寻百病之生违和,共缓急理殊,救治不同。缓者年月乃剧,急者不延时即剧。缓者久而
自瘥,急者不救即殒。或有见药欲服未详之,顷而致逝者。此比甚众寻方,学之要以验速为
贵。
夫欲执术者,皆宜善识暴卒病侯,看方宜先解救急要说,次精和缓,末详辅卫,此则要
矣。是以官府有成合见药者,以备仓卒也。凡多口数家,亦宜其然也。
夫病之根源,有风、有寒、有冷、有热、有湿、有劳、有损、有伤、有醉酒、有饮食、
有惊怖恐惧怵惕忧恚、有产乳落胎 堕吐下去血、有贪饵五石,皆为病之根源也,为患生诸
枝条耳。既不脉之本不知根源也。但问人男女长少根据方说,方说有半与病相会便可服也。宜
有增
凡病剧者人必弱,人弱则不胜药,处方宜用分两单省者也。病轻者人则强,胜于药,处
方宜用分量重复者也。
凡久病者,日月已积,必损于食力,食力既弱,亦不胜药,处方宜用分量单省者也。新
病者日月既浅,虽损于食,其谷气未虚,犹胜于药,处方亦宜用分两重复者也。
少壮者,病虽重,其人壮,气血盛,胜于药,处方宜用分两重复者也。虽是优乐人,其
人骤病,数服药则难为药势,处方亦宜如此也。
衰老者,病虽轻,其气血衰,不胜于药,处方亦宜用分两单省者也。虽是辛苦人,其人
希病,不经服药者,则易为药势,处方亦宜如此也。
夫人壮病轻,而用少分两方者,人盛则胜于药势,方分两单省者则不能制病,虽积服之,
其势随消,终不制病,是以宜服分两重复者也。
夫衰老虚人,久病病重,而用多分两方者,人虚衰气力弱则不堪药,药未能遣病而人气
力先疲,人疲则病胜,便不敢复服,则不得力也,是以宜服分两单省者也。
女子妇人,其治异品,女子年十六以上则有月病,其是月病来日,得风寒冷湿,四时
之病相协者,皆应自说之,不尔治相触会,便致增困也,处方者亦应问之,是月病来限有他
疾者,其方在妇人方卷上。其是凡曰有疾者故同余人方耳。
江西、江北,其地早寒,寒重于江东,令人阳气早伏,内养肾气。至春解亦晚,腠理闭
密,外不受邪湿,故少患脚弱上气,无甚毒螫也。
江东、岭南晚寒寒轻,令人阳气不伏,肾气弱,且冬月暖,熏于肌肤,腠理开疏而受邪
湿,至春解阳气外泄,阴气倍盛于内,邪湿乘之,故多患上气、四肢痿弱及温疟、发黄,多
诸毒螫也。
凡用诸方欲随土地所宜者,俱是治一冷病,共方用温药分两多者,宜江西、江北;用温
药分两少者,宜江东,岭南也。所以方有同说而异药者,皆此之类也。
《经方短剧》有十二卷,所治皆周遍众病也。其中秘要者,是第六一卷,治四时之病,
周员终竟,四时无究,终极为最要也。
夫病有重 ,而不妨气力食饮,而行走如常者;自有休强人,小病便妨食饮眠卧致极者,
其中有轻者消息自瘥,服汤不过一两剂而瘥者也。小重者二月卅日可瘥者,既不解脉,得病
之始亦无以得知,其应经一月卅日也。唯望五日三日得瘥耳,亦不可日日服汤也。
自有病源已除,而人气力未展平复者,正宜消息者,五三日中乃复,根据所宜投汤耳。
自有小盛之人,不避风凉,触犯禁忌,暴竭精液,虽得微疾,皆不可轻以利药下之,一
利便竭其精液,因滞着床席,动经年岁也。初始皆宜与平药治也,宜利者乃转就下之耳。唯
小儿不在此例,大法宜如此也。
夫长宿人病宜服利汤药者,未必顿尽一剂也,皆视其利多少,且消息之于一日之宽也。
病源未除者,明后更合一剂,不必服尽,但以前后利势相成耳。气力堪尽剂者,则不制也。
病源宜服利药治取除者,服汤之后宜将丸散也,时时服汤助丸散耳。
夫病是服利汤得瘥者,从此以后慎不中服补汤也,得补病势即还复成也,重就利之,其
人则重弊也。若初瘥,气力未展平复者,当消息之。宜服药者,当以平和药逐和之也。若垂
平复欲将补益丸散者,自可以意量耳。
夫有常患之人,不妨行走,气力未衰,欲将补益,冷热随宜丸散者,乃可先服利汤下,
便除胸腹中瘀积痰实,然后可将补药。复有虚人,积服补药,或中实食为害者,可止服利药
除之。复有平实之人,暴虚空竭者,亦宜以微补药止以和之,而不可顿补也,暴虚微补,则
易平也,过补喜痞结为害也。
夫极虚极劳病应服补汤者,风病应服治风汤者,此皆非五三剂可知也。自有滞风洞虚,
积服数十剂及至百余剂,乃可瘥者也,然应随宜增损之,以逐其体寒温涩利耳。
要方第一卷所治如下∶
调三焦诸方
治胸痹诸方
治胸胁痰冷气满诸方
治心腹胀满冷痛诸方
治下利诸方
治咳嗽上气诸方
治气逆如奔豚状并诸汤方
治虚满水肿诸方
上七件
探寻百病产生的违和之因,其轻重缓急的道理不同,救治方法也各异。病情缓慢的,经过年月才会加剧;病情急重的,不拖延时间就会立刻恶化。病情缓慢的,时间久了或许能自愈;病情急重的,若不救治就会死亡。有的见到药物想要服用,却未详细斟酌,顷刻间便导致死亡。此类情况甚多。寻找方剂时,学习的要点以验证迅速有效为珍贵。
凡是掌握医术的人,都应当善于识别暴卒(突然发作)的病候,查看方剂时应先解救急症的要法,其次精通调和缓症的方法,最后详察辅助护卫之法,这是关键所在。因此官府有预先合制好的现成药物,以备仓促之用。凡是有许多人口的家庭,也应当如此准备。
疾病的根源,有风、有寒、有冷、有热、有湿、有劳损、有损伤、有醉酒、有饮食不当、有惊恐恐惧忧愤、有产后乳期或流产堕胎导致的吐血下血、有贪食五石散等,这些都是疾病的根源,由此衍生出各种病症枝条。如果不通过脉诊探究根本,就不知道疾病的源头。只能询问病人的男女老少,根据方书所述,方书所述有一半与病情相符就可以服用了。应当有所增减调整。
凡是病情严重的,人必然虚弱,人虚弱则不能承受药力,处方宜用分量单一且节省的药量。病情轻微的,人则强壮,能承受药力,处方宜用分量加倍重复的药量。
凡是久病的,日月已久,必然损耗食欲和体力,食欲体力既然虚弱,也不能承受药力,处方宜用分量单一且节省的药量。新病的,时日尚浅,虽然可能损耗食欲,但谷气尚未虚弱,仍能承受药力,处方也宜用分量加倍重复的药量。
年轻力壮者,即使病重,其人身体强壮,气血旺盛,能承受药力,处方宜用分量加倍重复的药量。即使是优乐之人(指生活安逸享乐者),其人突然患病,多次服药后难以承受药势,处方也应如此处理。
衰老者,即使病轻,其气血衰弱,不能承受药力,处方宜用分量单一且节省的药量。即使是辛苦劳作之人,其人很少生病,未曾经历过服药,则容易承受药势,处方也应如此处理。
人体壮实而病轻,却使用分量单一节省的方剂,人盛则能胜过药势,方剂分量单一节省则不能制约疾病,即使累积服用,药势也会随之消散,最终不能制约疾病,因此宜服用分量加倍重复的方剂。
若是衰老虚弱的病人,久病且病重,却使用分量加倍重复的方剂,人虚衰气力弱则不堪受药,药力未能驱除疾病而人的气力先已疲惫,人疲惫则病邪占上风,便不敢再服药,这样就不得力了,因此宜服用分量单一节省的方剂。
女子妇人,治疗有其特殊之处。女子十六岁以上便有月经病,在月经来潮之日,若感受风寒湿热,四季之病相夹杂,都应自行说明,否则治疗相互冲突,便会加重困顿。开方者也应当询问,若在月经期间有其他疾病,其方剂在《妇人方》卷上。其余日常疾病则与普通人的方剂相同。
江西、江北地区,地势早寒,寒气重于江东,使人阳气早伏,内养肾气。到春季解除寒冷也晚,腠理闭合致密,外不受邪湿侵袭,所以少患脚弱上气(下肢软弱及气喘),没有严重的毒虫叮咬。
江东、岭南地区晚寒且寒气轻,使人阳气不伏,肾气弱,且冬季温暖,熏蒸肌肤,腠理开疏而受邪湿侵袭,到春季阳气外泄,阴气在内倍盛,邪湿乘虚而入,所以多患上气、四肢痿弱及温疟、发黄,以及多种毒虫叮咬。
凡是使用各方剂都要随土地适宜性而定。都是治疗冷病,共用方剂中使用温热药分量多的,适合江西、江北;使用温热药分量少的,适合江东、岭南。所以方剂有名称相同而药物不同的,都是这一类原因。
《经方短剧》有十二卷,所治疗的疾病遍及众病。其中秘要的部分,是第六卷,治疗四季的疾病,周全完备,四季无穷无尽,最终归结为最重要的一点。
有的病虽重,但不妨碍气力饮食,行走如常;有的自恃强壮之人,小病便妨碍饮食眠卧至极。其中有轻症的,自我调摄可自愈,服用汤药不过一两剂即可痊愈。稍重的,三十天可痊愈,既然不懂脉诊,得知发病之初也无从知晓,按理应经过一个月三十天。只希望五日或三日痊愈,也不可每日服用汤药。
有的病源已去除,但人气力未完全平复恢复的,正宜自我调摄,五至三日中乃恢复,根据适宜的情况投予汤药罢了。
有的身体稍强之人,不避风凉,触犯禁忌,暴竭精液,虽然得了微疾,都不可轻易用利药(泻下药)攻下,一旦利下便竭尽精液,因而滞留床席,动辄经年岁。初始都宜给予平和药物治疗,适宜利下的才转而攻下。只有小儿不在此例,大法应当如此。
年老宿疾之人病宜服用利汤药的,未必一次喝完一剂,都要观察其利下的多少,且在一天之内慢慢调摄。病源未除的,明后天再合一剂,不必服完,只要看前后利下的势头相配合罢了。气力能喝完一剂的,则不限制。病源宜服用利药治疗去除的,服用汤药之后宜将丸散药配合,时时服用汤药帮助丸散药发挥作用。
有病是服用利汤得愈的,从此以后慎重不要再服用补汤,得到补益病势即会复发,再次利下,其人则会更加弊败。若初愈,气力未完全平复恢复的,应当调摄。适宜服药的,当以平和药逐渐调和。若接近平复欲用补益丸散者,自然可以凭心意衡量。
有的人经常患病,不妨碍行走,气力未衰,想用补益药,冷热随宜选用丸散者,才可先服用利汤攻下,清除胸腹中瘀积痰实,然后可用补药。又有虚人,长期服用补药,或因中实食积为害者,可停止服用利药以清除之。又有平实之人,突然变得虚空枯竭的,也宜用微补药止住并调和,不可一次性大补,突然虚弱轻微补益,则容易平复,过度补益喜欢痞结为害。
极虚极劳的病应服用补汤的,风病应服用治风汤的,这些都不是三五剂就能知道的。有的滞风洞虚,长期服用数十剂乃至百余剂,才可痊愈,然而应随宜增减,以顺应其体质的寒温涩利。
要方第一卷所治疗的如下:
调理三焦诸方
治疗胸痹诸方
治疗胸胁痰冷气满诸方
治疗心腹胀满冷痛诸方
治疗下利诸方
治疗咳嗽上气诸方
治疗气逆如奔豚状并诸汤方
治疗虚满水肿诸方
以上七件
Seeking the causes of disharmony in the generation of hundreds of diseases, the principles of urgency and slowness differ, and the methods of rescue vary. Those that are slow become severe only after months or years; those that are urgent become severe without delay. Slow conditions may heal themselves over time, while urgent conditions will lead to death if not rescued. There are cases where one sees a medicine and wishes to take it but fails to examine it carefully, leading to death within moments. Such cases are numerous. When seeking prescriptions, the essence of learning lies in valuing speed and verification of efficacy.
Those who wish to master medical arts should be adept at recognizing sudden (Bao Cu) disease patterns. When examining prescriptions, one should first address the urgent necessities for rescue, then master the harmonization of slow conditions, and finally detail auxiliary protection methods; this is the key. Therefore, government offices have pre-prepared medicines ready for emergencies. Large households should also maintain such preparations.
The roots of disease include wind, cold, chill, heat, dampness, labor, damage, injury, drunkenness, dietary issues, fright/fear/terror/sorrow/anger, postpartum/lactation/miscarriage/abortion with vomiting or bleeding, and greedily consuming Five Minerals Powder. These are all roots of disease, branching out into various symptoms. Without pulse diagnosis to understand the root, one cannot know the source. One can only ask about the patient's gender and age, and according to the prescription book, if half of the description matches the illness, it can be taken. Adjustments should be made.
When the illness is severe, the person is necessarily weak; weakness means they cannot withstand strong medication, so prescriptions should use single, reduced dosages. When the illness is mild, the person is strong and can withstand medication, so prescriptions should use doubled, repeated dosages.
For chronic illnesses accumulated over long periods, appetite and strength are inevitably damaged; since strength is weak, they cannot withstand medication, so prescriptions should use single, reduced dosages. For new illnesses with short duration, although appetite may be affected, the Grain Qi (Gu Qi) is not yet deficient and can still withstand medication, so prescriptions should also use doubled, repeated dosages.
Young and vigorous individuals, even with severe illness, are strong with abundant Qi and Blood, able to withstand medication, so prescriptions should use doubled, repeated dosages. Even for those living in leisure, if they suddenly fall ill, multiple doses may be hard to bear regarding the drug's momentum, so prescriptions should handle them similarly.
Elderly individuals, even with mild illness, have depleted Qi and Blood and cannot withstand medication, so prescriptions should use single, reduced dosages. Even for hardworking individuals who rarely get sick and are unaccustomed to taking medicine, they easily tolerate the drug's momentum, so prescriptions should handle them similarly.
If a robust person with mild illness uses a prescription with single, reduced dosages, their robustness will overpower the drug's effect; the reduced dosage cannot control the disease, and even with cumulative intake, the effect dissipates, ultimately failing to control the disease. Thus, doubled, repeated dosages are suitable.
If an elderly, weak person with chronic, severe illness uses a prescription with doubled, repeated dosages, their deficiency and weakness mean they cannot endure the medicine; the medicine fails to expel the disease before the person's strength collapses. Once collapsed, the disease prevails, and they dare not continue taking it, rendering it ineffective. Thus, single, reduced dosages are suitable.
Women have different treatment protocols. Women above sixteen experience menstrual disorders. On the days of menstruation, if exposed to wind, cold, heat, or dampness, mixing seasonal pathogens, they should report this themselves; otherwise, treatments may conflict and worsen the condition. Prescribers should inquire. If there are other ailments during menstruation, refer to the "Prescriptions for Women" volume. Otherwise, general illnesses follow standard prescriptions.
Jiangxi and Jiangbei regions are early cold, colder than Jiangdong, causing Yang Qi to settle early and nourish Kidney Qi internally. Spring thaw comes late, pores close tightly, resisting external pathogenic dampness, thus rarely suffering from lower limb weakness and asthma, nor severe insect bites.
Jiangdong and Lingnan regions have late, light cold, preventing Yang Qi from settling and weakening Kidney Qi. Winters are warm, steaming the skin, opening pores to pathogenic dampness. In spring, Yang Qi leaks outward, Yin Qi becomes doubly excessive internally, allowing pathogenic dampness to invade. Thus, they often suffer from asthma, flaccidity of limbs, warm malaria, jaundice, and various insect bites.
All prescriptions should adapt to local geography. For treating cold diseases using warming medicines: higher dosages suit Jiangxi/Jiangbei; lower dosages suit Jiangdong/Lingnan. This explains why some prescriptions share names but differ in ingredients.
"Jing Fang Duan Ju" has twelve volumes, covering all diseases comprehensively. The most secret and essential part is Volume Six, treating four-season diseases, completing the cycle endlessly, which is ultimately the most crucial.
Some severe illnesses do not hinder strength or diet, allowing normal walking; some self-proclaimed strong people find minor illnesses severely disrupt diet and sleep. Mild cases may heal through self-regulation, requiring no more than one or two doses of decoction. Slightly severe cases may heal in thirty days; without pulse diagnosis, knowing the onset is difficult, theoretically taking a month. Hope for healing in five or three days, but do not take decoctions daily.
Some have eliminated the disease source but lack restored strength; proper regulation allows recovery in five to three days, administering decoctions as appropriate.
Some slightly robust individuals ignore wind/chill, violate taboos, and exhaust Essence rapidly. Even with minor illness, do not lightly use purgatives (Li Yao); purging exhausts Essence, leading to prolonged bedridden states. Initially, use mild medicines; switch to purgatives only if indicated. Children are exceptions; this is the general rule.
For elderly patients needing purgative decoctions, do not necessarily finish one dose at once. Observe the degree of purging and regulate within a day. If the source remains, combine another dose tomorrow or the next day; do not force completion, just match the purging trend. If strength allows finishing a dose, do not restrict. After using purgative decoctions to remove sources, follow with pills/powders, using decoctions occasionally to assist.
After healing via purgative decoctions, strictly avoid tonic decoctions; tonics cause relapse. Re-purging will further weaken the patient. If newly healed with incomplete strength restoration, regulate. Use mild medicines to harmonize. If nearing recovery and wishing to use tonic pills/powders, judge by intuition.
Chronic patients walking normally with unimpaired strength wishing to use tonics (pills/powders matching hot/cold needs) should first take purgative decoctions to clear chest/abdominal stasis/phlegm, then use tonics. Weak patients chronically taking tonics who develop excess food stagnation should stop tonics and use purgatives to clear it. Robust patients suddenly becoming empty/deficient should use slight tonics to harmonize, not massive tonification. Sudden deficiency with slight tonification restores balance; over-tonification causes stagnation/harm.
Extremely weak/labor-induced illnesses needing tonics, or wind diseases needing wind-treating decoctions, cannot be determined in 3-5 doses. Some cases of stagnant wind/internal emptiness require dozens to hundreds of doses to heal, adjusting based on individual constitution's cold/warmth/astringency/purgation.
Volume One of Yao Fang treats the following:
Prescriptions for Regulating the Three Jiao
Prescriptions for Chest Bi Syndrome
Prescriptions for Phlegm-Cold Fullness in Chest/Hypochondrium
Prescriptions for Heart/Abdominal Fullness/Cold Pain
Prescriptions for Diarrhea
Prescriptions for Cough and Asthma
Prescriptions for Qi Reversal resembling Running Piglet and Other Decoctions
Prescriptions for Empty Fullness and Edema
Above seven items