素问五常政大论上取下取内取外取以求其过能毒者以浓药不胜毒者以薄药
王冰曰上取谓以药制有过之气也制而不顺则吐之下取谓以迅疾之药除下病攻之不去则下之内取谓食及以药内之审其
寒热而调之外取谓熨药令所病气调适也当寒反热以冷调之当热反寒以温和之上盛不已吐而脱之下胜不已下而夺之谓求得
气过之道也药浓薄谓气味浓薄者也新校正云按甲乙经胃浓色黑大骨肉肥者皆胜毒其瘦而薄胃者皆不胜毒又按异法方宜论
西方之民陵居而多风水土刚强不衣而褐荐华食而脂肥故邪不能伤其形体其病生于内其治宜毒药吴昆曰察其面目口舌上取
也问其二便通塞不取也切其脉之虚实内取也探其身之寒热外取也若其人胃浓色黑形大肉肥此能毒者宜治以浓药若其胃薄
色浮形小肉瘦此不能毒者宜治以薄药张志聪曰上下谓司天在泉之气夫司天在泉之气升降于上下五运之气出入于外内各求
其有过者取而治之此治岁运之法也徐振公曰能以大寒之药治热淫大热之药治寒病是能胜其毒者马莳曰凡治病者或取之上
而吐之或取之下而下之或取之内而内消之或取之外而熨解之此上下内外皆就人身言皆求人身之有病者何在灵枢经论痛篇
少俞曰胃寒色黑大骨及肥者皆胜毒故其瘦而薄皮者皆不胜毒骥案人身有上下内外证治亦有上下内外三焦之气所以通行上
下者也营卫之气所以内外出入者也素问至真要大论气有高下证有内外补上治上制以缓缓则气味薄薄者则频而少服补中治
下制以急急则气味浓浓者则频而多服阴阳应象大论高者因而越之下者引而竭之皆上取下取之法又从内之外者调其内从外
之内者治其外从内之外而盛于外者先调其内而后治其外从外之内而盛于内者先调其外而后调其内外有轻扬汗发之制内有
泄泻攻通之制此内取外取也凡药皆有毒周礼医师类聚毒药以供医事素问异法方宜篇西方之人邪不能伤其形体病生于内治
宜毒药灵枢邪气脏腑病形篇阴阳形气俱不足调以甘药终始篇阴阳俱不足可将以甘药不可饮以至剂盖药味之甘而淡者和平
无毒药之有毒者谓乖戾不和禀气之偏者也故气之毒者必热味之毒者必辛枝苗气薄而升以治上根须味浓而降以治下又郑注
药之辛苦者恒多毒然苦参细辛虽辛苦而无毒有毒者谓巴豆野狼牙之类无毒者谓人参芎 之类变通运用存乎其人
气反者病在上取之下病在下取之上病在中傍取之
王冰曰下取谓寒逆于下而热攻于上不利于下气盈于上则温下以调之上取谓寒积于下温之不去阳藏不足则补其阳也傍
取谓气并于左则药熨其右气并于右则熨其左以和之必随寒热为适凡是七者皆病无所逃动而必中斯为妙用矣吴昆曰反谓反
其常候也治之者亦权其反而取之张介宾曰气反者本在此而标在彼也其病既反其治亦宜反张志聪曰至真要大论上胜而下俱
病者以地名之下胜而上俱病者以天名之即此义也马莳曰上文上下内外皆正治也然有反气而治者骥案阴阳上下中外左右互
为其根上为阳下为阴外为阳内为阴左为阳右为阴素问阴阳应象大论阳病治阴阴病治阳缪刺论左刺右右刺左清阳为天浊阴
为地天气上为云地气下为雨雨出地气云出天气六微旨篇升已而降降者谓天降已而升升者谓地脉要精微论上部法天胸喉中
事下部法地少腹腰股膝胫足中事易雷风相薄天地交泰水火既济山泽通气上下相通故气反者逆取之又脾主为胃行其津液建
中央以运四旁又中外不相及则治主病皆经说
治热以寒温而行之治寒以热凉而行之治温以清冷而行之治清以温热而行之
王冰曰气性有刚柔形证有轻重方用有大小调治有寒温盛大则顺气性以取之小软则逆气性以伐之气殊则主必不容力倍
则攻之必胜是则谓汤饮调气之制新校正云按至真要大论热因寒用寒因热用必伏其所主而先其所因其始则同其终则异可使
破积可使溃坚可使气和可使必已者也吴昆曰治热以寒温而行之者寒药温服也治寒以热凉而行之者热药凉服也治温以清冷
而行之者清药冷服也治清以温热而行之者温药热服也张介宾曰药以与病逆者恐不相投故从其气以行之假借之道也骥案寒
热阴阳各有真假似是而非每至错乱如病患大热烦燥口渴舌躁似乎热病视其面色赤此戴阳也切其脉尺弱而无力寸关豁大而
无伦此则阴盛于下逼阳于上假阳之症以苦寒之药从其性而折之顷刻平矣如人恶寒身不离复衣手足逆冷有似乎寒视其面色
滞切其脉涩按之细数而无力此系假寒之症寒在皮肤热在骨髓以辛凉之剂温而行之一汗而愈仲景白通用胆汁五苓用桂明乎
逆顺思过半矣刘河间曰夏热太甚林木流津冬寒太甚流水冰坚火极似水阴极似阳也
故消之削之吐之下之补之泻之久新同法
王冰曰量气盛虚而行其法病之新久无异道也张志聪曰消之削之内取外取也吐之下之上取下取也补之泻之补上补下治
上治下也久者谓伏气之病新者感而即发也张介宾曰消以去滞削以攻坚上实者宜吐下实者宜下补因正之不足泻因邪之有余
但此中用有缓急治有先后而病之久新同其法也骥案徐之才十剂宣可去壅姜橘之属推之瓜蒂散栀豉汤姜盐汤参芦藜芦之类
皆宣也皆所以吐之也通可去滞通草防己之属推之五苓四苓琥珀海金砂桃仁红花五灵脂之类皆通也皆所以消之削之也泻可
去闭葶苈大黄之属推之大小承气大柴胡十枣汤之类皆泻也皆所以下之泻之也补可扶弱人参羊肉之类推之四君四物八珍十
全皆所以补之也和剂者本此
帝曰病在中而不实不坚且聚且散奈何岐伯曰悉乎哉问也无积者求其藏虚则补之
王冰曰随病所在命其藏以补之吴昆曰积者五脏所生聚而不散者不实不坚且聚且散则为无积张志聪曰此谓五运之气为
病而有治之之法也病在中者根于中也不实不坚且聚且散者出入于外内也故敷和之纪其藏肝其病里急支满备化之纪其藏脾
其病痞盖五运之气内合五藏故无积者当求其藏也藏气虚则补之马莳曰此言病有在中而聚散不常当审虚实兼药食和中外以
治之张介宾曰积者有形之病有积在中则坚实不散今不实不坚且聚且散无积可知无积而病在中藏之虚也故当随病所在求其
藏而补之骥案素问大积大聚衰其大半五十五难积者阴气聚者阳气气之所积名曰积气之所聚名曰聚积发有常处痛不离其部
上下有终始左右有常处聚发无根本上下无留止痛无始处金匮五藏风寒积聚篇积者藏病终不移聚者府病发作有时展转痛移
此不坚不实且聚且散是无积也无积是脏虚虚则当补之脏虚连读
药以祛之食以随之
王冰曰食以无毒之药随汤元以迫逐之使其尽也马莳曰食即谷肉果菜张介宾曰药以祛之去其病也食以随之养其气也骥
案此承上补虚来邪之所凑其正必虚补正所以祛邪也如先天之阳虚当补命门桂附之类是也先天之阴虚宜补肾水地茱麦味之
类是也后天之阳虚宜温胃以补气参 苓术之类后天之阴虚宜补心肝以养血归地芍药之类正盛而邪自祛矣如邪未去或少加
祛邪之药而邪无不祛矣食即周礼食医食齐 春时羹齐 夏时酱齐 秋时饮齐 冬时此药食宜也参五宜篇
行水渍之和其中外可使毕已
王冰曰中外通和气无流碍则释然消散真气自平张志聪曰行水渍之以取汗和其中外使邪从外出可使毕已马莳曰用药之
汤水以渍之则药食调其中而汤水治其外庶几中外和而病可已张介宾曰行水渍之通其经也若是则中外调和而病可已祛者非
攻击之谓凡去病者皆可言祛渍资四切浸洗也骥案水渍法所以宣通形表散发邪气虚邪伤人当以汗解若人肌肤坚实腠理密致
难于取汗素问阴阳应象大论其有邪者渍形以为汗玉机真藏论脾风可浴巢氏病源邪在表洗浴发汗本草衍义热汤助阳气行经
络风冷气痹之人多以汤渍脚至膝上浓被使汗出朱真人治风疾掘坑令坐坑内热汤淋之良久以簟盖之汗出而愈许仁则桃柳等
三物浴汤取汗李时珍治寒湿加艾煎汤治风虚加五枝按食物本草五枝桃柳桑柘槐也或五加煎汤薰洗为效更速皆取汗法圣济
总录有因大饮中酒恐毒瓦斯内攻于藏者有服五石发动气攻于阳者皆以浴法治之圣惠治传尸骨蒸有沐浴方驱恶气千金方有沐
浴方七首治客忤马通浴方本草治咳嗽生姜沐浴婴孺方治小儿不生肌肉又三岁不行五参浴汤小儿直诀治肥体体热用乌蛇白
矾青黛天麻全蝎朱麝桃枝浴体博爱心鉴治痘疮顶陷有水扬汤经验后方小儿胗豆令速出酒沃沸胡荽喷一身百合病金匮有百
合洗方卒死壮热又有矾石水煎渍脚中风千金有大戟洗方方氏家藏方用蛇床防风等八味淋渫水肿本草引韦宙独行方赤小豆
煮烂汁渍膝以下神巧万全方樟柳赤豆麻黄桑白水气薰洗虚冷御医院方还童散外固壮阳气用丁香十四味水煎少腹以下淋浴
又百花散用百花窠等五味水煎淋洗补元阳通血脉又施圆端效方治下元虚冷用椒目桂川乌细辛干姜水煎渫浴下部圣惠发背
门已溃未溃毒瓦斯结聚当用药煮汤淋拓疮上散其热毒是水渍除汗法外有攻有补法各不同今 亮祗卿医事启源皇国亦有汤渍
法见荣花物语余谓暖洗所以生阳宜澡洗而不澡洗使人阳气上行阴邪相害不当澡渫而澡渫使人湿侵皮肤热生肌体若用之得
宜汗下攻补无不取效此承上补虚来当从虚边治
帝曰有毒无毒服有约乎岐伯曰病有新久方有大小有毒无毒固宜常制矣大毒治病十去其六
王冰曰下品药毒毒之大也吴昆曰此约其常制也勿使过之过之恐伤其正而生大患张志聪曰约规则也病有久新者谓病之
能胜毒不能胜毒也方有大小者谓有可以浓药可以薄药也毒者有大寒大热及燥湿偏胜之毒瓦斯故止可攻疾中病即止过则伤正
矣是以大毒之药治病病去其六即止后服马莳曰灵枢禁服篇约方犹约囊也囊满而弗约则输泄方成而弗约则神与弗俱伯言病
有久者则方必大病有新者则方必小故药有大毒常毒小毒无毒之分则去病以六分七分八分九分而止当量其病之新故而制方
大小以用之病重者宜大毒轻者宜小毒无毒者宜多有毒者宜少骥案神农本草名例下品一百二十种为佐使以应地多毒不可久
服此属大毒
常毒治病十去其七
王冰曰中品药毒次于下也张志聪曰常毒治病病去其七即止骥案神农本草名例中品一百二十种为臣以应人有毒无毒斟
酌其宜此属常毒小毒
小毒治病十去其八
王冰曰上品药毒毒之小也张志聪曰小毒治病病去其八即止之
无毒治病十去其九
王冰曰上品中品下品无毒药悉谓之平张志聪曰即无毒之药亦不可太过所谓久而增气物化之常也气增而久夭之由也张
介宾曰治病之法药不及病则无济于事药过于病则反伤其正而生他患故当知约制而进止有度也骥案神农本草名例上品一百
二十种为君以养天无毒多服此属无毒
谷肉果菜食养尽之无使过之伤其正也
王冰曰大毒之性烈其为伤也多少毒之性和其为伤也少常毒之性减大毒之性一等加小毒之性一等所伤可知也故至约必
止之以待来证尔然无毒之药性虽平和久而多之则气偏胜则有偏绝久攻之则藏气偏弱既弱且困不可长也故十去其九而止服
至约已则以五谷五肉五果五菜随五藏宜者食之已尽其余病药食兼行亦通也新校正云按藏气法时论毒药攻邪五谷为养五果
为助五畜为益五菜为充张志聪曰药石治病谷肉食养使病尽去张介宾曰病以去其八九而有余未尽者但当以谷肉果菜饮食之
类培养正气而余邪自尽骥案食养详五宜篇周礼食医和六食六饮六 百馐百酱八珍之齐食齐 春春多酸羹齐 夏夏多苦酱
齐秋秋多辛饮齐 冬冬多咸凡会 食之宜牛宜 羊宜黍豕宜稷犬宜梁雁宜麦鱼宜 新林元圭食物摘要分水谷菜果鱼介
禽兽八种孟铣食物本草因食医之义着书三卷张鼎补八十九种陈士良食性本草附以食医诸方及四时调养之法皆可参
不尽行复如法
王冰曰法谓前四约也余病不尽然再行之毒之大小至约而止必无过骥案长生秘典饮食之后解带摸腹伸腰徐行作喷以通
其秘用呵以通其滞能令饮食下行方可就坐饱坐发痔曲腰而坐成中满醉后勿食冷饱余勿使卧食后勿怒怒后勿食冷热之物不
宜互食尊生编饮以养阳食以养阴食宜常少亦勿令虚不饥强食不渴强饮则脾黄发胀朝勿令饥夜勿令饱淡食则多补五辛善助
火调食法宁少毋食多宁饥毋食饱宁迟毋食速宁热毋食冷宁零毋食顿宁软毋食硬修养不如节劳服药不如忌口灵枢食饮者热
无灼灼寒无沧沧寒温适中故气将持乃不致邪辟此可为食养法故并述之
必先岁气无伐天和
王冰曰岁有六气分主有南面北面之政先知此六气所在人脉至尺寸应之太阴所在其脉沉少阴所在其脉钩厥阴所在其脉
弦太阳所在其脉大而长阳明所在其脉短而涩少阳所在其脉大而浮如是六脉则谓天和不识不知呼为寒热攻寒令热脉不变而
热疾已生制热令寒脉如故而寒病又起欲求其适安可得乎夭枉之来率由于此吴昆曰岁气有偏胜人病因之用药者必明夫岁气
不得更益其邪而伐其天和天和者天真冲和元气也张志聪曰必先知岁运之盛衰衰则补之盛则泻之补则从之泻则逆之无伐天
运之中和张介宾曰五运有纪六气有序四时有令阴阳有节皆岁气也人气应之以生长收藏即天和也设不知岁气变迁而妄呼寒
热则邪正盛衰无所辨未免于犯岁气伐天和矣夭枉之由此其为甚骥案岁气乃五运之岁太过不及之气例如甲己之年丙作首丙
《素问·五常政大论》中提到：根据病位的上下内外来选取治疗方法，以探求疾病的根源。对于体质强壮、能耐受药力的人，使用药性浓烈的药物；对于体质虚弱、不能耐受药力的人，使用药性清淡的药物。
王冰注释说：“上取”是指用药物制约上部过盛的气机，如果制约后气机仍不顺，就会发生呕吐；“下取”是指用迅疾猛烈的药物清除下部的疾病，如果攻逐无效，则采用泻下的方法；“内取”是指通过饮食或口服药物进行调理，仔细辨别寒热性质并加以调和；“外取”是指用熨帖药物使患病部位的气机调适。应当是寒证反而出现热象时，用冷性药物来调和；热证反而出现寒象时，用温和药物来调和。上部邪气盛久治不愈，可用吐法使其耗散；下部邪气盛久治不愈，可用下法使其夺除。这就是所谓求得气机逆乱之道的方法。“药之浓薄”指的是药物气味（辛甘酸苦咸）的浓烈与淡薄程度。新校正按语说：查阅《甲乙经》，胃气浓厚、面色黑、骨骼粗大、肌肉丰满的人，都能耐受药毒；而胃气薄弱、面色浮白、形体瘦小、肌肉消瘦的人，都不能耐受药毒。又查阅《异法方宜论》，西方地区的百姓居住在山陵地带，多风，水土刚硬，不穿丝绸衣物而穿粗布，饮食丰盛且脂肪丰富，所以邪气不能伤害他们的形体，他们的病多生于内部，治疗适宜使用毒药。吴昆注释说：观察患者的面目口舌，属于上取的范畴；询问二便的通塞情况，不属于上取；切诊脉象的虚实，属于内取；探查身体的寒热状况，属于外取。如果一个人胃气浓厚、面色黑、形体大、肌肉丰满，这是能耐受药毒的人，适宜用浓药治疗；如果一个人胃气薄弱、面色浮白、形体小、肌肉瘦弱，这是不能耐受药毒的人，适宜用薄药治疗。张志聪注释说：上下指的是司天和在泉之气。司天和在泉之气升降于上下，五运之气出入于内外，各自探求有过盛之处而取法治疗，这是治疗岁运的方法。徐振公说：能用大寒药物治疗热淫之证，用大热药物治疗寒病，这是能耐受其毒性的人。马莳说：凡是治病，有的从上而取用吐法，有的从下而取用下法，有的从内而取用内消法，有的从外而取用熨解法。这上下内外都是就人身而言，都是寻找人身有病的地方在哪里。《灵枢·论痛篇》中少俞说：胃寒、色黑、骨大且肥胖的人都能耐受药毒，所以那些瘦弱且皮肤薄的人都不能耐受药毒。张骥案语：人体有上下内外之分，证治也有上下内外之别。三焦之气用来通行上下，营卫之气用来出入内外。《素问·至真要大论》说：气有高下，证有内外。补上治上，制方宜缓，则药气味淡薄，淡薄者则少量多次服用；补中治下，制方宜急，则药气味浓厚，浓厚者则多次大量服用。《阴阳应象大论》说：高处的病因而越之（吐法），低处的病引而竭之（下法），这都是上取下取的方法。又从内之外者，调理其内部；从外之内者，治疗其外部。从内之外而盛于外者，先调理内部而后治疗外部；从外之内而盛于内者，先治疗外部而后调理内部。内有轻扬发汗的制度，内有泄泻攻通的制度，这就是内取外取。凡药都有毒，《周礼·医师》分类聚集毒药以供医事。《素问·异法方宜篇》说：西方之人邪气不能伤害其形体，病生于内部，治疗适宜用毒药。《灵枢·邪气脏腑病形篇》说：阴阳形气俱不足，用甘药调和。《终始篇》说：阴阳俱不足，可以用甘药调养，不可饮用极峻猛的药剂。大概药味甘甜而淡的，平和无毒；药有毒的，是指乖戾不和、禀气偏颇的东西。所以气之毒者必热，味之毒者必辛。枝苗气薄而升，用以治上；根须味浓而降，用以治下。又郑玄注：药之辛苦者恒多毒，然而苦参、细辛虽然辛苦却无毒；有毒的是指巴豆、野狼牙之类；无毒的是指人参、川芎之类。变通运用在于人自己。
气机反逆者，病在上取之下，病在下取之上，病在中旁取之。
王冰注释说：下取是指寒气逆于下而热攻于上，不利于下焦，气盈于上，则温下以调和。上取是指寒积于下，温之不去，阳气脏器不足，则补其阳。傍取是指气并于左，则药熨其右；气并于右，则熨其左，以调和它。必须随寒热为适宜。凡是这七种情况，病无处可逃，动而必中，这才是妙用。吴昆注释说：反是指违反常候。治疗者也要权衡其反而取之。张介宾注释说：气反者，根本在这里而标症在彼处。既然病势反逆，治疗也应当反逆。张志聪注释说：《至真要大论》说：上胜而下俱病者，以地名之；下胜而上俱病者，以天名之。就是这个意思。马莳注释说：上文上下内外都是正治，然而有反气而治的情况。张骥案语：阴阳、上下、中外、左右互为其根。上为阳，下为阴；外为阳，内为阴；左为阳，右为阴。《素问·阴阳应象大论》说：阳病治阴，阴病治阳。《缪刺论》说：左刺右，右刺左。清阳为天，浊阴为地。天气上为云，地气下为雨。雨出地气，云出天气。《六微旨大论》说：升已而降，降者谓天降；已而升，升者谓地脉。《要精微论》说：上部法天，胸喉中事；下部法地，少腹腰股膝胫足中事。《易经》雷风相薄，天地交泰，水火既济，山泽通气，上下相通。所以气反者，逆取之。又脾主为胃行其津液，建中央以运四旁。又中外不相及则治主病，皆经说。
治疗热证用寒药，但温服；治疗寒证用热药，但凉服；治疗温证用清药，但冷服；治疗清证用温药，但热服。
王冰注释说：气性有刚柔，形证有轻重，方用有大小，调治有寒温。盛大则顺气性以取之，小软则逆气性以伐之。气殊则主必不容，力倍则攻之必胜。这就是汤饮调气之法。新校正按语说：查阅《至真要大论》“热因寒用，寒因热用”，必须伏其所主而先其所因，其始则同，其终则异，可使破积，可使溃坚，可使气和，可使必已。吴昆注释说：治热以寒温而行之，是寒药温服；治寒以热凉而行之，是热药凉服；治温以清冷而行之，是清药冷服；治清以温热而行之，是温药热服。张介宾注释说：药与病逆，恐不相投，故从其气以行之，是假借之道。张骥案语：寒热阴阳各有真假，似是而非，每至错乱。如病患大热烦躁口渴舌燥，似乎热病，视其面色赤，这是戴阳证；切其脉尺弱而无力，寸关豁大而无比，这是阴盛于下逼阳于上的假阳症。用苦寒之药从其性而折之，顷刻平矣。如人恶寒身不离复衣手足逆冷，似乎寒证，视其面色滞，切其脉涩，按之细数而无力，这是假寒之症，寒在皮肤热在骨髓。用辛凉之剂温而行之一汗而愈。仲景白通用胆汁，五苓用桂，明乎逆顺思过半矣。刘河间说：夏热太甚林木流津，冬寒太甚流水冰坚，火极似水，阴极似阳。
所以消之、削之、吐之、下之、补之、泻之，无论病之久新，同此法度。
王冰注释说：量气盛虚而行其法，病之新久无异道。张志聪注释说：消之削之，是内取外取；吐之下之，是上取下取；补之泻之，是补上补下、治上治下。久者指伏气之病，新者指感而即发。张介宾注释说：消以去滞，削以攻坚。上实者宜吐，下实者宜下。补因正之不足，泻因邪之有余。但此中用有缓急，治有先后，而病之久新同其法。张骥案语：徐之才十剂，宣可去壅，姜橘之属推之，瓜蒂散、栀豉汤、姜盐汤、参芦、藜芦之类皆宣也，皆所以吐之也。通可去滞，通草、防己之属推之，五苓、四苓、琥珀、海金砂、桃仁、红花、五灵脂之类皆通也，皆所以消之削之也。泻可去闭，葶苈、大黄之属推之，大小承气、大柴胡、十枣汤之类皆泻也，皆所以下之泻之也。补可扶弱，人参、羊肉之类推之，四君、四物、八珍、十全皆所以补之也。和剂者本于此。
黄帝问：病在中而不实不坚，且聚且散，奈何？岐伯答：问得详尽啊！无积者，求其藏虚则补之。
王冰注释说：随病所在命其藏以补之。吴昆注释说：积者五脏所生，聚而不散者不实不坚，且聚且散则为无积。张志聪注释说：此谓五运之气为病而有治之之法。病在中者根于中，不实不坚且聚且散者出入于外内。故敷和之纪其藏肝，其病里急支满；备化之纪其藏脾，其病痞。盖五运之气内合五脏，故无积者当求其藏。藏气虚则补之。马莳注释说：此言病有在中而聚散不常，当审虚实兼药食和中外以治之。张介宾注释说：积者有形之病，有积在中则坚实不散。今不实不坚且聚且散，无积可知。无积而病在中，藏之虚也。故当随病所在求其藏而补之。张骥案语：《素问》大积大聚，衰其大半。《五十五难》积者阴气，聚者阳气。气之所积名曰积，气之所聚名曰聚。积发有常处，痛不离其部，上下有终始，左右有常处；聚发无根本，上下无留止痛无始处。《金匮五脏风寒积聚篇》积者藏病终不移，聚者府病发作有时展转痛移。此不坚不实且聚且散是无积也。无积是脏虚，虚则当补之。脏虚连读。
药以祛之，食以随之。
王冰注释说：食以无毒之药随汤元以迫逐之，使其尽也。马莳注释说：食即谷肉果菜。张介宾注释说：药以祛之，去其病也；食以随之，养其气也。张骥案语：此承上补虚来，邪之所凑其正必虚，补正所以祛邪也。如先天之阳虚当补命门，桂附之类是也；先天之阴虚宜补肾水，地茱麦味之类是也；后天之阳虚宜温胃以补气，参苓术之类；后天之阴虚宜补心肝以养血，归地芍药之类。正盛而邪自祛矣。如邪未去或少加祛邪之药而邪无不祛矣。食即《周礼》食医食齐：春时羹齐，夏时酱齐，秋时饮齐，冬时... 此药食宜也。参《五宜篇》。
行水渍之，和其中外，可使毕已。
王冰注释说：中外通和气无流碍则释然消散，真气自平。张志聪注释说：行水渍之以取汗，和其中外使邪从外出，可使毕已。马莳注释说：用药之汤水以渍之，则药食调其中而汤水治其外，庶几中外和而病可已。张介宾注释说：行水渍之通其经也。若是则中外调和而病可已。祛者非攻击之谓，凡去病者皆可言祛。渍资四切，浸洗也。张骥案语：水渍法所以宣通形表散发邪气。虚邪伤人当以汗解。若人肌肤坚实腠理密致，难于取汗。《素问·阴阳应象大论》其有邪者，渍形以为汗。《玉机真藏论》脾风可浴。《巢氏病源》邪在表洗浴发汗。《本草衍义》热汤助阳气行经络，风冷气痹之人多以汤渍脚至膝上，浓被使汗出。朱真人治风疾掘坑令坐坑内，热汤淋之良久，以簟盖之，汗出而愈。许仁则桃柳等三物浴汤取汗。李时珍治寒湿加艾煎汤，治风虚加五枝。按《食物本草》五枝桃柳桑柘槐也。或五加煎汤薰洗为效更速，皆取汗法。《圣济总录》有因大饮中酒恐毒瓦斯内攻于藏者，有服五石发动气攻于阳者，皆以浴法治之。《圣惠》治传尸骨蒸有沐浴方，驱恶气。《千金方》有沐浴方七首，治客忤马通浴方。《本草》治咳嗽生姜沐浴婴孺方，治小儿不生肌肉又三岁不行五参浴汤。《小儿直诀》治肥体体热用乌蛇白矾青黛天麻全蝎朱麝桃枝浴体。《博爱心鉴》治痘疮顶陷有水扬汤。《经验后方》小儿胗豆令速出酒沃沸胡荽喷一身。百合病《金匮》有百合洗方。卒死壮热又有矾石水煎渍脚。中风《千金》有大戟洗方。方氏家藏方用蛇床防风等八味淋渫水肿。《本草》引韦宙独行方赤小豆煮烂汁渍膝以下。《神巧万全方》樟柳赤豆麻黄桑白水气薰洗。虚冷御医院方还童散外固壮阳气用丁香十四味水煎少腹以下淋浴。又百花散用百花窠等五味水煎淋洗补元阳通血脉。又施圆端效方治下元虚冷用椒目桂川乌细辛干姜水煎渫浴下部。《圣惠》发背门已溃未溃毒瓦斯结聚当用药煮汤淋拓疮上散其热毒。是水渍除汗法外有攻有补法各不同。今亮祗卿《医事启源》皇国亦有汤渍法见《荣花物语》。余谓暖洗所以生阳，宜澡洗而不澡洗使人阳气上行阴邪相害，不当澡渫而澡渫使人湿侵皮肤热生肌体。若用之得宜，汗下攻补无不取效。此承上补虚来，当从虚边治。
黄帝问：有毒无毒，服有约乎？岐伯答：病有新久，方有大小，有毒无毒，固宜常制矣。大毒治病，十去其六。
王冰注释说：下品药毒，毒之大也。吴昆注释说：此约其常制也，勿使过之，过之恐伤其正而生大患。张志聪注释说：约规则也。病有久新者，谓病之能胜毒不能胜毒也。方有大小者，谓有可以浓药可以薄药也。毒者有大寒大热及燥湿偏胜之毒瓦斯，故止可攻疾，中病即止，过则伤正矣。是以大毒之药治病，病去其六即止，后服。马莳注释说：《灵枢·禁服篇》约方犹约囊也。囊满而弗约则输泄，方成而弗约则神与弗俱。伯言病有久者则方必大，病有新者则方必小。故药有大毒、常毒、小毒、无毒之分，则去病以六分、七分、八分、九分而止。当量其病之新故而制方大小以用之。病重者宜大毒，轻者宜小毒，无毒者宜多，有毒者宜少。张骥案语：《神农本草名例》下品一百二十种为佐使以应地，多毒不可久服，此属大毒。
常毒治病，十去其七。
王冰注释说：中品药毒次于下也。张志聪注释说：常毒治病，病去其七即止。张骥案语：《神农本草名例》中品一百二十种为臣以应人，有毒无毒斟酌其宜，此属常毒小毒。
小毒治病，十去其八。
王冰注释说：上品药毒，毒之小也。张志聪注释说：小毒治病，病去其八即止之。
无毒治病，十去其九。
王冰注释说：上品中品下品无毒药悉谓之平。张志聪注释说：即无毒之药亦不可太过，所谓久而增气，物化之常也。气增而久，夭之由也。张介宾注释说：治病之法，药不及病则无济于事，药过于病则反伤其正而生他患，故当知约制而进止有度也。张骥案语：《神农本草名例》上品一百二十种为君以养天，无毒多服，此属无毒。
谷肉果菜，食养尽之，无使过之，伤其正也。
王冰注释说：大毒之性烈，其为伤也多少；毒之性和，其为伤也少。常毒之性减大毒之性一等，加小毒之性一等，所伤可知也。故至约必止之以待来证尔。然无毒之药性虽平和，久而多之则气偏胜，则有偏绝；久攻之则藏气偏弱，既弱且困，不可长也。故十去其九而止。服至约已，则以五谷五肉五果五菜随五脏宜者食之，已尽其余病，药食兼行亦通也。新校正按语说：查阅《藏气法时论》毒药攻邪，五谷为养，五果为助，五畜为益，五菜为充。张志聪注释说：药石治病，谷肉食养，使病尽去。张介宾注释说：病以去其八九而有余未尽者，但当以谷肉果菜饮食之类培养正气，而余邪自尽。张骥案语：食养详《五宜篇》。《周礼》食医和六食六饮六... 百馐百酱八珍之齐。食齐：春春多酸，羹齐夏夏多苦，酱齐秋秋多辛，饮齐冬冬多咸。凡会... 食之宜牛宜... 羊宜黍，豕宜稷，犬宜梁，雁宜麦，鱼宜... 新林元圭《食物摘要》分水谷菜果鱼介禽兽八种。孟铣《食物本草》因食医之义着书三卷，张鼎补八十九种。陈士良《食性本草》附以食医诸方及四时调养之法，皆可参。不尽行复如法。
王冰注释说：法谓前四约也。余病不尽然再行之，毒之大小至约而止，必无过。张骥案语：《长生秘典》饮食之后解带摸腹伸腰徐行作喷以通其秘，用呵以通其滞，能令饮食下行方可就坐。饱坐发痔，曲腰而坐成中满。醉后勿食冷，饱余勿使卧。食后勿怒，怒后勿食冷热之物不宜互食。《尊生编》饮以养阳，食以养阴。食宜常少，亦勿令虚。不饥强食不渴强饮则脾黄发胀。朝勿令饥，夜勿令饱。淡食则多补，五辛善助火。调食法宁少毋食多，宁饥毋食饱，宁迟毋食速，宁热毋食冷，宁零毋食顿，宁软毋食硬。修养不如节劳，服药不如忌口。《灵枢》食饮者热无灼灼，寒无沧沧，寒温适中故气将持乃不致邪辟，此可为食养法，故并述之。
必先岁气，无伐天和。
王冰注释说：岁有六气分主，有南面北面之政。先知此六气所在，人脉至尺寸应之。太阴所在其脉沉，少阴所在其脉钩，厥阴所在其脉弦，太阳所在其脉大而长，阳明所在其脉短而涩，少阳所在其脉大而浮。如是六脉则谓天和。不识不知呼为寒热，攻寒令热脉不变而热疾已生，制热令寒脉如故而寒病又起，欲求其适安可得乎？夭枉之来率由于此。吴昆注释说：岁气有偏胜，人病因之。用药者必明夫岁气，不得更益其邪而伐其天和。天和者天真冲和元气也。张志聪注释说：必先知岁运之盛衰，衰则补之，盛则泻之。补则从之，泻则逆之。无伐天运之中和。张介宾注释说：五运有纪，六气有序，四时有令，阴阳有节，皆岁气也。人气应之以生长收藏，即天和也。设不知岁气变迁而妄呼寒热，则邪正盛衰无所辨，未免于犯岁气伐天和矣。夭枉之由此其为甚。张骥案语：岁气乃五运之岁太过不及之气。例如甲己之年丙作首丙...
In the *Suwen* (Basic Questions), Chapter "Da Yuan Zheng Da Lun" (Great Treatise on the Great Regularity of the Five Constants), it is stated: Seek the fault by selecting treatments from above, below, inside, and outside. Those who can tolerate toxicity should be treated with strong medicines; those who cannot tolerate toxicity should be treated with mild medicines.
Wang Bing commented: "Selecting from above" means using medicine to restrain the excessive Qi in the upper part. If restraint does not lead to smoothness, vomiting will occur. "Selecting from below" means using swift and potent medicines to eliminate diseases in the lower part. If attack fails to remove them, downward purgation is used. "Selecting from inside" means regulating through diet or oral medication, carefully examining cold and heat patterns to harmonize them. "Selecting from outside" means applying hot compresses with medicinal herbs to adjust the Qi in the diseased area. When cold presents as heat, use cold-natured medicines to regulate it; when heat presents as cold, use warm-natured medicines to regulate it. If excess in the upper part persists despite treatment, induce vomiting to deplete it; if excess in the lower part persists, use purgation to drain it. This is the method to find the way to correct Qi deviation. "Strong and mild medicines" refer to the intensity of the flavor and aroma of the drugs. The New Correction notes: According to the *Jia Yi Jing*, those with thick stomach Qi, dark complexion, large bones, and full muscles can tolerate toxicity; those with thin stomach Qi, floating complexion, small stature, and emaciated muscles cannot tolerate toxicity. Also, according to the *Yi Fa Fang Yi Lun*, people in the West live on hills, are exposed to much wind, have hard soil and water, wear coarse cloth instead of silk, eat rich fatty foods, so pathogens cannot harm their bodies, their diseases arise internally, and treatment is suitable for toxic medicines. Wu Kun commented: Observing the face, eyes, mouth, and tongue belongs to selecting from above; asking about the patency or obstruction of urination and defecation does not belong to selecting from above; palpating the pulse for deficiency or excess belongs to selecting from inside; exploring body temperature for cold or heat belongs to selecting from outside. If a person has thick stomach Qi, dark complexion, large body, and full muscles, they can tolerate toxicity and should be treated with strong medicines. If a person has thin stomach Qi, floating complexion, small body, and emaciated muscles, they cannot tolerate toxicity and should be treated with mild medicines. Zhang Zhicong commented: Above and below refer to the Si Tian (Heavenly Ruler) and Zai Quan (Earthly Minister) Qi. The Si Tian and Zai Quan Qi ascend and descend above and below; the Five Movements Qi enter and exit inside and outside. Each seeks its excess and treats it; this is the method for treating annual movements. Xu Zhengong said: Those who can treat heat excess with great cold medicines and cold diseases with great heat medicines are those who can tolerate the toxicity. Ma Shi said: In treating diseases, one may select from above and induce vomiting, from below and purge, from inside and resolve internally, or from outside and apply hot compresses. These above, below, inside, and outside all refer to the human body, seeking where the disease lies. Shao Yu in the *Lingjing* chapter "Lun Tong" said: Those with cold stomach, dark color, large bones, and obesity can tolerate toxicity; thus, those who are thin and have thin skin cannot tolerate toxicity. Zhang Ji's case note: The human body has above, below, inside, and outside distinctions, and treatment also has these divisions. The San Jiao Qi circulates up and down; Ying and Wei Qi move in and out. The *Suwen* "Zhi Zhen Yao Da Lun" states: Qi has high and low positions, symptoms have inside and outside locations. Tonifying the upper and treating the upper requires slow preparation, resulting in light flavors and aromas; light preparations should be taken frequently in small doses. Tonifying the middle and treating the lower requires urgent preparation, resulting in strong flavors and aromas; strong preparations should be taken frequently in large doses. The *Yin Yang Ying Xiang Da Lun* states: For high conditions, use the method of ascending and dispersing (vomiting); for low conditions, use the method of drawing down and exhausting (purging). These are methods of selecting from above and below. For conditions originating inside but manifesting externally, regulate the inside; for conditions originating outside but penetrating inside, treat the outside. If internal conditions become severe externally, first regulate the inside then treat the outside; if external conditions become severe internally, first treat the outside then regulate the inside. There are methods of light and rising sweating for the interior, and methods of purgation and unblocking for the interior; these are selecting from inside and outside. All medicines have toxicity. The *Rites of Zhou* classifies toxic medicines for medical use. The *Suwen* "Yi Fa Fang Yi Pian" states: Western people are not harmed by pathogens because their bodies are strong, diseases arise internally, and treatment suits toxic medicines. The *Lingjing* "Xie Qi Zang Fu Bing Pian" states: When Yin-Yang, form, and Qi are both deficient, harmonize with sweet medicines. The *Zhong Shi Pian* states: When Yin-Yang are both deficient, nourish with sweet medicines, do not drink extreme agents. Generally, sweet and bland flavors are peaceful and non-toxic; toxic medicines refer to those that are discordant and possess biased Qi. Thus, Qi toxicity is necessarily hot, and Flavor toxicity is necessarily pungent. Branches and leaves have light Qi and rise, used to treat the upper; roots and rhizomes have heavy flavors and descend, used to treat the lower. Zheng Xuan noted: Pungent and bitter medicines often have toxicity, but Ku Shen (Sophorae Flavescentis Radix) and Xi Xin (Asari Radix et Rhizoma), though pungent and bitter, are non-toxic. Toxic ones include Ba Dou (Crotonis Fructus) and Ye Lang Ya (Sarcandrae Herba); non-toxic ones include Ren Shen (Ginseng Radix et Rhizoma) and Xiong Diao (Chuanxiong Rhizoma). Adaptation depends on the practitioner.
When Qi rebels, treat upper diseases by selecting from below, lower diseases by selecting from above, and middle diseases by selecting from the sides.
Wang Bing commented: Selecting from below refers to Cold rebellion in the lower part causing Heat attack in the upper part, unfavorable to the lower; Qi fills the upper, so warm the lower to harmonize. Selecting from above refers to Cold accumulation in the lower part, which warming fails to remove due to insufficient Yang organ Qi, so tonify the Yang. Selecting from the side refers to Qi merging to the left, so apply hot compress to the right; Qi merging to the right, apply hot compress to the left, to harmonize. One must adapt to cold and heat. In all seven cases, disease has nowhere to escape; moving and hitting accurately is the subtle application. Wu Kun commented: "Rebel" means contrary to normal patterns. The healer must weigh the rebellion and treat accordingly. Zhang Jiebin commented: Qi rebellion means the root is here but the branch is there. Since the disease pattern is reversed, the treatment should also be reversed. Zhang Zhicong commented: The *Zhi Zhen Yao Da Lun* states: When the upper wins and the lower suffers, name it by Earth location; when the lower wins and the upper suffers, name it by Heaven location. This is the meaning. Ma Shi commented: The previous text discusses standard treatments for above, below, inside, and outside, but there are also treatments for rebellious Qi. Zhang Ji's case note: Yin-Yang, above-below, outside-inside, left-right are mutually rooted. Above is Yang, below is Yin; outside is Yang, inside is Yin; left is Yang, right is Yin. The *Suwen* "Yin Yang Ying Xiang Da Lun" states: Treat Yin diseases by addressing Yang, treat Yang diseases by addressing Yin. The *Miao Ci Lun* states: Pierce left for right, pierce right for left. Clear Yang is Heaven, Turbid Yin is Earth. Heaven Qi rises to form clouds, Earth Qi descends to form rain. Rain comes from Earth Qi, clouds come from Heaven Qi. The *Liu Wei Zhi Da Lun* states: After rising, it descends; descending means Heaven descends. After descending, it rises; rising means Earth pulses. The *Yao Jing Wei Lun* states: The upper part models Heaven, concerning chest, throat, and middle; the lower part models Earth, concerning lower abdomen, waist, thighs, knees, shins, and feet. The *I Ching* speaks of Thunder and Wind clashing, Heaven and Earth communicating, Water and Fire completing each other, Mountains and Marshes venting Qi, upper and lower connecting. Thus, for Qi rebellion, use reverse selection. Also, Spleen governs transporting fluids for the Stomach, establishing the Center to move the four peripheries. If inside and outside are unrelated, treat the main disease; all are explained in the classics.
Treat heat with cold medicines, but administer them warm; treat cold with hot medicines, but administer them cool; treat warmth with clearing medicines, but administer them cold; treat chill with warming medicines, but administer them hot.
Wang Bing commented: Qi nature has rigidity and flexibility; symptom forms have severity. Formulas have large and small sizes; regulation has cold and warm approaches. For major conditions, follow the Qi nature to capture it; for minor/soft conditions, oppose the Qi nature to attack it. If Qi differs, the master cannot accommodate; if force doubles, attack will surely succeed. This is the system of decoctions and drinks for regulating Qi. The New Correction notes: According to the *Zhi Zhen Yao Da Lun*, "Use heat for cold, use cold for heat." One must subdue the main cause and address the initial cause. Initially similar, finally different, one can break accumulations, dissolve hardness, harmonize Qi, and ensure cure. Wu Kun commented: Treating heat with cold administered warm means taking cold medicines warm; treating cold with hot administered cool means taking hot medicines cool; treating warmth with clearing administered cold means taking clearing medicines cold; treating chill with warming administered hot means taking warming medicines hot. Zhang Jiebin commented: Medicines oppose diseases, fearing incompatibility, so borrow the Qi nature to administer them. Zhang Ji's case note: Cold, heat, Yin, and Yang each have true and false aspects, appearing similar yet different, often confusing. For example, a patient with severe heat, irritability, thirst, and dry tongue seems to have a heat disease, but red facial color indicates Dai Yang (Floating Yang). Palpating the pulse: Chi position weak and powerless, Cun and Guan positions vast and boundless, indicating Yin excess in the lower forcing Yang to the upper—a false Yang syndrome. Using bitter-cold medicines following its nature to suppress it brings instant relief. Conversely, a person fearing cold, wrapped in layers, with cold extremities seems to have a cold syndrome, but dull facial color and choppy pulse, fine and rapid yet powerless upon pressure, indicate false cold—cold in the skin, heat in the marrow. Using acrid-cool agents to warm and promote sweating leads to recovery. Zhang Zhongjing used Pig Bile generally and Gui Zhi (Cinnamon Twig) in Wu Ling San, understanding reversal and compliance makes half the problem solved. Liu Hejian said: Extreme summer heat causes trees to sweat; extreme winter cold causes water to freeze. Extreme fire resembles water; extreme Yin resembles Yang.
Therefore, dissipate, reduce, induce vomiting, purge, tonify, and drain. Whether the disease is new or chronic, the same principles apply.
Wang Bing commented: Measure Qi excess or deficiency to apply the method; whether new or old, the path is the same. Zhang Zhicong commented: Dissipating and reducing correspond to selecting from inside and outside; vomiting and purging correspond to selecting from above and below; tonifying and draining correspond to tonifying upper/lower and treating upper/lower. "Old" refers to latent Qi diseases; "new" refers to immediate onset after infection. Zhang Jiebin commented: Dissipation removes stagnation; reduction attacks solidity. Upper excess suits vomiting; lower excess suits purging. Tonification addresses righteous deficiency; draining addresses pathogenic excess. However, usage has urgency, treatment has sequence, yet the method for old and new diseases is the same. Zhang Ji's case note: Xu Zhicai's Ten Categories: "Xuan (Dispersing) can remove obstruction," such as Jiang (Ginger) and Ju (Citrus peel), extending to Gua Di San (Melon Seed Powder), Zhi Chi Tang (Gardenia and Soybean Decoction), Jiang Yan Tang (Ginger and Salt Decoction), Shen Lu (Ginseng Stalk), Li Lu (Veratrum Rhizome)—all are Xuan, all used for vomiting. "Tong (Unblocking) can remove stasis," such as Tong Cao (Tetrapanaxis Medulla) and Fang Ji (Stephania Root), extending to Wu Ling San (Five-Ingredient Powder with Poria), Si Ling San, Hu Po (Amber), Hai Jin Sha (Lygodium Spore), Tao Ren (Peach Kernel), Hong Hua (Carthamus Flower), Wu Ling Zhi (Trogopterus Feces)—all are Tong, all used for dissipation and reduction. "Xie (Draining) can remove closure," such as Ting Li (Descurainia Seed) and Da Huang (Rhubarb Root), extending to Da Cheng Qi Tang (Major Order the Qi Decoction), Xiao Cheng Qi Tang, Da Chai Hu Tang, Shi Zao Tang (Ten Jujube Decoction)—all are Xie, all used for purging and draining. "Bu (Tonifying) can support weakness," such as Ren Shen (Ginseng) and Lamb meat, extending to Si Jun Zi Tang (Four-Gentlemen Decoction), Si Wu Tang (Four-Substance Decoction), Ba Zhen Tang (Eight-Treasure Decoction), Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction)—all are used for tonification. Harmonizing formulas originate from this.
The Yellow Emperor asked: If the disease is in the interior, not solid or firm, gathering and scattering, what should be done? Qi Bo replied: Excellent question! For those without accumulation, seek deficiency in the Zang organs and tonify them.
Wang Bing commented: Follow the disease location to identify the Zang organ and tonify it. Wu Kun commented: Accumulations are generated by the five Zang organs. Gathering without scattering is not solid or firm; gathering and scattering implies no accumulation. Zhang Zhicong commented: This refers to diseases caused by the Five Movements Qi and their treatment. Diseases in the interior have their root in the interior; not solid/firm, gathering/scattering implies movement between inside and outside. Thus, in the Fu He era, the Liver is affected, causing abdominal tightness and flank fullness; in the Bei Hua era, the Spleen is affected, causing痞 (stuffiness). Since Five Movements Qi internally connect with the five Zang organs, for those without accumulation, one must seek the Zang organ. If Zang Qi is deficient, tonify it. Ma Shi commented: This discusses diseases in the interior that gather and scatter irregularly; one must examine deficiency/excess and combine medicine and food to harmonize inside and outside. Zhang Jiebin commented: Accumulations are tangible diseases; if accumulated in the interior, they are solid and do not scatter. Now, since it is not solid/firm and gathers/scatters, there is no accumulation. Disease in the interior without accumulation indicates Zang deficiency. Therefore, follow the disease location to seek the Zang and tonify it. Zhang Ji's case note: The *Suwen* states for major accumulations, reduce by more than half. The *Nan Jing* Chapter 55 states: Accumulations are Yin Qi; Gatherings are Yang Qi. What Qi accumulates is called Accumulation; what Qi gathers is called Gathering. Accumulations have fixed locations, pain stays in the region, has beginning and end, constant on left or right. Gatherings have no root, no fixed pain location, shifting pain. The *Jin Gui* chapter on Cold-Fever-Accumulation in Five Zang Organs states: Accumulations are Zang diseases, permanently unmoving; Gatherings are Fu diseases, occurring at times, shifting pain. This non-solid/non-firm, gathering/scattering condition is no accumulation. No accumulation means Zang deficiency; deficiency requires tonification. "Zang deficiency" is read continuously.
Medicines dispel the pathogen; food follows to nourish.
Wang Bing commented: Use non-toxic food/herbs to follow the decoction, urging expulsion until complete. Ma Shi commented: Food refers to grains, meats, fruits, and vegetables. Zhang Jiebin commented: Medicines dispel the disease; food follows to nourish Qi. Zhang Ji's case note: This continues from tonifying deficiency. Where pathogens gather, righteousness is definitely deficient; tonifying righteousness dispels pathogens. For congenital Yang deficiency, tonify Ming Men with Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Lateralis Radix Praeparata). For congenital Yin deficiency, tonify Kidney Water with Di Gu Pi (Lycii Cortex), Shan Zhu Yu (Corni Fructus), Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Fructus). For acquired Yang deficiency, warm the Stomach and tonify Qi with Ren Shen (Ginseng), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma). For acquired Yin deficiency, tonify Heart and Liver blood with Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata), Bai Shao (Paeoniae Radix Alba). When righteousness is strong, pathogens naturally disperse. If pathogens remain, add a little dispelling medicine, and pathogens will surely disperse. Food refers to the *Rites of Zhou* Dietary Physician regulations: Spring soup, Summer sauce, Autumn drink, Winter... This is the suitability of medicine and food. Refer to the "Wu Yi Pian" (Five Suitabilities Chapter).
Soak with water to harmonize inside and outside, making the disease completely resolve.
Wang Bing commented: Harmonizing inside and outside allows Qi to flow without obstruction, dissipating naturally, restoring True Qi. Zhang Zhicong commented: Soaking with water induces sweating; harmonizing inside and outside expels pathogens outward, ensuring complete resolution. Ma Shi commented: Soaking with medicinal decoctions regulates the interior while the water treats the exterior, hopefully harmonizing inside and outside to cure the disease. Zhang Jiebin commented: Soaking with water unblocks meridians. If so, inside and outside harmonize, and the disease resolves. "Qu" (dispel) does not mean aggressive attack; any method removing disease can be called dispelling. "Zi" (soak) means immersion and washing. Zhang Ji's case note: The water soaking method promotes circulation in the body surface and disperses pathogens. When deficient pathogens invade, release via sweating. If skin is firm and pores tight, sweating is difficult. The *Suwen* "Yin Yang Ying Xiang Da Lun" states: For those with pathogens, soak the form to induce sweat. The *Yu Ji Zhen Zang Lun* states: Spleen wind can be bathed. *Chao Yuan Fang* states: Pathogens in the exterior, bathing induces sweat. *Ben Cao Yan Yi* states: Hot water aids Yang Qi circulation in meridians; people with wind-cold qi bi often soak feet to knees in hot water under thick blankets to sweat. Zhu Zhenren treated wind disease by digging a pit, sitting inside, pouring hot water, covering with a mat, inducing sweat. Xu Renze used Peach, Willow, and three substances bath to induce sweat. Li Shizhen added Ai Ye (Artemisiae Argyi Folium) for cold-dampness, or Wu Zhi (Five Branches) for wind-deficiency. According to *Shi Wu Ben Cao*, Wu Zhi includes Peach, Willow, Mulberry, Morus alba, and Sophora. Or soak with Wu Jia Pi (Acanthopanacis Cortex) fumigation for faster effect, all inducing sweat. *Sheng Ji Zong Lu* mentions bathing for toxin attack from alcohol or Wushi Dan activation. *Tai Ping Sheng Hui Fang* has bathing prescriptions for consumption and evil Qi. *Qian Jin Fang* has seven bathing prescriptions for fright and horse dung baths. *Ben Cao* mentions Ginger bath for cough in infants. *Er Tong Zhi Jue* uses Snake, Alum, Qing Dai, Tian Ma, Quan Xie, Zhu Sha, She Xiang, Tao Zhi bath for obese children with heat. *Bo Ai Xin Jian* uses boiling water bath for pockmarks. *Jing Yan Hou Fang* uses wine-boiled Coriander spray for chickenpox. *Jin Gui* has Lily Bath for Bai He Bing. Alum water foot soak for sudden death and fever. *Qian Jin* has Da Ji bath for stroke. Fang Shi's Family Prescription uses She Chuang Zi, Fang Feng, etc., for edema. *Ben Cao* cites Wei Zhou's Du Xing Fang using Red Bean juice for knee soaking. *Shen Qiao Wan Quan Fang* uses Camphor, Willow, Red Bean, Ephedra, Mulberry for water qi fumigation. Imperial Hospital's Huan Tong San uses Clove and fourteen ingredients for lower abdomen showering. Bai Hua San uses five flowers for blood vessel tonification. Shi Yuanduan's Effective Prescription uses Pepper Eye, Cinnamon, Chuan Wu, Xi Xin, Gan Jiang for lower body wash. *Sheng Hui* uses boiled汤 for carbuncles. Water soaking includes sweating methods plus attacking and tonifying methods. Liang Zhiqing's *Yi Shi Qi Yuan* and Japan's *Eiga Monogatari* mention soaking methods. I believe warm washing generates Yang; bathing is appropriate, but improper bathing harms Yin. Improper soaking invades skin with dampness and generates heat. If used correctly, sweating, purging, attacking, and tonifying are effective. This continues from tonifying deficiency, treating from the deficiency aspect.
The Yellow Emperor asked: Are there regulations for taking toxic and non-toxic medicines? Qi Bo replied: Diseases vary in newness and duration; formulas vary in size; toxic and non-toxic medicines have established limits. For major toxic medicines, stop when six-tenths of the disease is removed.
Wang Bing commented: Lower-grade medicines are highly toxic. Wu Kun commented: This sets the standard limit. Do not exceed it, or you may damage righteousness and cause major disasters. Zhang Zhicong commented: Limit means rules. New vs. old disease refers to tolerance of toxicity. Large vs. small formulas refer to strong vs. mild medicines. Toxicity refers to extreme cold/heat or dry/wet bias. Stop when the disease is addressed; exceeding damages righteousness. Thus, for major toxic medicines, stop after removing six-tenths. Ma Shi commented: The *Lingjing* "Jin Fu Pian" compares limiting a formula to tying a bag. An untied full bag leaks; an unbounded formula loses spirit. Long diseases require large formulas; new diseases require small formulas. Medicines are divided into major, common, minor, and non-toxic. Remove six, seven, eight, or nine-tenths respectively. Size the formula based on disease duration. Severe diseases suit major toxicity; mild diseases suit minor toxicity; non-toxic medicines can be used more; toxic medicines less. Zhang Ji's case note: *Shennong Ben Cao Jing* lists 120 lower-grade medicines as assistants corresponding to Earth, mostly toxic, not for long-term use; these are major toxins.
For common toxic medicines, stop when seven-tenths of the disease is removed.
Wang Bing commented: Middle-grade medicines have toxicity secondary to lower grades. Zhang Zhicong commented: For common toxic medicines, stop after removing seven-tenths. Zhang Ji's case note: *Shennong Ben Cao Jing* lists 120 middle-grade medicines as ministers corresponding to Humans, with varying toxicity; these are common/minor toxins.
For minor toxic medicines, stop when eight-tenths of the disease is removed.
Wang Bing commented: Upper-grade medicines have slight toxicity. Zhang Zhicong commented: For minor toxic medicines, stop after removing eight-tenths.
For non-toxic medicines, stop when nine-tenths of the disease is removed.
Wang Bing commented: Non-toxic medicines from upper, middle, and lower grades are all considered neutral. Zhang Zhicong commented: Even non-toxic medicines should not be overused. Prolonged use increases Qi, which is the norm of transformation. Increasing Qi for too long causes premature death. Zhang Jiebin commented: If medicine is insufficient, it is useless; if excessive, it damages righteousness and causes other disorders. Know the limits and advance/stop with measure. Zhang Ji's case note: *Shennong Ben Cao Jing* lists 120 upper-grade medicines as sovereigns corresponding to Heaven, non-toxic, suitable for long-term use; these are non-toxic.
Use grains, meats, fruits, and vegetables to complete the nourishment. Do not overuse, lest it damage righteousness.
Wang Bing commented: Major toxins are fierce, causing significant damage; mild toxins are gentle, causing less damage. Common toxins are one degree less than major, one degree more than minor. Thus, reach the limit and stop to await further symptoms. Non-toxic medicines are peaceful, but prolonged use causes Qi bias and potential extinction. Long attack weakens Zang Qi, leading to exhaustion. Thus, stop after removing nine-tenths. Once limited, eat grains, meats, fruits, and vegetables suitable for the Zang organs to finish curing residual disease; combining medicine and food is acceptable. The New Correction notes: According to *Zang Qi Fa Shi Lun*, toxic medicines attack pathogens; grains nourish, fruits assist, meats benefit, vegetables fill. Zhang Zhicong commented: Medicine treats disease; food nourishes, ensuring disease elimination. Zhang Jiebin commented: After removing eight or nine-tenths, remaining disease should be cultivated with food to strengthen righteousness, allowing residual pathogens to vanish. Zhang Ji's case note: Food nourishment details in "Wu Yi Pian". *Rites of Zhou* Dietary Physician harmonizes six foods, six drinks, hundred delicacies, hundred sauces, eight treasures. Food suitability: Spring sour, Summer bitter, Autumn pungent, Winter salty. Suitable pairings: Ox with..., Sheep with Millet, Pig with Ji, Dog with Liang, Goose with Wheat, Fish with... Xin Lin Yuan Gui's *Shi Wu Zhai Yao* divides into grains, vegetables, fruits, fish, shellfish, poultry, beasts. Meng Xian's *Shi Wu Ben Cao* writes three volumes based on Dietary Physician ideas, expanded by Zhang Ding. Chen Shiliang's *Shi Xing Ben Cao* adds dietary physician formulas and seasonal care methods.
If not fully resolved, repeat the method.
Wang Bing commented: Method refers to the previous four limits. If residual disease remains, repeat. Stop according to toxicity level and limits; do not exceed. Zhang Ji's case note: *Chang Sheng Mi Dian* advises loosening belt, rubbing abdomen, stretching, walking slowly after eating to clear secretions, using "Ha" sound to clear stagnation, allowing food to descend before sitting. Sitting full causes hemorrhoids; bending over causes middle-fullness. Do not eat cold after drunkenness; do not lie down after fullness. Do not anger after eating; do not eat hot/cold after anger. Do not mix hot/cold foods. *Zun Sheng Bian* states: Drink nourishes Yang, food nourishes Yin. Eat moderately, not starving. Force eating/drinking causes spleen yellow and bloating. Do not starve in morning, do not overeat at night. Light diet tonifies; five pungents aid fire. Eating rules: Less rather than more, hungry rather than full, late rather than fast, hot rather than cold, fragmented rather than meal-sized, soft rather than hard. Restraint is better than labor cessation; fasting is better than medication. *Lingjing* states: Food/drink should not be scorching or freezing; moderate temperature maintains Qi and prevents pathogenic invasion. This is the food nourishment method, hence included.
First know the annual Qi, do not violate Heavenly Harmony.
Wang Bing commented: The year has Six Qi ruling successively, with North/South policies. Know the Six Qi locations; pulse responses at Cun/Guan positions. Taiyin location: deep pulse; Shaoyin: hook pulse; Jueyin: string-like pulse; Taiyang: large and long pulse; Yangming: short and choppy pulse; Shaoyang: large and floating pulse. These six pulses constitute Heavenly Harmony. Ignoring this, calling cold/heat arbitrarily, attacking cold with heat without pulse change generates heat disease; controlling heat with cold without pulse change generates cold disease. Seeking comfort is impossible. Premature death stems from this. Wu Kun commented: Annual Qi has bias, causing human disease. Prescribers must understand annual Qi, not exacerbating pathogens or violating Heavenly Harmony. Heavenly Harmony is innate, balanced Original Qi. Zhang Zhicong commented: First know annual movement decline/rise. Decline: tonify; Rise: drain. Tonify following, drain opposing. Do not violate the balance of Heavenly Movement. Zhang Jiebin commented: Five Movements have order, Six Qi have sequence, Four Seasons have commands, Yin-Yang have rhythm—all are Annual Qi. Human Qi responds with growth/storage, which is Heavenly Harmony. Ignoring Annual Qi changes and arbitrarily calling cold/heat makes distinguishing pathogen/righteousness impossible, violating Annual Qi and Heavenly Harmony. Premature death results severely. Zhang Ji's case note: Annual Qi refers to Five Movements' excess/deficiency years. For example, Jia/Ji years begin with Bing...