（张）因幼年多病，弃儒习医，从师访道，纂读群书，苦攻十载，方敢临症，悉遵
古哲准绳，兢兢业业，全活颇多，阅历既久，心得精微，更难言尽。盖如先贤立法，
外感而风伤卫者。辛温疏表；寒伤荣者，辛热发散∶病尚未已，继以和解；和解不已，
病传于里，则有攻下救里之法；病解而愈，乃用调元返本；病剧则危，亦有温经益元，
坏症夺命等汤，纯以救本为事也。内伤而属劳倦者，即用调补，毋审别议。内伤而属饮
食者，必先为消导，病尚未已，攻下继之，病愈之后，亦以调脾养胃。倘遇本元怯弱
者，或消补并行，或补多消少，或先补后消，皆为成法，条分次第，未尝不善。然最
宜于上古之人，禀赋壮浓，及藜霍之民，中表坚实，既能任病消磨，复能任治荡涤，难
伤浓浓之天元，无损百岁之大寿，不宜乎晚季之受气既薄，性复斫削，肾梁子弟，体质
娇嫩，轻寒轻冷，便能伤表，遇劳遇食，易致伤中，一经受病，神气沮丧，再加攻克，
益促虚危，既不能任病久磨，复不能任药次第，每有骤至，精神垂绝，方投峻补挽救，
脱极者，追之何及？未脱者，侥幸全生。况，如从前治法，只可暂去其病，而使精神还
本，得尽中寿之年，不能永却其病，而使元气胜常，更获长生之术，殊不思《经》曰∶
“精神内守，病安从来？”又曰∶邪之所凑，其正必虚。不治其虚，安问其余？而先贤治
法，更有识中标，只取本，治千人无一损，皆至言也。要知易风为病者，表气素虚；易
寒为病者，里气素弱；易热为病者，阴气素衰；易伤食者，脾胃必亏；易劳伤者，中气
必损。非因邪气之有余，实由正虚之所召，未病已病既病益虚，用药泻补泻之愈虚，其
虚补之，惟偿其所泻，纵得痊可如常，精神仍是怯弱，须知病发有余之日，即正气不足
之时，何如当受风为病也，辛温卫气以法之。受寒为病也，辛温荣气以化之。受热为
病也，甘苦阴气以胜之，因滞而病也。健中气以翼运之，因劳而病也，培元气以匡复
之，使正气宣行以逐邪，邪消正复，邪不胜正而自化，化旧生新，客邪顿释于无事之
中，正气复生于受伤之际，再加调养，不惟消弭新病，而旧患藉此搜除，未知病根，长
生气血，讵不快哉！况精神之损益，由乎阴阳之盛衰，阴阳更由乎水火之消长，皆无形
者也。而外感之六淫，及内伤之七情亦无形，惟饮食之滞有迹，然实由乎气化之所运
亦无形。以无形之邪，而干无形之正，治之者，只可作无形之相，以气味性情相感相化
以调之，不可作有形之象，而攻无形之虚。书所谓攻之一字，仁人之所恶也。况受寒而
变热，寒者，客邪致病之原由；热者，感触元阳之外越，寒既去而复疏之，益促虚阳之
耗散，因食而伤胃，胃既伤而脾亦虚，肿胃之气既虚。脏腑之禀皆失，斯时食虽腐化于
中，然内而脏腑，外而四肢，皆无气以动。食既化而复消之，难免重虚之患，故贵乎以
脉消息，则有形之变症百出，总属无形之根本一源。有迹无形之病，仍取有迹无形之
药，气类相从，投之可入。盖炳之生也，必在人身气血之中，而用药以调病者，亦必取
草木与气血有情者而投之，自能与血气相须而却病。则气血借药势而驱驰有力，药力护
气血而攻逐无伤，正气既旺，邪得即解。若猛投野狼虎险健恶毒之药，则未逐客邪，先伤
正气，正气伤而邪愈固，名为逐邪，实为损正，故贵乎不治之治，无形神圣之用也。
（张）临症三十年来，伤寒未经一遇，如古之壮热头痛太阳证者，不用麻桂羌柴而病自
已，何知有传经之论，大寒大热而为疟者，何事青、槟、陈、半、柴、黄，而寒热自
平。腹痛赤白杂下而为痢者，焉赖香、连、青、陈、槟、朴而便自调。胸满噫气嗳臭恶
食而为停滞者，不赖楂、曲、棱、术而食自消。肺胀痰壅而为咳嗽者，焉仗橘、半、
桑、贝而痰嗽自痊！有迹之疾病既除，而无形之元气反长，因审其所因，求其所属，避
其盛，因其衰，安其正，化共邪，还其元，胜其旧。《经》曰∶毋致邪，毋失正，长有
天命。此之谓欤，所谓仁义之师，无敌于天下也。此（张）于法外求全之法，而于《内
经》“不治其虚，安问其余？”及前贤识标取本之主不背矣。
（张）按∶人之赖以有生者，惟仗一点真阳之气耳。即百病发热，莫不由命火离
宫。若火得安位，则百病俱已。故古人谆谆慎用寒凉，而曰∶服寒凉者，百不一生。又
曰∶误服寒凉者，立死。示人寒凉为害之甚而且速，以慎不可轻用误用。至于极虚极危
之症，全以救阳为主，盖阳气一分不尽则不死。然阳气之尽也有二∶凡六脉沉微，两尺
无根者，此元气之元阳欲尽也，惟参、木、附子可以挽之。若六脉细数，两尺无根者，
此元阴之元阳欲竭也，惟地、茱、桂、附可以挽之。迨至龙雷假火一退，其脉细数而变
为沉微，则药之地、茱、桂有者，亦当变为参、术、附子，故即吐血阴虚之症，每以脾
胃药收功。然凡峻补之药，若遇六脉有根者，及尺脉不绝者，挽回易见其效。盖如树
木有根，而加之脂膏灌溉，易得发生而蕃茂也。若六脉无神，及尺脉无根者，挽回最难
见功。盖根气已失，惟图药力挽回，药力少缓，脱势便来，非重为陆续补接，不能以转
生发之机。盖如栽培无根草木，全赖土以培之，水以滋之，日以暄之，使阳和之气，煦
濡不绝，方可令无根而化生有根，必三五日少转，六七日乃复，展转进迟，良非易也。
然古人救脱之方，惟有人参一两，生附子半个，可谓大力救生之药矣。奈今人元阳之虚
愈甚，而参力之补复微，每多投此，甚难见功。（张）思附子通经达络，必赖人参大力
驾驱，否则通达迅速，元气转伤，故古人有参、附、 、附、术附等汤，附子必兼人
参、 、术同用，既欲赖以通经，复可补其走泄。柰天地气化转薄，人与草木所禀皆
虚，参力亦非昔比，倘人参一两，生附半个，则走多补少，焉能托住真元？故（张）
凡治脱症，人参三四两，而熟附方投半个。极寒极危之症，即人参之力尚未足以挽之，
盖参性和平，更必兼白术之补速而有刚性者，方能力散沉寒，追复元阳，况阳虚重在
胃也。若不重为托住中气，则虽有附子追复元阳之力，然未免通达之性，反寓走泄之
机。如修理破房，若不先用大木架托梁栋，而妄将斧锯穿凿动摇，能保其房屋不为倾
覆，而梁栋不为折裂乎？兼之脏腑沉寒固闭之症，而用温补之药，流通其气者，凡遇身
形瘦小之人则小剂煎浓，使可周及。若身形肥大之人，必大剂浩饮，方能遍达，且躯体
丰浓，则禀阴气独重，非阳药倍加，不足以胜之。
余治翰苑熊老先生尊翁年七十余岁，食后受惊，随即大吐不已，饮食出尽，痰涎继
之，目窜身热，面赤口张，头仰手搐，自午至戌，溃汗如雨，急延余诊，六脉豁大而
空，乃假阳上越也。以人参二两，炒白术三两制附子五钱，五味子二钱，煎浓汁灌服，
始乃搐止汗止，热退身宁。但昏迷不醒，次日照前方，早晚各进一服，服至三日之外，
始乃神清识人，能迸薄粥，继用十全大补，及人参养荣等汤而安。又有周姓年方五十余
岁，向来心肺之火有余，而脾肾之阳不足，常发喘症，一发垂危。适因夏月劳伤发热，
误用香薷清暑，及六一散、冰水、酷嗜西瓜，以致下焦沉塞，上焦愈热，烦躁喘急，
饮食久废，其脉乍大乍小，两尺无根，渐至乍有乍无沉微迟缓，三至一止，时欲脱去，
乃延余治。急以人参三两，白术四两，炮姜三钱，五味子二钱，制附子五钱，煎浓汁灌
之，服后脉气少起。神气少旺，药性少过，脱势便来，随即照方又服，每日人参用至八
两，白术用至十两，附子用至二两，渐至尺脉有根，始无脱势，乃大加温补而痊。观
此，则今人之虚较古更甚，人参之力，较古亦微，可洞见矣。
（张氏）因为幼年时多病，便放弃儒学转而学习医学。他跟随老师寻访名医，研读各类医书，刻苦钻研了十年，才敢开始临证诊疗。他完全遵循古代圣贤的准则，兢兢业业，治愈存活的患者很多。随着阅历加深，心得日益精微，难以用言语穷尽。
大致如先贤所确立的治疗法则：外感病中，风邪伤及卫气的，用辛温药物疏解表邪；寒邪伤及营气的，用辛热药物发散风寒；如果病势未止，接着采用和解法；和解无效，病邪传入体内，则采用攻下以救里的方法；病邪解除且病情好转后，再用调补元气、恢复根本的方法；如果病情危重，也有温经益元、治疗坏证及抢救生命等汤剂，纯粹以挽救根本为要务。内伤病中，属于劳倦过度的，立即使用调补之法，无需再作其他辨析议论；属于饮食积滞的，必须先进行消食导滞，如果病势未止，继之以攻下法，病愈之后，也以调理脾胃为主。如果遇到先天元气虚弱的人，或者消法与补法并用，或者补多于消，或者先补后消，这些都是成熟的法则，条理分明，未曾有过不好之处。
然而，这些方法最适合上古时期的人，他们禀赋强壮浓厚，以及平民百姓，中焦和体表坚实，既能耐受疾病的消耗，又能承受药物的荡涤攻伐，不易损伤深厚的先天元气，无损于百岁的长寿。但不适合晚近时代的人，他们禀受之气已经薄弱，性情又被过度耗损，那些娇生惯养的子弟，体质娇嫩，轻微的寒冷就能伤害体表，遇到劳累或饮食不当，容易损伤中焦。一旦患病，神气就会沮丧，如果再加以攻伐克削，只会加速其虚危状态。他们既不能耐受疾病的长期消磨，也不能耐受药物治疗的循序渐进，往往病情突然加重，精神濒临灭绝，此时才投用峻猛的补药来挽救，对于已经脱绝的，追悔莫及；对于尚未脱绝的，也只是侥幸保全性命。
况且，像从前那种治法，只能暂时去除病邪，使精神回归本源，得以享尽中等寿命，而不能永远祛除病邪，使元气胜过常人，更获得长生之术。这殊未思考《内经》所说：“精神内守，病安从来？”又说：“邪气聚集的地方，正气必定虚弱。”如果不治疗正气的虚弱，还问其他的什么呢？而先贤的治疗法则，更有洞察病机标本的智慧，只取根本，治疗千人无一受损，都是至理名言。要知道，容易因风致病的人，表气素来虚弱；容易因寒致病的人，里气素来虚弱；容易因热致病的人，阴气素来衰少；容易伤食的人，脾胃必然亏虚；容易劳伤的人，中气必然受损。这不是因为邪气有余，实在是由正气虚弱所招致。未病时已虚，既病后更虚，用药泻之则更虚，补之也只能偿还被泻去的损耗，即使痊愈如常，精神依然是怯弱的。须知发病时看似有余，即是正气不足之时。何如在受风致病时，用辛温之法护卫卫气；受寒致病时，用辛温之法化散营气；受热致病时，用甘苦之法胜复阴气；因停滞致病时，健运中气以辅助运化；因劳倦致病时，培补元气以匡正恢复。使正气宣通运行以驱逐邪气，邪气消除正气恢复，邪不胜正则自然化解，化旧生新，客邪在不知不觉中顿然释放，正气在受伤之际重新产生。再加上调养，不仅能消除新病，而且旧患借此得以搜除，不知病根，长久生气血，难道不快乐吗！
况且精神的损益，取决于阴阳的盛衰；阴阳的变化，又取决于水火的消长，这些都是无形的。而外感的六淫，以及内伤的七情也是无形的，只有饮食的停滞有迹可循，但实际上也由气化所运化，也是无形的。以无形的邪气，干扰无形的正气，治疗者，只能以无形的方式应对，通过药物的气味性情相互感应、相互化裁来调节，不可将其当作有形的形象，去攻伐无形的虚弱。书中所说的“攻”字，是仁人所厌恶的。况且受寒而变为热证，寒是客邪致病的根源；热是感触元阳外越的表现。寒邪既然去除后又疏泄它，只会加速虚阳的耗散。因饮食而伤胃，胃既受伤脾也虚弱，胃气既虚，脏腑的禀赋都失去了。此时食物虽然在中焦腐熟消化，但内而脏腑，外而四肢，都没有气来推动。食物既然消化了又去消导它，难免有双重虚损的祸患。所以贵在通过脉象来斟酌，那么有形变化的症状虽多，总归属于无形根本这一源头。有迹无形之病，仍取有迹无形之药，气类相从，投服即可入体。大概草木生长，必在人身气血之中，而用药治疗疾病，也必须选取与气血有情分的草木来投服，自能与血气相辅相从而驱除疾病。这样气血借药势而驱驰有力，药力护气血而攻逐无伤，正气既旺，邪气得即解除。如果猛投野狼虎豹般险恶有毒的药物，则未驱逐客邪，先伤正气，正气受伤而邪气更固结，名为驱逐邪气，实为损害正气，所以贵在“不治之治”，运用无形的神圣效用。
（张氏）临证三十年来，伤寒症从未遇到过一例。像古书上记载的壮热头痛的太阳证患者，不用麻黄、桂枝、羌活、柴胡等药，病自然就好了，哪里知道有什么传经的理论？大寒大热而发为疟疾的，何必用青皮、槟榔、陈皮、半夏、柴胡、黄芩等药，寒热自然平复。腹痛赤白杂下而发为痢疾的，哪里依赖香附、黄连、青皮、陈皮、槟榔、厚朴等药，大便自然调和。胸满噫气嗳腐恶食而发为停滞的，不依赖山楂、神曲、三棱、白术等药，食物自然消化。肺胀痰壅而发为咳嗽的，哪里倚仗橘红、半夏、桑白皮、贝母等药，痰嗽自然痊愈！有迹的疾病既然去除，而无形的元气反而增长。因此审察病因，探求所属，避开邪气盛的时候，顺应正气衰的时候，安定正气，化解邪气，归还元气，战胜旧疾。《内经》说：“不要导致邪气入侵，不要丢失正气，才能长久享有天命。”说的就是这种情况吧。所谓仁义之师，无敌于天下。这是（张氏）在常规法则之外寻求完善的方法，而与《内经》“不治其虚，安问其余”以及先贤识标取本的主张并不违背。
（张氏）按语：人赖以生存的根本，只依靠一点真阳之气罢了。即使百病发热，没有不是由于命火离开本宫所致。如果火得安位，则百病自愈。所以古人谆谆告诫慎用寒凉药，并说：“服用寒凉药的人，百人中难有一人生存。”又说：“误服寒凉药的人，立刻死亡。”以此显示寒凉药危害之大且速，警示人们谨慎，不可轻用误用。至于极虚极危的病症，全以救阳为主，大概阳气一分不尽则不死。然而阳气耗尽有两种情况：凡是六脉沉微，两尺脉无根的，这是元气中的元阳欲尽，只有人参、木香、附子可以挽回。如果六脉细数，两尺脉无根的，这是元阴中的元阳欲竭，只有地黄、山茱萸、肉桂、附子可以挽回。等到龙雷假火一退，脉象细数变为沉微，那么原本用地黄、山茱萸、肉桂的药，也应当变为参、术、附子。所以即使是吐血阴虚的病症，每以调理脾胃药收功。然而凡是峻补的药，如果遇到六脉有根，及尺脉不绝者，挽回容易见效。就像树木有根，加上脂膏灌溉，容易发生而繁茂。如果六脉无神，及尺脉无根者，挽回最难见效。因为根气已失，只图靠药力挽回，药力稍缓，脱绝之势便来，非重用陆续补接，不能扭转生机。就像栽培无根的草木，全靠土来培固，水来滋润，日光照耀，使阳和之气，温暖濡润不断，才可以令无根化为有根，必须三五天稍见转机，六七天才恢复，辗转进药迟缓，实在不容易。然而古人救脱的方子，只有人参一两，生附子半个，可以说是大力救生的药物了。无奈今人元阳之虚更甚，而人参的补力却微弱，每每投用此方，很难见效。（张氏）思虑附子通经达络，必赖人参大力驾驭，否则通达迅速，元气反受损伤，所以古人有参附、术附等汤，附子必兼人参、白术同用，既想依靠它通经，又可补其走泄之弊。无奈天地气化转薄，人与草木所禀赋的都虚，人参之力也不比从前，倘若人参一两，生附子半个，则走散多而补益少，怎么能托住真元？所以（张氏）凡治疗脱症，用人参三四两，而熟附子才投半个。极寒极危的病症，即使人参的力量还不足以挽回，大概人参性味平和，更必须兼用白术补益迅速且有刚性的药，才能力散沉寒，追复元阳。况且阳虚重在胃气。如果不重重地托住中气，那么虽然有附子追复元阳的力量，但其通达之性，反而寓含走泄之机。如同修理破败的房屋，若不先用大木头架托梁栋，而妄用斧锯穿凿动摇，能保房屋不倾覆，梁栋不折裂吗？加之脏腑沉寒固闭的病症，用温补药流通其气，凡遇身形瘦小的人则用小剂量煎浓，使药力周遍。若身形肥大的人，必须大剂量浩饮，方能遍达，且躯体丰浓，则禀受阴气独重，非阳药加倍，不足以胜之。
我曾诊治翰林院熊老先生的父亲，年七十多岁，进食后受惊，随即大吐不止，饮食吐尽，痰涎继之，眼球上窜，身体发热，面赤口张，头仰手搐，从午时到戌时，大汗如雨。急忙延请我诊脉，六脉豁大而空，这是假阳上越。用人参二两，炒白术三两，制附子五钱，五味子二钱，煎浓汁灌服，才开始抽搐停止，汗止，热退身宁。但昏迷不醒，第二天照原方，早晚各进一服，服至三天之后，才开始神志清醒认识人，能吃稀粥，继用十全大补汤，及人参养荣汤等而安。又有周某，年五十多岁，向来心肺之火有余，而脾肾之阳不足，常发喘症，一发便垂危。恰逢夏季劳伤发热，误用香薷清暑，及六一散、冰水、酷嗜西瓜，以致下焦沉塞，上焦愈热，烦躁喘急，饮食久废。其脉乍大乍小，两尺无根，渐至乍有乍无，沉微迟缓，三至一止，时时欲脱绝，于是延请我诊治。急忙用人参三两，白术四两，炮姜三钱，五味子二钱，制附子五钱，煎浓汁灌服，服药后脉气稍起，神气稍旺。药性稍过，脱势便来，随即照方又服，每日用人参至八两，白术至十两，附子至二两，渐至尺脉有根，才无脱势，乃大加温补而痊愈。观此，则今人之虚较古人更甚，人参之力较古人亦微弱，可以洞见了。
(Zhang) Because he was frequently ill in his childhood, he abandoned Confucian studies to learn medicine. He followed teachers, sought the Dao, compiled and read various books, studied bitterly for ten years, and only then dared to practice clinically. He strictly followed the standards of ancient sages, working diligently and cautiously, saving many lives. With long experience, his insights became subtle and profound, difficult to fully express in words.
Generally, as established by former sages: For external contraction where wind injures the Wei (Defensive Qi), use acrid-warm herbs to disperse the exterior; where cold injures the Ying (Nutritive Qi), use acrid-hot herbs to dissipate. If the disease persists, follow with harmonizing methods; if harmonizing fails and the pathogen transmits inward, employ purgative methods to rescue the interior. Once the pathogen is resolved and recovery begins, use methods to regulate Yuan Qi and restore the root. If the condition is critical, there are also decoctions for warming meridians, benefiting Yuan Qi, treating mishandled cases, or rescuing life, all purely focused on saving the root. For internal injury due to overexertion, immediately use regulating and tonifying methods without further differentiation. For internal injury due to dietary accumulation, first employ digestion-promoting methods; if the disease persists, follow with purgatives; after recovery, regulate the Spleen and Stomach. If encountering patients with weak constitutional Yuan Qi, one may combine draining and tonifying, tonify more than drain, or tonify before draining. These are established methods, clearly categorized and sequential, never ineffective.
However, these methods are most suitable for people of ancient times, who had strong constitutions, and commoners, whose middle jiao and exterior were solid. They could withstand the consumption of disease and the scouring action of treatment, not easily damaging their deep Tian Yuan (Heavenly Origin), thus preserving their longevity to a hundred years. They are not suitable for people of later generations, whose acquired Qi is thin, whose natures are depleted, and who are pampered youths with delicate constitutions. Slight cold can injure the exterior; labor or improper diet easily injures the middle. Once diseased, their Shen Qi becomes depressed. Adding attacking and draining methods accelerates their deficiency and danger. They cannot withstand prolonged disease consumption nor gradual drug treatment. Often, conditions suddenly worsen, spirit approaches extinction, and only then are harsh tonics administered to rescue. For those already collapsed, it is too late; for those not yet collapsed, survival is merely luck.
Moreover, such previous treatment methods only temporarily remove pathogens, allowing spirit to return to its origin, enabling one to live out a medium lifespan, but cannot permanently eliminate pathogens or make Yuan Qi exceed normal limits to achieve immortality. One fails to consider the *Jing* (Classic) saying: "If spirit is kept within, how can disease arise?" And again: "Where pathogen gathers, Zheng Qi must be deficient." If one does not treat the deficiency, what else is there to ask about? Former sages' treatment methods possessed insight into the root, focusing solely on the foundation, treating thousands without causing harm, which are supreme truths. Know that those prone to wind diseases have inherently weak exterior Qi; those prone to cold diseases have inherently weak interior Qi; those prone to heat diseases have inherently deficient Yin Qi; those prone to food stagnation have inherently deficient Spleen and Stomach; those prone to labor injuries have inherently damaged Middle Qi. This is not due to excess of pathogenic factors, but truly summoned by deficiency of Zheng Qi. Before illness, deficiency exists; during illness, deficiency increases. Using draining drugs makes deficiency worse; using tonics merely compensates for what was drained. Even if recovered to normal, spirit remains timid. Understand that when symptoms appear excessive, it is precisely when Zheng Qi is insufficient. Why not, when suffering from wind, use acrid-warm methods to protect Wei Qi? When suffering from cold, use acrid-warm methods to transform Ying Qi? When suffering from heat, use sweet-bitter methods to overcome Yin deficiency? When suffering from stagnation, strengthen Middle Qi to assist transportation? When suffering from labor, cultivate Yuan Qi to restore balance? Let Zheng Qi circulate freely to expel pathogens. When pathogens are eliminated and Zheng Qi restored, pathogens cannot overcome Zheng Qi and naturally dissolve. Transform old to generate new, releasing guest pathogens effortlessly. Zheng Qi regenerates at the time of injury. Add nursing care, not only eliminating new diseases, but also eradicating old ailments through this method. Unknown to the disease root, generating Qi and Blood for a long time, is this not joyful!
Furthermore, the increase or decrease of spirit depends on the flourishing or declining of Yin and Yang; Yin and Yang changes depend on the waxing and waning of Water and Fire, all of which are formless. External six excesses and internal seven emotions are also formless; only dietary stagnation has traces, yet it is actually operated by Qi transformation, also formless. Treating formless pathogens interfering with formless Zheng Qi requires treating them as formless phenomena, adjusting through the interaction and transformation of drug flavors and natures, not treating them as有形 (formable) entities to attack formless deficiency. The word "attack" mentioned in books is detested by benevolent people. Moreover, when cold transforms into heat, cold is the original cause of guest pathogen disease; heat is the outward flare of touched Yuan Yang. After removing cold, if one again disperses it, it accelerates the dissipation of deficient Yang. When food injures the Stomach, the Spleen becomes deficient as well. With Stomach Qi deficient, the endowment of Zang-Fu organs is lost. At this time, although food rots and digests internally, neither internal organs nor external limbs have Qi to move. If one eliminates food after it has already transformed, one risks severe double deficiency. Therefore, it is crucial to judge via pulse. Though有形 (formable) symptoms vary, they all stem from one formless root. For diseases with traces but formless essence, still use drugs with traces but formless essence, following affinity of Qi categories, so administration enters effectively. Generally, plants grow within human body Qi and Blood; treating disease with drugs also requires selecting herbs with emotional connection to Qi and Blood, naturally assisting blood and Qi to expel disease. Thus, Qi and Blood drive powerfully with drug momentum, while drug force protects Qi and Blood without injury. When Zheng Qi is robust, pathogens are quickly resolved. If one recklessly throws wild wolf-tiger-like dangerous and toxic drugs, one injures Zheng Qi before expelling guest pathogens. Injured Zheng Qi allows pathogens to consolidate. Named expelling pathogens, actually damaging Zheng Qi. Hence, the value lies in "treating by not treating," utilizing formless divine efficacy.
(Zhang) In thirty years of clinical practice, I have never encountered a single case of Shanghan (Cold Damage). For example, ancient descriptions of high fever and headache characteristic of Taiyang syndrome: without using Mahuang (Ephedra), Guizhi (Cinnamon Twig), Qianghuo (Notopterygium), or Chaihu (Bupleurum), the disease resolves itself. How can one know theories of meridian transmission? For malaria caused by extreme cold and heat: why use Qingpi (Citrus Peel), Binglang (Areca Seed), Chenpi (Tangerine Peel), Banxia (Pinellia), Chaihu, or Huangqin (Scutellaria)? Cold and heat resolve spontaneously. For dysentery with abdominal pain and mixed red/white discharge: why rely on Xiangfu (Cyperus), Lianhua (Lotus Flower/Honeysuckle - likely referring to Lianpu or similar clearing herbs, context implies clearing heat/dampness), Qingpi, Chenpi, Binglang, or Houpo (Magnolia Bark)? Bowel movements regulate themselves. For food stagnation with chest fullness, belching, foul odor, and aversion to food: without relying on Shanzha (Hawthorn), Shenqu (Medicated Leaven), Sanleng (Sparganium), or Baizhu (Atractylodes), food digests itself. For lung distension with phlegm obstruction causing cough: without relying on Juhong (Tangerine Pith), Banxia, Sangbaipi (Mulberry Root Bark), or Beimu (Fritillaria), phlegm and cough heal themselves! Once trace-based diseases are removed, formless Yuan Qi instead grows. Therefore, examine the cause, seek the affiliation, avoid excess, follow deficiency, stabilize Zheng Qi, transform pathogens, restore Yuan, overcome old patterns. The *Jing* says: "Do not induce pathogens, do not lose Zheng Qi, and you will long possess your heavenly mandate." This is what is meant. It is like a righteous army, invincible under heaven. This is (Zhang's) method of seeking perfection beyond standard rules, aligning with the *Neijing*'s "If you do not treat deficiency, what else is there to ask?" and the former sages' principle of identifying the mark to take the root.
(Zhang) Commentary: What sustains human life relies solely on a spark of True Yang Qi. Even when hundred diseases present with fever, none arises except when Mingmen Fire leaves its palace. If fire rests in its proper position, all diseases cease. Thus, ancients earnestly warned against using cold-cool drugs, saying: "Those who take cold-cool drugs, one in a hundred survives." And again: "Those who mistakenly take cold-cool drugs die instantly." Showing the severe and rapid harm of cold-cool drugs, warning caution against light or mistaken use. For extremely deficient and critical conditions, the main focus is entirely on rescuing Yang. As long as one part of Yang Qi remains, death does not occur. However, exhaustion of Yang Qi has two types: If six pulses are deep and minute, and both Chi (Kidney) positions lack root, this is Yuan Yang of Yuan Qi about to exhaust; only Renshen (Ginseng), Muxiang (Aucklandia), and Fuzi (Aconite) can salvage it. If six pulses are fine and rapid, and both Chi positions lack root, this is Yuan Yang within Yuan Yin about to deplete; only Dihuang (Rehmannia), Zhuyu (Cornus), Rougui (Cinnamon Bark), and Fuzi can salvage it. Once Dragon-Lei false fire retreats, and pulses change from fine-rapid to deep-minute, then drugs like Dihuang, Zhuyu, Rougui should change to Renshen, Baizhu, Fuzi. Thus, even for hematemesis with Yin deficiency, success is often achieved with Spleen-Stomach regulating drugs. However, for harsh tonics, if six pulses have root and Chi pulse is unbroken, recovery is easy to see effect. Like trees with roots, adding fat and irrigation makes them easily sprout and flourish. If six pulses lack spirit and Chi pulse lacks root, recovery is hardest to see effect. Because root Qi is lost, relying only on drug force to recover; if drug force slows slightly, collapse comes immediately. Only heavy, continuous supplementation can turn around the mechanism of life generation. Like cultivating rootless plants, relying entirely on soil to support, water to nourish, sun to warm, making Yang-harmonious Qi warm and moisten continuously, only then can rootless become rooted. Must take three to five days for slight turning, seven days to recover. Gradual slow progress is indeed difficult. However, ancient formulas for rescuing collapse used only one liang of Renshen and half a raw Fuzi, considered powerful life-saving drugs. Alas, modern people's Yuan Yang deficiency is more severe, while Renshen's tonifying power is weaker. Often administering this formula yields little result. (Zhang) Reflects that Fuzi penetrates meridians and collaterals, requiring Renshen's great power to drive it; otherwise, its rapid penetration damages Yuan Qi. Thus, ancients had formulas like Renshen-Fuzi, Baizhu-Fuzi. Fuzi must be used with Renshen and Baizhu, aiming to penetrate meridians while supplementing its scattering nature. Unfortunately, Heaven and Earth Qi transformation has thinned; humans and herbs are endowed with deficiency. Renshen's power is not like before. If one uses one liang of Renshen and half a raw Fuzi, scattering exceeds tonifying, how can it hold True Yuan? Therefore, (Zhang) whenever treating collapse, uses three to four liang of Renshen, and only then administers half a cooked Fuzi. For extreme cold and critical conditions, even Renshen's power may be insufficient to rescue. Since Renshen is mild, one must additionally use Baizhu, which tonifies rapidly and has rigid strength, to scatter deep cold and追回 (retrieve) Yuan Yang. Moreover, Yang deficiency focuses on the Stomach. If one does not heavily support Middle Qi, although Fuzi has power to retrieve Yuan Yang, its penetrating nature contains scattering mechanisms. Like repairing a broken house, if one does not first use large timber to prop up beams, but rashly uses axes and saws to pierce and shake, can one guarantee the house won't collapse and beams won't break? Additionally, for Zang-Fu deep cold and solid closure conditions, using warm-tonic drugs to circulate Qi: for thin/small bodies, use small doses decocted thick to ensure coverage. For large/heavy bodies, must use large doses drunk copiously to reach everywhere. Since bulky bodies have heavy Yin endowment, non-Yang drugs doubled are insufficient to overcome it.
I treated the father of Mr. Xiong from the Hanlin Academy, over seventy years old. After eating, he was startled, leading to incessant vomiting. Food expelled completely, followed by phlegm-saliva. Eyes rolled back, body feverish, face red, mouth open, head tilted back, hands convulsing. From Wu hour to Xu hour, sweating profusely like rain. Urgently summoned me to diagnose. Six pulses were wide and empty—this was False Yang floating upward. Prescribed Renshen two liang, fried Baizhu three liang, processed Fuzi five qian, Wuweizi (Schisandra) two qian. Decocted thick and灌服 (force-fed). Initially, convulsions stopped, sweat ceased, fever subsided, body calmed. But remained comatose. Next day, continued same formula, morning and evening one dose each. After three days, finally clear-headed, recognized people, could eat thin porridge. Subsequently used Shiquan Dabu Tang (Ten Significant Tonifying Decoction) and Renshen Yangrong Tang (Ginseng Nourishing Spirit Decoction) until stable. Another case: Mr. Zhou, fifty-plus years old. Always had excess Heart-Lung Fire, but deficient Spleen-Kidney Yang. Frequently suffered asthma attacks, each threatening life. In summer, labor-induced fever occurred. Mistakenly used Xiangru (Elsholtzia) for clearing summerheat, Liuyisan (Six-Ingredient Powder), ice water, and craved watermelon excessively. Resulted in lower jiao blockage, upper jiao heat worsening. Restlessness, panting urgency, long abstinence from food. Pulses fluctuated large and small, Chi positions lacked root. Gradually became intermittent, deep-minute, slow, stopping every three beats, constantly near collapse. Summoned me for treatment. Urgently prescribed Renshen three liang, Baizhu four liang, Paojiang (Roasted Ginger) three qian, Wuweizi two qian, processed Fuzi five qian. Decocted thick and灌服. After taking, pulse Qi slightly rose, Shen Qi slightly revived. Drug nature slightly passed, collapse tendency returned. Immediately repeated prescription. Daily Renshen increased to eight liang, Baizhu to ten liang, Fuzi to two liang. Gradually Chi pulses gained root, collapse tendency ceased. Then heavily added warm-tonics until cured. Observing this, modern deficiency is more severe than ancient times, and Renshen's power is weaker than ancient times, clearly visible.