活血驻颜。强志轻身。）
薛氏医案云。八味丸。治命门火衰。不能生土。以致脾
胃虚寒。而患流注鹤膝等症。不能消溃收敛。或饮食少思。或食而不化。或脐腹疼痛。夜多漩溺。经云。
益火之源以消阴翳。即此方也。又治肾水不足。虚火上炎。发热作渴。口舌生疮。或牙龈溃烂。咽
喉作痛。形体憔悴。寝汗等证。加五味子四两。
吴氏方考云。今人入房盛。而阳事愈举者。阴虚火动也。
阳事先痿者。命门火衰也。是方于六味中。加桂附。以益命门之火。使作强之官得其职矣。
王氏小青囊云。又治下元冷惫。心火炎上。肾水不能摄养。多唾痰涎。又治肾虚齿痛。又治肾虚淋沥。
王氏药性纂要云。治一少年哮喘者。其性善怒。病发寒
天。每用桂附八味地黄汤。及黑锡丹而平。一次用之未效。加生铁落于八味汤中。一剂而愈。
千金肾气丸。治虚劳肾气不足。腰痛阴寒。少便数。囊冷湿。尿有余沥。精自出。阴痿不起。忽忽悲喜。
于本方。去牡丹皮。加玄参芍药。（千金翼。有牡丹皮。名十味肾气丸。）
千金又方。治肾气不足。羸瘦日剧。吸吸少气。体重耳聋。眼暗百病。
于本方。去附子山茱萸。加半夏。（千金肾气丸。凡五方。今录其二。）
严氏加味肾气丸。治肾虚腰重脚肿。小便不利。
于本方中。加车前子川牛膝。（薛氏云。治脾肾虚。腰重脚肿。小便
不利。或肚腹肿胀。四肢浮肿。或喘急痰盛。已成蛊症。其效如神。）
又十补丸。治肾脏虚弱。面色黧黑。足冷足肿。耳鸣耳
聋。肢体羸瘦。足膝软弱。小便不利。腰脊疼痛。但是肾虚之证。
于本方中。加鹿茸五味子。
医垒元戎。都气丸。补左右二肾。水火兼益。
于本方中。加五味子。
钱氏小儿方诀。地黄丸。治肾虚解颅。或行迟语迟等症。
于本方中。去桂枝附子。（薛氏云。治肾经虚热作渴。小便淋秘。痰气
上壅。或肝经血虚燥热。风客淫气。而患瘰 结核。或四肢发搐。眼目 动。或肺经虚火。
咳嗽吐血。头目眩晕。或咽喉燥痛。口舌疮裂。或心经血虚有火。自汗盗汗。便血诸血。
或脾虚湿热。下刑于肾。腰膝不利。或疥癣疮毒等症。并用此为主。而佐以各脏之药。此
药为天一生水之剂。若禀赋不足。肢体瘦弱。解颅失音。或畏明下窜。五迟五软。肾疳肝疳。或早近女色。精
气亏耗。五脏齐损。凡诸虚不足之症。皆用此以滋化源。其功不能尽述。○案此增味颇多。今省之。）
虚劳诸不足。风气百疾。薯蓣丸主之。
薯蓣丸方
薯蓣（三十分） 当归 桂枝 曲（千金作神曲。局方三因等并同） 干地黄
豆黄卷（各十分。千金作大豆黄卷） 甘草（二十八分） 芎 麦门冬 芍药
白术 杏仁（各六分） 人参（七分） 柴胡 桔梗 茯苓（各五分） 阿胶（七分）
干姜（三分） 白蔹（二分） 防风（六分） 大枣（百枚为膏）
上二十一味。末之。炼蜜和丸如弹子大。空腹酒服一丸。一百丸为剂。
〔魏〕盖人之元气在肺。元阳在肾。既剥削则难于遽复矣。全赖后天之谷气。资益其生。是荣卫非脾胃。
不能通宣。而气血非饮食。无由平复也。仲景故为虚劳诸不足。而带风气百疾。立此方。以薯蓣为主。 理
脾胃。上损下损。至此可以撑持。以人参。白术。茯苓。干姜。豆黄卷。大枣。神曲。甘草助之。除湿益气。
而中土之令得行矣。以当归。芎 。芍药。地黄。麦冬。阿胶。养血滋阴。以柴胡。桂枝。防风。
升邪散热。以杏仁。桔梗。白蔹。下气开郁。惟恐虚而有热之人。资补之药。上拒不受。故为散其邪热。开
其逆郁。而
气血平顺。补益得纳。勿以其迂缓而舍之。
案风气。盖是两疾。唐书张文仲曰。风状百二十四。气状八十。治不以时。则死及之。是也。此方千
金。载风眩门。有黄芩。云。治头目眩冒。心中烦郁。惊悸狂癫。外台。引古今录验。大薯蓣丸。疗男子五
劳七伤。晨夜气喘急。内冷身重。骨节烦疼。腰背强痛。引腹内。羸瘦不得饮食。妇人
绝孕。疝瘕诸病。服此药。令人肥白。补虚益气。凡二十四味云。张仲景方。有大豆黄卷曲柴胡白蔹芎 。
无附子黄芩石膏黄 前胡。为二十一味。（外台。更有大黄。五味子。泽泻。干漆。合廿
四味。和剂局方。大山蓣丸。与本书同。）
虚劳虚烦。不得眠。酸枣汤主之。
〔尤〕人寤则魂寓于目。寐则魂藏于肝。虚劳之人。肝气不荣。则魂不得藏。魂不藏。故不得眠。酸枣
仁。补肝敛气。宜以为君。而魂既不归容。必有浊痰燥火。乘间。而袭其舍者。烦之所由作也。故以知母
甘草。清热滋燥。茯苓川芎。行气除痰。皆所以求肝之治。而宅其魂也。
三因云。外热曰燥。内热曰烦。虚烦之证。内烦身不觉热。头目昏疼。口干咽燥不渴。清清不寐。皆虚烦也。
叶氏统旨云。虚烦者。心中扰乱。郁郁而不宁也。良由津液去多。五内枯燥。或荣血不足。阳胜阴微。
张氏医通云。虚烦者。肝虚而火气乘之也。故特取枣仁以安肝胆为主。略加芎 。调血以养肝。
茯苓甘草。培土以荣木。知母。降火以除烦。此平调土木之剂也。
案虚烦。空烦也。无热而烦之谓。千金。恶阻半夏茯苓汤。主疗空烦吐逆。妇人良方。作虚烦。可证。
酸枣汤方
酸枣仁（二升） 甘草（一两） 知母（二两） 茯苓（二两） 芎 （二两，〔原注〕深
师有生姜二两○深师名小酸枣汤。疗虚劳不得眠烦不宁者。出于外台。煮法后云一方加桂二两。）
上五味。以水八升。煮酸枣仁。得六升。纳诸药。煮取三升。分温三服。
千金翼大酸枣汤 主虚劳烦悸。奔气在胸中。不得眠方。
于本方去知母。加人参生姜桂心。（千金。去芎 。用知母。更加石膏。名酸枣汤。主疗同。）
又酸枣汤 主伤寒及吐下后。心烦乏气不得眠方。
于本方。加麦门冬干姜。
五劳虚极。羸瘦腹满。不能饮食。食伤。忧伤。饮伤。
房室伤。饥伤。劳伤。经络荣卫气伤。内有干血。肌肤甲错。两目黯黑。缓中补虚。大黄 虫丸主之。
〔程〕此条单指内有干血而言。夫人或因七情。或因饮食。或因房劳。皆令正气内伤。血脉凝积。
致有干血积于中。而 羸见于外也。血积则不能以濡肌肤。故肌肤甲错。不能以营于目。则两目黯黑。与大
黄虫丸。以下干血。干血去则邪除正旺。是以谓之缓中补虚。非大黄 虫丸。能缓中补虚也。
案金鉴云。缓中补虚四字。当在不能饮食之下。必是传写之讹。然内有干血。故腹满。若虚劳证。而
无腹满。则大黄 虫丸不中与也。巢源云。五劳。志劳。思劳。忧劳。瘦劳。方言郭注。极。疲也。喻氏
法律云。甲错者。皮间枯涩。如鳞甲错出也。楼氏纲目云。索泽。即仲景所谓皮肤甲错。
山海经。HT 羊可以己腊。郭璞注。腊。体皴甲错。谓皮皴如鳞甲也。
张氏医通云。举世皆以参 归地等为补虚。仲景独以大黄 虫等补虚。苟非神圣。不能行是法也。夫
五劳七伤。多缘劳动不节。气血凝滞。郁积生热。致伤其阴。世俗所称干
血劳是也。所以仲景乘其元气未漓。先用大黄 虫水蛭虻虫蛴螬等。蠕动啖血之物。佐以干漆生地桃杏仁。行
去其血。略兼甘草芍药。以缓中补虚。黄芩以开通热瘀。酒服以行药势。待干血行尽。然后纯行缓中补虚收
功。其授陈大夫百劳丸一方。亦以大黄 虫水蛭虻虫为主。于中除去干漆蛴螬桃杏仁。而加当归乳香没药。
以散血结。即用人参。以缓中补虚。兼助药力。以攻干血。栀子以开通热郁。服用劳水者。
取其行而不滞也。仲景按证用药。不虑其峻。授人方术。已略为降等。犹恐误施。故方下注云。治一切劳瘵
积滞。疾不经药坏者宜服。可见慎重之至也。（此系于抄节喻氏法律之文。百劳丸。
非仲景之方。出于医学纲目。而吴氏方考亦云。百劳丸。齐大夫传张仲景方也。未见所据。）
大黄 虫丸
大黄（十分蒸） 黄芩（一两） 甘草（三两） 桃仁（一升） 杏仁（一升） 芍药
（四两） 干地黄（十两） 干漆（一两） 虻虫（一升） 水蛭（百枚） 蛴螬（一升） 虫（半升）
上十二味。末之。炼蜜和丸小豆大。酒饮服五丸。日三服。
倪氏本草汇言云。仲景方。治五劳虚极羸瘦。腹满不能饮食。内有干血。肌肤甲错者。用干漆（一两。
炒烟尽。） 虫（十个。去足。焙燥。共为细末。）大黄（一两） 酒煮半日。捣膏为丸。如黍米大。每
服十丸。白汤送下。案此盖后人以意减味者。李氏纲目 虫
条所收。大黄 虫丸。乃本书妇人产后病篇下瘀血汤也。虽是似误。然二方并单捷。亦不可废焉。
附方
千金翼炙甘草汤（〔原注〕一云复脉汤○案翼方。标以复脉汤。注仲景名炙甘草汤。）治虚劳不足。汗出
而闷。脉结悸。行动如常。不出百日。危急者十一日死。（翼。悸上。有心字。十二。作二十二。）
甘草（四两炙） 桂枝 生姜（各三两） 麦门冬（半升） 麻仁（半升） 人
参阿胶（各二两） 大枣（三十枚） 生地黄（一斤）
上九味。以酒七升。水八升。先煮八味。取三升。去滓。
纳胶消尽。温服一升。日三服。（翼云。越公杨素。患失脉七日服五剂而复。）
〔尤〕脉结。是荣气不行。悸则血亏而心无所养。荣滞血亏。而更出汗。岂不立槁乎。故虽行动如常。
断云不出百日。知其阴亡而阳绝也。人参桂枝甘草生姜。行身之阳。胶麦麻地。行身之阴。盖欲使阳得复行
阴中。而脉自复也。后人只喜用胶地等。而畏姜桂。岂知阴凝燥气。非阳不能化耶。
案本草。甘草。别录云。通经脉。利血气。大明云。通九窍。利百脉。寇宗 云。生则微凉。炙则温。
盖四逆汤之治逆冷。复脉汤之复失脉。功 在乎甘草。伤寒类要。伤寒
心悸脉结代者。甘草二两。水三升。煮一半。服七合。日一服。此单甘草汤。其义可知耳。
肘后獭肝散 治冷劳。又主鬼疰一门相染。
獭肝一具。炙干末之。水服方寸匕。日三服。（炙。肘后。作阴。）
案本草。獭肝。甘温有毒。别录。治鬼疰。而肘后。无治冷劳之文。云。尸疰鬼疰者。即是五尸之中。
尸疰。又挟诸鬼邪为害也。其病变动。乃有三十六种。至九十九种。大略令人寒热沉沉嘿嘿。不的知其所苦。
而无处不恶。累年积月。渐沉顿滞。以至于死。后复注易傍人。乃至灭门。觉如
此候者。宜急疗之。千金。外台。引崔氏。并同。
巢源鬼注候云。注之言住也。言其连滞停住也。人有先无他病。忽被鬼排击。当时或心腹刺痛。或闷绝
倒地。如中恶之类。其得瘥之后。余气不歇。停住积久。有时发动。连滞停住。乃至于死。死后注易傍人。故
谓之鬼注。刘熙释名
云。注。注也。相灌注也。疰。即注之从 者。
Invigorate blood and preserve youth. Strengthen willpower and lighten the body (promote longevity).
Xue's Medical Records states: Bawei Wan (Eight-Ingredient Pill) treats Mingmen fire decline (deficiency of Kidney Yang), which fails to warm Spleen Earth, leading to deficiency-cold of the Spleen and Stomach. This results in conditions such as flowing abscesses (Liuzhu) and crane-knee disease (He Xi Feng), where sores cannot dissipate, suppurate, or heal. Alternatively, it treats reduced appetite or anorexia, indigestion after eating, pain around the umbilicus and abdomen, and frequent nocturia. The Classics state: "Boost the source of fire to eliminate yin shadows," referring to this formula. It also treats insufficiency of Kidney Water with deflection of deficient fire upward, manifesting as fever and thirst, sores on the mouth and tongue, ulceration of gums, sore throat, emaciation, and night sweats. In these cases, add Schisandrae Fructus (Wuweizi) four liang.
Wu's Examination of Formulas states: Nowadays, those who engage in excessive sexual activity yet experience heightened erectile function suffer from Yin deficiency with hyperactive fire. Those whose erections fail prematurely suffer from Mingmen fire decline. This formula adds Cinnamon Twig (Guizhi) and Aconite Root (Fuzi) to Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to tonify Mingmen fire, allowing the official of strength and vigor (the Kidney) to perform its duties.
Wang's Xiao Qing Nang states: It also treats coldness and exhaustion of the lower origin (lower jiao), with Heart fire flaming upward and Kidney Water failing to nourish and control, resulting in excessive salivation and phlegm-saliva. It treats toothache due to Kidney deficiency and dribbling urination due to Kidney deficiency.
Wang's Compilation of Medicinal Properties states: It treated a young boy suffering from asthma who had an irritable temperament. Attacks were triggered by cold weather. He was typically treated with Guifu Bawei Dihuang Tang (Cinnamon and Aconite Eight-Ingredient Rehmannia Decoction) and Heixi Dan (Black Tin Pill) to calm the wheezing. Once, when this was ineffective, Raw Iron Drop (Sheng Tieluo) was added to the Bawei Tang, and he recovered after one dose.
Qianjin Shenqi Wan treats deficiency-wasting (Xulao) with insufficiency of Kidney Qi, presenting with lower back pain accompanied by a sensation of cold, frequent urination, cold and damp scrotum, post-void dribbling, spontaneous seminal emission, impotence, and emotional instability (sudden sadness or joy). This formula is based on the original formula (Bawei Wan/Shenqi Wan), removing Moutan Cortex (Mudanpi) and adding Scrophulariae Radix (Xuanshen) and Paeoniae Radix (Shaoyao). (*Qianjin Yifang* includes Mudanpi, naming it Shiw Wei Shenqi Wan / Ten-Ingredient Kidney Qi Pill.)
Another formula in *Qianjin Fang* treats insufficiency of Kidney Qi, presenting with progressive emaciation, shallow breathing and shortness of qi, heaviness of the body, deafness, blurred vision, and various diseases. This formula removes Aconite Root (Fuzi) and Cornus Fructus (Shanzhuyu) from the base formula and adds Pinelliae Rhizoma (Banxia). (*Qianjin* contains five formulas for Kidney Qi; two are recorded here.)
Yan's Modified Shenqi Wan treats heavy waist and swollen feet due to Kidney deficiency, along with difficult urination. This formula adds Plantaginis Semen (Cheqianzi) and Achyranthis Bidentatae Radix (Chuan Niuxi). (Xue states: It treats deficiency of both Spleen and Kidney causing heavy waist and swollen feet, difficult urination, abdominal swelling, edema of the four limbs, panting with abundant phlegm, or ascites (Guzheng), with miraculous efficacy.)
There is also Shibu Wan (Ten-Ingredient Pill), treating weak Kidneys manifesting as dark complexion, cold and swollen feet, tinnitus and deafness, emaciated limbs, weakness of the feet and knees, difficult urination, and pain in the lower back and spine. It is suitable for any syndrome of Kidney deficiency. This formula adds Deer Antler (Lurong) and Schisandrae Fructus (Wuweizi).
*Yilei Yuanrong*'s Duqi Wan tonifies the left and right Kidneys, benefiting both Water and Fire. This formula adds Schisandrae Fructus (Wuweizi) to the base formula.
Qian's *Pediatric Formulas* Dihuang Wan treats fontanelle delay (Jielu) due to Kidney deficiency, or delayed walking and speaking. This formula removes Cinnamon Twig (Guizhi) and Aconite Root (Fuzi) from the base formula. (Xue states: It treats deficiency-heat of the Kidney channel causing thirst, dysuria with retention, phlegm-Qi obstructing upwards; or Liver channel blood-deficiency with dry-heat, wind pathogens invading, leading to scrofula and tubercles; or spasms of the four limbs, eye twitching; or deficiency-fire of the Lung channel causing coughing and hemoptysis, dizziness; or dry painful throat, cracked mouth and tongue; or heart channel blood-deficiency with fire causing spontaneous sweating, night sweats, hematochezia, and other bleeding syndromes; or Spleen deficiency with damp-heat attacking the Kidney causing stiff waist and knees; or scabies, tinea, and toxic sores. This formula serves as the principal agent, supplemented by herbs for specific organs. This formula generates Water from One (Tianyi Shengshui). For congenital insufficiency, emaciation, fontanelle delay with aphasia, photophobia with crouching, five delays and five softnesses, Kidney and Liver malnutrition, or premature sexual activity depleting essence and damaging all five Zang organs, this formula is used to nourish the source of transformation. Its merits cannot be fully described. ○ Note: Many additional herbs are included here; they are omitted now.)
For deficiency-wasting with multiple insufficiencies and hundred diseases caused by Wind-Qi, Shuyu Wan (Dioscorea Pill) is indicated.
**Shuyu Wan Formula**
Dioscoreae Rhizoma (Shuyu) (30 fen)
Angelicae Sinensis Radix (Danggui)
Cinnamomi Ramulus (Guizhi)
Fermented Soybean Curd (Qu) (*Qianjin* uses Shenqu; *Ju Fang* and *San Yin Fang* agree)
Rehmanniae Radix Preparata (Gan Dihuang)
Sojae Semens Praeparatum (Dahuangjuan) (10 fen each; *Qianjin* uses Da Dou Huang Juan)
Glycyrrhizae Radix et Rhizoma (Gancao) (28 fen)
Ligustici Chuanxiong Rhizoma (Chuanxiong)
Ophiopogonis Tuber (Mendong)
Paeoniae Radix Alba (Shaoyao)
Atractylodis Macrocephalae Rhizoma (Baizhu)
Pruni Semen (Xingren) (6 fen each)
Codonopsis Radix (Renshen) (7 fen)
Bupleuri Radix (Chaihu)
Platycodonis Radix (Jiegeng)
Poria (Fuling) (5 fen each)
Donkey-hide Gelatin (Ejiao) (7 fen)
Zingiberis Rhizoma Recens (Ganjiang) (3 fen)
Ampelopsis Radix (Bailian) (2 fen)
Saposhnikoviae Radix (Fangfeng) (6 fen)
Jujubae Fructus (Dazao) (100 pieces, made into paste)
The above twenty-one ingredients are powdered. Honey is refined and used to form pills the size of quail eggs. Take one pill with wine on an empty stomach. One hundred pills constitute one dose.
[Gai] Human Yuan Qi resides in the Lungs, and Yuan Yang resides in the Kidneys. Once depleted, recovery is difficult. It relies entirely on post-heaven Grain Qi to nourish life. Thus, Ying and Wei Qi cannot circulate freely without the Spleen and Stomach, and Blood and Qi cannot recover without dietary intake. Therefore, Zhang Zhongjing created this formula for deficiency-wasting with multiple insufficiencies complicated by Wind-Qi diseases. Dioscorea is the chief herb to regulate the Spleen and Stomach. Whether the damage is upper or lower, this can provide support. Codonopsis, Atractylodes, Poria, Ginger, Prepared Soybean, Jujube, Fermented Curd, and Licorice assist in dispelling dampness and boosting Qi, allowing the Middle Earth function to operate. Angelica, Ligusticum, Paeonia, Rehmannia, Ophiopogon, and Donkey-hide Gelatin nourish Blood and Yin. Bupleurum, Cinnamon Twig, and Saposhnikovia raise and disperse pathogenic heat. Prunus, Platycodon, and Ampelopsis descend Qi and open stagnation. Fearing that patients with deficiency and heat may reject tonics, the formula disperses pathogenic heat and opens rebellious stagnation, ensuring smooth Qi and Blood so tonics can be absorbed. Do not discard it because its action is slow.
Note: "Wind-Qi" refers to two distinct pathological factors. Zhang Wenzhong in the *Book of Tang* stated there are 124 types of Wind patterns and 80 types of Qi patterns. Untreated timely, death ensues. This formula appears in the *Qianjin Fang* under Wind-Dizziness, containing Scutellariae Radix (Huangqin), stating it treats dizziness, mental restlessness, palpitations, mania, and epilepsy. *Waitai Miyao* cites *Gujin Luyian*, describing Dashuyu Wan for treating men's Five Wastings and Seven Injuries, morning and evening panting, internal cold, heaviness, joint pain, back stiffness, abdominal traction, emaciation, anorexia, female infertility, hernia, and masses. It fattens, tonifies deficiency, and boosts Qi. It contains 24 ingredients. Zhang Zhongjing's version includes Sojae Semens Praeparatum, Fermented Curd, Bupleurum, Ampelopsis, and Ligusticum. It lacks Aconite, Scutellaria, Scutellariae Radix (Gypsum? likely Gypsum), Phellodendri Cortex (Huangbai), and Peucedani Radix (Qianhu), totaling 21 ingredients. (*Waitai* adds Rheum, Schisandra, Alisma, Dried Lacquer, totaling 24. *Heji Ju Fang's* Dashuyu Wan matches this book.)
For deficiency-wasting with empty vexation and insomnia, Suanzaoren Tang (Sour Jujube Decoction) is indicated.
[You] When awake, the Hun (Ethereal Soul) resides in the eyes; when sleeping, it stores in the Liver. In deficiency-wasting, Liver Qi fails to nourish, so the Hun cannot store. Since the Hun does not store, insomnia occurs. Sour Jujube Seed (Suanzaoren) tonifies the Liver and astringes Qi, serving as the Chief herb. However, since the Hun has no abode, turbid phlegm and dry fire must have invaded its residence, causing vexation. Therefore, Anemarrhenae Rhizoma (Zhimu) and Licorice clear heat and moisten dryness. Poria and Ligusticum move Qi and resolve phlegm. These treat the Liver to house the Hun.
*San Yin Fang* states: External heat is called Dryness; internal heat is called Vexation. Empty vexation presents with internal vexation but no feeling of heat, dizzy and painful head, dry mouth and throat without thirst, and wakefulness without sleep.
Ye's *Tongzhi* states: Empty vexation is mental disturbance and depression. It arises from excessive loss of Body Fluids causing dryness of the Five Viscera, or insufficient Ying Blood with Yang prevailing over Yin.
Zhang's *Yitong* states: Empty vexation is Liver deficiency allowing Fire to attack. Thus, Sour Jujube Seed is taken primarily to calm the Liver and Gallbladder, slightly combined with Ligusticum to regulate Blood and nourish the Liver. Poria and Licorice strengthen Earth to benefit Wood. Anemarrhena descends Fire to relieve vexation. This is a balanced formula regulating Liver and Spleen.
Note: Empty vexation means hollow vexation. Vexation without heat is called empty vexation. *Qianjin Fang's* Ezu Banxia Fuling Tang treats empty vexation with vomiting. *Furen Liangfang* calls it empty vexation, confirming this.
**Suanzaoren Tang Formula**
Sour Jujube Seed (Suanzaoren) (2 sheng)
Licorice (Gancao) (1 liang)
Anemarrhenae Rhizoma (Zhimu) (2 liang)
Poria (Fuling) (2 liang)
Ligustici Chuanxiong Rhizoma (Chuanxiong) (2 liang, [Original Note]: *Shenshi Fang* has Ginger 2 liang. ○ *Shenshi Fang* names it Xiaosuanzaoren Tang, treating deficiency-wasting insomnia and restless vexation, cited in *Waitai*. Post-boiling instructions say: One variant adds Cinnamon 2 liang.)
The above five ingredients are boiled in 8 sheng of water. Boil Sour Jujube Seed until 6 sheng remain. Add remaining herbs and boil until 3 sheng remain. Divide into three warm doses.
*Qianjin Yifang* Dasuanzaoren Tang treats deficiency-wasting with vexation and palpitations, rushing Qi in the chest, and insomnia.
Remove Anemarrhena from this formula; add Codonopsis, Ginger, and Cinnamon Heart. (*Qianjin* removes Ligusticum, keeps Anemarrhena, adds Gypsum, naming it Suanzaoren Tang, with identical indications.)
Another Suanzaoren Tang treats vexation, fatigue, and insomnia following Taiyang disease or after vomiting/purging.
Add Ophiopogon and Dried Ginger to this formula.
When Five Wastings lead to extreme deficiency, emaciation, abdominal fullness, and inability to eat; caused by food injury, worry injury, drink injury, sexual injury, hunger injury, labor injury, damaging meridians, Ying, Wei, and Qi, with dry blood retained internally, rough skin like scales, and dark eyes, to gently tonify the middle and supplement deficiency, Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) is indicated.
[Cheng] This clause refers specifically to retained dry blood. Whether due to seven emotions, diet, or sexual excess, Zheng Qi is injured internally, causing blood stasis accumulation. Dry blood accumulates in the middle, while emaciation manifests externally. Blood stasis fails to nourish the skin, causing rough, scaly skin (Jiacuo); it fails to nourish the eyes, causing dark eyes. Dahuang Zhechong Wan purges the dry blood. Once dry blood is removed, pathogens are eliminated and Zheng Qi strengthens; thus it is called "gently tonifying the middle." It is not that the pill itself directly tonifies, but rather the removal of stasis allows recovery.
Note: *Jinjian* states "gently tonify the middle and supplement deficiency" should follow "inability to eat," likely a transcription error. However, abdominal fullness exists due to internal dry blood. If deficiency-wasting occurs without abdominal fullness, this pill is contraindicated. Chaoyuanfang defines Five Wastings as Will, Thought, Worry, Emaciation, and Labor. Guo Zhu notes "Ji" means fatigue. Yu Shi's *Falü* states Jiacuo is dry, rough skin like overlapping scales. Lou Shi's *Gangmu* equates Suoze with Zhongjing's Jiacuo. *Shanhai Jing* mentions HT sheep curing "La"; Guo Pu notes La means skin cracking like scales.
Zhang's *Yitong* states: The world uses Ginseng, Angelica, and Rehmannia to tonify deficiency, but Zhongjing uniquely uses Rhubarb and Ground Beetles to tonify deficiency. Only a sage could employ this method. Five Wastings and Seven Injuries often stem from irregular labor, causing Qi and Blood stagnation,郁积 generating heat, injuring Yin. This is the secular "Dry Blood Lao." Thus, Zhongjing, while Yuan Qi remains intact, first uses Rhubarb, Ground Beetles, Leeches, Horseflies, and Silphium Larvae—creatures that feed on blood—assisted by Dried Lacquer, Rehmannia, Peach Kernel, and Apricot Seed to move blood. Licorice and Paeonia gently tonify the middle. Scutellaria opens heat-stasis. Wine administration promotes drug movement. Once dry blood is cleared, pure gentle tonification concludes. His prescription of Bailao Wan to Dr. Chen also prioritizes Rhubarb, Ground Beetles, Leeches, and Horseflies, removing Dried Lacquer, Silphium Larvae, Peach Kernel, and Apricot Seed, adding Angelica, Frankincense, and Myrrh to dissolve blood clots. Ginseng gently tonifies the middle and assists power. Gardenia opens heat-depression. Using Lao Water (labor water) ensures movement without stagnation. Zhongjing prescribes according to syndrome, not fearing harshness, yet lowers the grade when teaching others to prevent misuse, noting: "Suitable for all consumption with stagnation, diseases ruined by improper medication." This shows extreme caution. (This excerpt is from Yu Shi's *Falü*. Bailao Wan is not Zhongjing's formula, originating from *Yixue Gangmu*; Wu's *Fangkao* claims it was transmitted by Qi Dafu from Zhongjing, but evidence is lacking.)
**Dahuang Zhechong Wan Formula**
Rhubarb (Dahuang) (10 fen, steamed)
Scutellariae Radix (Huangqin) (1 liang)
Licorice (Gancao) (3 liang)
Peach Kernel (Taoren) (1 sheng)
Apricot Seed (Xingren) (1 sheng)
Paeoniae Radix (Shaoyao) (4 liang)
Rehmanniae Radix Secata (Gan Dihuang) (10 liang)
Dried Lacquer (Ganqi) (1 liang)
Horsefly (Mengchong) (1 sheng)
Leech (Shuizhi) (100 pieces)
Silphium Larva (Qicao) (1 sheng)
Ground Beetle (Zhechong) (0.5 sheng)
The above twelve ingredients are powdered. Honey is refined to form pills the size of small beans. Take five pills with wine, three times daily.
Ni's *Bencao Huiyan* states: Zhongjing's formula for Five Wastings, extreme deficiency, emaciation, abdominal fullness, anorexia, internal dry blood, and scaly skin uses Dried Lacquer (1 liang, stir-fried until smoke ceases) and Ground Beetles (10 pieces, feet removed, dried and roasted), ground fine. Rhubarb (1 liang) is boiled in wine for half a day, pounded into paste, and formed into pills the size of millet seeds. Take ten pills with plain water. Note: This appears to be a later reduction of ingredients. Li Shi's *Gangmu* entry for Zhechong cites this Dahuang Zhechong Wan as actually the Xiayuxue Tang (Downward Expelling Blood Decoction) from the Postpartum Diseases chapter. Although seemingly erroneous, both formulas are simple and effective, and should not be discarded.
**Attached Formulas**
*Qianjin Yifang* Zhigancao Tang (Also known as Fumai Tang / Pulse-Recovering Decoction). Treats deficiency-wasting insufficiency, sweating with chest stuffiness, knotted pulse with palpitations. If the patient moves normally, death occurs within 100 days; if critical, within 11 days. (*Yifang* adds "Heart" before palpitations. 12 becomes 22.)
Licorice (Gancao) (4 liang, honey-fried)
Cinnamon Twig (Guizhi)
Fresh Ginger (Shengjiang) (3 liang each)
Ophiopogon Tuber (Mendong) (0.5 sheng)
Hemp Seed (Maren) (0.5 sheng)
Codonopsis (Renshen)
Donkey-hide Gelatin (Ejiao) (2 liang each)
Jujube (Dazao) (30 pieces)
Rehmanniae Radix Fresh (Sheng Dihuang) (1 jin)
The above nine ingredients are boiled in 7 sheng of wine and 8 sheng of water. First boil the eight ingredients (excluding gelatin) to obtain 3 sheng. Strain.
Add gelatin and melt completely. Take 1 sheng warm, three times daily. (*Yifang* notes: Duke Yue, Yang Su, suffered lost pulse for seven days; after five doses, pulse recovered.)
[You] Knotted pulse indicates stagnant Ying Qi. Palpitations indicate Blood deficiency leaving the Heart unsupported. With stagnant Ying, deficient Blood, and sweating, the body would quickly wither. Thus, even if movement is normal, death is predicted within 100 days, indicating Yin extinction and Yang severance. Codonopsis, Cinnamon Twig, Licorice, and Ginger move Yang Qi in the body; Gelatin, Ophiopogon, Hemp Seed, and Rehmannia move Yin Qi. The goal is to allow Yang to re-enter Yin, restoring the pulse. Later practitioners prefer Gelatin and Rehmannia but fear Ginger and Cinnamon, not realizing that Yin coagulation and dryness require Yang to transform.
Note: *Bencao*, *Bielu* states Licorice unblocks meridians and benefits Blood/Qi. *Daming* states it unblocks nine orifices and benefits hundred vessels. Kou Zongshi states raw is slightly cool, honey-fried is warm. Essentially, Si Ni Tang treats cold reversal, and Fumai Tang restores lost pulse; the merit lies in Licorice. *Shanghan Leiyao*: For Taiyang disease with palpitations and knotted/substitute pulse, use Licorice 2 liang, water 3 sheng, boil to half, take 7 she once daily. This single-herb Licorice Decoction reveals the principle.
*Zhouhou Beiji Fang* Tagan San (River Otter Liver Powder) treats Cold Lao (Consumption). Also treats Gui Zhu (Ghost Transmission) infectious diseases.
One River Otter Liver, dried and powdered. Take one fangcun bi with water, three times daily. (Drying method in *Zhouhou* is "Yin" drying/shade-drying.)
Note: *Bencao* states River Otter Liver is sweet, warm, and toxic. *Bielu* treats Ghost Transmission. *Zhouhou* lacks text on treating Cold Lao. It states: Shi Zhu and Gui Zhu belong to the Five Shi. Shi Zhu is compounded with ghost evils. Symptoms vary from 36 to 99 types, generally causing alternating chills and fever, lethargy, silence, unknown discomfort, and aversion everywhere. Over years, it progresses to stagnation and death, then infects others, potentially wiping out a family. Immediate treatment is required. *Qianjin* and *Waitai* cite Cui Shi similarly.
Chaoyuanfang *Gui Zhu Hou* states: "Zhu" means to stay/stagnate. A person previously healthy is suddenly struck by ghosts, experiencing stabbing heart/abdominal pain or fainting, like Evil Invasion. After recovery, residual Qi lingers, accumulating and occasionally flaring up, leading to death. After death, it transmits to others, hence "Ghost Zhu." Liu Xi's *Shiming* explains: Zhu means pouring/transmitting. Zhu (with disease radical) is the variant of Zhu.