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Treats heat in the Qi level (Qi Fen), characterized by calmness at night and exacerbation during the day, thirst, turbid urine, or sores on the mouth and tongue, dry throat, irritability, red and scanty dysuric urine, recurring upon exertion.

Chuan Xiong Radix (Fried) [Note: Text says Huang Qin, corrected to Huang Qin based on context of heat clearing] -> Huang Qin (Scutellariae Radix, Scutellaria Root) (fried), Dong Mai Cao (Ophiopogonis Radix, Ophiopogon Root), Di Gu Pi (Lycii Cortex, Lycium Bark), Che Qian Zi (Plantaginis Semen, Plantago Seed), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root and Rhizome) (1.5 qian each), Shi Lian Rou (Nelumbinis Plumula, Lotus Plumule), Bai Fu Ling (Poria, Poria Cocos), Ren Shen (Panacis Ginseng Radix, Ginseng Root) (1 qian each). Decoct with water and take orally.

The Heart governs Fire. Fire is the thief of Yuan Qi (Primordial Qi); Heat and Yuan Qi cannot coexist. The Small Intestine and Heart are exterior-interior paired organs. If Heart Fire moves recklessly, urination will inevitably become difficult. Therefore, Mai Dong (Ophiopogonis Radix) and Shi Lian Rou (Nelumbinis Plumula) are used to pacify the Tian Jun (Heavenly Sovereign, referring to the Heart/Shen) to prevent the danger of self-incineration; Huang Qin (Scutellariae Radix) and Fu Ling (Poria) clear heat from the highest regions to prevent the hazard of consumption and destruction; Ren Shen (Panacis Ginseng Radix) assists Qi transformation to reach the Zhou Du (Bladder); Che Qian Zi (Plantaginis Semen) opens the Jue Du (Waterways) to supply the Shou Sheng (Small Intestine); Gan Cao (Glycyrrhizae Radix et Rhizoma) alone can act both above and below, harmonizing the various herbs to jointly achieve success. Once urination is unobstructed, the Heart becomes clear and all fires subside naturally; one should treat the root directly without needing to address the branch symptoms simultaneously.

Treats heat in the Stomach, vomiting, coughing and rebellious Qi, empty irritability and restlessness.

Ren Shen (Panacis Ginseng Radix, Ginseng Root) (5 qian), Ban Xia (Pinelliae Rhizoma, Pinellia Tuber), Zhu Ru (Bambusae Caulis in Taenia, Bamboo Shavings) (one ball, another version adds Ju Hong (Citri Reticulatae Pericarpium Rubrum, Red Tangerine Peel) 1 qian). Divide into six doses, decoct with ginger water, and take warm.

Treats internal injury due to fatigue and overexertion, presenting with feverish sensation, irritability, headache, aversion to cold, spontaneous sweating due to Yang deficiency, reluctance to speak, anorexia, or panting, thirst, or inability of Qi deficiency to control blood, pulse that is flooding yet forceless, or minute, fine, weak, and soft, or malaria and dysentery due to Spleen deficiency persisting for a long time without cure, all syndromes of sinking of Clear Yang and insufficiency of Middle Qi, or deficient individuals suffering from wind-cold invasion who cannot tolerate diaphoretic treatments; this formula is suitable as a substitute. (The "Middle" refers to the Spleen and Stomach. All Zang-Fu organs and limbs derive Qi from the Spleen and Stomach. Irregular diet and physical overwork injure the Spleen and Stomach, causing the whole body to lack Qi and become diseased. When Yang Qi sinks, Yin Fire flares upward, so fever and irritability are not excess heat. The head is the convergence point of all Yang meridians; when Clear Yang does not ascend, turbid Qi rebels upward, causing headache. The pain comes and goes, unlike external contraction headaches which are continuous. Yang deficiency fails to protect the exterior, causing aversion to cold and spontaneous sweating. Qi deficiency causes reluctance to speak. Spleen deficiency causes anorexia; Spleen/Stomach deficiency allows Fire to flare to the Lung, causing panting. Metal is controlled by Fire and cannot generate Water, causing thirst. Spleen deficiency fails to control blood, leading to hematemesis and hematochezia; sinking of Clear Yang leads to diarrhea and dysentery. Deficiency of both Qi and Blood leads to persistent malaria. In summary, these are all manifestations of insufficient Middle Qi.)

Huang Qi (Astragali Radix, Astragalus Root) (1.5 qian, honey-fried), Ren Shen (Panacis Ginseng Radix, Ginseng Root), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, Prepared Licorice Root and Rhizome), Dang Gui Shen (Angelicae Sinensis Radix, Dong Quai Root - heart portion), Bai Zhu (Atractylodis Macrocephalae Rhizoma, Atractylodes Rhizome fried in earth) (1 qian each), Chen Pi (Citri Reticulatae Pericarpium, Tangerine Peel) (0.5 qian), Sheng Ma (Cimicifugae Rhizoma, Black Cohosh Rhizome), Chai Hu (Bupleuri Radix, Bupleurum Root) (0.3 qian each). Decoct with fresh ginger and jujube, and take orally.

Fatigue and overwork injure the Spleen and Stomach; Heart Fire attacks Earth (Spleen), and Lung Metal suffers evil. When Spleen and Stomach are deficient, Lung Qi is first exhausted. The Lung is the root of Qi; Huang Qi (Astragali Radix) tonifies the Lung and consolidates the exterior as the Sovereign herb; the Spleen is the root of the Lung; Ren Shen (Panacis Ginseng Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) tonify the Spleen, benefit Qi, harmonize the middle, and drain fire as the Minister herbs; Bai Zhu (Atractylodis Macrocephalae Rhizoma) dries dampness and strengthens the Spleen, Dang Gui (Angelicae Sinensis Radix) harmonizes blood and nourishes Yin as the Assistant herbs; Sheng Ma (Cimicifugae Rhizoma) raises the Clear Yang of the Yangming channel, Chai Hu (Bupleuri Radix) raises the Clear Yang of the Shaoyang channel. When Yang rises, all things grow; when Clear Yang rises, turbid Yin descends. Chen Pi (Citri Reticulatae Pericarpium) is added to promote Qi circulation; fresh ginger is acrid and warm, jujube is sweet and warm, used to harmonize Ying and Wei (Nutritive and Defensive levels), open the Cou Li (pores/skin texture), and generate fluids. For various deficiencies and insufficiencies, first establish the Middle Qi. What is the Middle? It is the Spleen and Stomach. The *Classic* states: "For exhaustion, use warmth." Warmth can eliminate great heat. One must strictly avoid bitter-cold medicines to prevent damaging the Stomach Qi. Generally, after age fifty, descending Qi is often abundant while ascending Qi is scarce; the influences of Autumn and Winter dominate over Spring and Summer. If constitution is inherently weak, with internal injury to Yuan Qi (Primordial Qi) and suppression of Clear Yang, this active method of treatment is appropriate. The Spleen is Kun Earth, corresponding to Earth Qi. When Earth Qi ascends, the command of sprouting and renewing spreads; when Heaven Qi descends, the command of drying and killing operates. Fatigue and overwork injure the Spleen, causing Earth deficiency and sinking. The *Classic* states: "If communication is not manifested, famous trees die much; if white dew does not descend, withered grass does not flourish." This describes the imagery of stagnation and killing. Humans responding to this result in hundreds of variable syndromes and premature extinction. Master Dongyuan deeply understood the laws of creation, thus establishing a mild and warm therapeutic principle. Mildness and warmth correspond to Spring Qi and are the way of nurturing life. Specifically, Sheng Ma (Cimicifugae Rhizoma) lifts the right-side sinking of the Spleen, ascending from the right; Chai Hu (Bupleuri Radix) lifts the left-side sinking of the Liver, ascending from the left. When Earth ascends, Heaven must descend. The interaction of these two Qi forms rain and dew; thus, Qi circulates and the generating Qi is inexhaustible. Is it not necessary to treat fatigue in this manner? Ancient formulas used 1 qian of Huang Qi (Astragali Radix), with other ingredients at 0.3 or 0.5 qian. Lizhai commonly used Ren Shen (Panacis Ginseng Radix) and Huang Qi (Astragali Radix) at 1.5 qian each, Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Dang Gui (Angelicae Sinensis Radix) at 1 qian each, Chen Pi (Citri Reticulatae Pericarpium) at 0.5 qian, and Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) at 0.3 qian each, adjusting up or down infinitely. For severe cases, Ren Shen (Panacis Ginseng Radix) and Huang Qi (Astragali Radix) may be increased to 3 or 5 qian, added according to symptoms. The Spleen and Stomach prefer sweet and dislike bitter, prefer tonification and dislike purgation, prefer warmth and dislike cold, prefer free flow and dislike stagnation, prefer ascending and dislike descending, prefer dryness and dislike dampness. This formula aligns with these preferences but is only extremely appropriate for conditions of extreme insufficiency of the Original Yang Qi of the Spleen and Stomach. If used for insufficiency of Original Yin Qi, it may be unsuitable. Since there are many Qi-moving herbs and few Blood-nourishing herbs, along with acrid and ascending agents, those with Yin deficiency may experience easy rising of floating fire and rebellious deficient Qi. Since ancient times, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) has been praised for its endless benefits for generations. What is its meaning? It expresses what predecessors had not yet revealed, continuing the traditions of Zhang Zhongjing and Liu Wansu, with profound intent. People seeing fever immediately attribute it to external contraction of wind, cold, summerheat, or dampness, asking how pathogens can be resolved without diaphoresis. Yet they fail to accurately identify wind, cold, summerheat, or dampness to treat symptomatically, instead using general exterior-resolving formulas such as Jiu Wei Qiang Huo Tang (Nine-Ingredient Notopterygium Decoction), Bai Du San (Detoxicate Powder), or Shi Shen Tang (Ten-God Decoction). Worse still, some combine Lian Ge San (Clear the Chest Powder) and Bai Hu Tang (White Tiger Decoction) indiscriminately, resulting in many deaths. Dongyuan deeply lamented this harm and established this formula, asserting that where pathogenic factors gather, Qi must be deficient; internal injuries are common, while external contractions are occasional. Even if external pathogens exist, they enter through deficiency. By tonifying the Middle and benefiting Qi, pathogens retreat spontaneously; there is no need to attack pathogens, for attacking makes the deficient even more deficient, leading to imminent peril. If there is an external contraction with slight internal injury, appropriate herbs can be酌情 added to this base formula, and external pathogens will retreat spontaneously. This is like a righteous army, invincible under heaven. Regarding irregular diet and excessive labor, Stomach Yang Qi becomes deficient internally and sinks into Yin, causing fever. This is Yang deficiency self-disease; mistaking it for external contraction and using diaphoretics further depletes deficiency. How grave is the harm! There is also a type of fever caused by internal injury to True Yin, similar to internal injury to Yang Qi. This requires filling True Yin. The Heart and Lung are above, the Liver and Kidney are below, and the Spleen and Stomach reside in the Central Region, governing the Qi of the four Zang organs. The formless Qi of the Middle Jiao steams and rots food and drink, governing ascending, descending, exiting, and entering. This is Pre-Heaven Qi, which is also the master of the Spleen and Stomach. Post-Heaven Earth (Spleen) cannot function without Pre-Heaven Qi. This formula addresses this Qi sinking into the Liver and Kidney due to fatigue, where Clear Yang does not ascend and turbid Qi does not descend. Thus, Sheng Ma (Cimicifugae Rhizoma) is used to ascend via the right armpit, and Chai Hu (Bupleuri Radix) via the left armpit. Without the merit of Ren Shen (Panacis Ginseng Radix), the lifting power would be insufficient; thus, it supplements the Pre-Heaven within the Post-Heaven. Ascending and descending, descending and ascending, aim only to harmonize Qi and Blood. Therefore, sinking and descending must not have ascending without descending, nor should there be only Spring and Summer without Autumn and Winter, only growth without storage. Master Dongyuan's entire *Treatise on the Spleen and Stomach* centers on Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), nothing more than cultivating the root of Post-Heaven Yuan Qi (Primordial Qi). Yuan Qi (Primordial Qi) is the essence and Qi of life, actually originating from the Stomach. Thus, Stomach Qi is distinguished as Grain Qi (Gu Qi), Ying Qi (Nutritive Qi), Chong Qi (Penetrating Qi), and Yang Qi, all being different names for Yuan Qi (Primordial Qi). This Qi is rooted in the Pre-Heaven Generating Qi. Mild Fire generates Qi, becoming True Yang Qi. Yuan Qi (Primordial Qi) is Fire; Fire is Yuan Qi (Primordial Qi). This is the foundation for establishing life. This Fire resides in the Liver and Kidney, rooted in Minister Fire (Xiang Huo). Minister Fire (Xiang Huo) acts on behalf of the Monarch Fire (Jun Huo) when Monarch Fire does not govern commands. Thus it is said: "When Minister Fire occupies its position," this Fire is originally not Pathogenic Fire. How can it be called the thief of Yuan Qi (Primordial Qi)? Yuan Qi (Primordial Qi) lies between the two Kidneys and the Gate of Life (Ming Men), warming the flesh and filling the skin with the Three Burner Minister Fire (San Jiao Xiang Huo), steaming dregs and transforming them into essence. Thus, Yuan Qi (Primordial Qi) is transformed by Minister Fire (Xiang Huo), not a thing that steals Yuan Qi (Primordial Qi). The thing that steals Yuan Qi (Primordial Qi) is Mild Fire (Shao Huo) changing abnormally into Blazing Fire (Zhuang Huo), not Mild Fire (Shao Huo). If one points to it as the thief of Yuan Qi (Primordial Qi) and argues "Fire and Yuan Qi (Primordial Qi) cannot coexist; one wins, the other loses," then what Fire generates Yuan Qi (Primordial Qi)? However, all Zang organs have Yin and Yang; Yin is Blood, Yang is Qi. Qi deficiency cannot contain the Original Yang of the Middle Palace; Blood deficiency cannot anchor the Thunder Fire of the Lower Jiao. Both are deficient heat. Therefore, sweet-warm is appropriate, and bitter-cold is taboo. Although injuries to the four Zang organs all cause internal injury, Dongyuan focuses solely on the Spleen and Stomach because fatigue and overwork injure the Spleen, and the Spleen and Stomach are the root of Yuan Qi (Primordial Qi).

The *Classic* states: "All Qi disorders and fullness/stagnation belong to the Lung." It also says: "Anger causes Qi to rise, joy causes Qi to slacken, worry causes Qi to dissipate, fear causes Qi to sink, cold causes Qi to contract, heat causes Qi to leak, shock causes Qi to become chaotic, fatigue ruins and consumes Qi, thought causes Qi to knot." The nine Qi are different, and hundred diseases often arise from Qi. What sustains human life is this Qi. It originates in the Middle Jiao, is commanded by the Lung, protects the exterior, travels internally, circulates throughout the body without pause, exits and enters, ascends and descends, with regularity day and night. How could it ever cause disease in humans? Until seven emotions attack each other, five desires erupt recklessly, deviating from normalcy. Clear transforms into turbid, movement is blocked and不通 (unobstructed), the exterior loses protection and harmony, the interior loses operation and smoothness. Qi belongs to Yang; when excessive, it becomes Fire. This is what Hejian meant by "extremes of the five desires all become Fire," and Danxi meant by "excess of Qi is Fire." The human body has Zong Qi (Pectoral Qi), Ying Qi (Nutritive Qi), Chong Qi (Penetrating Qi), Zhong Qi (Middle Qi), Yuan Qi (Primordial Qi), Wei Qi (Stomach Qi), Chong He Qi (Harmonious Qi), and Ascending Qi, with Zong Qi (Pectoral Qi) being particularly dominant. When diseased, they become Cold Qi, Stagnant Qi, Rebellious Qi, and Counterflow Qi, and various changes of Qi deficiency. When healthy, one should preserve, nourish, harmonize, and smooth it. When disease arises, one must examine which meridian and syndrome, whether cold, heat, deficiency, or excess, and apply tonification or sedation accordingly.