十劑詳解（詳本）

The Ten Agents: The Complete Account

據《台北臨床三十年·辨證論治概說》(pp.104–106) 整理。Organized from the source text; no content invented. For education; suitability is decided by in-person assessment.

什麼叫正治？

正治，就是用與病氣相反的性味來治病的方法——「逆者正治」之道。熱者寒之，寒者熱之；虛者補之，實者瀉之。

徐之才說：「十劑者，(1)補可扶弱，(2)重可鎮怯，(3)輕可去實，(4)宣可去壅，(5)通可行滯，(6)澀可固脫，(7)滑可去著，(8)燥可去濕，(9)濕可潤燥，(10)寒能制熱。」此十劑之說，皆所以成正治之用。

Direct treatment opposes the disease qi with medicinals of opposite nature — heat cooled, cold warmed, deficiency supplemented, excess drained. Xu Zhicai’s ten agents — supplement, weight, lightness, diffuse, flow, astringe, smooth, dry, moisten, cold — all serve this direct treatment.

十劑，一劑一解

(1) 補可扶弱 — Supplement the weak

如先天不足，宜補腎；後天不足，宜補脾。氣弱宜補肺，血弱宜補肝，神弱宜補心。

Prenatal insufficiency calls for supplementing the kidney; postnatal insufficiency, the spleen. Weak qi: supplement the lung. Weak blood: supplement the liver. Weak spirit: supplement the heart. Each weakness is met at its source.

(2) 重可鎮怯 — Anchor the timid with weight

如怯則氣浮，重以鎮之是也。

When timidity lets qi float upward, heavy medicinals anchor and settle it.

(3) 輕可去實 — Lift excess with lightness

如頭目鼻病，牙關喉塞，實邪上逆者，宜輕揚使從外解是也。

For disorders of the head, eyes, and nose, locked jaw and blocked throat — excess pathogens rebelling upward — light, ascending medicinals lift and release them outward.

(4) 宣可去壅 — Diffuse what is congested

法當宣達。如邪盛則閉塞，必以瀉劑從大便奪之是也。

Where congestion blocks, the method is to diffuse and open. When the pathogen is exuberant and the passages close, draining medicinals seize it through the bowels.

(5) 通可行滯 — Flow what stagnates

如火氣鬱滯者，宜用通劑。

Where fire and qi stagnate and bind, flowing agents move them.

(6) 澀可固脫 — Astringe what slips away

如洞泄、遺精滑泄、大汗亡陽等症，宜收澀以斂之是也。

Relentless diarrhea, slippery seminal emission, great sweating with yang on the verge of collapse — astringe and secure what is slipping away.

(7) 滑可去著 — Smooth what clings

如痰粘、溺濁、溺澀等，宜滑澤以滌之是也。

Sticky phlegm, turbid or hesitant urine that clings and will not pass — smooth, slippery agents wash it away.

(8) 燥可去濕 — Dry what is damp

如外感之濕：濕泛為痰者，化而降之；濕停不溺者，利而行之是也。

For externally contracted dampness: dampness welling upward as phlegm is transformed and sent down; dampness retained with blocked urination is drained and moved out.

(9) 濕可潤燥 — Moisten what is dry

如風熱拂郁，則血液枯竭而為燥病；上燥則結，均宜清潤是也。

When wind-heat stagnates and binds, blood and fluids dry up into dryness disease; dryness above binds — all call for clearing and moistening.

(10) 寒能制熱 — Cold restrains heat

有正治不應者，徐之才曰：「熱宜寒也。」如傷寒、溫瘧、虛勞等證，正治不應者，以寒藥治之。

Where ordinary direct treatment fails to answer — in cold damage, warm malaria, consumptive taxation — Xu Zhicai says: heat calls for cold. Treat with cold medicinals.

寒熱是辨證的首要大綱

十劑大體均以正治為說。不過，「寒能制熱」一條，須知寒熱是辨證的首要大綱：證如傷寒溫瘧虛勞，有正治不應者，就以寒藥來治。

《內經》在實踐中所選得的治法，可以分類如下：

甘寒之劑，如白虎湯之類——熱在氣分，壯熱煩渴者用之。

苦寒之劑，如龍膽瀉肝湯之類——肝膽實火上炎者用之。

熱可制寒：少陰之寒，用四逆理中湯；表寒一類，用桂枝湯；脾腎之寒，用吳茱萸湯；蛔厥腹痛，用烏梅湯；肺寒咳喘，用青龍湯；心胸之寒，用薤白；亡陽危候，用回陽救急湯。

寒可制熱：肺胃之熱，宜用銀翹、石膏；心火亢盛，宜用黃連、黃芩；肝腎之熱，宜用黃柏、知母。

寒熱分明，然後十劑各得其所。

Cold and heat: the first outline of differentiation

Cold and heat are the foremost outline of pattern differentiation. The Neijing’s proven methods sort accordingly: sweet-cold formulas like White Tiger Decoction for heat at the qi level with high fever and thirst; bitter-cold formulas like Gentian Drain the Liver Decoction for liver-gallbladder excess fire flaring upward. Heat restraining cold: Sini and Lizhong Decoctions for Shaoyin cold; Cinnamon Twig Decoction for exterior cold; Evodia Decoction for spleen-kidney cold; Mume Decoction for roundworm reversal with abdominal pain; Green Dragon Decoction for lung cold with cough and panting; Chinese chive for cold in the chest; Return Yang Emergency Decoction for collapsing yang. Cold restraining heat: honeysuckle and gypsum for lung-stomach heat; coptis and scutellaria for exuberant heart fire; phellodendron and anemarrhena for liver-kidney heat. With cold and heat distinguished, each of the ten agents finds its place.

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此十劑之說，本於徐之才，皆所以成正治之用。辨證既明，十劑以應。

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