河井水各一盏煎,空腹温服,如头痛加白芷八分。按此方合小柴胡、平胃散,青皮饮三方为一,面以槟榔易草果之辛烈,加威灵仙,通行十二经络,彻内外而透邪出表,故奏效捷而成功伟也。盖人身中水湿有形之阴邪,每留着于肠胃,多化为热;中暑热无形之阳邪,每游溢于经络与湿相搏,遂化为疟痢。暑邪初中,不为湿所羁留,而即病自当从暑治,香薷散等方,表散之而外出是也,既化为疟痢,则当从疟痢治,犹米已成饭,不可以出汁,须由里而和之,使外出是也。故治疟发表非治法也,尽用麻,桂、羌、防,几曾见一汗而愈者?疟邪之汗,犹之瘟疫同法,必里气和而表自解。倪先生此方,专以疏利留着之湿邪为主,而以和胃化滞为佐。独黄芩一味,堪清游溢经络之暑热,可与疫症达原饮同调,不藉香茹之发表,而况麻、桂、羌、防,散太阳风寒之晶,可浪施乎?至若但热不寒之瘅疟疫厉,传变之温疟,自有白虎、承气在,但寒不热之牝疟,则又有附子理中、大小建中在,亦非徒恃发表可愈也。
第二方 治疟发三四次后,痰滞稍减,正气渐亏,一二剂即可止住。即极弱之人,缠极重之症,十剂后无不奏效。
生何首乌三钱 醋炙鳖甲?知母各二钱白术 当归 威灵仙各椙? 白茯苓 黄芩柴胡 广橘皮各八分 炙甘草三分 生姜一钱
河井水各半。煎,加无灰酒一盏,再煎数沸,空心温服。按此方妙在补泻互用,虚实得宜,不用人参、黄耆之骤补,屏去常山、草果之峻削,平平无奇,却神有效。慎勿混行加减,即无效矣。盖疟舍于营,邪伤血分,表邪稍解,当顾营血。方中首乌、鳖甲、当归正力血分药也。
第三方 治久疟虚弱并虚人患疟,扶正祛邪大有神效。
人参(或以玉竹代之,沙参无益也) 炙黄耆各一二钱 白术钱半 当归一饯?柴胡橘皮各八分 升麻四分 炙甘草三分 生何首乌二钱 大枣一枚 生姜八分
渴加知母一钱,热甚加青蒿八分,胃口不和加麦芽一钱,在半饥时服。
《素问》疟论,黄帝问曰;痃疟皆生于风,其蓄作有时者,何气使然?岐伯对曰:阴阳上下交争,虚实更作,阳并于阴,则阴实而阳虚。阴胜寒生于内,阳虚寒生于外,故中外皆寒极,则阳回而外出。阴并于阳,则阳实而阴虚,阳盛则外热,阴虚则内热,内外皆热,故喘而渴,欲饮冷也,此皆得之。夏伤于暑,热气盛,藏于肌肉之内,肠胃之外,此营气之所舍也。令人汗孔疏,腠理开。因得秋气,汗出遇风,及得之浴,水气舍于皮肤之内,与卫气并居。卫气者,昼日行于阳,夜行于阴。此气得阳而外出,得阴而内薄,内外相薄,是以日作其间。日作者,由邪气内薄于五脏,横连于募原,其道远,其气深,其行迟,故间日发也。至间数日发者,邪客于六腑有时,与卫气相失,故数日乃作也。
按经文则疟为先伤暑湿,后感寒风,构煽而起,其病根于肌肉之内,营气界分。不比风寒,骤感之在皮毛,不与营气相涉,可用麻、桂,羌,防发表,一汗而愈也。故治法必求之营气,用药必遵夫和解,由半表半里之间,导之使出。半表半里者,少阳之分也。少阳为枢,开阖必经之地也。虽刺疟篇有三阴三阳五脏及胃腑十二疟形状,乃邪走空窍,游溢于虚隙之处而现症,究其受病之原,乃舍于营分及募原皆半表里也。惟间数日者,则舍于六腑而更深入。然求其外出,亦必由少阳之枢辟,而后甫能达之皮毛。故小柴胡为治疟要药,奈今人因李士材有疟非少阳者,慎用柴胡一语,寒邪在太阳者,柴胡投早引入少阳等语,举世畏柴胡如虎,而治疟有终始弃置不用者。讵不思非少阳者,固不可用,在少阳者,非此不达也。前贤垂训,原欲人辨症而施药,试思寒热往来之为少阳症也,千古不易。既见寒热往来而犹侵柴胡,甘事麻、桂、羌、防,能不偾败乎?且士材所云疟非少阳,宁非指瘅疟、牝疟乎?奈何泥于一而不通乎?概遂致因噎而废食,岂不可叹!因疏倪先生方,而并拈经旨以印之,为同道共商榷焉。且风寒在表之恶寒发热,人虽恶寒而肌肤已热。疟疾之恶寒,内外俱寒,及其发热,绝不恶寒矣。风寒得汗,退热即解。疟疾自能作汗,而退热次日仍复。如是可见其病在里而不在表,非可求汗而解,必里清而表白清。强表徒伤正气,而疟必淹缠。故疟疾有汗者,及其无汗即愈;无汗者,及其有汗即愈。疟之为汗,乃其所自为也,非可强发也。故曰:里气和,汗自出,里和而表从之矣。
瘅 疟
经曰:瘅疟者,肺素有热,气盛于身,厥逆上冲,中气实而不外泄,因有所用力,腠理开,风寒舍于皮肤之内,分肉之间而发,发则阳气盛而不衰,不及于阴,故伹热不寒,气内藏于心,外舍于分肉,令人消烁脱肉。
按:此则治瘅疟主于肺热,实者白虎汤,虚者竹叶石膏汤,或君以知母,佐以人参,但二味更专功也。
湿温如疟论
原夫疟疾多端,《内经》详论已备。后人体认不真,每舍少阳不治,徒事发表攻里,往往贻误。不知疟之关于少阳,犹咳之不离乎肺也,纵有十二经之兼症,不过兼药以治之。若舍少阳而治疟,犹舍肺而治咳也。疟为少阳证,小柴胡为少阳药,舍小柴胡其孰用耶?少阳症忌汗吐下,此仲景之格言也。舍和解其又孰从之耶?今乃有湿温如疟一证,亦少阳病也。而又若似乎非疟,湿邪郁蒸而成,而又若似乎温疫,其初起也,先觉身体懒倦,神思困顿,微觉怯寒,而又不甚畏风寒,似将发热,而又不觉其大热,三五日间,似饥非饥,欲食不食,渐渐加热,非若伤寒之猝然洒浙,恶寒而发热,非若温疫之陡然蒸热而昏迷也,每热则渴,欲饮水而不甚贪,太阳或痛,筋骨或酸。或现少阳一二症,口苦而不胁胀,胁胀而不耳聋,耳聋而不作呕;或兼阳明一二症,两目微胀鼻干,不干时或眠,不眠更或腰脊强痛;又似太阳证状。然而种种杂出,俱随热轻重而增减,且不恶寒而反爱凉,热时手心甚于手背,一日之内,平旦前后,必有一二时辰安静,头颈以上若似有汗而润泽,摸之黏手,而实无可拭之汗,及至巳午以后,热甚则肤腠干燥,似睡非睡,呓语如谵,唤醒则清,而非若谵妄之不知人事,舌苔白滑,中或微黄,口糙无味,脉则两关滑数,少阳更弦,浮部不足,沉部有力,此湿温时气杂合所致,脾胃虚弱之人多成此症,乃少阳、阳明而兼涉太阴之候也。因其非风寒之邪,故不恶寒,而但作热。因其似疟,故不若伤寒之恶寒发热,头痛无休,不若疫症之大热娟然,神昏志乱也。因是湿温,故但热不寒,而渴不贪水。不若冬伤于风,至春作疟之先热后寒而为温疟也,不若夏伤于暑,秋必为疟之先寒后热而为寒疟也。但其作止有时,轻重有候,即同疟症,邪由湿温内发,干涉太阴,是以难汗发。从少阳、阳明,当用柴平散以萎蕤代人参和解之法治之。且此症更多自肘至腕之臂,自膝至踝之胫不热可征,其兼太阴而外验诸四肢也,其手足心更热者可征,其邪在少阳而内热甚也,人见其但热不寒,而又不若瘅疟之但热面有汗也,故不敢断其为疟。因其无汗,多用羌、防、荆、葛,求其汗解而不应,益以麻、桂,重竭其表,而汗愈不至,转而疑为血虚,不能作汗,重施归、葛、逍遥,而终不应,其或有兼腰痛者,非太阳症,或增注泻者,乃邪留少阳,日久而动厥阴经气,即经所云足厥阴之脉络胆,是动则病,腰痛不可以俯仰,嗌干,面尘脱色,胸满呕逆飧泄是也。伹和少阳,则邪自解矣。此症多发于春暮,以至中秋,当木土火气值令之时为最多。奈病家但见发热,咸为著表,喜从发散,不知发热之症多端,岂尽表耶?南方人更怕寒凉,视三黄、白虎如蛇蝎,以小柴胡方内有黄芩,多不敢服,北方人怕温燥,视姜、桂如虎狼,且嫌和解之功缓,喜从攻下,而服承气。此俱一隅之偏见,必藉医家把握,剀切开导,使知此症当从少阳治法,而柴胡为少阳之表药,清肌解热,黄芩为少阳之里药,利热燥湿,二者去一则不成其为小柴胡汤也。而人参、半夏,乃佐使之晶,在可增可减耳。炙草固胃气,姜枣和营卫,俱不可少者也。若有兼症,则以兼药治之,岂可舍少阳而他求乎?
萎蕤三钱柴胡 黄芩酒妙 制半夏各二钱 茅苍术 厚朴姜炒 橘皮 炙甘草各八分红枣三枚 生姜一片
如屡服发散药而无汗,重竭其津液而烦渴者,加天花粉、麦冬,减半夏;如服攻下药而溏泻,夜甚,五心烦热,邪陷血分者,须调中益气汤加减治之,提邪外出阳分。
生黄耆 生白术 萎蕤各二钱 茯苓一钱二分 炙甘草 橘皮 柴胡各八分 升麻四分枣三枚姜一片 若腹胀泻不止,加煨木香八分
凡治伤寒者,咸祖述仲景。然多致力于汗下,而于温清和补之法,每略而不究。时人用药,动称景岳而言新方者,惟擅有归、理阴,但用其热补二阵,而遗其六阵于不问,殊不察用和之法,莫善于景岳,其于和阵略中言之详矣。且其散阵中之六柴胡饮,更可为善用柴胡者。奈人咸谓景岳偏于温补,乃今人用其偏,而景岳原未之偏也。
男子热入血室论
《金匮要略》曰:妇人中风七八日,续得寒热,发作有时,经水适断,此为热入血室,其血必结,故使如疟状,发作有时者,小柴胡汤主之。又曰;妇人伤寒发热,经水适来,昼日明了,暮则谵语,如见鬼状,此谓热入血室,治之无犯胃气及上二焦,必自愈也。又曰:阳明病下血谵语者,此为热入血室,但头汗出,当刺期门,随其实而泻之,濈然汗出者愈,
愚按:血室即血海也。肝为血海,乃厥阴也。妇人伤寒时疫,适逢经至,血海空虚,邪陷入内,面作寒热往来,谵妄如疟,此邪犯厥阴而列入少阳篇者,所以明少阳为厥阴之府,必和邪使从表出,故治法不外乎小柴胡汤也。然血海男女皆同,而不及男子热入血室之故者,乃古之缺文也。成无已则以阳明病下血谵语一条谓指男女者,犹未可为定论。若然,则妇人岂独无阳明病下血之症乎?妇人之月经有信可验人所易知,男子则无以考证。成无已泥于必见血而方可为热入血室,故以阳明病下血条印之,独不思无下血症而往来寒热如疟,又当指为何症乎?愚意男子是症,必其人素有遗滑惯病,或感邪后而梦遗,或入房,至使邪热乘虚而入血室也。夫遗精出自前阴,人皆认为肾病,而愚曰:厥阴非创说耶,然不知经云肝主疏泄,故遗精必先治肝,况女子之月水亦出前阴,非同根于厥阴之疏泄,而出则俱从外肾也。细绎《金匮》所列三条,受症不同,治法各异,总以和解为主。其曰;无犯胃气及上二焦者,恐人误施汗吐法也。曰:当刺期门,随其实面泻之,濈然汗出者愈。恐人误施攻下,并戒不可大汗,以明少阳症忌汗吐下法也明矣。故妇人必察其适断适至,而于和邪中兼以活血导血之药;在男子则察其有无下血遗滑,而兼以逐瘀养阴之药,和解缓攻,万无以刚药与之,以致不救。乃人往往见男子是症,认为肾虚,投以姜、附、桂、地,甚则参、耆,纯于温补,忘其谵忘热邪,多致昏惑,愤乱而毙,更不思阴寒直中少阴之症,自有脉症之可据,今纵因疏泄而肾虚,乃热邪之陷入,非阴寒初感直中之可比。奈医家不察经义,而置和解提邪于不问,病家期于速效,而喜补正祛邪之稳妥,致令死者之含冤,徒使二竖之窃笑,深可慨夫!
以上二症,同出少阳病,最淹缠,医易摇惑。若更病家欲求速效,则多所贻误用抒一得之忱,惟冀大雅之鉴,倘蒙赐教,更幸甚矣。
河水和井水各一盏,煎煮后空腹温服。如果头痛,加白芷八分。按此方综合了小柴胡汤、平胃散和青皮饮三方为一,用槟榔替代草果的辛烈之性,加入威灵仙,通行十二经络,彻透内外以透邪出表,所以见效快且功效显著。大概人身中的水湿是有形的阴邪,常滞留于肠胃,多化为热;中暑热是无形的阳邪,常在经络中游溢,与湿相搏结,遂化为疟疾或痢疾。暑邪初起时,若不被湿邪羁留而立即发病,自然应当从暑治,香薷散等方剂就是用来解表散邪使之外出的。既然已经化为疟痢,就应当从疟痢治疗,这就像米已经煮成饭,不能再提取汁液,必须通过调和里气的方法,使邪气由内向外排出。所以治疗疟疾发表并不是正确的治法,尽用麻黄、桂枝、羌活、防风等药,何曾见过发一次汗就痊愈的?疟邪的发汗,与瘟疫的治疗原则相同,必须里气和顺,表邪自然解除。倪先生的这个方子,专门以疏利滞留的湿邪为主,而以和胃化滞为辅。只有黄芩一味,能够清除游溢在经络中的暑热,可以与疫症达原饮配合调理,不借助香薷的发表作用,更何况麻黄、桂枝、羌活、防风是发散太阳经风寒的药物,岂能滥用呢?至于那种但热不寒的瘅疟疫病,传变而来的温疟,自有白虎汤、承气汤在,只是寒不热的牝疟,又有附子理中汤、大小建中汤在,也不是单纯依靠发表就能治愈的。
第二方 治疗疟疾发作三四次后,痰滞稍减,正气逐渐亏损,服用一二剂即可止住。即使是极度虚弱的人,缠患极重的病症,十剂后无不奏效。
生何首乌三钱,醋炙鳖甲、知母各二钱,白术、当归、威灵仙各一钱(原文“椙”疑为钱之误),白茯苓、黄芩、柴胡、广橘皮各八分,炙甘草三分,生姜一钱。
河水和井水各半盏,煎煮,加入无灰酒一盏,再煎数沸,空腹温服。按此方的妙处在于补泻互用,虚实得宜,不用人参、黄芪的骤补,屏去常山、草果的峻烈削伐,平平无奇,却神效有效。千万不要随意加减,否则就会无效。大概疟邪寄居在营分,邪气伤害血分,表邪稍解,应当顾护营血。方中的何首乌、鳖甲、当归正是入血分的药物。
第三方 治疗久疟体虚以及体虚之人患疟,扶正祛邪大有神效。
人参(或用玉竹代替,沙参无益),炙黄芪各一二钱,白术钱半,当归一钱(原文“饯”疑为钱之误),柴胡、橘皮各八分,升麻四分,炙甘草三分,生何首乌二钱,大枣一枚,生姜八分。
口渴加知母一钱,热甚加青蒿八分,胃口不和加麦芽一钱,在半饥时服用。
《素问·疟论》中,黄帝问道:痃疟都生于风,其蓄积发作有定时,是什么气造成的?岐伯回答说:阴阳上下交争,虚实更替作乱,阳气并入阴分,则阴实而阳虚。阴胜则寒生于内,阳虚则寒生于外,所以内外皆寒至极,然后阳气回复而外出。阴气并入阳分,则阳实而阴虚,阳盛则外热,阴虚则内热,内外皆热,所以气喘而口渴,想喝冷水,这都是因为夏天伤于暑气,热气旺盛,藏于肌肉之内,肠胃之外,这是营气所寄居的地方。使人汗孔疏松,腠理开泄。因而遇到秋气,出汗遇风,以及洗澡时,水气舍于皮肤之内,与卫气并居。卫气,白天行于阳分,夜晚行于阴分。此气得到阳气则外出,得到阴气则内迫,内外相搏,所以每天发作。每天发作的,是因为邪气内迫于五脏,横连于募原,其路径远,其气深,其运行迟缓,所以隔日发作。至于间隔数日才发作的,是因为邪客于六腑有时,与卫气相失,所以数日才发作。
按经文来说,疟疾是先伤于暑湿,后感寒风,构煽而起,病根在于肌肉之内,营气界分。不像风寒,骤然感受在皮毛,不与营气相涉,可用麻黄、桂枝、羌活、防风发表,发一次汗就痊愈了。所以治法必须求之于营气,用药必须遵循和解之道,由半表半里之间,引导邪气外出。半表半里者,是少阳的分野。少阳为枢机,是开阖必经之地。虽然《刺疟篇》有三阴三阳五脏及胃腑十二种疟疾的形状描述,那是邪气走窜空窍,游溢于虚隙之处而现出的症状,究其受病的根源,乃是舍于营分及募原,都属于半表里。只有间隔数日发作的,则是舍于六腑而更深入。然而寻求其外出,也必须经由少阳的枢机开辟,然后才能到达皮毛。所以小柴胡汤是治疗疟疾的要药,无奈今人因为李士材有“疟非少阳者,慎用柴胡”一句话,以及“寒邪在太阳者,柴胡投早引入少阳”等语,举世畏惧柴胡如虎,而治疗疟疾有始终弃置不用的。难道不想想,非少阳证固然不可用,在少阳证,非此药不能通达啊。前贤垂训,原本是想让人辨证施药,试思寒热往来作为少阳证,千古不易。既然见到寒热往来还侵夺柴胡的使用,甘愿使用麻黄、桂枝、羌活、防风,能不失败吗?况且李士材所说的“疟非少阳”,难道不是指瘅疟、牝疟吗?为何拘泥于一端而不通融呢?这简直是因噎废食,岂不可叹!因此疏解倪先生的方子,并拈出经典旨意来印证它,与同道共同商讨。而且风寒在表的恶寒发热,人虽然恶寒但肌肤已热。疟疾的恶寒,内外俱寒,等到发热时,绝不恶寒了。风寒得汗,退热即解。疟疾自能作汗,而退热次日仍会复发。如此可见其病在里而不在表,不可以求汗而解,必须里清而表自清。强行解表徒伤正气,而疟疾必然缠绵。所以疟疾有汗的,等到无汗时就愈;无汗的,等到有汗时就愈。疟疾的汗,是它自己发出的,不可以强行发汗。所以说:里气和,汗自出,里和而表从之矣。
经文说:瘅疟,是肺素有热,气盛于身,厥逆上冲,中气实而不外泄,因有所用力,腠理开,风寒舍于皮肤之内,分肉之间而发,发则阳气盛而不衰,不及于阴,所以但热不寒,气内藏于心,外舍于分肉,令人消烁脱肉。
按:此则治疗瘅疟主于肺热,实证用白虎汤,虚证用竹叶石膏汤,或者以知母为主药,佐以人参,但这二味药更专功。
湿温如疟论
原来疟疾多端,《内经》详细论述已完备。后人认识不真切,常常舍弃少阳不治,只从事发表攻里,往往贻误病情。不知道疟疾关于少阳,就像咳嗽离不开肺一样,纵有十二经的兼症,不过是加兼药来治疗。如果舍弃少阳而治疟,就像舍弃肺而治咳一样。疟为少阳证,小柴胡汤为少阳药,舍弃小柴胡汤谁还用呢?少阳症忌汗吐下,这是张仲景的格言。舍弃和解又听从谁呢?现在又有湿温如疟一证,也是少阳病。而又似乎不是疟疾,湿邪郁蒸而成,而又似乎像温疫,其初起时,先觉得身体懒倦,神思困顿,微觉怯寒,而又不甚畏风寒,似将发热,而又不觉得大热,三五日间,似饥非饥,欲食不食,渐渐加热,不像伤寒那样猝然洒浙恶寒而发热,不像温疫那样陡然蒸热而昏迷,每发热则口渴,想喝水但不甚贪饮,太阳经或痛,筋骨或酸。或现少阳一二症,口苦而不胁胀,胁胀而不耳聋,耳聋而不作呕;或兼阳明一二症,两目微胀鼻干,不干时或眠,不眠更或腰脊强痛;又似太阳证状。然而种种杂出,都随热轻重而增减,且不恶寒而反爱凉,热时手心甚于手背,一日之内,平旦前后,必有一二时辰安静,头颈以上若似有汗而润泽,摸之黏手,而实无可拭之汗,及至巳午以后,热甚则肤腠干燥,似睡非睡,呓语如谵,唤醒则清,而非若谵妄之不知人事,舌苔白滑,中或微黄,口糙无味,脉则两关滑数,少阳更弦,浮部不足,沉部有力,这是湿温时气杂合所致,脾胃虚弱之人多成此症,乃少阳、阳明而兼涉太阴之候也。因其非风寒之邪,故不恶寒,而但作热。因其似疟,故不若伤寒之恶寒发热,头痛无休,不若疫症之大热娟然,神昏志乱也。因是湿温,故但热不寒,而渴不贪水。不像冬伤于风,至春作疟之先热后寒而为温疟也,不像夏伤于暑,秋必为疟之先寒后热而为寒疟也。但其作止有时,轻重有候,即同疟症,邪由湿温内发,干涉太阴,是以难汗发。从少阳、阳明,当用柴平散以萎蕤代人参和解之法治之。且此症更多自肘至腕之臂,自膝至踝之胫不热可征,其兼太阴而外验诸四肢也,其手足心更热者可征,其邪在少阳而内热甚也,人见其但热不寒,而又不若瘅疟之但热面有汗也,故不敢断其为疟。因其无汗,多用羌活、防风、荆芥、葛根,求其汗解而不应,益以麻黄、桂枝,重竭其表,而汗愈不至,转而疑为血虚,不能作汗,重施当归、葛根、逍遥散,而终不应,其或有兼腰痛者,非太阳症,或增注泻者,乃邪留少阳,日久而动厥阴经气,即经所云足厥阴之脉络胆,是动则病,腰痛不可以俯仰,嗌干,面尘脱色,胸满呕逆飧泄是也。伹和少阳,则邪自解矣。此症多发于春暮,以至中秋,当木土火气值令之时为最多。奈病家但见发热,咸为著表,喜从发散,不知发热之症多端,岂尽表耶?南方人更怕寒凉,视三黄、白虎如蛇蝎,以小柴胡方内有黄芩,多不敢服,北方人怕温燥,视姜、桂如虎狼,且嫌和解之功缓,喜从攻下,而服承气汤。此俱一隅之偏见,必藉医家把握,剀切开导,使知此症当从少阳治法,而柴胡为少阳之表药,清肌解热,黄芩为少阳之里药,利热燥湿,二者去一则不成其为小柴胡汤也。而人参、半夏,乃佐使之晶,在可增可减耳。炙草固胃气,姜枣和营卫,俱不可少者也。若有兼症,则以兼药治之,岂可舍少阳而他求乎?
萎蕤三钱,柴胡、黄芩(酒炒)、制半夏各二钱,茅苍术、厚朴(姜炒)、橘皮、炙甘草各八分,红枣三枚,生姜一片。
如屡服发散药而无汗,重竭其津液而烦渴者,加天花粉、麦冬,减半夏;如服攻下药而溏泻,夜甚,五心烦热,邪陷血分者,须调中益气汤加减治之,提邪外出阳分。
生黄芪、生白术、萎蕤各二钱,茯苓一钱二分,炙甘草、橘皮、柴胡各八分,升麻四分,枣三枚,姜一片。若腹胀泻不止,加煨木香八分。
凡治疗伤寒者,都祖述张仲景。然而多致力于汗下,而对于温清和补之法,每每忽略而不探究。时人用药,动辄称道张景岳而言新方者,惟擅长有归、理阴,但用其热补二阵,而遗其六阵于不问,殊不察用和之法,莫善于景岳,其于和阵略中言之详矣。且其散阵中之六柴胡饮,更可为善用柴胡者。奈人咸谓景岳偏于温补,乃今人用其偏,而景岳原未之偏也。
男子热入血室论
《金匮要略》说:妇人中风七八日,续得寒热,发作有时,经水适断,此为热入血室,其血必结,故使如疟状,发作有时者,小柴胡汤主之。又说:妇人伤寒发热,经水适来,昼日明了,暮则谵语,如见鬼状,此谓热入血室,治之无犯胃气及上二焦,必自愈也。又说:阳明病下血谵语者,此为热入血室,但头汗出,当刺期门,随其实而泻之,濈然汗出者愈。
我按:血室即血海也。肝为血海,乃厥阴也。妇人伤寒时疫,适逢经至,血海空虚,邪陷入内,面作寒热往来,谵妄如疟,此邪犯厥阴而列入少阳篇者,所以明少阳为厥阴之府,必和邪使从表出,故治法不外乎小柴胡汤也。然血海男女皆同,而不及男子热入血室之故者,乃古之缺文也。成无己则以阳明病下血谵语一条谓指男女者,犹未可为定论。若然,则妇人岂独无阳明病下血之症乎?妇人之月经有信可验人所易知,男子则无以考证。成无己泥于必见血而方可为热入血室,故以阳明病下血条印之,独不思无下血症而往来寒热如疟,又当指为何症乎?愚意男子是症,必其人素有遗滑惯病,或感邪后而梦遗,或入房,至使邪热乘虚而入血室也。夫遗精出自前阴,人皆认为肾病,而愚曰:厥阴非创说耶,然不知经云肝主疏泄,故遗精必先治肝,况女子之月水亦出前阴,非同根于厥阴之疏泄,而出则俱从外肾也。细绎《金匮》所列三条,受症不同,治法各异,总以和解为主。其曰:无犯胃气及上二焦者,恐人误施汗吐法也。曰:当刺期门,随其实面泻之,濈然汗出者愈。恐人误施攻下,并戒不可大汗,以明少阳症忌汗吐下法也明矣。故妇人必察其适断适至,而于和邪中兼以活血导血之药;在男子则察其有无下血遗滑,而兼以逐瘀养阴之药,和解缓攻,万无以刚药与之,以致不救。乃人往往见男子是症,认为肾虚,投以姜、附、桂、地,甚则参、耆,纯于温补,忘其谵忘热邪,多致昏惑,愤乱而毙,更不思阴寒直中少阴之症,自有脉症之可据,今纵因疏泄而肾虚,乃热邪之陷入,非阴寒初感直中之可比。奈医家不察经义,而置和解提邪于不问,病家期于速效,而喜补正祛邪之稳妥,致令死者之含冤,徒使二竖之窃笑,深可慨夫!
以上二症,同出少阳病,最淹缠,医易摇惑。若更病家欲求速效,则多所贻误用抒一得之忱,惟冀大雅之鉴,倘蒙赐教,更幸甚矣。
Decoct river water and well water, each one cup, and take warm on an empty stomach. If headache occurs, add Baizhi (Angelicae Dahuricae Radix) 8 fen. According to this formula, it combines Xiao Chai Hu Tang (Minor Bupleurum Decoction), Ping Wei San (Calm the Stomach Powder), and Qing Pi Yin (Green Tangerina Peel Drink) into one. It replaces the pungent and acrid nature of Caoguo (Tsaoko Fructus) with Binglang (Arecae Semen), adds Weilingxian (Syringae Ramulus et Folium) to circulate through the twelve meridians, thoroughly penetrating the interior and exterior to expel pathogenic factors from the surface, thus achieving rapid effect and great success. Generally speaking, water-dampness in the human body is a tangible yin pathogen that often lingers in the intestines and stomach, frequently transforming into heat; summer-heat is an intangible yang pathogen that often overflows in the meridians, where it combats with dampness, thereby transforming into malaria or dysentery. When summer-heat pathogen initially strikes, if it is not detained by dampness and illness arises immediately, treatment should naturally follow the summer-heat pattern; formulas such as Xiangru San (Moslae Herba Powder) are used to release the exterior and disperse outward. Once it has transformed into malaria or dysentery, treatment must follow the malaria/dysentery pattern. This is like rice that has already been cooked into porridge; one cannot extract juice from it. One must harmonize the interior to guide the pathogen out from within. Therefore, releasing the exterior to treat malaria is not the correct method. Have you ever seen anyone cured after a single sweating treatment using only Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Qianghuo (Notopterygii Rhizoma et Radix), and Fangfeng (Saposhnikoviae Radix)? The sweating method for malaria follows the same principle as for plague-like epidemics: the interior qi must be harmonized first, and the exterior will resolve spontaneously. Mr. Ni's formula focuses primarily on dispersing and draining the lingering dampness pathogen, with harmonizing the stomach and resolving stagnation as an auxiliary function. Only Huangqin (Scutellariae Radix) alone can clear the summer-heat heat overflowing in the meridians; it can be coordinated with Dayuan Yin (Reach the Origin Drink) for epidemic conditions. It does not rely on the exterior-releasing property of Xiangru (Moslae Herba), let alone Mahuang, Guizhi, Qianghuo, and Fangfeng, which are crystals for dispersing wind-cold of the Taiyang channel; how could they be used indiscriminately? As for Danre Malaria (Febrile Malaria) characterized by fever without chills, or Wenmalaria (Warm Malaria) resulting from transmission, there are Baihu Tang (White Tiger Decoction) and Chengqi Tang (Descending the Qi Decoction). For Nvmalaria (Yin Malaria) characterized by chills without fever, there are Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) and Da/Xiao Jianzhong Tang (Great/Minor Construct the Middle Decoctions); these are also not curable by merely relying on exterior-releasing methods.
Second Formula: Treats malaria after three or four attacks, when phlegm-stagnation is slightly reduced and healthy qi gradually declines; one or two doses can stop the attacks. Even for extremely weak individuals suffering from severe conditions, ten doses will invariably produce effective results.
Sheng Heshouwu (Polygoni Multiflori Radix Praeparata) 3 qian, Cu Zhi Biejia (Testudinis Carapax et Plastrum Vinegar-fried) and Zhimu (Anemarrhenae Rhizoma) each 2 qian, Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), and Weilingxian (Syringae Ramulus et Folium) each 1 qian, Baifuling (Poria), Huangqin (Scutellariae Radix), Chaihu (Bupleuri Radix), and Guang Jupi (Citri Reticulatae Pericarpium) each 8 fen, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Honey-fried) 3 fen, Shengjiang (Zingiberis Rhizoma Recens) 1 qian.
Decoct half a cup each of river water and well water, add one cup of unadulterated wine, boil for a few more boils, and take warm on an empty stomach. The brilliance of this formula lies in the mutual use of tonification and purgation, appropriately balancing deficiency and excess. It avoids the sudden tonification of Ren Shen (Ginseng Radix) and Huangqi (Astragali Radix), and excludes the harsh depletion of Changshan (Dichroae Radix) and Caoguo (Tsaoko Fructus). It appears ordinary but is miraculously effective. Do not arbitrarily modify it, or it will become ineffective. Generally, malaria resides in the Ying (Nutritive) level, and the pathogen damages the Blood level. When the exterior pathogen is slightly resolved, one must attend to the Ying-Blood. Heshouwu, Biejia, and Danggui in the formula are precisely herbs entering the Blood level.
Third Formula: Treats chronic malaria with weakness and malaria in weak individuals; supporting healthy qi and expelling pathogens yields miraculous effects.
Ren Shen (Ginseng Radix) (or substitute with Yuzhu (Polygonati Odorati Rhizoma); Shashen (Glehniae Radix) is of no benefit), Zhi Huangqi (Astragali Radix Honey-fried) each 1-2 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 1.5 qian, Danggui (Angelicae Sinensis Radix) 1 qian, Chaihu (Bupleuri Radix) and Jupi (Citri Reticulatae Pericarpium) each 8 fen, Shengma (Cimicifugae Rhizoma) 4 fen, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Honey-fried) 3 fen, Sheng Heshouwu (Polygoni Multiflori Radix Praeparata) 2 qian, Dazao (Jujubae Fructus) one piece, Shengjiang (Zingiberis Rhizoma Recens) 8 fen.
If thirsty, add Zhimu (Anemarrhenae Rhizoma) 1 qian; if heat is severe, add Qinghao (Artemisiae Annuae Herba) 8 fen; if appetite is poor, add Maiya (Hordei Fructus Germinatus) 1 qian; take when half-hungry.
In *Suwen: Malaria Theory*, the Yellow Emperor asked: "All Xuanmalaria arise from wind. Why do their accumulation and发作 occur at specific times?" Qibo replied: "Yin and Yang contend above and below, alternating between deficiency and excess. When Yang merges into Yin, Yin becomes full and Yang deficient. Yin dominance causes cold to arise internally; Yang deficiency causes cold to arise externally. Thus, both interior and exterior become extremely cold, until Yang returns and moves outward. When Yin merges into Yang, Yang becomes full and Yin deficient. Yang excess causes external heat; Yin deficiency causes internal heat. Both interior and exterior become hot, leading to panting and thirst, desiring cold drinks. All this results from Summer Heat injuring during summer, with abundant heat qi storing inside the muscles and outside the intestines/stomach, where Ying Qi resides. This causes sweat pores to open and Couli (interstices) to relax. Consequently, encountering Autumn Qi, sweating while exposed to wind, or bathing allows Water Qi to lodge inside the skin, residing together with Wei Qi (Defensive Qi). Wei Qi travels in Yang during the day and in Yin at night. This Qi moves outward when encountering Yang and presses inward when encountering Yin. Interior-exterior contention causes daily发作. Daily发作 occurs because the pathogen presses inward on the five zang organs and horizontally connects to the Mu Yuan (Master Source). The path is long, the qi is deep, and its movement is slow, hence interdaily发作. For发作 every few days, the pathogen lodges in the six fu organs at certain times, losing sync with Wei Qi, hence发作 after several days."
According to the classic text, malaria originates from initial injury by Summer-Heat-Dampness, followed by wind-cold sensation, igniting the disease. Its root lies within the muscles, in the realm of Ying Qi. Unlike wind-cold, which suddenly affects the skin and hair without involving Ying Qi, allowing cure via Ma-Gui-Qiang-Fang exterior-releasing sweating, malaria treatment must seek the Ying Qi and adhere to Harmonization methods, guiding the pathogen out from the Half-Exterior/Half-Interior. The Half-Exterior/Half-Interior belongs to Shaoyang. Shaoyang serves as the pivot, the必经 path for opening and closing. Although the *Ci Malaria Chapter* describes twelve types of malaria involving three Yin, three Yang, five zang, and stomach/fu organs, these are symptoms appearing when pathogen wanders through orifices and overflows into void spaces. Investigating the origin of disease, it lodges in the Ying level and Mu Yuan, both being Half-Exterior/Half-Interior. Only interdaily发作 lodges deeper in the six fu organs. However, seeking its exit still requires passing through the Shaoyang pivot to reach the skin/hair. Thus, Xiao Chai Hu Tang is the essential medicine for treating malaria. Yet today, people fear Chaihu like a tiger due to Li Shicai's statement "For malaria not in Shaoyang, use Chaihu cautiously," and warnings against introducing Taiyang cold pathogen into Shaoyang too early. Consequently, many abandon Chaihu entirely for malaria. Did they not consider that while non-Shaoyang cases indeed forbid its use, Shaoyang cases cannot resolve without it? Ancients instructed differentiation of symptoms before prescribing. Consider that "alternating chills and fever" is the hallmark of Shaoyang syndrome, unchanging since antiquity. Seeing alternating chills and fever yet withholding Chaihu, preferring Mahuang, Guizhi, Qianghuo, Fangfeng, inevitably leads to failure. Moreover, did Li Shicai's "malaria not in Shaoyang" refer specifically to Danre Malaria or Nvmalaria? Why be so rigid? This is akin to giving up eating because of choking, truly lamentable! I elucidate Mr. Ni's formula here and cite classic principles to verify them, inviting discussion among colleagues. Furthermore, wind-cold at the exterior presents aversion to cold with fever, where although the patient feels cold, the skin is hot. In malaria, aversion to cold involves both interior and exterior; when fever arises, there is absolutely no aversion to cold. Wind-cold resolves upon sweating and fever reduction. Malaria produces spontaneous sweat, yet fever returns the next day despite reduction. This shows the disease is in the interior, not the exterior; it cannot be solved by seeking sweat. The interior must clear for the exterior to clarify. Forcible exterior-releasing only injures healthy qi, prolonging malaria. Thus, malaria with sweat cures when sweat stops; malaria without sweat cures when sweat begins. Malaria sweat is self-generated, not forcibly induced. Hence: "When interior qi harmonizes, sweat emerges spontaneously; interior harmony leads to exterior resolution."
Danre Malaria (Febrile Malaria)
The Classic states: "Danre Malaria arises from lungs having prior heat, qi abundance throughout the body, counterflow rushing upward, middle qi full but not venting outward. Due to physical exertion, Couli open, wind-cold lodges inside skin and between muscle layers, triggering fire. Upon onset, Yang qi becomes excessive and does not decline, failing to reach Yin. Thus, there is only heat without chills. Qi stores internally in the heart and externally in muscle layers, causing emaciation and flesh wasting."
Commentary: Treatment for Danre Malaria focuses on Lung Heat. Excess patterns use Baihu Tang (White Tiger Decoction); deficiency patterns use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction), or use Zhimu as sovereign herb with Ren Shen as minister. These two herbs are particularly specialized.
On Wet-Warmth Resembling Malaria
Malaria is multifarious, fully detailed in *Neijing*. Later practitioners often fail to recognize accurately, abandoning Shaoyang treatment, resorting only to exterior-releasing or interior-purging, often causing errors. They do not realize that malaria's relation to Shaoyang is like cough's relation to Lungs. Regardless of twelve-meridian accompanying symptoms, one merely adds herbs to treat them. Abandoning Shaoyang to treat malaria is like abandoning Lungs to treat cough. Malaria is a Shaoyang syndrome; Xiao Chai Hu Tang is the Shaoyang medicine. Who else would use it? Shaoyang syndrome contraindicates sweating, vomiting, and purging—this is Zhang Zhongjing's golden rule. Without Harmonization, who else to follow? Now, there exists a condition called "Wet-Warmth resembling Malaria," which is also a Shaoyang disease. It seems unlike malaria, formed by dampness pathogen depression and steaming; it seems like warm epidemic. Initially, one feels body lethargy, mental fatigue, slight aversion to cold but not severe fear of wind-cold, seeming to have fever but not feeling intense heat. Over 3-5 days, feeling hungry yet not wanting food, heat gradually increases. Unlike sudden chills and fever in Shanghan (Cold Damage), or sudden steaming heat and coma in epidemics, wet-warmth brings thirst upon fever, desiring water but not greedily. Taiyang channel may hurt, bones/joints may ache. Occasional Shaoyang symptoms: bitter taste without hypochondriac distension; distension without deafness; deafness without vomiting. Occasional Yangming symptoms: slight eye swelling, dry nose; sleepiness when not dry; back/spine stiffness when not sleeping. Resembles Taiyang symptoms. Yet all mixed symptoms increase/decrease with heat intensity. No aversion to cold, preference for coolness. Palms hotter than backs during fever. Within a day, around dawn, there is 1-2 hours of quietude. Head/neck seem sweaty and moist, sticky to touch, yet no wipeable sweat. After Si/Wu hours (9 AM - 1 PM), heat intensifies, skin becomes dry. Sleepy but not asleep, muttering deliriously, clearing upon waking, unlike true delirium unaware of surroundings. Tongue coating white slippery, center slightly yellow. Mouth rough, tasteless. Pulse: Guan positions slippery-numerous, Shaoyang string-taut, Floating position insufficient, Sinking position forceful. This results from mixed Wet-Warmth seasonal qi, common in Spleen-Stomach weak individuals. It is a Shaoyang-Yangming syndrome involving Taiyin. Because it is not wind-cold, there is no aversion to cold, only heat. Because it resembles malaria, it lacks Shanghan's relentless chills/fever/headache, and lacks epidemic's intense heat/coma. Being wet-warmth, it has heat without chills, thirst without water craving. Unlike Winter-wind Spring-malaria (warm malaria: heat then chills) or Summer-heat Autumn-malaria (cold malaria: chills then heat). But发作 has timing, severity has signs, just like malaria. Pathogen originates internally from wet-warmth, interfering with Taiyin, making sweating difficult. From Shaoyang/Yangming, use Chaiping San (Bupleurum and Atractylodes Powder) replacing Ren Shen with Weiyu (Polygonati Rhizoma) for Harmonization. Also, arms from elbow to wrist, legs from knee to ankle are notably cool, indicating Taiyin involvement manifesting in limbs. Hands/feet palms hotter indicate severe internal heat in Shaoyang. People see heat without chills, unlike Danre Malaria's heat with sweat, so dare not diagnose as malaria. Due to lack of sweat, many use Qianghuo, Fangfeng, Jingjie, Gegen seeking sweat, but fail. Adding Mahuang, Guizhi exhausts the exterior further, sweat still absent. Then suspecting Blood deficiency preventing sweat, adding Danggui, Gegen, Xiaoyao San fails again. Some with lower back pain: not Taiyang syndrome. Some with diarrhea: pathogen lingering in Shaoyang, moving Jueyin qi over time. As Classic says: Foot Jueyin meridian connects to Gallbladder; when moved, disease manifests as lower back pain unable to bend/straighten, dry throat, dusty complexion, chest fullness, vomiting, undigested stool. Only Harmonizing Shaoyang resolves the pathogen. This syndrome mostly occurs late spring to mid-autumn, when Wood/Earth/Fire qi dominate. Patients seeing fever assume exterior, preferring dispersing. Not knowing fever has many causes, not all exterior. Southerners fear cold/cool, viewing Sanhuang (Three Yellows) and Baihu as snakes/scorpions; fearing Huangqin in Xiao Chai Hu Tang, they dare not take it. Northerners fear warm/dry, viewing Jiang/Gui as tigers/wolves; disliking slow Harmonization, they prefer purging, taking Chengqi Tang. These are partial views. Physicians must grasp principles, explain clearly, teaching Shaoyang treatment. Chaihu is Shaoyang exterior herb, clearing muscle/relieving heat. Huangqin is Shaoyang interior herb, draining heat/drying dampness. Remove one, and it ceases to be Xiao Chai Hu Tang. Ren Shen, Banxia are assistants, adjustable. Zhi Gancao stabilizes Stomach Qi, Jiang/Zao harmonizes Ying/Wei; neither is dispensable. With accompanying symptoms, treat with accompanying herbs. How can one abandon Shaoyang to seek elsewhere?
Modified Chaiping San
Weiyu (Polygonati Rhizoma) 3 qian, Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix Wine-fried), Zhi Banxia (Pinelliae Rhizoma Preparata) each 2 qian, Mao Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex Ginger-fried), Jupi (Citri Reticulatae Pericarpium), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Honey-fried) each 8 fen, Hongzao (Jujubae Fructus) 3 pieces, Shengjiang (Zingiberis Rhizoma Recens) 1 slice.
If repeated dispersing herbs cause no sweat, exhausting fluids leading to irritability/thirst, add Tianhuafen (Trichosanthis Radix), Maidong (Ophiopogonis Radix), reduce Banxia. If purging herbs cause loose stools, worse at night, five-center heat, pathogen sinking into Blood level, use Tiaozhong Yiqi Tang (Regulate Middle Boost Qi Decoction) modified to lift pathogen out to Yang level.
Modified Tiaozhong Yiqi Tang
Sheng Huangqi (Astragali Radix), Sheng Baizhu (Atractylodis Macrocephalae Rhizoma), Weiyu (Polygonati Rhizoma) each 2 qian, Fuling (Poria) 1.2 qian, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Honey-fried), Jupi (Citri Reticulatae Pericarpium), Chaihu (Bupleuri Radix) each 8 fen, Shengma (Cimicifugae Rhizoma) 4 fen, Zao (Jujubae Fructus) 3 pieces, Jiang (Zingiberis Rhizoma Recens) 1 slice. If abdominal distension/diarrhea persists, add Wei Muxiang (Aucklandiae Radix Roasted) 8 fen.
Those treating Shanghan all follow Zhongjing. Yet most focus on sweating/purging, neglecting Warm/Clear/Harmonize/Tonify methods. Modern doctors citing Zhang Jingyue's new formulas only use his Hot-Tonify two arrays, ignoring the other six. They fail to see Jingyue excels in Harmonization, detailed in his Harmonize array. His Liu Chaihu Yin (Six Bupleurum Drinks) in the Disperse array is ideal for skilled Chaihu use. Yet people claim Jingyue biased toward warm-tonifying; moderns use this bias, though Jingyue himself was not biased.
On Men's Heat Entering Blood Chamber
*Jingui Yaolue* states: "Woman struck by wind for 7-8 days, developing alternating chills/fever at intervals, menstruation abruptly stops. This is Heat Entering Blood Chamber, blood coagulating, causing malaria-like intermittent发作. Xiao Chai Hu Tang governs." Also: "Woman with Shanghan fever, menstruation arriving. Clear during day, delirious at night seeing ghosts. This is Heat Entering Blood Chamber. Treat without violating Stomach Qi or Upper/Middle Jiao; it will heal itself." Also: "Yangming disease with bleeding and delirium is Heat Entering Blood Chamber. Only head sweats. Puncture Qimen point, drain based on excess. Profuse sweating indicates cure."
My Commentary: Blood Chamber is Blood Sea. Liver is Blood Sea, belonging to Jueyin. Women with Shanghan/epidemic during menstruation have empty Blood Sea, pathogen sinks inward, causing alternating chills/fever, delirium like malaria. This pathogen invading Jueyin is listed in Shaoyang chapter to show Shaoyang is Jueyin's paired organ; must harmonize pathogen to exit via exterior. Thus treatment is essentially Xiao Chai Hu Tang. Blood Sea is same in men/women, but ancient texts omit men's Heat Entering Blood Chamber. Cheng Wuji linked Yangming bleeding/delirium to both sexes, but this is not definitive. If so, do women never have Yangming bleeding? Women's menstruation is observable; men's is not. Cheng Wuji insisted on visible blood for diagnosis, linking to Yangming bleeding. But what about no bleeding, only alternating chills/fever like malaria? I believe men with this condition usually have chronic spermatorrhea/slippage, or dream emission/sexual activity post-infection, allowing heat pathogen to enter empty Blood Chamber. Emission exits anterior orifice, considered Kidney disease by many. I say: Jueyin is not a novel concept. Classic says Liver governs Shuxie (dispersing/excreting); thus spermatorrhea must treat Liver first. Women's menstruation also exits anterior orifice, rooted in Jueyin Shuxie, exiting via external kidneys. Analyzing the three *Jingui* clauses: different symptoms, different treatments, all centered on Harmonization. "Do not violate Stomach Qi/Upper Jiao" warns against mistaken sweating/vomiting. "Puncture Qimen, drain excess, profuse sweat cures" warns against mistaken purging and excessive sweating, clarifying Shaoyang contraindicates sweating/vomiting/purging. Thus, for women, check if menstruation stopped/started, add blood-invigorating/guiding herbs to harmonize. For men, check for bleeding/spermatorrhea, add stasis-dispelling/yin-nourishing herbs. Harmonize gently; never use harsh drugs risking death. Yet people often diagnose men's case as Kidney Deficiency, prescribing Jiang, Fuzi, Guizhi, Dihuang, even Renshen, Huangqi, purely warm-tonifying. Forgetting delirium/heat pathogen, this causes confusion, agitation, death. They ignore that True Cold attacking Shaoyin has distinct pulse/symptoms. Though Shuxie causes Kidney Deficiency, this is Heat Pathogen sinking, incomparable to initial True Cold. Physicians ignoring classics, abandoning Harmonization/lifting pathogen; patients seeking quick cure, preferring safe tonification/purging. This leaves the dead wronged, parasites laughing. Deeply lamentable!
These two syndromes both originate from Shaoyang disease, are most lingering, confusing physicians. If patients demand quick cure, errors multiply. Expressing my humble insights, hoping for expert review. Further instruction would be greatly appreciated.
Postscript on Correcting Errors in Taoyin Spleen Channel Theory