人生之初。具此阴阳。则亦具此血气。所以得全性命者。气与血也。血气者。乃人身之
根本
乎。气取诸阳。血取诸阴。血为荣。荣行脉中。滋荣之义也。气为卫。卫行脉外。护卫之义
也。人受谷气于胃。胃为水谷之海。灌溉经络。长养百骸。而五脏六腑。皆取其气。故清气
为荣。浊气为卫。荣卫二气。周流不息。一日一夜。脉行五十度。平旦复会于气口。阴阳相
贯。血荣气卫。常相流通。何病之有。一窒碍焉。则百病由此而生。且气之为病。发为寒热
喜怒忧思。积痞疝瘕 癖。上为头旋。中为胸膈。下为脐间动气。或喘促。或咳噫。聚则
中满。逆则足寒。凡此诸疾。气使然也。血之为病。妄行则吐衄。衰涸则虚劳。蓄之在上。
其人忘。蓄之在下。其人狂。逢寒则筋不荣而挛急。挟热毒则内瘀而发黄。在小便为淋痛。
在大便为肠风。妇人月事进退。漏下崩中。病症非一。凡此诸疾。皆血使之也。夫血者譬则
水也。气者譬则风也。风行水上。有血气之象焉。盖气者血之帅也。气行则血行。气止则血
止。气温则血滑。气寒则血凝。气有一息之不运。则血有一息之不行。病出于血调。其气犹
可以导达。病原于气。区区调血。又何加焉。故人之一身调气为上。调血次之。先阳后阴也
若夫血有败瘀滞泥诸经。壅遏气之道路。经所谓去其血而后调之。不可不通其变矣。然调
气之剂。以之调血而两得。调血之剂。以之调气则乖张。如木香、官桂、细辛、浓朴、乌药
、香附、三棱、莪术之类。治气可也。治血亦可也。若以当归、地黄辈。施之血症则可。然
其性缠滞。有亏胃气。胃气亏则五脏六腑之气亦馁矣。善用药者。必以胃药助之。凡治病当
识本末。如呕吐痰涎。胃
虚不食。以致发热。若以凉剂退热。则胃气愈虚。热亦不退。宜先助胃止吐为本。其热自退
纵然不退。但得胃气已正。旋与解热。又有伤寒大热。屡用寒凉疏转。其热不退。若与调
和胃气。自然安愈。
心为血之主。肝为血之藏。肺为气之主。肾为气之藏。止知血之出于心。而不知血之纳
于肝
知气之出于肺。而不知气之纳于肾。往往用药。南辕北辙矣。假如血痢。以五苓、门冬等
剂。行其心。巴豆、大黄逐其积。其病犹存者。血之所藏。无以养也。必佐以芎、归、。则
病自止。假如喘嗽。以枳壳、桔梗、紫苏、桂、姜、橘等剂调其气。以南星、半夏、细辛豁
其痰。而终不升降者。气之所藏。无以收也。必佐以补骨脂辈。则气归原矣。病有标本。治
有先后。纲举而目斯张矣。噫此传心至妙之法。敢不与卫生君子共之。
人在刚出生时,就具备了阴阳,因此也具备了血气。人之所以能够保全性命,依靠的就是气与血。血气,可以说是人身体的根本所在。气归属于阳,血归属于阴。血具有荣养的功能,运行于脉管之中,起到滋养的作用;气具有卫外的功能,运行于脉管之外,起到护卫的作用。人从胃中摄取水谷之气,胃被称为“水谷之海”,它灌溉经络,长养全身骨骼脏腑,五脏六腑都从中获取气。所以,清轻的气化为营气(荣),重浊的气化为卫气。营气和卫气这两股气,在体内周流不息,一天一夜之间,脉气运行五十个周次,清晨时分重新汇聚于手腕部的寸口脉。阴阳相互贯通,血主荣养而气主卫外,二者常常保持流通顺畅,这样会有什么疾病呢?一旦出现了阻滞阻碍,百病就会由此产生。
况且,气发生病变时,会表现为寒热往来、喜怒忧思等情绪变化,或者形成积块、痞块、疝气、瘕聚、癖积等病症;向上会导致头晕目眩,在中部会导致胸膈不适,在下部会导致脐间动气异常,或者出现气喘急促、咳嗽嗳气等症状;气聚则导致腹部胀满,气逆则导致足部发冷。凡是这些疾病,都是气引起的。血发生病变时,如果血妄行则会吐血、衄血;如果血衰败枯竭则会导致虚劳;瘀血蓄积在上部,人会健忘;瘀血蓄积在下部,人会狂躁;遇到寒气则筋脉得不到荣养而拘挛紧急;夹杂热毒则内部瘀滞而发黄;在小便方面表现为淋证疼痛,在大便方面表现为肠风出血;妇女月经周期紊乱,或漏下不止、崩中出血,病症不一。凡是这些疾病,都是血引起的。
血可以比作水,气可以比作风。风吹在水面上,就形成了气血运行的景象。大概来说,气是血的统帅,气行则血行,气停则血停,气温则血流畅,气寒则血凝滞。气只要有一息不能运化,血就有一息不能运行。如果病源于血,调理气机还可以起到引导通达的作用;但如果病源在于气,仅仅去调血,又有什么帮助呢?所以,人体一身之中,调气为上策,调血为次策,这是遵循先阳后阴的原则。
至于血有败瘀、停滞、黏腻阻塞各条经脉,壅塞了气运行的道路,正如医经所说,必须先去除瘀血然后再进行调理,这一点不可不灵活变通。然而,调气的药物,用来调血也能两全其美;但调血的药物,用来调气则会产生偏差。比如木香、官桂、细辛、厚朴、乌药、香附、三棱、莪术这类药物,治疗气病可以,治疗血病也可以。如果用当归、地黄这类药物,施用于血症是可以的,但是它们的性质缠滞,容易损伤胃气。胃气亏损,那么五脏六腑的气也会衰弱。善于用药的人,必定会用养胃的药物来辅助。大凡治病应当认清根本和末节。例如呕吐痰涎、胃虚不能进食,以致引起发热,如果用凉剂退热,胃气会更加虚弱,热也不会退去。应该以先助胃止吐为根本,热自然就会退去。纵然热不退,只要胃气已经恢复,随即给予解热的药物,又有伤寒大热,多次使用寒凉药物疏通转导,热仍不退,如果调和胃气,自然会痊愈。
心是血的主宰,肝是血的储藏库;肺是气的主宰,肾是气的储藏库。人们往往只知道血出于心,却不知道血收纳于肝;只知道气出于肺,却不知道气收纳于肾。因此在用药时,往往南辕北辙。假如是血痢,只用五苓散、麦冬等药剂来行心气,用巴豆、大黄来驱逐积滞,病仍然存在的,是因为血的储藏之处(肝)没有受到滋养。必须辅佐以川芎、当归等药物,病自然停止。假如是喘嗽,用枳壳、桔梗、紫苏、桂枝、生姜、橘皮等药剂调理气机,用天南星、半夏、细辛豁除痰液,但最终气机不能升降的,是因为气的储藏之处(肾)没有能力收敛。必须辅佐以补骨脂之类的药物,气才能回归本源。疾病有标本之分,治疗有先后顺序,抓住了纲领,细节自然就能展开。唉!这是传授心法的精妙之处,怎敢不与注重养生的人士共同分享呢?
At the beginning of human life, one possesses Yin and Yang, and therefore also possesses Blood and Qi. It is through Qi and Blood that life is preserved. Blood and Qi are indeed the root of the human body. Qi belongs to Yang, and Blood belongs to Yin. Blood serves as Ying (Nutritive Qi), circulating within the vessels, fulfilling the meaning of nourishment. Qi serves as Wei (Defensive Qi), circulating outside the vessels, fulfilling the meaning of protection. Humans obtain Gu Qi (Grain Qi) from the Stomach. The Stomach is the "Sea of Water and Grain," irrigating the meridians and nurturing the bones and viscera, so that the Five Zang and Six Fu organs all derive their Qi from it. Thus, clear Qi becomes Ying (Nutritive Qi), and turbid Qi becomes Wei (Defensive Qi). These two types of Qi, Ying and Wei, circulate continuously without cessation. In one day and night, Qi circulates through the vessels fifty times, reconverging at the Qi Kou (Cunkou pulse point) at dawn. Yin and Yang interpenetrate each other; Blood provides nourishment while Qi provides defense, and they constantly flow smoothly. How could disease arise? Once there is an obstruction, a hundred diseases will emerge from this.
Moreover, when Qi becomes pathological, it manifests as alternating cold and heat, or emotions such as anger, joy, worry, and overthinking; it can accumulate into masses,痞 (Pi syndrome), hernias, Jia (soft masses), and Pi (hard masses); upward it causes dizziness; in the middle it affects the chest and diaphragm; downward it causes movement of Qi around the umbilicus; it may cause panting or coughing and belching; when gathered, it leads to abdominal fullness; when rebellious, it leads to cold feet. All these ailments are caused by Qi. When Blood becomes pathological, reckless flowing leads to hematemesis or epistaxis; depletion and exhaustion lead to deficiency consumptive disease; accumulation above causes forgetfulness; accumulation below causes mania. Encountering cold causes sinews to lack nourishment, resulting in spasms and stiffness; accompanying heat toxins causes internal stasis leading to jaundice; in urination it presents as painful dysuria; in defecation it presents as intestinal wind bleeding; in women, menstrual irregularities, metrorrhagia, or uterine bleeding occur. The symptoms are numerous, but all these diseases are caused by Blood.
Blood can be compared to water, and Qi to wind. Wind blowing on water creates the image of Qi and Blood interaction. Generally speaking, Qi is the commander of Blood: where Qi moves, Blood moves; where Qi stops, Blood stops; where Qi is warm, Blood flows smoothly; where Qi is cold, Blood coagulates. If Qi fails to move for even a breath, Blood fails to circulate for that same breath. If the disease originates in Blood, regulating Qi can still guide and unblock it. However, if the disease originates in Qi, merely regulating Blood adds little value. Therefore, in the human body, regulating Qi is superior, and regulating Blood is secondary; this follows the principle of prioritizing Yang before Yin.
As for Blood causing敗瘀 (stagnant blood), stagnation, and viscosity blocking the various meridians, obstructing the pathways of Qi, as the classics state, one must remove the blood first before regulating. This variation must not be overlooked. However, formulas for regulating Qi can also benefit Blood, achieving both effects. Conversely, formulas for regulating Blood, when used to regulate Qi, will produce discordance. For example, drugs like Muxiang (Aucklandiae Radix), Guigui (Cinnamomi Cortex), Xixin (Asari Radix), Houpo (Magnoliae Officinalis Cortex), Wuyao (Linderae Radix), Xiangfu (Cyperi Rhizoma), Sanleng (Sparganii Rhizoma), and Ezhu (Curcumae Rhizoma) can treat Qi disorders and also Blood disorders. Drugs like Danggui (Angelicae Sinensis Radix) and Dihuang (Rehmanniae Radix) are suitable for Blood disorders, but their nature is cloying and stagnant, which can impair Stomach Qi. If Stomach Qi is impaired, the Qi of the Five Zang and Six Fu organs will also become weak. A skilled practitioner must always use Stomach-nourishing herbs to assist. In treating any disease, one must understand the root and the branch. For instance, vomiting phlegm and saliva due to Stomach deficiency and inability to eat leads to fever. If cooling agents are used to reduce fever, Stomach Qi becomes even more deficient, and the fever does not subside. One should prioritize strengthening the Stomach and stopping vomiting as the root treatment; the fever will naturally recede. Even if the fever does not subside immediately, once Stomach Qi is restored, heat-clearing agents can then be applied. Similarly, in severe febrile disease from Cold Damage, if repeated use of cold and cooling purgatives fails to reduce the fever, harmonizing the Stomach Qi will naturally lead to recovery.
The Heart is the master of Blood, and the Liver stores Blood; the Lung is the master of Qi, and the Kidney stores Qi. People often know only that Blood issues from the Heart, but do not know that Blood is stored in the Liver; they know only that Qi issues from the Lung, but do not know that Qi is stored in the Kidney. Consequently, when prescribing medication, they often go in the opposite direction. For example, in cases of bloody dysentery, using formulas like Wu Ling San (Five-Ingredient Powder with Poria) or Maidong (Ophiopogonis Radix) to move Heart Qi, and Radix Euphorbiae Lathyris (Baidu) or Rhei Radix et Rhizoma (Dahuang) to purge accumulation, the disease persists because the storage site of Blood (Liver) lacks nourishment. One must supplement with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix), and the disease will cease. In cases of wheezing and coughing, using Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix), Zisu (Perillae Folium), Guizhi (Cinnamomi Ramulus), Shengjiang (Zingiberis Rhizoma Recens), and Chenpi (Citri Reticulatae Pericarpium) to regulate Qi, and Nanting (Arisaematis Rhizoma Preparatum), Banxia (Pinelliae Rhizoma), and Xixin (Asari Radix) to resolve phlegm, if the Qi mechanism still fails to ascend and descend, it is because the storage site of Qi (Kidney) lacks the ability to grasp/receive. One must supplement with Buguzhi (Psoraleae Fructus), and the Qi will return to its origin. Diseases have root and branch aspects, and treatments have sequence. Once the main thread is lifted, the meshes follow. Alas! This is the profound method passed down from heart to heart; how dare I not share it with those who value health preservation?