徐东皋曰∶百凡治病，胃气实者，攻之则去，而疾恒易愈。胃气虚者，攻之不去。盖以
本虚，攻之则胃气益弱，反不能行其药力，而病所以自如也。非药不能去病，亦以主气不行
药力故也。若峻攻之，则元气伤而病益甚，若不知机，攻尽元气则死矣。如虚热者，服寒凉
之药而热反甚何也？经曰∶服寒而反热者，奈何？岐伯曰∶治其王气，是以反也。若胃气不虚
，虽有病者，不攻自愈，故中医用药亦常效焉。观夫藜藿野人之病，尝不药自愈可知矣。故
曰∶治病不察脾胃之虚实，不足以为太医。
又曰∶汉张仲景着《伤寒论》，专以外伤为法，其中顾盼脾胃元气之秘，世医鲜有知之
者。观其少阳证，小柴胡汤用人参，则防邪气之入三阴，或恐脾胃稍虚，邪乘而入，必用人
参、甘草，固脾胃以充元气，是外伤未尝忘内因也。至于阳毒升麻汤、人参败毒散、化斑汤
、黄连汤、白通汤、理中汤、炙甘草汤、橘皮汤、五味子汤、栝蒌根汤、建中汤等，未尝不
用参 以治外感，可见仲景公之立方，神化莫测。或者只以外伤是其所长，而内伤非所知也
，此诚不知公者也。何今世之医不识元气之旨，惟见王纶《杂着》戒用人参之谬说，执泥不
移，乐用苦寒攻病之标，致误苍生，死于非命，抑何限耶！间有病家疑信相半，两勿之从，
亦但不速其死耳，直以因循，俟其元气自尽，终莫之救而致毙者，可谓知乎。况斯世斯时，
人物剧繁，禀气益薄，兼之劳役名利之场，甚至蹈水火而不知恤，耽酒色以竭其真，不谓内
伤元气，吾弗信也。观其杂病稍用攻击，而脾胃遂伤，甚则绝谷而死者，皆可类推矣。
徐东皋说：大凡治疗疾病，胃气充实的人，使用攻邪法病邪就能去除，疾病往往容易痊愈。胃气虚弱的人，使用攻邪法病邪却去不掉。这是因为根本已经虚损，再攻伐则胃气更加衰弱，反而不能推动药力发挥作用，所以疾病依然如故。并不是药物不能去除病邪，而是因为主气（脾胃之气）不运行，导致药力无法发挥。如果猛烈攻伐，就会损伤元气，使病情更加严重；如果不识时机，将元气攻尽，人就会死亡。比如虚热证，服用寒凉药物后发热反而加重，为什么呢？《内经》说：服用寒药后发热反而加重，这是怎么回事？岐伯说：这是因为只治疗了亢盛的邪气（王气），而没有顾护正气，所以出现反常现象。如果胃气不虚，即使有病，不经过攻伐也能自愈，所以中医用药也常常见效。看那些吃粗茶淡饭的平民百姓生病，常常不吃药也能自愈，由此可知。所以说：治病如果不考察脾胃的虚实情况，不足以称为优秀的医生。
又说：汉代张仲景撰写《伤寒论》，专门以外感病为法则，其中关于顾护脾胃元气的奥秘，世间医生很少有人知道。看他的少阳证治疗，小柴胡汤中用人参，是为了防止邪气侵入三阴经，或者是担心脾胃稍微虚弱，邪气乘虚而入，必须用人参、甘草来固护脾胃以充实元气，这说明外感病治疗也未尝忘记内因。至于像升麻汤治阳毒、人参败毒散、化斑汤、黄连汤、白通汤、理中汤、炙甘草汤、橘皮汤、五味子汤、栝蒌根汤、建中汤等方剂，未尝不用人参来治疗外感病，可见张仲景先生创立方剂，变化神奇，难以测度。或许有人认为他只擅长外感病，而不了解内伤病，这确实是不了解张先生的人啊。为什么现在的医生不懂得元气的宗旨，只是看到明代王纶《杂著》中禁止使用人参的错误说法，固执不移，乐于使用苦寒药物攻伐病邪的表面症状，导致误害百姓，死于非命，这种情况难道还少吗？间或有病人家属对医生半信半疑，两边都不听从，也只是没有加速死亡罢了，直接因为拖延，等待元气耗尽，最终无法救治而致死，这能说是明智的吗？况且当今世界人口众多，人的禀赋越来越薄弱，加上在名利场中劳役奔波，甚至不顾水火危险，沉溺酒色以耗尽真元，如果不认为这是内伤元气，我是不相信的。看那些杂病患者稍微用一点攻伐药物，脾胃就受伤，甚至绝食而死的，都可以由此类推了。
Xu Donggao said: In general, when treating diseases, if the Stomach Qi (Stomach Energy) is substantial, attacking pathogens will eliminate them, and the disease is often easily cured. If the Stomach Qi is deficient, attacking pathogens will not remove them. This is because the root is already deficient; further attack weakens the Stomach Qi even more, rendering it unable to transport and transform the medicinal power, so the disease remains unchanged. It is not that the medicine cannot remove the disease, but rather that the governing Qi fails to move the medicinal efficacy. If one attacks violently, the Original Qi (Yuan Qi) will be damaged, and the disease will become more severe. If one fails to recognize the appropriate timing and exhausts the Original Qi through attack, death will ensue. For example, in cases of deficiency-heat, why does heat worsen after taking cold-cooling medicines? The Classic says: "Why does heat worsen after taking cold medicines?" Qibo replied: "This occurs because only the Wang Qi (Exuberant Pathogenic Qi) was treated, leading to a counter-effect." If the Stomach Qi is not deficient, even if there is disease, it may heal spontaneously without attack, which is why Chinese medicine using herbs often achieves effectiveness. Observing that common people who eat simple food often recover from illness without medication confirms this. Therefore, it is said: "One who treats diseases without examining the deficiency or excess of the Spleen and Stomach is not qualified to be a great physician."
He also said: Zhang Zhongjing of the Han Dynasty wrote *Treatise on Cold Damage Disorders* (*Shanghan Lun*), focusing specifically on external injury (exogenous pathogens). However, the secret of caring for the Spleen and Stomach's Original Qi within his work is rarely known by physicians of later generations. Looking at his Shaoyang syndrome (Lesser Yang Syndrome), the use of Ginseng Radix et Rhizoma (Renshen, 人参) in Xiao Chai Hu Tang (Minor Bupleurum Decoction) is to prevent pathogenic factors from entering the Three Yin channels, or perhaps fearing slight Spleen and Stomach deficiency allowing pathogens to invade. Thus, Ginseng Radix et Rhizoma (Renshen, 人参) and Licorice Root (Gancao, 甘草) are used to consolidate the Spleen and Stomach and replenish the Original Qi. This shows that even in treating external injuries, internal causes were never forgotten. As for formulas such as Shengma Decoction for Yang Toxicity, Renshen Baidu San (Ginseng Powder to Rescue from Disaster), Hua Ban Tang (Spot-Resolving Decoction), Huanglian Tang (Coptis Decoction), Baitong Tang, Lizhong Tang (Regulate the Middle Decoction), Zhi Gancao Tang (Honey-Fried Licorice Decoction), Jupi Tang (Tangerine Peel Decoction), Wuweizi Tang (Schisandra Decoction), Gualou Gen Tang (Trichosanthes Root Decoction), and Jianzhong Tang (Establish the Middle Decoction), none failed to use Ginseng Radix et Rhizoma (Renshen, 人参) to treat exogenous conditions. This demonstrates that Master Zhongjing’s formulation of prescriptions was divine and unfathomable. Some might claim he only excelled in external injuries and did not understand internal injuries; this truly reflects a lack of understanding of him. Why do physicians today fail to grasp the principle of Original Qi? They merely adhere to the erroneous doctrine in Wang Lun’s *Miscellaneous Writings* (*Zazhu*) prohibiting the use of Ginseng Radix et Rhizoma (Renshen, 人参), sticking rigidly to this view. They prefer using bitter-cold herbs to attack the superficial symptoms of disease, thereby harming the populace and causing untimely deaths. How widespread is this! Occasionally, patients’ families are half-doubting and half-believing, refusing to follow either doctor, which merely delays death rather than accelerating it. Directly due to procrastination, waiting until the Original Qi is exhausted, they ultimately die without rescue. Can this be considered wise? Moreover, in this era, with the population growing rapidly and innate constitution becoming thinner, combined with labor and struggle for fame and profit, even disregarding dangers of fire and water, indulging in alcohol and lust to deplete true essence—if one does not believe this leads to internal injury of the Original Qi, I would not believe it. Observing that patients with miscellaneous diseases suffer Spleen and Stomach damage even with slight use of attacking methods, and some even die from inability to eat, all can be inferred from this.