经义
帝曰∶气有多少，病有盛衰，治有缓急，方有大小。愿闻其约，奈何？岐伯曰∶气有高下，病有远近，
证有中外，治有轻重。适其至所为故也。大要曰∶君一臣二，奇之制也；君二臣四，偶之制也；君二臣三，奇
之制也；君二臣六，偶之制也。故曰∶近者奇之，远者偶之。汗者不以偶，下者不以奇。补上治上，制以缓；
补下治下，制以急。急则气味浓，缓则气味薄。适其至所，此之谓也。病所远而中道气味之者，食而过之，无
越其制度也。是故平气之道，近而奇偶，制小其服也；远而奇偶，制大其服也。大则数少，小则数多。多则九
之，少则二之。奇之不去，则偶之，是谓重方。偶之不去，则反佐以取之。所谓寒热温凉，反从其病也。○帝
曰∶非调气而得者，治之奈何？有毒无毒，何先何后，愿闻其道。岐伯曰∶有毒无毒，所治为主，适大小为制
也。帝曰∶请言其制？岐伯曰∶君一臣二，制之小也；君一臣三佐五，制之中也；君一臣三佐九，制之大也。
○帝曰∶方制君臣，何谓也？岐伯曰∶主病之谓君，佐君之谓臣，应臣之谓使。非上下三品之谓也。（《素问》）
约方，犹约囊也。囊满弗约，则输泄；方成弗约，则神与弗俱。（《灵枢》）
总论
方之为言，仿也。仿病而有方也。《素》、《难》无方，非无方也，为仿为活法也。汉世才有方，为备
于仿也。今时奇方疗
疾，倘果可以发无不中，则昔轩、岐、扁、仓神灵之智，慈爱之仁，岂不及此！何不每病只立一方，使后人彰
明显著，用无不当，而乃广为昭析，多立言词以累后学，纷赜难穷，效无十全哉！虽然，方不可泥，亦不可遗。
以古方为规矩，合今病而变通。既详古论之病情，复揣立方之奥旨，病同药异，病异药同。证端蜂起，而线索
井然；变见多危，而执持不乱。诚为良矣！（《冯氏锦囊》）
医当论方，不当论药。当就方以论药，不当执药以论方。（《己任编》）
医者，意也。如对敌之将，操舟之工，贵乎临机应变。方固难于尽用，然非方，则古人之心弗传。望洋捕
风，必有率意而失之者矣。方果可以不用乎？虽然，方固良矣，然必熟之《素问》，以求其本；熟之本草，以
究其用；熟之诊视，以察其证；熟之治疗，以通其变。始于用方而终无俟于方。夫然后医之道成矣。（商辂）
方有七∶大、小、缓、急、奇、偶、复是也。张从正曰∶大方有二，有君一臣三佐九之大方，病邪不一，
不可以一、二味治者宜之；有分两重而顿服之大方，肝肾及下部之病道远者宜之。小方有二，有君一臣二之小
方，病邪专一，可一、二味治者宜之；有分两小而频服之小方，心肺及在上之病宜之，徐徐细呷是也。刘完素
曰∶肝肾位远，数多则其气缓，不能速达于下，必大剂而数少，取其迅速下行也；心肺位近，数少则其气急，
不能升发于上，必小剂而数多，取其易散而上行也。《经》曰∶补上治上制以缓，补下治下制以急。急则气味
浓，缓则气味薄。适其病所而中道，无越其制度也。王冰曰∶假如病在肾，而心气不足，服药宜急过之，不以
气味饲心，肾药凌心，心复益衰矣。刘完素曰∶圣人治上不犯下；治下不犯上；治中上下俱不犯。故曰∶诛伐
无过者，命曰大惑。张从正曰∶缓方有五，有甘以缓之之缓方，甘草、饴蜜之属是也，病在胸膈，取其留恋也；
有丸以缓之之缓方，比之汤散，其行迟慢也；有品件众多之缓方，药聚则递相拘制，
不得独骋其性也；有无毒治病之缓方，无毒则性纯缓也；有气味俱薄之缓方，气味薄则长于治上，及其至下，
药力已衰矣。王好古曰∶治主宜缓，缓则治其本也；治客宜急，急则治其标也。张从正曰∶急方有四，有急病
急攻之急方，中风、关格之病是也；有汤散荡涤之急方，下咽易散而行速也；有毒药之急方，毒药能上通下泄，
以夺病势也；有气味俱浓之急方，直趋于下而力不衰也。奇方有二，有独用一物之奇方，病在上而近者宜之；
有药合阳数，一、三、五、七、九之奇方，宜下不宜汗是也。刘完素曰∶小承气，奇之小者也；大承气、抵当
汤，奇之大者也。因其攻下而为之也。桂枝、麻黄，偶之小者也；葛根、青龙，偶之大者也。因其发汗而用之
也。偶方之制，有两味相配之偶方；有古之二方并用之偶方，古谓之复方。皆病在下而远者宜之。有药合阴数，
二、四、六、八、十之偶方，宜汗不宜下是也。王好古曰∶奇之不去复以偶，偶之不去复以奇，故曰复；复者，
再也。王太仆以偶方为复方，七方之中有偶又有复，岂非偶乃二方相合，复乃数方相合乎？（《怡堂散记》）
许学士云∶余读仲景书，用仲景法，然未尝守其方，乃为得仲景之心也。（李东垣）
或问仲景处方，药品甚少，及东垣用药多至二十余味。丹溪云∶余每治病，用东垣之药，效仲景处方，庶
品味数少，则药力专精。丹溪何以不法东垣而效仲景耶？曰∶明察药性，莫如东垣，盖所谓圣于医者也。故在
东垣则可多，他人而效其多，斯乱杂矣。东垣如韩信将兵，多多益善，丹溪不过能将十万，故不敢效其多。（王节斋）
仲景立方，精而不杂，其中以六方为主，诸方从而加减焉。凡汗剂，皆本桂枝；吐剂，皆本栀豉；攻剂，
皆本承气；和剂，皆本柴胡；寒剂，皆本泻心；温剂，皆本四逆。混而数之，为一百十三方者，未之审也。○
仲景方备十剂之法∶轻可散实，麻黄、
葛根诸汤是已；宣可决雍，栀豉、瓜蒂二方是已；通可行滞，五苓、十枣之属是已；泄可去闭，陷胸、承气、
抵当是已；滑可去着，胆导、蜜煎是已；涩可固脱，赤石脂、桃花汤是已；补可扶弱，附子、理中丸是已；重
可镇怯，禹余粮、代赭石是已；湿可润燥，黄连阿胶汤是已；燥可去湿，麻黄连翘赤小豆汤是已；寒能胜热，
白虎、黄连汤是已；热能制寒，白通、四逆诸汤是已。○仲景制方，随方立禁，使人受其功不蹈其弊也。如用
发表药，一服汗者停后服。若脉紧发热汗不出者，不可与桂枝；脉微弱汗出恶风者，不可服青龙；脉浮发热无
汗表不解者，不可与白虎；诸亡血虚家，不可用瓜蒂；病患旧微溏者，不可与栀子；阳明病汗出多者，不可与
猪苓；外未解其热不潮者，未可与承气；呕家不可与建中。此仲景慎重之心。○仲景用攻、下二字，不专指大
便。凡与桂枝汤欲攻其表，此指发汗言；表解者乃可攻之，指利水言；有热属脏者攻之，指清火言也。寒湿在
里不可下，指利水言，以有热故也。当以汤下之，指清火言也。○六经各有主方，而他经有互相通用之妙。如
麻、桂二汤，为太阳营卫设，阳明之病在营卫者亦用之。真武汤，为少阴水气设，太阳之汗后亡阳者亦用之。
四逆汤，为太阴下利清谷设，太阳之脉反沉者亦宜之。五苓散，为太阳消渴水逆设，阳明之饮水多者亦宜之。
猪苓汤，为少阴下利设，阳明病小便不利者亦宜之。抵当汤，为太阳淤血在里设，阳明之蓄血亦宜之。瓜蒂散，
为阳明胸中痞硬设，少阴之温温欲吐亦宜之。合是证便用是方。方各有经，而用不拘，是仲景法也。方虽有表、
里、寒、热、虚、实之不同，并无伤寒、中风杂证之分别，且风、寒有两汤迭用之妙，表、里有二方更换之奇。
或以全方取胜，或以加减奏功。后人论方不论证，故反以仲景方为难用耳。○桂枝，汗剂中第一品也。麻黄之性，
直透皮毛，生姜之性，横散肌肉，故桂枝佐麻黄则开元府，而逐卫分之邪，令无汗者有汗而解，故曰发汗。
桂枝率生姜则开腠理，而驱营分
之邪，令有汗者复汗而解，故曰解肌。解肌肉之邪，正在营分，何立三纲者反立麻黄主营、桂枝主卫耶？麻黄
不言解肌，而肌未尝不解。桂枝之解肌，正所以发汗。要知麻黄、桂枝二汤，是发汗分深浅之法，不得以解肌
与发汗对讲。○麻黄、桂枝，太阳、阳明表之表药；瓜蒂、栀豉，阳明里之表药；小柴胡，少阳半表之全药。
太阴表药，桂枝汤；少阴表药，麻黄附子细辛汤；厥阴表药，当归四逆汤。六经之用表药，为六经风寒之出路
也。○凡治病必分表里，而表里偏有互呈之证。如麻黄之喘，桂枝之自汗，大青龙之烦躁，小青龙之咳，皆病
在表而夹里证也。用杏仁以治喘，芍药以止汗，石膏以治烦躁，五味、干姜以治咳，是于表剂中兼治里也。○
麻黄汤，于发表中降气；桂枝汤，于发表中滋阴；葛根汤，于发表中生津；大青龙汤与麻杏甘膏汤、麻翘赤小
豆汤，于发表中清火；小青龙汤与五苓散，于发表中利水。○葛根与大、小青龙，皆合麻、桂二方加减。葛根
减麻黄之杏仁者，以不喘故；加葛根者，和太阳之津，升阳明之液也。大青龙减桂枝之芍药者，以汗不出故；
加石膏者，以烦躁故也。若小青龙减麻黄之杏仁，桂枝之姜、枣，既加细辛、干姜、半夏、五味，而又立加减
法，神而明之，不可胜用矣。○小青龙治伤寒未解之水气，故用温剂汗而发之；十枣汤治中风已解之水气，故
用寒剂引而竭之。此寒水、风水之异治也。小青龙之水，动而不居；五苓散之水，留而不行；十枣汤之水，纵
横不羁；大陷胸之水，痞硬坚满；真武汤之水，四肢沉重。水气为患不同，所以治法各异。○膀胱主水，为太
阳之里。十枣、五苓，为太阳水道之下药。胃腑主谷，为阳明之里。三承气为阳明谷道之下药。胆腑主气，为
少阳之里。大柴胡为少阳气分之下药。三阳实邪之出路也。大肠、小肠，皆属于胃。胃家实，则二肠俱实矣。
若三分之，则调胃承气，胃家之下药；小承气，小肠之下药；大承气，大肠之下药。戊为燥土，庚为燥金，故
加芒硝以润其燥也。桂枝加大黄，太阳转属阳明之
下药，桂枝加芍药，太阳转属太阴之下药。凡下剂兼表药，以未离于表故也。柴胡加芒硝，少阴转属阳明之下
药。大柴胡，下少阳无形之邪；柴胡加芒硝，下少阳有形之邪也。桂枝加芍药，下太阴无形之邪；三物白散，
下太阴有形之邪也。四逆散，下少阴、厥阴无形之邪；承气汤，下诸经有形之邪也。其间有轻重之分∶下剂
之轻者，只用气分；下剂之重者，兼用血分。酸苦涌泄，下剂之轻，故芍药、枳实为轻；咸苦涌泄，下剂之重，
故大黄、芒硝为重。○仲景方，每用粥为佐者，以草木之性各有偏胜，惟稼穑作甘，为冲和之味，人之精神血
气，皆赖之以生。故桂枝汤，以热粥发汗；理中汤，以热粥温中；白散，以热粥导利，复以冷粥止利。神哉！
今人服大黄后，用冷粥止利，尚是仲景遗意乎？（柯韵伯）
桂枝、麻黄之辈，在皮毛者汗而发之也；葛根、升麻之辈，因其轻而扬之也；承气、陷胸之辈，下者引
而竭之也；泻心、十枣之辈，中满者泄之于内也；瓜蒂、栀豉之辈，高者因而越之也。此仲景因病制方之法也。
（刘河间）
小柴胡汤，主少阳之半表里也；五苓散，分利膀胱之半表里也；理中汤，治吐泻不定，上下之半表里也。
（《医学入门》）
古人立方取名，非无故而然。顾名思义，昔者，胡不名之曰汤中、汤尾，而必名之曰汤头？盖头者，头目
之意也。能领群药直至患所，如将之统兵剿贼以逐寇也。柯氏云∶如大将立旗鼓，使人知有所向。如某方之入
某经，某药之走某络；某方利于攻策，某方善于守法；某方其功在补，某方得力在泻；某方止宜陆路，某方精
于水路；某方惯使奇法，某方可遵正法；某方得法用机，某方用法使巧；某方升而成功，某方降而获效。方法
之妙，乌可忽视哉！夫某方入某经络者，如养心汤之入心，固金汤之入肺，补中汤之入脾，左金丸之入肝，固
本丸之入肾之类。又如攻剂大、小承气之类，守剂理中、四逆之类；补剂十全、归脾之类，泻剂
大、小柴胡之类；陆剂五味异功、六君之类，水剂五苓、八正之类；升剂升阳散火之类，降剂苏子降气之类；
奇剂滋肾丸、栀子干姜汤之类，正剂附子、理中汤、三黄散之类；机剂附子热药冷探之类，巧剂六君汤吞养正
丹、四物汤吞活络丹、四六君送香连丸之类。李子云∶用药之难，非顺用之难也，逆用而与病情恰当之难也。
今之医师，知以寒治热，以热治寒，寒者热之，热者寒之，独不闻诸《内经》曰∶通因通用，塞因塞用，寒因
热用，热因寒用，用热远热，用寒远寒耶？盖塞因塞用者，若脾虚作胀，治以参、术，脾得补而胀自消也。通
因通用者，若伤寒挟热下利，或中有燥屎，用调胃承气汤乃安；滞下不休，用芍药汤通之而愈也，寒因热用者，
药本寒也，而反佐之以热；热因寒用者，药本热也，而反佐之以寒，俾无拒格之患。所谓必伏其所主，而先其
所因也。用热远热，用寒远寒者，如寒病宜投热药，热病宜投寒药，仅使中病而已，勿使过焉。过用则反为伤
矣。古人之法，妙用如此。柯氏有云∶方外有方，法外有法。诚哉斯言也！（《医学阶梯》）
【经文义理】
黄帝问道：人体之气有多少之分，疾病有盛衰之别，治疗有缓急之异，方剂有大小的不同。我想了解其概要，该怎么做呢？岐伯回答说：气有在上在下的区别，病位有远近的不同，证候有在内在外的差异，治法有轻重之分。关键在于使药力恰好到达病变部位。大要说：君药一味、臣药二味，是奇方的制法；君药二味、臣药四味，是偶方的制法；君药二味、臣药三味，是奇方的制法；君药二味、臣药六味，是偶方的制法。所以说：病位近的用奇方，病位远的用偶方。发汗法不用偶方，攻下法不用奇方。补益上部或治疗上部疾病，方剂制法宜缓；补益下部或治疗下部疾病，方剂制法宜急。急则药气味浓厚，缓则药气味淡薄。使药力恰达病所，说的就是这个道理。如果病位虽远但药气在中途被消耗，可以通过饭后服药来引导药力，不要超越这种制度规范。因此，平调气机的原则是：病位近而用奇方或偶方，则减小服用剂量；病位远而用奇方或偶方，则增大服用剂量。大方则药味少，小方则药味多。药味多则可达九味，药味少则可为两味。用奇方无效，就改用偶方，这叫做重方（复方）。用偶方无效，就采用反佐法来取效。所谓寒热温凉，都是顺从病性而言的。
黄帝又问：不是通过调理气机就能治愈的病，该怎么治疗？有毒和无毒的药物，先用哪个后用哪个，我想听听其中的道理。岐伯说：无论有毒无毒，都以治疗疾病为主，根据病情大小来确定方剂的规模。黄帝说：请讲讲具体的制方规则。岐伯说：君药一味、臣药二味，是小方的制法；君药一味、臣药三味、佐药五味，是中方的制法；君药一味、臣药三味、佐药九味，是大方的制法。
黄帝问：方剂中的君臣制度，是什么意思？岐伯说：主治疾病的药物称为君，辅助君药治疗的称为臣，配合臣药发挥作用的称为使。这并不是指《神农本草经》上中、上、下三品的分类。（出自《素问》）
约束方剂，就像捆扎口袋一样。口袋满了如果不扎紧，就会泄漏；方剂组成了如果不加以约束（控制药力走向和剂量），神气就不能与之俱备。（出自《灵枢》）
【总论】
“方”这个字，意思是仿效。仿效病情特点而制定的治疗方案。《素问》、《难经》中没有明确的固定方剂，并不是没有方剂，而是为了体现灵活变通的活法。到了汉代才有固定的方剂，是为了完备地仿效病情。如今用奇方治疗疾病，如果真的能做到无往不利，那么昔日轩辕、岐伯、扁鹊、仓公神灵般的智慧、慈爱般的仁心，难道还不如现在的人吗？为什么不针对每种病只设立一个方子，让后人清楚明白地使用，没有不当之处，反而广泛地辨析，设立很多言辞来累赘后学，繁杂难以穷尽，疗效不能十全十美呢！虽然如此，方剂既不能拘泥，也不能丢弃。以古方为规矩，结合今病进行变通。既要详细研究古论中的病情，又要揣测立方的奥妙宗旨，做到病同药异，病异药同。证候纷繁兴起，但线索井然有序；变化多见危重，但执持不乱。这确实是良策！（出自《冯氏锦囊》）
医生应当讨论方剂，不应当单独讨论药材。应当就方剂来讨论药材的作用，不应当执着于药材去讨论方剂。（出自《己任编》）
医者，靠的是意念。就像面对敌人的将领、驾船的技术工人，贵在随机应变。方剂固然难以完全套用，但如果没有方剂，古人的心意就无法传承。若像望洋兴叹、捕风捉影那样随意行事，必定会因草率而失误。方剂真的可以不用吗？虽然方剂很好，但必须熟读《素问》以探求根本；熟读《本草》以探究用途；熟习诊视以察明证候；熟习治疗以通达变化。始于使用方剂，最终达到不需要依赖方剂的地步。只有这样，医道才算成就。（商辂）
方剂有七种：大、小、缓、急、奇、偶、复。张从正说：大方有两种，一种是君药一味、臣药三味、佐药九味的大方，适用于病邪不一，不能用一两味药治疗的病症；另一种是分量重且一次性服下的大方，适用于肝肾及下部病位较远的病症。小方也有两种，一种是君药一味、臣药二味的小方，适用于病邪专一，可以用一两味药治疗的病症；另一种是分量轻且频繁服用的小方，适用于心肺及在上部的病症，慢慢细细饮用即可。刘完素说：肝肾位置偏远，药味多则药气缓慢，不能迅速到达下部，必须用大剂量而药味少，取其迅速下行；心肺位置邻近，药味少则药气急迫，不能升发于上，必须用小剂量而药味多，取其易散而上行。《内经》说：补益上部治疗上部疾病制方宜缓，补益下部治疗下部疾病制方宜急。急则药气味浓厚，缓则药气味淡薄。使药力适达病所，中途不偏离，不超越制度规范。王冰说：假如病在肾，而心气不足，服药宜快速通过胃部，不要用浓厚的药气喂养心脏，以免肾药凌犯心脏，导致心气更加衰弱。刘完素说：圣人治疗上部不侵犯下部，治疗下部不侵犯上部，治疗中部上下都不侵犯。所以说：诛伐无罪之地，叫做大大惑乱。张从正说：缓方有五种，有用甘味药缓急的缓方，如甘草、饴糖蜂蜜之类，病在胸膈，取其留恋停留；有用丸药缓急的缓方，比起汤剂和散剂，其运行迟缓；有用药品种类众多的缓方，药物聚集则互相制约，不能独自行使其药性；有用无毒药物治病的缓方，无毒则药性纯粹缓和；有用气味淡薄的缓方，气味薄则长于治疗上部，等到到达下部时，药力已经衰减了。王好古说：治疗主病宜缓，缓则治其本；治疗客邪宜急，急则治其标。张从正说：急方有四种，有急病急攻的急方，如中风、关格等病；有汤散荡涤的急方，咽下后容易消散且运行迅速；有毒药的急方，毒药能上通下泄，以夺取病势；有气味浓烈的急方，直趋下部而药力不衰。奇方有两种，有独用一味药的奇方，适用于病在上部且病位近的；有药味符合阳数（一、三、五、七、九）的奇方，适宜攻下而不适宜发汗。刘完素说：小承气汤，是奇方中小型的；大承气汤、抵当汤，是奇方中大型的。因为它们是用于攻下的。桂枝汤、麻黄汤，是偶方中小型的；葛根汤、大青龙汤，是偶方中大型的。因为它们是用于发汗的。偶方的制法，有两味药相配的偶方；有古方两个方剂并用的偶方，古代称之为复方。都适用于病在下部且病位远的。有药味符合阴数（二、四、六、八、十）的偶方，适宜发汗而不适宜攻下。王好古说：用奇方无效再用偶方，用偶方无效再用奇方，所以叫复；复，就是再的意思。王太仆认为偶方就是复方，七方中有偶又有复，难道偶方是两方相合，复方是多方相合吗？（出自《怡堂散记》）
许学士说：我读仲景的书，用仲景的方法，但从未死守他的方子，这才是得到了仲景的心意。（李东垣）
有人问：仲景处方，药品很少，而李东垣用药多达二十余味。朱丹溪说：我每次治病，用李东垣的药，效法仲景的处方，大概是因为药味少，则药力专精。丹溪为什么不效法东垣而效法仲景呢？回答说：明察药性，没有人比得上东垣，他可以说是医学圣人了。所以在东垣那里可以多用，别人如果效法他用得多，就会杂乱无章。东垣就像韩信带兵，越多越好；丹溪不过只能带十万兵，所以不敢效法他用得多。（王节斋）
张仲景创立方剂，精粹而不杂乱，其中以六个方子为主，其他方子都由此加减而来。凡是发汗剂，都以桂枝汤为本；催吐剂，都以栀子豉汤为本；攻下剂，都以承气汤为本；和解剂，都以柴胡汤为本；清热剂，都以泻心汤为本；温里剂，都以四逆汤为本。混在一起数起来有一百一十三方，这是没有仔细审察的结果。
张仲景的方剂具备“十剂”的方法：轻可解散实邪，如麻黄汤、葛根汤等；宣可决壅，如栀子豉汤、瓜蒂散等；通可行滞，如五苓散、十枣汤等；泄可去闭，如陷胸汤、承气汤、抵当汤等；滑可去着，如胆导、蜜煎等；涩可固脱，如赤石脂禹余粮汤、桃花汤等；补可扶弱，如附子汤、理中丸等；重可镇怯，如禹余粮、代赭石等；湿可润燥，如黄连阿胶汤等；燥可去湿，如麻黄连翘赤小豆汤等；寒能胜热，如白虎汤、黄连汤等；热能制寒，如白通汤、四逆汤等。
张仲景制方，随方设立禁忌，使人受益而不蹈弊。如用发表药，服一次出汗的就停服后面的药。如果脉紧发热汗不出者，不可给桂枝汤；脉微弱汗出恶风者，不可服大青龙汤；脉浮发热无汗表不解者，不可给白虎汤；所有亡血虚家，不可用瓜蒂散；病人平时大便微溏者，不可给栀子豉汤；阳明病汗出多者，不可给猪苓汤；外证未解且热不潮者，不可给承气汤；呕吐者不可给建中汤。这是张仲景慎重的心思。
张仲景使用“攻”、“下”二字，不专指大便。凡是用桂枝汤想要“攻”其表，这里指发汗；表解之后才可以“攻”之，这里指利水；有热属于脏器的“攻”之，这里指清火。寒湿在里不可“下”，这里指利水，因为有热的原因。应当用汤药“下”之，这里指清火。
六经各有主方，而其他经有互相通用的妙处。如麻黄汤、桂枝汤，是为太阳营卫设立的，阳明病在营卫的也使用。真武汤，是为少阴水气设立的，太阳病发汗后亡阳的也使用。四逆汤，是为太阴下利清谷设立的，太阳病脉反沉的也适宜。五苓散，是为太阳消渴水逆设立的，阳明病饮水多的也适宜。猪苓汤，是为少阴下利设立的，阳明病小便不利的也适宜。抵当汤，是为太阳瘀血在里设立的，阳明病蓄血的也适宜。瓜蒂散，是为阳明胸中痞硬设立的，少阴病温温欲吐的也适宜。符合这些证候就用这些方子。方剂各有归属的经络，但运用不拘泥，这就是张仲景的法度。方剂虽然有表、里、寒、热、虚、实的不同，并没有伤寒、中风、杂证的分别，而且风、寒有两汤交替使用的妙处，表、里有两方更换的奇特。有的用全方取胜，有的通过加减奏功。后人只论方不论证，所以反而觉得张仲景的方子难用。
桂枝，是发汗剂中的第一品。麻黄的药性，直透皮毛；生姜的药性，横散肌肉。所以桂枝辅助麻黄则开启腠理，驱逐卫分之邪，令无汗者出汗而解，所以叫发汗。桂枝率领生姜则开泄腠理，驱除营分之邪，令有汗者再出汗而解，所以叫解肌。解除肌肉之邪，正在营分，为什么确立三纲的人反而说麻黄主营、桂枝主卫呢？麻黄不说解肌，但肌肉未曾不解。桂枝的解肌，正是为了发汗。要知道麻黄汤、桂枝汤这两个方子，是发汗分深浅的方法，不能把解肌与发汗对立起来讲。
麻黄、桂枝，是太阳、阳明表证的表药；瓜蒂、栀子豉，是阳明里证的表药；小柴胡汤，是少阳半表半里的全方。太阴的表药，是桂枝汤；少阴的表药，是麻黄附子细辛汤；厥阴的表药，是当归四逆汤。六经使用表药，是为了给六经风寒提供出路。
凡是治病必分表里，而表里偏颇常有互见的证候。如麻黄汤证的喘，桂枝汤证的自汗，大青龙汤证的烦躁，小青龙汤证的咳，都是病在表而夹杂里证。用杏仁治喘，芍药止汗，石膏治烦躁，五味子、干姜治咳，这是在表剂中兼治里证。
麻黄汤，在发表中降气；桂枝汤，在发表中滋阴；葛根汤，在发表中生津；大青龙汤与麻杏甘膏汤、麻翘赤小豆汤，在发表中清火；小青龙汤与五苓散，在发表中利水。
葛根汤与大、小青龙汤，都是合用麻黄、桂枝两个方子加减而成。葛根汤减去麻黄汤中的杏仁，是因为不喘；加入葛根，是为了调和太阳之津，升发阳明之液。大青龙汤减去桂枝汤中的芍药，是因为无汗；加入石膏，是因为烦躁。至于小青龙汤减去麻黄汤中的杏仁，桂枝汤中的姜、枣，既加了细辛、干姜、半夏、五味子，又立下加减法，神妙无穷，不可胜用。
小青龙汤治疗伤寒未解的水气，所以用温剂发汗；十枣汤治疗中风已解的水气，所以用寒剂引而竭之。这是寒水和风水不同的治疗方法。小青龙汤的水气，动而不居；五苓散的水气，留而不行；十枣汤的水气，纵横不羁；大陷胸汤的水气，痞硬坚满；真武汤的水气，四肢沉重。水气为患不同，所以治法各异。
膀胱主水，是太阳之里。十枣汤、五苓散，是太阳水道之下的下药。胃腑主谷，是阳明之里。三承气汤是阳明谷道之下的下药。胆腑主气，是少阳之里。大柴胡汤是少阳气分之下的下药。这是三阳实邪的出路。大肠、小肠，都隶属于胃。胃家实，则二肠都实了。如果三分开来，则调胃承气汤是胃家之下的下药；小承气汤是小肠之下的下药；大承气汤是大肠之下的下药。戊为燥土，庚为燥金，所以加芒硝以润其燥。桂枝加大黄汤，是太阳转属阳明之下的下药；桂枝加芍药汤，是太阳转属太阴之下的下药。凡是下剂兼有表药，是因为病邪尚未离开表。柴胡加芒硝汤，是少阴转属阳明之下的下药。大柴胡汤，下少阳无形之邪；柴胡加芒硝汤，下少阳有形之邪。桂枝加芍药汤，下太阴无形之邪；三物白散，下太阴有形之邪。四逆散，下少阴、厥阴无形之邪；承气汤，下诸经有形之邪。其中有轻重的区分：下剂轻的，只用气分；下剂重的，兼用血分。酸苦涌泄，是下剂之轻，所以芍药、枳实为轻；咸苦涌泄，是下剂之重，所以大黄、芒硝为重。
张仲景的方剂，每用粥作为佐助，是因为草木之性各有偏胜，只有五谷作甘，是冲和的味道，人的精神血气，都依靠它而生。所以桂枝汤，用热粥发汗；理中汤，用热粥温中；白散，用热粥导利，又用冷粥止利。神妙啊！现代人服大黄后，用冷粥止利，这还是张仲景的遗意吗？（柯韵伯）
桂枝、麻黄这类药，在皮毛的，汗而发之；葛根、升麻这类药，因其轻而扬之；承气、陷胸这类药，下者引而竭之；泻心、十枣这类药，中满者泄之于内；瓜蒂、栀豉这类药，高者因而越之。这是张仲景因病制方的方法。（刘河间）
小柴胡汤，主治少阳的半表半里；五苓散，分利膀胱的半表半里；理中汤，治疗吐泻不定，上下之间的半表半里。（《医学入门》）
古人创立方剂取名，不是无故这样的。顾名思义，过去为什么不叫它汤中、汤尾，而一定要叫它汤头？盖“头”是头目的意思。能统领群药直达患处，如同将领统帅军队剿灭贼寇驱逐敌人。柯氏说：如同大将树立旗鼓，使人知道有所指向。如某方入某经，某药走某络；某方利于攻策，某方善于守法；某方功效在补，某方得力在泻；某方只宜陆路，某方精于水路；某方惯用奇法，某方可遵正法；某方得法用机，某方用法使巧；某方升而成功，某方降而获效。方法的妙处，怎么可以忽视呢！如某方入某经络，如养心汤入心，固金汤入肺，补中汤入脾，左金丸入肝，固本丸入肾之类。又如攻剂大、小承气之类，守剂理中、四逆之类；补剂十全、归脾之类，泻剂大、小柴胡之类；陆剂五味异功、六君之类，水剂五苓、八正之类；升剂升阳散火之类，降剂苏子降气之类；奇剂滋肾丸、栀子干姜汤之类，正剂附子、理中汤、三黄散之类；机剂附子热药冷探之类，巧剂六君汤吞养正丹、四物汤吞活络丹、四六君送香连丸之类。李子云：用药的难点，不在于顺用，而在于逆用而与病情恰当匹配。现在的医师，只知道以寒治热，以热治寒，寒者热之，热者寒之，唯独没听说《内经》说：通因通用，塞因塞用，寒因热用，热因寒用，用热远热，用寒远寒吗？所谓塞因塞用，如脾虚作胀，用参、术治疗，脾得到补益而胀自然消除。通因通用，如伤寒挟热下利，或中有燥屎，用调胃承气汤才安；痢疾不止，用芍药汤通之而愈。寒因热用，药本是寒的，却反佐以热；热因寒用，药本是热的，却反佐以寒，以避免格拒之患。所谓必须制服其主要矛盾，先找出其原因。用热远热，用寒远寒，如寒病宜投热药，热病宜投寒药，仅使中病而已，不要过量。过量则反而受伤。古人的方法，妙用如此。柯氏有话说：方外有方，法外有法。这话确实正确！（《医学阶梯》）
[Scriptural Meaning]
The Yellow Emperor asked: Qi has variations in quantity, diseases have fluctuations in severity, treatment has differences in urgency, and prescriptions have distinctions in size. I wish to hear the general principles; how should this be done? Qibo replied: Qi has positions high or low, disease locations are near or far, syndromes manifest internally or externally, and treatments vary in intensity. The key is to ensure the medicinal force reaches precisely where the pathology lies. The Great Summary states: One sovereign herb and two minister herbs constitute a singular (Qi) prescription; two sovereign and four minister herbs constitute an even (Ou) prescription; two sovereign and three minister herbs constitute a singular prescription; two sovereign and six minister herbs constitute an even prescription. Therefore it is said: For distant conditions, use even prescriptions; for near conditions, use singular prescriptions. Diaphoretic methods do not use even prescriptions; purgative methods do not use singular prescriptions. Tonifying the upper or treating upper body disorders requires a slow-acting formulation; tonifying the lower or treating lower body disorders requires a rapid-acting formulation. Rapid action implies strong flavor and aroma; slow action implies weak flavor and aroma. Ensuring the medicine reaches its target is what is meant here. If the disease location is distant but the medicinal qi is consumed en route, one should take the medicine after meals to guide it, without violating these regulations. Thus, the principle of balancing Qi is: for near conditions using singular or even prescriptions, reduce the dosage; for distant conditions using singular or even prescriptions, increase the dosage. Large prescriptions have fewer ingredients; small prescriptions have more ingredients. Many ingredients can reach nine; few ingredients may be two. If a singular prescription fails, switch to an even one; this is called a compound prescription (Chong Fang). If an even prescription fails, employ counter-assistance (Fan Zuo) to achieve efficacy. This refers to cold, heat, warm, and cool properties being used in accordance with the disease nature.
The Yellow Emperor further asked: For those not cured by regulating Qi alone, how should they be treated? Regarding toxic and non-toxic herbs, which should be used first or last? I wish to hear the method. Qibo said: Whether toxic or non-toxic, the primary consideration is the disease being treated; the size of the prescription is determined accordingly. The Yellow Emperor said: Please explain the rules of formulation. Qibo said: One sovereign and two minister herbs make a small prescription; one sovereign, three ministers, and five assistant herbs make a medium prescription; one sovereign, three ministers, and nine assistant herbs make a large prescription.
The Yellow Emperor asked: What is meant by the Sovereign-Minister system in prescriptions? Qibo replied: The herb that primarily treats the disease is called Sovereign (Jun); the herb assisting the Sovereign is called Minister (Chen); the herb responding to the Minister is called Envoy (Shi). This does not refer to the Upper, Middle, and Lower categories of the *Shennong Bencao Jing*. (From *Suwen*)
Restraining a prescription is like tying a bag. If a full bag is not tied, it leaks; if a prescription is formed but not restrained (controlled), the spirit and efficacy will not accompany it. (From *Lingshu*)
[General Discussion]
The character "Fang" (Prescription) means imitation. It imitates the characteristics of the disease to formulate a treatment plan. The *Suwen* and *Nanjing* did not contain fixed prescriptions, not because there were no prescriptions, but to demonstrate flexible and living methods. Fixed prescriptions only appeared in the Han Dynasty to fully accommodate the imitation of diseases. Today, if singular prescriptions could truly treat every disease without fail, would the divine wisdom and benevolent kindness of Xuanyuan, Qibo, Bian Que, and Cang Gong be inferior to ours? Why not establish just one prescription per disease for future generations to use clearly and correctly, rather than extensively analyzing and creating verbose theories that burden learners, making them complex and difficult to master, resulting in imperfect efficacy? Nevertheless, prescriptions must neither be rigidly adhered to nor discarded. Use ancient prescriptions as standards, adapting them to contemporary diseases. Study the pathological conditions described in ancient theories and ponder the profound principles of formulation, achieving the ability to use different herbs for the same disease and the same herbs for different diseases. Although syndromes arise in swarms, the threads remain orderly; although changes often appear critical, adherence remains steady. This is indeed excellent! (From *Feng Shi Jin Nang*)
Physicians should discuss prescriptions, not merely individual herbs. One should discuss herbs within the context of prescriptions, not discuss prescriptions by fixating on individual herbs. (From *Jiren Bian*)
Medicine relies on intent (Yi). It is like a general facing an enemy or a boatman navigating waters; agility in adapting to circumstances is prized. Prescriptions cannot be applied exhaustively, yet without them, the minds of the ancients cannot be transmitted. Acting blindly or grasping at wind will surely lead to errors due to rashness. Can prescriptions really be abandoned? Although prescriptions are good, one must thoroughly study the *Suwen* to seek the root, master the *Bencao* to investigate usage, become proficient in diagnosis to observe syndromes, and understand treatment to navigate changes. One begins by using prescriptions and ultimately reaches a state where reliance on prescriptions is unnecessary. Only then is the Way of Medicine perfected. (Shang Lu)
There are seven types of prescriptions: Large, Small, Slow, Rapid, Singular, Even, and Compound. Zhang Congzheng stated: There are two types of Large Prescriptions. One consists of one sovereign, three ministers, and nine assistants, suitable for diseases with diverse pathogens that cannot be treated with one or two herbs. The other involves heavy dosages taken in a single dose, suitable for diseases of the liver, kidneys, or lower parts where the distance is great. There are also two types of Small Prescriptions. One consists of one sovereign and two ministers, suitable for diseases with specific pathogens treatable by one or two herbs. The other involves light dosages taken frequently, suitable for diseases of the heart, lungs, or upper parts, sipped slowly. Liu Wansu stated: The liver and kidneys are located far away; many ingredients make the qi slow, preventing rapid arrival below. Thus, large doses with few ingredients are used to ensure rapid descent. The heart and lungs are near; few ingredients make the qi urgent, preventing ascent. Thus, small doses with many ingredients are used to facilitate dispersion and ascent. The Classics state: Tonifying/treating the upper requires slow formulations; tonifying/treating the lower requires rapid formulations. Rapid means strong flavor/aroma; slow means weak flavor/aroma. Ensure the medicine reaches the disease site without deviating midway or exceeding regulations. Wang Bing said: If the disease is in the kidney but heart qi is deficient, the medicine should pass through quickly without nourishing the heart with strong flavors, so that kidney medicine does not oppress the heart, causing further decline. Liu Wansu said: The Sage treats the upper without offending the lower, treats the lower without offending the upper, and treats the middle without offending either. Thus, punishing the innocent is called great confusion. Zhang Congzheng said: There are five types of Slow Prescriptions. One uses sweet herbs to slow, such as licorice and maltose/honey, suitable for chest/diaphragm diseases to retain the effect. One uses pills to slow, which act slower than decoctions/powders. One uses many ingredients, where herbs constrain each other and cannot exert their nature independently. One uses non-toxic herbs, which have pure and gentle natures. One uses weak-flavored herbs, which excel at treating the upper and lose strength by the time they reach the lower. Wang Haogu said: Treating the principal requires slowness to address the root; treating the pathogen requires speed to address the branch. Zhang Congzheng said: There are four types of Rapid Prescriptions. One is for urgent attacks on acute diseases, such as stroke or Guan Ge. One is decoctions/powders that cleanse rapidly upon ingestion. One uses toxic herbs to attack downward and upward, seizing the disease momentum. One uses strong-flavored herbs that go straight down without losing power. There are two types of Singular Prescriptions. One uses a single herb, suitable for near upper diseases. One uses an odd number of herbs (1, 3, 5, 7, 9), suitable for purgation rather than diaphoresis. Liu Wansu said: Xiao Chengqi Tang is a small singular prescription; Da Chengqi Tang and Didang Tang are large singular prescriptions, designed for purgation. Guizhi Tang and Mahuang Tang are small even prescriptions; Gegen Tang and Da Qinglong Tang are large even prescriptions, designed for diaphoresis. Even prescriptions include those with two paired herbs and those combining two ancient prescriptions, known as Compound Prescriptions. These are suitable for distant lower diseases. They involve even numbers of herbs (2, 4, 6, 8, 10), suitable for diaphoresis rather than purgation. Wang Haogu said: If singular fails, use even; if even fails, use singular again; hence "Compound" (Fu), meaning repetition. Wang Taipu considered even prescriptions as compound. In the Seven Prescriptions, there is both Even and Compound. Does this mean Even is two combined, and Compound is multiple combined? (From *Yitang Sanji*)
Scholar Xu said: I read Zhongjing's books and use his methods, but I never rigidly stick to his formulas; this is truly understanding Zhongjing's mind. (Li Dongyuan)
Someone asked: Zhongjing's prescriptions use few herbs, while Dongyuan uses over twenty. Danxi said: When I treat diseases, I use Dongyuan's herbs but follow Zhongjing's prescription style. Fewer ingredients mean concentrated medicinal power. Why does Danxi not emulate Dongyuan but emulate Zhongjing? The answer is: No one understands herb properties better than Dongyuan, the Saint of Medicine. Thus, for Dongyuan, using many is appropriate; for others to emulate this multiplicity leads to chaos. Dongyuan is like Han Xin leading troops: the more, the better. Danxi can only lead a hundred thousand, so he dares not emulate the multiplicity. (Wang Jiezhai)
Zhongjing's prescriptions are precise and uncluttered, centered around six main formulas from which others are derived. All diaphoretics are based on Guizhi Tang; all emetics on Zhizi Chi Tang; all purgatives on Chengqi Tang; all harmonizers on Chaihu Tang; all cooling agents on Xiexin Tang; all warming agents on Sini Tang. Counting them together as 113 formulas shows a lack of careful examination.
Zhongjing's methods embody the Ten Categories: Light disperses solidity (Mahuang Tang, Gegen Tang); Exhale resolves obstruction (Zhizi Chi Tang, Goudi San); Unblock moves stagnation (Wuling San, Shizao Tang); Drain removes closure (Xianxiong Tang, Chengqi Tang, Didang Tang); Slippery removes sticking (Dan Dao, Mi Jian); Astringent secures collapse (Chishizhi Yu Liang Tang, Taohua Tang); Tonify supports weakness (Fuzi Tang, Lizhong Wan); Heavy calms fright (Yuyuliang, Daizheshi); Damp moistens dryness (Huanglian Ejiao Tang); Dry removes dampness (Mahuang Lianqiao Chixiaodou Tang); Cold conquers heat (Baitu Tang, Huanglian Tang); Heat controls cold (Baitong Tang, Sini Tang).
Zhongjing established prohibitions for each prescription to maximize benefit and minimize harm. For example, after one dose of a diaphoretic causes sweating, stop subsequent doses. If pulse is tight, feverish, and sweatless, do not give Guizhi Tang; if pulse is faint, sweaty, and aversive to wind, do not give Qinglong Tang; if pulse is floating, feverish, sweatless, and exterior unresolved, do not give Baitu Tang; blood-deficient patients should not use Goudi San; patients with chronic loose stools should not use Zhizi; Yangming patients with excessive sweating should not use Zhu Ling Tang; exterior unresolved without tidal fever should not receive Chengqi Tang; vomiting patients should not receive Jianzhong Tang. This reflects Zhongjing's caution.
Zhongjing's use of "Attack" (Gong) and "Purge" (Xia) does not exclusively refer to bowel movements. Using Guizhi Tang to "attack" the exterior refers to sweating; attacking after the exterior is resolved refers to promoting urination; attacking internal heat refers to clearing fire. "Do not purge cold-damp in the interior" refers to urination due to heat. "Purge with decoction" refers to clearing fire.
Each of the Six Channels has a principal formula, with mutual applicability. Mahuang and Guizhi Tangs are for Taiyin Ying-Wei, but also used for Yangming Ying-Wei diseases. Zhenwu Tang is for Shaoyin water qi, but also for Taiyin yang loss after sweating. Sini Tang is for Taiyin diarrhea with undigested food, but also for Taiyin deep pulse. Wuling San is for Taiyin thirst/water reversal, but also for Yangming excessive drinking. Zhu Ling Tang is for Shaoyin diarrhea, but also for Yangming difficult urination. Didang Tang is for Taiyin blood stasis, but also for Yangming blood accumulation. Goudi San is for Yangming chest oppression, but also for Shaoyin nausea. Match the syndrome to the formula. Formulas belong to channels but are applied flexibly; this is Zhongjing's method. Despite differences in Exterior/Interior, Cold/Heat, Deficiency/Excess, there is no distinction between Cold Damage, Wind Strike, or miscellaneous diseases. Wind and Cold have alternating therapies; Exterior and Interior have switching miracles. Some win with whole formulas; some succeed via modifications. Later physicians discussed formulas without discussing syndromes, making Zhongjing's formulas seem difficult to use.
Guizhi is the premier diaphoretic. Mahuang penetrates skin/hair directly; Ginger spreads horizontally in muscles. Guizhi assists Mahuang to open pores and expel Wei-pathogens, inducing sweat in sweatless cases (Diaphoresis). Guizhi leads Ginger to open interstices and expel Ying-pathogens, resolving sweatiness (Muscle-Releasing). Muscle-releasing targets Ying. Why do the Three Guidelines claim Mahuang governs Ying and Guizhi governs Wei? Mahuang doesn't explicitly say "release muscle," yet muscles are released. Guizhi's muscle-release is for diaphoresis. Mahuang and Guizhi Tangs represent depth levels of sweating, not opposing concepts.
Mahuang/Guizhi are exterior herbs for Taiyang/Yangming. Goudi/Zhizi are exterior herbs for Yangming interior. Xiao Chaihu is the complete formula for Shaoyin half-exterior/half-interior. Taiyang exterior herb: Guizhi Tang. Shaoyin exterior herb: Mahuang Fuzi Xixin Tang. Jueyin exterior herb: Danggui Sini Tang. Exterior herbs provide exits for wind-cold in the Six Channels.
Treating diseases requires distinguishing Exterior/Interior, which often overlap. Mahuang's wheezing, Guizhi's spontaneous sweating, Da Qinglong's irritability, Xiao Qinglong's cough—all are exterior diseases with interior involvement. Using Xingren for wheezing, Shaoyao for sweating, Shigao for irritability, Wuweizi/Ganjiang for cough treats the interior within exterior formulas.
Mahuang Tang descends Qi while releasing exterior; Guizhi Tang nourishes Yin while releasing exterior; Gegen Tang generates fluids while releasing exterior; Da Qinglong, Ma Xing Gan Shi, Ma Qiao Chixiaodou clear fire while releasing exterior; Xiao Qinglong, Wuling San promote urination while releasing exterior.
Gegen, Da/Xiao Qinglong modify Mahuang/Guizhi. Gegen Tang removes Xingren (no wheezing) and adds Gegen (harmonize Taiyang fluids, raise Yangming fluids). Da Qinglong removes Shaoyao (no sweat) and adds Shigao (irritability). Xiao Qinglong removes Xingren, Ginger, Jujube, adding Xixin, Ganjiang, Banxia, Wuweizi, with further modifications, demonstrating infinite adaptability.
Xiao Qinglong treats unresolved cold-damage water qi with warm diaphoretics; Shizao Tang treats resolved wind-strike water qi with cold draining. This distinguishes cold-water from wind-water treatments. Xiao Qinglong water moves freely; Wuling San water stagnates; Shizao Tang water runs wild; Da Xianxiong water is obstructed/hard/full; Zhenwu Tang water causes heavy limbs. Different water pathologies require different treatments.
Bladder governs water, interior of Taiyang. Shizao/Wuling are descending drugs for Taiyang water pathways. Stomach governs grain, interior of Yangming. Three Chengqi are descending drugs for Yangming grain pathways. Gallbladder governs Qi, interior of Shaoyang. Da Chaihu is a descending drug for Shaoyang Qi. These are outlets for Three Yang excess pathogens. Large/Small Intestines belong to Stomach. Stomach excess implies intestinal excess. Divided: Tiaowei Chengqi for Stomach; Xiao Chengqi for Small Intestine; Da Chengqi for Large Intestine. Wu is dry earth, Geng is dry metal; Mangxiao moistens dryness. Guizhi Dahuang is for Taiyang transferring to Yangming; Guizhi Shaoyao is for Taiyang transferring to Taiyin. Descending drugs with exterior herbs are used because the pathogen hasn't left the exterior. Chaihu Jia Mangxiao is for Shaoyin transferring to Yangming. Da Chaihu clears formless Shaoyang pathogens; Chaihu Jia Mangxiao clears material Shaoyang pathogens. Guizhi Shaoyao clears formless Taiyin pathogens; Sanwu Baisan clears material Taiyin pathogens. Sini San clears formless Shaoyin/Jueyin pathogens; Chengqi Tang clears material pathogens in all channels. Light descending drugs use Qi aspect; heavy ones use Blood aspect. Sour/bitter induce vomiting/drainage (light): Shaoyao, Zhishi are light. Salty/bitter induce vomiting/drainage (heavy): Dahuang, Mangxiao are heavy.
Zhongjing uses porridge as an adjunct because plant/herb natures have biases, while grains offer balanced sweetness, sustaining spirit and blood. Guizhi Tang uses hot porridge for sweating; Lizhong Tang uses hot porridge for warming middle; Baisan uses hot porridge to guide drainage, then cold porridge to stop diarrhea. Modern use of cold porridge after Dahuang follows Zhongjing's intent. (Ke Yunbo)
Guizhi/Mahuang release exterior via sweat; Gegen/Shengma lift light pathogens; Chengqi/Xianxiong drain downward; Xiexin/Shizao drain interior fullness; Goudi/Zhizi induce vomiting for high pathogens. This is Zhongjing's method of prescribing based on disease. (Liu Hejian)
Xiao Chaihu Tang governs Shaoyang half-exterior/half-interior; Wuling San separates bladder half-exterior/half-interior; Lizhong Tang treats unstable vomiting/diarrhea, governing upper/lower half-exterior/half-interior. (*Yixue Rumen*)
Ancient prescription names are meaningful. "Tou" (Head) implies leadership. Like a general leading troops to defeat enemies, the head prescription guides herbs to the disease site. Ke said: Like a general setting banners, indicating direction. Which formula enters which channel? Which herb travels which meridian? Which attacks, which defends? Which tonifies, which drains? Which is land-based, which water-based? Which uses unusual methods, which orthodox? Which rises, which descends? Methods are subtle; ignore them at your peril. Examples: Yangxin enters Heart; Gujin enters Lung; Buzhong enters Spleen; Zuojin enters Liver; Guben enters Kidney. Attackers: Da/Xiao Chengqi. Defenders: Lizhong, Sini. Tonics: Shiquan, Guipi. Drainers: Da/Xiao Chaihu. Land-type: Wuwei Yigong, Liu Jun. Water-type: Wuling, Bazheng. Rising: Shengyang Sanhuo. Descending: Suzi Jiangqi. Unusual: Zishen Wan, Zhizi Ganjiang. Orthodox: Fuzi, Lizhong, Sanhuang. Ingenious: Fuzi hot/cold probing. Clever: Liu Jun with Yangzheng Dan; Siwu with Huoluo Dan; Si Liu Jun with Xianglian Wan. Li Zi said: Difficulty lies not in standard use, but in reverse use matching the disease. Physicians know cold treats heat, heat treats cold, but forget *Neijing*: Treat openness with openness, blockage with blockage, cold with heat, heat with cold. Avoid heat when using heat, avoid cold when using cold. Blockage with blockage: Spleen deficiency bloating treated with Renshen/Atractylodes; tonification resolves bloating. Openness with openness: Cold damage with heat diarrhea or dry stool treated with Tiaowei Chengqi; dysentery treated with Shaoyao Tang. Cold with heat: Cold herbs with hot assistants. Heat with cold: Hot herbs with cold assistants, avoiding rejection. Subdue the master, address the cause. Avoid heat/cold extremes to prevent injury. Ancient methods are profound. Ke said: Beyond formulas are formulas; beyond methods are methods. Truly spoken! (*Yixue Jieti*)