答曰。病有标本。病为本令为标。用寒则顺时而失本。用热则从本而逆时。故不从标本
而从乎中治。中治者用温也。然则温不能救大
寒之病。用姜附则不可。若用姜附。似非温治之。不然衰其大半乃止。脉反四至余病便天令
治之足矣。虽用姜附。是亦中治也。非温而何。经曰。用热远热。虽用之不当。然胜主可化
亦其理也。
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东南二方用麻黄。谓开腠理发汗也。西北二方用桂枝。谓闭腠理止汗也。
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久咳不已。三焦受之。其状咳而腹满不欲食饮。此皆聚于胃关于肺。使人多涕唾。面浮肿气
逆也。钱氏异功散。
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疟之为病以暑舍于荣卫之间得秋之风寒所伤而后
发。亦有非暑感冒风寒而得之者。邪并于阳。则发热来水不能凉邪并于阴则发寒汤火不能温
。并则病作。离则病止。作止故有时。在气则发早。在血则发晏。浅则日作。深则间日。或
在头项或在背中。或在腰脊。虽上下远近之不同。在太阳一也。或在四肢者。风淫之所及。
随所伤而作。不必尽当风府也先寒而后热者。谓之寒疟。先热而后寒者。谓之温疟二者不当
治水。火当从乎中治。中治者少阳也。渴者燥胜也不渴者湿胜也。疟虽伤暑。遇秋而发。
其不应也。秋病寒甚。太阳多也。冬寒不甚。阳不
争也。春病则恶风。夏病则多汗。汗者皆少阳虚也。其病随四时。而作异形如此。又有得之
于冬而发之于暑。邪舍于肾足少阴也。有藏之于心。内热素于肺。手太阴也至于少气烦冤手
足热而呕。但热而不寒。谓之痹疟。足阳明也治之奈何。方其盛矣。
勿取必毁。因其衰也。事必大昌。治法易老疟论备矣。
Answer: Diseases have a root (Ben) and a branch (Biao). The pathogenic factor is the root, while the seasonal climate is the branch. Using cold herbs to treat follows the branch but deviates from the root; using hot herbs treats according to the root but contradicts the branch. Therefore, one should not follow merely the root or the branch, but adopt "middle treatment" (Zhong Zhi). Middle treatment involves using warm herbs. However, warm herbs cannot rescue severe cold diseases, so Ginger (Sheng Jiang) and Aconite (Fu Zi) should not be used. If Ginger and Aconite are used, it is no longer considered "warm treatment." Otherwise, one should follow the principle of "stopping when more than half of the pathogen is eliminated." When the pulse returns to four beats per respiration (normal rate), the remaining symptoms will resolve naturally in accordance with the season. Even if Ginger and Aconite are used, this still falls under the category of middle treatment; if it were not warm, what would it be? The Classics state: "When using hot remedies, avoid hot seasons." Although using them inappropriately might seem contrary, resolving the primary pathogen through treatment is also consistent with medical principles.
In the southeast regions, Ephedrae Herba (Mahuang, 麻黄) is used to open the interstices (Cou Li) and induce sweating. In the northwest regions, Cinnamon Twig Decoction (Guizhi Tang, 桂枝汤) is used to close the interstices and stop sweating.
[Diagram of Formulas for Coughs According to Zang-Fu Organs]
Chronic cough that does not heal affects the San Jiao (Triple Burner). The presentation includes coughing, abdominal fullness, and loss of appetite. This occurs because phlegm-fluids accumulate in the Stomach and affect the Lung, causing excessive nasal discharge and saliva, facial edema, and rebellious Qi. Yi Gong San (Isolated Efficacy Powder) by Qian Yi can be used.
[Diagram of Malaria Syndromes and Formulas]
Malaria arises when Summerheat (Shu) lingers between the Ying (Nutritive) and Wei (Defensive) levels, and is triggered by Wind-Cold in autumn. There are also cases not caused by Summerheat complicated by Wind-Cold. When the pathogen merges with Yang, fever occurs, and drinking water cannot cool it; when it merges with Yin, chills occur, and fire cannot warm it. When merged, the disease manifests; when separated, it ceases, hence the periodicity. If in Qi, onset is early; if in Blood, onset is late. If shallow, it occurs daily; if deep, every other day. It may manifest in the head and neck, back, or waist and spine. Regardless of location, it often relates to the Taiyang (Greater Yang) channel. Manifestations in the limbs are due to Wind pathogen invasion, occurring at the site of injury, not necessarily only at Fengfu (GV16). Chills preceding fever is called Cold Malaria (Han Nue); fever preceding chills is called Warm Malaria (Wen Nue). These two types should not be treated solely by manipulating Water or Fire, but via middle treatment, which corresponds to Shaoyang (Lesser Yang). Thirst indicates Dryness predominance; lack of thirst indicates Dampness predominance. Although Malaria originates from Summerheat, its occurrence in autumn contradicts the nature of Summerheat. Autumn has severe cold, often involving Taiyang; winter cold is mild, with less Yang contention; spring onset involves aversion to wind; summer onset involves profuse sweating, all indicating Shaoyang deficiency. The disease presents differently across seasons. Some contracts pathogens in winter but manifests in summer, with pathogens lodging in the Kidney (Foot-Shaoyin); some lodge in the Heart, with inherent internal heat affecting the Lung (Hand-Taiyin), presenting with shortness of breath, vexation, heat in hands and feet, and vomiting. Only fever without chills is called Bi Malaria, relating to Foot-Yangming. How to treat? Do not attack forcefully when the pathogen is strong, lest you damage healthy Qi; treat when the pathogen is declining, and success is assured. Yi Lao's Treatise on Malaria provides comprehensive treatment methods.