《千金》紫菀汤云∶小儿六十日至百日,一服二合半,百日至二百日,一服三合(若如今之八勺有奇,百日以内之
小儿能顿服耶?)。
(以上辨古升)
夫以药秤药升,农、轩创造之法物,晋、宋以来 失古意,故梁·陶贞白先生着《名医别录》,论用药分剂法则,一
遵神农之秤,而不用子谷 黍之制。孙真人祖述其意,定《千金方》,首言“今根据四分为一两称为定”,亦不根据隋人以三
两为一两之法,其述古药升制度下即曰∶“今人分药,不复用此”,盖有存羊爱礼之思焉。继此有王刺史者,辑《外台秘
要》,每万必纪其所出,凡六朝诸名家所定分两升合,皆兢兢法守,间有大升大两,必分别注明。今良方具在,顾以权量
难求,弃若弁髦,强作解事者,从而武断之,而医宗之微旨,势不至尽坠于地不止。
武断之最者,莫如景岳,以其所宗者,悉本之伪造夏律周 之郑世子也。
微旨者何?圣人治病之枢机也。升降浮沉之气,顺者生,逆者死,但得拨之使转,即行所无事矣。故药也者,求其
中,不贵多也;求其循序,不贵速也。药必有毒,非毒无以驭病,非节制无以驭毒。故升秤之以小为度者,诚慎之也。
陶隐居曰∶一物一毒,服一丸如细麻大;二物一毒,服二丸如大麻;三物一毒,服三丸如胡豆;四物一毒,服四丸
如小豆;五物一毒,服五丸如大豆;六物一毒,服六丸如梧子,从此至十,皆以梧子为度。按《千金》论如梧子者(准
上论重一分),以二大豆准之;如大豆者(重五厘),以二小豆准子;如小豆者(重二厘半),以三大麻准之;如胡豆者(重
一厘七毫),以二大麻准之;如大麻者(重八毫半),准三细麻(每一细麻重二毫八丝)。
今人疑古方立法太峻,而不详其用意之谨密,反谓古人禀浓,能胜重剂,则所见益颠倒矣。得吾说而通之,庶儿能
师古之意,用古之法乎。
《千金》论云∶“古者,药在土中,自养经久,气味真实。今时药力轻虚,人多巧诈。学人须加意,重复用药,药乃
有力。”此亦不可不知也。然观东垣方,药味多而分量轻,又宋时一切作煮散者,每服皆以五钱为例,可知仍不贵多也。
古人疑汉方汤液,大剂三十余两,小剂十余两,用水六七升,煎取二三升,并分三服,若以古龠量水七升,煎今之
三十两,未淹得过?又疑散末药只服方寸刀圭匕,圆子如梧子大,极至三十粒,汤液岂得如此悬绝?又疑风引汤一料计
五十五两,每用三指撮,水三升,煮三沸,去渣,温服一升,观其煮制,每只三指撮末,应料剂如此之多?今一旦考而
正之,三疑尽释矣。
古方惟百合汤用百合七只,配水三升,似与前说不相合,顷友人言;吾苏阳山澄照寺前一片地上,天然自产百合,
仅如钱大,煮之清香绝胜,疗病极效。可知百合入药者,以小为贵耳。
The *Ziwan Tang* (Aster Decoction) in the *Qianjin Fang* (Prescriptions Worth a Thousand Gold) states: For infants aged 60 to 100 days, one dose is 2.5 *he* (a unit of volume); for those aged 100 to 200 days, one dose is 3 *he* (If calculated as slightly more than eight modern spoons, can an infant under 100 days old swallow it all at once?).
(Above discusses the ancient unit of *Sheng*)
Using drug scales and measuring vessels (*Sheng*) was the method created by Shennong and Xuanyuan. Since the Jin and Song dynasties, people have lost the original intent of the ancients. Therefore, Tao Hongjing, a gentleman of the Liang Dynasty, wrote the *Mingyi Bielu* (Record of Famous Physicians), discussing the rules for dosage and measurement, strictly following Shennong's scale, and not adopting the system of *zi*, *gu*, and *shu* (tiny units of weight). Sun Simiao honored this intent and established the *Qianjin Fang*, stating at the beginning, "Now we take four *fen* as one *liang* as the standard," and did not follow the Sui Dynasty method of treating three *liang* as one *liang*. After describing the ancient system of measuring vessels for herbs, he immediately said, "People today do not use this when dividing medicines." This likely reflects a desire to preserve the essence of ritual and propriety. Subsequently, Wang Tao, a prefect, compiled the *Waitai Miyao* (Secret Essentials from the Imperial Library), recording the source of every citation. He carefully adhered to the weights, measures, *sheng*, and *he* determined by various masters of the Six Dynasties, and whenever there were large *sheng* or large *liang*, he clearly noted them. Good prescriptions are still available today, but because accurate weights and measures are hard to find, they are discarded like worn-out headgear. Those who act arrogantly and make arbitrary judgments cause the subtle principles of medical orthodoxy to fall into ruin.
The most arbitrary among them is Zhang Jingyue, whose theories are entirely based on the forged Xia laws and the teachings attributed to the Prince of Zheng in the Zhou Dynasty.
What are the subtle principles of medicine? They are the pivot of curing diseases by sages. The ascending, descending, floating, and sinking of *Qi*: if smooth, life prevails; if reversed, death ensues. If one can merely adjust it to restore circulation, matters will be handled effortlessly. Therefore, regarding medication, one seeks balance, not quantity; one seeks gradual progress, not speed. All medicines possess toxicity; without toxicity, one cannot subdue disease; without moderation, one cannot control toxicity. Thus, using smaller scales for weighing herbs is indeed an act of caution.
Tao Hongjing stated: If one herb is toxic, take one pill the size of a fine hemp seed; if two herbs are toxic, take two pills the size of a large hemp seed; if three herbs are toxic, take three pills the size of a broad bean; if four herbs are toxic, take four pills the size of a small bean; if five herbs are toxic, take five pills the size of a soybean; if six herbs are toxic, take six pills the size of a sophora seed. From this up to ten, all are measured by the size of a sophora seed. According to the discussion in the *Qianjin Fang* regarding pills the size of a sophora seed (equivalent to one *fen* in weight in the above discussion), two soybeans are used as a reference; for pills the size of a soybean (weighing five *li*), two small beans are used as a reference; for pills the size of a small bean (weighing 2.5 *li*), three large hemp seeds are used as a reference; for pills the size of a broad bean (weighing 1.7 *hao*), two large hemp seeds are used as a reference; for pills the size of a large hemp seed (weighing 8.5 *hao*), three fine hemp seeds are equivalent (each fine hemp seed weighs 2.8 *si*).
Modern people suspect that ancient prescriptions were too harsh, failing to appreciate their rigorous and precise intent. Instead, they argue that ancients had robust constitutions and could tolerate heavy doses, which is a further inversion of truth. If one understands my explanation and grasps its logic, perhaps one can emulate the intent of the ancients and apply their methods.
The *Qianjin Fang* states: "In ancient times, herbs grew in the soil, maturing naturally over time, possessing authentic aroma and potency. Today, herbal potency is light and insubstantial, and people are often deceitful. Students must pay close attention and repeat the dosage to ensure efficacy." This is also something one must know. However, observing the formulas of Li Dongyuan, although they contain many herbs, the dosages are light. Furthermore, in the Song Dynasty, decoctions made into powders for boiling (*zhusan*) typically had a single dose of five *qian*. This indicates that abundance in quantity was still not prized.
Ancients questioned Han dynasty liquid prescriptions (*tangye*): large doses exceeded thirty *liang*, small doses over ten *liang*, using six or seven *sheng* of water, boiled down to two or three *sheng*, divided into three doses. If using the ancient *yue* measure for seven *sheng* of water, would it even cover thirty *liang* of modern-weighted herbs? They also questioned powdered medicines, where only a *fangcun bi* or *daogui bi* was taken, or pills the size of a sophora seed, up to thirty grains, wondering how liquid prescriptions could differ so drastically. They also questioned the *Fengyin Tang* (Wind-Driving Decoction), where one batch weighed fifty-five *liang*, yet only a pinch taken with three fingers was used with three *sheng* of water, boiled three times, strained, and one *sheng* taken warm. Observing the preparation, taking only a pinch of powder per dose, why such a large batch size? Now, upon examination and correction, these three doubts are fully resolved.
Among ancient prescriptions, only the *Baihe Tang* (Lily Bulb Decoction) uses seven lily bulbs with three *sheng* of water, which seems inconsistent with the previous statement. Recently, a friend mentioned: In front of Chengzhao Temple in Yangshan, Suzhou, lilies grow naturally on a patch of land, only as large as coins. When boiled, they have an exquisite fragrance and are extremely effective in treating diseases. This shows that for medicinal use, smaller lilies are valued.