论脾肺同治 论肾肝同治 论心肾同治 论肺经独治
天师曰∶脏治者，五脏中有病而治之者也。脏有五，治法惟三，脾肺同一治，肾肝同一治，心肾同
一治也。肺气之伤，必补脾气，脾气既伤，肺气亦困，故补肺必须补脾，而补脾必须补肺。如人或咳嗽不
已，吐泻不已，此肺脾之伤。人以为咳嗽宜治肺，吐泻宜治脾。殊不知咳嗽由于脾气之衰，而吐呕泻由于
肺气之衰，盖肺气无清肃之下行，始上呕而下泻∶脾气斡旋之令不行，则上为咳嗽矣。方用人参一钱，麦
冬三钱，茯苓三钱，柴胡一钱，神曲五分，车前子一钱，甘草一钱，薏仁五钱，水煎服。（〔批〕肺脾双
解饮。）此方乃治肺治脾之药合而用之者也。咳嗽喘病之尽除，吐呕泻症之各去，所谓一方两用也。
肾肝同治者，肾水不能滋肝，则肝木抑郁而不舒，必有两胁饱闷之症；肝木不能生肾中之火，则肾水
日寒，必有腰脊难于俯仰之症，故补肝必须补肾中之水，补肾中之水，又不可不补肝木。倘补肝而不补肾，
则胁痛何以顿除；补肾而不补肝，则腰脊何以立愈。方用熟地一两，山茱萸五钱，白芍五钱，当归五钱，
柴胡二钱，肉桂一钱，水煎服。（〔批〕肾肝同补汤。）此方熟地、山茱补肾之药，而当归、白芍、柴胡、
肉桂补肝之品，既两脏平补，似乎药不该轻重。今补肝之药反多于补肾者，可见肾为肝之母，肝又为命门
之母也。命门是一身主宰，当生五脏之气，不宜为五脏所生。然而五脏叠为
生克。肝既是木，岂木独不可以生命门之火乎。此有至理存焉，非吾仙人，安能阐发。愿世人勿惊为创
说奇闻，而疑为不可执之以治病也。
再心肾治法。二脏合而治之者，其义又何居？肾，水脏也；心，火脏也。是心肾二经为仇敌，似乎不
宜牵连而一治之。不知心肾虽相克，其实相须。无心之火，则成死灰，无肾之水，则成冰炭，心必得肾水
以滋养，肾必得心火而温暖。如人惊惕不安，梦遗精泄，岂非心肾不交乎。人以为惊惕不安，心之病，我以
为肾之病；梦遗精泄，人以为肾之病，我以为心之病。非颠倒之也，实至当不易之理。方用人参三两，
白术五两，远志一两，炒枣仁三两，熟地五两，山茱萸三两。麦冬三两，北五味一两，芡实五两，山药三
两，菖蒲一两，柏子仁三两，去油，茯神三两，砂仁三钱，橘红一两，各为末，蜜为丸。白滚水送下五
钱。（〔批〕心肾同补丹。）此丸之妙，乃治肾之药少于治心。盖心君宁静，肾气自安，肾气既安，何
至心动。此治心正所以治肾，而治肾正所以治心也。此治脏之法，幸人加之意哉。
张公曰∶脏治之法尽于三方，无可再议。不已，其肺脏之独治乎。肺有忽感风寒，而鼻塞出嚏，咳
嗽不已，吐痰如败絮，乃肺经独病也，不必兼治于脾。予留一方∶用甘草一钱，桔梗三钱，半夏一钱，
射干一钱，水煎服。（〔批〕散寒汤。）此方之妙，妙在桔梗升提于鼻，引去痰之药上行于肺，以散风
寒之邪。邪散则鼻塞顿除，痰亦随之而散，又何必治脾之迂缓哉。然止可治风寒之外感，而不可治内伤
之诸症。内伤诸症，有天师方在，肺脾同治之可耳。肾肝与心肾治法，亦不必再言。
天师曰∶尽善也。
华君曰∶无。
（此脾湿熏肺之症，方用燥脾利湿为宜，如肺热移于大肠者，又宜清肺润燥法治之，不可以泄泻而
戒用润剂也。李子永识。）
天师说：所谓脏治，是指五脏中有病邪而进行治疗的法则。五脏共有五种，但治疗法则只有三种：脾和肺采用同一治法，肾和肝采用同一治法，心和肾采用同一治法。肺气的损伤，必须补益脾气；脾气既然受伤，肺气也会困顿。所以补肺必须同时补脾，而补脾也必须同时补肺。比如有人咳嗽不止，或者呕吐腹泻不停，这是肺和脾都受了伤。人们通常认为咳嗽应该治肺，呕吐腹泻应该治脾。却不知道咳嗽是由于脾气衰弱引起的，而呕吐腹泻是由于肺气衰弱导致的。这是因为肺气如果没有清肃下降的功能，就会导致上呕下泻；脾气如果失去了斡旋（调节气机升降）的作用，就会在上表现为咳嗽。方剂用人参一钱，麦冬三钱，茯苓三钱，柴胡一钱，神曲五分，车前子一钱，甘草一钱，薏仁五钱，加水煎服。（批注：肺脾双解饮。）这个方子是治疗肺和治疗脾的药物合在一起使用的。咳嗽气喘的病完全去除，呕吐腹泻的症状各自消除，这就叫作一方两用。
所谓肾肝同治，是因为肾水不能滋养肝木，导致肝木抑郁而不能舒展，必然出现两胁部胀满闷痛的症状；肝木不能生发肾中的命门之火，导致肾水日渐寒冷，必然出现腰脊难以俯仰的动作症状。所以补肝必须补肾中的水，而补肾中的水，又不可不补肝木。如果只补肝而不补肾，那么胁痛怎么能立刻消除；如果只补肾而不补肝，那么腰脊怎么能立刻痊愈。方剂用熟地黄一两，山茱萸五钱，白芍五钱，当归五钱，柴胡二钱，肉桂一钱，加水煎服。（批注：肾肝同补汤。）这个方子中，熟地黄、山茱萸是补肾的药物，而当归、白芍、柴胡、肉桂是补肝的药物。既然两脏都是平补，似乎药物剂量不该有轻重之分。现在补肝的药物反而多于补肾的药物，这可见肾是肝的母亲，肝又是命门的母亲。命门是一身的主宰，应当生发五脏之气，不应当被五脏所生。然而五脏之间层层相生相克。肝既然是属木的，难道木不可以用来维持命门之火吗？这里面有着深刻的道理，如果不是我这位仙人，怎能阐发出来。希望世人不要惊讶这是创说的奇闻，而怀疑它不能用来治病。
再谈心和肾的治疗法则。这两脏合起来一起治疗，其中的道理在哪里呢？肾是水脏；心是火脏。这样看来，心和肾两条经脉像是仇敌，似乎不应该牵连在一起共同治疗。不知道心和肾虽然相互克制，其实却是相互需要的。没有心的火，身体就会变成死灰；没有肾的水，身体就会像冰炭一样冲突。心必须得到肾水的滋养，肾必须得到心火的温暖。比如有人惊悸惕怵、心神不安，或者梦中遗精泄精，这难道不是心和肾不交通吗？人们认为惊悸不安是心的病，我认为这是肾的病；梦中遗精泄精，人们认为是肾的病，我认为是心的病。这并不是颠倒黑白，实在是至当不易的道理。方剂用人参三两，白术五两，远志一两，炒酸枣仁三两，熟地黄五两，山茱萸三两，麦冬三两，北五味子一两，芡实五两，山药三两，石菖蒲一两，柏子仁三两（去油），茯神三两，砂仁三钱，橘红一两，各研为末，用蜂蜜制成丸药。用温开水送服五钱。（批注：心肾同补丹。）这个丸药的妙处在于，治疗肾的药物少于治疗心的药物。因为心君宁静，肾气自然安定；肾气既然安定，怎么会引起心动呢。这就是治心正是为了治肾，而治肾正是为了治心。这种治疗脏腑的方法，希望大家多加留意啊。
张公说：治疗脏腑的方法就这三种方子，没有什么可以再议论的了。如果不满足于此，那就是肺脏的单独治疗了。肺突然感受风寒，出现鼻塞打喷嚏，咳嗽不止，吐出的痰像烂棉絮一样，这是肺经单独生病，不需要兼治脾脏。我留下一个方子：用甘草一钱，桔梗三钱，半夏一钱，射干一钱，加水煎服。（批注：散寒汤。）这个方子的妙处，妙在桔梗提升气机于鼻窍，引导祛痰的药物上行到肺，以疏散风寒之邪。邪气散去则鼻塞立刻消除，痰也随之消散，又何必去治脾那样迂回缓慢呢。然而这个方子只可治疗风寒的外感病，不可治疗内伤的各类病症。内伤的各类病症，有天师留下的方子在，可以通过肺脾同治来调理就可以了。肾肝同治和心肾同治的方法，也不必再说了。
天师说：非常完美。
华君说：没有异议。
（此条为脾湿熏蒸肺部的病症，使用燥脾利湿的方剂为宜；如果是肺热移行到大肠的情况，又适宜用清肺润燥法治之，不可以因为有泄泻症状就禁止使用润燥药剂。李子永识。）
On the Simultaneous Treatment of Spleen and Lung, Kidney and Liver, Heart and Kidney, and Exclusive Treatment of the Lung Meridian
The Heavenly Master said: "The method of treating Zang organs refers to treating diseases within the five Zang organs. There are five Zang organs, but there are only three treatment methods: Spleen and Lung are treated together; Kidney and Liver are treated together; Heart and Kidney are treated together. Injury to Lung Qi must be supplemented by tonifying Spleen Qi; once Spleen Qi is injured, Lung Qi also becomes constrained. Therefore, tonifying the Lung requires tonifying the Spleen, and tonifying the Spleen requires tonifying the Lung. For instance, if a person suffers from incessant coughing or incessant vomiting and diarrhea, this indicates injury to both the Lung and the Spleen. People generally believe that coughing should be treated in the Lung, while vomiting and diarrhea should be treated in the Spleen. However, they do not realize that coughing arises from the decline of Spleen Qi, while vomiting and diarrhea arise from the decline of Lung Qi. This is because if Lung Qi lacks its downward descending function of clearing and purifying (Qing Su), it leads to upward vomiting and downward diarrhea; if the Spleen's regulatory function of rotating Qi dynamics (Wan Xuan) fails, it manifests as coughing above. The prescription uses Ren Shen (Ginseng Radix) 1 qian, Mai Dong (Ophiopogonis Tuber) 3 qian, Fu Ling (Poria) 3 qian, Chai Hu (Bupleuri Radix) 1 qian, Shen Qu (Massa Medicata Fermentata) 5 fen, Che Qian Zi (Plantaginis Semen) 1 qian, Gan Cao (Licorice Root) 1 qian, Yi Yi Ren (Coicis Semen) 5 qian, decocted in water and taken orally. [Commentary: Fei Pi Shuang Jie Yin (Lung-Spleen Dual Resolution Decoction)]. This formula combines herbs for treating the Lung with herbs for treating the Spleen. The cessation of coughing and asthma, and the elimination of vomiting and diarrhea symptoms, exemplify 'one formula serving two purposes.'
The simultaneous treatment of Kidney and Liver applies because when Kidney Water fails to nourish Liver Wood, the Liver Wood becomes depressed and unable to flow freely, inevitably resulting in distension and fullness in the hypochondriac region. When Liver Wood fails to generate the Fire of Ming Men (Gate of Life) within the Kidney, Kidney Water becomes increasingly cold, inevitably resulting in stiffness and difficulty in bending and extending the waist and spine. Therefore, tonifying the Liver requires tonifying Kidney Water, and tonifying Kidney Water requires tonifying Liver Wood. If one tonifies the Liver without tonifying the Kidney, how can hypochondriac pain be instantly relieved? If one tonifies the Kidney without tonifying the Liver, how can the waist and spine heal immediately? The prescription uses Shu Di Huang (Rehmanniae Radix Praeparata) 1 liang, Shan Zhu Yu (Corni Fructus) 5 qian, Bai Shao (Paeoniae Radix Alba) 5 qian, Dang Gui (Angelicae Sinensis Radix) 5 qian, Chai Hu (Bupleuri Radix) 2 qian, Rou Gui (Cinnamomi Cortex) 1 qian, decocted in water and taken orally. [Commentary: Shen Gan Tong Bu Tang (Kidney-Liver Simultaneous Tonification Decoction)]. In this formula, Shu Di Huang and Shan Zhu Yu are herbs for tonifying the Kidney, while Dang Gui, Bai Shao, Chai Hu, and Rou Gui are herbs for tonifying the Liver. Since both Zang organs are being tonified evenly, one might expect no disparity in dosage. Yet, the herbs for tonifying the Liver exceed those for tonifying the Kidney. This reveals that the Kidney is the mother of the Liver, and the Liver is the mother of the Ming Men (Gate of Life). The Ming Men is the master of the whole body; it should generate Qi for the five Zang organs rather than be generated by them. Nevertheless, the five Zang organs interact through mutual generation and restriction. Since the Liver belongs to Wood, why could Wood not sustain the Fire of the Ming Men? There lies profound logic here. Without my guidance as an immortal, how could this be elucidated? I hope people will not be startled by this novel theory or doubt its efficacy in treating disease.
Regarding the treatment of the Heart and Kidney: What is the rationale for treating these two Zang organs together? The Kidney is a Water Zang; the Heart is a Fire Zang. Thus, the Heart and Kidney meridians seem like enemies, making joint treatment seemingly inappropriate. However, although the Heart and Kidney mutually restrict each other, they actually depend on one another. Without Heart Fire, the body becomes like dead ash; without Kidney Water, the body becomes like ice and charcoal conflicting. The Heart must receive nourishment from Kidney Water, and the Kidney must receive warmth from Heart Fire. For example, if a person experiences palpitations, fright, restlessness, or nocturnal emission and seminal loss, is this not due to the failure of communication between the Heart and Kidney? People consider palpitations and restlessness as diseases of the Heart, whereas I consider them diseases of the Kidney. People consider nocturnal emission and seminal loss as diseases of the Kidney, whereas I consider them diseases of the Heart. This is not inversion, but an unchangeable truth. The prescription uses Ren Shen (Ginseng Radix) 3 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 5 liang, Yuan Zhi (Polygalae Radix) 1 liang, Chao Zao Ren (Ziziphi Spinosani Semen Ustums) 3 liang, Shu Di Huang (Rehmanniae Radix Praeparata) 5 liang, Shan Zhu Yu (Corni Fructus) 3 liang, Mai Dong (Ophiopogonis Tuber) 3 liang, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 1 liang, Qian Shi (Euryales Semen) 5 liang, Shan Yao (Dioscoreae Rhizoma) 3 liang, Chang Pu (Acori Tatarinowii Rhizoma) 1 liang, Bai Zi Ren (Platycladi Semen) 3 liang (de-oiled), Fu Shen (Poria cum Radix et Wood) 3 liang, Sha Ren (Amomi Fructus) 3 qian, Ju Hong (Citri Reticulatae Pericarpium Rubrum) 1 liang. Each is powdered, mixed with honey to form pills. Take 5 qian with warm boiled water. [Commentary: Xin Shen Tong Bu Dan (Heart-Kidney Simultaneous Tonification Pill)]. The subtlety of this pill lies in using fewer herbs for treating the Kidney than for treating the Heart. Because if the Heart Monarch is tranquil, Kidney Qi naturally settles; once Kidney Qi is settled, how can Heart movement be disturbed? Thus, treating the Heart is precisely to treat the Kidney, and treating the Kidney is precisely to treat the Heart. Regarding this method of treating Zang organs, I hope people pay close attention.
Lord Zhang said: "The methods for treating Zang organs are exhausted in these three formulas; there is nothing further to discuss. If not satisfied, there remains the exclusive treatment of the Lung Zang. If the Lung suddenly contracts Wind-Cold, presenting with nasal congestion, sneezing, incessant coughing, and expectoration of sputum resembling rotten cotton, this is a disease exclusive to the Lung meridian, requiring no concurrent treatment of the Spleen. I leave a formula: Gan Cao (Licorice Root) 1 qian, Jie Geng (Platycodonis Radix) 3 qian, Ban Xia (Pinelliae Rhizoma) 1 qian, She Gan (Belamcandae Rhizoma) 1 qian, decocted in water and taken orally. [Commentary: San Han Tang (Dispersing Cold Decoction)]. The brilliance of this formula lies in Jie Geng lifting Qi to the nose, guiding phlegm-resolving herbs upward to the Lung to disperse Wind-Cold pathogens. Once pathogens are dispersed, nasal congestion is instantly relieved, and sputum dissipates accordingly. Why resort to the slow approach of treating the Spleen? However, this formula is only suitable for external contraction of Wind-Cold, not for various internal injury syndromes. For internal injuries, the Heavenly Master’s formula for simultaneous treatment of Lung and Spleen is available. The methods for simultaneous treatment of Kidney-Liver and Heart-Kidney need not be repeated."
The Heavenly Master said: "Perfect."
Lord Hua said: "None."
(Note: This case involves Spleen Dampness steaming the Lung; using formulas to dry the Spleen and promote diuresis is appropriate. If Lung Heat transfers to the Large Intestine, methods for clearing the Lung and moistening dryness should be used. One should not refrain from using moistening agents merely because diarrhea is present. Recorded by Li Ziyong.)