资生万物位坤宫，忌湿宜温益理中；血气源头从此化，先天化育赖为宗。土为万物之母
，在
蔻、陈皮、山药之类相投，深有补益。先天后天所生气血，由此而化。凡治百病，先观胃气
之有无，次察生死之变化。所至重者，惟中气耳，可不谨乎！
一点真阳寄坎中，固根须要药灵通，甘温有益寒无补，我笑丹溪错认功。水中之火，乃
先天真一之气，藏于坎中。其气自下而上，与后天胃气相接而生，乃人身之至宝。劳伤过度，损
竭真阴，以致精不能生气，气不能安神，使相火妄动飞腾，而现有余之证，非真有余，是因
下元不足之故也。火与元气，势不两立，若执丹溪法，降火滋阴，而用黄柏、知母治之，恐
其愈投愈损。（王胥山曰∶丹溪以四物汤加黄柏、知母，为滋阴降火之妙剂，亦是一法，若
以慎斋所言之证，而以丹溪之法治之，大非所宜矣。炳章按∶语甚精奥，然以此诋丹溪则不
可，王氏批语甚为的当焉。）若见此证，宜温补于下，而火自归原，病即愈矣。如元气骤脱
，相火亦衰，脉微足冷厥逆，各脱阳证，更宜大剂温补，缓则不能救矣。
肺为华盖主皮毛，金体由来畏火烧，便竭皮枯津液涸，滋干润燥见功劳。润治之方，其
理不出乎滋阴润燥，流通血气。夫人身之中，水一火五，阳实阴虚。若嗜欲无节，以致肾水受伤
，虚火为患，肾虚恶燥，或前后闭结，或痰在咽喉中干咯，此皆津液不足之故。而火动元阳
，焉能全其化育？理宜补养肺金，使金水相生。（肺金，钱本作肾中之金。）自然出入升降，
脾胃位居坤宫，是化生滋养万物的根本，性质上厌恶湿邪而适宜温养，从而益助中焦脾胃之气；它是气血生成的源头，先天的化育功能也依赖于此作为宗主。土（脾）被视为万物的母亲，若出现相关病症，使用白豆蔻、陈皮、山药等药物进行调理，具有极深的补益作用。先天与后天所化生的气血，都由此产生。凡是治疗各种疾病，首先要观察胃气的有无，其次要察知生死的变化。其中最为重要的，唯有中气罢了，怎能不谨慎对待呢！
一点真阳寄居在坎位（肾），固护根基必须依靠灵通有效的药物，甘温性质的药物有益处，而寒凉药物无补益之功，我笑朱丹溪错误地认识了这一功效。水中之火，即是先天的真一之气，藏于坎位之中。这股气自下而上运行，与后天的胃气相接并共同生化，是人体最宝贵的东西。如果因过度劳累损伤，导致真阴枯竭，致使精不能化生气，气不能安守神志，使得相火妄动飞腾，从而表现出看似有余的证候，这并非真正的实证有余，而是因为下元不足的缘故。火与元气，势不两立，如果拘泥于朱丹溪的方法，采用降火滋阴，并使用黄柏、知母来治疗，恐怕会越治越亏损。（王胥山说：朱丹溪用四物汤加上黄柏、知母，作为滋阴降火的妙剂，这也是一种方法，但如果针对慎斋所说的这种证候，却用朱丹溪的方法来治疗，就非常不适宜了。炳章按语：这话非常精奥，但以此来诋毁朱丹溪则不可取，王氏的批语非常恰当。）如果见到这种证候，适宜在下焦进行温补，那么火自然回归本源，病就会痊愈。如果元气突然脱失，相火也随之衰微，出现脉象微弱、脚冷、四肢厥逆等各种阳气脱失的证候，更应当使用大剂量的温补药物，如果迟缓就不能挽救了。
肺位于上方如华盖般覆盖诸脏，主管皮毛，金的体质向来畏惧火烧，如果津液枯竭，皮肤干枯，滋润干燥的功效就能显现出来。润燥治疗的方剂，其原理不出乎滋阴润燥、流通气血。在人体之中，水为一，火为五，阳气实而阴气虚。如果嗜欲没有节制，导致肾水受伤，虚火成为病患，肾虚厌恶燥邪，或者出现前后二便闭结，或者痰在咽喉中干涩难咯，这都是津液不足的缘故。而火动耗损元阳，怎么能保全化育的功能呢？理应补养肺金，使金水相生。（肺金，钱乙的版本注为肾中之金。）自然实现出入升降的生理功能。
The Spleen resides in the Kun Palace (Earth), serving as the foundation for nourishing all things; it abhors dampness and favors warmth to benefit the Middle Jiao (Middle Burner); it is the source of Qi and Blood generation, and the congenital transformation relies on it as the patriarch. Earth (Spleen) is regarded as the mother of all things; when relevant conditions arise, using herbs such as *Amomi Fructus Rotundus* (Cardamom), *Citri Reticulatae Pericarpium* (Tangerine Peel), and *Dioscoreae Rhizoma* (Chinese Yam) for treatment yields profound tonifying effects. The Qi and Blood generated from both the congenital and postnatal sources are transformed here. In treating all diseases, one must first observe the presence or absence of Stomach Qi (Stomach's digestive vitality), and subsequently examine changes indicating life or death. Among these, the Middle Qi (Central Qi) is of utmost importance; how can one not be cautious?
A trace of True Yang resides within Kan (Kidney); securing the root requires effective and unobstructed medicinal intervention. Sweet-warm substances offer benefits, whereas cold substances provide no tonification; I laugh at Zhu Danxi for misinterpreting this merit. Fire within Water refers to the congenital True One Qi, hidden within Kan. This Qi moves upward from below, connecting with postnatal Stomach Qi to generate vitality, representing the body's supreme treasure. Excessive labor and injury deplete True Yin, causing Essence to fail to generate Qi, and Qi to fail to calm Shen (Spirit), leading to the reckless movement and soaring of Ministerial Fire (Xiang Huo). This manifests as symptoms appearing to indicate excess, but this is not true excess; rather, it stems from deficiency in the Lower Yuan (Lower Origin). Fire and Original Qi are mutually exclusive. If one adheres strictly to Zhu Danxi’s method of descending fire and nourishing Yin, using *Phellodendri Cortex* (Huangbai) and *Anemarrhenae Rhizoma* (Zhimu), it is feared that the condition will worsen with each administration. (Wang Xushan stated: Zhu Danxi used Siwu Tang added with Huangbai and Zhimu as an excellent formula for nourishing Yin and descending fire, which is indeed a valid method. However, applying Zhu Danxi’s method to the specific syndrome described by Shenzhai is highly inappropriate. Bingzhang notes: The statement is profound, but using it to disparage Zhu Danxi is unjustified; Wang’s commentary is very apt.) When encountering such a syndrome, warming and tonifying the lower region is appropriate, allowing the fire to return to its origin, and the disease will heal. If Original Qi suddenly collapses, Ministerial Fire also declines, presenting with faint pulse, cold feet, and cold limbs (Jue Ni)—various signs of Yang collapse—then large doses of warming and tonifying agents are urgently required; delay renders rescue impossible.
The Lung acts as the Imperial Canopy covering the organs above, governing the skin and hair; the nature of Metal inherently fears burning. If fluids exhaust and skin withers due to dryness, the efficacy of moistening dryness becomes apparent. Formulas for moistening treatment operate on the principle of nourishing Yin, moistening dryness, and promoting the circulation of Qi and Blood. Within the human body, Water is one and Fire is five; Yang is substantial while Yin is deficient. Unrestrained desires injure Kidney Water, causing Deficient Fire to become pathological. Kidney deficiency dislikes dryness, potentially leading to constipation of both bowels, or phlegm stuck in the throat with dryness and difficulty expectorating; all these result from insufficient Body Fluids. Furthermore, if Fire agitates and damages Original Yang, how can transformation and generation be preserved? It is proper to tonify Lung Metal, enabling Metal and Water to generate each other. (Lung Metal, in Qian’s version, is annotated as Metal within the Kidney.) Naturally, this facilitates the ascending, descending, exiting, and entering physiological functions.