洁古云心主热自病或大热泻心汤主之实则烦热黄连泻心汤主之虚则惊悸生犀汤主之
肺乘心微邪喘而壮热泻白散主之
肺乘心虚邪风热煎大青膏下大青丸
脾乘心贼邪恐怖恶寒安神丸主之
按刘宗浓云乘者犹车乘之乘也大抵五脏之病相乘伏匿隐显莫测以上但言本病乘胜之道故
以五脏治要附于下宜参考焉
凡心脏得病必先调其肝肾两脏肾者心之鬼肝气通则心气和肝气滞则心气乏此心病先求于
肝清
其源也五脏受病必先传其所胜水能胜火则肾之受邪必传于心故先治其肾遂其邪也故当退肾气
益肝气两方或诊其脉肝肾两脏俱和而心自生疾然后审其心家虚实治之
肺主燥自病则喘嗽燥则润之实则喘而气盛泻白散虚则喘而少气先益黄散而后阿胶散
心乘肺贼邪热而喘嗽先地黄丸中导赤散后阿胶散主之
肝乘肺微邪恶风眩冒昏愦嗽羌活膏主之
肾乘肺实邪增寒嗽清利百部丸主之
脾乘肺虚邪体重吐痰泄泻人参白术散主之
凡肺之得病必先观心之虚实若心火炎盛铄金即当先益心气后吃肺药若心气和即便看脾脉
若脾
气虚冷却不能相生而肺家生气不足则风邪易感故患肺寒者皆脾虚得之若脾气盛实则亦痞隔中
焦而大肠与肺表里不能相通夫中焦热隔则肺与大肠不通其热毒之气必上蒸于肺而生痰故患肺
热者多脾实得之心气盛者泻之脾气虚者益之脾气实者通之然后随其肺之寒热以治之故有抑
心气益脾气通肺气三药若诊其脉气心脾两脏俱和而肺自生疾则但察肺家虚实而治之
肝主风自病则风搐拘急肝苦急急食甘以缓之佐以酸苦以辛散之实则风搐力大泻青丸主之
虚则风搐力少地黄丸主之
心乘肝实邪壮热而搐利惊丸主之
肺乘肝贼邪气盛则前伸呵欠微搐法当泻肺先补本脏补肝地黄丸主之泻肺泻白散主之
脾乘肝微邪多睡体重而搐先当定搐泻青丸主之搐止再见后证则别立法治之
肾乘肝虚邪增寒呵欠而搐羌活膏主之
凡肝得病必先察其肺肾两脏根其病之所起然后审其肝家本脏之虚实方可治疗然肾者肝之
母金
者木之贼今肝之得病若非肾水之不能相生必是肺金之鬼来相攻击不得不详审而求之故其来在
肺先治其肺攻其鬼也其来在肾先补其肾滋其根也然后审其肝家本脏之虚实而寒温之
脾主湿自病则泄泻多睡体重昏倦脾苦湿急食甘以缓之实则泄泻赤黄睡不露睛泻黄散主之
虚则泄泻白色睡露睛白术散主之
肝乘脾贼邪风泻而吐茯苓半夏汤主之
心乘脾虚邪壮热体重而泻羌活黄芩甘草苍术汤主之
肺乘脾微邪恶寒泄泻理中丸之类
凡脾之得病必察其肝心两脏之虚实根其源之所起然后救疗盖肝是脾之鬼心是脾之母肝气
盛则
鬼胜心气亏则脾家生气不足盛者抑之则退亏者益之不乏所以有抑脾气益心气两药诊其脉肝心
两脏俱和则是脾自生疾察其虚实而治之
肾主寒自病则足胫寒而逆人之五脏惟肾无实小儿疮疹变黑陷则是肾水实克退心火是以水
能制火也
心乘肾微邪内热不恶寒桂枝汤主之
肝乘肾实邪拘急气搐身寒理中丸主之
肺乘肾虚邪喘嗽皮涩身寒百部丸主之
脾乘肾贼邪体重泄泻身寒理中丸主之
本脏虚弱是自己正令不行乃鬼贼所克害当补本脏之正气假令肺病喘嗽时于初春见之法当
补肾
见于夏救肺见于秋泻肺见于冬补心泻本脏乃名寒嗽大抵五脏各至本位即气盛不可更补到所克
位不可更泻
又按刘氏云五行之间惟有肾之一脏母盛而子反受邪而物之性有不可一概论者肺肾是也何
则肺
属金射于皮毛所主者气肾属水主于骨髓所藏者精气之轻浮能上而不能下精之沉重能下而不能
上此物性之自然今肺之盛盖热之作也气得热则上蒸于肺不能下生于肾而肾受邪矣急食凉药解
之使肾气温和自能下生于肾此肾之病必先求之于肺若肺脏安和而肾忽然受病者不过脾之湿相
形于肾而生疾所以有解肺热去脾邪两药若脾肺两脏俱和而肾自生病亦察其本脏而治之
洁古说：心脏受邪自病，若表现为大热，用泻心汤主治；若实证表现为烦热，用黄连泻心汤主治；若虚证表现为惊悸，用生犀汤主治。
按：刘宗浓说，“乘”就像车马的乘坐一样。大体上五脏的疾病相互乘侮，潜伏隐匿，显现莫测。以上只讲了本脏发病时乘胜的道理，所以将《五脏治要》附在下面，供参考。
凡是心脏得病，必须先调理肝肾两脏。肾是心的“鬼”（相克之脏），肝气通畅则心气和顺，肝气郁滞则心气衰弱。这是治疗心病先求于肝，以清其源头。五脏受病，必先传其所胜之脏。水能胜火，所以肾受邪必传于心，因此先治肾以驱逐邪气。应当退肾气，益肝气。如果诊察脉象，发现肝肾两脏都调和，而心脏自己生病，然后审察心脏的虚实进行治疗。
肺主燥，自病则气喘咳嗽。燥则润之。实证表现为气喘且气盛，用泻白散主治；虚证表现为气喘且少气，先用益黄散，后用阿胶散。
心乘肺（贼邪），表现为热而喘嗽，先用地黄丸中的导赤散，后用阿胶散主治。
肝乘肺（微邪），表现为恶风、眩晕、昏愦、咳嗽，用羌活膏主治。
脾乘肺（虚邪），表现为身体沉重、呕吐痰涎、泄泻，用人参白术散主治。
凡是肺得病，必须先观察心的虚实。如果心火炎盛，灼伤肺金，就应当先益心气，后吃肺药。如果心气调和，便要看脾脉。如果脾气虚冷，不能相生，导致肺家生气不足，则风邪易感，所以患肺寒者多因脾虚所致。如果脾气盛实，也会痞塞中焦，而大肠与肺表里相应，不能相通。如果中焦热隔，则肺与大肠不通，其热毒之气必上蒸于肺而生痰，所以患肺热者多因脾实所致。心气盛者泻之，脾气虚者益之，脾气实者通之。然后随其肺的寒热来治疗。所以有抑心气、益脾气、通肺气三法。如果诊察脉气，发现心脾两脏都调和，而肺自己生病，则只察肺家的虚实而治疗。
肝主风，自病则风搐、拘急。肝苦急，急食甘味以缓之，佐以酸苦味，用辛味发散之。实证表现为风搐有力，用泻青丸主治；虚证表现为风搐无力，用地黄丸主治。
肺乘肝（贼邪），气盛则前伸、呵欠、微搐。治法当泻肺，先补本脏。补肝用地黄丸主治，泻肺用泻白散主治。
脾乘肝（微邪），表现为多睡、身体沉重而抽搐。先当定搐，用泻青丸主治。抽搐停止后再见后证，则另立法治疗。
凡是肝得病，必须先察其肺肾两脏，根究病因所在，然后审察肝家本脏的虚实，方可治疗。然而肾是肝之母，金是木之贼。现在肝得病，如果不是肾水不能相生，必定是肺金之鬼来相攻击，不得不详审而求之。所以病源在肺，先治其肺，攻其鬼；病源在肾，先补其肾，滋其根。然后审察肝家本脏的虚实，或寒或温地治疗。
脾主湿，自病则泄泻、多睡、身体沉重、昏倦。脾苦湿，急食甘味以缓之。实证表现为泄泻色赤黄、睡觉不露睛，用泻黄散主治；虚证表现为泄泻色白、睡觉露睛，用白术散主治。
心乘脾（虚邪），表现为壮热、身体沉重而泄泻，用羌活黄芩甘草苍术汤主治。
凡是脾得病，必须察其肝心两脏的虚实，根究病因所在，然后救疗。盖肝是脾的“鬼”，心是脾之母。肝气盛则鬼胜，心气亏则脾家生气不足。盛者抑之则退，亏者益之则不乏。所以有抑脾气、益心气两药。诊察脉象，如果肝心两脏都调和，则是脾自己生病，察其虚实而治疗。
肾主寒，自病则足胫寒冷逆冷。人的五脏中只有肾没有实证。小儿疮疹变黑陷，则是肾水实克退心火，是以水能制火也。
本脏虚弱，是自己正令不行，乃被鬼贼所克害，应当补本脏的正气。假令肺病喘嗽，时在初春见到，治法当补肾；见于夏季，救肺；见于秋季，泻肺；见于冬季，补心。泻本脏，名叫寒嗽。大体上五脏各至本位，即气盛，不可更补；到所克之位，不可更泻。
又按刘氏说，五行之间，惟有肾这一脏，母盛而子反受邪，而物的性质有不可一概而论的，肺肾就是如此。为什么呢？肺属金，外合皮毛，所主的是气；肾属水，主于骨髓，所藏的是精气。气的轻浮能上而不能下，精的沉重能下而不能上。这是物性的自然。现在肺之盛，大概是热作祟。气得热则上蒸于肺，不能下生于肾，而肾受邪了。急食凉药解之，使肾气温和，自能下生于肾。这是肾的病必先求之于肺。如果肺脏安和而肾忽然受病，不过是脾之湿相形于肾而生疾。所以有解肺热、去脾邪两药。如果脾肺两脏都调和，而肾自己生病，亦察其本脏而治疗。
Jiegu said: When the Heart is affected by pathogenic factors and manifests as its own disease, if there is severe heat, Xixin Tang (Heart-Draining Decoction) should be used; if it is excess syndrome manifesting as irritability and heat, Huanglian Xixin Tang (Coptis Heart-Draining Decoction) should be used; if it is deficiency syndrome manifesting as palpitations and fright, Shengxi Tang (Raw Rhinoceros Horn Decoction) should be used.
When the Lung is affected by slight pathogenic factors from the Heart, manifesting as wheezing and high fever, Xiebai San (White Powder for Draining the Lung) should be used.
When the Lung is affected by deficient pathogenic factors from the Heart due to wind-heat, Daqing Gao (Major Blue Paste) should be decocted and drunk, along with Daqing Wan (Major Blue Pill).
When the Spleen is affected by thief-pathogenic factors from the Heart, manifesting as terror and aversion to cold, Anshen Wan (Spirit-Calming Pill) should be used.
Note: Liu Zongnong stated that "Cheng" (overcoming/assaulting) is like riding a carriage. Generally, diseases of the Five Zang organs overcome each other, lying hidden or appearing unpredictably. The above only discusses the principle of the primary organ overcoming others when sick. Therefore, *Essentials for Treating the Five Zang Organs* is attached below for reference.
Whenever the Heart suffers disease, one must first regulate the Liver and Kidney. The Kidney is the "Ghost" (organ that controls/overcomes) of the Heart. If Liver Qi flows smoothly, Heart Qi harmonizes; if Liver Qi stagnates, Heart Qi becomes deficient. This means treating Heart disease by seeking the source in the Liver to clear it. When any of the five Zang organs suffer disease, they must first transmit to the organ they control. Water overcomes Fire, so if the Kidney suffers evil, it must transmit to the Heart. Thus, one treats the Kidney first to expel the evil. One should reduce Kidney Qi and tonify Liver Qi. If pulse diagnosis reveals both the Liver and Kidney are harmonious, yet the Heart falls ill spontaneously, then examine the Heart's deficiency or excess and treat accordingly.
The Lung governs dryness. If it suffers disease itself, it manifests as wheezing and coughing. Dryness requires moistening. Excess syndrome manifests as wheezing with abundant Qi, treated with Xiebai San (White Powder for Draining the Lung); deficiency syndrome manifests as wheezing with shortness of breath, initially treated with Yihuang San (Yellow-Protecting Powder), followed by Ejiao San (Donkey-Hide Gelatin Powder).
When the Heart assaults the Lung (thief-pathogen), manifesting as heat with wheezing and coughing, first use Daochi San (Guide Out Redness Powder) within Dihuang Wan (Rehmannia Pill), followed by Ejiao San (Donkey-Hide Gelatin Powder).
When the Liver assaults the Lung (slight pathogen), manifesting as aversion to wind, dizziness, confusion, and coughing, use Huoxiao Gao (Notopterygium Paste).
When the Kidney assaults the Lung (excess pathogen), manifesting as increased cold and coughing, use Qingli Baibu Wan (Clearing and Benefiting Stemona Pill).
When the Spleen assaults the Lung (deficient pathogen), manifesting as heavy body, vomiting phlegm, and diarrhea, use Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder).
Whenever the Lung suffers disease, one must first observe the Heart's deficiency or excess. If Heart Fire blazes and scorches Metal (Lung), one must first tonify Heart Qi before administering Lung medicine. If Heart Qi is harmonious, check the Spleen pulse. If Spleen Qi is deficient and cold, failing to generate support, Lung Qi generation will be insufficient, making it susceptible to wind pathogens. Thus, lung cold cases often stem from Spleen deficiency. If Spleen Qi is excessive and solid, it may cause blockage in the Middle Jiao. Since the Large Intestine and Lung are exterior-interior related, they cannot communicate freely. If heat blocks the Middle Jiao, Lung and Large Intestine communication fails, and toxic heat steams upward to the Lung, generating phlegm. Thus, lung heat cases often stem from Spleen excess. Tonify deficient Heart Qi, drain excess Heart Qi, tonify deficient Spleen Qi, and unblock excessive Spleen Qi. Then treat according to the Lung's cold or heat. Hence, there are three methods: suppressing Heart Qi, tonifying Spleen Qi, and unblocking Lung Qi. If pulse diagnosis shows both Heart and Spleen are harmonious, yet the Lung falls ill spontaneously, examine the Lung's deficiency or excess and treat accordingly.
The Liver governs wind. If it suffers disease itself, it manifests as wind convulsions and stiffness. The Liver dislikes tension; quickly administer sweet flavors to relax it, assist with sour and bitter flavors, and disperse with pungent flavors. Excess syndrome manifests as forceful wind convulsions, treated with Xieqing Wan (Draining Green Pill); deficiency syndrome manifests as weak wind convulsions, treated with Dihuang Wan (Rehmannia Pill).
When the Heart assaults the Liver (excess pathogen), manifesting as high fever and convulsions, use Lijing Wan (Relieving Convulsion Pill).
When the Lung assaults the Liver (thief pathogen), with excessive Qi, manifesting as stretching forward, yawning, and slight convulsions, the treatment method should drain the Lung. First tonify the primary organ. Tonify the Liver with Dihuang Wan (Rehmannia Pill); drain the Lung with Xiebai San (White Powder for Draining the Lung).
When the Spleen assaults the Liver (slight pathogen), manifesting as excessive sleep, heavy body, and convulsions, first stop convulsions using Xieqing Wan (Draining Green Pill). After convulsions cease, address subsequent symptoms with separate methods.
When the Kidney assaults the Liver (deficient pathogen), manifesting as increased cold, yawning, and convulsions, use Huoxiao Gao (Notopterygium Paste).
Whenever the Liver suffers disease, one must first inspect the Lung and Kidney to root the cause, then examine the Liver's primary organ deficiency or excess before treating. The Kidney is the Mother of the Liver, and Metal (Lung) is the Thief of Wood (Liver). Now, if the Liver suffers disease, unless it is due to Kidney Water failing to generate, it must be an attack by Lung Metal. One must carefully investigate. If the source is in the Lung, treat the Lung first to attack the thief; if the source is in the Kidney, tonify the Kidney first to nourish the root. Then examine the Liver's primary organ deficiency or excess and treat with cold or warm methods.
The Spleen governs dampness. If it suffers disease itself, it manifests as diarrhea, excessive sleep, heavy body, and fatigue. The Spleen dislikes dampness; quickly administer sweet flavors to relax it. Excess syndrome manifests as yellow-red diarrhea and sleeping with eyes partially closed, treated with Xiehuang San (Draining Yellow Powder); deficiency syndrome manifests as white diarrhea and sleeping with eyes open, treated with Baizhu San (Atractylodes Macrocephala Powder).
When the Liver assaults the Spleen (thief pathogen), manifesting as wind-diarrhea and vomiting, use Fuling Banxia Tang (Poria and Pinellia Decoction).
When the Heart assaults the Spleen (deficient pathogen), manifesting as high fever, heavy body, and diarrhea, use Qianghuang Huangqin Gancao Cangzhu Tang (Notopterygium, Coptis, Licorice, and Atractodes Lancea Decoction).
When the Lung assaults the Spleen (slight pathogen), manifesting as aversion to cold and diarrhea, use Lizhong Wan (Regulate the Middle Pill) and similar formulas.
Whenever the Spleen suffers disease, one must inspect the Liver and Heart for deficiency or excess to root the cause before treating. The Liver is the Ghost of the Spleen, and the Heart is the Mother of the Spleen. If Liver Qi is excessive, the ghost prevails; if Heart Qi is deficient, Spleen Qi generation is insufficient. Suppress the excessive to reduce it; tonify the deficient to prevent scarcity. Hence, there are two methods: suppressing Spleen Qi and tonifying Heart Qi. If pulse diagnosis shows both Liver and Heart are harmonious, then the Spleen falls ill spontaneously; examine its deficiency or excess and treat accordingly.
The Kidney governs cold. If it suffers disease itself, it manifests as cold and reversal in the lower legs and shins. Among the five Zang organs of humans, only the Kidney has no excess syndrome. In pediatric smallpox/variolous eruptions turning black and sinking inward, this is Kidney Water excess overcoming Heart Fire, demonstrating water controlling fire.
When the Heart assaults the Kidney (slight pathogen), manifesting as internal heat without aversion to cold, use Guizhi Tang (Cinnamon Twig Decoction).
When the Liver assaults the Kidney (excess pathogen), manifesting as stiffness, Qi convulsions, and cold body, use Lizhong Wan (Regulate the Middle Pill).
When the Lung assaults the Kidney (deficient pathogen), manifesting as wheezing, dry skin, and cold body, use Baibu Wan (Stemona Pill).
When the Spleen assaults the Kidney (thief pathogen), manifesting as heavy body, diarrhea, and cold body, use Lizhong Wan (Regulate the Middle Pill).
Primary organ weakness occurs when one's own righteous command fails, leading to being overcome by ghost/thief pathogens. One should tonify the righteous Qi of the primary organ. For example, if Lung disease presents with wheezing and coughing: seen in early spring, treat by tonifying the Kidney; seen in summer, rescue the Lung; seen in autumn, drain the Lung; seen in winter, tonify the Heart. Draining the primary organ is named Cold Cough. Generally, when each of the five Zang organs reaches its own position, Qi is excessive and should not be further tonified; when reaching the position it controls, it should not be further drained.
Furthermore, according to Master Liu, among the Five Elements, only the Kidney exhibits a condition where the Mother is excessive and the Child suffers reverse evil. However, the nature of things cannot be generalized. The Lung and Kidney are examples. Why? The Lung belongs to Metal, connects to skin and hair, and governs Qi; the Kidney belongs to Water, governs bone marrow, and stores Essence-Qi. Qi is light and floating, able to ascend but not descend; Essence is heavy and sinking, able to descend but not ascend. This is the natural nature of things. Currently, Lung excess is likely caused by heat. Qi heated steams upward to the Lung and cannot descend to generate the Kidney, causing the Kidney to suffer evil. Quickly administer cool medicines to resolve this, allowing Kidney Qi to become harmonious and naturally descend to generate the Kidney. This is why Kidney disease must first seek its source in the Lung. If the Lung is harmonious but the Kidney suddenly suffers disease, it is merely Spleen dampness influencing the Kidney to create illness. Hence, there are two methods: resolving Lung heat and removing Spleen evil. If both Spleen and Lung are harmonious but the Kidney falls ill spontaneously, examine the primary organ and treat accordingly.