阳虚。即真气虚。其证恶寒。或发热。自汗。汗多亡阳。然阳虚不发热。单恶寒者居多。治宜甘补温热。
阴虚。即精血虚。其证为咳嗽多痰。吐血咯血嗽血。鼻衄齿衄。盗汗自汗。发热寒热潮热。骨乏无力。不眠气急。腰背
痛。治宜生精补血。气清虚热敛摄。酸寒甘寒甘平咸寒。略兼苦寒。
表虚。其证自汗恶风。洒淅寒热。善就温暖。脉浮无力。治宜甘酸补敛。益气实表。
里虚其证洞泄或完谷不化。心腹痛。按之即止。或腹胀。或伤寒下后痞满。治宜温补。甘温佐以辛热。
阳实。即表邪热盛。其症头痛寒热。遍身骨痛无汗。治宜辛寒发散。天寒略加辛热辛温佐之。
阴实。即里实外感证。属邪热内结者。其症胸腹硬痛。手不可近。大便七八日不行。或挟热下利。治宜下。苦寒咸
寒甘辛。
阳厥。即热厥。其证四肢厥。身热面赤。唇燥大渴。口干舌苦。目闭或不闭。小便赤涩短少。大便燥结。不省人事。
治宜下。清热。甘寒苦寒咸寒。有挟虚有痰者。宜麦冬竹沥芦根汁梨汁牛黄童便。如妇人热入血室。因而厥者。药中以
童便为君。加赤芍生地牛膝丹皮桃仁。甚者大便燥结。加芒硝大黄下之。通即止。
阴厥。即寒厥。其证四肢厥逆。身冷面青。嗜卧。手指爪青黯。腹痛。大便溏或完谷不化。小便自利。不渴。不省
人事。治宜补气温中。甘温辛热。
上盛下虚。属阳盛阴虚。治宜降。益阴。甘寒酸寒。佐以咸寒苦寒。下盛上虚。属阴盛阳虚。治宜益气升阳。甘温
甘辛。
心虚八证。治宜补血。甘温酸敛。佐以咸寒。镇坠。惊邪属心气虚。经曰。惊者平之。宜降。清热豁痰。平癫痫属
心气虚。有热亦宜降。清热豁痰。不得眠属心血虚。有热治宜敛。养阴血清热。心烦属心家有热。宜清。兼生津液。甘
寒甘平甘酸。参用不得眠中诸药。怔忡属心血不足。心澹澹动。盗汗属心血虚。汗者心之液也。宜补敛。清虚热。甘酸
甘平甘寒。苦寒咸寒。伏梁属心经气血虚。以致邪留不去。治宜活血凉血。散热通结。辛咸。
心实。即实火实热五症。治宜降火清热。苦寒以折之。辛寒以散之。甘寒以缓之。咸寒以润之。谵语属心家初热。
舌破属心火。烦躁属心家邪热。及心内火炎。自笑属心家有热邪。发狂属心家有邪热甚。(烦属心躁属肾)
肝虚十证。治宜辛散甘缓。胸胁痛属肝血虚与肝气实。。因而上逐。宜降气养血和肝。辛甘平缓。转筋属血虚。宜酸
辛甘平。目光短属肝血虚。及肾水不足。真阴亏。宜补肝兼滋肾。甘温益血。甘寒除热。目昏属肝血虚。有热。兼肾水
真阴不足。目翳属肝热。兼肾水不足。宜补肝血。除热退翳。亡血过多角弓反张属肝血虚。有热宜补血清热。甘寒甘温
酸寒咸寒辛润。少腹连阴作痛按之则止属足厥阴经血虚。宜同角弓反张。偏头痛属血虚。肝家有热。不急治之。久之必
损目。宜养血清虚热。甘寒酸寒辛寒。目黑暗眩晕属血虚。兼肾水真阴不足。宜养血补肝清热。甘寒甘平酸寒苦寒。肥
气属气血两虚。肝气不和。逆气与瘀血相并而成。宜和肝散结气。兼行气血凝滞。甘温甘平。肝实五证。宜清热降气。
苦寒辛寒甘寒酸寒。善怒。怒则气上逆。甚则呕血反飧泄。宜降气清热。甘寒咸寒酸寒。且佐以辛散。善太息。忽忽不
乐。胁痛呕血属肝气逆。肝火盛。肝血虚。发搐属肝家邪热。热则生风。风主掉眩故也。宜清热降气。利小便缓中。目
赤肿痛属血热。宜凉血清热。甘寒苦寒酸寒。
脾虚十二证。宜甘温。佐以辛香酸平。饮食劳倦伤脾。发热。宜补中益气。甘温升酸。饮食不消化属脾气虚。宜益
其气。甘温甘辛。伤食必恶食。宜健消导。甘温辛香。如腹痛大便不通。宜下。枳实槟榔浓朴大黄。元气虚人不可下。
宜加参术。伤内食。轻者。宜蒜。山楂兼黄连。重者。宜矾。红枣肉为丸服二钱。不可过。终身忌荞麦。伤面食。宜炒
莱菔子。停饮为恣饮汤水或冷茶冷酒所致。宜健脾利水。淡渗兼辛散。水肿属脾气虚。宜补脾益气。燥湿利水。辛香甘
温。佐以淡渗。脾虚中满属脾气虚兼脾阴虚。昼剧夜静属脾气虚。宜补气健脾。甘温淡渗。佐以辛香。夜剧昼静属脾阴
虚。宜补脾阴。兼制肝清热。甘平酸寒淡渗。噎膈属气血两虚。由于血液衰少而作。痰气壅遏所成。宜降。清热润燥。
甘温甘平以益血。略佐辛香以顺气。脾泄属气虚。宜温中。补气升清。甘温甘平。佐以辛香。兼有湿及痰。经年不愈。
粪色白者。须服九制松脂。健忘属气血两虚。宜益脾阴兼补气。酸敛甘温甘寒辛平以通窍。倦怠嗜卧属脾气不足。宜补
气兼健脾。甘温辛香。腹痛按之则止属脾血虚。宜益气补血。甘温酸平。痞气属脾虚及气郁所致。宜健脾兼散结滞。甘
温辛香。
脾实。即湿热邪胜六证。宜除湿清热。利小便。辛散风燥苦寒。蛊胀由于脾家湿热积滞。或内伤瘀血。停积而成。
宜除湿清热。利小便。消谷易饥属脾家邪火。宜清火除热。生津液。益脾阴。甘寒苦寒酸寒。口唇生疮宜甘寒酸寒苦寒
辛寒。口糜宜同唇疮。中消属脾家实火。宜同唇生疮加人参。湿热腹痛按之愈甚。宜利小便。兼升提。苦寒不愈者。加
熟大黄。即土郁则夺之义也。
肺虚七证。宜清热降气。酸敛润燥。 喘属肺虚有热。因而壅痰。宜降气消痰。辛凉甘寒苦平。咳嗽吐血痰属肺热
甚。宜降气清热。润肺生津液凉血益血。甘寒甘平咸寒。佐以苦寒。声哑属肺热甚。宜同咳治。咽喉燥痛属水涸。火炎
肺热之极也。此症法所难治者。肺痿属肺气虚有热。龟胸属肺热有痰。息贲属肺气虚。痰热壅结所致。宜降气清热。开
痰。佐以散结。参东垣息贲丸治之。
肺实八证。宜降气散闭。甘寒苦寒。佐以辛散。喘急属肺有实热及肺气上逆。宜同肺实。加桔梗甘草栝蒌仁玄参青
黛。气壅属肺热气逆。同肺实。声重痰稠属肺热。肺痈属肺热极。宜清热消痰。降火解毒散结。甘寒苦寒辛寒。肺胀闷
属肺热。同肺实。吐脓血血痰咳嗽嗽血属肺家火实热甚。此正邪气胜则实之谓。宜清热降气。凉血豁痰。喉癣属肺热。
宜同肺实。加鼠粘子玄参射干。上消属肺家实及上焦热。宜降气清热。补肺生津。甘寒苦寒酸寒辛寒。
肾虚。即肾水真阴不足十八证。宜滋阴润燥。生精补血除热。甘寒酸寒苦寒咸寒。肾虚腰痛属精气虚。骨乏无力属
阴精不足。肾主骨故也。骨蒸潮热属精血虚极。以致阳无所附。虚火上炎诸症。皆同肾虚。传尸劳。宜除热益阴杀劳虫
兼清镇。五心烦热为真阴不足。梦遗泄精属肾虚有火。宜滋阴生精。补血除热。酸敛佐以涩精。小便短涩。热赤频数。
属肾虚有火。宜同肾虚。溺有余沥属气虚。宜同肾虚。以五味子黄柏人参为君。加菟丝子覆盆子为臣。益智为佐。如觉
平日肺家有热。或咳嗽有火者。忌人参。用沙参。溺血血淋属肾虚有火。热伤血。不宜同肾虚。加侧柏阿胶茅根地黄戎
盐蒲黄之类。伤精白浊属房劳过度。以致精伤流出似白浊症。宜同肾虚。五淋属肾虚兼有湿热。宜同肾虚。加清湿热。
精塞水窍不通属房欲不禁。或思欲不遂。或惧泄忍精。或老人气不足以逐精出窍。宜行败精。壮实人兼泄火。老人宜兼
补气血。外治用吮法。齿浮真牙摇动。及下龈软或齿衄。肾虚有热。宜益阴凉血固肾。应以地黄黄柏五味子为君。桑椹
牛膝沙蒺藜鹿茸天冬为臣。龙骨牡蛎为使。下滑属肾阴虚火伏下焦。宜清热及峻补真气。润兼酸敛。宜以黄柏五味子。
生地天门冬人参为君。石斛牛膝知母人乳及童便为臣。地骨皮青蒿侧柏叶为佐。善恐属肾气虚。肾藏志故也。宜补。强
气志。辛平甘温。佐以辛香。阴窍涌气属肾气虚不固。肾主纳气。虚则不能纳。故见是证。宜补真气。酸敛固涩。参用
肾虚诸药。疝属肾虚。寒湿邪乘虚客之所致。丹溪谓与肾经绝不相干者误也。又有先因湿邪为病。后成湿热者。药宜分
寒热先后二途。宜补气通肾气除湿。又有阴虚有热之人病此。兼宜除热。虚寒而痛。加桂茴香补骨脂仙茅。虚热而痛。
加黄柏车前子。湿盛者加术。奔豚属肾虚。脾家湿邪下传客肾所致。宜补气健脾。辛温散结。参用东垣奔豚丸治之。
肾无实。故无治法。
命门虚。治元阳真火不足四证。宜益真阳之气。甘温咸温甘热酸敛。阴痿为命门火衰。下焦虚寒。宜同命门虚加海
狗肾蛇床子原蚕蛾狗阴茎等。精寒精薄属命门火衰。阳气不足。宜同阴痿。肾泄即五更及黎明泄泻者是也。亦名火瘕泄。
属命门真火不足。宜益气。甘温酸敛畏寒足冷。宜同命门虚。
命门实二证。宜苦寒甘寒咸寒。强阳不倒属命门火实。孤阳无阴所致。此证多不治。宜同命门实加五味子童便生地黄。
水窍涩痛属命门实火。宜清热利窍甘寒苦寒咸佐以淡渗。
小肠虚宜补气。甘温酸温。遗尿属小肠气虚兼肾气虚。宜同小肠兼固涩。小肠实。宜通利淡渗。苦寒甘寒咸寒。小水不
利及赤或涩痛尿血。宜同小肠实。
胆虚二证。宜甘温甘平酸敛佐以微辛。易惊属胆气虚。宜补胆气。甘温辛温酸平。病后不得眠属胆虚。治同胆虚。
胆实二证。宜和解。辛寒甘寒辛温苦寒。口苦耳聋胁痛。往来寒热。宜小柴胡汤随所见兼症加减。鼻渊属胆移热于
脑。宜清热补脑。甘寒甘平佐以辛寒。
胃虚七证。宜益气。甘平甘淡酸。胃弱不纳食。及不思饮食。宜同胃虚。仍分寒热治。胃虚呕吐宜分寒热。霍乱转
筋为胃虚猝中邪恶气及毒瓦斯兼有停滞所致。此转筋与肝经血虚不同。宜调气和中。辛散消导。由于暑必口渴或口干。齿
燥口苦。小水短赤。由于寒则小水清白。不渴不热。绞肠痧属胃气虚。猝中天地邪恶秽污之气也。郁于胸腹之间。上不
得吐。下不得泄。以致肠胃绞痛异常。胸腹骤胀。遍体紫黑。头顶心必有红发。急寻出拔去之。急以三棱针刺委中挤出
热血。即可苏醒。次用新汲凉水投入盐两许恣饮。得吐泻即止。委中穴在两膝下弯横纹中间两筋之中。刺入一分。切忌
火酒姜蒜。及谷气米饮热汤。入口即死。宜通窍辟恶。辛散咸寒。煎药亦宜冷服。中恶腹中 痛属胃气虚。恶气客之所
致。宜辟恶气通肠胃。用辛散。反胃属胃气虚。宜补气降气。和胃清热。酸敛以制肝。若因虚寒而得者。加生姜。中酒
属胃弱。宜养胃。酸辛散淡渗。
胃实六证。宜下。如邪未结宜清热发散。苦寒辛寒甘寒。谵语发狂发斑。弃衣而走。登高而歌。属胃家邪热实。宜
同胃实。如大便结者。加芒硝亟下之。发斑者。加鼠粘子玄参栝蒌根。多用石膏为君。便结亦加大黄下之。口臭数欲饮
食属胃火。宜清热降火。苦寒甘寒辛寒。嘈杂属胃火。宜同口臭。略兼消导。口淡属胃热。宜同口臭。呕吐属胃火者。
必面赤。小便短赤或涩。大便多燥。口苦或干渴。宜同胃实加枇杷竹茹木瓜芦根橘皮通草白茯苓。吞酸者属胃火。宜同
嘈杂。
大肠虚四证。宜补气润燥。甘温。虚热便闭不通属血虚。津液不足。宜生津液润燥。凉血益血。虚寒滑泄不禁属气
虚。宜补气升提。甘温酸敛。肠鸣属气虚。宜同大肠虚。加柴胡升麻以佐之。脱肛为气虚兼有湿热。宜补气升提。险湿
热。外用五倍子敷之。
大肠实四证。宜润下苦寒辛寒。便硬闭。宜同大肠实。加芒硝猪胆槟榔郁李仁石蜜。肠风下血属大肠湿热。宜清热
凉血兼升。甘寒苦寒。脏毒属血热。宜同肠风。加忍冬麦冬地榆蒲黄。肠痈属大肠实火。宜下。苦寒解毒。
膀胱虚三证。宜补气。酸敛。小便不禁属气血虚。宜同膀胱虚加牡蛎龙骨鹿茸桑螵蛸鸡 。频数不能少忍。加麦冬
五味子黄柏山茱枸杞等。遗尿属本经气虚。见小肠虚条内。因膀胱虚亦能致遗尿。故复列此。膀胱气宜同疝。
膀胱实宜润。淡渗。癃闭属膀胱实热。同膀胱实。佐以升提。
三焦虚二证。宜补中益气。佐以辛温。腹寒属中气虚。同三焦虚。短气少气属气虚。宜补气益精。甘温甘寒酸温。
三焦实三证。宜降。清热调气。甘寒苦寒咸寒。喉痹即缠喉风。属少阳相火少阴君火并炽。经曰。一阴一阳结为喉痹。
一阴者少阴君火也。一阳者少阳相火也。宜辛散。佐以苦寒咸寒。急则有针法吹法吐法。急治用胆矾朴硝牛黄为末和匀。
吹入喉中。又法用明矾三钱。巴豆七粒去壳。同矾 。矾枯。去巴豆。取矾细末。吹入喉中即宽。头面赤热属上焦火升。
宜降。清热。甘缓佐以酸敛。赤白游风属血热。热则生风。故善游走。俗名火丹。小儿多患此。大人亦时有之。宜清热
凉血。兼行血。辛寒甘寒苦寒咸寒。宜兼外治。砭出热血。及用漆姑草。慎火草。捣烂敷之。即易愈。
东逸。曰认证精详。治法稳当。但权衡脏腑上下互取之法。不在是例耳。
阳虚,即真气虚弱。其症状表现为怕冷,或者发热、自汗,汗出过多会导致亡阳。然而,阳虚患者不发热、仅怕冷的情况居多。治疗宜用甘味补益的温热药物。
阴虚,即精血亏虚。其症状表现为咳嗽多痰、吐血、咯血、嗽血(咳血)、鼻出血、牙龈出血、盗汗、自汗、发热、寒热往来或潮热、骨骼乏力、失眠、气短急促、腰背疼痛。治疗宜生精补血,清退虚热并收敛固摄,用药多选酸寒、甘寒、甘平、咸寒之品,略兼苦寒。
表虚,其症状表现为自汗、怕风、洒淅恶寒发热、喜欢靠近温暖处、脉浮而无力。治疗宜用甘酸之品补益收敛,益气实表。
里虚,其症状表现为洞泄(腹泻如水)或完谷不化(大便中有未消化食物)、心腹痛,按压后疼痛缓解,或腹胀,或伤寒误下后出现痞满。治疗宜温补,用甘温药佐以辛热药。
阳实,即表邪热盛。其症状表现为头痛、寒热、全身骨痛、无汗。治疗宜用辛寒之品发散解表,天气寒冷时略加辛热、辛温药辅助。
阴实,即里实兼外感证,属于邪热内结者。其症状表现为胸腹部硬痛,手不可触碰,大便七八日不通,或伴有热性下利。治疗宜攻下,用苦寒、咸寒、甘辛之品。
阳厥,即热厥。其症状表现为四肢厥冷、身热面赤、嘴唇干燥、大渴、口干舌苦、眼睛闭合或不闭合、小便红涩短少、大便燥结、神志不清。治疗宜攻下、清热,用甘寒、苦寒、咸寒之品。若有兼夹虚证或痰浊者,宜用麦冬、竹沥、芦根汁、梨汁、牛黄、童便。如妇人热入血室因而导致厥逆者,药中以童便为君药,加赤芍、生地、牛膝、丹皮、桃仁。病情严重者若大便燥结,加芒硝、大黄攻下,一旦通畅即止。
阴厥,即寒厥。其症状表现为四肢厥逆、身冷面青、嗜睡、手指指甲青黯、腹痛、大便溏薄或完谷不化、小便自利、口不渴、神志不清。治疗宜补气温中,用甘温、辛热之品。
上盛下虚,属于阳盛阴虚。治疗宜降气、益阴,用甘寒、酸寒之品,佐以咸寒、苦寒。下盛上虚,属于阴盛阳虚。治疗宜益气升阳,用甘温、甘辛之品。
心虚八证,治疗宜补血,用甘温、酸敛之品,佐以咸寒、镇坠之品。惊邪属心气虚,《内经》说:“惊者平之”,宜降气、清热、豁痰。癫痫属心气虚且有热,也宜降气、清热、豁痰。不得眠属心血虚且有热,治疗宜收敛、养阴血、清热。心烦属心有热,宜清热兼生津液,用甘寒、甘平、甘酸之品,参用治不得眠的药物。怔忡属心血不足,心中悸动不安。盗汗属心血虚,汗为心之液,宜补益收敛、清虚热,用甘酸、甘平、甘寒、苦寒、咸寒之品。伏梁属心经气血虚,致使邪气留恋不去,治疗宜活血凉血、散热通结,用辛咸之品。
心实,即实火实热五症,治疗宜降火清热,用苦寒药折其势,辛寒药散其邪,甘寒药缓其急,咸寒药润其燥。谵语属心家初起热证。舌破属心火。烦躁属心家邪热及心内火炎。自笑属心家有热邪。发狂属心家有甚重邪热。(注:烦属心,躁属肾)。
肝虚十证,治疗宜辛散、甘缓。胸胁痛属肝血虚与肝气实,因此宜降气养血和肝,用辛甘平缓之品。转筋属血虚,宜酸辛甘平。目光短属肝血虚及肾水不足、真阴亏,宜补肝兼滋肾,用甘温益血、甘寒除热之品。目昏属肝血虚且有热,兼肾水真阴不足。目翳属肝热,兼肾水不足,宜补肝血、除热退翳。亡血过多致角弓反张属肝血虚且有热,宜补血清热,用甘寒、甘温、酸寒、咸寒、辛润之品。少腹连阴作痛按之则止属足厥阴经血虚,宜同角弓反张治法。偏头痛属血虚,肝家有热,若不急治,久之必损目,宜养血清虚热,用甘寒、酸寒、辛寒之品。目黑暗眩晕属血虚,兼肾水真阴不足,宜养血补肝清热,用甘寒、甘平、酸寒、苦寒之品。肥气属气血两虚,肝气不和,逆气与瘀血相并而成,宜和肝散结气,兼行气血凝滞,用甘温、甘平之品。
肝实五证,宜清热降气,用苦寒、辛寒、甘寒、酸寒之品。善怒,怒则气上逆,甚则呕血、反飧泄,宜降气清热,用甘寒、咸寒、酸寒之品,且佐以辛散。善太息,忽忽不乐,胁痛呕血属肝气逆、肝火盛、肝血虚。发搐属肝家邪热,热则生风,风主掉眩,故宜清热降气、利小便缓中。目赤肿痛属血热,宜凉血清热,用甘寒、苦寒、酸寒之品。
脾虚十二证,宜甘温,佐以辛香、酸平。饮食劳倦伤脾致发热,宜补中益气,用甘温升提、酸收之品。饮食不消化属脾气虚,宜益其气,用甘温、甘辛之品。伤食必恶食,宜健胃消导,用甘温、辛香之品。如腹痛大便不通,宜攻下,用枳实、槟榔、浓朴、大黄,但元气虚人不可单纯攻下,宜加人参、白术。伤内食,轻者宜用蒜、山楂兼黄连,重者宜用矾、红枣肉为丸服二钱,不可过量,终身忌荞麦。伤面食,宜炒莱菔子。停饮因恣饮汤水或冷茶冷酒所致,宜健脾利水,用淡渗兼辛散之品。水肿属脾气虚,宜补脾益气、燥湿利水,用辛香、甘温之品,佐以淡渗。脾虚中满属脾气虚兼脾阴虚。昼剧夜静属脾气虚,宜补气健脾,用甘温、淡渗之品,佐以辛香。夜剧昼静属脾阴虚,宜补脾阴,兼制肝清热,用甘平、酸寒、淡渗之品。噎膈属气血两虚,由于血液衰少而作,痰气壅遏所成,宜降气、清热润燥,用甘温、甘平以益血,略佐辛香以顺气。脾泄属气虚,宜温中、补气升清,用甘温、甘平之品,佐以辛香,兼有湿及痰。经年不愈,粪色白者,须服九制松脂。健忘属气血两虚,宜益脾阴兼补气,用酸敛、甘温、甘寒、辛平之品以通窍。倦怠嗜卧属脾气不足,宜补气兼健脾,用甘温、辛香之品。腹痛按之则止属脾血虚,宜益气补血,用甘温、酸平之品。痞气属脾虚及气郁所致,宜健脾兼散结滞,用甘温、辛香之品。
脾实,即湿热邪胜六证,宜除湿清热、利小便,用辛散风燥、苦寒之品。蛊胀由于脾家湿热积滞,或内伤瘀血停积而成,宜除湿清热、利小便。消谷易饥属脾家邪火,宜清火除热、生津液、益脾阴,用甘寒、苦寒、酸寒之品。口唇生疮宜用甘寒、酸寒、苦寒、辛寒之品。口糜宜同唇疮治法。中消属脾家实火,宜同唇生疮治法加人参。湿热腹痛按之愈甚,宜利小便兼升提,苦寒不愈者,加熟大黄,即“土郁则夺”之义。
肺虚七证,宜清热降气、酸敛润燥。喘属肺虚有热,因而壅痰,宜降气消痰,用辛凉、甘寒、苦平之品。咳嗽吐血痰属肺热甚,宜降气清热、润肺生津液、凉血益血,用甘寒、甘平、咸寒之品,佐以苦寒。声哑属肺热甚,宜同咳嗽治法。咽喉燥痛属水涸、火炎、肺热之极,此症法所难治。肺痿属肺气虚有热。龟胸属肺热有痰。息贲属肺气虚,痰热壅结所致,宜降气清热、开痰,佐以散结,参用东垣息贲丸治之。
肺实八证,宜降气散闭,用甘寒、苦寒之品,佐以辛散。喘急属肺有实热及肺气上逆,宜同肺实治法,加桔梗、甘草、栝蒌仁、玄参、青黛。气壅属肺热气逆,同肺实治法。声重痰稠属肺热。肺痈属肺热极,宜清热消痰、降火解毒散结,用甘寒、苦寒、辛寒之品。肺胀闷属肺热,同肺实治法。吐脓血血痰咳嗽嗽血属肺家火实热甚,此正谓邪气胜则实,宜清热降气、凉血豁痰。喉癣属肺热,宜同肺实治法,加鼠粘子、玄参、射干。上消属肺家实及上焦热,宜降气清热、补肺生津,用甘寒、苦寒、酸寒、辛寒之品。
肾虚,即肾水真阴不足十八证,宜滋阴润燥、生精补血除热,用甘寒、酸寒、苦寒、咸寒之品。肾虚腰痛属精气虚。骨乏无力属阴精不足,肾主骨故也。骨蒸潮热属精血虚极,以致阳无所附,虚火上炎,诸症皆同肾虚。传尸劳,宜除热益阴、杀劳虫兼清镇。五心烦热为真阴不足。梦遗泄精属肾虚有火,宜滋阴生精、补血除热,用酸敛佐以涩精之品。小便短涩、热赤频数,属肾虚有火,宜同肾虚治法。溺有余沥属气虚,宜同肾虚治法,以五味子、黄柏、人参为君,加菟丝子、覆盆子为臣,益智为佐。如觉平日肺家有热,或咳嗽有火者,忌用人参,改用沙参。溺血血淋属肾虚有火,热伤血,不宜同一般肾虚治法,加侧柏、阿胶、茅根、地黄、戎盐、蒲黄之类。伤精白浊属房劳过度,以致精伤流出似白浊症,宜同肾虚治法。五淋属肾虚兼有湿热,宜同肾虚治法,加清湿热之品。精塞水窍不通属房欲不禁,或思欲不遂,或惧泄忍精,或老人气不足以逐精出窍,宜行败精,壮实人兼泄火,老人宜兼补气血,外治用吮法。齿浮真牙摇动,及下龈软或齿衄,肾虚有热,宜益阴凉血固肾,应以地黄、黄柏、五味子为君,桑椹、牛膝、沙蒺藜、鹿茸、天冬为臣,龙骨、牡蛎为使。下滑属肾阴虚火伏下焦,宜清热及峻补真气,润兼酸敛,宜以黄柏、五味子、生地、天门冬、人参为君,石斛、牛膝、知母、人乳及童便为臣,地骨皮、青蒿、侧柏叶为佐。善恐属肾气虚,肾藏志故也,宜补强气志,用辛平、甘温之品,佐以辛香。阴窍涌气属肾气虚不固,肾主纳气,虚则不能纳,故见是证,宜补真气、酸敛固涩,参用肾虚诸药。疝属肾虚,寒湿邪乘虚客之所致,丹溪谓与肾经绝不相干者误也。又有先因湿邪为病,后成湿热者,药宜分寒热先后二途,宜补气通肾气除湿。又有阴虚有热之人病此,兼宜除热,虚寒而痛,加桂枝、茴香、补骨脂、仙茅;虚热而痛,加黄柏、车前子;湿盛者加白术。奔豚属肾虚,脾家湿邪下传客肾所致,宜补气健脾、辛温散结,参用东垣奔豚丸治之。肾无实证,故无治法。
命门虚,治元阳真火不足四证,宜益真阳之气,用甘温、咸温、甘热、酸敛之品。阴痿为命门火衰,下焦虚寒,宜同命门虚治法加海狗肾、蛇床子、原蚕蛾、狗阴茎等。精寒精薄属命门火衰,阳气不足,宜同阴痿治法。肾泄即五更及黎明泄泻者是也,亦名火瘕泄,属命门真火不足,宜益气,用甘温、酸敛之品。畏寒足冷,宜同命门虚治法。
命门实二证,宜苦寒、甘寒、咸寒。强阳不倒属命门火实,孤阳无阴所致,此证多不治,宜同命门实治法加五味子、童便、生地黄。水窍涩痛属命门实火,宜清热利窍,用甘寒、苦寒、咸寒佐以淡渗之品。
小肠虚宜补气,用甘温、酸温之品。遗尿属小肠气虚兼肾气虚,宜同小肠治法兼固涩。小肠实,宜通利淡渗,用苦寒、甘寒、咸寒之品。小水不利及赤或涩痛尿血,宜同小肠实治法。
胆虚二证,宜甘温、甘平、酸敛佐以微辛。易惊属胆气虚,宜补胆气,用甘温、辛温、酸平之品。病后不得眠属胆虚,治同胆虚。
胆实二证,宜和解,用辛寒、甘寒、辛温、苦寒之品。口苦耳聋胁痛、往来寒热,宜用小柴胡汤随所见兼症加减。鼻渊属胆移热于脑,宜清热补脑,用甘寒、甘平佐以辛寒之品。
胃虚七证,宜益气,用甘平、甘淡、酸之品。胃弱不纳食及不思饮食,宜同胃虚治法,仍分寒热治。胃虚呕吐宜分寒热。霍乱转筋为胃虚猝中邪恶气及毒瓦斯兼有停滞所致,此转筋与肝经血虚不同,宜调气和中、辛散消导。由于暑必口渴或口干、齿燥口苦、小水短赤;由于寒则小水清白、不渴不热。绞肠痧属胃气虚,猝中天地邪恶秽污之气也,郁于胸腹之间,上不得吐,下不得泄,以致肠胃绞痛异常,胸腹骤胀,遍体紫黑,头顶心必有红发,急寻出拔去之,急以三棱针刺委中挤出热血,即可苏醒,次用新汲凉水投入盐两许恣饮,得吐泻即止。委中穴在两膝下弯横纹中间两筋之中,刺入一分,切忌火酒姜蒜及谷气米饮热汤,入口即死,宜通窍辟恶,用辛散、咸寒之品,煎药亦宜冷服。中恶腹中痛属胃气虚,恶气客之所致,宜辟恶气通肠胃,用辛散之品。反胃属胃气虚,宜补气降气、和胃清热,用酸敛以制肝,若因虚寒而得者,加生姜。中酒属胃弱,宜养胃,用酸辛散淡渗之品。
胃实六证,宜攻下。如邪未结宜清热发散,用苦寒、辛寒、甘寒之品。谵语发狂发斑、弃衣而走、登高而歌,属胃家邪热实,宜同胃实治法,如大便结者,加芒硝亟下之;发斑者,加鼠粘子、玄参、栝蒌根,多用石膏为君;便结亦加大黄下之。口臭数欲饮食属胃火,宜清热降火,用苦寒、甘寒、辛寒之品。嘈杂属胃火,宜同口臭治法,略兼消导。口淡属胃热,宜同口臭治法。呕吐属胃火者,必面赤,小便短赤或涩,大便多燥,口苦或干渴,宜同胃实治法加枇杷、竹茹、木瓜、芦根、橘皮、通草、白茯苓。吞酸者属胃火,宜同嘈杂治法。
大肠虚四证,宜补气润燥,用甘温之品。虚热便闭不通属血虚,津液不足,宜生津液润燥、凉血益血。虚寒滑泄不禁属气虚,宜补气升提,用甘温、酸敛之品。肠鸣属气虚,宜同大肠虚治法,加柴胡、升麻以佐之。脱肛为气虚兼有湿热,宜补气升提,险湿热,外用五倍子敷之。
大肠实四证,宜润下,用苦寒、辛寒之品。便硬闭,宜同大肠实治法,加芒硝、猪胆、槟榔、郁李仁、石蜜。肠风下血属大肠湿热,宜清热凉血兼升提,用甘寒、苦寒之品。脏毒属血热,宜同肠风治法,加忍冬、麦冬、地榆、蒲黄。肠痈属大肠实火,宜攻下,用苦寒解毒之品。
膀胱虚三证,宜补气,用酸敛之品。小便不禁属气血虚,宜同膀胱虚治法加牡蛎、龙骨、鹿茸、桑螵蛸、鸡内金。频数不能少忍,加麦冬、五味子、黄柏、山茱萸、枸杞等。遗尿属本经气虚,见小肠虚条内,因膀胱虚亦能致遗尿,故复列此。膀胱气宜同疝治法。
膀胱实宜润,用淡渗之品。癃闭属膀胱实热,同膀胱实治法,佐以升提。
三焦虚二证,宜补中益气,佐以辛温。腹寒属中气虚,同三焦虚治法。短气少气属气虚,宜补气益精,用甘温、甘寒、酸温之品。
三焦实三证,宜降气、清热调气,用甘寒、苦寒、咸寒之品。喉痹即缠喉风,属少阳相火少阴君火并炽,《内经》说:“一阴一阳结为喉痹”,一阴者少阴君火也,一阳者少阳相火也,宜辛散,佐以苦寒、咸寒。急则有针法、吹法、吐法,急治用胆矾、朴硝、牛黄为末和匀,吹入喉中。又法用明矾三钱、巴豆七粒去壳,同矾煅至矾枯,去巴豆,取矾细末,吹入喉中即宽。头面赤热属上焦火升,宜降气、清热,用甘缓佐以酸敛之品。赤白游风属血热,热则生风,故善游走,俗名火丹,小儿多患此,大人亦时有之,宜清热凉血兼行血,用辛寒、甘寒、苦寒、咸寒之品,宜兼外治,砭出热血,及用漆姑草、慎火草捣烂敷之,即易愈。
东逸说:罗氏认证精详,治法稳当。但权衡脏腑上下互取之法,不在上述条例之中。
Yang deficiency refers to the deficiency of true qi. Its symptoms include aversion to cold, or fever, spontaneous sweating; excessive sweating may lead to the collapse of yang. However, cases where yang deficiency presents without fever and solely with aversion to cold are more common. Treatment should employ sweet, tonifying, and warm-hot herbs.
Yin deficiency refers to the deficiency of essence and blood. Its symptoms include cough with profuse phlegm, hematemesis (vomiting blood), hemoptysis (coughing up blood), epistaxis (nosebleed), gingival bleeding, night sweats, spontaneous sweating, fever, alternating chills and fever, tidal fever, bone weakness and fatigue, insomnia, shortness of breath, and pain in the lower back. Treatment should focus on generating essence and nourishing blood, clearing deficient heat, and astringing. Herbs should be sour-cold, sweet-cold, sweet-neutral, salty-cold, slightly combined with bitter-cold.
Exterior deficiency presents with spontaneous sweating, aversion to wind, shivering chills and fever, a preference for warmth, and a floating but forceless pulse. Treatment should employ sweet and sour herbs to tonify and astringe, benefiting qi and strengthening the exterior.
Interior deficiency presents with watery diarrhea or undigested food in stool, heart and abdominal pain that ceases upon pressure, abdominal distension, or fullness and stuffiness after incorrect purgation in Cold Damage diseases. Treatment should employ warming and tonifying methods, using sweet-warm herbs assisted by pungent-hot herbs.
Yang excess refers to intense heat from exterior pathogens. Its symptoms include headache, chills and fever, generalized bone pain, and absence of sweat. Treatment should employ pungent-cold herbs to disperse and release the exterior; in cold weather, slightly add pungent-hot or pungent-warm herbs as assistants.
Yin excess refers to interior excess combined with external contraction, specifically where pathogenic heat is knotted internally. Its symptoms include hardness and pain in the chest and abdomen that cannot be touched, constipation for seven to eight days, or diarrhea accompanied by heat. Treatment should employ purgation, using bitter-cold, salty-cold, and sweet-pungent herbs.
Yang jue (syncope) refers to heat jue. Its symptoms include cold extremities, body heat, red face, dry lips, extreme thirst, dry mouth and bitter taste, closed or open eyes, scanty dark and turbid urine, dry and hard stools, and loss of consciousness. Treatment should employ purgation and clearing heat, using sweet-cold, bitter-cold, and salty-cold herbs. If there is concurrent deficiency or phlegm, use *Ophiopogonis Radix* (Maidong), bamboo sap (*Zhuli*), reed rhizome juice (*Lugen Zhi*), pear juice, *Realgar* (Niuhuang), and child's urine. In women with heat entering the blood chamber causing jue, child's urine should be the sovereign herb, added with *Paeoniae Rubra Radix* (Chishao), *Rehmanniae Radix* (Shengdi), *Achyranthis Bidentatae Radix* (Niuxi), *Moutan Cortex* (Danpi), and *Persicae Semen* (Taoren). In severe cases with dry hard stools, add *Natrii Sulfas* (Mangxiao) and *Rhei Radix et Rhizoma* (Dahuang) to purge; stop once unobstructed.
Yin jue refers to cold jue. Its symptoms include cold extremities, cold body and blue face, lethargy, cyanotic fingers and nails, abdominal pain, loose stools or undigested food in stool, free urination, no thirst, and loss of consciousness. Treatment should tonify qi and warm the middle, using sweet-warm and pungent-hot herbs.
Upper excess and lower deficiency belong to yang excess and yin deficiency. Treatment should descend qi and benefit yin, using sweet-cold and sour-cold herbs, assisted by salty-cold and bitter-cold herbs. Lower excess and upper deficiency belong to yin excess and yang deficiency. Treatment should benefit qi and raise yang, using sweet-warm and sweet-pungent herbs.
Eight syndromes of Heart deficiency: Treatment should nourish blood, using sweet-warm and sour-astringent herbs, assisted by salty-cold and heavy-settling herbs. Palpitations due to fright belong to Heart qi deficiency; as stated in the Classics, "For fright, normalize it." Treatment should descend qi, clear heat, and resolve phlegm. Epilepsy belongs to Heart qi deficiency with heat; treatment should also descend qi, clear heat, and resolve phlegm. Insomnia belongs to Heart blood deficiency with heat; treatment should astringe, nourish yin-blood, and clear heat. Restlessness belongs to heat in the Heart; treatment should clear heat and generate fluids, using sweet-cold, sweet-neutral, and sweet-sour herbs, incorporating herbs for insomnia. Palpitations (Zhencong) belong to insufficient Heart blood, characterized by palpitations. Night sweats belong to Heart blood deficiency, as sweat is the fluid of the Heart; treatment should tonify and astringe, clear deficient heat, using sweet-sour, sweet-neutral, sweet-cold, bitter-cold, and salty-cold herbs. Fuliang (a mass under the heart) belongs to deficiency of qi and blood in the Heart meridian, allowing pathogens to linger; treatment should invigorate blood, cool blood, dissipate heat, and unblock stagnation, using pungent and salty herbs.
Heart excess involves five syndromes of excess fire and heat. Treatment should reduce fire and clear heat: bitter-cold to break it, pungent-cold to scatter it, sweet-cold to moderate it, and salty-cold to moisten it. Delirium belongs to initial heat in the Heart. Tongue ulcers belong to Heart fire. Irritability belongs to pathogenic heat in the Heart and flaming internal fire. Spontaneous laughter belongs to heat pathogens in the Heart. Mania belongs to severe heat pathogens in the Heart. (Note: Fan [restlessness] belongs to the Heart; Zao [agitation] belongs to the Kidney.)
Ten syndromes of Liver deficiency: Treatment should disperse with pungent and moderate with sweet. Hypochondriac pain belongs to Liver blood deficiency and Liver qi excess; thus, treat by descending qi, nourishing blood, and harmonizing the Liver, using sweet-pungent and mild herbs. Muscle spasms belong to blood deficiency; use sour, pungent, and sweet-neutral herbs. Short-sightedness belongs to Liver blood deficiency and insufficiency of Kidney water/true yin; tonify the Liver and nourish the Kidney, using sweet-warm to benefit blood and sweet-cold to clear heat. Blurred vision belongs to Liver blood deficiency with heat and insufficiency of Kidney true yin. Corneal opacity belongs to Liver heat with insufficiency of Kidney water; nourish Liver blood, clear heat, and eliminate opacity. Opisthotonos due to excessive blood loss belongs to Liver blood deficiency with heat; nourish blood and clear heat, using sweet-cold, sweet-warm, sour-cold, salty-cold, and pungent-moistening herbs. Pain in the lower abdomen radiating to the genitals that stops upon pressure belongs to blood deficiency in the Foot Jueyin meridian; treat similarly to opisthotonos. Migraine belongs to blood deficiency and heat in the Liver; if not treated urgently, it will damage the eyes over time. Nourish blood and clear deficient heat, using sweet-cold, sour-cold, and pungent-cold herbs. Darkened vision and dizziness belong to blood deficiency and insufficiency of Kidney true yin; nourish blood, tonify the Liver, and clear heat, using sweet-cold, sweet-neutral, sour-cold, and bitter-cold herbs. Feiqi (a mass) belongs to dual deficiency of qi and blood and disharmony of Liver qi, formed by rebellious qi and blood stasis; harmonize the Liver, dissipate nodules, and move qi and blood stagnation, using sweet-warm and sweet-neutral herbs.
Five syndromes of Liver excess: Clear heat and descend qi, using bitter-cold, pungent-cold, sweet-cold, and sour-cold herbs. Irritability causes qi to rebel upward, potentially leading to hematemesis or incomplete digestion in stool; descend qi and clear heat, using sweet-cold, salty-cold, and sour-cold herbs, assisted by pungent dispersants. Frequent sighing and depression belong to rebellious Liver qi, excess Liver fire, and Liver blood deficiency. Convulsions belong to pathogenic heat in the Liver; heat generates wind, which causes tremors and dizziness. Clear heat, descend qi, promote urination, and moderate the center. Red, swollen, and painful eyes belong to blood heat; cool blood and clear heat, using sweet-cold, bitter-cold, and sour-cold herbs.
Twelve syndromes of Spleen deficiency: Use sweet-warm, assisted by pungent-aromatic, sour, and neutral herbs. Fever from diet and overwork damaging the Spleen: Tonify the middle and benefit qi, using sweet-warm to raise and sour to astringe. Indigestion belongs to Spleen qi deficiency; benefit qi with sweet-warm and sweet-pungent herbs. Food stagnation causes aversion to food; strengthen digestion using sweet-warm and pungent-aromatic herbs. Abdominal pain with constipation requires purgation (*Aurantii Fructus*, *Arecae Semen*, *Magnoliae Cortex*, *Rhei Radix et Rhizoma*), but avoid purging those with deficient yuan qi; add *Codonopsis Radix* and *Atractylodis Macrocephalae Rhizoma*. For internal food stagnation, mild cases use garlic and hawthorn with *Coptidis Rhizoma*; severe cases use alum and jujube pills, avoiding buckwheat lifelong. For wheat food stagnation, use fried radish seeds. Fluid retention from drinking too much water, cold tea, or wine: Strengthen the Spleen and promote diuresis with light-leaching and pungent-dispersing herbs. Edema belongs to Spleen qi deficiency; tonify the Spleen, benefit qi, dry dampness, and promote diuresis with pungent-aromatic and sweet-warm herbs, assisted by light-leaching herbs. Spleen deficiency with fullness belongs to Spleen qi and yin deficiency. Worse during day, quiet at night indicates Spleen qi deficiency; tonify qi and strengthen Spleen with sweet-warm and light-leaching herbs, assisted by pungent-aromatics. Worse at night, quiet during day indicates Spleen yin deficiency; tonify Spleen yin and control Liver/clear heat with sweet-neutral, sour-cold, and light-leaching herbs. Dysphagia belongs to dual deficiency of qi and blood due to blood decline and phlegm-qi obstruction; descend qi, clear heat, and moisten dryness, using sweet-warm and sweet-neutral to benefit blood, slightly assisted by pungent-aromatics to smooth qi. Spleen diarrhea belongs to qi deficiency; warm the middle, benefit qi, and raise clear yang with sweet-warm and sweet-neutral herbs, assisted by pungent-aromatics, addressing dampness and phlegm. Chronic white stool requires processed pine resin. Forgetfulness belongs to dual deficiency of qi and blood; benefit Spleen yin and qi with sour-astringent, sweet-warm, sweet-cold, and sweet-pungent herbs to open orifices. Fatigue and lethargy belong to insufficient Spleen qi; benefit qi and strengthen Spleen with sweet-warm and pungent-aromatic herbs. Abdominal pain stopping upon pressure belongs to Spleen blood deficiency; benefit qi and nourish blood with sweet-warm and sweet-neutral herbs. Piqi (mass) belongs to Spleen deficiency and qi stagnation; strengthen Spleen and dissipate stagnation with sweet-warm and pungent-aromatic herbs.
Spleen excess involves six syndromes of damp-heat pathogen dominance. Remove dampness, clear heat, and promote urination with pungent-dispersing wind-drying and bitter-cold herbs. Gu distension results from damp-heat accumulation or internal blood stasis; remove dampness, clear heat, and promote urination. Polyphagia belongs to pathogenic fire in the Spleen; clear fire, remove heat, generate fluids, and benefit Spleen yin with sweet-cold, bitter-cold, and sour-cold herbs. Lip sores require sweet-cold, sour-cold, bitter-cold, and pungent-cold herbs. Mouth thrush follows lip sore treatment. Middle Xiao (polydipsia) belongs to Spleen excess fire; follow lip sore treatment plus *Codonopsis Radix*. Damp-heat abdominal pain worsens with pressure; promote urination and raise, adding prepared *Rhei Radix et Rhizoma* if bitter-cold fails, following the principle of "Earth stagnation requires draining."
Seven syndromes of Lung deficiency: Clear heat, descend qi, astringe, and moisten dryness. Asthma belongs to Lung deficiency with heat and phlegm obstruction; descend qi and resolve phlegm with pungent-cool, sweet-cold, and bitter-neutral herbs. Cough with bloody sputum belongs to severe Lung heat; descend qi, clear heat, moisten Lungs, generate fluids, cool blood, and nourish blood with sweet-cold, sweet-neutral, and salty-cold herbs, assisted by bitter-cold. Hoarseness belongs to severe Lung heat; treat like cough. Dry and painful throat belongs to fluid exhaustion and flaming fire/extreme Lung heat; this is difficult to treat. Lung萎 (flaccidity) belongs to Lung qi deficiency with heat. Tortoise chest belongs to Lung heat with phlegm. Xiben (accumulation in lung) belongs to Lung qi deficiency with phlegm-heat knotting; descend qi, clear heat, open phlegm, and assist with nodule-dispersing herbs, referencing Dongyuan's Xiben Pill.
Eight syndromes of Lung excess: Descend qi and disperse closure with sweet-cold and bitter-cold herbs, assisted by pungent dispersants. Urgent asthma belongs to Lung excess heat and rebellious Lung qi; follow Lung excess treatment, adding *Platycodonis Radix*, *Glycyrrhizae Radix*, *Trichosanthis Semen*, *Scrophulariae Radix*, and *Indigo Naturalis*. Qi congestion belongs to Lung heat and rebellious qi; follow Lung excess treatment. Heavy voice and thick phlegm belong to Lung heat. Lung abscess belongs to extreme Lung heat; clear heat, resolve phlegm, reduce fire, detoxify, and dissipate nodules with sweet-cold, bitter-cold, and pungent-cold herbs. Lung distension belongs to Lung heat; follow Lung excess treatment. Vomiting pus/bloody sputum/coughing blood belongs to severe Lung fire/excess heat; clear heat, descend qi, cool blood, and resolve phlegm. Throat tinea belongs to Lung heat; follow Lung excess treatment, adding *Arctii Fructus*, *Scrophulariae Radix*, and *Belamcandae Rhizoma*. Upper Xiao belongs to Lung excess and Upper Jiao heat; descend qi, clear heat, tonify Lung, and generate fluids with sweet-cold, bitter-cold, sour-cold, and pungent-cold herbs.
Kidney deficiency involves eighteen syndromes of insufficient Kidney water/true yin. Nourish yin, moisten dryness, generate essence, nourish blood, and clear heat with sweet-cold, sour-cold, bitter-cold, and salty-cold herbs. Low back pain from Kidney deficiency belongs to essence/qi deficiency. Bone weakness belongs to insufficient yin-essence, as the Kidney governs bones. Bone-steaming tidal fever belongs to extreme essence-blood deficiency causing yang to have no attachment and deficient fire to flare; all such symptoms follow Kidney deficiency treatment. Transmitted corpse劳 (TB-like disease): Clear heat, benefit yin, kill parasites, and calm with clearing/settling herbs. Five-center heat belongs to true yin insufficiency. Nocturnal emission belongs to Kidney deficiency with fire; nourish yin, generate essence, nourish blood, and clear heat with sour-astringent herbs assisting in securing essence. Scanty, hot, red, frequent urination belongs to Kidney deficiency with fire; follow Kidney deficiency treatment. Post-void dribbling belongs to qi deficiency; follow Kidney deficiency treatment using *Schisandrae Fructus*, *Phellodendri Cortex*, and *Codonopsis Radix* as sovereign, *Cuscutae Semen*, *Rubus Fructus* as minister, and *Alpinia Oxyphylla Fructus* as assistant. Avoid *Codonopsis Radix* if Lung heat/cough exists; use *Glehniae Radix* instead. Hematuria and painful urinary dysuria belong to Kidney deficiency with fire damaging blood; do not follow general Kidney deficiency treatment; add *Platycladi Cacumen*, *Ejiao*, *Imperatae Rhizoma*, *Rehmanniae Radix*, *Halotitum*, and *Polygoni Multiflori Caulis*. White turbid discharge from semen injury belongs to excessive sexual activity; follow Kidney deficiency treatment. Five types of Lin (dysuria) belong to Kidney deficiency with damp-heat; follow Kidney deficiency treatment plus damp-heat clearing. Blocked seminal aperture belongs to unrestrained desire, unfulfilled longing, holding back ejaculation, or elderly qi insufficiency; move stale semen, clear fire in robust persons, tonify qi-blood in elderly, and use external suction. Loose teeth and bleeding gums belong to Kidney deficiency with heat; nourish yin, cool blood, and secure the Kidney using *Rehmanniae Radix*, *Phellodendri Cortex*, *Schisandrae Fructus* as sovereign, *Mori Fructus*, *Achyranthis Bidentatae Radix*, *Tribuli Fructus*, *Cervi Cornu Pantotrichum*, and *Asparagi Radix* as ministers, *Dragon Bone* and *Oyster Shell* as guides. Sliding down belongs to Kidney yin deficiency with hidden fire in Lower Jiao; clear heat and strongly tonify true qi, moisten and astringe, using *Phellodendri Cortex*, *Schisandrae Fructus*, *Rehmanniae Radix*, *Asparagi Radix*, and *Codonopsis Radix* as sovereign, *Dendrobii Caulis*, *Achyranthis Bidentatae Radix*, *Anemarrhenae Rhizoma*, human milk, and child's urine as ministers, *Lycii Cortex*, *Artemisiae Annuae Herba*, and *Platycladi Cacumen* as assistants. Excessive fear belongs to Kidney qi deficiency, as the Kidney stores Zhi; tonify and strengthen qi/Zhi with sweet-neutral and sweet-warm herbs, assisted by pungent-aromatics. Gas rushing from genital orifice belongs to insecure Kidney qi; the Kidney governs grasping qi, and deficiency leads to inability to grasp; tonify true qi, astringe and secure with sour herbs, incorporating Kidney deficiency herbs. Hernia belongs to Kidney deficiency with cold-damp invading; Danxi's claim that it has nothing to do with the Kidney meridian is erroneous. Some start as dampness then become damp-heat; treat cold and heat separately. Benefit qi, unblock Kidney qi, and remove dampness. For yin-deficient heat patients, also clear heat; for cold-pain, add *Cinnamomi Ramulus*, *Foeniculi Fructus*, *Psoraleae Fructus*, and *Curculiginis Rhizoma*; for heat-pain, add *Phellodendri Cortex* and *Plantaginis Semen*; for damp-excess, add *Atractylodis Rhizoma*. Ben tun (rushing gas) belongs to Kidney deficiency with Spleen damp-heat transmitting to the Kidney; benefit qi, strengthen Spleen, and disperse nodules with pungent-warm herbs, referencing Dongyuan's Bentun Pill. The Kidney has no excess, hence no specific treatment for excess.
Mingmen deficiency treats four syndromes of insufficient primal yang/fire. Benefit primal yang qi with sweet-warm, salty-warm, sweet-hot, and sour-astringent herbs. Impotence belongs to Mingmen fire decline and Lower Jiao cold; follow Mingmen deficiency treatment plus *Otaria Verrucifera Penis*, *Cnidii Fructus*, *Bombyx Batryticatus*, and dog penis. Cold/thin semen belongs to Mingmen fire decline and yang insufficiency; follow impotence treatment. Kidney diarrhea (morning diarrhea) belongs to insufficient Mingmen true fire; benefit qi with sweet-warm and sour-astringent herbs. Aversion to cold and cold feet follow Mingmen deficiency treatment.
Two syndromes of Mingmen excess: Use bitter-cold, sweet-cold, and salty-cold. Persistent erection belongs to Mingmen fire excess caused by solitary yang without yin; often untreatable. Follow Mingmen excess treatment plus *Schisandrae Fructus*, child's urine, and *Rehmanniae Radix*. Painful/difficult urination belongs to Mingmen excess fire; clear heat and unblock orifices with sweet-cold, bitter-cold, and salty-cold assisted by light-leaching herbs.
Small Intestine deficiency benefits qi with sweet-warm and sour-warm herbs. Enuresis belongs to Small Intestine qi deficiency combined with Kidney qi deficiency; follow Small Intestine treatment plus securing/astringing. Small Intestine excess promotes unblocking and light-leaching with bitter-cold, sweet-cold, and salty-cold herbs. Difficult/hot/painful urination or hematuria follows Small Intestine excess treatment.
Two syndromes of Gallbladder deficiency: Use sweet-warm, sweet-neutral, and sour-astringent assisted by slight pungency. Easily frightened belongs to Gallbladder qi deficiency; tonify Gallbladder qi with sweet-warm, pungent-warm, and sweet-neutral herbs. Insomnia after illness belongs to Gallbladder deficiency; treat same as Gallbladder deficiency.
Two syndromes of Gallbladder excess: Harmonize with pungent-cold, sweet-cold, pungent-warm, and bitter-cold herbs. Bitter taste, deafness, hypochondriac pain, and alternating chills/fever: Use *Xiao Chaihu Tang* modified for accompanying symptoms. Nasal sinusitis belongs to Gallbladder heat transferring to the brain; clear heat and tonify the brain with sweet-cold and sweet-neutral assisted by pungent-cold herbs.
Seven syndromes of Stomach deficiency: Benefit qi with sweet-neutral, sweet-bland, and sour herbs. Weak Stomach failing to accept food/lack of appetite follows Stomach deficiency treatment, differentiated by cold/heat. Stomach deficiency vomiting differentiates cold/heat. Cholera with spasms results from sudden invasion of evil qi/toxins and stagnation in weak Stomach qi; distinct from Liver blood deficiency spasms. Regulate qi, harmonize middle, disperse with pungent, and digest. Summerheat causes thirst/dry mouth/red teeth/bitter taste/scanty red urine; cold causes clear urine/no thirst/no heat. Colic (Jiao Chang Sha) belongs to Stomach qi deficiency and sudden invasion of foul air, stagnating in chest/abdomen, causing severe pain, distension, purple-black body, and red hair on vertex. Extract red hair, prick Weizhong (BL40) with three-edged needle to bleed, wake patient, drink salted cold water until vomiting/diarrhea occurs. Weizhong is between tendons in popliteal crease; puncture 1 fen. Avoid alcohol, ginger, garlic, rice soup, hot water. Promote orifices and repel evil with pungent-dispersing and salty-cold herbs; decoctions taken cold. Mid-e (Zhong E) abdominal pain belongs to Stomach qi deficiency and evil qi invasion; repel evil and unblock intestines with pungent dispersants. Reverse regurgitation belongs to Stomach qi deficiency; benefit qi, descend qi, harmonize Stomach, clear heat, and astringe to control Liver; add *Zingiberis Rhizoma* if cold-deficiency. Wine intoxication belongs to weak Stomach; nourish Stomach with sour-pungent, dispersing, and light-leaching herbs.
Six syndromes of Stomach excess: Purge. If pathogen not knotted, clear heat and disperse with bitter-cold, pungent-cold, and sweet-cold herbs. Delirium, mania, macules, discarding clothes, climbing and singing belong to Stomach pathogenic heat excess; follow Stomach excess treatment. Add *Natrii Sulfas* urgently if constipated; add *Arctii Fructus*, *Scrophulariae Radix*, *Trichosanthis Radix*, and *Gypsum Fibrosum* (sovereign) for macules; add *Rhei Radix et Rhizoma* for constipation. Bad breath and frequent hunger belong to Stomach fire; clear heat and reduce fire with bitter-cold, sweet-cold, and pungent-cold herbs. Gastric discomfort belongs to Stomach fire; follow bad breath treatment plus digestion aids. Tasteless mouth belongs to Stomach heat; follow bad breath treatment. Vomiting from Stomach fire presents with red face, scanty red/turbid urine, dry stools, bitter/dry mouth; follow Stomach excess treatment plus *Loquat Leaf*, *Bambusa Textilis Tarsodes*, *Chaenomelis Fructus*, *Imperatae Rhizoma*, *Citri Reticulatae Pericarpium*, *Akebia Caulis*, and *Poria*. Sour regurgitation belongs to Stomach fire; follow gastric discomfort treatment.
Four syndromes of Large Intestine deficiency: Benefit qi and moisten dryness with sweet-warm herbs. Constipation from deficient heat/blood/yin deficiency: Generate fluids, moisten dryness, cool blood, and nourish blood. Diarrhea from deficient cold/qi: Benefit qi and raise with sweet-warm and sour-astringent herbs. Bowel sounds belong to qi deficiency; follow Large Intestine deficiency treatment plus *Bupleuri Radix* and *Angelicae Pubescentis Radix*. Rectal prolapse belongs to qi deficiency with damp-heat; benefit qi and raise, address damp-heat, apply *Myrobalani Fructus* externally.
Four syndromes of Large Intestine excess: Moisten and purge with bitter-cold and pungent-cold herbs. Hard constipation follows Large Intestine excess treatment, adding *Natrii Sulfas*, *Suis Fel*, *Arecae Semen*, *Pruni Semen*, and rock sugar. Intestinal wind bleeding belongs to Large Intestine damp-heat; clear heat, cool blood, and raise with sweet-cold and bitter-cold herbs. Zangdu (internal toxin bleeding) belongs to blood heat; follow intestinal wind treatment plus *Lonicerae Japonicae Flos*, *Ophiopogonis Radix*, *Sanguisorbae Radix*, and *Polygoni Multiflori Caulis*. Intestinal abscess belongs to Large Intestine excess fire; purge with bitter-cold detoxifying herbs.
Three syndromes of Bladder deficiency: Benefit qi with sour-astringent herbs. Urinary incontinence belongs to qi-blood deficiency; follow Bladder deficiency treatment plus *Concha Ostreae*, *Os Draconis*, *Cervi Cornu Pantotrichum*, *Mantis Ootheca*, and *Gallus Gallus Domesticus Gizzard Lining*. Frequency without retention adds *Ophiopogonis Radix*, *Schisandrae Fructus*, *Phellodendri Cortex*, *Corni Fructus*, and *Lycii Fructus*. Enuresis belongs to meridian qi deficiency (see Small Intestine deficiency); listed again as Bladder deficiency also causes enuresis. Bladder qi issues follow hernia treatment.
Bladder excess requires moistening and light-leaching. Anuria belongs to Bladder excess heat; follow Bladder excess treatment, assisted by raising.
Two syndromes of Sanjiao (Triple Burner) deficiency: Tonify middle and benefit qi, assisted by pungent-warm. Abdominal cold belongs to middle qi deficiency; follow Sanjiao deficiency treatment. Shortness of breath belongs to qi deficiency; benefit qi and essence with sweet-warm, sweet-cold, and sour-warm herbs.
Three syndromes of Sanjiao excess: Descend, clear heat, and regulate qi with sweet-cold, bitter-cold, and salty-cold herbs. Hou bi (sore throat/wind-binding throat) belongs to simultaneous blazing of Shaoyang Minister Fire and Shaoyin Sovereign Fire; as stated, "One Yin and One Yang knotting causes Hou bi." One Yin is Shaoyin Sovereign Fire; One Yang is Shaoyang Minister Fire. Disperse with pungent, assisted by bitter-cold and salty-cold. Emergency treatments include acupuncture, blowing powder, and emetics. Emergency blow: *Chalcanthite*, *Mirabilite*, and *Realgar* powder into throat. Alternative: Calcined alum (with *Crotonis Fructus*) blown into throat. Red-hot head/face belongs to Upper Jiao fire rising; descend and clear heat with sweet-moderating and sour-astringent herbs. Chi Bai You Feng (red-white wandering wind/herpes zoster-like) belongs to blood heat generating wind; clears heat, cools blood, and moves blood with pungent-cold, sweet-cold, bitter-cold, and salty-cold herbs. Combine with external treatment: bloodletting and applying crushed *Phyllanthus urinaria* and *Solidago decurrens*.
Dongyi states: Diagnosis is precise, and treatment methods are steady. However, the method of weighing mutual selection between upper and lower organs is not included in these examples.