论肾虚感寒 水亏夜热
天师曰∶阴治者,病症乃阴气不足,而阴邪又犯之也。如肾水虚寒,又感寒者;或肾水亏竭,夜热
昼寒是也。此等病,若认作阳症治之,则口渴而热益炽,必致消尽阴水,吐痰如絮,咳嗽不已,声哑声嘶,
变成痨瘵。法当峻补其阴。则阴水足而火焰自消,骨髓清泰,上热余火俱归乌有矣。方用熟地一两,山茱
萸五钱,麦冬五钱,北五味五钱,元参三
钱,地骨皮三钱,丹皮一钱,沙参五钱,白芥子一钱,芡实五钱,车前子一钱,桑叶七片,水
煎服。(〔批〕安火至圣汤。)此方妙在全用纯阴之品,一直竟进肾宫,滋其匮乏,则焦急之形,不上
焰于口舌皮毛之际∶又加元参、地骨皮、沙参、丹皮之品,少清其骨髓中之内热,自然阴长阳消,不治
阳而自安也,又何必更加柴胡以散之,而邪始去哉。此方乃治阴火自动者神效。若阴寒无火者,又不宜
用此方。当用肉桂一钱,附子一钱,熟地一两,山茱萸四钱,白术三钱,人参三钱,柴胡五分,水煎
服。(〔批〕祛寒至圣丹。)此方之妙用附、桂祛寒之药,加之于参、熟补阴之内,使阳得阴而有制,不
致奔越沸腾∶少加柴胡数分,则阴邪自散,又何必纯用麻黄、桂枝之类,铄尽真阴哉;况肾中之火,必
得水而后生。以水非邪水,乃真水也。邪水可以犯心而立死,真水可以救心而长延。盖阳根于阴,而真
阴肾水,实为真阳君相之火之母也。此方中加熟地,山萸,正是此意。(〔批〕妙极)恐人未知,故又表
而出之。倘止用附、桂以祛寒,未尝不效。然而邪去而阴消,必然枯竭。苟或治之不得法。必有亡阳之
症矣。愿人加意于水中补火,更于水中去邪也。
张公曰∶妙绝之论,发千古所未发,何以再赞高深。然尚有一方以参之。前症乃阴虚火动也,用六
味汤似亦相宜;后症乃阴寒无火也,八味汤似亦可用,然而终不及天师二方。盖治阴之内,即留以治阳;
而治阳之中,即藏于补阴也。有贫不能用人参者,用予后方可也。
华君曰∶同传予法无异。
Chen Shiduo said: The so-called "Yin Treatment Method" refers to conditions where there is a deficiency of Yin Qi, accompanied by an invasion of Yin pathogens. For example, when the Kidney water is deficient and cold, and simultaneously exposed to cold pathogens; or when Kidney water is exhausted, resulting in night fever and daytime chills. Such diseases, if mistakenly treated as Yang syndromes, will lead to thirst and intensified heat, inevitably consuming all Yin fluids, causing vomiting of sputum like cotton floss, incessant coughing, hoarseness, and eventually evolving into Lao Zhai (chronic consumptive disease). The treatment method should be to vigorously tonify Yin. When Yin fluids are sufficient, the deficient fire will naturally subside, the bone marrow will become clear and peaceful, and the residual heat and fire above will vanish. The prescription uses Shu Di Huang (Rehmanniae Radix Praeparata) 1 liang, Shan Zhu Yu (Corni Fructus) 5 qian, Mai Dong (Ophiopogonis Tuber) 5 qian, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 5 qian, Yuan Shen (Scrophulariae Radix) 3 qian, Di Gu Pi (Lycii Cortex) 3 qian, Dan Pi (Moutan Cortex) 1 qian, Sha Shen (Glehniae Radix) 5 qian, Bai Jie Zi (Sinapis Semen) 1 qian, Qian Shi (Euryales Semen) 5 qian, Che Qian Zi (Plantaginis Semen) 1 qian, Sang Ye (Mori Folium) 7 leaves, decocted in water and taken orally. (Commentary: An Huo Zhi Sheng Tang [Supreme Sage Decoction for Calming Ministerial Fire].) The brilliance of this formula lies in its exclusive use of pure Yin herbs, which penetrate directly into the Kidney palace to nourish deficiencies. Thus, the anxious symptoms will not flare up on the surface of the mouth, tongue, skin, and hair. Furthermore, by adding Yuan Shen, Di Gu Pi, Sha Shen, and Dan Pi to slightly clear the internal heat within the bone marrow, Yin naturally grows while Yang declines. The body becomes peaceful without specifically treating Yang, so why add Chai Hu (Bupleuri Radix) to disperse, only for the pathogen to leave? This formula is highly effective for treating spontaneously arising Yin fire. However, it is not suitable for cases of Yin cold without fire. In such cases, one should use Rou Gui (Cinnamomi Cortex) 1 qian, Fu Zi (Aconiti Lateralis Radix Preparata) 1 qian, Shu Di Huang 1 liang, Shan Zhu Yu 4 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 3 qian, Ren Shen (Ginseng Radix) 3 qian, Chai Hu 5 fen, decocted in water and taken orally. (Commentary: Qu Han Zhi Sheng Dan [Supreme Sage Pill for Expelling Cold].) The ingenious application of this formula lies in combining cold-expelling herbs like Fu Zi and Rou Gui with Yin-tonifying herbs like Ren Shen and Shu Di Huang, allowing Yang to be controlled by Yin, preventing it from surging and boiling. Adding a small amount of Chai Hu allows Yin pathogens to dissipate naturally. Why use purely Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamomi Ramulus) to scorch away true Yin? Moreover, the fire in the Kidneys must arise from Water. This Water is not pathogenic water but True Water. Pathogenic water can invade the Heart leading to immediate death, whereas True Water can save the Heart and prolong life. Generally, Yang is rooted in Yin, and True Yin Kidney Water is truly the mother of True Yang Jun Xiang Fire (Monarch and Minister Fire). The addition of Shu Di Huang and Shan Yu in this formula embodies this principle. (Commentary: Extremely brilliant.) Fearing that people might not understand, I have elaborated on this. If one uses only Fu Zi and Rou Gui to expel cold, it may indeed be effective. However, after the pathogen is expelled, Yin will diminish, inevitably leading to exhaustion. If treated improperly, symptoms of Wang Yang (collapse of Yang) will surely occur. I hope people pay attention to tonifying fire within water and removing pathogens within water.
Mr. Zhang said: This is an extraordinarily brilliant discussion, revealing insights never expressed in millennia. How could I add further praise to its profundity? Nevertheless, there is another formula for reference. The former symptom is Yin deficiency with fire movement, for which Liu Wei Wan (Six-Ingredient Rehmannia Pill) seems appropriate; the latter symptom is Yin cold without fire, for which Ba Wei Wan (Eight-Ingredient Rehmannia Pill) seems usable. However, neither ultimately compares to Master Chen's two formulas. Essentially, within the treatment of Yin, methods for treating Yang are retained; and within the treatment of Yang, principles of tonifying Yin are hidden. For those too poor to afford Ren Shen, the method of my previous formula can be used.
Mr. Hua said: It is no different from the method transmitted to me.