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Whenever the Yang Qi of the Heart and Spleen is insufficient, and the Qi and Blood of the Five Zang Organs are simultaneously injured, presenting with spontaneous sweating, aversion to cold, body heat, pain in the waist and back, contraction of seasonal epidemic pathogens, symptoms resembling malaria but not quite, fever due to overexertion, this formula should be used, named Shiquan Buzheng Tang (Ten Complete Decoction for Supplementing Righteousness). This formula addresses the injury of all five Zang organs, supplementing both Qi and Blood. If external pathogens take advantage of the deficiency to invade, the righteous Qi, aided by this supplementation, can naturally cooperate to expel the pathogens, leaving no place for them to reside. The medical texts state: "Supplement the righteousness, and the pathogens will eliminate themselves." Hence the name.

Ren Shen (Ginseng Radix) [1 qian 5 fen], Zhi Huang Qi (Honey-fried Astragali Radix) [2 qian], Zao Ren (Ziziphi Spinosae Semen, stir-fried and crushed) [2 qian], Dang Gui (Angelicae Sinensis Radix, wine-fried) [1 qian 2 fen], Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried until slightly yellow) [2 qian], Bai Shao Yao (Paeoniae Radix Alba, wine-fried) [1 qian 2 fen], Bai Fu Ling (Poria [with Pine Wood]) [1 qian 2 fen], Sheng Du Zhong (Eucommiae Cortex, raw) [2 qian], Chuan Xu Duan (Dipsaci Radix) [1 qian 5 fen], Niu Xi (Achyranthis Bidentatae Radix) [2 qian], Tian Bo Gui (Cinnamomi Ramulus, thin bark) [8 fen]. Add two Da Zao (Jujubae Fructus), decoct in water and take orally.

If there is floating heat in the heart, add Deng Xin Cao (Junci Medullia); if Yin deficiency is severe, add Shu Di Huang (Rehmanniae Radix Preparata); if there is an external contraction, remove Ren Shen, add Chai Hu (Bupleuri Radix) and Sheng Jiang (Zingiberis Rhizoma Recens); if there is Qi stagnation, add a small amount of Mu Xiang (Aucklandiae Radix); if there is cough, remove Ren Shen and add Chao Mai Dong (Ophiopogonis Radix, stir-fried); if the right Chi pulse is forceful, remove Bo Gui; if the Lung pulse is surging and large, remove Huang Qi.

The mother of a Mr. Zhang in the capital suffered from Wei Syndrome (flaccidity syndrome), unable to get out of bed for several years. She prayed to Guan Sheng Di Jun (Lord Guan), obtaining a lot that indicated she would meet a noble young man from Qingjiang. Someone informed me that I was from Zhejiang, so he invited me to examine her. I found her Qi and Blood were both deficient, so I prescribed the aforementioned formula. In less than ten doses, she could walk normally. This shows the coincidence of medicinal affinity and the efficacy of Lord Guan.

Well said! As Mr. Lizhai stated, when Qi and Blood are deficient and manifest various symptoms, it is difficult to name the disease specifically. My friend, Mr. Zhang Zifang, nearly sixty years old, had no fever or headache, but his diet decreased daily, his stool was very thin and difficult to pass, and his urine was very red and painful/obstructed. Every three days, at night, his Qi would reverse and rush upward, feeling as if he were dying, unable to sleep all night. His spirit gradually became fatigued, his appearance withered, and his six pulses were surging and rapid, except for the right Guan and Chi positions which were slightly slow and weak. I said: "This is extreme depletion of Yin, with solitary Yang having no foundation. The worsening every three days indicates involvement of the Spleen's governing rhythm. For diseases difficult to name, they all stem from disorders of the fundamental Qi. Treat the root, and once the root is secured, even if external pathogens exist, they will have nowhere to hide and will manifest externally." Thus, I used Shu Di Huang [1 liang 6 qian], Chao Mai Dong [3 qian], Chao Bai Zhu [6 qian], Niu Xi [3 qian], Wu Wei Zi (Schisandrae Chinensis Fructus) and Fu Zi (Aconiti Lateralis Radix Preparata) [each 1 qian], taken with Ren Shen Tang (Ginseng Decoction). After a few doses, at each interval, he developed alternating chills and fever, resembling malaria. I said: "Now the pathogen has reached the exterior." Continue taking the same prescription. Since the pathogen exits through here, it can also dissipate through here. After more than ten doses, he slept peacefully at the appointed times, the "three-malaria" symptoms completely resolved, his stool became thick and large and smooth, urine pale white and long, diet gradually increased, and spirit recovered.

Although diagnosing diseases involves inspection, listening/smelling, inquiry, and palpation, ultimately, pulse diagnosis must be primary, as the pulse reveals the true condition of the Zang organs, while symptoms often present deceptive appearances. My friend Mr. Zhang once suffered from Yangmei Chuang (chancre/syphilis). After healing with a cooling and detoxifying formula, it relapsed, causing unbearable pain in the head, cheeks, nasal bridge, and gums, making eating difficult. Believing it was residual toxin, he again used cooling and detoxifying formulas, leading to loss of appetite, inability to sit or lie down, and mental fatigue. I examined him and found his six pulses were faint. I said: "If it were truly Yang toxin, the pulse should be surging and large. Moreover, the head is the meeting point of clear Yang, the brain is the sea of essence, the face belongs to the Yangming channel (abundant in blood and Qi), and teeth are the remnants of the Shaoyin bones. Now, True Yin and True Yang have been trapped by cold-cooling medicines for a long time, causing Yin and Yang to lose their functions. How can one throw stones into a well that is already sinking? Even the initial onset of the chancre was due to the loss of essence, blood, and Yuan Yang, allowing Yin-cold stagnant Qi to invade. If one generally uses cooling methods, it only increases harm. Have you not considered the Classic saying: 'When Qi and Blood are disharmonious, accumulation forms abscesses.' Diseases arising in muscles are disorders of Qi and Blood; those forming in sinews and bones are disorders of essence and marrow. Outside of Qi, Blood, and Essence/Marrow in the human body, what toxins can run parallel in the meridians? Outside the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) of Heaven and Earth, what toxins are interspersed? For example, frostbite in winter or heat boils in summer—where is the toxin? If one takes harmonizing Qi and Blood as the branch treatment, and replenishing True Yin and True Yang as the root treatment, then Ying and Wei will circulate freely, like flowing water that does not become turbid." I prescribed the decoction together with Ba Wei Wan (Eight-Ingredient Pill) to be taken concurrently. In less than half a month, all pains healed, and diet and spirit became robust.

The Classic says: "Where pathogens gather, righteousness must be deficient." It also says: "If you do not treat the deficiency, how can you ask about the rest?" And: "Treating disease must seek its root." These are indeed eternal maxims of medical wisdom. Suppose there is stagnation fever, red face, and irritability, appearing as excess. However, investigating the root, it is Spleen-Stomach righteous Qi deficiency failing to transport and transform; thus, deficiency is the root. One should promote grain Qi and assist Spleen digestion. If one merely attacks from the branch, internal Yang disasters will follow. Similarly, in wind-cold common cold with high fever and headache, although it seems like excess, it is what the Classic calls "Pathogenic Qi flourishing leads to excess," caused by failure of Stomach Qi to consolidate. If one purely uses strong dispersing agents, exterior Qi becomes more deficient, and external pathogens will invade endlessly. Again, in cough and wheezing with irritability, Lung Qi heat appears excessive, but the source is either Water deficiency failing to control Fire, or Fire deficiency causing floating empty Yang. If one treats the Lung from the branch, it may temporarily heal but recur worse. Therefore, any disease presenting as external excess is actually a time of deficiency in the relevant channel's righteous Qi. If one does not treat from the source, further depleting what is already deficient, the deficient will become increasingly deficient, followed by danger and death. It is crucial to protect the root, seek the source, prevent subtle changes, so that disease roots are permanently eliminated, righteous Qi arises, not only curing the disease but also prolonging life.

Someone asked: "Your treatments are effective, but your prescriptions are ordinary, mostly using Ba Zhen Tang, Shiquan Buzheng Tang, Gui Pi Tang, Yang Rong Tang, Du Shen Tang, Sheng Mai San, Liu Wei Wan, Ba Wei Wan, Can Fu Li Zhong Tang, etc. Are the treatments for all hundred diseases the same?" I said: "The Classic states: 'He who knows the essentials needs but one word to finish.' The ancient sages Qibo and Huangdi merely clarified the flourishing and decline of Yin and Yang, the emptiness and fullness of pathogenic and righteous Qi, victory and defeat, generation and restriction. There is no other theory outside this. Although Heaven and Earth's creation is wondrous, its Yin and Yang principle is one, not exceeding the application of Five Elements generation and restriction. Those governing True Yin and True Yang are the Sun and Moon. Although humans vary in size and strength, their safety and longevity depend on the changes in the flourishing and decline of the Five Zang, utilizing Qi and Blood, with Water and Fire as roots. If one abandons these for the bizarre, one seeks Yin and Yang beyond the Five Elements, claiming humans have different Zang, Qi, Blood, Water, and Fire functions. Heaven and Man are one body; creation cannot be wondrous outside Yin and Yang, nor can human life differ in Zang organs. How can physicians seeking life and death go beyond Zang, Qi, Blood, Water, and Fire to pursue the bizarre? Moreover, where pathogens are toxic, righteousness must be deficient. When disease reaches crisis, Yuan Shen is exhausted. Victory and defeat are normal. Treating disease requires protecting the root and attacking pathogens, correcting bias and saving defects; we still fear insufficiency, how dare we pursue the exotic? Going south by driving the chariot north, how can it benefit the world? Thus, the ancient sage Zhang Zhongjing created Ba Wei Wan to tonify Ming Men (Gate of Life), emphasizing pre-heaven Yang; Zhang Zhongjing reduced Gui and Fu to use Liu Wei Wan for children, emphasizing pre-heaven Yin. Zhao Xianke (pseudonym Shoukui) used Liu Wei and Ba Wei interchangeably, emphasizing both pre-heaven Yin and Yang. Li Dongyuan emphasized Spleen and Stomach, establishing Bu Zhong Yi Qi Tang, cultivating the post-heaven source of transformation. Zhu Danxi supplemented Qi and Blood primarily with Si Jun Zi Tang and Si Wu Tang, assisting post-heaven function. Zhao Xianke (Shuizhai) used Gui Pi, Yang Rong, and Ba Wei as mainstays, a general rule for pre- and post-heaven. Ancient sages studied extensively, daring not to seek fame or rely on oddities, limited by the constant principle of Heaven and Man being one. If the principles of Heaven and Earth's Yin and Yang took another path, and human Zang organs had different functions, why would thousands of years of famous sages emerge without creating new theories to emphasize later generations!"

Ancients, when using hot medicines, often instructed patients to drink them cold, fearing that false Yang above would reject the hot medicine upon entry. Thus, cold administration allows cold to meet cold, facilitating entry without vomiting. After swallowing, the cold nature dissipates, and the hot nature activates, calming false Yang. This is indeed a good method. If the syndrome is purely deficiency-cold without false Yang signs, simply take it warm; no need for cold administration. Because in pure deficiency-cold syndromes, cold administration accelerates Yang collapse, causing diarrhea, hiccups, etc. By the time the hot nature acts, the merit cannot cover the fault, and it is too late. Therefore, in extremely deficient and cold critical cases, aiming to restore near-death conditions, the medicine must include Yin-natured ingredients, and the patient should retain some cold/nature during ingestion. When false Yang is absent, how can the body tolerate such falsely cold properties? With no Yang-warming Qi in the abdomen, it cannot bear Yin-natured medicines.

Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Preparata) were not frequently used by ancient philosophers, and when used, in small amounts, yet effects were fast. Moderns use them frequently and heavily, yet effects are slow. Why? Because the Qi of Heaven and Earth has thinned. Humans and plants derive life from Heaven's Qi; plants additionally rely on Earth's flavor to form shape. Thinner Qi results in thinner endowment. Human pre-heaven Qi is Yuan Yang Qi. Since Yuan Yang Qi is thin, how can it not borrow the power of Gui and Fu? Thus, modern frequent use is appropriate. Alas, Gui and Fu also inherit Heaven and Earth's Qi, so their power is thin. Hence, heavy use yields slow results. Moreover, the origin of all diseases lies in Fire departing from its position. To cure disease, one must not let Fire hide its source.

Ancient proverbs have deep meanings; later generations should not ignore the name but examine it carefully. For instance, saying a person died means "finished/wan le," which is most accurate. Human life depends on the solidity of Jing (Essence), Qi, and Shen (Spirit). Jing is the flower of Yin-Blood transformation. Shen is the truth of Yuan Qi condensation. Insufficient Yin-Blood cannot generate its essence; un-filled Yuan Qi cannot condense its true Shen. Shen relies on Jing for support; Jing shines relying on Shen. Thus, the Classic says: "Jing nourishes Shen." When Spirit and Jing function in harmony, one enjoys natural lifespan; what disease could there be? Even strong pathogens can be resisted. If Spirit and Jing lose their hold and fail to manifest, lifespan is short, and hundred diseases arise. Even slight pathogens cause harm. Truly, when Spirit and Jing are "finished," strength cannot resist. How much more so for有形 (form-based) diseases with no limit, while无形 (formless) Yuan Qi easily perishes. At the verge of death from hematemesis, spitting phlegm, or consumption, due to prior exhaustion of Yin-Jing, although the form is withered, the Shen-Qi remains clear. Yet, since essence and flower are exhausted, Shen has no foundation, and suddenly Qi cuts off and passes. In sudden death from stroke or cold invasion, due to prior exhaustion of Yuan Yang and True Qi, although the form is robust, the Shen-thought is confused. Since true Shen is lacking, even if Yin-Jing is not depleted, it is like water losing Yang-warmth, becoming solid ice and lifeless. Thus, many die unconscious. Observing this, the character "Wan" (Finished) should make those who cherish life and physicians reflect deeply! The Classic says: "Do not treat the deficiency, how can you ask about the rest?" This precisely worries about Spirit and Jing finishing before the disease heals.

In ancient times, when treating major diseases, great force was used. A few sovereign herbs ensured focused efficacy, capable of immediately reversing critical conditions. For minor diseases, small force was used; assistant and envoy herbs sufficed. Why use harsh, fierce agents that disturb and injure life? Regarding decoctions, pills, pastes, and powders, each has its suitability. For diseases of the Five Zang and meridians, large-dose decoctions are used to purge. To target Yang divisions, take hot; to target Yin divisions, take warm; to reach the exterior of meridians, decoct with wine. For Heart and Lung diseases, decoct strongly in small quantities, swallow slowly far from meals to guide it down, as their location is upper and near, tolerating frequent small doses. For Kidney diseases, located lowest, Yang-tonifying drugs may hurt Heart/Lung; Yin-nourishing drugs may hinder Spleen/Stomach. Pills swallowed whole are best to reach lower Jiao directly for transformation, a method called "stealing past the pass." For acute cases requiring decoctions, take large doses immediately before meals to reach lower Jiao. For Spleen/Stomach diseases, powders are suitable. All transformations rely on Spleen/Stomach. If two channels are diseased, transformation is difficult; pills cannot exert effect, decoctions rush downward, powders rely on dregs entering stomach directly without traversing meridians, sparing stomach transformation. Middle Jiao benefits, Spleen trouble wakes, naturally transporting medicinal power, enhancing efficacy. For withered diseases of Five Zang, pastes are needed for sticky, moist filling; pills are too slow, decoctions too fast, powders too thin, all hard to see effect. Also, long-term use of Qi/Blood tonics may seem to decrease Qi/Blood, while subsequent use of draining/promoting agents seems to instantly increase them. This is not error in tonification. Long-term tonification generates much Sheng Qi (generating Qi), but Xie Qi (draining Qi) becomes heavier, and stickiness is excessive. Blood stagnates and does not move; Qi hides and does not function. Thus, one dose of draining/promoting causes Qi and Blood to circulate, revealing previous merits. Long-term use of warming/tonifying Yuan Yang may seem to trap Yuan Yang daily, while subsequent cooling agents seem to instantly strengthen Yuan Yang. This is not error in warming/tonifying. Like spring/summer growth, Qi and Blood flow freely without restraint, causing fatigue. Without autumn/winter gathering and storing Qi, how can one achieve solidification? Furthermore, treating one channel exclusively for deficiency or disease, using specific agents, achieves quick results but cannot last long. Long-term use leads to mutual generation of victory/defeat, increasing bias and harm. Treating with intervals (skipping one or two channels) is slower but lasts longer, like deep sources flowing far, deep roots holding firm. Moreover, Zang organs receiving generating Qi nurture each other, avoiding bias harm. These are my humble views, added to supplement omissions.

A youth overworked mentally and excessively indulged in sexual desire, suffering from dribbling urination, severe distension and pain, with pain radiating to the liver from both bowels. Cun pulses were deep and faint, Left Guan very weak, Right Guan rapid and slippery, Chi string-like and choppy. I knew Heart/Lung Qi was insufficient, sinking into Kidney/Liver. Kidney/Liver Qi was also insufficient, thus failing to disperse and failing to store. Middle Qi was deficient, so Clear Yang could not rise, causing Middle Jiao stagnation, steaming into damp-heat, seeping into Bladder. Thus, it resembled strangury but wasn't, with pain in both bowels, like Da Xia Xie (major abdominal mass diarrhea). I ordered morning intake of Ba Wei Wan combined with Er Miao San, made into decoction, using cold and heat as guides to remove damp-heat and clarify the source. At noon, before food, use Bu Zhong Yi Qi Tang. But Heart Qi is already deficient, how dare I drain Qi further? Remove Chen Pi (Citri Reticulatae Pericarpium). Liver Qi is already weak, how dare I soothe Liver further? Remove Chai Hu. Take the dregs in evening, decoct and induce vomiting. Turbid Qi sinking obstructs, necessitating light diuresis, so add Fu Ling. Fearing that removing Chai Hu leaves Sheng Ma (Cimicifugae Rhizoma) alone lifting weakly, add Jiu Chao Nen Fang Feng (Saposhnikoviae Radix, wine-fried tender) to assist. Wine-frying Fang Feng removes its pungent-dispersing nature, enhancing its ascending power. Taking dregs to induce vomiting: Dampness, stagnation, and heat, upon receiving ascending release, dissipate naturally. Moreover, if upper orifices open, lower orifices benefit. Indeed, it was very effective. The formula follows, to broaden knowledge.