热用者，如大热在中，以寒攻治则不入，以热攻治则病增，乃以寒药热服，入腹之后，热气既消，寒性遂行，
情且协和而病以减，此“寒因热用”之法也。治热以寒，温而行之，治寒以热，凉而行之，亦寒因热用，热因
寒用之义。塞因塞用者，如下气虚乏，中焦气壅，欲散满则更虚其下，欲补下则满甚于中，治不知本而先攻
其满，药入或减，药过依然，气必更虚，病必渐甚，乃不知少服则资壅，多服则宣通，峻补其下，以疏启其中，
则下虚自实，中满自除，此“塞因塞用”之法也。通因通用者，如大热内蓄，或大寒内凝，积聚留滞，泻利
不止，寒滞者以热下之，热滞者以寒下之，此“通因通用”之法也。以上四治，必伏其所主者，制病之本也；
先其所因者，求病之由也。既得其本，而以真治真，以假治假，其始也类治似
同，其终也病变则异矣。是为反治之法。故可使破积、溃坚、气和而病必
已也。）逆之从之，逆而从之，从而逆之，疏气令调，则其道也。（气调而得者。言气本调和而偶感于病，则
或因天时，或因意料之外者也。其治法亦无过逆从而已，或可逆者，或可从者，或先逆而后从者，
或先从而后逆者，但疏其邪气而使之调和，则治道尽矣。）方制有君臣，主病之谓君，佐君之谓臣，应臣之
谓使，非上下三品之谓，所以明善恶之殊贯也。（主病者，对证之要药也，故谓之君。君者，
味数少而分两重，赖之以为主也。佐君者谓之臣，味数稍多而分两稍轻，所以匡君之不逮也。应臣者谓之使，
数可出入而分两更轻，所以备通行向导之使也。此则君臣佐使之义，非上下三品如善恶殊贯之谓也。处方之
制，有君臣佐使。三品，言药性善恶，故有上、中、下之殊。上药为君，主养命以应天；中药为臣，主养性
以应人；下药为佐使，主治病以应地。所谓“善恶之殊贯”也。）病有中外，从内之外者，调其内，从外之
内者，治其外。（从内之外者，内为本；从外之内者，外为本。但治其本，无不愈矣。）从内之外而盛于
外者，先调其内，而后治其外；从外之内而盛于内者，先治其外而后调其内。（病虽盛于标，治
必先其本而后可愈，此治病之大法也。）中外不相及，则治主病。中外不相及，谓既不从内，又不从外，
则但求其见在所主之病而治之，此即“三因”之义也。千般 难，不越三条∶一者经络受邪入脏腑，为内所因
也；二者四肢九窍，血脉相传，壅塞不通，为外皮肤所中也；三者房室、金刃、虫兽所伤也。故《三因方》
有内因、外因、不内外因，盖本诸此耳。 ，昌震切，病也。调气之方，必别阴阳；定其中外，各守其乡。
内者内治，外者外治，微者调之，其次平之，盛者夺之，汗之下之，寒热温凉，衰之以属，随其攸利。（方，
法也。阴阳之道，凡病治脉药，皆有关系，故必当详别之。中外，表里也。微者调之，
谓小寒之气，和之以温，小热之气，和之以凉也。其次平之，谓大寒之气，
平之以热，大热之气，平之以寒也。盛者夺之，谓邪之甚者，当直攻而取
之，如甚于外者汗之，甚于内者下之。凡宜寒宜热，宜温宜凉，当各求其属以衰去之，惟随其攸利而已。
攸，所也。）病在中而不实不坚，且聚且散，无积者，求其脏虚则补之，药以祛之，食以随之，
行水渍之，和其中外，可使毕已。（积者，有形之病。有积在中，则坚实不散矣。今其不实不坚，且聚且
散者，无积可知也。无积而病在中者，脏之虚也，故当随病所在，求其脏而补之。药以祛之，去其病也。食
以随之，养其气也。行水渍之，通其经也。若是则中外和调而病可已矣。祛者，非攻击之谓，凡去病者皆
可言“祛”。渍，资四切，浸洗也。）治寒以热，治热以寒，绳墨也。有病热者寒之而热，有病寒者热
之而寒，二者皆在新病复起，是治王气，所以反也。（病有阴阳，气有衰王。不明衰王，则治之反盛。如阳
盛阴衰者，阴虚火王也，治之者不知补阴以配阳，专用苦寒，是治火之王也；阳衰阴盛者，气弱生寒
也，治之者不知补阳以配阴，专用辛温，是治阴之王也。如夏令本热，而伏阴在内，每多中寒；冬令本寒，
而伏阳在内，每多内热。设不知此，而必欲用寒于夏，治火之王，用热于冬，治寒之王，则有中寒隔阳者，服寒
反热，中热隔阴者，服热反寒矣。是皆治王之谓而病之所以反也。春、秋同法。）而不知诸寒之而热者，
取之阴，热之而寒者，取之阳，所谓求其属也。（诸寒之而热者，谓以苦寒治热而热反增，非火之有余，
乃真阴之不足也。阴不足则阳有余而为热，故当取之于阴，不宜治火也。只补阴以配其阳，则阴气复而热自退
矣。热之而寒者。谓以辛热治寒而寒反甚，非寒之有余，乃真阳之不足也。阳不足则阴有余而为寒，故当取之
于阳，不宜攻寒也，但补水中之火，则阳气复而寒自消也。益火之源，以消阴翳；壮水之主，以制阳光。
脏腑之原，有寒热温凉之主，取心者不必齐以热，取肾者不必齐以寒，但益心之阳，寒亦通行，强肾之阴，热
之犹可。故或治热以热，治寒以寒，所谓“求其属”也。属者，根本之谓，水火
之本，则皆在命门之中耳。）不治王而然者，五味之属，治有不当
也。夫五味入胃，各归所喜攻。久而增气，物化之常也，气增而久，夭之由也。（不因治王而病不愈者，
以五味之属，治有不当也。凡五味必先入胃，而后各归所喜攻之脏。喜攻者，谓五味、五脏各有
所属也。如病在筋无食酸，病在气无食辛，病在骨无食咸，病在血无食苦，病在肉无食甘，犯之者，即
所谓五味之属不当也。五味之性，各有所入。若味有偏用，则气有偏病。偏用既久，其气必增，此物化之
常也。气增而久，则脏有偏胜，脏有偏胜，则必有偏绝矣。此致夭之由也。如“味过于酸，肝气以津，脾气
乃绝；味过于咸，大骨气劳，短肌，心气抑”之类是也。言寒热者，言病机也。后言五味者，言药饵也。
药饵、病机，必审其真，设有谬误，鲜不害矣。）邪风之至，疾如风雨。（邪风中人疾速
如此。）故善治者治皮毛，（皮毛尚浅，用力少而成功易也。）其次治肌肤，（深于皮毛矣。）其次治
筋脉，（深于肌肤矣。）其次治六腑，（深于筋脉矣。）其次治五脏。治五脏者，半死半生也。（邪愈深则治
愈难，故上工救其萌芽，下工救其已成。救其已成者，用力多而成功少，凶吉相半矣。）天之邪气，感则害
人五脏，水谷之寒热，感则害于六腑。（天之邪气，即风、寒、暑、湿、火、燥，受于无形者也。喉主
天气而通于脏，故感则害人五脏。水谷之寒热，即谷食之气味，受于有形者也。咽主地气而通于腑，故感
则害于六腑。）地之湿气，感则害皮肉筋脉。（人之应土者肉也，湿胜则营卫不行，故感则害于皮肉筋脉。
）善诊者，察色按脉，先别阴阳；（此下皆言诊法。“诊”之一字，所该者广，先别阴阳，不可缓也。）
审清浊而知部分；（色者神之华，故可望颜察色，审清浊而知部分。如病患有气色见于面部∶“鼻头色青，
腹中痛，苦冷者死；鼻头色微黑者，有水气；色黄者，胸中有寒；色白者，亡血也。设微赤非时者死。”又“
色青为痛，色黑为劳，色赤为风，色黄者便难，色鲜明者有留饮”之类是也。）视喘息、听音声而知所苦；（
病苦于中，声发于外，故可视喘息、听音声而知其苦也。如肝在音为角，声为
呼；心在音为征，声为笑；脾在音为宫，声为歌；肺在音为商，声为哭；肾在音为羽，声为呻之类。又如“病
人语声寂然，喜惊呼者，骨节间病；语声喑喑然不彻者，心膈间病；语声啾啾然细而长者，头中病”；“息摇
肩者，心中坚；息引胸中上气者，咳；息张口短气者，肺痿唾沫”；“吸而微数，其病在中焦，实也，当下
之则愈，虚者不治；在上焦者其吸促，在下焦者其吸远，此皆难治。呼吸动摇振振者，不治”。又设令病患
向壁卧，闻师到不惊起而 视，若三言三止，脉之咽唾者，此诈病也；设令脉自和处，但言此病大重，须服
吐下药，及针灸数十百处当自愈，师持脉，病患欠者，无病也；脉之呻者，痛也；言迟者，风也；摇头言者，
里痛也；行迟者，表强也；坐而伏者，短气也；坐而下一脚者，腰痛也；里实护腹如怀卵者，心痛也。
人病恐怖者，脉形如循丝累累然，其面白脱色也；人愧者，脉浮而面色乍白乍赤也。此皆疾病之声、色。总
之，声由气发，气充则声壮，气衰则声怯，阳候多语，阴证无声。多语者易济，无声者难荣。
然则音声不惟知所苦，而且可知死生矣。）观权衡规矩而知病所主；（权衡规矩，所包者多。权言其重，衡
言其轻，规言其圆，矩言其方。能明方圆轻重之理，则知变通之道矣。）按尺寸，观浮、沉、滑、涩而知
病所生以治。（所以别阴阳表里也。）无过以证，则不失矣。（过，失也。言无失诸法，则治亦可以无失矣。）
故因其轻而扬之，因其重而减之，因其衰而彰之。（轻者浮于表，故宜扬之，扬者散也；重者实
于内，故宜减之，减者泻也；衰者气血虚，故宜彰之，彰者补之益之，而使气血复彰也。于此三者，而表
里虚实之治尽之矣。）形不足者温之以气，精不足者补之以味。（此正言彰之之法，而在于药食之气味也。
以形精言，则形为阳，精为阴；以气味言，则气为阳，味为阴。阳者，卫外而为固也；阴者，藏精而起亟也。
故形不足者，阳之衰也，非气不足以达表而温之；精不足者，阴之衰也，非味不足以实中而补之。阳性暖，故
曰温；阴性静，故曰补。按本篇有云“味归形”，“形食味”，“气归精”，“精
食气，”可知形以精成，精以气化；气以味生，味以气行。以阴阳言，则形与气皆阳也，故可以温；味与精皆
阴也，故可以补。以清浊言，则味与形皆浊也，故味归形；气与精皆清也，故气归精。然气不能外乎味，味亦
不能外乎气，虽气味有阴阳清浊之分，而实则相须为用者也。）其高者因而越之，（越，发扬也。谓升散之，
湓涌之，可以治其上之表里也。）其下者引而竭之，（竭，祛除也，谓荡涤之，疏利之，可以治其下之
前后也。）中满者泻之于内，（“中满”二字，最宜详察，即痞满大实坚之谓，故当泻之于内。若外见浮肿，
而胀不在内者，非“中满”也，妄行攻泻，必至为害。此节之要，在一“中”字。）其有邪者渍形以为汗，（
邪在肌表，故当渍形以为汗。渍，浸也，如许胤宗用黄 防风汤数十斛置于床下以蒸汗，张苗烧地加桃叶于
上以蒸汗，或用药煎汤熏之沐之，皆渍形之法也。）其在皮者汗而发之，（前言有邪者，兼经络而言，言其深
也。此言在皮者，言其浅也。均为表证，故皆宜汗。）其 悍者按而收之，（此兼表里而言。凡邪气之
急利者，按得其状，则可收而制之矣。如今之刮痧、揣摩、推拿、收惊之类，亦其遗也。）其实者散而泻之。
（阳实者宜散之，阴实者宜泻之。）审其阴阳，以别柔刚。（形证有柔刚，脉色有柔刚，气味尤有柔刚。柔
者属阴，刚者属阳。知刚柔之化者，知阴阳之妙用矣。故必审而别之。）阳病治阴，阴病治阳。（阳胜者阴必病，
阴胜者阳必病，如“诸寒之而热者，取之阴，热之而寒者，取之阳”；“壮水之主，以制阳光，益火之源，以
消阴翳”之类，皆阳病治阴、阴病治阳之道也。）定其血气，各守其乡。（病之或在血分，或在气分，当各察
其处而不可乱也。）血实宜决之，（决，谓泄去其血。）气虚宜掣引之。（掣，挽也。气虚者，无气之渐。
无气则死矣，故当挽回其气而引之使复也。如上气虚者，升而举之；下气虚者，纳而归之；中气虚者，温
而补之也。）
一病而治各不同，皆愈者，地势使然也。（地势不同，则气
习有异，故治法亦随而不一也。）故东方之域，天地之所始生也。（天地之气，自东而升，为阳生之始，故
发生之气，始于东方，而在时则为春。）鱼盐之地，海滨傍水，（地不满东南，故东南低下而多水。鱼盐、
海滨，皆傍水之地利也。）其民食鱼而嗜咸，皆安其处，美其食。（得鱼盐之地，故居安食美。）鱼者使
人热中，（鱼，鳞虫也。鱼生水中，水体外阴而内阳，故能热中，然水从寒化，亦脾寒者所忌。）盐者胜血，
（食咸者渴，胜血之征也。）故其民皆黑色疏理，其病皆为痈疡。（血弱故黑色疏理，热多故为痈疡。）
其治宜砭石，故砭石者亦从东方来。（砭石，石针也，即瓷锋之属。高氏之山，有石如玉，可以为针，
即砭也。东方之民，疏理而痈疡，其病在肌表，故用砭石。砭石者，其治在浅，凡后世所用砭石之法，亦自
东方来也。来，起见也。砭，音边。）西方者，金玉之域，沙石之处，天地之所收引也。（地之刚在西
The method of "treating heat with heat application" refers to situations such as intense heat located in the interior. If treated directly with cold-natured drugs, the medicinal force fails to penetrate; if treated with warm-natured drugs, the disease worsens. Therefore, cold-natured herbs are administered hot. After entering the stomach, the existing heat is dissipated, and the cold nature of the medicine takes effect, leading to harmonization and reduction of the disease. This is the method of "using cold for heat application." Treating heat with cold herbs but administering them warm, or treating cold with hot herbs but administering them cool, also aligns with the principles of "cold used for heat application" and "heat used for cold application."
The method of "treating obstruction with obstruction application" applies to cases where deficiency of Qi in the lower Jiao leads to stagnation in the middle Jiao. Attempting to dissipate fullness would further deplete the lower Jiao, while tonifying the lower Jiao might exacerbate the middle Jiao's fullness. If one treats without addressing the root cause and attacks the fullness first, symptoms may temporarily improve but will return worse once the drug's effect wears off, leading to greater Qi deficiency and worsening disease. Understanding that small doses may nourish stagnation while large doses promote circulation, one should strongly tonify the lower Jiao to unblock the middle. Thus, lower deficiency naturally fills, and middle fullness naturally clears. This is the method of "treating obstruction with obstruction application."
The method of "treating patency with patency application" involves conditions like internal accumulation of intense heat or severe cold causing stagnation and persistent diarrhea. For cold stagnation, hot purgatives are used; for heat stagnation, cold purgatives are used. This exemplifies "treating patency with patency application." These four treatments require subduing the primary pathogen to address the root of the disease and investigating the cause to understand its origin. Once the root is identified, treating the true nature with true methods (following the disease trend) or false nature with false methods (utilizing deceptive trends) may appear similar initially but yield different outcomes finally. This is called "contrary treatment." Consequently, it can break down accumulations, soften hardness, harmonize Qi, and cure the disease.
Adverse and compliant treatments involve opposing or following the disease trend, alternating between them to regulate Qi flow, which constitutes the proper therapeutic approach. (When Qi is originally harmonious but affected by external factors due to climate or unforeseen circumstances, treatment involves either opposing or complying with the trend—either opposing first then complying, or vice versa—to disperse pathogens and restore harmony.)
Prescription formulation follows the hierarchy of Sovereign (Jun), Minister (Chen), Assistant (Zuo), and Envoy (Shi). The Sovereign herb addresses the main disease; the Minister assists the Sovereign; the Envoy coordinates with the Minister. This classification differs from the Upper, Middle, and Lower grades of the *Shennong Bencao Jing*, serving to clarify the distinct roles rather than moral qualities. (The Sovereign herb is the key agent against the syndrome, few in number but heavy in dosage. The Minister assists the Sovereign, slightly more numerous and lighter in dosage. The Envoy facilitates circulation and guidance, variable in number and lightest in dosage. This defines the Sovereign-Minister-Assistant-Envoy structure, distinct from the three grades based on toxicity and efficacy.)
Diseases manifest internally or externally. Those originating internally and affecting the exterior require regulating the interior; those originating externally and affecting the interior require treating the exterior. (Internal origin makes the interior the root; external origin makes the exterior the root. Treating the root ensures recovery.) If an internal disease manifests severely externally, treat the interior first, then the exterior. If an external disease manifests severely internally, treat the exterior first, then the interior. (Although symptoms may be severe at the branch level, treating the root is essential for recovery, a fundamental principle.) If internal and external factors do not interact, treat the predominant manifestation. This relates to the concept of "Three Causes": 1) Pathogens entering meridians and organs constitute internal causes; 2) Pathogens affecting limbs, orifices, and skin via blood vessels constitute external causes; 3) Injuries from intercourse, metal/blades, or insects/beasts constitute non-internal/external causes.
Regulating Qi requires distinguishing Yin and Yang and determining internal/external locations. Internal diseases are treated internally; external diseases externally. Mild cases are regulated, moderate cases balanced, and severe cases attacked via sweating or purging. Cold, heat, warmth, and coolness are applied according to their specific affinities to reduce pathology.
For diseases in the middle Jiao that are neither solid nor firm, fluctuating in presence, indicating no fixed accumulation, one must identify organ deficiency and tonify it. Use herbs to expel pathogens, food to support Qi, and water immersion therapies to unblock meridians, harmonizing the interior and exterior to achieve cure. (Accumulation implies tangible, solid pathology. Fluctuating, non-solid conditions indicate organ deficiency rather than accumulation. Herbs remove disease; food nourishes Qi; water immersion unblocks meridians. 'Qu' means removal, not aggression. 'Zi' means soaking.)
Treating cold with heat and heat with cold is the standard rule. However, if heat persists after cold treatment or cold persists after heat treatment, it often indicates new complications arising from treating the excessive pathogenic factor (Wang Qi) rather than the root, leading to counterproductive effects. (Failure to distinguish between deficiency and excess can lead to worsening conditions. For example, treating Yin deficiency fire with bitter-cold herbs alone treats the fire's excess but ignores the Yin deficiency. Similarly, treating Yang deficiency cold with acrid-warm herbs alone treats the cold's excess but ignores Yang deficiency. Seasonal variations also matter: summer heat may hide internal cold, and winter cold may hide internal heat. Ignoring this leads to paradoxical reactions.)
One must understand that when cold treatments fail to resolve heat, one should tonify Yin; when heat treatments fail to resolve cold, one should tonify Yang. This is seeking the underlying affinity. (Persistent heat despite cold herbs indicates Yin deficiency, not Fire excess. Tonify Yin to balance Yang. Persistent cold despite heat herbs indicates Yang deficiency, not Cold excess. Tonify Yang to balance Yin. Strengthen the source of Water to control Solar flare; strengthen the source of Fire to eliminate Yin shadow. Heart-Yang and Kidney-Yin are fundamental; treating heat with heat or cold with cold can work if targeting the root.)
If a disease resolves without attacking excess, it is because the Five Flavors were appropriately matched. Flavors enter the stomach and target specific organs. Long-term use enhances corresponding Qi, which is normal, but prolonged enhancement leads to imbalance and premature death. (Excessive sour harms Liver and Spleen; excessive salty harms bones and Heart. Proper matching of flavors to syndromes is crucial.)
Evil wind strikes swiftly. Skillful physicians treat at the skin/hair stage (shallow, easy to cure); next at muscles/skin; then sinews/pulses; then Six Fu Organs; finally Five Zang Organs. Treating Zang organ diseases has only a fifty-fifty chance of survival. (Deeper invasion means harder treatment. Experts intervene early; novices intervene late.)
Heavenly evils (Wind, Cold, Summerheat, Dampness, Fire, Dryness) affect the Five Zang Organs through the throat. Food/drink temperature affects the Six Fu Organs through the esophagus. Earthly dampness affects skin, flesh, sinews, and pulses.
Skilled diagnosticians observe complexion and pulse to distinguish Yin/Yang first; examine clarity/turbidity of complexion to locate lesions; observe breathing and listen to voice to determine suffering. (Voice reflects Qi status. Yang patterns speak much; Yin patterns are silent. Voice changes indicate specific organ issues or severity.) Observe pulse characteristics (weighing rules) to identify the affected organ; palpate Cun/Guan/Chi positions and pulse qualities (Floating, Deep, Slippery, Choppy) to determine etiology and treat accordingly. Avoid errors in method to avoid therapeutic failure.
Treat mild/pathogenic-floating conditions by dispersing; heavy/internal-solid conditions by purging; deficient conditions by tonifying. (Dispersing treats exterior; purging treats interior; tonifying treats deficiency.) For form deficiency, warm with Qi; for essence deficiency, tonify with Flavor. (Form/Qi are Yang; Essence/Flavor are Yin. Warmth reaches the exterior; flavor fills the interior.)
For high-positioned diseases, induce vomiting; for low-positioned diseases, induce purging/drainage; for middle Jiao fullness, purge internally; for exterior pathogens, soak the body to induce sweat; for skin-level pathogens, induce sweat; for acute/aggressive pathogens, massage/restrain; for excess conditions, disperse and purge.
Examine Yin/Yang to distinguish soft/rigid. Treat Yin diseases by addressing Yang, and Yang diseases by addressing Yin. (Balance Yin and Yang. Tonify Yin to control Yang fire; tonify Yang to dispel Yin cold.) Determine Blood and Qi status, keeping them in their proper domains. For Blood excess, drain it; for Qi deficiency, lift and guide it.
Different treatments for the same disease can all succeed due to geographical differences. Eastern regions, where Yang energy begins, have people eating fish and salt near water. Fish causes internal heat; salt damages blood. People here have dark skin and loose textures, prone to sores/ulcers. Treatment favors Bian stones (stone needles), originating from the East. Western regions, characterized by metals/jewels and sand/stones, represent the gathering and contracting energy of Heaven and Earth...