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Western Ginseng (Xi Yang Shen): Sweet in taste, slightly bitter, cool in nature. It can tonify the Qi aspect and simultaneously nourish the Blood aspect. Due to its cool yet tonifying nature, whenever Ren Shen (Ginseng Root) is indicated but the patient cannot tolerate its warming tonification, Western Ginseng can be used as a substitute. However, in Bai Hu Jia Ren Shen Tang (White Tiger Decoction Plus Ginseng), Ren Shen should still be replaced by Dang Shen (Codonopsis Root) rather than Western Ginseng, because Dang Shen possesses ascending and dispersing power that helps Shi Gao (Gypsum Fibrosum) expel pathogens outward. Moreover, *Shen Nong Ben Cao Jing* (Divine Farmer's Materia Medica) states that Ren Shen tastes sweet and does not mention bitterness, which coincides with the taste of Dang Shen. Therefore, the "Ren Shen" of ancient times refers to what is now called Dang Shen. In contrast, both Western Ginseng and Korean Ginseng (Gao Li Shen) taste sweet and bitter; thus, they are unsuitable for use in ancient formulas. Western Ginseng originates from France. When covered with rough bark, it appears yellow; after removing the bark, it turns white. Regardless of color, those with numerous transverse rings are authentic. I exclusively use Western Ginseng with yellow skin and many transverse rings, as counterfeiters can produce white-skinned Western Ginseng but cannot replicate the yellow-skinned variety.

Astragalus (Huang Qi): Warm in nature, slightly sweet in taste. It tonifies Qi and has an ascending effect, making it particularly effective for treating the sinking of the Great Qi in the chest (i.e., Zong Qi / Pectoral Qi, the primary driving force for lung expansion). *Shen Nong Ben Cao Jing* states it treats severe wind disorders ("Da Feng"), because when combined with exterior-releasing herbs, it dispels external wind; when combined with Yin-nourishing and heat-clearing herbs, it extinguishes internal wind. It is said to treat carbuncles and chronic ulcers because its tonifying power promotes flesh regeneration and facilitates the natural discharge of pus. For patients with spontaneous sweating due to exterior deficiency, it can be used to secure the exterior Qi. For edema accompanied by difficult urination, it promotes diuresis. For women suffering from metrorrhagia and leukorrhea due to Qi deficiency and sinking, it secures against leakage. Because its Qi-tonifying efficacy is superior, it is regarded as the chief among tonics, hence named "Huang Qi" (Yellow Elder/Chief).

[Attached Case 1] A woman from the Dong family in Cangzhou, over twenty years old, presented with fullness and oppression in the chest and hypochondrium, palpitations (Zheng Tong), and spontaneous sweating upon exertion. Her pulse was deep, slow, and weak, especially on the right side. Initially suspecting Heart and Lung Yang deficiency due to the slow pulse, inquiry revealed no sensation of cold, leading to the diagnosis of sinking Great Qi in the chest. The family had purchased a packet of Huang Qi, so she was instructed to take one liang decocted in water. Her cousin, who understood medicine, doubted the prescription. I stated, "Do not doubt excessively; if there is an error, I will bear responsibility." After ingestion, all symptoms resolved. The cousin asked skeptically, "*Shen Nong Ben Cao Jing* states Huang Qi treats severe wind and has exterior-dispersing properties; raw usage enhances this dispersing power, which seems contraindicated for spontaneous sweating. Its ascending and tonifying nature causes distension, seemingly contraindicated for fullness. How did single-dose raw Huang Qi cure both conditions and the palpitations?" I replied, "Huang Qi indeed has dispersing power. If Qi deficiency prevents pathogen expulsion, combining it with exterior-releasing herbs induces sweating. However, in cases of strong Yang and deficient Yin, misuse causes uncontrollable profuse sweating. Only when Great Qi sinks, causing Wei Qi to lose control and resulting in spontaneous sweating, does Huang Qi prove miraculous. Regarding fullness: if caused by respiratory difficulty due to sinking Great Qi rather than Qi stagnation, Huang Qi is appropriate. Since Heart and Lung hang in the chest and are enveloped by Great Qi, when Great Qi rises, the Heart finds support, and palpitations cease." Subsequently, Jie Geng (Platycodon Root) and Zhi Mu (Anemarrhena Rhizome) were added, and two more doses were taken to consolidate recovery.

A woman, four or five days postpartum, suffered from profuse sweating lasting several days, presenting with critical condition, faint breath, and a pulse so weak it seemed absent. She nodded affirmatively to questions about shortness of breath, palpitations, and fever. This indicated sinking Great Qi failing to secure Wei Qi, compounded by sudden postpartum Yin deficiency failing to anchor Yang, causing such severe sweat loss. Treatment involved Sheng Huang Qi (Raw Astragalus) 6 qian, Xuan Shen (Scrophularia Root) 1 liang, Jing Yu Rou (Prepared Cornus Fruit) 5 qian, Sheng Bai Shao (Raw White Peony Root) 5 qian, and Jie Geng 2 qian. Sweating decreased after one dose, and all symptoms resolved after three doses. Bowel movements, absent for five to six days, also resumed.

A young woman from the Wang family in the county, over twenty, complained of coldness in the heart region and reduced appetite. Medical treatment for over a year failed, and she became increasingly emaciated. My examination revealed a weak, unrising left pulse, leading to a diagnosis of Liver deficiency. Her father, knowledgeable in medicine, questioned why only Liver deficiency was diagnosed based on the weak left pulse, given previous diagnoses of Spleen/Stomach weakness and diminished Ministerial Fire. I explained, "Although anatomically located on the right, Liver Qi function manifests primarily on the left. Does the patient feel her left side is weaker than the right?" Inquiry confirmed she felt a downward dragging sensation in her left side while sitting and dared not lie on her left side. Her father accepted the diagnosis. Prescription: Sheng Huang Qi 8 qian, Chai Hu (Bupleurum Root) 1 qian, Chuan Xiong (Ligusticum Rhizome) 1 qian, Gan Jiang (Dried Ginger) 3 qian. Within moments, she could lie comfortably on her left side. After several doses, all symptoms resolved except for persistent leukorrhea. Several qian of Mu Li (Oyster Shell) were added to the original formula, curing the leukorrhea after a few doses. Her father asked why Huang Qi, a Lung/Spleen tonic, cured Liver deficiency. I answered, "The Liver corresponds to Wood and Spring, favoring warmth and free flow. Huang Qi is warm and ascending, matching the Liver's nature (same energy seeks similar energy). In my clinical experience, when Liver Qi fails to flow freely and other Liver tonics fail, heavy use of Huang Qi with minor Qi-regulating herbs yields rapid results. Those claiming 'Liver deficiency has no tonification method' lack profound understanding."

*Shen Nong Ben Cao Jing*'s claim that Huang Qi treats severe wind is valid (see Fu's wife case under "Causes and Treatments of Limb Paralysis"). Its efficacy for chronic ulcers is also remarkable. Patient Zhang from Fengtian, over thirty, contracted seasonal toxic pathogens. Poor medical management directed the toxin downward, causing swelling below the navel, followed by ulceration, exposed testicles, and five holes in the lower abdomen discharging urine. Prescription: Sheng Huang Qi 1 liang, Hua Fen (Tian Hua Fen/Trichosanthes Root) 1 liang, Ru Xiang (Frankincense) 3 qian, Mo Yao (Myrrh) 3 qian, Yin Hua (Honeysuckle Flower) 3 qian, Gan Cao (Licorice Root) 3 qian. Taken continuously for over twenty doses, the ulcers regenerated flesh, discharged pus, formed scars, and healed without topical applications.

Huang Qi also promotes diuresis (see Wang case under Qu Zhi Tang).

Beyond tonifying Qi, proper use of Huang Qi can also nourish Yin. An elderly woman, Zhang, nearly fifty, suffered from fever and chronic cough with a rapid pulse (eight beats per respiration). Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and Zuo Gui Yin (Left Restoring Decoction) failed. Realizing the need for a different approach, I prescribed Sheng Huang Qi 6 qian and Zhi Mu 8 qian. Symptoms improved after several doses. Dan Shen (Salvia Root) and Dang Gui (Angelica Sinensis) 3 qian each were added, and ten doses resulted in full recovery. Consumptive diseases often damage the Kidney; Huang Qi tonifies Lung Qi to benefit the source of Kidney Water. As Qi flourishes, Water generates. Zhi Mu nourishes Lung fluids, balancing Yin and Yang. Dan Shen and Dang Gui were added later because Blood Bi and consumptive disease are linked in *Jin Gui Yao Lue*; preventing blood stasis is crucial in treating consumption.

Huang Qi effectively treats limb paralysis, provided the pulse is assessed carefully. Weak pulse with paralysis indicates cerebral anemia (Western term). Limb movement is controlled by brain marrow nerves, which rely on ascending blood for nourishment. Weak pulse signifies deficient Great Qi in the chest, unable to assist blood ascent to nourish the brain, leading to nerve dysfunction (*Nei Jing*: "Insufficiency of Upper Qi leads to incomplete filling of the Brain"). My formulas, Jia Wei Bu Xue Tang (Modified Blood-Tonifying Decoction) and Gan Tui Tang (Dry Atrophy Decoction), heavily feature Huang Qi and are effective for weak-pulse paralysis. Conversely, strong pulse with paralysis indicates cerebral congestion (Western term), where excessive ascending blood compresses brain nerves (*Nei Jing*: "Blood stagnates above, causing abrupt collapse"). Huang Qi is strictly contraindicated initially; misuse brings immediate danger. Such cases require sedative and astringent herbs like Zhen Gan Xi Feng Tang (Settle Liver and Extinguish Wind Decoction) or Jian Ling Tang (Build High Terrace Decoction). If the pulse becomes soft but paralysis persists, small amounts of Huang Qi can aid blood-invigorating herbs to unblock collaterals. If the pulse strengthens again, sedatives must be reintroduced, as in Qi Wei Tang (Raise Atrophy Decoction), combining Huang Qi with Zhe Shi (Magnetite) and E Chong (Ground Beetle).

Huang Qi's ascending and tonifying power is particularly effective for miscarriage, metrorrhagia, and leukorrhea. Wife of Wang from Xifu Village, pregnant for the first time, experienced two miscarriages at five months and threatened abortion with bleeding at six to seven months. Emergency treatment: Sheng Huang Qi 2 liang, Sheng Di Huang (Rehmannia Root) 2 liang, Bai Zhu (Atractylodes Rhizome) 1 liang, Jing Yu Rou 1 liang, Long Gu (Fossilized Bone) 1 liang, Mu Li 1 liang. Decocted in a large bowl and taken at once, fetal stability was restored. The dose was halved for one more dose. She delivered a healthy boy.

Zhu from Shenyang arrived at dawn reporting his wife's continuous menstrual bleeding, confusion, and near-absent breath. Pulse was faint and irregular. Emergency prescription: Sheng Huang Qi 1 liang, Ye Tai Shen (Wild Codonopsis) 1 liang, Jing Yu Rou 1 liang, Long Gu 8 qian, Mu Li 8 qian. Decocted and administered, bleeding stopped significantly, and consciousness returned. Hours later, the dose was halved, plus Sheng Huai Shan Yao (Chinese Yam) 1 liang, resulting in full recovery.

Wife of Liu in the county, over twenty, was emaciated, felt cold in the heart, and suffered severe leukorrhea resistant to prior treatments. Pulse was very fine and weak, especially on the left. Prescription: Sheng Huang Qi 8 qian, Sheng Mu Li 8 qian, Gan Jiang 4 qian, Bai Zhu 4 qian, Dang Gui 4 qian, Gan Cao 2 qian. Full recovery after several doses. This condition stemmed from severe Liver Qi deficiency and deficient Ministerial Fire, causing Qi sinking and cold-dampness descending. Heavy Huang Qi tonified Liver Qi; Gan Jiang assisted Ministerial Fire; Bai Zhu strengthened Earth to overcome dampness; Mu Li astringed to secure the lower jiao; Dang Gui warmed and moistened, combining with Huang Qi to tonify Qi and Blood without excessive astringency. Gan Cao moderated Gan Jiang's heat, preventing upward flare-up, ensuring rapid efficacy.

Note: Furnaces contain hydrogen; humans have hydrogen in the abdomen. Huang Qi guides hydrogen up to the lungs to combine with inhaled oxygen, forming water. It also stimulates stomach fluids upward and regulates Lower Jiao Qi, preventing frequent urination, thus treating Xiao Ke (Wasting-Thirst). Yu Ye Tang (Jade Fluid Decoction) and Zi Na Yin (Nourish Adrenal Decoction) both heavily feature Huang Qi for this purpose.

In decoctions, raw Huang Qi acts as cooked Huang Qi; honey-frying is unnecessary. For pills/powders requiring cooked properties, honey-frying is acceptable. For sores/ulcers, even in pills/powders, frying is inappropriate (as detailed in Wang Hongxu's *Waike Zhengzhi Quansheng Ji*). Claims that raw Huang Qi induces sweating and cooked stops it are absurd. It stops sweating in Qi-sinking cases but causes profuse sweating in Yang-excess/Yin-deficiency cases. Combined with exterior-releasing herbs for Qi-deficient pathogen retention, it induces sweating. Thus, sweating effects depend on clinical application, not raw/cooked status.

Appendix:
Letter from Zhong of Liuhe:
In late autumn of the Gengwu year, I felt coldness in the heart. Hot herbs failed. Ten days later, cold qi rushed to the brain, causing unconsciousness, recurring 3-4 times daily. Doctors failed. During remission, I read *Zhong Zhong Can Xi Lu*, specifically the case of left-side dragging and inability to sleep on the left, diagnosed as Liver deficiency. Noting Huang Qi's affinity with Liver Wood, I used heavy raw Huang Qi and recovered. I realized my own inability to sleep on the left confirmed Liver deficiency as the root cause, with coldness due to deficient Ministerial Fire. Prescription: Sheng Jian Huang Qi 2 liang, Guang Tiao Gui (Cinnamon Twig) 5 qian. Due to slight urinary difficulty, Jiao Mu (Zanthoxylum Seed) 5 qian was added. One dose brought significant improvement. Continued dosage led to full recovery.