《魏志·华佗传》有府吏儿寻、李延共止，俱头痛身热，所苦正同。佗曰∶寻当下之，延当发
汗。或难其异，佗曰∶寻外实，延内实，故治之宜殊。即各与药，明早并起。某深疑陈寿误用内外
字，非华佗本意也。病者头痛身热，恶寒，为阴邪
外实，法当发汗；病者头疼身热，但蒸蒸发热，不恶寒，为阳邪内实也，法当下之。所谓外实者，
外为阳为表也。阳气为寒所折，争于表间，阳衰而阴胜，故发热复有恶寒之证，可以汗而发之，以
复阳气也。所谓内实者，内为阴为里也，极阴变阳，寒甚生热，阳气反胜而入里，故胃腑内实，蒸
蒸作热，不恶寒，可以泄利，以复阴气。言实者，非正实，乃邪实也。《素问》云∶邪气盛则实。
所以知佗传内外二字差谬矣。
近世常行煮散，古方汤液存而不用。盖古方升两大多，或水少汤浊，药味至浓。殊不知圣人专
攻一病，决一两剂以取验，其水少者，自是传写有舛，非古人本意也。唐自安史之乱，藩镇跋扈，
至于五代，天下兵戈，道路艰难，四方草石，鲜有交通，故医家省约，以汤为煮散。至有未能中病，
疑混而数更方法者多矣。沿习至今，未曾革弊，古方汤液，实于今世为无用之书。唐徐氏《大和济
要方》减其升两，虽则从俗，患其太省，故病未半而汤剂已竭，鄙心患之。自顾抄撮斟酌，积三十
余年，稍习其事，故敢裁减升两，庶从俗而便于行用。或一方而取半剂，或三分取一，
或四分取一，或五分取一，或增其水有可以作煮散者，有病势重专用汤攻者。或云∶古升秤省三升
准今之一升，三两准今之一两，斯又不然。且晋葛氏云∶附子一枚准半两。又云∶以盏当升，以分
当两。是古之升秤与今相同，许人减用尔。今之为医者，多是愚俗，苟且衣食，贪冒货贿，大方广
论，何以该通？唯密窖鄙浅方技，使人不窥其隙，以自矜大，乘便为神工致远，恐泥其夭枉，固已
多矣。鲜有多闻博识者。虽时有之士大夫，咸鄙其为术。自非罔顾流俗，以拯济为心，则不能留神
焉。今解释前言，详正脱误，择其笃论，删其繁方，仍增入新意，不敢穿凿，冀新学易见，览斯文
已得其七八矣。此方皆古圣贤撰用，其效如神，更不一一具姓名，载其所出。其间自有所见，经手
得验者，具缉成卷，在识者览而知焉。
《三国志·华佗传》中记载，府吏儿寻和李延一同就诊，两人都头痛、身体发热，所受的痛苦完全相同。华佗说：“儿寻应当用泻下法治疗，李延应当用发汗法治疗。”有人对这种差异提出质疑，华佗说：“儿寻属于外实，李延属于内实，所以治疗方法应该不同。”随即分别给他们用药，第二天早上病都好了。我深深怀疑陈寿在记录时误用了“内外”二字，这并非华佗的本意。
如果病人头痛、身热、怕冷，这是阴邪导致的外实，按照法则应当发汗；如果病人头痛、身热，只是像蒸笼一样持续发热，不怕冷，这是阳邪导致的内实，按照法则应当泻下。所谓“外实”，是指体表属阳、属表。阳气被寒邪遏制，在体表抗争，阳气衰弱而阴气盛，所以出现发热又伴有怕冷的症状，可以用发汗的方法来发散邪气，以恢复阳气。所谓“内实”，是指体内属阴、属里，极端的阴转化为阳，寒气极盛而生热，阳气反而亢盛并陷入体内，所以胃腑内部实热，持续发热，不怕冷，可以用通泄利下的方法，以恢复阴气。这里说的“实”，并不是正气真正的充实，而是邪气盛实的表现。《素问》说：“邪气盛则实。”因此我知道华佗传记中“内外”二字存在谬误。
近代常使用煮散（将药物捣碎后煎煮）的方法，古代的汤液方剂虽然保留下来却不再使用。大概是因为古方的剂量单位“升”和“两”大多数值较大，或者水量少导致药汤浑浊，药味过于浓烈。殊不知圣人专门针对一种疾病进行治疗，决定一两剂就能见效，那些水量少的记载，自然是传抄过程中产生的错误，并非古人的本意。
自从唐代安史之乱以来，藩镇割据跋扈，直到五代十国时期，天下战乱频繁，道路艰难，各地的草药石材很少能流通运输，所以医家为了节省，将汤剂改为煮散。以至于有很多不能准确对症治疗的病例，因为疑惑混淆而多次更改治疗方法的情况很多。这种习俗沿袭至今，未曾革除弊端，古代的汤液方剂，实际上在当今时代成了无用的书。唐代徐氏的《大和济要方》减少了药物的升两用量，虽然是顺应世俗，但我担心减得太少，导致病情还没好一半，药汤就已经喝完了，我心里对此感到担忧。我自己通过搜集整理、斟酌推敲，积累了三十多年，稍微熟悉了其中的门道，所以敢于裁减升两的用量，希望能顺应世俗且便于临床使用。有的方子取半剂，有的取三分之一，有的取四分之一，有的取五分之一，有的增加水量以便制作成煮散，有的病情严重专门用汤剂攻治。有人说：古代的升秤折算，三升相当于现在的一升，三两相当于现在的一两，这又是错误的。况且晋代葛氏说：一枚附子相当于半两。又说：用盏代替升，用分代替两。这说明古代的升秤与现在是相同的，只是允许人们减少用量罢了。
现在的医生，大多是愚昧庸俗之人，苟且维持衣食生计，贪婪地索取财物。对于大方广论，怎么能通达理解？只是秘密窖藏浅薄的医术，让人无法窥探其破绽，以此自夸自大，凭借便利自称神工，恐怕导致许多人夭折枉死，这种情况已经很多了。很少有见闻广博的人。虽然有偶尔出现的士大夫阶层，也都鄙视他们的医术。如果不是不顾流俗，以拯救救济为心志，就不能专心研究于此。现在我解释前人的言论，详细纠正脱漏和错误，选择确切的论述，删除繁杂的方剂，仍然加入新的见解，不敢牵强附会，希望初学者容易看懂，阅读这篇文章已经能掌握七八分了。这些方剂都是古代圣贤撰写的，效果如神，不一一列举姓名，也不记载出处。其中如果有我自己的见解，经手验证有效的，都收集整理成卷，让有识之士阅览后自然知晓。
In the *Biography of Hua Tuo* in the *Records of Wei*, it is recorded that two government clerks, Er Xun and Li Yan, sought treatment together. Both suffered from headache and fever, experiencing identical distress. Hua Tuo stated: "Er Xun should be treated with purgation (Xia Fa), while Li Yan should be treated with diaphoresis (Fa Han)." Someone questioned this difference, to which Hua Tuo replied: "Er Xun has an exterior excess (Wai Shi), whereas Li Yan has an interior excess (Nei Shi); therefore, their treatments must differ." He administered different medicines to each, and by the next morning, both had recovered. I deeply suspect that Chen Shou mistakenly used the characters "interior" and "exterior" in his record, which does not reflect Hua Tuo's original intent.
If a patient presents with headache, fever, and aversion to cold, this indicates an exterior excess caused by Yin pathogenic factors; according to the principles, diaphoresis should be employed. If a patient presents with headache and fever, characterized only by a steaming sensation of heat without aversion to cold, this indicates an interior excess caused by Yang pathogenic factors; according to the principles, purgation should be employed. The term "exterior excess" refers to the exterior being Yang and representing the surface level. When Yang Qi is constrained by Cold pathogens and struggles at the surface, Yang becomes deficient while Yin prevails, resulting in symptoms of fever accompanied by aversion to cold. In such cases, diaphoresis can be used to disperse the pathogen and restore Yang Qi. The term "interior excess" refers to the interior being Yin and representing the deep level. Extreme Yin transforms into Yang; when Cold is severe, it generates Heat, causing Yang Qi to become excessive and penetrate inward. This results in interior excess in the Stomach Fu organ, manifesting as continuous steaming heat without aversion to cold. Here, purgation or draining methods can be used to restore Yin Qi. The "excess" mentioned here does not refer to the true fullness of healthy Qi, but rather to the excess of pathogenic factors. As stated in the *Su Wen*: "When pathogenic factors are vigorous, there is excess." Thus, I conclude that the terms "interior" and "exterior" in the biography of Hua Tuo contain errors.
In recent times, decoction powder (Zhu San) has been commonly prepared, while ancient liquid decoctions (Tang Ye) remain preserved but unused. This is likely because the dosages in ancient prescriptions, measured in *sheng* and *liang*, were often large, or the water volume was small leading to turbid, overly concentrated medicinal fluids. However, one fails to realize that the Sages specifically targeted single diseases, determining that one or two doses would yield results. Records indicating small water volumes are merely transcription errors, not the original intent of the ancients.
Since the An Lushan Rebellion in the Tang Dynasty, regional military governors became arrogant and unruly, continuing through the Five Dynasties period. With frequent warfare across the realm and difficult travel conditions, herbs and minerals from various regions rarely circulated. Consequently, physicians simplified their methods, converting decoctions into decoction powders. This led to many instances where treatments failed to address the disease accurately, causing confusion and frequent changes in prescription. This custom has persisted to the present day without reform, rendering ancient liquid decoctions practically useless books in the current era. Xu’s *Dahe Ji Yao Fang* from the Tang Dynasty reduced the *sheng* and *liang* measurements. While this adapted to popular practice, I feared the reduction was too drastic, causing the medicinal fluid to be exhausted before half the illness was cured, which concerned me. Through my own collection, organization, and deliberation over more than thirty years, I have gradually mastered these matters. Therefore, I dare to reduce the *sheng* and *liang* dosages, hoping to accommodate contemporary customs while facilitating clinical application. Some prescriptions may use half a dose, one-third, one-fourth, or one-fifth. Some increase water volume to prepare decoction powders, while others with severe conditions require specific liquid decoctions for aggressive treatment.
Some argue that ancient measurement units convert such that three ancient *sheng* equal one modern *sheng*, and three ancient *liang* equal one modern *liang*. This is incorrect. Ge Shi of the Jin Dynasty stated: "One Fuzi (Aconite Root) equals half a *liang*." He also said: "Use a cup instead of a *sheng*, and *fen* instead of *liang*." This indicates that ancient *sheng* and *liang* were consistent with modern ones, allowing people simply to reduce the dosage.
Most physicians today are ignorant and vulgar, content with mere subsistence, greedy for wealth. How could they possibly understand broad and comprehensive theories? They hoard shallow medical skills, preventing others from seeing their flaws, thereby boasting of their greatness. Relying on convenience, they claim divine skill, yet unfortunately, many die prematurely due to such negligence. There are few who are well-read and knowledgeable. Although some scholars occasionally appear, they all despise such practices. Unless one disregards worldly trends and is dedicated to saving lives, one cannot devote oneself to this study. Now, I explain previous statements, carefully correct omissions and errors, select sound arguments, delete cumbersome prescriptions, and add new insights without forced interpretations. I hope beginners can easily comprehend them; after reading this text, one should grasp seventy to eighty percent of the knowledge. These prescriptions were authored by ancient sages and are effective as if by magic. I do not list every name or source individually. Any personal insights or verified cases handled by myself are compiled in this volume for discerning readers to recognize.