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夫药有寒热温凉之性,酸苦辛咸甘淡之味。各有所能,不可不通也。药之气味,不比同
时之物,味皆咸,其气皆寒之类是也。凡同气之物必有诸味,同味之物必有诸气。互相气味
,各有浓薄,性用不等。制其方者,必且明其为用。经曰∶味为阴,味浓为纯阴,味薄为阴
中之阳;气为阳,气浓为纯阳,气薄为阳中之阴。然,味浓则泄,薄则通;气薄则发泄,浓
则
发热。又曰∶辛甘发散为阳,酸苦涌泄为阴;咸味涌泄为阴,淡味渗泄为阳。凡此之味,各
有所能。然辛能散结、润燥;苦能燥湿、坚软;咸能软坚;酸能收缓收散;甘能缓急;淡能
利窍。故经曰∶肝苦急,急食甘以缓之;心苦缓,急食酸以收之;脾苦湿,急食苦以燥之;
肺苦气上逆,急食苦以泄之;
肾苦燥,急食辛以润之,开腠理、致津液、通其气也。肝欲散,
急食辛以散之;心欲软,急食咸以软之;脾欲缓,急食甘以缓之;肺欲收,急食酸以收之;
肾欲坚,急食苦以坚之。凡此者,是明其气味之用也。若用其味,必明其气之可否;用其气
,必明其味之所宜。识其病之标本、脏腑、寒热、虚实、微甚、缓急而用其药之气味,随其
证而制其方也。是故方有君臣、佐使、轻重、缓急、大小、反正逆从之制也。
主治病者为君,佐君者为臣,应臣者为使。用此随病之所宜,而又赞成方而用之。
君一臣二,奇之制也,君二臣四,偶之制也;君二臣三,奇之制也;君二臣六,偶之制
也。去咽嗌近者奇之,远者偶之。汗者不奇,下者不偶。补上治上,制之以缓;补下治下,
制之以急。急者气味浓也,缓者气味薄也;薄者少服而频食,浓者多服而顿食。
又当明五气之郁∶木郁达之,谓吐,令条达也;火郁发之,谓汗,令疏散也;土郁夺之
,谓下,令无壅滞也;金郁泄之,谓解表,利小便也;水郁折之,谓制其冲逆也。通此五法
,乃治病之大要也。
太阴经向导图\pt2.bmp
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药物具有寒、热、温、凉四种性质,以及酸、苦、辛、咸、甘、淡六种味道。每种药性气味都有其特定的功效,这是不可不通晓的。药物的气味,不同于同时生长的其他事物(例如那些味道都是咸、气性都是寒的事物)。凡是气性相同的药物,必然具备各种味道;凡是味道相同的药物,必然具备各种气性。它们互相交错的气味,各有浓烈与浅薄的区别,因此药效作用也不相同。制定方剂的人,必须明确药物的具体用途。《内经》说:味道属阴,味道浓厚属于纯阴,味道淡薄属于阴中之阳;气性属阳,气性浓厚属于纯阳,气性淡薄属于阳中之阴。然而,味道浓厚能泄下,味道淡薄能通利;气性淡薄能发散透表,气性浓厚能产生发热效应。又说:辛味和甘味具有发散作用,属于阳;酸味和苦味具有涌吐和泄下的作用,属于阴;咸味具有涌吐和泄下的作用,属于阴;淡味具有渗湿利窍的作用,属于阳。以上这些味道,各自都有特定的功能。其中,辛味能散结气、润燥;苦味能燥湿、使松弛的组织变得坚实;咸味能软化坚硬之物;酸味能收敛缓急、收摄散失之气;甘味能缓解急迫;淡味能通利孔窍。所以《内经》说:肝苦于拘急,应当紧急食用甘味药来缓和它;心苦于弛缓,应当紧急食用酸味药来收敛它;脾苦于湿邪困阻,应当紧急食用苦味药来燥湿;肺苦于气机上逆,应当紧急食用苦味药来泄降肺气;肾苦于干燥,应当紧急食用辛味药来滋润它,通过开发腠理、促进津液生成、通畅气机来实现。肝喜条达而恶抑郁,应当紧急食用辛味药来疏散它;心喜软坚,应当紧急食用咸味药来软化它;脾喜缓,应当紧急食用甘味药来缓和它;肺喜收敛,应当紧急食用酸味药来收敛它;肾喜坚固,应当紧急食用苦味药来坚固它。以上这些,是阐明药物气味的作用。如果使用药物的味道,必须明辨其气性是否适宜;如果使用药物的气性,必须明辨其味道是否合适。识别疾病的标本、涉及的脏腑、寒热属性、虚实状态、病情的轻重缓急,从而选用相应气味特性的药物,根据证候来制定方剂。因此,方剂的组成有君臣佐使、轻重缓急、大小反正逆从等法度。
主治疾病的是君药,辅助君药的是臣药,配合臣药起作用的是使药。使用这些药物要顺应病情的需要,并以此协助完善方剂的功效。
君药一味、臣药两味,称为“奇方”;君药两味、臣药四味,称为“偶方”;君药两味、臣药三味,称为“奇方”;君药两味、臣药六味,称为“偶方”。病位靠近咽喉上部的用奇方,远离的用偶方。发汗的方剂不用奇方(即多用偶数),攻下的方剂不用偶方(即多用奇数)。补益上部或治疗上部疾病,方剂制法宜缓;补益下部或治疗下部疾病,方剂制法宜急。所谓“急”,是指药性气味浓厚;所谓“缓”,是指药性气味淡薄。气味淡薄的药,应少量多次服用;气味浓厚的药,应多量一次性服用。
还应当明辨五气的郁滞:木气郁结,应用“达”法,即催吐,使其条达舒畅;火气郁结,应用“发”法,即发汗,使其疏散;土气郁结,应用“夺”法,即攻下,使其无壅滞;金气郁结,应用“泄”法,即解表、利小便;水气郁结,应用“折”法,即制约其冲逆之势。通晓这五种治法,就是治病的关键要领。
Diagram of the Guide for Taiyin Meridian \pt2.bmp
Diagram of the Guide for Yangming Meridian \pt3.bmp
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Diagram of the Guide for Shaoyang Meridian \pt5.bmp
Diagram of the Guide for Taiyang Meridian \pt6.bmp
Diagram of the Guide for Shaoyin Meridian \pt7.bmp
Medicinals possess four natures: Cold (Han), Heat (Re), Warm (Wen), and Cool (Liang); and six flavors: Sour (Suan), Bitter (Ku), Acrid/Pungent (Xin), Salty (Xian), Sweet (Gan), and Bland (Dan). Each has its specific capabilities, which must be thoroughly understood. The nature and flavor of medicinals differ from other substances growing at the same time (such as those that are all salty in flavor and cold in nature). All things sharing the same nature necessarily possess various flavors; all things sharing the same flavor necessarily possess various natures. Their mutual interactions of nature and flavor vary in intensity and thinness, resulting in unequal therapeutic effects. Those who formulate prescriptions must clearly understand their uses. The Classics state: Flavor is Yin; strong flavor is Pure Yin, while weak flavor is Yang within Yin. Nature is Yang; strong nature is Pure Yang, while weak nature is Yin within Yang. However, strong flavor causes purgation/drainage, while weak flavor promotes unblocking; weak nature promotes sweating/venting, while strong nature generates heat. It is also said: Acrid and Sweet flavors promote dispersing and diffusing, belonging to Yang; Sour and Bitter flavors promote vomiting and purging, belonging to Yin; Salty flavor promotes vomiting and purging, belonging to Yin; Bland flavor promotes seeping and draining, belonging to Yang. All these flavors have specific functions. Specifically, Acrid can dissipate nodules and moisten dryness; Bitter can dry dampness and firm softness; Salty can soften hardness; Sour can astringe and restrain dispersion; Sweet can relieve urgency; Bland can open orifices. Thus, the Classics state: When the Liver suffers from tension/urgency, urgently consume Sweet medicinals to relax it; when the Heart suffers from flaccidity/laxity, urgently consume Sour medicinals to astringe it; when the Spleen suffers from Dampness, urgently consume Bitter medicinals to dry it; when the Lung suffers from rebellious Qi ascending, urgently consume Bitter medicinals to drain it; when the Kidney suffers from dryness, urgently consume Acrid medicinals to moisten it, by opening the interstices (Cou Li), generating body fluids, and promoting Qi circulation. The Liver desires dispersion, so urgently consume Acrid medicinals to disperse it; the Heart desires softening, so urgently consume Salty medicinals to soften it; the Spleen desires relaxation, so urgently consume Sweet medicinals to relax it; the Lung desires consolidation/restriction, so urgently consume Sour medicinals to astringe it; the Kidney desires firmness, so urgently consume Bitter medicinals to firm it. These clarify the functions of nature and flavor. If using the flavor, one must determine if the nature is appropriate; if using the nature, one must determine if the flavor is suitable. By identifying the root and branch of the disease, the involved Zang-Fu organs, the Cold-Heat status, the Deficiency-Excess condition, and the severity and urgency, one selects medicinals with appropriate natures and flavors, formulating prescriptions according to the syndrome. Therefore, prescriptions follow principles of Sovereign-Minister-Assistant-Courier roles, weightiness-lightness, urgency-slowness, size, reversal/concordance, and following/opposition.
The Sovereign (Jun) herb treats the main disease; the Minister (Chen) herb assists the Sovereign; the Assistant (Zuo) and Courier (Shi) herbs respond to the Minister. These are used according to the needs of the disease, thereby completing and supporting the prescription's function.
One Sovereign and two Ministers constitute an Odd (Qi) formula; two Sovereigns and four Ministers constitute an Even (Ou) formula; two Sovereigns and three Ministers constitute an Odd formula; two Sovereigns and six Ministers constitute an Even formula. For diseases near the throat, use Odd formulas; for distant diseases, use Even formulas. For diaphoretic (sweating) treatments, do not use Odd formulas; for purgative treatments, do not use Even formulas. Tonifying the upper or treating upper diseases requires slow-formulated prescriptions; tonifying the lower or treating lower diseases requires urgent-formulated prescriptions. "Urgent" refers to strong/nature-rich medicinals; "slow" refers to weak/flavor-thin medicinals. Thin-natured medicinals should be taken in small doses frequently; rich-natured medicinals should be taken in large doses at once.
Furthermore, one must understand the five types of Qi stagnation: Wood stagnation is resolved by "reaching" (Da), meaning inducing vomiting to allow free flow; Fire stagnation is resolved by "venting" (Fa), meaning inducing sweating to allow dispersion; Earth stagnation is resolved by "seizing" (Duo), meaning purging to remove obstruction; Metal stagnation is resolved by "draining" (Xie), meaning releasing the exterior and promoting urination; Water stagnation is resolved by "checking" (Zhe), meaning restraining its rebellious upward surge. Mastering these five methods constitutes the major essentials of treating disease.