干姜、甘草、人参、白术、黄 ，补中气之品也，是以吐伤中气者，用理中圆，乃人参、甘草、干
姜、白术四味。附子乃助下焦之生气者也，是以手足厥冷，脉微欲绝者，用四逆汤，乃附子、干姜、甘草三
味。夫启下焦之生气者宜生附，补下焦之元气，或汗漏不止，而阳欲外脱者，宜熟附以固补之。盖元气发
原于下，从中焦而达于四肢，故生气欲绝于下者，用下焦之附子，必配中焦之甘草、干姜，或加人参、白
术。若止伤中气，而下焦之生原不伤者，止用理中，
而不必附子矣。不格物性中下之分，不体先圣立方之意，有以生附配干姜，补中有发，附子得生姜则能发
散之说者；有以附子无干姜不热，得甘草则性缓之说者。盖以姜、附为同类，疑惑后人，误事匪细。如生
气欲绝于下，所当急温者，若不用附而以姜试之，则不救矣！元如曰∶不敢用附，而先以桂代之者，亦误事不浅。
上古以司岁备物，谓得天地之专精。如君、相二火司岁，则收取姜、桂、附子之热类。如太阳寒水司
岁，则收取芩，连、大黄之寒类。如太阴土气司岁，则收取 、术、参，苓、山药、黄精之土类。如厥阴
风木司岁，则收取羌活、防风、天麻、独活之风类。如阳明燥金司岁，则收取苍术、桑皮、半夏之燥类。
盖得主岁之气以助之，则物之功力倍浓。中古之世，不能司岁备物，故用炮制以代天地之气。如制附子曰
炮，制苍术、桑皮曰炒，盖以火助热、以炒助燥也。制白术以土拌，制黄连以水浸，皆所以助之也。近有制
附子以水煮曰阴制，用芝麻炒苍术、以蜜拌桑皮曰润燥，以姜酒炒芩、连，（按《伤寒》、《金匮》诸方，芩、连俱生用。）
以半夏作曲饼，此皆由狐疑，而无力量故也。昔齐相徐之才论药，有宣、通、补、泄、轻、重、滑、涩、
燥、湿之十剂，元人王安道，补出寒、热二种。是宜用寒者，专取其寒；用热者，专取其热；宜涩者，专
取其燥；宜泄者，专取其滑。若反制其性而用之，何异束缚手足而使之战斗哉！
干姜、甘草、人参、白术、黄芩，是补益中气（脾胃之气）的药物，因此对于呕吐损伤中气的情况，使用理中丸（温中散寒、补气健脾的方剂），该方由人参、甘草、干姜、白术四味药组成。附子（附子的块根，具有回阳救逆、补火助阳功效）是用来辅助下焦（肾与命门）生发之气的药物，因此对于手足厥冷、脉象微弱几乎摸不到的情况，使用四逆汤（回阳救逆的代表方剂），该方由附子、干姜、甘草三味药组成。
想要激发下焦的生发之气，应当使用生附子；若要补益下焦的元气，或者出现汗出不止、阳气即将外脱的情况，应当使用熟附子以固摄并补益元气。因为元气发源于下焦，经过中焦而通达四肢，所以当下焦的生发之气将要断绝时，使用中焦的附子，必须配伍中焦的甘草、干姜，或者加入人参、白术。如果只是损伤了中气，而下焦的生发本源没有受损，只需使用理中丸，而不必使用附子。如果不探究药物性质在中焦和下焦的区别，不体会古代圣贤创立方剂的意图，有人提出用生附子配伍干姜，认为这样“补中有发散”；有人说附子如果没有干姜就不热，有了甘草药性就会缓和。这些人将干姜和附子视为同类，使后人产生疑惑，造成的误事非常严重。如下焦生发之气欲绝，应当紧急温补时，如果不用附子而先用干姜试探，那就无法挽救了！元代医家朱丹溪曾说：“不敢使用附子，而先用桂枝代替”，这也是极大的失误。
上古时期根据主管岁运的气候来准备药材，称为得到天地精专之气。如君火、相火主管岁运，则收取生姜、肉桂、附子等热性类药物。如太阳寒水主管岁运，则收取黄芩、黄连、大黄等寒性类药物。如太阴湿土主管岁运，则收取苍术、白术、人参、茯苓、山药、黄精等土性类药物。如厥阴风木主管岁运，则收取羌活、防风、天麻、独活等风性类药物。如阳明燥金主管岁运，则收取苍术、桑白皮、半夏等燥性类药物。大概是因为得到了主管岁运的气候之气来相助，药物的功力加倍浓厚。中古时代，不能根据岁运气候来准备药材，所以采用炮制方法来替代天地之气。如将附子炮制为熟附子，将苍术、桑白皮炒制，这是用火来助热、通过炒制来助燥。将白术用土拌制，将黄连用水浸泡，都是为了增强其相应属性。近代有人将附子用水煮制称为“阴制”，用芝麻炒苍术、用蜜拌桑白皮称为“润燥”，用姜酒炒黄芩、黄连（按《伤寒论》、《金匮要略》各方，黄芩、黄连均生用），将半夏制成曲饼，这都是由于心存疑虑、缺乏定力所致。昔日齐国宰相徐之才论述药物，有宣、通、补、泄、轻、重、滑、涩、燥、湿十种剂型，元代医家王安道补充了寒、热两种。应该用寒药的，专门取其寒性；用热药的，专门取其热性；宜用涩药的，专门取其燥性；宜用泄药的，专门取其滑性。如果反过来制约药性而使用它，这与束缚住手脚却让人去战斗有什么区别呢！
Ganjiang (Dried Ginger), Gancao (Licorice Root), Renshen (Ginseng Root), Baizhu (Atractylodis Macrocephalae Rhizoma), and Huangqin (Scutellariae Radix) are substances that tonify the Middle Qi (Qi of the Spleen and Stomach). Therefore, for conditions where vomiting has injured the Middle Qi, Lizhong Wan (Regulate the Middle Pill) is used, which consists of four ingredients: Renshen, Gancao, Ganjiang, and Baizhu. Fuzi (Prepared Aconiti Lateralis Radix, possessing the efficacy of restoring devastated Yang and supplementing fire to assist Yang) is used to assist the generating Qi of the Lower Jiao (Kidney and Mingmen). Thus, for symptoms such as cold extremities and a faint pulse nearly imperceptible, Sini Tang (Reverse the Extremity Decoction) is employed, comprising three ingredients: Fuzi, Ganjiang, and Gancao.
To stimulate the generating Qi of the Lower Jiao, raw Fuzi should be used. To tonify the primal Qi of the Lower Jiao, or in cases of incessant sweating with Yang about to escape externally, cooked Fuzi should be used to secure and tonify the primal Qi. This is because primal Qi originates from the Lower Jiao, passes through the Middle Jiao, and reaches the four limbs. Therefore, when the generating Qi at the Lower Jiao is on the verge of exhaustion, Fuzi from the Lower Jiao must be combined with Gancao and Ganjiang from the Middle Jiao, or supplemented with Renshen and Baizhu. If only the Middle Qi is injured while the generating source of the Lower Jiao remains intact, one should use only Lizhong Wan without the need for Fuzi. Those who fail to investigate the distinction between the properties of herbs affecting the Middle and Lower Jiao, and fail to comprehend the intent of the ancient sages in formulating prescriptions, propose using raw Fuzi paired with Ganjiang, claiming it offers "tonification with dispersion." Others claim that Fuzi is not hot without Ganjiang and becomes mild in nature when combined with Gancao. By treating Jiang (Ginger) and Fu (Fuzi) as similar categories, they confuse later generations, causing significant errors. In situations where the generating Qi at the Lower Jiao is exhausted and urgent warming is required, if one does not use Fuzi but instead tests with Ganjiang, rescue will be impossible! Zhu Danxi of the Yuan Dynasty stated, "I dare not use Fuzi, so I first substitute it with Guizhi (Cinnamon Twig)," which is also a grave error.
In ancient times, medicines were prepared according to the climate governing the year, termed obtaining the essence of Heaven and Earth. When Jun Huo (Monarch Fire) and Xiang Huo (Minister Fire) governed the year, hot-natured herbs like Shengjiang (Fresh Ginger), Rougui (Cinnamon Bark), and Fuzi were collected. When Taiyang Han Shui (Taiyang Cold Water) governed the year, cold-natured herbs like Huangqin (Scutellariae Radix), Lianhua (Coptidis Rhizoma), and Dahuang (Rhei Radix et Rhizoma) were collected. When Taiyin Tu Qi (Taiyin Earth Qi) governed the year, earth-natured herbs like Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Root), Fuling (Poria), Shanyao (Dioscoreae Rhizoma), and Huangjing (Polygonati Rhizoma) were collected. When Jueyin Feng Mu (Jueyin Wind-Wood) governed the year, wind-natured herbs like Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma), and Duhuo (Angelicae Pubescentis Radix) were collected. When Yangming Zao Jin (Yangming Dryness-Metal) governed the year, dry-natured herbs like Cangzhu (Atractylodis Rhizoma), Sangbai Pi (Mori Cortex), and Banxia (Pinelliae Rhizoma) were collected. Generally, by receiving the Qi of the governing year to assist them, the efficacy of these substances becomes doubly concentrated. In the middle antiquity, since one could not prepare medicines according to the governing year's climate, processing methods were used to substitute for the Qi of Heaven and Earth. For example, processing Fuzi by roasting, and processing Cangzhu and Sangbai Pi by stir-frying, uses fire to enhance heat and stir-frying to enhance dryness. Processing Baizhu by mixing with soil, and processing Huanglian (Coptidis Rhizoma) by soaking in water, both serve to enhance their respective attributes. Recently, some process Fuzi by boiling in water, termed "Yin processing"; stir-fry Cangzhu with sesame seeds and mix Sangbai Pi with honey, termed "moistening dryness"; stir-fry Huangqin and Huanglian with ginger and wine; and make Banxia into pill cakes. These practices stem from hesitation and lack of conviction. As noted, in the formulas of *Shanghan Lun* and *Jingui Yaolue*, Huangqin and Huanglian are all used raw.
In the past, Xu Zhicai, Prime Minister of Qi, discussed herbs, categorizing them into ten types: Xuan (Dispersing), Tong (Unblocking), Bu (Tonifying), Xie (Draining), Qing (Light), Zhong (Heavy), Hua (Slippery), Se (Astringent), Zao (Dry), and Shi (Moist). Wang Andao of the Yuan Dynasty added two more: Han (Cold) and Re (Hot). When cold herbs are indicated, one should specifically select those with cold properties; when hot herbs are indicated, one should specifically select those with hot properties; when astringency is needed, one should specifically select dry herbs; when draining is needed, one should specifically select slippery herbs. If one reverses the nature of the herbs and uses them contrary to their inherent properties, what difference is there from binding someone's hands and feet and forcing them to fight?