肺为气主，忌乎 郁。《经》曰∶“忧愁者，气闭塞而不行”，是忧能伤肺之由也。至于喜可胜忧，其义何居？亦考诸
岐伯曰∶“喜则气和志达，营卫通利，故气缓矣。”则以闭塞者而和缓之，岂不得谓之胜乎？然亦更有显明者，凡人有所
忧愁，每多胸膈不舒，适逢欢快之事，即可情怀开旷，此尤情性之常，宁独火可胜金而已哉。
此症行止坐卧皆不能安，自朱奉议以为伤寒之变证，后之注《金匮》者，或言属气，或言属血，论说纷纭，余窃以
为皆未中肯。夫“百脉一宗，悉致其病”，乃本乎心神涣散也。心主脉，故心病而脉为之皆病矣。惟其心神涣散，故下文
常默默，不能食，不能卧，不能行数句，无可奈何之态，皆所以形容百脉悉病之语。未经误治，病情如是者，乃为此病
之正，故用百合而加生地黄汁，显为五志之火，消烁心阴，于是以此救之。《经》所云“津液相成，神乃自生”之意也。
此外因误治之变，而随症治之，如《金匮》所立数方，亦不过略举其概，以令人隅反；设未用汗、吐、下三法，而曾或
寒、或热、或补、或泻之药以误治者，治法亦宜权变，惟在法古者之引伸触类耳。赵以德《衍义》云∶“病多从心主，或
因情欲不随，或因离绝菀结，或忧惶煎迫，致二火郁之所成”，最为切当。惜其有见及此，而未明言心神涣散之故，注中
反杂以热毒瘀血等解，殊为白璧之瑕。昔张路玉治孟端士太夫人此病，用生脉散加百合、茯神、龙齿，稍兼黄连而病愈，
盖以百合摄神之法而推展之，洵为能读仲景书者矣。第安神之药不一，而专取乎百合者，因其形象心，瓣瓣合抱，取
其凝合涣散之心神，由是而百脉皆利矣。尝阅《中吴纪闻》云∶百合乃蚯蚓所化，张路玉亦曾亲见，于包山土罅中，有
变化未全者，大略野生百合，蚓化有之。夫蚯蚓性动而专通经络，及至变而为百合，则由动而静，由散而合，用为主治，
即此意耳。且百脉悉病，则病变百出，非经文数症之所能尽；设或症不尽合乎经文，而遇病态类此者，亦宜体会其意而
推测之，不可泥定下文数症也。当明欲食不能食等句，乃无可形容之辞，病为神病，而难以形容，医者亦须神会，而非
语言文本之所能罄者矣。景岳云∶无形者，神也，变幻倏忽，换回非易，引《经》文“粗守形，上守神”二句，而叹安
得有通神明而见无形者，与之共谈斯道哉。旨哉，是言也！向来注者，多以百合为消瘀血，然消瘀血者，乃赤花之山丹，
非百合也。苏颂以病名百合，而用百合，不识其义。李士材曰∶亦清心安神之效耳。士材能见及此，而未发明此症之机
要，殊缺典也。
肺是气的主宰，忌讳气机郁滞。《黄帝内经》说：“忧愁会导致气机闭塞而不运行”，这就是忧愁能损伤肺的原因。至于喜悦可以克制忧愁，其中的道理在哪里呢？这也考察自岐伯所说：“喜悦则气和顺、意志通达，营卫之气通畅流利，所以气机舒缓。”既然用和气缓的方法来对待闭塞的状态，难道不能称之为克制吗？然而还有更明显的表现：凡人有了忧愁，往往胸膈部感到不舒畅，恰好遇到令人欢快的事，心情就能开阔豁达，这更是情性的常态，哪里仅仅是火能克金（五行相克）而已呢？
这种病症在行走、站立、坐着、卧躺时都不能安宁，自从朱奉议认为它是伤寒的变证后，后世注释《金匮要略》的人，有的说属于气病，有的说属于血病，议论纷纷。我私下认为这些都没有切中要害。“百脉一宗，悉致其病”，这是根本在于心神涣散。心主宰血脉，所以心病导致血脉都随之生病。正因为心神涣散，所以下文所说的“常常沉默不语”、“不能进食”、“不能安卧”、“不能行走”等几句，无可奈何的情态，都是为了形容百脉全都生病的状态。如果没有经过误治，病情像这样的，才是此病的正证，所以使用百合并加入生地黄汁，显然是针对五志之火消烁心阴的情况，以此来救治。这正是《内经》所说的“津液相互生成，神气自然产生”的意思。此外对于因误治产生的变证，则根据症状进行治疗，如《金匮要略》中所设立的几个方剂，也不过是略微列举大概，让人举一反三；假如没有使用汗、吐、下三法，而是曾用过寒、热、补、泻等药物误治的，治疗方法也应当权宜变通，只在于遵循古法者能够引申触类旁通罢了。赵以德在《金匮衍义》中说：“病多从心主起，或因情欲不顺，或因离别孤绝郁结，或因忧惶煎熬逼迫，导致二火郁结而成”，最为恰当。可惜他虽然见识到了这一点，却没有明确说明心神涣散的原因，在注释中反而混杂了热毒瘀血等解释，实在是白璧微瑕。昔日张路玉治疗孟端士太夫人的此病，使用生脉散加百合、茯神、龙齿，稍加黄连而病愈，这是将百合安神的方法推展运用，确实是能读懂仲景书籍的人啊。只是安神的药物不只一种，而专门选取百合，是因为它的形象像心，花瓣层层合抱，取它凝聚合拢涣散心神的作用，由此使得百脉都通畅。曾经阅读《中吴纪闻》说：百合是由蚯蚓变化而来的，张路玉也曾亲眼见过，在包山泥土缝隙中，有变化未完全的百合，大抵野生百合，确实有由蚯蚓化生的说法。蚯蚓本性好动且善于疏通经络，等到变化为百合后，就由动转静，由散转合，用它作为主治药物，就是取这个意思。况且百脉都生病，那么病变层出不穷，不是经文列举的几个症状所能穷尽的；假设症状不完全符合经文，但遇到病态类似的，也应该体会其意推测它，不可拘泥于下文那几句话。应当明白“想吃饭却吃不下”等句子，是无法形容的辞藻，病在于神，难以形容，医者也需要神会领悟，而不是语言文本所能完全表达的。张景岳说：无形的是神，变幻迅速，挽回不易，引用《内经》“粗工守形，上工守神”两句，感叹哪里有通晓神明而能见到无形之人，能与他共谈这门学问呢？这话真深刻啊！向来注释的人，大多认为百合是消除瘀血的，然而消除瘀血的是赤花的山丹，不是百合。苏颂因为病名叫百合，就用百合药，是不懂其中的含义。李士材说：也只是清心安神的效果罢了。李士材能看到这一层，却没有阐明此症的关键要点，确实有所欠缺。
The Lung is the master of Qi, and it abhors stagnation. The Classic states: "Those who are worried have Qi that is blocked and does not move." This is the reason why worry can injure the Lung. As for joy overcoming worry, where lies the meaning? It is also derived from Qibo's saying: "Joy leads to harmonious Qi and accessible will, allowing Ying and Wei (Nutritive and Defensive Qi) to flow freely, thus causing the Qi to relax." By using a method of harmonizing and relaxing to address blockage, how could it not be called overcoming? However, there is an even more obvious manifestation: whenever a person has worries, they often feel uncomfortable in the chest and diaphragm; encountering something joyful allows the mood to open up and broaden. This is the normal nature of emotions, and it is not merely about Fire overcoming Metal (in Five Elements theory).
This syndrome involves restlessness in walking, standing, sitting, and lying down. Since Zhu Fengyi considered it a variant syndrome of Shanghan (Cold Damage), later annotators of *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) have argued whether it belongs to Qi or Blood, leading to divergent theories. I privately believe none of them hit the mark. "All vessels belong to one source, and all suffer disease"; this stems fundamentally from the dissipation of Heart Spirit (Shen). The Heart governs the vessels; therefore, when the Heart is diseased, the vessels become diseased as well. Because the Heart Spirit is dissipated, the subsequent descriptions of "often silent," "unable to eat," "unable to sleep," and "unable to walk" depict a helpless state, serving to describe the condition where all vessels are diseased. If untreated by error, such presentation constitutes the standard form of this disease. Hence, Baihe Tang (Lily Bulb Decoction) with added Shengdihuang Zhi (Raw Rehmannia Root Juice) is used, clearly targeting the fire of the five emotions that consumes Heart Yin, thereby rescuing it. This embodies the meaning of the Classic: "When body fluids and essence complement each other, Shen naturally arises." Regarding variations caused by erroneous treatment, one treats according to symptoms. The several formulas established in *Jingui Yaolue* merely outline the general principles to inspire analogical reasoning. If the sweating, vomiting, or purging methods were not used, but cold, heat, tonifying, or draining herbs were erroneously administered, the treatment should be flexible, relying on the practitioner's ability to extend and apply ancient principles. Zhao Yi-de in *Jingui Yanyi* stated: "Diseases mostly originate from the Heart Master, due to unfulfilled desires, separation and isolation leading to depression, or anxiety and torment, resulting from the stagnation of the two fires." This is most appropriate. Regrettably, while he saw this, he did not explicitly explain the cause of dissipating Heart Spirit, instead mixing in explanations of heat toxicity and blood stasis, which is a flaw in an otherwise jade-like commentary. Previously, Zhang Luyu treated Madam Meng Duan's case of this disease using Shengmai San (Generate the Pulse Powder) added with Baihe (Lily Bulb), Fushen (Poria with Hostwood), and Longchi (Dragon Bone), with a slight addition of Huanglian (Coptis Rhizome), resulting in recovery. This extended the method of Baihe calming the spirit, truly demonstrating mastery of Zhongjing's writings. Although there are many sedatives, Baihe is specifically chosen because its shape resembles the Heart, with petals embracing each other, symbolizing the gathering and uniting of dissipating Heart Spirit, thereby benefiting all vessels. I once read *Zhongwu Jiwen* stating that Baihe is transformed from earthworms; Zhang Luyu had personally seen incomplete transformations in soil crevices at Baoshan. Generally, wild Baihe may indeed transform from earthworms. Earthworms are active and good at unblocking meridians; upon transforming into Baihe, they shift from activity to stillness, from dispersion to union. Using it as the main treatment takes advantage of this meaning. Furthermore, since all vessels are diseased, pathological changes are myriad and cannot be exhausted by the few symptoms in the Classic text. If symptoms do not fully match the Classic but resemble the disease pattern, one should comprehend the intent and infer accordingly, rather than being rigidly bound to the specific sentences below. One must understand that phrases like "wants to eat but cannot" are indescribable metaphors. The disease affects Shen, which is hard to describe; physicians must grasp it intuitively, beyond what language and text can fully express. Jingyue said: "That which is formless is Shen; it changes swiftly and is difficult to reverse." He quoted the Classic: "Crude practitioners guard form; superior practitioners guard Shen," sighing that it is rare to find someone who understands Shen and perceives the formless to discuss this path with. Profound words! Traditionally, annotators often regarded Baihe as eliminating blood stasis. However, eliminating blood stasis is the function of Chanhua Shandan (Red-flowered Lilium bulb), not Baihe. Su Song used Baihe because the disease was named Baihe, failing to understand the underlying principle. Li Shicai said: "It merely clears the Heart and calms the spirit." Li Shicai reached this insight but failed to elucidate the key mechanism of this syndrome, which is indeed lacking.