《内经》并无转下之说，止言发散，又止言辛甘发散为阳。辛温之药达表则自然汗散，攻里则自然开通。
（据先生之论谓辛甘发散为阳，故表邪解而里自和，非辛甘能攻里也，后人当活看。）非若寒苦之药，动人
脏腑，泄人元气也。夫巴豆、硝黄之类能直穿脏腑，非大积大聚，元气壮实者，不敢轻用。今之庸医不问虚实，
动辄便行转下，以泄六腑各气，转生他证。重则脾胃渐衰，不进饮食，肌肉消瘦而死。又俗云∶春行夏补，至
秋时须服通行药数剂，以泄夏月积热，此语甚讹。（俗医惯将此数语印人耳目，夫《内经》四时调养生长收藏
之道，与春夏养阳、秋冬养阴之法，何等圆活，而愚人执守一说，不肯精求《灵》、《素》，良可慨也！）
夫热在内，自然从五脏六腑及大小便中泄出。若以凉药泄热，吾恐热气未去一分，而元气已衰九分。尝观服转药一
剂，则有五七日饮食脾胃不能复旧。况乎三焦暖热方能腐熟水谷，若一刻无火则肌肤冰冷，阳气脱尽而死矣。故《内经》
止有沉寒痼冷之论，未有积热纯阳之说。纵然积热为病，一服转下便可解救。若阴寒为病，则四肢逆冷，死在须臾。古
人立法，若狂言妄语，逾垣上屋诸大热证，亦要论其大便如何。数日不出者，有燥屎也，方下之，若大便如常，即不可
下。（狂言妄语，逾垣上屋，自是热证，然有一种面青脉急，或面黑脉微，手足厥冷者，又属阴证。此系无附之阳，
必死之证，若治之早或有生者。）
今人于并无以上热证，而亦概用寒凉转下，必欲尽去其热，吾不知将以何为生气。夫人身无热则阳气尽矣。此河
间、丹溪遗讹后世，业医者不可以不察此弊也。
《黄帝内经》中并没有“转下”（通过泻下法通导大便以祛除病邪）的说法，只提到发散表邪，又只说辛味和甘味的药物具有发散作用，属于阳的性质。辛温性质的药物能够通达体表，自然就会出汗而散邪；作用于体内，自然就能通畅腑气。
（根据窦材先生的观点，认为辛甘发散属于阳，所以表邪解除后里气自然调和，并不是辛甘药能直接攻逐里实，后人应当灵活看待。）这不同于寒凉苦味的药物，会扰动脏腑，耗泄人的元气。像巴豆、芒硝、大黄这类药物，能够直接穿透脏腑，如果不是大积大聚之证，且患者元气壮实的，不敢轻易使用。现在的庸医不分虚实，动不动就施行转下法，以泄六腑之气，反而衍生出其他病症。严重的会导致脾胃逐渐衰弱，不能进食，肌肉消瘦而死。又有俗语说：春天要像夏天一样进补，到了秋天必须服用几剂通行排泄的药物，以泄去夏季积聚的热邪，这种说法非常错误。（庸医习惯用这几句话来迷惑世人，《黄帝内经》中关于四时调养生长收藏的道理，以及春夏养阳、秋冬养阴的方法，是多么圆融灵活，而愚昧的人固执于一种说法，不肯精心探求《灵枢》和《素问》，实在令人感慨！）
热邪在体内，自然会从五脏六腑以及大小便中排出。如果用寒凉药物来泄热，我担心热邪没有去掉一分，而元气已经衰败了九分。曾经观察到服用泻下药一剂，就有五到七天饮食脾胃功能不能恢复常态。何况三焦温暖才能腐熟水谷，如果一刻没有阳气之火，肌肤就会冰冷，阳气脱尽而死。所以《黄帝内经》只有沉寒痼冷（深重顽固的寒邪）的论述，没有积热纯阳（极度亢盛的阳热）的说法。纵然积热成为疾病，服一次泻下药就可以解救。如果是阴寒致病，那么四肢逆冷，很快就会死亡。古人制定法则，对于狂言妄语、爬墙越屋等大的热证，也要考察其大便情况。几天不排出的，是有燥屎，才用泻下法；如果大便正常，就不可用泻下法。（狂言妄语、爬墙越屋，自然是热证，但也有一种面色青黑、脉象紧急或微弱、手足厥冷的，又属于阴证。这是无根之阳外越，必死的证候，如果治疗及时或许还有生机。）
现在的人在没有以上热证的情况下，也一概使用寒凉泻下的方法，一定要把热邪全部去除，我不知道拿什么作为生命的生气。人身上如果没有热，阳气就竭尽了。这是刘河间、朱丹溪遗留的错误影响后世，行医的人不可以不察觉这种弊端。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) contains no concept of "Zhuanxia" (purging to induce bowel movement to eliminate pathogens); it only mentions dispersing the exterior, and further states that pungent and sweet herbs possess dispersing properties and belong to Yang. Pungent-warm herbs reaching the exterior will naturally cause sweating to dissipate pathogens; acting on the interior, they will naturally unblock the fu organs.
(Note: According to Mr. Dou Cai's argument, since pungent and sweet dispersing belongs to Yang, resolving exterior pathogens harmonizes the interior naturally; this does not mean pungent-sweet herbs can directly attack interior excess. Later generations should view this flexibly.) This is unlike cold-bitter herbs, which disturb the zang-fu organs and drain the body's Yuan Qi (Primordial Energy). Substances like Crotonis Fructus (Badou, 巴豆), Natrii Sulfas (Xiaomangxiao, 芒硝), and Rheum Palmatum Radix et Rhizoma (Dahuang, 大黄) can penetrate straight through the zang-fu organs. Unless there is a massive accumulation or mass, and the patient's Yuan Qi is robust, one dares not use them lightly. Today's mediocre physicians, regardless of deficiency or excess, frequently resort to purging methods, draining the qi of the six fu organs, thereby generating other syndromes. In severe cases, the Spleen and Stomach gradually decline, food intake ceases, emaciation occurs, and death follows. There is also a vulgar saying: "Summer-like tonification in Spring requires taking several doses of purgative herbs by Autumn to drain summer heat accumulation." This statement is highly erroneous. (Mediocre doctors habitually imprint these words upon people's minds. The principles of nourishing, growing, harvesting, and storing according to the four seasons in the *Neijing*, along with the methods of nourishing Yang in Spring and Summer and Yin in Autumn and Winter, are so flexible and comprehensive. Yet fools stick rigidly to one view, unwilling to carefully seek understanding from the *Lingshu* (Spiritual Pivot) and *Suwen* (Basic Questions). It is truly lamentable!)
Heat within the interior will naturally discharge through the five zang and six fu organs, as well as via urination and defecation. If one uses cold herbs to drain heat, I fear that while the heat may not decrease by even one part, the Yuan Qi will have declined by nine parts. I have observed that after taking one dose of purgative medicine, digestive and Spleen-Stomach functions fail to recover for five to seven days. Moreover, only when the Sanjiao (Triple Burner) is warm can it rot and ripen water and grain. If there is no fire (Yang Qi) for even a moment, the skin and muscles become ice-cold, and death ensues due to the exhaustion of Yang Qi. Therefore, the *Neijing* discusses only deep-seated cold and chronic cold conditions, but never speaks of pure Yang heat accumulation. Even if disease arises from accumulated heat, a single dose of purgatives can provide relief. However, if the disease is caused by Yin-Cold, leading to cold extremities, death occurs almost immediately. The ancients established rules such that for major heat syndromes like delirious speech, climbing walls, or jumping onto roofs, one must still examine the stool. If there has been no bowel movement for several days, indicating dry feces, then purgation is indicated. If the stool is normal, purgation is contraindicated. (Delirious speech and climbing walls are naturally heat syndromes, yet there is a type presenting with a blue-black complexion, urgent or faint pulse, and cold limbs, which belongs to Yin syndromes. This is floating Yang without root, a fatal syndrome; if treated early, survival might be possible.)
Today, people indiscriminately use cold and purgative methods even in the absence of the aforementioned heat syndromes, insisting on eliminating all heat. I do not know what remains to sustain life. If the human body lacks heat, Yang Qi is exhausted. These errors left by Liu Wansu and Zhu Danxi have misled later generations. Practitioners must not fail to recognize this malpractice.