诸涩枯涸。干劲皴揭。皆属于燥。阳明燥金。乃肺与大肠之气也。
涩。遍身涩滞。不滑泽也。枯。不荣生也。涸。不流通也。干。不滋润也。劲。不柔和
也。皴揭。皮肤开裂也。
诸病上下所出水液。澄澈清冷。 瘕 疝。坚痞腹满急痛。下痢清白。食已不饥。吐利
腥秽
屈伸不变。厥逆禁固。皆属于寒。足太阳寒水。乃肾与膀胱之气也。至上下所出水液。澄
澈清冷。如天气寒。则水自然澄清也。
。气聚之积。或聚或散。无有常处也。瘕。血积之块。盖由女子月水沉滞。久而成瘕
也。
经曰。小肠移热于大肠。为虚瘕为沉。然则血瘕亦有热者也。当以标本明之。 疝。足厥阴
经受寒。则阴肿也。坚痞腹满急痛。如水寒则冰。坚硬如地也。下痢清白。水寒则清而明白
也。食已不饥。胃热能消谷。寒则不能消谷。虽已而亦不饥也。吐利腥秽。寒水甚而制火。
则不能平金。肺金自盛。故水腥也。屈伸不变。厥逆禁固。谓手足蜷挛而冷也。
夫气淫太过。曰亢则害。物极而得复。则曰承乃制也。盖阴阳互藏平气以为和。五行偏
胜而
为眚。轩岐法则天地。把握阴阳。人禀太极全体至理而生成者也。故内经所言君火之下。阴
精承之者。相火之下。水气承之。木气之下。金气承之。水气之下。土气承之。土气之下。木
气承之。谓土必克水。以水之子木也。承于土之下。此乃先天和平之配偶耳。
经言亢则害承乃制者。谓其亢之为害。必得受害者之子。以承其胜而制之也。即子复母仇之
义耳。原夫木极似金。火极似水。土极似木。金极似火。水极似土。如风木为病。掉眩甚则
肢
体拘挛。固劲而不能动。动极静也。火之太过。则 木溶金。人为渴汗。土极之病。肉 筋
惕。慢惊 。 之类。静极动也。金暴敛则反热。水极则冰凝如石。人病则收引癃结。时工
昧知阴阳生杀之机。不究火亢则害阴金。症出战栗恶寒。当辨目之黄赤。口之干渴。二便通
塞。脉之迟数。以别是是非非。庶无误人之弊。设若口燥便赤。脉不迟。纵寒战之甚。急宜
清凉为当。时医辄见战栗厥逆恶寒。不谙厥深热亦深之理。迳投热药。则如伤寒赋云。桂枝
下咽。阳盛则毙。又有阴症似阳者。亦有谵言妄语。欲奔泥水。但不甚渴。便清脉迟。俗工
认为阳治。赋亦云。承气入胃。阴盛乃亡。凡为良医者。须博理广见可也。所以承气解毒等
汤。可治似阴之症。理中四逆等汤。可疗似阳之急。庸常昧知亢极之变。误指附子可以治热
病。凉药可以疗寒厥。殊不知有义理当然而用之也。吁。附子承气。备为明医以救人。何期
又为庸医之杀人。仁人君子。其亢则害承乃制之理。岂容不加究此心哉。且如杂症。木亢则
害其土也。土受木之克害。则不善食。木曰曲直。曲直作酸。故为膈噎中满等症
生焉。其所承于木之下者肺金也。土之子。缘肺金主气。气属阳。阳行健。其播敷运化。气
之力也。肺金大肠。职司传送。今夫木之亢也。则侮金而害土。必当扶土之子。金气之壮。
则能制其木之过。所以法当资益肺金之气。则木可平。而土可保矣。俗夫反以耗气散气之药
则土益衰。而木愈克。可胜惜哉。又如火亢可害其肺金。金受火克之极。病则恶寒战栗。
而发晚热咳渴。直俟夜半之后。气血传过肺金。得微汗方解。此系承乃制之义也。苟不扶水
以济金。即元气日索矣。法当培其阴精真水。以御君相二火之暴。则恶寒退而潮热减。自汗
而凉。正气回也。人或以辛甘之剂。兼以解散疗之。则精液愈涸。而真精愈竭。则虚其虚也
余可类推。人身安危之机。在于阴阳
互藏以为和。否则五行更胜。克害而生病也。故经曰。气之胜者。则薄其所不胜。而害其所
能胜。嗟夫。亢之所以为害。责在承之不足而起之也。确乎论欤。致中和以全生者。良医
也。大易曰。造物不致终穷。其久病有待时令迁转。而承乃制。而自愈矣。如伤寒待日期传
过而凉者。即承乃制而痊也。此造物化工之妙耳。僻处乏医。则从汉书有云。不药当中医可
也。与其亢则害承乃制之说。庶乎得矣。
各种涩滞、干枯、枯竭、干硬、皮肤皲裂，都归属于燥邪。阳明燥金之气，就是肺与大肠的气机。
“涩”，指全身涩滞，不滑润。“枯”，指失去荣养生机。“涸”，指气液不流通。“干”，指缺乏滋润。“劲”，指僵硬不柔和。“皴揭”，指皮肤开裂。
各种病证中，从上到下排出的水液，清澈寒冷；以及瘕聚、疝气、坚硬痞块、腹部胀满急痛、下痢清稀白冻、进食后不觉饥饿、呕吐腹泻气味腥秽、肢体屈伸不利、四肢厥冷且拘挛固着，都归属于寒邪。足太阳寒水之气，就是肾与膀胱的气机。至于上下排出的水液清澈寒冷，就像天气寒冷时，水自然澄清一样。
“气”聚而成的积块，有时聚集有时消散，没有固定的位置，称为瘕（此处原文似有混淆，通常气聚为瘕，血积为癥，但原文语境需结合下文理解，下文明确区分了瘕与疝及血积）。 “瘕”，是血积形成的块状物，大概是由于女子月经沉滞，日久形成瘕块。
《内经》说：“小肠移热于大肠，形成虚瘕和沉疝。”那么血瘕也有热证的情况。应当从标本角度来辨析。“疝”，是足厥阴肝经受寒，导致阴部肿胀。坚硬痞块、腹部胀满急痛，就像水寒则结冰，坚硬如大地一样。下痢清稀白冻，是因为水寒则清澈明白。进食后不觉饥饿，因为胃中有热能消化食物，若是寒邪则不能消化食物，即使吃过也不觉得饿。呕吐腹泻气味腥秽，是因为寒水太盛制约了火气，导致不能平抑金气，肺金自盛，所以水液带有腥味。肢体屈伸不利、四肢厥冷且拘挛固着，是指手足蜷缩痉挛且发冷。
如果气淫溢太过，就叫做“亢则害”；事物发展到极点而得到回复，就叫做“承乃制”。大概阴阳互相蕴藏，保持平衡状态才能和谐；五行偏胜就会造成灾祸。轩辕黄帝和岐伯效法天地，把握阴阳，人禀受太极的全体至理而生成。所以《内经》所说：君火之下，有阴精来承制它；相火之下，有水气来承制它；木气之下，有金气来承制它；水气之下，有土气来承制它；土气之下，有木气来承制它。意思是土必然克水，以水之子木气来承位于土之下。这是先天的和平配偶关系。
经文说“亢则害，承乃制”，是说其亢盛造成的危害，必须得到被克制者的子气，来承接其胜气并制约它。这就是“子复母仇”的道理。原本木极似金，火极似水，土极似木，金极似火，水极似土。如风木为病，抽搐眩晕严重时会导致肢体拘挛，僵硬而不能活动，这是动极转静。火气太过，则熔化金气，人表现为口渴多汗。土极的病证，肌肉跳动、筋惕肉瞤、慢惊风之类，是静极转动。金气暴敛则反而发热，水极则冰凝如石，人患病则收敛牵引、小便不通。当时的医生不明白阴阳生杀的关键，不探究火亢则伤害阴金的道理，症状出现战栗恶寒时，应当辨别眼睛的黄赤、口干的渴感、二便的通塞、脉象的迟数，来分辨是非对错，以免误人。假如口燥、大便红赤、脉象不迟，纵然寒战严重，也应当紧急使用清凉药。当时的医生往往见到战栗、厥逆、恶寒，不懂“厥深热亦深”的道理，径直投用热药，这就如同《伤寒赋》所说：“桂枝汤服下，阳盛者必死。”又有阴证似阳的情况，也有胡言乱语、想跳进泥水里，但不怎么渴，小便清长、脉迟，庸俗的医生认为是阳证而治之，《赋》也说：“承气汤入胃，阴盛者必亡。”凡是成为良医的人，必须博通医理、见识广博才行。所以承气解毒等汤剂，可以治疗似阴的真热假寒症；理中、四逆等汤剂，可以治疗似阳的真寒假热急症。平庸之人不明白亢极变化的义理，错误地认为附子可以治疗热病，凉药可以治疗寒厥。殊不知其中有义理当然才使用的原则。唉！附子和承气汤，本是明医用来救人的，没想到又成了庸医杀人的工具。仁人君子，对于“亢则害，承乃制”的道理，难道能不加研究于心吗？
况且如杂病，木亢则会伤害土。土受到木的克制伤害，就不好好吃饭。木性曲直，曲直作酸，所以产生膈噎、中满等病症。其所承位于木之下的，是肺金。土之子是金，因为肺金主气，气属阳，阳气运行刚健，其播敷运化，靠的是气的力量。肺和大肠，职责在于传送。如今木气亢盛，则侮金而害土，必须扶持土之子，即壮大气金之气，那么就能制约木的过亢。所以治法应当资助益肺金之气，那么木气可平，土气可保。世俗之人反而使用耗气散气的药物，那么土更衰，木更克土，岂不可惜？另外如火亢盛可伤害肺金，金受火克至极，生病则恶寒战栗，傍晚发热、咳嗽口渴，直到半夜之后，气血传过肺金，得微汗才解。这属于“承乃制”的意义。如果不扶助水气以济助肺金，元气就会日渐消损。治法应当培补阴精真水，以抵御君火、相火的暴烈，那么恶寒退去而潮热减轻，自汗而身凉，正气恢复。有人用辛甘发散剂兼以解散疗法，那么精液更加枯竭，真精更加耗尽，这是使虚者更虚。其余情况可类推。人身安危的关键，在于阴阳互藏以保持和谐，否则五行更替胜克，伤害人体而生疾病。所以经文说：“气胜者，则侵凌其所不胜，而伤害其所胜。”唉！亢之所以为害，责任在于承制的不足而起的作用。确实是确切的论述吧！达到中和以保全生命，才是良医。《易经》说：造物主不会让事物最终穷尽，久病有待时令转换，从而承乃制，自愈好了。如伤寒等待日期传变过后而凉爽，就是承乃制而痊愈。这是造物化工的妙处。偏僻地方缺乏医生，就从《汉书》中说：不吃药当作中医也可以。与其说是亢则害承乃制的说法，差不多也就得到了。
Various conditions of astringency, withering, drying up, stiffness, and skin cracking all belong to Dryness (Zao). The Metal of Yangming Dryness refers to the Qi of the Lung and Large Intestine.
"Astringency" (Se) indicates a sensation of stagnation throughout the body, lacking smoothness and lubrication. "Withering" (Ku) signifies a lack of nourishment and vitality. "Drying up" (He) denotes a lack of circulation of Qi and fluids. "Dryness" (Gan) means a lack of moistening. "Stiffness" (Jin) implies rigidity and lack of flexibility. "Cracking" (Cun Jie) refers to the splitting or fissuring of the skin.
Various diseases involving the discharge of clear, cold fluids from above and below; as well as masses (Jia), hernias (Shan), hard epigastric masses, abdominal distension with urgent pain, dysentery with clear and white discharge, feeling no hunger after eating, vomiting and diarrhea with fishy or foul odors, inability to flex and extend limbs, cold extremities (Jue Ni), and rigid fixation, all belong to Cold (Han). The Water of Foot-Taiyang Cold refers to the Qi of the Kidney and Bladder. Regarding the clear and cold fluids discharged from above and below, it is like how water naturally clarifies when the weather is cold.
The accumulation formed by the gathering of Qi, which gathers and scatters without a fixed location, is referred to in the context of pathological masses. "Jia" (often associated with blood stasis in this specific textual context regarding women's menstruation) refers to mass formations due to blood stasis, often arising from stagnant menstruation in women over time.
The Classic states: "Heat transferring from the Small Intestine to the Large Intestine forms deficiency Jia and sinking disorders." Thus, blood Jia can also involve heat. This must be distinguished by analyzing the root and branch. "Shan" (Hernia) occurs when the Foot-Jueyin Liver channel is affected by Cold, leading to swelling of the genitalia. Hard masses, abdominal distension, and urgent pain are like ice forming from cold water, becoming hard as the earth. Dysentery with clear and white discharge occurs because cold water appears clear and bright. Feeling no hunger after eating happens because Stomach Heat digests food, whereas Cold prevents digestion; thus, even after eating, there is no sensation of hunger. Vomiting and diarrhea with fishy/foul odors occur when Cold Water is excessive and suppresses Fire, failing to control Metal; Lung Metal becomes excessive, causing the fluid to have a fishy odor. Inability to flex/extend limbs, cold extremities, and rigid fixation refer to curled, spasmodic, and cold hands and feet.
When Qi overflows excessively, it is called "Excess leads to Harm" (Kang Ze Hai). When things reach their extreme and recover, it is called "Succession brings Control" (Cheng Nai Zhi). Generally, Yin and Yang mutually contain each other to maintain balance and harmony; if the Five Elements become unbalanced, disaster ensues. Xuanyuan (Yellow Emperor) and Qibo modeled themselves on Heaven and Earth, grasping Yin and Yang. Humans are generated by inheriting the complete principle of Taiji. Therefore, as stated in the *Neijing*: Below Ministerial Fire, Yin Essence succeeds it; below Ashman Fire (Ministerial Fire), Water Qi succeeds it; below Wood Qi, Metal Qi succeeds it; below Water Qi, Earth Qi succeeds it; below Earth Qi, Wood Qi succeeds it. This means Earth controls Water, but Wood (the child of Water) succeeds below Earth. This represents the innate harmonious pairing.
The scripture says "Excess leads to Harm, Succession brings Control," meaning that the harm caused by excess must be countered by the child element of the harmed party to succeed its victory and control it. This is the principle of "the child avenging the mother." Originally, extreme Wood resembles Metal, extreme Fire resembles Water, extreme Earth resembles Wood, extreme Metal resembles Fire, and extreme Water resembles Earth. For example, Wind-Wood disease causes tremors and dizziness; when severe, limbs become spasmodic, stiff, and immobile, representing movement turning into stillness. Excessive Fire melts Metal, causing thirst and sweating. Extreme Earth disease manifests as muscle twitching, palpitations, slow convulsions, etc., representing stillness turning into movement. Violent contraction of Metal leads to apparent heat; extreme Water leads to ice-like freezing; human illness involves constriction and urinary retention. Contemporary physicians often fail to understand the mechanism of Yin-Yang generation and destruction. They do not investigate that Fire excess harms Yin-Metal. When symptoms present as shivering and aversion to cold, one must distinguish yellow/red eyes, dry mouth/thirst, patency/obstruction of urination and defecation, and pulse speed/slowness to discern right from wrong, avoiding misdiagnosis. If there is dry mouth, red stool, and a non-slow pulse, even with severe chills, cooling agents should be urgently used. Contemporary physicians often see chills, cold extremities, and aversion to cold, failing to comprehend the principle that "deep cold extremities indicate deep heat," and blindly administer hot medicines. As the *Shanghan Fu* states: "If Guizhi Tang enters the stomach, those with Excess Yang will die." There are also Yin syndromes resembling Yang, characterized by delirium, restlessness, desire to jump into mud/water, but without significant thirst, with clear urine and a slow pulse. Vulgar physicians treat these as Yang syndromes. The Fu also states: "If Chengqi Tang enters the stomach, those with Excess Yin will perish." Any good physician must possess broad knowledge and profound understanding. Therefore, decoctions like Chengqi and Jiedu can treat syndromes resembling Yin (True Heat, False Cold); decoctions like Lizhong and Sini can treat emergencies resembling Yang (True Cold, False Heat). Mediocre people do not understand the changes of extreme excess, mistakenly believing Fuzi can treat heat diseases and cooling herbs can treat cold extremities. They fail to realize that usage depends on appropriate principles. Alas! Fuzi and Chengqi are tools for enlightened physicians to save lives, yet they become instruments for mediocre physicians to kill. Benevolent gentlemen, how can they neglect studying the principle of "Excess leads to Harm, Succession brings Control"?
Regarding miscellaneous diseases, Wood excess harms Earth. When Earth is controlled and harmed by Wood, appetite suffers. Wood's nature is bending and straightening, producing sourness, leading to conditions like dysphagia, chest fullness, and abdominal distension. What succeeds below Wood is Lung Metal. Metal is the child of Earth. Since Lung Metal governs Qi, and Qi belongs to Yang, Yang moves vigorously, facilitating distribution and transformation through Qi power. Lung and Large Intestine are responsible for transmission. Now, Wood excess insults Metal and harms Earth. One must support the child of Earth, i.e., strengthen Lung Qi, so it can control Wood's excess. Thus, the treatment method should nourish Lung Metal Qi, thereby calming Wood and protecting Earth. Vulgar practitioners instead use Qi-consuming and dispersing herbs, causing Earth to weaken further and Wood to attack more fiercely. How lamentable! Furthermore, Fire excess can harm Lung Metal. When Metal is severely controlled by Fire, illness presents as aversion to cold, shivering, evening fever, cough, and thirst. It resolves only after midnight, when Qi and Blood pass through Lung Metal, accompanied by slight sweating. This embodies the meaning of "Succession brings Control." If one does not nourish Water to assist Metal, Yuan Qi will daily diminish. The treatment should cultivate Yin Essence and True Water to resist the violence of Ministerial and Sovereign Fire, thereby reducing aversion to cold and tidal fever, stopping spontaneous sweating, cooling the body, and restoring Zheng Qi. Some use acrid-sweet dispersing agents, which further deplete fluids and essence, making deficiency worse. Other cases can be inferred similarly. The key to human health lies in Yin and Yang mutually containing each other to maintain harmony; otherwise, the Five Elements alternate in conquest, harming the body and causing disease. Hence, the scripture says: "When Qi is in excess, it encroaches upon what it cannot overcome and harms what it can overcome." Alas! The reason excess causes harm lies in the insufficiency of succession/control initiating the reaction. Is this not a firm argument? Achieving neutrality and harmony to preserve life is the mark of a good physician. The *I Ching* states: Creation does not allow things to end in exhaustion. Chronic illnesses await seasonal shifts, where succession brings control, leading to self-healing. For instance, in Shanghan, waiting for the disease to transmit and cool down is success bringing control, resulting in recovery. This is the wonder of creative force. In remote areas lacking doctors, as stated in the *Book of Han*, "Not taking medicine is equivalent to being treated by a doctor." Compared to the theory of "Excess leads to Harm, Succession brings Control," this approach might suffice.