《语》云∶子之所慎，齐、战、疾。又曰∶丘未达，不敢尝。此言服药不可不畏
慎也。然世有百十年相袭之弊，至今不除者，敢略数一、二，使后车改辙，不蹈前覆。夫伤寒、温疫、
时气、中暑、风温、风疟，与中酒伤食者，其初相类，此最误人。或先一日头痛，曾伤酒便归过于洒
，曾伤食便归过于食。初觉满闷，医者不察其脉，不言其始，径用备急丹、缠积丹、软金丸、酒
症丸。此药犯巴豆，或出油不尽，大热大毒，走泄五、七行，或十余行。其人必津液枯涸，肠胃转
燥，发黄瘀热，目赤口干，恍惚潮热，昏愦惑狂，诸热交作。如此误死者，不可胜举。若其人
或本因酒食致过，亦能头痛身热，战栗恶寒。医者不察其脉，不究其原，反作伤寒发之，桂
枝、麻黄、升麻之属，以汗解之。汗而不解，辗转疑惑，反生他证。如此误死者，可胜计哉
？
又如久病咳嗽，形体羸瘦，食欲减少，旦静夜剧。医者不察，便与乌梅、罂粟壳、紫菀、枯矾
，如此峻攻，嗽疾未除，涩滞之病作矣。嗽加之涩，饮食弥减。医者不察，更以热剂养胃
，温剂和脾，致令头面汗出，燥热潮发，形容瘦瘁，涎液上出，流如涌泉。若此死者，不可胜数。
又如妇人产余之疾，皆是败血恶物，发作寒热，脐腹撮痛，乳潼枯涸，食饮稍减。医者不察，
便谓产后血出数斗，气血俱虚，便用温热之剂，养血补虚，止作寒治，举世皆然。岂知妇人
之孕，如天地之孕物也。物以阴阳和合而后生，人亦以阴阳和合而后孕。偏阴偏阳，岂有孕
乎？此与禾黍、瓜果之属何异哉？若水旱不时，则华之与实，俱痿落矣。此又与孕而不育者
，复何异哉？七月立秋后十八日，寸草不结者，犹天寒故也。今妇人妊娠，终十月无难而生，
反谓之寒，何不察其理之甚也？窃譬之冶砖者，炎火在下，以水沃其窑之巅，遂成砖矣。砖
既出窑，窑顿寒邪！世俗竟传黑神散之属，治产后一十八证，非徒其不愈
，则经脉涸闭，前后淋闭，呕吐嗽痰，凡百热证生矣。若此误死者，不可计之。曷若四物汤
与凉膈散停对，大作汤剂而下之，利以数行，恶物俱尽，后服淡甘之剂自愈矣。
又如小儿腹
满，喘嗽痰涎不利，医者不察，便用白饼子之属。夫白饼子，巴豆大热有大毒，兼用腻粉，
其后必生口疮，上喘咳嗽，呕吐不嗜饮食之疾。然此治贫家小儿，犹或可效，膏粱之家，必
生他病，又何疑哉？又如泻利之疾，岁岁有之，医者不察，便用圣散子之属，干姜、赤石脂、乌
梅、罂粟壳、官桂、石榴皮、龙骨、牡蛎之属，变生小便癃闭，甚者为胀，又甚者，水肿之
疾生矣！间有愈者，病有微者也，甚则必不愈矣。
又如人病停饮，或因夏月伤冷过多，皆为脾胃客气有
余也。宜逐而去之。医者不可以为脾衰而补之，则痞者更痞，满者更满。复有巴豆丸下之者
，病虽少解，必不嗜食，上燥之病生矣。
又如人因闪肭膝髁肘腕大痛，医者不察，便用
针出血，如未愈者，再三刺血。出血既多，遂成跛 。
内经》曰∶足得血而能步。血尽安得步哉？若余治闪肭则不然，以禹功散，或通经二、
三钱下；神 丸，或除湿丹百余丸，峻泻一、二十行，则痛出当痒发。
痛属夏，痒属秋，出则夏衰矣！此五行胜复之理也。
故凡腰胯胁痛，杖疮落马，坠堕打扑，
莫不同然。盖此痛得之于外，非其先元虚元弱。古人云∶“痛随利减”。宜峻泻一、二十行
毕。但忌热酒，可一药而愈。勿谓峻泻，轻侮此法。昔有齿痛，连月不止，以铁铃钮取之，血不止
而死。又有人因上下齿痛，凡百痛者辄取，不数年，上下齿尽。至五十岁，生硬之物，皆不
能食。夫上下齿痛，皆由手足阳明二经，风热甚而痛矣，可用大、小承气汤、藏用丸、祛风
丸等药泻之，则痛当自止。《内经》曰∶诸痛痒疮疡，皆属心火。启玄子云∶百端之起，皆自心生
。心者，火也，火生土之故也。出牙之误，不可不知。又如治水肿痛者，多用水银、轻粉、白丸
子，大毒之药下之，水肿未消而牙齿落，牙齿落而不进食，水尽而立毙。复有人于两足针之，水出如泉，水尽亦毙矣！
《论语》中说：“君子所谨慎对待的，是斋戒、战争和疾病。”又说：“孔子对于不懂的事情，不敢轻易尝试。”这些话都在强调服药不可不谨慎。然而世间有一百多年沿袭下来的弊端，至今未能消除，我斗胆列举一二，使后来的医者能够改变做法，不再重蹈覆辙。
伤寒、温疫、时气、中暑、风温、风疟，以及饮酒过量、饮食积滞所致之病，在初期症状非常相似，这最容易误导人。有的人前一天头痛，如果曾饮酒，就把过错归咎于酒；如果曾伤食，就把过错归咎于食物。刚觉得胸脘满闷，医生不诊察脉象，不探究病因，直接使用备急丹、缠积丹、软金丸、酒症丸等药物。这些药含有巴豆，若炼油不尽，其性大热大毒，会导致腹泻五到七次，甚至十几次。病人必然津液枯竭，肠胃转燥，出现发黄、瘀热、目赤、口干、神志恍惚、潮热、昏愦狂乱等症状，各种热证交作。像这样误治致死的，数不胜数。
如果病人原本就是因酒食致病，也会出现头痛、身热、战栗恶寒的症状。医生不诊察脉象，不探究本源，反而当作伤寒来发汗治疗，使用桂枝、麻黄、升麻等药物，试图通过出汗来解表。汗出后病未解除，辗转之间产生疑惑，反而生出其他病症。像这样误治致死的，难道能计算得过来吗？
又如久病咳嗽，形体消瘦，食欲减退，白天安静夜间加重。医生不仔细诊察，就给予乌梅、罂粟壳、紫菀、枯矾等药物。如此峻猛攻伐，咳嗽病未除，涩滞之病又产生了。咳嗽加上涩滞，饮食更加减少。医生不仔细诊察，反而用热剂养胃，温剂和脾，导致头面出汗，燥热潮热发作，形容枯瘦，涎液上涌，流如泉水。像这样死亡的，不可胜数。
又如妇人产后余疾，多是败血恶物，发作寒热，脐腹拘挛疼痛，乳房干枯，饮食稍减。医生不仔细诊察，便认为产后失血数斗，气血俱虚，于是使用温热药剂养血补虚，按寒证治疗，举世皆如此。哪里知道妇人的怀孕，就像天地孕育万物一样。万物以阴阳和合而后生成，人也以阴阳和合而后受孕。偏阴或偏阳，岂能有孕呢？这与禾黍、瓜果有何不同？如果水旱失调，那么花与果实都会枯萎掉落。这又与怀孕而不能生育者有何区别？七月立秋后十八天，寸草不结果实，是因为天气寒冷。如今妇人妊娠，经过十月顺利生产，反而被说是寒证，这是多么不考察事理啊！我私下比喻冶炼砖瓦的人，下面燃着烈火，用水浇淋窑顶，砖瓦便烧成了。砖瓦既已出窑，窑顿时变冷！世俗竟流传黑神散等方剂，治疗产后十八种病症，不仅不能治愈，反而导致经脉干涸闭塞，大小便淋闭，呕吐咳嗽痰多，各种热证由此而生。像这样误治致死的，不可计数。不如将四物汤与凉膈散配合使用，制成大方剂服用，使其腹泻数次，恶物排尽，之后服用淡甘之剂即可自愈。
又如小儿腹部胀满，气喘咳嗽，痰涎不利，医生不仔细诊察，便使用白饼子等药物。白饼子含有巴豆，大热有大毒，兼用腻粉（轻粉），其后必然生出口疮、上喘咳嗽、呕吐、食欲不振等疾病。虽然此法治疗贫家小儿或许有效，但对于富贵人家的小孩，必然生出其他疾病，这有什么可疑的呢？
又如泻利之病，每年都有发生，医生不仔细诊察，便使用圣散子等方剂，其中包含干姜、赤石脂、乌梅、罂粟壳、官桂、石榴皮、龙骨、牡蛎等药物，变生出小便癃闭之症，严重的变成腹胀，更严重的则生出水肿之病！偶尔有痊愈的，是因为病情轻微，严重时必然不能痊愈。
又如人患停饮（水饮停滞），或因夏季受寒过多，都是脾胃客气有余所致。应当驱逐而去。医生不可以因为脾衰而补益它，否则痞满会更严重。又有用巴豆丸攻下的，病虽稍解，但必然食欲不振，上部燥热之病随之产生。
又如人因闪挫导致膝、髁、肘、腕剧烈疼痛，医生不仔细诊察，便用针刺出血，如果未愈，再三刺血。出血过多，遂成跛足。《内经》说：“脚得到血液才能行走。”血液耗尽了怎么能行走呢？如果我治疗闪挫则不然，使用禹功散，或者通经二、三钱服用；或者神祐丸、除湿丹百余丸，峻猛泻下十余至二十行，则疼痛会转化为瘙痒发作。痛属夏，痒属秋，疼痛消退则邪气衰退了！这是五行胜复的道理。
所以凡是腰胯胁痛，杖疮、落马、坠堕打扑所致之痛，莫不是如此。因为这些疼痛得之于外，并非先天元气虚弱。古人说：“痛随利减”。适宜峻猛泻下十余至二十行。只要忌食热酒，可以一药而愈。不要认为这是峻泻之法而轻视它。过去有人牙齿疼痛，连续数月不止，用铁铃钮拔取，血流不止而死。又有人因上下齿痛，凡是有疼痛的地方就拔取，没过几年，上下牙齿掉光。到了五十岁，坚硬的食物都不能吃。夫上下齿痛，都是由手足阳明二经风热甚盛所致，可以使用大承气汤、小承气汤、藏用丸、祛风丸等药物泻下，则疼痛自然停止。《内经》说：“诸痛痒疮疡，皆属于心火。”启玄子（王冰）说：“百端之起，皆自心生。”心属火，火生土的缘故。出牙治疗的失误，不可不知道。
又如治疗水肿疼痛者，多用水银、轻粉、白丸子等大毒药物攻下，水肿未消而牙齿脱落，牙齿脱落后不能进食，水液耗尽便立即死亡。又有人在两足针刺放水，水流如泉，水放尽也死亡了！
As stated in the *Analects*: "The gentleman is cautious in three matters: fasting, warfare, and disease." It also says: "Confucius did not dare to taste [a remedy] for what he did not understand." These words emphasize that taking medicine must be done with extreme caution. However, there are detrimental practices inherited for hundreds of years that have not yet been eradicated. I venture to list one or two examples so that future practitioners may change their ways and avoid repeating past mistakes.
Shanghan (Cold Damage), Wenyi (Plague-Heat), Shiqi (Seasonal Qi), Zhongshu (Heatstroke), Fengwen (Wind-Warmth), Fengnie (Wind-Malaria), as well as conditions caused by excessive alcohol consumption and food stagnation, present similar symptoms in their early stages. This similarity most often leads to misdiagnosis. If a patient experiences headache the day before, and has consumed alcohol, the fault is attributed to wine; if they have overindulged in food, the fault is attributed to food. Upon feeling initial chest and epigastric fullness, physicians fail to examine the pulse or investigate the origin, instead directly administering medicines such as Beiji Dan (Emergency Rescue Pill), Chanji Dan (Accumulation-Entangling Pill), Ruanjin Wan (Soft Gold Pill), or Jiu Zheng Wan (Alcohol-Stagnation Pill). These preparations contain Radix Crotonis Tiglii (Baidu Dou, 巴豆). If the oil is not fully refined out, the substance is extremely hot and toxic, causing diarrhea five to seven times, or even more than ten times. The patient inevitably suffers from dried-up body fluids, dry intestines and stomach, yellowing of the skin, stasis-heat, red eyes, dry mouth, mental confusion, tidal fever, stupor, and mania, with various heat syndromes arising simultaneously. There are countless cases of death due to such mismanagement.
If a patient originally suffered from alcohol or food injury, they may also exhibit headache, body heat, trembling, and aversion to cold. Physicians, failing to examine the pulse or investigate the root cause, treat it as Shanghan (Cold Damage) and attempt to resolve it through sweating, using herbs such as Ramulus Cinnamomi (Guizhi, 桂枝), Herba Ephedrae (Mahuang, 麻黄), and Rhizoma Cimicifugae (Shengma, 升麻). When sweating fails to resolve the condition, doubt arises, leading to the generation of other complications. How many deaths can be counted from such errors?
Consider chronic cough, emaciation, reduced appetite, and worsening symptoms at night while quiet during the day. Physicians, without careful examination, administer fruits such as Fructus Mume (Wumei, 乌梅), Pericarpium Papaveris (Yingsuqiao, 罂粟壳), Flos Asteris (Ziwan, 紫菀), and Alum (Kufan, 枯矾). Such harsh astringent attacks leave the cough unresolved and induce stagnation diseases. With cough compounded by stagnation, dietary intake further decreases. Physicians, again failing to examine carefully, use hot-natured agents to nourish the stomach and warm-natured agents to harmonize the spleen. This results in sweating on the head and face, onset of dryness and tidal fever, emaciation, and upward flow of saliva like a gushing spring. Deaths resulting from this are innumerable.
Regarding postpartum ailments in women, these are often caused by retained blood and evil substances, presenting with alternating chills and fever, cramping pain in the umbilical and abdominal regions, dry and shriveled breasts, and slightly reduced appetite. Physicians, failing to examine carefully, assume that losing several dou of blood postpartum means both qi and blood are deficient. They then use warm-tonifying agents to nourish blood and tonify deficiency, treating it as a cold syndrome. This is universally practiced. Do they not know that pregnancy in women is akin to heaven and earth nurturing things? Things are born only after the harmony of yin and yang; humans conceive only after the harmony of yin and yang. Can conception occur with an excess of either yin or yang alone? What difference is there between this and grains, millet, melons, and fruits? If water and drought are untimely, flowers and fruits will wither and fall. How is this different from pregnancy that does not result in birth? After the Start of Autumn in the seventh month, if no grass bears fruit for eighteen days, it is because the weather is cold. Now, a woman carries a fetus for ten months without difficulty and gives birth, yet it is labeled as a cold syndrome. Is this not a profound failure to investigate principles? I liken this to brick makers: fire burns below, and water is poured on the top of the kiln, thus forming bricks. Once the bricks exit the kiln, the kiln instantly becomes cold! The common people blindly transmit formulas such as Heishen San (Black Divine Powder) to treat eighteen postpartum syndromes. Not only do these fail to cure, but they also cause the meridians to become dry and closed, dysuria, retention of urine and feces, vomiting, cough, and phlegm, generating all sorts of heat syndromes. Deaths from such errors are incalculable. It would be better to combine Siwu Tang (Four Substances Decoction) with Liangge San (Cool the Chest Powder), prepare them as a large decoction, and administer them to induce several bowel movements. Once the evil substances are exhausted, subsequent administration of bland and sweet agents will lead to self-healing.
Consider infants with abdominal distension, wheezing, coughing, and difficult expectoration of phlegm. Physicians, failing to examine carefully, administer Baibingzi (White Cake Pills). Baibingzi contains Radix Crotonis Tiglii (Baidu Dou, 巴豆), which is extremely hot and highly toxic, combined with Calomelas (Nifen, 腻粉/轻粉). Later, the child inevitably develops oral ulcers, upper respiratory wheezing, coughing, vomiting, and loss of appetite. Although this might be effective for poor families' children, for wealthy families' children, it will certainly generate other diseases. This is beyond doubt.
Consider diarrheal diseases, which occur every year. Physicians, failing to examine carefully, administer Shengsanzi (Holy Dispersion Formula), containing Radix Zingiberis Preparata (Ganjiang, 干姜), Lapis Kaolinicus (Chishizhi, 赤石脂), Fructus Mume (Wumei, 乌梅), Pericarpium Papaveris (Yingsuqiao, 罂粟壳), Cortex Cinnamomi (Guangui, 官桂), Pericarpium Granati (Shiliupi, 石榴皮), Os Draconis (Longgu, 龙骨), and Concha Ostreae (Muli, 牡蛎). This transforms into urinary retention (Longbi, 癃闭); severe cases develop into abdominal distension; even more severe cases develop edema. Occasionally, some recover because the disease was mild; severe cases will definitely not recover.
Consider patients with retained fluid (Tingyin, 停饮), possibly due to excessive cold injury in summer. This indicates an excess of pathogenic qi in the Spleen and Stomach. It should be purged and removed. Physicians should not tonify it under the assumption of Spleen deficiency; otherwise, palpitations and fullness will worsen. Some use Radix Crotonis Tiglii pills to purge. Although the disease alleviates slightly, the patient inevitably loses appetite, and upper dryness diseases arise.
Consider patients suffering from severe pain in the knees, ankles, elbows, and wrists due to sprains or dislocations. Physicians, failing to examine carefully, use acupuncture to bleed. If not cured, they repeat bloodletting multiple times. Excessive blood loss leads to limping. The *Neijing* states: "The feet can walk only when they receive blood." How can one walk when the blood is exhausted? My treatment for sprains is different. I use Yugong San (Meritorious Action Powder), or Tongjing (2–3 qian), administered orally; or Shenyu Wan (Divine Blessing Pill), or Chushi Dan (Dampness-Expelling Pill), administered in quantities of over a hundred pills, to vigorously purge ten to twenty bowel movements. Then, pain transforms into itching. Pain belongs to Summer, itching belongs to Autumn; when pain exits, Summer [pathogens] decline! This is the principle of the victory and recovery of the Five Phases.
Therefore, whether it is pain in the waist, hips, or flanks, or injuries from beating, falling from horses, or blows and falls, the principle is the same. These pains originate externally and are not due to innate deficiency of Yuan Qi (Original Qi). The ancients said: "Pain diminishes with purgation." It is appropriate to vigorously purge ten to twenty bowel movements. One must avoid hot wine, and the disease can be cured with one prescription. Do not consider vigorous purgation lightly or disdain this method. In the past, someone suffered from toothache for months. Using an iron bell-shaped tool to extract teeth, they bled to death. Another person suffered from upper and lower toothache and extracted teeth wherever there was pain. Within a few years, all upper and lower teeth were lost. By age fifty, they could not eat hard foods. Upper and lower toothaches are caused by excessive wind-heat in the Hand and Foot Yangming Meridians. Da Chengqi Tang (Major Order the Qi Decoction), Xiao Chengqi Tang (Minor Order the Qi Decoction), Zangyong Wan (Storehouse Use Pill), and Qufeng Wan (Wind-Expelling Pill) can be used to purge, and the pain will stop naturally. The *Neijing* states: "All pain, itching, sores, and ulcers belong to Heart Fire." Qixuanzi (Wang Bing) stated: "All kinds of origins arise from the Heart." The Heart belongs to Fire; Fire generates Earth. The error of extracting teeth must be understood.
Furthermore, those treating edema and pain often use Calomelas (Shuiyin, 水银), Calomelas (Qingfen, 轻粉), and Baiwanzi (White Pill), which are highly toxic purgatives. Edema does not subside, but teeth fall out. Once teeth are lost and eating ceases, the body's fluids are exhausted, leading to immediate death. Others puncture the soles of the feet to drain fluid; when the fluid is exhausted, death ensues.