凡非风而有兼证者,则通经佐使之法本不可废。盖其脉络不通,皆由血气,血气兼证,
各有所因∶如因于风者必闭郁。因于寒者必凝涩。因于热者必干涸。因于湿者必壅滞。因于
虚者必不营运。诸如此者,皆能阻塞经络,此佐使之法所以亦有不同也。凡风闭者,宜散而
通之,如麻黄、桂枝、柴胡、羌活、细辛、白芷之属是也。寒凝者,宜热而通之,如葱、椒
、桂、附、干姜之属是也。热燥者,宜凉而通之,如芩、连、栀、柏、石膏、知母之属是也
。湿滞者,宜温利而通之,如苍术、浓朴、茵陈、萆 、五苓之属是也。血滞者,宜活而通
之,如芎、归、牛膝、红花、桃仁、大黄、芒硝之属是也。气滞者,宜行而通之,如木香、
香附、乌、沉、枳、藿之属是也。痰滞者,宜开而通之,如南星、半夏、牛黄、天竺黄、朱
砂、海石、玄明粉之属是也。气血虚弱者,宜温补而通之,如参、 、归、术、熟地、枸杞
、杜仲、牛膝之属是也。凡此通经之法,若乎尽矣,然虚实之异犹当察焉。盖通实者,各从
其类。使无实邪,而妄用通药,则必伤元气,反为害矣。通虚者,则或阴或阳,尤当知其要
也。如参 所以补气。而气虚之甚者,非姜附之佐,必不能追散失之元阳;归地所以补精血
,而阴虚之极者,非桂附之引,亦不能复无根之生气。寒邪在经,而客强主弱,非桂附之勇
则血脉不行,寒邪不去。痰湿在中而土寒水泛者,非姜附之暖,则脾肾不健,痰湿不除。此
通经之法,大都实者可用寒凉,虚者必宜温热也。但附子之性,刚勇而热,凡阴虚水亏而多
热多燥者,自非所宜;若无燥热,但涉阳虚,而诸药有不及者,非此不能达也。古人云∶附
子与酒同功,义可知矣。今人谓附子有毒,多不敢用,不知制用得宜,何毒之有,此诚奇品
,其毋忽之。
In cases of non-wind diseases (stroke-like disorders) accompanied by concurrent syndromes, the method of using adjuvant and guiding herbs to unblock the meridians should not be discarded. This is because the obstruction of meridian collaterals stems from issues with Blood and Qi. The concurrent syndromes of Blood and Qi have various causes: if caused by Wind, there must be closure and depression; if caused by Cold, there must be coagulation and stagnation; if caused by Heat, there must be drying and depletion; if caused by Dampness, there must be congestion and stasis; if caused by Deficiency, there must be failure of circulation. All such conditions can block the meridians, which is why the methods for using adjuvants and guides differ accordingly.
For cases of Wind closure, it is appropriate to use dispersing agents to promote flow, such as Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi), Bupleuri Radix (Chaihu), Notopterygii Rhizoma et Radix (Qianghuo), Asari Radix et Rhizoma (Xixin), and Angelicae Dahuricae Radix (Baizhi). For Cold coagulation, it is appropriate to use hot agents to promote flow, such as Allii Fistulosi Bulbus (Congbai), Zanthoxyli Pericarpium (Jiaopao), Cinnamomi Cortex (Rougui), Aconiti Lateralis Radix Praeparata (Fuzi), and Zingiberis Rhizoma (Ganjiang). For Heat dryness, it is appropriate to use cool agents to promote flow, such as Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Zhizi), Phellodendri Cortex (Huangbai), Gypsum Fibrosum (Shigao), and Anemarrhenae Rhizoma (Zhimu). For Dampness stasis, it is appropriate to use warm and diuretic agents to promote flow, such as Atractylodis Macrocephalae Rhizoma (Cangzhu), Magnoliae Officinalis Cortex (Houpo), Yinchenhao, Dioscoreae Hypoglaucae Rhizoma (Bixie), and Wuling San (Five-Ling Powder). For Blood stasis, it is appropriate to use blood-activating agents to promote flow, such as Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Achyranthis Bidentatae Radix (Niuxi), Carthami Flos (Honghua), Persicae Semen (Taoren), Rheum Palmatum Radix et Rhizoma (Dahuang), and Mirabilite (Mangxiao). For Qi stagnation, it is appropriate to use Qi-moving agents to promote flow, such as Aucklandiae Radix (Muxiang), Cyperi Rhizoma (Xiangfu), Linderae Fructus (Wuyao), Aquilariae Lignum Resinatum (Chenxiang), Aurantii Fructus Immaturus (Zhishi), and Agastaches Herba (Huoxiang). For Phlegm stasis, it is appropriate to use phlegm-resolving and orifice-opening agents to promote flow, such as Pinelliae Tuber Preparatum (Nanxing), Pinelliae Tuber (Banxia), Bos Calculus (Niuhuang), Bambusae Spica (Tianzhuhuang), Cinnabaris (Zhusha), Lithostes (Haishi), and Natrii Sulfas Exsiccatus (Xuanmingfen). For Qi and Blood deficiency, it is appropriate to use warming and tonifying agents to promote flow, such as Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi), Angelicae Sinensis Radix (Danggui), Atractylodis Macrocephalae Rhizoma (Baizhu), Rehmanniae Radix Praeparata (Shudihuang), Lycii Fructus (Gouqi), Eucommiae Cortex (Duzhong), and Achyranthis Bidentatae Radix (Niuxi).
These methods for unblocking the meridians seem exhaustive, yet one must still carefully distinguish between Excess and Deficiency. To treat Excess, one follows the nature of the pathogen; without Excess pathogens, the reckless use of purgative/unblocking drugs will inevitably damage Yuan Qi (Original Qi), causing harm instead. To treat Deficiency, whether targeting Yin or Yang, one must grasp the key principles. For instance, Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi) are used to tonify Qi; however, in severe Qi deficiency, without the assistance of Zingiberis Rhizoma (Ganjiang) and Aconiti Lateralis Radix Praeparata (Fuzi), it is impossible to retrieve scattered Yuan Yang (Original Yang). Angelicae Sinensis Radix (Danggui) and Rehmanniae Radix Praeparata (Shudihuang) are used to tonify Essence and Blood; however, in extreme Yin deficiency, without the guidance of Cinnamomi Cortex (Rougui) and Aconiti Lateralis Radix Praeparata (Fuzi), it is impossible to restore the life force rooted in nothingness. When Cold pathogens reside in the meridians and the exogenous pathogen is strong while the host is weak, without the bold action of Cinnamomi Cortex (Rougui) and Aconiti Lateralis Radix Praeparata (Fuzi), the blood vessels cannot circulate, and the Cold pathogens cannot be expelled. When Phlegm and Dampness are in the Middle Jiao and the Earth element is cold with Water overflowing, without the warmth of Zingiberis Rhizoma (Ganjiang) and Aconiti Lateralis Radix Praeparata (Fuzi), the Spleen and Kidney will not be robust, and the Phlegm and Dampness will not be eliminated. Generally, these methods for unblocking meridians indicate that Excess patterns may use Cool/Cold herbs, while Deficiency patterns must use Warm/Hot herbs.
However, the nature of Aconiti Lateralis Radix Praeparata (Fuzi) is bold, fierce, and hot. It is naturally unsuitable for those with Yin deficiency and fluid depletion who suffer from much Heat and dryness. If there is no dryness or heat, but only Yang deficiency, and other herbs are insufficient, Fuzi is indispensable. The ancients said that Fuzi shares the same efficacy as wine, the meaning of which is clear. Modern people believe Fuzi is toxic and dare not use it, unaware that if processed and administered properly, what toxicity could there be? This is indeed a unique treasure; do not neglect it.