人有胃火熏蒸，日冲肺金，遂至痿弱不能起立，欲嗽不能，欲咳不敢，及至咳
嗽又连声不止，肺中大痛，非肺痈之毒，乃肺痿之病也。夫肺之成痿也，由于阳明
之火上冲于肺，而肺经津液衰少，不能灭阳明之焰，金从火化，累年积岁，肺叶之
间酿成火宅，而清凉之药，不能直入于肺，非 格清凉之故也。肺既大热，何能
下生肾水，水干无以济火，则阳明之炎蒸更甚，自然求救于水谷；而水谷因肺金清
肃之令不行，不能化成津液，以上输于肺，则肺之燥益甚；肺燥而肺中津液尽变为
涎沫浊唾矣。肺液既干，肺气自怯，所成涎沫浊唾，若难推送而出，此欲嗽之所以
不能也。然而涎沫浊唾，终非养肺之物，必须吐出为快，无奈其盘踞于火宅，倘一
咳而火必沸腾，胸膈之间必至动痛，此欲咳之所以不敢也。迨忍之又忍至不可忍，
而咳嗽涎沫浊唾虽出，而火无水养。上冲于咽喉，不肯遽下，此咳嗽所以又连声而
不止也。咳嗽至连声不止，安得不伤损干燥之肺而作痛乎。人见其痿弱不能起立，
或用治痿之药，愈伤肺气，奚能起痿。治法宜泻其胃中之火，大补其肺经之气，然
又不可徒补其肺中之气，更宜兼补其肾中之水。方用生津起痿汤∶
麦冬（一两） 甘草（二钱） 玄参（一两） 甘菊花（五钱） 熟地（一两）
天门冬（三钱） 天花粉（一钱） 贝母（一钱） 金银花（五钱） 水煎服。连服四剂，而咳
嗽轻，再服四剂，而咳嗽止，再服十剂，而痿症除矣。
盖阳明之火，本可用大寒之药。然而阳明初起之火，可用大寒；而阳明久旺之
火，宜用微寒。因阳明之火，乃胃土中之火，初起可用大寒泻火，以救肾中之水，
久旺用微寒散火，所以生胃中之土也。胃火之盛，胃土之衰也，扶其土，即所以泻
其火。而胃土自健，自能升腾胃气，化水谷之精微，输津液于肺中也。又加之二冬、
甘草、天、贝之类，原能益肺消痰，则肺中更加润泽。得金银花同入，以消除其败
浊之毒，则肺金何至再燥乎？加熟地者，以填补肾水，水旺而肺不必去顾肾子之涸，
则肺气更安，清肃下行于各府，水生火息，不必治痿而痿自愈也。
此症用紫花饮亦神。
麦冬（三两） 桔梗 甘菊花 薄公英（各五钱） 生甘草 贝母（各二钱） 生地（一两）
紫花地丁（三钱） 水煎服。
胃火上冲于心，心中烦闷，怔忡惊悸，久则成痿，两足无力，不能动履，此总
属胃火之盛，非心火之旺也。夫胃属土，而心属火，心乃生胃，而胃不宜克心。然
心火生胃，则心火不炎，胃火熏心，则心火大燥，此害生于恩也。倘徒泻心火，则
胃子见心母之寒，益肆其炎氛，愈添心中之燥。必下取于肾水，而肾因胃火之盛，
熬干肾水，不能上济于心，火益旺而水益枯，骨中无髓，安得两足之生力乎？治法
宜大益其肾中之水，少清其胃中之火，则胃气安而肾水生，自然上交于心也。方用
清胃生髓丹∶
玄参（一两） 麦冬（五钱） 甘菊花（五钱） 熟地（二两） 北五味（二钱） 沙参（五钱）
水煎服。十剂即可行步，二十剂怔忡惊悸之病除，又十剂烦闷痿弱之症去，再服十剂
全愈。
痿症无不成于阳明之火，然用大寒之药，如石膏、知母之类，虽泻胃火甚速，
然而多用必至伤胃，胃伤而脾亦伤，脾伤而肾安得不伤乎。故不若用玄参、甘菊之
类，既清其胃火，而又不损其胃土，则胃气自生，能生津液，下必注于肾，而上且
灌于心矣。况麦冬、五味以益心，熟地、沙参以滋肾，上下相资，水火既济，痿病岂
不愈乎。
此症用石斛玄参汤亦佳。
金钗 石斛（一两） 玄参（二钱） 水煎服。
阳明之火，固结于脾，而不肯解，善用肥甘之物，食后即饥，少不饮食，便觉
头红面热，两足乏力，不能行走，人以为阳明胃火之旺，以致成痿，谁知是太阴脾
火之盛，以烁干其阴乎。夫痿症皆责之阳明，何以太阴火旺，亦能成痿？盖太阴与
阳明为表里，阳明火旺，而太阴之火亦旺矣。二火相合，而搏结于腑脏之间，所用
饮食，仅足以供火之消磨，而不能佐水之 渥。火旺水亏，则肾宫干涸，何能充足
于骨中之髓耶。骨既无髓，则骨空无力，何能起立以步履哉。治法益太阴之阴水，
以胜其阳明之阳火，则脾胃之中，水火无亢炎之害；而后筋骨之内，髓血有盈满之
机也。方用调脾汤∶
人参（五钱） 玄参（一两） 麦冬（五钱） 甘菊花（五钱） 薏仁（五钱） 金钗石斛（三钱）
芡实（一两） 山
药（五钱） 水煎服。连服四剂便觉腹不甚饥，再服四剂，火觉少息，再服十剂全愈。
此方补脾胃之土，即所以补其火也。然而火之所以旺者，正坐于土之衰耳。土
衰则不生水，而生火矣。今于补土之中，加入玄参、甘菊、石斛微寒之药，则脾胃
之火自衰，而脾胃之土自旺；脾胃之士既旺，而脾胃之津自生。于是灌注于五脏之
间，转输于两足之内。火下温而不上发，头面无红热之侵，何至胫趾之乏力哉。或
曰∶火盛易消，以至善饥，似宜用消导之剂，以损脾胃之气，乃不损其有余，而反
增益其不足，恐未可为训也。不知脾胃之土，俱不可伤，伤土而火愈旺矣。补阴则
阳伏，消食则伤阴。补阴可也，宁必用消导之药哉。
此症用玄母菊英汤亦效。
玄参（二两） 甘菊花（一两） 知母（三钱） 熟地（二两） 水煎服。
大怒之后，两胁胀满，胸间两旁时常作痛，遂至饭食不思，口渴索饮，久则两
腿酸痛，后则遍身亦痛，或痛在两臂之间，或痛在十指之际，痛来时可卧而不可行，
足软筋麻，不可行动，人以为痰火之作祟也，谁知是肝经之痿症乎。夫肝经之痿，
阳明之火助之也。当其大怒时，损伤肝气，则肝木必燥，木中之火无以自存，必来
克脾胃之土。脾阴不受，而胃独受之，胃初自强，不服其克，两相战克，而胸胁所
以作痛。后则胃土不敌肝木之旺，乃畏之而不敢斗，亦归附于肝，久之而饮食少用，
则不化津液以生肾水，肾无水以养肝，而肝气无非火气，胃亦出其火，以增肝火之焰，
肝火之性动，遂往来于经络之内而作痛。倘更加色欲，则精泄之后，无水制火，自
然足软筋麻，呻吟于卧榻之上，而不可行动也。治法必须平肝，而并泻阳明之火，
惟是阳明久为肝木之克，则阳明之经必虚，若再加泻火，胃气乌能不伤。必须泻阳
明之火，仍不损阳明之气为得也。方用伐木汤∶
炒栀子（三钱） 白芍（一两） 当归（五钱） 甘菊花（五钱） 女贞子（五钱） 地骨
皮（三钱） 丹皮（三钱） 青黛（三钱） 金钗石斛（三钱） 水煎服。连服四剂，而诸痛除，再服
四剂，口思饮食，再服十剂全愈。
此方泻肝火以平肝气，然而阳明胃火，未尝不同治之。胃气不伤而胃火自息，
饮食进而津液生，肾水足而骨髓裕，不须止痛而痛自失，毋须治痿而痿自起矣。
此症用二石汤亦佳。
白芍（一两） 熟地（三两） 金钗石斛 牛膝（各五钱） 石膏（三钱） 水煎服。
素常贪色，加之行役劳瘁，伤骨动火，复又行房鼓勇大战，遂至两足痿弱，立
则腿颤，行则膝痛，卧床不起，然颇能健饭易消，人以为食消之症也，谁知是肾火
之盛，引动胃火以成肾痿乎。盖胃为肾之关，胃之开阖肾司之也。肾火直冲于胃，
而胃之关门曷敢阻之，且同群助势，以听肾火之上炎矣。况肾火乃龙雷之火也，胃中
之火，其性亦喜炎上，二火相因而起，销铄肾水，有立尽之势。幸肾火盛，而胃火尚
未大旺，故但助肾以消食，不至发汗以亡阳。且饮食易消，犹有水谷以养其阴，虽
不能充满于骨中，亦可以少滋于肾内，故但成痿而不至于死亡也。治法急宜大补肾
水以制阳光。方用起痿降火汤∶
熟地（三两） 山茱萸（一两） 薏仁（五钱） 金钗石斛（五钱） 牛膝（五钱）
水煎服。四剂腿颤足痛之病去，十剂可以步履，饮食不至易饥，二十剂全愈。
此方大补肾阴，全不去泻胃中之火。譬如城内粮足，则士马饱腾，安敢有鼓噪
之声，而兴攘夺争取之患乎！
此症用充髓汤亦妙。
熟地（三两） 玄参（二两） 金钗石斛 牛膝（各五钱） 女贞子（五钱） 水煎服。
烦躁口渴，面红而热，时索饮食，饮后仍渴，食后仍饥，两足乏力，不能起立，
吐痰甚多，人以为阳明之实火也，谁知是阳明之虚火乎。夫阳明属阳火，亦宜实，
何以虚名之？不知胃火初起为实，而久旺为虚。当胃火之初起也，口必大渴，身必
大汗，甚则发狂，登高而呼，弃衣而走，其势甚急，所谓燎原之火也，非实而何。
至于旺极必衰，时起时灭，口渴不甚，汗出不多，虽谵语而无骂詈之声，虽烦闷而
无躁扰之动，得水而渴除，得食而饥止，此乃零星之余火也，非虚而何。实火不泻，
必至熬干肾水，有亡阳之变；虚火不清，则销铄骨髓，有亡阴之祸。阴既亡矣，安
得不成痿乎？故治痿之法，必须清胃火而加之生津、生液之味，自然阴长而阳消也。
方用散余汤∶
生地（一两） 玄参（一两） 茯苓（三钱） 竹叶（一百片） 麦冬（一两） 人参（三钱）
麦芽（一钱） 天花粉（二钱） 神曲（一钱） 水煎服。二剂阳明之余火息，再服二剂，烦躁、
饥渴之病除，更用十剂痿症全愈。
此方散胃火之余氛，不去损胃土之生气。胃气一生，而津液自润，自能灌注肾
经，分养骨髓矣。倘用大寒之药，直泻其胃火，则胃土势不能支，必致生意索然，
元气之复，反需岁月矣。譬如大乱之后，巨魁大盗，已罄掠城中所有而去，所存者
不过余党未散耳。用一文臣招抚之有余，若仍用大兵搜索剿除，则鸡犬不留，玉石
俱焚，惟空城独存，招徕生聚，有数十年而不可复者矣。何若剿抚兼施之为得哉。
此症用润胃汤亦效。
人参（五钱） 麦冬（二两） 天花粉（三钱） 玄参（一两） 丹参（一两） 甘草（一钱）
山楂（二十粒） 神曲（二钱） 水煎服。
人有好酒，久坐腰痛，渐次痛及右腹，又及右脚，又延及右手，不能行动，已
而齿痛，人以为贼风之侵体也，谁知是痿症乎。或谓∶痿不宜痛，今腹、脚、手、
齿俱痛，恐非痿也。嗟乎！诸痿皆起于肺热，人善饮，则肺必热矣。经曰∶治痿必
取阳明。阳明者胃也，胃主四肢岂独脚耶。夫痿虽热病，而热中有湿，不可不察。
痿病兼湿重者，必筋缓而软；痿病兼热多者，必筋急而痛，是痿症未尝无痛也。苟
不祛湿以清火，而反助湿以动热，则痿症不能痊，转增添其痛矣。治法专治阳明以
生胃气，佐之泻火利湿之品，则诸痛自消。方用释痛汤∶
人参（三钱） 黄 （三钱） 白术（五钱） 茯苓（三钱） 生地（五钱） 麦冬（五钱）
当归（三钱） 玄参（一两） 甘草（三分） 水煎服。连服四剂而病除。
此方皆入阳明之药也。入阳明以平胃气，即入阳明以平胃火，宜痿症之顿起矣。
况茯苓、白术善能去湿，复是生胃之品，是治湿又治阳明也。药投病之所喜，安得
而不速愈哉。
此症用解酲饮亦佳。
干葛 白术 人参 石膏（各三钱） 麦冬（三两） 茯苓（五钱） 半夏（一钱） 水煎服。
人有肥胖好饮，素性畏热，一旦得病，自汗如雨，四肢俱痿，且复恶寒，小便
短赤，大便或溏或结，饮食亦减，人以为感中风邪也，谁知是痿病之已成乎。夫痿
有五，皆起于肺热，好饮之人，未有不热伤肺者也。肺之母为胃，欲救热伤之肺，
必须速救胃土。经曰∶治痿独取阳明，正言其救胃也。胃土不足，而肺金受伤，则
金失所养，而不能下生肾水，水干则火盛，而肺金益伤矣。况胃主四肢，肺主皮毛。
今病四肢不举，非胃士之衰乎；自汗如雨，非肺金之匮乎。明是子母两病，不急救
胃，何能生肺以生肾水哉。方用滋涸汤∶
玄参（一两） 麦冬（一两） 茯苓（三钱） 芡实（五钱） 人参（三钱） 甘菊花（三钱）
女贞子（三钱） 生地（二钱） 天门冬（三钱） 黄芩（一钱） 天花粉（一钱） 水煎服。十剂胃气生，二
十剂肺热解，三十剂痿废起，四十剂全愈。
此方独取阳明以补胃土，兼清肺经之热也。不必去补肾，而肾水自润矣。李东
垣立有清燥汤，亦可治痿，不若此方之更神耳。
此症用柞木化 汤亦效。
玄参 麦冬（各二两） 柞木枝（三钱） 甘草（五分） 人参（一两） 天冬（三钱） 黄芩
贝母（各二钱） 水煎服。
[Background Information]
Book: Bian Zheng Lu (Record of Syndrome Differentiation)
Author: Chen Shiduo
Dynasty: Qing
Chapter: Wei Syndrome Section (Eight Cases)
Category: Comprehensive
[Original Text Translation]
There are cases where stomach fire (Stomach Heat) steams upward, daily rushing to the Lung Metal, leading to limb flaccidity and inability to stand. The patient desires to cough but lacks strength, desires to sneeze but dares not, and when coughing finally occurs, it continues incessantly with severe pain in the lungs. This is not the toxicity of Lung Abscess (Fei Yong), but rather the disease of Lung Flaccidity (Fei Wei). The formation of Lung Flaccidity is due to the fire of the Yangming channel rushing upward to the Lungs, while the fluids of the Lung channel are depleted and cannot extinguish the flame of Yangming. Metal transforms into Fire through this process. Over years, the lung lobes become like a house on fire. At this stage, cooling herbs cannot directly enter the Lungs, not because they are repelled, but because the Lungs are excessively hot. How can such heat generate Kidney Water downward? With dry Kidney Water unable to assist Heart Fire, the steaming of Yangming becomes even more severe. Naturally, there is a cry for help from water and grain; however, due to the failure of Lung Metal’s clearing and descending function, water and grain cannot transform into fluids to transport upward to the Lungs, making Lung dryness worse. Lung dryness causes all fluids in the Lungs to turn into saliva and turbid sputum. Once Lung fluids are dry, Lung Qi naturally becomes weak. The formed saliva and turbid sputum are difficult to expel, which explains why the desire to cough results in inability to do so. However, saliva and turbid sputum are not nourishing to the Lungs; they must be expelled for relief. Unfortunately, they reside in this "fire house." If one coughs, the fire boils over, causing movement and pain in the chest and diaphragm, which explains why the desire to sneeze/cough leads to hesitation. Enduring忍耐 until unbearable, although coughing expels saliva and turbid sputum, the fire has no water to nourish it. Rushing up to the throat, it refuses to descend quickly, explaining why coughing continues incessantly. Such incessant coughing inevitably damages the dry Lungs, causing pain. Observers seeing flaccidity and inability to stand may use medicines for treating flaccidity, but these further damage Lung Qi, how can they restore flaccidity? The treatment method should clear the fire in the Stomach, greatly tonify the Qi of the Lung channel, yet one must not merely tonify Lung Qi, but also supplement Kidney Water. Use Sheng Jin Qi Wei Tang (Generate Fluids and Restore Flaccidity Decoction):
Mai Dong (Ophiopogonis Radix, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Xuan Shen (Scrophulariae Radix, 1 liang), Gan Ju Hua (Chrysanthemi Flos, 5 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 1 liang), Tian Dong (Asparagi Radix, 3 qian), Tian Hua Fen (Trichosanthis Radix, 1 qian), Bei Mu (Fritillariae Cirrhosae Bulbus, 1 qian), Yin Hua (Lonicerae Japonicae Flos, 5 qian). Decoct in water and take orally. After taking four doses, coughing lightens; after another four doses, coughing stops; after ten more doses, the flaccidity syndrome is eliminated.
Yangming fire could originally be treated with great cold medicines. However, initial Yangming fire can be treated with great cold, while long-standing vigorous Yangming fire should be treated with mild cold. Because Yangming fire is the fire within Stomach Earth, initial fire can be cleared with great cold to save Kidney Water, while long-standing fire requires mild cold to scatter it, thereby generating Stomach Earth. Excessive Stomach fire indicates decline of Stomach Earth; supporting Earth is the way to clear fire. When Stomach Earth is robust, it naturally ascends Stomach Qi, transforms the essence of water and grain, and transports fluids to the Lungs. Additionally, Er Dong (Tian Dong and Mai Dong), Gan Cao, Tian Hua Fen, and Bei Mu naturally benefit the Lungs and eliminate phlegm, making the Lungs more moist. Combined with Yin Hua to eliminate toxic turbidity, how can Lung Metal become dry again? Adding Shu Di Huang fills Kidney Water; when Water is abundant, the Lungs need not worry about their "child" (Kidney) being dry, allowing Lung Qi to settle. Clearing and descending functions flow to all organs, Water generates and Fire rests; without specifically treating flaccidity, it heals itself.
For this syndrome, Zi Hua Yin (Purple Flower Drink) is also miraculous.
Mai Dong (Ophiopogonis Radix, 3 liang), Jie Geng (Platycodonis Radix), Gan Ju Hua (Chrysanthemi Flos), Pu Gong Ying (Taraxaci Herba) (each 5 qian), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Bei Mu (Fritillariae Cirrhosae Bulbus) (each 2 qian), Sheng Di Huang (Rehmanniae Radix, 1 liang), Zi Hua Di Ding (Viola Herba, 3 qian). Decoct in water and take orally.
When Stomach fire rushes upward to the Heart, causing mental restlessness, palpitations, and fright, prolonged cases develop flaccidity with weak legs unable to move or walk. This generally belongs to excessive Stomach fire, not vigorous Heart fire. Stomach belongs to Earth, Heart to Fire; Heart generates Stomach, and Stomach should not overcome Heart. However, if Heart fire generates Stomach, Heart fire does not flare; if Stomach fire steams the Heart, Heart fire becomes very dry. This harm arises from grace. If one merely clears Heart fire, the Stomach (child) sees the Cold of its Mother (Heart) and increases its inflammatory atmosphere, adding more dryness to the Heart. One must seek Kidney Water below. Due to excessive Stomach fire boiling Kidney Water, it cannot ascend to assist the Heart. Fire becomes more vigorous while Water dries up. Without marrow in bones, how can legs gain strength? Treatment should greatly benefit Kidney Water and slightly clear Stomach fire. Then Stomach Qi settles, Kidney Water generates, and naturally communicates upward to the Heart. Use Qing Wei Sheng Sui Dan (Clear Stomach and Generate Marrow Pill):
Xuan Shen (Scrophulariae Radix, 1 liang), Mai Dong (Ophiopogonis Radix, 5 qian), Gan Ju Hua (Chrysanthemi Flos, 5 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 2 liang), Bei Wu Wei Zi (Schisandrae Chinensis Fructus, 2 qian), Sha Shen (Glehniae Radix, 5 qian). Decoct in water and take orally. After ten doses, walking is possible; after twenty doses, palpitations and fright are eliminated; after another ten doses, restlessness and flaccidity disappear; after ten more doses, full recovery.
Flaccidity syndromes all result from Yangming fire. However, using great cold medicines like Shi Gao (Gypsum Fibrosum) and Zhi Mu (Anemarrhenae Rhizoma) clears Stomach fire quickly, but overuse damages the Stomach. Damaging the Stomach damages the Spleen; damaging the Spleen inevitably damages the Kidney. Therefore, it is better to use Xuan Shen and Gan Ju Hua, which clear Stomach fire without damaging Stomach Earth. Stomach Qi generates naturally, producing fluids that flow down to the Kidneys and up to the Heart. Moreover, Mai Dong and Wu Wei Zi benefit the Heart, while Shu Di Huang and Sha Shen nourish the Kidneys. Upper and lower support each other, Water and Fire interact harmoniously; will the flaccidity disease not heal?
For this syndrome, Shi Hu Xuan Shen Tang (Dendrobium and Scrophularia Decoction) is also excellent.
Jin Chai Shi Hu (Dendrobii Caulis, 1 liang), Xuan Shen (Scrophulariae Radix, 2 qian). Decoct in water and take orally.
Yangming fire solidifies in the Spleen and refuses to resolve. Those who enjoy rich and sweet foods feel hungry immediately after eating; if they eat little, they feel head redness and facial heat, leg weakness, and inability to walk. People think this is due to vigorous Yangming Stomach fire causing flaccidity, but who knows it is excessive Taiyin Spleen fire scorching its Yin? Flaccidity syndromes are blamed on Yangming, so why can Taiyin fire also cause flaccidity? Taiyin and Yangming are exterior-interior pairs. When Yangming fire is vigorous, Taiyin fire is also vigorous. These two fires combine and knot between the fu and zang organs. Food consumed only suffices to fuel the fire’s consumption but cannot assist water’s moistening. Vigorous fire and deficient water lead to dry Kidney Palace, how can bone marrow be sufficient? Without marrow, bones are empty and weak, how can one stand and walk? Treatment should benefit Taiyin Yin Water to overcome Yangming Yang Fire. Then in Spleen and Stomach, Water and Fire have no excessive heat harm; subsequently, inside tendons and bones, marrow and blood have opportunities for fullness. Use Tiao Pi Tang (Regulate Spleen Decoction):
Ren Shen (Ginseng Radix, 5 qian), Xuan Shen (Scrophulariae Radix, 1 liang), Mai Dong (Ophiopogonis Radix, 5 qian), Gan Ju Hua (Chrysanthemi Flos, 5 qian), Yi Yi Ren (Coicis Semen, 5 qian), Jin Chai Shi Hu (Dendrobii Caulis, 3 qian), Qian Shi (Nelumbinis Semen, 1 liang), Shan Yao (Dioscoreae Rhizoma, 5 qian). Decoct in water and take orally. After four doses, abdominal hunger lessens; after another four doses, fire feels slightly suppressed; after ten more doses, full recovery.
This formula tonifies Spleen and Stomach Earth, which is the way to tonify its fire. However, the reason fire is vigorous lies precisely in Earth’s decline. Declining Earth fails to generate Water and instead generates Fire. Now, adding mild-cold herbs like Xuan Shen, Gan Ju Hua, and Shi Hu to tonifying Earth causes Spleen-Stomach fire to decline naturally, while Spleen-Stomach Earth becomes vigorous. Once Earth is vigorous, Spleen-Stomach fluids generate naturally. Thus, they pour into the five zang organs and circulate to the two legs. Fire warms downward and does not flare upward; head and face are not invaded by redness and heat, how can shins and toes be weak? Some say: Vigorous fire consumes easily, leading to good appetite/hunger, seemingly requiring digestive agents to damage Spleen-Stomach Qi. But not damaging excess and instead increasing deficiency is likely not instructive. They do not know Spleen-Stomach Earth must not be damaged; damaging Earth makes fire more vigorous. Tonifying Yin subdues Yang; digesting food damages Yin. Tonifying Yin is acceptable; why must one use digestive medicines?
For this syndrome, Xuan Mu Ju Ying Tang is also effective.
Xuan Shen (Scrophulariae Radix, 2 liang), Gan Ju Hua (Chrysanthemi Flos, 1 liang), Zhi Mu (Anemarrhenae Rhizoma, 3 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 2 liang). Decoct in water and take orally.
After great anger, hypochondriac distension and frequent pain on both sides of the chest occur, leading to loss of appetite, thirst seeking drink. Prolonged cases develop soreness and pain in both legs, then pain throughout the body, sometimes in arms, sometimes between fingers. When pain comes, one can lie down but not walk; legs are soft, tendons numb, unable to move. People think this is caused by Phlegm-Fire, but who knows it is Liver Channel Flaccidity? Liver Channel Flaccidity is assisted by Yangming fire. During great anger, Liver Qi is damaged, so Liver Wood becomes dry. Fire within Wood has nowhere to exist and must overcome Spleen-Stomach Earth. Spleen Yin does not accept it, but Stomach alone bears it. Initially, Stomach is strong and resists, fighting back, causing chest and hypochondriac pain. Later, Stomach Earth cannot match vigorous Liver Wood, fears it, dares not fight, and submits to Liver. Long-term reduced food intake fails to transform fluids to generate Kidney Water. Without Water to nourish Liver, Liver Qi becomes nothing but Fire Qi. Stomach also emits fire to increase Liver Fire’s flame. Liver Fire’s nature is moving, so it travels within meridians causing pain. If sexual indulgence is added, after essence leakage, with no Water to control Fire, legs naturally become soft and tendons numb, groaning in bed, unable to move. Treatment must calm the Liver and simultaneously clear Yangming fire. Since Yangming has been overcome by Liver Wood for a long time, Yangming channels must be deficient. If fire is cleared further, how can Stomach Qi not be damaged? One must clear Yangming fire without damaging Yangming Qi. Use Fa Mu Tang (Wood-Chopping Decoction):
Chao Zhi Zi (Gardeniae Fructus, fried, 3 qian), Bai Shao (Paeoniae Radix Alba, 1 liang), Dang Gui (Angelicae Sinensis Radix, 5 qian), Gan Ju Hua (Chrysanthemi Flos, 5 qian), Nu Zhen Zi (Ligustri Lucidi Fructus, 5 qian), Di Gu Pi (Lycii Cortex, 3 qian), Dan Pi (Moutan Cortex, 3 qian), Qing Dai (Indigo Naturalis, 3 qian), Jin Chai Shi Hu (Dendrobii Caulis, 3 qian). Decoct in water and take orally. After four doses, all pains are eliminated; after another four doses, desire for food returns; after ten more doses, full recovery.
This formula clears Liver Fire to calm Liver Qi, yet Yangming Stomach fire is never ignored in treatment. Stomach Qi is not damaged, Stomach fire rests naturally. Food intake advances, fluids generate, Kidney Water is sufficient, and marrow is abundant. Pain disappears without needing painkillers; flaccidity rises without needing specific flaccidity treatment.
For this syndrome, Er Shi Tang (Two Stones Decoction) is also excellent.
Bai Shao (Paeoniae Radix Alba, 1 liang), Shu Di Huang (Rehmanniae Radix Praeparata, 3 liang), Jin Chai Shi Hu (Dendrobii Caulis), Niu Xi (Achyranthis Bidentatae Radix) (each 5 qian), Shi Gao (Gypsum Fibrosum, 3 qian). Decoct in water and take orally.
Those usually greedy for sex, plus laborious travel exhausting the body, damaging bones and stirring fire, followed by vigorous sexual activity, eventually suffer flaccid legs. Standing causes leg trembling, walking causes knee pain, bedridden. Yet digestion is good and food digests easily. People think this is a food stagnation syndrome, but who knows it is excessive Kidney Fire stirring Stomach Fire to form Kidney Flaccidity? Stomach is the gate of the Kidney; Kidney controls its opening and closing. Kidney Fire rushes straight to Stomach, and how dare Stomach gate block it? It joins forces to listen to Kidney Fire flaming upward. Moreover, Kidney Fire is Dragon-Thunder Fire; Stomach Fire also likes flaming upward. These two fires rise together, melting Kidney Water with imminent exhaustion. Fortunately, Kidney Fire is strong, but Stomach Fire is not yet very vigorous, so it only assists Kidney in digesting food, not sweating to lose Yang. Easy digestion still provides water and grain to nourish Yin. Though not filling bones, it slightly nourishes Kidney interior, thus forming flaccidity without death. Treatment urgently needs to greatly tonify Kidney Water to control sunlight (excessive fire). Use Qi Wei Jiang Huo Tang (Restore Flaccidity and Descend Fire Decoction):
Shu Di Huang (Rehmanniae Radix Praeparata, 3 liang), Shan Zhu Yu (Corni Fructus, 1 liang), Yi Yi Ren (Coicis Semen, 5 qian), Jin Chai Shi Hu (Dendrobii Caulis, 5 qian), Niu Xi (Achyranthis Bidentatae Radix, 5 qian). Decoct in water and take orally. After four doses, leg trembling and foot pain disappear; after ten doses, walking is possible, food does not cause easy hunger; after twenty doses, full recovery.
This formula greatly tonifies Kidney Yin, completely avoiding clearing Stomach fire. Like having sufficient grain in the city, soldiers and horses are full; how dare they make noise and cause robbery?
For this syndrome, Chong Sui Tang (Fill Marrow Decoction) is also wonderful.
Shu Di Huang (Rehmanniae Radix Praeparata, 3 liang), Xuan Shen (Scrophulariae Radix, 2 liang), Jin Chai Shi Hu (Dendrobii Caulis), Niu Xi (Achyranthis Bidentatae Radix) (each 5 qian), Nu Zhen Zi (Ligustri Lucidi Fructus, 5 qian). Decoct in water and take orally.
Restlessness, thirst, red and hot face, occasional craving for food. Still thirsty after drinking, still hungry after eating. Legs weak, unable to stand. Much phlegm spit out. People think this is Yangming Excess Fire, but who knows it is Yangming Deficiency Fire? Yangming belongs to Yang Fire, which should be excess, why name it deficiency? Do not know Stomach fire is excess at onset, but deficiency when long-standing. Initial Stomach fire causes great thirst, heavy sweating, even madness, shouting from heights, discarding clothes and running. Its momentum is urgent, called prairie-fire, surely excess. When extreme vigor declines, fire comes and goes. Thirst is not severe, sweat is not much. Delirium without cursing, restlessness without agitation. Water removes thirst, food stops hunger. This is scattered residual fire, surely deficiency. Uncleared excess fire boils Kidney Water, causing Yang collapse; uncleared deficiency fire melts bone marrow, causing Yin collapse. Once Yin is lost, how can flaccidity not form? Thus, treating flaccidity requires clearing Stomach fire and adding fluid-generating tastes, naturally Yin grows and Yang declines. Use San Yu Tang (Disperse Residual Fire Decoction):
Sheng Di Huang (Rehmanniae Radix, 1 liang), Xuan Shen (Scrophulariae Radix, 1 liang), Fu Ling (Poria, 3 qian), Zhu Ye (Bambusae Folium, 100 leaves), Mai Dong (Ophiopogonis Radix, 1 liang), Ren Shen (Ginseng Radix, 3 qian), Mai Ya (Hordei Fructus Germinatus, 1 qian), Tian Hua Fen (Trichosanthis Radix, 2 qian), Shen Qu (Massa Medicata Fermentata, 1 qian). Decoct in water and take orally. After two doses, Yangming residual fire rests; after another two doses, restlessness and hunger/thirst diseases are eliminated; after ten more doses, flaccidity fully heals.
This formula disperses residual Stomach fire atmosphere without damaging Stomach Earth’s vital energy. Once Stomach Qi generates, fluids naturally moisten, pouring into Kidney channel, dividing nourishment to bone marrow. If great cold medicines are used to directly clear Stomach fire, Stomach Earth cannot support it, vitality becomes desolate, recovery of Yuan Qi takes years. Like after great chaos, major thieves have looted everything, leaving only scattered remnants. Using a civil official to pacify is sufficient; using large troops to search and exterminate leaves nothing, destroying jade and stone alike, leaving only an empty city. Recruiting and gathering people would take decades to recover. Why not combine suppression and pacification?
For this syndrome, Run Wei Tang (Moisten Stomach Decoction) is also effective.
Ren Shen (Ginseng Radix, 5 qian), Mai Dong (Ophiopogonis Radix, 2 liang), Tian Hua Fen (Trichosanthis Radix, 3 qian), Xuan Shen (Scrophulariae Radix, 1 liang), Dan Shen (Salviae Miltiorrhizae Radix, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Shan Zha (Crataegi Fructus, 20 grains), Shen Qu (Massa Medicata Fermentata, 2 qian). Decoct in water and take orally.
People who love wine, sit long with waist pain gradually spreading to right abdomen, right foot, right hand, unable to move. Later toothache occurs. People think it is thief-wind invading, but who knows it is flaccidity? Some say: Flaccidity should not hurt. Now abdomen, feet, hands, teeth all hurt, likely not flaccidity. Alas! All flaccidities start from Lung Heat. Good drinkers certainly have Lung Heat. Classics say: Treat flaccidity by selecting Yangming. Yangming is Stomach. Stomach governs four limbs, not just feet. Although flaccidity is a heat disease, heat contains dampness, which must be observed. Flaccidity with heavy dampness causes loose and soft tendons; flaccidity with much heat causes tight and painful tendons. Thus flaccidity does have pain. If one does not remove dampness to clear fire, but instead aids dampness to stir heat, flaccidity will not heal, and pain increases. Treatment focuses on Yangming to generate Stomach Qi, assisting with fire-clearing and damp-draining items, then all pains disappear. Use Shi Tong Tang (Release Pain Decoction):
Ren Shen (Ginseng Radix, 3 qian), Huang Qi (Astragali Radix, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian), Fu Ling (Poria, 3 qian), Sheng Di Huang (Rehmanniae Radix, 5 qian), Mai Dong (Ophiopogonis Radix, 5 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Xuan Shen (Scrophulariae Radix, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen). Decoct in water and take orally. After four doses, disease is eliminated.
All herbs in this formula enter Yangming. Entering Yangming to calm Stomach Qi is entering Yangming to calm Stomach Fire, suitable for sudden rise of flaccidity. Moreover, Fu Ling and Bai Zhu remove dampness and are Stomach-generating items; treating dampness is also treating Yangming. Medicine matches what the disease likes, how can it not heal quickly?
For this syndrome, Jie Cheng Yin (Sobering Drink) is also excellent.
Ge Gen (Puerariae Lobatae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ren Shen (Ginseng Radix), Shi Gao (Gypsum Fibrosum) (each 3 qian), Mai Dong (Ophiopogonis Radix, 3 liang), Fu Ling (Poria, 5 qian), Ban Xia (Pinelliae Rhizoma, 1 qian). Decoct in water and take orally.
Obese people who love drinks, naturally fear heat. Suddenly getting sick, sweating like rain, all four limbs flaccid, plus aversion to cold. Urine short and red, stool loose or constipated, food intake reduced. People think it is wind-stroke pathogen, but who knows it is established flaccidity disease? There are five types of flaccidity, all starting from Lung Heat. Good drinkers invariably have heat damaging Lungs. Lung’s mother is Stomach. To save heat-damaged Lungs, one must quickly save Stomach Earth. Classics say: Treat flaccidity by exclusively selecting Yangming, meaning saving Stomach. Insufficient Stomach Earth damages Lung Metal. Metal loses nourishment, cannot generate Kidney Water downward. Water dries, fire becomes vigorous, Lung Metal is further damaged. Moreover, Stomach governs four limbs, Lungs govern skin and hair. Now limbs cannot lift, is it not Stomach Earth decline? Sweating like rain, is it not Lung Metal deficiency? Clearly both child and mother are diseased. Not urgently saving Stomach, how can one generate Lungs to generate Kidney Water? Use Zi He Tang (Nourish Dryness Decoction):
Xuan Shen (Scrophulariae Radix, 1 liang), Mai Dong (Ophiopogonis Radix, 1 liang), Fu Ling (Poria, 3 qian), Qian Shi (Nelumbinis Semen, 5 qian), Ren Shen (Ginseng Radix, 3 qian), Gan Ju Hua (Chrysanthemi Flos, 3 qian), Nu Zhen Zi (Ligustri Lucidi Fructus, 3 qian), Sheng Di Huang (Rehmanniae Radix, 2 qian), Tian Dong (Asparagi Radix, 3 qian), Huang Qin (Scutellariae Radix, 1 qian), Tian Hua Fen (Trichosanthis Radix, 1 qian). Decoct in water and take orally. After ten doses, Stomach Qi generates; after twenty doses, Lung heat resolves; after thirty doses, flaccidity rises; after forty doses, full recovery.
This formula exclusively selects Yangming to tonify Stomach Earth, simultaneously clearing Lung channel heat. No need to tonify Kidney, Kidney Water naturally moistens. Li Dongyuan established Qing Zao Tang, which can also treat flaccidity, but not as miraculous as this formula.
For this syndrome, Zuo Mu Hua Tang is also effective.
Xuan Shen, Mai Dong (each 2 liang), Zuo Mu Zhi (Quercus variabilis Branch, 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 fen), Ren Shen (Ginseng Radix, 1 liang), Tian Dong (Asparagi Radix, 3 qian), Huang Qin (Scutellariae Radix), Bei Mu (Fritillariae Cirrhosae Bulbus) (each 2 qian). Decoct in water and take orally.