【歌】营运不息真元气，出自中焦统属肺。外护皮毛内导血，冲和百脉名为卫。七情六欲有所干，清者浊
而行者滞。扰乱妄动失其常，痞闷壅塞从此致。局方治气多辛温，往往流传千古弊。至我丹溪一发挥，凡气有
余从火治。气变火证常八九，冷生气者无一二。气虚气实细斟量，勿泥辛香峻削剂。
【论】夫气者，氤氲浩大之元气。斯气也，在外则卫护皮毛，充实腠理；在内则导引血脉，调和阴阳。周
流一身，营运不息，如环无端，出入升降，继而有常，源出中焦，总统于肺，气曷赏病于人也。及其七情之交
攻，五志之间发，乖戾失常，则清者遽变而为浊，行者抑遏而反止，扰乱妄动，失其常度，变而为火。河间云∶
五志过极，则为火也。丹溪云∶气有余，便是火。又云∶上升之气，至肝而出，中挟相火，冷生气者，十无一、
二也。若此者，则气之属火明矣。而局方以沉香、木香、丁、檀、藿、麝等香，与香附、砂仁、丁皮、益智、
三棱、蓬术、枳壳、枳实、青皮、浓朴、半夏、乌药、紫苏、莱菔子等辛香燥剂之破耗者，通治诸气，此千古
之弊也。丹溪《局方发挥》痛斥其非，以开后学之盲聩。若痞闷壅塞，喘满肿胀之证，或暂用以开导，若使常
服久服，宁无助火添病，耗损真气乎？然，气有虚有实，安可一概治之乎？消息而调之可也。
【脉】下手脉沉，便知是气。沉极则伏，濡软难治。其或沉滑，气兼痰饮。
气虚
劳役伤气，中气不足，四君子汤、补中益气汤。真气虚，脉脱神衰，气短不足息，人参养荣汤、生脉散。
气血两虚，自汗喘急，脉细，十全大补汤、八珍汤。
四君子汤（方见脾胃条。）
人参养荣汤
治积劳虚损，气血俱亏。
人参（一钱，去芦） 白术（一钱，土炒） 白茯苓（八分） 陈皮（八分） 甘草（炙，八分） 黄
（蜜炙，八分） 当归（一钱） 白芍药（酒炒，一钱） 熟地黄（一钱） 远志（去心，八分） 五味子
（八分） 肉桂（七分）
上锉，一剂，姜三片，枣二枚，水二盏，煎一盏，清晨服。
补中益气汤（方见内伤条。）
生脉散
清暑益气，生脉补元。
人参（去芦，一钱） 麦门冬（去心，一钱） 五味子（一钱）
上用水煎，时时服之。
八珍汤
平补气血，调和阴阳。
白术（一钱，炒） 人参（一钱） 当归（一钱二分） 熟地黄（一钱五分） 川芎（八分） 白芍药
（一钱） 白茯苓（一钱） 甘草（八分）
上锉，一剂，水二盏，煎一盏，空心服。
十全大补汤
治男子、女人诸虚不足，五劳七伤。
白术（炒，一钱半） 人参（去芦，一钱） 白茯苓（一钱） 甘草（炙，一钱）
当归（一钱二分） 白芍药（一钱） 川芎（八分） 熟地黄（一钱五分） 黄 （蜜炙，一钱） 肉桂（七分）
上锉，一剂，水二盏，姜三片，枣二枚，煎一盏，食前服。
气实
气实者，邪气实也，乃为气实，当从火治。气有余，便是火，当归龙荟丸。气实胀满，四七汤加黄芩、
黄连、山栀、香附、枳实、陈皮之类。挟痰者，加栝蒌、贝母、香附、海石之类治之。
当归龙荟丸（方见胁痛条。）
四七汤
治气实胀满，胸膈不舒，一切诸气之证。
浓朴（一两半） 茯苓（一两半） 半夏（二两半） 紫苏（一两）
上锉，每服五钱，姜三片，枣二枚，水二盏，煎一盏服。
气滞
气滞者，郁而不伸也，木香化滞汤主之。破滞气在上，枳壳、桔梗、砂仁、香附。在中，浓朴、枳实。
在下，青皮、木香、槟榔。因怒而气滞不行者，二陈汤加山栀、柴胡、香附。气滞而痛，再加木香、乌药。在
内挟相火上冲而气滞者，知母、黄柏、黄芩、黄连、香附。阴虚气滞者，四物汤加知母、黄柏。
木香化滞汤
治因忧、气、食、湿，面结于中脘，腹皮底微痛，心下痞满，不思饮食，食之不散，常常痞气。
枳实（二分） 柴胡（四分） 木香（三分） 陈皮（五分） 甘草（一分） 半
夏（姜制，一钱） 草豆蔻（五分） 当归（二分） 红花（一分）
上锉，一剂，姜三片，水二盏，煎一盏，空心服。
气寒
气寒者，明知身受寒气，口食寒物。在表，身热者，麻黄、桂枝之类。寒气犯脑作痛，羌活黑附汤。寒气
犯胃作痛，草豆蔻丸。寒气在腹作痛，作泻，作呕，厥逆者，理中汤。寒气在少腹作痛，脉沉迟，厥冷，四逆
汤加吴茱萸，或理中汤加吴茱萸。
羌活黑附汤
羌活（五分） 黑附（炮，三分） 苍术（五分） 麻黄（不去根，三分） 僵蚕（三分） 白芷（二
分） 升麻（二分） 防风（二分） 黄 （一钱） 黄柏（三分，酒炒） 甘草（二分）
上锉，一剂，水二盏，煎一盏，不拘时服。
草豆蔻丸
治秋、冬伤寒冷之物，胃脘当心而痛，上支两胁，膈咽不通。
草豆蔻（湿面裹，煨，去皮取仁，一两） 大麦 面（炒黄色，半两） 神曲（炒黄，半两） 白术（炒，
一两） 黄芩（半两，去皮） 枳实（麸炒黄色，一两） 半夏（汤泡七次，晒干，半两） 橘皮（一钱） 青皮
（二钱） 干生姜（二钱） 炒盐（半钱）
上为极细末，汤浸蒸饼丸，如绿豆大一倍，每服五十丸，白汤下。量所伤多少加减服之。（如冬月用，
别作一药，不用黄芩。）岁火不及，又伤冷物，加以温剂，是其治也。然有热物伤者，从权以寒药治之，随时
之宜，不可不知也。
理中汤（方见中寒条。）
四逆汤（方见中寒条。）
达按∶经云∶诸痛皆因于气，诸病皆生于气。诚哉斯
言！是气也，常则为气，导引血液，升降三焦，周流四体。变则为火，有升无降，燔灼中外，以致血液停留，
为痰为积。充乎脏腑，溢乎经络，胶乎咽膈，为咳呕、为痞塞、为胀满，为疼痛之所由也。凡遇气动痛作之时，
非辛温消散不可。然必详其所起之因，触动何脏之令，于辛温药中，加以苦寒之药尤佳。如∶喜动心火，加黄
连。怒动肝火，加柴胡。悲动肺火，加黄芩。恐动肾火，加黄柏。思动脾火，加芍药之类是也。
[Song]
The true primordial qi (Zhen Yuan Qi), which circulates without cease, originates from the Middle Jiao (Middle Burner) and is governed by the Lung. Externally it protects the skin and hair; internally it guides the blood. Harmonizing the hundred vessels, it is named Wei Qi (Defensive Qi). When disturbed by the seven emotions and six desires, clear qi becomes turbid, and moving qi stagnates. Disordered and erratic movement loses its normal state, leading to obstruction, fullness, and blockage. The *Ju Fang* (Formulas of the Bureau) treats qi disorders mostly with acrid-warm herbs, often perpetuating an ancient flaw. It was my Danxi who elaborated on this: whenever there is excess in qi, treat it as fire. Eight or nine out of ten cases where qi transforms into a fire syndrome occur; only one or two are caused by cold generating qi. One must carefully weigh qi deficiency versus qi excess, and not rigidly adhere to harsh, acrid-aromatic agents that deplete healthy qi.
[Discussion]
Qi refers to the vast and misty true primordial qi. This qi, externally, guards the skin and hair and fills the interstices (Cou Li); internally, it guides the blood vessels and harmonizes Yin and Yang. It flows throughout the body, circulating endlessly like a ring without end, entering and exiting, ascending and descending, maintaining regularity. Its source is the Middle Jiao, and it is commanded by the Lung. How can qi cause disease in humans? However, when the seven emotions attack each other and the five wills erupt, deviating from normalcy, clear qi suddenly turns turbid, and moving qi is suppressed and stops. Disordered and erratic movement loses its measure and transforms into fire. Hejian said: "Extreme excess of the five wills transforms into fire." Danxi said: "Excess of qi is fire." He also said: "Ascending qi emerges from the Liver and carries Ministerial Fire (Xiang Huo); cases of qi generated by cold account for only one or two out of ten." In such cases, it is evident that qi belongs to fire. Yet, *Ju Fang* uses aromatic drugs such as Chen Xiang (Aquilaria Wood), Mu Xiang (Vladimiria Root), Ding Xiang (Clove), Tan Xiang (Sandalwood), Huo Xiang (Pogostemon), and She Xiang (Musk), along with pungent-aromatic desiccating agents like Xiang Fu (Cyperus Rhizome), Sha Ren (Amomum Fruit), Ding Pi (Clove Peel), Yi Zhi Ren (Alpinia Fruit), San Leng (Burreed Tuber), Peng Ze (Curcuma Rhizome), Zhi Qiao (Aurantium Fructus), Zhi Shi (Immature Aurantium), Qing Pi (Unripe Citrus Peel), Hou Po (Magnolia Bark), Ban Xia (Pinellia Tuber), Wu Yao (Lindera Root), Zi Su (Perilla Leaf), and Lai Fu Zi (Radish Seed) to indiscriminately treat all qi disorders. This is an ancient flaw. Danxi, in *Ju Fang Fa Hui* (Elaboration on Ju Fang), severely criticized this error to enlighten future students. For symptoms such as obstruction, fullness, wheezing, distension, and swelling, these might be used temporarily to open and guide, but if taken regularly over a long period, would they not aid fire and aggravate the disease, consuming true qi? Nevertheless, qi has deficiency and excess; how can it be treated uniformly? One should observe and adjust accordingly.
[Pulse Diagnosis]
If the pulse feels deep upon palpation, it indicates a qi disorder. If extremely deep, it may be hidden (Fu pulse), and if soft and deficient, it is difficult to treat. If deep and slippery, it indicates qi disorder complicated by phlegm-fluid retention.
Qi Deficiency
Caused by labor and fatigue damaging qi, with insufficiency of Middle Qi, use Si Jun Zi Tang (Four Gentlemen Decoction) or Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For deficiency of true qi, with absent pulse and spirit decline, and shortness of breath insufficient for respiration, use Ren Shen Yang Rong Tang (Ginseng Nourishing Harmony Decoction) or Sheng Mai San (Generate Pulse Powder). For dual deficiency of qi and blood, with spontaneous sweating and panting urgency, and a fine pulse, use Shi Quan Da Bu Tang (Great Tonifying Ten Ingredients Decoction) or Ba Zhen Tang (Eight Treasures Decoction).
Si Jun Zi Tang (See Spleen/Stomach section for formula.)
Ren Shen Yang Rong Tang
Treats chronic fatigue and deficiency damage, with dual deficiency of qi and blood.
Ren Shen (Panax Ginseng Radix et Rhizoma, 1 qian, remove rhizome) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian, stir-fried with soil) Bai Fu Ling (Poria, 8 fen) Chen Pi (Citri Reticulatae Pericarpium, 8 fen) Gan Cao (Licorice Radix et Rhizoma, honey-roasted, 8 fen) Huang Qi (Astragali Radix, honey-roasted, 8 fen) Dang Gui (Angelicae Sinensis Radix, 1 qian) Bai Shao Yao (Paeoniae Radix Alba, wine-fried, 1 qian) Shu Di Huang (Rehmanniae Radix Praeparata, 1 qian) Yuan Zhi (Polygalae Radix, remove heart, 8 fen) Wu Wei Zi (Schisandrae Fructus, 8 fen) Rou Gui (Cinnamomi Cortex, 7 fen)
Crush the above ingredients. For one dose, add three slices of fresh ginger and two jujubes. Add two cups of water, decoct to one cup, and take in the early morning.
Bu Zhong Yi Qi Tang (See Internal Injury section for formula.)
Sheng Mai San
Clears summerheat and tonifies qi, generates pulse and supplements yuan qi.
Ren Shen (Panax Ginseng Radix et Rhizoma, remove rhizome, 1 qian) Mai Men Dong (Ophiopogonis Tuber, remove heart, 1 qian) Wu Wei Zi (Schisandrae Fructus, 1 qian)
Decoct with water and take frequently.
Ba Zhen Tang
Balanced tonification of qi and blood, harmonization of Yin and Yang.
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian, stir-fried) Ren Shen (Panax Ginseng Radix et Rhizoma, 1 qian) Dang Gui (Angelicae Sinensis Radix, 1.2 qian) Shu Di Huang (Rehmanniae Radix Praeparata, 1.5 qian) Chuan Xiong (Ligustici Chuanxiong Rhizoma, 8 fen) Bai Shao Yao (Paeoniae Radix Alba, 1 qian) Bai Fu Ling (Poria, 1 qian) Gan Cao (Licorice Radix et Rhizoma, 8 fen)
Crush the above ingredients. For one dose, add two cups of water, decoct to one cup, and take on an empty stomach.
Shi Quan Da Bu Tang
Treats various deficiencies and insufficiencies in men and women, and five labors and seven injuries.
Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 1.5 qian) Ren Shen (Panax Ginseng Radix et Rhizoma, remove rhizome, 1 qian) Bai Fu Ling (Poria, 1 qian) Gan Cao (Licorice Radix et Rhizoma, honey-roasted, 1 qian) Dang Gui (Angelicae Sinensis Radix, 1.2 qian) Bai Shao Yao (Paeoniae Radix Alba, 1 qian) Chuan Xiong (Ligustici Chuanxiong Rhizoma, 8 fen) Shu Di Huang (Rehmanniae Radix Praeparata, 1.5 qian) Huang Qi (Astragali Radix, honey-roasted, 1 qian) Rou Gui (Cinnamomi Cortex, 7 fen)
Crush the above ingredients. For one dose, add two cups of water, three slices of fresh ginger, and two jujubes. Decoct to one cup, and take before meals.
Qi Excess
Qi excess refers to pathogenic excess, constituting a state of qi excess, which should be treated as fire. "Excess of qi is fire"; use Dang Gui Long Hui Wan (Angelica Dragon Bile Pill). For qi excess with distension and fullness, use Si Qi Tang (Four Seven Decoction) added with Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Shan Zhi (Gardeniae Fructus), Xiang Fu (Cyperi Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), and Chen Pi (Citri Reticulatae Pericarpium). If complicated by phlegm, add Gua Lou (Trichosanthis Fructus), Bei Mu (Fritillariae Bulbus), Xiang Fu (Cyperi Rhizoma), and Hai Shi (Fossilia Osseum).
Dang Gui Long Hui Wan (See Hypochondriac Pain section for formula.)
Si Qi Tang
Treats qi excess with distension and fullness, chest and diaphragm discomfort, and all types of qi disorders.
Hou Po (Magnoliae Officinalis Cortex, 1.5 liang) Fu Ling (Poria, 1.5 liang) Ban Xia (Pinelliae Tuber, 2.5 liang) Zi Su Ye (Perillae Folium, 1 liang)
Crush the above ingredients. Take 5 qian per dose, with three slices of fresh ginger and two jujubes. Add two cups of water, decoct to one cup, and take.
Qi Stagnation
Qi stagnation refers to depression without extension; treat primarily with Mu Xiang Hua Zhi Tang (Costus Regulating Stagnation Decoction). To break stagnation in the Upper Jiao, use Zhi Qiao (Aurantii Fructus), Jie Geng (Platycodonis Radix), Sha Ren (Amomi Fructus), and Xiang Fu (Cyperi Rhizoma). In the Middle Jiao, use Hou Po (Magnoliae Officinalis Cortex) and Zhi Shi (Aurantii Fructus Immaturus). In the Lower Jiao, use Qing Pi (Citri Reticulatae Pericarpium Viride), Mu Xiang (Aucklandiae Radix), and Bing Lang (Arecae Semen). If due to anger causing qi stagnation and non-movement, use Er Chen Tang (Two Aged Decoction) added with Shan Zhi (Gardeniae Fructus), Chai Hu (Bupleuri Radix), and Xiang Fu (Cyperi Rhizoma). If qi stagnation causes pain, add Mu Xiang (Aucklandiae Radix) and Wu Yao (Linderae Radix). If internal ministerial fire rushes upward causing qi stagnation, use Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Xiang Fu (Cyperi Rhizoma). For yin deficiency with qi stagnation, use Si Wu Tang (Four Substances Decoction) added with Zhi Mu (Anemarrhenae Rhizoma) and Huang Bo (Phellodendri Cortex).
Mu Xiang Hua Zhi Tang
Treats accumulation of worry, qi, food, and dampness knotting in the Middle Jiao, slight pain at the base of the abdominal wall, epigastric fullness and obstruction, loss of appetite, indigestion, and chronic qi stagnation.
Zhi Shi (Aurantii Fructus Immaturus, 2 fen) Chai Hu (Bupleuri Radix, 4 fen) Mu Xiang (Aucklandiae Radix, 3 fen) Chen Pi (Citri Reticulatae Pericarpium, 5 fen) Gan Cao (Licorice Radix et Rhizoma, 1 fen) Ban Xia (Pinelliae Tuber, ginger-processed, 1 qian) Cao Dou Kou (Alpiniae Katsumadai Semen, 5 fen) Dang Gui (Angelicae Sinensis Radix, 2 fen) Hong Hua (Carthami Flos, 1 fen)
Crush the above ingredients. For one dose, add three slices of fresh ginger and two cups of water. Decoct to one cup, and take on an empty stomach.
Qi Cold
Qi cold occurs when one knowingly suffers from external cold or consumes cold foods. If in the exterior with body heat, use Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamomi Ramulus). If cold qi invades the head causing pain, use Qiang Huo Hei Fu Tang (Notopterygii and Black Aconite Decoction). If cold qi invades the stomach causing pain, use Cao Dou Kou Wan (Alpiniae Katsumadai Seed Pill). If cold qi is in the abdomen causing pain, diarrhea, vomiting, and cold extremities, use Li Zhong Tang (Regulate the Middle Decoction). If cold qi is in the lower abdomen causing pain, with deep-slow pulse and cold extremities, use Si Ni Tang (Frigid Extremities Decoction) added with Wu Zhu Yu (Evodiae Fructus), or Li Zhong Tang (Regulate the Middle Decoction) added with Wu Zhu Yu (Evodiae Fructus).
Qiang Huo Hei Fu Tang
Qiang Huo (Notopterygii Rhizoma et Radix, 5 fen) Hei Fu Zi (Aconiti Lateralis Radix Praeparata, processed, 3 fen) Cang Zhu (Atractylodis Rhizoma, 5 fen) Ma Huang (Ephedrae Herba, roots not removed, 3 fen) Jiang Can (Bombyx Batryticatus, 3 fen) Bai Zhi (Angelicae Dahuricae Radix, 2 fen) Sheng Ma (Cimicifugae Rhizoma, 2 fen) Fang Feng (Saposhnikoviae Radix, 2 fen) Huang Qi (Astragali Radix, 1 qian) Huang Bo (Phellodendri Cortex, wine-fried, 3 fen) Gan Cao (Licorice Radix et Rhizoma, 2 fen)
Crush the above ingredients. For one dose, add two cups of water. Decoct to one cup, and take at any time.
Cao Dou Kou Wan
Treats injury from cold objects in autumn and winter, pain in the epigastrium centering on the heart region, radiating to both hypochondria, and obstruction in the diaphragm and throat.
Cao Dou Kou (Alpiniae Katsumadai Semen, wrapped in wet dough, roasted, peel removed, kernel taken, 1 liang) Da Mai Mian (Hordeum Vulgare Farina, stir-fried until yellow, 0.5 liang) Shen Qu (Medicated Leaven, stir-fried until yellow, 0.5 liang) Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 1 liang) Huang Qin (Scutellariae Radix, peeled, 0.5 liang) Zhi Shi (Aurantii Fructus Immaturus, bran-stir-fried until yellow, 1 liang) Ban Xia (Pinelliae Tuber, soaked in boiling water seven times, sun-dried, 0.5 liang) Ju Pi (Citri Reticulatae Pericarpium, 1 qian) Qing Pi (Citri Reticulatae Pericarpium Viride, 2 qian) Gan Sheng Jiang (Zingiberis Rhizoma Recens, dried, 2 qian) Chao Yan (Salt, stir-fried, 0.5 qian)
Grind into an extremely fine powder. Moisten with water and steam cake to form pills, double the size of mung beans. Take 50 pills per dose, washed down with plain warm water. Adjust dosage according to the amount of injury. (In winter, prepare separately without Huang Qin.) If the year lacks fire energy and cold is injured, add warm agents; this is the treatment. However, if hot substances cause injury, treat opportunistically with cold herbs. One must know the appropriateness of timing.
Li Zhong Tang (See Middle Cold section for formula.)
Si Ni Tang (See Middle Cold section for formula.)
Commentary by Da: The Classics state: "All pains are due to qi; all diseases arise from qi." These words are truly profound! This qi, when normal, guides blood, regulates the ascent and descent of the Three Jiao, and circulates through the four limbs. When transformed, it becomes fire, ascending without descending, blazing inside and outside, causing blood to stagnate, forming phlegm and accumulations. It fills the zang-fu organs, overflows into the meridians, and adheres to the throat and diaphragm, becoming cough, vomiting, obstruction, distension, and the cause of pain. Whenever qi moves and pain arises, dispersal with acrid-warm herbs is indispensable. However, one must carefully investigate the cause and which organ's command was triggered. Adding bitter-cold herbs to acrid-warm ones is particularly beneficial. For example: if joy stirs Heart Fire, add Huang Lian (Coptidis Rhizoma); if anger stirs Liver Fire, add Chai Hu (Bupleuri Radix); if sorrow stirs Lung Fire, add Huang Qin (Scutellariae Radix); if fear stirs Kidney Fire, add Huang Bo (Phellodendri Cortex); if pensiveness stirs Spleen Fire, add Bai Shao Yao (Paeoniae Radix Alba), etc.