论治心痛 论上热下寒 论两胁胀满 论胃气 痛脾不化食 论痿 论厥 论吐血 论治头痛
腰背手足痛 论梦遗 喘嗽 口眼歪斜 目痛
天师曰∶偏治者,乃一偏之治法。譬如人病心痛,不治
心而偏治肝;譬如病在上,而偏治下∶譬如病在右,而偏治左;譬如病在四肢手足,而偏治其腹心也。
心痛,人以为病在心也,不知心乃神明之宰,一毫邪气不可干犯,犯则立死。人病心痛,终年累月而不
愈者,非心痛也,乃包络为心之膜,以障心宫,邪犯包络,则心必痛。包络名为膻中,乃心之臣也。相
为贼所攻,君有不振恐者乎?臣辱则君忧,此心之所以痛而不宁也。然则宜治包络,何以必责之肝也?
肝属木,包络属火,肝木生心火,治其肝木之寒,则心火有养,而包络之寒邪自散。况肝木之气既温,生
心之余,必能来生包络,故不必救包络,而必先救肝。肝木得寒,则涩而不舒,散肝中之邪,即所以散包
络之邪也。方用苍术二钱,白芍五钱,当归一两,肉桂一钱,良姜一钱,水煎
服。(〔批〕定痛至圣丹)。此寒邪犯包络之方如此。更有热邪来犯包络奈何?寒邪之犯,必恶寒,见水
则如仇雠,手火
燠之则快。热邪之犯,见水喜悦,手按之转痛是也。故热痛之病,必然呼号,不能安于床席,治法亦责之
肝。盖包络之热,由于肝经之热也。泻其肝木之旺,而去其郁热之火,不必救包络之焚,而包络之火自衰
矣。方用白芍一两,炒栀子三钱,甘草一钱,当归三钱,生地五钱,陈皮八分,
水煎
服。(〔批〕解热至圣丹。)二剂即安然如故。此偏治之一端也。病在上者,乃上焦火热之盛,吐痰如涌泉,
面赤喉痛,上身不欲盖衣,而下体冰凉,此上假热而下真寒也。方用附子一个,熟地半斤,山茱
萸四两,北五味一两,麦冬一两,茯苓三两,泽泻三两,丹皮三两,山药四
两,肉桂一两,水十余碗,煎四碗。探凉与病患服之,二刻内四碗服尽,立刻安静,此病在上而下
治之法也。(〔批〕增减地黄汤。雷公曰∶上热下寒,予更有方,用熟地三两,山萸一两,车前
子三钱。
肉桂三钱,牛膝五钱,麦冬五钱,北五味三钱,水煎冷服,一剂即安。可佐六味汤
也。天师曰∶此方奇妙)。盖此病乃下焦肾中水火俱耗尽真阴,而元阳无可居之地,于是上腾而作乱。
倘以寒药救之则愈炽,以补气药救之则反危。必须用八味地黄汤,大剂与服,加麦冬、五味,少救其肺
金之气,下治而上自安,子不见天地之道乎。冬至之时,地下大热,则天道自寒;夏至之时,地下大寒,
天上自热。人身亦如是也。肾经热,则头目咽喉心肺皆寒,安享其清肃之气;肾经寒、则头目咽喉心肺
反生其拂逆之躁矣。此亦上病下治之一法也。
病在左者,如两胁胀满,不可左卧者,此病在肝也,法亦专治肝矣。今偏不治肝,而兼治肺。盖肝
木之旺,由于肺经之虚。金不能制木,则木愈盛,木盛则脾土更无所养,肺金益虚,则肝木益旺,而病无
已时也。方用人参一钱,黄芩三钱,麦冬三钱,甘草一钱,白芍三钱,当归三
钱,柴胡一钱,茯苓一钱,陈皮五分,水煎服。一剂知,二剂愈,四剂全瘥。盖参、
乃补气之味,与肝木不相干也;虽用柴胡舒肝,然而柴胡亦是肺经主药,一味而两用之;白芍、当归,
虽专入肝经,然亦能入肺。所以同群入肺以助气,而非逐队以平肝,此左病治右之一法也。
右病治左,可以悟矣,予再传一方。人病胃气痛,或脾气不好,不能饮食,或能饮食而不能化,
作痛作满,上吐下泻者,此乃肝经来克土也。平其肝木,则脾胃之土得养、而前症俱愈矣。方用白芍三
钱,甘草一钱,当归二钱,柴胡二钱,茯苓三钱,白芥子一钱。有火者,加炒栀
子二钱;无火者,加肉桂一钱,水煎服。此方再加白术三钱;有食者,加山楂二钱;伤
米食者,加枳壳一钱,麦芽一钱;有痰者,加
半夏一钱。此方虽白术、茯苓乃脾胃之品,然其性亦能入肝。白芍、当归、柴胡,则纯是肝经之
正药;有此三味,直入肝经,则各药无不尽入肝以平木,木平则脾胃之土安然。况有食则化食,有痰则祛
痰,有火则散火,有寒则去寒,有不功效立奏者乎。此右病而左治之一法也。
治在腹心者,乃人生疡生痈,或痿厥之类是也。痈疡不治痈疡,而内治其中气,少加以祛邪散火之
品是也。备有专门,兹不再赘。如痿症、厥症甚多,不能枚举,止举一二之病,可触类而通。人有痿症,
终年不能起床,面色光鲜,足弱无力,不能举步者,人以为两足之无力也,不知乃阳明火盛。不必去治两
足,止平其胃火,则火息而足自坚凝。若不平胃火,而徒用补阴之剂,则饮食愈多,而两足益弱。法当
用元参三两,麦冬一两,甘菊花三钱,人参一钱,熟地一两,菟丝子一钱。水
数碗,煎汤四碗,恣其吞饮,则胃火渐平,而两足自然生力。此不治足而正所以治足也。
厥病,一时手足厥逆,痛不可忍。人以为手足四肢之风症也,不知乃心中热蒸,外不能泄,故四肢手
足则寒,而胸腹皮热如火。方用柴胡三钱,当归二钱,荆芥一钱,黄连二钱,炒栀子二
钱,半夏一钱,枳壳一钱,水煎服。一剂即平,二剂即全愈。(〔批〕雷公治厥,方用白芍一
两,炒栀子三钱,陈皮一钱,柴胡一钱,天花粉二钱,水煎服。治热厥最妙,以其入
肝而平木也。妙。)盖厥症多是火病,厥之甚。则热之甚也。故舒其内热,而四肢手足自温矣。方中妙在
用柴胡为君,用诸寒凉之药,直入心肝之内,又不凝滞于胸膈之间,盖柴胡能散半表半里之邪,又善疏泄
郁闷之气。若止治其四肢手足之风,而不直捣其中坚,则贼首不擒,余党安息?故不治四肢手足,而专治
其心胸也。以上三法,亦偏治之一法也。
张公曰∶此一门余无可赞高深。无已,则再言厥症、痿症。痿症中有不是阳明之痿,不可不辨。
其症亦不能起床,亦能善饭,亦骨无力不能起立。人以为此痿症也。而不知非痿症也。此肾寒极而火
沸腾,似痿而非痿也。初起之时,未尝不是阳明火炽而来,用寒凉折服之,则胃火息矣。而肾水熬干,
夜必咳嗽吐痰,而日间转觉少轻。呻吟床席,饮食少迟,更觉难堪。方用元参一两,麦冬三两,
熟地二两,水煎。服。若有肝火者,加白芍五钱,水煎服。四剂可以起床。后用六味汤,大
剂煎饮。加麦冬一两,五味一钱,熟地一两,山茱萸四钱,山药三钱,丹皮三
钱,泽泻二钱,茯苓二钱,水煎服。此方妙在用元参、麦冬,滋肺金而去心间之游火,又妙
在用熟地以补肾水,则水足而胃火自坚矣。肺金自然下生肾水,则肾水藏于肾宫,不上冲咽门,不必止
嗽,而嗽自除矣。
厥症虽多是火,然亦有非火而亦厥者,乃直中阴经也。阴寒直入于肾宫,则必挟肾水上犯心君之火。
君弱臣强,犯上自所不免。若不用大热之药,急救心君,则危亡顷刻。方用人参三钱,白术一
两,附子一钱,肉桂一钱,吴茱萸一钱,水煎服。一剂即愈。(〔批〕急救寒厥汤。)然寒
厥与热厥大相悬绝,不可不辨。寒厥手足必青,饮水必吐,腹必痛,喜火熨之。若热厥,手足虽寒,而不
青紫,饮水不吐,熨火则腹必加痛是也。能辨症清而用药者,下喉即定,便是神医,何必用追魂之符录哉。
华君曰∶偏治法多有未全,予为补之。人有病吐血者,似乎胃经之病,而不知非胃,乃肾火之冲上
也。若止治胃,则胃气益伤,胃伤则无以输精于肾,而肾水益虚,肾火愈炽,吐血无已时也。法当峻补肾
水,水足而火不上沸矣。方用六
味地黄汤加麦冬、五味,大剂吞饮,血症可痊。否则,用寒凉之品,临时止血,而血之冲决,安能
止抑哉。
如人病头痛者,人以为风在头,不知非风也,亦肾水不足,而邪火冲入于脑,终朝头晕,似头痛而
非头痛也。若止治风,则痛更甚。法当大补肾水,而头痛头晕自除。方用熟地一两,山茱萸四
钱,山药三钱,北五味二钱,麦冬二钱,元参三钱,川芎三钱,当归三钱,
葳蕤一两,二剂即愈。(〔批〕定风去晕丹)。此方妙在治肾而不治风,尤妙在治肾而兼治肝也。肝
木不平,则肺金失化源之令,而肾水愈衰。今补肝又补肾,子母相资,自然上清头目。况又入麦冬、五
味,以滋肺金之清肃乎,所以下喉即安然也。
如人患腰痛者,人以为肾之病也,不知非肾,乃脾湿之故,重如系三千文。法当去腰脐之湿,则腰
痛自除。方用白术四两,薏仁三两,水六碗,煎汤一碗,一气饮之,一剂即痛如失。此方不
治肾,而正所以治肾,世人未知也。
如人患背痛者,人以为心病,而非心也,乃膀胱之气化不行,故上阻滞而作痛。法当清其膀胱之
火。背痛自止。盖膀胱乃肾之府,肾虚膀胱亦虚。夹脊乃河车之路,膀胱借肾道而行,所以肾脊作楚耳。
方用熟地一两,茯苓五钱,肉桂三分,车前子三钱,泽泻三钱,薏仁五钱,
芡实五钱,水煎服。二剂,膀胱之水道大通,而背脊之疼亦愈矣。(〔批〕护背丹。)盖熟地乃补肾之
圣剂,肾足而膀胱之气亦足;况又有茯苓、车前、薏仁等类,以泻其水;而肉桂又引入诸药,直达膀胱。
以通其气。自然化行而水泄,水泄而火散,上行之郁结有何不除,此痛之所以立效也。
如人手足痛者,人以为脾经之热,不知非脾也,乃肝木之郁结也。散其郁气,则手足之痛自去。方用
逍遥散加栀子三钱,半夏二钱,白芥子二钱,水煎服。二剂即痛如失。盖肝木作祟,则脾
不敢当其锋,气散于四肢,结而不伸,所以作楚。今一旦平其肝气,而脾气自舒,脾舒而痛在手足有不
尽除者乎。
如人病在两足之弱,不能步履,人以为肾水之亏,不知非肾也,盖气虚不能运用耳。方用补中益气
汤加牛膝三钱,金钗石斛五钱,黄 一两,人参三钱治之。二剂即足生力。四剂可以
步履矣。盖人参、 、术,皆补气之圣药,而牛膝、石斛,亦健足之神剂,所以两用之而成功。
如人病梦遗者,人以为心气之虚,不知非心也。盖肾水耗竭,上不能通于心,中不能润于肝,下不能
生于脾土,以致玉关不关,无梦且遗。徒责之梦中之冤业,谁任其咎。法当大剂补肾,而少佐以益心、益
肝、益脾之品,自然渐渐成功,不止而止也。方用熟地一两,山茱萸四钱,北五味一钱,茯
苓三钱,生枣仁五钱,当归三钱,白芍三钱,薏仁五钱,白术五钱,白芥
子一钱,茯神二钱;肉桂三分,黄连三分。水煎服。(〔批〕断梦止遗丹。)一剂即止梦
遗,十剂即全愈。此方妙在心肝肾脾肺五脏兼补,不止止其遗,安其梦;尤妙在黄连、肉桂同用,使心
肾两交,自然魂魄宁而精窍闭。若不补其五脏,而惟是止涩之,则精愈旺而梦益动,久则不须梦而自遗
矣。此方之所以奇妙而入神也。
如人病喘嗽者,人以为肺虚而有风痰,不知非然也。乃气虚不能归元于肾,而肝木挟之作祟耳。法当
峻补其肾,少助引火之品,则气自归元,而痰喘可息,方用人参一两,熟地二两,山茱萸四钱,
麦冬五钱,五味子一钱,牛膝一钱,
枸杞子一钱,菟丝子一钱,茯苓三钱,白芥子一钱,水煎服。此方妙在多用人参于
补肾之中,使其直走丹田气海,而生元阳之神,而火自归元,不致上沸。一连数剂,必获奇功。倘以四
磨、四七等汤,治其风痰,一线元阳,必致断绝不救矣。以上诸治,皆偏治之最奇最效者,不可不补入也。
如人病口眼歪斜、人以为胃中之痰,不知非也,乃心中虚极,不能运于口目之间,轻则歪斜,重则
不语。方用人参一钱,白术五钱,茯苓三钱,甘草一钱,陈皮一钱,肉桂一
钱,菖蒲五钱;半夏一钱,当归五钱,白芍五钱治之。一剂少愈,二剂全愈。此方之
妙,全不去祛风法邪一味补正,而歪斜自愈,此方之所以为妙也。
如人病目痛而涩,无泪红赤,人以为热,不知非热也,乃肾水亏而虚火冲上耳。方用六味地黄汤加柴
胡一钱,白芍三钱,当归三钱,甘菊花三钱治之。一剂轻,二剂全愈。此亦上病治下
之法,可以参观并传之。
(始发热,渐至壮热。而后厥者,为热厥∶始不发热,而厥者∶为寒厥,李子永识。)
Discussion on Treating Heart Pain, Upper Heat and Lower Cold, Distension and Fullness of Both Hypochondria, Stomach Qi, Spleen Failure to Transform Food, Flaccidity Syndrome, Jue Syndrome, Hematemesis, Treatment of Headache, Pain in Waist, Back, Hands and Feet, Nocturnal Emission, Asthma and Cough, Deviation of Mouth and Eye, and Eye Pain.
The Heavenly Master said: "Pian Zhi" (Lateral/Specialized Treatment) refers to a treatment method targeting one aspect of the disease. For example, when a person suffers from heart pain, instead of treating the heart directly, one treats the liver; for instance, when the disease is in the upper part, one treats the lower part; for instance, when the disease is on the right, one treats the left; for instance, when the disease is in the limbs and hands/feet, one treats the abdomen and heart area.
Heart pain is commonly believed to be a disease of the heart. However, the heart is the master of spirit and consciousness (Shen Ming), and not even a trace of pathogenic factor can invade it; if invaded, death occurs immediately. When a person suffers from heart pain that persists for years without healing, it is not actually heart pain, but rather an invasion of the Pericardium (the membrane surrounding the heart, protecting it). The Pericardium acts as a shield for the heart palace. When pathogens invade the Pericardium, the heart feels pain. The Pericardium is also known as Danzhong (Chest Center), serving as the minister to the heart's sovereign. If the minister is attacked by thieves, would the sovereign not feel fear and unrest? When the minister is humiliated, the sovereign worries; this is why the heart hurts and feels unsettled. Since this is the case, why should we treat the Pericardium but instead blame the liver? The liver belongs to Wood, and the Pericardium belongs to Fire. Liver Wood generates Heart Fire. By treating the cold in Liver Wood, Heart Fire receives nourishment, and the cold pathogen in the Pericardium naturally dissipates. Moreover, once the Qi of Liver Wood becomes warm, after generating Heart Fire, it will inevitably come to generate the Pericardium. Therefore, there is no need to rescue the Pericardium directly, but rather one must first rescue the liver. When Liver Wood suffers from cold, its flow becomes stagnant and unrelaxed. Dispersing the pathogen in the liver is equivalent to dispersing the pathogen in the Pericardium. The prescription uses Cang Zhu (Atractylodis Rhizoma) 2 qian, Bai Shao (Paeoniae Radix Alba) 5 qian, Dang Gui (Angelicae Sinensis Radix) 1 liang, Rou Gui (Cinnamomi Cortex) 1 qian, and Gao Liang Jiang (Galangal Rhizome) 1 qian, decocted in water and taken orally. (Commentary: Ding Tong Zhi Sheng Dan - Supreme Holy Pill for Pain Relief). This is how the formula for cold pathogen invading the Pericardium works. What if a heat pathogen invades the Pericardium? When cold pathogen invades, there is aversion to cold; water is seen as an enemy, and warmth from fire brings comfort. When heat pathogen invades, water is pleasing, and pressure with hand exacerbates the pain. Thus, diseases of heat pain involve crying out and inability to rest on the bed. The treatment method also blames the liver. Because the heat in the Pericardium stems from heat in the Liver Meridian. By draining the excess of Liver Wood and removing the stagnant heat fire, there is no need to rescue the burning Pericardium, as the fire in the Pericardium will naturally subside. The prescription uses Bai Shao (Paeoniae Radix Alba) 1 liang, Chao Zhi Zi (Gardeniae Fructus, stir-fried) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, Dang Gui (Angelicae Sinensis Radix) 3 qian, Sheng Di Huang (Rehmanniae Radix) 5 qian, and Chen Pi (Citri Reticulatae Pericarpium) 8 fen, decocted in water and taken orally. (Commentary: Xie Re Zhi Sheng Dan - Supreme Holy Pill for Heat Resolution.) After two doses, the patient returns to normal. This is one aspect of Pian Zhi.
Diseases in the upper part are characterized by excessive fire-heat in the Upper Jiao, vomiting phlegm like a gushing spring, red face and sore throat, desire not to cover the upper body with clothes, while the lower body is ice-cold. This is false heat above and true cold below. The prescription uses Fu Zi (Aconiti Lateralis Radix Praeparata) 1 piece, Shu Di Huang (Rehmanniae Radix Praeparata) 0.5 jin, Shan Zhu Yu (Corni Fructus) 4 liang, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 1 liang, Mai Dong (Ophiopogonis Radix) 1 liang, Fu Ling (Poria) 3 liang, Ze Xie (Alismatis Rhizoma) 3 liang, Dan Pi (Moutan Cortex) 3 liang, Shan Yao (Dioscoreae Rhizoma) 4 liang, and Rou Gui (Cinnamomi Cortex) 1 liang, decocted in over ten bowls of water down to four bowls. Given cool to the patient to drink, all four bowls consumed within half an hour, resulting in immediate calmness. This is the method of treating the lower part for disease in the upper part. (Commentary: Zeng Jian Di Huang Tang - Modified Rehmannia Decoction. Lei Gong said: For upper heat and lower cold, I have another formula: Shu Di Huang (Rehmanniae Radix Praeparata) 3 liang, Shan Yu 1 liang, Che Qian Zi (Plantaginis Semen) 3 qian, Rou Gui (Cinnamomi Cortex) 3 qian, Niu Xi (Achyranthis Bidentatae Radix) 5 qian, Mai Dong (Ophiopogonis Radix) 5 qian, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 3 qian, decocted in water and taken cold. One dose brings relief. It can be used alongside Liu Wei Di Huang Wan. Heavenly Master said: This formula is wonderful.) This disease arises because the Water and Fire in the Kidney of the Lower Jiao are exhausted, depleting True Yin, leaving Yuan Yang (Primal Yang) with no place to reside, causing it to rise upward and cause chaos. If treated with cold herbs, the fire intensifies; if treated with Qi-tonifying herbs, it becomes dangerous. One must use Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill) in large doses, adding Mai Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Chinensis Fructus) to slightly assist Lung Metal Qi. Treating from below ensures peace above. Do you not see the way of Heaven and Earth? At Winter Solstice, the earth is very hot, so Heaven becomes cold; at Summer Solstice, the earth is very cold, so Heaven becomes hot. The human body is the same. If Kidney Meridian is hot, the head, eyes, throat, heart, and lungs enjoy clear and肃 (quiet/clear) Qi; if Kidney Meridian is cold, the head, eyes, throat, heart, and lungs produce rebellious irritability. This is another method of treating upper disease from below.
Diseases on the left, such as distension and fullness of both hypochondria, inability to lie on the left side, indicate disease in the Liver. The standard method is to treat the Liver specifically. However, here we do not just treat the Liver, but also treat the Lung. The exuberance of Liver Wood is due to deficiency in the Lung Meridian. Metal fails to control Wood, so Wood becomes more exuberant; exuberant Wood starves Spleen Earth, making Lung Metal more deficient, which makes Liver Wood even more exuberant, leading to endless disease. The prescription uses Ren Shen (Ginseng Radix) 1 qian, Huang Qin (Scutellariae Radix) 3 qian, Mai Dong (Ophiopogonis Radix) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, Bai Shao (Paeoniae Radix Alba) 3 qian, Dang Gui (Angelicae Sinensis Radix) 3 qian, Chai Hu (Bupleuri Radix) 1 qian, Fu Ling (Poria) 1 qian, and Chen Pi (Citri Reticulatae Pericarpium) 5 fen, decocted in water and taken orally. One dose shows improvement, two doses cure, four doses fully recover. Ren Shen and Gan Cao are Qi-tonifying substances unrelated to Liver Wood; although Chai Hu (Bupleuri Radix) soothes the Liver, it is also a principal herb for the Lung Meridian, serving a dual purpose. Bai Shao and Dang Gui enter the Liver Meridian primarily but also enter the Lung. Thus, they enter the Lung together to assist Qi, rather than marching in formation to pacify the Liver. This is the method of treating the right side for disease on the left.
Treating the left for disease on the right can be understood similarly. I will transmit another formula. When a person suffers from Stomach Qi pain, or poor Spleen Qi function, inability to eat, or ability to eat but inability to digest, causing pain and fullness, with vomiting above and diarrhea below, this is Liver Wood attacking Spleen Earth. Pacifying Liver Wood allows Spleen-Stomach Earth to be nourished, and previous symptoms heal. The prescription uses Bai Shao (Paeoniae Radix Alba) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, Dang Gui (Angelicae Sinensis Radix) 2 qian, Chai Hu (Bupleuri Radix) 2 qian, Fu Ling (Poria) 3 qian, and Bai Jie Zi (Sinapis Semen) 1 qian. If there is fire, add Chao Zhi Zi (Gardeniae Fructus, stir-fried) 2 qian; if no fire, add Rou Gui (Cinnamomi Cortex) 1 qian, decocted in water and taken orally. Add Bai Zhu (Atractylodis Macrocephalae Rhizoma) 3 qian to this formula; if there is food stagnation, add Shan Zha (Crataegi Fructus) 2 qian; if rice food injury, add Zhi Ke (Aurantii Fructus Immaturus) 1 qian and Mai Ya (Hordei Fructus Germinatus) 1 qian; if there is phlegm, add Ban Xia (Pinelliae Rhizoma) 1 qian. Although Bai Zhu and Fu Ling are Spleen-Stomach herbs, their nature also enters the Liver. Bai Shao, Dang Gui, and Chai Hu are pure principal herbs of the Liver Meridian; with these three entering the Liver Meridian directly, all other herbs enter the Liver to pacify Wood. Once Wood is pacified, Spleen-Stomach Earth is at peace. Furthermore, if there is food, it transforms food; if phlegm, it dispels phlegm; if fire, it scatters fire; if cold, it removes cold. How could efficacy not be immediate? This is the method of treating the left for disease on the right.
Treatment focusing on the abdomen and heart involves conditions like sores, carbuncles, flaccidity syndrome (Wei Zheng), or Jue syndrome. For sores and carbuncles, one does not treat the sore directly but treats the Middle Qi internally, adding some herbs to dispel pathogens and scatter fire. These have specialized treatments, so I will not elaborate further. There are many types of Wei Zheng (Flaccidity Syndrome) and Jue Syndrome (Cold/Hot Extremities Syndrome); I cannot list them all, so I mention only one or two to illustrate the principle. A person with Wei Zheng cannot get out of bed all year, has a bright complexion, weak legs unable to take steps. People think it is weakness of the legs, but it is actually excessive Fire in the Yangming (Stomach) channel. One need not treat the legs directly; pacifying Stomach Fire extinguishes the fire, and the legs naturally become firm. If one does not pacify Stomach Fire but merely uses Yin-nourishing agents, increased diet leads to weaker legs. The method uses Xuan Shen (Scrophulariae Radix) 3 liang, Mai Dong (Ophiopogonis Radix) 1 liang, Gan Ju Hua (Chrysanthemi Flos) 3 qian, Ren Shen (Ginseng Radix) 1 qian, Shu Di Huang (Rehmanniae Radix Praeparata) 1 liang, and Tu Si Zi (Cuscutae Semen) 1 qian. Decocted in several bowls of water down to four bowls, drunk freely, Stomach Fire gradually平和 (calms), and legs naturally gain strength. Not treating the feet is precisely how one treats the feet.
Jue Syndrome involves sudden cold extremities, unbearable pain. People think it is wind in the limbs, but it is actually heat steaming in the heart, unable to vent outward, causing cold hands and feet while the chest and abdomen skin is hot as fire. The prescription uses Chai Hu (Bupleuri Radix) 3 qian, Dang Gui (Angelicae Sinensis Radix) 2 qian, Jing Jie (Schizonepetae Herba) 1 qian, Huang Lian (Coptidis Rhizoma) 2 qian, Chao Zhi Zi (Gardeniae Fructus, stir-fried) 2 qian, Ban Xia (Pinelliae Rhizoma) 1 qian, and Zhi Ke (Aurantii Fructus Immaturus) 1 qian, decocted in water and taken orally. One dose calms it, two doses cure completely. (Commentary: Lei Gong treats Jue with Bai Shao 1 liang, Chao Zhi Zi 3 qian, Chen Pi 1 qian, Chai Hu 1 qian, Tian Hua Fen (Trichosanthis Radix) 2 qian, decocted in water. Excellent for Heat Jue as it enters the Liver to pacify Wood. Wonderful.) Jue syndrome is mostly a Fire disease; severe Jue means severe heat. So, soothing internal heat warms the limbs naturally. The brilliance of the formula lies in using Chai Hu as the sovereign herb, combined with various cooling herbs entering the Heart and Liver directly without stagnating in the chest/diaphragm, because Chai Hu disperses pathogens in the Shaoyang (Half-Exterior/Half-Interior) and soothes depressed Qi. If one only treats wind in the limbs without striking the core, the leader remains uncaught, and followers rest? Thus, not treating the limbs but focusing on the Heart and Chest. The above three methods are also forms of Pian Zhi.
Master Zhang said: I have nothing more profound to add to this section. Reluctantly, I will discuss Jue and Wei syndromes again. In Wei syndrome, there are cases not caused by Yangming Fire, which must be distinguished. Symptoms include inability to get out of bed, ability to eat well, bone weakness preventing standing. People think it is Wei syndrome, but it is not. This is extreme Kidney Cold causing Fire to boil, resembling Wei but not being Wei. Initially, it may stem from Yangming Fire blazing; using cold herbs to suppress it stops Stomach Fire but boils dry Kidney Water, causing night coughs and phlegm, with slight relief during the day. Moaning in bed, delayed eating causes distress. The prescription uses Xuan Shen (Scrophulariae Radix) 1 liang, Mai Dong (Ophiopogonis Radix) 3 liang, Shu Di Huang (Rehmanniae Radix Praeparata) 2 liang, decocted in water and taken. If Liver Fire exists, add Bai Shao (Paeoniae Radix Alba) 5 qian, decocted and taken. Four doses allow getting out of bed. Afterwards, use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) in large doses. Add Mai Dong 1 liang, Wu Wei Zi 1 qian, Shu Di Huang 1 liang, Shan Zhu Yu 4 qian, Shan Yao 3 qian, Dan Pi 3 qian, Ze Xie 2 qian, Fu Ling 2 qian, decocted in water and taken. This formula is wonderful for using Xuan Shen and Mai Dong to nourish Lung Metal and remove wandering Fire in the Heart, and wonderfully uses Shu Di Huang to tonify Kidney Water, so Water sufficiency solidifies Stomach Fire. Lung Metal naturally generates Kidney Water downward, storing Water in the Kidney Palace without rushing up to the throat; cough stops spontaneously.
Although Jue syndrome is mostly Fire, there are non-Fire cases involving direct invasion of Yin meridians. Yin Cold enters the Kidney Palace directly, carrying Kidney Water to attack the Fire of the Heart Sovereign. The Minister is strong, the Sovereign weak; rebellion is inevitable. Without large hot herbs to urgently rescue the Heart Sovereign, danger and death occur instantly. The prescription uses Ren Shen (Ginseng Radix) 3 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 1 liang, Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian, Rou Gui (Cinnamomi Cortex) 1 qian, and Wu Zhu Yu (Evodiae Fructus) 1 qian, decocted in water and taken orally. One dose cures. (Commentary: Ji Jiu Han Jue Tang - Emergency Rescue Decoction for Cold Jue.) However, Cold Jue and Heat Jue are vastly different and must be distinguished. Cold Jue features blue/green hands and feet, vomiting upon drinking water, abdominal pain, preference for warming. Heat Jue features cold hands and feet that are not blue/purple, no vomiting upon drinking, and abdominal pain worsened by warming. One who distinguishes symptoms clearly and prescribes correctly achieves instant results upon ingestion, becoming a divine physician; why use soul-chasing talismans?
Master Hua said: Pian Zhi methods are incomplete; I will supplement them. Hematemesis (vomiting blood) seems like a Stomach Meridian disease, but it is not; it is Kidney Fire rushing upward. Treating only the Stomach injures Stomach Qi further; injured Stomach cannot transport essence to the Kidney, worsening Kidney Water deficiency and intensifying Kidney Fire, leading to endless hematemesis. The method is to vigorously tonify Kidney Water; when Water is sufficient, Fire does not boil. Use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) added with Mai Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Chinensis Fructus), taken in large doses; blood disorders heal. Otherwise, using cold herbs to stop bleeding temporarily cannot restrain the surging blood.
Headache is thought to be Wind in the head, but it is not; it is insufficient Kidney Water allowing Evil Fire to rush into the brain, causing constant dizziness, resembling headache but not being true headache. Treating only Wind worsens pain. The method is to vigorously tonify Kidney Water, eliminating headache and dizziness. The prescription uses Shu Di Huang (Rehmanniae Radix Praeparata) 1 liang, Shan Zhu Yu 4 qian, Shan Yao 3 qian, Bei Wu Wei Zi 2 qian, Mai Dong 2 qian, Xuan Shen 3 qian, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 3 qian, Dang Gui 3 qian, and Yu Zhu (Polygonati Odorati Rhizoma) 1 liang. Two doses cure. (Commentary: Ding Feng Qu Yun Dan - Wind-Calming Dizziness-Removing Pill.) This formula is wonderful for treating the Kidney rather than Wind, and especially wonderful for treating the Kidney while simultaneously treating the Liver. If Liver Wood is unbalanced, Lung Metal loses its source of transformation, worsening Kidney Water deficiency. Now, tonifying Liver and Kidney supports mother and child, naturally clearing the head and eyes. Plus Mai Dong and Wu Wei Zi nourish Lung Metal's clarity and quietness, ensuring instant peace upon ingestion.
Lower back pain is thought to be a Kidney disease, but it is not; it is due to Spleen Dampness, feeling heavy as if tied with three thousand coins. The method is to remove dampness from the waist and navel, curing back pain spontaneously. The prescription uses Bai Zhu (Atractylodis Macrocephalae Rhizoma) 4 liang, Yi Yi Ren (Coicis Semen) 3 liang, decocted in six bowls of water down to one bowl, drunk in one breath. One dose eliminates pain. This formula treats the Kidney by not directly treating the Kidney, a secret unknown to the world.
Back pain is thought to be a Heart disease, but it is not; it is due to failure of Bladder Qi transformation, causing obstruction and pain above. The method is to clear Bladder Fire, stopping back pain. The Bladder is the mansion of the Kidney; Kidney deficiency leads to Bladder deficiency. The spine is the path of He Che (River Cart); the Bladder travels via the Kidney pathway, hence Kidney-Spine discomfort. The prescription uses Shu Di Huang 1 liang, Fu Ling 5 qian, Rou Gui 3 fen, Che Qian Zi 3 qian, Ze Xie 3 qian, Yi Yi Ren 5 qian, and Qian Shi (Euryales Semen) 5 qian, decocted in water and taken. Two doses open Bladder water passages, curing back/spine pain. (Commentary: Hu Bei Dan - Back-Protecting Pill.) Shu Di Huang is a sage agent for tonifying the Kidney; sufficient Kidney Qi suffices Bladder Qi. Plus Fu Ling, Che Qian Zi, Yi Yi Ren drain water; Rou Gui guides herbs directly to the Bladder to open Qi. Naturally, transformation occurs, water drains, fire scatters, and ascending stagnation is removed, explaining the immediate efficacy.
Hand and foot pain is thought to be Heat in the Spleen Meridian, but it is not; it is stagnation of Liver Wood. Dispersing stagnant Qi removes pain. The prescription uses Xiao Yao San (Free and Easy Wanderer Powder) added with Zhi Zi 3 qian, Ban Xia 2 qian, and Bai Jie Zi 2 qian, decocted in water and taken. Two doses eliminate pain. When Liver Wood wreaks havoc, the Spleen dares not bear the brunt; Qi scatters to the limbs, knots and fails to extend, causing pain. Pacifying Liver Qi allows Spleen Qi to relax; with relaxed Spleen, limb pain must disappear.
Weakness in both legs, inability to walk, is thought to be Kidney Water deficiency, but it is not; it is Qi deficiency failing to operate. The prescription uses Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Niu Xi 3 qian, Jin Cha Shi Hu (Dendrobii Officinalis Caulis) 5 qian, Huang Qi (Astragali Radix) 1 liang, and Ren Shen 3 qian. Two doses restore leg strength; four doses allow walking. Ren Shen, Huang Qi, and Bai Zhu are sage Qi-tonifying herbs; Niu Xi and Shi Hu are divine agents for strengthening legs. Using both succeeds.
Nocturnal emission is thought to be Heart Qi deficiency, but it is not. It is Kidney Water exhaustion, unable to connect to the Heart above, moisten the Liver in the middle, or generate Spleen Earth below, causing the Jade Gate to fail to close, leading to emission even without dreams. Blaming dream karma is futile. The method is large-dose Kidney tonification with minor additions of Heart, Liver, and Spleen tonics, achieving gradual success, stopping emission spontaneously. The prescription uses Shu Di Huang 1 liang, Shan Zhu Yu 4 qian, Bei Wu Wei Zi 1 qian, Fu Ling 3 qian, Sheng Suan Zao Ren (Ziziphi Spinosae Semen) 5 qian, Dang Gui 3 qian, Bai Shao 3 qian, Yi Yi Ren 5 qian, Bai Zhu 5 qian, Bai Jie Zi 1 qian, Fu Shen (Poria with Hostwood) 2 qian; Rou Gui 3 fen, Huang Lian 3 fen. Decocted in water and taken. One dose stops nocturnal emission; ten doses cure completely. This formula is wonderful for tonifying all five Zang organs (Heart, Liver, Spleen, Lung, Kidney), not just stopping emission but calming dreams. Especially wonderful is the combination of Huang Lian and Rou Gui, allowing Heart and Kidney to interact, naturally calming Hun and Po and closing the Essence Orifice. Without tonifying the five organs, merely using astringents makes Essence vigorous and dreams active, leading to spontaneous emission without dreams eventually. This is why the formula is miraculous and divine.
Asthma and cough are thought to be Lung deficiency with Wind-Phlegm, but this is incorrect. It is Qi deficiency failing to return to the Kidney root, with Liver Wood joining to cause trouble. The method is vigorous Kidney tonification with minor addition of Fire-guiding herbs, allowing Qi to return to the root and phlegm-asthma to cease. The prescription uses Ren Shen 1 liang, Shu Di Huang 2 liang, Shan Zhu Yu 4 qian, Mai Dong 5 qian, Wu Wei Zi 1 qian, Niu Xi 1 qian, Gou Qi Zi (Lycii Fructus) 1 qian, Tu Si Zi 1 qian, Fu Ling 3 qian, and Bai Jie Zi 1 qian, decocted in water and taken. This formula is wonderful for using much Ren Shen within Kidney tonification, allowing it to go directly to the Dantian/Qi Sea, generating Yuan Yang Spirit, returning Fire to the root, preventing upward boiling. Several consecutive doses yield miraculous results. If Si Mo Tang or Si Qi Tang were used to treat Wind-Phlegm, the thread of Yuan Yang would be severed, unrecoverable. All above treatments are the most miraculous and effective aspects of Pian Zhi, which must be supplemented.
Deviation of mouth and eye is thought to be Phlegm in the Stomach, but it is not. It is extreme Heart deficiency failing to transport to the mouth and eyes; mild cases deviate, severe cases lose speech. The prescription uses Ren Shen 1 qian, Bai Zhu 5 qian, Fu Ling 3 qian, Gan Cao 1 qian, Chen Pi 1 qian, Rou Gui 1 qian, Shi Chang Pu (Acori Tatarinowii Rhizoma) 5 qian; Ban Xia 1 qian, Dang Gui 5 qian, Bai Shao 5 qian. One dose improves slightly, two doses cure. The brilliance lies in not using wind-dispelling or pathogen-expelling methods, but solely tonifying Righteous Qi, allowing deviation to heal itself.
Eye pain with dryness, no tears, redness, is thought to be Heat, but it is not. It is Kidney Water deficiency with Deficient Fire rushing upward. The prescription uses Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) added with Chai Hu 1 qian, Bai Shao 3 qian, Dang Gui 3 qian, and Gan Ju Hua 3 qian. One dose lightens, two doses cure. This is also the method of treating the lower part for upper disease, worthy of study and transmission.
(Initial fever progressing to high fever followed by Jue is Heat Jue; initial non-fever followed by Jue is Cold Jue. Recorded by Li Zi Yong.)