既论制方之大法，又分六经之方以论之，亦云详矣。而定方不同之故，更不可不辨也。夫风寒暑湿之伤人，
六经各有所受，而发见之脉不同。或脉同而症异，或脉症皆同而主症不同者，此经气之有别也。盖六经分界，
如九州之风土，人物虽相似，而衣冠、饮食、言语、性
情之不同，因风土而各殊。则人身表里之寒热虚实，亦皆因经气而异矣。如太阳一经，寒热互呈，虚实递见，
治之者，当于表中顾里，故发表诸方，往往兼用里药。阳明之经主实热，治者当于实中防虚，故制攻下诸方，
而又叮咛其不可轻用。少阳之经气主虚热，故立方凉解，每用人参。太阴之经气主虚寒，故立方温补，不离姜、
附。少阴之经气多虚寒，故虽见表热而用附子，亦间有虚热，故亦有滋阴之剂。厥阴之经气主实热，故虽手足
厥冷，脉微欲绝，而不用姜、附。然此为无形之实热，与阳明有形之实热径庭矣。仲景制方，因乎经气，《内经》
“审其阴阳，以别刚柔，阳病治阴，阴病治阳，定其气血，各守其乡”之理也。所以表里攻补阴阳之品，或同或异
者，亦因其经气血之多少而为之定剂耳。请再以表里论之∶三阳主表而有里，三阴主里而无表，何也？太阳为五
脏之主，以胸中为里，以少阴为里；阳明为六腑之主，以腹中为里，以太阴为里；少阳为十一脏所决之主，故胸
腹皆为其里而无定位，以厥阴为里，犹运筹于帷幄也。治三阳者，既顾心腹之里，又顾三阴之里，所以阳经之方
倍于阴经。而阳有多少，病有难易，所以阳明之方不及太阳，少阳之方更少于阳明也。三阴非无表症也，而谓其
无表。故少阴之一身尽热，无非太阳渐外之阳；太阴之四肢烦疼，原是胃脘之所发；厥阴之厥而发热，畴非三焦
胆甲之气也。第不头痛项强，胃家不实，不口苦目眩，定其为阴经耳。三阴之表自三阳来，所以三阴表剂，仍用
麻黄、桂枝为出路。太阴之芍药，少阴之附子，厥阴之当归，得互列于表剂之间，并行而不悖。此《内经》阴
阳、表里、雌雄相输应之义也。
麻黄升麻汤∶
麻黄 升麻 黄芩 知母 石膏 芍药 天冬 干姜 桂枝 当归 茯苓 白术 玉竹 甘草
六经方中，有不出于仲景者。合于仲景，则亦仲景而已矣。若此汤其大谬者也。伤寒六七日，大下后，
寸脉沉而迟。夫寸为阳，主上焦，沉而迟，是无阳矣。沉为在里，则不当发汗；迟为脏寒，则不当清火。且下
部脉不至，手足厥冷，泄利不止，是下焦之元阳已脱，又咽喉不利吐脓血，是上焦之虚阳无根据而将亡，故扰乱
也。如用参、附以回阳，而阳不可回，故曰难治，则仲景不立方治也明矣。此用麻黄、升麻、桂枝以散之，汇集
知母、天冬、黄芩、芍药、石膏等大寒之品以清之，以
治阳实之法，治亡阳之症，是速其阳之毙也。安可望其汗出而愈哉！用干姜一味之温，苓、术、甘、归之补，
取玉竹以代人参，是犹攻金城高垒，而用老弱之师也。且用药至十四味，犹广罗原野，冀获一兔，与防风通圣
等方，同为粗工侥幸之符也。谓东垣用药多多益善者，是不论脉病之合否，而殆为妄谈欤！
既然已经论述了制定方剂的大法，又分别针对六经的方剂进行论述，可以说非常详细了。但是，决定方剂不同的原因，更是不可不辨别的。风寒暑湿等邪气伤人，六经各有其受邪之处，而显现出的脉象各不相同。有时脉象相同而症状不同，有时脉象和症状都相同而主要症状却不同，这是因为各经经气有所区别的缘故。大概六经的分界，就像九州的风土人情一样，人物虽然相似，但衣冠、饮食、言语、性情因风土不同而各自殊异。那么人身表里的寒热虚实，也都因为经气的不同而有所差异。
例如太阳经（足太阳膀胱经），寒热交错呈现，虚实交替出现，治疗时应当在解表的同时顾护里气，所以发表（发散表邪）的各种方剂中，往往兼用调理里气的药物。阳明经（足阳明胃经）的主气是实热，治疗时应当在攻实的同时防止伤虚，所以制定攻下（泻下积滞）的各种方剂时，又反复叮咛不可轻易使用。少阳经（足少阳胆经）的经气主虚热，所以立方以清凉和解为主，常用人参（Ren Shen, Ginseng Radix）。太阴经（足太阴脾经）的经气主虚寒，所以立方以温补为主，离不开干姜（Gingeris Rhizoma）和附子（Aconiti Lateralis Radix Praeparata）。少阴经（足少阴肾经）的经气多属虚寒，所以即使见到表热证而使用附子，也间或有虚热证，因此也有滋阴的方剂。厥阴经（足厥阴肝经）的经气主实热，所以即使出现手足厥冷、脉微欲绝的症状，也不使用干姜和附子。然而这是无形之实热，与阳明经有形之实热截然不同。张仲景（Zhang Zhongjing）制定方剂，是依据经气的特性，符合《内经》“审察阴阳，以辨别刚柔，阳病治阴，阴病治阳，确定气血，各守其位”的道理。所以表里、攻补、阴阳的药物，有的相同有的不同，也是根据各经气血的多少来定量的。请再从表里角度来论述：三阳经（太阳、阳明、少阳）主表而有里，三阴经（太阴、少阴、厥阴）主里而无表，为什么呢？太阳经为五脏之主，以胸中为里，以少阴经为里；阳明经为六腑之主，以腹中为里，以太阴经为里；少阳经为十一脏决断之主，所以胸腹都是它的里而没有固定定位，以厥阴经为里，就像在帷幄中运筹帷幄一样。治疗三阳经的病，既要顾护心腹之里，又要顾护三阴经之里，所以阳经的方剂数量多于阴经。而且阳气有盛衰，病情有难易，所以阳明经的方剂不如太阳经多，少阳经的方剂比阳明经更少。三阴经并非没有表证，却说它无表证。所以少阴经的一身尽热，无非是太阳经渐向外透发的阳气；太阴经的四肢烦疼，原是胃脘部位所发出的；厥阴经的手足厥冷而发热，难道不是三焦（San Jiao, Triple Burner）和胆甲之气的作用吗？只是因为没有头痛项强、胃家不实、口苦目眩等症状，才确定其为阴经。三阴经的表证来自三阳经，所以三阴经的解表剂，仍然使用麻黄（Ephedrae Herba）、桂枝（Cinnamomi Ramulus）作为出路。太阴经用的芍药（Paeoniae Radix Alba），少阴经用的附子，厥阴经用的当归（Angelicae Sinensis Radix），得以互列于解表剂之间，并行而不违背。这是《内经》阴阳、表里、雌雄相互对应的意义。
麻黄升麻汤（Mahuang Shengma Decoction）：
麻黄、升麻、黄芩、知母、石膏、芍药、天冬、干姜、桂枝、当归、茯苓、白术、玉竹、甘草。
六经方剂中，有不出自张仲景的。如果合乎张仲景的法度，那也就是张仲景的方子了。像这个汤剂就是大错特错的。伤寒病经过六七天，经过猛烈攻下之后，寸脉沉而迟。寸脉属阳，主上焦，沉而迟，说明没有阳气了。沉表示病在里，就不应当发汗；迟表示脏寒，就不应当清火。况且下部脉不至，手足厥冷，泄利不止，这是下焦的元阳已经脱失，再加上咽喉不利、吐脓血，这是上焦的虚阳没有根基而即将亡失，所以导致气机扰乱。如果使用人参、附子来回阳，而阳气已无法挽回，所以说难治，那么张仲景不为此立方的意思就很明白了。这里使用麻黄、升麻、桂枝来发散，汇集知母、天冬、黄芩、芍药、石膏等大寒的药物来清热，是用治疗阳实证的方法，来治疗亡阳证的症状，这是加速阳气的死亡。怎么指望它能通过出汗而痊愈呢！只用干姜一味的温热，配合茯苓、白术、甘草、当归的补益，取玉竹代替人参，这就像是攻打坚固的城池，却使用老弱的军队。而且用药多达十四味，如同在广阔的原野上撒网，希望捕获一只兔子，这与防风通圣散（Fangfeng Tongsheng San）等方剂，同样是粗疏工匠侥幸成功的符咒。如果说李东垣（Li Dongyuan）用药多多益善，这是不论脉象与病症是否相符，简直是妄谈啊！
Having discussed the general principles of formulating prescriptions, and further analyzing the prescriptions for each of the Six Channels (Liu Jing), one can say it is quite detailed. However, the reasons for the differences among these fixed prescriptions must be distinguished. Wind, cold, summer-heat, and dampness pathogenic factors injure the body, and each of the Six Channels has its specific site of reception, manifesting with different pulses. Sometimes the pulse is the same but symptoms differ; sometimes both pulse and symptoms are the same but the chief symptoms differ; this is due to the distinction in the Qi of the channels. The boundaries of the Six Channels are like the geography and customs of the Nine Provinces: although people and things may seem similar, their clothing, diet, speech, and temperament vary according to local conditions. Similarly, the exterior-interior, cold-heat, deficiency-excess states of the human body vary according to the channel Qi.
For instance, the Taiyang Channel (Foot-Taiyang Bladder Channel) presents alternating cold and heat, and alternating deficiency and excess. Treatment should protect the interior while releasing the exterior; therefore, many exterior-releasing prescriptions often include herbs that regulate the interior. The Yangming Channel (Foot-Yangming Stomach Channel) governs excess-heat. Treatment should prevent deficiency while attacking excess; thus, when formulating purgative prescriptions, one must repeatedly caution against their casual use. The Shaoyang Channel (Foot-Shaoyang Gallbladder Channel) governs deficiency-heat; hence, prescriptions are formulated with cooling and harmonizing methods, frequently using Ren Shen (Ginseng Radix). The Taiyin Channel (Foot-Taiyin Spleen Channel) governs deficiency-cold; hence, prescriptions are formulated with warming and tonifying methods, relying on Gan Jiang (Gingeris Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata). The Shaoyin Channel (Foot-Shaoyin Kidney Channel) is mostly deficiency-cold; thus, even when treating exterior-heat patterns, Fu Zi is used, and occasionally there are deficiency-heat patterns, requiring yin-nourishing agents. The Jueyin Channel (Foot-Jueyin Liver Channel) governs excess-heat; thus, even if presenting with cold extremities and a faint pulse nearly imperceptible, Gan Jiang and Fu Zi are not used. This is because it is formless excess-heat, which is vastly different from the material excess-heat of the Yangming Channel. Zhang Zhongjing’s prescription formulation follows the nature of channel Qi, aligning with the *Neijing* principle: “Examine Yin and Yang to distinguish Gang and Rou; treat Yin diseases by addressing Yang, and Yang diseases by addressing Yin; determine Qi and Blood, and let each remain in its place.” Therefore, the use of exterior-interior, attacking-tonifying, and Yin-Yang herbs varies or remains the same depending on the abundance or scarcity of Qi and Blood in each channel.
Let us discuss this from the perspective of Exterior and Interior: The Three Yang Channels (Taiyang, Yangming, Shaoyang) govern the Exterior but contain an Interior; the Three Yin Channels (Taiyin, Shaoyin, Jueyin) govern the Interior but lack an Exterior. Why? Taiyang is the master of the Five Zang Organs, regarding the chest as its Interior and the Shaoyin Channel as its Interior; Yangming is the master of the Six Fu Organs, regarding the abdomen as its Interior and the Taiyin Channel as its Interior; Shaoyang is the master of decision-making for the eleven organs, so both chest and abdomen serve as its Interior without a fixed location, regarding the Jueyin Channel as its Interior, much like strategizing within a tent. Treating the Three Yang Channels requires protecting both the Heart-Abdomen Interior and the Three Yin Interiors; hence, prescriptions for Yang Channels outnumber those for Yin Channels. Furthermore, since Yang Qi has degrees of abundance and diseases have varying difficulties, Yangming prescriptions are fewer than Taiyang, and Shaoyang prescriptions are even fewer than Yangming.
The Three Yin Channels do have Exterior manifestations, yet they are said to lack an Exterior. Thus, the generalized heat of the Shaoyin Channel is essentially the Yang Qi of Taiyang gradually moving outward; the painful discomfort of the limbs in Taiyin originates from the stomach region; the cold extremities followed by fever in Jueyin are none other than the Qi of the San Jiao (Triple Burner) and Gallbladder. It is only because there is no headache and stiff neck, no fullness in the stomach, and no bitter taste or dizziness that they are determined to be Yin Channels. The Exterior of the Three Yin Channels derives from the Three Yang Channels; therefore, exterior-releasing prescriptions for the Three Yin Channels still use Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) as outlets. Shaoyao (Paeoniae Radix Alba) in Taiyin, Fu Zi in Shaoyin, and Danggui (Angelicae Sinensis Radix) in Jueyin are interposed among exterior-releasing agents, functioning together without contradiction. This reflects the *Neijing* meaning of the mutual correspondence between Yin-Yang, Exterior-Interior, and Male-Female.
Mahuang Shengma Decoction (Mahuang Shengma Tang):
Mahuang, Shengma, Huangqin, Zhimu, Shigao, Shaoyao, Tiandong, Ganjiang, Guizhi, Danggui, Fuling, Baizhu, Yuzhu, Gancao.
Among the Six Channel prescriptions, some are not authored by Zhang Zhongjing. If they conform to Zhang Zhongjing’s principles, they are effectively his prescriptions. However, this decoction is fundamentally erroneous. In Cold Damage disease, after six or seven days, following severe purging, the Cun (Inch) pulse is deep and slow. Cun belongs to Yang and governs the Upper Jiao; deep and slow indicates the absence of Yang Qi. Deep signifies pathology in the Interior, so sweating should not be induced; slow signifies Cold in the Zang, so clearing Fire should not be employed. Moreover, the lower pulses are absent, extremities are cold, and diarrhea persists, indicating that the Primordial Yang of the Lower Jiao has collapsed. Additionally, throat obstruction with vomiting of pus and blood indicates that the Deficient Yang of the Upper Jiao lacks foundation and is perishing, causing chaotic Qi movement. If Renshen and Fuzi were used to restore Yang, but Yang cannot be restored, it is termed "difficult to treat," implying that Zhang Zhongjing did not formulate a prescription for this condition. Here, Mahuang, Shengma, and Guizhi are used to disperse, while Zhimu, Tiandong, Huangqin, Shaoyao, and Shigao—major cold herbs—are gathered to clear heat. Using methods for Excess-Heat to treat Yang Collapse accelerates death. How could one expect recovery through sweating? Using only Ganjiang for warmth, and Fuling, Baizhu, Gancao, and Danggui for tonification, substituting Yuzhu for Renshen, is like attacking a fortified city with an old and weak army. Prescribing fourteen herbs is akin to casting a wide net in the wilderness hoping to catch one rabbit; such approaches, similar to Fangfeng Tongsheng San, are merely lucky charms for incompetent physicians. To claim that Li Dongyuan advocated "the more herbs, the better" is to ignore the compatibility of pulse and disease, amounting to reckless talk!