(制方用药附)
东方∶甲风、乙木,其气温,其味甘,在人以肝胆应之。
南方∶丙热、丁火,其气热,其味辛,在人以心、小肠、三焦、包络应之。
中央∶戊湿,其本气平,其兼气温凉寒热,在人以胃应之。
中央∶己土,其本味咸,其兼味辛甘酸苦,在人以脾应之。
西方∶庚燥、辛金,其气凉,其味酸,在人以肺、大肠应之。
北方∶壬寒、癸水,其气寒,其味苦,在人以肾、膀胱应之。
人乃万物中之一也,独阳不生,独阴不长,须禀两仪之气而生化也。圣人垂世立教,不
能浑说,必当分析,以至理而言,则阴阳相附不相离,其实一也。呼则因阳出,吸则随阴入
。天以阳生阴长,地以阳杀阴藏,此上说止明补泻用药君之一也。故曰∶主病者为君。用药
之机会,要明轻清成象,重浊成形。本乎天者亲上,本乎地者亲下,则各从其类也。清中清
者,清肺以助其天真;清中浊者,荣华腠理;浊中清者,荣养于神;浊中浊者,坚强骨髓。
故《至真要大论》云∶五味阴阳之用,辛甘发散为阳,酸苦涌泄为阴,淡味渗泄为阳,咸味
涌泄为阴,六者或收或散,或缓或急,或燥或润,或软或坚,各以所利而行之,调其气使之
平也。详见本论。
如头痛,须用川芎。如不愈,各加引经药∶太阳,川芎;阳明,白芷;少阳,柴胡;太
阴,苍术;少阴,细辛;厥阴,吴茱萸。
如顶巅痛,须用 本,去川芎。
如肢节痛,须用羌活,去风湿亦宜用之。
如腹痛,须用芍药,恶寒而痛,加桂;恶热而痛,加黄柏。
如心下痞,须用枳实、黄连。
如肌热及去痰者,须用黄芩。肌热,亦用黄 。
如腹胀,用姜制浓朴(一本有芍药)。
如虚热,须用黄 ,止虚汗,亦用。
如胁下痛,往来潮热,日晡潮热,须用柴胡。
如脾胃受湿,沉困无力,怠惰好卧,去痰,用白术。
如破滞气,用枳壳,高者用之。夫枳壳者,损胸中至高之气,二三服而已。
如破滞血,用桃仁、苏木。
如去痰,须用半夏。热痰,加黄芩;风痰,加南星;胸中寒痰、痞塞,用陈皮、白术,
多用则泻脾胃。
如腹中窄狭,须用苍术。
如调气,须用木香。
如补气,须用人参。
如和血,须用当归,凡血受病者,皆当用当归也。
如去下焦湿肿及痛,并膀胱有火邪者,必须酒洗防己、草龙胆、黄柏、知母。
如去上焦湿及热,须用黄芩,泻肺火故也。
如去中焦湿与痛热,用黄连,能泻心火故也。
如去滞气用青皮,勿多服,多则泻人真气。
如渴者,用干葛、茯苓,禁半夏。
如嗽者,用五味子。
如喘者,用阿胶。
如宿食不消,须用黄连、枳实。
如胸中烦热,须用栀子仁。
如水泻,须用白术、茯苓、芍药。
如气刺痛,用枳壳,看何部分,以引经药导使之行则可。
如血刺痛,用当归,详上下,用根梢。
如疮痛不可忍者,用寒苦药,如黄柏、黄芩,详上下,用根梢,及引
如眼痛不可忍者,用黄连、当归身,以酒浸煎。
如小便黄者,用黄柏;数者、涩者,或加泽泻。
如腹中实热,用大黄、芒硝。
如小腹痛,用青皮。
如茎中痛,用生甘草梢。
如惊悸恍惚,用茯神。
如饮水多,致伤脾,用白术、茯苓、猪苓。
如胃脘痛,用草豆蔻。
凡用纯寒、纯热药,必用甘草,以缓其力也。
寒热相杂,亦用甘草,调和其性也。中满者禁用。经云∶中满者勿食甘。
(制方用药附)
东方:对应甲风、乙木,其气温暖,其味甘甜,在人体中与肝胆相应。
南方:对应丙热、丁火,其气炎热,其味辛散,在人体中心脏、小肠、三焦、心包络与之相应。
中央:对应戊湿,其本气平和,兼有温、凉、寒、热之气,在人体中胃与之相应。
中央:对应己土,其本味咸,兼有辛、甘、酸、苦之味,在人体中脾与之相应。
西方:对应庚燥、辛金,其气清凉,其味酸收,在人体中与肺、大肠相应。
北方:对应壬寒、癸水,其气寒冷,其味苦降,在人体中与肾、膀胱相应。
人是万物中的一员,单独只有阳不能生长,单独只有阴也不能发育,必须禀受阴阳两仪之气才能生化。圣人设立世间教化,不能笼统地说,必须进行分析,从最高的道理来说,阴阳相互依附而不分离,其实质是统一的。呼气是因阳气而出,吸气是随阴气而入。天依靠阳气使阴物生长,地依靠阳气使阴物肃杀收藏,上述说法只阐明了补泻用药中“君药”的一个方面。所以说:主治疾病的药物为君药。运用药物的时机,要明白轻清之物成象,重浊之物成形。源于天的属性亲近上方,源于地的属性亲近下方,则各自遵循同类相从的规律。清中之清者,能清肺以助益天真之气;清中之浊者,能荣华腠理;浊中之清者,能荣养神志;浊中之浊者,能坚固骨髓。所以《至真要大论》说:五味阴阳的作用,辛味和甘味发散属于阳,酸味和苦味涌吐泄下属于阴,淡味渗利泄下属于阳,咸味涌吐泄下属于阴,这六种味道有的收敛,有的发散,有的缓和,有的急迫,有的燥湿,有的润燥,有的软坚,有的坚骨,各自根据其有利的一面来施行,调理人气使之平衡。详见本篇论述。
如果是头痛,必须用川芎。如果不好转,各加引经药:太阳经头痛用川芎;阳明经头痛用白芷;少阳经头痛用柴胡;太阴经头痛用苍术;少阴经头痛用细辛;厥阴经头痛用吴茱萸。
如果是肢节疼痛,必须用羌活,去除风湿也适宜使用它。
如果是腹痛,必须用芍药,怕冷而痛的,加桂枝;怕热而痛的,加黄柏。
如果是肌表发热及需要去痰的,必须用黄芩。肌表发热,也可以用黄芩。(注:原文此处可能有脱字或异文,通常指黄芩或相关清热药,依上下文保留原意)。
如果是破滞气,用枳壳,适用于病位在高处的情况。枳壳会损伤胸中至高之气,服用二三服即可。
如果是去痰,必须用半夏。热痰,加黄芩;风痰,加天南星;胸中寒痰、痞塞,用陈皮、白术,多用则会泻伤脾胃。
如果是腹中感觉狭窄紧迫,必须用苍术。
如果是去除下焦湿肿及疼痛,以及膀胱有火邪的,必须用酒洗过的防己、草龙胆、黄柏、知母。
如果是气刺痛,用枳壳,看是哪个部位,用引经药引导使其运行即可。
如果是疮痛不可忍受,用寒性苦味的药,如黄柏、黄芩,详细辨别上下,使用根或梢,以及引经药。
如果是尿道痛,用生甘草梢。
(Attachment on Formulation and Medication)
East: Corresponds to Jia Wind and Yi Wood. Its nature is warm, its flavor is sweet, and in the human body it corresponds to the Liver and Gallbladder.
South: Corresponds to Bing Heat and Ding Fire. Its nature is hot, its flavor is pungent, and in the human body it corresponds to the Heart, Small Intestine, Sanjiao (Triple Burner), and Pericardium.
Center: Corresponds to Wu Dampness. Its fundamental nature is neutral, with concurrent properties of warm, cool, cold, and hot. In the human body, it corresponds to the Stomach.
Center: Corresponds to Ji Earth. Its fundamental flavor is salty, with concurrent flavors of pungent, sweet, sour, and bitter. In the human body, it corresponds to the Spleen.
West: Corresponds to Geng Dryness and Xin Metal. Its nature is cool, its flavor is sour, and in the human body it corresponds to the Lung and Large Intestine.
North: Corresponds to Ren Cold and Gui Water. Its nature is cold, its flavor is bitter, and in the human body it corresponds to the Kidney and Bladder.
Humans are but one among all things. Alone, Yang cannot generate; alone, Yin cannot grow. One must receive the Qi of both Yin and Yang to undergo transformation and generation. The sages established teachings for the world; they could not speak generally but had to analyze specifically. From the perspective of ultimate truth, Yin and Yang attach to each other and do not separate; in essence, they are one. Exhalation occurs due to the emergence of Yang; inhalation follows the entry of Yin. Heaven uses Yang to promote the growth of Yin; Earth uses Yang to kill and store Yin. The above statements only clarify one aspect of using Sovereign drugs (Jun Yao) for tonification and purgation. Therefore, it is said: "The drug that treats the main disease is the Sovereign." Understanding the opportunity for medication requires knowing that light and clear substances form images, while heavy and turbid substances form shapes. Those originating from Heaven tend towards the upper; those originating from Earth tend towards the lower; thus, each follows its own kind. That which is clear within the clear clears the Lungs to assist True Heavenly Qi; that which is turbid within the clear nourishes the Couli (interstitial spaces); that which is clear within the turbid nourishes the Shen (Spirit); that which is turbid within the turbid strengthens the Marrow. Thus, the *Treatise on the Most Important Essentials* states: "The use of Yin and Yang of the Five Flavors: Pungent and Sweet disperse and belong to Yang; Sour and Bitter induce vomiting and purging and belong to Yin; Bland flavors drain and purge and belong to Yang; Salty flavor induces vomiting and purging and belongs to Yin. These six either astringe or disperse, either relax or accelerate, either dry or moisten, either soften or harden. Each acts according to what benefits it, regulating Qi to bring it to balance." For details, see this treatise.
If there is headache, Chuanxiong Rhizome (Chuanxiong) must be used. If it does not improve, add channel-guiding herbs according to the meridian: Taiyang channel, Chuanxiong; Yangming channel, Angelica Dahurica Root (Baizhi); Shaoyang channel, Bupleurum Root (Chaihu); Taiyin channel, Atractylodes Rhizome (Cangzhu); Shaoyin channel, Asarum Root (Xixin); Jueyin channel, Evodia Fruit (Wuzhuyu).
If there is pain at the vertex, Gaoben Rhizome (Gaoben) must be used, removing Chuanxiong.
If there is pain in the limbs and joints, Qianghuo Rhizome (Qianghuo) must be used; it is also suitable for dispelling wind-dampness.
If there is abdominal pain, White Peony Root (Shaoyao) must be used. If accompanied by aversion to cold and pain, add Cinnamon Twig (Guizhi); if accompanied by aversion to heat and pain, add Phellodendron Bark (Huangbai).
If there is epigastric fullness and obstruction (Pi), Zizyphus Fruit (Zhishi) and Scutellaria Root (Huanglian) must be used.
If there is muscle fever and phlegm needs to be removed, Scutellaria Root (Huangqin) must be used. For muscle fever, Huangqin can also be used.
If there is abdominal distension, Ginger-processed Magnolia Bark (N Houpo) should be used (another version includes Shaoyao).
If there is deficiency heat, Huangqin must be used; to stop spontaneous sweating due to deficiency, Huangqin is also used.
If there is hypochondriac pain, alternating tidal fever, or afternoon tidal fever, Bupleurum Root (Chaihu) must be used.
If the Spleen and Stomach are affected by dampness, resulting in heaviness, fatigue, weakness, lethargy, and a desire to lie down, and to remove phlegm, Atractylodes Macrocephala Rhizome (Baizhu) should be used.
To break stagnant Qi, Zizyphus Fruit (Zhike) should be used, particularly for conditions located high in the body. Zhike damages the highest Qi in the chest; three doses are sufficient.
To break stagnant Blood, Peach Kernel (Taoren) and Calamus Wood (Sumu) should be used.
To remove phlegm, Pinellia Tuber (Banxia) must be used. For heat-phlegm, add Huangqin; for wind-phlegm, add Arisaema Rhizome (Nanxing); for cold-phlegm in the chest causing obstruction, use Tangerine Peel (Chenpi) and Baizhu. Using too much will purge the Spleen and Stomach.
If there is a sensation of tightness in the abdomen, Cangzhu must be used.
To regulate Qi, Aucklandia Root (Muxiang) must be used.
To tonify Qi, Ginseng Radix et Rhizoma (Renshen) must be used.
To harmonize Blood, Angelica Sinensis Radix (Danggui) must be used; whenever Blood is diseased, Danggui should be used.
To remove dampness, swelling, and pain in the Lower Jiao, and fire-pathogens in the Bladder, Stephania Root (Fangji) and Gentiana Scabra Root (Caolongdan), Huangbai, and Anemarrhena Rhizome (Zhimu) washed in wine are required.
To remove dampness and heat in the Upper Jiao, Huangqin must be used, as it drains Lung Fire.
To remove dampness and painful heat in the Middle Jiao, Huanglian is used, as it drains Heart Fire.
To remove stagnant Qi, Green Tangerine Peel (Qingpi) is used; do not take too much, as excessive use purges True Qi.
If there is thirst, Kudzu Root (Gegen) and Poria (Fuling) should be used; Banxia is contraindicated.
If there is cough, Schisandra Berry (Wuweizi) should be used.
If there is wheezing, Donkey-hide Gelatin (Ejiao) should be used.
If there is undigested food retention, Huanglian and Zhishi must be used.
If there is vexation and heat in the chest, Gardenia Seed (Zhizi Ren) must be used.
If there is watery diarrhea, Baizhu, Fuling, and Shaoyao must be used.
If there is stabbing pain caused by Qi stagnation, Zhike should be used; depending on the location, channel-guiding herbs should be added to direct its action.
If there is stabbing pain caused by Blood stasis, Danggui should be used; carefully distinguish between upper and lower parts, using the root or tip accordingly.
If there is unbearable pain from sores/ulcers, cold and bitter herbs such as Huangbai and Huangqin should be used; carefully distinguish upper and lower parts, using roots or tips, along with channel-guiding herbs.
If there is unbearable eye pain, Huanglian and the body of Danggui should be soaked in wine and decocted.
If urine is yellow, Huangbai should be used; if frequent or difficult/painful, Ze Xie may be added.
If there is excess heat in the abdomen, Rhubarb Radix et Rhizoma (Dahuang) and Mirabilite (Mangxiao) should be used.
If there is lower abdominal pain, Qingpi should be used.
If there is pain in the urethra, raw Licorice Root tip (Sheng Gancao Shao) should be used.
If there is palpitations and mental confusion, Poria with Hostwood (Fushen) should be used.
If excessive drinking of water injures the Spleen, Baizhu, Fuling, and Polyporus (Zhuling) should be used.
If there is stomach pain, Alpinia Katsumadai Seed (Caodoukou) should be used.
Whenever pure cold or pure heat herbs are used, Licorice Root (Gancao) must be added to moderate their potency.
When cold and heat properties are mixed, Gancao is also used to harmonize their nature. However, it is contraindicated in cases of fullness in the middle (epigastric distension). The Classics state: "Those with middle fullness should not consume sweet foods."