人生天地中,随气受病,医之治病,从气所宜,统论之,阴阳殊化,有东南西北之异气
,内经所谓地有高下,气有温凉,高者气寒,下者气热。故曰∶气寒气凉,治以寒凉,气温
气热,治以温热。又曰∶东方之民治宜砭石,西方之民治宜毒药,北方之民治宜灸 ,南方
之民治宜微针,中央之民治宜导引按跷,然则从气所宜而治之,固可知也。至如岭南多瘴,
江湖多湿,山阴水野沙石之气,生病悉异,为治之方,安可一概,又况内经论一州之气,生
化寿夭各不同。则知地有小大。小者小异,大者大异,唯圣人能杂合以治,各得其所宜。
昔人概举万病,亦颇有不治自愈者,盖欲药石无妄投,针灸无妄用,使五脏安平,不相
干扰,无恋卷怆囊之伪为也。姑摭一二证之,肝脉 暴有所惊骇,脉不至若喑。不治自已,
心脉搏坚而长,舌卷不能言,其 而散者,当消环自已,脉至如数,使人暴惊,三四日自已
,重身而喑,十月当复,阳厥之病要在夺食则已。是数者备见于经,苟能缘类而知,则不治
而瘳者,率皆了然于胸次,倘不察此,必以毒药攻其内,针石汤火铄其外。胶胶扰扰,力不
暇给,奚足以议平治之道。
病有本标,治有缓急,知所先后,乃得其宜。凡言本标,其说有三,有气之本标,若六
气为本,三阴三阳为标是也。有病之本标,若百病之生,或生于本,或生于标,或生于中气
是也。有治之本标,若取本而得,取标而得是也。三者虽若不同,要之皆以所因为本,所应
为标。是故有病伤寒者,因寒而得,即以寒为本,随其变传所在,或客于阳,或客于阴,即
以阴证阳证为标,以至风暑燥湿。饮食劳倦,喜怒忧恐,皆可类举。然邪气所伤,如风雨寒
暑之类,本自外至,腑脏生病,如喜怒忧惧之类,本由内生,及病成而变,有先表后里者,
治法皆当治其本,唯先病而后中满,及大小不利之病,则治其标,此无他,以救里为急故也
。故曰病非其本,中标之病,治非其本,中标之方,审究逆从,以施药石,标本相得,邪气
乃服,病者知此,则病以许治为本,治者能此。则治以适当为工,是以内经又言,病为本工
为标。
Human beings live within heaven and earth, contracting diseases in response to the movement of Qi. Physicians treating diseases should act according to what is suitable for the Qi. Generally speaking, Yin and Yang undergo different transformations, leading to variations in Qi among the East, South, West, and North. The *Neijing* (Classic of Internal Medicine) states: "Earth has high and low points; Qi has warm and cool temperatures. Where it is high, the Qi is cold; where it is low, the Qi is hot." Therefore, it is said: In areas where Qi is cold and cool, treatment employs cold and cool methods; in areas where Qi is warm and hot, treatment employs warm and hot methods. It is also stated: People in the East are suited for treatment with Bian stones (lithotherapy); people in the West are suited for treatment with medicinal substances (poisons/drugs); people in the North are suited for treatment with Moxibustion (Ai Jiu); people in the South are suited for treatment with fine needles (Wei Zhen); and people in the Central regions are suited for treatment with Daoyin (qigong guidance and pulling) and Anqiao (massage and manipulation). Thus, treating according to the suitability of the Qi can certainly be understood. As for Lingnan being prone to miasma, and Jianghu (rivers and lakes) being prone to dampness, or the climatic conditions of mountain shadows, watersides, and sandy/stony areas causing entirely different diseases, how can treatment methods be uniform? Furthermore, the *Neijing* discusses that the Qi of each province results in different biological processes and lifespans. From this, we know that territories vary in size; small differences yield minor variations, while large differences yield major variations. Only a sage can synthesize various treatments to ensure each person receives what is suitable for them.
Ancients generally enumerated ten thousand diseases, some of which healed spontaneously without treatment. This was likely intended to prevent the reckless administration of drugs and acupuncture/moxibustion, thereby keeping the Five Viscera (Wu Zang) peaceful and uninterfered with, avoiding the pretense of creating difficult cases to feign medical skill. Let us briefly cite one or two examples: If the Liver pulse is suddenly affected by fright, resulting in an absent pulse or aphonia, it will heal spontaneously without treatment. If the Heart pulse is firm and long, accompanied by tongue retraction and inability to speak, but if the pulse becomes scattered, the pathogen at the Huantiao point will dissipate and health will return naturally. If the pulse is rapid like a Shu pulse, causing sudden fright, it will heal spontaneously after three to four days. Aphonia during pregnancy will resolve after ten months (childbirth). The disease of Yang Jue (Yang reversal) resolves primarily by stopping food intake. These cases are all documented in the classics. If one understands them by categorization, then those diseases that heal without treatment become clear in mind. If these are not observed, one must inevitably use drugs to attack internally and needles, stones, decoctions, and fire to cauterize externally. In such chaotic turmoil, energy is insufficient to cope, let alone discuss the way of balanced treatment.
Diseases have a Root (Ben) and a Branch (Biao); treatments have urgency and slackness. Knowing the sequence allows one to find the appropriate method. Regarding Root and Branch, there are three interpretations: 1. The Root and Branch of Qi, e.g., the Six Qi (Liu Qi) as Root, and the Three Yin and Three Yang (San Yin San Yang) as Branch. 2. The Root and Branch of Disease, e.g., the origin of hundred diseases may lie in the Root, the Branch, or the Middle Qi (Zhong Qi). 3. The Root and Branch of Treatment, e.g., curing by treating the Root or curing by treating the Branch. Although these three seem different, essentially they regard the cause as the Root and the manifestation/response as the Branch. For instance, in Taiyang Cold Damage (Shanghan), the disease arises from Cold, so Cold is the Root. Depending on transmission, whether lodging in Yang or Yin, the Yang or Yin syndrome becomes the Branch. Similarly, Wind, Summer-heat, Dryness, Dampness, diet, fatigue, and emotions like anger, joy, worry, and fear can be classified thus. However, pathogens like wind, rain, cold, and heat originate externally; visceral diseases caused by emotions originate internally. Once the disease forms and changes, there are cases of exterior preceding interior. Generally, treatment should target the Root. Exceptions are cases where fullness in the middle jiao occurs first, or cases of difficulty in urination and defecation; these are treated by targeting the Branch. There is no other reason than that rescuing the interior is urgent. Thus, it is said: If the disease is not the Root but a Branch manifestation, and the treatment is not targeting the Root but addressing the Branch, one must carefully study the principles of contrary and compliant approaches to apply medicines. When Root and Branch harmonize, the pathogenic factor submits. If patients understand this, they know that treating the Root is primary. If physicians achieve this, they know that appropriateness constitutes skill. Hence, the *Neijing* further states: The patient is the Root, and the physician is the Branch.