或问∶仲景处方，药品甚少，及东垣用药，多至二十余味。丹溪云∶余每治病，用东垣之药，效仲
景处方，庶品味数少，则药力专精。丹溪何以不法东垣而效仲景耶？曰∶明察药性，莫如东垣，盖所谓圣
于医者也。故在东垣则可多，他人而效其多，斯乱杂矣。东垣如韩信将兵，多多益善；丹溪不过能将十
万，故不敢效其多。
愚按经云治病必求其本，本于四时五脏之根也。故洁古张先生云五脏子母虚实，鬼邪微正，若不达其
旨意，不易得而入焉。徐用诚先生云，凡心脏得病，必先调其肝肾二脏，肾者心之鬼，肝气通则心气和，
肝气滞则心气乏。此心病先求于肝，清其源也。五脏受病，必传其所胜。水能胜火，则肾之受邪，必传于
心，故先治其肾逐其邪也，故有退肾邪、益肝气两方。或诊其脉，肝肾两脏俱和，而心自主疾，然后察
其心家虚实治之。（余仿此，详见《玉机微义·小儿部》。）
或问∶人言东南气热，可服寒药∶西北气寒，可服温药。然今东南之人，常服胡椒、姜、桂，不见生
病；而西北之人，畏食椒、姜辛热之物何也？曰，东南虽热，然地卑多湿，辛热食药亦能劫湿；西北虽寒，
然地高多燥，辛热食药却能助燥故耳！治病用药者，须识此意。
愚按异法方宜论云∶东南之域，下卑湿热，其人腠理疏通，汗液妄泄，阳气内虚，故宜食椒、姜辛
热之物，以助其阳也；西北之域，高陵风寒，其人腠理致密，汗液内固，阳气充实，不宜食椒、姜辛热之
物，反盖其阳也。东坡先生仕黄州，其民疫疠流行，先生以圣散子治之，其功甚效。是其地卑湿，四时郁
热，腠理疏通，汗液妄泄，阳气虚寒，是以相宜。西北疫疠，民用之死者接踵，此余之目击也。
有人问：张仲景开方，药物种类很少；而李东垣用药，多至二十余味。朱丹溪说：“我每次治病，使用李东垣的药方，效果却像张仲景的处方那样好。大概是因为药味数量少，药力就专精。”为什么朱丹溪不效法李东垣而效法张仲景呢？回答说：明察药性，没有比得上李东垣的，他可以说是医学圣人。所以在李东垣那里可以多用，其他人如果效仿他的多用，就会杂乱无章了。李东垣就像韩信带兵，越多越好；朱丹溪不过只能率领十万兵，所以不敢效仿他多用。
我按语：经典说治病必须探求根本，根本在于四时和五脏的根源。所以洁古先生（张元素）说，五脏子母关系的虚实，以及鬼邪与正气的盛衰，如果不通晓其旨意，很难进入医道。徐用诚先生说，凡是心脏得病，必须先调理肝肾两脏。肾是心的“鬼”（即克我者），肝气通畅则心气和顺，肝气郁滞则心气匮乏。这是心病先从肝论治，以清除病源。五脏受病，必定传变其所克的脏腑。水能胜火，所以肾脏受邪，必定传变到心脏，因此先治疗肾脏以驱逐邪气，所以有退肾邪、益肝气两个方剂。或者诊察脉象，发现肝肾两脏都调和，而心脏独自患病，然后才考察心脏的虚实进行治疗。（其余类推，详见《玉机微义·小儿部》。）
有人问：人们说东南地区气候炎热，可以服用寒凉药物；西北地区气候寒冷，可以服用温热药物。然而现在东南地区的人，常服胡椒、生姜、肉桂，不见生病；而西北地区的人，却畏惧食用花椒、生姜等辛热之物，为什么呢？回答说：东南地区虽然炎热，但地势低洼多湿气，辛热食物也能驱散湿气；西北地区虽然寒冷，但地势高亢多燥气，辛热食物却能助长燥气罢了！治病用药的人，必须懂得这个道理。
我按语：《异法方宜论》说：东南地域，地势低洼湿热，当地人的腠理疏松，汗液妄泄，阳气内虚，所以适宜食用花椒、生姜等辛热之物，以助长其阳气；西北地域，高陵风寒，当地人的腠理致密，汗液内固，阳气充实，不适宜食用花椒、生姜等辛热之物，否则会闭塞阳气。苏东坡先生在黄州做官时，当地瘟疫流行，他用圣散子治疗，效果很好。这是因为该地地势低洼潮湿，四季郁热，腠理疏松，汗液妄泄，阳气虚寒，所以相宜。而在西北瘟疫中，百姓使用此方死者接踵而至，这是我亲眼目睹的。
Question: Zhang Zhongjing's prescriptions contain few medicinal ingredients, whereas Li Dongyuan's prescriptions often contain more than twenty. Zhu Danxi said, "When I treat diseases using Li Dongyuan's formulas, the efficacy is comparable to that of Zhang Zhongjing's prescriptions. This is likely because fewer ingredients result in more focused medicinal power." Why did Zhu Danxi not emulate Li Dongyuan but instead emulate Zhang Zhongjing? The answer is: No one understands the properties of medicines better than Li Dongyuan; he can be considered a sage in medicine. Therefore, it is appropriate for him to use many ingredients, but if others emulate his extensive use, the prescription will become chaotic and disordered. Li Dongyuan is like Han Xin leading troops: the more, the better. Zhu Danxi, however, could only lead an army of a hundred thousand, so he dared not emulate his extensive use.
My commentary: The classics state that treating disease requires seeking its root, which lies in the origins of the four seasons and the five zang organs. Thus, Master Jiegu (Zhang Yuansu) said that regarding the deficiency and excess of the mother-son relationships among the five zang organs, as well as the subtle interplay between pathogenic factors (ghosts/evil) and healthy qi, without comprehending their purport, one cannot easily enter the realm of medical mastery. Mr. Xu Yongcheng said, "Whenever the heart suffers from disease, one must first regulate the liver and kidney zang organs. The kidney is the 'ghost' (the element that controls it) of the heart; when liver qi flows freely, heart qi harmonizes; when liver qi stagnates, heart qi becomes deficient." This illustrates that for heart disease, treatment begins with the liver to clear the source. When any of the five zang organs are diseased, the pathology inevitably transmits to the organ it controls. Water overcomes fire; thus, when the kidney receives pathogenic factors, they transmit to the heart. Therefore, one should first treat the kidney to expel the pathogens, hence the existence of two formulas: one to retreat kidney pathogens and another to benefit liver qi. Alternatively, upon pulse diagnosis, if both the liver and kidney zang organs are harmonious, yet the heart alone exhibits disease, then one examines the deficiency and excess of the heart before treating it. (The rest follows this pattern; see *Yuji Wei Yi · Pediatric Section* for details.)
Question: People say that in the southeast, where the climate is hot, cold-natured medicines can be taken; in the northwest, where the climate is cold, warm-natured medicines can be taken. However, people in the southeast today frequently consume pepper, ginger, and cinnamon without falling ill, while people in the northwest fear eating pungent and hot substances like Sichuan pepper and ginger. Why? The answer is: Although the southeast is hot, the land is low and damp; pungent-hot foods can also dispel dampness. Although the northwest is cold, the land is high and dry; pungent-hot foods can instead exacerbate dryness. Practitioners who prescribe medicines for treating diseases must understand this principle.
My commentary: The *Treatise on Different Methods and Appropriate Formulas* states: In the southeastern region, the terrain is low, and the climate is damp-heat. The people there have loose interstices (cou li), excessive sweating, internal deficiency of yang qi, and therefore it is suitable to consume pungent-hot items like Sichuan pepper and ginger to assist their yang qi. In the northwestern region, the terrain is high with wind-cold; the people there have dense interstices, retained sweat, and abundant yang qi. It is unsuitable for them to consume pungent-hot items like Sichuan pepper and ginger, as this would obstruct their yang qi. When Su Dongpo served as an official in Huangzhou, an epidemic swept through the area. He treated patients with Sheng San Zi (Holy Dispersion Powder), achieving excellent results. This was because the local terrain was low and damp, with stagnant heat throughout the four seasons, loose interstices, excessive sweating, and deficient-cold yang qi, making such treatment appropriate. Conversely, during epidemics in the northwest, many patients died after using this formula, a fact I witnessed personally.