治外感如将,(意在去其所本无,所谓急则治标。)治内伤如相,(意在复其所固有,所谓缓
则治本。)治心肺如羽,(药当从轻)。治脾胃如衡,(药当从平。)治肝肾如权。(药当从重。)
古人治外感,有汗吐下三法。治内伤有温清和三法,其实皆治肺胃也。肺寒实则汗
之。胃寒虚则温之。肺胃虚热,治以清和。肺胃实热,治以吐下。此至当不易之法,时医
不识,调理肺胃,归宗脾肾,去古远矣。
脏腑为病者∶心为噫,肺为咳,肝为语,脾为吞,肾为欠为嚏,胃为气逆为哕为恐,大
小肠为泄,下焦溢为水肿,膀胱不利为癃闭,不约为遗溺,胆气郁为怒。诸病所属者∶诸
风掉眩,皆属于肝。诸寒收引,皆属于肾。诸气 郁,皆属于肺。诸湿肿满,皆属于脾,诸
疮痛痒,皆属于心。诸痿喘呕,皆属于上。诸厥固泄,皆属于下。诸暴强直,皆属于风。诸
病水液,澄澈清冷,皆属于寒。诸呕吐酸,暴注下迫,皆属于热。诸胀腹大,诸病有声,按
之如鼓,诸转反戾,水液混浊,皆属于热。诸痉项强,皆属于湿。诸热督 ,诸禁鼓栗,如
丧神守,诸病跗肿,疼酸惊骇,诸逆冲上,诸躁狂越,皆属于火。四时所病者∶春善病鼽
衄,仲夏善病胸胁,长夏善病洞泄,寒中,秋善病风疟,冬善病痹厥,此病机之要旨也。
风淫于内,治以辛凉,佐以苦甘,以甘缓之,以酸泻之。寒淫于内,治以辛凉,佐
以甘苦,以咸泻之。暑淫于内,治以咸寒,佐以苦甘,以酸收之。湿淫于内,治以苦热,佐
以酸辛,以苦燥之,以淡泄之。燥淫于内,治以苦温,佐以酸辛,以苦下之。火淫于内,治
以咸冷,佐以苦甘,以酸收之,以苦发之。此治法之要则也。
治疗外感病要像将军一样果断,(意在去除体内本不该有的邪气,即所谓紧急时先治标症。)治疗内伤病要像宰相一样稳重,(意在恢复人体固有的正气,即所谓从容时先治本因。)治疗心肺疾病用药要轻灵如羽毛,(药物剂量应当从轻。)治疗脾胃疾病用药要平稳如秤杆,(药物性质应当平和。)治疗肝肾疾病用药要沉重如秤锤,(药物剂量应当从重。)
古人治疗外感病,采用汗法、吐法、下法三种方法。治疗内伤病采用温法、清法、和法三种方法,其实质都是调理肺和胃。肺受寒邪且实证,用发汗法治疗。胃受寒邪且虚证,用温补法治疗。肺和胃出现虚热,用清热调和法治疗。肺和胃出现实热,用催吐或泻下法治疗。这是最为恰当且不可改变的方法,但当时的医生不认识这一点,调理肺胃时却归结于脾肾,这与古人的医理相距甚远了。
脏腑发生病变的表现:心病变表现为嗳气,肺病变表现为咳嗽,肝病变表现为多言,脾病变表现为吞咽异常,肾病变表现为呵欠和喷嚏,胃病变表现为气逆、呃逆和恐惧,大肠和小肠病变表现为泄泻,下焦水液泛滥表现为水肿,膀胱气化不利表现为小便不通,约束无力表现为遗尿,胆气郁结表现为易怒。各种病症所属的病机:凡是风邪引起的肢体震颤、头晕目眩,都归属于肝。凡是寒邪引起的筋脉收缩牵引,都归属于肾。凡是气机郁滞,都归属于肺。凡是湿邪引起的水肿胀满,都归属于脾。凡是疮疡引起的疼痛瘙痒,都归属于心。凡是痿证、喘促、呕吐,病位都属上焦。凡是厥证、二便不通或失禁,病位都属下焦。凡是突然发生的身体强直,都归属于风邪。凡是排泄物清澈透明、寒冷,都归属于寒邪。凡是呕吐酸水、突然剧烈腹泻且伴有里急后重,都归属于热邪。凡是腹部胀大、肠鸣有声、按压如鼓声、肢体扭转反折、尿液混浊,都归属于热邪。凡是痉挛、项背强直,都归属于湿邪。凡是高热、牙关紧闭、战栗发抖、神志失常如丧失主宰、足部肿胀、酸痛惊骇、气机上冲、烦躁狂乱,都归属于火邪。四季好发的疾病:春季容易患鼻渊和鼻衄,仲夏容易患胸胁病痛,长夏容易患洞泄和寒中,秋季容易患风疟,冬季容易患痹证和厥证,这是疾病机理的要旨。
风邪侵袭体内,用辛凉药物为主进行治疗,辅以苦甘药物,用甘味药来缓和病情,用酸味药来泻除风邪。寒邪侵袭体内,用辛凉药物为主进行治疗,辅以甘苦药物,用咸味药来泻除寒邪。暑邪侵袭体内,用咸寒药物为主进行治疗,辅以苦甘药物,用酸味药来收敛暑邪。湿邪侵袭体内,用苦热药物为主进行治疗,辅以酸辛药物,用苦味药来燥湿,用淡味药来渗湿泄浊。燥邪侵袭体内,用苦温药物为主进行治疗,辅以酸辛药物,用苦味药来通下燥结。火邪侵袭体内,用咸冷药物为主进行治疗,辅以苦甘药物,用酸味药来收敛火气,用苦味药来发散火邪。这是治疗法则的重要准则。
Treating exogenous diseases is like a general (the intent is to eliminate what should not be there, known as treating the branch symptoms when urgent). Treating endogenous injuries is like a prime minister (the intent is to restore what is inherent, known as treating the root cause when leisurely). Treating Heart and Lung diseases requires light medication, like feathers (medicinal dosage should be light). Treating Spleen and Stomach diseases requires balanced medication, like a scale (medicinal nature should be neutral). Treating Liver and Kidney diseases requires heavy medication, like weights (medicinal dosage should be heavy).
In ancient times, treating exogenous diseases employed three methods: sweating (inducing perspiration), vomiting (emesis), and purging (downward draining). Treating endogenous injuries employed three methods: warming, clearing, and harmonizing. In essence, these all treat the Lungs and Stomach. For Cold excess in the Lungs, induce sweating. For Cold deficiency in the Stomach, apply warming. For Deficient Heat in the Lungs and Stomach, use clearing and harmonizing. For Excess Heat in the Lungs and Stomach, use emesis or purging. This is the most appropriate and unchangeable method. However, physicians of that time failed to recognize this; when regulating the Lungs and Stomach, they attributed it to the Spleen and Kidneys, deviating far from ancient principles.
Manifestations of Zang-Fu diseases: Heart disease manifests as belching; Lung disease manifests as coughing; Liver disease manifests as excessive talking; Spleen disease manifests as swallowing difficulties; Kidney disease manifests as yawning and sneezing; Stomach disease manifests as Qi rebellion, hiccups, and fear; Large and Small Intestine diseases manifest as diarrhea; Overflow of the Lower Jiao manifests as edema; Bladder dysfunction manifests as strangury (difficulty urinating); lack of restraint manifests as enuresis; Gallbladder Qi stagnation manifests as anger. Etiological classifications of various diseases: All wind-induced tremors and dizziness belong to the Liver. All cold-induced contraction and pulling belong to the Kidney. All Qi stagnation belongs to the Lung. All dampness-induced swelling and fullness belong to the Spleen. All sores, ulcers, pain, and itching belong to the Heart. All flaccidity syndromes, wheezing, and vomiting belong to the Upper Jiao. All厥 (Jue) syndromes, constipation, and incontinence belong to the Lower Jiao. All sudden stiffness and rigidity belong to Wind. All bodily fluids that are clear, transparent, and cold belong to Cold. All vomiting of sour fluid, sudden violent diarrhea with tenesmus belong to Heat. All abdominal distension and enlargement, bowel sounds, drum-like percussion upon pressing, torsion and convulsions, and turbid fluids belong to Heat. All spasms and neck stiffness belong to Dampness. All high fever, locked jaws, shivering, loss of mental control, foot swelling, soreness, and fright, rebellious Qi rushing upward, restlessness, mania, and recklessness belong to Fire. Diseases occurring in the four seasons: Spring predisposes to rhinorrhea and epistaxis; Mid-Summer predisposes to chest and hypochondriac pain; Late Summer predisposes to severe diarrhea and cold invasion in the middle; Autumn predisposes to wind-malaria; Winter predisposes to Bi syndrome and Jue syndrome. These are the essential principles of disease mechanisms.
When Wind invades internally, treat with acrid-cool herbs, assist with bitter-sweet herbs, use sweet herbs to relax, and use sour herbs to drain. When Cold invades internally, treat with acrid-cool herbs, assist with sweet-bitter herbs, and use salty herbs to drain. When Summer-heat invades internally, treat with salty-cold herbs, assist with bitter-sweet herbs, and use sour herbs to astringe. When Dampness invades internally, treat with bitter-hot herbs, assist with sour-acrid herbs, use bitter herbs to dry dampness, and use bland herbs to leach out dampness. When Dryness invades internally, treat with bitter-warm herbs, assist with sour-acrid herbs, and use bitter herbs to purge downward. When Fire invades internally, treat with salty-cold herbs, assist with bitter-sweet herbs, use sour herbs to astringe, and use bitter herbs to disperse. These are the essential rules of treatment methods.