节为节省之义。虚劳之人,其性情多有偏重之处,每不能撙节其精神,故须各就性情所
失以
,宜节忿怒以养肝;在躁而不静者,宜节辛勤以养力;在琐屑而不坦夷者,宜节思虑以养心
;在慈悲而不解脱者,宜节悲哀以养肺。此六种,皆五志七情之病,非药石所能疗,亦非眷
属所可解,必病者生死切心,自讼自克,自悟自解,然后医者得以尽其长,眷属得以尽其力也。
虚人再经不得一番伤寒,或一番痢疾,或半年几月疟疾,轻伤风感冒,亦不宜辄受。所
以一年之内,春防风,又防寒;夏防暑热,又防因暑取凉,而致感寒;长夏防湿,秋防燥,冬防
寒,又防风。此八者,病者与调理病患者,皆所当知,即医师亦须深明五运六气之理,每当
时序推迁,气候偏重,即宜预为调摄挽救,以补阴阳造化之偏,而制其太过,扶其不足。经
云∶毋翼其胜,毋赞其复,闲其未然,谨其将然,修其已然。即此之谓也。
寒从足起,风从肩俞、眉际而入。病者常护此二处,则风寒之乘于不意者少矣。其间有
最紧
,立身不定光景,即刻断食一周;其稍重者,略散以煎剂,自脱然而愈。若时气初染,不自
觉察,再加以饮食斗凑,经邪传里,轻者蒸灼几日,重者恒致大害。
前者四季之防六气,本而防标之说也。若夫二十四候之间,有最与本症为仇者。其候有
三∶
曾通过,虽嗽平吐止,火降痰宁,病者怡然,以为无事矣。而不知气候之相克,有在于寻常
调燮之外者,一交三候,遂与本症大逆,平者必复,复者必深,深者不救。是惟时时防外邪
、节嗜欲、调七情、勤医药,思患而预防之,方得涉险如夷耳!
“节”意为节省、节制。患有虚劳病的人,其性情往往有偏颇之处,常常不能节制自己的精神消耗,因此需要根据各自性情的缺失来进行调节:对于易怒的人,应当节制愤怒以养护肝脏;对于急躁而不能静心的人,应当节制辛勤劳作以保养体力;对于琐碎计较而不能坦荡平和的人,应当节制思虑以养护心脏;对于慈悲过度而不能解脱放下的人,应当节制悲哀以养护肺脏。这六种情况,都属于五志七情致病,不是药物和针石所能治愈的,也不是家属所能解决的,必须让病人从生死关头切身感悟,自我责备、自我克制、自我领悟、自我解脱,然后医生才能发挥其专长,家属才能尽其辅助之力。
体质虚弱的人,不能再承受一次伤寒,或一次痢疾,或长达半年数月的疟疾,即使是轻微的伤风感冒,也不宜轻易感染。所以一年内,春季要防风邪,又要防寒邪;夏季要防暑热,又要防止因贪凉而感受寒邪;长夏(夏末秋初)要防湿邪,秋季要防燥邪,冬季要防寒邪,又要防风邪。这八种防护,病人和调理病人的家属都应当知晓,即便是医师也必须深刻通晓五运六气的理论,每当季节更替、气候出现偏盛时,就应当预先进行调养摄护以挽救局面,从而弥补阴阳造化的偏差,制约过度的因素,扶持不足的因素。《内经》说:“不要助长胜气,不要赞助复气,在病未发生前加以防范,在病将发生时谨慎对待,在病发生后认真治疗。”说的就是这种情况。
寒邪多从足部侵入,风邪多从肩部的俞穴及眉际进入。病人如果经常保护这两个部位,那么风寒之邪趁人不备侵袭的情况就会减少。其中如果有最紧急的情况,表现为站立不稳、头晕目眩,应立即断食一周;病情稍重的,用少量煎剂稍微发散一下,自然就能痊愈。如果是时令疫病刚刚感染,自己并未察觉,再加上饮食不节制,导致外邪传入体内,轻者会蒸腾灼烧几天,重者则常造成严重危害。
前面提到的四季预防六气,是治本以防标的说法。至于二十四候之中,有些候气是与本症最为仇视对立的。这种候气有三种:曾经经历过,虽然咳嗽平息、呕吐停止,火降痰宁,病人感到安然无恙,以为没事了。却不知道气候之间的相克关系,有超出日常调养范围的因素,一旦进入这三种候气,就会与本症产生巨大的逆反,原本平稳的病情必然复发,复发后必然加深,加深了就难以救治。只有时时防范外邪、节制嗜欲、调畅七情、勤于医药,思患而预防,才能像走在平坦大道上一样安全度过险境!
"Jie" (Restraint) implies saving and tempering. Patients with consumptive disease (Xu Lao, 虚劳) often have imbalanced dispositions and frequently fail to restrain their mental exertion. Therefore, regulation should be tailored to their specific emotional deficits: those prone to anger should restrain anger to nourish the Liver; those who are restless and unable to remain calm should restrain excessive toil to preserve physical strength; those who are meticulous yet lack magnanimity should restrain overthinking to nourish the Heart; those who are overly compassionate yet unable to let go should restrain sorrow to nourish the Lungs. These six conditions all stem from diseases of the Five Wills and Seven Emotions. They cannot be cured by herbs or acupuncture, nor can they be resolved by family members alone. The patient must deeply internalize the stakes of life and death, engage in self-reproach and self-discipline, achieve self-realization and self-liberation. Only then can the physician fully exert their expertise, and the family members fully exert their supportive efforts.
Individuals with deficient constitutions cannot withstand another episode of Cold Damage (Shang Han, 伤寒), dysentery, or malaria lasting half a year or several months. Even mild wind-cold common colds should not be casually contracted. Therefore, throughout the year: in Spring, one must guard against Wind pathogens and Cold pathogens; in Summer, one must guard against Summerheat and Heat, as well as Cold acquired from cooling down excessively due to heat; in Late Summer, one must guard against Dampness; in Autumn, one must guard against Dryness; in Winter, one must guard against Cold and Wind. These eight precautions must be known by both the patient and those caring for them. Physicians must also deeply understand the principles of the Five Movements and Six Qi (Wu Yun Liu Qi, 五运六气). Whenever seasons shift and climatic factors become predominant, preventive regulation and rescue measures should be taken in advance to compensate for deviations in Yin-Yang creation, restrict excesses, and support deficiencies. The Classic states: "Do not assist the prevailing pathogen, do not aid the retaliatory reaction; prevent it before it arises, be cautious when it is about to arise, and treat it properly once it has arisen." This is what is meant.
Cold pathogens typically enter from the feet, while Wind pathogens enter via the Shoulder Shu points (Jian Shu, 肩俞) and the brow area. If patients consistently protect these two areas, unexpected invasions by Wind and Cold will be minimized. In the most critical situations, characterized by instability in standing and dizziness, fasting for one week should be instituted immediately. For slightly more severe cases, a mild decoction to disperse the pathogen suffices for spontaneous recovery. However, if an epidemic pathogen is initially contracted without awareness, and this is compounded by dietary indiscretion, leading to the transmission of external pathogens into the interior, mild cases may involve steaming and burning for several days, while severe cases often result in significant harm.
The aforementioned prevention of the Six Qi (Six Pathogens) across the four seasons represents treating the root to prevent the branch. Among the twenty-four solar terms (Hou, 候), there are specific periods that are particularly antagonistic to the primary condition. There are three such periods: Although the patient may have passed through previous stages, with coughing ceased, vomiting stopped, fire subsided, and phlegm calmed, feeling at ease and believing the illness is over, they remain unaware that climatic interactions involving mutual overcoming exist beyond ordinary regulation. Once these three periods arrive, they create a major reversal relative to the primary condition. Previously stable conditions will inevitably relapse; relapses will inevitably deepen; deepened conditions are incurable. Only by constantly preventing external pathogens, restraining desires, regulating the Seven Emotions, and diligently using medicine—anticipating trouble and preventing it—can one navigate dangers as if on flat ground.