一人两足酸重,不任行动,发则肿痛。一日在不发中,诊脉二部皆大,两手加葱管无力,身半以上肥
盛。予以其膏粱外家御,嗜恣无穷,精血皆不足,湿热太盛,因用益精血于其下,清湿热于其上。二方与之,
或言香港脚无补法,故不肯服。三月后痛作,一医用南法治不效,一医用北法泻之,即死于溺器上。吁!不
识病之虚实,执方误人多矣。
经曰∶肾属水,受五脏六腑之精而藏之。又曰∶主蛰,封藏之本,精之处也。又曰∶阴阳之要,阳密乃
固。故阳强不能密,阴气乃绝;阴平阳秘,精神乃治;阴阳离决,精气乃绝。又曰∶阴阳总宗筋之会,会于
气街。《灵枢》曰∶厥气客于阴器则梦接内。盖阴器者,宗筋之所聚也,而足太阴、阳明、少阴、厥阴之筋,
皆结聚于阴器,与冲、任、督三脉之所会,然厥阴主筋,
故诸筋皆通于厥阴。肾为阴,主藏精;肝为阳,主疏泄。阴器乃泄精之窍,故肾之阴虚则精不藏,肝之阳
强则气不固。若阴客于其窍与所强之阳相感,则精脱出而成梦。阳强者,非脏真之阳强,乃肝脏所寄之相
火强耳!火盛不已,反有以消其脏之真阳者。肝藏魂,脏真之阳虚则游魂为变,变则为梦,与肝虚多梦亡人
无异。然病之初起,亦有不在肾肝而在心肺脾胃之不足者,然必传于肾肝而致精之走也,有自然相传之理
焉!宗筋者,上络胸腹,夹脐下,合横骨,故《内经》谓其总宗筋之会,会于气街,主束骨而利机关也。五
脏俱有火,相火寄于肝者,善者则发生,恶者为害甚于他火,故平人肝气刚勇,充于筋而为罢极之本也。
其阴器既宗筋之所聚,乃强于作用,皆相火充其力也。若遇接内得阴气与合,则三焦内外之火翕然下从,火从
而动则百体玄府悉开,其资生之精尽趋会于阴器以跃出焉,岂肾之所藏者而已!所谓厥气客于阴器,厥
气亦身中阴分所逆之气,与接内之气同是阴类,故梦犹接内之脱精也。梦则真阳泄,未免形体衰惫,其
气难复,不比平人接内一二时间气便可复也。曰∶治法何如?曰∶病从他脏起者,则以初感症者为本,肾
肝聚病之处为标;由肝肾自得者,独治肝肾可也;由
阴阳离决,水火不交通者,则既济之阴阳不相抱负者,则因而和之。阳虚补气,阴虚补血,阳旺者泻火,
火有正治、反治,从少、从多,随其攸利。奈何今人不辨阴阳虚实,惟务温之、热之于内,灸之于外,甚
至阴水耗竭,壮火独炎,枯脂消肉,骨立筋痿,不可复救矣!余惟从经旨以治多验。
一人二十余岁,夜读书至四鼓犹未已,遂发此病。卧间茎但着被与腿,便梦精遗,悬空则否,饮食
日减,倦怠少气。余以用心太过,二火俱起,夜不得眠,血不归肝,则肾水不足,火乘阴虚,入客下焦,
鼓其精房,则精不得聚脏而走失矣。因玉茎着物,犹厥气客之,故作接内之梦。于是上则补心安神;中则
调理脾胃,升举其阴,下则益精生阴固阳。不三月而愈。
一老人,六十岁,患疟而嗽,多服四兽饮,积成湿热,乘于下焦,几致危困。余诊尺脉数而有力,与
补中益气加凉剂,三日,与黄柏丸,次早尺数顿减,因问∶有夜梦否?曰∶然,幸不泄尔。余谓年老精衰,
固无以泄。盖以大热结于精房,得泄火益阴之药,其火散走于阴器之窍,病可减矣。再服二日,又梦,其
疟、嗽全愈。
一人每夜有梦,余连诊二日脉,观其动静,终不
举头,但俯视不正,必阴邪相着,叩之不言其状。遍问随其出入之仆,乃言至庙见侍女,以手抚摩其
身久之,不三日遂病。令法师入庙毁其像,小腹中泥土皆湿,其病遂安。此则鬼魅相感耳!
尝观仲景治下焦真阳与精血两虚,少腹弦急,脉芤动微紧,男子失精,女子梦交通者,用桂枝、龙骨
之属温之、固之。若阳浮上而不降,悸衄,手足烦,咽干口燥,阴独居内,为里急腹痛,梦失精者,以
小建中汤和之。皆可取以为法也。
一个人双足酸重,无法支撑身体行动,发作时出现肿痛。有一天在他未发病时,诊察双侧脉象均盛大,两手搭在葱管上感觉无力,上半身肥胖壮实。我认为是因为他长期食用肥甘厚味,纵欲无度,导致精血亏虚,湿热过盛,因此采用下方补益精血,上方清利湿热。给他开了两个方子,有人告诉他香港脚(足部湿邪引起的疾病)没有补法,所以他不肯服用。三个月后疼痛发作,一位医生用南方医法治疗无效,另一位医生用北方医法泻下,结果他死在了马桶上。唉!不认识病证的虚实,拘泥于成方而误害人的太多了。
经典记载:肾属水,接受五脏六腑的精微物质并加以贮藏。又说:肾主蛰伏,是封藏的根本,是精气所在之处。又说:阴阳的关键在于阳气致密才能固守。所以阳气亢盛而不能致密,阴气就会枯竭;阴气平和、阳气固秘,精神才能正常;如果阴阳分离决裂,精气就会断绝。又说:阴阳总汇于宗筋(前阴部位),汇聚于气街(腹股沟动脉处)。《灵枢》说:厥逆之气客居在阴器,就会梦见性交。大概阴器是宗筋汇聚的地方,而足太阴、阳明、少阴、厥阴的筋脉,都结聚在阴器,并与冲、任、督三条经脉相会合,然而厥阴经主管筋脉,所以所有筋脉都通达于厥阴经。肾为阴,主管贮藏精气;肝为阳,主管疏泄。阴器是排泄精气的窍道,所以肾阴虚则精气不能固藏,肝阳亢盛则气机不能固摄。如果阴邪客居在窍道与亢盛的阳气相互感应,就会导致精气脱出而形成梦遗。所谓的阳强,并非脏腑真阳的亢盛,而是肝脏所寄居的相火亢盛罢了!相火旺盛不已,反而会消耗脏腑的真阳。肝藏魂,脏腑真阳虚弱则游魂发生变化,变化就会产生梦境,这与肝虚多梦且伴有亡人(幻觉或神志异常)的情况无异。然而疾病初起时,也有不在肝肾而在心肺脾胃不足的情况,但必然传变到肝肾而导致精气外泄,这是有自然相传的道理的!宗筋,向上联络胸腹,夹脐下行,与横骨相合,所以《内经》称其为宗筋总会,汇聚于气街,主要功能是约束骨骼而利于关节运动。五脏都有火,相火寄居于肝,正常的相火能发生作用,异常的相火危害比其他火更甚,所以普通人肝气刚勇,充养于筋脉,成为罢极之本(耐受疲劳的基础)。既然阴器是宗筋汇聚之处,其功能强劲有力,都是相火充养其力量的结果。如果遇到性交行为,得到阴气的配合,那么三焦内外的火气就会一同向下顺从,火随气而动,全身玄府(汗孔及毛孔等微观通道)全部打开,赖以生存的精气全都趋向汇聚于阴器而跃出,这哪里仅仅是肾脏所贮藏的精气呢!所谓厥气客居在阴器,厥气也是体内阴分逆乱之气,与性交时的气同属阴类,所以梦境如同性交时精气脱出一样。做梦会导致真阳泄露,难免形体衰惫,气难以恢复,不像正常人性交一两次时间气就能恢复。问:治疗方法如何?答:疾病从他脏发起的,以初感症状为本,肝肾积聚病变的部位为标;由肝肾自身得病的,单独治疗肝肾即可;由阴阳离决,水火不交通导致的,对于既济之阴阳不相抱持的情况,就顺势调和它。阳虚补气,阴虚补血,阳旺者泻火,火证有正治和反治,根据病情轻重缓急,随其适宜而定。奈何现在的人不辨别阴阳虚实,只致力于在内温补、热治,在外艾灸,甚至导致阴水耗竭,壮火独炎,枯瘦脂肪,消瘦肌肉,骨立筋痿,不可救药了!我只遵循经典旨意来治疗,大多有效。
一个人二十多岁,夜间读书直到四鼓(凌晨1-3点)仍不停止,于是发了这个病。卧床时阴茎只要接触被子和大腿,就会梦见遗精,悬空则不会,饮食日渐减少,倦怠少气。我认为他是用心过度,心火与相火同时兴起,夜晚不能安眠,血液不能归藏于肝,导致肾水不足,火热乘阴虚之机,侵入下焦,鼓动精室,使得精气不能在脏中聚集而流失。因为玉茎(阴茎)接触物体,犹如厥气客居其中,所以产生性交之梦。于是上部补心安神;中部调理脾胃,升举阴气;下部益精生阴、固护阳气。不到三个月就好了。
一位老人,六十岁,患疟疾兼咳嗽,多次服用四兽饮,积滞形成湿热,侵袭下焦,几乎导致危困。我诊察尺脉数而有力,给予补中益气汤加入凉性药物,三天后,给予黄柏丸,第二天早晨尺脉数象顿时减轻,于是询问:是否有夜梦?回答说:有,幸好没有射精。我说老人精气衰竭,本来就没有什么可泄的。大概是大热结聚在精室,得到泻火益阴的药物后,火势散走于阴器之窍,病情就可以减轻了。再服用两天,又做梦,疟疾和咳嗽全愈。
一个人每晚都有梦境,我连续诊察两天脉象,观察其动静,始终不抬头,只是俯视不正,必定是阴邪附着,询问他不说明情况。遍问跟随他出入的仆人,才说是去庙里见到侍女,用手抚摸身体很久,不到三天就病了。让法师进入庙里毁坏神像,小腹中的泥土都湿了,他的病就好了。这是鬼魅相互感应罢了!
曾经观察张仲景治疗下焦真阳与精血两虚,少腹弦急,脉芤动微紧,男子失精,女子梦交的情况,使用桂枝、龙骨之类温补、固涩。如果阳气浮越于上而不降,心悸鼻衄,手足烦热,咽干口燥,阴独居内,导致里急腹痛,梦遗失精的,用小建中汤调和。这些都可以取法作为准则。
A patient suffered from soreness and heaviness in both feet, unable to support movement; upon onset, swelling and pain occurred. During a remission period, the pulse at both wrists was large and forceful, while the pulse felt weak when pressing through scallion tubes (a traditional diagnostic technique); the upper body was obese and robust. I attributed this to his consumption of rich and sweet foods, excessive indulgence in sexual activity, leading to deficiency of essence and blood, and excessive damp-heat. Therefore, I prescribed one formula to tonify essence and blood below, and another to clear damp-heat above. He refused to take them, citing advice that Hongjiao (foot disease caused by damp-evil) has no place for tonification. Three months later, the pain recurred. One physician attempted Southern methods without success; another used Northern purgative methods, resulting in his death on the toilet. Alas! How many have been misled by rigid adherence to formulas without discerning the excess or deficiency of the disease.
The Classics state: The Kidney belongs to Water, receiving and storing the essence of the five zang and six fu organs. It is also said: The Kidney governs hibernation, serving as the root of sealing and storing, and the residence of essence. Furthermore: The key to yin and yang lies in the density of yang; if yang is strong but not dense, yin qi will be exhausted. If yin is peaceful and yang is secure, spirit and vitality are regulated; if yin and yang separate and rupture, essence and qi perish. Additionally: Yin and yang converge at the Zongjin (tendons of the genitalia), meeting at the Qichao (groin area). The *Lingshu* states: When Jueqi (rebellious qi) lodges in the yinqi (genitals), dreams of intercourse occur. The yinqi is the gathering point of Zongjin; the tendons of the Foot Taiyin, Yangming, Shaoyin, and Jueyin meridians all converge here, intersecting with the Chong, Ren, and Du vessels. Since the Jueyin meridian governs tendons, all tendons connect to it. The Kidney is yin, governing the storage of essence; the Liver is yang, governing dispersion and drainage. The yinqi is the orifice for expelling essence; thus, Kidney yin deficiency leads to insecure storage of essence, while Liver yang hyperactivity leads to insecure qi retention. If yin evil lodges in the orifice and interacts with hyperactive yang, essence escapes, causing nocturnal emission. This "yang hyperactivity" is not an excess of true organ yang, but rather an excess of Ministerial Fire (Xianghuo) residing in the Liver. Unchecked ministerial fire consumes the true yang of the organs. The Liver stores the Hun (ethereal soul); deficiency of true organ yang causes the Hun to wander and transform, creating dreams, similar to cases of liver deficiency with frequent dreams and hallucinations. However, initial pathology may originate from deficiency in the Heart, Lung, Spleen, or Stomach, but inevitably transmits to the Liver and Kidney, causing essence loss, following natural transmission principles. Zongjin connects upward to the chest and abdomen, runs alongside the umbilicus, and joins the Henggu bone. Thus, the *Neijing* calls it the convergence of Zongjin at the Qichao, functioning to bind bones and facilitate joint movement. All five zang possess fire; ministerial fire resides in the Liver. Normal ministerial fire promotes function, while abnormal ministerial fire causes severe harm. Normally, Liver qi is vigorous, nourishing the tendons as the root of endurance. Since the yinqi gathers Zongjin, its strength in function derives from ministerial fire. Upon sexual intercourse, receiving yin qi causes fire in the Sanjiao (Triple Burner) to descend. As fire moves with qi, all Xuanfu (micro-pores/channels) open, and vital essence rushes to the yinqi to exit, beyond just Kidney storage. The "Jueqi lodging in yinqi" refers to rebellious qi from the yin aspect, similar to the qi of intercourse, hence the dream resembles actual seminal emission. Dreams deplete true yang, leading to physical exhaustion and difficult qi recovery, unlike normal post-coital recovery. Question: What is the treatment? Answer: If disease originates from other zang, treat the initial symptoms as the root and the Liver/Kidney accumulation as the branch; if originating from Liver/Kidney, treat them alone; if due to yin-yang separation and lack of water-fire communication, harmonize the unembracing yin and yang. Tonify qi for yang deficiency, tonify blood for yin deficiency, purge fire for yang hyperactivity. Fire patterns have direct and reverse treatments, adjusted according to severity. Regrettably, modern physicians fail to distinguish yin/yang and excess/deficiency, relying only on internal warming/heating and external moxibustion, leading to depletion of yin water, independent blazing of strong fire, emaciation, bone prominence, tendon flaccidity, and incurable conditions. I follow the Classics' principles, achieving many cures.
A man in his twenties stayed up reading until the fourth watch (1–3 AM), triggering this illness. In bed, if the penis touched the blanket or legs, he dreamed of seminal emission; if suspended, it did not. His diet decreased daily, accompanied by fatigue and shortness of breath. I diagnosed excessive mental effort causing simultaneous Heart and Ministerial Fire rise, preventing sleep, leading to blood failing to return to the Liver, resulting in Kidney water deficiency. Fire exploited the yin deficiency, invading the Lower Jiao, agitating the Jingfang (essence chamber), causing essence to leak rather than gather in the organs. Contact of the Yujing (penis) with objects mimicked Jueqi lodging, inducing dreams of intercourse. Treatment: Upper body – tonify Heart and calm Spirit; Middle body – regulate Spleen/Stomach, raise yin; Lower body – benefit essence, generate yin, secure yang. He recovered within three months.
An elderly man, sixty years old, suffered from malaria and cough. Overuse of Six-Bite Decoction (Sishou Yin) accumulated damp-heat in the Lower Jiao, nearing critical condition. His Chi (cun) pulse was rapid and forceful. I prescribed Buzhong Yiqi Tang with cooling herbs for three days, followed by Huangbai Wan. The next morning, the rapid Chi pulse subsided significantly. I asked about nocturnal dreams; he confirmed having them but no emission. I explained that due to age and essence depletion, there was little to emit. The intense heat had lodged in the essence chamber; the heat-clearing and yin-nourishing herbs dispersed the fire toward the genital orifice, reducing the disease. After two more doses, he dreamed again, and both malaria and cough resolved completely.
Another patient experienced nightly dreams. I palpated his pulse for two days; he remained head-down, looking askance, suggesting yin evil attachment. He refused to describe his condition. Inquiry among servants revealed he had visited a temple, seen a maid, and engaged in prolonged manual stimulation, falling ill within three days. A Daoist priest destroyed the idol in the temple; the mud in the lower abdomen became wet, and the illness resolved. This was caused by spiritual interaction with a ghostly entity.
I have observed Zhang Zhongjing treating Lower Jiao true yang and essence-blood deficiency, presenting with tightness in the lower abdomen, Kou (hollow), Dong (fluttering), and Wei Jin (slight tightness) pulses, seminal loss in men, and dream intercourse in women, using Guizhi (Cinnamon Twig) and Longgu (Dragon Bone) to warm and secure. If yang floats upward without descending, causing palpitations, epistaxis,手足烦热 (restlessness in hands and feet), dry throat and mouth, with yin isolated internally causing abdominal urgency and pain, and dream seminal loss, Xiaojianzhong Tang is used to harmonize. These serve as valid models.