若明六气为病，疹不难治。但疹之限期最迫，只有三日。一以辛凉为主，如俗所用防风、广皮、升
麻、柴胡之类，皆在所禁。俗见疹必表，外道也。大约先用辛凉清解，后用甘凉收功。赤疹误用麻黄、
三春柳等辛温伤肺，以致喘咳欲厥者，初用辛凉加苦梗、旋复花，上提下降；甚则用白虎加旋复、杏
仁；继用甘凉加旋复草以救之；咳大减者去之。凡小儿连咳数十声不能回转，半日方回如鸡声者，千
金苇茎汤合葶苈大枣泻肺汤主之；近世用大黄者，杀之也。盖葶苈走肺经气分，虽兼走大肠，然从上
下降，而又有大枣以载之缓之，使不急于趋下；大黄则纯走肠胃血分，下有形之滞，并不走肺，徒伤
其无过之地故也。若固执病在脏泻其腑之法，则误矣。
钱氏制泻白散，方用桑白皮、地骨皮、甘草、粳米，治肺火皮肤蒸热，日晡尤甚，喘咳气急，面肿热
郁肺逆等证。历来注此方者，只言其功，不知其弊，如李时珍以为泻肺诸方之准绳，虽明如王晋
三、叶天士，犹率意用之。愚按此方治热病后与小儿痘后，外感已尽真气不得归元，咳嗽上气，身虚
热者，甚良；若兼一毫外感，即不可用。如风寒、风温正盛之时，而用桑皮、地骨，或于别方中加桑皮，
或加地骨，如油入面，锢结而不可解矣。考《金匮》金疮门中王不留行散，取用桑东南根白皮以引生
气，烧灰存性以止血，仲景方后自注云∶小疮即粉之，大疮但服之，产后亦可服，如风寒，桑根勿取
之。沈目南注云∶风寒表邪在经络，桑根下降，故勿取之。愚按∶桑白皮虽色白入肺，然桑得箕星之
精，箕好风，风气通于肝，实肝经之本药也。且桑叶横纹最多而主络，故蚕食桑叶而成丝，丝，络象
也，桑皮纯丝结成象筋，亦主络；肝主筋，主血，络亦主血，象筋与络者，必走肝，同类相从也。肝经
下络阴器，如树根之蟠结于土中；桑根最为坚结，诗称∶“彻彼桑土”，《易》言∶“系于苞桑”是也。再
按∶肾脉之直者，从肾上贯肝膈，入肺中，循喉咙，
挟舌本；其支者，从肺出络心。注胸中。肺与肾为子母，金下生水。桑根之性，下达而坚结，由肺下
走肝肾者也。内伤不妨用之，外感则引邪入肝肾之阴，而咳嗽永不愈矣。吾从妹八、九岁时，春日
患伤风咳嗽，医用杏苏散加桑白皮，至今将五十岁，咳嗽永无愈期，年重一年，试思如不可治之嗽，
当早死矣，如可治之嗽，何以至四十年不愈哉？亦可以知其故矣。遇见小儿久嗽不愈者，多因桑皮、
地骨，凡服过桑皮、地骨而嗽不愈者，即不可治，伏陷之邪，无法使之上出也，至于地骨皮之不可用
者，余因仲景先师风寒禁桑皮而悟入者也。盖凡树木之根，皆生地中，而独枸杞之根，名地骨者何？
盖拘杞之根，深入黄泉，无所终极，古又名之曰仙人杖，盖言凡人莫得而知其所终也。木本之入下
最深者，未有如地骨者，故独异众根，而独得地骨之名。凡药有独异之形，独异之性，得独异之名
者，必有独异之功能，亦必有独异之偏胜也。地骨入下最深，禀少阴水阴之气，主骨蒸之劳热，力能
至骨，有风寒外感者，而可用之哉！或曰∶桑皮，地骨，良药也，子何畏之若是？余曰∶人参、甘草，非良
药耶？实证用人参，中满用甘草，外感用桑皮、地骨，同一弊也。
如果明了六气致病机理，疹病并不难治。但疹病的限期最为紧迫，只有三天。治疗应以辛凉解表为主，如民间常用的防风、广陈皮、升麻、柴胡等药物，都在禁忌之列。世俗之人见疹必用发表药，这是外行之见。大致先用辛凉清解之法，后用甘凉之法收功。赤疹误用麻黄、三春柳等辛温药物损伤肺脏，导致气喘咳嗽甚至昏厥的，初起用辛凉药加桔梗、旋覆花，以提上降下；严重时用白虎汤加旋覆花、杏仁；继用甘凉药加旋覆草来救治；咳嗽大幅减轻后去掉旋覆草。凡是小儿连续咳嗽数十声不能换气，半天才回气像鸡叫声的，用千金苇茎汤合葶苈大枣泻肺汤主治；近代医家使用大黄的，是害死病人啊。因为葶苈子走肺经气分，虽然也兼走大肠，但是从上向下行，又有大枣承载并缓和药性，使其不急于趋下；大黄则纯走肠胃血分，攻下有形之积滞，并不走肺经，徒然伤害无辜之地罢了。如果固执于“病在脏则泻其腑”的方法，那就错了。
钱乙创制了泻白散，方剂由桑白皮、地骨皮、甘草、粳米组成，治疗肺火引起的皮肤蒸热，下午尤甚，气喘咳嗽气急，面肿热郁肺逆等症状。历来注释此方的人，只说它的好处，不知道它的弊端，比如李时珍认为它是泻肺诸方的准绳，即使是明察秋毫的王晋三、叶天士，也随意使用它。我认为此方治疗热病后与小儿痘疹后，外感已尽真气不得归元，咳嗽上气，身体虚热的情况，效果很好；但如果夹杂丝毫外感，就不可使用。如风寒、风温正盛之时，而使用桑白皮、地骨皮，或在其他方剂中加入桑白皮、地骨皮，就像油渗入面粉中，锢结而无法解开。考证《金匮要略》金疮门中的王不留行散，取用桑树东南方向的根白皮以引导生气，烧灰存性以止血，仲景方后自注说：小疮即研粉敷之，大疮只服用汤药，产后也可服用，如果有风寒，不要取用桑根。沈目南注释说：风寒表邪在经络，桑根药性下降，所以不要取用。我认为：桑白皮虽然色白入肺，但桑树得箕星之精华，箕宿好风，风气通于肝，实际上是肝经的本药。而且桑叶横纹最多而主络脉，所以蚕吃桑叶而成丝，丝，就是络象，桑皮纯丝结成象筋，也主络脉；肝主筋，主血，络脉也主血，象筋与络脉，必定走肝经，同类相从。肝经下行联络阴器，像树根盘结在土中；桑根最为坚结，诗经称：“彻彼桑土”，易经言：“系于苞桑”就是这样。再按：肾脉直行者，从肾上行贯穿肝膈，入肺中，循喉咙，挟舌本；其支脉，从肺出联络心，注入胸中。肺与肾为子母关系，金生水。桑根的药性，下达而坚结，是由肺下走肝肾的。内伤病不妨使用它，外感病则会引邪深入肝肾之阴，而咳嗽永远无法痊愈了。我的表妹八九岁时，春日患伤风咳嗽，医生用杏苏散加桑白皮，至今将近五十岁，咳嗽永远没有痊愈的时候，一年比一年重，试想如果是不可治的咳嗽，早就死了；如果是可治的咳嗽，为什么长达四十年不愈呢？也可以从中知道原因了。遇见小儿久咳不愈的，多因桑白皮、地骨皮引起，凡是服用过桑白皮、地骨皮而咳嗽不愈的，就不可治了，伏陷之邪，没有办法使其向上排出。至于地骨皮不可用的原因，我是从仲景先师对风寒禁用桑白皮的启示中领悟到的。大概凡树木的根，都生于地下，唯独枸杞的根，名叫地骨是什么原因呢？因为枸杞的根，深入黄泉，没有终极，古时候又名叫仙人杖，大概说的是凡人不知道它的终点。木本植物入土最深的，没有超过地骨的，所以独异众根，而独得地骨之名。凡是有独特形状、独特药性、独特名称的药物，必然有独特的功能，也必然有独特的偏胜之处。地骨入土最深，禀受少阴水阴之气，主治骨蒸劳热，力量能到达骨头，有风寒外感的人，怎么可以使用它呢！有人说：桑白皮、地骨皮，是良药啊，你为什么如此害怕它们？我说：人参、甘草，不是良药吗？实证用人参，中满用甘草，外感用桑白皮、地骨皮，弊病是一样的。
If one understands the pathogenesis of the Six Qi (Six Climatic Factors), treating exanthema (rash) is not difficult. However, the time limit for exanthema is most urgent, lasting only three days. Treatment should primarily use acrid-cool methods; herbs commonly used by laypeople such as Fangfeng (Saposhnikovia Root), Guangpi (Tangerine Peel), Shengma (Cimicifuga Rhizome), and Chaihu (Bupleurum Root) are all prohibited. The common belief that exanthema must be treated with exterior-releasing methods is erroneous. Generally, one first uses acrid-cool clearing and resolving methods, followed by sweet-cooling methods to conclude treatment. If red exanthema is mistakenly treated with Ma Huang (Ephedra Herb) or Sanchunliu (Salix Caprea Flower Bud), which are acrid-warm and damage the Lung, leading to wheezing, coughing, and impending syncope, initially use acrid-cool formulas added with Jiegeng (Platycodon Root) and Xuan Fuhua (Inula Flower) to lift upward and descend downward; in severe cases, use Bai Hu Tang (White Tiger Decoction) added with Xuan Fuhua and Xing Ren (Apricot Seed); subsequently use sweet-cooling formulas added with Xuan Fu Cao (Inula Herb) to rescue the patient; remove Xuan Fu Cao when the cough significantly decreases. For children who cough continuously for dozens of times without being able to inhale, taking half a day to recover their breath resembling a chicken's crow, Qian Jin Wei Jing Tang (Thousand Gold Reed Stamen Decoction) combined with Ting Li Da Zao Fei Li Tang (Descurainia Seed and Jujube Lung-Draining Decoction) should be the primary treatment; using Da Huang (Rhubarb Root) in modern times kills the patient. This is because Ting Li Zi (Descurainia Seed) enters the Qi aspect of the Lung meridian; although it also affects the Large Intestine, it moves from top to bottom, and with Da Zao (Jujube Fruit) carrying and缓ing its action, it does not rush downward; Da Huang, however, purely enters the Blood aspect of the intestines and stomach, purging有形 (solid) stagnation, and does not affect the Lung, merely injuring innocent tissue. If one rigidly adheres to the method of "draining the Fu organ when the disease is in the Zang organ," it is an error.
Qian Yi formulated Xie Bai San (Drain White Powder), consisting of Sang Bai Pi (Mulberry Root Bark), Di Gu Pi (Lycium Root Bark), Gan Cao (Licorice Root), and Geng Mi (Rice Grain), to treat symptoms such as steaming heat in the skin due to Lung Fire, worsening in the afternoon, wheezing, coughing, shortness of breath, facial swelling, heat stagnation, and rebellious Lung Qi. Commentators on this formula throughout history have only praised its merits, ignoring its drawbacks. For instance, Li Shizhen considered it the standard for all Lung-draining formulas; even wise physicians like Wang Jinsan and Ye Tianshi used it indiscriminately. I believe this formula is excellent for treating post-febrile disease or post-smallpox conditions in children where external pathogens have exhausted themselves, true Qi fails to return to its origin, causing coughing, rebellious Qi, and deficient heat; however, if there is even a trace of external pathogen, it must not be used. When Wind-Cold or Wind-Warm pathogens are flourishing, using Sang Bai Pi or Di Gu Pi, or adding them to other formulas, is like oil mixing into flour—binding and inseparable. Examining the Wang Bu Liu Xing San (Never Stop Flowing Powder) in the Traumatology section of *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet), it uses the white bark of the southeast root of the Mulberry tree to guide vital Qi, and burnt ash to stop bleeding. Zhongjing's post-script notes: "For small wounds, apply powder; for large wounds, take orally; it can also be taken postpartum. If Wind-Cold is present, do not use Mulberry root." Shen Munan commented: "Wind-Cold exterior pathogens are in the meridians; Mulberry root has a descending nature, so do not use it." I argue: Although Sang Bai Pi is white and enters the Lung, the Mulberry tree absorbs the essence of the Ji Star (箕宿). Ji favors wind, and wind connects to the Liver; thus, it is fundamentally a herb of the Liver meridian. Furthermore, Mulberry leaves have many transverse veins and govern collaterals; silkworms eat mulberry leaves to produce silk, and silk represents the image of collaterals. Mulberry root bark, composed of pure silk-like fibers forming tendon-like structures, also governs collaterals. The Liver governs tendons and blood; collaterals also govern blood. Tendon-like structures and collaterals necessarily enter the Liver meridian, following the principle of similar things attracting each other. The Liver meridian descends to connect with the genitalia, like roots knotted in the earth; Mulberry roots are extremely firm and knotted. The *Shi Jing* (Classic of Poetry) says, "Strip the Mulberry soil," and the *Yi Jing* (Book of Changes) states, "Tied to the cluster of Mulberries." Additionally, the direct branch of the Kidney meridian ascends from the Kidney, passes through the Liver and diaphragm, enters the Lung, follows the throat, and flanks the root of the tongue; its branch emerges from the Lung, connects with the Heart, and pours into the chest. The Lung and Kidney are mother-son organs, with Metal generating Water. The nature of Mulberry root is descending and firm, moving from the Lung down to the Liver and Kidneys. It is acceptable for internal injuries but will draw pathogens into the Yin of the Liver and Kidneys in external contraction cases, making cough incurable. My younger cousin suffered from Wind-Cold cough at age eight or nine in spring. A physician used Xing Su San (Apricot and Perilla Decoction) added with Sang Bai Pi. Now nearly fifty, her cough remains incurable, worsening annually. Consider: if the cough were truly incurable, she would have died long ago; if curable, why did it persist for forty years? This reveals the cause. Many cases of chronic cough in children are caused by Sang Bai Pi and Di Gu Pi. Any case where cough persists after taking these herbs is incurable; the trapped pathogens cannot be expelled upward. As for why Di Gu Pi is unusable, I realized this from Zhongjing’s prohibition of Sang Bai Pi for Wind-Cold. Why is the root of Goji berry named Di Gu (Earth Bone)? Its roots penetrate deep into the yellow springs (underworld/earth) without end, anciently called Immortal Staff, implying no one knows its depth. Among woody plants, none penetrate deeper than Di Gu, hence its unique name. Herbs with unique shapes, natures, and names possess unique functions and unique biases. Di Gu penetrates deepest, inheriting the Yin Qi of Shaoyin Water, treating bone-steaming consumptive fever, reaching the bones. How can those with Wind-Cold exterior contraindications use it? Some say: "Sang Bai Pi and Di Gu Pi are good medicines; why fear them?" I reply: "Are Ren Shen (Ginseng Root) and Gan Cao not good medicines? Using Ren Shen for excess patterns, Gan Cao for fullness in the middle jiao, and Sang Bai Pi/Di Gu Pi for external contractions—all result in the same detriment."