尝读朱肱《活人书》云∶妇人伤寒,治法与男子不同,举男子调气,女于调血以为大略,似补前人之未及,然愚谓
此说未可一概论也。夫长沙张氏,医中之圣也,其着《伤寒论》,原为卒病而设,故又谓之《卒病论》。卒病者,宜舍本
而治标,故一百一十三方,皆男妇共享,即热入血室,亦用小柴胡汤,妇人之阴阳易,亦用烧KT 散。自有《活人书
》创
立妇人治法异于男子之说,后人宗之者多矣,不思仲圣之方,早合气血为一致,今试以药考之,其立法用意,自跃如也。
即如桂枝、芍药,固营而闭卫,非血药乎?麻黄、防风,虽谓之发汗,本治乳子余疾,非血药乎?白虎、小柴胡中,知
母则治肾,柴胡则调经,皆气中之血药也,当归、地黄,固不必言,即白术、人参,人皆以为气剂,而《本草》言能“利
腰脐间血”,可知亦为血药也。大抵用之在阳,便为气药,用之在阴,便为血药。总之,伤寒一证,皆为营卫受病耳,何
必分男先调气女先调血耶?云岐张氏,好古王氏,皆以朱氏之说为治杂病之常法,诚所谓自具慧眼,而不为前人所惑者
也。
本仲圣以论伤寒治法,由正路也,中幅诠疏气血阴阳尤妙,独开生面,斯可谓用古而不泥古者乎。今而后读《活人
书》者,当知所择矣(西畴顾业师评)。
I once read Zhu Gong's *Huoren Shu* (Book of Vitality), which states: "For women suffering from Shanghan (Cold Damage), the treatment method differs from that for men; generally, one regulates Qi in men and Blood in women." This seems to supplement what previous authors omitted. However, I believe this view cannot be applied universally.
Zhang Zhongjing of Changsha is a sage among physicians. His work, *Shanghan Lun* (Treatise on Cold Damage), was originally established for treating sudden illnesses, hence it is also called *Zubing Lun* (Treatise on Sudden Illness). For sudden illnesses, one should abandon the root and treat the branch; therefore, the 113 formulas contained therein are shared by both men and women. Even in cases of Heat entering the Blood Chamber (Re Ru Xue Shi), Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used; and for Yin-Yang Yi disease (a condition recurring after intercourse following a major illness) in women, Shao Kun San (Burnt Undergarment Powder) is employed. Since *Huoren Shu* established the theory that women's treatment differs from men's, many later generations have followed it blindly, failing to realize that Zhang Zhongjing's formulas had long integrated Qi and Blood as one. Now, let us examine the herbs to verify this; the intent behind the formulation becomes self-evident.
Take Guizhi (Cinnamon Twig) and Shaoyao (White Peony Root): they stabilize Ying (Nutritive Qi) and secure Wei (Defensive Qi); are they not Blood-invigorating herbs? Mahuang (Ephedra Herb) and Fangfeng (Saposhnikovia Root), although termed diaphoretic herbs, were originally used to treat residual ailments postpartum; are they not Blood-invigorating herbs? In Baihu Tang (White Tiger Decoction) and Xiao Chai Hu Tang, Zhimu (Anemarrhena Rhizome) treats Kidney-related issues, and Chaihu (Bupleurum Root) regulates menstruation; these are all Blood-invigorating herbs within the context of Qi regulation. Danggui (Angelica Sinensis Root) and Dihuang (Rehmannia Root) need not be mentioned. Even Baizhu (Atractylodes Macrocephala Rhizome) and Renshen (Ginseng Root), which people consider Qi-tonifying herbs, according to *Bencao* (Materia Medica) can "benefit blood in the waist and umbilical region," indicating they are also Blood-invigorating herbs. Generally speaking, when used in Yang aspects, they act as Qi herbs; when used in Yin aspects, they act as Blood herbs. In summary, Shanghan syndrome involves pathology of Ying and Wei; why distinguish between regulating Qi first for men and Blood first for women?
Yunqi Zhang Yuansu and Haogu Wang Haogu both regarded Zhu Gong's theory as the standard method for treating miscellaneous diseases. This is truly possessing unique insight, not being confused by predecessors.
This text follows Zhang Zhongjing's approach to discussing Shanghan treatment, taking the orthodox path. The middle section elucidates the dispersion and regulation of Qi, Blood, Yin, and Yang with particular brilliance, carving out a new path. This can indeed be described as utilizing ancient methods without being bound by them. Henceforth, those who read *Huoren Shu* should know how to select their references. (Commentary by Master Gu Yeshi of Xichou)