经云∶阴阳者，万物之能始也。水为阴，火为阳。是病机虽繁，可一言以蔽之曰阴阳而
已。
试观天有四时，以生寒暑燥湿风。人有五脏，以生喜怒悲忧恐。五脏所患不同，要不外乎心
肾。此阴阳窟宅，水火根基。恙缘夙夜烦劳，心肾不交，水火失济。夫营卫二气，行阳则寤
，行阴则寐。若卫气不得入阴，则但寤而无寐矣。医用补心丹、养心汤，安神定志，未为不
善，要知心为虚灵之脏，草木无情，非假物类之灵以引之，焉能望效?拟以纯甘加入龟板虎
睛龙齿琥珀珍珠，谅当有应。
安波按∶此议诚言人所未言，拟再参入磁石，取其黑色通肾，上交于心，灵情活泼，
上应虚灵之脏，未识与先生合拍否。
诊脉沉伏模糊，证见肢厥声鼾，口鼻气冷，人事迷惑。处由真元内戕，阴寒直中，阳气
外脱
，势属危殆。内经以阳气者，若天与日。今则冱寒凝泣，阳霾用事，使非重阳见 ，何以复
其散失之元乎?夫人身之真阳，譬之鳌山走马灯，拜舞飞走，无一不具，其间惟是一点火耳
。火旺则动速，火微则动缓，火熄则寂然不动，而拜舞飞走之躯壳，未尝不存也。方用参附
二味，重加分两，昼夜频进。本草言人参能回元气于无何有之乡，附子为斩关夺门之将。潭
底日红阴怪灭，分阳未尽则不死。但脉证败坏如斯，欲图断鳌立极之功，亦难之难矣。
安波按∶此症亡阳也，急用附片垫气海，关元炙数百壮，或可挽。
《黄帝内经》说：阴阳，是万物产生的根本源头。水属于阴，火属于阳。因此，虽然疾病的机理纷繁复杂，但可以用“阴阳”这一原则来概括它。
试看自然界有四季的变化，从而产生寒、暑、燥、湿、风六种气候现象；人体有五脏的功能，从而产生喜、怒、悲、忧、恐五种情志变化。五脏所患的疾病各不相同，但归根结底都不外乎心和肾。心与肾是阴阳的居所，也是水火（肾水与心火）的根本基础。此病源于日夜过度劳累，导致心肾不交（心火不能下降温煦肾水，肾水不能上济制约心火），水火失去既济平衡。营气和卫气这两股正气，运行于体表阳分人就清醒，运行于体内阴分人就入睡。如果卫气不能进入阴分，人就只能清醒而无法入睡。医生使用补心丹和养心汤来安神定志，这并非不好，但要明白心是虚灵之脏，草木药材没有灵性，如果不借助具有灵性的动物或矿物类药物作为引导，怎么能期望见效呢？我打算在方中加入纯甘味的龟板、虎睛、龙齿、琥珀、珍珠等药，想来应当会有疗效。
安波按语：这个建议确实说出了别人未曾说出的道理，我打算再加入磁石，取它黑色入肾的特性，使肾气上交于心，这样灵动活泼的情志之气，就能上应心的虚灵之性，不知是否与先生的想法一致。
诊察脉搏沉伏且模糊不清，症状表现为四肢厥冷、打鼾、口鼻气息寒冷、神志昏迷迷惑。这是由于真元（人体最根本的阳气）在内受损，阴寒之邪直中脏腑，阳气向外脱失，形势属于危重。《黄帝内经》说，人体的阳气就像天上的太阳一样重要。如今寒气凝结，阳气被阴霾遮蔽，如果不是重用温热药物来振奋阳气，怎么能恢复散失的真元呢？人身体的真阳，好比鳌山上的走马灯，里面的拜舞飞走的人物形象无一不全，其中关键只有一点火光罢了。火旺则转动快，火微则转动慢，火熄灭则静止不动，而拜舞飞走的躯壳依然存在。方剂选用人参和附子两味药，加重分量，昼夜频繁服用。本草书籍说，人参能在虚无缥缈之处挽回元气，附子是斩关夺门的猛将。如同潭底太阳变红，阴邪鬼怪就会消灭，只要还有一丝阳气未尽就不会死亡。但是脉象和证候已经败坏到这种地步，想要达到断鳌立极（比喻挽救极度危重的局面）的功效，也是非常困难的了。
安波按语：这是亡阳证，急需使用附片艾灸气海穴和关元穴数百壮，或许可以挽回生机。
The *Classic of Difficult Issues* (Huangdi Neijing) states: Yin and Yang are the primary origins of all things. Water belongs to Yin, and Fire belongs to Yang. Therefore, although the mechanisms of disease are complex, they can be summarized in one word: Yin and Yang.
Observe that nature has four seasons, which generate the climatic factors of Cold, Heat, Dryness, Dampness, and Wind. Humans have five Zang organs, which generate the emotional responses of Joy, Anger, Sorrow, Worry, and Fear. Although the ailments of the five Zang organs differ, they ultimately do not go beyond the Heart and Kidney. The Heart and Kidney are the dwellings of Yin and Yang, and the foundations of Water and Fire. This illness arises from day-and-night overexertion, leading to a failure of communication between the Heart and Kidney (Heart Fire failing to descend to warm Kidney Water, and Kidney Water failing to ascend to control Heart Fire), resulting in a loss of mutual interaction between Water and Fire. Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) circulate; when they move through the Yang aspects, the person is awake; when they move through the Yin aspects, the person sleeps. If Wei Qi cannot enter the Yin, the person remains awake but cannot sleep. The physician used Buxin Dan (Heart-Nourishing Pill) and Yangxin Tang (Heart-Nourishing Decoction) to calm the spirit and stabilize the will, which was not improper. However, one must understand that the Heart is an organ of emptiness and spirituality. Herbal medicines lack sentience; without employing substances with spiritual properties as guides, how can efficacy be expected? I propose adding pure sweet-tasting substances such as Guiban (Tortoise Shell), Hu Jing (Tiger Eye), Longchi (Dragon Bone), Hupo (Amber), and Zhenzhu (Pearl). It is likely there will be a response.
An Bo’s Note: This discussion indeed articulates what others have not said. I propose further incorporating Cishi (Magnetite), taking advantage of its black color to enter the Kidney, allowing it to ascend and interact with the Heart. This would make the spiritual consciousness active and responsive to the Heart’s empty and spiritual nature. I wonder if this aligns with your thoughts.
Pulse diagnosis revealed a deep, hidden, and indistinct pulse. Symptoms included cold extremities, snoring, cold breath from the mouth and nose, and confused consciousness. This resulted from damage to the True Yuan (Original Qi) internally, with Direct Invasion by Yin-Cold pathogenic factors, and external collapse of Yang Qi. The situation is critical. The *Inner Canon* states that human Yang Qi is like the sky and the sun. Now, freezing cold condenses and stagnates, and Yang Qi is obscured by Yin-miasma. Unless heavy doses of Yang-reinforcing herbs are used, how can the scattered Original Qi be restored? The True Yang of the human body is like the moving horse lantern on Mount Ao; the figures bowing, dancing, flying, and walking are all present, yet the key lies only in a single spark of fire. When the fire is strong, movement is fast; when weak, movement is slow; when extinguished, motion ceases, yet the shell of the bowing and dancing figures remains. The prescription uses Renshen (Ginseng Root) and Fuzi (Aconite Lateral Root) in heavy dosages, administered frequently day and night. Materia Medica states that Renshen can restore Yuan Qi from the realm of nothingness, while Fuzi is a general who breaches gates and captures passes. As long as even a trace of Yang remains, death does not occur. However, given that the pulse and symptoms are so deteriorated, achieving the feat of stabilizing the extreme crisis is exceedingly difficult.
An Bo’s Note: This is a case of Collapse of Yang. Urgently applying Moxibustion with Fupian (Prepared Aconite) to Qihai (CV6, Sea of Qi) and Guanyuan (CV4, Gate of Origin), several hundred moxa cones, might possibly save the patient.