仲景云：阳盛阴虚，下之则愈，汗之则死。发热身疼，脉浮紧者，当发汗。假令尺脉迟弱者，不可发汗，以营弱血少故也。咽燥喉痹者，不可发汗，津液现已伤也。咳而小便利，若失小便者，不可发汗，下元虚也。下利，虽有表证，不可发汗，发汗则水湿必散于周身，而成浮肿胀满。淋家不可发汗，发汗则津液内亡，客热更增。衄血亡血家，不可发汗，以其血液虚也。疮家不可发汗，发汗则痉。表虚热盛故生疮，汗之则表愈虚而热愈炽，热则伤血，热则生风，故变为痉。少阴病，脉沉细数。沉为在里，不可发汗。大便素难便者，不可发汗，发汗则谵语，以其血液既少，而复夺之，表虚里实，故谵语。汗家不可重发汗，发汗则心神恍惚，盖以汗为血液也，心液大耗，神无所主，故见恍惚。虚人发热，无身疼者，不可发汗，发汗则阳亡。盖以发热乃阳越于外，收之唯恐不及，今误汗之，阳必亡。血气欲绝，手足厥冷，引衣踡卧，不可发汗，发汗则殆。厥证脉紧，不可发汗，汗则声绝咽嘶舌萎。要知阳厥宜下，即热深厥深是也。阴厥宜回阳，即四逆汤法之也。脉弦细，头痛发热者，属少阳，宜和解，不宜发汗，发汗则变证百出。太阳与少阳并病，头项［1］强痛，或眩冒，时加结胸，心下痞硬者，
[1] 项 原本作"顶"，据文义改。
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不可发汗。风温证不可发汗，汗之则热盛，汗则血伤也。湿温证不可发汗，汗之卫阳虚，津液竭，热必盛也。 虚烦证不可发汗，汗之则心血虚，而烦愈盛也。午后热，不可发汗，汗之则阳亡。久病阳虚阴虚，一切诸证，不可擅发汗。
病有宜吐者
病如桂枝证，头不疼，项不强，寸脉微浮，胸中痞硬，气上冲咽喉，不和息者，此为有寒。一云内有久痰，宜吐之。病人胸中菀菀而痛，不能食，欲使人按之，而反有涏唾，下利日十余行，其脉反迟，寸口微滑。此宜吐之，吐之则利止。少阳病，饮食入口即吐，心下温温欲吐，复不能吐者，宜吐之。宿食在上脘者，当吐之。病手足逆冷，脉乍结，以客气在胸中，心下满而烦，欲食不能，病在胸中，当吐之。凡病在膈上，脉大胸满多痰者，食在胃口，脉滑者，俱宜吐之。
病有不宜吐者
脉虚、脉微者，不可吐。太阳病干呕，呕逆者，不可吐。吐之则伤胃。 四肢厥逆者，不可吐。膈上有寒饮干呕者，不宜吐，当温之。凡中下二部之病，切不可吐，吐则为逆。
病有宜下者
发汗不解，腹满痛者，急下之。 下利，三部脉皆平，按之心下硬者，急下之。 下利，脉迟滑者，内实也，利未欲止，当下之。 脉滑而数者，有宿食也，宜下之。 寸脉浮大，按之反涩，尺中亦微而涩，知有宿食也，宜下之。下
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利，不欲食者，以有宿食故了，当下之。不利，见谵语者，有屎燥也，宜下之。 下利瘥，至其年月日时复发者，病不尽故也，当下之。伤寒六七日，目中不了了，晴不合，无表里证，大便难，身微热者，此为实也。急下之。阳明病，发热汗出多者，急下之。二阳并病，太阳证罢，但发潮热，手足漐漐汗出，大便难而谵语者，下之则愈。少阴病得之二三日，口燥咽干者，急下之，此邪未深入，便作口燥，肾水将干，宜急下之，以救欲绝之水也。少阴证六七日，腹胀不大便者，急下之，此少阴邪热入胃府也，土胜则水干，宜急下以救肾水。 少阴病，自利清水，色纯青，心中必痛，口中燥者，急下之。青为肝色，肝邪乘肾，故下利。阳邪上攻，故口燥，此亦少阴传阳明腑证也。厥阴证，舌卷囊缩，宜急下之。此证有寒极而缩者，宜温。此由阳明之热，陷入厥阴，阳明主润宗筋，宗筋为热所功，弗荣而急引舌睾丸，故舌卷囊缩，此为热极，故宜急下以存阴也。
须知胃为五脏之大源，凡胃受热，处处皆可传及。总之，土燥则水易亏，故阳明与厥阴皆有急下法。法虽不同，其入腑之理则一也。
病有不宜下者
仲景云：阳盛阳虚，汗之则愈，下之则死。 太阳病外证未解者，不可下。下之则引邪入里也。 脉浮大者，不可下。浮大为在表也。 恶寒者，不可下。邪尚在表也。 呕多，虽有阳明证，不可下。邪在上焦也。阳明病不能食，攻其热必哕，胃中虚冷故也。 阳明病应发汗，反下之，则为大逆。太阳阳明合病，喘而胸满，不可下，宜麻黄汤。寒散肺清，胃邪亦自散也。 脉细数者，不可下。细数为血虚
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有热，下之热邪入里，恐亡阴。 恶水者，不可下，下之则内冷，不嗜食，完谷出。 头痛目黄者，不可下，邪在上也。阳微者，不可下，下之痞硬，阴盛而阳不宣也。 寒厥者，不可下，下之则死。 腹胀可按而减者，不可下，里虚而邪未实也。咽中秘塞者，不可下，邪未上也。 阳明病，面赤，心下虽微满，不可下，邪未实也。 腹中上下左右有动气者，不可下。结胸证，脉浮大者，不可下，邪在表也。脏结无阳证，舌上苔滑，安静不渴者，不可下。 大便硬，小便数者，不可下，乃脾约丸证也。 阳明病，自汗出，若发汗小便自利者，不可下，此为津液内竭，虽硬不可攻，宜蜜煎导之。
凡病之当汗与不当汗，当吐与不当吐，当下与不当下，浅深各有定据，不得砐行妄为。务宜详察病情，诊视脉象有神无神，声音微厉，饮热饮冷，喜按畏按，各处搜求，自然有下手处也。
服 药 须 知
大凡阳虚阴盛之人，满身纯阴，虽现一切证形，如气喘气短，痰多咳嗽，不食嗜卧，面白唇青、午后、夜间发热，咽痛，腹痛泄泻，无故目赤，牙疼，腰痛膝冷，足软手弱，声低息微，脉时大时劲，或浮或空，或沉或细，种种不一。皆宜扶阳，驱逐阴邪，阳旺阴消，邪尽正复，方可了扶阳之品。但初服辛温，有胸中烦燥者，有昏死一二时者，有鼻血出者，有满口起泡者，有喉干痛、目赤者。此是阳药运行，阴邪化去，从上窍而出也。以不思冷水吃为准，即吃一二口冷水，皆无妨。服辛浊温四五剂，或七八剂，忽咳嗽痰多，日夜不辍。此是肺胃之阴邪，从上出也，切不可清润。服辛温
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十余剂后，忽然周身面目浮肿，或发现斑点，痛痒异常，或汗出，此是阳药运行，阴邪化去，从七窍而出也，以饮食渐加为准。服辛温十余剂，或二十余剂，或腹痛泄泻。此是阳药运行，阴邪化去，从下窍而出也。但人必困倦数日，饮食懒餐，三五日自己。其中尚有辛温回阳，而击身反见大痛大热者，阴陷于内，得阳运而外解也，半日即愈。
凡服此等热药，总要服至周身、腹中发热难安时、然后与以一剂滋阴，此乃全身阴邪化去，真阳已复，即与以一剂滋阴之品，以敛其所复之阳，阳得阴敛，而阳有所依，自然互根相济，而体健身轻矣。虽然邪之情形，万变莫测。以上所论，不过略陈大意耳，学者须知。
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卷四
失血破疑说
今人一见失血诸证，莫不称为火旺也。称为火旺，治之莫不用寒凉以泻火。举世宗之而不疑，群医信之而不察。所以一得失血证，群皆畏死，由其一经失血，死者甚多，不知非死于病，实死于泻火之凉药耳。然则，凉药其可废乎？非即谓凉药之可废，但失血之人，正气实者少也，正气一衰，阴邪上逆，十居八九，邪火所致十仅一二。不可不慎。
予有见于今之失血家，群皆喜服清凉而恶辛温，每每致死，岂不痛惜。予故为当服辛温者，决其从违焉。不观天之日月，犹人身之气血乎。昼则日行于上，而月伏于下，夜则月行于上，而日伏于下，人身气血同然。失血之人，血行于上，而气伏不升可知。欲求血之伏于下，是必待气之升于上，气升于上，血犹有不伏者乎。知得此中消息，则辛温扶阳之药，实为治血之药也。
又可怪者，人人身中本此气血二物，气为阳，法天，火也；血为阴，法地，水也。故曰人非水火不生活。水火二字，指先天先地真气，非凡世之水火也。愚夫愚妇，固说不知，而读书明理这之士，亦岂不晓。明知血之为水，水既旺极而上逆，何得更以滋水之品助之。此其中亦有故，故者何？惑于血色之红也，不知血从火里化生出来，经火锻炼，故有色赤之象。岂得以色红，而即谓之火，即宜服凉药乎？此处便是错误关头。毒流有年，牢不可破，予不惮烦，又从而言之，愿与后之来
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者作一臂力焉。幸甚。
附：七绝一首
吐血都传止血方，生军六味作主张。甘寒一派称良法，并未逢人用附姜。姜、附，阳也。血，阴也。以阳治阴，即益火之源，以消阴翳。血水如潮本阳亏，阳衰阴盛敢僭为。阴盛，即君弱臣强，夫弱妻强的章本。人若识得升降意，阳主升，阴主降，乃是定理。今阴升而阳不升，更以阴药助之，阴愈升而阳愈降，不死何待。宜若宜辛二法持。宜苦者，十仅一二，宜辛者十居八九。
益火之源以消阴翳辩解
前贤云：益火之源，以消阴翳，阳八味是也。此方此语相传已久，市医莫不奉为准绳，未有几个窥透破绽，予不能无疑也。疑者何？疑方药之不与命名相符［1］。既云益火之源，以消阴翳，必是在扶助坎中一点真气上说，真气一衰，群阴四起，故曰阴翳。真气一旺 阴邪即灭，故曰益火。方中桂、附二物，力能扶坎中真阳，用此便合圣经。何得又用熟地、枣皮之滋阴，阴邪即盛，就不该用此。丹皮之泻火，益火而反泻火，实属不通。山药、伏苓、泽泻之甘淡养阴则利水乎？推其意也，以为桂、附之辛热属火，降少升多，不能直趋于下，故借此熟地、枣皮，沉重收敛之品，而使其趋下。又以丹皮之苦寒助之，更经苓、泽利水，使阴邪由下而出，［眉批］孰知五味下喉，其气味立刻周遍，呼吸立刻上下交通，何待此。似为有理，独不思仲景治少阴病，四肢厥逆，腹痛囊缩。爪黑唇青，大汗淋漓，满身全是阴翳，何不重用此熟地、枣皮、丹皮、苓、泽之品，而独重用姜、附、草三味起死回生，其功迅速。由此观之，仲
[1] 符 原本作"孚"，据文义改。
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景之白通、四逆，实益火之源，以消阴翳者也。若此方而云，益火消阴，断乎不可。予非固为好辨，此是淆乱圣经之言。毒流已久，祸延已深，不得不急为剪除也。
壮水之主以制阳光辨解
前贤云：壮水之主，以制阳光，六味丸是也。此方此说，相传有年，举世宗之而不疑，群医用之而不辨，予不能无说也。窃思此方，必是为邪火伤阴立说，并不是言坎中阳旺立说。今人动云阴虚火旺。阴虚便说是肾水虚，通身血水皆属肾，言肾虚亦可。火旺便说是肾火旺，通身之气，皆本肾中一点真火生来，即云肾火旺亦可。但有邪正，不可混淆。统以六味丸治之，其蒙蔽有年矣。予特辨而明之。阴者，水也。阳者，火也。水火互为其根，合而为一，不可分为二也。水从火里生来，故曰天一生水，先天真气，号曰真火、真气，即真金所化。阳旺一分，指真气，阴即旺一分；指真阴。阳衰一分，阴即衰一分。试问阴虚火旺何来？［眉批］阴阳，一气耳。岂有阳虚而阴不虚，阴虚而阳不虚者乎？知古疑团，一语道破，仲景一生全在邪正上论偏盛，今人在一气上论偏盛，相隔天渊，源头错乱。今得此说，方知前人之错误不少。所谓制阳光者，明是教人泻邪火也。邪火始能伤阴，真火实能生阴，此邪正关键，用药攸分区处，岂堪混淆莫辨。要知邪火窃发，无论在于何处，皆能伤血，即以三黄、白虎、承气，与此六味丸，按定轻重治之，皆是的对妙法。今人不明阴阳一气，不明邪正机关，专以此方滋肾中之元阴，泻肾中之元阳，实属不通。
申明阴盛扶阳阳盛扶阴的确宗旨
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此二语实治病金针。救生宝筏，惜乎人之不得其要耳。今人动以水火二字喻天平，水火不可偏盛，偏盛则为病。予谓不然。人自乾坤立命以来，二气合为一气，充塞周身，上下四旁，毫无偏奇。火盛则水盛，此火指真火，水指真阴。言火盛、水盛者，即五六月之寸水可知。火衰则水衰，即十冬月雨水可知。此正气自然之道，不作病论，亦无待于扶。所谓偏盛者何？偏于阴者宜扶阳，是言阴邪之盛，不是言肾中之真阴偏盛也。偏于阳者，宜扶阴，是言邪火之盛，不是言肾中之真阳偏盛也。前贤立阳八味、六味丸，以言治元阴元阳之方。此说一倡，俱言真阴真阳之果有偏盛也。此语害世非浅。今人又不读圣经，无怪乎六味，八味之盛行，而承气、四逆之莫讲也。
邪 正 论
凡天地之道，有阴即有阳，有盈即有虚，有真即有伪，有邪即有正。试问邪正之道若何？邪也者，阴阳中不正之气也。［眉批］不正之气，四时皆有，六经分为六气。不正之气流行于中，故曰六客。不正之气，伤于物则物病，伤于则人病。治之调之，皆有其道。欲得其道，必明其正。正也者，阴阳太和之气也。［眉批］太和者，真阴真阳浑然一气，氤氲化育之消息也。太和之气，弥纶六合，万物皆荣。人身太和充溢，百体安舒。太和之气有亏，鬼魅丛生，灾异叠见，诸疾蜂起矣。
张仲景说：阳盛阴虚，用泻下法可以痊愈，用发汗法则会导致死亡。如果发热、身体疼痛、脉象浮紧的，应当使用发汗法。假如尺部脉象迟而弱的，不可发汗，这是因为营气虚弱、血液不足的缘故。咽喉干燥、喉痹（咽喉肿痛闭塞）的，不可发汗，因为津液已经受伤。咳嗽且小便通畅，或者小便失禁的，不可发汗，这是因为下元（肾与膀胱）虚损的缘故。腹泻，即使有表证，也不可发汗，发汗则水湿之气必然散布到全身，形成浮肿胀满。患有淋病（小便频数短涩、滴沥刺痛）的人不可发汗，发汗则体内津液亡失，客热（外感之热邪）会更加加重。经常流鼻血或失血的人不可发汗，因为他们的血液已经亏虚。患有疮疡的人不可发汗，发汗会导致痉病（肌肉痉挛、角弓反张）。这是因为表虚热盛而生疮，发汗会使表气更虚而热势更炽，热伤血液，热极生风，所以变为痉病。少阴病，脉象沉细数。沉脉主病在里，不可发汗。平时大便困难的人，不可发汗，发汗会导致谵语（神志不清、胡言乱语），因为血液本就稀少，再被强行夺去津液，导致表虚里实，所以出现谵语。平素多汗的人不可再次发汗，发汗会导致心神恍惚，因为汗为血液所化，心液大量耗损，神无所主，所以见到恍惚症状。体虚之人发热，但没有身体疼痛的，不可发汗，发汗会导致阳气亡脱。因为发热是阳气浮越于外，收敛还唯恐不及，现在误用发汗，阳气必定亡脱。气血将要断绝，手足厥冷，蜷缩着身子想裹衣而卧的，不可发汗，发汗则有危险。厥证脉象紧的，不可发汗，发汗则声音消失、咽喉嘶哑、舌体萎缩。要知道阳厥适宜用泻下法，就是所谓的“热深厥亦深”。阴厥适宜回阳救逆，即采用四逆汤的方法。脉象弦细，头痛发热的，属于少阳病，适宜和解，不宜发汗，发汗则会变证百出。太阳病与少阳病并病，头项强痛，或者头晕目眩，时常伴有结胸（胸胁苦满、按之疼痛），心下痞硬（胃脘部堵塞感且坚硬）的，不可发汗。风温证不可发汗，发汗则热势更盛，汗出则血液受伤。湿温证不可发汗，发汗则卫阳虚弱，津液枯竭，热势必然更盛。虚烦证不可发汗，发汗则心血亏虚，烦躁更加严重。午后发热，不可发汗，发汗则阳气亡脱。久病导致阳虚或阴虚，以及各种杂证，都不可擅自发汗。
疾病中有适宜用吐法的
病情类似桂枝汤证，但头部不疼，项部不强硬，寸脉微浮，胸中痞塞坚硬，气上冲至咽喉，呼吸不畅的，这是内有寒邪。另一种说法认为内有久积之痰，适宜用吐法。病人胸中郁郁而痛，不能进食，想要让人按压胸部，反而吐出黏稠唾液，每日腹泻十多次，脉象反而迟缓，寸口脉微滑。这适宜用吐法，吐后腹泻自止。少阳病，饮食入口即吐，心中温温欲吐却又吐不出来的，适宜用吐法。宿食停留在上脘的，应当用吐法。病人手足逆冷，脉象乍现结代，因为客气（邪气）停留在胸中，心下满闷而烦躁，想吃东西却吃不下，病位在胸中，应当用吐法。凡是病位在膈以上，脉大、胸满、多痰的，食物停滞在胃口，脉滑的，都适宜用吐法。
疾病中有不适宜用吐法的
脉虚、脉微的，不可用吐法。太阳病出现干呕、呕吐逆气的，不可用吐法。吐法会损伤胃气。四肢厥冷的，不可用吐法。膈上有寒饮导致干呕的，不适宜用吐法，应当温补。凡是中焦和下焦的疾病，切不可用吐法，用吐法是逆治。
疾病中有适宜用下法的
发汗后病不解，腹部胀满疼痛的，紧急使用下法。腹泻，三部脉象都平和，但按压心下部位感觉坚硬的，紧急使用下法。腹泻，脉象迟滑的，是内里有实邪，腹泻不会停止，当下之。脉象滑而数的，是有宿食，适宜用下法。寸脉浮大，重按反而涩滞，尺中脉也微而涩的，可知有宿食，适宜用下法。腹泻，不想吃东西的，是因为有宿食，当下之。不大便，出现谵语的，是有燥屎，适宜用下法。腹泻痊愈后，到了原来的年月日时又复发的，是因为病根未除，当下之。伤寒六七天，眼睛视物不清，眼球转动不灵活，没有明显的表证和里证，大便困难，身体微热的，这是实证。紧急使用下法。阳明病，发热出汗多的，紧急使用下法。太阳与阳明两经并病，太阳证已罢，只出现潮热，手足微微出汗，大便困难且谵语的，用下法即可痊愈。少阴病得之二三日，口燥咽干的，紧急使用下法，这是因为邪气尚未深入，就出现口燥，说明肾水即将干枯，宜紧急使用下法以挽救将绝的肾水。少阴病证见六七天，腹胀且不大便的，紧急使用下法，这是少阴邪热传入胃腑，土气胜则肾水干，宜紧急使用下法以救肾水。少阴病，自动排出清水，颜色纯青，心中必定疼痛，口中干燥的，紧急使用下法。青色属肝色，肝邪乘袭肾脏，所以下利。阳邪上攻，所以口燥，这也是少阴病传变为阳明腑实证。厥阴病证见舌卷缩、睾丸上缩，适宜紧急使用下法。此证有因寒极而收缩的，适宜温补。此证是由阳明热邪陷入厥阴，阳明主润宗筋，宗筋被热邪所伤，不能濡养而急引舌和睾丸，所以舌卷囊缩，此为热极，故宜紧急使用下法以保存阴液。
要知道胃是五脏的大源头，凡胃受热邪，处处皆可传及。总之，土燥则水易亏，所以阳明与厥阴都有急下法。方法虽然不同，但其入腑的道理是一致的。
疾病中有不适宜用下法的
张仲景说：阳盛阳虚（此处原文似有误，结合上下文应指表证或特定虚实情况，通常指表证未解或虚证），发汗则愈，下之则死。太阳病外证未解的，不可下。下之则引邪入里。脉象浮大的，不可下。浮大表示病在表。恶寒的，不可下。邪气尚在表。呕吐多者，即使有阳明证，也不可下。邪气在上焦。阳明病不能进食，攻其热必致呃逆，这是因为胃中虚冷。阳明病应当发汗，反而用下法，就是大逆。太阳阳明合病，喘而胸满的，不可下，适宜用麻黄汤。寒散肺清，胃邪自然消散。脉象细数的，不可下。细数为血虚有热，下之则热邪入里，恐怕导致亡阴。怕水的，不可下，下之则内寒，食欲不振，完谷不化。头痛目黄的，不可下，邪气在上。阳气微弱的，不可下，下之则痞硬，阴盛而阳气不宣。寒厥的，不可下，下之则死。腹部胀满可按揉缓解的，不可下，这是里虚而邪气未实。咽喉闭塞的，不可下，邪气未上。阳明病，面色红赤，心下虽微满，不可下，邪气未实。腹中上下左右有动气（搏动感）的，不可下。结胸证，脉象浮大的，不可下，邪气在表。脏结无阳证，舌苔滑润，安静不渴的，不可下。大便硬，小便次数多的，不可下，这是脾约丸证。阳明病，自汗出，如果发汗且小便自利的，不可下，这是因为津液内竭，虽然大便硬也不可攻下，适宜用蜜煎导法。
凡是疾病应当发汗或不应当发汗，应当吐或不应当吐，应当下或不应当下，深浅各有定论，不得随意妄为。务必详细察看病症，诊视脉象有神无神，声音微弱或高亢，喜饮热饮还是冷饮，喜欢按压还是畏惧按压，各处搜求证据，自然就有下手的地方了。
服药须知
大凡阳虚阴盛之人，满身纯阴，虽然呈现一切证状，如气喘气短，痰多咳嗽，不食嗜卧，面白唇青，午后或夜间发热，咽痛，腹痛泄泻，无故目赤，牙疼，腰痛膝冷，足软手弱，声低息微，脉象时而大时而劲急，或浮或空，或沉或细，种种不一。都适宜扶阳，驱逐阴邪，阳气旺盛则阴邪消退，邪气尽去正气恢复，才可以停止服用扶阳的药物。但是初服辛温药物，有的感到胸中烦躁，有的昏死一两个小时，有的流鼻血，有的满口起泡，有的喉咙干痛、目赤。这是阳药运行，阴邪化去，从上窍排出的表现。以不思喝冷水为标准，即使喝一两口冷水，都没有妨碍。服用辛浊温药四五剂，或七八剂，忽然咳嗽痰多，日夜不停。这是肺胃的阴邪，从上窍排出的表现，切不可用清润之法。服用辛温药十余剂后，忽然周身面目浮肿，或发现斑点，痛痒异常，或出汗，这是阳药运行，阴邪化去，从七窍排出的表现，以饮食逐渐增加为标准。服用辛温药十余剂，或二十余剂，或腹痛泄泻。这是阳药运行，阴邪化去，从下窍排出的表现。人必定困倦数日，饮食懒餐，三五日后自愈。其中还有服用辛温回阳药，反而击身出现大痛大热的，这是阴邪陷于内，得到阳气运化而从外解的表现，半天即愈。
凡是服用这类热药，总要服到周身、腹中发热难安时，然后给予一剂滋阴药，这是全身阴邪化去，真阳已复，随即给予一剂滋阴之品，以收敛所恢复的阳气，阳气得到阴液的敛藏，而有所依附，自然互根相济，身体就会健康轻健了。虽然邪气的情况，万变莫测。以上所论，不过是略陈大意罢了，学者须知。
卷四
失血破疑说
现代人一见失血诸证，无不称为火旺。称为火旺，治疗时莫不用寒凉药来泻火。举世宗奉而不怀疑，群医相信而不考察。所以一旦遇到失血证，大家都害怕致死，因为一经失血，死者甚多，不知道不是死于疾病，实在是死于泻火的凉药。那么，凉药就可以废弃吗？并非就说凉药可废，只是失血之人，正气实的很少，正气一衰，阴邪上逆，十居八九，邪火所致的十仅一二。不可不慎。
我观察到现在的失血患者，都喜欢服用清凉药而厌恶辛温药，每每因此致死，岂不痛惜。所以我对于那些应当服用辛温药的，决断其从违。不看天上的日月，就像人身的气血吗？白天太阳行于上，月亮伏于下；夜晚月亮行于上，太阳伏于下，人身气血也是如此。失血之人，血行于上，而气伏而不升可知。想要让血伏于下，必须等待气升于上，气升于上，血哪有不服的？懂得其中的消息，就知道辛温扶阳的药，实际上是治血的药。
又可怪的是，人人身上本有此气血二物，气为阳，法天，是火；血为阴，法地，是水。所以说人非水火不生活。水火二字，指的是先天先地的真气，不是凡世的水火。愚夫愚妇固然不知，读书明理的士人，难道也不晓？明知血是水，水既旺极而上逆，为何还要用滋水之品助它？这其中也有缘故，什么缘故呢？是被血色之红迷惑了，不知道血是从火里化生出来的，经过火的锻炼，所以有色赤之象。岂能因为色红，就说是火，就适宜服凉药？这里便是错误的关键。毒流多年，牢不可破，我不嫌麻烦，又进而言之，愿与后来的医者作一臂之力。幸甚。
附：七绝一首
吐血都传止血方，生军六味作主张。甘寒一派称良法，并未逢人用附姜。姜、附，阳也。血，阴也。以阳治阴，即益火之源，以消阴翳。血水如潮本阳亏，阳衰阴盛敢僭为。阴盛，即君弱臣强，夫弱妻强的章本。人若识得升降意，阳主升，阴主降，乃是定理。今阴升而阳不升，更以阴药助之，阴愈升而阳愈降，不死何待。宜若宜辛二法持。宜苦者，十仅一二，宜辛者十居八九。
益火之源以消阴翳辩解
前贤说：益火之源，以消阴翳，指的是八味丸（金匮肾气丸）。此方此语相传已久，市井医生莫不奉为准绳，没几个人窥透破绽，我不能不怀疑。怀疑什么呢？怀疑方药与命名不相符。既然说益火之源，以消阴翳，必定是在扶助坎中一点真气上说，真气一衰，群阴四起，所以叫阴翳。真气一旺，阴邪即灭，所以叫益火。方中桂、附二物，力能扶助坎中真阳，用此便符合圣经。为何又用熟地、枣皮之滋阴，阴邪即盛，就不该用此。丹皮之泻火，益火而反泻火，实属不通。山药、茯苓、泽泻之甘淡，是养阴还是利水？推究其意，认为是桂、附之辛热属火，降少升多，不能直趋于下，所以借此熟地、枣皮，沉重收敛之品，使其趋下。又以丹皮之苦寒助之，更经苓、泽利水，使阴邪由下而出。[眉批]孰知五味下喉，其气味立刻周遍，呼吸立刻上下交通，何待于此。看似有理，但不想想张仲景治疗少阴病，四肢厥逆，腹痛囊缩，爪黑唇青，大汗淋漓，满身全是阴翳，为何不重用此熟地、枣皮、丹皮、苓、泽之品，而独重用姜、附、草三味起死回生，其功迅速。由此观之，张
[1] 符 原本作"孚"，据文义改。
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仲景的白通汤、四逆汤，才是真正的益火之源，以消阴翳。如果这个方子说益火消阴，断乎不可。我不是故意好辩，这是淆乱圣经之言。毒流已久，祸延已深，不得不急为剪除。
壮水之主以制阳光辨解
前贤说：壮水之主，以制阳光，指的是六味丸。此方此说，相传有年，举世宗奉而不疑，群医用之而不辨，我不能无说。窃思此方，必是为邪火伤阴立说，并不是言坎中阳旺立说。今人动不动就说阴虚火旺。阴虚便说是肾水虚，通身血水皆属肾，言肾虚亦可。火旺便说是肾火旺，通身之气，皆本肾中一点真火生来，即云肾火旺亦可。但有邪正，不可混淆。统以六味丸治之，其蒙蔽有年矣。我特意辨而明之。阴者，水也。阳者，火也。水火互为其根，合而为一，不可分为二也。水从火里生来，故曰天一生水，先天真气，号曰真火、真气，即真金所化。阳旺一分，指真气，阴即旺一分；指真阴。阳衰一分，阴即衰一分。试问阴虚火旺从何而来？[眉批]阴阳，一气耳。岂有阳虚而阴不虚，阴虚而阳不虚者乎？知晓古人的疑团，一语道破，张仲景一生全在邪正上论偏盛，今人在一气上论偏盛，相隔天渊，源头错乱。今得此说，方知前人之错误不少。所谓制阳光者，明是教人泻邪火也。邪火始能伤阴，真火实能生阴，此邪正关键，用药攸分区处，岂堪混淆莫辨。要知邪火窃发，无论在于何处，皆能伤血，即以三黄、白虎、承气，与此六味丸，按定轻重治之，皆是的对妙法。今人不明阴阳一气，不明邪正机关，专以此方滋肾中之元阴，泻肾中之元阳，实属不通。
申明阴盛扶阳阳盛扶阴的确宗旨
这两句话确实是治病的金针，救生的宝筏，可惜人们不得其要领。今人动不动用水火二字比喻天平，水火不可偏盛，偏盛则为病。我认为不然。人自乾坤立命以来，二气合为一气，充塞周身，上下四旁，毫无偏奇。火盛则水盛，此火指真火，水指真阴。言火盛、水盛者，即五六月之寸水可知。火衰则水衰，即十冬月雨水可知。这是正气自然之道，不作病论，亦无待于扶。所谓偏盛者何？偏于阴者宜扶阳，是言阴邪之盛，不是言肾中之真阴偏盛也。偏于阳者，宜扶阴，是言邪火之盛，不是言肾中之真阳偏盛也。前贤立阳八味、六味丸，以言治元阴元阳之方。此说一倡，俱言真阴真阳之果有偏盛也。此语害世非浅。今人又不读圣经，无怪乎六味，八味之盛行，而承气、四逆之莫讲也。
邪 正 论
凡天地之道，有阴即有阳，有盈即有虚，有真即有伪，有邪即有正。试问邪正之道若何？邪也者，阴阳中不正之气也。[眉批]不正之气，四时皆有，六经分为六气。不正之气流行于中，故曰六客。不正之气，伤于物则物病，伤于人则人病。治之调之，皆有其道。欲得其道，必明其正。正也者，阴阳太和之气也。[眉批]太和者，真阴真阳浑然一气，氤氲化育之消息也。太和之气，弥纶六合，万物皆荣。人身太和充溢，百体安舒。太和之气有亏，鬼魅丛生，灾异叠见，诸疾蜂起矣。
Zhang Zhongjing stated: In cases of Yang excess and Yin deficiency, purgation leads to recovery, while diaphoresis leads to death. If there is fever, body pain, and a floating-tight pulse, diaphoresis should be employed. However, if the Chi (Cun-Kuan-Guan) pulse at the wrist is slow and weak, diaphoresis is contraindicated because Ying Qi (Nutritive Qi) is weak and Blood is scant. In cases of dry throat and Bi syndrome (obstruction and pain in the throat), diaphoresis is contraindicated as Jin Ye (Body Fluids) are already injured. In cases of cough with normal urination or urinary incontinence, diaphoresis is contraindicated due to deficiency of the Lower Yuan (Kidney and Bladder). In cases of diarrhea, even if exterior symptoms exist, diaphoresis is contraindicated; inducing sweat will scatter water-dampness throughout the body, leading to edema and fullness. Patients with Lin syndrome (dysuria) must not undergo diaphoresis, as it causes internal loss of fluids and aggravates pathogenic heat. Patients with frequent epistaxis or blood loss must not undergo diaphoresis because their Blood is deficient. Patients with sores and ulcers must not undergo diaphoresis, as it leads to Jing disease (spasm). This is because exterior deficiency with excessive heat generates sores; diaphoresis further depletes the exterior and intensifies heat, which injures Blood and generates Wind, resulting in spasm. In Shaoyin disease, with a deep, fine, and rapid pulse, since deep indicates interior involvement, diaphoresis is contraindicated. Those who habitually suffer from difficult defecation must not undergo diaphoresis, as it leads to delirious speech (Chan Yu); this occurs because Blood is already scant, and forcing fluid loss creates exterior deficiency and interior excess, causing delirium. Habitual sweaters must not undergo heavy diaphoresis, as it leads to mental confusion and vagueness; this is because sweat is derived from Blood, and excessive consumption of Heart fluids leaves the Shen (Spirit) without a master. In deficient individuals with fever but no body pain, diaphoresis is contraindicated, as it leads to Yang collapse. Fever here represents Yang floating outward; one should strive to consolidate it, and erroneous diaphoresis will cause Yang to perish. When Qi and Blood are about to fail, presenting with cold extremities, curling up for warmth, diaphoresis is dangerous. In Jue syndrome with a tight pulse, diaphoresis is contraindicated, as it leads to loss of voice, hoarseness, and tongue atrophy. One must understand that Yang Jue (Cold Extremities due to Heat) requires purgation, known as "the deeper the heat, the deeper the cold extremities." Yin Jue (Cold Extremities due to Cold) requires restoration of Yang, using the method of Sini Tang (Frigid Extremities Decoction). With a string-like and fine pulse, headache, and fever, the condition belongs to Shaoyang; harmonization is indicated, not diaphoresis, as sweating will produce myriad complications. In concurrent Taiyang and Shaoyang diseases, with stiffness and pain in the head and neck, dizziness, occasional chest binding (Jie Xiong), and epigastric hardness, diaphoresis is contraindicated. Fengwen syndrome (Wind-Warmth) must not undergo diaphoresis, as it intensifies heat and injures Blood. Wenwen syndrome (Damp-Warmth) must not undergo diaphoresis, as it damages Wei Yang (Defensive Yang), exhausts fluids, and intensifies heat. Xu Fan syndrome (Empty Irritability) must not undergo diaphoresis, as it depletes Heart Blood and worsens irritability. Afternoon fever is contraindicated for diaphoresis, as it leads to Yang collapse. In chronic illness involving Yang or Yin deficiency, and in all miscellaneous conditions, unauthorized diaphoresis is forbidden.
There are conditions suitable for emesis.
If the presentation resembles Guizhi Tang syndrome, but without headache or neck stiffness, with a slightly floating Cun pulse, epigastric oppression and hardness, Qi rushing to the throat, and dyspnea, this indicates internal Cold. Another view suggests long-standing Phlegm retention, suitable for emesis. If a patient suffers from郁 pain in the chest, inability to eat, desire for pressure on the chest, yet expectorates sticky saliva, with diarrhea occurring more than ten times daily, and the pulse is surprisingly slow with a slightly slippery Kou position, emesis is indicated; diarrhea will cease after vomiting. In Shaoyang disease, where food is vomited immediately upon entry, or there is a warm sensation in the chest with an urge to vomit but inability to do so, emesis is indicated. For food stagnation in the Upper Wan (Upper Stomach), emesis is appropriate. For patients with cold extremities and intermittent knotted pulses, due to pathogenic Qi in the chest, epigastric fullness and irritability, and desire to eat but inability, where the disease is in the chest, emesis is indicated. Generally, for diseases above the Diaphragm with large pulses, chest fullness, and much phlegm, or food stagnation at the stomach opening with a slippery pulse, emesis is suitable.
There are conditions unsuitable for emesis.
With empty or faint pulses, emesis is contraindicated. In Taiyang disease with dry heaving or retching, emesis is contraindicated, as it damages Stomach Qi. With cold extremities, emesis is contraindicated. For cold-fluid retention above the Diaphragm causing dry heaving, emesis is not suitable; warming is indicated. Diseases of the Middle and Lower Jiao must never be treated with emesis, as it is contrary to treatment principles.
There are conditions suitable for purgation.
If diaphoresis fails to resolve the condition and abdominal fullness and pain occur, urgent purgation is required. In diarrhea, if all three pulses are level but palpation reveals epigastric hardness, urgent purgation is required. In diarrhea with a slow-slippery pulse, indicating internal excess, if diarrhea does not stop, purgation is indicated. A slippery and rapid pulse indicates food stagnation, suitable for purgation. A floating-large Cun pulse that feels choppy upon pressure, with a micro-choppy Chi pulse, indicates food stagnation, suitable for purgation. In diarrhea with loss of appetite due to food stagnation, purgation is indicated. In constipation with delirious speech, indicating dry feces, purgation is indicated. If diarrhea resolves but recurs at the same time of year/month/day, indicating incomplete resolution, purgation is indicated. In Shanghan (Cold Damage) lasting six to seven days, with unclear vision, unblinking eyes, no obvious exterior or interior signs, difficult defecation, and slight fever, this is an Excess pattern requiring urgent purgation. In Yangming disease with fever and profuse sweating, urgent purgation is required. In concurrent Taiyang and Yangming diseases, when Taiyang signs cease but tidal fever, slight sweating on hands and feet, difficult defecation, and delirium persist, purgation leads to recovery. In Shaoyin disease developing over two to three days with dry mouth and throat, urgent purgation is required; this indicates pathogenic heat has not deeply penetrated but is consuming Kidney Water, so urgent purgation saves the impending exhaustion of fluids. In Shaoyin disease persisting for six to seven days with abdominal distension and constipation, urgent purgation is required; this indicates Shaoyin pathogenic heat entering the Stomach Fu, where Earth excess dries Water, so urgent purgation saves Kidney Water. In Shaoyin disease with spontaneous passage of clear green liquid, severe heart pain, and dry mouth, urgent purgation is required. Green corresponds to Liver; Liver pathogen attacking Kidney causes diarrhea. Yang pathogen attacking upward causes dry mouth; this is also a transmission of Shaoyin to Yangming Fu-excess. In Jueyin disease with tongue retraction and testicular contraction, urgent purgation is indicated. Note: Contraction can also result from extreme Cold, requiring warming. This case involves Yangming heat sinking into Jueyin; Yangming moistens the Sinews, but heat injures them, causing retraction of the tongue and testes. This is extreme heat, so urgent purgation preserves Yin.
One must know that the Stomach is the great source of the Five Zang organs. Heat in the Stomach can transmit everywhere. Ultimately, Dry Earth leads to depletion of Water; thus, both Yangming and Jueyin have methods of urgent purgation. Although methods differ, the principle of entering the Fu organs is the same.
There are conditions unsuitable for purgation.
Zhang Zhongjing stated: In certain patterns, diaphoresis leads to recovery, while purgation leads to death. In Taiyang disease with unresolved exterior signs, purgation is contraindicated, as it draws pathogens inward. With floating-large pulses, purgation is contraindicated, as this indicates the exterior. With aversion to cold, purgation is contraindicated, as the pathogen remains in the exterior. With frequent vomiting, even if Yangming signs exist, purgation is contraindicated, as the pathogen is in the Upper Jiao. In Yangming disease with inability to eat, attacking the heat will cause hiccups due to Stomach deficiency-cold. Yangming disease should be treated with diaphoresis; purgation is a major error. In concurrent Taiyang and Yangming diseases with wheezing and chest fullness, purgation is contraindicated; Mahuang Tang (Ephedra Decoction) is indicated. Dispelling cold clears the Lungs, and Stomach pathogen dissipates naturally. With fine-rapid pulses, purgation is contraindicated; fine-rapid indicates Blood deficiency with heat, and purgation drives heat inward, risking Yin collapse. With aversion to water, purgation is contraindicated, as it causes internal cold, anorexia, and undigested food in stool. With headache and yellow eyes, purgation is contraindicated, as the pathogen is above. With faint Yang, purgation is contraindicated, as it leads to epigastric hardness due to Yin excess and Yang suppression. With cold Jue, purgation is contraindicated, as it leads to death. With abdominal distension relieved by pressure, purgation is contraindicated, indicating interior deficiency without excess. With throat obstruction, purgation is contraindicated, as the pathogen has not ascended. In Yangming disease with red face and slight epigastric fullness, purgation is contraindicated, as the pathogen is not yet solid. With pulsating sensations in the abdomen, purgation is contraindicated. In Jie Xiong (Chest Binding) with floating-large pulses, purgation is contraindicated, as the pathogen is in the exterior. In Zang Jie (Zang Binding) without Yang signs, with slippery tongue coating, quietness, and lack of thirst, purgation is contraindicated. With hard stool and frequent urination, purgation is contraindicated; this is Pi Yue Wan (Spleen Restriction Pill) syndrome. In Yangming disease with spontaneous sweating, if diaphoresis is used and urination is free, purgation is contraindicated; this indicates internal exhaustion of fluids. Even if stool is hard, it cannot be attacked with harsh purgatives; Honey Suppository (Mi Jian Dao) is indicated.
Regarding whether a disease requires diaphoresis, emesis, or purgation, and when it does not, the depth and extent have fixed criteria. One must not act arbitrarily. Carefully observe the disease state, check if the pulse has Shen (Spirit), listen to the voice (weak or loud), note preferences for hot/cold drinks, and whether the patient likes or dislikes pressure. Gathering evidence from all aspects will naturally reveal the correct approach.
Instructions on Taking Medicine
Generally, in individuals with Yang deficiency and Yin excess, presenting with pure Yin signs such as asthma, shortness of breath, copious phlegm and cough, anorexia, lethargy, pale face and blue lips, afternoon or night fever, sore throat, abdominal pain and diarrhea, sudden red eyes, toothache, lower back pain, cold knees, weak legs and arms, low voice, faint breathing, and variable pulses (large/tense, floating/empty, deep/fine), all require supporting Yang and expelling Yin pathogens. As Yang strengthens and Yin recedes, and pathogens are eliminated while Zheng Qi (Upright Qi) recovers, one may stop Yang-supporting herbs. However, upon initial intake of Acrid-Warm herbs, some may experience chest irritability, temporary unconsciousness for one to two hours, epistaxis, oral blisters, dry painful throat, or red eyes. This indicates Yang herbs are circulating, Yin pathogens are transforming, and exiting through upper orifices. The standard is a lack of desire for cold water; drinking a sip or two is harmless. After four to five doses, or seven to eight doses of Acrid-Turbid-Warm herbs, sudden increase in cough and phlegm day and night may occur. This is Lung and Stomach Yin pathogens exiting from above; do not use clearing-moistening methods. After more than ten doses of Acrid-Warm herbs, sudden facial and whole-body edema, eruption of spots with intense pain and itching, or sweating may occur. This indicates Yang herbs circulating, Yin pathogens transforming, and exiting through the seven orifices. The standard is gradual improvement in appetite. After ten to twenty doses of Acrid-Warm herbs, abdominal pain and diarrhea may occur. This indicates Yin pathogens exiting through lower orifices. The patient will likely feel fatigued for several days, with poor appetite, recovering spontaneously within three to five days. Some may experience severe pain and heat after taking Acrid-Warm Yang-restoring herbs; this is Yin pathogens trapped inside being resolved outwardly by Yang circulation, resolving within half a day.
When taking such hot medicines, one must continue until feeling heat throughout the body and abdomen, causing discomfort. Then, administer one dose of Yin-nourishing medicine. This signifies that systemic Yin pathogens have transformed, True Yang has recovered, and the Yin-nourishing herb consolidates the restored Yang. Yang, constrained by Yin, finds support, leading to mutual rooting and assistance, resulting in health and lightness of body. Although pathogenic conditions vary infinitely, the above outlines the general principles. Students must understand this.
Volume Four
Debunking Myths on Blood Loss
Modern physicians, upon seeing any blood loss syndrome, invariably attribute it to Fire Excess. Attributing it to Fire Excess, they invariably treat with Cold-Cooling herbs to drain Fire. The world follows this without doubt, and doctors believe it without scrutiny. Thus, upon encountering blood loss, everyone fears death, as many die after bleeding. They do not realize they do not die from the disease, but from the cooling herbs used to drain Fire. So, should cooling herbs be abolished? Not necessarily. It is just that those with blood loss rarely have strong Zheng Qi. Once Zheng Qi declines, Yin pathogens rebel upward in eight or nine out of ten cases, while pathogenic Fire accounts for only one or two. Caution is essential.
I observe that modern patients with blood loss prefer cooling herbs and reject Acrid-Warm ones, often leading to death. This is truly lamentable. Therefore, I clarify which cases require Acrid-Warm herbs. Consider the sun and moon in the sky, analogous to Qi and Blood in the body. During the day, the Sun is above and the Moon below; at night, the Moon is above and the Sun below. Human Qi and Blood follow the same pattern. In blood loss, Blood flows upward while Qi sinks and fails to ascend. To make Blood settle downward, Qi must ascend. If Qi ascends, how can Blood remain unsettled? Understanding this mechanism reveals that Acrid-Warm Yang-supporting herbs are actually blood-regulating herbs.
It is also strange that everyone possesses Qi and Blood. Qi is Yang, modeling Heaven, representing Fire; Blood is Yin, modeling Earth, representing Water. Thus, humans cannot live without Water and Fire. These terms refer to Pre-heaven and Post-heaven True Qi, not ordinary worldly water and fire. While commoners may not understand, educated scholars should know this. Knowing Blood is Water, and Water rising excessively causes rebellion, why add more Water-nourishing herbs? The reason lies in the misconception caused by the red color of blood. Blood is generated from Fire and refined by it, hence its red appearance. One cannot assume that red color implies Fire and thus requires cooling herbs. This is the critical error. This poison has flowed for years, firmly entrenched. I do not shy away from explaining this again, hoping to assist future practitioners. How fortunate.
Appendix: A Seven-Character Quatrain
Hemoptysis treatments often advocate stopping blood,
Using Da Huang (Rhubarb) and Liu Wei (Six Ingredients) as mainstays.
Sweet-Cold approaches are praised as excellent methods,
Yet Fu Zi (Aconite) and Sheng Jiang (Ginger) are rarely used.
Ginger and Aconite are Yang; Blood is Yin.
Treating Yin with Yang is "Benefiting the Source of Fire to eliminate Yin Shadows."
Blood and water surging like tides stem from Yang deficiency;
How dare Yin excess usurp dominance when Yang declines?
Yin excess is like a weak ruler and strong minister, a weak husband and strong wife.
If one understands the principles of ascending and descending,
Yang governs ascent, Yin governs descent—this is the fixed law.
Now, Yin ascends while Yang fails to rise; aiding Yin with Yin herbs
Causes Yin to rise further and Yang to fall further. Death is inevitable.
One should hold to either Bitter or Acrid methods.
Bitter is suitable for one or two out of ten; Acrid for eight or nine out of ten.
Explanation of "Benefiting the Source of Fire to Eliminate Yin Shadows"
Former sages stated: "Benefiting the Source of Fire to eliminate Yin Shadows" refers to Ba Wei Wan (Eight-Ingredient Pill). This formula and saying have been passed down for ages, accepted by market doctors as absolute truth, with few penetrating its flaws. I cannot help but doubt. What is my doubt? I doubt the mismatch between the formula's ingredients and its name. If it truly benefits the Source of Fire to eliminate Yin Shadows, it must focus on supporting the True Qi in Kan (Water/Kidney). When True Qi declines, Yin pathogens rise, called "Yin Shadows." When True Qi strengthens, Yin pathogens vanish, called "Benefiting Fire." Cinnamon Twig (Guizhi) and Aconite Root (Fuzi) powerfully support True Yang in Kan, fitting the classics. Why then use Rehmannia Root (Shu Di) and Cornus Fruit (Shan Zhu Yu) to nourish Yin? If Yin pathogens are abundant, these should not be used. Moutan Bark (Mu Dan Pi) drains Fire; benefiting Fire while draining Fire is illogical. Are Chinese Yam (Shan Yao), Poria (Fu Ling), and Alisma (Ze Xie) for nourishing Yin or promoting urination with their sweet-bland nature? Their intent seems to be that the Acrid-Hot nature of Cinnamon and Aconite rises more than it descends, so heavy, astringent Rehmannia and Cornus guide them downward. Bitter-Cold Moutan assists, and Poria/Alisma promote urination to expel Yin pathogens downward. [Commentary] Who knows that once herbs enter the mouth, their flavors circulate instantly, and respiration connects upper and lower immediately; why wait for this? It seems reasonable, but consider Zhang Zhongjing's treatment of Shaoyin disease with cold extremities, abdominal pain, testicular retraction, black nails/lips, profuse sweating, and total Yin Shadow presentation. Why did he not heavily use Rehmannia, Cornus, Moutan, Poria, and Alisma, but instead relied heavily on Ginger, Aconite, and Licorice for life-saving speed? From this, we see that Zhang Zhongjing's Bitong Tang and Sini Tang truly embody "Benefiting the Source of Fire to eliminate Yin Shadows." Claiming this Eight-Ingredient Pill does so is absolutely incorrect. I am not arguing for argument's sake; this confuses the Classics. The poison has flowed long, harm deep; urgent removal is necessary.
Explanation of "Strengthening the Master of Water to Control Solar Flare"
Former sages stated: "Strengthening the Master of Water to control Solar Flare" refers to Liu Wei Wan (Six-Ingredient Pill). Passed down for years, accepted globally without doubt, used by doctors without debate, I must speak. I suspect this formula was established for Pathogenic Fire injuring Yin, not for Hyperactive Yang in Kan. Modern people often say "Yin Deficiency with Fire Excess." Yin Deficiency is equated with Kidney Water deficiency; since all blood and water belong to the Kidney, calling it Kidney deficiency is acceptable. Fire Excess is equated with Kidney Fire hyperactivity; since all Qi originates from the True Fire in the Kidney, calling it Kidney Fire hyperactivity is also acceptable. However, Pathogenic and Upright factors must not be confused. Treating everything with Liu Wei Wan has misled people for years. I specifically clarify this. Yin is Water; Yang is Fire. Water and Fire root each other, forming one unity, indivisible. Water is born from Fire; thus, "Heaven generates One as Water." Pre-heaven True Qi is called True Fire and True Qi, transformed from True Metal. When Yang increases by one part (True Qi), Yin increases by one part (True Yin). When Yang decreases by one part, Yin decreases by one part. Ask then: Where does "Yin Deficiency with Fire Excess" come from? [Commentary] Yin and Yang are one Qi. Can there be Yang deficiency without Yin deficiency, or Yin deficiency without Yang deficiency? Uncovering ancient doubts with one phrase: Zhang Zhongjing always discussed imbalance based on Pathogenic vs. Upright factors, while modern people discuss imbalance based on a single Qi. They are worlds apart, with confused origins. Now understanding this, we see many errors by former sages. "Controlling Solar Flare" clearly teaches draining Pathogenic Fire. Only Pathogenic Fire injures Yin; True Fire actually generates Yin. This key distinction between Pathogenic and Upright dictates medication choices and must not be confused. Know that wherever Pathogenic Fire flares, it injures Blood. Using San Huang (Three Yellows), Bai Hu (White Tiger), Cheng Qi (Descending Qi), or Liu Wei Wan, according to severity, are all precise and effective methods. Modern people, unaware of the unity of Yin-Yang Qi and the mechanism of Pathogenic/Upright factors, specifically use this formula to nourish Original Yin and drain Original Yang in the Kidney, which is truly illogical.
Clarification of the True Principle: Supporting Yang in Yin Excess, Supporting Yin in Yang Excess
For eternity, there is only Yin and Yang. In Yin Excess, supporting Yang is urgent; in Yang Excess, supporting Yin comes first.
These two sentences are the golden needle for treating diseases and the raft for saving lives. Unfortunately, people miss the key point. Modern people often compare Water and Fire to a balance scale, stating they must not be imbalanced, as imbalance causes disease. I disagree. Since the establishment of Heaven and Earth, the two Qi merged into one, filling the body, with no bias. When Fire is abundant, Water is abundant (Fire refers to True Fire, Water to True Yin). Abundant Fire/Water is seen in summer (fifth and sixth lunar months). When Fire declines, Water declines, seen in winter (tenth lunar month). This is the natural way of Zheng Qi, not a pathological discussion, requiring no support. What is meant by "imbalance"? Imbalance towards Yin requires supporting Yang, referring to the abundance of Yin Pathogens, not the abundance of Original Yin in the Kidney. Imbalance towards Yang requires supporting Yin, referring to the abundance of Pathogenic Fire, not the abundance of Original Yang in the Kidney. Former sages established Ba Wei and Liu Wei pills to treat Original Yin and Yang. Once this idea spread, everyone assumed Original Yin and Yang were indeed imbalanced. This teaching has harmed the world significantly. Modern people do not read the Classics; no wonder Liu Wei and Ba Wei are prevalent, while Cheng Qi and Sini are neglected.
On Pathogenic and Upright Factors
The Way of Heaven and Earth includes Yin and Yang, Fullness and Emptiness, Truth and Falsehood, Pathogenic and Upright. How is the Way of Pathogenic and Upright? Pathogenic Qi is the unjust Qi within Yin and Yang. [Commentary] Unjust Qi exists in all seasons, divided into Six Qi across the Six Meridians. Flowing internally, it is called "Six Guests." Unjust Qi harms objects causing object disease, and harms humans causing human disease. Treatment and regulation have their ways. To find the way, one must understand the Upright. Upright Qi is the Great Harmony Qi of Yin and Yang. [Commentary] Great Harmony is the seamless unity of True Yin and True Yang, the subtle changes of nurturing and transformation. Great Harmony Qi permeates the universe, flourishing all things. When human Great Harmony Qi is abundant, the body is comfortable. If Great Harmony Qi is deficient, demons arise, disasters appear, and diseases swarm.