一、补方之制。补其虚也。凡气虚者宜补其上。人参、黄 之属是也。精虚者宜补其下。熟地、
枸杞之属是也。阳虚者宜补而兼暖。桂、附、干姜之属是也。阴虚者宜补而兼清。门冬、芍、地
之属是也。此固阴阳之治辨也。其有气因精而虚者。自当补精以化气。精因气而虚者。自当补气
以生精。又有阳失阴而离者。不补阴何以收散亡之气。水失火而败者。不补火何以苏垂绝之阴。
此又阴阳相济之妙用也。故善补阳者。必于阴中求阳。则阳得阴助而生化无穷。善补阴者。
必于阳中求阴。则阴得阳升而泉源不竭。余故曰。以精气分阴阳。则阴阳不可离。以寒热分阴阳。
则阴阳不可混。此又阴阳邪正之离合也。故凡阳虚多寒者。宜补以甘温。而清润之品非所宜。
阴虚多热者。宜补以甘凉。而辛燥之类不可用。知宜知避。则不惟用补。而八方之制。皆可得
而贯通矣。
一、和方之制。和其不和者也。凡病兼虚者补而和之。兼滞者行而和之。兼寒者温而和之。兼热
者凉而和之。和之为义广矣。亦犹土兼四气。其于补泻温凉之用。无所不及。务在调平元气。
不失中和之为贵也。故凡阴虚于下而精血亏损者。忌利小水。如四苓、通草汤之属是也。阴虚于上
而肺热干咳者。忌用辛燥。如半夏、苍术、细辛、香附、芎、归、白术
之属是也。阳虚于上者忌消耗。如陈皮、砂仁、木香、槟榔之属是也。阳虚于下者忌沉寒。如黄柏、
知母、栀子、木通之属是也。大便溏泄者忌滑利。如二冬、牛膝、苁蓉、当归、柴胡、童便之属是也。
表邪未解者忌收敛。如五味、枣仁、地榆、文蛤之属是也。气滞者忌闭塞。如黄 、白术、山药、
甘草之属是也。经滞者忌寒凝。如门冬、生地、石斛、芩、连之属是也。凡邪火在上者不宜升。
火得升而愈炽矣。沉寒在下者不宜降。阴被降而愈亡矣。诸动者不宜再动。如火动者忌温暖。血
动者忌辛香。汗动者忌疏散。神动者忌耗伤。凡性味之不静者。皆所当慎。其于刚暴更甚者。则又
在不言可知也。诸静者不宜再静。如沉微细弱者。脉之静也。神昏气怯者。阳之静也。肌体清寒者。
表之静也。口腹畏寒者。里之静也。凡性味之阴柔者。皆所当慎。其于沉寒更甚者。又在不言可知也。
夫阳主动。以动济动。火上添油也。不焦烂乎。阴主静。以静益静。雪上加霜也。不寂灭乎。凡
前所论。论其略耳。而书不尽言。言不尽意。能因类而广之。则存乎其人矣。不如此义。又何
和剂之足云。
一、补方(具有补益作用的方剂)的制定原则。是为了补益人体的虚损。凡是气虚的人,适宜补益上焦(心肺部位)。人参、黄芪之类的药物是适用的。精血亏虚的人,适宜补益下焦(肝肾部位)。熟地黄、枸杞子之类的药物是适用的。阳虚的人,适宜在补益的同时兼用温暖的药物。肉桂、附子、干姜之类的药物是适用的。阴虚的人,适宜在补益的同时兼用清润的药物。麦冬、白芍、生地黄之类的药物是适用的。这确实是区分阴阳治疗的基本原则。如果有因为精亏而导致气虚的情况,自然应当通过补精来化生气血;有因为气虚而导致精亏的情况,自然应当通过补气来滋生精血。又有阳气失去阴液依附而离散的情况,不补阴液怎么能收敛散失亡脱的阳气?肾水失去命门火气的温煦而败坏的情况,不补火怎么能让垂危的阴液复苏?这又是阴阳相互济助的妙用。所以善于补阳的人,必定在补阴中寻求补阳的方法,那么阳气得到阴液的资助而生化无穷无尽。善于补阴的人,必定在补阳中寻求补阴的方法,那么阴液得到阳气的升发而源泉不枯竭。我因此说:如果以精气来划分阴阳,那么阴阳是不可分离的;如果以寒热来划分阴阳,那么阴阳是不可混淆的。这又是阴阳邪正离合的道理。所以凡是阳虚且多寒症的人,适宜用甘温的药物补益,而清凉滋润的药物是不适宜的。阴虚且多热症的人,适宜用甘凉的药物治疗,而辛香燥烈的药物不可使用。知道适宜什么和避免什么,那么不仅在使用补法时,就是八方(八法)的制剂原理,都可以贯通理解了。
一、和方(具有调和作用的方剂)的制定原则。是为了调和人体不和的状态。凡是疾病兼有虚损的,用补益的方法来调和;兼有气滞的,用行气导滞的方法来调和;兼有寒症的,用温中的方法来调和;兼有热症的,用清凉的方法来调和。“和”的含义非常广泛。也就像土德兼备四季之气一样,它在补、泻、温、凉各种用途上,没有不涉及的。务必在于调平元气,不失中和的原则最为珍贵。所以凡是下焦阴虚且精血亏损的人,忌讳通利小便。如四苓散、通草汤之类的方剂是禁忌的。上焦阴虚且肺热干咳的人,忌讳使用辛燥药物。如半夏、苍术、细辛、香附、川芎、当归、白术之类的药物是禁忌的。上焦阳虚的人,忌讳耗散正气。如陈皮、砂仁、木香、槟榔之类的药物是禁忌的。下焦阳虚的人,忌讳沉寒药物。如黄柏、知母、栀子、木通之类的药物是禁忌的。大便溏泄的人,忌讳滑利药物。如天冬、麦冬、牛膝、肉苁蓉、当归、柴胡、童便之类的药物是禁忌的。表邪未解的人,忌讳收敛药物。如五味子、酸枣仁、地榆、文蛤之类的药物是禁忌的。气滞的人,忌讳闭塞药物。如黄芪、白术、山药、甘草之类的药物是禁忌的。经络阻滞的人,忌讳寒凝药物。如麦冬、生地黄、石斛、黄芩、黄连之类的药物是禁忌的。凡是邪火在上部的,不宜使用升提药。火性得升腾会更加炽盛。沉寒在下部的,不宜使用降下药。阴气被下降会更加消亡。凡是处于“动”态的病证,不宜再用动药。如火动者忌讳温暖药,血动者忌讳辛香药,汗动者忌讳疏散药,神动者忌讳耗伤药。凡是药性气味不宁静的,都应当谨慎。其中刚烈暴戾更严重的,则更在不言之中可知了。凡是处于“静”态的病证,不宜再用静药。如脉象沉微细弱,这是脉之静;神志昏沉、气息怯弱,这是阳气之静;肌体清冷畏寒,这是表之静;口腹畏寒,这是里之静。凡是药性气味阴柔的,都应当谨慎。其中沉寒更严重的,更在不言之中可知了。阳气主“动”,用动药去济助动证,如同火上浇油,难道不会焦烂吗?阴气主“静”,用静药去益助静证,如同雪上加霜,难道不会寂灭吗?以上所论述的,只是大概的原理。书本不能完全表达言语,言语不能完全表达心意。能够根据这些类别加以推广运用的,取决于医者本人。如果不明白这个道理,又谈得上什么和剂呢。
1. The formulation of tonifying formulas (Tonifying Formulas). Their purpose is to tonify deficiency. For those with Qi deficiency, it is appropriate to tonify the Upper Jiao (the area of the Heart and Lungs). Herbs such as Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix) are suitable. For those with Essence-Blood deficiency, it is appropriate to tonify the Lower Jiao (the area of the Liver and Kidneys). Herbs such as Shu Di Huang (Prepared Rehmanniae Radix) and Gou Qi Zi (Lycii Fructus) are suitable. For those with Yang deficiency, it is appropriate to tonify while simultaneously applying warming properties. Herbs such as Rou Gui (Cinnamomi Cortex), Fu Zi (Aconiti Lateralis Radix Praeparata), and Gan Jiang (Zingiberis Rhizoma) are suitable. For those with Yin deficiency, it is appropriate to tonify while simultaneously applying clearing and moistening properties. Herbs such as Mai Dong (Ophiopogonis Radix), Bai Shao (Paeoniae Radix Alba), and Sheng Di Huang (Rehmanniae Radix) are suitable. This indeed constitutes the fundamental distinction in treating Yin and Yang. If there is a case where Qi becomes deficient due to Essence depletion, one should naturally tonify Essence to transform into Qi. If there is a case where Essence becomes deficient due to Qi deficiency, one should naturally tonify Qi to generate Essence. Furthermore, if Yang loses its attachment to Yin and scatters, how can scattered and perishing Yang Qi be gathered without tonifying Yin? If Kidney Water fails due to the loss of Fire's warmth, how can nearly extinct Yin fluids revive without tonifying Fire? This represents the subtle application of mutual assistance between Yin and Yang. Therefore, those skilled in tonifying Yang must seek Yang within Yin; thus, Yang receives the aid of Yin and its generation becomes inexhaustible. Those skilled in tonifying Yin must seek Yin within Yang; thus, Yin receives the ascent of Yang and its source remains unexhausted. I therefore say: If Yin and Yang are distinguished by Essence and Qi, then Yin and Yang cannot be separated. If Yin and Yang are distinguished by Cold and Heat, then Yin and Yang cannot be confused. This refers to the separation and union of pathogenic and righteous factors in Yin and Yang. Therefore, for those with Yang deficiency manifesting mostly as Cold, it is appropriate to tonify with Sweet-Warm herbs, while Cooling-Moistening substances are unsuitable. For those with Yin deficiency manifesting mostly as Heat, it is appropriate to tonify with Sweet-Cool herbs, while Acrid-Dry substances must not be used. Knowing what is suitable and what to avoid allows one not only to apply tonification correctly but also to comprehend the principles of all eight methods of treatment.
2. The formulation of harmonizing formulas (Harmonizing Formulas). Their purpose is to harmonize disharmony. For diseases accompanied by deficiency, tonification is used to harmonize; for those accompanied by stagnation, moving and resolving agents are used to harmonize; for those accompanied by Cold, warming agents are used to harmonize; for those accompanied by Heat, cooling agents are used to harmonize. The meaning of "Harmonizing" is broad. It is akin to Earth possessing the qualities of all four seasons; its application in tonification, purgation, warming, and cooling covers everything. The aim is always to balance Yuan Qi (Original Qi), adhering to the principle of Zhong He (Central Harmony) is paramount. Therefore, for those with Yin deficiency in the Lower Jiao and depletion of Essence-Blood, diuretics that promote urination are contraindicated. Formulas such as Si Ling San (Four-Poria Powder) and Tong Cao Tang (Tetrapanacis Medulla Decoction) are among those to be avoided. For those with Yin deficiency in the Upper Jiao and Lung-Heat causing dry cough, Acrid-Dry herbs are contraindicated. Herbs such as Ban Xia (Pinelliae Rhizoma), Cang Zhu (Atractylodis Rhizoma), Xi Xin (Asari Radix et Rhizoma), Xiang Fu (Cyperi Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Bai Zhu (Atractylodis Macrocephalae Rhizoma) are among those to be avoided. For those with Yang deficiency in the Upper Jiao, herbs that consume and disperse Qi are contraindicated. Herbs such as Chen Pi (Citri Reticulatae Pericarpium), Sha Ren (Amomi Fructus), Mu Xiang (Aucklandiae Radix), and Bing Lang (Arecae Semen) are among those to be avoided. For those with Yang deficiency in the Lower Jiao, sinking-Cold herbs are contraindicated. Herbs such as Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), Zhi Zi (Gardeniae Fructus), and Mu Tong (Akebiae Caulis) are among those to be avoided. For those with loose stools, slippery and lubricating herbs are contraindicated. Herbs such as Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Niu Xi (Achyranthis Bidentatae Radix), Cong Rong (Cynomorii Herba), Dang Gui (Angelicae Sinensis Radix), Chai Hu (Bupleuri Radix), and Tong Bian (Human Urine) are among those to be avoided. For those with unresolved Exterior pathogens, astringent herbs are contraindicated. Herbs such as Wu Wei Zi (Schisandrae Fructus), Suan Zao Ren (Ziziphi Spinosae Semen), Di Yu (Sanguisorbae Radix), and Wen Ge (Meretricis et Cyclinae Concha) are among those to be avoided. For those with Qi stagnation, obstructive herbs are contraindicated. Herbs such as Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Shan Yao (Dioscoreae Rhizoma), and Gan Cao (Glycyrrhizae Radix et Rhizoma) are among those to be avoided. For those with meridian stagnation, cold-congealing herbs are contraindicated. Herbs such as Men Dong (Dendrobii Caulis), Sheng Di Huang (Rehmanniae Radix), Shi Hu (Dendrobii Caulis), Huang Qin (Scutellariae Radix), and Lian Zi (Nelumbinis Semen) [Note: Context implies Lian Qiao or similar, but text says Lian] are among those to be avoided. For pathogenic Fire located in the Upper Jiao, ascending herbs are inappropriate. Fire will become more blazing when ascended. For sinking-Cold located in the Lower Jiao, descending herbs are inappropriate. Yin will perish further when descended. For conditions characterized by "Movement," one should not use further moving agents. For Fire-movement, warming agents are contraindicated; for Blood-movement, Acrid-Aromatic agents are contraindicated; for Sweat-movement, dispersing agents are contraindicated; for Spirit-movement, consuming agents are contraindicated. All herbs with unstable flavors and natures should be used with caution. Those that are even more harsh and violent are obviously to be avoided. For conditions characterized by "Stillness," one should not use further stilling agents. A pulse that is deep, faint, fine, and weak is Stillness of the Pulse. Confusion of spirit and timidity of Qi is Stillness of Yang. A cold body surface is Stillness of the Exterior. Cold sensitivity in the mouth and abdomen is Stillness of the Interior. All herbs with Yin-Soft natures should be used with caution. Those that are even more deeply cold are obviously to be avoided. Yang governs Movement; using moving agents to assist a movement condition is like adding oil to fire—will it not cause burning? Yin governs Stillness; using stilling agents to assist a stillness condition is like adding frost to snow—will it not lead to extinction? The above discussions cover only the general principles. Books cannot fully express words, and words cannot fully express intent. The ability to generalize from these categories depends on the practitioner. Without understanding this principle, how can one speak of Harmonizing Formulas?