一、和方之制,和其不和者也。凡病兼虚者,补而和之。兼滞者,行而和之。兼寒者,
温而和之。兼热者,凉而和之,和之为义广矣。亦犹土兼四气,其于补泻温凉之用,无所不
及,务在调平元气,不失中和之为贵也。故凡阴虚于下而精血亏损者,忌利小水,如四苓、
通草汤之属是也。阴虚于上而肺热干咳者,忌用辛燥,如半夏、苍术、细辛、香附、芎、归
、白术之属是也。阳虚于上,忌消耗。如陈皮、砂仁、木香、槟榔之属是也。阳虚于下者,
忌沉寒。如黄柏、知母、栀子、木通之属是也。大便溏泄者,忌滑利。如二冬、牛膝、苁蓉
、当归、柴胡、童便之属是也。表邪未解者,忌收敛。如五味、枣仁、地榆、文蛤之属是也
。气滞者,忌闭塞。如黄 、白术、薯蓣、甘草之属是也。经滞者,忌寒凝。如门冬、生地
、石斛、芩、连之属是也。凡邪火在上者不宜升,火得升而愈炽矣。沉寒在下者不宜降,阴
被降而愈亡矣。诸动者不宜再动,如火动者忌温暖,血动者忌辛香,汗动者忌苏散,神动者
忌耗伤,凡性味之不静者皆所当慎,其于刚暴更甚者,则又在不言可知也。诸静者不宜再静
,如沉微细弱者脉之静也,神昏气怯者阳之静也,肌体清寒者表之静也,口腹畏寒者里之静也
。凡性味之阴柔者,皆所当慎,其于沉寒更甚者,又在不言可知也。夫阳主动,以动济动,
火上添油也。不焦烂乎?阴主静,以静益静,雪上加霜也。不寂灭乎?凡前所论,论其略耳,
而书不尽言,言不尽意,能因类而广之,则存夫其人矣。不知此义,又何和剂之足云。
一、和方的组方原则,是为了调和机体中不协调的状态。凡是疾病兼有虚证的,用补益的方法来调和;兼有气滞的,用行气的方法来调和;兼有寒证的,用温里的方法来调和;兼有热证的,用清凉的方法来调和。“和”的含义非常广泛。这也就像土(脾)兼具四气一样,在补益、泻实、温里、清热等方面的作用,无所不及,务必以调理平衡元气,不失中和之道为贵。
因此,凡是下焦阴虚且精血亏损的患者,忌讳使用利尿通淋的药物,如四苓散、通草汤之类的药物。上焦阴虚且肺热干咳的患者,忌讳使用辛温燥烈的药物,如半夏、苍术、细辛、香附、川芎、当归、白术之类的药物。上焦阳虚的患者,忌讳耗散正气,如陈皮、砂仁、木香、槟榔之类的药物。下焦阳虚的患者,忌讳使用沉寒之品,如黄柏、知母、栀子、木通之类的药物。大便溏泄的患者,忌讳使用滑利通便的药物,如天冬、麦冬、牛膝、肉苁蓉、当归、柴胡、童便之类的药物。表邪尚未解除的患者,忌讳使用收敛固涩的药物,如五味子、酸枣仁、地榆、文蛤之类的药物。气机阻滞的患者,忌讳使用闭塞气机的药物,如黄芪、白术、山药、甘草之类的药物。经脉瘀滞的患者,忌讳使用寒凝血脉的药物,如麦冬、生地黄、石斛、黄芩、黄连之类的药物。凡是邪火在上部的,不宜使用升提药,因为火性炎上,若再升提会使火势更加炽盛。沉寒在下部的,不宜使用沉降药,因为阴气易损,若再沉降会使阳气更加消亡。凡是处于亢动状态的病证,不宜再用动药,如火旺者忌讳温热药,出血者忌讳辛香走窜药,汗出过多者忌讳发汗解表药,神志不安者忌讳耗伤正气药,凡是药性气味不够平和宁静的,都应当谨慎,其中性质刚烈暴戾的更是不言自明。凡是处于沉静状态的病证,不宜再用静药,如脉象沉微细弱是阴寒之静,神志昏沉、气息怯弱是阳气之静,肌肤清冷是表寒之静,口腹畏寒是里寒之静。凡是药性阴柔的,都应当谨慎,其中沉寒严重的更是不言自明。阳气主运动,以动助动,如同火上浇油,难道不会导致焦烂吗?阴气主静止,以静益静,如同雪上加霜,难道不会导致寂灭吗?以上所论述的,只是和法的大略而已,但书本不能完全表达言语,言语不能完全表达意旨,能够根据这些类别加以推广运用,那就在于医者本人的悟性了。如果不明白这个道理,又谈什么和剂呢。
1. The formulation principle of Harmonizing Formulas (He Fang) is to harmonize the disharmony within the body. For diseases accompanied by deficiency, tonification is used to harmonize; for those accompanied by stagnation, moving methods are used to harmonize; for those accompanied by cold, warming methods are used to harmonize; for those accompanied by heat, cooling methods are used to harmonize. The meaning of "Harmonizing" (He) is extensive. It is akin to Earth (Spleen/Stomach) encompassing the four Qi, possessing functions in tonifying, purging, warming, and cooling without omission. The utmost importance lies in regulating and balancing the Yuan Qi (Primary Qi), ensuring it does not deviate from the state of Zhong He (Central Harmony).
Therefore, for patients with Yin deficiency in the lower Jiao and depletion of essence and blood, diuretic agents such as Siling San (Four-Ingredient Powder) and Tongcao Tang (Platycodon Decoction) should be avoided. For patients with Yin deficiency in the upper Jiao and dry cough due to Lung heat, acrid-drying herbs such as Banxia (Pinellia Rhizome), Cangzhu (Atractylodis Rhizoma), Xixin (Asari Radix et Rhizoma), Xiangfu (Cyperus Rhizoma), Xiong (Ligusticum Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma) should be avoided. For Yang deficiency in the upper Jiao, herbs that consume and disperse Qi, such as Chenpi (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus), Muxiang (Aucklandiae Radix), and Binglang (Arecae Semen), should be avoided. For Yang deficiency in the lower Jiao, heavy-cold herbs such as Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Zhizi (Gardeniae Fructus), and Mutong (Akebiae Caulis) should be avoided. For patients with loose stools or diarrhea, slippery and lubricating herbs such as Dongdong (Tianmaifeng and Maidong), Niuxi (Achyranthis Bidentatae Radix), Congrong (Cynomorii Herba), Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), and Tongbian (Child's Urine) should be avoided. For cases where exterior pathogens have not yet been resolved, astringent herbs such as Wuweizi (Schisandrae Fructus), Zaoren (Ziziphi Spinosae Semen), Diyu (Sanguisorbae Radix), and Wen Ge (Clam Shell) should be avoided. For patients with Qi stagnation, herbs that obstruct Qi flow, such as Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Shuyu (Dioscoreae Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma), should be avoided. For patients with meridianal stagnation, herbs that cause cold coagulation, such as Mendong (Ophiopogonis Tuber), Shengdi (Rehmanniae Radix), Shihu (Dendrobii Caulis), Qin (Scutellariae Radix), and Lian (Isodontiae Radix), should be avoided.
For evil fire located in the upper part of the body, ascending drugs are unsuitable, as ascending will intensify the fire. For deep cold located in the lower part of the body, descending drugs are unsuitable, as descending will further deplete the Yin. For conditions characterized by hyperactivity, one should avoid using activating drugs: for Fire hyperactivity, warm herbs are contraindicated; for Blood hyperactivity (bleeding), acrid-aromatic herbs are contraindicated; for Sweat hyperactivity, diaphoretic herbs are contraindicated; for Spirit hyperactivity (restlessness), herbs that consume and injure are contraindicated. One must be cautious with any herb whose nature and flavor are not tranquil; this applies even more so to those with harsh and violent properties. Conversely, for conditions characterized by stillness, one should avoid using sedating/stilling drugs: a pulse that is deep, faint, fine, and weak represents Yin stillness; lethargy and timid breathing represent Yang stillness; cold skin and body represent Exterior stillness; and aversion to cold in the mouth and abdomen represents Interior stillness. One must be cautious with any herb of Yin and soft nature; this applies even more so to those with deep cold properties.
Yang governs movement; assisting movement with movement is like adding oil to a fire—will it not lead to scorching? Yin governs stillness; enhancing stillness with stillness is like adding frost to snow—will it not lead to extinction? The above discussion covers only the general principles. As books cannot fully express words, and words cannot fully express intent, the ability to generalize from these categories depends on the practitioner's wisdom. Without understanding this principle, how can one speak of Harmonizing Formulas?