關於 澤漆湯 ，我們在網路上蒐集到這些相關的討論、資訊與評價

新冠肺炎「快樂缺氧」

台灣新冠疫情爆發後，出現了一些很短時間內猝死的病例，甚至有位女病患前一天快篩陰性，隔天卻病逝了。這樣駭人的病例，這一年多來在世界各地有很多，最常看到的情況是血氧快速大幅下降，往往在病人自身還不覺得有什麼不舒服時，突然死亡。去年四五月時，這樣的現象被稱為「快樂缺氧（Happy Hypoxia）」，意思是病人還很快樂而不自覺，血氧已經大幅下降到危及生命的程度。

為什麼會出現「快樂缺氧」？網路上有很多正式的西醫學討論，讀者可以自己查詢研究。簡單的說，新冠病毒大量複製後，肺部大幅度發炎，血栓和肺部積水現象非線性地快速增加，導致血氧大幅下降。然而，病人體內的二氧化碳濃度還沒有大幅增加，肺部內氣體壓力也尚未大幅改變，因此病人一開始感覺不到什麼不舒服，等病人感到不舒服時，往往已經很嚴重了。這也是為什麼有許多病人看起來明明是輕症，突然由輕症轉重症的原因。

中醫怎麼看如此快速缺氧的現象？其實，我們在中國大陸新冠肺炎剛爆發時，就已經觀察到了。新冠肺炎進程可以非常快，前一天還只是肺部輕微寒涼或輕微燥熱，隔不到十二小時，病人肺部就出現大量的濃痰、積液，醫生得大幅提高對病情變化的靈敏度，看到了一些細微的蛛絲馬跡，就得採取跳躍式的治療，以防病情惡化。如同我去年三月整理的文章「新冠肺炎的中醫救治及釋疑」（ http://andylee.pro/wp/?p=7660 ）中解釋的，對於這樣快速變化的濃痰、積液，不是一般清痰潤喉的中藥材能抵抗的，往往得用到「射干麻黃湯」、「葶藶大棗瀉肺湯」、「澤漆湯」、「十棗湯」等等相對彪悍的方劑及中藥材，如果醫生判斷正確、開方精準，效果非常好且快速，臨床治療上已經有很多的驗證。反過來說，魚腥草、板藍根等清熱解毒的中藥材，不但無法擋下這樣的病情變化，往往還可能造成肺部痰飲、積液的惡化，讓病人血氧更加下降。

根據世界各地對新冠疫情的統計，大約85%的確診病人為輕症或沒有症狀，不需要治療也會在一兩週內自癒。換句話說，防疫一個很重要的考量，不是讓輕症病人感覺比較舒服，而是避免他們由輕症轉重症。中國大陸的「連花清瘟」及台灣的「清冠一號」都無法防止新冠輕症轉重症，當兩岸華人到處宣揚這樣的藥方時，應該先好好研究及思考，不要為了宣揚中醫，反而讓人誤解中醫、對中醫療效大感失望。不要忘了，魯迅說過：「中醫不過是一種有意或無意的騙子」，民國初年的社會菁英為何如此瞧不起中醫？沒有紮實的醫理及大量臨床療效的實證，推廣中醫只不過又是一場義和團運動！

#當張仲景遇上史丹佛
(http://andylee.pro/wp/?p=10122)

TCM Treatments of COVID-19

Written in Chinese by Dr. Andy Lee, March 7, 2020 (http://andylee.pro/wp/?p=7660)

Translated to English by Dr. James Yeh, March 13, 2020

I published an essay “From SARS to Novel Coronavirus” in Chinese on January 21, 2020 (http://andylee.pro/wp/?p=7169). At that time, I tried to discuss possible Traditional Chinese Medicine (TCM) treatments of Novel Coronavirus based on my clinical experience of treating many severe cases of pneumonia caused by various influenza and other diseases. Since then, I have directly and indirectly participated in treating patients of Novel Coronavirus successfully, had discussions with many doctors fighting the epidemic at the front line and many researchers conducting related researches, and read many reports on this subject. Although the “Novel Coronavirus Pneumonia” has been renamed to “COVID-19” (coronavirus disease 2019) and the name of the virus has officially named from “2019-nCoV” to “SARS-CoV-2”, I now firmly believe that my original judgment, views, and interpretations are correct. For the sake of easiness for people to read and share, in this essay, I am reorganizing my previous discussions and including some explanations on certain confusions as well.

First, there are numerous provinces and cities in China using TCM to fight the “COVID-19” (I will use the term “Coronavirus” from now on.) No matter whether the treatments were primarily using TCM or the combination of TCM and the methods of Western medicine, there have been a significant amount of positive outcomes. On the other hand, the views of how to use TCM to treat and the use of corresponding herbal formulas vary quite a bit. Even when TCM remedies were effective, why did some patients fully recover and were discharged from the hospitals but other patients still could not get the virus-free “negative confirmation” from virus DNA tests?

Many TCM doctors participating in the treatments and discussions often look at the Coronavirus issue from a single “Point” or the condition of the patient at that specific moment. Some interpreted the disease as “Dampness” (濕), “Dryness” (燥), “Cold” (寒), or “Heat” (熱). (Translator’s note: These interpretations are often the opposite ends of the spectra, like Dampness is opposite to Dryness; and Cold is opposite to Heat.) From the clinical practice point of view, those treatments based on such conflicting interpretations all had positive effects to some degrees. Then, which interpretation is the “correct one”? In fact, those simple interpretations all have some merits but don’t fully cover the subject in hand. Although TCM is based on “Dialectical Treatment” (辯證論治), i.e. treatment is derived from “observation and diagnosis” of patients’ complex symptoms, the most important thing is that disease shouldn’t be viewed as an isolated problem at a specific time, but the whole development of symptoms along a timeline. Not only we need to observe and diagnose the current ailment but also we have to understand the development history of the disease and to project how the disease will develop in the future. For a single patient, we might be able to focus on the clinical results of this patient. But for epidemics, we have to look at a bigger picture and take into account how this Coronavirus develops health issues inside the human body from TCM’s perspective. And, in clinical treatments, we also need to consider many variants caused by each patient’s preconditions and one’s strength to fight off the disease.

From my experience of curing many patients who were inflicted with flu-induced pneumonia and complications, and the recent participation in treating and curing Coronavirus patients, it is proper to summarize that no matter whether the virus is Coronavirus, bird flu, swine flu, or the “common” flu, we found that the bodily deterioration caused by the virus, in general, follows the description from the TCM theory first covered in the ancient literature “Treatise on Cold Damage on Miscellaneous Disease ” (傷寒雜病論). However, the progressions of the disease from such special viruses are much faster, more severe, and/or more persistent than that of the common flu. Patients’ own original “health” condition also complicates the progression. (Translator’s note: For example, the infliction rate of young children is much smaller than that of adults for Coronavirus.)

As I explained before, the TCM theory discussed that for the common flu or “catching a cold”, the disease starts with “Exterior Deficiency or Weakness” (表虛). That is, the “exterior” of the body is invaded by the “External Pathogen” (外邪), like virus, and has adverse reactions. (Translator’s note: Here the exterior doesn’t mean just the outside surface of the body like the skin, but all the surfaces topologically exposed to the outside like lining of throat, nose, and bronchus of the body.) This is the first stage of the whole episode and often can be effectively treated with the herbal prescriptions such as “Gui Zhi Tang” (桂枝湯). If the patient is not properly treated, the body fluids within the surface and muscles could not function properly. It will cause the transition to the next stage “Exterior Excess” (表實). (Translator’s note: The word Excess has various meanings: excessive reactions all the way to neoplasm, excessive wasteful things, etc.) Viral infection at this stage is matched to one of the several syndromes named with the corresponding herbal remedies such as “Ge Geng Tang” (葛根湯), “Ma Huang Tang” (麻黃湯證), and others. The TCM theory calls this stage “Exterior Coldness” (表寒). In history, many TCM doctors considered this stage as the body being hurt by outside coldness (傷於寒) or in plain words “Catching Cold”. However, that is a misunderstanding. While outside coldness is one of the causes leading to the stage “Exterior Coldness”, it is not the only cause. When the body fluids could not function properly, the normal body fluids which had proper fluidity to circulate and to fulfill vital functions (活水) became a pot of “Dead Water” (死水), i.e. wasteful water which can’t fulfill vital functions. In other words, the ancient literature “Treatise on Cold Damage on Miscellaneous Disease” (傷寒雜病論) is much beyond the simple interpretation of how to treat the ailment caused by “cold damage”, but a classical literature of explaining both the physiology and pathology of human body functions.

Normally, the ailment or symptoms of the common flu would be limited at this stage of “Exterior Coldness”. Even without any treatment, the human body often could fight off the virus with an immune response and fully recover. But when the effects of Exterior Coldness started to penetrate into the interior of the body, the first common organs to be affected will be the organs that have a short path to the outside. (Translator’s note: Topologically, trachea and lung are only a membrane distance away from the outside air.) Then the Exterior Coldness gets transformed into the next stages such as “Interior Coldness” (裡寒) and “Lung Coldness” (肺寒). (Translator’s note: Here “Lung” means the whole respiratory system, not only the lung organ.) Clinically, the patients start to show symptoms of the syndrome named after its herbal remedy “Xiao Qing Long Tang” (小青龍湯). At this stage, the patients have serious coughing and running nose. When the respiratory system is “affected by the coldness”, the body fluid function of the respiratory system gets affected. Just like when the cooling system of a car malfunctions, the engine would overheat. The circulation function of the lung becomes “Dry and Overheated” (燥热). This would lead to the next stage of “Heated Interior” (入裡化熱) and often be matched to its herbal remedy “Da Qing Long Tang” (大青龍湯). At this stage, it does not mean that the whole lung is “dry and heated”. In fact, many pneumonia patients exhibit “mixed coldness and heat” (寒熱夾雜) in the lung. For example, while the upper part of the lung is “dry and heated”, the lower part of the lung might suffer excessive mucus of a high density. Pleural effusion and hydronephrosis might start to develop quickly.

Such a complex situation was extensively discussed in Chapter 7 of the ancient literature “Synopsis of Prescriptions of the Golden Chamber” (金匱要略肺痿肺癰咳嗽上氣病脈證治第七篇). At this complex stage, the illness development varies significantly among patients of different preconditions and other variants. It is no longer the situation that a simple herbal remedy can be applied to all the situations. The TCM theory illustrates various treatments by those herbal remedies such as “She Gan Ma Hung Tang” (射干麻黃湯), “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯), “Xiao Qing Long Jia Shi Gao Tang” (小青龍加石膏湯), and others. It doesn’t mean that one of the herbal remedies should be selected to treat a patient directly. Instead, the TCM Theory used these herbal remedies to teach its practitioners how to “think” and create a proper herbal remedy based on the conditions of a specific patient.

For example, the Coronavirus has quite a puzzling situation that many Western medicine doctors haven’t yet fully understood. Some severely affected patients exhibited fibrosis of the lung like the SARS phenomenon. Other severely affected patients did not have SARS-like lung fibrosis but had massive liquid cumulated in the lung, which even “drown” some patients to death. From the TCM point of view, it is not strange at all. Fibrosis of the lung is the typical following stage of Heated Interior matching to “Da Qing Long Tang” (大青龍湯). It was named as “Lung Atrophy” (肺痿) in the TCM theory. And the situation that one suffers from massive dense liquid accumulation is matched to symptoms of severe development after the stages matched to “She Gan Ma Hung Tang”( 射干麻黃湯) , “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), and others as discussed earlier. The TCM theory called it “Lung Abscess” (肺癰). In the TCM theory, Lung Atrophy and Lung Abscess are two progression paths of this virus depending on which path develops faster or even simultaneously. From the past and current reports, SARS virus tilts toward the path of Lung Atrophy, while the Coronavirus tilts a little more toward Lung Abscess.

The above explained the progression of flu and other epidemic virus infections. Now you might understand how different TCM doctors had different views or treatment methods, but all of the treatments had some partially positive effects. If a TCM doctor’s diagnosis at one particular moment was slight hotness of the lung, some mild herbs to “clean up the heat” (清熱解毒輕劑), often used by the “Southern School” doctrine (溫病派), might relieve the patient’s symptoms. But if a TCM doctor’s diagnosis at a different point of the progression was massive mucus accumulation, heavy dosage of strong herbs, often used by the “Northern or Classic School” doctrine (經方派) might be needed to treat Lung Abscess (肺癰). That is why we saw some reports that the “Pneumonia Formula One” (肺炎一號) used in Guangzhou city, which was based on mild herbs to reducing the “heat”, had some positive effects in Guangzhou but not so effective in Shanghai. In Shanghai, many TCM doctors had to switch to stronger herbal ingredient often found in “Da Qing Long Tang” (大青龍湯) and “She Gan Ma Hung Tang”( 射干麻黃湯) as discussed earlier. This was due to different weather patterns and different patients, i.e. different progression paths described in the previous paragraphs. In other words, from the specific moment of the doctor’s diagnosis, both views were correct. But neither of them grasped the progression timeline of this severe illness.

Another point raised earlier was why did some patients fully recover while others did not? According to the information given by the doctors on the front line, there were so-called “Western medicine and TCM combined treatments” in which Western medicine drugs were continuously given to the patients and TCM herbs were used as supplements. When adding TCM herbs had a positive effect and made a speedier recovery, it was all goodness. But when adding TCM herbs did not have positive results, then what? According to the doctors on the front line, the medical team did not really think through the stages of disease progression as discussed earlier and switch to different TCM remedies, but only increased the dosage of Western medicine drugs such as Interferon (干擾素), Chloroquine phosphate (磷酸氯喹) used to treat malaria (抗瘧疾藥物), Arbidol (阿比多爾) used to treat influenza (抗流感藥物), and others. Heavy dosages of such drugs had severe side effects and sequelae. In those “combined” treatments, the medical teams didn’t have enough TCM expertise to make sound decisions on herbal remedies. Instead, they simply used TCM herbs as “extra help”.

How about treatments primarily with TCM remedies? The chief Western medicine expert who leads the fight against the Coronavirus, Dr. Nanshan Zhong, admitted under political pressure that TCM was useful against light or even medium threat situations of Coronavirus but insisted that TCM could not cure severe cases. His statement was based on his belief that there is no ingredient in TCM herbs that could kill Coronavirus. I am sorry to say that Dr. Zhong is incorrect in this aspect. With solid patient cases as proof, TCM can actually cure severe cases of Coronavirus infection and other flu-related infections. When it did not, it is the particular TCM doctors who had not mastered the whole theory and methodology of TCM. But one thing that Dr. Zhong said correctly was that no ingredient in TCM herbs can “kill” the virus. However, the TCM treatment isn’t based on the ability to kill the virus. (Translator’s note: Western medicine drugs could not kill the virus either.) Many people still have the level of limited understanding that TCM can only improve the immunization ability or some herbs such as the root of Isatis tinctoria (板藍根) has some natural antibiotic chemicals. Such understanding is unfortunately poor and very limited. Although modern medical science still could not fully comprehend TCM theory and its clinical outcome, against Coronavirus, the better explanation is that TCM remedies can “improve the internal environment of the human body”. (Translator’s note: So that the patient would not fall into the adverse conditions that the organs fail to function.) In plain words, when the virus causes more mucus, TCM remedies reduce the mucus. When the virus causes fibrosis, TCM remedies reduce the “heat level” of the lung. TCM remedies tend to push the body and organs back to the original healthy states. Once the environment is unfriendly for the virus to keep replicating, the patients will have higher chances to eradicate the virus by themselves and recover. One can probably say that this explanation and method is similar to the idea of using Western medicine Interferon but without severe side effects. That is, TCM can cure not because it has the ability to “kill” virus by some ingredients but to help to restore patients’ “internal environment” to healthier conditions that prevent the virus from replicating quickly. (Translator’s note: If one buys the same argument made by Dr. Zhong that a medication needs to have ingredients to kill the Coronavirus, then all the medications used today would not qualify. Then do we give up? In fact, why TCM was not selected to treat severe cases was because those stronger and less commonly used herbs were not applied properly or the TCM doctors at hand had less confidence for doing so. )

Now, we can go back to discuss how clinically TCM can treat and cure Coronavirus patients. For light to mild cases, most of the different TCM treatment methodologies could help. For medium to severe cases, as I discussed in my previous essay, we need to utilize the strength of certain herbs:

- Sheng Shi Gao (Gypsum, 生石膏): To reduce heat inside the lung (清肺熱) and enhance the liquid circulation in the respiratory system (加強肺津液運作)

- She Gan (Belamcanda chinensis, 射干)、Zi Wan (Aster tataricus, 紫菀) 、Kuan Dong Hua (Tussilago farfara flower, 款冬花)、Sheng Ban Xia (Pinellia ternate, 生半夏)、Ting Li (Sisymbrium indicum, 葶藶)、Da Ji (Euphorbia pekinensis Rupr., 大戟), etc.: To reduce accumulation of excessive mucus and wasteful fluids inside the respiratory system (去肺下方濃稠痰飲、肺積水、胸腔積液等)

- Ma Huang (Ephedra sinica Stapf., 麻黃), etc.: To enhance the lung function (宣肺、發陽)

- Mai Men Dong (Ophiopogon japonicas, 麥門冬)、Xing Ren (Prunus armeniaca, 杏仁): To moisturize the lung (潤肺)

That is, we need to combine the theory and targeted responses of the various herbal remedies such as “Da Qing Long Tang” (大青龍湯), “She Gan Ma Hung Tang” (射干麻黃湯) , “Ting Li Da Zao Xie Fei Tang” (葶藶大棗瀉肺湯), ”Ze Qi Tang” (澤漆湯)“, etc. as discussed earlier, and properly adjust the dosages and ratios of ingredients to fit the requirements of individual patients based on their conditions. In addition, if the patients have other ailments, those conditions need to be taken into account also, such as:

- For “Coldness and Wetness of the Middle and Lower Abdomen“ (中下焦寒濕) or “Deficient Kidney Function” (腎陽不足): Add Bao Fu Zi (processed Aconitum carmichaelii Debx root, 炮附子)、Xi Xin (Asarum sieboldii, 細辛), etc.

- When the liver function is weak or damaged by heavy dosages of Western medicine drugs such as interferon: Add Chai Hu (Bupleuri Radix, 柴胡)、Huang Qin (Scutellaria baicalnsis Geprgi root, 黃芩), etc.

There is no question that it is very challenging to fight off the Coronavirus. The clinical treatments will seriously test TCM doctors’ thorough understanding of TCM and their ability and courage to call the right shots under a great amount of pressure. On the other hand, it is also a good time to prove that TCM can be effectively used to fight various viruses in a superb and speedy fashion with little sequelae and at a much lower cost.

For fighting such a new and aggressive virus epidemic, there is no single TCM herbal formula that can treat all situations. One must have deep knowledge of the stages of the disease, along with close examinations on patients’ preconditions, so one can use the most effective prescription to intercept and turn the symptoms around. On the other hand, many provinces and cities in China provided TCM guidelines on Coronavirus treatments and pre-fixed herbal formulas to address people’s demands on a herbal remedy for “common usage”. Among them, I found the current recommendation from the Chinese National TCM Administration the most appropriate for a good percentage of Coronavirus patients. The herbal remedy was recently named as “Qing Fei Pai Du Tang” (清肺排毒湯), which could probably be translated to “clean up the lung and get rid of the toxic”. In line with the discussion above, this specific herbal formula includes Ma Huang (Ephedra sinica Stapf., 麻黃), Zhi Gan Cao (processed Glycyrrhiza uralensis Fisch., 炙甘草)、Xing Ren (Prunus armeniaca, 杏仁)、Sheng Shi Gao (Gypsum, 生石膏)、Gui Zhi (Ramulus Cinnamom, 桂枝)、Ze Xie (Alisma orientalis, 澤瀉)、Zhu Ling (Polyporus umbellatus, 豬苓)、Bai Zhu (Atractylodes macrocephala Koidz., 白朮)、Fu Ling (Poria, 茯苓)、Chai Hu (Bupleuri Radix, 柴胡)、Huang Qin (Scutellaria baicalnsis Geprgi root, 黃芩)、Jiang Ban Xia (Pinellia ternate, 薑半夏)、Sheng Jiang (Ginger, 生薑)、Zi Wan (Aster tataricus, 紫菀)、Kuan Dong Hua (Tussilago farfara flower, 款冬花)、She Gan (Belamcanda chinensis, 射干)、Xi Xin (Asarum sieboldii, 細辛)、Shan Yao (Dioscorea oppositifolia, 山药)、Zhi Shi (Citrus aurantium, 枳實)、Chen Pi (Citrus reticulata Blanco, 陳皮)、and Huo Xiang (Pogostemon cabin, 藿香). Since such an herbal remedy was designed for “common usage”, it has to consider all degrees of disease severity. Therefore, the dosages can’t be too heavy, as the majority of the patient cases are light to mild. As the result, “Da Qing Long Tang” (大青龍湯) discussed earlier became a lighter herbal formula named as “Ma Xing Gan Shi Tang” (麻杏甘石湯). The stronger herbal ingredients such as Ting Li (Sisymbrium indicum, 葶藶) and Da Ji (Euphorbia pekinensis Rupr., 大戟) to treat pleural effusion and hydronephrosis are not included. Hence, for severe cases, the herbal remedy from the Chinese National TCM Administration needs to be enhanced with additional ingredients and larger dosages.

In summary, as long as the TCM doctors have sufficient knowledge and clinical experience, by applying the proper methodology, TCM alone is capable of dealing with severe Coronavirus infections. (Translator’s note: There is much to do to develop a comprehensive diagnostic and treatment methodology which can help many TCM doctors to pinpoint the patient’s condition and stages of the infection to make the proper decision, especially when fully qualified TCM doctors are of short supply.) At this moment, there is no “special drug” in Western medicine to cure Coronavirus, but to resort to cortisone, antibiotics, interferon, anti-malaria, anti-flu drugs to maintain the lives of patients and passively wait and hope that the patients’ bodies can find their own way to turn the situation around. Even then, the Western medicine drugs mentioned above all potentially have significant side effects and sequelae. Patients with severe cases might be able to get out of the deathbed but most likely live with some permanent damages to the body. Dr. Zhong, China’s chief Western medicine expert on the Coronavirus epidemic, also warned that the current path of developing the “special drug” would most likely lead to severe sequelae to the patients. Given that is the case, why don’t we put much more effort to fully develop the TCM treatment of viral infection, not just for Coronavirus but also for future viruses which will bound to happen in the future?

(Translator’s note: As China is getting good control of the virus spread and gradually recovers from this epidemic, the knowledge learned will be invaluable to the rest of the world. Europe and the United States are on the exponential rise of new cases as of the writing on 3/14/2020. Various models predict that in the US alone Coronavirus infections can reach millions, as discussed in the Opinion Column of New York Times, “How Much Worse the Coronavirus Could Get, in Charts” by Nicholas Kristof and Stuart A. Thompson, March 13, 2020. China should continue to put efforts to develop TCM diagnostic and treatment methodology so that millions of people in the rest of the world can be helped and saved. TCM is not just for science, it is for humanity.)

（http://andylee.pro/wp/?p=7729）
#當張仲景遇上史丹佛

新冠肺炎的中醫救治及釋疑

我於1月21日發表了第一篇新冠肺炎的文章「從非典到武漢肺炎」（http://andylee.pro/wp/?p=7169） ，那個時候是依據我多年治療很多各種流感肺炎急症及重症病例的經驗，來討論這個新型病毒可能的對應治療方法。這一個半月來，我直接及間接參與了治療新冠肺炎，和許多一線救治醫師及在背後做研究的專業人士討論，也研讀了很多相關的報導。雖然「武漢肺炎」改名為「新冠肺炎」(WHO英文名"Coronavirus Disease 2019", 簡稱"COVID-19")，病毒也由「2019-nCoV」正式命名為「SARS-CoV-2」，我確定了我原來的判斷及解說是對的。為了大家傳閱方便，我在這裡重新整理一次，也討論一些大眾可能有的疑慮。

首先，中國很多省市都有使用中藥來對抗新冠肺炎，無論是中醫為主，還是中西醫結合，或多或少都有些療效。可是，為什麼各地中醫專家對新冠肺炎的看法及藥方會相差那麼多？而既然中藥有效，同一家醫院，同樣的中西醫結合治療，為什麼有些病人痊癒出院了，有些病人卻遲遲不能核酸檢測轉陰性，達到出院標準？

很多參與治療或討論的中醫師，都只是從一個「點」上來看新冠肺炎，有的說是濕，有的說是燥，有的說是寒，有的說是熱。既然臨床都有些療效，那誰是對的？其實，都對也都不對。雖然中醫講求「辨證論治」，利用病人望聞問切下的綜合症狀來決定治療方法，不要忘了，「病」不是一個「點」，而是一個時間軸上的「線」，除了現在看到了什麼，還得去探討和以前及未來的連結。一位單獨的病人，我們或許可以從臨床看到病人時的情況來討論，對於大型瘟疫，我們必須從整個病情發展的進程來探討，再加上每個病人特殊情況來治療。

從我治好過很多各種不同流感肺炎急症重症的經驗，加上這次參與治癒抗新冠肺炎的經驗來總結，無論是新冠病毒、禽流感、豬流感、還是每年的流感，人體敗壞的進程依然如同「傷寒雜病論」探討的一樣。不過，這些嚴重流感肺炎病情進程比普通的「外感」快非常多，病情猛烈頑強很多，也更容易因病人原有健康問題而複雜化。

如我之前解釋的，「傷寒雜病論」對「外感」的敘述從「表虛」開始，身體最外層受到了「外邪」的侵犯，沒有好好抵擋下來而開始衰弱，出現「桂枝湯證」。皮表、肌肉的津液無法正常運作，開始了第一階段的轉變，造成了「表實」的「葛根湯證」、「麻黃湯證」等等，中醫古籍把這個階段稱為「表寒」。許多醫家就認為是「傷於寒」，白話說就是身體冷到了。其實，「傷於寒」並非「表寒」的唯一來源。當津液無法正常運作時，體表原本帶有熱氣、帶有能力的「活水」變成了一灘「死水」，也就造成了「表寒」。換句話說，「傷寒雜病論」並非如後代許多醫家解釋為只是治療「傷於寒」的病症，而是對人體生理和病理解釋非常透徹的一部經典。

一般的「外感」停留在「表寒」這個階段，即使不治療，病人往往也可以自己康復。當「表寒」開始往身體內部發展，通常第一個受到影響的是與外界直接溝通的肺家，「表寒」轉變成了「裡寒」、「肺寒」，出現「小青龍湯證」等現象，病人開始咳嗽、流清鼻水等等。肺家受寒了，肺的津液運作開始出問題，好比汽車冷卻水無法正常運作，肺臟部份因津液不足而開始燥熱，進入下一階段，中醫稱為「入裡化熱」，變成比較嚴重的「大青龍湯證」，通常代表到了西醫的肺炎階段。然而，即使到了「入裡化熱」的「大青龍湯證」，不代表整個肺臟都燥熱，許多肺炎病人肺臟出現「寒熱夾雜」，肺部下方的寒稠痰飲還是可以繼續大量累積，甚至開始出現胸腔積水、肺積水等現象。這些複雜的變化，在「金匱要略」中「肺痿肺癰咳嗽上氣病脈證治第七篇」討論很多，「射干麻黃證」、「葶藶大棗瀉肺湯證」、「澤漆湯證」、「小青龍加石膏湯證」等等，可以混雜出現，把病情搞得很複雜，更隨著病人本身的情況而有很大的個體差異，不再是什麼簡單方劑可以對應的。

譬如，這次新冠肺炎重症出現了一個奇怪的現象，讓許多西醫專家不解，一部分重症病人出現如SARS非典肺炎的肺纖維化，另一部分重症病人卻沒有出現如SARS非典肺炎的肺纖維化，反而肺臟裡累積了非常多濃稠的黏液，有些重症病人因此而被嗆死。這樣現象在中醫看來一點都不奇怪，肺纖維化是典型肺熱的「大青龍湯證」加重後的結果，或許可以和「肺痿」對應。而往生病人解剖發現的肺臟累積濃稠黏液，正好對應嚴重「射干麻黃證」、「葶藶大棗瀉肺湯證」等的「肺癰」現象。這兩條變化的道路，就看「肺痿」和「肺癰」哪一個進展更快，通常兩個是可以也常常一起出現的。以目前的報導看來，SARS非典肺炎偏向「大青龍湯證」為多，而新冠肺炎偏向「射干麻黃證」、「葶藶大棗瀉肺湯證」為多。

上面解釋了流感肺炎類瘟疫的進程，大家就比較能理解為什麼中國各地中醫專家對新冠肺炎的看法及藥方會相差那麼多，卻好像都有一些效果。如果一位醫家看到的「點」，正好是輕症病人肺微微化熱，那麼一些所謂溫病派的清熱解毒輕劑，自然也可以幫上一些忙。如果一位醫家看到的「點」，正好是重症病人肺部已經大量累積濃稠黏液，那麼非得使用所謂經方派的祛肺癰重劑。所以，我們看到一些報導，廣州推廣的「肺炎一號」，以金銀花等清熱解毒的中藥材為主，在廣州有不錯的效果。可是，上海使用「肺炎一號」的效果卻不理想，非得使用麻黃、石膏等較重的中藥材。畢竟廣州和上海的天氣不一樣，收治的病人情況也不一樣，從單獨的「點」來看，兩個都對，但從整個瘟疫進程的討論上，兩個都沒有看到整條線、整個面。

文章前面還問了另一個問題。既然中藥有效，為什麼有些病人痊癒出院了，有些病人卻遲遲沒有痊癒出院？根據許多一線醫生透露的消息，許多所謂「中西醫結合」的治療，西藥還是不斷的使用，只是額外加入中藥來治療。那些中藥方劑可能確實發揮了作用，讓部份病人開始好轉，或加速他們康復，這當然是件很好的事情。可是，那些額外加入中藥治療卻沒有改善的病人怎麼辦？根據一線醫生透露，醫療團隊急了，不是去深入思考中醫的治療方案，而是加大西藥的使用，干擾素、磷酸氯喹（抗瘧疾藥物）、阿比多爾（抗流感藥物）等不斷加重，這些西藥有嚴重的副作用及後遺症，武漢市還特地通知其它省市，磷酸氯喹不可多用，已經有使用過度而導致病人死亡的病例。這些「中西醫結合」不敢放下西藥，改以純中醫的方式來治療，代表這樣的中藥方劑，雖然有些效用，卻依然不到位。

那中醫為主的治療呢？中國領頭對抗新冠肺炎的鐘南山院士，在眾多壓力下承認中藥對輕症及中型新冠肺炎有用處，卻仍堅持中醫無法治療重症病人，因為中藥材中找不到可以殺死新冠病毒的成分。很抱歉，鐘院士是錯的，中醫是可以治癒重症新冠肺炎及其它嚴重流感肺炎，沒有治好，是主治中醫師功力的問題，不是中醫這門學問無法應對。不過，鐘院士有一點說對了，中藥材中是找不到可以殺死新冠病毒的成分，因為中醫的治療根本不是殺死病毒！許多人對中醫的理解，只停留在「增加免疫力」或「板藍根有天然抗生素的成分」，這樣的認知是很差的。雖然現代科學還不能徹底解釋中醫的理論及臨床療效，針對新冠肺炎治療，比較好的解釋是「改善身體內部環境」。病毒想讓肺內黏液積多，中藥方劑把黏液退祛，病毒想讓肺纖維化，中藥方劑把肺熱降下來。中藥方劑強硬的把身體內部環境推回到比較正常狀態，不適合病毒大量複製繁衍，病人也就可以康復，這個解釋或許和西藥干擾素有雷同的地方，卻沒有西藥干擾素的嚴重副作用。也就是說，中藥之所以能治癒重症，並非含有什麼能殺死病毒的成分，也不一定是直接把人體免疫系統大幅增強來「殺死病毒」。

回頭來討論中醫臨床如何獨當一面治療新冠肺炎。輕症到略偏中型病人，大概可以讓各地各派的中醫師「自由發揮」。中型到重症的病人，如我之前文章提到的，得使用石膏清肺熱、加強肺津液運作；射干、紫菀 、款冬花、生半夏、葶藶、大戟等把肺下方濃稠的痰飲、肺積水、及胸腔積液去掉；麻黃等宣肺、發陽；麥門冬、杏仁潤肺等等。綜合「大青龍湯」、「射干麻黃」、「葶藶大棗瀉肺湯」、「澤漆湯」等的方義，針對病人病情差異來把握用藥的時機、劑量、比例。另外，如果有其它病症，也得一併考慮。譬如中下焦寒濕、腎陽不足，得使用炮附子、細辛等，又譬如肝家受到牽連，或者之前西藥治療時使用大量干擾素而損傷肝臟，得使用柴胡、黃芩等等。嚴格考驗中醫師的功力與膽識，卻也可以充分驗證經典中醫對抗瘟疫療效卓越、快速、無後遺症、成本低廉。

對抗這樣嚴重的瘟疫，並非單一中藥方劑可以解決的，必須深入了解疫病肺炎的進程，不同的病人情況，在不同的點上，使用最適合的藥方來攔截、來逆轉病情。然而，如果硬要推展一個「通方」的話，各地及各級政府發表眾多的中藥方中，國家中醫藥管理局推展的「清肺排毒湯」應該是最到位的方劑，建議使用麻黃、炙甘草、杏仁、生石膏、桂枝、澤瀉、豬苓、白朮、茯苓、柴胡、黃芩、薑半夏、生薑、紫菀、冬花、射干、细辛、山药、枳實、陳皮、藿香。不過，既然國家中醫藥管理局發佈的「清肺排毒湯」以「通方」為目標，必須同時兼顧輕症、中型、及重症病患，不得不把劑量減輕，原本該使用的「大青龍湯」變成了「麻杏甘石湯」。另外，沒有加入葶藶子、大戟等較重的中藥材來去除胸腔及肺臟積液，比較適合輕症和中型病例，對於重症病例，力度不足，得在此「通方」上再加強。

只要中醫師有足夠的臨床功力，使用正確的方法，中醫是可以獨當一面治癒新冠肺炎重症病人的。目前，西醫沒有特效藥，只能靠激素、抗生素、干擾素、抗瘧疾藥物、抗流感藥物等，盡量想辦法維持病人的生命，被動等待病人的免疫系統逆轉病情。然而，就算重症病人靠西醫這樣的「支持性治療」而痊癒，往往不是全面恢復健康，而是換來許多後遺症。就算特效藥開發成功，連中國領頭抗疫的鐘南山院士都警告，特效藥很可能帶來嚴重的後遺症。既然如此，為什麼不全面推展中醫治療呢？

English translation: http://andylee.pro/wp/?p=7729

Traducción Española: http://andylee.pro/wp/?p=7794

（http://andylee.pro/wp/?p=7660）
#當張仲景遇上史丹佛

一聲鳥鳴，劃破長空。

拍翅下，見三圍六村環抱出屏山一貌。蜿蜒着的屏山文物徑，古木蒼翠，偶爾幾幢青磚土瓦明清建築老房子，石牆上的斑駁，在無聲歲月中落地生根，盤踞在石縫磚隙中，一身老氣，對照出旁邊高聳的新型村屋，卻又顯得特別驕矜。

那是一千年以前的事兒。渺渺時空，茫茫人海，都從中原南下，先在江西再往廣東後遷居於此，得豐盛水土，自稱「客家」，勤儉刻苦，莫失莫忘，且保留了中原古韻。

天真地以為能攀星摘月的七層古塔「聚星樓」，某年風災後只剩下三層，靜默地立在原地。古雅風流倒映在地下出現的一口古井，那一汪清澈冰涼的水中育有搖頭擺尾色彩斑斕的錦鯉，只是架在井面的鐵柵欄狠狠地破壞了錦鯉圖的美感。曾有不少文人進士，寒窗苦讀浪漫軼事的覲廷書室，門前一對蒼勁有力的端莊黑字「德澤流芳、祟山毓秀」，仍舊雋刻在硃砂紅木上，以書香墨魂冷眼河山變改、戰火無情和世事更易，正是千古江山，英雄無覓。


尋常巷陌中，那株開得姹紫嫣紅的簕杜鵑，一樹紫紅放肆任性的開在三層高的村屋前，然而再矚目也不及寫着「屏山盆菜」的大字招牌。

惜舊。一碟一碗皆有情
招牌底下昏黃的舊店裏，一時被兩邊一列長架上堆放着過千的碗碟所震懾，罎罐碗碟、沙煲罌罉，銅皮木製陶瓷，公雞、萬壽無疆、蟠龍翻雲、清花等花紋，有些是民國，甚至清朝時候製的，全是舊食具，也有盆菜、九大簋古盛器。短毛頭圓臉兒的店主鄧聯興(聯哥)，伸手把器笑謂：「全部都係呢條村好多家村屋拆嗰陣時丟嘅，我唔保留就冇㗎啦！」

聯哥是這盆菜店第三代傳人，也是屏山鄧氏的後人。隨時代變遷，圍村生活一點一滴改變了，舊東西正在消失中，他很想保留這裏的一事一物。碗碟叢中，電話猛烈又急促地響起，幾乎是從早到晚響不停，原來不少識途老馬惠顧過他，從此愛上那獨有的圍村客家風味，每年如燕歸來，都會在喜慶時節訂盆菜、九大簋。他拿起電話對客說︰「冇送貨㗎！對唔住！」


一般盆菜店為增生意，多設外送。聯哥寧願賺少些錢，卻堅持傳統，規定只可在鋪吃，或可訂在祠堂內的大地堂吃。「盆菜、九大簋屬於我哋圍村宴席菜，外送拎出去市區食，完全唔夾！要喺我哋條村食，咁先有風味！」他竭力保衛不單是一個失傳飲食，還有它的良美附景──

這天，就有村民大排筵席吃九大簋。「我有盆菜同九大簋，但九大簋佔咗生意嘅七八成。九大簋出面少做，係我至有！」聯哥、兒子Jeff、大廚及四五個女工，早在各有各活兒在忙，有的在巨型鑊前炒呀炒；有的將各款食物舀進銻盆，包上保溫錫紙；有的張羅執拾餐具和食物搬上貨車。眾人浩浩蕩蕩乘着車沿鄉村小路，直抵盛宴氛圍。

顯赫。祠堂寶地見昌盛
「九大簋，傳統喺祠堂食！」
頂着七百多年的歷史，鄧氏宗祠的雕樑畫棟，青磚紅瓦，在風霜刀劍下，仍汨汨細流着官宦世家一時的顯赫，鄧氏後人在此祭祖、慶祝節日喜事、父老子孫聚會等，無法撼動的熱鬧場面，記載着族人的昌盛，如一樹繁花。

繁花散落處，是這個過萬呎的大地堂前，擺好的二十多圍筵席，喜氣不言而喻。「通常我哋村民結婚、BB滿月、舊時新居入伙，同埋點丁燈，先會擺九大簋。傳統一圍枱人係雙數，所以要坐八仙枱。」八仙枱其實是四方枱，坐八個人，後期改為圓枱，人數再沒有規定。

開席了！祠堂門前的一根火苗，燃點藥引，數十萬台的紅衣鞭炮就措手不及在耳邊炸開，硝火及散開的紅衣頓時在空氣中飄飄而下，驚惶的心被期待開餐的興奮掩蓋。「喺祠堂擺酒近村屋，祠堂門前燒炮杖，村兄弟聽到炮杖聲，就知道開餐，走嚟食。」

上菜講次序，先來的是湯，其他出場不分先後，離不開雞鴨豬手冬菇……中間上子薑菠蘿，消滯去膩，最後才是小盆菜。「食到咁上下，主人家會逐枱敬酒，都係最長輩嗰個行先，譬如結婚，就由老爺奶奶率領。」

鄉情。添飯加菜作叮嚀
吃九大簋，味道其外，碗碗藏鄉情，像添菜，「主人家客氣啲，客人嚟到好似唔夠食，覺得唔好，會抽個裝食物嘅桶，譬如冬菇豬肉，睇吓邊啲唔夠，逐圍添加。」如有吃剩的菜，也會送給朋友親戚，充分如俗語說「又食又拎」般慷慨豪情。其他沒有請來的，主人家都會分給同巷，或隔離巷的鄉里，這份鄉土人情在城市裏，真正少見。

舊日請喜酒，取好事成雙，連餸菜也呈雙數，如「四簋」、「八簋」，但客家人認為九大簋的「九」與「久」同音，有長長久久之意頭，才有九缽。其實九大簋還有一款飯，加起來共十款，就是飯菜齊備，十全十美，人生的圓滿就捧在一手間，見證於觥籌交錯中。「以前唔係咁富有嘅，請食盆菜已經好好。係富貴人家，捨得使，先請九大簋，請最好嘅俾人食！」

昔時九大簋食材貴重，主人家一頓飯宴，揮擲千金萬丈豪氣。聯哥自小就見識有錢人排場，筵開百席是閒事，設流水席，大宴群親好友吃足三天三夜不足為奇，相比今天這樣的場面，當年盛況，由衷地帶點悲壯。

一碗。百菜百味筵席盛
「九大簋矜貴在每一樣餸都係獨立，唔似盆菜嘅食物混埋一齊，一菜一碗，比盆菜好食。」
簋，在古代是貴族放食物的器皿。他們客家人吃九大簋就用九個大簋放食物，後來簋經過演變，叫兩杉四缽。「杉，係大碟。缽，即係大湯碗。用碟同碗將餸分開嚟裝，唔好撈埋一齊。」

現時九大簋已全然以碗盛載，還因應時節調校不同菜式來宴客。「天冷天熱唔同，天熱煮清啲嘅好似梅子鴨，天冷煮南乳鴨，就濃啲。」口味的轉換，使人不易生厭。菜式獨立，百菜百味，使味蕾每次都有新衝擊，吃出其中的風味，這才是九大簋精緻之處。

近年在香港，大時大節吃盆菜愈演愈烈，愈趨普遍，但對吃九大簋，大眾多聞所未聞。

「做九大簋好少人識。譬如我同村都曾經有人做過，味道唔得，冇咗啦！美心啲大廚都嚟試食過，跟足啲餸推出，出晒報紙、電視，最後都係冇做。你唔係我哋圍村人，又唔係好似我做咗咁耐，係做唔到嗰種味！」聯哥帶點自豪說。
客家人靠山吃山，靠水吃水。九大簋菜式在不同村或會有差異，主要視乎村內有甚麼食材便用甚麼，如村有魚塘，便有淡水魚。或者宴席主人家的要求，捨得出錢的，便有山珍海錯。聯哥則身為屏山鄧族，傾盡識才，續承庥美。「我由細到大喺條村嘅九大簋大多都係呢九款，陳皮鴨湯、了酸豬手、黃酒雞、南乳鴨、炸門鱔、雞汁燴花菇、魚肉丸、子薑菠蘿、小盆菜，加埋雞鴨飯，總共十款。」

獨特。自家佳餚自家味
做九大簋，逐樣做，炆、炸、煮、燉、燴、滷、醃樣樣齊，比起盆菜，工夫多，利錢低，但聯哥廿多年來，仍恪遵一份客家人特色。其他人依循抄襲，卻做不到同樣的美味。他的九大簋味味是精品，首重用料精。「我哋嘅炆豬肉同了酸豬手，係用每朝劏嘅新鮮豬。」連炸門鱔都是新鮮即日捕，門鱔來價貴，外面會用較平宜的炸芋頭、炸花枝丸代替。「圍頭客家近海，舊時喺大埔東嘅海面有好多門鱔魚，所以我哋嘅九大簋一定有門鱔。」

再者，聯哥是元朗原居民，魚販和豬農必然將新鮮門鱔及本地新鮮豬先預留給他。而且坊間沒有多少人做九大簋，要煮出真正味道，他須用圍村傳統的獨有調味。「炆豬肉嘅麵豉醬，係用黃豆加麵粉自己整；黃酒雞嘅黃酒，用糯米同酒餅自己釀；子薑菠蘿嘅子薑，每年六七月啱時候用醋嚟醃，味道先正宗。」調味可說是做九大簋的靈魂，更重要還有手藝。

「煮九大簋，主角係做小盆菜嘅炆豬肉，豬肉炆得好，啲汁滲到入盆底嘅蘿蔔、豬皮同枝竹，成個盆菜都好味。」

他選腩肉和前胛，斬了件，燒熱巨鑊，下油，加入豬肉、香料、糖，之後加水。大灶火力猛，豬肉容易黐底，所以要揸起大鑊鏟不停攪動。一鑊豬肉，炆上一小時，來來回回翻廿多次。要懂得用力，不須太大力，順着力去剷。豬肉炒到六、七成熟，才下麵豉醬和南乳，既不黐底，醬料香味發揮得最好。他還有秘技，就是炆好的豬肉，不要趕着吃，攤放兩至三小時，更臻入味。

眾望所歸的炆豬肉，樣子紅彤彤，乾淨利落，不見有油水蔓延，鬆軟不油膩，吃時展露山賊氣質一口吃掉，入口的瞬間，豬皮帶點嚼勁，豬油與醬汁完美的邂逅，令嘴角上揚的味道，毋須言語，就有口水直流的魔性！

宗親。人人為我厚恩情
這無法停口的炆豬肉，手法技藝是傳承自聯哥父親，也是他人生的第一個大恩人。他父親以前在村裏務農，懂煮幾味撚手家鄉菜。遇有同村喜事要煮盆菜或九大簋，就會叫他來幫手。

「老竇完全係義務，永無托手踭，每次做完喜事，封番封利是仔，小小心意！唔會賺到錢。大家同村，你幫我、我幫你，人情味好好﹗」聯哥憶述說。聯哥十一歲起，就跟父親到祠堂煮九大簋，他充當小幫手，切菜起爐生火等。「我好鍾意做呢樣嘢，有得玩又有得食！」而父親負責掌勺，他看得多，慢慢學會了煮筵席菜。酒菜圍繞，鄉親為屏，長年累月浸淫在筵席的氣氛中，團聚的熱鬧、鄉里的恭親，種下對老鄉土深微綿邈的感情來。

九五年，其父因年邁而退休。「成條村都冇人做，我唔接手做，九大簋就會失傳！」他惟有繼承父親的衣缽，把手藝延續下去，也保留了當時碩果僅存的盆菜和九大簋。

「老竇係業餘，搵唔到食。我要開鋪，煮九大簋嚟做生意。」起初他的字號寂寂無名，三日打魚，兩日曬網，大拍烏蠅。同村的人知道他的難處，也念起他兩父子經常為村出心出力，都不時帶朋友回村，藉詞宴客，特意叫聯哥煮九大簋，讓他有生意可做。甚至容許他在富濃烈圍村色彩的祠堂擺席。

「最感激係同宗兄弟鄧達智，市區人先至認識我。」九五、九六年時著名時裝設計師鄧達智與傳媒、文化界，在圍村吃過聯哥煮的盆菜宴後，經過報道，盆菜開始廣受大眾認識，聯哥越見名氣，即使沒賣廣告，生意大旺。連明星周潤發、甄子丹、郭富城，政界唐英年、葉澍堃等名人都是常客。

人情，就是人人為我，我為人人，交心而生。「老竇教我，對鄉親要好，因為同村都係兄弟，自家人，有力出力，有心出心。」他對父親的教誨，仍刻記在心。像是每年清明拜山祭祖，他一切都以村事為先，年年為此都推卻不少大宗的九大簋生意，也幫族人煮山頭。只要村裏要他幫手，他從來都是義不容辭。

每朝六七點，天邊方呈魚肚白，沉睡的鄉村，巷弄後小門半掩，漆黑中廚房亮着一團燈光，冒出縷縷煙霧，傳出咔嚓咔嚓聲響。一個肥圓身影，汗涔涔地已提起鑊鏟，鏟挖着鑊中豬肉，繁忙的氣力活早就展開了。聯哥臉上仍含笑說︰「我幾乎日日都咁早，一直做到晚上六七點，十二三個鐘㗎！但一啲都唔辛苦！」
他奮力以煙火、菜甜、肉香，留住屬於圍村風味的九大簋，以食物的味道譜寫宗族和鄉村人情的記憶，透過節日、慶典，寄語一代又一代人的祝福，不忘祖、不忘根，如一根無形的絲線，把人與人拉近了。

撰文：孟惠良
攝影：陳秉謙、魯雋華

屏山傳統盆菜
地址：元朗屏山塘坊村36號(屏山文物徑路口)
電話：2617 8000
營業時間：11am-9pm
詳情： http://bit.ly/2UxOwEC

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日本東北山形縣的藏王溫泉區四季景色宜人，春夏可以踏青郊遊、秋季遍山楓紅、冬季白雪皚皚。不過說到最能感受藏王魅力的，一定是冬天雪季。這裏不但是滑雪勝地，還可以看着雪景浸溫泉、食靚和牛，最重要的是能夠觀賞一個藏王得天獨厚的大自然鬼斧神工──樹冰（Ice-monster）！

【樹冰】
樹冰之所以罕見，全因為它的形成必須配合多種氣候地理條件及特殊因素。第一，嚴峻寒冷的東北季風遇上日本對馬暖流產生的大量水氣，產生過冷卻水滴的雲粒。加上藏王高原連峰上的雪，形成雪加冷水滴的共融狀態。第二，必須要有固定方向而且持續的強風使雪水附着樹木，樹冰結構才不會被破壞。第三，樹種必須為常綠針葉植物，這樣才容易附着冰雪。第四，積雪量不能過多或過少。積雪不夠當然不能形成樹冰，可是積雪太多的話樹木容易被壓垮，而且山林有可能被掩沒，也就無法造就整片樹冰的奇景。研究樹冰的專家稱最佳的環境為積雪量2至3米。


樹冰只出現在海拔超過1,550米的高山地區。除了藏王，日本東北地區還有幾處地方可以觀賞樹冰，較著名的還有八甲田山、森吉山等。不過說到規模最大型的還是藏王樹冰。樹冰的形態每棵各異，大多都呈現蝦尾形狀。由於表面不平滑，其實近看有點像動畫片中的怪獸，甚為詭異，也難怪樹冰的別名叫「雪怪」（Ice-monster）。而且剛才提到樹冰形成必須有固定方向且持續的強風，所以「雪怪」的頭都往同一方向望，有點像一隊軍隊準備出征。不過從纜車上或展望台看一整片樹冰，不得不讚嘆大自然的厲害，超－壯－觀！

樹冰大約從每年11月底至12月初開始形成，2月至3月初為觀賞樹冰的最佳時機。

【藏王纜車】
從公園入口藏王山麓駅（海拔855米）到山頂（海拔1,661米）共需搭乘兩段纜車，全程共需約三十分鐘。沿途能夠欣賞到樹冰與普通樹木交匯的位置，也可以看到有不少人在雪道滑雪。景色之美使人目不暇給，根本就無法好好在纜車休息，因為會不斷拍照啊！


【樹冰幻想迴廊】
為讓旅客能夠欣賞不同的樹冰姿態，12月至3月初當中的50多天會舉行「樹冰幻想迴廊」。旅客坐上附有暖氣的新型雪地車「夜間巡邏號」，在車廂中近距離欣賞樹冰。靜寂漆黑的晚上，將白色「雪怪」打上七彩的燈光，令「怪獸」更加生動有趣，與白天看到的模樣完全不一樣。到了海拔大概1,500米處，會讓旅客下車拍照，時間只有十餘分鐘，要把握機會打卡！聽說這個位置連滑雪人士也到不了的，機會實屬難得。

記者採訪的日子，剛巧藏王有滑雪活動，在雪地車上，看到遠處的煙火，非常浪漫美麗！不過有一點要留意：由於車廂內外的溫差，所以車上玻璃窗常有霧氣，記得要帶毛巾去擦玻璃，避免因霧氣而影響視覺效果！

最後溫馨提示，冬天去藏王溫泉區，山頂溫度可低至零下16°C或更低，因此記得做足禦寒措施！除了穿著足夠保暖衣物、手襪（滑雪手襪最佳）、冷帽、頸巾、保暖防水靴，記得要多帶幾個暖包傍身。由於有時候山頂風雪甚大，戴上口罩可以防止凍傷！

【藏王溫泉】
欣賞完冰天雪地，當然要回酒店浸暖笠笠藏王溫泉！這次記者入住的Takamiya Village Hotel Jurin的室外風呂可以看着雪景泡湯，很寫意。藏王溫泉開湯至今已經有差不多2,000年歷史，屬強酸性硫磺泉，一旦接觸空氣就會變成奶白色。據說對皮膚疾病和腸胃問題很有療效，還有嫩膚美白功效，有「美人湯」之稱，長年備受女士喜愛！

不過如果你是敏感性皮膚，或者不喜歡硫磺味，這裏也有非硫磺泉，讓你消除疲勞，促進血液循環。

【山形料理】
去旅行又怎麼少得了吃特色料理！這間酒店一泊二食的晚餐都相當豐富。一年四季都可以選擇牛壽喜燒、各種肉類的Shabu Shabu（包括藏王牛、米之娘豚肉及羊肉）、藏王名物成吉思汗羊肉，而冬季更有雞煲供選擇。這次試吃三肉Shabu Shabu，藏王牛雖然不及米澤牛、山形牛等入口即化，可是相較起來沒有那麼肥膩。米之娘豚肉出產自山形縣，肉質嫩滑多汁。而羊肉不太羶，吃起來有點像豬肉，而且切得夠薄，味道不錯。其他前菜、配菜等如雞肉蝦沙律、海鮮刺身的擺盤也相當用心，值得一讚。

看雪景、拜訪樹冰大神、滑雪、泡湯、飲飽食醉，晚上相信可以好好睡一覺了！一天下來不就是Yurutabi (ゆるたび)嗎？（Yurutabi (ゆるたび)，即「閒式遊日本」，以「悠閒」、「舒適」的方式遊日。）

藏王温泉 Takamiya Village Hotel Jurin
地址：〒990-2301山形縣山形市藏王温泉上ノ台814
電話：+81 23-694-9511
網址： http://www.zao.co.jp/jurin/
交通：除自駕遊外，還可以到山形站或仙台站搭乘巴士往返

藏王纜車 Zao Ropeway
►地址：山形縣山形市藏王温泉229-3
►電話：+81-23-694-9518
►營業時間：
冬季（12月11日至3月31日)
藏王纜車山麓線 8:15am - 4:45pm；藏王纜車山頂線 8:30am - 4:30pm
夏季（4月1日至12月10日)
8:30am - 5pm
►費用（成人：初中學生以上／兒童：小學學生）：
目的地－地藏山頂站：成人單程$107、往返$200；兒童單程$57、往返$100
目的地－樹冰高原站：成人單程$57、往返$107；兒童單程$29、往返$57
►備註：遊客眾多時，會臨時加開班次。依天候狀況而定，有時會停運

樹冰幻想迴廊
►日期：2018年12月22日至2019年3月3日期間指定日子共52天
（22/12-23/12,28/12-6/1,11/1-13/1,18/1-20/1,25/1-27/1,1/2-3/3）
►出發時間：5pm,6pm,7pm,8pm（每次一小時）
►費用：成人$286、兒童$236
►備註：如遇惡劣天氣，可能會被取消。需要提前預訂。
►網址： http://zaoropeway.co.jp/zao/winter/nightcruiser.html

採編：黃愷晴
拍攝：周義安
鳴謝：
JNTO 日本國家旅遊局 (www.welcome2japan.hk)
日本精彩無限Japan Endless Discovery
Yurutabi 閒式遊日本

===================================
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炎天暑月，天水圍宛如一座密樓圍城，滴風不漏。
高樓下，一路之隔，有一處奇怪空曠地。內有一家小醬油廠，和一排排深啡色的瓦缸。
醬油廠和瓦缸是一個中年男人的命根。
男人叫黃國輝，九龍醬園第三代掌舵人。他一生，與醬油有糾纏不清的關係。
曾經忽視到珍而重之。
今天，他每年的生日願望，是長命百歲。人健在，醬園才可繼續在空地上，親吻陽光。

九龍醬園，100年老字號，但無論工廠招牌，產品招紙，甚至黃國輝的卡片上，都很少出現九龍醬園一名。有的，只是美珍這兩個大字。當中原來有轉折。1917年，黃和甫（黃國輝的爺爺）和幾個鄉親合作，創立「美珍醬油菓子廠」，生產豉油、醬料、涼果、酸果等，主要賣埠歐洲。生意一直不俗，直至1941年，香港淪陷，因正值日本攻打美國，見「美珍」招牌有個美字，頓生憤懣，切斷外銷之路。當時已傳到第二代黃洪（即黃國輝的爸爸），將美珍改名，其時醬園設於九龍城，遂信手拈來「九龍」一名，專注內銷，獲不少街坊食客賞識，亂世現生機。戰後，他們決定保留九龍醬園字號，服務香港，美珍繼續主攻外銷市場，花開兩朵。「所以九龍醬園，其實即是美珍。」


五十年代是豉油盛世。「我聽阿爸講，香港嗰時有五大家頭，華珍、宜珍、冠珍、美珍、品珍，我們排第四，嗰陣好巴閉，做豉油真係有出頭天。」當時香港經濟起飛，九龍醬園出口內銷生意兩得意。那時坐巴士不過一毛幾角，他們卻能靠賣豉油，年賺過百萬。全盛時期，西環、中環、銅鑼灣、天后和筲箕灣皆有分店。九龍醬園，於醬油界是無人不曉的巨人。
奈何到八十年代，地價急升，需要大片土地的豉油業大受打擊，又因粗製、廉價豉油氾濫，令珍字輩老派豉油廠一顆一顆墮落，有的移民，有的轉行，有的不再生曬豉油，輝煌日子成絕唱。美珍醬園，也要從九龍城搬到元朗屏山，部分廠房被迫北移至大陸，門市只餘嘉咸街一家，他們更獨靠美珍的外銷生意，補貼九龍醬園的本地生產。黃國輝說笑道：「如果當時無賣塊地畀政府，留到依家，可能好似人哋賣豉油賣到起咗XX花園。」八十年代是豉油業最艱難的時間，偏偏黃國輝卻在這時接手祖業。


人在異地 方知誰最珍貴
天天吃着豉油，小伙子不會細味其中，到失去時，才發覺有些東西留在心中。黃國輝18歲到加拿大留學，大學讀農務系，習慣當地生活，惟獨吃不慣西餐，轉吃中餐，卻又覺得不對勁。初時以為水土不服，後來才知是豉油「出事」：「我食靚豉油長大，以前唔覺亦唔識珍惜，身在福中不知福。」有次，爸爸到加拿大探他，帶來一樽自家出品，他吃後，雙眼發光，是從前吃慣純正的味道，是自己深處味覺的記憶。他開始重新審視自己的祖業。
1981年，29歲的黃國輝，決定回流香港，試過出外找工作，「漁農署、ICAC都請我，係幾巴閉。」但還是心繫家業，最終被父親說服，加入醬油廠。黃家三兄弟中，只有他肯承繼。「始終要有人做。阿哥喺加拿大當會計師，細佬啱啱結婚有家室，我最吊兒郎當，所以阿爸氹我入局，哈哈。」開初他抱着一試無妨的心，但一栽進去，才發現有他珍視的價值。
黃國輝在外地十年，浸過鹹水，知道天空很闊。但自從踏進廠房，他才驚覺原來一家小小的醬油廠，一樣是個大千世界。祖傳家業，秘釀一支豉油，材料、時間、工夫全部都很重要，絕不能急功近利。
製豉油，先要將黃豆烚熟。再將麵粉與黃豆拌勻，給菌營養，讓它通氣。接着是上糟，將黃豆放進攝氏40至42度的房間內，發酵一星期。然後於缸內，淘入攝氏18度的鹽水，在陽光下生曬，平均曬期100日。
「陽光可分解黃豆內的胺基酸，是最天然最乾淨的方法。」九龍醬園的豉油之所以好味，全因其堅持生曬，跟外頭用機器弄乾，風味是兩碼子的事。陽光好，黃豆的胺基酸分解得快一點，豉油會呈黑漆，味道濃郁，豆味猶存，色香味俱全。但若陰天下雨，黃豆未能及時分解胺基酸，色澤未夠，味道稀淡，惟有多熬一會，延長收成期。一切就是這樣要望天打卦，導致不能大量生產。

擇善固執 帶來意外收穫
九龍醬園現時共賣五種豉油，不少都走高質路線，專攻食家市場。經天然生曬的，主要分為「頭抽」及「二過」兩種釀製方式。最招牌的是「頭抽」，用燉雞打個比喻，一隻雞燉一鍋湯，頭啖湯永遠是最濃縮，自然鮮味十足，稱作「頭抽」，加水煮下一鍋的，必然會變淡，那稱作「二過」。其「金牌生抽皇」及「金牌抽油皇」均是頭抽，放瓦缸100日，味香濃，豉味足，賣百多元一瓶，依然有價有市。次一點是天頂、原生抽、甜豉油等，是抽走頭抽後，再加鹽水曬100日而成，正是二過，各賣七十餘元，味道次一等，但依然甚具風味。

他們的豉油與別不同，還因其古董瓦缸，白天吸收，晚上懂透氣呼吸，令豉油味道更鮮活，是石缸無法比擬的味道。可惜瓦缸屬古董，買少見少，加上佔地甚廣，不合成本效益，所以不少醬園，寧用化學方法取替，摒棄傳統。「瓦缸釀製，好多時會帶來一些意外收穫。」黃國輝順勢一指瓦缸邊緣，看到一些鹽的結晶，他說，那是盆鹽。
原來用瓦缸生曬黃豆時，水分蒸發，結成鹽霜，證明鹽度飽和。他隨即用鏟子，從盆中刮出棕啡色的結晶，再放到鋼造網子上，用錘子逐塊敲打。這就是盆鹽，味道帶豆香，鹹而鮮活，用來煮湯，往往令味道更添層次。但盆鹽難求，不常有，所以較少公開售賣，只在食家熟客之間流傳。黃國輝續道，有時夠產量也會賣，但要一百元一小瓶，屬寶中之寶。
即使能製作出高質產品，但豉油生意，在香港，還是不易為。九龍醬園內銷本地，只佔公司的10%，黃國輝需要靠外地訂單，才可找到生存空間。「我們現時最大出口國是荷蘭，荷蘭一個省的訂單，都大過香港啦。貨櫃小的20呎，大的40呎，一落地就收錢。」他們把豉油、醬料、酸果等，用美珍名義，出口到外國，有華人的地方，有中菜的地方，就有他們蹤影。反觀香港市場呢？實在細小，「邊度有得賺呀？計時間、心機、人工，最多打個和。」但黃國輝卻甚聰明，知道香港食家多，懂得欣賞高質豉油，專攻優質市場。論質素，美珍出口到外國的，根本沒法比，就算是AA級，也不過從石缸中榨取。「外國人唔識分，睇價錢做人。係香港食家食客先食得咁招積。」黃國輝從來沒想過放棄香港市場，他只想在狹窄的路上，找出生機。
是故九龍醬園也兼賣不少偏門的失傳食品，如夏天時令的仁稔。「以前錦繡花園附近滿山都係，後生仔未必知係乜！」現時在香港難找，他們惟有從國內特地找回來，每年只有五六月當造，較罕有。將它用豉油與糖醃製，製成小吃，酸酸甜甜，清爽盎然，是悶熱夏天的最佳涼伴。「齋做豉油，齋做香港，真係無得賺，惟有兼做其他，咁先有利可圖。」

不離不棄 路上注滿記憶
黃家大部分人，已經移民加拿大落地生根。惟獨他和父親，這些年為醬油廠鎮守香港。「我唔鍾意嗰邊嘅生活，嘢食唔得，我條根喺香港，始終唔想離開。」他寧願辛苦點，做太空人兩邊走，也從未想過離開。爸爸幾年前過身，工作到九十歲，每個星期落廠一次。黃國輝迄今也六十有七：「我沒冀望下一代接手，反是希望自己健康，做多30年。」他的子女都身在加拿大，暫未有人想回來幫手。兜兜轉轉，就只剩下他，孤身走我路。
黃國輝如老爸一樣，天天回廠，一個人，偶而會想起從前的日子。那是人生中最快樂的時光，只是當時不知道；他拖着爸爸的手回廠上班，「以前未有屯門公路，行青山公路入廠，好遠，路邊都是牛，好似去旅行咁開心。」言教不及身教，老爸日復日的工作，竟影響了身邊的年輕人。黃國輝應承過爸爸，一日人在，一日都有九龍醬園。
「我好記得，爸爸好勤力，總係做嘢到深夜。有一次，晚上離開工廠，街冇晒街燈，阿爸開車摸黑搵路，搵咗足足一個鐘，佢一直搵光嘅地方。」當年摸黑找路的畫面，就這樣烙在心中，當身在一片漆黑中，他仍相信會有路，和有光。

九龍醬園
地址：中環嘉咸街9號
營業時間：8am-6pm（星期日休息）
電話：2544 3697

撰文：莫小巧
攝影：謝致中
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