二方皆阴阳并用之方也,然其间有轻重之别,在乎分量之多寡以别之。如损处重在阳,
则血药多用,气药次之;重在阴,则气药多用,血药次之。血为阴,气为阳,盈虚消息之理,后
至者成功也。伊芳尹十全大补汤,用四君以补气,加木香不使上焦气滞也;用四物以补血,加
沉香不使下焦气滞也。盖上古气血俱浓,故用二香,补而兼之以行。若叔季之人,气血俱虚
,故东垣以黄 代木香,兼益上焦之气,以肉桂代沉香,温暖阴血,血得温而生,气得温而
长。经云∶虚者十补勿一泄。此类是矣。
归脾,味味皆滞,故用木香以疏肝,肝疏得归身、枣仁,肝血润矣。肝血能润,则脾血
能藏,脾既能藏,而后能为胃行其津液,使周身皆利也。盖参、 、术、草之补脾,当归之补肝
,茯神、枣仁、远志之补心,各守一经,性皆滞碍,得木香之疏通,破上焦之滞,醒动脾气
,而后脾能淫气于心,心始生血,散精于肝,肝始藏血,心肝既足,而后脾得以统血,血足
则火不郁,三焦通达而无捍格之患矣。今之用归脾而去木香者,能不为之慨叹哉!
补中者,补中气也。参、 、术、草所以补脾,五行相制则生化,广皮以疏肝气,归身
以养肝血,清气升则阴阳皆长,故用柴胡、升麻以升提清气,清气既升则阳生,阳生而阴自长矣
这两张方子都是阴阳并用的方剂,然而其中存在轻重之别,依靠药物分量多少来区分。如果亏损之处重在阳气,那么补血药多用,补气药次之;如果亏损之处重在阴血,那么补气药多用,补血药次之。血属于阴,气属于阳,盈虚消长的道理是:后到达的药物起到成功的作用。
伊芳尹(人名)的十全大补汤(Shiquan Dabu Decoction),使用四君子汤(Sijunzi Tang,由人参、白术、茯苓、甘草组成)来补气,加入木香(Aucklandiae Radix)是为了防止上焦气机阻滞;使用四物汤(Siwu Decoction,由熟地黄、当归、白芍、川芎组成)来补血,加入沉香(Aquilariae Lignum Resinatum)是为了防止下焦气机阻滞。大概上古时期人的气血都浓厚,所以使用两种香药,在补益的同时兼以行气。如果是末世之人,气血都虚弱,所以李东垣(Li Dongyuan)用黄芪(Astragali Radix)代替木香,兼补上焦之气,用肉桂(Cinnamomi Cortex)代替沉香,温暖阴血,血得到温暖就能生成,气得到温暖就能生长。《内经》说:“虚证应当十次补益而不要一次泻泄。”这类情况就是如此。
归脾汤(Guipi Decoction),每一味药的性质都偏于滞碍,所以使用木香来疏理肝气,肝气疏泄正常后,配合当归身(Angelicae Sinensis Radix)和酸枣仁(Ziziphi Spinosae Semen),肝血就能滋润。肝血能够滋润,那么脾血就能固藏,脾既然能够固藏,然后才能为胃传输津液,使周身通畅。大概人参(Ginseng Radix)、白术(Atractylodis Macrocephalae Rhizoma)、甘草(Glycyrrhizae Radix et Rhizoma)补脾,当归补肝,茯神(Poria with Hostwood)和酸枣仁、远志(Polygalae Radix)补心,各守一经,药性都滞碍,得到木香的疏通,破除上焦的滞塞,醒动脾气,然后脾能将精气输送给心,心才开始生血,散布精微给肝,肝才开始藏血,心肝既已充足,然后脾得以统摄血液,血充足则火不郁结,三焦通达而没有格拒的隐患了。如今有人使用归脾汤却去掉木香,能不为此感叹吗!
补中益气汤(Buzhong Yiqi Decoction),是补益中气的。人参、白术、甘草用来补脾,五行相互制约则生化无穷,陈皮(Citri Reticulatae Pericarpium)来疏理肝气,当归身来养肝血,清气上升则阴阳皆长,所以使用柴胡(Bupleuri Radix)和升麻( Cimicifugae Rhizoma)来升提清气,清气既然上升则阳气生发,阳气生发而阴血自然增长了。
Both formulas are those that combine yin and yang tonification. However, there is a distinction in their emphasis, which is determined by the relative dosages of the ingredients. If the deficiency primarily involves yang, blood-nourishing herbs are used in greater quantity, while qi-tonifying herbs are secondary; if the deficiency primarily involves yin, qi-tonifying herbs are used in greater quantity, while blood-nourishing herbs are secondary. Blood belongs to yin, and qi belongs to yang. The principle of waxing and waning dictates that the herb arriving last achieves the therapeutic effect.
In the Shiquan Dabu Decoction (Ten Ingredients Great Tonifying Decoction) attributed to Yi Fangyin, Si Jun Zi Tang (Four Gentlemen Decoction) is used to tonify qi, with added Mu Xiang (Aucklandiae Radix) to prevent stagnation of qi in the upper jiao (upper burner); Si Wu Tang (Four Substances Decoction) is used to nourish blood, with added Chen Xiang (Aquilariae Lignum Resinatum) to prevent stagnation of qi in the lower jiao (lower burner). Generally, in ancient times, people's qi and blood were robust, so two aromatic herbs were used to promote movement alongside tonification. In later eras, however, people's qi and blood are both deficient. Therefore, Li Dongyuan substituted Huang Qi (Astragali Radix) for Mu Xiang to additionally tonify qi in the upper jiao, and substituted Rou Gui (Cinnamomi Cortex) for Chen Xiang to warm the yin-blood. Blood is generated when warmed, and qi grows when warmed. The Classics state: "For deficiency patterns, tonify ten times without purging once." Such cases exemplify this principle.
Regarding Guipi Decoction (Restore the Spleen Decoction), every ingredient tends to be cloying or stagnant. Therefore, Mu Xiang is used to soothe the Liver. Once the Liver qi is unblocked, combined with Dang Gui Shen (Angelicae Sinensis Radix) and Suan Zao Ren (Ziziphi Spinosae Semen), the Liver blood becomes moistened. When Liver blood is moistened, Spleen blood can be stored properly. Once the Spleen can store blood, it can then transport fluids for the Stomach, ensuring smooth circulation throughout the body. Specifically, Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Gan Cao (Glycyrrhizae Radix et Rhizoma) tonify the Spleen; Dang Gui tonifies the Liver; Fu Shen (Poria with Hostwood), Suan Zao Ren, and Yuan Zhi (Polygalae Radix) tonify the Heart. Each acts on its respective meridian, but their nature is inherently stagnant. With the unblocking action of Mu Xiang, upper jiao stagnation is broken, and Spleen qi is awakened. Only then can the Spleen transmit essence to the Heart, allowing the Heart to generate blood, distribute essences to the Liver, and enabling the Liver to store blood. Once the Heart and Liver are sufficient, the Spleen can control blood. When blood is abundant, fire does not become constrained, and the three jiao remain unobstructed without risk of rebellion. Today, some use Guipi Decoction but omit Mu Xiang; one cannot help but sigh at this!
Bu Zhong Yi Qi Decoction (Tonify the Middle and Augment the Qi Decoction) tonifies middle qi. Ren Shen, Bai Zhu, and Gan Cao are used to tonify the Spleen. Through the mutual restriction of the Five Elements, transformation and generation occur endlessly. Chen Pi (Citri Reticulatae Pericarpium) soothes Liver qi, and Dang Gui Shen nourishes Liver blood. When clear qi ascends, both yin and yang grow. Therefore, Chai Hu (Bupleuri Radix) and Sheng Ma (Cimicifugae Rhizoma) are used to lift clear qi. Once clear qi ascends, yang is generated; once yang is generated, yin naturally grows.