风寒在其中,燥火在其中,暑湿在其中。
夫冬天之风,人人欲避之,畏其寒也。早春之风料峭入骨,人畏之,亦因寒也。当其杨
柳风
和,吹面不寒;夏月北窗,清风徐至。人非止不避,而反爱之,故风而寒则伤人;和而清者
不伤人;觉其寒则伤人,不觉其寒则不伤人。惟脑后与隙中来者,咸宜避之。假如密室,当
伏
天其热必甚。设遇外间凉风大至,人思挟纩,入此室中,其热不减,但洞启窗户,霎时而凉
,
可见寒在风中明矣。太阳为真火,诸湿一承其耀,无不 然,火亦喜从其类,故易称火就燥
。风虽亦可为燥,然必假气收肃;晴光轩豁之时,非其良能焉。更有藏麻年久,自能出火,
可见燥在火中明矣。夫暑,火之余气也,必因湿而成。六月为火德,小暑大暑系焉;或当
亢阳,忽地潮础汗,龙雷并起,大雨滂沛。人快其凉,而不知热土受湿,暑气上蒸,此时感
邪最易。又如萤火,腐草所化,亦由湿热相蕴而成。始于长夏,绝于寒露,此暑之始终也。
前人称暑必挟湿,信夫!若暑不因湿,则可谓之火,火而兼湿,方成暑矣。
医之用药,如将之用兵。热之攻寒,寒之攻热,此正治也。因寒攻寒,因热攻热,此因
治也
。子虚者补其母,母虚者益其子;培东耗西,增水益火;或治标以救急,或治本以湔缓。譬
如兵法,声东击西,奔左备右,攻其所不守,守其所不攻。卫其虚,避其实,击其惰,还其
锐,兵无常势,医无常形。能因敌变化而取胜者,谓之神明;能因病变化而取效者,谓之神
医。
风寒之邪存在于体内,燥火之邪存在于体内,暑湿之邪存在于体内。
冬天的风,人人都想躲避它,是因为畏惧它的寒冷。早春的风刺骨寒冷,人们畏惧它,也是因为寒冷。当春风和煦,吹在脸上不觉得冷;夏天在北窗下,清风徐徐吹来。人们不仅不躲避,反而喜爱它,所以风若带有寒性则伤害人体;风和气清则不伤害人体;感觉到寒冷则伤害人体,感觉不到寒冷则不伤害人体。只有从脑后以及缝隙中吹来的风,都应当躲避。假如在密闭的房间里,正值伏天,天气必然非常炎热。如果此时外面凉风大作,人想要穿上棉衣保暖,进入这个房间后,室内的热气并未减少,只是打开窗户,片刻之后便感到凉爽,由此可见寒气是在风中,这是很明显的。太阳经(足太阳膀胱经)对应真火,各种湿气一旦受到阳光的照耀,没有不蒸发的,火也喜欢跟随同类,所以《易经》中说“火就燥”。风虽然也可以导致干燥,但必须借助于秋气的收敛肃杀之气;在阳光明媚、天空开阔的时候,并不是风的正常功能。更有陈年的麻,时间久了,自己也能生出火气,由此可见燥是在火中,这也是很明显的。暑,是火的余气,必须依靠湿气才能形成。六月属于火的德运,小暑和大暑节气就在其中;有时遇到极度的阳气,忽然间础石出汗,龙雷之声并起,大雨倾盆。人们喜欢这种凉爽,却不知道热土受湿,暑气向上蒸腾,此时最容易感受邪气。又比如萤火虫,是由腐烂的草变化而来,也是由湿热相互蕴结而形成的。始于长夏,终结于寒露,这就是暑的开始和结束。前人常说暑必挟带湿气,确实如此啊!如果暑不因为湿气,就可以称之为火,火兼夹湿气,才成为暑。
医生用药,就像将领用兵。用热药去攻伐寒邪,用寒药去攻伐热邪,这是正治法。因寒邪而使用寒药,因热邪而使用热药,这是反治法(因治)。子脏虚弱就补益母脏,母脏虚弱就补益子脏;培补东方耗损西方,增加水液以助益火势;或者治疗标症以救急,或者治疗本症以缓解慢性病症。譬如兵法,声东击西,奔向左方却防备右方,攻击敌人防守薄弱的地方,坚守敌人不进攻的地方。保卫虚弱的部位,避开坚实的部位,攻击懈怠的敌人,回击锐利的敌人,兵势没有固定的形态,医法也没有固定的模式。能够根据敌人的变化而取得胜利的人,称为神明;能够根据疾病的变化而取得疗效的人,称为神医。
Wind and cold pathogens reside within, dryness and fire pathogens reside within, summerheat and dampness pathogens reside within.
The wind in winter is something everyone wishes to avoid, fearing its cold. The biting wind of early spring penetrates the bones; people fear it also because of the cold. When the willow wind is gentle and does not chill the face; or when a cool breeze arrives slowly from the north window in summer, people not only do not avoid it but actually love it. Therefore, wind that carries cold harms the human body; wind that is mild and clear does not harm; if one feels the cold, it harms; if one does not feel the cold, it does not harm. Only wind coming from the back of the neck or through cracks should be avoided. Suppose one is in a sealed room during the dog days of summer; the heat must be intense. If a strong cool breeze blows from outside, and one desires to wear cotton padding for warmth, entering this room does not reduce the internal heat. However, if one opens the windows wide, coolness arrives in an instant. This clearly shows that cold resides in the wind. The Taiyang channel (Foot-Taiyang Bladder Channel) corresponds to true fire; all dampness, upon receiving its shine, evaporates without exception. Fire likes to follow its kind, hence the *I Ching* states "fire follows dryness." Although wind can also cause dryness, it must borrow the敛肃 (contracting and肃降 descending/clearing) energy of autumn air. During times of bright sunlight and open skies, this is not the natural function of wind. Furthermore, hemp stored for many years can spontaneously generate heat/fire, which clearly shows that dryness resides within fire. Summerheat is the residual qi of fire and must form with dampness. The sixth month belongs to the virtue of fire, encompassing the Minor Heat and Major Heat solar terms. Sometimes, under extreme yang, suddenly moisture sweats from the foundation stones, dragon-thunder rises together, and heavy rain pours down. People delight in the coolness, unaware that hot earth accepting dampness causes summerheat qi to steam upward; at this time, contracting pathogens is easiest. Again, fireflies are transformed from rotting grass, also formed by the mutual accumulation of dampness and heat. It begins in late summer and ends at Cold Dew, marking the beginning and end of summerheat. Predecessors said summerheat must carry dampness; this is indeed true! If summerheat did not rely on dampness, it could be called fire; only when fire combines with dampness does it become summerheat.
A physician's use of medicine is like a general's use of troops. Using heat to attack cold, and using cold to attack heat, this is the direct treatment method (Zheng Zhi). Attacking cold with cold, and attacking heat with heat, this is the indirect/conforming treatment method (Yin Zhi). If the "son" organ is deficient, tonify the "mother" organ; if the "mother" organ is deficient, benefit the "son" organ; nourish the East while depleting the West; increase water to assist fire; or treat the branch (biao) to save emergencies, or treat the root (ben) to alleviate chronic conditions. Like military strategy: feign an attack on the east but strike the west; rush left but prepare right; attack where the enemy is undefended; defend where the enemy does not attack. Protect the weak, avoid the solid, strike the sluggish, repel the sharp. Military tactics have no fixed form, nor does medical practice. One who can achieve victory by adapting to the enemy's changes is called divine and enlightened; one who can achieve efficacy by adapting to the disease's changes is called a divine physician.