治病当知标本。先受病为本,后传流之病为标。如先感轻病而后滋生重病,亦先治轻病
而后治重病,于是邪气乃伏,盖治其本故也。若先治本,虽病有十余症皆去矣,不先治本,
而治其标,邪气益甚,病势益重,不可去矣。若有中满,无问标本,先治中满,谓其急也。
若中满复有闭结,亦无论标本,当先治闭结,后治中满,谓尤急也。除闭结中满之外,皆先
治本,不可不慎也。假如肝受心火之邪,是从前来者为实邪,当泻其子火也。故经曰,本而
标之,先治其本。入肝经药为引,用泻心火药为君,是治实邪之病也。假如肝受肾邪,是从
后来者为虚邪,当补其母水也。故经曰,标而本之,先治其标。入肾经药为引,用补肝药为
君,是治虚邪之病也。
凡用其味,必用其味之可否。若用其气,必用其气之所宜。识其病之标本,及脏腑寒热
虚实微甚缓急,而用其药之气味,随其症而取方也。主治病者为君,佐君者为臣,应臣者为
使,此随病之所宜,而赞成方以用之。君一臣二,奇之制也。君二臣四,偶之制也。去咽嗌
之病近。近者奇之。去肝肾之病远,远者偶之。汗者不可以奇,下者不可以偶。补上治下制
以缓,缓则气味薄。补下治上制以急,急则气味浓。薄者则频而小服,浓者则暂而多服。
治病应当知晓标本关系。先感受的病邪为本,后传变产生的病证为标。例如,先感染轻浅的疾病而后滋生严重的疾病,也应当先治疗轻病,然后再治疗重病,这样邪气才能潜伏消退,这是因为治好了根本的缘故。如果先治疗根本,虽然病症有十余种都会随之消除;若不先治根本,反而去治疗标症,邪气会更加旺盛,病情更加严重,就无法治愈了。如果有中满(脘腹胀满)的症状,无论涉及标本,都应当先治疗中满,因为这是急症。如果中满又伴有闭结(二便不通),也无论涉及标本,都应当先治疗闭结,然后再治疗中满,因为这更为紧急。除了闭结和中满之外,其他情况都应当先治本,不可不谨慎。
假如肝脏受到心火之邪的侵袭,这是从“前”传来的,属于实邪,应当泻其子脏(心属肝之子,此处原文逻辑似有倒置或特指,按中医五行肝木生心火,泻子即泻心火,但通常实则泻其子,虚则补其母。原文说“肝受心火...当泻其子火”,心为肝之子,故泻心火符合“实则泻其子”原则,但语境是肝受邪,若心火亢盛反侮肝木或肝木生心火导致心火旺,需结合上下文。原文表述为:肝受心火之邪...当泻其子火。注:在五行相生中,肝木生心火,心为肝之子。若肝有病,实者泻其子,即泻心火。)。所以《内经》说:“本而标之”,先治其本。使用入肝经的药物作为引经药,用泻心火的药物作为君药,这是治疗实邪的方法。
假如肝脏受到肾邪的侵袭,这是从“后”传来的,属于虚邪,应当补其母脏(肾属肝之母,水生木,补肾水以养肝木,符合“虚则补其母”原则)。所以《内经》说:“标而本之”,先治其标。使用入肾经的药物作为引经药,用补肝的药物作为君药,这是治疗虚邪的方法。
凡是用药物的气味,必须依据药物气味的偏性是否适宜。如果使用药物的“气”(寒热温凉四气),必须符合病情的需要。认清疾病的标本,以及脏腑的寒热、虚实、轻重缓急,从而选择药物的气味,根据症状来组方。主治疾病的药物称为君药,辅助君药的药物称为臣药,配合臣药发挥作用的药物称为使药,这是根据病情适宜之处,来协助组成方剂并加以运用。君药一味、臣药两味,是奇方的制度。君药两味、臣药四味,是偶方的制度。治疗咽喉部位的疾病,病位较近,近者用奇方。治疗肝肾部位的疾病,病位较远,远者用偶方。发汗法不能用奇方,攻下法不能用偶方。补上焦或治疗下部疾病,制方宜缓和,缓和则药物气味轻薄。补下焦或治疗上部疾病,制方宜峻急,峻急则药物气味浓厚。气味薄的药物,应当少量多次服用;气味浓厚的药物,应当一次性多量服用。
In treating diseases, one must understand the concepts of Root (Ben) and Branch (Biao). The initial pathogenic factor contracted is the Root; the disease manifestations that transmit subsequently are the Branch. For instance, if a mild disease is contracted first and later gives rise to a severe disease, the mild disease should be treated first, followed by the severe disease, so that the pathogenic qi may subside. This is because treating the Root achieves this result. If the Root is treated first, although there may be more than ten symptoms, they will all disappear. However, if the Root is not treated first, but instead the Branch is treated, the pathogenic qi will become more intense, the condition will worsen, and it will become incurable. In cases of fullness in the middle jiao (abdominal distension), regardless of Root or Branch, the fullness in the middle jiao should be treated first, as it is an urgent condition. If abdominal distension is accompanied by constipation (obstruction of bowel movements and urination), regardless of Root or Branch, the constipation should be treated first, followed by the abdominal distension, as this is even more urgent. Apart from constipation and abdominal distension, the Root should always be treated first; this must not be neglected.
Suppose the Liver receives pathogenic heat-fire from the Heart. This transmission comes from "before" (in the sequence of generation, Wood generates Fire, so Heart is the Child of Liver), constituting an Excess Pathogen (Shi Xie). One should drain the Child organ's fire (Heart fire). Thus, the Classic states: "Root then Branch," treat the Root first. Use herbs entering the Liver Meridian as guiding agents, and use herbs draining Heart fire as the Sovereign (Jun) herb. This is the method for treating Excess Pathogens.
Suppose the Liver receives pathogenic factors from the Kidney. This transmission comes from "after" (Water generates Wood, so Kidney is the Mother of Liver), constituting a Deficient Pathogen (Xu Xie). One should tonify the Mother organ's water (Kidney water). Thus, the Classic states: "Branch then Root," treat the Branch first. Use herbs entering the Kidney Meridian as guiding agents, and use herbs tonifying the Liver as the Sovereign (Jun) herb. This is the method for treating Deficient Pathogens.
When using the flavors of herbs, one must consider whether their flavors are appropriate. When using the Qi (thermal nature: cold, hot, warm, cool) of herbs, one must ensure it suits the condition. By recognizing the Root and Branch of the disease, as well as the Cold-Heat, Deficiency-Excess, severity, and urgency of the Zang-Fu organs, one selects the Qi and Flavor of the herbs and formulates prescriptions according to the symptoms. The herb that primarily treats the disease is the Sovereign (Jun); those assisting the Sovereign are the Ministers (Chen); those responding to the Ministers are the Envoys (Shi). This follows the appropriateness of the disease to assist in composing the prescription. A formula with one Sovereign and two Ministers is a "Odd" (Qi) system. A formula with two Sovereigns and four Ministers is an "Even" (Ou) system. Diseases near the throat are considered "near"; near conditions use Odd formulas. Diseases in the Liver and Kidneys are considered "far"; far conditions use Even formulas. Diaphoretic methods (sweating) should not use Odd formulas; purgative methods should not use Even formulas. Tonifying the Upper Jiao or treating Lower Jiao diseases requires a slow/gradual formulation; slow formulations have light/thin Qi and Flavor. Tonifying the Lower Jiao or treating Upper Jiao diseases require a rapid/intense formulation; intense formulations have heavy/thick Qi and Flavor. Light/thin herbs should be taken frequently in small doses; heavy/thick herbs should be taken in large doses at once.