一、时医治病，但知察标，不知察本，且常以标本借口。曰∶急则治其标，缓则治其本
。是岂知《内经》必求其本之意。故但见其所急在病，而全不知所急在命，此其孰可缓也？
孰当急也？孰为今日之当急，孰为明日之更当急也？缓急既不知，则每致彼此误认，尚何标本
为言乎！
一、中风证悉由内伤，本无外感。既无外感，必不可散。若过用治风等药，则轻者必重
，重者必速死。
一、伤寒关系全在虚实二字。实者易治，虚者难治。以其元气本虚，故邪不易解。若治
挟虚伤寒，不知托散，而但知攻邪，愈攻则愈虚，愈虚则无有不死。若甚虚者，即微补且无
益，而但以治标为主者必死。
一、伤寒阳经与阳证不同。阳经者，邪在表也；阳证者，热在里也。若内无实热脉候，
而以阳经作阳证，妄用寒凉治其火，因致外内合邪而不可解者必死。
一、痢疾之作，惟脾肾薄弱之人极易犯之。夫因热贪凉，致伤脏气，此人事之病，非天
时之病也。今之治痢者，止知治天时之热，不知治人事之寒何也？矧痢证多在秋深。斯时
也，炎暑既消，固不可执言热毒。秋凉日至，又何堪妄用寒凉？凡若此者，既不知人事，又
不知天时，失之远矣。害莫甚矣。当因予言而熟思之矣。
一、小儿血气未充，亦如苗萼之柔嫩。一或伤残，无不凋谢。故平时最宜培植，不可妄
行消导。其或果有食滞胀痛，则宜暂消。果有风寒发热，则宜暂散。果有实热痰火，则宜暂
清。此不得不治其标也。舍此之外，如无暴急标病，而时见青黄羸瘦，或腹膨微热，溏泄困
倦等证，则悉由脾肾不足，血气薄弱而然。而时医见此，无非曰食积痰火，而但知消导，尤
尚清凉，日消日剥，则元气日损，再逢他疾，则无能支矣。此幼科时俗之大病，有不可不察
者也。
一、小儿痘疹发热，此其正候。盖不热则毒不能透。凡其蒸热之力，即元气之力，故自
起至化，自收至靥，无不赖此热力为之主，是诚痘疹之用神，必不可少，亦不必疑者也。惟
是热甚而毒甚者，则不得不清火以解其毒。然必有内热真火脉证，方可治以清凉，此不过数
十中之一二耳。如无内热，而但有外热，此自痘家正候，必不可攻热以拔元气之力，以伤脾
肾之源。奈近代痘科全不知此，但见发热，则无论虚实，开口止知解毒，动手只知寒凉，多
致伤脾而饮食日减，及靥时泄泻而毙者，皆其类也。此误最多，不可不察。
一、痘疮不起，如毒盛而不可起者，此自不救之证，不必治也。若别无危证而痘不起者
，总由元气无力，但培气血，则无有不起。近见痘科凡逢此证，则多用毒药，如桑蚕、穿山
甲之类，逼而出之，见者以为奇效，而不知起发非由根本，元气为毒所残，发泄太过，内必
匮竭，以此误人，所当切省。
一、妇人经脉滞逆，或过期不至，总由冲任不足而然。若不培养血气，而止知通经逐瘀
，则血以日涸，而崩漏血枯等证，无所不至矣。
一、凡情欲致伤，多为吐血失血，及或时发热，此真阴受伤之病。若但知治火，而不知
治阴，则阴日消亡，而劳瘵反成矣。
一、痰证必有所因，是痰本不能生病，而皆因病生痰也。若止知治痰，而不知所以生痰
，则痰必愈甚，未有可消而去者也。
一、膨满总由脾胃，脾胃虽虚，未必即胀。若但知消导，则中气愈虚，而胀必日甚矣。
一、气滞隔塞，总属脾虚不运，故为留滞。若不养脾而但知破气，则气道日亏，而渐成噎
隔等病。
一、小水短赤，惟劳倦气虚及阴虚之人多有之。若以此类通作火治，而专用寒凉，则变
病有不可测矣。
一、脉虚证热，本非真火。若作热治，而肆用寒凉，则轻者必重，重者必死。
一、病本大虚而治以微补，药不及病，本无济益。若疑为误而改用消伐则死。
一、病有缓急，效有迟速。若以迟病而求速效，则未免易医，易医多则高明本少，庸浅
极多，少不胜多，事必败矣。
一、任医须择贤者，而于危急之际，尤不可苟。若彼宵小之辈，惟妄 已长，好翻人按
，不幸遇之，多致淆惑是非，生命所系不浅。
一、经曰∶人迎盛坚者伤于寒，气口坚盛者伤于食。此本以阳明太阴之脉分言表里，而
王叔和以左为人迎，右为气口，因致后人每以左脉辨外感，右脉辨内伤。岂左无内伤，而右
无外感乎？谬甚！谬甚！
一、经曰∶病生于内者，先治其阴，后治其阳，反者益甚。病生于阳者，先治其外，后
治其内，反者益甚。
一、病患善服药者，闻其气，尝其味，便可觉宜否之优劣，固无待入腹而始知也。独悯
乎无识无知者，但知见药服药，而不知药之为药；但知见医求医，而不知医之为医，亦可悲矣。
一、当时的医生治病，只知道观察表象（标），不知道探究根本（本），并且常常以“标本”作为借口。他们说：“病情紧急时先治其标，病情缓和时再治其本。”这哪里懂得《黄帝内经》中“必须探求疾病根本原因”的本意呢？所以，他们只看到病症上的急迫，却完全不知道生命安危才是更紧迫的事，这其中的缓急究竟该如何区分？哪一天应当优先处理什么，哪一天又应当更优先处理什么？既然连缓急都分不清，就往往导致彼此误认，还谈什么标本先后呢！
二、中风证全部是由内伤引起的，本来就没有外感邪气。既然没有外感，就绝对不可以使用发散解表的方法。如果过度使用治疗风证的药物，轻的病一定会加重，重的病一定会迅速死亡。
三、伤寒的治疗关键在于虚实二字。实证容易治疗，虚证难以治疗。因为患者元气原本虚弱，所以邪气不容易被解除。如果治疗夹杂虚证的伤寒，不懂得扶正托毒外出，而只知道攻伐邪气，越攻伐则正气越虚，正气越虚则没有不死亡的。如果身体极度虚弱，即使轻微补益都没有益处，而仅仅以治疗表象为主的人，必定死亡。
四、伤寒中的阳经病与阳证是不同的。阳经病，是指邪气在体表；阳证，是指热邪在体内。如果体内没有实热的脉象和症状，却把阳经病当作阳证，胡乱使用寒凉药物治疗火热，从而导致内外邪气结合而无法解开，这样的人必定死亡。
五、痢疾的发生，只有脾肾薄弱的人才极易感染。因为贪恋凉爽饮食，导致损伤脏腑之气，这是人为因素导致的疾病，而不是天时气候导致的疾病。现在的治痢医生，只知道治疗天时之热，却不知道治疗人事之寒，这是为什么呢？况且痢疾病症多在深秋时节发生。这个时候，炎热暑气已经消退，固然不能固执地说是热毒所致。秋凉之日到来，又怎么忍心胡乱使用寒凉药物？像这样的情况，既不了解人事因素，又不了解天时变化，偏差太远了。危害没有比这更大的了。应当根据我的言论仔细思考。
六、小儿血气尚未充盈，就像幼苗花萼一样柔嫩。一旦受到伤残，没有不枯萎凋谢的。所以平时最适宜培育滋养，不可胡乱使用消食导滞的药物。如果确实有食积停滞导致的胀痛，则应该暂时使用消导法。如果确实有风寒发热，则应该暂时使用发散法。如果确实有实热痰火，则应该暂时使用清热法。这是不得不治其标的情况。除此之外，如果没有暴发的紧急标病，而是经常见到面色青黄、身体消瘦，或者腹部膨隆微热、大便稀溏、困倦乏力等症状，这些都是由脾肾不足、血气薄弱造成的。而当时的医生看到这些，无非说是食积痰火，只知道使用消导法，甚至更加推崇清凉药物，每天消削剥蚀，导致元气日益受损，再遇到其他疾病，就无法支撑了。这是儿科领域的世俗通病，是不可不察知的。
七、小儿出痘疹发热，这是正常的征候。因为如果不发热，毒素就不能透发出来。那种蒸腾发热的力量，就是元气的力量，所以从起发到化脓，从收敛到结痂，无不依赖这种热力作为主导，这确实是痘疹发病的关键神灵所在，必不可少，也不应怀疑。只是当热势很盛且毒素严重时，才不得不清泻火热以解除毒素。然而，必须有内在真火的热脉和症状，才可以采用清凉药物治疗，这种情况不过几十例中有一二例罢了。如果没有内热，只有外热，这自是痘疹的正常征候，绝不可以攻伐热邪来拔除元气的力量，从而伤害脾肾之源。无奈近代专攻痘科的医生全不懂这个道理，只要见到发热，无论虚实，开口只知道解毒，动手只知道用寒凉药，大多导致损伤脾胃而饮食日渐减少，等到结痂时出现泄泻而死亡的，都属于这一类。这种错误最多，不可不察知。
八、痘疮不起发，如果是毒素过盛导致无法起发的，这是不治之证，不必治疗。如果并没有其他危重症状而痘疮不起发的，总归是元气无力，只要培补气血，就没有不起发的。近来见到痘科医生凡是遇到这种情况，就多用毒药，如桑蚕、穿山甲之类，逼迫痘疮发出，旁观者以为这是奇效，却不知道起发并非源于根本，元气被毒素残害，发泄太过，内部必然枯竭，以此来误导他人，应当深刻反省。
九、妇女月经阻滞逆乱，或过期不来，总归是由于冲任二脉不足造成的。如果不培养血气，而只知道通经逐瘀，那么血液会日益枯竭，而导致崩漏、血枯等病症，无所不至。
十、凡是因情欲过度导致损伤的，多为吐血、失血，以及有时发热，这是真阴受伤的疾病。如果只知道治疗火热，而不知道滋养阴液，那么阴液会日益消亡，反而形成劳瘵（虚劳咳嗽）之症。
十一、痰证必定有产生的原因，痰本身不能致病，都是因病生痰。如果只知道治痰，而不知道产生痰的原因，那么痰一定会更加严重，没有可以消除去除的。
十二、腹胀满总归与脾胃有关，脾胃虽然虚弱，未必立即就会胀满。如果只知道消导，那么中气会更加虚弱，而胀满必定日益严重。
十三、气机阻滞、胸膈堵塞，总属脾虚不能运化，所以导致留滞。如果不养脾而只知道破气行气，那么气道日益亏损，逐渐形成噎隔等疾病。
十四、小便短少赤红，只有劳累疲倦、气虚及阴虚的人多有此症。如果把这些一概当作火热来治疗，而专门使用寒凉药物，那么变生的疾病将不可预测。
十五、脉象虚弱而症状表现为热，本来就不是真正的火邪。如果当作热证治疗，而肆意使用寒凉药物，那么轻的病一定会加重，重的病一定会死亡。
十六、疾病本质是大虚，而治疗只用轻微补益，药力达不到病所，本来就没有帮助。如果怀疑这是误治而改用消伐药物，则会导致死亡。
十七、疾病有缓急之分，疗效有快慢之别。如果用治疗慢性病的心态去追求速效，就难免频繁更换医生，更换医生多了，高明的大夫很少，平庸浅陋的医生极多，少数胜不过多数，事情必定失败。
十八、选择医生必须挑选贤能之人，而在危急关头，尤其不可草率苟且。如果遇到那些品行卑劣之辈，只会狂妄自大，喜欢推翻别人的诊断，不幸遇到他们，大多导致混淆是非，性命攸关，影响不小。
十九、《内经》说：“人迎脉盛大坚硬的，是伤于寒邪；气口脉坚硬盛大的，是伤于饮食。”这本来是分别论述阳明经和太阴经的脉象以区分表里，但王叔和认为左手为人迎，右手为气口，因此导致后人每以左脉辨别外感，右脉辨别内伤。难道左边没有内伤，而右边没有外感吗？这是极大的谬误！极大的谬误！
二十、《内经》说：“疾病生于内部的，先治其阴，后治其阳，如果反过来做，病情会更加严重。疾病生于外部的，先治其外，后治其内，如果反过来做，病情会更加严重。”
二十一、病人善于服药的，闻到药的气味，尝到药的味道，就可以觉察是否合适及其优劣，根本不需要等到药进入腹中才知道。唯独怜悯那些无识无知的人，只知道看见药就吃，而不知道药之所以为药的道理；只知道看见医生就求医，而不知道医生之所以为医生的道理，这也太可悲了。
1. Contemporary physicians, when treating diseases, only know how to observe the branch manifestations (Biao, secondary symptoms or superficial aspects) but do not know how to investigate the root cause (Ben, primary etiology or fundamental condition), and often use "branch and root" as an excuse. They say: "When the condition is urgent, treat the branch; when it is slow, treat the root." How can this be said to understand the meaning of "seeking the root" in the *Huangdi Neijing* (Yellow Emperor's Inner Canon)? Thus, they only see the urgency in the disease itself, while completely failing to realize that the urgency lies in preserving life. Which aspect should be considered slow? Which should be urgent? Which requires immediate attention today, and which requires even more urgent attention tomorrow? Since they do not understand the distinction between urgency and slowness, they often lead to mutual misinterpretation, making any discussion of branch and root moot!
2. Stroke syndromes are entirely caused by internal injury, with no external contraction involved. Since there is no external contraction, dispersing methods must absolutely not be used. If wind-treating medicines are overused, mild cases will inevitably become severe, and severe cases will die quickly.
3. The treatment of Shanghan (Cold Damage) hinges entirely on the concepts of Excess (Shi) and Deficiency (Xu). Excess patterns are easy to treat, while deficiency patterns are difficult. This is because the patient's Yuan Qi (Original Qi) is originally deficient, making it difficult for pathogenic factors to be resolved. When treating Shanghan complicated by deficiency, if one does not employ methods to support the healthy qi and expel pathogens, but only knows how to attack the pathogen, the more one attacks, the more deficient the qi becomes; the more deficient the qi, the more inevitable death becomes. In cases of extreme deficiency, even slight tonification may be of little benefit, and those who focus solely on treating the branch will certainly die.
4. Yang Meridian diseases in Shanghan are different from Yang Syndromes. A Yang Meridian disease refers to pathogens located at the exterior; a Yang Syndrome refers to heat located in the interior. If there are no pulse signs or symptoms of interior excess heat, yet one treats a Yang Meridian disease as a Yang Syndrome and recklessly uses cold-cooling medicines to treat fire, causing exterior and interior pathogens to combine and become intractable, such patients will certainly die.
5. The onset of dysentery occurs most easily in individuals with weak Spleen and Kidney. It results from indulging in cold foods due to heat, thereby damaging Zang-Fu Qi. This is a disease caused by human behavior, not by seasonal climate. Current practitioners of dysentery only know how to treat the heat of the season, but fail to address the cold induced by human habits. Why is this so? Moreover, dysentery often occurs in late autumn. At this time, the summer heat has dissipated, so one cannot rigidly adhere to the theory of heat toxicity. As autumn coolness arrives, how can one bear to recklessly use cold-cooling medicines? Such practitioners, ignorant of both human factors and seasonal changes, are far off the mark. There is no harm greater than this. One should ponder my words carefully.
6. Children's Blood and Qi are not yet fully developed, akin to the tender shoots and sepals of seedlings. Once injured, they invariably wither. Therefore, daily cultivation and nourishment are most appropriate; one must not recklessly use digestive-promoting and stagnation-resolving methods. If there is indeed food stagnation causing distension and pain, temporary digestion promotion is suitable. If there is indeed Wind-Cold causing fever, temporary dispersal is suitable. If there is indeed Excess Heat, Phlegm, and Fire, temporary clearing is suitable. These are situations where treating the branch is unavoidable. Outside of these, if there are no acute emergency branch symptoms, but rather frequent appearances of sallow complexion, emaciation, abdominal distension with slight fever, loose stools, fatigue, etc., these are all due to Spleen and Kidney insufficiency and weak Blood and Qi. However, contemporary physicians seeing these merely attribute them to food accumulation and Phlegm-Fire, knowing only to use digestion promotion and even more cooling methods. Day after day, they deplete and erode, causing Yuan Qi to diminish daily. When encountering other illnesses later, the body will be unable to sustain itself. This is a major malpractice in pediatric practice, which must not go unnoticed.
7. Fever during chickenpox or smallpox eruption in children is a normal sign. Without fever, toxins cannot be expelled. The power of this steaming heat is the power of Yuan Qi. From eruption to suppuration, from scabbing to healing, all rely on this heat power as the main driver. This is indeed the vital spirit of the eruption process, indispensable and beyond doubt. Only when the heat is severe and the toxin is heavy is it necessary to clear fire to resolve the toxin. However, this is only applicable when there are true internal heat pulse and symptom signs, allowing for cooling treatment. This applies to only one or two out of dozens of cases. If there is no internal heat, but only external heat, this is the normal sign of the eruption and must not be treated by attacking heat, which would drain the power of Yuan Qi and damage the source of Spleen and Kidney. Regrettably, modern dermatologists specializing in eruptions know nothing of this. Upon seeing fever, regardless of Excess or Deficiency, they immediately speak of detoxification and act with cooling medicines. This often damages the Spleen, leading to reduced appetite, and causes diarrhea upon scabbing, resulting in death. These are common occurrences. This error is most frequent and must not go unnoticed.
8. If pustules do not rise, and this is due to overwhelming toxins preventing eruption, this is a hopeless condition and need not be treated. If there are no other critical signs but the pustules do not rise, it is generally due to insufficient Yuan Qi. By tonifying Blood and Qi, eruption will occur without exception. Recently, I have seen specialists in eruptions, upon encountering this condition, mostly using toxic substances like silkworms or pangolin scales to force eruption. Observers regard this as a miraculous effect, unaware that eruption not rooted in the foundation harms Yuan Qi through excessive depletion, leading to internal exhaustion. Using this to mislead people is something one should deeply reflect upon.
9. Menstrual stagnation and retrogression, or delayed menstruation, are always due to insufficiency of the Chong and Ren vessels. If one does not cultivate Blood and Qi, but only knows how to unblock meridians and drive out stasis, Blood will dry up daily, leading to conditions such as metrorrhagia and blood exhaustion, without limit.
10. Injuries caused by emotional desires often manifest as hematemesis, hemorrhage, or intermittent fever. These are diseases of damaged True Yin. If one only knows how to treat fire without nourishing Yin, Yin will consume away daily, eventually forming Laozai (consumptive tuberculosis/chronic wasting syndrome).
11. Phlegm syndromes must have a cause. Phlegm itself does not cause disease; rather, disease generates phlegm. If one only knows how to treat phlegm without understanding its origin, phlegm will worsen, and there will be no way to eliminate it.
12. Abdominal distension and fullness are primarily related to the Spleen and Stomach. Although the Spleen and Stomach may be deficient, distension does not necessarily follow immediately. If one only knows how to promote digestion, Middle Qi will become more deficient, and distension will worsen daily.
13. Qi stagnation and chest obstruction are primarily due to Spleen deficiency failing to transport, leading to retention. If one does not nourish the Spleen but only knows how to break Qi stagnation, the Qi pathway will gradually decline, eventually forming Yige (dysphagia/esophageal obstruction) diseases.
14. Short, scanty, and red urine is common in individuals suffering from fatigue, Qi deficiency, and Yin deficiency. If these are uniformly treated as Fire and exclusively using cold-cooling medicines, the resulting complications will be unpredictable.
15. A deficient pulse with heat symptoms is not genuine Fire. If treated as Heat and cold-cooling medicines are used indiscriminately, mild cases will become severe, and severe cases will result in death.
16. If the disease is fundamentally a major deficiency but treated with slight tonification, the medicinal strength will not reach the pathology, providing no benefit. If one suspects this is an error and switches to draining/purging methods, death will ensue.
17. Diseases have urgency, and effects have speed. If one seeks rapid results for a chronic condition, one inevitably changes doctors frequently. Frequent doctor changes mean few competent physicians and many mediocre ones. The few cannot overcome the many, and the matter will surely fail.
18. Physicians must be selected for their virtue and competence, especially in critical moments, one must not be casual. Encountering petty characters who arrogantly defend their own views and overturn others' diagnoses is unfortunate; they often confuse right and wrong, posing significant risks to life.
19. The Classic states: "A Renying pulse that is large and firm indicates injury by Cold; a Qikou pulse that is firm and large indicates injury by food." This originally referred to the Maiyang and Taiyin meridians to distinguish exterior and interior. However, Wang Shuhe identified the left side as Renying and the right as Qikou, leading later generations to differentiate external contractions by the left pulse and internal injuries by the right pulse. Does the left have no internal injury, nor the right any external contraction? This is a great fallacy! A great fallacy!
20. The Classic states: "Diseases arising internally should first be treated by addressing Yin, then Yang; reversing this order exacerbates the condition. Diseases arising externally should first be treated by addressing the Exterior, then Interior; reversing this order exacerbates the condition."
21. Patients skilled in taking medicine can judge the suitability and quality of prescriptions by smell and taste, without needing to ingest them first. It is pitiable that ignorant people, knowing only to take medicine when they see it without understanding the nature of medicine, and seeking doctors when they see them without understanding the essence of medical practice, are truly lamentable.