窃谓医虽小道，乃寄死生，最要变通，不宜固执，明药、脉、病、治之理，（药性、脉
诀、病机、治法。）悉望、闻、问、切之情。（望色、闻声、问故、切脉。）药推寒热、温凉、
平和之气，辛甘、淡苦、酸咸之味，升降、浮沉之性，宣通、泻补之能。脉究浮沉、迟数、
滑涩之形，表里、寒热、实虚之应，阿阿嫩柳之和，弦钩毛石之顺。药用君臣佐使，（主病
之谓君，最多；辅君之谓臣，次之；应臣之谓佐使，又其次之。）脉分老幼瘦肥。（老人脉濡，
小儿脉数，瘦者脉大，肥者脉细。）药乃天地之精，药宜切病，（药不泛用，则切病矣。）脉
者气血之表，脉贵有神。（脉中有力，谓有神也。）病有外感内伤、风寒、暑湿、燥火之机，
治用宣通、泻补、滑涩、温燥、重轻之剂。外感异乎内伤，（外感乃有余之症，内伤乃不足
之证。）寒证不同热证。（伤寒直中之邪为寒，伤寒传经之邪为热。）外感宜泻而内伤宜补，
寒证可温而热证可清。补泻得宜，须臾病愈；温清失度，顷刻人亡。外感风寒宜分经而解散
，（外感风寒传变不一，宜分经络解散方可。）内伤饮食可谓胃以消溶。（内伤饮食只在一处
，不过调胃消导而已。）胃阳主气，司纳受，阳常有余。脾阴主血，司运化，阴常不足。胃
乃六腑之本，（能纳受水谷方可伤化气液。）脾为五脏之源。（能运化气液方可克营卫。）胃气
弱则百病生，脾阴足而万邪息。调理胃脾为医中之王道，节戒饮食乃却病之良方。病多寒冷
、郁气，气郁发热。（寒谓风寒外感，昼夜发热。冷谓生冷内伤，午后发热。）或出七情动火
，火动生痰。有因行藏动静以伤暑邪，或是出入雨水而中湿气。亦有饮食失调而生湿热，倘
或房劳过度以动相火。（以上六条言病机。）制伏相火要滋养其真阴，（以下六条言治法。）祛
除湿热须燥补其脾胃。外湿宜表散，内湿宜淡渗。阳暑可清热，阴暑可散寒。寻火寻痰分多
分少而治，究表究里或汗或下而施。（是风寒则汗之，谓温散也；是生冷则下之，谓温利也
。）痰因火动，治火为先；火因气生，理气为本。治火轻者可降，重者从其性而升消。理气
微则宜调，甚则究其源而发散。实火可泻，或泻表或泻里。（指外感也。）虚火宜补，或补阴
而或补阳。（指内伤也。）暴病之谓火，怪病之谓痰。寒、热、湿、燥、风，五痰有异；温、
清、燥、润、散，五治不同。（寒痰温之，热痰清之，湿痰燥之，燥痰润之，风痰散之。）有
因火而生痰，有因痰而生火，或郁久而成病，或病久而成郁。金、水、木、火、土，五郁当
分；泄、折、达、发、夺，五法宜审。（金郁泄之、水郁折之、木郁达之、火郁发之、土郁
夺之。）郁则生火生痰而成病，病则耗气耗血以致虚。病有微甚，治有逆从。微则逆治。（以
寒药治热，以热药治寒。）甚则从攻，（以寒药治热佐以热药，以热药治寒佐以寒药。）病有
本标，急则治标，缓则治本。法分攻补，虚而用补，实而用攻。少壮新邪专攻则是，老衰久
病兼为补为规。
久病兼补虚而兼解郁，陈症或荡涤而或消溶。积在胃肠可下而愈，块居经络宜消而痊
。女人气滞淤血宜开血而行气；男子阳多乎阴，可补阴以配阳。苁蓉、山药，男子之佳珍，
（补阴故也。）香附、缩砂，女人之至宝，（行气故也。）气病血病二者宜分，阳虚阴虚两般
勿紊。阳虚气病昼重而夜轻，（自子至巳为昼。）血病阴虚昼轻而夜重。（自午至亥为夜。）阳
虚生寒，寒生湿，湿生热。（阳为气、为真火。）阴虚生火，火生燥，燥生风。（阴为血，为
真水。）阳盛阴虚则生火，火逼血而错轻妄行。阴盛阳虚则生寒，寒滞气而周身浮肿。阳虚
畏外寒，（阳气虚不能外，故畏外寒。）阴虚生内热。（阴血虚不能配气，故生内热。）补阳补
气用甘温之品，滋阴滋血以苦寒之流。调气贵用辛凉，（气属阳，无形者也。气郁则发热，
故宜用辛凉之药以散之。）和血必须辛热。（血属阴，有形者也。血积则作痛，故宜用辛热之
药以开之。）阳气为阴血之引导，阴血乃阳气之依归。阳虚补阳，而阴虚滋阴；气病调气，
而血病和血。阴阳两虚，惟补其阳，阳生而阴长；气血俱病，只调其气，气行而血随。藏冰
发冰以节阳气之燔，滋水养水以制心火之亢。火降水升斯人无病，阴平阳秘我体长春。小儿
纯阳而无阴，老者多气而少血。肥人气虚有痰宜豁痰而补气，瘦者血虚有火可泻火以滋阴。
膏粱无厌发痈疽，热燥所使；痰薄不堪生肿胀，寒湿而然。北地耸高宜清热而用燥，南方
下可散湿以温寒。
我私下认为，医学虽然是一门技艺，却寄托着人的生死，最关键的是要懂得变通，不应当固执己见。必须明了药性、脉象、病机和治法的原理，（即药物性质、脉诊口诀、疾病机理、治疗法则。）全面掌握望、闻、问、切四种诊法的情况。（观察面色、听声音、询问病史、切按脉搏。）
药物具有寒、热、温、凉、平和的气，以及辛、甘、淡、苦、酸、咸的味道，还有升、降、浮、沉的特性，以及宣散疏通、泻下补益的功能。脉象需要探究其浮、沉、迟、数、滑、涩的形态，以及表、里、寒、热、实、虚的对应关系，还要体会如阿阿嫩柳般柔和、弦钩毛石般顺应四时的顺脉。
用药讲究君臣佐使的配合，（主治病的称为君药，用量最大；辅助君药的称为臣药，用量次之；配合臣药或引导药力的称为佐使药，用量又其次。）脉象需区分老、幼、瘦、肥的不同体质。（老人脉象多濡软，小儿脉象多数疾，瘦人脉象多宏大，肥人脉象多细弱。）
药物是天地精华的凝聚，用药必须切合病情，（如果不泛泛使用药物，就能切合病情了。）脉象是气血的外在表现，脉象贵在“有神”。（脉中有力，就叫做有神。）
疾病有外感与内伤、风寒、暑湿、燥火等发病机理，治疗需使用宣通、泻补、滑涩、温燥、重轻等不同性质的方剂。外感病不同于内伤病，（外感属于有余的实证，内伤属于不足的虚证。）寒证与热证也不同。（伤寒直中脏腑的邪气表现为寒证，伤寒传经入里的邪气表现为热证。）外感病适宜用泻法，内伤病适宜用补法；寒证可以用温法，热证可以用清法。补泻得当，片刻之间病愈；温清失度，顷刻之间人亡。
外感风寒应当分经络进行解散，（外感风寒传变不一，只有分经络解散才能治愈。）内伤饮食应当调理脾胃以消导化解。（内伤饮食的病位只在局部，不过是调理脾胃、消食导滞罢了。）
胃阳主司气，负责受纳，阳气通常有余。脾阴主司血，负责运化，阴气通常不足。胃是六腑的根本，（能够受纳水谷，才能化生气液。）脾是五脏的源头。（能够运化气液，才能滋养营卫。）胃气虚弱则百病丛生，脾阴充足则万邪平息。调理胃脾是医学中的王道，节制饮食是祛除疾病的良方。
疾病多由寒冷、郁气引起，气郁会导致发热。（寒冷指风寒外感，昼夜都会发热；冷指生冷内伤，午后才会发热。）或者因七情波动引动火邪，火动则生痰。有的因为起居动静不当而损伤于暑邪，有的是因为出入雨水环境而中受湿气。也有因饮食失调而生湿热，倘若房劳过度而动相火。（以上六条阐述病机。）
制约相火关键在于滋养真阴，（以下六条阐述治法。）祛除湿热必须燥湿并补益脾胃。外湿适宜用表散法，内湿适宜用淡渗利湿法。阳暑可用清热法，阴暑可用散寒法。寻找火邪和痰邪，需分辨其多少而进行治疗；探究病位在表在里，或采用汗法或采用下法来施治。（如果是风寒则用汗法，即温散；如果是生冷积滞则用下法，即温利。）
痰因火动而产生，治疗火邪为先；火因气滞而生，调理气机为本。治疗火邪，轻症可用降火法，重症则顺应其性用升散消法。调理气机，轻微者宜调畅，严重者需究其根源而发散。实火可以泻下，或泻表或泻里。（指外感实火。）虚火适宜补益，或补阴或补阳。（指内伤虚火。）暴发的病症称为火，怪异的病症称为痰。寒、热、湿、燥、风五种痰证各有不同；温、清、燥、润、散五种治法也各不相同。（寒痰用温法，热痰用清法，湿痰用燥法，燥痰用润法，风痰用散法。）
有的因火而生痰，有的因痰而生火，或者郁结日久而成病，或者患病日久而成郁结。金、水、木、火、土五郁应当区分；泄、折、达、发、夺五法应当审慎运用。（金郁用泄法，水郁用折法，木郁用达法，火郁用发法，土郁用夺法。）
郁结则生火生痰而成病，生病则耗气耗血以致虚损。病情有轻重，治疗有逆从。轻症则逆治。（用寒药治热病，用热药治寒病。）重症则从攻（顺势而治），（用寒药治热病时佐以热药，用热药治寒病时佐以寒药。）疾病有本标之分，急则治标，缓则治本。治法分为攻补，虚证用补法，实证用攻法。少壮之人新感邪气专一用攻法是正确的，老衰之人久病则兼用补法作为常规。
久病兼有虚损且兼有郁结，陈年旧症或荡涤清除或消解溶化。积滞在胃肠的可通过泻下痊愈，肿块居于经络的宜用消散法而康复。女子气滞淤血适宜活血而行气；男子阳气多于阴气，可补阴以配阳。肉苁蓉、山药，是男子的佳珍，（因为能补阴的缘故。）香附、缩砂仁，是女子的至宝，（因为能行气的缘故。）气病和血病二者应当区分，阳虚和阴虚两种情况不要混淆。阳虚导致的气病白天重而晚上轻，（自子时至巳时为白天。）血病导致的阴虚白天轻而晚上重。（自午时至亥时为夜晚。）
阳虚生寒，寒生湿，湿生热。（阳代表气、代表真火。）阴虚生火，火生燥，燥生风。（阴代表血、代表真水。）阳盛阴虚则生火，火逼迫血液妄行错乱。阴盛阳虚则生寒，寒气阻滞气机而导致周身浮肿。阳虚畏惧外寒，（阳气虚弱不能固护于外，所以畏惧外寒。）阴虚产生内热。（阴血虚弱不能制约阳气，所以产生内热。）
补阳补气使用甘温的药物，滋阴滋血使用苦寒的药物。调气贵在运用辛凉之品，（气属阳，是无形的。气郁则发热，所以适宜用辛凉药物来疏散它。）和血必须运用辛热之品。（血属阴，是有形的。血积滞则疼痛，所以适宜用辛热药物来开通它。）阳气是阴血的引导，阴血是阳气的依归。阳虚补阳，阴虚滋阴；气病调气，血病和血。阴阳两虚，只补其阳，阳生则阴长；气血俱病，只调其气，气行则血随。藏冰发冰以节制阳气的燔灼，滋水养水以制约心火的亢盛。火降水升这个人就没有疾病，阴平阳秘我的身体就能长久健康。
小儿纯阳而无阴，老者多气而少血。肥胖人气虚有痰，适宜豁痰而补气；瘦者血虚有火，可泻火以滋阴。嗜好膏粱厚味易发痈疽，这是热燥所致；痰薄不堪（形容体质虚弱）易生肿胀，这是寒湿造成。北方地势高耸适宜清热而用燥法，南方地势低下适宜散湿以温寒。
I privately hold that although medicine is a minor art, it entrusts life and death, making adaptability the most crucial aspect; one should not be stubborn. One must understand the principles of herbs (herbal properties), pulse diagnosis (pulse formulas), disease mechanisms, and therapeutic methods, as well as fully grasp the situations revealed by observation, listening/smelling, inquiry, and palpation (observing complexion, listening to voice/smelling odors, asking about history, feeling the pulse).
Herbs possess qi of cold, heat, warm, cool, and neutral natures, flavors of pungent, sweet, bland, bitter, sour, and salty, properties of ascending, descending, floating, and sinking, and functions of dispersing/venting and purging/nourishing. Pulse diagnosis requires investigating forms such as superficial, deep, slow, rapid, slippery, and choppy, and their correspondences to exterior/interior, cold/heat, excess/deficiency, as well as harmonious pulses like "a-a tender willow" and compliant pulses like "string, hook, hair, stone." Herb prescription follows the hierarchy of Sovereign, Minister, Assistant, and Envoy (the herb treating the main disease is Sovereign, used in largest quantity; assisting the Sovereign is Minister, used in lesser quantity; responding to the Minister or guiding the drug is Assistant/Envoy, used in even lesser quantity). Pulse differentiation considers age, body size, and constitution (elderly pulses are often soft/soggy, children's pulses are often rapid, thin people's pulses are often large, fat people's pulses are often fine).
Herbs are the essence of heaven and earth; medication must fit the disease (if herbs are not used indiscriminately, they will fit the disease). The pulse is the manifestation of qi and blood; the pulse values having "spirit" (strength within the pulse is called having spirit). Diseases have mechanisms of external contraction and internal injury, wind-cold, summer-heat, dampness, dryness, and fire. Treatments use agents of venting/purging, tonifying/reducing, lubricating/astringing, warming/drying, and heavy/light. External contractions differ from internal injuries (external contractions are excess syndromes, internal injuries are deficiency syndromes). Cold syndromes differ from heat syndromes (wind-cold directly attacking the interior manifests as cold, while transmitted pathogenic factors manifest as heat). External contractions are suitable for reducing methods, internal injuries for tonifying methods; cold syndromes can be warmed, heat syndromes can be cleared. If tonification and reduction are appropriate, the disease heals in an instant; if warming and clearing are mismanaged, death occurs in an instant.
External wind-cold should be resolved by channel differentiation (external wind-cold varies in transmission, so resolving by channel differentiation is necessary). Internal dietary injury involves regulating the stomach to dissolve accumulation (internal dietary injury is localized, merely requiring stomach regulation and digestion promotion). Stomach yang governs qi and reception; yang is often in excess. Spleen yin governs blood and transformation; yin is often deficient. The stomach is the root of the six fu organs (only by receiving water and grain can qi and fluids be transformed). The spleen is the source of the five zang organs (only by transforming qi and fluids can ying and wei be nourished). When stomach qi is weak, hundred diseases arise; when spleen yin is sufficient, ten thousand evils cease. Regulating the stomach and spleen is the kingly way of medicine; dietary restraint is the good prescription for dispelling disease.
Diseases often stem from cold and qi stagnation, where qi stagnation generates heat (cold refers to external wind-cold causing fever day and night; cold refers to internal raw/cold food injury causing fever in the afternoon). Or seven emotions stir fire, and fire stirring generates phlegm. Some are injured by summer-evil due to improper activity/rest, or infected by dampness due to exposure to rain/water. Others generate damp-heat due to dietary imbalance, or stir ministerial fire due to excessive sexual activity. (The above six points discuss disease mechanisms.)
Subduing ministerial fire requires nourishing true yin (the following six points discuss therapeutic methods). Dispelling damp-heat requires drying dampness and tonifying the spleen/stomach. External dampness is suitable for surface-dispersing methods; internal dampness is suitable for bland-leaching methods. Yang summer-heat can be cleared; yin summer-heat can be dispersed with warmth. Treating fire and phlegm requires distinguishing their abundance or scarcity. Investigating exterior or interior dictates using sweating or purging methods accordingly (for wind-cold, sweat it, i.e., warm dispersion; for raw/cold accumulation, purge it, i.e., warm purgation). Phlegm arises from fire, so treating fire is primary; fire arises from qi, so regulating qi is fundamental. For treating fire, mild cases can be descended; severe cases follow its nature to ascend and dissipate. For regulating qi, mild cases require adjustment; severe cases require tracing the source and dispersing. Excess fire can be purged, either from the exterior or interior (referring to external contractions). Deficient fire is suitable for tonification, either tonifying yin or yang (referring to internal injuries). Sudden illness is termed fire; strange illness is termed phlegm. Wind-cold, heat, dampness, dryness, and wind produce five different types of phlegm; warming, clearing, drying, moistening, and dispersing constitute five different treatments (warm cold-phlegm, clear heat-phlegm, dry damp-phlegm, moisten dry-phlegm, disperse wind-phlegm). Fire can generate phlegm; phlegm can generate fire. Prolonged stagnation becomes disease; prolonged disease becomes stagnation. Metal, water, wood, fire, and earth stagnations must be distinguished; draining, restraining, reaching, issuing, and seizing methods must be carefully considered (drain metal stagnation, restrain water stagnation, reach wood stagnation, issue fire stagnation, seize earth stagnation). Stagnation generates fire and phlegm to cause disease; disease consumes qi and blood leading to deficiency. Diseases vary in severity; treatments vary in counteracting or following. Mild cases are treated counteractively (using cold herbs for heat, hot herbs for cold). Severe cases are treated by following (using cold herbs for heat assisted by hot herbs, hot herbs for cold assisted by cold herbs). Diseases have root and branch; urgent cases treat the branch, chronic cases treat the root. Methods divide into attacking and tonifying: deficiency uses tonification, excess uses attack. Young and strong with new pathogens should exclusively attack; old and frail with long-term illness should combine tonification as a rule.
Long-term illness with deficiency and stagnation requires tonifying deficiency and resolving stagnation; chronic conditions may require purging or dissolving. Accumulations in the stomach/intestines can be cured by purging; masses in meridians should be dissolved to heal. Women with qi stagnation and blood stasis benefit from invigorating blood and moving qi; men have more yang than yin, so tonifying yin to match yang is appropriate. Cistanche and Dioscorea are excellent for men (because they tonify yin). Cyperus and Amomum are treasures for women (because they move qi). Qi and blood diseases must be distinguished; yang deficiency and yin deficiency must not be confused. Yang deficiency qi disease is worse during the day and better at night (Zi to Si hours are day). Blood disease yin deficiency is better during the day and worse at night (Wu to Hai hours are night). Yang deficiency generates cold, cold generates dampness, dampness generates heat (yang is qi, true fire). Yin deficiency generates fire, fire generates dryness, dryness generates wind (yin is blood, true water). Yang excess and yin deficiency generate fire, forcing blood to flow recklessly. Yin excess and yang deficiency generate cold, cold stagnates qi causing generalized edema. Yang deficiency fears external cold (yang qi is weak and cannot protect the exterior, hence fearing external cold). Yin deficiency generates internal heat (yin blood is weak and cannot anchor qi, hence generating internal heat). Tonifying yang and qi uses sweet-warm substances; nourishing yin and blood uses bitter-cold substances. Regulating qi prefers pungent-cool agents (qi belongs to yang, is formless; qi stagnation causes heat, so pungent-cool herbs are used to disperse it). Harmonizing blood requires pungent-hot agents (blood belongs to yin, is有形/form; blood stasis causes pain, so pungent-hot herbs are used to open it). Yang qi guides yin blood; yin blood relies on yang qi. Yang deficiency tonifies yang, yin deficiency tonifies yin; qi disease regulates qi, blood disease harmonizes blood. If both yin and yang are deficient, only tonify yang, as yang generation leads to yin growth; if both qi and blood are diseased, only regulate qi, as qi movement leads to blood circulation. Store ice to emit ice to control the blazing of yang qi; nourish water to control the hyperactivity of heart fire. When fire descends and water rises, the person is free of disease; when yin is peaceful and yang is secure, my body remains youthful forever.
Children are pure yang without yin; the elderly have much qi but little blood. Fat people with qi deficiency and phlegm should resolve phlegm and tonify qi; thin people with blood deficiency and fire should clear fire and nourish yin. Indulgence in rich foods causes carbuncles/fistulas due to heat-dryness; thin phlegm and poor constitution cause swelling due to cold-dampness. Northern highlands suit clearing heat and using drying methods; southern lowlands suit dispersing dampness and warming cold.