详见中风门
详见痰饮门
原病式曰气为阳而主轻微诸所动乱劳伤乃为阳火之化神狂气乱而为病热者多矣子和云河
间治
五志独得言外之意凡见喜怒悲恐思之证皆以平心火为主至于劳者伤于动动便属阳惊者骇于心
心便属火二者亦以平心火为主今之医者不达此旨遂有寒凉之谤
谨按或云捍卫冲和不息之谓气扰乱妄动变常之谓火当其和平之时外护其表复行于里周流
一身
循环无端出入升降继而有常源出中焦总统于肺气曷尝病于人也及其七情之交攻五志之间发乖
戾失常清者遽变之为浊行者抑遏而反止表失卫护而不和内失健悍而少降营运渐远肺失主持妄
动不已五志厥阳之火起于马上燔于肺气乃病焉何者气本属阳反胜则为火矣河间有曰五志过极
皆为火也何后世不本此议而一概类聚香辛燥热之剂气作寒治所据何理且言指迷七气汤制作者
其皆用青皮陈皮三棱蓬术益智官桂甘草遂为平和可以常用通治七情所伤混同一意未喻某药以
治某气以下诸方尤有甚焉者兹不复叙况所起之情各各不同且夫经言丸气之变未尝略而不详如
怒则气上等证其言治法高者抑之下者举之寒者热之热者寒之惊者平之劳者温之结者散之喜者
以恐胜之悲者以喜胜之九气之治各有分别何尝混作寒论而类以香热之药通言而治诸气岂理之
谓欤若香辛燥热之剂但可劫滞气冲快于一时以其气久抑滞借此暂行开发之意药中不佐制伏所
起之气服甚则增炽郁火蒸熏气液而自成积积滋长而成痰一饮下膈气乃氤氲清虚之象若雾露之
着物虽滞易散内挟痰积开而复结服之日久安有气实而不动气动而不散者乎此皆人所受误之由
习俗已久相沿而化卒莫能救升发大过香辛散气燥热伤气真气耗散浊气上腾犹曰肾虚不能摄气
归原遂与苏子降气汤四磨汤下黑锡丹养气丹镇坠上升之气且硫黄黑锡佐以香热又无补养之性
藉此果能生气而补肾乎请熟详之夫湿痰甚者亦或当之初服未显增变由喜坠而愈进形质弱者何
以收救不悟肺受火炎子气亦弱降令不行火无以制相扇而动本势空虚命绝如缕积而至深丹毒济
大一旦火气狂散喘息奔急而死吁以有形丹石丸药重坠无形之气将何抵受随而降之乎譬以石投
水水故未尝沉也岂不死欤丹溪有曰上升之气自肝而出中挟相火其热为甚自觉其冷非真冷也火
极似水积热之甚阳亢阴微故有此证认假作真似是之祸可胜言哉内经虽云百病皆生于气以正气
受邪之不一也今七情伤气郁结不舒痞闷壅塞发为诸病当详所起之因滞于何经上下部分脏气之
不同随经用药有寒热温凉之同异若枳壳利肺气多服损胸中至高之气青皮泻肝气多服损真气与
夫木香之行中下焦气香附之快滞气陈皮之泄逆气紫苏之散表气浓朴之泻卫气槟榔之泻至高之
气藿香之馨香上行胃气沉香之升降真气脑麝之散真气若此之类气实所宜其中有行散者有损泄
者其过剂乎用之能却气之标而不能制气之本岂可又佐以燥热之药以火济火混同谓治诸气使之
常服多服可乎气之与火一理而已动静之变反化为二气作火论治与病情相得丹溪发挥论之冷生
气者出于高阳生之谬言也身非自受寒气口食寒物而是论寒者吾恐十之无一二也
刘完素在《原病式》中说：气属于阳，性质轻清微细；各种动摇混乱的症状，因劳损受伤而转化为阳火的化生。神志狂乱、气机紊乱而致病，大多属于热证。张子和说：河间先生治疗“五志”（喜、怒、忧、思、恐）独得言外之意。凡是见到喜怒悲恐思的情志病症，都以平抑心火为主。至于劳伤者，伤于动，动便属阳；惊骇者，惊吓于心，心便属火。这两种情况也都以平抑心火为主。现在的医生不明白这个宗旨，于是遭到使用寒凉药物的非议。
谨按：有人说，护卫冲和之气、运行不息的叫做气；扰乱妄动、改变常态的叫做火。当气处于和平状态时，在外保护体表，在内运行脏腑，周流一身，循环无端，出入升降，继而有常度。气源出中焦，统摄于肺气，何曾会使人患病呢？等到七情相互交攻，五志之间发作乖戾失常，清气突然变为浊气，行气被抑制遏止反而停止，表失卫护而不内守，内失健悍而少降运。营运逐渐远离，肺失去主持，妄动不已。五志厥阳之火起于马背上（比喻迅速），燔灼于肺气，于是生病。为什么呢？气本属阳，反胜则为火了。河间先生说：“五志过极，皆为火也。”为什么后世不根据这一议论，却一概聚集香辛燥热的药剂，将气作为寒证来治疗，所依据的道理是什么？况且像《指迷》中的七气汤，其制作者全都使用青皮、陈皮、三棱、蓬术、益智、官桂、甘草，于是认为平和可以常用通治七情所伤，混同一意，不明白某药以治某气。以下诸方更有甚者，这里不再叙述。何况所引发的情志各不相同。而且经书所言九气之变，未曾有略而不详的，如“怒则气上”等证，其言治法：高者抑之，下者举之，寒者热之，热者寒之，惊者平之，劳者温之，结者散之，喜者以恐胜之，悲者以喜胜之。九气的治疗各有分别，何曾混同作为寒证论治，而类以香热之药通言而治？这难道是治理诸气的道理吗？如果香辛燥热的药剂，只能暂时劫夺滞气，使气冲快于一时，因为气久被抑制滞涩，借此暂行开发的意思。药物中如果不佐以制伏所起之气，服用后甚则增炽郁火，蒸熏气液，而自成积，积滋长而成痰。一饮下膈，气乃氤氲，这是清虚之象，若雾露之物，虽然滞涩容易消散。内挟痰积，开而复结。服用日久，哪有气实而不动、气动而不散的？这都是人们受误的原因，习俗已久，相沿而化，最终不能挽救。升发大过，香辛散气，燥热伤气，真气耗散，浊气上腾，还说是肾虚不能摄气归原，于是给予苏子降气汤、四磨汤，下黑锡丹、养气丹，镇坠上升之气。况且硫黄、黑锡佐以香热，又无补养之性，借此果真能生气而补肾吗？请熟详之。湿痰甚者，也许应当用这些药。初服未显增变，由喜坠而愈进。形质弱者，何以收救？不悟肺受火炎，子气亦弱，降令不行，火无以制，相扇而动，本势空虚，命绝如缕，积而至深，丹毒济大，一旦火气狂散，喘息奔急而死。吁！以有形丹石丸药重坠无形之气，将何抵受，随而降之乎？譬以石投水，水故未尝沉也，岂不死欤？朱丹溪说：上升之气自肝而出，中挟相火，其热为甚，自觉其冷，非真冷也。火极似水，积热之甚，阳亢阴微，故有此证。认假作真，似是之祸，可胜言哉？《内经》虽云百病皆生于气，是以正气受邪之不一也。今七情伤气，郁结不舒，痞闷壅塞，发为诸病，当详所起之因，滞于何经，上下部分脏气之不同，随经用药，有寒热温凉之同异。若枳壳利肺气，多服损胸中至高之气；青皮泻肝气，多服损真气；与夫木香之行中下焦气，香附之快滞气，陈皮之泄逆气，紫苏之散表气，浓朴之泻卫气，槟榔之泻至高之气，藿香之馨香上行胃气，沉香之升降真气，脑麝之散真气。若此之类，气实所宜，其中有行散者，有损泄者，其过剂乎？用之能却气之标，而不能制气之本，岂可又佐以燥热之药，以火济火，混同谓治诸气，使之常服多服可乎？气之与火，一理而已，动静之变，反化为二。气作火论治，与病情相得。丹溪发挥论之。冷生气者，出于高阳生之谬言也。身非自受寒气，口食寒物，而是论寒者，吾恐十之无一二也。
See the section on Wind Stroke (Zhong Feng).
See the section on Phlegm-Fluids (Tan Yin).
Liu Wansu stated in *Yuan Bing Shi* (Treatise on Original Causes of Disease): Qi belongs to Yang and is light and subtle. Various symptoms of agitation and disorder, resulting from labor and injury, transform into the generation of Yang-Fire. Divine madness and chaotic Qi leading to disease are mostly heat syndromes. Zhang Zihe said: Hejian (Liu Wansu) uniquely grasped the implicit meaning in treating the "Five Emotions" (Wu Zhi: joy, anger, worry, thought, fear). Whenever manifestations of joy, anger, sorrow, fear, or thought are seen, the primary treatment is to calm Heart Fire. As for those injured by labor, injury stems from movement; movement belongs to Yang. Those startled are frightened at the Heart; the Heart belongs to Fire. Both cases also prioritize calming Heart Fire. Current physicians fail to understand this principle, thereby facing criticism for using cold and cool remedies.
Respectfully noted: It is said that protecting the harmonious Qi and its unceasing operation is called Qi; disturbing,妄动 (reckless movement), and altering normal states is called Fire. During times of peace, it protects the exterior, circulates within, flows through the entire body, cycles without end, enters and exits, ascends and descends, maintaining regularity. Qi originates from the Middle Jiao and is commanded by Lung Qi; how could it cause disease? However, when the Seven Emotions attack each other and the Five Emotions erupt in aberration and失常 (abnormality), clear Qi suddenly turns turbid, moving Qi is suppressed and stops, the exterior loses protection and fails to maintain interior harmony, and the interior lacks robustness and descending transport. Vital circulation gradually deviates, the Lung loses control, and reckless movement continues incessantly. The Jue-Yang Fire of the Five Emotions rises rapidly (metaphorically like a horse galloping) and blazes in the Lung Qi, causing disease. Why? Qi inherently belongs to Yang; if it overacts, it becomes Fire. Hejian stated: "When the Five Emotions reach extremes, they all become Fire." Why do later generations not base their discussions on this, but instead indiscriminately gather aromatic, acrid, drying, and hot agents, treating Qi disorders as Cold syndromes? What is the rationale? Furthermore, regarding *Zhi Mi Qi Qi Tang* (Seven Qi Decoction to Eliminate Confusion), its creator used Qing Pi (Green Tangerine Peel), Chen Pi (Aged Tangerine Peel), San Leng (Burreed Rhizome), Peng Ze (Curcuma Rhizome), Yi Zhi Ren (Alpinia Oxyphylla Fruit), Guan Gui (Cinnamon Twig), and Gan Cao (Licorice Root), deeming them mild enough for common use to treat injuries from the Seven Emotions uniformly, without distinguishing which herb treats which Qi pattern. The following formulas are even more extreme, so they are not listed here. Moreover, the originating emotions vary. The Classics detailed the changes of the Nine Qi without omission, such as "Anger causes Qi to ascend." Their treatments include: suppress what is high, lift what is low, warm what is cold, cool what is hot, calm what is startled, tonify/warm what is labored, disperse what is knotted, conquer joy with fear, and conquer sorrow with joy. The treatments for the Nine Qi are distinct; how can they be mixed as Cold syndromes and treated uniformly with aromatic-hot herbs? Is this the way to manage Qi disorders? If aromatic, acrid, drying, and hot agents only temporarily force stagnant Qi to move quickly because Qi has been long suppressed, and if the formula does not aid in subduing the generated Qi, ingestion will intensify constrained Fire, steaming Qi fluids, forming accumulations, which grow into Phlegm. Once fluid enters below the diaphragm, Qi becomes misty; this is a clear and empty state, like fog and dew, which, though stagnant, easily dissipates. Internally accompanied by Phlegm accumulations, opening leads to re-knotting. Long-term use cannot result in excess Qi remaining static or moving Qi failing to disperse. These are errors people have suffered from; customs persist, transforming habits, ultimately unable to be saved. Excessive ascending and dispersing, aromatic herbs scatter Qi, dry-heat injures Qi, True Qi dissipates, turbid Qi ascends. They claim Kidney Deficiency fails to grasp Qi back to its origin, thus administering Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction), Si Mo Tang (Four-Mortar Decoction), Hei Xi Dan (Black Tin Pill), and Yang Qi Dan (Nourishing Qi Pill) to suppress ascending Qi. Yet Sulfur and Black Tin, aided by aromatic-hot substances, lack tonifying properties. Can these truly generate Qi and tonify the Kidney? Please consider carefully. Severe Damp-Phlegm might warrant such drugs. Initial use shows no worsening, and patients rejoice at the sinking effect, progressing further. How can frail constitutions be rescued? Failing to realize that Lung suffers from Fire flaming upward, its child organ (Large Intestine/Kidney relation context implies weakening of descending function) is weak, descending commands fail, Fire is unchecked, fanning each other, the root is empty, life hangs by a thread, accumulation deepens, Dan-Du (mineral drug toxicity) increases, until suddenly Fire Qi scatters wildly, panting rushes urgently, and death occurs. Alas! Using solid mineral pills to weigh down formless Qi—how can it withstand being forced down? It is like throwing a stone into water; the water does not sink, but the vessel sinks. Does this not lead to death? Zhu Danxi said: Ascending Qi emerges from the Liver, carrying Ministerial Fire, making heat severe. Feeling cold is not true cold. Extreme Fire resembles Water; excessive accumulated heat, hyperactive Yang, deficient Yin, thus this syndrome appears. Mistaking the false for the true, the disaster of similarity is incalculable. Although *Nei Jing* states all diseases arise from Qi, it is because Zheng Qi (Upright Qi) is affected by pathogens differently. Now, Seven Emotions injure Qi, causing stagnation, discomfort, fullness, obstruction, manifesting as various diseases. One must detail the cause, which meridian is stagnated, and differences in Zang-Fu Qi in upper/lower parts, prescribing according to meridians with variations in cold, heat, warm, and cool. For example, Zhi Qiao benefits Lung Qi but damages the highest Qi in the chest with long use; Qing Pi drains Liver Qi but damages True Qi with long use; Mu Xiang moves Qi in the middle and lower Jiao; Xiang Fu relieves Qi stagnation; Chen Pi drains rebellious Qi; Zi Su Ye disperses Exterior Qi; Hou Po drains Wei Qi; Bing Lang drains the highest Qi; Huo Xiang's fragrance ascends Stomach Qi; Chen Xiang regulates True Qi; Nao Bing (Camphor) and She Xiang (Musk) scatter True Qi. Among these, suitable for excess Qi patterns, some move and disperse, some drain and damage. Are they not excessive? Using them can address the branch of Qi disorders but not the root. How can one add drying-hot herbs to fuel fire with fire, mixing them as treatments for all Qi disorders for frequent/long-term use? Qi and Fire share one principle; the change between movement and stillness divides them into two. Treating Qi as Fire aligns with pathology. Danxi elaborated on this. Gao Yangsheng's erroneous theory that Cold generates Qi is flawed. Unless one contracts external Cold or consumes cold foods, claiming Cold is the cause applies to less than one or two percent.