天地四时之令，春夏之气温而升浮，则万物发生。秋冬之气寒而降沉。则万物肃杀。人
肖天地，常欲使胃气温而升浮，而行春夏发生之令，不欲使胃气寒而降沉，而行秋冬肃杀之
令。盖升麻能令清气从右而上达，柴胡能令清气从左而上达。经曰，清气在下，则生飧泄，
浊气在上，则生 胀。是以清气一升，则浊气随降，而无以上等症。
病在上膈，法当用木香槟榔以降之。病在下膈，法当用升麻柴胡以提之，此常理也。然
或泄泻脱肛后重，疼不可忍，是乃气下陷也，法当举之，以升麻柴胡，和之以木香，攻之以
槟榔。或曰，四药同剂，不无升降混淆，奚有治病归一之功也。曰，天生药石治其病，各有
其能，如仲景立大柴胡汤，用柴胡大黄同剂，以治伤寒表里俱见之症，然柴胡升散外邪，大
黄降泄内实，使病者热退气和而愈。故用升麻柴胡，自能升清气而上行，槟榔木香，自能逐
浊气而下降，能使脱肛举而后重除，自可同剂而成功矣。何疑之有。
虚损之疾，世医例用十全大补汤以补之，其方实为虚损之关键也。方用参 苓术甘草以
补气虚，用归芎地黄芍桂以补血少，此方乃为真气血两虚而设，或血虚而气尚实，或气虚而
血尚充，又不可一例施也。盖药性各有能毒，中病者借其能以付安，不中病者，徒惹毒以增
病耳。如心脾二经虚，当用茯苓补之，虚而无汗，及小便短少者，服之有功，虚而小便数者，
服之令人目盲，虚而多汗者，久服损其元气，夭人天年，以其味淡而利窍也。如肺气弱及无
阳之虚者，当以参 补之，然肥白人及气虚而多汗者，服之有功。若苍黑人及肾气虚而未甚
虚者，服之必满闷不安，以其性滞而闭气也。甘草健脾补中，乃泻火除燥之良剂，然呕吐与
中满并嗜酒之人，服之多敛膈不行，而呕满增剧，以其气味之甘缓也。川芎补血行血，清利
目首之圣药，然骨蒸多汗，及气弱之人服之，则真气走散，而阴虚愈甚，以其气味之辛散也。
生地黄能生血脉，然胃气弱者服之，防损胃不食。熟地黄补血养血，然痰火盛者服之，恐泥
膈不行。人参为润肺健脾之药，元气虚损者，不可缺也。如久嗽劳喘咯血，郁火在肺者服之，
必加嗽增喘不宁，以其气味之甘温滞气也。白芍为凉血益血之剂，血虚腹疼者，不可缺也。
若形瘦气弱，禀赋素虚寒者服之，反伐发生之气，以其气味之酸寒也，用方者当慎之。
天地四季的时令规律，春夏季节的气候温暖而具有升浮的特性，因此万物得以生长发育。秋冬季节的气候寒冷而具有降沉的特性，因此万物呈现肃杀凋零之象。人效法天地，应当常使胃气保持温暖并向上向外升浮，以顺应春夏季万物生长的时令；而不希望胃气变得寒冷并向下向内沉降，去顺应秋冬季万物肃杀的时令。因为升麻能使清气从右侧上升通达，柴胡能使清气从左侧上升通达。《内经》说：“清气在下，则产生完谷不化的泄泻；浊气在上，则产生胸腹胀满。”所以，一旦清气上升，浊气就会随之下降，从而不会出现上述等病症。
病位在上膈（上焦），治法应当使用木香、槟榔来降泄气机。病位在下膈（下焦），治法应当使用升麻、柴胡来提升气机，这是常规的理法。然而，如果出现泄泻、脱肛、里急后重且疼痛难忍的症状，这是由于气机下陷所致，治法应当提升举陷，使用升麻、柴胡，配合木香调和气机，并用槟榔攻逐积滞。有人问：这四种药物同用一方，难道不会造成升降混乱吗？怎么还能达到治病归一的功效呢？回答说：上天生成的药物治疗疾病，各有其特定的功效。例如张仲景创立大柴胡汤，将柴胡与大黄同用，以治疗伤寒表证与里证同时出现的病症。其中柴胡升散以祛除在表之外邪，大黄降泄以通导在里之实热，从而使患者热退气和而痊愈。因此，使用升麻、柴胡，自然能升发清气而上行；使用槟榔、木香，自然能驱逐浊气而下降。这样能使脱肛得到提升而后重感消除，自然可以同方合用而取得成功，有什么可怀疑的呢？
虚损类的疾病，世俗医生习惯性地使用十全大补汤来进补，这个方子确实是治疗虚损的关键方剂。方中用人参、茯苓、白术、甘草来补气虚，用当归、川芎、地黄、芍药、肉桂来补血少。此方是为真正的气血两虚证而设的。如果是血虚但气尚充实，或者气虚但血尚充盈的情况，又不可一概而论地施用。因为药物的性质各有其偏性和毒性，对症用药是借助其偏性来恢复平衡，不对症用药则是徒然引入毒性以增加病情。例如心脾二经虚弱，应当用茯苓来补益，如果表现为虚弱且无汗，以及小便短少的情况，服用茯苓有效；但如果虚弱且小便频数者，服用茯苓会导致目盲；如果虚弱且多汗者，长期服用会损伤元气，折损人的寿命，这是因为茯苓味道淡渗而利窍的缘故。例如肺气虚弱及阳气不足的虚证，应当用人参来补益，但是形体肥胖的人以及气虚多汗的人，服用人参有效。如果是面色苍黑的人以及肾气虚弱但尚未极度虚弱的人，服用人参必然导致胸闷不安，这是因为人参性质滞涩而闭阻气机的缘故。甘草能健脾补中，是泻火除燥的良好药剂，但是呕吐以及中焦胀满并嗜好饮酒的人，服用甘草大多会导致膈气阻滞不通，使呕吐和胀满症状加剧，这是因为甘草气味甘缓的缘故。川芎能补血行血，是清利头目的圣药，但是骨蒸潮热多汗，以及气弱的人服用，则会导致真气走散，使阴虚更加严重，这是因为川芎气味辛散的缘故。生地黄能生养血脉，但是胃气虚弱的人服用，需防止其损伤胃气导致食欲不振。熟地黄能补血养血，但是痰火旺盛的人服用，恐怕会滋腻碍胃导致膈气阻滞不通。人参是润肺健脾的药物，元气虚损者不可或缺。但是久咳劳喘咯血，以及肺中有郁火的人服用，必然加重咳嗽、增加气喘且不得安宁，这是因为人参气味甘温而滞气的缘故。白芍是凉血益血的药剂，血虚腹痛者不可或缺。但是如果形体消瘦、气弱，平素禀赋虚寒的人服用，反而会伐伤生机之气，这是因为白芍气味酸寒的缘故，开方者应当谨慎。
The seasonal laws of Heaven and Earth dictate that the climate of Spring and Summer is warm and ascending, causing all things to grow and develop. The climate of Autumn and Winter is cold and descending, causing all things to wither and die. Humans emulate Heaven and Earth; one should constantly maintain the Stomach Qi (Stomach Energy) as warm and ascending, to follow the generative command of Spring and Summer, rather than allowing it to become cold and descending, following the destructive command of Autumn and Winter. This is because Shengma (Rhizoma Cimicifugae) allows Clear Qi (Clear Energy) to ascend from the right side, and Chaihu (Radix Bupleuri) allows Clear Qi to ascend from the left side. The Classics state: "If Clear Qi remains below, it generates diarrhea with undigested food; if Turbid Qi remains above, it generates abdominal distension." Therefore, once Clear Qi ascends, Turbid Qi descends accordingly, preventing such symptoms.
When the disease is located in the Upper Jiao (Upper Burner), the method dictates using Muxiang (Radix Aucklandiae) and Binglang (Semen Arecae) to descend the Qi. When the disease is located in the Lower Jiao, the method dictates using Shengma and Chaihu to lift the Qi; this is the general principle. However, if there are symptoms of diarrhea, rectal prolapse, tenesmus, and unbearable pain, this indicates sinking of Qi. The treatment should be to raise and lift it, using Shengma and Chaihu, harmonized with Muxiang, and attacking stagnation with Binglang. One might ask: Using these four herbs in the same formula, does it not cause confusion between ascending and descending actions? How can it achieve a unified therapeutic effect? The answer is: Herbs created by Nature treat diseases, each possessing specific capabilities. For instance, Zhang Zhongjing established Da Chaihu Tang (Major Bupleurum Decoction), combining Chaihu and Dahuang (Radix et Rhizoma Rhei) to treat Shaoyang syndrome (Shaoyang Disease) where exterior and interior symptoms coexist. Here, Chaihu disperses and ascends to expel exterior pathogens, while Dahuang purges and descends to clear interior excess, allowing the patient's heat to subside and Qi to harmonize for recovery. Thus, using Shengma and Chaihu naturally ascends Clear Qi, while Binglang and Muxiang naturally descend Turbid Qi. This can lift rectal prolapse and relieve tenesmus. They can succeed when used together in one formula. What is there to doubt?
For deficiency consumptive diseases, worldly physicians habitually use Shiquan Dabu Tang (Ten Significant Tonifying Decoction) for tonification. This formula is indeed a key remedy for consumptive conditions. It uses Renshen (Radix Ginseng), Fuling (Poria), Baizhu (Rhizoma Atractylodis Macrocephalae), and Gancao (Radix Glycyrrhizae) to tonify Qi deficiency, and Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Dihuang (Radix Rehmanniae), Shaoyao (Radix Paeoniae Alba/Rubra), and Rougui (Cortex Cinnamomi) to tonify Blood deficiency. This formula is designed for true Qi and Blood dual deficiency. If there is Blood deficiency but Qi is still substantial, or Qi deficiency but Blood is still abundant, it cannot be applied uniformly. Since drug properties have their own biases and potential toxicity, using them correctly leverages their bias to restore peace; using them incorrectly merely introduces toxicity and exacerbates the disease. For example, if the Heart and Spleen meridians are deficient, Fuling should be used. If the deficiency presents without sweating and with scanty urine, taking Fuling is beneficial. However, if the deficiency presents with frequent urination, taking Fuling may cause blindness. If the deficiency presents with profuse sweating, long-term use damages Yuan Qi (Primal Energy), shortening the lifespan, due to its bland taste and pore-opening nature. For weak Lung Qi and deficiency of Yang, Renshen should be used. Fat individuals and those with Qi deficiency and profuse sweating benefit from it. However, individuals with dark complexion and Kidney Qi deficiency (not yet severe) will experience chest fullness and discomfort after taking it, due to its cloying nature which obstructs Qi flow. Gancao (Licorice Root) strengthens the Spleen and tonifies the Middle Jiao; it is an excellent agent for draining fire and removing dryness. However, for those with vomiting, middle-jiao fullness, and alcoholism, taking Gancao often causes obstruction of the diaphragm, worsening vomiting and fullness, due to its sweet and slow nature. Chuanxiong nourishes Blood and promotes circulation; it is a holy medicine for clearing and benefiting the head and eyes. However, for those with bone-steaming fever, profuse sweating, and weak Qi, taking it causes the True Qi to scatter, worsening Yin deficiency, due to its acrid and dispersing nature. Shengdihuang (Raw Rehmannia Root) generates Blood vessels; however, for those with weak Stomach Qi, caution is needed to prevent damage to the Stomach and loss of appetite. Shudihuang (Prepared Rehmannia Root) nourishes and tonifies Blood; however, for those with abundant Phlegm-Fire, caution is needed as it may cause cloying obstruction of the diaphragm. Renshen is a herb for moistening the Lungs and strengthening the Spleen; it is indispensable for those with damaged Yuan Qi. However, for those with chronic cough, labor-induced asthma, hemoptysis, or stagnant Fire in the Lungs, taking it will inevitably worsen coughing, increase wheezing, and cause restlessness, due to its sweet-warm nature which stagnates Qi. Shaoyao is a preparation for cooling Blood and benefiting Blood; it is indispensable for those with Blood deficiency and abdominal pain. However, for those who are emaciated, weak in Qi, and constitutionally cold-deficient, taking it will instead attack the generative Qi, due to its sour-cold nature. Prescribers must exercise caution.