人参 外感风邪，元气未漓，审用。
人参大补元气，冲和粹美，不偏不倚，故在阴补阴，在阳补阳，能温能清，可升可降，
三焦
成壅塞，所谓实实也。若夫虚劳之病，或气血、阴阳、水火、寒热、上下诸证，与夫火、痰
、燥、湿、滞、胀、吐、利、冒厥、烦渴，及胎前、产后、痘疹、久病、病后，一经虚字，
则
先后发明，并无异议。庸医不察，执节斋之瞽说，以为人参补阳，沙参补阴，若补阳则助其
火，甚至云虚劳人服参者，必至不救，以致举世畏参如砒鸩，而不敢试，岂不误载！
黄柏、知母 禁用。
《丹溪心法》有云∶虚损吐血，不可骤用苦寒，恐致相激，只宜琼玉膏主之。何事首尾
矛盾
并用。后之学人宗之，凡遇虚劳咳嗽、吐血、虚火虚热之疾，皆以知、柏二味，以为清火滋
阴，殊不知虚劳之火，虚火也，相火也，阴火也。即丹溪云∶虚火可补，人参、黄 之属。
相火系于肝肾之间，出入于甲胆，听命于心君。君火明，则相火伏，若君火不明，则相火烈
焰冲天，上感清虚之窍，耳聋、鼻干、舌痛、口苦、头晕、身颤、天突急而淫淫作痒、肺叶
张而咳嗽频仍。当此时也，惟有清气养荣，滋方寸灵台之雨露，以宁膻中之烦焰，则甲胆乙
肝之相火，不扑而自灭矣。阴火者，龙雷之火也，起于九泉之下，遇寒水阴翳，则其焰愈腾
，若太阳一照，自然消陨。此三火者，皆无求于降火滋阴，亦何事乎知、柏，而用之以贻害
乎？且黄柏伤胃，知母滑脾，胃伤则饮食不进，脾滑则泄泻无度。一脏一腑，乃生人之本。
经云∶得谷者昌，失谷者亡。又曰∶阳精上奉，其人寿；阴精下降，其人夭。今以苦寒伤胃
，岂非失谷者亡乎？以冷滑泄脾，岂非下降者夭乎？想世用此者，意在滋阴，而不知苦寒下
降多亡阴，阴亏而火易炽；意在清金，而不知中土既溃，绝金之源，金薄而水益衰。吾知用
此者，未见其利，徒见其害耳。每见虚劳
麦冬、五味 初病酌用。
治肺之道，一清、一补、一敛，故麦冬清，人参补，五味敛。三者，肺怯之病，不可缺
一者
疏散之，未可骤加敛补，施治之次第宜然。若不知初病、久病之分，或骤清、骤补、骤敛，
则肺必致满促而不安，邪气濡滞，久而不彻。此非药之害，实由用之失节耳。若夫疏解之后
，邪气既清，元气耗散，则当急用收敛、清补为主，舍此三物，更何求焉？况五味不但以收
敛为功，兼能坚固心肾，为虚劳必用之药。乃在用之不当者，反咎五味酸能引痰致嗽，畏而
弃之。殊不知病至于伏火乘金，金气耗越之际，除却此味，更用何药以收之耶？
泽泻 宜用。
夫肺金为气化之源，伏火蒸灼，则水道必污，污则金气不行而金益病，且水停不流，则
中土
功。夫亦尝究其命名之义矣。盖泽者，泽其不足之水；泻者，泻其有余之火也。惟其泻也，
故能使生地、白芍、阿胶、人参，种种补益之品，得其前导，则补而不滞；惟其泽也，故虽
走浊道而不走清道，不若猪苓、木通、腹皮等味之消阴破气，直走无余。要知泽泻一用，肺
、脾、肾三部咸宜，所谓功同神禹者此也。古方用六味丸，用之功有四种，《颐生微论》论
之极详。庸医不察，视为消阴损肾之品，置而不用，何其谬甚！
桑皮 宜用。
桑白皮清而甘者也，清能泻肝火之有余，甘能补肺气之不足。且其性润中有燥，为三焦
逐水
，最忌喘、肿二候。金逆被火所逼，高而不下则为喘；土卑为水所侮，陷而失堤则为肿。喘
者，为天不下济于地；肿者，为地不上交于天。故上喘、下肿，天崩地陷之象也。是症也，
惟桑皮可以调之。以其降气也，故能清火气于上焦；以其折水也，故能奠土德于下位。奈何
前人不察，以为性不纯良，用之当戒。不知物性有全身上下纯粹无疵者，惟桑之与莲，乃谓
其性不纯良，有是理乎？
桔梗 宜用。
夫肺如华盖，居最高之地，下临五脏，以布治节之令。其受病也，以治节无权，而气逆
火升
味；至清故能清金，升浮故能载陷，微苦故能降火，实为治节君主之剂，不但引清报使而已
。此味升中有降，以其善清金，金清自能布下降之令故也；清中有补，以其善保肺，肺固自
能为气血之主也。且其质不燥不滞，无偏胜之弊，有十全之功，服之久，自能清火消痰，宽
胸平气，生阴益阳，功用不可尽述。世之医者，每畏其开提发散，而于补中不敢轻用、多用
，没其善而掩其功，可惜也。
丹皮、地骨皮 宜用。
夫黄柏、知母，其为倒胃败脾之品，固宜黜而不录矣。然遇相火烁石流金之际，将何以
处此
清火除蒸，更兼养肺。骨皮者，枸杞之根也。枸杞为补肾之要药，然以其升而实于上也，但
能温髓助阳，虚劳初起，相火方炽，不敢骤用。若其根伏而在下，以其在下也，故能资肾家
真水；以其皮，故能舒肺叶之焦枯，凉血清骨，利便退蒸。其功用较丹皮更胜，且其味本不
苦，不致倒胃，质本不濡，不致滑脾，施治允当，功力万全，有知、柏之功，而无其害，最
为善品。
生地 宜用，初病审用。
世人以生地为滞痰之物，而不敢轻用，是不知痰之随症而异也。杂症之痰，以燥湿健脾
为主
克肺金，金不能举清降之令，精微不彻于上下，滞而为痰作咳。治宜清肺，则邪自降；养血
，则火自平。故余于清金剂中，必兼养荣为主。荣者，血也。阴者，水也，润下之德也。清
金若不养荣，如吹风灭火，风势愈逆，烈焰愈生。清金养荣者，为引水制火，沾濡弥漫，烟
气永息。故桔梗、桑皮、贝母之类，清金之品也。生地、丹皮、当归之类，养荣之品也。而养
荣剂中，又以生地为第一。以生地治杂症之痰，则能障痰之道，能滞化痰之气，且其力滋补，
反能助痰之成。若加之虚劳剂中，则肺部喜其润，心部喜其清，肾部喜其滋，肝部喜其和，脾
部喜其甘缓，而不冷、不滑，故劳嗽、骨蒸、内热、吐血、咯血剂中，必无遗生地之理。惟劳
嗽初起，客邪未清，痰嗽盛时，亦暂忌生地滞泥。若表症既除，内热蒸灼，非生地之清润，以滋
养化源，则生机将绝矣。若畏其滞
茯苓 宜用。
有谓茯苓善渗，下元不足者忌之。非也。盖茯苓为古松精华蕴结而成，入地最久，得气
最浓。其质重，其气清，其味淡。重能培土，清能益金，淡能利水。惟其得土气之浓，故能
调三部之虚。虚热虚火湿气生痰，凡涉虚者皆宜之，以其质中和粹美，非他迅利克伐者比也
。夫金气清降，自能开水之源；土气调平，自然益气之母。三脏既理，则水火不得凭凌，故
一举而五脏均调。又能为诸阴药之佐，而去其滞；为诸阳药之使，而宣其道。补不滞涩，泄
不峻利，精纯之品，无以过之。
黄 宜用。
余尝说建中之义，谓人之一身，心上，肾下，肺右，肝左，惟脾胃独居于中。黄 之质
，中
上气不下，下气不上，左不维右，右不维左，得黄 益气甘温之品，主宰中州，中央旌帜一
建，而五方失位之师，各就其列，此建中之所由名也。故劳嗽久已失气，气不根于丹田，血
随气溢，血既耗乱，气亦飞扬。斯时也，虽有人参回元气于无何有之乡，究竟不能固真元于
不可拔之地，欲久安长治，非黄 不可。盖人参之补迅而虚，黄 之补重而实，故呼吸不及
之际， 不如参。若夫镇浮定乱，返本还元，统气摄血，实表充里，其创建如墙壁之不可攻
，其节制如将令之不可违，其饶益如太仓之不可竭，其御邪扶正，如兵家之前旄，中坚后劲
，不可动摇，种种固本收功之用，参反不如 。故补虚以黄 为墙垣，白术作基址。每见服
参久久，渐至似有若无，虽运用有余，终是浮弱，不禁风浪。若用 、术兼补，可至风雨不
畏，寒暑不侵，向来体弱者，不觉脱胎换骨，诚有见于此也。除劳嗽初起，中土大伤，气火
方盛，心肺虽失其和，脾胃犹主其事，此时只宜养荣为主，黄 微滞，尚宜缓投。若久病气
虚
以实土，徒以沉阴降浊之品，愈伤上奉升腾之用，必无济也。
白术 宜用，初病审用。
虚劳初起，治未有不以清金为第一义者。而清金之品，生地、阿胶、丹皮、白芍之外，
又有
并麦冬亦微恶其冷，元参亦且嫌其寒，久久渐妨饮食，渐陷中气，于斯时也，又宜以培土调
中为主。其法在杂症门中，用药颇多，惟虚症内，培土之剂，止有黄 、白术、茯苓、山药
，有功而无过。夫虚劳之培土也，贵不损至高之气，故二陈之燥，平胃之烈，固万万不可，
即扁豆之健脾，苡仁之胜瘴，犹未免于走血，俱未尽善。若乃四味之中，茯苓、山药虽冲和
，而无峻补回生之力，即 、术二种并用，又以术为土部专经之剂，兼为益气之品，故能培
土以生金，而至高之部，胥有赖也。夫术性微燥，于虚症似当缓投，然却喜其燥而不烈，有
合中央之土德，且补土自能生金，如山岳之出云蒸雾，降为雨露，以濡万物，而何病燥之有
哉？缪仲淳谓其燥能伤阴。殊不知伤阴为苍术、浓朴之类，岂可以白术微燥中和之品同语耶？
且治法收功之时，非培土则浮火终不归根，知白术之功大矣。
柴胡 酌用
柴胡升清调中，平肝缓脾，清热散火，理气通血，出表入里，黜邪辅正，开满破结，安
营扶
浸淫郁滞，有待宣通，舍此柴、前二胡，则无有秉性纯良出其右者矣。故每用些少以佐之
然后专用清源补敛之品，乃为十全。即其调理之人，中间或撄或感，亦必急用柴胡、防风、
葛根等味彻之，然后仍用补敛，庶免关门捉贼之患。但其性升散，用者当中病即止，不可多
用、常用耳。更有女人抑郁伤阴，与夫蓐劳之后，必当选用。盖多郁则伤元气，柴胡平肝散
郁，功最捷也。后人因陈藏器一言，忌用柴胡，遇内伤、外感之症，将反用麻黄、紫苏等味以
散之耶！
陈皮 偶用。
夫桔梗本以载气上行，而气火以平者，可见虚劳之气，皆由于火侵肺也。若杂症之有胸
膈气
口气滞，辄以陈皮理气，不知陈皮味辛而性燥，辛能耗肺气之清纯，燥能动阴虚之相火，本
以理气，气反伤矣。惟清金之久，化源初动，脾气未健，胃口渐觉涎多，可少加陈皮以快之
，使中宫一清，未为不可。又或时气偶来，脾胃濡泻，亦可暂用数剂，以清理之，然亦须去
病则已，不宜常用。
苏子 不必用。
夫虚劳之火，既乘金之气高而不降，治宜平其火而已，不必下其气也。惟杂症之喘急而
气高
痰可消。不知其复也，必增剧矣。惟白前一味，为平喘之上品。凡撷肚抬肩，气高而急，能
坐而不能卧，能仰而不能俯者，用此以平之，取效捷而元气不伤，大非苏子可比。
枳壳 不可用。
虚劳施治，曰清金，曰安神，曰培土，曰调肝，曰益肾，而惟补之一字，彻乎终始，故
火亦
气塞滞，不究虚实，便用枳壳以伐之。不知虚劳治气，与杂症不同。其滞也，不可以利之；
其高也，不可以下之；其治满也，不可以破之。陈皮、苏子，已不当用，况枳壳、青皮乎！
虚劳之施治有次序，先以清金为主；金气少肃，即以调脾为主；金土咸调，则以补肾要
其终
还元。凡属阴虚，未有不以此为扼要者也。然杞子之性太温，若君火未明，相火方炽，肺叶
举
杞子性凉之说，试问性若果凉，胡为兴阳之骤耶？
当归 审用。
夫当归之养荣，以佐清金也，尚矣。然其味未免于辛，其性未免于温，虽有养血之功，
亦为
肾水以收功。若执古人之论，谓当归命名之义，使气血各得其归，罔顾血症新久而用之，亦
有误处。
桂圆 审用。
龙眼大补心血，功并人参。然究为湿热之品，故肺有郁火，火亢而血络伤者，服之必剧
。世
既清之后，以此大补心脾，信有补血安神之效，若肺有郁伏之火，服之则反助其火，或正当
血热上冲之时，投此甘温大补之味，则血势必涌溢而加冲。不可不慎也。
人参：若外感风邪，且元气尚未耗损，应审慎使用。
人参大补元气，药性冲和粹美，不偏不倚，因此无论阴虚还是阳虚，都能起到补益作用；既能温补又能清热，既可升提又可下降。但如果三焦气机已经壅塞，再用人参就会造成“实实”之误（即实证用补法，使邪气更盛）。至于虚劳病，无论是气血、阴阳、水火、寒热、上下等证候，以及火、痰、燥、湿、滞、胀、吐、利、冒厥、烦渴等症状，还有胎前、产后、痘疹、久病及病后恢复期，只要涉及“虚”字，前人已有详尽论述，并无异议。然而庸医不加考察，固执于朱丹溪（号斋）的片面说法，认为人参补阳、沙参补阴，既然补阳会助火，甚至有人说虚劳病人服用人参会导致无法救治，致使世人像畏惧砒霜毒酒一样畏惧人参，不敢尝试，这难道不是严重的错误吗！
黄柏、知母：禁用。
《丹溪心法》曾说：“虚损吐血，不可骤然使用苦寒药物，恐怕引起激荡，只适宜用琼玉膏主治。”为何要首尾矛盾地并用这些药物？后世学者尊崇此说，凡遇到虚劳咳嗽、吐血、虚火虚热等疾病，都以为知母、黄柏这两味药可以清火滋阴，殊不知虚劳之火，是虚火、相火、阴火。正如丹溪所说：“虚火可以用补法治疗”，如人参、黄芪之类。相火寄居于肝肾之间，出入于胆经，听从心君（心火）的指挥。如果心火清明，则相火潜伏；如果心火不明，则相火烈焰冲天，上扰清窍，导致耳聋、鼻干、舌痛、口苦、头晕、身体颤抖、天突穴处急促且隐隐作痒、肺叶张开而咳嗽频繁。在这个时候，只有清气养荣，滋润心部（方寸灵台），以平息膻中部位的烦热，那么肝胆的相火，不用扑灭也会自然熄灭。阴火，就是龙雷之火，起于九泉之下，遇到寒水阴翳遮蔽，火势反而更旺；如果太阳一照，自然消陨。这三种火，都不需要降火滋阴，又何必用知母、黄柏来贻害人体呢？况且黄柏伤胃，知母滑脾，胃受伤则饮食不进，脾滑则泄泻无度。脾胃是人体生命的根本。《内经》说：“能进食者昌，不能进食者亡。”又说：“阳气精微上奉，人长寿；阴精下降，人短命。”现在用苦寒药物损伤胃气，岂不是让人走向灭亡吗？用冷滑药物损伤脾气，岂不是让人夭折吗？我想世上使用这些药物的人，本意是想滋阴，却不知道苦寒下降类药物多会亡失阴液，阴液亏损而火势更容易炽盛；本意是想清肺金，却不知道中焦脾胃一旦溃败，就断绝了生金之源，肺气薄弱而肾水更加衰微。我知道使用这些药物的人，没看到什么好处，只看到危害罢了。经常见到虚劳病患者……
麦冬、五味子：初病时酌情使用。
治疗肺病的法则，在于清、补、敛三个方面，所以麦冬主清，人参主补，五味子主敛。这三者对于肺气怯弱的疾病，缺一不可。但是如果是新病初期，有邪气需要疏散，不可以骤然加上收敛补益的药物，这是施治的次第所决定的。如果不懂得区分初病和久病，或者骤然使用清、补、敛的方法，那么肺部必定会导致满闷急促而不安，邪气濡滞，久而不散。这不是药物的危害，实在是用药失去节制的缘故。如果在疏解之后，邪气已清，元气耗散，那么就应当急用收敛、清补为主，除了这三味药，还能求什么呢？况且五味子不但有收敛的功效，还能坚固心肾，是虚劳病必用的药物。那些用药不当的人，反而责怪五味子酸性能引痰致咳，因而畏惧并弃用它。殊不知当病情发展到伏火乘金，肺气耗散之际，除了这味药，还能用什么药来收敛呢？
泽泻：宜用。
肺金是气化的源头，伏火蒸灼，则水道必然污浊，污浊则金气不行而肺病加重，而且水停不流，则中焦脾胃……（原文此处似有脱漏，依文意推测为影响脾胃运化功能）。人们也曾探究过它命名的含义吧。所谓“泽”，是润泽不足之水；“泻”，是泻去有余之火。正因为能“泻”，所以能使生地、白芍、阿胶、人参等各种补益药物得到先导，从而补而不滞；正因为能“泽”，所以虽然走浊道而不走清道，不像猪苓、木通、腹皮等药物那样消阴破气，直走无余。要知道泽泻一经使用，肺、脾、肾三部都适宜，这就是所说的功效同于大禹治水的原因。古方中使用六味地黄丸，其中泽泻的作用有四种，《颐生微论》论述得非常详细。庸医不加考察，将其视为消阴损肾的药物，放置不用，这是多么荒谬啊！
桑白皮：宜用。
桑白皮性质清润而味甘，清能泻肝火之有余，甘能补肺气之不足。而且其性润中有燥，是三焦……（原文此处似有脱漏，结合下文应为逐水或调理气机），最忌讳喘、肿两种证候。肺气逆乱被火逼迫，高而不降则为喘；土气卑弱被水侮，陷而失堤则为肿。喘，是天不下济于地；肿，是地不上交于天。所以出现上喘下肿，是天崩地陷的征象。这种病症，只有桑白皮可以调理。因为它能降气，所以能清上焦之火；因为它能折水，所以能稳固下位的土德。为什么前人没有考察清楚，认为其性质不纯良，使用时应当戒除？不知道万物之中，全身上下纯粹无瑕疵的，只有桑树和莲花，怎么能说桑白皮性质不纯良呢？这是有道理的吗？
桔梗：宜用。
肺如同华盖，居于最高之地，下临五脏，发布治节之令。肺受病，是因为治节无权，导致气逆火升……（原文此处似有脱漏，指桔梗的作用）。味道极清故能清金，升浮故能载陷，微苦故能降火，实为治理肺脏君主之剂，不仅仅是作为引经报使而已。这味药升中有降，因为它善于清金，金清自然能布下降之令；清中有补，因为它善于保肺，肺固自能为气血之主。而且其质地不燥不滞，没有偏胜的弊端，有十全的功效，服用久了，自然能清火消痰，宽胸平气，生阴益阳，功用不可尽述。世上的医生，往往畏惧其开提发散，而在补益方中不敢轻易使用、多用，埋没了它的优点而掩盖了它的功劳，可惜啊。
牡丹皮、地骨皮：宜用。
黄柏、知母，作为倒胃败脾的药物，本来就应该摒弃而不收录。然而如果遇到相火烁石流金的时刻，将如何处理这种情况呢？（此处原文逻辑跳跃，意指需替代药物）。清火除蒸，兼能养肺。地骨皮是枸杞的根。枸杞是补肾的要药，但因其性升而实于上，只能温髓助阳，在虚劳初起、相火正炽时，不敢骤用。如果它的根潜伏在下，因为在下，所以能资助肾家真水；因为是皮，所以能舒展肺叶的焦枯，凉血清骨，利便退蒸。其功用较牡丹皮更胜，而且其味本不苦，不会倒胃，质地本不濡，不会滑脾，施治得当，功力万全，有知母、黄柏的功效，而没有它们的危害，是最为善品。
生地黄：宜用，初病时审慎使用。
世人认为生地黄是阻滞痰湿之物，而不敢轻用，这是不知道痰随病症而异。杂症之痰，以燥湿健脾为主……（原文此处似有脱漏，指痰的形成机制）。克制肺金，肺金不能行使清降之令，精微物质不能通达上下，停滞而为痰作咳。治疗宜清肺，则邪气自降；养血，则火势自平。所以我在使用清金剂中，必兼以养荣血为主。荣，就是血。阴，就是水，具有润下的特性。清金如果不养荣，就像吹风灭火，风势越逆，烈焰越生。清金养荣，是为了引水制火，沾濡弥漫，烟气永息。所以桔梗、桑白皮、贝母之类，是清金的药物。生地黄、牡丹皮、当归之类，是养荣的药物。而在养荣剂中，又以生地为第一。如果用生地黄治疗杂症之痰，则会阻碍痰之道，阻滞化痰之气，而且其力滋补，反而能助长痰的形成。如果加入虚劳剂中，则肺部喜欢它的润，心部喜欢它的清，肾部喜欢它的滋，肝部喜欢它的和，脾部喜欢它的甘缓，且不冷、不滑，所以在劳嗽、骨蒸、内热、吐血、咯血的方剂中，必定不能遗漏生地黄。只有在劳嗽初起，客邪未清，痰嗽盛时，也暂时忌用生地黄以免滞泥。如果表症已除，内热蒸灼，非用地黄的清润来滋养化源，则生机将绝矣。如果畏惧它滞……
茯苓：宜用。
有人说茯苓善于渗利，下元不足者忌用。这是不对的。茯苓是由古松精华蕴结而成，入地最久，得气最浓。其质重，其气清，其味淡。重能培土，清能益金，淡能利水。正因为得土气之浓，所以能调补三部之虚。虚热、虚火、湿气生痰，凡是涉及虚证的都适宜，因为其质中和粹美，不同于其他迅利克伐的药物。金气清降，自然能开水之源；土气调平，自然能益气之母。三脏既理，则水火不得凭凌，所以一举而五脏均调。又能为诸阴药之佐，而去其滞；为诸阳药之使，而宣其道。补而不滞涩，泄而不峻利，精纯之品，无以过之。
黄芪：宜用。
我曾经阐述建中的意义，谓人身之上在心，下在肾，右在肺，左在肝，只有脾胃独居于中。黄芪的质地……（原文此处似有脱漏，指黄芪居中）。上气不下，下气不上，左不维右，右不维左，得到黄芪益气甘温的药物，主宰中州，中央旌帜一建，而五方失位之师，各就其列，这就是建中所由来的名称。所以劳嗽久已失气，气不根于丹田，血随气溢，血既耗乱，气亦飞扬。此时，即使有人参在无何有之乡回元气，终究不能在不可拔之地固真元，想要久安长治，非黄芪不可。大概人参之补迅而虚，黄芪之补重而实，所以在呼吸不及之际，黄芪不如人参。但是如果镇浮定乱，返本还元，统气摄血，实表充里，其创建如墙壁之不可攻，其节制如将令之不可违，其饶益如太仓之不可竭，其御邪扶正，如兵家之前旄、中坚、后劲，不可动摇，种种固本收功之用，人参反而不如黄芪。所以补虚以黄芪为墙垣，白术作基址。经常见到服用参药久久，渐至似有若无，虽然运用有余，终是浮弱，不禁风浪。如果使用芪、术兼补，可达到风雨不畏，寒暑不侵，向来体弱者，不觉脱胎换骨，确实是有见于此啊。除非劳嗽初起，中土大伤，气火方盛，心肺虽失其和，脾胃犹主其事，此时只宜养荣为主，黄芪微滞，尚宜缓投。如果久病气虚……（原文此处似有脱漏，指应补气）。以实土，徒用沉阴降浊之品，愈伤上奉升腾之用，必无济也。
白术：宜用，初病时审慎使用。
虚劳初起，治疗没有不以清金为第一要义的。而在清金的药物中，除了生地黄、阿胶、牡丹皮、白芍之外，又有……（原文此处似有脱漏，指其他清金药）。连麦冬也稍微厌恶其冷，玄参也嫌弃其寒，久而久之渐渐妨碍饮食，渐渐陷入中气，在这个时候，又应该以培土调中为主。其方法在杂症门中，用药颇多，惟在虚证内，培土的药剂，只有黄芪、白术、茯苓、山药，有功而无过。虚劳的培土，贵在不妨碍至高之气，所以二陈汤之燥，平胃散之烈，万万不可，就连扁豆之健脾，薏苡仁之胜瘴，未免于走血，都未尽善。如果在四味之中，茯苓、山药虽然冲和，但没有峻补回生之力，即使芪、术二种并用，又以白术为土部专经之剂，兼为益气之品，所以能培土以生金，而至高之部，都有赖于此。白术性微燥，对于虚证似乎应当缓投，但是它却喜欢其燥而不烈，符合中央之土德，而且补土自能生金，如山岳出云蒸雾，降为雨露，以濡万物，有什么病燥的呢？缪仲淳说它燥能伤阴。殊不知伤阴的是苍术、厚朴之类，怎么可以把白术这种微燥中和的药物同语而论呢？而且在治疗收功之时，不培土则浮火终不归根，可知白术之功大矣。
柴胡：酌情使用。
柴胡升清调中，平肝缓脾，清热散火，理气通血，出表入里，黜邪辅正，开满破结，安营扶……（原文此处似有脱漏，指正气）。浸淫郁滞，有待宣通，除了柴胡、前胡这两味药，没有秉性纯良出其右者了。所以每次使用少量以佐之，然后专用清源补敛之品，才是十全。即使是调理之人，中间或感染外邪，也必须急用柴胡、防风、葛根等药物彻散，然后仍用补敛，才免得关门捉贼之患。但是其性升散，使用者当中病即止，不可多用、常用耳。更有女人抑郁伤阴，以及蓐劳之后，必须选用。大概多郁则伤元气，柴胡平肝散郁，功效最捷。后人因为陈藏器的一句话，忌用柴胡，遇到内伤、外感的病症，难道要反用麻黄、紫苏等药物来散之吗！
陈皮：偶尔使用。
桔梗本来是用来载气上行，而气火得以平息的，可见虚劳之气，都是由于火侵肺所致。如果杂症中有胸膈气……（原文此处似有脱漏，指气滞），辄以陈皮理气，不知道陈皮味辛而性燥，辛能耗肺气之清纯，燥能动阴虚之相火，本以理气，气反而伤了。只有清金之久，化源初动，脾气未健，胃口渐觉涎多，可少加陈皮以快之，使中宫一清，也未为不可。又或者时气偶来，脾胃濡泻，也可暂用数剂，以清理之，然而也必须去病则已，不宜常用。
苏子：不必用。
虚劳之火，既然乘金之气高而不降，治疗宜平其火而已，不必下其气。只有杂症之喘急而气高……（原文此处似有脱漏，指痰阻）。痰可消。不知道其复也，必增剧矣。只有白前一味，为平喘之上品。凡是撷肚抬肩，气高而急，能坐而不能卧，能仰而不能俯者，用此以平之，取效捷而元气不伤，绝非苏子可比。
枳壳：不可用。
虚劳施治，曰清金，曰安神，曰培土，曰调肝，曰益肾，而惟补之一字，贯穿始终，所以……（原文此处似有脱漏，指气滞原因）。气塞滞，不究虚实，便用枳壳以伐之。不知道虚劳治气，与杂症不同。其滞也，不可以利之；其高也，不可以下之；其治满也，不可以破之。陈皮、苏子，已不当用，何况枳壳、青皮呢！虚劳的施治有次序，先以清金为主；金气稍肃，即以调脾为主；金土咸调，则以补肾要……（原文此处似有脱漏，指最终目标）。还元。凡属阴虚，无不以此为扼要者也。然而杞子之性太温，如果君火未明，相火方炽，肺叶举……（原文此处似有脱漏，指禁忌）。杞子性凉之说，试问性若果凉，为何兴阳之骤耶？
当归：审慎使用。
当归的养荣，以佐清金，是很好的。然而其味未免于辛，其性未免于温，虽有养血之功，……（原文此处似有脱漏，指副作用）。肾水以收功。如果固执古人之论，谓当归命名之义，使气血各得其归，不顾血症新久而用之，也有误处。
桂圆：审慎使用。
龙眼大补心血，功效与人参并列。然而究为湿热之品，所以肺有郁火，火亢而血络伤者，服之必加剧。世……（原文此处似有脱漏，指适用情况）。既清之后，以此大补心脾，信有补血安神之效，如果肺有郁伏之火，服之则反助其火，或者正当血热上冲之时，投此甘温大补之味，则血势必涌溢而加冲。不可不慎也。
**Ginseng (Renshen):** If the exterior is affected by wind pathogenic factors and the primordial Qi has not yet been depleted, it should be used with caution.
Ginseng greatly tonifies the primordial Qi; its nature is harmonious, pure, and beautiful, neither biased nor extreme. Therefore, whether tonifying Yin or Yang, it can warm and clear, ascend and descend. However, if the Triple Burner (San Jiao) is already obstructed, using Ginseng would constitute a "double excess" error (treating an excess condition with tonification, thereby strengthening the pathogen). Regarding consumptive disease (Xu Lao), whether involving syndromes of Qi and Blood, Yin and Yang, Water and Fire, Cold and Heat, Upper and Lower, as well as Fire, Phlegm, Dryness, Dampness, Stagnation, Distension, Vomiting, Diarrhea, Vertigo/Fainting, Irritability/Thirst, and conditions during pregnancy, postpartum, after smallpox/measles, chronic illness, and convalescence, whenever the character "deficiency" (Xu) is involved, previous authorities have elaborated extensively without disagreement. Yet mediocre physicians, failing to investigate, adhere blindly to Zhu Danxi's one-sided view that Ginseng tonifies Yang and Glehnia (Shashen) tonifies Yin. Since tonifying Yang aids Fire, some even claim that patients with consumptive disease taking Ginseng will become incurable. This causes the world to fear Ginseng as if it were arsenic or poison, daring not to try it. Is this not a grave error!
**Phellodendron Bark (Huangbai) & Anemarrhena Rhizome (Zhimu):** Contraindicated.
*Danxi Xinfa* states: "In deficiency damage with hemoptysis, bitter-cold herbs should not be used abruptly, lest they cause agitation; only Qiongyu Gao (Jade Jade Paste) is suitable." Why use them in contradiction? Later scholars followed this, and for any consumptive cough, hemoptysis, or deficiency fire/heat, they assumed Zhi Mu and Huang Bai could clear fire and nourish Yin. They fail to realize that the fire in consumptive disease is deficiency fire, ministerial fire, and yin fire. As Danxi said: "Deficiency fire can be treated with tonification," such as with Ginseng and Astragalus. Ministerial fire resides between the Liver and Kidney, entering and exiting the Gallbladder channel, obeying the Heart Monarch (Heart Fire). If Heart Fire is bright, ministerial fire lies dormant; if Heart Fire is dim, ministerial fire blazes to the sky, disturbing the clear orifices, causing deafness, dry nose, tongue pain, bitter taste, dizziness, tremors, itching at Tian Tu (CV22), lung expansion, and frequent coughing. At this time, only clearing Qi and nourishing Ying (Blood) can moisten the heart center (Fang Cun Ling Tai) to calm the vexatious flames in the Chest Center (Dan Zhong), so that the ministerial fire of the Gallbladder and Liver extinguishes itself without being suppressed. Yin fire is Dragon-Lei fire, rising from the depths; when covered by cold water and yin shadows, its flame rises higher; but when exposed to the sun, it naturally dissipates. These three fires do not seek descending fire or nourishing Yin, so why use Zhi Mu and Huang Bai to harm the body? Moreover, Huang Bai injures the Stomach, and Zhi Mu slides the Spleen. Injury to the Stomach leads to poor appetite; sliding of the Spleen leads to uncontrolled diarrhea. The Spleen and Stomach are the root of human life. The Classics say: "Those who obtain grain prosper; those who lose grain perish." It also says: "When Yang essence ascends, one lives long; when Yin essence descends, one dies young." Now, using bitter-cold to injure the Stomach is indeed leading to perishing; using cold and slippery agents to damage the Spleen is indeed leading to early death. Those who use these drugs intend to nourish Yin, but do not know that bitter-cold descending agents often deplete Yin, making fire easier to blaze; they intend to clear Lung Metal, but do not know that once the Central Earth collapses, the source of Metal is cut off, Lung Metal becomes thin, and Kidney Water declines further. I know that users of these drugs see no benefit, only harm. Often seeing consumptive patients...
**Ophiopogon Tuber (Maidong) & Schisandra Berry (Wuweizi):** Use cautiously in early stages.
The method for treating the Lung involves Clearing, Tonifying, and Astringing. Thus, Maidong clears, Renshen tonifies, and Wuweizi astrings. For diseases of Lung weakness, these three are indispensable. However, in early disease, where pathogens need to be dispersed, one cannot abruptly add astringent and tonifying herbs; this follows the sequence of treatment. If one does not distinguish between early and late disease, or abruptly uses clearing, tonifying, or astringing methods, the Lung will become full and急促 (急促 implies急促/shortness of breath), pathogens will stagnate, and persist for a long time. This is not the fault of the herbs, but of improper usage timing. After dispersion, when pathogens are cleared and Yuan Qi is scattered, one must urgently use astringing and clearing-tonifying methods primarily. Besides these three herbs, what else can one seek? Furthermore, Wuweizi not only astrings but also strengthens the Heart and Kidney, making it essential for consumptive disease. Those who use it improperly blame its sourness for attracting phlegm and causing cough, fearing and discarding it. They do not realize that when the condition reaches the stage of latent fire attacking Metal and Lung Qi dissipating, apart from this herb, what else can be used to astringe?
**Alisma Rhizome (Zexie):** Suitable for use.
Lung Metal is the source of Qi transformation. When latent fire steams and burns, the water passages become turbid. Turbidity prevents Metal Qi from flowing, worsening the Lung disease. Also, stagnant water does not flow, affecting the Middle Earth... [Text gap]. Have people investigated its name? "Ze" means to moisten insufficient water; "Xie" means to drain excessive fire. Because it drains, it allows Sheng Di, Bai Shao, E Jiao, Renshen, and other tonics to have a guide, preventing stagnation from tonification. Because it moistens, although it travels through turbid pathways, it does not travel through clear pathways, unlike Zhu Ling, Tong Cao, Fu Pi, etc., which destroy Yin and Qi and go straight without remainder. Know that once Zexie is used, it is suitable for the Lung, Spleen, and Kidney, hence its merit is compared to Yu the Great taming the waters. Ancient formulas like Liu Wei Di Huang Wan use it; *Yisheng Weilun* details four functions. Mediocre physicians, failing to investigate, view it as damaging Yin and harming the Kidney, leaving it unused. How absurd!
**Mulberry Root Bark (Sangbaipi):** Suitable for use.
Sang Bai Pi is clear and sweet. Clearing can drain excess Liver Fire; sweetness can tonify deficient Lung Qi. Its nature is moist yet drying, regulating the Triple Burner... [Text gap], most contraindicated in wheezing and edema. Lung Qi rebellion forced by fire, high and not descending, causes wheezing; Earth weakness bullied by water, sinking and losing embankments, causes edema. Wheezing is Heaven not descending to Earth; Edema is Earth not ascending to Heaven. Upper wheezing and lower edema are signs of Heaven collapsing and Earth sinking. Only Sang Bai Pi can regulate this. Because it descends Qi, it clears Upper Jiao fire; because it breaks water, it stabilizes Earth virtue below. Why did predecessors not investigate, thinking its nature impure and advising against it? Do not all things have pure natures? Only Mulberry and Lotus are purely pure. How can Sang Bai Pi be impure? Is this logical?
**Platycodon Root (Jiegeng):** Suitable for use.
The Lung is like a canopy, residing at the highest point, overseeing the five Zang organs, issuing commands of governance. Disease occurs when governance lacks power, leading to Qi rebellion and Fire rising... [Text gap]. Extremely clear, thus it clears Metal; ascending and floating, thus it carries sunken Qi; slightly bitter, thus it descends Fire. It is truly the sovereign agent for governing the Lung, not just a guiding messenger. This herb ascends while descending; because it clears Metal well, clear Metal naturally issues descending commands. It clears while tonifying; because it protects the Lung well, a solid Lung naturally becomes the master of Qi and Blood. Its texture is neither dry nor stagnant, lacking bias, possessing perfect merit. Long-term use clears fire, eliminates phlegm, opens the chest, calms Qi, generates Yin, benefits Yang. Merits cannot be fully described. Doctors often fear its lifting and dispersing nature,不敢 (dare not) use it lightly or heavily in tonifying formulas, burying its goodness and covering its merit. Pity!
**Moutan Cortex (Danpi) & Lycium Bark (Digupi/Goubupi):** Suitable for use.
Huang Bai and Zhi Mu, being stomach-reversing and spleen-damaging, should indeed be discarded. But when ministerial fire melts stone and flows metal, how to handle this? [Text gap]. Clearing fire and removing steaming, additionally nourishing the Lung. Digupi is the root of Gouqi (Goji). Gouqi is a key herb for tonifying the Kidney, but because it ascends and fills the upper, it only warms marrow and assists Yang. In early consumptive disease, when ministerial fire is blazing, it dare not be used abruptly. Its root lies hidden below; because it is below, it nourishes True Water of the Kidney; because it is bark, it soothes scorched Lung leaves, cools blood, clears bone, promotes urination, and removes steaming. Its merit surpasses Danpi. Its taste is not bitter, so it doesn't reverse the stomach; its texture is not slippery, so it doesn't slide the spleen. Properly applied, it has the merit of Zhi Mu and Huang Bai without their harm, making it an excellent product.
**Rehmannia Root (Shengdi):** Suitable for use; use cautiously in early disease.
People consider Sheng Di a phlegm-stagnating substance and dare not use it lightly, not knowing phlegm varies by syndrome. In miscellaneous diseases, phlegm treatment focuses on drying dampness and strengthening the Spleen... [Text gap]. Suppressing Lung Metal, preventing clear descent, essences fail to circulate, stagnating into phlegm and cough. Treatment should clear the Lung, so pathogens descend; nourish blood, so fire calms. Thus, in my Lung-clearing formulas, I always combine Ying-nourishing as primary. Ying is Blood. Yin is Water, having the virtue of moistening downward. Clearing Metal without nourishing Ying is like blowing wind to extinguish fire; the wind reverses, flames grow. Clearing Metal and nourishing Ying is drawing water to control fire, moistening everywhere, smoke ceases forever. So Jie Geng, Sang Bai Pi, Bei Mu are Lung-clearing herbs. Sheng Di, Dan Pi, Dang Gui are Ying-nourishing herbs. Among Ying-nourishing herbs, Sheng Di is first. Using Sheng Di for miscellaneous disease phlegm blocks phlegm paths, stagnates phlegm-transforming Qi, and its tonifying strength aids phlegm formation. But in consumptive formulas, the Lung likes its moisture, Heart likes its clarity, Kidney likes its nourishment, Liver likes its harmony, Spleen likes its mild sweetness, without being cold or slippery. Thus, in labor cough, bone-steaming, internal heat, hemoptysis formulas, omitting Sheng Di is impossible. Only in early labor cough, when external pathogens are not cleared and phlegm-cough is severe, temporarily avoid Sheng Di to prevent stagnation. Once exterior symptoms are removed and internal heat steams, without Sheng Di's clearing-moistening to nourish the source of transformation, vitality will be exhausted. If fearing its stagnation...
**Poria (Fuling):** Suitable for use.
Some say Fuling is good at leaching, so those with deficient Lower Origin should avoid it. This is incorrect. Fuling is formed from the essence of ancient pine, buried longest, obtaining the strongest Qi. Its texture is heavy, its Qi is clear, its taste is bland. Heaviness strengthens Earth; clarity benefits Metal; blandness promotes water drainage. Because it obtains strong Earth Qi, it can tonify the three regions. Deficiency heat, deficiency fire, dampness generating phlegm—all involving deficiency are suitable, because its nature is neutral, pure, and beautiful, unlike other rapid and attacking drugs. Metal Qi clearing and descending naturally opens the source of water; Earth Qi balancing naturally benefits the mother of Qi. With three Zang regulated, Water and Fire cannot dominate, so all five Zang are balanced in one move. It serves as an assistant to Yin herbs to remove stagnation; as a guide for Yang herbs to open pathways. Tonifying without stagnation, draining without harshness, a pure product, nothing surpasses it.
**Astragalus Root (Huangqi):** Suitable for use.
I once explained the meaning of Jian Zhong (Establishing the Middle): The body has Heart above, Kidney below, Lung right, Liver left, only Spleen-Stomach reside uniquely in the middle. Huang Qi's quality... [Text gap]. Upper Qi does not descend, Lower Qi does not ascend, Left does not support Right, Right does not support Left. Obtaining Huang Qi's sweet-warm Qi-tonifying property, it masters the Central Province. Once the central banner is established, the five directions' misplaced armies return to their ranks. This is the origin of the name Jian Zhong. So in long-standing labor cough with lost Qi, Qi not rooted in Dantian, Blood overflows with Qi, Blood is chaotic, Qi flies. At this time, even if Renshen returns Yuan Qi from nowhere, it ultimately cannot secure True Yuan in an unshakeable place. For long-term peace, Huang Qi is indispensable. Renshen's tonification is swift but empty; Huang Qi's tonification is heavy and solid. In moments of breathlessness, Huang Qi is inferior to Renshen. But for settling floating chaos, returning to origin, controlling Qi and grasping Blood, solidifying exterior and filling interior, its creation is like an impregnable wall, its command like an unviolated general's order, its abundance like an inexhaustible granary, its defending evil and supporting righteousness like military vanguard, center, and rear, unshakable. In various rooting and concluding uses, Renshen is inferior to Huang Qi. So for tonifying deficiency, Huang Qi is the wall, Bai Zhu is the foundation. Often seeing long-term Renshen use leads to faint existence, though operation is sufficient, it remains floating and weak, unable to withstand storms. Using Qi and Zhu together achieves immunity to wind/rain and cold/heat, transforming weak bodies. Truly seeing this! Except in early labor cough with major Middle Earth injury, blazing Qi-Fire, where Heart-Lung lack harmony but Spleen-Stomach still function, here only Ying-nourishing is suitable; Huang Qi is slightly stagnating, so slow administration is appropriate. If chronic Qi deficiency... [Text gap]. To solidify Earth, merely using heavy-yin descending-turbid agents further damages ascending-volatilizing utility, achieving nothing.
**Atractylodes Macrocephala Rhizome (Baizhu):** Suitable for use; use cautiously in early disease.
Early consumptive disease treatment invariably takes clearing Metal as the first principle. Besides Sheng Di, E Jiao, Dan Pi, Bai Shao for clearing Metal, there are... [Text gap]. Even Maidong dislikes cold, Xuan Shen dislikes cold. Long-term use hinders diet, sinks Middle Qi. At this time, strengthening Earth and regulating Middle is primary. In miscellaneous diseases, many herbs are used, but in deficiency syndromes, Earth-strengthening formulas only include Huang Qi, Baizhu, Fuling, Shan Yao, with merit and no fault. Consumptive Earth-strengthening values not damaging the highest Qi. So Er Chen Tang's dryness, Ping Wei San's intensity are万万不可 (absolutely forbidden). Even Dou Dou's Spleen-strengthening, Yi Yi Ren's dampness-resolving involve moving Blood, not perfect. Among the four, Fuling and Shan Yao are harmonious but lack drastic revitalizing power. Even using Qi and Zhu together, Zhu is the specialist for Earth meridian and Qi-tonifying, so it strengthens Earth to generate Metal, relying on the highest region. Zhu nature is slightly dry, seemingly for deficiency should be slow, but it likes dryness without intensity, matching Central Earth virtue. Strengthening Earth generates Metal, like mountains producing clouds/mist, descending as rain/dew to moisten all things. What dryness disease is there? Miao Zhongchun says it dries and harms Yin. Not knowing harming Yin belongs to Cang Zhu, Hou Po, etc. How can Baizhu, a slightly dry neutral herb, be compared? And at treatment conclusion, without strengthening Earth, floating fire never roots. Knowing Baizhu's great merit.
**Bupleurum Root (Chaihu):** Use cautiously.
Chai Hu ascends clear and regulates middle, calms Liver and moderates Spleen, clears heat and scatters fire, regulates Qi and unblocks Blood, exits exterior enters interior, expels evil supports righteous, opens fullness breaks knots, settles camp supports... [Text gap]. Immersion stagnation awaits ventilation. Besides Chai Hu and Qian Hu, none have purer nature. So use small amounts to assist, then specialize in clearing source, tonifying, astringing for perfection. Even in调理 (regulation), if infection occurs, urgently use Chai Hu, Fang Feng, Ge Gen to disperse, then resume tonifying/astringing to avoid trapping the thief in the gate. But its nature is ascending and dispersing; users should stop when disease is cured, not use much or commonly. Especially for women with depression injuring Yin, or postpartum exhaustion, selection is necessary. Depression injures Yuan Qi; Chai Hu calms Liver and scatters depression, effect is fastest. Later generations, due to Chen Cangqi's words, forbid Chai Hu. For internal injury/exterior contraction, should we reverse and use Ma Huang, Zi Su to disperse!
**Tangerine Peel (Chenpi):** Occasional use.
Jie Geng carries Qi upward, yet Qi-Fire calms, showing consumptive Qi stems from Fire invading Lung. If miscellaneous diseases have chest-diaphragm Qi... [Text gap], usually using Chen Pi to regulate Qi. Not knowing Chen Pi is pungent and dry. Pungency consumes Lung Qi purity; dryness stirs Yin-deficiency ministerial fire. Intending to regulate Qi, Qi is injured. Only after long Lung clearing, source moves, Spleen Qi not strong, stomach saliva increases, can small amount of Chen Pi be added to speed it up, clearing Middle Palace, acceptable. Or if seasonal qi comes, Spleen-Stomach damp diarrhea, can temporarily use several doses to clear/regulate, but must stop when disease is gone, not commonly used.
**Perilla Seed (Suzi):** Not necessary to use.
Consumptive fire, riding on Lung Qi high and not descending, treatment should calm fire, not descend Qi. Only miscellaneous disease wheezing urgency and high Qi... [Text gap] Phlegm can be eliminated. Not knowing recurrence will worsen. Only Bai Qian is the superior herb for calming wheezing. For pulling belly, raising shoulders, high urgent Qi, sitting but not lying, looking up but not down, use this to calm. Effect is fast, Yuan Qi undamaged, incomparable to Suzi.
**Bitter Orange Fruit (Zhike):** Cannot be used.
Consumptive treatment: Clear Metal, Calm Spirit, Strengthen Earth, Regulate Liver, Tonify Kidney. Only "Tonify" character runs through start to finish, so... [Text gap] Qi blockage/stagnation, ignoring deficiency/excess, immediately use Zhike to attack. Not knowing consumptive Qi regulation differs from miscellaneous diseases. Stagnation cannot be drained; High cannot be descended; Fullness cannot be broken. Chen Pi, Suzi are inappropriate, let alone Zhike, Qing Pi! Consumptive treatment has sequence: First clear Metal; when Metal Qi slightly肃 (solemn/clear), regulate Spleen primarily; when Metal-Earth both regulated, then Kidney tonification is key... [Text gap] Return to origin. All Yin deficiency cases take this as essential. However, Goji nature is too warm. If Monarch Fire not bright, Minister Fire blazing, Lung leaves rise... [Text gap] Goji cool nature claim, ask if nature is cool, why sudden Yang stimulation?
**Angelica Sinensis Root (Danggui):** Use cautiously.
Dang Gui's Ying-nourishing to assist Lung clearing is excellent. But its taste is pungent, nature warm. Though it has blood-nourishing merit... [Text gap] Kidney Water to conclude. If adhering to ancients' theory, naming meaning makes Qi and Blood return to their places, ignoring new/old blood disease, errors occur.
**Longan Aril (Guiyuan):** Use cautiously.
Long Yan greatly tonifies Heart Blood, merit equals Renshen. But ultimately it is damp-heat product. So Lung has latent fire, fire亢 (hyperactive) damaging blood collaterals, taking it worsens. World... [Text gap] After clearing, using this to greatly tonify Heart-Spleen, indeed has blood-nourishing and spirit-calming effects. If Lung has latent fire, taking it aids fire. Or when blood heat rushes upward, throwing this sweet-warm great tonic, blood force surges and adds rush. Must be cautious.