实病因由汗不宣，脉应证对法当权，休将忽略轻生命，诀有言传出自然。泻者，泻其有
余。有余者，邪气实也。泻实之法，有汗、吐、下三法，病在上者，或寒，或食，或痰，并宜吐
之。邪在表者汗之，邪在里者下之，此皆有余之证，当及时施治，不可因循。盖补泻二字，
寒热从之，医中之秘，的在于斯。泻法先缓而后急，不及可再攻，太过恐难复旧。然亦不可
确然竟以攻下为长策。盖商鞅治国之法，原非治平之正道也。（有余之证宜霸，不宜王法，
当下不可因循而失，或不当下而下之，祸不旋踵。又云∶补则补其不足，泻则泻其有余，脉
有虚实，证以明之。钱本有此一段，而草庐本无之，今附录于后。）
气虚下陷因何故？劳损伤神理必然，闭脱两般要所据，全凭提固法相兼。胃气在中，肾
气在下，二气相接，周流营运不息，何病之有？一或有伤而气虚下陷之病生矣。故肝肾之阴不能
升，心肺之火不能降，则有闭结之患。（张东扶曰∶肝肾之阴不升，则上燥，心肺之火不降
，则下寒。）须先行通知，兼以升提。如或不效，即宜温补真阳，其气自然通达。又如妇人
血崩，下气虚脱而患泄泄者，皆宜峻补兼提。经云∶出入废，则神机化灭，升降息，则气立
孤危。盖天地人一也，而生生化化，莫不由此一气之升降。所以提则春气生发而元气营运也
实证病因多因汗法未能宣通，脉象与证候相应时，治疗应当权衡利弊，切勿轻视而忽略生命安危，医诀中曾说：治病应顺应自然规律。所谓“泻”，即泻除体内有余之邪气。所谓“有余”，是指邪气盛实。泻除实邪的方法，包括汗、吐、下三法。病位在上部的，无论是寒邪、食积还是痰饮，都适宜采用吐法。邪气在体表的，用发汗法；邪气在体内的，用攻下法。这些都属于有余的证候，应当及时施治，不可拖延。补法和泻法二字，寒证和热证的治疗都要遵循这一原则，这是医学中的奥秘所在。泻法的使用要先缓和而后猛烈，如果力度不够可以再次攻伐，但如果太过则恐怕难以恢复原状。然而也不可绝对地认为攻下法是长久之策。这就像商鞅治理国家的方法，原本就不是太平盛世的正道。（对于有余的证候，宜用霸道之法，不宜用王道之法，该下之时不可拖延以免错失良机，或不该下之时误用下法，灾祸就会立刻降临。又说：补法是补其不足，泻法是泻其有余，脉象有虚有实，通过证候来明确辨别。钱本中有这一段内容，而草庐本中没有，现附录在后面。）
气虚下陷是什么原因造成的？劳倦损伤导致神气耗损，道理是必然的。闭证和脱证两种情况需要依据什么来判断？完全依靠提固法相结合。胃气位于中部，肾气位于下部，二气相互连接，周流运转不息，会有什么疾病呢？一旦有所损伤，就会产生气虚下陷的病证。因此，肝肾之阴不能上升，心肺之火不能下降，就会产生闭塞结滞的祸患。（张东扶说：肝肾之阴不升，则上部干燥；心肺之火不降，则下部寒冷。）必须先进行通知（疏通），兼用升提法。如果这样无效，就应当温补真阳，气机自然会通达。又如妇女血崩，因下焦气虚欲脱而导致泄泻的，都应当峻补兼用提法。经书说：出入功能废弛，则神机化灭；升降功能停止，则气立孤危。天地人是一体的，而生生不息的变化，没有不是由这一气的升降所主导的。所以提法能使春气生发，元气得以营运。
The etiology of excess syndromes often stems from the failure of sweating methods to disperse pathogens. When the pulse corresponds with the symptoms, treatment must be weighed carefully; one must not neglect or take life lightly. Medical aphorisms state: treating disease should follow natural laws. "Xie" (Purgation/Draining) refers to draining what is excessive. "Excessive" means pathogenic qi is solid and abundant. Methods for draining excess include sweating, vomiting, and purgation. For diseases located in the upper jiao, whether due to cold, food stagnation, or phlegm, vomiting is appropriate. For pathogens in the exterior, use sweating; for pathogens in the interior, use purgation. These are all excess syndromes that require timely treatment without delay. The concepts of tonification and draining apply to both cold and heat treatments; this is the secret of medicine. Draining methods should start gently and become intense if necessary; if ineffective, attack again, but if too aggressive, recovery may be difficult. However, one cannot absolutely regard purgation as a long-term strategy. Just as Shang Yang's governance was not the orthodox way for peaceful times. (For excess syndromes, hegemonic methods are suitable, not kingly methods. Failure to purge when indicated leads to missed opportunities; purging when not indicated brings immediate disaster. It is also said: Tonify deficiency, drain excess. Pulses have deficiency and excess, clarified by symptoms. This passage exists in Qian's edition but not in Caolu's edition, so it is appended here.)
What causes Qi deficiency with sinking? Labor injury damages spirit and reason inevitably. How to distinguish between closure and collapse syndromes? Rely entirely on combining lifting and consolidating methods. Stomach Qi is in the middle, Kidney Qi is in the lower part. When these two Qi connect and circulate continuously, what disease would arise? Once injured, Qi deficiency with sinking occurs. Therefore, if Yin of Liver and Kidney cannot ascend, and Fire of Heart and Lung cannot descend, closure and stagnation will result. (Zhang Dongfu said: If Yin of Liver and Kidney does not ascend, the upper part becomes dry; if Fire of Heart and Lung does not descend, the lower part becomes cold.) One must first ensure communication (unblocking), combined with lifting. If ineffective, warm-tonify True Yang, and Qi will naturally flow. For example, in women with uterine bleeding, where lower Qi deficiency leads to collapse and diarrhea, severe tonification combined with lifting is appropriate. The Classics state: If exit and entry cease, the Spirit mechanism perishes; if ascending and descending stop, the Qi establishment stands alone in danger. Heaven, Earth, and Man are one, and all generation and transformation stem from the ascending and descending of this one Qi. Thus, lifting promotes the sprouting of Spring Qi and the circulation of Yuan Qi.