今人以古人气体充实，故方剂分两甚重，此无稽之说也。自三代至汉、晋，升斗权衡，
异同，以今较之，不过十分之二。（余亲见汉时，有六升铜量，容今之一升二合。）如桂枝汤
，伤寒大大剂也。桂枝、芍药各三两，甘草二两，共八两为一剂。在今只一两六钱，又分三
服，则一服不过五钱三仞零。他方有药品多者，亦不过倍之而已。况古时之药，医者自备，
俱用鲜者，分两以鲜者为准，干则折算。如半夏、麦冬之类，皆生大而干小。至附子，则野
生者甚小，后人种之乃肥大，皆有确证。今人每方必十余味每味三四钱，则一剂重一三两矣
。更有熟地用至四两一剂者，尤属可怪。古丸药如乌梅丸，每服如桐子大十丸，今秤不过二
三分，今则用三四钱至七八钱矣。古末药用方寸经匕，不过今之六七分，今服三四钱矣。古
人用药，分两未尝从重。（《周礼·遗人》凡万民之食，食者人四 ，六斗四升曰 ，四 共
二石五斗六升，为人一月之食，则每日食八升有余矣。盖一升只二合也。）二十年来，时医误
阅古方，增重分两，此风日炽。即使对病，无气不胜药力，亦必有害，况更与病相反，害不
尤速乎？既不考古，又无师授，无怪乎其动成笑柄也。
古人治法，无一方不对病，无一药不对病。如是而病犹不愈，此乃病本不可愈，非医之咎也
。后世医失其传，病之名亦不能知，宜其胸中毫无所主也。凡一病有一病之名，如中风，总
名也。其类有偏枯、痿痹、风痱、历节之殊，而诸症之中，又各有数症，各有定名，各有主
方。又如水肿，总名也。其类有皮水、正水、石水、风水之殊，而诸症又各有数症，各有定
名，各有主方。凡病尽然。医者必能实指其何名，遵古人所主何方，加减何药，自有法度可
循。乃不论何病，总以阴虚阳虚等笼之谈概之，而试以笼统不切之药。然亦竟有愈者。或其病
本轻，适欲自愈。或偶有一二对症之药，亦奏小效。皆属误治。其得免于杀人之名者，何也
？盖杀人之药，必大毒，如砒鸠之类，或大热大寒，峻厉之品。又适与病相反，服后立见其
危。若寻常之品，不过不能愈病，或反增他病耳，不即死也，久而病气自退，正气自复，无
不愈者。间有迁延日久，或隐受其害而死。更或屡换庸医，遍试诸药，久而病气益深，元
气竭亦死。又有初因误治，变成他病，展转而死。又有始服有小效，久服太过，反增他病而
死。盖日日诊视，小效则以为可愈，小剧又以为难治，并无误治之形，确有误治之实。病家
以为病久不痊，自然不起，非医之咎，因其不即死，而不之罪。其实则真杀之而不觉也。若
夫误投峻厉相反之药，服后显然为害，此其杀人，人人能知之矣；惟误服参附峻厉之药，而
即死者，则病家之所甘心，必不归咎于医。故医者虽自知其误，必不以此为戒，而易其术也
。
现代人认为古人的体质充实，所以古代方剂的药量很重，这是一种没有根据的说法。从夏、商、周三代到汉代、晋代，升、斗等容量单位和权衡（重量）标准虽有差异，但与现代相比，不过只有现在的十分之二。（我亲眼见过汉代的六升铜量器，其容量相当于现在的一升二合。）比如桂枝汤，是治疗伤寒的大剂量方剂。其中桂枝、芍药各三两，甘草二两，总共八两作为一剂。换算到现在只有一两六钱，又分为三次服用，那么每次服用不过五钱三分多一点。其他方剂中药物较多的，也不过加倍而已。况且古代的药材，由医生自备，都使用新鲜的，药量以鲜药为准，干药则进行折算。例如半夏、麦冬这类药材，都是生长时体积大，干燥后体积小。至于附子，野生的非常小，后人种植后才变得肥大，都有确凿的证据。现在的人每方必用十余味药，每味药三四钱，那么一剂的总重量就达到一两三钱了。更有甚者，熟地黄一剂用到四两，尤其令人奇怪。古代丸药如乌梅丸，每次服用像梧桐子大小的十丸，现在称不过二三钱，而现在则用到三四钱至七八钱了。古代散末药用方寸匕舀取，不过相当于现在的六七分，现在服用则是三四钱了。古人用药，药量从未从重过。（《周礼·遗人》记载：凡是万民的饮食，每人每天四升，六斗四升称为“”，四“”共二石五斗六升，这是一个人一个月的口粮，那么每天吃八升多。大概一升只等于现在的二合。）二十年来，当时的医生错误地阅读古方，增加药量，这种风气日益炽盛。即使是对症之病，如果病人正气不胜药力，也必然有害，何况药性与病情相反，危害不是更快吗？既不考证古代情况，又没有师承传授，难怪他们动不动就成为笑柄。
古人治病的方法，没有一方不对应病症，没有一味药不对应病症。像这样病情还不能痊愈的，这是因为病根本身不可治愈，而不是医生的过错。后世医生失传了医术，连病的名称都不能知晓，所以他们心中毫无主见。凡是一病就有一病的名称，比如中风，是总名。其类别有偏枯、痿痹、风痱、历节等不同，而在各种症状之中，又各有几种症状，各有定名，各有主治方剂。又如水肿，是总名。其类别有皮水、正水、石水、风水等不同，而各种症状又各有几种表现，各有定名，各有主治方剂。所有疾病都是如此。医生必须能确切指出是什么名称，遵循古人所定的何方，加减何药，自有法度可循。然而现在不论什么病，总是用阴虚、阳虚等笼统的理论来概括，并试用笼统而不切实际的药物。然而竟然也有痊愈的。或者是他的病本来轻，恰好想要自愈。或者偶然有一两味对症的药物，也奏效很小。这都属于误治。他们之所以能免于杀人的罪名，为什么呢？因为杀人的药物，一定是大毒之物，如砒霜、鸩鸟之类，或者是大热大寒、峻烈猛厉的药物。又恰好与病情相反，服用后立即显现危险。如果是寻常的药物，不过是不能治愈疾病，或者反而增加其他疾病罢了，不会立即死亡，时间久了病气自然消退，正气自然恢复，没有不痊愈的。间或有拖延日久，或者暗中受到损害而死。又或者屡次更换庸医，遍试各种药物，时间久了病气更深，元气耗尽而死。又有起初因误治，变成其他疾病，辗转致死。又有开始服用有小效，久服太过，反而增加其他疾病而死。因为天天诊视，小效就以为可以痊愈，小加重又以为难治，并没有误治的迹象，确实有误治的事实。病人家属以为病久不愈，自然不起，不是医生的过错，因为不立即死亡，所以不怪罪医生。其实则是真正杀死了人而自己不觉察。至于误投峻烈相反的药物治疗，服用后明显为害，这是杀人，人人都能知道；唯独误服人参、附子等峻烈药物而立即死亡的，则是病人家属心甘情愿，必定不归咎于医生。所以医生虽然自知其误，必定不以此为戒，而改变他的医术。
Modern people believe that ancient individuals had robust constitutions, therefore the dosages in ancient prescriptions were very heavy. This is an unfounded assertion. From the Three Dynasties (Xia, Shang, Zhou) to the Han and Jin dynasties, although units of volume (Sheng, Dou) and weight standards differed, compared to modern times, they amounted to only two-tenths of the current standard. (I have personally seen a bronze measuring vessel from the Han dynasty marked as "six Sheng," which holds the equivalent of one Sheng and two Ge in modern measurement.) For instance, Guizhi Tang (Cinnamon Twig Decoction), a large-dose prescription for treating Cold Damage (Shanghan), contains Guizhi (Cinnamon Twig) and Shaoyao (Peony Root) each at three Liang, and Gancao (Licorice Root) at two Liang, totaling eight Liang per dose. Converted to modern units, this is only one Liang and six Qian, divided into three doses, meaning each dose amounts to merely five Qian and three Fen. Other prescriptions with more ingredients do not exceed double this amount. Moreover, in ancient times, physicians prepared their own medicines, using fresh herbs whenever possible; dosages were based on fresh weight, with dried herbs being converted accordingly. For example, Banxia (Pinelliae Rhizoma) and Maidong (Ophiopogonis Radix) are larger when fresh and shrink significantly when dried. As for Fuzi (Aconiti Lateralis Radix Praeparata), wild specimens were very small, while cultivated ones became much larger later on, which is supported by solid evidence. Today, practitioners often use over ten herbs per prescription, with each herb weighing three to four Qian, resulting in a total dose weight of one Liang and three Qian. Even more strangely, some use up to four Liang of Shudi (Rehmanniae Radix) per dose. Ancient pills, such as Wumei Wan (Mume Pill), were taken as ten pills the size of tung tree seeds, weighing no more than two or three Qian today, whereas now doses range from three to seven or eight Qian. Ancient powders measured with a Fangcunbi (square-inch spoon) amounted to only six or seven Fen today, but now patients take three to four Qian. Ancient physicians never used heavy dosages. (The *Rites of Zhou* (*Zhou Li*) records under "Yiren": For the sustenance of the common people, each person consumes four Sheng daily; six Dou and four Sheng constitute a unit called "Si"; four "Si" equal two Shi and five Dou and six Sheng, which is one month's ration for one person. Thus, daily consumption exceeds eight Sheng. Essentially, one ancient Sheng equals only two modern Ge.) Over the past twenty years, contemporary physicians have erroneously interpreted ancient prescriptions by increasing dosages, a trend that has intensified daily. Even if the prescription matches the disease, if the patient's healthy Qi cannot withstand the medicinal force, harm will inevitably occur; how much more so if the medicine contradicts the disease, accelerating harm? Since they neither research antiquity nor receive proper transmission from masters, it is no wonder they frequently become objects of ridicule.
Ancient therapeutic methods ensured that every prescription corresponded precisely to the disease, and every herb matched the pathology. If the illness still did not resolve under such conditions, it was because the disease itself was incurable, not due to the physician's fault. Later generations lost this transmission; physicians could not even identify disease names, leading to a complete lack of internal guidance. Every disease has its specific name. For example, Zhongfeng (Wind Stroke) is a general term. Its subtypes include Pianku (Hemiplegia), Weibi (Flaccid Paralysis), Fengfei (Wind Flaccidity), and Lijie (Bi Syndrome affecting joints). Within these categories, there are further specific symptoms, each with defined names and primary formulas. Similarly, Shuizhong (Edema/Water Swelling) is a general term, encompassing Pishui (Skin Water), Zhengshui (True Water), Shishui (Stone Water), and Fengshui (Wind Water). Each subtype presents distinct symptoms, possesses specific names, and has corresponding main formulas. This applies to all diseases. A physician must be able to accurately identify the specific diagnosis, adhere to the primary formula prescribed by ancients, and adjust herbs according to established principles. However, nowadays, regardless of the disease, physicians generalize everything under vague concepts like Yin Deficiency or Yang Deficiency, and apply indiscriminate, imprecise medications. Yet, some cases do recover. This may be because the disease was mild and naturally resolving, or coincidentally, one or two herbs happened to match the pathology, yielding minor effects. These are all instances of mismanagement. Why do these physicians escape the label of "murderers"? Because truly lethal drugs are highly toxic, such as Pishuang (Arsenic Trioxide) or Zhenwu (Ibis poison), or extremely hot/cold and harsh substances. When administered against the disease nature, danger manifests immediately. Ordinary herbs, however, merely fail to cure the disease or may exacerbate other conditions, but do not cause immediate death. Given time, pathogenic factors recede, and Healthy Qi recovers, leading to recovery. Occasionally, prolonged illness leads to hidden damage and death. Or, frequent changes of incompetent doctors and trial-and-error with various drugs deepen the pathogen and deplete Yuan Qi (Original Qi), causing death. Some cases transform into different diseases due to initial misdiagnosis, leading to death through complications. Others show initial minor improvement, but long-term excessive use causes new ailments and death. Physicians visit daily; seeing minor improvement, they assume curability; seeing slight worsening, they deem it difficult to treat. There is no visible sign of mismanagement, yet the reality is clear. Patients' families attribute the prolonged non-recovery to the natural course of the disease, not blaming the doctor because death does not occur immediately. In truth, the patient is killed without awareness. If harsh, contradictory drugs are mistakenly administered, causing obvious harm, everyone recognizes this as murder. However, when patients die quickly after taking harsh tonics like Renshen (Ginseng Radix) and Fuzi (Prepared Aconite Root), families accept it willingly and do not blame the physician. Consequently, even if physicians know their mistake, they do not take it as a warning nor change their methods.