炮？或谓止血之药多炒黑用，如荆芥、蒲黄之类皆是。予曰∶荆芥本血分药，炒黑故能去血分之风而止血；
蒲黄性涩，炒黑亦能止血。血之为病，热则妄行。炮姜岂容轻试？或曰∶荆芥、蒲黄轻浮之性，炮姜力猛直达
下焦，去恶生新，能引血药至气分而生血，子何訾之深也？予曰∶大剂四物，少加熟附佐之，未常不可，若必
藉炮姜止血，吾恐其逼血妄行，血海为之竭矣。○桂、附之纯阳，天之阳也。天之阳，阳中必有阴，桂之有油即
有阴矣。附子置器中久则器润，即有阴矣。干姜虽极辛辣，其中尚含生气，炮之以烈火，生气何在？○九制之
药，大概利于补，不利于攻。地黄、首乌为滋补良药，故宜于蒸晒，愈蒸则其液愈透，其味愈浓，守而不走，
其力乃纯。大黄气味俱浓，走而不守，气先至而味随之，九蒸则气散，气散则所存者渣滓耳，故无用也。○天
南星味辛性燥，虑其过猛，故以胆汁之苦寒抑之。一制而陈者良。近世将牛胆汁九制南星，藏为奇货，不思南
星之用，取其辛以散风，燥以祛痰，九加胆汁，则辛燥之性全失，而苦寒纯矣。是名以胆汁制南星，而实以南
星收胆汁。抑思胆汁能治风痰否？唯肝胆火盛生痰生风而成颠狂者，用为引经恰合，此外无可用之。（《怡堂散记》）
长沙夫子用阿胶，何曾云炒？后人画蛇添足耳。阿胶之用，专为济水伏流也，炒之济水何在哉！（《吴医汇讲》）
公制龙骨， 淬为末，藏诸燕腹而后用。述以语人，人以为奇。是不知古人用意故也。盖龙蜕骨去，在
地不知其年，则与
石无异。加之 淬，岂非死灰乎？而龙嗜燕，有炙燕熏龙髯，能冉冉自动，又闻食燕人不可渡海，藏之燕腹，
以回其灵，此可想见矣。（卢不远）
凡药须待炮制毕，然后称用，不得生称。湿润药须加分两，燥乃称之。（《千金方》）
咀，古制也。古无铁刃，以口咬细，令如麻豆，为粗药煎之，使药水清，饮于腹中，则易升易降。今
人以刀锉，比 咀之易成也。若概为细末，不厘清浊矣。散者，细末也，不循经络，止去胃中及脏腑之积气，
味浓者白汤调服，气味薄者煎之，和渣服。丸药去下部之疾者极大，治中焦者次之，治上焦者极小。用稠面糊
丸者，取其迟化，直至下焦也。或酒或醋丸者，取其收其散之意也。稀面糊丸者，取其易化也。汤泡蒸饼丸者，
又易化也。滴水丸者，尤易化也。炼蜜丸者，取其缓化也。蜡丸者，取其难化也。大抵汤者，荡也，去大病
用之；散者，散也，去急病用之。丸者，缓也，不能速去之病，取缓而治之之意也。（李东垣）
凡修丸剂，须每种各为细末，以末之轻重合之，则分两方准。不然，易细者一磨无遗，难碎者三复不尽。（《雷公炮制》）
凡炼蜜先掠去沫，令熬微黄试水不散，再熬二、三沸，每蜜一斤，加清水一杯，又熬一、二沸作丸，则
收潮气而不成块。○冬月炼蜜，成时加水二杯，《衍义》云∶每蜜一斤，只炼得十二两，和药末要乘极滚和之
臼内，用力捣千百杵，自然软熟，容易作条好丸。○凡汤、酒、膏中用诸石药，皆细捣之，以新绢裹之纳中。
《衍义》云∶石药入散，如钟乳粉之属，用水研极细，以水漂澄，方可服耳，岂但捣细绢裹耶？○凡药烧灰，
如十灰散之类，勿烧焦枯，用器覆存性，若 成死灰，则罔效矣。（《广笔记》）
分两升合
用药分两，为君者多；臣者次之；佐者又次之。药之于证
所主同者则等分。○古之药剂，锱铢分两，与今不同。云一升者，即今之一茶盏也；云铢者，六铢即二钱半，
二十四铢为一两也；云三两者，即今之一两；云二两即今之六钱半也。（李东垣）
数乃积小以成大，故十粉曰丸；一丸如黍；十黍为累；十累为铢；两铢四累为钱；十钱为两；八铢为锱；
三锱为一两；十六两为一斤。（《正理论》）
凡丸药云如细麻者，即胡麻也。如黍粟亦然。以十六黍为一大豆；如大麻子者，准三细麻也。如胡豆者，
即今青斑豆也。以二大麻子准之。如小豆者，即今赤小豆也。以三大麻子准之。如大豆者，以二小豆准之。如
梧桐子者，以二大豆准之。如弹丸及鸡子黄者，以十梧子准之。（《类证本草》）
凡散药有云刀圭者，有云方寸匕者，有云一字者。刀圭者，十分方寸匕之一。准方寸匕者，作匕方正一寸，
抄散取不落纸为度。一撮者四刀圭也，十撮为一勺。一字者即今之二分半也，如一钱有四字之义。（《医宗粹言》）
凡云等分者，非分两之分，谓诸药斤两多少皆同尔。（《汤液本草》）
凡言等分者，分两均等无异也，补养缓方宜之。若治病急方，须分君臣佐使。（朱丹溪）
赏读古方每有药味之下不注分两，而于末一味下，注各等分者，今人误认为一样分两，余窃不能无疑焉。
夫一方之中，必有君、臣、佐、使，相为配合，况药味有浓薄，药质有轻重，若分两相同，吾恐驾驭无权，难
于合辙也。即如地黄饮子之熟地、菖蒲，分两可同等乎？天真丸之杜仲、牵牛，分两可同等乎？诸如此类，不
一而足。岂可以各等分为一样分两哉！或曰∶子言是矣，
然则古人之不为注定，而云各等分者何谓耶？余曰∶各者，各别也。古人云∶用药如用兵，药有各品，犹之将
佐偏裨，各司厥职也。等者，类也。分类得宜，如节制之师，不致越伍而 也。分者，大小不齐，各有名分也。
惟以等字与上各字连读，其为各样分两，意自显然。今以等字与下分字连读，则有似乎一样分两耳。千里之错，
失于毫厘。窥先哲之不以分两明示后人者，盖欲人临证权衡，毋胶柱而鼓瑟也。○古方凡云一两者，以今之七
分六厘准之。凡云一升者，以今六勺七抄准之。○《千金》云∶十黍为一铢，六铢为一分，四分为一两，十六
两为一斤。此神农秤也。○方寸匕者，作匕正方一寸。钱匕者，以五铢钱为之，开元钱亦同。皆抄散取不落为度。
○《千金》论钱匕者，以大钱全抄之。半钱匕者，则是一钱抄取半边耳。钱五匕者，钱边五字者，以抄之。一
钱匕者，准今五分六厘。半钱匕者。准今二分八厘。钱五匕者，准今一分四厘。○凡丸药如梧子大者，准药末
一分。如弹丸及鸡子黄者，准药末一钱。○凡药有云大升大两者，以神农秤三两为一两，药升三升为一升。○凡
煮汤，大略古药二十两，今一两五钱；用水一斗，今七合；煮取四升，今二合八勺。○张介宾惑于郑世子之乐
书，定为古方一两，今之六钱；古方一升，今之三合三勺。大谬。李时珍云∶古之一两，今之一钱；古之一升，
今之二合半。亦非也。以古方参之，《肘后方》治消渴，以黄连三斤，纳猪肚中蒸服，根据景岳说是二十八两八
钱矣。猪肚中能容之否？又方治中风腹痛，用盐半斤熬水干，着口中，饮热汤二升，得吐愈。根据景岳则四两八
钱，能着口中耶？并能饮如许热汤耶？○古人疑汉方汤液大剂三十余两，小剂十余两，用水六、七升，煎取二、
三升，并分三服，若以古龠量水七升煎，今之三十两未淹得过。又疑散只服方寸刀圭匕，丸如梧子大，极至三
十粒，
汤此悬绝？又疑风引汤一料，计五十五两，每用三指撮，水三升煮液岂得如三沸，去渣温服一升。观其煮制，
每只三指撮，未应料剂如此之多，一旦考而正之，三疑尽释矣。（《吴医汇讲》）
今之论古方者。皆以古方分两太重为疑，以为古人体浓，故用药宜重。不知此不考古，而为无稽之谈也。
古时升斗权衡，历代各有异同。三代至汉，较之今日，仅十之二。（余亲见有汉时六升铜量容今之一升二合）。
如桂枝汤，乃伤寒大剂也。桂枝三两，芍药三两，甘草二两，共八两。二八不过一两六钱。为一剂，分作三服，
则一服药不过今之五钱三分零。他方间有药品多而加重者，亦不过倍之而已。今人用药必数品各一、二钱，或
三、四钱，则反用三两外矣。更有无知妄作，用四、五两为一剂者，复有用熟地八两为一剂者，尤属不伦。即
用丸、散亦然，如古方乌梅丸，每服如桐子大二十丸，今不过四、五分。今人服丸药则用三、四钱至七、八钱
不等矣。古方末药只用方寸匕，不过今之六、七分，今亦服三、四钱矣。古人之用分两，未尝重于今日，而谬
说相传，方剂日重，即此一端，荒唐若此，况其深微者乎？（徐灵胎）
煎药
病患服药，煎熬制度，必令亲信人煎，铫器涤净油腻。用新汲水酌量多少，慢火煎熬，分数滤渣取汁，服
之无不效。（李东垣）
凡煎汤药，以主治之君药先煮数沸，后入余药，文火缓熬得所，勿揭封盖，连罐取起，坐凉水中候温服之，
庶气味不泄。若遽乘热揭封倾出，则气泄而性不全矣。煎时不宜烈火，其汤腾沸，耗蚀速涸，药性未出，气味
不纯，人家多有此病，而反责药不效，咎将谁归？○凡煎汤药，初欲微火令小沸，其水数根据方多少，大略药二
十两，用水一斗，煮四升，以此为准。然利汤欲生，少水而多取汁；补汤欲熟，多水而少取汁。（《医宗粹言》）
煎药之法，最宜深讲。药之效不效，全在乎此。夫烹饪失其调度，尚能损人，况药之治病，可不讲乎？法载
古方，种种各殊。
如麻黄汤先煮麻黄去沫，然后加余药同煎，此主药当先煎之法也。而桂枝汤又不必先煎桂枝，服药后须啜热粥
以助药力，此又一法也。如茯苓桂枝甘草大枣汤，则以甘澜水先煎茯苓。如五苓散则以白饮和服，服后又当多
饮暖水。小建中汤则先煎五味去渣，而后纳饴糖。大柴胡汤则煎减半去渣再煎。柴胡加龙骨牡蛎汤则煎药成而
后纳大黄。其煎之多寡，或煎水减半，或十分煎去二、三分，或止煎一、二十沸。煎药之法，不可胜数，皆各
有意义。大都发散及芳香之药，不宜多煎，取其生而疏荡；补益滋腻之药宜多煎，取其熟而停蓄。此其总诀也。
故药虽中病，而煎法失度，药必无效。盖病家之常服药者，或尚能根据法为之，其粗鲁贫苦之家，安能如法制度，
是以病难愈也。若今之医者亦不能知，况病家乎？（徐灵胎）
凡汤中用阿胶、饴糖、芒硝，皆须待汤熟去渣，内净汁中煮二、三沸，俟溶化尽，倾盏内服。○凡汤中用
完物，如干枣、莲子、乌梅、决明、青箱、蔓荆、萝卜、芥、苏、韭等子，皆劈破研碎入煎，方得味出。若不
碎，如米之在谷，虽煮之终日，米味岂能出哉？至若桃、杏等仁，皆用汤泡，去皮尖及双仁者，或捣如泥，或
炒黄色，或生用俱可。○凡用砂仁、豆蔻、丁香之类，皆须打碎，迟后入药，煎数沸即起，久煎香气消散，是
以效少。○凡汤中用犀角、羚角，概末如粉，临服内汤中，后入药，或磨汁入药亦通。（《广笔记》）
琥珀木体，冲服则浮；辰砂石质，冲服则沉。若加一、二分于煎剂，不能入胃，用之何益？凡用必先为末，
置器中，以蜜调匀，然后以汤冲服。用棕、发灰亦宜先用蜜调，不尔则泛。（许宣治）
煎药用水，当以药五钱，水一盏半为率。（《活人书》）
凡煎药用水，亦各有宜。如治湿肿浮胀，而欲使利水道，则取长流水，以流长源远，其性通达，直引四肢
之间也。如治二便不通，及足胫以下风湿，则取急流水，以其湍纵峻急，性速下也。
如治痰饮郁滞而欲吐发升散，则取逆流水，以其性逆倒流，洄澜涌决也。如治中气不足，则取春雨水，有阳道
发生之意也。如治下元不足，则取井华水，盖清晨井中天一之气浮结于面，有补阴之功也。如治火热阳证，则
取雪水，大能退热也。如治伤寒阴证奔豚等疾，则取甘澜水，盖盛之于缸，扬过千遍，水珠沫液盈溢于面，性
柔味甘，能和气也。如治脾胃虚弱泄泻不食等证，则取池潦水，盖停蓄既久，不流不动，殊有土气，能助脾元
也。如治阴不升，阳不降，乖隔诸疾，则取阴阳水河井各半，阴阳相成，可升可降，而使气平者也。（《雷公炮制》）
病家各药各罐，勿与他人共享。恐彼煎攻克，此煎补益，彼煎寒凉，此煎温热。譬如酒壶泡茶，虽不醉人，
难免酒气。（《吴医汇讲》）
服药
服药活法，在上不厌频而少；在下不厌顿而多。少服则滋荣于上；多服则峻补于下。病在心上者，先食
而后药；病在心下者，先药而后食。病在四肢者，宜饥食而在日；病在骨髓者，宜饱食而在夜。（李东垣）
病在上，煎药宜武、宜清，服宜缓∶病在下，煎药宜文、宜浓，服宜急。（张洁古）
凡云分再服、三服者，要视人之强弱，病之轻重，为之进退。增减不必局于方说。又云 时，周时也。从
今旦至明旦，亦有止一宿者。○清热药宜凉服，如三黄汤之类；消暑药宜冷服，如香薷饮之类；散寒药宜热服，
如麻黄汤之类；温中药宜熟而热，补中药皆然；利下药宜生而温，如承气汤之类。（《医宗粹言》）
凡服药，寒药热饮，热药寒饮，中和之剂，温而服之。○凡汤温热易下，冷则呕涌。（《汤液本草》）
【关于炮制】有人称止血药物多炒黑使用，如荆芥、蒲黄等皆是如此。我说：荆芥本是入血分的药物，炒黑后能去除血分中的风邪从而止血；蒲黄性质涩滞，炒黑也能止血。血液为病，受热则妄行乱动。炮姜（Paojiang, 炮姜）岂能轻易尝试？有人说：荆芥、蒲黄性质轻浮，而炮姜药力猛烈直达下焦，能祛除瘀血、生成新血，能引导补血药进入气分以生血，您为何如此贬低它呢？我说：大剂量的四物汤（Siyu Tang, Four Substance Decoction），少加熟附子（Shufuzi, Prepared Aconite Root）作为佐使，未尝不可，但如果必须依靠炮姜来止血，我担心它会逼迫血液妄行，导致血海枯竭。○桂枝（Guizhi, Cinnamon Twig）、附子（Fuzi, Aconite Root）属于纯阳之品，如同天之阳。天的阳气中必有阴，桂枝含有油脂即含有阴；附子放置在容器中久了容器会湿润，这也说明其中含有阴。干姜（Ganjiang, Dried Ginger）虽然极辛辣，但其中尚含生机，用烈火炮制，生机何在？○经过九次炮制的药物，大概利于补益，不利于攻伐。地黄（Dihuang, Rehmannia Root）、何首乌（Shouwu, Fleeceflower Root）是滋补良药，所以适宜蒸晒，越蒸其汁液越透彻，味道越浓郁，守而不走，药力才纯正。大黄（Dahuang, Rhubarb Root）气味俱浓，走而不守，气先到达而味随之，九次蒸制则气散，气散后剩下的不过是渣滓罢了，所以没有用处了。○天南星（Tiannanxing, Arisaema Rhizome）味辛性燥，担心它过于猛烈，所以用胆汁的苦寒来抑制它。经过一次炮制并陈放者良。近代将牛胆汁九次炮制天南星，收藏起来当作奇货，却不思考天南星的用途在于取其辛味以散风，燥性以祛痰，如果九次加入胆汁，则辛燥之性全失，只剩下苦寒。这是名义上用胆汁炮制天南星，实际上是用天南星吸收胆汁。再想想胆汁能治疗风痰吗？只有肝胆火盛生痰生风而成癫狂的，用它作为引经药才恰当，除此之外没有可用的。（《怡堂散记》）长沙夫子（指张仲景）使用阿胶（Ejiao, Donkey-hide Gelatin），何曾说需要炒制？后人这是画蛇添足。阿胶的用途，专门是为了济水伏流（Jishui Fuliu, a metaphor for Yin fluid hidden within Yang），炒制它济水在哪里呢！（《吴医汇讲》）公制龙骨（Longgu, Fossilized Bones），淬炼成末，藏在燕子腹中然后使用。述（程杏轩自称）以此告诉别人，人们觉得很奇怪。这是不了解古人用意的缘故。龙蜕下的骨头，在地里不知多少年，那就与石头无异。加上淬炼，岂不是死灰吗？而龙喜欢燕子，有炙烤燕子熏龙髯，能使龙髯冉冉自动，又听说吃燕子的鸟不能渡海，藏在燕子腹中，以恢复其灵性，这可以想见了。（卢不远）凡药物须等待炮制完毕，然后称量使用，不得生称。湿润的药物须增加分量，干燥后再称量。（《千金方》）
【关于剂型与度量】咀，是古法。古代没有铁刃，用口咬细，使其像麻豆大小，作为粗药煎煮，使药液清澈，饮入腹中，则易于升降。现在的人用刀锉，比咀更容易制成。如果一概磨成细末，就不能分清浊了。散剂，是细末，不循经络，只去除胃中及脏腑的积气，气味浓郁的用白开水调服，气味薄的煎煮，连同药渣一起服用。丸药治疗下部疾病的颗粒极大，治疗中焦的次之，治疗上焦的极小。用稠面糊做丸药的，取它缓慢化开，直达下焦的意思。或用酒或醋做丸药的，取它收敛发散之意。稀面糊做丸药的，取它容易化开的意思。汤泡蒸饼做丸药的，也容易化开。滴水做丸药的，尤其容易化开。炼蜜做丸药的，取它缓慢化开的意义。蜡丸，取它难以化开的意义。大抵汤剂，是荡涤的意思，用于去大病；散剂，是消散的意思，用于去急病。丸剂，是缓和的意思，对于不能迅速去除的疾病，取缓而治之的意思。（李东垣）凡制作丸剂，须每种药材分别磨成细末，以末的重量相加，则分两方准。不然，易碎的磨完了，难碎的反复也磨不碎。（《雷公炮制》）凡炼蜜先撇去泡沫，令熬至微黄，试水不散，再熬二、三沸，每蜜一斤，加清水一杯，又熬一、二沸作丸，则能收潮气而不结成块。○冬天炼蜜，成时加水二杯，《衍义》说：每蜜一斤，只能炼得十二两，和药末要乘极滚和在臼内，用力捣千百杵，自然软熟，容易做成好丸。○凡在汤、酒、膏中使用各种石药，都要细捣，用新绢包裹放入其中。《衍义》说：石药入散，如钟乳粉之类，用水研极细，用水漂澄，才可以服用，岂只是捣细绢裹而已？○凡烧药成灰，如十灰散之类，不要烧焦枯，用器皿覆盖存性，若烧成死灰，则无效了。（《广笔记》）
【关于分两升合】用药分两，君药多；臣药次之；佐药又次之。药与证所主相同的则等分。○古代的药剂，锱铢分两，与现在不同。说一升的，就是现在的一茶盏；说铢的，六铢即二钱半，二十四铢为一两；说三两的，就是现在的一两；说二两的就是现在的六钱半。（李东垣）数是积累小以成大，所以十粉称为丸；一丸如黍米；十黍为累；十累为铢；两铢四累为钱；十钱为两；八铢为锱；三锱为一两；十六两为一斤。（《正理论》）凡丸药说如细麻大小的，就是胡麻。如黍粟也是这样。以十六黍为一大豆；如大麻子大小的，准三细麻。如胡豆大小的，就是现在的青斑豆。以二大麻子为准。如小豆大小的，就是现在的赤小豆。以三大麻子为准。如大豆大小的，以二小豆为准。如梧桐子大小的，以二大豆为准。如弹丸及鸡子黄大小的，以十梧子为准。（《类证本草》）凡散药有的说刀圭，有的说方寸匕，有的说一字。刀圭，是方寸匕的十分之一。准方寸匕，做匕方正一寸，抄散取不落纸为度。一撮是四刀圭，十撮为一勺。一字就是现在的二分半，如一钱有四字的含义。（《医宗粹言》）凡说等分的，不是分两的分，是说诸药斤两多少都相同。（《汤液本草》）凡言等分，分两均等无异，补养缓方适宜。若治病急方，须分君臣佐使。（朱丹溪）赏读古方每每有药味之下不注分两，而在最后一味下，注各等分者，今人误认为一样分两，我私下不能不怀疑。一方之中，必有君、臣、佐、使，相互配合，何况药味有浓薄，药质有轻重，如果分两相同，我担心驾驭无权，难于合辙。就像地黄饮子（Dihuang Yinzi, Rehmannia Decoction）的熟地、菖蒲，分两可同等吗？天真丸（Tianzhen Wan, Tianzhen Pill）的杜仲、牵牛，分两可同等吗？诸如此类，不一而足。岂可以把各等分当作一样分两呢！有人说：你说得对，那么古人不为注定，而云各等分是什么意思呢？我说：各，是各别。古人说：用药如用兵，药有各品，犹如将佐偏裨，各司其职。等，是类。分类得宜，如节制之师，不致越伍而乱。分，是大小不齐，各有名分。惟以等字与上各字连读，其为各样分两，意自显然。今以等字与下分字连读，则有似乎一样分两耳。千里之错，失于毫厘。窥探先哲不以分两明示后人，大概是希望人临证权衡，不要胶柱鼓瑟。○古方凡云一两的，以现在的七分六厘为准。凡云一升的，以现在六勺七抄为准。○《千金》说：十黍为一铢，六铢为一分，四分为一两，十六两为一斤。这是神农秤。○方寸匕，做匕正方一寸。钱匕，以五铢钱为之，开元钱也同。皆抄散取不落为度。○《千金》论钱匕，以大钱全抄之。半钱匕，则是一钱抄取半边耳。钱五匕，钱边五字者，以抄之。一钱匕，准现在五分六厘。半钱匕，准现在二分八厘。钱五匕，准现在一分四厘。○凡丸药如梧子大的，准药末一分。如弹丸及鸡子黄大的，准药末一钱。○凡药有大升大两的，以神农秤三两为一两，药升三升为一升。○凡煮汤，大略古药二十两，今一两五钱；用水一斗，今七合；煮取四升，今二合八勺。○张介宾（Zhang Jiebin, Zhang Jingyue）惑于郑世子的乐书，定为古方一两，今之六钱；古方一升，今之三合三勺。大谬。李时珍（Li Shizhen）说：古之一两，今之一钱；古之一升，今之二合半。也不对。以古方参之，《肘后方》治消渴，以黄连三斤，纳猪肚中蒸服，根据景岳说是二十八两八钱了。猪肚中能容之否？又方治中风腹痛，用盐半斤熬水干，着口中，饮热汤二升，得吐愈。根据景岳则四两八钱，能着口中耶？并能饮如许热汤耶？○古人疑汉方汤液大剂三十余两，小剂十余两，用水六、七升，煎取二、三升，并分三服，若以古龠量水七升煎，今之三十两未淹得过。又疑散只服方寸刀圭匕，丸如梧子大，极至三十粒，汤此悬绝？又疑风引汤（Fengyin Tang, Wind-Driving Decoction）一料，计五十五两，每用三指撮，水三升煮液岂得如三沸，去渣温服一升。观其煮制，每只三指撮，未应料剂如此之多，一旦考而正之，三疑尽释矣。（《吴医汇讲》）
今之论古方者，皆以古方分两太重为疑，以为古人体浓，故用药宜重。不知此不考古，而为无稽之谈也。古时升斗权衡，历代各有异同。三代至汉，较之今日，仅十之二。（我亲眼见过汉时六升铜量容现在之一升二合）。如桂枝汤（Guizhi Tang, Cinnamon Twig Decoction），乃伤寒大剂也。桂枝三两，芍药三两，甘草二两，共八两。二八不过一两六钱。为一剂，分作三服，则一服药不过现在的五钱三分零。他方间有药品多而加重者，亦不过倍之而已。今人用药必数品各一、二钱，或三、四钱，则反用三两外矣。更有无知妄作，用四、五两为一剂者，复有用熟地八两为一剂者，尤属不伦。即用丸、散亦然，如古方乌梅丸（Wumei Wan, Mume Pill），每服如桐子大二十丸，现在不过四、五分。今人服丸药则用三、四钱至七、八钱不等矣。古方末药只用方寸匕，不过现在的六、七分，今亦服三、四钱矣。古人之用分两，未尝重于今日，而谬说相传，方剂日重，即此一端，荒唐若此，况其深微者乎？（徐灵胎）
【关于煎药】病患服药，煎熬制度，必令亲信人煎，铫器涤净油腻。用新汲水酌量多少，慢火煎熬，分数滤渣取汁，服之无不效。（李东垣）凡煎汤药，以主治之君药先煮数沸，后入余药，文火缓熬得所，勿揭封盖，连罐取起，坐凉水中候温服之，庶气味不泄。若遽乘热揭封倾出，则气泄而性不全矣。煎时不宜烈火，其汤腾沸，耗蚀速涸，药性未出，气味不纯，人家多有此病，而反责药不效，咎将谁归？○凡煎汤药，初欲微火令小沸，其水数根据方多少，大略药二十两，用水一斗，煮四升，以此为准。然利汤欲生，少水而多取汁；补汤欲熟，多水而少取汁。（《医宗粹言》）煎药之法，最宜深讲。药之效不效，全在乎此。夫烹饪失其调度，尚能损人，况药之治病，可不讲乎？法载古方，种种各殊。如麻黄汤（Mahuang Tang, Ephedra Decoction）先煮麻黄去沫，然后加余药同煎，此主药当先煎之法也。而桂枝汤又不必先煎桂枝，服药后须啜热粥以助药力，此又一法也。如茯苓桂枝甘草大枣汤（Fuling Guizhi Gancao Dazao Tang），则以甘澜水先煎茯苓。如五苓散（Wuling San, Five-Ingredient Powder with Poria）则以白饮和服，服后又当多饮暖水。小建中汤（Xiao Jianzhong Tang, Minor Construct the Middle Decoction）则先煎五味去渣，而后纳饴糖。大柴胡汤（Da Chaihu Tang, Major Bupleurum Decoction）则煎减半去渣再煎。柴胡加龙骨牡蛎汤（Chaihu Jia Longgu Muli Tang, Bupleurum Plus Dragon Bone and Oyster Shell Decoction）则煎药成而后纳大黄。其煎之多寡，或煎水减半，或十分煎去二、三分，或止煎一、二十沸。煎药之法，不可胜数，皆各有意义。大都发散及芳香之药，不宜多煎，取其生而疏荡；补益滋腻之药宜多煎，取其熟而停蓄。此其总诀也。故药虽中病，而煎法失度，药必无效。盖病家之常服药者，或尚能根据法为之，其粗鲁贫苦之家，安能如法制度，是以病难愈也。若今之医者亦不能知，况病家乎？（徐灵胎）凡汤中用阿胶、饴糖、芒硝（Mangxiao, Mirabilite），皆须待汤熟去渣，内净汁中煮二、三沸，俟溶化尽，倾盏内服。○凡汤中用完物，如干枣、莲子、乌梅、决明、青箱、蔓荆、萝卜、芥、苏、韭等子，皆劈破研碎入煎，方得味出。若不碎，如米之在谷，虽煮之终日，米味岂能出哉？至若桃、杏等仁，皆用汤泡，去皮尖及双仁者，或捣如泥，或炒黄色，或生用俱可。○凡用砂仁、豆蔻、丁香之类，皆须打碎，迟后入药，煎数沸即起，久煎香气消散，是以效少。○凡汤中用犀角、羚角，概末如粉，临服内汤中，后入药，或磨汁入药亦通。（《广笔记》）琥珀木体，冲服则浮；辰砂石质，冲服则沉。若加一、二分于煎剂，不能入胃，用之何益？凡用必先为末，置器中，以蜜调匀，然后以汤冲服。用棕、发灰亦宜先用蜜调，不尔则泛。（许宣治）煎药用水，当以药五钱，水一盏半为率。（《活人书》）凡煎药用水，亦各有宜。如治湿肿浮胀，而欲使利水道，则取长流水，以流长源远，其性通达，直引四肢之间也。如治二便不通，及足胫以下风湿，则取急流水，以其湍纵峻急，性速下也。如治痰饮郁滞而欲吐发升散，则取逆流水，以其性逆倒流，洄澜涌决也。如治中气不足，则取春雨水，有阳道发生之意也。如治下元不足，则取井华水，盖清晨井中天一之气浮结于面，有补阴之功也。如治火热阳证，则取雪水，大能退热也。如治伤寒阴证奔豚等疾，则取甘澜水，盖盛之于缸，扬过千遍，水珠沫液盈溢于面，性柔味甘，能和气也。如治脾胃虚弱泄泻不食等证，则取池潦水，盖停蓄既久，不流不动，殊有土气，能助脾元也。如治阴不升，阳不降，乖隔诸疾，则取阴阳水河井各半，阴阳相成，可升可降，而使气平者也。（《雷公炮制》）病家各药各罐，勿与他人共享。恐彼煎攻克，此煎补益，彼煎寒凉，此煎温热。譬如酒壶泡茶，虽不醉人，难免酒气。（《吴医汇讲》）
【关于服药】服药活法，在上不厌频而少；在下不厌顿而多。少服则滋荣于上；多服则峻补于下。病在心上者，先食而后药；病在心下者，先药而后食。病在四肢者，宜饥食而在日；病在骨髓者，宜饱食而在夜。（李东垣）病在上，煎药宜武、宜清，服宜缓∶病在下，煎药宜文、宜浓，服宜急。（张洁古）凡云分再服、三服者，要视人之强弱，病之轻重，为之进退。增减不必局于方说。又云 时，周时也。从今旦至明旦，亦有止一宿者。○清热药宜凉服，如三黄汤（Sanhuang Tang, Three-Yellow Decoction）之类；消暑药宜冷服，如香薷饮（Xiangru Yin, Mosla Drink）之类；散寒药宜热服，如麻黄汤之类；温中药宜熟而热，补中药皆然；利下药宜生而温，如承气汤（Chengqi Tang, Purge-the-Yang Decoction）之类。（《医宗粹言》）凡服药，寒药热饮，热药寒饮，中和之剂，温而服之。○凡汤温热易下，冷则呕涌。（《汤液本草》）
[Regarding Processing] Some claim that hemostatic drugs are mostly used after being stir-fried until black, such as Schizonepetae Herba (Jingjie) and Sparganii Semen (Puhuang). I say: Schizonepetae Herba is originally a drug entering the Blood aspect; after being stir-fried black, it can remove wind from the Blood aspect and stop bleeding. Sparganii Semen has an astringent nature, and being stir-fried black also helps stop bleeding. Diseases of blood, when heated, flow recklessly. How can processed Zingiberis Rhizoma (Paojiang) be lightly tried? Someone says: Schizonepetae Herba and Sparganii Semen have light and floating natures, whereas processed Zingiberis Rhizoma has fierce power reaching directly to the Lower Jiao, removing evil and generating newness, and can guide blood-nourishing drugs to the Qi aspect to generate blood. Why do you criticize it so deeply? I say: A large dose of Siwu Tang (Four Substance Decoction), with a small amount of prepared Aconiti Lateralis Radix (Shufuzi) added as an assistant, is not unacceptable. But if one must rely on processed Zingiberis Rhizoma to stop bleeding, I fear it will force blood to flow recklessly, exhausting the Sea of Blood. ○ Cinnamon Twig (Guizhi) and Aconite Root (Fuzi) are purely Yang, like the Yang of Heaven. The Yang of Heaven must contain Yin; the oil in Cinnamon Twig indicates the presence of Yin. When Aconite Root is placed in a vessel for a long time, the vessel becomes moist, indicating the presence of Yin. Although Dried Ginger (Ganjiang) is extremely pungent and hot, it still contains vital energy. What remains of this vital energy when processed with fierce fire? ○ Drugs processed nine times are generally beneficial for tonification but detrimental for attack. Rehmanniae Radix (Dihuang) and Polygoni Multiflori Caulis (Shouwu) are excellent nourishing drugs, so they are suitable for steaming and drying. The more they are steamed, the more penetrating their fluids and the richer their taste. They stay rather than move, making their power pure. Rhubarb Root (Dahuang) has both strong aroma and flavor, moving rather than staying; its Qi arrives first and its flavor follows. If steamed nine times, its Qi scatters, and what remains is merely dregs, thus useless. ○ Arisaematis Rhizoma (Tiannanxing) is pungent and dry; fearing it is too fierce, it is suppressed by the bitter cold of bile. One processing followed by aging is good. In recent times, people process Arisaematis Rhizoma nine times with ox bile and store it as a rare treasure, failing to consider that the use of Arisaematis Rhizoma lies in its pungency to disperse wind and its dryness to resolve phlegm. Adding bile nine times causes all its pungent and drying properties to be lost, leaving only bitter cold. This is nominally using bile to process Arisaematis Rhizoma, but actually using Arisaematis Rhizoma to absorb the bile. Consider whether bile can treat wind-phlegm? Only in cases where excessive fire of the Liver and Gallbladder generates phlegm and wind leading to mania is it appropriate as a guiding drug; otherwise, it is not usable. (Yitang Sanji) Changsha Master (referring to Zhang Zhongjing) used Asini Corii Colla (Ejiao); did he ever say it should be fried? Later generations are adding feet to a snake (doing unnecessary work). The use of Asini Corii Colla is specifically for the hidden flow of Ji Water; if fried, where is the Ji Water? (Wu Yi Hui Jiang) Processed Longgu (Dragon Bone) is quenched into powder, stored in swallow bellies, and then used. I told others about this, and they found it strange. This is because they do not understand the intention of the ancients. Dragon bones shed and left underground for unknown years are no different from stones. Adding quenching makes them dead ash. Since dragons love swallows, roasting swallows to smoke dragon whiskers can make them move slowly, and it is said that birds eating swallows cannot cross the sea. Storing them in swallow bellies restores their spirit, which can be imagined. (Lu Yuanbu) All drugs must wait until processing is complete before weighing; raw weighing is not allowed. Moist drugs must have extra weight added and be weighed only when dry. (Qianjin Fang) [Regarding Dosage Forms and Measures] Ju (chewing) is an ancient method. In ancient times, there were no iron blades, so drugs were chewed fine, like hemp seeds, for coarse decoction, making the liquid clear so that it rises and falls easily in the abdomen. Today, people use knives to chop, which is easier than chewing. If all are ground into fine powder, clarity and turbidity cannot be separated. San (powder) refers to fine powder; it does not follow meridians but removes accumulated Qi in the stomach and organs. Drugs with strong flavors are taken with plain water; those with weak flavors are decocted and taken with dregs. Wan (pill) particles for treating lower body diseases are very large; those for the Middle Jiao are medium; those for the Upper Jiao are very small. Pills made with thick flour paste are intended to dissolve slowly and reach the Lower Jiao. Pills made with wine or vinegar aim to gather scattered effects. Pills made with thin flour paste dissolve easily. Pills made with steamed dough soaked in soup also dissolve easily. Pills made with dripping water dissolve especially easily. Pills made with refined honey aim for slow dissolution. Wax pills aim for difficult dissolution. Generally, Tang (decoction) sweeps away; it is used for serious diseases. San (powder) disperses; it is used for acute diseases. Wan (pill) is slow; it is used for diseases that cannot be removed quickly, aiming for gradual treatment. (Li Dongyuan) When preparing pills, each herb must be ground into fine powder separately, and the weights of the powders combined to ensure accurate dosage. Otherwise, easily crushed herbs may be completely ground while hard-to-crush ones remain unprocessed. (Leigong Paozhi) When refining honey, skim off the foam first, boil until slightly yellow and stable in water, then boil two or three more times. For every jin of honey, add one cup of clear water, boil one or two more times to make pills; this absorbs moisture without clumping. ○ In winter, when refining honey, add two cups of water at the end. Yan Yi states: One jin of honey yields only twelve liang after refining. Mix with herb powder while boiling hot in a mortar, pounding thousands of times until soft and ripe, making easy-to-shape pills. ○ When using mineral drugs in decoctions, wines, or pastes, grind them finely and wrap in new silk before adding. Yan Yi states: For mineral drugs in powders, such as Gypsum Fibrosum powder, grind extremely fine with water, wash and settle, then take; simply grinding fine and wrapping in silk is insufficient. ○ When burning drugs to ash, such as in Shihui San, do not burn until charred black. Cover with a vessel to preserve the nature; if burned to dead ash, it will be ineffective. (Guang Biji) [Regarding Dosage and Measures] In prescription dosage, the Sovereign drug is most abundant; the Minister drug is next; the Assistant drug is less. If drugs target the same syndrome, they are equal in weight. ○ Ancient drug measures differed from modern ones. "One sheng" referred to one tea cup today; "Zhu" (grain): six zhu equal 2.5 qian; twenty-four zhu equal one liang. "Three liang" equals one liang today; "Two liang" equals 6.5 qian today. (Li Dongyuan) Numbers accumulate small to large: ten fen make a pill; one pill is like a millet grain; ten millet grains make lei; ten lei make zhu; two zhu and four lei make qian; ten qian make liang; eight zhu make zi; three zi make one liang; sixteen liang make one jin. (Zheng Lilun) When pill size is described as "like fine hemp," it means Sesamum indicum seed. Like millet/grain is similar. Sixteen millet grains equal one large soybean; like large hemp seed equals three fine hemp seeds. Like broad bean equals current green spotted bean; two large hemp seeds equal one broad bean. Like mung bean equals current red adzuki bean; three large hemp seeds equal one mung bean. Like soybean equals two mung beans. Like paulownia seed equals two soybeans. Like bullet or egg yolk equals ten paulownia seeds. (Leizheng Bencao) Powders are measured by Dao Gui, Fang Cun Bi, or Yi Zi. Dao Gui is one-tenth of Fang Cun Bi. Fang Cun Bi is square, one inch per side, scooping powder without spilling. One cuo is four Dao Gui; ten cuo make one shao. Yi Zi is equivalent to 2.5 fen today; one qian has the meaning of four Yi Zi. (Yizong Cuiyan) "Equal parts" does not mean equal weight, but that the quantity of all herbs is the same. (Tangye Bencao) "Equal parts" means equal weight, suitable for tonic and slow-acting formulas. For urgent disease treatments, Sovereign, Minister, Assistant, and Envoy roles must be distinguished. (Zhu Danxi) Reading ancient formulas, sometimes dosages are not noted under individual herbs, but "equal parts" is noted under the last herb. Moderns mistakenly think this means identical weights. I doubt this. A formula must have Sovereign, Minister, Assistant, and Envoy working together. Herbs vary in potency and density. If weights are identical, control is lost, and harmony is difficult. Can Shudi and Changpu in Dihuang Yinzi have equal weights? Can Duzhong and Qian Niu in Tianzhen Wan have equal weights? There are many such cases. How can "equal parts" mean identical weights? Some ask: If correct, why did ancients say "equal parts" instead of fixed amounts? I say: "Ge" (each) means distinct. Using medicine is like using troops; different herbs are like generals and officers, each performing specific duties. "Deng" (equal) means category. Proper categorization is like disciplined troops, preventing disorder. "Fen" (part) means varying sizes with distinct roles. Reading "Deng" with "Ge" above implies different weights for different categories, which is obvious. Reading "Deng" with "Fen" below suggests identical weights. A thousand-li error stems from a tiny mistake. Ancients did not explicitly state weights to encourage clinicians to weigh situations flexibly, rather than rigidly adhering to rules. ○ Ancient "one liang" equals 0.76 qian today. Ancient "one sheng" equals 6 shao 7 chao today. ○ Qianjin states: Ten millet grains = one zhu; six zhu = one fen; four fen = one liang; sixteen liang = one jin. This is the Shenneng scale. ○ Fang Cun Bi is square, one inch. Qian Bi uses a five-zhu coin; Kaiyuan coins are similar. Scoop powder without spilling. Qianjin discusses Qian Bi: Full scoop with large coin. Half Qian Bi is half a coin's scoop. "Qian Wu Bi" uses the five characters on the coin edge. One Qian Bi equals 0.56 qian today. Half Qian Bi equals 0.28 qian. Qian Wu Bi equals 0.14 qian. ○ Pill size like paulownia seed equals 1 fen of powder. Bullet/egg yolk size equals 1 qian of powder. ○ "Large Sheng/Liang" refers to Shenneng scale: 3 liang = 1 liang; 3 sheng = 1 sheng. ○ Decoction: Ancient 20 liang ≈ 1.5 qian today; 1 dou water ≈ 7 he today; yield 4 sheng ≈ 2.8 shao today. ○ Zhang Jiebin, confused by Prince Zheng's music book, set ancient 1 liang = 0.6 qian today; 1 sheng = 3.3 shao today. This is greatly wrong. Li Shizhen said: Ancient 1 liang = 1 qian today; 1 sheng = 2.5 he today. Also incorrect. Referencing ancient formulas: Zhouhou Fang treats diabetes with 3 jin Huanglian steamed in pig stomach. According to Jingyue, this is 28.8 liang. Could a pig stomach hold this? Another formula for stroke abdominal pain uses half jin salt boiled dry, placed in mouth, drinking 2 sheng hot soup to induce vomiting. According to Jingyue, this is 4.8 liang. Could this fit in the mouth? Could one drink such hot soup? ○ Ancients doubted Han dynasty decoctions: large doses over 30 liang, small over 10 liang, using 6-7 sheng water, yielding 2-3 sheng, divided into three doses. If measuring 7 sheng water with ancient units, 30 liang of herbs would not be submerged. Doubts arose regarding powder doses (Fang Cun Bi/Dao Gui) and pill doses (paulownia seed size, max 30 pills), contrasting sharply with decoctions. Doubt also arose regarding Fengyin Tang: one batch 55 liang, taking 3 fingers pinch, boiling 3 sheng water, filtering, drinking 1 sheng warm. Observing preparation, only 3 fingers pinch was used, not implying such large batches. Once examined and corrected, these three doubts were resolved. (Wu Yi Hui Jiang) Those discussing ancient formulas today suspect ancient dosages are too heavy, assuming ancients had dense bodies requiring heavy medication. This ignores historical research and is baseless. Measures varied by dynasty. From Three Dynasties to Han, compared to today, they were only 20%. (I personally saw a Han bronze measure of 6 sheng holding 1.2 sheng today.) Guizhi Tang is a large dose for Cold Damage. Guizhi 3 liang, Shaoyao 3 liang, Gancao 2 liang, total 8 liang. Two eights is 1.6 liang. One dose divided into three servings is approx 0.53 qian today. Other formulas with more herbs might double this. Today, people use 1-2 qian or 3-4 qian per herb, exceeding 3 liang. Ignorant practitioners use 4-5 liang per dose, or 8 liang of Shudi, which is absurd. Even for pills/powders: Wumei Wan, 20 pills like paulownia seeds, is now 0.4-0.5 fen. Today people take 3-8 qian of pills. Ancient powder dose was Fang Cun Bi, approx 0.6-0.7 fen today; now people take 3-4 qian. Ancients did not use heavier dosages than today; false theories spread, causing dosages to increase daily. This absurdity extends to deeper mysteries. (Xu Lingtai) [Regarding Decoction] Patients taking medicine must have trusted persons prepare it, cleaning the pot of grease. Use fresh well water, moderate amount, simmer slowly, filter dregs to extract juice; efficacy is guaranteed. (Li Dongyuan) When decocting, boil the Sovereign drug first for a few boils, then add other herbs. Simmer gently on low heat, do not lift lid, remove pot, place in cool water, wait for warmth before taking, to prevent loss of aroma and nature. If lifted hot and poured out immediately, Qi escapes and nature is incomplete. Do not use fierce fire; boiling splashes, evaporates quickly, drug nature not released, aroma impure. Many blame ineffective drugs for this fault. ○ Initial boil should be gentle. Water amount depends on formula. Approx 20 liang herbs to 1 dou water, boil to 4 sheng. For purgative decoctions, use less water to get more juice (raw effect); for tonic decoctions, use more water to get less juice (cooked effect). (Yizong Cuiyan) Decoction methods require deep study. Efficacy depends entirely on this. Poor cooking harms people; how much more so medicine? Ancient methods vary. Mahuang Tang: boil Mahuang first to remove foam, then add others (Sovereign first). Guizhi Tang: Guizhi not pre-boiled; drink hot porridge after taking to boost power. Fuling Guizhi Gancao Dazao Tang: use Ganlan Water to boil Fuling first. Wuling San: mix with white drink, drink warm water after. Xiao Jianzhong Tang: boil five ingredients, remove dregs, add Yitang. Da Chaihu Tang: boil half, remove dregs, boil again. Chaihu Jia Longgu Muli Tang: add Dahuang after decoction is ready. Boiling amounts vary: halve water, reduce by 2-3 tenths, or boil 10-20 boils. Countless methods, each significant. Generally, dispersing/aromatic herbs should not be boiled long (retain raw/dispersing nature); tonifying/greasy herbs should be boiled longer (retain cooked/storing nature). This is the general rule. Even if herbs match the disease, improper decoction leads to ineffectiveness. Wealthy patients may follow methods; poor/rude families cannot, hence difficulty in recovery. If doctors don't know, how can patients? (Xu Lingtai) For Ejiao, Yitang, Mangxiao in decoctions, wait until decoction is done, remove dregs, add to clear liquid, boil 2-3 boils until dissolved, pour and take. ○ Whole items like dried dates, lotus seeds, wumei, jueming, etc., must be cracked and crushed before decoction to release flavor. If not crushed, like rice in husk, boiling all day won't release flavor. Peach/apricot kernels: soak in soup, remove skin/tips/double kernels, crush to paste, fry yellow, or use raw. ○ Sharen, Doukou, Dingxiang: crush, add late, boil a few boils then remove; long boiling dissipates aroma, reducing efficacy. ○ Xijiao, Lingjiao: grind to powder, add to decoction just before taking, or grind with liquid and add. (Guang Biji) Hupo (amber) floats if taken alone; Chen Shi (cinnabar) sinks if taken alone. Adding 1-2 fen to decoction doesn't enter stomach; what is the benefit? Grind to powder, mix with honey, then take with decoction. Brown hair ash also mix with honey first, otherwise it floats. (Xu Xuanzhi) Ratio: 5 qian herbs to 1.5 cups water. (Huo Ren Shu) Water selection varies. For damp swelling/ascites promoting urination, use long-flowing water (penetrating nature). For urinary/fecal obstruction or wind-damp below knees, use rapid-flowing water (descending nature). For phlegm-fluid stagnation needing vomiting/dispersing, use reverse-flowing water (upward surge). For Middle Qi deficiency, use spring rainwater (Yang generation). For Lower Yuan deficiency, use well-water at dawn (Yin tonification). For heat-fire Yang syndromes, use snow water (clearing heat). For Cold Damage Yin syndromes/Ben Tun, use Ganlan Water (agitated water, sweet/soft, harmonizing Qi). For Spleen/Stomach weakness/diarrhea, use pond water (earth qi, supporting Spleen). For Yin not rising/Yang not descending, use Yin-Yang water (half river/half well, balancing Qi). (Leigong Paozhi) Each patient's herbs in separate pots, do not share. Fear one pot attacks, another tonifies; one cold, one hot. Like brewing tea in a wine pot;虽不醉人 (won't intoxicate), but retains wine smell. (Wu Yi Hui Jiang) [Regarding Administration] Administration principles: Upper body benefits from frequent, small doses; Lower body benefits from single, large doses. Small doses nourish upper; large doses strongly tonify lower. Disease in Heart proper: food then medicine. Disease below Heart: medicine then food. Disease in limbs: take on empty stomach during day. Disease in marrow: take after meal at night. (Li Dongyuan) Disease in Upper: strong fire, clear decoction, slow intake. Disease in Lower: gentle fire, concentrated decoction, quick intake. (Zhang Jiegu) "Divide into two/three doses" depends on patient strength and disease severity; adjustments need not strictly follow formula. "Shi" means a full day/night cycle, or sometimes just one night. ○ Clearing-heat drugs: cool temperature (e.g., Sanhuang Tang). Summer-heat resolving: cold temperature (e.g., Xiangru Yin). Dispersing-cold: hot temperature (e.g., Mahuang Tang). Warming-Middle: hot/cooked. Tonifying-Middle: hot. Purging-Lower: raw/warm (e.g., Chengqi Tang). (Yizong Cuiyan) Generally: Cold drugs hot drink; Hot drugs cold drink; Neutral drugs warm drink. ○ Decoctions are easier to swallow warm; cold causes vomiting. (Tangye Bencao)