【歌】气血冲和安有患，若还抑郁病相寻。湿痰气血热兼食，六郁之形体认真。
【论】夫人之气血冲和，百病不生。一有抑郁，诸病生焉。故人之诸病，多生于六郁。盖郁者，结聚而
不发越之谓。当升不升，当降不降，当变化不得变化，所以传化失常而六郁之病生焉。六郁者，气、血、湿、
热、食、痰所郁也，而其状不一，开具于左∶盖诸郁之脉皆沉，沉则为郁故也，但其兼芤、涩、数、紧、滑、
缓之不同耳。丹溪云∶病之属郁者常八、九，看所挟，以开导之可也，故制越鞠丸通疗之。
越鞠丸（一名芎术丸）
苍术 香附 抚芎 神曲 栀子（各等分）
上为末，水丸，如绿豆大，温水下，每服五钱。
气郁
其状胸满胁肋胀痛，脉沉而涩，用二陈汤加香附、抚芎、苍术。气实者，加枳实、浓朴、砂仁、山栀、青
皮、木香之类。
二陈汤（方见痰证条。）
湿郁
其状周身走痛，或关节痛，遇阴寒则发，脉沉而细缓，
身体重，头重痛是也。白芷、苍术、川芎、茯苓、香附，或升阳除湿汤主之。
升阳除湿汤（方见湿证条。）
血郁
其状四肢无力，能食，便血，脉涩而芤，四物汤加桃仁、红花、青黛、抚芎、香附，或子和越鞠丸合四物汤治之。
四物汤（方见血证条。）
子和越鞠丸
桃仁（去皮尖） 红花 香附（醋制） 抚芎 青黛（各等分）
上为末，水丸，如梧子大，每服四、五十丸，白汤送下。
痰郁
其状动则喘，寸口脉沉而滑，二陈汤加海石、南星、香附、栝蒌仁、半夏，或王汝言化痰丸、润下丸。
二陈汤（方见痰证条。）
王汝言化痰丸（方见痰证条。）
润下丸（方见痰证条。）
火郁
其状瞀闷，小便赤涩，脉沉而数，骨髓中热，肌痹热，扪之烙手，逍遥散加山栀、香附、青黛、抚芎、贝
母、苍木，或火郁汤。
逍遥散（方见火证条。）
火郁汤（方见火证条。）
食郁
其状嗳酸，胸满腹胀，不能食，或呕酸水，恶闻食气，人迎脉平和，气口脉紧盛，或沉缓而大，保和丸加
枳实、麦芽、砂仁、香附之类。
保和丸（方见伤食条。）
达按∶气、血、痰三病，多有兼郁者。或郁久而生病，或病久而成郁。虽则气用四君，血用四物，痰用二
陈，必以开郁药佐之，是得治法之大要也。
[Verse] When Qi and Blood are harmonious and flowing smoothly, how can illness arise? If depression (stagnation) occurs, various diseases will follow. The manifestations of the six types of stagnation—Dampness, Phlegm, Qi, Blood, Heat, and Food—must be carefully identified.
[Discussion] When a person's Qi and Blood are harmonious, hundred diseases do not arise. Once there is stagnation, various diseases emerge. Therefore, most human diseases originate from the Six Stagnations. "Stagnation" refers to the condition where pathogenic factors gather and fail to disperse. What should ascend does not ascend; what should descend does not descend; what should transform fails to transform. Consequently, transmission and transformation functions become abnormal, giving rise to diseases of the Six Stagnations. The Six Stagnations refer to the stagnation of Qi, Blood, Dampness, Heat, Food, and Phlegm. Their clinical presentations vary, as listed below: Generally, the pulse in all types of stagnation is Deep (Chen), because a Deep pulse indicates stagnation, though it may be accompanied by other qualities such as Hollow (Kou), Choppy (Se), Rapid (Shu), Tight (Jin), Slippery (Hua), or Slow (Huan). Zhu Danxi stated: Eight or nine out of ten diseases belong to stagnation; one should observe the accompanying symptoms and treat with methods that open and guide the flow. Thus, Yueju Wan was formulated to treat all types of stagnation generally.
Yueju Wan (also known as Xiongshu Wan)
Cangzhu Rhizoma Atractylodis Macrocephalae, Xiangfu Radix Cyperi, Fuxiong Rhizoma Chuanxiong, Shenqu Mass Medicamentum Fermentatum, Zhizi Fructus Gardeniae (equal parts).
Grind into powder, make pills with water, size of mung beans. Take with warm water, 5 qian per dose.
Qi Stagnation
Symptoms include chest fullness and distending pain in the hypochondrium; the pulse is Deep and Choppy. Use Erchen Tang (Two-Aged Decoction) plus Xiangfu, Fuxiong, and Cangzhu. For excess Qi, add Zhishi Immature Bitter Orange Fruit, Houpo Cortex Magnoliae Officinalis, Sharen Fructus Amomi Rotundus, Shanzhi, Qingpi Pericarpium Citri Reticulatae Viride, and Muxiang Radix Aucklandiae.
Erchen Tang (See formula under Phlegm Syndrome).
Dampness Stagnation
Symptoms include wandering pain throughout the body or joint pain, which exacerbates in cold and damp weather; the pulse is Deep, Fine, and Slow. The body feels heavy, and there is a heavy sensation in the head. This is treated with Baizhi Radix Angelicae Dahuricae, Cangzhu, Chuanxiong, Fuling Poria, and Xiangfu, or primarily with Shengyang Chushi Tang (Decoction to Raise Yang and Dispel Dampness).
Shengyang Chushi Tang (See formula under Dampness Syndrome).
Blood Stagnation
Symptoms include weakness in the four limbs, ability to eat, blood in stool; the pulse is Choppy and Hollow. Use Siwu Tang (Four Substances Decoction) plus Taoren Semen Persicae, Honghua Flos Carthami, Qingdai Indigo Naturalis, Fuxiong, and Xiangfu. Alternatively, treat with Hezi Yueju Wan combined with Siwu Tang.
Siwu Tang (See formula under Blood Syndrome).
Hezi Yueju Wan
Taoren (dehulled and core removed), Honghua, Xiangfu (vinegar-processed), Fuxiong, Qingdai (equal parts).
Grind into powder, make pills with water, size of Sophora seeds. Take 40–50 pills per dose with plain boiled water.
Phlegm Stagnation
Symptoms include panting upon movement; the pulse at the Cun position is Deep and Slippery. Use Erchen Tang plus Haishi (Haiyao/Floating Stone), Nanxing Rhizoma Arisaematis Cum Bile, Xiangfu, Gualouren Semen Benincasae, and Banxia Rhizoma Pinelliae Preparatum. Alternatively, use Wang Ruyan Huatan Wan (Wang Ruyan’s Phlegm-Resolving Pill) or Runxia Wan (Moistening-Down Pill).
Erchen Tang (See formula under Phlegm Syndrome).
Wang Ruyan Huatan Wan (See formula under Phlegm Syndrome).
Runxia Wan (See formula under Phlegm Syndrome).
Fire Stagnation
Symptoms include dizziness and mental oppression, red and scanty urine; the pulse is Deep and Rapid. There is heat in the bone marrow, heat in muscle bi-syndrome, and the skin feels hot to the touch. Use Xiaoyao San (Free and Easy Wanderer Powder) plus Shanzhi, Xiangfu, Qingdai, Fuxiong, Beimu Bulbus Fritillariae Cirrhosae, and Cangzhu. Alternatively, use Huoyu Tang (Fire-Stagnation Decoction).
Xiaoyao San (See formula under Fire Syndrome).
Huoyu Tang (See formula under Fire Syndrome).
Food Stagnation
Symptoms include belching with sour odor, chest fullness and abdominal distension, inability to eat, vomiting of sour fluid, aversion to the smell of food. The Renying pulse (radial artery at the neck) is peaceful; the Qikou pulse (radial pulse at the wrist) is Tight and Excessive, or Deep, Slow, and Large. Use Baohe Wan (Preserve Harmony Pill) plus Zhishi, Maiya Fructus Hordei Germinatus, Sharen, and Xiangfu.
Baohe Wan (See formula under Food Injury).
Commentary by Da: Diseases of Qi, Blood, and Phlegm often involve concurrent stagnation. Sometimes stagnation persists for a long time before generating disease, or disease persists for a long time leading to stagnation. Although Qi deficiency is treated with Sijunzi Tang (Four Gentlemen Decoction), Blood deficiency with Siwu Tang, and Phlegm-fluid with Erchen Tang, it is essential to assist these formulas with herbs that resolve stagnation. This captures the main principle of treatment.