有邪不除，淹缠日久，必至 羸，庸医望之，辄用补剂，殊不知无邪不病，邪
去，而正气得通，何患乎虚之不复也？今投补剂，邪气益固，正气日郁，转郁转热，转热转瘦
，转瘦转补，转补转郁，循环不已，乃至骨立而毙，犹言服参几许，补之不及，天数也。
病家止误一人，医者终身不悟，不知杀人无算。
疫邪结于膜原，与卫气并，固而昼夜发热，五更稍减，日晡益甚，此与瘅疟相类
。瘅疟热短，过时如失，明日至期复热。今温疫热长，十二时中首尾相接，寅卯之间，乃其
热之首尾也。即二时余焰不清，似乎日夜发热。且其始也，邪结膜原，气并为热，胃本无病
，误用寒凉，妄伐生气，此其误者一；及邪传胃，烦渴口燥，舌干苔刺，气喷如火，心腹
痞满，午后潮热，此应下之证，若用大剂芩连栀柏，专务清热，竟不知热不能自成其热，皆
由邪在胃家，阻碍正气，郁而不通，火亦留止，积火成热，但知火与热，不知因邪而为火热
，智者必投承气，逐去其邪，气行火泄，而热自已。若概用寒凉，何异扬汤止沸，每见今医好
用黄连解毒汤，黄连泻心汤，盖本《素问》热淫所胜治以寒凉，以为圣人之言必不我欺，况
热病用寒药，最是快捷方式，又何疑乎？每遇热甚，反指大黄能泻，而损元气，黄连清热，且不
伤元气，更无下泄之患，且得病家无有疑虑，守此以为良法。由是凡遇热证，大剂与之，二
三钱不已，增至四五钱，热又不已，昼夜连进，其病转剧，至此技穷力竭，反谓事理当然。
又见有等日久，腹皮贴背，乃调胃承气证也，况无痞满，益不敢议承气，唯类聚寒凉，专务
清热，又思寒凉之最者莫如黄连，因而再倍之，日近危笃，有邪不除，耽误至死，犹言服黄
连至几两，热不能清，非药之不到，或言不治之证，或言病者之数也。他日凡遇此证，每每
如是，虽父母妻子，不过以此法毒之，盖不知黄连苦而性滞，寒而气燥，与大黄均为寒药，
大黄走而不守，黄连守而不走，一燥一润，一通一塞，相去甚远，且疫邪首尾以通行为治，
若用黄连，反招闭塞之害，邪毒何由以泻？病根何由以拔？既不知病原，焉能以愈疾耶？
问曰∶间有进黄连而得效者，何也？曰∶其人正气素胜，又因所受之邪本微，此不药自愈
之
证，医者误投温补，转补转郁，转郁转热，此以三分客热，转加七分本热也。客热者，因客
邪所郁，正分之热也，此非黄连可愈；本热者，因误投温补，正气转郁，反致热极，故续加
烦
渴、不眠谵语等证，此非正分之热，乃庸医添造分外之热也因投黄连，于是烦渴、不眠、
谵语等证顿去。要之黄连，但可清去七分无邪本热，又因热减而正气即回，所存三分有邪客
热，气行即已也。医者不解，遂以为黄连得效，他日藉此，概治客热，则无效矣。必以昔效
而今不效，疑其病原本重，非药之不到也，执迷不悟，所害更不可胜计矣。
问曰∶间有未经温补之误，进黄连而疾愈者何也？曰∶凡元气胜病为易治，病胜元气为难
治
，元气胜病者，虽误治，未必皆死；病胜元气者，稍误未有不死者。此因其人元气素胜，所
感之邪本微，是正气有余，足以胜病也，虽少与黄连，不能抑郁正气，此为小逆，以正气
犹胜而疾幸愈也。医者不解，窃自邀功，他日设遇邪气胜者，非导邪不能瘳其疾，误投黄连
，反招闭塞之害，未有不危者。
如果病邪未能清除，缠绵日久，必然导致身体极度消瘦虚弱。庸医看到这种情形，就随意使用补益剂，殊不知没有病邪就不会生病，只有病邪去除，正气才能通畅，还担心什么虚损不能恢复呢？现在反而投用补剂，使得病邪更加固结，正气日益郁滞，越郁滞越发热，越发热身体越消瘦，越消瘦越进补，越进补越郁滞，循环往复不停，以至于身体瘦得只剩骨架而死，还说是服用人参多少却补不进去，这是天数注定。病人只耽误了一人，医生终身都不醒悟，不知道这样杀人无数。
疫邪结聚在膜原（半表半里的部位），与卫气相搏，所以昼夜发热，五更时分稍微减轻，日晡时（下午3-5点）更加严重，这与瘅疟（一种以高热为主症的疟疾）相似。瘅疟的热势短促，过时就像消失一样，第二天到了那个时间又发热。现在的温疫热势持久，十二个时辰中首尾相接，寅卯之间（凌晨3-7点），正是它热势的起始和终结。即使这两个时辰余焰不清，看起来像是日夜发热。况且起初邪气结聚在膜原，气机并合化为热，胃本身并没有病，误用寒凉药，妄自损伤生机，这是第一个错误；等到邪气传入胃腑，出现烦躁口渴、口燥、舌干生刺、呼吸喷火般热气、心腹部痞满胀痛、午后潮热，这应当使用攻下法，如果使用大剂量的黄芩、黄连、栀子、黄柏，专门致力于清热，竟然不知道热不能独自形成，都是由邪气在胃中阻碍正气，郁滞不通，火气停留，积火而成热，只知道是火与热，却不知道是因为邪气才成为火热，明智的人必定投用承气汤类方剂，驱逐病邪，气行则火泄，热自然消除。如果一概使用寒凉药，何异于扬汤止沸？常常看见现在的医生喜欢用黄连解毒汤、黄连泻心汤，大概是根据《素问》中“热淫所胜，治以寒凉”的说法，认为圣人的话一定不会欺骗我们，况且热病用寒药，是最快捷的方式，又有什么可怀疑的呢？每次遇到热势很盛，反而指责大黄能泻下而损伤元气，黄连清热且不伤元气，更没有泻下的祸患，而且让病人没有疑虑，坚守此法作为良策。因此凡是遇到热证，大量给予，二三钱不见效，增加到四五钱，热势仍不退，昼夜连续服用，病情反而加重，到了这时技术穷尽、力量衰竭，反而认为事理本来就是这样。又看见有些病程日久，腹皮紧贴背部，这是调胃承气汤的适应证，况且没有痞满症状，更加不敢议论使用承气汤，只是聚集寒凉药，专门致力于清热，又想到寒凉药中最厉害的莫过于黄连，因而加倍使用，日渐危重，因为病邪未除，耽误至死，还说是服用了黄连几两，热不能清，不是药力不到，或者说是不治之症，或者是病人的命数。他日凡遇到这种证候，每每如此，即使是父母妻子，也不过是用这种方法毒害他们，大概不知道黄连苦而性质滞涩，寒而气性燥烈，与大黄同为寒药，大黄走而不守，黄连守而不走，一燥一润，一通一塞，相差甚远，且疫邪的治疗从头到尾都以通行为原则，如果使用黄连，反而招致闭塞的危害，邪毒从哪里排泄？病根从哪里拔除？既然不知道病原，怎么能治愈疾病呢？
有人问：间或有服用黄连而见效的，为什么呢？回答说：那个人正气素来强盛，又因为感受的病邪本来轻微，这是不吃药也能自愈的证候，医生误投温补药，越补越郁滞，越郁滞越发热，这是将三分客邪之热，转加七分本有之热。客热，是由于客邪郁滞所致，属于正气分内的热，这不是黄连可以治愈的；本热，是由于误投温补，正气转加郁滞，反致热极，所以继续出现烦躁口渴、失眠谵语等症状，这不是正气分内的热，而是庸医添造的外分之热。因为投用黄连，于是烦躁口渴、失眠谵语等症状顿时去除。总之，黄连只能清去七分无邪的本热，又因为热减而正气随即恢复，所存的三分有邪的客热，气机运行也就消除了。医生不理解，于是认为黄连见效，他日借此法，一概治疗客热，那就无效了。必定会因为以前有效而现在无效，怀疑病原本很重，不是药力不到，执迷不悟，所害更深不可胜计。
有人问：间有未经过温补误治，服用黄连而疾病痊愈的，为什么呢？回答说：凡是元气胜过病邪为易治，病邪胜过元气为难治，元气胜过病邪者，虽然误治，未必都会死；病邪胜过元气者，稍有误治无不死的。这是因为那人元气素来强盛，所感受的病邪本来轻微，是正气有余，足以战胜病邪，虽然少量给予黄连，不能抑郁正气，这是轻微的逆乱，因为正气仍然强盛而侥幸痊愈。医生不理解，私下里窃取功劳，他日假如遇到邪气胜者，非引导邪气不能治愈疾病，误投黄连，反而招致闭塞的危害，没有不危险的。
If pathogenic factors are not eliminated and the disease lingers for a long time, it will inevitably lead to emaciation (severe wasting). Quack doctors, upon seeing this condition, indiscriminately use tonic prescriptions. They fail to realize that without pathogenic factors, there is no disease; once the pathogens are expelled, the healthy Qi (Vital Energy) can flow freely, so why worry about the inability to recover from deficiency? Now, by administering tonics, the pathogenic factors become more entrenched, and the healthy Qi becomes increasingly stagnant. The more stagnation, the more fever; the more fever, the more emaciation; the more emaciation, the more tonification; the more tonification, the more stagnation. This cycle continues endlessly until the patient dies, reduced to a skeleton, yet they still claim that despite taking several taels of Ginseng Radix et Rhizoma (Renshen), the deficiency could not be supplemented, attributing it to fate. The patient is misled for a lifetime, while the doctor remains oblivious, unaware that such practices have killed countless people.
When epidemic pathogens accumulate in the Mo Yuan (Membrane Source, a location between the exterior and interior) and contend with Wei Qi (Defensive Qi), fever persists day and night, slightly subsiding at Wu Geng (around 3-5 AM) and worsening at Ri Bu (around 3-5 PM). This resembles Dan Nue (Crimson Malaria, a type of malaria characterized by high fever). In Dan Nue, the heat is short-lived, disappearing after its peak, only to return at the same time the next day. In contrast, the heat of Warm Epidemic (Wen Yi) is prolonged, connecting head to tail throughout the twelve two-hour periods. The period between Yin and Mao (3-7 AM) marks the beginning and end of its heat. Even if residual heat lingers during these two hours, it appears as continuous day-and-night fever. Initially, when pathogens are stuck in the Mo Yuan, Qi combines to generate heat, but the Stomach itself is not diseased. Misusing cold-cooling herbs recklessly damages the vital energy; this is the first error. Later, when pathogens transmit to the Stomach, symptoms such as irritability, thirst, dry mouth, dry tongue with prickles, breath hot as fire, epigastric and abdominal fullness and distension, and afternoon tidal fever appear. These indicate a syndrome requiring purgation. If large doses of Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), and Huang Bo (Phellodendri Cortex) are used solely for clearing heat, one fails to understand that heat does not arise spontaneously. It is caused by pathogens in the Stomach obstructing the healthy Qi, leading to stagnation where Fire stays and accumulates into Heat. One must recognize that it is not merely Fire and Heat, but Heat generated due to Pathogens. A wise practitioner would administer Cheng Qi Decoction (Ordering the Qi Decoction) variants to expel pathogens. Once Qi moves, Fire dissipates, and Heat resolves naturally. Using cold-cooling herbs indiscriminately is like stirring boiling water to stop it from boiling. Many modern physicians favor Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) and Huang Lian Xie Xin Tang (Coptis Decoction for Draining the Epigastrium), citing the *Su Wen* (Basic Questions): "When Heat dominates excessively, treat it with cold." They believe the Sage’s words cannot deceive them. Moreover, using cold herbs for heat diseases seems the quickest method, leaving no room for doubt. Whenever heat is severe, they blame Da Huang (Rhei Radix et Rhizoma) for purging and damaging Yuan Qi (Original Qi), claiming Huang Lian clears heat without harming Yuan Qi and avoids purgative risks, reassuring patients. Thus, for any heat syndrome, they prescribe large doses. If 2-3 qian are ineffective, they increase to 4-5 qian. If heat persists, they continue administration day and night, worsening the condition. Exhausted of skill and strength, they rationalize this as natural course. Seeing patients with long-standing disease whose abdominal skin adheres to the back indicates a Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction) syndrome. Yet, lacking fullness/distension, they dare not consider Cheng Qi formulas, instead aggregating cold herbs for clearing heat. Thinking no herb is colder than Huang Lian, they double the dose. The patient deteriorates daily. Due to uneliminated pathogens, delay leads to death. They claim taking several liang of Huang Lian failed to clear heat, blaming insufficient dosage, incurable disease, or fate. Tomorrow, encountering similar cases, they repeat this, even poisoning parents and wives, unaware that Huang Lian is bitter, cloying, cold, and drying. Like Da Huang, it is cold, but Da Huang moves and does not stay, while Huang Lian stays and does not move. One is drying, the other moistening; one is unblocking, the other obstructing—vastly different. Since treating epidemic pathogens requires unblocking throughout, using Huang Lian causes obstruction, preventing pathogen expulsion and root removal. How can one cure the disease without knowing the pathogenesis?
Question: Occasionally, some recover after taking Huang Lian. Why? Answer: Those individuals possess strong Zheng Qi (Upright Qi) and contracted mild pathogens initially. This is a self-healing case without medication. However, doctors mistakenly administered warm-tonic herbs, causing stagnation and heat. This transformed minor external heat into major internal heat. External heat arises from pathogen stagnation within the Zheng Qi realm and cannot be cured by Huang Lian. Internal heat results from mistaken warm tonification causing Zheng Qi stagnation and extreme heat, leading to irritability, thirst, insomnia, and delirium. This is not Zheng Qi heat but externally added heat by quacks. Huang Lian clears the seven parts of non-pathogenic internal heat. As heat decreases, Zheng Qi recovers. The remaining three parts of pathogenic external heat resolve as Qi flows. Doctors misunderstand this, believing Huang Lian was effective. Applying this universally to external heat later yields no effect. When previous efficacy fails now, they suspect severe underlying disease rather than recognizing their error, persisting in delusion and causing immense harm.
Question: Occasionally, those who did not suffer from mistaken warm tonification recover after taking Huang Lian. Why? Answer: When Yuan Qi overcomes the pathogen, treatment is easy; when the pathogen overcomes Yuan Qi, treatment is difficult. If Yuan Qi is strong, even mistaken treatment may not be fatal. If the pathogen is strong, slight mistakes are often fatal. Here, the person’s Yuan Qi was originally strong, and the contracted pathogen was mild. With surplus Zheng Qi sufficient to overcome the pathogen, small amounts of Huang Lian do not depress Zheng Qi. This is a minor adverse reaction, and recovery is fortunate due to strong Zheng Qi. Doctors, misunderstanding this, claim credit. Later, encountering cases where pathogens dominate, they fail to guide pathogens out. Mistakenly using Huang Lian causes obstruction, leading to danger.