溃以膏贴之。以手探肿上，热者有脓，不热者无脓也。
又曰∶凡肌肉伤而疮口不敛者，用六君子汤以补脾胃为主；若气虚恶寒，而疮
口不敛者，用补中益气汤以补脾肺；若血虚发热而疮口不敛者，用四物参 以滋肝
脾；若脓多而疮口不敛者，用八珍汤、十
全大补汤以养血气。经曰∶脾主肌肉，如前药未应，但用四君归 以补脾胃；若更
不应，乃下元阳虚，用八味丸以壮火生土；若脉数发渴者难治，此真气虚而邪气实也。
又曰∶按一切痈疽，初起则邪毒未曾达表，脏腑壅热，一毫热药不可用；若既
出脓后，则毒瓦斯外泄，气血皆虚，胃气自弱。一毫凉药不可用。比古人之成法也。然
亦有气血虚寒，初起毒陷阴分者，非阳和托里，何能升达在表；既溃而阴血干枯，若
非滋阴充畅，何能接续脓浆。外则疮毒枯焦，内则口干烦躁，故全在以脉消息。盖
气主煦之，血主濡之，气以成形，血以华色，故诸痈疽平塌不易高耸者，乃阳气虚
弱，不能逐毒以出阴分，即为阴毒也；根红散漫者，亦气虚不能拘血紧附也；红活
光润者，气血拘毒出外也；外红里黑者，毒滞于内也；紫黯不明者，气血不充，不能
化毒成脓也；脓色浓浓者，气血旺也；脓色清淡者，气血衰也。未出脓前，或有有
余之热，既出脓后，尽从不足之治；但毒瓦斯一分未尽，不可姑纵容留，以致蔓延，便
成大患，犹之养虎，久必噬人。气虚不能逐毒者，温补兼托，阳和一转，阴分凝泣
之滞，自能冰解；血虚不能化毒者，尤宜滋补排脓，故当溃脓毒瓦斯未尽之时，其托
里之功，刻不可缓，一容一纵，毒即逗留；一解一清，毒即冰伏；托里不兼滋补气血，
虚者何以成脓，犹无米而使之炊饭也；滋补不兼托里，仅可调和气血，何能直达溃
所成功，且毒瓦斯盛者，则反受其助，犹裹粟以资盗粮矣。滋补不兼温暖，则血凝气
滞，孰作酿脓之具，犹之造酒不暖，何以成浆，造饭无火，何以得熟。世人但知以
毒为火，清火以解毒，殊不知毒即火，毒化而火亦清，毒凝而火愈郁。然毒之化必
由脓，脓之来必由气血，气血之化，必由火也，火可清乎？况清凉之法，仅可施于
疮疥小疖耳。若忽遇通经达络之疽，攻托尚虞不暇，岂可复行清解，反伤胃气，以
致阳气不振，难溃难长，甚则内攻脏腑，可不畏欤！迨至毒既去尽，肉 肌生，则和
平补养气血之中，乃可佐以银花国老，以解有余不尽之毒，至如连翘、花粉，亦能解毒伤胃气，盒饭禁用。
程山龄曰∶凡痈疽服药，宜照顾脾胃为主，不得已而用清凉，但期中病，切
勿过剂。初起时设有挟风寒者，宜先用芎芷香苏散一剂，或万灵丹、蟾酥丸以散之，
散后而肿未消，随用银花甘草汤、四妙汤以和解之。若肿势 痛，大便闭结，内热
极盛者，则清药中须兼补托之剂，透脓散主之。若脓水已溃，必须托补元气为主，参
内托散主之；如元气虚寒，则补托药中须加辛热以佐之；脾虚者，理中汤、参
白术散；气虚下陷者，补中益气汤；胃经受寒，饮食停滞者，藿香正气散；气血两
虚者，十全大补汤加附子、鹿茸；间亦有虚而挟热者，即去附子、肉桂，加麦冬、银
花、丹皮以收功，不可不知也。大抵有阳毒，有半阴半阳，宜细辨之。阳毒者疮势
红肿，疮顶尖耸，根脚不散，饮食如常，口渴便结，五心烦热，脉洪数；阴毒者疮势
灰白平塌，顽麻少痛，根脚走散，食少便溏，手足厥冷，口鼻气冷，脉沉迟；半阴
半阳者，疮虽红肿，不甚尖耸，饮食差减，大便不结，寒热往来，微渴喜热，脉虚软；
此三者必须细辨，俾用药寒温得宜，方为合法。治阳者清凉解毒，治阴者温中回阳，
半阴半阳之法，清不伤胃，温不助邪，如斯而已矣。（《十法》）
胡公弼曰∶痈疽最忌发汗，恐表虚不能成脓，后必难治。（《无愧青囊》）
又曰∶败脓不出者，用白芷，不可用白术，盖白术能化毒生脓。
经曰∶无阳则阴无以生，无阴则阳无以化。
张景岳曰∶阴根于阳，阳根于阴，凡
病有不可正治者，当从阳以引阴，从阴以引阳，各求其属而衰之。如求汗于血，生
气于精，从阳引阴也；又如引火归原，纳气归肾，从阴引阳也；此即水中取火，火中取水之义。
又曰∶阴之病也，来亦缓而去亦缓；阳之病也，来亦速而去亦速；阳生于热，热
则舒缓，阴生于寒，寒则拳急。
又曰∶寒邪中于下，热邪中于上，饮食之邪中于中。
又曰∶考之《中藏经》曰∶阳病则旦静，阴病则夜宁，阳虚则暮乱，阴虚则朝
争。盖阳虚喜阳助，所以朝轻而暮重，阴虚喜阴动，所以朝重而暮轻，此言阴阳之
虚也。若实邪之候，则与此相反，凡阳邪盛者，必朝重暮轻，阴邪盛者，必朝轻暮
重，此阳逢阳王，阴得阴强也。其有或昼或夜，时作时止，不时而动者，以正气不
能主持，则阴阳胜负交相错乱，当以培养正气为主，则阴阳将自和矣。但或水或火，
宜因虚实以求之。
又曰∶病有六变者，表里、寒热、虚实也。是即医中之关键，明此六者，万病
皆指诸掌矣。以表言之，则风、寒、暑、湿、火、燥，感于外者是也；以里言之，则七
情、劳欲、饮食，伤于内者是也；寒者，阴之类也，或为内寒，或为外寒，寒者多虚；
热者，阳之类也，或为内热，或为外热，热者多实。虚者正气不足也，内出之病多不
足；实者，邪气有余也，外入之病多有余。
又曰∶病必自表而入者，方得为之表证，若由内以及外，便非表证矣。经曰∶从
内之外者，调其内，从外之内者，治其外，从内之外而盛于外者，先治其内，而后治
其外，从外之内，而盛于内者，先治其外，而后调其内，此内外先后之不可不知也。
又曰∶热在表者，为发热头痛，为丹肿斑黄，为揭去衣被。为诸痛疮疡。热在
里者，为瞀闷胀满，为烦渴喘结，或气急叫吼，或躁扰狂越。热在上者，为头痛目
赤，为喉疮牙痛，为诸逆冲上，为喜冷舌黑。热在下者，为腰足肿痛，为二便秘涩，
或热痛遗精，或溲浑便赤。
又曰∶寒在表者，为憎寒，为身冷，为浮肿，为容颜青惨；为四肢寒厥。寒在里
者，为冷咽肠鸣，为恶心呕吐，为心腹疼痛，为恶寒喜热。寒在上者，为吞酸，为
膈噎，为饮食不化，为嗳腐胀哕。寒在下者，为清浊不分，为 溏痛泄，为阳痿，为
遗尿，为膝寒足冷。
又曰∶真寒之脉，必迟弱无神，真热之脉，必滑实有力。
又曰∶阳脏之人多热，阴脏之人多寒。阳脏者必平生喜冷畏热，即朝夕食冷，一
无所病，此其阳之有余也；阴脏者，一犯寒凉，则脾肾必伤，此其阳之不足也。第
阳强者少，十惟二三；阳弱者多，十常五六；然恃强者多反病，畏弱者多安宁。
又曰∶假寒误服热药，假热误服寒药等证，但以冷水少试之。假热者必不喜水，
即有喜者，或服后见呕，盒饭以温热药解之；假寒者，必多喜水，或服反快而无所
逆者，盒饭以寒凉药解之。
又曰∶今人病虚证者极多，非补不可。但用补之法，不宜造次，欲察其可补不可
补之机，则全在先察胸腹之宽否，何如？然后以渐而进，如未及病，再为放胆用之，庶
无所碍，此用补之大法也。
又曰∶凡势在危急，难容少缓，亦必先问其胸宽者，乃可骤进；若元气真虚，而
胸腹又胀，是必虚不受补之证，若强进补剂，非惟无益，适足以招谤耳。
又曰∶制方用药，气味有阴阳，阴者降，阳者升；阴者静，阳者动；阴者柔，阳
者刚；阴者怯，阳者勇；阴主精，阳主气；其于善恶、喜恶，皆有妙用。
又曰∶气味之升降，升者浮而散，降者沉而利，宜升者勿降，宜降者勿升。
又曰∶气味之动静，静者守而动者走，走者可行，守者可安。
又曰∶气味刚柔，柔者纯而缓，刚者躁而急；纯者可和，躁者可却；非刚不足
以去暴，非柔不足以济刚。
又曰∶气味之勇怯，勇者，直达病所，可赖出奇；怯者用以周全，籍其平妥。
又曰∶气味之主气者，有能为精之母；主精者，有能为气之根；或阴中之阳者，能
动血中之气；或阳中之阴者，能顾气中之精。
又曰∶气味有善恶，善者，赋性驯良，尽堪择用；恶者气味残狠，何必近之。
又曰∶气味有善恶，有素性之喜恶，有一时之喜恶者，相宜取效尤易，恶者见忌，不必强投。
又曰∶治病用药；本贵精专，尤宜勇敢，凡久远之病，则当要其终始，治从乎
缓，此宜然也。若新暴之病，虚实既得其真，即当以峻剂直攻其本，拔之甚易，若
逗留畏缩，养成深固之势，则死生系之，谁其罪也。故凡真见里实，则以凉膈、承气；
真见里虚，则以理中、十全；表虚则 术、建中；表实则麻黄、柴、桂之类；但用一
味为君，二三味为佐使，大剂进之，多多益善。夫用多之道何在？在乎必赖其力，而
料无害者，即放胆用之，性缓者，可用数两，而性急者亦可数钱。若三五七分之说，
亦不过点名具数儿戏而已，解纷治剧之才，举动固如是乎！
又曰∶治病之则，当知邪正，当权重轻。凡治实者，譬如耘禾，禾中生稗，禾
之贼也，有一去一，有二去二，耘之善者也；若有一去二，伤一禾矣，有二去四，伤
二禾矣；若识禾不的，俱认为稗，而计图尽之，则无禾矣。此用攻之法，贵乎察得
其真，不可过也。凡治虚者，譬之给饷，一人一升，十人一斗，日饷足矣。若百人一
斗，千人一斛，而三军之众，又岂担石之粮，所能活哉！一饷不继，将并前饷而弃
之，而况于从中克减乎！此用补之法，贵乎轻重有度，难从简也。
又曰∶虚实之治，大抵实能受寒，虚能受热，所以补必兼温，泻必兼凉者，盖
凉为秋气，阴主杀也，万物逢之，便无生长，欲补元气，故非所宜，凉且不利于补，
寒者益可知矣，即有火盛气虚，宜补以凉者，亦不过因火暂用，火去即止，终非治
虚之法也。又或有以苦寒之物，谓其能补阴者，则《内经》有曰∶形不足者，温之
以气，精不足者，补之以味。夫气味之相，宜于人者，谓之曰补可也，未闻以味苦气
劣，而不相宜于人者，亦可谓之补也。虽《内经》有曰∶水位之主，其泻以咸，其补
以苦等论，然此特以五行岁气之味，据理而言耳。矧其又云∶麦、羊肉、杏、薤，皆
苦之类，是则苦而补者也。岂若大黄、黄柏之类，气味苦劣，若此而谓之能补，无
是理也。尝闻之王应震曰∶一点真阳寄坎宫，固根须用味甘温，甘温有益寒无补，堪
笑庸医错用功。此一言蔽之也，不可不察。
又曰∶补泻之法，补亦治病，泻亦治病，但当知其要也。如以新暴之病，而少
壮者，乃可攻之泻之，攻但可用于暂，未有衰久之病，可屡攻可以无害者，故攻不
可以收缓功延久之病。而虚弱者理宜温之补之，补乃可于常，未有根本既伤，而舍
补可以复元者，故补不可以求速效。然犹有其要，则凡临证治病，不必论其有虚证，
无虚证，但无实证可据而为病者，盒饭兼补以调荣卫精血之气；亦不必论其有火证
无火证，但无热证可据而为病者，盒饭兼温以培命门脾胃之气，此补泻要领，苟不
知此，未有不至决裂败事者。
又曰∶治法有逆从，以寒热有假真也，此《内经》之旨也。经曰∶逆者正治，从
者反治。夫以寒治热，以热治寒，此正治也，正即逆也；以热治热，以寒治寒，此
反治也，反即从也。如以热药治寒病而寒不去者，是无火也，当治命门，以参、姜、
桂、附之类，此王太仆所谓益火之源以消阴翳，是亦正治之法也。又如热药治寒病
而寒不退，反用寒凉而愈者，此正假寒之病，以寒从治之法也。
又如以寒药治热病而热不除者，是无水也，治当在肾，以六味丸之类，此王太
仆所谓壮水之主以镇阳光，是亦正治之法也。又有寒药治热病，而热不愈，反用参、
姜、桂、附八味丸之属而愈者，此即假热之病，以热从治之法也，亦所谓甘温除大
热也。第今人之虚者多，实者少，故真寒假热之病为极多，而真热假寒之病则仅见耳。
又曰∶探病之法，不可不知，如当局临证，或虚实有难明，寒热有难辨，病在
疑似之间，补泻之意未定者，即当先用此法。若疑其为虚，意欲用补而未决，则以
轻浅消导之剂，纯用数味，先以探之，消而不投，即知为真虚矣。疑其为实，意欲
用攻而未决，则以甘温纯补之剂，轻用数味，先以探之，补而觉滞，即知有实邪也。
假寒者，略温之，必见躁烦；假热者，略寒之，必加呕恶，探得其情意自定矣。经
曰∶有者求之，无者求之。
又曰∶假者反之，此之谓也。但用探之法，极宜精简，不可杂乱，精简则真伪
立辨，杂乱则是非难凭，此疑似中之活法，必不得已而用之可也。
华元化曰∶大凡治疗，脉不紧数，则勿发其汗；脉不实数，不可以下；心胸不
闭，尺脉微弱，不可以吐；关节不急，营卫不壅，不可以针；阴气不盛，阳气不衰，
用膏药贴敷溃烂处。用手触摸肿胀部位，感觉发热说明有脓，不发热说明没有脓。
又说：凡是肌肉受损而疮口不能愈合的，以六君子汤为主来补益脾胃；如果是气虚怕冷且疮口不愈合的，用补中益气汤来补益脾肺；如果是血虚发热且疮口不愈合的，用四物参（四物汤加人参）来滋养肝脾；如果脓液多且疮口不愈合的，用八珍汤、十全大补汤来养血补气。经书说：脾主肌肉，如果上述药物无效，只用四君归（四君子汤加当归）来补益脾胃；如果仍然无效，则是下元阳气虚弱，用八味丸（金匮肾气丸）来温壮命门之火以生脾土；如果脉象数急且口渴的则难治，这是真气虚弱而邪气实盛的表现。
又说：按一切痈疽来看，初起时邪毒尚未透达体表，脏腑壅滞热盛，一毫热性药物都不可用；如果已经出脓后，则毒瓦斯向外排泄，气血皆虚，胃气自然衰弱，一毫凉性药物都不可用。这是遵循古人的成法。然而也有气血虚寒，初起时毒邪陷入阴分的，如果不是用阳和托里之法，怎么能升发透达于体表？如果溃破后阴血干枯，如果不是滋阴充畅，怎么能接续生成脓浆？外部则疮毒枯焦，内部则口干烦躁，所以全在于通过脉象来斟酌判断。大概气主温煦，血主濡润，气形成形体，血荣华色泽，所以各种痈疽平塌不易高耸的，是阳气虚弱，不能驱逐毒邪使其从阴分透出，这就称为阴毒；根部红赤散漫的，也是气虚不能约束血液紧密附着；红活光润的，是气血拘束毒邪使其外发；外部红赤内部黑紫的，是毒邪滞留于体内；紫暗不明的，是气血不充盛，不能化解毒邪生成脓液；脓色浓稠的，是气血旺盛；脓色清淡的，是气血衰败。在未出脓之前，或许有有余之热，在出脓之后，治疗完全应从不足方面着手；但只要毒瓦斯一分未尽，不可姑息纵容留滞，以致蔓延，酿成大患，就像养虎一样，时间久了必定会噬人。气虚不能驱逐毒邪的，宜温补兼托毒，阳气一转，阴分凝涩之滞，自然能像冰解一样消散；血虚不能化解毒邪的，尤其适宜滋补排脓，所以在溃脓毒瓦斯未尽之时，其托里的功效，片刻也不能迟缓，一旦容留纵容，毒邪就会逗留；一旦解散清除，毒邪就会像冰伏一样潜伏；托里如果不兼补益气血，虚弱者怎么能生成脓液，就像没有米却让人做饭一样；滋补如果不兼托里，仅能调和气血，怎么能直达溃烂之处取得成功，况且毒瓦斯盛者，反而会受到滋补的助长，就像包裹粟米去资助盗粮一样。滋补如果不兼温暖，则血液凝滞气机阻滞，谁来做酿脓的工具，就像酿酒不温暖，怎么能成浆，做饭没有火，怎么能煮熟。世人只知道把毒当作火，清火来解毒，却不知道毒就是火，毒化解了火也就清了，毒凝滞了火就更郁结。然而毒的化解必然通过脓，脓的产生必然来自气血，气血的转化，必然来自火啊，火可以清吗？何况清凉之法，仅可施用于疮疥小疖罢了。如果遇到通经达络的大疽，攻托还担心来不及，怎么可以再行清解，反而损伤胃气，导致阳气不振，难以溃破难以生长，甚至内攻脏腑，能不害怕吗！等到毒邪去除干净，肌肉生长，则在和平补养气血之中，才可以佐以金银花、甘草，来解除剩余不尽的毒邪，至于连翘、天花粉，也能解毒但伤胃气，应当禁用。
程山龄说：凡是痈疽服药，应当以照顾脾胃为主，不得已而用清凉药，只要中病即止，切勿过量。初起时如果有挟带风寒的，宜先用芎芷香苏散一剂，或者万灵丹、蟾酥丸来发散，发散后如果肿势未消，随即用银花甘草汤、四妙汤来和解。如果肿势疼痛，大便闭结，内热极盛的，则在清药中须兼用补托之剂，以透脓散为主。如果脓水已溃，必须以托补元气为主，以参内托散为主；如果元气虚寒，则在补托药中须加辛热药来辅助；脾虚的，用理中汤、参苓白术散；气虚下陷的，用补中益气汤；胃经受寒，饮食停滞的，用藿香正气散；气血两虚的，用十全大补汤加附子、鹿茸；间或有虚而挟热的，就去掉附子、肉桂，加麦冬、金银花、牡丹皮来收功，不可不知道这些。大抵有阳毒，有半阴半阳，应当仔细辨别。阳毒的症状是疮势红肿，疮顶尖耸，根脚不散，饮食如常，口渴便秘，五心烦热，脉象洪数；阴毒的症状是疮势灰白平塌，顽麻少痛，根脚走散，食少便溏，手足厥冷，口鼻气冷，脉象沉迟；半阴半阳的症状是，疮虽然红肿，但不甚尖耸，饮食稍减，大便不结，寒热往来，微渴喜热饮，脉象虚软；这三者必须仔细辨别，使用药寒温得当，才是合法的治疗。治疗阳毒用清凉解毒，治疗阴毒用温中回阳，治疗半阴半阳的方法，清热不伤胃，温补不助邪，如此而已。（《十法》）
胡公弼说：痈疽最忌讳发汗，恐怕表虚不能成脓，后来必定难治。（《无愧青囊》）
又说：败脓排不出来的，用白芷，不可用白术，因为白术能化毒生脓。
经书说：没有阳则阴无法生成，没有阴则阳无法化生。
张景岳说：阴根源于阳，阳根源于阴，凡是有病不能用常规方法治疗的，应当从阳来引导阴，从阴来引导阳，各自寻求其归属而使之衰退。比如求汗于血，生气于精，这是从阳引阴；又比如引火归原，纳气归肾，这是从阴引阳；这就是水中取火，火中取水的含义。
又说：阴的病，来得慢去得也慢；阳的病，来得快去得也快；阳生于热，热则舒缓，阴生于寒，寒则收缩紧急。
又说：考察《中藏经》说：阳病则早晨安静，阴病则夜晚安宁，阳虚则傍晚混乱，阴虚则早晨争斗。大概阳虚喜欢阳气帮助，所以早晨轻傍晚重，阴虚喜欢阴气活动，所以早晨重傍晚轻，这是说的阴阳之虚。如果是实邪的证候，则与此相反，凡是阳邪盛者，必定早晨重傍晚轻，阴邪盛者，必定早晨轻傍晚重，这是阳逢阳旺，阴得阴强。那些有时白天有时晚上，时作时止，不时发作的，是因为正气不能主持，则阴阳胜负交相错乱，应当以培养正气为主，则阴阳将自然调和。但是或水或火，应当因虚实来探求。
又说：病有六种变化，即表里、寒热、虚实。这就是医中的关键，明白这六者，万病都在掌握之中了。从表来说，风、寒、暑、湿、火、燥，感于外部的是表证；从里来说，七情、劳欲、饮食，伤于内部的是里证；寒者，属于阴类，或为内寒，或为外寒，寒证多虚；热者，属于阳类，或为内热，或为外热，热证多实。虚者是正气不足，内出的病多不足；实者是邪气有余，外入的病多有余。
又说：病必须由表而入，才称之为表证，如果由内及外，就不是表证了。经书说：从内之外者，调治其内，从外之内者，治治其外，从内之外而盛于外者，先治其内，而后治其外，从外之内而盛于内者，先治其外，而后调治其内，这是内外先后次序不可不知道的。
又说：热在表者，表现为发热头痛，表现为丹肿斑黄，表现为揭去衣被。表现为各种痛疮疡。热在里者，表现为昏闷胀满，表现为烦渴喘结，或者气急叫吼，或者躁扰狂越。热在上者，表现为头痛目赤，表现为喉疮牙痛，表现为各种逆冲上行的症状，表现为喜冷舌黑。热在下者，表现为腰足肿痛，表现为二便秘涩，或者热痛遗精，或者小便浑浊大便赤红。
又说：寒在表者，表现为憎恶寒冷，表现为身体冷，表现为浮肿，表现为容颜青惨；表现为四肢寒厥。寒在里者，表现为冷咽肠鸣，表现为恶心呕吐，表现为心腹疼痛，表现为恶寒喜热。寒在上者，表现为吞酸，表现为膈噎，表现为饮食不化，表现为嗳腐胀哕。寒在下者，表现为清浊不分，表现为溏痛泄泻，表现为阳痿，表现为遗尿，表现为膝寒足冷。
又说：阳脏的人多热，阴脏的人多寒。阳脏的人必定平生喜冷畏热，即使早晚吃冷的，也一无所病，这是其阳有余；阴脏的人，一犯寒凉，则脾肾必伤，这是其阳不足。只是阳强者少，十人中只有二三；阳弱者多，十人中常有五六；然而恃强的人多反而生病，畏弱的人多反而安宁。
又说：假寒误服热药，假热误服寒药等证，只用冷水少量试探。假热的人必定不喜欢水，即使有喜欢的，或者服药后见呕，应当立即用温热药解救；假寒的人，必定多喜欢水，或者服药后反觉舒适而无抵触的，应当立即用寒凉药解救。
又说：现在人患虚证者极多，非补不可。但用补的方法，不宜仓促，想要观察其可补不可补的时机，则全在于先察胸腹是否宽舒，如何？然后逐渐进补，如果还没到病态，再大胆使用，这样才无所阻碍，这是用补的大法。
又说：凡是形势危急，不容稍缓，也必须先问其胸腹宽舒者，才可以骤进补药；如果元气真虚，而胸腹又胀，这是虚不受补的证候，如果强行进补剂，不仅无益，恰恰足以招致非议罢了。
又说：制方用药，气味有阴阳，阴者降，阳者升；阴者静，阳者动；阴者柔，阳者刚；阴者怯，阳者勇；阴主精，阳主气；其于善恶、喜恶，都有妙用。
又说：气味的升降，升者浮而散，降者沉而利，宜升者勿降，宜降者勿升。
又说：气味的刚柔，柔者纯而缓，刚者躁而急；纯者可和，躁者可却；非刚不足以去暴，非柔不足以济刚。
又说：气味的勇怯，勇者，直达病所，可赖出奇；怯者用以周全，籍其平妥。
又说：气味之主气者，有能为精之母；主精者，有能为气之根；或阴中之阳者，能动血中之气；或阳中之阴者，能顾气中之精。
又说：气味有善恶，善者，赋性驯良，尽堪择用；恶者气味残狠，何必近之。
又说：气味有善恶，有素性的喜恶，有一时的喜恶者，相宜取效尤易，恶者见忌，不必强投。
又说：治病用药，本来贵在精专，尤其宜勇敢，凡是久远的病，则应当追究其终始，治疗从缓，这是理所当然的。如果是新暴的病，虚实既得其真，就应当以峻剂直攻其本，拔除很容易，如果逗留畏缩，养成深固之势，则生死系于此，谁的罪过呢？所以凡是真见里实，则以凉膈散、承气汤；真见里虚，则以理中汤、十全大补汤；表虚则用白术、建中汤；表实则用麻黄、柴胡、桂枝之类；只用一味为君，二三味为佐使，大剂进之，多多益善。用多的道理在哪里？在于必定依赖其力，而且料定无害的，就大胆使用，性缓的，可用数两，而性急的也可用数钱。如果三五七分的说法，也不过是点名具数的儿戏而已，解纷治剧之才，举动固然是这样的吗！
又说：治病的法则，应当知道邪正，应当权重轻。凡是治实证，譬如耘禾，禾中生稗草，是禾的贼害，有一株去一株，有两株去两株，是耘田的好手；如果有一株去两株，伤害了一株禾，有两株去四株，伤害了两株禾；如果识别禾不准确，都认为是稗草，而企图全部除去，那么就没有禾了。这是用攻的方法，贵在察得其真，不可过度。凡是治虚证，譬之给军饷，一人一升，十人一斗，每日军饷足够了。如果百人一斗，千人一斛，而三军之众，难道是担石之粮所能养活的呢！一份军饷接不上，将会连同前面的军饷一起抛弃，更何况从中克扣呢！这是用补的方法，贵在轻重有度，难以从简。
又说：虚实的治疗，大抵实证能受寒，虚证能受热，所以补必兼温，泻必兼凉的缘故，大概凉为秋气，阴主杀伐，万物逢之，便无生长，想补元气，所以不适宜，凉尚且不利于补，寒的就更可知了，即使有火盛气虚，宜用凉补的，也不过是因火暂用，火去即止，终究不是治虚的方法。又或者有人用苦寒之物，谓其能补阴的，则《内经》有说：形不足者，温之以气，精不足者，补之以味。夫气味的相合，适宜于人的，称之为补是可以的，没听说过以味苦气劣，而不适宜于人的，也可以称之为补的。虽然《内经》有说：水位之主，其泻以咸，其补以苦等论述，然而这特指五行岁气之味，据理而言罢了。况且他又说：麦、羊肉、杏、薤，都是苦之类，这是苦而补的。哪里像大黄、黄柏之类，气味苦劣，像这样而称其能补，是没有道理的。曾经听王应震说：一点真阳寄坎宫，固根须用味甘温，甘温有益寒无补，堪笑庸医错用功。这一句话概括了它，不可不考察。
又说：补泻的方法，补也是治病，泻也是治病，但应当知道其要点。比如对新暴的病，而少壮者，才可攻之泻之，攻只可用于暂时，未有衰久之病，可屡攻可以无害的，所以攻不可以收缓功延久之病。而虚弱者理应温之补之，补乃可用于常态，未有根本既伤，而舍补可以复元的，所以补不可以求速效。然而仍有其要点，则凡是临证治病，不必论其有虚证，无虚证，只要无实证可据而为病的，应当兼补以调荣卫精血之气；也不必论其有火证无火证，只要无热证可据而为病的，应当兼温以培命门脾胃之气，这是补泻要领，假如不知道这些，没有不到决裂败事的。
又说：治法有逆从，因为寒热有假真，这是《内经》的宗旨。经书说：逆者正治，从者反治。用寒治热，用热治寒，这是正治，正即逆；用热治热，用寒治寒，这是反治，反即从。比如用热药治寒病而寒不去的，是无火，当治命门，用参、姜、桂、附之类，这是王太仆所谓益火之源以消阴翳，这也是正治之法。又如热药治寒病而寒不退，反用寒凉而愈的，这是正假寒的病，用寒从治之法。
又如用寒药治热病而热不除的，是无水，治当在肾，用六味丸之类，这是王太仆所谓壮水之主以镇阳光，这也是正治之法。又有寒药治热病，而热不愈，反用参、姜、桂、附八味丸之属而愈的，这就是假热的病，用热从治之法，也所谓甘温除大热。只是今人之虚者多，实者少，所以真寒假热之病为极多，而真热假寒之病则仅见耳。
又说：探病的方法，不可不知，如当局临证，或虚实有难明，寒热有难辨，病在疑似之间，补泻之意未定的，就应当先用此法。如果疑其为虚，意欲用补而未决，则以轻浅消导之剂，纯用数味，先以探之，消而不投，即知为真虚矣。疑其为实，意欲用攻而未决，则以甘温纯补之剂，轻用数味，先以探之，补而觉滞，即知有实邪也。假寒者，略温之，必见躁烦；假热者，略寒之，必加呕恶，探得其情意自定矣。经书说：有者求之，无者求之。
又说：假者反之，说的就是这个意思。但用探的方法，极宜精简，不可杂乱，精简则真伪立辨，杂乱则是非难凭，这是疑似中的活法，必不得已而用之可也。
华元化说：大凡治疗，脉不紧数，则不要发其汗；脉不实数，不可以下；心胸不闭，尺脉微弱，不可以吐；关节不急，营卫不壅，不可以针；阴气不盛，阳气不衰，
Apply plaster to the ulcerated area. Touch the swollen area with your hand; if it feels hot, there is pus; if not hot, there is no pus.
It is also said: For any injury to the muscles where the sore does not heal, use Liu Jun Zi Tang (Six Gentlemen Decoction) primarily to tonify the Spleen and Stomach; if Qi deficiency causes aversion to cold and the sore does not heal, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to tonify the Spleen and Lungs; if Blood deficiency causes fever and the sore does not heal, use Si Wu Shen (Four Substances Decoction with Ginseng) to nourish the Liver and Spleen; if there is excessive pus and the sore does not heal, use Ba Zhen Tang (Eight Treasures Decoction) or Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) to nourish Blood and tonify Qi. The Classics state: The Spleen governs the muscles. If the aforementioned medicines are ineffective, use Si Jun Gui (Four Gentlemen Decoction with Angelica Sinensis) solely to tonify the Spleen and Stomach; if still ineffective, it indicates deficiency of Yang in the Lower Yuan, use Ba Wei Wan (Eight-Ingredient Pill) to strengthen the Fire of the Gate of Vitality to generate Earth; if the pulse is rapid and there is thirst, it is difficult to treat, as this represents deficiency of True Qi and excess of Pathogenic Factors.
It is also said: Regarding all carbuncles and sores, at the initial stage, the pathogenic toxins have not yet reached the exterior, and the Zang-Fu organs are congested with heat; absolutely no warming herbs should be used. After pus has been discharged, the toxic vapors are excreted externally, Qi and Blood are both deficient, and Stomach Qi naturally weakens; absolutely no cooling herbs should be used. This follows the established methods of the ancients. However, there are cases of Qi and Blood deficiency with Cold, where toxins sink into the Yin aspect at the onset. Without using Yang-Harmonizing and Interior-Supporting methods, how can they rise and reach the exterior? After ulceration, if Yin Blood is dry and depleted, without nourishing Yin and promoting circulation, how can pus production continue? Externally, the sore toxin becomes dry and scorched; internally, there is dry mouth and irritability. Therefore, treatment depends entirely on careful assessment via the pulse. Generally, Qi provides warmth, Blood provides moisture; Qi forms the structure, Blood provides luster. Thus, for various carbuncles and sores that are flat and fail to elevate, it is due to weakness of Yang Qi, unable to expel toxins from the Yin aspect, termed Yin Toxin. If the base is red and diffuse, it is also due to Qi deficiency failing to constrain Blood tightly. If red and vibrant/lustrous, it indicates Qi and Blood constraining toxins to the exterior. If red externally but black internally, toxins are stagnant within. If purple and dull, Qi and Blood are insufficient to transform toxins into pus. Thick pus indicates robust Qi and Blood; thin pus indicates declining Qi and Blood. Before pus appears, there may be excess Heat; after pus appears, treatment must address deficiency. As long as even a fraction of toxic vapors remains, one must not tolerate their retention, lest they spread and cause major disaster, like raising a tiger which will eventually bite. For Qi deficiency failing to expel toxins, warm tonification combined with supporting expulsion is needed; once Yang Qi turns, stagnation in the Yin aspect resolves like melting ice. For Blood deficiency failing to transform toxins, nourishment and suppuration promotion are especially suitable. During the time of ulceration and pus discharge while toxins remain, the function of supporting the interior cannot be delayed for a moment; tolerance allows toxins to linger; clearing/dispersing causes toxins to become frozen/stagnant. Supporting the interior without tonifying Qi and Blood leaves the deficient unable to form pus, like trying to cook rice without grain; nourishing without supporting the interior only harmonizes Qi and Blood but cannot reach the ulcerated site to succeed, and in cases of abundant toxins, it反而 aids them, like feeding grain to bandits. Nourishment without warmth leads to Blood coagulation and Qi stagnation, who then serves as the vessel for pus formation? Like brewing wine without warmth, how can it become liquid? Like cooking rice without fire, how can it become熟? People generally know to treat toxin as Fire and clear Fire to detoxify, but do not realize that toxin is Fire; when toxin transforms, Fire clears; when toxin stagnates, Fire becomes more depressed. However, toxin transformation necessarily goes through pus; pus generation necessarily comes from Qi and Blood; Qi and Blood transformation necessarily comes from Fire. Can Fire be cleared? Moreover, cooling methods are only applicable to minor skin eruptions like sores and boils. If encountering a deep abscess penetrating meridians and collaterals, attacking and supporting may barely suffice; how can one further apply clearing and resolving, thereby damaging Stomach Qi, leading to invigoration of Yang, difficulty in ulceration and healing, and potentially internal attack on Zang-Fu organs? Is this not something to fear! Once toxins are completely removed and flesh regenerates, within the peaceful tonification of Qi and Blood, one may add Jin Yin Hua (Lonicerae Japonicae Flos) and Guo Lao (Licorice Root) to resolve residual toxins. As for Lian Qiao (Forsythiae Fructus) and Hua Fen (Trichosanthis Radix), they can detoxify but damage Stomach Qi and should be strictly prohibited.
Cheng Shanling said: When taking medicine for carbuncles and sores, priority should be given to protecting the Spleen and Stomach. Cooling herbs should be used only when necessary, targeting the disease precisely, and never overdosed. At the onset, if complicated by Wind-Cold, first use Xiong Zhi Xiang Su San (Cyperi Rhizomatis, Chuanxiong, Aucklandiae, and Perilla Leaf Powder) for one dose, or Wan Ling Dan (Ten Thousand Spirits Pill) or Chan Su Wan (Toad Venom Pill) to disperse. After dispersion, if swelling persists, immediately use Yin Hua Gan Cao Tang (Honeysuckle and Licorice Decoction) or Si Miao Tang (Four Marvels Decoction) to harmonize. If swelling is painful, stool is constipated, and internal heat is extreme, cooling herbs must be combined with supporting/expelling agents, primarily Tou Nong San (Pus-Releasing Powder). If pus has drained, priority must be given to supporting and tonifying Yuan Qi, primarily Shen Nei Tuo San (Ginseng Interior-Supporting Powder); if Yuan Qi is deficient and cold, acrid-hot herbs must be added to the supporting/tonifying formula; for Spleen deficiency, Li Zhong Tang (Regulate the Middle Decoction) or Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder); for Qi deficiency sinking downward, Bu Zhong Yi Qi Tang; for Stomach Meridian Cold with food stagnation, Huo Xiang Zheng Qi San (Agastache and Magnolia Bark Powder); for dual Qi and Blood deficiency, Shi Quan Da Bu Tang plus Fu Zi (Aconite Root) and Lu Rong (Deer Antler Velvet); occasionally, deficiency with Heat occurs, in which case remove Fu Zi and Rou Gui (Cinnamon Bark), add Mai Dong (Ophiopogonis Radix), Jin Yin Hua, and Mu Dan Pi (Moutan Cortex) to conclude treatment; these points must be known. Generally, there are Yang Toxin and Half-Yin Half-Yang types, which must be carefully distinguished. Yang Toxin symptoms: sore is red and swollen, tip is elevated, base is compact, appetite is normal, thirst with constipation, five-palm heat, pulse is surging and rapid. Yin Toxin symptoms: sore is gray-white and flat, numb with little pain, base is spreading, poor appetite with loose stools, cold extremities, cold breath from mouth/nose, pulse is deep and slow. Half-Yin Half-Yang symptoms: sore is red and swollen but not highly elevated, appetite slightly reduced, stool not constipated, alternating chills and fever, slight thirst preferring hot drinks, pulse is deficient and soft. These three must be carefully distinguished so that medication is appropriately cold or warm, constituting legal treatment. Treat Yang Toxin with cooling and detoxification; treat Yin Toxin with warming the middle and restoring Yang; treat Half-Yin Half-Yang with methods that clear without damaging the Stomach and warm without aiding pathogens, and nothing more. (From "Ten Methods")
Hu Gongbi said: Carbuncles and sores most strongly contraindicate sweating, fearing that exterior deficiency prevents pus formation, making later treatment difficult. (From "Wu Kui Qing Nang")
It is also said: For unexpelled foul pus, use Bai Zhi (Angelicae Dahuricae Radix); do not use Bai Zhu (Atractylodis Macrocephalae Rhizoma), as Bai Zhu promotes toxin transformation and pus generation.
The Classics state: Without Yang, Yin cannot be generated; without Yin, Yang cannot be transformed.
Zhang Jingyue said: Yin roots in Yang, Yang roots in Yin. For diseases that cannot be treated conventionally, one should guide Yin from Yang, and guide Yang from Yin, seeking their respective affiliations to reduce them. For example, seeking sweat from Blood, generating Qi from Essence, this is guiding Yin from Yang; again, guiding Fire back to its source, gathering Qi into the Kidney, this is guiding Yang from Yin; this is the meaning of extracting Fire from Water and Water from Fire.
It is also said: Yin diseases come slowly and leave slowly; Yang diseases come quickly and leave quickly. Yang is born from Heat, Heat is relaxing; Yin is born from Cold, Cold is contracting and tense.
It is also said: Cold pathogens strike the lower part; Heat pathogens strike the upper part; dietary pathogens strike the middle.
It is also said: Examining the *Zhong Zang Jing*, it says: Yang diseases are quiet in the morning, Yin diseases are calm at night; Yang deficiency causes confusion in the evening, Yin deficiency causes contention in the morning. Generally, Yang deficiency favors Yang assistance, so symptoms are lighter in the morning and heavier in the evening; Yin deficiency favors Yin movement, so symptoms are heavier in the morning and lighter in the evening. This refers to deficiency of Yin and Yang. If presenting with excess pathogens, the opposite holds: Yang excess is heavy in the morning and light in the evening; Yin excess is light in the morning and heavy in the evening. This is Yang meeting Yang becoming prosperous, Yin obtaining Yin becoming strong. Cases occurring day or night, intermittently, arise because Righteous Qi cannot maintain control, causing Yin and Yang victory and defeat to intermingle chaotically. Treatment should focus on cultivating Righteous Qi, after which Yin and Yang will naturally harmonize. However, whether dealing with Water or Fire, one must seek based on deficiency or excess.
It is also said: Diseases have six transformations: Exterior/Interior, Cold/Heat, Deficiency/Excess. These are the keys to medicine; understanding these six makes all diseases clear as palm lines. From the Exterior perspective, Wind, Cold, Summerheat, Dampness, Fire, Dryness affecting the outside are Exterior syndromes; from the Interior perspective, Seven Emotions, Labor/Desire, Diet injuring the inside are Interior syndromes. Cold belongs to Yin, either Internal Cold or External Cold, Cold syndromes are mostly Deficient; Heat belongs to Yang, either Internal Heat or External Heat, Heat syndromes are mostly Excess. Deficiency is insufficiency of Righteous Qi, diseases arising internally are mostly deficient; Excess is surplus of Pathogenic Factors, diseases entering externally are mostly excess.
It is also said: A disease must enter from the Exterior to be called an Exterior syndrome; if it arises from the Interior and manifests outwardly, it is not an Exterior syndrome. The Classics state: From Interior to Exterior, regulate the Interior; from Exterior to Interior, treat the Exterior; from Interior to Exterior becoming severe externally, first treat the Interior, then the Exterior; from Exterior to Interior becoming severe internally, first treat the Exterior, then regulate the Interior. This sequence of Interior/Exterior treatment must be understood.
It is also said: Heat in the Exterior presents as fever and headache, erysipelas/swelling/rashes/yellowing, removing clothes/bedding, and various painful sores. Heat in the Interior presents as dizziness/distension/fullness, irritability/thirst/panting/constraint, or急促 breathing/shouting, or restlessness/manic behavior. Heat in the Upper presents as headache/red eyes, throat sores/toothache, various rebellious upward movements, preference for cold/black tongue. Heat in the Lower presents as waist/foot swelling/pain, urinary/fecal retention, or painful nocturnal emission, turbid urine/red stool.
It is also said: Cold in the Exterior presents as aversion to cold, cold body, edema, blue/gloomy complexion, and cold paralysis of limbs. Cold in the Interior presents as cold throat/bowel sounds, nausea/vomiting, heart/abdominal pain, aversion to cold/preference for warmth. Cold in the Upper presents as acid regurgitation, dysphagia, undigested food, belching/rotten smell/distension/hiccups. Cold in the Lower presents as indistinct clear/turbid separation, loose/painful diarrhea, impotence, enuresis, cold knees/cold feet.
It is also said: The pulse of True Cold is definitely slow, weak, and spiritless; the pulse of True Heat is definitely slippery, full, and forceful.
It is also said: Persons with Yang Constitution tend toward Heat; persons with Yin Constitution tend toward Cold. Yang Constitution persons invariably prefer cold and fear heat in life; eating cold morning and night causes no illness, indicating Yang excess. Yin Constitution persons, upon exposure to cold/cool, inevitably injure Spleen and Kidney, indicating Yang insufficiency. Only few are Yang-strong (2-3 in 10); many are Yang-weak (5-6 in 10). However, those relying on strength often fall ill; those fearing weakness often remain healthy.
It is also said: For False Cold misusing Hot Medicine, or False Heat misusing Cold Medicine, test with a small amount of cold water. False Heat patients will dislike water; even if some like it, vomiting may occur after ingestion, requiring immediate resolution with Warm-Hot medicine. False Cold patients will likely like water; if ingestion brings comfort without resistance, resolve with Cold-Cool medicine.
It is also said: Many people today suffer from Deficiency syndromes requiring tonification. However, tonification methods should not be hasty. To observe the opportunity for tonification, first examine if the chest and abdomen are comfortable/open. Then advance gradually. If not yet pathological, boldly use it later, ensuring no obstruction. This is the great method of tonification.
It is also said: In critical situations allowing no delay, one must first ask if the chest/abdomen are open before sudden advancement; if Yuan Qi is truly deficient but chest/abdomen are distended, this is a sign of "Deficiency unable to accept tonification." Forcing tonifying agents is not only useless but invites criticism.
It is also said: In prescribing and medicating, flavors and aromas have Yin/Yang. Yin descends, Yang ascends; Yin is static, Yang is active; Yin is soft, Yang is rigid; Yin is timid, Yang is brave; Yin governs Essence, Yang governs Qi. Their good/bad nature and preferences have subtle applications.
It is also said: Regarding ascending/descending of flavors/aromas, ascending ones float and disperse, descending ones sink and promote flow. Those suited for ascending should not descend; those suited for descending should not ascend.
It is also said: Regarding moving/staying of flavors/aromas, staying ones anchor, moving ones travel. Traveling ones can move, anchoring ones can stabilize.
It is also said: Regarding rigid/soft flavors/aromas, soft ones are pure and slow, rigid ones are restless and urgent. Pure ones can harmonize, restless ones can repel. Without rigidity, violent pathogens cannot be removed; without softness, rigidity cannot be assisted.
It is also said: Regarding brave/timid flavors/aromas, Brave ones reach the disease site directly, relying on surprise tactics; Timid ones ensure周全, relying on stability.
It is also said: Flavors/aromas governing Qi can be the mother of Essence; those governing Essence can be the root of Qi. Yin-within-Yang can move Qi within Blood; Yang-within-Yin can protect Essence within Qi.
It is also said: Flavors/aromas have good/bad qualities. Good ones have gentle natures, fully selectable for use. Bad ones have cruel flavors/aromas, why approach them?
It is also said: Flavors/aromas have good/bad qualities, inherent preferences, and temporary preferences. Compatibility yields easy effects; bad ones are avoided, no need to force administration.
It is also said: Treating diseases with medication values precision and specialization, and bravery. For chronic diseases, trace the beginning and end, treating slowly is appropriate. For acute diseases, once true Deficiency/Excess is identified, use potent formulas to attack the root directly; extraction is easy. Delaying or shrinking back creates entrenched patterns, determining life or death. Who bears the blame? Thus, for true Interior Excess, use Liang Ge San (Cool the Chest Powder) or Cheng Qi Tang (Order the Qi Decoction); for true Interior Deficiency, use Li Zhong Tang or Shi Quan Da Bu Tang; for Exterior Deficiency, use Bai Zhu and Jian Zhong Tang; for Exterior Excess, use Ma Huang, Chai Hu, Gui Zhi, etc. Use one herb as Sovereign, two or three as Ministers/Assistants, administer large doses, more is better. Where lies the principle of using large amounts? It relies on their power and safety. For mild-natured herbs, use several taels; for urgent-natured herbs, use several qian. The theory of 3-5-7 fen is merely child's play of counting names. A talent for resolving chaos and treating severe conditions acts thus!
It is also said: The principle of treatment requires knowing Evil vs. Righteous, weighing importance. Treating Excess is like weeding rice fields; barnyard grass is the thief of rice. Remove one weed for one plant, two weeds for two plants; this is good weeding. Removing two weeds damages one plant; removing four weeds damages two plants. If misidentifying rice as weeds and attempting total eradication, no rice remains. Using attacking methods requires accurate identification and avoiding excess. Treating Deficiency is like supplying rations: one person gets one sheng, ten get one dou; daily rations suffice. Giving one dou to a hundred, one hu to a thousand—can stone-carrying rations feed an army? If one ration fails, previous rations are abandoned, let alone deductions. Using tonifying methods requires measured weight/importance, not simplicity.
It is also said: In treating Deficiency/Excess, generally Excess can tolerate Cold, Deficiency can tolerate Heat. Hence, tonification must include Warmth, purgation must include Cooling. Cooling is Autumn Qi, Yin governs killing; all things meeting it cease growth. To tonify Yuan Qi, Cooling is unsuitable; if Cooling is unfavorable for tonification, Cold is even worse. Even for Fire-excess with Qi-deficiency requiring Cool tonification, it is only temporary for Fire; once Fire is gone, stop. It is ultimately not a method for treating Deficiency. Some claim Bitter-Cold substances tonify Yin; however, *Nei Jing* states: For bodily insufficiency, warm with Qi; for Essence insufficiency, tonify with Flavor. Harmonious flavors/aromas suitable for humans are called tonification. Never heard of bitter-flavored, inferior-aroma substances unsuitable for humans being called tonification. Although *Nei Jing* mentions: For Water element ruler, purge with Salty, tonify with Bitter, this specifically refers to Five Elements seasonal Qi flavors, discussed theoretically. Furthermore, Wheat, Mutton, Apricot, Leek are all Bitter categories, representing Bitter tonification. How can Da Huang (Rhei Radix et Rhizoma) or Huang Bo (Phellodendri Cortex), with bitter-flavored inferior aromas, be called tonifying? This is illogical. Wang Yingzhen said: A point of True Yang resides in Kan Palace; strengthening the root requires Sweet-Warm. Sweet-Warm benefits, Cold does not tonify; laugh at mediocre doctors wasting effort. This summarizes it; one must investigate.
It is also said: Tonification and Purging are both treatments, but one must know the key. For acute diseases in young/strong individuals, attacking/purging is acceptable. Attack is for temporary use; chronic debilitation cannot be cured by repeated attacks without harm; thus, attack cannot achieve slow recovery for prolonged illness. Weak individuals should be warmed and tonified; tonification is for constant use. Once the root is damaged, abandoning tonification prevents recovery; thus, tonification cannot seek rapid effect. However, there is a key: In clinical practice, regardless of Deficiency/Non-Deficiency syndromes, if no Excess evidence exists, combine tonification to harmonize Ying-Wei, Jing-Blood Qi. Regardless of Fire/Non-Fire syndromes, if no Heat evidence exists, combine Warming to cultivate Mingmen and Spleen/Stomach Qi. This is the essence of tonification/purging. Ignoring this leads to disaster.
It is also said: Treatment methods have Reversal (Ni) and Following (Cong), due to Fake/True Cold/Heat, the essence of *Nei Jing*. Classics state: Reversal is Standard Treatment (Zheng Zhi); Following is Counter-Treatment (Fan Zhi). Treating Heat with Cold, Cold with Heat is Standard Treatment (Reversal); Treating Heat with Heat, Cold with Cold is Counter-Treatment (Following). E.g., using Hot medicine for Cold disease without relief indicates No Fire; treat Mingmen with Ren Shen, Sheng Jiang, Gui Zhi, Fu Zi. This is Wang Tai Pu’s "Enrich the Source of Fire to eliminate Yin Shadows," also Standard Treatment. If Hot medicine for Cold disease fails, but Cold medicine succeeds, this is Fake Cold, using Cold Following Method. If Cold medicine for Heat disease fails, treat Kidneys with Liu Wei Wan (Six-Ingredient Pill with Rehmannia). This is Wang Tai Pu’s "Strengthen the Master of Water to suppress Solar Flare," also Standard Treatment. If Cold medicine for Heat disease fails, but Ren Shen, Sheng Jiang, Gui Zhi, Fu Zi Ba Wei Wan succeeds, this is Fake Heat, using Heat Following Method, also "Sweet-Warm removes Great Heat." Today, Deficiency is common, Excess rare; thus, True Cold/Fake Heat is very common, True Heat/Fake Cold is rare.
It is also said: Probing disease methods must be known. In clinical practice, if Deficiency/Excess is unclear, Cold/Heat hard to distinguish, disease is ambiguous, and tonification/purgation intent is undecided, use this method first. Suspecting Deficiency, intending tonification but undecided, use mild/digestive agents with few herbs to probe. If digestion fails, it is True Deficiency. Suspecting Excess, intending attack but undecided, use mild Sweet-Warm pure tonification with few herbs to probe. If tonification causes stagnation, there is Excess Pathogen. For Fake Cold, slight warming reveals irritability; for Fake Heat, slight cooling reveals nausea/vomiting. Probing determines intent. Classics state: Seek what exists, seek what does not exist.
It is also said: Fake is opposite, this is the meaning. Probing methods must be concise, not mixed. Concise distinguishes true/false clearly; mixed makes right/wrong hard to judge. This is a flexible method for ambiguity, used only when necessary.
Hua Yuanhua said: Generally in treatment, if pulse is not tight/rapid, do not induce sweating; if pulse is not full/rapid, do not purge; if chest/mind not closed, Chi pulse weak, do not vomit; if joints not stiff, Ying-Wei not congested, do not needle; if Yin Qi not excessive, Yang Qi not declining,