概用药之弊也，始于执流而忘源，信方而遗理，泥成方之验，不解随人活泼，胶章
句之迹，未能广会灵通。王太仆曰∶粗工偏浅，学问未精，以热攻寒，以寒疗热，治热
未已，而冷疾顿生，攻寒日深，而热病更起，热起而中寒尚在，寒生而外热不除，欲
攻寒，则惧热不前，欲疗热，则思寒又止，岂知脏腑之源，有寒热温凉之主哉！夫药有
君臣佐使，逆从反正，浓薄轻重，畏恶相反，未得灵通，而漫然施疗，许学士所谓猎
不知兔，广络源野，术亦疏矣。君为主，臣为辅，佐为助，使为用，制方之原也。逆则
攻，从则顺，反则异，正则宜，治病之法也。必热必寒，必散必收者，君之主也。不
宣不明，不受不行者，臣之辅也。能受能令，能合能公者，佐之助也。或击或发，或
劫或开者，使之用也。破寒必热，逐热必寒，去燥必濡，除湿必泄者，逆则攻也。治
惊须平，治损须温，治留须收，治坚须溃者，从则攻也。热病用寒药，而导寒攻热者
必热，如阳明病发热，大便硬者，大承气汤，酒制大黄热服之类也。寒病用热药，而
疗热去寒者必寒，如少阴病下利，服附子、干姜不止者，白通汤加入尿、猪胆之类也。
塞病用通药，而导通除塞者必塞，如胸满烦惊，小便不利者，柴胡加龙骨、牡蛎之类
也。通病用塞药，而导塞止通者必通，如太阳中风下利，心下痞硬者，十枣汤之类。反
则异也。治远以大，治近以小，治主以缓，治客以急，正则宜也。轻清成象，重浊成
形，清阳发腠理，浊阴走五脏，清中清者，荣养于神，浊中浊者，坚强骨体，辛甘发散
为阳，酸苦涌泄为阴，气为阳，气浓为阳中之阳，气薄为阳中之阴，薄则发泄，浓则发
热，味为阴，味浓为阴中之阴，味薄为阴中之阳，薄则疏通，浓则滋泄，亲上亲下，各
从其类也。畏者，畏其制我，不得自纵。恶者，恶其异我，不得自知。畏恶之中，亦可
相成，在因病制方轻重多寡之间也。至于相反，两仇不共，然大毒之病，又须大毒之药
以劫之，虽相反之中，亦有相成之妙，神化在是，顾良工用之耳，奈何近医舍至灵至变
之玄理，而执不灵不变之成方，果若斯之奇，则上古圣贤，千言万卷，只为赘余，而
今之学人，神圣工巧，一切可废矣。不知方之为言，仿也，仿病而有方也。其将立也，
因是病而后成，融通不滞。其既立也，非是病则勿用，确然难移。是以《素问》无方，
《难经》亦无方，非无方也，为仿，为活法也。汉世才有方，为借于仿也。今奇方疗
疾，倘果可以发无不中，则昔者轩、岐、扁、仓，神灵之智，慈济之仁，岂不及此，
何不每一病，只立一方，使后人彰明显著，用无不当，而乃广为昭析，多立文词，以累
后学，纷赜难穷，效无十全哉！虽然，方不可泥，亦不可遗，以古方为规矩，合今病而
变通，既详古论之病情，复揣立万之奥旨，或病在上而治反在下，病在下而治反在上，
病同而药异，病异而药同，症端蜂起，而线索井然，变现多危，而持执不乱，诚为良
矣。倘此旨未达，逐症寻求，既治其上，又攻其下，既疗其彼，复顾其此，本之不揣，
药无精一，如着百家衣，徒为识者笑，救头救脚之讥，宁能免夫。要知一身所犯，病情
虽多，而其源头，只在一处，治其一，则百病消，治其余，则头绪愈多，益增别病。盖
古今亿万人之形体虽殊，而其相传相成之脏腑、阴阳则一，百病之害人虽异，而治法不
外乎气血虚实之间，虚实既明，而寒热亦在其中。正强邪盛者，亟祛邪以保正，正弱邪
强者，亟保正以御邪，务使神气勿伤，长有天命。盖岐黄仁术，原重生命以治病，故每
重本而轻标，何今之人，徒知治病而罔顾生命，每多遗本顾末，不惟不胜治，终亦不可
治也。故能于虚实寒热邪正处灼然明辨，则益心之阳，寒亦通行，强肾之阴，热亦痊
可。发舒阳气，以生阴精，滋养阴精，以化阳气，或养正而邪自除，或驱邪而正始复，
或因攻而为补，或借补为攻，治千万种之疾病，统不出乎一理之阴阳。苟临症狐疑，不
知所重，姑以轻和之剂，以图万一之功，昔有直入之兵，焉望捷得之效？因循待毙，亦
何异于操刃杀人！此皆不求至理，徒守成方者之误也。
用药的弊端，始于拘泥于表象而忘记根本，迷信固定方剂而忽略医理，死守成方的疗效，却不理解根据患者具体情况灵活变通，拘泥于文字字句的痕迹，未能广泛领会灵动通达的道理。王冰（王太仆）说：粗疏的医生偏颇浅薄，学问不精，用热药攻治寒证，用寒药治疗热证，治疗热病还没结束，冷疾就突然产生；攻治寒病日益深入，热病却更加兴起。热邪起而中焦寒邪仍在，寒邪生而体表热邪未除。想要攻逐寒邪，又畏惧热邪不敢前进；想要治疗热邪，又顾虑寒邪而停止。哪里知道脏腑的源头，是有寒、热、温、凉的主次之分的啊！
药物有君、臣、佐、使的配合，有逆治、从治、反治、正治的区别，有浓淡、厚薄、轻重之分，有相畏、相恶、相反的关系。如果没有灵动通达的智慧，就随意施治，正如许叔微（许学士）所说的那样：像打猎却不知道兔子在哪里，在广阔的田野里盲目张网，这种医术也是疏漏的。君药为主帅，臣药为辅佐，佐药为协助，使药为引导，这是制方的原则。逆则攻邪，从则顺气，反则异法，正则适宜，这是治病的方法。必须用热药或必须用寒药，必须发散或必须收敛，这是君药的主导作用。不能宣通就不明达，不能受纳就不能运行，这是臣药的辅助作用。能够受纳命令，能够配合协同，这是佐药的协助作用。或者攻伐或者激发，或者劫夺或者开泄，这是使药的作用。
破除寒邪必须用热药，驱逐热邪必须用寒药，去除燥结必须滋润，除湿邪必须渗泄，这是“逆则攻”的原则。治疗惊悸须平定，治疗虚损须温补，治疗留滞须收敛，治疗坚硬须软坚散结，这是“从则攻”的原则。治疗热病使用寒药，但引导寒邪以攻逐热邪时，药性必显热意，例如阳明病发热、大便硬结者，使用大承气汤，将大黄用酒炮制后热服之类。治疗寒病使用热药，但引导热势以去除寒邪时，药性必显寒意，例如少阴病下利，服用附子、干姜不止者，在白通汤中加入人尿、猪胆汁之类。治疗闭塞的病使用通利药，但引导通利以消除闭塞时，药性必显塞意，例如胸满烦惊、小便不利者，使用柴胡加龙骨牡蛎汤之类。治疗通利的病使用固涩药，但引导固涩以止住通利时，药性必显通意，例如太阳中风伴下利、心下痞硬者，使用十枣汤之类。这就是“反则异”。
治疗远处的病用大方，治疗近处的病用小方，治疗本脏的病用缓剂，治疗客邪的病用急剂，这是“正则宜”的原则。轻清之气形成象，重浊之气形成形，清阳之气发越于腠理，浊阴之气走注于五脏。清中之清者，荣养精神；浊中之浊者，坚固骨骼形体。辛味和甘味发散属于阳，酸味和苦味涌吐泄下属于阴。气属于阳，气浓厚者为阳中之阳，气淡薄者为阳中之阴，气薄则发泄，气浓则发热。味属于阴，味浓厚者为阴中之阴，味淡薄者为阴中之阳，味薄则疏通，味浓则滋泄。药物亲上或亲下，各自遵循其同类属性。
所谓“畏”，是畏惧它制约我，使我不能放纵妄行。所谓“恶”，是厌恶它与我不合，使我不能自知相投。在相畏和相恶之中，也可以相互成就，关键在于根据病情制定方剂时的轻重多寡调配。至于“相反”，如同两仇敌不能共存，但对于大毒的疾病，又必须用大毒的药物来劫夺病邪，虽然在相反之中，也有相互成就的妙处，神妙的变化就在这里，只看高明医生如何运用罢了。为什么现在的医生舍弃了最灵动变化的玄妙道理，而固执于不灵动不变的成方？如果真是这样神奇，那么上古圣贤千言万卷，都成了多余，而现在的学习者，神圣工巧的一切医术都可以废除了。
不知道“方”的意思就是“仿”，模仿病情而设立方剂。当它确立之前，是因为这个病才形成的，融通而不凝滞。当它确立之后，如果不是这个病就不要使用，坚定不可移易。所以《素问》没有具体的方剂，《难经》也没有方剂，不是没有方剂，而是为了示范，为了活法。到了汉代才有固定的方剂，是为了借鉴模仿。现在奇方治疗疾病，如果真的可以发射无有不中，那么昔日的轩辕、岐伯、扁鹊、仓公，他们神灵般的智慧，慈悲救济的仁爱，难道不如这些人吗？为什么不每种病只设立一个方子，让后人明显显著地使用，没有不当之处，反而广泛地昭示分析，设立很多文词，连累后世学者，纷繁复杂难以穷尽，疗效没有十全十美的呢！
虽然如此，方剂不可拘泥，也不可遗弃。以古方为规矩，结合今病而变通，既详细研究古论中的病情，又揣度创立万法的奥旨。或者病在上而治疗反而在下，病在下而治疗反而在上，病相同而药物不同，病不同而药物相同，症状端绪蜂拥而起，而线索井然有序，变现情况多危重，而持守执念不乱，这才是良医。如果这个宗旨没达到，逐症寻求，既治疗上面，又攻治下面，既治疗这里，又顾及那里，根本不揣度，药物不精专一致，就像穿着百家衣，徒然被识者嘲笑，救头救脚的讥讽，怎么能避免呢？要知道一身所患，病情虽然多，但源头只在一处，治好这一处，百病消解；治疗其余的，则头绪越多，反而增加其他疾病。
大概古今亿万人形体虽然不同，但他们相传相成的脏腑、阴阳是一致的。百病害人虽然各异，但治法不外乎气血虚实之间。虚实既然明了，寒热也就在其中了。正气强盛邪气盛者，亟需祛除邪气以保护正气；正气虚弱邪气强者，亟需保护正气以抵御邪气。务必使神气不受损伤，长久保有天命。大概岐黄仁术，原本重视生命以治病，所以每重本而轻标。为什么现在的人，只知道治病而不管生命，大多遗留根本只顾末节，不仅不胜任治疗，最终也无法治愈。所以能在虚实、寒热、邪正之处灼然明辨，那么益心之阳，寒邪也能通行；强肾之阴，热邪也能痊愈。发舒阳气以生阴精，滋养阴精以化阳气，或者养正而邪自除，或者驱邪而正始复，或者因攻而为补，或者借补为攻，治疗千万种疾病，统不出乎一理之阴阳。如果临症狐疑，不知道重点所在，姑且用轻和的药剂，以求万一的功效，昔日有直入之兵，焉能指望捷报？因循等待死亡，又有什么不同于拿着刀杀人呢！这都是不求至理，只守成方的医生的错误。
The drawbacks of using medicine begin with clinging to superficial phenomena while forgetting the root, believing in fixed prescriptions while neglecting medical principles, adhering rigidly to the efficacy of established formulas without understanding how to adapt flexibly to individual patients, and being stuck on literal interpretations rather than broadly grasping agile and penetrating wisdom. Wang Bing (Wang Taipu) said: "Rough practitioners are biased and shallow, their learning not refined; they use hot medicines to attack cold syndromes and cold medicines to treat heat syndromes. Before the treatment for heat is finished, cold diseases suddenly arise; as the attack on cold deepens day by day, heat diseases emerge again. When heat arises, the cold in the middle jiao remains; when cold generates, the external heat is not eliminated. If one wishes to attack the cold, one fears the heat and dares not advance; if one wishes to treat the heat, one hesitates due to the cold and stops. How can they know that the source of the Zang-Fu organs has a hierarchy of Cold, Heat, Warmth, and Coolness!"
Medicines have the roles of Jun (Monarch), Chen (Minister), Zuo (Assistant), and Shi (Envoy); there are treatments of Ni (Rebellious/Contrary), Cong (Following), Fan (Reverse), and Zheng (Regular); distinctions in density, thickness, and weight; and relationships of Wei (Fear), E (Aversion), and Xiang Fan (Mutual Opposition). Without agile and penetrating wisdom, administering treatment arbitrarily is like what Xu Shumi (Xu Xueshi) described: "Hunting without knowing where the rabbit is, spreading nets widely across the fields"—this kind of medical skill is indeed deficient. The Jun herb acts as the commander, Chen herbs as assistants, Zuo herbs as helpers, and Shi herbs as guides; this is the principle of formulating prescriptions. Treating by opposing pathogenic factors is "Ni", following the disease nature is "Cong", using contrary methods is "Fan", and applying regular approaches is "Zheng"; these are the methods of treating diseases. Necessitating hot or cold, necessitating dispersing or astringing, represents the dominant role of the Jun herb. Inability to circulate leads to lack of clarity; inability to receive leads to failure of movement; this is the auxiliary role of Chen herbs. Being able to receive commands and cooperate harmoniously is the assisting role of Zuo herbs. Striking or stimulating, purging or opening, is the functional role of Shi herbs.
To break cold, one must use hot medicines; to drive out heat, one must use cold medicines; to remove dryness, one must moisten; to drain dampness, one must purge; this is the principle of "Ni Ze Gong" (Opposing to Attack). To treat palpitations/fright, one must calm; to treat deficiency/injury, one must warm; to treat stagnation, one must astringe; to treat hardness, one must soften; this is the principle of "Cong Ze Gong" (Following to Treat). When treating heat syndromes with cold medicines, but guiding the cold to attack the heat, the medicinal property must manifest heat. For example, in Yangming syndrome with fever and hard stool, Da Cheng Qi Tang (Major Order the Qi Decoction) is used, such as taking Rhubarb processed with wine while hot. When treating cold syndromes with hot medicines, but guiding the heat to eliminate the cold, the medicinal property must manifest cold. For example, in Shaoyin syndrome with diarrhea, if Aconite and Dried Ginger fail to stop it, Bai Tong Tang (White Pass Decoction) is modified with human urine and pig bile. When treating obstruction syndromes with unblocking medicines, but guiding unblocking to remove obstruction, the medicinal property must manifest blocking. For example, in cases of chest fullness, vexation, fright, and difficult urination, Chai Hu Jia Long Gu Mu Li Tang (Bupleurum Decoction plus Dragon Bone and Oyster Shell) is used. When treating unblocking syndromes with obstructing/astringent medicines, but guiding obstruction to stop unblocking, the medicinal property must manifest unblocking. For example, in Taiyang Wind Strike with diarrhea and epigastric stiffness, Shi Zao Tang (Ten Jujube Decoction) is used. This is "Fan Ze Yi" (Reverse implies difference).
Treating distant diseases requires large formulas; treating nearby diseases requires small formulas; treating the primary organ requires slow-acting remedies; treating exogenous pathogens requires urgent remedies; this is "Zheng Ze Yi" (Regular implies suitability). Light and clear qi forms images; heavy and turbid qi forms structure. Clear Yang ascends to the Cou Li (interstices/skin muscles); Turbid Yin descends to the Five Zang organs. That which is clear within the clear nourishes the Shen (Spirit); that which is turbid within the turbid strengthens the bones and body. Pungent and Sweet flavors disperse and belong to Yang; Sour and Bitter flavors induce vomiting and purging and belong to Yin. Qi belongs to Yang; dense Qi is Yang within Yang; thin Qi is Yin within Yang. Thin Qi dissipates; dense Qi generates heat. Flavor belongs to Yin; dense flavor is Yin within Yin; thin flavor is Yang within Yin. Thin flavor promotes circulation; dense flavor nourishes and drains. Medicinals tend toward the upper or lower parts, each following its own category.
"Wei" (Fear) means fearing that the substance will restrain me, preventing me from acting recklessly. "E" (Aversion) means disliking that it differs from me, preventing mutual compatibility. Within Wei and E, mutual achievement is possible, depending on the dosage and proportion adjusted according to the disease. As for "Xiang Fan" (Mutual Opposition), enemies cannot coexist. However, for severe toxic diseases, highly toxic medicines are required to seize the pathogen. Even within opposition, there is a subtle synergy of mutual achievement. Divine transformation lies herein, relying solely on the skill of the expert practitioner. Why do modern physicians abandon the most agile and variable profound principles, clinging instead to inflexible, established formulas? If this were truly miraculous, then the thousands of words and volumes of the ancient sages would be superfluous, and all knowledge of the sacred, divine, skilled, and adept arts of today could be discarded.
Do you not know that "Fang" (Formula) means "Fang" (Imitation)? Formulas are established by imitating the disease. Before establishment, they are formed because of the specific disease, flowing freely without stagnation. After establishment, if it is not that specific disease, they should not be used; they are firm and immovable. Therefore, the *Su Wen* (Basic Questions) contains no specific formulas, nor does the *Nan Jing* (Classic of Difficult Issues). This is not because there are no formulas, but because they serve as models and living methods. Fixed formulas only appeared in the Han Dynasty, borrowed from imitation. If modern miraculous formulas could truly hit the target every time, would the spiritual wisdom and benevolent compassion of Xuanyuan, Qibo, Bian Que, and Cang Gong be inferior to this? Why did they not establish just one formula for each disease, making it obvious for later generations to use correctly, yet instead extensively analyzed and wrote many texts, burdening future learners with complexity and difficulty, resulting in no perfect efficacy!
Nevertheless, formulas should not be rigidly adhered to, nor should they be neglected. Use ancient formulas as rules, adapting them to current diseases. Thoroughly study the disease conditions in ancient theories, and comprehend the profound essence of creating myriad methods. Sometimes, disease located above is treated below, and disease located below is treated above; diseases are similar but medicines differ, diseases differ but medicines are similar. Symptoms may arise like bees, yet the thread of logic remains orderly; manifestations may be critical, yet adherence remains steady. This is truly excellent. If this principle is not understood, seeking treatment symptom by symptom—treating the top then attacking the bottom, treating here then attending there, without assessing the root, lacking precision in medicine—is like wearing clothes patched from a hundred families, merely becoming a laughingstock to experts. How can one avoid the ridicule of "saving the head but losing the feet"? Know that although the body suffers from many conditions, the source lies in one place. Treating this one source eliminates hundred diseases; treating the rest increases confusion and creates other ailments.
Although the physical forms of hundreds of millions of people throughout history differ, the transmitted and mutually supportive Zang-Fu organs and Yin-Yang are identical. Although the harm caused by hundred diseases varies, treatment methods do not go beyond the realms of Qi-Blood and Deficiency-Excess. Once Deficiency and Excess are clarified, Cold and Heat are included therein. When Zheng Qi (Upright Qi) is strong and Xie Qi (Pathogenic Qi) is excessive, urgently dispel the pathogen to protect the upright. When Zheng Qi is weak and Xie Qi is strong, urgently protect the upright to resist the pathogen. Ensure the Shen Qi (Spiritual Qi) is not injured, preserving natural lifespan. The Benevolent Art of Qi Bo and Huang Di originally emphasized life to treat disease, thus prioritizing the root over the branch. Why do people today only know how to treat the disease while ignoring life, often neglecting the root for the branch? Not only is treatment ineffective, but ultimately incurable. Therefore, if one can clearly distinguish between Deficiency/Excess, Cold/Heat, Pathogen/Upright, then benefiting Heart Yang allows even Cold to circulate; strengthening Kidney Yin allows even Heat to heal. Disseminating Yang Qi generates Yin Essence; nourishing Yin Essence transforms into Yang Qi. One may nourish the upright so the pathogen removes itself, or expel the pathogen so the upright recovers. One may use attack as tonification, or tonification as attack. Treating thousands of diseases ultimately does not exceed the single principle of Yin and Yang. If one hesitates at the bedside, unsure of priorities, and tentatively uses mild and harmonizing agents hoping for a slight effect, how can one expect victory akin to an army charging directly? Delaying until death arrives is no different from wielding a knife to kill! These are the errors of those who seek no profound truth and merely guard established formulas.