人身不过表里，气血不过虚实。良工先治其实，后治其虚；粗工或治虚，或治实；谬工
虚实实；惟庸工但补其虚，不敢治其实。举世不省悟，此余所以着三法也。夫病非人身素有
之物，或自外入，或自内生，皆邪气也。邪气中人，去之可也，揽而留之可乎？留之轻则久
而自尽，甚则久而不已，更甚则暴死矣。若不去邪，先以补剂，是盗未出门，而先修室宇，
正气未胜，而邪气已横 矣。惟脉脱下虚，无邪无积之人，始可议补耳。他病惟先用三法攻
去邪气，而元气自复也。《素问》一书，言辛甘发散渗淡为阳，酸苦涌泄为阴，发散归于汗
，涌归于吐，泄归于下，渗归解表，解表同于汗，泄利便同于下，殊不言补。所谓补者，辛
补肝，咸补心，甘补肾，酸补脾，苦补肺，更相君臣佐使，皆以发腠理，致津液通血气而已
。非今人所谓用温燥邪僻之补也，盖草木皆以治病，病去则五谷果菜肉皆补也。又当辨其所
宜，使无偏倾可也。若以药为补，虽甘草、人参，亦有偏胜之患，是故三法犹刑罚也，粱肉
犹德政也。治乱用刑，治治用德，理也。余用三法，常兼众法，有按有跷，有 有导，有增
减，有续止。医者不得余法而反诬之，哀哉！如引痰、漉涎、取涕迫泪，凡上行者，皆吐法
也；熏蒸、渫洗、熨烙、针制、砭射、导引、按摩，凡解表者，皆汗法也；催生、下乳、磨
积、逐水、破经、泄气，凡下行者，皆下法也。天之六气，风寒暑湿燥火，发病多在于上。
地之六气，雾露雨雪水泥，发病多在于下。酸苦
甘辛咸淡，发病多在于中。发病者三，出病亦三。风寒之邪，结搏于皮肤之间，滞于经络之
内，留而不去，或发痛麻淋痹肿痒拘挛，皆可汗而去之。痰饮宿食，在胸膈，发为诸病，皆
可涌而去之。寒热痼冷火热，客下焦，发为诸病，皆可泄而出之。吐中有散，下中有补，经
言知其要者，一言而终。此之谓也。
人体的病变范围不过表证与里证，气血的状态不过虚证与实证。高明的医生先治疗实证，后治疗虚证；一般的医生有时治虚证，有时治实证；错误的医生在虚证上误用泻法导致更虚，或在实证上误用补法导致更实（注：原文“虚实实”疑为衍文或特定语境下的简写，结合下文“庸工但补其虚”，此处意指误治导致虚实错杂或加重）；只有平庸的医生只懂得补益虚证，不敢治疗实证。世人不醒悟这一点，这就是我撰写论述汗、吐、下三法的原因。疾病不是人体原本就有的东西，或者是从外部侵入，或者是从内部产生，都是邪气。邪气侵犯人体，去除它是可以的，将其揽住并留存在体内可以吗？留存下来轻则时间久了自然耗尽，重则时间久了病愈严重，更严重的则会突然死亡。如果不祛除邪气，先用补剂，这就像盗贼还没出门，就先修补房屋墙壁，正气尚未战胜邪气，邪气已经横行霸道了。只有脉象沉伏、身体虚弱、没有邪气也没有积滞的人，才可以讨论使用补法。其他疾病都应当先用汗、吐、下三法攻逐邪气，元气自然会恢复。《素问》一书中，说辛味和甘味发散、淡味渗利属于阳，酸味和苦味涌泄属于阴；发散归于汗法，涌吐归于吐法，泄利归于下法，渗利归于解表，解表同于汗法，泄利二便同于下法，唯独不谈补法。所谓的补，是指辛味补肝，咸味补心，甘味补肾，酸味补脾，苦味补肺，它们相互作为君臣佐使，都是通过开发腠理，促使津液流通，通达血气而已。并不是现在人们所说的用温燥、偏邪的药物进行补益。大概草木药物都是用来治病的，病去除了，那么五谷、水果、蔬菜、肉类才是补品。还应当辨别适宜的情况，使身体不偏颇倾斜就可以了。如果把药物当作补品，即使是甘草、人参，也有偏胜的危害，所以汗、吐、下三法如同刑罚，粮食肉类如同德政。治理乱世用刑罚，治理太平盛世用德政，这是常理。我运用汗、吐、下三法时，常常兼用其他方法，有按压，有跷引，有引导，有增减，有继续或停止。医生如果得不到我的这些方法反而诬蔑我，真是悲哀啊！比如引出痰液、滤出涎沫、取出鼻涕、逼迫流泪，凡是向上行的，都属于吐法；熏蒸、洗涤、熨烫、烙印、针刺、砭石射毒、导引、按摩，凡是解除表证的，都属于汗法；催生、下乳、磨消积滞、逐水、破开经闭、泄气，凡是向下行的，都属于下法。天的六气，即风、寒、暑、湿、燥、火，发病多在上部。地的六气，即雾、露、雨、雪、泥、水，发病多在下部。酸、苦、甘、辛、咸、淡六种味道，发病多在中部。发病的部位有三类，排出病邪的方法也有三类。风寒邪气，结聚搏结在皮肤之间，阻滞在经络之内，停留不去，或者引发疼痛、麻木、淋沥、痹症、肿胀、瘙痒、拘挛等症状，都可以用汗法来祛除。痰饮、宿食，停留在胸膈部位，引发各种疾病，都可以用涌吐法来祛除。寒热、痼冷、火热，客居于下焦，引发各种疾病，都可以用泄下法来排出。吐法中包含发散之意，下法中包含补益之意，《内经》说知道要领的人，一句话就能终结道理。说的就是这种情况。
The pathology of the human body is limited to Exterior (Biao) and Interior (Li), and the state of Qi and Blood is limited to Deficiency (Xu) and Excess (Shi). A skilled physician first treats Excess, then treats Deficiency; a mediocre physician sometimes treats Deficiency, sometimes treats Excess; an erroneous physician [mismanages both, leading to further imbalance]; only a dull physician knows only to tonify Deficiency and dares not treat Excess. The world fails to realize this, which is why I wrote about the three methods: Sweating (Han), Vomiting (Tu), and Purgation (Xia). Disease is not something inherent in the body; whether it enters from outside or arises from inside, it is all Pathogenic Factor (Xieqi). When pathogenic factors invade the body, it is permissible to eliminate them; is it permissible to retain them? If retained, mild cases may resolve naturally over time, severe cases may worsen over time, and even more severe cases may result in sudden death. If one does not eliminate the pathogenic factor but uses tonifying agents first, it is like repairing the house before the thief has left; the Healthy Qi (Zhengqi) has not yet overcome the pathogen, while the pathogen runs rampant. Only in cases where the pulse is deep/faint, the body is weak, and there are no pathogens or accumulations, can one discuss using tonification. For other diseases, one should first use the three methods to attack and eliminate the pathogenic factor, and the Original Qi (Yuanshen) will recover on its own. In the *Suwen* (Plain Questions), it states that Acrid (Xin) and Sweet (Gan) flavors that disperse, and Bland (Dan) flavors that drain, belong to Yang; Sour (Suan) and Bitter (Ku) flavors that induce vomiting and purging belong to Yin. Dispersing belongs to the Sweating Method (Han Fa); inducing vomiting belongs to the Vomiting Method (Tu Fa); purging belongs to the Purgation Method (Xia Fa); draining belongs to releasing the exterior. Releasing the exterior is similar to sweating; purging bowels and bladder is similar to purgation. It speaks little of tonification. What is called "tonification" refers to: Acrid tonifies Liver, Salty tonifies Heart, Sweet tonifies Kidney, Sour tonifies Spleen, Bitter tonifies Lung. They act as Sovereign, Minister, Assistant, and Courier (Jun-Chen-Zuo-Shi), merely by opening the Couli (pores/skin texture), promoting the flow of Jin-Ye (body fluids), and circulating Qi and Blood. This is not what modern people call tonification using warm, dry, or eccentric substances. Generally, herbal medicines are used to treat disease; once the disease is gone, grains, fruits, vegetables, and meats serve as tonics. One must also distinguish what is appropriate to avoid bias. Even if herbs are considered tonics, such as Gancao (Licorice Root) and Renshen (Ginseng Root), they carry the risk of excessiveness. Therefore, the three methods (Sweating, Vomiting, Purgation) are like punishments, while food and meat are like virtuous governance. Using punishment to govern chaos, and virtue to govern peace, is the principle. When I use the three methods, I often combine other methods, including pressing, lifting/guiding, directing, increasing/decreasing, continuing/stopping. Physicians who do not grasp these methods and instead slander me—how sorrowful! For example, drawing out phlegm, filtering saliva, extracting nasal discharge, forcing tears—all upward-moving actions belong to the Vomiting Method; fumigation, washing, hot compresses, cauterization, acupuncture, bi-shi (stone therapy), Dao-yin (guiding and pulling), massage—all actions that release the exterior belong to the Sweating Method; inducing labor, promoting lactation, grinding accumulations, driving out water, breaking menstrual stasis, venting Qi—all downward-moving actions belong to the Purgation Method. The Six Qi of Heaven: Wind, Cold, Summer-heat, Dampness, Dryness, Fire; diseases caused by these mostly occur in the Upper Jiao (Upper Burner). The Six Qi of Earth: Fog, Dew, Rain, Snow, Mud, Water; diseases caused by these mostly occur in the Lower Jiao. The six flavors: Sour, Bitter, Sweet, Acrid, Salty, Bland; diseases caused by these mostly occur in the Middle Jiao. There are three categories of disease onset, and correspondingly, three methods of expulsion. Wind-Cold pathogens, knotting between the skin and muscles, stagnating within the meridians, remaining without going, may cause pain, numbness, dripping sensations, Bi-syndrome (obstruction), swelling, itching, or spasms; all can be expelled via Sweating. Phlegm-fluids and retained food, lodged in the chest and diaphragm, causing various diseases, can all be expelled via induced vomiting. Cold, Heat, chronic cold, and fire-heat, lodging in the Lower Jiao, causing various diseases, can all be expelled via purgation. Vomiting contains dispersing properties; purgation contains tonifying properties. The Classics say, "He who grasps the essence needs only one word to conclude." This is what is meant.