治诸复者,风复治以酸寒,佐以甘辛,以咸泻之,以甘缓之。热复治以咸寒,佐以苦辛,以
甘泻之,以酸收之,以辛苦发之,以咸软之。湿复治以苦热,佐以酸辛,以苦泻之,燥之泄之。
火复治以咸冷,佐以苦辛,以酸收之,辛苦发之。发表不远热,无犯温凉。少阴同法。燥复治之
辛温,佐以苦甘,以苦泻之,以酸补之。寒复治以咸热,佐以甘辛,以苦坚之。
复者,有胜而有复也。(新添)假令少阳下降,肺气承之,金乃受邪,病喘咳头痛。肺金生
水,邪传入肾,病脐腹痛,腿脚肿痛,身寒。水为金之子,水克火,金水相生,子母同制于火,
乃子救于金母也,此名复也。治者补其子,折其肝气也。风复者,治以酸寒,佐以甘辛,以咸泻
之,以甘缓之。木胜则土气受邪,土生金,为子者。治以酸寒者,酸补金,寒去热。更以辛甘佐
之,甘者补脾,泻火之盛势,辛佐肺气,泻其邪气。以咸泻之者,脾宜食之,肾者胃之机关,咸
柔和之性,以利机关也。其余湿火燥寒,治之皆若此也。
(旧经)凡治诸胜复者,以寒治热,以
热治寒,以清治温,以温治清,以酸收散收缓,以辛散抑散结润燥,以甘缓急,以咸软坚,以苦
坚脆,以燥除湿,泻盛补衰,以平为期,必安其气,而病已矣。有胜至而未复者,上胜下俱病,
以地名之,病上胜,其方顺地气而逆天气,下胜上俱病者,以天名之,病下胜,其方顺天气而逆
地气为制。复至则不以天地异名,悉如复气为法。然胜复之变,虽有常位,而气无必至。上三气,
天主之,胜之常也,下三气,地主之,复之常也。有胜则复,无胜则否。胜至则复,无常数也,
衰乃止耳。复已而胜,不复则害,此伤生也。复而反自病者,谓居非其位,不相得也。大复其胜,
则主胜之,故反病也。所谓二火在泉,居其水位,谓司天金居其火位也,余气则否也。然治气胜
者,随微制甚,制气复者,和以平调,暴者泻盛补衰,其气自平。而以主客之气胜而无复,所谓
阴阳自有盛衰之故也。
主胜为逆,客胜为从,上下之道也。巳亥上角,客胜则耳鸣掉眩,其则咳,主胜则胸胁痛,
舌难以言。子午上征,居臣位,客胜则鼽嚏,颈项强,肩背瞀热,头痛少气,发热,耳聋目瞑,
甚则 肿,血溢,疮疡,咳喘,主胜则心热烦躁,甚则胁痛支满。丑未上宫,客胜则首面 肿,
呼吸气喘,主胜则胸腹满,食已而瞀。寅申上征,客胜则丹疹外发,及为丹 疮疡,呕逆,喉痹,
头痛,嗌肿,内为螈 ,主胜则胸满,咳仰息,甚而有血,手热。卯酉上商,金居火之位上,火
气上行,则清复内余,则咳衄嗌塞,心膈中热,咳不止而白血出者死。(浅淡红色血,似肉似肺,
是白血也。)辰戌上羽,客胜则胸中不利,而出清涕,感寒而咳,主胜则喉嗌中鸣。(在泉主客,)
寅申下角,客胜则大关节不利,(所谓腰脊也。)内为痉强拘 ,外为不便,主胜则筋骨繇,腰
腹时痛。卯酉下征,(火居水位之上,水曰下流,故有客胜之理。相火同候。)客胜则腰痛,尻
股膝髀 足皆病,瞀热以酸, 肿,不能久立,溲便变,主胜则厥气上行,心痛,发热,膈中,
众痹皆作,发于 胁,魄汗不藏,四逆而起。辰戌下宫,客胜则足痿下重,便溲不利,湿客下
焦,发而濡泄,及为肿隐曲之疾,(是谓隐蔽委曲之处。)主胜则寒气逆满,饮食不下,甚则为
疝。巳亥下征,客胜则腰腹痛,反恶寒,甚则下白溺白,主胜则热反上行,而客于心,心痛发热,
格中而呕。少阴同候。子午下商,客胜则清气动下,少腹坚满而数便泻,主胜则腰重腹痛,少腹
生寒,下为骛溏,(是谓鸭溏之候也。)则寒厥于肠,上冲胸中,甚则喘,不能久立。丑未下羽,
客主俱水,则寒复内余,病腰尻痛而屈伸不利,股胫足膝中痛。
凡治主客之胜者,举下抑高,补衰泻盛,适气同异,主客气相得,则逆所胜气以治之,气不
相得,则顺其不胜气以治之。逆者,主治之法也。然客者,天之六气行乎主位之上,主者,地之
六气在于客气之下。客气动而不息,每一岁二气司天地,四气为左右之间气,随主气之所在,居
无常位。主气静而守位,永定无移,常以木为初气,火为二气,相火为三气,土为四气,金为五
气,水为终气。凡此六气之中,各有主客之胜,经唯言天地主客之胜者,以举水火二位,余皆可
知也。故经曰木位之主,其泻以酸,其补以辛,火位之主,其泻以甘,其补以咸,土位之主,其
泻以苦,其补以甘,金位之主,其泻以辛,其补以酸,水位之主,其泻以咸,其补以苦。厥阴之
客,以辛补之,以
酸泻之,以甘缓之,少阴之客,以咸补之,以甘泻之,以酸收之,太阴之客,以甘补之,以苦泻
之,以甘缓之,少阳之客,以咸补之,以甘泻之,以咸软之,阳明之客,以酸补之,以辛泻之,
以苦泻之,太阳之客,以苦补之,以咸泻之,以苦坚之,以辛润之。开发腠理,致津液,通气也。
适主客之胜,而补泻也。所之妙道,不可不通矣。
治疗各种“复气”所致疾病的原则是:风复证,用酸寒药为主治,辅以甘辛药,用咸味药泻之,用甘味药缓急。热复证,用咸寒药为主治,辅以苦辛药,用甘味药泻之,用酸味药收敛,用辛苦药发散,用咸味药软坚。湿复证,用苦热药为主治,辅以酸辛药,用苦味药泻之、燥之、泄之。火复证,用咸冷药为主治,辅以苦辛药,用酸味药收敛,用辛苦药发散。发表时不避忌热性药,但要避免误用温凉之品(此处指根据病情灵活使用,不可拘泥)。少阴经的病证也采用同样的法则。燥复证,用辛温药主治,辅以苦甘药,用苦味药泻之,用酸味药补之。寒复证,用咸热药主治,辅以甘辛药,用苦味药坚固正气。
所谓“复”,是指有胜气而后有复气。(新添内容)举例来说,少阳相火之气下降,肺气承袭其位,金气受到邪气侵害,出现气喘、咳嗽、头痛等症状。肺金生水,邪气传入肾脏,导致脐腹疼痛、腿脚肿痛、身体寒冷。水是金之子,水克火,金水相生,子母共同制约火势,这是子救母的现象,这就叫做“复”。治疗时应当补益子脏(肾),以折损肝木过盛之气。对于风复证,用酸寒药主治,辅以甘辛药,用咸味药泻之,用甘味药缓急。木气过胜则土气受邪,土生金,土为金之母(原文逻辑似有误,通常土生金,土为母,金为子;此处刘完素论述较为复杂,依原文直译:土生金,故言“为子者”可能指代关系转换或特定语境,按字面翻译:土生金,作为子的角色)。用酸寒药治疗,是因为酸能补金,寒能去热。再用辛甘药辅助,甘味能补脾,泻除火的盛势,辛味辅助肺气,泻除邪气。用咸味药泻之,是因为脾适宜食用咸味(注:此处原文可能有误或特指某种机制,通常咸入肾,但原文如此),肾是胃的机关,咸味具有柔和的性质,有利于通利机关。其余湿、火、燥、寒的复证,治疗方法都与此类似。
(旧经原文)凡是治疗各种胜复病证,用寒药治热证,用热药治寒证,用清药治温证,用温药治清证,用酸味药收敛散乱之气并缓解急迫,用辛味药发散郁结、润燥,用甘味药缓解急迫,用咸味药软化坚硬,用苦味药坚固脆弱,用燥湿药除湿,泻除盛实之气,补益衰弱之气,以达到平衡为目的,必须使气机安宁,病就好了。如果有胜气到来而没有复气的,称为“地胜”,病在上部胜,其治法顺应地气而逆天气;下部胜而上部俱病的,称为“天胜”,病在下部胜,其治法顺应天气而逆地气以制之。复气到来时,就不以天地异名区分,完全按照复气的法则处理。然而胜复的变化,虽然有固定的位置规律,但气并不一定会必然到达。上三气(厥阴、少阴、太阴),由天所主,是胜气的常态;下三气(少阳、阳明、太阳),由地所主,是复气的常态。有胜气就有复气,没有胜气就没有复气。胜气到来就会有复气,但没有固定的次数,等到胜气衰退就停止了。复气过后又有胜气,如果不复气就会造成伤害,这损伤生命。复气反而导致自身生病的,是指复气居于非其本位,与主气不相协调。如果过度复其胜气,那么主气就会克制它,所以反而生病。所谓二火在泉,却居于水位(指少阳/少阴客气加临于太阳/太阴主气等复杂情况),或者司天金气居于火位,其余气则不是这样。然而治疗气胜者,要随着微甚来制约,治疗气复者,要以和平调顺为原则,暴烈的要泻盛补衰,气机自然平和。如果是主客之气相胜而没有复气,这是阴阳自有盛衰的缘故。
主气胜为逆,客气胜为从,这是上下运行的规律。巳亥年,厥阴风木司天,客气胜则耳鸣、眩晕,严重时咳嗽;主气胜则胸胁痛,舌强言语困难。子午年,少阴君火司天,居臣位,客气胜则鼻塞喷嚏,颈项强直,肩背闷热心烦,头痛气短,发热,耳聋目眩,严重时浮肿,血溢,疮疡,咳喘;主气胜则心热烦躁,严重时胁痛胀满。丑未年,太阴湿土司天,客气胜则头面浮肿,呼吸气喘;主气胜则胸腹胀满,进食后头晕昏蒙。寅申年,少阳相火司天,客气胜则丹疹外发,以及丹毒疮疡,呕吐逆气,喉痹,头痛,咽喉肿痛,内部出现抽搐痉挛;主气胜则胸满,咳嗽仰息,严重时咯血,手部发热。卯酉年,阳明燥金司天,金居火位之上,火气上行,则清凉之气内余,出现咳嗽、鼻衄、咽喉阻塞,心膈中热,咳嗽不止且吐出白血者死。(浅淡红色血,似肉似肺,称为白血。)辰戌年,太阳寒水司天,客气胜则胸中不利,流出清涕,感寒而咳;主气胜则咽喉中有鸣响。
(在泉主客部分)寅申年,厥阴风木在泉,客气胜则大关节不利(即腰脊部位),内部出现痉挛强直拘挛,外部行动不便;主气胜则筋骨动摇,腰腹时常疼痛。卯酉年,少阴君火在泉(火居水位之上,水曰下流,故有客胜之理。相火同候),客气胜则腰痛,尻、股、膝、髀、足皆发病,头晕发热且伴有酸痛,浮肿,不能久立,小便异常;主气胜则厥气上行,心痛,发热,膈中不适,众痹发作,发于胁肋,汗出不藏,四肢逆冷而起。辰戌年,太阴湿土在泉,客气胜则足痿无力下肢沉重,小便不利,湿气客于下焦,发生濡泄,以及肿胀和隐蔽委曲之处(如前后阴)的疾病;主气胜则寒气逆满,饮食不下,严重时形成疝气。巳亥年,少阳相火在泉,客气胜则腰腹痛,反而恶寒,严重时下利白浊、小便清白;主气胜则热反上行,客于心,心痛发热,格拒于中而呕吐。少阴经症状相同。子午年,阳明燥金在泉,客气胜则清气动于下,少腹坚硬满闷且频繁便泻;主气胜则腰部沉重腹痛,少腹生寒,下部出现鸭溏(即大便稀薄如水鸭粪),寒气厥逆于肠,上冲胸中,严重时喘息,不能久立。丑未年,太阳寒水在泉,客主俱属水,则寒气内余,病见腰尻痛且屈伸不利,大腿、小腿、足、膝中疼痛。
凡是治疗主客之胜的方法,是抑高举下,补衰泻盛,观察气机的同异。主客气相得(和谐),则逆其所胜之气来治疗;气不相得(冲突),则顺其不胜之气来治疗。逆治,是主治的方法。然而客气,是天的六气运行在主位之上;主气,是地的六气处于客气之下。客气变动而不息,每一年有二气司管天地,四气为左右间气,随主气所在,居无定位。主气静止而守位,永久固定不移,常以木为初气,火为二气,相火为三气,土为四气,金为五气,水为终气。在这六气之中,各有主客之胜,经文只说天地主客之胜,是为了列举水火二位,其余皆可类推。所以经文说:木位之主,其泻用酸,其补用辛;火位之主,其泻用甘,其补用咸;土位之主,其泻用苦,其补用甘;金位之主,其泻用辛,其补用酸;水位之主,其泻用咸,其补用苦。厥阴之客,用辛补之,用酸泻之,用甘缓之;少阴之客,用咸补之,用甘泻之,用酸收之;太阴之客,用甘补之,用苦泻之,用甘缓之;少阳之客,用咸补之,用甘泻之,用咸软之;阳明之客,用酸补之,用辛泻之,用苦泻之;太阳之客,用苦补之,用咸泻之,用苦坚之,用辛润之。开发腠理,致津液,通气机。适应主客之胜,进行补泻,这是精妙的道理,不可不通晓。
Treatment of various "Fu" (Rebound) conditions follows specific principles: For Wind Fu, treat with Sour-Cold herbs, assist with Sweet-Acrid herbs, drain with Salty herbs, and relax tension with Sweet herbs. For Heat Fu, treat with Salty-Cold herbs, assist with Bitter-Acrid herbs, drain with Sweet herbs, astringe with Sour herbs, disperse with Bitter-Acrid herbs, and soften hardness with Salty herbs. For Dampness Fu, treat with Bitter-Hot herbs, assist with Sour-Acrid herbs, and drain, dry, and purge with Bitter herbs. For Fire Fu, treat with Salty-Cold herbs, assist with Bitter-Acrid herbs, astringe with Sour herbs, and disperse with Bitter-Acrid herbs. When releasing the exterior, do not avoid Hot herbs, but avoid violating the balance with Warm or Cool properties unnecessarily. The Shaoyin channel adopts the same method. For Dryness Fu, treat with Acrid-Warm herbs, assist with Bitter-Sweet herbs, drain with Bitter herbs, and tonify with Sour herbs. For Cold Fu, treat with Salty-Hot herbs, assist with Sweet-Acrid herbs, and consolidate righteousness with Bitter herbs.
"Fu" refers to a rebound condition that occurs following a "Sheng" (Excess/Dominant) condition. (New addition) For example, when Shaoyang (Ministerial Fire) qi descends, Lung Metal qi succeeds it, causing Metal to be affected by pathogens, resulting in symptoms such as wheezing, cough, and headache. Lung Metal generates Kidney Water; if pathogens transmit to the Kidney, symptoms include umbilical and abdominal pain, swelling and pain in the legs and feet, and cold body. Water is the child of Metal, and Water controls Fire. Metal and Water generate each other, and the child and mother jointly restrain Fire; this is the child saving the mother, which is named "Fu". Treatment should tonify the child organ (Kidney) to break the excessive Liver Wood qi. For Wind Fu, treat with Sour-Cold herbs, assist with Sweet-Acrid herbs, drain with Salty herbs, and relax with Sweet herbs. When Wood qi is excessive, Earth qi is affected. Earth generates Metal. Treating with Sour-Cold herbs works because Sour tonifies Metal, and Cold removes Heat. Further assisting with Sweet-Acrid herbs: Sweet tonifies Spleen and drains excessive Fire, while Acrid assists Lung Qi to drain pathogenic factors. Draining with Salty herbs is indicated because the Spleen benefits from Salty taste (note: context-specific), and the Kidney acts as the gatekeeper for the Stomach; Salty has a softening nature that facilitates the opening of these gates. The treatment for other Fu conditions like Dampness, Fire, Dryness, and Cold is similar.
(Old Canon) In treating all Sheng-Fu conditions, use Cold to treat Heat, Hot to treat Cold, Clear to treat Warm, and Warm to treat Clear. Use Sour to astringe scattered Qi and relieve urgency, Acrid to disperse stagnation and moisten dryness, Sweet to relieve urgency, Salty to soften hardness, Bitter to consolidate fragility, and drying agents to remove dampness. Drain excess and tonify deficiency, aiming for balance. Ensure Qi is peaceful, and the disease will resolve. If there is a Sheng arrival without a subsequent Fu, it is called "Earth Sheng" (Dominance from below). Disease due to upper dominance requires methods that follow Earth Qi and oppose Heaven Qi. Disease due to lower dominance affecting the upper part is called "Heaven Sheng," requiring methods that follow Heaven Qi and oppose Earth Qi to control it. When Fu arrives, distinctions based on Heaven and Earth names are discarded, and treatment follows the laws of Fu Qi strictly. However, changes in Sheng-Fu, though having fixed positions, do not necessarily occur inevitably. The upper three Qi (Jueyin, Shaoyin, Taiyin) are governed by Heaven and represent the norm of Sheng; the lower three Qi (Shaoyang, Yangming, Taiyang) are governed by Earth and represent the norm of Fu. Where there is Sheng, there is Fu; where there is no Sheng, there is no Fu. Sheng brings about Fu, but there is no fixed number; it stops when the excess declines. If Fu occurs after Sheng, and there is no further Fu, harm results, damaging life. If Fu causes self-disease, it means the Fu Qi occupies an improper position and is incompatible. Excessive Fu against Sheng leads to the Master Qi counter-acting it, causing reverse illness. This refers to situations like Two Fires being in the Fountain position but occupying the Water position, or Si Tian Metal occupying the Fire position; other Qi combinations differ. However, treating Qi excess involves controlling severity according to subtlety; treating Qi rebound involves harmonizing and balancing. Violent cases require draining excess and tonifying deficiency so Qi naturally balances. If Master and Guest Qi clash without Fu, it is due to the natural fluctuation of Yin and Yang.
Master excess is "Ni" (Reverse), Guest excess is "Cong" (Following), which is the way of Upper and Lower. In Si-Hai years, Jueyin Wind Wood governs the Upper (Si Tian): Guest excess causes tinnitus, dizziness, and severe cough; Master excess causes chest and hypochondriac pain, tongue stiffness, and speech difficulty. In Zi-Wu years, Shaoyin君Fire governs the Upper: Guest excess causes nasal congestion, sneezing, neck stiffness, shoulder/back heat, headache, shortness of breath, fever, deafness, eye closure, severe edema, bleeding, sores, cough, and wheezing; Master excess causes heart heat, irritability, severe hypochondriac pain, and fullness. In Chou-Wei years, Taiyin Damp Earth governs the Upper: Guest excess causes head/facial edema, breathing difficulty, and wheezing; Master excess causes chest/abdominal fullness and dizziness after eating. In Yin-Shen years, Shaoyang Ministerial Fire governs the Upper: Guest excess causes erysipelas rashes, carbuncles, vomiting, throat obstruction, headache, throat swelling, and internal spasms; Master excess causes chest fullness, cough with仰息 (breathing with raised chest), severe hemoptysis, and hand heat. In Mao-You years, Yangming Dry Metal governs the Upper: Metal occupies the Fire position; Fire qi ascends, leaving residual coolness internally, causing cough, epistaxis, throat blockage, chest/diaphragm heat, persistent cough with expulsion of "White Blood" (light red blood resembling flesh/lung), which is fatal. In Chen-Xu years, Taiyang Cold Water governs the Upper: Guest excess causes chest discomfort, clear nasal discharge, and cold-induced cough; Master excess causes ringing in the throat.
(In Quan / Lower Position) In Yin-Shen years, Jueyin Wind Wood is in Quan: Guest excess causes large joint stiffness (waist/spine), internal spasms/tightness, and external movement difficulty; Master excess causes bone/tendon trembling and periodic waist/abdominal pain. In Mao-You years, Shaoyin君Fire is in Quan (Fire above Water position, Water flows down, hence Guest excess logic applies; Ministerial Fire shares signs): Guest excess causes waist pain, pathology in buttocks/thighs/knees/calves/feet, dizziness/heat with soreness, edema, inability to stand long, and urinary changes; Master excess causes Jue Qi ascending, heart pain, fever, diaphragmatic discomfort, widespread bi-syndrome onset in hypochondrium, uncontrolled sweating, and four extremities cold. In Chen-Xu years, Taiyin Damp Earth is in Quan: Guest excess causes foot atrophy/heaviness, difficult urination, dampness invading lower Jiao leading to loose stools, edema, and diseases of hidden areas (genitals/anus); Master excess causes cold Qi reversing with fullness, inability to eat, and severe hernia. In Si-Hai years, Shaoyang Ministerial Fire is in Quan: Guest excess causes waist/abdominal pain, aversion to cold, severe white discharge/urine; Master excess causes heat rising to the Heart, heart pain, fever, regurgitation/vomiting. Shaoyin signs are similar. In Zi-Wu years, Yangming Dry Metal is in Quan: Guest excess causes clear Qi moving downward, lower abdominal hardness/fullness, and frequent diarrhea; Master excess causes heavy waist/abdominal pain, cold in lower abdomen, duck-like loose stools, cold Jue in intestines rising to chest, severe wheezing, and inability to stand long. In Chou-Wei years, Taiyang Cold Water is in Quan: Both Master and Guest are Water, causing internal cold residue, waist/buttock pain with limited flexion/extension, and pain in thighs/shins/feet/knees.
In treating Master-Guest excesses, suppress high and elevate low, tonify deficiency and drain excess, and adjust according to Qi similarities/differences. If Master and Guest Qi are compatible, treat by opposing the dominant Qi; if incompatible, follow the non-dominant Qi. Opposition treatment is the primary method. Guest Qi is Heaven's Six Qi moving above Master positions; Master Qi is Earth's Six Qi beneath Guest Qi. Guest Qi moves ceaselessly; each year, two Qi govern Heaven/Earth, and four Qi act as Left/Right Intermediary Qi, changing positions with Master Qi. Master Qi is static and fixed, always starting with Wood (1st), Fire (2nd), Ministerial Fire (3rd), Earth (4th), Metal (5th), and Water (6th). Among these Six Qi, each has Master-Guest excesses. The Canon mentions Heaven/Earth Master-Guest excesses primarily to illustrate Water and Fire positions; others can be inferred. Thus, the Canon states: For Wood position Master, drain with Sour, tonify with Acrid; for Fire position Master, drain with Sweet, tonify with Salty; for Earth position Master, drain with Bitter, tonify with Sweet; for Metal position Master, drain with Acrid, tonify with Sour; for Water position Master, drain with Salty, tonify with Bitter. For Jueyin Guest, tonify with Acrid, drain with Sour, relax with Sweet; for Shaoyin Guest, tonify with Salty, drain with Sweet, astringe with Sour; for Taiyin Guest, tonify with Sweet, drain with Bitter, relax with Sweet; for Shaoyang Guest, tonify with Salty, drain with Sweet, soften with Salty; for Yangming Guest, tonify with Sour, drain with Acrid, drain with Bitter; for Taiyang Guest, tonify with Bitter, drain with Salty, consolidate with Bitter, moisten with Acrid. Open interstices, promote fluid production, and circulate Qi. Adapting to Master-Guest excesses for tonification and drainage is the subtle Dao, which must be thoroughly understood.