肝苦急,急食甘以缓之,甘草。
心苦缓,急食酸以收之,五味子。
脾苦湿,急食苦以燥之,白术。
肺苦气上逆,急食苦以泄之,黄芩。
肾苦燥,急食辛以润之,黄柏、知母。
注云∶开腠理,致津液,通气血也。
肝欲散,急食辛以散之,川芎。以辛补之,细辛。以酸泻之,白芍药。
心欲软,急食咸以软之,芒硝。以〔咸〕补之,泽泻。以甘〔泻〕之,黄 、甘
草、人参。
脾欲缓,急食甘以缓之,甘草。以甘补之,人参。以苦泻之,黄连。
肺欲收,急食酸以收之,白芍药。以酸补之,五味子。以辛泻之,桑白皮。
肾欲坚,急食苦以坚之,知母。以苦补之,黄柏。以〔咸〕泻之,泽泻。
注云∶此五者,有酸、辛、甘、苦、咸,各有所利,或散、或收、或缓、或软、或
坚,四时五脏病,随五味〔所〕宜也。
气交变〔论云〕∶五运太过不及。夫五运之政,犹权衡也,高者抑之,下者举
之,化者应之,变者复之,此长、化、收、藏之运,气之常也,失常则天地四塞矣。
注云∶失常之理,则天地四时之气,无所营运。故动必有静,胜必有复,乃天地阴
阳之道也。以热治热法,经曰∶病气热甚,而与寒药交争,〔则〕寒药难下,故反热
服,顺其病势,热势既休,寒性乃发,病热除愈,则〔如〕承气汤寒药,反热〔服之〕
者是也。病寒亦同法也。凡治病,必求〔其〕所在,病在上者治上,在下者治下,
故中外脏腑经络皆然。病气热,则除其热;病气寒,则退其寒,六气同法。泻实补虚,
除邪养正,平则守常,医之道也。
大法曰∶前人方法,即当时对证之药也。后人用之,当体指下脉气,从而加减,否
则不效。余非鄙乎前人而自用也,盖五行相制相兼,生化制〔承〕之体,一时之间,
变乱无常,验脉〔处〕方,亦前人之〔法〕也。厥后通乎理者,〔当〕以余言为
〔然〕。
肝脏受急迫之苦,应当立即食用甘味药物来缓解它,如甘草。
心脏受弛缓之苦,应当立即食用酸味药物来收敛它,如五味子。
脾脏受湿困之苦,应当立即食用苦味药物来燥湿它,如白术。
肺脏受气机上逆之苦,应当立即食用苦味药物来泄降它,如黄芩。
肾脏受干燥之苦,应当立即食用辛味药物来滋润它,如黄柏、知母。
注释说:这是指开发腠理(皮肤毛孔),使津液流通,通畅气血。
肝脏喜好疏散,应当立即食用辛味药物来疏散它,如川芎。用辛味来补肝,如细辛。用酸味来泻肝,如白芍药。
心脏喜好软坚,应当立即食用咸味药物来软化它,如芒硝。用咸味来补心,如泽泻。用甘味来泻心,如黄耆、甘草、人参。
脾脏喜好缓和,应当立即食用甘味药物来缓和它,如甘草。用甘味来补脾,如人参。用苦味来泻脾,如黄连。
肺脏喜好收敛,应当立即食用酸味药物来收敛它,如白芍药。用酸味来补肺,如五味子。用辛味来泻肺,如桑白皮。
肾脏喜好坚固,应当立即食用苦味药物来坚固它,如知母。用苦味来补肾,如黄柏。用咸味来泻肾,如泽泻。
注释说:这五种情况,有酸、辛、甘、苦、咸五味,各自有不同的益处,或疏散、或收敛、或缓和、或软化、或坚固,四季五脏的疾病,随着五味的适宜性而治疗。
《气交变大论》说:五运有过盛和不足。五运的政令,就像秤杆一样,高的地方压低它,低的地方抬起它,化生者顺应它,变化者报复它,这是长、化、收、藏的五运,是气的常态,失去常态则天地四时闭塞不通了。
注释说:失去常态的道理,就是天地四时的气,无法正常运行。所以动中必有静,胜复必有报复,这是天地阴阳的道理。用热治热的治疗方法,经书说:病气热得很厉害,与寒药相互抗争,那么寒药难以服下,所以反而热服,顺从病势,热势既然平息,寒性才发作,病热除去痊愈,就像承气汤这样的寒药,反而热服用的情况就是这样。治疗寒病也采用同样的方法。大凡治病,必须探求病邪所在之处,病在上部的治上部,在下部的治下部,所以内外脏腑经络都是这样。病气热,就清除其热;病气寒,就退去其寒,六气都采用同样的方法。泻实补虚,祛除邪气养护正气,平和则遵守常规,这就是医道。
大法说:前人的方法,就是当时针对证候的药物。后人使用它们,应当体会指下的脉气,从而进行加减,否则没有疗效。我并不是轻视前人的方法而自以为是,大概五行之间相互制约又相互兼合,生化制约承接的本体,一时之间,变化混乱无常,诊察脉象处方,也是前人的法则。此后通晓道理的人,应当认为我的话是正确的。
The Liver suffers from tension (Ji), so one should urgently consume sweet-flavored substances to relax it, such as Glycyrrhizae Radix et Rhizoma (Gancao, 甘草).
The Heart suffers from flaccidity (Huan), so one should urgently consume sour-flavored substances to astringe it, such as Schisandrae Fructus (Wuweizi, 五味子).
the Spleen suffers from dampness (Shi), so one should urgently consume bitter-flavored substances to dry it, such as Atractylodis Rhizoma (Baizhu, 白术).
The Lungs suffer from rebellious Qi (Qi Shangni), so one should urgently consume bitter-flavored substances to drain it, such as Scutellariae Radix (Huangqin, 黄芩).
The Kidneys suffer from dryness (Zao), so one should urgently consume pungent-flavored substances to moisten them, such as Phellodendri Cortex (Huangbai, 黄柏) and Anemarrhenae Rhizoma (Zhimu, 知母).
The annotation states: This refers to opening the Couli (interstices/skin pores), promoting the flow of Jin-Ye (body fluids), and unblocking Qi and Blood.
The Liver desires dispersion, so one should urgently consume pungent-flavored substances to disperse it, such as Chuanxiong Rhizoma (Chuanxiong, 川芎). To tonify the Liver with pungency, use Asari Radix et Rhizoma (Xixin, 细辛). To drain the Liver with sourness, use Paeoniae Radix Alba (Baishao, 白芍药).
The Heart desires softening, so one should urgently consume salty-flavored substances to soften it, such as Natrii Sulfas (Mangxiao, 芒硝). To tonify the Heart with saltiness, use Alismatis Rhizoma (Zexie, 泽泻). To drain the Heart with sweetness, use Astragali Radix (Huangqi, 黄耆), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), and Ginseng Radix (Renshen, 人参).
The Spleen desires relaxation, so one should urgently consume sweet-flavored substances to relax it, such as Glycyrrhizae Radix et Rhizoma (Gancao, 甘草). To tonify the Spleen with sweetness, use Ginseng Radix (Renshen, 人参). To drain the Spleen with bitterness, use Coptidis Rhizoma (Huanglian, 黄连).
The Lungs desire astringency, so one should urgently consume sour-flavored substances to astringe them, such as Paeoniae Radix Alba (Baishao, 白芍药). To tonify the Lungs with sourness, use Schisandrae Fructus (Wuweizi, 五味子). To drain the Lungs with pungency, use Morus Cortex (Sangbaipi, 桑白皮).
The Kidneys desire firmness, so one should urgently consume bitter-flavored substances to firm them, such as Anemarrhenae Rhizoma (Zhimu, 知母). To tonify the Kidneys with bitterness, use Phellodendri Cortex (Huangbai, 黄柏). To drain the Kidneys with saltiness, use Alismatis Rhizoma (Zexie, 泽泻).
The annotation states: Among these five, there are sour, pungent, sweet, bitter, and salty flavors, each having its specific benefits, whether dispersing, astringing, relaxing, softening, or firming. Diseases of the Zang organs in the four seasons follow the suitability of the five flavors.
The "Treatise on Changes in the Intersection of Qi" states: The Five Movements (Wuyun) have excess and deficiency. The administration of the Five Movements is like a balance; what is high is suppressed, what is low is lifted, what transforms responds to it, and what changes avenges it. These are the movements of growth, transformation, harvest, and storage, which constitute the normal state of Qi. If this normal state is lost, the heaven and earth become blocked in all four directions.
The annotation states: The principle of losing the normal state is that the Qi of heaven, earth, and the four seasons cannot circulate and operate normally. Therefore, movement must contain stillness, and victory must be followed by retaliation; this is the Way of Yin and Yang of heaven and earth. Regarding the method of treating heat with heat: The Classics state: When pathogenic heat is severe and contends with cold medicine, the cold medicine is difficult to swallow, so it is administered hot instead, following the momentum of the disease. Once the heat momentum subsides, the cold nature takes effect, and the pathological heat is eliminated and cured. This is exemplified by administering cold medicines like Chengqi Decoction (Chengqi Tang, 承气汤) while hot. The same method applies to treating cold diseases. In general, treating diseases requires seeking the location of the pathology; if the disease is in the upper part, treat the upper part; if in the lower part, treat the lower part. Thus, this applies to internal and external Zang-Fu organs and meridians. If the pathogenic Qi is hot, remove the heat; if the pathogenic Qi is cold, dispel the cold. The Six Qi follow the same method. Draining excess and tonifying deficiency, eliminating evil and nourishing healthy Qi, maintaining constancy when in balance—this is the Way of Medicine.
The Great Principle states: The methods of predecessors were medicines appropriate for the syndromes at that time. Later generations using them should examine the pulse Qi under the fingers and make additions or subtractions accordingly; otherwise, there will be no efficacy. I am not disparaging the methods of predecessors to act on my own initiative. Rather, the Five Elements mutually constrain and complement each other, forming the body of generation, transformation, constraint, and succession. Within a moment, changes are chaotic and unpredictable. Examining the pulse and prescribing formulas is also the method of predecessors. Those who understand the principles later should consider my words correct.