阴虚为劳。即今所谓怯弱症也。虽有五脏之别。然皆起于心脾。脉必数而有浮大细小之分。
浮大而数。阴虚甚也。细小而数。阴中之阳绝矣。此等症。必见咳嗽。或吐红。或遗精。或女子
不月。或诸般劳伤而起。要当治之于始。妇人产后。最易成此症。慎之慎之。治法只一归脾汤。
加麦冬五味白芍。去木香。吞六味丸。此外别无治法。有一种郁而起者。即以前方虽味外,再加
丹皮山栀。曾经庸医用寒凉者。不可复服。又有一种阳虚者。脉不数。但缓而大不收。奄奄无力
。夜卧不安。梦中常见神鬼不吉。醒来胸中战跳。或下见遗精。口中无味。饮食不思。略食即饱
。此皆命门虚损。心火衰息。以致脾土不运。生气不旺。大剂养荣汤。加附子。吞
八味丸。(又有两尺脉微弱。而阴阳俱虚者。宜十补丸。此皆滋其化源也。治弱之法。指不胜屈。
然皆不得其要。必如此乃为不易之则耳。试于阴阳两症。剖别分明。遵此守服。必无不效。切勿
误用寒凉败胃之剂。促人寿限也。有蹈前弊者。庶几改之。)
三消之病形何如。曰。消之为病。一原于心火炽炎。火甚于上。为膈膜之消。甚于中。为肠
胃之消。甚于下。为膏液之消。甚于外。为肌肉之消。上甚不已。则消及肺。中甚不已。则消及
脾。下甚不已。则消及肝肾。外甚不已。则消及筋骨。四脏皆消甚。则其心始自焚而死矣。然其
病之始。皆由不节嗜欲。不慎喜怒。膏粱爆炙。酒酪 乳。湿热之气。浸淫燔灼。郁成燥热。气
不宣平。故其传变之形。为饮水多而小便多。曰消渴。胃中津液干枯。不能上荣舌本也。为善饥
多食而渴。小便数而消瘦。曰消中。胃中热极。所食之物。随火而化也。为渴而饮水不绝。腿消
瘦而小便有脂液。曰肾消。是燥热并及于胃底大小肠。故脂液凝浊。清阳与浊阴不能分疏也。三
消之中。上中可治。下消最难治。然饮一溲未二。犹可治。饮一溲二。不可治矣。又三消久而小
便不臭。反作甘气。在溺桶中涌沸。其病为重。更有浮在溺面如猪脂油溅在桶边。如 烛泪。此
精不禁而真元竭矣。然何以甘气为重。大抵水在天地与人身。皆有甘有咸。甘为生气。而咸为死
气。小便本咸而反甘。
是生气泄也。是脾气下陷入于肾也。土克水。故死也。(有一种渴而恶甘。但饮茶为快者。属肾
消。赵邯郸云。治消之法。无分上中下。先治肾为急。惟以六味八味及加减八味。降其心火。
滋其肾水。则消自止。然三消俱宜戒浓味酒面房劳。不守禁忌。虽药无功。重生者其知之。
阴虚导致劳损,也就是现在所说的怯弱症。虽然根据五脏有所不同,但都起源于心和脾。脉象必定数(快),且有浮大或细小之分。
脉象浮大而数,说明阴虚严重。脉象细小而数,说明阴中的阳气已经衰竭。这类病症,必然出现咳嗽,或者吐血,或者遗精,或者女子月经闭止,或者是由于各种劳伤引起。应当在初期进行治疗。妇女产后,最容易形成这种病症,务必谨慎。治疗方法只用归脾汤(补益心脾的方剂),加入麦冬、五味子、白芍,去掉木香,同时吞服六味丸(滋补肾阴的方剂)。除此之外没有别的治法。有一种是由于情志郁结引起的,就用前面的方子,虽然味道不同,再加牡丹皮、山栀。曾经被庸医用寒凉药物治疗过的,不可再服用。又有一种是阳虚的,脉象不数,只是缓(慢)而大且不收摄,气息微弱无力。夜间睡眠不安稳,梦中经常见到神鬼等不吉利的事物,醒来时心中惊悸颤抖,或者下部出现遗精,口中无味,不想饮食,稍微吃一点就饱胀。这都是命门(肾阳之根)虚损,心火衰微,导致脾土不能运化,生气不旺盛。用大剂量的养荣汤(养血补气的方剂),加入附子,吞服八味丸(温补肾阳的方剂)。(又有两尺脉微弱,阴阳俱虚的,适宜用十补丸。这些都是滋养其化源的方法。治疗弱症的方法多得数不清,但都没有抓住要领,必须像这样才是不可改变的准则。试着将阴阳两种病症剖析辨别清楚,遵照此法坚持服用,必定没有不生效的。千万不要误用寒凉败坏胃气的药剂,缩短人的寿命。如果有重蹈前人覆辙的,希望改正。)
三消病的形态是怎样的?回答说:消病,根源在于心火炽盛燃烧。火气在上部严重,表现为膈膜部位的消渴;在中部严重,表现为肠胃部位的消中;在下部严重,表现为膏液部位的肾消;在外围严重,表现为肌肉部位的消瘦。上部严重不止,则消耗波及肺;中部严重不止,则消耗波及脾;下部严重不止,则消耗波及肝肾;外围严重不止,则消耗波及筋骨。四脏都消耗严重,那么心脏才会自焚而死。然而疾病的开始,都是由于不节制欲望,不谨慎喜怒情绪,食用肥甘厚味、油炸烧烤、酒类奶酪等食物,湿热之气浸淫焚烧灼烧,郁结成为燥热,气机不能宣通平和。所以其传变的形态,表现为喝水多而小便也多,称为消渴。这是胃中津液干枯,不能上荣于舌本。表现为容易饥饿、多吃东西且口渴,小便频繁且身体消瘦,称为消中。这是胃中热极,所吃的食物随着火势而消化。表现为口渴且饮水不停,腿部消瘦且小便中有脂液,称为肾消。这是燥热并及于胃底和大小肠,所以脂液凝浊,清阳与浊阴不能分别疏导。在三消之中,上消和中消可以治疗,下消最难治疗。然而如果喝一份尿排出一份,还可以治疗;如果喝一份尿排出两份,就无法治疗了。另外,三消久了之后,小便不臭,反而发出甜味,在溺桶中涌起泡沫,病情较重。更有漂浮在小便表面像猪油溅在桶边,像蜡烛泪一样的,这是精气不禁固而真元枯竭了。然而为什么甜味表示病情重呢?大概水在天地之间和人体内部,都有甘味和咸味。甘味代表生气,而咸味代表死气。小便本来应该是咸的却反而变甘,这是生气泄漏的表现,这是脾气下陷进入肾脏。土克水,所以会死亡。(有一种口渴且厌恶甜食,只喜欢喝茶的人,属于肾消。赵邯郸说:治疗消病的方法,不分上中下,先以治疗肾脏为急务。只用六味丸、八味丸及加减八味丸,降低心火,滋润肾水,那么消渴自然停止。然而三消都应该戒除浓味食物、酒面以及房事劳累,如果不遵守禁忌,即使用药也没有功效。珍爱生命的人应该知道这一点。)
Yin deficiency leads to consumptive disease, which is what is now called "Qie Ruo Zheng" (Frailty Syndrome). Although there are distinctions among the five Zang organs, all originate from the Heart and Spleen. The pulse must be rapid (Shu), with variations of floating and large or fine and small.
A floating, large, and rapid pulse indicates severe Yin deficiency. A fine, small, and rapid pulse indicates that the Yang within Yin has exhausted. These syndromes inevitably present with coughing, hemoptysis (spitting blood), nocturnal emission, amenorrhea in women, or arise from various forms of overstrain. Treatment should begin at the onset. Postpartum women are most prone to developing this syndrome; caution is essential. The treatment method relies solely on Guipi Tang (Spleen-Restoring Decoction), modified by adding Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), and Paeoniae Radix Alba (Baishao), while removing Aucklandiae Radix (Muxiang). Simultaneously, administer Liuwei Wan (Six-Ingredient Pill with Rehmannia) orally. There is no other treatment method for this. In cases arising from Qi stagnation, use the aforementioned formula but modify it by adding Moutan Cortex (Danpi) and Gardeniae Fructus (Shanzhi). If the patient has previously been treated by incompetent physicians using cold-natured herbs, do not re-administer this formula. Another type involves Yang deficiency, where the pulse is not rapid but rather slow (Huan), large, and unconsolidated, with faint strength. Sleep is restless at night, often dreaming of deities, ghosts, or ominous signs; upon waking, palpitations and trembling occur internally. Externally, there may be nocturnal emission, a tasteless mouth, anorexia, and early satiety after slight food intake. These are all due to deficiency and damage of the Mingmen (Gate of Life/Kidney Yang root), decline of Heart Fire, leading to failure of Spleen Earth to transform and transport, and weak Sheng Qi (Vital Qi). Use a large dose of Yangrong Tang (Nourishing Glory Decoction) with added Aconiti Lateralis Radix Praeparata (Fuzi), taken with Bawei Wan (Eight-Ingredient Pill with Rehmannia). (In cases where both Chi pulses [at the wrist] are weak, indicating dual deficiency of Yin and Yang, Shibu Wan (Ten-Ingredient Pill) is suitable. All these methods aim to nourish the source of transformation. Methods for treating weakness are countless, yet none grasp the essence. Only this approach serves as an immutable principle. By clearly distinguishing between Yin and Yang syndromes and adhering strictly to this regimen, efficacy is guaranteed. Do not mistakenly use cold-natured agents that damage Stomach Qi and shorten lifespan. Those who repeat past errors should correct themselves.)
What is the morphology of the San Xiao (Three Consumptions) disease? It is said: The origin of Xiao disease lies in the blazing fire of the Heart. When fire is excessive in the upper jiao, it manifests as Ge Mo Xiao (Diaphragm Consumption); when excessive in the middle jiao, it manifests as Chang Wei Xiao (Stomach and Intestine Consumption); when excessive in the lower jiao, it manifests as Gao Ye Xiao (Essence and Fluid Consumption); and when excessive externally, it manifests as Ji Rou Xiao (Muscle Consumption). If upper excess persists, consumption spreads to the Lung; if middle excess persists, it spreads to the Spleen; if lower excess persists, it spreads to the Liver and Kidneys; if external excess persists, it spreads to the sinews and bones. When the four Zang organs are severely consumed, the Heart itself burns out, leading to death. However, the onset of the disease stems from immoderate desires and unregulated emotions, along with the consumption of rich, sweet, fried, roasted foods, alcohol, cheese, and milk. Damp-heat qi infiltrates, burns, and scorches, condensing into dryness-heat. Qi fails to circulate smoothly and peacefully. Thus, its transmission takes the form of drinking much water yet urinating much, known as Xiao Ke (Thirst-Diabetes). This occurs because stomach fluids are dried up and cannot nourish the tongue base. It also presents as frequent hunger, excessive eating with thirst, frequent urination, and emaciation, known as Xiao Zhong (Middle Consumption). This is due to extreme heat in the stomach, causing ingested food to be digested rapidly by fire. It presents as persistent thirst with continuous drinking, emaciated legs, and fatty substances in urine, known as Shen Xiao (Kidney Consumption). This indicates dryness-heat affecting the bottom of the stomach and the large and small intestines, causing fatty fluids to turbidly coagulate, preventing the separation of clear Yang and turbid Yin. Among the three Xiao diseases, Upper and Middle Xiao are treatable, while Lower Xiao is the most difficult. However, if one cup of fluid yields one cup of urine, it is still treatable; if one cup of fluid yields two cups of urine, it is untreatable. Furthermore, if after prolonged Three Xiao, the urine loses its odor and instead emits a sweet smell, bubbling vigorously in the chamber, the condition is severe. Even more critical is when a layer floats on the surface resembling lard splashed on the bucket's edge or candle wax dripping; this signifies the loss of Jing (Essence) and exhaustion of True Yuan (Original Qi). Why is sweetness considered a sign of severity? Generally, water in heaven, earth, and the human body possesses both sweet and salty qualities. Sweetness represents Sheng Qi (Vital/Life-generating Qi), while saltiness represents Si Qi (Dead/Death-associated Qi). Urine should naturally be salty; if it becomes sweet, it indicates the leakage of Sheng Qi and the sinking of Spleen Qi into the Kidney. Since Earth controls Water, this leads to death. (There is a type characterized by thirst, aversion to sweets, and a preference for tea, which belongs to Shen Xiao. Zhao Handan stated: In treating Xiao disease, regardless of whether it is Upper, Middle, or Lower, priority must be given to treating the Kidney. Utilize Liuwei Wan, Bawei Wan, and their modified versions to descend Heart Fire and nourish Kidney Water, so that consumption will cease naturally. However, patients with any of the three Xiao types must avoid rich flavors, alcohol, wheat products, and sexual indulgence. Without observing these taboos, even medicine will be ineffective. Those who cherish life should understand this.)