《内经》初无命门之名,命门之说始于越人之三十六难,而曰肾有两,左为肾,右为命门,男子藏
精,女子系胞。夫右肾既藏男子之精,则左肾将藏何物?女子之胞何独偏系于右?此其说之不能无疑也。
命门居两肾之中,而不偏于右,即妇人子宫之门户也。子宫者,肾脏藏精之府也,当关元、气海之间,
男精女血皆聚于此,为先天真一之气,所谓坎中之真阳,为一身生化之原。此命门在两肾中间,而不可以
独偏于右。两肾属水,有阴阳之分,命门属火,在二阴之中。故《脉经》以肾脉配两尺,但当曰左尺主
真阴,右尺主真阳,而命门则为阳气之根,随三焦相火,以同见于右尺则可,若谓左肾则主于肾,而右肾
偏为命门,此千古讹传之弊,而不得不亟正之者也。
疟、痢发于夏秋,本因溽暑,岂非湿热?但炎蒸之令出于天,苟能顺天之气,安能有病?惟因热求
凉,过于纵恣,则病由于人矣。故凡风寒感于外者,其邪在经,病多为疟;生冷伤于内者,其邪在脏,病
多为痢。痢之来也,暑湿郁久,则为湿热,然有瓜果生冷,凉风冰水,未必郁积,加以饮食相犯,触而成
痢,则痢未有不本于寒湿生灾者,岂必专以湿热为患哉?
痢以赤白分寒热,巢元方而下主之。此自古法,不为谬论。自河间以白者属肺,肺主气;赤者属心,
心主血,亦属有理。丹溪因之,遂谓白痢自大肠来,赤痢自小肠来。愚谓赤痢亦有寒证,终是热多;
白痢亦有热证,终是寒多。其有白而热者,脉症必热;赤而寒者;脉症必寒。若谓白必属肺,恐白痢非无
血化;赤必属心,恐血痢不离乎气。《局方》治痢,例用温热∶河间治痢,专主苦寒∶皆偏见也。
《黄帝内经》中最初并没有“命门”这一名称,“命门”的说法始于《难经》的第三十六难,其中说肾有两个,左边称为肾,右边称为命门,男子在右肾藏精,女子在右肾系胞宫。既然右肾既负责藏男子的精气,那么左肾又将藏什么?女子的胞宫为何偏偏只系于右侧?这种说法确实令人怀疑。
命门位于两肾之间,并不偏向右侧,它也就是妇女子宫的门户。子宫,是肾脏贮藏精气的府库,位于关元穴和气海穴之间,男精女血都汇聚于此,这是先天的真一之气,也就是所谓坎卦中的真阳,是一身生命生化作用的根源。因此,命门位于两肾中间,不能单独偏于右侧。两肾属水,有阴和阳的区别;命门属火,位于两阴之中。所以,《脉经》将肾脉配属于两尺部,但应该说左尺主真阴,右尺主真阳,而命门则是阳气的根本,随着三焦相火,一同显现于右尺脉是可以的;如果说左肾主要主管肾的功能,而右肾专门作为命门,这是千古流传的错误弊端,不得不急于纠正。
疟疾和痢疾多发于夏秋季节,原本是因为湿热气候,难道不是湿热致病吗?但是炎热蒸腾的气候源于自然天道,如果能顺应天时的气候,怎么会有疾病呢?只有因为贪热而求凉,行为过于放纵肆意,疾病才由人为因素导致。所以凡是风寒邪气侵袭体表的,邪气在经络,病证多为疟疾;生冷食物损伤体内的,邪气在脏腑,病证多为痢疾。痢疾发作时,暑湿郁积久了,就会变成湿热,但也有因食用瓜果生冷、凉风冰水,未必经过郁积,再加上饮食相互冲犯,触发而成痢疾,那么痢疾没有不基于寒湿引发灾祸的,哪里一定专以湿热为患呢?
用痢疾粪便中赤色和白色的比例来区分寒热,是从巢元方以来的传统主张。这是自古以来的法则,并非谬论。自从刘河间提出白色属肺,因为肺主气;红色属心,因为心主血,这也有一定的道理。朱丹溪沿袭此说,于是认为白痢来自大肠,赤痢来自小肠。我认为赤痢也有寒证,但终究热多;白痢也有热证,但终究寒多。那些白痢却表现为热证的,脉象和症状必然显示热象;赤痢却表现为寒证的,脉象和症状必然显示寒象。如果说白色必定属肺,恐怕白痢并非没有血液化生;如果说红色必定属心,恐怕血痢也离不开气的影响。《太平惠民和剂局方》治疗痢疾,惯例使用温热药;刘河间治疗痢疾,专门主张苦寒药;这都是片面的见解。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) originally did not have the term "Mingmen" (Gate of Life). The concept of Mingmen originated from Difficulty 36 of the *Nan Jing* (Classic of Difficult Issues), which stated that there are two kidneys: the left is the Kidney, and the right is the Mingmen. In men, it stores essence; in women, it connects to the uterus. If the right kidney stores the essence of men, then what does the left kidney store? Why is the uterus of women connected exclusively to the right? This theory raises significant doubts.
Mingmen is located between the two kidneys, not biased towards the right, and serves as the gateway to the uterus in women. The uterus is the mansion where the Kidney stores essence, situated between the Guanyuan (CV4) and Qihai (CV6) acupoints. Male essence and female blood gather here, constituting the primordial True One Qi, also known as the True Yang within Kan (Water trigram), which is the origin of biological transformation for the whole body. Therefore, Mingmen lies in the center of the two kidneys and cannot be solely biased to the right. The two kidneys belong to Water and are divided into Yin and Yang; Mingmen belongs to Fire and resides among the two Yins. Thus, the *Mai Jing* (Pulse Classic) associates the Kidney pulse with both Chi positions (cun-chi pulse at the wrist). It should be stated that the Left Chi governs True Yin, and the Right Chi governs True Yang. Mingmen, being the root of Yang Qi, follows the Minister Fire of the Sanjiao (Triple Burner) and manifests together at the Right Chi position. However, claiming that the left Kidney primarily governs the Kidney function while the right Kidney specifically serves as the Mingmen is an error transmitted through millennia, which must be urgently corrected.
Malaria and dysentery occur in summer and autumn, originally due to damp-heat. Is this not damp-heat pathology? However, the scorching heat comes from Heaven (nature). If one can adapt to the natural climate, how could illness arise? Illness arises only when one seeks coolness due to heat and acts with excessive indulgence. Therefore, when Wind-Cold pathogens invade the exterior, the pathogen is in the meridians, and the disease is mostly malaria; when raw and cold foods damage the interior, the pathogen is in the Zang organs, and the disease is mostly dysentery. When dysentery arises, long-standing stagnation of summer-heat and dampness transforms into damp-heat. However, consuming melons, raw/cold foods, cool winds, or ice water may not necessarily involve stagnation. Combined with dietary clashes triggering the condition, dysentery invariably originates from Cold-Damp disasters. How can it be exclusively attributed to Damp-Heat?
Differentiating the cold and heat nature of dysentery by the red and white color of stool has been advocated since Chao Yuanfang. This is an ancient method and not a fallacy. Since Liu Wansu (Hejian) proposed that white belongs to the Lung (which governs Qi) and red belongs to the Heart (which governs Blood), this reasoning has merit. Zhu Danxi followed this, asserting that white dysentery comes from the Large Intestine and red dysentery from the Small Intestine. I argue that red dysentery can also present with Cold syndromes, though Heat predominates ultimately; white dysentery can also present with Heat syndromes, though Cold predominates ultimately. Cases of white dysentery with Heat will manifest Heat in pulse and symptoms; cases of red dysentery with Cold will manifest Cold in pulse and symptoms. To claim that white must belong to the Lung ignores that white dysentery may involve blood transformation; to claim that red must belong to the Heart ignores that bloody dysentery involves Qi dynamics. The *Ju Fang* (Prescriptions of the Bureau) treats dysentery using warm-hot herbs; Liu Hejian treats dysentery focusing on bitter-cold herbs; both are biased views.