假令高者抑之。非高者固当抑也。以其本下而失之太高。故抑之而使下。若本高何抑之有。
假令下者举之。非下者固当举也。以其本高而失之太下。故举之而使高。若本下何举之有。
仲景治表虚。制桂枝汤。桂枝味辛热发散。助阳体轻。本乎天者亲上。故桂枝为君。芍药、甘
草佐之。阳脉涩。
阴脉弦。法当腹中急痛。仲景制小建中汤。芍药味酸寒。主收补中。本乎地者亲下。故芍药为
君。官桂、甘草佐之。一则治表虚。一则治里虚。各言其主用也。后之人用古方者。触类而长之。
则知其本而不至于差误矣。
至元庚辰六月中。许伯威五旬有四。中气本弱。病伤寒八九日。医者见其热甚。以凉剂下之。
又食梨三四枚。伤脾胃。四肢冷。时昏愦。请予治之。诊其脉动而中止。有时自还。乃结脉也。亦
心动悸。呃噫不绝。色青黄。精神减少。目不欲开。倦卧恶人语。予以炙甘草汤治之。成无己云。
补可去弱。人参大枣。甘。补不足之气。桂枝、生姜、辛。益正气。五脏痿弱。荣卫涸流。湿以润
之。麻仁、阿胶、麦门冬、地黄之甘。润经益血。复脉通心。加桂枝。人参。急扶正气。减生地黄
。恐损阳气。锉一两服之。不效。予再思脉病对。莫非药陈腐而不效乎。再于市铺选尝气味浓者。
再煎服之。其病减半。再服而愈。凡药昆虫草木。生之有地。根叶花实。采之有时。失其地。
性味少异。失其时。气味不全。又况新陈不同。精粗不等。倘不择用。用之不效。医之过也。内
经云。司岁备物。气味之专精也。修合之际。宜加意焉。
假设病情表现为上部邪气盛，应当予以抑制。并非凡是上部盛就必然要抑制，而是因为其根本在于下部虚弱却表现出过高的假象，所以通过抑制上部的方法来引导气机下行。如果原本就是上部实证，又何必去抑制呢？
假设病情表现为下部虚陷，应当予以升举。并非凡是下部虚就必然要升举，而是因为其根本在于上部有余而下部不足导致的下陷，所以通过升举的方法来使气机回升。如果原本就是下部真实证，又何必去升举呢？
张仲景治疗表虚证，制定了桂枝汤。桂枝味辛、性热，具有发散作用，助阳且质地轻清，顺应天道属性而趋向于上，因此桂枝作为君药；芍药、甘草作为佐药辅助。若出现阳脉涩、阴脉弦的脉象，按照医理应当出现腹中拘急疼痛的症状。张仲景于是制定了小建中汤。芍药味酸、性寒，主要起到收敛和补益中焦的作用，顺应地道属性而趋向于下，因此芍药作为君药；官桂、甘草作为佐药辅助。前者用于治疗表虚，后者用于治疗里虚，各自阐述其主要功效。后世的人使用古方时，若能触类旁通、举一反三，就能明白方剂的本来用意，从而避免差错错误。
至元朝庚辰年六月，许伯威四十四岁。他中气（脾胃之气）原本虚弱，患伤寒病已经八九天了。医生看到他的热象很重，就用寒凉药剂攻下，他又吃了三四枚梨，导致脾胃受损。症状表现为四肢冰冷，时常神志昏沉迷糊。请我诊治。诊察他的脉搏，跳动时有中止，有时又能自行恢复，这是结脉。同时伴有心悸，呃逆嗳气不止，面色青黄，精神萎靡减少，眼睛不想睁开，疲倦嗜卧，厌恶听到人说话。我用炙甘草汤来治疗他。成无己说：“补法可以去除虚弱。人参、大枣味甘，能补益不足之气；桂枝、生姜味辛，能增益正气。五脏痿弱，营卫气血枯竭流动，需要用湿润的药物来滋润。麻仁、阿胶、麦门冬、地黄味甘，能润养经脉、补益血液，恢复脉象、通达心窍。加入桂枝、人参，是为了紧急扶持正气；减去生地黄，是担心损伤阳气。”将药材锉碎，煮一两剂服用，没有见效。我再思考脉象与病症是否对应，莫非是因为药材陈旧腐败而不生效吗？于是再到市场上挑选气味浓郁的药材，重新煎服。服药后病情减轻了一半，再服用一次就好了。大凡药物中的昆虫草木，生长有特定的地域，根、叶、花、实，采集有特定的时节。失去了适宜的地域，药性的味道就会略有差异；失去了适宜的时节，药的气味就不完整。更何况新旧不同，精粗不等，如果不加选择地选用，用药无效，这是医生的过错。《内经》说：“根据岁气准备药物，才能获取药气的专精。”在炮制配合的时候，应该格外留意。
Suppose the condition manifests as excess in the upper part, it should be suppressed. It is not that any excess in the upper part must necessarily be suppressed; rather, it is because the root lies in deficiency of the lower part presenting with a false appearance of excess, so suppressing the upper part guides the Qi downward. If there were originally true excess in the upper part, why would suppression be necessary?
Suppose the condition manifests as sinking or deficiency in the lower part, it should be lifted. It is not that any deficiency in the lower part must necessarily be lifted; rather, it is because the root lies in surplus above and insufficiency below leading to sinking, so lifting the lower part restores the Qi upward. If there were originally true excess in the lower part, why would lifting be necessary?
Zhang Zhongjing treated exterior deficiency by formulating Guizhi Tang (Cinnamon Twig Decoction). Guizhi (Cinnamomi Ramulus) is pungent and hot, possessing dispersing properties, aiding Yang, and being light in texture. Following the principle that "what belongs to Heaven tends toward the Upper," Guizhi serves as the Jun (Sovereign) herb; Shaoyao (Paeoniae Radix Alba) and Gancao (Glycyrrhizae Radix et Rhizoma) serve as Chen (Minister) herbs assisting it. When the Yang pulse is choppy (Se) and the Yin pulse is taut (Xian), according to medical principles, acute abdominal pain should occur. Zhang Zhongjing then formulated Xiaojianzhong Tang (Minor Construct the Middle Decoction). Shaoyao is sour and cold, primarily governing astringency and tonifying the Middle Jiao. Following the principle that "what belongs to Earth tends toward the Lower," Shaoyao serves as the Jun herb; Guan Gui (Cinnamomi Cortex) and Gancao serve as Chen herbs assisting it. The former treats exterior deficiency, the latter treats interior deficiency, each stating its primary function. Those who use ancient formulas in later generations, if they can extend knowledge by analogy, will understand the original intent and avoid errors.
In the sixth month of Gengchen year of the Yuan Dynasty, Xu Bowei was forty-four years old. His Zhong Qi (Middle Qi/Spleen-Stomach Qi) was inherently weak. He had suffered from Shanghan (Cold Damage) for eight or nine days. The physician, seeing severe heat, administered cooling purgatives. Additionally, he ate three or four pears, injuring the Spleen and Stomach. Symptoms included cold limbs, frequent mental confusion, and lethargy. I was invited to treat him. Palpation revealed a pulse that beat but occasionally stopped, sometimes recovering on its own; this is a Jie Pulse (Knotted Pulse). There was also palpitations (Xin Dong Ji), incessant hiccups and belching, a complexion of greenish-yellow, reduced spirit, unwillingness to open the eyes, fatigue and desire to lie down, and aversion to hearing people speak. I treated him with Zhigancao Tang (Honey-Pounded Licorice Decoction). Cheng Wuji stated: "Tonification can remove weakness. Renshen (Ginseng Radix et Rhizoma) and Dazao (Ziziphi Jujubae Fructus) are sweet and tonify deficient Qi. Guizhi and Shengjiang (Zingiberis Rhizoma Recens) are pungent and benefit righteous Qi. With atrophy and weakness of the five Zang organs, and exhaustion of Ying and Wei circulation, moistening agents are used. Mahuang Ren (Arillused Semen Armeniacae Amarum), Ejiao (Colla Corii Asini), Maimendong (Ophiopogonis Radix), and Dihuang (Rehmanniae Radix Preparata) are sweet, moistening the meridians and benefiting blood, restoring the pulse and unblocking the Heart. Adding Guizhi and Renshen urgently supports righteous Qi; reducing Shengdihuang (Rehmanniae Radix) avoids damaging Yang Qi." The herbs were chopped and one liang dose was decocted and taken, but there was no effect. I reconsidered whether the pulse and disease matched, wondering if the herbs were stale and ineffective. I went again to the market, selected herbs with strong aroma and flavor, and decocted them again. After taking the medicine, the illness decreased by half; after another dose, he recovered. Generally speaking, herbs and insects grow in specific places, and their roots, leaves, flowers, and fruits are harvested at specific times. Losing the proper place causes slight differences in nature and flavor; losing the proper time results in incomplete aroma and flavor. Moreover, fresh and old materials differ, and refined and coarse qualities vary. If not carefully selected and used, and treatment fails, it is the physician's fault. The Neijing states: "Prepare substances according to the annual climate to obtain the essence of their aroma and flavor." During processing and compounding, one should pay close attention.