诸风∶风本生热,以热为本,风为标,言风者,即风热病也。
诸热∶热甚而生风,或热微风甚,即兼治风热,或风微热甚,但治其热,即风自消也。
诸湿∶湿本土气,火热能生土湿,故夏热则万物湿润,秋凉则湿复燥干也。湿病本不
自生,因于火热怫郁,水液不能宣行,即停滞而生水湿也。凡病湿者,多自热生,而热气尚
多,以为兼证,当云湿热。亦犹风热,义同。虽病水寒,不得宣行,亦能为湿。虽有此异,亦
以鲜矣。或跗肿体寒,而有水者,以为蓄热入里极深,本非病寒也。及夫寒热吐泻,因得湿
而成也。
诸燥∶燥干者,金肺之本。肺藏气,以血液内损,气虚成风,则皴揭。风能胜湿,热能
耗液,皆能成燥。故经云∶风热火兼为阳,寒湿燥同为阴。又燥湿亦异也,然燥虽属秋阴,
而其性异于寒湿。燥阴盛于风热也,故风热甚而寒湿同于燥也。然中寒吐泻,亡液而成燥
者,亦以此矣。故经云∶诸涩枯涸,干劲皴揭,皆属于燥也。
诸寒∶寒者,上下所生水液,澄澈清冷,谷不化,小便清白不涩,身凉不渴,本末不经有
见阳热证,其脉迟者是也。此因饮食冷物过多,阴胜阳衰,而为中寒也。或冷热相并,而反阳
气怫郁,不能宣散,怫热内作,以成热证者,不可亦言为冷,当以热证辨之。夫湿热吐泻,
当见阳脉,若亡液气虚,亦能反见诸阴脉也,当以标本明之,不可妄治。或热证误服白术
调中汤,温药亦能开发,阳气宣通而愈,别无加害也。
各种风病:风的本质源于热,以热为根本,风为表象。所说的“风”,实际上就是风热病。
各种热病:热邪极盛则生风,或者热轻微而风邪严重,此时应同时治疗风与热;如果风轻微而热邪严重,只需治疗热邪,风邪自然就会消除。
各种湿病:湿气本是土的本气,火热之气能化生出土的湿气,所以夏季炎热时万物湿润,秋季凉爽时湿气又恢复干燥。湿病本身并非凭空产生,而是因为火热之气郁结在内,导致水液不能正常宣发运行,从而停滞并生成水湿。凡是患湿病的,大多由热而生,且热气往往较多,作为兼夹证候,应当称为湿热。这也如同风热一样,道理相同。即使是因寒水凝滞、不得宣通,也能形成湿邪。虽然情况有所不同,但这种情况很少见。如果是足背浮肿、身体寒冷且有水肿的情况,认为是蓄积的热邪深入体内,这本来不是寒病。至于寒热交替、呕吐腹泻等症状,是因为感受湿邪而形成的。
各种燥病:干燥枯槁,是金(肺)的本性。肺主藏气,如果血液内部受损,气虚而生内风,就会导致皮肤皱裂。风能胜湿,热能耗伤津液,都能导致燥证。所以医经说:风、火、热同属阳,寒、湿、燥同属阴。然而燥与湿也是不同的,虽然燥属于秋天的阴气,但其性质不同于寒湿。燥气的阴盛程度超过风热,所以当风热严重时,寒湿的表现也类似于燥。但是,如果是中寒导致的呕吐腹泻,因津液亡失而形成燥证,也是基于这个原理。所以医经说:各种涩滞、干枯、涸竭、肌肤干硬皱裂的症状,都属于燥证。
各种寒病:寒证表现为上下所生的水液清澈冷凉,食物不消化,小便清亮白色且不涩痛,身体发凉且不口渴,从头到尾都没有出现阳热证候,脉象迟缓,这就是寒证。这是因为过多食用生冷食物,导致阴气胜过阳气,从而形成中寒。或者是冷热之邪相搏结,反而导致阳气郁结,不能宣散,郁热在体内产生,从而形成热证,这种情况下,不能再说它是冷证,应当按热证来辨证。如果是湿热引起的呕吐腹泻,应当见到阳脉;但如果津液亡失、气虚,也可能反过来见到各种阴脉,这时应当分清标本,不可胡乱治疗。如果是热证误服了白术调中汤,温性的药物也能起到开发宣通的作用,使阳气通畅而痊愈,并不会带来其他危害。
Various Wind Diseases: The origin of wind lies in heat, with heat as the root and wind as the manifestation. When referring to "wind," it actually denotes wind-heat disease.
Various Heat Diseases: Excessive heat generates wind; or if heat is mild but wind is severe, both wind and heat should be treated simultaneously. If wind is mild but heat is severe, only heat needs to be treated, and the wind will naturally dissipate.
Various Dampness Diseases: Dampness is the native qi of Earth. Fire and heat can generate Earth-dampness; thus, in summer heat, all things are moist, while in autumn coolness, dampness returns to dryness. Dampness diseases do not arise spontaneously but result from the stagnation of fire-heat, which prevents the normal distribution and circulation of body fluids, leading to their accumulation and transformation into water-dampness. Most dampness diseases originate from heat, where excessive heat often serves as a concurrent syndrome, hence they should be termed damp-heat. This is analogous to wind-heat. Even when cold-water stagnation fails to circulate properly, it can also give rise to dampness. Although such cases differ, they are rare. For instance, edema of the dorsum of the foot accompanied by cold body and fluid retention is considered deep-seated accumulated heat within the interior, rather than a cold disease. Conversely, alternating chills and fever with vomiting and diarrhea arise from contracting dampness.
Various Dryness Diseases: Dryness and withering are the intrinsic nature of Metal (Lung). The Lung stores Qi; if internal blood damage occurs, Qi deficiency generates internal wind, leading to skin cracking and scaling. Wind can overcome dampness, and heat can consume fluids, both resulting in dryness. Thus, the classics state: Wind, Fire, and Heat belong to Yang, while Cold, Dampness, and Dryness belong to Yin. However, Dryness differs from Dampness. Although Dryness belongs to Autumn Yin, its nature differs from Cold-Dampness. Dryness Yin prevails over Wind-Heat; therefore, when Wind-Heat is severe, Cold-Dampness manifests similarly to Dryness. Nevertheless, vomiting and diarrhea due to middle-jiao cold, resulting in fluid loss and subsequent dryness, also follow this principle. Hence, the classics state: Various instances of astringency, withering, depletion, hardness, and skin cracking all belong to Dryness.
Various Cold Diseases: Cold syndromes present with clear, cold, and transparent body fluids above and below, undigested food in stool, clear white urine without dysuria, a cool body without thirst, and no signs of Yang-heat symptoms throughout. The pulse is slow. This results from excessive consumption of cold foods, causing Yin to prevail over Yang, leading to Middle-Jiao Cold. Alternatively, when Cold and Heat pathogens combine, Yang Qi may become stagnant and unable to disperse, generating internal郁-heat and forming a Heat syndrome; in such cases, it cannot be classified as Cold but must be differentiated as Heat. In damp-heat vomiting and diarrhea, Yang pulses should appear; however, if fluids are lost and Qi is deficient, Yin pulses may paradoxically appear. One must clarify the root and branch to avoid erroneous treatment. If a Heat syndrome is mistakenly treated with Baizhu Tiaozhong Decoction, the warm herbs can still promote dispersion and unblocking, allowing Yang Qi to circulate freely for recovery, without causing further harm.