陈远公曰∶缪仲醇因陶隐居十剂中增入寒热二剂，辟其虚寒虚热之不可用也，另增入升
降二
剂。虽亦有见，而终非至当不移之法。夫升即宣之义，降即泻之义也。况通之中未尝无升，
通
则气自升矣；补之中未尝无升，补则气自升矣。推而轻重滑涩燥湿，无不有升之义在也。况
通之内何常非降，通则气自降矣；补之内何常非降，补则气自降矣。推而轻重滑涩燥湿，无
不有降之义在也。是十剂无剂不可升阳，何必再立升之名，无剂不可降阴，何必重多降之目
。夫人阳不交于阴则病，阴不交于阳则亦病。十剂方法，无非使阳交阴而阴交阳也。阳既交
，阴则阳自降矣。阴既交阳，则阴自升矣。阳降则火自安于下，何必愁火空难制；阴升则水
自润于上，何必虞水涸难济。此升降二剂所以宜删，而前圣立方实无可议也。
或问升降二剂经吾子之快论，觉十剂无非升降也，但不识于吾子所论之外，更可阐其微
乎？
曰∶升降不外阴阳，而阴阳之道何能以一言尽。有升阳而阳升者，有升阳而阳反降者，有降
阴而阴降者，有降阴而阴愈不降者，又不可不知也。然而升降之法，实包于十剂之中。有十
剂之法，则可变通而甚神，舍十剂之法，而止执升降之二剂，未免拘滞而不化，此升降之二
剂所以可删耳。
或疑执升降二剂，不可尽升降阴阳也，岂增入之全非耶。曰∶升降可增，则前人早增之
矣，
何待仲醇乎。正以阴阳之道无穷，升降之法难尽，通十剂以为升降，可以尽症之变，倘徒执
升降之二剂，又何以变通哉。（〔批〕升降一言破的，何必执升降以为升降。）
或疑可升可降，十剂中未尝言也，何不另标升降之名，使世人一览而知升降哉。曰∶有
升有
降者，病之常也；宜升宜降者，医之术也。切人之脉，即知阴阳之升降矣。阴阳既知，升降
何难辨哉。使必览剂而后知之，无论全用十剂，不可升降人之阴阳，即单执升降二剂，又何
能治阴阳之升降哉。夫十剂之中，皆可升可降之剂也。人知阴阳，即知升降矣。何必另标升
降之多事哉。
陈远公说：缪仲醇在陶弘景的“十剂”中增加了寒、热两剂，是为了批判虚寒和虚热证不可随意用药的观点；他又另外增加了升、降两剂。虽然这也有他的见解，但终究不是绝对正确、不可更改的方法。所谓“升”，就是宣通的意思；所谓“降”，就是泻下的意思。况且在“通”剂之中未尝没有“升”的含义，气机通畅了，气自然就会上升；在“补”剂之中未尝没有“升”的含义，正气得到补益，气自然就会上升。推而广之，轻、重、滑、涩、燥、湿各剂，无不包含有“升”的意义在内。况且在“通”剂之内何尝不是“降”，气机通畅了，气自然就会下降；在“补”剂之内何尝不是“降”，正气得到补益，气自然就会下降。推而广之，轻、重、滑、涩、燥、湿各剂，无不包含有“降”的意义在内。因此，“十剂”中没有哪一剂不能起到升发阳气的作用，何必再单独设立“升”的名称？“十剂”中没有哪一剂不能起到沉降阴气的作用，何必再多设“降”的名称？人如果阳气不能与阴气相交合就会生病，阴气不能与阳气相交合也会生病。“十剂”的治疗方法，无非是使阳气交合于阴气，阴气交合于阳气罢了。阳气既然已经交合，阴气就会随着阳气而自然下降；阴气既然已经交合于阳气，阳气就会随着阴气而自然上升。阳气下降，则火气自然安守于下焦，何必担忧火气空虚难以制约；阴气上升，则水液自然滋润于上焦，何必忧虑水源枯竭难以济助。这就是“升”、“降”两剂应当删除的原因，而前代圣贤创立方剂的法则确实没有什么可以非议的。
有人问：“关于‘升’、‘降’两剂经过您的痛快论述，让人觉得‘十剂’无非就是升降罢了，只是不知道在您所论述的范围之外，还可以进一步阐发其中的精微之处吗？”
回答说：“升降的道理不外乎阴阳，而阴阳的大道怎么能用一句话就穷尽呢？有升发阳气而阳气随之上升的，有升发阳气而阳气反而下降的，有沉降阴气而阴气随之下降的，有沉降阴气而阴气更加不下降的，这些情况也是不可忽视的。然而，升降的方法，实际上已经包含在‘十剂’之中了。掌握了‘十剂’的方法，就可以灵活变通，达到神妙的境界；如果舍弃‘十剂’的方法，仅仅拘泥于‘升’、‘降’这两剂，未免显得拘谨呆板而不能灵活变化，这就是‘升’、‘降’两剂之所以可以删除的原因。”
有人怀疑说：“只执着于‘升’、‘降’两剂，并不能完全概括升降阴阳的道理，难道增加这两剂就全错了吗？”回答说：“如果‘升’、‘降’可以单独作为一剂来增加，那么前人早就增加了，何必等到缪仲醇呢？正是因为阴阳的道理无穷无尽，升降的方法难以穷尽，通过贯通‘十剂’来实现升降，就可以应对病症的所有变化；如果仅仅执着于‘升’、‘降’这两剂，又怎么能够灵活变通呢？”（批注：用“升降”一词点破要害，何必执着于“升”、“降”这两个名称来理解升降。）
有人怀疑说：“可升可降的道理，在‘十剂’中未曾明言，为什么不另外标明‘升’、‘降’的名称，让世人一眼就能知道什么是升降呢？”回答说：“有升有降，是疾病的常态；宜升宜降，是医生的医术。切按病人的脉搏，就知道阴阳的升降情况了。既然知道了阴阳，辨别升降又有什么困难呢？如果一定要看了药方才知道如何升降，那么即使完全使用‘十剂’，也不能调节人的阴阳升降；即使是单凭执着于‘升’、‘降’两剂，又怎么能治疗阴阳的升降问题呢？‘十剂’中的每一剂，都是既可升又可降的药剂。人只要懂得了阴阳，就知道了升降的道理。何必多此一举，另外标出‘升’、‘降’的名称呢？”
Chen Yuan Gong said: Miao Zhongchun added the "Cold" and "Heat" categories to Tao Hongjing's "Ten Categories of Medicaments," criticizing the indiscriminate use of medicines for deficiency-cold and deficiency-heat patterns; he additionally added the "Ascending" and "Descending" categories. Although this reflects his own insights, it is ultimately not an absolute or unchangeable method. The term "Ascending" (Sheng) implies dispersion and unblocking, while "Descending" (Jiang) implies purging and draining. Moreover, within the category of "Unblocking" (Tong), there is inherently the meaning of ascending; when Qi flows freely, Qi naturally rises. Within the category of "Tonifying" (Bu), there is inherently the meaning of ascending; when Qi is tonified, Qi naturally rises. By extension, all categories such as Light, Heavy, Slippery, Astringent, Dry, and Damp contain the principle of ascending. Furthermore, within "Unblocking," there is invariably the meaning of descending; when Qi flows freely, Qi naturally descends. Within "Tonifying," there is invariably the meaning of descending; when Qi is tonified, Qi naturally descends. By extension, all categories such as Light, Heavy, Slippery, Astringent, Dry, and Damp contain the principle of descending. Therefore, among the Ten Categories, no category fails to have the function of raising Yang Qi; why establish a separate name for "Ascending"? Among the Ten Categories, no category fails to have the function of sinking Yin Qi; why add a redundant category of "Descending"? If Yang Qi does not interact with Yin Qi, disease occurs; if Yin Qi does not interact with Yang Qi, disease also occurs. The therapeutic methods of the Ten Categories are nothing but facilitating the interaction between Yang and Yin. Once Yang interacts, Yin will naturally descend with Yang. Once Yin interacts with Yang, Yang will naturally rise with Yin. When Yang descends, Fire Qi naturally settles in the Lower Jiao; why worry about Fire being difficult to control due to emptiness? When Yin ascends, Water fluids naturally moisten the Upper Jiao; why fear that Water sources are exhausted and unable to nourish? This is why the "Ascending" and "Descending" categories should be deleted, and the formulas established by the sages of old are indeed beyond reproach.
Someone asked: "After your vigorous discussion on the 'Ascending' and 'Descending' categories, I feel that the Ten Categories essentially amount to Ascending and Descending. However, I do not know if, beyond your discussion, there are further subtleties that can be elucidated?"
The reply was: "Ascending and Descending are not outside the realm of Yin and Yang, yet how can the Way of Yin and Yang be fully expressed in a single statement? There are cases where tonifying Yang leads to Yang rising; there are cases where tonifying Yang leads to Yang instead descending. There are cases where descending Yin leads to Yin descending; there are cases where descending Yin leads to Yin failing to descend even more. These situations must also be known. However, the methods of Ascending and Descending are actually contained within the Ten Categories. With the methods of the Ten Categories, one can adapt flexibly and achieve miraculous results; abandoning the methods of the Ten Categories and sticking rigidly only to the two categories of Ascending and Descending inevitably leads to rigidity and lack of flexibility. This is precisely why the two categories of Ascending and Descending can be deleted."
Someone doubted: "Sticking solely to the two categories of Ascending and Descending cannot fully encompass the regulation of Yin and Yang. Is it entirely wrong to add them?" The reply was: "If Ascending and Descending could be added as separate categories, predecessors would have done so long ago; why wait for Miao Zhongchun? It is precisely because the Way of Yin and Yang is infinite and the methods of Ascending and Descending are hard to exhaust completely, that by integrating the Ten Categories to achieve Ascending and Descending, one can address all variations of symptoms. If one merely sticks to the two categories of Ascending and Descending, how can one achieve flexible adaptation?" (Commentary: Using the concept of 'Ascending and Descending' hits the mark; why cling to these specific names to understand the principles?)
Someone doubted: "The principles of being able to ascend or descend are not explicitly stated in the Ten Categories. Why not separately label them as 'Ascending' and 'Descending' so that the public may understand them at a glance?" The reply was: "Having ascent and descent is the normal state of disease; knowing whether to ascend or descend is the skill of the physician. Upon palpating the pulse, one knows the Ascension and Descent of Yin and Yang. Once Yin and Yang are understood, how difficult is it to distinguish Ascension and Descent? If one must consult the formula to know how to regulate, then even using the full Ten Categories would fail to regulate the Yin and Yang of the person; and even relying solely on the two categories of Ascending and Descending, how could one treat the Ascension and Descent of Yin and Yang? Every category within the Ten Categories is capable of both ascending and descending. If one understands Yin and Yang, one understands Ascension and Descent. Why engage in the unnecessary task of separately labeling 'Ascending' and 'Descending'?"