天下之病，竟有不宜服药者，如黄胆之类是也。黄胆之症，仲景原有煎方。然轻者用之
俱效
不入囊中，所服之药，非补邪，即伤正，故反有害。若轻病则囊尚未成，服药有效。至囊成
之后，则百无一效。必须用轻透之方，或破其囊，或消其水。另有秘方传授，非泛然煎丸之
所能治也。痰饮之病，亦有囊，常药亦不能愈。外此如吐血久痞等疾，得药之益者甚少，受
药误者甚多。如无至稳必效之方，不过以身试药，则宁以不服药为中医矣！
方之与药，似合而实离也。得天地之气，成一物之性，各有功能，可以变易血气，以除
疾病，此药之力也。然草木之性，与人殊体，入人肠胃，何以能如人之所欲，以致其效？圣人为
之制方以调剂之，或用以专攻，或用以兼治，或相辅者，或相反者，或相用者，或相制者，
故方之既成，能使药各全其性，亦能使药各失其性。操纵之法，有大权焉。此方之妙也。若
夫按病用药，药虽切中，而立方无法，谓之有药无方；或守一方以治病，方虽良善，而其药
有一二味与病不相关者，谓之有方无药。譬之作书之法，用笔已工，而配合颠倒；与夫字形
俱备，而点画不成者，皆不得谓之能书。故善医者分观之，而无药弗切于病情；合观之，而
无方不本于古法，然后用而弗效，则病之故也，非医之罪也。而不然者，即偶或取效，隐害
必多，则亦同于杀人而已矣。至于方之大小奇偶之法，则《内经》详言之，兹不复赘云。
天下的疾病，竟然有不适合服药的情况，比如黄疸病就是这类。黄疸这种病症，张仲景原本就有煎煮的方剂。然而对于轻症使用这些方剂，虽然大多有效，但对于重症（如胆囊肿大或积液等严重情况）则无效。此时服用的药物，不是助长邪气，就是损伤正气，因此反而有害。如果是轻病，那么囊状病变尚未形成，服药是有效的。等到囊状病变形成之后，就百无一效了。必须使用轻清透达的方剂，或者破除其囊，或者消除其中的积水。另有秘方传授，不是普通的煎剂或丸药所能治疗的。痰饮这类疾病，也有类似“囊”的病理产物，普通药物也不能治愈。除此之外，像吐血、长期痞块等疾病，得到药物益处的很少，受到药物误治伤害的很多。如果没有极其稳妥且必定有效的方子，不过是拿自己的身体去试药，那么宁愿不服药来保持中道（即不犯大错）！
方剂与药物，看似结合实则分离。药物禀受天地之气，形成各自独特的性质，各有功能，能够改变人体的血气，从而去除疾病，这是药物的力量。然而草木药物的性质，与人体结构不同，进入人的肠胃后，怎么能顺从人的意愿而发挥疗效呢？圣人制定方剂来调和它们，有的用于专攻病邪，有的用于兼治多病，有的相互辅助，有的相互制约，有的相互利用，有的相互抑制。所以方剂一旦组成，既能使药物保全其本性，也能使药物失去其本性。其中操纵调控的方法，掌握着巨大的权变之道。这就是方剂的奥妙所在。如果按照病情用药，药物虽然切中要害，但组方没有法度，这叫作“有药无方”；或者死守一方来治病，方子虽然良善，但其中有一两味药与病情无关，这叫作“有方无药”。这就好比写字的方法，用笔已经工整，但字形配合颠倒；或者字形都具备，但点画不成形，都不能叫作擅长书法。所以高明的医生，从单个药物来看，没有一味药不切合病情；从整体方剂来看，没有一方不遵循古法。然后如果用药仍无效，那是疾病的缘故，不是医生的罪过。如果不这样做，即使偶尔取得疗效，隐藏的害处必然很多，那也就等同于杀人罢了。至于方剂大小、奇偶配伍的方法，《黄帝内经》中已有详细论述，这里不再赘述。
Among the diseases of the world, there are indeed those unsuitable for medication, such as **huangdan** (jaundice). For this condition, Zhang Zhongjing originally provided decoction prescriptions. However, while these are effective for mild cases, they are ineffective for severe cases where a "sac-like" pathology (referring to severe accumulation or cystic formation) has formed. In such instances, administered drugs either augment the pathogenic factor or damage the healthy qi, thereby causing harm. If the disease is mild, the sac-like pathology has not yet formed, and medication is effective. Once the sac-like pathology has formed, however, there is virtually no efficacy. One must employ light and penetrating prescriptions to either break the sac or resolve the fluid accumulation. There are secret formulas passed down that cannot be treated by ordinary decoctions or pills. Diseases such as **tanyin** (phlegm-fluid retention) also involve similar sac-like pathological products, which ordinary medicines cannot cure. Besides these, in conditions such as hematemesis (vomiting blood) and chronic pi (abdominal masses), few benefit from medication, while many suffer from mismedication. Without extremely stable and invariably effective prescriptions, one would merely be testing drugs on one's own body; thus, it is better to abstain from medication to maintain the middle way (avoiding major errors)!
Prescriptions (fang) and herbs (yao) appear combined but are essentially distinct. Herbs, imbued with the qi of heaven and earth, possess unique natures and functions capable of altering the body's blood and qi to eliminate disease; this is the power of herbs. However, the nature of herbal materials differs from the human constitution. Upon entering the stomach and intestines, how can they align with human intent to achieve therapeutic effects? The sages formulated prescriptions to regulate them: some are used for targeted attack, others for concurrent treatment; some mutually assist, others mutually constrain; some utilize each other, others counteract each other. Thus, once a prescription is composed, it can either preserve the inherent nature of the herbs or alter their nature. The method of manipulation holds significant authority; this is the subtlety of prescriptions. If one selects herbs according to the disease, and although the herbs hit the mark, the prescription lacks structural principle, it is called "herbs without a prescription." Conversely, if one rigidly adheres to a single prescription, and although the formula is sound, one or two herbs are irrelevant to the disease, it is called "a prescription without relevant herbs." This is akin to calligraphy: even if the brushwork is skilled, if the character structure is disordered; or if the character forms are present but the strokes are incomplete, neither constitutes mastery of writing. Therefore, a skilled physician, viewing individually, ensures no herb is irrelevant to the patient's condition; viewing collectively, ensures no prescription deviates from ancient principles. Only then, if treatment fails, is it due to the disease itself, not the physician's fault. Otherwise, even if occasional success is achieved, hidden harms will likely abound, effectively equating to killing the patient. As for the methods regarding the size and odd/even parity of prescriptions, these are detailed in the *Neijing* (Inner Canon), so I shall not repeat them here.