论治实邪
天师曰∶实病亦不同，亦甚多，今亦举其一二。如人终岁终年，不畏劳役，不辞辛苦，寒凉之品，
可以多餐，辛热
之味，不能上口者是也。至于邪气之入，不可同观。吾言实病之多，皆邪气之多也。人实者少而虚者
多。邪气之入，别有治法，不可混入于此门。倘人有强壮之容颜，过于热甚，欲求方者与之。方用陈皮
一钱，神曲一钱，麦芽一钱，黄芩一钱，浓朴一钱，天花粉一钱，甘草五分，芍药二钱，山楂十粒，枳
壳五分，当归二钱，茯苓一钱，水煎服。此等方，止可备用，以治有余之人，不可据之以概治天下之人
也。盖实者，一百中一二人，而虚者遍天下。天地之气，何能过浓。况培植者少，而琢削者多乎。今定此
方，亦定一门之治法，非教医者，执此以消导之耳。
张公曰∶仁心仁术，于此方并见。实病甚少，天师言多者，乃言邪气之实，非言正气之实也。邪气
之实，伤寒门最多。天师言有专门者，说有伤寒之书也，倘人病邪气之实。幸于伤寒门查而治之，无差毫
发。伤寒书卷繁多，兹不能备载耳。
华君曰∶予未传。
论吐血衄血 目肿 口舌生疮
天师曰∶寒治者，乃火盛而正折之也。如人病目痛，口舌生疮，鼻中出血，口中吐血是也。此等之
症，乃火气郁勃于上焦，不能分散，故重则上冲，而为吐血衄血，轻者目痛而口舌生疮也，法当用寒凉之
品，以清其火热燎原之势，并泻其炎上巅顶之威。方用生地一两，当归一两，川芎五钱，元参五钱，黄
芩三钱，三七根末三钱，甘草一钱，荆芥炒一钱，水煎服。此方妙在不纯用寒凉以逐火，而反用微寒
之药
以滋阴，盖阴气生则阳气自然下降。尤妙用荆芥引血归经，用三七末以上截其新来之路，又加黄芩以
少清其奔腾之势，诚恐过于寒凉，恐冷热相战，又加甘草以和之，此治热之最巧、最妙法也。若竟用寒
凉折之，非不取快一时。然火降而水不足，则火无所归，仍然焰生风起，必较前更胜，而始以清补之药
救之，则胃气已虚，何能胜任，予所以乘其初起，即用之为妙也。
目肿而痛，亦是火症，然必看其眵多泪多，红肿而痛，如有物针触二般。用柴胡三钱，甘草一钱，
炒栀子三钱，半夏一钱，白蒺藜三钱，水煎服。此方之妙，全在直散肝胆之郁火，火散则热自退。不攻之
攻胜于攻，不下之下胜于下也。一剂即可奏功，正不必再服。
口舌生疮，又不可如是治之。乃心火郁热，而舌乃心苗，故先见症。法用黄连二钱，菖蒲一钱，
水煎服。一剂而愈，神方也。此方不奇在黄连，而奇在菖蒲。菖蒲引心经之药，黄连虽亦入心经，然未免
肝脾亦入，未若菖蒲之单入心也。况不杂之以各经之品，孤军深入，又何疑哉，此所以奏功如响也。倘不
知用药神机，轻混之以肝脾之药，虽亦奏功，终不能捷如桴鼓，此治热之又一法也。
张公曰∶寒治之法，世人最多，予皆不取。今天师之法，不容予不首折也。用寒而又远寒，用散而
又远散，真奇与巧并行，而攻与补兼用也，予又何必多言哉。无已，则更有一方。在治火初起之时，尚未
现于头目口舌之际，亦可化有为无。方用柴胡二钱，白芍三钱，甘草一钱，炒栀子三钱，半夏一钱，羌活五
分，茯苓三钱，水煎服。一剂可以散火。方名先解汤。乘外症之不见，而先解之。亦争上流法，医者宜
留意焉。
华君曰∶亦无有传我。
孙真人曰∶予有吐血方传子。生地汁一碗，无鲜生地处，用干者一两，煎汤半碗，调三七根末三钱，
炮姜灰末五分，服一剂即止，吐血神效，衄血亦可治，妙。
论治实邪
天师说：实证疾病也不尽相同，种类很多，现在仅列举其中一两种。例如有人整年整月，不怕劳累，不辞辛苦，能够多吃寒凉性质的食物，却吃不下辛热性质的食物，这就是实证的表现。至于外邪侵入人体，不能一概而论。我所说的实证之多，实际上是指邪气之盛。人体真正属于正气充实的很少，而虚损的很多。邪气入侵，有专门的治疗法则，不能混入此门讨论。如果见到一个人面色强壮红润，体内热势极盛，前来求方的人，给他这个方子。方用陈皮一钱，神曲一钱，麦芽一钱，黄芩一钱，厚朴一钱，天花粉一钱，甘草五分，芍药二钱，山楂十粒，枳壳五分，当归二钱，茯苓一钱，水煎服。这样的方子，只可作为备用，用来治疗那些体质有余（实证）的人，不能依据它来治理天下所有人。因为实证者，一百人中只有一二人，而虚证者遍布天下。天地之气，怎么能过于浓厚呢？况且精心培育的人少，而雕琢损伤的人多啊。制定这个方子，也是确立一门治疗法则，并非教导医者死守此方来进行消食导滞。
张公说：仁心仁术，在这个方子里都体现了。实证很少，天师说“多”，是指邪气的实，而非正气的实。邪气之实，在伤寒门中最多。天师说有专门的书，是指有论述伤寒的书籍，如果有人病邪气之实，幸亏可以在伤寒门中查阅并治疗，不会差之毫厘。伤寒类的书籍卷帙浩繁，这里不能全部记载罢了。
华君说：我没有传承这个方子。
天师说：寒治法，就是用寒凉药物来遏制旺盛的火邪。比如人患眼痛，口舌生疮，鼻中出血，口中吐血等症。这些症状，是由于火气郁结勃发于上焦，不能疏散，所以严重的向上冲逆，导致吐血和衄血；轻度的则表现为眼痛和口舌生疮。治疗方法应当使用寒凉性质的药物，以清除火热燎原的势头，并泻去炎上至头顶的威力。方用生地一两，当归一两，川芎五钱，玄参五钱，黄芩三钱，三七根末三钱，甘草一钱，荆芥炒制一钱，水煎服。这个方子的妙处在于不单纯使用寒凉药物来驱逐火邪，反而使用微寒的药物来滋阴，因为阴气生成，阳气自然下降。尤其妙在用荆芥引导血液回归经脉，用三七末在上面截断新来的血路，又加黄芩来稍微清泄奔腾的势头，实在担心过于寒凉，导致冷热相争，所以又加甘草来调和，这是治疗热证最巧妙、最精妙的办法。如果竟然只用寒凉药物来折抑火邪，虽然能取快一时，但是火降之后若水液不足，火就没有归宿，仍然会焰起风生，必定比之前更厉害，等到开始用清补药物来救治时，胃气已经虚弱，哪里还能胜任呢？所以我主张趁病情初起时就使用此方，这才是妙处所在。
眼睛肿胀且疼痛，也是火证，但必须看其眼屎多、泪水多，红肿且痛，好像有东西针刺触碰一般。用柴胡三钱，甘草一钱，炒栀子三钱，半夏一钱，白蒺藜三钱，水煎服。这个方子的妙处，全在于直接疏散肝胆的郁火，火散则热自退。这种不直接攻伐的攻法胜过直接攻伐，不直接下法的下法胜过直接下法。服用一剂即可见效，正不必再服。
口舌生疮，又不应该像上面那样治疗。这是由于心火郁热，而舌是心的苗窍，所以先出现症状。治疗方法用黄连二钱，石菖蒲一钱，水煎服。一剂就能痊愈，是神效方。这个方子奇妙之处不在黄连，而在石菖蒲。石菖蒲是引药入心经的，黄连虽然也入心经，但未免也会入肝脾经，不如石菖蒲单入心经。况且不混杂其他各经的药物，让石菖蒲孤军深入，又有什么可怀疑的呢？这就是为什么疗效如回声般迅速的原因。如果不知道用药的神机妙算，轻易混杂肝脾经的药物，虽然也能奏效，终究不能像敲鼓后槌落声即响那样快捷，这是治疗热证的另一种方法。
张公说：寒治的方法，世人用得最多，我都不采纳。今天天师的这种方法，不容我不首先折服。使用寒凉却又远离寒凉的弊端，使用发散却又远离发散的弊端，真是奇巧并行，攻补兼用，我又何必多言呢？如果没有别的，那就再提供一个方子。在治疗火邪初起之时，尚未表现在头目口舌部位，也可以化有为无。方用柴胡二钱，白芍三钱，甘草一钱，炒栀子三钱，半夏一钱，羌活五分，茯苓三钱，水煎服。一剂可以散火。方名叫先解汤。趁着外在症状还没有显现，就先将其解除。这也是争夺上流（先机）的方法，医者应当留意。
华君说：也没有传给我。
孙真人说：我有治疗吐血的方子传给子孙。生地汁一碗，如果没有新鲜的生地，就用干生地一两，煎汤半碗，调服三七根末三钱，炮姜灰末五分，服用一剂即可止血，对吐血神效，衄血也可以治疗，很奇妙。
On Treating Excess Pathogens
The Heavenly Master said: Excess diseases are not all the same and there are many types; I will now mention only one or two. For instance, some people endure labor and hardship throughout the year without fear, can consume large amounts of cold-natured foods, but cannot tolerate pungent and hot-flavored foods. This is an example of excess syndrome. However, the invasion of pathogenic factors should not be viewed uniformly. When I speak of the abundance of excess diseases, I am referring to the abundance of pathogenic factors. Few people have true excess (of healthy Qi), while many are deficient. The treatment for the invasion of pathogens has its own specific methods and should not be mixed into this category. If a person appears robust and radiant, with extreme internal heat, seeking a prescription, give them this formula: Chenpi (Tangerine Peel) 1 qian, Shenqu (Medicated Leaven) 1 qian, Maiya (Sprouted Barley) 1 qian, Huangqin (Scutellaria Root) 1 qian, Houpo (Magnolia Bark) 1 qian, Tianhuafen (Trichosanthes Root) 1 qian, Gancao (Licorice Root) 5 fen, Shaoyao (Peony Root) 2 qian, Shanzha (Hawthorn Fruit) 10 seeds, Zhike (Aurantium Fruit) 5 fen, Danggui (Angelica Sinensis) 2 qian, Fuling (Poria) 1 qian. Decoct in water and take orally. Such formulas are only for backup use, to treat those with surplus constitution (excess syndrome), and should not be used to govern the treatment of everyone in the world. After all, among every hundred people, only one or two have excess syndrome, while deficiency is widespread. How can the Qi of Heaven and Earth be overly dense? Moreover, few are nurtured, while many are depleted. This formula is established merely to define a therapeutic approach for this category, not to teach physicians to rigidly apply it for digestion and guiding out stagnation.
Lord Zhang said: Benevolence and skill are both evident in this formula. Excess syndromes are rare; when the Heavenly Master says "many," he refers to the excess of pathogens, not the excess of healthy Qi. The excess of pathogens is most common in the Shanghan (Cold Damage) category. When the Heavenly Master mentions specialized books, he refers to texts on Shanghan. If a patient suffers from excess pathogens, fortunately, they can be treated by consulting the Shanghan section, ensuring no deviation. Books on Shanghan are voluminous and cannot be fully recorded here.
Lord Hua said: I did not inherit this.
On Hematemesis, Epistaxis, Eye Swelling, and Mouth/Tongue Ulcers
The Heavenly Master said: The Cold Treatment method involves using cold-natured herbs to suppress flourishing fire. For example, patients suffering from eye pain, mouth and tongue ulcers, epistaxis (nosebleed), or hematemesis (vomiting blood). These symptoms arise because fire Qi is stagnant and vigorous in the Upper Jiao (Upper Burner), unable to disperse. Severe cases surge upward, causing hematemesis and epistaxis; mild cases present as eye pain and mouth/tongue ulcers. The method should employ cold-natured substances to clear the blazing momentum of the fire and drain its inflammatory power rising to the vertex. Use Dihuang (Rehmannia Root) 1 liang, Danggui (Angelica Sinensis) 1 liang, Chuanxiong (Ligusticum Rhizome) 5 qian, Xuanshen (Scrophularia Root) 5 qian, Huangqin (Scutellaria Root) 3 qian, Sanqi (Notoginseng Root) powder 3 qian, Gancao (Licorice Root) 1 qian, Jingjie (Schizonepeta Spike) stir-fried 1 qian. Decoct in water and take orally. The brilliance of this formula lies not in purely using cold herbs to drive away fire, but in using slightly cold herbs to nourish Yin. When Yin Qi generates, Yang Qi naturally descends. It is particularly ingenious to use Jingjie (Schizonepeta Spike) to guide blood back to its vessels, use Sanqi (Notoginseng Root) powder to intercept new bleeding pathways above, and add Huangqin (Scutellaria Root) to slightly clear the surging momentum. One must fear that excessive coldness might cause a clash between cold and heat, so Gancao (Licorice Root) is added to harmonize. This is the most clever and exquisite method for treating heat. If one were to simply use cold herbs to suppress the fire, although it might bring temporary relief, once the fire subsides but water/Yin is insufficient, the fire will have no place to reside, still generating flames and wind, likely becoming worse than before. By the time clearing and tonifying herbs are used to rescue the situation, the Stomach Qi would already be deficient and unable to cope. Therefore, using this at the onset is the key.
Eye swelling and pain are also fire syndromes, but one must observe if there is much discharge and tearing, with redness, swelling, and pain as if pricked by objects. Use Chaihu (Bupleurum Root) 3 qian, Gancao (Licorice Root) 1 qian, Zhizi (Gardenia Fruit) stir-fried 3 qian, Banxia (Pinellia Tuber) 1 qian, Bijieli (Tribulus Fruit) 3 qian. Decoct in water and take orally. The妙处 (brilliance) of this formula lies entirely in directly dispersing the stagnant fire of the Liver and Gallbladder. When the fire disperses, the heat retreats naturally. This indirect attack surpasses direct attack, and indirect purgation surpasses direct purgation. One dose is sufficient for efficacy; further doses are unnecessary.
Mouth and tongue ulcers should not be treated thus. They result from stagnant heat in the Heart Fire, and since the tongue is the sprout of the Heart, symptoms appear there first. The method uses Huanglian (Coptis Rhizome) 2 qian, Shichangpu (Acorus Rhizome) 1 qian. Decoct in water and take orally. One dose cures it; it is a miraculous formula. Its wonder lies not in Huanglian (Coptis Rhizome), but in Shichangpu (Acorus Rhizome). Shichangpu (Acorus Rhizome) guides medicine into the Heart Meridian. Although Huanglian (Coptis Rhizome) also enters the Heart Meridian, it inevitably affects the Liver and Spleen meridians as well, unlike Shichangpu (Acorus Rhizome) which enters only the Heart. Furthermore, by not mixing it with herbs for other meridians, it advances alone into the heart of the disease, leaving no room for doubt. This is why its effect is as immediate as an echo. If one does not understand the divine mechanism of herb selection and lightly mixes in Liver and Spleen herbs, although it may work, it will never be as swift as a drumstick striking a drum. This is another method for treating heat.
Lord Zhang said: The Cold Treatment method is widely used by people, but I do not adopt it. Today, the Heavenly Master's method compels my admiration. Using cold yet avoiding the pitfalls of cold, using dispersion yet avoiding the pitfalls of dispersion, truly combining ingenuity with effectiveness, and integrating attacking and tonifying methods. What more need I say? If pressed, here is another formula. Used when fire pathogens are just beginning, before manifesting in the head, eyes, mouth, or tongue, it can transform existence into non-existence. Use Chaihu (Bupleurum Root) 2 qian, Baishao (White Peony Root) 3 qian, Gancao (Licorice Root) 1 qian, Zhizi (Gardenia Fruit) stir-fried 3 qian, Banxia (Pinellia Tuber) 1 qian, Qianghuo (Notopterygium Rhizome) 5 fen, Fuling (Poria) 3 qian. Decoct in water and take orally. One dose disperses the fire. The formula is named Xianjie Tang (First-Resolution Decoction). It resolves the issue before external symptoms appear. This is also a strategy to seize the initiative; physicians should pay attention.
Lord Hua said: He did not transmit this to me either.
Sun Simiao said: I have a formula for hematemesis passed down to my descendants. Dihuang juice (Rehmannia Juice) one bowl. If fresh Dihuang (Rehmannia Root) is unavailable, use dried Dihuang (Rehmannia Root) 1 liang, decoct until half a bowl remains, then mix with Sanqi (Notoginseng Root) powder 3 qian and Paoliuhui (Charred Ginger) powder 5 fen. Take one dose to stop bleeding immediately. It is highly effective for hematemesis and can also treat epistaxis. Marvelous.