徐灵胎
古时权量甚轻，古一两今二钱零。古一升，今二合。古一剂，今之三服。又，古之医者，皆自采鲜药，
如生地、半夏之类，其重比干者数倍。故古方虽重，其实无过今之一两
左右者，惟（《千金》）（孙思藐着《千金方》）（《外台》）（王焘着《外台秘要》）间有重剂，此乃治强实大症，
亦不轻用也。若宋元以来，每总制一剂方，下必注云，每服或三钱或五钱，亦无过一两外者，此煎剂之法也。末
药则用一钱匕，丸药则如桐子大者，十丸加至二三十丸。试将古方细细考之，有如今日二三两至七八两之煎剂
乎。皆由医者不明古制，以为权量与今无异，又自疑为太重，为之说曰。今人气薄，当略为减轻，不知已重于
古方数倍矣。所以药价日贵，而受害愈速也。又有方中熟地用三四两，余药只用一二钱者亦从无此轻重悬殊之法。要知
药气入胃，不过借此调和气血，非药入口即变为气血，所以不在多也。又有病患粒米不入，反用腻膈酸苦腥臭
之药，大碗浓煎灌之，即使中病，尚难运化，况与病相反之药，填塞胃中，即不药死，亦必灌死。小儿尤甚。又
不论人之贫富，人参总为不挑之品，人情无不贪生，必竭蹶措处，熟知反以此而丧身。其贫者，送终无具，妻子
飘零，是杀其身而并破其家也。吾少时，见前辈老医，必审贫富而后用药，尤见居心长浓，况是时参，价犹贱于
今日数十倍，尚如此谨慎，即此等存心，今人已不逮，昔人远矣。
古代的度量衡非常轻，古代的一两相当于现在的二钱多一点。古代的一升，相当于现在的二合。古代的一剂药，相当于现在的三次服用量。另外，古代的医生，都是自己采摘新鲜药材，比如生地黄、半夏等，其重量比干燥的药材重数倍。所以古方的剂量虽然看起来重，但实际上没有超过现在一两左右的，只有《千金方》（孙思邈所著《千金方》）和《外台秘要》（王焘所著《外台秘要》）中偶尔有重剂，这是为了治疗强壮且病情严重的病症，也不会轻易使用。如果从宋代、元代以来，每制定一剂方子，下面必定注明“每次服用三钱或五钱”，也没有超过一两之外的，这是煎煮汤剂的方法。散末药则用一钱匕的量，丸药如桐子大小的，从十丸增加到二三十丸。试着将古方细细考证一下，有像今天二三两至七八两这样的煎剂吗？这都是因为医生不明白古代的制度，认为度量衡与现在没有不同，又自己怀疑剂量太重，于是解释说：“现在人的体质虚弱，应当稍微减轻剂量”，却不知道这已经比古方重了数倍。所以药价日益昂贵，而受害的速度也越快。又有方子中熟地黄用三四两，其余药物只用一二钱的，从来没有这样轻重悬殊的用法。要知道药气进入胃中，不过是借此来调和气血，并不是药物入口立即就变成气血，所以不在于多。又有病人一粒米都吃不下，反而使用滋腻碍胃、酸苦腥臭的药物，用大碗浓煎灌下去，即使对症，也难以运化吸收，何况是与病情相反的药物，填塞在胃中，即使不被药毒死，也一定会被灌死。小儿尤其严重。又不分病人的贫富，人参总是作为不可挑剔的补品，人之常情无不贪生怕死，必定竭尽全力去筹措购买，谁知道反而因此丧命。那些贫穷的人，连送终的器具都没有，妻子儿女流离失所，这是杀了他的身体并导致家破人亡啊。我年轻时，见到前辈老医生，一定要审察病人的贫富情况然后才用药，尤其看到当时用心厚道，况且那时的参价还比今日便宜几十倍，尚且如此谨慎，就这种用心程度，现在的人已经比不上，古人远远超越了他们。
Xu Lingtai
In ancient times, the units of weight and volume were very light. One tael (liang) in ancient times is equivalent to a little more than two qian in modern times. One sheng in ancient times is equivalent to two he in modern times. One prescription (ji) in ancient times is equivalent to three doses taken today. Furthermore, ancient physicians all harvested fresh herbs themselves, such as Shengdi Huang (Rehmanniae Radix, raw) and Banxia (Pinelliae Rhizoma), whose weight was several times that of dried herbs. Therefore, although the dosages in ancient prescriptions appear heavy, they actually did not exceed around one tael (liang) in modern terms. Only occasionally were heavy dosages used in *Qianjin Fang* (Prescriptions Worth a Thousand Gold) by Sun Simiao and *Waitai Miyao* (Secrets of the Outer Palace) by Wang Tao; these were for treating robust patients with severe conditions and were not used lightly. Since the Song and Yuan dynasties, when formulating a prescription, it was customary to note "each dose: 3 qian or 5 qian," rarely exceeding one tael (liang). This refers to the method of decocting herbal medicine. For powdered medicines, a quantity of one qian bi (a spoonful measuring approximately one qian) was used; for pills sized like paulownia seeds, the dosage increased from ten pills to twenty or thirty pills. If one carefully examines ancient prescriptions, are there any decoctions weighing two to three taels up to seven or eight taels as seen today? This situation arises because physicians do not understand ancient standards, believing that weights and measures are no different from modern ones, yet they doubt the dosages are too heavy. They offer an explanation: "People nowadays have weak constitutions, so dosages should be slightly reduced." However, they fail to realize that this has already made the dosages several times heavier than those in ancient prescriptions. Consequently, herb prices rise daily, and harm comes faster. There are also cases where Shu Di Huang (Rehmanniae Radix, prepared) is used in amounts of three to four taels, while other herbs are only used in amounts of one or two qian. There has never been such a drastic disparity in heaviness and lightness in herbal combinations. It must be understood that when medicinal qi enters the stomach, it merely serves to harmonize Qi and Blood; it does not instantly transform into Qi and Blood upon ingestion. Therefore, the quantity is not the primary factor. In cases where patients cannot swallow even a grain of rice, using cloying, obstructive, sour, bitter, fishy, or foul-smelling herbs, brewed thickly in large bowls and force-fed, makes digestion difficult even if the treatment is correct. How much more so if the herbs contradict the disease, filling the stomach? The patient may not die from toxicity but will certainly die from being force-fed. This is especially true for children. Regardless of whether the patient is rich or poor, Ren Shen (Ginseng Radix et Rhizoma) is always considered an indispensable tonic. Human nature naturally desires life, leading people to exhaust their resources to procure it, only to find that this leads to their demise. The poor lose their means for funeral arrangements, and their wives and children wander destitute. This kills the body and destroys the family. In my youth, I observed senior physicians who would first assess the patient's financial status before prescribing medication. They exhibited great benevolence. Moreover, at that time, the price of Ginseng was dozens of times lower than today, yet they remained so cautious. Such conscientiousness is something modern physicians lack, falling far short of the ancients.