而感邪者多见阴脉。盖证之阳者,假实也;脉之阴者,真虚也。阳证阴脉,即阴证也。观陶节庵曰∶凡察阴证,不分热
与不热,须凭脉下药,至为切当。不问脉之浮沉大小,但指下无力,重按全无,便是伏阴,不可与凉药,服之必死。然
则脉之沉小者,人知其为阴脉矣;而浮大者亦有阴脉,则人所不知也。治以凉药犹且不可,况其他乎?故余于此证,必
舍证从脉,所以十全其九。然所用之法,多非本门正方,随手而应,见者无不异之,夫亦何异之有,药对证而已矣,余
请再悉其义。夫伤寒之千态万状,只虚实二字足以尽之。一实一虚,则邪正相为胜负,正胜则愈,邪胜则死,死生之要,
在虚实间耳。若正气实者,即感大邪,其病亦轻;正气虚者,即感微邪,其病亦甚。凡气实而病者,但去其邪则愈矣,
放胆攻之,何难之有?此而当余,亦不过若吹灰拉朽耳,无足齿也。虽付之庸手,自无难愈。即不治之,俟其经尽气复,
亦无不愈。此譬之两敌相持,主强则客不能胜,必自解散而去,何患之有?故凡正气实者,无论治与不治,皆无虑也。
所可虑者,惟挟虚伤寒耳。凡疾病相加,未有元气不竭而死者,强弱相攻,未有根本不伤而败者,此理势之必然也。伤
寒之难,止于此耳。奈何庸浅之辈,初不识人虚实,但见发热,动手便攻。夫不可攻而攻之,则未有不死者何也?盖攻
者所以攻邪,然必借元气以为之帅,设主气不足而强攻其邪,则邪气未去,而正气因攻先败矣。如此杀人,罪将谁委?
又其最可怪者,则有曰伤寒无补法,惑乱人心,莫此为甚。独不观仲景立三百九十七法,而脉证之虚寒者一百有余;定
一百一十三方,而用人参者三十,用桂附者五十有余。此下如东垣、丹溪、陶节庵辈所用补中益气、回阳返本、温经益
元等汤,皆未尝不用补也,孰谓伤寒无补法耶?此其立法,固为不少,但在余则犹谓未尽,在人则目为异常,不惟异常,
而且曰无之,高明者岂其然哉?矧今人之患挟虚伤寒者十尝六七,传诵伤寒无补法者十之八九,虚而不补,且复攻之,
余目睹其受害者盖不可胜纪矣,心切悲之,故力辩于此,欲以救时弊耳,非好补也。观者惟加详察,则苍生大幸。)
In cases of pathogenic invasion, Yin pulses are frequently observed. This is because Yang manifestations often represent false excess (Xu Shi), whereas Yin pulses indicate true deficiency (Zhen Xu). The presence of Yang symptoms accompanied by Yin pulses constitutes a Yin syndrome (Yin Zheng). As Tao Jie'an stated: When examining Yin syndromes, regardless of the presence or absence of heat, medication must be prescribed based on the pulse condition, which is highly appropriate. Regardless of whether the pulse is floating (Fu), deep (Chen), large (Da), or small (Xiao), if it feels weak under the fingers and completely empty upon heavy pressure, this indicates concealed Yin cold (Fu Yin). Cool medicines must not be administered; doing so will inevitably lead to death. Consequently, while people recognize that sinking and small pulses are Yin pulses, they are unaware that floating and large pulses can also belong to Yin pulses. It is inadvisable to use cool medicines for such conditions, let alone other methods. Therefore, in treating this type of syndrome, I invariably discard the symptoms and follow the pulse, achieving a cure rate of nine out of ten. However, the methods I employ are often not standard formulas from my school but are applied flexibly according to the situation, causing observers to express surprise. Yet, what is there to be surprised about? It is merely that the medicine matches the syndrome. Let me elaborate further on the principles involved.
The myriad manifestations of Cold Damage (Shang Han) can be fully summarized by the two concepts of Deficiency (Xu) and Excess (Shi). In the dynamic between one and the other, Evil (Xie) and Healthy Qi (Zheng Qi) contend for dominance. If Healthy Qi prevails, recovery occurs; if Evil prevails, death ensues. The critical factor determining life and death lies within the balance of Deficiency and Excess. If Healthy Qi is robust, even severe pathogenic invasion results in mild illness; if Healthy Qi is deficient, even slight pathogenic invasion results in severe illness. For illnesses caused by Qi excess, removal of the pathogen leads to recovery. Boldly attacking the pathogen poses no difficulty. In such cases, treatment is as easy as blowing away dust or snapping dry wood, requiring no special mention. Even an incompetent physician could easily cure it. Indeed, without treatment, waiting for the meridian cycle to complete and Healthy Qi to recover would also result in healing. This is akin to two armies clashing; if the host is strong, the guest cannot prevail and will eventually disperse. Thus, individuals with robust Healthy Qi need not worry, whether treated or not.
The only cause for concern is Cold Damage complicated by deficiency (Jia Xu Shang Han). In any disease progression, death does not occur unless Yuan Qi (Original Qi) is exhausted. In conflicts of strength, defeat does not happen unless the root foundation is damaged; this is an inevitable logical progression. The difficulty of Cold Damage lies solely here. Regrettably, many mediocre practitioners fail to distinguish between deficiency and excess at the outset. Upon seeing fever, they immediately resort to purgative or attacking methods. Attacking when inappropriate inevitably leads to death. Why? Because attacking methods target pathogens but rely on Healthy Qi as their commander. If the primary Qi is insufficient yet one forcibly attacks the pathogen, the pathogen remains while Healthy Qi collapses due to the attack. Such actions constitute homicide; who bears the responsibility?
Most perplexing is the claim that "Cold Damage has no tonification method," which confuses and misleads people more than anything else. Have they not observed that Zhang Zhongjing established 397 treatment protocols, over 100 of which address pulse and symptom patterns of deficiency and cold? Among his 113 prescriptions, 30 contain Ren Shen (Ginseng Radix et Rhizoma), and over 50 contain Gui Zhi (Cinnamon Twig) or Fu Zi (Aconite Lateralis Radix Praeparata). Later physicians such as Li Dongyuan, Zhu Danxi, and Tao Jie'an utilized tonifying formulas like Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Hui Yang Fan Ben Tang (Restore Yang and Return to the Root Decoction), and Wen Jing Yi Yuan Tang (Warm the Meridians and Enrich the Origin Decoction), all employing tonification. Who claims that Cold Damage precludes tonification? While these legislative contributions are substantial, I consider them incomplete, and others view them as exceptional. Some go further to deny their existence entirely. Would enlightened scholars truly think so? Moreover, today, six or seven out of ten patients suffer from Cold Damage complicated by deficiency, yet eight or nine out of ten propagate the idea that "Cold Damage has no tonification." Patients with deficiency are neither tonified nor protected from attacking therapies. I have witnessed countless victims of this practice and feel profound sorrow. Hence, I argue vigorously here to correct contemporary abuses, not because I favor tonification per se. Readers should examine this carefully, for it is a great blessing to the populace.)