济生拔粹云。宣可以去壅。姜橘之属是也。此大略言之。盖外感六经之邪。欲传入里。
三阴
有
。未深入胃中。以生姜橘皮治之。或以藿香丁香半夏枳壳之类投之必愈。此天分气分虚无处
。一无所受。今乃窒在。仲景谓膈之上属上焦。于表或有形质之物。因而越之则可。若气壅
则不可用破气药也。(辛泻气。越之者吐也。亦无下之理)若阴虚哕气逆上。窒塞呕哕不定
之
病。此地道不通也。正当用生地黄当归桃仁红花之类。和血凉血润血。兼用甘药以补其气
。微加大黄芒硝以通其闭。大便利。邪气去。则气逆呕哕自不见矣。复有胃中虚热。谷气久
虚。发而为呕哕者。但得五谷之阴以和之。五谷皆属阴。或食或饮。白汤皆止呕哕则呕哕自
止。且如小儿斑后。余热不退。痂不收敛。大便不行。是谓血燥。则当以阴药治血。因而补
之。用清凉饮子。通利大便。而泻其热也。洁古云。凉风至而草木实。夫清凉饮子乃秋风彻
热之剂。伤寒家邪入于里。日晡潮热。大渴引饮。谵语燥狂。不大便。是谓胃实。乃可攻之
。夫胃气为湿热所伤。以承气汤泻其土实。元气乃得周流。承气之名于此见矣。今衰世人以
苦寒泻火。故备陈之。除热泻火。非甘寒不可。以苦寒泻火。非徒无益。而反害之。故谆谆
及此。至如孙真人言生姜呕家之圣药。谓上焦气壅表实而言之。非以泻气而言之也。若脾胃
虚弱。谷气不行。荣卫下流。清气不上。胸中闭塞。惟益气推扬谷气而已。不宜泻也。若妄
以泻气泻血下之。则转增闭塞疼痛。或变作结胸。复不缓下其膈。由此至危者多矣。针经说
。呵欠哕唏。振塞噫嚏。 涕泪出。太息涎下。耳中鸣。自啮舌颊唇。视主病者补之。此十
二邪者皆奇邪之走空窍者也。凡邪之所在。皆为不足。宜补而不宜泻。空窍者胃之清气能通
也。胃既虚则谷不上行。是气路不利。经云。廉泉玉英者津液之道路也。津液不上。胸中气
路不开。亦令人哕。勿作外实。以辛药生姜之类。泻其壅滞。盖肺气已虚。而反泻之。是重
泻其气。必胸中如刀 之痛。与正结胸无异。亦声闻于外。用药之际。可不慎哉。
通。可以去滞。通草防己之属是也。防己大苦寒。能泻血中大热之滞也。亦能泻大便。
与大
泻气
约缩
咽嗌
苓泽
肺中
极。
求治
无阴
利小
方寒
久
在
遂处以禀北方之寒水所化。大苦寒气味者。黄柏知母各二两。酒洗之。以肉桂为之引用。所
谓寒因热用者也。同为极细末。煎热水为丸。如梧桐子大。焙干。空腹。令以沸汤下二百丸
。少时乘热药之。须臾如刀刺前阴火烧之痛。溺如暴泉涌出。卧具尽湿。床下成流。顾盼之
间。肿胀消散。故因记之。或曰。防己之性若何。曰。防己大苦寒。能泄血中之湿热。通血
中之滞塞。补阴泻阳。助秋冬泻春夏药也。比之于人。则险而健者也。险健小人幸灾乐祸。
遇风尘之警。则首为乱阶。然而见善亦喜。逢恶亦怒。如善用之。亦可以敌凶暴之人。保险
固之地。此瞑眩之药。圣人有所存而不废耳。大抵闻其臭则可恶。下咽则令人身心为之烦乱
。饮食为之减少。至于十二经有湿热。壅塞不通。及治下疰香港脚。除膀胱积热。而庇其基本
。非此药不可。其行经之仙药。无可代之者。复有不可用者数事。若遇饮食劳倦。阴虚生内
热。元气谷气已亏之病。以防己泄大便。则重亡其血。此不可用一也。如大渴人引饮。是热
在上焦肺经气分。宜淡渗之。此不可用二也。若人久病。津液不行。上焦虚渴。补以人参葛
根之甘温。用苦寒之剂则速危。此不可用三也。若下有湿热。流入十二经。致二阴不通。然
后可审而用之耳。
补。可以去弱。人参羊肉之属是也。夫人参之甘温。能补气之虚。羊肉之甘热。能补血
之虚
也。
人之
乃生长万物也。地欲静。静则万物
用者也。动之有时。春耕是也。若
万化不安。亦如人之劳役形体。则
则百脉争张。血脉沸腾。精气竭
曷若救其未病。为拔本塞源之
省语养气。庶几于道。何病之
升。则四脏各得其所。以气论
食。适其寒温。黄 之甘温。
脾胃之中经络之气。肺主诸气
谓也。血不自生。须得生阳气
无阳故也。仲景以人参为补血
黄之属是也。此二味皆大苦寒。葶苈气味俱浓。不减大黄。又性过于
闭也。亦能泻大便。为体轻象阳故也。大黄之苦寒。能走而不守。泻
中壅积有形之物闭塞者也。阳明病。胃家实是也。日晡潮热、大渴躁
便。使通和汗出而愈矣。一则治血病泻大便。一则泻气闭利小便。若
有疼痛。一概用牵牛大黄下之。乖戾甚矣。通则不痛。痛则不通。痛
则疼痛去矣。如轻可以去实。麻黄葛根之属是也。谓如头痛。当以细
所凝滞。即痛随利减也。臂痛有六道经络。究其痛在何经络之闭。以
血通利则愈矣。若表上诸疼痛。便下之则不可。当详细而辨之也。轻。可以去实。麻黄葛根
之属是也。夫六淫有余之邪。客于阳分皮毛之间。腠理闭拒。谓之
之谓也。宜以轻利开腠理致津液通气也。皮毛经络寒邪之实去矣。
象气之轻浮也。寒邪为实。轻可以去之。若大同而小异。盖麻黄微
寒水之经。其经皆下行。本寒而又受外寒。汗出乃愈。当以发之。
燥火之经。身以前所受寒也。非正发汗之药。谓阳明禁发汗利小便
其气和汗自出矣。麻黄专发汗。去皮毛气分寒邪。葛根和解血分
实。不能泻里实。若饮食劳倦杂病自汗表虚之证。认作有余。便
虚。此盖不知表虚宜补。其亡阳其自汗。秋冬用桂枝。春夏用黄
自汗。阳明胃主自汗。
小便数。若以人参甘草之
而出。清气上行。虽飧泄
亦
其表。仲景所论内外不足自
不可禁也。寒邪已出。重发
故也。汗家不得重发汗。小
一云亡阳。一云脱血。病
根之宜禁。故兼及之。
Jisheng Bahui states: The method of "Xuan" (dispersing and unblocking) can eliminate stagnation. Substances such as Shengjiang (Zingiberis Rhizoma, Fresh Ginger) and JuPi (Citri Reticulatae Pericarpium, Tangerine Peel) are representative. This is a general statement. Generally speaking, when pathogens from the Six Meridians (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin) externally contract and intend to transmit inward, if there is stagnation in the Three Yin meridians but has not yet deeply entered the Stomach, it can be treated with Shengjiang or JuPi. Alternatively, administering herbs such as Huoxiang (Agastaches Herba), Dingxiang (Caryophylli Flos), Banxia (Pinelliae Rhizoma), and Zhike (Aurantii Fructus Immaturus) will surely lead to recovery. This occurs because the innate constitution and Qi dynamics have void areas where nothing should be retained, yet now they are obstructed. Zhang Zhongjing stated that the area above the diaphragm belongs to the Upper Jiao. If there are pathogenic factors or tangible substances on the exterior, they can be expelled via emesis (Yue). However, if it is Qi stagnation, Qi-breaking medicines should not be used. (Pungent flavors drain Qi; "Yue" refers to vomiting/emesis, and there is no rationale for using purgatives). If there is hiccups due to Yin deficiency with rebellious Qi rising, causing obstruction, vomiting, and irregular hiccups, this indicates blockage in the "Earthly Pathway" (intestines). One should appropriately use Shengdihuang (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Taoren (Persicae Semen), and Honghua (Carthami Flos) to harmonize, cool, and moisten the blood, while simultaneously using sweet-flavored medicines to tonify Qi. Slightly adding Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas) to unblock the closure. Once bowel movements are smooth and pathogenic factors are eliminated, the rebellious Qi, vomiting, and hiccups will naturally cease.
Furthermore, if there is deficient heat in the Stomach, with long-term deficiency of Grain Qi manifesting as vomiting and hiccups, obtaining the Yin nature of the Five Grains to harmonize it suffices. All five grains belong to Yin; whether consumed as food or drink, plain hot water can stop vomiting and hiccups, thus resolving the condition spontaneously. For instance, after children suffer from smallpox/rash, if residual heat persists, scabs do not heal, and bowel movements are absent, this is termed Blood Dryness. In such cases, Yin-nourishing medicines should be used to treat the blood and subsequently tonify it. Using Liangqing Yinzi (Cooling Decoction) to promote bowel movements thereby clearing the heat. Jiegu stated: "When cool winds arrive, grasses and trees bear fruit." Liangqing Yinzi is a formula that clears heat like autumn wind. In typhoid diseases, when pathogens enter the interior, tidal fever occurs in the afternoon (Shen/You hours), accompanied by intense thirst, delirium, restlessness, mania, and constipation. This is termed Stomach Excess (Wei Shi), and only then can purgative methods be applied. When Stomach Qi is injured by damp-heat, using Chengqi Tang (Stomach Harmony Decoction) to purge the Earth excess allows Yuan Qi (Primal Qi) to circulate freely throughout the body. The name "Chengqi" derives from this mechanism. Nowadays, people mistakenly use bitter-cold medicines to drain fire. Therefore, these points are elaborated extensively. To clear heat and drain fire, sweet-cold medicines are indispensable. Using bitter-cold medicines to drain fire is not only ineffective but also harmful. Hence, this is emphasized repeatedly. Regarding Sun Simiao's statement that Shengjiang is the holy medicine for vomiting, he referred to Qi stagnation in the Upper Jiao and exterior excess, not to draining Qi. If Spleen and Stomach Qi are weak, Grain Qi fails to move, Ying and Wei Qi flow downward, Clear Qi fails to ascend, and the chest is blocked, one should only tonify Qi and promote the ascent of Grain Qi, rather than draining. If one recklessly uses Qi-draining, Blood-draining, or purgative methods, it will exacerbate obstruction and pain, potentially transforming into Jie Xiong (Chest Binding syndrome). If the diaphragmatic obstruction is not relieved gently, many deaths may result. The *Needle Classic* states: yawning, hiccups, sighing, shivering, nasal congestion, sneezing, runny nose, tearing, deep sighing, salivation, tinnitus, and self-biting of tongue/cheeks/lips. Treat by tonifying the affected meridian. These twelve types of pathogens are odd pathogens wandering through the orifices. Wherever pathogens reside, it is due to deficiency; thus, tonification is indicated over drainage. The patency of orifices depends on the Clear Qi of the Stomach. If the Stomach is deficient, Grain Qi cannot ascend, leading to impaired Qi pathways. The classics state: Lianquan and Yuying are the pathways for fluids. If fluids fail to ascend and the chest Qi pathway is blocked, hiccups may occur. Do not mistake this for exterior excess and use pungent-warm medicines like Shengjiang to drain stagnation. Since Lung Qi is already deficient, draining it further constitutes severe Qi depletion, inevitably causing chest pain like knife stabbing, indistinguishable from true Jie Xiong, with audible sounds. Caution is essential in medication.
The method of "Tong" (unblocking/patency) can remove stagnation. Tongcao (Tetrapanici Medulla) and Fangji (Stephaniae Tetrandrae Radix) are examples. Fangji is greatly bitter and cold, capable of draining heat stagnation in the blood and promoting bowel movements. [Text fragment missing] ...formulated based on receiving the cold water of the North, using Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma), each two liang, washed with wine, with Rougui (Cinnamomi Cortex) as a guiding herb. This is called "treating cold with heat." Ground into fine powder, mixed with hot water to form pills the size of paulownia seeds, dried. Taken on an empty stomach with boiling water, 200 pills at a time. Shortly after taking the warm medicine, within moments, there is a sensation of knife-like burning pain in the anterior genitalia, and urine flows out like a gushing spring, wetting bedding and flowing under the bed. In the blink of an eye, swelling dissipates. Thus, it is recorded. Someone asked: What is the nature of Fangji? Answer: Fangji is greatly bitter and cold, able to drain damp-heat from the blood, unblock blood stagnation, tonify Yin, and drain Yang. It assists in draining Spring/Summer pathogens during Autumn/Winter. Compared to humans, it is dangerous yet robust. Dangerous villains rejoice in others' misfortune and instigate chaos during crises, yet they also appreciate good and detest evil. If used properly, it can counter violent forces and secure safety. This is a "Mingxuan" (reversal reaction) medicine; sages retain it without abolishing it. Generally, its odor is repulsive, and upon ingestion, it causes mental and physical agitation and reduces appetite. However, for damp-heat in the Twelve Meridians causing blockage, treating lower sores and podagra, clearing bladder accumulated heat, and protecting the root, this medicine is irreplaceable. It is a miraculous drug for meridian circulation, having no substitute. There are several contraindications. First, if illness arises from diet and fatigue, with internal heat due to Yin deficiency and depleted Yuan/Grain Qi, using Fangji to purge bowels will cause further loss of blood; this is the first contraindication. Second, if a person is extremely thirsty and drinks excessively, the heat is in the Upper Jiao/Lung Qi level; light leaching agents are suitable; this is the second contraindication. Third, if a person suffers from chronic illness with non-moving fluids and Upper Jiao deficiency-thirst, tonifying with Ganwen (sweet-warm) herbs like Renshen (Ginseng Radix) and Gegen (Puerariae Lobatae Radix) is appropriate; using bitter-cold agents would rapidly endanger life; this is the third contraindication. Only when damp-heat flows from below into the Twelve Meridians, causing blockage of the two yin openings, should it be used cautiously.
The method of "Bu" (tonification) can address weakness. Renshen (Ginseng Radix) and Yangrou (Ovis/Aries Meat) are examples. Renshen is sweet and warm, tonifying Qi deficiency; Yangrou is sweet and hot, tonifying Blood deficiency. Human... [Text fragment missing] ...grows all things. Earth desires stillness; stillness allows all things to... [Text fragment missing] ...use. Movement has its timing; spring plowing is an example. If... [Text fragment missing] ...ten thousand transformations are unsettled, it is like human physical labor, causing... [Text fragment missing] ...meridians to compete in expansion, blood vessels to boil, and Essence/Qi to exhaust... [Text fragment missing] ...why not prevent disease before it arises, addressing the root? ...concise words to nourish Qi, approaching the Dao, what disease would... [Text fragment missing] ...ascend, allowing the Four Zang organs to find their proper places. Discussing Qi... [Text fragment missing] ...diet, adjusting cold and warmth, Huangqi (Astragali Radix) is sweet and warm... [Text fragment missing] ...Qi in the meridians of the Spleen and Stomach; Lung governs all Qi... [Text fragment missing] ...so it is said. Blood does not generate itself; it requires the generation of Yang Qi... [Text fragment missing] ...due to lack of Yang. Zhang Zhongjing used Renshen to tonify Blood... [Text fragment missing] ...Huangqi and similar herbs. These two are greatly bitter and cold; Tingli (Descurainiae/Sisymbrii Semen) has strong flavor and effect, comparable to Dahuang, but its nature is overly... [Text fragment missing] ...closure. It can also purge bowels because its texture is light and corresponds to Yang. Dahuang's bitter cold moves freely and does not stay, draining... [Text fragment missing] ...tangible obstructions accumulating in the center. Yangming disease, characterized by Stomach excess, presents with afternoon tidal fever, intense thirst, restlessness... [Text fragment missing] ...bowel movement, allowing harmony and sweating to resolve the condition. One treats blood disease by purging bowels; the other drains Qi closure to promote urination. If... [Text fragment missing] ...pain exists, indiscriminately using Qianniu (Pharbitidis Semen) and Dahuang to purge is highly inappropriate. Patency prevents pain; pain indicates blockage. When... [Text fragment missing] ...pain is removed. As for "Qing" (lightness) removing excess, Mahuang (Ephedrae Herba) and Gegen are examples. For headache, use Xi... [Text fragment missing] ...stagnation, pain decreases with relief. Arm pain involves six meridians; determine which meridian's blockage causes the pain, and... [Text fragment missing] ...blood patency leads to healing. If exterior pains exist, purging is contraindicated; detailed differentiation is required. Lightness removes excess; Mahuang and Gegen are examples. The excess pathogens of the Six Evils lodge between the skin/hair and Yang levels, blocking the Cou Li (pores), termed... [Text fragment missing] ...phenomenon. Light and penetrating herbs should open pores, generate fluids, and move Qi. The excess cold pathogens in skin and meridians are removed... [Text fragment missing] ...like floating Qi. Cold pathogen as excess can be removed by lightness. Similar yet different, Mahuang slightly... [Text fragment missing] ...Cold Water meridians descend; originally cold and receiving external cold, sweating resolves it, requiring dispersal... [Text fragment missing] ...Dry Fire meridians, cold received on the front of the body, not standard sweating herbs; Yangming prohibits sweating and promoting urination... [Text fragment missing] ...Qi harmonizes and sweat emerges. Mahuang specifically induces sweating, removing cold pathogens from skin/hair Qi level; Gegen harmonizes Blood level... [Text fragment missing] ...excess, cannot purge interior excess. If spontaneous sweating and exterior deficiency arise from diet/fatigue/miscellaneous diseases, mistaking them for excess... [Text fragment missing] ...deficiency, failing to know exterior deficiency requires tonification. Yang collapse and spontaneous sweating: Cinnamon Twig (Guizhi Tang) in autumn/winter, Huang... [Text fragment missing] ...spontaneous sweating; Yangming Stomach governs spontaneous sweating... [Text fragment missing] ...frequent urination; if using Renshen and Gancao... [Text fragment missing] ...emerges, Clear Qi ascends, even if loose stools occur... [Text fragment missing] ...also... [Text fragment missing] ...exterior. Zhang Zhongjing discussed internal/external deficiency... [Text fragment missing] ...cannot be prohibited. Once cold pathogens exit, heavy sweating... [Text fragment missing] ...reason. Those who sweat frequently must not sweat heavily again, small... [Text fragment missing] ...one says Yang collapse, one says Blood loss, disease... [Text fragment missing] ...root should be prohibited, hence mentioned together.