论补正攻邪
天师曰∶后治法者,宜后而后之也。人有正气虚寒,以中邪气风寒,不可先攻其邪。盖邪之所凑,
其气必虚,邪之敢入于正气之中者,是人之正气先虚也。不急补其正气,则邪何所畏而肯速去哉。譬如贼人
入室,主懦而仆从又怯;贼必将安坐门庭,逍遥酒食矣。苟能用一二果敢之士,出死力而争敌,则盗寇且
急走而不遑也。故必先补其正,而后可以散邪。方用人参三钱,黄 三钱,柴胡二钱,半夏一钱,甘
草一钱,当归三钱,陈皮一钱,白术三钱,神曲五分,黄芩五分,山楂五粒,水煎服。(〔批〕补正散。)
此方妙在用参、归、 、术以扶正气,加柴胡、半夏以祛邪,加陈皮、山楂以消食,加甘草以和中,不治
邪而邪自退。此后治之妙法也。
张公曰∶后治法甚多,再传二法。一方用人参一钱,白术三钱,甘草一钱,半夏一钱,柴胡三钱,茯
苓三钱,水煎服。(〔批〕扶正散邪汤。)此方专治正气虚而邪入之者。如头疼发热,凡脉右寸口大于
左寸口者,急用此方,无不全愈。盖虽有外邪,不可纯作邪治,当以补正为先,治邪为后。又一方∶用当
归三钱,白芍三钱。枳壳一钱,槟榔一钱,甘草一钱,水煎服,(〔批〕补血荡邪汤。)此方治痢疾之病
最妙。以补正为先,荡邪为后。其余后治之法,可意会而默通之也。
华君曰∶予未传。
雷公曰∶后治法有疟疾方。用人参五钱,白术一两,青皮一钱,柴胡一钱,半夏三钱,水煎服。疟
病虽有痰邪,不可先治邪。此方一味补正,略为祛邪以消痰,然正足而邪自退矣。更有阴虚而发热如疟者,
亦以前方加熟地一两,生何首乌一两,去半夏,换白芥子三钱,治之亦效。
天师说:后治法,是指应当先补益正气,然后再祛除邪气的方法。人体如果正气虚弱且伴有寒象,又感受了风寒邪气,就不能先攻伐邪气。因为邪气聚集的地方,正气必然虚弱;邪气之所以敢侵入正气的领域,是因为人的正气预先已经虚弱。如果不急于补益正气,那么邪气有什么可畏惧而肯于迅速离去呢?这就好比强盗进入室内,主人懦弱,仆从又胆怯;强盗必定会安坐厅堂,逍遥饮酒进食。如果使用一两个果敢之士,拼死力与之争斗,那么盗贼就会急忙逃跑,来不及停留。所以必须先补益正气,然后才可以疏散邪气。方剂用人参三钱,黄芪三钱,柴胡二钱,半夏一钱,甘草一钱,当归三钱,陈皮一钱,白术三钱,神曲五分,黄芩五分,山楂五粒,水煎服。(批注:补正散。)这个方剂的妙处在于用人参、当归、黄芪、白术来扶持正气,加入柴胡、半夏来祛除邪气,加入陈皮、山楂来消食导滞,加入甘草来调和脾胃,不直接治疗邪气而邪气自然消退。这是后治法的精妙之处。
张公说:后治法有很多,再传授两种方法。一方用人参一钱,白术三钱,甘草一钱,半夏一钱,柴胡三钱,茯苓三钱,水煎服。(批注:扶正散邪汤。)此方专门治疗正气虚弱而邪气入侵的情况。如果出现头痛发热,凡是脉象右寸口大于左寸口的,紧急使用此方,没有不痊愈的。虽然存在外邪,不能单纯当作邪气来治疗,应当以补益正气为先,治疗邪气为后。又一方:用当归三钱,白芍三钱,枳壳一钱,槟榔一钱,甘草一钱,水煎服(批注:补血荡邪汤)。此方治疗痢疾最为巧妙。以补益正气为先,荡涤邪气为后。其余的后治方法,可以用心领会并默默贯通它。
华君说:我没有传授。
雷公说:后治法中有治疗疟疾的方子。用人参五钱,白术一两,青皮一钱,柴胡一钱,半夏三钱,水煎服。疟病虽然有痰邪,不可先治疗邪气。此方一味补益正气,略微辅以祛邪以消除痰饮,然而正气充足而邪气自然消退。更有阴虚而导致发热像疟疾一样的情况,也用前方加熟地黄一两,生何首乌一两,去掉半夏,换成白芥子三钱,治疗也有效。
Tian Shi (Heavenly Master) said: The method of "treating after" refers to the principle of tonifying healthy Qi first, and then dispelling pathogenic factors. When a person has deficient and cold healthy Qi and is invaded by wind-cold pathogenic factors, one must not attack the pathogens first. Wherever pathogens gather, Qi must be deficient; the reason pathogens dare to enter the realm of healthy Qi is that the body's healthy Qi was previously deficient. If one does not hasten to tonify healthy Qi, what would make the pathogens fear it enough to depart quickly? It is like thieves entering a house where the master is weak and the servants are cowardly; the thieves will surely sit comfortably in the hall, enjoying food and wine freely. However, if one employs one or two courageous individuals who fight with their lives at stake, the bandits will flee hastily without time to linger. Therefore, one must first tonify healthy Qi before one can disperse pathogens. The prescription uses Ren Shen (Ginseng Radix et Rhizoma) 3 qian, Huang Qi (Astragali Radix) 3 qian, Chai Hu (Bupleuri Radix) 2 qian, Ban Xia (Pinelliae Rhizoma) 1 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, Dang Gui (Angelicae Sinensis Radix) 3 qian, Chen Pi (Citri Reticulatae Pericarpium) 1 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 3 qian, Shen Qu (Massa Medicata Fermentata) 5 fen, Huang Qin (Scutellariae Radix) 5 fen, and Shan Zha (Crataegi Fructus) 5 pieces, decocted in water and taken orally. (Commentary: Bu Zheng San [Tonify Healthy Qi Powder].) The brilliance of this formula lies in using Ren Shen, Dang Gui, Huang Qi, and Bai Zhu to support healthy Qi, adding Chai Hu and Ban Xia to expel pathogens, adding Chen Pi and Shan Zha to resolve food stagnation, and adding Gan Cao to harmonize the middle Jiao. By not directly attacking the pathogens, they retreat naturally. This is the exquisite method of "treating after."
Zhang Gong said: There are many methods of "treating after"; I will transmit two more. One prescription uses Ren Shen 1 qian, Bai Zhu 3 qian, Gan Cao 1 qian, Ban Xia 1 qian, Chai Hu 3 qian, Fu Ling (Poria) 3 qian, decocted in water and taken orally. (Commentary: Fu Zheng San Xie Tang [Support Healthy Qi and Dispel Pathogens Decoction].) This formula is specifically for cases where healthy Qi is deficient and pathogens have entered. If there are symptoms such as headache and fever, and the pulse at the right Cun position is larger than that at the left Cun position, use this formula urgently, and recovery will be complete. Although external pathogens exist, one should not treat them purely as pathogenic conditions; instead, tonifying healthy Qi should come first, and treating pathogens second. Another prescription: uses Dang Gui 3 qian, Bai Shao (Paeoniae Radix Alba) 3 qian, Zhi Ke (Aurantii Fructus Immaturus) 1 qian, Bing Lang (Arecae Semen) 1 qian, Gan Cao 1 qian, decocted in water and taken orally. (Commentary: Bu Xue Dang Xie Tang [Nourish Blood and Sweep Away Pathogens Decoction].) This formula is most effective for treating dysentery. It prioritizes tonifying healthy Qi and subsequently sweeps away pathogens. The remaining methods of "treating after" can be understood through mental contemplation and silent comprehension.
Hua Jun said: I have not transmitted these.
Lei Gong said: Among the methods of "treating after," there is a formula for malaria. It uses Ren Shen 5 qian, Bai Zhu 1 liang, Qing Pi (Citri Reticulatae Pericarpium Viride) 1 qian, Chai Hu 1 qian, Ban Xia 3 qian, decocted in water and taken orally. Although malaria involves phlegm-pathogens, one must not treat the pathogens first. This formula solely tonifies healthy Qi, slightly assisting in expelling pathogens to resolve phlegm; however, once healthy Qi is sufficient, pathogens naturally recede. Furthermore, for cases of Yin deficiency causing fever resembling malaria, use the aforementioned formula with added Shu Di Huang (Rehmanniae Radix Praeparata) 1 liang, Sheng He Shou Wu (Polygoni Multiflori Radix) 1 liang, removing Ban Xia and replacing it with Bai Jie Zi (Sinapis Semen) 3 qian; treatment is also effective.