阴胜则阳病，阳胜则阴病。阳胜则热，阴胜则寒。重寒则热，重热则寒。
则身热，腠理闭，喘粗为之俯仰，汗不出而热，齿干，以烦冤，腹满死，能冬不能夏。阴胜
则身寒，汗出，身常清，数栗而寒，寒则厥，厥则腹满死，能夏不能冬。（录《素问·阴阳
应象论》中语。）
诸有过者切之，（有过，即有病也。）涩者，阳气有余也；滑者，阴气有余也。阳气有余
，则
予谓病之重者，莫大于此，如刀削肌肉，危甚不能久矣。（“诸有过者切之”至“无汗而身
寒”止，皆《素问·脉要精微论》中语也。其“阴阳不足”二句，乃慎斋所补。以此证甚危
险，不可以经中未言而忽之也。故既补之，而又详言以申之。）
经云∶邪生于阳者，得之风雨寒暑。又云∶阳虚生外寒，阳受气于上焦，以温皮肤分肉
之间，今寒气在外，则上焦不通，上焦不通，则寒气独留于外，故寒栗。又云∶阳盛生外热，上
焦不通利，则皮肤致密，腠理闭塞，玄府不通，卫气不得泄越，故外热。又云∶邪生于阴者
，得之饮食起居，阴阳喜怒。又云∶阴虚生内热，有所劳倦，形气衰少，谷气不盛，上焦不
行，下脘不通，胃气热，热气熏胸中，故内热。又云∶阴盛生内寒，厥气上逆，寒气积于胸
中而不泻，不泻则温气去，寒独留，则血凝涩，血凝则脉不通，其脉盛大以涩，故中寒。
视其颜色，黄赤者多热气，青白者多寒气，黑色者多血少气。（录《灵枢·五音五味篇
》中语，“青白者多寒气”，原文是“青白者少热气”，其语胜此，似不必易。）
凡诊络脉，脉色青则寒且痛，赤则有热。胃中寒，手鱼际之络多青矣；胃中有热，鱼际
之络赤。其暴黑者，留久痹也。其有赤，有黑，有青者，寒热气也。其青短者，少气也。（录《
浮络多青则痛，多黑则痹，黄赤则热，多白则寒，五色皆见则寒热也。（录《素问·皮
部论》中语。）
数则为热，迟则为寒，诸阳为热，诸阴为寒。
人迎盛则为热，虚则为寒，气口盛则胀满，寒中热不化。虚则热中，出糜，少气，溺色
变。（录《灵枢·禁服篇》中语。）
岐伯曰∶寒者热之，热者寒之，微者逆之，盛者从之。帝曰∶何谓逆从？岐伯曰∶逆者
正治，从者反治。从少从多，观其事也。帝曰∶反治何如？岐伯曰∶热因寒用，寒因热用，塞因
塞用，通因通用。必伏其主，而先其所因。其始则同，其终则异。可使破积，可使溃坚，可
使和气，可使必己。（录《素问·至真要大论》中语。）
微者调之，其次平之，盛者夺之，汗之下之，寒热温凉，衰之以属，随其攸利。假如小
寒之气，温以和之；大寒之气，热以取之；甚寒之气，则下夺之；夺之不已，则逆折之；折之不
尽，则求其属以衰之。小热之气，凉以和之；大热之气，寒以取之；甚热之气，则汗发之；
发之不尽，则逆制之；制之不尽，则求其属以衰之。（自“微者调之”以下二十八字，亦至
真要大论中语，“假如小寒”以下八十八字，乃启元子注也。）
阳盛阴虚，下之则愈，汗之则死，此热证也。阳盛生外热，阴虚生内热，下之者寒药清
之也，寒凉之性下行也。
阴盛阳虚，汗之则愈，下之则死，此寒证也。阳盛生内寒，阳虚生外寒，汗之者热药温
之也，非正发汗也。用药以助生浮、升长之气，所以扶其阳也。
帝曰∶论言治热以寒，治寒以热，方士不能废绳墨而更其术也。有病热者，寒之而热，
有病寒者，热之而寒，二者皆在，新病复起，奈何？岐伯曰∶诸病寒之而热者，取之阴，热之而
寒者，取之阳，所谓求其属也。盖益火之原，以消阴翳，壮水之主，以制阳光也。
帝曰∶服寒而反热，服热而反寒，其故何也？岐伯曰∶治其旺气，是以反也。帝曰∶不
治旺气而然者，其故何也？岐伯曰∶悉乎哉问也！不治五味属也。夫五味入胃，各归所喜，故酸先
入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾。久而增气，物化之常也；气增而久，夭
之由也。（以上亦是至真要大论中语，以下则启元子注也。）入肝为温，入肺为清，入心为热
，入肾为寒，入脾为至阴，而四时兼之，皆为增其味而益其气，故久服黄连、苦参而反热者
，此类是也。故曰久而增气，物化之常也。气增不已，则脏气偏胜；脏气有偏胜，则有偏绝
；脏气有偏绝，则有暴夭。故曰气增而久，夭之由也。
问∶寒病服热药而寒不退，热病服寒热而热不退，何也？答曰∶热不得寒，是无水也；
寒不得热，是无火也。寒之不寒，责其无水；热之不热，责其无火。经云∶滋其化源，化源已绝
，药之假，焉能滋其真水火也。（至真要大论。）帝曰∶脉从而病反者，何如？岐伯曰∶脉至
而从，按之不鼓，诸阳皆然。（启元子注言∶）病热而脉数，按之不鼓动，乃阴盛格阳所致，
非热也。此一节言证属阳，脉亦从证，虽属热而反病寒也，诸阳皆然，谓诸阳概数而不鼓，
太阳标本不同之脉也。（又至真要大论云∶）帝曰∶诸阴之反，何如？岐伯曰∶脉至而从，按
之鼓盛而甚也。（启元子注言∶）形证皆寒，按之而脉鼓击于指下盛者，此为热甚拒阴所致，
病非寒也。此一节言证属寒，脉亦从证，虽似寒而反病热也。是故百病之起，有生于本者，
有生于标者，有生于中气者，有取本而得者，有取标而得者，有取中气而得者，有逆取而得
者，有从取而得者。逆，正顺也。若顺逆也。故曰∶知标与本，用之不殆，明知顺逆，正行
无间，此之谓也。不知是者，不足以言诊，足以乱经。故大要曰∶粗工嘻嘻，以为可知，言
热未已，病寒复始，同气异形，迷诊乱经，此之谓也。夫标本之道，要而博，小而大，可以
言一而知百病之害，言标与本，易而勿损，察本与标，气可令调，明知胜复，为万民式，天
之道毕矣。（自“百病之起”至此亦是至真要大论中语，）六气之病，标本相反者，惟太阳少
阴之病为最。盖太阳标热本寒，少阴标寒本热，启元子释诸阳脉至而从为病热，脉数者，太
阳之标也。按之不鼓，为阴盛格阳者，寒水之本，与标相反也。诸阴脉至而从为脉证，似寒
者，少阴之标也。按之鼓盛，为热盛拒阴者，君火之本，与标相反也。是故不知相反者，逆
标气之阴阳而正治，则顺本气之寒热而病如故，外则似顺，中气乃逆，故方若顺，乃实则逆
也。知相反者，顺标气之阴阳而反治，则逆本气之寒热而愈，故外虽用逆，中乃顺也，此似
逆而实正顺也。知标与本，用之不殆，明知顺逆，正行无间也。若脉从病反，言证似阳者，
脉亦从证似阳，而其病反是寒也。证似阴者，脉亦从证似阴，而其病反是热也。故皆反其脉
证施治。（下文详言脉证相反者之治法，当舍证从脉。然其中又有脉证相合，而病之真情实
相反者，又宜反其证脉以施治。以总明病机千变万化，学人之不可不细审而详察也。）如身
热烦躁面赤，其脉沉而微者，阴证似阳也。身热者，里寒故也；烦躁，阴盛故也；面赤，戴
阳，下虚故也。若医者不知脉，误为实热，反用寒凉，则气消成大病矣。《外台秘要》云∶
阴盛发躁，欲坐井中者，宜以热药治之。故仲景以少阴证面赤者，四逆汤加葱白治之，以逆
气象阳也。若寒凉之药入腹，周身之火得水则升走，阴躁之极，往往欲坐井中，医犹不悟，
此是阴证，仍认为热，复以寒药投之，其死也何疑？或因呕吐，或因嗽而发躁，蒸蒸身热，
如坐甑中，欲去衣近寒处，或饮食寒水则便振寒如故，上气短促，胸中满闷欲死，甚则口开
目瞪，声闻于外，而泪涕痰涎大作，其发躁须臾而已。六脉沉细而涩，按之而虚，是大寒之
证。以辛甘甘温之剂饮之则愈。《活人书》∶手足逆冷，大便闭，小便赤，或大便黑色，脉
沉而滑，阳证似阴也。轻者白虎汤，重者承气汤。伤寒失下，血气不通，令四肢逆冷，此是
伏热，故厥亦深，速以大承气汤下之，汗出即愈。盖热厥与阴厥不同，热厥者微，厥即发热
，阴厥不发热，四肢逆冷，恶寒，脉沉细，大小便滑泄。
上二节，言证似阳而脉病属阴，证似阴而脉病属阳，故反其证而治之。盖证似阳而脉病
属阴，证似阴而脉病属阳者，世尚能辨。若脉证俱似阴而病属阳，脉证俱似阳而病属阴者，举世
莫辨矣。许学士云∶熙宁邹守迪，因其犹子病伤寒，见其烦渴而汗多，以凉药治之，遂成阴
毒，数日卒。迪悼痛之，遂作“阴毒形证诀”三篇。盖伤世之意深矣！太阳膀胱之经，乃热
因寒用，且膀胱本寒，其经太阳也。太阳为标，有阳之名，无阳之实，谓其将变阴也。其脉
紧而数，按之不鼓而空虚，是外见虚阳而内有真寒也。故仲景用姜、附久久煎之，不温服而
冷服，亦是治寒也。姜、附气味俱阳，加之久久熟煎，取重阳之热，泻纯阴之寒，是治本也
。不温服而冷服，此以假寒治太阳标之假阳，故为真假相对之治法。用药处治者，当知其脉
之空虚，则是内伏阴寒之气，外显热证，大渴引饮，目赤口干，面红身热，四肢热如火者，
此浮阳将绝于外，而内则为寒所拒也。手少阴之心经，乃寒因热用，少阴之经真阴，其心根
本是真火也。故曰∶少阴经标阴本热，是内则以阳为本，外则真阴为标也，其脉沉细，按之
洪大紧甚而盛者，心火在内，则紧甚洪大，真阴为标，则脉沉细，盖寒水之体也。故仲景以
大承气汤煎成热服之，以除标寒，用大黄、芒硝辛苦咸寒之气味，以泻本热，其用药可以为
万世之法矣！盖治热以寒，温而行之也。
经云∶治热以寒，温而行之，其义有三∶大热在身，用人参、黄 、甘草退之。此三味
者皆甘温之品，虽表里皆热，躁发于内，扪之肌热于外，能和之，汗自出而愈矣。此甘温能治大
热之理，一也；热极生风，乃左迁入地，补母以实其子，使天道右迁顺行，诸病得天令行而
必愈，二也；况大热在外，其寒必伏于内，温能退寒以助地气，地气者，在人乃胃中之生气
，使其生气旺，三也。经云∶治寒以热，凉而行之。仲景治少阴病下利脉微者，与白通汤，
利不止，厥逆无脉，干呕烦者，白通汤加猪胆汁主之。此治寒以热，用胆汁凉而行之也。治
寒以热，凉而行之，其义有三∶北方人为大寒所伤，其足胫胀，乃寒胜则浮，理之常也，若
以火灸汤浴，必有脱皮见骨之害，须先以新汲水浴之，实时完复矣。其有大寒冻其面或耳，
若见火汤，必脱皮成疮，须先以凉水浴之，少时即温手熨烙，必能完复，此凉而行之，能除
大寒，一也。大寒之气，必令母实，乃地道左迁入肺，逆行于天，以凉药投之，使天道右迁
而顺行，诸病得天令行而必愈，二也。况大寒在外，则大热伏于九地，人身之内，乃三焦、
包络，天真之气所居之根蒂也，热伏于中，原气必伤，人身原气乃胃也，以凉药和之，使原
气充足而不伤，三也。经曰∶恶寒战栗者，皆属于热。又曰∶战栗如丧神守，皆属于火。恶
寒者，虽当炎月，若遇风雨重绵在身，仍觉凛凛战栗，如丧神守，恶寒之至也。《原病式》
曰∶病证热而反觉身寒，此为病热，实非寒也。或曰∶往往见服热药而愈者，何也？病热之
人，其气炎上，郁为痰饮，抑遏清道，阴气不升，病热犹甚，积痰得热亦为暂退，热势助邪
，其病益深。或曰∶寒势如此，谁敢以寒药投之？投之是杀之也。予曰∶古人遇战栗之证，
有以大承气汤下燥屎而愈者，则恶寒战栗，明系热证，但有虚实之分耳。
经曰∶阴虚则发热，夫阳在外为阴之卫，阴在内为阳之守。精神外驰，嗜欲无节，阴气
耗散，阳无所附，遂致浮散于肌表之间而发热，实非是热，当作阴虚治之，而用补阴之法可也。
或曰∶伤寒发热，俱系邪气何耶？予曰∶伤寒热邪，自外而入；阴虚发热，自内而出也。火
郁之热，当看热在何经，轻者可降，重者随其性而升之。
实火可降，小便降火甚速，补阴则火亦自降，用炒黄柏、生地黄之属。
虚火可补，参、术之类，甘以缓之也。凡气有余便是火，急甚者缓之，生甘草缓之之药
火盛不可骤用寒凉，必兼温以散之。左金丸治火，川连六两，佐以吴茱萸一两。
阴虚火动者，不治。
验案
丹溪治色白妇人恶寒，用八珍汤去川芎，加炒黄柏，治之反剧，知其病热深而无反佐之
过也。仍用前药炒熟，与之而愈。治热以寒，借火之力，温而行之也。
一人寒热，盗汗，倦怠，食少，六脉俱弦，尺大于寸，心部更虚。曰∶此肝之脾胃虚也
，胃气不能到肝，则肝木挟邪上克脾土，故肝强而脉弦，弦者减也，减者中和之气少也，此虚在
脾，脾当扶也。然扶脾不制木，无益也。而木中又有虚实之分，凡阴之长生，即阳之死位；
阳之长生，即阴之死位。胆为甲木，长生在亥，则肝为乙木而死于亥。故其虚在木之阴，而
实在木之阳，则知气有余而血不足矣。心主血，故心脉虚，血不足则阳陷，故尺脉大，法当
阴气偏胜则损伤阳气，阳气偏胜则损伤阴气。阳气偏胜会出现热证，阴气偏胜会出现寒证。寒邪极盛可转化为热象，热邪极盛可转化为寒象。
如果是阳热亢盛，则身体发热，腠理（皮肤毛孔）闭塞，呼吸急促粗重，甚至因呼吸困难而被迫俯仰起伏，汗液无法排出导致体内积热，牙齿干燥，心中烦闷冤屈，若出现腹部胀满则为死证，患者能耐受冬季而不能耐受夏季。如果是阴寒偏胜，则身体寒冷，出汗，身体经常感到清冷，频繁战栗发冷，寒冷至极则出现四肢厥逆，四肢厥逆且伴有腹部胀满则为死证，患者能耐受夏季而不能耐受冬季。（摘录自《素问·阴阳应象大论》中的语句。）
凡是患有疾病的，可以通过切脉来诊断。（“有过”，即指有病。）脉象涩滞的，说明阳气有余；脉象滑利的，说明阴气有余。阳气有余，（会导致相应的病变）。我认为病情严重的，没有比这更严重的了，就像肌肉被刀削一样，危险得很，不能长久存活。（从“诸有过者切之”到“无汗而身寒”止，都是《素问·脉要精微论》中的语句。其中关于“阴阳不足”的两句话，是慎斋先生补充的。因为这种证候非常危险，不能因为经典中没有提及就忽视它。所以既进行了补充，又详细阐述以申明其义。）
经典说：邪气生于阳分的，是由于风雨寒暑等外感因素。又说：阳气虚衰会产生外寒。阳气从上焦获得气机，用来温煦皮肤和分肉之间。现在寒气在体表，导致上焦不通畅，上焦不通畅，则寒气独自停留在体表，所以出现寒战。又说：阳气亢盛会产生外热。如果上焦不通利，则皮肤致密，腠理闭塞，玄府（汗孔）不通，卫气不能宣泄发散，所以产生外热。又说：邪气生于阴分的，是由于饮食起居失调以及情绪喜怒变化。又说：阴气虚衰会产生内热。如果有过度劳累，形体和气都衰弱减少，水谷精气不充足，上焦之气不能运行，下脘（胃之下口）不通畅，胃气郁而化热，热气熏蒸于胸中，所以产生内热。又说：阴气亢盛会产生内寒。厥逆之气向上冲逆，寒气积聚在胸中而不能排泄，不能排泄则温煦之气离去，只有寒气独留，血液就会凝滞涩涩不畅，血液凝滞则脉道不通，脉象盛大而兼涩，所以产生内寒。
观察病人的面色，黄赤色的多属有热，青白色的多属有寒，黑色的多属血少气虚。（摘录自《灵枢·五音五味篇》中的语句，“青白者多寒气”，原文是“青白者少热气”，这里的表述更好，似乎不必更改。）
凡是诊察浮络（浅表小血管），络脉颜色青色的，主寒且痛；红色的，主热。胃中有寒，手鱼际部位的络脉多呈青色；胃中有热，鱼际的络脉呈红色。如果突然变黑的，是久留不去的痹症。如果有红、黑、青多种颜色的，是寒热错杂的表现。如果青色且短小的，是气少的表现。（摘录自……浮络多青则痛，多黑则痹，黄赤则热，多白则寒，五色皆见则寒热也。（摘录自《素问·皮部论》中的语句。）
脉数主热，脉迟主寒，诸阳经脉主热，诸阴经脉主寒。
人迎脉（颈动脉）盛大主热，虚弱主寒；气口脉（桡动脉）盛大则腹胀满，寒中热不化。气口脉虚弱则热在中焦，出现口腔糜烂，气短，小便颜色改变。（摘录自《灵枢·禁服篇》中的语句。）
岐伯说：寒证用热药治疗，热证用寒药治疗，病势轻微的采用逆其病性治疗的正治法，病势强盛的采用顺其病性治疗的反治法。黄帝问：什么叫逆治和从治？岐伯说：逆治就是正治，从治就是反治。从少或从多，要观察病情的具体情况。黄帝问：什么是反治？岐伯说：热因寒用，寒因热用，塞因塞用，通因通用。必须制服主要矛盾，先找出病因。开始时用药性质与病象相同，最终效果却相反。可以破除积滞，可以消散坚块，可以调和气血，可以使疾病痊愈。（摘录自《素问·至真要大论》中的语句。）
病势轻微的予以调理，其次予以平复，病势强盛的予以攻夺，通过发汗或泻下的方法，利用寒热温凉不同的药性，根据所属脏腑来衰减病邪，顺应其有利的方面。假如是小寒之气，用温和的药来调和它；是大寒之气，用热的药来祛除它；是极寒之气，则用泻下的方法攻夺它；攻夺无效，则用逆势的方法折损它；折损不尽，则求其所属的根本来衰减它。如果是小热之气，用凉的药来调和它；是大热之气，用寒的药来祛除它；是极热之气，则用发汗的方法发散它；发散不尽，则用逆势的方法制约它；制约不尽，则求其所属的根本来衰减它。（从“微者调之”以下二十八字，也是《至真要大论》中的语句，“假如小寒”以下八十八字，是启元子的注释。）
阳气亢盛、阴气不足的，用泻下法可以痊愈，用发汗法会导致死亡，这是热证。阳气亢盛产生外热，阴气不足产生内热，用泻下法是运用寒凉药物清除它，寒凉药性趋向下行。
阴气亢盛、阳气不足的，用发汗法可以痊愈，用泻下法会导致死亡，这是寒证。阳气亢盛产生内寒（此处原文逻辑似有误，通常阳盛生外热，阴虚生内热；阴盛生内寒，阳虚生外寒。但依原文翻译），阳气不足产生外寒，用发汗法是运用温热药物温补它，这并不是真正的发汗，而是用药助长升发、浮越、生长的阳气，以此来扶持阳气。
黄帝问：医论说治疗热证用寒药，治疗寒证用热药，方术之士不能废除规矩而改变其技术。但是有的热病患者，用了寒药反而更热；有的寒病患者，用了热药反而更寒，这两种情况都存在，新病又起，怎么办？岐伯说：所有用寒药治疗后热势不减的，应当滋补肾阴；用热药治疗后寒势不退的，应当温补心阳，这就是所谓探求病证的根本属性。大概是益补命门之火，以消除阴寒之翳障；壮补水中之主，以制约阳光之亢盛。
黄帝问：服用寒药反而发热，服用热药反而发寒，这是什么缘故？岐伯说：这是因为治疗时只针对旺盛的病气（邪气），而没有顾护正气，所以反而加重。黄帝问：不针对旺盛病气而出现这种情况，是什么缘故？岐伯说：你问得真详尽啊！这是因为没有考虑五味的归属。各种味道进入胃后，各自归于其所喜应的脏腑，所以酸味先入肝，苦味先入心，甘味先入脾，辛味先入肺，咸味先入肾。长期服用会增强相应脏腑之气，这是事物变化的常规；但如果气偏增久了，就会导致夭折，这是早逝的原因。（以上也是《至真要大论》中的语句，以下是启元子的注释。）入肝为温，入肺为清，入心为热，入肾为寒，入脾为至阴，而兼有四时之气，都是为了增加其味从而增益其气，所以长期服用黄连、苦参反而发热的，就是这类情况。所以说长期服用会增强其气，这是事物变化的常规。如果气偏增不已，则脏气偏胜；脏气有偏胜，则有偏绝；脏气有偏绝，则有暴死。所以说气偏增久了，是夭折的原因。
问：寒病服用热药而寒不退，热病服用寒药而热不退，为什么？答：热证得不到寒药的疗效，是因为体内无水（阴液枯竭）；寒证得不到热药的疗效，是因为体内无火（阳气衰微）。用寒药治寒而不退，责任在于无水；用热药治热而不退，责任在于无火。经典说：滋养其化源，如果化源已经断绝，药物的假借之力，怎么能滋养其真水火呢？（出自《至真要大论》。）黄帝问：脉象顺从病证但症状相反的，是什么样的？岐伯说：脉象看似顺从，但按之无力不鼓动，诸阳经脉大多如此。（启元子注释说：患热病而脉数，按之却不鼓动，这是阴盛格阳所致，并非真热。这一节说的是证候属阳，脉象也顺从证候，虽然属于热证但反而表现出寒象，诸阳经脉都是这样，指的是诸阳经脉普遍表现为数而无力，这是太阳经标本不同的脉象。）（又《至真要大论》说：）黄帝问：诸阴经脉的反常是怎样的？岐伯说：脉象看似顺从，但按之鼓动有力且盛大。（启元子注释说：形证都表现为寒，但按之脉象在指下鼓击盛大，这是热甚拒阴所致，病非寒证。这一节说的是证候属寒，脉象也顺从证候，虽然看似寒证但反而病属热证。因此百病的起因，有的生于本，有的生于标，有的生于中气，有的取本而治愈，有的取标而治愈，有的取中气而治愈，有的逆取而治愈，有的从取而治愈。逆治，实质上是正治；若顺治，则是逆治。所以说：懂得标与本，使用就不会有危险；明晓顺逆，正道行走就没有间隙，说的就是这个道理。不懂得这些，不足以谈论诊病，只会扰乱经络。所以大体上说：庸医嘻嘻哈哈，以为容易知道，刚说完热病，寒病又开始了，同气异形，迷惑诊法扰乱经络，说的就是这种情况。标本之道，简要而广博，微小而宏大，可以说一而知百病的危害，言标与本，容易而不减损，考察本与标，气机就可以调和，明晓胜复规律，作为万民的准则，天道的道理就完备了。）（从“百病之起”至此也是《至真要大论》中的语句。）六气致病，标本相反的，只有太阳和少阴的病最为严重。大概太阳标热本寒，少阴标寒本热，启元子解释诸阳脉至而从为病热，脉数的，是太阳的标；按之不鼓动，为阴盛格阳的，是寒水之本，与标相反。诸阴脉至而从为脉证，似寒的，是少阴的标；按之鼓盛，为热盛拒阴的，是君火之本，与标相反。因此不知道相反的，逆着标气的阴阳进行正治，则会顺着本气的寒热而病如故，外表看似顺从，中气乃逆，所以方剂看似顺从，实际上是逆治。知道相反的，顺着标气的阴阳进行反治，则会逆着本气的寒热而痊愈，所以外表虽然用逆治，中气反而是顺的，这看似逆治实则正顺。知标与本，使用就不会有危险；明晓顺逆，正道行走就没有间隙。如果脉象顺从病证但症状相反，言证候似阳的，脉象也顺从证候似阳，但其病反而是寒。证候似阴的，脉象也顺从证候似阴，但其病反而是热。所以都要反其道而施治。（下文详细论述脉证相反者的治法，应当舍证从脉。但其中又有脉证相合，而病的真情实意相反的，又宜反其证脉以施治。以此总明病机千变万化，学医者不可不仔细审察。）比如身体发热烦躁面赤，但脉象沉而微的，是阴证似阳。身体热，是因为里寒；烦躁，是因为阴盛；面赤，是戴阳，因为下虚。如果医生不知脉象，误认为是实热，反而用寒凉药，则会导致气消而成大病。《外台秘要》说：阴盛发躁，想坐在井中的，应用热药治疗。所以张仲景治疗少阴证面赤的，用四逆汤加葱白治疗，以逆气象阳。如果寒凉药入腹，周身之火得水则升走，阴躁之极，往往想坐在井中，医生仍不醒悟，这是阴证，仍认为是热，再用寒药投之，其死亡有何可疑？或者因为呕吐，或者因为咳嗽而发躁，蒸蒸身热，如坐蒸笼中，想脱衣靠近寒处，或者喝冷水后就振寒如故，上气短促，胸中满闷欲死，甚至张口瞪眼，声音传于外面，而且泪涕痰涎大作，其发躁片刻而已。六脉沉细而涩，按之而虚，是大寒之证。用辛甘甘温的药剂饮用即可痊愈。《活人书》：手足逆冷，大便闭结，小便赤，或大便黑色，脉沉而滑，是阳证似阴。轻者用白虎汤，重者用承气汤。伤寒失于泻下，血气不通，导致四肢逆冷，这是伏热，所以厥逆也深，速以大承气汤泻下，汗出即愈。大概热厥与阴厥不同，热厥较轻，厥逆后即发热，阴厥不发热，四肢逆冷，恶寒，脉沉细，大小便滑泄。
上面两节，讲的是证似阳而脉病属阴，证似阴而脉病属阳，所以反其证而治之。大概证似阳而脉病属阴，证似阴而脉病属阳的情况，世上尚能辨别。如果脉证俱似阴而病属阳，脉证俱似阳而病属阴的情况，举世无人能辨。许学士说：熙宁年间邹守迪，因其侄子患伤寒，见他烦渴而汗多，用凉药治疗，遂成阴毒，数日后去世。邹守迪悲痛万分，于是作“阴毒形证诀”三篇。这真是深切地哀叹世风啊！太阳膀胱之经，乃是热因寒用，且膀胱本寒，其经名为太阳。太阳为标，有阳之名，无阳之实，谓其将变为阴。其脉紧而数，按之不鼓而空虚，是外见虚阳而内有真寒。所以张仲景用干姜、附子久久煎煮，不温服而冷服，这也是治寒。姜、附气味俱阳，加之久久熟煎，取重阳之热，泻纯阴之寒，这是治本。不温服而冷服，这是以假寒治太阳标的假阳，所以是真假相对的治疗方法。用药处置者，当知其脉之空虚，则是内伏阴寒之气，外显热证，大渴引饮，目赤口干，面红身热，四肢热如火者，此浮阳将绝于外，而内则为寒所拒也。手少阴之心经，乃寒因热用，少阴之经真阴，其心根本是真火也。故曰：少阴经标阴本热，是内则以阳为本，外则真阴为标也，其脉沉细，按之洪大紧甚而盛者，心火在内，则紧甚洪大，真阴为标，则脉沉细，盖寒水之体也。故仲景以大承气汤煎成热服之，以除标寒，用大黄、芒硝辛苦咸寒之气味，以泻本热，其用药可以为万世之法矣！盖治热以寒，温而行之也。
经云：治热以寒，温而行之，其义有三：大热在身，用人参、黄芪、甘草退之。这三味药皆甘温之品，虽表里皆热，躁发于内，扪之肌热于外，能和之，汗自出而愈矣。此甘温能治大热之理，一也；热极生风，乃左迁入地，补母以实其子，使天道右迁顺行，诸病得天令行而必愈，二也；况大热在外，其寒必伏于内，温能退寒以助地气，地气者，在人乃胃中之生气，使其生气旺，三也。经云：治寒以热，凉而行之。仲景治少阴病下利脉微者，与白通汤，利不止，厥逆无脉，干呕烦者，白通汤加猪胆汁主之。此治寒以热，用胆汁凉而行之也。治寒以热，凉而行之，其义有三：北方人为大寒所伤，其足胫胀，乃寒胜则浮，理之常也，若以火灸汤浴，必有脱皮见骨之害，须先以新汲水浴之，实时完复矣。其有大寒冻其面或耳，若见火汤，必脱皮成疮，须先以凉水浴之，少时即温手熨烙，必能完复，此凉而行之，能除大寒，一也。大寒之气，必令母实，乃地道左迁入肺，逆行于天，以凉药投之，使天道右迁而顺行，诸病得天令行而必愈，二也。况大寒在外，则大热伏于九地，人身之内，乃三焦、包络，天真之气所居之根蒂也，热伏于中，原气必伤，人身原气乃胃也，以凉药和之，使原气充足而不伤，三也。经曰：恶寒战栗者，皆属于热。又曰：战栗如丧神守，皆属于火。恶寒者，虽当炎月，若遇风雨重绵在身，仍觉凛凛战栗，如丧神守，恶寒之至也。《原病式》曰：病证热而反觉身寒，此为病热，实非寒也。或曰：往往见服热药而愈者，何也？病热之人，其气炎上，郁为痰饮，抑遏清道，阴气不升，病热犹甚，积痰得热亦为暂退，热势助邪，其病益深。或曰：寒势如此，谁敢以寒药投之？投之是杀之也。予曰：古人遇战栗之证，有以大承气汤下燥屎而愈者，则恶寒战栗，明系热证，但有虚实之分耳。
经曰：阴虚则发热，夫阳在外为阴之卫，阴在内为阳之守。精神外驰，嗜欲无节，阴气耗散，阳无所附，遂致浮散于肌表之间而发热，实非是热，当作阴虚治之，而用补阴之法可也。或曰：伤寒发热，俱系邪气何耶？予曰：伤寒热邪，自外而入；阴虚发热，自内而出也。火郁之热，当看热在何经，轻者可降，重者随其性而升之。
实火可降，小便降火甚速，补阴则火亦自降，用炒黄柏、生地黄之属。
虚火可补，参、术之类，甘以缓之也。凡气有余便是火，急甚者缓之，生甘草缓之之药火盛不可骤用寒凉，必兼温以散之。左金丸治火，川连六两，佐以吴茱萸一两。
阴虚火动者，不治。
验案
丹溪治色白妇人恶寒，用八珍汤去川芎，加炒黄柏，治之反剧，知其病热深而无反佐之过也。仍用前药炒熟，与之而愈。治热以寒，借火之力，温而行之也。
一人寒热，盗汗，倦怠，食少，六脉俱弦，尺大于寸，心部更虚。曰：此肝之脾胃虚也，胃气不能到肝，则肝木挟邪上克脾土，故肝强而脉弦，弦者减也，减者中和之气少也，此虚在脾，脾当扶也。然扶脾不制木，无益也。而木中又有虚实之分，凡阴之长生，即阳之死位；阳之长生，即阴之死位。胆为甲木，长生在亥，则肝为乙木而死于亥。故其虚在木之阴，而实在木之阳，则知气有余而血不足矣。心主血，故心脉虚，血不足则阳陷，故尺脉大，法当
When Yin prevails, Yang becomes diseased; when Yang prevails, Yin becomes diseased. When Yang prevails, there is heat; when Yin prevails, there is cold. Extreme cold transforms into heat, and extreme heat transforms into cold.
If Yang heat is hyperactive, the body will be feverish, the couli (skin pores) closed, breathing rapid and coarse, causing the patient to assume a prone or supine position due to dyspnea. Sweat cannot be excreted, leading to internal heat retention, dry teeth, mental restlessness and grievance. If abdominal fullness occurs, it indicates a fatal prognosis. The patient can tolerate winter but not summer. If Yin cold prevails, the body will be cold, sweating, often feeling chilly, with frequent shivering and cold sensations. Extreme cold leads to jue (cold extremities), and if jue is accompanied by abdominal fullness, it indicates a fatal prognosis. The patient can tolerate summer but not winter. (Excerpted from the *Suwen: Yingxiang Dalun* chapter.)
For any disease, palpation should be performed. ("Youguo" refers to having a disease.) A choppy pulse indicates excess Yang qi; a slippery pulse indicates excess Yin qi. Excess Yang qi... I believe that among severe diseases, none is more critical than this, as it resembles muscles being sliced by a knife, extremely dangerous and unsustainable for long. (From "Zhu youguozhe qie zhi" to "Wu han er shen han" are all excerpts from the *Suwen: Maiyao Jingwei Lun*. The two sentences regarding "Yin and Yang insufficiency" were supplemented by Shenzhai. Because this syndrome is extremely dangerous, it should not be ignored just because it is not mentioned in the classics. Therefore, it was supplemented and elaborated upon to clarify its significance.)
The classics state: Pathogens arising from the Yang aspect result from wind, rain, cold, and summer heat. It also states: Yang deficiency generates external cold. Yang receives qi from the upper jiao to warm the skin and muscle intervals. Now, if cold qi remains on the exterior, the upper jiao becomes obstructed. Obstruction of the upper jiao causes cold qi to remain solely on the exterior, resulting in chills. It also states: Yang excess generates external heat. If the upper jiao is not smooth, the skin becomes dense, the couli close, and the xuanguan (sweat pores) become blocked. Wei qi cannot diffuse outward, thus generating external heat. It also states: Pathogens arising from the Yin aspect result from dietary and lifestyle irregularities, as well as emotional fluctuations like joy and anger. It also states: Yin deficiency generates internal heat. Fatigue and overwork lead to depletion of form and qi, insufficient grain qi, failure of upper jiao function, and obstruction at the lower wan (lower stomach opening). Stomach qi stagnates and generates heat, which steams upward into the chest, causing internal heat. It also states: Yin excess generates internal cold. Jue qi rebels upward, and cold qi accumulates in the chest without being discharged. Lack of discharge causes warming qi to depart, leaving only cold. Blood then coagulates and flows sluggishly, blocking the vessels. The pulse becomes large and choppy, indicating internal cold.
Observe the complexion: yellow and red indicate excess heat; green and white indicate excess cold; black indicates blood deficiency and qi insufficiency. (Excerpted from the *Lingnu: Wuyin Wuwei Pian* chapter. The original text says "Green and white indicate less heat," but the current phrasing is superior, so it need not be changed.)
When examining floating collaterals, a blue color indicates cold and pain; red indicates heat. Cold in the stomach manifests as blue collaterals on the大鱼际 (thenar eminence); heat in the stomach manifests as red collaterals there. Sudden blackening indicates chronic bi syndrome. Presence of red, black, and blue indicates mixed cold and heat. Blue and short indicates qi deficiency. (Excerpted from... Floating collaterals that are mostly blue indicate pain; mostly black indicate bi; yellow and red indicate heat; mostly white indicate cold; seeing all five colors indicates mixed cold and heat. (Excerpted from the *Suwen: Pibu Lun* chapter.)
A rapid pulse indicates heat; a slow pulse indicates cold. All Yang pulses indicate heat; all Yin pulses indicate cold.
A renying pulse (carotid artery) that is vigorous indicates heat; deficient indicates cold. A qikou pulse (radial artery) that is vigorous indicates abdominal fullness and cold in the middle with inability to transform heat. A deficient qikou pulse indicates heat in the middle, oral ulcers, qi deficiency, and changes in urine color. (Excerpted from the *Lingnu: Jinfu Pian* chapter.)
Qibo said: Treat cold with heat, treat heat with cold. For mild conditions, use contrary treatment (Zhengzhi); for excessive conditions, use following treatment (Fanzhi). The Emperor asked: What do contrary and following mean? Qibo said: Contrary is standard treatment; following is reverse treatment. Depending on the severity, observe the situation. The Emperor asked: What is reverse treatment? Qibo said: Heat used with cold properties, cold used with heat properties, obstruction treated with obstruction, diarrhea treated with purgation. One must subdue the main pathogen and address the root cause. Initially, the treatment may seem similar to the pathology, but ultimately, it differs. It can break up accumulations, dissipate hardness, harmonize qi and blood, and ensure recovery. (Excerpted from the *Suwen: Zhi Zhen Yao Da Lun* chapter.)
For mild conditions, regulate them; for moderate conditions, level them; for excessive conditions, drain them. Use sweating or purging methods. Utilize cold, heat, warm, and cool properties to attenuate based on the affected organ, following what is beneficial. For mild cold, use warm harmonizing agents; for severe cold, use hot resolving agents; for extreme cold, use purgative draining. If draining fails, use opposing measures. If opposing measures fail, seek the root element to attenuate it. For mild heat, use cool harmonizing agents; for severe heat, use cold resolving agents; for extreme heat, use sweating dispersants. If dispersal fails, use opposing constraints. If constraint fails, seek the root element to attenuate it. (The twenty-eight characters starting from "Wei zhe tiao zhi" are also from the *Zhi Zhen Yao Da Lun*; the eighty-eight characters starting from "Jia ru xiao han" are annotations by Qiyuanzi.)
Yang excess and Yin deficiency are cured by purgation but killed by sweating; this is a heat syndrome. Yang excess generates external heat; Yin deficiency generates internal heat. Purgation uses cold medicines to clear heat, as cold nature tends downward.
Yin excess and Yang deficiency are cured by sweating but killed by purgation; this is a cold syndrome. Yang excess generates internal cold (Note: Text logic implies Yin excess generates internal cold, Yang deficiency generates external cold, but translating literally as per source); Yang deficiency generates external cold. Sweating here uses hot medicines to warm, not true sweating, but rather using medicine to assist rising, floating, and growing qi to support Yang.
The Emperor asked: Discussions say treat heat with cold and cold with heat, and physicians cannot abandon rules. Yet some heat patients become hotter after taking cold medicine, and some cold patients become colder after taking hot medicine. Both occur, and new diseases arise. What should be done? Qibo said: For those whose heat persists despite cold treatment, tonify Yin. For those whose cold persists despite hot treatment, tonify Yang. This is seeking the root attribute. It is essentially boosting the source of fire to eliminate Yin shadows, and strengthening the master of water to control Yang brilliance.
The Emperor asked: Why does taking cold medicine cause heat, and taking hot medicine cause cold? Qibo said: Treating only the flourishing pathogenic qi leads to this reaction. The Emperor asked: Why does it happen even without treating the flourishing qi? Qibo said: You ask profoundly! It is due to ignoring the attributes of the Five Flavors. Each flavor enters the stomach and goes to its preferred organ: sour to Liver, bitter to Heart, sweet to Spleen, pungent to Lung, salty to Kidney. Long-term intake increases the qi of that organ, which is normal transformation. However, prolonged increase leads to premature death. (Above is from *Zhi Zhen Yao Da Lun*; below is Qiyuanzi's annotation.) Sour enters Liver as warm, Lung as clear, Heart as hot, Kidney as cold, Spleen as supreme Yin, combining four seasons. All increase flavor to benefit qi. Thus, long-term use of Huanglian or Kushen may cause heat. Hence, long-term intake increases qi, which is normal. But prolonged increase leads to organ qi excess; excess leads to exclusion; exclusion leads to sudden death. Hence, prolonged increase is the cause of early death.
Question: Why does cold not retreat with hot medicine, and heat not retreat with cold medicine? Answer: Heat failing to respond to cold indicates lack of Water (Yin); cold failing to respond to heat indicates lack of Fire (Yang). Failure to cool cold is blamed on lack of Water; failure to warm heat is blamed on lack of Fire. The classics say: Nourish the source of transformation. If the source is exhausted, how can medicinal imitation nourish the true Water and Fire? (From *Zhi Zhen Yao Da Lun*.) The Emperor asked: What if the pulse follows the disease but symptoms contradict? Qibo said: The pulse seems to follow, but upon pressure, it does not throb; this applies to all Yang pulses. (Qiyuanzi notes: Fever with rapid pulse but non-throbbing upon pressure indicates Yin excess repelling Yang, not true heat. This section describes Yang syndromes where the pulse follows the symptom, appearing hot but presenting cold signs. All Yang pulses show rapidity without throbbing, reflecting Sun Taiyang's different root and branch.) (Also *Zhi Zhen Yao Da Lun* says:) The Emperor asked: What about Yin pulse reversals? Qibo said: The pulse seems to follow, but upon pressure, it beats vigorously and strongly. (Qiyuanzi notes: Cold signs with strong pulsation under pressure indicate Heat excess repelling Yin, not true cold. This section describes Yin syndromes where the pulse follows the symptom, appearing cold but actually being heat. Thus, diseases originate from root, branch, or intermediate qi. Treatment can target root, branch, or intermediate. Contrary treatment is actually correct; following treatment is actually contrary. Knowing root and branch ensures safety; knowing correct and contrary ensures precise action. Ignorance confuses meridians. Thus, crude physicians laugh, thinking they know, confusing heat and cold, mixing similar Qi with different forms, disrupting diagnosis. The way of root and branch is concise yet comprehensive, small yet great. Speaking of root and branch prevents harm. Observing root and branch harmonizes Qi. Knowing overcoming and returning sets an example for all people, completing the Way of Heaven. (From "Bai bing zhi qi" onwards is from *Zhi Zhen Yao Da Lun*.) Among Six Qi diseases, Sun Taiyang and Shao Yin have the most contradictory root and branch. Sun Taiyang has Heat branch and Cold root; Shao Yin has Cold branch and Heat root. Qiyuanzi explains Yang pulse following as heat disease (Taiyang branch); non-throbbing pressure indicates Yin excess repelling Yang (Cold water root, opposite to branch). Yin pulse following as cold signs (Shao Yin branch); strong throbbing pressure indicates Heat excess repelling Yin (Minister Fire root, opposite to branch). Thus, ignoring contradiction and treating branch oppositely with standard methods follows root cold/heat, leaving disease unchanged. Outwardly seeming compliant, inwardly rebellious, making prescriptions seemingly compliant but actually contrary. Knowing contradiction, treating branch oppositely with reverse methods opposes root cold/heat, leading to cure. Outwardly contrary, inwardly compliant. This seems contrary but is actually correct. Knowing root and branch ensures safety; knowing correct and contrary ensures precision. If pulse follows disease but symptoms reverse: Yang-like symptoms with Yang-like pulse but actual cold; Yin-like symptoms with Yin-like pulse but actual heat. Thus, treat opposite to pulse and symptom. (Below details treatment for pulse-symptom mismatch, advocating discarding symptoms for pulse. However, sometimes pulse and symptom match but disease truth is opposite, requiring reversing treatment based on symptom/pulse. This clarifies infinite disease mechanisms, urging careful examination.) For example, fever, irritability, red face, but deep, faint pulse indicates Yin syndrome mimicking Yang. Fever is due to interior cold; irritability due to Yin excess; red face is Dai Yang (floating Yang) due to lower deficiency. If doctors ignore pulse and mistake for excess heat, using cold/cool drugs destroys Qi and causes major illness. *Waitai Mi Yao* says: Yin excess causing agitation, wanting to sit in a well, should be treated with hot medicine. Zhang Zhongjing treats Shao Yin red face with Sini Tang plus Congbai to counteract Yang. If cold drugs enter, fire rises with water, extreme Yin agitation makes one want to sit in a well. Doctors failing to recognize Yin syndrome as heat and administering cold drugs inevitably cause death. Vomiting or coughing causing agitation, steaming fever, wanting to remove clothes near cold, or drinking cold water causing chills, shortness of breath, chest fullness, open mouth, staring eyes, loud voice, tears/snot/phlegm, brief agitation. Six pulses deep, fine, choppy, empty upon pressure indicate extreme cold. Sweet-warm pungent formulas cure it. *Huo Ren Shu*: Cold limbs, constipation, red urine, or black stool, deep slippery pulse indicates Yang syndrome mimicking Yin. Mild cases use Baihu Tang; severe cases use Chengqi Tang. Typhoid missed by purgation causes blood/qi blockage and cold limbs (latent heat). Deep jue requires rapid Da Chengqi Tang purgation; sweating cures it. Heat jue is mild, fever follows jue; Yin jue has no fever, cold limbs, aversion to cold, deep fine pulse, loose stools.
These two sections discuss Yang-like symptoms with Yin disease, and Yin-like symptoms with Yang disease, hence treating opposite to symptoms. While Yang-like/Yin-disease and Yin-like/Yang-disease are distinguishable, Pulse-Symptom both Yin with Yang disease, and Pulse-Symptom both Yang with Yin disease are universally indistinguishable. Xu Xueshi recounts Zou Shoudi’s nephew with typhoid,烦渴 (irritability/thirst) and sweating, treated with cool drugs, becoming Yin Du (Yin toxin) and dying. Zou wrote "Yin Du Formulas." This laments the world. Sun Taiyang Bladder meridian uses Heat due to Cold application. Bladder root is cold, meridian name is Taiyang. Branch is heat, Root is cold. Pulse tight/rapid, non-throbbing/empty indicates false Yang outside, true cold inside. Zhongjing uses Ginger/Aconite boiled long, served cold. Ginger/Aconite are Yang; long boiling extracts heavy Yang heat to purge pure Yin cold (treating root). Serving cold uses fake cold to treat Taiyang branch fake Yang, a method of opposing truth/falsehood. Physicians must know empty pulse indicates hidden Yin cold showing heat signs (thirst, red eyes/mouth/face, hot limbs). This is floating Yang ending externally, rejected by internal cold. Hand Shao Yin Heart meridian uses Cold due to Heat application. Shao Yin meridian true Yin, Heart root is true Fire. Shao Yin branch Yin, root Heat. Inside Yang is root, outside True Yin is branch. Pulse deep/fine, throbbing/huge/tight/strong upon pressure indicates Heart Fire inside (tight/huge) and True Yin branch (deep/fine, Water nature). Zhongjing uses Da Chengqi Tang hot to remove branch cold, using Dahuang/Mangxiao bitter/salty/cold to purge root heat. This is eternal method. Treating heat with cold, administered warm.
Classics say: Treat heat with cold, administer warm. Three meanings: 1. Severe heat uses Renshen, Huangqi, Gancao (sweet/warm). Though内外皆热 (heat inside/outside), internal irritability and external skin heat are harmonized by sweet/warm, inducing sweat and cure. Sweet/warm treats severe heat. 2. Extreme heat generates wind; Earth moves left, Mother strengthens Child, Heaven moves right順行 (smoothly). Diseases heal with Heaven's command. 3. External heat hides internal cold. Warmth dispels cold, aiding Earth Qi (Stomach vital Qi). Making vital Qi robust. Classics say: Treat cold with heat, administer cool. Zhongjing treats Shao Yin diarrhea with weak pulse using Baitong Tang. If diarrhea persists, jue, no pulse, dry heaves, irritability, add Pig Bile. Treating cold with heat, using bile to administer cool. Three meanings: 1. Northerners injured by extreme cold have swollen calves (cold wins causing float). Moxa/bath causes skin loss/bone exposure. First wash with fresh water to restore. Frozen face/ears: fire/bath causes sores. First wash with cool water, then warm compress restores. Cool administration removes extreme cold. 2. Extreme cold strengthens Mother (Earth/Lung), moving left against Heaven. Cool drugs make Heaven move right smoothly, healing diseases. 3. External extreme cold hides extreme heat in Nine Earths (Sanjiao/Pericardium, root of Tianzhen Qi). Heat inside damages Yuan Qi (Stomach). Cool drugs harmonize Yuan Qi, preventing damage. Classics: Aversion to cold/shivering belongs to heat. Shivering losing spiritual control belongs to fire. Even in summer, wind/rain/heavy clothes cause shivering. *Yuan Bing Shi* says: Hot symptoms feeling cold are heat diseases, not cold. Some ask: Why do hot medicines cure? Heat patients' Qi flares up, condensing into phlegm-fluid, blocking clear pathways, Yin not rising, heat worsening. Phlegm temporarily retreats with heat, but heat aids evil, deepening disease. Some ask: Who dares use cold drugs for such cold? Answer: Ancients cured shivering with Da Chengqi Tang purging dry stool. Shivering is clearly heat, differing in deficiency/excess.
Classics: Yin deficiency causes fever. Yang outside guards Yin; Yin inside guards Yang. Spirit wanders, desires uncontrolled, Yin dissipates, Yang has no attachment, floating on surface causing fever. Not true heat, treat as Yin deficiency with Yin tonification. Some ask: Typhoid fever is all pathogenic? Answer: Typhoid heat enters from outside; Yin deficiency fever emerges from inside. Stagnant Fire heat depends on meridian. Mild cases descend; severe cases ascend according to nature.
Excess Fire descends; urination descends fire quickly. Tonifying Yin descends fire naturally. Use Chao Huangbo, Sheng Dihuang.
Deficient Fire tonifies; Renshen, Baizhu, sweet to缓 (slow/relax). Any excess Qi is Fire. Urgent cases require缓 (slowing); raw Gancao slows. Fire excess cannot suddenly use cold/cool; must combine warm to disperse. Zuojin Wan treats fire: Chuanlian 6 liang, assisted by Wuzhuyu 1 liang.
Yin deficiency with Fire movement: Untreatable.
Case Study
Danxi treated a pale woman with aversion to cold using Bazhen Tang minus Chuanxiong, plus Chao Huangbo. Condition worsened. He realized deep heat lacked anti-assistant (fan zuo) measure. Used previous herbs roasted, cured her. Treating heat with cold, borrowing Fire power, administered warm.
One patient with alternating cold/heat, night sweats, fatigue, poor appetite. Six pulses wiry, Chi larger than Cun, Xin area more deficient. Said: Liver/Spleen/Stomach deficiency. Stomach Qi cannot reach Liver, Liver Wood carries evil to attack Spleen Earth. Liver strong, pulse wiry. Wiry means reduction, meaning less neutral Qi. Deficiency in Spleen, Spleen should be supported. But supporting Spleen without controlling Wood is useless. Wood has deficiency/excess. Yin's growth is Yang's death; Yang's growth is Yin's death. Gallbladder is Jia Wood, born in Hai, Liver is Yi Wood, dies in Hai. Deficiency in Wood's Yin, excess in Wood's Yang. Qi excess, Blood deficiency. Heart governs Blood, Xin pulse deficient, Blood insufficient, Yang sinks, Chi pulse large. Method should...