徐之才十剂∶宣、通、补、泄、轻、重、滑、涩、燥、湿。王好古补二种曰∶寒可去热
黄、芒硝之属是也；热可去寒，附子、官桂之属是也。药之用已无遗。《心印绀珠经》标十
八剂之目曰∶轻、解、清、缓、寒、调、甘、火、暑、淡、湿、夺、补、平、荣、涩、温、
郑康成《周官疾医》注∶五谷∶麻、黍、稷、麦、豆。《素问》以麦、黍、稷、稻、豆
谷，分属心、肝、脾、肺、肾，治病当从之。《程杏轩医案辑录》治胸脘胀痛，泛泛欲呕，食
面尚安，稍饮米汤，脘中即觉不爽，谓肝之谷为麦，胃弱故米不安，肝强故麦可受，当用安
胃制肝法，此得《内经》之旨者也。
名家治病，往往于众人所用方中加一味药，即可获效。如宋徽宗食冰太过患脾疾，杨吉
大理中丸，上曰∶服之屡矣。杨曰∶疾因食冰，请以冰煎此药，是治受病之源也。果愈。杜清
碧病脑疽，自服防风通圣散，数回不愈，朱丹溪视之曰∶何不以酒制之？清碧乃悟，服不尽
剂而愈。张养正治闻教谕羸疾，吴医皆用三白汤无效，张投熟附二三片，煎服即瘥。缪仲淳
治王官寿遗精，闻妇人声即泄，瘠甚欲死，医者告术穷，缪之门人以远志为君，连须、石莲子
为臣，龙齿、茯神、沙苑蒺藜、牡蛎为佐使，丸服稍止，然终不断，缪加鳔胶一味，不终剂
即愈。叶天士治难产，众医用催生药不验，是日适立秋，叶加梧桐叶一片，药下咽即产。嘉
定何弁伯患呕吐，医用二妙丸不效，徐灵胎为加茶子四两，煎汤服之遂愈。因其病茶积，故
用此为引经药。略识数条，以见治病者，必察理精而运机敏，始能奏捷功也。
邹润庵治一人暑月烦满，以药搐鼻不得嚏，闷极，遂取药四五钱匕，服之，烦满益甚，昏不
知人，不能言语，盖以药中有生半夏、生南星等物也。邹谓南星、半夏之毒，须姜汁乃解，
盛暑烦懑，乌可更服姜汁？势必以甘草解之，但其味极甘，少用则毒瓦斯不解，服至一二钱，
即不能更多，因以甘草一斤蒸露饮之，饮尽而病退。凡病者畏药气之烈，恶药味之重，皆可
仿用此法。陈载庵尝治一人，热甚喉痛，用甘草、桔梗、连翘、马勃、牛蒡、射干、元参等
味，其人生平饮药即呕，坚不肯服而病剧，又不能不进药，乃令以药煎露，饮二十余碗而全
许允宗治王太后病风不能言，以防风、黄 煎汤数斛，置床下熏蒸，使口鼻俱受，此夕便得
语。陆严治徐氏妇产后血闷暴死，胸膈微热，用红花数十斤，大锅煮汤，盛木桶，令病者寝
其上熏之，汤气微，复进之，遂得苏，此善师古法者也。李玉治痿，谓病在表而深，非小剂
愈，乃熬药二锅，倾缸内稍冷，令病者坐其中，以药浇之，超时汗大出立愈，则又即其法而
变化之。医而若此，与道大适矣。
吴人畏服重药，马元仪预用麻黄浸豆发 ，凡遇应用麻黄者，方书大黄豆卷，俾病家无
惧。（当时治病皆于医家取药。）徐灵胎治张某病当用大黄，恐其不服，诡言以雪蛤蟆配药制
丸，与服得瘥。可想见良工心苦，非拘方之士所能及也。
病有因偏嗜食物而成者，非详问得之，奚由奏效？前人治验，略志数则，以资玩索。朱
治叔祖泄泻，脉涩而带弦，询知喜食鲤鱼，以茱萸、陈皮、生姜、砂糖等药探吐胶痰而泻止
。林学士面色顿青，形体瘦削，夜多惊悸，杜某询知喜食海蛤味咸，故心血衰，令多服生津
液药而病愈。富商患腹胀，百药无效，反加胃呕食减 羸，一草泽医询知夏多食冰浸瓜果，
取凉太过，脾气受寒，医复用寒凉，重伤胃气，以丁香、木香、官桂健脾和胃，肺气下行，
由是病除。赵尹好食生米而生虫，憔悴萎黄，不思饮食，用苍术米泔水浸一夜，锉焙末，蒸
饼丸米汤下而愈。吴孚先治长夏无故四肢厥冷，神昏不语，问之曾食猪肺，乃令以款冬花二
两煎汤灌之而痊，盖所食乃瘟猪肺也。沈绎治肃王嗜乳酪获疾，饮浓茶数碗，荡涤膈中而愈
薛立斋治一老人，似痢非痢，胸膈不宽，用痰痢等药不效，询知素以酒乳同饮，为得酸则凝
结，得苦则行散，逐以茶茗为丸，时用清茶送三五十丸，不数服而瘥。吴廷绍治冯延已胸中
痛，询知平日多食山鸡、鹧鸪，投以甘草汤而愈。杨吉老治杨立之喉痛溃烂，饮食不进，询
知平日多食鹧鸪肉，令食生姜一片，觉香味异常，渐加至半斤余，喉痛顿消，饮食如故。梁
新治富商暴亡，谓是食毒，询知好食竹鸡，令捣姜捩汁折齿灌之而苏。某医治一妇面生黑斑
数点，日久满面俱黑，询知日食斑鸠，用生姜一斤切碎研汁，将滓焙干，却用生姜煮汁糊丸
食之，一月平复。盖山鸡、鹧鸪、竹鸡、斑鸠皆食半夏，故以解其毒也。沈宗常治庐陵人胀
而喘，三日食不下咽，视脉无他，问知近食羊脂，曰∶脂冷则凝，温熨之所及也。温之得利
治痼病宿病有不能求速愈者，如朱丹溪治虚损瘦甚，右胁下痛，四肢软弱，用二陈汤加白芥
子、枳实、姜炒黄连、竹沥，八十贴而安。祝仲宁治脚膝痹痛，服清燥汤百剂而愈。此类甚
多，当初服数剂时，必不见效，非信任之深，谁能耐久乎？吁！世之延医治病，往往求其速效
，更易医者，杂投方药而病转增剧，盖比比然矣。
袁随园作《徐灵胎先生传》有云∶张雨村儿生无皮，先生命以糯米作粉糁其体，裹以绢
之土中，出其头，饮以乳，两昼夜而皮生。此盖有所本也。元·危亦林《得效方》∶生子无
皮，速用白早米粉干扑，候生皮方止。明·葛可久治舟人生子身无全肤，令就岸畔作一坎置
其中，以细土隔衾覆之，且戒勿动，久之生肤，盖其母怀妊舟中，久不登岸，失受土气故也
。徐参用二法而得效，洵乎医之贵博览也。
治妇人肝症，每用疏泄攻伐之药，而不知阴受其伤。治小儿惊风，每用香窜镇重之剂，
知隐贻之害。治肝莫善于高鼓峰之滋水法，治风莫善于吴鞠通之解儿难，询可以挽积弊，拯
世人袭引火归源之说以用桂、附，而不知所以用之之误，动辄误人。今观秦皇士所论，
用桂、附之准，特录于此。赵养葵用附、桂辛热药，温补相火，不知古人以肝肾之火喻龙雷
者，以二经一主乎木，一主乎水，皆有相火存其中，故乙癸同源。二经真水不足，则阳旺阴
亏，相火因之而发，治宜培养肝肾真阴以制之。若用辛热摄伏，岂不误哉？夫引火归源而用附
、桂，实治真阳不足。无根之火，为阴邪所逼，失守上炎，如戴阳阴躁之症，非龙雷之谓也
。（何西池曰∶附、桂引火归源为下寒上热者言之，若水涸火炎之症，上下皆热，不知引此
火归于何处？此说可与秦论相印证。）龙雷之火，肝肾之真阴不足，肝肾之相火上炎，水亏火
旺，自下冲上，此不比六淫之邪天外加临，而用苦寒直折，又不可宗火郁发之，而用升阳散
火之法，治宜养阴制火，六味丸合滋肾丸及家秘肝肾丸（地黄、天冬、归身、白芍、黄柏、
知母，共研细末，元武胶为丸。）之类是也。
病有上下悬殊者，用药殊难。《陆养愚医案》有足以为法者，录之。陆前川素患肠风便
燥，冬天喜食铜盆柿，致胃脘当心而痛，医以温中行气之药疗其心痛，痛未减而肠红如注，以寒
凉润燥之药疗其血，便未通而心痛如刺，陆诊其脉，上部沉弱而迟，下部洪滑而数，曰∶此
所谓胃中积冷，肠中热也。用润字丸三钱，以沉香衣其外，浓煎姜汤送下二钱，半日许，又
送一钱，平日服寒凉药一过胃脘，必痛如割，今两次丸药，胸膈不作痛，至夜半大便行极坚
而不甚痛，血减平日十之六七，少顷又便一次，微痛而血亦少，便亦不坚，清晨又解溏便一次
，微见血而竟不痛矣，惟心口之痛尚未舒，因为合脏连丸，亦用沉香为衣，姜汤送下，以清
下焦之热而润其燥，又用附子理中料为散，以温其中，饴糖拌吞之，以取恋膈，不使速下，
不终剂而两症之相阻者并痊，此上温下清之治法也。（卢绍庵曰∶丸者，缓也，达下而后溶
化，不犯中宫之寒。散者，散也，过咽膈即销溶，不犯魄门之热。妙处在于用沉香、饴糖。）
陈曙仓室人咳嗽吐痰有血，夜热头眩，胸膈不舒，脚膝无力，医用滋阴降火药已半年，饮
食渐少，精神渐羸，诊其脉，两寸关沉数有力，两尺涩弱而反微浮，曰∶此上盛下
虚之症。上盛者，心肺间有留热瘀血。下虚者，肝肾之气
不足也。用人参固本丸，令空腹时服之，日中用贝母、苏子、山楂、丹皮、桃仁、红花、小
蓟，以茅根煎汤代水煎药，服之十贴，痰清血上，后以清气养营汤，（茯苓、白芍、归身、
川芎、木香、白豆蔻、陈皮、黄连。）与固本丸间服，三月后病瘥而受孕。此上清下补之治法
物性有相忌者，即可因之以治病。如铁畏朴硝，张景岳治小儿吞铁钉入腹内，用活磁石
，朴硝二钱，并研末，熬熟猪油加蜜和调，与之吞尽，遂裹护铁钉从大便解下。豆腐畏莱菔
，《延寿书》云∶有人好食豆腐中毒，医不能治，作腐家言莱菔入汤中，则腐不成，遂以莱
菔汤下药而愈。菱畏桐油，《橘旁杂论》云∶一医治某嗜菱食之过多，身热胸满，腹胀不食
病势垂危，知菱花遇桐油气辄萎，因取新修船上油滞作丸，入消食行气药中与服，即下黑燥
粪而痊。此类尚多，未能缕举，习医术者，诚不可不博识多闻也。
徐之才提出的“十剂”包括：宣、通、补、泄、轻、重、滑、涩、燥、湿。王好古又补充了两种，即：寒性药可以去除热邪，如黄芩、芒硝之类；热性药可以去除寒邪，如附子、官桂之类。药物的作用已经无所遗漏。《心印绀珠经》列出了十八剂的名称：轻、解、清、缓、寒、调、甘、火、暑、淡、湿、夺、补、平、荣、涩、温、润（注：原文此处似有缺漏或异文，依上下文及常规中医理论，十八剂通常包含润，且后文提到“郑康成...”，此处暂按原文列举）。郑玄在注释《周礼·天官·疾医》时提到五谷：麻、黍、稷、麦、豆。《素问》将麦、黍、稷、稻、豆分别归属于心、肝、脾、肺、肾，治疗疾病应当遵循这一原则。《程杏轩医案辑录》中记载治疗胸脘部胀痛，泛泛欲呕，吃面食尚且安适，稍喝米汤，胃脘中就觉得不舒服，认为肝对应的谷物是麦，胃气虚弱所以米汤不能耐受，肝气强盛所以麦面可以承受，应当采用安胃制肝的方法，这是深得《内经》宗旨的做法。
名医治病，往往在众人所用的方剂中加入一味药，就能获得疗效。例如宋徽宗因吃冰过多患上脾胃病，杨吉老使用大理中丸，皇帝说：“我已经服用了多次。”杨吉老说：“疾病是因为吃冰引起的，请允许我用冰来煎煮这味药，这是治疗致病之源。”果然痊愈。杜清碧患有脑疽，自己服用防风通圣散，几次都不见效，朱丹溪查看后说：“为什么不用酒来炮制药材呢？”清碧于是领悟，服药不到一疗程就痊愈了。张养正治疗闻教谕的瘦弱疾病，吴地医生都用三白汤无效，张投用熟附子二三片，煎服后立即好转。缪仲淳治疗王官寿遗精，听到妇人声音就会射精，身体极度消瘦几乎要死，医生们说无计可施，缪的门人用远志作为君药，连须石莲子作为臣药，龙齿、茯神、沙苑蒺藜、牡蛎作为佐使药，制成丸药服用后症状稍止，但始终不能完全断绝，缪仲淳加入鳔胶一味药，不到一个疗程就痊愈了。叶天士治疗难产，众医生用催生药没有效果，那天恰逢立秋，叶天士加入梧桐叶一片，药咽下后立即分娩。嘉定何弁伯患呕吐，医生用二妙丸无效，徐灵胎为他加入茶子四两，煎汤服用后痊愈。因为他的病是茶积所致，所以用这个作为引经药。略记这几条，以说明治病的人，必须洞察医理精微并且运用机敏，才能取得迅速的功效。
邹润庵治疗一个人在暑月感到烦闷胀满，用药搐鼻不能打喷嚏，憋闷至极，于是取药四五钱匕直接吞服，烦闷更加严重，昏迷不知人事，不能说话，这是因为药中有生半夏、生南星等有毒物质。邹润庵说南星、半夏的毒性，必须用姜汁才能解除，但在盛夏烦闷之时，怎么可以再服用姜汁？势必需要用甘草来解毒，但是甘草味道极甜，少用则毒气不解，服用到一二钱就不能再多了，因此用一斤甘草蒸露饮用，饮尽后病症消退。凡是病人畏惧药气的猛烈，厌恶药味的厚重，都可以仿照这种方法。陈载庵曾治疗一个人，热势很盛喉咙痛，用甘草、桔梗、连翘、马勃、牛蒡、射干、元参等药物，这个人平时喝药就呕吐，坚决不肯服用导致病情加重，但又不能不给药，于是让他把药煎好后露置过夜，喝了二十多碗而完全康复。许允宗治疗王太后患风病不能说话，用防风、黄芪煎汤数斛，放在床下熏蒸，让口鼻都受到药气影响，当晚就能说话了。陆严治疗徐氏妇人产后血晕暴死，胸膈微热，用红花数十斤，大锅煮汤，装在木桶里，让病人睡在上面熏蒸，药气微弱时就再添加，于是苏醒，这是善于师法古人方法的人。李玉治疗痿证，认为病在体表而深入，小剂量药不能治愈，于是熬药两锅，倒入缸内稍冷，让病人坐在其中，用药水浇淋，过了一段时间大汗出立愈，则是根据这种方法而变化运用的。医术达到这种境界，与大道非常契合了。
吴地人害怕服用重药，马元仪预先用麻黄浸泡豆子使其发芽，凡遇到应用麻黄的情况，就在方书中写大黄豆卷，让病人家属没有恐惧。（当时治病都在医家取药。）徐灵胎治疗张某的病应当用大黄，恐怕他不肯服用，谎称用雪蛤蟆配制药制成丸药，给病人服用后病愈。可以想见良工用心之苦，不是拘泥于成方的士人能比得上的。
疾病有因为偏嗜食物而形成的，如果不详细询问怎么能奏效？前人治疗验证的案例，略记几则，以供玩味探索。朱治叔祖患泄泻，脉象涩而带弦，询问得知喜欢食鲤鱼，用茱萸、陈皮、生姜、砂糖等药物探吐胶痰而腹泻停止。林学士面色突然变青，形体瘦削，夜间多惊悸，杜某询问得知喜欢食海蛤味道咸，所以心血衰败，令其多服生津液的药物而病愈。富商患腹胀，百药无效，反而加重胃呕食减，身体羸弱，一位民间医生询问得知夏天多吃冰浸瓜果，取凉太过，脾气受寒，医生又复用寒凉药，重伤胃气，用丁香、木香、官桂健脾和胃，肺气下行，由此病除。赵尹喜欢吃生米而生虫，憔悴萎黄，不思饮食，用苍术在米泔水中浸泡一夜，切碎焙干研末，蒸饼为丸，米汤送下而痊愈。吴孚先治疗长夏无故四肢厥冷，神昏不语，询问曾吃过猪肺，于是令用款冬花二两煎汤灌服而痊愈，原来所吃的是瘟猪肺。沈绎治疗肃王嗜食乳酪获疾，饮浓茶数碗，荡涤膈中而痊愈。薛立斋治疗一位老人，似痢非痢，胸膈不宽，用治痰痢等药无效，询问得知平时以酒乳同饮，因为酸则凝结，苦则行散，遂以茶茗为丸，时常送服三五十丸，不服几次就好了。吴廷绍治疗冯延已胸中痛，询问得知平日多吃山鸡、鹧鸪，投以甘草汤而痊愈。杨吉老治疗杨立之喉痛溃烂，饮食不进，询问得知平日多吃鹧鸪肉，令食生姜一片，觉得香味异常，逐渐加至半斤余，喉痛顿消，饮食如故。梁新治疗富商暴亡，说是食毒，询问得知喜欢吃竹鸡，令捣姜取汁撬开牙齿灌服而苏醒。某医生医治一妇人脸生黑斑数点，日久满面俱黑，询问得知日食斑鸠，用生姜一斤切碎研汁，将渣滓焙干，却用生姜煮汁糊丸食用，一月平复。原来山鸡、鹧鸪、竹鸡、斑鸠都吃半夏，所以用生姜来解其毒。沈宗常治疗庐陵人胀而喘，三日食不下咽，视脉无他，问知近食羊脂，说：“脂冷则凝，需用温熨之法。”温熨之后得利而愈。
治疗顽固疾病宿疾有不能求速愈的，如朱丹溪治疗虚损消瘦严重，右胁下痛，四肢软弱，用二陈汤加白芥子、枳实、姜炒黄连、竹沥，八十帖而安。祝仲宁治疗脚膝痹痛，服清燥汤百剂而愈。此类很多，当初服用几剂时，必然不见效，如果不是信任很深，谁能耐久呢？唉！世上请医生治病，往往求其速效，更换医生，杂投方药而病情转增剧烈，比比皆是。
袁随园作《徐灵胎先生传》中有云：张雨村的儿子出生时无皮，徐先生命人以糯米作粉撒在其体上，裹以绢布埋入土中，露出其头，饮以乳汁，两昼夜而皮生。这大概是有依据的。元代危亦林《得效方》记载：生子无皮，速用白早米粉干扑，候生皮方止。明代葛可久治疗舟人生子身无全肤，令就在岸畔挖一坑放置其中，以细土隔被覆盖，并告诫不要动，久之生肤，大概是因为其母怀孕在舟中，久不登岸，失受土气所致。徐灵胎兼用二法而得效，确实说明医学贵在博览。
治疗妇人肝症，每用疏泄攻伐之药，而不知阴分受其损伤。治疗小儿惊风，每用香窜镇重之剂，不知隐贻之害。治疗肝病莫善于高鼓峰的滋水法，治疗风病莫善于吴鞠通的解儿难，确实可以挽回积弊，拯救世人。有人沿袭引火归源之说而用桂枝、附子，而不知所以用之的错误，动辄误人。现在看秦皇士所论述的，用桂枝、附子的准则，特录于此。赵养葵用附子、桂枝辛热药，温补相火，不知古人以肝肾之火喻为龙雷者，是因为这两经一主乎木，一主乎水，皆有相火存其中，故乙癸同源。二经真水不足，则阳旺阴亏，相火因之而发，治疗宜培养肝肾真阴以制约它。如果用辛热药摄伏，岂不误哉？所谓引火归源而用附子、桂枝，实际上是治疗真阳不足。无根之火，为阴邪所逼，失守上炎，如戴阳阴躁之症，并非指龙雷之火。（何西池说：附子、桂枝引火归源是针对下寒上热而言的，若是水涸火炎之症，上下皆热，不知将此火归于何处？此说可与秦皇士的论述相印证。）龙雷之火，是肝肾之真阴不足，肝肾之相火上炎，水亏火旺，自下冲上，这不同于六淫之邪从天外加临，而不能用苦寒直折，也不可宗奉火郁发之，而用升阳散火之法，治疗宜养阴制火，六味丸合滋肾丸及家秘肝肾丸（地黄、天冬、归身、白芍、黄柏、知母，共研细末，用元武胶为丸）之类是也。
疾病有上下悬殊者，用药殊难。《陆养愚医案》中有足以为法的案例，录之。陆前川素患肠风便燥，冬天喜食铜盆柿，致胃脘当心而痛，医生用温中行气之药疗其心痛，痛未减而肠红如注，用寒凉润燥之药疗其血，便未通而心痛如刺，陆诊其脉，上部沉弱而迟，下部洪滑而数，说：这就是所谓的胃中积冷，肠中热也。用润字丸三钱，以沉香衣其外，浓煎姜汤送下二钱，半日许，又送一钱，平日服寒凉药一过胃脘，必痛如割，今两次丸药，胸膈不作痛，至夜半大便行极坚而不甚痛，血减平日十之六七，少顷又便一次，微痛而血亦少，便亦不坚，清晨又解溏便一次，微见血而竟不痛矣，惟心口之痛尚未舒，因为合脏连丸，亦用沉香为衣，姜汤送下，以清下焦之热而润其燥，又用附子理中料为散，以温其中，饴糖拌吞之，以取恋膈，不使速下，不终剂而两症之相阻者并痊，这是上温下清之治法。（卢绍庵说：丸者，缓也，达下而后溶化，不犯中宫之寒。散者，散也，过咽膈即销溶，不犯魄门之热。妙处在于用沉香、饴糖。）
陈曙仓室人咳嗽吐痰有血，夜热头眩，胸膈不舒，脚膝无力，医生用滋阴降火药已半年，饮食渐少，精神渐羸，诊其脉，两寸关沉数有力，两尺涩弱而反微浮，说：这是上盛下虚之症。上盛者，心肺间有留热瘀血。下虚者，肝肾之气不足也。用人参固本丸，令空腹时服之，日中用贝母、苏子、山楂、丹皮、桃仁、红花、小蓟，以茅根煎汤代水煎药，服之十贴，痰清血上，后以清气养营汤（茯苓、白芍、归身、川芎、木香、白豆蔻、陈皮、黄连），与固本丸间服，三月后病瘥而受孕。这是上清下补之治法。
物性有相忌者，即可因之以治病。如铁畏朴硝，张景岳治疗小儿吞铁钉入腹内，用活磁石、朴硝二钱，并研末，熬熟猪油加蜜和调，与之吞尽，遂裹护铁钉从大便解下。豆腐畏莱菔，《延寿书》云：有人好食豆腐中毒，医不能治，作腐家言莱菔入汤中，则腐不成，遂以莱菔汤下药而愈。菱畏桐油，《橘旁杂论》云：一医治某嗜菱食之过多，身热胸满，腹胀不食，病势垂危，知菱花遇桐油气辄萎，因取新修船上油滞作丸，入消食行气药中与服，即下黑燥粪而痊。此类尚多，未能缕举，习医术者，诚不可不博识多闻也。
Xu Zhicai's "Ten Categories of Medicines" include: Xu (Dispersing), Tong (Unblocking), Bu (Tonifying), Xie (Draining), Qing (Lightening), Zhong (Heaviness), Hua (Slippery), Se (Astringent), Zao (Drying), Shi (Moistening). Wang Haogu added two more categories: Cold-natured medicines can remove heat, such as Huangqin (Scutellariae Radix) and Mangxiao (Natrii Sulfas); Heat-natured medicines can remove cold, such as Fuzi (Aconiti Lateralis Radix Praeparata) and Guigui (Cinnamomi Ramulus). The uses of medicines are now comprehensive. *Xinyin Gan Zhu Jing* lists eighteen categories: Qing (Lightening), Jie (Resolving), Qing (Clearing), Huan (Relaxing), Han (Cold), Tiao (Regulating), Gan (Sweet), Huo (Fire), Shu (Summerheat), Dan (Bland), Shi (Dampness), Duo (Seizing), Bu (Tonifying), Ping (Leveling), Rong (Nourishing), Se (Astringent), Wen (Warming), Run (Moistening). Zheng Xuan, in his commentary on *Zhou Li - Tian Guan - Ji Yi*, mentions the five grains: Ma (Hemp), Shu (Millet), Ji (Setaria), Mai (Wheat), Dou (Beans). *Su Wen* assigns Wheat, Millet, Setaria, Rice, and Beans to the Heart, Liver, Spleen, Lung, and Kidney respectively; treating diseases should follow this principle. In *Cheng Xingxian Yi An Ji Lu*, a case is recorded where the patient suffered from distension and pain in the chest and epigastrium, with nausea. Eating wheat-based foods was comfortable, but drinking rice soup caused discomfort in the epigastrium. It was reasoned that the grain corresponding to the Liver is Wheat, and since the Stomach Qi is weak, it cannot tolerate Rice, while the Liver Qi is strong, so it can accept Wheat. The treatment should employ methods to calm the Stomach and restrain the Liver. This approach aligns with the principles of *Nei Jing*.
Famous physicians often achieve efficacy by adding just one herb to formulas commonly used by others. For instance, Emperor Huizong of Song suffered from a Spleen disorder due to excessive consumption of ice. Yang Jilao prescribed Dali Zhong Wan (Great Middle Pill), but the Emperor said he had taken it many times without success. Yang replied, "The disease originated from eating ice; please allow me to decoct this medicine using ice." This addressed the root cause, and the Emperor recovered. Du Qingbi suffered from a carbuncle on the brain. He self-administered Fangfeng Tongsheng San (Saposhnikovia Decoction for Unblocking the Intestines and Clearing Heat) several times without effect. Zhu Danxi examined him and asked, "Why not process the herbs with wine?" Qingbi realized the error, took the modified prescription, and recovered before finishing the course. Zhang Yangzheng treated an instructor named Wen who suffered from emaciation. Physicians in Wu used Sanbai Tang (Three Whites Decoction) without success. Zhang administered 2-3 slices of Shu Fuzi (Prepared Aconite Root), and the patient improved after decoction and ingestion. Miu Zhongchun treated Wang Guanshou for spermatorrhea, where hearing women's voices triggered emission. The patient was severely emaciated and near death. Physicians felt helpless. Miu's disciple used Yuanzhi (Polygalae Radix) as the sovereign herb, Lianxu Shilianzi (Stone Lotus Seed with Filament) as the minister herb, and Longchi (Dragon Bone), Fushen (Poria with Hostwood), Shayuan Jili (Astragali Complanati Semen), and Muli (Oyster Shell) as assistant and guide herbs. The pills stopped symptoms temporarily but did not cure them completely. Miu added Biao Jiao (Fish Maw Gelatin), and the patient recovered before finishing the course. Ye Tianshi treated difficult labor. Other doctors' parturition-inducing medicines failed. On that day, coinciding with the Start of Autumn, Ye added one Wutongye (Firmiana Leaf). The baby was delivered immediately after swallowing the medicine. He Bianbo from Jiading suffered from vomiting. Doctors used Ermiao Wan (Two Marvels Pill) without effect. Xu Lingtai added Chazi (Tea Seeds) four liang, decocted in water, and the patient recovered. Since the disease was caused by tea accumulation, Chazi served as a guiding herb. These few examples illustrate that a physician must understand medical principles profoundly and apply them flexibly to achieve rapid results.
Zou Run'an treated a person suffering from irritability and fullness during summer. Nasal insufflation with medicine failed to induce sneezing, causing extreme distress. The patient then swallowed 4-5 qian of the powder directly. The irritability worsened, leading to coma, unconsciousness, and aphasia. This was due to the presence of raw Banxia (Pinelliae Rhizoma) and raw Nanting (Arisaematis Rhizoma) in the medicine. Zou stated that the toxicity of Nanting and Banxia is resolved by Jiangzhi (Ginger Juice). However, in the heat of summer with irritability, administering Ginger Juice is inappropriate. Instead, Gancao (Licorice Root) should be used to detoxify. Since Gancao is very sweet, small doses are ineffective against the toxin, but large doses are hard to swallow. Therefore, one jin of Gancao was steamed and dew-collected for drinking. After finishing the drink, the illness subsided. Patients who fear the pungency of medicines or dislike heavy tastes can imitate this method. Chen Zai'an treated a person with severe heat and sore throat using Gancao, Jiegeng (Platycodonis Radix), Lianqiao (Forsythiae Fructus), Bobo (Polyporus), Niubangzi (Arctii Fructus), Shegan (Belamcandae Rhizoma), and Yuanshen (Scrophulariae Radix). The patient usually vomited upon taking medicine and refused to take it, worsening the condition. To ensure administration, the medicine was decocted and exposed to night dew. Drinking over twenty bowls led to complete recovery. Xu Yongzong treated Empress Dowager Wang for wind-stroke resulting in aphasia. Fengfang (Saposhnikoviae Radix) and Huangqi (Astragali Radix) were decocted in large quantities and placed under the bed for fumigation, allowing inhalation through mouth and nose. She could speak that evening. Lu Yan treated a woman from the Xu family who died suddenly from postpartum blood stagnation, with slight heat in the chest and diaphragm. Dozens of jin of Honghua (Carthami Flos) were boiled in a large pot, poured into a wooden barrel, and the patient lay on top for fumigation. As the vapor weakened, more was added until she revived. This demonstrates skillful application of ancient methods. Li Yu treated flaccidity syndrome, believing the pathology was superficial yet deep-seated, requiring more than small doses. Two pots of medicine were boiled, cooled slightly in a vat, and the patient sat in it while being poured with the liquid. Profuse sweating occurred, and the patient recovered instantly. This is a variation of existing methods. Such medical practice aligns closely with the Dao.
People in Wu feared taking heavy medicines. Ma Yuanyi pre-treated soybeans with Mahuang (Ephedrae Herba) to sprout them. Whenever Mahuang was indicated, the prescription book listed "Large Soybean Sprouts," alleviating the family's fear. (Medicines were typically obtained from the physician at that time.) Xu Lingtai treated a patient named Zhang who needed Dahuang (Rhei Radix et Rhizoma). Fearing refusal, he falsely claimed the pill was made with Xue Hamo (Snow Toad). The patient took it and recovered. One can imagine the painstaking effort of skilled physicians, which rigid prescribers cannot match.
Some diseases result from dietary preferences. Without detailed inquiry, how can efficacy be achieved? I record a few past cases for study. Zhu treated his uncle's diarrhea. The pulse was choppy and wiry. Inquiry revealed a preference for carp. Using Yuzhu (Polygonati Odorati Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Shengjiang (Zingiberis Rhizoma Recens), and砂糖 (Sugar) to induce vomiting of sticky phlegm stopped the diarrhea. Academic Lin suddenly turned blue, became emaciated, and suffered night palpitations. Du inquired about a preference for salty sea clams, which depleted Heart Blood. Prescribing fluids-generating medicines cured him. A wealthy merchant suffered abdominal distension. Hundreds of medicines failed, worsening gastric vomiting and appetite loss. A folk doctor learned he ate too much ice-soaked fruit in summer, chilling the Spleen Qi. Previous doctors used cold medicines, further injuring Stomach Qi. Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), and Guigui (Cinnamomi Ramulus) were used to strengthen the Spleen and harmonize the Stomach. Lung Qi descended, and the disease was cured. Zhao Yin developed worms from eating raw rice, becoming sallow and anorexic. Cangzhu (Atractylodis Rhizoma) soaked in rice wash overnight, dried, powdered, and formed into pills with steamed bread dough, taken with rice water, cured him. Wu Fuxian treated a person with sudden cold limbs, coma, and aphasia in late summer. Inquiry revealed consumption of pig lung. Kuandonghua (Kirengeshomae Flos) decoction was灌fed, curing him, as the lung was diseased. Shen Yi treated Prince Su's illness from craving dairy. Drinking strong tea cleared the diaphragm, curing him. Xue Lizhai treated an elderly man with dysentery-like symptoms and chest tightness. Phlegm-dysentery medicines failed. Inquiry revealed mixing wine and milk. Acid causes coagulation, bitterness promotes dispersion. Tea leaves were formed into pills, taken with clear tea. Several doses cured him. Wu Tingshao treated Feng Yanji's chest pain. Inquiry revealed frequent consumption of pheasant and partridge. Licorice Soup cured him. Yang Jilao treated Yang Lizhi's ulcerated sore throat preventing eating. Inquiry revealed frequent partridge meat consumption. Eating one slice of ginger tasted exceptionally good. Gradually increasing to half a jin eliminated the throat pain and restored appetite. Liang Xin treated a wealthy merchant who died suddenly from food poisoning. Inquiry revealed a preference for bamboo partridge. Crushed ginger juice was forced down the teeth, reviving him. A certain doctor treated a woman with black spots on her face spreading to the whole face. Inquiry revealed daily consumption of turtledoves. One jin of ginger was chopped, juiced, dregs dried, and re-boiled to form pills. Eating these for a month restored normal complexion. Pheasants, partridges, bamboo partridges, and turtledoves eat Pinellia, so ginger resolves their toxicity. Shen Zongchang treated a person from Luling with distension, wheezing, and inability to swallow food for three days. Pulse was normal otherwise. Inquiry revealed recent consumption of sheep fat. "Fat congeals when cold; it requires warming." Warming induced bowel movement, curing him.
Stubborn diseases cannot be cured quickly. Zhu Danxi treated severe deficiency and emaciation with right hypochondriac pain and weak limbs. Erchen Tang (Two-Aged Decoction) plus Baijiezi (Sinapis Semen), Zhishi (Aurantii Fructus), Jiangchao Huanglian (Scutellariae Radix stir-fried with ginger), and Zhuli (Bambusae Caulis in Taenia) for eighty doses brought stability. Zhu Zhongning treated bi-syndrome in legs and knees. Qingzao Tang (Clear Dryness Decoction) for hundred doses cured him. There are many such cases. Initially, few doses show no effect. Only deep trust allows endurance. Alas! People seeking medical help often demand quick results, change doctors frequently, mix prescriptions, and worsen their conditions. This is common.
Yuan Suiyuan wrote in *Biography of Mr. Xu Lingtai*: Zhang Yucun's son was born without skin. Mr. Xu instructed using glutinous rice flour dusted on the body, wrapped in silk, buried in soil with only the head exposed, fed milk. Skin grew within two days. This has precedent. Yuan Dynasty, Wei Yilin's *Defxiao Fang*: For infants born without skin, quickly dust with dry white early rice flour. Stop when skin grows. Ming Dynasty, Ge Kejiu treated a boatman's child born without complete skin. Dig a pit on shore, place the infant inside, cover with fine soil and quilt, forbid movement. Skin grows later. This is because the mother carried the fetus on the boat, lacking exposure to Earth Qi. Xu Lingtai combined both methods successfully, proving the value of broad learning in medicine.
Treating Liver disorders in women often involves dispersing and attacking herbs, unknowingly damaging Yin. Treating pediatric convulsions often uses aromatic penetrating and heavy sedative agents, unknowingly causing hidden harm. Treating Liver disorders best follows Gao Gufeng's Water-Nourishing Method. Treating Wind disorders best follows Wu Jutong's *Jie Er Nan* (Resolving Pediatric Difficulties). These can rectify accumulated abuses and save people. Some follow the theory of "Guiding Fire Back to Source" using Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata) without understanding the errors, often harming patients. Qin Huangshi's discussion on the criteria for using Cinnamon Twig and Prepared Aconite Root is recorded here. Zhao Yangkui used acrid-hot Fuzi and Cinnamon Twig to warm and tonify Minister Fire. He ignored that ancients compared Liver-Kidney fire to "Dragon and Thunder Fire" because these organs govern Wood and Water, containing Minister Fire, hence "Yi and Gui share the same source." When True Water of these two organs is insufficient, Yang becomes hyperactive and Yin deficient, triggering Minister Fire. Treatment should nourish Liver-Kidney True Yin to control it. Using acrid-hot herbs to suppress this would be erroneous. "Guiding Fire Back to Source" with Fuzi and Cinnamon Twig actually treats True Yang deficiency. Rootless Fire, forced upward by Yin pathogens, losing its station, manifests as Daiyang (Floating Yang) or Yin restlessness. This is not Dragon-Thunder Fire. (He Xichi noted: Fuzi and Cinnamon Twig guide fire back to source for patterns of lower cold and upper heat. In patterns of water exhaustion and fire blazing, where both upper and lower are hot, where does one guide the fire? This comment corroborates Qin's argument.) Dragon-Thunder Fire arises from Liver-Kidney True Yin deficiency, causing Minister Fire to flare up. Water deficiency leads to Fire hyperactivity, rushing upward from below. This differs from Six Evils invading from outside. It should not be treated with bitter-cold direct suppression, nor with the "Fire郁 (Stagnation) Release" method using ascending and dispersing Fire techniques. Treatment should nourish Yin and control Fire using Liuwei Wan (Six-Ingredient Pill with Rehmannia), Zishen Wan (Kidney-Nourishing Pill), and Family Secret Liver-Kidney Pill (Shudihuang, Tiandong, Danggui Shen, Baishao, Huangbai, Zhimu, powdered, bound with Xuanwu Jiao).
Diseases with significant upper-lower disparity are hard to treat. *Lu Yangyu Yi An* offers a model case. Lu Qianchuan suffered from intestinal wind and dry stool. He liked eating copper-basin persimmons in winter, causing epigastric pain. Doctors treated the heart/epigastric pain with warming and Qi-moving herbs, but pain persisted, and intestinal bleeding increased. They then treated the blood with cold-moistening herbs, but stool remained blocked, and pain became stabbing. Lu diagnosed the pulse: upper part deep, weak, and slow; lower part surging, slippery, and rapid. He diagnosed "Accumulated Cold in Stomach, Heat in Intestines." He prescribed Runzi Wan (Moistening Pill) coated with Chenxiang (Aquilariae Lignum Resinatum), taken with strong Ginger Soup. Half a dose initially, then another half dose after half a day. Previously, cold medicines caused cutting pain in the epigastrium. With these pills, no chest/diaphragm pain occurred. By midnight, hard stool passed with little pain, bleeding reduced by 60-70%. Later, another soft stool passed with slight pain and less blood. Early morning, loose stool passed with trace blood and no pain. Only epigastric pain remained. He then prescribed Zanglian Wan (Organ-Connecting Pill) also coated with Agarwood, taken with Ginger Soup to clear Lower Jiao Heat and moisten dryness. He also prepared Fuzi Lizhong San (Aconite Regulate the Middle Powder) to warm the Middle Jiao, mixed with Yitang (Maltose) to retain it in the chest/diaphragm and prevent rapid downward passage. Before finishing the course, both conflicting symptoms resolved. This is the "Warm Upper, Clear Lower" method. (Lu Shaohan noted: Pills act slowly, reaching the lower part before dissolving, avoiding Middle Jiao cold. Powders disperse, dissolving upon swallowing, avoiding Anus heat. The brilliance lies in using Agarwood and Maltose.)
Chen Shucang's wife suffered from coughing with bloody sputum, night fever, dizziness, chest discomfort, and weak legs/knees. Doctors used Yin-nourishing and Fire-descending medicines for half a year. Appetite decreased, spirit weakened. Pulse: Cun and Guan positions deep, rapid, and forceful; Chi positions choppy, weak, and slightly floating. Diagnosis: Upper Excess, Lower Deficiency. Upper Excess: Retained Heat and Blood Stasis in Heart/Lung. Lower Deficiency: Insufficient Qi in Liver/Kidney. Ren Shen Gu Ben Wan (Ginseng Solidify the Root Pill) was taken on an empty stomach. During the day, Beimu (Fritillariae Bulbus), Suzi (Perillae Fructus), Shanzha (Crataegi Fructus), Danpi (Moutan Cortex), Taoren (Persicae Semen), Honghua (Carthami Flos), Xiaoji (Cirsii Herba) were decocted in Mugen (Imperatae Rhizoma) water. Ten doses cleared phlegm and stopped bleeding. Then, Qingqi Yang Ying Tang (Clear Qi Nourish Ying Decoction: Fu Ling, Baishao, Danggui Shen, Chuanxiong, Muxiang, Baixiudoukou, Chenpi, Huanglian) was alternated with Gu Ben Wan. Three months later, the disease remitted, and pregnancy occurred. This is the "Clear Upper, Tonify Lower" method.
Substances have mutual antagonisms that can be used to treat disease. Iron fears Poxiao (Mirabilite). Zhang Jingyue treated a child who swallowed an iron nail. Living Magnetite and Poxiao (2 qian) were powdered, mixed with boiled lard and honey, and ingested. The nail was protected and passed in stool. Tofu fears Radish. *Yanshou Shu* records someone poisoned by tofu. Doctors couldn't cure it. A tofu maker said Radish prevents tofu formation in soup. Radish soup was given, curing the poisoning. Water caltrop fears Tung oil. *Jupang Zalan* records a doctor treating excessive water caltrop consumption causing fever, chest fullness, abdominal distension, and anorexia, nearing death. Knowing water caltrop flowers wither upon contact with Tung oil vapor, he collected oil residue from a new boat, formed pills with digestion-promoting and Qi-moving herbs, and administered them. Black dry stool passed, and the patient recovered. Many such cases exist. Practitioners must indeed be well-read.