凡病患或体虚而患实邪，或旧有他病与新病相反，或一人兼患二病，其因又相反，或外
上下
各有所病，医者踌躇束手，不敢下药，此乃不知古人制方之道者也。古人用药，惟病是求。
药所以制病，有一病，则有一药以制之。其人有是病，则其药专至于病所而驱其邪，决不反
至无病之处，以为祸也。若留其病不使去，虽强壮之人，迁延日久，亦必精神耗竭而死，此
理甚易明也。如怯弱之人，本无攻伐之理。若或伤寒而邪入阳明，则仍用硝黄下药，邪去而
精气自复。如或怀妊之妇，忽患 瘕，必用桃仁、大黄以下其瘕，瘀去 台自安。或老年及
久病之人，或宜发散，或宜攻伐，皆不可因其血气之衰，而兼用补益。如伤寒之后，食复、
女劳复，仲景皆治其食，清其火，并不因病后而用温补。惟视病之所在而攻之，中病即止，
不复有所顾虑，故天下无束手之病。惟不能中病，或偏或误，或太过，则不病之处亦伤，而
人危矣。俗所谓有病病当之。此历古相传之法也。故医者当疑难之际，多所顾忌，不敢对症
用药者，皆视病不明，辨证不的，审方不真，不知古圣之精义者也。
天下有治法不误，而始终无效者。此乃病气深痼，非泛然之方药所能愈也。凡病在皮毛
荣卫
之间，即使病势极重，而所感之位甚浅，邪气易出。至于脏腑筋骨之痼疾，如劳怯、痞隔，
风痹痿厥之类，其感非一日，其邪在脏腑筋骨，如油之八面，与正气相并。病家不知，屡易
医家，医者见其不效，杂药乱投，病日深而元气日败，遂至不救。不知此病，非一二寻常之
方所能愈也。今之集方书者，如风痹大症之类，前录古方数首，后附以通治之方数首，如此
而已。此等治法，岂有愈期？必当遍考此病之种类，与夫致病之根源，及变迁之情状，并询
其历来服药之误否。然后广求古今以来治此症之方，选择其风上种种治法次第施之；又时时
消息其效否，而神明变通之，则痼疾或有可愈之理。若徒执数首通治之方，屡试不效，其计
遂穷，未有不误者也。故治大症，必学问深博，心思精敏，又专心久治，乃能奏效。世又有
极重极久之病，诸药罔效，忽服极轻淡之方而愈，此乃其病本有专治之方，从前皆系误治。
忽遇对症之药，自然应手而痊也。
凡是病人有的身体虚弱却患有实邪，有的原本有其他疾病且与新病性质相反，有的人同时患两种病，其病因又相互冲突，或者身体上下不同部位各有所病，医生犹豫不决、束手无策，不敢用药，这是不了解古人制定方剂的原则的人。古人用药，只针对病情。药物是用来控制疾病的，有一种病，就有一种药来制约它。如果人有这种病，那么这种药就会专门到达病灶处驱除邪气，绝不会跑到没有病的地方去造成祸害。如果保留疾病不让它去除，即使是强壮的人，拖延日久，也一定会精神耗竭而死，这个道理很容易明白。比如怯弱的人，本来没有使用攻伐药物的道理。但如果患了伤寒且邪气进入阳明经，则仍然使用硝石、大黄等泻下药，邪气去除后精气自然恢复。如果是怀孕的妇女，突然患上癥瘕（腹内结块），必须使用桃仁、大黄等来消除癥瘕，瘀血去除后胎元自然安宁。或者是老年人及久病之人，有的适宜发散，有的适宜攻伐，都不可因为他们的血气衰弱，就兼用补益药物。比如伤寒之后，因饮食不当导致的复发（食复）、因房事不当导致的复发（女劳复），张仲景都是治疗其积食，清除其火热，并不因为病后体虚而使用温补药物。只是视病变所在之处进行攻治，药力中病即止，不再有所顾虑，所以天下没有束手无策的病。只有不能中病，或者偏颇或错误，或者太过分，才会伤害到没有病的地方，从而使人陷入危险。世俗所说的“有病病当之”，就是历代相传的方法。所以医生在疑难之际，多有顾忌，不敢对症用药的，都是因为对病情观察不明，辨证不确切，审察方义不真切，不了解古代圣人的精微义理。
天下有治疗方法没有错误，但始终无效的。这是因为病气深重顽固，不是普通的方药所能治愈的。凡是病在皮毛和营卫之间，即使病势极重，但感受的部位很浅，邪气容易排出。至于脏腑筋骨的顽固疾病，如虚劳怯弱、痞满隔塞，风痹痿厥之类，其感受非一日之寒，其邪气在脏腑筋骨，像油渗入八面一样，与正气相搏结。病人不知道，频繁更换医生，医生见其无效，杂乱地投药，病情日益加深而元气日益败坏，最终导致无法救治。不知道这种病，不是一两个寻常的方子所能治愈的。现在编纂方书的人，对于风痹等重大病症，前面收录几首古方，后面附上几首通治的方子，仅此而已。这样的治法，哪里有痊愈的日期？必须全面考察这类病的种类，以及致病的根源，和病情变化的情状，并询问以往服药是否有误。然后广泛寻求古今以来治疗此症的方子，选择其中各种治法依次施用；又时常斟酌其效果如何，而灵活变通，那么顽固的疾病或许还有可愈的道理。如果仅仅执着于几首通治的方子，屡次尝试无效，计谋就用尽了，没有不失误的。所以治疗重大病症，必须学问深博，心思精敏，又专心持久治疗，才能奏效。世上又有极重极久的病，各种药物都没有效果，忽然服用极其轻淡的方子而痊愈，这是因为他的病本来有专门治疗的方子，从前都是误治。忽然遇到对症的药物，自然应手而痊愈。
Whenever a patient has a weak constitution but suffers from excess pathogens, or has an existing disease that contradicts a new one, or suffers from two diseases simultaneously with conflicting etiologies, or has different ailments in different parts of the body, and the physician hesitates, feeling helpless and daring not to prescribe medicine, this is due to ignorance of the ancient principles of formula formulation. Ancient practitioners sought only the disease when prescribing. Medicines are used to control diseases; for every disease, there is a specific medicine to subdue it. If a person has a specific disease, the corresponding medicine will act specifically at the site of the disease to expel the pathogen, and will certainly not travel to healthy areas to cause harm. If the disease is retained and not expelled, even a robust person will eventually die from exhaustion of spirit and vitality after prolonged delay; this principle is quite obvious. For instance, although frail individuals generally should not undergo purgative therapies, if they contract Cold Damage (Shanghan) and the pathogen enters the Yangming channel, purgatives such as Natrii Sulfas (Xiaoshi, 芒硝) and Rheum Radix et Rhizoma (Dahuang, 大黄) may still be used. Once the pathogen is expelled, the essence and qi will naturally recover. Similarly, if a pregnant woman suddenly develops a mass (Zhengjia, 癥瘕), ingredients like Prunus Persica Seed (Taoren, 桃仁) and Rheum Radix et Rhizoma (Dahuang, 大黄) must be used to eliminate the mass; once the blood stasis is removed, the fetus will naturally remain secure. In the case of the elderly or those with chronic illnesses, whether dispersing or purging is indicated, one must not combine tonifying herbs merely because their blood and qi are deficient. For example, following Cold Damage, if relapse occurs due to improper diet (Shifu, 食复) or sexual indiscretion (Nulaofu, 女劳复), Zhang Zhongjing treated the food stagnation and cleared the heat, without using warming and tonifying methods simply because the patient was post-illness. The treatment focuses solely on the location of the pathology; once the medicine acts effectively on the disease, it is stopped, without further hesitation. Thus, there are no incurable cases in the world. Only when the medicine fails to hit the target—being biased, erroneous, or excessive—will healthy tissues be damaged, leading to danger. This aligns with the common saying: "The disease bears the burden of the medicine." This is a method passed down through generations. Therefore, physicians who hesitate and dare not prescribe according to symptoms during difficult cases do so because their observation of the disease is unclear, their syndrome differentiation is inaccurate, their understanding of formulas is superficial, and they lack comprehension of the profound meaning of the ancient sages.
There are cases in the world where the treatment method is correct, yet there is no effect throughout. This is because the pathological qi is deep-seated and stubborn, and cannot be cured by ordinary prescriptions. When a disease is located in the skin, hair, Ying (Nutritive), and Wei (Defensive) levels, even if the condition is severe, the site of invasion is shallow, and the pathogen is easy to expel. However, regarding stubborn diseases of the Zang-Fu organs, tendons, and bones, such as Consumption and Deficiency Cold (Laoqie, 劳怯), Epigastric Fullness and Obstruction (Pige, 痞隔), Wind-Bi, Flaccidity, and Cold Reversal (Feijue, 痿厥), the infection did not occur in a single day. The pathogen resides in the Zang-Fu and bones/tendons, permeating like oil in all directions, merging with the healthy qi. Patients, unaware of this, frequently change doctors. Physicians, seeing no efficacy, administer miscellaneous drugs indiscriminately. The disease deepens daily, and the primordial qi deteriorates, ultimately becoming incurable. They fail to realize that such diseases cannot be cured by one or two ordinary formulas. Modern compilers of formula books, for major conditions like Wind-Bi, merely record several ancient formulas at the beginning and append several general-purpose formulas at the end. Such treatment methods offer no hope of a cure date. One must thoroughly investigate the types of the disease, its root causes, and its changing manifestations, and inquire about any errors in previous medication. Then, broadly seek formulas from both ancient and modern times to treat this syndrome, selecting and applying various therapeutic methods in sequence; constantly evaluate the efficacy and adapt flexibly. In this way, stubborn diseases might have a chance of recovery. If one merely clings to a few general formulas and finds them ineffective repeatedly, resources are exhausted, and error is inevitable. Therefore, treating major syndromes requires profound learning, acute intellect, and dedicated, long-term treatment to achieve efficacy. There are also extremely severe and chronic cases where all medicines fail, yet suddenly heal after taking a very mild and light prescription. This is because the disease originally had a specific curative formula, and previous treatments were erroneous. Upon encountering the correct symptomatic medicine, recovery follows naturally.