一、攻方之制。攻其实也。凡攻气者攻其聚。聚可散也。攻血者攻其瘀。瘀可通也。攻积者攻其坚。
在脏者可破可培。在经者可针可灸也。攻痰者攻其急。壮实者暂宜解标。多虚者只宜求本也。但诸
病之实有微甚。用攻之法分重轻。大实者攻之未及。可以再加。微实者攻之太过。每因致害。凡
病在阳者不可攻阴。在胸者不可攻脏。若此者。邪必乘虚内陷。所谓引贼入寇也。病在阴者勿攻其
阳。病在里者勿攻其表。若此者。病必因误而甚。所谓自撤藩蔽也。大都治
宜用攻。必其邪之甚者也。其若实邪果甚。自与攻药相宜。不必杂之补剂。盖实不嫌攻。若但略
加甘滞。便相牵制。虚不嫌补。若但略加消耗。偏觉相妨。所以寒实者最不喜清。热实者最不喜暖。
然实而误补。不过增病。病增者可解。虚而误攻。必先脱元。元脱者无治矣。是皆攻法之要也。
其或虚中有实。实中有虚。此又当酌其权宜。不在急宜攻。急宜补者之例。虽然。凡用攻之法。
所以除凶剪暴也。亦犹乱世之兵。必不可无然。惟必不得已乃可用之。若或有疑。慎勿轻试。
盖攻虽去邪。过则伤气。受益者四。受损者六。故攻之一法。先哲最为详审。正恐其成之难败之易耳。
倘任意不思。此其人可知矣。
（盖麻黄为太阳之本药至必不可移易哉一节石顽润色）
一、散方之制。散表证也。观仲景太阳证用麻黄汤。阳明证用葛根汤。少阳证用小柴胡汤。此散
表之准绳也。后世宗之。而复不能用之。在不得其意耳。盖麻黄为太阳之本药。阳明经证亦多用之。
观阳明经证治例。其义可见。按麻黄苦温。专泄肺气。仲景借以开发太阳经邪。为解表之重剂。
若非冬月正伤寒。原无藉此。即阳明之葛根汤。未尝不用麻黄。未尝不走太阳也。岂谓某经某药必
不可移易哉。但用散之法。当知性力缓急及气味温寒之辨。用得其宜。诸经无不应也。如麻黄、
桂枝峻散者也。防风、荆芥、紫苏平散者也。细辛、白芷、生姜温散者也。升麻、川芎能举陷上
行而散者也。第邪浅者忌峻利之属。气弱者忌雄悍之属。热多者忌温散之属。寒多者忌清凉之属。
凡渴而烦躁者喜干葛。而呕恶忌之。寒热往来者宜柴胡。而泄泻者忌之。寒邪在上者宜升麻、
川芎。而内热火升者忌之。此性用之宜忌。
所当辨也。至于相配之法。则尤当知要。凡以平兼清。自宜凉散。以平兼暖。亦可温经。宜大温者
以热济热。宜大凉者以寒济寒。此其运用之权。则毫厘进退自有伸缩之妙。又何必胶柱刻舟以
限无穷之病变哉。此无他。在不知仲景之意耳。
1. The formulation of attacking methods (methods using purgation, resolution, etc., to eliminate pathogens). The purpose is to attack excess pathogens within the body. When treating Qi stagnation, one must target the accumulation; accumulations can be dispersed. When treating blood disorders, one must target blood stasis; stasis can be unblocked. When treating masses/accumulations, one must target the hardness of the deposits.
If the disease location is in the Zang-Fu organs, methods of breaking down or tonifying may be used; if the disease location is in the meridians, acupuncture or moxibustion may be used. When treating phlegm, one must address urgent symptoms: for robust constitutions, temporarily resolving the branch (symptoms) is suitable; for deficient constitutions, only seeking the root cause is suitable.
However, excess conditions in various diseases vary in severity. The application of attacking methods must distinguish between heavy and light degrees. For severe excess conditions, if the attacking force is insufficient, the dosage may be increased again; for mild excess conditions, excessive attacking often leads to harm.
When the disease is in the Yang aspect, one must not attack the Yin aspect; when the disease is in the chest, one must not attack the internal organs. In such cases, the pathogen will inevitably sink inward by taking advantage of deficiency, which is termed "leading the thief into the house." When the disease is in the Yin aspect, one must not attack the Yang aspect; when the disease is in the interior, one must not attack the exterior. In such cases, the illness will inevitably worsen due to misdiagnosis/treatment, which is termed "removing one's own fence" (destroying one's own defense).
Generally, treatment is suitable for attacking methods only when the pathogen is extremely vigorous. If the excess pathogen is indeed severe, it naturally suits attacking medicines, without the need to mix in tonifying agents. Excess conditions do not fear attacking; however, adding even a slight amount of sweet, cloying, or stagnant herbs will cause mutual restriction. Deficient conditions do not fear tonifying; however, adding even a slight amount of draining or consuming herbs will feel mutually obstructive. Therefore, cold-excess conditions least desire clearing heat, while heat-excess conditions least desire warming.
Nevertheless, if an excess condition is mistakenly treated with tonification, it merely increases the illness, which can still be resolved if the illness worsens. If a deficient condition is mistakenly attacked, it will first lead to the collapse of Yuan Qi (Primordial Qi); once Yuan Qi collapses, there is no cure. These are the key points of attacking methods.
In cases of deficiency containing excess, or excess containing deficiency, one must weigh the circumstances flexibly; these do not fall under the examples of urgently needing attacking or urgently needing tonification. Although so, whenever attacking methods are used, they serve to eliminate凶险 (dangerous factors) and cut down暴疾 (violent diseases), much like troops in chaotic times, which are indispensable. However, they should only be used when absolutely necessary. If there is any doubt, one must not lightly experiment.
Because although attacking methods remove pathogens, overuse damages Qi; four parts benefit, while six parts suffer damage. Therefore, the method of attacking was most meticulously examined by ancient sages, precisely because they feared that establishing success is difficult while failure is easy. If one acts arbitrarily without thought, such a person's character is evident.
(Regarding the statement that Mahuang is the fundamental herb for Taiyang syndrome and cannot be changed under any circumstances, polished by Shiwan.)
1. The formulation of dispersing methods (methods using diaphoresis to release the exterior). This is used to disperse exterior syndromes. Observing Zhang Zhongjing’s use of Mahuang Tang for Taiyang syndrome, Gegen Tang for Yangming syndrome, and Xiao Chaihu Tang for Shaoyang syndrome, these are the standards for dispersing the exterior. Later generations followed this but failed to apply it correctly, owing to a lack of understanding of its intent.
Mahuang is the fundamental herb for the Taiyang meridian, and it is also widely used for Yangming meridian syndromes. Observing the treatment examples for Yangming meridian syndromes reveals the underlying principle. According to materia medica: Mahuang is bitter and warm, specifically venting Lung Qi. Zhang Zhongjing utilized it to open up pathogens in the Taiyang meridian; it is a potent agent for releasing the exterior. Unless it is a true cold injury contracted in winter, there is originally no need to rely on it. Even in Gegen Tang for Yangming syndrome, Mahuang is not unused, nor does it fail to pass through the Taiyang meridian. How could one claim that specific herbs for specific meridians are absolutely immutable?
However, when using dispersing methods, one must understand the differences in the speed of drug action and the distinctions between warm/cold flavors and properties. Applied appropriately, there is no meridian disorder that will not respond. For example, Mahuang and Guizhi belong to harsh/potent dispersants; Fangfeng, Jingjie, and Zisu belong to mild dispersants; Xixin, Baizhi, and Shengjiang belong to warm dispersants; Shengma and Chuanxiong can lift sunken Qi upward to disperse.
Yet, for shallow pathogens, harsh/draining types are contraindicated; for weak Qi, fierce/aggressive types are contraindicated; for abundant heat, warm-dispersing types are contraindicated; for abundant cold, cooling types are contraindicated.
For those with thirst and irritability, Gan Ge (Gegen/Puerariae Radix) is preferred, but it is contraindicated for vomiting and nausea; for alternating chills and fever, Chaihu is suitable, but contraindicated for diarrhea; for cold pathogens in the upper jiao, Shengma and Chuanxiong are suitable, but contraindicated for internal fire rising with heat. These are the appropriate uses and contraindications of drug properties, which must be distinguished.
As for the methods of combination, one must particularly grasp the essentials. Combining mildness with clearing naturally suits cool dispersing; combining mildness with warming can also warm the meridians. For great warmth needed, heat can assist heat; for great cooling needed, cold can assist cold. This is the flexibility of application, where minute adjustments have subtle effects of expansion and contraction. Why then stick rigidly to dogmas to limit infinite variations in disease changes? There is no other reason than failing to understand Zhang Zhongjing’s intent.