术之燥,不利肾阴,茯苓渗泄,碍乎生升,肉桂辛热,动其虚火。此六味皆醇浓和平而滋
润,服之则气血疏通,内外调和,合于圣度矣。
地骨皮饮 治阴虚火旺,骨蒸发热,日静夜剧者;妇人热入血室,胎前发热者。
四物汤加地骨皮、牡丹皮(各三钱)。
水煎服。
【集注】柯琴曰∶阴虚者阳往乘之,发热也。当分三阴而治之。阳邪乘入太阴脾部,当
补中益气以升举之,清阳复位而火自熄也。若乘入少阴肾部,当六味地黄丸以对待之,壮
水之主而火自平也。乘入厥阴肝部,当地骨皮饮以凉补之,血有所藏而火自安也。四物
汤为肝家滋阴调血之剂,加地骨皮清志中之火以安肾,补其母也;加牡丹皮清神中之火
以凉心,泻其子也。二皮凉而不润,但清肝
火不伤脾胃,与四物加知柏之湿润而苦寒者不同也。故逍遥散治肝火之郁于本脏者也,木
郁达之,顺其性也;地骨皮饮,治阳邪之乘于肝脏者也,客者除之,勿纵寇以遗患也。二
方皆肝家得力之剂。
犀角地黄汤 治热伤吐衄、便血,妇人血崩、赤淋。
生犀角 生地黄 白芍 牡丹皮
上四味,先用三物水煎,去滓,入生犀汁,热服。
【注】吐血之因有三∶曰劳伤,曰努伤,曰热伤。劳伤以理损为主,努伤以去瘀为主,
热伤以清热为主。热伤阳络则吐衄,热伤阴络则下血。是汤治热伤也,故用犀角清心去
火之本,生地凉血以生新血,白芍敛血止血妄行,丹皮破血以逐其瘀。此方虽曰清火,而
实滋阴;虽曰止血,而实去瘀。瘀去新生,阴滋火熄,可为探本穷源之法也。若心火独盛,
则加黄芩、黄连以泻热,血瘀胸痛,则加大黄、桃仁以逐瘀也。
四生丸 治阳盛阴虚,血热妄行,或吐或衄者。
生地黄 生柏叶 生荷叶 生艾叶(各等分)
上四味,捣烂为丸,如鸡子大,每服一丸,滚汤化服。
【集注】柯琴曰∶阴虚而阳无所附,则火炎上焦;阳盛则阳络伤,故血上溢于口鼻也。
凡草木之性,生者凉,而熟之则温;熟者补,而生者泻。四味皆清寒之品,尽取其生者,而
捣烂为丸,所以全其水气,不经火煮,更远于火令矣。生地多膏,清心肾而通血脉之源。
柏叶西指,清肺金而调营卫之气。艾叶芳香,入脾胃而擅去瘀生新之权。荷叶法震,入肝
家而和藏血摄血之用。五志之火既清,五脏之阴安堵,则阴平阳秘,而血归经矣。是方
也,可暂用以遏妄行之热血,如多用则反伤营。盖血得寒,则瘀血不散,而新血不生也。
设但知清火凉血,而不用归脾、养荣等剂以善其后,鲜有不绵连岁月而毙者。非立法之
不善,妄用者之过耳。
当归六黄汤 治阴虚有火,令人盗汗者。
当归 生地 熟地 黄 黄芩 黄连 黄柏
上水煎服。
【注】寤而汗出曰自汗,寐而汗出曰盗汗。阴盛则阳虚不能外固,故自汗。阳盛则阴虚
不能中守,故盗汗。若阴阳平和之人,卫气昼则行阳而寐,夜则行阴而寐,阴阳既济,病
安从来?惟阴虚有火之人,寐则卫气行阴,阴虚不能济阳,阳火因盛而争于阴,故阴液失
守外走而汗出,寤则卫气复行出于表,阴得以静,故汗止矣。用当归以养液,二地以滋
阴,令阴液得其养也。用黄芩泻上焦火,黄连泻中焦火,黄柏泻下焦火,令三火得其平
也,又于诸寒药中加黄 ,庸者不知,以为赘品,且谓阳盛者不宜,抑知其妙义正在于
斯耶!盖阳争于阴,汗出营虚,则卫亦随之而虚。故倍加黄 者,一以完已虚之表,一
以固未定之阴。经曰∶阴平阳秘,精神乃治。此之谓欤!
【集注】吴琨曰∶杂证盗汗,与伤寒盗汗不同。伤寒是半表半里之邪未尽,杂证则阴
虚有火而已。彼以和表为主,此以救阴为急。故以补阴之品,佐泻火之药,明者辨之。
黄 建中汤 治虚劳里急,悸、衄、腹中痛,夜梦失精,四肢酸痛,手足烦热,咽
干口燥,诸不足诸证。
黄 胶饴 白芍 甘草 桂枝 生姜 大枣
上七味,水煎服。
【集注】喻昌曰∶虚劳而至于亡血、失精,津液枯槁,难为力矣!《内经》于针砭所莫治
者,调以甘药,《金匮》遵之而立黄 建中汤,
急建其中气,俾饮食增而津液旺,以至充血生精,而复其真阴之不足。但用稼穑作甘之
本味,而酸辛咸苦在所不用,盖舍此别无良法也。然用法贵立于元过之地,不独呕家不
可用建中之甘,即微觉气滞,更当虑甘药大过,令人中满也。至大建中则大建其中之阳,
小建中则小小创建之义,理中则燮理之义,治中则分治之义,补中、温中,何莫非先中州
之义。缘伤寒外邪逼入于内,法难尽用,仲景但于方首以“小”之一字,微示其意,至
《金匮》始尽建中之义。后人引伸触类,制乐令建中汤、十四味建中汤,曲畅建中之旨。学
者心手之间,所当会其大义也。
双和饮 治大病之后,虚劳气乏。补血益气,不热不冷,温而调之。
白芍(二钱) 黄 (炙,一钱半) 甘草(炙,七分)
中桂(七分) 当归(一钱) 熟地黄(一钱) 川芎(七分)
生姜三片,大枣二枚,水二盏,煎一盏,温服。
【注】此汤乃李杲以黄 建中汤减饴糖合四物之方也。黄 建中,治虚劳不足,是从
脾胃中化生血气。此则直补阴血,兼之温养阳气,所以减饴糖之甘,加纯阴之品,名曰
双和也。地骨皮饮,其意在凉血热,故佐二皮以清之。圣愈汤,其意在救血脱,故佐参、
以补之。双和饮,其意在温养血气,故佐 、桂、炙草以温之。经曰∶形不足者,温之以气。是也。
人参养荣汤 治脾肺俱虚,发热恶寒,肢体瘦倦,食少作泻等证。若气血虚而变见诸
证,弗论其病其脉,但用此汤,诸证悉退。
人参 白术 茯苓 甘草 黄 陈皮 当归 熟地 白芍 桂心 远志 五味子
上十二味,加姜三片,枣二枚,水煎服。
【集注】柯琴曰∶古人治气虚以四君子,治血虚以四物,气血俱虚者以八珍,更加黄
、肉桂,名十全大补,宜乎万举万当也。而用之有不获效者,盖补气而不用行气之品,则
气虚之甚者,几无气以运动。补血而仍用行血之物,则血虚之甚者,更无血以流行。故
加陈皮以行气,而补气者悉得效其用。去川芎行血之味,而补血者因以奏其功。此善治
者,只一加一减,便能转旋造化之机也。然气可召而至,血易亏而难成,苟不有以求其
血脉之主而养之,则营气终归不足。故倍人参为君,而佐以远志之苦,先入心以安神定
志,使甘温之品,始得化而为血,以奉生身。又心苦缓,必得五味子之酸,以收敛神明,使
营行脉中而流于四脏,名之曰养荣,不必仍十全之名,而收效有如此者。
归脾汤 治思虑伤脾,或健忘怔忡,惊悸盗汗,寤而不寐,或心脾作痛,嗜卧少食,
及妇女月经不调。
人参 龙眼肉 黄 甘草 白术 茯苓 木香 当归 酸枣仁 远志
姜三片,水煎服。
【集注】罗谦甫曰∶方中龙眼、枣仁、当归,所以补心也;参、 、术、苓、草,所
以补脾也。薛己加入远志,又以肾药之通乎心者补之,是两经兼肾合治矣。而特名归脾
何也?夫心藏神,其用为思;脾藏智,其出为意,见神智思意火土合德者也。心以经营
之久而伤,脾以意虑之郁而伤,则母病必传之子,子又能令母虚,所必然也。其病则健
忘怔忡,怵惕不安之征见于心也;饮食倦怠不能运输,手足无力,耳目昏 既之证见于
脾也。故脾阳苟不运,心肾必不交,彼黄婆者,若不为之媒合,则已不能摄肾气归心,而
心阴何所赖以养?此取坎填离者,所以必归之脾也。其药一滋心阴,一养脾阳,取乎健
者,以壮子益母。然恐脾郁之久,思意不通,故少取木香之辛且散者,以畅气醒脾,使能
速通脾气,以上行心阴。脾之所归,正在斯
耳。
张璐曰∶补中益气与归脾同出保元,并加归、术,而有升举胃气,滋补脾阴之不同。
此方滋养心脾,鼓动少火,妙佐以木香少许,调顺诸气,畅和心脾。世医不谙此理,反以
木香性燥不用,服之多致痞闷减食者,以其补药多滞,不能输化故耳。
妙香散 治梦遗失精,惊悸郁结。
山药(二两) 人参 黄 远志(制) 茯苓 茯神(一两) 桔梗(三钱) 甘草 辰砂
(另研,一钱) 麝香(一钱) 木香(二钱五分)
为末,每服二钱,酒下。
【集注】汪昂曰∶心,君火也。君火一动,相火随之。相火寄于肝胆,肾之阴虚则精不
藏,肝之阳强则气不固,故精脱而成梦矣。山药益阴,兼能涩精,故以为君。人参、黄
用以固气,远志、二茯用以宁神。神宁气固,则精自守其位矣。丹砂镇心安魂,二香开郁
通窍,桔梗载诸心药久留膈上,甘草调和诸药,交和于中。是方不以泻火固涩立法,但
安神固气,使精与神气相根据,而梦少精秘矣。
【按】朱震亨云∶主秘藏者肾也,司疏泄者肝也。二脏有相火,而其系上属于心。心,
君火也。为物所感则易于动,心动则相火翕然随之,虽不交会,精亦暗流而渗漏矣。所
以圣人只是教人收心养性,其旨深矣。震亨此论至当,其平生精力在补阴以制相火,深
得《内经》天以阳生阴长,地以阳杀阴藏之旨。近世医者惟知阳生,不知阴亦能生;惟
知阴杀,不知阳亦能杀。经虽每每指出阳脱、阴脱,阳绝、阴绝皆令人死,奈志迷偏见者
不回也。即此一证,老年之人,心有所动,而相火衰不能翕然随之,虽有所梦而无所遗,由
此可知震亨用黄柏一味,少佐冰片,名清心丸,独泻相火,而治中年相火盛,梦遗心悸
者,屡用屡效也。
天王补心丹 治心血不足,神志不宁,津液枯竭,健忘怔忡,大便不利,口舌生疮等证。
人参 酸枣仁 当归 生地黄 麦冬 天冬 柏子仁 远志 五味子 丹参 元参
白茯苓 桔梗
上为末,炼蜜丸如椒目大,白汤下。
【集注】柯琴曰∶心者主火,而所以主之者神也,火盛则神困。心藏神,补神者必补
其心;补心者必清其火,而神始安。补心丹故用生地黄为君,取其下足少阴以滋水,主
水盛可以伏火,此非补心之阳,乃补心之神耳。凡果核之有仁,犹心之有神也,清气无
如柏子仁,补血无如酸枣仁,以其神存耳。参、苓之甘,以补心气;五味之酸,以收心气;二
冬之寒,以清气分之火,心气和而神自归矣。当归之甘,以补心血;丹参之寒,以生心血;
元参之咸,以清血中之火,血足而神自藏矣。更加桔梗为舟楫,远志为向导,和诸药,入
心而安神明。以此养生,则百体从令,何有健忘怔忡、津液干涸、舌上生疮、大便不利之虞哉?
酸枣仁汤 治虚劳,虚烦不得眠。
酸枣仁(二升) 甘草(一两) 知母(二两) 白茯苓(二两) 川芎(二两)
上五味,以水八升,煮枣仁得六升,内药煮取三升,分温三服。
【集注】罗谦甫曰∶经云,肝藏魂,人卧则血归于肝。又曰∶肝者,罢极之本。又曰∶
阳气者,烦劳则张。罢极必伤肝,烦劳则精绝。肝伤精绝,则虚劳虚烦不得卧明矣。枣
仁酸平,应少阳木化而治肝,极者宜收宜补,用酸枣仁至二升,以生心血、养肝血,所谓
以酸收之,以酸补之是也。顾肝郁欲散,散以川芎之辛散,使辅枣仁通肝调荣,又所谓
以辛补之也。肝急欲缓,缓以甘草之甘缓,使防川芎疏泄过急,此所谓以土葆之也。然终
恐劳极则火发,伤阴阳旺,阳分不行于阴,而仍不得眠,故佐知母崇阴水以制火,茯苓利
阳水以平阴,将水壮而魂自宁,火清而神且静矣。此治虚劳肝极之神方也。
朱砂安神丸 治心神昏乱,惊悸怔忡,寤寐不安。
朱砂(另研) 黄连(各半两) 当归(二钱) 生地黄(三钱) 甘草(三钱)
上为细末,酒泡蒸饼,丸如麻子大,朱砂为衣。每服三十九,卧时津液下。
【集注】叶仲坚曰∶经云∶神气舍心,精神毕具。又曰∶心者生之本,神之舍也。且
心为君主之官,主不明,则精气乱;神太劳,则魂魄散,所以寤寐不安,淫邪发梦。轻则
惊悸怔忡,重则痴妄癫狂也。朱砂具光明之体,色赤通心,重能镇怯,寒能胜热,甘以
生津,抑阴火之浮游,以养上焦之元气,为安神之第一品。心若热,配黄连之苦寒,泻
心热也,更佐甘草之甘以泻之。心主血,用当归之甘温,归心血也,更佐地黄之寒以补
之。心血足则肝得所藏,而魂自安,心热解则肺得其职,而魄自宁也。
The acrid-hot nature of Cinnamon Twig (Rougui) damages Kidney Yin; the draining and leaching action of Poria (Fuling) hinders the generation and ascent of Yang Qi. These six ingredients (referring to Liuwei Dihuang Wan) possess mellow, rich, mild, moistening, and nourishing properties. Upon ingestion, they facilitate the smooth flow of Qi and Blood, harmonize the interior and exterior, and align with the sage's standards.
Digupi Yin (Groundcherry Root Bark Decoction): Treats deficiency-fire hyperactivity, bone-steaming tidal fever, symptoms that are calm during the day but worsen at night; also treats women with heat entering the blood chamber and fever during pregnancy.
Composition: Siwu Tang (Four Substances Decoction) added with Groundcherry Root Bark (Digupi) and Moutan Cortex (Mudanpi), each 3 qian.
Usage: Decoct in water and take orally.
[Collected Notes] Ke Qin stated: In Yin deficiency, Yang Qi invades vacuity, causing fever. Treatment should be differentiated by the three Yin meridians. If pathogenic Yang invades the Taiyin Spleen region, Bu Zhong Yi Qi Tang should be used to raise Yang Qi, restoring clear Yang to its proper position so that fire extinguishes itself. If it invades the Shaoyin Kidney region, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) should be used to strengthen the master of Water (nourish Kidney Yin), thereby calming the fire. If it invades the Jueyin Liver region, Digupi Yin should be used for cooling tonification, allowing Blood to be stored and fire to settle. Siwu Tang is a formula for nourishing Yin and regulating Blood in the Liver. Adding Groundcherry Root Bark clears fire within Zhi (Will) to pacify the Kidney, following the method of "tonifying the mother"; adding Moutan Cortex clears fire within Shen (Spirit) to cool the Heart, following the method of "draining the child". These two bark medicines are cooling but not moistening; they clear Liver Fire without damaging the Spleen and Stomach, differing from Siwu Tang combined with Anemarrhena Rhizome (Zhimu) and Phellodendron Bark (Huangbai), which are moist and bitter-cold. Therefore, Xiaoyao San treats Liver Fire stagnating in its own organ, following the principle of "releasing Liver depression," accommodating its nature. Digupi Yin treats pathogenic Yang invading the Liver, following the principle of "expelling intruders," preventing the enemy from leaving trouble behind. Both formulas are effective agents for treating Liver disorders.
Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction): Treats bleeding due to heat injury, including hematemesis, epistaxis, hematochezia, metrorrhagia in women, and red strangury.
Composition: Raw Rhino Horn (Xijiao), Raw Rehmannia Root (Shengdihuang), White Peony Root (Baishao), Moutan Cortex (Mudanpi).
Usage: The first three ingredients are decocted in water, the dregs are removed, and juice from raw Rhino Horn is added. Take warm.
[Note] There are three causes of hematemesis: injury from overexertion (Laoshang), injury from straining (Nushang), and injury from heat (Reshang). Laoshang is treated primarily by regulating injury; Nushang by removing stasis; Reshang by clearing heat. Heat injuring the Yang collaterals causes hematemesis and epistaxis; heat injuring the Yin collaterals causes lower bleeding. This formula treats heat injury. Thus, Rhino Horn clears the Heart and removes the root of fire; Rehmannia cools Blood to generate new Blood; White Peony astringes Blood to stop reckless flow; Moutan Cortex breaks stasis to drive out blood stasis. Although this formula is said to clear fire, it actually nourishes Yin; although it is said to stop bleeding, it actually removes stasis. Once stasis is removed and new blood generated, Yin is nourished and fire extinguishes. This can be considered a method of tracing to the source. If Heart Fire alone is excessive, add Scutellaria Root (Huangqin) and Coptis Rhizome (Huanglian) to drain heat. If there is chest pain due to blood stasis, add Rhubarb (Dahuang) and Peach Kernel (Taoren) to remove stasis.
Sisheng Wan (Four Raw Herbs Pill): Treats Yang excess with Yin deficiency, reckless bleeding due to blood heat, manifesting as vomiting or epistaxis.
Composition: Raw Rehmannia Root (Shengdihuang), Fresh Biota Tops (Shengbaiye), Fresh Lotus Leaf (Shengheye), Fresh Mugwort Leaf (Shengaiye), equal parts.
Usage: The four herbs are pounded into a paste and formed into pills the size of a chicken egg. Take one pill per dose, dissolved in boiling water.
[Collected Notes] Ke Qin stated: In Yin deficiency, Yang has no attachment, causing fire to flare upward in the Upper Jiao. Yang excess injures Yang collaterals, causing blood to overflow from the mouth and nose. Generally, the nature of herbs is cooling when raw and warm when cooked; cooked herbs tonify, while raw herbs drain. These four herbs are all cold and clearing. By using them raw and pounding them into pills without cooking, their aqueous energy is preserved, distancing them further from fire. Raw Rehmannia is rich in mucilage, clearing the Heart and Kidney and opening the source of blood vessels. Biota tops point west (Metal), clearing Lung Metal and regulating Ying and Wei Qi. Mugwort is aromatic, enters the Spleen and Stomach, and excels in removing stasis and generating new blood. Lotus leaf corresponds to Zhen (Thunder/Wood), enters the Liver, and aids in storing and controlling blood. Once the fire of the five emotions is cleared and the Yin of the five zang organs is secure, Yin and Yang will be balanced and secret, and blood will return to its vessels. This formula can temporarily arrest reckless hot blood; however, overuse will damage Ying Blood. Since cold congeals blood, stasis will not disperse, and new blood will not generate. If one only knows how to clear fire and cool blood but does not follow up with Guipi Tang (Restore the Spleen Decoction) or Rongyang Tang (Nourish Ying Decoction) to consolidate the foundation, few will survive without lingering illness until death. This is not a flaw in the prescription but the fault of misuse.
Danggui Liuhuang Tang (Angelica Hexa-Huang Decoction): Treats Yin deficiency with fire, causing night sweats.
Composition: Angelica Sinensis (Danggui), Raw Rehmannia (Shengdi), Prepared Rehmannia (Shudi), Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), Phellodendron Bark (Huangbai).
Usage: Decoct in water and take orally.
[Note] Sweating while awake is called spontaneous sweating (Zihan); sweating while asleep is called night sweats (Daohan). Yin excess leads to Yang deficiency, failing to secure the exterior, causing spontaneous sweating. Yang excess leads to Yin deficiency, failing to guard the interior, causing night sweats. In individuals with balanced Yin and Yang, Wei Qi travels through Yang during the day and sleeps, and through Yin at night. With Yin-Yang harmony, where would disease come from? Only in those with Yin deficiency and fire, when sleeping, Wei Qi enters the Yin. Yin deficiency cannot assist Yang, so Yang fire becomes excessive and contends with Yin. Consequently, Yin fluids lose control and escape outward as sweat. When awake, Wei Qi returns to the exterior, Yin rests, and sweating stops. Danggui nourishes fluids; Shengdi and Shudi nourish Yin, ensuring Yin fluids are sustained. Huangqin drains Upper Jiao fire; Huanglian drains Middle Jiao fire; Huangbai drains Lower Jiao fire, balancing the three fires. Adding Astragalus (Huangqi) among these cold herbs is often misunderstood by mediocre physicians as superfluous, and they claim it is unsuitable for Yang excess. Do they not realize the profound meaning lies precisely here? When Yang contends with Yin and sweat depletes Ying, Wei also becomes deficient. Therefore, doubling Huangqi serves two purposes: to repair the already deficient exterior and to secure the unsettled Yin. The Classic states: "When Yin is peaceful and Yang is firm, spirit thrives." This refers to such cases!
[Collected Notes] Wu Kun stated: Night sweats in miscellaneous diseases differ from those in Cold Damage. Cold Damage involves incomplete resolution of pathogens in the half-exterior/half-interior; miscellaneous diseases involve merely Yin deficiency with fire. The former focuses on harmonizing the exterior; this formula prioritizes saving Yin. Thus, Yin-nourishing herbs are paired with fire-draining herbs. Discerning physicians should distinguish between them.
Huangqi Jianzhong Tang (Astragalus Build-the-Middle Decoction): Treats deficiency-wasting with internal urgency, palpitations, epistaxis, abdominal pain, nocturnal seminal emission, limb soreness and pain, vexing heat in hands and feet, dry throat and mouth, and various insufficiency syndromes.
Composition: Astragalus (Huangqi), Malt Sugar (Jiaoyi), White Peony Root (Baishao), Licorice Root (Gancao), Cinnamon Twig (Guizhi), Ginger (Shengjiang), Jujube (Dazao).
Usage: Decoct the seven ingredients in water and take orally.
[Collected Notes] Yu Chang stated: When deficiency-wasting reaches the point of blood loss and essence leakage, with withered fluids, it is difficult to treat! The Neijing states that for conditions unresponsive to acupuncture and moxibustion, sweet medicines should be used to regulate. Jingui Yaolue follows this by establishing Huangqi Jianzhong Tang, urgently building Middle Qi so that food intake increases and fluids flourish, eventually generating blood and essence to restore true Yin insufficiency. It uses only the sweet flavor derived from grain cultivation, avoiding sour, acrid, salty, and bitter tastes, as there is no other good method. However, usage must avoid excess. Not only should those who vomit avoid the sweetness of Jianzhong, but even if slight Qi stagnation is felt, one must consider that excessive sweet medicine may cause fullness in the middle. Dajianzhong Tang greatly builds Middle Yang; Xiaojianzhong Tang implies small creation; Lizhong Tang implies regulation; Zhizhong Tang implies separate treatment; Buzhong and Wenzhong all imply starting from the Middle Jiao. Because external pathogens in Cold Damage force inward, methods cannot be fully applied. Zhang Zhongjing only used the character "Small" in the formula name to subtly indicate his intent. It was in Jingui Yaolue that the full meaning of "Building the Middle" was realized. Later scholars extended this concept, creating Le Ling's Jianzhong Tang and Shisiwei Jianzhong Tang, elaborating on the purport of building the middle. Scholars should grasp the major principles in their practice.
Shuanghe Yin (Double Harmony Decoction): Treats deficiency-wasting and Qi exhaustion after severe illness. Tonifies Blood and Qi, neither hot nor cold, warming and regulating.
Composition: White Peony Root (Baishao, 2 qian), Astragalus (Huangqi, roasted, 1.5 qian), Licorice Root (Gancao, roasted, 0.7 qian), Cassia Bark (Zhonggui, 0.7 qian), Angelica Sinensis (Danggui, 1 qian), Prepared Rehmannia (Shudihuang, 1 qian), Szechuan Lovage Root (Chuanxiong, 0.7 qian).
Usage: Three slices of ginger, two jujubes, two cups of water, decoct to one cup. Take warm.
[Note] This decoction is a formula by Li Gao, combining Huangqi Jianzhong Tang (minus malt sugar) with Siwu Tang. Huangqi Jianzhong treats deficiency-wasting insufficiency by generating Blood and Qi from the Spleen and Stomach. This formula directly tonifies Yin Blood and simultaneously warms and nourishes Yang Qi. Hence, malt sugar's sweetness is reduced, and pure Yin ingredients are added, named Double Harmony. Digupi Yin aims to cool blood heat, aided by the two barks for clearing. Shengyu Tang aims to save from blood collapse, aided by Ginseng and Astragalus for tonification. Shuanghe Yin aims to warmly nourish Blood and Qi, aided by Astragalus, Cinnamon, and roasted Licorice for warming. The Classic says: "For those with insufficient form, warm them with Qi." This applies here.
Renshen Yangrong Tang (Ginseng Nourish-Ying Decoction): Treats simultaneous deficiency of Spleen and Lung, fever with aversion to cold, emaciation and fatigue of limbs, poor appetite with diarrhea, etc. If various symptoms arise from Qi and Blood deficiency, regardless of the specific disease or pulse, using this decoction will resolve all symptoms.
Composition: Ginseng (Renshen), Atractylodes Macrocephala (Baizhu), Poria (Fuling), Licorice Root (Gancao), Astragalus (Huangqi), Tangerine Peel (Chenpi), Angelica Sinensis (Danggui), Prepared Rehmannia (Shudi), White Peony Root (Baishao), Cinnamon Heart (Guixin), Polygala Root (Yuanzhi), Schisandra Berry (Wuweizi).
Usage: The twelve ingredients, plus three slices of ginger and two jujubes, are decocted in water and taken orally.
[Collected Notes] Ke Qin stated: Ancients treated Qi deficiency with Sijunzi Tang, Blood deficiency with Siwu Tang, and simultaneous Qi-Blood deficiency with Bazhen Tang. Adding Astragalus and Cinnamon creates Shiquan Dabu Tang (Ten Complete Tonifying Decoction), which should be infallible. Yet some fail to achieve results. This is because tonifying Qi without moving Qi means severely deficient Qi lacks the power to move. Tonifying Blood while still using blood-moving substances means severely deficient Blood lacks the medium to flow. Thus, Chenpi is added to move Qi, allowing Qi-tonics to function effectively. Chuanxiong, a blood-mover, is removed, allowing Blood-tonics to succeed. This shows that skilled practitioners can turn the wheel of造化 (creation/nature) with just one addition and one subtraction. However, Qi can be summoned, but Blood is easily depleted and hard to regenerate. Without seeking the master of blood vessels to nourish it, Ying Qi will remain insufficient. Therefore, Ginseng is doubled as the Sovereign herb, assisted by Yuanzhi's bitterness to enter the Heart first, calming Spirit and stabilizing Will, so that sweet-warm substances can transform into Blood to nourish the body. Since the Heart dislikes laxity, Wuweizi's sourness is needed to astringe Spirit, allowing Ying to circulate in the vessels and flow to the four Zang organs. Named Nourish-Ying, it achieves such great effect without retaining the name Ten Complete.
Guipi Tang (Restore the Spleen Decoction): Treats Spleen injury from overthinking, or forgetfulness and palpitations, fright and night sweats, insomnia, heart-spleen pain, lethargy with poor appetite, and irregular menstruation in women.
Composition: Ginseng (Renshen), Longan Aril (Longyanrou), Astragalus (Huangqi), Licorice Root (Gancao), Atractylodes Macrocephala (Baizhu), Poria (Fuling), Costus Root (Muxiang), Angelica Sinensis (Danggui), Sour Jujube Seed (Suanzaoren), Polygala Root (Yuanzhi).
Usage: Three slices of ginger, decoct in water and take orally.
[Collected Notes] Luo Qianfu stated: Longan, Sour Jujube Seed, and Angelica in the formula tonify the Heart; Ginseng, Astragalus, Atractylodes, Poria, and Licorice tonify the Spleen. Xue Ji added Polygala, using kidney herbs that connect to the Heart to tonify both, treating the two meridians along with the Kidney. Why is it specifically named Restore the Spleen? The Heart stores Spirit (Shen), whose function is thought; the Spleen stores Wisdom (Zhi), whose output is intention. Spirit, wisdom, thought, and intention represent the virtue of Fire and Earth combining. The Heart is injured by prolonged management; the Spleen is injured by郁 (depression) of intention. Mother disease transmits to the Child, and the Child can weaken the Mother; this is inevitable. Symptoms include forgetfulness, palpitations, fear, and unrest manifesting in the Heart; dietary fatigue, inability to transport, weak limbs, and dull eyes/ears manifesting in the Spleen. If Spleen Yang does not transform, Heart and Kidney will not interact. If the "Yellow Woman" (Earth/Spleen) does not act as a matchmaker, it cannot guide Kidney Qi to the Heart, and how will Heart Yin be nourished? This is why "drawing Kan to fill Li" must return to the Spleen. The herbs one nourish Heart Yin, the other nourish Spleen Yang. Taking "Jian" (Health/Stability) strengthens the Child to benefit the Mother. However, fearing long-standing Spleen depression blocks thought and intention, a small amount of Costus Root's acrid and dispersing nature is taken to promote Qi, awaken the Spleen, and quickly open Spleen Qi to ascend Heart Yin. The return of the Spleen lies precisely here.
Zhang Lu stated: Buzhong Yiqi Tang and Guipi Tang both originate from Baoyuan Tang, adding Angelica and Atractylodes, but differ in raising Stomach Qi versus nourishing Spleen Yin. This formula nourishes Heart and Spleen, stirs the Lesser Fire, and cleverly assists with a little Costus Root to regulate Qi and harmonize Heart and Spleen. Physicians of the world do not understand this principle and omit Costus Root due to its drying nature, leading to bloating and reduced appetite after ingestion, because tonic herbs tend to stagnate and cannot be transformed.
Miaoxin San (Wonderful Spirit Powder): Treats nocturnal emission, fright, palpitations, and depression.
Composition: Chinese Yam (Shanyao, 2 liang), Ginseng (Renshen), Astragalus (Huangqi), Prepared Polygala (Yuanzhi), Poria (Fuling), Spirit Poria (Fushen, 1 liang), Platycodon Root (Jiegeng, 3 qian), Licorice Root (Gancao), Cinnabar (Chensha, ground separately, 1 qian), Musk (Shexiang, 1 qian), Costus Root (Muxiang, 2.5 qian).
Usage: Grind into powder. Take 2 qian per dose, washed down with wine.
[Collected Notes] Wang Ang stated: The Heart is Ministerial Fire (Jun Huo). When Ministerial Fire moves, Executive Fire (Xiang Huo) follows. Executive Fire resides in the Liver and Gallbladder. Kidney Yin deficiency fails to store Essence; Liver Yang excess fails to secure Qi. Thus, Essence escapes, resulting in dreams. Chinese Yam benefits Yin and astringes Essence, serving as the Sovereign herb. Ginseng and Astragalus secure Qi; Polygala and Fuling/Fushen calm Spirit. With calm Spirit and secured Qi, Essence naturally guards its position. Cinnabar calms the Heart and anchors Soul; the two musks open depression and unblock orifices; Platycodon carries Heart herbs to linger above the diaphragm; Licorice harmonizes all herbs, interacting in the center. This formula does not establish law via draining fire or astringing; it merely calms Spirit and secures Qi, making Essence and Spirit-Qi rely on each other, reducing dreams and securing Essence.
[Commentary] Zhu Zhenheng stated: The Kidney governs storage; the Liver governs discharge. Both organs contain Executive Fire, connected superiorly to the Heart. The Heart is Ministerial Fire. Stimulated by objects, it moves easily. When the Heart moves, Executive Fire flares up. Even without intercourse, Essence secretly flows and leaks. Thus, sages teach only to gather the Heart and nourish Nature; the purport is profound. Zhu Zhenheng's theory is most appropriate. His lifelong effort focused on nourishing Yin to control Executive Fire, deeply grasping the Neijing principle: Heaven generates Yin with Yang growth; Earth kills Yin with Yang storage. Modern physicians only know Yang generates, not that Yin also generates; only know Yin kills, not that Yang also kills. Although Classics repeatedly state that Yang collapse, Yin collapse, Yang extinction, and Yin extinction all lead to death, biased minds refuse to return. Regarding this symptom: in the elderly, the Heart may move, but Executive Fire is too weak to flare up. Though dreams occur, no emission happens. From this, we see Zhu Zhenheng's use of Phellodendron Bark (Huangbai) alone, with a little borneol, named Qingxin Wan (Clear Heart Pill), exclusively draining Executive Fire, proves frequently effective for middle-aged people with strong Executive Fire, nocturnal emissions, and palpitations.
Tianwang Buxin Dan (Heavenly Emperor Heart-Nourishing Pill): Treats Heart Blood insufficiency, restless Spirit, dried fluids, forgetfulness, palpitations, constipation, mouth and tongue ulcers, etc.
Composition: Ginseng (Renshen), Sour Jujube Seed (Suanzaoren), Angelica Sinensis (Danggui), Raw Rehmannia (Shengdihuang), Ophiopogon Tuber (Maidong), Asparagus Tuber (Tian dong), Biota Seed (Baiziren), Polygala Root (Yuanzhi), Schisandra Berry (Wuweizi), Salvia Root (Danshen), Scrophularia Root (Yuanshen), White Poria (Baifuling), Platycodon Root (Jiegeng).
Usage: Grind into powder, refine honey into pills the size of pepper seeds. Take with plain warm water.
[Collected Notes] Ke Qin stated: The Heart governs Fire, and what governs it is Spirit. Excessive Fire traps Spirit. The Heart stores Spirit; to nourish Spirit, one must nourish the Heart; to nourish the Heart, one must clear Fire, so Spirit can be pacified. Tianwang Buxin Dan uses Raw Rehmannia as Sovereign, descending to Foot Shaoyin to nourish Water. Abundant Water can subdue Fire. This does not tonify Heart Yang, but nourishes Heart Spirit. Just as fruit kernels have仁 (Ren/Spirit), so does the Heart. Nothing clears Qi like Biota Seed; nothing nourishes Blood like Sour Jujube Seed, because Spirit resides therein. The sweetness of Ginseng and Poria tonifies Heart Qi; the sourness of Schisandra gathers Heart Qi; the coldness of Ophiopogon and Asparagus clears Qi-level Fire. With harmonized Heart Qi, Spirit returns naturally. The sweetness of Angelica tonifies Heart Blood; the coldness of Salvia generates Heart Blood; the saltiness of Scrophularia clears Blood-level Fire. With sufficient Blood, Spirit hides naturally. Adding Platycodon as a vessel and Polygala as a guide harmonizes herbs, enters the Heart, and pacifies Spirit. Using this for health preservation, all limbs obey commands. How could there be worry about forgetfulness, palpitations, dried fluids, mouth ulcers, or constipation?
Suanzaoren Tang (Sour Jujube Seed Decoction): Treats deficiency-wasting, empty vexation, and inability to sleep.
Composition: Sour Jujube Seed (Suanzaoren, 2 sheng), Licorice Root (Gancao, 1 liang), Anemarrhena Rhizome (Zhimu, 2 liang), White Poria (Baifuling, 2 liang), Szechuan Lovage Root (Chuanxiong, 2 liang).
Usage: The five ingredients, with eight sheng of water, boil Sour Jujube Seed until six sheng remain. Add other herbs, boil to three sheng. Divide into three warm doses.
[Collected Notes] Luo Qianfu stated: The Classic says: The Liver stores Hun (Ethereal Soul); when lying down, Blood returns to the Liver. Also: The Liver is the root of endurance. Also: Yang Qi, when subjected to烦劳 (vexatious labor), expands. Endurance injury inevitably harms the Liver; vexatious labor exhausts Essence. Liver injury and Essence exhaustion clearly explain deficiency-wasting, empty vexation, and inability to sleep. Sour Jujube Seed is sour and neutral, corresponding to Shaoyang Wood transformation to treat the Liver. Exhaustion requires gathering and tonifying. Using two sheng of Sour Jujube Seed generates Heart Blood and nourishes Liver Blood, fulfilling "gather with sour, tonify with sour." However, Liver depression desires dispersion; disperse with Chuanxiong's acrid dispersion, assisting Sour Jujube Seed to open Liver and regulate Ying, fulfilling "tonify with acrid." Liver tension desires relaxation; relax with Licorice's sweet缓 (slackening), preventing Chuanxiong from dispersing too hastily, fulfilling "protect with Earth." Nevertheless, fearing extreme labor triggers Fire, damaging Yin and Yang, preventing Yang from entering Yin, and still causing insomnia, Anemarrhena is added to elevate Yin Water to control Fire, and Poria to drain Yang Water to balance Yin. With strengthened Water, Hun calms; with cleared Fire, Spirit rests. This is a divine formula for treating deficiency-wasting and Liver exhaustion.
Zhusha Anshen Wan (Cinnabar Pacifying-Spirit Pill): Treats chaotic Spirit, fright, palpitations, and disturbed sleep.
Composition: Cinnabar (Zhusha, ground separately), Coptis Rhizome (Huanglian, each 0.5 liang), Angelica Sinensis (Danggui, 2 qian), Raw Rehmannia (Shengdihuang, 3 qian), Licorice Root (Gancao, 3 qian).
Usage: Grind into fine powder. Soak steamed cake in wine, form pills the size of sesame seeds, coat with Cinnabar. Take 30 pills per dose, swallowed with saliva before bed.
[Collected Notes] Ye Zhongjian stated: The Classic says: Spirit Qi resides in the Heart; Spirit and Essence are complete. Also: The Heart is the root of life, the dwelling of Spirit. Moreover, the Heart is the Official of the Monarch. If the Monarch is unclear, Essence and Qi become chaotic; if Spirit is overly labored, Hun and Po scatter. Thus, sleep is disturbed, and strange dreams occur. Mildly, there is fright and palpitations; severely, there is dementia, delusion, and mania. Cinnabar possesses a luminous body, red color connects to the Heart, heaviness calms fear, coldness overcomes heat, sweetness generates fluids. It suppresses floating Yin Fire and nourishes Upper Jiao Original Qi, being the premier herb for calming Spirit. If the Heart is hot, pair with Coptis's bitter-cold to drain Heart Heat, assisted by Licorice's sweetness to drain it. The Heart governs Blood; use Angelica's sweet-warm nature to return Blood to the Heart, assisted by Rehmannia's coldness to tonify it. When Heart Blood is sufficient, the Liver finds storage, and Hun calms. When Heart Heat resolves, the Lung fulfills its duty, and Po rests.