阴阳平补理中汤，参（柔润多液，味苦甘）草（吐胜平气）滋阴姜术阳，统主五虚（五脏之虚）中（中
，脾胃也）布达，循环血气效难量（五脏六腑循环以受中气之益。
坎卦先天始一阳，阳虚（一昼之阳虚）渐致五虚殃，长沙附子汤须记，造化生机贮锦囊。
东方之气在于肝，肝木敷荣五气安，仲景遗来炙甘草，滋阴真谛已开端。
虚痨症，痨字从火，未有痨症而不发热者也。医以苦寒为戒，谓滋阴一法，最为妥当，
而不知此证多是阴盛为病，滋阴是增其病也。人皆曰阴虚则火动，吾则曰阴盛则火动。何以
言之，心肺在上，阳之位也；胸中之阳宣布，如日月一出，燔火无光，何有发热之病，惟下
焦阴盛，无不上干阳位。足太阴脾之湿气，动而为水饮，即上干于手太阴肺，而为咳嗽不已
。足少阴肾之寒气，动而为阴血，即上干手少阴心，而为吐血不休。虚痨以咳嗽、吐血二证
为提纲，非阴盛所致而何。且心肺之位，如太空也，下焦之阴气上冲，阴霾散布，白昼亦如
长夜，不独灯烛之火有光，即腐草萤虫俱能生光，岂非阴盛火动之一证乎。况人身中有龙雷之
火，非诸经之火所可比。然必阴云四合，而龙雷方得遂其升腾之势，而烈日当空，龙雷潜伏
矣。大法以小建中汤加黄 为主，热甚汗多，心悸者，二加龙骨汤；吐血不已者，理中汤、
甘草干姜汤；气短小水少者，桂附八味丸、桂苓甘术汤；发热咳嗽者，小柴胡汤去人参、姜
枣加干姜、五味；咳嗽恶寒者，小青龙汤加紫菀、茯苓、阿胶。宜溯其源而治之，总以温脾
为上乘之法，非笔楮所可尽也。
虚痨以小建中汤为第一方，时医未解，而多诋之。兹得张心在之论甚妙。心在云∶“肺
损之病，多由五志生火，销灼金脏，咳嗽发热，渐至气喘侧眠，消瘦羸瘠，虚证交集，咽痛
失音而不起矣。”“壮水之主，以制阳光。”王冰成法，于理则通，而多不效，其故何哉。
窃尝观于炉中之火而得之。炊饭者，始用武火，将熟则掩之以灰，饭徐透而不焦黑。则知以
灰养火，得火之用，而无火之害，断断如也。五志之火内燃，温脾之土以养之，而焰自息，
方用小建中汤，虚甚加黄 ，火得所养而不燃，金自清肃，又况饴糖为君，治嗽妙品，且能
补土以生金。肺损虽难着手，不患其不可治也。然不独治肺，五痨、七伤皆可以通治。
（经义）《上古天真论》曰∶“今时之人，以酒为浆、以妄为常，醉以入房，以欲竭其精，
以耗散其真，不知持漏，不知御神，务快其心，逆于生乐，起居无节，故半百而衰也。”《
阴阳应象大论》曰∶“年四十而阴气自半也，起居衰矣。”《宣明五气篇》曰∶“久视伤血
、久卧伤气，久坐伤肉，久立伤骨，久行伤筋。”《评热病论》曰∶“邪之所凑，其气必虚
，阴虚者，阳必凑之。”《本神篇》曰∶“五脏主脏精者也，不可伤，伤则失守而阴虚，阴
虚则无气，无气则死矣。”《经脉别论》曰∶“勇者气行则已，怯者则着而为病。”《口问
篇》曰∶“邪之所在，皆为不足。故上气不足，脑为之不满，耳为之苦鸣，头为之苦倾，目
为之眩。中气不足，溲便为之变，肠为之苦鸣。下气不足，则乃为痿厥心 。”《逆调论
》
曰∶“荣气虚则不仁，卫气虚则不用，荣卫俱虚则不仁且不用，肉如故也，人身与死不相有
，曰死。”《海论》曰∶“气海有余者，气满胸中， 息面赤；气海血不足，则气少不足以
言
。海有余，则常想其身大，怫然不知其所病；血海不足，亦常想其身小，狭然不知其所病
。水谷之海有余，则腹满；水谷之海不足，则饥不受谷食。髓海有余，则轻劲多力，自过其
度；髓海不足，则脑转耳鸣，胫酸眩冒，目无所见，懈怠安卧。”《卫气篇》曰∶“下虚则
厥，上虚则眩。”《脉解篇》曰∶“内夺而厥，则为喑痱，此肾虚也。”《决气篇》曰∶“
精脱者耳聋，气脱者目不明。津脱者凑理开，汗大泄。液脱者，骨属屈伸不利，色夭，脑少
髓消，胫酸耳数鸣。血脱者，色白夭然不泽，其脉空虚，此其候也。”
阴阳平补的理中汤，由人参（柔润多液，味苦甘）、甘草（呕吐剧烈可平抑气逆）、干姜、白术组成，以温阳滋阴。它统摄主治五脏之虚（五脏功能衰退）以及中焦（即脾胃）的气机布达，使循环的血气功效难以估量。
坎卦象征先天的一阳初生，阳气虚弱（一昼夜中阳气的衰弱）逐渐导致五脏皆虚的祸殃，长沙太守张仲景的附子汤必须牢记，其中蕴藏着造化生机，如同贮藏在锦囊中的妙方。
东方的气机归属于肝，肝木之气敷布荣养，则五气安宁。这是张仲景遗留下来的炙甘草汤，开启了滋阴的真谛。
虚劳病，从字形看，“痨”字带火旁，没有患虚劳病而不发热的。医生们忌讳使用苦寒药物，认为滋阴这一方法最为妥当，却不知此证大多是由阴盛引起的疾病，滋阴反而会增加病情。人们都说阴虚则火动，我却说是阴盛则火动。为什么这样说呢？心肺位于上部，属于阳的位置；胸中的阳气宣通布散，就像太阳月亮一出，烈火的光芒便显得黯淡，怎么会有发热的病呢？只有下焦阴气过盛，才会向上侵犯阳位。足太阴脾经的湿气，变动而为水饮，就会上犯手太阴肺经，导致咳嗽不止。足少阴肾经的寒气，变动而为阴血，就会上犯手少阴心经，导致吐血不停。虚劳病以咳嗽、吐血这两个症状为提纲，如果不是阴盛所致，还能是什么呢？况且心肺的位置，就像广阔的太空一样，下焦的阴气上冲，阴霾散布，即使是白昼也像漫长的黑夜，不仅灯烛之火有光，就是腐烂的草和萤火虫也能发出光芒，这难道不是阴盛火动的一个证据吗？何况人身中有龙雷之火，不是其他经络的火所能比拟的。然而必须阴云四合，龙雷之火才能得以升腾之势，若是烈日当空，龙雷之火就会潜伏。治疗的大法以小建中汤加黄芪为主药；如果热势严重、汗多、心悸的，用二加龙骨汤；吐血不停的，用理中汤、甘草干姜汤；气短、小便少的，用桂附八味丸、桂苓甘术汤；发热咳嗽的，用小柴胡汤去掉人参、生姜、大枣，加入干姜、五味子；咳嗽且恶寒的，用小青龙汤加紫菀、茯苓、阿胶。应当追溯病源而治疗，总的原则是以温补脾土为上乘的方法，这不是笔墨所能详尽描述的。
虚劳病以小建中汤为第一方，当时的医生不理解，反而多加诋毁。这里引用张心在的论述非常精妙。张心在说：“肺损的病，多由五种情志化火，销蚀灼伤肺金脏，导致咳嗽发热，逐渐发展到气喘、侧卧睡眠，身体消瘦羸弱，各种虚证交织在一起，最终咽喉痛、失音而不能起身。”“壮水之主，以制阳光。”这是王冰制定的成法，理论上通顺，但往往不生效，这是什么原因呢？我曾观察炉中之火而得到启示。做饭时，开始用猛火，快熟时用灰覆盖，饭慢慢透熟而不焦黑。就知道用灰来养护火，能发挥火的作用，而没有火的危害，这是确凿无疑的。五种情志之火在内燃烧，用温补脾土的方法来养护它，火焰自然熄灭，这时才用小建中汤，极度虚弱的加黄芪，火得到滋养而不燃烧，肺金自然清肃，更何况饴糖作为君药，是治疗咳嗽的妙品，而且能补益脾土以生肺金。肺损虽然难以下手，但不必担心它不可治愈。然而这不仅限于治肺，五劳、七伤都可以通治。
（经文义理）《上古天真论》说：“现在的人，把酒当作浆水喝，把妄动当作常态，醉酒后行房事，用欲望耗尽精气，耗散真气，不知道保持节制，不知道御守精神，务必求得心意快乐，违背了生命的乐趣，起居没有节律，所以不到五十岁就衰老了。”《阴阳应象大论》说：“年四十岁，阴气就自然减半了，起居能力也衰退了。”《宣明五气篇》说：“久视伤血，久卧伤气，久坐伤肉，久立伤骨，久行伤筋。”《评热病论》说：“邪气聚集的地方，正气必然虚弱，阴虚的时候，阳邪必定凑集侵犯。”《本神篇》说：“五脏是藏精的器官，不能受伤，受伤就会失守而导致阴虚，阴虚就没有气，没有气就会死亡。”《经脉别论》说：“勇敢的人，气运行通畅病就好了；怯懦的人，邪气停留就成为疾病。”《口问篇》说：“邪气所在之处，都是因为正气不足。所以上部气不足，头脑就会感觉空虚，耳朵痛苦鸣响，头部痛苦倾斜，眼睛眩晕。中部气不足，大小便就会异常，肠道痛苦鸣响。下部气不足，就会发生痿厥和心痛。”《逆调论》说：“营气虚则肢体麻木不仁，卫气虚则肢体不能使用，营卫都虚则既麻木又不使用，肌肉依然如故，人身与死不相分离，这就叫死。”《海论》说：“气海有余，气满胸中，呼吸急促面红；气海血不足，则气少不足以说话。气海有余，常觉得自己身体大，郁怒不知自己得了什么病；血海不足，也常觉得自己身体小，局促不知自己得了什么病。水谷之海有余，则腹部胀满；水谷之海不足，则饥饿却不能吃谷物食物。髓海有余，则轻捷强劲有力，超过正常限度；髓海不足，则头晕耳鸣，小腿酸软眩晕，眼睛看不见东西，懈怠嗜睡。”《卫气篇》说：“下部虚则四肢厥冷，上部虚则头晕。”《脉解篇》说：“内部精气被夺而厥逆，就会失音和足废不用，这是肾虚的表现。”《决气篇》说：“精脱者耳聋，气脱者视力不明。津脱者腠理开泄，大汗淋漓。液脱者，关节屈伸不利，面色枯槁，脑髓减少，小腿酸软耳朵频繁鸣响。血脱者，面色苍白无光泽，脉象空虚，这就是征候。”
The Li Zhong Tang (Cinnamon Twig and Atractylodes Macrocephala Decoction) for balancing and tonifying Yin and Yang consists of Renshen (Ginseng Radix, moist and fluid-rich, bitter and sweet taste), Gancao (Licorice Root, calms rebellious Qi when vomiting is severe), Ganjiang (Dried Ginger), and Baizhu (Atractylodis Macrocephalae Rhizoma). It governs the deficiency of the Five Zang organs (deficiency of the five viscera) and the distribution of Qi in the Middle Jiao (Spleen and Stomach), enhancing the circulation of Blood and Qi with effects that are hard to measure.
The Kan Trigram symbolizes the initial Yang of the Pre-heaven period. Gradual deficiency of Yang (Yang deficiency throughout a day) leads to the disaster of deficiency in all Five Zang organs. The Fuzi Tang (Aconite Decoction) by Zhang Zhongjing, the Prefect of Changsha, must be remembered; it stores the vitality of creation like a precious remedy in a brocade bag.
The Qi of the East belongs to the Liver. When Liver Wood spreads and nourishes, the Five Qi remain peaceful. This refers to the Zhi Gancao Tang (Honey-fried Licorice Decoction) left by Zhang Zhongjing, which initiated the true essence of nourishing Yin.
Consumptive disease (Xulao), the character "Lao" contains the fire radical; there is no consumptive disease without fever. Physicians warn against bitter-cold herbs, considering the method of nourishing Yin as the most appropriate, yet they do not realize that this condition is mostly caused by excess Yin. Nourishing Yin would only increase the disease. People say that Yin deficiency causes Fire to move, but I say that Yin excess causes Fire to move. Why? The Heart and Lung are located superiorly, in the position of Yang. When the Yang of the Chest is distributed, like the sun or moon rising, the light of a blazing fire becomes dim; how could there be a feverish disease? Only when Yin is excessive in the Lower Jiao does it invade the Yang position upwards. Dampness from the Foot-Taiyin Spleen channel transforms into Phlegm-Fluids and invades the Hand-Taiyin Lung channel, causing persistent cough. Cold-Qi from the Foot-Shaoyin Kidney channel transforms into Yin-Blood and invades the Hand-Shaoyin Heart channel, causing incessant hemoptysis. Consumptive disease takes cough and hemoptysis as its main symptoms; if not caused by Yin excess, what else could it be? Moreover, the positions of the Heart and Lung are like the vast sky. When Yin-Qi from the Lower Jiao rushes upward, spreading like dark clouds, even daytime resembles a long night. Not only do lamps and candles shine, but rotting grass and fireflies also emit light. Is this not evidence of Yin excess causing Fire to move? Furthermore, the Dragon-Thunder Fire in the human body cannot be compared to the Fire of other channels. However, Dragon-Thunder Fire can only rise vigorously when dark clouds gather; under the scorching sun, it remains latent. The general treatment principle uses Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) added with Huangqi (Astragali Radix) as the principal formula. If heat is severe, sweating is profuse, and palpitations occur, use Erjia Longgu Tang (Two-Added Dragon Bone Decoction). For incessant hemoptysis, use Lizhong Tang (Regulate the Middle Decoction) or Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction). For shortness of breath and scanty urination, use Guifu Bawei Wan (Cinnamon Twig, Aconite, and Eight-Ingredient Pill) or Guiling Gan Zhu Tang (Cinnamon Twig, Poria, Licorice, and Atractylodes Decoction). For fever and cough, use Xiaochaihu Tang (Minor Bupleurum Decoction) removing Renshen, Shengjiang (Fresh Ginger), and Dazao (Jujube), adding Ganjiang and Wuweizi (Schisandrae Fructus). For cough with aversion to cold, use Xiao Qinglong Tang (Minor Blue Dragon Decoction) adding Ziwan (Asteli Herba), Fuling (Poria), and Ejiao (Donkey-hide Gelatin). One should trace the source and treat accordingly. The supreme method is always to warm the Spleen, which cannot be fully described here.
For consumptive disease, Xiao Jian Zhong Tang is the first choice. Contemporary physicians do not understand it and often disparage it. Here, the argument of Zhang Xinza is excellent. Zhang Xinza said: "Diseases of lung damage are mostly caused by Fire generated from the Five Emotions, consuming and burning the Metal organ (Lung), leading to cough and fever, gradually progressing to asthma and sleeping on one side, emaciation and weakness, with various deficiency syndromes intersecting, eventually resulting in sore throat, loss of voice, and inability to rise." 'Strengthen the master of Water to control the sunlight.' This is Wang Bing's established method. Although theoretically sound, it is often ineffective. Why? I once observed the fire in a stove and gained insight. When cooking rice, one starts with fierce fire, then covers it with ash when nearly done, allowing the rice to cook slowly without burning. Thus, using ash to nurture the fire utilizes its function without its harm. This is certain. When Fire from the Five Emotions burns internally, warming and strengthening the Earth (Spleen) nurtures it, and the flame naturally subsides. Then, use Xiao Jian Zhong Tang. For severe deficiency, add Huangqi. When Fire is nurtured, it does not burn, and the Metal (Lung) becomes clear and肃 (descending). Moreover, Yitang (Maltose) is the sovereign herb, a wonderful product for treating cough, and it tonifies Earth to generate Metal. Although lung damage is difficult to treat, there is no need to worry about incurability. This applies not only to the Lung but also to the Five Labors and Seven Injuries.
(The Meaning of Classics) *Suwen: Shanggu Tianzhen Lun* states: "People nowadays treat wine as water and recklessness as routine. They engage in intercourse while drunk, exhaust their Essence with desires, dissipate their True Qi, do not know how to maintain restraint, do not know how to guard their Spirit, seek only mental pleasure, go against the joys of life, and have irregular daily routines. Therefore, they age prematurely, becoming decrepit before fifty." *Suwen: Yinyang Yingxiang Dalun* states: "At forty years old, Yin Qi naturally halves, and daily activities decline." *Suwen: Xuanming Wuqi Pian* states: "Prolonged viewing damages Blood; prolonged lying down damages Qi; prolonged sitting damages Flesh; prolonged standing damages Bones; prolonged walking damages Sinews." *Suwen: Ping Re Bing Lun* states: "Where pathogenic factors gather, Qi must be deficient. When Yin is deficient, Yang inevitably invades." *Suwen: Benshen Pian* states: "The Five Zang organs store Jing (Essence) and must not be injured. Injury leads to loss of control and Yin deficiency. Yin deficiency leads to lack of Qi, and lack of Qi leads to death." *Suwen: Jingmai Bie Lun* states: "Courageous people recover as Qi flows smoothly; timid people develop disease as pathogens linger." *Suwen: Kouwen Pian* states: "Wherever pathogens reside, there is insufficiency. Upper Qi insufficiency causes fullness in the head, painful tinnitus, heavy head, and dizziness. Middle Qi insufficiency causes abnormalities in urination and defecation, and painful intestinal rumbling. Lower Qi insufficiency leads to Wei-Jue (impotence and cold limbs) and heart pain." *Suwen: Nitiao Lun* states: "Deficiency of Ying Qi causes numbness; deficiency of Wei Qi causes immobility. Deficiency of both Ying and Wei causes both numbness and immobility, while muscles remain normal. When the body separates from life, it is called death." *Suwen: Hai Lun* states: "Excess in the Sea of Qi fills the chest, causes rapid breathing and red face; deficiency of Qi and Blood in the Sea of Qi results in insufficient breath to speak. Excess in the Sea of Qi makes one feel large and irritable, unaware of the illness; deficiency in the Sea of Blood makes one feel small and confined, unaware of the illness. Excess in the Sea of Food and Water causes abdominal fullness; deficiency causes hunger but inability to eat. Excess in the Sea of Marrow makes one light, strong, and exceeding normal limits; deficiency causes dizziness, tinnitus, sore legs, visual impairment, lethargy, and desire to lie down." *Suwen: Weiqi Pian* states: "Lower deficiency leads to cold limbs; upper deficiency leads to dizziness." *Suwen: Maijie Pian* states: "Internal depletion leading to厥 (fainting/cold limbs) results in aphasia and foot paralysis, indicating Kidney deficiency." *Suwen: Jueqi Pian* states: "Loss of Jing causes deafness; loss of Qi causes blurred vision. Loss of Jin causes open pores and profuse sweating. Loss of Ye causes stiffness in joints, sallow complexion, reduced brain marrow, sore legs, and frequent tinnitus. Loss of Blood causes pale, lusterless complexion and empty pulse. These are the signs."