身亦有上下表里之别。莫不各随其类以相从。所谓各有法度也。故风为阳而中于前。寒为阴而中于后。
湿气浊而伤于下。雾气清而伤于上。经脉阴而伤于寒。络脉阳而伤于热。合而言之。无非阳邪亲上。
阴邪亲下。热气归阳。寒气归阴之理。
问曰。病有急当救里救表者。何谓也。师曰。病医下之。续得下利清谷不止。身体疼痛者。急当
救里。后身疼痛。清便自调者。急当救表也。
治实证者。以逐邪为急。治虚证者。以养正为急。盖正气不固。则无以御邪而却疾。故虽身体疼
痛。而急当救里。表邪不去。势必入里而增患。故既清便自调。则仍当救表也。
夫病痼疾。加以卒病。当先治其卒病。后乃治其痼疾也。
卒病易除。故当先治。痼疾难拔。故宜缓图。且勿使新邪得助旧疾也。读二条。可以知治病缓急
先后之序。
师曰。五脏病各有所得者愈。五脏病各有所恶。各随其所不喜者为病。病者素不应食。而反暴思
之。必发热也。
所得所恶所不喜。该居处服食而言。如脏气法时论云。肝色青。宜食甘。心色赤。宜食酸。肺色
白。宜食苦。肾色黑。宜食辛。脾色黄。宜食咸。又心病禁温食热衣。脾病禁温食饱食。湿地濡衣。肺
病禁寒饮食寒衣。
肾病禁淬HT 热食温炙衣。宣明五气篇所云。心恶热。肺恶寒。肝恶风。脾恶湿。肾恶燥。灵枢五味篇
所云。肝病禁辛。心病禁咸。脾病禁酸。肺病禁苦。肾病禁甘之属皆是也。五脏病各有所得而愈者。
谓得其所宜之气之味之处。足以安脏气而却病气也。各随其所不喜为病者。谓得其所禁所恶之气之味
之处。足以忤脏气而助病邪也。病者素不应食。而反暴思之者。谓平素所不喜之物。而反暴思之。由
病邪之气。变其脏气使然。食之则适以助病气而增发热也。
夫诸病在脏。欲攻之。当随其所得而攻之。如渴者与猪苓汤。余皆仿此。
无形之邪。入结于脏。必有所据。水血痰食。皆邪薮也。如渴者。水与热得。而热结在水。故与
猪苓汤利其水。而热亦除。若有食者。食与热得。而热结在食。则宜承气汤下其食。而热亦去。若无
所得。则无形之邪。岂攻法所能去哉。
猪苓汤方（见后消渴证中）
The human body also has distinctions of upper and lower, exterior and interior. Pathogenic factors do not fail to follow their respective categories and associate with one another. This is what is meant by having specific laws and principles. Therefore, wind pathogen is yang and attacks the anterior; cold pathogen is yin and attacks the posterior. Dampness is turbid and injures the lower part; misty qi is clear and injures the upper part. The meridians are yin and are injured by cold; the collaterals are yang and are injured by heat. In summary, this is nothing but the principle that yang pathogens tend toward the upper, yin pathogens tend toward the lower, heat qi returns to yang, and cold qi returns to yin.
Question: There are cases where treating the interior or the exterior should be prioritized urgently. What does this mean? The Master said: If a physician mistakenly uses purgation therapy, and the patient subsequently suffers from continuous diarrhea with undigested food (xia li qing gu) accompanied by body pain, urgent treatment of the interior syndrome is required. Later, if the body pain persists but bowel movements and urination have normalized (qing bian zi tiao), urgent treatment of the exterior syndrome is required.
In treating excess syndromes, expelling the pathogen is the priority; in treating deficiency syndromes, nourishing the healthy qi is the priority. Since healthy qi must be secure to resist pathogens and drive away disease, even if there is body pain, urgent treatment of the interior is necessary. If exterior pathogens are not expelled, they will inevitably penetrate inward and exacerbate the condition. Thus, once bowel movements and urination are normal, treatment of the exterior should still be pursued.
When a chronic disease (gu ji) coexists with an acute sudden illness (cu bing), the acute sudden illness should be treated first, followed by the chronic disease.
Acute illnesses are easy to eliminate, so they should be treated first; chronic diseases are difficult to eradicate, so they should be addressed gradually. Moreover, one must prevent new pathogens from aiding old diseases. Reading these two passages allows one to understand the order of urgency and sequence in treating diseases.
The Master said: Diseases of the five zang organs heal when they obtain what is suitable for them; conversely, they worsen when exposed to what they dislike. Any exposure to what the organ dislikes induces pathology. If a patient suddenly craves food they normally would not eat, fever will likely ensue.
"Obtaining," "disliking," and "not preferring" refer to living environments and dietary intake. As stated in the *Zang Qi Fa Shi Lun*: The liver corresponds to green and prefers sweet flavors; the heart corresponds to red and prefers sour flavors; the lungs correspond to white and prefer bitter flavors; the kidneys correspond to black and prefer pungent flavors; the spleen corresponds to yellow and prefers salty flavors. Furthermore, heart disease contraindicates warm foods and hot clothing; spleen disease contraindicates warm, full meals, damp residences, and wet clothing; lung disease contraindicates cold foods and cold clothing; kidney disease contraindicates scalding hot foods and garments heated by fire roasting. The *Xuan Ming Wu Qi Pian* states: The heart dislikes heat, the lungs dislike cold, the liver dislikes wind, the spleen dislikes dampness, and the kidneys dislike dryness. The *Ling Shu: Wu Wei Pian* states: Liver disease contraindicates pungent flavors, heart disease contraindicates salty flavors, spleen disease contraindicates sour flavors, lung disease contraindicates bitter flavors, and kidney disease contraindicates sweet flavors. These are all examples. When diseases of the five zang organs heal upon obtaining what is suitable, it means acquiring the appropriate qi, flavors, and environments that stabilize the zang qi and repel pathogenic qi. When diseases arise from what is disliked, it means encountering prohibited or abhorred qi, flavors, and environments that offend the zang qi and assist pathogenic factors. A sudden craving for normally unpalatable food indicates that pathogenic qi has altered the zang qi's nature; consuming such food aids the pathogenic qi and increases fever.
For diseases located in the zang organs, when attacking them, one should follow the location where the pathogen has gathered. For example, for thirst, administer Zhu Ling Tang (Polyporus Decoction); apply this principle to other cases.
Formless pathogens, when entering and knotting within the zang organs, must have a basis. Water retention, blood stasis, phlegm, and food stagnation are all reservoirs for pathogens. For instance, in cases of thirst, water and heat combine, with heat knotting in the water; thus, Zhu Ling Tang is used to promote diuresis, eliminating the heat along with the water. In cases of food stagnation, food and heat combine, with heat knotting in the food; thus, Cheng Qi Tang (Order the Qi Decoction) is used to purge the food, eliminating the heat as well. If there is no such attachment, how can formless pathogens be removed by purgative methods?
Zhu Ling Tang Formula (see later under Xiao Ke Syndrome)