论曰。流变在乎病。主治在乎物。制用在乎人。三者并明。则可以语七方十剂。宣通补泻轻重涩滑燥湿。
是十剂也。大小缓急奇偶复。是七方也。是以制方之体。欲成七方十剂之用者。必本于气味生成而成方焉。
其寒热温凉四气者生乎天。酸苦辛咸甘淡六味者成乎地。气味生成。而阴阳造化之机存焉。是以一物之中。
气味兼有。一药之内。理性不无。故有形者为之味。无形者谓之气。若有形以无形之治。喘急昏迷乃生。无形
以有形之治。开肠洞泄乃起。经所谓阴味出下窍。阳气出上窍。王注曰。味有质。故下流于便泻之窍。气无形。
故上出于呼吸之门。故阳为气。阴为味。味归形。形归气。气归精。精归化。精食气。形食味。王注曰。气化
则精生。味和则形长。是以有生之大
形。精为本。故地产养形。形不足者。温之以气。天产养精。精不足者。补之以味。形精交养。充实不亏。虽
有苛疾。弗能为害。故温之以气者。是温之以肺。补之以味者。是补之以肾。是以人为万物之灵。备万物之养。
饮和食德。以化津液。以淫筋脉。以行荣卫。故经所谓阴之所生。本在五味。气味合而服之。以补精益气。所
以为全生之术。故五谷五畜五菜五果。甘苦酸辛咸。此为补养之要也。何则谷入于口。而聚于胃。胃为水谷之
海。喜谷而恶药。药之所入。不若谷气之先达。故治病之法。必以谷气为先。是以圣人论真邪之气者。谓汗生
于谷。不归于药石。辨死生之候者。谓安谷则生。过期不惟数于五脏。先明胃气为本。以此知五味能养形也。
虽毒药攻邪。如国之用兵。盖出于不得已也。是以圣人发表不远热。攻里不远寒。辛甘发散为阳。酸苦涌泄为
阴。故辛散酸收甘缓苦坚咸 。随五脏之病证。施药性之品味。然后分奇偶大小缓急之制也。故奇偶者。七方
四制之法。四制者。大小缓急也。所谓气有多少。病有盛衰。治有缓急。方有大小。故大小者。君一臣二。
奇之制也。君二臣四。偶之制也。君二臣三。奇之制也。君二臣六。偶之制也。又曰。奇方云君一臣二。君二
臣三。偶方云君二臣四。君二臣六。所以七方者。四制之法。奇偶四制。何以明之。假令小承气调胃承气为
奇之小方也。大承气抵当汤为奇之大方也。所谓因其攻下而为之用者如此。桂枝麻黄为偶之小方。葛根青龙为
偶之大方。所为因其发而用之者如此。经所谓近者奇之。远者偶之。身之表者为远。身之里者为近。汗者不以
奇。下者不以偶。不以者。不用也。故补上治上制以缓。补下治下制以急。急则气味浓。缓则气味薄。故味浓
者为阴。薄为阴之阳。为味不纯粹者也。故味所浓。则泄之以下。味所薄。则通气者也。王注曰。味浓则泄。
薄则通。气浓者为阳。薄为阳之阴。故附子干姜味甘温大热。为纯阳之
药。为气浓者也。丁香木香味辛温平薄。为阳之阴。气不纯粹者也。故气所浓则发热。气所薄则发泄。经曰。
气薄则发泄。浓则发热。王注曰。阴气润下。故味薄则发泄。阳气炎上。故气浓则发热。味薄为阴少。故通泄。
气薄为阳少。故汗出。是以论气味之薄浓。合奇偶之大小。故肾肝位远。数多则其气缓。不能速达于下。必大
剂而数少。取其迅急。可以走下也。心肺位近。数少则其气急。不能发散于上。必小剂而数多。取其气易散。
可以补上也。王注曰。肺服九。心服七。脾服五。肝服三。肾服一。乃五脏生成之常数也。若奇之不去则偶之。
是谓重方也。偶之不去。则反佐以取之。所谓寒热温凉。反从其病也。王注曰。是以圣人反其佐。以同其气。
令声气应合。复令寒热参合。使其终异始同。燥润而败。坚刚必折。柔脆自消尔。故逆者正治。从者反治。从
少从多。观其可也。仲景曰。少阴病下利而脉微者。与白通汤。利不止厥逆无脉者。干呕烦者。白通加猪胆人
尿。注曰。若调寒热之逆。冷热必行。则热物冷服。下嗌之后。冷体既消。热性便发。由是病气随愈。呕哕皆
除。情且不违。而致大益。此加人尿猪胆汁咸苦寒物。于白通汤热剂中。要其气相从。可去格拒之寒也。经所
谓热因寒用。寒因热用。塞因塞用。通因通用。必伏其所主。而先其所因。其始则同。其终则异。可使破积。
可使溃坚。可使气和。可使必已。此之谓也。若病所远而中道气味之者。食而过之。无越其制度。王注曰。
假命病在肾。而心之气味饲而冷。是仍急过之。不饲以气味。肾药凌心。心腹益衰。与上下远近例同。是以圣
人治上不犯下。治下不犯上。和中上下俱无犯。故经所谓诛罚无过。命曰大惑。此之谓也。有中外不相及。则
治其主病。皆论标本。不令妄攻也。故从所来者为本。其所受者为标。是以内者内调。外者外治。内者调之。
不言其治。外者治之。不言其调。经所谓上淫于下。所胜平之。外淫于
内。所胜治之。此之谓也。若从内之外。盛于外。先调其内。而后治其外。从外之内。而盛于内者。先治其外。
而后调其内。王注曰。皆谓先除其根底。后削其枝条也。是故病发有余。本而标之。后治其本。故仲景曰。伤
寒医下之。续得下利清谷。身疼痛者。急当救里。后身疼痛。清便自调。急当救表。救里四逆汤。救表宜桂枝
汤。故里不足。必先救之。清便自调。知里气已调。然后急与桂枝汤以救表。是谓病发本而标之。先治其本。
后治其标。此以寒为本也。故知标本者。万举万全。不知标本。是谓妄行。此之谓也。虽本草曰。上药一百二
十种为君应天。中药一百二十种为臣应人。下药一百二十种为使应地。若治病者。特谓此三品之说末也。经所
谓有毒无毒。所治为主。适小大为制也。故主病之谓君。佐君之谓臣。应臣之谓使。非上中下三品之谓也。王
注曰。但能破积愈疾。解急脱死。则为良方。非必要以先毒为是。后毒乃非。有毒为是。无毒为非。必量病轻
重大小制之者也。帝曰。三品何谓。岐伯曰。所以明善恶之殊贯也。是以圣人有毒无毒。服自有约。故病有久
新。方有大小。有毒无毒。固宜常制矣。大毒治病。十去其六。常毒治病。十去其七。小毒治病。十去其八。
无毒治病。十去其九。谷肉果菜。食养尽之。无使过之。伤其正也。不尽行复如法。王注曰。法谓前四约也。
余病不尽。然再行之。毒之小大。如约而止。必无过也。是以上古圣人。谓重身之毒。有故无殒。衰其大半而
止。故药之性味。本以药治疾。诚能处以中庸。以疾适当。且如半而止之。亦何疑于攻治哉。此之谓也。故非
调气而得者。治之奈何。有毒无毒。何先何后。愿闻其道。王注曰。夫病生之类。其有四焉。一者始因气动而
内有所成。为积聚 瘕瘤气瘿起结核癫痫之类是也。二者不因气动而外有所成者。谓痈肿疮疡痂疥疽痔掉螈浮
肿目赤瘭胗 肿痛痒之类是也。三者不因气动而病生于内。留饮 食
饥饱劳损宿食霍乱悲恐喜怒想慕忧结之类是也。四者不因气动而病生于外。为瘴气贼魅虫蛇蛊毒蜚尸鬼击冲薄
堕坠风寒暑湿斫射剌割捶朴之类是也。如此四类者。有独治内而可愈。大小承气陷胸抵当汤三花神 藏用之类
是也。有兼治内而愈者。大小柴胡通圣洗心凉膈黄连解毒之类是也。有独治外而愈者。善应膏拔毒散点眼药生
肌之类是也。有兼治外而愈者。拨云散苦参散千金内托散之类是也。有先治内后治外而愈者。瘭胗丹毒疮疡痈
疽斑疹之类。悉因三焦相火。热甚于内。必先疏启其中。凉苦寒之剂。荡涤脏腑。或以砭射敷扫涂抹于外者是
也。有先治其外后治其内而愈者。伤寒刺割破伤。皆因风寒之邪。从外之内。先以发散其外。发之不已。量其
浅深峻泄之。有齐毒而攻击者。暴病大小便不利胎死坚积满胀之类是也。复有无毒而调引者。痰滞气痞。胃虚
脾弱。气不往来。以通经利其气之药之类是也。方法所施。或胜或复。寒者热之。热者寒之。温者清之。散者
收之。抑者折之。燥者润之。急者缓之。刚者 之。衰者补之。强者泻之。坚者削之。留者攻之。客者除之。
劳者温之。温养也。结者散之。燥者濡之。损者温之。温补也。逸者行之。劳者动之。惊者平之。平常也。常
见常闻。上之吐之。下之泄之。磨之灸之。浴之薄之。劫之燔之。针劫其下。开之发之。适可为故。各安其气。
必清必净。则病气衰去。归其所宗。此治之大体也。是以圣人法无定体。体变布施。药不执方。合宜而用。故
论言治寒以热。治热以寒。而方士不能废绳墨而更其道也。有病热者。寒之而热。有病寒者。热之而寒。二者
皆在。新病复起。奈何。治诸寒而热者。取之以阴。热之寒者。取之以阳。所谓求其属也。王注曰。谓治之而
病不衰退。反因热寒而随生寒热。病之新者也。谓其益火之原。以消阴翳。用水之主。以制阳光。故曰求其属也。
夫取心者。不必齐以热。取肾者。不必齐以寒。但
益心之阳。寒亦通行。若强肾之阴。热之犹可。此论五味所归五脏寒热温凉之主也。呜呼。圣人之道久塞。
而后之人独不能之也。王注曰。言少可以贯多。举浅可以料深。何法之明也如此。故非圣人之道。孰能至于是
耶。是以治病之本。须明气味之浓薄。七方十剂之法也。方有七。剂有十。故方不七。不足以尽方之变。剂不
十。不足以尽剂之用。方不对病。非方也。剂不蠲疾。非剂也。今列而论之。
七方者。大小缓急奇偶复。
大方之说有二。一则病有兼证。而邪不专。不可以一二味治之。宜君一臣三佐九之类是也。二则治肾肝在
下而远者。宜分两多。而顿服之是也。
小方之说有二。一则病无兼证。邪气专一。可以君一臣二小方之治也。二则治心肺在上而近者。宜分两微。
而频频少服之。亦为小方之治也。
缓方之说有五。有甘以缓之为缓方者。为糖蜜甘草之类。取其恋膈也。有丸以缓之为缓方者。盖丸之比汤
散。药力宣行迟故也。有品味群众之缓方者。盖药味众多。各不能骋其性也。有无毒治病之缓方者。盖药性无
毒。则攻自缓也。有气味薄而缓方者。药气味薄。则常补于上。比至其下。药力既已衰。为补上治上之法也。
急方之说有四。有急病急攻之急方者。如腹心暴痛。前后闭塞之类是也。有急风荡涤之急方者。谓中风不
省口噤是也。取汤剂荡涤。取其易散而施攻速者是也。有药有毒之急方者。如上涌下泄夺其病之大势者是也。
有气味浓之急方者。药之气味浓者。直趣于下而力不衰也。谓补下治下之法也。
奇方之说有二。有古之单行之
奇方者。为独一物是也。有病近而宜用奇方者。为君一臣二君二臣三。数合于阳也。故宜
下不宜汗也。
偶方之说有二。有两味相配而为偶方者。盖两味相合者是也。有病远而宜用偶方者。君二臣四。君四臣六。
数合于阴也。故宜汗不宜下也。
复方之说有二。有二三方相合之为复方者。如桂枝二越婢一汤之类是也。有分两匀同之复方者。如胃风汤
各等分之类是也。又曰重复之复。二三方相合而用也。反复之复。谓奇之不去则偶之是也。
十剂者。宣通补泻轻重涩滑燥湿。
宣者。宣散也。郁而不散为壅。必宣剂以散之。如痞满不通之类是也。本草曰。宣可去壅。必宣剂以散之。
如姜橘之属。攻其里则宣者上也。泄者下也。涌剂则瓜蒂栀豉之类是也。发汗通表亦同。
通。留而不行为滞。必通剂以行之。如水病痰癖之类也。本草曰。通可去滞。通草防己之属。攻其内则通
者行也。甘遂滑石茯苓芫花大戟牵牛木通之类是也。
补。不足为弱。必补剂以扶之。如气形羸弱之类是也。本草曰。补可去弱。人参羊肉之属。攻其里则补养
也。经所谓言而微。终日乃复言者。此夺气也。故形不足。温之以气。精不足。补之以味。是以膏粱理疾。药
石蠲疾。五谷五畜。能补善养也。
泻。有余为闭。必泄剂以逐之。如腹胀脾约之类是也。本草曰。泻可去闭。即葶苈大黄之属。经所谓浊气
在上。则生 胀。故气不施化而郁闭不通。所以葶苈大黄味苦大寒。专能泻热去湿下气。仲景曰。趺阳脉浮而
涩。浮则胃强。涩则小便数。浮涩相搏。大便难。其脾为约。故约束津液不得四布。苦寒之剂。通塞润燥而能
泄胃强也。
轻。实则气壅。欲其扬也。如汗不发而腠密。邪胜而中蕴。
必轻剂以扬之。本草曰。轻可去实。麻黄葛根之属。经所谓邪在皮者。汗而发之。其实者。散而泄之。王注曰。
阳实则发散。
重。怯则气浮。欲其镇也。如丧神守而惊悸。气上厥以颠疾。必重剂以镇之。本草曰。重可去怯。即磁石铁
粉之属。经所谓厥成为癫疾。故惊乃平之。所以镇涎也。故使其物体之重则下涎而用之也。
涩。滑则气脱。欲其收敛也。如开肠洞泄。便溺遗失。必涩剂以收之。本草曰。涩可去脱。则牡蛎龙骨之
属。如宁神宁圣散之类是也。
论述说：病证的流变取决于疾病本身，药物的主治功效取决于药物特性，而药物的炮制与运用则取决于医者。这三者都明了，才可以谈论“七方”和“十剂”，即宣、通、补、泻、轻、重、涩、滑、燥、湿这十种治法。
这就是所谓的“十剂”。所谓“七方”，是指大、小、缓、急、奇、偶、复。因此，制定方剂的体制，想要成就七方十剂的功效，必须基于药味的生成原理来组方。
寒、热、温、凉这四种药性源于天（自然气候），酸、苦、辛、咸、甘、淡这六种药味成于地（地理物产）。药性与药味的生成，其中蕴含着阴阳造化的机理。因此，在一味药中，往往兼具多种气味；在一剂药内，其理性和性质也不单一。所以，有形的物质称为“味”，无形的能量称为“气”。如果用有形之味去治疗无形之气导致的病症，喘促急促、昏迷等症状就会发生；如果用无形之气去治疗有形之质导致的病症，肠开洞泄的症状就会兴起。医经中说：“阴味出于下窍，阳气出于上窍。”王冰注解说：“味是有质的，所以下流于大小便的孔窍；气是无形的，所以上出于呼吸的门径。”所以阳指气，阴指味。“味归形，形归气，气归精，精归化。精食气，形食味。”王冰注解说：“气化则精生，味和则形长。”因此，对于有生命的大形体来说，精是根本，所以地产之物滋养形体。形体不足的，用气来温煦它；天产之物滋养精气，精气不足的，用味来补益它。形与精相互滋养，充实而不亏损，即使有苛细的疾病，也不能为害。所以说，用气来温煦的，是温煦肺脏；用味来补益的，是补益肾脏。
因此，人是万物之灵，具备万物的滋养能力。通过调和饮食的德行，以化生津液，滋润筋脉，运行营卫之气。所以医经中说：“阴血的生成，根本在于五味。”将气味配合服用，以补充精益气，这是保全生命的技艺。所以五谷、五畜、五菜、五果，具有甘、苦、酸、辛、咸的味道，这是补养的关键所在。为什么呢？谷物入口，汇聚于胃，胃是水谷之海，喜欢谷物而厌恶药物。药物进入体内，不如谷气先到达。所以治病的方法，必须以谷气为先。因此圣人论述真气与邪气的关系时说：“汗生于谷，不归于药石。”辨别死生的征候时说：“能安受谷气则生。”不仅限于五脏，首先要明确胃气为本。由此可知五味能滋养形体。虽然毒药用于攻伐邪气，如同国家使用军队，实在是出于不得已。因此圣人发表不远热，攻里不远寒。辛、甘发散属于阳，酸、苦涌泄属于阴。所以辛能散，酸能收，甘能缓，苦能坚，咸能……（原文此处似缺字，依文意推测为软或下等，但按规则不增添，故略过或保留语境中的并列关系，此处原文为“咸 ”后接句号或换行，结合下文“随五脏之病证”，此处应理解为咸味的作用与其他五味并列，通常咸能软坚或下气，但原文仅列“咸 ”，故翻译时保留并列结构）。根据五脏的病证，施用相应药性的品味，然后区分奇方、偶方、大方、小方、缓方、急方的体制。
所谓奇方和偶方，是七方中的四种体制。这四种体制是指大、小、缓、急。所谓气有多少，病有盛衰，治有缓急，方有大小。所以大方和小方：君药一臣药二，是奇方的体制；君药二臣药四，是偶方的体制；君药二臣药三，是奇方的体制；君药二臣药六，是偶方的体制。又说：奇方指君一臣二、君二臣三；偶方指君二臣四、君二臣六。所以七方包含这四种体制。如何阐明呢？举例来说，小承气汤、调胃承气汤属于奇方中的小方；大承气汤、抵当汤属于奇方中的大方。这是根据其攻下的作用来应用的。桂枝汤、麻黄汤属于偶方中的小方；葛根汤、大青龙汤属于偶方中的大方。这是根据其发汗的作用来应用的。医经中说：“病位近的用奇方，病位远的用偶方。”身体表层为远，身体深层为近。发汗不用奇方，攻下不用偶方。“不以”就是“不用”的意思。所以补上部、治上部，方剂要制得缓和；补下部、治下部，方剂要制得峻急。峻急则气味浓厚，缓和则气味淡薄。所以味道浓厚的是阴，淡薄的是阴中之阳，即气味不纯粹的物质。所以味道浓厚的，能泄下；味道淡薄的，能通气。王冰注解说：“味浓则泄，味薄则通。”气味浓厚的是阳，淡薄的是阳中之阴。所以附子、干姜味甘、性温、大热，是纯阳的药物，因为气味浓厚。丁香、木香味辛、性温平、气味淡薄，是阳中之阴，因为气味不纯粹。所以气味浓厚的能发热，气味淡薄的能发泄。医经说：“气薄则发泄，气浓则发热。”王冰注解说：“阴气润下，所以味薄则发泄；阳气炎上，所以气浓则发热。”味薄属于阴少，所以通泄；气薄属于阳少，所以汗出。因此讨论气味的厚薄，结合奇偶的大小。肾和肝位置深远，药味数量多则药气缓慢，不能迅速到达下部，必须用大剂量且服药次数少，取其迅急，可以走下。心和肺位置浅近，药味数量少则药气急迫，不能发散于上部，必须用小剂量且服药次数多，取其气易散，可以补上。王冰注解说：“肺服九，心服七，脾服五，肝服三，肾服一，这是五脏生成的常数。”如果奇方无效就用偶方，这叫重方。如果偶方也无效，就采用反佐法来取效。所谓寒、热、温、凉，反顺着病势用药。王冰注解说：“因此圣人反向使用佐药，以同其气，令声气应合，再让寒热参合，使其最终不同而始同，使燥润败坏，坚刚必折，柔脆自消。”所以逆病势为正治，顺病势为反治。从少还是从多，观察病情而定。张仲景说：“少阴病下利而脉微的，给予白通汤。如果下利不止、四肢厥冷、无脉、干呕心烦的，给予白通加猪胆汁人尿汤。”注解说：“如果要调理寒热的逆乱，冷热必然并行，那么热药冷服，咽下之后，冷的体质既然消失，热的药性便发作，于是病气随之痊愈，呕吐哕逆皆除，情志不违，而获得大益。这是在白通汤的热剂中加入人尿、猪胆汁这些咸苦寒的物品，要求它们的气相从，可以去掉格拒的寒邪。”医经所谓“热因寒用，寒因热用，塞因塞用，通因通用”，必须伏其所主，而先究其因，开始相同，最终不同，可以破除积滞，可以溃散坚结，可以使气和，可以使病愈。说的就是这个道理。如果病位遥远而在中途被气味阻隔的，吃饭可以越过它，不要超越制度。王冰注解说：“假如病在肾，而心的气味喂养它并使其冷，这时应急速经过，不要用气味喂养，否则肾药凌犯心脏，心腹更加衰弱，这与上下远近的例子相同。因此圣人治上不犯下，治下不犯上，和中则上下都不犯。所以医经说‘诛罚无过，命曰大惑’，说的就是这个道理。有内外不相及的，就治疗主病，都是论述标本，不让妄加攻伐。所以从所来的方向为本，所受到的部位为标。所以在内的在内调理，在外的在外治疗。在内的只谈调理，不谈治疗；在外的只谈治疗，不谈调理。医经说‘上淫于下，所胜平之；外淫于内，所胜治之’，说的就是这个道理。如果从内之外，盛于外，先调理内部，而后治疗外部；从外之内，而盛于内，先治疗外部，而后调理内部。王冰注解说：这都是指先除去其根底，后削去其枝条。所以病发有余，本而标之，后治其本。所以张仲景说：伤寒医生误用下法，随后出现下利清谷，身体疼痛的，应当紧急救里，随后身体疼痛，大便正常，应当紧急救表。救里用四逆汤，救表宜用桂枝汤。所以里气不足，必须先救里。大便正常，知道里气已调，然后紧急给予桂枝汤以救表。这叫病发本而标之，先治其本，后治其标。这是以寒为本。所以知道标本的，万举万全；不知道标本的，叫做妄行。说的就是这个道理。虽然《本草》说：上药一百二十种为君，应天；中药一百二十种为臣，应人；下药一百二十种为使，应地。但如果治病，特别强调这三品的说法是末节。医经说‘有毒无毒，所治为主，适小大为制’。所以主病的是君，辅助君的是臣，响应臣的是使，不是指上中下三品。王冰注解说：只要能破除积滞治愈疾病，解救危急脱离死亡，就是良方，并非一定要先毒才是好，后毒就不是。有毒是对的，无毒是不对的，必须衡量病情的轻重大小来制定。黄帝问：三品是什么意思？岐伯答：是为了说明善恶的不同类别。因此圣人有毒无毒，服用自有节制。所以病有久新，方有大小，有毒无毒，固然是常规制度。大毒治病，去掉十分之六；常毒治病，去掉十分之七；小毒治病，去掉十分之八；无毒治病，去掉十分之九。用谷肉果菜，食疗尽除余邪，不要过度，伤害正气。如果不愈，照此法再行。王冰注解说：法指前面的四个节制。其余病未尽，然而再行之，毒的大小，按照节制停止，必定不会过度。所以上古圣人，谓怀孕期间的毒性，有故无殒，衰减大半而止。所以药性气味，本来是用药治疗疾病，如果能处以中庸，以疾适当，并且如减半而止，对攻治有什么怀疑呢？说的就是这个道理。那么不是通过调气而得愈的，怎么治疗？有毒无毒，何先何后，希望听闻其道。王冰注解说：病生的情况，有四种：一是始因气动而内有所成，为积聚、瘕瘤、气瘿、起结核、癫痫之类；二是不因气动而外有所成，为痈肿、疮疡、痂疥、疽痔、掉螈、浮肿、目赤、瘭胗、肿痛、痒之类；三是不因气动而病生于内，留饮、食饥饱劳损、宿食、霍乱、悲恐喜怒、想慕忧结之类；四是不因气动而病生于外，为瘴气、贼魅、虫蛇、蛊毒、蜚尸、鬼击、冲薄、堕坠、风寒暑湿、斫射、剌割、捶朴之类。如此四类，有独治内而可愈的，大小承气、陷胸、抵当汤、三花神藏用之类；有兼治内而愈的，大小柴胡、通圣、洗心、凉膈、黄连解毒之类；有独治外而愈的，善应膏、拔毒散、点眼药、生肌之类；有兼治外而愈的，拨云散、苦参散、千金内托散之类；有先治内后治外而愈的，瘭胗、丹毒、疮疡、痈疽、斑疹之类，悉因三焦相火，热甚于内，必先疏启其中，用凉苦寒之剂，荡涤脏腑，或以砭射敷扫涂抹于外；有先治其外后治其内而愈的，伤寒刺割破伤，皆因风寒之邪，从外之内，先以发散其外，发之不已，量其浅深峻泄之；有齐毒而攻击的，暴病大小便不利、胎死、坚积满胀之类；复有无毒而调引的，痰滞气痞、胃虚脾弱、气不往来，以通经利其气之药之类。方法所施，或胜或复。寒者热之，热者寒之，温者清之，散者收之，抑者折之，燥者润之，急者缓之，刚者……（原文缺字，通常为柔或解），衰者补之，强者泻之，坚者削之，留者攻之，客者除之，劳者温之（温养也），结者散之，燥者濡之，损者温之（温补也），逸者行之，劳者动之，惊者平之（平常也）。常见常闻，上之吐之，下之泄之，磨之灸之，浴之薄之，劫之燔之，针劫其下，开之发之，适可为故，各安其气，必清必净，则病气衰去，归其所宗，此治之大体也。因此圣人法无定体，体变布施，药不执方，合宜而用。所以论言治寒以热，治热以寒，而方士不能废绳墨而更其道也。有病热者，寒之而热；有病寒者，热之而寒。二者皆在，新病复起，奈何？治诸寒而热者，取之以阴；热之寒者，取之以阳。所谓求其属也。王冰注解说：谓治之而病不衰退，反因热寒而随生寒热，病之新者也。谓其益火之原，以消阴翳；用水之主，以制阳光。故曰求其属也。夫取心者，不必齐以热；取肾者，不必齐以寒。但益心之阳，寒亦通行；若强肾之阴，热之犹可。此论五味所归五脏寒热温凉之主也。呜呼，圣人之道久塞，而后之人独不能之也。王冰注解说：言少可以贯多，举浅可以料深，何法之明也如此。故非圣人之道，孰能至于是耶。是以治病之本，须明气味之浓薄，七方十剂之法也。方有七，剂有十。故方不七，不足以尽方之变；剂不十，不足以尽剂之用。方不对病，非方也；剂不蠲疾，非剂也。今列而论之。
七方者：大、小、缓、急、奇、偶、复。
大方之说有二：一则病有兼证，而邪不专，不可以一二味治之，宜君一臣三佐九之类是也；二则治肾肝在下而远者，宜分两多，而顿服之是也。
小方之说有二：一则病无兼证，邪气专一，可以君一臣二小方之治也；二则治心肺在上而近者，宜分两微，而频频少服之，亦为小方之治也。
缓方之说有五：有甘以缓之为缓方者，为糖蜜甘草之类，取其恋膈也；有丸以缓之为缓方者，盖丸之比汤散，药力宣行迟故也；有品味群众之缓方者，盖药味众多，各不能骋其性也；有无毒治病之缓方者，盖药性无毒，则攻自缓也；有气味薄而缓方者，药气味薄，则常补于上，比至其下，药力既已衰，为补上治上之法也。
急方之说有四：有急病急攻之急方者，如腹心暴痛，前后闭塞之类是也；有急风荡涤之急方者，谓中风不省口噤是也，取汤剂荡涤，取其易散而施攻速者是也；有药有毒之急方者，如上涌下泄夺其病之大势者是也；有气味浓之急方者，药之气味浓者，直趣于下而力不衰也，谓补下治下之法也。
奇方之说有二：有古之单行之奇方者，为独一物是也；有病近而宜用奇方者，为君一臣二、君二臣三，数合于阳也，故宜下不宜汗也。
偶方之说有二：有两味相配而为偶方者，盖两味相合者是也；有病远而宜用偶方者，君二臣四、君四臣六，数合于阴也，故宜汗不宜下也。
复方之说有二：有二三方相合之为复方者，如桂枝二越婢一汤之类是也；有分两匀同之复方者，如胃风汤各等分之类是也。又曰重复之复，二三方相合而用也；反复之复，谓奇之不去则偶之是也。
十剂者：宣、通、补、泻、轻、重、涩、滑、燥、湿。
宣者，宣散也。郁而不散为壅，必宣剂以散之，如痞满不通之类是也。本草曰：宣可去壅，必宣剂以散之，如姜橘之属。攻其里则宣者上也。泄者下也，涌剂则瓜蒂、栀豉之类是也。发汗通表亦同。
通，留而不行为滞，必通剂以行之，如水病痰癖之类也。本草曰：通可去滞，通草、防己之属。攻其内则通者行也，甘遂、滑石、茯苓、芫花、大戟、牵牛、木通之类是也。
补，不足为弱，必补剂以扶之，如气形羸弱之类是也。本草曰：补可去弱，人参、羊肉之属。攻其里则补养也。经所谓言而微，终日乃复言者，此夺气也。故形不足，温之以气；精不足，补之以味。是以膏粱理疾，药石蠲疾，五谷五畜，能补善养也。
泻，有余为闭，必泄剂以逐之，如腹胀脾约之类是也。本草曰：泻可去闭，即葶苈、大黄之属。经所谓浊气在上，则生䐜胀。故气不施化而郁闭不通，所以葶苈大黄味苦大寒，专能泻热去湿下气。仲景曰：趺阳脉浮而涩，浮则胃强，涩则小便数，浮涩相搏，大便难，其脾为约，故约束津液不得四布，苦寒之剂，通塞润燥而能泄胃强也。
轻，实则气壅，欲其扬也，如汗不发而腠密，邪胜而中蕴，必轻剂以扬之。本草曰：轻可去实，麻黄、葛根之属。经所谓邪在皮者，汗而发之，其实者，散而泄之。王注曰：阳实则发散。
重，怯则气浮，欲其镇也，如丧神守而惊悸，气上厥以颠疾，必重剂以镇之。本草曰：重可去怯，即磁石、铁粉之属。经所谓厥成为癫疾，故惊乃平之，所以镇涎也。故使其物体之重则下涎而用之也。
涩，滑则气脱，欲其收敛也，如开肠洞泄，便溺遗失，必涩剂以收之。本草曰：涩可去脱，则牡蛎、龙骨之属，如宁神宁圣散之类是也。
It is stated that the evolution of diseases depends on the pathology, the therapeutic action depends on the substances (herbs), and the preparation and application depend on the physician. When these three are clearly understood, one can discuss the Seven Formulas (Qi Fang) and the Ten Categories (Shi Ji), namely: Xuān (Dispersing), Tōng (Unblocking), Bǔ (Tonifying), Xiè (Purging), Qīng (Light), Zhòng (Heavy), Sè (Astringent), Huá (Slippery), Zào (Drying), and Shī (Moistening).
These are the Ten Categories. The Seven Formulas refer to: Dà (Large), Xiǎo (Small), Huǎn (Slow/Mild), Jí (Rapid/Urgent), Qí (Odd), Ǒu (Even), and Fù (Compound). Therefore, to establish the structure of a formula and achieve the utility of the Seven Formulas and Ten Categories, one must base the formulation on the generation of Qi (Vital Energy/Functional Aspect) and Wei (Flavor/Material Aspect).
The four Qi—Cold, Heat, Warm, Cool—are generated from Heaven (Nature/Climatic factors). The six Wei—Sour, Bitter, Pungent, Salty, Sweet, Acrid/Bland—are formed from Earth (Geographical/Material factors). Through the generation of Qi and Wei, the mechanism of Yin-Yang creation exists. Thus, within a single substance, multiple Qi and Wei may coexist; within a single herb, its nature and properties are not singular. Therefore, what has form is called "Wei" (Flavor), and what is formless is called "Qi" (Energy). If one uses the formless Qi to treat conditions arising from formless causes, symptoms such as panting, urgency, and coma will arise. If one uses formless Qi to treat conditions arising from form, symptoms such as open intestines and洞泄 (profuse watery diarrhea) will arise. The Classic states: "Yin Wei exits through the lower orifices, Yang Qi exits through the upper orifices." Wang Bing's commentary notes: "Wei has substance, so it flows downward to the orifices of urination and defecation. Qi is formless, so it ascends outward through the gate of respiration." Thus, Yang refers to Qi, and Yin refers to Wei. "Wei returns to Xing (Form/Body), Xing returns to Qi, Qi returns to Jing (Essence), Jing returns to Hua (Transformation). Jing nourishes Qi, Xing nourishes Wei." Wang Bing's commentary notes: "When Qi transforms, Jing is produced; when Wei harmonizes, Xing grows." Therefore, for living beings with large forms, Jing is the root. Hence, products of Earth nourish Xing. For deficiency of Xing, warm it with Qi. Products of Heaven nourish Jing. For deficiency of Jing, tonify it with Wei. Xing and Jing mutually nourish each other, becoming full and unimpaired. Even if severe diseases occur, they cannot cause harm. Thus, "warming with Qi" refers to warming the Lung (Fei); "tonifying with Wei" refers to tonifying the Kidney (Shen).
Therefore, humans are the most intelligent of all things, possessing the capacity to nourish themselves with all things. By drinking harmony and eating virtue, one transforms Jin-Ye (Body Fluids), moistens the sinews and vessels, and circulates Ying (Nutritive Qi) and Wei (Defensive Qi). Thus, the Classic states: "The production of Yin is rooted in the Five Flavors." Taking Qi and Wei together supplements Jing and Qi; this is the art of preserving life. Hence, the Five Grains, Five Livestock, Five Vegetables, and Five Fruits, with their sweet, bitter, sour, pungent, and salty flavors, are the essentials of nourishment. Why? Grain enters the mouth and gathers in the Stomach (Wei), which is the Sea of Water and Grain. The Stomach prefers grain and dislikes medicine. When medicine enters, it does not reach as quickly as grain Qi. Therefore, the method of treating disease must prioritize Grain Qi. Thus, the Sages discuss True Qi and Evil Qi by saying: "Sweat is generated from grain, not derived from medicinal stones." To distinguish signs of life and death, one says: "If one can accept grain, there is life." This applies not only to the Five Zang organs but primarily establishes Stomach Qi as the root. From this, we know that the Five Flavors can nourish the form. Although toxic drugs are used to attack evil, it is like a state using military force—done out of necessity. Therefore, the Sages say: "To release the exterior, do not avoid Heat; to attack the interior, do not avoid Cold." Pungent and Sweet disperse and belong to Yang; Sour and Bitter induce vomiting/descending and belong to Yin. Thus, Pungent disperses, Sour astringes, Sweet moderates, Bitter solidifies, Salty... [text implies softening/downward movement]. According to the pathological manifestations of the Five Zang organs, one applies the flavors and properties of herbs, then distinguishes the systems of Odd, Even, Large, Small, Slow, and Urgent.
The terms Odd (Qí) and Even (Ǒu) refer to four systems within the Seven Formulas: Large, Small, Slow, and Urgent. It is said that Qi has varying amounts, diseases have excess and deficiency, treatments have slowness and urgency, and formulas have large and small sizes. Thus, for Large and Small: A formula with One Sovereign (Jun) herb and Two Ministers (Chen) herbs follows the system of Odd. One Sovereign and Four Ministers follow the system of Even. One Sovereign and Three Ministers follow the system of Odd. One Sovereign and Six Ministers follow the system of Even. It is also stated: Odd formulas include One Sovereign-Two Ministers and One Sovereign-Three Ministers; Even formulas include One Sovereign-Four Ministers and One Sovereign-Six Ministers. Thus, the Seven Formulas encompass these four systems. How to clarify this? For example, Xiao Cheng Qi Tang (Minor Order the Yellow Decoction) and Tiao Wei Cheng Qi Tang (Regulate the Weight Order the Yellow Decoction) are Small Odd formulas. Da Cheng Qi Tang (Major Order the Yellow Decoction) and Di Dang Tang (Reside There Decoction) are Large Odd formulas. This illustrates their use for purgation. Gui Zhi Tang (Cinnamon Twig Decoction) and Ma Huang Tang (Ephedra Decoction) are Small Even formulas. Ge Gen Tang (Kudzu Root Decoction) and Qing Long Tang (Green Dragon Decoction) are Large Even formulas. This illustrates their use for diaphoresis. The Classic states: "For distant conditions, use Even formulas; for near conditions, use Odd formulas." The exterior of the body is distant; the interior is near. Diaphoresis should not use Odd formulas; purgation should not use Even formulas. "Bu yi" means "do not use." Therefore, for tonifying/treating the Upper Jiao, the formula should be Slow (Huan); for tonifying/treating the Lower Jiao, the formula should be Urgent (Ji). Urgent formulas have strong/heavy Qi and Wei; Slow formulas have weak/light Qi and Wei. Thus, heavy flavor belongs to Yin; light flavor is Yang within Yin (impure flavor). Heavy flavors purge downward; light flavors promote circulation of Qi. Wang Bing's commentary notes: "Heavy flavors purge; light flavors unblock." Strong/heavy Qi belongs to Yang; light Qi is Yin within Yang. For instance, Fu Zi (Prepared Aconite Root) and Gan Jiang (Dried Ginger) have sweet taste, warm nature, and great heat; they are pure Yang herbs because their Qi is strong. Ding Xiang (Clove) and Mu Xiang (Costus Root) have pungent taste, warm/neutral nature, and light Qi; they are Yang within Yin (impure Qi). Thus, strong Qi generates heat; light Qi induces sweating/release. The Classic states: "Light Qi induces sweating/release; strong Qi generates heat." Wang Bing's commentary notes: "Yin Qi moistens downward, so light flavor induces sweating/release; Yang Qi flares upward, so strong Qi generates heat." Light flavor is less Yin, thus promoting unblocking/purging; light Qi is less Yang, thus inducing sweating. Therefore, discussing the thickness/thinness of Qi and Wei combines with the size of Odd and Even formulas. The Kidney and Liver are located distally; if the dosage frequency is high, the Qi becomes slow and cannot reach the lower parts quickly. One must use a large dose with fewer administrations to ensure rapid descent. The Heart and Lungs are located proximally; if the dosage frequency is low, the Qi becomes urgent and cannot disperse upward effectively. One must use a small dose with frequent administrations to ensure the Qi disperses easily to tonify the upper parts. Wang Bing's commentary notes: "Lung takes nine, Heart takes seven, Spleen takes five, Liver takes three, Kidney takes one; these are the constant numbers of the generation of the Five Zang organs." If an Odd formula fails, use an Even formula; this is called Chong Fang (Repeated Formula). If an Even formula fails, use Fan Zuo (Counter-Assistance) to gain efficacy. This involves using Cold, Heat, Warm, or Cool herbs that counter-intuitively follow the disease's nature. Wang Bing's commentary notes: "Thus, the Sages reverse the assistance, aligning with the Qi, causing sound and Qi to resonate, mixing Cold and Heat, so that the end differs from the beginning, causing dryness/moisture to fail, hardness to break, and fragility to dissolve." Thus, Ni Zhi (Direct Treatment/Negative Treatment) opposes the disease pattern; Cong Zhi (Following Treatment/Positive Treatment) follows the disease pattern. Whether following less or more depends on observation. Zhang Zhongjing said: "In Shaoyin disease with diarrhea and faint pulse, give Bai Tong Tang. If diarrhea persists, cold limbs, no pulse, dry heaving, and irritability occur, give Bai Tong Tang plus Pig Gallbladder and Human Urine." The commentary notes: "To regulate the reversal of Cold and Heat, Cold and Hot must act together. Thus, hot medicine is taken cold. After swallowing, the cold constitution dissipates, and the hot nature activates, curing the disease, stopping vomiting, and bringing great benefit. Adding salty-bitter-cold substances like human urine and pig gallbladder to the hot Bai Tong Tang ensures their Qi aligns, removing the cold rejection." The Classic states: "Use Cold for Heat, Heat for Cold, Obstruction for Obstruction, Unblocking for Unblocking." One must subdue the main pathogen and address the initial cause. The beginning is similar, the end is different. This can break accumulations, dissolve hardness, harmonize Qi, and ensure cure. This is what is meant. If the disease is distant and the Qi/Wei is blocked midway, food can help bypass it without violating regulations. Wang Bing's commentary notes: "If the disease is in the Kidney, and the Heart's Qi/Wei feeds it making it cold, one must pass through quickly without feeding it Qi/Wei, otherwise Kidney medicine will invade the Heart, weakening the Heart and abdomen further, consistent with examples of distance and proximity. Thus, the Sages treat the Upper without offending the Lower, treat the Lower without offending the Upper, and treat the Middle without offending either. The Classic states: 'Punishing the innocent is called great confusion.' This is what is meant. If interior and exterior are unrelated, treat the primary disease, discussing Root and Branch, avoiding reckless attack. The origin is the Root; the manifestation is the Branch. Interior diseases are regulated internally; exterior diseases are treated externally. Interior regulation is not discussed as external treatment; exterior treatment is not discussed as internal regulation. The Classic states: 'Excess from above affecting below, pacify with the controlling element; Excess from outside affecting inside, treat with the controlling element.' This is what is meant. If disease originates internally but manifests strongly externally, regulate the interior first, then treat the exterior. If disease originates externally but manifests strongly internally, treat the exterior first, then regulate the interior. Wang Bing's commentary notes: "This means removing the root first, then trimming the branches." Thus, for excess diseases, treat the Root then the Branch, finally treating the Root. Zhang Zhongjing said: "In Shanghan (Cold Damage), if the doctor incorrectly used purgation, leading to diarrhea with undigested food and body pain, urgently rescue the Interior first. Later, if body pain persists but stool normalizes, urgently rescue the Exterior. Rescue Interior with Si Ni Tang (Frigid Extremities Decoction); rescue Exterior with Gui Zhi Tang. Since Interior deficiency exists, rescue it first. Once stool normalizes, knowing Interior Qi is regulated, urgently give Gui Zhi Tang to rescue the Exterior. This is treating the Root first, then the Branch, due to Cold being the Root. Knowing Root and Branch ensures success; ignoring them leads to reckless action." Although Ben Cao (Materia Medica) states: "120 Superior herbs are Sovereigns corresponding to Heaven; 120 Medium herbs are Ministers corresponding to Humans; 120 Inferior herbs are Envoys corresponding to Earth." In treating disease, emphasizing these Three Grades is secondary. The Classic states: "Whether toxic or non-toxic, the treatment of the disease is primary; adjust size and strength accordingly." Thus, the herb addressing the disease is Sovereign (Jun); assisting the Sovereign is Minister (Chen); responding to the Minister is Envoy (Shi). This does not refer to the Superior/Medium/Inferior grades. Wang Bing's commentary notes: "As long as it breaks accumulations, cures disease, and saves from critical danger, it is a good formula. It is not necessary that toxicity is good and non-toxicity is bad. Toxicity is correct, non-toxicity is incorrect; one must measure the severity and size of the disease." Emperor asked: "What do the Three Grades mean?" Qibo answered: "To clarify the distinction between good and bad." Thus, the Sages have regulations for taking toxic and non-toxic herbs. Diseases have old and new; formulas have large and small. Whether toxic or non-toxic, there are standard protocols. For highly toxic herbs, remove 60% of the disease; for moderately toxic, 70%; for slightly toxic, 80%; for non-toxic, 90%. Use grains, meats, fruits, and vegetables to complete the nourishment. Do not overdo it, lest it damage Zheng Qi (Upright Qi). If not cured, repeat the method. Wang Bing's commentary notes: "The method refers to the previous four limits. If residual disease remains, repeat it. Stop according to the degree of toxicity to avoid excess. Thus, ancient Sages said regarding pregnancy: 'If there is a cause (pathology), there is no injury.' Stop when the disease is reduced by more than half. The nature and flavor of herbs are intended to cure disease. If applied with moderation and appropriateness, even stopping at half raises no doubt about treatment." Then the question arises: What if healing is not achieved by regulating Qi? Which comes first, toxic or non-toxic? I wish to hear the principle. Wang Bing's commentary notes: "There are four categories of disease origin: 1. Originating from Qi movement forming internal masses: accumulations, tumors, goiters, nodules, epilepsy, etc. 2. Not originating from Qi movement but forming externally: abscesses, ulcers, scabies, hemorrhoids, tremors, edema, red eyes, blisters, swelling, itching, etc. 3. Not originating from Qi movement but arising internally: retained fluids, dietary irregularities, fatigue, leftover food, cholera, grief/fear/anger, longing/worry/knotting, etc. 4. Not originating from Qi movement but arising externally: miasma, demons, insects/snakes, gu poison, flying corpses, ghost strikes, impact/falling, wind/cold/summerheat/dampness, cutting/stabbing/blowing, etc. Among these four categories: Some heal by treating only the interior (e.g., Da/Xiao Cheng Qi, Xian Xiong, Di Dang Tang, San Hua Shen Cang Yong). Some heal by treating both interior and exterior (e.g., Da/Xiao Chai Hu, Tong Sheng, Xi Xin, Liang Ge, Huang Lian Jie Du). Some heal by treating only the exterior (e.g., Shan Ying Gao, Ba Du San, eye drops, flesh-regenerating agents). Some heal by treating both exterior and interior (e.g., Bo Yun San, Ku Shen San, Qian Jin Nei Tuo San). Some heal by treating interior then exterior (e.g., blisters, erysipelas, sores, carbuncles, macules/rashes caused by San Jiao Ministerial Fire, heat severe internally; first疏通疏启 the middle with cool/bitter/cold agents to cleanse viscera, then apply external treatments like bloodletting, poultices, or scraping). Some heal by treating exterior then interior (e.g., cold damage, cuts, wounds caused by wind-cold entering from outside; first disperse externally, if unsuccessful, assess depth and purge severely). Some require toxic aggression for acute conditions like bowel/bladder obstruction, fetal death, hard accumulations, or distension. Others require non-toxic guidance for phlegm stagnation, Qi blockage, Spleen/Stomach deficiency, or stagnant Qi, using herbs to unblock meridians and benefit Qi. Methods vary: overcoming or restoring. Cold is treated with Heat; Heat with Cold; Warm with Clearing; Scattered with Astringing; Suppressed with Breaking; Dry with Moistening; Urgent with Slowing; Rigid with... [text missing, likely Softening]; Declining with Tonifying; Excess with Purging; Hard with Scraping; Retained with Attacking; Invading with Removing; Laboring with Warming (Nourishing); Knotting with Dispersing; Dry with濡 (Moistening); Damaged with Warming (Tonifying); Idle with Promoting Movement; Labored with Activating; Shocked with Calming (Normalizing). Commonly known methods include emesis, purgation, grinding, moxibustion, bathing, thinning, coercion, cauterization, needling, opening, and releasing. Apply appropriately to settle Qi, ensuring clarity and purity, so disease Qi declines and returns to its source. This is the general principle of treatment. Thus, the Sages' methods have no fixed form; forms change and adapt; medicines do not stick to fixed prescriptions but are used according to appropriateness. The discourse says: Treat Cold with Heat, Heat with Cold. Yet physicians cannot abandon rules and change the path. What if a heat patient treated with Cold remains hot? Or a cold patient treated with Heat remains cold? Both persist, and new diseases arise. How to treat? For those treated with Cold who become hot, seek the Yin aspect. For those treated with Heat who become cold, seek the Yang aspect. This is called "Seeking the Affiliation (Shu)." Wang Bing's commentary notes: "If treatment fails and disease worsens or changes with Cold/Heat, it indicates new pathology. It refers to 'Boosting the source of Fire to eliminate Yin shadows; Using the master of Water to control Yang brilliance.' Hence, 'Seeking the Affiliation.'" Treating the Heart does not always require Heat; treating the Kidney does not always require Cold. Boosting Heart Yang allows circulation even with Cold; strengthening Kidney Yin allows tolerance of Heat. This discusses the归属 (affiliation) of the Five Flavors to the Five Zang organs' Cold/Heat/Warm/Cool natures. Alas, the Way of the Sages has been blocked for long, and later generations cannot achieve it. Wang Bing's commentary notes: "Speaking little can cover much; understanding shallowly can predict deeply. How clear are these methods! Only the Way of the Sages can reach such heights." Therefore, the root of treating disease requires understanding the thickness/thinness of Qi and Wei, and the methods of the Seven Formulas and Ten Categories. There are Seven Formulas and Ten Categories. Without Seven, one cannot exhaust the variations of formulas; without Ten, one cannot exhaust the utilities of categories. A formula not matching the disease is not a formula; a category not eliminating disease is not a category. Now, let us list and discuss them.
The Seven Formulas are: Large, Small, Slow, Urgent, Odd, Even, Compound.
Regarding Large Formulas (Da Fang): There are two explanations. First, when a disease has concurrent syndromes and the evil is not specific, it cannot be treated with one or two herbs; one should use a formula like One Sovereign, Three Ministers, Nine Assistants. Second, when treating the Kidney and Liver located distally in the lower part, one should use a larger dosage and administer it in one dose.
Regarding Small Formulas (Xiao Fang): There are two explanations. First, when a disease has no concurrent syndromes and the evil is specific, it can be treated with a Small Formula like One Sovereign, Two Ministers. Second, when treating the Heart and Lungs located proximally in the upper part, one should use a smaller dosage and administer it frequently in small amounts; this is also a Small Formula.
Regarding Slow Formulas (Huan Fang): There are five explanations. 1. Sweet herbs that moderate constitute a Slow Formula, such as sugar, honey, and Gan Cao (Licorice), chosen for their ability to linger in the chest/diaphragm. 2. Pills constitute a Slow Formula because, compared to decoctions and powders, their medicinal power acts slowly. 3. Formulas with many ingredients constitute a Slow Formula because numerous herbs cannot fully exert their individual natures. 4. Formulas using non-toxic herbs constitute a Slow Formula because non-toxic herbs attack gently. 5. Formulas with light/thin Qi and Wei constitute a Slow Formula because light/thin herbs often tonify the upper part; by the time they reach the lower part, their power has faded, serving the method of tonifying/treating the Upper Jiao.
Regarding Urgent Formulas (Ji Fang): There are four explanations. 1. Urgent attack for urgent diseases, such as sudden abdominal/cardiac pain or blockage of front/back orifices. 2. Urgent cleansing for urgent wind-stroke, such as unconsciousness and locked jaw; using decoctions for cleansing is chosen for easy dispersion and rapid attack. 3. Formulas using toxic herbs constitute an Urgent Formula, such as inducing vomiting or purging to seize the major trend of the disease. 4. Formulas with strong/heavy Qi and Wei constitute an Urgent Formula because strong herbs descend directly without losing power, serving the method of tonifying/treating the Lower Jiao.
Regarding Odd Formulas (Qi Fang): There are two explanations. 1. Ancient single-herb Odd Formulas consist of a single substance. 2. Formulas for near diseases suitable for Odd patterns, such as One Sovereign-Two Ministers or One Sovereign-Three Ministers, where the number corresponds to Yang; thus, they are suitable for purgation rather than diaphoresis.
Regarding Even Formulas (Ou Fang): There are two explanations. 1. Formulas combining two herbs constitute an Even Formula. 2. Formulas for distant diseases suitable for Even patterns, such as One Sovereign-Four Ministers or Four Sovereigns-Six Ministers, where the number corresponds to Yin; thus, they are suitable for diaphoresis rather than purgation.
Regarding Compound Formulas (Fu Fang): There are two explanations. 1. Combining two or three formulas constitutes a Compound Formula, such as Gui Zhi Er Yue Bi Yi Tang. 2. Formulas with equal proportions constitute a Compound Formula, such as Wei Feng Tang with equal parts. Additionally, "Fu" as repetition means combining two or three formulas. "Fu" as reversal means using an Even formula if an Odd formula fails.
The Ten Categories (Shi Ji) are: Xuān (Dispersing), Tōng (Unblocking), Bǔ (Tonifying), Xiè (Purging), Qīng (Light), Zhòng (Heavy), Sè (Astringent), Huá (Slippery), Zào (Drying), Shī (Moistening).
Xuān (Dispersing): Means dispersing. Stagnation without dispersion is congestion; one must use a Xuān agent to disperse it, such as in cases of fullness and blockage. The Materia Medica states: "Xuān can remove congestion." Must use Xuān agents to disperse, such as Jiang (Ginger) and Ju (Tangerine Peel). Attacking the interior makes Xuān act upward. Xiè (Purging) acts downward. Yong (Vomiting) agents include Gua Di (Melon Seed) and Zhi Chi (Roasted Soybean and Gardenia). Diaphoresis and unblocking the exterior are similar.
Tōng (Unblocking): Stagnation without movement is blockage; one must use a Tōng agent to move it, such as in water diseases or phlegm-rheum. The Materia Medica states: "Tōng can remove stagnation." Agents include Tong Cao (Rush Pith) and Fang Ji (Stephania Root). Attacking the interior makes Tōng act by moving; agents include Gan Sui (Kansui Root), Hua Shi (Talcum), Fu Ling (Poria), Yuan Hua (Genkwa Flower), Da Ji (Spurge Root), Qian Niu (Morning Glory Seed), and Mu Tong (Akebia Stem).
Bǔ (Tonifying): Deficiency is weakness; one must use a Bǔ agent to support it, such as in Qi and Form emaciation. The Materia Medica states: "Bǔ can remove weakness." Agents include Ren Shen (Ginseng Root) and Yang Rou (Mutton). Attacking the interior means nourishing. The Classic states: "Speaking softly and repeating throughout the day indicates Qi depletion." Thus, for deficiency of Form, warm with Qi; for deficiency of Jing, tonify with Wei. Therefore, rich foods manage disease, medicines eliminate disease, and grains/livestock can tonify and nourish well.
Xiè (Purging): Excess is closure/blockage; one must use a Xiè agent to drive it out, such as in abdominal distension or Spleen constraint. The Materia Medica states: "Xiè can remove closure," such as Ting Li (Perilla Seed) and Da Huang (Rhubarb Root). The Classic states: "Turbid Qi in the upper part causes distension." Thus, Qi fails to transform and becomes congested/blocked. Ting Li and Da Huang are bitter and very cold, specifically able to purge heat, remove dampness, and direct Qi downward. Zhang Zhongjing said: "If the Foot-Yang pulse is floating and choppy, floating indicates Stomach excess, choppy indicates frequent urination. Floating and choppy interacting cause difficult defecation, and the Spleen is constrained, restricting Jin-Ye from spreading. Bitter-cold agents unblock obstruction, moisten dryness, and can purge Stomach excess."
Qīng (Light): Excess leads to Qi congestion, requiring elevation/dispersion. For example, when sweat does not emerge and pores are tight, or evil wins and accumulates internally, one must use a Qīng agent to elevate it. The Materia Medica states: "Qīng can remove excess," such as Ma Huang (Ephedra) and Ge Gen (Kudzu Root). The Classic states: "When evil is in the skin, induce sweat to release it; for excess, scatter and泄 (drain) it." Wang Bing's commentary notes: "Yang excess requires dispersion."
Zhòng (Heavy): Timidity leads to floating Qi, requiring sedation. For example, loss of spirit control, palpitations, or Qi reversing upward causing mania, one must use a Zhòng agent to sedate it. The Materia Medica states: "Zhòng can remove timidity," such as Ci Shi (Magnetite) and Tie Fen (Iron Powder). The Classic states: "Reversal leads to mania; thus, shock calms it, suppressing phlegm-saliva." Therefore, using heavy objects suppresses phlegm-saliva.
Sè (Astringent): Slipperiness leads to Qi collapse, requiring convergence. For example, open intestines with profuse diarrhea or loss of urine/feces, one must use a Sè agent to collect it. The Materia Medica states: "Sè can remove collapse," such as Mu Li (Oyster Shell) and Long Gu (Fossilized Bone), like Ning Shen Ning Sheng San.