夫标本而曰先受病为本,次传流受病为标,此言标本之大略也。假令病人发热恶寒,头痛身疼,则
知是太阳经表症,标病也。若加发热烦渴,小便不利,则知是太阳经入府,本病也]。假令病人目痛鼻
干不眠,则知是阳明经表症,标病也。若加烦渴欲饮,汗出恶热,则知是阳明经入府,本病也。若加潮
热谵语,发渴,不恶寒,反恶热,扬手掷足,斑黄狂乱,则知是阳明经传入胃府,实病也。假令病人头角
痛而耳聋,寒热呕而口苦,则知是少阳经经病也。缘少阳居表里之间。而胆又无出入之路,故皆以
小柴胡汤和解之。假令病人腹中满,嗌干,自利不渴,则知是阳经热邪传入太阴经,标病也。若加燥
渴腹满,则知是太阴经本病也。若初起便就怕寒吐利,则知是太阴经直中,本病也。假令病人舌干
口燥,大便不通,则知是阳经热邪传入少阴经,标病也。若初起便怕寒蜷卧,腹痛吐泻,则知是少阴
经直中,本病也。假令病人囊缩消渴舌卷,则知是阳经热邪传入厥阴经,标病也。若初起就怕寒,呕
吐涎沫,少腹疼痛,舌卷囊缩,则知是厥阴经直中,本病也。若总以六经言之,而不分标病本病,谬之
甚矣。故曰知标知本,万举万当,不知标本,如 者失杖而行,有路而不知也。
有表虚,有里虚,有表实,有里实,仲景用麻黄汤,为表实而设也,用桂枝汤,为表虚而设也,里实用承
气,里虚用四逆。昔华陀治倪寻、李延,俱患头疼身热,陀曰、寻当下,延当汗。或疑其异。陀曰、寻内实,延
外实,是以异也。
所谓“标”与“本”,先受邪气者为“本”,后传变受邪者为“标”,这是关于标本的大致说法。假如病人出现发热、恶寒(怕冷)、头痛、身体疼痛,就可以知道这是太阳经表症,属于标病。如果在此基础上加上发热、心烦口渴、小便不利,就可以知道这是太阳经邪气传入腑证,属于本病。假如病人出现眼睛痛、鼻子干、无法入睡,就可以知道这是阳明经表症,属于标病。如果再加上心烦口渴想喝水、出汗、怕热,就可以知道这是阳明经邪气传入腑证,属于本病。如果再加上定时发热、说胡话、极度口渴、不怕冷反而怕热、挥手踢脚、身上出斑发黄、神志狂乱,就可以知道这是阳明经邪气传入胃腑,属于实证。假如病人出现头角疼痛且耳聋,忽冷忽热、呕吐且口苦,就可以知道这是少阳经的病。因为少阳位于表里之间,而胆又没有出入的路径,所以都用小柴胡汤来和解治疗。假如病人腹部胀满、咽喉干燥、自发性腹泻且不口渴,就可以知道这是阳经的热邪传入太阴经,属于标病。如果再加上燥渴、腹部胀满,就可以知道这是太阴经的本病。如果一开始就怕冷、呕吐腹泻,就可以知道这是太阴经直中(寒邪直接侵入),属于本病。假如病人舌头干燥、口腔燥渴、大便不通,就可以知道这是阳经的热邪传入少阴经,属于标病。如果一开始就怕冷、蜷缩而卧、腹痛、呕吐腹泻,就可以知道这是少阴经直中,属于本病。假如病人睾丸收缩、极度口渴、舌头卷曲,就可以知道这是阳经的热邪传入厥阴经,属于标病。如果一开始就怕冷、呕吐涎沫、小腹疼痛、舌头卷曲、睾丸收缩,就可以知道这是厥阴经直中,属于本病。如果总括六经而言,却不区分标病和本病,那就错得很厉害了。所以说,懂得标和本,做事就能万无一失;不懂得标和本,就像盲人失去拐杖行走,虽然有路却不知道该走一样。
有表虚,有里虚,有表实,有里实。张仲景使用麻黄汤,是为表实证设立的;使用桂枝汤,是为表虚证设立的;里实证用承气汤类方剂,里虚证用四逆汤。从前华佗治疗倪寻和李延,两人都患有头痛和身体发热。华佗说:“倪寻应当用泻下法,李延应当用发汗法。”有人对此感到疑惑,认为两人的治法不同。华佗说:“倪寻是内实(体内有积滞),李延是外实(体表有邪气),所以治疗方法不同。”
The terms "Biao" (Branch/Superficial) and "Ben" (Root/Deep) refer to the initial site of pathogenic invasion as Ben, and the subsequent sites of transmission as Biao. This is a general overview of the concept. For instance, if a patient presents with fever and aversion to cold, headache, and body ache, it can be known that this is a Taiyang channel exterior syndrome, which is a Biao disease. If accompanied by fever, vexation, thirst, and dysuria, it indicates that the pathogen has entered the Fu organs of the Taiyang channel, constituting a Ben disease. If a patient experiences eye pain, nasal dryness, and insomnia, it indicates an Yangming channel exterior syndrome, which is a Biao disease. If accompanied by vexation, thirst with desire to drink, sweating, and aversion to heat, it indicates that the pathogen has entered the Fu organs of the Yangming channel, constituting a Ben disease. If further accompanied by tidal fever, delirium, severe thirst, absence of aversion to cold but presence of aversion to heat, waving hands and kicking feet, appearance of macules and jaundice, and manic confusion, it indicates that the pathogen has transmitted to the Stomach Fu organ of the Yangming channel, constituting an Excess syndrome. If a patient suffers from pain at the temples and deafness, alternating chills and fever, vomiting, and bitter taste in the mouth, it indicates a Shaoyang channel disease. Since Shaoyang resides between the exterior and interior, and the Gallbladder lacks pathways for entry and exit, Xiao Chai Hu Tang (Minor Bile Decoction) is used to harmonize the condition. If a patient presents with abdominal fullness, dry throat, spontaneous diarrhea without thirst, it indicates that heat pathogens from the Yang channels have transmitted to the Taiyin channel, constituting a Biao disease. If accompanied by dryness, thirst, and abdominal fullness, it indicates a Taiyin channel Ben disease. If from the onset there is aversion to cold, vomiting, and diarrhea, it indicates direct transmission (Zhi Zhong) to the Taiyin channel, constituting a Ben disease. If a patient has a dry tongue, oral dryness, and constipation, it indicates that heat pathogens from the Yang channels have transmitted to the Shaoyin channel, constituting a Biao disease. If from the onset there is aversion to cold, curling up in bed, abdominal pain, vomiting, and diarrhea, it indicates direct transmission to the Shaoyin channel, constituting a Ben disease. If a patient presents with retraction of the testicles, extreme thirst, and curled tongue, it indicates that heat pathogens from the Yang channels have transmitted to the Jueyin channel, constituting a Biao disease. If from the onset there is aversion to cold, vomiting of saliva, lower abdominal pain, curled tongue, and retraction of the testicles, it indicates direct transmission to the Jueyin channel, constituting a Ben disease. To discuss the Six Channels generally without distinguishing between Biao and Ben diseases is a grave error. Therefore, it is said: knowing both Biao and Ben ensures success in every action; not knowing them is like walking blindfolded without a cane, having a path but not knowing how to follow it.
There are Exterior Deficiency, Interior Deficiency, Exterior Excess, and Interior Excess. Zhang Zhongjing formulated Ma Huang Tang (Ephedra Decoction) for Exterior Excess patterns, and Gui Zhi Tang (Cinnamon Twig Decoction) for Exterior Deficiency patterns. Interior Excess is treated with Cheng Qi Tang (Order the Qi Decoction), while Interior Deficiency is treated with Si Ni Tang (Frigid Extremities Decoction). In ancient times, Hua Tuo treated Ni Xun and Li Yan, both suffering from headache and fever. Hua Tuo stated, "Ni Xun should undergo purgation, while Li Yan should undergo diaphoresis." Some were puzzled by the different treatments. Hua Tuo explained, "Ni Xun has Interior Excess, whereas Li Yan has Exterior Excess; hence the difference in treatment."