杂症主治四字者，气、血、痰、郁也。丹溪治法，气用四君子汤，血用四物汤，痰用二
陈汤，郁用越鞠丸，参差互用，各尽其妙。薛立斋从而广之，气用补中，而参以八味，益气
之源也。血或四物，而参以六味，壮水之主也。痰用二陈，而兼以六君，补脾土以胜湿，治
痰之本也。郁用越鞠，而兼以逍遥，所谓以一方治木郁而诸郁皆解也。用药之妙，愈见精微
以愚论之，气虚者，宜四君辈，而气实者，则香苏、平胃之类可用也。血虚者，宜四物辈
；而血实者，则手拈、失笑之类可用也。寻常之痰，可用二陈辈，而顽痰胶固致生怪症者，
自非滚痰丸之类不济也。些小之郁，可用越鞠、逍遥辈，而五郁相混，以致腹膨肿满，二便
不通者，自非神佑、承气之类弗济也。大抵寻常治法，取其平善，病势坚强必须峻剂
以攻之，若一味退缩，则病不除。而不察脉气，不识形情，浪施攻击，为害尤烈。务在平时
将此气、血、痰、郁四字，反复讨论，曲尽其情，辨明虚实寒热，轻重缓急，一毫不爽，
则临证灼然，而于治疗杂症之法，思过半矣。
凡看症之法，先辨内伤、外感，次辨表、里，得其大概，然后切脉、问症，与我心中符
合，斯用药无有不当。口鼻之气，可以察内伤、外感。身体动静，可以观表里。口鼻者，气
之门户也，外感、则为邪气有余，邪有余，则口鼻之气粗，疾出疾入。内伤、则为正气虚弱
正气虚，则口鼻之气微，徐出徐入。此决内外之大法也。动静者，表里之分也。凡发热，
静而默默者，此邪在表也。若动而躁，及谵语者，此邪在里也。而里证之中，复有阴阳之分
凡病患卧，须看其向里、向外睡，仰睡、处长睡，伸脚、蜷脚睡。向里者阴也，向外者
阳也，仰者多热，复者多寒，伸脚者为热，蜷脚者为寒。又观其能受衣被与否。其人衣
被全覆，手脚不露，身必恶寒，既恶寒，非表证即直中矣。若揭去衣被，扬手露脚，身必
恶热，既恶热，邪必入腑矣。此以身体动静并占其寒热也。然又有阳极似阴，其人衣被全覆
昏昏而睡；复有阴极似阳，假渴烦躁，欲坐卧泥水中。此乃真热假寒、真寒假热之象，
尤不可以不辨。
杂病治疗的四个关键字，是气、血、痰、郁。朱丹溪的治疗法则中，治气病用四君子汤，治血病用四物汤，治痰病用二陈汤，治郁病用越鞠丸，这些方剂可以灵活配合使用，各自发挥其精妙之处。薛立斋在此基础上加以推广：治气病用补中益气汤，并参合八味地黄丸，这是为了益气的源头；治血病用四物汤，并参合六味地黄丸，这是为了壮水之主（滋补肾阴）；治痰病用二陈汤，并兼用六君子汤，通过补益脾土来战胜湿气，这是治疗痰病的根本；治郁病用越鞠丸，并兼用逍遥散，这就是所谓用一方治疗木郁而使得各种郁结都得以解除。用药的精妙之处，由此可见更加精细微妙。依我看来，气虚的人，适宜用四君子汤这类方剂；而气实的人，则可以使用香苏散、平胃散之类的方剂。血虚的人，适宜用四物汤这类方剂；而血实的人，则可以使用手拈散、失笑散之类的方剂。普通的痰证，可以使用二陈汤这类方剂；但如果是顽痰胶结固着导致产生怪异病症的，自然非滚痰丸之类的方剂不能奏效。轻微的郁结，可以使用越鞠丸、逍遥散这类方剂；但如果五种郁结相互混杂，导致腹部膨胀肿满，大小便不通畅的，自然非神佑丸、承气汤之类的方剂不能救治。大抵常规的治疗方法，追求的是平和妥善；如果病势强劲猛烈，必须用峻猛的药剂来攻伐它，如果一味退缩不前，那么疾病就无法去除。然而如果不诊察脉象气息，不认识形体情状，盲目地施用攻伐之法，造成的危害尤其剧烈。务必在平时将气、血、痰、郁这四个字，反复讨论，详尽透彻地理解其情形，辨明虚实寒热，轻重缓急，丝毫不差，那么在临证时就能清楚明白，而对于治疗杂病的方法，也就掌握了一半以上的要领了。
大凡看诊的方法，先辨别内伤和外感，其次辨别表证和里证，掌握了大概情况之后，然后切脉、询问症状，如果与心中所想的相符，这样用药就没有不恰当的。口鼻的气息，可以用来察知是内伤还是外感。身体的动静，可以用来观察是表证还是里证。口鼻，是气息的门户，如果是外感，就是邪气有余，邪气有余，那么口鼻的气息就粗重，出气进气都很快。如果是内伤，就是正气虚弱，正气虚，那么口鼻的气息就微弱，出气进气都缓慢。这是决定内外的大法。动静，是区分表里的依据。凡是发热，身体安静且沉默不语的，这是邪气在表。如果身体躁动不安，以及说胡话的，这是邪气在里。而在里证之中，又有阴阳的区别。凡是病人睡觉，必须看他面向里睡还是面向外睡，仰卧睡还是侧卧蜷缩睡，伸脚睡还是蜷脚睡。面向里睡属阴，面向外睡属阳，仰卧的多为热证，侧卧蜷缩的多为寒证，伸脚睡的属于热证，蜷脚睡的属于寒证。又观察他是否能承受衣被覆盖。如果病人全身覆盖衣被，手脚不露出来，身体一定恶寒，既然恶寒，不是表证就是直中脏腑（寒邪直接侵入内脏）。如果掀开衣被，扬手露脚，身体一定恶热，既然恶热，邪气一定入腑了。这是通过身体的动静并占测其寒热的方法。然而又有阳极似阴的情况，病人全身覆盖衣被昏昏欲睡；又有阴极似阳的情况，假性口渴烦躁，想要坐在泥水中。这是真热假寒、真寒假热的征象，尤其不可以不辨别。
The four key characters for the treatment of miscellaneous diseases are Qi (Vital Energy), Blood, Phlegm, and Stagnation. Zhu Danxi's therapeutic principles state that for Qi disorders, Si Jun Zi Tang (Four Gentlemen Decoction) is used; for Blood disorders, Si Wu Tang (Four Substance Decoction) is used; for Phlegm disorders, Er Chen Tang (Two Aged Ingredients Decoction) is used; and for Stagnation disorders, Yue Ju Wan (Yueju Pill) is used. These formulas can be flexibly combined and used together, each demonstrating its own subtlety. Xue Lizhai further expanded upon this: for Qi disorders, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used, supplemented with Ba Wei Di Huang Wan (Eight-Ingredient Pill from the Kidney Mansion), which aims to benefit the source of Qi. For Blood disorders, Si Wu Tang is used, supplemented with Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), which aims to strengthen the master of Water (nourish Kidney Yin). For Phlegm disorders, Er Chen Tang is used, accompanied by Liu Jun Zi Tang (Six Gentlemen Decoction), tonifying Spleen Earth to overcome Dampness, addressing the root of Phlegm. For Stagnation disorders, Yue Ju Wan is used, accompanied by Xiao Yao San (Free and Easy Wanderer Powder), which is what is meant by treating Wood Stagnation with one formula so that all stagnations are resolved. The subtlety of medication use becomes increasingly refined and precise as seen here. In my opinion, those with Qi Deficiency should use formulas like Si Jun Zi Tang, whereas those with Qi Excess may use formulas such as Xiang Su San (Fragrant Perilla Powder) or Ping Wei San (Calm the Stomach Powder). Those with Blood Deficiency should use formulas like Si Wu Tang, whereas those with Blood Excess may use formulas such as Shou Nian San (Hand-Picking Powder) or Shi Xiao San (Painless Powder). Ordinary Phlegm disorders can be treated with formulas like Er Chen Tang, but if stubborn Phlegm is firmly consolidated causing bizarre symptoms, only formulas like Gun Tan Wan (Rolling Phlegm Pill) will suffice. Minor Stagnation can be treated with formulas like Yue Ju Wan or Xiao Yao San, but if the Five Types of Stagnation are mixed, leading to abdominal distension and fullness, and obstruction of urination and defecation, only formulas like Shen You Wan (Divine Protection Pill) or Cheng Qi Tang (Order the Qi Decoction) will suffice. Generally, routine treatments aim for balance and safety; however, if the disease momentum is strong and fierce, potent agents must be used to attack it. If one retreats timidly, the disease will not be eliminated. Yet, if pulse and Qi are not examined, and physical condition and presentation are not understood, blindly applying attacking methods causes even more severe harm. One must repeatedly discuss these four characters—Qi, Blood, Phlegm, and Stagnation—in daily life, exhaustively understanding their nature, clearly distinguishing between Deficiency and Excess, Cold and Heat, severity and urgency, without any error. Then, when facing clinical cases, one will be clear and certain, and regarding the methods for treating miscellaneous diseases, one will have mastered more than half of them.
In general, the method of examining symptoms involves first distinguishing between Internal Injury and External Contraction, then distinguishing between Exterior and Interior syndromes. Once the general outline is grasped, one proceeds to palpate the pulse and inquire about symptoms. If this aligns with one's internal understanding, then medication will be appropriate. The breath from the mouth and nose can indicate whether the cause is Internal Injury or External Contraction. The movement or stillness of the body can observe whether the syndrome is Exterior or Interior. The mouth and nose are the portals of Qi. In External Contraction, there is an excess of pathogenic factors; thus, the breath from the mouth and nose is coarse, exiting and entering rapidly. In Internal Injury, there is a deficiency of healthy Qi; thus, the breath is faint, exiting and entering slowly. This is the major principle for determining Exterior versus Interior. Movement and stillness distinguish between Exterior and Interior. Whenever there is fever, if the patient is still and silent, the pathogen is in the Exterior. If the patient is restless and agitated, or speaks deliriously, the pathogen is in the Interior. Within Interior syndromes, there is again a distinction between Yin and Yang. When observing a sleeping patient, note whether they sleep facing inward or outward, lying on their back or curled up, with legs extended or curled. Sleeping facing inward indicates Yin; facing outward indicates Yang. Lying on the back often indicates Heat; curling up often indicates Cold. Extending the legs indicates Heat; curling the legs indicates Cold. Also observe whether they can tolerate being covered with clothes and blankets. If a person is completely covered, with hands and feet hidden, they likely suffer from aversion to cold. If they have aversion to cold, it is either an Exterior syndrome or direct invasion into the Zang-Fu organs. If they throw off covers and blankets, waving hands and exposing feet, they likely suffer from aversion to heat, indicating the pathogen has entered the Fu organs. This uses body movement and stillness to infer Cold and Heat. However, there are cases where Extreme Yang resembles Yin, where the patient is fully covered and sleeps drowsily; and cases where Extreme Yin resembles Yang, presenting with false thirst, restlessness, and a desire to sit in mud or water. These are signs of True Heat with False Cold, and True Cold with False Heat, which must especially be distinguished.