一治曰和。假令小热之病。当以凉药和之。和之不已次用取。二冶曰取为热势稍大当以
寒药
取之。取之不已。次用从。三治曰从。为势既甚。当以温药从之。为药气温也。味随所为。
或以寒因热用。味通所用。或寒以温用。或以发汗之。不已又再折。四治曰折。为病势极甚
。当以逆制之。逆制之不已。当以下夺之。下夺之不已又用属。五治曰属。为求其属以衰之
。缘热深陷在骨髓间。无法可出。针药所不能及。故求其属以衰之。缘属之法。是同声相
应。同气相求。经曰。陷下者衰之。夫衰热之法同前所云。火衰于戌。金衰于辰之类是也。
如或又不已。当广其法而治之。譬如孙子之用兵。若在山谷则塞渊泉。在水陆则把渡口。在
平川广野。当青野千里。塞渊泉者刺俞穴把渡口者夺病发时。前青野千里者。如肌羸瘦弱。
宜广服大药以养正夫病有中外。治有缓急。在内者以内治法和之。
气微不和。以调气法调之。
在外者。以外治法和之。
其次大者。以平气法平之。
盛甚不已则夺其气。令其衰也。故经曰。调气之方。必别阴阳。定其中外。各守其乡。
内者内治。 外者外治。微者调治。其次平治。 盛者夺之。 汗者下之。
察色分位 坤胃(遗散至肾死) 兑肺 干大肠(遗散至肝死) 额 离心 坎肾颐 精明
五色 巽胆(遗散至脾死) 震肝 艮小肠(遗散至肺死)
第一种治法是“和”。假如是轻微发热的病证,应当用凉性药物来调和它。如果调和后病情未愈,接着采用“取”法。第二种治法是“取”。当热势稍大时,应当用寒性药物来攻取(清泻)它。如果攻取后病情未愈,接着采用“从”法。第三种治法是“从”。当病势已经很严重,应当用温性药物顺从其假象而治疗。因为药性是温的,味道则根据具体情况而定。有的用寒性药但热服(寒因热用),使药味通达所治之处;有的用寒性药但配合温性用法;或者通过发汗的方法治疗。如果仍未痊愈,再采用“折”法。第四种治法是“折”。当病势极其严重,应当用逆其病势的方法制约它。如果逆制后病情未愈,应当采用“下夺”法(泻下攻逐)。如果泻下攻逐后仍未痊愈,再采用“属”法。第五种治法是“属”。即寻求与病根同类的药物以削弱病势。因为热邪深陷在骨髓之间,无法排出,针药都难以到达,所以寻求同类属性以削弱它。“属”法的原理,如同声音相同相互应和,气息相同相互吸引。《内经》说:陷下的病证要使其衰退。那削弱热邪的方法,就像前面所说的,火气衰于戌月,金气衰于辰月之类。如果这样仍然无效,就应当广泛运用各种方法来治疗。这好比孙子用兵打仗:如果在山谷中,就堵塞深渊和泉水;在水陆交界处,就扼守渡口;在平原旷野,就面对千里青野(严阵以待)。堵塞深渊和泉水,对应的是针刺腧穴;扼守渡口,对应的是在病发作时截断病势;面对千里青野,对应的是肌肉消瘦虚弱,适宜广泛服用大补药物以养护正气。疾病有在体内和在体外的区别,治疗有缓和与急迫的不同。病在体内的,用内治法调和它。如果气机轻微不和,用调气法调理它。病在体外的,用外治法调和它。其次对于较大的病证,用平气法平复它。如果邪气盛极且久治不愈,就夺取其邪气,使其衰退。所以《内经》说:调气的方剂,必须辨别阴阳,确定病位在内还是在外,各自坚守其治疗的领域。病在内的用内治法,病在外的用外治法,病轻微的用调治法,病较重的用平治法,病邪盛的用攻夺法,该发汗的发汗,该泻下的泻下。
观察面色并分辨部位:坤卦对应胃(若色散至肾则死),兑卦对应肺,乾卦对应大肠(若色散至肝则死),额部对应心,坎卦对应肾,颐部对应精明(目),五色对应巽卦(胆,若色散至脾则死),震卦对应肝,艮卦对应小肠(若色散至肺则死)。
The first method of treatment is "Harmonizing" (He). For example, in a disease with slight heat, one should use cool-natured medicines to harmonize it. If harmonization fails, the next step is "Taking" (Qu). The second method of treatment is "Taking". When the heat pathogen is slightly more intense, cold-natured medicines should be used to purge and clear it. If purging fails, the next step is "Following" (Cong). The third method of treatment is "Following". When the pathological condition is already severe, warm-natured medicines should be used to follow the false signs (treating heat with warmth). Since the medicinal nature is warm, the flavor varies according to the situation. Sometimes cold medicines are administered hot (cold administered as hot), allowing the flavor to reach the targeted area; sometimes cold medicines are used in conjunction with warm methods; or diaphoresis (sweating) is employed. If still ineffective, "Breaking" (Zhe) is applied again. The fourth method of treatment is "Breaking". When the pathological condition is extremely severe, counteracting measures should be used to restrain it. If counteraction fails, "Downward Expulsion" (Xia Duo) should be used. If downward expulsion fails, the method of "Belonging" (Shu) is employed. The fifth method of treatment is "Belonging". This involves seeking medicines that share the same nature as the root cause to weaken the disease. Because the heat pathogen has sunk deep into the marrow, there is no way for it to exit, and neither acupuncture nor medicine can easily reach it. Therefore, one seeks to weaken it by targeting its belonging nature. The principle of "Belonging" is like sounds resonating with each other due to similarity, and qi attracting similar qi. The Classic states: "For conditions characterized by sinking, promote decline." The method of weakening heat is as previously described, such as Fire declining in Xu months and Metal declining in Chen months. If these methods remain ineffective, one must broaden the therapeutic approach. This is akin to Sun Tzu's use of military strategy: if in valleys, block the abyss and springs; at water-land junctions, guard the ferry crossings; on flat plains, face the thousand miles of green fields. Blocking abysses and springs corresponds to needling Shu points; guarding ferry crossings corresponds to intercepting the disease when it manifests; facing the thousand miles of green fields corresponds to cases of emaciation and weakness, where extensive use of potent tonifying medicines is appropriate to nourish Zheng Qi (Upright Qi). Diseases have locations inside and outside; treatments have缓 (moderate) and 急 (urgent) distinctions. For diseases inside, use internal treatment methods to harmonize them. If Qi is slightly disordered, use Qi-regulating methods to adjust them. For diseases outside, use external treatment methods to harmonize them. For larger conditions, use Qi-leveling methods to pacify them. If excess is extreme and unyielding, seize the pathogenic Qi to make it decline. Thus, the Classic states: "Formulas for regulating Qi must distinguish Yin and Yang, determine whether the location is internal or external, and adhere strictly to their respective domains." Internal diseases are treated internally; external diseases are treated externally; mild conditions are regulated; moderate conditions are pacified; severe excess conditions are expelled; those requiring sweating are induced to sweat; those requiring purgation are purged.
Observe facial colors and divide by positions: Kun corresponds to Stomach (death if color scatters to Kidney); Dui corresponds to Lung; Qian corresponds to Large Intestine (death if color scatters to Liver); Forehead corresponds to Heart; Kan corresponds to Kidney; Chin corresponds to Mingjing (Acuity/Vision); Five Colors correspond to Xun (Gallbladder, death if color scatters to Spleen); Zhen corresponds to Liver; Gen corresponds to Small Intestine (death if color scatters to Lung).