春温、夏热、秋燥、冬寒,固病之常,若夫疫者,秽恶之气,互相传染,吴又可论之详矣。惟吴氏谓从口鼻而入,
即踞膜原,愚谓既由口鼻吸受,肺为出入之门户,无有不先犯肺者。疫皆热毒,肺金所畏,每见此症之身热,先有憎寒,
肺先病也;继而充斥三焦,或有径入心胞者。所云厉气,无非郁热,是以喻西昌所讲瘟、温二字,未尝区别,盖亦有见
乎此耳。况所云“上焦如雾,升逐解毒,中焦如沤,疏逐解毒,下焦如渎,决逐解毒”,总不脱一毒字者,其为郁热,意
在言表矣。更有患此病者,纵饮冷水,亦能大汗而解,此非热毒之明验乎?至于疫邪虽解,而肺蓄余热,每多咳呛、肌
热、自汗等证,亦所谓肺先受病而未愈之明征也。又有大旱之年,水涸日烈,河水每多热毒,饮其水者,多发疫痢,以
痢门常法治之无效,余于治痢方中,加以贯众之苦寒解毒,无不应手取效,此亦热毒之一验也,合并志之。
丹溪论阳有余,阴不足,所谓阳者,相火也。景岳驳之,谓阴有余,阳不足,而着“相火以位”之辨。各树旗帜,
几如冰炭之不相入矣。尝举二者参之,丹溪大旨,本于周子主静立说,谓相火一动,则五志厥阳之火并煽,煎熬真阴,
故东垣目为元气之贼。此论相火二字,专从后天之变动者言,与景岳之主命门,有源流之别。夫“天非此火不能生物,
人非此火不能有生”,考前哲如褚氏、赵氏,人生先具命门及相火,行阳二十五度之语参之,景岳所云,相得益彰。盖静
而守位者,此相火,静则温养;动而无方者,亦此相火,动则燔灼。譬之天与日,太阳之火也,虽烈而不能焚物,以阳
燧取之,不过星星之火,其用即可燎原。故景岳之说日也,失其所则折寿而不彰,丹溪之说日而火也,飞走狂越,莫能
御之。今将指日为火固失之,而指火为日,亦岂云得乎?《阴阳应象大论》∶“壮火之气衰,少火之气壮”,“壮”与“少”
之别,即两家宗旨所分,故必合两家所论,义始完备,若偏执一说,于道失之。
春温、夏热、秋燥、冬寒,确实是疾病的常态;至于瘟疫,则是秽浊恶劣之气,相互传染,吴又可对此论述得很详细了。只是吴氏认为病邪从口鼻而入,随即占据膜原(半表半里的部位),我认为既然由口鼻吸入受邪,肺是气出入的门户,没有不先侵犯肺脏的。瘟疫都是热毒,这是肺金所畏惧的,常常见到这种病症身体发热,起初有怕冷的感觉,这是因为肺先发病;继而充斥三焦,或者有直接进入心包络的。所说的“厉气”,无非是郁结之热,所以喻西昌讲解瘟、温两个字时,未曾加以区别,大概也是看到了这一点吧。况且所说的“上焦如雾,升发逐邪解毒,中焦如沤,疏通逐邪解毒,下焦如渎,决泄逐邪解毒”,总离不开一个“毒”字,这其中的郁热之意,意在言表了。更有患此病的人,即使喝冷水,也能大汗而解,这不是热毒的明显证据吗?至于疫邪虽然解除,但肺中蓄积余热,常常出现咳嗽气喘、肌肤发热、自汗等症状,这也是所谓肺先受病而未痊愈的明显征象。又有大旱之年,水干日烈,河水往往多有热毒,饮用其水的人,多发生疫痢,用治疗痢疾的常规方法无效,我在治疗痢疾的方剂中,加入贯众的苦寒解毒药,没有不立刻见效的,这也是热毒的一个验证,一并记录下来。
丹溪论述阳气有余,阴气不足,所谓的阳,就是相火。景岳反驳他,认为阴气有余,阳气不足,并撰写了《相火以位》进行辨析。各自树立旗帜,几乎像冰和炭一样互不相容。我曾经将两者参合考察,丹溪的大旨,本源于周敦颐主静立说的理论,认为相火一旦妄动,则五志厥阳之火一起煽动,煎熬真阴,所以东垣将其视为元气的贼寇。这种关于“相火”二字的论述,专门是从后天的变动角度而言的,与景岳主张的命门学说,有源流上的区别。那“天没有这把火不能化生万物,人没有这把火不能维持生命”,参考前哲如褚氏、赵氏所说,人生下来先具备命门及相火,行阳二十五度的话语来参证,景岳所说的内容,相得益彰。大概静止而守位的,是此相火,静止则温养;躁动而无常的,也是此相火,躁动则燃烧灼热。譬如天和太阳,太阳之火,虽然猛烈但不能焚烧物体,如果用阳燧(古代取火工具)聚集阳光,不过是星星之火,但其作用即可燎原。所以景岳所说的“日”,如果失去其所处位置就会折损寿命而不显赫,丹溪所说的“日中之火”,飞走狂越,无法抵御。现在指着太阳说是火固然错误,而指着火说是太阳,难道就正确了吗?《阴阳应象大论》说:“壮火之气衰,少火之气壮”,“壮”与“少”的区别,正是两家宗旨的分野,所以必须结合两家的论述,义理才完备,如果偏执一说,就偏离大道了。
Spring warmth, summer heat, autumn dryness, and winter cold are indeed the normal patterns of disease. As for epidemics (Wenyi), they involve foul and noxious qi that transmits mutually; Wu Youke discussed this in detail. However, while Wu claimed that the pathogen enters through the mouth and nose and immediately occupies the Membrane Source (Moyuan, a location between the exterior and interior), I argue that since it is inhaled through the mouth and nose, and the Lung is the gateway for qi entry and exit, there is no case where the Lung is not first affected. Epidemics all consist of Heat-Toxin, which the Metal element of the Lung fears. It is often observed that in such cases, fever is present initially accompanied by aversion to cold, indicating that the Lung is diseased first; subsequently, the pathogen fills the Triple Burner or directly enters the Pericardium. The so-called "Pestilential Qi" is nothing but stagnant Heat. Therefore, Yu Xichang did not distinguish between the characters "Wen" (Warmth) and "Wen" (Plague/Warm Disease) when explaining them, likely because he perceived this connection. Furthermore, the statement that "the Upper Jiao is like mist, ascending to expel pathogens and detoxify; the Middle Jiao is like fermentation, smoothing to expel pathogens and detoxify; the Lower Jiao is like a drain, draining to expel pathogens and detoxify," always revolves around the character "Toxin." The meaning of stagnant Heat is evident. Moreover, patients suffering from this disease can achieve relief through profuse sweating even after drinking cold water; is this not clear evidence of Heat-Toxin? Even after the epidemic pathogen is resolved, residual Heat remaining in the Lung often leads to symptoms such as coughing and wheezing, skin heat, and spontaneous sweating. These are also clear signs that the Lung was initially diseased and has not yet fully recovered. In years of severe drought, when waters dry up and the sun is fierce, river water often contains much Heat-Toxin. Those who drink it frequently develop epidemic dysentery. Conventional treatments for dysentery are ineffective. When I added the bitter-cold detoxifying herb Guanzhong (Cyathulae Radix / Smilacis Glabrae Rhizoma depending on specific identification, here referring to *Smilacis Glabrae Rhizoma* or *Aconiti Lateralis Preparata* contextually usually *Smilacis Glabrae Rhizoma* for detoxification in plague contexts, specifically 贯众 *Guanzhong*) to my dysentery formulas, results were invariably prompt. This serves as another verification of Heat-Toxin, which I record together here.
Danjia argued that Yang is in excess and Yin is deficient; the so-called Yang refers to Minister Fire (Xianghuo). Jingyue refuted this, claiming that Yin is in excess and Yang is deficient, and wrote "On Minister Fire Keeping Its Position" to differentiate his view. Each established their own banner, appearing as incompatible as ice and charcoal. I have examined both perspectives. Danjia's main thesis originates from Zhou Dunyi's theory of establishing principles through stillness. He posited that once Minister Fire moves recklessly, the Fire of Jue-Yang from the Five Emotions flares up simultaneously, boiling and consuming True Yin. Thus, Dongyuan regarded it as a thief of Yuan Qi. This discussion of "Minister Fire" specifically addresses its postnatal changes, differing in origin and flow from Jingyue's emphasis on the Gate of Vitality (Mingmen). Regarding the quote, "Without this fire, Heaven cannot generate things; without this fire, humans cannot sustain life," and referencing predecessors such as Chu Shi and Zhao Shi who stated that humans possess the Mingmen and Minister Fire at birth, governing the twenty-five degrees of Yang movement, Jingyue's statements complement these views perfectly. Generally, the Minister Fire that remains still and keeps its position provides warmth and nourishment when still; the same Minister Fire that moves without fixed direction causes burning and scorching when active. It is like the sky and the sun: Solar Fire, though fierce, does not burn objects unless gathered by a Yang Sui (ancient fire-gathering mirror); even a small spark can start a prairie fire. Thus, Jingyue's reference to the "Sun" implies that if it loses its proper position, lifespan is shortened and brilliance obscured. Danjia's reference to the "Fire within the Sun" describes it as flying wildly and uncontrollably. To point at the Sun and call it Fire is indeed an error, but to point at Fire and call it the Sun is hardly correct either. The *Suwen: Yin Yang Yingxiang Dajie* states: "The Qi of Strong Fire declines, the Qi of Mild Fire strengthens." The distinction between "Strong" (Zhuang) and "Mild" (Shao) marks the divergence in the core tenets of the two schools. Therefore, combining both discussions completes the understanding; adhering rigidly to one side deviates from the Dao.