议曰合之则同离之则异水火之设品物之聚皆有同异何可怪哉火之为烟所郁则不明及其焰
也由
烟而明之水之为坎所壅则不流其湍也由坎以流之万物有品橐出其境则异于常人事有尊卑合其
道则异于众幼幼抱疾不作传变古今皆知言曰疳积吐利及其更也即作惊风痰热未为怪异可以循
其症候而疗之稍或变常当审其轻重而理之兹则世医务学莫执此端可否之意以尽其善殊不知疾
作有同异之别其所受之常曰同所作不常曰异前件八症候中皆能传之俗流不知其所以传作即曰
差异其实因差异所致当知所受在于传变欲以暴急之间妄投丸散冷热相互虚实相摧表里相隘阴
阳相反乱于百脉触于五脏迫于经络遏于荣卫是故本症遁作它疾所发不得其名所疗不审其理攻
劫无端幸全性命即其所受乃谓怪异积症之中得疾差异甚多(差异者是积等证候所治不当而传
反致勿谓诧异所受哉也)疳气之疾外候颇众其候但于积病坏症而与调理疳气亦然询其源则应
其端体其症则疗其疾是以丸散不良陈疾病莫延久凡儿所受异疾盖由失之明察苟或成人往往抱
HT荐之疾者有矣
议曰夫人之生以气血为根本人之命以安乐为寿元男即二八卫气方正女即二七荣血方行天
癸至
时其气与血始然父参年既未登即曰小儿然分形其名已载自幼至长久第言之今之世法男年十五
女年十三乃通嫁娶其道虽不应古其理在乎通情情动乎中男破阳大早则伤其精气女破阴大早则
伤其经脉虽成胎孕含育必亏儿生伛偻变蒸不备体作侏儒又或男子过于八八女人过于七七产诞
婴孩何足为善又或阴盛阳亏阳盛阴亏又或女因胎寒服药男以阴萎饵丹如此为后皆不足与议非
正论也前贤着述评较调理未尝与究其源远见分短夭利害由斯复见男女长成疾抱虚劳相继而死
者人谓传尸或曰有鬼所致或曰有虫所作愚谓不然传尸者传受骨肉气血之尸也乃是父精不足母
气虚羸而得之何更外有尸而可传有鬼致昧有虫为祸前件意义悉入其候虽则男女长大勿于劳瘵
相承但禀赋受气如花伤培似木败植荣壮枯谢各由根本所致凡为人子无能自知况又恣妄于女年
忽尔气虚脉脱惟恨天命病家坚忿药之不良无自责其根本不充所以然也
议论道:合起来看是相同的,分开看则是不同的。水火作为自然元素,万物的聚集,都有相同与不同之处,这有什么可奇怪的呢?火产生烟,被郁遏时就不明亮;等到火焰燃烧时,便由烟而变得明亮。水属于坎卦,被壅塞时就不流动;等到疏通了坎位的阻塞,水流就顺畅了。万物各有品类,超出其常规环境就会显得异常;人分尊卑,符合其道则与众人不同。
幼儿患病,如果不发生传变,古今都知道这是常理。说道:疳积、呕吐、腹泻等症状,如果进一步发展,就会变成惊风、痰热,这并不怪异,可以根据症状进行调理治疗。稍微出现变化,应当审察病情的轻重来治理。然而现在的医生,不学习医术,不能把握这个根本原则,对于是否可行的意见,未能做到尽善尽美。他们不知道疾病发作有相同与不同的区别:所接受的病因常态称为“同”,发作时的非正常表现称为“异”。在上述八种症候中,都能发生传变。世俗的医生不知道为什么会传变,一旦发作就说这是差异。其实是因为差异所致,应当知道所受之邪在于传变。如果在仓促之间,胡乱投用丸药散剂,导致冷热相互冲突,虚实相互摧残,表里相互闭塞,阴阳相反,扰乱百脉,触动五脏,阻滞经络,遏制营卫之气。因此,原本的症状隐匿并转化为其他疾病,发作时无法准确命名,治疗时不审察其原理,盲目攻伐劫夺,毫无根据。侥幸保全性命,但其所受的损伤,反而被认为是怪异。在积症之中,得病出现差异的情况很多(所谓差异,是指积等证候治疗不当而传变,反而导致病情变化,不要认为这是诧异,而是所受之邪造成的)。疳气之疾,外在征候颇多,其证候往往出现在积病坏症之后,对其进行调理,治疗疳气也是如此。探究其源头,应针对其开端;体察其症状,才能治疗其疾病。因此,丸散药物如果使用不当,陈旧的疾病就不会拖延太久。凡是幼儿所患的奇异疾病,大概是由于缺乏明察所致。如果成年后,往往会有遗留疾病的患者。
议论道:人的生存以气血为根本,人的生命以安乐为寿元。男子到了十六岁(二八),卫气方正充盈;女子到了十四岁(二七),荣血方才运行。天癸至之时,其气与血才开始旺盛。父亲参与生育之年,尚未达到成年标准,所以称为小儿,虽然形体已分,名字已定,但从幼年到长久,一直如此谈论。现在世俗的风俗,男子十五岁、女子十三岁就可以通婚嫁娶,其道虽不符合古代礼制,但其理在于顺应人情。情动于中,男子过早破阳则会损伤精气,女子过早破阴则会损伤经脉。即使怀孕生子,养育也必然亏损。孩子出生时佝偻,变蒸(婴幼儿生长发育过程中的生理现象)不全,身体长成侏儒。或者男子超过六十四岁(八八),女子超过四十九岁(七七)才产育婴孩,哪里算得上好?又或者阴盛阳亏,阳盛阴亏,或者女子因胎寒服药,男子因阳痿服用丹药。像这样对待后代,都不足与之讨论,不是正论。前贤的著作评论比较调理之法,未曾探究其源头,远见短浅,夭折与长寿、利害由此显现。又见男女长成后,疾病怀抱虚劳,相继而死的人,人们称之为“传尸”(一种具有传染性的慢性消耗性疾病,类似肺结核),或者说是有鬼所致,或者说是有虫作祟。我认为不是这样。“传尸”是传承受纳骨肉气血之尸气,乃是父亲精不足、母亲气虚羸弱而得的,怎么还有外来的尸气可以传播呢?说有鬼致害、有虫为祸,前面的意义都包含在其证候中。虽然男女长大,不要将这种病视为劳瘵相承,但禀赋受气,如花受伤需培土,如树木败植,繁荣壮盛或枯萎凋谢,都是由根本所致。凡是为人子女者,不能自知这些道理,况且又放纵妄为,女子忽然气虚脉脱,只恨天命,怪罪病人家属坚持认为药物不良,却不责备自己根本不充实,这才是之所以如此的原因。
Commentary states: When viewed as a whole, they are the same; when separated, they are different. The establishment of Fire and Water, and the gathering of all things, all possess similarities and differences; what is there to be surprised by? Fire produces smoke; when constrained, it is not bright; when the flame ignites, it becomes bright through the smoke. Water belongs to Kan (the trigram for water); when obstructed, it does not flow; when the obstruction in Kan is cleared, it flows. All things have their categories; when they exceed their boundaries, they differ from the norm. Humans have ranks of respect and humility; when they follow the Way, they differ from the masses.
Infants suffering from illness without progression of disease have been known since ancient times. It is said that conditions such as Gan accumulation (pediatric malnutrition syndrome), vomiting, and diarrhea, if they progress further, will transform into Wind-Startle (pediatric convulsions) and Phlegm-Heat. This is not strange; one can treat them according to their symptoms. If slight changes occur, one should examine the severity to manage them. However, contemporary physicians often neglect medical study and fail to grasp this fundamental principle. Their opinions on feasibility do not strive for perfection. They do not realize that disease onset has distinctions between similarity and difference: the commonality of the pathogen received is termed "Same," while the atypical manifestation is termed "Different." Among the aforementioned eight symptom patterns, transmission can occur. Unlearned practitioners do not understand the mechanism of transmission; upon onset, they simply claim it is a difference. In reality, it is caused by these differences. One must understand that the pathogen lies within the process of transmission. If, in haste, one recklessly administers pills and powders, cold and heat may conflict, deficiency and excess may destroy each other, exterior and interior may become blocked, and Yin and Yang may oppose each other. This disrupts the hundred vessels, disturbs the five Zang organs, obstructs the meridians, and impedes Ying and Wei (nutritive and defensive qi). Consequently, the original symptoms hide and transform into other diseases; the onset cannot be accurately named, and treatment fails to examine the underlying principles. Blindly attacking and purging without cause, yet miraculously preserving life, the damage sustained is then mistakenly regarded as bizarre. Within accumulation syndromes, many diseases present with differences (the so-called differences refer to improper treatment of accumulation syndromes leading to transmission, rather than mere surprise; it is the received pathogen that causes this). Gan Qi disease presents numerous external signs. Its manifestations often appear after the deterioration of accumulation diseases. Managing Gan Qi is similar. Investigating its source addresses its beginning; observing its symptoms allows for treating the disease. Therefore, if pills and powders are used improperly, chronic diseases will not linger long. Any strange diseases suffered by infants are likely due to a lack of clear observation. If neglected until adulthood, patients often suffer from lingering ailments.
Commentary states: Human life is rooted in Qi and Blood; longevity is found in peace and comfort. At age sixteen (2 x 8), a male's Defensive Qi (Wei Qi) becomes robust; at age fourteen (2 x 7), a female's Nutritive Blood (Ying Blood) begins to circulate fully. When Tian Gui (menstrual fluid/reproductive essence) arrives, Qi and Blood become vigorous. Although a father's reproductive age may not yet reach full maturity, he is still called a child; although his form is differentiated and name established, this description applies from childhood to old age. Current secular customs allow marriage at age fifteen for males and thirteen for females. While this does not conform to ancient rites, it aligns with human nature. Emotions stir within; if males break their Yang too early, their Essence and Qi are damaged; if females break their Yin too early, their meridians are injured. Even if pregnancy occurs, gestation and nurturing will inevitably be deficient. Children may be born with rickets, incomplete Bian Zheng (physiological growth phases in infants), or dwarfism. Or, if males reproduce beyond age sixty-four (8 x 8) and females beyond age forty-nine (7 x 7), the offspring are unlikely to be healthy. Alternatively, there may be Yin excess with Yang deficiency, or Yang excess with Yin deficiency. Females may take medicine for uterine cold, or males may take elixirs for impotence. Such practices regarding descendants are unworthy of discussion and are not orthodox theories. Ancient sages' writings evaluated management methods but rarely investigated their origins, showing limited foresight regarding premature death versus longevity and their associated harms. It is seen that adults suffer from Deficiency-Labor (Xu Lao) and die successively. People call this "Chuan Shi" (a contagious wasting disease, resembling tuberculosis), claiming it is caused by ghosts or parasites. I believe this is incorrect. "Chuan Shi" refers to the transmission of the "corpse" of flesh, bones, Qi, and Blood. It results from insufficient paternal Essence and deficient maternal Qi. How could there be an external corpse to transmit? Assertions of ghost-induced harm or parasite mischief ignore that the aforementioned meanings are contained within the symptoms. Although adults grow up, one should not view this merely as hereditary Labor-Wasting disease. Rather, constitutional endowment is like a flower needing soil protection or a tree whose prosperity or decline depends on its roots. As children, humans cannot know this themselves. Moreover, indulgence leads to sudden Qi deficiency and pulse collapse in females. Blaming fate or criticizing poor medication quality, they fail to blame their own insufficient root constitution, which is the true cause.