问曰∶《雷公炮制》一书，专以言制药之法，若有不制，则不可用之意。而仲景
用药则
或制或不制，五方风气不同。四川皆用生药，广东皆用制过之药，孰得孰失？请详言之。答
曰∶《雷公炮制》一书为本草门中添一别解，欲以“炮制”二字争胜于各家本草，故几于药
不炮制便不可服也。广东药肆炫其精洁，故炮制太过，药力太薄。四川药贱，虽极力炮制亦
不能得重价，故卖药者无意求精，然皆偏也。药有当生用者，乃一定之理，未可一律论也。
如仲景炙甘草汤取其益胃，则用炙而气升；芍药甘草汤取其平胃，则用生而气平；甘草干姜
汤、侧柏叶汤，其姜皆炮过，则温而不烈；四逆、理中，则干姜不炮，取其气烈，乃能去寒；
附子古用火炮，正是去其毒也，或解为助附子之热，非也。予四川人，知四川彰明县采制附
子，必用盐腌，其腌附子之盐，食之毒人至死，并无药可解。可知附子之毒甚矣，然将腌附
子
之盐放于竹筒中，用火 过则无毒，入补肾药又温而不烈，反为良药。据此则知，仲景炮附
子亦是制其毒也，其用生附又是以毒追风，毒因毒用，一生一炮，有一定之理。读《金匮》
者，可考而别之。葶苈不炒则不香，不能散，故必炒用。苏子、白芥必炒用，与此同意。半
夏
南星非制不用，去其毒也。礞石必用火硝 过，性始能发乃能坠痰，不 则石质不化，药性
不发，又毒不散故必用 。山甲不炒珠，则药性不发。鸡金不 ，其性亦不发。古铜钱、花
蕊石均非 不行，乃世不察，而矜言炮制。有朱砂亦用火 者，不知朱砂中含银水， 则水
走失朱砂之性矣。地黄用砂仁、生姜酒煮，反寒为温，殊失药性。童便煎作秋石以为滋阴，
实则大咸走血，反能发热，毫非童便本性。熟地烧炭则燥，安有滋润之功？若银花
炭，轻虚之质，火气之余，
故反能退火，与熟地炭有别。此最当审，未能尽述。
大抵性平之药不可太制，以竭其力；性猛峻有毒者，非制不堪用。且有制得其宜而功益妙者，
是在善于审量也。有如大黄直走下焦，用酒炒至黑色，则质轻味淡能上清头目，不速下也。
独黄丸杂以他药，九蒸九晒，清润而不攻下，名清宁丸，真有天得一以清，地得一以宁之
意。巴豆悍利，西洋人烘取去油，变其辛烈之味，为焦香，名曰咖啡茶。消食利肠
泻，真善制巴豆者也。外利
用巴豆为末，加雄黄炒至黑色为乌金膏。化腐肉妙不伤
好肉，皆是善于制药之法。总之用其长而去其短，善炮制者也；损其长而益其短，不善炮制
者也。
问曰∶《本草》明言十八反∶半贝蔹蒌桔攻乌，藻戟遂芫均战草，诸参辛芍反藜
芦。又
有十七忌，十九畏，宜恪守乎？
答曰∶性之反者，如水火冰炭之不容，故不可同用。然仲景
有甘遂甘草同用者，又取其相战以成功，后人识力不及，总以不用为是。至于相畏相使可不
必论，相忌亦难尽拘。然服麻黄、细辛忌油腻，服蜜与地黄忌葱白，服黄腊忌鸡肉，此皆大
不宜者，在所当忌不可不知。
问曰∶《本草》有引经之药，如羌活麻黄入太阳经，白芷、粉葛入阳明经；柴胡
入少阳
经；白芍入厥阴经；甘草入太阴，以为引经报使；细辛入少阴经，以为引经入使。用药之捷
径也，有是理乎？
答曰∶分经用药为仲景之大法，故伤寒论以六经括病，诚为治病用药一定
之门径也。惜引经之药拘守数药，未能尽妙。盖本于天地之六气，而生人身之脏腑。有脏
腑然后生经脉，即有气化往来出入于其间。不得单于经脉论之，果能将脏腑气化经脉合而论
之，以求药性之主治，则得仲景分经用药之妙，岂守引经报使之浅说哉？有如葛根，仲景用
治太阳痉病，而后人以为阳明引经，皆未深考耳。吾所论各条已寓引经之义，通观自明，兹
不再赘。
问曰∶六经六气本于《内经》明于仲景，能知经气则病药之理悉具。六气者，风
寒湿燥
火热也。治风之药有寒有热，治湿之药有寒有热，治燥火热三气之药，又似混同而无则，何
也？
答曰∶火者，地气也；热者，天气也；寒者，天气也；湿者，地气也；风者，阴
阳相应
之气也；燥者，阴阳消耗之气也；故有不同。
问曰∶六气之论未有如是之说者，益滋疑矣。试详言之，请先问风气。
答曰∶西洋天学
家言空中之气有冷热二种，故能起风，因空气热则涨而上升，他处冷空气即来补之。试于室
中加热，门之上下各有孔，则上孔之气必外出，下孔之气必内入，成风之理与此同也。因此
能成两种风∶一为自冷处吹向热处之风，如热带内气候常热则气涨而升，南北两极气候常冷，
则南北两极生风，吹向热带去；一为自热处吹向冷处之风，会于热带，乃复散而回转，吹向
冷处，转回两极。二者旋还不已，中国冬日则热带在南，故风从北吹往南去；夏日则热带转
北，故风从南吹回北方。余按吹往南者，是阳极而阴生，以阴从阳，如《周易》之巽
卦是矣。《周易》巽为风，正是阳极于上，阴生于下。热带在南，而风生于北，故其卦二阳
在上，而一阴在下也。吹往北者，是阴极而阳生，以阳复阴，如《周易》之震卦是矣。《周
易》震卦不作风解。然《内经》云东方生风，在《周易》震卦属东方，二阴极于上，而一阳
生于下，应春风阳回阴退之象。春分热带渐移向北，其风均从热带吹至北来，春夏所以多南
风也，阳回阴退，于卦象震，震东方也。故《内经》言东方生风，其义颇确。
问曰∶人身
之肝木，司风气，不应巽卦而应震卦。与《内经》合，而与《周易》不合，何也？
答曰∶《
周易》巽卦是冷处吹向热处之风，乃烈风暴风，非人身之和风，中人则为中风、抽风。于风
为常象，而于人为变病，非人身和畅之风也。《内经》所指东方生风，风生木，木生酸，酸
生肝，肝主人身之风气，则是阴退阳回之象，与震卦合德。故论人身肝木司风之气化，当从
《内经》东方生风之说。盖风者，东方之气，于卦为震，上二阴而下一阳即阴极阳生
之象。在人属厥阴经，厥者，尽也，逆也。阴尽而阳生，极而复返，故曰厥阴。所以《内经
》言厥阴中见相火，是阳生于阴中，有象乎震，而成为肝生风木之脏。其体阴而其用阳，阳
有余则生热风，阴有余则生寒风。故凡中风、伤风，或为热风，或为寒风，或热深厥深为外
寒内热，或阴搏阳回为左旋右转，皆系风木本藏之病。或发于四肢，或上于巅顶，是又厥阴
经脉之病。今且将药逐论之，肝之经脉与胆经同路而行，但分表里。然皆由身侧上项入脑，
至巅顶。故凡柴胡、蔓荆能引少阳经者，皆能引入肝经以上于头，而散风邪。苍耳有芒角，
得风气所生之物，乃应东方勾芒之象。其质又轻，故入肝经，散头目之风；而味苦，又兼清
热。钩藤有钩刺，亦入肝经，然系枝蔓，多主四达，故治肝筋脉之风热。巡骨风、五加皮皆
有毛，性辛温，故能散肝经之风寒，祛周身之痹痛。川芎气温，温者阴中之阳，恰是风木本
气，故入肝经。其气走窜，而根性又主上升，故能至于巅顶以散风寒。亦有性不上升，而能
上治头痛者，仲景头痛如破，用吴茱萸，此物速降，性不上头，然能降肝胃之寒，使不上充
于头，此为治脏腑而经脉自治也。天麻有风不动，无风独摇，其摇者，木之和气也；其不动
者，金之刚气也；气微温木也；味微辛，金也。是木受金制，金木合德之物。一茎直上，子
复还筒而归根，所以能通阳和阴，治头目定惊痫。夫子复还筒而归根，正如西洋所谓风起于
冷处，吹至热带，复还而吹向两极也。故以天麻为治风正药。夫人得间气而生者，为奇人；
药得间气而生者，为奇药。如天麻之木得金性，是间气也，故为治风妙药。白头翁亦无风独
摇，有风不动。盖白头翁通身有毛，一茎直上，与天麻同知，其皆得风木条达之气，故无风
能摇。其色纯白，是得金性，故有风不动。但其味苦，是治热风之妙药。仲景治产后中风，
及痢疾后重者，是取其熄风火、达肝阳也。羌独活皆一茎直上，有风不动，但味太辛，气太
温，能散寒风，力甚于天麻，而兼能燥湿，不如天麻之刚柔得中也。桑寄生味酸枝繁，具木
之性而生于桑上，桑者木中之金，寄生附之独得金木之间气，且根不粘土，纯感风气而生，
为清散风木之妙药。僵蚕得风而僵，故治风痉等症。风淫末疾，四肢麻木疼痛，用桂枝以散
寒风，用槐枝、桑枝以散热风，以枝横行，故能四达。肝主筋，风在筋脉。用秦艽有筋纹者
为引，味又辛散，故能温散筋脉。续断亦有筋，故皆主治筋脉，但秦艽纹左右扭转，利于左
右相交，续断筋纹如骨节相连，故主接筋骨，去骨节间之风寒。杜仲有膜坚勒而不断，象人
身之筋膜。盖人身两肾之中一条白膜。上生而为肝中之大膈膜，由肝肠串插生出肉外，包周
身之瘦肉，其瘦肉两头则生筋，筋又着于骨节之间。杜仲有膜，象人身之筋膜，故入肝肾，
强筋骨也。肝脉下走足，脾又主筋，干湿香港脚皆筋受病；《内经》云风胜湿，肝失风木之令
不能疏土，故湿流注。所以
西医言，凡是香港脚其尿必酸，木瓜酸收去湿，故治之。苡仁但
治湿，宜兼风药治之。虎胫骨辛温，以金平木，治风寒香港脚，风从虎，虎应西方七宿，金制
木也。干香港脚是风热，宜阿胶、龟板、地黄益阴气使阳不动，以还其厥阴之本体。玉竹柔润
熄风，亦是此意。故谚云∶治风先治血，血行风自灭。”血足则肝阳不动，而风自熄。痛风
症亦有寒风，有热风，伤热风则走痛，风鼓动而血不静也；伤寒风则痹痛血，寒凝而气不通
也，均责其血。观仲景红蓝花治风气百疾，则知治风先治血之理。虫感风化，凡疮癣有虫者，
皆是血留滞，遇肝风熏发则化虫。故用荆防以散风，归地以和血，外用椒几以杀虫。痨虫生
于脏腑，瘀血得风而化者也。鳗鱼蛇类又曲直形长，是得木气居水色白，是又得金气。据其
形色论，是木遇金水而化生者也，痨虫属风木所化，遇鳗鱼之气味则感金水而消化矣。故治
痨虫，其骨能熏蚊化为水，此皆秉间气而生之灵物也。獭肝亦然。其数应目，专得金水之精，
故化风木所生之痨虫，皆治风本所化者也。若风从湿化，而生之虫，如仲景吐蛔用乌梅丸，
是治风湿之虫也。乌梅以敛阳，花椒以化阴，而风湿之虫自化。观乌梅丸，寒热互用，则知
阳动阴应则风生，反阳入阴则风熄。故阳气怫郁之微风宜散，薄荷、荆芥、防风、紫苏、柴
胡之类是矣；阴气抑之暴风则宜温，附子、川乌、白附子之类是矣。六经惟厥阴经阴中有阳，
故有热深厥亦深之病。风温重证往往有此，法当但清其热，犀角、羚羊、牛黄以透达之，外
寒内热此如西洋所说热极于室中，则引寒风入户穴之义，故但当撤其热而风自不来。筋缩抽
扯者，热风也，宜羚羊角此物，角挂树梢身悬而睡，知其筋最直，角尤其精风所在，故性微
寒，功专舒筋。左右抽掣者，正如西洋所说热带往南则北风至，热带往北则南风至，循环而
不能息也，故以秦艽之左右交者为引，以虎睛之能定风者为治。左右偏风，理皆如此，定风
如白头翁、天麻、羚羊皆可用之。筋缓不收，又是寒，必风也，宜桂附论者，不可稍混。
问：《雷公炮制》这本书，专门论述制药的方法，似乎有不经过炮制就不能使用的意思。而张仲景用药有时炮制、有时不炮制，是因为五方风气不同吗？四川都用生药，广东都用炮制过的药，谁对谁错？请详细说说。
答：《雷公炮制》这本书是在本草学中增添了一种另类的见解，想要凭借“炮制”二字在各家本草中争胜，所以几乎到了药不炮制就不能服用的地步。广东的药铺炫耀其洁净精细，所以炮制过度，导致药力太薄弱。四川药材便宜，即使极力炮制也不能卖高价，所以卖药的人无意于求精，但这都是偏颇的观点。药物有应当生用的，这是一定的道理，不能一概而论。比如张仲景的炙甘草汤，取其补益胃气，所以用炙甘草，药气上升；芍药甘草汤，取其平抑胃气，所以用生芍药，药气平和；甘草干姜汤、侧柏叶汤，其中的干姜都经过炮制，所以温性温和而不猛烈；四逆汤、理中汤，则干姜不炮制，取其药气猛烈，才能驱散寒邪；附子古法用火炮制，正是为了去除其毒性，有人解释为帮助附子的热性，这是不对的。我是四川人，知道四川彰明县采制附子，必定用盐腌制，那腌附子的盐，人吃了会毒死，没有任何药能解。由此可知附子的毒性很大，然而将腌附子的盐放入竹筒中，用火煅烧后就没有毒性了，加入补肾药中又温性温和而不猛烈，反而成为良药。据此可知，张仲景炮制附子也是为了制约其毒性，而生用附子则是以毒攻风，毒因毒用，生用和炮制都有固定的道理。读《金匮要略》的人，可以考证并区分开来。葶苈子不炒就不香，不能发散，所以必须炒用。苏子、白芥子也必须炒用，与此同理。半夏、天南星不炮制就不能用，是为了去除其毒性。礞石必须用火硝煅烧，药性才能发挥，才能坠痰，不煅烧则石质不化，药性不发，毒性不散，所以必须煅烧。穿山甲不炒成珠状，药性就不能发挥。鸡内金不煅烧，其药性也不能发挥。古铜钱、花蕊石都必须煅烧才行，世人却不加考察，却夸耀炮制之功。有的甚至用火煅烧朱砂，不知道朱砂中含有水银（汞），煅烧则水银走失，失去了朱砂的本性。地黄用砂仁、生姜酒煮，反而由寒变温，大大失去了药性。童便煎制成秋石以为滋阴，实际上味大咸而走血，反而能发热，完全不是童便的本性。熟地烧成炭就燥了，哪里有滋润的功效呢？如果金银花烧成炭，因其质地轻虚，是火气之余烬，所以反而能退火，与熟地炭不同。这一点最应当审慎，未能全部陈述。
大体上，性味平和的药物不可过度炮制，以免耗尽药力；性味猛烈峻急有毒的药物，不炮制就无法使用。而且有的药物炮制得当功效更加奇妙，这在于善于审度衡量。比如大黄直走下焦，用酒炒至黑色，则质地变轻、味道变淡，能上行清头目，不再迅速泻下。独黄丸混杂其他药物，九蒸九晒，变得清润而不攻下，名叫清宁丸，真有“天得一以清，地得一以宁”的意思。巴豆悍烈利猛，西洋人烘烤取油，去掉其辛烈之味，变成焦香味，名叫咖啡茶，消食利肠通便，真是善于炮制巴豆的人。外用利疮疡用巴豆为末，加雄黄炒至黑色制成乌金膏，化解腐肉巧妙且不伤好肉，这都是善于制药的方法。总之，利用药物的长处而去除其短处，就是善于炮制；损害其长处而增加其短处，就是不善于炮制。
问：《本草》明确记载十八反：半贝蔹蒌桔攻乌（半夏、贝母、白蔹、瓜蒌、桔梗对抗乌头），藻戟遂芫均战草（海藻、大戟、甘遂、芫花都与甘草相战），诸参辛芍反藜芦（各种人参、细辛、芍药对抗藜芦）。又有十七忌、十九畏，应该恪守吗？
答：性味相反的药物，就像水火冰炭互不相容，所以不能同用。然而张仲景有用甘遂和甘草同用的例子，又是取其相互对抗以取得成功，后人见识能力不及，总认为不用为好。至于相畏、相使的关系不必多论，相忌也难以完全拘泥。但是服用麻黄、细辛时忌食油腻，服用蜂蜜和地黄时忌食葱白，服用黄蜡时忌食鸡肉，这些都是非常不适宜的，在所当忌，不可不知道。
问：《本草》中有引经报使之药，如羌活、麻黄入太阳经，白芷、粉葛入阳明经；柴胡入少阳经；白芍入厥阴经；甘草入太阴，作为引经报使；细辛入少阴经，作为引经入使。这是用药的捷径，有这个道理吗？
答：分经用药是张仲景的大法，所以《伤寒论》以六经概括病证，确实是治病用药的一定门径。可惜引经之药拘泥于少数几种药物，未能尽善尽美。盖源于天地的六气，产生人身脏腑。有了脏腑然后产生经脉，就有气化往来出入于其间。不能单从经脉来讨论，如果能将脏腑气化经脉合在一起讨论，以求得药性的主治，那就得到了张仲景分经用药的妙处，哪里是拘守引经报使这种浅显的说法呢？比如葛根，张仲景用它治疗太阳痉病，而后人认为是阳明经引经药，都没有深入考证罢了。我所论述的各条已经蕴含了引经的意义，通观自明，这里不再赘述。
问：六经六气本于《内经》，在张仲景那里阐明，能了解经气则病药的道理全在其中。六气是风、寒、湿、燥、火、热。治风的药有寒有热，治湿的药有寒有热，治燥、火、热三气的药，又似乎混同而没有准则，为什么呢？
答：火，是地气；热，是天气；寒，是天气；湿，是地气；风，是阴阳相应之气；燥，是阴阳消耗之气；所以有所不同。
问：关于六气的论述没有像这样的说法，更加令人疑惑了。请详细说说，请先问风气。
答：西洋天文学家说空气中的气有冷热两种，所以能起风，因为空气热则膨胀上升，他处的冷空气就来补充。如果在室内加热，门的上下各有孔，那么上孔的气必然向外出，下孔的气必然向内入，形成风的原理与此相同。因此能形成两种风：一种是从冷处吹向热处的风，如热带内气候常热则气膨胀上升，南北两极气候常冷，则南北两极生风，吹向热带去；一种是从热处吹向冷处的风，汇合于热带，然后分散回转，吹向冷处，转回两极。两者旋转不停，中国冬日则热带在南，所以风从北吹往南去；夏日则热带转北，所以风从南吹回北方。我按：吹往南者，是阳极而阴生，以阴从阳，如同《周易》中的巽卦。《周易》巽为风，正是阳极于上，阴生于下。热带在南，而风生于北，所以其卦象二阳在上，而一阴在下也。吹往北者，是阴极而阳生，以阳复阴，如同《周易》中的震卦。《周易》震卦不作风解。然而《内经》说东方生风，在《周易》震卦属东方，二阴极于上，而一阳生于下，应验春风阳回阴退之象。春分热带渐移向北，其风均从热带吹至北来，春夏所以多南风也，阳回阴退，于卦象为震，震代表东方。所以《内经》言东方生风，其义颇为确切。
问：人身之肝木，司掌风气，不应巽卦而应震卦。这与《内经》吻合，而与《周易》不合，为什么呢？
答：《周易》巽卦是冷处吹向热处的风，乃是烈风暴风，非人身之和风，中人则为中风、抽风。对于风来说是常态，而对于人来说是病变，并非人身和畅之风。《内经》所指东方生风，风生木，木生酸，酸生肝，肝主人身之风气，则是阴退阳回之象，与震卦合德。所以论人身肝木司风之气化，应当从《内经》东方生风之说。盖风者，东方之气，于卦为震，上二阴而下一阳即阴极阳生之象。在人属厥阴经，厥者，尽也，逆也。阴尽而阳生，极而复返，故曰厥阴。所以《内经》言厥阴中见相火，是阳生于阴中，有象乎震，而成为肝生风木之脏。其体阴而其用阳，阳有余则生热风，阴有余则生寒风。所以凡中风、伤风，或为热风，或为寒风，或热深厥深为外寒内热，或阴搏阳回为左旋右转，皆系风木本藏之病。或发于四肢，或上于巅顶，是又厥阴经脉之病。现在且将药逐条论述，肝之经脉与胆经同路而行，但分表里。然而都由身侧上项入脑，至巅顶。所以凡柴胡、蔓荆能引少阳经者，都能引入肝经以上于头，而散风邪。苍耳有芒角，得风气所生之物，乃应东方勾芒之象。其质又轻，故入肝经，散头目之风；而味苦，又兼清热。钩藤有钩刺，亦入肝经，然系枝蔓，多主四达，故治肝筋脉之风热。巡骨风、五加皮皆有毛，性辛温，故能散肝经之风寒，祛周身之痹痛。川芎气温，温者阴中之阳，恰是风木本气，故入肝经。其气走窜，而根性又主上升，故能至于巅顶以散风寒。亦有性不上升，而能上治头痛者，张仲景头痛如破，用吴茱萸，此物速降，性不上头，然能降肝胃之寒，使不上充于头，此为治脏腑而经脉自治也。天麻有风不动，无风独摇，其摇者，木之和气也；其不动者，金之刚气也；气微温木也；味微辛，金也。是木受金制，金木合德之物。一茎直上，子复还筒而归根，所以能通阳和阴，治头目定惊痫。子复还筒而归根，正如西洋所谓风起于冷处，吹至热带，复还而吹向两极也。故以天麻为治风正药。夫人得间气而生者，为奇人；药得间气而生者，为奇药。如天麻之木得金性，是间气也，故为治风妙药。白头翁亦无风独摇，有风不动。盖白头翁通身有毛，一茎直上，与天麻同知，其皆得风木条达之气，故无风能摇。其色纯白，是得金性，故有风不动。但其味苦，是治热风之妙药。张仲景治产后中风，及痢疾后重者，是取其熄风火、达肝阳也。羌活、独活皆一茎直上，有风不动，但味太辛，气太温，能散寒风，力甚于天麻，而兼能燥湿，不如天麻之刚柔得中也。桑寄生味酸枝繁，具木之性而生于桑上，桑者木中之金，寄生附之独得金木之间气，且根不粘土，纯感风气而生，为清散风木之妙药。僵蚕得风而僵，故治风痉等症。风淫末疾，四肢麻木疼痛，用桂枝以散寒风，用槐枝、桑枝以散热风，以枝横行，故能四达。肝主筋，风在筋脉。用秦艽有筋纹者为引，味又辛散，故能温散筋脉。续断亦有筋，故皆主治筋脉，但秦艽纹左右扭转，利于左右相交，续断筋纹如骨节相连，故主接筋骨，去骨节间之风寒。杜仲有膜坚勒而不断，象人身之筋膜。盖人身两肾之中一条白膜。上生而为肝中之大膈膜，由肝肠串插生出肉外，包周身之瘦肉，其瘦肉两头则生筋，筋又着于骨节之间。杜仲有膜，象人身之筋膜，故入肝肾，强筋骨也。肝脉下走足，脾又主筋，干湿香港脚皆筋受病；《内经》云风胜湿，肝失风木之令不能疏土，故湿流注。所以西医言，凡是香港脚其尿必酸，木瓜酸收去湿，故治之。薏苡仁但治湿，宜兼风药治之。虎胫骨辛温，以金平木，治风寒香港脚，风从虎，虎应西方七宿，金制木也。干香港脚是风热，宜阿胶、龟板、地黄益阴气使阳不动，以还其厥阴之本体。玉竹柔润熄风，亦是此意。故谚云：“治风先治血，血行风自灭。”血足则肝阳不动，而风自熄。痛风症亦有寒风，有热风，伤热风则走痛，风鼓动而血不静也；伤寒风则痹痛血，寒凝而气不通也，均责其血。观张仲景红蓝花治风气百疾，则知治风先治血之理。虫感风化，凡疮癣有虫者，皆是血留滞，遇肝风熏发则化虫。故用荆防以散风，归地以和血，外用椒几以杀虫。痨虫生于脏腑，瘀血得风而化者也。鳗鱼蛇类又曲直形长，是得木气居水色白，是又得金气。据其形色论，是木遇金水而化生者也，痨虫属风木所化，遇鳗鱼之气味则感金水而消化矣。故治痨虫，其骨能熏蚊化为水，此皆秉间气而生之灵物也。獭肝亦然。其数应目，专得金水之精，故化风木所生之痨虫，皆治风本所化者也。若风从湿化，而生之虫，如张仲景吐蛔用乌梅丸，是治风湿之虫也。乌梅以敛阳，花椒以化阴，而风湿之虫自化。观乌梅丸，寒热互用，则知阳动阴应则风生，反阳入阴则风熄。故阳气怫郁之微风宜散，薄荷、荆芥、防风、紫苏、柴胡之类是矣；阴气抑之暴风则宜温，附子、川乌、白附子之类是矣。六经惟厥阴经阴中有阳，故有热深厥亦深之病。风温重证往往有此，法当但清其热，犀角、羚羊、牛黄以透达之，外寒内热此如西洋所说热极于室中，则引寒风入户穴之义，故但当撤其热而风自不来。筋缩抽扯者，热风也，宜羚羊角此物，角挂树梢身悬而睡，知其筋最直，角尤其精风所在，故性微寒，功专舒筋。左右抽掣者，正如西洋所说热带往南则北风至，热带往北则南风至，循环而不能息也，故以秦艽之左右交者为引，以虎睛之能定风者为治。左右偏风，理皆如此，定风如白头翁、天麻、羚羊皆可用之。筋缓不收，又是寒，必风也，宜桂附论者，不可稍混。
Question: The book *Lei Gong Pao Zhi* (Lei Gong's Processing of Medicinal Materials) specifically discusses methods of processing medicinal materials, implying that without processing, they cannot be used. However, Zhang Zhongjing sometimes processed and sometimes did not process the herbs he used. Is this due to differences in the wind and climate of the five regions? Sichuan uses raw herbs, while Guangdong uses processed herbs. Who is right and who is wrong? Please explain in detail.
Answer: *Lei Gong Pao Zhi* adds an alternative perspective to the field of Materia Medica, striving for superiority among various herbal texts through the concept of "processing." Consequently, it suggests that herbs are unusable unless processed. In Guangdong, pharmacies boast of their cleanliness and refinement, leading to excessive processing that weakens the medicinal power. In Sichuan, herbs are cheap; even with intensive processing, they do not command high prices, so sellers have little incentive to pursue precision. Both approaches are biased. There is a fixed principle that some herbs should be used raw, and one cannot apply a uniform standard. For example, in *Zhi Gancao Tang* (Prepared Licorice Decoction), Zhang Zhongjing uses prepared licorice (*Radix Glycyrrhizae Preparata*) to benefit the stomach, causing the qi to ascend; in *Shaoyao Gancao Tang* (Peony and Licorice Decoction), he uses raw peony (*Paeoniae Radix Alba*) to level the stomach, keeping the qi balanced; in *Gancao Ganjiang Tang* (Licorice and Dried Ginger Decoction) and *Cebaiye Tang* (Biota Top Decoction), the dried ginger (*Zingiberis Rhizoma Recens/Recensum*) is processed, making its warming action mild rather than fierce; in *Sini Tang* (Frigid Extremities Decoction) and *Lizhong Tang* (Regulate the Middle Decoction), unprocessed dried ginger is used to leverage its fierce qi to dispel cold. Ancient methods of processing *Fuzi* (Prepared Aconite Root) by fire were precisely to remove its toxicity. Interpreting this as enhancing Fuzi's heat is incorrect. As a native of Sichuan, I know that in Zhangming County, Sichuan, *Fuzi* must be salted. The salt used for salting Fuzi is toxic enough to kill humans if ingested, with no known antidote. This shows the great toxicity of Fuzi. However, if this salt is placed in a bamboo tube and calcined over fire, it becomes non-toxic. When added to kidney-tonifying formulas, it warms gently without being fierce, becoming a good medicine. Thus, Zhang Zhongjing's processing of Fuzi was also to control its toxicity. Using raw Fuzi is to use poison to chase wind ("using poison to treat poison"). Both raw and processed forms have fixed principles. Readers of *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) can investigate and distinguish them. *Tinglizi* (Lepidium Seed) must be stir-fried to release its fragrance and dispersing properties. *Su Zi* (Perilla Fruit) and *Baijiezi* (White Mustard Seed) must also be stir-fried, following the same logic. *Banxia* (Pinellia Tuber) and *Nanxing* (Arisaema Tuber) cannot be used without processing to remove toxicity. *Mengshi* (Fluorite) must be calcined with *Huoxiao* (Saltpeter) to activate its property of sinking phlegm; otherwise, the stone texture remains unchanged, the medicinal property does not emerge, and the toxicity remains. *Shanjia* (Pangolin Scales) must be stir-fried into beads to activate its medicinal property. *Jijin* (Chicken Gizzard Lining) must be calcined to activate its property. Ancient copper coins and *Huaruishishi* (Flower Rhyolite Stone) must all be calcined. People today fail to examine this carefully yet boast about processing. Some even calcimize *Zhusha* (Cinnabar), unaware that Cinnabar contains mercury; calcination causes the mercury to escape, destroying the nature of Cinnabar. Rehmannia cooked with Amomum and fresh ginger in wine changes from cold to warm, greatly losing its original property. Child's urine processed into Qiushi (Autumn Stone) is claimed to nourish yin, but its strong salty flavor enters the blood and actually generates heat, contrary to the true nature of child's urine. Shu Dihuang (Prepared Rehmannia Root) burned into charcoal becomes dry and loses its moistening function. If Jinyinhua (Honeysuckle Flower) is burned into charcoal, due to its light and void nature and residual fire energy, it can actually clear heat, which is different from Shu Dihuang charcoal. This point requires careful examination and cannot be fully detailed here.
Generally, herbs with mild properties should not be excessively processed to avoid exhausting their power; herbs with fierce, harsh, or toxic properties must be processed to be usable. Moreover, proper processing can enhance efficacy, which depends on skillful assessment. For instance, Dahuang (Rhubarb Root) normally moves downward to the lower jiao. When stir-fried with wine until black, its texture becomes lighter and taste milder, allowing it to ascend to clear the head and eyes without causing rapid purgation. *Duhuang Wan* mixed with other herbs, steamed and sun-dried nine times, becomes moist and clearing without purging, named *Qingning Wan* (Clear Tranquility Pill), embodying the idea of "Heaven obtains One to become Clear, Earth obtains One to become Tranquil." Baiduou (Croton Seed) is fierce and purgative. Westerners bake it to remove the oil, changing its pungent and fierce taste to a roasted aroma, naming it coffee tea, which aids digestion and promotes bowel movement—a true master of processing Croton. For external use on ulcers, Baiduou powder mixed with Xionghuang (Realgar) and calcined to black forms *Wujin Gao* (Black Gold Ointment), which dissolves necrotic tissue without harming healthy flesh. These are all examples of skilled processing. In short, utilizing the strengths and removing the weaknesses constitutes skilled processing; damaging strengths and exacerbating weaknesses constitutes unskilled processing.
Question: The *Materia Medica* explicitly states the Eighteen Incompatibilities: Banxia, Beimu, Bailian, Gualou, and Jiegeng oppose Wutou; Haizao, Daji, Gansui, and Yuanhua all battle Gancao; various Shen (Ginsengs), Xixin, and Shaoyao oppose Lulü. There are also Seventeen Taboos and Nineteen Mutual Fears. Should these be strictly observed?
Answer: Herbs with opposing properties are like water and fire or ice and charcoal, mutually incompatible, and thus should not be used together. However, Zhang Zhongjing combined Gansui and Gancao, leveraging their mutual antagonism to achieve success. Later physicians lacked his insight and generally avoided such combinations. Relationships of mutual fear and mutual assistance need not be discussed extensively, and mutual taboos are difficult to adhere to rigidly. However, when taking Mahuang (Ephedra) or Xixin (Asarum), greasy food should be avoided; when taking Honey or Dihuang (Rehmannia), green onion white should be avoided; when taking Huangla (Yellow Wax), chicken meat should be avoided. These are highly inadvisable and must be noted.
Question: The *Materia Medica* mentions guiding herbs (herbs that guide other drugs to specific meridians), such as Qianghuo and Mahuang entering the Taiyang meridian, Baizhi and Fengge entering the Yangming meridian; Chaihu entering the Shaoyang meridian; Baishao entering the Jueyin meridian; Gancao entering the Taiyin meridian, acting as guides and messengers; Xixin entering the Shaoyin meridian. Is this a shortcut for medication, and is there truth to it?
Answer: Differentiating treatment by meridian is Zhang Zhongjing's major method. Thus, *Shanghan Lun* (Treatise on Cold Damage) encompasses diseases using the Six Meridians, providing a definite pathway for treating diseases and prescribing herbs. Unfortunately, limiting guiding herbs to a few specific ones fails to capture the full subtlety. Fundamentally, the Six Qi of Heaven and Earth generate the Zang-Fu organs of the human body. From Zang-Fu arise the meridians, where Qi transformation flows in and out. One cannot discuss this solely based on meridians. If one integrates Zang-Fu, Qi transformation, and meridians to seek the primary indications of herb properties, one grasps the essence of Zhang Zhongjing's meridian-based prescription, far beyond the shallow theory of guiding herbs. For example, Gegen (Kudzu Root) was used by Zhang Zhongjing to treat Taiyang Jing disease, but later generations mistakenly considered it a Yangming guiding herb due to lack of deep investigation. My discussions in previous sections already imply the meaning of guiding herbs; reading them thoroughly makes it clear, so I will not repeat myself here.
Question: The Six Meridians and Six Qi originate from *Neijing* and were clarified by Zhang Zhongjing. Understanding meridian Qi encompasses the principles of disease and herbs. The Six Qi are Wind, Cold, Dampness, Dryness, Fire, and Heat. Herbs for treating Wind have both cold and hot properties; herbs for treating Dampness have both cold and hot properties; yet herbs for treating Dryness, Fire, and Heat seem mixed without clear rules. Why?
Answer: Fire is Earth Qi; Heat is Heaven Qi; Cold is Heaven Qi; Dampness is Earth Qi; Wind is the Qi of Yin-Yang correspondence; Dryness is the Qi of Yin-Yang consumption. Hence, they differ.
Question: There is no such discussion regarding the Six Qi in existing literature, increasing my doubt. Please explain in detail. First, let me ask about Wind.
Answer: Western astronomers state that air has two types: hot and cold, which cause wind. Hot air expands and rises, and cold air from elsewhere moves in to fill the void. If you heat a room with holes at the top and bottom of a door, air exits the top hole and enters the bottom hole, creating wind. This principle is the same. Thus, two types of wind form: one blows from cold areas to hot areas. For example, the tropics are always hot, causing air to rise; the poles are always cold, generating wind blowing toward the tropics. The other type blows from hot areas to cold areas, converging at the tropics, then dispersing and returning to blow toward the cold areas and poles. These rotate endlessly. In winter in China, the tropics are south, so wind blows from north to south. In summer, the tropics shift north, so wind blows from south to north. I analyze: Wind blowing south represents Extreme Yang giving birth to Yin, with Yin following Yang, similar to the Sun (Xun) trigram in *I Ching*. Sun represents Wind, where Yang is extreme above and Yin is born below. With tropics in the south and wind originating in the north, the trigram has two Yang lines above and one Yin line below. Wind blowing north represents Extreme Yin giving birth to Yang, with Yang restoring Yin, similar to the Zhen (Thunder) trigram. The Zhen trigram is not typically interpreted as Wind. However, *Neijing* says "East generates Wind." In *I Ching*, Zhen belongs to the East. With two Yin lines above and one Yang line below, it corresponds to the image of spring wind returning Yang and retreating Yin. Around the Spring Equinox, the tropics gradually move north, and winds blow from the tropics to the north, explaining why there are many south winds in spring and summer. Yang returns, Yin retreats, corresponding to the Zhen trigram, which represents the East. Thus, *Neijing*'s statement that "East generates Wind" is quite accurate.
Question: The Liver Wood in the human body governs Wind Qi. It should correspond to the Zhen trigram, not the Sun trigram. This aligns with *Neijing* but conflicts with *I Ching*. Why?
Answer: The Sun trigram in *I Ching* represents wind blowing from cold to hot areas, which is fierce storm wind, not the harmonious wind of the human body. If it strikes a person, it causes stroke or convulsions. It is a normal phenomenon for wind but a pathological change for humans, not the smooth wind of the body. *Neijing* refers to "East generates Wind," Wind generates Wood, Wood generates Sour, Sour generates Liver. Liver governs the body's Wind Qi, representing the image of Yin retreating and Yang returning, which aligns with the Zhen trigram. Therefore, discussing the Qi transformation of Liver Wood governing Wind should follow *Neijing*'s "East generates Wind." Wind is the Qi of the East, corresponding to the Zhen trigram, with two Yin lines above and one Yang line below, symbolizing Extreme Yin giving birth to Yang. In the body, this belongs to the Jueyin Meridian. Jue means "end" or "reverse." Yin ends and Yang is born, reaching the extreme and returning, hence called Jueyin. Thus, *Neijing* states Jueyin manifests with Ministerial Fire, meaning Yang is born within Yin, resembling the Zhen trigram, forming the Liver, the organ that generates Wind-Wood. Its substance is Yin, but its function is Yang. Excess Yang generates Wind-Heat; excess Yin generates Wind-Cold. Therefore, any stroke or wind-cold/wind-heat, whether Heat Deep and Jue Deep (external cold, internal heat), or Yin pulsing and Yang returning (left-right rotation), are diseases of the Wind-Wood organ itself. If manifesting in the limbs or ascending to the vertex, they are diseases of the Jueyin meridian. Now, let us discuss the herbs one by one. The Liver meridian travels with the Gallbladder meridian, differing only in interior-exterior relationship. Both ascend from the side of the body to the neck, enter the brain, and reach the vertex. Therefore, herbs like Chaihu (Bupleurum Root) and Manjingzi (Vernonia Fruit) that guide the Shaoyang meridian can also guide the Liver meridian to the head to disperse Wind-Evil. Can'er (Xanthium Fruit) has prickles, derived from wind-generated things, corresponding to the image of Dongfang Goumang (Eastern God of Growth). Its texture is light, so it enters the Liver meridian to disperse Wind in the head and eyes; its bitter taste also clears Heat. Gouteng (Uncaria Ramulus cum Uncis) has hooks and spines, also entering the Liver meridian. Being vine-like, it spreads in four directions, thus treating Wind-Heat in Liver sinews and vessels. Xungufeng (Herba Siegesbeckiae) and Wujiapi (Acanthopanacis Cortex) have hairs, are acrid and warm, so they disperse Wind-Cold in the Liver meridian and relieve bi-pain throughout the body. Chuanxiong (Ligusticum Rhizome) is warm in nature. Warmth is Yang within Yin, exactly the fundamental Qi of Wind-Wood, so it enters the Liver meridian. Its Qi moves freely, and its root nature ascends, allowing it to reach the vertex to disperse Wind-Cold. Some herbs do not ascend but can still treat headache. Zhang Zhongjing used Wuzhuyu (Evodia Fruit) for severe headache. This herb descends rapidly and does not ascend to the head, but it descends Liver-Stomach Cold, preventing it from filling the head. This treats the Zang-Fu so the meridians heal themselves. Tianma (Gastrodia Rhizome) does not move when there is wind but sways alone when there is no wind. Its swaying is the harmonious Qi of Wood; its stillness is the rigid Qi of Metal. Its Qi is slightly warm (Wood); its taste is slightly acrid (Metal). It is a substance where Metal controls Wood, combining the virtues of both. It grows straight up, and its seed returns to the sheath and root, so it can unblock Yang, harmonize Yin, treat head/eye issues, and calm convulsions. The seed returning to the root is like Western theory: wind starts in cold areas, blows to the tropics, returns, and blows to the poles. Thus, Tianma is the principal herb for treating Wind. Humans born from intermediate Qi are extraordinary people; herbs born from intermediate Qi are extraordinary herbs. Tianma's Wood possesses Metal nature, which is intermediate Qi, making it a wonderful herb for treating Wind. Baitouweng (Pulsatilla Root) also sways alone without wind and stays still with wind. It is hairy all over, grows straight up, similar to Tianma, possessing the spreading Qi of Wind-Wood, so it sways without wind. Its pure white color indicates Metal nature, so it stays still with wind. Its bitter taste makes it a wonderful herb for treating Wind-Heat. Zhang Zhongjing used it for postpartum wind-stroke and tenesmus after dysentery, taking advantage of its ability to extinguish Wind-Fire and vent Liver Yang. Qianghuo (Notopterygium Rhizome) and Du Huo (Angelica Pubescens Root) both grow straight up, stay still with wind, but are too acrid and warm. They disperse Wind-Cold more powerfully than Tianma and also dry Dampness, unlike Tianma which balances rigidity and gentleness. Sangjisheng (Taxillus Branch) is sour with abundant branches, possessing Wood nature, growing on Mulberry trees. Mulberry is Metal within Wood. Sangjisheng attaches to it, uniquely obtaining the intermediate Qi of Metal and Wood. Its roots do not touch soil, growing purely from Wind Qi, making it a wonderful herb for clearing and dispersing Wind-Wood. Jiangcan (Bombyx Batryticatus) stiffens upon encountering wind, thus treating wind-spasm. Wind invading extremities causes numbness and pain. Guizhi (Cinnamon Twig) disperses Wind-Cold; Huaizhi (Sophora Branch) and Sangzhi (Mulberry Branch) disperse Wind-Heat. Because branches spread horizontally, they reach all directions. Liver governs sinews, and Wind resides in sinews and vessels. Qinjiao (Gentiana Macrophylla Root) with sinew-like striations serves as a guide; its acrid-dispersing taste warms and disperses sinews. Xuduan (Dipsacus Root) also has sinew-like structures, so both treat sinews and vessels. However, Qinjiao's striations twist left and right, facilitating intersection; Xuduan's striations resemble bone joints, so it connects sinews and bones and removes Wind-Cold between joints. Duzhong (Eucommia Bark) has tough membranes that do not break, resembling human fascia. Between the two kidneys lies a white membrane that grows upward into a large diaphragm in the Liver, weaving through intestines to wrap lean meat outside. Tendons form at the ends of this meat and attach to joints. Duzhong's membrane resembles human fascia, so it enters the Liver and Kidney to strengthen sinews and bones. Liver meridian descends to the feet; Spleen governs sinews. Both wet and dry gout affect sinews. *Neijing* says Wind overcomes Dampness. If Liver loses Wind-Wood command and cannot soothe Earth, Dampness flows downward. Western medicine states that gout patients always have acidic urine. Mugua (Chaenomeles Fruit) is sour and astringent, removing Dampness, thus treating it. Yiren (Coix Seed) only treats Dampness and should be combined with Wind-dispersing herbs. Hu Jinggu (Tiger Tibia Bone) is acrid and warm, using Metal to pacify Wood, treating Wind-Cold gout. Wind comes from tigers; tigers correspond to the Seven Mansions of the West (Metal), controlling Wood. Dry gout is Wind-Heat. Ejiao (Donkey-Hide Gelatin), Guiban (Tortoise Shell), and Dihuang (Rehmannia Root) should be used to nourish Yin, keep Yang still, and restore the original state of Jueyin. Yuzhu (Polygonatum Rhizome) is soft, moist, and extinguishes Wind, following this intent. Hence the proverb: "To treat Wind, first treat Blood; when Blood moves, Wind extinguishes." When Blood is sufficient, Liver Yang does not move, and Wind extinguishes itself. Gout also has Wind-Cold and Wind-Heat. Injury by Wind-Heat causes wandering pain because Wind agitates and Blood becomes restless; injury by Wind-Cold causes bi-pain because Cold coagulates and Qi does not flow. Both blame Blood. Observing Zhang Zhonghong's Honglanhua (Carthamus Flower) treating hundred Wind diseases reveals the principle of treating Blood first to treat Wind. Worms generated by Wind transformation: any sores or tinea with worms indicate stagnant Blood transforming into worms upon exposure to Liver Wind. Thus, Jingjie (Schizonepeta Spike) and Fangfeng (Saposhnikovia Root) disperse Wind; Danggui (Angelica Sinensis Root) and Dihuang nourish and harmonize Blood; externally, pepper kills worms. Tuberculosis worms arise in Zang-Fu, formed from stagnant Blood transformed by Wind. Eels and snakes are long and curved, possessing Wood Qi; their white color in water indicates Metal Qi. Based on form and color, they are Wood transformed by Metal and Water. TB worms belong to Wind-Wood transformation; encountering the smell/taste of eel induces Metal-Water response, digesting the worms. Thus, eel bones fumigate mosquitoes into water. These are spiritual creatures born of intermediate Qi. Otter liver is similar. Its number corresponds to the eye, specializing in obtaining the essence of Metal and Water, thus digesting TB worms generated by Wind-Wood, treating the root of Wind. If Wind transforms into Dampness and generates worms, such as vomiting roundworms treated by Zhang Zhongjing with Wu Mei Wan, it treats Wind-Damp worms. Wu Mei (Mume Fruit) astringes Yang; Huajiao (Zanthoxylum Pericarp) transforms Yin, and Wind-Damp worms naturally dissolve. Observing Wu Mei Wan, cold and heat are used mutually, revealing that Yang moving and Yin responding generates Wind, while reversing Yang into Yin extinguishes Wind. Thus, slight Wind from constrained Yang should be dispersed using Bohe (Mint), Jingjie, Fangfeng, Zisu (Perilla Leaf), and Chaihu. Violent Wind suppressed by Yin should be warmed using Fuzi, Chuanwu (Chuanwu Aconite), and Baifuzi (Typhonium Rhizome). Among the Six Meridians, only Jueyin contains Yang within Yin, hence diseases of Heat Deep and Jue Deep. Severe Wind-Warm cases often present this way. The method is to clear Heat alone using Xijiao (Rhinoceros Horn - substitute with Buffalo Horn), Lingyangjiao (Antelope Horn), and Niuhuang (Calculus Bovis) to penetrate and reach. External Cold and Internal Heat is like Western theory: extreme heat in a room draws cold wind through openings. Thus, one should only remove Heat, and Wind will not come. Muscle contraction and pulling is Wind-Heat; Lingyangjiao is suitable. This animal hangs its horn on tree branches and sleeps suspended, indicating its tendons are very straight, and the horn is the essence of Wind. Its nature is slightly cold, and its function specializes in relaxing sinews. Left-right pulling is like Western theory: when tropics move south, North Wind arrives; when tropics move north, South Wind arrives, cycling endlessly. Thus, Qinjiao's left-right intersection serves as a guide, and Tiger Eye (which calms Wind) is the treatment. Left-right hemiplegia follows the same logic. To calm Wind, Baitouweng, Tianma, and Lingyangjiao can be used. Flaccid sinews unable to contract indicate Cold and Wind; Guizhi and Fuzi are suitable. Those discussing this must not confuse them.