从来火字,《内经》有壮火、少火之名,后人则曰∶天火、人火、君火、相火、龙火、
雷火,种种不一,而朱丹溪复以虚实二字括之,可谓善言火矣。乃人人宗其说,而于治火,
卒无定见,何也?是殆辨之犹未确欤!予因易数字以解之,夫实火者,六淫之邪,饮食之伤,
自外而入,势犹贼也。虚火者,七情色欲,劳役耗神,自内而发,势犹子也。贼至则驱之,
如消散、清凉、攻伐等药,皆可按法取用,盖刀枪剑戟,原为驱贼设也。子逆则安之,如补
气、滋水、理脾等药,皆可按法施治,盖饮食、器用,原为养子设也。夫子者,奉身之本也
若以驱贼者驱其子,则无以为养身生命之本矣。人固不可认贼作子,更不可认子作贼。病
机一十九条,言火者十之八,言寒者十之二。若不明辨精切,恐后学卒至模糊,余故反复详
外火∶风、寒、暑、湿、燥、火,及伤热饮食,贼火也。贼可驱而不可留。
内火∶七情色欲,劳役耗神,子火也。子可养而不可害。
驱贼火有四法∶
一曰发∶风寒拥闭,火邪内郁,宜升发之,如升阳散火汤之类是也;
二曰清∶内热极盛,宜用寒凉,如黄连解毒汤之类是也;
三曰攻∶火气郁结,大便不通,法当攻下,此釜底抽薪之法,如承气汤之类是也;
四曰制∶热气拂郁,清之不去,攻之不可,此本来真水有亏,不能制火,所谓寒之不寒
是无水也,当滋其肾,如地黄汤之类可用也。
养子火有四法∶
一曰达∶肝经气结,五郁相因,当顺其性而升之。所谓木郁则达之,如逍遥散之类是也
此以一方治木郁而诸郁皆解也;
二曰滋∶虚火上炎,必滋其水。所谓壮水之主,以镇阳光,如六味汤之类是也;
三曰温∶劳役神疲,元气受伤,阴火乘其土位。经曰∶劳者温之。又曰∶甘温能除大热
如补中益气之类是也;
四曰引∶肾气虚寒,逼其无根失守之火,浮游于上,当以辛热杂于壮水药中,导之下行
所谓导龙入海,引火归元。如八味汤之类是也。
以上治火法中,贼则宜攻,子则宜养,固已。然邪盛正虚之时,而用攻补兼行之法,
或滋水制火之法,往往取效。是知养子之法,可借为驱贼之方,断无以驱贼之法,而为养
子之理。盖养正则邪自除,理之所有,伐正而能保身,理之所无也。世人妄用温补以养贼者
固多,而恣行攻伐以驱子者,更复不少。此皆不得火字真诠,而贻祸斯民也。可不慎欤!
自古以来,关于“火”这一概念,《黄帝内经》中有壮火、少火的名称,后世医家则将其分为天火、人火、君火、相火、龙火、雷火等,种类繁多。朱丹溪又用“虚”和“实”两个字来概括,可以说是对火理阐述得非常精妙了。然而,人们都尊崇他的说法,但在治疗火证时,最终还是没有固定的见解,这是为什么呢?这大概是因为辨析得还不够确切吧!我因此改动几个字来解释它:所谓的实火,是六淫邪气、饮食损伤所致,从外部侵入人体,其态势如同盗贼一般。所谓的虚火,是由七情过极、色欲过度、劳累役体耗伤精神所致,从内部产生,其态势如同子女一般。盗贼来了就要驱逐它,如消散、清凉、攻伐等药物,都可以按照法则选用,因为刀枪剑戟,原本就是为驱逐盗贼而设的。子女叛逆就要安抚它,如补气、滋水(滋养肾阴)、理脾等药物,都可以按照法则施治,因为饮食器具,原本就是为养育子女而设的。子女,是奉养身体的根本。如果用驱逐盗贼的方法来驱逐自己的子女,那么就没有用来奉养身体生命的根本了。人固然不能认贼作子,更不可认子作贼。《素问·至真要大论》中的病机十九条,谈论火的占十分之八,谈论寒的占十分之二。如果不能明辨精切,恐怕后学者最终会变得模糊不清,所以我反复详细论述。
外火:风、寒、暑、湿、燥、火,以及因热饮食造成的损伤,属于贼火。贼火可以驱逐但不宜留滞。
内火:七情过极、色欲过度、劳累役体耗伤精神,属于子火。子火可以养育但不宜伤害。
驱逐贼火有四种方法:
第一种叫发汗解表:风寒闭塞肌表,火邪郁结在内,应当升发疏散,如升阳散火汤之类的方剂;
第二种叫清热泻火:体内热势极盛,应当使用寒凉药物,如黄连解毒汤之类的方剂;
第三种叫攻下泄热:火气郁结,大便不通,法当攻下,这是釜底抽薪的方法,如承气汤之类的方剂;
第四种叫滋阴制火:热气拂郁,用清热法去不掉,用攻下法也不行,这是因为本来真水(肾阴)亏损,不能制约火气,所谓“寒之不寒是无水也”,应当滋补肾阴,如地黄汤之类的方剂可以使用。
养育子火有四种方法:
第一种叫疏肝达郁:肝经气机结滞,五种郁证相互影响,应当顺应其本性而升发。所谓“木郁则达之”,如逍遥散之类的方剂。这是用一个方子治疗木郁,从而使各种郁证都得以解除;
第二种叫滋阴降火:虚火上炎,必须滋养肾水。所谓“壮水之主,以镇阳光”,如六味地黄丸之类的方剂;
第三种叫温补元气:劳累役体导致神疲乏力,元气受伤,阴火乘袭脾土之位。经文说:“劳者温之。”又说:“甘温能除大热”,如补中益气汤之类的方剂;
第四种叫引火归元:肾气虚寒,逼迫那无根失守的火气,浮游于上,应当在辛热药中混杂壮水药,引导其下行。所谓“导龙入海,引火归元”,如八味丸(金匮肾气丸)之类的方剂。
以上治疗火证的方法中,贼火适宜攻逐,子火适宜养育,这已经是确定的道理了。然而,在邪气盛而正气虚的时候,采用攻补兼行的方法,或者滋水制火的方法,往往能取得疗效。由此可知,养育子火的方法,可以借用作为驱逐贼火的方剂,但绝不能把驱逐贼火的方法,当作养育子火的原理。因为养护正气则邪气自然消除,这是情理之中的事;伐害正气而能保全身体,这是情理中不存在的事。世人滥用温补药物来供养贼火的情况固然很多,而肆意实行攻伐方法来驱逐子火的情况,更是不少。这都是没有获得“火”字的真正内涵,从而给百姓带来祸患啊。能不谨慎吗!
Since ancient times, regarding the concept of "Fire" (Huo), *The Inner Canon* (Neijing) mentions the names of Exuberant Fire (Zhuang Huo) and Mild Fire (Shao Huo). Later generations classified it into Heavenly Fire, Human Fire, Ministerial Fire (Jun Huo), Ministerial Fire (Xiang Huo), Dragon Fire, and Thunder Fire, among others, with various types. Zhu Danxi further summarized them using the terms "Deficiency" (Xu) and "Excess" (Shi), which can be considered an excellent exposition on Fire. However, although everyone reveres his theory, there is still no fixed view on treating Fire syndromes. Why is this? It is likely because the differentiation has not been precise enough. Therefore, I have modified a few characters to explain it: The so-called Excess Fire arises from the pathogenic factors of the Six Evils (Liu Yin) and dietary injury, entering from the outside; its nature is like that of a thief. The so-called Deficiency Fire arises from emotional excess, sexual indulgence, and physical labor consuming the spirit; it originates from within; its nature is like that of a child. When a thief arrives, one must drive him away; drugs such as those for resolving accumulation, clearing heat, and attacking pathogens can be used according to the method, just as swords and spears are originally designed to drive away thieves. When a child is rebellious, one must pacify him; drugs for tonifying Qi, nourishing Water (nourishing Kidney Yin), and regulating the Spleen can be applied according to the method, just as food and utensils are originally designed to raise children. A child is the foundation upon which the body is sustained. If one uses methods to drive away thieves to treat one's own children, there will be no foundation left for sustaining life. One certainly should not mistake a thief for a child, nor should one mistake a child for a thief. In the Nineteen Pathogenesis Patterns of *Suwen*, eight-tenths discuss Fire, and two-tenths discuss Cold. If these are not clearly and precisely differentiated, later students may become confused. Thus, I elaborate repeatedly.
External Fire: Wind, Cold, Summerheat, Dampness, Dryness, Fire, as well as injuries from hot foods/drinks, constitute Thief Fire. Thief fire can be expelled but not retained.
Internal Fire: Emotional excess, sexual indulgence, and physical labor consuming the spirit constitute Child Fire. Child fire can be nurtured but not harmed.
There are four methods to expel Thief Fire:
1. Dispersing (Fa): When Wind-Cold obstructs the exterior and Fire pathogen is constrained internally, one should promote dispersal, such as using formulas like Sheng Yang San Huo Tang (Yang-Raising Fire-Scattering Decoction);
2. Clearing (Qing): When internal heat is extremely exuberant, cold-cooling agents should be used, such as formulas like Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity);
3. Purging (Gong): When Fire qi is constrained and constipation occurs, purgative methods are indicated. This is the method of removing firewood from under the cauldron (Fu Di Chou Xin), such as using formulas like Cheng Qi Tang (Order-Quieting Decoction);
4. Restraining (Zhi): When heat qi is stifled and cannot be cleared by cooling or removed by purging, it indicates a deficiency of original True Water (Kidney Yin) failing to restrain Fire. As stated, "If cooling does not reduce heat, it is due to lack of water." One should nourish the Kidneys, such as using formulas like Di Huang Tang (Rehmannia Decoction).
There are four methods to nurture Child Fire:
1. Reaching/Dispersing Liver Qi (Da): When Liver channel Qi is knotted and five types of stagnation interact, one should follow its nature to ascend it. As stated, "When Wood is stagnant, reach it," such as using formulas like Xiao Yao San (Free and Easy Wanderer Powder). This resolves all stagnations by treating Wood stagnation with one formula;
2. Nourishing (Zi): When Deficient Fire flares upward, one must nourish Water. As stated, "Strengthen the master of Water to suppress Solar brilliance," such as using formulas like Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill);
3. Warming (Wen): Physical labor causes spiritual fatigue and damages Yuan Qi, allowing Yin Fire to invade the Earth position (Spleen/Stomach). The Classics state: "For exhaustion, use warmth." Also: "Sweet-warm substances can eliminate great heat," such as using formulas like Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction);
4. Guiding (Yin): When Kidney Qi is deficient and cold, forcing rootless and unanchored Fire to float upward, one should mix pungent-hot substances with Water-nourishing drugs to guide it downward. This is known as "Guiding the Dragon into the Sea, Leading Fire back to its Source," such as using formulas like Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill).
Among the above methods for treating Fire, it is established that Thief fire should be attacked, and Child fire should be nurtured. However, when pathogenic factors are exuberant and healthy Qi is deficient, using methods that simultaneously attack and tonify, or methods that nourish Water to restrain Fire, often yield results. Thus, we know that methods for nurturing Child fire can be borrowed as prescriptions for expelling Thief fire, but methods for expelling Thief fire should never be used as principles for nurturing Child fire. Nurturing righteousness (Zheng Qi) naturally eliminates evil; this is logical. Attacking righteousness while preserving the body is illogical. Many people wrongly use warm-tonic drugs to nourish Thief fire, and even more people recklessly use attacking-purging methods to drive away Child fire. All these result from failing to grasp the true meaning of "Fire," thereby bringing disaster to the people. Can one not be cautious!