侵邪,未经宣发,而漫用固表滋里,遂致邪热胶固,永不得解。凡此,能使假者成真,轻者变重,所宜深辨也。
心主血而藏神,肾主志而藏精。以先天生成之体论,则精生气,气生神。以后天运用之主宰论,则神役气,
气役精。精气神,养生家谓之三宝,治之原不相离。故于滑精梦泄种种精病者,必本于神治。于怔忡惊悸,种
种神病者,必本于气治。盖安精必益其气,益气必补其精。
虚劳初起,多由于心肾不交,或梦泄滑精,体倦骨痿,健忘怔忡,或心脾少血,肝胆动焰,上热下厥,种
种诸症,但未至伤肺,终成蒸热者,可用养心丸,或归脾丸主之。其养心丸内以石莲、肉桂交心肾于顷刻,归
脾丸以龙眼、木香甘温辛热之品直达心脾,主补中而生血。故凡火未至于乘金,补火亦是生土之妙用,而何虑
乎温热之不可从治也哉?若夫阴剧阳亢,木火乘时,心火肆炎上之令,相火举燎原之焰,肺失降下之权,肾鲜
长流之用,气高而喘,咳嗽频仍,天突火燃,喉中作痒,咯咽不能,嗽久失气,气不纳于丹田,真水无以制火,
于是湿挟热而痰滞中焦。火载血而厥逆清窍,伏火射其肺系,则能坐而不能卧。膈痰滞于胃络,则能左而不能
右。斯时,急宜清金补肺,以宣清肃之令;平肝缓火,以安君相之炎;培土调中,以奠生金之母;滋阴补肾,
遏阳光之焰。一以中和为治。补其虚,戢其焰,镇其泛,定其乱,解其争,制其过,润其燥,疏其淹,收其耗
散,庶有济也。若执补火之说,用辛热之品,与彼寒凉伤中者,异病而同治,岂不殆哉。
外邪入侵,若未能及时宣散透发,却盲目使用固护体表、滋腻补里的药物,就会导致邪热胶结牢固,永远无法解除。凡是这种情况,都能使原本虚假的病证变为真实难治,使轻症转为重症,对此应当深入辨别。
心主司血液并藏纳神志,肾主司意志并藏纳精气。从先天生成的形体结构来看,则是精产生气,气产生神。从后天生命活动的主宰功能来看,则是神役使气,气役使精。精、气、神,被养生家称为“三宝”,在治疗上原本是不可分离的。因此,对于滑精、梦遗等各种精液亏损的疾病,必须从调理神志入手治疗;对于心悸怔忡、惊恐不安等各种神志疾病的,必须从调理气机入手治疗。大概安定精气必须增益其气,增益气机必须补养其精。
虚劳病初起,多由于心肾不交,或者出现梦遗滑精、身体疲倦、骨骼痿弱、健忘心悸等症状,或者是心脾血少、肝胆火旺,表现为上部发热下部厥冷等各种症状,但尚未发展到损伤肺脏、最终形成骨蒸潮热的程度,可以使用养心丸,或者归脾丸来主治。其中养心丸内用石莲子、肉桂在顷刻之间交通心肾;归脾丸用龙眼肉、木香等甘温辛热的药物直达心脾,主要起到补益中气而生化血液的作用。所以凡是火势尚未至于克制肺金(乘金),补益命门之火也是生助脾土(补火生土)的巧妙运用,那还担心温热药不可顺从病情而治吗?如果是阴液极度亏虚而阳气亢盛,肝木与心火乘势发作,心火肆意向上炎升,相火像燎原大火一样燃烧,肺脏失去肃降的功能,肾脏缺乏源源不断的滋润作用,气息高促而喘息,咳嗽频繁不断,胸膈如火烧,喉咙发痒,吞咽困难,久咳导致失气,气不能收纳于丹田,真水(肾阴)无法制约火邪,于是湿气挟带热邪导致痰浊停滞在中焦。火邪载着血液上逆扰乱清窍,伏火射入肺系,则患者只能坐卧不能躺卧。膈间痰浊阻滞胃络,则患者能向左侧卧而不能向右侧卧。此时,急需清肃肺金以补益肺气,以宣发清肃的命令;平抑肝木缓和火势,以安定君火与相火的炎威;培补脾土调理中焦,以奠定生成肺金的母源;滋阴补肾,遏制阳光般的烈火。一概以“中和”作为治疗原则。补益其虚弱,收敛其火势,镇摄其浮越,安定其紊乱,解除其争斗,制约其过度,润燥止渴,疏通郁滞,收摄耗散之气,这样或许能有疗效。如果固执于“补火”的说法,使用辛热性质的药物,这与那些因寒凉药物损伤中气的情况,看似病不同却用同一种治法,难道不是危险吗?
If pathogenic factors invade and are not promptly dispersed, but instead astringent and cloying tonics for the exterior and interior are blindly used, it will result in the entrapment of pathogenic heat, which can never be resolved. Such situations can transform false conditions into true ones, and mild conditions into severe ones; therefore, deep discernment is required.
The Heart governs blood and houses the Shen (Spirit). The Kidney governs Zhi (Will) and stores Jing (Essence). From the perspective of the congenital physical structure, Jing generates Qi, and Qi generates Shen. From the perspective of postnatal functional mastery, Shen directs Qi, and Qi directs Jing. Jing, Qi, and Shen are referred to as the "Three Treasures" by health preservation experts; in treatment, they are originally inseparable. Therefore, for various diseases of Jing such as spermatorrhea and nocturnal emission, treatment must be based on regulating Shen. For various diseases of Shen such as palpitations and fright, treatment must be based on regulating Qi. Generally, to stabilize Jing, one must benefit Qi; to benefit Qi, one must tonify Jing.
In the early stage of Xu Lao (Deficiency Consumption), it often stems from the failure of communication between the Heart and Kidney, or presents with symptoms such as nocturnal emission, spermatorrhea, body fatigue, skeletal flaccidity, forgetfulness, and palpitations. It may also involve insufficient Blood in the Heart and Spleen, or hyperactive Fire in the Liver and Gallbladder, manifesting as upper heat and lower cold. As long as these conditions have not progressed to damaging the Lung and resulting in steaming bone fever (Zheng Re), Yang Xin Wan (Nourish the Heart Pill) or Gui Pi Wan (Restore the Spleen Pill) may be used as the primary treatment. Yang Xin Wan uses Nelumbinis Semen (Shi Lian Zi) and Cinnamomi Ramulus (Rou Gui) to facilitate communication between the Heart and Kidney instantly. Gui Pi Wan uses Longan Aril (Long Yan Rou) and Aucklandiae Radix (Mu Xiang), which are sweet, warm, acrid, and hot, to reach the Heart and Spleen directly, primarily benefiting the Middle Jiao and generating Blood. Thus, whenever Fire has not yet overacted upon Metal (Lung), tonifying Fire is also a subtle application of generating Earth (Spleen/Stomach); why worry about the inapplicability of treating according to the nature of the disease using warm and hot methods? However, if Yin is severely deficient while Yang is hyperactive, and Wood and Fire act according to their season, with Heart Fire blazing upward and Ministerial Fire spreading like a prairie fire, the Lung loses its descending authority, and the Kidney lacks its continuous nourishing function. This results in high-pitched breathing and wheezing, frequent coughing, burning sensations in the chest and throat, itching in the throat, difficulty swallowing, loss of Qi after prolonged coughing, inability to grasp Qi into the Dantian, and True Water (Kidney Yin) failing to control Fire. Consequently, dampness carries heat, causing Phlegm to stagnate in the Middle Jiao. Fire carries Blood upward, disturbing the clear orifices; latent Fire shoots into the Lung system, causing the patient to sit but not lie down. Phlegm stagnates in the Stomach collaterals, causing the patient to lie on the left side but not the right. At this time, urgent measures should include clearing Metal and tonifying the Lung to promote clear and descending functions; calming the Liver and moderating Fire to pacify the Emperor and Ministerial Fires; cultivating Earth and regulating the Middle to establish the mother source of Metal; and nourishing Yin and tonifying the Kidney to suppress the flames of sunlight. All treatments should adhere to the principle of "Harmony." Tonify deficiency, restrain flames, anchor floating Yang, stabilize chaos, resolve conflict, moderate excess, moisten dryness, unblock stagnation, and gather scattered Qi; only then might there be hope. If one adheres rigidly to the theory of "tonifying Fire" and uses acrid-hot substances, applying this same treatment to conditions caused by cold-cold damage to the Middle Jiao, though the diseases differ, is indeed dangerous.