程郊倩曰∶拘挛顽麻不仁，风证有此，当是风痰阻滞经络，气道不通利也。气道不通利，脾虚不能
运气，虽是补，不忘攻，曰气顺则风消。尤须攻不忘补，从脾胃中壮及主气，使津液得达。阻滞自无，此
乌药八味顺气之所由设也。风眩头晕，风在上而虚在下，治法不治风而治血。血足于下，气自清于上，
何风之有？此阳病治阴之旨也。
心藏神而主血于脾，实为母子。脾乏膏腴，因夺母气以为食，虚处遂并移于母。健忘惊悸等证，实
由脾虚乏津乏液之故。必使脾气壮而无上夺，方得心血足而能下文，此又归脾汤之一义也。
中虚不能化气，则阴逆于下，阳格于上，此亦邪居半表里之间。变小柴胡汤为半夏泻心汤，
彼和解于表里间，此和解于上下际。表里间俱属阳，上下之际兼有阴也。阴逆则郁必甚，故去柴胡，加黄
连以解阳邪，佐温以破阴逆也。金主燥而令降，木主滋而令升，凡金令之不从其燥者，全赖木气
之升，能致五脏之蒸溽到肺，而成其津液也。故木气升，则五脏之气奉春令而俱升；木气降，则五
脏之气奉秋令而俱降。降则五脏之气不得上承，自然下蚀。凡土邪陷下而克水，火淫寡畏而 金，皆职
于此。金以溽蒸不到而加火淫，遂成燥金，津液之源已竭，周身之百骸，谁为之灌溉者，是则一燥
而无所不燥。降令多，升令少，而湿热之邪遂盛于下部，而成痿软。盖湿热为物，升则化，不升则不化
也。法欲救金体之燥，须是从木令之升。但使五脏各有升令之奉，则土能生金，金能生水，水能制火，
虽其间有补有泻，皆可以此一字为用神。所谓少阳为枢者，此也。故能致津液，通气血，则少阳之妙法矣。
肾气虚寒，自无温泉溉木，木无阳以养，气不上升而下陷。凡肾家阴精欲为闭藏者，肝偏盗之而疏
泄，阳并入阴，故阴精自出，夜梦鬼交。治法亟宜于阴中辅阳，使木气得暖敷荣，必不盗及母气矣。
疝气者，肝之经络环阴器，最为招寒之地。与寒为类者更有湿，寒湿互于阴处必凝，凝则成形。不
比阳经之能比气，易聚还易散也。经曰∶一阴盛而脉胀不通，故曰 癃疝，则知此中已多结滞，所宜
从寒湿中求之，破此结滞之阳也。精者水也，非火不成。火者人身之真气也，真气不足则脏寒，遂
无以锻炼成精。经曰∶水之精为志，火之精为神。惟交心肾为一家，夹一水于二火之间，直从两精相搏处
，始及坎离，此之谓鼎汞也。
有余在肝，不得肾水之升，而阳独治，故有余之邪见于上焦；不足在肾，不得肝火之降，而阴独治，
故不足之因见于下部。惟从肝肾二经，通及山泽之气，故补肾而肝亦益也。肾阴虚而阳得凑之，无以为内
之守，则阳强而阴益弱，故精
时自出，得热则遗。治法固宜滋肾，尤要清心。心者火之源也，火不扰而水自宁。
阴虚之人，水亏不能滋木，荣血必伤，所以阳火独治，而不得血润，则必吸动肾水以自救，
无奈滴水不能救盛火，反从火化，而升煎成血，咯血之出于肾者，此也。此际复营分之亏，与壮水
之主，养阴退阳，是为正治。然皆兼有破滞法者，以血成则必燥，燥成必带淤，况曾服过寒凉，
不淤处有淤也。
耳作脓疳者，肾开窍于耳，以阴逆于下，则阳越于上，邪从虚受，故上虚补在下，先求二肾纳气，
然后清发上焦，始为有功，盖精胜则邪却也。
肾虚耳重，头痛偏正，阴下而阳上，则格拒而多病及巅部，下虚上实，经谓厥成为巅疾是也。至阴虚
天气绝，至阳盛地气不足。故不足者温之，使阴中有阳，则下不虚；有余者泻之，使阳中有阴，则上不实
。补益肝肾，道并行而不相悖也。
头部为天；居阳中之阳，而能得地部阴精之上奉者，全赖督冲二脉领肾中水火之英精，交集于其巅也。
督冲虚而不到，则阴精莫奉而耳作蝉鸣，须发脱落，种种虚证，迭见于上，上虚而仍补在下，以生气之原
在肾中之水火，不在上也。
水有真水，有客水。肾气温则客水亦摄而归真，肾气寒则真水亦从而为客水。客寒必搏之，所以有身体
沉重疼痛之症。真武汤从土中植火，使真水从温处镇摄，客水自化而归真，正不必行导渗之令也。
人身以阳气为主，滋生发育之本也。有时互阴而举之，以抱阳之阴为妻阴，不嫌其偕；有时黜阴而伸
之，以背阳之阴为贼阴，最防其夺。经曰∶知阳者知阴，知阴者知阳。脉有
阴阳，病机之盈虚，倚伏在此。能于此穷其所谓，则于病在先一层深一层上，见病之源。
病之转移进退，机则系乎脉，阳中有阴，阴中有阳，不可不就病与脉交互处，一合参之；并就脉
与病参差处，一反勘之。死处便可冀生，生中且须防死，只在阴阳反复之间。
汗下之法，可施于有形之阴阳，不可施于无形之阴阳。有形者，汗下之邪，从汗下出，而阴阳自安。
无形者，一误汗下，无汗可去，而所去者无非本脏之气，损阴损阳，害不可言。六经内，三阴惟少阴，
厥阴多假症，如躁烦、戴阳是也，然而其脉不假。三阳中，阳明间有假脉，如热深厥深，而脉反沉之类是
也，然而口燥舌干、不得卧之证自在，若太阳证，原自无假，太阳之脉必浮，太阳之证必发热。然与少
阴肾同司寒水，所以表症原自根里。脉虽浮，而浮中自分虚实，实则主表，虚则便关乎里；症虽发热，而
发热原分标本，标则从邪，本则便关乎正。世人顾表不及里，顾邪不及正，卒病
一来，开手便错，以致坏病种种，莫不自太阳变成。此非太阳之假，人自不辨其标本，不辨其虚实耳。至
若少阳一经，岂无混淆，然少阳来路必由太阳，不兼太阳之症，不成少阳矣。
少阴得趺阳镇伏，而后肯交合三焦。三焦之气升则为神，元阳透脑，至髓海为神光，是即营卫发生之
祖。少阴之气升则为鬼，奔豚犯关，夺绛宫为死气，实由趺阳失令之由。为神为鬼，只在趺阳胜负间。营卫
盛其下，自有温泉；趺阳浓其上，必无阴气。
罗东逸曰∶补肝者养阴，肾肝同一治，古人言之矣。然肝木得少阳，土脉震发，非少阳不升；木气条茁
，又非太阴不长，故肝食采于脾者也。盖补肝者，必于土中升木。若补中益气之升柴，是以少阳腾土；
逍遥散之术苓，是以太阴升
木。前人已有其意，特未畅发耳。
喻嘉言曰∶肺燥喜于用润，脾滞又艰于运食。故脾胃虚之极，食饮不思，则于清肺药中，少
加参术以补脾；肺燥之极，热盛咳频，则于补脾药中，少加阿胶以润燥。治龙雷之火，全以收藏为主。
病有胃经受病，而胃脉反不见其病，只是上下两傍心肾肝肺之脉，时时另起一头，不安其常。此非上
下两傍之见病端也，乃中央气弱，不能四迄。如母虚子失乳，故见饥馁之象耳。治宜四君子以理脾胃，
则中央之枢轴转，而四畔之机关尽利矣。
人之阴气衰，则不能自主，而从阳上升。凡其泄越者，皆身中之至宝，向非收拾归元，将何底极？
是以《事亲养老》诸方，皆以温补下元为务。诚有见于老少不同治，少年人惟恐其有火，高年人惟恐其无
火。无火则营运艰而易衰。是火者老人性命之根，未可以水轻折也。昔贤治喉干，谓八味丸为圣药，譬之
釜底加薪，则釜中津气上腾。可见下虚者，不但真阴虚，究竟真阳亦虚。盖阳气以潜藏为贵，藏则勿亢
，藏则可久。惟真阴一虚，则孤阳失守，上浮为热。苟收而摄之
于下，则口中之浊痰，鼻中之浊涕不作，而口中之津液常生矣。
凡治气之原有三∶一曰肺气，肺气清则遍身之气肃然下行；一曰胃气，胃气和则胸中之气亦易下行
；一曰膀胱之气，膀胱之气壮则能吸引胸中之气下行。是以膻中之气乱而即治，
扰而即宁者，赖此三气为输运。若三气反干，则于胸膈为紧为胀，可胜道哉。然尚有一吃紧关头，人身
胸中空旷如太虚，地气上为云，必天气降为雨，地气始收藏不动，此义首重在膀胱。膻中位于膈内，膀
胱位于腹内。膀胱之气化则空洞善
容，而膻中之气得以下运；不化则腹已见胀，膻中之气安能下达耶？然其权在于葆肾，肾气动必先注
于膀胱，膀胱满胀势必奔于胸膈；肾气不动则收藏愈固，膀胱得以清静无为，而膻中之气注之不盈矣。
丹溪等方书，说病在左血多，病在右气多。教人如此认证，因起后执着。《内经》则无此说，《
内经》但言∶左右者，阴阳之道路。夫左右既为阴阳往还之道路，何尝可偏执哉？况左半虽血为主，非气
以统之则不流；右半虽气为主，非血以丽之则易散。故肝胆居左，其气常行于右；脾胃居右，其气常行于
左，是以生生不息也，故凡治一偏之病，法宜从阴引阳，从阳引阴，从左引右，从右引左。盖观树木之
偏枯者，将溉其枯者乎？抑溉其未枯者，使荣茂而因以条畅其枯者乎？
张隐庵曰，《灵枢·本输》篇曰∶少阳属肾，肾上连肺，故将两脏。盖少阳乃三焦之生气，发于右肾
上合包络，为相火之原。左肾属水，上连于肺，故为两脏也。又本藏篇曰∶肾合三焦、膀胱。盖右肾之气
上合于心主包络，而为一脏。又《素问·咳论》曰∶肾咳不已，则膀胱受之。久咳不已，则三焦受之。是
《内经》止曰肾，原无命门之名。盖以一肾合三焦，一肾合膀胱，是为两脏而配合两腑者也。
春伤于风，夏生飧泄。秋伤于湿，冬生咳嗽。东方生风，春之气也。中央生湿，土之气也，主于夏秋
之交，故曰秋伤于湿。阳受风气，阴受湿气。风乃阳邪，故伤于风者，上先受之。阳病者，上行极而下，
故春伤于风，夏生飧泄。湿乃阴邪，故伤于湿者，下先受之，阴病者，下行极而上，故秋伤于湿，冬生咳
嗽。此天地阴阳之邪，随人气之上下升降者也。冬伤于寒，春必病温。夏伤于暑，秋必 疟。夫温病、疟
病，皆邪伏于内而后发者。寒乃阴邪，冬时阳气内盛，故邪
伏于外，在皮肤之间。至春阳气长盛，外伏之阴邪与阳相遇，邪正相搏，寒已化热，故春发为温
病也。暑乃阳邪，夏时阳气在外，里气虚寒，故邪伏于里，在募原之间。至秋阴气长盛，内伏之阳邪与
阴相遇，邪正相持，故发为往来寒热之 疟。此天地阴阳之邪，随人气之内外出入者也。
柯韵伯曰∶人知火能生土，而不知水能生土；知土为水仇，而不知水为土母；但知脾为至阴，而不知胃
为元阳。盖阳明火气所钟，故主燥化。太阴湿土，真阴之所生，是水之子也。真阴之主，故名太阴；水精
所成，故主湿化。阳道主实，又主热，热实相搏，则胃实而地道不通；是以六经亡津液而胃中干燥者，皆
得转属于阳明，而阳明则无所复传，是即阳明燥化之为病。此知胃燥反传于脾之说，谬矣。阴道主
虚，又主寒，虚寒相搏，则腹满而下利益甚。凡五脏受病自利不渴者，咸属太阴。若脾家实，腐秽反自去，
是即太阴湿化之为患。此知脾强反为脾约之说，非矣。土有燥气，所以生金，则燥土是燥金之父也。土
有湿气，所以养金，则湿土是肺金之母也。无火则土不生，无水则土亦不生，土不燥则金不生，土不湿则金
亦不生，此水火互根，刚柔相须之理也。
喻嘉言曰∶今人学识未广者，见烦热枯燥等证，不敢用附子者，恶其以热助热也。孰知不藏精之人，
肾中阳气不鼓，精液不得上升，故枯燥外见，才用附子助阳，则阴气上交于阳位。如釜底加火，釜中之
气水上腾，而润泽有立至者。仲景方辄用附子一枚，今人亦不敢用一钱，总由其识之未充耳。
仲景用桂枝汤以和荣而解肌，此定例也。然不但为太阳中风本药，即少阴经之宜汗者，亦在取用。其
最妙处，在用芍药以益阴而和阳。太阳经之荣卫，得芍药酸收，则不为甘温发散所逼，而安其位也。至
若少阴，则更为阴藏而少血。所
以强逼少阴汗者，重则血从耳目口鼻出，而竭厥可虞；轻亦小便不利，而枯涸可待。用药自当知芍
药之例，倍加益阴以和阳。所用桂枝，多入地黄，以匡芍药之不逮，此比例之法也。
程郊倩曰∶人身以阳气为主，生身之源在此，切须从脉去照顾。浮阳多从证上见出假有余，真阳
自从脉上见出真不足，万不可以假乱真也。
程郊倩说：肢体拘挛、麻木不仁，风证中常有此表现，这应当是风痰阻滞了经络，导致气道不通利。气道不通利，是因为脾虚不能运化水谷精微之气，治疗时虽然要补益，但不可忘记攻邪，因为气机顺达则风邪自消。尤其需要在攻邪的同时不忘补益，通过强健脾胃来壮大主司一身之气的功能，使津液得以输布，阻滞自然消除，这就是设立乌药八味顺气汤的原因。
风眩头晕，病机在于风邪在上而正气（阴血）虚于下，治疗方法不应直接治风，而应治血。若下部血液充足，上部之气自然清宁，哪里还有风邪呢？这正是“阳病治阴”的要旨。
心藏神并主宰血液，与脾为母子关系（火生土）。若脾脏缺乏膏脂营养，便会掠夺母脏（心）的气血作为滋养，虚弱就会波及母脏。健忘、惊悸等症状，实际上是由于脾虚导致津液匮乏的缘故。必须使脾气强壮而不向上掠夺，才能使心血充足并能向下滋养，这是归脾汤的一层含义。
中焦虚弱不能化生元气，则阴气逆乱于下，阳气格拒于上，这也属于邪气居于半表半里之间。将小柴胡汤改为半夏泻心汤，前者是在表里之间和解，后者是在上下之间和解。表里之间均属阳，上下之际兼有阴。阴气逆乱则郁结必然严重，所以去掉柴胡，加入黄连以解除阳热之邪，佐以温性药物以破除阴寒之逆。肺金主燥而令气下降，肝木主滋而令气上升，凡是肺金之气不从其燥性而下降的，全赖肝木之气的升发，能使五脏的蒸腾湿润之气到达肺部，从而生成津液。所以肝木之气升发，则五脏之气顺应春令而共同升发；肝木之气沉降，则五脏之气顺应秋令而共同沉降。若气机沉降，则五脏之气不能上承，自然会向下蚀损。凡是土邪陷下克制肾水，或火气过盛灼伤肺金，都职掌于此。肺金因蒸腾湿润不到而受火邪侵袭，遂成为燥金，津液的源头已经枯竭，周身百骸，谁来灌溉呢？这就是一处干燥而全身无不干燥的道理。降令多而升令少，湿热之邪便盛行于下部，形成痿软证。湿热作为一种病邪，能升发则化为正常之气，不能升发则无法转化。想要救肺金之燥，必须从顺应肝木升发之令入手。只要使五脏各有升发的禀赋，那么土就能生金，金就能生水，水就能制火，即使其中有补有泻，都可以用这个“升”字作为运用神髓的关键。所谓少阳为枢机，就是这个道理。所以能够致生津液，通畅气血，就是少阳经的妙法。
肾气虚寒，自然没有温泉来灌溉肝木，肝木没有阳气以养护，气机不上升反而下陷。凡肾家阴精想要闭藏的，肝却偏颇地盗取它并进行疏泄，阳气并入阴中，所以阴精自行外泄，夜间出现梦交鬼魅之象。治疗方法亟需在阴中辅助阳气，使肝木之气得到温暖敷布而荣养，就一定不会盗取母脏（肾）的气了。
疝气病，肝的经络环绕阴器，是最容易招受寒邪的地方。与寒同类的是湿，寒湿在阴部相互凝结必然成形，凝滞则形成有形之邪。不像阳经之气那样容易聚集也容易消散。经文说：“一阴盛而脉胀不通”，所以说癃疝，就知道这里已有许多结滞，适宜从寒湿中寻找原因，破除这种结滞的阳气。
精，属水，没有火就不能化成精。火，是人身的真气。真气不足则脏腑寒冷，于是无法锻炼成精。经文说：“水的精华是志，火的精华是神。”只有心肾相交为一家人，夹一水于二火之间，直接从两精相搏之处，开始涉及坎离（水火），这就叫作鼎汞（炼丹术语，喻指精气神的交融）。
有余的病邪在肝，得不到肾水的升济，而阳气独治，所以有余之邪见于上焦；不足的病根在肾，得不到肝火的降下，而阴气独治，所以不足的成因见于下部。只有从肝肾二经着手，通达山泽之气，所以补肾而肝也受益。肾阴虚而阳气凑近，没有内守之力，则阳强而阴更弱，所以精液时常自出，受热则遗泄。治疗方法固然宜滋补肾阴，尤其要清心火。心是火的源头，火不扰动则水自然安宁。
阴虚的人，水亏不能滋养肝木，营血必受损，所以阳火独治，而得不到血的滋润，就必定吸动肾水以自救，无奈滴水不能救盛火，反被火化，煎熬而成血，咯血出于肾者，就是这种情况。此时又需补益营分之亏，壮水之主，养阴退阳，这才是正治。然而这些方法都兼有破滞之法，因为血成瘀则必燥，燥成瘀则必带淤，何况曾服用过寒凉药物，原本无淤处也会产生淤血。
耳部流脓患疮者，肾开窍于耳，因阴气逆乱于下，则阳气浮越于上，邪气乘虚而入，所以上部虚损应从下部补起，先求两肾纳气，然后清解发散上焦之邪，这才算有功，因为精气胜则邪气自退。
肾虚导致耳鸣耳聋，头痛部位在偏侧或正中，阴气在下而阳气在上，则相互格拒而多病及头部巅顶，这是下虚上实，经文所说的“厥成为巅疾”就是这种情况。至阴虚则天气绝，至阳盛则地气不足。所以对于不足的要温补，使阴中有阳，则下部不虚；对于有余的要泻之，使阳中有阴，则上部不实。补益肝肾，这两条道路并行而不相悖。
头部为天，居于阳中之阳，而能得到地部阴精之上奉，全赖督脉和冲脉统领肾中水火之英精，交汇于头顶。若督脉和冲脉虚弱而不能到达，则阴精不能上奉而出现耳鸣如蝉鸣、须发脱落等种种虚证，迭见于上部。上部虚仍应从下部补起，因为生气之源在肾中的水火，不在上部。
水有真水，有客水。肾气温煦则客水也能摄纳而归为真水，肾气寒则真水也随之变为客水。客寒必然搏击人体，所以有身体沉重疼痛的症状。真武汤从土中植火，使真水从温处镇摄，客水自然化解而归为真水，正不必使用导渗利尿的方法。
人身以阳气为主，是滋生发育的根本。有时互借阴气而举起它，以抱持阳气的阴气为妻阴，不嫌弃它们共存；有时贬黜阴气而伸张阳气，以背离阳气的阴气为贼阴，最防止它掠夺。经文说：“知阳者知阴，知阴者知阳。”脉象有阴阳，病机的盈虚，倚伏于此。能在此穷究其中的道理，则在疾病在先一层深一层上，见到病的根源。
病的转移进退，机理系于脉象，阳中有阴，阴中有阳，不可不就病与脉交互之处，一并参合考察；并就脉与病参差之处，一反复勘验。死处便可冀求生路，生中且须防备死亡，只在阴阳反复之间。
汗法和下法，可施用于有形的阴阳，不可施用于无形的阴阳。有形的，汗下之邪从汗下排出，而阴阳自然安定。无形的，一旦误用汗下，无汗可去，而去掉的无非是本脏之气，损伤阴或损伤阳，危害不可言说。六经之中，三阴经中唯少阴、厥阴多有假症，如躁烦、戴阳等，然而其脉象不假。三阳经中，阳明间有假脉，如热深厥深，而脉反沉之类，然而口燥舌干、不得卧的症状自在，至于太阳证，原本没有假象，太阳之脉必浮，太阳之证必发热。然而太阳与少阴肾同司寒水，所以表症原本根源于里。脉虽浮，而浮中自分辨虚实，实则主表，虚则便关乎里；症虽发热，而发热原分标本，标则从邪，本则便关乎正。世人只顾表不顾里，顾邪不顾正，卒病一来，起手便错，以致坏病种种，莫不是自太阳变成。这不是太阳的假象，是人自己不辨别标本，不辨别虚实罢了。至于少阳一经，难道没有混淆吗？然而少阳来路必由太阳，不兼太阳之症，不成少阳矣。
少阴得到趺阳脉的镇伏，而后才肯交合三焦。三焦之气升则为神，元阳透脑，至髓海为神光，这是营卫发生的祖源。少阴之气升则为鬼，奔豚犯关，夺绛宫（心）为死气，实由趺阳失令所致。为神为鬼，只在趺阳脉的胜负之间。营卫盛于下，自有温泉；趺阳脉浓盛于上，必无阴气。
罗东逸说：补肝即是养阴，肾肝同一治法，古人已经说过了。然而肝木得到少阳之气，土脉才能震发，非少阳之气不升；木气条达茁壮，又非太阴之气不长，所以肝采食于脾。大概补肝者，必须在土中升木。如补中益气汤中的升麻、柴胡，是以少阳之气腾跃土气；逍遥散中的白术、茯苓，是以太阴之气升举肝木。前人已有此意，只是未曾畅发罢了。
喻嘉言说：肺燥喜欢用润剂，脾滞又难以运化食物。所以脾胃虚极，饮食不思，则在清肺药中，少加人参、白术以补脾；肺燥之极，热盛咳频，则在补脾药中，少加阿胶以润燥。治疗龙雷之火，全以收藏为主。
有病在胃经受病，而胃脉反而不见病象，只是上下两旁的心、肾、肝、肺之脉，时时另起一头，不安其常。这不是上下两旁见病端，乃是中央气弱，不能四达。如同母亲虚弱儿子失乳，所以见到饥馁之象。治疗宜用四君子汤调理脾胃，则中央的枢轴转动，而四周的机关尽皆便利。
人的阴气衰，则不能自主，而从阳上升。凡是泄越的，都是身中的至宝，若非收拾归元，将有何底止？因此《事亲养老》诸方，都以温补下元为务。确实看到了老少不同治，少年人惟恐其有火，高年人惟恐其无火。无火则营运艰难而易衰老。这火是老人性命的根本，不可以用水轻易折损。昔贤治疗喉干，谓八味丸为圣药，譬如釜底加薪，则釜中津气上腾。可见下虚者，不但真阴虚，究竟真阳亦虚。盖阳气以潜藏为贵，藏则不亢，藏则可久。惟真阴一虚，则孤阳失守，上浮为热。若能收摄于下，则口中的浊痰、鼻中的浊涕不作，而口中的津液常生了。
大凡治气，其原有三：一是肺气，肺气清则遍身之气肃然下行；二是胃气，胃气和则胸中之气亦易下行；三是膀胱之气，膀胱之气壮则能吸引胸中之气下行。所以膻中之气乱而即治，扰而即宁者，赖此三气为输运。若三气反干，则于胸膈为紧为胀，岂可胜道哉。然而尚有一吃紧关头，人身胸中空旷如太虚，地气上为云，必天气降为雨，地气始收藏不动，此义首重在膀胱。膻中位于膈内，膀胱位于腹内。膀胱之气化则空洞善容，而膻中之气得以下运；不化则腹已见胀，膻中之气安能下达耶？然而其权在于葆肾，肾气动必先注于膀胱，膀胱满胀势必奔于胸膈；肾气不动则收藏愈固，膀胱得以清静无为，而膻中之气注之不盈矣。
丹溪等方书，说病在左血多，病在右气多。教人如此认证，因而起后执着。《内经》则无此说，《内经》只说：“左右者，阴阳之道路。”夫左右既为阴阳往还之道路，何尝可偏执哉？况左半虽血为主，非气以统之则不流；右半虽气为主，非血以丽之则易散。故肝胆居左，其气常行于右；脾胃居右，其气常行于左，是以生生不息也。故凡治一偏之病，法宜从阴引阳，从阳引阴，从左引右，从右引左。盖观树木之偏枯者，将溉其枯者乎？抑溉其未枯者，使荣茂而因以条畅其枯者乎？
张隐庵说：《灵枢·本输》篇说：“少阳属肾，肾上连肺，故将两脏。”盖少阳乃三焦之生气，发于右肾上合包络，为相火之原。左肾属水，上连于肺，故为两脏也。又《本藏》篇说：“肾合三焦、膀胱。”盖右肾之气上合于心主包络，而为一脏。又《素问·咳论》说：“肾咳不已，则膀胱受之。久咳不已，则三焦受之。”是《内经》只曰肾，原无命门之名。盖以一肾合三焦，一肾合膀胱，是为两脏而配合两腑者也。
春伤于风，夏生飧泄。秋伤于湿，冬生咳嗽。东方生风，是春之气。中央生湿，是土之气，主于夏秋之交，所以说秋伤于湿。阳受风气，阴受湿气。风乃阳邪，故伤于风者，上先受之。阳病者，上行极而下，故春伤于风，夏生飧泄。湿乃阴邪，故伤于湿者，下先受之，阴病者，下行极而上，故秋伤于湿，冬生咳嗽。此天地阴阳之邪，随人气之上下升降者也。冬伤于寒，春必病温。夏伤于暑，秋必疟。夫温病、疟病，皆邪伏于内而后发者。寒乃阴邪，冬时阳气内盛，故邪伏于外，在皮肤之间。至春阳气长盛，外伏之阴邪与阳相遇，邪正相搏，寒已化热，故春发为温病也。暑乃阳邪，夏时阳气在外，里气虚寒，故邪伏于里，在募原之间。至秋阴气长盛，内伏之阳邪与阴相遇，邪正相持，故发为往来寒热之疟。此天地阴阳之邪，随人气之内外出入者也。
柯韵伯说：人知道火能生土，而不知道水能生土；知道土为水仇，而不知道水为土母；只知道脾为至阴，而不知道胃为元阳。盖阳明火气所钟，故主燥化。太阴湿土，真阴之所生，是水之子也。真阴之主，故名太阴；水精所成，故主湿化。阳道主实，又主热，热实相搏，则胃实而地道不通；是以六经亡津液而胃中干燥者，皆得转属于阳明，而阳明则无所复传，是即阳明燥化之为病。此知胃燥反传于脾之说，谬矣。阴道主虚，又主寒，虚寒相搏，则腹满而下利益甚。凡五脏受病自利不渴者，咸属太阴。若脾家实，腐秽反自去，是即太阴湿化之为患。此知脾强反为脾约之说，非矣。土有燥气，所以生金，则燥土是燥金之父也。土有湿气，所以养金，则湿土是肺金之母也。无火则土不生，无水则土亦不生，土不燥则金不生，土不湿则金亦不生，此水火互根，刚柔相须之理也。
喻嘉言说：今人学识未广者，见烦热枯燥等证，不敢用附子者，恶其以热助热也。孰知不藏精之人，肾中阳气不鼓，精液不得上升，故枯燥外见，才用附子助阳，则阴气上交于阳位。如釜底加火，釜中之气水上腾，而润泽有立至者。仲景方辄用附子一枚，今人亦不敢用一钱，总由其识之未充耳。
仲景用桂枝汤以和荣而解肌，此定例也。然不但为太阳中风本药，即少阴经之宜汗者，亦在取用。其最妙处，在用芍药以益阴而和阳。太阳经之荣卫，得芍药酸收，则不为甘温发散所逼，而安其位也。至若少阴，则更为阴藏而少血。所以强逼少阴汗者，重则血从耳目口鼻出，而竭厥可虞；轻亦小便不利，而枯涸可待。用药自当知芍药之例，倍加益阴以和阳。所用桂枝，多入地黄，以匡芍药之不逮，此比例之法也。
程郊倩说：人身以阳气为主，生身之源在此，切须从脉去照顾。浮阳多从证上见出假有余，真阳自从脉上见出真不足，万不可以假乱真也。
Cheng Jiaoqian stated: Limb spasms, numbness, and insensibility are manifestations often seen in wind syndromes. This should be attributed to wind-phlegm obstructing the meridians, leading to the obstruction of Qi flow. When Qi flow is obstructed, it is because Spleen deficiency fails to transport and transform the essence of food and water into Qi. Although tonification is necessary, one must not forget to attack the pathogen, for when Qi flows smoothly, wind dissipates. It is especially crucial to combine attacking with tonifying, strengthening the Spleen and Stomach to bolster the Qi governing the whole body, allowing fluids to reach their destinations, thereby eliminating obstruction. This is the rationale behind the formulation of Wuyao Bawei Shunqi Tang (Eight-Ingredient Cinnamon Twig Decoction).
In cases of vertigo and dizziness caused by wind, the pathology lies in wind affecting the upper part while deficiency exists in the lower part. The treatment method should not directly address the wind but rather nourish the Blood. If the Blood is sufficient in the lower part, the Qi in the upper part will naturally become clear, leaving no room for wind. This embodies the principle of "treating Yang diseases by addressing Yin."
The Heart houses the Spirit (Shen) and governs the Blood, sharing a mother-child relationship with the Spleen (Fire generates Earth). If the Spleen lacks nourishment (fatty tissue and essence), it may drain the Qi of its mother organ (the Heart) for sustenance, causing deficiency to spread to the mother. Symptoms such as forgetfulness, palpitations, and fright are actually caused by Spleen deficiency leading to a lack of fluids and essence. One must ensure that Spleen Qi is strong and does not drain upwards, so that Heart Blood becomes sufficient and can nourish downwards. This is one layer of meaning in Guipi Tang (Restore the Spleen Decoction).
When the Middle Jiao is deficient and cannot transform Qi, Yin rebels downward while Yang is rejected upward. This also belongs to pathogens residing between the exterior and interior. Transforming Xiao Chaihu Tang (Minor Chest Triad Decoction) into Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) shifts the harmonizing action from between the exterior and interior to between the upper and lower parts. The exterior-interior interface belongs to Yang, while the upper-lower interface involves both Yin and Yang. Yin rebellion leads to severe stagnation; therefore, Chaihu (Bupleuri Radix) is removed, Huanglian (Coptidis Rhizoma) is added to resolve Yang heat pathogens, and warming herbs are assisted to break Yin rebellion. Metal (Lung) governs dryness and descending, while Wood (Liver) governs moistening and ascending. Whenever Lung Qi fails to descend due to dryness, it relies entirely on Liver Qi ascending to enable the steaming and moistening of the Five Zang organs to reach the Lungs, thereby generating fluids. Thus, when Liver Qi ascends, the Qi of the Five Zang organs rises in accordance with Spring; when Liver Qi descends, they fall in accordance with Autumn. If Qi descends, the Qi of the Five Zang organs cannot ascend to support the upper body, naturally leading to erosion below. Whenever Earth pathogens sink and overact on Water, or Fire excess scorches Metal, this mechanism is at play. Due to the lack of steaming and moistening, Metal suffers from Fire excess, becoming Dry Metal. With the source of fluids exhausted, who irrigates the entire body? This results in dryness everywhere. When descending functions exceed ascending ones, Damp-Heat pathogens flourish in the lower part, leading to flaccidity syndromes. Damp-Heat, as a pathogenic factor, transforms if it ascends; if it does not ascend, it remains stagnant. To rescue the dryness of Metal, one must follow the ascending command of Wood. By ensuring each Zang organ has its ascending function, Earth generates Metal, Metal generates Water, and Water controls Fire. Whether tonifying or purging, the key lies in this character "Ascending." This is what is meant by Shaoyang serving as the pivot. Therefore, generating fluids and unblocking Qi and Blood constitutes the subtle method of Shaoyang.
Kidney Qi deficiency and cold result in the absence of warm springs to irrigate Liver Wood. Without Yang to nourish Wood, Qi fails to ascend and sinks instead. When Kidney Yin essence intends to store itself, the Liver improperly drains it through dispersing and diffusing, causing Yang to merge into Yin, leading to spontaneous emission of essence and nocturnal emissions involving dreams of sexual intercourse with spirits. The treatment urgently requires assisting Yang within Yin, warming the Liver Wood to promote flourishing, preventing it from draining the mother organ's Qi.
Hernia disease involves the Liver meridian encircling the genitalia, a place most susceptible to Cold. Wetness shares affinity with Cold; Cold and Dampness condensing in the Yin regions form solid masses. Unlike Yang meridians where Qi easily gathers and scatters, here stagnation forms. The classics state: "When one Yin is excessive, pulses swell and blockage occurs," indicating hernia involves much stagnation. One should seek causes in Cold-Dampness and break this Yang stagnation.
Essence is Water, which cannot form without Fire. Fire is the True Qi of the human body. Insufficient True Qi leads to internal cold, preventing the refinement of essence. The classics say: "The essence of Water is Zhi (Will), the essence of Fire is Shen (Spirit)." Only when Heart and Kidney interact as one family, with Water sandwiched between two Fires, starting from the interaction of two essences reaching Kan and Li (Water and Fire), is this called Dingheng (refining elixir).
Excess in the Liver, lacking the ascent of Kidney Water, allows Yang to dominate alone, so excess pathogens manifest in the Upper Jiao. Deficiency in the Kidney, lacking the descent of Liver Fire, allows Yin to dominate alone, so deficiency causes manifest in the lower part. By addressing the Liver and Kidney meridians and communicating the energy of Mountain and Marsh, tonifying the Kidney benefits the Liver. In Kidney Yin deficiency with Yang encroaching, there is no internal defense, leading to hyperactive Yang and weaker Yin, causing spontaneous semen emission and leakage upon heat. Treatment should tonify Kidney Yin and clear Heart Fire. Since the Heart is the source of Fire, if Fire is undisturbed, Water calms itself.
In Yin deficiency, Water depletion fails to nourish Wood, damaging Ying Blood. Consequently, Yang Fire dominates alone. Without blood lubrication, it draws upon Kidney Water for self-rescue. However, a drop of water cannot extinguish raging fire; instead, it vaporizes, boiling blood, leading to hemoptysis originating from the Kidney. At this stage, replenishing Ying deficiency, strengthening the Master of Water, nourishing Yin, and retreating Yang constitute the correct treatment. However, these methods must include breaking stagnation, as coagulated blood becomes dry, dryness leads to stasis, and previous use of cold-cooling herbs may cause stasis even where none existed.
Ear suppuration and ulcers occur because the Kidney opens into the ears. Yin rebellion below causes Yang to float above, and pathogens enter via deficiency. Thus, treating upper deficiency requires tonifying the lower first, seeking to anchor Qi in the two Kidneys, then clearing and releasing the Upper Jiao. This is effective because abundant essence repels pathogens.
Kidney deficiency causing deafness and tinnitus, along with headache in the temporal or frontal regions, results from Yin below and Yang above repelling each other, affecting the vertex. This is lower deficiency and upper excess, known as "Jue transforming into head disease." Extreme Yin deficiency cuts off Heaven Qi; extreme Yang excess depletes Earth Qi. Therefore, deficiency requires warming to put Yang within Yin, preventing lower emptiness; excess requires purging to put Yin within Yang, preventing upper fullness. Tonifying Liver and Kidney follows parallel paths without contradiction.
The head is Heaven, residing in Yang among Yang. Its ability to receive the upbearing of Earth's Yin essence relies entirely on the Du Mai (Governing Vessel) and Chong Mai (Penetrating Vessel) leading the essence of Water and Fire from the Kidneys to converge at the vertex. If Du and Chong are deficient and fail to reach, Yin essence cannot upbear, leading to cicada-like tinnitus, hair loss, and various deficiency signs appearing above. Treating upper deficiency still requires tonifying the lower, as the source of life Qi lies in the Kidney's Water and Fire, not above.
Water has True Water and Guest Water. When Kidney Qi is warm, Guest Water is摄 (controlled) and returns to True Water; when Kidney Qi is cold, True Water turns into Guest Water. Guest Cold attacks, causing heaviness and pain in the body. Zhenwu Tang (True Warrior Decoction) plants Fire within Earth, allowing True Water to be controlled from warmth, transforming Guest Water back to True Water, without needing diuretic drainage.
The human body prioritizes Yang Qi as the root of growth and development. Sometimes Yin is borrowed to support Yang (Wife Yin), coexisting peacefully; sometimes Yin is rejected to extend Yang (Thief Yin), guarding against its theft. The classics say: "Knowing Yang means knowing Yin; knowing Yin means knowing Yang." Pulses have Yin and Yang aspects; the surplus and deficit of pathological mechanisms depend于此. Investigating this deeply reveals the source of disease.
Disease progression depends on pulses. Yang contains Yin, and Yin contains Yang; one must examine the intersection of disease and pulse, and contrast discrepancies between them. Life can be sought in death, and death guarded against in life, all within the reversal of Yin and Yang.
Sweating and purging methods apply to tangible Yin and Yang but not intangible ones. Tangible pathogens exit via sweat or purge, restoring balance. Intangible damage from mistaken sweating/purging depletes Zang Qi, harming Yin or Yang irreparably. Among the Six Channels, Shaoyin and Jueyin often present false symptoms like restlessness or floating red face, but their pulses are true. Yangming may show false pulses like deep pulse in deep heat, but oral dryness and insomnia remain real. Taiyang has no false signs; pulse floats, fever exists. However, Taiyang shares Cold-Water governance with Shaoyin, so exterior symptoms root in the interior. Floating pulse distinguishes excess (exterior) from deficiency (interior); fever distinguishes branch (pathogen) from root (righteous Qi). People often focus only on the exterior/pathogen, missing the interior/righteous Qi, leading to mishandling and transformation from Taiyang. This is not Taiyang falsity but failure to distinguish root/branch or excess/deficiency. Shaoyang always originates from Taiyang; without Taiyang symptoms, Shaoyang does not form.
Shaoyin requires the control of Fuyang pulse to interact with Sanjiao. Sanjiao Qi ascending becomes Spirit (Shen), Yuan Yang penetrating the brain to Marrow Sea creates Divine Light, the ancestor of Ying and Wei generation. Shaoyin Qi ascending becomes Ghost, Ben Tun (running piglet) invading passes, stealing Red Palace (Heart) creating Dead Qi, due to Fuyang losing command. Being Spirit or Ghost depends on Fuyang's victory. Abundant Ying/Wei below ensures warm springs; thick Fuyang above excludes Yin Qi.
Luo Dongyi stated: Tonifying Liver involves nourishing Yin; Kidney and Liver share treatment principles. Liver Wood receives Shaoyang Qi to stimulate Earth pulses; without Shaoyang, it does not rise. For Wood to grow freely, it needs Taiyin. Thus, Liver feeds on Spleen. Tonifying Liver requires raising Wood within Earth. Shengma and Chaihu in Buzhong Yiqi Tang raise Shaoyang to lift Earth; Baizhu and Fuling in Xiaoyao San raise Taiyin to lift Wood. Predecessors had this idea but did not elaborate fully.
Yu Jiayan said: Lung dryness prefers moistening; Spleen stagnation struggles with food transport. In extreme Spleen-Stomach deficiency with poor appetite, add Ginseng and Atractylodes to Lung-clearing herbs to tonify Spleen. In extreme Lung dryness with frequent coughing, add Ejiao to Spleen-tonifying herbs to moisten dryness. Treating Dragon-Leopard Fire relies on storage and collection.
Diseases affecting the Stomach channel may not show Stomach pulse abnormalities; instead, pulses of Heart, Kidney, Liver, and Lung on both sides fluctuate abnormally. This is not local pathology but central Qi weakness failing to reach four directions, like a starving child due to weak mother. Treat with Sijunzi Tang (Four Gentlemen Decoction) to regulate Spleen-Stomach, turning the central pivot to benefit surrounding mechanisms.
When Human Yin Qi declines, it loses autonomy and rises with Yang. All leakage represents precious bodily substances. Unless gathered and returned to origin, where will it end? Hence, formulas in *Shiqin Yanglao* focus on warming and tonifying the Lower Origin. Young people fear Fire; elderly fear lack of Fire. Lack of Fire makes circulation difficult and aging rapid. Fire is the root of the elderly's life; it cannot be lightly suppressed by Water. Ancients treated throat dryness with Bawei Wan (Eight-Ingredient Pill), likening it to adding fire to the pot bottom to steam moisture upward. Lower deficiency implies not just Yin but also Yang deficiency. Yang values submergence; submerged, it does not hyperactivity and lasts long. Once True Yin is deficient, lone Yang loses control, floating up as heat. If gathered and controlled below, turbid phlegm in mouth and nose cease, and saliva generates constantly.
There are three sources of Qi regulation: Lung Qi, clear and descending; Stomach Qi, harmonious and facilitating downward movement of chest Qi; Bladder Qi, strong and attracting chest Qi downward. Danzhong (Pericardium/Chest) chaos resolves relying on these three. If these three fail, chest tightness and distension occur. Crucially, the chest is empty like the sky; Earth Qi rises as clouds, Heaven Qi descends as rain for Earth Qi to store. This emphasizes Bladder. Danzhong is above diaphragm; Bladder is in abdomen. Bladder Qi transformation allows spaciousness, enabling Danzhong Qi to descend; without transformation, abdominal distension prevents Danzhong Qi from reaching down. Power lies in preserving Kidney. Kidney Qi moves to Bladder first; Bladder fullness rushes to chest. If Kidney Qi stays, storage is firm, Bladder remains quiet, and Danzhong Qi fills without overflow.
Danxi's texts claim left-sided disease involves more Blood, right-sided more Qi. *Neijing* states: "Left and right are pathways of Yin and Yang." Since they are pathways, one cannot bias. Left dominated by Blood needs Qi to circulate; Right dominated by Qi needs Blood to adhere. Liver/Gallbladder reside left but Qi travels right; Spleen/Stomach reside right but Qi travels left, ensuring continuous life. Treating unilateral disease should guide Yin to Yang, Left to Right, etc., like watering non-withered parts of a tree to revive the withered.
Zhang Yin'an cited *Lingshu*: "Shaoyang connects to Kidney, Kidney connects to Lung, thus managing two Zang." Shaoyang is Sanjiao's vital Qi, originating from Right Kidney connecting to Pericardium, source of Ministerial Fire. Left Kidney belongs to Water, connecting to Lung. *Ben Cang* chapter: "Kidney combines with Sanjiao and Bladder." Right Kidney Qi connects to Heart/Pericardium. *Suwen* Cough Chapter: "Kidney cough persists, Bladder receives it; long-term cough, Sanjiao receives it." *Neijing* mentions only Kidney, no Mingmen. One Kidney combines with Sanjiao, one with Bladder, forming two Zang-Fu pairs.
Spring Wind injury leads to Summer diarrhea; Autumn Dampness injury leads to Winter cough. East generates Wind (Spring); Center generates Dampness (Earth, late Summer/Autumn). Yang receives Wind (Yang pathogen, affects upper first); Yin receives Dampness (Yin pathogen, affects lower first). Yang disease goes up then down (Spring wind -> Summer diarrhea). Yin disease goes down then up (Autumn damp -> Winter cough). These pathogens follow Qi升降 (ascending/descending). Winter Cold injury leads to Spring Warmth disease; Summer Heat injury leads to Autumn Malaria. Warmth and Malaria pathogens lie dormant internally before erupting. Cold (Yin pathogen) in Winter (internal Yang strong) lies externally in skin. Spring Yang grows, external Yin meets Yang, fights, Cold transforms to Heat -> Spring Warmth. Heat (Yang pathogen) in Summer (external Yang, internal cold) lies internally in Muscular Intervals. Autumn Yin grows, internal Yang meets Yin, holds -> Autumn alternating chills/fever Malaria. These pathogens follow Qi 出入 (entering/exiting).
Ke Yunbo stated: People know Fire generates Earth but not Water generates Earth; know Earth opposes Water but not Water is Mother of Earth; know Spleen is Ultimate Yin but not Stomach is Prime Yang. Yangming gathers Fire Qi, governing Dryness transformation. Taiyin is Wet Earth, born of True Yin, child of Water. Named Taiyin as master of True Yin; generates Moisture transformation. Yang path governs Excess and Heat; Heat-Excess struggle causes Stomach excess and bowel blockage. Six channels losing fluids and drying in Stomach transfer to Yangming, which transmits nowhere, causing Yangming Dryness disease. Saying Stomach dryness transfers to Spleen is wrong. Yin path governs Deficiency and Cold; Deficiency-Cold struggle causes abdominal fullness and worsening diarrhea. All five Zang deficiencies with diarrhea and no thirst belong to Taiyin. If Spleen is Excess, rotting filth expels itself, causing Taiyin Moisture disease. Saying Spleen strength causes Spleen Confinement is wrong. Earth has Dryness generating Metal (Dry Earth is father of Dry Metal); Earth has Moisture nourishing Metal (Wet Earth is mother of Lung Metal). No Fire, Earth doesn't generate; No Water, Earth doesn't generate; Not Dry, Metal doesn't generate; Not Wet, Metal doesn't generate. This is mutual root of Water/Fire, interdependence of Hard/Soft.
Yu Jiayan said: Unlearned doctors avoid Fuzi (Aconite) for hot-dry symptoms fearing Heat aggravating Heat. They don't know that in those who fail to store Essence, Kidney Yang fails to stir, preventing Essence rising, causing external dryness. Using Fuzi to assist Yang sends Yin Qi to Yang positions. Like adding fire to pot bottom, steam rises instantly moistening. Zhang Zhongjing used one piece of Fuzi; moderns dare not use one qian, due to insufficient knowledge.
Zhang Zhongjing uses Guizhi Tang (Cinnamon Twig Decoction) to harmonize Ying and release muscle, standard for Taiyang Wind Strike. But it is also used for Shaoyin requiring sweating. Its brilliance lies in Shaoyao (Peony Root) nourishing Yin and harmonizing Yang. Taiyang Ying-Wei, aided by Shaoyao's sour astringency, avoids being forced by sweet-warm dispersants, stabilizing position. Shaoyin is Yin Zang with little Blood. Forcing sweat in Shaoyin risks bleeding from eyes/ears/mouth/nose and exhaustion/collapse; mildly, urinary difficulty and dehydration. One must use Shaoyao example, doubling Yin-nourishing to harmonize Yang. Guizhi combined with Dihuang (Rehmannia Root) aids Shaoyao's insufficiency, a proportional method.
Cheng Jiaoqian said: The body prioritizes Yang Qi, source of life. Must attend to pulses. Floating Yang shows false excess in symptoms; True Yang shows true deficiency in pulses. Never confuse false with true.