四君子汤
四君子汤，补脾药也。然得黄 则补肺，得当归则补血，得山药则补脾，得干姜则温中，得丁香则温胃，
得神曲则去胃中陈腐之气。脾气困倦，加木香、砂仁之香以醒之；丹田火起，加地黄之寒以泄之；木乘土位，
加芍药以补脾阴，而泻土中之木。（周慎斋）
四物汤
丹溪治阴虚用四物汤，亦分阴阳。动者为阳，芎、归是也；
静者为阴，地芍是也。血之阴不足，虽芎、归辛温亦不可用；血之阳不足，虽姜、桂辛热亦用之。此深得补阴
之旨矣。然天地之道，阳常有余，阴常不足。人身亦然。故血者，难成而易亏，况草木无情，安能生血？不过
以地、芍能养五脏之阴，芎、归能调营中之气，阴阳调和，而血自生耳。若夫失血太多，气息几微之际，慎勿
与之。盖四物阴类，非所以生物者也。当重用参、 。故曰∶血脱益气。盖有形之血，不能速生；无形之气，
所当急固。若与四物，则芎、归辛窜耗气动血，反致气血俱亡矣。（《冯氏锦囊》）
四物汤，隐潜脾胃治法，人昧久矣。脾经少血多气，当归、地黄生血，溉灌脾土；土畏贼邪，木来克土，
芍药能泻木补脾；肝欲散，用川芎之辛以散之。岂非制木补土，脾胃之药乎？（一阳子）
四物与桂枝、麻黄、白虎、柴胡、理中、四逆、吴茱萸、承气、凉膈等方，皆可作各半汤。此易老用药大
略也。（李时珍）
是方乃肝经调血之专剂，非心经生血之主方。能补有形之血于平时，不能生无形之血于仓卒。能调阴中之
血，而不能培真阴之本。为血分立法，不专为女科套剂也。王好古治妇女，不论内伤外感，胎前产后，随证加
二味于四物中，名曰六合。未免任意牵强。（柯韵伯）
十全大补汤
伊芳尹十全大补汤中，用四君子汤补气，加木香不使上焦气滞也；用四物汤补血，加沉香不使下焦血滞也。
上古气血皆浓，故用二香补而兼之以行。若叔季之人，气血多虚，故东垣以黄 代木香，更益其气；以肉桂代
沉香，温暖其血。《经》云∶虚者十补，勿以一泻。（周慎斋）
人参养营汤
古人治气虚以四君，治血虚以四物，治气血俱虚者以八珍，更加黄 肉桂名十全大补，宜乎万举万当也。
然用之有不获效者，
何也？盖补气而不用行气之品，则气虚之甚者，无气以受补；补血而仍用行血之物，则血虚之甚者，无血以流
行。故加陈皮以行气，而补气者悉得效其力；去川芎之行血，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。（柯韵伯）
补中益气汤
是方用以补脾，使地道卑而上行也；亦可以补心、肺，损其肺者益其气，损其心者调其营卫也；亦可以补
肝木，郁则达之也。惟不宜于肾，阴虚于下者不宜升，阳虚于下者，更不宜升也。（柯韵伯）
补中益气汤，为清阳下陷者设，非为下虚者设也。倘人之两尺虚微者，或癸水销竭，或命门火衰，若再
升提，则如大木将摇而拨其本，柯韵伯所谓独不宜于肾也。（陆丽京）
补中益气汤，东垣用治劳倦内伤寒热等证。虽曰为助阳也，非发汗也。然实有不散而散之意。若全无表
邪，而但中气亏甚者，则升、柴大非所宜。盖升、柴味兼苦寒，性专疏散，惟有邪者固可用之；使或无邪，能
不因散而气愈耗乎？且凡属补阳之剂无不能升，正以阳主升也。用其升而不用其散，斯得补阳之大法。要之，
能散者，断不能聚；能泄者，断不能补。而性味之苦寒，断非扶阳之物。如表不固，汗不敛者，不可用；外无
表邪，阴虚发热者，不可用；阳气无根，格阳戴阳者，不可用；脾、肺虚甚，气促似喘者，不可用；命门火衰，
虚寒泄泻者，不可用；水亏火亢，吐血衄血者，不可用；四肢厥逆，阳虚欲脱者，不可用。总之，元气虚极者
不可泄，阴阳下竭者不可升。今人但知补中益气汤可以补虚，不知关系判于举指之间，纤微不可紊误者，正此
类也。（《景岳全书》）
东垣补中益气汤，原为感证中有内伤一种，故立此方，以补伤寒书之所未及，非补方也。今感证家多不敢
用，而以为调理补虚之药，则谬矣。（《己任编》）
补中益气汤，人皆知为上焦之药，而不知其为下焦之药也。以脉右大于左，阳陷于阴，乃从阴引阳也。六
味地黄丸，人皆以为下焦之药，而不知其为上焦之药也。以脉寸旺于尺，阳亢于上，乃从阳引阴也。○补中益
气汤若欲下达，去升麻、柴胡，加杜仲、牛膝。○脾虚而脉弦者，服补中益气汤后必发疟；脾虚而湿胜者，服
补中益气汤后必患痢。此邪寻出路，仍服前汤自愈。○用补中益气汤，必用归脾汤，引血归经；用归脾汤，必
用参苓白术散，使气下达；用十全大补汤，必用虎潜丸，纳气归肾。（周慎斋）
后天脾土，非得先天之气不行。此气因劳下陷，清不升，浊不降，故用升、柴以佐参、 ，补益后天中之先天也。
凡脾胃喜甘而恶苦；喜补而恶攻；喜温而恶寒；喜通而恶滞；喜升而恶降；喜燥而恶湿，此方得之矣。（赵养葵）
归脾汤
此方乃严用和所造，其对证则二阳之病发心脾也。盖欲补脾，则先补心；欲补心，则先补肝。所谓隔二之
治。然往往用之于吐血、咳嗽、寒热，木香多不合，以其香燥，反能动肝火而燥津液。予每去之而加白芍，以
追已散之真阴。且肺受火刑，白术太燥，恐反助嗽，得芍药之阴以为佐，亦是妙于配合。如肺肾受伤，再加麦
冬、五味；肝肾受伤，则芍药更为有益。如从怫郁而起，则加柴胡、丹、栀。如非二阳之病至怔忡，则去木香
加枸杞、麦、味之属；如梦遗，则加五味、熟地、白芍、牡蛎之属；如怔忡而挟包络有余之痰火者，则加黄连、
生地、贝母以清之；梦遗而挟相火者，则加知、柏、麦冬以清之。惟脾虚久泻者，方留木香以醒脾；脾虚挟寒
者，虽肉果、桂、附皆可加也。（《己任编》）
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∶归脾滋养心脾，鼓动少火，
妙以木香调畅诸气，世以木香性燥不用，服之多致痞闷、或泄泻减食者，以其不能输化药力故耳。（张路玉）
八味丸
生人之禀赋不齐，阴阳各有偏胜，药为补偏救弊而设。六味加桂、附，治相火不足，真阳衰惫。王冰所谓
益火之原以消阴翳，尺脉弱者宜之。桂、附易知、柏名阴八味，治阴虚火动，骨痿精枯。王冰所谓壮水之主以
制阳光，尺脉旺者宜之。（《怡堂散记》）
《金匮》用八味丸治香港脚上入少腹不仁者。香港脚，即阴气；少腹不仁，即攻心之渐。故用之以驱逐阴邪
也。其虚劳腰痛，少腹拘急，小便不利，则因过劳其肾阴，气逆于少腹，阻遏膀胱之气化，小便不能通利，故
用之以收摄肾气也。其短气有微饮者，饮亦阴类，阻其胸中之阳，自致短气，故用之引饮下出以安胸中也。消
渴病，饮水一斗，小便亦一斗，此肾气不能摄水，小便恣出，源泉有立竭之势，故急用以逆折其水也。夫肾水
下趋之消，肾气不上升之渴，非用此以蛰护封藏，蒸动水气，曷从治哉！（喻嘉言）
六味丸
仲景八味丸，钱仲阳减去桂、附，以治小儿。以小儿纯阳，故减桂、附。今用通治大方证。○按六味丸
有熟地之温，丹皮之凉，山药之涩，茯苓之渗，山萸之收，泽泻之泻，补肾而兼补脾。有补而必有泻，相和相
济，以成平补之功。乃平淡之神奇，为古今不易之良方也。即有加减，或加河车，或五味、麦冬、杜仲、牛膝，
不过一、二味极三、四味而止。今人或疑泽泻之泻而减之，多拣本草补药，恣意加入，有补无泻，且客倍于主，
责成不专，而六味之功，反退处于虚位，失制方之本旨矣。○地黄、首乌，皆君药也。故六味丸以地黄为君，
七宝丹以首乌为君，各有配合，未可同类而共施也。即有加减，当各根据本方随病而施损益。今人多以首乌加入
地黄丸中，合两方为一方，是一药二君，安所适从乎？（《医方集解》）
肾气丸
按∶加减肾气丸，《济生》以附子为君，薛新甫用茯苓为君，合之牛膝、车前，治腰以下之水。然而肾之
关门不开，必以附子回阳，蒸动肾气，其关始开，胃中积水始下，以阳主开故也。关开，即不用茯苓、牛膝、
车前，而水亦下；关阖，则茯苓、车前用至无算，抑莫如之何矣。用方者，将君附子乎，抑君茯苓乎？（喻嘉言）
左、右归饮
左归饮，治肾水干枯，虚火上蒸脾胃，阴土受亏，以致饮食不进，大便燥结，甚至三阳癃闭，将成噎隔，
治之于早，无不愈也。尝以此方加归、芍，治伤寒舌黑唇焦，大渴引饮，必服攻伐寒凉之药过多也，此方救之。
并治疟疾而兼燥证，热重寒轻者。○凡命门虚寒等证，八味丸治之不愈者，宜用右归饮。（《己任编》）
圣愈汤
《经》曰∶阴在内，阳之守也；阳在外，阴之使也。故阳中无阴，谓之孤阳；阴中无阳，谓之死阴。（丹溪）
曰∶四物皆阴，行天地闭塞之令，非长养万物者也。故四物加知、柏，久服便能绝孕，谓其嫌于无阳耳。此方
取参、 配四物，以治阴虚血脱等证。盖阴阳互为其根，阴虚则阳无所附，所以烦热燥渴，而阳亦亡；气血相
为表里，血脱则气无所归，所以睡卧不安，而气亦脱。然阴虚无骤补之法，计在存阳；血脱有生血之机，必先
补气。此阳生阴长，血随气行之理也。故曰∶阴虚则元气，无气则死矣。前辈治阴虚，用八珍、十全，卒不获
效者，因甘草之甘，不达下焦；白术之燥，不利肺肾；茯苓渗泄，碍乎生升；肉桂辛热，动其虚火。此六味皆
醇浓和平，服之则气血疏通，内外调和，合于圣度矣。（柯韵伯）
附、术附、参附三汤
卫外之阳不固而自汗，则用 附；脾中之阳遏郁而自汗，则用术附；肾中之阳浮游而自汗，则用参附。凡
属阳虚自汗，不能舍三方为治。然三方之用大矣！ 附可以治虚风；术附可以治寒
湿；参附可以壮元阳。若用其所当用，功效若神。以黄 、人参驾驭附子，固不足以自恣；术虽不足以制附，
然遇阳虚阴盛，寒湿沉痼，即生附在所必用，何取制伏为耶？（喻嘉言）
四神丸
泻利为腹疾，而腹为三阴之都会。故三阴下利，仲景各为立方以主之∶太阴有理中、四逆；厥阴有乌梅、
白头翁；少阴有桃花、真武、猪苓、猪肤、四逆汤、散、白通、通脉等剂，可谓诸法备矣。然只为一脏立法，
若三脏相关，久留不痊，如子后作泻一证，犹未及也。夫鸡鸣至平旦，天之阴，阴中之阳也。因阳气当至不至，
故作泻于黎明，其由有四∶一为脾虚不能制水；一为肾虚不能行水。故二神丸君补骨脂之辛燥，入肾以制水；
佐肉豆蔻之辛温，入脾以暖土；丸以姜、枣，又辛甘发生诸阳也。一为命门火衰，不能生土；一为少阳气虚，
无以发陈。故五味子散，君五味之酸温，以收坎宫耗散之火，使少火生气以培土；佐吴萸之辛温，以顺肝木欲
散之势，为水气开滋生之路，以奉春生也。此四者，病因虽异，而见证则同，皆水亢为害。二神丸是承制之
剂，五味子散是化生之剂也。二方理不同，而用则同。故可互用以助效，亦可合用以建功。合为四神，是制生
之剂也。制则生化，久泄自瘳矣，比理中、八味二丸较速与？（柯韵伯）
滋肾丸
水为肾之体，火为肾之用。人知肾中有水，始能制火，不知肾中有火，始能致水耳。盖天一生水，一者，
阳气也，即火也。气为水母，阳为阴根，必火有所归，斯水有所主。故反佐以桂之甘温，引知、柏入肾而奏其
效。此相须之殷，亦承制之理也。（柯韵伯）
逍遥散
肝木之所以郁者，其说有二∶一为土虚不能升木也；一为血少不能养肝也。盖肝为木气，全赖土以滋培，
水以灌溉。若中气
虚，则九地不升，而木因之郁；阴血少，则木无水润，而肝遂以枯。方用白术、茯苓者，助土德以升木也；当
归、芍药者，益营血以养肝也；丹皮解热于中；草、栀清火于下；独柴胡一味，一以厥阴报使，一以升发诸阳。
《经》云∶木郁达之，柴胡其要矣。（赵羽皇）
越鞠丸
吴鹤皋曰∶越鞠者，发越鞠郁之谓也。香附开气郁；苍术燥湿郁；抚芎调血郁；栀子解火郁；神曲消食郁。
陈来章曰∶皆理气也，气畅而郁舒矣。（《医方集解》）
越鞠之芎 ，即逍遥之归、芍也；越鞠之苍术，即逍遥之白术也；越鞠之神曲，即逍遥之陈皮也；越鞠之
香附，即逍遥之柴胡也；越鞠之栀子，即逍遥之加味也。但越鞠峻，而逍遥则和矣；越鞠燥，而逍遥则润矣。
（《己任编》）
平胃散
平胃者，欲平治其不平也。此东垣为胃强邪实者设。故其性味，从辛、从燥、从苦，而能消、能散，惟有
滞有湿有积者宜之。今见方家，每以此为常服健脾之剂，动辄用之，其误甚矣！（张景岳）
《内经》以土运太过曰敦阜，其病腹满；不及曰卑监，其病留满痞塞。张仲景制三承气汤，调胃土之敦阜；
Si Jun Zi Tang (Four Gentlemen Decoction)
Si Jun Zi Tang (Four Gentlemen Decoction) is a formula for tonifying Spleen Qi. However, adding Huangqi (Astragali Radix) tonifies the Lung; adding Danggui (Angelicae Sinensis Radix) tonifies Blood; adding Shanyao (Dioscoreae Rhizoma) tonifies the Spleen; adding Ganjiang (Zingiberis Rhizoma) warms the Middle Jiao; adding Dingxiang (Caryophylli Flos) warms the Stomach; and adding Shenqu (Massa Medicata Fermentata) eliminates stale and turbid qi in the Stomach. If Spleen Qi is tired and fatigued, add Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus) for their aromatic properties to awaken the Spleen; if fire rises from the Dantian (indicating deficiency heat from Kidney Yin deficiency), add Dihuang (Rehmanniae Radix) for its cold nature to drain heat; if Liver Wood overacts on Spleen Earth, add Shaoyao (Paeoniae Radix) to nourish Spleen Yin and drain the Wood within the Earth. (Zhou Shenzhai)
Si Wu Tang (Four Substances Decoction)
Danxi used Si Wu Tang (Four Substances Decoction) to treat Yin deficiency, distinguishing between Yin and Yang within it. The active aspect is Yang, represented by Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix); the static aspect is Yin, represented by Dihuang (Rehmanniae Radix) and Shaoyao (Paeoniae Radix). If the Yin of Blood is insufficient, even though Chuanxiong and Danggui are acrid and warm, they should not be used; if the Yang of Blood is insufficient, even though Shengjiang (Zingiberis Rhizoma Recens) and Rougui (Cinnamomi Cortex) are acrid and hot, they can be used. This deeply grasps the principle of tonifying Yin. However, the Way of Heaven and Earth is that Yang is often in excess and Yin is often deficient. The human body is the same. Therefore, Blood is difficult to generate and easy to deplete. Moreover, herbs are lifeless; how can they directly generate Blood? It is merely that Dihuang and Shaoyao can nourish the Yin of the Five Zang organs, while Chuanxiong and Danggui can regulate the Qi in the Ying (Nutritive) level. When Yin and Yang are harmonized, Blood generates naturally. In cases of massive blood loss where breath is faint, one must strictly avoid administering this formula. Since Si Wu Tang belongs to the Yin category, it is not suitable for generating life-giving Blood. One should heavily use Renshen (Ginseng Radix) and Huangqi (Astragali Radix). Thus it is said: "In blood collapse, tonify Qi." Because tangible Blood cannot be rapidly generated, whereas intangible Qi must be urgently secured. If Si Wu Tang is given, the acrid and dispersing nature of Chuanxiong and Danggui will consume Qi and disturb Blood, leading to the depletion of both Qi and Blood. (Feng Shi Jin Nang)
Si Wu Tang (Four Substances Decoction) implicitly contains methods for treating the Spleen and Stomach, which people have long misunderstood. The Spleel Meridian has little Blood and much Qi. Danggui (Angelicae Sinensis Radix) and Dihuang (Rehmanniae Radix) generate Blood and irrigate Spleen Earth. Earth fears thief pathogens (Liver Wood overacting), and Shaoyao (Paeoniae Radix) can drain Wood to benefit Spleen. The Liver desires dispersion, so the acrid nature of Chuanxiong (Ligustici Chuanxiong Rhizoma) is used to disperse it. Is this not controlling Wood to tonify Earth, making it a Spleen-Stomach herb? (Yiyangzi)
Si Wu Tang (Four Substances Decoction), along with Guizhi Tang (Cinnamon Twig Decoction), Mahuang Tang (Ephedra Decoction), Baihu Tang (White Tiger Decoction), Xiaochaihu Tang (Minor Bupleurum Decoction), Lizhong Tang (Regulate the Middle Decoction), Sini Tang (Frigid Extremities Decoction), Wuzhuyu Tang (Evodia Decoction), Chengqi Tang (Descending the Qi Decoctions), and Liangge San (Cool the Diaphragm Powder), can all be combined as "Half-Formulas" (Ge Ban Tang). This is the general principle of medication by Yi Lao. (Li Shizhen)
This formula is a specialized agent for regulating Blood in the Liver Meridian, not the main formula for generating Blood in the Heart Meridian. It can tonify tangible Blood during normal times but cannot generate intangible Blood in emergencies. It can regulate Blood within Yin but cannot cultivate the root of True Yin. It establishes laws for the Blood level, not merely as a routine formula for Gynecology. Wang Haogu treated women's diseases, regardless of internal injury or external contraction, antenatal or postnatal conditions, by adding two herbs to Si Wu Tang, naming it Liuhe Tang (Six Harmonies Decoction). This was somewhat arbitrary and forced. (Ke Yunbo)
Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction)
Yifangyin, in Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction), uses Si Jun Zi Tang (Four Gentlemen Decoction) to tonify Qi, adding Muxiang (Aucklandiae Radix) to prevent Qi stagnation in the Upper Jiao; and uses Si Wu Tang (Four Substances Decoction) to tonify Blood, adding Chenxiang (Aquilaria Lignum) to prevent Blood stagnation in the Lower Jiao. In ancient times, Qi and Blood were dense, so two aromatic herbs were used to tonify and move. For people of later ages, whose Qi and Blood are mostly deficient, Dongyuan replaced Muxiang (Aucklandiae Radix) with Huangqi (Astragali Radix) to further augment Qi; and replaced Chenxiang (Aquilaria Lignum) with Rougui (Cinnamomi Cortex) to warm the Blood. The Classic states: "For deficiency, tonify fully; do not use a single purgative method." (Zhou Shenzhai)
Renshen Yangying Tang (Ginseng Nourishing the Innervation Decoction)
The ancients used Si Jun Zi Tang (Four Gentlemen Decoction) for Qi deficiency, Si Wu Tang (Four Substances Decoction) for Blood deficiency, and Bazhen Tang (Eight Treasures Decoction) for combined Qi and Blood deficiency. Adding Huangqi (Astragali Radix) and Rougui (Cinnamomi Cortex) creates Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction), which should ideally succeed every time. Yet sometimes it fails. Why? Because tonifying Qi without using Qi-moving substances means that severe Qi deficiency lacks the Qi to receive tonification; tonifying Blood while still using Blood-moving substances means that severe Blood deficiency lacks Blood to circulate. Therefore, adding Chenpi (Citri Reticulatae Pericarpium) moves Qi, allowing those tonifying Qi to exert their power; removing Chuanxiong (Ligustici Chuanxiong Rhizoma)'s Blood-moving action allows those tonifying Blood to achieve success. This is the skill of a good practitioner: a single addition and subtraction can turn the mechanism of creation. (Ke Yunbo)
Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction)
This formula is used to tonify the Spleen, causing the Earth path (Spleen's ascending function) to rise from below; it can also tonify the Heart and Lungs; for lung damage, augment Qi; for heart damage, regulate Ying and Wei. It can also tonify Liver Wood; if constrained, disperse it. It is only unsuitable for the Kidney: Yin deficiency below should not be lifted, and Yang deficiency below should certainly not be lifted. (Ke Yunbo)
Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) is designed for sinking of Clear Yang, not for lower deficiency. If a person's Chi pulse (both wrists) is weak and minute, whether due to exhaustion of Gui Water (Kidney Yin) or decline of Mingmen Fire (Gate of Life Fire), lifting further would be like shaking a large tree by pulling its roots. This is what Ke Yunbo meant by "unsuitable for the Kidney." (Lu Lijing)
Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) was used by Dongyuan to treat symptoms such as fever and chills caused by fatigue and internal injury. Although it is said to assist Yang, it does not induce sweating. However, it has an inherent effect of dispersing without intentional dispersion. If there is no exterior pathogen at all, but only severe deficiency of Middle Qi, then Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) are highly inappropriate. Their flavor is bitter and cold, and their nature is specifically dispersing; they are only suitable for those with pathogens. If there is no pathogen, will they not cause further Qi consumption through dispersion? Furthermore, all formulas that tonify Yang have a lifting property, precisely because Yang governs ascent. Using their lifting property without their dispersing property achieves the great method of tonifying Yang. Essentially, what can disperse cannot gather; what can drain cannot tonify. Their bitter-cold nature is definitely not conducive to supporting Yang. It should not be used for unsecured exterior and non-stop sweating; for interior deficiency heat without exterior pathogens; for Yang floating away or floating to the head (Ge Yang/Dai Yang); for severe Spleen and Lung deficiency with shortness of breath resembling asthma; for Mingmen Fire decline with deficiency-cold diarrhea; for Water deficiency with Hyperactive Fire causing hematemesis or epistaxis; for cold extremities and impending Yang collapse. In summary, extreme Yuan Qi deficiency should not be drained, and exhausted Yin and Yang below should not be lifted. Today, people only know that Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) can tonify deficiency, unaware that the judgment lies in subtle details that must not be confused. This is exactly such a case. (Jing Yue Quan Shu)
Dongyuan's Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) was originally established for internal injury occurring within exogenous patterns, thus filling gaps left by Shanghan texts; it is not a tonifying formula. Now, many practitioners of exogenous diseases dare not use it, regarding it instead as a conditioning and tonifying medicine, which is erroneous. (Ji Ren Bian)
People know Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) as a formula for the Upper Jiao, but do not realize it acts on the Lower Jiao. With a pulse stronger on the right than the left, Yang sinks into Yin, drawing Yang from Yin. People consider Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) as a Lower Jiao formula, but do not realize it acts on the Upper Jiao. With a pulse stronger at the Cun position than the Chi position, Yang hyperactivity is above, drawing Yin from Yang. ○ To direct Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) downwards, remove Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), and add Duzhong (Eucommiae Cortex) and Niuxi (Achyranthis Bidentatae Radix). ○ For Spleen deficiency with a wiry pulse, taking Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) will inevitably lead to malaria; for Spleen deficiency with excessive dampness, it will inevitably lead to dysentery. This is the pathogen seeking an exit; continuing the previous formula will lead to self-healing. ○ When using Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction), one must use Guipi Tang (Restore the Spleen Decoction) to guide Blood back to its vessels; when using Guipi Tang (Restore the Spleen Decoction), one must use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) to direct Qi downward; when using Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction), one must use Huqian Wan (Tiger Crouching Pill) to guide Qi back to the Kidney. (Zhou Shenzhai)
Postnatal Spleen Earth cannot function without Pre-natal Qi. This Qi sinks due to labor, Clear Yang does not ascend, Turbid Yin does not descend. Therefore, Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) assist Renshen (Ginseng Radix) and Huangqi (Astragali Radix) to tonify the Pre-natal within the Post-natal. The Spleen and Stomach prefer sweet and dislike bitter; prefer tonification and dislike attack; prefer warmth and dislike cold; prefer free flow and dislike stagnation; prefer ascent and dislike descent; prefer dryness and dislike dampness. This formula embodies these principles. (Zhao Yangkui)
Guipi Tang (Restore the Spleen Decoction)
This formula was created by Yan Yonghe. Its indication is disease of the Two Yang (Stomach and Spleen) originating in the Heart and Spleen. To tonify the Spleen, first tonify the Heart; to tonify the Heart, first tonify the Liver. This is called treatment of the second removed organ. However, it is often used for hematemesis, cough, and alternating chills and fever. Muxiang (Aucklandiae Radix) is often unsuitable because its aromatic dryness can stir Liver Fire and dry Body Fluids. I usually remove it and add Shaoyao (Paeoniae Radix) to retrieve dispersed True Yin. Moreover, if the Lung is affected by Fire, Baizhu (Atractodis Macrocephalae Rhizoma) is too drying and may worsen cough; adding Shaoyao (Paeoniae Radix) for its Yin nature as an assistant is a clever combination. If Lung and Kidney are injured, add Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus); if Liver and Kidney are injured, Shaoyao (Paeoniae Radix) is more beneficial. If arising from depression, add Chaihu (Bupleuri Radix), Danpi (Moutan Cortex), and Zhizi (Gardeniae Fructus). If not a Two-Yang disease progressing to palpitations, remove Muxiang (Aucklandiae Radix) and add Gouqi (Lycii Fructus), Maidong (Ophiopogonis Radix), and Wuweizi (Schisandrae Fructus); if nocturnal emission, add Wuweizi (Schisandrae Fructus), Shudi (Rehmanniae Radix Preparata), Shaoyao (Paeoniae Radix), and Muli (Concha Ostreae); if palpitations accompanied by phlegm-fire excess in the Pericardium, add Huanglian (Coptidis Rhizoma), Shengdi (Rehmanniae Radix), and Beimu (Fritillariae Thunbergii Bulbus) to clear; if nocturnal emission accompanied by Minister Fire, add Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), and Maidong (Ophiopogonis Radix) to clear. Only for chronic diarrhea due to Spleen deficiency should Muxiang (Aucklandiae Radix) be retained to awaken the Spleen; for Spleen deficiency with Cold, even Rouguodou (Myristicae Semen), Rougui (Cinnamomi Cortex), and Fuzi (Aconiti Lateralis Radix Preparata) can be added. (Ji Ren Bian)
Buzhong Yiqi Tang (Supplement the Middle and Augment the Qi Decoction) and Guipi Tang (Restore the Spleen Decoction) both originate from Bao Yuan, and both add Danggui (Angelicae Sinensis Radix) and Baizhu (Atractodis Macrocephalae Rhizoma), yet they differ in lifting Stomach Qi versus nourishing Spleen Yin. Guipi Tang (Restore the Spleen Decoction) nourishes Heart and Spleen, stirring the Lesser Fire, ingeniously using Muxiang (Aucklandiae Radix) to smooth all Qi. The world avoids Muxiang (Aucklandiae Radix) due to its dry nature, and patients often experience fullness or reduced appetite after taking it, because it fails to transform and transport medicinal power. (Zhang Luyu)
Bawei Wan (Eight-Ingredient Pill)
Human endowment varies, and Yin and Yang each have excesses. Medicines are set to correct deviations and remedy defects. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) plus Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Preparata) treats insufficient Minister Fire and衰竭 of True Yang. As Wang Bing said: "Enlighten the source of Fire to eliminate Yin shadows," suitable for weak Chi pulses. Replacing Gui and Fu with Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex) creates Yin Bawei (Yin Eight-Ingredient Pill), treating Yin deficiency with hyperactive Fire, bone萎, and essence depletion. As Wang Bing said: "Strengthen the master of Water to control Solar glare," suitable for strong Chi pulses. (Yi Tang San Ji)
Jingui Yaolue uses Bawei Wan (Eight-Ingredient Pill) to treat Jiaogong (foot swelling/contraction) rising to the lower abdomen with numbness. Jiaogong is Yin Qi; lower abdominal numbness is the beginning of attacking the Heart. Thus, it is used to expel Yin pathogens. For deficiency consumptive low back pain, lower abdominal tension, and difficulty urinating, this is due to overworking Kidney Yin, causing Qi reversal in the lower abdomen, obstructing Bladder Qi transformation, preventing smooth urination. Thus, it is used to secure Kidney Qi. For shortness of breath with slight fluid retention, fluid is also Yin, obstructing Yang in the Chest, causing shortness of breath. Thus, it is used to guide fluids downward to calm the Chest. For Xiaoke (Wasting-Thirst), drinking one dou and urinating one dou, this is Kidney Qi's inability to control water, with urine flowing freely, threatening the source. Thus, it is urgently used to reverse the water flow. For Xiao (wasting) due to Kidney Water sinking, and Ke (thirst) due to Kidney Qi failing to ascend, without this formula to protect storage and vaporize water Qi, how else to treat it? (Yu Jiayan)
Liuwei Wan (Six-Ingredient Pill)
Zhongjing's Bawei Wan (Eight-Ingredient Pill), Qian Zhongyang removed Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Preparata) to treat children. Because children are Pure Yang, Gui and Fu are removed. It is now used broadly for major patterns. ○ Liuwei Wan (Six-Ingredient Pill) has the warmth of Shudi (Rehmanniae Radix Preparata), the coolness of Mudanpi (Moutan Cortex), the astringency of Shanyao (Dioscoreae Rhizoma), the leaching of Fuling (Poria), the gathering of Shanzhuyu (Corni Fructus), and the draining of Zexie (Alismatis Rhizoma). It tonifies the Kidney and simultaneously tonifies the Spleen. There must be draining alongside tonification, harmonizing and assisting each other to achieve balanced tonification. It is the miracle of plainness, an excellent formula unchanging since ancient times. Even with modifications, adding Heche (Placenta Hominis), Wuweizi (Schisandrae Fructus), Maidong (Ophiopogonis Radix), Duzhong (Eucommiae Cortex), or Niuxi (Achyranthis Bidentatae Radix) should be limited to one or two, at most three or four herbs. Today, people doubt the draining nature of Zexie (Alismatis Rhizoma) and remove it, arbitrarily adding various tonic herbs from Materia Medica. Having tonification without draining, with guest herbs doubling the host herbs, leads to lack of focus, and the efficacy of Liuwei Wan (Six-Ingredient Pill) retreats to a void position, losing the original intent of the formula. ○ Dihuang (Rehmanniae Radix) and Shouwu (Polygoni Multiflori Radix) are both Sovereign herbs. Thus, Liuwei Wan (Six-Ingredient Pill) uses Dihuang (Rehmanniae Radix) as Sovereign, while Qibao Dan (Seven-Treasure Pill) uses Shouwu (Polygoni Multiflori Radix) as Sovereign. They have different combinations and should not be mixed as similar herbs. Modifications should follow the base formula according to the disease. Today, people often add Shouwu (Polygoni Multiflori Radix) to Dihuang Wan, merging two formulas into one. This creates two Sovereigns for one herb; which one should be followed? (Yi Fang Ji Jie)
Shenqi Wan (Kidney Qi Pill)
Note: Modified Shenqi Wan (Kidney Qi Pill). Jisheng Fang uses Fuzi (Aconiti Lateralis Radix Preparata) as Sovereign; Xue Xinpu uses Fuling (Poria) as Sovereign, combined with Niuxi (Achyranthis Bidentatae Radix) and Cheqianzi (Plantaginis Semen), to treat edema below the waist. However, if the Gate of the Kidney does not open, Fuzi (Aconiti Lateralis Radix Preparata) must be used to restore Yang and vaporize Kidney Qi, so the gate opens, and stomach water begins to descend, because Yang governs opening. Once the gate opens, even without Fuling (Poria), Niuxi (Achyranthis Bidentatae Radix), or Cheqianzi (Plantaginis Semen), water will descend. If the gate closes, no matter how much Fuling (Poria) or Cheqianzi (Plantaginis Semen) is used, it is futile. Should the practitioner make Fuzi (Aconiti Lateralis Radix Preparata) the Sovereign, or Fuling (Poria)? (Yu Jiayan)
Zuogui Yin (Left Restoring Decoction) and Yougui Yin (Right Restoring Decoction)
Zuogui Yin (Left Restoring Decoction) treats dryness of Kidney Water, with Deficient Fire steaming the Spleen and Stomach, damaging Yin Earth, leading to poor appetite and dry stool, even progressing to obstruction of the Three Yang meridians and impending dysphagia. Treated early, it heals without fail. I once used this formula adding Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix) to treat typhoid with black tongue and scorched lips, intense thirst desiring drinks, caused by excessive use of attacking cold medicines. This formula rescues such cases. It also treats malaria with dryness patterns, where heat is heavy and chills are light. ○ For all conditions of Mingmen (Gate of Life) deficiency-cold where Bawei Wan (Eight-Ingredient Pill) fails, Yougui Yin (Right Restoring Decoction) should be used. (Ji Ren Bian)
Shengyu Tang (Sage Preserving Vitality Decoction)
The Classic says: "Yin inside is the guard of Yang; Yang outside is the servant of Yin." Therefore, Yang without Yin is called Solitary Yang; Yin without Yang is called Dead Yin. (Danxi) Also: "Si Wu Tang (Four Substances Decoction) consists entirely of Yin herbs, executing the command of Heaven and Earth's closure, not nurturing all things." Thus, Si Wu Tang (Four Substances Decoction) plus Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex), taken long-term, can cause sterility, because it lacks Yang. This formula takes Renshen (Ginseng Radix) and Huangqi (Astragali Radix) paired with Si Wu Tang (Four Substances Decoction) to treat Yin deficiency and Blood collapse. Because Yin and Yang are roots of each other, Yin deficiency leaves Yang without attachment, causing irritability, heat, dryness, and thirst, leading to Yang loss; Qi and Blood are exterior-interior partners, Blood collapse leaves Qi without return, causing restlessness in sleep, leading to Qi collapse. However, Yin deficiency has no method for rapid tonification; the strategy lies in preserving Yang. Blood collapse has the potential for regeneration; one must first tonify Qi. This is the principle of Yang generating Yin, and Blood following Qi. Thus it is said: "Yin deficiency [leads to] Yuan Qi [loss]; without Qi, there is death." Seniors treating Yin deficiency used Bazhen Tang (Eight Treasures Decoction) and Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction) without success because Gancao (Licorice Radix) sweetness does not reach the Lower Jiao; Baizhu (Atractodis Macrocephalae Rhizoma) dryness harms Lung and Kidney; Fuling (Poria) leaching hinders generation and ascent; Rougui (Cinnamomi Cortex) acrid-hot stirs Deficient Fire. These six ingredients [referring to the components of Shengyu Tang or contrasting elements] are mellow, rich, peaceful, and mild. Taking them makes Qi and Blood smooth, interior and exterior harmonious, conforming to Sage standards. (Ke Yunbo)
Qifu Tang (Astragalus and Aconite Decoction), Shufu Tang (Atractylodes and Aconite Decoction), Shenfu Tang (Ginseng and Aconite Decoction)
If Defensive Yang is insecure causing spontaneous sweating, use Qifu Tang (Astragalus and Aconite Decoction); if Spleen Yang is constrained causing spontaneous sweating, use Shufu Tang (Atractylodes and Aconite Decoction); if Kidney Yang is floating causing spontaneous sweating, use Shenfu Tang (Ginseng and Aconite Decoction). For all Yang deficiency spontaneous sweating, one cannot treat without these three formulas. However, their uses are vast! Qifu Tang (Astragalus and Aconite Decoction) can treat Deficient Wind; Shufu Tang (Atractylodes and Aconite Decoction) can treat Cold-Damp; Shenfu Tang (Ginseng and Aconite Decoction) can strengthen Prime Yang. If used appropriately, efficacy is miraculous. Using Huangqi (Astragali Radix) and Renshen (Ginseng Radix) to control Fuzi (Aconiti Lateralis Radix Preparata) prevents it from acting recklessly; although Baizhu (Atractodis Macrocephalae Rhizoma) cannot fully restrain Fuzi (Aconiti Lateralis Radix Preparata), in cases of Yang deficiency with Yin excess and deep-seated Cold-Damp, even raw Fuzi (Aconiti Lateralis Radix) is necessary. Why seek restraint? (Yu Jiayan)
Sishen Wan (Four Spirits Pill)
Diarrhea is an abdominal disease, and the abdomen is the confluence of the Three Yin. Thus, for Three Yin diarrhea, Zhongjing established separate formulas: Taiyin has Lizhong Tang (Regulate the Middle Decoction) and Sini Tang (Frigid Extremities Decoction); Jueyin has Wumei Wan (Mume Pill) and Baitouweng Tang (Pulsatilla Decoction); Shaoyin has Taohua Tang (Peach Seed Decoction), Zhenwu Tang (True Warrior Decoction), Zhuling Tang (Polyporus Decoction), Zhufu Tang (Pig Skin Decoction), Sini Tang (Frigid Extremities Decoction), San, Bitong Tang (White Connecting Decoction), Tongmai Sini Tang (Connecting Vessels Frigid Extremities Decoction), etc. Methods are comprehensive. However, these are established for a single Zang. If Three Zang are related and the condition persists, such as diarrhea at dawn (Ji Ming), it is not addressed. From Ji Ming to Ping Dan (dawn) is the Yin time of Heaven, Yang within Yin. Because Yang Qi should arrive but does not, diarrhea occurs at dawn. Causes include: 1. Spleen deficiency failing to control Water; 2. Kidney deficiency failing to move Water. Thus, Ershen Wan (Two Spirits Pill) uses Buguzhi (Psoraleae Fructus) as Sovereign, acrid-dry entering Kidney to control Water; assists with Roudoukou (Myristicae Semen), acrid-warm entering Spleen to warm Earth; pills with Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus), acrid-sweet to generate all Yang. 3. Mingmen (Gate of Life) Fire decline failing to generate Earth; 4. Shaoyang Qi deficiency failing to initiate growth. Thus, Wuweizi San (Schisandra Powder) uses Wuweizi (Schisandrae Fructus) as Sovereign, acrid-warm to gather scattered Fire in Kan Palace, allowing Lesser Fire to generate Qi to nurture Earth; assists with Wuzhuyu (Evodiae Fructus), acrid-warm to follow Liver Wood's desire to disperse, opening a path for Water Qi to generate, serving Spring growth. These four causes differ, but manifestations are the same, all due to Water excess harming. Ershen Wan (Two Spirits Pill) is a controlling formula; Wuweizi San (Schisandra Powder) is a generating formula. Principles differ, but usage is the same. They can be used interchangeably to aid efficacy or combined to achieve merit. Combined as Sishen Wan (Four Spirits Pill), it is a formula of control and generation. Control leads to transformation and generation; chronic diarrhea will heal. Is it faster than Lizhong Tang (Regulate the Middle Decoction) and Bawei Wan (Eight-Ingredient Pill)? (Ke Yunbo)
Zishen Wan (Nourish Kidney Pill)
Water is the substance of Kidney; Fire is the function of Kidney. People know Kidney Water controls Fire, but do not know Kidney Fire generates Water. Heaven generates Water with One; One is Yang Qi, which is Fire. Qi is the mother of Water; Yang is the root of Yin. Fire must have a home for Water to have a master. Thus, counter-assisting with Rougui (Cinnamomi Cortex) sweet-warm guides Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex) into the Kidney to achieve efficacy. This mutual assistance follows the principle of control. (Ke Yunbo)
Xiaoyao San (Free and Easy Wanderer Powder)
There are two reasons for Liver Wood constraint: 1. Earth deficiency failing to lift Wood; 2. Blood deficiency failing to nourish Liver. Liver is Wood Qi, relying entirely on Earth for nourishment and Water for irrigation. If Middle Qi is deficient, Earth does not rise, and Wood becomes constrained; if Yin Blood is scant, Wood lacks moisture, and Liver becomes withered. The formula uses Baizhu (Atractodis Macrocephalae Rhizoma) and Fuling (Poria) to assist Earth Virtue to lift Wood; Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix) to enrich Ying Blood to nourish Liver; Danpi (Moutan Cortex) clears heat in the middle; Gancao (Licorice Radix) and Zhizi (Gardeniae Fructus) clear fire below. Only Chaihu (Bupleuri Radix) serves as the messenger for Jueyin and lifts all Yang. The Classic says: "For Wood constraint, disperse it." Chaihu (Bupleuri Radix) is key. (Zhao Yuhuang)
Yueju Wan (Relieve Depression Pill)
Wu Hegao says: Yueju means releasing depression. Xiangfu (Cyperi Rhizoma) opens Qi depression; Cangzhu (Atractylodis Rhizoma) dries Damp depression; Chuanxiong (Ligustici Chuanxiong Rhizoma) regulates Blood depression; Zhizi (Gardeniae Fructus) resolves Fire depression; Shenqu (Massa Medicata Fermentata) eliminates Food depression. Chen Laizhang says: All regulate Qi; when Qi flows smoothly, depression relaxes. (Yi Fang Ji Jie)
Chuanxiong in Yueju Wan (Relieve Depression Pill) corresponds to Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix) in Xiaoyao San (Free and Easy Wanderer Powder); Cangzhu (Atractylodis Rhizoma) in Yueju Wan (Relieve Depression Pill) corresponds to Baizhu (Atractodis Macrocephalae Rhizoma) in Xiaoyao San (Free and Easy Wanderer Powder); Shenqu (Massa Medicata Fermentata) in Yueju Wan (Relieve Depression Pill) corresponds to Chenpi (Citri Reticulatae Pericarpium) in Xiaoyao San (Free and Easy Wanderer Powder); Xiangfu (Cyperi Rhizoma) in Yueju Wan (Relieve Depression Pill) corresponds to Chaihu (Bupleuri Radix) in Xiaoyao San (Free and Easy Wanderer Powder); Zhizi (Gardeniae Fructus) in Yueju Wan (Relieve Depression Pill) corresponds to the added herbs in Xiaoyao San (Free and Easy Wanderer Powder). But Yueju Wan (Relieve Depression Pill) is harsh, while Xiaoyao San (Free and Easy Wanderer Powder) is mild; Yueju Wan (Relieve Depression Pill) is drying, while Xiaoyao San (Free and Easy Wanderer Powder) is moistening. (Ji Ren Bian)
Pingwei San (Level the Stomach Powder)
Pingwei means to level the uneven. This was established by Dongyuan for Stomach Excess with Pathogenic Solidity. Thus, its nature and flavor are acrid, drying, and bitter, capable of eliminating and dispersing. It is suitable only for those with stagnation, dampness, and accumulation. Today, physicians often use this as a daily spleen-tonifying agent, using it indiscriminately. This is a great error! (Zhang Jingyue)
Neijing states that excessive Earth movement is called Dunfu, causing abdominal fullness; insufficient Earth movement is called Beijian, causing lingering fullness and obstruction. Zhang Zhongjing formulated the three Chengqi Decoctions to regulate the Dunfu of Stomach Earth;