余。又曰∶治病必求其本。诚医旨之格言也。假如停滞发热，脸红发燥，似有余也，然究其本，乃脾胃气虚，
不能传化，则虚乃其本也，理宜推扬谷气，助脾运化，设徒从标攻克，则内伤之患，接踵而至。又如伤风感冒，
壮热头痛，虽似有余，然即《内经》所谓，邪气胜则实，实因卫气不固所召也，若纯用猛剂发散，则表气愈虚，
外邪之乘，何时而已？更如咳嗽喘促，烦躁不安，肺气热盛，似有余也，然究其源，非水虚不能制火，即火虚
虚阳上浮，设从标理肺为事，虽暂愈而发愈甚。故凡外凑有余之病，即本经正气不足之时，若不从源调治，正
当不足而更不足之，虚者日虚，危亡继其后矣。（《冯氏锦囊》）
大实有羸状，误补益疾；至虚有盛候，反泻衔冤。阴证似阳，清之必死；阳证似阴，温之转伤。盖积聚在
中，实也，甚则嘿嘿不欲言，肢体不欲动，或眩晕眼花，或泄泻不实，皆大实有羸状，正如食而过饱，反倦怠
嗜卧也；脾胃损伤，虚也，甚则胀满而食不得入，气不得舒，便不得利，皆至虚有盛候，正如饥而过时，反不
思食也。脾肾虚寒，正阴证也，阴盛之极，往往格阳，面目红赤，唇裂谵语，扬手掷足，有似乎阳，正如严冬
惨肃，而水泽腹坚，坚为阳刚之象也；邪热未解，真阳证也，阳盛之极，往往发厥，厥则口鼻无气，手足逆冷，
有似乎阴，正如盛夏炎灼，而林木流津，津为阴柔之象也。（《医宗必读》）
热在上焦，咽干口糜；热在中焦，心烦口渴；热在下焦，便闭溺赤。（《医学入门》）
人身有宗气、营气、卫气、中气、元气、胃气、冲和之气、上升之气，而宗气尤为之主。及其为病，则为
冷气、滞气、上气、逆气、气虚，诸变证矣。无病之时，宜保之、养之、和之、顺之。病作之时，当审其何经、
何证，寒热虚实，而补泻之。（《医方集解》）
病患自言冷气从下而上者，此上升之气，自肝而出，中挟相火，其热为甚，自觉其冷，非真冷也，此火极
似水，阳亢阴微，
故见此证。冷生气者，高阳生之谬言也。《局方发挥》凡中气实则虚，谓能运动故也；虚则实，谓成填滞故也。
气滞则神困，实由于中气之不足，故急须补中益气，但使实其所虚，自能虚其所实，脾气一醒，何精神之不可
顿倍也？（程郊倩）
凡病微者可祛，盛者难救。故治病当视其微盛，以别其安危，毋徒泛视而轻断也。微者血气未损，第邪扰
动于内，故一伐邪而正气自复，病亦易祛；盛者血气先衰，邪气内炽，将扶正欤？适以助邪而正不能扶；将伐
邪欤？适以损正而邪不可伐。邪日盛而正日衰，如之何其可救也？（余午亭）
论病不易，论证尤难，而证中论证，难之又难也。凡有病必有证，有证必有论，论清则证明，证明则病易
疗，非可以模棱两端，取效于疑似之间也。如心痛、腰空、脊强、寒热、逆气、内结诸证，认病不的，愈治愈
深。夫心痛之病，始究胃气，继责心包血少，养血不应，理气不效，不知阴维为病，苦心痛也。腰空之病，悉
认肾虚，及至补肾，亦不应手，不知带脉为病，腰溶溶如坐水中也。脊强之病，均认太阳，非寒即湿，散寒驱
湿，漠不相关，不知督脉为病，脊强反折也。寒热之病，外感认作少阳，内伤认作少阴，和解不瘥，滋降不痊，
不知阳维为病，苦寒热也。逆气之病，有平肝泄肺者，有理气降气者，用俱不验，不知冲脉为病，气逆里急也。
内结之病，有不知名状者，有不知治疗者，不知任脉为病，男子内结七疝，女子带下瘕聚也。（《医学阶梯》）
内伤久病，必转病而后阳气活动，脉弦转疟方愈，脉缓转痢方愈，肺脉不足，转伤风、咳嗽方愈。寒热
似疟，是少阳经阳气通也；红白似痢，是阳明经阳气通也；伤风、咳嗽，是太阳经阳气通也。阳气通则病自退。
（查了吾）
凡诊病，不问三常，不知比类，不察神志，不遵圣训，故犯无忌，医之过也。○凡医不能察识营卫受病浅深，
虚实寒热，先后之变，白首有如童稚，不足数也。（《医门法律》）
我（程杏轩）又说：治病必须探求根本。这确实是医学宗旨中的格言。假如出现食积停滞导致的发热，面色发红、身体燥热，看起来像是实证有余，但追究它的根本，其实是脾胃气虚，不能运化传导，那么“虚”才是根本，按理应当推扬谷气，帮助脾脏运化；如果仅仅从表象进行攻伐克制，那么内伤的祸患就会接踵而至。又比如伤风感冒，高热头痛，虽然看似实证有余，但这正如《内经》所说的，邪气盛则表现为实，这种实是由于卫气不固所招致的；如果纯用猛烈的药剂发散，那么表气会更加虚弱，外邪侵袭，什么时候才能停止呢？再比如咳嗽气喘急促，烦躁不安，肺气热盛，看起来也是实证有余，但追究源头，要么是水（肾阴）虚不能制约火，要么是火（命门火）虚导致虚阳上浮；如果只从表象去调理肺脏，虽然暂时痊愈，但发作起来会更严重。所以凡是外部凑合表现出有余症状的疾病，都是本经正气不足的时候，如果不从源头调治，在正当不足的情况下更加耗损，虚弱的人日益虚弱，危险灭亡就在其后了。（引自《冯氏锦囊》）
大实证有时会出现羸弱的假象，误用补法会使病情加重；极度的虚证有时会出现强盛的假象，误用泻法只会带来冤屈（伤害）。阴证有时类似阳证，用清热法必死无疑；阳证有时类似阴证，用温补法反而造成伤害。大概积聚在中焦，属于实证，严重时默默不想说话，肢体不想活动，或者眩晕眼花，或者泄泻不成形，这都是大实有羸状，正如吃得太饱，反而倦怠嗜睡；脾胃损伤，属于虚证，严重时胀满且食物无法进入，气机无法舒展，大便无法通畅，这都是至虚有盛候，正如饥饿过了头，反而不想吃东西。脾肾虚寒，正是阴证，阴气盛到极点，往往格拒阳气于外，面目红赤，嘴唇干裂胡言乱语，挥手踢脚，似乎像阳证，正如严冬惨肃，而水泽腹部坚硬，坚硬是阳刚的象征；邪热未解，真是阳证，阳气盛到极点，往往发生厥逆，厥逆时口鼻无气，手足逆冷，似乎像阴证，正如盛夏炎热灼人，而林木流淌汁液，汁液是阴柔的象征。（引自《医宗必读》）
热邪在上焦，咽喉干燥、口腔糜烂；热邪在中焦，心烦口渴；热邪在下焦，大便闭塞、小便短赤。（引自《医学入门》）
人体有宗气、营气、卫气、中气、元气、胃气、冲和之气、上升之气，其中宗气尤其作为主导。当它们发病时，就变成了冷气、滞气、上气、逆气、气虚等各种变证。没有生病的时候，应该保护它、调养它、调和它、顺应它。疾病发作的时候，应当审察是哪条经络、哪种证候，辨别寒热虚实，然后进行补泻治疗。（引自《医方集解》）
病人自己说冷气从下往上走，这是上升之气，从肝脏发出，中间夹带着相火，其热势很盛，病人自觉寒冷，并非真正的寒冷，这是火极似水，阳亢阴微，所以出现这种证候。认为冷能生气的说法，是高阳生的谬论。《局方发挥》中说：中气实则显得虚，是因为能够运动的原因；中气虚则显得实，是因为形成填塞阻滞的原因。气滞则神志困顿，其实是由于中气不足，所以急需补中益气，只要使虚者充实，自然能使实者（因阻滞而显的实）变虚，脾气一旦苏醒，精神怎能不顿时加倍呢？（程郊倩）
凡是病势轻微的可以祛除，病势强盛的难以救治。所以治病应当观察病势的微与盛，以区别安危，不要只是泛泛地看而轻率判断。病势微者，血气尚未受损，只是邪气在内扰动，所以一但祛伐邪气，正气自然恢复，病也容易祛除；病势盛者，血气先已衰弱，邪气在内炽盛，如果要扶正吗？恰好会助长邪气而正气不能被扶助；如果要祛邪吗？恰好会损伤正气而邪气不能被祛除。邪气日益强盛而正气日益衰弱，怎么能救治呢？（余午亭）
论述疾病不容易，辨析证候尤其困难，而在证候中进一步辨析，更是难上加难。凡是有病必有证，有证必有理论分析，理论清晰则证候明确，证候明确则疾病容易治疗，不可以模棱两可，在疑似之间寻求疗效。比如心痛、腰部空虚感、脊背僵硬、寒热往来、气逆、体内结聚等证候，如果认病不准，越治越深重。心痛之病，起初究查胃气，继而责怪心包血少，养血无效，理气无功，不知道阴维脉为病，痛苦在于心痛。腰部空虚之病，全部认定为肾虚，等到补肾，也不见效，不知道带脉为病，腰部溶溶然如坐在水中。脊背僵硬之病，都认定为太阳经病，非寒即湿，散寒驱湿，漠不相关，不知道督脉为病，脊背僵硬反折。寒热之病，外感认定为少阳经，内伤认定为少阴经，和解无效，滋阴降火不愈，不知道阳维脉为病，痛苦在于寒热。气逆之病，有的平肝泄肺，有的理气降气，使用都不灵验，不知道冲脉为病，气逆里急。体内结聚之病，有的不知名状，有的不知治疗方法，不知道任脉为病，男子内结七疝，女子带下瘕聚。（引自《医学阶梯》）
内伤久病，必须转变病势之后阳气才能活动，脉象由弦转疟疾样才痊愈，脉象由缓转痢疾样才痊愈，肺脉不足，转伤风、咳嗽才痊愈。寒热类似疟疾，是少阳经阳气通达的表现；红白类似痢疾，是阳明经阳气通达的表现；伤风、咳嗽，是太阳经阳气通达的表现。阳气通达则病自然退去。（查了吾）
凡是诊病，不问病人的生活常情（饮食起居等），不懂比类分析，不观察神志变化，不遵循圣人的训诫，故意犯禁无忌，这是医生的过错。○凡是医生不能察识营卫受病的深浅，虚实寒热的先后变化，即使白头到老也如同孩童幼稚，不值得称道。（引自《医门法律》）
I (Cheng Xingxuan) further state: Treating disease requires seeking the root cause. This is indeed a golden rule in medical principles. For instance, if there is fever due to food stagnation, with a red face and dry body heat, it appears as an excess condition; however, investigating its root reveals that it is actually Spleen-Stomach Qi deficiency (Spleen-Stomach Qi deficiency), which fails to transport and transform, making "deficiency" the root. Theoretically, one should promote grain Qi and assist the Spleen's transformation and transportation. If one merely attacks the branch symptoms with purgatives, internal injury complications will follow closely. Similarly, in wind-cold common cold, with high fever and headache, although it seems like an excess condition, this aligns with what *Neijing* states: "When pathogenic factors are strong, it manifests as excess." This excess is summoned by the insecurity of Defensive Qi (Defensive Qi). If purely using potent diaphoretic agents is employed, the Exterior Qi will become even more deficient, and when will the invasion of external pathogens cease? Furthermore, in cases of cough, wheezing, restlessness, and irritability, indicating Lung Heat Excess (Lung Heat Excess), it also appears as excess. However, tracing the source, it is either Kidney Yin deficiency (Kidney Yin deficiency) failing to control Fire, or Mingmen Fire deficiency (Mingmen Fire deficiency) causing floating Deficient Yang. If treatment focuses only on regulating the Lungs based on surface symptoms, although temporary relief may occur, subsequent relapses will be more severe. Therefore, any disease presenting with external excess symptoms indicates a time when the Zheng Qi (Upright Qi) of the meridian is insufficient. If treatment does not address the source, further depleting what is already insufficient, the deficient will become increasingly deficient, leading to danger and demise. (Quoted from *Feng Shi Jin Nang*)
Great excess may present with emaciated appearances; mistakenly tonifying will aggravate the illness. Extreme deficiency may present with flourishing signs; mistakenly purging will bring unjust harm. Yin syndromes may resemble Yang syndromes; clearing them will surely lead to death. Yang syndromes may resemble Yin syndromes; warming them will cause further injury. Generally, accumulation in the middle jiao is excess. In severe cases, the patient may be silent and unwilling to speak, limbs unwilling to move, or experience dizziness, blurred vision, or loose stools. These are all examples of great excess presenting with emaciated appearances, just as overeating leads to lethargy and desire to lie down. Spleen-Stomach damage is deficiency. In severe cases, there may be distension preventing food intake, Qi stagnation preventing comfort, and stool retention preventing evacuation. These are all examples of extreme deficiency presenting with flourishing signs, just as prolonged hunger leads to loss of appetite. Spleen-Kidney Yang deficiency is truly a Yin syndrome. When Yin is extremely abundant, it often repels Yang outward, causing redness of the face and lips, delirious speech, and tossing about, resembling Yang syndrome. This is like the harsh severity of deep winter where water freezes solid; solidity represents the image of Yang strength. Unresolved pathogenic heat is truly a Yang syndrome. When Yang is extremely abundant, it often causes Jue (Cold Extremities). In Jue, there is no breath at mouth and nose, and hands and feet are cold, resembling Yin syndrome. This is like the scorching heat of midsummer where trees weep sap; sap represents the image of Yin softness. (Quoted from *Yi Zong Bi Du*)
Heat in the Upper Jiao causes dry throat and oral ulcers. Heat in the Middle Jiao causes heart vexation and thirst. Heat in the Lower Jiao causes constipation and dark urine. (Quoted from *Yi Xue Ru Men*)
The human body possesses Zong Qi (Pectoral Qi), Ying Qi (Nutritive Qi), Wei Qi (Defensive Qi), Zhong Qi (Middle Qi), Yuan Qi (Source Qi), Wei Qi (Stomach Qi), Chong He Zhi Qi (Harmonious Qi), and Sheng Shang Zhi Qi (Ascending Qi), among which Zong Qi serves as the master. When they become diseased, they manifest as Cold Qi, Stagnant Qi, Ascending Qi, Rebellious Qi, Qi Deficiency, and various other transformed syndromes. When healthy, one should protect, nourish, harmonize, and comply with them. When disease arises, one must examine which meridian and which syndrome, distinguishing cold, heat, excess, and deficiency, and then apply tonification or sedation. (Quoted from *Yi Fang Ji Jie*)
If a patient reports cold qi rising from below, this is Ascending Qi originating from the Liver, carrying Ministerial Fire (Ministerial Fire), where the heat is intense, but the patient feels cold, not true cold. This is "Fire extremity resembling Water," where Yang is hyperactive and Yin is minute, hence this syndrome appears. The notion that cold generates Qi is a fallacy of Gao Yangsheng. *Ju Fang Fa Hui* states: When Zhong Qi is excess, it appears deficient because it can move; when Zhong Qi is deficient, it appears excess because it forms obstruction. Qi stagnation traps Shen (Spirit); this excess is actually due to Zhong Qi insufficiency. Therefore, one must urgently tonify Zhong Qi and boost Qi. By filling the deficiency, the apparent excess (due to stagnation) will naturally become deficient. Once Spleen Qi awakens, how can Spirit not double instantly? (Cheng Jiaoqian)
Generally, mild diseases can be expelled, while severe ones are hard to save. Thus, treating disease requires observing whether it is mild or severe to distinguish safety from danger, rather than making hasty judgments superficially. In mild cases, Blood and Qi are undamaged, only disturbed internally by pathogens; thus, once pathogens are attacked, Zheng Qi recovers naturally, and the disease is easily cured. In severe cases, Blood and Qi have already declined, while pathogens burn fiercely internally. If one tries to tonify Zheng Qi, it inadvertently aids the pathogens, failing to support Zheng Qi; if one tries to attack pathogens, it damages Zheng Qi, failing to eliminate pathogens. As pathogens grow stronger daily and Zheng Qi weaker daily, how can it be saved? (Yu Wuting)
Discussing disease is not easy; analyzing syndromes is even harder, and analyzing within syndromes is the hardest of all. Wherever there is disease, there is a syndrome; wherever there is a syndrome, there is theoretical analysis. Clear theory clarifies the syndrome; clarified syndrome makes treatment easier. One cannot be ambiguous and seek efficacy in doubtful situations. For example, in syndromes like Heart Pain, Empty Waist, Spinal Rigidity, Alternating Chills and Fever, Rebellious Qi, and Internal Knotting, if the disease is misidentified, treatment will deepen the condition. For Heart Pain, initially investigate Stomach Qi, then blame Heart Pericardium Blood deficiency. If blood tonification fails and Qi regulation fails, one should know that Yin Wei Mai pathology causes painful Heart Pain. For Empty Waist, fully recognize Kidney deficiency. If kidney tonification fails, one should know that Dai Mai pathology causes waist feeling like sitting in water. For Spinal Rigidity, usually identify Taiyang channel, attributing it to Cold or Dampness. If dispelling Cold and driving out Dampness yields no result, one should know that Du Mai pathology causes spinal rigidity and retroflexion. For Alternating Chills and Fever, exterior contraction is identified as Shaoyang, interior injury as Shaoyin. If harmonizing fails and yin-nourishing descending fails, one should know that Yang Wei Mai pathology causes alternating chills and fever. For Rebellious Qi, some use Liver-pacifying and Lung-draining, others Qi-regulating and Qi-descending, yet none work. One should know that Chong Mai pathology causes rebellious Qi and abdominal urgency. For Internal Knotting, some do not know the description, others do not know the treatment. One should know that Ren Mai pathology causes Seven Types of Hernia in men and Leukorrhea and Masses in women. (Quoted from *Yi Xue Ti Jie*)
In chronic internal injuries, the disease must transform before Yang Qi becomes active. Recovery occurs when the pulse changes from wiry to malaria-like, or from slow to dysentery-like. If Lung pulse is insufficient, recovery occurs upon developing wind-cold and cough. Alternating chills and fever resembling malaria indicates the unblocking of Shaoyang Yang Qi; red and white discharge resembling dysentery indicates the unblocking of Yangming Yang Qi; wind-cold and cough indicate the unblocking of Taiyang Yang Qi. When Yang Qi unblocks, the disease retreats naturally. (Cha Liaowu)
In diagnosing disease, failing to inquire about the Three Constants (diet, lifestyle, etc.), not understanding analogy, not observing Shen (Spirit), and not following sage teachings, while deliberately violating taboos without fear, constitutes medical error. ○ Any physician who cannot discern the depth of Ying and Wei pathogenesis, and the variations of excess/deficiency and cold/heat in sequence, remains like a child despite white hair, and is unworthy of mention. (Quoted from *Yi Men Fa Lv*)