论久嗽久泻久汗
天师曰∶收治者，气散而收之也。如人病久嗽不已，久泻不已，久汗不已是也。久嗽省，人无不为
邪之聚也，日日用发散之剂而不效者何？气散故耳。气散矣，而仍用散药，无怪乎经月而不效也。法当用
收敛之药一二剂，便见成功。方用人参一钱，白芍三钱，酸枣仁二钱，北五味子一钱，麦冬五钱，苏子一
钱，益智仁五分，白芥子一钱，水煎服。（〔批〕止嗽神丹。）一剂轻，二剂全愈。后服六味地黄丸，加
麦冬三两，北五味子一两。服之不再发，否则不能保其不发也。盖久服散药，耗尽真阴，虽暂用收敛之
药，一时奏功，而真阴既亏，腠理不密，一经风邪，最易感入，此必须之势也。服地黄丸，水足而肺金有
养，腠理自密，又何患重感风邪哉。
大泻之后，必多亡阴，亡阴既多则元阳亦脱。若不急为收止，则阴绝阳亡，可立而待，法当用止塞之
品。或疑邪未尽去，如何止住其水，万一邪居中州，则腹心之患，不可
不虑。其言则是，其理则非。吾言大泻者，乃纯是下清水，非言下利也。利无止法，岂泻水亦无止法
乎。敌人患水泻者，急宜止遏。方用白术五钱，茯苓三钱，车前子一钱，北五味一钱，吴茱萸五分，酸枣
仁一钱，水煎服。（〔批〕分水神丹）。此方止药少于补药，健脾去湿，水性分消，不收而自收也。
若纯以粟壳以涩止之，而不分消其滔天之势，则阻滞一时，势必溃决，反生大害矣。
大汗之病，阳气尽随汗而外越，若不急为止抑，则阳气立散，实时身死。法当以大补之剂煎饮，一线
之气可留，而大汗可止。方用人参一两，或黄 二两代之，当归一两，北五味一钱，桑叶七片，急为煎
服。此方即补血汤之变，妙在补气药多于补血，使气旺则血自生，血生汗可止。况方中加五味子以收汗，
加桑叶以止汗，有不相得益彰者乎。倘以大汗之人，气必大喘，不可以参 重增其气，纯用补血之品，
未为无见。然而，血不可骤生，气当急固，罔顾气，徒补血，未见功成。此似是而非，又不可不急辨之也。
此收法宜知，医可不细加体认乎。
张公曰∶俱论得畅而妙，吐泻无可再言。惟久嗽之法，吾意即宜以六味地黄汤，加麦冬、五味治之，
似宜不必先用人参以救肺气之害也。然而天师用之，必有深意，他日再敬询之。
（大汗症，多系阳脱，有用大剂参附汤者。李子永识。）
陈士铎（号天师）说：所谓“收治法”，是指针对气机耗散而采用收敛固摄的治疗方法。例如，有人患久咳不愈、久泻不止、大汗淋漓不止等病症，就是这种情况。
对于久咳，人们往往认为这是邪气聚集所致，因此每日使用发散解表的药物，却不见疗效，为什么呢？这是因为肺气已经耗散。既然气已耗散，仍然继续使用发散的药物，难怪经过一个月也无效。治疗法则应当使用一两剂收敛性质的药物，就能见到成效。方剂用人参一钱，白芍三钱，酸枣仁二钱，北五味子一钱，麦冬五钱，苏子一钱，益智仁五分，白芥子一钱，加水煎服。（批注：止嗽神丹。）服用一剂症状减轻，两剂即可痊愈。之后服用六味地黄丸，加入麦冬三两，北五味子一两。坚持服用可以防止复发，否则不能保证不再发作。因为长期服用发散药物，会耗尽真阴（人体根本的阴液），虽然暂时使用了收敛药物取得效果，但真阴既然亏损，腠理（皮肤毛孔及肌肉纹理）就不致密，一旦遇到风邪，最容易侵入，这是必然的趋势。服用地黄丸，使肾水充足从而滋养肺金（肺属金，肾属水，金生水，故滋肾水可养肺），腠理自然致密，又何必担心再次感受风邪呢？
在大泻之后，必然导致大量亡阴（阴液严重亏损），亡阴过多则元阳（根本阳气）也会随之脱失。如果不紧急进行收涩止泻，那么阴绝阳亡的局面就会立刻出现，死亡指日可待。治疗法则应当使用具有止涩作用的药物。有人怀疑邪气尚未完全清除，怎么能强行止住泄泻呢？万一邪气停留在中焦脾胃，造成腹心之患，不得不考虑。这种说法在情理上似乎正确，但在医理上则是错误的。我所说的“大泻”，是指纯粹排出清水样便，并非指一般的痢疾或下利。痢疾没有止泻的法度，难道排清水也没有止泻的法度吗？对于患有水泻的病人，应当紧急遏制。方剂用白术五钱，茯苓三钱，车前子一钱，北五味子一钱，吴茱萸五分，酸枣仁一钱，加水煎服。（批注：分水神丹）。这个方剂中止涩药少于补益药，旨在健脾祛湿，使水湿分消，无需刻意收敛而自然收敛。如果单纯用罂粟壳来涩止，而不分消那滔天般的水势，只是暂时阻滞，势必会导致溃决，反而产生更大的危害。
大汗的病证，阳气随着汗液全部向外耗散，如果不紧急制止抑制，阳气就会立即消散，人随即死亡。治疗法则应当用大补气的药剂煎服，保留一线生机之气，大汗就可以停止。方剂用人参一两，或者用黄芪二两代替，当归一两，北五味子一钱，桑叶七片，紧急煎服。这个方剂是补血汤（当归补血汤）的变方，妙处在于补气药多于补血药，使气旺盛则血自然生成，血生成则汗可止。况且方中加入五味子以收敛汗液，加入桑叶以止汗，不是相得益彰吗？如果有人认为大汗的人必然气虚喘促，不可以用人参、黄芪加重补气，而应纯用补血药物，这看似有道理。然而，血液不能骤然生成，气必须紧急固摄，不顾气虚而只补血，未见能成功。这种观点似是而非，不可不仔细辨别。
这种收摄的方法应该了解，医生能不细细体察认识吗？
张公说：都说得透彻精妙，关于吐泻的内容无可再言。唯独关于久咳的治疗，我的意见是直接用六味地黄汤，加入麦冬、五味子来治疗，似乎不必先用人参来救治肺气的损害。然而天师这样使用，必有深意，日后我再恭敬地请教他。
Chen Shiduo (styled Tianshi) stated: The so-called "Shou Zhi Fa" (Method of Astringing and Stopping) refers to the therapeutic approach of employing astringent and consolidating methods for conditions characterized by the dispersion of Qi. For instance, when a patient suffers from chronic cough that does not cease, chronic diarrhea that persists, or profuse sweating that continues unabated, these are cases fitting this description.
Regarding chronic cough, people generally believe it is caused by the accumulation of pathogenic factors. Therefore, they use diaphoretic agents daily without effect. Why? It is because the Lung Qi has become dispersed. Since the Qi is already dispersed, continuing to use dispersing herbs is no wonder if there is no improvement after a month. The treatment principle should be to use one or two doses of astringent herbs to achieve success. The prescription consists of Ren Shen (Ginseng Radix et Rhizoma) 1 qian, Bai Shao (White Peony Root) 3 qian, Suan Zao Ren (Ziziphus Seed) 2 qian, Bei Wu Wei Zi (Schisandra Fruit) 1 qian, Mai Dong (Ophiopogon Tuber) 5 qian, Su Zi (Perilla Fruit) 1 qian, Yi Zhi Ren (Alpinia Oxyphylla Fruit) 0.5 fen, and Bai Jie Zi (Mustard Seed) 1 qian, decocted in water and taken orally. (Commentary: Zhi Sou Shen Dan - Divine Elixir for Cough Cessation.) Symptoms will alleviate after one dose and resolve completely after two doses. Subsequently, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) should be taken, supplemented with Mai Dong 3 liang and Bei Wu Wei Zi 1 liang. Consistent administration prevents recurrence; otherwise, recurrence cannot be guaranteed to be avoided. This is because long-term use of diaphoretic drugs depletes Zhen Yin (True Yin). Although astringent herbs may yield temporary results, the deficiency of True Yin leads to loose Cou Li (skin pores and interstitial spaces), making the body highly susceptible to Wind pathogens upon exposure, which is an inevitable trend. Taking Di Huang Wan nourishes Kidney Water to support Lung Metal (as Metal generates Water, nourishing Water supports Metal), causing the Cou Li to naturally become dense. In such a state, why worry about re-contracting Wind pathogens?
Following severe diarrhea, there is inevitably significant loss of Yin fluids. When Yin loss is extensive, Yuan Yang (Primordial Yang) also risks collapse. If immediate astringency and cessation are not employed, Yin exhaustion and Yang collapse will occur swiftly, leading to imminent death. The treatment principle dictates using substances with astringent properties. Some may doubt: if pathogens have not been fully expelled, how can one forcibly stop the diarrhea? If pathogens remain in the Middle Jiao (Spleen and Stomach), causing abdominal distress, this must be considered. While this reasoning seems plausible on the surface, it is medically incorrect. By "severe diarrhea," I refer specifically to the passage of pure watery stool, not dysentery or general loose stools. Dysentery lacks a specific method for stopping flow; does watery diarrhea also lack a method for cessation? For patients suffering from watery diarrhea, urgent intervention is required. The prescription uses Bai Zhu (Atractylodes Macrocephala Rhizome) 5 qian, Fu Ling (Poria) 3 qian, Che Qian Zi (Plantago Seed) 1 qian, Bei Wu Wei Zi 1 qian, Wu Zhu Yu (Evodia Fruit) 0.5 fen, and Suan Zao Ren 1 qian, decocted in water and taken orally. (Commentary: Fen Shui Shen Dan - Divine Elixir for Dividing Waters.) In this formula, astringent herbs are fewer than tonifying herbs, aiming to strengthen the Spleen and remove Dampness, allowing water to be separated and eliminated. Thus, astringency occurs naturally without forced intervention. If one were to solely use Poppy Shell (Yu Ke) to astringently stop the flow without addressing the torrential volume of water, the blockage would only be temporary, inevitably leading to rupture and greater harm.
In cases of profuse sweating, Yang Qi escapes entirely with the sweat. If not urgently restrained, Yang Qi will dissipate instantly, resulting in immediate death. The treatment principle requires administering strong Qi-tonifying decoctions to preserve a thread of vital Qi, thereby stopping the sweating. The prescription consists of Ren Shen 1 liang, or Huang Qi (Astragalus Root) 2 liang as a substitute, Dang Gui (Angelica Sinensis Root) 1 liang, Bei Wu Wei Zi 1 qian, and Sang Ye (Mulberry Leaf) 7 leaves, prepared urgently for oral administration. This formula is a variation of Bu Xue Tang (Blood-Nourishing Decoction). Its brilliance lies in using more Qi-tonifying herbs than Blood-nourishing ones; when Qi becomes robust, Blood generates spontaneously, and once Blood is generated, sweating stops. Furthermore, the addition of Wu Wei Zi to astringe sweat and Sang Ye to stop sweating creates a synergistic effect. Some might argue that patients with profuse sweating likely suffer from severe panting due to Qi deficiency, and thus adding heavy doses of Ren Shen and Huang Qi to boost Qi is inappropriate, suggesting instead a pure Blood-nourishing approach. This view appears reasonable but is fundamentally flawed. Blood cannot be generated rapidly, whereas Qi must be urgently consolidated. Ignoring Qi deficiency while merely tonifying Blood rarely yields success. This perspective is superficially plausible yet essentially erroneous, requiring careful distinction.
Physicians must understand this method of consolidation and exercise diligent contemplation.
Master Zhang commented: All points were discussed thoroughly and ingeniously; nothing further needs to be added regarding vomiting and diarrhea. Regarding the treatment of chronic cough, my opinion is that it is appropriate to directly treat with Liu Wei Di Huang Tang (Six-Ingredient Decoction with Rehmannia) supplemented with Mai Dong and Wu Wei Zi, seemingly avoiding the initial use of Ren Shen to rescue Lung Qi damage. However, Tianshi's usage implies profound intent, which I shall respectfully inquire about at a later date.
(Commentary by Li Ziyong: Profuse sweating syndromes often relate to Yang collapse; cases exist where large doses of Shen Fu Tang (Ginseng and Aconite Decoction) were used.)