详见气门
详见热门
子和曰李屏山素饮酒一日得病医用酒蒸丸热后目睹天地但见红色遂成龙火卒不能救 棠
溪李
济之常病目及居省掾每服补肝散以致睛胀但见窗槛横排几至丧明令涌泄五七次继服凉剂方始
如故 丹霞朱僧氏代章宗出家既病三阳蓄热常居静室不敢见明明则头疼如锥每置冰于顶上不
能解其热历诸医莫能辩其病后治之七日而愈其法用汗吐下三法而已后用凉物清镇之平复如故
谨按以上病例非汗吐下法则不能已人惟阴平阳秘神气以宁盖昧者徇情纵欲因致积热之证
非
一朝一夕故也治当如此其为治不能究其源委岂得不遂致误人者哉今以积热沉寒论附录于下
王安道曰人之所借以生者气也气者何阴阳是也夫阴与阳可以和而平可以乖而否善摄与否
吉凶
于是乎定夫惟摄之不能以皆善也故偏寒偏热之病始莫逃于乖否之余矣虽然寒也热也苟未至于
甚粗工为之而不难设热积而寒沉良工犹弗能以为计况其下乎奈之何俗尚颛蒙恪恃方药愈投
愈
盛迷不之反岂知端本澄源中含至理执其枢要众妙俱呈且以积热言之始而凉和次而寒取寒取不
愈则因热而从之从之不愈则技穷矣由是苦寒频岁而弗停又以沉寒言之始而温和次而热取热取
不
愈则因寒而从之从之不愈则技穷矣由是辛热比年而弗止叹夫苦寒益深而积热弥炽辛热太过而
沉
寒愈滋苟非大圣慈仁明垂枢要生也孰从而全之经曰诸寒之而热者取之阴热之而寒者取之阳
所谓
求其属也属也者其枢要之所存乎斯旨也王太仆知之故曰益火之原以消阴翳壮水之主以制阳光
又曰取心者不必齐以热取肾者不必齐以寒但益心之阳寒亦通行强肾之阴热之犹可吁混乎千言
万
语之间殆犹和璧之在璞也夫寒之而热者徒知以寒治热而不知热之不衰者由乎真水之不足也热
之
而寒者徒知以热治寒而不知寒之不衰者由乎真火之不足也不知真水火不足泛以寒热药治之非
惟脏腑习熟药反见化于其病而有者弗去无者复至矣故取之阴所以益肾水之不足而使其制夫心
火之有余取之阳所以益心火之不足而使其胜夫肾水之有余也其指水火也属犹主也谓心肾也求
其属者言水火不足而求之于心肾也火之原者阳气之根即心是也水之主者阴气之根即肾是也非
谓火
为心而原为肝水为肾而主为肺也寒亦益心热亦强肾此太仆之至理于规矩准绳之外而非迂生曲
士之可以 及矣
详见“气门”章节。
详见“热门”章节。
张子和说:李屏山平时喜欢饮酒,有一天生病了。医生用酒蒸制的丸药,患者服后感到发热,随后出现视觉幻觉,看到天地都变成了红色,最终因龙火(肾中虚火上炎)爆发而死亡,无法救治。
溪人李济之经常患有眼疾,担任省掾(官职)期间,每次服用补肝散导致眼睛胀痛,几乎失明。后来经过涌泄法(催吐或泻下以祛除邪气)治疗五到七次,继而又服用凉性药剂,病情才恢复如常。
丹霞朱僧氏是章宗时期的出家僧人。他患病时三阳经蓄积热邪,常常居住在安静的房间里,不敢见光,一见光就头痛如锥刺一般。他曾在头顶放置冰块,但无法缓解体内的热感。历经多位医生诊治,都无法辨明病因。后来通过汗、吐、下三种方法治疗七天痊愈,之后再用凉性药物清镇,身体完全康复。
谨按:以上病例,如果不使用汗、吐、下法,病就无法治愈。人们只有做到阴平阳秘(阴阳平衡协调),神气才能安宁。那些不明医理的人放纵情欲,导致积热证的形成,这不是一朝一夕的事情。治疗应当如此。如果治病不能探究其根源和原委,怎么能不导致误人呢?现将关于积热沉寒的论述附录如下。
王安道说:人类赖以生存的是气。气是什么?就是阴阳。阴阳可以和谐平衡,也可以乖违阻滞。善于调养与否,吉凶由此而定。因为调养不可能每次都完美,所以偏寒偏热的疾病开始出现在阴阳乖违之后了。虽然说是寒证或热证,如果尚未发展到严重程度,粗劣的医生治疗起来也不难。但如果热邪积聚且寒邪深重,即使是良工也难以制定对策,何况是低水平的医生呢?无奈世俗崇尚愚昧无知,固执地依赖固定方药,越投药病情越重,迷惑而不回头。岂不知正本清源中包含着至深的道理,掌握关键枢纽,各种奥妙都会呈现出来。
就拿积热来说,起初用凉和法,其次用寒取法;如果寒取法无效,则顺应热势而从治;如果从治无效,医术就穷尽了。于是苦寒药物常年不停使用。再从沉寒来说,起初用温和法,其次用热取法;如果热取法无效,则顺应寒势而从治;如果从治无效,医术就穷尽了。于是辛热药物连年不断。感叹啊,苦寒用得越深,积热反而越炽盛;辛热用得太过,沉寒反而更加滋长。如果不是大圣大慈之人明示关键枢纽,生命谁能得以保全呢?《内经》说:“诸寒之而热者取之阴,热之而寒者取之阳。”这就是所说的“求其属”。所谓“属”,就是关键枢纽所在吧。这个宗旨王太仆(王冰)深知,所以说:“益火之原以消阴翳,壮水之主以制阳光。”又说:“取心者不必齐以热,取肾者不必齐以寒。但益心之阳,寒亦通行;强肾之阴,热之犹可。”唉,这千言万语之间,大概就像和氏璧藏在璞玉之中一样。
凡是寒之而热者,只知道用寒药治热,却不知道热不退是因为真水不足。凡是热之而寒者,只知道用热药治寒,却不知道寒不退是因为真火不足。不知道真水火不足,泛泛地使用寒热药物治疗,不仅脏腑对药物习以为常,药物反而被病变所同化,有的病邪不去,新的病邪又产生。所以“取之阴”是为了补充肾水的不足,从而制约心火的有余;“取之阳”是为了补充心火的不足,从而战胜肾水的有余。这里说的“指水火”,“属”相当于“主”,指的是心肾。“求其属”的意思是,水火不足,就要从心肾去寻求根本。“火之原”是阳气的根,即心;“水之主”是阴气的根,即肾。并不是说火属于心而原属于肝,水属于肾而主属于肺。寒也能益心,热也能强肾,这是王太仆的至理名言,超越了规矩准绳,不是迂腐的书生和孤陋寡闻的人所能达到的境界。
See the chapter on "Qi Gate" (Vital Qi Disorders).
See the chapter on "Hot Gate" (Heat Disorders).
Zihe (Zhang Congzheng) said: Li Pingshan usually drank alcohol. One day he fell ill. The physician administered pills steamed with wine. After taking them, the patient felt feverish and subsequently experienced visual hallucinations, seeing heaven and earth turn red. Ultimately, he died from the eruption of Long Huo (Dragon Fire, referring to defluxion of ministerial fire from the Kidney), and could not be saved.
Li Jizhi from Xixi often suffered from eye diseases. While serving as a provincial clerk (Sheng Yuan), every time he took Bu Gan San (Liver-Nourishing Powder), his eyes swelled, nearly causing blindness. He was treated with Yong Xie (Draining and Purging methods, such as emesis or purgation) five to seven times, followed by the administration of cooling agents, after which he recovered to normal.
Zhu Sengshi from Danxia was a monk ordained during the reign of Emperor Zhangzong. When he fell ill, heat accumulated in the Three Yang channels. He often stayed in quiet rooms and dared not look at light; exposure to light caused headaches like needle pricks. He placed ice on his head, but it could not relieve the internal heat. Many physicians failed to diagnose his condition correctly. Later, he was cured in seven days using the three methods of sweating, vomiting, and purging, followed by cooling and settling agents, after which he fully recovered.
Note: For the above cases, if the methods of sweating, vomiting, and purging are not used, the disease cannot be resolved. Only when Yin and Yang are balanced and secret (Yin Ping Yang Mi) can Shen Qi (Spiritual Qi) remain tranquil. Ignorant people indulge their desires, leading to conditions of accumulated heat, which do not arise overnight. Treatment must be conducted accordingly. If one treats without investigating the source and context, how can one avoid harming patients? Below is an appendix on the discussion of accumulated heat and deep-seated cold.
Wang Andao said: What humans borrow for life is Qi. What is Qi? It is Yin and Yang. Yin and Yang can be harmonious and balanced, or they can be discordant and obstructed. Whether one manages them well or poorly determines auspiciousness or misfortune. Since management is not always perfect, diseases of bias toward cold or heat begin to appear amidst the aftermath of Yin-Yang discord. Although these are merely cold or heat syndromes, if they have not reached severity, even mediocre physicians find treatment easy. However, if heat accumulates and cold sinks deeply, even skilled physicians may struggle to devise a plan, let alone inferior ones. Why is it that common practice favors ignorance, rigidly relying on fixed prescriptions, making the condition worse with each dose, yet people remain deluded and do not return to the right path? Do they not know that rectifying the root and clearing the source contains profound principles? Grasping the pivotal key reveals all wonders.
Take accumulated heat as an example: initially use cooling and harmonizing methods; next, use cold-draining methods. If cold-draining fails, follow the heat (induce sweating or other methods based on heat patterns). If following the heat fails, medical skill is exhausted. Thus, bitter-cold herbs are used continuously year after year. Regarding deep-seated cold: initially use mild-warming methods; next, use hot-draining methods. If hot-draining fails, follow the cold. If following the cold fails, medical skill is exhausted. Thus, acrid-hot herbs are used continuously year after year. Alas! The deeper the use of bitter-cold, the more intense the accumulated heat becomes; the excessive use of acrid-hot makes the deep-seated cold more prevalent. Unless a Great Sage shows benevolence and clearly reveals the pivotal key, who can preserve life? The Classic says: "For those made hotter by cold treatments, treat the Yin; for those made colder by heat treatments, treat the Yang." This is called "seeking its affiliation/substance" (Qiu Qi Shu). The "Shu" (affiliation/substance) is where the pivotal key lies. Wang Taipu (Wang Bing) understood this principle, hence he said: "Boost the origin of Fire to dissipate Yin shadows; strengthen the master of Water to control Yang brightness." He also said: "Treating the Heart does not necessarily require uniform heat; treating the Kidney does not necessarily require uniform cold. Merely boost the Yang of the Heart, and cold will circulate freely; strengthen the Yin of the Kidney, and heat will still be manageable." Ah, within thousands of words, this truth is like the He Shi Bi (He's Jade Disc) hidden in uncarved stone.
For cases where cold treatment results in heat, people only know to use cold to treat heat, unaware that the persistence of heat is due to insufficiency of True Water. For cases where heat treatment results in cold, people only know to use heat to treat cold, unaware that the persistence of cold is due to insufficiency of True Fire. Not knowing that True Water and Fire are insufficient, and indiscriminately using cold and heat drugs, not only causes the Zang-Fu organs to become accustomed to the drugs, but the drugs may also be transformed by the pathology. Existing pathogens remain, and new ones arise. Therefore, "treating the Yin" supplements the insufficiency of Kidney Water to constrain the excess of Heart Fire. "Treating the Yang" supplements the insufficiency of Heart Fire to overcome the excess of Kidney Water. Here, "referring to Water and Fire," "Shu" (affiliation) is equivalent to "Zhu" (master), referring to the Heart and Kidney. "Seeking its Shu" means seeking the root of Water and Fire insufficiency in the Heart and Kidney. The "Origin of Fire" is the root of Yang Qi, which is the Heart. The "Master of Water" is the root of Yin Qi, which is the Kidney. It does not mean Fire belongs to the Heart while its Origin belongs to the Liver, nor that Water belongs to the Kidney while its Master belongs to the Lung. Cold can also benefit the Heart; Heat can also strengthen the Kidney. This is the supreme truth of Taipu, transcending standard rules and measurements, beyond the reach of pedantic scholars and narrow-minded individuals.