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Astragali Radix (Huangqi), sweet in taste, slightly warm in nature, with a light aroma and strong flavor, capable of ascending and descending, belongs to the Yang within Yang, non-toxic. It specifically tonifies Qi. It enters the Hand Taiyin Lung Meridian, Foot Taiyin Spleen Meridian, and Hand Shaoyin Heart Meridian. Its functions are numerous, but its most remarkable efficacy lies particularly in nourishing Blood. Astragalus is indeed a divine medicine for tonifying Qi; how can it be uniquely effective in nourishing Blood? This is because Qi is formless, whereas Blood has form. Formed substances cannot be generated rapidly; they must rely on formless Qi to generate them. When Astragalus is used together with Angelicae Sinensis Radix (Danggui), it naturally assists in generating Blood. Angelicae Sinensis Radix itself can generate Blood; why does it need to rely on Astragalus? One should know that using Blood-nourishing medicines alone to generate Blood is slow, while using Qi-tonifying medicines to generate Blood is fast. Moreover, when Qi-regulating medicines and Blood-nourishing medicines are combined harmoniously, Blood receives the impetus from Qi and generates rapidly. What could there be to doubt? Some may question: Since Blood is generated by Qi, a small dose of Astragalus should suffice. Even if not reduced, using equal amounts with Angelicae Sinensis Radix would work. Why does the Bu Xue Tang (Blood-Nourishing Decoction) use less Angelicae Sinensis Radix and double the dose of Astragalus? The reason is unknown. Although named "Blood-Nourishing," this decoction essentially focuses on tonifying Qi. After hemorrhage, blood has been lost profusely. Even if Blood-nourishing medicines are administered, the amount of new Blood generated will be minimal. How can such a small amount nourish the Five Zang and Six Fu organs? Thus, when Blood is lost, Qi also tends to escape. Since Blood cannot be regenerated quickly, the Qi that is on the verge of collapse but not yet gone must be rescued urgently. If not saved immediately, once dispersed, it will vanish in an instant. Therefore, to nourish Blood, one must first tonify Qi. However, there is a fear that tonifying Qi alone might cause Yang to become excessive and Yin deficient. Hence, Angelicae Sinensis Radix is added to generate Blood, ensuring that seven-tenths of the effect comes from Qi generation and three-tenths from Blood generation. This balances Yin and Yang, resulting in great benefit. Generating both Qi and Blood causes no harm. In the case of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Astragalus is used in conjunction with Ginseng Radix et Rhizoma (Renshen) to achieve success. With the assistance of Astragalus, Ginseng Radix et Rhizoma can simultaneously tonify Ying and Wei (Defensive and Nutritive Qi), consolidate the Couli (pores/skin texture), strengthen the Spleen and Stomach, and resolve phlegm and food stagnation. It aids Shengma Rhizoma (Cimicifugae Rhizoma) and Chaihu Radix (Bupleuri Radix) to lift Qi from the deepest Yin levels. Without Ginseng Radix et Rhizoma in the Qi-augmenting decoction, the lifting force is weak. Adding more Astragalus and Atractylodis Macrocephalae Rhizoma (Baizhu) enables proper elevation. If Ginseng Radix et Rhizoma and Atractylodis Macrocephalae Rhizoma are used without Astragalus, it is impossible to lift Qi from the profound Yin. Therefore, individuals with Qi deficiency should generally use Astragalus regardless of their specific disease, and those with Blood deficiency especially should use it frequently. However, it is contraindicated for those with bone-steaming tubercular fever (Gu Zheng Lao Re - Yin-deficiency heat) and abdominal fullness (Zhong Man). Nevertheless, clinical judgment is required. [Commentary: Without Astragalus, Qi cannot be lifted to the profound Yin; this innovative theory is indeed accurate.]

Someone asks: Astragalus is said to be inhibited by Saposhnikoviae Radix (Fangfeng), yet ancients stated that Astragalus becomes more effective with Fangfeng, describing a relationship of mutual inhibition and mutual enhancement. Is this true? This statement is credible yet questionable. Astragalus is non-toxic; why would it fear Fangfeng? The term "fear" implies that Astragalus has a tonifying nature, while Fangfeng has a dispersing nature. When combined, the tonification is not overly aggressive, and the dispersion is not too intense, thus enhancing overall efficacy. [Commentary: Astragalus needs Fangfeng because Fangfeng can unblock Qi throughout the body. Assisted by Astragalus, Astragalus reaches the exterior, Fangfeng defends against wind, and external wind pathogens are repelled by Astragalus.]

Someone asks: Astragalus tonifies Qi but sometimes increases distension, suggesting it might not be suitable for tonifying Qi. Is there a medicine to relieve this distension, or should Astragalus simply be avoided? Astragalus is a Qi-tonifying herb. If Qi deficiency exists and Astragalus is not used, what else can be used? However, if distension increases after ingestion, it is not because Astragalus promotes Qi excessively, but because it fails to properly assist Qi. Only when Yin and Yang have a root can Qi and Blood be tonified. If the root of Yin and Yang is perishing, the body cannot accept tonics. When a medicine finds that the condition cannot tolerate tonification, it ceases to tonify. This explains why Astragalus, intended to tonify Qi, causes increased distension—it fails to generate Qi. It is due to the body's inability to accept tonification that no benefit arises. Are there other medicines to relieve such distension?

Someone asks: Astragalus acts on the Qi level, yet you consider it a Blood-nourishing agent. Shouldn't all cases of Blood deficiency use Astragalus? Why do ancient texts show frequent use of Blood-nourishing formulas like Siwu Tang (Four Substances Decoction) and Foshou San (Buddha's Hand Powder), rarely mentioning Astragalus for Blood nourishment? Were the ancients wrong? The ancients were not wrong; rather, Blood disorders differ, having favorable (Shun) and unfavorable (Ni) patterns. Favorable patterns suit Blood-nourishing medicines; unfavorable patterns suit Qi-tonifying medicines. In unfavorable Blood disorders, it is not Blood that rebels, but Qi that rebels, leading to rebellious Blood. If rebellious Blood is treated with Blood-level medicines, Qi remains unsmooth, and Blood becomes more rebellious. Thus, one must tonify Qi to calm Blood. When Qi rebels, Blood rebels; when Qi calms, Blood calms. This is an immutable principle. Blood that should not ascend, such as in vomiting, hemoptysis, epistaxis, constitutes rebellion. Blood is like floodwater; if water flows backward, it floods the world; if Blood rebels, it boils in the Upper Jiao. Treating only Blood makes it difficult to achieve peace. Therefore, Qi-tonifying medicines must be included in Blood-nourishing prescriptions. Although Qi generates Blood, Qi also moves Blood. This is why Huangqi Bu Xue Tang (Astragalus Blood-Nourishing Decoction) excels through the ages. [Commentary: Distinguishing between Qi rebellion and smoothness in Blood nourishment shows profound insight.]

Someone asks: Astragalus uniquely treats Blood disorders caused by Qi rebellion, yet Siwu Tang and Foshou San also stop bleeding effectively. Why? Indeed, you ask well. Blood rebellion varies into major and minor forms. Major rebellion requires Qi tonification to stop bleeding; minor rebellion can be managed by regulating Blood to return it to its vessels. Using Siwu Tang or Foshou San stops bleeding because the Blood is replenished and returns to its channels. Blood is hardest to return to its channels; why do these formulas succeed? Because the Blood rebellion is mild. Mild rebellion indicates slight Qi rebellion; severe rebellion indicates significant Qi rebellion. While Siwu Tang and Foshou San can stabilize Blood, their effect is slower compared to the rapid cessation of bleeding achieved by Bu Xue Tang treating Qi.

Someone asks: Astragalus tonifies Qi, causing initial distension that resolves shortly after. Why? This occurs because Qi deficiency patients initially reject tonics. Astragalus tonifies Qi deficiency, and the Stomach craves tonification more than other organs. Upon entering the Stomach, fearing competition for tonification, the Stomach closes up and refuses to release, causing distension. The treatment is to never use Astragalus alone; add Danggui, Chuanxiong Rhizoma (Chuanxiong), and Ophiopogonis Radix (Maidong) to disperse the action throughout the upper and lower body, eliminating distension concerns. There are two types of distension from Astragalus: intolerance and over-reaction. Over-reaction presents as initial distension that relaxes soon after; intolerance presents as mild initial distension that worsens over time. These are easily distinguished.

Someone asks: As a divine Qi tonic, shouldn't all Qi deficiencies use it? Why is it avoided in cases of panting and fullness? Perhaps due to fears of exacerbating fullness. Having mastered Yin-Yang and Deficiency-Excess principles, I seek your guidance. Answer: Astragalus tonifies Qi but cannot treat fullness; this is not Astragalus's fault, but improper usage. Panting and chest fullness indicate Kidney Qi nearing exhaustion, surging upward. It appears as Qi excess but is actually Qi deficiency. Ancients used large doses of Ginseng Radix et Rhizoma because it does not aggravate fullness and effectively calms panting. However, Ginseng is expensive and scarce for the poor. Ancients substituted Astragalus, but when panting worsened, they stopped using it and recorded that "Astragalus is contraindicated in panting/fullness," avoiding further error. Who knew that skilled use of Astragalus could miraculously treat panting/fullness? I received transmission from an unusual master and dare not hide it. Process Astragalus with Saposhnikoviae Radix juice: fry until dry. Too little Fangfeng fails to control Astragalus; too much overwhelms it, risking Qi dispersion. Generally, use 1 jin of Astragalus with 1 liang of Fangfeng. Boil Fangfeng in 10 bowls of water briefly, remove dregs, soak Astragalus for 30 minutes until wet, then stir-fry dry. Repeat soaking and frying until juice is absorbed. Then decoct 3 qian of Schisandrae Fructus (Wuweizi) in 1 bowl of water, soak Astragalus until half-wet/half-dry, stir-fry, and bake dry to absorb Earth Qi. Use 1 liang of Astragalus where 1 liang of Ginseng is indicated. This calms panting miraculously without increasing fullness. All Astragalus should be processed this way. Although ancients used raw Astragalus with Fangfeng successfully, the properties were not fully controlled, risking erratic effects. Pre-processing is better, ensuring mutual restraint and greater efficacy. [Commentary: Using processed Astragalus for panting saves the poor. For the wealthy, Ginseng is preferable.]

Some suspect that adding Fangfeng to Astragalus is sufficient and pre-processing is unnecessarily curious. Not knowing that combining raw Astragalus and Fangfeng leaves their natures distinct. Pre-processing harmonizes their characters, subdues their actions, making them intimately united without distinction, like sworn brothers surpassing biological ones, achieving complete efficacy.

Some suspect Astragalus only treats acute Qi deficiency, not chronic. Reason given: Acute deficiency accepts Astragalus easily; chronic deficiency rejects it. Alas! Tonification for deficiency should be accepted by both new and old conditions. Those who reject it suffer from Qi rebellion, not simple deficiency. Qi rebellion requires Ginseng Radix et Rhizoma, not Astragalus. Even in early stages of Qi rebellion, Astragalus is contraindicated. If Qi is deficient but not rebellious, even chronic deficiency suits Astragalus, with no adverse reactions. Who says Astragalus is hard to tolerate? [Commentary: Astragalus cannot tonify Qi deficiency accompanied by rebellion; a brilliant argument.]

Some suspect: Astragalus tonifies Qi, why must it be assisted by Danggui to nourish Blood? Isn't Blood the source of Qi? Know that Qi generates Blood, but Blood does not generate Qi. Tonifying Qi requires accompanying Blood nourishment not to aid Qi directly, but because Qi deficiency invariably involves concurrent Blood depletion. Using large doses of Astragalus to generate Qi makes Qi vigorous but Blood weak. Blood cannot match the excess of Qi, leading to insufficient Blood generation, losing Qi's benefits and suffering its harms. Thus, tonifying Qi must include Blood nourishment. But if Qi deficiency is treated by tonifying Qi and then separately tonifying Blood, Blood becomes vigorous while Qi remains weak. How to resolve this? Knowing that when Blood is vigorous, Qi does not need to generate more Blood, so tonifying Blood naturally strengthens Qi, avoiding imbalance. However, tonifying Qi more heavily than Blood is the ideal balance.

Someone asks: Why must Astragalus be honey-fried? Is raw use inferior? Yet in Sores and Ulcers, raw Astragalus is preferred. Explanation: Astragalus need not necessarily be honey-fried. People believe fried Astragalus tonifies and raw Astragalus drains, but raw use also tonifies.