凡人参所忌者里证耳。邪在表及半表半里者，投之不妨，表有客邪者，古方如参
苏饮、小柴胡汤、败毒散是也。半表半里者，如久疟挟虚，用补中益气，不但无碍，而且得
效，即使暴疟，邪气正盛，投之不当，亦不至胀，为无里证也。夫里证者，不特伤寒温疫传
胃，至如杂证，气郁、血郁、火郁、湿郁、痰郁、食郁之类，皆为里证，投之即胀者，盖以
实填实也。今温疫下后，适有临时之通，即投人参，因而不胀，医者病者，以为用参之后虽
不见佳处，然不为祸，便为是福，乃恣意投之，不知参乃行血里之补药，下后虽通，余邪尚
在，再四服之，则助邪填实，前证复起，祸害随至矣。间有失下以致气血虚耗者，有因邪
盛数下，及大下而挟虚者，遂投人参，当觉精神爽慧，医者病者，皆以为得意，明后日再三
投之，即加变证。盖下后始则胃家乍虚，沾其补益而快，殊弗思余邪未尽，恣意投之，则渐
加壅闭，邪火复炽，愈投而变证愈增矣。所以下后邪缓虚急，是以补性之效速而助邪之害缓
，故前后利害之不同者有如此。
下后或数下，膜原尚有余邪未尽传胃，邪热与卫气相并，故热不能顿除，当宽缓
两日，俟余邪聚胃，再下之，宜柴胡清燥汤缓剂调理。
柴胡清燥汤
柴胡 黄芩 陈皮 甘草 花粉 知母
姜枣煎服。
凡是人参所禁忌的情况，仅限于里证。如果邪气在表以及半表半里的阶段，使用人参并无妨碍。对于表有客邪的情况，古代方剂如参苏饮、小柴胡汤、败毒散中便含有参类成分。对于半表半里的情况，例如久疟疾兼有虚证，使用补中益气汤，不仅没有阻碍，反而能取得疗效；即使是暴发的疟疾，邪气正盛时，误用人参不当，也不会导致腹胀，这是因为体内没有里证。所谓里证，不仅仅指伤寒或温疫传入胃腑，即使是杂病中的气郁、血郁、火郁、湿郁、痰郁、食郁等情况，都属于里证，此时若投用人参就会引起腹胀，这是因为以实邪填补了实证。
如今温疫病经过攻下治疗后，恰好遇到暂时通畅的情况，就立即投用人参，因此没有出现腹胀。医生和患者认为，用参之后虽然没看到明显的好转，但只要不造成祸害，就算是福气，于是肆意投用人参。他们不知道人参是行血分里的补药，攻下后虽然肠道暂通，但残余的邪气依然存在，反复服用，就会助长邪气并使其填塞实证，之前的病症重新发作，祸害随即到来。
偶尔有因失于攻下而导致气血虚耗的患者，或者有因邪气旺盛多次攻下，以及大剂量攻下而兼有虚证的患者，这时投用人参，应当会感到精神清爽聪慧，医生和患者都为此得意。但如果明后天再三投用人参，病情就会出现变化。因为攻下之后，起初胃气暂时虚弱，受到补益而感到舒适，却不曾想到残余的邪气尚未清除干净，肆意投用人参，就会逐渐导致壅滞闭塞，邪火重新炽盛，用药越多，变证也就越多。所以下法之后，邪气减缓而正气急虚，因此补益的功效迅速显现，而助长邪气的危害相对缓慢，这就是前后利害不同的原因所在。
攻下之后，或者经过数次攻下，膜原（半表半里之隙）尚有余邪未完全传入胃腑，邪热与卫气相搏结，所以发热不能立刻消除。应当宽缓两日，等待余邪汇聚于胃腑，再次进行攻下治疗，适宜用柴胡清燥汤这种缓剂来调理。
The contraindication for Ginseng Radix (Renshen, 人参) applies only to *Li Zheng* (Interior Syndrome). When the pathogenic factor is in the Exterior or at the Half-Exterior and Half-Interior level, its administration is not harmful. For cases where an external pathogen resides in the Exterior, ancient formulas such as Shen Su Yin (Ginseng and Perilla Decoction), Xiao Chai Hu Tang (Minor Bupleurum Decoction), and Bai Du San (Detoxification Powder) contain ginseng. For conditions at the Half-Exterior and Half-Interior level, such as chronic malaria complicated by deficiency, using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) not only causes no hindrance but also yields therapeutic effects. Even in acute malaria where the pathogenic factor is vigorous, improper administration of ginseng will not cause abdominal distension because there is no Interior Syndrome.
The term "Interior Syndrome" (*Li Zheng*) refers not only to Taiyang Cold Damage (*Shang Han*) or Warm Epidemic (*Wen Yi*) transmitting to the Stomach, but also includes miscellaneous diseases involving Qi stagnation (*Qi Yu*), Blood stagnation (*Xue Yu*), Fire stagnation (*Huo Yu*), Dampness stagnation (*Shi Yu*), Phlegm stagnation (*Tan Yu*), and Food stagnation (*Shi Yu*). In these cases, administering ginseng leads to abdominal distension because it fills excess with excess.
Currently, after purgative treatment for a warm epidemic, if there is a temporary passage, ginseng is immediately administered, resulting in no abdominal distension. Physicians and patients believe that although no obvious improvement is seen after taking ginseng, avoiding harm is considered a blessing; thus, they administer it indiscriminately. They fail to realize that Ginseng Radix is a tonic that acts within the blood level. Although the bowels are temporarily clear after purgation, residual pathogens remain. Repeated administration aids the pathogens and creates solid excess, causing previous symptoms to recur and misfortunes to follow.
Occasionally, patients suffer from depletion of Qi and Blood due to missed purgation, or those who have undergone multiple purgations due to vigorous pathogens, or massive purgation leading to deficiency, may receive ginseng. They should feel refreshed and mentally alert. Physicians and patients consider this a success. However, if administered repeatedly on subsequent days, complications arise. Initially, after purgation, the Stomach (*Wei Jia*) is temporarily deficient, and the tonification brings comfort. However, one must not overlook that residual pathogens are not yet cleared. Indiscriminate administration leads to gradual congestion and closure, reigniting pathogenic fire. The more it is administered, the more complications increase. Therefore, after purgation, while the pathogen slows down, the deficiency becomes urgent. Consequently, the effect of tonification is rapid, while the harm of aiding the pathogen is slower. This explains the difference in benefits and harms before and after.
After purgation, or even after several purgations, if residual pathogens in the Mo Yuan (Membrane Source) have not fully transmitted to the Stomach, and pathogenic heat binds with Wei Qi (Defensive Qi), fever cannot be eliminated instantly. One should wait for two days in a relaxed manner, allowing residual pathogens to gather in the Stomach, and then purge again. It is appropriate to use Chai Hu Qing Zao Tang (Bupleurum Clearing Dryness Decoction), a mild formula, for regulation.
Chai Hu Qing Zao Tang (Bupleurum Clearing Dryness Decoction)
Ingredients: Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Hua Fen (Tetrastigmatis Caulis), Zhi Mu (Anemarrhenae Rhizoma).
Preparation and Administration: Decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus).