论亡阳 论下血 论吐血 论头汗 论手汗
天师曰∶敛治者，乃气将散而收敛之也。譬如人汗出不已，此亡阳而气欲散也。又如下血与吐血
不已，此血欲散而不能住者是也。气散仅存一线之阳，倘再令其奔越，则阳脱而死所不免也。然而治脱之
法，惟在敛其肺气，使皮毛腠理
固密，则阳从何散。第徒敛肺气，而不大补元阳，则元气仍然欲脱，即不脱出于皮毛腠理，必然脱出于
口鼻耳目，故必以补为敛之为得也。方用人参一两，黄 一两，当归一两，五味子一钱，山莱萸四
钱，桑叶五片，酸枣仁一钱，麦冬三钱，水煎服。此方之妙，全在用参、归以补气，用山萸、五味以敛
气，则补足以济敛之功，而敛足以滋补之益。况又有桑叶收汗之妙品，调停于敛之中，不偏于敛，亦不偏
于补也。
下血之症，多因好酒成病。用解酒之品，可以成功，而殊不尽然也，世医所用解酒之品，无过干葛、
桑白皮而已。然而干葛不可多服，而桑白皮又气味轻清，不可专任此二味，所以解酒而酒病终难去也。况
中酒之病，其来已素非一朝一夕之有，岂是轻清不可久服之药，可能治之乎？余故皆弃而不取。方用人
参二钱，当归一两，地榆三钱，生地五钱，三七根末三钱，水煎服。（〔批〕生新汤。三六亦能生血，不
止止血也。）此方之妙，全在不去治酒病，亦不去治血病，全以生地、当归活其血，血活则新血生而旧血
止；况又佐以地榆之寒，以去大肠之火；又佐以三七之末，以杜塞大肠之窍，自然血止而病愈也。此敛之
一法也。
更有吐血之症，或倾盆，或盈碗，若不急以收敛，则吐将安底。然而一味酸收寒遏，则血势更狂，
愈足以恣其崩腾之势。不若从其性，而少加以收敛之品，则火寝息而血归经。方用人参一两，当归一两，
酸枣仁三钱，三七根末三钱，水煎调服。此方之妙，不去止血，而惟固其气。盖血脱益气，实有奇功。血乃
有形之物，既已倾盆盈碗，尽情吐出，则一身之中，无血以养可知，自当急用生血补血之品，尤以为迟，
奈何反用补气之味，得无迂而寡效乎？谁知血乃有形之物，
气为无形之化，有形不能速生，而无形实能先得，况有形之物，必从无形中生之。气无形，始能生血
有形之物，补气正所以补血，生气正所以生血也。况血既尽情吐出，止存几希一线之气，若不急为补
之，一旦气绝，又何以生血而补血哉。经云∶有形之血，不能速生，无形之气，所当急固。真治血之妙
法。此又敛之之一法也。
张公曰∶真有不可思拟之妙，余无以赞一词矣，止语汝头汗出而敛之法。凡人头顶出汗，乃肾火有
余，而肾水不足，若不知其故，而徒用止汗之药，必致目昏而耳痛。法当滋其肾，而清肺金之化源，自易
奏功如响。方用桑叶一斤，熟地二斤，北五味三两，麦冬六两，各为末，蜜为丸。（〔批〕遏汗汤。）每日
白滚水送下五钱或一两，一月后，永不出汗矣。更有人每饭之时，头汗如雨落者，此又胃火胜，而非肾
火余也。法当用元参一斤，麦冬一斤，天冬一斤，生地一斤，北五味四两，酸枣仁半斤，各为末，蜜为
丸。（〔批〕敛汗汤）。每日白滚水送下一两，二月必愈。似乎胃火胜宜用竹叶石膏汤，而余偏不用者
何也？盖胃火之胜者，微胜耳，非若炽盛而火炎，奔腾而热发，不过因饮食之味，入于胃中，逐觉津津汗出，
饮食完而汗随止。然则以元参一味，解之有余矣，况又用天、麦二冬，以清肺火，生地以凉血，酸枣仁以
平心火，五味子以收汗而滋液，则胃经有火之盛，亦已消磨，况原未十分之盛乎。此敛法之一也。手中
之汗，细小病也，不必入于此中，以药水洗之即愈，俟后可入处，予当言之。
华君曰∶亦未传。
天师说：敛治法，是指气机即将涣散时采用收敛的方法。就像人出汗不止，这是亡阳而气机将要涣散的表现。又如下血和吐血不止，这是血液欲涣散而不能止住的情况。气机涣散仅存一线阳气，如果再让它奔逸耗散，那么阳气脱失而死是不可避免的。然而治疗脱证的方法，关键在于收敛肺气，使皮毛腠理（皮肤毛孔及肌肉纹理）固密，那么阳气从何处散失呢？只是单纯收敛肺气，而不大补元阳，那么元气仍然想要脱失，即使不从皮毛腠理脱失，也必然从口鼻耳目脱失，所以必须以补益作为收敛的手段才算得当。方剂用人参一两，黄芪一两，当归一两，五味子一钱，山茱萸四钱，桑叶五片，酸枣仁一钱，麦冬三钱，水煎服。这个方子的妙处，全在于用人参、当归来补气，用山茱萸、五味子来敛气，这样补益足以辅助收敛的功效，而收敛足以增加补益的益处。况且又有桑叶这味收汗的妙品，在收敛之中起到调和作用，不偏重于收敛，也不偏重于补益。
下血的病症，多因嗜酒成疾所致。使用解酒的药物，可以取得成效，但并非完全如此。世医所用的解酒药物，不过是干葛（葛根）、桑白皮罢了。然而干葛不可多服，而桑白皮气味又轻清，不能专门依赖这两味药，所以虽然解酒，但酒病终究难以去除。况且中酒之病，其由来已久，并非一朝一夕形成的，难道是用那些轻清且不可久服的药，就能治愈吗？所以我全都摒弃不用。方剂用人参二钱，当归一两，地榆三钱，生地五钱，三七根末三钱，水煎服。（批注：生新汤。此方不仅能止血，也能生血。）这个方子的妙处，全在于不去治疗酒病，也不直接去治疗血病，全靠生地、当归活血，血活则新血生成而旧血停止；况且又佐以地榆的寒性，以清除大肠之火；又佐以三七粉，以堵塞大肠的出血孔窍，自然血止而病愈。这是敛治法的一种。
更有吐血的病症，有的如倾盆大雨，有的盈满碗盏，如果不紧急收敛，那么吐血何时才能停止。然而如果一味使用酸涩收敛、寒凉遏制的药物，那么血势会更加猖狂，更助长其崩腾之势。不如顺从其本性，稍加一些收敛的药物，那么火势平息而血归经。方剂用人参一两，当归一两，酸枣仁三钱，三七根末三钱，水煎后调服。这个方子的妙处，不在于止血，而在于固护气机。因为“血脱益气”，确实有奇效。血是有形的物质，既然已经倾盆盈碗，尽情吐出，那么可知全身之中没有血来滋养，此时应当紧急使用生血补血的药物，甚至觉得都晚了，为何反而使用补气的药物，岂不是迂阔而效果寡淡吗？谁知血是有形的物质，气是无形的化生力量，有形之物不能快速生成，而无形的东西实在能先得到，况且有形之物，必须从无中生有。气无形，才能生出有形的血，补气正是为了补血，生气正是为了生血。况且血既然尽情吐出，仅存几希一线之气，如果不紧急补益它，一旦气绝，又靠什么来生血补血呢？《内经》说：“有形之血，不能速生，无形之气，所当急固。”这真是治疗血证的妙法。这又是敛治法的一种。
张公说：真有不思议的妙处，我无法再赞一词了，只告诉你头汗出而用敛治法。凡是人头顶部出汗，是肾火有余，而肾水不足，如果不知道其中的缘故，而只用止汗的药物，必然导致目昏而耳痛。治法应当滋补肾阴，而清肃肺金的化源，自然容易奏效如响。方剂用桑叶一斤，熟地黄二斤，北五味子三两，麦冬六两，各研为末，蜂蜜制成丸药。（批注：遏汗汤。）每日用白开水送服五钱或一两，一个月后，永远不再出汗了。又有人每次吃饭时，头汗如雨落下的，这是胃火胜，而不是肾火有余。治法应当用玄参一斤，麦冬一斤，天冬一斤，生地一斤，北五味子四两，酸枣仁半斤，各研为末，蜂蜜制成丸药。（批注：敛汗汤）。每日用白开水送服一两，两个月必定痊愈。似乎胃火胜宜用竹叶石膏汤，而我偏偏不用为什么呢？盖因胃火之胜，只是轻微胜邪，不像炽盛而火炎上，奔腾而热发，不过是因饮食的味道，进入胃中，逐渐觉得津津汗出，饮食完毕而汗随之停止。既然如此，那么单用玄参一味，化解它已绰绰有余，况且又用天冬、麦冬二冬，以清肺火，生地以凉血，酸枣仁以平心火，五味子以收汗而滋液，那么胃经有火的盛势，也已消磨，何况原本并未达到十分之盛呢。这是敛治法的一种。手上的汗，属于细小病症，不必列入此中，用药水洗之即可痊愈，以后可以在别处讨论，我将会说明。
华君说：也没有传授下来。
On Yang Collapse, On Lower Bleeding, On Hematemesis, On Cranial Hyperhidrosis, On Palmar Hyperhidrosis
The Heavenly Master said: The method of astringent treatment refers to the strategy of astringing when Qi is on the verge of dissipating. For instance, continuous sweating indicates Yang collapse and the impending dissipation of Qi. Similarly, unceasing lower bleeding (bleeding from the lower orifices) and hematemesis (vomiting blood) represent blood that is dispersing and cannot be stopped. When Qi dissipates, only a thread of Yang remains; if allowed to scatter further, Yang collapse and death are inevitable. However, the treatment for collapse primarily lies in astringing Lung Qi, thereby securing the skin pores and interstices (the spaces between skin and muscle), so that where would Yang dissipate? Merely astringing Lung Qi without significantly tonifying Yuan Yang (Primary Yang) means that Original Qi will still tend to collapse; even if it does not escape through the skin pores, it will inevitably escape through the mouth, nose, eyes, and ears. Therefore, one must employ tonification as the means of astringency to achieve success. The prescription consists of Ren Shen (Ginseng Radix et Rhizoma) 1 liang, Huang Qi (Astragali Radix) 1 liang, Dang Gui (Angelicae Sinensis Radix) 1 liang, Wu Wei Zi (Schisandrae Chinensis Fructus) 1 qian, Shan Zhu Yu (Corni Fructus) 4 qian, Sang Ye (Mori Folium) 5 leaves, Suan Zao Ren (Ziziphi Spinosae Semen) 1 qian, and Mai Dong (Ophiopogonis Radix) 3 qian. Decoct with water and take orally. The efficacy of this formula lies entirely in using Ren Shen and Dang Gui to tonify Qi, and Shan Zhu Yu and Wu Wei Zi to astringe Qi. Thus, tonification aids the effect of astringency, and astringency enhances the benefit of tonification. Moreover, Sang Ye is a superb herb for arresting sweating, which mediates within the astringent action, avoiding bias towards either pure astringency or pure tonification.
Lower bleeding often arises from chronic alcohol abuse. While using herbs to resolve alcohol toxicity can be effective, it is not always sufficient. Physicians of the world typically use only Ge Gen (Puerariae Lobatae Radix) and Sang Bai Pi (Mori Cortex) for this purpose. However, Ge Gen should not be taken in large doses, and Sang Bai Pi has a light and clear nature, making it unsuitable as the sole agent. Consequently, although alcohol may be resolved, the underlying alcohol-induced pathology remains difficult to eradicate. Furthermore, alcohol-induced disease develops over a long period, not overnight; how could light and clear herbs, which are not suitable for prolonged use, cure such a condition? Therefore, I discard them. The prescription uses Ren Shen 2 qian, Dang Gui 1 liang, Di Yu (Sanguisorbae Radix) 3 qian, Sheng Di Huang (Rehmanniae Radix) 5 qian, and San Qi (Notoginseng Radix et Rhizoma powder) 3 qian. Decoct with water and take orally. [Commentary: Sheng Xin Tang (Generate New Blood Decoction). This formula generates blood, not merely stops bleeding.] The brilliance of this formula lies in neither treating the alcohol pathology nor directly stopping the bleeding. Instead, it relies on Sheng Di Huang and Dang Gui to invigorate blood; once blood circulation is restored, new blood is generated and old bleeding ceases. Additionally, Di Yu’s cold nature clears Fire in the Large Intestine, and San Qi powder seals the bleeding orifices in the Large Intestine, naturally stopping the bleeding and curing the disease. This is one method of astringent treatment.
Regarding hematemesis, whether profuse like an overturned basin or filling a bowl, if astringency is not applied urgently, when will the vomiting cease? However, using solely sour-astringent and cold-restrictive herbs may exacerbate the blood pathogen, further encouraging its violent eruption. It is better to follow its nature and add a small amount of astringent herbs, allowing the Fire to subside and blood to return to its vessels. The prescription consists of Ren Shen 1 liang, Dang Gui 1 liang, Suan Zao Ren 3 qian, and San Qi powder 3 qian. Decoct with water and take orally after mixing. The efficacy of this formula lies not in stopping bleeding but in consolidating Qi. "When blood is lost, tonify Qi" yields miraculous results. Blood is a tangible substance; having been vomited out in abundance, the body lacks blood for nourishment. One might think urgent use of blood-generating herbs is necessary, yet delaying them is already too late. Why then use Qi-tonifying agents, which seem ineffective? In truth, blood is tangible, while Qi is intangible transformation. Tangible substances cannot be generated quickly, whereas intangible Qi can be secured first. Moreover, tangible things must arise from the intangible. Only intangible Qi can generate tangible blood; tonifying Qi is precisely to tonify blood, generating Qi is precisely to generate blood. Since blood has been largely lost, only a trace of Qi remains. If this Qi is not urgently supplemented, once Qi perishes, what will generate and supplement blood? As the Classic states: "Tangible blood cannot be rapidly regenerated; intangible Qi must be urgently consolidated." This is indeed a subtle method for treating blood disorders. This is another method of astringent treatment.
Master Zhang said: Truly, there are wonders beyond imagination; I have no words to add. I will only explain the astringent method for cranial hyperhidrosis. Sweating exclusively on the crown of the head indicates excess Kidney Fire and deficiency of Kidney Water. Ignoring this cause and merely using antihidrotic herbs will inevitably lead to blurred vision and ear pain. The treatment should nourish the Kidneys and clear the source of transformation of Lung Metal, ensuring rapid efficacy. The prescription uses Sang Ye 1 jin, Shu Di Huang (Prepared Rehmanniae Radix) 2 jin, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 3 liang, and Mai Dong 6 liang. Grind each into powder and form pills with honey. [Commentary: E Han Tang (Arrest Sweat Decoction).] Take 5 qian or 1 liang daily with plain boiled water. After one month, sweating will cease permanently. Another case involves patients who sweat profusely on the head during meals; this is due to Stomach Fire excess, not Kidney Fire excess. The treatment should use Xuan Shen (Scrophulariae Radix) 1 jin, Mai Dong 1 jin, Tian Dong (Asparagi Radix) 1 jin, Sheng Di Huang 1 jin, Bei Wu Wei Zi 4 liang, and Suan Zao Ren 0.5 jin. Grind into powder and form honey pills. [Commentary: Lian Han Tang (Astringe Sweat Decoction).] Take 1 liang daily with plain boiled water; recovery is expected within two months. One might ask why Ye Zhu Gao Shi Tang (Bamboo Leaf and Gypsum Decoction) is not used for Stomach Fire excess. The reason is that the Stomach Fire here is mild, not blazing or turbulent, but rather triggered by food entering the stomach, causing slight perspiration that stops when eating ends. Thus, Xuan Shen alone is sufficient to resolve it. Furthermore, Tian Dong and Mai Dong clear Lung Fire, Sheng Di Huang cools blood, Suan Zao Ren calms Heart Fire, and Wu Wei Zi arrests sweating and nourishes fluids. These actions dissipate the Stomach Fire, especially since it was never severe. This is another method of astringent treatment. Palmar hyperhidrosis is a minor ailment and need not be included here; washing with medicinal herbs suffices for cure. I will discuss this later.
Master Hua said: It has not been transmitted.