医学一途，至微至精，古人立法立方，皆原探得阴阳盈虚消长，生机化机至理，始开渡世之法门，立不朽之功业，诚非易事也。全碌碌庸愚，何敢即谓知医，敢以管见臆说，为将来告。窃念一元肇始，人身性命乃立，所有五脏六腑，九窍百脉，周身躯壳，俱是天地造成，自然之理。但有形之躯壳，皆是一团死机，全赖这一团真气运用于中，而死机遂转成生机。奈人事不齐，不无损伤，真气虽存，却借后天水谷之精气而立（经云："无先天而后天不立，无后天而先天亦不生"）。故先天之本在肾（即真阳之寄处），后天之本在脾（即水谷之寄处），水谷之精气，与先天之真气，相依而行，周流上下四旁，真是无微不照者也。盖上下四旁，即三阴三阳六步，其中寓五行之义，各有界限。发病损伤，即有不同，总以阴、阳两字为主。阴盛则阳必衰，阳盛则阴必弱，不易之理也。然阴虚与阳虚，俱有相似处，学者每多不识，以致杀人。全不佞，采取阳虚、阴虚症各数十条，作为问答，阴、阳二症，判若眉列，以便学者参究，知得立解之意，则不为他症所惑，非有补于医门者哉？
阳虚症门问答
问曰：头面畏寒者，何故？
答曰：头为诸阳之首，阳气独盛，故能耐寒。今不耐寒，是阳虚也。法宜建中汤加附子，温补其阳自愈。
桂枝九钱白芍六钱甘草六钱炙生姜九钱大枣十二枚饴糖五钱附子三钱
用药意解
按桂枝辛温，能扶心阳。生姜辛散，能散滞机。熟附子大辛大热，足壮先天元阳。合甘草、大枣之甘，辛甘能化阳也。阳气化行，阴邪即灭，气机自然复盛，仍旧能耐寒也。但辛热太过，恐伤阴血，方中芍药苦平，饴糖味甘，合之苦甘能化阴也。此病重在阳不足一面，故辛热之品多，而兼化阴，亦是用药之妙也。此方乃仲景治阳虚之总方也，药味分两，当轻当重，当减当加，得其旨者，可即此一方，而治百十余种阳虚症候，无不立应。
【阐释】小建中汤由桂枝汤倍芍药加饴糖组成，取温以祛寒，辛以宣通，甘以缓急之义，一般用于太阳病及脾阳虚的病症。实则凡身体虚弱有腹痛、心悸、盗汗、衄血、梦遗、手足烦热、四肢倦怠疼痛、尿频数且量多等，均可应用。现代有人用以治虚弱小儿的感冒，夜尿、糖尿病、肺结核、贫血、胃炎。加淫羊藿治阳痿，加茵陈治黄疸，加龙齿治高血压，均获显著效果。若加当归、黄芪，更具滋养强壮之效，诚不愧为治阳虚之要方。
笔者用建中汤加丁香以治各种胃痛症，屡获良效，实由丁香辛温，能温中降逆，暖胃助阳之故。加破故纸，益智仁，桑螵蛸治老年人尿频数，小儿遗尿，十用九效，实由三药皆能补肾、命门之不足，益精气而固肾、有缩小便之功。
答曰：恶风者，见风始恶，非若畏寒者之不见风而亦畏寒也。恶风一症，兼发热、头项强痛、自汗者，仲景列于太阳风伤卫症，主桂枝汤。畏寒一症，兼发热、头项强痛、无汗者，仲景列于太阳寒伤营症，主麻黄汤。若久病之人，无身热、头痛等症，而恶风者，外体虚也（卫外之阳不足也）。而畏寒者，内气馁也（元阳衰于内，而不能充塞也）。恶风者可与黄芪建中汤，畏寒者可与附子甘草汤。新病与久病，畏寒恶风，有天渊之别，学者务宜知之。
（同上加黄芪一味）
用药意解
按桂枝汤一方，乃协和营卫之剂也。桂枝辛温，能化太阳之气；生姜辛散，能宣一切滞机。桂枝与生姜同气相应，合甘草之甘，能调周身之阳气，故曰辛甘化阳。阳气既化，恐阴不与之俱化，而邪亦未必遽出也，又得芍药之苦平，大枣之甘平，苦与甘合，足以调周身之阴液，故曰苦甘化阴。阴阳合化，协于中和，二气流通，自然无滞机矣。故曰营卫协和，则病愈。仲景更加服粥以助之，一取水谷之精以为汗，一是壮正气而胜邪气也。
按麻黄汤一方，乃发汗之峻剂也。因寒伤太阳营分，邪在肤表（肌腠浅一层，肤表深一层），表气不通，较桂枝症更重，故以麻黄之轻清，大开皮毛为君，皮毛大开，邪有路出，恐不即出，故以杏仁利之，气机得利，邪自不敢久停，复得甘草和中以助其正，更佐桂枝，从肌腠以达肤表，寒邪得桂枝辛温，势不能不散，遂从肤表达肌腠而出也。仲景不用服粥，恐助麻黄而发汗太过也。（发汗二字，大有深义。汗本血液，固是养营之物，何可使之外出也。不知寒邪遏郁，气机血液不畅，则为病。此际之血液，不能养营，必使之外出，即是除旧布新之义也。病家切不可畏发汗，汗出即是邪出也。医家切不可不发汗，当知有是病，即当用是药。总之认症贵宜清耳）按黄芪建中汤一方，乃桂枝汤加饴糖、黄芪耳。夫桂枝汤乃协和营卫之祖方也，复得黄芪能固卫外之气。饴糖一味有补中之能。若久病恶风之人，皆原中气不足，卫外气疏，今得桂枝汤调和阴阳，黄芪、饴糖卫外守中，而病岂有不愈者乎？
按附子甘草汤一方，乃先后并补之妙剂也。夫附子辛热，能补先天真阳，甘草味甘，能补后天脾土，土得火生而中气可复（附子补先天之火，火旺自能生脾土，故曰"中气可复"）。若久病畏寒之人，明系先天真阳不足，不能敌其阴寒之气，故畏寒。今得附子而先天真火复兴，得甘草而后天脾土立旺，何患畏寒之病不去乎？
附伏火说
世多不识伏火之义，即不达古人用药之妙也。余试为之喻焉：如今之人将火煽红，而不覆之以灰，虽焰，不久即灭，覆之以灰，火得伏即可久存。古人通造化之微，用一药、立一方，皆有深义。若附子甘草二物，附子即火也，甘草即土也。古人云："热不过附子，甜不过甘草"。推其极也，古人以药性之至极，即以补人身立命之至极，二物相需并用，亦寓回阳之义，亦寓先后并补之义，亦寓相生之义，亦寓伏火之义，不可不知。
【阐释】关于桂枝、麻黄二汤之应用，须遵守一定的标准。近代名医恽铁樵之说可供借鉴。其说谓："太阳病发热，形寒，头痛，项强，口中和，汗自出，始可用桂枝汤。口中和就是舌面润，舌质不绛，唇不干绛，不渴，如其口渴，舌干，唇绛，即是温病，桂枝是禁药。"用麻黄汤之标准，"除恶寒、发热，头痛、身痛等，更须注意两点：第一是无汗，第二是口中和。如其有汗，麻黄是禁药，如其口渴、舌干、唇绛，桂枝也是禁药。只要是真确无汗，口中和，此方是唯一无二的妙法，可以药到病除。"（见恽著《伤寒论辑义按》）何公度悼恽氏文谓恽氏三子皆死于伤寒，其第四子又病危，群医束手，恽氏乃自处麻黄汤方，虽分量极轻，而其子竟得救，于是乃益精研《伤寒论》，终至成为名家。但至今仍有惧用此方者，恽氏之说，实足为郑氏"认症贵宜清"之助，故摘录以资参考。
久病之恶风，多无身热、头痛等症，而系由于中气不足，卫外气疏，故主以黄芪建中汤。因本方系由桂枝汤加黄芪、饴糖组成，桂汤枝以调和阴阳，黄芪、饴糖以卫外而守中，中气卫气均固，自然不会畏风了。至于久病恶寒，明系元阳不足，不同于表症恶寒之重被不温，而是得暖即解，两者极易区别。郑氏主以附子甘草汤，药仅二味，具见精义。以附子辛热补先天真阳，甘草味甘补后天脾土，火生土而中气可复，土覆火而火得久存，故久病之恶寒可以痊愈。伏火说所论各点，妙喻精义，别开生面，其他医家少有论及。
问曰：头面忽浮肿，色青白，身重欲寐，一闭目觉身飘扬无依者，何故？
答曰：此少阴之真气发于上也。原由君火之弱，不能镇纳群阴，以致阴气上腾，蔽塞太空，而为浮肿。所以面现青黑，阴气太盛，逼出元阳，故闭目觉飘扬无依。此际一点真阳，为群阴阻塞，不能归根，若欲归根，必须荡尽群阴，乾刚复振。况身重欲寐，少阴之真面目尽露，法宜潜阳，方用潜阳丹。
用药意解
按潜阳丹一方，乃纳气归肾之法也。夫西砂辛温，能宣中宫一切阴邪，又能纳气归肾。附子辛热，能补坎中真阳，真阳为君火之种，补真火即是壮君火也。
况龟板一物，坚硬，得水之精气而生，有通阴助阳之力，世人以利水滋阴目之，悖其功也。佐以甘草补中，有伏火互根之妙，故曰潜阳。
【阐释】潜阳丹，笔者曾用此方治愈头痛如裂（即一般所说之脑震荡）患者多人，即以其无外感可凭，有阳虚之症状足征，而断为阴气逼阳上浮，用潜阳丹一服即效，数剂痊愈。
问曰：病将瘥，一切外邪悉退，通身面目浮肿者，何故？
答曰：此中气不足，元气散漫也。夫病人为外邪扰乱，气血大亏，中气未能骤复。今外邪虽去，而下焦之阴气，乘中土之虚，而上下四窜，故通身浮肿。虽云君火弱不足以制阴，此症实由脾土虚不能制水，而水气汜溢，可名水肿。一者脾土太弱，不能伏火，火不潜藏，真阳之气外越，亦周身浮肿，可名气肿。总而言之，不必定分何者为气肿、水肿，要知气行一寸，水即行一寸，气行周身，水即行周身，是元气散漫，而阴水亦散漫也。治病者不必见肿治肿，明知其土之弱，不能制水，即大补其土以制水，明知其元阳外越，而土薄不能伏之，即大补其土以伏火。火得伏而气潜藏，气潜藏而水亦归其宅，何致有浮肿之病哉！经云："火无土不潜藏"，真知虚肿之秘诀也。而余更有喻焉：试即蒸笼上气，而以一纸当气之上，顷刻纸即湿也。以此而推，气行则水行，气伏则水伏，可以无疑矣。此症可用理中汤加砂、半、茯苓温补其土，自愈。
人参四钱白术一两干姜一两甘草三钱〔炙〕西砂四钱半夏四钱茯苓三钱
用药意解
按理中汤一方，乃温中之剂也。以白术为君，大补中宫之土；干姜辛热，能暖中宫之气；半、茯淡燥，有行痰逐水之能，西砂辛温，有纳气归肾之妙。但辛燥太过，恐伤脾中之血，复得人参微寒，足以养液，刚柔相济，阴阳庶几不偏。然甘草与辛药同用，便可化周身之阳气。阳气化行，而阴邪即灭，中州大振，而浮肿立消，自然体健而身安矣。
【阐释】笔者常用理中汤加丁香治慢性胃病，患者大多胃胀痛或隐痛，饮食减少，人困无神，可说屡治屡效。
问曰：眼中常见五彩光华，气喘促者，何故？
答曰：此五脏之精气发于外也。夫目窠乃五脏精华所聚之地，今病人常见五彩光华，则五气之外越可知，而兼气喘，明系阴邪上干清道，元阳将欲从目而脱，诚危候也。法宜收纳阳光，仍返其宅，方用三才封髓丹。
用药意解
按封髓丹一方，乃纳气归肾之法，亦上、中、下并补之方也。夫黄柏味苦入心，禀天冬寒水之气而入肾，色黄而入脾，脾也者，调和水火之枢也，独此一味，三才之义已具。况西砂辛温，能纳五脏之气而归肾，甘草调和上下，又能伏火，真火伏藏，则人身之根蒂永固，故曰封髓。其中更有至妙者，黄柏之苦，合甘草之甘，苦甘能化阴。西砂之辛，合甘草之甘，辛甘能化阳。阴阳合化，交会中宫，则水火既济，而三才之道，其在斯矣。此一方不可轻视，余常亲身阅历，能治一切虚火上冲，牙疼，咳嗽，喘促，面肿，喉痹，耳肿，目赤，鼻塞，遗尿，滑精诸症，屡获奇效，实有出人意外，令人不解者。余仔细揣摹，而始知其制方之意，重在调和水火也，至平至常，至神至妙，余经试之，愿诸公亦试之。
附七绝一首
阴云四合日光微，转瞬真龙便欲飞（真龙即真火，或上或下，皆能令人病。
在上则有牙疼、喘促、耳、面肿诸症，在下则有遗尿，淋、浊、带诸症，学者苟能识得这一点真阳出没，以此方治之，真有百发百中之妙）。
识得方名封髓意，何忧大地不春归。
【阐释】眼中常见五彩光华而兼气喘促，郑氏断为五脏之精气外越，元阳将从目脱的危候，而治以三才封髓丹。方中西砂辛温，合甘草辛甘化阳以纳气；黄柏苦寒，合甘草苦甘化阴以伏火。阴阳合化，水火交济，会于中宫，则人身之根蒂永固，故曰三才封髓。郑氏曾亲身经历用此方治一切虚火上冲、咳、喘等症，屡获出人意外之效，经仔细揣摩，始悉立方之意重在调和水火，故以至平至常之药，而有至神至妙之用。此种经验，真堪宝贵。笔者治肾虚牙疼，常以此方治之取效。但须先用松针泡酒噙之，使吐出涎沫，痛即暂止，再服封髓丹，其效始著，屡试屡验。
答曰：此先天真火缘肝木而上，暴发欲从目脱也。夫先天之火，原寄于肾，病人阴盛已极，一线之元阳，即随阴气而上升。水为木母，母病及子，故缘肝木而上，厥阴脉会顶巅，真气附脉络而上行，阳气暴发，故头痛如裂。肝开窍于目，故肿如桃。气喘促者，阴邪上干清道，上下有不相接之势也。面、唇青黑，皆系一团阴气。元阳上脱，已在几希之间。此际若视为阳症，而以清凉发解投之，旦夕即死也。
The path of medicine is extremely subtle and profound. The ancients established laws and formulated prescriptions based on their exploration of the principles of Yin and Yang, including their waxing and waning, as well as the profound truths of vital energy (Shengji) and transformative mechanisms (Huaji). Thus, they opened the gate to saving the world and achieved immortal merit, which was indeed not an easy task. I, [Zheng Qin'an], though mediocre and dull, dare not claim to understand medicine. I only dare to offer my limited insights and subjective speculations for future reference.
I privately believe that when the primordial Qi of the universe first began, human life was established. All internal organs (Zang-Fu), orifices, meridians, and the physical body are creations of Heaven and Earth, following natural laws. However, this有形 (physical) body is essentially a mass of dead matter, relying entirely on a cluster of True Qi circulating within to transform this dead state into vitality. Unfortunately, due to various human activities, the body inevitably suffers damage. Although True Qi remains, it must rely on the essence from postnatal food and drink to sustain itself (as the classics state: "Without the prenatal foundation, the postnatal cannot be established; without the postnatal, the prenatal cannot be generated"). Therefore, the root of the prenatal lies in the Kidney (the abode of True Yang), and the root of the postnatal lies in the Spleen (the abode of food and drink essence). The essence of food and drink and the prenatal True Qi depend on each other for circulation, flowing through the upper, lower, front, and back, illuminating every part of the body with meticulous care.
The terms "upper, lower, front, and back" refer to the six stages of San Yin and San Yang (Three Yin and Three Yang), wherein the meaning of the Five Elements resides, each with its boundaries. Consequently, the nature of pathological damage varies, but it always centers on Yin and Yang. When Yin is excessive, Yang must decline; when Yang is excessive, Yin must weaken. This is an unchangeable principle. However, symptoms of Yin deficiency and Yang deficiency often appear similar, leading scholars to frequently misidentify them, resulting in fatal errors. I have selected dozens of cases each for Yang deficiency and Yin deficiency symptoms, presenting them in a Q&A format to clearly distinguish between Yin and Yang conditions, facilitating scholarly study. If one can grasp the intent behind these distinctions, one will not be confused by other symptoms, which undoubtedly benefits the medical field.
**Q&A on Yang Deficiency Symptoms**
Q: What causes cold intolerance in the head and face?
A: The head is the summit of all Yang meridians, where Yang Qi is predominantly abundant, enabling it to withstand cold. Cold intolerance here indicates Yang deficiency. The appropriate treatment is Jianzhong Tang (Middle-Building Decoction) with added Fuzi (Prepared Aconite Root) to warm and tonify Yang, leading to spontaneous recovery.
**Jianzhong Tang (Middle-Building Decoction)**
Guizhi (Cinnamon Twig) 9 qian, Baishao (White Peony Root) 6 qian, Gancao (Licorice Root) 6 qian, Zhi Shengjiang (Honey-fried Fresh Ginger) 9 qian, Dazao (Jujube) 12 pieces, Yitang (Maltose) 5 qian, Fuzi (Prepared Aconite Root) 3 qian.
**Explanation of Medicinal Intent**
Commentary: Guizhi is acrid and warm, supporting Heart Yang. Shengjiang is acrid and dispersing, clearing stagnant Qi. Shu Fuzi is highly acrid and hot, strongly fortifying Prenatal Yuan Yang. Combined with the sweetness of Gancao and Dazao, the combination of acrid and sweet flavors generates Yang Qi. Once Yang Qi transforms and circulates, Yin pathogens are extinguished, and Qi mechanism naturally recovers strength, restoring the ability to withstand cold. However, excessive acrid-hot herbs may damage Yin blood; thus, the bitter-cool nature of Baishao and the sweet nature of Yitang are included. The combination of bitter and sweet generates Yin fluid. Since this disease primarily involves insufficient Yang, the prescription contains more acrid-hot herbs while simultaneously incorporating Yin-generating agents, demonstrating the subtlety of herbal formulation. This formula is Zhang Zhongjing's general prescription for treating Yang deficiency. With proper understanding of dosage adjustments, this single formula can effectively treat over a hundred types of Yang deficiency syndromes.
[Interpretation] Xiaojianzhong Tang consists of Guizhi Tang with doubled Baishao and added Yitang. It embodies the principles of warming to dispel cold, acridity to promote circulation, and sweetness to relieve urgency. It is generally used for Taiyang disease and Spleen Yang deficiency. In reality, it can be applied to any weak constitution presenting with abdominal pain, palpitations, night sweats, epistaxis, nocturnal emission, heat sensation in hands and feet, limb fatigue and pain, frequent urination with large volume, etc. Modern practitioners use it for colds in frail children, nocturia, diabetes, pulmonary tuberculosis, anemia, and gastritis. Adding YinYanghuo (Epimedium Herba) treats impotence; adding Yinchén (Artemisiae Scopariae Herba) treats jaundice; adding Longchi (Fossilized Bones) treats hypertension, all with significant effects. Adding Danggui (Angelica Sinensis Radix) and Huangqi (Astragali Radix) enhances nourishing and strengthening properties, truly deserving its reputation as a key formula for Yang deficiency.
The author uses Jianzhong Tang with Dingxiang (Caryophylli Flos) to treat various gastric pains with frequent success, owing to Dingxiang's acrid-warm nature, which warms the middle, directs rebellious Qi downward, and warms the Stomach to assist Yang. Adding Poguozhi (Psoraleae Fructus), Yizhiren (Alpiniae Oxyphyllae Fructus), and Sangpiaoxiao (Mantis Egg Case) treats elderly polyuria and pediatric enuresis with nine successes out of ten trials. This is because these three herbs tonify the Kidney and Mingmen (Gate of Life), benefit Essence and Qi, consolidate the Kidney, and reduce urination.
Q: Is there a difference between aversion to cold (Wei Han) and aversion to wind (E Feng)?
A: E Feng refers to discomfort only upon exposure to wind, unlike Wei Han, which persists even without wind. E Feng accompanied by fever, stiffness/pain in the head and neck, and spontaneous sweating is classified by Zhang Zhongjing as Wind-striking the Defensive (Wei) level in Taiyang disease, treated primarily with Guizhi Tang. Wei Han accompanied by fever, stiffness/pain in the head and neck, and absence of sweating is classified as Cold-striking the Nutritive (Ying) level in Taiyang disease, treated primarily with Mahuang Tang. For chronic patients without fever or headache, E Feng indicates exterior weakness (insufficient Defensive Yang), while Wei Han indicates interior collapse (decline of Yuan Yang internally, failing to fill the body). E Feng is treated with Huangqi Jianzhong Tang; Wei Han is treated with Fuzi Gancao Tang. There is a vast difference between acute and chronic cases of Wei Han and E Feng; scholars must be aware of this.
**Guizhi Tang (Cinnamon Twig Decoction)**
Guizhi 9 qian, Baishao 6 qian, Gancao 6 qian, [Zhi] Shengjiang 9 qian, Dazao 12 pieces.
**Mahuang Tang (Ephedra Decoction)**
Mahuang 6 qian, Guizhi 3 qian, Xingren 2 qian, Gancao 2 qian [Zhi].
**Huangqi Jianzhong Tang (Astragalus Middle-Building Decoction)**
(Same as above plus Huangqi)
**Fuzi Gancao Tang (Aconite and Licorice Decoction)**
Fuzi 1 liang, Gancao 6 qian [Zhi].
**Explanation of Medicinal Intent**
Commentary: Guizhi Tang is a formula harmonizing Ying (Nutritive) and Wei (Defensive) levels. Guizhi is acrid and warm, transforming Taiyang Qi; Shengjiang is acrid and dispersing, promoting circulation of all stagnation. Guizhi and Shengjiang resonate in nature; combined with the sweetness of Gancao, they regulate whole-body Yang Qi, hence "Acrid-Sweet transforms Yang." To prevent Yin from lagging behind and pathogens from lingering, the bitter-cool Baishao and sweet-ping Dazao are added. Bitter and Sweet combine to regulate whole-body Yin fluids, hence "Bitter-Sweet transforms Yin." When Yin and Yang harmonize at neutrality, Qi flows freely without stagnation. Hence, "When Ying and Wei harmonize, the disease resolves." Zhang Zhongjing advises drinking warm porridge after administration to aid digestion and generate sweat from grain essence, thereby strengthening Zheng Qi (Upright Qi) to overcome pathogens.
Commentary: Mahuang Tang is a potent diaphoretic. It addresses Cold damaging the Taiyang Ying level, where pathogens reside in the skin surface (superficial layer of muscle interstices, deep layer of skin). Blockage of exterior Qi makes this condition heavier than Guizhi Tang patterns. Thus, Mahuang's light and clear nature opens the pores as the sovereign herb. To ensure pathogens exit promptly, Xingren is added to facilitate Lung Qi. With free Qi movement, pathogens cannot linger. Gancao moderates the middle and supports Zheng Qi, while Guizhi guides the action from muscle interstices to the skin surface. Cold pathogens, meeting Guizhi's acrid warmth, dissipate and exit from the skin to the muscle interstices. Zhang Zhongjing omits porridge here to avoid excessive sweating induced by Mahuang. ("Diaphoresis" has deep meaning: Sweat is derived from blood, a nutrient for Ying. Why let it escape? Because Cold constriction disrupts Qi and Blood flow, causing illness. At this stage, blood cannot nourish Ying; releasing it externally represents eliminating the old to make way for the new. Patients should not fear sweating; sweat means pathogen exit. Physicians should not withhold diaphoreis; if the syndrome exists, the herb must be used. Ultimately, accurate diagnosis is paramount.)
Commentary: Huangqi Jianzhong Tang is Guizhi Tang plus Yitang and Huangqi. Guizhi Tang is the ancestral formula for harmonizing Ying and Wei. Huangqi consolidates Exterior Defensive Qi. Yitang tonifies the Middle. Chronic E Feng stems from Middle Qi insufficiency and loose Defensive Qi. Guizhi Tang harmonizes Yin and Yang; Huangqi and Yitang secure the exterior and stabilize the middle. With Middle and Defensive Qi fortified, recovery is inevitable.
Commentary: Fuzi Gancao Tang is a miraculous formula tonifying both Prenatal and Postnatal foundations. Fuzi is acrid-hot, tonifying Prenatal True Yang. Gancao is sweet, tonifying Postnatal Spleen Earth. Earth is generated by Fire, allowing Middle Qi to recover (Fuzi tonifies Prenatal Fire; strong Fire naturally generates Spleen Earth, hence "Middle Qi recovers"). Chronic Wei Han indicates insufficient Prenatal True Yang unable to resist Yin-Cold. Fuzi revives Prenatal True Fire; Gancao strengthens Postnatal Spleen Earth. How could Wei Han persist?
**Appendix: Theory of Submerged Fire**
Many fail to understand "Submerged Fire," missing the subtlety of ancient herbal usage. Consider this analogy: When fanning fire until red-hot, if not covered with ash, flames die quickly. Covered with ash, fire submerges and lasts long. Ancients understood cosmic mysteries; every herb and formula holds deep meaning. Take Fuzi and Gancao: Fuzi is Fire, Gancao is Earth. As the saying goes, "No herb is hotter than Fuzi; none is sweeter than Gancao." Pushing this to the extreme, these herbs represent the utmost potency for sustaining life. Used together, they embody returning Yang, simultaneous Prenatal-Postnatal tonification, mutual generation, and submerged fire. This must be understood.
[Interpretation] Application of Guizhi and Mahuang Tangs requires strict criteria. Modern master Yun Tieqiao offers valuable insight: "For Taiyang disease with fever, chills, headache, stiff neck, neutral mouth (moist tongue, non-red tongue body, non-dry/red lips, no thirst), and spontaneous sweating, Guizhi Tang is indicated. 'Neutral mouth' means moist tongue, non-red tongue body, non-dry/red lips, no thirst. If thirsty, dry tongue, red lips, it is Warm Disease; Guizhi is contraindicated." For Mahuang Tang: "Beyond chills, fever, headache, body ache, note two points: First, absence of sweat; Second, neutral mouth. If sweating, Mahuang is contraindicated. If thirsty, dry tongue, red lips, Guizhi is also contraindicated. Only with confirmed absence of sweat and neutral mouth is this unique miracle method effective." (From Yun's *Collected Annotations on Treatise on Cold Damage*). He Gongdu noted that Yun's three sons died of cold damage; his fourth son was critically ill. With physicians helpless, Yun prescribed Mahuang Tang with very light dosages, saving his son. This led Yun to deeply study the *Treatise on Cold Damage*, becoming a renowned master. Yet some still fear this formula. Yun's words support Zheng's view that "accurate diagnosis is paramount," so I excerpt this for reference.
Chronic E Feng usually lacks fever/headache, stemming from Middle Qi insufficiency and loose Defensive Qi, hence treated with Huangqi Jianzhong Tang. Composed of Guizhi Tang plus Huangqi and Yitang, it harmonizes Yin/Yang and secures exterior/middle. With fortified Middle and Defensive Qi, wind aversion ceases. Chronic Wei Han indicates Yuan Yang insufficiency, distinct from exterior cold aversion requiring heavy blankets; it resolves with warmth. Zheng prescribes Fuzi Gancao Tang. Only two herbs reveal profound meaning: Fuzi warms Prenatal True Yang; Gancao tonifies Postnatal Spleen Earth. Fire generates Earth, recovering Middle Qi; Earth covers Fire, preserving it. Thus, chronic Wei Han heals. The theory of Submerged Fire offers novel perspectives rarely discussed by others.
Q: Sudden swelling of head/face, blue-white complexion, heavy body, desire to sleep, feeling weightless/unanchored when eyes closed—what is the cause?
A: This is Shaoyin True Qi rising upward. Originally caused by weak Jun Fire (Heart Fire) failing to control and anchor Yin, allowing Yin Qi to surge upward, blocking the void, causing swelling. Blue-black facial color indicates excessive Yin forcing out Yuan Yang, causing the floating sensation when eyes close. This remaining True Yang is blocked by Yin and cannot return to its root. To return, Yin must be cleared, and Qiangang (Pure Yang) revived. Heavy body and somnolence reveal the true nature of Shaoyin disease. Treatment requires submerging Yang using Qianyang Dan.
**Qianyang Dan (Submerging Yang Decoction)**
Xisha (Amomi Fructus Rotundus) 1 liang, stir-fried with ginger juice; Fuzi 8 qian; Guiban (Carapax Testudinis) 2 qian; Gancao 5 qian.
**Explanation of Medicinal Intent**
Commentary: Qianyang Dan anchors Qi into the Kidney. Xisha is acrid-warm, dispersing Yin pathogens in the Middle Jiao and anchoring Qi to the Kidney. Fuzi is acrid-hot, tonifying True Yang in Kan (Kidney). True Yang is the seed of Jun Fire; tonifying True Yang strengthens Jun Fire.
Guiban is hard, born of Water essence, possessing power to open Yin and assist Yang. Viewing it merely as a diuretic or Yin-nourisher misses its function. Gancao tonifies the middle, aiding the subtle interaction of submerged fire and mutual roots. Hence, "Submerging Yang."
[Interpretation] The author cured multiple patients with splitting headaches (concussion) using Qianyang Dan, diagnosing Yin forcing Yang upward due to Yang deficiency without external pathogens. One dose brought relief; several doses ensured recovery.
Q: Near recovery, all external pathogens gone, yet whole body and face swell—why?
A: This is Middle Qi insufficiency and scattered Yuan Qi. External pathogens disrupted Qi and Blood, causing severe depletion. Middle Qi cannot instantly recover. Though pathogens are gone, Lower Jiao Yin Qi exploits Spleen Earth weakness, scattering上下 (up and down), causing generalized edema. While Jun Fire weakness fails to control Yin, this case specifically involves Spleen Earth weakness failing to control Water, leading to water flooding—named Edema (Shui Zhong). Alternatively, weak Spleen Earth fails to submerge Fire; unconcealed True Yang escapes outward, causing generalized swelling—named Qi Edema (Qi Zhong). In summary, distinguishing Qi vs. Water edema is unnecessary. Where Qi moves, Water moves; where Qi scatters, Water scatters. Treating physicians should not treat swelling directly. Knowing Earth is weak and cannot control Water, heavily tonify Earth to control Water. Knowing Yuan Yang escapes and thin Earth cannot contain it, heavily tonify Earth to submerge Fire. Once Fire is submerged and Qi anchored, Water returns to its home, preventing swelling. The classic states: "Fire does not submerge without Earth," revealing the secret of deficiency edema. Analogy: Steam rises from a steamer; place paper above, and it gets wet instantly. Thus, Qi movement drives Water movement; Qi submersion leads to Water submersion. This condition is treated with Lizhong Tang plus Sharen (Amomi Fructus), Banxia (Pinelliae Rhizoma), and Fuling (Poria) to warm and tonify Earth, leading to spontaneous recovery.
**Lizhong Tang (Regulate the Middle Decoction)**
Renshen 4 qian, Baizhu 1 liang, Ganjiang 1 liang, Gancao 3 qian [Zhi], Xisha 4 qian, Banxia 4 qian, Fuling 3 qian.
**Explanation of Medicinal Intent**
Commentary: Lizhong Tang warms the Middle. Baizhu is sovereign, greatly tonifying Middle Earth. Ganjiang is acrid-hot, warming Middle Qi. Banxia and Fuling are bland and drying, resolving phlegm and driving out water. Xisha is acrid-warm, anchoring Qi to the Kidney. Excessive acrid-drying herbs may damage Spleen blood; Renshen's slight coolness nourishes fluids, balancing rigid and soft, Yin and Yang. Gancao combined with acrid herbs transforms whole-body Yang Qi. As Yang circulates, Yin pathogens vanish. Middle Jiao strengthens, swelling disappears, ensuring health and peace.
[Interpretation] The author frequently uses Lizhong Tang with Dingxiang for chronic stomach diseases, characterized by distending/aching pain, reduced appetite, and lethargy, achieving consistent success.
Q: Seeing colorful halos in eyes, accompanied by rapid breathing—why?
A: This is Essence-Qi of the Five Viscera manifesting externally. Eye sockets gather Essence-Qi of the Five Viscera. Colorful halos indicate escaping Five Qi. Rapid breathing shows Yin pathogens invading clear pathways, with Yuan Yang about to escape through the eyes—a critical sign. Treatment requires collecting Sunlight (Yang) and returning it to its home using Santai Fengsui Dan.
**Fengsui Dan (Sealing Marrow Decoction)**
Huangbai 1 liang, Sharen 7 qian, Gancao 3 qian [Zhi].
**Explanation of Medicinal Intent**
Commentary: Fengsui Dan anchors Qi to the Kidney and tonifies Upper, Middle, and Lower Jiaos. Huangbai is bitter, entering Heart, carrying Winter/Water Qi to enter Kidney, yellow color entering Spleen. Spleen is the pivot of Water-Fire balance. This single herb embodies Tian-Di-Ren (Heaven-Earth-Human). Xisha is acrid-warm, gathering Five Viscera Qi into the Kidney. Gancao harmonizes upper/lower and submerges Fire. Once True Fire is concealed, the root of life is secure. Hence, "Sealing Marrow."
Most subtly, Huangbai's bitterness combined with Gancao's sweetness generates Yin. Xisha's acridity combined with Gancao's sweetness generates Yang. Yin-Yang harmonization meets in the Middle Jiao, achieving Water-Fire intersection, fulfilling the Tao of Three Powers. Do not underestimate this formula. I have personally experienced its efficacy for false Fire rushing up, toothache, cough, asthma, facial swelling, throat obstruction, ear swelling, red eyes, nasal congestion, enuresis, and spermatorrhea, often with unexpected results. Careful analysis reveals its core intent: harmonizing Water and Fire. Simple yet miraculous. I recommend others try it.
**Attached Seven-Character Quatrain**
Dark clouds gather, sunlight dims;
Suddenly the True Dragon flies (True Dragon is True Fire; moving up or down causes disease. Upward: toothache, asthma, ear/facial swelling. Downward: enuresis, strangury, turbid urine, leukorrhea. Scholars who recognize this True Yang's emergence can cure with hundred percent accuracy using this formula).
Understanding the formula's name, Fengsui,
Why worry that Spring won't return to the earth?
[Interpretation] Colorful halos and rapid breathing indicate escaping Essence-Qi and impending Yuan Yang loss through eyes. Zheng prescribes Santai Fengsui Dan. Xisha (acrid-warm) + Gancao (sweet) generates Yang to anchor Qi; Huangbai (bitter-cool) + Gancao (sweet) generates Yin to submerge Fire. Yin-Yang harmonization, Water-Fire intersection in Middle Jiao, secures life's root. Zheng personally treated false Fire, cough, asthma with unexpected success, realizing the formula's focus on Water-Fire harmony. Using simple herbs for miraculous effects is precious experience. The author treats Kidney-deficiency toothache with this formula, but first rinses with Pine Needle wine to expel saliva and temporarily stop pain, then takes Fengsui Dan for lasting effect.
Q: Eyes suddenly swollen like peaches, splitting headache, rapid breathing, blue-black face/lips—why?
A: This is Prenatal True Fire ascending along Liver Wood, bursting to escape through the eyes. Prenatal Fire resides in Kidney. Extreme Yin excess forces the last thread of Yuan Yang upward with Yin. Water is Mother of Wood; mother's illness affects child, so Fire ascends with Liver Wood. Jueyin meridian connects to vertex; True Qi follows meridians upward. Yang bursts, causing splitting headache. Liver opens to eyes, hence peach-like swelling. Rapid breathing indicates Yin pathogens invading clear pathways, disconnecting upper and lower. Blue-black face/lips represent pure Yin. Yuan Yang escaping is imminent. Mistaking this for Yang syndrome and using cooling/dispersing herbs will cause death within days.
Treatment requires Sini Tang (Four Reversal Decoction) to restore Yang and dispel Yin for recovery.
**Sini Tang (Four Reversal Decoction)**