（《素问·玉机真藏论》 附∶虚损治法）
黄帝曰∶余闻虚实以决死生，愿闻其情。岐伯曰∶五实死，五虚死。（五实者，五脏之实也。五虚者，五脏之虚也。
五实五虚具者皆死。然气虚至尽，尽而死者，理当然也。若五实者，何以亦死？盖邪之所凑，其气必虚，不脱不死，仍
归于气尽耳。故愚谓邪无不足，正无有余，实有假实，虚则真虚也。）帝曰∶愿闻五实五虚。岐伯曰∶脉盛，皮热，腹胀，
前后不通，闷瞀，此谓五实。（实者，邪气盛实也。脉盛者，心所主也。皮热者，肺所主也。腹胀者，脾所主也。前后不
通，肾开窍于二阴也。闷瞀者，肝脉贯膈，气逆于中也。瞀，茂、务二音，昏闷也，一曰目不明。）脉细，皮寒，气少，
泄利前后，饮食不入，此谓五虚。（虚者，正气虚也。脉细，心虚也。皮寒，肺虚也。气少，肝虚也。泄利前后，肾虚也。
饮食不入，脾虚也。）帝曰∶其时有生者何也？岐伯曰∶浆粥入胃，泄注止，则虚者活；（治之者，能使浆粥入胃则脾渐
苏，泄注止则肾渐固，根本气回，故虚者活也。）身汗得后利，则实者活。此其候也。（得身汗则表邪解，得后利则里邪
除，内外通和，故实者活也。愚按∶病有虚实者，虚因正气不足，实因邪气有余也。凡外入之病多有余，如六气所感，
饮食所伤之类也。内出之病多不足，如七情伤气，劳欲伤精之类也。凡实者宜泻，如《经》曰寒者热之，热者寒之，坚
者削之，客者除之，结者散之，留者攻之，溢者行之，强者泻之之属，皆用泻之法也。凡虚者宜补，如云散者收之，燥
者润之，急者缓之，脆者坚之，衰者补之，劳者温之，损者益之，惊者平之之属，皆用补之法也。虚实之治，大概如此。
第当今之人，实者无几而虚者七八。病实者，其来速，其去亦速，故其治易。病虚者，损伤有渐，不易复元，故其治难。
治实者但知为少壮新邪，则可攻可拔，犹无足虑。治虚者，但察其根本有亏，则倏忽变幻，可无虑乎？凡治实之法，外
有余可散其表，内有余可攻其里，气有余可行其滞，血有余可逐其瘀，方治星罗，可无赘也。惟虚损之治，在法有未尽
者，不得不详其要焉。夫人之虚损，有先天不足者，有后天不足者。先天者由于禀受，宜倍加谨慎，急以后天人事培补
之，庶可延年，使觉之不早而慢不为意，则未有不夭折者矣。后天者由于劳伤，宜速知警省，即以情性药食调摄之，使
治之不早而迁延讳疾，则未有不噬脐者矣。凡劳伤之辨，劳者劳其神气，伤者伤其形体。如喜怒思虑则伤心，忧思悲哀
则伤肺，是皆劳其神气也。饮食失度则伤脾，起居不慎则伤肝，色欲纵肆则伤肾，是皆伤其形体也。凡损其肺者伤其气，
为皮焦而毛 ，损其心者伤其神，为血脉少而不营于脏腑，此自上而伤者也。损其肝者伤其筋，为筋缓不能自收持，损
其肾者伤其精，为骨髓消减，痿弱不能起，此自下而伤者也。损其脾者伤其仓廪之本，为饮食不为肌肤，此自中而伤者
也。夫心肺损而神色败，肝肾损而形体痿，脾胃损而饮食不化，感此病者，皆损之类也。《难经》曰∶损其肺者益其气，
损其心者调其营卫，损其脾者调其饮食，适其寒温，损其肝者缓其中，损其肾者益其精，此治损之法也。然所损虽分五
脏，而五脏所藏则无非精与气耳。夫精为阴，人之水也；气为阳，人之火也。水火得其正，则为精为气；水火失其和，
则为热为寒。此因偏损，所以致有偏胜。故水中不可无火，无火则阴胜而寒病生；火中不可无水，无水则阳胜而热病起。
但当详辨阴阳，则虚损之治无余义矣。如水亏者，阴虚也，只宜大补真阴，切不可再伐阳气；火虚者，阳虚也，只宜大
补元阳，切不可再伤阴气。盖阳既不足而复伐其阴，阴亦损矣；阴已不足而再伤其阳，阳亦亡矣。夫治虚治实本自不同，
实者阴阳因有余，但去所余，则得其平；虚者阴阳有不足，再去所有，则两者俱败，其能生乎？故治虚之要，凡阴虚多
热者，最嫌辛燥，恐助阳邪也；尤忌苦寒，恐伐生阳也；惟喜纯甘壮水之剂，补阴以配阳，则刚为柔制，虚火自降，而
阳归乎阴矣。阳虚多寒者，最嫌凉润，恐助阴邪也；尤忌辛散，恐伤阴气也；只宜甘温益火之品，补阳以配阴，则柔得
其主，沉寒自敛，而阴从乎阳矣。是以气虚者宜补其上，精虚者宜补其下，阳虚者宜补而兼暖，阴虚者宜补而兼清，此
固阴阳之治辨也。其有气因精而虚者，自当补精以化气；精因气而虚者，自当补气以生精。又如阳失阴而离者，非补阴
何以收散亡之气？水失火而败者，非补火何以苏随寂之阴？此又阴阳相济之妙用也。故善补阳者，必于阴中求阳，则阳
得阴助而生化无穷；善补阴者，必于阳中求阴，则阴得阳升而泉源不竭。故以精气分阴阳，则阴阳不可离；以寒热分阴
阳，则阴阳不可混。此又阴阳邪正之离合也。知阴阳邪正之治，则阴阳和而生道得矣。经曰∶不能治其虚，何问其余？
即此之谓。）
（《素问·玉机真藏论》 附∶虚损治法）
黄帝说：我听说通过虚实可以判断生死，希望听听其中的道理。岐伯说：出现五实就会死，出现五虚也会死。（所谓五实，是指五脏的实证；所谓五虚，是指五脏的虚证。如果五实或五虚的症状全部具备，都会导致死亡。然而，如果是气虚到了极点，耗尽而死的，这是理所当然的。至于五实为什么会死？大概是因为邪气聚集的地方，正气必然虚弱，如果不发生脱证而死，最终也是归于气尽罢了。所以我认为是邪气没有不足，正气没有有余，所谓的“实”往往是假实，而“虚”才是真虚。）
黄帝说：我想听听什么是五实和五虚。岐伯说：脉象盛大，皮肤发热，腹部胀满，大小便不通，胸闷昏花，这叫做五实。（所谓实，是邪气盛实。脉象盛大，由心所主；皮肤发热，由肺所主；腹部胀满，由脾所主；大小便不通，因为肾开窍于前后二阴；胸闷昏花，因为肝脉贯穿膈肌，气逆于中。瞀，读音同茂、务，意为昏闷，也有人说是指眼睛看不清。）脉象细弱，皮肤发冷，气短少言，大小便泄利不止，饮食无法入口，这叫做五虚。（所谓虚，是正气虚弱。脉象细弱，是心虚；皮肤发冷，是肺虚；气短少言，是肝虚；大小便泄利不止，是肾虚；饮食无法入口，是脾虚。）
黄帝说：其中有时有存活的情况，为什么呢？岐伯说：如果能喝进浆粥，泄泻停止，那么虚证患者就能活；（治疗时，能使浆粥进入胃中，则脾气逐渐复苏，泄泻停止则肾气逐渐固摄，根本之气回归，所以虚证患者能活。）身体出汗且大小便通利，那么实证患者就能活。这就是存活的征候。（身体出汗则表邪解除，大小便通利则里邪去除，内外通畅调和，所以实证患者能活。我按语道：疾病有虚实之分，虚是因为正气不足，实是因为邪气有余。凡是外来的病多属于有余，如六淫所感，饮食所伤之类。内生的病多属于不足，如七情伤气，劳欲伤精之类。凡是实证适宜用泻法，如《内经》所说寒者热之，热者寒之，坚者削之，客者除之，结者散之，留者攻之，溢者行之，强者泻之等，都属于用泻法。凡是虚证适宜用补法，如云散者收之，燥者润之，急者缓之，脆者坚之，衰者补之，劳者温之，损者益之，惊者平之等，都属于用补法。虚实的治疗，大致如此。只是当今之人，实证很少而虚证占七八成。患实证的人，发病快，去病也快，所以治疗容易。患虚证的人，损伤是渐进的，不容易恢复元气，所以治疗困难。治疗实证的人只知道是少壮之人的新邪，可以攻伐拔除，还不足以担忧。治疗虚证的人，只要察知根本亏虚，那么病情瞬息万变，难道可以不担忧吗？大凡治疗实证的方法，外在有余可以发散其表，内在有余可以攻逐其里，气有余可以行其滞涩，血有余可以逐其瘀血，方药治理星罗棋布，无需赘述。只有虚损的治疗，在方法上有未尽之处，不得不详细说明要点。人的虚损，有先天不足的，有后天不足的。先天不足是由于禀赋，应该倍加谨慎，急于通过后天的调养来培补，才可以延年益寿，如果觉察得不早而漫不经心，那么没有不夭折的。后天不足是由于劳伤，应该迅速知晓警醒，就用性情、药物、食物来调摄，如果治疗不早而拖延讳疾，那么没有不后悔莫及的。大凡劳伤的辨别，劳是劳损神气，伤是损伤形体。如喜怒思虑则伤心，忧思悲哀则伤肺，这些都是劳损神气。饮食失度则伤脾，起居不慎则伤肝，色欲纵肆则伤肾，这些都是损伤形体。凡是损伤肺的，伤及其气，表现为皮肤焦枯而毛发脱落；损伤心的，伤及其神，表现为血脉减少而不能营养脏腑，这是自上而下损伤的。损伤肝的，伤及其筋，表现为筋脉松弛不能自我收持；损伤肾的，伤及其精，表现为骨髓消减，痿弱不能起身，这是自下而上损伤的。损伤脾的，伤及其仓廪之本，表现为饮食不能化为肌肤，这是从中部损伤的。心肺受损则神色败坏，肝肾受损则形体痿废，脾胃受损则饮食不化，感受这些疾病的，都是虚损类的病。《难经》说：损伤肺的益其气，损伤心的调其营卫，损伤脾的调其饮食，适应寒温，损伤肝的缓和其中气，损伤肾的益其精，这是治疗虚损的方法。然而虽然损伤分属五脏，但五脏所藏的无非是精与气罢了。精属于阴，是人的水；气属于阳，是人的火。水火得其正，就成为精和气；水火失其和，就成为热和寒。这是因为偏颇损伤，所以导致偏胜。因此水中不可无火，无火则阴胜而寒病产生；火中不可无水，无水则阳胜而热病兴起。只应当详细辨别阴阳，那么虚损的治疗就没有遗漏了。如水亏损者，是阴虚，只宜大补真阴，切不可再伐伤阳气；火亏损者，是阳虚，只宜大补元阳，切不可再伤阴气。因为阳既然不足而又去伐伤其阴，阴也受损了；阴已经不足而又再伤其阳，阳也就亡失了。治疗虚证和治疗实证本来不同，实证阴阳因有余，只要去掉所余的，就能得到平衡；虚证阴阳有不足，再去掉所拥有的，那么两者都败坏，怎么能生存呢？所以治疗虚证的要点，凡是阴虚多热的，最忌讳辛燥，恐怕助长阳邪；尤其忌讳苦寒，恐怕伐伤生阳之气；只喜欢纯甘壮水的药剂，补阴以配阳，则刚强被柔顺制约，虚火自然下降，而阳回归于阴了。阳虚多寒的，最忌讳凉润，恐怕助长阴邪；尤其忌讳辛散，恐怕伤阴气；只宜甘温益火的药品，补阳以配阴，则柔顺得到主宰，沉寒自然收敛，而阴顺从于阳了。因此气虚的适宜补其上，精虚的适宜补其下，阳虚的适宜补而兼暖，阴虚的适宜补而兼清，这确实是阴阳治疗的辨别。其中有气因精而虚的，自然应当补精以化气；精因气而虚的，自然应当补气以生精。又如阳失去阴而离散者，不补阴怎么能收回散亡之气？水失去火而败坏者，不补火怎么能唤醒沉寂之阴？这又是阴阳相济的妙用。所以善于补阳的人，必须在阴中求阳，那么阳得到阴的帮助而生化无穷；善于补阴的人，必须在阳中求阴，那么阴得到阳的升发而泉源不竭。所以以精气分阴阳，则阴阳不可分离；以寒热分阴阳，则阴阳不可混淆。这又是阴阳邪正的离合关系。懂得阴阳邪正的治疗，那么阴阳和谐而生道就得到了。经上说：不能治疗其虚，何必问其余？就是这个意思。）
(Su Wen: Yu Ji Zhen Zang Lun [Plain Questions: Discussion on the True Viscera and Pulse] Appendix: Treatment Methods for Deficiency and Damage)
Huangdi said: I have heard that deficiency and excess can be used to determine life and death; I wish to hear the details. Qibo said: The presence of Five Excesses leads to death, and the presence of Five Deficiencies also leads to death. (The Five Excesses refer to the excess conditions of the five Zang organs; the Five Deficiencies refer to the deficiency conditions of the five Zang organs. If all symptoms of either Five Excesses or Five Deficiencies are present, death ensues. However, if death occurs due to Qi exhaustion reaching its limit, this is logically inevitable. As for why Five Excesses also lead to death: where pathogenic factors gather, Zheng Qi (Upright Qi) must be deficient. Unless there is a collapse leading to death, it ultimately returns to Qi exhaustion. Therefore, I believe that when pathogenic factors are not insufficient and Zheng Qi is not in excess, what appears as "excess" is often false excess, whereas "deficiency" is true deficiency.)
Huangdi said: I wish to hear about the Five Excesses and Five Deficiencies. Qibo said: A surging pulse, hot skin, abdominal distension, obstruction of urination and defecation, and chest oppression with dizziness constitute the Five Excesses. (Excess refers to the flourishing of pathogenic factors. A surging pulse is governed by the Heart; hot skin is governed by the Lung; abdominal distension is governed by the Spleen; obstruction of urination and defecation relates to the Kidney, which opens into the two yin orifices; chest oppression and dizziness relate to the Liver meridian penetrating the diaphragm, with Qi rebelling inward. 'Mao' sounds like 'mao' or 'wu', meaning drowsiness or confusion, or sometimes refers to blurred vision.) A fine pulse, cold skin, shortness of breath, diarrhea and incontinence of urine and stool, and inability to take in food constitute the Five Deficiencies. (Deficiency refers to the weakness of Zheng Qi. A fine pulse indicates Heart deficiency; cold skin indicates Lung deficiency; shortness of breath indicates Liver deficiency; diarrhea and incontinence indicate Kidney deficiency; inability to eat indicates Spleen deficiency.)
Huangdi said: Under what circumstances can there be survival? Qibo said: If fermented grain beverages enter the Stomach and diarrheal flux stops, the patient with deficiency will survive; (In treatment, if fermented grain beverages can enter the Stomach, the Spleen Qi gradually revives; if diarrheal flux stops, the Kidney Qi gradually consolidates. With the return of root Qi, the deficient patient survives.) If the body sweats and bowel movements become unobstructed, the patient with excess will survive. These are the signs of survival. (Sweating resolves exterior pathogens; unobstructed bowel movements eliminate interior pathogens. With internal and external pathways clear and harmonious, the excess patient survives. My commentary: Diseases are categorized as deficiency or excess. Deficiency arises from insufficient Zheng Qi; excess arises from surplus pathogenic factors. Diseases entering from outside are mostly excess, such as those caused by the Six Evils or dietary injury. Diseases arising from within are mostly deficiency, such as those caused by the Seven Emotions injuring Qi or labor and desire injuring Essence. Generally, excess conditions should be treated with purgative methods, as stated in the Classic: treat cold with heat, heat with cold, hardness by reducing, invaders by expelling, knots by dispersing, stagnation by attacking, overflow by promoting flow, strength by draining—these all use purgative methods. Generally, deficiency conditions should be treated with tonifying methods, such as gathering scattered Qi, moistening dryness, relaxing tension, strengthening fragility, tonifying decline, warming fatigue, benefiting loss, and calming fright—these all use tonifying methods. The treatment of deficiency and excess is generally as described. However, among people today, few cases are excess, while seven or eight out of ten are deficiency. Excess diseases come quickly and leave quickly, so treatment is easy. Deficiency diseases involve gradual damage and are difficult to restore, so treatment is difficult. Those treating excess know it is often new pathogenic factors in the young and strong, which can be attacked and expelled, causing little worry. Those treating deficiency must observe if the root is compromised; otherwise, sudden changes may occur, which cannot be ignored. The methods for treating excess include dispersing the exterior if there is excess outside, attacking the interior if there is excess inside, moving stagnation if there is excess Qi, and driving out stasis if there is excess Blood. Formulas are numerous, requiring no further elaboration. Only the treatment of deficiency and damage has incomplete methods, necessitating a detailed explanation of key points. Human deficiency and damage stem from congenital insufficiency or acquired insufficiency. Congenital insufficiency results from endowment and requires extra caution, urgently supplemented by postnatal efforts to nourish, thereby extending life. If noticed late or neglected, premature death is inevitable. Acquired insufficiency results from overwork and injury; one must quickly recognize and reflect, adjusting emotions, medication, and diet. If treatment is delayed or illness concealed, regret will be too late. Regarding the differentiation of overwork and injury: 'Overwork' damages Shen Qi (Spirit and Qi), while 'Injury' damages the physical form. Joy, anger, worry, and contemplation injure the Heart; sorrow, worry, and grief injure the Lung—all these damage Shen Qi. Improper diet injures the Spleen; careless living injures the Liver; excessive sexual indulgence injures the Kidney—all these damage the physical form. Damaging the Lung injairs its Qi, manifesting as scorched skin and falling hair. Damaging the Heart injures its Shen, manifesting as reduced blood vessels failing to nourish the viscera; this is damage from above. Damaging the Liver injures its sinews, manifesting as lax sinews unable to support themselves. Damaging the Kidney injures its Essence, manifesting as depleted marrow, atrophy, and inability to rise; this is damage from below. Damaging the Spleen injures the foundation of granaries, manifesting as food failing to transform into flesh and muscle; this is damage from the middle. When Heart and Lung are damaged, spirit and color deteriorate; when Liver and Kidney are damaged, the physical form becomes emaciated; when Spleen and Stomach are damaged, food fails to digest. Diseases feeling these patterns belong to the category of deficiency and damage. The Nan Jing states: Damage to the Lung benefits its Qi; damage to the Heart regulates Ying and Wei (Nutritive and Defensive Qi); damage to the Spleen regulates diet and adjusts to cold and warmth; damage to the Liver relaxes its interior; damage to the Kidney benefits its Essence. These are the methods for treating deficiency and damage. Although damage is divided among the five Zang organs, what they store is nothing but Essence and Qi. Essence is Yin, the water of humanity; Qi is Yang, the fire of humanity. When water and fire are correct, they become Essence and Qi; when water and fire are imbalanced, they become heat and cold. This imbalance arises from partial damage leading to partial dominance. Therefore, water must contain fire; without fire, Yin dominates and cold disease arises. Fire must contain water; without water, Yang dominates and heat disease arises. One must carefully distinguish Yin and Yang, and then the treatment of deficiency and damage will be complete. For example, water deficiency is Yin deficiency; only great tonification of True Yin is suitable, never harming Yang Qi again. Fire deficiency is Yang deficiency; only great tonification of Original Yang is suitable, never harming Yin Qi again. If Yang is already insufficient and Yin is further harmed, Yin is also damaged; if Yin is already insufficient and Yang is further harmed, Yang is also lost. Treating deficiency differs fundamentally from treating excess. In excess, Yin and Yang are surplus; removing the surplus restores balance. In deficiency, Yin and Yang are insufficient; removing what remains leads to mutual failure, how can life be sustained? Thus, the key to treating deficiency: for Yin deficiency with much heat, pungent-dry substances are most abhorrent as they may aid Yang pathogens; bitter-cold substances are especially avoided as they may attack generating Yang Qi; pure sweet-water-nourishing agents are preferred, tonifying Yin to match Yang, so that rigidity is controlled by softness, deficient fire naturally descends, and Yang returns to Yin. For Yang deficiency with much cold, cool-moist substances are most abhorrent as they may aid Yin pathogens; pungent-dispersing substances are especially avoided as they may harm Yin Qi; only sweet-warm fire-benefiting items are suitable, tonifying Yang to match Yin, so that softness finds its master, deep cold naturally gathers, and Yin follows Yang. Therefore, Qi deficiency should be tonified in the upper part; Essence deficiency should be tonified in the lower part; Yang deficiency should be tonified with warmth; Yin deficiency should be tonified with clearing. This is indeed the differentiation of Yin-Yang treatment. Where Qi is deficient due to Essence, one should tonify Essence to generate Qi; where Essence is deficient due to Qi, one should tonify Qi to generate Essence. Furthermore, if Yang separates from Yin, how else can scattered Qi be gathered but by tonifying Yin? If Water fails due to lack of Fire, how else can dormant Yin revive but by tonifying Fire? This is the wonderful application of mutual assistance between Yin and Yang. Therefore, those skilled in tonifying Yang must seek Yang within Yin, so that Yang receives Yin's assistance and generation is endless. Those skilled in tonifying Yin must seek Yin within Yang, so that Yin receives Yang's rising and the spring source does not dry up. Thus, dividing Yin and Yang by Essence and Qi means Yin and Yang cannot be separated; dividing Yin and Yang by cold and heat means Yin and Yang cannot be confused. This is the separation and union of Yin-Yang, pathogenic and righteous factors. Understanding the treatment of Yin-Yang, pathogenic, and righteous factors leads to Yin-Yang harmony and the attainment of the Dao. The Classic says: If you cannot treat deficiency, what need is there to ask about anything else? This is what is meant.)