东垣曰∶“相火者,元气之贼也。”丹溪述之,景岳非之。论曰“情欲之火,邪念也,邪念之火为邪气,非相火之所
为也。”二家之说俱有词障。夫相火者,肾中之真阳,禀自先天,为人生之根本,云为动作赖之以立,衰则病,息则死。
老子曰∶“一”生二。”周子曰∶“无极而太极,太极动静而生阴阳。”是相火一人身之太极也,太极不能无动,然动而有
节,即是少火以生气,动而无制,则为壮火以害气,如水能浮舟,亦能覆舟,实一相火之所为,岂得另有邪火也?故人
之喜怒爱惧,不过五藏之本志,男女大欲,则又万物之化醇,是皆天地间经常之理,原不至于伤生,惟狂荡无节,斯为
害耳。然相火既定位于下焦,蒸腾发育,夫能使之理胜而安,欲胜而危者,则唯一心,故心为君火。《经》曰∶“君火以
明,相火以位。”又曰∶“主不明则十二官危。”此其尤大彰明较着者也。《大学》正心,释氏降伏其心,养生者善治其心。
则推而极之,为圣贤,为仙佛,守而持之,康宁寿考。若舍君而言相,无怪乎或为元气之贼,或为生气之本,意旨岐趋,
则泻火补阳,争门角立,党同伐异,欲为阐发前贤,恐先与《经》旨相谬。
“五方风土异宜,古今元气不同”,医林每奉此二语为治病立方之要旨。以为西北高燥多寒,东南卑湿多热,高燥则
筋骨劲强,卑湿则肌肉柔弱,此分情势之刚柔,非以判本原之强弱,故《内经·异法方宜论》、《五常政大论》,圣人早为
详言之。至古今元气不同,则愚窃有说焉。皇古之世,寿称千百,荐绅先生难言之,或者书缺有间,未足征信欤?《尚
书》载自帝尧以来,则皆彰彰可考,所谓元气之浓薄,必征诸寿数之短长,故古人之元气不可见,而古人之寿数有可稽。
唐虞三代,已不闻有数百岁之人,观之孔颜,尤明验也。仲师诞生于汉,为制方之祖,其用药也,不啻数倍于今,由其
察脉真,审证确,任使精专,一汤日作数服,病愈或不终剂,盖有是病,必用是药,去疾务尽,断断然也,然非谓汉时
气浓则可也。古者以百岁为上寿,七八九十者为老,递降而夭殇,自汉迄今,果有异欤?盖至诚无息,天地之体未有久
而渐薄之理,惟天地无心于造物,人禀天地之气以生者,原各得此百年之用,而修短不齐者,人自有其浓薄耳,今古一
辙也。不然,轩岐垂教,长沙祖述,岂专为一方一代而言哉?若谓今之人禀气日薄,则善乎徐洄溪有草木之性随之亦薄
之论,此又不移至理也。自元气不同之说行,群以古法不宜于今,麻、桂虑其亡阳,姜、附畏其劫阴,柴、葛以升而代
之,硝、黄以厉而制之,即偶然一用,不过数分,病则犹是也,药则不及矣,安能奏效乎?因是邪不去,正立亡,始之
以谨慎爱之者,终之以因循害之也。故愚以为学人,当专务审证辨脉,既得证因之本,幸勿拘元气不同之见,当宗古人
用药而稍减之,矫今人立方而增重之,庶几病气速除,生机不息矣。鼎也学识浅陋,有志未逮,书此以俟之。
李东垣说:“相火,是元气的贼害。”朱丹溪继承了这个观点,张景岳则反对它。张景岳论述道:“情欲之火,属于邪念;由邪念产生的火属于邪气,并非相火的作用。”这两家的说法都存在一定的局限。所谓相火,是肾中的真阳之气,禀受于先天,是人生的根本,人的言语动作都依赖它来确立,它衰弱就会生病,它停止就会死亡。
老子说:“一生二。”周敦颐说:“无极而生太极,太极动静而生成阴阳。”因此,相火就是人身体的太极。太极不可能没有动静,但是动静有节制,就是“少火”从而滋生元气;如果动静失去控制,就是“壮火”从而损害元气。这就像水能浮起船,也能翻覆船,实际上都是相火的作用,难道还能另外存在所谓的邪火吗?所以人的喜怒爱惧,不过是五脏的本性志向;男女的大欲,则是万物化育醇厚的表现。这些都是天地间正常的道理,原本不至于伤害生命,只有狂荡无节制,才会造成危害。
既然相火已经定位于下焦,负责蒸腾发育,那么能够使其理胜而安、欲胜而危的,只是一颗心,所以心被称为君火。《黄帝内经》说:“君火以明,相火以位。”又说:“主不明则十二官危。”这是尤其明显确凿的道理。《大学》讲究正心,佛教讲究降伏其心,养生者善于治理其心。如果能推演到极致,就能成为圣贤、仙佛;如果能坚守持守,就能健康长寿。如果舍弃君火而只谈相火,难怪会出现有的说是元气的贼害,有的说是生气的根本,意旨分歧趋向不同,导致泻火与补阳两派争论不休,结党营私排斥异己,想要阐发前贤的思想,恐怕先就与《内经》的宗旨相违背了。
“五方风土适宜不同,古今元气有所不同”,医林人士常常奉这两句话为治病立方的重要宗旨。认为西北高燥多寒,东南卑湿多热,高燥则筋骨强劲,卑湿则肌肉柔弱,这是区分形势的刚柔,并不是用来判断本原强弱的,所以《内经·异法方宜论》和《五常政大论》中,圣人早就详细论述过了。至于古今元气不同这一点,我私下里有些看法。远古时代,寿命号称千百岁,士大夫先生们难以言说,或许是书籍残缺有所间断,不足以取信吗?《尚书》记载从帝尧以来,都清晰可考。所谓元气的浓薄,必须通过寿命的长短来验证,所以古人的元气不可见,但古人的寿命却有据可查。唐虞三代时期,已经听不到有几百岁的人了,看孔子和颜回的情况,更是明显的证据。
张仲师诞生于汉代,是制方的始祖,他用药量不止是现在的数倍,因为他诊脉真实,审证确切,任用药物精专,一剂汤药一天做成几次服用,病好了甚至不需要服完一剂,大概是有这种病,就一定用这种药,去除疾病务必彻底,这是毫无疑问的,但这并不意味着汉时的元气浓厚就可以这样用药。古代以百岁为上寿,七八九十岁称为老,依次递减直到夭折早逝,从汉代到现在,果真有什么不同吗?大概至诚是没有止息的,天地的本体没有久而逐渐变薄的道理,只是天地无心于造物,人禀受天地之气而生的人,原本各得此百年的效用,而修短不齐,是人自己有不同的浓薄罢了,今古是一样的。不然的话,轩辕、岐伯垂教,长沙太守(张仲景)祖述,难道是专门针对一方一代来说的吗?如果说现在的人禀受的元气日益淡薄,那么徐洄溪有草木的性质也随之变薄的理论,这就不是不移之理了。
自从“元气不同”的说法流行开来,大家普遍认为古法不适合现在,担心麻黄、桂枝会导致亡阳,姜、附子害怕劫伤阴液,用柴胡、葛根以升提代替,用芒硝、大黄以猛烈而加以制约,即使偶然使用一次,也不过几分重,病还是那个病,药力却不够了,怎么能奏效呢?因此邪气不去,正气立刻消亡,开始是因为谨慎爱惜病人,最终却因为因循守旧而害了病人。所以我认为求学之人,应当专心致力于审证辨脉,既然得到了证因的根本,希望不要拘泥于元气不同的见解,应当遵循古人用药而稍微减少剂量,纠正今人立方而增加重量,这样或许能使病气迅速去除,生机不息。鼎(作者自称唐大烈)学识浅陋,有志未逮,写下这些以等待高明之士指正。
Li Dongyuan stated: "Xianghuo (Ministerial Fire) is the thief of Yuanqi (Original Qi)." Zhu Danxi elaborated on this, while Zhang Jingyue refuted it. Zhang argued: "Fire arising from emotions and desires belongs to evil thoughts; fire generated by evil thoughts constitutes pathogenic factors, which is not the function of Xianghuo." The arguments of both schools have their limitations. Xianghuo refers to the True Yang within the Kidney, inherited from the congenital state, serving as the root of life. Human speech and movement rely on it for establishment; when it declines, disease occurs, and when it ceases, death follows.
Laozi said: "One generates Two." Zhou Dunyi stated: "Wuji gives rise to Taiji; the movement and stillness of Taiji generate Yin and Yang." Thus, Xianghuo is the Taiji of the human body. Taiji cannot be without movement or stillness. However, if movement is regulated, it constitutes Shaohuo (Lesser Fire), which generates Qi; if movement lacks control, it becomes Zhuanghuo (Greater Fire), which damages Qi. This is like water that can float a boat but also capsize it; in reality, all are functions of Xianghuo. How could there be another type of pathogenic fire? Therefore, human emotions such as joy, anger, love, and fear are merely the inherent aspirations of the Five Zang Organs. The great desire between men and women represents the醇厚 (richness/essence) of the transformation of all things. These are normal principles in heaven and earth, originally not harmful to life. Only when they become wild and unregulated do they cause harm.
Since Xianghuo is located in the Lower Jiao and responsible for steaming and development, the only factor that can ensure its rationality leads to peace while excessive desire leads to danger is the Heart. Hence, the Heart is called Junhuo (Monarch Fire). The *Huangdi Neijing* states: "Junhuo illuminates, while Xianghuo maintains its position." It also says: "If the Ruler is not enlightened, the Twelve Officials are in peril." This is a particularly evident principle. The *Great Learning* emphasizes rectifying the mind; Buddhism advocates subduing the mind; those who practice health preservation excel at governing the mind. If pushed to the extreme, one becomes a sage or an immortal/Buddha; if maintained, one enjoys health and longevity. If one discards Junhuo and discusses only Xianghuo, it is no wonder that some view it as the thief of Original Qi while others see it as the root of generating Qi. Such divergent intentions lead to disputes between clearing fire and tonifying yang, factionalism, and attacks on differing views. In attempting to elucidate the thoughts of former sages, one might first contradict the intent of the *Classic*.
"The five regions have different climatic suitability, and the Original Qi of ancient times differs from that of modern times." Medical practitioners often regard these two statements as the essential principles for treating diseases and prescribing formulas. They believe that the northwest is high, dry, and cold, while the southeast is low, damp, and hot. High and dry conditions make bones and sinews strong, whereas low and damp conditions make muscles weak. This distinguishes the rigidity and flexibility of physical constitution, not the strength or weakness of the original source. Therefore, in the *Yi Fa Fang Yi Lun* (Treatise on Different Methods and Suitable Areas) and *Wu Chang Zheng Da Lun* (Great Treatise on the Five Regular Policies) of the *Neijing*, the sages had already detailed this. Regarding the difference in Original Qi between ancient and modern times, I have my own perspective.
In the remote antiquity, lifespans were claimed to be hundreds or thousands of years, yet scholars found this difficult to explain. Perhaps books are missing gaps, making it unreliable? The *Book of Documents* records from Emperor Yao onwards, which are clearly verifiable. The thickness or thinness of Original Qi must be verified by the length or shortness of lifespan. Thus, while ancient Original Qi is invisible, ancient lifespans are traceable. By the Tang, Yu, and Three Dynasties periods, there were no longer people living for hundreds of years, as evidenced by Confucius and Yan Hui. Zhang Zhongjing was born in the Han Dynasty and is the ancestor of formula creation. His use of herbs was several times greater than that of today because he accurately diagnosed pulses and precisely assessed syndromes, using medications with precision. One decoction was taken in multiple doses daily; if the illness was cured, the full course might not even be finished. He believed that for every disease, there is a specific medicine, and eliminating the disease must be thorough. This does not imply that the Original Qi of the Han Dynasty was thicker to justify such dosage.
In ancient times, 100 years was considered the highest longevity, and 70-90 years was old age, decreasing sequentially until premature death. Is there truly a difference from the Han Dynasty to now? Sincerity has no rest; the body of Heaven and Earth does not have a principle of gradually thinning over time. Since Heaven and Earth are unintentional in creation, humans endowed with the Qi of Heaven and Earth originally possess the capacity for a hundred years. Variations in lifespan are due to individual differences in the thickness of their Qi, which is consistent across ancient and modern times. Otherwise, would Xuanyuan (Yellow Emperor) and Qibo's teachings, and Zhang Zhongjing's succession, be intended solely for one region or era? If one claims that modern people inherit increasingly thinner Qi, then Xu Huixi's theory that the nature of herbs also becomes thinner accordingly is not an immutable truth.
Since the theory of "different Original Qi" became popular, everyone assumed ancient methods were unsuitable for modern times. They feared Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) would cause Yang collapse, and Shengjiang (Zingiberis Rhizoma Recens) and Fuzi (Aconiti Lateralis Radix Praeparata) would劫伤 (rob/injure) Yin. They substituted Chaihu (Bupleuri Radix) and Gegen (Puerariae Lobatae Radix) for ascending actions, and restricted Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) due to their harshness. Even when used occasionally, the dosage was only a few fen. The disease remained the same, but the medicinal power was insufficient, so how could efficacy be achieved? Consequently, pathogens are not expelled, and healthy Qi perishes immediately. What began as caution and care for the patient ends up harming them through inertia. Therefore, I believe students should focus exclusively on assessing syndromes and differentiating pulses. Once the root of the syndrome and cause is identified, one should not be constrained by the view of differing Original Qi. Instead, one should follow ancient herbal usage but slightly reduce the dosage, correcting the modern tendency to increase dosages in prescriptions. This way, pathogenic Qi will be removed quickly, and vital energy will remain uninterrupted. Ding (the author referring to himself, Tang Dale) possesses shallow learning and unfulfilled ambitions, writing this to await correction from experts.