制方之体。宣、通、补、泻、轻、重、涩、滑、燥、湿十剂是也。制方之用。大、小、缓、急、奇、耦、复七方
是也。是以制方之体。欲成七方之用者。必本于气味生成。而制方成焉。其寒、热、温、
凉、四气者生乎天。酸、苦、辛、咸、甘、淡、六味者成乎地。生成而阴阳造化之机存焉。是
以一物之内。气味兼有。一药之中。理性具矣。主对治疗。由是而出。斟酌其宜。参合
为用。君臣佐使。各以相宜。宣摄变化。不可胜量。一千四百五十三病之方。悉自此
而始矣。其所谓君臣佐使者。非特谓上药一百二十种为君。中药一百二十种为
臣。下药一百二十五种为佐使。三品之君臣也。制方之妙。的与病相对。有毒无毒。
所治为病主。主病之谓。君佐君之谓。臣应臣之谓。使择其相须相使。制其相畏相
恶。去其相反相杀。君臣有序。而方道备矣。方宜一君二臣。三佐五使。又可一君三
臣。九佐使也。多君少臣。多臣少佐。则气力不全。君一臣二。制之小也。君一臣三佐
五。制之中也。君一臣三佐九。制之大也。君一臣二。奇之制也。君二臣四。偶之制也。
君二臣三。奇之制也。君二臣六。偶之制也。近者奇之。远者偶之。所谓远近者。身之
远近也。在外者身半以上。同天之阳。其气为近。在内者身半以下。同地之阴。其气
为远。心肺位膈上。其脏为近。肾肝位膈下。其脏为远。近而奇偶。制小其服。远而奇
偶。制大其服。肾肝位远。数多则其气缓。不能速达于下。必剂大而数少。取其气迅
急。可以走下也。心肺位近。数少则其气急。不能发散于上。必剂少而数多。取其气
易散。可以补上也。所谓数者。肾一、肝三、脾五、心七、肺九。为五脏之常制。不得越者。
补上治上制以缓。补下治下制以急。又急则气味浓。缓则气味薄。随其攸利而施
之。远近得其宜矣。奇方之制。大而数少。以取迅走于下。所谓下药不以偶。偶方之
制。少而数多。以取发散于上。所谓汗药不以奇。经曰。汗者不以奇。下者不以偶。处
方之制。无逾是也。自评古诸方。历岁浸远。难可考评。惟张仲景方一部。最为众方
之祖。是以仲景本伊芳尹之法。伊芳尹本神农之经。医帙之中。特为枢要。参今法古。不
越亳末。实乃大圣之所作也。一百一十二方之内。择其医门常用者方二十首。因
以方制之法明之。庶岁少发古人之用心焉。
制方(制定方剂)的体例,包括宣、通、补、泻、轻、重、涩、滑、燥、湿这“十剂”(中药方剂的分类法)。
制方的运用,包括大、小、缓、急、奇、耦(偶)、复这“七方”(中药方剂的组成原则)。
因此,要制定能够体现“七方”作用的方剂,必须以药物气味的生成规律为基础,方剂才能确立。
寒、热、温、凉这“四气”(药物的四种性质),源于天;
酸、苦、辛、咸、甘、淡这“六味”(药物的六种味道),成于地。
天地生成之后,阴阳造化的机理便蕴含其中。
所以在一味药之内,气味兼具;在一药之中,药性理性完备。
主治与对症的治疗作用,由此产生。
斟酌其适宜程度,参合起来发挥作用。
君臣佐使(方剂中药物配伍的主次关系),各自相宜。
宣摄变化,不可胜数。
一千四百五十三种病证的方剂,都从此开始。
所谓“君臣佐使”,不仅仅指上药一百二十种为君,中药一百二十种为臣,下药一百二十五种为佐使,这是基于《神农本草经》三品分类的君臣关系。
制方的奥妙,在于确切地与病证相对。
有毒无毒,以所治疗的疾病为主。
主病的是君药,辅助君药的是臣药,响应臣药的是佐使药。
选择相互需要、相互促进的药物,制约相互畏惧、相互厌恶的药物,去除相互相反、相互克制的药物。
君臣有序,方道的法则就具备了。
方剂的组成可以是一君二臣,三佐五使;也可以是一君三臣,九佐使。
如果君药多而臣药少,或者臣药多而佐药少,那么药力就不完整。
一君二臣,是小型的制方;
一君三臣佐五,是中等的制方;
一君三臣佐九,是大型的制方。
一君二臣,是奇方(单数药味或组方结构)的制法;
二君四臣,是偶方(双数药味或组方结构)的制法;
二君三臣,是奇方的制法;
二君六臣,是偶方的制法。
病位近的用奇方,病位远的用偶方。
所谓的远近,是指身体的远近。
在外的部位,身体上半部,同属于天的阳气,其气为近;
在内的部位,身体下半部,同属于地的阴气,其气为远。
心肺位于膈膜之上,其脏为近;
肾肝位于膈膜之下,其脏为远。
病位近且用奇方或偶方,则减小服药剂量;
病位远且用奇方或偶方,则增大服药剂量。
肾肝位置偏远,药味数量多则药气缓和,不能迅速到达下部。
必须药味少而剂量大,取其药气迅急,可以直达下部。
心肺位置偏近,药味数量少则药气急促,不能发散于上部。
必须药味多而剂量少,取其药气易散,可以补益上部。
所谓的“数”,是指肾一、肝三、脾五、心七、肺九,这是五脏的常规制方数目,不可逾越。
补上治上的方剂,制法宜缓;补下治下的方剂,制法宜急。
急则气味浓厚,缓则气味淡薄。
随着其有利之处而施用,远近就得其适宜了。
奇方的制法,药味少而数量大(此处指单数组合或特定比例,原文意指取迅走于下的特性),以取药气迅疾下行。
所谓下药不以偶方(注:此处原文逻辑较晦涩,通常理解为奇方主降/下,偶方主升/散,但原文说“汗药不以奇”,结合后文“下者不以偶”,意为发汗多用偶方,攻下多用奇方,或者反之,需依上下文理解,此处直译原文逻辑):
偶方的制法,药味多而数量少(此处指双数组合),以取药气发散于上。
所谓汗药不以奇方。
经文说:发汗不用奇方,攻下不用偶方。
处方的制法,没有超过这些原则的。
我自行评价古代的各方,历经岁月久远,难以考证评估。
只有张仲景的一部方书,最为众方之祖。
因此,张仲景秉承伊尹的法度,伊尹秉承神农的经典。
在医籍之中,特别作为关键枢纽。
参考今法,效仿古法,不差毫厘。
这确实是大圣人的著作啊。
在一百一十二首方剂中,选择医门常用的二十首方剂。
于是通过方制的法则来阐明它们。
希望借此减少对古人用心的误解吧。
The structure of formulating prescriptions consists of the "Ten Categories" (Shi Ji, a classification method for Chinese herbal formulas): Xuan (dispersing), Tong (unblocking), Bu (tonifying), Xie (draining), Qing (light), Zhong (heavy), Se (astringent), Hua (slippery), Zao (drying), and Shi (moistening).
The application of formulating prescriptions consists of the "Seven Forms" (Qi Fang, principles of prescription composition): Da (large), Xiao (small), Huan (slow/mild), Ji (rapid/urgent), Qi (odd/single), Ou (even/double), and Fu (compound).
Therefore, to formulate prescriptions that can realize the functions of the "Seven Forms," one must base them on the generation of medicinal flavors and qi, thereby establishing the prescription.
The "Four Natures" (Si Qi, four properties of herbs: cold, hot, warm, cool) are generated by Heaven;
The "Six Flavors" (Liu Wei, six tastes of herbs: sour, bitter, pungent, salty, sweet, bland) are formed by Earth.
Once generated by Heaven and Earth, the mechanism of Yin-Yang creation is preserved within.
Thus, within a single herb, both flavor and qi are present; within one medicine, its rational nature is complete.
The therapeutic actions of treating specific diseases and corresponding symptoms emerge from this.
By deliberating their appropriateness and combining them for use, the roles of Jun (Monarch), Chen (Minister), Zuo (Assistant), and Shi (Envoy) in a formula are determined according to mutual suitability.
The variations in dispersing and collecting are countless.
Prescriptions for 1,453 types of diseases all originate from this principle.
The concept of "Jun, Chen, Zuo, Shi" does not merely refer to the classification in the *Shennong Bencao Jing* where the 120 superior herbs are Monarchs, the 120 medium herbs are Ministers, and the 125 inferior herbs are Assistants and Envoys based on the Three Grades.
The subtlety of prescribing lies in precisely matching the disease.
Whether toxic or non-toxic, the treatment focuses on the primary disease.
Herbs that treat the primary disease are called Jun (Monarch); those that assist the Monarch are called Chen (Minister); those that respond to the Minister are called Zuo Shi (Assistant and Envoy).
One selects herbs that are mutually required and facilitating, restricts those that are mutually feared or repulsive, and eliminates those that are contrary or destructive.
When the hierarchy of Monarch, Minister, Assistant, and Envoy is orderly, the principles of the prescription are complete.
A prescription may consist of one Monarch and two Ministers, three Assistants, and five Envoys; or one Monarch, three Ministers, and nine Assistants and Envoys.
If there are many Monarchs and few Ministers, or many Ministers and few Assistants, the medicinal force will be incomplete.
One Monarch and two Ministers constitute a small prescription;
One Monarch, three Ministers, and five Assistants constitute a medium prescription;
One Monarch, three Ministers, and nine Assistants constitute a large prescription.
One Monarch and two Ministers represent the formulation of a Qi (Odd/Singular) prescription;
Two Monarchs and four Ministers represent the formulation of an Ou (Even/Dual) prescription;
Two Monarchs and three Ministers represent the formulation of a Qi (Odd/Singular) prescription;
Two Monarchs and six Ministers represent the formulation of an Ou (Even/Dual) prescription.
For conditions located near the surface, use Qi (Odd) formulations; for conditions located far from the surface, use Ou (Even) formulations.
The terms "near" and "far" refer to the location in the body.
The exterior parts, specifically the upper half of the body, correspond to the Yang Qi of Heaven, making them "near";
The interior parts, specifically the lower half of the body, correspond to the Yin Qi of Earth, making them "far."
The Heart and Lung are located above the diaphragm, so their organs are considered "near";
The Kidney and Liver are located below the diaphragm, so their organs are considered "far."
When the condition is near and uses either Qi or Ou formulations, the dosage should be reduced;
When the condition is far and uses either Qi or Ou formulations, the dosage should be increased.
Because the Kidney and Liver are located far away, if the number of ingredients is large, the medicinal qi becomes mild and cannot reach the lower part quickly.
Therefore, the prescription must have fewer ingredients but a larger dose, taking advantage of the rapid and urgent qi to reach the lower body.
Because the Heart and Lung are located near, if the number of ingredients is small, the medicinal qi becomes abrupt and cannot disperse effectively to the upper part.
Therefore, the prescription must have more ingredients but a smaller dose, taking advantage of the easy dispersion of qi to tonify the upper body.
The term "number" refers to the standard numbers for the Five Zang Organs: Kidney 1, Liver 3, Spleen 5, Heart 7, Lung 9. These are the regular limits and should not be exceeded.
Prescriptions for tonifying or treating the upper body should be formulated with a slow (Huan) action; prescriptions for tonifying or treating the lower body should be formulated with a rapid (Ji) action.
Rapid action implies strong and dense flavors; slow action implies weak and thin flavors.
Apply them according to what is beneficial, ensuring that near and far locations are treated appropriately.
The formulation of Qi (Odd) prescriptions, characterized by fewer ingredients and specific proportions, aims to take the qi rapidly downward.
It is said that purgative formulas do not use Ou (Even) structures.
The formulation of Ou (Even) prescriptions, characterized by more ingredients and specific proportions, aims to take the qi to disperse upward.
It is said that diaphoretic (sweat-inducing) formulas do not use Qi (Odd) structures.
The classic states: Diaphoretics are not made with Qi (Odd) structures; Purgatives are not made with Ou (Even) structures.
The principles of prescribing do not exceed these rules.
I have evaluated ancient prescriptions, but due to the passage of time, they are difficult to verify and assess.
Only the work of Zhang Zhongjing stands as the ancestor of all prescriptions.
Therefore, Zhang Zhongjing followed the methods of Yi Yin, who in turn followed the classics of Shennong.
Among medical texts, this work serves as a pivotal hub.
Referencing modern methods while emulating ancient ones, it deviates not by a hair's breadth.
This is truly the work of a Great Sage.
From the 112 prescriptions contained within, I have selected 20 that are commonly used in medical practice.
I have clarified them through the principles of prescription formulation.
May this effort help reduce misunderstandings regarding the intentions of the ancients.