主治肌表之水也。故能治黄汗、盗汗、皮水。又旁治身体肿或不仁者。
考 证
芍桂枝苦酒汤证曰∶身体肿、发热汗出而渴。又云∶汗沾衣、色正黄加 汁；防己黄
汤证曰∶身重、汗出恶风。
以上二方，黄 皆五两。
防己茯苓汤证曰∶四肢肿，水气在皮肤中。
黄 桂枝五物汤证曰∶身体不仁。
以上二方，黄 皆三两。
桂枝加黄 汤证曰∶身常暮盗汗出者。又云∶从腰以上必汗出、下无汗、腰 弛痛、如
有物在皮中状。
以上一方，黄 二两。
黄 建中汤证，不具也。
以上一方，黄 一两半。
上历观此诸方，黄 主治肌表之水也。故能治黄汗、盗汗、皮水。又能治身体肿或不仁
者，是肿与不仁，亦皆肌表之水也。
互 考
芍桂枝苦酒汤、桂枝加黄 汤，同治黄汗也。而 芍桂枝苦酒汤证曰∶汗沾衣，是汗
甚多也。桂枝加黄 汤证曰∶腰以上必汗出、下无汗，是汗少也。以此考之，汗之多少，即
用黄 多少，则其功的然可知矣。
防己黄 汤、防己茯苓汤。同治肌肤水肿也。而黄 有多少。防己黄 汤证曰∶身重汗
出。防己茯苓汤证曰∶水气在皮肤中，此随水气多少，而黄 亦有多少。则黄 治肌表之水
明矣。故 芍桂枝苦酒汤、桂枝加黄 汤，随汗之多少，而用黄 亦有多少也。
黄 桂枝五物汤证曰∶身体不仁。为则按∶仲景之治不仁，虽随其所在，处方不同。而
历观其药，皆是治水也。然则不仁，是水病也。故小腹不仁、小便不利者，用八味丸以利小
便，则不仁自治。是不仁者，水也。学人思诸。
防己黄 汤，《金匮要略》载其分量与《外台秘要》异。为则夷考其得失，《外台秘要》
古，而《金匮要略》不古矣。故今从其古者也。
辨 误
余尝读本草载黄 之功。陶弘景曰∶补丈夫虚损、五劳羸瘦、益气。甄权曰∶主虚喘，
肾衰耳聋，内补。嘉谟曰∶人参补中，黄 实表也。余亦尝读《金匮要略》，审仲景之处方，
皆以黄 治皮肤水气，未尝言补虚实表也。为则尝闻之，周分置医，职四焉∶曰食医、曰疾
医、曰疡医、曰兽医。夫张仲景者，盖古疾医之流也。夫陶弘景尊信仙方之人也。故仲景动
言疾病，而弘景动论养气，谈延命，未尝论疾病。后世之喜医方者，皆眩其俊杰，而不知其
有害于疾医也。彼所尊信而我尊信之，滔滔者天下皆是也。岂不亦悲哉？夫逐奔兽者，不见
大山。嗜欲在外，则聪明所蔽。故其见物同，而用物之异。仲景主疾病者也，弘景主延命者
也；仲景以黄 治水气，弘景以之补虚。夫药者，毒也。毒药何补之为，是以不补而为补，
以不补而为补，是其聪明为延命之欲所蔽也。古语曰∶邪气盛则实，精气夺则虚。夫古所谓
虚实者，以其常而言之也。昔者常无者，今则有之，则是实也。昔者常有者，今则无之，则
是虚也。邪者，常无者也；精者，常有者也。故古所谓实者，病也。而虚者，精也。因病而
虚，则毒药以解其病毒而复其故也。非病而虚，则非毒药之所治也，以谷肉养之。故曰攻病
以毒药，养精以谷肉果菜。今试论之。天寒肌肤粟起，当此时服黄 而不已也。以衣衾则已，
以衣衾而不已也，啜粥而已，无他。是非病而精虚也。若乃手足拘急恶寒，是与衣衾而不已
也，啜粥而不已也，与毒药而已也。无他，是邪实也。呜呼？仲景氏哉？信而有征，此孔子
所以非法言不敢道也，甄权、嘉谟不言疾医之法言也，抑亦弘景祸之矣。言必以仙方，必以
阴阳，此 功之所以不着也。
品 考
黄 汉土、朝鲜、本邦皆产也。汉土出绵上者，以为上品，其他皆下品也。其出朝
鲜、本邦者，亦皆下品也。今华舶之所载而来者，多是下品，不可不择也。凡黄 之品，柔
软、肉中白色，润泽味甘，是为上品也，锉用。
It governs the water-dampness at the muscle and surface level. Therefore, it can treat Huanghan (Yellow Sweat), Daohan (Night Sweats), and Pishui (Skin Edema). It also treats body swelling or numbness (loss of sensation).
Evidence Examination
The syndrome of Shaoyao Guizhi Kujiu Tang (Peony and Cinnamon Twig Vinegar Decoction) presents with: body swelling, fever, sweating, and thirst. It is also stated that: sweat stains clothes yellow like juice; the syndrome of Fangji Huangqi Tang (Stephania and Astragalus Decoction) presents with: heavy body, sweating, and aversion to wind.
In the above two formulas, Huangqi (Astragalus Root) is used in the amount of five liang.
The syndrome of Fangji Fuling Tang (Stephania and Poria Decoction) presents with: swelling of the four limbs, with water-qi residing in the skin.
The syndrome of Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction) presents with: body numbness.
In the above two formulas, Huangqi (Astragalus Root) is used in the amount of three liang.
The syndrome of Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction with Added Astragalus) presents with: frequent night sweating. It is also stated that: sweating must occur from the waist up, while there is no sweating below the waist; the waist feels flaccid and painful, as if there were an object within the skin.
In the above one formula, Huangqi (Astragalus Root) is used in the amount of two liang.
The text for Huangqi Jianzhong Tang (Astragalus and Middle-Warming Decoction) is incomplete.
In the above one formula, Huangqi (Astragalus Root) is used in the amount of one and a half liang.
Having observed these formulas comprehensively, Huangqi (Astragalus Root) governs water-dampness at the muscle and surface level. Thus, it can treat Huanghan (Yellow Sweat), Daohan (Night Sweats), and Pishui (Skin Edema). It can also treat body swelling or numbness, indicating that swelling and numbness are both caused by water-dampness at the muscle and surface level.
Cross-Examination
Shaoyao Guizhi Kujiu Tang (Peony and Cinnamon Twig Vinegar Decoction) and Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction with Added Astragalus) both treat Huanghan (Yellow Sweat). However, the syndrome of Shaoyao Guizhi Kujiu Tang states: "sweat stains clothes," indicating profuse sweating. The syndrome of Guizhi Jia Huangqi Tang states: "sweating must occur from the waist up, while there is no sweating below the waist," indicating scanty sweating. Based on this examination, the amount of sweating corresponds to the dosage of Huangqi (Astragalus Root); thus, its efficacy is clearly discernible.
Fangji Huangqi Tang (Stephania and Astragalus Decoction) and Fangji Fuling Tang (Stephania and Poria Decoction) both treat edema of the skin and muscles. However, the dosage of Huangqi (Astragalus Root) differs. The syndrome of Fangji Huangqi Tang states: "heavy body, sweating." The syndrome of Fangji Fuling Tang states: "water-qi in the skin." This indicates that the dosage of Huangqi (Astragalus Root) varies according to the amount of water-qi. Therefore, it is clear that Huangqi (Astragalus Root) treats water-dampness at the muscle and surface level. Consequently, in Shaoyao Guizhi Kujiu Tang (Peony and Cinnamon Twig Vinegar Decoction) and Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction with Added Astragalus), the dosage of Huangqi (Astragalus Root) varies according to the amount of sweating.
The syndrome of Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction) states: "body numbness." Weierze notes: Zhang Zhongjing's treatment of numbness varies the prescription according to the location. However, observing his herbs, they all treat water-dampness. Thus, numbness is a disease of water. Therefore, for numbness in the lower abdomen accompanied by difficult urination, using Bajian Wan (Eight-Ingredient Pill) to promote urination will cure the numbness naturally. Numbness is caused by water. Scholars should ponder this.
For Fangji Huangqi Tang (Stephania and Astragalus Decoction), the dosages recorded in *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) differ from those in *Waitai Miyao* (Secret Essentials of the Outer Palace). Weierze examined their merits and demerits; *Waitai Miyao* is older, whereas *Jingui Yaolue* is not as old. Therefore, we now follow the older version.
Correction of Errors
I once read in herbal texts about the efficacy of Huangqi (Astragalus Root). Tao Hongjing said: "Tonifies deficiency injuries in men, five labors, emaciation, and benefits qi." Zhen Quan said: "Treats deficiency wheezing, kidney decline, deafness, and provides internal tonification." Jiamo said: "Renshen (Ginseng) tonifies the middle, while Huangqi (Astragalus Root) solidifies the exterior." I have also read *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) and carefully examined Zhang Zhongjing's prescriptions; he always used Huangqi (Astragalus Root) to treat skin water-qi, never mentioning tonifying deficiency or solidifying the exterior. Weierze once heard that in the Zhou Dynasty, physicians were divided into four categories: Shi Yi (Dietary Physician), Ji Yi (Physician for Diseases), Yang Yi (Surgeon), and Shou Yi (Veterinarian). Zhang Zhongjing was likely a practitioner of the ancient Ji Yi (Physician for Diseases). Tao Hongjing was a person who revered and believed in immortal prescriptions. Thus, Zhang Zhongjing frequently discussed diseases, while Tao Hongjing frequently discussed nourishing qi and prolonging life, never discussing diseases. Later generations who favored medical prescriptions were dazzled by their brilliance but did not realize the harm done to the practice of Ji Yi (Physician for Diseases). What they revered, I also revere; this trend is ubiquitous under heaven. Is this not tragic? One chasing a fleeing beast does not see the great mountains. Desires external to oneself obscure wisdom. Thus, although they see the same objects, their use of them differs. Zhang Zhongjing focused on diseases, Tao Hongjing on prolonging life; Zhang Zhongjing used Huangqi (Astragalus Root) to treat water-qi, while Tao Hongjing used it to tonify deficiency. Medicines are toxic. How can toxic substances provide tonification? To treat non-deficiency as deficiency, and to claim tonification where there is none, is because their wisdom was obscured by the desire to prolong life. An ancient saying goes: "When pathogenic qi is exuberant, it is excess; when essential qi is depleted, it is deficiency." The ancient concepts of excess and deficiency were based on normalcy. What was normally absent but is now present constitutes excess. What was normally present but is now absent constitutes deficiency. Pathogens are what is normally absent; essence is what is normally present. Therefore, what the ancients called "excess" refers to disease, and "deficiency" refers to essence. When deficiency arises from disease, toxic medicines are used to resolve the pathogen and restore the original state. When deficiency is not due to disease, it is not treated with toxic medicines but nourished with grains and meats. Hence, it is said: "Attack disease with toxic medicines; nourish essence with grains, meats, fruits, and vegetables." Let us discuss this further. When the weather is cold and gooseflesh appears on the skin, taking Huangqi (Astragalus Root) at this time will not stop it. Covering oneself with clothes and quilts will stop it. If covering with clothes and quilts does not stop it, drinking hot porridge will stop it. There is no other reason. This is not disease but essence deficiency. However, if there are contracted limbs, aversion to cold, which do not improve with clothes and quilts or hot porridge, but only improve with toxic medicines, there is no other reason; this is pathogenic excess. Alas, Master Zhongjing! His records are true and verifiable. This is why Confucius said he would not speak words that were not proper. Zhen Quan and Jiamo did not speak the laws of the Ji Yi (Physician for Diseases); this disaster was indeed caused by Tao Hongjing. Speaking only of immortal prescriptions and yin-yang theory is why the efficacy of Huangqi (Astragalus Root) remains obscure.
Product Examination
Huangqi (Astragalus Root) is produced in Han lands, Korea, and our own country (Japan). Those produced in Mianshang of Han lands are considered superior grade, while others are inferior grade. Those produced in Korea and our own country are also inferior grade. Most of what is brought by Chinese merchant ships today is inferior grade, so selection is necessary. For all grades of Huangqi (Astragalus Root), those that are soft, white in the flesh, moist, and sweet-tasting are considered superior grade. They should be sliced before use.