为君者最多,为臣者次之,佐者又次之。药之于证,所主同者则等分。
黄芩、黄连、黄柏、知母,病在头面及手梢皮肤者,须用酒炒之。借酒力以上腾也。咽
之下、脐之上,须酒洗之。在下生用。大凡生升、熟降。大黄须煨,恐寒则损胃气。至于川
乌、附子须炮,以制毒也。黄柏、知母,下部药也,久弱之人,须合用之者,酒浸,曝干
,恐寒伤胃气也。熟地黄,酒洗亦然。当归,酒浸,曝,发散之意也。
凡根之在土者,中半以上,气脉之上行也,以生苗者为根;中半以下,气脉之下行也,
入土以为梢。病在中焦与上焦者,用根;在下焦者,用梢。根升而梢降。大凡药根有上中下
∶人身半以上,天之阳也,用头;在中焦用身;在身半以下,地之阴也,用梢。述类象形者
也。
仲景言∶锉如麻豆大,与 咀同意。夫 咀,古之制也。古者无铁刃,以口咬细,令如
麻豆,为粗药。煎之,使药水清,饮于腹中则易升易散也,此所谓 咀也。今人以刀器锉如
麻豆大,此 咀之易成也。若一概为细末,不厘清浊矣。经云∶清阳发腠理,浊阴走五脏,
果何谓也?又曰∶清阳实四肢,浊阴归六腑。 咀之药,取汁易行经络也。若治至高之病,
加酒煎。去湿,以生姜;补元气,以大枣;发散风寒,以葱白;去膈上痰,以蜜。细末者,
不循经络,止去胃中及脏腑之积。气味浓者白汤调,气味薄者煎之,和渣服。去下部之疾,
其丸极大而光且圆;治中焦者,次之;治上焦者,极小。稠面糊,取其迟化,直至下焦。或
酒、或醋,取其收其散之意也。犯半夏、南星,欲去湿者,以生姜汁。稀糊为丸,取其易化
也;水浸宿,炊饼,又易化;滴水丸,又易化。炼蜜丸者,取其迟化而气循经络也。蜡丸者
,取其难化,而旋旋取效也。大抵汤者“荡”也,去大病用之;散者“散”也,去急病用之
;丸者“缓”也,不能速去之,其用药之舒缓而治之意也。
The quantity of the sovereign drug (Jun Yao, 君药) is the largest, that of the minister drug (Chen Yao, 臣药) is next, and that of the assistant drug (Zuo Yao, 佐药) is even less. If the drugs target the same syndrome, their dosages are equal.
For Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), and Zhimu (Anemarrhenae Rhizoma), if the disease is located in the head, face, or skin of the fingertips, they must be stir-fried with wine. This utilizes the ascending power of wine to elevate the medicinal efficacy. If the disease is located below the throat and above the umbilicus, they should be washed with wine. If the disease is in the lower part, they should be used raw. Generally speaking, raw herbs tend to ascend, while processed ones tend to descend. Dahuang (Rhei Radix et Rhizoma) must be baked/roasted, lest its cold nature damage the Stomach Qi. As for Chuanwu (Aconiti Radix lateralis preparata) and Fuzi (Aconiti Lateralis Radix Preparata), they must be processed (pao zhi, 炮制) to reduce toxicity. Huangbai and Zhimu are herbs for treating lower-jiao diseases. For individuals with chronic weakness who require these herbs, they should be soaked in wine and then dried in the sun, to prevent their cold nature from injuring Stomach Qi. Shudihuang (Rehmanniae Radix Preparata) is treated similarly by washing with wine. Danggui (Angelicae Sinensis Radix) is soaked in wine and then dried, to impart a dispersing intention.
For roots growing in the soil, the upper half (closer to the surface) has qi and vessels flowing upward, and is called the "root" (gen, 根); the lower half (penetrating into the earth) has qi and vessels flowing downward, and is called the "tip" (shao, 梢). For diseases in the Middle Jiao (Zhong Jiao, 中焦) and Upper Jiao (Shang Jiao, 上焦), the root part is used; for diseases in the Lower Jiao (Xia Jiao, 下焦), the tip part is used. The root tends to ascend, and the tip tends to descend. Generally, the root of an herb can be divided into upper, middle, and lower sections: the area above the human body's midpoint belongs to Heaven's Yang, so the head/top of the herb is used; at the Middle Jiao, the body/middle of the herb is used; below the midpoint, belonging to Earth's Yin, the tip/bottom of the herb is used. This follows the principle of taking categories and imitating forms (shu lei xiang xing, 述类象形).
Zhang Zhongjing stated: "Crush to the size of hemp seeds," which is consistent with the concept of "ju" (zui, 咀). "Ju" is an ancient method. In ancient times, without iron blades, people bit the herbs finely with their mouths until they were the size of hemp seeds, constituting coarse processing. When decocted, this makes the medicinal liquor clear, allowing it to easily ascend and disperse after ingestion into the abdomen. This is what is meant by "ju." Today, people use knives and tools to crush herbs to the size of hemp seeds, which is an easier form of "ju." If all herbs are ground into fine powder, the distinction between clear and turbid substances would be lost. The Classics state: "Clear Yang emerges in the interstices of the skin (Cou Li, 腠理), Turbid Yin enters the Five Zang Organs." What does this mean? It also says: "Clear Yang fills the four limbs, Turbid Yin returns to the Six Fu Organs." Herbs processed by "ju" yield juices that easily circulate through the meridians. If treating diseases in high locations, add wine for decoction. To remove dampness, add fresh ginger (Shengjiang, 生姜); to tonify Yuan Qi (Primordial Qi, 元气), add jujube (Dazao, 大枣); to disperse wind-cold, add scallion white (Congbai, 葱白); to eliminate phlegm above the diaphragm, add honey. Fine powders do not follow the meridians but only remove accumulations in the Stomach and internal organs. Those with strong flavors are mixed with plain boiled water; those with weak flavors are decocted and taken with the dregs. For diseases in the lower part, pills are made very large, smooth, and round; for the Middle Jiao, they are smaller; for the Upper Jiao, they are extremely small. Thick wheat paste is used for pills to take advantage of slow dissolution, ensuring the medicine reaches the Lower Jiao. Alternatively, wine or vinegar may be used as binders to achieve either astringent or dispersing effects. When using Banxia (Pinelliae Rhizoma) or Nanxing (Arisaematis Rhizoma), if the goal is to remove dampness, use fresh ginger juice. Thin paste is used for pills to facilitate easy dissolution; soaked old steamed buns also dissolve easily; water-drop pills also dissolve easily. Honey-processed pills are used because they dissolve slowly and allow the medicinal qi to circulate through the meridians. Wax pills are used because they are difficult to dissolve, providing a gradual therapeutic effect. Generally speaking, Tangji (Decoctions, 汤剂) acts as a "sweeping" agent, used for serious illnesses; Sanji (Powders, 散剂) acts as a "dispersing" agent, used for acute illnesses; Wanji (Pills, 丸剂) acts as a "soothing/slow" agent, unable to quickly eliminate pathogens, reflecting the intent of using gentle medication for treatment.