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On Yang Collapse, On Lower Bleeding, On Hematemesis, On Cranial Hyperhidrosis, On Palmar Hyperhidrosis

The Heavenly Master said: The method of astringent treatment refers to the strategy of astringing when Qi is on the verge of dissipating. For instance, continuous sweating indicates Yang collapse and the impending dissipation of Qi. Similarly, unceasing lower bleeding (bleeding from the lower orifices) and hematemesis (vomiting blood) represent blood that is dispersing and cannot be stopped. When Qi dissipates, only a thread of Yang remains; if allowed to scatter further, Yang collapse and death are inevitable. However, the treatment for collapse primarily lies in astringing Lung Qi, thereby securing the skin pores and interstices (the spaces between skin and muscle), so that where would Yang dissipate? Merely astringing Lung Qi without significantly tonifying Yuan Yang (Primary Yang) means that Original Qi will still tend to collapse; even if it does not escape through the skin pores, it will inevitably escape through the mouth, nose, eyes, and ears. Therefore, one must employ tonification as the means of astringency to achieve success. The prescription consists of Ren Shen (Ginseng Radix et Rhizoma) 1 liang, Huang Qi (Astragali Radix) 1 liang, Dang Gui (Angelicae Sinensis Radix) 1 liang, Wu Wei Zi (Schisandrae Chinensis Fructus) 1 qian, Shan Zhu Yu (Corni Fructus) 4 qian, Sang Ye (Mori Folium) 5 leaves, Suan Zao Ren (Ziziphi Spinosae Semen) 1 qian, and Mai Dong (Ophiopogonis Radix) 3 qian. Decoct with water and take orally. The efficacy of this formula lies entirely in using Ren Shen and Dang Gui to tonify Qi, and Shan Zhu Yu and Wu Wei Zi to astringe Qi. Thus, tonification aids the effect of astringency, and astringency enhances the benefit of tonification. Moreover, Sang Ye is a superb herb for arresting sweating, which mediates within the astringent action, avoiding bias towards either pure astringency or pure tonification.

Lower bleeding often arises from chronic alcohol abuse. While using herbs to resolve alcohol toxicity can be effective, it is not always sufficient. Physicians of the world typically use only Ge Gen (Puerariae Lobatae Radix) and Sang Bai Pi (Mori Cortex) for this purpose. However, Ge Gen should not be taken in large doses, and Sang Bai Pi has a light and clear nature, making it unsuitable as the sole agent. Consequently, although alcohol may be resolved, the underlying alcohol-induced pathology remains difficult to eradicate. Furthermore, alcohol-induced disease develops over a long period, not overnight; how could light and clear herbs, which are not suitable for prolonged use, cure such a condition? Therefore, I discard them. The prescription uses Ren Shen 2 qian, Dang Gui 1 liang, Di Yu (Sanguisorbae Radix) 3 qian, Sheng Di Huang (Rehmanniae Radix) 5 qian, and San Qi (Notoginseng Radix et Rhizoma powder) 3 qian. Decoct with water and take orally. [Commentary: Sheng Xin Tang (Generate New Blood Decoction). This formula generates blood, not merely stops bleeding.] The brilliance of this formula lies in neither treating the alcohol pathology nor directly stopping the bleeding. Instead, it relies on Sheng Di Huang and Dang Gui to invigorate blood; once blood circulation is restored, new blood is generated and old bleeding ceases. Additionally, Di Yu’s cold nature clears Fire in the Large Intestine, and San Qi powder seals the bleeding orifices in the Large Intestine, naturally stopping the bleeding and curing the disease. This is one method of astringent treatment.

Regarding hematemesis, whether profuse like an overturned basin or filling a bowl, if astringency is not applied urgently, when will the vomiting cease? However, using solely sour-astringent and cold-restrictive herbs may exacerbate the blood pathogen, further encouraging its violent eruption. It is better to follow its nature and add a small amount of astringent herbs, allowing the Fire to subside and blood to return to its vessels. The prescription consists of Ren Shen 1 liang, Dang Gui 1 liang, Suan Zao Ren 3 qian, and San Qi powder 3 qian. Decoct with water and take orally after mixing. The efficacy of this formula lies not in stopping bleeding but in consolidating Qi. "When blood is lost, tonify Qi" yields miraculous results. Blood is a tangible substance; having been vomited out in abundance, the body lacks blood for nourishment. One might think urgent use of blood-generating herbs is necessary, yet delaying them is already too late. Why then use Qi-tonifying agents, which seem ineffective? In truth, blood is tangible, while Qi is intangible transformation. Tangible substances cannot be generated quickly, whereas intangible Qi can be secured first. Moreover, tangible things must arise from the intangible. Only intangible Qi can generate tangible blood; tonifying Qi is precisely to tonify blood, generating Qi is precisely to generate blood. Since blood has been largely lost, only a trace of Qi remains. If this Qi is not urgently supplemented, once Qi perishes, what will generate and supplement blood? As the Classic states: "Tangible blood cannot be rapidly regenerated; intangible Qi must be urgently consolidated." This is indeed a subtle method for treating blood disorders. This is another method of astringent treatment.

Master Zhang said: Truly, there are wonders beyond imagination; I have no words to add. I will only explain the astringent method for cranial hyperhidrosis. Sweating exclusively on the crown of the head indicates excess Kidney Fire and deficiency of Kidney Water. Ignoring this cause and merely using antihidrotic herbs will inevitably lead to blurred vision and ear pain. The treatment should nourish the Kidneys and clear the source of transformation of Lung Metal, ensuring rapid efficacy. The prescription uses Sang Ye 1 jin, Shu Di Huang (Prepared Rehmanniae Radix) 2 jin, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 3 liang, and Mai Dong 6 liang. Grind each into powder and form pills with honey. [Commentary: E Han Tang (Arrest Sweat Decoction).] Take 5 qian or 1 liang daily with plain boiled water. After one month, sweating will cease permanently. Another case involves patients who sweat profusely on the head during meals; this is due to Stomach Fire excess, not Kidney Fire excess. The treatment should use Xuan Shen (Scrophulariae Radix) 1 jin, Mai Dong 1 jin, Tian Dong (Asparagi Radix) 1 jin, Sheng Di Huang 1 jin, Bei Wu Wei Zi 4 liang, and Suan Zao Ren 0.5 jin. Grind into powder and form honey pills. [Commentary: Lian Han Tang (Astringe Sweat Decoction).] Take 1 liang daily with plain boiled water; recovery is expected within two months. One might ask why Ye Zhu Gao Shi Tang (Bamboo Leaf and Gypsum Decoction) is not used for Stomach Fire excess. The reason is that the Stomach Fire here is mild, not blazing or turbulent, but rather triggered by food entering the stomach, causing slight perspiration that stops when eating ends. Thus, Xuan Shen alone is sufficient to resolve it. Furthermore, Tian Dong and Mai Dong clear Lung Fire, Sheng Di Huang cools blood, Suan Zao Ren calms Heart Fire, and Wu Wei Zi arrests sweating and nourishes fluids. These actions dissipate the Stomach Fire, especially since it was never severe. This is another method of astringent treatment. Palmar hyperhidrosis is a minor ailment and need not be included here; washing with medicinal herbs suffices for cure. I will discuss this later.

Master Hua said: It has not been transmitted.