一、热方之制。为除寒也。夫寒之为病。有寒邪犯于肌表者。有生冷伤于脾胃者。有阴寒中于脏腑者。
此皆外来之寒。去所从来。则其治也。是皆人所易知者。至于本来之寒。生于无形无响之间。初无所感。
莫测其因。人之病此者最多。知此者最少。果何谓哉。观丹溪曰。气有余。便是火。余续之曰。
气不足。便是寒。夫今人之气有余者。能十中之几。其有或因禀受。或因丧败。以致阳气不足者。
多见寒从中生。而阳衰之病。无所不致。第其由来者渐。形见者微。当其未觉也。孰为之意。及其既甚也。
始知难治。矧庸医多有不识。每以假热为真火。因复毙于无形无响者。又不知其几许也。故惟高明见
道之士。常以阳衰根本为忧。此热方之不可不豫也。凡用热之法。如干姜能温中。亦能散表。呕恶
无汗者宜之。肉桂能行血。善达四肢。血滞多痛者宜之。吴茱萸善暖下焦。腹痛泄泻者极妙。肉豆蔻
可温脾胃。飧泄滑利者最奇。胡椒温胃和中。其类近于荜茇。丁香止呕行气。其暖过于豆仁。补骨脂性
降而善闭。故能纳气定喘。止带浊泄泻。制附子性行如酒。故无处不到。能救急回阳。至若半夏、
南星、细辛、乌药、良姜、香附、木香、茴香、仙茅、巴戟之属。皆性温之当辨者。然用热之法。
尚有其要。以散兼温者。散寒邪也。以行兼温者。行寒滞也。以补兼温者。补虚寒也。第多汗者忌姜。
姜能散也。失血者忌桂。桂动血也。气短气怯者忌骨脂。骨脂降气也。大凡气香者。皆不利于气虚证。
味辛者。多不利于见血证。是用热之概也。至于附子之辨。凡今之用者。必待势不可为。不得已然后
用之。不知回阳之功。当于阳气将去之际。盒饭渐用以望挽回。若用于既去之后。死灰不可复燃。
尚何益于事哉。但附子性悍。独任为难。
必得大甘之品。如人参、熟地、炙甘草之类。皆足以制其刚而济其勇。以补培之。无往不利矣。
此壶天中大将军也。可置之无用之地乎。但知之真而用之善。斯足称将将之手矣。
1. The formulation of heat-inducing prescriptions is intended to dispel cold pathogens. Cold diseases caused by cold pathogens include those where cold pathogens invade the muscle and surface (muscle-surface level), those where raw or cold food damages the Spleen and Stomach, and those where Yin-cold penetrates the Zang-Fu organs.
These are all exogenous cold pathogens; removing their source clarifies the treatment. These are matters easily understood by people. However, primordial cold arises from formless and soundless origins, initially presenting with no sensations, making its cause unpredictable. Many suffer from this disease, yet few understand it. What does this mean? Zhu Danxi stated, "Excess Qi constitutes Fire." I add, "Deficient Qi constitutes Cold."
In contemporary times, cases of excess Qi are rare. Those who, due to congenital endowment or acquired depletion, suffer from deficient Yang often manifest internal cold generation, leading to various diseases of Yang decline. Yet, the onset is gradual, and symptoms are subtle. When undetected, who pays attention? Only when the condition becomes severe do they realize it is difficult to treat. Moreover, mediocre physicians often fail to recognize this, mistaking false heat for true fire, resulting in countless deaths from misdiagnosis of formless conditions. Therefore, only insightful masters who comprehend medical principles worry about the root of Yang deficiency. This underscores the necessity of preparing heat-inducing prescriptions in advance.
Regarding the application of heat-inducing methods: Dried Ginger (Shengjiang) warms the Middle Jiao and can also disperse exterior cold, suitable for vomiting, nausea, and anhidrosis. Cinnamon Twig (Rougui) promotes blood circulation and reaches the four limbs, suitable for blood stasis accompanied by pain. Evodia Fruit (Wuzhuyu) warms the Lower Jiao, being excellent for abdominal pain and diarrhea. Nutmeg (Roudoukou) warms the Spleen and Stomach, showing remarkable efficacy for undigested stool in diarrhea and slippery discharge. Black Pepper (Hujiao) warms the Stomach and harmonizes the Middle, similar in nature to Long Pepper (Bibo). Clove (Dingxiang) stops vomiting and moves Qi, possessing greater warming properties than Cardamom (Douren). Psoralea Fruit (Buguzhi) has a descending nature and is good at astringency, thus able to grasp Qi to calm asthma, stop leukorrhea turbidity, and treat diarrhea. Prepared Aconite Root (Zhi Fuzi) acts swiftly like wine, reaching everywhere, capable of rescuing emergencies and restoring Yang. As for Pinellia Rhizome (Banxia), Arisaema Rhizome (Nanxing), Asarum Root (Xixin), Lindera Root (Wuyao), Galangal Rhizome (Liangjiang), Cyperus Rhizome (Xiangfu), Aucklandia Root (Muxiang), Fennel Seed (Huixiang), Curculigo Rhizome (Xianmao), and Morinda Root (Baji), these are all warm-natured herbs requiring careful differentiation.
However, there are key principles in using heat-inducing methods: combining dispersing with warming dispels cold pathogens; combining moving with warming resolves cold stagnation; combining tonifying with warming treats deficiency-cold. Conversely, those with excessive sweating should avoid Ginger as it disperses; those with hemorrhage should avoid Cinnamon as it agitates blood; those with shortness of breath and timidity should avoid Buguzhi as it descends Qi. Generally, aromatic substances are unfavorable for Qi-deficiency syndromes; pungent substances are often unfavorable for bleeding syndromes. This summarizes the use of heat-inducing agents.
Regarding the differentiation of Aconite (Fuzi): currently, it is often used only when the situation is hopeless and out of desperation. One fails to realize that the merit of restoring Yang should be utilized when Yang is on the verge of departing, administered gradually to hope for recovery. If used after Yang has already departed, it is like trying to reignite dead ash, yielding no benefit. Since Aconite is fierce and difficult to use alone, it must be combined with sweet and substantial herbs such as Ginseng (Renshen), Prepared Rehmannia Root (Shudi), and Honey-fried Licorice Root (Zhigancao). These can restrain its harshness and assist its vigor, facilitating tonification and ensuring efficacy without adverse effects. It is the Great General within the vessel of life; how can it be left unused? Only through true understanding and skillful application can one demonstrate the ability to command generals effectively.