三法者,国中末也。初治之道,法当猛峻,所谓用药势疾利猛峻也。缘病得之新暴,感之轻,
得之重,当以疾利猛峻之药急去之。中治之道,法当宽猛相济,为病得之非新非久,当以缓疾得
中,养正去邪相兼济而治之。养正去邪者,假令如见邪气多正气少,宜以去邪药多正气药少,凡
加减之法如此,更以临时对证消息增减用药,仍根据时令行之,更加针灸,其效甚速。末治之道,
法当宽缓。宽缓者,谓药性平善,广服无毒,惟能安中养血气。盖为病久,邪气潜伏,欲泻而正
气微,治故以善药养正而邪自去,更加针灸,其效必速。
五治者,和取从折属也。一治曰和,假令小热之病,当以凉药和之,和之不已,次用取。二
治曰取,为热势稍大,当以寒药取之,取之不已,次用从。三治曰从,为势既甚,当以温药从之,
为药气温也,味随所为。或以寒因热用,味通所用,或寒以温用,或以发汗之,不已,又再折。
四治曰折,为病势极甚,当以逆制之,制之不已,当以下夺之,下夺不已,又用属。五治曰属,
为求其属以衰之,缘身热陷在骨髓,无法可出,针
药所不能及,故求其属以衰之,缘属之法同声相应,同气相求。经曰∶陷下者衰之。夫衰热之法,
所云火衰于戌,金衰于辰之类是也。或有不已,当广其法而治之。
这三种治法,是治疗的常规、中间和末尾阶段。初治的原则,用药应当猛烈峻急,这就是所说的用药势要迅速、锋利、猛烈、峻急。因为疾病是新近突然得的,感受邪气轻浅,但病情却较重,应当用迅速、锋利、猛烈、峻急的药物尽快祛除病邪。中治的原则,用药应当宽缓与猛烈相互调剂,因为疾病既不是新近得的,也不是久留的,应当根据病情的缓急适中,扶正与祛邪同时兼顾来治疗。所谓扶正祛邪,假如见到邪气多而正气少,宜多用祛邪药,少用扶正药,凡是加减药物的方法都是如此,再根据临时的具体证候斟酌增减药物,仍然依据时令气候进行,再加上针灸治疗,疗效非常迅速。末治的原则,用药应当宽缓平和。宽缓平和,是指药性平和良善,长期服用无毒,只能安定中焦、滋养气血。因为疾病日久,邪气潜伏体内,想要泻下攻邪则正气虚弱,所以治疗时用良善的药物扶助正气,邪气自然就会去除,再加上针灸治疗,疗效必定迅速。
这五种治法,包括调和、顺从、折损、隶属等原则。第一种治法叫“和”,假如是轻微发热的病,应当用凉性药物来调和它,调和无效后,接着用“取”法。第二种治法叫“取”,因为热势稍微增大,应当用寒性药物来攻取它,攻取无效后,接着用“从”法。第三种治法叫“从”,因为病势已经很严重,应当用温性药物来顺从其势,因为药性是温的,药味随着治疗目的而定。或者用寒性药因热证而使用(反佐),药味通达所治之证;或者用寒性药因温证而使用;或者用发汗的方法治疗,如果无效,再用“折”法。第四种治法叫“折”,因为病势极其严重,应当用逆其病势的方法来制约它,制约无效后,应当用泻下的方法来夺其实邪,泻下无效后,再用“属”法。第五种治法叫“属”,是为了寻求疾病的本源以削弱它,因为身热深陷在骨髓之中,没有方法可以排出,针药都不能达到,所以寻求其本源以削弱它,因为“属”的法则是同声相应,同气相求。经书说:陷下的病证要用衰减法。所谓衰减热邪的方法,就是所说的火邪在戌时衰退,金邪在辰时衰退之类的道理。如果有无效的,应当广泛运用各种方法来治疗。
These three methods represent the initial, intermediate, and terminal stages of treatment. The principle of initial treatment dictates that medications should be potent and drastic, meaning the therapeutic momentum must be swift, sharp, fierce, and severe. Since the disease is newly acquired and sudden, with a light pathogenic invasion but heavy clinical presentation, one should employ swift, sharp, fierce, and severe drugs to rapidly eliminate the pathogen. The principle of intermediate treatment requires a balance between mildness and severity. As the disease is neither newly acquired nor chronic, the treatment should be moderate in pace, simultaneously supporting healthy Qi (vital energy) and eliminating pathogens. Specifically, if pathogenic factors are abundant while healthy Qi is deficient, more pathogen-eliminating herbs should be used than healthy Qi-nourishing ones. This approach applies to all modifications of prescriptions. Furthermore, medication dosage should be adjusted according to the specific syndrome at hand, aligned with seasonal climatic conditions, and combined with acupuncture for rapid efficacy. The principle of terminal treatment advocates for mild and gentle approaches. "Mild and gentle" refers to herbs that are balanced and benign, safe for long-term use without toxicity, primarily serving to stabilize the Middle Jiao (central digestive system) and nourish Qi and Blood. Because the disease has persisted for a long time, pathogens are latent, and attempting to purge them would further weaken already deficient healthy Qi. Therefore, treatment involves using benign herbs to support healthy Qi, after which pathogens will naturally dissipate. Combined with acupuncture, this yields certain and rapid results.
The five treatments encompass principles of harmonizing, following, countering, and relating. The first treatment is "Harmonizing." For minor heat conditions, cool-natured herbs should be used to harmonize the body; if harmonization fails, proceed to "Taking/Purging." The second treatment is "Taking/Purging." If the heat intensity increases moderately, cold-natured herbs should be used to purge the heat; if purging fails, proceed to "Following." The third treatment is "Following." When the condition becomes severe, warm-natured herbs should be used to follow the pathogenic trend, as the drug's nature is warm, and its flavor adapts to the therapeutic goal. This may involve using cold herbs in hot conditions (counter-assistance), where the flavor penetrates the targeted area, or using cold herbs in warm conditions, or employing diaphoresis (sweating). If ineffective, proceed to "Countering." The fourth treatment is "Countering." When the pathological momentum is extreme, one must counteract it directly. If direct counteraction fails, use downward purgation to drain excess. If purgation fails, proceed to "Relating/Attributing." The fifth treatment is "Relating/Attributing," which seeks the root cause to diminish the pathology. When fever sinks into the marrow, inaccessible to standard interventions, one seeks the root to reduce it, based on the principle that like sounds resonate and like energies attract. The Classics state: "For sinking conditions, apply reduction." Methods for reducing heat include concepts such as Fire declining at Xu hour and Metal declining at Chen hour. If these methods remain ineffective, a broader range of techniques should be employed.