论伤风初治 论伤寒初治 论伤食初治 论伤暑初治 论伤湿初治 论燥病初治 论火病初治
天师曰∶初治者，首先宜以此治之也。初病伤风，即以伤风治之；初病伤寒，即以伤寒治之；初病
伤食，即以伤食治之也。凡人病初起之时，用药原易奏功。无如人看不清，用药错乱，往往变症蜂起。苟认
得清，用得当，又何变症之生耶。如伤风之症必然头痛身疼，咳嗽痰多，切其脉必浮，此伤风也。即以防
风一钱，荆芥一钱，柴胡一钱，甘草一钱。黄芩一钱，半夏一钱，水煎服。（〔批〕逐风散。）一剂即止，
不再剂也。
伤寒之初起也，鼻塞目痛，项强头亦痛，然切其脉必浮紧，此伤寒也。若以伤寒治之即愈。方用桂枝
一钱，甘草一钱，陈皮一钱，干葛一钱，水煎服。（〔批〕荡寒汤，）一剂即愈。
伤食之症，心中饱闷，见食则恶，食之转痛，此伤食也，即以消食药服之立已。方用白术一钱，茯
苓一钱，枳壳一钱。山楂二十粒，麦芽二钱，谷芽二钱，神曲三分，半夏一钱，甘草五分，砂仁三粒，水
煎服。（〔批〕食食散。）一剂快，二剂愈。此初治之法，人易知之不能知，即知而不肯用，行医者无
轻易此初治法也。
张公曰∶又不必言。甚矣，圣人之言入也，三方而初症定之矣。初病伤暑，必然头晕、口渴、恶热，甚
则身热、痰多、气喘是也。方用青蒿一两，香薷三钱，白术五钱，陈皮一钱，甘草一钱，茯苓三钱，有参
加一钱，无亦可。（〔批〕青香散。）一剂即愈。
伤湿初起之时，必然恶湿身重，足肿，小便短赤。方用白术三钱，泽泻三钱，猪苓三钱；肉桂五分，
茯苓五钱，柴胡一钱，车前子一钱，半夏一钱，水煎服。（〔批〕引水散。）一剂立愈，二剂脱然。
燥病初起，咽干口燥、嗽不已、痰不能吐、面目红色、不畏风吹者是也。方用麦冬五钱，桔梗三钱，
甘草一钱，天花粉一钱，陈皮三分，元参五钱，百部八分，水煎服。（〔批〕宁肺汤。）一剂燥立止，二剂
嗽止，三剂全愈。
火症初起，必大渴引饮，身有斑点，或身热如焚，或发狂乱语。方急用石膏三钱，元参一两，麦冬
三两，甘草三钱，升麻三钱，知母三钱，半夏三钱，竹叶百片。（〔批〕平乱汤。）一剂少止，二剂即安，
三剂全愈，不可四剂也。若初起之时，大势少衰，减半与之，乘其火势初起，胃气未衰，急用此汤以
遏之，则火自然骤灭而不为害矣。方即竹叶石膏汤，妙在加入元参。麦冬数两，使石膏不为主帅，而反
为偏裨，听麦冬、
元参之差遣，则止去火而不损肾中之阴。又妙加入升麻，引其外出而不能入，止祛火而不损肾水，所以
更奏功如神也。倘疑升麻太多而少减之，则转不奏功之捷。予所以又戒世人之不知用升麻者。
华君曰∶余未传。
（暑症未有不兼湿者，故方中多用术苓，李子永识。）
论伤风初治 论伤寒初治 论伤食初治 论伤暑初治 论伤湿初治 论燥病初治 论火病初治
天师说：所谓“初治”，是指在疾病初期应当首先采用的治疗方法。刚患病时如果是伤风，就用治疗伤风的方法；刚患病时如果是伤寒（外感寒邪），就用治疗伤寒的方法；刚患病时如果是伤食（饮食积滞），就用治疗伤食的方法。凡是人在疾病初起的时候，用药原本容易见效。无奈人们看不清病情，用药错乱，往往导致各种变证蜂拥而起。如果能认清病情，用药得当，又怎么会生出变证呢？比如伤风的症状必然包括头痛身疼、咳嗽痰多，切脉必然见浮脉，这是伤风。立即使用防风一钱，荆芥一钱，柴胡一钱，甘草一钱，黄芩一钱，半夏一钱，水煎服。（批注：逐风散。）服用一剂即可停止，不再服用第二剂。
伤寒初起时，鼻塞目痛，项背强直且头部疼痛，然而切脉必然见浮紧脉，这是伤寒。如果用治疗伤寒的方法，就会痊愈。方剂用桂枝一钱，甘草一钱，陈皮一钱，干葛（葛根）一钱，水煎服。（批注：荡寒汤，）服用一剂即愈。
伤食的症状，心中饱闷，看见食物就厌恶，吃了之后反而更痛，这是伤食，立即服用消食药就能立刻好转。方剂用白术一钱，茯苓一钱，枳壳一钱，山楂二十粒，麦芽二钱，谷芽二钱，神曲三分，半夏一钱，甘草五分，砂仁三粒，水煎服。（批注：食食散。）服用一剂感觉舒畅，两剂痊愈。这是初治的方法，人们容易知道却不去知晓，即使知道了也不肯使用，行医的人不要轻易轻视这种初治法啊。
张公说：也不必多言。圣人的话真是深入人心啊，这三个方子就把初症定下来了。刚患病时如果是伤暑，必然头晕、口渴、怕热，严重时身体发热、痰多、气喘。方剂用青蒿一两，香薷三钱，白术五钱，陈皮一钱，甘草一钱，茯苓三钱，如果有参加入一钱，没有也可以。（批注：青香散。）服用一剂即愈。
伤湿初起之时，必然恶湿身重，足部肿胀，小便短赤。方剂用白术三钱，泽泻三钱，猪苓三钱，肉桂五分，茯苓五钱，柴胡一钱，车前子一钱，半夏一钱，水煎服。（批注：引水散。）服用一剂立刻痊愈，两剂后彻底摆脱病痛。
燥病初起，咽喉干燥、口舌燥渴、咳嗽不止、痰无法咳出、面目发红、不怕风吹的，就是这种情况。方剂用麦冬五钱，桔梗三钱，甘草一钱，天花粉一钱，陈皮三分，元参五钱，百部八分，水煎服。（批注：宁肺汤。）服用一剂燥象立刻停止，两剂咳嗽停止，三剂完全痊愈。
火症初起，必然大渴引饮，身上有斑点，或者身体热得像燃烧一样，或者发狂胡言乱语。此时紧急使用石膏三钱，元参一两，麦冬三两，甘草三钱，升麻三钱，知母三钱，半夏三钱，竹叶一百片。（批注：平乱汤。）服用一剂稍止，两剂即安，三剂全愈，不可服用第四剂。如果在初起之时，大势稍微衰退，减半剂量给予，趁着火势初起，胃气尚未衰弱，紧急使用此汤来遏制它，那么火自然会骤然熄灭而不为害了。这个方子就是竹叶石膏汤，妙处在于加入了元参、麦冬数两，使得石膏不充当主帅，反而成为偏将，听从麦冬、元参的差遣，这样只去除火邪而不损伤肾中的阴液。又妙在加入升麻，引导火邪外出而不能入内，只祛除火邪而不损伤肾水，所以更能奏效如神。如果怀疑升麻太多而减少它的用量，反而不能迅速奏效。我因此又告诫世人不要不知道使用升麻。
华君说：我没有传授过（这个观点）。
On the Initial Treatment of Wind Injury, Cold Injury, Food Stagnation, Summerheat Injury, Dampness Injury, Dryness Disease, and Fire Disease
The Heavenly Master said: "Initial treatment" refers to the method that should be employed first at the onset of the disease. If one contracts wind injury (Wind Pathogen) initially, treat it as wind injury; if one contracts cold injury (Cold Pathogen) initially, treat it as cold injury; if one suffers from food stagnation initially, treat it as food stagnation. When a person is in the early stage of illness, medication can originally achieve results easily. However, people fail to discern the condition clearly and use medications chaotically, often resulting in a swarm of complicated symptoms. If the condition is recognized clearly and the medication is applied appropriately, how could complicated symptoms arise? For instance, the symptoms of wind injury inevitably include headache and body ache, cough with profuse phlegm, and the pulse must be floating (Superficial Pulse), which indicates wind injury. Immediately use Fangfeng (Saposhnikovia Root) 1 qian, Jingjie (Schizonepeta Herb) 1 qian, Chaihu (Bupleurum Root) 1 qian, Gancao (Licorice Root) 1 qian, Huangqin (Scutellaria Root) 1 qian, Banxia (Pinellia Tuber) 1 qian, decocted in water and taken orally. (Annotation: Zhufeng San/Wind-Expelling Powder.) Stop after one dose; do not take a second dose.
At the initial stage of cold injury, there is nasal congestion, eye pain, stiffness of the neck, and headache. However, the pulse must be floating and tight (Floating-Tight Pulse), indicating cold injury. If treated according to the principles for cold injury, it will heal. The formula uses Guizhi (Cinnamon Twig) 1 qian, Gancao (Licorice Root) 1 qian, Chenpi (Tangerine Peel) 1 qian, Gange (Kudzu Root) 1 qian, decocted in water and taken orally. (Annotation: Danghan Tang/Cold-Scouring Decoction,) it heals after one dose.
The symptoms of food stagnation include fullness and oppression in the heart/chest area, aversion to seeing food, and increased pain upon eating, which indicates food stagnation. Taking food-digesting medicines will lead to immediate improvement. The formula uses Baizhu (Atractylodes Macrocephala Rhizome) 1 qian, Fuling (Poria) 1 qian, Zhike (Aurantii Fructus Immaturus) 1 qian, Shanzha (Hawthorn Fruit) 20 grains, Maiya (Hordeum Germinatum) 2 qian, Guya (Oryza Germen) 2 qian, Shenqu (Medicated Leaven) 3 fen, Banxia (Pinellia Tuber) 1 qian, Gancao (Licorice Root) 5 fen, Sharen (Amomum Fruit) 3 grains, decocted in water and taken orally. (Annotation: Shishi San/Food-Digesting Powder.) One dose brings relief, two doses cure it. This is the method of initial treatment. People find it easy to know but difficult to truly understand; even if they know it, they are unwilling to use it. Practitioners should not lightly disregard this method of initial treatment.
Master Zhang said: There is no need to say more. The words of the Sages indeed penetrate deeply; these three formulas have defined the initial symptoms. At the initial stage of summerheat injury, there is inevitably dizziness, thirst, and aversion to heat. In severe cases, there is fever, profuse phlegm, and panting. The formula uses Qinghao (Artemisia Annua Herb) 1 liang, Xiangru (Mosla Herb) 3 qian, Baizhu (Atractylodes Macrocephala Rhizome) 5 qian, Chenpi (Tangerine Peel) 1 qian, Gancao (Licorice Root) 1 qian, Fuling (Poria) 3 qian. If Renshen (Ginseng Root) is added, use 1 qian; without it is also acceptable. (Annotation: Qingxiang San/Green-Fragrant Powder.) It heals after one dose.
At the initial stage of dampness injury, there is inevitably aversion to dampness, heaviness of the body, swelling of the feet, and short, red urine. The formula uses Baizhu (Atractylodes Macrocephala Rhizome) 3 qian, Zexie (Alisma Rhizome) 3 qian, Zhuling (Polyporus) 3 qian, Rougui (Cinnamon Bark) 5 fen, Fuling (Poria) 5 qian, Chaihu (Bupleurum Root) 1 qian, Cheqianzi (Plantago Seed) 1 qian, Banxia (Pinellia Tuber) 1 qian, decocted in water and taken orally. (Annotation: Yinshui San/Water-Guiding Powder.) It heals immediately after one dose and completely resolves after two doses.
At the initial stage of dryness disease, there is dry throat and mouth, incessant cough, inability to expectorate phlegm, red face and eyes, and lack of aversion to wind blowing. The formula uses Maidong (Ophiopogon Tuber) 5 qian, Jiegeng (Platycodon Root) 3 qian, Gancao (Licorice Root) 1 qian, Tianhuafen (Trichosanthes Root) 1 qian, Chenpi (Tangerine Peel) 3 fen, Yuanshen (Scrophularia Root) 5 qian, Bubu (Stemona Root) 8 fen, decocted in water and taken orally. (Annotation: Ningfei Tang/Lung-Calming Decoction.) Dryness stops immediately after one dose, cough stops after two doses, and full recovery occurs after three doses.
At the initial stage of fire disease, there is extreme thirst with desire to drink, spots on the body, or body heat like burning, or mania and delirious speech. Urgently use Shigao (Gypsum Fibrosum) 3 qian, Yuanshen (Scrophularia Root) 1 liang, Maidong (Ophiopogon Tuber) 3 liang, Gancao (Licorice Root) 3 qian, Shengma (Cimicifuga Rhizome) 3 qian, Zhimu (Anemarrhena Rhizome) 3 qian, Banxia (Pinellia Tuber) 3 qian, Zhu Ye (Bamboo Leaf) 100 pieces. (Annotation: Pingluan Tang/Chaos-Pacifying Decoction.) Symptoms subside slightly after one dose, stabilize after two doses, and fully recover after three doses; do not take a fourth dose. If at the initial stage the major symptoms have slightly subsided, reduce the dosage by half. Take advantage of the fact that the fire pathogen is just rising and the Stomach Qi has not yet declined; urgently use this decoction to suppress it, and the fire will naturally extinguish suddenly without causing harm. This formula is essentially Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Its brilliance lies in adding large amounts of Yuanshen (Scrophularia Root) and Maidong (Ophiopogon Tuber), so that Shigao (Gypsum Fibrosum) does not act as the commander but rather as a subordinate, obeying the directives of Maidong and Yuanshen. Thus, it eliminates fire without damaging the Yin fluid in the Kidney. Another brilliance is the addition of Shengma (Cimicifuga Rhizome), which guides the pathogen outward and prevents it from entering, removing fire without damaging Kidney Water. Therefore, it achieves miraculous efficacy. If one suspects that Shengma (Cimicifuga Rhizome) is too much and reduces its amount, the rapid efficacy will be lost. I therefore warn people against failing to use Shengma (Cimicifuga Rhizome).
Master Hua said: I have not transmitted this.
(Note: Summerheat syndromes invariably involve dampness, hence the formula uses many Baizhu (Atractylodes Macrocephala Rhizome) and Fuling (Poria). Recorded by Li Ziyong.)