君为主,臣为辅,佐为助,使为用,制方之原也。逆则攻,从则顺,反则异,正则宜,
治病
之法也。必热必寒必散必收者,君之主也;不宜不明不授不行者,臣之辅也;能授能令能合
能
分,佐之助也;或劫或开或击或散,使之用也。破寒必热,逐热必寒,去燥必濡,除湿必渗
者,逆则攻也。治惊则平,治损须益,治留须攻,治坚须溃者,从则顺也。热病用寒药,而
导寒攻热者必热,如阳明病发热,大便硬者,大承气汤、酒制大黄热服之类是也。寒病用热
药,而导热去寒者必寒,如少阴病下利,服附子、干姜不止者,白通加人尿、猪胆之类是也
。塞病用通药,而导通除塞者必塞,如胸满烦惊小便不利者,柴胡加龙骨、牡蛎之类是也。
通病用塞药,而导塞止通者必通,如太阳中风下利,心下痞硬者,十枣汤之类是也。反则异
也,治远以大,治近以小,治主以缓,治客以急。正则宜也,至真大要论曰∶辛甘发散为阳
,酸苦涌泄为阴,淡味渗泄为阳,咸味涌泄为阴,六者,或收或散,或缓或急,或燥或润,
或软或坚,或以所利而行之,调其气使之平,故味之薄者,为阴中之阳,味薄则通,咸苦盐
平是也。气之浓者,为阳中之阳,气浓则发热,辛甘温热是也。气之薄者,为阴中之阳,气
薄则发泄,辛甘淡平温凉是也。味之浓者,为阴中之阴,味浓则泄,盐寒酸苦是也。《易》
曰∶同声相应,同气相求,水流湿,火就燥,云从龙,风从虎。圣人作而万物睹,本乎天者
亲上,本乎地者亲下,则各从其类也。故治病制方者,须本此说而推之。
君药是主药,臣药是辅佐药,佐药是协助药,使药是引导药,这是组方的基本原则。逆治法用于攻邪,顺治法用于顺应病势,反治法用于特殊情形,正治法用于适宜情况,这是治疗疾病的方法。必须用热药、寒药、散药或收涩药来确立君药的主导地位;对于不明确、不授予、不施行的情况,由臣药进行辅助;能够授予、发令、配合或区分作用的,是佐药的协助功能;或者劫夺、开通、击破或消散病邪,是使药的应用。破除寒邪必须用热药,驱逐热邪必须用寒药,去除燥邪必须用润药,祛除湿邪必须用渗利药,这属于逆治法(攻邪)。治疗惊悸需要平定,治疗虚损需要补益,治疗留滞需要攻逐,治疗坚硬需要软坚溃散,这属于顺治法(顺应)。热病使用寒药,但引导寒药以攻热时,服药温度必须是热的,例如阳明病(Yangming disease)发热、大便硬结的情况,使用大承气汤(Da Chengqi Tang)、酒制大黄热服等就是此类。寒病使用热药,但引导热药以去寒时,服药温度必须是冷的,例如少阴病(Shaoyin disease)下利,服用附子、干姜不止者,使用白通加人尿、猪胆汤等就是此类。闭塞之病使用通利药,但引导通利药以除塞时,服药方式或药性需体现“塞”的制约,例如胸满、烦惊、小便不利者,使用柴胡加龙骨牡蛎汤等就是此类。通利之病使用固涩药,但引导固涩药以止通时,服药方式或药性需体现“通”的转化,例如太阳中风(Taiyang wind-strike)伴下利、心下痞硬者,使用十枣汤等就是此类。反治法是指情况不同,治疗远处病变用大方,治疗近处病变用小方,治疗主病用缓剂,治疗客病用急剂。正治法是适宜的,《至真要大论》说:辛味和甘味发散属阳,酸味和苦味涌吐泄降属阴,淡味渗湿泄降属阳,咸味涌吐泄降属阴,这六类药味,有的收敛,有的发散,有的缓和,有的紧急,有的燥湿,有的滋润,有的软坚,有的坚固,根据病情有利而行,调理气机使之平衡,所以味道薄的药,属于阴中之阳,味道薄则能通利,如咸、苦、盐平之品。气味浓厚的药,属于阳中之阳,气味浓厚则能发热,如辛、甘、温、热之品。气味薄的药,属于阴中之阳,气味薄则能发泄,如辛、甘、淡、平、温、凉之品。味道浓厚的药,属于阴中之阴,味道浓厚则能泄降,如盐、寒、酸、苦之品。《易经》说:同样的声音相互呼应,同样的气息相互追求,水往湿处流,火向干燥处烧,云跟随龙而生,风跟随虎而起。圣人兴起而万物显现,源于天的亲近上方,源于地的亲近下方,则各自跟随其同类。因此,治病和组方的人,必须依据这一学说加以推演。
The Sovereign herb (Jun, 君) is the principal agent, the Minister herb (Chen, 臣) is the assistant, the Assistant herb (Zuo, 佐) is the helper, and the Envoy herb (Shi, 使) is the guide; this is the origin of formula composition. Adverse treatment (Ni, 逆) attacks the pathogen, conforming treatment (Cong, 从) follows the disease trend, contrary treatment (Fan, 反) addresses special conditions, and orthodox treatment (Zheng, 正) is suitable for standard cases; this is the method of treating diseases. The necessity of using hot, cold, dispersing, or astringent herbs to establish the dominance of the Sovereign herb; the handling of unclear, ungranted, or unexecuted aspects by the Minister herb as assistance; the ability to grant, command, combine, or separate functions characterizes the assistance of the Assistant herb; while劫夺 (jie, seizure/elimination), opening, striking, or dispersing pathogens constitutes the application of the Envoy herb. To break cold, heat must be used; to drive out heat, cold must be used; to remove dryness, moistening must be used; to eliminate dampness, leeching/drainage must be used; this is adverse treatment (attacking). To treat palpitations/fright, calming is required; to treat deficiency, tonification is needed; to treat stagnation, purging is necessary; to treat hardness, softening and dissolving are required; this is conforming treatment (following). In heat diseases, cold herbs are used, but when guiding cold herbs to attack heat, the administration temperature must be hot; for example, in Yangming disease (Yangming Bing) with fever and hard stool, Da Chengqi Tang (Major Order the Qi Decoction) or taking Rhizoma et Radix Notoginseng processed with wine (Jiu Zhi Da Huang) hot is such a case. In cold diseases, hot herbs are used, but when guiding hot herbs to remove cold, the administration temperature must be cold; for example, in Shaoyin disease (Shaoyin Bing) with diarrhea, if Fuzi (Prepared Aconite Root) and Shengjiang (Dried Ginger) fail to stop it, Ba Tong Tang plus human urine and pig gallbladder is such a case. For obstructive diseases, unblocking herbs are used, but when guiding unblocking herbs to remove obstruction, the nature/method reflects 'obstruction'; for example, with chest fullness, fright, and difficult urination, Chai Hu Jia Long Gu Mu Li Tang (Bupleurum Decoction plus Dragon Bone and Oyster Shell) is such a case. For unblocking diseases, astringent herbs are used, but when guiding astringent herbs to stop unblocking, the nature/method reflects 'unblocking'; for example, in Taiyang wind-strike (Taiyang Zhong Feng) with diarrhea and epigastric stiffness, Shi Zao Tang (Ten Date Decoction) is such a case. Contrary treatment implies difference: treating distant ailments uses large formulas, treating nearby ailments uses small formulas, treating primary diseases uses slow-acting agents, and treating secondary/invading ailments uses urgent agents. Orthodox treatment is appropriate; the Treatise on the Great Truth states: Pungent and sweet flavors that disperse belong to Yang; sour and bitter flavors that induce vomiting and purging belong to Yin; bland flavors that leech and drain belong to Yang; salty flavors that induce vomiting and purging belong to Yin. These six categories either astringe or disperse, either soothe or urgent, either dry or moisten, either soften or harden. They are administered according to what benefits the condition, regulating Qi to achieve balance. Therefore, herbs with thin flavors belong to Yin within Yang; thin flavors promote unblocking, such as salty, bitter, and salt-balanced substances. Herbs with thick aromas belong to Yang within Yang; thick aromas generate heat, such as pungent, sweet, warm, and hot substances. Herbs with thin aromas belong to Yin within Yang; thin aromas promote excretion/dispersal, such as pungent, sweet, bland, neutral, warm, and cool substances. Herbs with thick flavors belong to Yin within Yin; thick flavors promote purging/drainage, such as salty, cold, sour, and bitter substances. The I Ching says: Sounds of the same pitch resonate with each other; energies of the same type seek each other. Water flows to wetness; fire moves towards dryness. Clouds follow dragons; winds follow tigers. When sages arise, all things become visible. Those originating from Heaven亲近 (qin, approach/close to) the upper; those originating from Earth亲近 (qin, approach/close to) the lower; thus each follows its own kind. Therefore, those who treat diseases and compose formulas must deduce from this theory.