按伤寒一证，惟元气虚者为最重，虚而不补，何以挽回？奈何近代医流，咸谓伤寒无补法。此
一言者，古无是说，而今之庸辈，动以为言，遂致老幼相传，确然深信，其为害也，不可胜纪。兹
第以一岁之事言之，如万历乙巳岁，都下瘟疫盛行，凡涉年衰及内伤不足者，余即用大温大补兼散
之剂，得以全活者数十余人，使此辈不幸而遭庸手，则万无一免者矣。即余一人，于一年之中，所
遇若此，其如岁月之长，海宇之广，凡为无补所杀者，固可胜量哉！
余痛夫枉者之非命，因遍求经传，则并无伤寒无补法之例。必求其由，则惟陶节庵有云∶伤寒
汗、吐、下后，不可便用参 大补，使邪气得补，而热愈盛，所谓治伤寒无补法也。此一说者，盖
亦本于孙真人之言，云服承气汤得痢瘥，慎不中补也。此其意谓因攻而愈者，本为实邪，故不宜妄
用补药，复助其邪耳，初非谓
虚证亦不宜补也。此外则有最庸最拙，为万世之害者，莫如李子建之《伤寒十劝》，今后世谬传，
实基于此，故余于前论直叱其非，并详考仲景《伤寒论》，及诸贤之成法，以申明其义焉。矧今人
之患伤寒者，惟劳倦内伤，七情挟虚之类，十居七八，传诵伤寒无补者，十有八九，以挟虚之七八
，当无补之八九，果能堪乎！而不知以直攻而死者，皆挟虚之辈也。此在众人，则以传闻之讹，无
怪其生疑畏。至若名列医家，而亦曰伤寒无补法，何其庸妄无知，毫不自反，误人非浅，诚可丑可
恨者也。其有尤甚者，则本来无术，偏能惑人，但逢时病，则必曰∶寒邪未散，何可用补？若将邪
气补住，譬之关门赶贼。若此一言，又不知出自何典，乱道异端，尤可恨也。此外又有一辈，曰若
据此脉证，诚然虚矣，本当从补，但其邪气未净，犹宜缓之，姑俟清楚方可用也。是岂知正不能复
，则邪必日深，焉能清楚？元阳不支，则变生呼吸，安可再迟？此不知死活之流也。又有一辈，曰
此本虚证，如何不补，速当用人参七八分，但以青陈之类，监制用之，自然无害。是岂知有补之名
，无补之实，些须儿戏，何济安危，而尚可以一消一补，自掣其肘乎？此不知轻重之徒也。即或有
出奇言补者，亦必见势在垂危，然后曰∶快补快补。夫马到临涯，收缰已晚，补而无济，必又曰∶
伤寒用参者无不死。是伤寒无补之说益坚，而众人之惑益不可破，虽有仪秦不能辩也。余目睹其受
害于此者，盖不可胜纪矣，心切悲之，不得不辩。
夫伤寒之邪，本皆自外而入，而病有浅深轻重之不同者，亦总由主气之有强弱耳。故凡主强者
，虽感亦轻，以邪气不能深入也。主弱者，虽轻必重，以中虚不能自固也。此其一表一里，邪正相
为胜负，正胜则生，邪胜则死。倘以邪实正虚而不知固本，将何以望其不败乎？矧治虚治实，本自
不同，补以治虚，非以治实，何为补住寒邪？补以补中，非以补外，何谓关门赶贼？即曰强寇登堂
矣，凡主弱者，避之且不暇，尚敢关门乎？既能关门，主尚强也，贼闻主强，必然退遁，不遁即成
禽矣，谓之捉贼，又何不可？夫病情人事，理则相同，未有正胜而邪不却者。故主进一分，则贼退
一步，谓之内托，谓之逐邪，又何不可，而顾谓之关门耶？矧如仲
景之用小柴胡汤，以人参柴胡并用，东垣之用补中益气汤，以参术升柴并用，盖一以散邪，一以固
本，此自逐中有固，固中有逐，又岂皆补住、关门之谓乎？甚矣，一言之害，杀命无穷，庸医之庸
，莫此为甚。余不能以口遍传，故特为此辩，使有能广余之说，以活人一命者，必胜念弥陀经多多
矣。
徐东皋曰∶汉张仲景着《伤寒论》，专以外伤为法，其中顾盼脾胃元气之秘，世医鲜有知之者
。观其少阳证，小柴胡汤用人参，则防邪气之入三阴，或恐脾胃稍虚，邪乘而入，必用人参甘草，
固脾胃以充中气，是外伤未尝不内因也。即如理中汤、附子汤、黄连汤、炙甘草汤、吴茱萸汤、茯
苓四逆汤、桂枝人参汤、人参败毒散、人参白虎汤、阳毒升麻汤、大建中汤等，未尝不用参术以治
外感，可见仲景公之立方，神化莫测。或者谓外伤是其所长，而内伤非所知也，此诚不知公者也。
何今世之医，不识元气之旨，惟见王纶《杂着》戒用人参之谬说，执泥不移，乐用苦寒，攻病之标
，致误苍生，死于非命，抑何限耶。间有病家疑信相半，两弗之从，但不速其死耳，直以因循，俟
其元气自尽，终莫之救而毙者，可谓知乎？况斯世斯时，人物剧繁，禀气益薄，兼之劳役名利之场
，甚至蹈水火而不知恤，就酒色以竭其真，不谓内伤元气，吾弗信也。观其杂病，稍用攻击而脾胃
遂伤，甚则绝谷而死者，可以类推矣。
考察伤寒这一病证，只有元气虚弱的人最为严重，如果虚弱而不进行补益，怎么能挽回局面呢？无奈近代医生，都说伤寒没有补法。这句话，古代并没有这种说法，而是现在的庸医动不动就拿来当话柄，导致老少相传，深信不疑，其造成的危害，数不胜数。这里只举一年的事情来说明，比如万历乙巳年（1605年），京城瘟疫盛行，凡是遇到年老体衰及内伤不足的患者，我就用大温大补兼疏散的方剂，得以保全性命的有几十人，假如这些人不幸遇到庸医，那么就没有一个能活下来的了。像我一个人，在一年之中，所遇到的情况尚且如此，何况岁月漫长，地域广阔，凡是被“不可补”的说法害死的，哪里能计算得尽呢！
我痛惜那些枉死者不得善终，于是遍查经典著作，发现根本没有“伤寒无补法”的先例。一定要探究其来源，只有陶节庵说过：伤寒经过汗、吐、下法治疗后，不可以立刻用人参等大补之药，以免邪气得到补益而热势更盛，这就是所谓的“治伤寒无补法”。这一说法，大概是基于孙思邈的话，说服用承气汤后大便通畅病愈，要谨慎不要进补。他的意思是，因为攻下而痊愈的，原本就是实邪，所以不宜妄用补药，以免再次助长邪气罢了，起初并不是说虚证也不宜补。除此之外，最庸俗最拙劣、成为万世之害的，莫过于李子建的《伤寒十劝》，被后世谬传，实际上根源就在这里，所以我之前的论述中直接斥责其错误，并详细考证张仲景的《伤寒论》以及各位贤人的成法，来阐明其中的道理。况且现在患伤寒的人，大多是劳倦内伤、七情夹杂虚损之类的，占七八成；而诵读信奉“伤寒无补”说法的人，占八九成。用这七八成的挟虚体质，去应对那八九成的“不可补”理论，真的能承受吗？却不知道那些因直攻（强行攻下）而死的人，都是那些挟虚的人。对于普通人来说，因为传闻的错误，产生怀疑和畏惧是可以理解的。至于那些名列医家的人，也说“伤寒无补法”，是多么平庸狂妄、无知且不自我反省，误人不浅，真是可耻可恨啊。其中更有甚者，本来没有医术，偏偏能迷惑人，只要碰到时病，就一定说：“寒邪未散，怎么可以用补药？如果把邪气补在里面，就像关起门来赶贼。”这样的话，又不知道出自哪本典籍，乱讲异端邪说，更是可恨。此外还有一类人，说：“根据这些脉象和症状，确实是虚证，本当从补，但是邪气还没有清除干净，还是应该缓一缓，姑且等到邪气清楚之后再用补药。”这哪里知道正气如果不能恢复，邪气必然日益深入，怎么可能等到邪气清楚？元阳如果不支，则变化发生在一呼一吸之间，怎么可以再拖延？这是些不知死活的人。又有一类人，说：“这本来是虚证，怎么能不补，应当速用人参七八分，只是用青皮、陈皮之类来监制它，自然没有害处。”这哪里知道有名无实，像儿戏一样的小动作，对安危有什么帮助，还自以为可以一消一补，自己牵制自己呢？这是些不知轻重的人。即使偶尔有人出奇言说要用补法，也一定是看到病情垂危时，才说：“快补，快补。”马跑到悬崖边再收缰绳已经晚了，补而无济于事，必定又说：“伤寒用参者没有不死人的。”这样，“伤寒无补”的说法更加坚定，众人的困惑更加无法破除，虽然有张仪、苏秦那样的辩才也无法辩解了。我亲眼目睹因此受害的人，简直数不胜数，心中深切悲痛，不得不辩驳。
伤寒的病邪，本来都是从外而入，但病情有浅深轻重的不同，总归是由人体主气（正气）的强弱决定的。所以凡是正气强的，虽然感邪也轻，因为邪气不能深入。正气弱的，虽然感邪轻也必重，因为中气虚弱不能自固。这是一表一里，邪正相互胜负，正胜则生，邪胜则死。倘若面对邪实正虚而不知道固护根本，怎么能指望不败呢？况且治疗虚证和治疗实证，本来就不相同，补是用来治虚的，不是用来治实的，为什么说补住了寒邪？补是用来补中的，不是用来补外的，为什么说关门赶贼？即使说强寇登堂了，凡是正气弱的，躲避都来不及，还敢关门吗？既然能关门，说明主人还强，贼听说主人强，必然退却逃跑，不逃跑就被擒获了，这叫捉贼，又有什么不可以？病情和人事的道理是相同的，没有正气胜而邪气不消退的。所以正气进一分，贼就退一步，这叫内托，叫逐邪，又有什么不可以，反而说是关门呢？况且像张仲景用小柴胡汤，用人参、柴胡并用，李东垣用补中益气汤，用人参、白术、升麻、柴胡并用，大概是一个用来散邪，一个用来固本，这是自逐中有固，固中有逐，又岂能说都是补住邪气、关门赶贼呢？一句话的危害，杀人无数，庸医的平庸，没有比这更严重的了。我不能靠嘴巴到处传播，所以特意写这篇辩驳，希望有人能广泛传播我的观点，以此救活一条人命，其功德胜过念多少遍《弥陀经》。
徐东皋说：汉代张仲景著《伤寒论》，专门以外感病为法则，其中顾护脾胃元气的奥秘，世间医生很少知道的。看他的少阳证，小柴胡汤用人参，是为了防止邪气进入三阴经，或者恐怕脾胃稍虚，邪气乘虚而入，必须用人参、甘草，固护脾胃以充实中气，这说明外感病未尝不与内因有关。就像理中汤、附子汤、黄连汤、炙甘草汤、吴茱萸汤、茯苓四逆汤、桂枝人参汤、人参败毒散、人参白虎汤、阳毒升麻汤、大建中汤等，未尝不用人参、白术来治疗外感病，可见张仲景公的立方，神妙莫测。或许有人说外感病是他的专长，而内伤病不是他所知的，这真正是不了解张公的人。为什么现在的医生，不懂得元气的宗旨，只看到王纶《杂着》中戒用人参的谬说，固执不移，喜欢用苦寒药，攻击疾病的表象，致使百姓误诊，死于非命，这样的限制有多少呢？间或有病人家属半信半疑，两者都不听从，只是不加速其死亡罢了，一直因循守旧，等待其元气耗尽，最终无法救治而死去，这可以说是懂医吗？何况在这个时代，人口众多，禀赋之气越来越薄弱，加上在名利场中劳役，甚至不顾水火危险，沉溺酒色以竭尽真气，如果不说是内伤元气，我不相信。看那些杂病，稍微用点攻伐药脾胃就受伤，甚至绝食而死的，可以类推了。
Regarding the syndrome of Shanghan (Cold Damage), it is most severe in those with deficient Yuan Qi (Primordial Qi). If deficiency is not treated with tonification, how can the situation be reversed? Regrettably, modern physicians all claim that there is no tonifying method for Shanghan. This statement has no basis in ancient texts, yet contemporary mediocre practitioners frequently cite it, leading to widespread belief among people of all ages. The harm caused by this misconception is immeasurable. Let us consider a single year as an example: during the Yisi year of the Wanli era (1605 AD), a plague prevailed in the capital. For patients who were elderly or suffered from internal injury and insufficiency, I used formulas combining strong warming and tonifying properties with dispersing agents. Dozens of lives were saved. Had these patients unfortunately fallen into the hands of mediocre doctors, not one would have survived. Considering my own experience within just one year, let alone the long span of years and the vast expanse of the empire, how many must have been killed by the doctrine of "no tonification"? It is incalculable!
I grieved at the unjust deaths and searched extensively through classical texts, finding no precedent for the idea that "Shanghan has no tonifying method." Tracing its origin, only Tao Jie'an stated: "After treating Shanghan with sweating, vomiting, or purging methods, one should not immediately use Ginseng Radix et Rhizoma (Renshen) or other strong tonics, lest the pathogenic factor be strengthened by the tonic, causing the heat to intensify further. This is what is meant by 'no tonifying method for Shanghan.'" This view seems derived from Sun Simiao's advice: after recovery via Chengqi Decoction (Chengqi Tang), one must be cautious about tonification. His intent was that since recovery resulted from purging excess pathogens, using tonics indiscriminately might aid the pathogen; he did not mean that deficiency syndromes should not be treated with tonification. Beyond this, the most vulgar and detrimental influence on future generations came from Li Zijian's "Ten Admonitions on Shanghan," which became the source of this fallacy. Therefore, in previous discussions, I directly refuted his errors and examined Zhang Zhongjing's *Treatise on Cold Damage* (*Shanghan Lun*) and the established methods of other sages to clarify the truth. Moreover, currently, seven or eight out of ten cases of Shanghan involve fatigue-induced internal injury or emotional factors combined with deficiency. Yet, nine out of ten people blindly follow the teaching of "no tonification." How can patients with deficiency endure such rigid adherence to non-tonification? They do not realize that those who die from direct aggressive treatment are precisely those with underlying deficiency. For laypeople, skepticism due to erroneous rumors is understandable. However, for self-proclaimed physicians to assert "Shanghan has no tonifying method" is profoundly ignorant, arrogant, and harmful, deserving of shame and hatred.
Even worse are those without medical skill who bewitch others. Upon encountering seasonal diseases, they invariably declare: "The cold pathogen has not dispersed; how can tonification be used? Tonifying now is like closing the door to drive away thieves." This metaphor appears nowhere in classics and represents dangerous heresy. Another group argues: "Based on pulse and symptoms, the patient is indeed deficient and should be tonified. However, since pathogens remain, we must wait until they are cleared before tonifying." These individuals fail to understand that if Zheng Qi (Upright Qi) cannot recover, pathogens will deepen daily, making clearance impossible. If Yuan Yang (Primordial Yang) is unsupported, death can occur in a breath; delay is fatal. Such people ignore life and death. Others suggest: "This is a deficiency syndrome; why not tonify? Quickly administer 7-8 fen of Ginseng Radix et Rhizoma (Renshen), controlled by Qingpi (Aurantii Fructus Pericarpium Viride) and Chenpi (Aurantii Fructus Pericarpium), so it will be harmless." They fail to see that this nominal tonification lacks substance. Such trivial measures offer no security against danger, and relying on simultaneous dispersal and tonification merely hinders oneself. These are people who do not grasp weight and measure. Even when someone proposes urgent tonification, it is usually only when the condition is critical: "Tonify quickly!" But waiting until the horse reaches the cliff edge is too late. If tonification fails, they will claim: "Those who use Ginseng for Shanghan always die." Thus, the belief in "no tonification" strengthens, confusion deepens, and even eloquent speakers like Yi Qin could not refute it. I have witnessed countless victims of this error and feel profound sorrow; I must argue against it.
Pathogens of Shanghan enter from outside, but severity depends on the strength of the host's Qi. Strong hosts experience mild illness because pathogens cannot penetrate deeply. Weak hosts suffer severe illness because internal deficiency prevents self-defense. This is a struggle between exterior/interior and pathogen/upright Qi. Upright victory leads to survival; pathogen victory leads to death. In cases of pathogen excess and upright deficiency, failing to secure the root guarantees failure. Treating deficiency differs from treating excess. Tonification treats deficiency, not excess; why say it traps cold pathogens? Tonification supports the interior (Middle Jiao), not the exterior; why call it "closing the door to drive away thieves"? Even if invaders enter the hall, a weak host would flee, not close doors. If one can close doors, the host is strong. A strong host repels thieves; catching them is acceptable. Disease management mirrors human affairs: when upright Qi advances, pathogens retreat. This is called "internal support" or "expelling pathogens," not "closing doors." Consider Zhang Zhongjing’s use of Xiaochaihu Decoction (Minor Bupleurum Decoction), combining Ginseng Radix et Rhizoma (Renshen) and Chaihu (Bupleuri Radix); or Li Dongyuan’s use of Buzhong Yiqi Decoction (Decoction for Replenishing the Middle and Augmenting Qi), combining Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), Shengma (Cimicifugae Rhizoma), and Chaihu. One disperses pathogens, the other secures the root. This integrates expulsion within consolidation and consolidation within expulsion. It is neither trapping nor locking doors. The harm of a single false statement is infinite; no mediocrity exceeds this. Since I cannot spread this orally everywhere, I write this treatise. May anyone who propagates my views and saves a life accumulate merit greater than reciting the Amitabha Sutra countless times.
Xu Donggao said: Zhang Zhongjing of the Han Dynasty wrote *Shanghan Lun*, focusing on external injuries. The secret of protecting Spleen-Stomach Yuan Qi is rarely known by modern physicians. Observing Shaoyang syndromes, Xiaochaihu Decoction uses Renshen to prevent pathogens from entering the Three Yin channels, anticipating slight Spleen-Stomach deficiency allowing pathogen invasion. Renshen and Gancao (Glycyrrhizae Radix et Rhizoma) consolidate the Spleen-Stomach to fill Middle Qi, showing that external injuries often involve internal causes. Formulas like Lizhong Decoction (Regulate the Middle Decoction), Fuzi Decoction (Aconite Decoction), Huanglian Decoction (Coptis Decoction), Zhi Gancao Decoction (Honey-Fried Licorice Decoction), Wuzhuyu Decoction (Evodia Decoction), Fuling Sini Decoction (Poria and Four Reversal Decoction), Guizhi Renshen Decoction (Cinnamon Twig and Ginseng Decoction), Renshen Baidu Decoction (Ginseng and Toxin-Expelling Decoction), Renshen Baitu Decoction (Ginseng and White Tiger Decoction), Yangdu Shengma Decoction (Yang-Toxin Cimicifuga Decoction), and Da Jianzhong Decoction (Great Construct the Middle Decoction) all utilize Renshen and Baizhu for external infections. This reveals Zhang Zhongjing’s prescribing genius. Some claim he excelled in external injuries but ignored internal ones; this misunderstands him completely. Why do current physicians ignore the principle of Yuan Qi? Clinging to Wang Lun’s erroneous warning against Renshen in *Zazhuo* (Miscellaneous Writings), they stubbornly prefer bitter-cold herbs, attacking disease symptoms rather than roots, causing unnecessary deaths. Patients’ families hesitate between belief and doubt, delaying treatment until Yuan Qi exhausts itself, leading to inevitable death. Is this wise? In our time, population density increases while innate constitution weakens. People toil for fame and profit, risking fire and water, indulging in wine and lust, depleting true essence. Denying internal injury to Yuan Qi is unbelievable. Observing miscellaneous diseases, even mild aggressive treatments damage the Spleen-Stomach, sometimes causing death by starvation. This logic applies broadly.