indicates Yin Qi is ascending, and True Fire has also ascended with it. At this stage, collapse is imminent. Upon seeing any symptoms of Yin Qi ascending, do not wait until collapse occurs to use Yang-restoring methods. Seize the opportunity early and administer formulas for restoring Yang and anchoring [the spirit]. This will prevent the formation of collapse syndrome. Similarly, there are cases where Yang Qi trends downward but Jun Fire does not follow, and cases where Jun Fire follows. Do not neglect this. If signs of Lower Collapse are present—pulse minute and nearly imperceptible, profuse bloody discharge in urine/feces, or severe diarrhea with undigested food, cold limbs but not yet freezing, ability to control urine/feces—this indicates Yang Qi is trending downward, but Jun Fire has not yet followed. If limbs are severely cold, incontinence is severe and uncontrollable, this indicates Yang Qi is trending downward, and Jun Fire has also followed. At this stage, collapse is imminent. Upon seeing any symptoms of Yang Qi trending downward, do not wait for specific conditions to use counter-flow methods. Examine the mechanism beforehand and rescue with counter-flow and Qi-tonifying methods to avoid disaster. Generally, exhaustion from below rising to above is Yang Collapse (Yang in Kan is Heavenly Body, so collapse manifests from above). Exhaustion from above falling to below is Yin Collapse (Yin in Li is Earthly Body, so collapse manifests from below). For Yang about to collapse, tonify Yin to retain it, such as with Dushen Tang (Single Ginseng Decoction). For Yin about to collapse, tonify Yang to retrieve it, such as with Huiyang Yin (Restore Yang Drink). There are also cases where Yang is about to collapse but need not nourish Yin; if Yin is excessive, Yang extinguishes immediately. Cases where Yin is about to collapse but need not tonify Yang; if Yang is vigorous, Yin dissipates immediately. These are variations of Yin and Yang. Students must carefully contemplate to understand the meaning of the Unity's division and combination.
Brief Remarks on the True Dragon
The True Dragon refers to Qian as Heaven (Qian body belongs to Metal, a pure whole without any dross or dust. Ancients used Dragon to metaphorize it, saying it has unpredictable transformative wonders). Qian divides one Qi and falls into the Kun Palace, transforming into Water. Yin and Yang mutually root, generating the Post-Heaven Kan and Li trigrams, upon which the human body relies. The two Qi move back and forth, generating Middle Earth, giving birth to all things, while the two Qi also rely on Middle Earth. The Dragon in the Kan Palace (the single Yang line in Kan, transformed from Qian body) is a newborn Dragon, nurtured within Kun Earth. Hence it is said: "Seeing the Dragon in the Field." Although it lacks the ambition to soar, it has the merit of nurturing. Water without Earth does not accumulate; Dragon without Earth does not hide. Thus, when Earth covers Water, and Water is in the Earth, with Dragon in Water, Water does not reach extreme cold. With Dragon hiding in Earth, Earth achieves harmony. Earth and Water unite in virtue, and the world is greatly accomplished.
I ponder that Heaven opens at Zi (because one Yang moves at Zi hour), and the Dragon descends. Dragon descends at Zi, reaches completeness at Si, and soaring peaks (hence much rain in May/June, Dragons emerge, indicating complete Dragon body). Extremity generates one Yin. One Yin begins at Wu, reaches extreme purity at Hai, where Dragon body transforms into pure Yin. Extremity generates one Yang. Hence it is said: Fu Yi (Return One). Yi is True Qi, the body of Heaven. Though Qi is below, it never ceases to emit upward. If True Yin in Li is the body of Earth, though residing above, it never ceases to descend downward. Hence the *I Ching* says: "Those rooted in Heaven亲近 the Upper; those rooted in Earth亲近 the Lower." This is the key to Yin-Yang ascent and descent, an eternal truth.
If practitioners can study carefully and comprehend Yin and Yang through the True Dragon, they will obtain the complete Dragon structure of the human body.
San Jiao (Triple Burner) Locations [Discussion]
Shang Jiao (Upper Burner) commands the Qi of Heart and Lung, up to the diaphragm. Zhong Jiao (Middle Burner) commands the Qi of Spleen and Stomach, starting below the diaphragm to the navel. Xia Jiao (Lower Burner) commands the Qi of Liver and Kidney, starting from the navel to the feet. Shang Jiao is Heaven (Shang Yuan), Zhong Jiao is Earth (Zhong Yuan), Xia Jiao is Water (Xia Yuan). Heavenly Qi descends to Earth, entering Water from Earth. Earthly Qi rises to Earth, reaching Heaven from Earth. Thus it is said: Earth is the pivot harmonizing Yin and Yang. The Qi of San Jiao divides into three, unites into one. It is the most crucial organ in the body. If one Qi is obstructed, three Qi are unsmooth. This is the natural logic of Qi mechanism. Students should explore the transformative mechanism within these San Jiao Qi, and within the properties and flavors of medicines, to find the way of harmonizing Yin and Yang.
Transformation of the Five Movements
Jia and Ji transform into Earth. In years of Jia and Ji, Earth Movement governs; others are deduced similarly: Yi and Geng transform into Metal; Bing and Xin transform into Water; Ding and Ren transform into Wood; Wu and Gui transform into Fire.
Transmission of Diseases in the Essential Bodies of the Five Phases
Heaven and Earth generate the Five Phases, which inevitably have excesses. Each Phase embodies one Zang organ, receives one Qi, governs one direction, presides over one season, has its generation, transformation, restriction, and harm.
Thus, the East generates Wind-Wood, governing Spring. In humans, this is Liver. If Liver Qi is stagnant, disease arises with varying severity. The South generates Heat-Fire, governing Summer. In humans, this is Heart. If Heart Qi is stagnant, disease arises. The Late Summer generates Damp-Earth, governing the four seasons. In humans, this is Spleen. If Spleen Qi is stagnant, disease arises. The West generates Dryness-Metal, governing Autumn. In humans, this is Lung. If Lung Qi is stagnant, disease arises. The North generates Cold-Water, governing Winter. In humans, this is Kidney. If Kidney Qi is stagnant, disease arises. This is disease arising from the essential bodies of the Five Phases. Furthermore, Mother disease affecting Child occurs, e.g., Metal disease transferring to Kidney. Child disease affecting Mother occurs, e.g., Kidney disease transferring to Lung. Wife disease overcoming Husband occurs, e.g., Earth disease transmitting to Liver. Husband disease affecting Wife occurs, e.g., Liver disease transmitting to Earth. Disease transmission due to mutual generation occurs, e.g., Metal transfers to Water, Water to Wood, Wood to Fire, Fire to Earth, Earth to Metal. Disease transmission due to mutual restriction occurs, e.g., Metal restricts Wood, Wood restricts Earth, Earth restricts Water, Water restricts Fire, Fire restricts Metal. If students pay attention to this, treating diseases will not be difficult.
On the Chapter of Qi and Blood Excess and Deficiency
Although the human body has five Zang and six Fu organs, it ultimately boils down to Qi and Blood. Students should focus on these two characters; no other search is needed. Excess Qi is Fire; when Fire is strong, Yin must be deficient. Examples include Zhang Zhongjing's Renshen Baihu Tang (Ginseng and White Tiger Decoction) and Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction), which are methods to extinguish Fire and save Yin; Shaoyao Gancao Tang (Peony and Licorice Decoction) and Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction), which are methods to moisten dryness and support Yin; Siling Huashi Ejiao Tang (Four Poria, Talcum, and Donkey-Hide Gelatin Decoction) and Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill), which are methods to promote urination and nurture Yin.
Deficient Qi is Cold; when Cold is strong, Yang must decline. Examples include Zhang Zhongjing's Sini Tang (Reverse Cold Decoction) and Huiyang Yin (Restore Yang Drink), which are methods to warm meridians and save Yang; Lizhong Tang (Regulate the Middle Decoction) and Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction), which are methods to warm the center and support Yang; Fuzi Xixin Tang (Aconite and Asarum Decoction) and Zhenwu Tang (True Warrior Decoction), which are methods to warm the Kidney and assist Yang. Later scholars replaced these with Yin-nourishing and Fire-reducing methods, copying methods like Renshen Baihu Tang for moistening dryness and saving Yin. While applicable for treating excess Qi symptoms, using them on those with deficient Qi is far off the mark.
Methods for Identifying All Yang Deficiency Syndromes