吴球制大造丸，用此。以其有夺造化之权。极夸其功效也。四两。如无，用紫河车四具至十具，泔水
洗净，入隔汤煮熟捣烂，药拌晒干，共二十四味，诸胶髓丸，如桐子大，淡盐汤或圆肉汤送下，每服三、
四、五钱。〕
此方补肾理脾保肺兼而有之。补肾用熟地、萸肉、枸杞、菟丝、牛膝，有理脾药以佐之，则不嫌
其滋润。理脾用山药、茯苓、白芍、莲肉者，无香燥伤阴之患，以其能兼入肾经也。二冬清肺，五味敛
肺，皆所保肺也。保肺金正以生肾水，理脾土亦为生金以生水也。枣仁、圆肉、养心。一恐水虚而火
旺血耗，一恐心虚不下交于肾，莲须涩精固肠，玄参、骨皮、女贞、龟、鳖二甲退热除蒸，猪髓、鳔
胶，填精益髓，牛肉膏补脾消痰，紫河车峻补精血，是以血肉之物，
补血肉之躯，功效速也。嘉言云∶虚劳之疾，百脉空虚，非粘腻之物，不能填实。精血枯涸，非滋
湿之品，不能濡润。是以治虚劳，纵遇能消丸药之人，必煎膏服方效。若脾弱难化者，尤当膏服。胃
弱者，腥膻之品勿用。此丸功在六味、左归之上，不可忽之。
清金丸〔自制〕治阴虚咳嗽，或多痰，或干咳，或痰红，或纯红，主此随症加减。
桑皮 骨皮 甘草〔即泻白散。〕麦冬〔桑、骨、麦冬皆去肺中伏火。〕鲜百合〔保
肺，白花者一两至二两。〕款冬花〔治嗽要药，二味名百花膏。〕贝母〔消痰。〕米仁〔清
肺健脾益胃。〕枇杷叶〔降气。〕有血加茅根、藕汁、童便。〔皆消痰止血。〕
此清金润燥降气消痰之剂。凡阴虚咳嗽，最宜服之。愚按越人发明虚损一症，优入圣域，虽无方可
考，然其论治损之法，如云∶损其肺者益其气。愚谓参者，固为益气正治之药，然有肺火炽盛，日久必
致肺气索然，又当用清金润燥之药，清肺热，即所以救肺气，亦为益气之法也。凡用药须活泼泼地；如珠
走盘，越人所以不立方者，意在斯矣。损其心者，调其荣卫。心者，血之原，荣卫发动之所始。古方如归
脾汤，乃调荣卫之法也。损其脾者，调其饮食，适其寒温。如春夏食凉食冷，秋冬食温食热，及衣服起
居，各当其时可也。然亦不可执定。损其肝者，缓其中。经谓肝苦急，急食甘以缓之。逍遥散中用甘草，缓
其中之谓也。损其肾者，益
其精。凡粘腻滋湿之物，皆益精之品，经所谓精不足者，补之以味也。
加减清宁膏〔亦可煎服。〕润肺不碍脾，补脾不碍肺，凡阴虚内热，咳嗽痰血，脾胃虚
弱，食少泄多者，主此加减。
麦冬〔八两。〕鲜百合〔二斤。〕款冬花〔四两。〕薄荷末〔皆清肺润燥而
不伤脾。一两。熬成膏加入。〕枇杷叶〔去毛，蜜炙一斤，煎汤代水。〕橘红〔降气一
两。〕贝母末〔四两，熬膏加入。〕茯苓〔消痰，四两。〕米仁〔炒，八两。〕
圆肉 白芍〔各四两。〕甘草〔皆补脾而不碍香燥，有裨于肺也。炙一两。熬 糖一斤半，收
之。时时挑置口中噙化，或白汤调服，日二、三次，空心兼服保阴、回生之属。〕
此方清肺补脾，两不相碍之剂。士材云∶虚劳之所难者，如脾喜温燥，清肺则碍脾，肺喜清润，
补脾则碍肺。惟燥，热而甚，能食而不泄者，清肺为主，而参以补脾之品；倘虚羸而甚，食少泄多，虽
喘嗽不宁，但以补脾为要，清润之品，所宜斟酌。以脾有生肺之能，肺无扶脾之力，故制清宁膏一
方，脾肺兼理，取天清地宁之义。
噙化丸〔亦可膏服。〕治阴虚久嗽，及伤风外邪已解，久不愈者。
麦冬 天冬〔火灼肺金，则喉中淫痒为咳，故以二冬滋阴润燥，清金降火。〕 桑皮〔火
不乘金，则嗽自缓，故以桑皮泻肺中之火。〕薄荷末〔辛能散热，凉能清利。〕款冬花〔辛
温开豁，却不助火。〕百部〔润燥清热，兼能
杀虫。各三两。〕贝母 柿霜 花粉〔治嗽以理痰为要。故以贝母、柿霜，润肺中之燥痰，花粉
治膈之热痰，各二两。玉露霜更妙。〕枇杷叶〔蜜炙，三两。〕橘红 紫菀〔治痰又以顺气
为先，火清痰顺。三味皆下气，气降则火清痰顺而止嗽。〕玄参〔治胸中氤氲之气，无根之火。〕
北五味〔咳久必耗气，故用五味酸收之品。〕 桔梗 甘草〔咳病属上焦，故用甘桔为
舟楫之剂。各一两。共十六味炼蜜为丸，如弹子大，不时噙化，临卧更佳。〕
此清金润燥降气消痰而兼收敛之剂，仲淳所制，用治阴虚咳嗽不止者立应。世人多患阴虚者，如
伤风咳嗽，外邪已解，久不愈者，服之甚效。
琼玉膏
生地〔十二两熬成膏，入炼白蜜六两。〕 人参末〔一两二钱。〕 茯苓末〔二两四
钱。入膏中搅匀，隔汤再煮。〕
此方古人治干咳嗽， 仙加沉香、琥珀末各一钱。云神效异常，合宜则用，自无不应。
人参固本丸〔亦作煎服。〕
人参〔大气周流，无脏不有，故人参补虚，亦无处不宜。二两。〕 二地〔生地凉肾，
熟地补肾。〕二冬〔清肺，各四两。〕加牛膝、枸杞即集灵膏，〔蜜丸桐子大，空心白汤下。〕
此方壮水清金，健脾开胃之神剂也。按景岳云∶人参随熟地直入三阴，况剂之为丸，则亦下行而
补肾，虽有肺热伤肺之忌，然观古人治肺经积热，喘嗽多痰，胸满便秘者，反用人参同栀、芩、大黄，以
人参泻肺名汤，正嘉言所谓泻其
肺热，必不可伤其肺气，况人参之温、一味寒凉监之足矣；今方中有二冬清肺为君，可用之无患，晓林
云，当论方不当论药，当就方以论药，不当执药以拘方。故用药症所相宜，即便投之，须活泼泼地，不
可固执。
天王补心丹〔亦可小剂作煎。〕治忧愁思虑伤心，〔心为君主，心伤则神去，顷刻云亡。凡云
心病，皆胞络受病。〕心血不足，神志不宁，〔心藏神，肾藏志，心肾不交，故神志不宁。〕健忘怔
忡，心跳善惊，〔皆心血虚少之故，血虚则生火，火郁则生痰，痰动心胞，故为惊跳，及梦魇不宁。怔
忡者，心中惕惕，恍惚不安，如人将捕之状。〕虚烦无寐，〔肾水不上交，心火无所制，亦心血少
也。故仲淳云∶不眠者，以清心火为主。〕大便不利，〔心主血，心伤则血燥而便难。〕小便短
赤，〔心与小肠为表里，脏移热于腑也。〕咽干口渴，〔津液被灼也。〕口舌生疮等症。〔心火上炎
也。〕
人参〔补心气，五钱，虚者量加。〕当归〔养心血，一两。〕枣仁〔炒。四两。〕
北五味〔收心液。〕远志 丹皮〔各五钱。〕茯神 柏仁〔安心神。〕天冬 麦冬〔
益心津，各二两。〕生地〔四两。〕玄参〔壮肾水，一两。〕桔梗〔引诸药停留上焦，不
使之速下。五钱。〕朱砂〔护心。一两五钱。〕心火甚者加黄连。〔十四味蜜丸如弹子大，朱砂为
衣，食远临卧竹叶灯心汤，或桂圆汤化服，噙化，汤过口更佳。〕
此生津、养血清热镇心安神之剂。劳心之人，所宜服之。昔志公禅师，日夕讲经，邓天王悯其劳，
赐以此方，因得名。他如安神，则有石斛、龙齿、珍珠、琥珀，清热则有
犀角、木通、辰砂、益元散，豁痰则有竹沥、贝母、天竺黄、胆星、牛黄，〔汤中调服一、二
分。〕镇惊则有金箔、代赭石随症采用。
愚按∶经言心为五脏六腑之大主，而总统魂魄，兼该志意。故忧动于心则肺应，思动于心则
脾应，怒动于心，则肝应，恐动于心则肾应。凡喜、怒、忧、悲、思、恐、惊七情，虽分属五脏，然
无不从心而发。经又云∶心主一身之血脉。又云∶心生血。是心者，血之原，故心安则真血日生，
惟劳心过度，则心血日耗，由是脏腑无所润，筋脉无所养，荣气衰少，邪热随作，所谓阴虚生内热者
是也。若肾水不虚，犹能上交心火，不至灼肺为害，虚则心火无制，亢甚刑金，为咳为喘，肺阴消
灼，身体羸瘦，而危亡至矣。此症不得志者多有之。故治斯症者，必兼壮水为主，又须固中气为重。大
凡虚劳之病，无论何脏受伤，非内热骨蒸，则不谓之虚劳。非食少泄泻，肌肉消瘦，尚不至死地。所以
孙思邈谓∶补脾不如补肾。许学士谓∶补肾不如补脾。二先生深知二脏为生人之根本，故凡病皆当归重
脾肾，不独虚劳为然也。
归脾汤〔亦作膏丸。〕治思虑伤心，〔脾脏应之，以脾在志为思也。〕健忘怔忡，惊悸不
寐，〔悸者，心筑筑然跳动也。〕自汗盗汗。〔汗为心之液。凡汗出，无有不从心液而
来。自汗有阴阳之分，盗汗则专属心肾阴虚。〕或劳倦伤脾，〔应酬太繁，奔走太苦，饮食失
节，皆能伤脾。〕肢体酸疼，〔脾主四肢肌肉故也。然久立伤骨，久行伤筋，则肾、肝以伤，所以
亦有兼筋骨腰疼者。〕嗜卧少食。〔脾伤则神亦倦，故嗜卧。又胃病则嗜卧，精竭者神疲也，少食者
胃亦伤也。〕或心脾虚疼，〔所谓胃脘当心而痛是也。〕大便不调。〔脾主心虚，则或泄或秘，是
其本病也。〕或血无生统，〔心虚则不能生血，而脾虚则不能统血。〕错经妄行。〔或下或上皆是。〕
或血虚发热晡热，〔申、酉时热也。心、脾血虚，皆发热晡热。〕或经期不准，闭绝等症。〔心脾受伤
之故，亦有房劳伤肾，恼怒伤肝，而损冲任二脉所致也。〕
人参〔虚者多用。〕黄 〔蜜炙。〕白术〔米泔水浸半日，隔土蒸，晒干，再用白蜜调
人乳浸。照上法蒸晒，共九次。各一、二钱。〕炙甘草〔补气健脾，五分。〕茯神〔一、二
钱。〕远志〔安神补心以生脾，五分。〕枣仁〔炒研。三、五钱。〕当归〔养血益肝以生
心。五钱。〕圆肉〔甘先入脾；以脾喜肝也。十枚。〕木香〔香能快气，以脾喜通也。三。五
分。〕惊悸怔忡，加辰砂、麦冬。如有痰者，再加竹沥、天竺黄，或牛黄。
本方加柴胡、山栀，名加味归脾汤。
此方补气、养血、安神，乃心、脾、肝三经之药。赵氏谓∶凡治血症，须按三经用药。心主血，脾统
血，肝藏血。归脾汤一方，从肝补心，从心补脾，率所藏所主而从所统，
所谓隔二之治，其意盖归重血分药一边，后人不解，杂入香燥温中劫阴之药，大失制方之旨。高鼓峰独
悟其微，谓木香一味，香先入脾，总欲使血归于脾，此嘘血归经之法∶然其香燥，反动肝火，而干津
液，故其用每去木香而加白芍，以追已散之阴；且心血衰少，火必刑金，白术燥烈，恐增咳嗽，得芍药
则太阴为养荣之用。惟脾虚泄泻者，方留木香以醒脾，脾虚挟寒者，方加桂、附以补阳而外，此皆出入于
心、脾，此三经甘平清润之药。愚谓∶经。期不准，闭绝崩漏，及便血诸症，本方加减，多所相宜。若
呕吐诸血，果属气虚，不能统摄，必面色黄白而无神，语言轻微而倦怠，脾胃虚薄而不调，六脉微弱而
不数者，方可用本方。然患气虚失血者甚少、即思虑伤心，虚劳将成未成之界，未见肺肾阴虚诸病，而
兼脾虚症候，或大便溏泄者，则宜是方。若内热骨蒸，已成虚劳，又宜壮水滋阴为要，纵食少便泄，非参、
、白术助阳之药所宜矣。若劳役而兼劳心者，是心脾俱伤，且前列之症，未见肺肾阴虚诸病者，可用
本方加减。然劳倦伤脾，乃脾之阴分受伤者居多。故经曰∶阴虚生内热。因有所劳倦，形气衰少，谷气
不盛，上焦不行，下脘不通，胃中郁热之气熏胸，故内热，是以补脾胃之阴。此劳役太过，阳和之气
亢极化火，火旺则阴虚内热，但非比色欲伤肾，真阴虚而生内热之难疗。经又曰∶有所远行劳倦，逢大
热而渴，渴则阳气内伐，内伐则热舍于肾。肾者水脏也，今
水不胜火，则骨枯而髓虚，远行劳倦，骨必受伤。逢大热者，或逢天令之热，或阴不足而本热，火旺水
亏、故骨枯髓虚，而必现肾虚诸症。此平时色欲过度，以致不能劳役而然。亟当壮水滋阴为主，亦非
本方之所宜也。
逍遥散 治郁怒伤肝，肝血虚少，〔抑郁多怒，则肝火旺而血伤。〕寒热如疟，〔必先有微寒，
此阳陷入里之故，肝血少则发热，非真如疟之大寒大热也。〕暮热朝凉，〔血虚则暮热，起居如常，故此
虚最能误人。〕五心烦热，鼻燥咽干，〔血虚则内热矣。〕头晕眼花，两目干涩，〔肝伤血少之本病
也。〕胁肋作痛，〔肝脉布胁肋也。〕肢体尽疼，〔血不能荣筋也。〕嗜卧少食，〔子病及母，故嗜
卧，肝木乘胃，故少食。〕月水不调。〔血热相搏故也。〕或小腹重坠，水道涩痛，或肿痛出脓，〔亦有
阴中痒者，皆肝火所致，以肝脉绕阴器，抵少腹也。〕或遍身瘙痒，赤白游风，或瘰疠结核等症。〔肝
伤火旺，血燥生风，或疙瘩瘙痒，或脓水淋漓，或赤或白，游行无定，瘰 结核，皮色不变，皆属肝火血
燥，而筋挛所致。瘰 则累累如贯珠，多生于耳前后，胸胁间。结核则如榛如豆，亦有累累如贯珠者，不
拘头项肢体皆结也。〕
柴胡〔能散诸经血结气聚。〕薄荷〔木不宜郁，故用柴、薄之辛以散也。〕白芍〔肝气
不宜亢，白芍酸寒，可以泻肝火。〕当归〔肝血不可亏，归为血药以养之，如嫌辛温，少些用之，或
Wu Qiu prepared the Da Zao Wan (Great Creation Pill), using this formula. Because it possesses the power to rival creation. It is highly praised for its efficacy. The dosage is four liang. If not available, use four to ten placenta (Zi He Che), washed clean with rice water, cooked in a double boiler until soft, mashed, mixed with the powdered herbs, and dried. Together there are twenty-four ingredients. Various jellies and marrow are added to form pills, sized like paulownia seeds. Take with light salt water or longan flesh decoction, three to five qian per dose.
This formula simultaneously tonifies the kidney, regulates the spleen, and protects the lung. To tonify the kidney, Shu Di Huang (Prepared Rehmannia Root), Yu Rou (Cornus Fruit), Gou Qi Zi (Goji Berry), Tu Si Zi (Dodder Seed), and Niu Xi (Achyranthes Root) are used. With spleen-regulating herbs as assistants, one need not worry about their cloying nature. To regulate the spleen, Shan Yao (Dioscorea Rhizome), Fu Ling (Poria), Bai Shao (White Peony Root), and Lian Rou (Lotus Seed Meat) are used; they do not cause the damage of yin by aromatic dryness because they can enter the kidney meridian. Dong Tian (Asparagus Tuber) and Dong Mai (Ophiopogon Tuber) clear the lung, and Wu Wei Zi (Schisandra Fruit) astringes the lung; all these serve to protect the lung. Protecting Lung Metal generates Kidney Water; regulating Spleen Earth also generates Metal to generate Water. Suan Zao Ren (Ziziphus Seed) and Yuan Rou (Longan Flesh) nourish the heart. One fears that if Kidney Water is deficient, Heart Fire will be hyperactive and consume blood; the other fears that if Heart Qi is deficient, it cannot descend to communicate with the Kidney. Lian Xu (Lotus Stamen) astringes essence and secures the intestines; Xuan Shen (Scrophularia Root), Gu Pi (Moutan Bark), Nu Zhen Zi (Ligustrum Fruit), Gui Ban (Tortoise Shell), and Bie Jia (Softshell Turtle Shell) — known as the "Two Shells" — reduce fever and eliminate steaming bone disorder. Zhu Sui (Pork Marrow) and Biao Jiao (Fish Maw Gel) fill essence and nourish marrow; Niu Rou Gao (Beef Paste) tonifies the spleen and resolves phlegm; Zi He Che (Human Placenta) vigorously tonifies essence and blood. Being substances of flesh and blood, they replenish the body of flesh and blood quickly. Jiayan said: In deficiency consumptive diseases, the hundred vessels are empty; only viscous and glutinous substances can fill them. When essence and blood are withered and dry, only moistening and humidifying products can nourish them. Therefore, when treating deficiency consumptive disease, even if the patient can take pill medicines, one must prepare paste (Gao) for administration to be effective. For those with weak spleens difficult to transform, paste form is especially appropriate. For those with weak stomachs, fishy and muttony foods should not be used. This pill's efficacy surpasses Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and Zuo Gui Wan (Left Restoring Pill); it must not be ignored.
Qing Jin Wan (Clear Metal Pill) [Self-made] treats Yin-deficiency cough, excessive phlegm, dry cough, hemoptysis, or pure blood. This formula is modified according to symptoms.
Sang Bai Pi (Mulberry Root Bark), Gu Pi (Moutan Cortex), Gan Cao (Licorice Root) [This is Xie Bai San (Drain White Powder).] Mai Dong (Ophiopogon Tuber) [Sang Bai Pi, Gu Pi, and Mai Dong all clear latent fire in the lung.] Fresh Bai He (Lily Bulb) [Nourishes the lung, white-flowered variety, one to two liang.] Kua Dong Hua (Forsythia Flower) [Essential herb for treating cough, these two combined are named Bai Hua Gao (Hundred Flowers Paste).] Bei Mu (Fritillaria Bulb) [Resolves phlegm.] Yi Yi Ren (Coix Seed) [Clears the lung, tonifies the spleen, benefits the stomach.] Pi Pa Ye (Loquat Leaf) [Descends Qi.] If bleeding is present, add Mao Gen (Imperata Rhizome), Ou Zhi (Lotus Rhizome Juice), Tong Bian (Child's Urine) [All resolve phlegm and stop bleeding.]
This is a formula for clearing metal, moistening dryness, descending Qi, and resolving phlegm. It is most suitable for Yin-deficiency cough. I believe Yue Ren (Bian Que) elucidated the syndrome of deficiency consumption, reaching profound wisdom. Although no formulas are recorded, his discussion on treating consumption states: "For consumption of the lung, benefit its Qi." I consider Ren Shen (Ginseng Root) indeed to be the correct herb for benefiting Qi. However, if Lung Fire is blazing, prolonged illness will inevitably lead to exhaustion of Lung Qi; in such cases, herbs that clear metal and moisten dryness should be used. Clearing Lung Heat is equivalent to saving Lung Qi, which is also a method of benefiting Qi. Medication must be applied flexibly; like pearls rolling on a plate. This was likely the intent behind Yue Ren not prescribing specific formulas. "For consumption of the heart, regulate Ying and Wei." The heart is the source of blood and the beginning of Ying and Wei movement. Ancient formulas like Gui Pi Tang (Restore the Spleen Decoction) represent the method of regulating Ying and Wei. "For consumption of the spleen, regulate diet and adjust cold and warmth." For example, eating cool/cold foods in spring/summer and warm/hot foods in autumn/winter, and dressing/living habits should suit the season. However, one must not be rigid. "For consumption of the liver, soothe its center." The classics state: "The liver suffers from tension; eat sweet flavors to soothe it." Using Gan Cao (Licorice Root) in Xiao Yao San (Free and Easy Wanderer Powder) refers to soothing the center. "For consumption of the kidney, benefit its essence." All viscous, moistening, and humidifying substances are products that benefit essence. The classics say: "When essence is insufficient, tonify it with flavor."
Jia Jian Qing Ning Gao (Modified Clearing Tranquility Paste) [Can also be decocted.] Moistens the lung without hindering the spleen; tonifies the spleen without hindering the lung. It treats Yin-deficiency with internal heat, cough with hemoptysis, spleen-stomach weakness, poor appetite, and frequent diarrhea. Modify this formula accordingly.
Mai Dong (Ophiopogon Tuber) [Eight liang.] Fresh Bai He (Lily Bulb) [Two jin.] Kua Dong Hua (Forsythia Flower) [Four liang.] Bo He Mo (Mint Powder) [All clear the lung and moisten dryness without damaging the spleen. One liang. Add after boiling into paste.] Pi Pa Ye (Loquat Leaf) [Remove hairs, honey-fry one jin, decoct soup to replace water.] Ju Hong (Citrus Peel) [Descends Qi, one liang.] Bei Mu Mo (Fritillaria Powder) [Four liang, boil into paste and add.] Fu Ling (Poria) [Resolves phlegm, four liang.] Yi Yi Ren (Coix Seed) [Stir-fried, eight liang.]
Yuan Rou (Longan Flesh), Bai Shao (White Peony Root) [Each four liang.] Gan Cao (Licorice Root) [Tonifies spleen without being aromatic/dry, beneficial to the lung. Honey-fry one liang.] Boil sugar one and a half jin to set the paste. Pick up small amounts frequently to hold in the mouth, or mix with plain hot water to drink, twice or three times daily. Take on an empty stomach, combined with Bao Yin (Protect Yin) or Hui Sheng (Return Life) type preparations.
This formula clears the lung and tonifies the spleen, a preparation where neither hinders the other. Shi Cai said: The difficulty in treating deficiency consumption lies here: the spleen likes warmth and dryness, so clearing the lung hinders the spleen; the lung likes clarity and moisture, so tonifying the spleen hinders the lung. Only when dryness and heat are severe, appetite is good, and no diarrhea occurs, should clearing the lung be primary, supplemented by spleen-tonifying herbs. If emaciation is severe, with poor appetite and frequent diarrhea, even if panting and coughing are restless, tonifying the spleen is essential; clearing and moistening herbs should be used with caution. Because the spleen has the ability to generate the lung, but the lung has no strength to support the spleen. Thus, the Qing Ning Gao formula was created to manage both spleen and lung, taking the meaning of "Heaven Clear, Earth Tranquil."
Qin Hua Wan (Hold-in-Mouth Pill) [Can also be made as paste.] Treats chronic cough due to Yin deficiency, and lingering cough after wind-cold exterior pathogens have resolved.
Mai Dong (Ophiopogon Tuber), Tian Dong (Asparagus Tuber) [Fire scorching Lung Metal causes itching in the throat leading to cough; thus, these two nourish Yin, moisten dryness, clear metal, and descend fire.] Sang Bai Pi (Mulberry Root Bark) [If fire does not attack metal, cough subsides naturally; thus, Sang Bai Pi drains fire from the lung.] Bo He Mo (Mint Powder) [Acrid disperses heat, cool clears and benefits.] Kua Dong Hua (Forsythia Flower) [Acrid-warm opens and expels, yet does not aid fire.] Bai Bu (Stemona Root) [Moistens dryness, clears heat, and kills parasites. Each three liang.] Bei Mu (Fritillaria Bulb), Shi Shuang (Persimmon Frost), Hua Fen (Trichosanthes Root) [Treating cough requires managing phlegm. Thus, Bei Mu and Shi Shuang moisten dry phlegm in the lung; Hua Fen treats heat-phlegm in the diaphragm. Each two liang. Yu Lu Shuang is better.] Pi Pa Ye (Loquat Leaf) [Honey-fried, three liang.] Ju Hong (Citrus Peel), Zi Wan (Aster Root) [Treating phlegm prioritizes smoothing Qi; when fire clears, phlegm flows smoothly. These three descend Qi; when Qi descends, fire clears, phlegm flows, and cough stops.] Xuan Shen (Scrophularia Root) [Treats misty Qi in the chest and rootless fire.] Bei Wu Wei Zi (Schisandra Fruit) [Chronic cough consumes Qi; thus, sour astringent Wu Wei Zi is used.] Jie Geng (Platycodon Root), Gan Cao (Licorice Root) [Cough belongs to the Upper Jiao; thus, Gan Jie serves as a carrier agent. Each one liang.] Combine sixteen ingredients, refine honey to make pills, size of bullet, hold in mouth occasionally, best before sleep.
This is a formula for clearing metal, moistening dryness, descending Qi, resolving phlegm, and astringing. Created by Zhong Chun, it acts immediately for persistent Yin-deficiency cough. Many people suffer from Yin deficiency; for example, lingering cough after wind-cold exterior pathogens have resolved, taking this is very effective.
Qiong Yu Gao (Jade Essence Paste)
Sheng Di Huang (Rehmannia Root) [Twelve liang boiled into paste, add six liang refined white honey.] Ren Shen Mo (Ginseng Powder) [One liang two qian.] Fu Ling Mo (Poria Powder) [Two liang four qian. Mix into paste, boil again in double boiler.]
This formula was used by ancients to treat dry cough. Adding Chen Xiang (Agarwood) and Hu Po (Amber) powder, each one qian, is said to be extraordinarily effective. Use when appropriate; it will surely work.
Ren Shen Gu Ben Wan (Ginseng Solidify Foundation Pill) [Can also be taken as decoction.]
Ren Shen (Ginseng Root) [Vital Qi circulates everywhere, present in every organ; thus, Ginseng tonifies deficiency appropriately everywhere. Two liang.] Er Di (Two Rehmannies) [Sheng Di cools the kidney, Shu Di tonifies the kidney.] Er Dong (Two Dongs) [Clear the lung, each four liang.] Add Niu Xi (Achyranthes Root) and Gou Qi Zi (Goji Berry) to make Ji Ling Gao (Collection of Spirits Paste) [Honey pills, paulownia seed size, take with plain water on empty stomach.]
This formula is a divine preparation for strengthening water, clearing metal, tonifying the spleen, and opening the stomach. According to Jingyue: Ginseng enters the Three Yin meridians directly with Shu Di. Moreover, since it is prepared as pills, it also travels downward to tonify the kidney. Although there is a contraindication for Lung Heat damaging the Lung, observing ancients treating accumulated heat in the Lung meridian with panting, cough, excessive phlegm, chest fullness, and constipation, they actually used Ginseng together with Zhi Zi (Gardenia), Huang Qin (Scutellaria Root), and Da Huang (Rhubarb Root). Named "Ginseng Draining Lung Decoction," this aligns with Jiayan's saying: draining Lung Heat must not damage Lung Qi. Furthermore, the warmth of Ginseng is sufficient to be monitored by just one cold herb. In the current formula, Er Dong (Asparagus and Ophiopogon) clear the Lung as sovereign herbs, so there is no harm in using it. Xiaolin said: One should discuss the formula, not just the herb; discuss the herb within the context of the formula, not constrain the formula by the herb. Therefore, if the medication suits the syndrome, administer it; it must be flexible, not rigid.
Tian Wang Bu Xin Dan (Emperor of Heaven Tonifying the Heart Pill) [Can also be taken as small-dose decoction.] Treats injury to the heart from sorrow and overthinking. [The heart is the monarch; if injured, spirit departs, dying instantly. Any mention of heart disease involves the Pericardium meridian.] Insufficient Heart Blood, restlessness of spirit and will. [The heart stores Spirit, the Kidney stores Will; lack of communication between Heart and Kidney causes restlessness.] Amnesia, palpitations, frequent startle. [All due to insufficient Heart Blood. Blood deficiency generates fire; fire stagnation generates phlegm; phlegm agitates the Pericardium, causing startle jumps and nightmare unrest. Palpitations refer to a fearful, unsettled feeling in the heart, as if someone is about to catch you.] Empty vexation and insomnia. [Kidney Water does not ascend to communicate; Heart Fire has nothing to restrain it; this is also due to little Heart Blood. Thus, Zhong Chun said: For insomnia, the main approach is to clear Heart Fire.] Difficult defecation. [The heart governs blood; heart injury leads to blood dryness and difficult stool.] Scanty dark urine. [Heart and Small Intestine are interior-exterior pairs; organ heat transfers to the fu organ.] Dry throat and thirst. [Body fluids are scorched.] Mouth and tongue ulcers, etc. [Heart Fire flares upward.]
Ren Shen (Ginseng Root) [Tonifies Heart Qi, five qian, increase dose for deficiency.] Dang Gui (Angelica Root) [Nourishes Heart Blood, one liang.] Zao Ren (Ziziphus Seed) [Stir-fried. Four liang.]
Bei Wu Wei Zi (Schisandra Fruit) [Astringes Heart fluid.] Yuan Zhi (Polygala Root), Dan Pi (Moutan Bark) [Each five qian.] Fu Shen (Poria with Hostwood), Bai Ren (Biota Seed) [Calm the Spirit.] Tian Dong (Asparagus Tuber), Mai Dong (Ophiopogon Tuber) [Benefit Heart Fluid, each two liang.] Sheng Di Huang (Rehmannia Root) [Four liang.] Xuan Shen (Scrophularia Root) [Strengthens Kidney Water, one liang.] Jie Geng (Platycodon Root) [Guides herbs to stay in the Upper Jiao, preventing rapid descent. Five qian.] Zhu Sha (Cinnabar) [Protects the heart. One liang five qian.] If Heart Fire is severe, add Huang Lian (Coptis Rhizome). [Fourteen ingredients, honey pills size of bullet, coated with Cinnabar. Take near bedtime with Bamboo Leaf and Nymphoides Stem decoction, or Longan Flesh decoction to dissolve. Hold in mouth; better if swallowed with liquid.]
This is a formula for generating fluids, nourishing blood, clearing heat, calming the heart, and tranquilizing the spirit. Suitable for those who labor with their minds. Once, Chan Master Zhigong lectured on scriptures day and night; King Deng pitied his toil and bestowed this formula, hence the name. Others for calming spirit include Shi Hu (Dendrobium Stem), Long Chi (Dragon Tooth), Zhen Zhu (Pearl), Hu Po (Amber); for clearing heat: Xi Jiao (Rhinoceros Horn - *note: substitute with Buffalo Horn in modern practice*), Mu Tong (Akebia Stem), Chen Sha (Realgar), Yi Yuan San (Benefit Origin Powder); for resolving phlegm: Zhu Li (Bamboo Sap), Bei Mu (Fritillaria Bulb), Tian Zhu Huang (Calculus Aridis), Dan Xing (Areca Seed with Betel Leaf), Niu Huang (Calculus Bovis) [Take one or two fen mixed in decoction]; for settling fright: Jin Bo (Gold Foil), Dai Zhe Shi (Hematite) selected according to symptoms.
I believe: The classics state the heart is the great master of the five zang and six fu organs, commanding the Hun and Po, encompassing Will and Intent. Thus, sorrow moving the heart responds in the Lung; thinking moving the heart responds in the Spleen; anger moving the heart responds in the Liver; fear moving the heart responds in the Kidney. The seven emotions—Joy, Anger, Worry, Sorrow, Thinking, Fear, Fright—are distributed among the five zang, but all originate from the heart. The classics also say: The heart governs the blood vessels of the whole body. And: The heart generates blood. Thus, the heart is the source of blood. When the heart is peaceful, true blood is generated daily. Only when mental labor is excessive is Heart Blood consumed daily. Consequently, organs lack nourishment, sinews and vessels lack sustenance, Ying Qi becomes scarce, and pathogenic heat arises spontaneously. This is what is meant by "Yin deficiency generates internal heat." If Kidney Water is not deficient, it can still ascend to control Heart Fire, avoiding damage to the Lung. If deficient, Heart Fire is unrestrained, becoming hyperactive and punishing Metal, causing cough and panting. Lung Yin is scorched, the body becomes emaciated, and danger approaches. This syndrome is common among those frustrated in ambition. Therefore, treating this syndrome must prioritize strengthening Water (Kidney) and placing importance on securing Middle Qi (Spleen/Stomach). Generally, for deficiency consumptive disease, regardless of which organ is injured, if there is no internal heat with steaming bone disorder, it is not called deficiency consumption. If there is no poor appetite, diarrhea, and muscle emaciation, death is not imminent. Thus, Sun Simiao said: Tonifying the Spleen is not as good as tonifying the Kidney. Xu Xueshi said: Tonifying the Kidney is not as good as tonifying the Spleen. These two masters deeply understood that these two organs are the foundation of life. Therefore, for all diseases, one must value the Spleen and Kidney, not just for deficiency consumption.
Gui Pi Tang (Restore the Spleen Decoction) [Can also be made as paste or pills.] Treats injury to the heart from overthinking. [The Spleen responds to it, as Thinking is the emotion of the Spleen.] Amnesia, palpitations, fright, insomnia. [Palpitation refers to the heart beating violently.] Spontaneous sweating and night sweats. [Sweat is the fluid of the heart. All sweat comes from Heart fluid. Spontaneous sweating has Yin/Yang distinctions; night sweats belong specifically to Heart-Kidney Yin deficiency.] Or fatigue injuring the spleen. [Too much social interaction, too much running about, irregular diet can all injure the spleen.] Acid pain in limbs. [The spleen governs the four limbs and muscles. However, standing long injures bones, walking long injures sinews, thus Kidney and Liver are also injured, so there may be accompanying bone/sinew and waist pain.] Lethargy and poor appetite. [Spleen injury makes Spirit tired, hence lethargy. Stomach disease also causes lethargy; exhaustion of essence makes Spirit weary; poor appetite indicates Stomach injury.] Or Heart-Spleen deficiency pain. [Referring to epigastric pain corresponding to the heart.] Irregular bowel movements. [Spleen governs; Heart deficiency leads to either diarrhea or constipation, which is the fundamental disease.] Or blood lacks generation and control. [Heart deficiency cannot generate blood; Spleen deficiency cannot control blood.] Erratic menstruation and wild flow. [Either downward or upward.] Or blood deficiency fever and afternoon tidal fever. [Heat in Shen and You hours. Heart and Spleen blood deficiency both cause afternoon tidal fever.] Or irregular menstruation, amenorrhea, etc. [Due to Heart-Spleen injury; also caused by sexual excess injuring Kidney, anger injuring Liver, damaging Chong and Ren meridians.]
Ren Shen (Ginseng Root) [Use more for deficiency.] Huang Qi (Astragalus Root) [Honey-fried.] Bai Zhu (Atractylodes Rhizome) [Soak in rice water for half a day, steam over earth, dry, then soak in white honey and human milk. Repeat steaming and drying nine times. Each one to two qian.] Zhi Gan Cao (Honey-fried Licorice Root) [Tonifies Qi and strengthens spleen, five fen.] Fu Shen (Poria with Hostwood) [One to two qian.] Yuan Zhi (Polygala Root) [Calms spirit, tonifies heart to generate spleen, five fen.] Zao Ren (Ziziphus Seed) [Stir-fried and ground. Three to five qian.] Dang Gui (Angelica Root) [Nourishes blood, benefits liver to generate heart. Five qian.] Yuan Rou (Longan Flesh) [Sweet enters spleen first; spleen likes liver. Ten pieces.] Mu Xiang (Costus Root) [Aroma moves Qi rapidly; spleen likes unobstructed flow. Three to five fen.] For fright, palpitations, and palpitations, add Chen Sha (Realgar) and Mai Dong (Ophiopogon Tuber). If there is phlegm, add Zhu Li (Bamboo Sap), Tian Zhu Huang (Calculus Aridis), or Niu Huang (Calculus Bovis).
Adding Chai Hu (Bupleurum Root) and Shan Zhi Zi (Gardenia Fruit) to this formula is named Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction).
This formula tonifies Qi, nourishes blood, and calms the spirit; it acts on the Heart, Spleen, and Liver meridians. Zhao said: When treating blood disorders, one must use herbs according to the three meridians. The Heart governs blood, the Spleen controls blood, the Liver stores blood. The Gui Pi Tang formula tonifies the Heart via the Liver, and tonifies the Spleen via the Heart, following what is stored, governed, and controlled. This is the "treating two steps away" method. Its intent focuses heavily on blood-nourishing herbs. Later generations did not understand this, mixing in aromatic, dry, warming, and middle-jiao herbs that rob Yin, greatly losing the original intent of the formula. Gao Gugeng alone perceived its subtlety, stating that Mu Xiang's aroma enters the spleen first, aiming to return blood to the spleen; this is the method of calling blood back to its vessels. However, its aromatic dryness can stir Liver Fire and dry fluids. Therefore, in usage, Mu Xiang is often removed and replaced with Bai Shao (White Peony Root) to retrieve dispersed Yin. Moreover, when Heart Blood is depleted, Fire must punish Metal; Bai Zhu is dry and fierce, fearing it will increase cough; with Bai Shao, the Taiyin (Spleen) serves to nourish Ying. Only in cases of Spleen deficiency with diarrhea is Mu Xiang retained to awaken the spleen; in Spleen deficiency with cold, Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root) are added to tonify Yang. Otherwise, these are variations within the Heart and Spleen, using sweet, flat, clear, and moist herbs of these three meridians. I believe: For irregular menstruation, amenorrhea, metrorrhagia, and various bleeding symptoms, modifications of this formula are mostly suitable. If vomiting blood is truly due to Qi deficiency failing to control, the face must be sallow and spiritless, speech faint and fatigued, spleen-stomach weak and irregular, and six pulses weak and non-rapid; only then can this formula be used. However, few suffer from Qi deficiency bleeding. Even at the boundary of Heart injury from overthinking and impending deficiency consumption, without visible Lung-Kidney Yin deficiency syndromes but with Spleen deficiency symptoms or loose stools, this formula is appropriate. If there is internal heat with steaming bone disorder, constituting established deficiency consumption, strengthening Water and nourishing Yin is essential. Even with poor appetite and loose stools, herbs like Ren Shen, Huang Qi, and Bai Zhu that assist Yang are not suitable. If labor is combined with mental toil, both Heart and Spleen are injured. If the aforementioned symptoms show no Lung-Kidney Yin deficiency, modifications of this formula can be used. However, fatigue injuring the spleen mostly damages the Yin aspect of the Spleen. Thus, the classics say: "Yin deficiency generates internal heat." Due to fatigue, shape and Qi decline, Grain Qi is not abundant, Upper Jiao does not move, Lower Wan is blocked, stagnant heat in the stomach steams the chest, causing internal heat. Therefore, tonify the Yin of the Spleen and Stomach. This excessive labor causes Yang Harmony Qi to become hyperactive and transform into fire; fire hyperactivity leads to Yin deficiency internal heat. But this is not as difficult to treat as sexual excess injuring the Kidney, where True Yin deficiency generates internal heat. The classics also say: "Traveling far and working hard, encountering great heat and thirst; thirst causes Yang Qi to invade internally; internal invasion causes heat to lodge in the Kidney. The Kidney is the Water Organ; now Water cannot overcome Fire, so bones wither and marrow empties. Traveling far and working hard necessarily injures bones. Encountering great heat means either heavenly heat or inherent heat due to Yin insufficiency; Fire hyperactivity and Water deficiency cause bone withering and marrow emptiness, manifesting various Kidney deficiency symptoms." This results from excessive sexual desire normally, making one unable to endure labor. One must urgently prioritize strengthening Water and nourishing Yin; this is also not suitable for this formula.
Xiao Yao San (Free and Easy Wanderer Powder) Treats liver injury from depression and anger, insufficient Liver Blood. [Depression and anger make Liver Fire hyperactive and damage blood.] Alternating chills and fever like malaria. [Must first have slight chills; this is due to Yang sinking into the interior. Liver Blood deficiency causes fever, not true great chills and fever like malaria.] Evening fever, morning coolness. [Blood deficiency causes evening fever; daily activities remain normal, so this deficiency easily misleads people.] Five-palm heat, dry nose and throat. [Blood deficiency causes internal heat.] Dizziness and blurred vision, dry and gritty eyes. [Fundamental disease of Liver injury and blood deficiency.] Hypochondriac pain. [Liver meridian distributes over hypochondrium.] Whole body pain. [Blood cannot nourish sinews.] Lethargy and poor appetite. [Child disease affects mother, hence lethargy; Liver Wood invades Stomach, hence poor appetite.] Irregular menstruation. [Due to struggle between blood and heat.] Or heavy bearing sensation in lower abdomen, painful urination, or swelling/pain with pus. [Also vaginal itching, all caused by Liver Fire, as Liver meridian surrounds genitalia and reaches lower abdomen.] Or generalized itching, red/white wandering wind, or scrofula and lymph node tuberculosis. [Liver injury, Fire hyperactivity, blood dryness generates wind; or nodules with itching, or dripping pus, red or white, wandering不定ly. Scrofula and lymph nodes, skin color unchanged, all belong to Liver Fire and blood dryness causing sinew spasm. Scrofula appears like beads strung together, mostly born around ears, chest, and hypochondrium. Lymph nodes are like hazelnuts or beans, also sometimes like strung beads, occurring anywhere on head, neck, or limbs.]
Chai Hu (Bupleurum Root) [Can disperse blood stasis and Qi accumulation in all meridians.] Bo He (Mint) [Wood should not be depressed; thus, acridity of Chai Hu and Bo He is used to disperse.] Bai Shao (White Peony Root) [Liver Qi should not be hyperactive; Bai Shao is sour and cold, able to drain Liver Fire.] Dang Gui (Angelica Root) [Liver Blood must not be deficient; Dang Gui is a blood herb to nourish it. If pungent-warm is disliked, use less, or