《内经》但言左右者,阴阳之道路,未尝以人身之气血分左右也。人之气血,周流于一身,气如橐 ,
血如波澜,气为血行,血为气配,阴阳相维,循环无端,何尝有左右之分?自丹溪论中风症,半身不遂分
左右,谓在左者属血虚,以四物为主,加竹沥、姜汁;在右者属气虚,以四君为主,加竹沥、姜汁。夫
以脾肺在右,而右半身不遂者,主乎脾肺之为病;肾肝在左,而左半身不遂者,主乎肾肝之为病则可。若
必主乎在右属气,在左属血,岂血仅行于左,而右半身无血;气仅行于右,而左半身无气?是气血在人身,
已分离而不相属矣。夫气主 之,血主濡之;气行则血行,气滞则血滞。血与气原相维,而何有左右之
分?世医执此,以分左右气血治中风半身不遂之症,未有能愈人者也。果属血虚,亦当补气,以气有生
血之功;果属气虚,亦当养血,以血有和气之力。若血自血,气自气,则阴阳乖格,岂云治病之权衡乎?
(凡一切 癖、 瘕、痞气、奔豚,腹中如杯如盘者,皆肝虚、金衰、木横之病,当滋肾水以救之,切不可用疏利
伐肝之剂。)
足厥阴肝为风木之脏,喜条达而恶抑郁,故经云木郁则达之是也。然肝藏血,人夜卧则血归于肝,是肝
之所赖以养者,血也。肝血虚,则肝火旺;肝火旺者,肝气逆也。肝气逆,则气实,为有余;有余则泻,举世
尽曰伐肝,故谓“肝无补法”。不知肝气有余不可补,补则气滞而不舒,非云血之不可补也。肝血不
足,则为筋挛,为角弓,为抽搐,为爪枯,为目眩,为头痛,为胁肋痛,为少腹痛,为疝痛诸症。凡此皆
肝血不荣也,而可以不补乎?然补肝血,又莫如滋肾水。水者,木之母也,母旺则子强,是以当滋化源。
若谓“肝无补法”,见肝之病者,尽以伐肝为事,愈疏而愈虚,病有不可胜言矣。故谓“肝无补法”者,
以肝气之不可补,而非谓肝血之不可补也。
《黄帝内经》只说左右是阴阳运行的道路,从未说过人体的气血要分左右。人的气血,在全身周流不息,气像风箱一样推动,血像波澜一样流动,气推动血运行,血作为气的配伍伴随,阴阳相互维系,循环没有尽头,哪里会有左右的分别呢?自从朱丹溪论述中风病症时,将半身不遂分为左右,认为左侧的属于血虚,以四物汤为主方,加入竹沥、姜汁;右侧的属于气虚,以四君子汤为主方,加入竹沥、姜汁。如果说是脾肺位于右侧,所以右侧半身不遂是由脾肺的疾病引起的;肾肝位于左侧,所以左侧半身不遂是由肾肝的疾病引起的,这还可以说得通。但如果一定要主张右侧属气、左侧属血,难道血只在左边运行,而右半身没有血吗?气只在右边运行,而左半身没有气吗?这样气血在人体内,就已经分离而不相关联了。气主煦之(温煦),血主濡之(濡养);气行则血行,气滞则血滞。血与气原本相互维系,怎么会有左右的分别呢?世间的医生固执于这种观点,用区分左右气血的方法来治疗中风的半身不遂症状,从来没有能治愈病人的。如果确实属于血虚,也应当补气,因为气有生血的功效;如果确实属于气虚,也应当养血,因为血有调和气的力量。如果血自管血,气自管气,那么阴阳就会乖离格拒,这怎么能称为治病的权衡标准呢?
(凡是各种积聚癖块、瘕聚、痞气、奔豚,腹中有如杯如盘状硬块的病证,都是肝虚、金衰、木横的病,应当滋补肾水来救治,切不可使用疏利伐肝的药物。)
足厥阴肝经是风木之脏,喜欢条达舒畅而厌恶抑郁,所以《内经》说“木郁则达之”就是这个道理。然而肝藏血,人夜晚睡觉时血就回归肝脏,这是肝赖以滋养的物质,就是血。肝血虚,则肝火旺;肝火旺,就是肝气逆乱。肝气逆乱,则气实,属于有余;有余就要泻,举世都说是伐肝,所以说“肝无补法”。不知道肝气有余不可以补,补了会导致气滞而不舒展,这并不是说肝血不可以补。肝血不足,就会出现筋脉拘挛、角弓反张、抽搐、指甲枯槁、目眩、头痛、胁肋痛、少腹痛、疝痛等各种症状。凡这些症状都是肝血不能荣养所致,难道可以不补吗?然而补肝血,又不如滋补肾水。水是木的母亲,母亲旺盛则儿子强壮,所以应当滋生化之源。如果说“肝无补法”,见到肝病的人,全都把伐肝当作主要事务,越疏泄肝气就越虚弱,病情就有说不完的严重了。所以说“肝无补法”,是指肝气不可补,而不是指肝血不可补。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) only states that the left and right are the pathways of Yin and Yang, and never claims that Qi and Blood in the human body are divided by left and right. Qi and Blood circulate throughout the entire body; Qi acts like a bellows, driving movement, while Blood flows like waves. Qi moves Blood, and Blood accompanies Qi as its counterpart. Yin and Yang mutually sustain each other, circulating endlessly without beginning or end. How could there be any division between left and right? Since Zhu Danxi discussed stroke syndromes, dividing hemiplegia into left and right sides, he claimed that cases on the left belong to Blood deficiency, treated primarily with Siwu Tang (Four Substances Decoction) plus Zhuli (Bamboo Juice) and Jiangzhi (Ginger Juice); cases on the right belong to Qi deficiency, treated primarily with Sijunzi Tang (Four Gentlemen Decoction) plus Zhuli and Jiangzhi. It is acceptable to argue that since the Spleen and Stomach are associated with the right side, right-sided hemiplegia is caused by disorders of the Spleen and Stomach; and since the Kidney and Liver are associated with the left side, left-sided hemiplegia is caused by disorders of the Kidney and Liver. However, if one insists that the right side belongs to Qi and the left to Blood, does this mean Blood only flows on the left, leaving the right half of the body without Blood? Does it mean Qi only flows on the right, leaving the left half of the body without Qi? This would imply that Qi and Blood within the body are separated and unrelated. Qi provides warmth (Qi zhu xu zhi), and Blood provides nourishment (Xue zhu ru zhi). When Qi moves, Blood moves; when Qi stagnates, Blood stagnates. Blood and Qi originally sustain each other; how can there be a division of left and right? Physicians of later generations have adhered to this view, treating hemiplegia from stroke by distinguishing between Qi and Blood on the left and right, yet none have been able to cure patients. If it truly is Blood deficiency, one should tonify Qi, because Qi has the function of generating Blood; if it truly is Qi deficiency, one should nourish Blood, because Blood has the power to harmonize Qi. If Blood were to remain separate from Qi, and Qi from Blood, then Yin and Yang would become disjointed and incompatible, which certainly cannot be considered a standard for medical treatment.
(All conditions such as accumulations, masses, epigastric fullness, running piglet syndrome, and abdominal hard masses resembling cups or plates are diseases resulting from Liver deficiency, Metal decline, and Wood overacting. They should be treated by nourishing Kidney Water, and strictly avoid using herbs that drain or attack the Liver.)
The Foot-Jueyin Liver channel is the organ of Wind-Wood. It prefers free flow and detests depression, which is why the Classics state "When Wood is depressed, promote its flow." However, the Liver stores Blood. When a person sleeps at night, Blood returns to the Liver; thus, Blood is what nourishes the Liver. When Liver Blood is deficient, Liver Fire becomes hyperactive. Hyperactive Liver Fire indicates rebellious Liver Qi. Rebellious Liver Qi results in Qi excess, which is a condition of repletion. In cases of repletion, purging is indicated. The world universally calls this "attacking the Liver," hence the saying "There is no method to tonify the Liver." They do not realize that while excess Liver Qi should not be tonified (as tonification leads to Qi stagnation and discomfort), this does not mean Liver Blood cannot be tonified. Deficiency of Liver Blood leads to tendon spasms, opisthotonos, convulsions, brittle nails, vertigo, headache, hypochondriac pain, lower abdominal pain, and hernia pain. All these symptoms arise because Liver Blood fails to nourish the tissues. Can they be left untonified? However, nothing is better for tonifying Liver Blood than nourishing Kidney Water. Water is the mother of Wood; when the mother is robust, the child becomes strong. Therefore, one should nourish the source of transformation. If one holds the view that "there is no method to tonify the Liver," and treats all Liver diseases by attacking the Liver, the more one drains, the weaker the patient becomes, leading to countless severe complications. Thus, the statement "there is no method to tonify the Liver" refers specifically to the fact that excess Liver Qi should not be tonified, not that Liver Blood cannot be tonified.