(素问阴阳应象大论)
黄帝曰∶阴阳者,天地之道也,万物之纲纪,变化之父母,生杀之本始,神明之府也,(凡天地万物变化生杀神明之
道,总不外乎阴阳之理,故阴阳为万事之本。)治病必求于本。(万事万变既皆本于阴阳,而病机药性脉息论治则最切于
此,故凡治病者在必求于本,或本于阴,或本于阳,求得其本,然后可以施治。此篇上下详义已见阴阳类第一章,本类
复列首篇者,盖以治病之道,所重在本,故特表而冠之,观者当彼此互阅。愚按∶本者,原也,始也,万事万物之所以
然也。世未有无源之流,无根之木,澄其源而流自清,灌其根而枝乃茂,无非求本之道。故黄帝曰∶治病必求于本。孔
子曰∶其本乱而末治者否矣。此神圣心传出乎一贯,可见随几应变,必不可忽于根本,而于疾病尤所当先,察得其本,
无余义矣。惟是本之一字,合之则唯一,分之则无穷。所谓合之唯一者,即本篇所谓阴阳也,未有不明阴阳而能知事理
者,亦未有不明阴阳而能知疾病者,此天地万物之大本,必不可不知也。所谓分之无穷者,有变必有象,有象必有本,
凡事有必不可罔顾者,即本之所在也。姑举其略曰,死以生为本,欲救其死,勿伤其生。邪以正为本,欲攻其邪,必顾
其正。阴以阳为本,阳存则生,阳尽则死。静以动为本,有动则活,无动则止。血以气为本,气来则行,气去则凝。证
以脉为本,脉吉则吉,脉凶则凶。先者后之本,从此来者,须从此去。急者缓之本,孰急可忧,孰缓无虑。内者外之本,
外实者何伤,中败者堪畏。下者上之本,滋苗者先固其根,伐下者必枯其上。虚者实之本,有余者拔之无难,不足者攻
之何忍。真者假之本,浅陋者只知见在,精妙者疑似独明。至若医家之本在学力,学力不到,安能格物致知?而尤忌者,
不畏难而自足。病家之本在知医,遇士无礼,不可以得贤,而尤忌者,好杂用而自专。凡此者。虽未足以尽求本之妙,
而一隅三反,从可类推。总之求本之道无他也,求勿伤其生而已。列子曰∶圣人不察存亡,而察其所以然。淮南子曰∶
所以贵扁鹊者,知病之所从生也。所以贵圣人者,知乱之所由起也。王应震曰∶见痰休治痰,见血休治血,无汗不发汗,
有热莫攻热,喘生休耗气,精遗不涩泄,明得个中趣,方是医中杰。行医不识气,治法从何据,堪笑道中人,未到知音
处。此真知本之言也,学人当知省之。标本类第五章义有所关,当与此篇互阅。)
《素问·阴阳应象大论》
黄帝说:阴阳,是天地运行的规律,是万物的总纲纪,是变化的根源,是生长与消亡的根本起始,也是精神智慧产生的府库。(凡是天地万物变化、生长、消亡以及精神智慧产生的道理,总离不开阴阳的法则,所以阴阳是万事万物的根本。)治病必须探求根本。(万事万变既然都源于阴阳,而病机、药性、脉象、论述治法则最紧密地关联于此,所以凡治病的人必定要探求根本,或从阴求本,或从阳求本,找到了根本,然后才能实施治疗。这一篇上下的详细含义已经在“阴阳类”第一章中见过,在本类中再次列为首篇,大概是因为治病之道,重在根本,所以特意标示并放在篇首,读者应当彼此互相参考阅读。我认为:本,就是原初,就是起始,就是万事万物之所以如此的原因。世上没有无源头的流水,没有无根系的树木,澄清源头水流自然清澈,浇灌根系枝叶才能茂盛,这无非是探求根本的道理。所以黄帝说:治病必须探求根本。孔子说:如果根本乱了却想治理好枝节,是不可能的。这是神圣的心法传承出自一贯之理,可见随机应变,绝不可忽视根本,而在疾病方面尤其应当首先做到,察知了根本,就没有什么遗漏的了。只是这个“本”字,合起来看只有一个,分开看则有无穷无尽的变化。所谓合起来只有一个,就是本篇所说的阴阳,没有不明白阴阳就能知晓事理的,也没有不明白阴阳就能知晓疾病的,这是天地万物的根本大法,是不可不知道的。所谓分开看有无穷无尽的变化,是有变化就一定有表象,有表象就一定有根本,凡事都有不可不顾及的地方,那就是根本所在。姑且列举其大致情况:死以生为根本,想要挽救死亡,不要伤害生机。邪气以正气为根本,想要攻伐邪气,必须顾护正气。阴以阳为根本,阳气存在则生存,阳气耗尽则死亡。静以动为根本,有运动则活跃,无运动则停止。血以气为根本,气来则运行,气去则凝滞。证候以脉象为根本,脉象吉利则预后吉,脉象凶险则预后凶。先出现的症状是后出现症状的根本,从此处来的,须从此处去。急迫的症状是舒缓症状的根本,谁急迫可忧,谁舒缓无虑。内部是外部的根本,外部充实有什么妨害,内部败坏才令人畏惧。下部是上部的根本,滋养苗株要先稳固其根部,砍伐下部必然导致上部枯死。虚证以实证为根本(注:此处原文逻辑较深,意指虚实互根或治疗侧重),有余的病邪拔除不难,不足的病邪攻伐何忍?真象以假象为根本,浅陋的人只知道眼前的现象,精妙的人对疑似之处独自明察。至于医家的根本在于学力,学力达不到,怎么能格物致知?特别忌讳的是,不畏难而自满。病家的根本在于懂医,遇到医生无礼,不能得到贤良的医生,特别忌讳的是,喜好杂乱用药而独断专行。所有这些,虽然不足以穷尽探求根本的奥妙,但举一反三,可以由此类推。总之,探求根本的道理没有其他,只求不伤害生机罢了。列子说:圣人不去考察存亡的结果,而是考察其所以然的原因。淮南子说:之所以推崇扁鹊,是因为他知道病是从哪里产生的。之所以推崇圣人,是因为他知道混乱是从哪里引起的。王应震说:见到痰不要只治痰,见到血不要只治血,没有汗不要强行发汗,有热不要一味清热,喘症产生不要耗损气,遗精滑泄不要强行固涩,明白其中的趣味,才是医中的豪杰。行医如果不认识气,治疗方法依据从何而来?可笑那些庸医,还没到知音的境界。这才是真正懂得根本的话,学习者应当知道反省。标本类第五章的含义与此有关,应当与本篇互相参考阅读。)
*Suwen: Yin Yang Yingxiang Dalun* (The Great Treatise on the Correspondence of Yin and Yang in the Basic Questions)
Huangdi said: Yin and Yang are the Dao (Way/Law) of Heaven and Earth, the general principles of all things, the parents of change, the origin of life and death, and the residence of spiritual clarity. (All matters regarding the change, generation, destruction, and spiritual clarity of Heaven, Earth, and all things ultimately do not exceed the principle of Yin and Yang; thus, Yin and Yang are the root of all affairs.) In treating disease, one must seek the root. (Since all myriad changes originate from Yin and Yang, and pathogenesis, drug properties, pulse diagnosis, and therapeutic discussions are most closely related to this, therefore, whoever treats disease must necessarily seek the root, whether rooting in Yin or rooting in Yang. Only by finding the root can treatment be applied. The detailed meanings throughout this chapter have been seen in Chapter 1 of the "Yin Yang Category"; listing it as the first chapter in this category again is because the way of treating disease emphasizes the root, so it is specially highlighted and placed at the beginning. Readers should cross-reference them. I observe: The "root" means the source, the beginning, that which explains why all things are as they are. There is no flowing water without a source, nor a tree without roots. Clearing the source makes the water clear naturally; watering the roots makes the branches flourish. This is none other than the way of seeking the root. Thus, Huangdi said: In treating disease, one must seek the root. Confucius said: If the root is chaotic but the branches are to be governed, this is impossible. This sacred heart-mind transmission originates from a consistent principle. It can be seen that adapting to changing circumstances must never neglect the root, especially in diseases, where one must prioritize examining and obtaining the root. Once the root is known, there are no remaining ambiguities. However, the character "root," when combined, is singular; when divided, it is infinite. What is meant by "singular when combined" is precisely the Yin and Yang mentioned in this chapter. There is no one who does not understand Yin and Yang yet can comprehend affairs, nor one who does not understand Yin and Yang yet can comprehend diseases. This is the great root of Heaven, Earth, and all things, which must not be unknown. What is meant by "infinite when divided" is that with change, there must be phenomena; with phenomena, there must be a root. In all matters, there are aspects that cannot be ignored, which is where the root lies. Let us briefly list some examples: Death takes Life as its root; to save from death, do not injure Life. Pathogenic factors take Healthy Qi (Zheng Qi) as their root; to attack pathogens, one must protect Healthy Qi. Yin takes Yang as its root; if Yang exists, there is life; if Yang exhausts, there is death. Stillness takes Movement as its root; with movement, there is vitality; without movement, there is stagnation. Blood takes Qi as its root; when Qi arrives, it moves; when Qi departs, it coagulates. Symptoms take the Pulse as their root; an auspicious pulse indicates an auspicious outcome, while an ominous pulse indicates an ominous outcome. The earlier condition is the root of the later condition; what comes from here must go back through here. Urgency takes Slowness as its root; who is urgent and worrisome, who is slow and carefree? The interior is the root of the exterior; what harm is there if the exterior is solid, but internal collapse is terrifying? The lower part is the root of the upper part; to nourish the seedlings, one must first consolidate the roots; cutting the lower parts will inevitably cause the upper parts to wither. Deficiency takes Excess as its root (Note: Context implies the interdependence or therapeutic focus); removing excess pathogens is not difficult, but how can one bear to attack deficiencies? Truth takes Falsehood as its root; the shallow only know the immediate appearance, while the profound discern clearly amidst ambiguity. As for physicians, their root lies in scholarly effort; if scholarly effort is insufficient, how can one investigate things to extend knowledge? Particularly taboo is being unwilling to face difficulties and becoming self-satisfied. For patients, their root lies in understanding medicine; encountering practitioners with rudeness prevents obtaining wise doctors, and particularly taboo is preferring miscellaneous remedies and acting arbitrarily. All these, although insufficient to exhaust the subtleties of seeking the root, allow for inferring three instances from one, enabling classification by analogy. In short, the way of seeking the root is nothing else but ensuring no injury to Life. Liezi said: The sage does not examine survival or death, but examines the reason why. Huainanzi said: The reason Bian Que is valued is that he knows where the disease arises. The reason Sages are valued is that they know where chaos originates. Wang Yingzhen said: When seeing phlegm, do not merely treat phlegm; when seeing blood, do not merely treat blood; when there is no sweat, do not forcibly induce sweating; when there is heat, do not aggressively clear heat; when wheezing arises, do not deplete Qi; when essence leaks, do not astringe excessively. Understanding the interest within allows one to become a hero among physicians. Practicing medicine without recognizing Qi, from where do therapeutic methods derive? It is laughable to see laymen reach this point before attaining true understanding. These are truly words about knowing the root; learners should reflect upon them. The meaning in Chapter 5 of the "Root and Branch Category" is relevant and should be cross-referenced with this chapter.)