昔人谓仲景伤寒方分三大纲∶曰桂枝,曰麻黄,曰青龙是也。然此三方,皆隶太阳,何
得以
该全书之旨耶?窃尝反复《伤寒》一部,其方当分四派∶桂枝、麻黄、葛根、青龙、细辛为
一派,是发表之法也;理中、四逆、白通、真武为一派,是温里之法也;柴胡、泻心、白虎
、栀鼓为一派,是清气分无形虚热之法也;承气、陷胸、抵当、化瘀为一派,是攻血分有形
实邪之法也。其中参伍错综,发表之剂,有兼温中,有兼清气,有兼攻血;清里之剂,有兼
攻血,有兼发表,更有夹有温里者。变化无方,万法具备。故学人但熟读《伤寒》、《金匮
》方而深思之,有得于心,如自己出,自能动中规矩,肆应无穷矣。
阿片味苦性敛,苦属火而燥,走骨走血,敛属金而急,行肺行肤,清中含浊,能束人之
气,缩
人之血。气初得束则势激而鼓动有力,血初得缩则脉松而周运无滞,筋节亦借其束力、缩力
,顿觉坚强,故为之神清气爽而体健也。其能止痛,亦以其能束气而缩血故也。其性阴险,
中有所伏。其毒力能变化人之血性,使血脉骨髓脏腑之中,化生一种怪气,其形如虫,能使
人之性情俱变。盖性情随气血而变者也,虫即血中之灵气也,气血久束久缩,反被困而乏生
机,故日久则气短而音粗,血变而色坏,其常苦燥结者,以血气之势力,为烟力所束缩不得
宣发,而内积也。脱瘾则气驰而汗出,血散而身寒,筋骨亦为之缓纵而不收,甚至喘咳不止
者,以气血惯受束缩,一经松懈,遂涣散颓唐,无以温里而卫表也。治之必用苦燥敛急之品
,合行血固气之品,并能搜入骨脉深隐之处,抉其伏气,使其伏气遂渐外泄,正气日渐内充
,吐故纳新,渐复常度,乃真断瘾也。常须谨慎,稍有忽略,即易生病,而瘾象复见矣。若
气血本虚,瘾又深久,更难断戒,是终身之苦也。
Ancient scholars stated that Zhang Zhongjing's formulas for treating cold damage (Shanghan) are divided into three main categories: namely, Guizhi Tang (Cinnamon Twig Decoction), Mahuang Tang (Ephedra Decoction), and Qinglong Tang (Azure Dragon Decoction). However, these three formulas all belong to Taiyang disease (a syndrome caused by pathogenic factors invading the Taiyang channel, typically manifesting with aversion to cold and fever), so how can they encompass the purport of the entire book? I have repeatedly studied the *Treatise on Cold Damage* (*Shanghan Lun*) and believe that its formulas should be divided into four schools: The first school, represented by Guizhi Tang, Mahuang Tang, Gegen Tang (Kudzu Root Decoction), Xiao Qinglong Tang (Lesser Azure Dragon Decoction), and Xixin (Asarum), employs the method of releasing the exterior (dispersing exterior pathogens); the second school, represented by Lizhong Tang (Regulate the Middle Decoction), Sini Tang (Frigid Extremities Decoction), Baitong Tang (White Through Decoction), and Zhenwu Tang (True Warrior Decoction), employs the method of warming the interior (warming the yang qi of the zang-fu organs); the third school, represented by Chaihu Tang (Bupleurum Decoction), Xiexin Tang (Drain the Epigastrium Decoction), Baihu Tang (White Tiger Decoction), and Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), employs the method of clearing formless deficient heat from the Qi level; the fourth school, represented by Chengqi Tang (Purge the Bowels Decoction), Xianxiong Tang (Sunken Chest Decoction), Didang Tang (Aiming to Reside Decoction), and Huayu Tang (Invigorating Blood Decoction), employs the method of attacking tangible excess pathogens in the Blood level. Among them, the formulas are interwoven and complex: formulas for releasing the exterior may additionally warm the middle, clear the Qi, or attack the Blood; formulas for clearing the interior may additionally attack the Blood, release the exterior, or even combine with warming the interior. Their variations are boundless, containing myriad methods. Therefore, students who diligently study the formulas in the *Treatise on Cold Damage* (*Shanghan Lun*) and the *Essential Prescriptions of the Golden Cabinet* (*Jingui Yaolue*), and reflect deeply upon them, will gain insights as if originating from themselves. They will naturally act within proper principles and respond infinitely to changes.
Opium is bitter in taste and astringent in nature. Bitterness belongs to Fire and is drying, penetrating the bones and blood; astringency belongs to Metal and is urgent, circulating in the Lungs and skin. It contains turbidity within clarity and can bind the Qi of the body and constrict the Blood vessels. When Qi is initially bound, its momentum becomes vigorous and pulsating with strength; when Blood is initially constricted, the pulses become relaxed and circulation throughout the body proceeds without stagnation. The tendons and joints also borrow its binding and constricting force, suddenly feeling strong and firm. Thus, one feels refreshed and physically robust. Its ability to relieve pain is also due to its capacity to bind Qi and constrict Blood. Its nature is insidious, with toxicity lying dormant within. Its toxic power can alter the nature of the Blood, causing a strange evil Qi to arise within the blood vessels, bone marrow, and zang-fu organs. This evil Qi takes the shape of insects and causes complete changes in a person's temperament. Since temperament changes along with Qi and Blood, this "insect" is essentially the spiritual energy within the Blood. Long-term binding and constriction of Qi and Blood trap them, depriving them of vitality. Consequently, over time, shortness of breath and coarse voice occur, the Blood deteriorates, and the complexion sours. Those who often suffer from dry constipation do so because the power of Qi and Blood is bound and constricted by the force of smoking, preventing dissemination and leading to internal accumulation. Upon withdrawal, Qi relaxes and sweating occurs, Blood scatters and the body becomes cold, and the sinews and bones become lax and unable to contract, sometimes even resulting in incessant wheezing and coughing. This is because Qi and Blood, accustomed to being bound and constricted, become scattered and decadent upon relaxation, failing to warm the interior and protect the exterior. Treatment must employ bitter, drying, and astringent substances combined with agents that promote Blood circulation and consolidate Qi, capable of searching into the deep recesses of bones and vessels. These agents must extract the latent evil Qi, allowing it to gradually dissipate outward, while righteous Qi gradually fills the interior. Through eliminating the old and absorbing the new, normalcy is gradually restored, which constitutes true cessation of addiction. Caution is always required; slight negligence easily leads to illness and the recurrence of addiction symptoms. If Qi and Blood are originally deficient and the addiction is deep-seated and long-standing, cessation becomes even more difficult, representing a lifelong suffering.