或问∶近来习医者，案头无不置一《叶氏医案》，究竟其书何如？予曰∶先生乃吴中之
名医
也，始习幼科，后学力日进，扩充其道，于内科一门，可称集大成焉。其论肝风内动，非外
来之风，用和阳熄风之法，发前人所未发；于暑症一门，虽宗河间，而用方工细，亦可谓青
出于蓝；其于痢疾，辄用温补，疟疾少用柴胡，未免美玉微瑕。其案辨症多而论脉少，夫切
后于问，岂可浓非。更如肋痛用入络之品，若青葱管、新绛、旋复、桃仁之类；腹痛用甲己
化土，亦开后来无穷之秘。但欲观是书，须读张李刘朱各家之说，然后探究叶氏方意所从来
，庶不为无根之萍，亦免随波逐浪之诮。
古之为医，躬亲药物，如韩伯休之卖药，卖药即医也。《千金方》载采药以时，故有雷
公之
炮炙，仲景之咀 ，无一不入山采药，以救世人之疾。乐府虽有飞龙落药店之句，然至宋季
，始立和剂局，复多药铺。是时医人尚摧药笼，贮一切丸散，其饮片则取给于店铺矣。药乃
各方所产，皆本天生。白术赞曰∶津如玉液，味似琼浆；人参必钉头鼠尾，黄 必金井玉栏
。至于近世，药既有铺，聚必有行，若汉口集川陕两湖两广之药，号称为薮，天下之商贩感
集焉。蒙艟巨舰，日以百计，营运四方，而所产之地界不加广，生不敷销，无以应天下之求
。土着者乃有下子分根之法，如茯苓乃百年松脂所化。近以松枝埋于土中，三年可采。凤州
党参，陕州黄 ，于潜白术，无不称者，安能气味纯浓，得及上古哉？出处道地，最为难得
，欲求天生者，非我所知也。即人参一味，从长白发祥，得地灵气浓，功魁群草；尚有下子
分苗，名曰秧参，味淡而气薄，辛叨朝廷严禁，罪伪行真，功力如前。薄荷、青蒿，极贱
之品，吴中山野，几遍原隰，余者可知矣。惟金石血肉之品，与结子采叶之药，无分古今也
。
有人问：“近来学习中医的人，书桌上无不摆放一本《叶氏医案》，究竟这本书怎么样？”我说：“叶先生是吴地（今江苏苏州一带）的名医。他起初学习儿科，后来医术日益精进，扩充了他的学术体系，在内科方面，可称为集大成者。他论述肝风内动，认为这不是外来的风邪，而是采用调和阳气、平息内风的方法，这是前人未曾阐发的；在暑病方面，虽然宗法刘河间，但用药精细巧妙，也可以说是青出于蓝而胜于蓝；他在治疗痢疾时，往往使用温补法，治疗疟疾时少用柴胡，这未免美中不足。他的医案中辨证详细而论脉较少，诊脉排在问诊之后，怎么可以过分非议呢？又比如胁痛使用入络的药物，如青葱管、新绛、旋覆花、桃仁之类；腹痛使用‘甲己化土’法，也开启了后世无穷的奥秘。但是想要研读这本书，必须阅读张仲景、李东垣、刘河间、朱丹溪等各家学说，然后探究叶氏方义的来源，这样才不会像无根的浮萍，也能避免随波逐流的讥讽。”
古代行医的人，亲自参与药物采集和加工，如韩伯休卖药，卖药即是行医。《千金方》记载采药要按时令，所以有雷公的炮炙技术，张仲景的咀碎处理，没有谁不亲自进山采药，以救治世人的疾病。乐府诗中虽有“飞龙落药店”的句子，但直到宋代末年，才设立和剂局，随后药铺增多。那时医生还自己捣药笼，储存各种丸散，饮片则是从店铺购买的。药材都是各地所产，本乎天然生成。赞美白术说：其津液如玉液般珍贵，味道似琼浆般甘美；人参必须是钉头鼠尾状，黄芩必须有金井玉栏的特征。至于近代，既然有了药铺，聚集必然形成行业，像汉口汇集川陕、两湖、两广等地的药材，号称药库，天下的商贩都聚集于此。巨大的船只数以百计，营运四方，但产地范围并没有扩大，产量供不应求，无法应对天下的需求。当地居民于是有了播种分根的方法，比如茯苓本是百年松脂所化，现在将松枝埋入土中，三年即可采收。凤州的党参、陕州的黄芩、于潜的白术，无不受到称赞，怎么能保证气味纯正浓厚，达到上古时期的水平呢？产地道地与否，最为难得，想要追求天生原生的药材，我就不知道了。就说人参一味药，从长白山发祥之地获得浓厚的地气灵气，功效居群草之首；还有播种分苗的，名叫秧参，味道淡而气薄，虽然朝廷严禁伪劣，惩治伪品推崇真品，但其功力已不如从前。薄荷、青蒿，是极其便宜的药材，吴地的山野之间，几乎遍布原野和低湿之地，其他的药材也就可想而知了。只有金石类和血肉类药材，以及结子采叶类的药物，古今是没有区别的。
A question was raised: "Among those who are currently studying medicine, there is no one who does not keep a copy of *Ye Shi Yi An* (Medical Cases of Master Ye) on their desk. How is this book?" I replied: "Master Ye was a famous physician in Wu (present-day Suzhou area). He initially studied pediatrics, and his medical skills advanced day by day, expanding his academic system. In the field of internal medicine, he can be regarded as a synthesizer of great achievements. His discussion on 'internal stirring of liver wind' posits that it is not wind from outside, but rather employs methods to harmonize yang and extinguish wind, which was an insight not previously expounded by predecessors. Regarding summerheat diseases, although he followed the teachings of Liu Hejian, his prescriptions were meticulous and skillful, arguably surpassing his master. In treating dysentery, he often used warming and tonifying methods; in treating malaria, he rarely used Chaihu (Bupleuri Radix), which is a slight flaw in an otherwise perfect jade. His cases detailed syndrome differentiation but discussed pulse diagnosis less. Since palpation follows inquiry, how can it be severely criticized? Furthermore, for hypochondriac pain, he used herbs entering the collaterals, such as Qingcong Guan (Scallion Stem), Xinjiang (Safflower Stamen), Xuanfu Hua (Inulae Flos), and Taoren (Persicae Semen); for abdominal pain, he employed the 'Jia-Ji transforming earth' method, opening up endless secrets for later generations. However, to study this book, one must read the theories of Zhang Zhongjing, Li Dongyuan, Liu Hejian, Zhu Danxi, and others, so as to explore the origins of Master Ye's prescription logic. Only then will one not be like duckweed without roots, nor suffer the ridicule of drifting with the waves."
In ancient times, physicians personally engaged in drug collection and processing. For instance, Han Boxiu sold medicines, implying that selling medicine was synonymous with practicing medicine. *Qianjin Fang* records that herbs should be collected according to the seasons, hence the existence of Lei Gong's processing techniques and Zhang Zhongjing's chewing/crushing methods. No one failed to enter mountains to collect herbs to save people from illness. Although Yuefu poetry contains the line "Feilong fell into the pharmacy," it was not until the late Song Dynasty that the Heji Bureau (Bureau of Prepared Medicines) was established, leading to the proliferation of pharmacies. At that time, doctors still pounded medicines in mortars, storing various pills and powders, while sliced decoction pieces were purchased from shops. Herbs were produced in various regions, originating from nature. The praise for Baizhu (Atractylodis Macrocephalae Rhizoma) states: its essence is like jade nectar, its taste like fine wine gourd liquid; Ren Shen (Ginseng Radix et Rhizoma) must have nail-heads and mouse-tails, Huang Qin (Scutellariae Radix) must exhibit golden wells and jade railings. In modern times, since pharmacies exist, aggregation inevitably forms industries. Hankou, for example, gathers herbs from Sichuan, Shaanxi, Hubei, Hunan, Guangdong, and Guangxi, known as a herb reservoir, attracting merchants from all over the world. Huge ships, numbering in the hundreds daily, operate in all directions, yet the production areas have not expanded. Production cannot meet sales demand, failing to satisfy the needs of the world. Local residents thus adopted methods of sowing seeds and dividing roots. For example, Fu Ling (Poria) is transformed from pine resin of a hundred years; now, pine branches buried in soil can be harvested in three years. Dang Shen (Codonopsis Radix) from Fengzhou, Huang Qin from Shanzhou, and Baizhu from Yuqian are all praised. How can they maintain pure and strong flavors comparable to those of antiquity? Authentic origin and geographical indication are most difficult to obtain. As for seeking naturally grown herbs, I do not know. Take Ren Shen alone: originating from Changbai Mountain, absorbing rich earth qi and spiritual energy, its efficacy ranks among the top herbs. However, there are also seedlings propagated by sowing and dividing, called Yangshen (seedling ginseng), which have weak flavor and thin qi. Although the court strictly prohibits fake goods and punishes fraud while promoting authenticity, their efficacy is inferior to before. Bohe (Menthae Haplocalycis Herba) and Qinghao (Artemisiae Annuae Herba) are very cheap items, found almost everywhere in the plains and marshes of Wu region; the situation of other herbs can be imagined. Only minerals, stones, meat/blood products, and herbs harvested for fruits or leaves remain unchanged between ancient and modern times.