因热。因虚。由脾胃有亏，下陷于肾，与相火相合，湿热下迫，脉洪数而
实，先见寒热往来，心烦不得眠卧，宜大补脾胃，升举气血。
由心气不足，其火大炽，旺于血脉之中，形容似不病者，此心病也。四物汤
加镇坠心火之药，补阴泻阳。
由肾水真阴虚，不能镇守胞络相火，故血走而崩，是气血俱脱，为大寒之
证，轻手其脉数实，举手弦紧或涩，皆阳脱也，阴火亦亡，或渴，皆阴燥，宜
温之、补之、升之。
方 防风 羌活 升麻 柴胡 川芎（一钱升阴散火） 黄芩 黄连 黄柏 知母（五分凉
血泻相火） 川归（五钱） 黄 （补血凉血）
胃客寒心痛，加草豆蔻、神曲；气短加参 术；冬寒加麻黄、桂枝；久不止
加胶艾；血气俱脱，大寒证加附子、肉桂，干姜。
治本 四物。
虚加参术；热加芩连；寒加姜桂。香附行气。
治标 白芷汤调棕榈灰 五灵脂（亦治） 鹿角灰 蒲黄（炒黑亦治） 凌霄花
发灰用荆芥四物汤下大妙。
肝病 则胃脘当心而痛，上支两胁，鬲咽不通，饮食不下，甚则耳鸣、眩转、
目不识人，善暴 戾，胁痛呕泄，令人善恐。
虚则胁下坚胀，寒热，腹满不食，目无所见，耳无所闻，筋挛节痛，爪甲枯青色，善恐，脉沉细而滑。
实 则胁下痛，寒热，心下坚满，气逆头晕，颈直背强。
川芎（臣同上） 五味子（臣温同上） 茯神（君） 益智（臣安心气） 人参（君定心） 炒盐
心实
脾病
肺病 左 胁痛，心胁满分小腹不可转反侧寒清于中，咳逆 溏，嗌干、面
尘、脱色，丈夫 疝，妇人小腹痛。
虚则语嘶，用力掉颤，少气不足以息，耳聋咽干，咳喘，鼻清涕，恐怖，脉沉缓。
实 则胸膈满，上气咳逆，咽不利，鼻口亦张，饮无度，痰粘，肩背痛，脉不上不下。
肺绝 口似鱼口，气出不快，唇反无纹，皮毛焦，三日死。
又 鼻开而黑枯，足满，泄不觉，喘而目直，喘急短气，大肠绝，泄则无
度，六日死。
悲伤肺 为气消，阴缩筋挛，肌痹脉痿，男为数溲，女为血崩，酸苦辛泣则臂麻。
肺虚主 面色恍白，咳嗽涎唾，瘦瘁，气促，口无味，怯寒，喉痹，唇反，
无色，饮食胸痞不快。
钟乳粉（君，补肺虚） 紫石英（温补肺） 白茯苓（君，益肺气） 丹砂（臣寒温补）
白术（臣补肝） 磁石（君同上） 桑寄生（臣补） 茯神（臣补） 款冬花（臣补益气）
人参（末入） 山棱（末入）
肺实主 面赤唇焦，头皮四肢痒，痰涎胶粘，咽喉痛，或颈肿皮肤热疮，或发作寒热。
当归（臣利肺气） 升麻（臣寒泻肺气） 木香（君通同上） 桔梗（臣同上） 贝母（臣
解同上） 石膏（臣寒利胃气） 百合（臣退肺壅下痰） 桑白皮（臣泻肺气） 款冬花（臣利
肺气） 紫苏子（臣退肺气） 紫菀（君降肺气） 青皮（臣止肺气） 枳实（臣通三焦热）
牛蒡子（臣转肺气） 荆芥穗（臣凉肺气热） 赤芍药（臣） 诃子（末入止大府） 黄芩（末）
大肠冷虚 肠鸣泻痢，呕逆，手足冷。
肉果（君温暖止大肠泄） 白果（君温暖脾胃温大肠） 诃子（君温止泻） 人参（君寒暖
胃润肠） 白术（固元阳和气） 扁豆（臣生气止泄） 茯苓（君暖胃止泄） 桂（君热和脾胃，
温大府） 良姜（臣热，暖胃和肠）
附子（君热壮胃暖肠胃气） 吴茱萸（臣生气止吐）
肾虚 盗汗，梦齿脱落，余病同前虚条。
肉苁蓉（君壮阳道益精） 阳起石（君强肾） 牛膝（君补肾壮阳） 石斛（君壮肾）
磁石（君平补虚益肾气） 熟地（君平同上） 巴戟（强阳益肾） 菟丝子（君补肾冷） 乌药
（君益肾） 天雄（君壮肾气） 益智（君温暖肾虚冷） 青盐（臣补肾） 附子（少阴行经暖
壮阳道末入） 桑螵蛸（臣强壮阳道） 猪肾（君温补益肾） 海狗肾（君补暖益肾） 雀卵（臣
助阳道） 蛇床子（臣温强阳） 白茯苓（君补虚损添精） 黄柏（末入） 知母（末入）
肾实主 耳痛，头皮肩项肿，及脚心痛，腿漆生疮，腰肿，或鲜血目热泪，小便涩痛。
郁李仁（臣寒降肾气） 蒺藜（臣转肾气） 金铃子（臣退肾热） 地骨皮（臣导肾气）
槟榔（臣泻肾气） 青木香（同上） 车前子（臣利小便，除肾绝，降肾气） 防风（臣益肾，
治皮肤痒） 枳壳（臣降肾气） 青皮（臣寒同上） 牵牛（疏导肾气） 桑白皮（臣利肾气）
黄柏（臣降肾气） 地龙（臣凉益肾水）
膀胱寒热 小便淋涩或尿血。
石苇（臣平利水道） 瞿麦（臣退小便热） 芍药（臣利水道） 川归（臣平，疗便痛溺
血） 青皮（臣导水府） 葱（臣清小便） 木香（臣利小便血） 车前子（臣寒利小便溺）
灯草（臣通小肠） 京山棱（臣利小便） 黄芩（臣寒利小便血） 油麻（臣寒滑小府） 冬葵
子（臣治淋） 萝卜子（臣通小府） 白荠（臣同上） 生地
（臣冷利小肠热） 木通（末入）
祖按∶药性禀定之君臣，千古之经也；立方主治之君臣，一时之权也。学人自宜会心得之。
按∶旧本系 国初时孝顺方处善浦阳戴元礼同集于洪武庚戌年三月初二日。戴元
礼，丹溪先生之高弟也。今诠次成于天启辛酉年八月中秋日。 丁承祖谨识。
Due to heat pathogen. Due to deficiency. Caused by spleen and stomach deficiency, with qi sinking into the kidney, combining with ministerial fire (mingmen fire residing in liver and kidney), damp-heat pressing downward. The pulse is surging, rapid, and full. Initially presenting with alternating chills and fever, restlessness, and inability to sleep, it is appropriate to greatly tonify the spleen and stomach, and raise qi and blood.
Caused by heart qi insufficiency, leading to blazing heart fire, which flourishes within the blood vessels. The appearance seems healthy, but this is a heart disease. Use Siwu Tang (Four Substances Decoction) added with herbs that suppress heart fire, to tonify yin and drain yang.
Caused by depletion of kidney water and true yin, failing to control the ministerial fire in the uterus network, causing blood to rush and lead to metrorrhagia (uterine bleeding). This is a condition of simultaneous depletion of qi and blood, representing a severe cold syndrome. Light pressure reveals a rapid and full pulse; heavy pressure reveals a string-tight or choppy pulse, both indicating yang collapse. Yin fire also perishes. Thirst indicates dryness due to yin deficiency. It is appropriate to warm, tonify, and raise.
Formula: Fangfeng (Saposhnikovia Root), Qianghuo (Notopterygium Rhizome), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma) [1 qian, to raise yin and dissipate fire], Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma) [5 fen, to cool blood and drain ministerial fire], Chuangui (Angelicae Sinensis Radix) [5 qian], Huangqi (Astragali Radix) [to tonify blood and cool blood].
If gastric external cold causes heart pain, add Caoudoukou (Alpiniae Katsumadai Semen) and Shenqu (Massa Medicata Fermentata); for shortness of breath, add Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma); for winter cold, add Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus); if persistent, add Ejiao (Colla Corii Asini) and Aye (Folium Artemisiae Argyi); if qi and blood are simultaneously depleted, constituting a severe cold syndrome, add Fuzi (Aconiti Lateralis Radix Praeparata), Rougui (Cinnamomi Cortex), and Ganjiang (Zingiberis Rhizoma).
Treating the root: Siwu Tang (Four Substances Decoction).
For deficiency, add Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma); for heat, add Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma); for cold, add Ganjiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex). Xiangfu (Cyperi Rhizoma) moves qi.
Treating the branch: Use Baizhi Tang (Angelicae Dahuricae Decoction) to mix with Zonglvhui (Carbonized Palm Fruit), Wulingzhi (Trogopterori Faeces), Lujiiahui (Carbonized Deer Antler), Puhuang (Pollinis Typhae) [stir-fried until black, also effective], Lingxiaohua (Campsis Flower), and Fazhui (Carbonized Human Hair) [administered with Jingjie and Siwu Tang yields excellent results].
Liver disease: Pain at the epigastrium corresponding to the heart, radiating upward to support both hypochondria, obstruction of the diaphragm and throat, difficulty in eating and drinking. Severe cases present with tinnitus, vertigo, inability to recognize people, sudden irritability, hypochondriac pain, vomiting, and diarrhea, causing excessive fear.
Liver deficiency: Hardness and distension under the hypochondria, chills and fever, abdominal fullness with anorexia, blindness, deafness, tendon spasms and joint pain, withered and bluish nails, excessive fear. Pulse is deep, fine, and slippery.
Liver excess: Hypochondriac pain, chills and fever, hardness and fullness below the heart, rebellious qi with dizziness, stiff neck and back.
Chuanxiong (Minister herb, efficacy as above), Wuweizi (Schisandrae Chinensis Fructus) [Minister, warming, efficacy as above], Fushen (Poria with Hostwood) [Sovereign herb], Yizhi (Alpiniae Oxyphyllae Fructus) [Minister, calms heart qi], Renshen (Ginseng Radix) [Sovereign, stabilizes heart spirit], Fried Salt.
Heart excess:
Spleen disease:
Lung disease: Left hypochondriac pain, fullness in the heart and hypochondrium, lower abdomen discomfort, feeling cold internally when turning over. Cough and rebellious qi, loose stools, dry throat, dusty complexion, loss of luster. Men suffer from hernia; women suffer from lower abdominal pain.
Lung deficiency: Hoarseness, trembling when exerting force, shortness of breath insufficient for respiration, deafness, dry throat, cough and asthma, runny nose with clear mucus, fear. Pulse is deep and slow.
Lung excess: Chest and diaphragm fullness, rebellious qi with cough, throat obstruction, open mouth and nose, excessive drinking, sticky phlegm, shoulder and back pain. Pulse is neither rising nor falling.
Lung exhaustion: Mouth opens like a fish's gill, breathing is difficult, lips evert without wrinkles, skin and hair become withered. Death occurs in three days.
Also: Nostrils open wide and become black and withered, feet swell, uncontrollable diarrhea, wheezing with fixed gaze,急促 shortness of breath. Large intestine exhaustion. Uncontrollable diarrhea leads to death in six days.
Excessive sadness injures the lung, causing qi consumption, contraction of the yin organ and tendons, muscle bi and pulse wei. Men experience frequent urination; women experience metrorrhagia. Crying with sour, bitter, or pungent tastes causes arm numbness.
Lung deficiency primarily manifests as sallow white complexion, cough with saliva/phlegm, emaciation, shortness of breath, tasteless mouth, aversion to cold, throat obstruction, everted lips, lack of color, chest stuffiness and discomfort after eating.
Zhongru Fen (Stalactitum Pulveratum) [Sovereign, tonifies lung deficiency], Zishiyang (Fluorite) [warming and tonifying lung], Bai Fuling (Poria) [Sovereign, benefits lung qi], Dansha (Cinnabar) [Minister, cooling/warming tonification], Baizhu (Atractylodis Macrocephalae Rhizoma) [Minister, tonifies liver], Cishi (Magnetitum) [Sovereign, as above], Sangjisheng (Taxilli Caulis) [Minister, tonifies], Fushen (Poria with Hostwood) [Minister, tonifies], Kuidonghua (Farfarae Flos) [Minister, tonifies and benefits qi], Renshen (Ginseng Radix) [powder added], Sanleng (Sparganii Rhizoma) [powder added].
Lung excess primarily manifests as red face and scorched lips, itching of scalp and limbs, sticky phlegm, sore throat, or neck swelling with hot skin sores, or episodes of chills and fever.
Danggui (Angelicae Sinensis Radix) [Minister, promotes lung qi], Shengma (Cimicifugae Rhizoma) [Minister, cooling, drains lung qi], Muxiang (Aucklandiae Radix) [Sovereign, unblocks, as above], Jiegeng (Platycodonis Radix) [Minister, as above], Beimu (Fritillariae Cirrhosae Bulbus) [Minister, resolves, as above], Shigao (Gypsum Fibrosum) [Minister, cooling, benefits stomach qi], Baihe (Lilii Bulbus) [Minister, clears lung congestion and descends phlegm], Sangbaipi (Mori Cortex) [Minister, drains lung qi], Kuidonghua (Farfarae Flos) [Minister, promotes lung qi], Zisuzi (Perillae Fructus) [Minister, descends lung qi], Ziwan (Asternis Radix) [Sovereign, descends lung qi], Qingpi (Citri Reticulatae Pericarpium Viride) [Minister, stops lung qi], Zhishi (Aurantii Fructus Immaturus) [Minister, unblocks sanjiao heat], Niubangzi (Arctii Fructus) [Minister, turns lung qi], Jingjie Sui (Schizonepetae Spica) [Minister, cools lung heat], Chi Shaoyao (Paeoniae Radix Rubra) [Minister], Hezi (Terminalia Chebulae Fructus) [powder added, stops large intestine diarrhea], Huangqin (Scutellariae Radix) [powder].
Large Intestine Cold Deficiency: Borborygmus, diarrhea and dysentery, vomiting/rebellious qi, cold hands and feet.
Rougu (Myristicae Semen) [Sovereign, warms and stops large intestine diarrhea], Baiguo (Ginkgo Semen) [Sovereign, warms spleen/stomach and large intestine], Hezi (Terminalia Chebulae Fructus) [Sovereign, warms and stops diarrhea], Renshen (Ginseng Radix) [Sovereign, balances stomach temperature and moistens intestines], Baizhu (Atractylodis Macrocephalae Rhizoma) [consolidates yuan yang and harmonizes qi], Bidou (Phaseoli Semen) [Minister, generates qi and stops diarrhea], Fuling (Poria) [Sovereign, warms stomach and stops diarrhea], Gui (Cinnamomi Ramulus) [Sovereign, heating, harmonizes spleen/stomach, warms large intestine], Liangjiang (Alpiniae Officinarum Rhizoma) [Minister, heating, warms stomach and intestines].
Fuzi (Aconiti Lateralis Radix Praeparata) [Sovereign, heating, strengthens stomach and warms gastrointestinal qi], Wuzhuyu (Evodiae Fructus) [Minister, generates qi and stops vomiting].
Kidney Deficiency: Night sweats, dream of teeth falling out. Other symptoms follow the previous deficiency descriptions.
Roucongrou (Cistanches Herba) [Sovereign, strengthens yang pathway and benefits essence], Yangqishi (Activum) [Sovereign, strengthens kidney], Niuxi (Achyranthis Bidentatae Radix) [Sovereign, tonifies kidney and strengthens yang], Shihu (Dendrobii Caulis) [Sovereign, strengthens kidney], Cishi (Magnetitum) [Sovereign, neutral tonification of deficiency and benefits kidney qi], Shudi (Rehmanniae Radix Preparata) [Sovereign, neutral tonification as above], Bajitian (Morindae Officinalis Radix) [strengthens yang and benefits kidney], Tusizi (Cuscutae Semen) [Sovereign, tonifies kidney cold], Wuyao (Linderae Radix) [Sovereign, benefits kidney], Tianxiong (Aconiti Radix) [Sovereign, strengthens kidney qi], Yizhi (Alpiniae Oxyphyllae Fructus) [Sovereign, warms kidney cold], Qingyan (Halitum) [Minister, tonifies kidney], Fuzi (Aconiti Lateralis Radix Praeparata) [travels shaoyin channel, warms and strengthens yang pathway, powder added], Sangpiaoxiao (Mantis Oötheca) [Minister, strongly strengthens yang pathway], Zhu Shen (Porcinus Ren) [Sovereign, warming and tonifying kidney], Haigoushen (Viverridae Ren) [Sovereign, tonifies, warms, and benefits kidney], Queluan (Quail Egg) [Minister, assists yang pathway], Shechuangzi (Cnidii Fructus) [Minister, warms and strengthens yang], Bai Fuling (Poria) [Sovereign, tonifies deficiency and adds essence], Huangbai (Phellodendri Cortex) [powder added], Zhimu (Anemarrhenae Rhizoma) [powder added].
Kidney Excess primarily manifests as ear pain, swelling of scalp/shoulder/nape, foot sole pain, sores on legs/knees, waist swelling, or bloody tears, and painful/difficult urination.
Yuliren (Pruni Armeniacae Semen Amarum) [Minister, cooling, descends kidney qi], Jili (Tribuli Fructus) [Minister, turns kidney qi], Jinlingzi (Meliae Fructus) [Minister, reduces kidney heat], Digupi (Lycii Cortex) [Minister, guides kidney qi], Binglang (Arecae Semen) [Minister, drains kidney qi], Qingmuxiang (Aucklandiae Radix) [as above], Cheqianzi (Plantaginis Semen) [Minister, promotes urination, removes kidney exhaustion, descends kidney qi], Fangfeng (Saposhnikovia Root) [Minister, benefits kidney, treats skin itching], Zhike (Aurantii Fructus) [Minister, descends kidney qi], Qingpi (Citri Reticulatae Pericarpium Viride) [Minister, cooling, as above], Qianniu (Pharbitidis Semen) [dredges kidney qi], Sangbaipi (Mori Cortex) [Minister, benefits kidney qi], Huangbai (Phellodendri Cortex) [Minister, descends kidney qi], Dilong (Pheretima) [Minister, cools and benefits kidney water].
Bladder Cold-Heat: Dysuria or hematuria.
Shiwei (Pyrosiae Folium) [Minister, neutral, promotes water passages], Qumai (Dianthi Herba) [Minister, reduces bladder heat], Shaoyao (Paeoniae Radix Alba/Rubra) [Minister, promotes water passages], Chuangui (Angelicae Sinensis Radix) [Minister, neutral, treats painful urination and hematuria], Qingpi (Citri Reticulatae Pericarpium Viride) [Minister, guides water mansion], Cong (Allii Fistulosi Bulbus) [Minister, clears urine], Muxiang (Aucklandiae Radix) [Minister, promotes urinary blood], Cheqianzi (Plantaginis Semen) [Minister, cooling, promotes urinary fluid], Dengcao (Junci Medulla) [Minister, unblocks small intestine], Jingshan Leng (Sparganii Rhizoma) [Minister, promotes urination], Huangqin (Scutellariae Radix) [Minister, cooling, promotes urinary blood], Youma (Sesami Fructus Niger) [Minister, cooling, lubricates small mansion], Dongkuizi (Malvae Semen) [Minister, treats strangury], Luoboz (Brassicae Napus Semen) [Minister, unblocks small mansion], Baiqi (Cardamine Hirsuta) [Minister, as above], Shengdi (Rehmanniae Radix) [Minister, cooling, clears small intestine heat], Mutong (Akebiae Caulis) [powder added].
Ancestor's Note: The sovereign-minister relationship determined by inherent drug properties is an eternal classic principle; the sovereign-minister relationship determined by prescription indications is a temporary adaptation. Students should understand this through insight.
Note: The old edition was collected by Dai Yuanli of Shunxiao Fang, Shangpu, Puyang, on the 2nd day of the 3rd month in the Gengxu year of Hongwu (early Ming Dynasty). Dai Yuanli was a high disciple of Master Danxi. This revised version was completed on the Mid-Autumn Festival of the Xinyou year of Tianqi. Ding Chengzu respectfully recorded.