药不执方,合宜而用,此方之不必有也。方以立法,法以制宜,此方之不可无也。夫方
之善者,得其宜也。得其宜者,可为法也。方之不善者,失其宜也。失其宜者,可为鉴也。
第法有善不善,人有知不知,必善于知方者,斯可以执方,亦可以不执方,能执方能不执方
者,非随时之人不能也。此方之所不可废者,正欲以启发其人耳。余因选古方之得宜者共若
干首,列为八阵,已不为不多矣。第以余观之,若夫犹有未尽,因复制新方八阵,此其中有
心得焉,有经验焉,有补古之未备焉。凡各方之下,多附加减等法,及分两之数,俱有出入
不一者,正以见方之不可执也。八阵之中,如攻方、寒方之不多及者,以古法既多,不必更
为添足也。大都方宜从简,而余复冗之,不尤鄙乎?正意在冗中求简耳,此制方之意也。然
用方之意,则犹有说焉∶夫意贵圆通,用嫌执滞,则其要也。若但圆无主,则杂乱生而无不
可矣,不知疑似间自有一定不易之道,此圆通中不可无执持也;若执一不反,则偏
生而动相左矣。不知倏忽间每多三因难测之变,此执持中不可无圆活也。圆活宜从三思,执
持须有定见,既能执持,又能圆活,其能方能圆之人乎,而人其为谁哉!
一、补方之制,补其虚也。凡气虚者,宜补其上,人参、黄 之属是也。精虚者,宜补
其下,熟地、枸杞之属是也。阳虚者,宜补而兼暖,桂、附、干姜之属是也。阴虚者,宜补
而兼清,门冬、芍药、生地之属是也。此固阴阳之治辨也。其有气因精而虚者,自当补精以
化气;精因气而虚者,自当补气以生精。又有阳失阴而离者,不补阴何以收散亡之气?水失
火而败者,不补火何以苏垂寂之阴?此又阴阳相济之妙用也。故善补阳者,必于阴中求阳,
则阳得阴助,而生化无穷;善补阴者,必于阳中求阴,则阴得阳升,而源泉不竭。余故曰∶
以精气分阴阳,则阴阳不可离;以寒热分阴阳,则阴阳不可混,此又阴阳邪正之离合也。故
凡阳虚多寒者,宜补以甘温,而清润之品非所宜;阴虚多热者,宜补以甘凉,而辛燥之类不
可用。知宜知避,则不惟用补,而八方之制,皆可得而贯通矣。
药不拘泥于固定的方剂,只要合乎病情即可使用,这是说方剂不必死守成法。方剂通过确立治法来制定,治法依据具体情况而制宜,这是说方剂又是不可没有的。好的方剂,在于运用得当。运用得当的,可以作为法则。不好的方剂,在于运用失当。运用失当的,可以作为借鉴。只是法则有优劣之分,人的见识有深浅之别,必须善于理解方义的人,才可以灵活运用方剂,也可以不拘泥于方剂;能够既懂得遵循方剂又懂得不拘泥于方剂的人,不是顺应时势变化的人是做不到的。设立方剂的宗旨,正是为了启发人们的思维罢了。我因此选取古代方剂中运用得当的若干首,列为八阵,已经不算少了。但我认为,其中还有未尽之处,于是又创制了新方八阵,这里面有心得,有经验,有弥补古方不足之处。在各方之下,大多附加了加减等用法,以及药物分量的多少不一,这正是为了说明方剂不可死板拘执。在八阵之中,如攻邪方、寒凉方数量不多,是因为古法已经很多,不必再刻意凑足。大抵方剂应当从简,而我却写得繁琐,岂不是显得鄙陋吗?正意是在繁琐中寻求简约罢了,这就是制方的用意。然而用方的用意,还有进一步的阐述:用意贵在圆融通达,用药忌讳固执呆板,这是关键所在。如果只有圆通而没有主见,就会杂乱无章,无所适从,不知道在疑似之间自有确定不变的道理,这是在圆通中不可没有坚持原则;如果固执一端不知变通,就会产生偏颇,导致与病机相左。不知道瞬息之间常有因三因(内因、外因、不内外因)难以预测的变化,这是在坚持原则中不可没有灵活变通。灵活变通宜经过深思熟虑,坚持原则须有坚定见解,既能坚持原则又能灵活变通,这才是能掌握方剂精髓并能圆融运用的人吧,这样的人是谁呢!
一、补方(补益剂)的制定,是为了补益人体的虚损。凡是气虚的,适宜补益上部,如人参、黄芪之类的药物。精虚的,适宜补益下部,如熟地黄、枸杞子之类的药物。阳虚的,适宜补益兼以温暖,如肉桂、附子、干姜之类的药物。阴虚的,适宜补益兼以清润,如麦冬、白芍、生地黄之类的药物。这确实是辨别阴阳治疗的原则。如果有因为精亏而导致气虚的,自然应当补精以化生气;有因为气虚而导致精亏的,自然应当补气以滋生精。又有阳气失去阴液依附而离散的情况,不补阴怎么能收敛散亡的阳气?肾水失去命火温煦而衰败的情况,不补火怎么能唤醒将熄的阴精?这又是阴阳相互济助的妙用。所以善于补阳的人,必定在滋阴中求取阳气,那么阳气得到阴液的资助,生化就会无穷无尽;善于补阴的人,必定在助阳中求取阴液,那么阴液得到阳气的升发,源泉就不会枯竭。所以我常说:从精气角度区分阴阳,则阴阳不可分离;从寒热角度区分阴阳,则阴阳不可混淆,这又是阴阳邪正离合的道理。所以凡是阳虚多寒证的,适宜用甘温之品补益,而清润的药物就不适宜;阴虚多热证的,适宜用甘凉之品补益,而辛燥的药物就不可使用。知道适宜什么和避免什么,那么不仅是用补益之法,其他八方(八阵)的制方原理,都可以贯通理解了。
Medicines are not bound by fixed prescriptions; they should be used when appropriate. This implies that prescriptions need not be rigidly adhered to. Prescriptions are established through therapeutic principles, and principles are adapted to specific circumstances; this implies that prescriptions are indispensable. A good prescription is one that is applied appropriately. One that is applied appropriately can serve as a model. A poor prescription is one that is misapplied. One that is misapplied can serve as a warning. However, since principles vary in quality and people differ in their understanding, only those skilled in comprehending the rationale of prescriptions can both utilize them flexibly and know when to deviate from them. Only those who adapt to changing conditions can master the art of both following and transcending prescriptions. The purpose of establishing prescriptions is precisely to inspire such insight. Therefore, I have selected several ancient prescriptions that were well-applied and categorized them into Eight Arrays (Ba Zhen), which is already a considerable number. Yet, in my view, there remain areas not fully covered. Thus, I created new formulations within the Eight Arrays, incorporating personal insights, clinical experience, and supplements to the inadequacies of ancient formulas. Beneath each prescription, various modifications and dosage variations are often listed, demonstrating that prescriptions should not be rigidly followed. Within the Eight Arrays, for instance, the number of attacking (Gong) or cooling (Han) prescriptions is not extensive because ancient methods are already plentiful and do not require artificial supplementation. Generally, prescriptions should be simple, yet I have elaborated extensively, which might seem pedantic. However, the true intent is to seek simplicity within complexity; this is the philosophy behind formulating prescriptions. Nevertheless, regarding the application of prescriptions, further explanation is needed: The key lies in being flexible and comprehensive while avoiding rigidity. If one is flexible without a core principle, chaos ensues, leading to confusion. It must be understood that amidst ambiguity, there are unchanging truths; thus, flexibility must be grounded in firm principles. Conversely, if one sticks rigidly to one approach without adaptation, bias arises, causing treatments to contradict the pathology. One must recognize that sudden changes due to the Three Causes (San Yin - internal, external, and non-internal/external factors) are unpredictable; therefore, adherence to principles must allow for flexibility. Flexibility requires careful consideration, while adherence requires definite judgment. One who can both adhere to principles and act flexibly is truly a master of prescription application. Who could such a person be?
I. The formulation of Tonifying Formulas (Bu Fang) aims to replenish deficiency. For Qi deficiency, tonification should focus on the upper body, using herbs such as Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix). For Essence (Jing) deficiency, tonification should focus on the lower body, using herbs such as Shudi (Rehmanniae Radix Praeparata) and Gouqi (Lycii Fructus). For Yang deficiency, tonification should include warming properties, using herbs such as Rougui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata), and Ganjiang (Zingiberis Rhizoma). For Yin deficiency, tonification should include clearing and moistening properties, using herbs such as Maidong (Ophiopogonis Radix), Shaoyao (Paeoniae Radix Alba), and Shengdi (Rehmanniae Radix). These represent the fundamental distinction in treating Yin and Yang. If Qi deficiency stems from Essence depletion, one must tonify Essence to generate Qi. If Essence deficiency stems from Qi weakness, one must tonify Qi to nourish Essence. Furthermore, if Yang becomes detached due to lack of Yin support, how can scattered Yang Qi be gathered without tonifying Yin? If Kidney Water fails due to lack of Fire warmth, how can nearly extinguished Yin essence revive without tonifying Fire? This illustrates the subtle interaction where Yin and Yang mutually support each other. Therefore, those skilled in tonifying Yang must seek Yang within Yin, so that Yang receives assistance from Yin, resulting in endless generation. Those skilled in tonifying Yin must seek Yin within Yang, so that Yin benefits from Yang's ascent, ensuring an inexhaustible source. Hence, I say: When distinguishing Yin and Yang based on Essence and Qi, Yin and Yang are inseparable; when distinguishing them based on Cold and Heat, they must not be confused. This refers to the separation and union of pathogenic and righteous factors. Thus, for cases of Yang deficiency with cold predominance, sweet-warm tonics are appropriate, while cooling-moistening agents are unsuitable. For cases of Yin deficiency with heat predominance, sweet-cool tonics are appropriate, while acrid-dry agents are contraindicated. Knowing what is suitable and what to avoid allows one not only to apply tonification correctly but also to comprehend the principles underlying all Eight Arrays.