论虚劳
天师曰∶温治者,不可用寒凉,又不可用辛热,不得已
乃用温补之药,以中治之也。如人病虚劳,四肢无力,饮食少思,怔忡惊悸,失血之后,大汗之后
是也。此等各症,俱不可用偏寒偏热之药,必须温乎之品,少少与之,渐移默夺,庶几奏效。倘以偏师
出奇。必有后患。方用熟地五钱,白术五钱,茯苓五钱,白芥子五分,山药二钱,枸杞子一钱,当归
一钱,枣仁五分,麦冬一钱,神曲三分,芡实三钱,水煎服。此方去湿之药居多,使健脾利气,生血养
精,既无偏热之虞,又鲜偏寒之虑,中和纯正,久之可服,湿去则脾气自行,血足则精神自长,此温治之
所以妙也。
张公曰∶温治法妙,予亦有一方可存。熟地五钱,山药一钱,茯苓一钱,甘草一钱,女贞子一钱,
麦冬三钱,白芍三钱,当归二钱,菟丝子一钱,枣仁一钱,远志八分,山药一钱,陈皮三分,砂仁一粒,
覆盆子一钱,水煎服。此方不凉不热,补肾肝肺脾心之五脏,而无偏重之忧。可以温治者,幸留意于此方。
华君曰∶未传。
论脉燥
天师曰∶清治者,不可用凉药,又不可用温补,乃改用清平之剂,故曰清治。此等病,必是肺气之
燥。肺金之气一燥,即有意外之虞,若不急治,必变成肺痿、肺痈等症。盖燥极成火,自宜用凉药矣。此
不可凉药者何?肺居上流,用凉药以寒肺,或药不能遽入于肺中,势必趋于脾胃,肺之热未除,而胃口反成
虚寒之症,必致下泻,泻久而胃口无生气矣。胃既无生气,又何能生肺金而养肺气哉。故不若用清平
之味,平补胃口,而上清肺金之气之为得也。方用元参三钱,麦冬五钱,桔梗一钱,天门冬一钱,甘草
一钱,紫菀一钱,款冬花一钱,贝母一钱,苏子一钱,水煎服。(〔批〕清肺益气汤。)此方皆一派清平
之品,而专入肺金之妙剂也。久服胃既不寒,而肺金得养,又何肺痿、肺痈之生哉。故人久咳不已,即当
敬服此方,万勿惑于时师,而用偏寒之药也。
张公曰∶清治法,方最妙,予不能赞一词,不留方。
论虚劳
天师说:温治法,不能使用寒凉药物,也不能使用辛热药物,不得已才使用温补的药物,以中和之法来治疗。比如人患虚劳病,四肢无力,饮食减少且缺乏食欲,心悸怔忡、惊恐不安,这是在失血之后或大汗之后的情况。这些各种症状,都不可使用偏寒或偏热的药物,必须用温和性质的药品,少量给予,通过潜移默化的方式调理,这样才能奏效。如果像用奇兵一样使用偏激的药物,必定会有后患。方剂用熟地黄五钱,白术五钱,茯苓五钱,白芥子五分,山药二钱,枸杞子一钱,当归一钱,酸枣仁五分,麦冬一钱,神曲三分,芡实三钱,加水煎服。这个方剂中祛湿的药物居多,能使脾脏健运、气机通畅,生血养精,既没有偏热的担忧,也很少有偏寒的顾虑,药性中和纯正,长期服用可以见效,湿气去除则脾气自然运行,血液充足则精神自然增长,这就是温治法的妙处所在。
张公说:温治法很奇妙,我也有一首方剂可以留存。熟地黄五钱,山药一钱,茯苓一钱,甘草一钱,女贞子一钱,麦冬三钱,白芍三钱,当归二钱,菟丝子一钱,酸枣仁一钱,远志八分,山药一钱(注:原文重复出现山药,此处依原文列出),陈皮三分,砂仁一粒,覆盆子一钱,加水煎服。这个方剂不凉不热,补肾、肝、肺、脾、心五脏,而没有偏重某一方面的忧虑。可以用温治法治疗的,希望留意这个方剂。
华君说:未传授。
论脉燥
天师说:清治法,不能使用凉药,也不能使用温补药,于是改用清平之剂,所以称为清治。这类疾病,必然是肺气的干燥。肺金之气一旦干燥,就会有意外的危险,如果不紧急治疗,必然演变成肺痿、肺痈等症状。大概是因为燥极化成火,按理应该使用凉药了。为什么这里不能用凉药呢?肺位于上焦,如果用凉药使肺受寒,或者药物不能迅速进入肺部,势必会趋向于脾胃,肺部的热邪尚未清除,而胃口反而形成虚寒的症状,必然导致腹泻,腹泻久了胃口就没有生机了。胃既然没有生机,又怎么能生肺金并滋养肺气呢?所以不如使用清平的味道,平和地补益胃口,而上部清肃肺金之气,这才是得当的方法。方剂用玄参三钱,麦冬五钱,桔梗一钱,天门冬一钱,甘草一钱,紫菀一钱,款冬花一钱,贝母一钱,苏子一钱,加水煎服。(批注:清肺益气汤。)这个方剂都是一派清平的药物,是专门入肺金的妙剂。长期服用胃既不寒,而肺金得到滋养,又怎么会产生肺痿、肺痈呢?所以人久咳不止,就应当恭敬地服用此方,千万不要被当时的医生迷惑,而使用偏寒的药物。
On Consumption (Xu Lao)
The Heavenly Master said: In the method of warm treatment, cold and cooling medicines must not be used, nor should pungent and hot medicines be employed. Reluctantly, one must use warm-tonifying medicines to treat it with a neutralizing approach. For instance, when a person suffers from consumption (Xu Lao), characterized by weakness in the four limbs, reduced appetite and lack of desire for food, palpitations (Zhengchong), and frightful palpitations (Jingji), this occurs after hemorrhage or excessive sweating. For these various symptoms, neither偏-cold nor偏-hot medicines should be used. One must use medicines of a mild nature, administered in small amounts, allowing for gradual transformation and subtle absorption, so that efficacy may be achieved. If one were to use extreme measures like an unconventional army, there would inevitably be subsequent troubles. The prescription consists of Shudi (Rehmanniae Radix Preparata) 5 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 5 qian, Fuling (Poria) 5 qian, Baijiezi (Sinapis Semen) 5 fen, Shanyao (Dioscoreae Rhizoma) 2 qian, Gouqizi (Lycii Fructus) 1 qian, Danggui (Angelicae Sinensis Radix) 1 qian, Zaoren (Ziziphi Spinosae Semen) 5 fen, Maidong (Ophiopogonis Radix) 1 qian, Shenqu (Massa Medicata Fermentata) 3 fen, and Qianshi (Euryales Semen) 3 qian, decocted in water and taken orally. This prescription contains mostly damp-draining herbs, which strengthen the Spleen and promote Qi circulation, generate blood, and nourish essence. It avoids the risk of偏-heat and the concern of偏-cold; its nature is neutral, pure, and upright. It can be taken over a long period. When dampness is eliminated, Spleen Qi functions naturally; when blood is sufficient, spirit and vitality grow spontaneously. This is the subtlety of warm treatment.
Lord Zhang said: The method of warm treatment is wonderful. I also have a prescription to preserve. It consists of Shudi (Rehmanniae Radix Preparata) 5 qian, Shanyao (Dioscoreae Rhizoma) 1 qian, Fuling (Poria) 1 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian, Nüzhenzǐ (Ligustri Lucidi Fructus) 1 qian, Maidong (Ophiopogonis Radix) 3 qian, Baishao (Paeoniae Radix Alba) 3 qian, Danggui (Angelicae Sinensis Radix) 2 qian, Tuszizi (Cuscutae Semen) 1 qian, Zaoren (Ziziphi Spinosae Semen) 1 qian, Yuanzhi (Polygalae Radix) 8 fen, Shanyao (Dioscoreae Rhizoma) 1 qian, Chenpi (Citri Reticulatae Pericarpium) 3 fen, Sharen (Amomi Fructus) 1 grain, and Fupenzi (Rubiae Fructus) 1 qian, decocted in water and taken orally. This prescription is neither cold nor hot; it tonifies the Kidney, Liver, Lung, Spleen, and Heart (the five Zang organs) without the worry of偏-concentration on any single organ. For those who can undergo warm treatment, I hope you pay attention to this prescription.
Lord Hua said: Not transmitted.
On Pulse Dryness (Mai Zao)
The Heavenly Master said: In the method of clear treatment, cooling medicines must not be used, nor should warm-tonifying medicines be employed. Instead, one switches to clear-and-neutral agents, hence it is called clear treatment. Such diseases are necessarily due to dryness of Lung Qi. Once the Qi of Metal-Lung becomes dry, there is a risk of unexpected complications. If not treated urgently, it will inevitably transform into conditions such as Lung Atrophy Fei Wei (Fei Wei) or Lung Abscess Fei Yong (Fei Yong). Generally speaking, extreme dryness transforms into fire, so one ought to use cooling medicines. Why then can cooling medicines not be used here? The Lung resides in the Upper Jiao. If cooling medicines are used to chill the Lung, or if the medicine cannot quickly enter the Lung, it will inevitably tend toward the Stomach and Spleen. The heat in the Lung will not be cleared, while the Stomach's appetite area will instead develop deficiency-cold symptoms, inevitably leading to diarrhea. Prolonged diarrhea will deprive the Stomach of vital energy (Shengqi). Since the Stomach lacks vital energy, how can it generate Metal-Lung and nourish Lung Qi? Therefore, it is better to use flavors that are clear and neutral, to mildly tonify the Stomach's appetite area, and thereby clear the Qi of Metal-Lung above. This is the appropriate approach. The prescription consists of Xuanshen (Scrophulariae Radix) 3 qian, Maidong (Ophiopogonis Radix) 5 qian, Jiegeng (Platycodonis Radix) 1 qian, Tiandong (Asparagi Radix) 1 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian, Ziwan (Asternis Radix) 1 qian, Kuandonghua (Farfarae Flos) 1 qian, Beimu (Fritillariae Bulbus) 1 qian, and Suzi (Perillae Fructus) 1 qian, decocted in water and taken orally. (Commentary: Qingfei Yiqi Tang/Clear Lung and Boost Qi Decoction.) This prescription consists entirely of clear-and-neutral substances and is a miraculous agent specifically entering Metal-Lung. Long-term consumption ensures the Stomach remains unchilled, while Metal-Lung is nourished, thus preventing the occurrence of Lung Atrophy or Lung Abscess. Therefore, when a person suffers from chronic cough that does not cease, they should respectfully take this prescription. Do not be confused by contemporary physicians and use偏-cold medicines.
Lord Zhang said: The method of clear treatment and its prescriptions are most wonderful. I cannot add a word of comment, nor do I leave a prescription.