诸药合成方剂,分两各有重轻。重者主病以为君,轻者为臣而佐助。立方之法,仿此才
灵。
往往明医,不逾矩度。如解利伤风,风宜辛散,则以防风味辛者为君,白术、甘草为佐;若
解利伤寒,寒宜甘发,又以甘草味甘者为主,防风、白术为臣。 疟寒热往来,君柴胡、葛
根,而佐陈皮、白术;血痢腹痛不已,君芍药、甘草,而佐当归、木香。大便泻频,茯苓、
炒白术为主,芍药、甘草佐之;下焦湿盛,防己、草龙胆为主,苍术、黄 佐之。眼暴赤肿
,黄芩、黄连君也,佐以防风、当归;小便不利,黄 、知母君也,佐以茯苓、泽泻。诸疮
疹金银花为主,多热佐栀子、连翘,多湿佐防风、苍术;诸咳嗽五味子为主,有痰佐陈皮、
半夏,有喘佐紫菀、阿胶。如是多般,难悉援引,惟陈大要,余可例推。又况本草各条,亦
以君臣例载。各虽无异,义实不同。彼则以养命之药为君,养性之药为臣,治病之药为使。
优劣匀分,万世之定规也;此则以主病之药为君,佐君之药为臣,应臣之药为使。重轻互举
,一时之权宜也。万世定规者,虽前圣复起,犹述旧弗违;一时权宜者,固后学当宗,贵通
变无泥。医家活法,观此可知。
凡称气者,是香臭之气。其寒热温凉,是药之性。且如鹅条中云∶白鹅脂性冷,不可言
其气
冷也。况自有药性,论其四气,则是香臭腥臊,故不可以寒热温凉配之。如蒜、阿魏、鲍鱼
、汗袜,则其气臭;鸡、鱼、鸭、蛇,则其气腥;狐狸肾、白马茎、近阴处、人中白,则其
气臊;沉、檀、脑、麝,则其气香。如此方可以气言之。其古本序例中,并各条内气字,恐
或后世误书,当改为性字,于义方允,仍寒热温凉四性。五味之中,每一味各有此四者,如
辛之属,则有硝石、石膏、干姜、桂、附、半夏、细辛、薄荷、荆芥之类;甘之属,则有滑
石、凝水石、饧饴、酒、枣、参、耆、甘草、干葛、粳米之类;苦之属,则有大黄、枳实、
浓朴、酒、糯米、白术、麻黄、竹茹、栀子之类;咸之属,则有泽泻、犀角、阳起石、皂荚
、文蛤、白华、水蛭、牡蛎之类;酸之属,则有商陆、苦酒、硫黄、乌梅、五味子、木瓜、
芍药之类。此虽不足以尽举,大抵五味之中,皆有四者也。
各种药物合成方剂时,每味药的用量各有轻重。用量重的药物针对主病,作为君药;用量轻的药物作为臣药,起到辅助作用。制定方剂的法则,模仿这种原则才能显得灵验。
往往高明的医生,不会超越规矩法度。例如治疗伤风,风邪适宜用辛味药发散,就以气味辛的防风为君药,白术、甘草作为佐药;如果治疗伤寒,寒邪适宜用甘味药发汗,又以气味甘的甘草为主药(君药),防风、白术作为臣药。疟疾表现为寒热往来,以柴胡、葛根为君药,陈皮、白术作为佐药;血痢腹痛不止,以芍药、甘草为君药,当归、木香作为佐药。大便频繁泄泻,以茯苓、炒白术为主药,芍药、甘草作为佐药;下焦湿气盛重,以防己、草龙胆为主药,苍术、黄柏作为佐药。眼睛突然红肿,以黄芩、黄连为君药,防风、当归作为佐药;小便不通利,以黄芩、知母为君药,茯苓、泽泻作为佐药。各种疮疹以金银花为主药,热象多者佐以栀子、连翘,湿象多者佐以防风、苍术;各种咳嗽以五味子为主药,有痰者佐以陈皮、半夏,有气喘者佐以紫菀、阿胶。像这样多种情况,难以全部列举引用,只陈述主要纲要,其余可以类推。况且《本草》各条目中,也按照君臣的体例记载。虽然形式上没有不同,但含义实际上是有区别的。古本是以保养生命的药物为君,保养性情的药物为臣,治疗疾病的药物为使。优劣均匀分配,是万世不变的定规;这里是以主治疾病的药物为君,辅助君药的为臣,顺应臣药的为使。轻重相互举用,是一时的权宜之计。万世的定规,即使前代圣人复活,也会遵循旧制不违背;一时的权宜,固然后学者应当尊崇,但贵在通晓变化而不拘泥。医家的灵活治法,通过这点就可以知道了。
凡是称为“气”的,是指药物的香臭气味。其中的寒、热、温、凉,是指药物的性质。就像在鹅条中说:白鹅脂的性质寒冷,不能说是它的气味寒冷。况且自有药物性质以来,论述其四气,就是指香、臭、腥、臊,所以不能用寒、热、温、凉来搭配它们。如大蒜、阿魏、鲍鱼、汗袜,它们的气味是臭的;鸡、鱼、鸭、蛇,它们的气味是腥的;狐狸肾、白马阴茎、阴户处分泌物、人中白,它们的气味是臊的;沉香、檀香、冰片、麝香,它们的气味是香的。只有这样才能用“气”来谈论。古本序例及各条目内的“气”字,恐怕是后世误写,应当改为“性”字,这样在义理上才允当,仍保留寒、热、温、凉四种性质。五味之中,每一味都包含这四种性质,如辛味一类,就有硝石、石膏、干姜、桂枝、附子、半夏、细辛、薄荷、荆芥之类;甘味一类,就有滑石、凝水石、饴糖、酒、枣、人参、黄芪、甘草、干葛、粳米之类;苦味一类,就有大黄、枳实、厚朴、酒、糯米、白术、麻黄、竹茹、栀子之类;咸味一类,就有泽泻、犀角、阳起石、皂荚、文蛤、白华、水蛭、牡蛎之类;酸味一类,就有商陆、醋、硫黄、乌梅、五味子、木瓜、芍药之类。这些虽然不足以全部列举,但大致来说,五味之中,都具备这四种性质。
When various medicinal materials are combined into a prescription, the dosages of each ingredient vary in weight and lightness. The heavier dosage targets the main disease and serves as the Sovereign herb (Jun Yao); the lighter dosage serves as the Minister herb (Chen Yao), providing assistance. The method of formulating prescriptions follows this principle to achieve efficacy.
Often, skilled physicians do not exceed established rules. For instance, when treating wind-cold injury (Shang Feng), wind pathogens are suitable for dispersal with acrid herbs; thus, Fangfeng (Saposhnikovia Root), which is acrid in flavor, is used as the Sovereign herb, while Baizhu (Atractylodes Rhizome) and Gancao (Licorice Root) serve as Assistant herbs (Zuo Yao). If treating cold damage (Shang Han), cold pathogens are suitable for release via sweet herbs; therefore, Gancao (Licorice Root), which is sweet in flavor, is used as the Sovereign herb, while Fangfeng (Saposhnikovia Root) and Baizhu (Atractylodes Rhizome) serve as Minister herbs. For malaria characterized by alternating chills and fever, Chaihu (Bupleurum Root) and Gegen (Pueraria Root) are used as Sovereign herbs, while Chenpi (Citrus Peel) and Baizhu (Atractylodes Rhizome) serve as Assistant herbs. For bloody dysentery with unceasing abdominal pain, Shaoyao (Peony Root) and Gancao (Licorice Root) are used as Sovereign herbs, while Danggui (Angelica Sinensis Root) and Muxiang (Vladimiria Root) serve as Assistant herbs. For frequent loose stools, Fuling (Poria) and Chao Baizhu (Stir-fried Atractylodes Rhizome) are used as primary herbs, while Shaoyao (Peony Root) and Gancao (Licorice Root) serve as Assistant herbs. For excessive dampness in the lower jiao, Fangji (Stephania Root) and Cao Longdan (Gentiana Scabra Root) are used as primary herbs, while Cangzhu (Atractylodes Lancea Rhizome) and Huangbai (Phellodendron Bark) serve as Assistant herbs. For sudden redness and swelling of the eyes, Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome) are used as Sovereign herbs, while Fangfeng (Saposhnikovia Root) and Danggui (Angelica Sinensis Root) serve as Assistant herbs. For difficult urination, Huangqin (Scutellaria Root) and Zhi Mu (Anemarrhena Rhizome) are used as Sovereign herbs, while Fuling (Poria) and Zexie (Alisma Rhizome) serve as Assistant herbs. For various sores and rashes, Jinyinhua (Honeysuckle Flower) is used as the primary herb; if heat is predominant, Zhizi (Gardenia Fruit) and Lianqiao (Forsythia Fruit) are added as assistants; if dampness is predominant, Fangfeng (Saposhnikovia Root) and Cangzhu (Atractylodes Lancea Rhizome) are added as assistants. For various coughs, Wuweizi (Schisandra Fruit) is used as the primary herb; if phlegm is present, Chenpi (Citrus Peel) and Banxia (Pinellia Tuber) are added as assistants; if wheezing is present, Ziwan (Aster Root) and Ejiao (Donkey-hide Gelatin) are added as assistants. There are many such cases, making it difficult to cite them all; only the main principles are stated here, and others can be inferred by analogy. Furthermore, entries in Bencao (Materia Medica) also record ingredients according to the Sovereign-Minister model. Although the format appears similar, the underlying meaning differs. In the ancient view, herbs that nourish life are Sovereign, those that nourish nature are Minister, and those that treat disease are Envoy. This represents an equal distribution of superiority and inferiority, serving as an eternal standard. In the current view, herbs that treat the main disease are Sovereign, those assisting the Sovereign are Minister, and those responding to the Minister are Envoy. This involves a flexible adjustment of heavy and light dosages, serving as a temporary expedient. The eternal standard, even if revived by former sages, adheres to tradition without deviation; the temporary expedient, while worthy of respect by later learners, emphasizes adaptability without rigidity. Through this, one can understand the flexible methods of physicians.
Whenever "Qi" (Energy/Aroma) is mentioned, it refers to the fragrant or foul odor. The cold, hot, warm, and cool refer to the Xing (Nature/Property) of the medicine. As stated in the section on geese: White goose fat has a cold Xing, but its Qi is not cold. Since the discussion of drug properties involves the Four Qi (Four Natures), it specifically refers to fragrant, foul, fishy, and musky odors; therefore, they cannot be paired with cold, hot, warm, and cool. For example, garlic, asafoetida, abalone, and sweaty socks have a foul odor; chicken, fish, duck, and snake have a fishy odor; fox kidney, stallion penis, secretion from the genital area, and Renzhongbai (Human Tooth Bone Ash) have a musky odor; chenxiang (Agarwood), tanxiang (Sandalwood), naozhang (Borneol), and shexiang (Musk) have a fragrant odor. Only in this way can "Qi" be discussed. It is feared that the character "Qi" in the preface and various entries of ancient editions may be later errors and should be changed to "Xing" (Nature) for semantic accuracy, retaining the four Natures of cold, hot, warm, and cool. Among the Five Flavors, each flavor contains these four Natures. For example, among acrid (Xin) substances, there are Shixiao (Niter), Shigao (Gypsum Fibrosum), Ganjiang (Dried Ginger), Guizhi (Cinnamon Twig), Fuzi (Aconite Lateral Root), Banxia (Pinellia Tuber), Xixin (Asarum), Bohe (Mint), and Jingjie (Schizonepeta); among sweet (Gan) substances, there are Huashi (Talcum), Ningshuishi (Congelatum Nitri), Yiyi (Malt Sugar), wine, dates, Renshen (Ginseng Root), Qihuangqi (Astragalus Root), Gancao (Licorice Root), Gange (Kudzu Root), and Jingmi (Rice); among bitter (Ku) substances, there are Dahuang (Rhubarb Root), Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), wine, Nuomij (Glutinous Rice), Baizhu (Atractylodes Rhizome), Mahuang (Ephedra Herb), Zhuru (Bamboo Shavings), and Zhizi (Gardenia Fruit); among salty (Xian) substances, there are Zexie (Alisma Rhizome), Xijiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*), Yangqishi (Sunstone), Zaojiao (Tamarisk Pod), Wen Ge (Clam Shell), Baihua (Sea Coral), Shuizhi (Leech), and Muli (Oyster Shell); among sour (Suan) substances, there are Shanglu (Phytolacca Root), Kujiu (Vinegar), Liuhuang (Sulfur), Wumei (Mume Fruit), Wuweizi (Schisandra Fruit), Mugua (Chaenomeles Fruit), and Shaoyao (Peony Root). Although these examples are not exhaustive, generally speaking, within the Five Flavors, all four Natures are present.