典藏书目

I paid attention to medicine since childhood, but I had never seen anyone who truly mastered it. During the Zhenyou era, I came from Wo to the south of the Yellow River and went to Dunqiu County to study under Mr. Zhang Zhongjie. There, I met the Imperial Physician Mr. Zhang Zihe (Zhang Congzheng). He taught medicine to Zhongjie, and his influence extended to you Gong Junbao and myself. Oh, how great is Mr. Zhang's learning! He elucidated the origins of the profound Dao and the fundamentals of creation, discussed the stagnation and release of the Five Movements (Wu Yun), and analyzed the excess, deficiency, and oppression of the Six Qi (Liu Qi). He established methods he formulated and paired them with appropriate prescriptions. Once the standards are set, crookedness and straightness naturally become correct; once the compass and square are established, circles and squares naturally form. Is not Mr. Zhang's learning the standard and compass for learners? Even as a human, he could be considered a Heavenly Master. Through observation (Wang Zhen), he exhausts the spirit; through listening and smelling (Wen Zhen), he exhausts sagacity; through inquiry (Wen Zhen), he exhausts skill; through palpation (Qie Zhen), he exhausts dexterity. Why would he need to drink water from the upper pool to see through the five Zang organs? One glance reveals everything without omission!

The most concise treatment methods consist of three; the categories of medicines used consist of six. The three treatments are sweating (Han), purging (Xia), and vomiting (Tu); the six medicinal properties are pungent (Xin), sweet (Gan), sour (Suan), bitter (Ku), salty (Xian), and bland (Dan). Although "tonification" (Bu) is not explicitly mentioned, the principle is inherently included. Fearing that people would be confused by tonification and unable to resolve their misconceptions, I have appended this treatise on tonification after Mr. Zhang's discussions on sweating, purging, and vomiting. This is what our generation should hear, what the medical community should observe, and what people should collectively know.

I have examined the classics and inspected various formulas to speak to those in the world who favor tonification. People who favor tonification do so either when healthy or when ill. Who tonifies when healthy? They are, at the top, the scholar-officials, and below them, the sons of the wealthy. They adorn their bodies with gold and jade, delight their mouths with beef, mutton, pork, and dog meat; they wear furs when cold and dwell in pavilions when hot; they ride carriages and horses when moving, and sleep on soft mats when resting; they prefer the five pungent spices and drink wine until late night. After getting drunk and full, having nothing else to occupy their minds, they devote themselves to sexual intercourse, exhausting their essence through desire and dissipating their true Qi. Thus, before reaching fifty, their bodies decline. So, what do they do? They use medicine to tonify!

They consult quack doctors or ask wandering physicians. Quacks, seeking to please those who want tonification, discuss only light substances—herbal plants such as Cistanche Herba (Rongshou), Achyranthes Bidentatae Radix (Niuxi), Morinda Officinalis Radix (Bajitian), and Cuscutae Semen (Tusizi). Wandering physicians, seeking fame and elevating themselves, discuss only heavy substances—minerals and stones such as Cinnabar (Dansha), Quartz (Qishi), and Sulfur (Liuhuang). I do not know if this constitutes tonification. If so, which Zang organ is being tonified?

If one claims to tonify the Heart: The Heart belongs to Ding Fire, its meridian is the Hand-Shaoyin Heart Meridian. Using heat to tonify it will generate conditions like sores and ulcers.
If one claims to tonify the Liver: The Liver belongs to Yi Wood, its meridian is the Foot-Jueyin Liver Meridian. Using heat to tonify it will generate conditions like tremors and vertigo.
The Spleen belongs to Ji Earth, its meridian is the Foot-Taiyin Spleen Meridian. Using heat to tonify it will cause swelling and distension.
The Lung belongs to Xin Metal, its meridian is the Hand-Taiyin Lung Meridian. Using heat to tonify it will cause resentment and depression.
The Heart cannot be tonified, the Liver cannot be tonified, the Spleen cannot be tonified, the Lung cannot be tonified. Is it all about tonifying the Kidney? Everyone knows the Kidney belongs to Gui Water, but few know its meridian connects to the Zi-Wu Ministerial Fire. Tonifying the fire of the Kidney makes the fire blaze hotter due to heat; tonifying the water of the Kidney dries up the water due to heat. With the fire blazing and the water dried up, the excessive fire connects upward to the Heart's Ding Fire, allowing fire to dominate unchecked. The Liver Wood fails to control the Spleen Earth, and the Lung Metal fails to control the Liver Wood. When the pathology of the five Zang reaches its extreme, it transmits to the six Fu organs; when the pathology of the six Fu reaches its extreme, it spreads throughout the Sanjiao. Then, hundreds of diseases arise simultaneously, and ten thousand ailments are born. Minor issues are negligible, but major ones are terrifying. One may suffer from carbuncles or stroke, or suddenly lose voice and die. This is the result of tonifying when healthy.

And who tonifies when ill? At the top, officials and the wealthy; at the bottom, farmers, merchants, and commoners. They tonify for vomiting, for diarrhea, for dysentery, for malaria, for coughing, for consumptive fever, and for postpartum conditions. For vomiting, they use Hewei Wan and Dingchen Jian; for diarrhea and dysentery, they use Doukou Wan and Yumiqiao San; for coughing, instead of Schisandra Fructus (Wuweizi), they use Ningshen San; for consumptive fever, instead of Cinnamon Twig (Guizhi) and Aconite Root (Fuzi), they use Dioscorea Rhizome (Shanyao); for postpartum conditions, instead of Wujin Wan, they use Heishen San. I do not know what intent this tonification has. Little do they know that vomiting aggravated by heat becomes more acidic and violent; diarrhea aggravated by heat leads to indistinguishable clear and turbid discharges; dysentery aggravated by heat results in recurrent bouts; malaria aggravated by heat becomes frequent and hard to subside; coughing aggravated by heat prevents the removal of dampness; consumptive fever aggravated by heat increases vexatious fire; postpartum conditions aggravated by heat lead to severe uterine bleeding. Nine out of ten die from such errors, while only one or two survive. The dead die unjustly, the living survive by luck. Those who survive are left in a wretched state, unbearable to behold. Seeing cold syndromes, they use heat to tonify. If this is called tonification, then what good was the previous tonification for such illnesses?

Let me explain the true method of tonification. Generally, excess is reduced, and deficiency is supplemented; this is the meaning of tonification. If Yang is in excess and Yin is deficient, one should reduce Yang and tonify Yin; if Yin is in excess and Yang is deficient, one should reduce Yin and tonify Yang. For heat syndromes, using Mirabilite (Mangxiao) and Rhubarb (Dahuang) reduces Yang and tonifies Yin; for cold syndromes, using Dried Ginger (Ganjiang) and Prepared Aconite Root (Fuzi) reduces Yin and tonifies Yang. How can one claim that heat medicines constitute tonification? Moreover, cold medicines also possess the meaning of tonification. The Classic states: "Reduce what is excessive, and manifest what is deficient." This refers to this principle. Some say: "For deficiency of form, warm with Qi; for deficiency of essence, tonify with flavor." Clinging to the words "warm" and "tonify," they believe this is the method of warming and tonifying, using only warming and tonifying drugs. However, the terms "warm" and "tonify" were specifically established for deficiencies of form and essence, not for treating illness per se. Although it says "warm," it refers only to the Qi; although it says "tonify," it refers only to the flavor. It never mentions using heat-producing drugs. Regarding pathogenic Qi from heaven, upon infection, it harms humans; the five Zang become solid but not full, and can be treated with purgation. Regarding cold and heat from food and drink, upon infection, they harm humans; the six Fu become full but not solid, and can be treated with emesis. Regarding dampness from earth, upon infection, it harms humans; pathogens enter from outside into skin, flesh, sinews, and vessels, and can be treated with sweating. However, releasing the exterior does not avoid heat, and there is no intention of tonification here.

Human endowment varies between strong and weak. If one is strong and falls ill, recovers, and returns to health, they will likely regain their former strength. If one is weak and falls ill, recovers, and returns to health, they may not necessarily regain their former strength. Hence, the concept of maintenance exists. But even with this concept, where is there any use for heat medicines? One should merely guard speech and regulate diet. Speaking of daily diet, how many eat the remnants of millet and wheat? How many eat the remnants of chicken, pig, cow, and sheep? How many eat the remnants of peaches, apricots, plums, and plums? How many eat the remnants of green onions, leeks, wild garlic, and garlic? Condiments include ginger, cinnamon, pepper, and dill; seasonings include salt, oil, vinegar, and soy sauce; staples are porridge and soup; preparations include frying and roasting; exotic foods include grilling; some even eat the five pungent spices raw. Accompaniments for wine include ginger, vinegar, mutton soup, and mutton dishes. The wealthy enjoy these excessively, and even commoners partake. I do not know what is cold? What food is cold? Yet they consider heat medicines as tonics! In daily diet, one already consumes too much. I have heard that people desire life and abhor death. Now, they forget that cold promotes life and willingly accept heat leading to death. Why? Because they do not understand the principles of creation in *Suwen* (Basic Questions) and the sources of drug properties in *Bencao* (Materia Medica), entrusting everything to quack doctors. Doctors say: "Cold and cool medicines can remove disease, but why should the Zang-Fu not be kept warm, and the Spleen-Stomach not be kept free of cold? For maintenance, it is appropriate to warm and tonify." As soon as these words leave their mouths, they are deeply believed. Like unchangeable metal and stone, or immovable mountains, they persist until death, with no regret. Alas! The doctor's sin is indeed unpardonable; yet the user also shares the responsibility. It is not surprising that patients lack knowledge. But why is it that every household is like this, making it easy to see but hard to rectify? It is simply because people do not study.

There are also enlightened theories, taking *Suwen* as the standard and *Bencao* as the rule. Their medicines are cold and cool, dosages are measured in liang, and pills contain a hundred grains. When people hear this, it is like seeing maggots in delicious food, wishing to flee quickly. Why? Because what they see is merely a small mound; when Mount Tai is discussed, they are terrified. Not spitting and staying away is already lucky; how could they expect to follow such words? This is precisely why the orthodox path is hard to establish and heretical paths easy to spread. I am truly worried. Moreover, the ignorance of the world is not solely the fault of the world. If the medical community itself does not know, how can we blame the world? Ah! The *Spring and Autumn Annals* style dictates blaming the virtuous rather than the foolish. Our own generation, despite claiming to uphold the Dao, abandons the source of learning and clings to trivial verbalities. We boast of literary skills and rhetorical strength, sitting with heads high and walking with swagger, striding broadly and waving hands, considering ourselves superior and transcendent, believing no one in the world matches our wisdom. Yet, when disease strikes, we are茫然 (at a loss). Confused like trying to catch the wind, lost like trying to catch a shadow. Forced to rely on quack doctors' judgments. If cured, we think we found a sage; if not cured, we think the disease is terminal, helpless, resigning ourselves to fate and death. Alas! We are hardly different from ignorant fools. This is why I speak incessantly. However, I dare not assume they will listen. Nevertheless, my theory is not just for our generation to know, nor just for the medical community, but for the whole world to know. If our generation knows, the medical community knows, and the world knows, my wishes will be fulfilled.