人生至六十、七十以后，精血俱耗，平居无事，已有热证。何者？头昏，目眵，肌痒，溺数，鼻涕，牙落，涎多，
寐少，足弱，耳聩，健忘，眩运，肠燥，面垢，发脱，眼花，久坐兀睡，未风先寒，食则易饥，笑则有泪，但是老境，
无不有此。或曰∶《局方》乌附丹剂，多与老人为宜，岂非以其年老气弱不虚，理宜温补，今子皆以为热，乌附丹剂将不
可施之老人耶？余晓之曰∶奚止乌附丹剂不可妄用，至于好酒腻肉，湿面油汁，烧炙煨炒，辛辣甜滑，皆在所忌。或曰∶
子何愚之甚耶？甘旨养老，经训具在。为子为妇，甘旨不及，孝道便亏。而吾子之言若是，其将有说以通之乎？愿闻其
略。予愀然应之曰∶正所谓道并行而不悖者，请详言之。古者井田之法行，乡闾之教兴，人知礼让，比屋可封。肉食不
及幼壮，五十才方食肉。强壮恣饕，比及五十，疾已蜂起。气耗血竭，筋柔骨痿，肠胃壅阏，涎沫充溢，而况人身之阴
难成易亏。六、七十后阴不足以配阳，孤阳几欲飞越，因天生胃气尚尔留连，又藉水谷之阴，故羁縻而定耳！所陈前证，
皆是血少。《内经》曰∶肾恶燥。乌附丹剂，非燥而何？夫血少之人，若防风、半夏、苍术、香附，但是燥剂且不敢多，
况乌附丹剂乎？或者又曰∶一部《局方》，悉是温热养阳，吾子之言无乃谬妄乎？予曰∶《局方》用燥剂，为劫湿病也。
湿得燥则豁然而收。《局方》用暖剂，为劫虚病也。补肾不如补脾，脾得温则易化而食味进，下虽暂虚，亦可少回。《内
经》治法，亦许用劫，正是此意。盖为质浓而病浅者设。此亦儒者用权之意。若以为经常之法，岂不大误！彼老年之人，
质虽浓，此时亦近乎薄，病虽浅，其本亦易以拨，而可以劫药取速效乎？若夫形肥者血少，形瘦者气实，间或可用劫药
者，设或失手，何以取救？吾宁稍迟，计出万全，岂不美乎？乌附丹剂其不可轻饵也明矣。至于饮食，尤当谨节。夫老
人内虚脾弱，阴亏性急。内虚胃热则易饥而思食，脾弱难化则食已而再饱，阴虚难降则气郁而成痰，至于视听言动，皆
成废懒。百不如意，怒火易炽。虽有孝子顺孙，亦是动辄扼腕。况未必孝顺乎！所以物性之热者，炭火制作者，气之香
辣者，味之甘腻者，其不可食也明矣。虽然肠胃坚浓，福气深壮者，世俗观之，何妨奉养，纵口固快一时，积久必为灾
害。由是观之，多不如少，少不如绝，爽口作疾，浓味措毒，前哲格言，犹在人耳，可不慎欤！或曰∶如子之言，殆将
绝而不与于汝安乎？予曰∶君子爱人以德，小人爱人以姑息。况施于所尊者哉！惟饮与食将以养生，不以致疾。若以所
养转为所害，恐非君子之所谓孝与敬也。然则如之何则可？曰∶好生恶死，好安恶病，人之常情。为子为孙，必先开之
以义理，晓之以物性，旁譬曲喻，陈说利害，意诚辞确，一切以敬慎行之，又次以身先之，必将有所感悟而无捍格之逆
矣。吾子所谓绝而不与，施于有病之时，尤是孝道。若无病之时，量酌可否，以时而进。某物不食，某物代之，又何伤
于孝道乎？若夫平居闭话，素无开导诱掖之言，及至饥肠已鸣，馋涎已动，饮食在前，馨香扑鼻，其可禁乎？经曰∶以
饮食忠养之。“忠”之一字，恐与此意合，请勿易看过，予事老母，固有愧于古者，然母年逾七旬，素多痰饮，至此不作。
节养有道，自谓有术。只因大便燥结时，以新牛乳、猪脂和糜粥中进之，虽以临时滑利，终是腻物积多。次年夏时，郁
为粘痰，发为胁疮。连日作楚，寐兴陨获。为之子者，置身无地，因此苦思而得节养之说。时进参、术等补胃、补血之
药，随天令加减，遂得大腑不燥，面色莹洁，虽觉瘦弱，终是无病。老境得安，职此之由也。因成一方，用参、术为君，
牛膝、芍药为臣，陈皮、茯苓为佐。春加川芎；夏加五味、黄芩、麦门冬；冬加当归身，倍生姜。一日或一帖或二帖，
听其小水才觉短少，便进此药。小水之长如旧，即是却病 法。后到东阳，因闻老何安人性聪敏，七十以后稍觉不快，
便却粥数日，单进人参汤数帖而止。后九十余无疾而卒。以其偶同，故笔之以求是正。
人到六十岁、七十岁以后，精气和血液都已消耗，平时即使没有生病，体内也已有热证的表现。为什么呢？头昏沉，眼屎多，皮肤瘙痒，小便频数，流鼻涕，牙齿脱落，口水增多，睡眠少，脚部无力，耳聋，健忘，眩晕，肠道干燥，面部油腻污垢，头发脱落，眼花，久坐后突然打瞌睡，还没吹风就觉得冷，吃东西容易饿，笑的时候流出眼泪，凡是进入老年阶段的人，没有不出现这些症状的。
有人问：《太平惠民和剂局方》中的乌头、附子及丹砂制剂，大多适合老人服用，难道不是因为老人年老气弱但不虚损吗？按理应该温补，现在您却认为都是热证，那么乌头、附子和丹砂制剂就不能给老人使用了吗？我开导他说：何止是乌头、附子和丹砂制剂不能乱用，至于喜欢喝酒、吃肥腻肉类、湿面、油汁，以及烧烤、煨炒、辛辣、甜滑的食物，都在禁忌之列。
有人问：您怎么这么愚笨呢？用甘甜美味来养老，经典训诫里写得清清楚楚。作为子女或儿媳，如果不能提供甘甜美食，孝道就亏损了。而您的话却是这样，难道有什么说法可以通融解释吗？希望能听听您的简略观点。我神色庄重地回答：这正是所谓“道并行而不悖”的道理，请让我详细说说。
古代井田制实行时，乡里的教化兴起，人们懂得礼让，家家户户都可以受到封赏（指德行高尚）。肉食不给幼年和壮年人吃，要到五十岁才开始吃肉。强壮之人放纵食欲，等到五十岁时，疾病已经蜂拥而起。此时气耗血竭，筋骨柔弱萎软，肠胃壅塞阻滞，涎沫充满溢出，更何况人体的阴精难成而易亏。到了六、七十岁，阴气不足以制约阳气，孤阳几乎要飞越散失，因为天生的胃气还暂时留存，又借助水谷之阴的滋养，所以才能羁留安定下来！前面陈述的那些症状，都是因为血少所致。《内经》说：肾恶燥。乌头、附子及丹砂制剂，难道不是燥烈的吗？对于血少的人，像防风、半夏、苍术、香附这类燥性药物尚且不敢多用，何况是乌头、附子和丹砂制剂呢？
有人又说：整部《局方》，全是温热养阳的药物，您的话岂不是荒谬妄言吗？我说：《局方》使用燥剂，是为了攻伐湿病。湿气遇到燥性药就会豁然消散。《局方》使用暖剂，是为了攻伐虚病。补肾不如补脾，脾得到温煦就容易运化，食欲增进，虽然下焦暂时虚损，也可以稍微恢复。《内经》的治疗法则，也允许使用“劫法”，正是这个意思。这是为体质厚实而病情浅表的人设立的。这也是儒家学者运用权变的意思。如果把这当作常规的方法，岂不大大错误！那些老年人，体质虽然厚实，但此时也已经近乎薄弱；病情虽然浅表，其根本也容易动摇，可以用攻伐急效的药来取速效吗？
至于形体肥胖的人往往血少，形体消瘦的人往往气实，偶尔可以使用攻伐药，但如果失手，用什么来补救？我宁愿见效稍慢，但计谋出于万全，难道不好吗？乌头、附子和丹砂制剂不可轻易服用，这已经很明白了。至于饮食，更应当谨慎节制。老人内部虚弱、脾胃软弱，阴液亏损、性格急躁。内虚导致胃热则容易饥饿想吃东西，脾弱难以运化则吃完后又觉得饱胀，阴虚难以降敛则气机郁结而成痰，至于看、听、说、动，都变成废弛懒惰。百事不如意，怒火容易炽盛。虽然有孝顺的儿子和孙子，也是动不动就扼腕叹息。何况未必孝顺呢！所以性质热性的食物，炭火制作的食品，气味香辣的东西，味道甘腻的东西，显然不可食用。
虽然肠胃坚固厚实、福气深厚强壮的人，世俗看来，不妨奉养，纵容口腹之欲确实痛快一时，但积久必然成为灾害。由此看来，多吃不如少吃，少吃不如绝食，爽口之物致病，浓味之物如毒，前代哲人的格言犹在耳边，能不谨慎吗？有人问：按您的说法，大概是要断绝饮食而不让您安心吗？我说：君子以品德爱人，小人以姑息迁就爱人。何况是对尊长施加关爱呢！饮食旨在养生，而不是致病。如果把所养的变成了所害的，恐怕就不是君子所说的孝与敬了。
那么该怎么做才好呢？回答说：好生恶死，好安恶病，是人之常情。作为子女孙辈，必须先以义理开导他们，用物性知识晓谕他们，旁敲侧击地比喻，陈述利害，心意真诚、言辞确切，一切以恭敬谨慎的态度去执行，其次以身作则，必将有所感悟而没有抵触逆反之心。您所说的“断绝饮食而不给予”，是在有病的时候尤其体现孝道。如果没有病的时候，斟酌可否，按时令进补。某种食物不吃，用另一种代替，对孝道又有什么伤害呢？如果在平时闭口不言，素无开导诱导的话，等到肚子饿了，馋虫动了，食物摆在面前，香气扑鼻，怎么能禁止呢？经书说：“以饮食忠养之。”“忠”这一个字，恐怕与此意相合，请不要轻易看过。我侍奉老母亲，自愧不如古人，然而母亲年过七十，素来多痰饮，到这时不再发作。节制调养有方法，自认为有诀窍。只是因为大便干燥结滞时，用新牛乳、猪脂混合糜粥中给她吃，虽然当时起到润滑作用，终究是腻物积累过多。次年夏天，郁结化为粘痰，引发胁部疮疡。连续几天痛苦不堪，睡觉醒来都感到失落沮丧。作为儿子，感到无处容身，因此苦思冥想得出节制调养的说法。时常进服人参、白术等补胃、补血之药，随四季时令加减，于是大腑不再干燥，面色光洁晶莹，虽然觉得瘦弱，最终无病。老年生活得以安宁，就是靠这个原因。因此制定一方，用人参、白术为君药，牛膝、芍药为臣药，陈皮、茯苓为佐药。春季加川芎；夏季加五味子、黄芩、麦门冬；冬季加当归身，加倍生姜。一天一帖或两帖，只要感觉小便刚觉短少，就进服此药。小便长度恢复正常，就是祛病之法。后来我到东阳，听说老何安人性聪敏，七十岁以后稍觉不适，便停粥数日，单进人参汤几帖便停止。后来九十多岁无疾而终。因为偶然相同，所以写下来以求指正。
When people reach the age of sixty or seventy, their Jing (Essence) and Blood are both depleted. Even in daily life without illness, there are already signs of Heat syndromes. Why is this? Symptoms include dizziness (Tou Hun), excessive eye discharge (Mu Chi), skin itching (Ji Yang), frequent urination (Niao Shu), runny nose (Bi Ti), tooth loss (Ya Luo), excessive saliva (Xian Duo), insomnia or reduced sleep (Mei Shao), weakness in the feet (Zhuo Ruo), deafness (Er Kui), forgetfulness (Jian Wang), vertigo (Xuan Yun), dry intestines (Chang Zao), greasy face (Mian Gou), hair loss (Fa Tuo), blurred vision (Yan Hua), sudden dozing after sitting for a long time (Jiu Zuo Wu Shui), feeling cold before exposure to wind (Wei Feng Xian Han), easy hunger after eating (Shi Ze Yi Ji), and tearing when laughing (Xiao Ze You Lei). Anyone entering old age will inevitably exhibit these symptoms.
Someone might ask: The preparations containing Aconitum carmichaelii (Wutou, 乌头), Aconitum kusnezoffii (Fuzi, 附子), and Cinnabar (Dansha, 丹砂) from the *Ju Fang* (Formulas of the Bureau of Medical Relief) are mostly suitable for the elderly. Is it not because the elderly have weak Qi but are not deficient, and thus should be treated with warming and tonifying methods? Now you claim they all present as Heat syndromes; does this mean Wutou, Fuzi, and Dansha preparations cannot be used for the elderly? I explained to him: It is not only that Wutou, Fuzi, and Dansha preparations should not be used recklessly, but also that preferences for alcohol, fatty meats, wet noodles, oily juices, roasted, baked, fried foods, spicy flavors, and sweet or slippery textures are all contraindicated.
Someone asked: How foolish you are! Providing delicious food to nourish the elderly is clearly stated in classical teachings. If children or daughters-in-law fail to provide such delicacies, their filial piety is compromised. Your words seem to contradict this; do you have an explanation to reconcile this? I replied solemnly: This is what is meant by "paths running parallel without conflict." Let me explain in detail. In ancient times, when the Well-field system was implemented, local education flourished, people understood propriety and courtesy, and every household could be recognized for virtue. Meat was not given to the young or strong; one began eating meat only at fifty. Strong individuals indulged in gluttony; by the time they reached fifty, diseases had arisen like swarms of insects. At this stage, Qi is exhausted and Blood is depleted, tendons become soft and bones frail, the stomach and intestines become obstructed, and saliva overflows. Moreover, the Yin of the human body is difficult to form and easy to lose. After sixty or seventy, Yin is insufficient to control Yang, leaving solitary Yang on the verge of flying away. Because the innate Stomach Qi still lingers, and relying on the Yin from food and drink, it remains anchored and stable! The symptoms mentioned earlier are all due to Blood deficiency. The *Neijing* states: "The Kidney dislikes dryness." Are Wutou, Fuzi, and Dansha preparations not drying? For those with Blood deficiency, even drying herbs like Saposhnikovia root (Fangfeng, 防风), Pinellia rhizome (Banxia, 半夏), Atractylodes macrocephala rhizome (Cangzhu, 苍术), and Cyperus rotundus rhizome (Xiangfu, 香附) should not be used in large doses, let alone Wutou, Fuzi, and Dansha preparations.
Another might say: The entire *Ju Fang* consists of warming and Yang-nourishing formulas. Are your words not absurd? I said: The *Ju Fang* uses drying agents to attack Dampness syndromes. When Dampness meets dryness, it dissipates. The *Ju Fang* uses warming agents to attack Deficiency syndromes. Tonifying the Spleen is better than tonifying the Kidney; when the Spleen is warmed, transformation becomes easier, appetite improves, and although the Lower Jiao may be temporarily deficient, it can recover slightly. The treatment principles in the *Neijing* also permit the use of "robust" or "attacking" methods, which is exactly this meaning. This is designed for those with thick constitutions and shallow diseases. This is also the Confucian concept of using expedients. If regarded as a standard method, would it not be a great error! Although the elderly may have thick constitutions, at this stage they are nearly thin; although diseases may be shallow, their root is easily disturbed. Can robust drugs be used to achieve quick effects? Those who are fat often have Blood deficiency, while those who are thin often have Qi excess. Occasionally, robust drugs may be used, but if mistakes are made, how can rescue be effected? I prefer slower results that are absolutely safe rather than risks. It is clear that Wutou, Fuzi, and Dansha preparations should not be taken lightly. Regarding diet, caution is especially necessary. The elderly have internal deficiency and weak Spleen, Yin deficiency and irritable temper. Internal deficiency leads to Stomach Heat, causing easy hunger and desire to eat; weak Spleen makes digestion difficult, leading to fullness after eating; Yin deficiency makes descending difficult, causing Qi stagnation and Phlegm formation. Vision, hearing, speech, and movement become sluggish. Everything goes against wishes, making anger flare up easily. Even with filial sons and grandsons, frustration is common, let alone those who are not filial! Therefore, foods with hot properties, charcoal-processed items, pungent and spicy aromas, and sweet and greasy tastes are obviously inadvisable.
Although some have firm and thick intestines and stomachs, and deep fortune and strong vitality, allowing indulgence seems acceptable in secular views. Gratifying the mouth brings temporary pleasure, but accumulated over time, it must lead to disaster. Thus, more is worse than less, less is worse than none. Refreshing foods cause disease, rich flavors act like poison. The maxims of former sages are still heard; can we not be cautious? Someone asked: According to your words, do you intend to deny food entirely so that I am not at peace? I said: The gentleman loves others through virtue, while the petty person loves others through indulgence. How much more so for those respected! Food and drink are for nourishing life, not for causing disease. If what nourishes becomes harmful, this is likely not the filial piety and respect the gentleman advocates. So what should be done? One should know that loving life and hating death, preferring peace and hating illness, are common human emotions. Children and grandchildren must first guide them with righteousness, inform them about the nature of substances, use analogies, state pros and cons, be sincere and firm in speech, and act with reverence and caution. Secondly, lead by example. They will surely be moved without resistance. What you call "denying food entirely" is particularly filial when illness is present. When there is no illness, discretion should be exercised, and nourishment provided according to seasons. Not eating certain things and replacing them with others does not harm filial piety. However, if one remains silent in daily life, lacking guidance and encouragement, until hunger pangs sound and drool flows, with food before them and fragrance in the air, how can they be restrained? The Classics say: "Nourish with loyal food." The character "Loyalty" (Zhong, 忠) likely aligns with this meaning; please do not overlook it. I served my mother, feeling ashamed compared to ancients, yet she lived past seventy, previously suffering from Phlegm-fluid retention, which ceased at this stage. Through regulated nourishment, I believe I have found a method. Specifically, when constipation occurred, I mixed fresh cow's milk and pig fat into porridge. While this provided temporary lubrication, it ultimately led to accumulation of greasy substances. The following summer, stagnation transformed into sticky Phlegm, causing a carbuncle on the hypochondrium. Days of pain followed, disrupting sleep and waking. As a son, I felt helpless. Through bitter reflection, I derived the theory of regulated nourishment. I regularly administered Ginseng (Renshen, 人参) and Atractylodes macrocephala rhizome (Baizhu, 白术) to tonify Stomach and Blood, adjusting with seasonal changes. Consequently, bowels were no longer dry, complexion became bright and clean. Though thinner, she remained healthy. Peace in old age was achieved through this. Thus, I formulated a prescription: Ginseng and Atractylodes macrocephala rhizome as Sovereign herbs, Achyranthes bidentata root (Niuxi, 牛膝) and Paeonia lactiflora root (Shaoyao, 芍药) as Minister herbs, Tangerine peel (Chenpi, 陈皮) and Poria sclerotium (Fuling, 茯苓) as Assistant herbs. In Spring, add Ligusticum chuanxiong rhizome (Chuanxiong, 川芎); in Summer, add Schisandra chinensis fruit (Wuweizi, 五味子), Scutellaria baicalensis root (Huangqin, 黄芩), and Ophiopogon japonicus tuber (Maidong, 麦门冬); in Winter, add Angelica sinensis root body (Danggui shen, 当归身), and double the amount of Fresh ginger (Shengjiang, 生姜). Take one or two decoctions per day. Administer when urine volume is perceived to be slightly decreased. When urine volume returns to normal, the disease is expelled. Later, in Dongyang, I heard of He Anren, a wise man who, after seventy, felt slight discomfort. He stopped rice gruel for several days and took only Ginseng decoction for a few doses, then stopped. He died peacefully in his nineties. Due to this coincidence, I recorded it seeking correction.