夫治病有专宜于寒者、热者、补者，泻者，又宜寒热补泻之兼用者。如《伤寒》有附子泻心汤，用大
黄、芩、连、附子，寒热之并用者；有柴胡加龙骨牡蛎汤，以人参、大黄、黄芩、姜、桂，补泻寒热之并用者。
《金匮》有大黄附子细辛汤，有大黄、干姜、巴豆之备急丸。此皆先圣贤切中肯綮之妙用，当参究其所用
之因而取法之。今时有用凉药而恐其太凉，用热药而恐其太热，是止知药之寒热，而不知病之邪正虚实也。
然亦有并用寒热补泻而切当者，反为不在道者笑之。开之曰∶寒热补泻兼用，在邪正虚实中求之则得矣。
所谓官料药者，乃解京纳局之高品。近时有谓火瘅、黄疽、肿胀诸证，不宜服官料药者，真齐东野人
之语也。夫官料亦多系草根木皮，又何分草药之非官料，而官料之非草药乎？夫草药自神农至今，计六
百一十余种，又杂草九种，有名未用者一百五十三种，内多有名而不识其草者，有草而不知其名者，若
按《图经》以对草之形，以草之主治何病以对经，未尝不可，若凭荷担之野人，在彼亦不能识，而胡乱以
命名，即欲按经索草，彼亦胡乱付之，在所取之人，
亦不知其是与非也，是乌可尝试哉！
肾气丸乃上古之圣方，藏之金匮，故名金匮方。夫人秉先天之阴阳水火，而生木火土金之五行。此
方滋补先天之精气，而交通于五脏，故名肾气丸。用熟地黄八两，以滋天乙之精，八者，男子所得之阴数
也。用附子一枚重一两者，以资地二之火，两为阴数之终，一乃生阳之始，助阴中所生之阳。盖两肾之水火
互交，阴阳相合，是以用地黄、附子，以助先天之水火精气者也。用桂通肾气以生肝，桂色赤，而为百木
之长，肝主血而属木也。（古方原用桂枝。）用牡丹皮通肾气，上交于心脾，丹属火而主血，牡乃阴中之阳升
也。夫肾与肺，皆积水也。泽泻能行水上，复能泻水下行，主通水天之一气，是以配肉桂、丹皮、泽泻
者，导肾脏之水火，上交于四脏者也。茯苓归伏心气以下交，山药培养脾土以化水，山茱萸乃木末之实，
味酸色赤，复能导肝气交通于肾，是以配茯苓、山药、山萸、泽泻者，导四脏之气而下交于肾也。心肺
为阳，故用三两之奇，肝脾为阴，故用四两之偶，此培养精神气血，交通五脏五行之神，方不可缺一者
也。宋钱仲阳以为阳常有余，阴常不足，去桂、附而
改为六味地黄丸。夫精血固宜补养，而神气可不资生乎？后人因而有加知母、黄柏者，有加枸杞、菊花
者，有加麦冬、五味者，竟失本来面目矣。夫加减之法，因阴虚火盛之人，以之治病则可，若欲调摄阴
阳，存养精气，和平水火，交通五行，益寿延年，神仙不老，必须恒服此金丹矣。元如曰∶精生于五脏，
而下藏于肾，肾气上升，以化生此精，是以五脏交通而后精气充足。
治病有专门适用于寒证、热证、补法、泻法的情况，也有适宜于寒热并用、补泻兼施的情况。例如《伤寒论》中有附子泻心汤，使用大黄、黄芩、黄连、附子，这是寒药与热药并用的例子；有柴胡加龙骨牡蛎汤，用人参、大黄、黄芩、生姜、桂枝，这是补虚、泻实、清热、温散并用的例子。《金匮要略》中有大黄附子细辛汤，还有备急丸（含大黄、干姜、巴豆）。这些都是古代圣贤切中病机要害的巧妙运用，应当研究其用药的原理并效法它。如今有人使用凉药却担心太凉，使用热药却担心太热，这只是知道药物的寒热属性，而不知道疾病的邪正虚实本质。然而也有同时使用寒热补泻而非常恰当的，反而被那些不懂医道的人嘲笑。对此解释说道：寒热补泻兼用，只有在辨析邪正虚实的关系中才能掌握得当。
所谓“官料药”，是指解京纳局（指官方药材机构）的高品质药材。近来有人说火瘅、黄疸、肿胀等病症不宜服用官料药，这真是无知浅陋之人的话。官料药也多属于草根木皮，又何必区分草药中哪些不是官料药，以及官料药中哪些不是草药呢？从神农氏至今，草药共计六百一十余种，另有杂草九种，有名而未使用的有一百五十三种，其中多有名号却不识其草形的，有草形却不知其名号的。如果按照《图经》对照草的形状，以草的主治功效对应经络，未尝不可；但如果凭借挑担的乡野之人，他们在那里也不能识别，胡乱命名，即使想要按经典索求草药，他们也会胡乱交付，对于取药的人来说，也不知道是对是错，这怎么可以轻易尝试呢！
肾气丸是上古圣人的方剂，珍藏于金匮之中，所以称为金匮方。人禀受先天的阴阳水火之气，而生出木火土金五行。此方滋补先天的精气，并交通五脏，所以名叫肾气丸。方中用熟地黄八两，以滋养天乙之精，八是男子所得的阴数。用一枚重一两的附子，以资助地二之火，两是阴数的终结，一是生阳的开始，以此辅助阴中所生的阳气。大概两肾的水火互相交济，阴阳相合，所以用地黄、附子来辅助先天的水火精气。用桂枝（古方原用桂枝）通肾气以生肝气，桂色赤，为百木之长，肝主血而属木。（注：古方原用桂枝。）用牡丹皮通肾气，上交于心脾，丹属火而主血，牡乃阴中之阳上升。肾与肺，都是积水之处。泽泻能行水上，又能泻水下行，主要通调天水的一气，所以配伍肉桂、丹皮、泽泻，是为了引导肾脏的水火，上交于其他四脏。茯苓归伏心气以下交，山药培养脾土以化水，山茱萸是木末之实，味酸色赤，又能引导肝气交通于肾，所以配伍茯苓、山药、山茱萸、泽泻，是为了引导四脏之气而下交于肾。心肺属阳，所以用量为三两的奇数；肝脾属阴，所以用量为四两的偶数，这是培养精神气血，交通五脏五行的神妙之处，方中不可缺少的部分。宋代钱仲阳认为阳常有余，阴常不足，去掉桂、附而改为六味地黄丸。精血固然应该补养，但神气难道不需要滋生吗？后人因此有加知母、黄柏的，有加枸杞、菊花的，有加麦冬、五味子的，竟然失去了原来的面目了。加减之法，对于阴虚火盛的人，用来治病是可以的，如果想要调摄阴阳，存养精气，和平水火，交通五行，益寿延年，达到神仙不老的效果，必须长期服用这个金丹。元如说：精生于五脏，而下藏于肾，肾气上升，以化生此精，所以五脏交通之后精气才充足。
Treating diseases has specific indications for cold, heat, tonification, and purgation; there are also cases where cold and heat, or tonification and purgation, should be used simultaneously. For example, in the *Shanghan Lun* (Treatise on Cold Damage), there is the Fuzi Xie Xin Tang (Aconite Decoction to Drain the Epigastrium), which uses Dahuang (Rhubarb Root), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Fuzi (Prepared Aconite Root Lateralis), representing the simultaneous use of cold and hot herbs; there is also Chaihu Jia Longgu Muli Tang (Bupleurum Decoction with Dragon Bone and Oyster Shell), which uses Renshen (Ginseng Root), Dahuang (Rhubarb Root), Huangqin (Scutellaria Root), Shengjiang (Fresh Ginger Rhizome), and Guizhi (Cinnamon Twig), representing the simultaneous use of tonification, purgation, cooling, and warming. In the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), there is Dahuang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction) and the Beiji Wan (Emergency Rescue Pill) containing Dahuang (Rhubarb Root), Ganjiang (Dried Ginger Rhizome), and Badou (Croton Seed). These are all subtle applications by ancient sages that hit the crux of the matter precisely; one should investigate the reasons for their use and follow their examples. Nowadays, some people fear that cooling medicines are too cold or heating medicines are too hot; this shows they only know the cold and hot nature of drugs but do not understand the excess and deficiency of pathogenic factors and healthy qi in diseases. However, there are also cases where the simultaneous use of cold, heat, tonification, and purgation is highly appropriate, yet such practitioners are mocked by those who do not understand the Dao of medicine. The explanation is: The simultaneous use of cold, heat, tonification, and purgation can be mastered by seeking it within the context of pathogenic factors, healthy qi, excess, and deficiency.
The term "Guanliao Yao" (Official Grade Medicines) refers to high-quality herbs from the Imperial Pharmacy. Recently, some have claimed that conditions such as Huodan (Fire Jaundice), Huangdan (Jaundice), and Zhangzhong (Distension and Swelling) should not take Guanliao Yao; this is truly the talk of ignorant villagers. Guanliao Yao mostly consists of herb roots and tree barks; why distinguish between herbal medicines that are not official grade and official grade medicines that are not herbal? From Shennong to the present, medicinal herbs number over 610 species, plus 9 weed species, and 153 species with names but unused. Among them, many have names but unknown forms, and many have forms but unknown names. If one consults the *Tujing* (Illustrated Canon) to match herb shapes and uses the herb's therapeutic effects to correspond to meridians, it is feasible. However, relying on illiterate carriers who cannot identify them there and name them arbitrarily, even if one tries to trace herbs according to classics, they will hand over arbitrary substitutes. The person obtaining them will not know right from wrong; how can such things be casually tried!
Shenqi Wan (Kidney Qi Pill) is an ancient sage formula, stored in the Golden Cabinet, hence named Jingui Fang (Golden Cabinet Formula). Humans inherit the primordial Yin and Yang Water and Fire, generating the Five Phases of Wood, Fire, Earth, Metal, and Water. This formula tonifies primordial essence and qi, communicating with the Five Zang Organs, hence named Shenqi Wan. It uses Shudihuang (Prepared Rehmannia Root) eight liang to nourish the Essence of Tianyi (Heavenly One); eight is the Yin number obtained by men. It uses one Fuzi (Prepared Aconite Root Lateralis) weighing one liang to assist the Fire of Di'er (Earth Two); two is the end of Yin numbers, and one is the beginning of generating Yang, thus assisting the Yang born within Yin. Generally, the Water and Fire of the two Kidneys interact mutually, and Yin and Yang combine; therefore, Dihuang (Rehmannia Root) and Fuzi (Prepared Aconite Root Lateralis) are used to assist the primordial Water and Fire essence and qi. Guizhi (Cinnamon Twig) [Note: Ancient formulas originally used Guizhi] unblocks Kidney Qi to generate Liver Qi; Cinnamon is red and is the chief of hundred trees; the Liver governs Blood and belongs to Wood. Mudanpi (Moutan Cortex) unblocks Kidney Qi, sending it upward to communicate with the Heart and Spleen; Dan (Red) belongs to Fire and governs Blood; Mu (Oyster Shell/Male aspect) represents the rising of Yang within Yin. The Kidney and Lung are both reservoirs of water. Zexie (Alisma Rhizome) can move water upwards and drain water downwards, primarily regulating the unified Qi of Heaven and Water; therefore, Rougui (Cinnamon Bark), Mudanpi (Moutan Cortex), and Zexie (Alisma Rhizome) are paired to guide the Water and Fire of the Kidney to ascend and communicate with the other four Zang Organs. Fuling (Poria) settles Heart Qi to descend and communicate; Shanyao (Dioscorea Rhizome) cultivates Spleen Earth to transform water; Shanzhuyu (Cornus Fruit) is the fruit of wood, sour in taste and red in color, and can guide Liver Qi to communicate with the Kidney; therefore, Fuling (Poria), Shanyao (Dioscorea Rhizome), Shanzhuyu (Cornus Fruit), and Zexie (Alisma Rhizome) are paired to guide the Qi of the four Zang Organs to descend and communicate with the Kidney. The Heart and Lung are Yang, so their dosage is three liang (an odd number); the Liver and Spleen are Yin, so their dosage is four liang (an even number). This cultivates Spirit, Qi, and Blood, facilitating the divine communication of the Five Zang Organs and Five Phases; these components must not be omitted. Qian Zhongyang of the Song Dynasty believed that Yang is often in excess and Yin is often deficient, removing Gui (Cinnamon) and Fu (Aconite) to create Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). Although Essence and Blood should indeed be tonified, does Spirit and Qi not need nourishment? Later generations added Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark), or Gouqi (Goji Berry) and Juhua (Chrysanthemum Flower), or Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Fruit), completely losing the original appearance. The method of modification is suitable for treating diseases in individuals with Yin deficiency and flourishing Fire, but if one wishes to regulate Yin and Yang, preserve and nourish Essence and Qi, harmonize Water and Fire, communicate the Five Phases, extend life, and achieve immortality, one must constantly take this Golden Elixir. Yuan Ru said: Essence is generated by the Five Zang Organs and stored downward in the Kidney; Kidney Qi ascends to transform and generate this Essence; therefore, after the Five Zang Organs communicate, Essence and Qi become sufficient.