無或曰:，氣上升者，皆用黑錫丹，養正丹，養氣丹等藥，以為鎮墜，然服之者，隨手得效，吾子以為熱甚之病，亦將有誤耶，予曰：相火之外，又有臟腑，厥陽之火，五志之動，各有火起，相火者，此經所謂一水不勝二火之火，出於天造，厥陽者，此經所謂一水不勝五火之火，出於人欲，氣之升也，隨火炎上升而不降，孰能禦之，今人欲借丹劑之重墜而降之，氣鬱為濕痰，丹性熱燥，濕痰被劫，亦為暫開，所以清快，丹藥之法，偏助狂火，陰血愈耗，其升愈甚，俗人喜溫，迷而不返，被此禍者，滔滔皆是，
無或曰:丹藥之墜，欲降而升，然則如之何則可，予曰：投以辛涼，行以辛溫，制伏肝邪，治以鹹寒，佐以甘溫，收以苦甘，和以甘淡，補養陰血，陽自相附，陰陽比和，何升之有，先哲格言，其則不遠，吾不贅及，
無或曰:吐酸，素問曰，明以為熱。東垣又言為寒，何也？予曰：吐酸與吞酸不同，吐酸是吐出酸水如醋，平時津液隨上升之氣鬱積而成，鬱積之久，濕中生熱，故從火化，遂作酸味，非熱而何，其有積之於久，不能自涌而出，伏於肺胃之間，咯不得上，嚥不得下，肌表得風寒則內熱愈鬱，而酸味刺心，肌表溫暖，腠理開發，或得香熱湯丸，津液得行，亦得暫解，非寒而何？素問言熱者，言其本也。東垣言寒者，言其末也。但東垣不言外得風寒，而作收氣立說，欲瀉肺金之實，又謂寒藥不可治酸，而用安胃湯加減二陳湯，俱犯丁香，且無治熱濕鬱積之法，為未合經意，予嘗治吞酸，用黃連茱萸各製炒，隨時令迭為佐使，蒼朮茯苓為主病，湯浸炊餅為小丸吞之，仍教以粗食蔬菜，自養則病易安，
無或曰:蘇合香丸，雖是類聚香藥，其治骨蒸殗，月閉狐狸等病，吾子以為然乎？予曰：古人製方用藥，群隊者必是攻補兼施，彼此相制，氣味相次，孰為主病，孰為引經，或用正治，或用反佐，各有意義，今方中用藥一十五味，除白朮，硃砂，訶子共六兩，其餘一十二味，共二十一兩，皆是性急輕竄之劑，往往用之於氣病，與暴仆昏昧之人，其衝突經絡，漂蕩氣血，若摧枯拉朽，然不特此也。至如草豆蔻散，教人於夏月濃煎以代熱水，夫草豆蔻，性大熱，去寒邪，夏月有何寒氣而欲多服。縮脾飲用草果，亦是此意，且夏食寒，所以養陽也，草豆蔻，草果，其食寒之意乎，不特此也。抑又有甚者焉，接氣丹曰：陽氣暴絕，當是陰先虧，陰先虧則陽氣無所依附，遂致飛越而暴絕也，上文乃曰：陰氣獨盛，陰氣若盛，陽氣焉有暴絕之理，假令陽氣暴絕，宜以滋補之劑，保養而鎮淨之，庶乎其有合夏食寒以為養陽之本，何至又服辛香燥熱之劑乎，且此丹下咽，暴絕之陽果能接乎，孰為是否，君其算之，
無或曰:，局方言陰勝，陰邪盛也，陰邪既盛，陽有暴絕之理，子之所言，與陽氣相對待之陰也，果有陰虧而陽絕者，吾子其能救之乎？予曰：陰陽二字，固以對待而言，所指無定在，或言寒熱，或言血氣，或言臟腑，或言表裏，或言動靜，或言虛實，或言清濁，或言奇偶，或言上下，或言正邪，或言生殺，或言左右，求其立言之意，當是陰鬼之邪耳，陰鬼為邪，自當作邪鬼治之，若陰先虧而陽暴絕者，嘗治一人矣。浦江鄭兄，年近六十，奉養受用之人也，仲夏久患滯下，而又犯房勞，忽一晚，正走廁間，兩手舒撒，兩眼開而無光，尿自出，汗如雨，喉如拽鋸，呼吸甚微，其脈大而無倫次，無部位，可畏之甚，余適在彼，急令煎人參膏，且與灸氣海穴，艾炷如小指大，至十八壯，右手能動，又三壯，微動，參膏亦成，遂與一盞，至半夜後盡三盞，眼能動，盡二斤方能言，而索粥，盡五斤而利止，十斤而安，
無或曰:諸氣諸飲，與嘔吐吞酸，膈噎反胃等證，局方未中肯綮，我知之矣。然則要略之方，果足用乎？抑猶有未發者乎？予曰：天地氣化無窮，人身之病亦變化無窮，仲景之書載道者也，醫之良者，引例推類，可謂無窮之應用，借令略有加減脩合，終難踰越矩度，夫氣之初病也，其端甚微，或因些少飲食不謹，或外冒風雨，或內感七情，或食味過厚，偏助陽氣，積成膈熱，或資稟充實，表密無汗，或性急易怒，火炎上以致津液不行，清濁相干，氣為之病，或痞，或痛不思食，或噫腐氣，或吞酸，或嘈雜，或膨滿，不求原本，便認為寒，遽以辛香燥熱之劑投之，數帖時暫得快，以為神方，厚味仍前，不節七情，反復相仍，舊病被劫暫開，濁液易於攢聚，或半月，或一月，前證復作，如此延蔓，自氣成積，自積成痰，此為痰，為飲，為吞酸之由也，良工未遇繆藥，又行痰挾瘀血，遂成窠囊，此為痞，為痛嘔吐，為噎膈反胃之次第也，飲食湯液，滯泥不行，滲道蹇澀，大便或秘或溏，下失傳化，中焦愈停，醫者不察，猶執為冷，翻思前藥，隨手得快，至此賓主皆恨，藥欠燥熱顒伺，久服可以溫脾壯胃，消積行氣，以冀一旦豁然之效，不思胃為水穀之海，多血多氣，清和則能受脾，為消化之氣，清和則能運，今反得香熱之偏，助氣血沸騰，其始也，胃液凝聚，無所容受，其久也，脾氣耗散，傳化漸遲，其有胃熱易饑，急於得食，脾傷不磨，鬱積成痛，醫者猶曰虛而積寒，非尋常草木可療，徑以烏附助佐丹劑，專意服餌，積而久也，血液俱耗，胃脘乾槁，其槁在上，近咽之下，水飲可行，食物難入，間或可入亦不多，名之曰噎。其槁在下，與胃為近，食雖可久，難盡入胃，良入復出，名之曰膈，亦曰反胃，大便秘少，若羊矢然，名雖不同，病出一體，要略論，飲有六日，痰飲，懸飲，溢飲，支飲，留飲，伏飲，分別五臟諸證，治法至矣盡矣。第恨醫者不善處，治病者不守禁忌，遂使藥助病邪，展轉深痼，去生漸遠，深可哀憫，
無或曰:千金諸方治噎膈反胃，未嘗癈薑桂等劑，何吾子之多言也，予曰：氣之鬱滯久留清道，非借香熱不足以行，然悉有大黃，石膏，竹茹，芒硝，澤瀉，前胡，朴硝，茯苓，黃芩，蘆根，括蔞等藥，為之佐使，其始則同，其終則異，病邪易伏，其病自安，
無或曰:胃脘乾槁者，古方果可治乎，將他有要捷之法者，或可補前人之未發者乎，予曰：古方用人參以補肺，御米以解毒，竹瀝以消痰，乾薑以養血，粟米以實胃，蜜水以潤燥，薑以去穢，正是此意，張雞峰亦曰噎，當是神思間，病惟內觀自養，可以治之。此言深中病情，而施治之法，亦為近理。夫噎病生於血乾，夫血，陰氣也，陰主靜，內外兩靜，則臟腑之火不起，而金水二氣有養，陰血自生，腸胃津潤，傳化合宜，何噎之有，因觸類而長。曾製一方，治中年婦人以四物湯加和白陳皮，留尖桃仁，生甘草，酒紅花，濃煎入驢尿飲，以防其或生蟲也。與數十帖而安，又台州治一匠者，年近三十，勤於工作而有艾妻，且喜酒，其面白，其脈澀，重則大而無力，令其謝去工作，臥於牛家，取新溫牛乳細飲之，每蝢進一杯，一晝夜可飲五七次，盡郤食物，以漸而至八九次，半月大便潤，月餘而安，然或口乾，蓋酒毒未解，間飲甘蔗汁少許，或者又曰，古方之治噎膈反胃，未有不言寒者，子何不思之甚？予曰：古人著方，必為當時抱病者設也，其人實因於寒，故用之而得效，後人遂錄以為今式，不比局方，泛編成書，使天下後世之人，凡有此證者，率遵守之以為定法，而專以香熱為用也，雖然挾寒者，亦或有之，但今人之染此病，率因痰氣，久得醫藥傳變而成，其為無寒也明矣。
無或曰:，治脾腎以溫補藥，豈非局方之良法耶，吾子其將何以議之。予曰：眾言淆亂，必折諸聖，切恐脾腎有病，未必皆寒，觀其養脾丸，治脾胃虛冷，體倦不食。嘉禾散，治脾胃不和，不能多食。消食丸，治脾胃俱虛，飲食不下。小獨聖丸，治脾胃不和，不思飲食。大七香丸，治脾冷胃虛，不思飲食。連翹丸，治脾胃不和，飲食不下。分氣紫蘇飲，治脾胃不和。木香餅子，治脾胃虛寒。溫中良薑丸，曰溫脾胃。奪命抽刀散，曰脾胃冷。燒脾散，曰脾胃虛。進食散，曰脾胃虛冷，不思飲食。丁香煮散，曰脾冷胃寒。二薑丸，曰養脾溫胃。薑合丸，曰脾胃久虛。蓬煎丸，曰脾胃虛弱。守金丸，曰脾胃虛冷。集香丸，曰脾胃不和。蟠蔥散，曰脾胃虛冷。壯脾丸，曰脾胃虛弱。人參丁香散，曰脾胃虛弱。人參煮散，曰脾胃不和。丁香透膈湯，曰脾胃不和。丁香五奪丸，曰脾胃虛弱。膃肭臍丸之壯氣暖腎，菟絲子丸之治腎虛，金釵石斛丸之治氣不足，茴禾丸之治臟虛冷，玉霜丸之治氣虛，安腎丸之治腎積寒，麝香鹿茸丸之益氣，養正丹之治諸虛，朴附丸之治脾胃虛弱，接氣丹之治真氣虛，四神丹之治五臟，沉香鹿茸丸之治氣不足，椒附丸之溫五臟，蓯蓉大補丸之治元臟元氣虛，鍾乳白澤丸之治諸虛，三建湯之治氣不足，甚者類聚丹劑，悉曰補脾胃，溫脾胃，補腎，補五臟，補真氣，而各方條下曰舌苦，曰面黃，曰舌苦無味，曰中酒吐酒，曰酒積，曰酒癖，曰飲酒多，曰酒過傷，曰氣促喘急，曰口淡，曰舌澀，曰噫醋，曰舌乾，曰溺數，曰水道澀痛，曰小便出血，曰口苦，曰咽乾，曰氣促，曰盜汗，曰失精，曰津液內燥，曰氣上衝，曰外腎痒，曰枯槁失血，曰口唇乾燥，曰喘滿，曰肢體煩疼，曰衄血，曰小便淋瀝，悉是明具熱證，如何類聚燥熱，而謂可以健脾溫胃而滋腎補氣乎？經曰：熱傷脾，常服燥熱，寧不傷脾乎，又曰：腎惡燥，多服燥熱，寧不傷腎乎，又曰：熱傷元氣，久服燥熱，寧不傷氣乎。又曰：用熱遠熱。又曰：有熱者寒而行之。此教人用熱藥之法，蓋以熱藥治寒病，苟無寒藥為之響導佐使，則病拒藥而扞格不入，謂之遠熱者，行之以寒也。兩句同一意，恐後人不識此理，故重言以明之。今局方辛香燥熱以類而聚之，未嘗見其所謂遠熱也。用熱而不遠熱，非惟不能中病，抑且正氣先傷，醫云乎哉。夫良醫之治病也，必先求其得病之因。其虛邪也，當治其母，實邪也，當治其子。微邪也，當治其所勝，賊邪也，當治其所不勝，正邪也，當治其本經。索矩又謂雜合，受邪病者，所受非止一端，又須察其有無，雜合之邪，輕重較量，視標本之緩急，以為施治之先後，今乃一切認為寒冷，吾不知脾胃與腎，一向只是寒冷為病耶。論方至此，雖至愚昧，不能不致疑也，吾又攷之要略矣。諸嘔吐，穀不得入者，小半夏湯主之。疸病寒熱不食，食則頭眩，心胸不安者，茵陳湯主之。身腫而冷，胃窒不能食，病在骨節，發汗則安，心胸停痰吐水，虛滿不能食者，茯苓湯主之。中風手足拘急，惡寒不欲飲食者，三黃湯主之。下利不欲飲食者，大承氣湯主之。五勞虛極，羸瘦不能食者，大黃虫丸主之。虛勞不足，汗出而悶，脈結心悸者，炙甘草湯主之。虛勞腰痛，小腹拘急者，八味丸主之。虛勞不足者，大薯蕷丸主之。虛勞虛煩不得眠者，酸棗仁湯主之。夫嘔者，胸滿者，吐水者，下利者，惡寒者，腫而冷者，不能飲食者，虛勞羸瘦者，虛勞汗而悸者，虛勞而腰痛者，虛勞不足者，虛勞煩而不眠者，自局方之法觀之，寧不認為寒冷，而以熱藥行之乎，仲景施治則不然也，痰者導之，熱者清之，積者化之，濕者滲之，中氣清和，自然安裕，虛者補之，血凝者散之，躁者寧之，熱者和之，陰氣清寧，何虛勞之有也，
無或曰:傷寒一門，雖取雜方，仲景之法，亦摘取之矣。吾子其忘言乎，予曰：傷寒之法，仲景而下，發明殆盡，局方是否愚不必贅，雖然仲景論傷寒矣，而未及乎中寒，先哲治冒，大寒而昏中者，用附子理中湯而安，其議藥則得之矣。曰傷，曰中，未聞有議其異同之者。予俛而思之，傷寒有即病，有不即病，必大發熱病邪，循經而入，以漸而深，中寒則倉卒感受其病，即發而暴，傷寒之人，因其舊有鬱熱，風寒外束，肌腠自密，鬱發為熱，其初也，用麻黃桂枝輩，微表而安，以病體不甚虛也，中寒之人，乘其腠理疏豁，一身受邪，難分經絡，無熱可發，溫補自解，此謂氣之大虛也，傷寒熱雖甚不死，中寒若不急治，去生甚遠，其虛實蓋可見矣。
無或曰:脾胃，一門子以局方用藥太熱，未合經意，若平胃散之溫和，可以補養胃氣，吾子以為何如，予曰：蒼朮性燥氣烈，行濕解表，甚為有力，厚朴性溫散，氣非脹滿實急者，不用承氣用之可見矣。雖有陳皮甘草之甘緩，甘辛亦是決裂耗散之劑，實無補土之和，經謂土氣大過，曰敦阜，亦能為病，況胃為水穀之海，多氣多血，故因其病也，用之以瀉有餘之氣，使之平爾，又雖察其挾寒，得寒物者投之，胃氣和平，便須郤藥，謂之平者，非補之之謂其可常服乎，
無或曰:調胃承氣亦治胃病，謂之調者，似與平胃散之意義相近，何用藥之相遠也。予曰：調胃承氣治熱，中下二焦藥也。經曰：熱淫於內，治以鹹寒，佐以苦甘，功在乎導利而行之以緩，平胃散止治濕，上焦之藥也。經曰：濕上甚而熱，治以苦濕，佐以甘辛，以汗為效而止。
無或曰:，治濕不利小便，非治也。非仲景法耶。何子言之悖也。予曰：淡滲治濕，以其濕在中下二焦，今濕在上，宜以微汗而解，不欲汗多，故不用麻黃葛根輩，
有人问：气机上逆的病症，都使用黑锡丹、养正丹、养气丹等药物，作为镇坠之剂。然而服用这些药的人，往往随手见效。您认为这是热邪极盛的病证，难道也会误用吗？我回答说：除了相火之外，还有脏腑之火；厥阳之火，以及五志（喜、怒、忧、思、恐）的变动，各自都会引发火热。所谓相火，就是本经所说的“一水不胜二火”的火，它出于天造（先天之本）；所谓厥阳，就是本经所说的“一水不胜五火”的火，它出于人欲（后天之情志）。气的上升，是随着火势炎上而下降不得，谁能抵御它呢？现在人们想要借用丹药的重坠之性来降气，但气郁结化为湿痰，丹药性质热燥，湿痰被劫夺后，虽然暂时开通，所以感觉清爽。但是丹药的方法，偏助狂躁之火，使阴血更加耗损，气机上升反而更甚。世俗之人喜欢温补，沉迷其中不能回头，遭受这种祸害的人，比比皆是。
有人问：丹药的重坠之性，本想降气却导致升发，那么该怎么办才好呢？我回答说：投以辛凉的药物，配合辛温的药物运行，制伏肝木之邪，用咸寒的药物治疗，佐以甘温的药物，用苦甘的药物收敛，用甘淡的药物调和，补养阴血，阳气自然依附于阴。阴阳比和，哪里还会有气机上逆呢？先哲的格言，法则不远，我不再赘述。
有人问：吐酸水，《素问》说是热证。李东垣又说是寒证，为什么呢？我回答说：吐酸与吞酸不同。吐酸是吐出像醋一样的酸水，平时津液随着上升的气机郁积而成，郁积久了，湿气中生热，所以从火化，于是产生酸味，这不是热证是什么？有的人积滞日久，不能自行涌出，潜伏在肺胃之间，咳不出来，咽不下去，肌表受到风寒侵袭，则内热更加郁闭，酸味刺痛心脏；肌表温暖，腠理开发，或者喝下香热的汤丸，津液得以通行，也能暂时缓解，这难道不是寒证吗？《素问》说热，是指病的根本；李东垣说寒，是指病的表象。只是李东垣没有提到外感风寒，而是从收气（金气收敛）立论，想要泻肺金之实，又说寒药不可治酸，而使用安胃汤加减二陈汤，其中都含有丁香，而且没有治疗湿热郁积的方法，不符合经旨。我曾经治疗吞酸，用黄连、吴茱萸各制炒，根据时令交替作为佐使药，苍术、茯苓为主病药，用水浸过的炊饼做成小丸吞服，并教导患者吃粗粮蔬菜，自我调养，则病容易痊愈。
有人问：苏合香丸，虽然是聚集香药，但它治疗骨蒸劳热、殗𫹣（梦遗滑精）、月闭、狐狸病（狐惑病）等病症，您认为这样对吗？我回答说：古人制方用药，群队组合的方剂必定是攻补兼施，彼此制约，气味相次，谁为主病，谁为引经，有的用正治，有的用反佐，各有深意。现在方中用药十五味，除去白术、朱砂、诃子共六两，其余十二味共二十一两，都是性急轻窜的药物。往往用于气病，以及突然仆倒昏昧的病人，它们冲击经络，漂荡气血，如同摧枯拉朽。不仅如此。至于草豆蔻散，教人在夏天浓煎代替热水饮用。草豆蔻性大热，能去寒邪，夏天有什么寒气需要多服呢？缩脾饮用草果，也是这个意思。况且夏天吃寒凉食物，是为了保养阳气。草豆蔻、草果，符合吃寒凉以养阳的意思吗？不仅如此。更有甚者，接气丹说：阳气暴绝，应当是阴先亏损，阴先亏损则阳气无所依附，遂致飞越而暴绝。上文却说：阴气独盛。如果阴气盛，阳气怎么会有暴绝的道理？假如阳气暴绝，应该用滋补的药剂，保养并镇静它，这才符合夏天吃寒凉以养阳的根本，怎么会又服用辛香燥热的药剂呢？况且此丹下咽，暴绝的阳气真的能接续吗？谁对谁错，请您算一算。
有人问：《局方》说阴胜，是指阴邪盛也。阴邪既盛，阳气有暴绝的道理。您所讲的，是与阳气相对待的阴气。果真存在阴亏而阳绝的情况，您能救治吗？我回答说：“阴”“阳”二字，固然是相对而言，所指没有固定处所。或者说寒热，或者说血气，或者说脏腑，或者说表里，或者说动静，或者说虚实，或者说清浊，或者说奇偶，或者说上下，或者说正邪，或者说生杀，或者说左右。探求其立言之意，应当是指阴鬼之邪罢了。阴鬼为邪，自然应当当作邪鬼来治。至于阴先亏而阳暴绝的情况，我曾经治疗过一个人。浦江郑兄，年近六十，是个讲究奉养享受的人。仲夏时节久患痢疾，又犯了房劳。忽然有一天晚上，正在上厕所时，两手伸展撒开，两眼睁开而无神，小便自出，汗如雨下，喉间声音如拽锯，呼吸非常微弱，脉象大而无伦次，无部位，非常可怕。我恰好在那里，急忙让人煎人参膏，并且给他灸气海穴，艾炷如小指大小，灸到十八壮，右手能动了，又灸三壮，微微动弹，人参膏也煎好了，于是给他喝一盏，到半夜后喝完三盏，眼睛能动了，喝完二斤才能说话，并且索要粥喝，喝完五斤痢止，十斤才安稳。
有人问：诸气、诸饮，以及呕吐、吞酸、膈噎、反胃等证候，《局方》未能切中肯綮，我知道了。然而《伤寒杂病论》（要略）的方剂，果然足够使用吗？还是有未阐发的地方吗？我回答说：天地气化无穷，人身之病也变化无穷。张仲景的书记载的是大道。医术高明的人，引用例子推演类比，可以说是无穷的应用。假如《要略》稍有加减修合，终究难以逾越规矩法度。气病初起时，端倪很微小，或许因为少许饮食不慎，或许外冒风雨，或许内感七情，或许口味过重，偏助阳气，积成膈热；或许禀赋充实，表密无汗；或许性情急躁易怒，火炎上导致津液不行，清浊相干，气为之病。或者痞塞，或者疼痛不思食，或者嗳腐气，或者吞酸，或者嘈杂，或者膨满。如果不求原本，便认为是寒证，立即投以辛香燥热的药剂，几帖后暂时痛快，便以为是神方。厚味照旧，不节七情，反复相仍，旧病被劫夺暂时开通，浊液易于攒聚。或者半月，或者一月，前证复发。如此延蔓，自气成积，自积成痰。这就是痰、饮、吞酸的由来。良医未遇谬药，又行痰挟瘀血，遂成窠囊。这就是痞、痛、呕吐、噎膈、反胃的次第。饮食汤液，滞泥不行，渗道蹇涩，大便或秘或溏，下失传化，中焦愈停。医者不察，仍执为冷，回想前药，随手得快，至此宾主皆恨，药欠燥热颙伺，久服可以温脾壮胃，消积行气，以冀一旦豁然之效。不思胃为水谷之海，多血多气，清和则能受脾（气），为消化之气，清和则能运。今反得香热之偏，助气血沸腾。其始也，胃液凝聚，无所容受；其久也，脾气耗散，传化渐迟。其有胃热易饥，急于得食，脾伤不磨，郁积成痛。医者犹曰虚而积寒，非寻常草木可疗，径以乌头、附子助佐丹剂，专意服饵。积而久也，血液俱耗，胃脘干槁。其槁在上，近咽之下，水饮可行，食物难入，间或可入亦不多，名之曰噎。其槁在下，与胃为近，食虽可久，难尽入胃，良入复出，名之曰膈，亦曰反胃。大便秘少，若羊矢然。名虽不同，病出一体。《要略》论饮有六日：痰饮、悬饮、溢饮、支饮、留饮、伏饮，分别五脏诸证，治法至矣尽矣。只恨医者不善处理，治病者不守禁忌，遂使药助病邪，展转深痼，去生渐远，深可哀悯。
有人问：《千金方》诸方治疗噎膈反胃，未曾废弃姜桂等药剂，为何您这么多言？我回答说：气之郁滞久留清道，非借香热不足以行。然而方中悉有大黄、石膏、竹茹、芒硝、泽泻、前胡、朴硝、茯苓、黄芩、芦根、括蒌等药，为之佐使。其始则同，其终则异。病邪易伏，其病自安。
有人问：胃脘干槁者，古方果真可治吗？将有其他要捷之法吗？或许可以补前人之未发吗？我回答说：古方用人参以补肺，御米（罂粟壳）以解毒，竹沥以消痰，干姜以养血，粟米以实胃，蜜水以润燥，姜以去秽，正是此意。张鸡峰也说：噎，应当是神思间病，惟内观自养，可以治之。此言深中病情，而施治之法，也为近理。夫噎病生于血干。夫血，阴气也，阴主静。内外两静，则脏腑之火不起，而金水二气有养，阴血自生，肠胃津润，传化合宜，何噎之有？因触类而长。曾制一方，治疗中年妇人，用四物汤加和白陈皮，留尖桃仁，生甘草，酒红花，浓煎入驴尿饮，以防其或生虫也。与数十帖而安。又台州治疗一匠者，年近三十，勤于工作而有爱妻，且喜酒，其面白，其脉涩，重则大而无力。令其谢去工作，卧于牛家，取新温牛乳细饮之，每递进一杯，一昼夜可饮五七次，尽却食物，以渐而至八九次。半月大便润，月余而安。然或口干，盖酒毒未解，间饮甘蔗汁少许。或者又说：古方之治噎膈反胃，未有不言寒者，您为何不思之甚？我回答说：古人著方，必为当时抱病者设也。其人实因于寒，故用之而得效。后人遂录以为今式，不比《局方》，泛编成书，使天下后世之人，凡有此证者，率遵守之以定为法，而专以香热为用也。虽然挟寒者，亦或有之。但今人之染此病，率因痰气，久得医药传变而成，其为无寒也明矣。
有人问：治疗脾肾以温补药，岂非《局方》之良法耶？您将何以议之？我回答说：众言淆乱，必折诸圣。切恐脾肾有病，未必皆寒。观其养脾丸，治脾胃虚冷，体倦不食。嘉禾散，治脾胃不和，不能多食。消食丸，治脾胃俱虚，饮食不下。小独圣丸，治脾胃不和，不思饮食。大七香丸，治脾冷胃虚，不思饮食。连翘丸，治脾胃不和，饮食不下。分气紫苏饮，治脾胃不和。木香饼子，治脾胃虚寒。温中良姜丸，曰温脾胃。夺命抽刀散，曰脾胃冷。烧脾散，曰脾胃虚。进食散，曰脾胃虚冷，不思饮食。丁香煮散，曰脾冷胃寒。二姜丸，曰养脾温胃。姜合丸，曰脾胃久虚。蓬煎丸，曰脾胃虚弱。守金丸，曰脾胃虚冷。集香丸，曰脾胃不和。蟠葱散，曰脾胃虚冷。壮脾丸，曰脾胃虚弱。人参丁香散，曰脾胃虚弱。人参煮散，曰脾胃不和。丁香透膈汤，曰脾胃不和。丁香五夺丸，曰脾胃虚弱。膈肭脐丸之壮气暖肾，菟丝子丸之治肾虚，金钗石斛丸之治气不足，茴禾丸之治脏虚冷，玉霜丸之治气虚，安肾丸之治肾积寒，麝香鹿茸丸之益气，养正丹之治诸虚，朴附丸之治脾胃虚弱，接气丹之治真气虚，四神丹之治五脏，沉香鹿茸丸之治气不足，椒附丸之温五脏，苁蓉大补丸之治元脏元气虚，钟乳白泽丸之治诸虚，三建汤之治气不足。甚者类聚丹剂，悉曰补脾胃，温脾胃，补肾，补五脏，补真气。而各方条下曰舌苦，曰面黄，曰舌苦无味，曰中酒吐酒，曰酒积，曰酒癖，曰饮酒多，曰酒过伤，曰气促喘急，曰口淡，曰舌涩，曰噫醋，曰舌干，曰溺数，曰水道涩痛，曰小便出血，曰口苦，曰咽干，曰气促，曰盗汗，曰失精，曰津液内燥，曰气上冲，曰外肾痒，曰枯槁失血，曰口唇干燥，曰喘满，曰肢体烦疼，曰衄血，曰小便淋沥。悉是明具热证，如何类聚燥热，而谓可以健脾温胃而滋肾补气乎？经曰：热伤脾，常服燥热，宁不伤脾乎？又曰：肾恶燥，多服燥热，宁不伤肾乎？又曰：热伤元气，久服燥热，宁不伤气乎？又曰：用热远热。又曰：有热者寒而行之。此教人用热药之法，盖以热药治寒病，苟无寒药为之响导佐使，则病拒药而扞格不入，谓之远热者，行之以寒也。两句同一意，恐后人不识此理，故重言以明之。今《局方》辛香燥热以类而聚之，未尝见其所谓远热也。用热而不远热，非惟不能中病，抑且正气先伤，医云乎哉。夫良医之治病也，必先求其得病之因。其虚邪也，当治其母，实邪也，当治其子。微邪也，当治其所胜，贼邪也，当治其所不胜，正邪也，当治其本经。索矩又谓杂合受邪病者，所受非止一端，又须察其有无，杂合之邪，轻重较量，视标本之缓急，以为施治之先后。今乃一切认为寒冷，吾不知脾胃与肾，一向只是寒冷为病耶？论方至此，虽至愚昧，不能不致疑也。吾又考之《要略》矣。诸呕吐，谷不得入者，小半夏汤主之。疸病寒热不食，食则头眩，心胸不安者，茵陈汤主之。身肿而冷，胃窒不能食，病在骨节，发汗则安，心胸停痰吐水，虚满不能食者，茯苓汤主之。中风手足拘急，恶寒不欲饮食者，三黄汤主之。下利不欲饮食者，大承气汤主之。五劳虚极，羸瘦不能食者，大黄䗪虫丸主之。虚劳不足，汗出而闷，脉结心悸者，炙甘草汤主之。虚劳腰痛，小腹拘急者，八味丸主之。虚劳不足者，大薯蓣丸主之。虚劳虚烦不得眠者，酸枣仁汤主之。夫呕者，胸满者，吐水者，下利者，恶寒者，肿而冷者，不能饮食者，虚劳羸瘦者，虚劳汗而悸者，虚劳而腰痛者，虚劳不足者，虚劳烦而不眠者，自《局方》之法观之，宁不认为寒冷，而以热药行之乎？仲景施治则不然也。痰者导之，热者清之，积者化之，湿者渗之，中气清和，自然安裕。虚者补之，血凝者散之，躁者宁之，热者和之，阴气清宁，何虚劳之有也？
有人问：伤寒一门，虽取杂方，仲景之法，亦摘取之矣。您其忘言乎？我回答说：伤寒之法，仲景而下，发明殆尽。《局方》是否愚不必赘。虽然仲景论伤寒矣，而未及乎中寒。先哲治冒大寒而昏中者，用附子理中汤而安，其议药则得之矣。曰伤，曰中，未闻有议其异同之者。我俯而思之，伤寒有即病，有不即病，必大发热病邪，循经而入，以渐而深。中寒则仓卒感受其病，即发而暴。伤寒之人，因其旧有郁热，风寒外束，肌腠自密，郁发为热，其初也，用麻黄、桂枝辈，微表而安，以病体不甚虚也。中寒之人，乘其腠理疏豁，一身受邪，难分经络，无热可发，温补自解，此谓气之大虚也。伤寒热虽甚不死，中寒若不急治，去生甚远，其虚实盖可见矣。
有人问：脾胃一门，您以《局方》用药太热，未合经意。若平胃散之温和，可以补养胃气，您以为何如？我回答说：苍术性燥气烈，行湿解表，甚为有力。厚朴性温散，气非胀满实急者，不用承气用之可见矣。虽有陈皮甘草之甘缓，甘辛亦是决裂耗散之剂，实无补土之和。经谓土气大过，曰敦阜，亦能为病。况胃为水谷之海，多气多血，故因其病也，用之以泻有余之气，使之平尔。又虽察其挟寒，得寒物者投之，胃气和平，便须却药，谓之平者，非补之之谓，其可常服乎？
有人问：调胃承气亦治胃病，谓之调者，似与平胃散之意相近，何用药之相远也？我回答说：调胃承气治热，中下二焦药也。经曰：热淫于内，治以咸寒，佐以苦甘，功在乎导利而行之以缓。平胃散止治湿，上焦之药也。经曰：湿上甚而热，治以苦湿，佐以甘辛，以汗为效而止。
有人问：治湿不利小便，非治也。非仲景法耶？为何您言之悖也？我回答说：淡渗治湿，以其湿在中下二焦。今湿在上，宜以微汗而解，不欲汗多，故不用麻黄、葛根辈。
Someone asked: For conditions where Qi ascends, Black Tin Pill (Heixi Dan), Nourish Righteousness Pill (Yangzheng Dan), and Nourish Qi Pill (Yangqi Dan) are used as heavy sedatives. However, those who take them often experience immediate efficacy. Do you think that for diseases with extreme heat, these might also be misused? I replied: Besides the Ministerial Fire (Xianghuo), there are also Zang-Fu fires; Jue Yang fire (Jueyang Huo), and the movements of the Five Emotions (Wuzhi: joy, anger, worry, thought, fear) each generate their own fire. The so-called Ministerial Fire is what this classic refers to as "one water failing to overcome two fires," originating from heavenly endowment (innate constitution). The so-called Jue Yang is what this classic refers to as "one water failing to overcome five fires," originating from human desires (postnatal emotions). The ascent of Qi follows the flaming upward nature of fire and fails to descend; who can resist it? Now people wish to borrow the heavy, sinking nature of pill preparations to lower Qi. However, Qi stagnation transforms into damp-phlegm (Shitan); the pills' hot and dry nature劫 (forces) the damp-phlegm, which opens temporarily, thus feeling refreshing. But the method of these pills excessively assists wild fire, causing Yin blood to be further depleted, making Qi ascend even more. Laypeople favor warmth, becoming lost and unable to return, and those suffering from this disaster are numerous.
Someone asked: The heavy, sinking nature of pills intends to lower but causes ascending. Then what should be done? I replied: Administer acrid-cool herbs, move with acrid-warm herbs, subdue Liver pathogenic factors (Ganxie), treat with salty-cold herbs, assist with sweet-warm herbs, astringe with bitter-sweet herbs, harmonize with sweet-bland herbs, nourish Yin blood, and Yang will naturally attach. When Yin and Yang are in harmony, how can there be ascending? The maxims of former sages are not far; I will not elaborate further.
Someone asked: Vomiting acid juice (Tusan), the *Suwen* states it is heat. Li Dongyuan says it is cold. Why? I replied: Vomiting acid juice differs from swallowing acid juice. Vomiting acid juice involves spitting out sour liquid like vinegar. Normally, body fluids accumulate due to ascending Qi stagnation. After long stagnation, heat arises within dampness, transforming via fire, thus producing an acidic taste. How could this not be heat? In some cases, accumulation lasts long, cannot erupt spontaneously, and lies hidden between the Lungs and Stomach, unable to be coughed up or swallowed down. When the skin surface encounters wind-cold, internal heat becomes more stagnant, and the acidic taste pierces the heart. When the skin surface is warm and pores open, or after taking aromatic-hot soups or pills, body fluids circulate, providing temporary relief. Could this not be cold? The *Suwen* mentions heat because it refers to the root. Li Dongyuan mentions cold because it refers to the branch. However, Li Dongyuan did not mention external wind-cold but based his theory on the Metal Qi's contracting nature, aiming to drain excess Lung Metal. He also stated that cold herbs cannot treat acidity and used Anwei Tang modified with Erchen Tang, all containing Dingxiang (Caryophylli Flos), lacking methods to treat damp-heat stagnation, which does not conform to the classics. I once treated swallowing acid juice using Huanglian (Coptidis Rhizoma) and Zhuyu (Evodiae Fructus), both processed and stir-fried, alternating as assistants according to seasons, with Cangzhu (Atractylodis Rhizoma) and Fuling (Poria) as principal herbs, made into small pills soaked in water and steamed buns, and advised eating coarse food and vegetables for self-care, leading to easy recovery.
Someone asked: Suhexiang Wan (Succini Ambra Pilula), although gathering aromatic herbs, treats bone-steaming consumption, nocturnal emission, amenorrhea, and Huli disease (Fox Disease). Do you agree? I replied: Ancient physicians formulated prescriptions by grouping herbs, necessarily combining attack and tonification, restraining each other, following scent and flavor sequences, designating main herbs and meridian-guiding herbs, using direct treatment or reverse assistance, each with specific meaning. In the current prescription, fifteen ingredients are used. Excluding Baizhu (Atractylodis Macrocephalae Rhizoma), Zhusha (Cinnabaris), and Hezi (Terminaliae Chebulae Fructus) totaling six taels, the remaining twelve ingredients total twenty-one taels, all being urgent, light, and penetrating agents. They are often used for Qi disorders and patients with sudden collapse and unconsciousness, clashing through meridians and agitating Qi and Blood like destroying dry wood. Moreover, Caodoukou San (Cardamomi Fructus Powder) instructs brewing thickly in summer to replace hot water. Caodoukou is extremely hot and dispels cold; what cold exists in summer requiring excessive intake? Suopi Yin uses Caoguo (Tsaoko Fructus) with the same intent. Furthermore, eating cold in summer nourishes Yang. Do Caodoukou and Caoguo align with eating cold to nourish Yang? More importantly, Jieqi Dan states: Sudden collapse of Yang Qi implies prior Yin deficiency. If Yin is deficient first, Yang has no attachment, leading to floating away and sudden collapse. Yet the text previously stated: Yin Qi alone is abundant. If Yin is abundant, how can Yang suddenly collapse? If Yang collapses suddenly, one should use nourishing agents to preserve and calm it, aligning with the principle of eating cold in summer to nourish Yang. Why take acrid-aromatic-dry-hot agents? Once this pill is swallowed, can the collapsed Yang truly be restored? Who is right? Please calculate.
Someone asked: The *Ju Fang* states Yin excess means Yin pathogen abundance. If Yin pathogen is abundant, Yang may suddenly collapse. You speak of Yin relative to Yang. Can you really save cases of Yin deficiency and Yang collapse? I replied: The terms Yin and Yang are indeed relative, without fixed locations. They may refer to cold/heat, blood/Qi, Zang-Fu, exterior/interior, movement/stillness, deficiency/excess, clear/turbid, odd/even, upper/lower, correct/pathogenic, life/death, left/right. Seeking the intent of speech, it likely refers to Yin-Ghost pathogens. Yin-Ghost pathogens should be treated as such. Regarding Yin deficiency leading to Yang collapse, I once treated a patient. Brother Zheng from Pujiang, nearly sixty years old, accustomed to luxurious living. In mid-summer, he suffered from persistent dysentery and engaged in sexual activity. Suddenly one night, while using the toilet, his hands spread open, eyes wide but unseeing, urine flowed involuntarily, sweat poured like rain, throat sounded like sawing, breathing was very faint, pulse was large and chaotic without location, extremely frightening. I happened to be there, urgently ordered Ginseng Paste (Renshen Gao) to be decocted, and moxa-needling Qihai (CV6). Moxa cones were size of little finger, eighteen cones applied, right hand moved, three more cones, slight movement. Ginseng paste was ready, given one cup. By midnight, three cups consumed, eyes moved, two jin consumed before speaking, asking for porridge. Five jin consumed, diarrhea stopped. Ten jin consumed, stabilized.
Someone asked: Various Qi disorders, fluid retention, vomiting, swallowing acid, chest obstruction, and regurgitation, the *Ju Fang* misses the key point. I understand. Are the formulas from the *Yao Lue* (*Essential Prescriptions of the Golden Cabinet*) sufficient? Or are there unexplored areas? I replied: Heaven and Earth's Qi transformation is infinite; human diseases also change infinitely. Zhang Zhongjing's book records the Dao. Good physicians extrapolate examples, achieving infinite application. Even if the *Yao Lue* had slight modifications, it would not exceed boundaries. At the onset of Qi disorder, signs are subtle, possibly due to slight dietary indiscretion, external exposure to wind/rain, internal emotional disturbance, or rich flavors excessively assisting Yang, accumulating diaphragmatic heat; or robust constitution with tight pores and no sweat; or irritable temperament with fire flaming upward, stopping body fluids, mixing clear and turbid, causing Qi disorder. Symptoms include distension, pain, loss of appetite, belching rotten gas, swallowing acid, burning sensation, or bloating. Without seeking the root, it is assumed to be cold, and acrid-aromatic-dry-hot agents are administered. After a few doses, temporary relief occurs, deemed a divine formula. Rich diet continues, emotions unregulated, recurrence ensues. Old symptoms temporarily opened by force, turbid fluids gather easily. Half a month or a month later, previous symptoms return. This spreads, Qi becomes accumulation, accumulation becomes phlegm. This is the origin of phlegm, fluid retention, and swallowing acid. Skilled doctors avoid erroneous drugs; phlegm carrying blood stasis forms nests. This leads to distension, pain, vomiting, chest obstruction, and regurgitation sequence. Food and liquids stagnate, channels become obstructed, stool constipated or loose, lower transmission fails, middle Jiao stagnates. Doctors fail to observe, still insist on cold, recalling previous drugs gave quick relief. Guests and hosts regret, drugs lack dry-hot intensity, long-term use warms spleen/stomach, dissipates accumulation, moves Qi, hoping for sudden cure. Ignoring that Stomach is the Sea of Water and Grain, abundant in blood and Qi, only clear/harmonious state accepts Spleen Qi, only clear/harmonious digestion functions. Now receiving acrid-hot bias, assisting Qi/Blood boiling. Initially, stomach fluids coagulate, unable to accept; eventually, Spleen Qi scatters, transmission slows. Those with stomach heat, hungry, eager to eat, but Spleen injured fails to grind, stagnation causes pain. Doctors still say deficiency and accumulated cold, not treatable by ordinary herbs, directly using Wutou (Aconiti Lateralis Radix Preparata) and Fuzi (Aconiti Radix Preparata) assisting pill agents, focusing on ingestion. Long-term, blood and fluids depleted, stomach cavity dry and shriveled. Shriveling above, near throat, water drinks pass, food enters rarely, sometimes little, named Yē (Dysphagia). Shriveling below, near stomach, food stays long, hard to enter fully, good entry followed by exit, named Gé (Regurgitation) or Fanwei (Reverse Regurgitation). Stool scarce, like sheep droppings. Names differ, disease originates from one source. *Yao Lue* discusses six types of fluid retention: Tan Yin (Phlegm Fluid), Xuan Yin (Hanging Fluid), Yi Yin (Overflowing Fluid), Zhi Yin (Branch Fluid), Liu Yin (Retained Fluid), Fu Yin (Hidden Fluid), distinguishing five Zang syndromes, treatment methods are complete. Only pity that doctors handle poorly, patients ignore taboos, drugs aid pathogens, condition deepens, life recedes, deeply pitiable.
Someone asked: *Qianjin* formulas treat chest obstruction and regurgitation, never discarding Jiang (Zingiberis Rhizoma) and Gui (Cinnamomi Ramulus). Why do you speak so much? I replied: Qi stagnation lingering in clear pathways requires acrid-hot to move. However, formulas contain Dahuang (Rhei Radix et Rhizoma), Shigao (Gypsum Fibrosum), Zhuru (Bambusae Caulis in Taenia), Mangxiao (Natrii Sulfas), Zexie (Alismatis Rhizoma), Qianhu (Peucedani Radix), Puxiao (Natrii Sulfas), Fuling (Poria), Huangqin (Scutellariae Radix), Lugeng (Phragmitis Rhizoma), Gualou (Trichosanthis Fructus) as assistants. Start is same, end is different. Pathogens easily subside, disease heals.
Someone asked: Can ancient formulas treat stomach cavity dryness/shriveling? Are there other expedient methods to supplement predecessors? I replied: Ancient formulas use Renshen (Ginseng Radix) to tonify Lung, Yumi (Papaveris Pericarpium) to detoxify, Zhulu (Bambusae Succus) to resolve phlegm, Ganjiang (Zingiberis Rhizoma) to nourish blood, Sumi (Pollen Zeae Maydis) to solidify Stomach, Honey water to moisten dryness, Ginger to remove filth, exactly this intent. Zhang Jifeng also said: Yē is a spirit/mind disorder, only inner observation and self-nourishment can treat it. This hits the pathology deeply, and treatment method is reasonable. Yē disease arises from blood dryness. Blood is Yin Qi, Yin governs stillness. Inner and outer stillness prevents Zang-Fu fire from rising, Jin-Shui (Metal-Water) Qi nourished, Yin blood generated, intestines/stomach fluids moist, transmission harmonious, why Yē? Touching categories, I formulated a prescription for a middle-aged woman: Siwu Tang (Four Substances Decoction) added with Chenpi (Citri Reticulatae Pericarpium), Taoren (Persicae Semen) keeping tips, Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Jiuhonghua (Carthami Flos), decocted thickly with Donkey Urine (Lv Niao) to prevent parasites. Given dozens of doses, stabilized. Also treated a craftsman in Taizhou, nearly thirty, diligent worker, loved wife, liked wine, pale face, choppy pulse, heavy large and powerless. Ordered him to quit work, sleep at a cowherd's, drink fresh warm cow milk slowly, one cup per dose, five to seven times a day, stop all food, gradually increasing to eight or nine times. Half month stool moist, one month stabilized. Dry mouth remained, wine toxin unresolved, occasionally drank sugarcane juice. Someone else said: Ancient formulas for chest obstruction/regurgitation never mention cold. Why don't you think deeply? I replied: Ancients wrote formulas for contemporary patients. Their illness was truly caused by cold, hence effective. Later generations recorded them as standard models, unlike *Ju Fang*, broadly compiled into books, making future generations follow them as fixed laws, exclusively using acrid-hot. Although cold-clinging cases exist, modern infections usually stem from phlegm-Qi, transformed by long-term medication, clearly not cold.
Someone asked: Treating Spleen/Kidney with warm-tonifying agents, isn't this a good method of *Ju Fang*? How do you comment? I replied: Conflicting words must be judged by sages. Fear that Spleen/Kidney diseases are not always cold. Observe Yangpi Wan treating Spleen/Stomach deficiency-cold, fatigue, anorexia. Jiahe San treating Spleen/Stomach disharmony, inability to eat much. Xiaoshi Wan treating Spleen/Stomach dual deficiency, inability to eat. Xiaodusheng Wan treating Spleen/Stomach disharmony, no desire to eat. Daqiqiang Wan treating Spleen cold/Stomach deficiency, no desire to eat. Lianqiao Wan treating Spleen/Stomach disharmony, inability to eat. Fenqi Zisu Yin treating Spleen/Stomach disharmony. Muxiang Bingzi treating Spleen/Stomach deficiency-cold. Wenzhong Liangjiang Wan warming Spleen/Stomach. Duoming Choudao San stating Spleen/Stomach cold. Shaopi San stating Spleen/Stomach deficiency. Jinshi San stating Spleen/Stomach deficiency-cold, no desire to eat. Dingxiang Zhusan stating Spleen cold/Stomach cold. Erjiang Wan nourishing Spleen/warming Stomach. Jianghe Wan stating Spleen/Stomach long deficiency. Pengjian Wan stating Spleen/Stomach weakness. Shoujin Wan stating Spleen/Stomach deficiency-cold. Jixiang Wan stating Spleen/Stomach disharmony. Pancong San stating Spleen/Stomach deficiency-cold. Zhuangpi Wan stating Spleen/Stomach weakness. Renshen Dingxiang San stating Spleen/Stomach weakness. Renshen Zhusan stating Spleen/Stomach disharmony. Dingxiang Touge Tang stating Spleen/Stomach disharmony. Dingxiang Wu duo Wan stating Spleen/Stomach weakness. Genabi Qi Wan strengthening Qi/warming Kidney. Tusizi Wan treating Kidney deficiency. Jinchai Shihu Wan treating Qi insufficiency. Huihe Wan treating organ deficiency-cold. Yushuang Wan treating Qi deficiency. Anshen Wan treating Kidney accumulation-cold. Shexiang Lurong Wan benefiting Qi. Yangzheng Dan treating various deficiencies. Pufu Wan treating Spleen/Stomach deficiency. Jieqi Dan treating true Qi deficiency. Sishen Dan treating five Zang. Chenxiang Lurong Wan treating Qi insufficiency. Jiaofu Wan warming five Zang. Rongrong Dabu Wan treating primal organ/primal Qi deficiency. Zhongru Baize Wan treating various deficiencies. Sanjian Tang treating Qi insufficiency. Worse, gathering pill agents, all claiming tonify/warm Spleen/Stomach, tonify Kidney, tonify five Zang, tonify true Qi. Under each formula, symptoms listed: bitter tongue, yellow face, tasteless bitter tongue, alcohol vomiting, alcohol accumulation, alcohol mass, excessive drinking, alcohol injury, shortness of breath/wheezing, bland mouth, dry tongue, belching acid, dry tongue, frequent urination, painful urinary tract, hematuria, bitter mouth, dry throat, shortness of breath, night sweats, seminal emission, internal dryness of fluids, Qi rushing upward, external genital itching, emaciation/blood loss, dry lips, panting/fullness, limb pain, epistaxis, dribbling urination. All clearly show heat syndromes. How can gathering dry-hot agents claim to strengthen Spleen, warm Stomach, nourish Kidney, benefit Qi? Classics say: Heat injures Spleen; constant use of dry-hot, does it not injure Spleen? Again: Kidney dislikes dryness; excessive dry-hot, does it not injure Kidney? Again: Heat injures Yuan Qi; long-term dry-hot, does it not injure Qi? Again: Use hot far from heat. Again: With heat, administer cold. These teach using hot drugs: using hot drugs for cold diseases, if no cold drugs guide/assist, disease rejects drugs, conflict arises. "Far from heat" means administering with cold. Two sentences same meaning, fearing后代 don't understand, repeated to clarify. Now *Ju Fang* gathers acrid-aromatic-dry-hot, never seeing "far from heat." Using hot without distancing from heat, not only fails to hit disease, but injures healthy Qi first. What kind of doctor is this? Good doctors seek cause first. Deficient pathogen, treat mother; Excess pathogen, treat child. Minor pathogen, treat overcontrolled; Tyrant pathogen, treat unconquered; Correct pathogen, treat primary meridian. Suo Ju also says mixed pathogens have multiple sources, check existence, weigh severity, view root/branch urgency, determine treatment order. Now everything considered cold, I don't know if Spleen/Stomach/Kidney are always cold diseases. Discussing formulas here, even foolish ones doubt. I examined *Yao Lue*. Vomiting, grain cannot enter, Xiaobanxia Tang governs. Jaundice with cold/heat, anorexia, dizziness after eating, chest discomfort, Yinchen Tang governs. Body swelling/cold, stomach obstruction, inability to eat, bone/joint disease, sweating brings ease, chest/phlegm/vomiting water, deficiency-fullness, inability to eat, Fuling Tang governs. Wind-stroke limbs spasm, aversion to cold, no desire to eat, Sanhuang Tang governs. Diarrhea, no desire to eat, Dachengqi Tang governs. Five labors extreme emaciation, inability to eat, Dahuang Echu Wan governs. Deficiency labor insufficient, sweating/chest oppression, knotted palpitation, Zhigancao Tang governs. Deficiency labor back pain, lower abdominal spasm, Bawei Wan governs. Deficiency labor insufficient, Dayushu Yu Wan governs. Deficiency labor vexation insomnia, Suanzaoren Tang governs. Vomiting, chest fullness, vomiting water, diarrhea, aversion to cold, swelling/cold, inability to eat, deficiency emaciation, sweating/palpitation, back pain, insufficiency, vexation/insomnia, viewing from *Ju Fang* method, wouldn't one consider cold and use hot drugs? Zhongjing's treatment is different. Phlegm guides it, heat clears it, accumulation dissolves it, dampness渗es it, middle Qi harmonious, naturally comfortable. Deficiency tonifies it, blood stasis disperses it, restlessness calms it, heat harmonizes it, Yin Qi peaceful, what deficiency labor?
Someone asked: Shanghan category takes miscellaneous formulas, Zhongjing's methods also extracted. Do you forget your words? I replied: Shanghan methods, since Zhongjing, fully elucidated. Whether *Ju Fang* is foolish need not add. Although Zhongjing discussed Shanghan, he did not reach Zhonghan. Former sages treating sudden severe cold with coma used Fuzi Lizhong Tang, stabilizing, discussing drugs was correct. Said Shang, said Zhong, never heard discussion of differences. I pondered: Shanghan has immediate onset, delayed onset, must have high fever, pathogen enters meridians, gradually deepens. Zhonghan is sudden exposure, immediate violent onset. Shanghan patients, due to existing stagnant heat, wind-cold binds exterior, pores tighten, heat develops internally, initially use Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus) to mildly release exterior, stabilize, as body not very deficient. Zhonghan patients, pores loose, whole body affected, meridians indistinguishable, no heat to develop, warm-tonify resolves itself, this is great Qi deficiency. Shanghan heat severe not fatal; Zhonghan not treated urgently, life recedes far, deficiency/excess visible.
Someone asked: Spleen/Stomach category, you say *Ju Fang* drugs too hot, not conforming to classics. Pingwei San mild, can tonify Stomach Qi, what do you think? I replied: Cangzhu dry/aromatic, moves damp/releases exterior, very powerful. Houpo warm/dispersing, Qi not distension/excess/urgent, Chengqi not used, seen here. Though Chenpi/Gancao sweet/slow, sweet/acrid also tear/consume agents, truly no tonifying earth harmony. Classics say Earth Qi excess, Dunfu, also causes disease. Stomach is Sea of Water/Grain, abundant Qi/Blood, thus using it to drain excess Qi, making it level. Even observing cold-clinging, giving cold substances, Stomach Qi harmonious, then stop drugs. Called Ping (Level), not tonifying, can it be taken constantly?
Someone asked: Tiaowei Chengqi also treats Stomach disease, called Tiao (Regulate), similar to Pingwei San intent, why drugs far apart? I replied: Tiaowei Chengqi treats heat, Middle/Lower Jiao drug. Classics: Heat rampant inside, treat salty-cold, assist bitter-sweet, function guiding/draining, acting slowly. Pingwei San only treats damp, Upper Jiao drug. Classics: Damp upper severe heat, treat bitter-damp, assist sweet-acrid, sweat as effect then stop.
Someone asked: Treating damp without promoting urination is not treatment. Not Zhongjing's method? Why contradictory? I replied: Bland-draining treats damp, as damp in Middle/Lower Jiao. Now damp in Upper, should resolve with mild sweat, not want much sweat, thus not use Mahuang, Gegen (Puerariae Lobatae Radix).