卣翁老先生。脉盛体坚。神采百倍。从无病邪敢犯。但每早浴面。必呕痰水几口。胸前惯自摩揉。乳下
宗气。其动应衣。若夜睡宁。水道清。则胸中爽然。其候似病非病。遍考方书。广询明医。不得其解。昌谓是
痰饮结于胸膈。小有窠囊。缘其气之壮盛。随聚随呕。是以痰饮不致为害。而膻中之气。因呕而伤矣。
夫膻中者。与上焦同位胸膈。经云。上焦如雾。言其气之氤氲如雾也。又曰。膻中者臣使之官。言其能分布胸
中之气而下传也。今以呕之故。而数动其气。则氤氲变为急迫上奔。然稍定则仍下布。亦不为害也。大率痰为
标。气为本。治标易。而治本则难矣。非治本之难。以往哲从未言其治法。而后人不知所治耳。昌试论之。治
气之源有三。一曰肺气。肺气清。则周身之气肃然下行。先生之肺气则素清也。一曰胃气。胃气和。则胸中
之气亦易下行。先生之胃气则素和也。一曰膀胱之气。膀胱之气旺。则能吸引胸中之气下行。先生青年善养。
膀胱之气则素旺也。其膻中之气。乱而即治。扰而即恬者。赖此三气暗为输运。是以不觉其累。即谓之无病也
可。若三气反干胸膈之人。其为紧为胀。可胜道哉。故未形之病。可以不言。而屡动之气。不可不亟反于氤
氲。先生但觉为痰饮所苦。昼日常鼓呼吸之气。触出胸膈之痰。而未知痰不可出。徒伤气也。盖夜卧则痰聚于
胃。晨起自能呕出。日间胃之津液。四达脏腑。即激之出不出耳。然而痰消则气自顺。是必以治痰为急。而体
盛痰不易除。又必以健脾为先。脾健则新痰不生。其宿痰之在窠囊者。渐渍于胃。而上下分消。于
是无痰则不呕。不呕则气不乱。气不乱则自返于氤氲矣。虽然。尚有一吃紧关头。当并讲也。人身胸中。空旷
如太虚。地气上则为云。必天气降而为雨。地气始收藏不动。诚会上焦如雾。中焦
如沤。下焦如渎之意。则知云行雨施。而后沟渎皆盈。水道通
决。乾坤有一番新景象矣。此义首重在膀胱一经。经云。膀胱者州都之官。津液藏焉。气化则能出矣。如人之
饮酒无算而不醉者。皆从膀胱之气化而出也。盖膻中位于膈内。膀胱位于腹内。膀胱之气化。则空洞善容。
而膻中之气得以下运。若膀胱不化。则腹已先胀。膻中之气。安能下达耶。然欲膀胱之气化。其权尤
在于葆肾。肾以膀胱为府者也。肾气动。必先注于膀胱。屡动不已。膀胱满胀。势必逆奔于胸膈。其窒塞之
状。不可名言。肾气不动。则收藏愈固。膀胱得以清静无为。而膻中之气。注之不盈矣。膻中之气。下走
既捷。则不为牵引所乱。而胸中旷若太空。昌更曰。气顺则痰不留。即不治痰而痰自运矣。谨论。
胡卣臣先生问曰。痰在膈中。去喉不远。每早必痛呕始出者何耶。曰。道不同也。胸膈之间。重重膈
膜遮蔽。浑无空隙。痰从何出。所出者胃中之痰耳。曰。然则膈中之痰不出耶。曰。安得不出。但出之曲耳。
盖膻中之气。四布于十二经。布于手足六阳经。则其气从喉吻而上出。布于手足六阴经。则其气从前后
二阴而下出。然从下出者无碍。从上出者。亦必先下注阳明。始得上越。是以难也。曰。若是则所论膀胱
气化一段。渊乎微矣。但吸引之机权。从不见于经典。岂有所自乎。曰。内经有巨阳引精之义。缘无注解。
人不能会。巨阳者。太阳膀胱经也。谓膀胱能吸引胸中之气下行。而胸中之胀自消。此足证也。曰。胸中窠
囊之说。确然无疑。不知始于何因。结于何处。消于何时也。曰。人身之气。经盛则注于络。络盛则注于经。
窠囊之来。始于痰聚胃口。呕时数动胃气。胃气动则半从上出于喉。半从内入于络。胃之络贯膈者也。其气奔
入之急。则冲透膈膜。而痰得以居之。痰入既久。则阻碍气道。而气之奔入者。复结一囊。如蜂子之营
穴。日增一日。故治之甚难。必先去胃中之痰。而不呕不触。俾胃经之气。不急奔于络。转虚其胃。以听
络中之气。返还于胃。逐渐以药开导其囊。而涤去其痰。则自愈矣。此昌独得之见。屡
试之法也。曰。所言身内病情消息。如宝鉴列眉。令人钦服。生平读医书。于五脏位置。不能无疑。请并明
之。人身戴九履一。左三右七。五居中宫。则心南肾北肝东肺西。乃定位也。乃肾不居正北。而分隶东北西北
者何耶。曰。肾有两。故分隶两旁。而虚其在中之位以为用。所谓两肾中间一点明。正北方水中之真
火。而为藏精宅神之本。其体虽分左右。而用实在中。故心肾交媾之所。各该三寸六分。设从两肾歧行而上。
其去中黄。不太远乎。凡内观五脏。当观其用也。曰。肺为一身之华盖。如莲花舒叶于心之上。位正乎中。
何以定其位于西南耶。诚如两肾之例。则西南可位。岂东南独不可位乎。曰。肺居心上。其募不与左连。但
从右达。其用亦在西也。曰。其不与左连者何也。曰。地不满东南。其位常空隙不用。设肺募得与左连。地无
缺陷矣。曰。然则天不满西北。何以右肾居之耶。曰。两肾之用在中。此不过其空位耳。惟右肾为空位。故
与三焦之有名无形者相配。而三焦则决渎之官。水道由之而出。正以天不满西北也。曰。然则脾胃居右。其
用亦在右耶。曰。胃居中。脾居右。胃中所容之水谷。全赖脾以营运。而注其气以输周身。其用即在中也。其
用在中。故西方可容肺脾二脏。若脾之用在右。则置肺之用于何所乎。曰。然则肝之用何在耶。曰。肝木居于
正东。东南为地之空位。其气既无主。东北为左肾之本位。其用又不存。故肝之气得以彻上彻下。全运于东
方。其为用也大矣。曰。然则心之用何在耶。曰。心之外有包络。包络之外曰膻中。心者君主之官。膻中
者臣使之官。是膻中为心之用也。曰。心之神明。其用何在耶。曰。神明之用。无方无体。难言也。道经云。
太玄无边际。妙哉。大洞经曰太玄。曰无边际。曰妙哉。形容殆尽矣。禅机云。赤肉团上。有一无位真人。
旨哉斯言。惟无位乃称真人。设有位则仍为赤肉团矣。欲窥其倪。惟在感而遂通之界。先生曰。吾浅言
之。人能常存敬畏。便可识神明之所起。曰。此尧兢舜业。而为
允执者也。昌多言反晦。先生一言逗出。诚为布鼓过雷门矣。因并记之。
胡卣臣先生曰。每与嘉言接谭。如见刘颖川兄弟。使人神思清发。或体气偶有未佳。则陈琳一檄。枚氏七
发。少陵五言诗。辋川几重图。无不备矣。观此论至明至正。至精至微。愧无马迁笔。为作仓公传也。
Mr. Youweng, the elder gentleman, had a surging pulse and a solid constitution, with radiant spirit, immune to all diseases. However, every morning while washing his face, he would inevitably vomit several mouthfuls of phlegm-fluid. He habitually rubbed his chest, specifically the area below the breasts where the Zong Qi (Master Qi) resides; the movement there was so pronounced it could shake his clothes. If he slept peacefully at night and his water passages were clear and unobstructed, he felt refreshed in his chest. This condition appeared as neither illness nor health. After consulting numerous medical texts and seeking advice from renowned physicians without resolution, I opined that this was Phlegm-Fluid (Tan Yin, accumulation of pathological fluids) knotting in the chest and diaphragm, forming small "cocoons" (nests for fluid accumulation). Because his healthy Qi was robust, the fluid accumulated and was immediately vomited out, thus causing no major harm. However, the Qi of the Dan Zhong (Pericardium/Center of Chest) was injured by the frequent vomiting.
The Dan Zhong is located in the Upper Jiao (Upper Burner), same level as the chest and diaphragm. The Classics state: "The Upper Jiao is like mist," referring to its Qi being diffuse and mist-like. It also says: "The Dan Zhong is the official of the minister and messenger," indicating its function to distribute the Qi of the chest and transmit it downward. Now, due to vomiting, the Qi is frequently disturbed, changing from a diffuse state to an urgent upward rush. Although it settles and distributes downward again, preventing major harm, generally speaking, Phlegm is the branch (symptom), and Qi is the root (cause). Treating the branch is easy, but treating the root is difficult. Not because treating the root is inherently hard, but because past sages never explicitly stated the method, leaving later generations confused. Let me attempt to discuss this. There are three sources for regulating Qi: First, Lung Qi. When Lung Qi is clear, the Qi of the whole body descends solemnly; Mr.'s Lung Qi has always been clear. Second, Stomach Qi. When Stomach Qi is harmonious, the Qi in the chest easily descends; Mr.'s Stomach Qi has always been harmonious. Third, Bladder Qi. When Bladder Qi is vigorous, it can attract the Qi of the chest downward; Mr. cultivated himself well in his youth, so his Bladder Qi has always been vigorous. The chaotic Qi of the Dan Zhong recovers order and tranquility quickly, relying on these three Qi types for hidden transport, hence feeling no burden, allowing us to call it "no disease." If these three Qi interfered with a person's chest-diaphragm, the resulting tightness and distension would be unbearable. Therefore, pre-manifest illnesses may be ignored, but repeatedly disturbed Qi must be swiftly restored to a diffuse state. Mr. feels troubled by Phlegm-Fluid and uses daily breathing to expel chest-phlegm, unaware that forcing phlegm out only injures Qi. Generally, phlegm gathers in the Stomach during sleep and is vomited naturally in the morning; during the day, Stomach fluids reach the organs, making expulsion difficult even if stimulated. However, when phlegm dissipates, Qi flows smoothly. Thus, treating phlegm is urgent. But for those with strong constitutions, phlegm is hard to remove, so strengthening the Spleen must come first. A strong Spleen prevents new phlegm; old phlegm in cocoons gradually soaks into the Stomach and disperses up and down. Consequently, no phlegm means no vomiting; no vomiting means Qi is not chaotic; non-chaotic Qi returns to a diffuse state naturally.
Although so, there is a critical juncture to discuss. The human chest is vast and empty like the Great Void. Earth Qi rises to form clouds; only when Heaven Qi descends as rain does Earth Qi store and remain still. Truly understanding "Upper Jiao like mist, Middle Jiao like fermentation, Lower Jiao like drainage" reveals that after clouds move and rain falls, ditches fill, waterways open, and heaven and earth renew their scenery. This principle primarily emphasizes the Bladder channel. The Classics say: "The Bladder is the official of the capital, storing fluids; Qi transformation allows them to exit." Just as one can drink wine without getting drunk because it exits via Bladder Qi transformation. The Dan Zhong is inside the diaphragm; the Bladder is inside the abdomen. Normal Bladder Qi transformation makes the abdomen spacious, allowing Dan Zhong Qi to descend; if Bladder fails to transform, the abdomen distends first, and how can Dan Zhong Qi descend? To ensure Bladder Qi transformation, the key lies in preserving Kidney Qi. The Kidney pairs with the Bladder as its Fu organ. Kidney Qi moves, first pouring into the Bladder. If moved repeatedly, the Bladder becomes full and distended, inevitably rushing counter-current to the chest-diaphragm, causing indescribable blockage. If Kidney Qi remains still, storage is secure, the Bladder stays quiet, and Dan Zhong Qi fills without overflow. With swift descent of Dan Zhong Qi, it is not disturbed by traction, leaving the chest vast and empty. I further assert: When Qi flows smoothly, Phlegm does not stay; even without directly treating Phlegm, it will self-dissipate. Respectfully discussed.
Mr. Hu Youchen asked: Phlegm is in the diaphragm, close to the throat, why must it be violently vomited every morning to exit? Answer: The pathways differ. Between the chest and diaphragm, multiple membranes block any gap; where does the phlegm come from? What exits is actually Stomach phlegm. Question: Does diaphragmatic phlegm not exit? Answer: How could it not? But the path is circuitous. The Qi of the Dan Zhong spreads through the Twelve Meridians. Spreading through the Six Yang meridians of hand and foot, Qi exits upward from the throat; spreading through the Six Yin meridians, Qi exits downward from the anterior and posterior orifices. Downward exit is unimpeded; upward exit must first pour downward into the Yangming Meridian before rising, which is why it is difficult. Question: Regarding the profound discussion on Bladder Qi transformation, where is the mechanism of attraction found in classics? Answer: The *Nei Jing* mentions "Ju Yang drawing essence." Without annotation, people fail to grasp it. Ju Yang refers to the Taiyang Bladder Meridian, meaning the Bladder attracts chest Qi downward, resolving chest distension. This serves as proof. Question: The concept of chest cocoons is undeniable. What causes it, where does it form, and when does it dissolve? Answer: Human Qi flows from channels to collaterals when full. Cocoons begin with phlegm gathering at the stomach gate. Vomiting disturbs Stomach Qi repeatedly; Stomach Qi moves, half exiting upward from the throat, half entering inward into collaterals. Stomach collaterals pierce the diaphragm. Urgent Qi rushes through the membrane, allowing phlegm to occupy it. Long-term phlegm blocks airways, causing incoming Qi to knot into another cocoon, like bees building hives, increasing daily, making treatment difficult. One must first remove Stomach phlegm to stop vomiting and stimulation, letting Stomach Qi cease rushing to collaterals. By hollowing out the Stomach, allow collateral Qi to return to the Stomach. Gradually use medicine to open the cocoon and wash out phlegm, leading to self-healing. This is my unique insight, proven effective. Question: Your description of internal conditions is clear as a mirror, impressive. Reading medical books, I doubt the positions of the Five Zang. Please clarify. Humans wear nine and tread one, left three right seven, five in the center palace. Heart South, Kidney North, Liver East, Lung West—this is fixed position. Why do Kidneys not sit strictly North but split Northeast and Northwest? Answer: There are two Kidneys, split to sides, vacating the center for function. "The bright point between two Kidneys" is the True Fire in Water of the North, the root of storing Essence and housing Spirit. Though bodies are left/right, function is central. Heart-Kidney interaction spans 3.6 cun each. If rising separately from Kidneys, they would be far from the Central Yellow. Observing Zang organs requires observing their function. Question: Lung is the canopy, like lotus leaves above the Heart, centrally located, why placed Southwest? Like Kidneys, why not Southeast? Answer: Lung sits above Heart; its Mu point does not connect left but reaches right; its function is Western. Question: Why no left connection? Answer: Earth is incomplete in Southeast, leaving gaps unused. If Lung Mu connected left, Earth would have no defect. Question: Heaven is incomplete in Northwest, why Right Kidney there? Answer: Two Kidneys' function is central; this is merely an empty seat. Only the Right Kidney is empty, pairing with the San Jiao (Triple Burner), which is nameless and formless, the official of drainage, allowing waterways to exit, precisely because Heaven is incomplete in Northwest. Question: Spleen and Stomach are on the right; is their function also right? Answer: Stomach is central, Spleen is right. Food/drink in Stomach relies on Spleen for transport and Qi distribution to the body; function is central. Since function is central, West can house Lung and Spleen. If Spleen function were only right, where would Lung function go? Question: Where is Liver function? Answer: Liver Wood is East. Southeast is Earth's empty spot, Qi ownerless; Northeast is Left Kidney's base, function absent. Thus Liver Qi penetrates up and down, operating fully in the East, great in utility. Question: Where is Heart function? Answer: Outside Heart is Pericardium; outside Pericardium is Dan Zhong. Heart is Ruler; Dan Zhong is Minister-Messenger. Thus Dan Zhong is Heart's function. Question: Where is Heart's Shen (Spirit) function? Answer: Shen's function is directionless and formless, hard to speak of. Daoist Canon: "Great Mystery has no boundary, wonderful!" Da Dong Jing: "Great Mystery, boundless, wonderful." Describes perfectly. Chan Zen: "On the red flesh ball, there is a Truth Person without position." Profound! Only without position is it Truth Person; with position, it remains flesh. To glimpse it, one must be in the realm of responsive communication. Mr. said: Shallow words. If one maintains reverence, one can know the origin of Shen. Answer: This is Yao and Shun's diligence and holding true. My many words obscure; your one word illuminates, like beating a drum before Lei Men (showing off before experts). Recorded together.
Mr. Hu Youchen said: Conversations with Jiayan are like meeting the Liu brothers of Yingchuan, clearing the mind. If health falters, Chen Lin's manifesto, Mei Cheng's Seven Excitements, Du Fu's poems, Wangchuan paintings—all suffice. This discourse is bright, upright, precise, and subtle. I lack Sima Qian's pen to write Cang Gong's biography for him.