论
《内经》曰∶阳者，天气也，主外；阴者，地气也，主内。故阳道实，阴道虚。犯贼风虚邪者，阳受之；食饮不节，
起居不时者，阴受之。是故阳受之则入六腑，阴受之则入五脏。此内外阴阳腑脏虚实之不同也。举世医者，但见恶寒发
热、头目沉重之证，更不察内外虚实，便作伤寒模糊处治，辄用仲景汗下解利之法治之多死，良可叹哉！我东垣先生，
悯
生灵之夭枉，着内外伤辨惑论、脾胃论等书，一皆以扶植胃气为本，诚万世不刊之妙典也。其谆谆告诫之意，屡以饮食
失节、劳役过伤为言，而立补中益气等汤为主治。若能确守其法而行之，无有不验。惜乎今之医者，多承因习之弊，懵
然不识机变，睥睨其书而不视。间有读者，不明脉候虚实，不偏于此则偏于彼，或遇内伤挟痰与食，清气怫郁于下、浊
气填塞胸中之候，骤以补中益气等药一试，则气满痞塞，遂谓补药不宜于此证也，决意改用汗下解利之法，医死而不之
悔。故王安道有内伤不足中有有余之议，此发东垣之所未发者耳。学人宜潜心究察其虚实似是之非，庶不夭人之天年也。
东垣辨内外虚实之法，学人宜熟玩于胸中，临证之际，庶无鲁鱼亥豕之讹焉。抑考辨惑论曰∶夫外伤风寒有余之证，其
发热恶寒，寒热并作。其热也，拂拂发热，发于皮毛之上，如羽毛之拂，明其热在表也。其口鼻气塞不通，心中烦闷不
安。其恶风寒也，稍似裸体，便不能禁，虽重衣浓幕，逼近烈火，终不能御其寒，一时一日，增加愈甚，必待邪传入里
乃已。语声重浊，前轻后重，高厉有力，腹中和，口知谷味，大小便如常，筋骨疼痛，不能动摇，手背热，手心不热，
是皆外感有余之候也。其内伤饮食劳役不足之证，其发热恶寒，寒热间作。及热也，蒸蒸燥热，发于肌肉之间，扪之烙
手，明其热在内也。其口鼻中气短，少气不足以息。其恶风寒也，居露地中，遇大漫风起却乃不恶，惟门窗隙中些少贼
风则大恶之，亦必待其阴阳既和，汗出则已。语言困倦，前重后轻，气不相续，腹中不和，口不知谷味，大小便或闭或
溏，或心下痞闷，或胸中如刀 之痛，手心热，手背不热，是皆内伤不足之候也。以此辨之，岂不如黑白之易见乎。愚
故略述东垣之言，以为后学之矜式耳。临证又当参考其脉候，求其有余中之不足，或不足中之有余，或外感挟内伤，或
内伤挟外感，视其轻重而权宜用药以施治之，庶几登东垣之堂而为当世之司命矣。
脉法
东垣曰∶右寸气口脉，大于人迎一倍，过在少阴则二倍，太阴则三倍。（右手三部属三阴，少阴在关主脾，太阴在寸
主肺，肌肤大热，故脾肺二脏之脉皆紧盛也。）
右寸气口脉急大而数，时一代而涩。（涩者肺之本脉，代者元气不相接续，此饮食失节，劳役过甚，大虚之脉也。）
右关脾脉大而数，（谓独大于五脉也。）数中显缓，时一代也。（此不甚劳役之脉也。）右关胃脉损弱，甚则隐而不见，但
内显脾脉之大数微缓，时一代。（此饮食不节、寒温失所之脉也。）右关脉沉而滑。（此宿食不消之脉也。）
方法
丹溪曰∶东垣内外伤辨甚详，世之病此者为多，但有挟痰者，有挟外邪者，有热郁于内而发者，皆当以补元气为主，
看所挟而兼用药。气虚甚者，必少加附子，以行参 之气。挟痰者，补中益气加半夏，更以竹沥、姜汁传送。
（以上丹溪方法凡一条）
戴氏曰∶凡内外兼证，或内伤重而外感轻者，为内伤挟外感证，治法宜先补益而后散邪，或以补中益气为主治，加
散邪药，当以六经脉证参究，各加本经药治之。或外感重而内伤轻者，为外感挟内伤证，治法宜先散邪而后补益，或以
辛凉等解散药为君，而以参、术、茯苓、芎、归等药为臣使，是其治也。
补中益气汤（东垣）
黄 （一钱） 甘草（炙，五分或七分） 人参（病甚者一钱） 白术 当归（各七分） 陈皮（五分） 升麻 柴
胡（各三分）
上细切，作一服，水二盏，煎至一盏，去渣温服。
脾胃一虚，肺气先绝，故用黄 以益皮毛而闭腠理，不令自汗也。上喘气短，损其元气，用人参以补之。心火乘脾，
用炙甘草之甘温，以泻火热而补胃中元气。若脾胃急痛、腹中急缩者，宜多用之。此三味，除湿热烦热之圣药也。白术
苦甘温，除胃中热，利腰脐间血。升麻、柴胡苦平，味之薄者，升胃中之清气，又引黄 、甘草甘温之气味上升，能补
卫气之散解而实其表，又缓带脉之缩急。用当归以和血脉，橘红以理胸中之气，又能助阳气上升以散滞气，助诸甘辛为
用。或少加黄柏，以救肾水而泻阴中之伏火也。表热者，一、二服，气和微汗而愈。如咽干者，加干葛。如心刺痛，乃
血涩不足，加当归。如精神短少者，加人参、五味子。如头痛，加蔓荆子。痛甚，加川芎。头痛脑痛，加 本、细辛。
有痰，加半夏、生姜。如咳嗽，夏加五味子、麦门冬；秋冬，加去节麻黄；春加佛耳草、款冬花。久咳，肺中伏火，去
人参。如食不下，乃胸中有寒，或气涩滞，加青皮、木香、陈皮；寒月，更加益智、草豆蔻；夏月，更加芩、连；秋，
更加槟榔、砂仁。如心下痞闷，加芍药、黄连。如腹胀，加枳实、木香、砂仁、浓朴；天寒，加生姜、肉桂。如腹痛，
加白芍药、甘草；有寒，加桂心；夏，加黄芩、甘草、芍药；冬，加益智、草豆蔻、半夏。如胁痛或缩急，加柴胡、甘
草。如脐下痛，加熟地黄；不已，乃是寒也，加肉桂。如大便闭涩，加当归、大黄。如脚软乏力或痛，加黄柏；不已，
更加防己。如气浮心乱，以朱砂安神丸镇固之则愈。
上此方加减法，是饮食劳倦，喜怒不节，如病热中，则可用之。若未传寒中，则不可用也，盖甘酸适足以益其病耳，
如黄 、人参、甘草、芍药、五味子之类是也。见脾胃论。
朱砂安神丸
黄连（一钱五分） 朱砂（一钱） 酒生地黄 酒当归身 炙甘草（以上各五分）
上为极细末，汤浸蒸饼为丸，如黍米大，每服十五丸，津唾咽下，食后服。（一方无地黄、归身，用生甘草。）
调中益气汤
其脉弦洪缓而沉，按之中之下得时一涩，其证四肢倦怠，肢节烦疼，难以屈伸，身体沉重，烦心不安，忽肥忽瘦，
口失滋味，腹难舒伸，大小便清利而数，或上饮下便，或大便涩滞不行，一、二日一见，夏月飧泄，米谷不化，或便后
见血，或见白脓，胸满短气，膈噎不通，或痰嗽稠粘，口中沃沫，食入反出，耳鸣耳聋，目中溜火，视物昏花， 肉红
丝，热壅头目，不得安稳，嗜卧无力，不思饮食，此药主之。
黄 （一钱） 人参（有嗽去之） 甘草 苍术（各五分） 柴胡（此味为上气不足，胃气与脾气下溜，乃补上气，
从阴养阳也） 升麻（各二分） 橘红（二分，如腹中气不得运转，更加一分） 木香（一分或二分）
上细切，作一服，水二盏，煎至一盏，去渣空心温服。宁心绝思，药必神效，盖病在四肢血脉，空心在旦是也。如
时显热躁，乃下元阴火蒸发也，加生地黄二分，黄柏三分。大便虚坐不得，或了而不了，腹中逼迫，血虚血涩也，加当
归身三分。如身体沉重，虽小便数多，亦加茯苓二分，苍术一钱，泽泻五分，黄柏三分。如胃气不和，加半夏五分，生
姜三片。有嗽，加生地黄二分，以制半夏之毒。如痰厥头痛，非半夏不能除，此足太阴脾经邪所作也。如兼燥热，加黄
柏、生地黄各二分。如无以上证，只服前药。如春夏腹痛，加白芍药三分。如恶热而渴或腹痛者，更加白芍药五分，生
黄芩二分。如恶寒腹中痛，加桂心三分，去黄芩，名桂枝芍药汤。如冬月腹痛，不可用芍药，盖其性之大寒也。只加干
姜二分，或加半夏五、七分，以生姜制之。如秋冬之月，胃脉四道为冲脉所逆，并胁下少阳脉二道而反上行，病名厥逆。
《内经》曰∶逆气上行，满脉去形。明七神昏绝，离去其形而死矣。其证气上冲咽不得息，而喘息有音不得卧。加吴茱
萸五分或一钱，汤泡去苦用，观厥气多少而用。如夏月有此证，为大热也，盖此病随四时为寒热温凉也。宜以酒黄柏、
酒黄连、酒知母各等分，为细末，熟汤为丸，如梧桐子大，每服二百丸，白汤空心送下，仍多饮热汤，服毕少时，便以
美膳压之，使不得胃中停留，直至下元以泻冲脉之邪也。大抵治饮食劳倦之病，乃虚劳七损症也，当用温平、甘多辛少
之药治之，是其本法也。
升阳顺气汤 治因饮食不节，劳役所伤，腹胁满闷短气，遇春则口淡无味，遇夏虽热犹有恶寒，饥则常如饱，
不
喜食冷物。
黄 （一钱） 半夏（六分） 甘草（炙二分） 草豆蔻（四分） 神曲（三分，炒） 升麻 柴胡（各二分） 当
归身 陈皮（各三分） 黄柏（一分半） 人参（三分）
上细切，作一服，水二盏，生姜三片，煎至一盏，去渣食前温服。夫脾胃不足之证，须用升麻、柴胡苦平，味之薄
者，阴中之阳，引脾胃中清气，行于阳道及诸经，生发阴阳之气，以滋春气之和也。又引黄 、人参、甘草甘温之气味
上行，充实腠理，使阳气得卫外而为固也。凡治脾胃之药，多以升阳补气名之者此也。
升阳补气汤 治饮食不时，饥饱劳役，胃气不足，脾气下溜，气短无力，不能寒热，早饭后转增昏闷，频要眠
睡，
怠惰四肢不收，懒倦动作，五心烦热。
浓朴（姜制，三分） 升麻 羌活（各五分） 白芍药（煨五分） 独活（五分） 防己（五分） 甘草（炙，五
分） 泽泻（五分） 柴胡（一钱二分） 生地黄（七分半）
上细切，作一服，生姜三片，大枣二枚，水二盏，煎至一盏，去渣食前大温服。如腹胀及腹中窄狭，加浓朴一倍。
如腹中似硬，加砂仁三分。
当归补血汤 治肌热燥热，困渴引饮，目赤面红，昼夜不息，其脉洪大而虚，重按全无。《内经》曰∶脉虚血虚。
又云∶血虚发热。证像白虎，惟脉不长实为辨耳，误服白虎汤必死，此病得之于饥困劳役。
黄 （一两） 当归（酒洗，二钱）
上细切，作一服，水二盏，煎至一盏，食前温服。
木香化滞汤
治因忧，食湿面结于中脘，腹皮抵痛，心下痞满，不思饮食，食之不散，常常痞气，或胃脘当心而痛，并皆治之。
半夏（汤泡洗，一钱五分） 草豆蔻（湿面裹煨，杵碎） 甘草（炙，各七分半） 柴胡（去芦，六分） 木香 橘
红（各四分半） 枳实（麸炒黄色） 当归（各三分） 酒红花（一分）
上细切，作一服，水二盏，生姜五片，煎至一盏，去渣热服。
升阳益胃汤 治肺及脾胃虚，则怠惰嗜卧，四肢不收，时值秋燥令行，湿热少退，体重节痛，口燥舌干，饮食
无味，大便不调，小便频数，不欲食，食不消，兼见肺病，洒淅恶寒，惨惨不乐，面色恶而不和，乃阳气不伸故也，当
升阳益胃，此药主之。
黄 （一钱） 半夏 人参（去芦） 甘草（炙，各五分） 独活（三分） 防风（三分，因秋旺，故以辛温泻之）
白术（二
分） 羌活（三分） 黄连（一分） 柴胡（去芦，二分） 泽泻（二分，不淋秘者，不可用） 橘红（二分半） 白
芍药（三分，何故秋旺用人参白术芍药之类补肺？盖为脾胃虚则肺最受邪，故因时而补，易为力也） 茯苓（二分，小
便利、口不渴者，勿用）
上细切，作一服，生姜五片，大枣二枚，水二盏，煎至一盏，去渣，早饭后温服。
服药后，如小便罢而病加增剧，是不宜利小便，当去茯苓、泽泻。如方喜食，一、二日不可饱食，恐胃再伤，以药
力尚少，脾胃之气不得转运升发也。须滋味之食或美食助其药力，益升浮之气而滋其胃气，慎不可淡食，以损药力而助
邪气之降沉也。可以少役形体，使胃与药得转运开发，慎毋大劳役使气复伤，若脾胃得安静尤佳。若胃气稍强，少食嘉
果以助药力，经云五果为助是也。
双和散 补血益气，治虚劳少力，不热不寒，温而有补。
白芍药（一钱） 黄 （蜜炙） 熟地黄 川芎 川归（各六分） 甘草（炙） 肉桂（各四分）
上细切，作一服，生姜三片，大枣二枚，水一盏半，煎至一盏，温服。大病后血虚气乏者，以此调治。
门冬清肺饮 治脾胃虚弱，气促气喘，精神短少，或衄血吐血等证。
紫菀茸（一钱） 黄 （蜜炙） 白芍药（炒） 甘草（炙，各七分） 人参 麦门冬（去心） 当归身（各五分）
五味子（九粒）
上细切，作一服，水一盏半，煎至一盏，去渣，食后温服。
宽中进食丸 滋形气，喜饮食。
麦 面（一两，炒黄） 半夏（汤泡七次去皮脐） 猪苓（去黑皮，各七钱） 草豆蔻（湿面裹煨） 神曲（炒，
各五钱） 枳实（麸炒黄色） 橘红（各三钱） 白术（五钱） 白茯苓 泽泻（各三钱） 砂仁（二钱） 干生姜（炮，
五钱） 甘草（炙） 人参 青皮（各二钱） 木香（一钱）
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Yang corresponds to the Qi of Heaven and governs the exterior; Yin corresponds to the Qi of Earth and governs the interior. Therefore, the path of Yang is fullness (prone to excess pathogens), and the path of Yin is emptiness (prone to deficiency). Those who contract thieving wind and empty pathogens receive them in Yang; those whose diet and drinking are irregular, or whose daily routine is untimely, receive them in Yin. Thus, when contracted in Yang, the disease enters the Six Fu Organs; when contracted in Yin, it enters the Five Zang Organs. This illustrates the differences between interior/exterior, Yin/Yang, Zang/Fu, and deficiency/excess. Physicians of the world, seeing only symptoms such as aversion to cold, fever, heaviness of the head and eyes, without further investigating interior/exterior deficiency or excess, treat vaguely as Cold Damage (Shanghan). They frequently employ Zhang Zhongjing’s methods of sweating and purging to resolve the condition, resulting in many deaths—a truly lamentable situation! My Master Dongyuan (Li Gao), pitying the premature deaths of living beings, wrote works such as *Bianhuo Lun of Interior and Exterior Injury* and *Piwei Lun* (Treatise on the Spleen and Stomach), all taking the support of Stomach Qi as the foundation. These are indeed immortal classics. His earnest admonitions repeatedly emphasize that loss of dietary regulation and overstrain from labor cause injury, establishing formulas like Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) as primary treatments. If one strictly adheres to these methods, there will be no failure. Alas, modern physicians mostly suffer from the malpractice of following conventions blindly, ignorant of flexibility and change, looking down upon these books without reading them. Occasionally, some read them but do not understand the pulse diagnosis of deficiency and excess; they either bias towards one side or the other. Or, encountering conditions where interior injury is complicated by phlegm and food retention, with clear Qi stagnating below and turbid Qi filling the chest, they suddenly try Buzhong Yiqi Tang and similar medicines. This results in abdominal fullness and obstruction, leading them to claim that tonifying medicines are unsuitable for such conditions. They resolutely switch to sweating and purging methods, killing patients without regret. Thus, Wang Andao proposed the discussion that "interior deficiency contains excess," which elaborates on points not yet fully expounded by Dongyuan. Students should carefully investigate these seemingly correct but actually incorrect distinctions regarding deficiency and excess, so as not to shorten people's natural lifespan. The methods of Dongyuan for distinguishing interior/exterior and deficiency/excess should be thoroughly mastered by students; during clinical practice, this will prevent errors such as misreading characters (Lu Yu Hai Shi). Furthermore, consulting *Bianhuo Lun*: For exterior syndromes of excess due to Wind-Cold, fever and aversion to cold occur simultaneously. The heat is a slight fever arising on the skin and hair, like feathers brushing against it, clearly indicating heat at the exterior. There is blockage of breath through the mouth and nose, and inner restlessness and discomfort. The aversion to wind and cold is severe; even slightly exposed feels unbearable. Even wearing heavy clothes and thick curtains, or approaching fierce fire, cannot ward off the cold. It worsens hour by hour until the pathogen transmits to the interior. The voice is heavy and turbid, starting light and becoming heavy, high-pitched and powerful. The abdomen is harmonious, taste of grain is perceived normally, bowel movements and urination are regular. There is pain in sinews and bones, inability to move freely. The back of the hand is hot, but the palm is not. These are all signs of exterior excess. For interior injury syndromes of deficiency due to diet and labor, fever and aversion to cold occur alternately. The heat is steaming and dry, arising between the muscles, burning to the touch, clearly indicating heat within. There is shortness of breath through the mouth and nose, insufficient Qi for respiration. The aversion to wind and cold is paradoxical; staying in open air or facing strong winds may not cause fear, but even a tiny draft from a window crack causes great aversion. It persists until Yin and Yang harmonize and sweat appears. Speech is lethargic, starting heavy and becoming light, Qi failing to connect continuously. The abdomen is disharmonious, taste of grain is lost. Bowel movements and urination are either obstructed or loose. There may be epigastric fullness and oppression, or stabbing pain in the chest like a knife. The palm is hot, but the back of the hand is not. These are all signs of interior deficiency. Using this to distinguish, is it not as easy to see as black and white? I therefore briefly recount Dongyuan’s words as a model for future learners. In clinical practice, one must also refer to pulse diagnosis, seeking deficiency within excess, or excess within deficiency, or exterior infection complicating interior injury, or interior injury complicating exterior infection. Observe the severity and apply medication flexibly, so as to enter the hall of Dongyuan and become a life-saving physician of the times.
Pulse Methods
Dongyuan said: The Qi Kou pulse at the Right Cun position is larger than the Ying Ching pulse by one fold; if the pathology is in the Shaoyin channel, it is two folds larger; if in the Taiyin channel, three folds larger. (The three positions of the Right Hand belong to the Three Yin channels. Shaoyin at Guan governs the Spleen; Taiyin at Cun governs the Lung. With significant heat on the skin and flesh, the pulses of both Spleen and Lung are tight and vigorous.)
The Qi Kou pulse at the Right Cun is urgent, large, rapid, occasionally showing a Dai (intermittent) pulse and Se (choppy) quality. (Se is the native pulse of the Lung; Dai indicates Yuan Qi failing to connect continuously. This is a pulse of extreme deficiency due to dietary loss and excessive labor.)
The Spleen pulse at the Right Guan is large and rapid. (Referring to being uniquely larger than the other five pulses.) Within the rapidity, a slow quality appears, occasionally showing a Dai pulse. (This is a pulse of mild labor strain.) The Stomach pulse at the Right Guan is damaged and weak; severely, it is hidden and invisible, only internally showing the Spleen pulse as large, rapid, slightly slow, occasionally Dai. (This is a pulse of dietary irregularity and improper temperature regulation.) The Right Guan pulse is deep and slippery. (This is a pulse of undigested retained food.)
Methods
Danxi said: Dongyuan’s differentiation of interior and exterior injury is very detailed. Many people in the world suffer from this, but some have complications with phlegm, some with exterior pathogens, some with heat stagnating internally causing eruption. All should primarily tonify Yuan Qi, adding medications according to the complication. For severe Qi deficiency, add a small amount of Fuzi (Aconite Root) to promote the action of Renshen (Ginseng). For phlegm complications, add Banxia (Pinellia Tuber) to Buzhong Yiqi Tang, and administer with Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice).
Dai said: For combined interior-exterior syndromes, if interior injury is severe and exterior infection is mild, it is called "Interior Injury Complicated by Exterior Infection." The treatment method should first tonify and then dispel pathogens, or use Buzhong Yiqi Tang as the main treatment, adding pathogen-dispelling herbs. One should investigate based on the Six Channel syndromes and add channel-specific herbs. If exterior infection is severe and interior injury is mild, it is called "Exterior Infection Complicated by Interior Injury." The treatment method should first dispel pathogens and then tonify, using Xinliang Jiebiao (Acrid-Cool Exterior-Resolving) decoctions as the Sovereign herb, and Renshen, Baizhu, Fuling, Xiong, Danggui as Minister and Envoy herbs. This is its treatment.
Buzhong Yiqi Tang (Dongyuan)
Huangqi (1 qian) Gancao (Roasted, 5 or 7 fen) Renshen (1 qian for severe cases) Baizhu Danggui (Each 7 fen) Chenpi (5 fen) Shengma Chaihu (Each 3 fen)
Finely chop, make one dose. Add 2 zhan of water, decoct to 1 zhan. Remove dregs and take warm.
When Spleen and Stomach are deficient, Lung Qi is the first to fail. Therefore, Huangqi is used to benefit the skin/hair and close the Cou Li (pores/sweat glands), preventing spontaneous sweating. For upper asthma and shortness of breath caused by damage to Yuan Qi, Renshen is used to tonify. When Heart Fire attacks the Spleen, roasted Gancao’s sweet-warm nature is used to drain heat/fire and tonify Stomach Yuan Qi. For acute Spleen/Stomach pain or abdominal contraction, it should be used in larger amounts. These three herbs are sacred medicines for draining damp-heat and vexing heat. Baizhu is bitter, sweet, and warm; it drains heat in the Stomach and promotes blood flow in the waist and umbilicus. Shengma and Chaihu are bitter and neutral; their thin flavors ascend the clear Qi of the Stomach, guiding the sweet-warm aroma of Huangqi and Gancao upward. They can tonify the dispersal of Wei Qi (Defensive Qi) and solidify the exterior, while also relieving the contraction of the Dai Mai (Girdle Vessel). Danggui is used to harmonize the blood vessels; Juhong (Citrus Peel) regulates Qi in the chest, assisting Yang Qi to ascend and disperse stagnant Qi, aiding the various sweet and acrid herbs. A small amount of Huangbo may be added to rescue Kidney Water and drain latent fire in the Yin. For exterior heat, after one or two doses, Qi harmonizes, slight sweat appears, and recovery occurs. If the throat is dry, add Ge Gen (Kudzu Root). If there is stabbing heart pain due to blood stasis/deficiency, add Danggui. If mental energy is low, add Renshen and Wubeizi (Schisandra Berry). If there is headache, add Man Jing Zi (Vernonia Seed). For severe pain, add Chuanxiong (Sichuan Lovage Rhizome). For headache and brain pain, add Gaoben (Ligusticum Wallichii Rhizome) and Xixin (Asarum Root). For phlegm, add Banxia and Shengjiang (Fresh Ginger). For cough, add Wubeizi and Maidong (Ophiopogon Tuber) in summer; add Mahuang (Ephedra Stem) without joints in autumn/winter; add Foer Cao (Petasites Leaf) and Kuandonghua (Farfuge Flower) in spring. For chronic cough with latent fire in the Lung, remove Renshen. For poor appetite due to cold in the chest or Qi stagnation, add Qingpi (Green Tangerine Peel), Muxiang (Aucklandia Root), and Chenpi. In cold months, add Yizhiren (Buckthorn Seed) and Caodoukou (Cardamom Fruit); in summer, add Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome); in autumn, add Binglang (Areca Seed) and Sharen (Amomum Fruit). For epigastric fullness/oppression, add Shaoyao (Peony Root) and Huanglian. For abdominal distension, add Zhishi (Immature Bitter Orange), Muxiang, Sharen, and Houpo (Magnolia Bark); in cold weather, add Shengjiang and Rougui (Cinnamon Bark). For abdominal pain, add Baishao (White Peony Root) and Gancao; for cold, add Guixin (Cinnamon Twig); in summer, add Huangqin, Gancao, and Shaoyao; in winter, add Yizhiren, Caodoukou, and Banxia. For hypochondriac pain or contraction, add Chaihu and Gancao. For pain below the umbilicus, add Shudihuang (Prepared Rehmannia Root); if ineffective, it is cold, so add Rougui. For constipation, add Danggui and Dahuang (Rhubarb Root). For soft/weakened legs or pain, add Huangbo; if ineffective, add Fangji (Stephania Root). For floating Qi and chaotic mind, use Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) to settle and secure it, and it will heal.
The above modification methods for this formula apply to diseases of diet and fatigue, irregular emotions, etc., resembling heat in the middle. If it has not transmitted to cold in the middle, it should not be used, as sweet and sour herbs would only exacerbate the disease (e.g., Huangqi, Renshen, Gancao, Shaoyao, Wubeizi). See *Piwei Lun*.
Zhusha Anshen Wan
Huanglian (1.5 qian) Zhusha (1 qian) Jiusheng Dihuang (Wine-processed Raw Rehmannia Root) Jiudangguishen (Wine-processed Ginseng Root) Zhigancao (Roasted, Each 5 fen)
Grind into an extremely fine powder. Soak in soup and steam with steamed bread dough to form pills the size of millet seeds. Take 15 pills per dose, swallowed with saliva, after meals. (Another prescription omits Dihuang and Dangguishen, using raw Gancao instead.)
Tiaozhong Yiqi Tang
The pulse is wiry, surging, slow, and deep; pressing to the lower middle reveals an occasional Se quality. Symptoms include limb fatigue, joint pain, difficulty bending and stretching, body heaviness, vexation and anxiety, fluctuating weight (忽肥忽瘦), loss of taste, abdominal discomfort, frequent clear urination and defecation, or drinking leading immediately to urination, or constipation occurring once or twice a day. In summer, there is undigested diarrhea (Sunxie) with uncooked rice/grain. Blood or white pus may appear after defecation. Chest fullness and shortness of breath, dysphagia, thick sticky phlegm cough, foaming in the mouth, regurgitation of food, tinnitus or deafness, fire flashing in the eyes, blurred vision, red filaments in the eyelids, heat congestion in the head and eyes, restlessness, lethargy, weakness, and loss of appetite. This medicine treats these.
Huangqi (1 qian) Renshen (Remove if coughing) Gancao Cangzhu (Each 5 fen) Chaihu (Used for insufficiency of Upper Qi, descending Stomach and Spleen Qi; it tonifies Upper Qi and nourishes Yang from Yin) Shengma (Each 2 fen) Juhong (2 fen; add 1 fen more if abdominal Qi does not move) Muxiang (1 or 2 fen)
Finely chop, make one dose. Add 2 zhan of water, decoct to 1 zhan. Remove dregs and take warm on an empty stomach. Calming the mind and eliminating thoughts ensures divine efficacy, as the disease is in the limbs and blood vessels, and the empty stomach in the morning is the time. If heat and irritability appear intermittently, it is evaporation of Yin fire from the Lower Yuan; add Shengdihuang (2 fen) and Huangbo (3 fen). For tenesmus (虚坐不得) or incomplete evacuation with abdominal pressure due to blood deficiency/stasis, add Dangguishen (3 fen). For body heaviness despite frequent urination, add Fuling (2 fen), Cangzhu (1 qian), Zexie (5 fen), and Huangbo (3 fen). For Disharmony of Stomach Qi, add Banxia (5 fen) and Shengjiang (3 slices). For cough, add Shengdihuang (2 fen) to counteract Banxia’s toxicity. For Phlegm-Jue headache, only Banxia can eliminate it; this is caused by pathogens in the Foot Taiyin Spleen channel. If complicated by dryness-heat, add Huangbo and Shengdihuang (2 fen each). If none of the above symptoms exist, take only the previous herbs. For abdominal pain in Spring/Summer, add Baishao (3 fen). For aversion to heat/thirst or abdominal pain, add Baishao (5 fen) and Sheng Huangqin (2 fen). For aversion to cold/abdominal pain, add Guixin (3 fen) and remove Huangqin; named Guizhi Shaoyao Tang. In Winter, avoid Shaoyao due to its great cold nature; add Ganjiang (2 fen) or Banxia (5-7 fen) controlled by Shengjiang. In Autumn/Winter, if Stomach Qi’s four pathways are reversed by the Chong Mai, and the two pathways of the Shaoyang pulse under the hypochondrium reverse upwards, the disease is named Jue Ni (Reversal Cold). The *Neijing* says: "Reverse Qi moves upward, filling the pulse and departing from the form." This means the Seven Spirits become confused and depart from the form, leading to death. Symptoms include Qi rushing up to the throat, inability to breathe, noisy wheezing, and inability to lie down. Add Wuzhuyu (0.5 or 1 qian), soaked in soup to remove bitterness. Use according to the degree of Jue Qi. If this occurs in Summer, it is Great Heat; this disease changes with the seasons’ cold/heat/warm/cool. Use Jiuhuangbo, Jiuhuanglian, and Jizhimu (Anemarrhena Rhizome) in equal parts, grind to fine powder, form pills with hot water the size of paulownia seeds. Take 200 pills per dose with plain water on an empty stomach. Drink plenty of hot water afterwards. Immediately follow with a good meal to prevent retention in the Stomach, directing the action to the Lower Yuan to drain the Chong Mai pathogen. Generally, treating diseases of diet and fatigue involves Xu Lao (Deficiency Consumption) and Seven Damages. The method is to use warm-neutral, sweet-abundant, acrid-scarce herbs.
Shengyang Shunqi Tang Treats fullness and oppression in the abdomen/hypochondrium, shortness of breath due to irregular diet and labor injury. In Spring, taste is bland; in Summer, despite heat, there is aversion to cold. Hunger feels like fullness; dislikes cold foods.
Huangqi (1 qian) Banxia (6 fen) Zhigancao (Roasted, 2 fen) Caodoukou (4 fen) Shenqu (3 fen, stir-fried) Shengma Chaihu (Each 2 fen) Dangguishen Chenpi (Each 3 fen) Huangbo (1.5 fen) Renshen (3 fen)
Finely chop, make one dose. Add 2 zhan of water and 3 slices of Shengjiang. Decoct to 1 zhan. Remove dregs and take warm before meals. For Spleen/Stomach insufficiency, Shengma and Chaihu (bitter, neutral, thin flavor, Yang within Yin) are necessary to guide Clear Qi of Spleen/Stomach into the Yang pathways and various channels, generating Yin-Yang Qi to nourish the harmony of Spring Qi. They also guide the sweet-warm aroma of Huangqi, Renshen, and Gancao upward, filling the Cou Li, allowing Yang Qi to defend the exterior and maintain solidity. This is why most Spleen/Stomach remedies are named "Ascending Yang and Tonifying Qi."
Shengyang Bubu Tang Treats irregular diet, hunger/fullness/labor injury, insufficient Stomach Qi, descending Spleen Qi, shortness of breath, weakness, inability to tolerate cold/heat. Post-breakfast dizziness increases, frequent sleepiness, lethargy, limbs unable to hold themselves, laziness in movement, five-center heat.
Houpo (Ginger-processed, 3 fen) Shengma Qianghuo (Each 5 fen) Baishao (Baked, 5 fen) Duhuo (5 fen) Fangji (5 fen) Zhigancao (Roasted, 5 fen) Zexie (5 fen) Chaihu (1.2 qian) Shengdihuang (7.5 fen)
Finely chop, make one dose. Add 3 slices of Shengjiang, 2 dates, 2 zhan of water. Decoct to 1 zhan. Remove dregs and take large warm dose before meals. For abdominal distension/narrowness, double Houpo. For hardness in abdomen, add Sharen (3 fen).
Danggui Buxue Tang Treats muscle heat, dry heat, thirst with desire to drink, red eyes/face, continuous day and night. Pulse is Hong Da (Surging Large) but Xu (Empty), completely absent upon heavy pressure. *Neijing* says: "Empty pulse indicates Blood deficiency." Also: "Blood deficiency generates heat." The syndrome resembles Baihu Tang syndrome, distinguished only by the pulse not being Chang Shi (Long and Excess). Misusing Baihu Tang will cause death. This disease arises from hunger, exhaustion, and labor.
Huangqi (1 liang) Danggui (Wine-washed, 2 qian)
Finely chop, make one dose. Add 2 zhan of water. Decoct to 1 zhan. Take warm before meals.
Muxiang Huazhi Tang Treats depression causing damp noodles to knot in the Zhongwan, pain upon pressure on the abdominal wall, epigastric fullness, loss of appetite, indigestion, chronic Qi stagnation, or gastric pain opposite the heart. Treats all these.
Banxia (Soup-soaked and washed, 1.5 qian) Caodoukou (Wrapped in damp noodle, baked, crushed) Zhigancao (Roasted, Each 7.5 fen) Chaihu (De-rusted, 6 fen) Muxiang Juhong (Each 4.5 fen) Zhishi (Bran-roasted yellow) Danggui (Each 3 fen) Jiuhonghua (Wine-processed Safflower, 1 fen)
Finely chop, make one dose. Add 2 zhan of water and 5 slices of Shengjiang. Decoct to 1 zhan. Remove dregs and take hot.
Shengyang Yiwang Tang Treats Lung and Spleen/Stomach deficiency causing lethargy, preference for lying down, limbs unable to hold themselves. During Autumn Dryness command, damp-heat slightly recedes. Body weight, joint pain, dry mouth/tongue, tasteless diet, irregular bowels, frequent urination, anorexia, indigestion. Combined with Lung disease: chills, sadness, unpleasant/unharmonious complexion. This is due to Yang Qi not extending. Should Ascend Yang and Benefit Stomach; this medicine treats it.
Huangqi (1 qian) Banxia Renshen (De-rusted) Zhigancao (Roasted, Each 5 fen) Duhuo (3 fen) Fangfeng (3 fen, because Autumn is prosperous, use Acrid-Warm to drain it) Baizhu (2 fen) Qianghuo (3 fen) Huanglian (1 fen) Chaihu (De-rusted, 2 fen) Zexie (2 fen, do not use if no strangury/retention) Juhong (2.5 fen) Baishao (3 fen. Why use Renshen, Baizhu, Shaoyao to tonify Lung when Autumn is prosperous? Because Spleen/Stomach deficiency makes Lung most susceptible to pathogens, so tonify according to season, making it easier to exert force.) Fuling (2 fen, do not use if urination is smooth and no thirst)
Finely chop, make one dose. Add 5 slices of Shengjiang, 2 dates, 2 zhan of water. Decoct to 1 zhan. Remove dregs and take warm after breakfast.
After taking medicine, if urination stops but illness worsens, diuresis is inappropriate. Remove Fuling and Zexie. If appetite returns, do not eat too much for 1-2 days, fearing re-injury to the Stomach, as medicinal power is still slight, and Spleen/Stomach Qi cannot transport and ascend. Need flavorful/good food to assist medicinal power, increase floating Qi, and nourish Stomach Qi. Avoid bland food, which damages medicinal power and aids pathogenic sinking. Light physical activity can help Stomach and medicine transport and develop. Avoid heavy labor that injures Qi again. Quietness for Spleen/Stomach is best. If Stomach Qi is slightly strong, eat small amounts of good fruits to assist medicinal power. The Classic says: "Five fruits are assistants."
Shuanghe San Tonifies Blood and Qi, treats Deficiency Consumption with little strength, neither hot nor cold, warm and tonifying.
Baishao (1 qian) Huangqi (Honey-roasted) Shudihuang Chuanxiong Chuan Gui (Each 6 fen) Zhigancao Rougui (Each 4 fen)
Finely chop, make one dose. Add 3 slices of Shengjiang, 2 dates, 1.5 zhan of water. Decoct to 1 zhan. Take warm. For Blood deficiency and Qi exhaustion after major illness, use this for regulation.
Mendong Qingfei Yin Treats Spleen/Stomach weakness, shortness of breath/panting, low mental energy, or epistaxis/hematemesis.
Ziwanrong (1 qian) Huangqi (Honey-roasted) Baishao (Stir-fried) Zhigancao (Roasted, Each 7 fen) Renshen Maidong (De-heart) Dangguishen (Each 5 fen) Wubeizi (9 berries)
Finely chop, make one dose. Add 1.5 zhan of water. Decoct to 1 zhan. Remove dregs and take warm after meals.
Kuanzhong Jinshi Wan Nourishes Form and Qi, promotes appetite.
Maifan (Wheat bran flour, 1 liang, stir-fried yellow) Banxia (Soaked in soup 7 times, peel and navel removed) Zhuling (Remove black skin, Each 7 qian) Caodoukou (Wrapped in damp noodle, baked) Shenqu (Stir-fried, Each 5 qian) Zhishi (Bran-roasted yellow) Juhong (Each 3 qian) Baizhu (5 qian) Baifuling Zexie (Each 3 qian) Sharen (2 qian) Ganjiang (Pao, 5 qian) Zhigancao Renshen Qingpi (Each 2 qian) Muxiang (1 qian)