《经》说∶合药慎勿合相反畏恶相杀者，不能除病，反伤人命。检旧方相犯者甚多，今
根据方用之，乃未见有入口即毙者。凡服犯禁忌药，亦恐病不即除，久远潜为害也。如反药禁
所说，以相对者服之即甚耳。诸方既合杂多物，其势应小微，故得不即毙也。
《经》说∶药物有阴贼者，令人羸瘦，阴痿短气，伤坏五内。夫服相反畏恶之药，虽不
即毙，然久远潜害，亦可如此，岂可不避者焉。寻古之处方，皆当明审经禁，不应合其相反
畏恶也。恐特是野间山郡官典，医辈相传，以意增损，故有犯禁药耳。
凡病自有外候危急而反易瘥者，服一方即瘥，亦有不治自若瘥者，与此相会，便称方神
验，相承推之为旧方，皆不却除其犯禁药物而服之，其实不能除病也。且轻命者多不信脉，
亦云诊脉是精妙之术，非不博者所能解，不至辨之士所能究。亦相承见经方是官典医所执传，
便谓
仍决
必
是
施教，教民治病，非但慈于疾苦，亦以以强于国也。
寒食大散难将息者，由栝蒌恶干姜故也。夫服此药者，皆是虚冷之人也。虚冷为患，
其疾多端，有患咳嗽上气积年者，宜除栝蒌用紫菀二两代之，积服两剂无不皆瘥也。若患脚
弱冷痹缓弱者，以石斛二两代之栝蒌也，为治甚效，且无险迕，以为良决也。其余众病，
除去栝蒌而已。若虚热渴利痔血
不可尽从者也。大理宜知此决也。
茯苓恶白蔹，而镇心丸用之。茯苓主忧恚惊怒恐悸，心下结痛，是镇心所宜也。白蔹治
痈肿心惊痫不如茯苓，今宜除白蔹也。
麻子恶茯苓，而骨填煎用之。麻子主补中益气，复血脉，破石淋。若疾源须此治者，留
麻子去茯苓。若心下结痛，忧恚惊怒恐悸者，去麻子用茯苓也。
紫菀恶远志，而补心汤用之。远志主伤中，补不足，益智能，补心宜用远志。若患咳嗽
上气者，可以余主咳药代远志，用紫菀也。
牛黄恶龙骨，而治小儿方用之。若下利者，可去牛黄留龙骨。若壮热惊痫者，宜去龙骨
留牛黄也。
芍药恶芒硝，而治小儿方用之。芍药主益气，止邪气腹痛，作优利，除坚积聚耳。须此
治者，当去芒硝用芍药。若壮热结寒实毒瓦斯者，可留芒硝去芍药也。
干姜恶黄连，而断下利方悉用之。若暴冷下者，可以吴茱萸代干姜也。夫是久寒积冷有
饮水者，服茱萸喜先下饮水去，然后下止耳。大理宜知如此也。
乌头与半夏相反，而诸汤皆用之。乌头主中风洒洒恶寒、湿痹积聚、咳逆上气。须此治
者，留乌头去半夏。若患伤寒寒热，喉痹咽痛， 胸胀，咳逆，心下结坚，当用半夏。大都
此二物为治相似，会宜去一种也。
藜芦与细辛、人参相反，而乌头丸用之。藜芦主杀蛊毒诸虫，除咳逆肠 下利，若须此
治者，留藜芦去细辛、人参。若患久风风头，肢节痛，心神虚者，去藜芦留细辛、人参也。
藜芦恶大黄，而露宿丸用之。大黄主调中，破除诸积聚，须此治者，留大黄除藜芦也。
若须藜芦为治者，宜除大黄也。
石恶细辛，而附子丸用之。 石主寒热鼠痿蚀疮，死肌肉痹，腹中积聚结坚，令人发
热。若须此治者，留 石去细辛。若患风痹拘挛，缓弱膝痛，咳逆，坚瘕积聚者，可除 石
留
防己恶细辛，而治风汤悉用之。防己主中风伤寒，温疟洒洒寒热，诸痫，利大小便。若
须
浓朴恶泽泻，而前胡丸用之。浓朴主中风，伤寒头痛，寒热惊气，死肌血痹，去三虫。
若须此治者，留浓朴去泽泻。若须补养益气力者，留泽泻去浓朴也。
皂荚恶人参，而通草丸用之。皂荚主风痹死肌，风头泪出，利九窍，下水气，杀精物魔
鬼，咳逆上气。须此治者，留皂荚去人参。若须补五脏、安精神者，留人参去皂荚也。
矾石恶牡蛎，而却烦丸用之。矾石主疮蚀及咽痛，坚齿骨。须此治者，留矾石去牡蛎。
若患伤寒寒热，温疟，洗洗恶寒，忧恚惊怒，气结心痛，鼠 ，女子去赤白浚下血者，留牡
蛎去
当归恶 茹，而治疮方用之。当归主咳逆上气，温疟寒热，洗洗在皮肤中，妇人漏下绝
孕，诸疮痉金疮痛。须此治者，用当归。若欲食恶肉杀虫者，用 茹也。
甘草反海藻、甘遂、大戟、芫花，凡四物亦反甘草，而诸汤皆用之。甘草不只治病，宜
是通部制百药耳。须此四物为治者，除甘草用犀角屑亦佳。
上前件旧方用药犯经禁者，略见凡十七条，其所不见者甚多。若看方有所见，便应根据此
决却除之，然后可服耳。药性要物亦已甲乙注名也，故复重记述之，大法宜知此决也。
《黄帝内经》中说：配制药材时务必谨慎，不要将具有相反、相畏、相恶、相杀作用的药物合用，否则不仅不能去除疾病，反而会伤害人的生命。检查旧有的方剂，发现违反这一禁忌的情况非常多，现在根据这些方子用药，还没见到有人一入口就死亡的案例。凡是服用违反禁忌的药物，也担心疾病不能立即消除，长远来看会暗中造成危害。正如反药禁忌所说，如果单独服用相互对抗的药物，后果会很严重。由于各个方剂中混合了多种物质，其冲突的势力应该比较微弱，所以不会导致立即死亡。
《黄帝内经》又说：有些药物性质阴险贼害，会让人消瘦，阳痿短气，损伤五脏六腑。服用相反、相畏、相恶的药物，虽然不会立即致死，但长远来看会有潜在的损害，也可能像经书所说的那样严重，怎么能不避开呢？考察古代的处方，都应当明确审查经书的禁忌，不应该合用那些相反、相畏、相恶的药物。恐怕特别是一些乡野山郡的官吏和医生，代代相传，凭主观意愿增减药物，所以才出现了违反禁忌的药物。
凡是疾病自有外在征象危急却反而容易痊愈的，服用一个方子就能痊愈，也有不治疗自己恢复的，遇到这种情况，就称这个方子神奇灵验，沿袭推崇为旧方，都不剔除其中违反禁忌的药物而直接服用，其实并不能去除疾病。况且轻视生命的人大多不相信脉诊，也说诊脉是精妙之术，不是学识不渊博的人所能理解的，不是不通晓辨证的人所能探究的。也沿袭看到经方是官吏医生所执掌传承的，便认为是必定可行的施教方法，教导百姓治病，这不仅是对疾苦的慈悲，也是为了强国。
寒食大散难以调理的患者，是因为栝蒌与干姜相恶的缘故。服用这种药的人，都是虚冷体质的人。虚冷导致的疾病，病因多种多样，有患咳嗽上气多年的，应当除去栝蒌，用紫菀二两代替，长期服用两剂没有不痊愈的。如果患脚弱、冷痹、缓弱的，用石斛二两代替栝蒌，治疗效果很好，且没有危险冲突，作为良好的决断。其余各种疾病，除去栝蒌即可。如果是虚热、口渴、痢疾、痔血等情况，则不能完全照此办理。大理（官职名）应当知晓这个决断。
茯苓恶白蔹，但镇心丸中使用了它们。茯苓主治忧恚惊怒恐悸，心下结痛，这是镇心丸适宜使用的。白蔹治疗痈肿、心惊、痫证不如茯苓，现在应当除去白蔹。
麻子恶茯苓，但骨填煎中使用了它们。麻子主治补中益气，复血脉，破石淋。如果疾病根源需要此药治疗，保留麻子去掉茯苓。如果有心下结痛，忧恚惊怒恐悸等症状，去掉麻子使用茯苓。
紫菀恶远志，但补心汤中使用了它们。远志主治伤中，补不足，益智能，补心适宜用远志。如果患咳嗽上气的，可以用其他主咳药代替远志，使用紫菀。
牛黄恶龙骨，但治小儿方中使用了它们。如果下利的，可以去掉牛黄保留龙骨。如果壮热惊痫的，适宜去掉龙骨保留牛黄。
芍药恶芒硝，但治小儿方中使用了它们。芍药主治益气，止邪气腹痛，作优利（此处疑为衍文或特定语境，指通利），除坚积聚。需要此药治疗的，应当去掉芒硝使用芍药。如果有壮热结寒实毒瓦斯的情况，可以保留芒硝去掉芍药。
干姜恶黄连，但断下利方中都使用了它们。如果是暴冷下利的，可以用吴茱萸代替干姜。如果是久寒积冷且有饮水症状的，服用吴茱萸后喜欢先喝下去饮水，然后腹泻停止。大理应当知道这一点。
乌头与半夏相反，但各种汤剂中都使用了它们。乌头主治中风洒洒恶寒、湿痹积聚、咳逆上气。需要此药治疗的，保留乌头去掉半夏。如果患伤寒寒热，喉痹咽痛，胸胀，咳逆，心下结坚，应当使用半夏。大体上这两种药物治疗相似，会诊时适宜去掉其中一种。
藜芦与细辛、人参相反，但乌头丸中使用了它们。藜芦主治杀蛊毒诸虫，除咳逆肠下利，需要此药治疗的，保留藜芦去掉细辛、人参。如果患久风头风，肢节痛，心神虚的，去掉藜芦保留细辛、人参。
藜芦恶大黄，但露宿丸中使用了它们。大黄主治调中，破除诸积聚，需要此药治疗的，保留大黄除去藜芦。如果需要藜芦治疗，应当除去大黄。
石韦恶细辛，但附子丸中使用了它们。石韦主治寒热鼠痿蚀疮，死肌肉痹，腹中积聚结坚，令人发热。需要此药治疗的，保留石韦去掉细辛。如果患风痹拘挛，缓弱膝痛，咳逆，坚瘕积聚的，可以除去石韦保留细辛。（注：原文此处似有缺漏或错简，根据上下文逻辑推断，应为“留细辛去石韦”或类似意思，此处依原文结构翻译，意指根据病情选择保留哪一味）
防己恶细辛，但治风汤中都使用了它们。防己主治中风伤寒，温疟洒洒寒热，诸痫，利大小便。如果需要防己治疗，...（原文此处截断，依前例逻辑，应是指若需防己则去细辛，反之亦然，但原文未写完，故仅翻译可见部分）
浓朴恶泽泻，但前胡丸中使用了它们。浓朴主治中风，伤寒头痛，寒热惊气，死肌血痹，去三虫。需要此药治疗的，保留浓朴去掉泽泻。如果需要补养益气力的，保留泽泻去掉浓朴。
皂荚恶人参，但通草丸中使用了它们。皂荚主治风痹死肌，风头泪出，利九窍，下水气，杀精物魔鬼，咳逆上气。需要此药治疗的，保留皂荚去掉人参。如果需要补五脏、安精神的，保留人参去掉皂荚。
矾石恶牡蛎，但却烦丸中使用了它们。矾石主治疮蚀及咽痛，坚齿骨。需要此药治疗的，保留矾石去掉牡蛎。如果患伤寒寒热，温疟，洗洗恶寒，忧恚惊怒，气结心痛，鼠瘘，女子赤白带下崩漏的，保留牡蛎去掉矾石。
当归恶茹草（原文为“ 茹”，推测为“茹草”或特定草药名，如“茹”可能指“茹草”或“苦茹”等，此处保留原字或译为茹草），但治疮方中使用了它们。当归主治咳逆上气，温疟寒热，洗洗在皮肤中，妇人漏下绝孕，诸疮痉金疮痛。需要此药治疗的，使用当归。如果想要食用恶肉杀虫的，使用茹草。
甘草反海藻、甘遂、大戟、芫花，凡四物亦反甘草，但各种汤剂中都使用了它们。甘草不只治病，适宜用来通部制百药。需要这四物治疗的，除去甘草，使用犀角屑也很好。
以上列举旧方用药违反经书禁忌的，粗略见到十七条，所未见者很多。如果看方有所见，便应根据这个决断剔除它们，然后才可以服用。药性重要之物也已甲乙注名，所以再次重述之，大法应当知晓这个决断。
The *Classic* (Huangdi Neijing) states: When compounding medicines, one must be extremely cautious not to combine drugs that are mutually antagonistic, fearful, hostile, or destructive. Doing so will not cure the disease but will instead harm human life. Upon examining old prescriptions, many instances of such violations are found. However, following these prescriptions currently, no cases of immediate death upon ingestion have been observed. Nevertheless, taking drugs that violate contraindications may prevent the disease from being immediately eliminated and could cause latent harm over a long period. As stated in the prohibitions against counteracting drugs, taking them together would indeed lead to severe consequences. Since various prescriptions contain a mixture of many substances, their conflicting forces should be relatively minor, thus preventing immediate death.
The *Classic* also says: Some drugs have "yin treacherous" properties, causing emaciation, impotence, shortness of breath, and damage to the five internal organs. Taking mutually antagonistic, fearful, or hostile drugs, although not immediately fatal, can cause latent harm over time, just as described in the classics. How can one fail to avoid them? Examining ancient prescriptions, they should all clearly observe canonical prohibitions and should not combine mutually antagonistic, fearful, or hostile drugs. It is likely that this occurred due to local officials and physicians in remote mountainous regions passing down prescriptions through generations, adding or subtracting ingredients based on personal judgment, thereby introducing prohibited combinations.
For diseases that appear critical externally but recover easily, some recover after taking a single prescription, while others recover spontaneously without treatment. Encountering such cases, people claim the prescription is miraculous and pass it down as an old prescription, without removing the prohibited drugs, yet it actually cannot cure the disease. Moreover, those who disregard life often distrust pulse diagnosis, claiming it is a subtle art incomprehensible to the unlearned and uninvestigated by those lacking diagnostic skills. They also assume that canonical prescriptions, passed down by official physicians, are invariably correct for teaching public health, not only out of compassion for suffering but also to strengthen the state.
In the case of *Han Shi Da San* (Cold Food Great Powder), difficulty in regulation arises because *Gualou Fructus* (Trichosanthis Fructus) and *Ganjiang Rhizoma* (Dried Ginger) are mutually hostile. Those taking this medicine are typically of a deficiency-cold constitution. Deficiency-cold ailments are diverse. For chronic cough with rebellious qi lasting years, remove *Gualou Fructus* and substitute with two liang of *Ziwan Radix* (Asteris Radix). Long-term use of two doses ensures recovery. For weakness of the legs, cold bi-syndrome, and flaccidity, substitute *Gualou Fructus* with two liang of *Shihu Stem* (Dendrobii Caulis), which is highly effective and safe, serving as a sound decision. For other diseases, simply removing *Gualou Fructus* suffices. However, for deficiency-heat, thirst, dysentery, or hemorrhoids, this rule cannot be universally applied. The Chief Medical Officer should understand this principle.
*Fuling Sclerotium* (Poria) is hostile to *Bailian Bulbus* (Ampelopsis Radix), yet both are used in *Zhenxin Wan* (Heart-Calming Pill). *Fuling* treats anxiety, fright, anger, fear, palpitations, and epigastric knotting/pain, making it suitable for this formula. *Bailian* is inferior to *Fuling* for treating carbuncles, heart fright, and epilepsy; therefore, *Bailian* should now be removed.
*Mazi Semen* (Hemp Seed) is hostile to *Fuling*, yet both are used in *Gutian Jian* (Bone-Filling Decoction). *Mazi* tonifies the middle, benefits qi, restores blood vessels, and breaks stone strangury. If the disease etiology requires it, retain *Mazi* and remove *Fuling*. If there is epigastric knotting/pain, anxiety, fright, anger, fear, or palpitations, remove *Mazi* and use *Fuling*.
*Ziwan Radix* is hostile to *Yuanzhi Radix* (Polygalae Radix), yet both are used in *Buxin Tang* (Heart-Nourishing Decoction). *Yuanzhi* treats middle injury, tonifies insufficiency, enhances intelligence, and nourishes the heart. For cough with rebellious qi, replace *Yuanzhi* with other antitussive herbs and use *Ziwan*.
*Niu Huang Calculus Bovis* (Calculus Bovis) is hostile to *Longgu Os Draconis* (Fossilized Bones), yet both are used in pediatric formulas. For diarrhea, remove *Niu Huang* and retain *Longgu*. For high fever, fright, and epilepsy, remove *Longgu* and retain *Niu Huang*.
*Shaoyao Radix* (Peony Root) is hostile to *Mangxia Natrii Sulfas* (Mirabilite), yet both are used in pediatric formulas. *Shaoyao* benefits qi, stops abdominal pain caused by pathogenic factors, promotes urination/defecation, and resolves hard accumulations. If this treatment is needed, remove *Mangxia* and use *Shaoyao*. For high fever with cold-solid toxic accumulation, retain *Mangxia* and remove *Shaoyao*.
*Ganjiang Rhizoma* is hostile to *Huanglian Rhizoma* (Coptidis Rhizoma), yet both are used in formulas for stopping dysentery. For acute cold-induced diarrhea, substitute *Ganjiang* with *Wuzhuyu Fructus* (Evodiae Fructus). For chronic cold accumulation with thirst, taking *Wuzhuyu* followed by water intake helps stop diarrhea. The Chief Medical Officer should know this.
*Wutou Radix* (Aconiti Lateralis Radix Preparata) and *Banxia Rhizoma* (Pinelliae Rhizoma) are mutually antagonistic, yet both are used in various decoctions. *Wutou* treats wind-stroke with aversion to cold, damp-bi, accumulations, and cough with rebellious qi. Retain *Wutou* and remove *Banxia* if this treatment is needed. For wind-cold with alternating heat, throat obstruction/pain, chest distension, cough, or epigastric hardness, use *Banxia*. Generally, these two herbs have similar therapeutic effects; in consultation, it is appropriate to remove one of them.
*Lilu Rhizoma* (Veratri Rhizoma) is antagonistic to *Xixin Herba* (Asari Radix et Rhizoma) and *Renshen Radix* (Ginseng Radix), yet both are used in *Wutou Wan*. *Lilu* kills parasites/toxins, relieves cough/intestinal diarrhea. Retain *Lilu* and remove *Xixin* and *Renshen* if this treatment is needed. For chronic wind affecting the head, joint pain, or mental deficiency, remove *Lilu* and retain *Xixin* and *Renshen*.
*Lilu* is hostile to *Dahuang Radix et Rhizoma* (Rhei Radix et Rhizoma), yet both are used in *Luxiu Wan*. *Dahuang* regulates the middle, breaks down accumulations. Retain *Dahuang* and remove *Lilu* if this treatment is needed. If *Lilu* is required, remove *Dahuang*.
*Shiwei Folium* (Pyrosiae Folium) is hostile to *Xixin*, yet both are used in *Fuzi Wan*. *Shiwei* treats chills/fever, rat-miasma ulcers, necrotic muscle bi, abdominal hard accumulations, and induces fever. Retain *Shiwei* and remove *Xixin* if this treatment is needed. For wind-bi with spasms, knee weakness/pain, cough, or hard masses, remove *Shiwei* and retain *Xixin*.
*Fangji Radix* (Stephaniae Tetrandrae Radix) is hostile to *Xixin*, yet both are used in *Zhi Feng Tang*. *Fangji* treats wind-stroke/cold-warmth malaria with chills/fever, epilepsy, and promotes urination/defecation. (Text cuts off here, implying conditional retention/removal logic applies).
*Magnoliae Cortex* (Magnoliae Officinalis Cortex) is hostile to *Zexia Rhizoma* (Alismatis Rhizoma), yet both are used in *Qianhu Wan*. *Mangpiao* treats wind-stroke, cold headache, chills/fever, fright/qi disturbances, necrotic muscle/bi, and expels three types of worms. Retain *Mangpiao* and remove *Zexia* if this treatment is needed. For tonifying and benefiting qi strength, retain *Zexia* and remove *Mangpiao*.
*Saposhnikoviae Radix* (actually *Zaojiao Fructus* - Gleditsiae Sinensis Fructus) is hostile to *Renshen*, yet both are used in *Tongcao Wan*. *Zaojiao* treats wind-bi/necrotic muscle, head wind with tearing, opens orifices, reduces water qi, kills spirits/demons, and treats cough/rebellious qi. Retain *Zaojiao* and remove *Renshen* if this treatment is needed. For tonifying five zang organs and calming spirit, retain *Renshen* and remove *Zaojiao*.
*Fan Shi Alumen* (Alumen) is hostile to *Muli Concha Ostreae* (Oyster Shell), yet both are used in *Quefan Wan*. *Fan Shi* treats ulcerative sores, sore throat, and strengthens teeth/bones. Retain *Fan Shi* and remove *Muli* if this treatment is needed. For wind-cold/warmth malaria, chills, anxiety/fright/anger, qi-knotting heart pain, rat-miasma, or women's leukorrhea/hemorrhage, retain *Muli* and remove *Fan Shi*.
*Danggui Radix* (Angelicae Sinensis Radix) is hostile to *Ru Cao* (likely *Kuru* or specific herb, text unclear " 茹"), yet both are used in wound-healing formulas. *Danggui* treats cough/rebellious qi, warm malaria/chills/fever, skin sensations, uterine bleeding/infertility, and various wounds/spasms/gold injuries. Use *Danggui* if this treatment is needed. To consume foul flesh or kill insects, use *Ru Cao*.
*Gancao Radix* (Licorice Root) is antagonistic to *Haizao Thallus* (Sargassum), *Gansui Radix* (Euphorbiae Kansui Radix), *Daji Radix* (Euphorbiae Pekinensis Radix), and *Yuanhua Flos* (Genkwa Flos); these four are also antagonistic to *Gancao*. Yet both are used in various decoctions. *Gancao* not only treats disease but is suitable for harmonizing/regulating hundred drugs. If these four herbs are needed for treatment, remove *Gancao*; using *Xijiao Xie* (Rhinoceros Horn Shavings, though modern practice substitutes Buffalo Horn) is also good.
Above, seventeen cases of old prescriptions violating canonical prohibitions are briefly listed, with many more unseen. If any such cases are found in prescriptions, they should be removed according to this decision before administration. Important drug properties have already been annotated alphabetically; thus, this is reiterated. The general principle is to understand this decision.