夫药有君臣。人有虚实。服饵之法。轻重不同。少长殊途。强羸各异。或宜补宜泻。或
可汤
者。先服药而后食。病在四肢血脉者。宜空腹而在旦。病在骨髓者。宜饱满而在夜。凡药势
与食气不欲相逢。食气消即进药。药气散即进食。如此消息。即得五脏安和。非但药性之多
方。其节适早晚。复须调理。今所云先食后食。盖此义也。凡服汤。欲得稍热服之则易消。
下若冷
相去。如步行十里久再服。若太促者。前汤未消。后汤来冲。必当吐逆。仍问病者腹中药消
散否。乃更进服。
凡服丸药。补者。皆如梧桐子大。以二十丸为始。从一服渐加至四十丸为限。过多亦损
人。
饵名药获益甚少也。凡服浸酒药。欲得使酒气相接。无得断绝。断绝则不得药力。多少皆随
性饮之。以知为度。不可令大醉至吐。大损人也。
凡服药治病。先起黍粟。病去即止。不去倍之。不去十之。取去为度。今药中单行一两
种有
二味
服
岂同附子芫花之辈耶。则凡此之类。皆须量用也。
凡饵汤药。其粥食肉菜。皆须大熟。熟则易消。与药相宜。若生则难消。复损药力。仍
须少
首。
已。
夫济时之道。莫大于医。去病之功。无先于药。人居五行四气。病生暑湿风寒。药分三
品七
若
率自胸襟。深为造次。是以医不三世。不服其药。斯言信有之矣。岂不慎思者哉?又不得用
土地所无。贵价难市。珠珍诸宝。稀罕所闻。纵富贵而无处搜求。设贫下而寡财不及。或于
远邦求药。或则确执古方。不能变通。稽于致辩。病既深矣。药何疗焉。由是医者。必须舍
短从长。去繁就简。卷舒有自。盈缩随机。斟酌其宜。增减允当。察病轻重。用药精微。则
可谓上工矣。
凡药有君臣佐使。以相宣摄合和。宜用一君。二臣。三佐。五使。又可一君。三臣。九
佐使
者。
须相
咸甘
新
药物的配伍有君、臣之分。人的体质有虚、实之别。服用药物(服饵)的方法,因病情轻重而异;老少不同,身体强弱也各不相同。有的适宜补益,有的适宜泻下;有的适合用汤剂服用。
先服药后吃饭的情况:如果病在四肢血脉,应当在清晨空腹时服药;如果病在骨髓,应当在夜晚饱腹时服药。一般来说,药势与食物的气味不希望相互冲突。待食物消化后再进药,待药气散开后再进食。这样调节,就能使五脏安宁调和。这不仅在于药物方剂的多样,更在于早晚节制的调理。现在所说的“先食”或“后食”,大概就是这个意思。
凡是服用汤剂,希望稍微热着喝,这样容易消化。如果药液变冷,两次服药之间应间隔一段时间,比如步行十里路那么久再服第二次。如果间隔太短,前一次服的汤药尚未消化,后一次的汤药又来冲击,必然会导致呕吐逆乱。因此要询问病人腹中的药是否已经消散,然后再继续服用。
凡是服用丸药,如果是补益类的,大小都要像梧桐子那么大。以每次二十丸为起始量,逐渐增加到每次四十丸为止。过量也会损害人体。
服用名贵药材获益很少。凡是服用浸酒药,要使酒气与药力相接,不能中断。一旦中断就得不到药效。饮用量多少都随个人性情而定,以见效为限度,不可令人大醉至呕吐,这会严重损害人体。
凡是服药治病,开始时只吃黍米和粟米等清淡食物,病好了就停止忌口;如果病没好,就加倍坚持;如果还没好,就坚持十次,以病愈为标准。现在药方中单行一两味药,或者只有两味药组成的方子,难道能同附子、芫花这类峻烈药物相比吗?所以凡属此类情况,都必须斟酌用量。
凡是服用汤药,其中的粥、肉、菜等食物,都必须煮得非常熟。煮熟了就容易消化,与药物相宜。如果生的就难消化,又会损伤药效。还需要少食多餐,细嚼慢咽。
救治世人的道理,没有比医学更重要的了。去除疾病的功效,没有比药物更优先的。人处于五行四气的变化之中,疾病产生于暑、湿、风、寒等外邪。药物分为上、中、下三品……如果率由胸臆,深为草率,所以说“医不三世,不服其药”,这话确实是有道理的。这难道不值得慎重思考吗?又不得使用当地没有、价格昂贵难以购买、珍珠珍宝之类罕见听闻的药物。纵然富贵却无处搜求,设若贫贱而财力不及。或者向远方邦国求药,或者固执古方,不能变通,缺乏辨析能力。既然病已深入,药物又如何能治疗呢?因此医者,必须舍弃短处发挥长处,去掉繁杂追求简约,卷舒自如,盈缩随机,斟酌适宜,增减得当,察看病情的轻重,用药精微,这才可以称为高明的医生(上工)了。
凡是药物都有君、臣、佐、使的配合,以相互宣导摄取、调和合和。适宜用一君药,二臣药,三佐药,五使药;也可以是一君药,三臣药,九佐使药……须相互配合……咸味、甘味……新……
The compounding of medicines involves Sovereign (Jun), Minister (Chen) roles. Human constitutions vary between deficiency (Xu) and excess (Shi). The method of taking medicine differs according to the severity of the condition; the young and old follow different paths, and the strong and weak are distinct. Some conditions are suitable for tonification (Bu), others for purgation (Xie); some are suitable for administration as a decoction (Tang).
Regarding taking medicine before or after meals: If the disease is in the four limbs and blood vessels, it is appropriate to take medicine on an empty stomach in the morning. If the disease is in the bone marrow, it is appropriate to take medicine when full at night. Generally, the therapeutic potential of medicine and the qi of food should not clash. Take medicine after food has digested, and eat after the medicinal qi has dispersed. Through such regulation, the five Zang organs will be harmonized. This depends not only on the variety of medicinal formulas but also on the regulation of timing. The current discussion of "before eating" or "after eating" refers to this principle.
When taking decoctions, they should be taken slightly warm to facilitate digestion. If the decoction becomes cold, there should be a sufficient interval between doses, such as walking for the distance of ten li before taking the next dose. If the interval is too short, the previous dose has not yet been absorbed, and the new dose interferes, inevitably leading to vomiting and reflux. Therefore, one must ask the patient whether the medicine in the abdomen has dissipated before administering further doses.
When taking pills, if they are for tonification, they should be sized like paulownia seeds. Start with twenty pills per dose, gradually increasing to a limit of forty pills per dose. Excessive amounts will harm the body.
Taking famous/expensive herbs yields little benefit. When taking medicinal wines, the qi of the wine and the medicine should remain connected without interruption; interruption renders the medicinal power ineffective. The amount consumed should follow individual tolerance, stopping when efficacy is achieved. One must avoid becoming excessively drunk to the point of vomiting, which severely damages the body.
When treating diseases with medicine, initially consume only millet and broomcorn millet (light foods). Stop this restriction when the disease is cured; if not cured, double the adherence; if still not cured, adhere for ten times, taking cure as the goal. A formula consisting of only one or two single herbs—can it compare to harsh substances like Fuzi (Prepared Aconite Root) and Yuanhua (Kadsura Flower)? Thus, for such cases, dosage must be carefully measured.
When taking decoctions, accompanying foods like porridge, meat, and vegetables must be thoroughly cooked. Cooked food is easy to digest and compatible with medicine. Raw food is hard to digest and impairs medicinal efficacy. Meals should be small and frequent, chewed thoroughly.
The way to save the world lies in nothing greater than medicine. In removing disease, nothing precedes drugs. Humans exist within the changes of the Five Elements and Four Qi, while diseases arise from external pathogens such as heat, dampness, wind, and cold. Medicines are classified into three grades... Acting rashly from one's own mind is highly imprudent. Hence the saying, "Do not take medicine from a physician whose family has not practiced for three generations." This statement is indeed credible. Should one not ponder this carefully? Furthermore, one should not use medicines unavailable locally, those that are expensive and hard to purchase, or rare treasures like pearls. Even if wealthy, one may find no source; if poor, one lacks funds. Seeking medicine from distant lands or rigidly adhering to ancient formulas without flexibility and discernment leads to failure. Since the disease is deep, how can medicine treat it? Therefore, physicians must discard shortcomings and leverage strengths, simplify complexity, act with flexibility, adjust dosages according to circumstances, weigh appropriateness, modify additions and subtractions properly, observe the severity of the disease, and prescribe with precision. Only then can one be called a superior physician (Shang Gong).
Medicines have Sovereign (Jun), Minister (Chen), Assistant (Zuo), and Envoy (Shi) roles to mutually guide, absorb, and harmonize. It is appropriate to use one Sovereign, two Ministers, three Assistants, and five Envoys; or one Sovereign, three Ministers, and nine Assistants/Envoys... They must interact... Salty and Sweet flavors... Fresh/New...