《金匮》论治肝补脾，肝虚则用此法，此指肝之阳虚而言，非指肝之阴虚火旺而言也。肝阳虚而不能上升，则胃乏
生发之气，脾无健运之力；而水无土制，肾水之阴寒得以上制心阳，周身阴盛阳衰，而纯乎降令，则肺阴之金气盛行，
肝阳之生气愈病矣。必得补土之阳，以制肾水之阴寒，则心阳无水以克而火盛，火盛则肺金阴气不行，不至阴肃降令，
从右行左，以伤发生之气，则肝木之阳气自必畅茂条达矣。古方用逍遥散治木郁土中，以宣阳气，是肝木阳虚，而用治
肝补脾之法者也。乃后人用以治阴虚火旺之肝病，则以升令之太过者而复升之，宜其有升无降，而至厥逆矣。盖一阴一
阳，可不明辨哉。其治阴虚火旺之肝病，如血虚宜滋水，虚则补其母也；火旺则苦泄，实则泻其子也；气升上逆则降气，
以金制木也，其与治肝补脾之法正相反，岂可混治耶？
按王太仆注∶“四维”为血、肉、筋、骨。吴鹤版皋注∶“四维”为血、脉、筋、骨，以是四者，维持一身，以注“维”
字之义。马元台以血、脉、筋、骨于“四”字未妥，因注“四维”为四肢。汪 以王注之血、肉、筋、骨、马注之四
肢，俱于“代”字无着，因注“四维”为四时。诸说纷纭不一。顾四肢肿而愈者甚多，未可便云“阳气乃竭”；至血、脉、
筋、骨及四时之说，又肿病中从未论及。窃思“四维”之见《素问》者屡矣，《气交变大论》曰∶“土不及，四维有埃云
润泽之化，则春有鸣条鼓拆之政。”《五常政大论》曰∶“其眚四维。”故王注以“四维”为东南、西南、东北、西北之位
也。及后世马元台、吴鹤皋等注此二篇之四维，亦俱宗王注四隅方位而说，是“四维”当作“四隅”解，一定而不移矣。
“四维相代”，当作人身之“四隅”解，亦无疑矣。盖言肿之起于前后左右者，自此至彼，一身尽肿，阳气乃坏极而无存
矣。四隅尽肿者，即脐突、背平、缺盆平、足心平之类是也。丹溪以此二句为衍文，此求其说而不得，从而为之辞，亦
不知为不知之义也。但无此二句，则语气未全，且于义理亦未周足。至汪 以阳气乃竭之“竭”字作“坏”字，未知
本于何人，竭之与坏，其义不甚远，姑置不论。
《金匮要略》中论述的“治肝补脾”法，适用于肝虚证，这里指的是肝阳虚，并非指肝阴虚火旺的情况。肝阳虚弱不能上升，就会导致胃缺乏生发之气，脾失去健运之力；同时水液没有土的制约，肾水的阴寒之气得以向上克制心阳，导致全身阴盛阳衰，完全呈现下降的趋势，此时肺阴的金气盛行，肝阳的生发之气更加受损。必须通过补益脾土之阳，来制约肾水的阴寒，这样心阳就不会被水克制而火势旺盛，火势旺盛则肺金的阴气无法运行，不会过度肃降，从而避免从右向左行进而损伤生发之气，这样肝木的阳气自然就会畅茂条达了。古代方剂中的逍遥散用于治疗木郁于土中，以宣通阳气，正是针对肝木阳虚，采用治肝补脾之法的应用。然而后人用逍遥散治疗阴虚火旺的肝病，这就使得原本已经升发太过之气再次升发，必然导致有升无降，甚至出现厥逆的症状。阴阳之道，难道可以不明确辨别吗？对于阴虚火旺的肝病，如血虚应当滋补肾水（因为虚则补其母）；火旺应当用苦味药清泄（因为实则泻其子）；气机上逆应当降气（利用金克木的原理），这些方法与治肝补脾的方法正好相反，怎么可以混淆治疗呢？
按王冰注解说：“四维”是指血、肉、筋、骨。吴鹤皋注解说：“四维”是指血、脉、筋、骨，因为这四者维持着全身，以此来解释“维”字的含义。马元台认为将血、脉、筋、骨解释为“四”字不妥，因此将“四维”注解为四肢。汪昂认为王注的血、肉、筋、骨和马注的四肢，都无法在“代”字上得到落实，因此将“四维”注解为四季。各种说法纷纭不一。但是四肢浮肿而痊愈的情况很多，不能轻易说是“阳气乃竭”；至于血、脉、筋、骨以及四季的说法，在肿病中从未提及。我私下思考，“四维”一词在《素问》中多次出现，《气交变大论》说：“土气不及，四维有埃云润泽的教化，那么春天就有鸣条鼓拆的政治气象。”《五常政大论》说：“它的灾祸在于四维。”所以王冰注解说“四维”是东南、西南、东北、西北四个方位。到了后世，马元台、吴鹤皋等人注释这两篇中的“四维”，也都遵循王冰关于四隅方位的解释，因此“四维”应当解释为“四隅”，这是确定不移的。“四维相代”，应当解释为人身的“四隅”，也没有疑问。这是说浮肿从前后左右各处发起，由此处到彼处，全身尽肿，阳气就败坏至极而无存留了。四隅全部浮肿，就是脐突、背平、缺盆平、足心平这类情况。朱丹溪认为这两句是衍文（多余的文字），这是因为找不到其中的道理，从而为之辩解，这也是不知为不知的态度。但是没有这两句话，语气就不完整，且在义理上也不周全。至于汪昂将“阳气乃竭”的“竭”字作“坏”字解，不知道依据的是谁，竭与坏的意思相差不远，暂且不论。
The "treat the liver and tonify the spleen" method discussed in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) is applicable to Liver Deficiency patterns, specifically referring to Liver Yang Deficiency, not Liver Yin Deficiency with Fire Hyperactivity. When Liver Yang is deficient and fails to ascend, the Stomach lacks the Qi of generation, and the Spleen loses its power of transformation and transportation; meanwhile, without Earth to control Water, the Yin-Cold of Kidney Water can ascend to overcome Heart Yang, resulting in an excess of Yin and deficiency of Yang throughout the body, manifesting purely as descending functions. Consequently, the Metal Qi of Lung Yin becomes prevalent, further damaging the Sheng (generative) Qi of Liver Yang. It is necessary to tonify the Yang of Earth (Spleen/Stomach) to restrain the Yin-Cold of Kidney Water. In this way, Heart Yang will not be controlled by Water, allowing Fire to flourish. When Fire flourishes, the Yin-Qi of Lung Metal cannot circulate excessively, preventing excessive descending functions from moving from right to left and injuring the generative Qi. Thus, the Yang Qi of Liver Wood will naturally become smooth, lush, and free-flowing. The ancient formula Xiaoyao San (Free and Easy Wanderer Powder) is used to treat Wood Stagnation within Earth to disseminate Yang Qi; it is an application of the "treat the liver and tonify the spleen" method for Liver Wood Yang Deficiency. However, later practitioners used Xiaoyao San to treat Liver diseases characterized by Yin Deficiency and Fire Hyperactivity. This causes the already excessive ascending function to ascend further, inevitably leading to a state of only ascending and no descending, culminating in Jue Ni (Cold Extremities/Reversal). Must one not clearly distinguish between Yin and Yang? For Liver diseases involving Yin Deficiency and Fire Hyperactivity, if there is Blood Deficiency, one should nourish Kidney Water (tonifying the mother when deficient); if Fire is hyperactive, one should use bitter flavors to drain (draining the son when excess); if Qi ascends and rebels, one should descend Qi (using Metal to control Wood). These methods are exactly opposite to the "treat the liver and tonify the spleen" approach; how can they be confused?
According to Wang Bing's commentary: "Si Wei" (Four Dimensions/Pillars) refers to Blood, Flesh, Tendons, and Bones. Wu Hegao commented that "Si Wei" refers to Blood, Vessels, Tendons, and Bones, as these four maintain the entire body, thereby explaining the meaning of the character "Wei" (to maintain/support). Ma Yuantai considered the interpretation of Blood, Vessels, Tendons, and Bones as "Four" inappropriate, and thus annotated "Si Wei" as the Four Limbs. Wang Ang believed that neither Wang Bing's Blood, Flesh, Tendons, Bones nor Ma Yuantai's Four Limbs could be adequately explained by the character "Dai" (alternate/substitute), so he annotated "Si Wei" as the Four Seasons. Various interpretations are divergent. However, cases of edema in the four limbs healing are numerous; one cannot hastily conclude that "Yang Qi is exhausted." Furthermore, the theories regarding Blood, Vessels, Tendons, Bones, and Four Seasons have never been mentioned in the context of edema. I privately ponder that "Si Wei" appears frequently in the *Su Wen* (Plain Questions). The *Qi Jiao Bian Da Lun* (Treatise on the Great Discussion of Changes in Qi Intersections) states: "When Earth Qi is insufficient, the Si Wei undergoes the transformation of dust clouds and moistening dew, so in spring there is the political phenomenon of rustling branches and bursting buds." The *Wu Chang Zheng Da Lun* (Treatise on the Great Discussion of the Five Constant Policies) states: "Its disaster lies in the Si Wei." Therefore, Wang Bing annotated "Si Wei" as the positions of Southeast, Southwest, Northeast, and Northwest. Later commentators such as Ma Yuantai and Wu Hegao, when annotating "Si Wei" in these two chapters, also followed Wang Bing's explanation of the four corners. Thus, "Si Wei" should be interpreted as "Si Yu" (Four Corners), which is fixed and unchangeable. "Si Wei Xiang Dai" (The Four Corners Alternate/Substitute) should undoubtedly be interpreted as the "Four Corners" of the human body. This describes edema arising from the front, back, left, and right, spreading from one area to another until the whole body is swollen, indicating that Yang Qi is extremely damaged and non-existent. Edema of all four corners refers to conditions such as protruding umbilicus, flat back, flat clavicular fossa, and flat soles of the feet. Zhu Danxi considered these two sentences to be interlinear glosses (interpolations), but this was merely an excuse made because he could not find the rationale, reflecting an attitude of admitting ignorance where one should. Nevertheless, without these two sentences, the rhetorical flow is incomplete, and the theoretical logic is not fully comprehensive. As for Wang Ang interpreting the character "Jie" (exhausted) in "Yang Qi is Exhausted" as "Huai" (ruined/damaged), it is unknown whose source this is based on. Since "Jie" and "Huai" do not differ significantly in meaning, this shall be set aside for discussion.