《伤寒论》辨可汗云，凡云可发汗而无汤者，丸散亦可用，要以汗出为解，然不如汤随
症良
；辨可下云，凡服下药，用汤胜丸散。考仲景书，汗方除桂枝、麻黄等汤外，别无发汗之丸
散。今此云云，可见古方汤液丸散，随宜酌之，不似后世异法者必异方也。仲景于此起，例
如理中丸及汤、半夏散及汤、抵当丸及汤、蜘蛛散及丸，其最着者也。而于病后喜唾，用理
中丸；胸痹，用人参汤；于小腹硬满，小便利如狂者，用抵当汤；于但小腹满，小便利者，
用抵当丸∶非随症异法之证乎？他如太阳篇云∶伤寒十三日不解，过经谵语者，以有热也，
当以汤下之；若小便利者，大盒饭硬，而反下利，脉调和者，知医以丸药下之，非其治也
；
若自下利者，脉当微厥，今反和者，此为内实也，调胃承气汤主之。丸谓调胃承气丸也。此
症宜汤下不宜丸，故辨之尤明。且也仲景有麻黄汤，而《深师》直作麻黄散；仲景有干姜附
子
汤，而《肘后》变为姜附丸；仲景有枳术汤，而张洁古变为枳术丸。吾湖郡志所载，有以小
柴胡散治病不效，且作汤即效者，皆足证余说也。
仲景之《伤寒论》、《金匮要略》二书，古总为《伤寒杂病论》（杂或为卒，卒即杂之
剥文
，勿作伤寒为仓卒之病解），《外台》总称为《伤寒论》（详泉《金匮方论注·序注》），是
所谓《伤寒杂病论》者，为伤寒中之杂病说，非为一切杂病说（下另有论）。徒恃此书不足与
治杂病，则《千金》尚焉。孙氏亦推本仲景，而其论症之精详，用药之变化，杂法之明备，
数倍于仲景书。非仲景之贤不及孙氏也，仲景既以寒字目其书，自专于寒科尽其变，其他病
因，例不羼入。若《千金》统论百病，凡风雨寒暑、饮食居处、阴阳喜怒，诸因随病聚。则
二家命意不同，故其书详略亦异。读者能各得所宗，则伤寒、杂病两擅其长。自墨守者以《
金匮》为治一切杂病之宗，而《千金》遂斥为僻书，无惑乎学术隘而治法阙矣！
《伤寒论》在辨析可以使用发汗法时指出，凡是提到可以发汗但没有具体方剂的，也可以使用丸剂或散剂，关键在于以出汗作为病愈的标志，然而效果不如汤剂根据症状灵活调整那样好；在辨析可以使用泻下法时指出，凡是服用泻下药，使用汤剂优于丸剂和散剂。考察张仲景的著作，发汗的方剂除了桂枝汤、麻黄汤等汤剂外，并没有其他的发汗丸剂或散剂。现在这里说这样的话，可以看出古代的方剂中，汤液、丸剂、散剂都是根据情况酌情使用的，不像后世认为不同的治法必须对应不同的方剂那样僵化。张仲景在此列举的例子中，如理中丸及理中汤、半夏散及半夏汤、抵当丸及抵当汤、蜘蛛散及蜘蛛丸，是最为著名的。而在病后喜欢吐唾沫的情况下，使用理中丸；胸痹证，使用人参汤；在小腹部硬满、小便通畅且神志如狂的情况下，使用抵当汤；如果只是小腹胀满、小便通畅的情况，使用抵当丸：这难道不是随着症状不同而采用不同治法的证明吗？其他如《太阳篇》中说：伤寒十三天没有解除，经过传经出现谵语的，是因为有热，应当用汤剂来泻下；如果小便通畅，大便应该干硬，反而出现腹泻，脉象调和的，知道是医生用了丸药来泻下，这不是正确的治法；如果是自己腹泻，脉象应当微弱四肢厥冷，现在反而平和，这是体内有实邪，用调胃承气汤主治。这里的“丸”指的是调胃承气丸。这个病症适宜用汤剂泻下而不适宜用丸剂，所以辨析得特别明确。况且张仲景有麻黄汤，而《深师方》直接作麻黄散；张仲景有干姜附子汤，而《肘后备急方》变为姜附丸；张仲景有枳术汤，而张洁古变为枳术丸。我们湖州郡志记载，有用小柴胡散治病无效的，改为汤剂就见效了，这些都足以证明我的说法。
张仲景的《伤寒论》、《金匮要略》两本书，古代总称为《伤寒杂病论》（“杂”字可能是“卒”字的剥落误写，“卒”即“杂”的古字，不要解释为伤寒是仓促发生的病），《外台秘要》总称为《伤寒论》（详见泉氏《金匮方论注·序注》），所谓的《伤寒杂病论》，是指关于伤寒中的杂病的论述，而不是针对一切杂病的论述（下面另有论述）。如果仅仅依靠这本书不足以治疗杂病，那么还有《千金方》。孙思邈也是推本于张仲景，但他对病症论述的精详程度、用药的变化、杂病治法的明备程度，数倍于张仲景的著作。并不是张仲景的贤能不及孙思邈，而是张仲景既然以“寒”字命名他的书，自然专注于寒科疾病尽其变化，其他病因，例如不混入其中。而《千金方》统论百病，凡是风雨寒暑、饮食居处、阴阳喜怒等各种病因都随病症聚集。因此两家著书的意图不同，所以书籍的详略也不同。读者如果能各自得到其所宗奉的长处，那么伤寒和杂病就能各擅其长。自从墨守成规的人把《金匮要略》当作治疗一切杂病的宗师，而《千金方》就被斥为偏颇之书，难怪学术变得狭隘而治疗方法有所缺失了！
In the *Shanghan Lun* (Treatise on Cold Damage), when discussing the indication for diaphoresis (sweating therapy), it is stated that whenever sweating is indicated but no specific decoction is provided, pills or powders may also be used, with the key being that recovery is marked by perspiration; however, this is not as effective as decoctions which can be adjusted according to symptoms. When discussing the indication for purgation (draining downward), it states that for administering purgatives, decoctions are superior to pills and powders. Examining Zhang Zhongjing's works, aside from decoctions such as Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction), there are no other diaphoretic pills or powders. The statement mentioned above reveals that in ancient prescriptions, decoctions, pills, and powders were selected flexibly according to circumstances, unlike the later rigid view that different therapeutic methods must correspond to different formulas. Examples cited by Zhang Zhongjing include Lizhong Wan (Regulate the Middle Pill) and Lizhong Tang (Regulate the Middle Decoction), Banxia San (Pinellia Powder) and Banxia Tang (Pinellia Decoction), Didang Wan (Attack the Stasis Pill) and Didang Tang (Attack the Stasis Decoction), and Zhizhu San (Spider Powder) and Zhizhu Wan (Spider Pill), which are the most prominent. For post-illness hypersalivation, Lizhong Wan is used; for Xiongbi (Chest Bi syndrome/Obstruction of the Chest), Renshen Tang (Ginseng Decoction) is used; for hardness and fullness in the lower abdomen with clear urination and manic-like behavior, Didang Tang is used; whereas for mere fullness in the lower abdomen with clear urination, Didang Wan is used: does this not demonstrate the principle of varying methods according to symptoms? Furthermore, in the Taiyang Chapter, it is said: If cold damage persists for thirteen days without resolution and delirium occurs after passing through meridians, it indicates internal heat, and a decoction should be used for purgation; if urination is clear, stool should be hard, yet diarrhea occurs, and the pulse is harmonious, it indicates the physician incorrectly used a pill for purgation, which is not the correct treatment; if spontaneous diarrhea occurs, the pulse should be faint and extremities cold, but now it is harmonious, indicating interior excess, so Tiaowei Chengqi Tang (Stomach-Regulating Major Yellow Decoction) is the primary prescription. Here, "pill" refers to Tiaowei Chengqi Wan. This condition is suitable for purgation via decoction rather than pill, hence the clarification is particularly explicit. Moreover, Zhang Zhongjing has Mahuang Tang, while *Shenshi Fang* (Deep Master Formulas) directly uses Mahuang San (Ephedra Powder); Zhang Zhongjing has Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction), while *Zhouhou Beiji Fang* (Handbook of Prescriptions for Emergencies) changes it to Jiangfu Wan (Ginger and Aconite Pill); Zhang Zhongjing has Zhi Zhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction), while Zhang Jiegu changed it to Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill). Local gazetteers of our Huzhou region record cases where Xiaochaihu San (Minor Bupleurum Powder) failed to cure disease, but changing it to a decoction resulted in efficacy; all these suffice to prove my argument.
The two books *Shanghan Lun* and *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) by Zhang Zhongjing were collectively known in antiquity as *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases) ("Za" [Miscellaneous] might be a corruption of "Cu" [Hasty], where "Cu" is an ancient variant of "Za"; do not interpret it as cold damage being a hasty disease). *Waitai Miyao* (Prescriptions Worth a Thousand Gold for Emergencies) collectively refers to them as *Shanghan Lun*. What is referred to as *Shanghan Zabing Lun* discusses miscellaneous diseases within the context of cold damage, not miscellaneous diseases in general (as discussed elsewhere). Relying solely on this book is insufficient for treating miscellaneous diseases; thus, *Qianjin Yaofang* (Prescriptions Worth a Thousand Gold) exists. Sun Simiao also traces his roots to Zhang Zhongjing, but his detailed analysis of symptoms, flexibility in medication, and comprehensive methods for miscellaneous diseases are several times more extensive than Zhang Zhongjing's works. It is not that Zhang Zhongjing was less virtuous or capable than Sun Simiao, but because Zhang named his book with the character "Han" (Cold), he naturally focused exclusively on the variations of cold-related pathologies, excluding other etiologies. In contrast, *Qianjin Yaofang* comprehensively discusses hundred diseases, aggregating various causes such as wind, rain, cold, heat, diet, living conditions, yin-yang imbalance, and emotional disturbances according to the disease. Therefore, the intent behind their respective works differs, leading to differences in detail and brevity. Readers who can appreciate the strengths of each will excel in both cold damage and miscellaneous disease treatments. Since dogmatic scholars have regarded *Jingui Yaolue* as the sole authority for all miscellaneous diseases, dismissing *Qianjin Yaofang* as a biased text, it is no wonder that academic understanding has become narrow and therapeutic methods deficient!