邪之伤人也,始而伤气,继而伤血、继而伤肉、继而伤筋、继而伤骨。邪毒既退,始而复气,
继而复血、继而复肉、继而复筋、继而复骨。以柔脆者易损,亦易复也。
天倾西北,地陷东南,故男先伤右,女先伤左。及其复也,男先复左,女先复右。以素亏者
易损,以素实者易复也。
严正甫正,年三十,时疫后,脉证俱平,饮食渐进,忽然肢体浮肿,别无所苦,此即气复也。
盖大病后,血未盛,气暴复,血乃气之根据归,气无所根据,故为浮肿。嗣后饮食渐加,浮肿渐
消,若误投行气利水药则谬矣。
张德甫,年二十,患噤口痢,昼夜无度,肢体仅有皮骨,痢虽减,毫不进谷,以人参一钱煎
汤,入口不一时,身忽浮肿,如吹气球,自后饮食渐进,浮肿渐消,肿间已有肌肉矣。
若大病后,三焦受伤,不能通调水道,下输膀胱,肢体浮肿,此水气也,与气复悬绝,宜《金
匮》肾气丸及肾气煎,若误用行气利水药必剧。凡水气,足冷肢体常重;气复足不冷,肢体
常轻为异。
余桂玉正,年四十,时疫后四肢脱力,竟若瘫痪,数日后右手始能动,又三日左手方动。又俞
桂岗子室所患皆然。
诸窍乃人身之户牖也。邪自窍而入,未有不由窍而出。《经》曰∶未入于腑者,
可汗
而已,已入于腑者,可下而已。麻征君复增汗、吐、下三法,总是导引其邪打从门户而出,可
为治法之大纲,舍此皆治标云尔。今时疫首尾一于为热,独不言清热者,是知因邪而发热,但
能治其邪,不治其热,而热自已。夫邪之与热,犹形影相根据,形亡而影未有独存者。若以黄
连解毒汤、黄连泻心汤,纯乎类聚寒凉,专务清热,既无汗、吐、下之能,焉能使邪从窍而出!
是忘其本徒治其标,何异于小儿捕影?
邪气伤害人体,起初损伤气,接着损伤血,再损伤肌肉,然后损伤筋,最后损伤骨。邪毒消退后,先恢复气,接着恢复血,再恢复肌肉,然后恢复筋,最后恢复骨。因为柔弱脆嫩的部分容易受损,也容易恢复。
天向西北倾斜,地向东南凹陷,所以男子先伤右侧,女子先伤左侧。等到恢复时,男子先恢复左侧,女子先恢复右侧。因为原本虚弱的人容易受损,原本充实的人容易恢复。
严正甫,三十岁,患时疫之后,脉象和症状都平复了,饮食逐渐增加,忽然肢体浮肿,没有其他痛苦,这就是气恢复的表现。大概大病之后,血尚未充盈,气突然恢复,血是气的依托归宿,气没有依托,所以出现浮肿。此后饮食逐渐增加,浮肿逐渐消退,如果错误地投用行气利水的药物就错了。
张德甫,二十岁,患噤口痢(无法进食的痢疾),昼夜无度,身体只剩皮包骨头,痢疾虽然减轻,但完全不能进食,用人参一钱煎汤,入口不到一时辰,身体忽然浮肿,像吹起的气球一样,此后饮食逐渐增加,浮肿逐渐消退,肿胀处已有肌肉长出了。
如果大病之后,三焦受伤,不能通调水道,向下输送到膀胱,导致肢体浮肿,这是水气病,与气恢复截然不同,适宜使用《金匮要略》中的肾气丸及肾气煎,如果误用行气利水的药物病情一定会加重。凡是水气病,足冷且肢体常感沉重;气恢复则足不冷,肢体常感轻快,这是两者的区别。
余桂玉,四十岁,时疫后四肢无力,竟然像瘫痪一样,几天后右手才开始能动,又过了三天左手才动。还有俞桂岗子的妻子所患病症也是如此。
各种孔窍是人身的门户窗户。邪气从孔窍进入,没有不从孔窍排出的。《内经》说:邪气未进入腑的,可以用发汗法解除;已经入腑的,可以用泻下法解除。麻征君又增加了汗、吐、下三种方法,总是引导邪气从门户排出,这可以作为治疗方法的总纲,除此之外的都是治标的方法罢了。如今时疫从头到尾都表现为热证,唯独不说清热,这是因为知道发热是由于邪气引起的,只要能治疗邪气,不直接治疗热,热自然就会消除。邪气与热,就像形体与影子相互依存,形体消亡而影子没有单独存在的。如果用黄连解毒汤、黄连泻心汤,纯粹聚集寒凉药物,专门致力于清热,既然没有汗、吐、下的功能,怎么能使邪气从孔窍排出呢!这是忘记了根本只治疗表象,这与小孩子捕捉影子有什么区别?
When pathogenic factors injure the human body, they first damage Qi (vital energy), then Blood (ying blood), then flesh (muscles and subcutaneous tissue), then sinews (tendons and ligaments), and finally bones. After the pathogenic toxins recede, Qi recovers first, then Blood, then flesh, then sinews, and finally bones. Because those that are soft and brittle are easily damaged, they are also easily recovered.
The heaven tilts to the northwest, and the earth sinks to the southeast; therefore, men are injured on the right side first, and women on the left side first. When recovery occurs, men recover on the left side first, and women on the right side first. Those who are constitutionally deficient are easily damaged, while those who are constitutionally robust are easily recovered.
Yan Zhengfu, aged thirty, after suffering from a pestilential disease, his pulse and symptoms both normalized, and his diet gradually increased. Suddenly, his limbs became edematous, with no other discomfort. This is the manifestation of Qi recovering. Generally, after a severe illness, when Blood has not yet become abundant but Qi suddenly recovers, Blood serves as the foundation for Qi. Since Qi lacks a foundation, edema results. Subsequently, as his diet gradually increased, the edema subsided. If one were to mistakenly administer herbs that promote Qi circulation and drain dampness, it would be an error.
Zhang Defu, aged twenty, suffered from Jin Kou Li (dysentery with inability to eat). Day and night without limit, his body was reduced to skin and bone. Although the dysentery had decreased, he could not consume any food at all. He was given a decoction of one qian of Renshen (Ginseng Radix et Rhizoma). Within less than two hours of ingestion, his body suddenly became edematous, like an inflated balloon. Afterwards, his diet gradually increased, the edema subsided, and muscle tissue began to form in the previously swollen areas.
If, after a severe illness, the San Jiao (Triple Burner) is injured and cannot regulate water passages, transmitting fluids downward to the Bladder, resulting in limb edema, this is Shui Qi (Water Qi/Water retention). This is completely different from Qi recovery. It is appropriate to use Shen Qi Wan (Kidney Qi Pill) or Shen Qi Jian (Kidney Qi Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet). If one mistakenly uses herbs that promote Qi circulation and drain dampness, the condition will surely worsen. In cases of Water Qi, the feet are cold and the limbs feel heavy; in cases of Qi recovery, the feet are not cold, and the limbs feel light. This is the distinction.
Yu Guiyu, aged forty, suffered from paralysis-like weakness in all four limbs after a pestilential disease. Several days later, his right hand began to move. Three more days passed before his left hand moved. The same pattern was observed in the wife of Yu Guigang.
All orifices are the doors and windows of the human body. Pathogenic factors enter through the orifices and invariably exit through them. The *Classic of Medicine* (*Huangdi Neijing*) states: "If the pathogen has not entered the Fu organs, it can be resolved by sweating; if it has already entered the Fu organs, it can be resolved by purging." Master Ma further added the methods of sweating, vomiting, and purging. These methods all serve to guide the pathogen out through the orifices/doors. They constitute the general outline of treatment methods; anything else is merely treating the branch (symptoms) rather than the root. Currently, pestilential diseases present with heat throughout their course. Why is there no mention of clearing heat? This is because we understand that fever arises from the pathogen. By treating the pathogen, the fever resolves spontaneously without directly targeting the heat. The relationship between pathogen and heat is like form and shadow; they depend on each other. Where the form perishes, the shadow cannot exist alone. If one uses purely cold and cooling formulas such as Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) or Huanglian Xiexin Tang (Coptis Decoction for Draining the Heart), gathering only cold-natured herbs to focus solely on clearing heat, lacking the ability to induce sweating, vomiting, or purging, how can one expel the pathogen through the orifices? This is forgetting the root and merely treating the branch. What difference is there from a child trying to catch a shadow?