十剂之后，陶隐居续入寒热二剂，岂知寒有时而不可以治热，热有时而不可以治
寒，何者？阴虚内热，当用甘寒滋肾家之阴，是益水以制火也。设用芩连栀子苦寒之
剂以攻热，则徒败胃气，苦寒损胃而伤血，血愈不足而热愈炽，胃气伤则后天之元气愈
无所养，而病转增剧也。阳虚中外俱寒，当以人参黄 以益表里之阳气，而少佐桂附以
回阳，则其寒自解，是益火以祛寒也。设专用辛热，如吴茱萸、干姜、麻黄、葫芦芭、
胡椒之属以散寒。则辛能走散，真气愈虚，其寒愈甚，王安道所谓辛热愈投，而沉寒愈
滋也。二者非徒无益，而反害之。
三治者，初、中、未也。初治之道，法当猛峻，缘病得之新暴，邪入未深，当以急
利之药急去之。中治之道，法当宽猛相济，为病非新非久，当以缓急得中，时令消息对
症加减，养正祛邪相兼治之。末治之道，法当宽缓，谓药性平善安养血气，为病久人
虚，邪气潜伏，故以善药养正，而邪自去也。五治者，和取从折属也。一治曰和，假
令小热之病，当以凉药和之。和之不已，次用取。二治曰取，为热势稍大，当以寒药取
之。取之不已，次用从。三治曰从，为势即甚，当以温药从之，所谓承乃制也。温之不
已又再折。四治曰折，为病势极甚，当以逆治之。制之不已，当下夺之，夺之不已，又
用属。五治曰属，缘病陷在骨髓，无法可出，故求其属以衰之。四因者，有始因气
动，而内有所成病者，如积聚 瘕之类。有始因气动而外有所成病者，如痈疽疮疡之
类。有不因气动而内有所成病者，如留饮宿食，喜怒想慕之类。有不因气动外有所成病
者，如瘴气跌扑虫伤之类。六淫者，阴阳风雨晦明也。阴淫寒疾，则怯寒，此寒水太
过，别深浅以温之。阳淫热疾，则恶热，此相火太过，须审虚实以凉之。风淫末疾，末
谓四肢也。必身强直，此风木太过，须和冷热以平治之，在阳则热，热则痿缓不收，在
阴则寒，寒则筋挛骨痛，雨淫腹疾，则湿气濡泄，此湿土太过，以平渗燥之，兼看冷热
之候。晦淫惑疾，晦邪所干，精神惑乱，此燥金太过，当滋养之。明淫心疾，心气鼓
动，狂邪谵妄，此君火太过，当镇以敛之。八要者，虚实冷热邪正内外也。一曰虚，脉
细皮寒，气少泄泻。饮食不进，此为正虚。二曰实，脉盛皮热，腹胀前后不通闷瞀，此
为五实。三曰冷，阳气衰微，脏腑积冷。四曰热，阴气衰弱，脏腑积热。五曰邪，非脏
腑正病也。六曰正，非外邪所干也。七曰内，情欲所伤，不在外也。八曰外，外物所
伤不在内也。学人明此诸要，而治不紊矣。
After the Ten Categories (Shi Ji), Tao Hongjing added the Cold Category and the Hot Category. However, he did not realize that cold-natured herbs are not always suitable for treating heat syndromes, nor are hot-natured herbs always suitable for treating cold syndromes. Why? In cases of Yin deficiency with internal heat (Yin Xu Nei Re), one should use sweet-cold herbs to nourish Kidney Yin, a method known as "benefiting water to control fire" (Yi Shui Zhi Huo). If one mistakenly uses bitter-cold formulas such as Huangqin Tang (Scutellaria Decoction), Huanglian Jiedu Tang (Coptis Detoxification Decoction), or Zizhi (Gardenia) to attack the heat, it will only damage Stomach Qi. Bitter-cold herbs harm the Spleen and Stomach and injure Blood, leading to further Blood deficiency and more intense heat. Damage to Stomach Qi means the acquired Post-Heaven Yuan Qi has less nourishment, causing the disease to worsen.
In cases of Yang deficiency with cold throughout the interior and exterior, one should use Renshen (Ginseng Root) and Huangqi (Astragalus Root) to tonify the Wei and Ying Qi of the interior and exterior, and add small amounts of Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root) to restore Yang. The cold will then resolve naturally, a method known as "benefiting fire to dispel cold" (Yi Huo Qu Han). If one exclusively uses acrid-hot herbs like Wuzhuyu (Evodia Fruit), Ganjiang (Dried Ginger), Mahuang (Ephedra Herb), Huluba (Trigonella Foenum-graecum Seed), or Hujiao (Pepper Fruit) to scatter cold, the acrid nature causes dispersion, leading to further depletion of True Qi and worsening of the cold. As Wang Andao stated: "The more acrid-hot herbs are administered, the deeper the entrenched cold becomes." These two approaches are not only ineffective but harmful.
The "Three Treatments" refer to Initial Treatment, Middle Treatment, and Terminal Treatment. The principle of Initial Treatment is to be vigorous and drastic, because the disease is new and sudden, and the pathogenic factor has not penetrated deeply; thus, urgent and purgative herbs should be used to quickly eliminate the pathogen. The principle of Middle Treatment is to balance leniency and severity. Since the disease is neither new nor chronic, the treatment should be moderate in speed and intensity, adjusted according to seasonal changes, combining the support of healthy Qi with the expulsion of pathogens. The principle of Terminal Treatment is to be gentle and slow. Because the herbs are mild and beneficial, they can calm and nourish Qi and Blood. Given that the disease is chronic and the patient is weak, with pathogens lurking inside, one should use gentle herbs to tonify healthy Qi, after which the pathogens will naturally depart.
The "Five Treatments" refer to Harmonizing (He), Taking/Extracting (Qu), Following (Cong), Restraining/Breaking (Zhe), and Attributing/Relating (Shu).
1. Harmonizing (He): For mild heat diseases, cool herbs should be used to harmonize. If this fails, proceed to the next step.
2. Taking (Qu): For slightly increased heat intensity, cold herbs should be used to extract/purge the heat. If this fails, proceed to the next step.
3. Following (Cong): For severe conditions, warm herbs should be used to follow the pathogenic trend, known as "Cheng Nai Zhi" (adapting to the constraint). If warming fails, proceed to the next step.
4. Restraining (Zhe): For extremely severe conditions, contrary treatment (Ni Zhi) should be applied. If restraint fails, use purgation to drain excess. If purgation fails, proceed to the next step.
5. Attributing (Shu): When the disease has sunk into the bone marrow and no direct extraction is possible, seek herbs related to the root cause to diminish the disease.
The "Four Causes" refer to four etiological categories:
1. Diseases caused internally by Qi movement disturbances, such as Accumulations (Ji Ju) and Masses (Jia).
2. Diseases caused externally by Qi movement disturbances, such as Carbuncles (Yong Ju) and Sores (Chuang Yang).
3. Diseases caused internally without Qi movement disturbances, such as Retained Fluids (Liu Yin), Undigested Food (Su Shi), or emotional attachments like excessive joy, anger, or longing.
4. Diseases caused externally without Qi movement disturbances, such as Miasma (Zhang Qi), trauma from falls, or insect bites.
The "Six Excesses" (Liu Yin) refer to Yin, Yang, Wind, Rain, Obscurity (Hui), and Brightness (Ming).
- Yin excess leads to cold diseases, characterized by aversion to cold and fear of cold, due to excessive Cold-Water Qi; treat with warmth based on depth.
- Yang excess leads to heat diseases, characterized by aversion to heat, due to excessive Minister Fire (Xiang Huo); treat with cooling after assessing deficiency or excess.
- Wind excess affects the extremities ("Mo"), causing stiffness and rigidity due to excessive Wind-Wood Qi; treat by balancing cold and heat. In the Yang aspect, heat causes flaccidity and inability to grasp; in the Yin aspect, cold causes tendon contraction and bone pain.
- Rain excess leads to abdominal diseases, specifically dampness-induced diarrhea, due to excessive Damp-Earth Qi; treat with bland leaching and drying agents, considering cold and heat patterns.
- Obscurity excess leads to mental confusion due to excessive Dryness-Metal Qi; treat with nourishing and moistening methods.
- Brightness excess leads to Heart diseases, with agitated Heart Qi causing mania and delirium, due to excessive Sovereign Fire (Jun Huo); treat with sedating and astringent methods.
The "Eight Essentials" (Ba Yao) are Deficiency, Excess, Cold, Heat, Evil (Pathogen), Righteous (Healthy), Interior, and Exterior.
1. Deficiency (Xu): Fine pulse, cold skin, shortness of breath, diarrhea, loss of appetite. This indicates Healthy Qi deficiency.
2. Excess (Shi): Full pulse, hot skin, abdominal distension, obstruction of urination and defecation, chest tightness, and dizziness. This indicates Five Excess syndromes.
3. Cold: Decline of Yang Qi, accumulation of cold in the Zang-Fu organs.
4. Heat: Decline of Yin Qi, accumulation of heat in the Zang-Fu organs.
5. Evil (Xie): Pathogens affecting the body, distinct from normal organ function.
6. Righteous (Zheng): Internal organ disorders not caused by external pathogens.
7. Interior (Nei): Injuries caused by emotions/desires, located internally.
8. Exterior (Wai): Injuries caused by external physical factors, located externally.
If students understand these essentials, their treatments will not be chaotic.