治热在气分，夜安昼甚，口渴便浊，或口舌生疮，咽干烦躁，小便赤淋，遇劳即发。
黄芩（炒） 麦冬 地骨皮 车前子 甘草（各一钱五分） 石莲肉 白茯苓 黄
人参（各一钱） 水煎服。
心脏主火，火者，元气之贼，热不两立者也。小肠与心为表里，心火妄动，小便必
涩，故以门冬、石莲宁其天君，毋使有自焚之忧；黄芩、茯苓清其至高，毋使有销铄之
患；参 之用，肋气化以达州都；车前之功，开决渎以供受盛；甘草一味，可上可
下，调和诸药，共底成功。若小便既通，则心清而诸火自息，竟宜治本，不必兼标矣。
治胃中有热，呕吐咳逆，虚烦不安。
人参（五钱） 半夏（一两） 竹茹（一团，一方加橘红一两） 分作六服姜水煎，温服。
治劳倦内伤，身热心烦，头痛恶寒，阳虚自汗，懒言恶食，或喘或渴，或气虚不能
摄血，脉洪大无力，或微细软弱，或疟痢脾虚，久不能愈，一切清阳下陷，中气不足之
症，或虚人感冒风寒，不胜发表者，宜以此代之。（中者，脾胃也。脏腑肢体皆禀气于脾胃，
饥饱劳役，脾胃有伤，则众体无以禀气而皆病矣。阳气下陷则阴火上乘，故热而烦非实热也。
头者，诸阳之会，清阳不升则浊气上逆，故头痛。其痛或作或止非如外感头痛不休也。阳虚不
能卫外，故恶寒自汗。气虚故懒言。脾虚故恶食，脾胃虚则火上于肺，故喘。金受火克，
不能生水，故渴。脾虚不能统血，则血妄行而吐下，清阳下陷则为泻痢。气血两虚则疟不止。
总皆中气不足，变现诸症也。）
黄 （一钱五分，炙） 人参 炙甘草 归身 白术（土炒，各一钱） 陈皮（五分）
升
麻柴胡（各三分） 姜枣水煎服。
劳倦伤脾，心火乘土，而肺金受邪，脾胃一虚，肺气先绝，肺者，气之本，黄 补
肺固表为君；脾者，肺之本，人参、甘草补脾益气，和中泻火为臣；白术燥湿强脾，当
归和血养阴为佐；升麻以升阳明清气，柴胡以升少阳清气，阳升则万物生，清升则浊阴
降；加陈皮者，以通利其气，生姜辛温大枣甘温，用以和营卫，开腠理，致津液诸虚不
足，先建其中。中者何？脾胃是也。《经》曰∶劳者温之。温能除大热。大忌苦寒之
药，以伤胃土耳。大抵人年五十以后，降气常多，升气常少，秋冬之令多，春夏之令
少。若气禀素弱，内伤元气，清阳陷遏，并宜此药活法治之。脾为坤土，以应地气，地
气升而发陈之令布，天气降而肃杀之令行，劳倦伤脾，土虚下陷。《经》曰∶交通不表，
名木多死，白露不下，菀稿不荣。此言肃杀成否之象，人应之，则变症百出，未央绝
灭。东垣先生深达造化，故立温和之利，温和者，春气之应，养生之道也。但以升麻提
脾之右陷者，从右而升；柴胡提肝之左陷者，从左而升。地既上升，天必下降，二气
交通，乃成雨露，此气行而生气不竭矣。治劳伤者，可不如是耶！古方黄 一钱，其余
三分五分，立斋常用参 各钱半，白术当归各一钱，陈皮五分，升柴各三分，进退加
减，神应无穷。如病甚者，参 或三钱、五钱，随症加用。脾胃喜甘而恶苦，喜补而恶
攻，喜温而恶寒，喜通而恶滞，喜升而恶降，喜燥而恶湿，此方得之，但用之于脾胃
中元阳之气不足极当。若用之于脾胃中元阴之气不足，则恐不能相宜。盖气药多而血药
少，且有升提味辛之品，阴虚者，浮火易升，虚气易逆耳。古今称补中益气汤，为万
世无穷之利。其义云河？此发前人之所未发，继仲景、河间而立，意深远矣。世人一
见发热，便以外感风寒暑湿之邪，非发散邪从何解？又不能的见风寒暑湿，对症施治，
乃通用解表之剂，如九味羌活汤、败毒散、十神汤之类，甚有凉膈、白虎，杂然并进，
因而致毙者多矣。东垣深痛其害，创立此方，以为邪之所凑，其气必虚，内伤者多，
外感者，间或有之。纵有外邪，亦是乘虚而入，但补其中，益其气，而邪自退，不必攻
邪，攻则虚者愈虚，而危亡随其后矣。倘有外感而内伤不甚者，即于本方中，酌加对症
之药，而外邪自退，所谓仁义之师，无敌于天下也。至于饮食矢节，劳役过度，胃中阳
气自虚，下陷于阴中，而发热者，此阳虚自病，误作外感而发散之，益虚其虚矣。为害
岂浅哉！又有一种内伤真阴而发热者，与内伤阳气相似，此当填补真阴，心肺在上，肾
肝在下，脾胃处于中州，为四脏之主气者，中焦无形之气，所以蒸腐水谷，升降出入，
乃先天之气，又为脾胃之主，后天脾土，非得先天之气不行，是方盖为此气因劳而下陷
于肾肝，清气不升，浊气不降，故用升麻使由右腋而上，用柴胡使由左腋而上，非藉参
之功，则升提无力，所以补益后天中之先天也。升而降，降而升，务使气血和平而
已，故陷而降，固不可有升无降，亦不可所谓有春夏而无秋冬，有生发而无收藏矣。
东垣一部《脾胃论》，俱以补中益气汤为主，无非培人后天元气之本，顾元气为生
身之精气，而实祖于胃，故胃气有谷气、荣气、冲气、阳气之别，要皆元气之异称，而
此气又根乎先天生气之气，少火生气，即为真阳之气。元气即是火，火即是元气，乃为
主人立命之本，此火寄于肾肝，根乎相火相火者，因君火不主令，而代君以行，故
曰∶札火以位，则此火本非邪火。何得谓元气之贼？元气在两肾命门之中，随三焦相火
以温肉分，而充皮毛，蒸糟粕而化精微，是元气即相火之所化，而非贼元气之物，其贼
元气者，乃少火之变常为壮火，而非少火也。若即指为元气之贼，而曰“火与元气不
两立，一胜一负”为论，则生元气者，更有
何火也？然诸脏有阴有阳，阴为血，阳为气，气虚不能敛纳中宫之元阳，血虚不能按
藏下焦之雷火，皆虚热也。故宜甘温。并忌苦寒，但四脏有劳，皆致内伤，东垣独主脾
胃，以劳倦伤脾，脾胃为元气之本也。
《经》曰∶诸气 郁，皆属于肺。又曰∶怒则气上，喜则气缓，忧则气消，恐则气
下，寒则气收，热则气泄，惊则气乱，劳败气耗，思则气结，九气不同，百病多生于气
也。夫人身之所持以生者，此气耳，源出中焦，总统于肺，外护于表，内行于里，周流
一身，顷刻无间，出入升降，昼夜有常，曷常病于人哉？！及至七情交攻，五志妄发，
乖戾失常，清者化而为浊，行者阻而不通，表失护卫而不和，里失营运而弗顺，气本属
阳，及胜则为火矣。河间所谓五志过极皆为火，丹溪所谓气有余便是火也。人身有宗
气、营气、冲气、中气、元气、胃气、冲和之气、上升之气，而宗气尤为主，及其为
病，则为冷气、滞气、上气、逆气，气虚诸变症矣。无病之时，宜保之、养之、和之、
顺之，病作之时，当审其何经何症，寒热虚实而补泻之。
治疗热邪在气分，表现为夜间安静、白天加重，口渴、小便浑浊，或者口舌生疮，咽喉干燥、烦躁不安，小便赤涩淋痛，遇劳累即发作。
黄芩（炒） 麦冬 地骨皮 车前子 甘草（各一钱五分） 石莲肉 白茯苓 人参（各一钱） 加水煎服。
心脏主火，火是元气的贼害，热与元气不能并存。小肠与心互为表里，心火妄动，小便必然涩滞，所以用麦冬、石莲来安宁心神（天君），避免自焚的忧患；用黄芩、茯苓清泄至高之处的火热，避免销蚀损伤的祸患；用人参辅助气化以通达州都（膀胱）；用车前子的功效，开通决渎（水道）以供受盛（小肠）所需；甘草一味，可上可下，调和诸药，共同达成疗效。如果小便已经通畅，则心清而各种火自然平息，应当直接治本，不必兼顾标症了。
人参（五钱） 半夏（一两） 竹茹（一团，另一版本加橘红一两） 分为六次服用，用姜水煎煮，温服。
治疗因劳倦导致的内伤，身体发热、心烦，头痛、恶寒，阳虚导致自汗，懒言、厌恶饮食，或者气喘或者口渴，或者气虚不能摄血，脉象洪大无力，或者微细软弱，或者疟疾、痢疾脾虚，久治不愈，一切清阳下陷、中气不足的病症，或者体虚之人感冒风寒，不胜任发汗解表治疗的，适宜用此方替代。（中焦指脾胃。脏腑肢体都禀受脾胃之气，饥饱失常、劳役过度，脾胃受伤，则全身无法禀受气而都生病。阳气下陷则阴火上冲，所以发热心烦并非实热。头部是诸阳经汇聚之处，清阳不升则浊气上逆，所以头痛。其痛时作时止，不像外感头痛那样持续不休。阳虚不能卫护体表，所以恶寒自汗。气虚所以懒言。脾虚所以厌恶饮食，脾胃虚弱则火上炎于肺，所以气喘。金受火克，不能生水，所以口渴。脾虚不能统血，则血液妄行而吐血便血，清阳下陷则为泻痢。气血两虚则疟疾不止。总归都是中气不足，显现出各种症状。）
黄芪（一钱五分，炙） 人参 炙甘草 当归身 白术（土炒，各一钱） 陈皮（五分） 升麻 柴胡（各三分） 加生姜、大枣水煎服。
劳倦损伤脾胃，心火乘袭脾土，而肺金受邪，脾胃一虚，肺气先绝。肺是气的根本，黄芪补肺固表作为君药；脾是肺的根本，人参、甘草补脾益气，和中泻火作为臣药；白术燥湿强脾，当归和血养阴作为佐药；升麻提升阳明清气，柴胡提升少阳清气，阳气上升则万物生长，清气上升则浊阴下降；加入陈皮，是为了通利其气，生姜辛温、大枣甘温，用来调和营卫，开发腠理，化生津液。诸虚不足，先建立中气。中气是什么？就是脾胃。《内经》说：劳者温之。温能除大热。非常忌讳苦寒的药物，以免伤害胃气。大概人年过五十以后，降气常多，升气常少，秋冬的时令多，春夏的时令少。如果体质素弱，内伤元气，清阳陷遏，都适宜用此药活法治疗。脾为坤土，对应地气，地气上升则发陈的时令布散，天气下降则肃杀的时令运行，劳倦伤脾，土虚下陷。《内经》说：交通不表，名木多死，白露不下，菀稿不荣。这是说肃杀否塞的景象，人顺应它，则变症百出，未及终结就灭绝了。东垣先生深达造化规律，所以创立温和的利法，温和是春气相应，是养生的道理。只是用升麻提起脾之右陷者，从右而升；柴胡提起肝之左陷者，从左而升。地既上升，天必下降，二气交通，乃成雨露，这样气行而生气不竭。治疗劳伤者，能不如此吗！古方黄芪一钱，其余三分五分，立斋常用人参、黄芪各一钱半，白术、当归各一钱，陈皮五分，升麻、柴胡各三分，进退加减，神效无穷。如病重的，人参、黄芪可用三钱、五钱，随症加用。脾胃喜甘而恶苦，喜补而恶攻，喜温而恶寒，喜通而恶滞，喜升而恶降，喜燥而恶湿，此方符合这些特性，但只适用于脾胃中元阳之气不足极甚的情况。如果用于脾胃中元阴之气不足，则恐怕不相宜。因为气药多而血药少，且有升提味辛之品，阴虚者，浮火易升，虚气易逆耳。古今称补中益气汤，为万世无穷之利。其义何在？这是发前人所未发，继承仲景、河间而立，意深远矣。世人一见发热，便认为是外感风寒暑湿之邪，非发散邪气如何解除？又不能确切见到风寒暑湿，对症施治，乃通用解表之剂，如九味羌活汤、败毒散、十神汤之类，甚至有凉膈散、白虎汤杂然并进，因而致死的很多。东垣深痛其害，创立此方，认为邪之所凑，其气必虚，内伤者多，外感者间或有之。纵有外邪，也是乘虚而入，只要补其中，益其气，而邪自退，不必攻邪，攻则虚者愈虚，而危亡随即到来。倘有外感而内伤不甚者，即在本方中，酌加对症之药，而外邪自退，所谓仁义之师，无敌于天下也。至于饮食失节，劳役过度，胃中阳气自虚，下陷于阴中，而发热者，此阳虚自病，误作外感而发散之，益虚其虚矣。为害岂浅哉！又有一种内伤真阴而发热者，与内伤阳气相似，此当填补真阴，心肺在上，肝肾在下，脾胃处于中州，为四脏之主气者，中焦无形之气，所以蒸腐水谷，升降出入，乃先天之气，又为脾胃之主，后天脾土，非得先天之气不行，是方盖为此气因劳而下陷于肾肝，清气不升，浊气不降，故用升麻使由右腋而上，用柴胡使由左腋而上，非藉人参之功，则升提无力，所以补益后天中之先天也。升而降，降而升，务使气血和平而已，故陷而降，固不可有升无降，亦不可所谓有春夏而无秋冬，有生发而无收藏矣。东垣一部《脾胃论》，俱以补中益气汤为主，无非培人后天元气之本，顾元气为生身之精气，而实祖于胃，故胃气有谷气、荣气、冲气、阳气之别，要皆元气之异称，而此气又根乎先天生气之气，少火生气，即为真阳之气。元气即是火，火即是元气，乃为主人立命之本，此火寄于肾肝，根乎相火。相火者，因君火不主令，而代君以行，故曰：少火以位，则此火本非邪火。何得谓元气之贼？元气在两肾命门之中，随三焦相火以温肉分，而充皮毛，蒸糟粕而化精微，是元气即相火之所化，而非贼元气之物，其贼元气者，乃少火之变常为壮火，而非少火也。若即指为元气之贼，而曰“火与元气不两立，一胜一负”为论，则生元气者，更有何火也？然诸脏有阴有阳，阴为血，阳为气，气虚不能敛纳中宫之元阳，血虚不能按藏下焦之雷火，皆虚热也。故宜甘温。并忌苦寒，但四脏有劳，皆致内伤，东垣独主脾胃，以劳倦伤脾，脾胃为元气之本也。
《内经》说：诸气膹郁，皆属于肺。又说：怒则气上，喜则气缓，忧则气消，恐则气下，寒则气收，热则气泄，惊则气乱，劳则气耗，思则气结，九气不同，百病多生于气也。人身所赖以生存者，此气耳，源出中焦，总统于肺，外护于表，内行于里，周流一身，顷刻无间，出入升降，昼夜有常，何尝病于人哉！及至七情交攻，五志妄发，乖戾失常，清者化而为浊，行者阻而不通，表失护卫而不和，里失营运而弗顺，气本属阳，及胜则为火矣。河间所谓五志过极皆为火，丹溪所谓气有余便是火也。人身有宗气、营气、冲气、中气、元气、胃气、冲和之气、上升之气，而宗气尤为主，及其为病，则为冷气、滞气、上气、逆气，气虚诸变症矣。无病之时，宜保之、养之、和之、顺之，病作之时，当审其何经何症，寒热虚实而补泻之。
Treats heat in the Qi level (Qi Fen), characterized by calmness at night and exacerbation during the day, thirst, turbid urine, or sores on the mouth and tongue, dry throat, irritability, red and scanty dysuric urine, recurring upon exertion.
Chuan Xiong Radix (Fried) [Note: Text says Huang Qin, corrected to Huang Qin based on context of heat clearing] -> Huang Qin (Scutellariae Radix, Scutellaria Root) (fried), Dong Mai Cao (Ophiopogonis Radix, Ophiopogon Root), Di Gu Pi (Lycii Cortex, Lycium Bark), Che Qian Zi (Plantaginis Semen, Plantago Seed), Gan Cao (Glycyrrhizae Radix et Rhizoma, Licorice Root and Rhizome) (1.5 qian each), Shi Lian Rou (Nelumbinis Plumula, Lotus Plumule), Bai Fu Ling (Poria, Poria Cocos), Ren Shen (Panacis Ginseng Radix, Ginseng Root) (1 qian each). Decoct with water and take orally.
The Heart governs Fire. Fire is the thief of Yuan Qi (Primordial Qi); Heat and Yuan Qi cannot coexist. The Small Intestine and Heart are exterior-interior paired organs. If Heart Fire moves recklessly, urination will inevitably become difficult. Therefore, Mai Dong (Ophiopogonis Radix) and Shi Lian Rou (Nelumbinis Plumula) are used to pacify the Tian Jun (Heavenly Sovereign, referring to the Heart/Shen) to prevent the danger of self-incineration; Huang Qin (Scutellariae Radix) and Fu Ling (Poria) clear heat from the highest regions to prevent the hazard of consumption and destruction; Ren Shen (Panacis Ginseng Radix) assists Qi transformation to reach the Zhou Du (Bladder); Che Qian Zi (Plantaginis Semen) opens the Jue Du (Waterways) to supply the Shou Sheng (Small Intestine); Gan Cao (Glycyrrhizae Radix et Rhizoma) alone can act both above and below, harmonizing the various herbs to jointly achieve success. Once urination is unobstructed, the Heart becomes clear and all fires subside naturally; one should treat the root directly without needing to address the branch symptoms simultaneously.
Treats heat in the Stomach, vomiting, coughing and rebellious Qi, empty irritability and restlessness.
Ren Shen (Panacis Ginseng Radix, Ginseng Root) (5 qian), Ban Xia (Pinelliae Rhizoma, Pinellia Tuber), Zhu Ru (Bambusae Caulis in Taenia, Bamboo Shavings) (one ball, another version adds Ju Hong (Citri Reticulatae Pericarpium Rubrum, Red Tangerine Peel) 1 qian). Divide into six doses, decoct with ginger water, and take warm.
Treats internal injury due to fatigue and overexertion, presenting with feverish sensation, irritability, headache, aversion to cold, spontaneous sweating due to Yang deficiency, reluctance to speak, anorexia, or panting, thirst, or inability of Qi deficiency to control blood, pulse that is flooding yet forceless, or minute, fine, weak, and soft, or malaria and dysentery due to Spleen deficiency persisting for a long time without cure, all syndromes of sinking of Clear Yang and insufficiency of Middle Qi, or deficient individuals suffering from wind-cold invasion who cannot tolerate diaphoretic treatments; this formula is suitable as a substitute. (The "Middle" refers to the Spleen and Stomach. All Zang-Fu organs and limbs derive Qi from the Spleen and Stomach. Irregular diet and physical overwork injure the Spleen and Stomach, causing the whole body to lack Qi and become diseased. When Yang Qi sinks, Yin Fire flares upward, so fever and irritability are not excess heat. The head is the convergence point of all Yang meridians; when Clear Yang does not ascend, turbid Qi rebels upward, causing headache. The pain comes and goes, unlike external contraction headaches which are continuous. Yang deficiency fails to protect the exterior, causing aversion to cold and spontaneous sweating. Qi deficiency causes reluctance to speak. Spleen deficiency causes anorexia; Spleen/Stomach deficiency allows Fire to flare to the Lung, causing panting. Metal is controlled by Fire and cannot generate Water, causing thirst. Spleen deficiency fails to control blood, leading to hematemesis and hematochezia; sinking of Clear Yang leads to diarrhea and dysentery. Deficiency of both Qi and Blood leads to persistent malaria. In summary, these are all manifestations of insufficient Middle Qi.)
Huang Qi (Astragali Radix, Astragalus Root) (1.5 qian, honey-fried), Ren Shen (Panacis Ginseng Radix, Ginseng Root), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, Prepared Licorice Root and Rhizome), Dang Gui Shen (Angelicae Sinensis Radix, Dong Quai Root - heart portion), Bai Zhu (Atractylodis Macrocephalae Rhizoma, Atractylodes Rhizome fried in earth) (1 qian each), Chen Pi (Citri Reticulatae Pericarpium, Tangerine Peel) (0.5 qian), Sheng Ma (Cimicifugae Rhizoma, Black Cohosh Rhizome), Chai Hu (Bupleuri Radix, Bupleurum Root) (0.3 qian each). Decoct with fresh ginger and jujube, and take orally.
Fatigue and overwork injure the Spleen and Stomach; Heart Fire attacks Earth (Spleen), and Lung Metal suffers evil. When Spleen and Stomach are deficient, Lung Qi is first exhausted. The Lung is the root of Qi; Huang Qi (Astragali Radix) tonifies the Lung and consolidates the exterior as the Sovereign herb; the Spleen is the root of the Lung; Ren Shen (Panacis Ginseng Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) tonify the Spleen, benefit Qi, harmonize the middle, and drain fire as the Minister herbs; Bai Zhu (Atractylodis Macrocephalae Rhizoma) dries dampness and strengthens the Spleen, Dang Gui (Angelicae Sinensis Radix) harmonizes blood and nourishes Yin as the Assistant herbs; Sheng Ma (Cimicifugae Rhizoma) raises the Clear Yang of the Yangming channel, Chai Hu (Bupleuri Radix) raises the Clear Yang of the Shaoyang channel. When Yang rises, all things grow; when Clear Yang rises, turbid Yin descends. Chen Pi (Citri Reticulatae Pericarpium) is added to promote Qi circulation; fresh ginger is acrid and warm, jujube is sweet and warm, used to harmonize Ying and Wei (Nutritive and Defensive levels), open the Cou Li (pores/skin texture), and generate fluids. For various deficiencies and insufficiencies, first establish the Middle Qi. What is the Middle? It is the Spleen and Stomach. The *Classic* states: "For exhaustion, use warmth." Warmth can eliminate great heat. One must strictly avoid bitter-cold medicines to prevent damaging the Stomach Qi. Generally, after age fifty, descending Qi is often abundant while ascending Qi is scarce; the influences of Autumn and Winter dominate over Spring and Summer. If constitution is inherently weak, with internal injury to Yuan Qi (Primordial Qi) and suppression of Clear Yang, this active method of treatment is appropriate. The Spleen is Kun Earth, corresponding to Earth Qi. When Earth Qi ascends, the command of sprouting and renewing spreads; when Heaven Qi descends, the command of drying and killing operates. Fatigue and overwork injure the Spleen, causing Earth deficiency and sinking. The *Classic* states: "If communication is not manifested, famous trees die much; if white dew does not descend, withered grass does not flourish." This describes the imagery of stagnation and killing. Humans responding to this result in hundreds of variable syndromes and premature extinction. Master Dongyuan deeply understood the laws of creation, thus establishing a mild and warm therapeutic principle. Mildness and warmth correspond to Spring Qi and are the way of nurturing life. Specifically, Sheng Ma (Cimicifugae Rhizoma) lifts the right-side sinking of the Spleen, ascending from the right; Chai Hu (Bupleuri Radix) lifts the left-side sinking of the Liver, ascending from the left. When Earth ascends, Heaven must descend. The interaction of these two Qi forms rain and dew; thus, Qi circulates and the generating Qi is inexhaustible. Is it not necessary to treat fatigue in this manner? Ancient formulas used 1 qian of Huang Qi (Astragali Radix), with other ingredients at 0.3 or 0.5 qian. Lizhai commonly used Ren Shen (Panacis Ginseng Radix) and Huang Qi (Astragali Radix) at 1.5 qian each, Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Dang Gui (Angelicae Sinensis Radix) at 1 qian each, Chen Pi (Citri Reticulatae Pericarpium) at 0.5 qian, and Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) at 0.3 qian each, adjusting up or down infinitely. For severe cases, Ren Shen (Panacis Ginseng Radix) and Huang Qi (Astragali Radix) may be increased to 3 or 5 qian, added according to symptoms. The Spleen and Stomach prefer sweet and dislike bitter, prefer tonification and dislike purgation, prefer warmth and dislike cold, prefer free flow and dislike stagnation, prefer ascending and dislike descending, prefer dryness and dislike dampness. This formula aligns with these preferences but is only extremely appropriate for conditions of extreme insufficiency of the Original Yang Qi of the Spleen and Stomach. If used for insufficiency of Original Yin Qi, it may be unsuitable. Since there are many Qi-moving herbs and few Blood-nourishing herbs, along with acrid and ascending agents, those with Yin deficiency may experience easy rising of floating fire and rebellious deficient Qi. Since ancient times, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) has been praised for its endless benefits for generations. What is its meaning? It expresses what predecessors had not yet revealed, continuing the traditions of Zhang Zhongjing and Liu Wansu, with profound intent. People seeing fever immediately attribute it to external contraction of wind, cold, summerheat, or dampness, asking how pathogens can be resolved without diaphoresis. Yet they fail to accurately identify wind, cold, summerheat, or dampness to treat symptomatically, instead using general exterior-resolving formulas such as Jiu Wei Qiang Huo Tang (Nine-Ingredient Notopterygium Decoction), Bai Du San (Detoxicate Powder), or Shi Shen Tang (Ten-God Decoction). Worse still, some combine Lian Ge San (Clear the Chest Powder) and Bai Hu Tang (White Tiger Decoction) indiscriminately, resulting in many deaths. Dongyuan deeply lamented this harm and established this formula, asserting that where pathogenic factors gather, Qi must be deficient; internal injuries are common, while external contractions are occasional. Even if external pathogens exist, they enter through deficiency. By tonifying the Middle and benefiting Qi, pathogens retreat spontaneously; there is no need to attack pathogens, for attacking makes the deficient even more deficient, leading to imminent peril. If there is an external contraction with slight internal injury, appropriate herbs can be酌情 added to this base formula, and external pathogens will retreat spontaneously. This is like a righteous army, invincible under heaven. Regarding irregular diet and excessive labor, Stomach Yang Qi becomes deficient internally and sinks into Yin, causing fever. This is Yang deficiency self-disease; mistaking it for external contraction and using diaphoretics further depletes deficiency. How grave is the harm! There is also a type of fever caused by internal injury to True Yin, similar to internal injury to Yang Qi. This requires filling True Yin. The Heart and Lung are above, the Liver and Kidney are below, and the Spleen and Stomach reside in the Central Region, governing the Qi of the four Zang organs. The formless Qi of the Middle Jiao steams and rots food and drink, governing ascending, descending, exiting, and entering. This is Pre-Heaven Qi, which is also the master of the Spleen and Stomach. Post-Heaven Earth (Spleen) cannot function without Pre-Heaven Qi. This formula addresses this Qi sinking into the Liver and Kidney due to fatigue, where Clear Yang does not ascend and turbid Qi does not descend. Thus, Sheng Ma (Cimicifugae Rhizoma) is used to ascend via the right armpit, and Chai Hu (Bupleuri Radix) via the left armpit. Without the merit of Ren Shen (Panacis Ginseng Radix), the lifting power would be insufficient; thus, it supplements the Pre-Heaven within the Post-Heaven. Ascending and descending, descending and ascending, aim only to harmonize Qi and Blood. Therefore, sinking and descending must not have ascending without descending, nor should there be only Spring and Summer without Autumn and Winter, only growth without storage. Master Dongyuan's entire *Treatise on the Spleen and Stomach* centers on Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), nothing more than cultivating the root of Post-Heaven Yuan Qi (Primordial Qi). Yuan Qi (Primordial Qi) is the essence and Qi of life, actually originating from the Stomach. Thus, Stomach Qi is distinguished as Grain Qi (Gu Qi), Ying Qi (Nutritive Qi), Chong Qi (Penetrating Qi), and Yang Qi, all being different names for Yuan Qi (Primordial Qi). This Qi is rooted in the Pre-Heaven Generating Qi. Mild Fire generates Qi, becoming True Yang Qi. Yuan Qi (Primordial Qi) is Fire; Fire is Yuan Qi (Primordial Qi). This is the foundation for establishing life. This Fire resides in the Liver and Kidney, rooted in Minister Fire (Xiang Huo). Minister Fire (Xiang Huo) acts on behalf of the Monarch Fire (Jun Huo) when Monarch Fire does not govern commands. Thus it is said: "When Minister Fire occupies its position," this Fire is originally not Pathogenic Fire. How can it be called the thief of Yuan Qi (Primordial Qi)? Yuan Qi (Primordial Qi) lies between the two Kidneys and the Gate of Life (Ming Men), warming the flesh and filling the skin with the Three Burner Minister Fire (San Jiao Xiang Huo), steaming dregs and transforming them into essence. Thus, Yuan Qi (Primordial Qi) is transformed by Minister Fire (Xiang Huo), not a thing that steals Yuan Qi (Primordial Qi). The thing that steals Yuan Qi (Primordial Qi) is Mild Fire (Shao Huo) changing abnormally into Blazing Fire (Zhuang Huo), not Mild Fire (Shao Huo). If one points to it as the thief of Yuan Qi (Primordial Qi) and argues "Fire and Yuan Qi (Primordial Qi) cannot coexist; one wins, the other loses," then what Fire generates Yuan Qi (Primordial Qi)? However, all Zang organs have Yin and Yang; Yin is Blood, Yang is Qi. Qi deficiency cannot contain the Original Yang of the Middle Palace; Blood deficiency cannot anchor the Thunder Fire of the Lower Jiao. Both are deficient heat. Therefore, sweet-warm is appropriate, and bitter-cold is taboo. Although injuries to the four Zang organs all cause internal injury, Dongyuan focuses solely on the Spleen and Stomach because fatigue and overwork injure the Spleen, and the Spleen and Stomach are the root of Yuan Qi (Primordial Qi).
The *Classic* states: "All Qi disorders and fullness/stagnation belong to the Lung." It also says: "Anger causes Qi to rise, joy causes Qi to slacken, worry causes Qi to dissipate, fear causes Qi to sink, cold causes Qi to contract, heat causes Qi to leak, shock causes Qi to become chaotic, fatigue ruins and consumes Qi, thought causes Qi to knot." The nine Qi are different, and hundred diseases often arise from Qi. What sustains human life is this Qi. It originates in the Middle Jiao, is commanded by the Lung, protects the exterior, travels internally, circulates throughout the body without pause, exits and enters, ascends and descends, with regularity day and night. How could it ever cause disease in humans? Until seven emotions attack each other, five desires erupt recklessly, deviating from normalcy. Clear transforms into turbid, movement is blocked and不通 (unobstructed), the exterior loses protection and harmony, the interior loses operation and smoothness. Qi belongs to Yang; when excessive, it becomes Fire. This is what Hejian meant by "extremes of the five desires all become Fire," and Danxi meant by "excess of Qi is Fire." The human body has Zong Qi (Pectoral Qi), Ying Qi (Nutritive Qi), Chong Qi (Penetrating Qi), Zhong Qi (Middle Qi), Yuan Qi (Primordial Qi), Wei Qi (Stomach Qi), Chong He Qi (Harmonious Qi), and Ascending Qi, with Zong Qi (Pectoral Qi) being particularly dominant. When diseased, they become Cold Qi, Stagnant Qi, Rebellious Qi, and Counterflow Qi, and various changes of Qi deficiency. When healthy, one should preserve, nourish, harmonize, and smooth it. When disease arises, one must examine which meridian and syndrome, whether cold, heat, deficiency, or excess, and apply tonification or sedation accordingly.