余自从朱爻生习医后，在皖南遇一友，周君潜初也。在扬州遇一师，叶君子雨也。余川
广闽浙，足迹所经，知音者希。窃以不明营卫，血脉难通。不明三焦，气化何识？劳瘵，人
只知虚而不知实。蛊胀，人只知实而不知虚。霍乱第知其为寒，消渴第知其为热，而不知凡
病各有寒热虚实，偏则多弊。余不揣谫陋，谨将得诸师友者，都为一卷，以公同好。颜曰
《游艺志略》。盖持艺以游，游愈远而艺愈进，聊以备救弊补偏之一助，敢着述云乎哉！然亦
仅可为知者道也。
光绪二十七年岁次辛丑仲夏月两湖钓叟自记
滋腻妨中运，刚烈动内风
滋腻如天冬、麦冬、熟地、生地、石斛、葳蕤、人参、阿胶、百合、蜂蜜、甘草、大
枣、麻仁、文蛤、花粉、菊花、小麦、鸡黄、蚕砂、首乌之敛阴，刚烈如吴萸、丁香、川
椒、干姜、肉桂、附子、硫黄、苍术、巴豆、草果之动阳，乃一时救急之药，非常病可久
任之品。妨中运者，以土喜燥而恶湿。动内风者，以木喜水而憎火也。
辛热耗营液，温补实遂络
外感发表，辛药固不可少，如麻黄、苏叶、葛根、升麻、羌活之散气，桂枝、柴胡、
荆芥、当归、川芎之行血，各有奇功，误用耗液，多变痉厥。内伤托里，温药亦未可废，
如白术、黄 、饴糖之补脾，杜仲、菟丝、故脂之补肾，非无幸中，第过用阻络，定患药
癖。二者皆能助邪而益病，主用者，不可不慎。
苦寒伤生气，咸润蔽太阳
热在气分，宜甘寒，在血分，宜苦寒，尽人而知，据时令言，春温，秋燥，甘寒用处
甚多，惟夏外阳内阴，则宜苦以燥湿，寒以胜热。然胃阳素虚者，自不可过投。而《金
匮·吐衄》篇三黄泻心汤云∶治心气不足，西昌谓培生气而坚脏。诚然，何医只知有倒胃
之弊哉？其药如大戟、甘遂、葶苈、防己、知母、大黄、黄芩、黄连、栀子、丹皮、青黛、
木通、苦参、龙胆草、鸦胆子之类是苦寒，虽有清实热之益，弊与滋腻同，不再赘。咸寒
如鳖甲、蟹壳、僵蚕、蝉蜕、蛇皮、蜣螂、水蛭、 虫、海藻、紫葳、文蛤、牡蛎、秋石、
戎盐、人中白、肉苁蓉、桑螵蛸、元明粉之属，软坚，清燥，却风火，攻宿血，非无捷
效，用之过当，心阳蒙蔽，而神明为之不灵，精血为之日削矣，司命者尤当急知之。
外感忌酸收，内症戒消导
酸收如枣仁、榴皮、五味、乌梅、诃黎勒、罂粟花、宣木瓜、山茱萸，涩可固脱似
也。设有一毫外感，令邪永无出路。即系内伤吐血、咳嗽之证，反致成劳。观仲景用乌
梅，必用川椒，用五味，必用干姜，用麦冬必用半夏，用枣仁必用川芎，其意深矣。内
伤之证，有阳亏于外者，有阴虚于内者，彼茱萸、茯苓、泽泻、滑石、瞿麦、石韦之利
溺，牵牛、芒硝、大白、大青、大黄之滑肠，切勿乱投。即兼有外感，则麻桂发汗，瓜蒂、
皂角探吐，更宜酌用。伤寒有云∶亡血家不可发汗，疮家亦不可汗，湿家不可下，是其
例也。乃暴病忌参、术、黄 、熟地，沉 忌枳、朴、桃仁、山楂，亦可类推。
合观四节，可审用药之法。
二妙不尽妙，四神亦非神
苍术、黄柏，一生一熟，偶方中之小剂，湿热证之妙方，所以二妙命名。究竟治湿重
于热者则妙，若热重湿轻，当加入知母、地榆较妥，而风湿寒湿，终非其治也。故脂、豆
蔻、吴萸、五味，四药合丸，治食后脾泄、五更肾泄神效。殊不知脾肾之泄，有命火虚者，
有肝火炽者，徒以为神，即有增病速死之神矣，可知方书中，随意命方者，如八珍、十
全、固本、保真之类，不得以其名目好看，而妄投不计。但四君子扶脾，谁谓不善？以治
脾虚，可称君子，若遇胃实，何异小人？盖方无论平奇，要在对证。
白虎固金佳，青龙驱水捷
虎啸风生，其热自平，凡火刑肺胃，当推白虎第一。若火在肝肾，即芩连阿胶鸡子
黄汤、白头翁汤之证治，此方未能胜其任。胃有实邪，粳米又宜减之。而小青龙，桂枝开
天，细辛通地，复有姜、夏、麻、草温中以散其外，芍药内助以托其邪，面面周到，无
微不入，故洄溪谓为治寒水之神剂。发汗利水，并可补四逆、真武之不逮。然温邪咳嗽，
误投必毙。大青龙发汗亦然。是二法乃一大寒大热之对子，泻心、四逆，庶堪比肩。
理中伤胃脂，逍遥劫肝阴
理中汤之醒脾，逍遥散之疏肝，洵为良方，然治气分不足则可，若以之治血虚之体，
是增病而速毙。凡方皆利弊相因，彼偏用二方者，何徒知其利而不计其弊哉？
牛黄损离火，黑锡夺坎水
一清心中痰火，一摄肾下寒水，诚医家宜备之要药。然备以治仓猝闭证，则有无穷
之益，误施于久延脱证，其害不可胜言。苏合香丸治气闭，大活络丹治中风，损益同此。
合观四节，可以悟投方之机。
温寒须行气，清热要活血
气滞而后寒积，血壅而后热生。行气如旋复、香附、陈皮、葱、薤等味，加入温药
队中以散寒，其效倍捷。清热苦寒，甘寒咸寒诸药，大剂寒凉，必加入活血之品，如桃
仁、丹皮、泽兰、茜草、刘寄奴、参三七等，乃无冰伏热邪之弊。此理本易知，惜医多不
识，故特表而出之。
命方良有以制剂岂徒然
方有膏、丹、丸、散、煎、饮、汤、渍之名，各有取义。膏取其润，丹取其灵，丸
取其缓，散取其急，煎取其下达，饮取其中和，汤取其味，以涤荡邪气，渍取其气，以
留连病所。而君臣佐使，配合全在分量，如小承气用大黄为君，走中下焦血分，浓朴为
君，即变而为中上焦气分之法。阳旦汤桂枝为君，走太阳，芍药加倍，便入太阴。当归
赤小豆散，赤豆为君，重在败毒，当归为君，重在理血。主之，佐之，轻之，重之，运用
之妙，存乎一心，立方者讵可忽诸？
自从跟随朱爻生学习医学之后，我在皖南遇到一位朋友，是周潜初先生。在扬州遇到一位老师，是叶君子雨先生。我奔波于四川、广东、福建、浙江等地，所到之处，懂我的人很少。我私下认为，如果不明白营卫（营气与卫气），血脉就难以通畅；如果不明白三焦（上焦、中焦、下焦的总称及气化功能），如何能认识气化作用？对于劳瘵（虚劳肺痨一类疾病），人们只知道它是虚证而不知道也有实证的一面；对于蛊胀（腹部胀大如鼓，内有虫积或瘀血等病证），人们只知道它是实证而不知道也有虚证的一面；对于霍乱，人们只知道它是寒证；对于消渴（糖尿病类疾病），人们只知道它是热证，却不知道所有疾病都有寒、热、虚、实的区别，偏执一端往往带来弊端。我不自量力，浅陋无知，谨慎地将从师友那里得来的心得，汇总成一卷，以与同好者共享。命名为《游艺志略》。大概是秉持技艺而遨游其中，遨游得越远，技艺就越精进，姑且作为补救弊端、纠正偏颇的一点帮助，哪里敢说是著述呢！但这仅能对懂得的人说罢了。
光绪二十七年岁次辛丑仲夏月两湖钓叟自记
滋腻的药物妨碍脾胃运化，刚烈的药物扰动内风
滋腻的药物如同天冬、麦冬、熟地黄、生地黄、石斛、玉竹、人参、阿胶、百合、蜂蜜、甘草、大枣、火麻仁、文蛤、天花粉、菊花、小麦、鸡内金、蚕砂、何首乌等，具有收敛阴液的作用；刚烈的药物如同吴茱萸、丁香、川椒、干姜、肉桂、附子、硫黄、苍术、巴豆、草果等，具有振奋阳气的作用。这些都是一时救急的药物，不是治疗常规疾病可以长期服用的品种。妨碍脾胃运化的原因，是因为脾土喜欢干燥而厌恶湿气。扰动内风的原因，是因为肝木喜欢水滋润而憎恶火热。
辛热的药物耗伤营血津液，温补的药物使经络壅实
外感病需要发表解表，辛散药物固然不可少，如麻黄、紫苏叶、葛根、升麻、羌活等发散气机，桂枝、柴胡、荆芥、当归、川芎等通行血液，各有奇效，但如果误用，会耗伤津液，多变生痉厥（抽搐昏迷）之证。内伤病需要托里扶正，温补药物也未可废除，如白术、黄芪、饴糖等补益脾气，杜仲、菟丝子、故纸（补骨脂）等补肾，并非没有侥幸中的时候，只是如果过度使用会阻碍经络，定会产生药癖（对某种药物的依赖或不良反应）。这两类药物都能助长邪气而加重病情，主治者不可不慎重。
苦寒的药物损伤生气，咸润的药物遮蔽太阳经
热邪在气分，适宜用甘寒药；在血分，适宜用苦寒药，这是人人都知道的。根据时令来说，春温、秋燥，甘寒药的用处很多。只有夏季外阳内阴，才适宜用苦味以燥湿，寒性以胜热。然而胃阳素来虚弱的人，自然不可以过量投用。而《金匮要略·吐衄篇》中的三黄泻心汤说：治疗心气不足，西昌认为这是培补生气而坚固脏腑。确实如此，为什么医生只知有倒胃口（损伤胃气）的弊端呢？那些药物如大戟、甘遂、葶苈子、防己、知母、大黄、黄芩、黄连、栀子、丹皮、青黛、木通、苦参、龙胆草、鸦胆子等属于苦寒药，虽然有清除实热的益处，但弊端与滋腻药相同，不再赘述。咸寒的药物如鳖甲、蟹壳、僵蚕、蝉蜕、蛇皮、蜣螂、水蛭、虻虫、海藻、紫葳、文蛤、牡蛎、秋石、戎盐、人中白、肉苁蓉、桑螵蛸、元明粉等属类，具有软坚散结、清燥、祛风火、攻逐宿血的功效，并非没有快速见效的时候，如果使用不当，会使心阳被蒙蔽，而神明为之不灵，精血日渐亏损，掌握生命救治的人尤其应当急切知晓这一点。
外感病忌讳酸收，内伤病戒除消导
酸收的药物如酸枣仁、石榴皮、五味子、乌梅、诃黎勒、罂粟花、宣木瓜、山茱萸等，涩味似乎可以固脱。如果有一丝一毫的外感存在，就会让邪气永远没有出路。即使是内伤吐血、咳嗽的病症，反而会导致形成劳损。看张仲景使用乌梅，必定配合川椒；使用五味子，必定配合干姜；使用麦冬，必定配合半夏；使用酸枣仁，必定配合川芎，其中的用意很深了。内伤的病症，有阳气亏虚于外的，有阴虚于内的，那些如山茱萸、茯苓、泽泻、滑石、瞿麦、石韦等利尿的药物，牵牛子、芒硝、大白（商陆）、大青、大黄等滑肠的药物，千万不要乱投。即使兼有外感，那么麻黄、桂枝发汗，瓜蒂、皂角催吐，更应当斟酌使用。伤寒论中说：亡血家不可发汗，疮家也不可发汗，湿家不可攻下，就是这样的例子。至于暴病忌讳人参、白术、黄芪、熟地黄，沉疴久病忌讳枳实、厚朴、桃仁、山楂，也可以类推。
综合观察以上四节内容，可以审察用药的方法。
二妙丸不尽妙，四神丸亦非神
苍术、黄柏，一生一熟，是偶方中的小剂量，湿热证的妙方，所以命名为二妙。究竟治疗湿重于热的情况则很妙，如果热重湿轻，当加入知母、地榆较为妥当，而风湿、寒湿，终究不是它的适应症。故纸（补骨脂）、豆蔻、吴茱萸、五味子，四种药物合丸，治疗食后脾泄、五更肾泄非常有效。殊不知脾肾之泄，有命门火虚的，有肝火炽盛的，仅仅认为它神效，如果有增加病情迅速致死的神效了，可知方书中，随意命名方剂的，如八珍汤、十全大补汤、固本丸、保真汤之类，不要因为它们名字好听，就妄加投用不计后果。但是四君子汤扶助脾气，谁说不好？用来治疗脾虚，可称为君子，如果遇到胃实（实证），何异于小人？大概方剂无论平淡奇特，关键在于对症。
白虎汤固金佳，青龙汤驱水捷
虎啸风生，其热自平，凡是火刑肺胃，应当推白虎汤为第一。如果火在肝肾，那就是黄芩黄连阿胶鸡子黄汤、白头翁汤的证治，这个方子不能胜任。胃中有实邪，粳米又应当减少。而小青龙汤，桂枝开通天部（上焦/表），细辛通达地部（下焦/里），再加上姜、半夏、麻黄、甘草温中并疏散外邪，芍药在内辅助以托出邪气，面面周到，无微不入，所以洄溪（徐灵胎号）称之为治疗寒水的神剂。发汗利水，并可弥补四逆汤、真武汤的不足。然而如果是温邪咳嗽，误投必死。大青龙汤发汗也是如此。这两种方法是一大寒一大热的对子，泻心汤、四逆汤，差不多可以与之比肩。
理中汤伤胃脂，逍遥散劫肝阴
理中汤醒脾，逍遥散疏肝，确实是良方，然而治疗气分不足是可以的，如果用它们治疗血虚体质，是增加病情而加速死亡。凡方剂都是利弊相因的，那些偏执使用这两个方子的人，为何只知道它们的利益而不考虑它们的弊端呢？
牛黄损离火，黑锡丸夺坎水
一个清心中痰火，一个摄纳肾下寒水，诚然是医家应该备有的重要药物。然而准备用来治疗仓猝间的闭证，则有无穷的益处，误施用于久延不愈的脱证，其危害不可胜言。苏合香丸治疗气闭，大活络丹治疗中风，损益的道理与此相同。
综合观察以上四节内容，可以领悟投方的契机。
温寒必须行气，清热需要活血
气滞而后寒积，血壅而后热生。行气的药物如旋覆花、香附、陈皮、葱、薤白等味道，加入温药队伍中以散寒，其效果加倍快捷。清热用苦寒、甘寒、咸寒诸药，大剂量的寒凉药，必须加入活血的药物，如桃仁、丹皮、泽兰、茜草、刘寄奴、参三七等，才没有冰伏热邪（寒凉药遏制热邪导致热邪深伏不出）的弊端。这个道理本来容易知道，可惜医生大多不认识，所以特意提出出来。
命名方剂良有以，制剂岂徒然
方剂有膏、丹、丸、散、煎、饮、汤、渍的名称，各有取义。膏取其润，丹取其灵，丸取其缓，散取其急，煎取其下达（药力下行），饮取其中和，汤取其味，以涤荡邪气，渍取其气，以留连病所。而君臣佐使的配合全在于分量，如小承气汤用大黄为君药，走中下焦血分；如果用浓朴为君药，即变而为中上焦气分的方法。阳旦汤桂枝为君药，走太阳经；芍药加倍，便入太阴经。当归赤小豆散，赤豆为君药，重在败毒；当归为君药，重在理血。主之，佐之，轻之，重之，运用的奥妙，存乎一心，创立方剂的人难道可以忽视吗？
Since I began studying medicine under Zhu Yaosheng, I encountered a friend in southern Anhui, Mr. Zhou Qianchu. In Yangzhou, I met a teacher, Mr. Ye Ziyu. I traveled through Sichuan, Guangdong, Fujian, and Zhejiang; wherever my footsteps went, few were those who understood me. I privately believe that if one does not understand Ying-Wei (Ying-Qi and Wei-Qi), the blood vessels cannot flow smoothly; if one does not understand the Sanjiao (Triple Burner), how can one comprehend Qi transformation? Regarding Lao Zhai (consumptive disease resembling tuberculosis), people only know it as deficiency and do not realize there is also excess. Regarding Gu Zhang (abdominal distension resembling ascites with parasites or stasis), people only know it as excess and do not realize there is also deficiency. Regarding Huoluan (cholera-like syndrome with vomiting and diarrhea), people only know it as cold; regarding Xiaoke (wasting-thirst syndrome resembling diabetes), people only know it as heat, failing to realize that all diseases have aspects of cold, heat, deficiency, and excess. Bias towards one aspect often leads to harm. Presuming upon my own shallowness and ignorance, I have carefully compiled insights gained from teachers and friends into one volume to share with fellow enthusiasts. I titled it *Youyi Zhilue* (Brief Records of Wandering in Arts). The idea is to hold onto an art and wander within it; the further one wanders, the more advanced the art becomes. This serves merely as a modest aid to remedy flaws and correct biases; dare I call this a literary composition? Nevertheless, it can only be discussed with those who understand.
Recorded by the Angler from Lianghu in the mid-summer of Xin Chou year, 27th year of Guangxu.
Cloying and greasy substances hinder middle-jiao transportation; rigid and fierce substances stir internal wind.
Cloying and greasy substances include Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Shu Di Huang (Rehmanniae Radix Preparata), Sheng Di Huang (Rehmanniae Radix), Shi Hu (Dendrobii Caulis), Wei Rui (Polygonati Odorati Rhizoma), Ren Shen (Ginseng Radix), E Jiao (Colla Corii Asini), Bai He (Lilii Bulbus), Feng Mi (Honey), Gan Cao (Glycyrrhizae Radix et Rhizoma), Da Zao (Jujubae Fructus), Ma Ren (Semen Cannabis), Wen Ge (Clam Shell), Hua Fen (Trichosanthis Radix), Ju Hua (Chrysanthemi Flos), Xiao Mai (Tritici Fructus), Ji Huang (Chicken Gizzard Lining), Can Sha (Bombyx Batryticatus), and Shou Wu (Polygoni Multiflori Radix); these possess the function of astringing Yin. Rigid and fierce substances include Wu Yu (Evodiae Fructus), Ding Xiang (Caryophylli Flos), Chuan Jiao (Zanthoxyli Pericarpium), Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex), Fu Zi (Aconiti Lateralis Radix Preparata), Liu Huang (Sulfur), Cang Zhu (Atractylodis Rhizoma), Ba Dou (Crotonis Fructus), and Cao Guo (Tsaoko Fructus); these stimulate Yang. These are emergency remedies for acute situations, not suitable for long-term use in chronic conditions. Those that hinder middle-jiao transportation do so because Earth (Spleen) prefers dryness and dislikes dampness. Those that stir internal wind do so because Wood (Liver) prefers water and detests fire.
Acrid and hot substances deplete Ying fluid and body fluids; warming and tonifying substances cause stagnation in collaterals.
For exterior syndromes requiring release via sweating, acrid drugs are indispensable. For example, Ma Huang (Ephedrae Herba), Su Ye (Perillae Folium), Ge Gen (Puerariae Lobatae Radix), Sheng Ma (Cimicifugae Rhizoma), and Qiang Huo (Notopterygii Rhizoma et Radix) disperse Qi; Gui Zhi (Cinnamomi Ramulus), Chai Hu (Bupleuri Radix), Jing Jie (Schizonepetae Spica), Dang Gui (Angelicae Sinensis Radix), and Chuan Xiong (Ligustici Chuanxiong Rhizoma) promote Blood circulation. Each has unique merits. However, misuse can deplete fluids and lead to Jing Jue (spasms and convulsions). For interior injuries requiring support of the interior, warming drugs should not be discarded. For instance, Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qi (Astragali Radix), and Yi Tang (Maltose) tonify Spleen Qi; Du Zhong (Eucommiae Cortex), Tu Si Zi (Cuscutae Semen), and Gu Zhi (Psoraleae Fructus) tonify Kidney. While occasionally effective, overuse obstructs collaterals and may lead to drug dependency or adverse reactions. Both types can assist pathogenic factors and worsen illness; practitioners must exercise caution.
Bitter and cold substances damage vital Qi; salty and moistening substances obscure the Taiyang channel.
Heat in the Qi level is treated with sweet-cold herbs; heat in the Blood level is treated with bitter-cold herbs—a fact known to all. Considering seasonal variations: in Spring warmth and Autumn dryness, sweet-cold herbs are widely used. Only in Summer, characterized by external Yang and internal Yin, is it appropriate to use bitter flavors to dry dampness and cold nature to overcome heat. However, for those with pre-existing deficient Stomach Yang, excessive administration is contraindicated. The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) chapter on Vomiting and Epistaxis states that San Huang Xie Xin Tang (Three-Yellow Decoction to Drain the Heart) treats "deficiency of Heart Qi," which Xi Chang interprets as nourishing vital Qi and strengthening the zang organs. This is true. Why do physicians only recognize the drawback of damaging the stomach? Drugs such as Da Ji (Euphorbiae Pekinensis Radix), Gan Sui (Kansui Radix), Ting Li Zi (Lepidii Semen), Fang Ji (Stephaniae Tetrandrae Radix), Zhi Mu (Anemarrhenae Rhizoma), Da Huang (Rhei Radix et Rhizoma), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), Dan Pi (Moutan Cortex), Qing Dai (Indigo Naturalis), Mu Tong (Akebiae Caulis), Ku Shen (Sophorae Flavescentis Radix), Long Dan Cao (Gentianae Radix), and Ya Dan Zi (Brucea Fructus) are bitter-cold. Although they clear excess heat effectively, their drawbacks are similar to cloying substances, so no further elaboration is needed. Salty-cold substances like Bie Jia (Testudinis Carapax et Plastrum), Xie Ke (Portunus Shell), Jiang Can (Bombyx Batryticatus), Chan Tui (Cicadae Periostracum), She Pi (Snake Skin), Qiang Lang (Scarabaeus), Shui Zhi (Hirudo), Meng Chong (Omphalia), Hai Zao (Sargassum), Zi Wei (Tecoma Stem), Wen Ge (Clam Shell), Mu Li (Ostreae Concha), Qiu Shi (Urine Sediment), Rong Yan (Sea Salt), Ren Zhong Bai (Human Urine Deposit), Rou Cong Rong (Cistanche Herba), Sang Piao Xiao (Mantis Ootheca), and Yuan Ming Fen (Mirabilite) soften hardness, clear dryness, dispel wind-fire, and attack old blood stasis. They can yield rapid results, but improper use obscures Heart Yang, dulls the Spirit (Shen), and depletes Essence and Blood daily. Life-preserving practitioners must urgently understand this.
Exterior syndromes contraindicate sour astringents; interior syndromes forbid indiscriminate digestion-promoting methods.
Sour-astringent substances like Suan Zao Ren (Ziziphi Spinosae Semen), Liu Pi (Pomegranate Peel), Wu Wei Zi (Schisandrae Fructus), Wu Mei (Mume Fructus), He Li Le (Terminalia Chebulae Fructus), Ying Su Hua (Papaveris Capsule), Xuan Mu Gua (Chaenomelis Fructus), and Shan Zhu Yu (Corni Fructus) seem capable of securing collapse via astringency. However, if even a trace of exterior pathogen exists, it traps the pathogen without an exit. Even in cases of interior injury with hematemesis or cough, this can lead to consumptive disease. Observe Zhang Zhongjing’s use of Wu Mei paired with Chuan Jiao; Wu Wei Zi paired with Gan Jiang; Mai Dong paired with Ban Xia; Suan Zao Ren paired with Chuan Xiong. The intent is profound. Interior injury syndromes involve either Yang deficiency on the exterior or Yin deficiency on the interior. One must not recklessly administer diuretics like Shan Zhu Yu, Fu Ling (Poria), Ze Xie (Alismatis Rhizoma), Hua Shi (Talcum), Qu Mai (Polygalae Herba), and Shi Wei (Pyrrosiae Folium), or laxatives like Qian Niu (Pharbitidis Semen), Mang Xiao (Mirabilite), Da Bai (Phytolaccae Radix), Da Qing (Isatidis Folium), and Da Huang. Even if accompanied by exterior syndrome, sweating agents like Ma Huang and Gui Zhi, or emetics like Gua Di (Melon Peduncle) and Zao Jiao (Gleditsiae Spina), must be used with discretion. The *Shang Han Lun* (Treatise on Cold Damage) states: those who have lost blood should not be sweated; those with sores should not be sweated; those with dampness should not be purged. This is an example. Furthermore, acute illnesses contraindicate Ren Shen, Bai Zhu, Huang Qi, and Shu Di Huang; chronic debilitating illnesses contraindicate Zhi Shi, Hou Po, Tao Ren, and Shan Zha. This logic can be extended.
Observing these four sections allows one to examine the principles of medication.
Er Miao Wan is not entirely miraculous; Si Shen Wan is not divine.
Cang Zhu and Huang Bo, one raw and one processed, form a small formula among even-numbered prescriptions and a wonderful formula for damp-heat syndromes, hence the name Er Miao (Two Marvels). It is indeed marvelous when treating dampness outweighing heat. If heat outweighs dampness, adding Zhi Mu and Di Yu is more appropriate. However, for Wind-Damp or Cold-Damp, it is ultimately not the treatment. Gu Zhi (Psoraleae Fructus), Dou Kou (Cardamomi Fructus Rotundus), Wu Yu, and Wu Wei Zi combined into pills are miraculously effective for post-prandial Spleen diarrhea and dawn-time Kidney diarrhea. Little do they know that Spleen-Kidney diarrhea can stem from Ming Men (Gate of Life) fire deficiency or Liver fire blazing. Blindly considering it miraculous could lead to increased illness and rapid death. Thus, in prescription books, formulas arbitrarily named, such as Ba Zhen Tang (Eight-Treasure Decoction), Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction), Gu Ben Wan (Solidify Root Pill), and Bao Zhen Tang (Preserve Vitality Decoction), should not be administered blindly just because their names sound auspicious. However, Si Jun Zi Tang (Four Gentlemen Decoction) supports Spleen Qi; who says it is bad? To treat Spleen deficiency, it can be called a Gentleman; but in cases of Stomach excess, how is it different from a Villain? Formulas, whether plain or exotic, depend on matching the syndrome.
Bai Hu Tang is excellent for protecting Metal (Lung); Qing Long Tang is swift in driving out Water.
When the tiger roars, wind arises, and its heat naturally subsides. For Fire punishing Lung and Stomach, Bai Hu Tang (White Tiger Decoction) is paramount. If Fire is in Liver and Kidney, then Huang Qin Huang Lian E Jiao Ji Zi Huang Tang (Scutellaria, Coptis, Donkey-Hide Gelatin, and Egg Yolk Decoction) or Bai Tou Weng Tang (Podocarpus Decoction) are indicated; Bai Hu Tang cannot胜任 (fulfill the role). If there is excess pathogen in the Stomach, Jing Mi (Coicis Semen) should be reduced. Xiao Qing Long Tang (Minor Green Dragon Decoction): Gui Zhi opens the Heaven (Upper Jiao/Exterior), Xi Xin (Asari Radix) connects to Earth (Lower Jiao/Interior), supplemented by Ginger, Ban Xia, Ma Huang, and Gan Tang to warm the middle and disperse the exterior; Shao Yao assists internally to expel the pathogen. It is thorough and penetrates every detail, hence Xu Lingtai (Hui Xi) calls it a divine agent for treating Cold-Water. It promotes sweating and diuresis, compensating for the inadequacies of Si Ni Tang (Frigid Extremities Decoction) and Zhen Wu Tang (True Warrior Decoction). However, for Warm-Evil cough, misapplication is fatal. Da Qing Long Tang (Major Green Dragon Decoction) also induces strong sweating. These two methods are counterparts of extreme Cold and Heat, comparable to Xie Xin Tang (Drain the Heart Decoction) and Si Ni Tang.
Li Zhong Tang damages Stomach Yin; Xiao Yao San depletes Liver Yin.
Li Zhong Tang (Regulate the Middle Decoction) awakens the Spleen; Xiao Yao San (Free Wanderer Powder) soothes the Liver. Indeed, they are good formulas, but only suitable for Qi deficiency. Using them for Blood deficiency increases illness and accelerates death. All formulas have pros and cons. Those who rely exclusively on these two, knowing only their benefits while ignoring their drawbacks, are misguided.
Niu Huang (Calculus Bovis) damages Li Fire (Heart Fire); Hei Xi Dan (Black Tin Pill) drains Kan Water (Kidney Water).
One clears Phlegm-Fire from the Heart; the other secures Cold-Water in the lower Kidneys. They are essential medicines every physician should keep. Prepared for sudden Bi syndromes (obstruction/collapse), they offer infinite benefit. Misapplied to prolonged Tuo syndromes (collapse/deficiency), the harm is incalculable. Su He Xiang Wan (Styrax Pill) treats Qi obstruction; Da Huo Luo Dan (Great Meridian-Unblocking Pill) treats Stroke. The principles of addition and subtraction are the same.
Observing these four sections allows one to grasp the timing of administering formulas.
Warming Cold requires moving Qi; Clearing Heat requires invigorating Blood.
Qi stagnation leads to Cold accumulation; Blood congestion leads to Heat generation. Moving Qi substances like Xuan Fu Hua (Inulae Flos), Xiang Fu (Cyperi Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Cong Bai (Allii Fistulosi Bulbus), and Xie Bai (Allii Macrostemonis Bulbus) added to warming formulas disperse Cold with doubled speed. Clearing Heat using bitter-cold, sweet-cold, and salty-cold drugs in large doses of cooling nature must include blood-invigorating items like Tao Ren (Persicae Semen), Dan Pi (Moutan Cortex), Ze Lan (Lycopus Herba), Qian Cao (Rubiae Radix), Liu Ji Nu (Artemisiae Annuae Herba), and San Qi (Notoginseng Radix) to avoid the drawback of Bing Fu Re Xie (Ice-trapping Heat pathogens). This principle is easy to understand, yet many physicians fail to recognize it, so I specifically highlight it.
Naming formulas has purpose; preparation methods are not arbitrary.
Formulas come in names like Gao (Paste), Dan (Pellet/Elixir), Wan (Pill), San (Powder), Jian (Decoction), Yin (Drink), Tang (Soup/Decoction), and Zi (Soaking), each with specific meaning. Gao seeks moisture; Dan seeks efficacy/spirit; Wan seeks slowness; San seeks urgency; Jian seeks downward action; Yin seeks balance; Tang seeks flavor to wash away pathogens; Zi seeks aroma to linger at the disease site. The combination of Jun (Monarch), Chen (Minister), Zuo (Assistant), and Shi (Courier) depends entirely on dosage. For example, in Xiao Cheng Qi Tang (Minor Order the Qi Decoction), using Da Huang as Jun directs it to the Lower/Middle Jiao Blood level; using Hou Po as Jun changes it to a method for the Upper/Middle Jiao Qi level. In Yang Dan Tang, Gui Zhi as Jun targets Taiyang; doubling Shao Yao directs it to Taiyin. In Dang Gui Chi Xiao Dou San, Chi Xiao Dou as Jun focuses on resolving toxicity; Dang Gui as Jun focuses on regulating Blood. Whether primary, auxiliary, light, or heavy, the subtlety of application lies in the mind. Can the creator of formulas neglect this?