(素问至真要大论 随前篇)
是故百病之起,有生于本者,有生于标者,有生于中气者;有取本而得者,有取标而得者,有取中气而得者,有取
标本而得者;有逆取而得者,有从取而得者。(百病之生于本标中气者,义见前篇。中气,中见之气也,如少阳厥阴互为
中气,阳明太阴互为中气,太阳少阴互为中气,以其相为表里,故其气互通也。取,求也。病生于本者,必求其本而治
之。病生于标者,必求其标而治之。病生于中气者,必求中气而治之。或生于标、或生于本者,必或标或本而治之。取
有标本,治有逆从。以寒治热,治真热也。以热治寒,治真寒也,是为逆取。以热治热,治假热也,以寒治寒,治假寒
也,是为从取。逆从义,详论治类第四。)逆,正顺也。若顺,逆也。(病热而治以寒,病寒而治以热,于病似逆,于治
为顺,故曰逆,正顺也。病热而治以热,病寒而治以寒,于病若顺,于治为反,故曰若顺,逆也。本论曰∶逆者正治,
从者反治。是亦此意。)故曰∶知标与本,用之不殆,明知逆顺,正行无问。此之谓也。不知是者,不足以言诊,足以乱
经。(用,运用也。殆,危也。正行,执中而行,不偏不倚也。无问,无所疑问以资惑乱也。不有真见,乌能及此?错乱
经常,在不知其本耳。)故大要曰∶粗工嘻嘻,以为可知,言热未已,寒病复始,同气异形,迷诊乱经。此之谓也。(粗
工,浅辈也。嘻嘻,自得貌。妄谓道之易知,故见标之阳,辄从火治,假热未除,真寒复起。虽阴阳之气若同,而变见
之形则异。即如甲乙同为木化,而甲阳乙阴;一六同为水数,而一阳六阴,何非同气异形者?粗工昧此,未有不迷乱者
矣。)夫标本之道,要而博,小而大,可以言一而知百病之害,言标与本,易而勿损,察本与标,气可令调,明知胜复,
为万民式,天之道毕矣。(要而博、小而大者,谓天地之运气,人身之疾病,变化无穷,无不有标本在也。如三阴三阳,
皆由六气所化,故六气为本,三阴三阳为标。知标本胜复之化,则气可令调,而天之道毕矣。然疾病之或生于本,或生
于标,或生于中气,凡病所从生,即皆本也。夫本者,一而已矣。故知其要则一言而终,不知其要则流散无穷也。)
(《素问·至真要大论》承接前一篇)
因此,各种疾病的产生,有的源于本,有的源于标,有的源于中气;治疗时,有的通过治本而痊愈,有的通过治标而痊愈,有的通过调治中气而痊愈,有的通过兼顾标本而痊愈;有的采用逆治法而痊愈,有的采用从治法而痊愈。(疾病生于本、标、中气的道理,见前一篇。中气,即中见之气,如少阳与厥阴互为中气,阳明与太阴互为中气,太阳与少阴互为中气,因为它们互为表里,所以其气机互通。取,意为求索。病生于本的,必须求其本而治疗它。病生于标的,必须求其标而治疗它。病生于中气的,必须求其中气而治疗它。或者生于标、或者生于本的,必须或治标或治本而治疗它。取有标本之分,治有逆从之别。用寒凉药治疗热证,是治疗真热证。用温热药治疗寒证,是治疗真寒证,这叫做逆取。用温热药治疗热证,是治疗假热证;用寒凉药治疗寒证,是治疗假寒证,这叫做从取。逆从的含义,详见《论治类》第四篇。)所谓“逆”,其实是正顺。如果看似“顺”,其实是“逆”。(患热病却用寒凉药治疗,患寒病却用温热药治疗,对病势看似相反,但对治疗原则来说是顺应正道的,所以称为“逆”,实为真正的顺。患热病却用温热药治疗,患寒病却用寒凉药治疗,对病势看似顺应,但对治疗原则来说是反常的,所以称为“若顺”,实为逆。本篇论述说:逆者为正治,从者为反治。也是这个意思。)所以说:懂得标与本的关系,运用起来就不会有危险;明确知道逆与顺的区别,正确施行就没有疑问。说的就是这个道理。不知道这些道理的,不足以谈论诊病,只会扰乱医经。(用,指运用。殆,指危险。正行,指执守中道而行,不偏不倚。无问,指没有疑问从而不被迷惑扰乱。如果没有真知灼见,怎么能达到这种境界?错乱常规经典,就在于不知道根本罢了。)所以《大要》说:粗劣的医生嘻嘻哈哈,自以为懂医术,刚说完热病,寒病又发作了,同气异形,迷乱诊断,扰乱经络。说的就是这种情况。(粗工,指浅薄之辈。嘻嘻,形容自满得意的样子。妄称大道容易知晓,所以见到标证的阳热表现,就随意用火法治疗,假热未除,真寒又起。虽然阴阳之气看似相同,但变化显现的形态则不同。就像甲乙同属木化,但甲为阳乙为阴;一六同为水数,但一为阳六为阴,何尝不是同气异形呢?粗工不明白这一点,没有不迷乱的了。)关于标本的道理,简要而广博,微小而宏大,可以言一而知百病的危害,阐述标与本,容易理解而不受损害,考察本与标,气机就可以调和,明确知道胜复的变化,成为万民的典范,天地的道理也就完备了。(简要而广博、微小而宏大的含义,是指天地之运气、人身之疾病,变化无穷,无不包含标本在内。如三阴三阳,都由六气化生,所以六气为本,三阴三阳为标。懂得标本胜复的变化,气机就可以调和,天地的道理也就完备了。然而疾病有的生于本,有的生于标,有的生于中气,凡是疾病产生的根源,都是本。本只有一个而已。所以知道它的要点,一句话就能终结;不知道它的要点,就会流散无穷。)
(Su Wen: Zhizhen Yao Da Lun, following the previous chapter)
Therefore, the onset of various diseases arises from the root (Ben, fundamental cause), from the branch (Biao, superficial manifestation), or from the intermediate Qi (Zhong Qi, the Qi of the interiorly-exteriorly related meridians); treatment may be effective by addressing the root, by addressing the branch, by regulating the intermediate Qi, or by addressing both root and branch; it may be achieved through contrary treatment (Ni Qu, treating opposites) or through following treatment (Cong Qu, treating similarly). (The principles of diseases arising from root, branch, and intermediate Qi are explained in the previous chapter. Intermediate Qi refers to the Qi of the interiorly-exteriorly paired meridians; for instance, Shaoyang (Gallbladder/Triple Burner) and Jueyin (Liver/Pericardium) serve as each other's intermediate Qi, Yangming (Large Intestine/Stomach) and Taiyin (Spleen/Lung) do so, and Taiyang (Small Intestine/Bladder) and Shaoyin (Kidney/Heart) do so, because their interior-exterior relationship allows their Qi to interconnect. "Qu" means to seek. If a disease originates from the root, one must seek the root to treat it. If it originates from the branch, one must seek the branch. If it originates from the intermediate Qi, one must seek the intermediate Qi. Whether originating from the branch or the root, treatment should target either the branch or the root accordingly. Treatment involves selecting root or branch, and employing contrary or following methods. Using cold to treat heat addresses true heat. Using heat to treat cold addresses true cold; this is called contrary treatment (Ni Qu). Using heat to treat heat addresses false heat; using cold to treat cold addresses false cold; this is called following treatment (Cong Qu). The meanings of contrary and following are detailed in Chapter 4 of the Therapeutic Methods section.) Contrary (Ni) is actually correct compliance. What appears compliant (Shun) is actually contrary. (Treating heat with cold and cold with heat seems contrary to the disease but compliant with the correct therapeutic principle, hence termed "contrary," which is truly compliant. Treating heat with heat and cold with cold seems compliant with the disease but contrary to the therapeutic principle, hence termed "if compliant," which is actually contrary. This chapter states: "Contrary [treatment] is standard regulation; Following [treatment] is counter-regulation." This conveys the same meaning.) Thus it is said: Knowing the distinction between branch and root ensures error-free application; clearly understanding contrary and compliant approaches allows for correct practice without doubt. This is what is meant. Those who do not understand these principles are unworthy of discussing diagnosis and will only disrupt the canonical texts. (Application refers to practical use. Dai refers to danger. Zheng Xing refers to acting according to the mean, neither biased nor extreme. Wu Wen refers to having no doubts that could lead to confusion. Without genuine insight, how could one reach this level? Confusing the regular classics stems from ignorance of the root.) Therefore, the Da Yao states: The mediocre physician laughs carelessly, believing knowledge is easy; just as heat disorders end, cold disorders begin. Same Qi but different forms, confusing diagnosis and disrupting meridians. This describes such cases. (Cu Gong refers to inferior practitioners. Xi Xi describes an expression of self-satisfaction. Presumptuously claiming the Dao is easy to know, they encounter superficial Yang manifestations and indiscriminately apply fire treatments; false heat remains unresolved while true cold re-emerges. Although Yin and Yang Qi may appear similar, the manifested forms differ. For example, Jia and Yi both transform into Wood, yet Jia is Yang and Yi is Yin; One and Six are both Water numbers, yet One is Yang and Six is Yin. Are these not examples of same Qi but different forms? Ignorant of this, inferior practitioners inevitably become confused.) The way of root and branch is concise yet comprehensive, minute yet vast. By speaking of one, one can understand the harm of a hundred diseases; discussing branch and root is straightforward and unimpaired; examining root and branch allows Qi to be regulated; knowing victory and restitution enables one to serve as a model for all people, completing the Way of Heaven. (Concise yet comprehensive, minute yet vast, refers to the endless changes in Heavenly Luck and human diseases, all containing root and branch. As the Three Yin and Three Yang are transformed by the Six Qi, the Six Qi constitute the root, and the Three Yin and Three Yang constitute the branch. Understanding the transformations of root, branch, victory, and restitution allows Qi to be regulated, thereby completing the Way of Heaven. However, diseases may arise from the root, the branch, or the intermediate Qi; whatever source gives rise to a disease constitutes its root. The root is singular. Thus, knowing its essence allows one to conclude with a single statement; lacking this essence leads to infinite dispersion.)