67．高血压，肥人，可考虑痰的一面。遇有热象，用寒药而无好转者，应考虑滋阴的一面。肺气清肃，肾水充足，方能涵木，肝火之逆自可好转，故治之法，当滋肾水、平肝木、利肺气。便秘者，须兼泻法，避免精神刺激，忌食辛辣之品。
68．治痢久滑脱、脱肛．虽有脓血，但无里急后重者，治宜温中补虚．涩肠上泻，方用《局方》真人养脏汤，很有效。但对初期之痢，不宜早用补涩，应推荡之，同时要注意表证之有无，如有表证，必须先解表。治白痢须从气分用药，治赤痢须从血分用药．
69．脉与证不合．而欲吐不吐，欲泻不泻，腹中绞痛剧烈者，委中、曲池放血，放十宣，很有效。
70．痹证当早治，不当迟治，迟则易成为入脏之死症。
71．痹证初起，三气未行热化者，仍按治三气之法治之。治行痹。以散风为主，御寒利湿辅之，再参以补血之剂。盖治风先治血，血行风自灭也。治痛痹，以散寒为主，疏风燥湿辅之，再参以补火之剂，盖非大辛大温之品，不足以释其凝寒也。治着痹，以利湿为主，祛风解寒仍不可缺，再参以补脾补气之剂，因脾强可以胜湿，气足自不顽麻。
72．痹证失治，邪郁病久，风变为火，寒变为热，湿变为痰。又当于通经活血疏散邪滞剂中，再参以降火清热豁痰之品。
73。治痹总以通经活血、疏散邪滞之品为主，随所感之气、邪之轻重及见症之寒热虚实，而加以对证的药品。
74．虽云痛无补法，然病久痛，伤及元气，非补气血不可。参芪术地，随证用之，不必拘于痛无补法。
75．初潮提前属先天禀赋薄弱．血未充盛。气不摄血者，用人参养荣丸。
76．产妇乳头生疮，汗出疼痛难忍者，名垢乳，用鹿角9克，甘草3克，共为细末，用鸡子黄和之，置铜器内炙热，敷于乳头并固定，每日2次。
77．治产后青肿，以干漆、大麦芽等份为末，铺于青瓦中，干漆一层，麦芽一层，如此重复至满，盐泥封瓦，煅赤。研末，酒送服6克，并治产后诸证。
78．产后血晕预防：妊娠五月、七月服安胎饮，至八月、九月再加大腹皮、黄羊脑，元气虚弱者服八珍汤，临产服保生无忧散，或预烧红炭投醋内置产床，以醋涂口鼻。
79．久病有邪者正必有虚，不攻其邪正气必伤，故攻邪为治久病邪实者之要法，然攻之太过则正必不支，故攻邪时应务求其缓。如气虚而有风邪外客之久病者，欲用防风3克时，只可用至O．6～O．9克；大便秘结者，若欲用大黄9克时，只可用至1～2克。否则非但邪气不除，亦且正伤，病邪难除耳。所以，治久病邪实者，只可求其缓。
80．湿性趋下易袭阴位，故湿邪为病在妇科可见带下量多，经前泄泻，经前后浮肿等。湿证与热证兼见者为湿热证，其治法为清热除湿，分别湿与热之轻重主次不同，清热除湿偏重不同。除湿有健脾燥湿、温阳化湿、利水渗湿之分，温阳化湿为寒湿证治法，然对于湿热证之湿邪偏重者，以祛湿为主，清热为辅。祛湿之中温阳化湿不可或缺，因湿为阴邪，易阻遏气机，损伤阳气，况清热药必寒凉，而温阳化湿则有助于湿祛从速，并可防寒凉太过。
方药心得
81．凡用药之前，首先应该一分为二地考虑其效果，即既要考虑到其正面作用，亦要考虑其负面作用，究竟会否发生别的问题。如果用热药，寒证虽宜，但容易伤阴，或引致肝阳上逆；用寒药，热证虽宜，却易伤人之阳。因此，不要因某药有效而过量或连续多用，而应掌握好度，中病即止，见好就收，方不致出现负面作用。
82．药品的作用必须弄清楚，用量也是治疗的关键，同样的病证，同样的处方，有的见效，有的无效，就是用量上的问题。所以要学习，须从头做起，先弄清药物的性味功效、用法用量及配伍规律，庶几临床加减应用，心中有数，头头是道也．
83．用药须考虑三个方面，一是正面作用；二是反面作用，也就是用药后有什么副作用，有多大，如何补救和防上；三是和同用药的关系，有无矛盾和相互影响。用方也是一样，同样要注意三个方面，即主要作用、方中药物配伍的相互作用、副作用。只有掌握了所用方药的上述三个方面，应用才能正确无误。
84．驱邪药能除邪，补虚药能扶正，然药皆有毒，过则生病，故《内经》有“无使过之，伤其正也，气增而久，夭之由也”的警句。至若病久，虚实寒热夹杂证尤多，或寒，或热，或补，或泻，用药稍有不慎则过之，故不可乱施药饵．若少服或间断服用，针对其虚、实、寒、热治之，候其气之来复，自然可愈也。
85．补药之用，如异功散之有陈皮，归脾汤之用木香，意在行补药之滞。所以，用补药时，一定要注意反佐．些行气之品，以防滞腻。
86．治外感病，每用荆、防、羌、独。一般发散用荆、防为主，身痛者以羌、独为主，上半身痛用羌，下半身痛多用独，恶寒无汗而喘者，用麻、杏，兼热者加生行膏。如需用辛凉解表，只要无汗，也可以用荆、防，不过须结合连翘、薄荷、竹叶等同用之。麻黄、石膏配伍，亦成辛凉，如大青龙汤都属之。又如虚者无汗，配合党参用之。总之，用药当灵活掌握之。
87．童便，咸寒，滋阴降火，凡属各种上行之出血，由阴虚所致者，皆可用之。如系实火，类似于泻心汤用大黄之意。
88．白术为补脾之正药，陈氏说过，术能补脾之阴，又 能益脾之阳。欲补脾阳宜炮用，补阴可用生术，欲补气白术合党参，欲胜湿白术合云苓，欲行气白术合陈皮，所以，四君子汤既为补气药，又为补脾方也。
89．石膏之清热，为清燥热，厌烦口渴饮冷之证宜用。芩连之清热，为清湿热，大热、口不太干燥而口苦、苔稍腻若为宜。
90．甘草有和胃、解毒、泻火、补中等功用。遇用药时，需顾护胃气者，可炙用；需泻火解毒者，可生用。，
91．紫河车本身偏于补肾阳，如欲其滋肾阴，则必须配伍滋阴之剂，如麦味地黄丸、知柏地黄丸等．
92．海螵蛸之止崩漏，当注意以下问题：①因血热妄行所致者，不宜用；②因气虚不能摄血所致者，用之无效；③因瘀滞所致者，不宜用。其所适应者，为肝肾阴虚，冲任不固之崩漏。宜合茜草用之。海螵蛸又有去寒湿之作用，故又用于带下之证属寒湿者．
93．天麻治眩晕证多用之。但眩晕的原因不同，如血虚之晕，宜养血平肝；阴虚肝阳上升者，应滋阴平肝；如邪热炽盛，引起肝风者，又须清热降火。惟肝风夹痰湿者，天麻始为相宜。天麻辛燥，功能祛风燥湿化痰。所以火盛者、阴虚者均应慎用。
94．有寒热往来之症，不一定完全用柴胡，但用柴胡时，必须以寒热往来为主症。如桃仁承气汤之用于热入血室，可以将桂枝改为柴胡，效果很好。所以必须细心辨证及掌握方剂之主要精神，临证才能运用自如。又如用柴胡时，夏季多并用连翘、银花，或者不用柴胡。疟疾夹痰湿者，用柴胡于平胃散中很好。
95．山萸肉主治之证有八：①肝肾不足，腰酸眩晕，阳痿遗精，小便频数。②女子月经不止。③大汗亡阳虚脱。④止老人尿不节。⑤大能收敛元气。⑥肝虚自汗。⑦肝虚胁痛腰痛。⑧肝虚内风萌动。
96．丹参主治之证有十：①月经困难。②经闭癥瘕。③产后恶露不尽及瘀滞作痛。④消肿止痛。⑤乳痈初起红肿疼痛。⑥热病伤营，心烦不寐。⑦腰脊强。⑧脚痹。⑨破宿血，生新血。⑩安生胎，落死胎。
97．麻黄发汗解表，医家言其为诸药之首，然其用于临床亦有不见发汗者，亦有少量用之而大汗不止者，综其原因有三：①新鲜者发汗作用强，陈久者发汗作用弱，甚或无发汗作用。②气虚、阴虚证发汗作用强，风寒闭郁至甚者发汗作用弱。③热证发汗作用强。
98．麻黄宣肺定喘，医家言其为诸药之首，然其用于临床有有效者，有加剧者，综其原因有二：①风寒闭郁，肺气不宣之咳喘其效甚佳。②肾不纳气之喘和肺气虚的喘用之必甚。曾治一咳喘难止之患者，先予诸种定喘止咳方无效，后邀余治，诊为肾不纳气，予金匮肾气加蛤蚧，某医恐其无功酌加麻黄无效，及至改为去麻黄后愈。
99．白术：有健脾燥湿、补气安胎之功，为补脾正药，临证用之，欲运多于补则生用，欲补多于运则炒用。本品不宜炒焦，炒焦则伤脾增胀。
100．西洋参：苦、微甘，寒，补肺胃之阴，降火生津，凡肺胃津虚有火者用之。可用人参配麦冬或生石膏代之有同样效果。
101．百草霜：止血消积，主治吐衄、外伤出血、卤衄、脏毒下血、妇人崩中、食积泄痢及肠鸣泄泻。本品能止血但无益肠胃，救标则可，治本则非，故不宜多用。
102．泽兰：活血化瘀，通经利水，能舒肝脾之郁，不寒不燥，行而不峻，为妇科调经之要药。
103．胆矾：酸、辛，寒，有毒。用本品治重证沙眼时，以本品小块平面快速擦过，隔日1次，3次即愈。
104．玳瑁：甘、咸，寒，可解岭南百药毒、蛊毒及一氧化碳中毒。
105．党参：补中益气，生津养血，健脾运而不燥，滋胃阴而不湿，润肺而不犯寒凉，养血不偏滋腻，鼓舞清阳，振动中气，而无刚燥之弊。凡表证未解，中满邪实者忌用。
106．草蔻、草果：二药辛温，皆治寒湿，草蔻偏补，用之不宜过多，恐助脾热，伤肺损目，草果偏消。
107．桂枝：能升能降，升大气，降逆气，孕妇慎用，因胎前多热，恐胎堕。
108．荆芥：风邪郁于上之头痛多用穗，炒炭入血分止血，单用治风在皮里膜外，症见肌肤门热，头目昏眩，咽喉不利，身背疼痛，与防风同用兼治风入骨肉。
109．防风：通治一切风邪，为风病之主药。临床常与多种药物配伍，治疗各种风证．与南星同用，能治破伤风，如本事玉真散。与荆芥同用，能治时疹血风和皮里膜外、骨肉全身之风，如荆防败毒散及其他一切散风之方，不过兼寒者，配合苏叶等辛温之品，兼热者，配合连翘、薄荷、桑叶等辛凉之品，兼食滞者，配伍神曲、麦芽等消食之品，兼痰者，配伍陈皮、半夏等祛痰之品，兼疮毒肿痈者，配伍银花、连翘等解毒之品，更为有效，如不谢方“风寒温散剂”、“风热凉散剂”、“风寒夹食剂”、“风寒夹痰剂”、“连翘败毒散”等方剂，都属这一类的例证．与苍术、白术、防己等药同用，能治风邪兼湿之证，如海藏神术散、白术散、不谢方“风寒夹湿方”等即是。与黄芪同用，能治卫虚兼风之自汗证，如玉屏风散便是。与羌活同用，能散太阳经之风寒，治头痛项强，一身疼痛．发热恶风寒，或有汗或无汗，如九味羌活汤等方即是。
110．黄芪：补气升气，止痛生肌。气陷者生用或伍升麻、柴胡；中虚者炙用或伍人参、白术；虚甚者配人参，防热则再伍知母。
111．升麻：透疹解毒宜多用，升阳举陷宜少用．
112．柴胡：和解寒热，升举阳气，疏肝解郁，可解伤寒少阳旺，热入血分之寒热如疟证，及小儿食积、午后发热等证。退实证寒热宜多用，升阳解郁宜少用．
113．桑叶：疏风清热，凉血明目，并滋肾阴，故可用治肝阴不足之眼目昏花，寓肝肾同源之意，并治劳热咳嗽，
114．白芍：苦酸微寒，养血敛阴，柔肝止痛，平抑肝阳，酒炒可使上升，醋炒入肝去瘀。泄泻腹痛宜酒炒，失血 醋炒，大便燥、肝阳上逆者宜生用。
115．生姜：与大枣同用调和营血，生用发散之力强，煨用温中之力大，治脾胃虚寒证，浸汁点赤眼，捣汁与竹沥 同用，既制竹沥之阴寒，更借辛温之力以畅达其葯性。炮姜、干姜守而不走，治胃中寒，姜炭温经止血，用于寒性出血。
116．大黄：苦、寒．峻下宜生用，缓下宜熟用，泻头目之火宜酒制，破瘀血宜醋制。凡血中无郁热，肠胃中无积滞，及妇女胎前产后、月经期、哺乳期均应慎用，否则出血 不止，泄泻不止，或胎墮，或断乳。
117．生地：多液，性凝滞，胃气弱者服之恐伤胃，宜酒炒，忌铁。
118．猪蹄：补血生乳，解百药毒，煎汤煎药或单眼。
119．当归：补血和血，调经止痛，润肠通便，活血用酒洗，止血用头，补血用身，行血用尾，通络用须，和血全用。多生用，炒炭则具止血之效。
120．炒三仙：为消食药品，于脾虚证少用，如脾虚兼停食则须与参、术、苓等药相伍，方能有利无弊。
121．砂仁、藿香：二药利气行滞，化湿开胃，与熟地、人参、黄芪等补益药同用能防止其雍滞影响食欲之性。
122．马槟榔：常嚼二枚水送服，久则子宮冷而不孕，临产细嚼数枚町治难产、，
123．黄柏与知母同用滋阴降火，与苍术同用清热除湿。
124．治病当处处吻合病机．曾治一腹胀满因子气郁，但系久病体弱，仿厚姜半甘参之意，用人参、厚朴，酌加香附、木香以疏其气，半夏、茯苓以燥湿利水，应手而效。如果单纯疏气或单纯补虚，都不能达到预期的效果。
125．暑邪最易伤气耗沖，伤气则气短、倦怠，耗津则汗出、口渴、心烦，暑伤肺则咳，可以人参、麦冬、五味子为治．徐洄溪说：“麦冬、五味，咳者忌用，不咳之暑证可用。”我认为，因寒之咳，忌用麦味，而暑证之咳为热，又无痰，用之无妨，但须注意夏季贪凉而感寒咳嗽者多，用时必须辨明。
67. In patients with hypertension, if the body type is obese, phlegm-dampness should be considered. If heat signs are present but cold-natured herbs fail to improve the condition, yin-nourishing methods should be considered. When Lung Qi is clear and descending, and Kidney Water is sufficient, it can nourish Liver Wood, allowing rebellious Liver Fire to subside naturally. Therefore, the treatment principle should be to nourish Kidney Water, calm Liver Wood, and benefit Lung Qi. For those with constipation, purgative methods should be combined; mental stimulation should be avoided, and spicy foods should be prohibited.
68. For chronic dysentery leading to incontinence or rectal prolapse, despite the presence of pus and blood, if there is no tenesmus (urgency and pain in the rectum), treatment should focus on warming the middle and tonifying deficiency, using astringent herbs to stop diarrhea. The formula *Juren Yangzang Tang* (True Man Nourish the Viscera Decoction) from *Ju Fang* is very effective. However, for early-stage dysentery, tonifying and astringent herbs should not be used prematurely; instead, pathogens should be expelled. Attention must also be paid to the presence of exterior syndromes; if an exterior syndrome exists, the exterior must be resolved first. White dysentery should be treated by targeting the Qi level, while red dysentery should be treated by targeting the Blood level.
69. When pulse and symptoms do not match, characterized by the urge to vomit without success, the urge to defecate without success, and severe abdominal colic, bloodletting at Weizhong (BL-40) and Quchi (LI-11), as well as at the Ten Extremities (Shixuan, EX-UE11), is very effective.
70. Bi-syndrome (Arthralgia) should be treated early, not delayed. Delaying treatment makes it prone to becoming a fatal syndrome where pathogens enter the Zang organs.
71. In the initial stage of Bi-syndrome, when Wind, Cold, and Dampness have not yet transformed into Heat, treat according to the methods for these three pathogens. For Xing-Bi (Wandering Bi, dominated by Wind), disperse Wind as the primary method, assist with dispelling Cold and draining Dampness, and supplement with blood-nourishing agents. This is because treating Wind requires treating the Blood first; when Blood flows, Wind extinguishes itself. For Tong-Bi (Painful Bi, dominated by Cold), dispel Cold as the primary method, assist with dispersing Wind and drying Dampness, and supplement with Fire-tonifying agents, as only strongly pungent and warm herbs can resolve congealed Cold. For Zhuo-Bi (Fixed Bi, dominated by Dampness), drain Dampness as the primary method, do not omit dispelling Wind and resolving Cold, and supplement with Spleen-Qi tonifying agents, because a strong Spleen overcomes Dampness, and sufficient Qi prevents numbness.
72. If Bi-syndrome is neglected, pathogens stagnate for a long time: Wind transforms into Fire, Cold transforms into Heat, and Dampness transforms into Phlegm. At this stage, add herbs that descend Fire, clear Heat, and resolve Phlegm to formulas that unblock meridians, invigorate Blood, and disperse pathogenic stagnation.
73. Treatment of Bi-syndrome generally focuses on herbs that unblock meridians, invigorate Blood, and disperse pathogenic stagnation. Depending on the severity of the contracted Wind, Cold, or Dampness, and the nature of the symptoms (Cold/Heat, Deficiency/Excess), appropriate symptomatic herbs should be added.
74. Although it is said that "pain has no tonification method," prolonged pain damages Yuan Qi, necessitating tonification of Qi and Blood. Herbs such as Renshen (Ginseng Root), Huangqi (Astragalus Root), Baizhu (Atractylodes Rhizome), and Shudi (Rehmannia Root) should be used according to the syndrome, without rigid adherence to the notion that pain cannot be treated with tonification.
75. Early onset of menarche due to weak congenital constitution, insufficient Blood, and Qi failing to control Blood is treated with *Renyang Rong Wan* (Ginseng Nourishing Perfection Pill).
76. For cracked nipples in postpartum women, accompanied by sweating and unbearable pain, known as "Gou Ru" (Filthy Milk), use 9g of Lujiao (Deer Antler Glue) and 3g of Gancao (Licorice Root), grind into fine powder, mix with Egg Yolk, heat in a copper vessel, apply to the nipple, and fix in place. Apply twice daily.
77. For postpartum bruising/swelling, use equal parts of Ganxi (Dry Lacquer) and Dayaimai (Barley Sprout). Layer them in a blue tile, seal with salt mud, and calcine until red hot. Grind into powder and take 6g with wine. This also treats various postpartum conditions.
78. Prevention of Postpartum Syncope: Take Antai Yin (Fetus-Safining Decoction) in the fifth and seventh months of pregnancy. Add Dafupi (Areca Peel) and Huanyangnao (Sheep Brain) in the eighth and ninth months. Women with weak Yuan Qi should take Bazhen Tang (Eight Treasures Decoction). At delivery, take Baosheng Wuyou San (Safe Birth Without Worries Powder). Alternatively, pre-burn charcoal, place it in vinegar near the birthing bed, and apply vinegar to the mouth and nose.
79. In chronic illnesses with pathogens, Zheng Qi (Upright Qi) is inevitably deficient. Failing to attack pathogens will further damage Zheng Qi; thus, attacking pathogens is essential for chronic excess syndromes. However, excessive attacking will collapse Zheng Qi, so the approach must be gradual. For example, in a chronic case of Qi deficiency with external Wind, if Fangfeng (Saposhnikovia Root) 3g is indicated, only 0.6–0.9g should be used. For constipation, if Dahuang (Rhubarb Root) 9g is indicated, only 1–2g should be used. Otherwise, pathogens will not be removed, and Zheng Qi will be damaged. Therefore, treating chronic excess syndromes requires a gentle approach.
80. Dampness tends to flow downward and easily attacks Yin positions. In gynecology, Dampness pathology may manifest as excessive leukorrhea, diarrhea before menstruation, and edema before/after menstruation. When Dampness and Heat coexist, it is a Damp-Heat syndrome. The treatment is clearing Heat and draining Dampness. The emphasis varies based on whether Dampness or Heat is predominant. Methods for draining Dampness include strengthening the Spleen to dry Dampness, warming Yang to transform Dampness, and promoting urination to leach out Dampness. Warming Yang to transform Dampness is for Cold-Dampness. However, for Damp-Heat with predominant Dampness, resolving Dampness is primary, and clearing Heat is secondary. Warming Yang to transform Dampness is indispensable in resolving Dampness because Dampness is a Yin pathogen that obstructs Qi mechanism and damages Yang. Moreover, since Heat-clearing herbs are cold, warming Yang aids rapid Dampness resolution and prevents excessive cold injury.
[Insights on Formulas and Herbs]
81. Before prescribing, one must consider both positive and negative effects. Hot herbs suit Cold syndromes but may injure Yin or cause Liver Yang rebellion; cold herbs suit Heat syndromes but may injure Yang. Do not overdose or overuse effective herbs; master the degree, stop when the disease is cured, and withdraw when improvement is seen to avoid adverse effects.
82. The actions of herbs must be understood clearly. Dosage is key to treatment. Identical syndromes and prescriptions yield different results due to dosage differences. One must start from basics: understand herb properties, flavors, efficacy, usage, dosage, and compatibility rules to apply them confidently in clinical practice.
83. Medication consideration involves three aspects: 1) Positive effects; 2) Negative effects (side effects, severity, remedies); 3) Interactions with other herbs. Formula application follows the same three aspects: main action, internal herb interactions, and side effects. Mastery of these ensures correct application.
84. Expelling herbs remove pathogens; tonifying herbs support Zheng Qi. However, all herbs have toxicity if misused. As stated in *Nei Jing*: "Do not exceed the limit, lest you injure Zheng Qi. Prolonged excess leads to premature death." Chronic cases often present with mixed Deficiency/Excess and Cold/Heat. Careless dosing leads to excess. Prescribe sparingly or intermittently, targeting Deficiency/Excess and Cold/Heat, waiting for Qi recovery for natural healing.
85. Tonics often include moving Qi herbs to prevent stagnation, e.g., Chenpi (Tangerine Peel) in *Yigong San* or Muxiang (Saussurea Root) in *Guipi Tang*. When using tonics, always add some Qi-moving herbs to prevent cloying stagnation.
86. For exterior disorders, Jingjie (Schizonepeta), Fangfeng (Saposhnikovia), Qianghuo (Notopterygium Rhizome), and Duhuo (Angelica Pubescens Root) are common. For general dispersion, Jingjie and Fangfeng are primary. For body pain, Qianghuo and Duhuo are primary: Qianghuo for upper body, Duhuo for lower body. For aversion to cold, anhidrosis, and wheezing, use Mahuang (Ephedra) and Xingren (Apricot Seed); add Shigao (Gypsum) if Heat is present. For acrid-cool exterior resolution, Jingjie and Fangfeng can be used if there is no sweat, combined with Lianqiao (Forsythia), Bohe (Mint), and Zhuye (Bamboo Leaf). Mahuang combined with Shigao forms an acrid-cool pair, as in *Da Qinglong Tang*. For deficiency with no sweat, combine with Dangshen (Codonopsis). Flexibility is key.
87. Tongbian (Child's Urine) is salty and cold, nourishing Yin and descending Fire. It is suitable for upward bleeding caused by Yin deficiency. For Excess Fire, its use resembles the logic of using Dahuang in *Xiexin Tang*.
88. Baizhu (Atractylodes Rhizome) is the principal herb for tonifying the Spleen. Mr. Chen stated it tonifies Spleen Yin and benefits Spleen Yang. Roasted Baizhu tonifies Yang; raw Baizhu tonifies Yin. For Qi tonification, combine with Dangshen; for dampness, combine with Yunling (Poria); for Qi movement, combine with Chenpi. Thus, *Sijunzi Tang* (Four Gentlemen Decoction) is both a Qi tonic and a Spleen formula.
89. Shigao (Gypsum) clears Dry-Heat, suitable for irritability, thirst, and desire for cold drinks. Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome) clear Damp-Heat, suitable for high fever, bitter taste, slight greasy coating, and less intense dryness.
90. Gancao (Licorice Root) harmonizes the Stomach, detoxifies, drains Fire, and tonifies the Middle. Use roasted Gancao to protect Stomach Qi; use raw Gancao to drain Fire and detoxify.
91. Ziheche (Placenta Hominis) leans toward tonifying Kidney Yang. To nourish Kidney Yin, combine with Yin-nourishing formulas like *Maiwei Dihuang Wan* or *Zhibai Dihuang Wan*.
92. Haipiaoxiao (Cuttlefish Bone) stops metrorrhagia/metrostaxis, but note: 1) Not for Heat forcing blood recklessly; 2) Ineffective for Qi deficiency failing to control blood; 3) Not for stasis. It suits metrorrhagia/metrostaxis due to Liver-Kidney Yin deficiency and instability of Chong and Ren vessels. Combine with Qiancao (Madder Root). It also dispels Cold-Dampness, making it suitable for leukorrhea due to Cold-Dampness.
93. Tianma (Gastrodia Rhizome) is commonly used for vertigo. However, causes vary: Blood deficiency requires nourishing Blood and calming Liver; Yin deficiency with rising Liver Yang requires nourishing Yin and calming Liver; Excess Heat causing Liver Wind requires clearing Heat and descending Fire. Tianma is suitable only for Liver Wind with Phlegm-Dampness. Tianma is pungent and drying, dispelling Wind, drying Dampness, and resolving Phlegm. Thus, it should be used cautiously in Fire-excess and Yin-deficiency cases.
94. Alternating chills and fever does not always require Chaihu (Bupleurum Root), but Chaihu must be the primary symptom indicator. For *Taoren Chengqi Tang* used in Heat entering the Blood Chamber, replacing Guizhi (Cinnamon Twig) with Chaihu yields good results. Careful differentiation and understanding of the formula's core spirit are essential. In summer, Chaihu is often combined with Lianqiao and Yinhua (Honeysuckle) or omitted. For malaria with Phlegm-Dampness, Chaihu in *Pingwei San* is effective.
95. Shanzhuyu (Cornus Fruit) indications: 1) Liver-Kidney insufficiency, sore back/dizziness, impotence/spermatorrhea, frequent urination. 2) Menorrhagia in women. 3) Profuse sweating leading to Yang collapse. 4) Incontinence in the elderly. 5) Astringing Yuan Qi. 6) Spontaneous sweating due to Liver deficiency. 7) Hypochondriac/lower back pain due to Liver deficiency. 8) Internal Wind stirring due to Liver deficiency.
96. Danshen (Salvia Root) indications: 1) Dysmenorrhea. 2) Amenorrhea and masses. 3) Postpartum lochia retention and stasis pain. 4) Reducing swelling and relieving pain. 5) Early mastitis with redness/swelling/pain. 6) Heat damaging Ying level, restlessness/insomnia. 7) Stiffness of waist/spine. 8) Leg Bi-syndrome. 9) Breaking old blood, generating new blood. 10) Stabilizing viable fetus, expelling dead fetus.
97. Mahuang (Ephedra) induces sweating and releases the exterior. Clinically, sweating effects vary: 1) Fresh Mahuang sweats strongly; aged Mahuang sweats weakly or not at all. 2) Sweating is stronger in Qi/Yin deficiency than in severe Wind-Cold closure. 3) Sweating is stronger in Heat syndromes.
98. Mahuang diffuses Lung Qi and calms asthma. Efficacy varies: 1) Excellent for cough/wheeze due to Wind-Cold closure and Lung Qi stagnation. 2) Contraindicated or worsening for asthma due to Kidney failing to grasp Qi or Lung Qi deficiency. Case: A patient with refractory cough/wheeze was diagnosed with Kidney failing to grasp Qi. *Jinkui Shenqi Wan* plus Gejie (Gecko) helped. Adding Mahuang failed; removing Mahuang cured the patient.
99. Baizhu (Atractylodes Rhizome): Strengthens Spleen, dries Dampness, tonifies Qi, and calms fetus. Raw Baizhu promotes movement more than tonification; stir-fried Baizhu tonifies more than moves. Avoid burning it, as this injures the Spleen and causes bloating.
100. Xiyangshen (American Ginseng): Bitter, slightly sweet, cold. Tonifies Lung/Stomach Yin, descends Fire, generates fluids. Suitable for Lung/Stomach fluid deficiency with Fire. Can be substituted with Renshen (Ginseng) + Maidong (Ophiopogon) or Shigao (Gypsum) with similar effects.
101. Baicaoshuang (Soot): Stops bleeding and reduces accumulation. Indications: hematemesis, epistaxis, trauma bleeding, bloody stool, uterine bleeding, food stagnation diarrhea, borborygmus. It stops bleeding but does not benefit the intestines/stomach; it treats symptoms, not root. Do not use excessively.
102. Zelan (Lycopus Herb): Invigorates Blood, resolves stasis, unblocks menses, promotes urination. Soothes Liver/Spleen stagnation, neither cold nor drying, mild in action. It is a key herb for gynecological menstrual regulation.
103. Danfan (Alum): Sour, pungent, cold, toxic. For severe trachoma, rub small flat pieces quickly over the eye every other day; three treatments cure it.
104. Daimei (Horned Turtle Carapace): Sweet, salty, cold. Resolves poison from Lingnan herbs, gu poison, and carbon monoxide poisoning.
105. Dangshen (Codonopsis Root): Tonifies Middle and boosts Qi, generates fluids, nourishes Blood. Strengthens Spleen without drying, nourishes Stomach Yin without being cloying, moistens Lung without being cold, nourishes Blood without being sticky, lifts clear Yang, vibrates Middle Qi, without harsh/drying drawbacks. Contraindicated in unresolved exterior syndromes or Middle Fullness with Excess pathogens.
106. Cao Kou (Black Cardamom) and Cao Guo (Tsaoko Fruit): Both pungent and warm, treating Cold-Dampness. Cao Kou is more tonifying; use moderately to avoid aiding Spleen Heat and injuring Lung/Eyes. Cao Guo is more resolving.
107. Guizhi (Cinnamon Twig): Ascends and descends, raises large Qi, directs rebellious Qi downward. Use cautiously in pregnancy due to potential Heat and risk of miscarriage.
108. Jingjie (Schizonepeta): Use spikes for headache due to Wind stagnation above. Charred Jingjie enters Blood level to stop bleeding. Single use treats Wind in skin/fascia (feverish skin, dizziness, throat obstruction, back pain). Combined with Fangfeng, treats Wind invading muscles/bones.
109. Fangfeng (Saposhnikovia Root): Treats all Wind pathogens, chief herb for Wind diseases. Often combined: with Nanxing (Arisaema) for tetanus (*Yuzhen San*); with Jingjie for epidemic rashes, Blood Wind, and systemic Wind (*Jingfang Bai Du San*); with Suye (Perilla Leaf) for Wind-Cold; with Lianqiao/Bohe/Sangye for Wind-Heat; with Shenqu/Maiya for Food Stagnation; with Chenpi/Banxia for Phlegm; with Jinyinhua/Lianqiao for Sores/Toxins. Combined with Cangzhu/Baizhu/Fangji for Wind-Dampness (*Shenzhu San*, etc.). Combined with Huangqi for Wei-Qi deficiency spontaneous sweating (*Yupingfeng San*). Combined with Qianghuo for Taiyang Wind-Cold headache/stiffness/body ache (*Jiuwei Qianghuo Tang*).
110. Huangqi (Astragalus Root): Tonifies Qi, raises Qi, relieves pain, generates flesh. Raw for sinking Qi (with Shengma/Chaihu); roasted for Middle deficiency (with Renshen/Baizhu); severe deficiency with Renshen; add Zhimu (Anemarrhena) to prevent Heat.
111. Shengma (Cimicifuga Rhizome): Use heavily for erupting rashes and detoxifying; lightly for raising Yang and lifting sinking.
112. Chaihu (Bupleurum Root): Harmonizes Chills/Fevers, raises Yang, soothes Liver, resolves Shaoyang syndrome, Heat entering Blood Chamber (malaria-like), pediatric food stagnation, afternoon fever. Use heavily for Excess Chills/Fevers; lightly for raising Yang/resolving depression.
113. Sangye (Mulberry Leaf): Disperses Wind, clears Heat, cools Blood, brightens eyes, nourishes Kidney Yin. Treats blurry vision due to Liver Yin deficiency (reflecting Liver-Kidney homology) and consumptive Heat cough.
114. Baishao (White Peony Root): Bitter, sour, slightly cold. Nourishes Blood, astringes Yin, softens Liver, relieves pain, suppresses Liver Yang. Wine-fried ascends; vinegar-fried enters Liver to resolve stasis. Wine-fried for diarrhea/abdominal pain; vinegar-fried for bleeding; raw for dry stool/rebellious Liver Yang.
115. Shengjiang (Fresh Ginger): With Dazao (Jujube) harmonizes Ying/Blood. Raw strongly disperses; baked warms Middle effectively for Spleen-Stomach Cold. Juice for red eyes; mixed with Zhuli (Bamboo Sap) to counteract Zhuli's coldness and enhance its properties. Paojiang (Prepared Ginger) and Ganjiang (Dried Ginger) stay rather than move, treating Stomach Cold. Jiangtan (Ginger Charcoal) warms meridians and stops bleeding for Cold-type hemorrhage.
116. Dahuang (Rhubarb Root): Bitter, cold. Raw for drastic purgation; cooked for mild purgation; wine-processed for head/eye Fire; vinegar-processed for breaking Blood stasis. Use cautiously in absence of Blood Heat/GI stagnation, and in pregnancy/postpartum/menstruation/lactation to avoid uncontrollable bleeding/diarrhea/miscarriage/weaning.
117. Shengdi (Rehmannia Root): Juicy, viscous. May injure Stomach Qi in weak patients; wine-fry recommended. Avoid iron.
118. Zhu Ti (Pig Trotter): Nourishes Blood, generates milk, resolves drug poisons. Decoct for soup/medicine or eat alone.
119. Danggui (Angelica Sinensis): Nourishes Blood, harmonizes Blood, regulates menses, relieves pain, moistens intestines. Wine-washed for invigorating Blood; head for stopping bleeding; body for nourishing Blood; tail for moving Blood; fibers for unblocking collaterals; whole for harmonizing Blood. Mostly used raw; charred for stopping bleeding.
120. Chao Sanxian (Stir-fried Three Immortals - Maiya, Shenqu, Shan Zha): Digestive herbs. Use sparingly in Spleen deficiency. If Spleen deficiency with food stagnation, combine with Renshen/Baizhu/Fuling for benefit without harm.
121. Sharen (Amomum Fruit) and Huoxiang (Patchouli Herb): Move Qi, resolve stagnation, transform Dampness, open appetite. Combined with Shudi/Renshen/Huangqi prevents their cloying effect on appetite.
122. Ma Binglang (Areca Seed): Chew two with water regularly; long-term use causes uterine cold and infertility. Chew finely during labor to treat dystocia.
123. Huangbai (Phellodendron Bark) + Zimu (Anemarrhena Rhizome): Nourishes Yin, descends Fire. Huangbai + Cangzhu (Atractylodes Macrocephala Rhizome): Clears Heat, drains Dampness.
124. Treatment must align with pathogenesis. Case: Abdominal fullness due to Qi stagnation in a chronic weak patient. Modeled after *Houjiang Ban Gan Shen Tang*, used Renshen and Houpo, added Xiangfu/Muxiang to move Qi, Banxia/Fuling to dry Dampness/drain water. Effective immediately. Pure Qi-moving or pure tonification would fail.
125. Summer-Heat easily injures Qi and consumes Fluids. Qi injury causes shortness of breath/fatigue; Fluid consumption causes sweating/thirst/restlessness. Summer-Heat injuring Lung causes cough. Treat with Renshen, Maidong, Wuweizi (Schisandra). Xu Huixi said: "Maidong/Wuweizi contraindicated in cough; usable in non-cough Summer-Heat." I believe: Cough due to Cold contraindicates Maidong/Wuweizi; Summer-Heat cough is Heat-based with no Phlegm, so they are safe. However, distinguish carefully as many summer coughs are due to Cold from cooling habits.