不和也。行之不及。则内不化而外不充。行之太过。则枝强而干弱。偏于营则阴胜。偏于卫则阳胜。百病乃生。自然
之理也。是则营卫岂不为生身之大关键哉。医者治病。遵内经守经隧之训加意于营卫可也。读金匮要略营卫
不利。则腹满胁鸣。相逐气转。营卫俱微三焦无所御。四属断绝。身体羸瘦。益见荣卫之足重矣。即如痢疾一证。有
寒热表证者。咸知有关于营卫。此外则以病轻在腑。病重在脏。罔不谓内病也。而孰知王肯堂证治准绳论痢之
旧积新积。归重于营卫。内经守经隧之一语。此其一端欤。取其明白易晓。特拈出以印证之。其言曰。“积有新旧
之分。旧积者。气血食痰所化也。新积者。旧积已去。未几而复生也。然旧积宜下。新积禁下。其故何也。盖肠胃之熟
腐水谷。转输糟粕者。皆营卫洒陈于六腑之功。今肠胃有邪。则营卫营运之度。为之阻滞。不能施化。故卫气郁而
不舒。营气涩而不行。于是饮食积痰停于胃。糟粕留于肠。与气郁血涩之积。相挟而成滞下矣。必当下之。以通其
壅塞。既下之后。升降仍不得行。清浊仍不能分。则卫气复郁。营气复涩。又复成新积。乌可复下之乎。但理其卫气。
并和其营血。以调顺阴阳。则升降合节。积亦不滞而自化矣。”
〔十七〕短气与少气有辨。少气者。气少不足于言。内经云。“言而微。终日乃复言者。此夺气是也。”气短不能相
续。似喘非喘。若有气上冲。故似喘而不摇肩。似呻吟而无痛是也。金匮要略曰。“平人无寒热。短气不足以息者。
实也。”无寒热。无表邪。可知其短气不足以息者。非关邪束于外。毛窍有阻。而息道为之不利。盖由里气因邪而
实。或痰或食或饮。碍其升降之气致然耳。此条当与第八条参看。
〔十八〕学医犹学奕也。医书犹奕谱也。世之善奕者。未有不专心致志于奕谱。而后始有得心应手之一候。然对
局之际。检谱以应敌。则胶柱鼓瑟。必败之道也。医何独不然。执死方以治活病。强题就我。人命其何堪哉。故先哲
有言曰。“检谱对奕奕必败。拘方治病病必殆。”丹溪朱氏亦曰。“古方新病。安有能相值者。泥是且杀人。”由
是言之。世所传经验单方。往往仅标治某病。而不辨别脉证。其间清和平淡之品。即不对证。试用尚无大碍。若刚
暴猛烈之药。用者尚其慎之。余亲见一妇人。用密陀僧截疟。一男子用蕲蛇酒治痛风。皆顷刻告殂。与服毒无异。
又张石顽曰。“或问近世治黄瘅病多用草头单方。在穷乡绝域。犹之可也。城郭愚民亦多效尤。仁人鉴此。岂不
痛哉。尝见有服商陆根苦匏酒过山龙雪里青鹿葱等汁。吐利脱元而死者。指不胜屈。曾有孕妇病黄。误用瓜蒂
搐鼻。呕逆喘满。致胎息上冲。惨痛叫号而毙。设当此际。得何法以救之耶。答言。是皆宿孽使然。与飞蛾触火无异。
欲救之者。惟广行刊布。垂诫将来。勿蹈前辙。庶不失仁人之用心。欲手挽已覆之车。吾末如之何也。”按此则。草
头单方之误人。为祸尤烈。第瓜蒂搐鼻治黄。是仲圣法。因不知孕妇应忌。而误用致毙。拘方治病病必殆。斯言洵
不诬矣。至用商陆根等。犹举其名。当其误用时。或能知何药之误。尚可设法解救。特有一种以草药治病者。辗转
传授。谬称秘方。仅识其形状气色之草药。采而用之。在用者自己。尚不能举其名。而且先揉捣之。使人莫能识别。
故神其说以惑人。治或得效。则群相走告。诧为神奇。后凡遇是病。以为业经试验之方。放胆用之而不疑。一服未
效。再服三服。殊不知效于此者。未必效于彼。以病有浅深。体有强弱。证有寒热虚实。断不能执一病之总名。而以
一药统治之也。且草药之用。往往力专而性猛。药病偶或相当。其奏功甚捷。一不相当。亦祸不旋踵。深愿世之明
哲保身者。守未达不敢尝之训。万弗以性命为试药之具。并辗转劝诫。俾共知用药治病。虽专门名家。尚须详细
体察。讵可轻服草药。存侥幸之心。致蹈不测之祸哉。
〔十九〕娄全善医学纲目治血崩类用炭药。以血见黑则止也。香矾散用香附醋浸一宿。炒黑为炭。存性。每一两。
入白矾二钱。米饮空心调服。一法用薄荷汤更妙。（许学士曰。治下血不止。或成五色崩漏。香附是妇人圣药。）此气滞
者用行气炭止之也。五灵脂散治血崩。用五灵脂炒令烟尽。为末。每服一钱。温酒调下。一法每服三钱。水酒童便各半
盏煎服。名抽刀散。此血污者用行血炭止之也。荆芥散治血崩。用麻油点灯。多着灯心。就上烧荆芥焦色。为末。每服
三钱。童便调下。此气陷者用升药炭止之也。治崩中不止。不问年月远近。用槐耳烧作炭为末。以酒服方寸匕。此血热
者用凉血炭止之也。如圣散治血崩。棕榈乌梅各一两。干姜一两五钱。并烧炭存性。为细末。每服二钱。乌梅酒调下。
空心服。久患不过三服愈。此血寒者用热血炭止之也。棕榈白矾 为末。酒调服。每二钱。此血脱者涩血炭止之也。按
同一血崩证。同一用炭药。而条分缕晰有如是。治病用药。首贵识证。可一隅三反矣。（炭原本作灰。）
〔二十〕彻剩八编内镜曰。身内有三贵。热以为生。血以为养。气以为动觉。故心肝脑为贵。而余待命焉。血所由
生。必赖食化。食先历齿刀。次历胃釜。粗细悉归大络。细者可升至肝脑成血。粗者为滓。于此之际。存细分粗者脾。
包收诸物害身之苦者胆。吸藏未化者肾脾也。胆也肾也。虽皆成血之器。然不如肝独变结之。更生体性之气。故肝
贵焉。心则成内热与生养之气。脑生细微动觉之气。故并贵也。或问三贵之生气如何。曰。肝以窍体。内收半变之
粮。渐从本力全变为血。而血之精分。更变为血露。所谓性体之气也。此气最细。能通百脉。启百窍。引血周行遍体。
又本血一分。由大络入心。先入右窍。次移左窍。渐至细微。半变为露。所谓生养之气也。是气能引细血周身以存
原热。又此露一二分。从大络升入脑中。又变而愈细愈精。以为动觉之气。乃合五官四体。动觉得其分矣。主制群
微曰。人身湿热而已。热恒消湿。无以资养。则肤焦而身毁矣。故血者。资养之料也。血以行脉。脉有总曰络。络从肝
出者二。一上一下。各渐分小脉至细微。凡内而脏腑。外而肤肉。无不贯串。莫定其数。脉之状似机。其顺者因血势
而利导之。斜者留血毋退。横者送血使进也。脉之力又能存血。不合则坏。血合于痰。乃克顺流。合于胆。乃免凝滞。
合于体性之气。乃启诸窍。导之无闭塞也。从心出者。亦有二大络。一上一下。细分周身。悉与肝络同。所不同者。肝
引血存血。此专导引热势及生养之路耳。心以呼吸进新气退旧气。直合周身。脉与之应。少间不应。辄生寒热诸
证。医者必从三部跃动之势。揣知病源。盖以此也。脑散动觉之气。厥用在筋。第脑距身远。不及引筋以达百肢。复
得颈节膂髓。连脑为一。因遍及也。脑之皮分内外层。内柔而外坚。既以保存生身。又以肇始诸筋。筋自脑出者六
偶。独一偶逾颈至胸下。垂胃口之前。余悉存项内。导气于五官。或令之动。或令之觉。又从膂髓出筋三十偶。各有细
筋旁分。无肤不及。其与肤接处。稍变似肤。始缘以引气。入肤充满周身。无不达矣。筋之体。瓤其里。皮其表。类于
脑。以为脑与周身连接之要约。即心与肝所发之脉络。亦肖其体。因以传本体之性于周身。盖心肝与脑三者。体
有定限。必藉筋脉之势。乃能与身相维相贯。以尽厥职。否则。七尺之躯。彼三者何由营之卫之。使生养动觉各效
灵哉。无可注曰。此论以肝心脑筋立言。是灵素所未发。以上二则。从钞本医书录出。未详作者姓氏。其说与泰西
所着全体新论等书所言略同。而泰西诸书。与王勋臣所着医林改错所论亦略同。按泰西医书与医林改错。为
医家所当参阅。以目稽胜于悬揣也。然其言脏腑之功用及气机之流行。不无可议处。重庆堂随笔评泰西书。信
其可信。阙其可疑。两言韪矣。仁和徐然石书医林改错后曰。易云。天地定位。山泽通气。人身躯壳以内。物位之定
也。饮食之化精。化液。化血。化大小便。气之通也。信先生明位之定而执之。窃疑先生未能扩气之通而充之也。此
数言亦中肯。
〔二十一〕内经言。“胃中悍气。循咽而上。冲头中。外行诸窍。”可知头汗出者。湿热随胃中悍气上蒸故也。又人
逢饮食辄头汗出。甚者头上热气蒸腾如烟雾。俗谓之“蒸笼头。”此殆饮食入胃。饮气食气。辄随胃中悍气上
冲。是天禀然也。
〔二十二〕何西池医碥煎药用水歌曰。“急流性速堪通便。宣吐回澜水最宜。（即逆流水）百沸气腾能取汗。甘澜劳
水意同之。黄齑水吐痰和食。霍乱阴阳水可医。新汲无根皆取井。除烦去热补阴施。地浆解毒兼清暑。腊雪寒冰热
疫奇。更有轻灵气化水。奇功千古少人知。堪调升降充津液。滋水清金更益脾。”按甘澜水用水置盆。杓扬万遍。
亦名劳水。古人言水性咸而体重。劳之则甘而清。取其不助肾气。而益脾胃也。又言扬之万遍。取动极而静之义。
愚谓后说近是。试取仲圣所用甘澜水方细绎之。其义自见。气化水者。以水蒸汗。如蒸花露法。一名气汗水。一名
水露。内经谓地气上为云。天气下为雨。上为云者。水化为气也。下为雨者。气化为水也。水化为气。则津液上腾。可
润上燥。气化为水。则膏泽下布。可滋下涸。用水蒸气。气复化水。有循环之妙理。得升降之元机。不但可取以煎药。
燥火证口渴者。取而饮之。不亦宜乎。
〔二十三〕吴渭泉治大便燥结。粪后便血。用生豆腐浆七分。荸荠汁三分。约共一茶碗。将豆腐浆熬滚。和冰糖少
许。冲荸荠汁。空心温服。盖荸荠甘寒而滑。开胃消食。除热止血。豆浆乃清热散血。下大肠浊气。又鸡鸣录治女人
带下属湿盛者。松石猪肚丸每早淡豆腐浆送服三钱。又仁和何惠川辑文堂集验方治痰火年久不愈者。用饴
糖二两。豆腐浆一碗。煮化多服即愈。又鸡蛋豆腐浆冲服。久则自效。盖鸡蛋能去喉中之风也。余治一幼童喉风
证。与清轻甘凉法。稍加辛药。时止时发。后有人教服鸡蛋。顶上针一孔。每日生吞一枚。不及十枚。病愈不复发。此
鸡蛋能去喉风之一征。
〔二十四〕鸡鸣录治噎膈方。用川黄连去毛。细切。二两。以水九碗。煎至六碗。再加水六碗。煎至三碗。下赤金
纹银各一锭。每重二两。浸汤内。大田螺五十个。洗净。仰置盘中。以黄连汁挑点螺靥。顷刻化水。用绢滤收半碗。将
田螺水同黄连汁金银共入瓷锅内。煎至碗半。下芦菔汁小半碗。无芦菔时。以芦菔子煎取浓汁用。同煎至碗半。下韭
汁小半碗。次下侧柏汁小半碗。次下甘梨汁小半碗。次下竹沥小半碗。次下莹白童便小半碗。俱以煎至碗半为
候。将金银取起。下 白人乳一大碗。次下羊乳一大碗。次下牛乳一大碗。俱以煎至一碗为候。成膏。入瓷罐内。封
口埋土内一伏时。每用一茶匙。开水调服。极重者三服必愈。如汤水不能进者。将膏挑置舌上。听其渗入咽喉。自
能饮食。但愈后须食糜粥一月。方可用饭。此方清火消痰。去瘀下气。养营润燥。系京口何培元家秘传。能挽回垂
绝之证。故顾松园医镜名曰再造丹。按内经曰。“三阳结为之膈。”三阳结者。大肠小肠膀胱热也。小肠结热则
血脉燥。大肠结热则后不圊。膀胱结热则津液涸。三阳俱结。前后秘涩。下既不通。必反上逆。此所以噎食不下。从
下而逆上也。又昔人指噎膈为血液枯槁。沉痼之疾。非大剂无济于事。此方制法颇精。煎膏酿浓。药力甚大。正合
嘉言喻氏所谓“能变胃而不受胃变”之义。 良工调剂之苦心。有如是夫。
〔二十五〕重庆堂随笔谓。木通味苦。故泻心火由小肠出。诸本草皆云甘淡。或言微辛。岂诸君不但未经口尝。且
荛亦未询乎。按木通古名通草。今之通草。古名通脱木。云木通味甘淡。或通草之传误。未可知。其实今之木通
味极苦且劣。世谓黄连是苦口药。殊不知黄连之味。苦而清。木通之味。苦而浊。叶氏医案以芦荟入汤剂。徐氏批
曰。“请自尝之。方知其苦。”愿以斯语移之木通。且木通性极迅利。不宜多用。余友沈杏田言。曾见一小儿。误服
重剂木通汤药。小便遂不禁。继之以白膏。如精状。叫号惨痛而死。死后溺窍端。犹有精珠数粒。用木通者。其审慎之。
〔二十六〕人身内外作两层。上下作两截。而内外上下。每如呼吸而动相牵引。譬如攻下而利。是泄其在内之下
截。而上截之气即陷。内上既空。其外层之表气。连邪内入。此结胸之根也。譬如发表而汗。是疏其在外之上截。而
在内之气跟出。内上既空。其内下之阴气上塞。此痞闷之根也。识此在上禁过汗。在内慎攻下之法。后读仲圣伤
寒论结胸及痞塞诸证。则冰消雪化矣。此高学山伤寒尚论篇辨似中语。自昔名医。无不以阴阳升降。盈虚消长。
营卫之气不和。运行不及。则体内气血不能化生，体表气血不能充盈。运行太过。则四肢末梢强盛而主干虚弱。偏重于营气则阴气胜，偏重于卫气则阳气胜。百病由此产生。这是自然的道理。这样看来。营卫难道不是维持生命的重大关键吗？医生治病。遵循《内经》守护经隧的教诲。对营卫加以重视就可以了。读《金匮要略》可知。营卫不利。就会出现腹部胀满、胁下肠鸣。气机相互追逐转动。营卫俱虚微。三焦失去统御。四肢失养断绝联系。身体消瘦羸弱。更加可见营卫的重要性了。就像痢疾这一病症。有寒热表证的。都知道与营卫有关。除此之外。因为病轻在腑。病重在脏。无不认为是内伤疾病。然而谁知道王肯堂在《证治准绳》中论述痢疾的新积旧积。归重于营卫。《内经》“守经隧”的一句话。这只是其中的一个方面罢了。选取它明白易懂。特意提出以印证此理。他说：“积滞有新旧之分。旧积。是由气血食痰所化成的。新积。是旧积去除后。不久又生成的。然而旧积适宜攻下。新积禁止攻下。这是什么原因呢？大概肠胃消化水谷。转输糟粕。都是营卫洒陈于六腑的功效。现在肠胃有邪气。那么营卫运行的度数。因此阻滞。不能施化。所以卫气郁结而不舒展。营气涩滞而不运行。于是饮食积痰停于胃。糟粕留于肠。与气郁血涩之积。相互挟制而成滞下（痢疾）。必须攻下。以通其壅塞。攻下之后。升降仍然不得运行。清浊仍然不能分辨。那么卫气再次郁结。营气再次涩滞。又重新形成新积。怎么可以再攻下呢？只需调理卫气。并调和营血。以调顺阴阳。那么升降合乎节度。积滞也不停滞而自然化解了。”
〔十七〕短气与少气是有区别的。少气。是指气少不足以说话。《内经》说：“说话声音微弱。整天才再说一次。这是夺气（元气大伤）的表现。”气短不能连续。像喘又不是喘。好像有气上冲。所以像喘但不摇动肩膀。像呻吟但没有痛苦。《金匮要略》说：“平人无寒热。短气不足以息的。是实证。”无寒热。无表邪。可知其短气不足以息。不是由于邪气束缚于外。毛窍有阻碍。而是呼吸通道因此不利。大概是由于里气因邪气而实。或是痰。或是食。或是饮。阻碍了其升降之气导致的。这一条应当与第八条参看。
〔十八〕学医如同学下棋。医书如同棋谱。世上善于下棋的人。没有不专心致志于棋谱。然后才有得心应手的境界。然而在对局之际。如果检查棋谱来应对敌人。就是胶柱鼓瑟（拘泥不知变通）。必定失败的道理。医学何尝不是如此。拿着死板的方子去治疗活着的病人。强行让病情迁就我方。人的性命怎么能承受得住呢？所以先哲有话说：“检谱对奕奕必败。拘方治病病必殆。”丹溪朱氏也说：“古方新病。哪有能相吻合的。拘泥于此甚至会杀人。”由此而言。世间所传的经验单方。往往只标注治疗某种病。而不辨别脉象和证候。其中清和平淡的药物。即使不对证。试用也没有大碍。如果是刚暴猛烈的药物。使用者一定要谨慎。我亲眼见到一个妇人。用密陀僧截疟。一个男子用蕲蛇酒治痛风。都顷刻间死亡。与服毒无异。还有张石顽说：“有人问近代治疗黄疸病多用草头单方。在穷乡僻壤。还可以。城市愚民也大多效仿。仁人君子看到这种情况。难道不痛心吗？曾见有人服用商陆根、苦匏、酒过山龙、雪里青、鹿葱等汁液。吐利脱元而死的人。数不胜数。曾有孕妇患黄疸。误用瓜蒂搐鼻。呕吐逆乱气喘胸满。导致胎息上冲。惨痛叫号而死。假如在这个时候。有什么办法可以救治呢？回答说：这都是宿孽使然。与飞蛾扑火无异。想要救治的人。只有广泛刊布。告诫将来。不要重蹈覆辙。或许不失仁人的用心。想要挽回已经倾覆的车子。我也无能为力了。”按这条来看。草头单方误人。为祸尤其猛烈。只是瓜蒂搐鼻治黄。是张仲圣的法度。因为不知道孕妇应禁忌。而误用致死。“拘方治病病必殆”。这话确实不虚假。至于使用商陆根等。还能说出药名。当其误用时。或许能知道是什么药误用。还可以设法解救。特别有一种用草药治病的人。辗转传授。谬称秘方。只认识其形状气色的草药。采集而使用。在使用者自己。还不能说出它的名字。而且先揉捣它。使人不能识别。所以神化其说以迷惑人。治疗如果得效。则大家争相奔走告知。惊讶其为神奇。后来凡是遇到这种病。以为业经试验的方子。放胆使用而不怀疑。一服没效。再服三服。殊不知在此有效的。未必在彼有效。因为病有浅深。体质有强弱。证候有寒热虚实。绝对不能执着于一种病的总名。而用一种药统治所有情况。况且草药的使用。往往力专而性猛。药病偶尔相当。其奏效很快。一旦不相当。灾祸随即而至。深深希望世上明智保身的人。遵守未达不敢尝试的训诫。千万不要把性命当作试药的器具。并辗转劝诫。使大家都知道用药治病。即使是专门名家。还需要详细体察。岂可轻率服用草药。存侥幸心理。以致遭遇不测之祸呢？
〔十九〕娄全善《医学纲目》治疗血崩类病症多用炭药。因为血见黑则止。香矾散用香附醋浸一夜。炒黑成炭。存性。每一两。加入白矾二钱。米饮空心调服。另一法用薄荷汤送服更妙。（许学士说：治疗下血不止。或成五色崩漏。香附是妇女圣药。）这是气滞者用行气炭来止血。五灵脂散治疗血崩。用五灵脂炒令烟尽。研为末。每服一钱。温酒调下。另一法每服三钱。水酒童便各半盏煎服。名叫抽刀散。这是血污者用行血炭来止血。荆芥散治疗血崩。用麻油点灯。多放灯心。在上面烧荆芥至焦色。研为末。每服三钱。童便调下。这是气陷者用升提药炭来止血。治疗崩中不止。不问年月远近。用槐耳烧作炭为末。以酒服方寸匕。这是血热者用凉血炭来止血。如圣散治疗血崩。棕榈、乌梅各一两。干姜一两五钱。一起烧炭存性。研为细末。每服二钱。乌梅酒调下。空心服。久患不过三服痊愈。这是血寒者用热血炭来止血。棕榈、白矾研为末。酒调服。每二钱。这是血脱者用涩血炭来止血。按同一血崩证。同一用炭药。而条理分析清晰到如此程度。治病用药。首先贵在识证。可以举一反三了。（炭原本作灰。）
〔二十〕《彻剩八编内镜》说。身内有三贵。热作为生命之源。血作为滋养之源。气作为运动知觉之源。所以心肝脑为贵。其余听命于它们。血所由产生。必须依赖食物转化。食物先经过牙齿咀嚼。再经过胃釜消化。粗细全部归于大络。细的可升至肝脑成血。粗的成为渣滓。在此之际。脾负责存细分粗。胆负责包收诸物害身之苦。肾脾负责吸藏未化的物质。胆和肾。虽然都是成血的器官。然而不如肝独自变化凝结。更生体性之气。所以肝为贵。心则生成内热与生养之气。脑生成细微动觉之气。所以并列为贵。有人问三贵的生气如何？回答说。肝通过窍体。内收半变的粮食。逐渐从本力全变为血。而血的精分。更变为血露。所谓性体之气。这种气最细。能通百脉。启百窍。引血周行遍体。又有本血一分。由大络入心。先入右窍。次移左窍。渐至细微。半变为露。所谓生养之气。这种气能引细血周身以存原热。又有此露一二分。从大络升入脑中。又变而愈细愈精。以为动觉之气。乃合五官四体。动觉得其分矣。主制群微说。人身湿热而已。热常消湿。无以资养。则肤焦而身毁矣。所以血。是资养的原料。血以行脉。脉有总曰络。络从肝出者二。一上一下。各渐分小脉至细微。凡内而脏腑。外而肤肉。无不贯串。莫定其数。脉的形状似机。其顺者因血势而利导之。斜者留血毋退。横者送血使进也。脉之力又能存血。不合则坏。血合于痰。乃克顺流。合于胆。乃免凝滞。合于体性之气。乃启诸窍。导之无闭塞也。从心出者。亦有二大络。一上一下。细分周身。悉与肝络同。所不同者。肝引血存血。此专导引热势及生养之路耳。心以呼吸进新气退旧气。直合周身。脉与之应。少间不应。辄生寒热诸证。医者必从三部跃动之势。揣知病源。盖以此也。脑散动觉之气。厥用在筋。第脑距身远。不及引筋以达百肢。复得颈节膂髓。连脑为一。因遍及也。脑之皮分内外层。内柔而外坚。既以保存生身。又以肇始诸筋。筋自脑出者六偶。独一偶逾颈至胸下。垂胃口之前。余悉存项内。导气于五官。或令之动。或令之觉。又从膂髓出筋三十偶。各有细筋旁分。无肤不及。其与肤接处。稍变似肤。始缘以引气。入肤充满周身。无不达矣。筋之体。瓤其里。皮其表。类于脑。以为脑与周身连接之要约。即心与肝所发之脉络。亦肖其体。因以传本体之性于周身。盖心肝与脑三者。体有定限。必藉筋脉之势。乃能与身相维相贯。以尽厥职。否则。七尺之躯。彼三者何由营之卫之。使生养动觉各效灵哉。无可注说。此论以肝心脑筋立言。是灵素所未发。以上二则。从钞本医书录出。未详作者姓氏。其说与泰西所着全体新论等书所言略同。而泰西诸书。与王勋臣所着医林改错所论亦略同。按泰西医书与医林改错。为医家所当参阅。以目稽胜于悬揣也。然其言脏腑之功用及气机之流行。不无可议处。重庆堂随笔评泰西书。信其可信。阙其可疑。两言韪矣。仁和徐然石书医林改错后曰。易云。天地定位。山泽通气。人身躯壳以内。物位之定也。饮食之化精。化液。化血。化大小便。气之通也。信先生明位之定而执之。窃疑先生未能扩气之通而充之也。此数言亦中肯。
〔二十一〕《内经》说：“胃中悍气。循咽而上。冲头中。外行诸窍。”可知头汗出者。是湿热随胃中悍气上蒸的缘故。又人逢饮食辄头汗出。甚者头上热气蒸腾如烟雾。俗谓之“蒸笼头。”这大概是饮食入胃。饮气食气。辄随胃中悍气上冲。是天禀然也。
〔二十二〕何西池《医碥》煎药用水歌曰：“急流性速堪通便。宣吐回澜水最宜。（即逆流水）百沸气腾能取汗。甘澜劳水意同之。黄齑水吐痰和食。霍乱阴阳水可医。新汲无根皆取井。除烦去热补阴施。地浆解毒兼清暑。腊雪寒冰热疫奇。更有轻灵气化水。奇功千古少人知。堪调升降充津液。滋水清金更益脾。”按甘澜水用水置盆。杓扬万遍。亦名劳水。古人言水性咸而体重。劳之则甘而清。取其不助肾气。而益脾胃也。又言扬之万遍。取动极而静之义。我认为后说接近正确。试着取仲圣所用的甘澜水方细细推究。其义自然显现。气化水者。以水蒸汗。如蒸花露法。一名气汗水。一名水露。《内经》谓地气上为云。天气下为雨。上为云者。水化为气也。下为雨者。气化为水也。水化为气。则津液上腾。可润上燥。气化为水。则膏泽下布。可滋下涸。用水蒸气。气复化水。有循环之妙理。得升降之元机。不但可取以煎药。燥火证口渴者。取而饮之。不也是合适的吗？
〔二十三〕吴渭泉治疗大便燥结。粪后便血。用生豆腐浆七分。荸荠汁三分。约共一茶碗。将豆腐浆熬滚。和冰糖少许。冲荸荠汁。空心温服。盖荸荠甘寒而滑。开胃消食。除热止血。豆浆乃清热散血。下大肠浊气。又《鸡鸣录》治疗女人带下属湿盛者。松石猪肚丸每早淡豆腐浆送服三钱。又仁和何惠川辑《文堂集验方》治疗痰火年久不愈者。用饴糖二两。豆腐浆一碗。煮化多服即愈。又鸡蛋豆腐浆冲服。久则自效。盖鸡蛋能去喉中之风也。我治疗一幼童喉风证。给予清轻甘凉法。稍加辛药。时止时发。后有人教服鸡蛋。顶上针一孔。每日生吞一枚。不到十枚。病愈不复发。这是鸡蛋能去喉风的证据之一。
〔二十四〕《鸡鸣录》治疗噎膈方。用川黄连去毛。细切。二两。以水九碗。煎至六碗。再加水六碗。煎至三碗。下赤金纹银各一锭。每重二两。浸汤内。大田螺五十个。洗净。仰置盘中。以黄连汁挑点螺靥。顷刻化水。用绢滤收半碗。将田螺水同黄连汁金银共入瓷锅内。煎至碗半。下芦菔汁小半碗。无芦菔时。以芦菔子煎取浓汁用。同煎至碗半。下韭汁小半碗。次下侧柏汁小半碗。次下甘梨汁小半碗。次下竹沥小半碗。次下莹白童便小半碗。俱以煎至碗半为候。将金银取起。下白人乳一大碗。次下羊乳一大碗。次下牛乳一大碗。俱以煎至一碗为候。成膏。入瓷罐内。封口埋土内一伏时。每用一茶匙。开水调服。极重者三服必愈。如汤水不能进者。将膏挑置舌上。听其渗入咽喉。自能饮食。但愈后须食糜粥一月。方可用饭。此方清火消痰。去瘀下气。养营润燥。系京口何培元家秘传。能挽回垂绝之证。故顾松园《医镜》名曰再造丹。按《内经》说：“三阳结为之膈。”三阳结者。是大肠小肠膀胱热也。小肠结热则血脉燥。大肠结热则后不圊。膀胱结热则津液涸。三阳俱结。前后秘涩。下既不通。必反上逆。此所以噎食不下。从下而逆上也。又昔人指噎膈为血液枯槁。沉痼之疾。非大剂无济于事。此方制法颇精。煎膏酿浓。药力甚大。正合嘉言喻氏所谓“能变胃而不受胃变”之义。良工调剂之苦心。有如是夫。
〔二十五〕《重庆堂随笔》说。木通味苦。所以泻心火由小肠出。诸本草皆云甘淡。或言微辛。难道诸位不但未经口尝。且荛亦未询乎。按木通古名通草。今之通草。古名通脱木。云木通味甘淡。或通草之传误。未可知。其实今之木通味极苦且劣。世谓黄连是苦口药。殊不知黄连之味。苦而清。木通之味。苦而浊。叶氏医案以芦荟入汤剂。徐氏批曰：“请自尝之。方知其苦。”愿以斯语移之木通。且木通性极迅利。不宜多用。我朋友沈杏田说。曾见一小儿。误服重剂木通汤药。小便遂不禁。继之以白膏。如精状。叫号惨痛而死。死后溺窍端。犹有精珠数粒。用木通者。其审慎之。
〔二十六〕人身内外作两层。上下作两截。而内外上下。每如呼吸而动相牵引。譬如攻下而利。是泄其在内之下截。而上截之气即陷。内上既空。其外层之表气。连邪内入。这是结胸的根源。譬如发表而汗。是疏其在外之上截。而在内之气跟出。内上既空。其内下之阴气上塞。这是痞闷的根源。认识到这一点。在上禁过汗。在内慎攻下的方法。后读仲圣《伤寒论》结胸及痞塞诸证。则冰消雪化矣。这是高学山《伤寒尚论篇辨似》中的话。自昔名医。无不以阴阳升降。盈虚消长。
Disorder of Ying and Wei (Nutritive and Defensive Qi). If their movement is insufficient, internal transformation fails and external nourishment is lacking. If their movement is excessive, the branches become strong while the trunk becomes weak. Bias towards Ying leads to Yin excess; bias towards Wei leads to Yang excess. Thus, a hundred diseases arise. This is the natural principle. Therefore, are not Ying and Wei the major key to sustaining life? Physicians treating diseases should follow the instruction in *Neijing* (*The Yellow Emperor's Classic of Internal Medicine*) to guard the meridians and pay special attention to Ying and Wei. Reading *Jingui Yaolue* (*Essential Prescriptions from the Golden Cabinet*), it states: "When Ying and Wei are unfavorable, abdominal fullness and borborygmus in the hypochondrium occur, with qi chasing each other and rotating." When both Ying and Wei are deficient and minute, the Triple Burner loses its control, the four limbs lose connection, and the body becomes emaciated. This further demonstrates the importance of Ying and Wei. Take dysentery as an example. Cases with cold-heat exterior symptoms are known to relate to Ying and Wei. Outside of this, because mild disease affects the Fu organs and severe disease affects the Zang organs, all consider it an internal disease. However, who knows that Wang Kentang, in *Zhengzhi Zhunsheng* (*Standard for Diagnosis and Treatment*), attributes the old and new accumulations in dysentery primarily to Ying and Wei. The phrase "guard the meridians" in *Neijing* is but one aspect of this. I select it for its clarity and simplicity to verify this point. He said: "Accumulations have distinctions between old and new. Old accumulations are formed from qi, blood, food, and phlegm. New accumulations arise shortly after old ones are cleared. However, old accumulations are suitable for purgation, while new accumulations are contraindicated for purgation. Why? The digestion of water and grain and the transport of waste in the intestines and stomach are the functions of Ying and Wei sprinkling and arranging within the Six Fu organs. Now, if there is pathogenic factor in the intestines and stomach, the rhythm of Ying and Wei movement is obstructed, preventing transformation. Thus, Wei qi stagnates and fails to disperse, and Ying qi becomes stagnant and fails to flow. Consequently, food accumulation and phlegm stop in the stomach, and residue remains in the intestines, joining with qi stagnation and blood stasis to form dysentery. It must be purged to unblock the obstruction. After purging, if ascending and descending still fail to operate, and clear and turbid still fail to separate, then Wei qi stagnates again, and Ying qi becomes stagnant again, forming new accumulations. How can one purge again? One should only regulate Wei qi and harmonize Ying blood to balance yin and yang. Then, ascending and descending will follow proper rhythm, and accumulations will resolve naturally without stagnation."
[17] There is a distinction between shortness of breath (Duan Qi) and deficiency of qi (Shao Qi). Deficiency of qi refers to having insufficient qi to speak. *Neijing* states: "Speaking faintly, only speaking again after a whole day, this is loss of qi (Duo Qi)." Shortness of breath is inability to continue breathing, resembling panting but not true panting, as if qi rushes upward. Thus, it resembles panting but without shoulder shaking, and resembles groaning but without pain. *Jingui Yaolue* states: "In a healthy person without cold or heat, shortness of breath and inability to breathe fully indicates excess." Without cold or heat, and without exterior pathogens, it is known that shortness of breath is not due to pathogens binding externally and blocking hair pores, causing respiratory difficulty. Rather, it is likely due to interior excess caused by pathogens, such as phlegm, food, or fluid retention, obstructing the ascending and descending qi. This clause should be read in conjunction with Clause 8.
[18] Learning medicine is like learning chess. Medical books are like chess manuals. Those skilled in chess do not achieve ease and proficiency without devoting themselves wholeheartedly to the manual. However, consulting the manual during a game to respond to the opponent is rigid and stereotyped, leading to inevitable defeat. Is medicine any different? Using rigid prescriptions to treat living patients, forcing the condition to fit the prescription, how can human life bear this? Thus, ancient sages said: "Consulting the manual in chess guarantees defeat; using rigid prescriptions in medicine endangers the patient." Zhu Danxi also said: "Ancient prescriptions and new diseases, how can they match? Clinging to them may even kill." From this, we see that empirical single prescriptions passed down in the world often only label the disease treated without distinguishing pulse and syndrome. Among these, mild and bland herbs, even if mismatched, cause little harm if tried. But for harsh and fierce herbs, users must be cautious. I personally witnessed a woman who used Ledum powder (Miduoseng) to arrest malaria, and a man who used Qishe wine to treat gout; both died instantly,无异 to poisoning. Zhang Shiwan also said: "Some ask why modern treatments for jaundice often use herbal folk remedies. In remote areas, this is understandable. But ignorant people in cities also imitate this. Would benevolent men not feel pained seeing this? I have seen many die from vomiting and diarrhea due to yuan depletion after consuming juices of Phytolacca root, bitter melon, Jiushanguanlong, Xueliqing, and Luchong. The list is endless. Once, a pregnant woman with jaundice was mistakenly treated with Citrullus colocynthis (Gua Di) insufflated into the nose, causing vomiting, reflux, wheezing, and chest fullness, leading to fetal qi rushing upward, resulting in death amidst tragic cries. At that moment, what method could save her? The answer is: this is due to past karma,无异 to moths flying into fire. To save others, one must widely publish warnings to prevent future mistakes, preserving the intent of benevolence. As for saving the overturned cart, I am powerless." According to this, the harm of herbal folk remedies is particularly severe. Although Citrullus colocynthes insufflation for jaundice is a method from Zhang Zhongjing, it caused death because the pregnancy contraindication was unknown. "Using rigid prescriptions endangers the patient" is indeed true. Regarding Phytolacca root, at least the name is known, so if mistaken, one might identify the error and attempt rescue. However, there are those who use herbal medicines, passing them down辗转, falsely claiming them as secret formulas. They only recognize the shape and color of herbs, picking and using them. Even the user cannot name them, and they crush and pound them first, making identification impossible. Thus, they mystify the theory to deceive people. If treatment succeeds, everyone spreads the news, marveling at its miracle. Later, encountering the same disease, they boldly use it without doubt. If one dose fails, they try two or three. Little do they know that what works here may not work there, because diseases vary in depth, constitutions in strength, and syndromes in cold-heat and deficiency-excess. One cannot simply use one herb to rule all cases of a named disease. Moreover, herbal medicines often have specific potency and fierce nature. If the herb matches the disease, effect is swift; if not, disaster follows quickly. I deeply hope wise people who value their lives follow the precept of "not daring to taste what is not understood." Do not treat life as a tool for testing herbs. Persuade others to understand that even experts must carefully examine conditions before prescribing. How can one lightly take herbs with a侥幸 mindset, risking unforeseen disasters?
[19] Lou Quanshan's *Yixue Gangmu* uses carbonized herbs for metrorrhagia, based on the principle that blood stops when black. Xiangfan San uses Cyperi Rhizoma (Xiangfu) soaked in vinegar overnight, stir-fried to charcoal, retaining its nature. One liang mixed with Er qian of Alum (Baifan), taken empty-stomach with rice water. Another method uses Mint Decoction, which is better. (Xu Xueshi said: For persistent lower bleeding or five-color leukorrhea, Cyperi Rhizoma is a sacred herb for women.) This treats qi stagnation using qi-moving carbonized herbs. Wulingzhi San treats metrorrhagia using Trogopteri Dung (Wulingzhi) stir-fried until smoke ceases, powdered. Take one qian with warm wine. Another method takes three qian, decocted with half a cup each of water, wine, and child's urine, named Choudao San. This treats blood impurity using blood-invigorating carbonized herbs. Jingjie San treats metrorrhagia. Light a lamp with sesame oil, place many wicks, and burn Schizonepetae Herba (Jingjie) over it until charred. Powder it. Take three qian with child's urine. This treats qi sinking using lifting carbonized herbs. For persistent metrorrhagia, regardless of duration, use Psoraleae Fructus (Huai'er) burned to charcoal, powdered, taken with wine using a square-inch measure. This treats blood heat using blood-cooling carbonized herbs. Rusheng San treats metrorrhagia. Use one liang each of Palm Fruit (Zonglv) and Mume Fructus (Wumei), and one liang five qian of Dried Ginger (Ganjiang). Burn all to charcoal, retain nature, powder finely. Take two qian with Mume wine, empty-stomach. Chronic cases cure within three doses. This treats blood cold using blood-warming carbonized herbs. Palm Fruit and Alum powdered, taken with wine, two qian per dose. This treats blood loss using astringent carbonized herbs. Note that for the same metrorrhagia and same use of carbonized herbs, the differentiation is so clear. Treating disease and prescribing herbs prioritizes identifying the syndrome; one can infer other cases from this. (Charcoal originally written as ash.)
[20] *Chesheng Babian Jingnei* states: "Inside the body, there are three nobilities: Heat as the source of life, Blood as nourishment, and Qi as movement and sensation. Thus, Heart, Liver, and Brain are noble, and the rest obey." Blood generation relies on food transformation. Food passes through teeth, then the stomach cauldron. Coarse and fine parts enter the large collaterals. Fine parts rise to Liver and Brain to form blood; coarse parts become dregs. At this stage, Spleen separates fine from coarse, Gallbladder collects harmful substances, and Kidney/Spleen store untransformed matter. Though Gallbladder and Kidney are blood-forming organs, Liver alone transforms and condenses, generating the qi of body nature. Thus, Liver is noble. Heart generates internal heat and nurturing qi; Brain generates subtle sensory qi. Thus, they are equally noble. Question: How do the three nobles generate qi? Answer: Liver receives semi-transformed nutrients via orifices, gradually transforming them fully into blood through innate power. The essence of blood transforms into blood dew, called the qi of body nature. This qi is finest, connecting hundred vessels, opening hundred orifices, guiding blood throughout the body. One part of blood enters Heart via large collaterals, first entering right orifice, then left, becoming subtle, half-transforming into dew, called nurturing qi. This qi guides fine blood to preserve original heat. One or two parts of this dew ascend to Brain via large collaterals, becoming finer and more refined, forming sensory qi, integrating with five senses and four limbs. *Zhuzhi Qunwei* states: "The human body is merely dampness and heat. Heat constantly consumes dampness; without nourishment, skin burns and body destroys. Thus, blood is the material for nourishment." Blood moves in vessels. Vessels have general collaterals. Two collaterals emerge from Liver, one up, one down, branching into smaller vessels until subtle. They penetrate internal organs and external flesh. Their number is indefinite. Vessel shapes resemble mechanisms. Smooth ones guide blood flow; slanted ones retain blood; horizontal ones advance blood. Vessel force preserves blood; without union, they break. Blood combines with phlegm to flow smoothly; combines with Gallbladder to avoid stagnation; combines with body-nature qi to open orifices without blockage. Two large collaterals emerge from Heart, one up, one down, subdividing the body, similar to Liver collaterals. Difference: Liver guides and preserves blood; Heart specifically guides heat and nurturing pathways. Heart breathes in new qi and expels old, directly connecting to the body. Vessels respond to this. If response lags, cold-heat syndromes arise. Physicians must deduce disease sources from the pulsation of three positions. Brain scatters sensory qi, functioning in sinews. Since Brain is distant from the body, it cannot reach all limbs directly. It connects via neck vertebrae and spinal marrow to spread everywhere. Brain skin has inner soft and outer hard layers, protecting life and initiating sinews. Six pairs of sinews emerge from Brain. One pair crosses neck to below chest, hanging before stomach opening; others remain in neck, guiding qi to five senses, enabling movement or sensation. Thirty pairs of sinews emerge from spinal marrow, with fine branches reaching every skin area. Where connecting to skin, they slightly resemble skin, drawing qi to fill the body. Sinew structure has pulp inside and skin outside, resembling Brain, serving as the main link between Brain and body. Heart and Liver vessels also resemble this structure, transmitting innate nature to the body. Heart, Liver, and Brain have fixed limits; they rely on sinew and vessel momentum to maintain and connect with the body, fulfilling their duties. Otherwise, how would these three manage and protect the seven-foot body, ensuring nourishment and sensation function effectively? Wu Ke's commentary states: This discussion focuses on Liver, Heart, Brain, and Sinew, concepts not found in *Lingshu* and *Suwen*. The above two excerpts are recorded from manuscript medical books, author unknown. The theory is similar to Western texts like *New Anatomy*. Western texts also align with Wang Xunchen's *Yilin Gaicuo*. These should be consulted by physicians, as visual observation surpasses speculation. However, their explanations of organ functions and qi dynamics have debatable points. *Chongqing Tang Suibi* evaluates Western books: believe the credible, omit the doubtful. This is correct. Xu Ranshi of Renhe, in his postscript to *Yilin Gaicuo*, cites *I Ching*: "Heaven and Earth establish positions; Mountain and Lake communicate qi." Inside the body shell, material positions are fixed. Digestion transforms essence, fluids, blood, and excreta; this is qi communication. I suspect Mr. Wang emphasizes fixed positions but fails to expand upon qi communication. These words are pertinent.
[21] *Neijing* states: "The fierce qi of Stomach ascends through the throat, rushes to the head, and circulates externally through various orifices." This explains that head sweating is due to damp-heat steaming upward with the fierce qi of Stomach. Also, some people sweat on the head immediately after eating. Severe cases have steam rising from the head like smoke,俗称 "steamer head." This is likely because food and drink qi rush upward with the fierce qi of Stomach upon ingestion, a congenital trait.
[22] He Xichi's *Yi Que* song on water for decoction: "Rapid flowing water aids purgation; receding wave water is best for inducing vomiting (i.e.,逆流 water). Boiling water with rising vapor induces sweating; Ganlan Laoshui has similar intent. Pickled mustard water induces vomiting for phlegm and food; Huoluan can be treated with Yin-Yang water. Fresh well water or rootless water clears irritability, removes heat, and nourishes yin. Earth soil浆 detoxifies and clears summerheat; winter snow and ice are miraculous for febrile epidemics. There is also light qi-transformed water, whose miracles few know. It adjusts ascending/descending, replenishes fluids, nourishes water, clears metal, and benefits spleen." Ganlan water is made by stirring water in a basin ten thousand times with a ladle, also called Laoshui. Ancients said water is salty and heavy; stirring makes it sweet and clear, avoiding aiding Kidney qi and benefiting Spleen/Stomach. Stirring ten thousand times symbolizes movement turning to stillness. I believe this latter explanation is closer to truth. Examining Zhang Zhongjing's Ganlan water formulas reveals its meaning. Qi-transformed water is made by evaporating water, like distilling flower dew, also called Qi Han Shui or Water Dew. *Neijing* says: "Earth qi rises as clouds; Heaven qi falls as rain." Clouds are water transforming to qi; rain is qi transforming to water. Water to qi allows fluids to rise, moistening upper dryness; qi to water allows moisture to descend, nourishing lower depletion. Using steam to transform water back to qi has cyclic wonder and ascending-descending mechanism. It can be used for decoction. For dry-heat syndromes with thirst, drinking it is appropriate.
[23] Wu Weiquan treated dry stool constipation and hematochezia with 7 parts raw tofu milk and 3 parts water chestnut juice, totaling one teacup. Boil tofu milk, add small amount of rock sugar, mix with water chestnut juice, take warm on empty stomach. Water chestnut is sweet, cold, and slippery, opens stomach, digests food, clears heat, stops bleeding. Tofu milk clears heat, disperses blood, descends turbid qi from Large Intestine. *Jiming Lu* treats leukorrhea with dampness excess using Songshi Zhudu Wan, taken with plain tofu milk morning. He Huichuan's *Wentang Jiyian Fang* treats chronic phlegm-fire with two liang maltose and one bowl tofu milk, boiled and taken frequently cures. Egg and tofu milk taken together also works long-term. Eggs remove wind in throat. I treated a child with throat wind, using clear, light, sweet, cool method with slight acrid herbs. Symptoms stopped and started. Someone advised swallowing one raw egg daily with a hole pricked in top. Within ten eggs, cured without recurrence. This proves eggs remove throat wind.
[24] *Jiming Lu* recipe for dysphagia (Ye Ge): Remove hairs from Coptidis Rhizoma (Huanglian), cut finely, two liang. Add nine bowls water, boil to six bowls. Add six bowls water, boil to three bowls. Immerse one ingot each of red gold and patterned silver, two liang each, in the decoction. Wash fifty large river snails, place upside down in plate. Use Huanglian juice to touch the snail umbilicus; they melt into water in moments. Filter half a bowl through silk. Combine snail water, Huanglian juice, and metals in porcelain pot. Boil to half a bowl. Add small half bowl Radish Juice (Lufu); if no radish, use concentrated juice from Radish Seed. Boil to half bowl. Add small half bowl Leek Juice. Add small half bowl Biota Orientalis Leaf Juice (Cebai). Add small half bowl Pear Juice. Add small half bowl Bamboo Sap (Zhuli). Add small half bowl bright white child's urine. Stop boiling when reduced to half a bowl. Remove metals. Add one large bowl human milk, one large bowl goat milk, one large bowl cow milk. Boil to one bowl. Form paste. Seal in porcelain jar, bury in earth for one Fushi (12 hours). Take one tea spoon, dissolved in boiling water. Severe cases cure in three doses. If unable to swallow liquids, place paste on tongue to seep into throat, allowing self-feeding. After cure, eat porridge for one month before solid food. This formula clears fire, resolves phlegm, removes stasis, directs qi downward, nourishes Ying, moistens dryness. Secret transmission from He Peiyuan family in Jingkou. Can挽救 critical conditions. Gu Songyuan's *Yi Jing* names it Zaizao Dan. *Neijing* states: "Binding of Three Yang causes obstruction." Three Yang binding refers to heat in Large Intestine, Small Intestine, and Bladder. Small Intestine heat dries blood vessels; Large Intestine heat prevents defecation; Bladder heat depletes fluids. All Three Yang bound causes constipation. Downward blockage forces reversal upward, causing inability to swallow. Ancients described dysphagia as blood exhaustion and stubborn disease, requiring large doses. This formula is precisely prepared, concentrated paste, potent, matching Yu Jia Yan's principle of "changing stomach without being changed by stomach." The care of skilled practitioners is thus.
[25] *Chongqing Tang Suibi* states: Akebia Caulis (Mutong) is bitter, thus draining Heart fire via Small Intestine. Materia Medica says it is sweet and bland, or slightly acrid. Have you not tasted it or asked? Mutong was formerly named Tongcao. Current Tongcao was formerly named Tongduomu. Claiming Mutong is sweet/bland may be a transmission error of Tongcao. Actually, current Mutong is extremely bitter and inferior. People say Coptis (Huanglian) is bitter, but Huanglian is bitter and clear; Mutong is bitter and turbid. Ye's medical case used Aloe (Luhui) in decoction; Xu commented: "Taste it yourself to know bitterness." Apply this to Mutong. Mutong is extremely rapid and sharp, not suitable for high doses. Friend Shen Xingtian saw a child who accidentally took heavy dose Mutong decoction. Urine became incontinent, followed by white fluid like semen, dying in agony. After death, semen-like beads remained at urethral orifice. Users of Mutong must be cautious.
[26] Human body has inner/outer layers and upper/lower sections. Inner/outer and upper/lower interact like breathing, pulling each other. For example, purgation causing diarrhea drains lower interior, causing upper interior qi to sink. With upper interior empty, exterior surface qi enters internally with pathogens, causing Jie Xiong (Constraint Chest). For example, releasing exterior causing sweat vents upper exterior, causing interior qi to follow out. With upper interior empty, lower interior yin qi blocks upward, causing Pi Men (Stagnant Oppression). Understanding this, forbid excessive sweating above, caution against purgation below. Reading Zhang Zhongjing's *Shanghan Lun* on Jie Xiong and Pi syndromes becomes clear as melting ice/snow. This is from Gao Xueshan's *Shanghan Shanglun Pian Bensi*. Since ancient famous doctors, none did not use yin-yang ascending/descending, fullness/emptiness, waxing/waning...