（俱徐灵胎着。灵胎名大椿。江苏吴江人也。）
方药离合论
方之与药。似合而实离也。得天地之气。成一物之性。各有功能。可以变易血气。以除
疾病。此药之力也。然草木之性。与人殊体。入人肠胃。何以能如人之所欲以致其效。圣人
为之制方以调剂之。或用以专攻。或用以兼治。或相辅者。或相反者。或相用者。或相制者。
故
夫按病用药。药虽切
有一二味与病不相关者。谓之有方无药。譬之作书之法。用笔已工而配合颠倒。与夫字形俱
备而点画不成者。皆不得谓之能书。故善医者。分观之而无药弗切于病情。合观之而无方不
本于古法。然后用而弗
则亦同于杀人而已矣。至于方之大小奇偶之法。则内经详言之。兹不复赘云。
古方加减论
古人制方之义。微妙精详。不可思议。盖其审察病情。辨别经络。参考药性。斟酌轻重。
其于所治之病不爽毫发。故不必有奇品异术。而沉痼艰险之疾。投之辄有神效。此汉以前之
方也。但生民之疾病不可胜穷。若必每病制一方。是曷有尽期乎。故古人即有加减之法。其
病大端相同。而所现之症或不同。则不必更立一方。即于是方之内。因其现症之异。而为
加减。如伤寒论中治太阳病用桂枝汤。若见项背强者。则用桂枝加葛根汤。喘者。则用桂枝
加浓朴杏仁汤。下后脉促胸满者。桂枝去白芍汤。更恶寒者。去白芍加附子汤。此犹以药为
加减者也。若桂枝麻黄各半汤。则以两方为加减矣。若发奔豚者。用桂枝为加桂枝汤。则又
以药之轻重为加减矣。然一二味加减。虽不易本方之名。而必明着其加减之药。若桂枝汤倍
用芍药而加饴糖。则又不名桂枝加饴糖汤而为建中汤。其药虽同而义已别。则立名亦异。古
法之严如此。后之医者不识此义。而又欲托名用古。取古方中一二味。则即以某方目之。如
用柴胡则即曰小柴胡汤。不知小柴胡之力全在人参也。用猪苓、泽泻即曰五苓散。不知五苓
之妙专在桂枝也。去其要药。杂以他药。而仍以某方目之。用而不效。不知自咎。或则归咎
于病。或则归咎于药。以为古方不可治今病。嗟乎。即使果识其病。而用古方支离零乱。岂
有效乎。遂相戒以为古方难用。不知全失古方之精义。故与病毫无益而反有害也。然则当何
如。曰。能识病情与古方合者。则全用之。有别症。则据古法加减之。如不尽合。则根据古方
之法。将古方所用之药而去。取损益之。必使无一药之不对症。自然不倍于古人之法。而所
投必有神效矣。
方剂古今论
后世之方。已不知几亿万矣。此皆不足以名方者也。昔者圣人之制方也。推药理之本原。
识药性之专能。察气味之从逆。审脏腑之好恶。合君臣之配偶。而又探索病源。推求经络。
其思远。其义精。味不过三四。而其用变化无穷。圣人之智。真与天地同体。非人之心思所
能及也。上古至今。千圣相传。无敢失坠。至张仲景先生。复申明用法。设为问难。注明主
治之症。其伤寒论、金匮要略。集千圣之大成以承先而启后。万世不能出其范围。此之谓古
方。与内经并垂不朽者。其前后名家如仓公、扁鹊、华佗、孙思邈诸人。各有师承。而渊源
又与仲景微别。然犹自成一家。但不能与灵、素、本草一线相传。为宗支正脉耳。既而积习
相仍。每着一书。必自撰方千百。唐时诸公。用药虽博。已乏化机。至于宋人。并不知药。
其方亦板实肤浅。元时号称极盛。各立门庭。徒骋私见。迨乎前明。蹈袭元人绪余而已。
今之医者。动云古方。不知古方之称。其指不一。若谓上古之方。则自仲景先生流传以外。
无几也。如谓宋元所制之方。则其可法可传者绝少。不合法而荒谬者甚多。岂可奉为典章。
若谓自明人以前皆称古方。则其方不下数百万。夫常用之药不过数百品。而为方数百万。随
拈几味。皆已成方。何必定云某方也。嗟嗟。古之方何其严。今之方何其易。其间亦有奇巧
之法。用药之妙。未必不能补古人之所未及可备参考者。然其大经大法。则万不能及。其中
更有违经背法之方。反足贻害。安得有学之士。为之择而存之。集其大成。删其无当。实千
古之盛举。余盖有志而未遑矣。
古今方剂大小论
今之论古方者。皆以古方分两太重为疑。以为古人气体浓。故用药宜重。不知此乃不考
古而为此无稽之谈也。古时升斗权衡。历代各有异同。而三代至汉。较之今日。仅十之二。
（余亲见汉时有六升铜量。容今之一升二合。）如桂枝汤乃伤寒大剂也。桂枝三两。芍药三
两。甘草二两。共八两。二八不过一两六钱为一剂。分作三服。则一服药不过今之五钱三分
零。他方间有药品多而加重者。亦不过倍之而已。今人用药。必十数品。各一二钱。或三四
钱。则反用三两外矣。更有无知妄人。用四五两作一剂。近人更有用熟地八两为一剂者。尤
属不伦。用丸散亦然。如古方乌梅丸。每服如桐子大二十丸。今不过四五分。若今人之服丸
药。则用三四钱至七八钱不等矣。末药只用方寸匕。不过今之六七分。今亦服三四钱矣。古
人之用药分两。未尝重于今日。（周礼遗人。凡万民之食食者人四釜。注。六斗四升曰釜。
四釜共二石五斗六升。为人一月之食。则每日食八升有余矣。）而谬说相传。方剂日重。
此一端。而荒唐若此。况其深微者乎。盖既不能思考古。又无名师传授。无怪乎每举
谈也。
煎药法论
煎药之法。最宜深讲。药之效不效。全在乎此。夫烹饪禽鱼羊豕。失其调度。尚能损人。
况
然后加余药同煎。此主药当先煎之法也。而桂枝汤又不必先煎桂枝。服药后须啜热粥以助药
力。又一法也。如茯苓桂枝甘草大枣汤则以甘澜水先煎茯苓。如五苓散则以白饮和服。服后
又当多饮暖水。小建中汤则先煎五味去渣而后纳饴糖。大柴胡汤则煎减半去渣再煎。柴胡加
龙骨
二十沸。煎药之法。不可胜数。皆各有意义。大都发散之药及芳香之药不宜多煎。取其生而
疏泄。补益滋腻之药宜多煎。取其熟而停蓄。此其总诀也。故方药虽中病。而煎法失度。其
药
难愈也。若今之医者。亦不能知之矣。况病家乎。
服药法论
病之愈不愈。不但方必中病。方虽中病而服之不得其法。则非特无功。而反有害。此不
可不知也。如发散之剂。欲驱风寒出之于外。必热服而暖覆其体。令药气行于营卫。热气周
遍。挟风寒而从汗解。若半温而饮之。仍当风坐立。或仅寂然安卧。则药留肠胃。不能得汗。
风寒无暗消之理。而营气反为风药所伤矣。通利之药。欲其化积滞而达之于下也。必空腹顿
服。使药性鼓动。推其垢浊从大便解。若与饮食杂投。则新旧混杂。而药气与食物相乱。则
气性不专而食积愈顽矣。故伤寒论等书服药之法。宜热。宜温。宜凉。宜冷。宜缓。宜急。
宜多。宜少。宜早。宜晚。宜饱。宜饥。更有宜汤不宜散。宜散不宜丸。宜膏不宜丸。其轻
重大小上下表里。治法各有所当。此皆一定之至理。深思其义。必有得于心也。
方药离合论
方剂与药物，看似结合，实则分离。药物汲取天地之气，形成各自独特的药性，各有其功能，能够改变人体的血气运行，从而消除疾病。这是药物的力量所在。然而，草木的药性与人体体质不同，进入人的肠胃后，如何能顺应人的意愿而发挥疗效呢？圣人制定了方剂来调和它们。有的方剂用于专攻某一病邪，有的用于兼治多种病症，有的药物之间相互辅助，有的相互制约，有的相互利用，有的相互抑制。因此，按照病情用药，虽然药物对症，但如果方剂中有一两味药与病情无关，这就叫做“有方无药”。这就像写字的方法，用笔已经工整，但结构安排颠倒，或者字形都具备但笔画不成形，都不能称为擅长书法。所以，高明的医生，从单个药物看，没有一味药不切合病情；从整体方剂看，没有一方不遵循古法。然后才能使用，否则就等同于杀人罢了。至于方剂大小、奇偶配伍的方法，《黄帝内经》中已有详细论述，这里不再赘述。
古方加减论
古人制定方剂的用意，微妙精深，不可思议。大概是因为他们仔细审查病情，辨别经络，参考药性，斟酌药物轻重，对于所治疗的疾病丝毫不差。所以不需要奇特的药品或异术，那些顽固难治的疾病，投药后往往有神效。这是汉代以前的方剂特点。但是，百姓的疾病无穷无尽，如果每种病都专门制作一个方剂，那什么时候是个头呢？所以古人就有加减的方法。如果疾病的大致情况相同，但表现出的症状有所不同，就不必重新设立一方，而是在原方之内，根据现症的不同进行加减。例如《伤寒论》中治疗太阳病用桂枝汤，如果出现项背强痛，就用桂枝加葛根汤；出现喘息的，就用桂枝加厚朴杏子汤；下法治疗后出现脉促、胸满的，用桂枝去芍药汤；如果更怕冷的，去掉芍药加上附子汤。这还是通过增减单味药来进行加减。如果是桂枝麻黄各半汤，则是将两个方剂合并进行加减。如果是治疗奔豚病的，用桂枝汤加重桂枝用量，则又是通过调整药物轻重来进行加减。然而，一两味药的加减，虽然不改变原方的名称，但必须明确标示出加减的药物。如果是桂枝汤加倍使用芍药并加入饴糖，就不再叫桂枝加饴糖汤，而称为建中汤。药物虽然相同，但含义已不同，所以命名也不同。古法的严谨如此。后世的医生不懂这个道理，却又想借古方之名使用，从古方中取一两味药，就直接称之为某方。比如用到柴胡就说这是小柴胡汤，不知道小柴胡汤的功效全在于人参；用到猪苓、泽泻就说这是五苓散，不知道五苓散的妙处全在于桂枝。去掉关键药物，混杂其他药物，却仍然称其为某方，使用后无效，不知反省自己，反而归咎于病情或药物，认为古方不能治疗今病。唉！即使真的认识病情，如果使用古方支离破碎、零乱不堪，怎么会有疗效呢？于是大家互相告诫说古方难用，其实完全失去了古方的精义，所以对病情毫无益处反而有害。那么应该怎么做呢？回答说：如果能识别病情与古方相符的，就全方使用；如果有其他症状，就依据古法进行加减。如果不完全符合，就根据古方的法则，去掉古方中不对症的药，取其所宜，损其所害，务必使每一味药都对症，自然就不会违背古人的法则，而投药必有神效了。
方剂古今论
后世的方剂，已经不知道有几亿万种了。这些都不足以称为真正的方剂。昔日圣人制定方剂，推究药理的本源，认识药性的专长，考察气味的顺逆，审察脏腑的好恶，配合君臣药物的配偶关系，又探索病源，推求经络。他们的思路深远，义理精微，味道不过三四味，但其运用变化无穷。圣人的智慧，真可与天地同体，不是普通人的心思所能达到的。从上古到现在，千圣相传，不敢遗失坠落。到了张仲景先生，再次阐明用法，设置问答疑难，注明主治的症状，《伤寒论》和《金匮要略》，集千圣之大成以继承前贤并开启后世，万世都不能超出其范围。这叫做古方，与《黄帝内经》一样流传不朽。前后的名家如仓公、扁鹊、华佗、孙思邈等人，各有师承，渊源又与仲景略有不同，然而仍能自成一家，只是不能与《灵枢》、《素问》、《本草经》一脉相承，作为正宗血脉罢了。接着积习相沿，每写一本书，必定自己撰写千百个方剂。唐代各位公卿，用药虽然广博，但缺乏化机灵动。到了宋代人，根本不懂药理，他们的方剂也刻板实在、肤浅。元代号称极盛，各自建立门户，只是放纵私见。等到明代，不过是沿袭元人的残余罢了。现在的医生，动不动就谈古方，不知道古方这个称呼，所指不一。如果说是指上古的方剂，那么除了张仲景先生流传下来的以外，就没有多少了。如果说是指宋元时期制定的方剂，那么值得效法传承的极少，不合规范且荒谬的很多，怎么能奉为典章制度呢？如果说是指明代以前都称为古方，那么其中的方剂不下数百万。常用的药物不过几百种，却形成了数百万个方剂，随手抓几味药，都成了方剂，何必一定要说是某个特定的方剂呢？唉！古代的方剂何其严谨，现代的方剂何其随意。其中也有巧妙的方法，用药的精妙，未必不能弥补古人的不足，可以作为参考。但是其中的大经大法，则万万不能相比。其中更有违背经典法则的方剂，反而足以造成危害，怎么能有学识之士，为之选择并保存，集其大成，删除不当之处，这实在是千古盛事啊。我有心志但未及实行。
古今方剂大小论
现在讨论古方的人，都以古方分量太重为疑，认为古人身体强壮，所以用药宜重。不知道这是不考证历史而做出的无稽之谈。古代的量器升斗权衡，历代各有异同，而从夏商周三代到汉代，比起今天，仅仅只有今天的十分之二。（我亲眼见过汉代的六升铜量，容量相当于今天的一升二合。）比如桂枝汤是治疗伤寒的大方，桂枝三两，芍药三两，甘草二两，共八两。二八十六两折合为一两六钱作为一剂，分作三次服用，那么一次服药不过今天的五钱三分多一点。其他方剂间或有药品多而加重者，也不过加倍而已。现在的人用药，必定用十几味药，每味一二钱，或三四钱，这样反而用了三两以外了。更有无知妄人，用四五两作为一剂。近人更有用熟地黄八两作为一剂的，尤其属于不合伦常。使用丸药散剂也是如此。比如古方乌梅丸，每次服用如梧桐子大二十丸，现在不过四五分。如果现在人服用丸药，则用三四钱至七八钱不等了。末药只用方寸匕，不过今天的六七分，现在也服用三四钱了。古人的用药分量，从未重于今日。（《周礼·遗人》记载，凡是万民的食物，每人四釜。注解说：六斗四升叫做釜。四釜共二石五斗六升，为人一个月的食物，则每天吃八升多了。）而谬说相传，方剂分量日益加重，仅这一端，就荒唐到如此地步，何况其中深奥微妙的地方呢？大概既然不能思考古制，又没有名师传授，难怪每次谈论起来都是这种无稽之谈。
煎药法论
煎药的方法，最应该深入探讨。药效是否有效，全在于此。烹饪禽鱼羊豕，如果调度失当，尚且损害人，何况是药物呢？……（原文此处有缺漏，根据上下文补全逻辑）……然后加入其余药物同煎，这是主药应当先煎的方法。而桂枝汤又不必先煎桂枝，服药后须喝热粥以助药力，这是另一种方法。比如茯苓桂枝甘草大枣汤则以甘澜水先煎茯苓；比如五苓散则以米汤调服，服后又当多喝暖水；小建中汤则先煎五味药去渣后然后纳入饴糖；大柴胡汤则煎至减半去渣再煎；柴胡加龙骨牡蛎汤则煎煮二十沸。煎药的方法，数不胜数，都各有意义。大体上发散类药物及芳香类药物不宜多煎，取其生发疏泄之性；补益滋腻类药物宜多煎，取其熟透停蓄之性。这是总的诀窍。所以方药虽然对症，但如果煎法失度，其药也难以治愈疾病。至于现在的医生，也不能知道这些了，何况病人呢？
服药法论
疾病的痊愈与否，不仅方剂必须对症，方剂虽然对症，但如果服用不得法，则不仅没有功效，反而有害。这是不可不知道的。比如发散类的药剂，想要驱赶风寒排出体外，必须热服并用暖物覆盖身体，让药气行于营卫，热气周遍，挟带风寒从汗液解表。如果半温饮用，仍然对着风坐立，或者只是安静地躺着，那么药留在肠胃，不能出汗，风寒没有暗中消散的道理，而营气反而被风药所伤了。通利类的药物，想要化解积滞并下达排泄，必须空腹顿服，使药性鼓动，推动垢浊从大便排出。如果与饮食混合服用，则新旧混杂，药气与食物相乱，则气性不专一而食积更加顽固了。所以《伤寒论》等书中关于服药的方法，宜热、宜温、宜凉、宜冷、宜缓、宜急、宜多、宜少、宜早、宜晚、宜饱、宜饥，更有宜汤剂不宜散剂，宜散剂不宜丸剂，宜膏剂不宜丸剂。其轻重大小、上下表里，治法各有所当，这些都是确定的至理，深思其义，心中必有收获。
(All from the works of Xu Lingtai. Xu Lingtai, whose given name was Dachun, was a native of Wujiang, Jiangsu.)
On the Combination and Separation of Formulas and Herbs
Formulas (Fangji) and herbs (Yaowu) appear combined but are essentially distinct. Herbs absorb the Qi of Heaven and Earth, forming their unique natures, each possessing specific functions capable of altering the flow of Blood and Qi in the body to eliminate disease. This is the power of herbs. However, the nature of herbs differs from the human constitution. Upon entering the stomach and intestines, how can they act according to one's will to achieve efficacy? The Sages formulated formulas to regulate them. Some formulas are used for targeted attack, some for concurrent treatment of multiple conditions, some with herbs that assist each other, some that constrain each other, some that utilize each other, and some that suppress each other. Therefore, when prescribing based on the condition, even if the herbs are appropriate, if one or two herbs in the formula are irrelevant to the pathology, it is called "having a formula without proper herbs." This is like calligraphy: even if the brushwork is skilled, if the structure is inverted, or if the character forms are complete but the strokes are malformed, it cannot be called proficient writing. Thus, a skilled physician, viewing individual herbs, ensures none deviate from the pathology; viewing the whole formula, ensures no formula departs from ancient methods. Only then can they be applied; otherwise, it amounts to killing people. As for the methods regarding the size and odd/even combinations of formulas, these are detailed in the *Huangdi Neijing* (Yellow Emperor's Inner Canon), so there is no need to repeat them here.
On the Addition and Subtraction of Ancient Formulas
The intent behind the ancients' formulation of prescriptions was subtle, profound, and inconceivable. They carefully examined the pathology, differentiated the meridians, referenced herb properties, and weighed the dosages. Their accuracy regarding the treated diseases was impeccable. Thus, they did not need rare items or exotic techniques, yet stubborn and dangerous diseases often responded miraculously to these treatments. These were the formulas before the Han Dynasty. However, the diseases of the people are infinite. If a separate formula were created for every disease, when would it end? Therefore, the ancients employed the method of addition and subtraction. If the general nature of the disease is the same but the manifested symptoms differ, there is no need to establish a new formula. Instead, within the existing formula, adjustments are made based on the differing symptoms. For example, in the *Shanghan Lun* (Treatise on Cold Damage), Guizhi Tang (Cinnamon Twig Decoction) is used for Taiyang disease. If neck and back stiffness appears, Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Pueraria Decoction) is used. If wheezing occurs, Guizhi Jia Houpo Xingren Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel Decoction) is used. After purgative therapy, if rapid pulse and chest fullness appear, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony Root Decoction) is used. If aversion to cold worsens, Shaoyao is removed and Fuzi Tang (Aconite Decoction) is added. This is still adding or subtracting single herbs. If Guizhi Mahuang Ban Ge Tang (Half-and-Half Cinnamon Twig and Ephedra Decoction) is used, it involves combining two formulas. If treating Ben Tun (Running Piglet syndrome), using Guizhi Tang with increased dosage of Guizhi (Cinnamon Twig) represents adjustment by weight. However, adding or subtracting one or two herbs usually retains the original formula's name but must explicitly state the added or subtracted herbs. If Shaoyao (Peony Root) is doubled in Guizhi Tang and Yi Tang (Maltose) is added, it is no longer called Guizhi Jia Yitang Tang but Jianzhong Tang (Middle-Building Decoction). Although the herbs are similar, the meaning has changed, so the name differs. The rigor of ancient methods was such. Later physicians, failing to understand this principle yet wishing to borrow the prestige of ancient formulas, would take one or two herbs from an ancient formula and label it as that formula. For instance, using Chaihu (Bupleurum Root) and calling it Xiao Chaihu Tang (Minor Bupleurum Decoction), unaware that the efficacy of Xiao Chaihu Tang lies entirely in Renshen (Ginseng Root); using Zhuling (Polyporus) and Zexie (Alisma Rhizome) and calling it Wuling San (Five-Ingredient Powder with Poria), unaware that the subtlety of Wuling San lies entirely in Guizhi (Cinnamon Twig). Removing key herbs, mixing in others, yet still labeling it as a specific formula, results in inefficacy. Not blaming themselves, they blame the disease or the herbs, claiming ancient formulas cannot treat modern diseases. Alas! Even if the disease is correctly identified, using fragmented and disjointed ancient formulas cannot yield efficacy. Consequently, people warn that ancient formulas are difficult to use, completely missing the essence of ancient formulas, thus being not only useless but harmful. So, what should be done? One should say: If the pathology matches an ancient formula, use it entirely. If there are additional symptoms, apply additions and subtractions according to ancient methods. If it does not fully match, follow the principles of ancient formulas: remove inappropriate herbs from the ancient formula, retain beneficial ones, and discard harmful ones, ensuring every herb corresponds to the symptoms. Naturally, this will not violate ancient methods, and the prescription will yield miraculous effects.
On Ancient and Modern Formulas
Modern formulas number in the hundreds of millions, yet few deserve the title of true formulas. In antiquity, the Sages formulated prescriptions by exploring the origins of pharmacology, recognizing specific herb properties, investigating the compliance or opposition of flavors and aromas, assessing the preferences and aversions of Zang-Fu organs, coordinating the relationships between Sovereign, Minister, Assistant, and Envoy herbs, exploring disease sources, and tracing meridians. Their thinking was far-reaching, and their meanings profound. With merely three or four ingredients, their applications were infinite. The wisdom of the Sages was truly on par with Heaven and Earth, beyond the reach of ordinary human thought. From antiquity to the present, passed down through thousands of sages, never lost or abandoned. It was Mr. Zhang Zhongjing who clarified usage, posed questions and difficulties, and noted indicated symptoms. His *Shanghan Lun* (Treatise on Cold Damage) and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) gathered the achievements of thousands of sages to inherit the past and initiate the future. Ten thousand generations could not exceed its scope. These are called ancient formulas, immortal alongside the *Neijing*. Famous experts before and after him, such as Cang Gong, Bian Que, Hua Tuo, and Sun Simiao, each had their own lineages, slightly different from Zhongjing's, yet still forming their own schools. However, they could not claim direct lineage from the *Lingshu*, *Suwen*, and *Shennong Bencao Jing* as the orthodox branch. Gradually, habits persisted; every book written involved creating hundreds of new formulas. In the Tang Dynasty, although doctors used a wide variety of herbs, they lacked spiritual transformation. By the Song Dynasty, doctors barely understood herbs; their formulas were rigid, solid, and superficial. The Yuan Dynasty boasted great prosperity, with various sects displaying personal views. The Ming Dynasty merely followed Yuan remnants. Today's physicians constantly speak of ancient formulas, not realizing that "ancient formula" refers to different things. If referring to pre-Qin formulas, few exist outside those transmitted by Zhang Zhongjing. If referring to Song and Yuan formulas, very few are worthy of emulation, while many are irregular and absurd; how can they be regarded as canonical? If referring to all formulas before the Ming Dynasty, there are millions. With only hundreds of commonly used herbs, millions of formulas have been created by randomly picking a few ingredients. Why insist on naming them specific formulas? Alas! How rigorous were ancient formulas, and how casual are modern ones. Among them, there are ingenious methods and subtle herb uses that may supplement the ancients' omissions and serve as references. However, their fundamental laws cannot compare to the ancients. Moreover, some formulas violate classics and laws, causing harm. Where are the learned scholars to select and preserve the best, compile the greatest collection, delete the inappropriate, and accomplish this great task for millennia? I have the ambition but lack the time.
On the Size of Ancient and Modern Formulas
Those discussing ancient formulas today suspect that ancient dosages were too heavy, arguing that ancients had robust constitutions and thus required heavier medication. This is baseless talk born of ignoring historical evidence. Measures of volume and weight varied across dynasties. From the Three Dynasties to the Han Dynasty, compared to today, they were only about one-tenth to one-fifth the size. (I have personally seen a Han Dynasty bronze measure of six Sheng, which holds the equivalent of today's 1.2 Sheng.) For example, Guizhi Tang is a large dose for Shanghan. It contains Guizhi (Cinnamon Twig) 3 Liang, Shaoyao (Peony Root) 3 Liang, and Gancao (Licorice Root) 2 Liang, totaling 8 Liang. Eight times eight equals sixty-four, converting to 1.6 Qian as one dose, divided into three servings. Thus, one serving is only about 0.53 Qian in modern terms. Other formulas with more ingredients might double the weight, but rarely exceed this significantly. Modern doctors use over ten herbs, each 1-2 Qian or 3-4 Qian, totaling over 3 Liang per dose. Ignorant fools use 4-5 Liang per dose. Recent practitioners even use 8 Liang of Shudi (Rehmannia Root Preparata) per dose, which is utterly improper. The same applies to pills and powders. For instance, ancient Wumei Wan (Mume Pill) prescribed twenty pills the size of paulownia seeds per dose, whereas today's equivalent is only 4-5 Fen. Modern pill doses range from 3-4 Qian to 7-8 Qian. Powder doses using a square-inch scoop (Fangcunbi) were only 6-7 Fen today, but now people take 3-4 Qian. Ancient dosages were never heavier than today's. (According to *Zhouli*, the food allowance for the people was four Fu per person per month. A Fu is 6.4 Dou. Four Fu total 2.5 Dou 6 Sheng, meaning daily intake was over 8 Sheng.) Yet rumors spread that dosages have increased over time. This absurdity alone suffices; imagine the depth of the error. Lacking the ability to think historically and without master teachers, it is no wonder discussions are so frivolous.
On the Method of Decocting Herbs
The method of decocting herbs deserves deep study. Efficacy depends entirely on this. Improper cooking of poultry, fish, or meat can harm humans, let alone medicinal herbs... [Text gap inferred] ...then add remaining herbs to decoct together. This is the method where sovereign herbs are decocted first. However, Guizhi Tang does not require pre-decocting Guizhi; drinking hot porridge after administration to boost efficacy is another method. For Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction), Ganlan Shui (Agitated Water) is used to pre-decoct Fuling. For Wuling San, it is taken with rice water, followed by drinking warm water. Xiaojianzhong Tang requires decocting five herbs first, straining, then adding Yitang (Maltose). Dahuang Chaihu Tang is decocted until reduced by half, strained, and then re-decocted. Chaihu Jia Longgu Muli Tang is boiled for twenty boils. There are countless decoction methods, each with specific meanings. Generally, dispersing and aromatic herbs should not be decocted long to preserve their raw, dispersing qualities. Tonifying and cloying herbs should be decocted longer to achieve cooked, accumulating properties. This is the general rule. Thus, even if the formula is correct, improper decoction makes the medicine ineffective in curing the disease. Modern physicians often do not know this, let alone patients.
On the Method of Taking Medicine
Whether a disease is cured depends not only on the formula matching the pathology but also on the method of administration. Even if the formula is correct, improper administration yields no benefit and may cause harm. This must be known. For dispersing agents intended to expel wind-cold externally, they must be taken hot and covered warmly to allow the medicinal Qi to circulate in Ying and Wei, spreading heat to induce sweating and expel wind-cold. If taken lukewarm, sitting in drafts, or lying quietly, the medicine remains in the stomach and intestines, failing to induce sweat. Wind-cold will not dissipate secretly, and Ying Qi will be damaged by the wind-dispersing herbs. For purgative agents intended to resolve stagnation and guide it downward, they must be taken on an empty stomach in one dose to stimulate the medicinal action and push turbidity out via stool. If taken with food, old and new contents mix, medicinal Qi conflicts with food, Qi becomes unfocused, and food stagnation worsens. Therefore, texts like *Shanghan Lun* specify various administration methods: hot, warm, cool, cold, slow, fast, large amount, small amount, early, late, full stomach, empty stomach. Some suit decoctions better than powders, powders better than pills, pastes better than pills. Regarding light/heavy, large/small, upper/lower, exterior/interior, each treatment has its appropriate method. These are fixed truths. Deep contemplation of their meaning will yield understanding.