瘟疫一症，感邪疠之毒十之六，感温热之毒十之四，故用黄连解毒等汤。不唯在表时服之，
寒凝血滞，厥疾不瘳。即邪热内传，应服凉药，余往往不用黄连。不过生地、丹皮、二冬、元参、
银花、童便，极数用石膏、栀子、黄芩而止，无不奏效。故吴又可戒用寒剂而专用大黄，亦未可
为非。盖大黄虽寒，其性走而不守，当瘟疫胶固之时，得此一番推荡，邪便解散，较纯用寒凉者
固胜一筹。但邪未入腑而辄用之，既不能解在经之邪，徒受寒中破腹之患，其害有不可胜言者。
又可之用大黄虽不孟浪至是，但宜下诸症未免偏于攻击，全忘下不厌迟之说。□□□□□□□
□□若不善师又可而举手即用大黄，反引又可为证，则又为又可之罪人矣！
《活人》云∶一岁之中，病无长幼，率相似。此则时行之气，俗谓之天行是也。老君神明散、
务成子萤火丸、圣散子、败毒散，不拘日数浅深，吐下随症施行，所以圣散子不问阴阳表里也。
语云∶用古方治今病，譬如拆旧料盖新房，不再经匠氏之手，岂可用乎？旨哉斯言，洵堪为
医学用药之准矣。夫古今之元气不同，观汉人之处方，动以两计，宋元而降，不过钱计而已。以
汉人之方，治今人之病，吾知其过于峻重，以今人之方，治汉人之病，吾知其不及病情。此处方
分两之未可泥也。至于用药之权衡，则又不得以漫投者，盖四方之风土不齐，群伦之老少各异，
天道之寒暄无定，南北之燥湿顿殊。人在气交之中，或偏于阳，或偏于阴，或有时而壮旺，或
有时而虚怯，即一人之身，一日之际，内伤七情，外感六气，其病情之出没隐现，真有若云龙
之不可方物者。若必执一方，以应无穷之变也，有是理乎？《活人》以老君神明散、东坡圣散子
为治疫疠之的方，不拘日数之浅深，病症之吐下，亦不问阴阳表里，便率尔
妄投，其不杀人如麻者鲜矣！盖二方中用乌、附、吴萸毒热之品，阴寒直中者，服之庶或无过。
若伤寒传经热症，以及瘟疫、瘟毒正宜用芩、连、大黄之时，若投此汤，入口必毙。神明散用绢
袋盛带，以此外治，不服食尚不能为害，至于圣散子则煎服之药，是断断乎不可用者。此方药味
乱杂，即真阴寒症用之亦恐未能获效也。后世因过信苏长公，随奉为良剂，甘就死地。噫！抑何
其为东坡之名之所震，以至于此哉？以及神明散不过平人所制，假以李、苏之名，以眩人之耳目，
好异者遂深信而不疑者。若必谓是方出自李、苏，则张景岳新方八阵中王母桃一品，岂真瑶池仙
府之所垂乎？吾愿世之业医者不可拘于一定之方，亦不可执其一偏之见，变动不拘，权衡有准，
则于岐黄一道思过半矣。
瘟疫这一病症，有十分之六是由于感受了疫疠的毒气，有十分之四是由于感受了温热的毒气，因此使用黄连解毒汤等方剂。不仅是在邪气在体表时服用，（若）寒邪凝滞血脉、气血运行不畅，导致顽固的疾病不愈。即使邪热内传脏腑，应当服用凉性药物，我往往不使用黄连。不过使用生地、丹皮、天冬、麦冬、玄参、金银花、童便，最多用到石膏、栀子、黄芩为止，没有不奏效的。所以吴又可告诫不要使用寒凉药剂而专门使用大黄，这也并非不可。因为大黄虽然性寒，但其药性走窜而不固守，当瘟疫病邪胶结固着的时候，借助大黄的推荡作用，邪气便能解散，这比单纯使用寒凉药物的确要高明一筹。但是，如果邪气尚未传入腑脏就贸然使用大黄，既不能解除在经络中的邪气，反而会导致寒邪中伤脾胃、损伤腹部的祸患，其危害有说不尽的。吴又可使用大黄虽然不至于如此鲁莽，但在适宜攻下的各种症状上未免偏重于攻击，完全忘记了“下法不宜过早”的说法。□□□□□□□ □□如果不善于学习吴又可的方法，而是举手就用大黄，反而引用吴又可作为证据，那就成了吴又可的罪人了！
《活人书》说：一年之中，患病的人不分老少，症状大致相似。这就是时行之气，俗称天行疫病。老君神明散、务成子萤火丸、圣散子、败毒散，不拘泥于发病日数的深浅，根据症状采用催吐或攻下的方法施治，所以圣散子不问是阴证还是阳证、表证还是里证。（有人）说：用古方治疗今天的疾病，就像拆旧房子的材料去盖新房，如果不经过工匠之手重新加工，怎么可以用呢？这话很有深意，确实可以作为医学用药的标准。古今人的元气不同，看汉代人的处方，动不动就用“两”来计算重量，宋代、元代以后，不过用“钱”来计算而已。用汉代人的方子治疗今天人的病，我知道会过于峻猛沉重；用今天人的方子治疗汉代人的病，我知道又不足以符合病情。这里处方的分量是不可拘泥的。至于用药的权衡，又不能随意乱投，因为四方的风土气候不齐，人群的年龄各异，天道的寒暖无常，南北的燥湿截然不同。人生活在天地气交之中，有的偏于阳，有的偏于阴，有时身体壮旺，有时身体虚怯，就是同一个人，在一天的时间里，内伤七情，外感六气，其病情的出没隐现，真像云龙一样不可捉摸。如果一定要执着于一个方子，来应对无穷的变化，有这样的道理吗？《活人书》把老君神明散、东坡圣散子当作治疗疫疠的确切方子，不拘泥于发病日数的深浅，病症是否需要吐下，也不问阴阳表里，就轻率地妄加投用，这样不杀人如麻的情况是很少见的！因为这两个方子中使用了乌头、附子、吴茱萸等毒性热性的药物，只有对于阴寒之邪直中脏腑的患者，服用或许没有过错。如果是伤寒传经的热症，以及瘟疫、瘟毒正适宜使用黄芩、黄连、大黄的时候，如果投用这个汤药，入口必死。神明散用绢袋盛装佩戴，以此作为外治法，不服食尚且不能造成危害，至于圣散子是煎服的药物，是绝对不可以使用的。这个方子的药味杂乱无章，即使是真正的阴寒症使用它，也恐怕不能获得疗效。后世因为过分相信苏东坡，随即奉为良剂，甘愿走向死亡之地。唉！为什么会被苏东坡的名声所震慑，以至于到了这种地步呢？至于神明散不过是普通人制作的，假借李、苏的名字，来迷惑人们的耳目，喜好新奇的人于是深信不疑。如果一定要说这些方子出自李、苏二人，那么张景岳新方八阵中的王母桃一品，难道是真正来自瑶池仙府赐予的吗？我希望世上的行医者不要拘泥于固定的方子，也不要执着于一偏之见，变动不拘，权衡得当，那么在岐黄医术之道上就思过半了。
Plague (Yi Wen) is a condition where 60% of cases are caused by contracting the toxic qi of epidemic pathogens (Yi Li), and 40% by contracting the toxic heat of warm pathogens (Wen Re); therefore, formulas such as Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) are used. This applies not only when the pathogen is in the exterior, but also when cold coagulates blood and stagnates flow, leading to stubborn diseases that do not heal. Even when pathogenic heat transmits inward to the interior, requiring cooling medicines, I often avoid using Huanglian (Coptidis Rhizoma). Instead, I use Shengdi (Rehmanniae Radix Preparata), Danpi (Moutan Cortex), Dong Tian (Asparagi Radix), Dong Bai (Lili Bulbus), Yuan Shen (Scrophulariae Radix), Yinhua (Lonicerae Flos), and Tong Bian (Infant Urine), rarely exceeding the use of Shigao (Gypsum Fibrosum), Zhizi (Gardeniae Fructus), and Huangqin (Scutellariae Radix), with no failure in efficacy. Thus, Wu Keyou’s warning against using cold agents and his exclusive use of Dahuang (Rhei Radix et Rhizoma) cannot be entirely dismissed. Although Dahuang is cold in nature, its action is mobile rather than static; when plague pathogens are firmly entrenched, this purgative action can disperse the pathogen, proving superior to the pure use of cold-cooling herbs. However, if Dahuang is used prematurely before the pathogen enters the Fu organs, it fails to resolve the pathogen in the Jing meridians and instead causes harm from cold injuring the middle and damaging the abdomen, with consequences too numerous to mention. While Wu Keyou’s use of Dahuang was not so reckless, his approach to indications for purgation was somewhat biased towards attack, completely forgetting the principle that "purgation should not be applied too early." □□□□□□□ □□ If one does not learn properly from Wu Keyou but rashly uses Dahuang at every turn, citing him as justification, one becomes a sinner against Wu Keyou!
The *Qianjin Fang* (actually referring to *Baihuo Lu*, often associated with Zhao Kuangzhi's *Nanbing Huowren Lun*) states: "Throughout the year, illness affects all ages similarly." This refers to the seasonal epidemic qi, commonly known as Tian Xing (Heavenly Transmission). Laojun Shenming San (Old Lord's Divine Spirit Powder), Wuchengzi Yinghuo Wan (Wuchengzi's Firefly Pill), Shengsan Zi (Holy Dispersion Powder), and Baidu San (Deficiency-Dispelling Powder) can be used regardless of the duration of the disease; emesis or purgation is applied according to symptoms. Hence, Shengsan Zi is used without distinguishing between Yin/Yang or Exterior/Interior patterns. It is said: "Using ancient formulas to treat modern diseases is like dismantling old materials to build a new house; without reworking them by craftsmen, how can they be used?" This statement is profound and truly serves as a standard for medical medication. The primordial qi of ancient and modern times differs; observing Han dynasty prescriptions, dosages were often measured in *liang* (taels), whereas Song and Yuan dynasties reduced this to *qian* (mace). Using Han formulas to treat modern patients would likely be too harsh and heavy; using modern formulas to treat Han patients would likely be insufficient. Therefore, dosage weights in prescriptions should not be rigidly adhered to. Regarding the weighing of medicinal properties, one must not prescribe randomly, as wind and soil vary across regions, populations differ in age, climatic changes are unpredictable, and dryness/dampness differs between North and South. Humans exist within the intersection of Qi; some lean Yang, some Yin; sometimes robust, sometimes deficient. Even within one person, over one day, internal injury from Seven Emotions and external contraction of Six Evils make the manifestation of disease elusive, like clouds and dragons. To insist on a single formula to address infinite variations—would this be logical? *Huoren Lun* regards Laojun Shenming San and Dongpo Shengsan Zi as specific remedies for plague, ignoring the depth of days, need for emesis/purgation, and Yin/Yang or Exterior/Interior distinctions, prescribing them rashly. Few escape killing many people! These two formulas contain toxic hot substances like Wutou (Aconiti Lateralis Radix Praeparata), Fuzi (Aconiti Lateralis Radix Preparata), and Wuyu (Evodiae Fructus); they might be harmless only for direct invasion of Yin-Cold. For Shanghan transmitted heat patterns, or plague/toxic plague requiring Huangqin, Huanglian, and Dahuang, administering these decoctions would be fatal upon entry. Shenming San is carried in silk bags for external use; even then, ingestion is harmful. Shengsan Zi is a decoction for internal use and is absolutely contraindicated. Its ingredients are chaotic; even for true Yin-Cold patterns, efficacy is doubtful. Later generations, overly trusting Su Dongpo, revered it as a good remedy, willingly heading toward death. Alas! How could one be so shocked by Su Dongpo's fame to this extent? As for Shenming San, it was merely made by ordinary people, falsely attributed to Li and Su to dazzle the public; those fond of novelty believed it unquestioningly. If one insists these formulas originated from Li and Su, then Wangmu Tao (Queen Mother's Peach) in Zhang Jingyue's *Xin Fang Ba Zhen*—was it truly bestowed from the Jade Pool Immortal Mansion? I wish physicians today would not adhere to fixed formulas nor hold biased views, but remain flexible and balanced, thus mastering more than half of the art of Qi Bo and Huang Di.