Library

Sun Simiao stated: Whenever one intends to take large decoctions or pills such as the Five-Mineral Powder for tonification, one must first take a purgative decoction to cleanse the intestines and stomach of phlegm-rheum and accumulated fluid. Initially, I also praised the merit of this method; now, I find his words even more profound. Those who experience abdominal fullness after taking herbs such as Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragali Radix), and Dihuang (Rehmanniae Radix) do so because there is pathogenic factor present within. Generally, those taking these tonifying herbs are weak due to deficiency. In individuals with deficiency, the Qi of the Middle Jiao fails to circulate, leading to the accumulation of damp-heat, phlegm-turbidity, and water-fluid in the intestines and stomach. These pathological products obstruct the Zheng Qi (Upright Qi), preventing its free flow. Since tonifying herbs have a mild nature and tend to remain in the Middle Jiao, upon entering the abdomen, they encounter the pathogenic factors directly. Unable to dispel the pathogens to allow the Zheng Qi to connect, they instead exacerbate the pathogenic factors, causing harm. Therefore, anyone taking tonifying herbs must first take a heavy dose of purgative decoction to repel and expel the pathogens, thereby opening the pathway for the tonics to nourish the body. Alternatively, if attacking methods are interspersed with tonification, the force of attack must exceed the force of tonification; this does not destroy the nature of the tonics. For instance, when Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) are combined with Binglang (Arecae Semen) and Houpo (Magnoliae Officinalis Cortex), their tonifying power is significantly reduced. When combined with Huangbai (Phellodendri Cortex), Fuling (Poria), Taoren (Persicae Semen), and Muxiang (Aucklandiae Radix), they act separately, clearing damp-heat to assist the Zheng Qi (Upright Qi). Furthermore, there is a crucial point: if the phlegm-fluid in the stomach is not cleared first, and one hastily proceeds to strengthen the Spleen and tonify Qi, the充盈 (abundant) Qi and Blood will stir up the phlegm-fluid, causing it to overflow and invade the collaterals, resulting in greater harm. It is often observed that after taking tonics, patients suffer from pain in all bone joints; or lumps as large as plums or peaches appear, causing pain during movement; or limb joints suddenly become immobile; or patches of skin become swollen, numb, cold, and painful like ice, feeling like needle pricks or knife cuts; or the pulse becomes deep, knotted, or irregular. People mistakenly believe that the tonic has trapped the phlegm; in fact, the tonic has stirred up the phlegm. Zhang Shiwang stated: There are individuals who are obese and phlegm-dense, working tirelessly without fatigue, but feel fatigued and achy when resting. This is because during labor, Qi stirs and moves the phlegm, while at rest, the phlegm coagulates and obstructs Qi and Blood. Once phlegm-fluid has invaded the collaterals, it cannot be transformed into essence and nutrients again. From then on, this corrupted phlegm flows and accumulates; long-term stagnation and putrefaction lay the foundation for conditions such as carbuncles, flaccidity syndromes, paralysis, bi-syndromes (painful obstruction), and hemiplegia. Those who do not understand this attribute the disaster to the tonic, whereas it is actually the disaster of failing to use purgative methods. Yu Jiayan also stated: Individuals with abundant phlegm should rest frequently to allow phlegm in the collaterals to retreat back to the Stomach, providing an exit route. They should not greedily consume acrid-warm agents, as this may irritate the phlegm, causing it to rupture and spread, making it impossible to drain. However, merely prohibiting acrid-warm drugs is inferior to using bitter-astringent and sinking-depressing agents, taken lightly and frequently, to absorb and extract turbid evils from the membranes and collaterals, carrying them downward together. This keeps the Stomach empty and clean, allowing it to accept warm-tonifying herbs, making the use of acrid-warm herbs acceptable. Herbs with acrid-numbing flavors are most capable of traveling along the sinews and are also most likely to guide phlegm into the collaterals.