东垣谓∶参、术补脾,非以防风、白芷行之,则补药之力不能到。慎斋谓∶调理脾胃,
须加羌活
,以散肝结。此皆发表散气之品也,是能运补药之力于周身,又能开通三焦与经络之滞气也
。此外尚有川芎、乌药、香附、降香、白檀香、郁金,皆可选用,以皆芳香,有通气之功也
。防风、秦艽,尤为散中之润。若味辛者,不可混用,味辛则燥,能耗津液矣。
滑伯仁谓∶每加行血药于补剂中,其效倍捷。行血之药,如红花、桃仁、茜草、归须、
茺蔚
子、三棱、莪术之属皆是也。叶天士亦谓热病用凉药,须佐以活血之品,始不致有冰伏之虞
。盖凡大寒、大热病后,脉络之中必有推荡不尽之瘀血,若不驱除,新生之血不能流通,元
气终不能复,甚有传为劳损者。又有久病气虚,痰涎结于肠胃,此宜加涤痰之品,如蒌皮、
焦楂、蒲黄、刺蒺藜、 牡蛎、海蛤粉、海浮石、青黛、 石膏,皆可随寒热而施之。行血
之药,以水蛭为上,虻虫、 虫、蛴螬次之。坏痰之药,以硼砂为上,礞石、皂荚次之,今
人已不敢用矣。痰本血液,非津水之类也,世以茯苓、泽泻利之;血属有形,瘀积膜络曲折
之处,非潜搜默剔不济也,世以大黄、芒硝下之,大谬。着有《痰饮分治说》、《仲景抵当
汤丸解》,具在集中,可以互览。
Li Dongyuan stated: When using Renshen (Ginseng Radix) and Baizhu (Atractylodis Rhizoma) to tonify the Spleen, if Fengfang (Saposhnikoviae Radix) and Baizhi (Angelicae Dahuricae Radix) are not added to promote circulation, the efficacy of the tonifying herbs cannot reach the whole body. Shen Zhai stated: When regulating the Spleen and Stomach, Qianghuo (Notopterygii Rhizoma et Radix) must be added to dissipate Liver Qi stagnation. These are all herbs that release the exterior and disperse Qi; they can mobilize the power of tonifying herbs throughout the body and open up stagnant Qi in the Sanjiao (Triple Burner) and meridians. Additionally, Chuanxiong (Ligustici Chuanxiong Rhizoma), Wuyao (Linderae Radix), Xiangfu (Cyperi Rhizoma), Jiangxiang (Dalbergiae Odoriferae Lignum), Baitanxiang (Santalum Album Lignum), and Yujin (Curcumae Longae Radix) can all be selected because they possess aromatic properties and have the function of promoting Qi movement. Fengfang (Saposhnikoviae Radix) and Qinjiao (Gentianae Macrophyllae Radix) are particularly moistening among dispersing herbs. If herbs with pungent flavors are mixed indiscriminately, their dryness will consume Body Fluids.
Hua Borun stated: Adding blood-invigorating herbs to tonifying formulas doubles the speed of efficacy. Blood-invigorating herbs include Honghua (Carthami Flos), Taoren (Persicae Semen), Qiancao (Rubiae Cordifoliae Radix), Guixu (Angelicae Sinensis Radix), Chongweizi (Leonuri Fructus), Sanleng (Sparganii Rhizoma), and Ezhu (Curcumae Rhizoma). Ye Tianshi also stated: When treating heat diseases with cooling herbs, one must assist them with blood-invigorating agents to avoid the risk of "Ice-Fu" (cold coagulation causing pathogens to become deeply entrenched). Generally, after severe cold or heat diseases, there must be residual blood stasis in the collaterals that has not been fully swept away. If this is not expelled, newly generated blood cannot circulate freely, and Yuan Qi (Primal Qi) ultimately cannot recover; it may even progress into consumptive disease (Lao Sun). Furthermore, in chronic illnesses leading to Qi deficiency, phlegm-saliva may knot in the intestines and stomach; in such cases, phlegm-resolving herbs should be added, such as Loupi (Benincasae Exocarpium), Jiaozha (Crataegi Fructus Preparata), Puhuang (Typhae Pollen), Cijili (Tribuli Fructus), Muli (Concha Ostreae), Haigefen (Concha Arcae), Haifushi (Lithotrichum), Qingdai (Indigo Naturalis), and Shigao (Gypsum Fibrosum), which can be applied according to the cold or heat nature of the condition.
Among blood-invigorating herbs, Shui zhi (Hirudo) is superior, followed by Meng chong (Tabanus), E chong (Eupolyphaga), and Qiluo (Blaberus). Among phlegm-breaking herbs, Pengsha (Borax) is superior, followed by Mengshi (Calamine) and Zaojiao (Gleditsiae Sinensis Fructus); however, modern practitioners dare not use these. Phlegm is essentially transformed blood, not a type of fluid or water; yet the world uses Fuling (Poria) and Zexie (Alismatis Rhizoma) to drain it via diuresis. Blood is tangible matter; when blood stasis accumulates in the tortuous places of membranes and collaterals, only subtle searching and meticulous elimination can resolve it; yet the world uses Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas) to purge it downward, which is a great error. I have written "Shu Tan Yin Fen Zhi Shuo" (Theory on Separate Treatment of Phlegm and Fluid Retention) and "Zhongjing Didang Tang Wan Jie" (Explanation of Zhang Zhongjing's Didang Decoction and Pills), both included in my collected works, for mutual reference.