谨按《神农本草经》人参味甘,气微寒,无毒。主补五脏,安精神,定魂魄,止惊悸,除邪气
,明目开心,益智。附子味辛甘,气大热,有大毒。主风寒咳逆邪气,温中,破坚积聚,血瘕,寒
湿 ,拘挛膝痛,不能行步。入补剂宜熟,温散寒气宜生。人参补脏腑元气,附子益脏腑真阳,
火衰阳弱,非此不能回生。如久病气血虚惫,一切虚损,人参可用。如命门火熄,中气日损,一切
虚寒,附子可用。先哲用补剂,必加附子数分,以壮参、 之功力,追复散失之元阳。参、附之助
,岂小补哉!凡有 羸虚冷之象,亟宜用矣。倘有如疟邪未散之类,医家常执正气足而邪自避之语
,专用补法,犹如闭门逐盗,盗从何出?且邪得补而愈盛,反助其邪,为害匪细。此所谓损不足而
益有余。如肺热还伤肺,参亦不可概用。近医遇富贵人,辄虑其虚,不问病之虚实,一例从补,亦
致失误。此与当用不用者,等于亡羊,皆由不能洞瞩病情故耳。
张子和治病,不离汗、吐、下三法,本疗暴病,而久病亦可以奏捷。暴病者,如伤寒冒邪者,
汗之;及大头瘟面肿胀,并热为寒包,喘急难眠,诸风湿证,一汗可安。痈毒初起,经曰∶汗之则
疮已。此皆邪随汗解也。如食积痰滞者,吐之。及喉风、乳蛾,而头面颈项大肿,点水不入,音声
不出,命悬须臾,慎勿刺破,破者多立毙,唯一吐,则肿消索食。并干霍乱、绞肠沙类,皆赖吐全
。经曰∶木郁达之是也。如里邪实热者,下之,及头目周身火热炽盛,皆可下之。痢疾腹痛等证,
下之即畅。经曰∶痛随利减,胀以利宽是也。久病者,如风寒久伏肌髓,微热恶风,或累月 疟,
诸寒湿肿胀,皆可汗之。年远厉风,大汗驱之。如积月关格或小便癃闭等患;或伏痰滞气,时痛时
胀,恹恹数年,不能发越,百药无功,一吐可愈。如痢证始初失下,大痛口渴,肛门肿闭,小便不
通,粒米不进,气息机微,一下霍然。至于气结痰凝,蓄血留积,必以攻下,推陈致新是也。可见
此三法之妙,毋论暴病,即久病亦甚神。又毋论少壮,即衰老亦多奏功。今人能以此治暴病,而不
敢用诸久病。又并遇暴病而谬虑虚弱,疑畏不用,以致病邪深入,渐不可救。虽然病属有余。极至
困笃,用可立起;病属不足亦难行之,最宜详审。
谨依据《神农本草经》记载:人参味甘,气微寒,无毒。主要功效为补益五脏,安定精神,镇定魂魄,止住惊悸,祛除邪气,明亮双目,开通心窍,增进智慧。附子味辛甘,气大热,有大毒。主要功效为治疗风寒引起的咳嗽气逆及邪气,温煦中焦,破除坚硬的积聚和血瘕(腹内结块),缓解寒湿导致的拘挛和膝痛,改善行走困难。在补益方剂中宜用熟附子,用于温散寒气时宜用生附子。人参能补益脏腑的元气,附子能增益脏腑的真阳,若火衰阳弱,非此二者不能挽回生机。如果是久病导致气血极度虚弱,以及一切虚损病症,可以使用人参。如果是命门之火熄灭,中气日渐损耗,以及一切虚寒病症,可以使用附子。先贤在使用补剂时,必定加入数分附子,以增强人参、附子的功力,追回并恢复散失的元阳。人参与附子的辅助作用,难道不是巨大的补益吗!凡是出现羸弱、虚冷征象的,应当紧急使用。倘若像疟疾邪气尚未消散这类情况,医生常固执于“正气充足则邪气自避”的说法,专门使用补法,这犹如关起门来追赶盗贼,盗贼从哪里出去呢?况且邪气得到补益会更加旺盛,反而助长邪气,造成的危害不小。这就是所谓的“损害不足而增加有余”。如果肺热又伤肺,人参也不可一概使用。近代医生遇到富贵人,就担心他们体虚,不问病情虚实,一律采用补法,这也导致了失误。这与该用不用的人相比,都如同丢失了羊却不去寻找,都是因为不能透彻洞察病情所致。
张子和治病,不离汗、吐、下三法,原本用于治疗急暴之病,但久病也能取得捷效。急暴之病,如伤寒感受外邪者,用发汗法;以及大头瘟导致面部肿胀,并且热被寒包裹,气喘急促难以入睡,各种风湿证候,一发汗即可安宁。痈毒初起时,医经说:“发汗则疮疡痊愈。”这些都是邪气随汗液而解的情况。如食积痰滞者,用催吐法。以及喉风、乳蛾(扁桃体炎),导致头面颈项严重肿胀,滴水难进,声音不出,生命悬于顷刻之间,切勿刺破,刺破者多立即死亡,唯有催吐,则肿胀消退并能索求饮食。还有干霍乱、绞肠痧之类病症,都依赖催吐得以保全性命。医经说:“木郁则达之”,就是这个道理。如里邪实热者,用泻下法,以及头目周身火热炽盛,都可以用泻下法。痢疾腹痛等证候,泻下后即通畅。医经说:“痛随利减,胀以利宽”,就是这个道理。久病者,如风寒长久潜伏在肌髓,微热恶风,或者连月发作的疟疾,各种寒湿肿胀,都可以用发汗法。多年患厉风(麻风或严重皮肤病),用大汗法驱除。如积月不愈的关格(小便不通与呕吐并见)或小便癃闭等病患;或者伏痰滞气,时常疼痛胀满,萎靡不振数年,无法发散,百药无效,一次催吐即可痊愈。如痢疾证初期误用攻下不及时,出现剧烈疼痛口渴,肛门肿胀闭塞,小便不通,粒米不进,气息微弱,一旦泻下即豁然开朗。至于气结痰凝,蓄血留积,必须用攻下法,这是推陈致新的道理。由此可见这三法的妙处,不论急暴之病,即使是久病也非常神奇。又不论老少,即使是衰老之人也多能奏效。如今的人能用此法治治急暴之病,却不敢用于久病。又并遇到急暴之病而错误地忧虑其虚弱,怀疑畏惧而不用,以致病邪深入,逐渐不可救治。虽然病属有余(实证),极至困顿危重,用药可立即起效;病属不足(虚证)也难以施行,最宜详细审慎。
According to the *Shennong Bencao Jing* (Divine Farmer's Materia Medica): Ren Shen (Ginseng Root) has a sweet taste and a slightly cold nature, is non-toxic. Its main functions are tonifying the five Zang organs, calming the spirit (Shen), stabilizing the soul (Hun and Po), arresting palpitations and fright, eliminating pathogenic factors, brightening the eyes, opening the heart orifices, and enhancing wisdom. Fu Zi (Aconite Lateral Root) has a pungent and sweet taste, a great heat nature, and possesses great toxicity. Its main functions are treating cough and rebellious Qi caused by wind-cold and pathogenic factors, warming the Middle Jiao, breaking up hard accumulations and blood masses (Xia), relieving spasms and knee pain due to cold-dampness, and improving walking ability. In tonic prescriptions, cooked Fu Zi should be used; for warming and dispersing cold, raw Fu Zi should be used. Ren Shen tonifies the Yuan Qi of the Zang organs, while Fu Zi benefits the True Yang of the Zang organs. When Fire is deficient and Yang is weak, only these two can restore life. For chronic illnesses resulting in extreme deficiency of Qi and Blood, and all types of deficiency damage, Ren Shen can be used. When the Fire of the Gate of Vitality (Mingmen) is extinguished, the Qi of the Middle Jiao is daily depleted, and in all types of deficiency-cold conditions, Fu Zi can be used. Ancient sages, when using tonic prescriptions, would invariably add a few fen of Fu Zi to strengthen the efficacy of Ren Shen and Fu Zi, recovering and restoring scattered Yuan Yang. The assistance provided by Ren Shen and Fu Zi is certainly not a minor benefit! Whenever there are signs of emaciation, deficiency, and cold, they should be urgently employed. However, if pathogens such as malaria have not yet dissipated, physicians often stubbornly adhere to the saying that "when Zheng Qi (Upright Qi) is sufficient, pathogens naturally avoid it," and exclusively use tonification methods. This is like closing the door to chase thieves; how will the thieves exit? Moreover, pathogens become more vigorous with tonification, thereby assisting the pathogen, causing significant harm. This is what is meant by "damaging the insufficient and increasing the excessive." If Lung Heat injures the Lung again, Ren Shen should not be used indiscriminately. Modern physicians, upon encountering wealthy patients, often worry about their deficiency without distinguishing between excess and deficiency patterns, applying tonification uniformly, which also leads to errors. This is equivalent to those who fail to use necessary treatments; both are like losing sheep and not seeking them, stemming from an inability to thoroughly perceive the condition.
Zhang Hezi’s treatment of diseases revolves around the three methods: sweating (Han), vomiting (Tu), and purging (Xia). Originally intended for acute and sudden illnesses, these methods can also yield rapid results for chronic diseases. For acute illnesses, such as Taiyang disease contracted from external pathogens, sweating is indicated; for Da Tou Wen (Big Head Plague) causing facial swelling, where heat is trapped by cold, leading to panting, urgency, and insomnia, and various wind-dampness syndromes, a single application of sweating can bring peace. For early-stage carbuncles and toxins, the classics state: "Sweating will cure the sores." These are cases where pathogens resolve through sweat. For food stagnation and phlegm retention, vomiting is indicated. For throat wind and tonsillar swelling (Ru E) causing severe swelling of the head, face, neck, and throat, inability to swallow even water, loss of voice, and life hanging by a thread, do not puncture; puncturing often leads to immediate death. Only vomiting can reduce swelling and restore appetite. Similarly, dry Huoluan (cholera-like syndrome with abdominal cramping) and related conditions rely on vomiting for survival. The classics say: "When Wood is stagnant, unblock it," which applies here. For interior excess-heat patterns, purging is indicated, including intense heat in the head, eyes, and whole body. For dysentery with abdominal pain, purging brings relief. The classics say: "Pain decreases with free flow, distension widens with purgation," which applies here. For chronic illnesses, such as wind-cold lingering deeply in muscles and marrow, causing slight fever and aversion to wind, or malaria lasting months, and various cold-dampness swellings, sweating is indicated. For long-standing Li Feng (leprosy or severe dermatological conditions), heavy sweating drives out the pathogen. For Guan Ge (obstruction and reversal, characterized by vomiting and inability to urinate) persisting for months, or urinary retention, or latent phlegm and stagnant Qi causing intermittent pain and distension over years, unresponsive to hundreds of medicines, a single vomiting session can cure. For dysentery initially mishandled by lack of purging, presenting with severe pain, thirst, swollen and closed anus, urinary obstruction, inability to eat, and faint breath, a single purgation brings immediate relief. For Qi knotting and phlegm coagulation, accumulated blood and retained stasis, purging is essential to push out the old and generate the new. Thus, the wonder of these three methods is evident: whether for acute or chronic diseases, they are highly effective. Whether for the young and strong or the elderly, they often succeed. Today, people use these methods for acute diseases but dare not apply them to chronic ones. Furthermore, when facing acute diseases, they erroneously fear deficiency, hesitate, and refrain from using them, allowing pathogens to penetrate deeply until incurable. Although for excess patterns, even in critical distress, treatment can produce immediate results; for deficiency patterns, these methods are difficult to apply and require utmost caution.