仲景云。凡作汤药。不可避晨夜。觉病须臾即宜便治。不等早晚。则易愈矣。如或差迟。病即传变。
虽欲除治。必难为力。今之医者不究根源。执以死法。必汗之于四日之前。必下之于四日之后。
殊不知此大纲也。又云。甚者。病不服药。犹得中医。此为无医处而设也。苟大小便不通。可待其自
瘥乎。盖前后不得溲。必腹胀。不过数日而死矣。又况结胸瘀血。发狂发黄发斑之类。未有勿药而喜者。
智者知变。愚者执一。所以取祸也。须是随病浅深。在表在里。早为治疗。如救火拯溺。庶易瘥也。
素问云。邪风之至。疾如风雨。故善治者治皮毛。其次治肌肤。其次治筋脉。其次治六腑。其次治五脏。治
五脏者半死半生也。扁鹊望齐桓侯而走者。其以此欤。
仲景云。假令寸口脉微。名曰阳不足。阴气上入阳中。则洒淅恶寒也。尺脉弱。名曰阴不足。阳气下陷
入阴中。则发热也。此谓元受病而然也。又云。阳微则恶寒。阴弱则发热。此医发其汗。使阳气微。又大
下之。令阴气弱。此谓医所病而然也。大抵阴不足。阳往从之。故阳内陷则发热。阳不足。阴往乘之。故阴
上入阳中。则恶寒。阴阳不归其分。故寒热交争。是以发热而恶寒也。故孙思邈云。有热不可大攻之。热去
则寒至矣。
Zhang Zhongjing stated: When preparing decoctions, one must not avoid morning or night. As soon as a disease is perceived, treatment should be initiated immediately without waiting for specific times of day or night; thus, recovery will be easier. If treatment is delayed, the disease will progress and transform. Although one may wish to eliminate the pathogen, it will be difficult to succeed. Physicians today often fail to investigate the root cause, adhering rigidly to fixed rules, insisting on applying sweating methods before the fourth day of illness and purging methods after the fourth day. They fail to understand that these are merely general principles.
Furthermore, it is said: In severe cases, taking no medicine is better than receiving mediocre medical care. This statement is set for situations where competent physicians are unavailable. If there is an inability to urinate or defecate, can one wait for spontaneous recovery? Generally, if both upper and lower orifices fail to excrete urine and stool, abdominal distension will inevitably occur, leading to death within a few days. Moreover, in conditions such as chest binding (Jie Xiong), blood stasis, mania, jaundice, and macules, there is no case of recovery without medication. The wise know how to adapt, while the foolish remain rigid, thereby inviting disaster. Treatment must be undertaken early according to the depth of the disease and whether it is in the exterior or interior, like rescuing someone from fire or drowning, so that recovery may be achieved.
The *Suwen* states: When evil wind arrives, its speed is like wind and rain. Therefore, skilled physicians treat at the level of the skin and hair; next, they treat the muscles and skin; next, the sinews and vessels; next, the Six Fu Organs; and finally, the Zang Organs. Those treated at the level of the Zang Organs have a fifty-fifty chance of survival. The reason Bian Que fled upon seeing Duke Huan of Qi was likely due to this principle.
Zhang Zhongjing stated: For instance, if the Cun Kou pulse is faint, it is called Yang insufficiency. When Yin qi enters the Yang region, it causes chills and shivering (Sa Xi). If the Chi pulse is weak, it is called Yin insufficiency. When Yang qi sinks into the Yin region, it causes fever. This refers to the condition arising from the initial pathology.
He also stated: Faint Yang leads to aversion to cold, while weak Yin leads to fever. This refers to conditions caused by physicians inducing sweating, which makes Yang faint, and then administering harsh purgatives, which weakens Yin. This denotes disease resulting from iatrogenic error. Generally, when Yin is insufficient, Yang tends to follow it; thus, when Yang sinks inward, fever occurs. When Yang is insufficient, Yin takes advantage of it; thus, when Yin enters the Yang region, aversion to cold occurs. Because Yin and Yang do not remain in their proper positions, cold and heat contend with each other, resulting in fever accompanied by aversion to cold. Therefore, Sun Simiao said: In cases of heat, one must not attack vigorously; once the heat is eliminated, cold will arrive.