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Xu Lingtai

In ancient times, the units of weight and volume were very light. One tael (liang) in ancient times is equivalent to a little more than two qian in modern times. One sheng in ancient times is equivalent to two he in modern times. One prescription (ji) in ancient times is equivalent to three doses taken today. Furthermore, ancient physicians all harvested fresh herbs themselves, such as Shengdi Huang (Rehmanniae Radix, raw) and Banxia (Pinelliae Rhizoma), whose weight was several times that of dried herbs. Therefore, although the dosages in ancient prescriptions appear heavy, they actually did not exceed around one tael (liang) in modern terms. Only occasionally were heavy dosages used in *Qianjin Fang* (Prescriptions Worth a Thousand Gold) by Sun Simiao and *Waitai Miyao* (Secrets of the Outer Palace) by Wang Tao; these were for treating robust patients with severe conditions and were not used lightly. Since the Song and Yuan dynasties, when formulating a prescription, it was customary to note "each dose: 3 qian or 5 qian," rarely exceeding one tael (liang). This refers to the method of decocting herbal medicine. For powdered medicines, a quantity of one qian bi (a spoonful measuring approximately one qian) was used; for pills sized like paulownia seeds, the dosage increased from ten pills to twenty or thirty pills. If one carefully examines ancient prescriptions, are there any decoctions weighing two to three taels up to seven or eight taels as seen today? This situation arises because physicians do not understand ancient standards, believing that weights and measures are no different from modern ones, yet they doubt the dosages are too heavy. They offer an explanation: "People nowadays have weak constitutions, so dosages should be slightly reduced." However, they fail to realize that this has already made the dosages several times heavier than those in ancient prescriptions. Consequently, herb prices rise daily, and harm comes faster. There are also cases where Shu Di Huang (Rehmanniae Radix, prepared) is used in amounts of three to four taels, while other herbs are only used in amounts of one or two qian. There has never been such a drastic disparity in heaviness and lightness in herbal combinations. It must be understood that when medicinal qi enters the stomach, it merely serves to harmonize Qi and Blood; it does not instantly transform into Qi and Blood upon ingestion. Therefore, the quantity is not the primary factor. In cases where patients cannot swallow even a grain of rice, using cloying, obstructive, sour, bitter, fishy, or foul-smelling herbs, brewed thickly in large bowls and force-fed, makes digestion difficult even if the treatment is correct. How much more so if the herbs contradict the disease, filling the stomach? The patient may not die from toxicity but will certainly die from being force-fed. This is especially true for children. Regardless of whether the patient is rich or poor, Ren Shen (Ginseng Radix et Rhizoma) is always considered an indispensable tonic. Human nature naturally desires life, leading people to exhaust their resources to procure it, only to find that this leads to their demise. The poor lose their means for funeral arrangements, and their wives and children wander destitute. This kills the body and destroys the family. In my youth, I observed senior physicians who would first assess the patient's financial status before prescribing medication. They exhibited great benevolence. Moreover, at that time, the price of Ginseng was dozens of times lower than today, yet they remained so cautious. Such conscientiousness is something modern physicians lack, falling far short of the ancients.