张子和曰∶脏毒、酒毒、下血、呕血,妇人三十以下血闭,六七月间红痢,妇初得孕择食者,以上皆不禁
口。凡久病之人,胃气虚弱者,忽思尝茹,亦当少少与之,图引浆粥,谷气入胃,此权变之道也。
若专以淡粥责之,则病不悦而食减不进。胃气斯所以难复,病所以难痊。此忌之之过也,智者通之。
《内经》曰∶必先岁气,无伐天和,又曰∶升降浮沉,则顺之。寒热温凉,则迎之。凡用药
须看时令,如常用调理药,春加川芎,夏加黄芩,秋加茯苓,冬加干姜。如解肌发表,春温月用
辛凉药,川芎、防风、荆芥、柴胡、紫苏、薄荷之类;夏暑月用甘辛寒药,干葛、石膏、甘草、
薄荷、升麻、柴胡之类;秋凉月用辛温药,羌活、防风、苍术、荆芥之类;冬寒月用辛热药,麻
黄、桂枝、干姜、附子之类。若病与时违,勿拘此例。如温暑月治热病、疫疠病,不可用辛温热
药,宜温凉辛甘苦寒之药,升麻、柴胡、干葛、薄荷、石膏、黄芩、黄连、甘草、芍药之类。
治咳嗽,春多上升之气,用川芎、芍药、半夏、黄芩之类;夏多火炎逼肺,用黄芩、山栀、
桑白皮、石膏、知母之类;秋多湿热伤肺,用苍术、桑白皮、黄芩、防风之类;冬多风寒外来,
用麻黄、桂枝、干姜、半夏、防风、羌活之类。若病与时违,不拘此例。如治泻泄,冬寒月用辛
苦温药,干姜、砂仁、陈皮、浓朴之类;夏暑月暴注水泻,用苦寒酸寒药,黄连、山栀、茵陈、
芍药之类。若病与时违,不拘此例。如伤冷食,腹痛或霍乱吐泻,虽夏暑月,可用辛热温中药,
干姜、茱萸、砂仁、浓朴之类。如酒客病,或素有热证,虽在寒凉月,可用清凉药,芩连、干葛之类。
凡用药若不本四时,以顺为逆。四时者,是春升夏浮秋降冬沉,乃天地之升降浮沉。化化者,
脾土中造化也。是为四时之宜,但言补之以辛甘温热之剂,及味之薄者,诸风药是也。此助春夏
之升浮者也,此便是泻秋收冬藏之药也,在人之身乃肝心也。但言之以酸苦寒凉之剂,并淡味渗
泻之药,此助秋冬之降沉者也,在人之身乃肺肾也。用药者,因此法度则生,逆之则死,其不死者,必危困矣。
张子和说:患有脏毒、酒毒、便血、呕血,以及三十岁以下妇女经闭,六月七月间的红色痢疾,孕妇刚怀孕时挑食等情况,以上这些情况都不必严格禁止进食。凡是久病的人,胃气虚弱的人,忽然想吃些食物,也应当少量给予,以此引导米汤和粥进入胃中,使谷气入胃,这是权宜变通的方法。如果一味地只责求吃清淡的粥,那么病人会感到不适,食欲减退而不进食。胃气因此难以恢复,疾病因此难以痊愈。这就是过度忌讳饮食造成的过错,明智的人懂得通融变通。
《黄帝内经》说:必须首先了解当年的气候特点,不要破坏人体的自然和谐;又说:药物的升降浮沉特性,要顺应病势;药物的寒热温凉性质,要迎治病邪。凡是用药都必须看时令季节,比如常用的调理药物,春季加川芎,夏季加黄芩,秋季加茯苓,冬季加干姜。如果是解肌发表(解除肌表之邪),春温月份用辛凉药,如川芎、防风、荆芥、柴胡、紫苏、薄荷等;夏暑月份用甘辛寒药,如葛根、石膏、甘草、薄荷、升麻、柴胡等;秋凉月份用辛温药,如羌活、防风、苍术、荆芥等;冬寒月份用辛热药,如麻黄、桂枝、干姜、附子等。如果病情与季节相违背,不要拘泥于这个例子。比如在温热暑月治疗热病、疫病,不可用辛温热药,宜用温凉、辛甘、苦寒的药,如升麻、柴胡、葛根、薄荷、石膏、黄芩、黄连、甘草、芍药等。
治疗咳嗽,春季多上升之气,用川芎、芍药、半夏、黄芩等;夏季多火炎逼肺,用黄芩、山栀、桑白皮、石膏、知母等;秋季多湿热伤肺,用苍术、桑白皮、黄芩、防风等;冬季多风寒外来,用麻黄、桂枝、干姜、半夏、防风、羌活等。如果病情与季节相违背,不拘泥于这个例子。比如治疗泄泻,冬寒月份用辛苦温药,如干姜、砂仁、陈皮、厚朴等;夏暑月份暴注水泻,用苦寒酸寒药,如黄连、山栀、茵陈、芍药等。如果病情与季节相违背,不拘泥于这个例子。比如伤食冷物,腹痛或霍乱吐泻,即使在夏暑月份,也可用辛热温中药,如干姜、吴茱萸、砂仁、厚朴等。比如嗜酒之人患病,或素来有热证,即使在寒凉月份,也可用清凉药,如黄芩、黄连、葛根等。
凡是用药如果不根据四时变化,就会以顺为逆。四时,就是春升、夏浮、秋降、冬沉,这是天地自然的升降浮沉规律。化化者,是脾土中的造化功能。这是符合四时适宜的原则,只说用辛甘温热的补剂,以及气味薄弱的药,这些都是风药。这是辅助春夏升浮的药物,这也就是泻除秋收冬藏的药物,在人体对应肝心。只说用酸苦寒凉的药剂,以及淡味渗泻的药物,这是辅助秋冬降沉的药物,在人体对应肺肾。用药者,遵循这种法度就能生存,违背它就会导致死亡,不死的人,也一定是处于危险困顿的状态了。
Zhang Zihe said: For conditions such as zangdu (visceral toxin), jiudu (alcohol toxin), hematochezia (blood in stool), hematemesis (vomiting blood), amenorrhea in women under thirty, red dysentery between the sixth and seventh lunar months, and selective eating in early pregnancy, none of these require strict dietary prohibitions. For patients with chronic illness and weak stomach qi (Stomach Qi), if they suddenly crave food, it should be given in small amounts to guide broth and gruel into the stomach, allowing grain qi (Grain Qi) to enter the stomach; this is a method of flexible adaptation. If one strictly demands only bland gruel, the patient will feel displeased, leading to reduced appetite and lack of intake. Consequently, stomach qi becomes difficult to recover, and the illness difficult to cure. This is an excessive over-caution regarding dietary taboos; wise individuals understand how to adapt flexibly.
The *Neijing* (Inner Canon) states: "One must first consider the annual climate and not disrupt the harmony of heaven and humanity." It also states: "Regarding the ascending, descending, floating, and sinking [properties of drugs], follow the trend." And: "Regarding cold, heat, warm, and cool [natures], counteract them." In all medication use, one must observe the seasonal timing. For commonly used regulating formulas, add Chuanxiong Rhizoma (Chuanxiong) in spring, Scutellariae Radix (Huangqin) in summer, Poria (Fuling) in autumn, and Zingiberis Rhizoma Recens (Ganjiang) in winter. For releasing the muscle layer and expelling the exterior (Jieji Fabiao): in warm spring months, use acrid-cool herbs such as Chuanxiong Rhizoma (Chuanxiong), Saposhnikoviae Radix (Fangfeng), Schizonepetae Herba (Jingjie), Bupleuri Radix (Chaihu), Perillae Folium (Zisu), and Menthae Haplocalycis Herba (Bohe); in hot summer months, use sweet-acrid-cold herbs such as Puerariae Lobatae Radix (Gegen), Gypsum Fibrosum (Shigao), Glycyrrhizae Radix et Rhizoma (Gancao), Menthae Haplocalycis Herba (Bohe), Cimicifugae Rhizoma (Shengma), and Bupleuri Radix (Chaihu); in cool autumn months, use acrid-warm herbs such as Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Atractylodis Macrocephalae Rhizoma (Cangzhu), and Schizonepetae Herba (Jingjie); in cold winter months, use acrid-hot herbs such as Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi), Zingiberis Rhizoma Recens (Ganjiang), and Aconiti Lateralis Radix Praeparata (Fuzi). If the disease contradicts the season, do not adhere rigidly to this example. For instance, when treating febrile diseases or epidemics during hot and humid summer months, acrid-warm-hot drugs should not be used; instead, use warm-cool, sweet-acrid, or bitter-cold drugs such as Cimicifugae Rhizoma (Shengma), Bupleuri Radix (Chaihu), Puerariae Lobatae Radix (Gegen), Menthae Haplocalycis Herba (Bohe), Gypsum Fibrosum (Shigao), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Glycyrrhizae Radix et Rhizoma (Gancao), and Paeoniae Radix Alba (Shaoyao).
When treating cough: in spring, when rising qi is predominant, use Chuanxiong Rhizoma (Chuanxiong), Paeoniae Radix Alba (Shaoyao), Pinelliae Tuber (Banxia), and Scutellariae Radix (Huangqin); in summer, when fire flares up and presses on the lungs, use Scutellariae Radix (Huangqin), Gardeniae Fructus (Shanzhi), Morus Albae Cortex Radicis (Sangbaipi), Gypsum Fibrosum (Shigao), and Anemarrhenae Rhizoma (Zhimu); in autumn, when damp-heat injures the lungs, use Atractylodis Macrocephalae Rhizoma (Cangzhu), Morus Albae Cortex Radicis (Sangbaipi), Scutellariae Radix (Huangqin), and Saposhnikoviae Radix (Fangfeng); in winter, when wind-cold comes from outside, use Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi), Zingiberis Rhizoma Recens (Ganjiang), Pinelliae Tuber (Banxia), Saposhnikoviae Radix (Fangfeng), and Notopterygii Rhizoma et Radix (Qianghuo). If the disease contradicts the season, do not adhere rigidly to this example. When treating diarrhea: in cold winter months, use bitter-acrid-warm drugs such as Zingiberis Rhizoma Recens (Ganjiang), Amomi Fructus Rotundus (Sharen), Citri Reticulatae Pericarpium (Chenpi), and Magnoliae Officinalis Cortex (Houpo); in hot summer months, for sudden watery diarrhea, use bitter-cold and sour-cold drugs such as Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Shanzhi), Imperatae Rhizoma (Yinchen), and Paeoniae Radix Alba (Shaoyao). If the disease contradicts the season, do not adhere rigidly to this example. For injury from cold food, abdominal pain, or cholera-like vomiting and diarrhea, even in hot summer months, acrid-hot and warm-moderate drugs can be used, such as Zingiberis Rhizoma Recens (Ganjiang), Corni Fructus (Zhuyu), Amomi Fructus Rotundus (Sharen), and Magnoliae Officinalis Cortex (Houpo). For alcoholics suffering from illness, or those with inherent heat syndromes, even in cold months, cooling drugs can be used, such as Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), and Puerariae Lobatae Radix (Gegen).
In all medication use, if one does not base decisions on the four seasons, one turns compliance into violation. The four seasons refer to spring rising, summer floating, autumn descending, and winter sinking, which are the ascending, descending, floating, and sinking patterns of heaven and earth. "Huahua" refers to the transformative power within Spleen Earth. This aligns with the appropriateness of the four seasons. It is stated that using acrid-sweet-warm-hot tonifying agents, and drugs with thin flavors (such as wind-dispersing herbs), assists the rising and floating of spring and summer; these are effectively drugs that drain autumn's gathering and winter's storing, corresponding to Liver and Heart in the human body. Conversely, using sour-bitter-cold-cool agents, and bland-draining-leaching drugs, assists the descending and sinking of autumn and winter, corresponding to Lung and Kidney in the human body. Those who prescribe medication follow these principles to survive; violating them leads to death. Those who do not die will certainly be in a critical and distressed state.