用药如用兵，医之有方法，如兵之有军法也。医用药而无准绳，犹将之用兵而无纪律也。凡
用药须择一味为主帅，其余分佐使而驱用之。治上必达下，下病必升举，法固然也。若治病
无法，虽轻病亦不宜措手。如有邪固宜攻邪，攻邪而邪不退者，因正气虚，不能胜邪故也。
必要扶正为主，正气足，邪自然不能藏匿，求路而出矣。然又必顺其开 。令邪得有出路，
而其出无难矣。如补中益气汤，加羌活、防风，头痛加川芎、蔓荆子，使邪从汗散。若自汗
表虚，邪因虚入，补中正法，无如缓治最宜，或补中，或保元，加桂枝、白芍，因表虚也。
故正气未虚，邪气独盛，邪在于表，当却邪而存正，作伤寒治之，若病久则不可用此法。寒
热往来，仲景用小柴胡汤，黄芩清肺，柴胡行表，半夏豁痰，甘草和中是矣。又用人参者何
？为肺虚也。内热见渴，病在上焦，加麦冬、干葛。热而不渴，是未达也，加猪苓、木通。
五苓散，散表之里药，白术、茯苓各一钱五分，猪苓、泽泻各二钱，四味是矣，又用肉桂者
何？是暑热之药，能行表里，热饮通表，水调达下，烦渴饮水过多，水入则吐，心中痰湿在
内，即当利之。五苓用肉桂，补中用升麻，当知其为引使通达之妙也。潮热，病在上焦，宜
表；病在中焦，宜理；病在下焦，宜升不宜降，宜缓不宜急。使血气归于中道，斯无偏胜之
诸药方有用气留味者，有用味留气者。如补中益气汤，用之入阳分以补气，黄 、当归
气浓者，宜重用，人参、白术味浓者，次之，升麻、柴胡升散，陈皮
破滞，俱于气不利，用之宜最少，故味先而气后，后至者成功，是为用味留气。用之入阴分
以补血，人参、白术味浓者，宜重用，黄 、当归气浓者，次之，升麻、柴胡提气，陈皮行
气，俱于血有益，用之不妨多。（张东扶曰∶提气所以有益于血者，
阳生则阴长也。行气所以有益于血者，气行则血生也。）故气先
味后，后至者成功，是为用气留味。自余诸方，大约仿此而已。补中益气汤，升麻、柴胡升
提走表，黄 、陈皮气药，余皆血药。
凡服温补药，调理莫过于参苓白术散；服大热药，调理莫过于八珍散。
凡病先用热药太过，现出热证，用清凉和解，二三剂即愈。用寒凉太过，现出寒证，用
温中理脾，三五剂即愈。
上通，益气汤。下达，六味丸。
如用补中益气汤，汗少肺气不开，重用黄 ；汗多里气不守，重用人参；热不退，重用
甘草
如保元汤、益气汤、归脾汤，用木香同煎，令其气味浸入，则能助参 成功，是谓补正
却邪。四君、十全大补用木香，但以汤磨，冲和药内，不入药器同煎，令其气味不散，则能行参
之滞，是谓去邪存正。
用干姜不得用莲肉，一清一温，则温者力减，不能见功。
暑月用滋阴药，必用燥药调理，用燥药，必用滋阴药调理。
胃有邪火，宜养不宜燥，胃无邪火，宜燥不宜养。养者，养胃阴也。（张东扶曰∶此二
语殊不然，脾宜燥，胃不宜燥，不必定有火也。经云∶胃为多气多血之海，燥则气增而血耗矣，
故胃之治法始终宜养，不可偏言燥也。王胥山曰∶谓胃无邪火，宜燥不宜养，若以胃家有停
饮者当之，此理亦是，未可驳其非也。学人看书，须有圆通之法，自然四通八方，路路皆达
矣。）表里不清，但用补中益气汤。病久不愈，但宜八珍。若附子必无热证方可用；干姜、
肉桂，必是寒证方可用；血凝气滞，表上焦热，升阳散火，补中益气，调理莫过于参苓白术
散；散火调理，莫宜于八珍。补中益气，加附子合和中散，内伤尽矣。十全大补合二陈汤，
凡有湿热在上焦者，用茯神、远志，能使浊气下降；在中焦用之，能使清气上升。
参苓白术散，大人小儿俱宜之药。用砂仁，所以行滞燥湿，不可无也。
其人素见阴脉，服补药不合者，以其阴中之阳虚也。宜补阴中之阳，用八味地黄丸。但
见脉数，是为细数，细数者不治。
其人素见阳脉，服热药不得者，以其阳中之阴虚也。宜补阳中之阴，用补中益气汤。倘
脉见数，是为弦数，弦数者无妨。
人参、黄 、甘草，退热之圣药也。不有细辛，其何能使肾水之上升？不有干姜、肉桂
，其何能使邪热之发越也？（王胥山曰∶此为治虚邪、寒邪者言，与治实邪，热邪迥异。）
肺气宜敛，有不可敛者，痛不可敛，胀不可敛，浑身肿胀，俱不可敛。有不可开者，
嘈杂不可开。如治消中，不宜莲子之类。
上焦血虚，当归、肉桂多用，白术少用。中焦白术多用，血燥则与归身并用。下焦血虚
，用熟地、肉桂，涌泉火起用黄柏。
四君加用木香，治滞气在胸中。四物加用沉香，治动气在脐下。若气虚不用木香，用黄
，血虚不用沉香，用肉桂。
补脾兼补肾。如腹痛腹鸣，脾土虚寒可知。而或肾亦虚寒，倘专一补脾，未免有土克水
之患，故用药有兼施焉。山药、白茯苓、干姜所以补肾者也，而补骨脂、大茴香、肉桂、杞子、
熟地，则补脾之中，兼以补肾矣。所谓补脾兼补肾者如此。
补肾兼补脾。如小腹胀满，肾气虚寒可知。而或脾亦虚寒，倘专一补肾，未免有水来侮
土之患，故用药有概举焉。补骨脂、肉苁蓉、大茴香、肉桂，所以温肾者也，而干姜则温肾兼温
脾矣。所谓补肾兼补脾者以此。
补脾兼补肾，不宜用白术。补肾兼补脾，不宜用熟地。又二治法俱不用小茴，恐其行肾
气也。（钱登谷曰∶久泄则术反不宜，以其燥健，能渗土中真气也。故脾病久者，必兼补肾，若
脾中有湿，又不可拘此。）
凡嘈杂，脾阴不足，山药宜多用；火旺，甘草宜多用；大便艰，血燥，当归宜多用；心
不宁，莲心，苡仁宜多用。忌生熟地，脾恶血药故也。
阳虚下陷，填入命门，上无气以养而枯槁，大升大举，使气上归于肺，皮毛遂润泽。盖
阳不可下陷，下陷则阳为火而阴气绝矣。阳升则肺气下滋，气归于肺，泽及皮毛矣。
调理脾胃，有治理、调和、养补之不同。用山楂、神曲、麦冬等药谓之治。用消克之药
，以攻其病，是治贼邪也，故云治。用四君子汤谓之理，是清理之也，故云理。用参苓白术散加
益智谓之调，此药能上能下能中，故云调。用四君子汤，寒加干姜，热加川连，谓之和，有
热去热，有寒去寒，故云和。四君子汤等分用之谓之养，等分均平，不攻不入，故云养。补
者不必正治，但补肾令脾土自湿，谓之补。补者补其母也。土之母，命门火是也。
六味丸汤，用山药、白茯苓，皆脾经药也，如单补肾，不宜加入。（张东扶曰∶此论殊
不然，山药滋精固气，白茯苓极降肾逆，俱是肾精对证药。古人用此专以补肾，而兼以补脾，所
谓治病莫忘脾胃者此也，若六味去此二味用之，便不成方矣。）
命门脉实，六味丸；脉弱八味丸。如痰嗽腹胀者不宜。咳嗽夜间舌干口燥，亦可酌用。
口干不渴，血虚血燥故也，宜 归汤。
凡用温暖药，细辛切忌用之，以其引阳气上升故也。
脾多血少气，患其不醒，药味带醒，则入脾矣，如四君用陈皮之类。胃多血少气，患其
不举，药味带举，则入胃矣，如四君、八珍用半夏之类。
药有必不可用者，如肝病之于白术，脾病之于当归，肺病之于生地，肾病之于桔梗，心
病之于桂附，此则必不可用者也。有必不可已者，如纳气用地黄，脾病用茯苓，肺病用参 ，肝
病用白芍，肺火用门冬，心火用川连，胆火用黄芩，肾火用泽泻，小肠用木通，大肠用萆
，膀胱用羌活，有其证，不可不用其药也。纵有未宜处，亦当以他药制之，如藏附于术，藏
附于乌药，藏桂于芍之类也。
所谓热因寒引者，如用热药佐以辛凉，则由表达里，荣卫和而热者不燥。所谓寒因热引
者，如用寒药，佐以温热，则上通下达，炎焰消而寒者不滞。故退热用紫苏、葛根、前胡、桔梗
，攻热用黄连一分，炮姜四五分之类。
病在肝，用白术则引肝邪入脾。病在脾，用当归则引脾邪入肝。盖白术走脾，当归走肝
故也。脾虚亦忌当归，白术，用之反致胀满。
凡腰痛小腹痛者，阴中之气滞，用小茴、补骨脂行气破滞。阳痿多属于寒，琐阳固精，
苁蓉壮阳，菟丝子添精明目，杞子升发阳气，随见证用之。腰以下脚膝痿软无力，多属湿热，若
大便结燥，四物加苍术、黄柏、虎骨、龟板、汉防己之类。脾胃虚，四君子加入前药。腹胀
用苍术煮白术入药，参苓白术散亦可。骨髓中热，加知母、杜仲，补脾阴之不足，且能走肾
。诸药得牛膝下引，能退骨髓中邪热，而助诸药成功，故曰牛膝下部药也。
用川芎，不得用牛膝，嫌其行血行气也。如气血大虚，十全大补汤，加杜仲、补骨脂、
凡用阳药宜和，阴药宜急。行气药宜少不宜多，少则效，多则无效。
凡发散药内，不得用白术，白术性滞入脾，反能令邪气滞而不散也。
凡怒气伤肝，不可用白术，当用人参、黄 、五味，清理肺气。
凡用药必须求得君药。如浑身胀痛，羌活为君；血病，当归、肉桂为君；气虚，人参为
君；表虚，黄 为君。余仿此。
汗后虚烦不安，麦冬五钱，黄 二钱，当归二钱，甘草、五味各一钱，煎服。麦冬引甘
草，泻心中之火，加灯草之清空，则麦冬、甘草，降火下行甚速。
凡病势已亟，议用姜、桂、附子热药，须脉带缓沉无力，或豁大而胃气尚存者可用。倘
脉细小数，外现气促神昏，形脱音哑，自汗潮热泄泻者，切忌用之。
防风，黄 所畏。用黄 ，则防风只可用一分，多则反致不效。用羌活须用归身制之。
凡病和之不足须补，补而不愈宜发。
中气足，则清升浊降，诸病皆愈。倘宜用寒凉药，须用一二味，引入小便去，能使中气
伤寒证中，须知有内伤。杂病证中，须知重脾胃。胃气不伤，百病皆易痊。
五味味酸，从参、 、甘草，则入脾助参 ，补上焦元气，宜槌碎少用。从当归、麦冬，则
主收敛，助归、麦，滋下焦阴气，宜全用多用。入温肺汤中，收敛下行，补益真阴，桂、姜
导火，藏于九地之内，反不热而凉矣。
木香行痰导气，磨服；入补药，煎服。
升麻升气，用三分气可升至胸，用五分可升至顶，过此不可再增矣。
黄连去心肝之火。引入心用一分，引入肝用三分，俱不宜制。若酒炒入肺，则能引热入
黑山栀清中带补，泻肺肝脾三经之火，胃口痛尤宜多用。
伤血重用芍药，伤气重用甘草。白术水煮烂成饼晒干，能补脾阴之不足。鹿茸温肾，其
性走
荜茇但能温肺，肉豆蔻温肾，宜去油。白芥子破胁下痰积，不可轻用。萝卜子破痰破气。苏
马兜铃，大寒之药，用以治咳，取其清空。紫菀补血补阴。款冬劫药，必须斟酌用之。
川芎、补骨脂二味，殊不宜轻用。一则太窜散，一则太窜燥，最宜斟酌。
槟榔、枳壳，俱行气破滞之药。如胃口作痛，用良姜温散，不有槟榔，其何能使郁积下
行？上焦虚弱，用参 温补，不有枳壳，其何能使胸膈无滞？
专于补益，而不加之以行气，补益者何能成功？偏于行气，而不先之以补益，行气者何能获效？
车前子退热利小便。瞿麦利心经湿热。 蓄破血，主赤淋。
沉香行血中之气，小腹滞痛者宜之。肉桂与沉香同功，且能补血。血滞者用沉香，血虚
蟹爪能去死血，下死胎胞衣。
香附开郁行滞疏肝，故能止疟。桃仁元胡索，俱为破血之药。然香附见元胡索则破气，
红花凉血，丹皮退热，不可混施。
炮姜、肉桂，所以温胃也，见吴茱萸则温中。四君子所以补脾也，见丁香则温胃。止呕
吐必
，万升而不降。草果其性猛烈，破积气痰食。冻米温中，白糖温中，益智暖丹田，红曲健脾
蜜糖开肺润皮毛，沙糖动胃利小肠，饴糖润脾泽胃，白糖温胃，大便泻者相宜。
益智温肾，且入胃。鹿茸温肾，其性下走。肉苁蓉壮阳。肉桂行血生血温血。巴戟温肾
。以上数味，皆命门之药。命门乃阳中之阴，用之于所不当用，恐动大便。琐阳、菟丝、鹿角胶
、鹿角霜、破故纸、小茴香、枸杞子，以上数味，俱少阴肾药。肾乃阴中之阳，用之于所不
苁蓉补肾中之阴，菟丝子补肾经之阳，杜仲平肾经气分之湿。益智温肾，与山药同用，
上焦满闷，用紫苏、杏仁、陈皮。中焦满闷，用炮姜、肉桂、吴茱萸。下焦亦同中焦。
但加小茴。上焦热，用栀子。中焦热，用黄连。下焦热，用黄柏。上焦虚，用保元汤。中焦虚，
用补中益气汤。下焦虚，用地黄丸。上焦嘈杂，用生地。中焦嘈杂，用山药。下焦嘈杂，用
气结涩，苏梗、杏仁。血结涩，桃仁红花。木瓜淡能利湿。青皮泄肝气，不使之上升。
枳壳解肝结利气。防风为却风润剂，去肝家气分之风。蒺藜去肝家血分之风，益心火，制肺金，
所以疏肝。萆 去肾湿，亦平肝家血分之湿。山栀清肝火。柴胡清胆火。郁李仁清利胆气，
Using medicine is like using troops; a physician's methods are like an army's military laws. If a physician uses medicine without standards, it is like a general using troops without discipline. In all medication, one must select one herb as the commander (Jun Yao), while the remaining herbs serve as assistants (Zuo Yao) and guides (Shi Yao). Treating diseases in the upper part requires the medicinal force to reach the lower part; treating diseases in the lower part requires lifting methods; this is the inherent principle. If there is no correct method for treatment, even mild diseases should not be approached. If pathogenic factors exist, they should naturally be attacked; if attacking pathogens does not eliminate them, it is because the righteous Qi (Zheng Qi) is deficient and cannot overcome the pathogens. At this time, supporting the righteous Qi must be the priority. Once the righteous Qi is sufficient, pathogens can no longer hide and will find a way out. However, one must also follow the trend of opening up, allowing pathogens an exit, so that their expulsion becomes easy. For example, in Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), adding Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix), and for headache adding Chuanxiong (Ligustici Chuanxiong Rhizoma) and Manjingzi (Viticis Semen), allows pathogens to disperse through sweat. If there is spontaneous sweating and exterior deficiency, with pathogens entering due to deficiency, the standard method of tonifying the middle is appropriate, but slow treatment is most suitable. One may use Buzhong Yiqi Tang or Baoyuan Tang (Protect the Origin Decoction), adding Guizhi (Cinnamomi Ramulus) and Baishao (Paeoniae Radix Alba) due to exterior deficiency. Therefore, if righteous Qi is not deficient and only pathogens are abundant, with pathogens at the exterior, one should dispel pathogens and preserve righteous Qi, treating it as a Shanghan (Cold Damage) disease; however, if the illness has persisted for a long time, this method should not be used. For alternating chills and fever, Zhang Zhongjing used Xiaochaihu Tang (Minor Bupleurum Decoction); Huangqin (Scutellariae Radix) clears lung heat, Chaihu (Bupleuri Radix) releases the exterior, Banxia (Pinelliae Rhizoma) resolves phlegm, and Gancao (Glycyrrhizae Radix et Rhizoma) harmonizes the middle Jiao. Why is Renshen (Ginseng Radix) added? Because of lung deficiency. Internal heat with thirst indicates disease in the Upper Jiao; add Maidong (Ophiopogonis Radix) and Gegen (Puerariae Lobatae Radix). Fever without thirst indicates stagnation; add Zhuling (Polyporus) and Mutong (Akebiae Caulis). Wuling San (Five-Ingredient Powder with Poria) is a formula for dispersing interior pathogens from the exterior. Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria) each 1.5 qian, Zhuling 2 qian, and Zexie (Alismatis Rhizoma) 2 qian constitute the main ingredients. Why is Rougui (Cinnamomi Cortex) added? Rougui is a herb for summerheat-heat, capable of circulating through the exterior and interior; taken hot, it reaches the exterior; taken with water, it descends to the lower part. For excessive thirst and drinking, where water intake leads to vomiting, and phlegm-dampness is retained in the heart region, diuresis is indicated. The use of Rougui in Wuling San and Shengma (Cimicifugae Rhizoma) in Buzhong Yiqi Tang demonstrates the subtlety of using guiding herbs to facilitate circulation. Tidal fever: if the disease is in the Upper Jiao, release the exterior is appropriate; if in the Middle Jiao, regulate is appropriate; if in the Lower Jiao, lift rather than descend, and treat slowly rather than urgently. This ensures blood and Qi return to the central pathway, avoiding bias.
Various formulas have effects of "using flavor to retain qi" or "using qi to retain flavor." For instance, when Buzhong Yiqi Tang enters the Yang aspect to tonify Qi, Huangqi (Astragali Radix) and Danggui (Angelicae Sinensis Radix) have strong qi properties and should be used in heavy doses; Renshen and Baizhu have strong flavor properties and are secondary; Shengma and Chaihu ascend and disperse, Chenpi (Citri Reticulatae Pericarpium) breaks stagnation; these are less favorable for qi, so they should be used in minimal amounts. Thus, flavor acts first and qi second; the latter succeeds, which is called "using flavor to retain qi." When entering the Yin aspect to tonify Blood, Renshen and Baizhu (strong flavor) are used heavily; Huangqi and Danggui (strong qi) are secondary; Shengma and Chaihu lift qi, Chenpi moves qi; these benefit blood, so they can be used in larger quantities. Thus, qi acts first and flavor second; the latter succeeds, which is called "using qi to retain flavor." Other formulas generally follow this principle. In Buzhong Yiqi Tang, Shengma and Chaihu lift and move to the exterior; Huangqi and Chenpi are qi herbs; the rest are blood herbs.
For regulation with warm-tonifying medicines, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) is unsurpassed; for regulation with strongly heating medicines, Bazhen San (Eight-Treasure Powder) is unsurpassed.
If a disease is initially treated with excessive hot medicines, resulting in heat signs, cool and harmonizing medicines will cure it in two to three doses. If cold-cooling medicines are overused, resulting in cold signs, warm-middle and spleen-regulating medicines will cure it in three to five doses.
For upper blockage, use Buzhong Yiqi Tang. For lower blockage, use Liuwei Wan (Six-Ingredient Rehmannia Pill).
When using Buzhong Yiqi Tang: if sweat is scant and lung qi is unopened, increase Huangqi; if sweat is profuse and interior qi is unsecured, increase Renshen; if fever persists, increase Gancao.
When using Baoyuan Tang, Buzhong Yiqi Tang, or Guipi Tang (Restore the Spleen Decoction), decocting with Muxiang (Aucklandiae Radix) allows its aroma to penetrate, assisting Renshen and Huangqi, termed "tonifying righteousness to repel pathogens." When using Sijunzi Tang (Four Gentlemen Decoction) or Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction), Muxiang is ground into powder and mixed into mild medicines, not decocted together, to prevent aroma loss, thereby moving Renshen's stagnation, termed "removing pathogens to preserve righteousness."
Do not use Lianrou (Lotus Seed Endocarp) with Ganjiang (Zingiberis Rhizoma); one clears and one warms, reducing the warming power and efficacy.
In summer, when using yin-nourishing medicines, dryness-resolving medicines must be used for regulation; when using dryness-resolving medicines, yin-nourishing medicines must be used for regulation.
If the stomach has evil fire, nourishment is preferred over drying; if no evil fire, drying is preferred over nourishment. Nourishment refers to nourishing stomach yin. (Zhang Dongfu says: This statement is incorrect. The spleen prefers drying, the stomach does not; it is not necessary to have fire. The classics state: The stomach is the sea of abundant qi and blood. Drying increases qi and consumes blood. Therefore, stomach treatment always favors nourishment, never片面ly favoring drying. Wang Xushan says: Saying the stomach without evil fire prefers drying over nourishment applies if there is fluid retention in the stomach; this logic is sound and should not be refuted. Students must read with flexibility to achieve comprehensive understanding.) For unclear exterior-interior states, use only Buzhong Yiqi Tang. For chronic non-healing conditions, only Bazhen Tang is suitable. Fuzi (Aconiti Lateralis Radix Praeparata) should only be used if there are no heat signs; Ganjiang and Rougui should only be used if there are cold signs. For blood stasis and qi stagnation with upper jiao heat, raising yang and scattering fire, Buzhong Yiqi Tang is used; for regulation, Shenling Baizhu San is unsurpassed. For scattering fire and regulation, Bazhen Tang is most suitable. Buzhong Yiqi Tang plus Fuzi combined with Hezhong San (Harmonize the Middle Powder) treats all internal injuries. Shiquan Dabu Tang combined with Erchen Tang (Two-Aged Decoction): for damp-heat in the upper jiao, Fushen (Poria cum Radix) and Yuanzhi (Polygalae Radix) cause turbid qi to descend; in the middle jiao, they cause clear qi to ascend.
Shenling Baizhu San is suitable for adults and children. Shaoren (Amomi Fructus Rotundus) is essential for moving stagnation and drying dampness.
If a person typically presents with yin pulses and does not respond well to tonics, it is due to deficiency of yang within yin. Tonify yang within yin using Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill). If the pulse is rapid, specifically fine-rapid (Xi Shu), it is incurable.
If a person typically presents with yang pulses and does not respond well to hot medicines, it is due to deficiency of yin within yang. Tonify yin within yang using Buzhong Yiqi Tang. If the pulse is rapid, specifically wiry-rapid (Xian Shu), it is not concerning.
Renshen, Huangqi, and Gancao are supreme herbs for clearing heat. Without Xixin (Asari Radix et Rhizoma), how can kidney water ascend? Without Ganjiang and Rougui, how can evil heat expand? (Wang Xushan says: This refers to treating deficiency-cold and cold pathogens, distinct from excess-heat and heat pathogens.)
Lung qi should be astringent, but not in cases of pain, distension, or generalized edema. It should not be dispersed in cases of acid regurgitation/heartburn. For treating Xiao Zhong (Middle Consumptive Disease/Diabetes), avoid Lotus Seeds.
For upper jiao blood deficiency, use more Danggui and Rougui, less Baizhu. For middle jiao, use more Baizhu; if blood is dry, combine with Danggui body. For lower jiao blood deficiency, use Shudi (Rehmanniae Radix Preparata) and Rougui; if fire rises from Yongquan (KI1), use Huangbai (Phellodendri Cortex).
Add Muxiang to Sijunzi Tang to treat chest qi stagnation. Add Chenxiang (Aquilariae Lignum Resinatum) to Siwu Tang (Four Substances Decoction) to treat qi movement below the umbilicus. If qi deficient, do not use Muxiang, use Huangqi instead; if blood deficient, do not use Chenxiang, use Rougui instead.
Tonify spleen while tonifying kidney. Abdominal pain and borborygmus indicate spleen earth deficiency and cold. If kidney is also deficient and cold, solely tonifying the spleen risks Earth overcoming Water. Therefore, herbs are combined. Shanyao (Dioscoreae Rhizoma), Fuling, and Ganjiang tonify kidney; Buguzhi (Psoraleae Fructus), Dahuixiang (Foeniculi Fructus), Rougui, Gouqizi (Lycii Fructus), and Shudi tonify spleen while simultaneously tonifying kidney. This is "tonifying spleen while tonifying kidney."
Tonify kidney while tonifying spleen. Lower abdominal fullness indicates kidney qi deficiency and cold. If spleen is also deficient and cold, solely tonifying the kidney risks Water insulting Earth. Therefore, herbs are broadly selected. Buguzhi, Rongrong (Cynomorii Herba), Dahuixiang, and Rougui warm the kidney; Ganjiang warms both kidney and spleen. This is "tonifying kidney while tonifying spleen."
When tonifying spleen while tonifying kidney, avoid Baizhu. When tonifying kidney while tonifying spleen, avoid Shudi. Also, avoid Xiaohui (Foeniculi Fructus) in both methods to prevent moving kidney qi. (Qian Denggu says: For chronic diarrhea, Baizhu is unsuitable because its dryness and strength can seep out the true qi of the earth. Thus, chronic spleen disease must combine kidney tonification. If there is dampness in the spleen, do not adhere strictly to this rule.)
For heartburn: if spleen yin is insufficient, use more Shanyao; if fire is hyperactive, use more Gancao; if stool is hard due to blood dryness, use more Danggui; if heart is unsettled, use more Lianxin (Nelumbinis Plumula) and Yiren (Coicis Semen). Avoid Shengdi (Rehmanniae Radix) and Shudi because the spleen dislikes blood-invigorating herbs.
Yang deficiency sinking into Mingmen (Gate of Life) causes upper body withering due to lack of qi nourishment. Greatly lift and raise to return qi to the lungs, moistening skin and hair. Yang must not sink; if it sinks, Yang becomes Fire and Yin Qi perishes. Yang rising allows Lung Qi to nourish downwards, returning to the lungs and moistening skin and hair.
Regulating the spleen and stomach involves governance, harmonization, and nourishment. Using Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata), and Maidong is called "Governance" (Zhi), attacking pathogenic thieves. Using Sijunzi Tang is called "Regulation" (Li), meaning cleaning. Using Shenling Baizhu Tang plus Yizhi Ren (Alpiniae Oxyphyllae Fructus) is called "Harmonization" (Tiao), as it works on upper, middle, and lower. Adding Ganjiang for cold or Huanglian (Coptidis Rhizoma) for heat to Sijunzi Tang is called "Harmony" (He), removing heat or cold. Using equal parts of Sijunzi Tang is called "Nourishment" (Yang), balancing without attacking. Tonification (Bu) need not be direct; tonifying the kidney makes spleen earth naturally moist. Tonification tonifies the mother. The mother of Earth is the Fire of Mingmen.
In Liuwei Wan Tang, Shanyao and Fuling are spleen channel herbs; if solely tonifying the kidney, they should not be added. (Zhang Dongfu says: This is incorrect. Shanyao nourishes essence and secures qi; Fuling directs rebellious kidney qi downward. Both are specific for kidney essence. Ancients used them to tonify kidney while supplementing spleen, embodying "do not forget spleen and stomach when treating disease." Removing them from Liuwei Wan ruins the formula.)
If Mingmen pulse is solid, use Liuwei Wan; if weak, use Bawei Wan. Contraindicated for phlegm-cough and abdominal distension. Night cough with dry tongue and mouth may酌情 use it.
Dry mouth without thirst indicates blood deficiency and dryness; use Danggui Tang.
When using warm medicines, strictly avoid Xixin, as it draws Yang qi upward.
The spleen has much blood but little qi, prone to lethargy; herbs with awakening properties enter the spleen, e.g., Chenpi in Sijunzi Tang. The stomach has much blood but little qi, prone to sinking; herbs with lifting properties enter the stomach, e.g., Banxia in Sijunzi Tang or Bazhen Tang.
Some herbs are absolutely contraindicated: Baizhu for liver disease, Danggui for spleen disease, Shengdi for lung disease, Jiegeng (Platycodonis Radix) for kidney disease, Guizhi (Cinnamomi Ramulus) and Fuzi for heart disease. Some herbs are indispensable: Dihuang for grasping qi, Fuling for spleen disease, Renshen/Huangqi for lung disease, Baishao (Paeoniae Radix Alba) for liver disease, Maidong for lung fire, Huanglian for heart fire, Huangqin (Scutellariae Radix) for gallbladder fire, Zexie for kidney fire, Mutong for small intestine, Bibi (Dioscoreae Hypoglaucae Rhizoma) for large intestine, Qianghuo (Notopterygii Rhizoma et Radix) for bladder. If symptoms exist, these herbs must be used. If unsuitable, counteract with other herbs, e.g., hiding Fuzi within Baizhu or Wuyao (Linderae Radix), hiding Guizhi within Baishao.
"Heat guided by cold": using hot herbs with acrid-cool auxiliaries allows entry from exterior to interior, harmonizing Ying and Wei so heat is not drying. "Cold guided by heat": using cold herbs with warm-hot auxiliaries allows upper-lower communication, extinguishing flame so cold is not stagnant. Thus, for clearing heat, use Zisu (Perillae Folium), Gegen, Qianhu (Peucedani Radix), Jiegeng; for attacking heat, use 1 fen Huanglian and 4-5 fen Paojiang (Zingiberis Rhizoma Preparata).
Disease in liver: using Baizhu draws liver pathogens to spleen. Disease in spleen: using Danggui draws spleen pathogens to liver. Because Baizhu travels to spleen and Danggui travels to liver. Spleen deficiency also avoids Danggui and Baizhu, as they cause distension.
Lower back and lower abdominal pain indicates qi stagnation in yin; use Xiaohui and Buguzhi to move qi and break stagnation. Impotence often belongs to cold; Suoyang (Cynomorii Herba) secures essence, Rongrong strengthens yang, Tusizi (Cuscutae Semen) adds essence and brightens eyes, Gouqizi raises yang. Use according to syndrome. Weakness in knees and legs below waist often belongs to damp-heat; if constipation, use Siwu Tang plus Cangzhu (Atractylodis Rhizoma), Huangbai, Hugu (Pantheris Os), Guiban (Testudinis Carapax et Plastrum), Hanfangji (Stephaniae Tetrandrae Radix). For spleen-stomach deficiency, add Sijunzi Tang to previous herbs. For abdominal distension, decoct Cangzhu with Baizhu and add to medicine; Shenling Baizhu San is also suitable. For heat in bone marrow, add Zhimu (Anemarrhenae Rhizoma) and Duzhong (Eucommiae Cortex) to tonify spleen yin and reach kidney. All herbs guided downward by Niuxi (Achyranthis Bidentatae Radix) clear bone marrow heat and assist success; thus Niuxi is a lower-body herb.
Do not use Niuxei with Chuanxiong, as both move blood and qi. For severe qi and blood deficiency, use Shiquan Dabu Tang plus Duzhong and Buguzhi.
Yang herbs should be harmonized; yin herbs should be urgent. Qi-moving herbs should be few, not many; few are effective, many are ineffective.
In dispersing formulas, do not use Baizhu; its sticky nature enters spleen and traps pathogens.
For anger injuring liver, do not use Baizhu; use Renshen, Huangqi, and Wuweizi (Schisandrae Fructus) to clear lung qi.
Always identify the Jun (Commander) herb. For whole-body pain/distension, Qianghuo is Jun; for blood disease, Danggui and Rougui are Jun; for qi deficiency, Renshen is Jun; for exterior deficiency, Huangqi is Jun. Follow this pattern.
After sweating, with deficiency vexation and unrest: Maidong 5 qian, Huangqi 2 qian, Danggui 2 qian, Gancao and Wuweizi 1 qian each. Decoct and drink. Maidong guides Gancao to drain heart fire; adding Dengcao (Junci Medulla) clears emptiness, making Maidong and Gancao descend fire rapidly.
For critical illness, considering Jiang (Ginger), Gui (Cinnamon), Fuzi (Aconite): usable only if pulse is slow, deep, and weak, or wide with preserved stomach qi. Contraindicated if pulse is fine-rapid, with shortness of breath, confusion, emaciation, hoarseness, spontaneous sweating, tidal fever, or diarrhea.
Fangfeng is feared by Huangqi. When using Huangqi, Fangfeng should be limited to 1 fen; more reduces efficacy. When using Qianghuo, constrain it with Danggui body.
If harmonization is insufficient, tonify; if tonification fails, disperse.
Sufficient middle qi leads to clear ascending and turbid descending, curing all diseases. If cold-cooling herbs are needed, use 1-2 to guide via urine, restoring middle qi.
In Shanghan, know internal injury exists. In miscellaneous diseases, prioritize spleen and stomach. If stomach qi is unharmed, hundred diseases heal easily.
Wuweizi is sour. With Renshen, Huangqi, Gancao, it enters spleen to assist Renshen/Huangqi in tonifying upper jiao yuan qi; crush lightly and use sparingly. With Danggui, Maidong, it astrings, assisting them to nourish lower jiao yin; use whole and in larger doses. In Wenfei Tang, it astrings and descends, tonifying true yin; Gui and Jiang guide fire, hiding it within the earth, becoming cool rather than hot.
Muxiang moves phlegm and guides qi: grind and take; decoct with tonics.
Shengma lifts qi: 3 fen lifts to chest, 5 fen lifts to vertex; do not exceed.
Huanglian clears heart and liver fire. 1 fen guides to heart, 3 fen guides to liver; do not process. Wine-fried for lung guides heat into... (text incomplete).
Heishanzhi (Gardeniae Fructus) clears and tonifies, draining fire from lung, liver, and spleen channels; especially suitable for stomach pain.
For blood injury, heavily use Shaoyao; for qi injury, heavily use Gancao. Baizhu boiled soft, dried into cakes, tonifies spleen yin insufficiency. Lurong (Cervi Cornu Degelatinatum) warms kidney, nature moves... (text incomplete).
Bibo (Piperis Longi Fructus) only warms lung; Rou Doukou (Myristicae Semen) warms kidney, remove oil. Baijiezi (Brassicae Semenis) breaks phlegm accumulation under ribs, use cautiously. Luoboziren (Raphani Semen) breaks phlegm and qi. Su... (text incomplete).
Madouling (Aristolochiae Manshuriensis Fructus) is very cold, used for cough to clear emptiness. Ziwan (Asternis Radix) tonifies blood and yin. Kuandonghua (Farfarae Flos) is a harsh herb, use with caution.
Chuanxiong and Buguzhi should not be used lightly. One is too dispersing, the other too drying; exercise caution.
Binglang (Arecae Semen) and Zhike (Aurantii Fructus Immaturus) move qi and break stagnation. For stomach pain, use Liangjiang (Alpiniae Officinarum Rhizoma) to warm and disperse; without Binglang, how can stagnation descend? For upper jiao weakness, tonify with Renshen/Huangqi; without Zhike, how can chest/diaphragm be free of stagnation?
Tonification without qi-moving herbs fails; qi-moving without prior tonification fails.
Cheqianzi (Plantaginis Semen) clears heat and promotes urination. Qumai (Dianthi Herba) drains damp-heat from heart channel. Xu... (text incomplete) breaks blood, treats red strangury.
Chenxiang moves qi within blood, suitable for lower abdominal stagnation/pain. Rougui has same function and tonifies blood. For blood stagnation, use Chenxiang; for blood deficiency... (text incomplete).
Xiezha (Carcinis Pedis Spina) removes dead blood and delivers dead fetus/placenta.
Xiangfu (Cyperi Rhizoma) opens depression, moves stagnation, soothes liver, stops malaria. Taoren (Persicae Semen) and Yuanshusu (Curcumae Phaeocaulis Rhizoma) break blood. Xiangfu meets Yuanshusu to break qi. Honghua (Carthami Flos) cools blood, Danpi (Moutan Cortex) clears heat; do not mix indiscriminately.
Paojiang and Rougui warm stomach; meet Wuzhuyu (Evodiae Fructus) to warm middle. Sijunzi Tang tonifies spleen; meet Dingxiang (Caryophylli Flos) to warm stomach. To stop vomiting, must... (text incomplete) rise ten thousand times without descending. Caoguo (Tsaoko Fructus) is fierce, breaks accumulated qi/phlegm/food. Dongmi (Frozen Rice) warms middle; Baitang (White Sugar) warms middle; Yizhi Ren warms Dantian; Hongqu (Red Yeast Rice) strengthens spleen. Mitang (Honey) opens lung, moistens skin/hair; Shatang (Brown Sugar) moves stomach, benefits small intestine; Yitang (Maltose) moistens spleen, lusters stomach; Baitang warms stomach, suitable for diarrhea.
Yizhi Ren warms kidney and enters stomach. Lurong warms kidney, nature moves downward. Rongrong strengthens yang. Rougui moves, generates, and warms blood. Bajitian (Morindae Officinalis Radix) warms kidney. These are Mingmen herbs. Mingmen is yin within yang; misuse may disturb bowels. Suoyang, Tusizi, Lujiaojiao (Cervi Cornus Colla), Lujiaoshuang (Cervi Cornus Degelatinatum Fragmentum), Poguzhi, Xiaohui, Gouqizi are Shaoyin kidney herbs. Kidney is yang within yin; misuse... (text incomplete).
Rongrong tonifies kidney yin; Tusizi tonifies kidney channel yang; Duzhong dries dampness in kidney channel qi aspect. Yizhi warms kidney, use with Shanyao... (text incomplete).
Upper jiao fullness: Zisu, Xingren (Pruni Armeniaci Semen), Chenpi. Middle jiao fullness: Paojiang, Rougui, Wuzhuyu. Lower jiao same as middle, add Xiaohui. Upper jiao heat: Zhizi (Gardeniae Fructus). Middle jiao heat: Huanglian. Lower jiao heat: Huangbai. Upper jiao deficiency: Baoyuan Tang. Middle jiao deficiency: Buzhong Yiqi Tang. Lower jiao deficiency: Dihuang Wan. Upper jiao heartburn: Shengdi. Middle jiao heartburn: Shanyao. Lower jiao heartburn... (text incomplete).
Qi knot/stagnation: Sugeng (Perillae Caulis), Xingren. Blood knot/stagnation: Taoren, Honghua. Mugua (Chaenomelis Fructus) is bland, drains dampness. Qingpi (Citri Reticulatae Pericarpium Viride)泄s liver qi, prevents ascent.
Zhike resolves liver knots, benefits qi. Fangfeng is wind-dispelling and moistening, removes wind from liver qi aspect. Jili (Tribuli Fructus) removes wind from liver blood aspect, benefits heart fire, controls lung metal, thus soothes liver. Bibi removes kidney dampness, also dries liver blood dampness. Zhizi clears liver fire. Chaihu clears gallbladder fire. Yuliren (Pruni Semen) clears/benefits gallbladder qi,